1: World J Gastroenterol. 2009 Feb 28;15(8):1004-6.

Severe autoimmune hepatitis triggered by varicella zoster infection.

Al-Hamoudi WK.

Gastroenterology and Hepatology Unit (59), Department of Medicine, King Saud
University, PO Box 2925, Riyadh 11461, Saudi Arabia. walhamoudi@gmail.com.

Autoimmune hepatitis (AIH) is a chronic disease of unknown etiology that is
characterized by the presence of circulatory autoantibodies and inflammatory
histological changes in the liver. Although the pathogenesis of AIH is not known,
it is thought that, in a genetically predisposed individual, environmental
factors such as viruses can trigger the autoimmune process. Herpes simplex virus,
Epstein-Barr virus, measles virus, and hepatitis viruses are thought to play a
role in the etiology of AIH. Proteins belonging to these viruses may be similar
to the amino acid chains of different autoantigens in the liver, this causes
immune cross reactions and liver tissue damage. We report a case of severe AIH
following varicella zoster infection in a 23-year-old man, and speculate that,
based on the molecular mimicry hypothesis, the liver damage was caused by an
immune cross reaction to the viral proteins. Varicella-zoster-induced AIH has not
been reported previously.

PMID: 19248202 [PubMed - in process]

2: Indian J Ophthalmol. 2009 Mar-Apr;57(2):163-4.

Herpes zoster ophthalmicus or Herpes zoster maxillaris?

Chandravanshi SL, Rathore MK.

Department of Ophthalmology, S. S. Medical College and Gandhi Memorial Hospital
Rewa, M.P - 486 001, India. dr_scl@rediffmail.com.

Publication Types: 
    Letter

PMID: 19237800 [PubMed - in process]

3: Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2009 Feb;17(1):214-7.

[Bortezomib combined with other drugs for treating 60 cases of multiple myeloma.]

[Article in Chinese]

Zhong YP, Chen SL, Li X, Hu Y, Zhang JJ.

Department of Hematology and Oncology, Beijing Chaoyuang Hospital, Capital
Medical University, Beijing 100043, China. E-mail: zhongyp3352@126.com.

The aim of this study was to investigate the efficacy and safety of
bortezomib-combined with dexamethasone, methylprednisolone and other drugs in the
treatment of patients with multiple myeloma (MM). 60 MM patients including 19 de 
novo patients, out of them 14 patients received the treatment using regimen of
bortezomib in combination with thalidomide (BT), 5 patients received
bortezomib-methylprednisolone regimen (BMP). Out of 41 patients with refractory
or relapsed myeloma 26 cases of MM received the treatment using regimen of
bortezovnib combirned with methylpreamsolone (BMP), 6 cases received the
treatment using regimen of bortezomib combined with cyclophosphamide, predisone
and thalidomide (BCPT), 5 cases received the treatment using regimen of
bortezomib combined with cis-diaminodichloroplatimm, etoposide, cydophosphomide
and dexame thecson (BDECD), 4 cases received the treatment using regimen of
bortesomib combined with dexamethason (BD). Each patient received treatment of
2-8 courses at least. Response was assessed according to the criteria of the
Blade. Adverse events were graded according to the commom Toxicity Criteria,
version 3.0 (NCI CTCAE, USA). The median follow-up from the start of bortezomib
treatment was 9 months. The results showed that out of 19 newly aiagnosed
patients, 6 cares acheieved CR, 6 cases acheived nearly CR, 5 cases acheived PR, 
1 case acheived MR, resulting in an ORR of 94.7%. Out of 41 refractory or
relapsed patients, 5 cases acheieved CR, 10 cases got nearly CR, 14 cases were PR
and 5 cases were MR, resuling in an ORR of 82.92%. The main toxicities were
fatigue, gastrointestinal disorders, peripheral neuropathy, thrombocytopenia,
herpes zoster, skinrash. All adverse events were diminished by using routine
ways. In couclusion, bortezomib combined with orthe drugs is a very effective
regimen, its side effects are predictable and manageable.

Publication Types: 
    English Abstract

PMID: 19236782 [PubMed - in process]

4: Mol Pharmacol. 2009 Feb 20. [Epub ahead of print]

Human Mitochondrial Thymidine Kinase (TK-2) is Selectively Inhibited by
3'-Thiourea Derivatives of {beta}-Thymidine. Identification of residues crucial
for both inhibition and catalytic activity.

Balzarini J, Van Daele I, Negri A, Solaroli N, Karlsson A, Liekens S, Gago F, Van
Calenbergh S.

Rega Institute for Medical Research.

Substituted 3'-thiourea derivatives of beta-thymidine (dThd) and 5'-thiourea
derivatives of alpha-dThd have been evaluated for their inhibitory activity
against recombinant human cytosolic dThd kinase-1 (TK-1), human mitochondrial
TK-2, herpes simplex virus type 1 (HSV-1) TK and varicella-zoster virus (VZV) TK.
Several substituted 3'-thiourea derivatives of beta-dThd proved highly inhibitory
to and selective for TK-2 (IC50: 0.15-3.1 microM). The 3'-C-branched
p-methylphenyl (1) and 3-CF3-4-Cl-phenyl (7) thiourea derivatives of beta-dThd
showed competitive inhibition of TK-2 when dThd was used as the variable
substrate (Ki: 0.40 microM and 0.05 microM, respectively) but uncompetitive
inhibition in the presence of variable concentrations of ATP (Ki: 15 microM and
2.0 microM, respectively). These kinetic properties of 1 and 7 against TK-2 could
be accounted for by molecular modeling showing that two hydrogen bonds can be
formed between the thiourea nitrogens of 7 and the oxygens of the gamma-phosphate
of ATP. The importance of several active-site residues was assessed by
site-directed mutagenesis experiments on TK-2 and the related HSV-1 TK. The low
Ki/Km ratios for 1 and 7 (0.38 and 0.039 against dThd, and 0.75 and 0.12 against 
ATP, respectively) indicate that these compounds are amongst the most potent
inhibitors of TK-2 described so far. In addition, a striking close correlation
was found between the inhibitory activities of the test compounds against TK-2
and Mycobacterium tuberculosis thymidylate kinase that is strongly indicative of 
close structural and/or functional similarities between both enzymes in relation 
to their mode of interaction with these nucleoside analogue inhibitors.

PMID: 19233899 [PubMed - as supplied by publisher]

5: J Clin Virol. 2009 Feb 20. [Epub ahead of print]

Detection of herpes viruses in children with acute appendicitis.

Katzoli P, Sakellaris G, Ergazaki M, Charissis G, Spandidos DA, Sourvinos G.

Laboratory of Virology, Faculty of Medicine, University of Crete, Heraklion
71003, Crete, Greece.

OBJECTIVE: This study aimed to investigate the incidence of herpes simplex virus 
(HSV) types-1 and -2, varicella-zoster virus (VZV), cytomegalovirus (CMV),
Epstein-Barr virus (EBV), human herpes virus 6 (HHV-6) and human herpes virus 7
(HHV-7) in childhood acute appendicitis. STUDY DESIGN: Polymerase chain reaction 
(PCR) assays were applied to detect herpes virus DNA in 38 children [11 girls and
27 boys, mean age 9 years (STD+/-2.59), range 6-14 years], who underwent an
appendectomy within a 2.5-year period. Appendix, omentum and peripheral blood
mononuclear cells (PBMCs) were available from each case. Of the 38 children with 
acute appendicitis, 20 (52.6%) had advanced (phlegmonous) acute appendicitis and 
18 (47.4%) had perforated appendicitis and local peritonitis. Forty-one blood
specimens from age-matched healthy children (25 female and 16 male), with
clinical manifestations unrelated to viral infections served as negative
controls. RESULTS: CMV was the most frequently detected virus (8/38, 21%),
followed by HHV-6 (3/38, 7.9%). EBV and HSV-1 were detected, though not in all
three different types of tissue specimens tested. None of the samples examined
were HSV-2-, VZV- or HHV-7-positive. Of all the specimens, the omentum was the
most commonly infected tissue (63.0%) while the appendix and peripheral blood
specimens were found to be positive for viral infection in 60.5% and 50% of
cases, respectively. The CMV IgG+ antibodies were positive in 54% of the control 
cases while 86% of the same group presented HHV-6 IgG+ antibodies. CONCLUSION: To
the best of our knowledge, this is the first study documenting the presence of
herpes virus DNA in children with acute appendicitis, suggesting that possible
viral infection or reactivation is associated with childhood appendicitis.

PMID: 19233720 [PubMed - as supplied by publisher]

6: Pain. 2009 Feb 20. [Epub ahead of print]

Controlled release oxycodone - An evidence-based treatment for pain in acute
herpes zoster.

Haanpaa M.

Rehabilitation Centre ORTON, Tenholantie 10, FIN-00280 Helsinki, Finland;
Department of Neurosurgery, Helsinki University Central Hospital, Helsinki,
Finland.

Publication Types: 
    EDITORIAL

PMID: 19233562 [PubMed - as supplied by publisher]

7: Eye. 2009 Feb 20. [Epub ahead of print]

Herpes zoster ophthalmicus complicated by incomplete ophthalmoplegia and a
neurotrophic ulcer.

Chan EW, Sanjay S.

[1] 1Department of Ophthalmology and Visual Sciences, Alexandra Hospital,
Singapore, Singapore [2] 2Eye Clinic, Jurong Medical Centre, Singapore,
Singapore.

PMID: 19229277 [PubMed - as supplied by publisher]

8: Masui. 2009 Feb;58(2):153-9.

[The effects of early nerve blocks for prevention of postherpetic neuralgia and
analysis of prognostic factors]

[Article in Japanese]

Tajima K, Iseki M, Inada E, Miyazaki T.

Department of Anesthesiology and Pain Medicine, Juntendo University of Medicine, 
Tokyo 113-0033.

BACKGROUND: Herpes zoster causes acute pain and sometimes leads to postherpetic
neuralgia (PHN). The previously reported risk factors of PHN such as old age,
allodynia, paresthesia and so on are not based on evidence. Although nerve block 
is useful to relieve acute pain and recommended for prevention of PHN, evidence
is scanty. METHODS: The patients with herpes zoster within 3 months after the
onset were studied. The patient underwent nerve blocks and proper medical
treatment, and were followed for up to one year. The risk factors of PHN were
assessed. We evaluated whether nerve block prevented PHN. RESULTS: A total of 144
consecutive patients were studied. Twenty seven % of patients suffered PHN. Old
age (> 65 y. o) and hypesthesia were confirmed to be the risk factors of PHN,
whereas the intensity of acute pain was not. Patients who underwent nerve block
within 1 month after the onset were less likely to suffer from PHN compared with 
patients of delayed nerve blocks. CONCLUSIONS: Old age, hypesthesia and delayed
nerve blocks were the risk factors of PHN. Nerve blocks in the early phase of
herpes zoster may be useful to prevent PHN, particularly in the younger patients.

Publication Types: 
    English Abstract

PMID: 19227166 [PubMed - in process]

9: JAMA. 2009 Feb 18;301(7):774-5.

Comment on:
    JAMA. 2009 Feb 18;301(7):737-44.

Herpes zoster in the age of focused immunosuppressive therapy.

Whitley RJ, Gnann JW Jr.

Publication Types: 
    Comment
    Editorial
    Research Support, N.I.H., Extramural

PMID: 19224757 [PubMed - indexed for MEDLINE]

10: JAMA. 2009 Feb 18;301(7):737-44.

Comment in:
    JAMA. 2009 Feb 18;301(7):774-5.

Risk of herpes zoster in patients with rheumatoid arthritis treated with
anti-TNF-alpha agents.

Strangfeld A, Listing J, Herzer P, Liebhaber A, Rockwitz K, Richter C, Zink A.

Epidemiology Unit, German Rheumatism Research Center, Chariteplatz 1, 10117
Berlin, Germany. strangfeld@drfz.de

CONTEXT: The risk of bacterial infection is increased in patients treated with
drugs that inhibit tumor necrosis factor alpha (TNF-alpha). Little is known about
the reactivation of latent viral infections during treatment with TNF-alpha
inhibitors. OBJECTIVE: To investigate whether TNF-alpha inhibitors together as a 
class, or separately as either monoclonal anti-TNF-alpha antibodies (adalimumab, 
infliximab) or a fusion protein (etanercept), are related to higher rates of
herpes zoster in patients with rheumatoid arthritis. DESIGN, SETTING, AND
PATIENTS: Patients were enrolled in the German biologics register RABBIT, a
prospective cohort, between May 2001 and December 2006 at the initiation of
treatment with infliximab, etanercept, adalimumab, or anakinra, or when they
changed conventional disease-modifying antirheumatic drug (DMARD). Treatment,
clinical status, and adverse events were assessed by rheumatologists at fixed
points during follow-up. MAIN OUTCOME MEASURES: Hazard ratio (HR) of herpes
zoster episodes following anti-TNF-alpha treatment. Study aims were to detect a
clinically significant difference (HR, 2.0) between TNF-alpha inhibitors as a
class compared with DMARDs and to detect an HR of at least 2.5 for each of 2
types of TNF-alpha inhibitors, the monoclonal antibodies or the fusion protein,
compared with conventional DMARDs. RESULTS: Among 5040 patients receiving
TNF-alpha inhibitors or conventional DMARDs, 86 episodes of herpes zoster
occurred in 82 patients. Thirty-nine occurrences could be attributed to treatment
with anti-TNF-alpha antibodies, 23 to etanercept, and 24 to conventional DMARDs. 
The crude incidence rate per 1000 patient-years was 11.1 (95% confidence interval
[CI], 7.9-15.1) for the monoclonal antibodies, 8.9 (95% CI, 5.6-13.3) for
etanercept, and 5.6 (95% CI, 3.6-8.3) for conventional DMARDs. Adjusted for age, 
rheumatoid arthritis severity, and glucocorticoid use, a significantly increased 
risk was observed for treatment with the monoclonal antibodies (HR, 1.82 [95% CI,
1.05-3.15]), although this risk was lower than the threshold for clinical
significance. No significant associations were found for etanercept use (HR, 1.36
[95% CI, 0.73-2.55]) or for anti-TNF-alpha treatment (HR, 1.63 [95% CI,
0.97-2.74]) as a class. CONCLUSION: Treatment with monoclonal anti-TNF-alpha
antibodies may be associated with increased risk of herpes zoster, but this
requires further study.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 19224750 [PubMed - indexed for MEDLINE]

11: Am J Clin Dermatol. 2009;10(2):73-86. doi: 10.2165/00128071-200910020-00001.

Clinical implications of aging skin: cutaneous disorders in the elderly.

Farage MA, Miller KW, Berardesca E, Maibach HI.

The Procter & Gamble Company, Winton Hill Business Center, Cincinnati, Ohio, USA.

Aging skin undergoes progressive degenerative change. Structural and physiologic 
changes that occur as a natural consequence of intrinsic aging combined with the 
effects of a lifetime of ongoing cumulative extrinsic damage and environment
insult (e.g. overexposure to solar radiation) can produce a marked susceptibility
to dermatologic disorders in the elderly. As skin ages, the vasculature
progressively atrophies. The supporting dermis also deteriorates, with collagen
and elastin fibers becoming sparse and increasingly disordered. These changes
leave the elderly increasingly susceptible to both vascular disorders such as
stasis dermatitis and skin injuries such as pressure ulcers and skin tears, with 
a steadily decreasing ability to effect skin repair. A parallel erosion of normal
immune function produces higher levels of autoimmune skin disorders such as
bullous pemphigoid, benign mucous membrane pemphigoid, paraneoplastic pemphigoid,
and pemphigus vulgaris. Lichen sclerosus, an autoimmune disorder often occurring 
in the genital area in older women, is not common but is an important development
because of the potential for substantial discomfort as well as serious
complications. The prevalence of polypharmacy in this population increases the
risk for autoimmune drug reactions, and diagnosis should be undertaken with an
awareness that polypharmacy in this population creates a greatly increased
susceptibility to drug eruptions that can mimic other cutaneous disorders.
Immunologic senescence in the elderly also sets the stage for potential
reactivation of the Varicella zoster virus, in which initial dermatologic
involvement expands into the major sensory ganglia. Known as shingles, this
disorder can be excruciatingly painful with the potential to cause blindness if
the optic nerve becomes involved. Dermatoses such as xerosis, pruritus, and
eczema are also widespread in the elderly, create substantial suffering in those 
afflicted, and often prove recalcitrant to treatment. Individual susceptibility
to specific types of contact dermatitis changes over the lifetime, and seborrheic
dermatitis is substantially more prevalent in the elderly. It is not uncommon for
older patients to have multiple impairments, with the potential for cognitive
dysfunction as well as impaired vision, hearing, or mobility. In addition, they
may not have adequate housing or nutrition, or the financial resources necessary 
for adequate compliance. Physicians must take into consideration the patient's
physical ability to comply with the recommended therapy as well as socioeconomic 
factors that may impact on compliance. Simple topical regimens are preferable
wherever possible in order to maximize compliance and, therefore, efficacy. Extra
effort may be necessary to ensure that instructions are accurately followed and
that ongoing compliance with the regimen prescribed is actually achieved.
Management of dermatologic disorders in the elderly is often less than optimal,
due to the fact that the special needs and limitations of this population are not
adequately considered. Treatments should consider the intrinsic differences
between younger and older patients that may impact on diagnosis and therapy
choice. The aged patient is often afflicted with numerous co-morbidities that can
influence the choice of therapy. Skin integrity in the elderly is compromised,
and safety concerns are increased with the long-term use of any medication
prescribed. In addition, the prevalence of polypharmacy in the aged population
substantially increases the risk of cutaneous drug reactions, which can
profoundly complicate accurate diagnosis of dermatologic disorders. The aged
population also needs to be more closely monitored because of increased fragility
of the skin and the physical limitations that may hinder compliance with
prescribed regimens.

PMID: 19222248 [PubMed - in process]

12: Neurology. 2009 Feb 17;72(7):670-1.

Brown-Sequard syndrome after herpes zoster.

Young-Barbee C, Hall DA, LoPresti JJ, Schmid DS, Gilden DH.

Department of Neurology, Mail Stop B182, University of Colorado Denver School of 
Medicine, 4200 E. 9th Ave., Denver, CO 80262, USA.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 19221302 [PubMed - in process]

13: Cancer Biother Radiopharm. 2009 Feb 13. [Epub ahead of print]

Rituximab and Chemotherapy in Primary Gastric Lymphoma.

Aviles A, Castaneda C, Cleto S, Neri N, Huerta-Guzman J, Gonzalez M, Nambo MJ.

Oncology Research Unit, Oncology Hospital, National Medical Center, Mexico City, 
Mexico.

Purpose: We perfomed a phase II clinical trial to assess the efficacy and
toxicity of the addition of rituximab and conventional chemotherapy in primary
gastric lymphoma (PGL). Methods: Forty-two (42) patients with PGL, stage IE and
IIE, and with low- or low-intermediate clinical risk were treated in a
prospective longitudinal study with standard CHOP (cyclophosphamide, doxorubicin,
vincristine, and prednisone) chemotherapy and rituximab (375 mg/m(2),
intravenously) on day 1 of each cycle administered every 21 days, for 6 cycles.
The endpoint was to assess improvement in outcome measured by prolongation in
event-free survival (EFS) and overall survival (OS). Complete response was
achieved in 40 cases (95%) (95% confidence interval [CI]: 88%-102%). Relapse was 
observed in 2 cases. Two (2) patients died secondary to tumor progression. Thus, 
actuarial 5-year EFS was 95% (95 % CI: 87%-104%) and OS was 95% (95% CI:
88%-101%), which was not statistically different to historic controls. Acute
toxicity was minimal and well tolerated, 4 cases developed late toxicity, 2 cases
of herpes zoster infection, and 2 cases with granulocytopenia; in 1 case, the
patient continued with mild granulocytopenia 3 years after treatment.
Conclusions: The addition of rituximab to CHOP chemotherapy did not improve
outcome in early-stage PGL.

PMID: 19216628 [PubMed - as supplied by publisher]

14: Semin Neurol. 2009 Feb;29(1):5-13. Epub 2009 Feb 12.

Seventh cranial neuropathy.

Gilchrist JM.

Warren Alpert Medical School of Brown University, Rhode Island Hospital,
Providence, Rhode Island.

Facial neuropathy, or seventh cranial neuropathy, is the most common cranial
neuropathy. The anatomy of the facial nerve is rather complex for a cranial
nerve, with a long intracranial course, in which the nerve takes three bends (or 
genu). Electrodiagnosis can be helpful in prognosis, but not before several days.
Imaging is rarely indicated in Bell's palsy, but is often abnormal nonetheless,
and can be very useful in other causes of facial neuropathy. The clinical
presentation is of unilateral facial weakness of upper and lower face,
hyperacusis, dysgeusia, and disordered lacrimation and salivation. Many different
disease processes can result in facial neuropathy, but 70% of cases are
idiopathic, or as it is best known, Bell's palsy. Ramsay Hunt syndrome, defined
as facial neuropathy with herpes zoster oticus, is another common cause. Steroids
given acutely are beneficial in improving outcome in Bell's palsy, and antiviral 
therapy seems helpful in more severe cases. Antiviral therapy is definitely
helpful in Ramsay Hunt disease when given within 3 days of onset. Antibiotics are
helpful in Lyme facial neuropathy, which has a very good prognosis.

PMID: 19214928 [PubMed - in process]

15: Laryngoscope. 2009 Feb 11. [Epub ahead of print]

Herpes zoster oticus associated with varicella zoster virus encephalitis.

Eskiizmir G, Uz U, Taskiran E, Unlu H.

Department of Otorhinolaryngology, Celal Bayar University, Manisa, Turkey.

Ramsay-Hunt syndrome, herpes zoster oticus (HZO), derived its name from James
Ramsay Hunt, who first described it in 1907. It is classically characterized by
acute peripheral facial paralysis, herpetic eruptions on the auricle, and
vestibulocochlear dysfunction due to the reactivation of varicella zoster virus
(VZV). In this Case Report, the authors describe an HZO patient with simultaneous
VZV encephalitis. To date, only eight cases of HZO associated with VZV
encephalitis have been reported in the English literature. Therefore, the authors
discuss all the aspects of this rare entity, including clinical examination,
radiological evaluation, laboratory evaluation, and treatment options.
Laryngoscope, 2009.

PMID: 19213041 [PubMed - as supplied by publisher]

16: J Virol. 2009 Feb 11. [Epub ahead of print]

Components of Nuclear Domain 10 bodies Regulate Varicella Zoster Virus
Replication.

Kyratsous CA, Silverstein SJ.

Department of Microbiology, College of Physicians and Surgeons, Columbia
University, 701 W. 168 St., New York, New York 10032, USA.

PML, Sp100 and Daxx are proteins that normally reside within Nuclear Domains 10
(ND10s). They associate with DNA virus genomes and repress the very early stages 
of DNA virus replication cycle. Virus encoded proteins counteract this innate
anti-viral response. ICP0, a Herpes Simplex Virus (HSV) immediate early protein, 
is necessary and sufficient to dissociate ND10s and target their two major
components PML and Sp100 for proteasomal degradation. In this report we show that
ORF61p, the Varicella Zoster Virus (VZV) ortholog, does not degrade PML and only 
slightly alters Sp100 levels. Furthermore, we demonstrate that other virus
proteins cannot substitute for this lack of function during infection. By use of 
short interfering RNAs we depleted PML, Sp100 and Daxx and studied their role in 
plaquing efficiency, virus protein accumulation, infectious center titer and
virus spread. These studies show that components of ND10s can accelerate VZV
replication but do not ultimately control cell-associated virus titers. We
conclude that while both ICP0 and ORF61p activate virus gene expression, they
modulate host innate repression mechanisms in two different ways. As a result HSV
and VZV commandeer their hosts by distinct mechanisms to ensure their replication
and spread.

PMID: 19211749 [PubMed - as supplied by publisher]

17: Arch Ophthalmol. 2009 Feb;127(2):222-3.

Interstitial keratitis following varicella vaccination.

Nagpal A, Vora R, Margolis TP, Acharya NR.

Francis I. Proctor Foundation for Research in Ophthalmology, University of
California, San Francisco, 95 Kirkham St, San Francisco, CA 94143-0944, USA.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 19204247 [PubMed - indexed for MEDLINE]

18: Ann Clin Lab Sci. 2009 Winter;39(1):43-50.

IgE anti-varicella zoster virus and other immune responses before, during, and
after shingles.

Smith-Norowitz TA, Josekutty J, Lev-Tov H, Kohlhoff S, Norowitz KB, Silverberg
JI, Chice S, Durkin HG, Bluth MH.

Departments of Pediatrics, SUNY Downstate Medical Center, Brooklyn, New York
11203, USA. tamar.smithnorowitz@downstate.edu

Blood lymphocyte distributions, serum immunoglobulin and cytokine levels, and
serum IgE and IgG anti-varicella zoster virus (VZV) levels were measured in an
atopic girl (age 15 yr) who developed shingles 10 yr after infection with chicken
pox. Before, during, and 5 months after the shingles episode, the child's
distributions of blood lymphocytes (excluding CD23+) and serum immunoglobulin
levels (excluding IgE) were within the normal ranges. Her blood level of CD23+
lymphocytes decreased >50% during the shingles episode and remained low
thereafter. Her serum level of IgE was elevated before and during shingles (154
and 168 IU/ml, respectively), but was reduced after recovery from shingles (<100 
IU/ml). Before, during, and after shingles, her serum contained IgE and IgG
anti-VZV antibodies. Before, during, and after shingles, low levels of IFN-gamma 
were detected in serum, but neither IL-1beta nor IL-4 were detected. Before
shingles, low levels of IL-10 were detected in serum; during shingles, the serum 
level of IL-10 was increased 30-fold; it subsequently diminished at 5 mo after
shingles. The role of IgE in immunity against varicella zoster virus (VZV) has
not previously been studied. Our observations in this patient suggest that
immunomodulation of IgE and accessory proteins may play a role in VZV
pathogenesis.

PMID: 19201740 [PubMed - in process]

19: Int J Dermatol. 2009 Feb;48(2):212-4.

A case of secondary cutaneous mucinosis following herpes zoster: Wolf's isotopic 
response.

Kim MB, Jwa SW, Ko HC, Kim SJ, Kwon KS, Oh CK.

Publication Types: 
    Letter

PMID: 19200212 [PubMed - in process]

20: J Antibiot (Tokyo). 2009 Feb;62(2):95-8. Epub 2009 Jan 23.

Anti-herpes virus activity of polyether antibiotic CP-44161 in vivo.

Yamagishi Y, Ueno M, Ueno C, Kato A, Kanasaki R, Sato B, Takakura K, Fujie A,
Nakajima H, Fujii T, Hino M, Tsujii E.

[1] 1Fermentation Research Labs, Astellas Pharma Inc., Tokodai, Tsukuba-shi,
Ibaraki, Japan [2] 7These authors contributed equally to this work.

In the previous study, we discovered a polyether antibiotic CP-44161, which was
reported earlier as an anticoccidal agent, as an anti-varicella zoster virus
compound. In this study, we demonstrated that CP-44161 had a very strong and
broad anti-herpes virus activities against herpes simplex virus type 1 (HSV-1)
and type 2 (HSV-2) in vitro. To determine the antiviral activity of CP-44161 in
vivo, we examined its effect on the cutaneous HSV-2 infection model in Balb/c
mice. CP-44161 showed inhibitory effect on lesion development as well as
acyclovir (ACV) when the treatment was started from day 3. Meanwhile, in case the
start of treatment was delayed until day 4, when ACV was no longer effective, the
effectiveness of CP-44161 still remained. In this model, CP-44161 also showed
inhibitory effect on the proliferation of HSV-2 DNA in dorsal root ganglia. This 
is the first article to report that polyether antibiotics can be effective on
viral infection in vivo.The Journal of Antibiotics (2009) 62, 95-98;
doi:10.1038/ja.2008.18; published online 23 January 2009.

PMID: 19198635 [PubMed - in process]

21: Bull Soc Belge Ophtalmol. 2008;(309-310):63.

Unilateral panuveitis secondary to varicella zoster virus.

Van Calster J.

Publication Types: 
    Case Reports

PMID: 19198557 [PubMed - indexed for MEDLINE]

22: J Am Pharm Assoc (2003). 2009 Jan-Feb;49(1):12-7.

Retrospective financial analysis of a herpes zoster vaccination program from an
independent community pharmacy perspective.

Wood HM, McDonough RP, Doucette WR.

College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA.

OBJECTIVE: To determine the net financial gain or loss for herpes zoster
vaccination services provided to patients from the perspective of an independent 
community pharmacy. DESIGN: Retrospective review of pharmacy records over the
program's initial 11-month period. SETTING: Independent community pharmacy in
Iowa City, IA. PARTICIPANTS: Patients received immunization with the herpes
zoster vaccine from a certified pharmacist. INTERVENTION: Herpes zoster
vaccination services were provided to the patient and documented by the
pharmacist. MAIN OUTCOME MEASURE: Net financial gains or losses were calculated
for the herpes zoster vaccination program. Sensitivity analyses were based on
costs that might be incurred during program start-up. RESULTS: 478 patients
received zoster vaccination services over the initial 11-month period. A net
financial gain for the herpes zoster vaccination program was achieved, with a net
profit of $15.02, or 8.15%, per vaccination. CONCLUSION: Revenues for this
vaccination program exceeded its costs from the independent community pharmacy
perspective.

PMID: 19196591 [PubMed - in process]

23: Pain. 2009 Feb 3. [Epub ahead of print]

A randomized, placebo-controlled trial of oxycodone and of gabapentin for acute
pain in herpes zoster.

Dworkin RH, Barbano RL, Tyring SK, Betts RF, McDermott MP, Pennella-Vaughan J,
Bennett GJ, Berber E, Gnann JW, Irvine C, Kamp C, Kieburtz K, Max MB, Schmader
KE.

Departments of Anesthesiology and Neurology, University of Rochester School of
Medicine and Dentistry, 601 Elmwood Avenue, Box 604, Rochester, NY 14642, USA.

Although acute pain in patients with herpes zoster can be severe and has a
substantial impact on health-related quality of life, there have been no
randomized clinical trials of oral medications specifically for its ongoing
treatment. A randomized clinical trial was conducted in which 87 subjects 50
years of age with herpes zoster within 6 calendar days of rash onset and with
worst pain in the past 24h3 on a 0-10 rating scale initiated 7 days of treatment 
with famciclovir in combination with 28 days of treatment with either
controlled-release (CR) oxycodone, gabapentin, or placebo. Subjects were
evaluated for adverse effects of treatment, acute pain, and health-related
quality of life. The results showed that CR-oxycodone and gabapentin were
generally safe and were associated with adverse events that reflect well-known
effects of these medications. Discontinuing participation in the trial, primarily
associated with constipation, occurred more frequently in subjects randomized to 
CR-oxycodone (27.6%) compared with placebo (6.9%). Treatment with CR-oxycodone
reduced the mean worst pain over days 1-8 (p=0.01) and days 1-14 (p=0.02)
relative to placebo but not throughout the entire 28-day treatment period as pain
resolved in most subjects. Gabapentin did not provide significantly greater pain 
relief than placebo, although the data for the first week were consistent with a 
modest benefit. By demonstrating that CR-oxycodone is safe, generally adequately 
tolerated, and appears to have efficacy for relieving acute pain, the results of 
this clinical trial provide a foundation for evidence-based treatment for acute
pain in herpes zoster.

PMID: 19195785 [PubMed - as supplied by publisher]

24: Ophthalmology. 2009 Feb 3. [Epub ahead of print]

Cytomegalovirus Endotheliitis in Descemet's Stripping Endothelial Keratoplasty.

Anshu A, Chee SP, Mehta JS, Tan DT.

Singapore National Eye Center, Singapore; Singapore Eye Research Institute,
Singapore.

OBJECTIVE: To report 4 cases of undiagnosed cytomegalovirus (CMV) endotheliitis
in patients who underwent Descemet's stripping automated endothelial keratoplasty
(DSAEK). DESIGN: Retrospective interventional case series. PARTICIPANTS: Four
eyes of 4 patients diagnosed with active CMV endotheliitis after DSAEK. METHODS: 
Retrospective review of the medical records of 4 patients with DSAEK who had an
aqueous tap that was positive for CMV DNA but negative for herpes simplex virus
(HSV) and varicella zoster virus. MAIN OUTCOME MEASURE: Clinical features and
management. RESULTS: Four immunocompetent Chinese male patients with a mean age
of 67 years underwent DSAEK for posterior polymorphous dystrophy (1), Fuchs'
heterochromic cyclitis (1), pseudophakic bullous keratopathy (1), and herpetic
keratouveitis (1). Clinical findings seen in all patients were localized corneal 
edema, increased intraocular pressure, pigmented keratic precipitates (KPs), and 
no/minimal anterior chamber (AC) activity. An unexplained sudden decrease in
endothelial cell count (ECC) in the absence of rejection or significant
inflammation was seen in 3 patients, whereas 1 patient also developed concomitant
retinitis. CMV DNA was positive in all aqueous specimens and from the vitreous of
the patient with retinitis. All patients were treated with oral valganciclovir
with resolution of inflammation; 2 patients had recurrences; 1 patient developed 
recurrent retinitis; and 1 patient developed recurrent CMV endotheliitis and is
currently receiving maintenance therapy with oral valganciclovir. CONCLUSIONS:
CMV endotheliitis with corneal edema masqueraded as a variety of other
endothelial conditions, which resulted in DSAEK surgery being performed in these 
patients who may have responded to antiviral treatment without the need for
endothelial transplantation. A heightened awareness is required to exclude CMV
endotheliitis as the cause for endothelial decompensation or unexplained, sudden 
reduction in ECCs post-DSAEK in the absence of other complications, and it should
be differentiated from allograft rejection in view of the critical difference in 
treatment. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or
commercial interest in any materials discussed in this article.

PMID: 19195708 [PubMed - as supplied by publisher]

25: J Clin Microbiol. 2009 Feb 4. [Epub ahead of print]

Eight-plex PCR and liquid array detection of bacterial and viral pathogens in
cerebrospinal fluid from patients with suspected meningitis.

Boving MK, Pedersen LN, Moller JK.

Department of Clinical Microbiology, Aarhus University Hospital, Skejby, DK-8200 
Arhus N, Denmark.

We here report the development of a novel multiplex PCR with product detection in
a Luminex(R) 100 suspension array system. The assay covers the nine most
important bacterial and viral pathogens found in Danish meningitis patients. The 
microorganisms include Neisseria meningitidis, Streptococcus pneumoniae,
Escherichia coli, Staphylococcus aureus, Listeria monocytogenes, Streptococcus
agalactiae, Herpes Simplex Virus 1 and 2, and Varicella Zoster Virus. The study
was based on 1187 samples of which 55 were found positive by PCR. Excellent
sensitivity and specificity compared to a gold standard defined by routine
laboratory tests was found for the two most important pathogens S. pneumoniae
(95/99.1 %), and N. meningitidis (100/99.7). The method provides a valuable
supplement to the traditional microscopy and culture of CSF samples in a routine 
diagnostic setting, and results can be available within one workday. The method
is suitable for initial screening and identification of nine important
microorganisms in cerebrospinal fluids from patients with suspected meningitis.
Compared to microscopy and culture of CSF this rapid and sensitive method will
support physicians in the timely treatment with appropriate antimicrobial agents 
also in the absence of live microorganisms in the CSF.

PMID: 19193844 [PubMed - as supplied by publisher]

26: Ophthalmology. 2009 Feb;116(2):361.

Non-necrotizing herpetic vasculitis.

Wickremasinghe SS, Stawell R, Lim L, Pakrou N, Zamir E.

Publication Types: 
    Case Reports
    Letter

PMID: 19187825 [PubMed - indexed for MEDLINE]

27: Eur J Neurol. 2009 Jan 27. [Epub ahead of print]

Valacyclovir neurotoxicity: clinical experience and review of the literature.

Asahi T, Tsutsui M, Wakasugi M, Tange D, Takahashi C, Tokui K, Okazawa S, Okudera
H.

Department of Crisis Medicine, Graduate School of Medicine, University of Toyama,
Sugitani, Toyama, Japan.

Valacyclovir (VACV) is used increasingly to treat herpes zoster, although
neuropsychiatric symptoms [VACV neurotoxicity (VAN) or acyclovir neurotoxicity], 
may accompany use of this drug. To promote awareness of this rare condition, we
describe here two clinical cases of VAN we previously reported and review 20
cases from the literature. In all cases, chronic or acute renal failure preceded 
VAN. The symptoms of VAN varied, but disturbances of consciousness and
hallucination occurred most commonly. When acute renal failure was due to the
drug, recovery from both the disturbance of consciousness and renal failure
followed within several days after discontinuation of VACV. Early recognition and
diagnosis will ensure effective treatment of VAN.

PMID: 19187258 [PubMed - as supplied by publisher]

28: Pathol Res Pract. 2009 Jan 29. [Epub ahead of print]

Prevalence of infectious pathogens in Crohn's disease.

Knosel T, Schewe C, Petersen N, Dietel M, Petersen I.

Institute of Pathology, Friedrich-Schiller University, Ziegelmuehlenweg 1,
D-07740 Jena, Germany.

The importance of infectious pathogens in Crohn's disease (CD) is still under
debate. Therefore, we examined a panel of potential viral and bacterial pathogens
in a large series of CD patients and controls. Archival tissue from 76 patients, 
56 with CD and 20 control patients, with normal colon mucosa (n=10) and
non-steroid anti-inflammatory drug (NSAID)-induced colitis (n=10) were examined
using PCR-based detection methods for human cytomegalovirus (CMV), Epstein-Barr
virus (EBV), herpes simplex virus 1, 2 (HSV1,2), adenovirus (AD),
varicella-zoster virus (VZV), human herpes virus 6 (HHV6), human herpes virus 8
(HHV8), Mycobacterium tuberculosis complex (Mtbc), atypical mycobacteria
(nM/MG1), including Mycobacterium avium (subspecies paratuberculosis, MAP),
Stenotrophomonas maltophilia (Sm), and Yersinia enterocolitica (Ye). In CD
patients, positive PCR results were achieved in 19 cases (34%). Sm was most
frequent in 10 of 56 cases (17.9%) followed by EBV (6/56, 10.7%), nM/MG1 (4/56,
7.1%), including MAP, HHV6, and CMV (2/56, 3.6%), and finally Mtbc and AD (1/56, 
1.8%). The control patients showed positive PCR results in 12 patients (12/20,
60%), nine of them with only weak signals, suggesting a persistent infection. In 
addition, we compared typical pathomorphological features of CD patients with the
PCR results and found a significant correlation between EBV infection and mural
abscesses (P=0.014). Our data demonstrate that several potential pathogens can be
detected in a sizeable fraction of specimens from patients with CD, but also in
control patients, suggesting that the analyzed infectious pathogens may be
associated with the disease, but do not represent an obligatory cause.

PMID: 19186006 [PubMed - as supplied by publisher]

29: Nippon Rinsho. 2009 Jan;67(1):107-16.

[STD in the eye]

[Article in Japanese]

Usui M, Minoda H.

Department of Ophthalmology, Tokyo Medical University.

In this paper, we review sexually transmitted diseases (STD) involving the eye.
Recently conjunctivitis due to Chlamydia trachomatis in children and adults is
increasing, and that of Neisseria gonorrhoeae resistant to multiple antibiotics
has attracted special attention in our country. Syphilis has many ocular
manifestations such as keratitis, iridocyclitis, retinochorioiditis, and
neuritis, etc. Ocular complications related to HIV infection, including HIV
retinopathy, cytomegalovirus retinitis, zoster ophthalmics, and Kaposi s sarcoma 
in conjunctiva are increasing in Japan. Phthirus pubis infection of the eye lid, 
and human T-cell lymphotropic virus type 1 (HTLV-1)-associated uveitis are
occasionally reported. Furthermore conjunctival tumor associated with human
papilloma virus (HPV) infection, acute retinal necrosis(ARN) due to herpes
simplex virus type 2 (HSV-2), as well as hepatitis B virus (HVB) and hepatitis C 
virus (HVC) retinopathy are also mentioned in this review.

Publication Types: 
    English Abstract

PMID: 19177759 [PubMed - in process]

30: Indian J Dermatol Venereol Leprol. 2008 Nov-Dec;74(6):619-21.

Immune reconstitution inflammatory syndrome.

Sharma A, Makrandi S, Modi M, Sharma A, Marfatia Y.

Department of Skin and V.D., Medical College and SSG Hospital, Vadodara, India.

BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) is a paradoxical
deterioration in clinical status in a patient on antiretroviral treatment (ART)
despite satisfactory control of viral replication and improvement of CD4 count.
AIM: To study development of IRIS as a part of ART. METHODS: Hundred patients on 
antiretroviral treatment were studied prospectively in the Department of Skin and
VD over a period of 2 years. Patients were asked to come if they developed any
symptoms or on a monthly basis. They were screened clinically and investigated
suitably for evidence of opportunistic infections. RESULTS: Out of 100 patients, 
10 patients did not come for follow-up. Twenty (22.2%) out of the 90 patients
developed IRIS. Herpes zoster (HZ), herpes simplex virus (HSV), and tuberculosis 
(TB) were the cases of IRIS seen in the present study. CONCLUSIONS: IRIS in terms
of HSV/TB is known to accelerate HIV disease progression. Hence early detection
and prompt treatment, along with continuation of highly active ART, are of utmost
importance.

PMID: 19171986 [PubMed - in process]

31: Clin Pediatr (Phila). 2009 Jan 26. [Epub ahead of print]

Varicella Reactivation Presenting as Shingles and Aseptic Meningitis in an
Immunocompetent 11-Year-Old Boy.

Pena JA, Pirics ML, Dicaprio HS, Julapalli MR, Phelps BR, Castagnini LA, Tolle
MA.

PMID: 19171911 [PubMed - as supplied by publisher]

32: J Endod. 2009 Feb;35(2):182-8.

Herpesviruses in abscesses and cellulitis of endodontic origin.

Chen V, Chen Y, Li H, Kent K, Baumgartner JC, Machida CA.

Department of Integrative Biosciences, Oregon Health & Science University School 
of Dentistry, Portland, Oregon 97239, USA.

Acute apical abscesses and cellulitis are severe endodontic diseases caused by
opportunistic bacteria with possible coinfection with latent herpesviruses. The
objectives of this study are to identify herpesviruses, including human
cytomegalovirus (HCMV), Epstein-Barr virus (EBV), herpes simplex virus-1 (HSV-1),
and Varicella zoster virus (VZV) in patients (n = 31) presenting with acute
apical abscesses and cellulitis of endodontic origin. Primary and nested
polymerase chain reaction (PCR) was conducted using virus-specific primers and
DNA isolated from cell-free abscess fluid. From patients exhibiting concurrent
spontaneous pain (n = 28), nine abscesses contained HCMV, two abscesses contained
EBV, one abscess contained HSV-1, and no abscesses contained VZV. Control PCR
using genomic or recombinant templates showed detection limits to a single
genomic copy of HCMV, 100 genomic copies for EBV, and 1 to 10 copies for HSV-1
with no cross-amplification between herpesviral DNA targets. Nested PCR was
required for detection of herpesviral DNA in the abscess specimens, indicating
that these viruses were present in low copy number. Filtration of abscess
specimens and virus transfer experiments using human fibroblastic MRC-5 cells
confirmed the presence of HCMV particles in several abscess specimens. We
conclude that herpesviruses are present but not required for the development of
acute apical abscesses and cellulitis of endodontic origin.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 19166769 [PubMed - in process]

33: Ann Thorac Surg. 2009 Feb;87(2):423-6.

Herpes zoster after lung transplantation: incidence, timing, and outcome.

Fuks L, Shitrit D, Fox BD, Amital A, Raviv Y, Bakal I, Kramer MR.

Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel.

BACKGROUND: Although herpes zoster is a common complication of lung
transplantation, the epidemiologic data are limited. The aims of the present
study were to determine the incidence and clinical manifestations of herpes
zoster in a large cohort of lung transplant recipients and to identify risk
factors associated with its development. METHODS: The files of all adult patients
who underwent lung transplantation at a major tertiary medical center from
January 2001 to December 2007 were reviewed. Data were extracted on background,
transplant-related, and posttransplantation factors. The occurrence and clinical 
characteristics of all episodes of herpes zoster were recorded. RESULTS: Of the
198 lung transplant recipients, 23 had a herpes zoster infection, of whom 18 had 
herpes in a single dermatome. Disseminated cutaneous infection was documented in 
4 cases (17%) and visceral involvement in 1. The median duration of follow-up was
34 months (range, 1 to 85 months). There were no recurrent infections.
Postherpetic neuralgia was detected in 26% of cases. Antiviral prophylaxis,
primarily for cytomegalovirus, was effective (during treatment) against herpes
zoster. The incidence of herpes zoster was higher in patients treated with rabbit
antithymocyte globulin. CONCLUSIONS: The occurrence of herpes zoster peaks
between 12 and 36 months after lung transplantation. Additional immunosuppression
may increase the risk. Further studies on preventive strategies against herpes
zoster in this population are warranted.

PMID: 19161751 [PubMed - indexed for MEDLINE]

34: J AAPOS. 2009 Jan 19. [Epub ahead of print]

Role of polymerase chain reaction in early diagnosis of herpes zoster
ophthalmicus in children.

Bhatnagar A, Tomlins P, Parulekar MV.

Birmingham Children's Hospital, Steelhouse Lane, Birmingham, United Kingdom.

Herpes zoster ophthalmicus is uncommon in children, and diagnosis may be delayed 
until the typical skin lesions become apparent. Delay in appropriate treatment
may result in sight-threatening complications. We report a case of an
18-month-old child in whom we promptly confirmed the clinical suspicion of herpes
zoster ophthalmicus by the identification of viral DNA using polymerase chain
reaction. This procedure enabled us to administer prompt antiviral treatment,
preventing sight-threatening sequelae. We review the literature regarding the
possible mechanism of herpes zoster ophthalmicus in immunocompetent children and 
discuss the role of polymerase chain reaction in its diagnosis.

PMID: 19157933 [PubMed - as supplied by publisher]

35: Rheumatol Int. 2009 Jan 20. [Epub ahead of print]

Adding low dose tacrolimus in rheumatoid arthritis patients with an inadequate
response to tumor necrosis factor inhibitor therapies.

Naniwa T, Watanabe M, Banno S, Maeda T.

Division of Rheumatology, Nagoya City University Hospital, Kawasumi, Mizuho-ku,
Nagoya, Aichi, 467-8601, Japan, tnaniwa@med.nagoya-cu.ac.jp.

In the present study, we retrospectively evaluate the efficacy of low dose
tacrolimus (TAC) as add-on therapy in refractory rheumatoid arthritis (RA)
despite a combination of tumor necrosis factor (TNF) inhibitor and methotrexate
(MTX) using consecutive case series of five patients with active RA (mean disease
duration 2.3 years) despite MTX and TNF inhibitors for at least 3 months (mean
9.5 months) treated with low dose TAC (1.5-2 mg/day) for at least 6 months (mean 
1.8 years). Clinical and radiographic efficacy was assessed according to the
European league against rheumatism response criteria and the modified Sharp
method, respectively. At 1 year, three patients reached to remission. The mean
yearly progression of radiographic joint damage of all five patients after the
onset of TAC was significantly decreased compared to that observed during
anti-TNF therapy without TAC (p = 0.04). One patient temporally discontinued the 
treatment because of herpes zoster. In RA patients with inadequate response to
MTX and a TNF inhibitor, additions of low dose TAC markedly improved clinical
variables including radiographic scores without remarkable detrimental effects.
It seems that TAC in combination with MTX and TNF inhibitors may be a hopeful
treatment option for RA patients with inadequate response to anti-TNF therapy.

PMID: 19153737 [PubMed - as supplied by publisher]

36: Evid Based Dent. 2008;9(4):116.

Comment on:
    Cochrane Database Syst Rev. 2008;(4):CD006851.

Do antiviral agents effectively treat Ramsay Hunt syndrome?

Porter S.

University College London Eastman Dental Institute, London, UK.

DATA SOURCES: The Cochrane Ear, Nose and Throat Disorders Group Trials Register, 
the Cochrane Central Register of Controlled Trials, Medline, PubMed, Embase and
other relevant databases (Cinhal.LILACS,KoreaMed, IndMed, PakMediNet, theUK
Clinical Research Network Portfolio Database (UKCRN), the World Health
Organization International Clinical Trials Registry Platform (ICTRP), Google
Scholar, NLH ENT & Audiology Specialist Library and the metaRegister of
Controlled Trials (mRCT).) were utilised to identify possible trials. STUDY
SELECTION: Randomised controlled trials (RCT) were eligible for inclusion if
antiviral agents alone or in combination with other therapies (using different
routes of administration and dosage schemes) had been taken as treatment for
Ramsay Hunt syndrome. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently 
assessed eligibility and trial quality. RESULTS: Only one RCT was identified and 
included. It was of low quality and included only 15 participants. In this 1992
trial, treatment with intravenous aciclovir and corticosteroids was compared with
corticosteroids alone. Analysis found no statistically significant difference
between the two groups. CONCLUSIONS: The use of antiviral agents against herpes
zoster infections in other parts of the body suggests that they could be useful
in the case of herpes zoster oticus. We found no evidence that they have a
beneficial effect on outcomes in Ramsay Hunt syndrome, despite their widespread
use in this condition. As usual, however, the absence of positive evidence of
benefit (or, in this case, the 'negative' result of one small, statistically
underpowered study) does not necessarily indicate that antivirals are
ineffective. The results of the review do suggest that the various adverse
effects of antivirals should be taken into consideration in the risk-benefit
analysis that foregoes treatment.

Publication Types: 
    Comment

PMID: 19151685 [PubMed]

37: Haemophilia. 2009 Jan;15(1):210-6.

Rituximab as a single agent in the management of adult patients with haemophilia 
A and inhibitors: marked reduction in inhibitor level and clinical improvement in
bleeding but failure to eradicate the inhibitor.

Aleem A, Saidu A, Abdulkarim H, Al-Diab AR, Al-Sagheer A, Qayum A, Al-Momen AK.

Department of Medicine, Division of Haematology/Oncology, College of Medicine,
King Khalid University Hospital, Riyadh, Saudi Arabia. aameraleem@hotmail.com

Management of patients with severe haemophilia A who develop inhibitors is
difficult and expensive. Standard treatment of this complication is immune
tolerance induction (ITI) therapy, but is successful in only 60-80% of the
patients. Failure of ITI results in a higher risk of morbidity and mortality. We 
used rituximab, an anti-CD20 antibody, in three patients with severe haemophilia 
A and inhibitors. Two patients with high-titre inhibitors had marked reduction in
the inhibitor level; the third patient with low-titre inhibitor had a
disappearance of the inhibitor. All patients improved clinically, with fewer
bleeding episodes and a better quality of life. Inhibitor level increased with
time in these patients, but the clinical benefit continued in two patients with
high-titre inhibitors initially, after a follow-up of 48 and 22 months. One of
the patients with concomitant human immunodeficiency virus (HIV) infection and a 
very low CD4 lymphocyte count developed severe truncal herpes zoster after the
third weekly dose of rituximab. Caution is required in such patients, and we
recommend avoiding rituximab use in HIV-infected patients with very low CD4
lymphocyte count. In conclusion, rituximab is useful in reducing the inhibitor
level with clinical benefit in patients with severe haemophilia A and inhibitors,
but it cannot eradicate the inhibitors for long periods with the currently used
protocol of up to five doses.

PMID: 19149851 [PubMed - in process]

38: Curr Drug Saf. 2009 Jan;4(1):30-3.

An atypical case of fulminant interstitial pneumonitis induced by carbamazepine.

Narita H, Ozawa T, Nishiyama T, Matsumoto S, Watanabe S, Isshiki A.

Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku,
Shinjuku-ku, Tokyo 160-0023, Japan. narita@tokyo-med.ac.jp.

Carbamazepine is a therapeutic anticonvulsant, used to manage pain. We often use 
it to treat trigeminal and post-herpes zoster neuralgias. Interstitial
pneumonitis (IP) is a known adverse consequence of using carbamazepine, with
bronchiolitis obliterans and organizing pneumonitis. (BOOP) drug-induced IP as
typical examples. Here we described a patient with post-herpes zoster neuralgia, 
who suffered from drug-induced acute IP that differed from cases typically
induced by carbamazepine.

PMID: 19149523 [PubMed - in process]

39: Support Care Cancer. 2009 Jan 13. [Epub ahead of print]

Use of a lidocaine patch in the management of postsurgical neuropathic pain in
patients with cancer: a phase III double-blind crossover study (N01CB).

Cheville AL, Sloan JA, Northfelt DW, Jillella AP, Wong GY, Bearden Iii JD, Liu H,
Schaefer PL, Marchello BT, Christensen BJ, Loprinzi CL.

Mayo Clinic and Mayo Foundation, Rochester, MN, 55905, USA.

OBJECTIVE: Current therapies often have limited efficacy and untenable side
effects when used to treat persistent incisional pain following cancer-related
surgery. Lidocaine patches reduce neuropathic pain from herpes zoster but their
benefits for persistent cancer-related postsurgical incisional pain remain
unclear. STUDY DESIGN: Multicenter, double-blind, randomized, two-period
crossover trial. MATERIALS AND METHODS: Twenty-eight cancer patients with
postsurgical incisional pain were randomly assigned to receive either lidocaine
patches followed by placebo patches or the reverse. Each study period lasted 4
weeks. Patches were applied daily upon waking and left in place for a maximum of 
18 h. The primary outcome measure, an 11-point pain intensity rating scale, was
administered weekly. Secondary outcomes were administered weekly (Brief Pain
Inventory-Short Form(BPI-SF), Subject Global Impression of Change) and at the end
of each study period (Short Form-Magill Pain Questionnaire, Linear Analogue Self 
Assessment Scale, Neuropathy Pain Scale, Pain Catastrophizing Scale, Profile of
Mood States Short Form). RESULTS: Twenty-one patients completed the first period 
and 18 completed their crossover second phase. No significant intergroup
differences were detected in pain intensity ratings. Few secondary end points
were significantly different when subjects used the lidocaine versus placebo
patches. BPI-SF interference scores were lower in patients using the lidocaine
patch during the first study period, including several scores that achieved
statistical significance, general activity (p = 0.02), work (p = 0.04), and
relations with others (p = 0.02). CONCLUSION: Lidocaine patch use did not
significantly reduce pain intensity ratings or the majority of related secondary 
end points in cancer patients with persistent incisional pain.

PMID: 19142669 [PubMed - as supplied by publisher]

40: Ir J Med Sci. 2009 Jan 13. [Epub ahead of print]

Superior orbital fissure syndrome in herpes zoster ophthalmicus.

Kirwan RP, Abdalla M, Hogan A, Tubridy N, Barry P, Power W.

Department of Ophthalmic Surgery, St Vincent's University Hospital, Dublin 4,
Ireland, ruaidhri.kirwan@ucd.ie.

AIM: To report a case of superior orbital fissure syndrome (SOFS) in a patient
with herpes zoster ophthalmicus (HZO). MATERIALS AND METHODS: A case report.
RESULTS: A 71-year-old male with HZO presented acutely to accident and emergency 
complaining of right vision loss, double vision and drowsiness. The right visual 
acuity was counting fingers. There was no relative afferent pupillary defect. He 
had interstitial keratitis, ptosis, proptosis and total ophthalmoplaegia. The
signs indicated HZO complicated by SOFS. Brain imaging and lumbar puncture
confirmed the diagnosis of varicella zoster encephalitis. Systemic acyclovir and 
prednisolone led to recovery of visual acuity and ocular motility in addition to 
resolution of his proptosis and ptosis. CONCLUSION: SOFS is a rare complication
of herpes zoster infection. With the appropriate treatment and follow-up,
patients may be reassured that recovery of their visual acuity and ocular
motility will occur.

PMID: 19139952 [PubMed - as supplied by publisher]

41: J Drugs Dermatol. 2008 Dec;7(12):1173-6.

Varicella virus and the herpes zoster vaccine. A review of Zostavax and the new
AFIP recommendations.

Ebede TL, Zippin JH.

Publication Types: 
    News

PMID: 19137773 [PubMed - indexed for MEDLINE]

42: Vaccine. 2009 Feb 25;27(9):1454-67. Epub 2009 Jan 9.

Estimating the cost-effectiveness of vaccination against herpes zoster in England
and Wales.

van Hoek AJ, Gay N, Melegaro A, Opstelten W, Edmunds WJ.

Modelling and Economics Unit, Health Protection Agency, Centre for Infections,
London NW9 5EQ, UK.

A live-attenuated vaccine against herpes zoster (HZ) has been approved for use,
on the basis of a large-scale clinical trial that suggests that the vaccine is
safe and efficacious. This study uses a Markov cohort model to estimate whether
routine vaccination of the elderly (60+) would be cost-effective, when compared
with other uses of health care resources. Vaccine efficacy parameters are
estimated by fitting a model to clinical trial data. Estimates of QALY losses due
to acute HZ and post-herpetic neuralgia were derived by fitting models to data on
the duration of pain by severity and the QoL detriment associated with different 
severity categories, as reported in a number of different studies. Other
parameters (such as cost and incidence estimates) were based on the literature,
or UK data sources. The results suggest that vaccination of 65 year olds is
likely to be cost-effective (base-case ICER= pound20,400 per QALY gained). If the
vaccine does offer additional protection against either the severity of disease
or the likelihood of developing PHN (as suggested by the clinical trial), then
vaccination of all elderly age groups is highly likely to be deemed
cost-effective. Vaccination at either 65 or 70 years (depending on assumptions of
the vaccine action) is most cost-effective. Including a booster dose at a later
age is unlikely to be cost-effective.

PMID: 19135492 [PubMed - in process]

43: J Acquir Immune Defic Syndr. 2009 Feb 1;50(2):182-91.

Short-term and long-term effects of highly active antiretroviral therapy on the
incidence of herpes zoster in HIV-infected children.

Levin MJ, Anderson JP, Seage GR 3rd, Williams PL; PACTG/IMPAACT 219C Team.

Pediatric Infectious Diseases Section, University of Colorado at Denver Health
Sciences Center, Mailstop C227, Building 401, (Room R09-108), 1784 Racine Street,
Aurora, CO 80045-0508, USA. myron.levin@uchsc.edu

BACKGROUND: Highly active antiretroviral therapy (HAART) has reduced herpes
zoster (HZ) incidence in HIV-infected children, yet it remains common. METHODS:
We evaluated perinatally HIV-infected youth with varicella infection enrolled
between 1993 and 2006 in a prospective cohort study. Incidence rates (IRs) and
95% confidence intervals of HZ were estimated by calendar year, age group, and
HAART use. The effect of initiating HAART was also evaluated by fitting Cox
survival models adjusted for potential confounders. RESULTS: Among 536
perinatally infected children with documented prior varicella (median follow-up =
6.8 years), 116 (22%) developed HZ (IR = 3.2 events/100 person-years, confidence 
interval: 2.6 to 3.8). IRs increased from 1993 to 1996 and then declined
significantly through 2006 (P < 0.001). However, an IR of 1.4-3.1 HZ episodes per
100 person-years persisted from 2001 to 2006. The risk of HZ was higher for those
with lower CD4% or in Centers for Disease Control and Prevention clinical class
C. The IR of HZ was similar in the 90 days before or after initiation of HAART
but declined significantly after more than 90 days of HAART. CONCLUSIONS:
Although HAART has markedly reduced the IR of HZ, it remains a frequent
complication in HIV-infected children. The risk of HZ is similar in the 90 days
before and after initiating HAART.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 19131890 [PubMed - indexed for MEDLINE]

44: J Pediatr Hematol Oncol. 2008 Dec;30(12):931-4.

Visceral varicella zoster virus (VZV) after allogeneic hematopoietic stem cell
transplant (HSCT) in pediatric patients with chronic graft-versus-host disease
(cGVHD).

Peritz DC, Duncan C, Kurek K, Perez-Atayde AR, Lehmann LE.

Dana-Farber Cancer Institute, Children's Hospital, Boston, MA, USA.
David_Peritz@dfci.harvard.edu

Reactivation of latent varicella zoster virus is one infectious complication
associated with the extensive immunosuppression necessary for hematopoietic stem 
cell transplant. Most cases are limited to skin and mortality is low. Isolated
visceral zoster is rare, presenting with ileus/abdominal pain, hepatitis, and/or 
hyponatremia. We present 2 cases of visceral varicella zoster virus in
adolescents with chronic graft-versus-host disease after hematopoietic stem cell 
transplant. Both presented with elevated liver enzymes, severe abdominal pain,
and hyponatremia but lacked cutaneous involvement. Both received high-dose
acyclovir and showed improvement, but eventually expired from hepatic failure.
The diagnosis of visceral zoster can be difficult especially without cutaneous
manifestations. Vigilance is necessary in patients with chronic graft-versus-host
disease, abdominal pain, and/or hepatitis and antiviral therapy should be
initiated promptly.

Publication Types: 
    Case Reports

PMID: 19131784 [PubMed - indexed for MEDLINE]

45: J Formos Med Assoc. 2008 Dec;107(12):958-60.

Herpes zoster infection associated with poor peripheral blood hematopoietic stem 
cell mobilization.

Liu YC, Lu PL, Hsiao HH, Tsai HJ, Liu TC, Lin SF.

Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung
Medical University Hospital, Kaohsiung, Taiwan.

The efficacy of peripheral blood hematopoietic stem cell (PBSC) harvest is
important for successful autologous transplantation. The impact of viral
infection on PBSC mobilization has rarely been reported. Here, we report a
patient with relapsed diffuse large B-cell lymphoma who experienced disseminated 
cutaneous herpes zoster infection during the neutropenic phase of PBSC
mobilization. A markedly reduced number of PBSCs was initially harvested (1.72 x 
10(6)/kg, 77.2% reduction), followed by a sufficient number (7.55 x 10(6)/kg)
during remobilization with the same mobilization regimen when herpes zoster
infection had subsided. Because of the temporal association, we suggest that
herpes zoster infection is a risk factor for poor PBSC mobilization, and
remobilization with the same regimen is feasible.

PMID: 19129057 [PubMed - in process]

46: Clin Infect Dis. 2009 Feb 1;48(3):372-3.

Fatal acute varicella-zoster virus hemorrhagic meningomyelitis with necrotizing
vasculitis in an HIV-infected patient.

Chang CC, McLean C, Vujovic O, Jenney AJ, Short M, Lyon S, Storey E, Lewin SR.

Publication Types: 
    Case Reports
    Letter

PMID: 19128163 [PubMed - indexed for MEDLINE]

47: Medicina (Kaunas). 2008;44(11):821-6.

[Acute infectious encephalitis and pathogens coming from animals]

[Article in Lithuanian]

Stahl JP, Mailles A, Vaillant V, Floret D; Encephalitis Protocol Group.

CHU Michallon, Grenoble Cedex, France. JPStahl@chu-grenoble.fr

Despite better knowledge of pathophysiology and a wider use of new molecular
technologies for the diagnosis, the etiological diagnosis of acute encephalitis
is not established in most cases. Incidence, prognosis, rate of this disease and 
severity of sequelae remain unknown. In France, according to the published data, 
the incidence of encephalitis is estimated to be 1.9 cases per 100 000
inhabitants in average among non-HIV patients. The etiological diagnosis is
established in less than 30% of cases. The more frequent diagnosis is herpetic
encephalitis in adults and encephalitis caused by Varicella zoster virus in
children younger than 16 years. Despite a difficult diagnosis and the lack of
specific treatment for most of these infections, the etiological diagnosis should
always be deeply explored to precise the individual prognosis, to allow better
management of antibiotic therapy, and to improve epidemiological knowledge. We
present the recommendations established by the French Society for Infectious
Diseases. First designed to suit the French epidemiology, they take in count the 
possible exposure of patients to different epidemiological patterns. Three levels
of etiological tests are proposed, from the most common infections and those,
which required an immediate treatment, to the rarest ones.

Publication Types: 
    English Abstract
    Review

PMID: 19124957 [PubMed - indexed for MEDLINE]

48: New Microbiol. 2008 Oct;31(4):445-50.

A two-year prospective study of clinical criteria and polymerase chain reaction
assay of cerebrospinal fluid for the diagnosis of viral infections of the central
nervous system.

Boaretti M, Scalet G, Fontana R.

Department of Pathology, Section of Microbiology, University of Verona, Italy.
marzia.boaretti@univr.it

Cerebrospinal fluid specimens from 226 patients with suspected viral infections
of the central nervous system (CNS) were tested by polymerase chain reaction
(PCR) to identify the most frequent viruses involved in these infections. A
positive PCR result was obtained in 18 patients (7 cases positive for herpes
simplex viruses, 5 for enterovirus, 3 for JC virus, 2 for varicella-zoster virus,
and 1 for Epstein-Barr virus). All patients with positive PCR results had a
definite diagnosis of CNS viral infection. However, a negative result did not
rule out the possibility of viral infection of the CNS.

PMID: 19123298 [PubMed - indexed for MEDLINE]

49: Singapore Med J. 2008 Dec;49(12):e340-2.

An unusual complication of dengue infection.

Chien J, Ong A, Low SY.

Department of Respiratory and Critical Care Medicine, Singapore General Hospital,
Outram Road, Singapore 169608. jaimechien@yahoo.com.sg

We present an unusual complication of dengue infection resulting in postviral
phrenic neuropathy and diaphragmatic paralysis in a 34-year-old man. There is a
paucity of literature on this condition, with postviral neuropathies previously
reported to be associated commonly with herpes zoster, poliovirus, and rarely,
West Nile virus and human immunodeficiency virus infections. To our knowledge,
this is the first reported case of flavivirus causing isolated postviral phrenic 
neuropathy and diaphragmatic paralysis.

PMID: 19122929 [PubMed - in process]

50: Rev Cardiovasc Med. 2008 Fall;9(4):275-9.

Symptomatic metastatic right atrial lymphoma in a patient with AIDS presenting
with pulmonary embolization.

Lather N, Islam M, Fergus IV.

Department of Medicine, Columbia University, Harlem Hospital Center, New York,
NY, USA.

Tumors involving the heart are rare, and the majority of them are benign.
Secondary lymphoma with localization to the heart is the third most common
malignant heart tumor and is more common, by far, than primary cardiac lymphomas.
In patients with human immunodeficiency virus, the risk of development of
systemic lymphoma is 60 to 200 times higher than in the general population.
Symptoms usually consist of chest pain and dyspnea. Patients can also present
with obstructive symptoms, based on the location and size of the tumor, and signs
such as elevated jugular venous pressure, peripheral edema, ascites, and
hepatomegaly. Transthoracic echocardiography is the initial modality of choice
for diagnosis of cardiac lymphomas because it is readily available and helps
localize the tumor, but transesophageal echocardiography and magnetic resonance
imaging remain the best tests for evaluation. Treatment consists primarily of
chemotherapy, and anticoagulation can be used in certain cases where embolization
of the tumor is likely. This case review describes a 37-year-old man with past
medical history significant for herpes zoster and stage 1 syphilis who presented 
with complaints of weight loss, intermittent fevers, and vague chest pains of
1-month duration.

PMID: 19122586 [PubMed - in process]

51: Cleve Clin J Med. 2009 Jan;76(1):45-8.

Q: Who should receive the shingles vaccine?

Singh A, Englund K.

Division of Hospital Medicine, University of California San Francisco, USA.

PMID: 19122110 [PubMed - in process]

52: Clin Exp Dermatol. 2008 Dec 22. [Epub ahead of print]

Herpes zoster complicated by delayed intracranial haemorrhage.

Song HJ, Hong WK, Lee HS, Choi GS, Shin JH.

Department of Dermatology, Inha University School of Medicine, 7-206
shinhung-dong-3-ka, Jung-ku, Incheon, 400-711, Republic of Korea. E-mail:
jshin@inha.ac.kr.

PMID: 19120386 [PubMed - as supplied by publisher]

53: Physiol Biochem Zool. 2008 Dec 31. [Epub ahead of print]

Sublethal Concentrations of Ammonia Impair Performance of the Teleost Fast-Start 
Escape Response.

McKenzie DJ, Shingles A, Claireaux G, Domenici P.

1Universite Montpellier 2, Place Eugene Bataillon, 34095 Montpellier cedex 05,
France; 2Centre National de la Recherche Scientifique, Institut des Sciences de
l'Evolution, Unite Mixte de Recherche 5554, Station Mediterraneenne de
l'Environnement Littoral, 1 quai de la Daurade, 34200 Sete, France;
3International Marine Centre, Localita Sa Mardini, 09072 Torregrande, Oristano,
Italy; 4Unite de Physiologie Comparee et Integrative, Unite de Recherche et de
Formation, Sciences et Technologies, Universite de Bretagne Occidentale, 6 avenue
Le Gorgeu, 29285 Brest cedex 3, France; 5Consiglio Nationale de Ricerca-Istituto 
Ambiente Marino Costiero-c/o International Marine Centre, Localita Sa Mardini,
09072 Torregrande, Oristano, Italy.

Abstract The fast-start escape response in fish is essential for predator
avoidance, but almost nothing is known about whether sublethal concentrations of 
pollutants can impair this reflex. Ammonia, a pervasive pollutant of aquatic
habitats, is known to have toxic effects on nervous and muscle function in
teleost fish. Golden gray mullet (Liza aurata L.) were exposed for 24 h to
sublethal ammonia concentrations in seawater (control, 400 mumol L(-1), or 1,600 
mumol L(-1) NH(4)Cl), and then their response to startling with a mechanical
stimulus was measured with high-speed video. Initiation of the escape response
was significantly slowed by ammonia exposure: response latency rose
proportionally from <50 ms in controls to >300 ms at a concentration of 1,600
mumol L(-1 ) NH(4)Cl. This indicates toxic effects on nervous function within the
reflex arc. Impaired escape performance was also observed: maximum turning rate, 
distance covered, velocity, and acceleration were significantly reduced by >45%
at a concentration of 1,600 mumol L(-1) NH(4)Cl. This indicates toxic effects on 
fast-twitch glycolytic white muscle function, the muscle type that powers the
fast-start response. These neuromotor impairments were associated with
significant ammonia accumulations in venous plasma and white muscle and brain
tissue. These results indicate that anthropogenic ammonia pollution in aquatic
habitats may increase the vulnerability of fish to predation, especially by birds
and mammals that are not affected by water ammonia concentrations.

PMID: 19117412 [PubMed - as supplied by publisher]

54: Nucleosides Nucleotides Nucleic Acids. 2009;28(1):43-55.

5'-O-D-valyl ara A, a potential prodrug for improving oral bioavailability of the
antiviral agent vidarabine.

Shen W, Kim JS, Mitchell S, Kish P, Kijek P, Hilfinger J.

TSRL Inc., Ann Arbor, Michigan 48108, USA. wshen@tsrlinc.com

In order to improve the oral bioavailability of Adenine
9-beta-D-arabinofuranoside (Vidarabine, also called ara A), an antiviral drug
which is active against herpes simplex and varicella zoster viruses and the first
agent to be licensed for the treatment of systematic herpes virus infection in
man, the corresponding 5'-O-D-valyl ester derivative has been synthesized. Based 
on their physicochemical properties, 5'-O-valyl ara A has emerged as a potential 
prodrug candidate to improve the oral bioavailability of vidarabine. We describe 
in this paper a facile synthesis route for the prodrug and its physicochemical
properties.

PMID: 19116869 [PubMed - indexed for MEDLINE]

55: Br J Ophthalmol. 2009 Jan;93(1):119.

Type I Boston keratoprosthesis with cataract extraction and intraocular lens
placement for visual rehabilitation of herpes zoster ophthalmicus: the "KPro
Triple".

Todani A, Gupta P, Colby K.

Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.

INTRODUCTION: Management of corneal scarring following herpes zoster ophthalmicus
(HZO) is challenging due to the dense corneal anesthesia that results from viral 
damage to the subepithelial nerve plexus. These patients have significant risk of
graft failure following traditional corneal transplantation. We present a case of
a 74-year-old white woman with counting fingers vision from HZO-associated
corneal scarring and mature cataract where visual rehabilitation was accomplished
with a Type I Boston keratoprosthesis (KPro) and concurrent extracapsular
cataract extraction and posterior chamber intraocular lens placement (the "KPro
Triple"). One month following surgery, the patient's uncorrected visual acuity
improved to 20/25; this level of vision has been maintained for 7 months at
present. SURGICAL TECHNIQUE (SEE VIDEO): The keratoprosthesis is assembled by
creating a sandwich composed of the KPro front plate, the donor cornea, and the
KPro backplate that is secured with a locking ring. The host cornea is then
trephined and posterior synechiae lysed to allow access to the mature cataract.
The cataract is manually expressed and a posterior chamber intraocular lens
implanted. The assembled keratoprosthesis is then sutured into position with 9.0 
nylon. A bandage contact lens is placed. COMMENT: In patients with severe
neurotrophic keratopathy, traditional penetrating keratoplasty is fraught with
problems, including poor epithelial healing and corneal ulceration. The Boston
KPro can provide rapid visual rehabilitation, despite corneal anaesthesia in
these patients, and is currently our treatment of choice as a primary procedure
for HZO patients who need corneal transplantation.

Publication Types: 
    Case Reports

PMID: 19098045 [PubMed - indexed for MEDLINE]

56: Semin Fetal Neonatal Med. 2008 Dec 17. [Epub ahead of print]

Varicella in the fetus and newborn.

Smith CK, Arvin AM.

Stanford University School of Medicine, 300 Pasteur Drive, G322, Stanford, CA
94305, USA.

Varicella (chickenpox) in pregnancy is unusual because most women of childbearing
age are immune. It can, however, cause significant morbidity for the pregnant
woman and in rare cases cause congenital varicella syndrome. The incidence of
congenital varicella syndrome after maternal varicella during the first two
trimesters is <1% across multiple cohort studies. Maternal infection in the third
trimester is not associated with congenital varicella syndrome, but the infant
may develop herpes zoster during the first one or two years. Maternal infection
just before or after delivery presents a high risk for disseminated varicella in 
the infant. Serious infection can be prevented with passive antibody prophylaxis 
and antiviral therapy. Maternal herpes zoster does not result in adverse fetal or
neonatal outcomes.

PMID: 19097954 [PubMed - as supplied by publisher]

57: J Korean Neurosurg Soc. 2008 Oct;44(4):199-204. Epub 2008 Oct 30.

The Treatment Outcome of Elderly Patients with Idiopathic Trigeminal Neuralgia : 
Micro-Vascular Decompression versus Gamma Knife Radiosurgery.

Oh IH, Choi SK, Park BJ, Kim TS, Rhee BA, Lim YJ.

Department of Neurosurgery, Kyung Hee University Hospital, Seoul, Korea.

OBJECTIVE: This study was designed to compare the efficacy of micro-vascular
decompression (MVD) and Gamma knife radiosurgery (GKRS) for elderly idiopathic
trigeminal neuralgia patients by analyzing the clinical outcome. METHODS: In the 
past 10 years, 27 elderly patients were treated with MVD while 18 patients were
treated with GKRS (>65-years-old). We reviewed their clinical characteristics and
clinical courses after treatment as well as the treatment outcomes. For patients 
who were treated with MVD, additional treatment methods such as rhizotomy were
combined in some areas. In GKRS, we radiated the root entry zone (REZ) with the
mean maximum dose of 77.8 (70-84.3) Gy and one 4 mm collimator. RESULTS: The mean
age was 68.1 years for MVD, and 71.1 years for GKS group. The average time
interval between first presenting symptom and surgery was 84.1 (1-361) months,
and 51.4 (1-120) months, respectively. The mean follow-up period after the
surgery was 35.9 months for MVD, and 33.1 months for GKRS. According to Pain
Intensity Scale, MVD group showed better prognosis with 17 (63%) cases in grade
I-II versus 10 (55.6%) cases in GKRS group after the treatment. The pain
recurrence rate during follow up did not show much difference with 3 (11.1%) in
MVD, and 2 (11.1%) in GKRS. After the treatment, 2 cases of facial numbness, and 
1 case each of herpes zoster, cerebrospinal fluid (CSF) leakage, hearing
disturbance, and subdural hematoma occurred in MVD Group. In GKRS, there was 1
(5.6%) case of dysesthesia but was not permanent. Three cases were retreated by
GKRS but the prognosis was not as good as when the surgery was used as primary
treatment, with 1 case of grade I-II, and 1 case of recurrence. The maximal
relieve of pain was seen just after surgery in MVD group, and 1 year after
treatment in GKRS group. CONCLUSION: For trigeminal neuralgia patients with
advanced age, MVD showed advantages in immediately relieving the pain. However,
in overall, GKRS was preferable, despite the delayed pain relief, due to the
lower rate of surgical complications that arise owing to the old age.

PMID: 19096677 [PubMed - in process]

58: Am J Emerg Med. 2008 Nov;26(9):1062-3.

An unusual cause of abdominal pain: implications for infection control in the ED.

Chan SS.

Publication Types: 
    Case Reports
    Letter

PMID: 19091278 [PubMed - indexed for MEDLINE]

59: Cancer. 2009 Jan 1;115(1):229-32.

Acyclovir to prevent reactivation of varicella zoster virus (herpes zoster) in
multiple myeloma patients receiving bortezomib therapy.

Vickrey E, Allen S, Mehta J, Singhal S.

Division of Hematology/Oncology, Feinberg School of Medicine, Robert H. Lurie
Comprehensive Cancer Center, Northwestern University, Chicago, Illinois 60611,
USA.

BACKGROUND: Humoral-mediated as well as cell-mediated immunity is compromised in 
myeloma patients receiving treatment. Immunocompromised patients are at risk of
developing herpes zoster. There is evidence from clinical trials that bortezomib 
therapy is associated with a significant risk of herpes zoster. It is the
authors' clinical policy to administer long-term acyclovir prophylactically to
all symptomatic myeloma patients. METHODS: A retrospective review of the records 
of 125 myeloma patients who were treated with bortezomib and who also received
routine acyclovir prophylaxis at the dose of 400 mg daily in >80% of patients was
undertaken. Alternatives, used in <20% of patients, were 200 mg of acyclovir,
250/500 mg of valacyclovir, or 500 mg of famciclovir administered daily. This was
accompanied by patient education regarding the importance of compliance with
these prophylactic medications. RESULTS: The duration of bortezomib therapy was 1
to 164 weeks (median, 16 weeks). The total duration of exposure to bortezomib was
4150 weeks (80 patient-years). Except for the occasional missed dose, the
self-reported compliance with antiviral prophylaxis was 100%. Not a single
episode of herpes zoster was reported during this period. No adverse effects were
noted that could be definitely attributed to acyclovir, valacyclovir, or
famciclovir. CONCLUSIONS: Daily acyclovir (or a suitable alternative) appears to 
be effective at preventing herpes zoster virus in patients with myeloma who are
receiving bortezomib, with or without corticosteroids. Copyright (c) 2008
American Cancer Society.

PMID: 19090004 [PubMed - in process]

60: J Endod. 2009 Jan;35(1):23-9. Epub 2008 Oct 31.

Herpesviruses in endodontic pathoses: association of Epstein-Barr virus with
irreversible pulpitis and apical periodontitis.

Li H, Chen V, Chen Y, Baumgartner JC, Machida CA.

Department of Endodontology, Oregon Health & Science University, School of
Dentistry, Portland, Oregon 97239, USA.

Irreversible pulpitis and apical periodontitis are inflammatory diseases caused
by opportunistic bacteria with possible co-infection with latent herpesviruses.
The objectives of this study are to identify herpesviruses, including human
cytomegalovirus (HCMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV-1),
and Varicella zoster virus (VZV) in patients with irreversible pulpitis (n = 29) 
or apical periodontitis, either primary (n = 30) or previously treated (n = 23). 
Using primary and nested polymerase chain reaction (PCR) and reverse
transcription-PCR, EBV DNA and RNA were present in endodontic pathoses in
significantly higher percentages (43.9% and 25.6%, respectively) compared with
healthy pulp controls (0% and 0%, respectively). HCMV DNA and RNA were found in
measurable numbers in both endodontic patients (15.9% and 29.3%, respectively)
and in healthy pulp controls (42.1% and 10.5%, respectively). HSV-1 DNA was found
in low percentages in endodontic patients (13.4%), and only one patient showed
the presence of VZV. In conclusion, EBV may be associated with irreversible
pulpitis and apical periodontitis.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 19084119 [PubMed - in process]

61: Vaccine. 2009 Feb 5;27(6):882-7. Epub 2008 Dec 9.

Herpes zoster vaccination among adults aged 60 years or older in the United
States, 2007: Uptake of the first new vaccine to target seniors.

Lu PJ, Euler GL, Jumaan AO, Harpaz R.

Immunization Services Division, National Center for Immunization and Respiratory 
Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, NE,
Atlanta, GA 30333, United States.

BACKGROUND: Approximately one million new cases of shingles (herpes zoster [HZ]),
a severely painful and debilitating disease caused by reactivation of
varicella-zoster virus (VZV), occur in the United States each year. HZ incidence 
increases with age, especially after age 50. A vaccine to prevent HZ and its
sequelae was licensed in May 2006 for those aged 60 years or older, making it the
first new vaccine targeted to this age group in many years. In October 2006 the
Advisory Committee on Immunization Practices (ACIP) recommended HZ vaccination of
persons aged >/=60 years; these recommendations were published in 2008. We
examined HZ vaccination coverage among persons aged >/=60 years in the U.S. in
2007, and evaluated factors affecting the uptake of HZ vaccine in this
population. METHODS: Data from the 2007 National Immunization Survey-Adult
(NIS-Adult) restricted to individuals aged >/=60 years were analyzed using SUDAAN
software to estimate national HZ vaccination coverage, and reasons for not
receiving the HZ vaccine. We used multivariable logistic regression analysis to
identify factors independently associated with HZ vaccination. RESULTS: Of 3662
respondents, 1.9% (95% confidence interval=1.3%, 2.8%) reported having received
the HZ vaccine. A total of 72.9% of respondents were unaware of the HZ vaccine
but 77.8% stated that they would accept HZ vaccination if their doctor
recommended it. Of the remaining 556 respondents, key reasons reported for not
accepting HZ vaccine included 'vaccination not needed' (34.8%), 'not at risk'
(12.5%), and 'don't trust in doctors or medicine' (9.5%). CONCLUSIONS: Soon after
its availability in the United States, coverage among adults recommended to
receive the HZ vaccine was low. Our data provide evidence that the lack of
patient awareness and of physician recommendations were barriers to vaccine
uptake.

PMID: 19071175 [PubMed - in process]

62: Adv Skin Wound Care. 2008 Dec;21(12):582-8; quiz 589-90.

Republished from:
    Nurse Pract. 2007 Sep;32(9):19-24, quiz, 24-5.

Herpes zoster: prevention, diagnosis, and treatment--2008 update.

Wilson DD.

Mennonite College of Nursing, Illinois State University, Normal, IL, USA.

PURPOSE: To provide the wound care practitioner with a review of strategies to
diagnose, prevent, and manage herpes zoster. TARGET AUDIENCE: This continuing
education activity is intended for physicians and nurses with an interest in skin
and wound care. OBJECTIVES: After reading this article and taking this test, the 
reader should be able to: 1. Identify signs and symptoms of herpes zoster. 2.
Describe herpes zoster complications and treatment. 3. Discuss means of
preventing herpes zoster.

PMID: 19065085 [PubMed]

63: Ann Rheum Dis. 2008 Dec 5. [Epub ahead of print]

Long term safety of Methotrexate monotherapy in rheumatoid arthritis patients: A 
systematic literature research.

Salliot C, van der Heijde D.

Rheumatology B Department, Cochin Hospital, France.

OBJECTIVE: To perform a systematic literature review regarding the long term
safety of methotrexate (MTX) monotherapy in rheumatoid arthritis (RA). METHODS:
The search was performed in MEDLINE, COCHRANE and EMBASE. The population studied 
was adults with RA who received MTX monotherapy for more than 2 years. RESULTS:
88 published studies were included. Over 12 years of treatment, the termination
rate of MTX for toxicity is less than for Sulfasalazine, Gold, D-penicillamine
and higher than for HCQ (level of evidence 2a-2b). Long term use of MTX treatment
does not appear as a risk factor for serious infections including herpes zoster
(2b-4) and could provide a survival benefit by reduction of cardiovascular
mortality (2b). The prevalence of elevated liver enzymes (more than twice upper
limit of normal) is close to 13% of the patients and 3.7% of them stopped MTX
permanently for liver toxicity (2b). Data on the risk for liver
fibrosis/cirrhosis are conflicting: a meta-analysis shows an incidence of
fibrosis of 2.7% after 4 years of MTX (2a). However, 2 other studies on
sequential liver biopsies do not show evidence for developing severe damage (2b).
Insufficient data are available to fully assess the risk of lymphoma and
malignancies, although there is no strong evidence of increased risk (2b-4).
CONCLUSION: This systematic literature search on MTX monotherapy with relatively 
low dose use during at least 2 years shows a favourable long-term safety.

PMID: 19060002 [PubMed - as supplied by publisher]

64: Eur J Dermatol. 2009 Jan-Feb;19(1):61-3. Epub 2008 Dec 5.

Trigeminal trophic syndrome with extensive ulceration following herpes zoster.

Kautz O, Bruckner-Tuderman L, Muller ML, Schempp CM.

Department of Dermatology, University Medical Center Hauptstrasse 7, 79104
Freiburg, Germany. ocko.kautz@uniklinik-freiburg.de

The trigeminal trophic syndrome is a rare complication following central or
peripheral injury of the trigeminal nerve typically characterized by unilateral
distribution of anaesthesia, paraesthesia and ulceration. In one third of cases
it is preceded by an iatrogenic damage of the trigeminal nerve, in another third 
by a history of stroke. Other causes include head trauma, intracranial tumours,
herpes virus infection, degenerative diseases of the CNS and idiopathic. Little
is known about the pathogenesis. Contribution of neurotrophic factors and an
altered sympathetic activity is assumed but a pivotal role of self-mutilation is 
generally accepted. We report a case of a patient who developed a strictly
unilateral crescent ulcer of the ala nasi in addition to an extensive ulceration 
of the forehead and scalp following herpes zoster ophthalmicus.

PMID: 19059825 [PubMed - in process]

65: Harv Health Lett. 2008 Oct;33(12):6-7.

Should you get the shingles vaccine? If you're 60 or older, the official
recommendations say yes. But pluses and minuses make for a complicated equation.

[No authors listed]

PMID: 19058405 [PubMed - indexed for MEDLINE]

66: J Arthroplasty. 2008 Dec 3. [Epub ahead of print]

Acute Postoperative Herpes Zoster With a Sciatic Nerve Distribution After Total
Joint Arthroplasty of the Ipsilateral Hip and Contralateral Knee.

Park KS, Yoon TR, Kim SK, Park HW, Song EK.

Center for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam,
Republic of Korea.

The differential diagnosis of a patient with acute onset of hip pain during the
postoperative recovery period after total hip arthroplasty includes sciatic nerve
injury, infection, incisional pain, hardware, or simply muscular issues related
to overactivity. Moreover, because the rash of herpes zoster develops after 4 or 
5 days of pain, it is difficult to diagnose herpes zoster during the early
period. A number of reports have been issued on herpes zoster after surgery or
trauma, but no report is available on herpes zoster development with a sciatic
nerve distribution after ipsilateral total hip arthroplasty. The authors report
the case of 75-year-old woman with herpes zoster with a sciatic nerve
distribution after 2 primary total joint arthroplasties of a hip and knee.

PMID: 19056216 [PubMed - as supplied by publisher]

67: J Med Chem. 2008 Dec 25;51(24):7744-50.

Interactions of antiviral indolo[2,3-b]quinoxaline derivatives with DNA.

Wilhelmsson LM, Kingi N, Bergman J.

Department of Chemical and Biological Engineering/Physical Chemistry, Chalmers
University of Technology, SE-41296 Gothenburg, Sweden.

Here, we present the synthesis of five novel indoloquinoxaline derivatives and
investigate the DNA binding properties of these monomeric as well as dimeric
compounds using absorption, fluorescence, and linear dichroism. Several of the
mono- and dicationic derivatives presented have previously demonstrated an
excellent antiviral effect that is higher than already acknowledged agents
against human cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1), and
varicella-zoster virus (VZV). We find that the DNA binding constants of the
monomeric and dimeric derivatives are high (approximately 10(6)) and very high
(approximately 10(9)), respectively. Results from the spectroscopic measurements 
show that the planar aromatic indoloquinoxaline moieties upon interaction with
DNA intercalate between the nucleobases. Furthermore, we use poly(dA-dT)(2) and
calf thymus DNA in a competitive binding experiment to show that all our
derivatives have an AT-region preference. The findings are important in the
understanding of the antiviral effect of these derivatives and give invaluable
information for the future optimization of the DNA binding properties of this
kind of drugs.

PMID: 19053744 [PubMed - indexed for MEDLINE]

68: Rev Med Suisse. 2008 Nov 5;4(178):2398-402, 2404.

[Herpes zoster and post-herpetic neuralgia in older adults]

[Article in French]

Lang PO, Zarate-Lagunes M, Pautex S.

Departement de rehabilitation et geriatrie, Hopital des Trois-Chene, Ch.
Pont-Bochet 3, 1226 Thonex. Pierre.O.Lang@hcuge.ch

Varicella-Zoster virus is responsible for chickenpox and, after reactivation,
herpes zoster. Herpes zoster causes a vesicular dermatomal rash, traditionally
metameric. Old adults can present severe pain during the acute phase, and late
complications, such as post-herpetic neuralgia that can trying and crippling.
Initiated within the first 72 hours of the rash, antivirals accelerate rash
healing, reducing both rash and acute pain severity but incompletely the onset of
other complications. Complementary therapeutic drug is often necessary. However, 
their application in old, frail, co-morbid and often poly-medicated patients have
to be carefully considered as their use may be contraindicated. A specific
vaccine is enable to reduce herpes zoster-related morbidity.

Publication Types: 
    English Abstract
    Review

PMID: 19051627 [PubMed - indexed for MEDLINE]

69: Eur J Pediatr. 2008 Dec 3. [Epub ahead of print]

Acute retinal necrosis caused by herpes simplex virus type 2 in a 3-year-old
Japanese boy.

Tanaka-Kitajima N, Iwata N, Ando Y, Sakurai H, Iwami M, Tsuzuki KI, Kondo M, Ito 
Y, Kimura H.

Department of Infection and Immunology, Aichi Children's Health and Medical
Center, Aichi, Japan.

Acute retinal necrosis (ARN), which is characterized by rapidly progressing
peripheral retinal necrosis, is caused mainly by herpes simplex virus type 1,
herpes simplex virus type 2 (HSV-2), or varicella-zoster virus. A previously
healthy 3-year-old Japanese boy developed ARN in his left eye after being bruised
by a milk container. HSV-2 DNA was detected in the aqueous humor of the affected 
eye. Serological testing suggested that the route of infection was from mother to
child, although there was no past history of apparent HSV-2 infection. Childhood 
ARN has not been previously reported in Japan, possibly because of the low
seroprevalence of HSV-2 in Japanese women. Pediatricians must be aware of this
rare disease, which can affect individuals without a previous history of HSV even
in a country with a low seroprevalence of HSV-2.

PMID: 19050917 [PubMed - as supplied by publisher]

70: Plast Reconstr Surg. 2008 Dec;122(6):211e-213e.

Herpes zoster after reconstruction for head and neck cancer.

Parikh PM, Davison SP.

Department of Plastic Surgery, Georgetown University Hospital, Washington, DC
20007, USA.

Publication Types: 
    Case Reports

PMID: 19050493 [PubMed - indexed for MEDLINE]

71: J Pain Palliat Care Pharmacother. 2008;22(3):235-8.

European pain management discussion forum.

Eisenberg E.

Pain Relief Unit, Ramban Medical Centre, Israel. e_eisenberg@rambam.health.gov.il

Queries from European physicians about analgesic pharmacotherapy and responses
from the author are presented. The topics addressed are tolerance to opioid
side-effects, use of botulinum toxin A in pain management, use of ketamine in
pain management, opioid addicts' perception of pain, intra-articular injections
following joint surgery, and opioid rescue doses for breakthrough pain.

PMID: 19042856 [PubMed - indexed for MEDLINE]

72: Biol Blood Marrow Transplant. 2008 Dec;14(12):1417-24.

Recovery of varicella-zoster virus-specific T cell immunity after T cell-depleted
allogeneic transplantation requires symptomatic virus reactivation.

Distler E, Schnurer E, Wagner E, von Auer C, Plachter B, Wehler D, Huber C, Kolbe
K, Meyer RG, Herr W.

Department of Medicine III, Hematology and Oncology, Johannes
Gutenberg-University, Mainz, Germany.

Reactivated varicella-zoster virus (VZV) infection causes herpes zoster and
commonly occurs after allogeneic hematopoietic stem cell transplantation
(allo-HSCT). Because VZV-specific T cell immunity is essential to prevent virus
reactivation, we developed an interferon-gamma enzyme-linked immunosorbent spot
(ELISPOT) assay for the sensitive detection of VZV-reactive T cells at the
single-cell level ex vivo. We used this assay to monitor the frequency of
VZV-reactive T cells in 17 seropositive patients during the first year after T
cell-depleted allo-HSCT. The patients did not receive anti-herpesvirus
prophylaxis after stem cell engraftment. Independent of the magnitude of
transferred donor immunity, VZV-reactive T cell numbers decreased to low levels
(median, 2/mL; range, 0 to 35/mL) in peripheral blood early after
transplantation. Only patients with subsequent zoster (n = 5) exhibited a
dramatic boost in VZV-reactive T cells (median, 366/mL; range, 158 to 756/mL),
which was induced by the reactivation event. The postzoster VZV-reactive T cell
levels were similar to those seen in healthy virus carriers. In contrast,
antiviral T cell levels remained low in patients without VZV disease. Our results
demonstrate that VZV-specific T cell immunity recovered efficiently during zoster
in T cell-depleted allo-HSCT recipients. It did not reconstitute spontaneously in
nonzoster patients, even in the absence of antiviral prophylaxis. Prospective
studies should investigate whether VZV vaccination can substitute for natural
resensitization by virus disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 19041065 [PubMed - in process]

73: Virus Genes. 2009 Feb;38(1):19-29. Epub 2008 Nov 27.

Genome-wide reduction in transcriptomal profiles of varicella-zoster virus
vaccine strains compared with Parental Oka strain using long oligonucleotide
microarrays.

Grinfeld E, Ross A, Forster T, Ghazal P, Kennedy PG.

Department of Neurology, Division of Clinical Neurosciences, Institute of
Neurological Sciences, Southern General Hospital, Glasgow, G51 4TF, Scotland, UK.

Varicella-Zoster virus (VZV) causes varicella as a primary infection following
which it becomes latent in human ganglia and then reactivates to cause herpes
zoster. VZV vaccines are used to prevent primary infection with varicella, and
also to reduce the incidence of viral reactivation causing herpes zoster and
post-herpetic neuralgia. To gain further insights into the molecular basis of
their attenuated virulence, we used long oligonucleotide microarrays to determine
the lytic transcriptomal profiles of two vaccine VZV strains (Merck and GSK)
compared with the Oka parental (P-Oka) strain. There was a global downregulation 
of transcription of both vaccines relative to P-Oka, although this downregulation
was more extensive in the GSK strain. Open Reading Frames (ORFs) 62 and 14 were
the most transcriptionally downregulated on the arrays for both vaccines compared
with the parental strain.

PMID: 19037717 [PubMed - in process]

74: Ann Hepatol. 2008 Oct-Dec;7(4):382-5.

Multinodular fatty liver after herpes-zoster vaccine: case report and review of
the literature.

Shim M, Durazo F.

North County Gastroenterology Medical Group, Oceanside, California 92056, USA.
mshim@ncgastro.com

Multinodular fatty liver (MNFL) is a pattern of fatty infiltration of the liver
characterized by multiple well-circumscribed nodules on hepatic imaging, often
raising the concern of metastatic malignancy. Here we describe a case of MNFL and
review the published literature. There is likely some association between
traditional risk factors for hepatic steatosis (e.g. alcohol, rapid weight
change, metabolic syndrome, medications, TPN) and MNFL. Further study and
reporting of cases of MNFL are needed to better characterize its pathogenesis and
natural history.

PMID: 19034241 [PubMed - in process]

75: Vet Res Commun. 2008 Nov 22. [Epub ahead of print]

Alcelaphine herpesvirus-1 open reading frame 57 encodes an immediate-early
protein with regulatory function.

Leenadevi T, Dalziel RG.

Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik,
Midlothian, EH26 0PZ, UK.

Alcelaphine herpesvirus-1 (AlHV-1) is the causative agent of Malignant Catarrhal 
fever, a lymphoproliferative and degenerative disease of large ruminants and
ungulate species. The Alcelaphine Herpesvirus-1 gene product encoded by open
reading frame 57 (ORF 57) is the positional homologue of the ORF 57 of Herpes
Virus Saimiri (HVS), Kaposi's Sarcoma associated herpesvirus (KSHV) and Murine
Gammaherpesvirus 68 (MHV 68), the Epstein-Barr virus BMLF1 gene, the herpes
simplex virus (HSV-1) ICP 27 and the IE 4 gene of Varicella Zoster virus (VZV).
In these viruses the ORF 57 gene product is expressed very early and encodes a
regulatory protein, which is essential for viral replication acting both at the
transcriptional and post-transcriptional levels. The function of ORF 57 gene
product in the life cycle of AlHV-1 however remains unknown. Here we examined the
expression of this gene and the function of its product. We have demonstrated
that it is expressed very early in infection and have shown that the ORF57 gene
product activates the promoter of another classical transactivator gene ORF50. It
activates ORF50 promoter driving expression of an intron-less reporter gene to 50
fold and does not have any effect on an intron-containing reporter gene driven by
the ORF 50 promoter. The 50 fold increase in the luciferase activity was not
correlated with a similar fold increase in the luciferase RNA levels indicating
that ORF 57 protein acts at a post-transcriptional level to regulate gene
expression.

PMID: 19031004 [PubMed - as supplied by publisher]

76: Ann Emerg Med. 2008 Nov 22. [Epub ahead of print]

Herpes Zoster and Meningitis Resulting From Reactivation of Varicella Vaccine
Virus in an Immunocompetent Child.

Iyer S, Mittal MK, Hodinka RL.

the Division of Emergency Medicine; The Children's Hospital of Philadelphia,
Philadelphia, PA; the University of Pennsylvania School of Medicine,
Philadelphia, PA.

Herpes zoster complicated by meningitis has been mainly reported in
immunocompromised patients after reactivation of wild-type varicella-zoster
virus. We present one of the first cases of aseptic meningitis after herpes
zoster caused by reactivation of vaccine-type varicella-zoster virus in an
immunocompetent child. We also highlight the increasing role of both wild-type
and vaccine strains of varicella-zoster virus as a cause of viral
meningoencephalitis and the use of appropriate laboratory tools to rapidly and
accurately identify the virus in order to provide prompt patient care and
management.

PMID: 19028409 [PubMed - as supplied by publisher]

77: Presse Med. 2008 Nov 21. [Epub ahead of print]

[Herpes zoster in old adults.]

[Article in French]

Lang PO, Belmin J, Michel JP.

Departement de rehabilitation et geriatrie, Faculte de medecine et Hopitaux
universitaires de Geneve, CH-1226 Thonex-Geneve, Suisse.

The varicella-zoster virus is an exclusively human herpesvirus, responsible for
chickenpox. Its reactivation, after several decades, causes herpes zoster
(shingles). Herpes zoster produces a rash, classically metameric, that causes
acute pain and complications to elderly patients. The last, most painful, and
disabling of these is postherpetic neuralgia. This neuralgia is defined as a
painful syndrome lasting for more than 30 days after eruption of the rash.
Today's systemic antiviral drugs can reduce the severity of the eruption, limit
the pain, and diminish the incidence of postherpetic neuralgia. A recent advance 
in primary prevention is approval of a vaccine (Zostavax((R))) to prevent herpes 
zoster and postherpetic neuralgia in subjects 60 years or older.

PMID: 19028069 [PubMed - as supplied by publisher]

78: Vaccine. 2009 Jan 22;27(4):520-9. Epub 2008 Nov 21.

Herpes zoster burden of illness and health care resource utilisation in the
Australian population aged 50 years and older.

Stein AN, Britt H, Harrison C, Conway EL, Cunningham A, Macintyre CR.

CSL Limited, 45 Poplar Road, Parkville, Victoria 3052, Australia.
alicia.stein@csl.com.au

Incidence of zoster and post-herpetic neuralgia (PHN) and associated health care 
resource utilisation were investigated in the Australian population aged > or =50
years, using general practice data from 2000 to 2006, and pharmaceutical
prescribing, hospital morbidity and emergency department data from 1998 to 2005. 
Zoster and PHN incidence rates were estimated as approximately 10/1000 and
1.45/1000 persons, respectively, with antivirals prescribed for 73.5% of zoster
cases. Estimated hospitalisation and emergency department visit rates were
0.67/1000 and 0.38/1000 persons, respectively. Management of zoster (including
PHN) involved approximately 2.4 general practitioner consultations. Total costs
to the health care system were estimated as approximately 32.8 million per year. 
The substantial burden of zoster and PHN highlights the potential benefit of
zoster vaccination.

PMID: 19027048 [PubMed - in process]

79: Clin Infect Dis. 2009 Jan 1;48(1):e6-8.

Transmission of atypical varicella-zoster virus infections involving palm and
sole manifestations in an area with monkeypox endemicity.

Macneil A, Reynolds MG, Braden Z, Carroll DS, Bostik V, Karem K, Smith SK,
Davidson W, Li Y, Moundeli A, Mombouli JV, Jumaan AO, Schmid DS, Regnery RL,
Damon IK.

National Center for Zoonotic, Vector-Borne, Centers for Disease Control and
Prevention, Atlanta, Georgia 30333, USA. aho3@cdc.gov

During a suspected monkeypox outbreak in the Republic of Congo, we documented
transmission of varicella-zoster virus (VZV) infection with palm and sole
manifestations among 5 family members. Genotyping results confirmed the VZV
strain European E2, a genotype not previously reported in Africa. VZV with palm
and sole involvement should be considered when differentiating a monkeypox
diagnosis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 19025497 [PubMed - indexed for MEDLINE]

80: J Am Acad Dermatol. 2009 Mar;60(3):484-6. Epub 2008 Nov 20.

Atypical presentations of herpesvirus infections in patients with chronic
lymphocytic leukemia.

Khera P, Haught JM, McSorley J, English JC 3rd.

Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh,
Pennsylvania 15213, USA.

The characteristic presentation of herpesvirus infections is a vesicular rash.
The initial lesions appear as erythematous papules that turn into grouped
vesicles and pustules eventuating into crusts. In most cases, the features are so
characteristic that a diagnosis can be made by history and physical examination
without further diagnostic testing. However, patients who are immunosuppressed
(including those with hematologic malignancies) often have atypical presentations
of herpesvirus infections. These cases require a high index of suspicion and
appropriate diagnostic testing for proper management. In this report, we describe
two patients with chronic lymphocytic leukemia who developed atypical
presentations of herpes zoster and herpes simplex infections. Herpetic infections
should always be in the differential diagnosis of cutaneous ulcerations with
necrosis in patients who are immunocompromised. Because of the atypical
appearance of the lesions, the diagnosis may be confused or mistaken for several 
other conditions.

PMID: 19022529 [PubMed - in process]

81: J Virol Methods. 2009 Feb;155(2):161-6. Epub 2008 Dec 2.

Detection of herpesvirus and adenovirus co-infections with diagnostic
DNA-microarrays.

Muller R, Ditzen A, Hille K, Stichling M, Ehricht R, Illmer T, Ehninger G,
Rohayem J.

The Calicilab, Institut fur Virologie, Medizinische Fakultat Carl Gustav Carus,
Dresden, Germany.

In immunocompromised patients, the diagnosis of infections with herpesviruses and
adenoviruses relies mainly on PCR amplification of viral genomic DNA from
clinical samples. In the case of co-infections with two or more viruses, single
amplification of viral DNA from clinical samples has proven to be time-consuming 
and expensive, hampering the efficient diagnosis and therapy of viral
co-infections. In this study, a diagnostic DNA-microarray allowing simultaneous
detection of herpes simplex virus types 1 and 2 (HSV 1/2), varicella zoster virus
(VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus-6 types
A and B (HHV-6 A/B), and adenovirus in clinical samples was developed and
validated. The assay displays a high analytical sensitivity
(10genomeequivalents(GE)/reaction) and specificity, being cost-effective and
time-saving. Because the DNA-microarray uses the same analytical conditions as
real-time quantitative PCR, it can be used as a screening device for multiple
viral infections, followed by selective viral load measurement depending on the
clinical context. Those features make the DNA-microarray an attractive device for
the management of viral infections in immunocompromised patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 19022297 [PubMed - in process]

82: Drugs Aging. 2008;25(12):991-1006. doi: 10.2165/0002512-200825120-00002.

Herpes zoster and postherpetic neuralgia: optimizing management in the elderly
patient.

Johnson RW, Wasner G, Saddier P, Baron R.

Bristol Royal Infirmary and University of Bristol, Bristol, United Kingdom.
r.w.johnson@bris.ac.uk

Herpes zoster (HZ) results from reactivation of varicella-zoster virus (VZV) that
has been persistent and clinically dormant in spinal ganglia or cranial sensory
nerves since primary infection with VZV. The most common reason for reactivation 
is a decline in zoster-specific cell mediated immunity as a result of aging
(immunosenescence). More than two-thirds of HZ cases occur in people >or=60 years
of age. HZ incidence is higher in persons who are immunocompromised as a result
of disease (e.g. malignancies such as lymphoma, HIV/AIDS, diabetes mellitus) or
treatments such as chemotherapy and radiotherapy. HZ incidence is also increased 
by therapeutic immune suppression following organ transplantation and in patients
taking high-dose corticosteroids. However, HZ may occur in otherwise healthy
young people. Although serious and life-threatening complications sometimes
occur, the most common complication is postherpetic neuralgia (PHN), which may
persist for months or years and is significantly resistant to treatment despite
substantial advances in the understanding of its pathological mechanisms. The
medical and social costs of HZ and PHN are high, particularly in older patients. 
Prevention of PHN in patients with HZ is unsatisfactory although antiviral drugs 
reduce the duration of pain after HZ. A live attenuated vaccine has been shown to
reduce the incidence of HZ and PHN as well as the burden of illness in subjects
aged >or=60 years. In view of the increasing numbers of elderly persons in the
population and the poor outcomes of PHN treatment, vaccination against HZ at
approximately 60 years of age appears to be an appropriate strategy.

Publication Types: 
    Review

PMID: 19021299 [PubMed - indexed for MEDLINE]

83: Virology. 2009 Jan 20;383(2):216-25. Epub 2008 Nov 20.

Distribution of varicella-zoster virus (VZV) wild-type genotypes in northern and 
southern Europe: evidence for high conservation of circulating genotypes.

Loparev VN, Rubtcova EN, Bostik V, Tzaneva V, Sauerbrei A, Robo A,
Sattler-Dornbacher E, Hanovcova I, Stepanova V, Splino M, Eremin V, Koskiniemi M,
Vankova OE, Schmid DS.

National VZV Laboratory, Centers for Disease Control and Prevention, Coordinating
Center for Infectious Diseases, National Center for Preparedness, Detection, and 
Control of Infectious Diseases, Atlanta, GA, USA.

Phylogenetic analysis of 19 complete VZV genomic sequences resolves wild-type
strains into 5 genotypes (E1, E2, J, M1, and M2). Complete sequences for M3 and
M4 strains are unavailable, but targeted analyses of representative strains
suggest they are stable, circulating VZV genotypes. Sequence analysis of VZV
isolates identified both shared and specific markers for every genotype and
validated a unified VZV genotyping strategy. Despite high genotype diversity no
evidence for intra-genotypic recombination was observed. Five of seven VZV
genotypes were reliably discriminated using only four single nucleotide
polymorphisms (SNP) present in ORF22, and the E1 and E2 genotypes were resolved
using SNP located in ORF21, ORF22 or ORF50. Sequence analysis of 342 clinical
varicella and zoster specimens from 18 European countries identified the
following distribution of VZV genotypes: E1, 221 (65%); E2, 87 (25%); M1, 20
(6%); M2, 3 (1%); M4, 11 (3%). No M3 or J strains were observed.

PMID: 19019403 [PubMed - indexed for MEDLINE]

84: CJEM. 2008 May;10(3):247-50.

Ramsay Hunt syndrome presenting as simple otitis externa.

Kim D, Bhimani M.

Division of Emergency Medicine, Department of Medicine, University of Toronto,
Toronto, Ontario, Canada. dkim000@gmail.com

Ramsay Hunt syndrome is a rare complication of herpes zoster in which
reactivation of latent varicella zoster virus infection occurs in the geniculate 
ganglion, causing otalgia, auricular vesicles and peripheral facial paralysis.
Because these symptoms do not always present at the onset, this syndrome can be
misdiagnosed. We report the case of a patient who was diagnosed with simple
otitis externa after presenting to the emergency department (ED) with a 3-day
history of right-sided otalgia. Her condition subsequently evolved to include
right-sided auricular vesicles and right-sided facial weakness. She presented to 
the ED again after 2 days and was correctly diagnosed with Ramsay Hunt syndrome. 
We describe the clinical presentation, diagnostic findings and management of this
uncommon but important entity.

Publication Types: 
    Case Reports

PMID: 19019276 [PubMed - indexed for MEDLINE]

85: J Am Geriatr Soc. 2008 Nov;56(11):2160-2.

A rare case of herpes zoster ophthalmicus with complete ophthalmoplegia.

Ying XH, Wagle AM, Tan L, Sanjay S, Hedge SR, Chew YC, Yap P.

Publication Types: 
    Case Reports
    Letter

PMID: 19016960 [PubMed - indexed for MEDLINE]

86: Turk J Pediatr. 2008 Jul-Aug;50(4):342-8.

The evaluation of acquired aplastic anemia in children and unexpected frequency
of varicella-zoster virus association: a single-center study.

Yetgin S, Kuskonmaz B, Aytac S, Cetin M.

Division of Pediatric Hematology, Department of Pediatrics, Hacettepe University 
Faculty of Medicine, Ankara, Turkey.

In this study, 32 patients under the age of 17 years with acquired aplastic
anemia (AAA) were evaluated. Nine patients developed AAA associatedwith viral
infection in which viral hepatitis and varicella infection were nearly equal.
Four of the patients were administered drugs before developing AAA. Patients were
treated as follows: combined immunosuppressive therapy (CIST) including
anti-thymocyte or anti-lymphocyte globulin plus high-dose methylprednisolone
(HDMP) and cyclosporin A and granulocyte colony-stimulating factor (G-CSF) (14
patients); mega-dose (30 mg/kg) methylprednisolone (8 patients); and HDMP
combined with cyclosporin A or anapolon or cyclophosphamide (6 patients).
Complete remission was seen in 10 patients and partial remission in 2 patients.
The response rate was similar in the CIST and MDMP groups. The most striking
findings of this study were the frequent association of AAA withvaricella
infection and the low cure rate, which was due to patient non-compliance with the
treatment and inadequate isolation conditions in the hospital.

Publication Types: 
    Evaluation Studies

PMID: 19014047 [PubMed - indexed for MEDLINE]

87: Medicine (Baltimore). 2008 Nov;87(6):311-8.

Acute viral infections in patients with systemic lupus erythematosus: description
of 23 cases and review of the literature.

Ramos-Casals M, Cuadrado MJ, Alba P, Sanna G, Brito-Zeron P, Bertolaccini L,
Babini A, Moreno A, D'Cruz D, Khamashta MA.

Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, 
Institut d'Investigacions Biomediques August Pi i Sunyer, Hospital Clinic,
Barcelona, Spain. mramos@clinic.ub.es

Few studies have evaluated the impact of viral infections on the daily management
of patients with systemic lupus erythematosus (SLE). We analyzed the etiology and
clinical features of acute viral infections arising in patients with SLE and
their influence on the diagnosis, prognosis, and treatment of SLE. Cases
occurring within the last 5 years were selected from the databases of 3 large
teaching hospitals. Acute viral infections were confirmed by the identification
of specific antiviral IgM antibodies and subsequent seroconversion with detection
of specific IgG antibodies. In autopsy studies, macroscopic findings suggestive
of viral infection were confirmed by direct identification of the virus or
viruses in tissue samples. We performed a MEDLINE search for additional cases
reported between January 1985 and March 2008. We included 88 cases (23 from our
clinics and 65 from the literature review) of acute viral infections in patients 
with SLE. Twenty-five patients were diagnosed with new-onset SLE (fulfillment of 
the 1997 SLE criteria) associated with infection by human parvovirus B19 (n =
15), cytomegalovirus (CMV; n = 6), Epstein-Barr virus (EBV; n = 3), and hepatitis
A virus (n = 1). The remaining 63 cases of acute viral infections arose in
patients already diagnosed with SLE: in 18 patients, symptoms related to
infection mimicked a lupus flare, 36 patients, including 1 patient from the
former group who presented with both conditions, presented organ-specific viral
infections (mainly pneumonitis, colitis, retinitis, and hepatitis), and 10
patients presented a severe, multiorgan process similar to that described in
catastrophic antiphospholipid syndrome-the final diagnosis was hemophagocytic
syndrome in 5 cases and disseminated viral infection in 5. Twelve patients died
due to infection caused by CMV (n = 5), herpes simplex virus (n = 4), EBV (n =
2), and varicella zoster virus (n = 1). Autopsies were performed in 9 patients
and disclosed disseminated herpetic infection in 6 patients (caused by herpes
simplex in 4 cases, varicella in 1, and CMV in 1) and hemophagocytic syndrome in 
3. A higher frequency of renal failure (54% vs. 19%, p = 0.024), antiphospholipid
syndrome (33% vs. 6%, p = 0.023), treatment with cyclophosphamide (82% vs. 37%, p
= 0.008), and multisystemic involvement at presentation (58% vs. 8%, p < 0.001); 
and a lower frequency of antiviral therapy (18% vs. 76%, p < 0.001) were found in
patients who died, compared with survivors. The most common viral infections in
patients with SLE are parvovirus B19 (predominantly mimicking SLE presentation)
and CMV (predominantly presenting in severely immunosuppressed patients). CMV
infection may mimic a lupus flare or present with specific organ involvement such
as gastrointestinal bleeding or pulmonary infiltrates. Other herpesviruses are
common in immunosuppressed SLE patients and may produce a wide range of
manifestations. Physicians should examine the pharynx, eyes, skin, and genitalia 
and should conduct serologic and molecular studies to improve early detection of 
viral infection in patients with SLE.

Publication Types: 
    Review

PMID: 19011502 [PubMed - indexed for MEDLINE]

88: Can J Public Health. 2008 Sep-Oct;99(5):383-6.

Estimating the number needed to vaccinate to prevent herpes zoster-related
disease, health care resource use and mortality.

Brisson M.

Departemente de medecine sociale et preventive, Universite Laval, Quebec, QC.
marc.brisson@uresp.ulaval.ca

BACKGROUND: A clinical trial has shown that a live-attenuated varicella-zoster
virus vaccine is effective against herpes zoster (HZ) and post-herpetic neuralgia
(PHN). The aim of the study was to estimate the number needed to vaccinate (NNV) 
to prevent HZ-related outcomes. METHODS: A cohort model of HZ associated disease,
health care resource use and mortality was developed. Canadian population-based
data were used to estimate age-specific incidence, hospitalization,
quality-adjusted life-year (QALY) lost and mortality. NNV was calculated as the
number of individuals needed to be vaccinated to prevent a specific HZ-related
outcome during their lifetime. Different ages at vaccination were examined and
probabilistic sensitivity analysis was performed. RESULTS: For 65 year olds, the 
NNV (HZ vaccine efficacy=63%, PHN vaccine efficacy=67%, no waning) to prevent a
case of HZ, a case of PHN, a HZ death, a life-year lost and a QALY lost is
estimated to be 11 (90% Crl: 10-13), 43 (90% Crl: 33-53), 23,319 (90% Crl:
15,312-33,139), 3762 (90% Crl: 1650-4629) and 165 (90% Crl: 105-197),
respectively. Results were most sensitive to the duration of vaccine protection
and the age at vaccination. DISCUSSION: The predicted NNV to prevent HZ and PHN
are low even though vaccine efficacy is between 50-70%, which reflects the high
incidence of these diseases among older adults. Results clearly show that the
main benefit of HZ vaccination is prevention of morbidity caused by pain (as
measured by QALYs lost) rather than mortality.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 19009921 [PubMed - indexed for MEDLINE]

89: Br Dent J. 2008 Nov 22;205(10):E20; discussion 562-3. Epub 2008 Nov 14.

Immunisation status of dental practice staff in Kent.

Rhodes A, Aw TC, Allen C, Ridout M.

Health Management Ltd, Ash House, The Broyle, Ringmer, East Sussex, BN8 5NW.

AIM: To determine the hepatitis B, tuberculosis (TB), varicella and rubella
immunisation status of dental practice workers in Kent. METHOD: A cross-sectional
survey using a) a dental practice questionnaire sent to all 275 registered dental
practices in Kent in February 2005, to determine the numbers of staff employed
and their job titles, and b) a confidential personal health questionnaire for
every staff member employed by each practice, to determine past history of
infections and immunisation history. RESULTS: Two hundred out of 257 (78%) dental
practices took part in the survey, and 1,415 staff (76% of known participants)
returned completed personal health questionnaires. Three hundred and eighty-four 
out of 395 dentists (97%) indicated previous immunisation against hepatitis B.
The corresponding percentages for other occupational groups were dental
hygienists (94%), nurses (89%), dental therapists (75%), and other non-clinical
staff (65%). 1,197 (85%) of participants reported previous chicken pox and/or
shingles; 1,208 (85%) gave a history of previous immunisation against TB; and 823
(58%) had either had rubella or were immunised against rubella. Male participants
were less likely to have had rubella immunisation. CONCLUSIONS: The study has
demonstrated the variations in knowledge about personal immunity status amongst
dental practice staff for some infectious diseases. Improvement in establishing
personal immunity status of individual dental care workers and provision of a
vaccination programme could be facilitated. This preventive measure could be
arranged through occupational health providers.

PMID: 19008925 [PubMed - indexed for MEDLINE]

90: Transpl Infect Dis. 2009 Feb;11(1):72-4. Epub 2008 Oct 30.

Unusual presentation of Ramsay Hunt syndrome in renal transplant patients: case
report and literature review.

Mortada RA, El Fakih RO, Assi M.

Department of Medicine, Internal Medicine, University of Kansas School of
Medicine-Wichita, Wichita, Kansas, USA. ramimortada@hotmail.com

Ramsay Hunt syndrome (RHS) is a rare manifestation of varicella zoster virus
(VZV) infection that accounts for around 12% of all cases of facial paralysis.
Although it is more common in immunosuppressed individuals, it has not been yet
reported in kidney transplant recipients. We describe the case of a 41-year-old
man with a history of renal transplant for whom the diagnosis and treatment of
RHS were delayed owing to an unusual presentation. We also review the literature 
on VZV infection in renal transplant patients.

Publication Types: 
    Case Reports
    Review

PMID: 19000154 [PubMed - indexed for MEDLINE]

91: Infect Control Hosp Epidemiol. 2008 Dec;29(12):1157-63.

Herpes zoster-related hospitalizations and expenditures before and after
introduction of the varicella vaccine in the United States.

Patel MS, Gebremariam A, Davis MM.

University of Michigan Medical School, University of Michigan, Ann Arbor,
Michigan, USA.

OBJECTIVE: With childhood varicella vaccination in the United States have come
concerns that the incidence of herpes zoster may increase, because of diminishing
natural exposure to varicella and consequent reactivation of latent varicella
zoster virus. We wanted to estimate the rate of herpes zoster-related
hospitalizations and the associated hospital charges before and during the
promotion of varicella vaccination in the United States. DESIGN: A retrospective 
study of patients from the Nationwide Inpatient Sample for the years 1993-2004
who were hospitalized due to herpes zoster infection. METHODS: We searched for
diagnoses of herpes zoster (using the International Classification of Diseases,
Ninth Revision, Clinical Modification codes starting with 053) in all 15
diagnostic-code fields included for hospital discharges in the Nationwide
Inpatient Sample during 1993-2004. We designed our analysis to examine the rates 
of severe illness due to herpes zoster that resulted in hospitalization, as
measured by the rates of herpes zoster-related hospital discharges (HZHDs). The
annual population-adjusted rate of HZHDs (per 10,000 US population) and the
annual inflation-adjusted total charges for HZHDs were the primary outcomes.
Secondary outcomes included mean charges for HZHDs and the distribution of total 
charges for HZHDs by expected primary payer. Varicella-related hospital
discharges (VRHDs) were identified by use of similar diagnosis-based methods,
which were described in our previous study. RESULTS: Population-adjusted rates of
HZHDs did not change significantly from the prevaccination years (1993-1995)
through the initial 5 years of the varicella vaccination period. Beginning in
2001, however, the rate of HZHDs overall began to increase, and by 2004 the
overall rate was 2.5 HZHDs (95% confidence interval, 2.38-2.62) per 10,000 US
population, significantly higher than any of the rates calculated during the
years prior to 2002. Hospital charges for HZHDs overall increased by more than
$700 million annually by 2004; in particular, we found that the herpes zoster
vaccine-eligible population (ie, persons aged 60 years or older) accounted for
74% of the total annual hospital charges in 2004. The annual rate of VRHDs and
the associated hospital charges decreased significantly from 1993 through 2004,
but the decrease in hospitalizations and charges for VRHDs was less than the
increase in hospitalizations and charges for HZHDs. CONCLUSIONS: As the rates of 
VRHDs and the associated charges have decreased, there has been a significant
increase in HZHDs and associated charges, disproportionately among older adults. 
Herpes zoster vaccine may mitigate these trends for HZHDs.

PMID: 18999945 [PubMed - indexed for MEDLINE]

92: Vaccine. 2009 Jan 7;27(2):192-6. Epub 2008 Nov 7.

Determinants of non-compliance with herpes zoster vaccination in the
community-dwelling elderly.

Opstelten W, van Essen GA, Hak E.

University Medical Center Utrecht, Julius Center for Health Sciences and Primary 
Care, Utrecht, The Netherlands.

As part of a series of studies on vaccine acceptance, we assessed determinants of
compliance of the community-dwelling elderly with herpes zoster (HZ) vaccination 
in an existing influenza vaccination program. General practitioners (GPs) sent
out a questionnaire to 1778 patients aged > or =65 years, and offered them free
HZ vaccination simultaneously with the yearly influenza vaccination. In all, 690 
patients (39%) were vaccinated against HZ; 1349 patients (76%) accepted influenza
vaccination. Determinants of non-compliance with HZ vaccination were perceived
lack of recommendation by the GP, unwillingness to comply with the doctor's
advice, perception of low risk of contracting HZ, perception of short pain
duration of HZ, and the opinion that vaccinations weaken one's natural defenses. 
The same determinants were associated with non-compliance with both vaccinations,
but objections in general towards vaccination, a high education and difficulties 
to visit GPs were also important. Uptake of HZ vaccination was rather low and
more data on (cost-)effectiveness might encourage GPs to offer HZ vaccination to 
their patients.

PMID: 18996427 [PubMed - in process]

93: Int J Dermatol. 2008 Oct;47(10):1087.

Linear IgA dermatosis after herpes zoster; Wolf's isotopic response.

Goksugur N.

Publication Types: 
    Comment
    Letter

PMID: 18986367 [PubMed - in process]

94: MMW Fortschr Med. 2008 Sep 18;150(38):31-4.

[Virus-induced diseases of the external genital region]

[Article in German]

Mohrenschlager M, Ring J, Kohn FM.

Klinik und Poliklinik fur Dermatologie und Allergologie am Biederstein,
Technische Universitat Munchen. moehrenschlager@lrz.tum.de

PMID: 18985902 [PubMed - indexed for MEDLINE]

95: Ugeskr Laeger. 2008 Oct 20;170(43):3435.

[Picture of the month: varicella zoster virus]

[Article in Danish]

Wejse C, Maier C.

Arhus Universitetshospital, Skejby, Infektionsmedicinsk Afdeling. wej@sks.aaa.dk

Publication Types: 
    Case Reports

PMID: 18976602 [PubMed - indexed for MEDLINE]

96: Expert Opin Drug Deliv. 2008 Nov;5(11):1217-30.

Acyclovir delivery systems.

Cortesi R, Esposito E.

University of Ferrara, Department of Pharmaceutical Sciences, CoReS Techno Group,
Via Fossato di Mortara, 19-44100 Ferrara, Italy. crt@unife.it

Herpes viruses (herpes simplex, varicella zoster, cytomegalovirus) are the main
cause of a wide variety of human infections. Although the development of
successful antiviral agents against infections caused by herpes viruses had been 
slow until the last decade, the production of delivery systems for acyclovir are 
a promising alternative. The present review summarizes the principal advances
made in developing carriers for the delivery of acyclovir by different routes of 
administration.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18976132 [PubMed - indexed for MEDLINE]

97: AIDS Read. 2008 Oct;18(10):524-7.

Comment in:
    AIDS Read. 2008 Oct;18(10):526.

Extensive development of flat warts as a cutaneous manifestation of immune
reconstitution syndrome.

Iarikov D, Duke W, Skiest D.

Baystate Medical Center, Tufts University School of Medicine, Springfield,
Massachusetts, USA.

Cutaneous manifestations of immune recovery in response to highly active
antiretroviral therapy may account for up to 54% to 78% of the clinical
presentations of the immune reconstitution syndrome (IRS). Genital herpes,
varicella-zoster virus infection, genital warts, and molluscum contagiosum
represent the majority of these cutaneous manifestations. Inflammation of
preexisting cutaneous warts in response to effective antiretroviral therapy has
rarely been described. We report the case of sudden extensive development of
cutaneous warts, specifically verruca plana confirmed by skin biopsy, observed
following antiretroviral therapy-associated immune reconstitution in a patient
without a history of warts. The possibility of cutaneous IRS after commencement
of antiretroviral therapy should be considered in a patient with unusual skin
manifestations.

Publication Types: 
    Case Reports

PMID: 18975443 [PubMed - indexed for MEDLINE]

98: Virology. 2008 Dec 20;382(2):171-81. Epub 2008 Oct 26.

Discordant varicella-zoster virus glycoprotein C expression and localization
between cultured cells and human skin vesicles.

Storlie J, Carpenter JE, Jackson W, Grose C.

Departments of Microbiology and Pediatrics, University of Iowa, Iowa City, IA
52242, USA.

Because of its very low titer, varicella-zoster virus (VZV) infectivity is
usually transferred by passage of trypsin dispersed infected cells. Previously,
we observed that gC biosynthesis was markedly delayed in monolayers inoculated
with cell free virus. In this report, we investigated the kinetics of gC
expression in more detail and included studies of monolayers inoculated with
trypsin dispersed infected cells, the more traditional method of VZV infection.
Extensive imaging analyses disclosed that gC was detectable in some inoculum
cells, but little gC biosynthesis occurred during the first 48 hpi in the newly
infected underlying monolayer. In contrast, during the first 24-48 hpi,
expression of VZV gE and gB was easily detectable. Using real-time RT-PCR, we
found a delay in accumulation of VZV gC transcripts that paralleled the delay in 
expression of VZV gC protein. Treatment with hexamethylene bisacetamide (HMBA)
increased expression of both gC protein and gC mRNA. HMBA treatment also
increased virus titer by 4-fold, but paradoxically reduced plaque size in the
titration assay. Finally, we examined skin vesicles from cases of chickenpox and 
zoster in humans and observed abundant amounts of gC expression. In short, this
report documents an unexpected delay in both gC mRNA and protein production under
all conditions of VZV infection of cultured cells.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18954885 [PubMed - indexed for MEDLINE]

99: Clin Exp Dermatol. 2008 Nov;33(6):808-10.

A case of zosteriform metastatic skin cancer.

Minakawa S, Nakajima K, Aizu T, Kaimori M, Nomura K.

Department of Dermatology and Clinical Pathology, Aomori Prefectural Central
Hospital, Hirosaki, Aomori, Japan. minakawas@yahoo.co.jp

Publication Types: 
    Case Reports

PMID: 18954423 [PubMed - indexed for MEDLINE]

100: Rev Epidemiol Sante Publique. 2008 Oct;56(5):323-31. Epub 2008 Oct 31.

[Modelling the impact of vaccination on the epidemiology of varicella zoster
virus]

[Article in French]

Bonmarin I, Santa-Olalla P, Levy-Bruhl D.

Departement des maladies infectieuses, institut de veille sanitaire, 12, rue du
Val-d'Osne, 94415 Saint-Maurice, France. i.bonmarin@invs.sante.fr

BACKGROUND: The soon to come the availability of a combined MMR-varicella vaccine
has re-stimulated the debate around universal infant vaccination against
varicella. In France, the incidence of varicella is estimated at about 700,000
cases per year, with approximately 3500 hospitalisations and 15-25 deaths, the
latter mainly occurring in those over 15years. Vaccination would certainly
decrease the overall incidence of the disease but concerns about vaccination
leading to a shift in the average age at infection followed by an increase in
incidence of severe cases and congenital varicella, still remain. In order to
provide support for decision-making, a dynamic mathematical model of varicella
virus transmission was used to predict the effect of different vaccination
strategies and coverages on the epidemiology of varicella and zoster. METHODS: A 
deterministic realistic age-structured model was adapted to the French situation.
Epidemiological parameters were estimated from literature or surveillance data.
Various vaccine coverages and vaccination strategies were investigated. A
sensitivity analysis of varicella incidence predictions was performed to test the
impact of changes in the vaccine parameters and age-specific mixing patterns.
RESULTS: The model confirms that the overall incidence and morbidity of varicella
would likely be reduced by mass vaccination of 12-month-old children. Whatever
the coverage and the vaccine strategy, the vaccination will cause a shift in age 
distribution with, for vaccination coverage up to at least 80% in the base-case
analysis, an increased morbidity among adults and pregnant women. However, the
total number of deaths and hospitalisations from varicella is predicted to remain
below that expected without vaccination. The model is very sensitive to the
matrix of contacts used and to the parameters describing vaccine effectiveness.
Zoster incidence will increase over a number of decades followed by a decline to 
below prevaccination levels. CONCLUSION: Mass varicella vaccination, in France,
will result in an overall reduction of varicella incidence but will cause a shift
in age distribution with an increase in adult cases. Due to the uncertainties in 
key parameters values, the exact magnitude of this shift is difficult to assess.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 18951741 [PubMed - indexed for MEDLINE]

101: Pain Med. 2008 Oct;9(7):958-62.

Facial pain: a possible therapy with stellate ganglion block.

Salvaggio I, Adducci E, Dell'Aquila L, Rinaldi S, Marini M, Zappia L, Mascaro A.

Anaesthesiology and Intensive Care Institute, Catholic University, Medical
School, Rome, Italy. ilaria.salvaggio@tiscali.it

OBJECTIVE: The goal of the present study is to verify the efficacy of stellate
ganglion block (SGB) in the treatment of facial pain that can be found in
different pathological syndromes, and also to examine whether the efficacy is
dependent upon when this therapy is administered. PATIENTS: Fifty patients
(divided into two randomized groups) with facial pain caused by traumas,
iatrogenic issues, herpes zoster, or neurological pathologies participated in
this study. DESIGN AND INTERVENTIONS: The first group (N = 25) was treated with
SGB produced by 10 administrations of 10 mg of levobupivacaine given every other 
day, followed by one administration per month for 6 months thereafter. The second
group was treated with the drugs tramadol 100 mg/day and gabapentin 1800 mg/day
orally for 6 months; during the 7th month they were given SGB therapy using the
same methodology as that described for the first group. RESULTS: Before
treatment, the mean visual analog scale (VAS) pain score for the first group was 
8.89; after the 10th block treatment it was just 0.2, and it remained at that
reduced level for the 6th and 12th months. Before treatment, the mean VAS pain
score for the second group was 8.83; after the 20th day on medication it was
reduced to 4.1, after 6 months it was 5.7 and after 12 months it was 4.9.
CONCLUSIONS: Our results indicate that patients must be treated with SGB therapy 
precociously to receive its full benefits.

Publication Types: 
    Randomized Controlled Trial

PMID: 18950449 [PubMed - indexed for MEDLINE]

102: Arq Neuropsiquiatr. 2008 Sep;66(3B):685-90.

Neurological complications of hematopoietic stem cell transplantation (HSCT): a
retrospective study in a HSCT center in Brazil.

Teive HA, Funke V, Bitencourt MA, de Oliveira MM, Bonfim C, Zanis-Neto J, de
Medeiros CR, Zetola VF, Werneck LC, Pasquini R.

Neurology Service, Internal Medicine Department, Hospital de Clinicas, Federal
University of Parana, Curitiba, PR, Brazil. hagteive@mps.com.br

We present the neurological complications evaluated in a series of 1000 patients 
who underwent hematopoietic stem cell transplantation (HSCT). Central nervous
system (CNS) neurological complications, particularly brain hemorrhages, were the
most common, followed by seizures and CNS infections. An unusual neurological
complication was Wernicke's encephalopathy. Less frequent neurological
complications were metabolic encephalopathy, neuroleptic malignant syndrome,
reversible posterior leukoencephalopathy syndrome, brain infarct and movement
disorders. The most common neurological complication of the peripheral nervous
system was herpes zoster radiculopathy, while peripheral neuropathies,
inflammatory myopathy and myotonia were very rarely found.

PMID: 18949262 [PubMed - in process]

103: J Am Osteopath Assoc. 2008 Oct;108(10):615-21.

Complete ophthalmoplegia with pupillary involvement as an initial clinical
presentation of herpes zoster ophthalmicus.

Delengocky T, Bui CM.

South Texas Retina Consultants in Corpus Christi, McAllen, Tex., USA.
drtd2002@hotmail.com

Complete oculomotor nerve palsy with pupillary involvement is a
neuro-ophthalmologic emergency because it is commonly caused by a compressive
aneurysm at the junction of the posterior communicating artery and the internal
carotid artery. If left untreated, this condition can be potentially fatal within
days. The present report describes a 45-year-old African American woman with
human immunodeficiency virus who presented with complaint of new-onset
nonspecific headache, acute onset of complete oculomotor nerve palsy, and a
dilated pupil of the right eye. Results of standard work-up for aneurysm and
other etiologic factors were negative. Ten days after presentation,
papulovesicular eruptions occurred over the V1 and V2 dermatomes, revealing
herpes zoster ophthalmicus. The present case may be the first to identify a
patient with complete ophthalmoplegia with pupil involvement as a pre-eruptive
manifestation of herpes zoster. The literature on epidemiology, pathogenesis,
clinical presentation, diagnosis, and current treatment options for this rare
form of shingles are reviewed.

PMID: 18948645 [PubMed - in process]

104: Clin Neurol Neurosurg. 2009 Jan;111(1):54-6. Epub 2008 Oct 22.

Association of a history of varicella virus infection with multiple sclerosis.

Rodriguez-Violante M, Ordonez G, Bermudez JR, Sotelo J, Corona T.

Neurodegenerative Diseases Clinical Research Unit, National Institute of
Neurology and Neurosurgery, Mexico City, Mexico.

OBJECTIVE: To analyze the association of a previous history of varicella virus
infection with multiple sclerosis (MS) and its subtypes. MATERIAL AND METHODS: We
performed a case-control study including 126 cases and 157 controls. Subjects
were divided into subgroups according to MS subtype and the history of varicella 
virus infection along with other variables was assessed. RESULTS: History of
varicella zoster virus (VZV) infection was positive in 42% of controls and 66% of
MS cases (p<or=0.001). Patients with a history of VZV infection had a threefold
risk increase of having MS. Regarding MS subtypes, relapsing-remitting (RR) MS
had four times the risk and secondary progressive had a threefold increase in
risk when compared with control patients. CONCLUSIONS: An association between
varicella infection history and MS was found, particularly in the RR subtype.

PMID: 18947921 [PubMed - indexed for MEDLINE]

105: J Virol. 2009 Jan;83(1):228-40. Epub 2008 Oct 22.

Deletion of the first cysteine-rich region of the varicella-zoster virus
glycoprotein E ectodomain abolishes the gE and gI interaction and differentially 
affects cell-cell spread and viral entry.

Berarducci B, Rajamani J, Reichelt M, Sommer M, Zerboni L, Arvin AM.

Institut Pasteur, Department de Virologie, 25 rue du Dr Roux, 75015 Paris,
France. barbara.berarducci@pasteur.fr

Varicella-zoster virus (VZV) glycoprotein E (gE) is the most abundant
glycoprotein in infected cells and, in contrast to those of other
alphaherpesviruses, is essential for viral replication. The gE ectodomain
contains a unique N-terminal region required for viral replication, cell-cell
spread, and secondary envelopment; this region also binds to the
insulin-degrading enzyme (IDE), a proposed VZV receptor. To identify new
functional domains of the gE ectodomain, the effect of mutagenesis of the first
cysteine-rich region of the gE ectodomain (amino acids 208 to 236) was assessed
using VZV cosmids. Deletion of this region was compatible with VZV replication in
vitro, but cell-cell spread of the rOka-DeltaCys mutant was reduced
significantly. Deletion of the cysteine-rich region abolished the binding of the 
mutant gE to gI but not to IDE. Preventing gE binding to gI altered the pattern
of gE expression at the plasma membrane of infected cells and the
posttranslational maturation of gI and its incorporation into viral particles. In
contrast, deletion of the first cysteine-rich region did not affect viral entry
into human tonsil T cells in vitro or into melanoma cells infected with cell-free
VZV. These experiments demonstrate that gE/gI heterodimer formation is essential 
for efficient cell-cell spread and incorporation of gI into viral particles but
that it is dispensable for infectious varicella-zoster virion formation and entry
into target cells. Blocking gE binding to gI resulted in severe impairment of VZV
infection of human skin xenografts in SCIDhu mice in vivo, documenting the
importance of cell fusion mediated by this complex for VZV virulence in skin.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 18945783 [PubMed - indexed for MEDLINE]

106: Br J Dermatol. 2008 Dec;159(6):1217-28. Epub 2008 Sep 25.

The impact of treatment with tumour necrosis factor-alpha antagonists on the
course of chronic viral infections: a review of the literature.

Domm S, Cinatl J, Mrowietz U.

Psoriasis-Center at the Department of Dermatology, University Medical Center
Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105 Kiel, Germany.
sdomm@dermatology.uni-kiel.de

Biologics that antagonize the biological activity of tumour necrosis factor
(TNF)-alpha, namely infliximab, etanercept and adalimumab, are increasingly used 
for treatment of immune-mediated inflammatory diseases, including psoriasis,
worldwide. TNF-alpha antagonists are known to increase the risk of reactivation
and infection, particularly of infections with intracellular bacteria such as
Mycobacterium tuberculosis. More frequently these agents are given to patients
with viral infections. Viral hepatitis and human immunodeficiency virus
infections are often present in these patients, with a considerable geographical 
variation. Other concomitant viral infections such as herpes, cytomegalovirus and
varicella zoster virus may occur much more frequently than tuberculosis or
leprosy. General recommendations about the management related to possible
problems associated with anti-TNF-alpha treatment and these viral infections are 
lacking. This short review will give an overview of the most recent data
available on the effects of anti-TNF-alpha therapy on viral infections with a
particular focus on patient management and screening recommendations.

Publication Types: 
    Review

PMID: 18945310 [PubMed - indexed for MEDLINE]

107: J Coll Physicians Surg Pak. 2008 Oct;18(10):615-9.

Post-transplant outcome in chronic myeloid leukaemia.

Raza S, Ullah K, Ahmed P, Khan B, Kamal MK.

Department of Transplant MED/Haematology, Armed Forces Bone Marrow Transplant
Centre, Rawalpindi.

OBJECTIVE: To determine post-transplant survival in chronic myeloid leukaemia
patients undergoing allogeneic stem cell transplant. STUDY DESIGN: Longitudinal, 
descriptive study. PLACE AND DURATION OF STUDY: Armed Forces Bone Marrow
Transplant Centre, Rawalpindi, Pakistan, between April 2002 and August 2007.
METHODOLOGY: All patients of chronic myeloid leukaemia in chronic phase having
HLA identical donor and age under 55 years, normal hepatic, renal and cardiac
functions with good performance status were selected. Patients in accelerated
phase or blast crisis, poor performance status, impaired hepatic, renal, cardiac 
functions or pregnancy were excluded. Survival was calculated from the date of
transplant to death or last follow-up according to Kaplan-Meier and Cox
(proportional hazard) regression analysis methods. RESULTS: Thirty seven patients
with chronic myeloid leukaemia underwent allogeneic stem cell transplant from HLA
identical sibling donors. Thirty two patients were male and five were females.
Median age of patients was 28 years. All patients and donors were CMV positive.
Post-transplant complications encountered were acute GvHD (Grade II-IV) (n=13,
35.1%), chronic GvHD in 18.9% (n=7), Veno Occlusive Disease (VOD) in 5.4% (n=2), 
acute renal failure in 2.7% (n=1), haemorrhagic cystitis in 2.7% (n=1), bacterial
infections in 40.5% (n=15), fungal infections in 16.2% (n=6), CMV infection in
5.4% (n=2), tuberculosis in 5.4% (n=2), Herpes Zoster infection 2.7% (n=1) and
relapse in 2.7% (n=1). Mortality was observed in 27% (n=10). Major causes of
mortality were GvHD, VOD, septicemia, CMV infection and disseminated
Aspergillosis. Overall Disease Free Survival (DFS) was 73% with a median duration
of follow-up of 47.4 +/-12 months. DFS was 81% in standard risk and 54.5% in
high-risk group. CONCLUSION: Results of allogeneic stem cell transplant in
standard risk group CML patients were good and comparable with other
international centres, however, results in high-risk CML patients need further
improvement, although, number of patients in this group is small.

PMID: 18940118 [PubMed - indexed for MEDLINE]

108: Clin Experiment Ophthalmol. 2008 Jul;36(5):422-5.

Ocular surface squamous neoplasia as the first apparent manifestation of HIV
infection in Malawi.

Spitzer MS, Batumba NH, Chirambo T, Bartz-Schmidt KU, Kayange P, Kalua K, Szurman
P.

Lion's Sight First Eye Hospital, College of Medicine, Blantyre, Malawi.
martin.spitzer@med.uni-tuebingen.de

PURPOSE: To evaluate the prevalence of undiagnosed and asymptomatic HIV infection
in patients with ocular surface squamous neoplasia (OSSN) in an urban patient
population in Malawi. METHODS: A consecutive series of patients presenting with
OSSN was evaluated in an African academic centre. A detailed history and physical
examination in 53 consecutive patients with conjunctival squamous cell carcinoma 
and conjunctival intraepithelial neoplasia were performed. Thirty eight (72%)
patients agreed to undergo serological HIV testing. RESULTS: Seventy-nine per
cent (30 of 38) patients were HIV positive. None of the patients had previous HIV
testing or was aware of having symptoms of HIV. Seventy per cent (n = 21) of the 
HIV-positive patients had no other symptoms suggestive of HIV infection or any
other disease. Patients were far more likely to refuse HIV testing if they were
married and male. CONCLUSIONS: The conjunctival tumour may be the primary and
only apparent manifestation of HIV in patients presenting with OSSN in
Sub-Saharan Africa.

PMID: 18939345 [PubMed - indexed for MEDLINE]

109: Invest Ophthalmol Vis Sci. 2009 Feb;50(2):743-51. Epub 2008 Oct 20.

Human ocular-derived virus-specific CD4+ T cells control varicella zoster virus
replication in human retinal pigment epithelial cells.

Milikan JC, Baarsma GS, Kuijpers RW, Osterhaus AD, Verjans GM.

Institute of Virology, Erasmus Medical Center, Rotterdam, The Netherlands.

PURPOSE: Varicella zoster virus (VZV)-induced retinitis is characterized by the
presence of virus-infected cells in the retinal layer and the ocular infiltration
of VZV-specific T cells. Herein, the susceptibility of human retinal pigment
epithelial (RPE) cells to VZV infection and the ability of virus-specific CD4(+) 
T cells to control VZV infection in RPE cells in vitro is addressed. METHODS:
Human primary RPE cell cultures (n=2) were infected with a VZV strain expressing 
green fluorescent protein. The infection and viability of infected RPE cells was 
monitored by flow cytometry or by a fluorescent imager on RPE monolayers. RPE
cells, pretreated with or without interferon-gamma (IFN-gamma), were infected
with VZV and subsequently cultured with VZV-specific CD4(+) T-cell clones (TCCs; 
n=3) recognizing disparate VZV proteins presented by different HLA class II
alleles. IFN-gamma production and cytotoxicity of the TCCs in response to
VZV-infected RPE cells was determined by flow cytometry. RESULTS: Human RPE cells
are permissive to a productive VZV infection. VZV-infected RPE cells presented
the cognate antigen to the CD4(+) TCCs only if the RPE cells were pretreated with
IFN-gamma and expressed the appropriate HLA class II allele. VZV-specific TCCs
inhibited productive VZV infection in RPE cells, which was in part attributed to 
TCC-mediated killing of the VZV-infected RPE cells. CONCLUSIONS: The results
presented suggest that RPE cells may play a role as retina-resident
antigen-presenting cells in the intraocular, VZV-specific, T cell-mediated
inflammatory response of VZV-induced uveitis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18936136 [PubMed - indexed for MEDLINE]

110: Harefuah. 2008 Aug-Sep;147(8-9):693-7, 751, 750.

[Incorporation of varicella-zoster virus vaccination in childhood immunization
schedules]

[Article in Hebrew]

Rothbart H, Rishpon S.

Northern District Health Office, Nazareth Illit. haim.rotbart@lbr.health.gov.il

Varicella is a highly infectious disease caused by the varicella-zoster virus
(VZV). Usually chickenpox is a self-limiting and relatively mild disease of
childhood, although it is frequently more severe with significant complications, 
and less often, is responsible for case fatalities. Varicella disease is more
severe and its complications are more frequent and severe amongst high risk
groups (neonates, pregnant women and immunocompromised patients). After the
initial infection, the VZV remains dormant in dorsal root ganglia and may
reactivate with declining cellular immunity to cause herpes zoster, particularly 
in the elderly and immunocompromised. Varicella vaccine is an effective
preventive tool for decreasing the burden attributable to the disease and its
complications. The incorporation of VZV vaccination in childhood immunization
schedules was restricted until recently. Nowadays, many countries implement it. A
few years ago, the Israeli Ministry of Health recommended adding the vaccine to
the childhood immunization schedule. This was not enacted because of budgetary
constraints. This is due in September this year, together with an additional dose
of pertussis vaccine for pupils in 8th grade. During the next few years there are
plans for other new vaccines, that are being incorporated in the routine
vaccination programs in developed countries, also to be added to the Israeli
childhood immunization schedule: the conjugated pneumococcal vaccine, the vaccine
against the rotavirus and the HPV vaccine.

Publication Types: 
    English Abstract
    Review

PMID: 18935757 [PubMed - indexed for MEDLINE]

111: Biopolymers. 2009 Jan;91(1):61-7.

Spectroscopic detection and identification of infected cells with herpes viruses.

Erukhimovitch V, Karpasasa M, Huleihel M.

Analytical Equipment Unit, Ben-Gurion University of the Negev, Beer-Sheva,
Israel.

Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and
Fourier transform infrared (FTIR) microspectroscopy were previously applied for
the identification of various biological samples. In the present study, normal
cells in culture and cells infected with herpes simplex virus type 2 (HSV-2) or
varicella-zoster virus (VZV) were analyzed by MALDI-TOF and FTIR microscopy.
Specific spectral biomarkers for rapid and reliable monitoring and identification
of infected cells and probably for the discrimination between these viruses were 
searched. The results show consistent spectral peaks in all examined normal
uninfected human fibroblast cells both in MALDI-T0F and FTIR microscopy. In
HSV-2- or VZV-infected cells, two unique peaks for each appeared at m/z 5397 and 
5813 or at m/z 3501 and 4951, respectively, in MALDI-TOF spectra. In addition,
several peaks that appeared in control uninfected cells at the region m/z
13,000-20,000 disappeared completely in all examined infected samples. When these
infected cells were examined by FTIR microscopy, a band at 859 cm(-1) in control 
uninfected cells was significantly shifted to 854 cm(-1) in both HSV2- and
VZV-infected cells. In addition, phosphate levels were considerably increased in 
all infected cells compared to normal uninfected cells. These parameters could be
used as a basis for developing a spectral method for the detection and
identification of cells infected with herpes viruses.

PMID: 18932269 [PubMed - in process]

112: Leuk Res. 2009 Mar;33(3):366-7. Epub 2008 Oct 18.

Comment on:
    Leuk Res. 2009 Mar;33(3):500-5.

Non-hemic autoimmunity in CLL.

Hamblin TJ.

Non-hemic autoimmune complications of chronic lymphocytic leukemia are very rare 
compared to autoimmune haemolytic anemia, which occurs in between 10% and 20% of 
patients and immune thrombocytopenia, which occurs in between 1% and 2% of
patients. A clear relationship has only been established with three non-hemic
syndromes: acquired angioedema, glomerulonephritis and paraneoplastic pemphigus. 
The first is a result of a secreted product of the tumor, but the last two seem
to be a product of the disordered immune system, and may be triggered by
treatment with purine analogues suggesting a mechanism involving regulatory T
cells. Apart from Herpes Zoster infections, neurological syndromes are rare in
CLL and most have been attributed to either leukemic infiltration of the CNS or
progressive multifocal leukoencephalopathy.

Publication Types: 
    Comment
    Editorial

PMID: 18930543 [PubMed - indexed for MEDLINE]

113: Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2008 Oct;16(5):1130-4.

[Immune reconstitution after allogeneic peripheral blood stem cell
transplantation]

[Article in Chinese]

Hong M, Li JY, Qian SX, Wu HX, Lu H, Zhang R, Zhang XY, Xu W.

Department of Hematology, The First Hospital, Nanjing Medical University, Nanjing
210029, Jiangsu Province, China.

This study was purposed to investigate immune reconstitution at 12 months after
allogeneic peripheral blood stem cell transplantation (all-PBSCT) and its
relation with the influencing factors such as age, HLA compatibility, graft
versus host disease and viral infection. The T lymphocyte subgroups (CD3(+),
CD4(+), CD8(+)), B lymphocyte (CD19(+)) and NK (CD16(+)CD56(+)) cells in
peripheral blood and serum immunoglobulin concentrations (IgG, IgA and IgM) of 37
patients were analyzed by flow cytometry and scatter turbidimetry, respectively
at 1, 3, 6 and 12 months after transplantation. The results showed that CD3(+)
cell percentage was (47.5 +/- 23.2)% at 1 month, (75.1 +/- 6.4)% at 3 months,
(69.7 +/- 12)% at 6 months and (71.7 +/- 4.2)% at 12 months. CD4(+) cell
percentage was (13.3 +/- 6.4)% at 1 month, (20.2 +/- 11.4)% at 3 months, (46.9
+/- 10.3)% at 6 months and (29.1 +/- 18.7)% at 12 months. CD8(+) cell percentage 
was (43.1 +/- 23.2)% at 1 month, (42.6 +/- 16.9)% at 3 months, (69.7 +/- 12)% at 
6 months and (47 +/- 5.6)% at 12 months. CD16(+)56(+) cell percentage was (14.4
+/- 8.4)% at 1 month, (15.9 +/- 7.6)% at 3 months, (14.7 +/- 6.6)% at 6 months
and (13.6 +/- 3.4)% at 12 months. CD19(+) cell percentage was (6.4 +/- 5.6)% at 1
month, (11.7 +/- 2.4)% at 3 months, (13.3 +/- 7.3)% at 6 months and (16.7 +/-
5.7)% at 12 months. The serum concentration of IgA was (0.37 +/- 0.14) g/L at 1
month, (0.28 +/- 0.21) g/L at 3 months, (0.42 +/- 0.18) g/L at 6 months and (0.53
+/- 0.34) g/L at 12 months. The serum concentration of IgG was (12.7 +/- 3.8) g/L
at 1 month, (16.3 +/- 5.2) g/L at 3 months, (14.3 +/- 6.2) g/L at 6 months and
(15.4 +/- 6.9) g/L at 12 months. The serum concentration of IgM was (0.56 +/-
0.24) g/L at 1 month, (0.64 +/- 0.16) g/L at 3 months, (1.1 +/- 0.35) g/L at 6
months and (1.2 +/- 0.28) g/L at 12 months. There were no significant differences
between percentage of T lymphocyte subgroups in peripheral blood and serum
immunoglobulin concentrations of the patients > or = 45 years old and the
patients < 45 years old. The CD19(+) cell percentage of the patients with chronic
GVHD at 12 month was less than that of the other ones at 12 months after
transplantation. CD4(+) and CD19(+) cell percentage recovery in the patients of
haploidentical transplantation was later than that in patients of HLA complete
identical transplantation. The CD4(+)/CD8(+) cell ratio and CD4(+) cell
percentage of those patients infected with herpes zoster were significantly lower
than those without herpes zoster. It is concluded that the CD3(+) cell percentage
begins to recover at 3 months after allo-PBSCT. CD4(+) cell percentage begins to 
recover at 6 months after allo-PBSCT. CD8(+) cell percentage begins to recover at
1 month after allo-PBSCT. B cell percentage recovers at 3 to 6 months after
allo-PBSCT. NK cell percentage recovers at 1 to 3 months after allo-PBSCT. The
serum concentration of IgG recovers to normal at 1 month after transplantation
which is associated with routine infusion of immunoglobulin. The concentration of
IgM gradually recovers to normal at 3 months after transplantation. The
concentration of IgA does not recover to normal at 12 months after
transplantation. The function of B cells recovers slowly in patients with cGVHD. 
The CD4(+) cell absolute value and CD4(+)/CD8(+) ratio significantly decrease in 
patients with herpes zoster.

Publication Types: 
    English Abstract

PMID: 18928611 [PubMed - in process]

114: Med Pregl. 2007;60 Suppl 2:62-5.

[Evaluation of effects of the intravenous cyclophosphamide treatment of primary
glomerulonephritis and the estimation of complications]

[Article in Serbian]

Strazmester-Majstorovic G, Mitic I, Ilic T, Celic D, Milosevic A, Curic S.

Klinika za nefrologiju i klinicku imunologiju, Institut za interne bolesti,
Klinicki centar Vojvodine, Novi Sad. gsmajstorovic@sbb.co.yu

INTRODUCTION: Primary glomerulonephritis can be treated by the intravenous use of
cyclophosphamide. The aim of our study is to evaluate the effect of the drug in
the treatment of mentioned diseases and the follow-up of complications. MATERIAL 
AND METHODS: There are 30 patients included in this study, mean-age of 46.83
years. Renal biopsy was performed in 25 patients. Membranoproliferative
glomerulonephritis was diagnosed in 36.67% of patients, mesangioproliferative in 
16.67%, rapidly progressive in 13,33%, membranous in 10%, chronic in 10%, primary
focal segmental glomerulosclerosis in 3,33% and 10% of patients were unclassified
They have been treated with cyclophosphamide in intermittent "pulse" doses: once 
a month fbr the first 6 months and once in 3 months, for 18 months or longer,
after that. RESULTS AND DISCUSSION: The drug was given in the recommended dose of
0.5-lg/m of body-surface area, in the combination with a low-dose
corticosteroides. Hematological and renal fimnctional tests were checked before
every "pulse" dose. Concerning the development of the renal ailure the fivorable 
effect occurred in 50% of patients. Proteinuria was found in all patients (80%
>3.5 gr/24 h). The favorable effect occurred in 80% patients. At the end, serum
proteins were normal in 76.67% patients. 30% of patients normalized the
erythrocyte sedimentation level. Remission has not been achieved in 23.33% of
patients, 10% of patients developed relapse. 20% of patients died infections were
the most common complication and they occurred in 30% of patients. Sepsis,
leucopenia, Herpes Zoster infection and hemorrhagic cystitis have not occurred in
any patient. Malignant tumor was found in 6.67% of patients.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 18928160 [PubMed - indexed for MEDLINE]

115: Rev Prat. 2008 Sep 15;58(13):1407.

[Trigeminofacial zoster]

[Article in French]

Sene T, Gesquiere-Dando A, Riou B.

Service d'accueil des urgences, groupe hospitalier Pitie-Salpetriere - universite
Pierre-et-Marie-Curie, 75651 Paris Cedex 13, France. thomas_sene1@yahoo.fr

Publication Types: 
    Case Reports

PMID: 18924319 [PubMed - indexed for MEDLINE]

116: Int Ophthalmol. 2008 Oct 14. [Epub ahead of print]

VZV retinal vasculitis without systemic infection: diagnosis and monitoring with 
quantitative polymerase chain reaction.

Wimmersberger Y, Gervaix A, Baglivo E.

Clinique d'Ophtalmologie-Uveitis Department, Hopitaux Universitaires de Geneve,
rue Alcide-Jentzer, 22, 1205, Geneva, Switzerland.

To report a case of unilateral varicella zoster virus (VZV) retinal vasculitis
aspect in an immunocompetent child without systemic infection. Clinically, no
signs of retinal necrosis or frosted branch vasculitis were present. This is an
observational case report. Quantitative PCR was performed on the aqueous humor
(AH) using primers specific for herpes virus (cytomegalovirus, Epstein-Barr
virus, herpes simplex virus 1-2, and VZV). The patient was treated with
intravenous acyclovir, intravitreous ganciclovir, and oral valacyclovir. A
positive quantitative PCR result was found for VZV DNA (1.72 x 10(6) viral
copies/ml) in the AH. After 6 months, PCR of the AH was negative. Herpes viruses 
are involved in the pathogenesis of isolated retinal vasculitis. This case
demonstrates that quantitative PCR is useful to detect viral DNA in AH and to
monitor the viral activity and the therapeutic response.

PMID: 18853105 [PubMed - as supplied by publisher]

117: Neurology. 2008 Oct 14;71(16):1268-74.

Herpetic encephalitis is a risk factor for acute retinal necrosis.

Vandercam T, Hintzen RQ, de Boer JH, Van der Lelij A.

Department of Ophthalmology, University Medical Center Utrecht, Heidelberglaan
100, 3584 CX Utrecht, The Netherlands.

BACKGROUND: Acute retinal necrosis (ARN) has been observed in several cases after
herpetic encephalitis (HE). ARN is a devastating ocular disease with a very
disappointing visual outcome. Therefore, early recognition and diagnosis are
crucial. OBJECTIVE: To study the association between ARN and preceding neurologic
illness, especially the co-occurrence of HE in patients with ARN; to compare the 
causal agent in ARN and HE; and to determine the visual outcome of ARN with HE vs
ARN without HE. METHODS: A retrospective study including ophthalmologic and
neurologic follow-up together with virologic data of patients with ARN.
PARTICIPANTS: Seven patients with ARN diagnosed with a history of HE (13.5%) out 
of a source population of 52 patients with ARN admitted to a major academic
ophthalmologic referral center between 1983 and 2008. RESULTS: In five out of
seven patients unilateral ARN occurred after HE under immunocompetent conditions,
and both ARN and HE were caused by the herpes simplex virus (HSV), whereas the
other two patients were immunocompromised, had bilateral ARN, and both ARN and HE
were caused by the varicella zoster virus (VZV). The latency period between the
HE and the ARN was shorter when VZV was involved than with HSV (5 weeks vs 20.6
months). The visual outcome in patients with ARN with HE, as defined by legally
blind eyes after a follow-up of 1 year, did not differ significantly from
patients with ARN without HE. CONCLUSION: Herpetic encephalitis seems to be a
risk factor for acute retinal necrosis syndrome. Since treatment may improve the 
outcome at least for the second eye, it is relevant for clinicians to be aware of
this association.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18852442 [PubMed - indexed for MEDLINE]

118: Eur J Med Chem. 2008 Sep 11. [Epub ahead of print]

Structure-activity relationships for dipeptide prodrugs of acyclovir:
Implications for prodrug design.

Santos CR, Capela R, Pereira CS, Valente E, Gouveia L, Pannecouque C, De Clercq
E, Moreira R, Gomes P.

CIQUP, Departamento de Quimica, Faculdade de Ciencias, Universidade do Porto, R. 
Campo Alegre 687, P-4169-007 Porto, Portugal.

A series of water-soluble dipeptide ester prodrugs of the antiviral acyclovir
(ACV) were evaluated for their chemical stability, cytotoxicity, and antiviral
activity against several strains of Herpes Simplex-1 and -2, vaccinia, vesicular 
stomatitis, cytomegalovirus and varicella zoster viruses. ACV dipeptide esters
were very active against herpetic viruses, independently of the rate at which
they liberate the parent drug. Their minimum cytotoxic concentrations were above 
100muM and the resulting MCC/EC(50) values were lower than those of ACV. When
comparing the reactivity of Phe-Gly esters and amides (ACV, zidovudine,
paracetamol, captopril and primaquine) in pH 7.4 buffer it was found that the
rate of drug release increases with drug's leaving group ability. Release of the 
parent drug from Phe-Gly in human plasma is markedly faster than in pH 7.4
buffer, thus suggesting that the dipeptide-based prodrug approach can be
successfully applied to bioactive agents containing thiol, phenol and amine
functional groups.

PMID: 18848738 [PubMed - as supplied by publisher]

119: W V Med J. 2008 Sep-Oct;104(5):22-4.

Reactivation of herpes zoster (shingles) infection associated with an increased
risk of death in immunocompetent older persons.

DeLaGarza VW, Arbogast JG, Podolinski CF, Gunel E.

Department of Family Medicine, West Virginia University School of Medicine, USA.

OBJECTIVES: To determine whether cutaneous herpes zoster infection in
immunocompetent older people is correlated with an increased risk for death.
SETTING: Primary care clinics associated with West Virginia University,
Morgantown West Virginia. DESIGN: Case-control study PARTICIPANTS:
Immunocompetent outpatients born from 1903 through 1931, seen from 1994 through
2001; 102 patients diagnosed with herpes zoster (HZV) infection and 201 controls.
The median age of both groups was 75 and the sample size was approximately 5,000.
MEASUREMENTS: Three-year mortality, risk, and age of death after first clinic
visit for herpes zoster. RESULTS: Fourteen deaths occurred in the control group
with a mean age of death of 83.4 and 26 deaths among the subjects with HZV with a
mean age of death of 79.6. This age difference was not statistically significant,
however the age adjusted risk of dying in three years after reactivation of HZV
was 4.9 times the adjusted odds of dying without HZV, controlling for age. (95%
confidence intervals for the ratio of adjusted odds: 2.4-10.44) CONCLUSION: In
this study reactivation of herpes zoster infection was associated with an
increased risk for death in the three years following an infection; deaths were
not directly correlated with such an infection, but occurred for various other
reasons. This suggests that herpes zoster infections may be a marker for early
mortality.

PMID: 18846755 [PubMed - indexed for MEDLINE]

120: Cochrane Database Syst Rev. 2008 Oct 8;(4):CD006851.

Comment in:
    Evid Based Dent. 2008;9(4):116.

Antiviral therapy for Ramsay Hunt syndrome (herpes zoster oticus with facial
palsy) in adults.

Uscategui T, Doree C, Chamberlain IJ, Burton MJ.

A&E Department, Basildon and Thurrock University Hospital, Nethermayne, Basildon,
Essex, UK, SS16 5NL. tere_u@yahoo.com

BACKGROUND: Herpes zoster oticus (HZO) is a viral infection of the ear and when
associated with acute facial paralysis is known as Ramsay Hunt syndrome.
Antiviral agents are the standard first-line treatment for herpes zoster
infections at other body sites and are thought to reduce or minimise nerve
damage, thereby improving outcomes. It has been suggested that these agents
improve the chance of facial weakness improving or resolving completely in
patients with Ramsay Hunt syndrome. OBJECTIVES: To determine the effectiveness of
antiviral agents in the treatment of adult patients with Ramsay Hunt syndrome
(HZO with facial palsy). SEARCH STRATEGY: We searched the Cochrane ENT Disorders 
Group Trials Register, the Cochrane Central Register of Controlled Trials
(CENTRAL) (The Cochrane Library, current issue), Medline (1950 - 2007), PubMed
2007 - 2008, EMBASE (1974 onwards) and other relevant databases. The date of the 
most recent search was June 2008. SELECTION CRITERIA: Two authors scrutinized all
possible citations to identify randomised controlled trials in which antiviral
agents alone or in combination with other therapies (using different routes of
administration and dosage schemes) were given as treatment for Ramsay Hunt
syndrome. We contacted an author for further information. DATA COLLECTION AND
ANALYSIS: Two reviewers independently assessed eligibility and trial quality.
MAIN RESULTS: Only one randomised, controlled trial was identified and included. 
It was of low quality and included only 15 participants. In this 1992 trial,
intravenous acyclovir and corticosteroids were compared with corticosteroids
alone. Our analysis found no statistically significant difference between the two
groups. AUTHORS' CONCLUSIONS: We found no evidence that anti-viral agents have a 
beneficial effect on outcomes in Ramsay Hunt syndrome, despite their widespread
use in this condition. The use of these drugs in patients with herpes zoster
infections in other parts of the body might suggest that they have a role in
herpes zoster oticus. As usual, the absence of positive evidence of benefit (or, 
in this case, the 'negative' result of one small, statistically under-powered
study) does not necessarily indicate that antivirals are ineffective. However,
these drugs are associated with a number of adverse effects and this must be
taken into consideration when undertaking the requisite risk-benefit analysis
before instigating treatment.

Publication Types: 
    Meta-Analysis
    Review

PMID: 18843734 [PubMed - indexed for MEDLINE]

121: Infez Med. 2008 Sep;16(3):144-7.

Anti-varicella-zoster vaccination in contacts of children receiving
antineoplastic chemotherapy: a prospective pilot study.

Timitilli A, Bertoluzzo L, Micalizzi C, Faraci M, Hanau G, Ricci R, Giacchino R, 
Castagnola E.

Unit of Infectious Diseases, G. Gaslini Childrens Hospital, Genoa, Italy.

Varicella may be a severe infection in children with malignancy. Varicella
vaccination is either not recommended for immunocompromised children or it
requires temporary discontinuation of immunosuppression. We prospectively
evaluated the feasibility of a varicella vaccination programme of household
contacts of varicella-negative children receiving antineoplastic chemotherapy.
From April 2004 to April 2005, 207 children were evaluated; in 49 (24 percent)
the attending physicians collected no history about previous varicella and
performed no serological evaluation before any transfusion. Among the 158
patients with complete history and/or a screening test, 51 (32 percent) were
negative, with a total of 110 household contacts eligible for the study. Of
these, 13 (12 percent) subjects resulted negative for varicella. In three of them
vaccination was not performed due to parental refusal. This study demonstrates
the difficulties in implementing a varicella vaccination programme targeting
negative household contacts of immunocompromised children. The attitude of
paediatric oncologists and parental refusal currently represent the main
challenges against the complete success of this strategy in countries where VZV
vaccination is not inserted in the general vaccination programme.

PMID: 18843211 [PubMed - indexed for MEDLINE]

122: J Dermatol. 2008 Sep;35(9):585-9.

Ecthyma gangrenosum without pseudomonas septicemia in a kidney transplant
recipient.

Nakai N, Takenaka H, Kishimoto S.

Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural 
University of Medicine, Kyoto, Japan. nnakai@koto.kpu-m.ac.jp

We report a case of ecthyma gangrenosum (EG) without septicemia in a renal
transplant recipient who presented with a 1-month history of painful ulcers,
vesicles and bullae on the face and extremities. Histopathological findings
revealed subepidermal bullae covered by a necrotic epidermis containing an
infiltrate of a moderate number of lymphocytes, neutrophils and necrotic
collagen. Many dilated and congested capillaries were also present due to thrombi
beneath the bullae, with alteration of collagen fibers through the superficial to
middle dermis with some infiltrate. A culture from the ulcers revealed the
presence of Pseudomonas aeruginosa and methicillin-resistant Staphylococcus
aureus, whereas the results of repeated blood cultures were negative. The ulcers 
were completely cured by early appropriate i.v. antibiotic therapy with
granulocyte colony-stimulating factor, without progression to EG with septicemia.
An immunocompromised state due to immunosuppressive drugs, in addition to
diabetes mellitus, hypogammaglobulinemia and hypoproteinemia, may have caused the
EG and herpes zoster may have exacerbated the condition.

Publication Types: 
    Case Reports

PMID: 18837704 [PubMed - indexed for MEDLINE]

123: Acta Otolaryngol. 2008 Oct 3:1-6. [Epub ahead of print]

Correlation between enhanced MRI and surgical findings in herpes zoster oticus.

Kim J, Chung SM, Moon IS, Lee HK, Lee WS.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, 
Korea.

Conclusion: This study demonstrates good correlation between enhanced MRI and
surgical findings. Objectives: This study investigated the reliability of
enhanced magnetic resonance imaging (MRI) to make a surgical decision on the
strategy for facial nerve decompression in herpes zoster oticus, by determining
the degree of correlation between contrast enhancement in MRI and the pathologic 
change in the facial nerve. Subjects and methods: This retrospective study of 13 
patients, who underwent facial nerve decompression with herpes zoster oticus, was
designed to compare gadolinium-enhanced segment of facial nerve on MRI and the
pathologically changed segment confirmed by surgical exploration, grouping them
by the timing of operation after onset of facial paralysis. Results: Commonly
enhanced segments on MRI were the labyrinthine, intracanalicular, and geniculate 
ganglion, found in 84%, 69%, and 69% of all patients, respectively. The most
common pathologic segment was the labyrinthine segment (92%), followed by the
geniculate ganglion (84%).

PMID: 18836966 [PubMed - as supplied by publisher]

124: Eye. 2008 Oct 3. [Epub ahead of print]

Herpes zoster ophthalmicus complicated by incomplete ophthalmoplegia and a
neurotrophic ulcer.

Drew B, Ibrahim K, Reddy MA.

1Department of Ophthalmology, Royal London Hospital, London, UK.

PMID: 18836413 [PubMed - as supplied by publisher]

125: Bioorg Med Chem. 2008 Nov 1;16(21):9536-45. Epub 2008 Sep 13.

Influence of 6- or 8-substitution on the antiviral activity of
3-arylalkylthiomethylimidazo[1,2-a]pyridine against human cytomegalovirus (CMV)
and varicella-zoster virus (VZV): part II.

Veron JB, Allouchi H, Enguehard-Gueiffier C, Snoeck R, Andrei G, De Clercq E,
Gueiffier A.

PCMB EA 4244, Faculte de Pharmacie, Universite Francois Rabelais, 31 avenue
Monge, 37200 Tours, France.

The synthesis of original imidazo[1,2-a]pyridines bearing a thioether side chain 
at the 3 position and diversely substituted on the 6 or 8 position, and their
antiviral activities are reported. From the synthesized compounds, the
imidazo[1,2-a]pyridines bearing a 5 membered heterocycle (thiophene, furane or
pyrrole) in the 6 position or a phenylthio group in the 6 or 8 position were the 
most potent against human cytomegalovirus (CMV) and varicella-zoster virus (VZV),
whereas several other congeners, while less potent, were more selective in their 
inhibitory activity against VZV and CMV. These compounds showed similar activity 
against thymidine kinase competent (TK+) and deficient (TK-) VZV strains,
demonstrating a mechanism of action independent of the viral thymidine kinase.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18835175 [PubMed - indexed for MEDLINE]

126: Am J Ophthalmol. 2009 Jan;147(1):140-147.e2. Epub 2008 Oct 2.

Comment in:
    Am J Ophthalmol. 2009 Jan;147(1):5-7.

Polymerase chain reaction analysis of aqueous and vitreous specimens in the
diagnosis of posterior segment infectious uveitis.

Harper TW, Miller D, Schiffman JC, Davis JL.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami
Miller School of Medicine, Miami, Florida, USA.

PURPOSE: To assess polymerase chain reaction (PCR) analysis of intraocular fluid 
as a test for infectious uveitis of the posterior segment in a representative
patient population. DESIGN: Retrospective, interventional case series. METHODS:
One hundred and thirty-three patients with possible infectious chorioretinitis
underwent PCR testing of aqueous or vitreous in a university setting. Baseline
characteristics predictive of test positivity were identified. Positive and
negative predictive values were calculated. RESULTS: Four hundred and
thirty-three PCR tests of 105 aqueous and 38 vitreous specimens (mean, 3.3 tests 
per patient) identified 77 of the 95 patients with a final clinical diagnosis of 
infectious uveitis (81%). Herpes simplex virus, varicella zoster virus, and
cytomegalovirus PCR analysis were performed in almost all cases, with fewer tests
for toxoplasmosis or Epstein-Barr virus. Clinical features associated with
positive PCR results were retinal vascular inflammation (P < .001), optic nerve
involvement (P = .008), immunocompromised state (P = .039), and extensive
retinitis (P = .002). Cases sampled within one week of presentation were more
likely to have positive PCR results than those sampled later (P = .071). The
predictive value of positive and negative tests was 98.7% and 67.9%,
respectively, in this patient group. Alteration in treatment based on PCR and
syphilis serologic results led to resolution in 25 of 26 patients after treatment
was changed. CONCLUSIONS: PCR testing is a useful adjunct in the diagnosis of
infectious causes of posterior uveitis. Cases with vascular or optic nerve
inflammation, extensive retinitis, or immunocompromise are more likely to have
positive PCR results and may benefit from PCR testing of aqueous humor.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18834576 [PubMed - indexed for MEDLINE]

127: G Ital Dermatol Venereol. 2008 Feb;143(1):88.

Zosteriform lichen planus.

Colasanti P.

Publication Types: 
    Case Reports
    Letter

PMID: 18833057 [PubMed - indexed for MEDLINE]

128: G Ital Dermatol Venereol. 2008 Apr;143(2):119-23.

A novel vaccine (Zostavax) to prevent herpes zoster.

Holcomb K, Weinberg JM.

Department of Dermatology, St. Luke's-Roosevelt Hospital Center, Beth Israel
Medical Center, New York, New York 10025, USA.

Varicella-zoster virus is the causal agent of varicella and herpes zoster (HZ) in
humans. HZ results from reactivation of latent varicella-zoster virus (VZV)
within the sensory ganglia. The incidence and severity of HZ increase with
advancing age; more than half of all persons in whom HZ develops are older than
60 years. The most frequent debilitating complication is postherpetic neuralgia, 
a neuropathic pain syndrome that persists or develops after the dermatomal rash
has healed, and can be prolonged and disabling. There are many limitations of the
current therapies for HZ and postherpetic neuralgia. A live attenuated VZV
vaccine has been developed and recently approved by the United States Food and
Drug Administration (FDA) and the European Union for the prevention of HZ in
individuals 60 years of age and older. In a randomized, double-blind,
placebo-controlled trial 38,546 adults of 60 years of age or older, the use of
the HZ vaccine reduced the burden of illness due to HZ by 61.1% (P<0.001),
reduced the incidence of postherpetic neuralgia by 66.5% (P<0.001), and reduced
the incidence of HZ by 51.3% (P<0.001). In this review, the authors will discuss 
the history of the use of the varicella vaccine in children, and the subsequent
development of the new HZ vaccine.

Publication Types: 
    Review

PMID: 18833038 [PubMed - indexed for MEDLINE]

129: Clin Infect Dis. 2008 Nov 1;47(9):1235-6; author reply 1236-7.

Erratum in:
    Clin Infect Dis. 2008 Dec 15;47(12):1611.

Comment on:
    Clin Infect Dis. 2008 May 1;46(9):1452-4.

Relationship between shingles (varicella zoster) and hypercalcemia not found.

Rafeiner P, Henz S, Boggian K.

Publication Types: 
    Comment
    Letter

PMID: 18831701 [PubMed - indexed for MEDLINE]

130: Time. 2008 Jul 28;172(4):53.

Rash redux. Why chicken pox strikes some adults a second time--as shingles--and
how to avoid the repeat.

Gupta S.

Publication Types: 
    News

PMID: 18831097 [PubMed - indexed for MEDLINE]

131: Geriatrics. 2008 Oct;63(10):6-9.

Herpes zoster virus vaccine.

Woolery WA.

Department of Family and Community Medicine, School of Medicine, Mercer
University, Macon, GA, USA.

Varicella zoster virus (VZV) is the etiologic agent of varicella and herpes
zoster (HZ) in humans. Herpes zoster is the result of reactivation of VZV within 
certain sensory ganglia. The burden of illness from HZ and post-herpetic
neuralgia (PHN) is high. Herpes-zoster vaccine contains live attenuated
varicella-zoster virus in an amount approximately 14 times greater than that
found in the varicella virus vaccine. Herpes zoster vaccine is approved for the
prevention of shingles in appropriate persons aged 60 and older. The vaccine is
administered in a single subcutaneous dose. Reported side effects are mild and
generally limited to localized injection site findings. Herpes-zoster vaccine
reportedly decreases the occurrence of herpes zoster by approximately 50 percent 
and prevents the development of PHN by two thirds. The vaccine appears to be
minimally effective in those individuals over the age of 80 and is not
recommended in this age group.

Publication Types: 
    Review

PMID: 18828650 [PubMed - indexed for MEDLINE]

132: J Infect Dis. 2008 Nov 15;198(10):1444-7.

Herpes zoster with skin lesions and meningitis caused by 2 different genotypes of
the Oka varicella-zoster virus vaccine.

Levin MJ, DeBiasi RL, Bostik V, Schmid DS.

Department of Pediatrics, University of Colorado Health Sciences Center, Denver, 
CO 80045-0508, USA. myron.levin@uchsc.edu

A previously healthy boy who had received varicella vaccine developed herpes
zoster with meningitis. The vaccine strain recovered from scabs of 3 skin lesions
had the wild-type allele at position 108111, a vaccine marker never previously
associated with vaccine-associated adverse events. The vaccine strain from
cerebrospinal fluid also contained mutations never previously observed at
vaccine-associated single nucleotide polymorphisms that would alter amino acid
sequences in ORF54 and ORF59. The presence of distinct strains in skin lesions
and cerebrospinal fluid indicate that >1 variant strain may reactivate to cause
herpes zoster.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 18826373 [PubMed - indexed for MEDLINE]

133: J Clin Virol. 2009 Jan;44(1):9-14. Epub 2008 Sep 27.

Comparison of the performance of the LIAISON VZV-IgG and VIDAS automated enzyme
linked fluorescent immunoassays with reference to a VZV-IgG time-resolved
fluorescence immunoassay and implications of choice of cut-off for LIAISON assay.

Maple PA, Rathod P, Smit E, Gray J, Brown D, Boxall EH.

Virus Reference Department, HPA Centre for Infections, Colindale, London, United 
Kingdom.

BACKGROUND: Determination of Varicella Zoster virus (VZV) immune status in
pregnant women without history of chickenpox is important in identifying those
who genuinely need VZV immune globulin prophylaxis following significant exposure
to chickenpox or shingles. Immune status testing requires highly sensitive and
specific immunoassays for timely and accurate results. OBJECTIVES: To compare the
performance of DiaSorin LIAISON and Biomerieux VIDAS VZV-IgG assays with
reference to a VZV-IgG time-resolved fluorescence immunoassay (TRFIA). STUDY
DESIGN: A panel of sera collected from 65 pregnant contacts of VZV and 62
individuals tested for VZV immunity was tested in all three assays. Dose-response
curves were generated using International Standards W1044 and 90/690. RESULTS:
Sensitivity and specificity of VIDAS compared to VZV-TRFIA was 54.5% and 97.9%
respectively and for LIAISON compared to VZV-TRFIA was 67% and 100% respectively.
Both assays correlated well with TRFIA with R2 correlation coefficients of 0.79
and 0.76 respectively. Dose-response curves showed both Standards behaved in a
similar manner in each assay. For VIDAS, the test cut-off value of 0.9 correlated
with 275-280mIU/ml and for LIAISON a cut-off value of 150mIU/ml correlated with
208-219mIU/ml. CONCLUSIONS: By dose-response data and in comparison with TRFIA,
LIAISON is more sensitive and specific than VIDAS.

PMID: 18823815 [PubMed - in process]

134: Arthritis Rheum. 2008 Oct;58(10):2949-57.

Viral infection and reactivation in autoimmune disease.

Chakravarty EF.

Division fo Immunology and Rheumatology, Stanford University School of Medicine, 
Palo Alto, California 94304, USA. echakravarty@stanford.edu

Publication Types: 
    Review

PMID: 18821704 [PubMed - indexed for MEDLINE]

135: J Virol. 2008 Dec;82(23):11723-33. Epub 2008 Sep 24.

Cellular transcription factors Sp1 and Sp3 suppress varicella-zoster virus
origin-dependent DNA replication.

Khalil MI, Hay J, Ruyechan WT.

Department of Microbiology and Immunology and Witebsky Center for Microbial
Pathogenesis and Immunology, University at Buffalo, The State University of New
York, Buffalo, New York 14214, USA.

The varicella-zoster virus (VZV) origin of DNA replication (oriS) contains a
46-bp AT-rich palindrome and three consensus binding sites for the VZV origin
binding protein (OBP) encoded by VZV ORF51. All three OBP binding sites are
upstream of the palindrome in contrast to the sequence of the herpes simplex
virus oriS, which has required OBP binding sites upstream and downstream of the
AT-rich region. We are investigating the roles that sequences downstream of the
palindrome play in VZV oriS-dependent DNA replication. Computer analysis
identified two GC boxes, GC box 1 and GC box 2, in the downstream region which
were predicted to be binding sites for the cellular transcription factor Sp1.
Electrophoretic mobility shift assay and supershift assays showed that two
members of the Sp family (Sp1 and Sp3) stably bind to GC box 1, but not to GC box
2. A predicted binding site for the cellular factor Yin Yang 1 (YY1) that
overlaps with GC box 2 was also identified. Supershift and mutational analyses
confirmed the binding of YY1 to this site. Mutation of GC box 1 resulted in loss 
of Sp1 and Sp3 binding and an increase in origin-dependent replication efficiency
in DpnI replication assays. In contrast, mutation of the YY1 site had a
statistically insignificant effect. These results suggest a model where
origin-dependent DNA replication and viral transcription are coupled by the
binding of Sp1 and Sp3 to the downstream region of the VZV replication origin
during lytic infection. They may also have implications regarding establishment
or reactivation of viral latency.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18815296 [PubMed - indexed for MEDLINE]

136: Br J Dermatol. 2008 Nov;159(5):1212-3. Epub 2008 Sep 20.

Risk of herpes zoster infection in patients with pemphigus on mycophenolate
mofetil.

Saha M, Black MM, Groves RW.

Publication Types: 
    Letter

PMID: 18811686 [PubMed - in process]

137: Transpl Infect Dis. 2009 Feb;11(1):64-7. Epub 2008 Sep 21.

Community-acquired methicillin-resistant Staphylococcus aureus endomyocardial
abscesses in a heart transplant recipient.

Oyler A, Riveros-Angel M, Shaw K, Forrest GN.

School of Medicine, Division of Infectious Diseases, University of Maryland,
Baltimore, Maryland, USA.

Infective endocarditis is more common in heart transplant recipients than in the 
general population. We report a case of endomyocardial abscesses and sepsis
syndrome due to community-acquired methicillin-resistant Staphylococcus aureus
(MRSA) in a heart transplant recipient with a negative transesophageal
echocardiogram. The suspected portal of entry for this MRSA infection was through
infected herpes zoster lesions. This case demonstrates the difficulty of
diagnosing endomyocardial abscesses in heart transplant patients.

Publication Types: 
    Case Reports

PMID: 18811630 [PubMed - indexed for MEDLINE]

138: Gen Dent. 2008 Sep-Oct;56(6):563-6; quiz 567-8, 591-2.

Prevention and management of trigeminal herpes zoster and postherpetic neuralgia.

Closmann JJ, Fielding CG, Pogrel MA.

Oral and Maxillofacial Surgery Residency, Tripler Army Medical Center, Tripler
AMC, Hawaii, USA.

Herpes zoster (HZ, also known as shingles) is caused by the reactivation of a
dormant varicella zoster virus and can be a source of significant morbidity. Oral
manifestations can include vesicular eruptions of the mucosa, osteonecrosis with 
tooth loss, and postherpetic neuralgia (PHN). This article discusses treatment
for trigeminal nerve involvement with herpes zoster, as well as for the painful
syndrome PHN.

PMID: 18810918 [PubMed - indexed for MEDLINE]

139: Handb Clin Neurol. 2006;81:653-9.

Chapter 43 Acute herpes zoster pain.

Haanpaa M.

PMID: 18808865 [PubMed - in process]

140: J Vector Borne Dis. 2008 Sep;45(3):251-3.

Reactivation of Herpes zoster in an adult with Plasmodium infection.

Regunath H, Shivashankara KN, Sundeep KB, Bhaskar AP.

Department of Medicine, Kasturba Medical College, Manipal, India.
k_madhs@yahoo.com

Publication Types: 
    Case Reports

PMID: 18807384 [PubMed - indexed for MEDLINE]

141: Am J Phys Med Rehabil. 2008 Oct;87(10):859-61.

Axillary mononeuropathy after herpes zoster infection mimicking subacromial
impingement syndrome.

Aktas I, Akgun K, Gunduz OH.

Marmara University Institute of Neurological Sciences, Istanbul, Turkey.

Subacromial impingement syndrome is a frequent cause of shoulder pain and it is
readily confused with other shoulder problems. We present a patient with herpes
zoster infection associated with axillary mononeuropathy that was initially
misdiagnosed as subacromial impingement syndrome. A 75-yr-old female patient was 
admitted to the internal medicine clinic because of pain and weakness in her
right shoulder. As she did not respond to medical treatment and local injection
therapy, magnetic resonance imaging of the right shoulder was ordered. As the
magnetic resonance imaging revealed subacromial impingement of the supraspinatus 
tendon, the patient was referred to the physical medicine and rehabilitation
department for rehabilitation. In our initial physical examination, her shoulder 
abductor muscle strength was 2/5 and her shoulder external rotator muscle
strength was 3/5. A subacromial injection test with 10 ml of 1% lidocain was
negative and the magnetic resonance imaging did not show a complete rotator
tendon rupture that could explain such a muscle strength loss. So, an
electrodiagnostic evaluation was performed and the patient was diagnosed to have 
a right axillary neuropathy. A more detailed questioning of the patient disclosed
a history of herpes zoster approximately 3 mos ago. Herpes zoster-associated
axillary neuropathy can mimic subacromial impingement syndrome, and magnetic
resonance imaging examination alone may lead to a misdiagnosis. Therefore, we
imply that clinical and electrophysiological evaluations would be of great
importance in relevant patients with shoulder problems.

Publication Types: 
    Case Reports

PMID: 18806513 [PubMed - indexed for MEDLINE]

142: Am J Phys Med Rehabil. 2008 Oct;87(10):853-8.

Zoster sine herpete with thoracic motor paralysis temporally associated with
thoracic epidural steroid injection.

Schuchmann JA, McAllister RK, Armstrong CS, Puana R.

Department of Physical Medicine and Rehabilitation, Scott & White Memorial
Hospital, Texas A&M Health Sciences Center College of Medicine, Temple, Texas
76508, USA.

Reactivation of latent varicella-zoster virus can occur when the immune system is
weakened leading to the typical presentation seen with herpes zoster or shingles.
In a small percentage of these patients, motor paralysis can be seen in the
affected myotomal distribution. Zoster sine herpete, or shingles without the
typical vesicular rash, is an uncommon variant of zoster. Systemic steroids are
known to weaken the immune response. Two previous case reports have implicated
epidural steroid injections as a precipitating cause of zoster.We present a case 
of serologically verified zoster sine herpete producing an abdominal wall bulge, 
which occurred 1 wk after thoracic epidural steroid injection. Electromyography
documented the presence of abdominal wall denervation. Given the low incidence of
serologically proven zoster sine herpete--especially with thoracic motor
paralysis--and the equally rarely documented incidence of zoster related to
epidural steroids, we present what we believe to be the first reported case of
zoster sine herpete with a neuropathic abdominal wall bulge occurring in close
temporal association to receiving epidural steroids.

Publication Types: 
    Case Reports

PMID: 18806512 [PubMed - indexed for MEDLINE]

143: J Neurol Sci. 2009 Jan 15;276(1-2):184-6. Epub 2008 Sep 20.

Aquaporin-4 antibody positive longitudinally extensive transverse myelitis
following varicella zoster infection.

Heerlein K, Jarius S, Jacobi C, Rohde S, Storch-Hagenlocher B, Wildemann B.

Division of Molecular Neuroimmunology, Department of Neurology, University of
Heidelberg, Germany.

Longitudinally extensive transverse myelitis (LETM) is a condition shown to
confer high risk of conversion into neuromyelitis optica (NMO). Increasing
evidence from immunological and histopathological studies suggests that LETM is
an autoimmune disorder caused by pathogenic antibodies to aquaporin-4 (AQP4-Ab), 
the most abundant water channel in the CNS, at least in a subset of patients.
However, cases of infectious or parainfectious NMO/LETM (mostly associated with
herpes zoster) have been repeatedly reported in the previous literature, raising 
the question of aetiological diversity in NMO/LETM. Here we present a case of
acute LETM in a 63-year-old patient occurring two weeks after reactivation of
varicella zoster virus (VZV). Serological testing revealed antibodies to AQP4.
Plasma exchange was paralleled by disappearance of AQP4-Ab and sustained clinical
improvement. Our observations provide further evidence for a pathogenic role of
AQP4-Ab in LETM and suggest that AQP4-Ab associated auto-immunity should be
considered also in apparently infectious/parainfectious settings.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18805556 [PubMed - in process]

144: Med J Aust. 2008 Sep 15;189(6):347.

Comment on:
    Med J Aust. 2008 Feb 4;188(3):171-6.

The prevention and management of herpes zoster.

Senanayake SN.

Publication Types: 
    Comment
    Letter

PMID: 18803546 [PubMed - indexed for MEDLINE]

145: Clin Exp Dermatol. 2008 Aug;33(5):677-8.

Postherpetic abdominal-wall pseudohernia.

Dobrev H, Atanassova P, Sirakov V.

Department of Dermatology, Medical University, Plovdiv, Bulgaria.
hristo_dobrev@hotmail.com

Publication Types: 
    Case Reports

PMID: 18801105 [PubMed - indexed for MEDLINE]

146: J Eur Acad Dermatol Venereol. 2008 Sep 12. [Epub ahead of print]

Sarcoid tissue reaction on herpes zoster scars in a myelodysplastic syndrome
patient: Wolf's isotopic response.

Watanabe D, Kuhara T, Ishida N, Tamada Y, Matsumoto Y.

Department of Dermatology, Aichi Medical University, Nagakute, Aichi, Japan Tel: 
+81 561 62 3311 (ext. 2161); Fax: +81 561 63 9914.

PMID: 18793243 [PubMed - as supplied by publisher]

147: AAOHN J. 2008 Sep;56(9):404.

Herpes zoster in the workplace.

Chalupka S.

Department of Nursing, University of Massachusetts, Lowell, MA, USA.

PMID: 18792615 [PubMed - indexed for MEDLINE]

148: Eur J Immunol. 2008 Sep;38(9):2377-85.

Langerhans cells and viral immunity.

Cunningham AL, Carbone F, Geijtenbeek TB.

Centre for Virus Research, Westmead Millennium Institute and University of
Sydney, Westmead, Sydney, Australia. tony_cunningham@wmi.usyd.edu.au

Langerhans cells (LC) are a unique dendritic cell subset that are located in
mucosal stratified squamous epithelium and skin epidermis. Their location is
ideally suited for their function as antigen presenting cells that capture
invading viruses and induce anti-viral immunity. However, it is becoming evident 
that the interaction between LC and viruses can result in different responses,
depending on the virus and the receptors involved. Here we will discuss the
recent data on the similarities and differences in roles of LC in viral immunity 
to and infection with HIV, herpes simplex and varicella-zoster virus. Although
all three viruses interact with LC during initial infection, the effects can be
quite different, reflecting differences in biology and pathogenesis.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18792031 [PubMed - indexed for MEDLINE]

149: J Clin Neurosci. 2008 Nov;15(11):1246-52. Epub 2008 Sep 11.

Differential diagnosis of intraspinal and extraspinal non-discogenic sciatica.

Kulcu DG, Naderi S.

Department of Physical Medicine and Rehabilitation, Yeditepe University School of
Medicine, Yeditepe University Hospital, Devlet Yolu Ankara Caddesi No. 102/104
Kozyatagi, Istanbul, Turkey. d_geler@yahoo.com.tr

The aim of this study is to present a series of 11 patients with non-discogenic
sciatica (NDS), and to review the diagnostic techniques of careful clinical and
radiological examination. The cases include lumbar radicular herpes zoster,
lumbar nerve root schwannoma, lumbar instability, facet hypertrophy, ankylosing
spondylitis, sacroiliitis, sciatic neuritis, piriformis syndrome, intrapelvic
mass and coxarthrosis. The pain pattern and accompanying symptoms were the major 
factors suggesting a non-discogenic etiology. Pelvic MRI and CT scans, and
sciatic nerve magnetic resonance neurography were the main diagnostic tools for
diagnosis of NDS. The treatment of choice depended on the primary diagnosis.
Detailed physical examinations with special attention paid to the extraspinal
causes of sciatica and to pain characteristics are the major components of
differential diagnosis of NDS.

PMID: 18789864 [PubMed - in process]

150: Am J Phys Med Rehabil. 2008 Dec;87(12):992-7.

Cutaneous electrical stimulation treatment in unresolved facial nerve paralysis: 
an exploratory study.

Hyvarinen A, Tarkka IM, Mervaala E, Paakkonen A, Valtonen H, Nuutinen J.

Department of Oto-Rhino-Laryngology, University of Kuopio, Kuopio University
Hospital, Kuopio, Finland.

OBJECTIVE: The purpose of this study was to assess clinical and
neurophysiological changes after 6 mos of transcutaneous electrical stimulation
in patients with unresolved facial nerve paralysis. DESIGN: A pilot case series
of 10 consecutive patients with chronic facial nerve paralysis either of
idiopathic origin or because of herpes zoster oticus participated in this open
study. All patients received below sensory threshold transcutaneous electrical
stimulation for 6 mos for their facial nerve paralysis. The intervention
consisted of gradually increasing the duration of electrical stimulation of three
sites on the affected area for up to 6 hrs/day. Assessments of the facial nerve
function were performed using the House-Brackmann clinical scale and
neurophysiological measurements of compound motor action potential distal
latencies on the affected and nonaffected sides. Patients were tested before and 
after the intervention. RESULTS: A significant improvement was observed in the
facial nerve upper branch compound motor action potential distal latency on the
affected side in all patients. An improvement of one grade in House-Brackmann
scale was observed and some patients also reported subjective improvement.
CONCLUSIONS: Transcutaneous electrical stimulation treatment may have a positive 
effect on unresolved facial nerve paralysis. This study illustrates a possibly
effective treatment option for patients with the chronic facial paresis with no
other expectations of recovery.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 18787496 [PubMed - indexed for MEDLINE]

151: Eur J Gastroenterol Hepatol. 2008 Oct;20(10):1049.

Pregabalin as a probable cause of acute liver injury.

Einarsdottir S, Bjornsson E.

Department of Internal Medicine, Section of Haematology and Coagulation,
Sahlgrenska University Hospital, Gothenburg, Sweden. einar.bjornsson@medic.gu.se

Publication Types: 
    Case Reports

PMID: 18787478 [PubMed - indexed for MEDLINE]

152: J Virol. 2008 Nov;82(22):11023-44. Epub 2008 Sep 10.

Complete DNA sequences of two oka strain varicella-zoster virus genomes.

Tillieux SL, Halsey WS, Thomas ES, Voycik JJ, Sathe GM, Vassilev V.

Viral Vaccines Research and Development, GlaxoSmithKline Biologicals, Rue de
l'Institut, 89 (P31-005), B-1330 Rixensart, Belgium.

Varicella-zoster virus (VZV) is a herpesvirus and is the causative agent of
chicken pox (varicella) and shingles (herpes zoster). Active immunization against
varicella became possible with the development of live attenuated varicella
vaccine. The Oka vaccine strain was isolated in Japan from a child who had
typical varicella, and it was then attenuated by serial passages in cell culture.
Several manufacturers have obtained this attenuated Oka strain and, following
additional passages, have developed their own vaccine strains. Notably, the
vaccines Varilrix and Varivax are produced by GlaxoSmithKline Biologicals and
Merck & Co., Inc., respectively. Both vaccines have been well studied in terms of
safety and immunogenicity. In this study, we report the complete nucleotide
sequence of the Varilrix (Oka-V(GSK)) and Varivax (Oka-V(Merck)) vaccine strain
genomes. Their genomes are composed of 124,821 and 124,815 bp, respectively. Full
genome annotations covering the features of Oka-derived vaccine genomes have been
established for the first time. Sequence analysis indicates 36 nucleotide
differences between the two vaccine strains throughout the entire genome, among
which only 14 are involved in unique amino acid substitutions. These results
demonstrate that, although Oka-V(GSK) and Oka-V(Merck) vaccine strains are not
identical, they are very similar, which supports the clinical data showing that
both vaccines are well tolerated and elicit strong immune responses against
varicella.

Publication Types: 
    Comparative Study

PMID: 18787000 [PubMed - indexed for MEDLINE]

153: Expert Opin Pharmacother. 2008 Oct;9(14):2531-6.

Valacyclovir for the treatment of Bell's palsy.

Hato N, Sawai N, Teraoka M, Wakisaka H, Takahashi H, Hinohira Y, Gyo K.

Ehime University School of Medicine, Department of Otolaryngology, Shitsukawa,
Toon city, Ehime 791-0295, Japan. nhato@m.ehime-u.ac.jp

Despite recent evidence suggesting that Bell's palsy is associated with
reactivation of alfa-herpes viruses, the disease has been treated empirically,
and the use of valacyclovir has not been definitively established. In 2007, two
prospective, randomised, placebo-controlled trials evaluating valacyclovir were
reported in patients with Bell's palsy. One demonstrated that
valacyclovir/prednisolone therapy was statistically more effective than
placebo/prednisolone therapy in improving the recovery of patients with Bell's
palsy, excluding zoster sine herpete. However, considering the cost-benefit ratio
of this treatment and the limitations of virological diagnoses, we recommend that
valacyclovir should be used in cases of severe palsy within 3 days after the
onset of Bell's palsy.

PMID: 18778190 [PubMed - indexed for MEDLINE]

154: Manag Care. 2008 Aug;17(8):32-4.

Plans feel pressure to vaccinate more adults. The cost-effectiveness of
prevention is undeniable, yet vaccination rates for everything but influenza
decline.

Sipkoff M.

PMID: 18777787 [PubMed - indexed for MEDLINE]

155: J Infect Dis. 2008 Nov 1;198(9):1327-33.

Measurement of varicella-zoster virus (VZV)-specific cell-mediated immunity:
comparison between VZV skin test and interferon-gamma enzyme-linked immunospot
assay.

Sadaoka K, Okamoto S, Gomi Y, Tanimoto T, Ishikawa T, Yoshikawa T, Asano Y,
Yamanishi K, Mori Y.

Laboratory of Virology and Vaccinology, Division of Biomedical Research, National
Institute of Biomedical Innovation, Ibaraki, Osaka, Japan.

Cell-mediated immunity (CMI) is critical for the prevention and control of
varicella-zoster virus (VZV)-related disease. To assess CMI to VZV, a varicella
skin test and interferon-gamma enzyme-linked immunospot (ELISPOT) assay were both
performed in healthy volunteers, and the results were compared. A total of 151
subjects were examined: 16 aged 20-29 years, 26 aged 30-39 years, 18 aged 40-49
years, 73 aged 50-59 years, and 18 aged 60-69 years. All were seropositive by a
glycoprotein antigen-based enzyme-linked immunosorbent assay (gpELISA). Skin test
reactivity was significantly correlated with the ELISPOT count, and both
decreased with increasing age, indicating an age-dependent decline in CMI to VZV.
In contrast, the antibody titer obtained by the gpELISA did not correlate with
skin test reactivity. The results suggest that the skin test and ELISPOT assay
are both reliable for assessing CMI to VZV and can easily be applied to screen
individuals susceptible to the development of herpes zoster.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 18774884 [PubMed - indexed for MEDLINE]

156: J Clin Virol. 2008 Oct;43(2):233-5. Epub 2008 Sep 3.

A rare case of disseminated shingles in an immunocompetent patient following a
7-day treatment with oral valacyclovir.

Burdett C, Mendoza N, Arora A, Bartlett B, Gewirtzman A, Tremaine AM, Tyring S.

University of Texas Medical School at Houston, 7675 Phoenix Drive #1028, Houston,
TX 77030, United States. Catherine.E.Burdett@uth.tmc.edu

Publication Types: 
    Case Reports

PMID: 18771948 [PubMed - indexed for MEDLINE]

157: Am J Perinatol. 2008 Oct;25(9):573-5. Epub 2008 Sep 3.

Varicella zoster meningitis in a pregnant woman with acquired immunodeficiency
syndrome.

Jayakrishnan A, Vrees R, Anderson B.

Department of Obstetrics and Gynecology, Brown Medical School/Women & Infants'
Hospital of Rhode Island, Providence, Rhode Island 02905, USA.
ajayakrishnan@WIHRI.org

Between 6000 and 7000 women in the United States infected with human
immunodeficiency virus (HIV) give birth annually. It is well known that
HIV-related immunosuppression significantly increases the risk for acquiring
opportunistic infections (OIs). However, there is limited information regarding
the relationship of pregnancy in the setting of HIV/AIDS infection, subsequent
development of OIs, and maternal and fetal outcomes. A pregnant 36-year-old woman
with AIDS was diagnosed with varicella zoster meningitis. Weight-based therapy
with acyclovir was initiated with clinical improvement in symptoms. Care of a
pregnant HIV-infected patient with an OI poses a unique diagnostic and
therapeutic challenge for clinicians. Early diagnosis and initiation of
appropriate treatment may provide an opportunity to improve both maternal and
fetal outcomes.

Publication Types: 
    Case Reports

PMID: 18770492 [PubMed - indexed for MEDLINE]

158: J Neurol. 2008 Nov;255(11):1726-30. Epub 2008 Sep 3.

Bell's palsy : Combined treatment of famciclovir and prednisone is superior to
prednisone alone.

Minnerop M, Herbst M, Fimmers R, Matz B, Klockgether T, Wullner U.

Dept. of Neurology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53105,
Bonn, Germany, m.minnerop@uni-bonn.de.

There is insufficient evidence concerning the efficacy of antiviral treatment of 
Bell's palsy (BP). We therefore compared the efficacy of prednisone and
famciclovir to prednisone treatment alone in BP. A total of 167 consecutive
patients with untreated acute BP were included. Severity of BP was evaluated
using the House-Brackmann scale (HBS) and virus antibody tests (herpes simplex
virus, varicella zoster virus) were performed. Patients admitted on even dates
were treated with prednisone ("P group") and patients admitted on odd dates were 
treated with prednisone and famciclovir ("P+F group"). 117 patients completed the
follow-up after 3 months or later (67 P/51 P+F). While most patients showed at
least partial recovery with both treatment types, improvement of at least 4
grades in the HBS was more common in the "P+F group" (29.4 % vs. 11.9 %), whereas
smaller changes of less than 3 grades were more common in the "P group" (29.9 %
vs. 17.6 %; Chi-square test, p = 0.02). Patients with complete BP (HBS grade of 5
or 6) had significantly better chances of reaching normal function if treated
with famciclovir additionally instead with prednisone alone (73.7 % vs. 47.1 %;
Cochran-Armitage trend test, p = 0.03). These results suggest that the combined
treatment of famciclovir and prednisolone should be considered (at least) in
patients with severe BP.

PMID: 18769863 [PubMed - in process]

159: Clin Lymphoma Myeloma. 2008 Aug;8(4):237-40.

Bortezomib and the increased incidence of herpes zoster in patients with multiple
myeloma.

Kim SJ, Kim K, Kim BS, Lee HJ, Kim H, Lee NR, Nam SH, Kwon JH, Kim HJ, Sohn SK,
Won JH, Lee JH, Suh C, Yoon SS, Kim HJ, Kim I, Do YR, Lee WS, Joo YD, Shin HJ;
Korean Multiple Myeloma Working Party.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seoul.

BACKGROUND: Bortezomib has significantly advanced the treatment of patients with 
multiple myeloma (MM). However, considering that most patients with MM are
elderly, bortezomib-related morbidity should be thoroughly studied to ensure the 
safe use of this drug. Herpes zoster has been reported as a possible adverse
event associated with bortezomib because a major target of bortezomib, nuclear
factor-kappaB, is known to be involved with T-cell immunity. PATIENTS AND
METHODS: We performed a retrospective analysis of the incidence of herpes zoster 
among 282 patients treated with a bortezomib-containing regimen. RESULTS: During 
the patients' pre-bortezomib treatment (median, 2.14 years), the incidence of
herpes zoster was 11% (31 of 282 patients). However, after the patients were
treated with bortezomib, the incidence increased to 22.3% (63 of 282 patients),
of which almost all occurrences were within the first 3 cycles (median duration, 
41 days). The time interval from diagnosis to bortezomib initiation date was
shorter in herpes zoster-positive patients than in herpes zoster-negative
patients (2.14 +/- 1.87 years vs. 3.38 +/- 2.95 years; P = .002). Disease
duration, previous herpes zoster infection, disease stage and type of myeloma,
and the type and intensity of previous treatments failed to show any relationship
with herpes zoster. These findings suggest that longer history of disease and
treatments did not affect the occurrence of herpes zoster, nor did the type of
bortezomib regimens or their toxicities. CONCLUSION: Bortezomib can increase the 
incidence of herpes zoster regardless of disease duration, previous treatments,
and concomitantly administered drugs. Thus, the occurrence of herpes zoster
should be monitored during bortezomib treatment.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18765311 [PubMed - indexed for MEDLINE]

160: Expert Opin Emerg Drugs. 2008 Sep;13(3):393-416.

Emerging antiviral drugs.

De Clercq E.

Katholieke Universiteit Leuven, Rega Institute for Medical Research,
Minderbroedersstraat 10, B-3000 Leuven, Belgium. erik.declercq@rega.kuleuven.be

Foremost among the newly described antiviral agents that may be developed into
drugs are, for the treatment of human papilloma virus (HPV) infections,
cPrPMEDAP; for the treatment of herpes simplex virus (HSV) infections, BAY
57-1293; for the treatment of varicella-zoster virus (VZV) infections, FV-100
(prodrug of Cf 1743); for the treatment of cytomegalovirus (CMV) infections,
maribavir; for the treatment of poxvirus infections, ST-246; for the treatment of
hepatitis B virus (HBV) infections, tenofovir disoproxil fumarate (TDF) (which in
the meantime has already been approved in the EU); for the treatment of various
DNA virus infections, the hexadecyloxypropyl (HDP) and octadecyloxyethyl (ODE)
prodrugs of cidofovir; for the treatment of orthomyxovirus infections (i.e.,
influenza), peramivir; for the treatment of hepacivirus infections (i.e.,
hepatitis C), the protease inhibitors telaprevir and boceprevir, the nucleoside
RNA replicase inhibitors (NRRIs) PSI-6130 and R1479, and various non-nucleoside
RNA replicase inhibitors (NNRRIs); for the treatment of human immunodeficiency
virus (HIV) infections, integrase inhibitors (INIs) such as elvitegravir,
nucleoside reverse transcriptase inhibitors (NRTIs) such as apricitabine,
non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as rilpivirine and 
dapivirine; and for the treatment of both HCV and HIV infections, cyclosporin A
derivatives such as the non-immunosuppressive Debio-025.

Publication Types: 
    Review

PMID: 18764719 [PubMed - indexed for MEDLINE]

161: Pediatrics. 2008 Sep;122(3):e744-51.

Varicella prevention in the United States: a review of successes and challenges.

Marin M, Meissner HC, Seward JF.

Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, MS A-47,
Atlanta, GA 30333, USA. mmarin@cdc.gov

OBJECTIVE: In 1995, the United States was the first country to introduce a
universal 1-dose childhood varicella vaccination program. In 2006, the US
varicella vaccine policy was changed to a routine 2-dose childhood program, with 
catchup vaccination for older children. The objective of this review was to
summarize the US experience with the 1-dose varicella vaccination program,
present the evidence considered for the policy change, and outline future
challenges of the program. METHODS: We conducted a review of publications
identified by searching PubMed for the terms "varicella," "varicella vaccine,"
and "herpes zoster." The search was limited to US publications except for herpes 
zoster; we reviewed all published literature on herpes zoster incidence. RESULTS:
A single dose of varicella vaccine was 80% to 85% effective in preventing disease
of any severity and >95% effective in preventing severe varicella and had an
excellent safety profile. The vaccination program reduced disease incidence by
57% to 90%, hospitalizations by 75% to 88%, deaths by >74%, and direct inpatient 
and outpatient medical expenditures by 74%. The decline of cases plateaued
between 2003 and 2006, and outbreaks continued to occur, even among highly
vaccinated school populations. Compared with children who received 1 dose, in 1
clinical trial, 2-dose vaccine recipients developed in a larger proportion
antibody titers that were more likely to protect against breakthrough disease and
had a 3.3-fold lower risk for breakthrough disease and higher vaccine efficacy.
Two studies showed no increase in overall herpes zoster incidence, whereas 2
others showed an increase. CONCLUSIONS: A decade of varicella prevention in the
United States has resulted in a dramatic decline in disease; however, even with
high vaccination coverage, the effectiveness of 1 dose of vaccine did not
generate sufficient population immunity to prevent community transmission. A
2-dose varicella vaccine schedule, therefore, was recommended for children in
2006. Data are inconclusive regarding an effect of the varicella vaccination
program on herpes zoster epidemiology.

Publication Types: 
    Review

PMID: 18762511 [PubMed - indexed for MEDLINE]

162: Ophthalmology. 2008 Sep;115(9):1632-3.

Acute retinal necrosis in Japan.

Usui Y, Takeuchi M, Goto H, Mori H, Kezuka T, Sakai J, Usui M.

Publication Types: 
    Letter

PMID: 18762074 [PubMed - indexed for MEDLINE]

163: J Eur Acad Dermatol Venereol. 2008 Aug 27. [Epub ahead of print]

Herpes zoster histopathologically mimicking CD30-positive anaplastic large cell
lymphoma.

Shiohara J, Koga H, Uhara H, Takata M, Saida T, Uehara T.

Department of Dermatology, Shinsu University School of Medicine, Nagano, Japan.

PMID: 18759786 [PubMed - as supplied by publisher]

164: Paediatr Drugs. 2008;10(5):337-47.

Live attenuated measles, mumps, rubella, and varicella zoster virus vaccine
(Priorix-Tetra).

Dhillon S, Curran MP.

Wolters Kluwer Health | Adis, Auckland, New Zealand. demail@adis.co.nz

The live attenuated tetravalent vaccine against measles, mumps, rubella, and
varicella zoster viruses (MMRV) is a combination of the measles, mumps, and
rubella (MMR) vaccine and the varicella zoster virus vaccine. The immunogenicity 
after each dose of a two-dose vaccination course of MMRV vaccine was generally
similar to that of two doses of separately administered MMR plus varicella zoster
vaccines, or a single dose of separately administered MMR plus varicella zoster
vaccines followed by a dose of MMR vaccine, in infants aged 9-24 months. In
infants aged 9-24 months administered a two-dose course of MMRV vaccine,
geometric mean titers for antibodies against all vaccine antigens increased after
the second dose relative to the first dose, with the increase being most
pronounced for varicella zoster virus antibodies (10- to 21-fold). MMRV as the
second vaccination was immunogenic in children aged 5-6 years who had previously 
received either MMRV or MMR as the first vaccination at 12-24 months of age. The 
immunogenicity for measles, mumps, rubella, and varicella zoster viruses, in
terms of seropositivity and antibody titers, was not altered when MMRV was
coadministered with a booster dose of diphtheria, tetanus, acellular pertussis,
hepatitis B, inactivated poliovirus, and Haemophilus influenzae type b conjugate 
vaccine in infants aged 12-23 months. Nor was the immunogenicity of the latter
vaccine altered by coadministration. The tolerability profile of MMRV vaccine was
comparable to that of separately administered MMR plus varicella zoster vaccines 
or of MMR vaccine alone. Injection-site redness and fever (rectal temperature >
or =38degreesC or axillary temperature > or =37.5degreesC) were the most frequent
adverse events in both groups.

Publication Types: 
    Review

PMID: 18754700 [PubMed - indexed for MEDLINE]

165: Am J Med. 2008 Sep;121(9):772-3.

Inka dinka don't. Herpes zoster.

German V, Sakagiannis G, Margaritis G, Falagas ME.

Second Internal Medicine and Infectious Diseases Department, 401 Army General
Hospital of Athens, Greece.

Publication Types: 
    Case Reports

PMID: 18724965 [PubMed - indexed for MEDLINE]

166: Muscle Nerve. 2008 Aug;38(2):1070-3.

Unilateral diaphragmatic paralysis and segmental motor paresis following herpes
zoster.

Bahadir C, Kalpakcioglu AB, Kurtulus D.

Haydarpasa Numune Training and Research Hospital, Physical Medicine and
Rehabilitation Clinic, Istanbul, Turkey. delta2006@ttmail.com

We report the case of a 73-year-old woman who complained of acute onset of pain
and weakness of her left shoulder and proximal arm muscles 3 weeks after a
diagnosis of herpes zoster. Electromyography revealed involvement of the C5-6
myotomes and the upper trunk of the brachial plexus. Chest X-ray and
electromyographic studies documented paralysis of the left diaphragm. One year
after onset, muscle strength returned to normal, but radiographic and
electrophysiologic findings of diaphragm paralysis were unchanged.

Publication Types: 
    Case Reports

PMID: 18724399 [PubMed - indexed for MEDLINE]

167: J Drugs Dermatol. 2008 Aug;7(8):741-8.

Long-term safety of mycophenolate mofetil and cyclosporine: a review.

Buell C, Koo J.

University of California-Los Angeles, Los Angeles, CA 90025, USA.
catherinebuell@hotmail.com

The prevailing notion in dermatology is that mycophenolate mofetil (MMF) is safer
than cyclosporine (CsA), but that CsA has greater efficacy. This literature
review evaluates the available long-term safety data of MMF and CsA. Literature
in the fields of dermatology, autoimmune disease, and transplantation were
retrieved from PubMed. Data regarding immunosuppressive and non-immunosuppressive
side effects of MMF and CsA are presented along with available pregnancy safety
data. Surprisingly, there is a paucity of data on long-term MMF monotherapy.
Transplant data is presented separately due to the concomitant use of other
immunosuppressants along with MMF. Trends that can be identified include a less
discernable cancer or end-organ damage risk in MMF compared to CsA. However, MMF 
appears to have a greater risk in pregnancy and increased reports of herpes
simplex and zoster infection compared to CsA.

Publication Types: 
    Meta-Analysis
    Review

PMID: 18720690 [PubMed - indexed for MEDLINE]

168: Eur J Neurol. 2008 Oct;15(10):e90-1. Epub 2008 Jul 20.

Comment in:
    Eur J Neurol. 2008 Oct;15(10):e88-9.

Stroke and multiple peripheral thrombotic events in an adult with varicella.

Massano J, Ferreira D, Toledo T, Mansilha A, Azevedo E, Carvalho M.

Publication Types: 
    Case Reports
    Letter

PMID: 18717719 [PubMed - indexed for MEDLINE]

169: Orbit. 2008;27(4):325-7.

Severe, permanent orbital disease in herpes zoster ophthalmicus.

Dhingra S, Williams G, Pearson A.

Eye Department, John Radcliffe Hospital, Oxford, United Kingdom.
drsumitdhingra@hotmail.com

A 63-year-old man with HZO presented with involvement of cranial nerves II, III, 
IV, V, and VI, with proptosis, raised intraocular pressure, and chemosis. With
the aid of orbital imaging, a diagnosis of orbital apex inflammation secondary to
HZO was confirmed, and he was treated with intravenous acyclovir and oral
steroids. Despite this, he made a minimal recovery at eight months following
presentation. Severe, irreversible orbital disease may develop following HZO, and
an ischemic vasculitis may play a role in the pathogenesis of the disease.

Publication Types: 
    Case Reports

PMID: 18716975 [PubMed - indexed for MEDLINE]

170: BMJ. 2008 Aug 19;337:a1164. doi: 10.1136/bmj.a1164.

Childhood immunisation against varicella zoster virus.

Farlow A.

Publication Types: 
    Editorial

PMID: 18713808 [PubMed - indexed for MEDLINE]

171: J Med Virol. 2008 Oct;80(10):1756-61.

First report on fatal myocarditis associated with adenovirus infection in Cuba.

Valdes O, Acosta B, Pinon A, Savon C, Goyenechea A, Gonzalez G, Gonzalez G,
Palerm L, Sarmiento L, Pedro ML, Martinez PA, Rosario D, Kouri V, Guzman MG, Llop
A, Casas I, Perez Brena MP.

Respiratory Viruses Laboratory, Virology Department, Division of Microbiology,
Instituto de Medicina Tropical Pedro Kouri, Havana, Cuba. odalys@ipk.sld.cu

Myocarditis is caused frequently by viral infections of the myocardium. In the
past, enteroviruses (EV) were considered the most common cause of myocarditis in 
all age groups. Other viruses that cause myocarditis are adenovirus and influenza
viruses. Parvovirus B19 infection is associated sometimes with myocarditis.
Members of the Herpesviridae family, cytomegalovirus (CMV), and human herpesvirus
6 (HHV-6) have been associated occasionally with myocarditis. During an atypical 
outbreak of acute febrile syndrome, eight children, with ages from 5 months to 15
years, died in cardiogenic shock due to myocarditis in July-August 2005, in the
city of Havana, Cuba. Nested polymerase chain reaction (nPCR) and nested reverse 
transcription-PCR (nRT-PCR) were carried out on fresh heart muscle and lung
tissue to analyze the genomic sequences of adenovirus, CMV, HHV-6, herpes simplex
virus, Epstein-Barr virus (EBV), varizella zoster virus, influenza virus A, B, C,
respiratory syncytial virus (RSV) A and B, parainfluenza viruses, rhinoviruses,
coronavirus, flaviruses and enteroviruses. Evidence was for the presence of the
adenovirus genome in 6 (75%) of the children. Phylogenetic analyses of a
conserved hexon gene fragment in four cases showed serotype 5 as the causal
agent. No others viruses were detected. Histological examination was undertaken
to detect myocardial inflammation. After exclusion of other possible causes of
death, the results indicated that viral myocarditis was the cause of death in
patients with adenovirus infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18712847 [PubMed - indexed for MEDLINE]

172: Indian J Ophthalmol. 2008 Sep-Oct;56(5):363-75.

Anterior segment manifestations of human immunodeficiency virus/acquired immune
deficiency syndrome.

Biswas J, Sudharshan S.

Sankara Nethralaya, 18, College Road, Chennai - 600 006, India.
drjb@sankaranethralaya.org

Ocular complications are known to occur as a result of human immunodeficiency
virus (HIV) disease. They can be severe leading to ocular morbidity and visual
handicap. Cytomegalovirus (CMV) retinitis is the commonest ocular opportunistic
infection seen in acquired immune deficiency syndrome (AIDS). Though posterior
segment lesions can be more vision-threatening, there are varied anterior segment
manifestations which can also lead to ocular morbidity and more so can affect the
quality of life of a HIV-positive person. Effective antiretroviral therapy and
improved prophylaxis and treatment of opportunistic infections have led to an
increase in the survival of an individual afflicted with AIDS. This in turn has
led to an increase in the prevalence of anterior segment and adnexal disorders.
Common lesions include relatively benign conditions such as blepharitis and dry
eye, to infections such as herpes zoster ophthalmicus and molluscum contagiosum
and malignancies such as squamous cell carcinoma and Kaposi's sarcoma. With the
advent of highly active antiretroviral therapy, a new phenomenon known as immune 
recovery uveitis which presents with increased inflammation, has been noted to be
on the rise. Several drugs used in the management of AIDS such as nevirapine or
indinavir can themselves lead to severe inflammation in the anterior segment and 
adnexa of the eye. This article is a comprehensive update of the important
anterior segment and adnexal manifestations in HIV-positive patients with special
reference to their prevalence in the Indian population.

Publication Types: 
    Review

PMID: 18711264 [PubMed - indexed for MEDLINE]

173: J Clin Oncol. 2008 Oct 10;26(29):4784-90. Epub 2008 Aug 18.

Analysis of herpes zoster events among bortezomib-treated patients in the phase
III APEX study.

Chanan-Khan A, Sonneveld P, Schuster MW, Stadtmauer EA, Facon T, Harousseau JL,
Ben-Yehuda D, Lonial S, Goldschmidt H, Reece D, Neuwirth R, Anderson KC,
Richardson PG.

Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
asher.chanan-khan@roswellpark.org

PURPOSE: The aim of this subset analysis was to determine if bortezomib treatment
is associated with increased incidence of varicella-zoster virus (VZV)
reactivation in patients with relapsed multiple myeloma (MM). PATIENTS AND
METHODS: Incidence of herpes zoster was evaluated in 663 patients with relapsed
MM from the phase III APEX trial comparing single-agent bortezomib with high-dose
dexamethasone. RESULTS: Bortezomib was associated with a significantly higher
incidence of herpes zoster compared with dexamethasone treatment (13%, 42 of 331 
v 5%, 15 of 332; P = .0002). Most herpes zoster infections were grade 1/2;
incidences of grade 3/4 events (1.8% v 1.5%) and infections considered serious
adverse events (1.5% v 0.9%) were similar between treatment arms, and no herpes
zoster-related deaths occurred. Neither the time to onset of the herpes event nor
the patients' absolute lymphocyte counts at baseline differed significantly
between arms. VZV reactivation was the only herpes viral event noted to be
significantly elevated in the bortezomib treatment group compared with the
dexamethasone treatment group (P = .0002). The incidence of non-VZV-related
herpes viral infections was comparable between arms. No additional risk factors
for herpes zoster reactivation were identified. CONCLUSION: Further studies are
needed to explain these observations and their implications; however, for
patients treated with bortezomib or bortezomib-containing regimens, the risk of
VZV reactivation should be monitored and routine use of antiviral prophylaxis
considered.

Publication Types: 
    Clinical Trial, Phase III
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 18711175 [PubMed - indexed for MEDLINE]

174: Acta Med Croatica. 2008 May;62(2):163-72.

[Craniofacial neuralgias]

[Article in Croatian]

Mikula I.

Klinika za neurologiju, Referentni centar za neurovaskularne poremecaje
Ministarstva zdravstva RH, Klinicka bolnica Sestre milosrdnice, Zagreb, Hrvatska.

Craniofacial neuralgias are characterized by sudden paroxysmal pain along the
distribution of one or more of the cranial or upper cervical spinal nerves. The
most significant neuralgia of the craniofacial region is trigeminal neuralgia,
while geniculate neuralgia, glossopharyngeal neuralgia and occipital neuralgia
are less common. Trigeminal neuralgia may be primary or secondary. Idiopathic
trigeminal neuralgia or tic douloureux has been recognized for centuries as an
extremely painful disorder most commonly involving the maxillary nerve. Recurrent
lancinating, shocklike unilateral pain lasting for seconds to minutes is provoked
by non noxious stimulation of the skin at specific sites around the face and less
frequently by movement of the tongue. The trigger zones are usually within the
same dermatome as the painful sensation. After each episode, there is usually a
refractive period during which stimulation of the trigger zone will not induce
pain. Idiopathic trigeminal neuralgia occurs somewhat more frequently in women
and usually begins in individuals 50 to 70 years of age. There is no pain between
attacks, and the frequency of painful episodes can range from several per day to 
only a few per year. With time, the features may become more atypical, with
greater areas of more enduring and dull pain and occasionally bilateral pain,
rarely on both sides simultaneously. No sensory or reflex deficit is detectable
by routine neurologic testing. Diagnostic local anesthetic blocks will identify
the specific nerves involved and the trigger point distribution. Neurologic and
neuroradiologic examination is advised in all cases to rule out diseases such as 
intracranical tumors, vascular malformations or multiple sclerosis.

Publication Types: 
    English Abstract
    Review

PMID: 18710080 [PubMed - indexed for MEDLINE]

175: J Clin Microbiol. 2008 Oct;46(10):3530-3. Epub 2008 Aug 13.

Molecular analysis of varicella-zoster virus strains circulating in Tanzania
demonstrating the presence of genotype M1.

Schmidt-Chanasit J, Olschlager S, Gunther S, Jaeger G, Bleymehl K, Schad SG,
Heckel G, Ulrich RG, Doerr HW.

Bernhard-Nocht-Institute for Tropical Medicine, Diagnostic Virology Laboratory,
Bernhard-Nocht-Strasse 74, D-20359 Hamburg, Germany. jonassi@gmx.de

Based on analysis of 16,392 bp encompassing the complete open reading frames
(ORFs) 1, 5, 31, 36, 37, 47, 60, 62, 67, and 68 of the genome of genotype M1
varicella-zoster virus (VZV) was found in swab samples originating from eight
Tanzanian zoster patients. Moreover, sequence analysis suggests recombination
events between different VZV genotypes within ORFs 1, 31, 60, and 67.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18701658 [PubMed - indexed for MEDLINE]

176: Dermatol Online J. 2008 Feb 28;14(2):24.

Persistent varicella as the initial manifestation of systemic lymphoma.

Ferreira M, Sanches M, Teixeira M, Guerra M, Selores M.

Service of Dermatology, Hospital Geral de Santo Antonio, Porto, Portugal.
marcia_ferreira@hotmail.com

Varicella is a common benign childhood disease that often presents in adolescents
and adults in a more severe form. We report a previously healthy 50-year-old man 
who developed multiple necrotic cutaneous ulcers associated with fever, asthenia 
and anorexia. Physical examination revealed few tense hemorrhagic vesicles on the
trunk and necrotic cutaneous ulcers scattered over the entire cutaneous surface. 
After the diagnosis of varicella with varicella pneumonia was established,
treatment with acyclovir was instituted. His poor response to treatment was
indicative of immune compromise; an underlying peripheral T-cell lymphoma was
discovered.

Publication Types: 
    Case Reports

PMID: 18700127 [PubMed - indexed for MEDLINE]

177: J Orthop Sci. 2008 Jul;13(4):383-6. Epub 2008 Aug 13.

Morphological changes of the dorsal root ganglion in a patient with herpes zoster
seen by magnetic resonance imaging.

Yoshimoto M, Kawaguchi S, Takebayashi T, Isogai S, Nonaka S, Kosukegawa I,
Yamashita T.

Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine,
S1 W16, Chuo-ku, Sapporo, 060-8543, Japan.

Publication Types: 
    Case Reports

PMID: 18696200 [PubMed - indexed for MEDLINE]

178: Vaccine. 2008 Nov 25;26(50):6487-90. Epub 2008 Aug 9.

Clinicopathologic understanding and control of varicella-zoster virus infection.

Asano Y.

Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, 
Aichi 470-1192, Japan. yasano@fujita-hu.ac.jp

As reflections by the recipient for the Japanese society for vaccinology
Takahashi award, clinicopathologic understanding and control of varicella-zoster 
virus (VZV) infection was briefly reviewed. In 1974, a live varicella vaccine was
developed by attenuating the Oka strain of VZV after the passages in non-human
cells at a low temperature. The vaccine was immunogenic, well tolerated, and
effective, and distributed worldwide so far. For post-exposure prophylaxis of
varicella, the vaccine and acyclovir is effectively used in the incubation period
of varicella. The delayed type hypersensitivity to VZV skin test antigen was
applied for evaluation of cell-mediated immunity to VZV which is commercially
available in Japan. The biphasic viremia during incubation period of varicella
and airborne spread of VZV from varicella patients and from herpes zoster
patients with localized lesions were shown by the virus isolation or by detection
of the virus DNA.

Publication Types: 
    Review

PMID: 18694794 [PubMed - indexed for MEDLINE]

179: Eur J Dermatol. 2008 Sep-Oct;18(5):499-503. Epub 2008 Aug 8.

Tracing of the molecular remnants of herpes virus infections in necrotic skin
tissue.

Yamamoto T, Yamada A, Tsuji K, Iwatsuki K.

Department of Dermatology, Okayama University Graduate School of Medicine,
Dentistry and Pharmaceutical Sciences, Okayama, Japan. go-yama@md.okayama-u.ac.jp

We have established an assay system to detect herpesvirus-derived transcripts in 
lesional crusts. Fifteen patients with herpes simplex (HS), 21 with herpes zoster
(HZ), 2 with varicella, and 20 with irrelevant diseases were enrolled in the
present study. Total RNA was extracted from crusts or scales, and converted to
cDNA. Virus-encoded transcripts were amplified using reverse transcriptase
(RT)-PCR. Housekeeping gene transcripts such as beta2-microglobulin (beta2-MG)
and beta-actin (beta-actin) mRNA were also examined, and an efficient
preservative condition of the crusts was determined. With extracted RNAs,
beta2-MG and beta-actin mRNA were successfully amplified in all crust samples.
Herpes simplex virus (HSV)-specific, lytic cycle-related transcript, UL30 mRNA
was detected in all 15 HS samples, including 13 samples of HSV-1- and 2 of
HSV-2-encoded UL30 mRNA, respectively. Of 23 samples, including 21 HZ and 2
varicella cases, varicella zoster virus (VZV)-specific, lytic cycle-related
transcript, ORF40 mRNA was detected in 22 samples. In a control group, no UL30
and ORF40 mRNA were detected. Crust samples that had been stored without any
pretreatment or preservative for 6 months at room temperature (RT) were available
for the present assay. When compared with the freshly obtained materials, the
amount of beta2-MG mRNA was reduced to 51% in the stored samples covered with
adhesive tape, to 48% in a sample left at R.T. without any treatment, and to 1.2%
in the samples stocked in saline for 5 days. Herpes virus- and host-derived
transcripts contained in crusts can be detected by RT-PCR amplification. Crusts
or dry epidermal necrosis with inflammatory cells may provide beneficial
diagnostic information.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18693150 [PubMed - indexed for MEDLINE]

180: Clin Exp Dermatol. 2008 Aug 7. [Epub ahead of print]

Haemorrhagic herpes zoster associated with clopidogrel treatment.

Ghosh S, Bandyopadhyay D.

Department of Dermatology, Venereology, and Leprosy, R. G. Kar Medical College,
Kolkata, India.

PMID: 18691243 [PubMed - as supplied by publisher]

181: Med Trop (Mars). 2008 Jun;68(3):273-6.

[Mucocutaneous manifestations of human immunodeficiency virus infection in
Cotonou, Benin]

[Article in French]

Atadokpede F, Yedomon H, Adegbidi H, Sehonou JJ, Azondekon A, Do Ango-Padonou F.

Hopital d'Instruction des Armees, Camp Guezo, BP 517, Cotonou.
felixatadokpede@yahoo.fr

The purpose of this study was to describe mucocutaneous manifestations observed
in persons living with human immunodeficiency virus (PLHIV) in Cotonou, Benin. A 
transverse retrospective study was carried out on the records of PLHIV who
underwent follow-up at the Military Teaching Hospital in Cotonou from February
2002 to September 2005. The files of all eligible adult patients examined by
dermatologists prior to initiation of antiretroviral treatment were reviewed.
Dermatologic manifestations were defined as any cutaneous or cicatricial lesion
of the skin. Data was analyzed using the EPI INFO software package. (version
6.0). A total of 152 patient files were included. The sex ratio was 1.10 with a
female predominance. Mean age was 37.8 years. HIV1 was predominant (98%).
Two-thirds of patients were as stage 3 according to the WHO classification. A
total of 276 dermatologic manifestations were identified. The most common
manifestations were buccopharyngeal candidiasis (24.6%), prurigo (20.6%),
shingles (11.6%), and dermatophytosis (10.5%). The mean CD4 lymphocyte level was 
106 cells/mm3. The CD4 level was below 100 cells/mm3 in 52% of cases involving
candidiasis and 60% of cases involving prurigo. Dermatologic findings in this
study were identical to those described in most studies from Africa and Asia.
However the low prevalence of Koposi's sarcoma and seborrheic dermitits was
surprising given the advanced stage of immunodepression in our patients. The most
frequent mucocutaneous manifestations of HIV infection in Benin are infectious
disease and prurigo.

Publication Types: 
    English Abstract

PMID: 18689320 [PubMed - indexed for MEDLINE]

182: Zh Nevrol Psikhiatr Im S S Korsakova. 2007;107(2):76-9.

[The current aspects of herpes-zoster infection. Post herpes neuralgia: clinical 
symptoms, treatment, prevention]

[Article in Russian]

Volkova AI.

Publication Types: 
    Review

PMID: 18689003 [PubMed - indexed for MEDLINE]

183: Clin Interv Aging. 2008;3(2):241-50.

Zoster vaccine live for the prevention of shingles in the elderly patient.

Zussman J, Young L.

Department of Medicine, Dermatology Division, David Geffen School of Medicine at 
the University of California, Los Angeles, California 90095-6957, USA.

Shingles, also known as herpes zoster, is a common disease in the elderly
population that is caused by reactivation of latent varicella zoster virus. Its
manifestations and complications can lead to significant short- and long-term
morbidity. In 2006, the United States Food and Drug Administration approved
Zoster Vaccine Live (Zostavax) for the prevention of herpes zoster in
immunocompetent adults age 60 and over. The approval was based on the results ofa
large, multi-center clinical trial, the Shingles Prevention Study. This study
showed that vaccination significantly decreased shingles incidence, burden of
illness due to disease, and the development of, and severity of postherpetic
neuralgia. This review offers an overview of varicella zoster virus infection and
complications, a summary of the Shingles Prevention Study, and a critical
analysis designed to aid the practicing physician who has questions about vaccine
administration.

Publication Types: 
    Review

PMID: 18686747 [PubMed - indexed for MEDLINE]

184: Clin Exp Dermatol. 2008 Nov;33(6):740-2. Epub 2008 Aug 2.

Pseudozoster clinical presentation of Demodex infestation after prolonged topical
steroid use.

Karincaoglu Y, Tepe B, Kalayci B, Seyhan M.

Department of Dermatology, Inonu University School of Medicine, Malatya, Turkey. 
ykarincaoglu@inonu.edu.tr

A 60-year-old man presented with a plaque lesion on the upper right half of the
face, which had developed after ophthalmic varicella zoster infection about 2
years previously. The lesion, which was burning and itchy, included a few tiny
erythematous pustules, and was slightly squamous and infiltrated. The lesion
covered the upper two-thirds of the right trigeminal nerve dermatome, involving
half of the face with the forehead, the periorbital area, upper part of the cheek
and the nose. The lesion became more marked after continuous topical anaesthetic 
and corticosteroid use. A standardized skin-surface biopsy was taken, and
revealed a large number of Demodex folliculorum (38/cm(2)) in the lesion area.
The lesions completely abated after topical 5% permethrin treatment, and no
recurrence was observed during follow-up. Demodicosis may have atypical clinical 
presentations, other than the well-known classic forms. To our knowledge, this is
the first unilateral trigeminal, pseudozoster presentation in the literature.

Publication Types: 
    Case Reports

PMID: 18684117 [PubMed - indexed for MEDLINE]

185: Clin Infect Dis. 2008 Sep 15;47(6):783-9.

Clinical features of viral meningitis in adults: significant differences in
cerebrospinal fluid findings among herpes simplex virus, varicella zoster virus, 
and enterovirus infections.

Ihekwaba UK, Kudesia G, McKendrick MW.

Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals,
National Health Service Foundation Trust, Sheffield, United Kingdom.

BACKGROUND: In this retrospective study, our objective was to review the
epidemiology of viral meningitis and to compare clinical features associated with
enterovirus, herpes simplex virus (HSV), and varicella zoster virus (VZV)
infections in immunocompetent adults. METHODS: Data on cerebrospinal fluid (CSF) 
samples submitted to the Trust Virology Laboratory (Sheffield, UK) from April
2004 through April 2007 were reviewed. Notes on immunocompetent adults who were
polymerase chain reaction (PCR) positive for enterovirus, HSV type 2, or VZV and 
who had presented to local clinical departments were scrutinized (4 patients were
positive for HSV type 1 and did not meet the inclusion criteria). RESULTS: A
total of 2045 samples were analyzed for viral pathogens during the 3-year period.
Of the 109 PCR-positive samples, 38 (35%) were from immunocompetent adults, of
whom 22 were infected with enterovirus, 8 were infected with HSV type 2, and 8
were infected with VZV. The median ages were 32 years (range, 16-39 years), 39
years (range, 22-53 years), and 47.5 years (range, 26-80 years), respectively.
Rash occurred after the meningitis symptoms in 5 patients infected with VZV
(median time from meningitis symptoms to rash, 6 days). Protein levels were
significantly higher in CSF samples from patients infected with HSV type 2
(median, 1205 mg/L) and in samples from those infected with VZV (median, 974
mg/L) than in samples from those infected with enterovirus (median, 640 mg/L; P =
.001 and P = .01, respectively). White blood cell counts were significantly
higher in CSF samples from patients infected with HSV type 2 (median, 240 x 10(6)
cells/L) than in samples from those infected with enterovirus (median, 51 x 10(6)
cells/L; P = .01). CONCLUSIONS: Enterovirus infection was the most common cause
of viral meningitis in immunocompetent adults in this study. White blood cell
counts and protein levels were significantly higher in CSF samples from patients 
infected with HSV type 2 than in samples from patients with enterovirus
infection. Zoster rash often occurs after meningitis. PCR testing provides a
rapid and specific etiological diagnosis.

PMID: 18680414 [PubMed - in process]

186: Clin Infect Dis. 2008 Sep 15;47(6):754-9.

Hospitalizations to treat herpes zoster in older adults: causes and validated
rates.

Jackson LA, Reynolds MA, Harpaz R.

Group Health Center for Health Studies, Seattle, Washington 98101, USA.
Jackson.L@ghc.org

BACKGROUND: The availability of a vaccine for the prevention of herpes zoster has
increased interest in methods to measure zoster disease burden. Hospitalizations 
assigned a zoster diagnosis code have been used as indicators of severe zoster in
prior studies. However, a zoster diagnosis code may not be a specific indicator
of severe zoster illness, because the code may be assigned to a hospitalization
for another cause in a person with coincident zoster. METHODS: To assess the
validity of a hospital diagnosis code of zoster as an indicator of
hospitalizations that are attributable to zoster, we identified all
hospitalizations with a zoster diagnosis code assigned in any position among
members of a managed-care organization who were >or=50 years of age during
1992-2004. Of those, we selected a sample of 260 hospitalizations for chart
review. RESULTS: Chart reviews were completed for 225 hospitalizations.
Sixty-five (29%) were because of zoster or a complication of zoster treatment,
and an additional 9 (4%) were because of postherpetic neuralgia or a complication
of postherpetic neuralgia treatment. Although the overall age-adjusted rate of
hospitalizations with a zoster diagnosis code was 42.5 hospitalizations per
100,000 population per year, the estimated rate of hospitalizations because of
zoster, postherpetic neuralgia, or adverse effects of a medication used to treat 
zoster or postherpetic neuralgia was only 14.0 hospitalizations per 100,000
population per year. CONCLUSIONS: Rates of hospitalizations associated with a
zoster diagnosis code will substantially overestimate the burden of
hospitalizations attributable to zoster in older adults.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 18680413 [PubMed - in process]

187: Urologe A. 2008 Sep;47(9):1097-8, 1100-2, 1104-5.

[Neuromuscular dysfunction of the lower urinary tract dysfunction beyond spinal
cord injury and multiple sclerosis. A challenge for urologists]

[Article in German]

Reitz A, Fisang C, Muller SC.

Klinik und Poliklinik fur Urologie, Universitatsklinikum, Bonn, Deutschland.
reitz@godeshoehe.de

Neurogenic bladder subsequent to paraplegia serves as a paradigm when classifying
the type of disorder analogous to the level of paralysis. In cases of multiple
sclerosis micturition symptoms already present a manifold picture that changes in
the clinical course. Rarer neurological disorders, on the other hand, such as
infantile cerebral palsy, Parkinson's disease, multisystem atrophy, Alzheimer's
disease, cerebrovascular disorders, Guillain-Barre syndrome, AIDS, herpes zoster,
systemic lupus erythematosus, and herniated lumbar disc, often cause uncertainty 
with regard to necessary diagnostic tests and treatment.This review considers the
available knowledge about voiding disorders and urinary incontinence associated
with specific neurologic and neuromuscular diseases and provides recommendations 
for diagnostic work-up and pragmatic therapy.

Publication Types: 
    English Abstract
    Review

PMID: 18679645 [PubMed - indexed for MEDLINE]

188: Reg Anesth Pain Med. 2008 Jul-Aug;33(4):320-5.

Analgesic effect of lidocaine patch 5% in the treatment of acute herpes zoster: a
double-blind and vehicle-controlled study.

Lin PL, Fan SZ, Huang CH, Huang HH, Tsai MC, Lin CJ, Sun WZ.

Department of Anesthesiology, National Taiwan University Hospital, Taipei,
Taiwan.

BACKGROUND AND OBJECTIVES: Although lidocaine patch 5% has been widely used for
postherpetic neuralgia, its analgesic effect on the intense pain associated with 
acute herpes zoster has not been investigated because of its potential hazard to 
damaged skin. METHODS: Forty-six patients suffering from moderate to severe pain 
caused by acute herpes zoster infection (within 4 weeks of onset) were enrolled
in a randomized, double-blind, vehicle-controlled, parallel study. Lidocaine
patch 5% or vehicle patch were applied to the intact portion of the painful skin 
area without blisters at 12-hour intervals twice a day for 2 consecutive days.
Analgesic efficacy and side effect profiles were assessed before and 48 hours
after patch application. RESULTS: We found that both groups of patients
experienced significant pain relief during rest and movement. Differences of mean
reduction of pain intensity between the two groups were 14.7 (4.7-24.8, P =
0.005) during rest and 10.4 (1.6-19.3, P = 0.007) during movement, favoring the
lidocaine patch. The lidocaine patch produced a greater percentage change in a
patient's global impression than the vehicle patch. The incidence and severity of
adverse events were low with both treatments. CONCLUSIONS: This study
demonstrates that lidocaine patch 5%, applied twice a day, could serve as a well 
tolerated and effective modality to relieve moderate to severe pain associated
with acute herpes zoster presumably through its pharmacological action and
physical barrier effect on sensitized skin.

Publication Types: 
    Randomized Controlled Trial

PMID: 18675742 [PubMed - indexed for MEDLINE]

189: Joint Bone Spine. 2008 Oct;75(5):540-3. Epub 2008 Jul 31.

Herpes zoster in patients taking TNFalpha antagonists for chronic inflammatory
joint disease.

Wendling D, Streit G, Toussirot E, Prati C.

Service de Rhumatologie, CHU Minjoz et Universite de Franche-Comte, 25030
Besancon, France. dwendling@chu-besancon.fr

OBJECTIVE: To assess the rate of occurrence and outcomes of herpes zoster in
patients taking TNFalpha antagonists. METHODS: Retrospective review of the
medical records of 300 patients who received TNFalpha antagonists to treat
chronic inflammatory joint disease. RESULTS: We identified 9 (9/300, 3%) patients
who experienced herpes zoster, 6 women and 3 men, with rheumatoid arthritis (n=7)
or ankylosing spondylitis (n=2). The drug was infliximab in 4 patients,
adalimumab in 2 patients, and etanercept in 3 patients, including 2 patients with
a prior history of infliximab therapy (for 12 and 36 months, respectively). Mean 
treatment duration at the occurrence of herpes zoster was 27 months (range, 6-42 
months). DISCUSSION: Glucocorticoid therapy (n=7) and methotrexate therapy (n=6) 
were the only risk factors identified in our study. Mean follow-up was 26 months.
All 9 patients achieved a full recovery with antiviral treatment and interruption
of the TNFalpha antagonist. One patient experienced a recurrence after resuming
TNFalpha antagonist therapy. CONCLUSION: The scant data in the literature suggest
a higher risk of herpes zoster with anti-TNFalpha antibodies than with the
soluble receptor. The role for concomitant treatments (glucocorticoids and
methotrexate) should be taken into account.

PMID: 18674945 [PubMed - indexed for MEDLINE]

190: Zhongguo Zhong Xi Yi Jie He Za Zhi. 2008 May;28(5):451-3.

[Integrative medicinal therapy on herpes zoster in middle and old aged patients]

[Article in Chinese]

Wang YF, Zhang M, Geng L.

Department of Dermatology, Yueyang Integrative Medical Hospital Affiliated to
Shanghai University of TCM, Shanghai. wyf_cz@163.com

OBJECTIVE: To study the therapeutic effect of integrative medicinal therapy with 
Qinzhu Liangxue Mixture (QLM) in combined with valaciclovir on herpes zoster (HZ)
in middle and old aged patients. METHODS: Ninety-seven HZ patients were randomly 
assigned to three groups and treated respectively with QLM alone (A),
valaciclovir alone (B) and QLM plus valaciclovir (C). Times for stopping newly
appeared blisters, scabbing relieving pain, and curing, as well as incidence rate
of postherpetic neuralgia (PHN) after treatment were evaluated. Patients'
symptoms and signs were scored before and after treatment. RESULTS: Time for
appeaed newly blister and scabbing was shorter in Group B than in Group A; time
for relieving pain and curing was shorter in Group C than in Group A; and the PHN
incidence rate in Group C was the lowest. CONCLUSION: Valaciclovir can control
the skin rash of HZ with quicker initiating time, and QLM can effectively relieve
pain, the combined use with the two drugs can decrease the incidence rate of PHN 
availably.

Publication Types: 
    English Abstract

PMID: 18672776 [PubMed - in process]

191: Endoscopy. 2008 Sep;40 Suppl 2:E157-8.

Herpes simplex virus esophagitis in an immunodeficient patient with
non-small-cell lung cancer following a disseminated herpes zoster infection.

Gundling F, Rohrbach H, Nerlich A, Schepp W.

Second Department of Medicine, Bogenhausen Academic Teaching Hospital, Technical 
University of Munich, Munich, Germany. Gastroenterologie@kh-bogenhausen.de

Publication Types: 
    Case Reports

PMID: 18668447 [PubMed - indexed for MEDLINE]

192: J Virol. 2008 Oct;82(19):9555-63. Epub 2008 Jul 30.

Association of the cellular coactivator HCF-1 with the Golgi apparatus in sensory
neurons.

Kolb G, Kristie TM.

National Institutes of Health, 4-129, 4 Center Drive, Bethesda, MD 20892, USA.

HCF-1 is a cellular transcriptional coactivator that is critical for mediating
the regulated expression of the immediate-early genes of the alphaherpesviruses
herpes simplex virus type 1 and varicella-zoster virus. HCF-1 functions, at least
in part, by modulating the modification of nucleosomes at these viral promoters
to reverse cell-mediated repressive marks and promote activating marks.
Strikingly, HCF-1 is specifically sequestered in the cytoplasm of sensory neurons
where these viruses establish latency and is rapidly relocalized to the nucleus
upon stimuli that result in viral reactivation. However, the analysis of HCF-1 in
latently infected neurons and the protein's specific subcellular location have
not been determined. Therefore, in this study, the localization of HCF-1 in
unstimulated and induced latently infected sensory neurons was investigated and
was found to be similar to that observed in uninfected mice, with a time course
of induced nuclear accumulation that correlated with viral reactivation. Using a 
primary neuronal cell culture system, HCF-1 was localized to the Golgi apparatus 
in unstimulated neurons, a unique location for a transcriptional coactivator.
Upon disruption of the Golgi body, HCF-1 was rapidly relocalized to the nucleus
in contrast to other Golgi apparatus-associated proteins. The location of HCF-1
is distinct from that of CREB3, an endoplasmic reticulum-resident HCF-1
interaction partner that has been proposed to sequester HCF-1. The results
support the model that HCF-1 is an important component of the viral
latency-reactivation cycle and that it is regulated by association with a
component that is distinct from the identified HCF-1 interaction factors.

Publication Types: 
    Research Support, N.I.H., Intramural

PMID: 18667495 [PubMed - indexed for MEDLINE]

193: Expert Rev Vaccines. 2008 Aug;7(6):753-82.

Cost-effectiveness of varicella vaccination programs: an update of the
literature.

Rozenbaum MH, van Hoek AJ, Vegter S, Postma MJ.

Groningen Research Institute of Pharmacy (GRIP), University of Groningen,
Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. m.h.rozenbaum@rug.nl

Varicella is one of the most common infectious diseases in childhood, caused by
the varicella zoster virus. Although vaccines are available, there are only a few
countries with an early-childhood vaccination program. Most countries mainly
focus on vaccination of high-risk groups, such as susceptible healthcare workers.
One of the main concerns with a routine early-childhood vaccination program is a 
potential (temporal) increase of the incidence of herpes zoster among elderly
adults. In this review, we focus on the cost-effectiveness of varicella
vaccination and on the methodology used in the health-economic studies. In
particular, we focus on the perspective adopted, type of model used, the modeled 
effect on herpes zoster, the vaccine efficacy and price, and on the value of time
lost by infection. The vast majority of studies show vaccination of high-risk
groups - including susceptible adolescents - to be cost saving. Routine
early-childhood vaccination programs are always cost saving if indirect costs of 
production losses are included, or cost effective, as long as the potential
negative effects on zoster are not taken into account. We note that most studies 
included in the review used old vaccine prices and a single dose of the varicella
vaccine, whereas multiple doses are now becoming the standard. Despite that,
those aspects limit the timeliness of our review and we believe that the current 
work does provide useful insights in the cost-effectiveness of varicella
vaccination.

Publication Types: 
    Review

PMID: 18665775 [PubMed - indexed for MEDLINE]

194: Expert Rev Vaccines. 2008 Aug;7(6):721-3.

11th Annual Conference on Vaccine Research.

O'Brien J.

Department of Global Health and Population, Harvard School of Public Health, 665 
Huntington Avenue, Boston, MA 02115, USA. jobrien@hsph.harvard.edu

The 11th Annual Conference on Vaccine Research, hosted by the National Foundation
for Infectious Disease, attracted approximately 450 leaders in the fields of
epidemiology, health economics, immunology and vaccinology, making it the largest
scientific meeting devoted exclusively to vaccine research and technology. The
conference highlighted recent advancements in vaccine design, including the
discovery of new adjuvants, cytokines and regulatory pathways. Other topics
included a comprehensive overview of the development and uses of cutaneous
vaccination and a discussion of recently licensed vaccines against the human
papillomavirus, herpes zoster virus, meningococcal disease and rotavirus and a
discussion on the importance of redesigning and increasing the coverage of the
influenza vaccine. Keynote remarks were provided by the demographer and economist
David E Bloom (Harvard School of Public Health, USA), who argued that traditional
economic evaluations of vaccine interventions have failed to account for the full
range of benefits that can accrue from vaccination. These benefits are
substantial in size and potentially decisive with respect to the bottom-line
results of benefit-cost calculations.

Publication Types: 
    Congresses

PMID: 18665770 [PubMed - indexed for MEDLINE]

195: Pediatr Infect Dis J. 2008 Sep;27(9):847-8.

Vaccine-strain varicella zoster virus causing recurrent herpes zoster in an
immunocompetent 2-year-old.

Ota K, Kim V, Lavi S, Ford-Jones EL, Tipples G, Scolnik D, Tellier R.

The Hospital for Sick Children, Toronto, ON, Canada.

Varivax III is a live attenuated vaccine against varicella zoster virus (VZV). We
report a case of recurrent vaccine-strain herpes zoster in an immunocompetent
2-year-old child. Vaccine-strain VZV was identified through polymerase chain
reaction. This report aims to alert physicians that recurrent vaccine-strain
herpes zoster can be a rare complication of VZV vaccination in apparently
immunocompetent hosts.

Publication Types: 
    Case Reports

PMID: 18664930 [PubMed - indexed for MEDLINE]

196: J Fam Pract. 2008 Apr;57(4 Suppl):S1-11; quiz S12.

Comment in:
    J Fam Pract. 2008 Jul;57(7):438.

Update on vaccine-preventable diseases: are adults in your community adequately
protected?

Schaffner W.

Department of Preventive Medicine, Vanderbilt University School of Medicine,
Nashville, TN, USA.

Vaccine-preventable diseases continue to be a significant cause of morbidity and 
premature death among adults. The Advisory Committee on Immunization Practices
Recommended Adult Immunization Schedule provides recommendations for 14
vaccine-preventable diseases. This supplement reviews the benefits of
immunization against 6 vaccine-preventable diseases that physicians frequently
encounter among adult patients: influenza, pneumococcal infections, herpes
zoster, human papillomavirus, and hepatitis B.

Publication Types: 
    Review

PMID: 18655764 [PubMed - indexed for MEDLINE]

197: Clin Pediatr (Phila). 2009 Jan;48(1):116-8. Epub 2008 Jul 25.

Severe headache.

Tolbert C, Kamat R, Chhabra S.

Inova Fairfax Hospital for Children, Fall Church, Virginia, USA.

Publication Types: 
    Case Reports

PMID: 18660456 [PubMed - indexed for MEDLINE]

198: Neurol Clin. 2008 Aug;26(3):675-97, viii.

Varicella zoster virus infection: clinical features, molecular pathogenesis of
disease, and latency.

Mueller NH, Gilden DH, Cohrs RJ, Mahalingam R, Nagel MA.

Department of Neurology, University of Colorado School of Medicine, 4200 East 9th
Avenue, Mail Stop B182, Denver, CO 80262, USA.

Varicella zoster virus (VZV) is an exclusively human neurotropic
alphaherpesvirus. Primary infection causes varicella (chickenpox), after which
virus becomes latent in cranial nerve ganglia, dorsal root ganglia, and autonomic
ganglia along the entire neuraxis. Years later, in association with a decline in 
cell-mediated immunity in elderly and immunocompromised individuals, VZV
reactivates and causes a wide range of neurologic disease. This article discusses
the clinical manifestations, treatment, and prevention of VZV infection and
reactivation; pathogenesis of VZV infection; and current research focusing on VZV
latency, reactivation, and animal models.

Publication Types: 
    Review

PMID: 18657721 [PubMed - indexed for MEDLINE]

199: J Infect. 2008 Sep;57(3):266-8. Epub 2008 Jul 24.

Famciclovir substitution for patients with acyclovir-associated renal toxicity.

Htwe TH, Bergman S, Koirala J.

Division of Infectious Diseases, Department of Medicine, Southern Illinois
University School of Medicine, Springfield, P.O. Box-19636, IL 62794-9636, USA.

Acyclovir-induced nephrotoxicity is well known, but published literature lacks
information on the safety of substitution with other antiviral agents. We
describe four patients with acyclovir-induced renal toxicity that were
subsequently managed with hydration and famciclovir. All four patients
subsequently had improvements in their symptoms with full recovery of their
baseline renal function.

Publication Types: 
    Case Reports

PMID: 18656262 [PubMed - indexed for MEDLINE]

200: Indian J Med Res. 2008 May;127(5):447-52.

Comment in:
    Indian J Med Res. 2008 May;127(5):428-30.

Comorbidities among HIV-infected injection drug users in Chennai, India.

Solomon SS, Hawcroft CS, Narasimhan P, Subbaraman R, Srikrishnan AK, Cecelia AJ, 
Suresh Kumar M, Solomon S, Gallant JE, Celentano DD.

YR Gaitonde Centre for AIDS Research & Education, VHS Campus Adyar, Chennai,
India. suniti@yrgcare.org

BACKGROUND & OBJECTIVE: HIV-infected injection drugs users (IDUs) are known to
have high rates of co-infections. A few reports exist on comorbidities among
HIV-infected IDUs in India. We carried out a retrospective study to analyse data 
on comorbidities in India and treatment challenges faced when treating
HIV-infected IDUs in India. METHODS: A retrospective chart review of 118
HIV-infected IDUs who accessed care at the YRG Centre for Substance Abuse-Related
Research, Chennai, between August 2005 and February 2006 was done. Demographic,
laboratory and clinical information was extracted from medical records.
Descriptive demographic and clinical characteristics and distributions of
comorbidities across CD4 cell count strata were analysed. RESULTS: All IDUs were 
male with a median age of 35.5 yr. The majority were married with average monthly
income less than INR 3000 per month. The prevalence of hepatitis B and C
infections were 11.9 and 94.1 per cent, respectively. Other common co-morbidities
included oral candidiasis (43.2%), tuberculosis (33.9%), anaemia (22.9%), lower
respiratory tract infections (16.1%), cellulitis (6.8%), herpes zoster (9.3%) and
herpes simplex (9.3%). Among participants with CD4+ < 200 cells/microl, the
prevalence of TB was 60 per cent. INTERPRETATION & CONCLUSION: IDUs in Chennai
were commonly co-infected with HBV, HCV and tuberculosis, complicating use of
antiretroviral and anti-tuberculous therapy. The current regimens available for
the management of HIV and TB in India may need to be re-assessed for IDUs given
the potential for increased rates of hepatotoxicity.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 18653907 [PubMed - indexed for MEDLINE]

201: Kathmandu Univ Med J (KUMJ). 2005 Jul-Sep;3(3):230-3.

Viral infections in sudden hearing loss. Do we have enough evidence?

Mishra B, Panda N, Singh MP, Ratho RK.

Department of Virology, Postgraduate Institute of Medical, Education & Research, 
Chandigarh, India.

OBJECTIVE: The aetiology of sudden deafness remains unknown even though some
evidences suggest that it could be viral in origin. This study aimed to find out 
the relationship between viral infections and sudden sensorineural hearing loss. 
METHODS: 32 patients presenting with sudden deafness and 10 healthy controls were
included in the study. IgM antibodies to varicella zoster virus, measles,
cytomegalovirus and herpes simplex virus were detected using micro ELISA.
RESULTS: Overall, 7(21.8%) patients showed seropositivity to one or more viruses.
Virus specific IgM antibodies against measles and varicella zoster could be
demonstrated in 4 (12.5%) and 3 (9.4%) patients respectively. None of the samples
were found to be positive for herpes simplex virus (HSV) and human
cytomegalovirus (HCMV) specific IgM antibodies. Controls were negative for all
the viruses tested. The difference in seropositivity between the patient and
control group was not statistically significant (p>0.05). CONCLUSION: Thus, this 
study suggests that sudden deafness is not commonly associated with a systemic
viral infection.

PMID: 18650582 [PubMed - indexed for MEDLINE]

202: Masui. 2008 Jul;57(7):874-8.

[Effective treatment of acute pain and related symptoms in elderly with herpes
zoster]

[Article in Japanese]

Tajima K, Kawagoe I, Kanai M, Mitsuhata H.

Department of Anesthesiology and Pain Medicine, Juntendo Tokyo Koto Geriatric
Medical Center Tokyo 136-5632.

BACKGROUND: The incidence of herpes zoster increases with age. Immediate pain
relief is required for prevention of postherpetic neuralgia (PHN) and also its
related symptoms that worsen the general condition because acute herpetic pain
often interferes with sleep, mood, and general activities in elderly patients.
Nerve block is useful to relief acute pain and recommended for prevention of PHN.
Tricyclic antidepressant drugs have antinoticeptive effect in acute pain in
experimental models, in addition to its antidepressant effect. METHODS: Forty
elderly patients with herpes zoster within 3 months after the onset underwent
nerve blocks and received tricyclic antidepressant drugs. We assessed the effect 
of treatments and adverse effects. RESULTS: No significant adverse effects were
found in elderly patients who had received nerve blocks and/or tricyclic
antidepressant drugs. Alleviation of acute pain was obtained in more than 80% of 
patients, and in all patients depressive state and/or disturbance of the general 
condition were significantly improved. CONCLUSIONS: With careful technique and
assessment of patients, both nerve block and tricyclic antidepressant drugs were 
beneficial and safe treatments in elderly patients with herpes zoster.

Publication Types: 
    English Abstract

PMID: 18649643 [PubMed - indexed for MEDLINE]

203: J Med Virol. 2008 Sep;80(9):1646-52.

Clinical and psychosocial correlates of post-herpetic neuralgia.

Volpi A, Gatti A, Pica F, Bellino S, Marsella LT, Sabato AF.

Department of Public Health, University of Rome "Tor Vergata", Rome, Italy.
volpi@med.uniroma2.it

Post-herpetic neuralgia is the most challenging and debilitating complication of 
herpes zoster in the immunocompetent host. Because the effect of treatment is
disappointing once the syndrome has developed, it is important to know which
factors predict post-herpetic neuralgia occurrence to facilitate selection of
herpes zoster patients with a higher risk of developing neuralgia and undertake
preventative strategies. The present study aimed at identifying demographic,
clinical and psychosocial correlates of post-herpetic neuralgia in a sample of
219 immunocompetent patients, who were examined by dermatologists in private
practice in Italy and who completed a questionnaire designed to evaluate their
clinical and psychosocial profile at the time of clinical diagnosis of herpes
zoster and at a follow-up visit 6 months later. In a univariate analysis,
post-herpetic neuralgia was associated significantly with older age, longer
duration of prodromal pain, greater acute pain intensity, greater extent of rash,
presence of abnormal sensations and use of systemic antiviral therapy. Compared
to the values at herpes zoster onset, at the follow-up visit patients with
post-herpetic neuralgia presented with similar high mean scores of pain
intensity, anxiety and depression and greatly reduced quality of life, whereas
patients without neuralgia presented with improved scores. In a multivariate
model, older age, greater acute pain intensity, greater extent of rash and longer
duration of prodromal pain were independently associated with post-herpetic
neuralgia. The results of this study may help physicians to identify patients
with a higher risk of developing post-herpetic neuralgia and undertaking
preventative strategies.

PMID: 18649332 [PubMed - indexed for MEDLINE]

204: J Med Virol. 2008 Sep;80(9):1684-8.

Reliable detection and quantitation of viral nucleic acids in oral fluid: Liquid 
phase-based sample collection in conjunction with automated and standardized
molecular assays.

Raggam RB, Wagner J, Michelin BD, Putz-Bankuti C, Lackner A, Bozic M, Stauber RE,
Santner BI, Marth E, Kessler HH.

Molecular Diagnostics Laboratory, IHMEM, Medical University of Graz, Graz,
Austria.

Oral fluid has been used widely as sample matrix for the detection and
quantitation of viral nucleic acids. However, in the vast majority of previous
studies, various methods for collection of oral fluid and molecular assays
lacking automation and standardization were used. In this study, a new
standardized liquid phase-based saliva collection system was employed followed by
a fully automated viral nucleic acid extraction and real-time PCR using
commercially available in vitro diagnostics (IVD)/Conformite Europeene (CE)
labeled molecular assays. When the lower limit of detection of herpes simplex
virus (HSV)-1/2 DNA, varicella zoster virus (VZV) DNA, and hepatitis C virus
(HCV) RNA in spiked oral fluid was tested, the results were found to be
comparable to those with defined sample materials recommended by the assay
manufacturers. When clinical specimens were investigated, 21 of 25 (84%) oral
fluids obtained from patients with clinically apparent herpetic lesions tested
positive for HSV DNA, 7 of 10 (70%) oral fluids obtained from patients with
Ramsay Hunt Syndrome tested positive for VZV DNA, and 19 of 40 (48%) oral fluids 
collected from patients with chronic HCV infection tested positive for HCV RNA.
The automated extraction instruments completed all extractions without
malfunction and no inhibitions were observed throughout the entire study. Liquid 
phase-based saliva collection in conjunction with automated and standardized
commercially available molecular assays allows reliable quantitation of viral
nucleic acids in oral fluid samples and may contribute to improved comparable and
interpretable test results.

Publication Types: 
    Comparative Study
    Evaluation Studies

PMID: 18649328 [PubMed - indexed for MEDLINE]

205: Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006852.

Corticosteroids as adjuvant to antiviral treatment in Ramsay Hunt syndrome
(herpes zoster oticus with facial palsy) in adults.

Uscategui T, Doree C, Chamberlain IJ, Burton MJ.

Department of Paediatrics, Basildon University Hospital, Nethermayne, Basildon,
Essex, UK, SS16 5NL. tere_u@yahoo.com

BACKGROUND: Inflammation and oedema of the facial nerve due to viral infection by
the herpes zoster virus are implicated in the aetiology and clinical
manifestation of Ramsay Hunt syndrome (herpes zoster oticus with facial palsy).
Corticosteroids, with their powerful anti-inflammatory effect, have a potential
role to play in the reduction or minimisation of nerve damage when administered
together with antiviral therapy, and therefore may improve the outcome for
patients with Ramsay Hunt syndrome. OBJECTIVES: To determine the effectiveness of
corticosteroids as an adjuvant to antiviral therapy in adult patients with Ramsay
Hunt syndrome (herpes zoster oticus with facial palsy). SEARCH STRATEGY: We
searched the Cochrane ENT Group Trials Register, the Cochrane Central Register of
Controlled Trials (CENTRAL), (The Cochrane Library Issue 4, 2007), MEDLINE (1950 
to December 2007) and EMBASE (1974 to December 2007), CINAHL (1982 to December
2007), LILACS, KoreaMed, IndMed, PakMediNet, ZETOC, Cambridge Scientific
Abstracts (Conference Proceedings Database), ISI Proceedings (Web of Science),
the National Research Register (NRR), the UK Clinical Research Network Portfolio 
Database (UKCRN), the World Health Organization International Clinical Trials
Registry Platform (ICTRP), the Research Findings Register (ReFeR) and the
metaRegister of Controlled Trials (mRCT). SELECTION CRITERIA: All randomised
controlled trials in which corticosteroids (by any route of administration at any
dosage) were given as an adjuvant to antiviral agents in the treatment of Ramsay 
Hunt syndrome. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed
eligibility and trial quality of the available studies, whether they were
published or unpublished. No trials were found and therefore no data were
analysed. MAIN RESULTS: This is an empty review as no trials were found that
fulfilled the inclusion criteria. AUTHORS' CONCLUSIONS: Since no randomised
controlled trials investigating the use of corticosteroids as an adjuvant to
antiviral treatment in Ramsay Hunt syndrome were identified, such studies are
needed to assess the effects of such therapy.

Publication Types: 
    Review

PMID: 18646170 [PubMed - indexed for MEDLINE]

206: Biol Blood Marrow Transplant. 2008 Aug;14(8):867-71.

Varicella-zoster virus disease is more frequent after cord blood than after bone 
marrow transplantation.

Vandenbosch K, Ovetchkine P, Champagne MA, Haddad E, Alexandrov L, Duval M.

Groupe de Recherche en Immunologie et Transplantation de Sang de Cordon, Service 
d'Hematologie-Oncologie, Centre de Cancerologie Charles-Bruneau, Montreal,
Quebec, Canada.

Immune reconstitution may differ following cord blood transplantation (CBT) and
bone marrow transplantation (BMT), and this may lead to a difference in varicella
zoster virus (VZV) disease rates. One hundred fourteen VZV seropositive children 
received a CBT (37 patients), or a T-replete BMT (77 patients) at our
institution. Patients did not received specific VZV disease prophylaxis. VZV
disease was diagnosed by immunofluorescence or culture in 41 (36%) patients. In
multivariate analysis, VZV disease was more frequent in older children (relative 
risk [RR] 1.11 per year; 95% confidence interval [CI], 1.04-1.18; P = .002), and 
after CBT (RR 2.27; 95% CI, 1.18-4.34; P = .013). The cumulative incidence of VZV
disease at 3 years posttransplant was 46% following CBT. VZV disease incidence
was 71% in CBT patients over 10 years old at transplant. Visceral dissemination
occurred in 7 patients (6 CBT and 1 BMT) (P = .005). VZV disease is thus more
frequent and more severe after CBT than after BMT.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 18640569 [PubMed - indexed for MEDLINE]

207: Eur J Neurol. 2008 Sep;15(9):995-7. Epub 2008 Jul 14.

Aseptic meningitis and encephalitis because of herpesviruses and enteroviruses in
an immunocompetent adult population.

Frantzidou F, Kamaria F, Dumaidi K, Skoura L, Antoniadis A, Papa A.

A Department of Microbiology, School of Medicine, Aristotle University of
Thessaloniki, Thessaloniki, Greece. filanthi@med.auth.gr

BACKGROUND AND AIM: Human herpesviruses (HHVs) and enteroviruses (EVs) are the
major causative agents of CNS viral infections. The aim of the study was to
identify the etiology and determine the frequency of aseptic meningitis and
encephalitis due to HHVs and EVs in an immunocompetent adult population. METHODS:
Eighty-one patients (ages >or=15) with aseptic meningitis or encephalitis treated
in the Infectious Diseases Hospital of Thessaloniki, Greece, during 2003-2006,
were included in the study. Polymerase chain reaction for detection of herpes-
and enterovirus genome direct in cerebrospinal fluid samples was performed.
RESULTS: Based on clinical and laboratory data, 36/81 patients had meningitis and
45/81 had encephalitis. Etiology was defined in 11 patients (31%) with aseptic
meningitis. EVs were the major causative agents (8/36, 22%), followed by
varicella zoster virus (2/36, 5%) and herpes simplex virus-2 (HSV-2) (1/36, 3%). 
Etiology was identified in 8 of 45 (18%) patients with encephalitis, EV (4/45,
9%) and HSV-1 (4/45, 9%) being the most common pathogens. CONCLUSION:
Enteroviruses are the most common cause of adult aseptic meningitis and together 
with HSV-1 the main causes of encephalitis.

PMID: 18637823 [PubMed - indexed for MEDLINE]

208: J Fam Pract. 2008 Jul;57(7):438.

Comment on:
    J Fam Pract. 2008 Apr;57(4 Suppl):S1-11; quiz S12.

FluMist: refrigerated, never frozen.

Susla GM.

Publication Types: 
    Comment
    Letter

PMID: 18634200 [PubMed - indexed for MEDLINE]

209: Ann Pharmacother. 2008 Sep;42(9):1323-6. Epub 2008 Jul 15.

Famciclovir-induced leukocytoclastic vasculitis.

Te CC, Le V, Allee M.

Department of Internal Medicine, University of Oklahoma Health Sciences Center,
Oklahoma City, OK 73190, USA. charles-te@ouhsc.edu

OBJECTIVE: To report a case of famciclovir-induced leukocytoclastic vasculitis
(LCV). CASE SUMMARY: A 67-year-old white female presented to the hospital for
evaluation of large, bilateral palpable purpura; coalescing ulcers with central
eschars; and small, red violaceous papules on her legs and groin. Approximately 2
months prior to this hospitalization, the woman was diagnosed with shingles of
her left T1-T2 nerve distribution and was treated with famciclovir 500 mg 3 times
daily, which was her first exposure to this medication. Her shingles resolved;
however, on day 4 of treatment, she began to notice red spots on both of her legs
that began to progressively blister and increase in size. She discontinued
famciclovir at that time. The rash persisted and spread to her abdomen, groin,
legs, feet, and toes. She underwent punch biopsy that revealed LCV. Workup was
negative for antinuclear antibody, rheumatoid factor, hepatitis B and C virus,
perinuclear-staining antineutrophil cytoplasmic antibodies, cytoplasmic-staining 
antineutrophil cytoplasmic antibodies, antibodies to extractable nuclear
antigens, proteinase 3, and myeloperoxidase. The patient improved with daily oral
steroids and local wound care. DISCUSSION: LCV has been reported only once before
in the English literature as of January 2008. The most common cause of LCV is
medication use, but it is a diagnosis of exclusion. It is hypothesized that drugs
act as haptens, which cause an immune response. An objective causality assessment
using the Naranjo probability scale suggested that famciclovir was the probable
cause of LCV in this patient. CONCLUSIONS: Healthcare professionals should be
aware of the possible development of famciclovir-induced LCV.

Publication Types: 
    Case Reports

PMID: 18628445 [PubMed - indexed for MEDLINE]

210: Clin Transplant. 2008 Jul-Aug;22(4):502-7. Epub 2008 Jul 8.

Herpes zoster infection after liver transplantation in patients receiving
induction therapy with alemtuzumab.

Alcaide ML, Abbo L, Pano JR, Gaynor JJ, Tryphonopoulos P, Weppler D, Moon JI,
Tzakis AG, Morris MI.

Department of Infectious Diseases, Miller School of Medicine, Miami, FL 33136,
USA.

BACKGROUND: The incidence of herpes zoster (HZ) infection in liver transplant
recipients prior to the use of induction therapy with monoclonal antibodies has
been reported as being 1.2-18%. We studied the occurrence of HZ in liver
transplant recipients that received induction therapy with alemtuzumab (Campath
1H). MATERIAL AND METHODS: This was a retrospective review of primary liver
transplant recipients who received alemtuzumab as induction therapy at our
center. HZ infection was diagnosed clinically as the presence of a characteristic
vesicular rash in a dermatomal distribution without any further virological
confirmation. RESULTS: A total of 118 liver transplant recipients were treated
with alemtuzumab between August 2002 and August 2005. Twelve patients developed
HZ infection, and the cumulative probability of a patient developing HZ infection
by 36 months post-transplant +/-1 SE was estimated as 16.5 +/- 5.0%. The median
time for onset of the infection was 10.2 months (range 4.7-30.7) after the
transplant. All patients had only one dermatomal distribution, and none developed
systemic infection or complications such as postherpetic neuropathy. All patients
except one were treated with systemic intravenous acyclovir. One patient received
famciclovir. All of the patients had received ganciclovir during the
post-transplant period but were not receiving any other antiviral medication at
the time of the infection. CONCLUSION: Herpes zoster infection has previously
been reported as a frequent complication of liver transplantation. Our study
suggests that it occurs in approximately 16% of patients receiving induction
therapy with alemtuzumab. Although alemtuzumab is a powerful immunosuppressive
agent and there is still little information regarding its long-term safety when
used in liver transplantation, our data do not suggest any increase in the
occurrence and complications of HZ.

PMID: 18627401 [PubMed - indexed for MEDLINE]

211: Lupus. 2008 Jul;17(7):622-9.

A prospective multicentre study of mycophenolate mofetil combined with
prednisolone as induction therapy in 213 patients with active lupus nephritis.

F L, Y T, X P, L W, H W, Z S, H Z, Z H; MMF in Induction Therapy for Active Lupus
Nephritis in Mainland China Study Group.

Collaborators: Tu Y, Peng X, Wang L, Wang H, Sun Z, Zheng H, Hu Z, Shao F, Wang
Y, Zhan F, Gu Y, Wang F, Zhou Z, Liu X, Dong J, Wang R, Feng X, Fu S, Zhu Q, Liu 
Z, Zuo X, Peng Y, Tang X, Yue H, Yang N, Zhu H, Xing C, Chen J, Wu G, Shi W, Xu
L.

The Nephrology Division, Huashan Hospital, Fudan University, Shanghai, China.
lufuming@medmail.com.cn

Mycophenolate mofetil (MMF) with prednisolone has been associated with high
remission rates when used as induction treatment for lupus nephritis. This
prospective, multicentre, cohort study investigates the efficacy and safety of
this regimen over 24 weeks in 213 Chinese patients with active lupus nephritis
(Classes III, IV, V or combination). Baseline activity index (AI) was 6.91+/-3.33
and chronicity index (CI) was 1.9+/-1.2. The remission rate was 82.6% at 24 weeks
(complete remission, 34.3%; partial remission, 48.4%). There were significant
(P<0.01) improvements in kidney function shown by reductions in proteinuria,
serum albumin, serum creatinine and creatinine clearance, as well as in systemic 
lupus erythematosus disease activity index (SLEDAI) scores. Independent risk
factors influencing remission were pathological classification (including Class V
and III or Class V and IV nephritis) and elevated serum creatinine at baseline
(OR 2.967, 95% CI: 1.479-6.332, P=0.001 and OR 1.007, 95% CI: 1.002-1.011,
P=0.001, respectively). Patients with concomitant membranous features on biopsy
had a lower remission rate than those with Class III and IV nephritis (66.7% vs
87.3%, P=0.002). Renal biopsy was repeated in 25 patients following treatment.
There was a transition to less severe pathological morphologies in majority of
subjects. Infections were monitored throughout treatment: eight patients (3.8%)
experienced bacterial infections, whereas herpes zoster occurred in seven
patients. Nine patients (4.2%) suffered from gastrointestinal upset, which
resolved without discontinuation of MMF. One patient became leucopenic, whereas
another died from active disease unrelated to kidney symptoms. MMF combined with 
prednisolone is an effective and well-tolerated induction treatment for patients 
with active lupus nephritis and for controlling SLE systemic activity.

Publication Types: 
    Clinical Trial
    Multicenter Study

PMID: 18625634 [PubMed - indexed for MEDLINE]

212: Antiviral Res. 2008 Nov;80(2):206-12. Epub 2008 Jul 11.

Efficacy of orally administered Lobelia chinensis extracts on herpes simplex
virus type 1 infection in BALB/c mice.

Kuo YC, Lee YC, Leu YL, Tsai WJ, Chang SC.

Institute of Life Science, Fu-Jen University, Taipei, Taiwan, ROC.
021553@mail.fju.edu.tw

By a plaque reduction assay, methanolic extracts from Lobelia chinensis (LC)
significantly blocked herpes simplex virus type 1 (HSV-1) replication in HeLa
cells without apparent cytotoxicity. The 50% inhibitory concentration (IC(50)) of
LC on HSV-1 replication is 139.2 microg/ml. To elucidate LC anti-HSV-1 activity
in vivo, BALB/c mice were injected subcutaneously with HSV-1 (2.5 x 10(6)PFU/50
microl), treated orally thrice a day with acyclovir (60 mg/kg/dose) or LC (20 and
50 mg/kg/dose) for 7 days, and inspected daily for signs of disease. Data from
the scoring system indicated that animals infected with HSV-1, developed
progressive zoster lesions starting 2 days postinfection (p.i.) and appeared the 
most serious syndromes at 4-5 days p.i. In marked contrast to the results with
control mice, treatment with acyclovir or 50 mg/kg/dose LC resulted in a
sustained protective effect. The HSV-1 titers and DNA levels in ground skin
samples were significantly reduced by LC. No toxic effect of LC on liver and
kidney functions was apparent. These results indicated that LC was a potent
inhibitor of the in vitro and in vivo replication of HSV-1.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18621082 [PubMed - indexed for MEDLINE]

213: Vaccine. 2008 Sep 26;26(41):5244; author reply 5245. Epub 2008 Jul 9.

Comment on:
    Vaccine. 2007 Nov 28;25(49):8326-37.

Interpretation of results of the cost-effectiveness analysis reported by
Pellissier et al. on October 2007.

Najafzadeh M, Sadatsafavi M, Marra CA.

Publication Types: 
    Comment
    Letter

PMID: 18619510 [PubMed - indexed for MEDLINE]

214: Gastroenterology. 2008 Aug;135(2):362, 715. Epub 2008 Jul 9.

Clinical challenges and images in GI. Colonic pseudo-obstruction as a rare
complication of herpes zoster.

Dedemadi G, Georgoulis G.

Department of Surgery, "A. Fleming" Hospital, Athens, Greece.

Publication Types: 
    Case Reports

PMID: 18619453 [PubMed - indexed for MEDLINE]

215: J Clin Neurosci. 2008 Sep;15(9):1068-9. Epub 2008 Jul 9.

Tuberculous myelitis diagnosed by elevated adenosine deaminase activity in
cerebrospinal fluid.

Suda S, Ueda M, Komaba Y, Yamazaki M, Katsumata T, Katayama Y.

Publication Types: 
    Case Reports
    Letter

PMID: 18617398 [PubMed - indexed for MEDLINE]

216: Bioorg Med Chem Lett. 2008 Aug 1;18(15):4364-7. Epub 2008 Jun 24.

Successful kinase bypass with new acyclovir phosphoramidate prodrugs.

McGuigan C, Derudas M, Bugert JJ, Andrei G, Snoeck R, Balzarini J.

Welsh School of Pharmacy, Cardiff University, Redwood Building, King Edward VII
Avenue, Cardiff CF10 3NB, UK. mcguigan@cardiff.ac.uk

Novel phosphoramidates of acyclovir have been prepared and evaluated in vitro
against acyclovir-sensitive and -resistant herpes simplex virus (HSV) types 1 and
2 and varicella-zoster virus (VZV). Unlike the parent nucleoside these novel
phosphate prodrugs retain antiviral potency versus the ACV-resistant virus
strain, suggesting an efficient bypass of the viral thymidine kinase.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18614365 [PubMed - indexed for MEDLINE]

217: Cuad Bioet. 2008 May-Aug;19(66):321-53.

[Vaccines, biotechnology and their connection with induced abortion]

[Article in Spanish]

Redondo Calderon JL.

Alminares del Genil, 18006 Granada. redondojoseluis@telefonica.net

Diploid cells (WI-38, MRC-5) vaccines have their origin in induced abortions.
Among these vaccines we fi nd the following: rubella, measles, mumps, rabies,
polio, smallpox, hepatitis A, chickenpox, and herpes zoster. Nowadays, other
abortion tainted vaccines cultivated on transformed cells (293, PER.C6) are in
the pipeline: flu, Respiratory Syncytial and parainfluenza viruses, HIV, West
Nile virus, Ebola, Marburg and Lassa, hepatitis B and C, foot and mouth disease, 
Japanese encephalitis, dengue, tuberculosis, anthrax, plague, tetanus and
malaria. The same method is used for the production of monoclonal antibodies and 
other proteins, gene therapy and genomics. Technology enables us to develop the
aforementioned products without resorting to induced abortion. Full disclosure of
the cell origin in the labelling of vaccines and other products must be
supported. There are vaccines from non-objectionable sources which should be made
available to the public. When no alternative vaccines exist, ethical research
must be promoted. Non-objectionable sources in the production of monoclonal
antibodies, gene therapy and genomics must be encouraged. It is not be consistent
to abstain from products originated in embryonic stem cells and at the same time 
approve of products obtained from induced abortions. It is of paramount
importance to avoid that induced abortion technology seeps into every field of
Medicine.

Publication Types: 
    English Abstract

PMID: 18611078 [PubMed - indexed for MEDLINE]

218: J Dermatolog Treat. 2008;19(4):255-6.

Perineal muco-cutaneous herpes zoster treated with brivudin.

Correia O, Pereira MA, Pereira T, Santos A.

Centro Dermatologia Epidermis, Faculty of Medicine University of Porto, Portugal.

Herpes zoster results from the reactivation of latent varicella-zoster virus
(VZV) from the dorsal root ganglion of sensory nerves. It is rarely described in 
the pediatric population. We report the case of an 8-year-old immunocompetent boy
with a painful lumbosacral herpes zoster that was treated with brivudin and
achieved rapid and sustained improvement in the absence of muco-cutaneous or
pharmacological side effects.

PMID: 18608718 [PubMed - in process]

219: Kathmandu Univ Med J (KUMJ). 2006 Apr-Jun;4(2):246-8.

Hemidiaphragmatic paralysis: a rare complication of cervical herpes zoster.

Paudyal BP, Karki A, Zimmerman M, Kayastha G, Acharya P.

Department of Medicine, Patan Hospital, Lalitpur, Nepal. buddhipaudyal@yahoo.com

Herpes zoster, a sequel of the reactivation of the varicella zoster virus,
usually presents with cutaneous eruptions associated with intense pain and
burning sensation in the affected dermatomes. Motor weakness, however, can
sometimes complicate herpes zoster. In this report we present a case that had
diaphragmatic motor weakness as a sequel of herpes zoster lesions in the neck.

PMID: 18603908 [PubMed - indexed for MEDLINE]

220: Int J Infect Dis. 2009 Jan;13(1):e1-8. Epub 2008 Jul 3.

Incidence of common opportunistic infections in HIV-infected individuals in Pune,
India: analysis by stages of immunosuppression represented by CD4 counts.

Ghate M, Deshpande S, Tripathy S, Nene M, Gedam P, Godbole S, Thakar M, Risbud A,
Bollinger R, Mehendale S.

National AIDS Research Institute, Pune, India. mghate@nariindia.org

BACKGROUND: Opportunistic infections (OIs) influence the morbidity and mortality 
due to HIV infections. Data from India on the incidence of OIs among HIV-infected
individuals by stages of immunodeficiency are scarce. METHODS: Between September 
2002 and November 2004, HIV-infected individuals were enrolled in a prospective
study in Pune. They were clinically and immunologically evaluated quarterly.
Incidence rates of specific OIs were calculated. RESULTS: Median CD4 counts in
HIV-infected male and female patients at baseline were 197/mm(3) and 413/mm(3),
respectively. Tuberculosis was the most common OI with an incidence of 15.4 (95% 
CI 12.2-19.2) per 100 person-years, followed by oral candidiasis 11.3 (95% CI
8.6-14.5), herpes zoster 10.1 (95% CI 7.6-13.1), and cryptococcal meningitis 1.7 
(95% CI 0.8-3.1) per 100 person-years. Patients with baseline CD4 counts of
<200/mm(3) were six times more likely to develop OIs compared to those with CD4
counts of >350/mm(3) (p<0.001). CONCLUSIONS: The high incidence of commonly
reported OIs in Indian HIV-infected individuals highlights the need for early
screening and also the need to increase awareness in healthcare providers, in
order to improve decisions regarding prophylaxis for prevention and appropriate
therapeutic intervention. Emphasis needs to be given to the early diagnosis and
management of tuberculosis in HIV-infected individuals.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18602329 [PubMed - indexed for MEDLINE]

221: IDrugs. 2008 Jul;11(7):471-4.

Vaccine Research--11th Annual Conference: cutaneous formulations, universal
vaccinations and recently licensed vaccines.

O'Brien J.

Harvard University, Harvard School of Public Health, 677 Huntington Avenue,
Boston, MA 02115, USA. jobrien@hsph.harvard.edu

Publication Types: 
    Congresses

PMID: 18600589 [PubMed - indexed for MEDLINE]

222: Semin Ophthalmol. 2008 Jul-Aug;23(4):285-90.

Therapy for acute retinal necrosis.

Kawaguchi T, Spencer DB, Mochizuki M.

Department of Ophthalmology & Visual Science, Tokyo Medical and Dental University
Graduate School of Medicine, Tokyo, Japan.

Acute retinal necrosis is a progressive necrotizing retinopathy caused by herpes 
simplex virus (HSV) or varicella zoster virus (VZV). The mainstay of its
treatment is antiviral therapy against these pathogenic organisms, such as
intravenous acyclovir or oral valacyclovir. Systemic and topical corticosteroids 
together with antiviral therapy are used as an anti-inflammatory treatment to
minimize damages to the optic nerve and retinal blood vessels. Because the
majority of severe cases of the disease show occlusive retinal vasculitis, a low 
dosage of aspirin is used as anti-thrombotic treatment. Vitreo-retinal surgery is
useful to repair rhegmatogenous retinal detachment, one of the main late-stage
complications. Moreover, recent articles have reported some encouraging results
of prophylactic vitrectomy before rhegmatogenous retinal detachment occurs. The
efficacy of laser photocoagulation to prevent the development or extension of
rhegmatogenous retinal detachment is controversial. Despite these treatments, the
visual prognosis of acute retinal necrosis is still poor, in particular
VZV-induced acute retinal necrosis.

Publication Types: 
    Review

PMID: 18584565 [PubMed - indexed for MEDLINE]

223: Semin Ophthalmol. 2008 Jul-Aug;23(4):275-83.

Overview and diagnosis of acute retinal necrosis syndrome.

Usui Y, Goto H.

Department of Ophthalmology, Tokyo Medical University Hospital, Tokyo, Japan.
usuyoshi@aol.com

Acute retinal necrosis (ARN) syndrome, also known as Kirisawa's uveitis, is one
of the most serious ocular diseases, and is characterized by a combination of
peripheral, confluent, necrotizing retinitis, retinal arteritis, and intraocular 
inflammation. ARN syndrome is caused by the herpesvirus family, including herpes 
simplex virus (HSV) and varicella-zoster virus (VZV). The diagnosis of ARN
syndrome is fundamentally based on clinical appearance and the demonstration of
viral infection. Recently, polymerase chain reaction techniques permit detection 
of very small amounts of viral DNA in intraocular specimens. This knowledge can
help in both the diagnosis and design of therapeutic strategy for ARN syndrome.
Here we review the clinical presentation and the current advances in the
diagnosis of ARN syndrome.

Publication Types: 
    Review

PMID: 18584564 [PubMed - indexed for MEDLINE]

224: Semin Ophthalmol. 2008 Jul-Aug;23(4):235-40.

Corneal endotheliitis.

Suzuki T, Ohashi Y.

Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan.

Corneal endotheliitis is an intriguing clinical entity manifested by corneal
edema, keratic precipitates, and mild anterior chamber reaction, and can be
defined as a spectrum of the disorder in which the corneal endothelium is the
primary site of the inflammation. The disease etiology consists of accumulating
evidence of various viral infections including herpes simplex virus, varicella
zoster virus, and cytomegalovirus. Corneal endotheliitis can be classified
clinically into four forms: linear, sectorial, disciform, and diffuse. Antiviral 
treatment in combination with topical corticosteroids is generally effective to
suppress the inflammation; however, irreversible corneal endothelial dysfunction 
may develop in some cases.

Publication Types: 
    Review

PMID: 18584561 [PubMed - indexed for MEDLINE]

225: Acta Med Croatica. 2008;62 Suppl 1:76-81.

[Neurological complications in renal transplant recipients]

[Article in Croatian]

Basic-Jukic N, Basic-Kes V, Kes P, Furic-Cunko V, Bacic-Baronica K.

Zavod za dijalizu, Klinicki bolnicki centar Zagreb, Hrvatska. nina_basic@net.hr

Renal transplantation is method of choice for treatment of patients with
end-stage renal disease without contraindications for immunosuppressive therapy. 
Neurological complications occur frequently in renal transplant recipients. They 
may be the consequence of immunosuppressive treatment, but more often evolve as
the consequence of previous disturbances which developed during the state of
uraemia and treatment with dialysis. The most pronounced neurotoxic effect has
calcineurin inhibitors tacrolimus and cyclosporine. The spectrum of neurological 
disturbances caused by calcineurin inhibitors range from very mild symptoms as
paraesthesiae, tremor, headache or flushing, to severe changes that may cause
lethal outcome. Peripheral neuropathies in renal transplant recipients may occur 
in the form of mononeuropathy or polyneuropathy. Cerebrovascular diseases are
consequence of changes on blood vessels caused by uraemia, dialysis and side
effects of immunosuppressive drugs. They cause death in 8% of renal transplant
recipients. Central nervous system (CNS) infections usually occur during the
first posttransplant year. Unclear symptomatology frequently postpones the
diagnosis. Diagnostic evaluation should include magnetic resonance imaging for
localization of the process, as well as lumbal puncture in cases without
contraindications for the procedure, in order to determine the causative agent.
Regarding the ominous prognosis of CNS infections in the immunocompromised host, 
only timely diagnosis may improve survival. The most common causative agents are 
Cryptococcus neoformans, Listeria monocytogenes and Aspergillus funigatus. Viral 
infections also occur, and are commonly caused by herpes virideae,
varicella-zoster virus and papova virus. CNS infections clinically present as
meningitis, progressive dementia or focal neurological defect. The most common
primary brain tumors are B-cell lymphomas, but glioblastoma, hemangioblastoma,
leiomyosarcoma or glioma may also occur. In cases of neurological posttransplant 
complications, optimal treatment should be guided by neurologist, nephrologist
and infectologist, in some cases also by neurosurgeons.

Publication Types: 
    English Abstract

PMID: 18578336 [PubMed - indexed for MEDLINE]

226: Nurs Stand. 2008 Jun 4-10;22(39):49-56; quiz 58, 60.

Management of patients with post-herpetic neuralgia.

Doble S.

Cardiffand Vale NHS Trust, Cardiff. Sharon.doble@cardiffandvale.wales.nhs.uk

This article provides an overview of the management of post-herpetic neuralgia
(PHN)--a debilitating nerve pain that continues after the herpes zoster
(shingles) rash has cleared. PHN mainly affects older people and although there
are a number of treatment options available, drug interactions and side effects
frequently limit their use. Nurses need to demonstrate an understanding of the
difficulties associated with the management of PHN to provide safe and effective 
pain relief and to improve the patient's quality of life.

PMID: 18578133 [PubMed - indexed for MEDLINE]

227: MMW Fortschr Med. 2008 May 22;150(21):33-4.

[Case report: again just an idiopathic facial nerve palsy?]

[Article in German]

Seidel BM, Pichler J, Grune S.

Discipline of General Practice, The University of Adelaide, Australien.
bastian.seidel@adelaide.edu.au

Publication Types: 
    Case Reports

PMID: 18575251 [PubMed - indexed for MEDLINE]

228: Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2008 Apr;22(2):98-100.

[Laboratory testing of specimens from patients with viral encephalitis from some 
regions of China]

[Article in Chinese]

Xu ZQ, Fu SH, Zhang YP, Li XL, Gao XY, Wang L, Cao YX, Xu LH, Jin Y, Tang Q,
Liang GD.

Institute for Viral Disease Control and Prevention, Chinese Center for Disease
Control and Prevention, Beijing, China.

OBJECTIVE: To understand the viral etiology of viral encephalitis in China by
detecting IgM antibody and viral RNA in the clinical samples of patients from
some provinces of China by enzyme-linked immunosorbent assay and polymerase chain
reaction. METHOD: Serum and cerebrospinal fluid samples of 771 patients with
viral encephalitis or meningitis were collected from six provinces of China and
were stored at -20 degrees C or -70 degrees C. Enzyme-linked immunosorbent assays
were used for detection of IgM antibody to Japanese encephalitis virus,
coxsackievirus, echovirus, herpes simplex virus, measles virus, varicella-zoster 
virus, mumps virus, cytomegalovirus and Epstein-Barr virus. Polymerase chain
reaction was applied for the detection of viral RNA of enteroviruses and
seadornavirus. RESULTS: IgM antibody was detected in 567 of 771 (73.5%) cases.
The most common pathogen was Japanese encephalitis virus (47.0%, 362/771),
followed by mumps virus (10.6%, 82/771), enteroviruses (8.8%, 68/771), herpes
simplex virus (5.7%, 44/771), measles virus (0.4%, 3/771), varicella-zoster virus
(0.4%, 3/771), Epstein-Barr virus (0.4%, 3/771), and cytomegalovirus (0.3%,
2/771). Enterovirus was positive in 8 cases, seadornavirus was negative in all
the cases by PCR. CONCLUSION: According to the study, Japanese encephalitis was
the most important encephalitis in China. Mumps virus was another important
pathogen. Enteroviruses and herpes simplex virus were also important pathogens.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 18574526 [PubMed - indexed for MEDLINE]

229: Eur J Dermatol. 2008 Jul-Aug;18(4):440-3. Epub 2008 Jun 23.

Herpes simplex virus infection in pemphigus vulgaris: clinical and immunological 
considerations.

Caldarola G, Kneisel A, Hertl M, Feliciani C.

Department of Dermatology and Allergology, Philipp Universitat, Marburg, Germany.
giacomocaldarola@libero.it

Different environmental factors have been implicated in the pathogenesis of
pemphigus vulgaris (PV), including drugs, diet, burns, X-rays, ultraviolet
radiation, neoplasms, and infections. Several reports described the manifestation
or aggravation of PV due to herpes simplex virus (HSV), varicella-zoster virus,
Epstein-Barr virus, cytomegalovirus and human herpesvirus-8 infections. In the
present study, we correlated secondary HSV1 infection in 3 PV patients on
immunosuppressive treatment with the titers of IgG autoantibodies against
desmoglein 1 (DSG1) and 3 (DSG3) over a follow-up period of at least 18 months.
In these patients, the detection of HSV1 and clinical flare-up of PV did not
correlate with a significant increase of DSG-specific IgG. Thus, secondary
cutaneous HSV infections should be considered in patients with chronic PV with
atypical sudden relapses or resistance to sufficient immunosuppressive treatment 
who do not show an increase of DSG-specific IgG autoantibodies.

Publication Types: 
    Case Reports

PMID: 18573719 [PubMed - indexed for MEDLINE]

230: Rinsho Ketsueki. 2008 May;49(5):331-4.

[Aggravated post-herpetic neuralgia due to bortezomib]

[Article in Japanese]

Kirizume K, Imataki O, Shintani T, Fujihara S, Waki F, Ohue Y, Ohnishi H.

Post-graduate Clinical Education Center, Kagawa University Hospital, Kagawa,
Japan.

Bortezomib, a proteasome inhibitor, has been used for patients with refractory
multiple myeloma. We present a 58-year old man who had IgG-gamma-type multiple
myeloma, refractory for MP (melphalan-predonisolone) and VAD
(vincrisitine-doxorubicin-dexamethasone) therapy. He was complicated with
reactivation of varicella-zoster virus (VZV) 4 weeks before bortezomib
administration. Two weeks of consolidation treatment with standard dose
valaciclovir caused VZV infection to settle down and, after a further 2 weeks,
VZV remission was confirmed. Bortezomib was started at a dose of 1.3 mg/m2 with
prophylactic use of valaciclovir for VZV reactivation, post-herpetic neuralgia
exacerbated the following day and grade 3 neuralgia developed the following week 
without recurrence of skin eruption. Neuralgia improved after the cessation of
bortezomib with various supportive treatments and interventions. Although the
reactivation of VZV was suspicious, no apparent skin lesions were observed.
Although the mechanisms of post-herpetic neuralgia and chemotherapy-induced
neuropathy are different, bortezomib might enhance post-herpetic neuralgia
independent of the manner of viral reactivation.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18572810 [PubMed - indexed for MEDLINE]

231: Virology. 2008 Aug 1;377(2):289-95.

Varicella-zoster virus ORF1 gene product is a tail-anchored membrane protein
localized to plasma membrane and trans-Golgi network in infected cells.

Koshizuka T, Sadaoka T, Yoshii H, Yamanishi K, Mori Y.

Laboratory of Virology and Vaccinology, Division of Biomedical Research, National
Institute of Biomedical Innovation, 7-6-8, Saito-Asagi, Ibaraki, Osaka 567-0085, 
Japan.

Varicella-zoster virus (VZV) encodes five genes that do not have herpes simplex
virus homologs. One of these genes, VZV open reading frame 1 (ORF1), encodes a
membrane protein with a hydrophobic domain at its C-terminus that is predicted to
be the transmembrane domain. However, the detailed characterization of ORF1
protein in infected cells has not been reported. Here, we produced mono-specific 
antibodies against ORF1 protein and characterized the gene products in infected
cells. Western blot analyses showed the ORF1 polypeptides had apparent molecular 
masses of approximately 14-17 kDa. Furthermore, ORF1 was found to be a
phosphoprotein by immunoprecipitation assay. In immunofluorescence assays, the
VZV ORF1 protein was detected at both the plasma membrane and trans-Golgi network
in both VZV-infected and ORF1-transfected cells. Moreover, ORF1 proteins
associated with each other to form homodimer, and were incorporated into viral
particles. The C-terminal hydrophobic domain was required for the association of 
ORF1 with the membrane structures, indicating that ORF1 protein is anchored to
the membrane thorough its C-terminus, which is a transmembrane domain. Because
ORF1 possesses a C-terminal transmembrane domain without an N-terminal signal
sequence for its translocation to the ER lumen, ORF1 can be classified as a
tail-anchored membrane protein. These results show that the N terminus of ORF1
protein faces the cytoplasm in infected cells and the tegument region in mature
virions.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18570967 [PubMed - indexed for MEDLINE]

232: Mult Scler. 2008 Jun;14(5):595-601.

Herpesviruses and human endogenous retroviral sequences in the cerebrospinal
fluid of multiple sclerosis patients.

Alvarez-Lafuente R, Garcia-Montojo M, De Las Heras V, Dominguez-Mozo MI,
Bartolome M, Benito-Martin MS, Arroyo R.

Servicio de Neurologia, Hospital Clinico San Carlos, Madrid, Spain.
labesmul@hcsc.es

OBJECTIVE: To analyze the possible role of human herpesvirus (HHVs) and human
endogenous retroviruses (HERVs) infection in multiple sclerosis (MS)
pathogenesis. METHODS: A total of 92 cerebrospinal fluid (CSF) samples were
collected: 48 from MS patients at the first clinically evident demyelinating
event, 23 from patients with other inflammatory neurological diseases (OINDs) and
21 from patients with other non-inflammatory neurological diseases (ONINDs).
Total DNA and RNA were isolated, and the prevalences and viral loads of herpes
simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV),
cytomegalovirus (CMV), HHV-6, HERV-H and HERV-W in the CSF of MS patients and
controls were evaluated using a quantitative real-time polymerase chain reaction 
assay. RESULTS: (i) For HSV, 1/48 (2.1%, 86 copies/ml of CSF) MS patients and
1/23 (4.3%, 115.2 copies/ml of CSF) OIND patients (a myelitis case) had HSV
sequences in the CSF; (ii) for EBV, only 1/48 (2.1%, 72 copies/ml of CSF) MS
patients was positive for EBV; (iii) for HHV-6, only 5/48 (10.4%) MS patients had
HHV-6 genomes in their CSF (128.1 copies/ml of CSF); (iv) we did not find any
positive cases for VZV, CMV, HERV-H and HERV-W among MS patients or controls; (v)
no cases of co-infections were found; (vi) the whole prevalence of HHVs was 7/48 
(14.6%) for MS patients and 1/44 (2.3%) for controls (p = 0.038). CONCLUSION: The
findings described here show that HHV infection is more frequent in the CSF of MS
patients than in patients with other neurological diseases; however, only HHV-6
seems to be involved in the pathogenesis of MS in a subset of patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18566025 [PubMed - indexed for MEDLINE]

233: AJNR Am J Neuroradiol. 2008 Oct;29(9):1743-5. Epub 2008 Jun 19.

A case of Varicella zoster virus polyneuropathy: involvement of the
glossopharyngeal and vagus nerves mimicking a tumor.

Adachi M.

Department of Radiology, Ohshima Clinic, Yamagata, Japan. miadchi@beach.ocn.ne.jp

A 36-year-old woman presented with glossopharyngeal and vagus nerve palsy, which 
proved to be herpes zoster based on the high titers of Varicella zoster virus
antibody in her serum. Thin-section T1-weighted images with contrast media
demonstrated swelling and distinct contrast enhancement of the glossopharyngeal
and vagus complex, mimicking a tumor. Following MR imaging, the size of the nerve
complex returned to normal; however, the contrast enhancement remained longer
than the symptoms.

Publication Types: 
    Case Reports

PMID: 18566008 [PubMed - indexed for MEDLINE]

234: Fertil Steril. 2008 Jun 17. [Epub ahead of print]

Prevalence of human herpes virus types 1-7 in the semen of men attending an
infertility clinic and correlation with semen parameters.

Neofytou E, Sourvinos G, Asmarianaki M, Spandidos DA, Makrigiannakis A.

Laboratory of Human Reproduction, IVF Clinic, Department of Obstetrics and
Gynecology, University of Crete, Crete, Greece.

OBJECTIVE: To determine the prevalence of herpes viruses in the semen of an
asymptomatic male cohort with and without infertility problems and its
association with altered semen parameters. DESIGN: A prospective randomized
study. SETTING: Medical school and IVF clinic. PATIENT(S): One hundred
seventy-two male patients undergoing routine semen analysis: 80 with normal semen
parameters (control group) and 92 with abnormal semen parameters.
INTERVENTION(S): Semen samples were collected by masturbation. MAIN OUTCOME
MEASURE(S): The DNA from the Herpesviridae family (herpes simplex virus 1
[HSV-1], herpes simplex virus 2 [HSV-2], Varicella zoster virus [VZV],
Epstein-Barr virus [EBV], cytomegalovirus [CMV], human herpes virus type 6
[HHV-6], human herpes virus type 7 [HHV-7]) and routine semen parameters.
RESULT(S): Viral DNA was detected in 143/172 (83.1%) of the total samples for at 
least one herpes virus: HSV-1, 2.5%; VZV, 1.2%; EBV, 45%; CMV, 62.5%; HHV-6, 70%;
HHV-7, 0% in the normal semen samples and HSV-1, 2.1%; VZV, 3.2%; EBV, 39.1%;
CMV, 56.5%; HHV-6, 66.3%; HHV-7, 0% in the abnormal semen samples. No association
was found between the presence of viral DNA and semen parameters. Interestingly, 
a statistical significance between leukocytospermia and the presence of EBV DNA
was observed. CONCLUSION(S): The DNA of herpes viruses is frequently detected in 
the semen of asymptomatic fertile and infertile male patients. Further studies
are required to investigate the role of herpes viruses in male factor
infertility.

PMID: 18565516 [PubMed - as supplied by publisher]

235: Acta Neurol Taiwan. 2008 Mar;17(1):47-9.

Acute orbital myositis heralding herpes zoster ophthalmicus: report of a case.

Tseng YH.

From the Department of Neurology, Chia-Yi Yang-Ming Hospital, Taiwan.
erwintseng@hotmail.com

We report a rare case that developed orbital myositis before appearance of zoster
rashes. A 54 year-old man came to our hospital with a 4-day history of left
orbital shooting pain extending to left temporal area. Neurological examinations 
demonstrated mild left proptosis and hyperemic conjunctiva without
ophthalmoplegia. Brain magnetic resonance imaging (MRI) revealed left orbital
myositis and periorbital skin eruptions appeared two days after this MRI study.
The symptoms were improved after antiviral therapy and a follow-up MRI showed
resolution of orbital myositis. Herpes zoster ophthalmicus may present as acute
orbital myositis preceding skin eruptions and the recovery of orbital myositis
was excellent in these patients. Our patient had postherpetic neuralgia which did
not develop in previously reported cases. We conclude that herpes zoster should
be listed as a cause of orbital myositis even without skin rashes.

Publication Types: 
    Case Reports

PMID: 18564828 [PubMed - indexed for MEDLINE]

236: J Fr Ophtalmol. 2008 Apr;31(4):457-8.

[Zona ophthalmica. Part I]

[Article in French]

Labetoulle M.

Service d'Ophtalmologie, Hopital de Bicetre, Le Kremlin-Bicetre.

PMID: 18563049 [PubMed - indexed for MEDLINE]

237: J Virol. 2008 Sep;82(17):8673-86. Epub 2008 Jun 18.

Nuclear import of the varicella-zoster virus latency-associated protein ORF63 in 
primary neurons requires expression of the lytic protein ORF61 and occurs in a
proteasome-dependent manner.

Walters MS, Kyratsous CA, Wan S, Silverstein S.

Department of Microbiology, College of Physicians and Surgeons, Columbia
University, New York, New York 10032, USA.

Varicella-zoster virus (VZV) open reading frame (ORF) 63 protein (ORF63p) is one 
of six VZV ORFs shown to be transcribed and translated in latently infected human
dorsal root ganglia. ORF63p accumulates exclusively in the cytoplasm of latently 
infected sensory neurons, whereas it is both nuclear and cytoplasmic during lytic
infection and following reactivation from latency. Here, we demonstrate that
infection of primary guinea pig enteric neurons (EN) with an adenovirus
expressing ORF63p results in the exclusive cytoplasmic localization of the
protein reminiscent of its distribution during latent VZV infection in humans. We
show that the addition of the simian virus 40 large-T-antigen nuclear
localization signal (NLS) results in the nuclear import of ORF63p in EN and that 
the ORF63p endogenous NLSs are functional in EN when fused to a heterologous
protein. These data suggest that the cytoplasmic localization of ORF63p in EN
results from the masking of the NLSs, thus blocking nuclear import. However, the 
coexpression of ORF61p, a strictly lytic VZV protein, and ORF63p in EN results in
the nuclear import of ORF63p in a proteasome-dependent manner, and both ORF63p
NLSs are required for this event. We propose that the cytoplasmic localization of
ORF63p in neurons results from NLS masking and that the expression of ORF61p
removes this block, allowing nuclear import to proceed.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 18562514 [PubMed - indexed for MEDLINE]

238: SADJ. 2008 Mar;63(2):106-10.

Alveolar bone necrosis and spontaneous tooth exfoliation in an HIV-seropositive
subject with herpes zoster.

Feller L, Wood NH, Raubenheimer EJ, Meyerov R, Lemmer J.

Department of Periodontology and Oral Medicine, School of Dentistry, University
of Limpopo, Medunsa Campus, South Africa. lfeller@medunsa.ac.za

Herpes zoster in the distribution of the maxillary and mandibular divisions of
the trigeminal nerve is characterized by painful vesicular eruptions of the skin 
and oral mucosa in the distribution of the affected nerves. Oral complications
may occur, including post-herpetic neuralgia, devitalization of teeth, abnormal
development of permanent teeth, root resorption and periapical lesions. In cases 
where necrosis of the alveolar bony process occur it may be preceded or
accompanied by spontaneous exfoliation of teeth. This usually follows the
resolution of the acute phase of HZ and is more prevalent in HIV-seropositive
than in HIV-seronegative subjects. A case of HZ of the trigeminal nerve in an
HIV-seropositive subject, with complications of necrosis of alveolar bony
process, external root resorption and tooth exfoliation is presented and the
literature of HIV-associated HZ is reviewed.

Publication Types: 
    Case Reports
    Review

PMID: 18561810 [PubMed - indexed for MEDLINE]

239: Pediatr Blood Cancer. 2008 Oct;51(4):504-8.

Valacyclovir and acyclovir pharmacokinetics in immunocompromised children.

Bomgaars L, Thompson P, Berg S, Serabe B, Aleksic A, Blaney S.

Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas, USA. 
lbomgaars@txccc.org

BACKGROUND: Valacyclovir, an orally administered pro-drug of acyclovir, is
utilized in the therapy of herpes simplex and herpes zoster infections. Little
data regarding the pharmacokinetics, safety and tolerability are available for
pediatric patients. This report describes acyclovir pharmacokinetics following
valacyclovir administration in immunocompromised pediatric patients, compares
pharmacokinetic parameters following oral valacyclovir and IV acyclovir, and
provides a limited assessment of efficacy in the setting of active herpes zoster 
infection. PROCEDURE: A total of 37 immunocompromised children were enrolled on
one of two studies. Pharmacokinetic data are available for 32 patients following 
valacyclovir (15 mg/kg) administration, 11 of whom also had pharmacokinetic
sampling following IV acyclovir administration. Three patients received
valacyclovir as treatment for herpes zoster infections. RESULTS: Mean (+/-SD)
C(max) values for acyclovir following oral valacyclovir were 18.8 +/- 7 microM
with a total exposure of 4,106 +/- 1,519 microM min. The mean bioavailability of 
acyclovir from valacyclovir was 64%. Grade 1 nausea and emesis, which occurred in
five patients was the only valacyclovir-related toxicity. Two of the three
patients treated for herpes zoster had complete scabbing of lesions by day 9.
CONCLUSION: Valacyclovir (15 mg/kg) was well tolerated in pediatric patients and 
demonstrated excellent bioavailability. Consideration should be given to the use 
of oral valacyclovir for the treatment of herpes zoster in clinically stable
pediatric oncology patients. (c) 2008 Wiley-Liss, Inc.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18561175 [PubMed - indexed for MEDLINE]

240: Eur J Pediatr. 2009 Apr;168(4):469-76. Epub 2008 Jun 17.

Incidence of hepatotropic viruses in biliary atresia.

Rauschenfels S, Krassmann M, Al-Masri AN, Verhagen W, Leonhardt J, Kuebler JF,
Petersen C.

Department of Pediatric Kidney and Liver Diseases and Metabolic Disorders,
Hannover Medical School, Hannover, Germany.

Biliary atresia (BA) is the most frequent indication for paediatric liver
transplantation. We tested the hypothesis of a viral aetiology of this disease by
screening liver samples of a large number of BA patients for the common human
hepatotropic viruses. Moreover, we correlated our findings to the expression of
Mx protein, which has been shown to be significantly up-regulated during viral
infections. Seventy-four liver biopsies (taken during Kasai portoenterostomy)
were tested by polymerase chain reaction (PCR) for DNA viruses (herpes simplex
virus [HSV], Epstein-Barr virus [EBV], varicella zoster virus [VZV],
cytomegalovirus [CMV], adenovirus, parvovirus B19 and polyoma BK) and RNA viruses
(enteroviruses, rotavirus and reovirus 3). Mx protein expression was assessed by 
immunohistochemistry. Virus DNA/RNA was found in less than half of the biopsies
(8/74 CMV, 1/74 adenovirus; 21/64 reovirus, 1/64 enterovirus). A limited number
presented with double infection. Patients that had detectable viral RNA/DNA in
their liver biopsies were significantly older than virus-free patients (P =
0.037). The majority (54/59) of the liver biopsies showed expression of Mx
proteins in hepatocytes, bile ducts and epithelium. Our data suggest that the
known hepatotropic viruses do not play a major role in the aetiology and
progression of BA. Their incidence appears to be, rather, a secondary phenomenon.
Nonetheless, the inflammatory response in the livers of BA patients mimics that
observed during viral infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18560888 [PubMed - in process]

241: Br J Hosp Med (Lond). 2008 May;69(5):275-8.

Prevention and medical management of postherpetic neuralgia.

Dainty P.

Mid-Staffordshire NHS Trust, Staffordshire General Hospital, Stafford.

Postherpetic neuralgia is the commonest complication of shingles, a debilitating 
disease common in daily clinical practice. Treatment of postherpetic neuralgia is
often complicated, with numerous potential options. This review looks at the
evidence in support of the more commonly used medical therapies for this
challenging condition.

Publication Types: 
    Review

PMID: 18557554 [PubMed - indexed for MEDLINE]

242: Psychol Neuropsychiatr Vieil. 2008 Jun;6(2):107-14.

[Neuropathic pain in the elderly]

[Article in French]

Pickering G, Capriz-Ribiere F.

Centre de Pharmacologie Clinique, Inserm CIC 501, CHU de Clermont-Ferrand,
France. gisele.pickering@u-clermont1.fr

Neuropathic pain is characterized by a heavier intensity and a longer duration
than in non-neuropathic chronic pain. Its frequency is estimated around 9% of the
population aged 65 years and over. Diabetes, shingles, cancer, surgery,
radiculopathies or stroke are frequent in elderly and may lead to neuropathic
pain. It's treatment is a real challenge in elderly. Beside the difficulties of
pain evaluation and choice of a therapeutic strategy, intercurrent diseases
associated with aging and polymedication require a complex drug treatment. The
leading role of cognition, emotion, physical activity for autonomy preservation, 
and the dynamic interaction between these domains in the old, oldest old and most
fragile persons, imply that any pharmacological treatment must be integrated into
a non-pharmacological approach. However, very few studies has been specifically
devoted to neuropathic pain in elderly. Epidemiological studies and controlled
clinical trials are necessary to optimize pain treatment and could result in
polymodal therapeutic strategies, which until now only are evidence-based or
intuitively developed.

Publication Types: 
    English Abstract
    Review

PMID: 18556269 [PubMed - indexed for MEDLINE]

243: Internist (Berl). 2008 Jul;49(7):887-90.

[Therapy of herpes zoster]

[Article in German]

Ullmann AJ.

III. Medizinische Klinik und Poliklinik, Klinikum Johannes Gutenberg Universitat,
Mainz, Langenbeckstrasse 1, 55101 Mainz, Deutschland. ullmann@uni-mainz.de

Publication Types: 
    Case Reports

PMID: 18551263 [PubMed - indexed for MEDLINE]

244: Int J Prosthodont. 2008 May-Jun;21(3):253-8.

Effect of a jig on EMG activity in different orofacial pain conditions.

Bodere C, Woda A.

Faculte d'Odontologie, Brest, France. cel.bodere@wanadoo.fr

PURPOSE: The bite stop (jig) is commonly used in clinical practice. It has been
recommended as a simple means to routinely record or provide centric relation
closure and, more recently, to reduce migraines and tension-type headaches.
However, the reason for the jig effect has yet to be explained. This study tested
the hypothesis that it works through a decrease in masticatory muscle activity.
MATERIALS AND METHODS: The effect of a jig placed on the maxillary anterior teeth
was investigated by recording the electromyographic (EMG) activity of the
superficial masseter and anterior temporal muscles at postural position and when 
swallowing on the jig. EMG recordings were obtained from 2 groups of pain
patients (myofascial and neuropathic) and from 2 groups of pain-free patients
(disc derangement and controls) unaware of the role of dental occlusion
treatments. RESULTS: EMG activity in postural position was higher in pain groups 
than in pain-free groups. The jig strongly but temporarily decreased the postural
EMG activity for masseter muscles in all groups except for the neuropathic group 
and for temporal muscles in the myofascial group. The EMG activity when
swallowing with the jig was reduced in control, disc derangement, and myofascial 
groups; however, EMG "hyperactivity" in the neuropathic pain group seemed to be
locked. CONCLUSIONS: The decrease of postural EMG activity, especially in the
myofascial group, was short lasting and cannot be considered as evidence to
support the hypothesis of a long-term muscle relaxation jig effect. However, the 
results may uphold certain short-term clinical approaches.

Publication Types: 
    Comparative Study

PMID: 18548966 [PubMed - indexed for MEDLINE]

245: Int J Infect Dis. 2008 Nov;12(6):e159-60.

Herpes zoster in healthy children.

Teran CG, Villarroel P, Teran-Escalera CN.

Pediatric Center Albina Patino, Calle Jordan 886, Cochabamba, Bolivia.

Publication Types: 
    Case Reports

PMID: 18547857 [PubMed - indexed for MEDLINE]

246: Bull Soc Belge Ophtalmol. 2008;(307):39-43.

[Orbital apex syndrome secondary to herpes zoster infection. A case report]

[Article in French]

Baha Ali T, Moutaouakil A, Ouaggag B, Khoumiri R, Aderdour L, Hassani R, Raji A, 
Jamali A.

Service d'Ophtalmologie, CHU Mohammed VI, Marrakech, Maroc. tbahaali@yahoo.fr

The orbital apex syndrome is defined by the association of visual loss,
ophtalmoplegia, blepharoptosis, proptosis along with forehead and upper eyelid
anesthesia. This syndrome is secondary to traumatism, malignancy or infection of 
orbital apex. Herpes zoster is an uncommon cause. We discuss the physiopathologic
mechanism, evolution and management of this affection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18546925 [PubMed - indexed for MEDLINE]

247: J Cutan Med Surg. 2008 May-Jun;12(3):126-32.

Dermatologic immune restoration syndrome: report of five cases from a tertiary
care center in north India.

Handa S, Narang T, Wanchu A.

Department of Dermatology, Venereology and Leprology, Postgraduate Institute of
Medical Education and Research, Chandigarh, India. handa_sanjeev@yahoo.com

BACKGROUND: Dermatologic conditions are often an early clue to human
immunodeficiency virus (HIV) infection. As the disease progresses and the host
immunity fails, patients may develop a number of skin conditions. At this point, 
they have a dominant T helper 2 immunologic response. After the initiation of
antiretroviral therapy, the T helper 1 response is restored, and some skin
problems, paradoxically, make their appearance then. CONCLUSION: Herpes zoster,
mucocutaneous herpes, eosinophilic folliculitis, and mycobacterial infections
have been known to occur at this stage. This may be because immune restoration of
a host's immunity causes recognition of silent or latent infection and results in
development of the condition. We report five cases that were seen at our center
during a 2-year period.

Publication Types: 
    Case Reports

PMID: 18544296 [PubMed - indexed for MEDLINE]

248: J Cutan Pathol. 2008 Oct;35 Suppl 1:17-9. Epub 2008 Jun 9.

Giant cell lichenoid dermatitis in a patient with baboon syndrome.

Khelifa-Hamdani E, Touati-Serraj M, Perriard J, Chavaz P, Saurat JH, Kaya G.

Department of Dermatology, University of Geneva, Geneva, Switzerland.

Giant cell lichenoid dermatitis is a recently described pathological entity,
which can be seen as an unusual lichenoid drug eruption, a manifestation of
sarcoidosis or within herpes zoster scars. Histopathological findings include
focal vacuolar alteration of the basal layer with cytoid bodies, dermal and
intraepidermal multinucleated giant cells and a mixed chronic inflammatory
infiltrate with a lichenoid pattern consisting of lymphocytes, histiocytes,
eosinophils and plasma cells. Here, we report a giant cell lichenoid dermatitis
in a 41-year-old male patient who developed, 3 days after intravenous treatment
with amoxicillin-clavulanic acid for erysipelas of the left leg, a clinical
picture suggesting a baboon syndrome characterized by an erythematous and
pruritic eruption on the axillary, inguinal and popliteal areas and the anterior 
side of elbows. This is the first reported case of giant cell lichenoid
dermatitis in a patient with baboon syndrome. Copyright Blackwell Munksgaard
2008.

Publication Types: 
    Case Reports

PMID: 18544061 [PubMed - indexed for MEDLINE]

249: SADJ. 2008 Feb;63(1):048.

General practitioner's radiology case 60. Herpes zoster infection.

Nortje CJ.

Faculty of Dentistry, University of the Western Cape. cnortje@uwc.ac.za

Publication Types: 
    Case Reports

PMID: 18543744 [PubMed - indexed for MEDLINE]

250: Biol Blood Marrow Transplant. 2008 Jul;14(7):831-9.

Human herpes virus 6 plasma DNA positivity after hematopoietic stem cell
transplantation in children: an important risk factor for clinical outcome.

de Pagter PJ, Schuurman R, Visscher H, de Vos M, Bierings M, van Loon AM,
Uiterwaal CS, van Baarle D, Sanders EA, Boelens J.

Department of Immunology/Haematology and BMT, University Medical Center Utrecht, 
Utrecht, The Netherlands. p.j.depagter@umcutrecht.nl

Human herpes virus 6 (HHV6) is known to reactivate after hematopoietic stem cell 
transplantation (HSCT), and has been suggested to be associated with severe
clinical manifestations in adults. The clinical significance in children remains 
unclear. We investigated the incidence of HHV6 reactivation in relation to
HSCT-associated morbidity and mortality in children. Between January 2004 and May
2006, 58 pediatric patients, median age 7.6 years (range: 0.1-18.1 years),
received their first allogeneic HSCT. After HSCT, HHV6, Epstein Barr Virus (EBV),
cytomegalovirus (CMV), and adenovirus (AdV)-plasma loads were weekly measured by 
quantitative PCR. Clinical features, engraftment, graft-versus-host disease
(GVHD), and HSCT-associated mortality and morbidity were monitored. HHV6
reactivations were classified in group I (no reactivation), group II (loads <1000
cp/mL) and group III (loads >1000 cp/mL). CMV, EBV, Herpes Simpex Virus,
Varicella Zoster Virus, and AdV-reactivations were treated according to local
guidelines. HHV6 was treated only when there was clinical suspicion of disease.
Thirty-six HLA-identical and 22 HLA nonidentical grafts were transplanted of
which 43 were bone marrow or peripheral blood stem cells grafts and 15 were cord 
blood (CB) grafts. Median follow-up of the patients was 15.5 (1-35) months. HHV6 
reactivation occurred in 39 of 58 (67%) patients with 31 of 39 (80%) occurring
within the first 30 days post-HSCT. In 26 of 58 (45%) patients (group III), HHV 6
reactivation was significantly associated with higher nonrelapse mortality (P =
.02), using multivariate Cox proportional hazard models and grade 2-4 acute GVHD 
(P = .03) and chronic GVHD (P = .05) in a multivariate logistic regression
analysis. HHV6 reactivation is very common after HSCT in children and is
associated with serious transplantation-related morbidity and mortality. Although
the exact role of HHV6 reactivation after HSCT has to be elucidated, early
detection and initiation of therapy might be of benefit.

PMID: 18541204 [PubMed - indexed for MEDLINE]

251: Am Fam Physician. 2008 May 1;77(9):1307-9.

Scalded mouth with headache. Herpes zoster (shingles).

Grimard BH, Larson JM, Mcbrayer RH.

Mayo Clinic, Jacksonville, Florida, USA. grimard.brian@mayo.edu

Publication Types: 
    Case Reports

PMID: 18540498 [PubMed - indexed for MEDLINE]

252: Acta Cytol. 2008 May-Jun;52(3):337-43.

Morphologic changes in fibroadenoma of breast due to chickenpox: a case report
with suspicious cytology in fine needle aspiration smears.

Das DK, Rifaat AA, George SS, Grover VK, Mathew TC, Mirza K.

Department of Pathology, Faculty of Medicine, Kuwait University, P.O. Box: 24923,
Safat 13110, Kuwait. dilip76@hotmail.com

BACKGROUND: Fibroadenomas with stromal giant cell reaction have been described in
the literature, but cytologic atypia including giant cell reaction due to
chickenpox giving rise to suspicious cytology has not been reported. CASE REPORT:
A 25-year-old woman, recovering from chickenpox, presented with a 1.5 x 1.5-cm
mass in the lower outer quadrant of her right breast. Fine needle aspiration
smears showed sheets of benign ductal cells with overlapping myoepithelial cells 
and many bipolar bare nuclei. Cells showing nuclear enlargement, prominent
nucleoli and multilobated or multinucleated giant cell formation occurred in
separate sheets or dispersed among groups of benign ductal cells. Cytodiagnosis
was suspicion for malignancy; excision biopsy was advised. Histopathologic
examination showed fibroadenoma with evidence of epithelial hyperplasia, nuclear 
enlargement and multilobated giant cell formation. Atypical ductal cells,
including the giant cells, were immunohistochemically positive for epithelial
membrane antigen, estrogen receptor and progesterone receptor and negative for
smooth muscle actin, indicating epithelial origin. Both cytologic and histologic 
specimens showed focal positive reaction with HSV-1 and HSV-2 antibodies.
Ultrastructural examination of aspirated material revealed cytoplasmic viral
particles with characteristic surface projections. CONCLUSION: Herpes zoster
virus can produce morphologic alteration mimicking a malignancy. Pathologists
should be aware of these changes to avoid a false positive diagnosis.

Publication Types: 
    Case Reports

PMID: 18540301 [PubMed - indexed for MEDLINE]

253: Am J Emerg Med. 2008 Jun;26(5):612-7.

Ophthalmic diagnoses in the ED: herpes zoster ophthalmicus.

Carter WP 3rd, Germann CA, Baumann MR.

Emergency Medicine Department, Maine Medical Center, Portland, ME 04102, USA.
cartew2@mmc.org

The epidemiology, pathophysiology, and clinical presentation of herpes zoster
ophthalmicus in the emergency department is discussed with an emphasis on the
identification of the numerous potential ocular complications. Emergency
physicians need to be able to recognize the clinical features of herpes zoster
ophthalmicus and initiate appropriate therapy and referral.

PMID: 18534294 [PubMed - indexed for MEDLINE]

254: MMWR Recomm Rep. 2008 Jun 6;57(RR-5):1-30; quiz CE2-4.

Erratum in:
    MMWR Recomm Rep. 2008 Jul 18;57(28):779.

Prevention of herpes zoster: recommendations of the Advisory Committee on
Immunization Practices (ACIP).

Harpaz R, Ortega-Sanchez IR, Seward JF; Advisory Committee on Immunization
Practices (ACIP) Centers for Disease Control and Prevention (CDC).

Collaborators: Treanor J, Atkinson WL, Cohen JI, Dworkin RH, Gargiullo PM,
Gershon AA, Glasser JW, Guris D, Haber P, Harpaz R, Hibbs BF, Iskander JK, Katz
SL, Krause PR, LaRussa PS, Levin MJ, Lieu TA, Marin ME, Neuzil KM, Nichol K,
Ortega-Sanchez IR, Poland GA, Rosenbaum S, Santibanez TA, Schaffner W, Schmader
KE, Schmid DS, Seward J, Stafford H, Strikas R, Wallace GS, Watson B, Abramson
JS, Pickering LK, Allos BM, Baker C, Beck RL, Gilsdorf JR, Hull H, Lett S, Lieu
T, Morse DL, Morita J, Neuzil K, Stinchfield P, Sumaya CV, Treanor JJ, Womeodu
RJ, Cheek J, Hachey W, Evans GS, Gellin B, Murphy L, Curlin GT, Baylor N, Nichol 
KL, Temte J, Campos-Outcalt D, Powell K, Baker C, Gelzer A, Turner JC, Gall S,
Neuzil KM, Tan L, Foster SL, McKinney WP, Lewin C, Naus M, Gordon S, Katz SL,
Salisbury D, Bennett N, Duchin JS, Neumann DA, Schaffner W, Rodriquez RS,
Whitley-Williams P, Freed G, Paradiso P, Middleman AB, Araga DA.

Division of Viral Diseases, National Center for Immunization and Respiratory
Diseases, USA.

These recommendations represent the first statement by the Advisory Committee on 
Immunization Practices (ACIP) on the use of a live attenuated vaccine for the
prevention of herpes zoster (zoster) (i.e., shingles) and its sequelae, which was
licensed by the U.S. Food and Drug Administration (FDA) on May 25, 2006. This
report summarizes the epidemiology of zoster and its sequelae, describes the
zoster vaccine, and provides recommendations for its use among adults aged > or
=60 years in the United States. Zoster is a localized, generally painful
cutaneous eruption that occurs most frequently among older adults and
immunocompromised persons. It is caused by reactivation of latent varicella
zoster virus (VZV) decades after initial VZV infection is established.
Approximately one in three persons will develop zoster during their lifetime,
resulting in an estimated 1 million episodes in the United States annually. A
common complication of zoster is postherpetic neuralgia (PHN), a chronic, often
debilitating pain condition that can last months or even years. The risk for PHN 
in patients with zoster is 10%-18%. Another complication of zoster is eye
involvement, which occurs in 10%-25% of zoster episodes and can result in
prolonged or permanent pain, facial scarring, and loss of vision. Approximately
3% of patients with zoster are hospitalized; many of these episodes involved
persons with one or more immunocompromising conditions. Deaths attributable to
zoster are uncommon among persons who are not immunocompromised. Prompt treatment
with the oral antiviral agents acyclovir, valacyclovir, and famciclovir decreases
the severity and duration of acute pain from zoster. Additional pain control can 
be achieved in certain patients by supplementing antiviral agents with
corticosteroids and with analgesics. Established PHN can be managed in certain
patients with analgesics, tricyclic antidepressants, and other agents. Licensed
zoster vaccine is a lyophilized preparation of a live, attenuated strain of VZV, 
the same strain used in the varicella vaccines. However, its minimum potency is
at least 14-times the potency of single-antigen varicella vaccine. In a large
clinical trial, zoster vaccine was partially efficacious at preventing zoster. It
also was partially efficacious at reducing the severity and duration of pain and 
at preventing PHN among those developing zoster. Zoster vaccine is recommended
for all persons aged > or =60 years who have no contraindications, including
persons who report a previous episode of zoster or who have chronic medical
conditions. The vaccine should be offered at the patient's first clinical
encounter with his or her health-care provider. It is administered as a single
0.65 mL dose subcutaneously in the deltoid region of the arm. A booster dose is
not licensed for the vaccine. Zoster vaccination is not indicated to treat acute 
zoster, to prevent persons with acute zoster from developing PHN, or to treat
ongoing PHN. Before administration of zoster vaccine, patients do not need to be 
asked about their history of varicella (chickenpox) or to have serologic testing 
conducted to determine varicella immunity.

Publication Types: 
    Practice Guideline

PMID: 18528318 [PubMed - indexed for MEDLINE]

255: J Clin Neuromuscul Dis. 2008 Jun;9(4):402-6.

Brachial neuritis with bilateral diaphragmatic paralysis following herpes zoster:
a case report.

Hoque R, Schwendimann RN, Liendo C, Chesson AL Jr.

Department of Neurology, Louisiana State University Health Sciences Center,
Shreveport, LA 71130, USA. rhoque@lsuhsc.edu

We present a case of supine respiratory failure due to a bilateral diaphragmatic 
paralysis associated with brachial neuritis secondary to thoracic herpes zoster. 
Fluoroscopy in both the standing and supine positions revealed bilateral
diaphragmatic paralysis accentuated in the supine position. To our knowledge,
this is the first case of thoracic herpes zoster associated with brachial
neuritis and bilateral diaphragmatic paralysis.

Publication Types: 
    Case Reports

PMID: 18525424 [PubMed - indexed for MEDLINE]

256: Ophthal Plast Reconstr Surg. 2008 May-Jun;24(3):218-9.

Radiesse-induced herpes zoster.

Sires B, Laukaitis S, Whitehouse P.

Allure Facial Laser and Medispa, Kirkland, Washington 98033, U.S.A.
bryan@aeamail.com

Radiesse is a filler material for deep nasolabial folds that was recently
approved by the United States Food and Drug Administration. It is composed of
calcium hydroxylapatite crystals measuring 25 mum to 45 mum. Few complications
have been reported to date. We present a case of a woman who developed herpetic
appearing skin lesions after the injection of Radiesse in the glabella. She noted
tenderness and tingling along with redness and bumps. The vesicles were isolated 
to the right ophthalmic branch of the trigeminal nerve distribution and the skin 
was erythematous with associated pustules. After disease progression while on
systemic antibiotics, she improved markedly when started on antivirals. Three
days later the tingling resolved, the erythema was markedly improved, and the
vesicles started to resolve. She had returned to baseline after a month.
Physicians should be suspicious for herpetic infection or reactivation with
facial injections of Radiesse or other fillers and should initiate immediate
treatment with oral antivirals upon identifying the above signs and symptoms.

Publication Types: 
    Case Reports

PMID: 18520838 [PubMed - indexed for MEDLINE]

257: Korean J Gastroenterol. 2008 May;51(5):291-7.

Comment in:
    Korean J Gastroenterol. 2008 May;51(5):319-22.

[The frequency and the course of the adverse effects of
azathioprine/6-mercaptopurine treatment in patients with inflammatory bowel
disease]

[Article in Korean]

Kim JH, Cheon JH, Kim WH.

Department of Internal Medicine, Institute of Gastroenterology, Yonsei University
College of Medicine, Seodaemun-gu, Seoul, Korea.

BACKGROUND/AIMS: This study was to evaluate the frequency and the course of the
adverse effects of AZA/6-MP in Korean patients with inflammatory bowel disease
(IBD). METHODS: Medical records of the patients with IBD treated with AZA/6-MP at
Severance hospital from June 1996 to September 2006 were retrospectively
analyzed. RESULTS: A total of 133 patients were studied. Male to female ratio was
1.3:1. The mean age was 31.7+/-10.9 year. Adverse effects included leukopenia
occurred in 75 cases (56.4%), nausea/vomiting in 32 cases (24.1%), arthralgia in 
6 cases (4.5%), hepatitis in 6 cases (4.5%), skin rash in 4 cases (3.0%), herpes 
zoster in 3 cases (2.3%), and headache in 1 case (0.8%). Most of leucopenia
(58.7%) developed within 3 months after maximal tolerated dose of AZA/6-MP and
nausea/vomiting frequently occurred within 3 months after start of AZA/6-MP
treatment. Thirty-eight patients (28.6%) required the discontinuation of
medication due to adverse effects. CONCLUSIONS: Leukopenia was the most common
adverse effect of AZA/6-MP treatment. Leukopenia and nausea/vomiting developed
frequently in the early period of treatment of AZA/6-MP in patients with IBD.
AZA/6-MP should be used cautiously to scrutinize bone marrow suppression.

Publication Types: 
    English Abstract

PMID: 18516013 [PubMed - indexed for MEDLINE]

258: Verh K Acad Geneeskd Belg. 2008;70(1):47-65.

[Immune evasion of alphaherpesviruses]

[Article in Dutch]

Favoreel HW.

Vakgroep Virologie Parasitologie en Immunologie, Faculteit Diergeneeskunde,
Universiteit Gent, Merelbeke.

Alphaherpesviruses represent the largest subfamily of the herpesviruses and
comprise many different, closely related pathogens of man and animal, including
herpes simplex virus (cold sores, genital lesions) and varicella-zoster virus
(chickenpox, shingles) in man, pseudorabies virus orAujeszky's disease virus in
pigs (neurological and respiratory symptoms, abortion), equine herpesvirus type 1
(neurological and respiratory symptoms, abortion), and bovine herpesvirus type 1 
(respiratory symptoms, abortion). Typical for alphaherpesviruses, and for
herpesviruses in general, is their ability to persist in a non-replicative,
latent state in their host during its entire lifetime. Specific stimuli can lead 
to reactivation of these viruses from their latent state, which can lead to
renewed spread within and between hosts and recurrent symptoms. This recurrent
replication and spread implies that herpesviruses have evolved techniques to
delay and avoid recognition and elimination by the immune system, so-called
immune evasion mechanisms. In the current manuscript, different alphaherpesvirus 
immune evasion mechanisms will be reviewed that have been discovered and
elucidated at our research group based on pseudorabies virus and that interfere
with the antiviral activity of virus-specific antibodies. Investigating immune
evasion mechanisms leads to novel insights in the interactions between viruses,
host cells, and the immunity, but can also lead to novel avenues in the design of
strategies to interfere with viral infections.

Publication Types: 
    English Abstract
    Review

PMID: 18512358 [PubMed - indexed for MEDLINE]

259: Br J Clin Pharmacol. 2008 Aug;66(2):327-8. Epub 2008 Apr 10.

Decompensation of chronic heart failure associated with pregabalin in a
73-year-old patient with postherpetic neuralgia: a case report.

De Smedt RH, Jaarsma T, van den Broek SA, Haaijer-Ruskamp FM.

Publication Types: 
    Case Reports
    Letter

PMID: 18507657 [PubMed - indexed for MEDLINE]

260: Mayo Clin Womens Healthsource. 2008 Jun;12(6):6.

Mayo Clinic office visit. The shingles vaccine. An interview with Gregory Poland,
M.D.

Poland G.

Publication Types: 
    Interview

PMID: 18506118 [PubMed - indexed for MEDLINE]

261: Antimicrob Agents Chemother. 2008 Aug;52(8):2727-33. Epub 2008 May 27.

Amphipathic DNA polymers exhibit antiherpetic activity in vitro and in vivo.

Bernstein DI, Goyette N, Cardin R, Kern ER, Boivin G, Ireland J, Juteau JM,
Vaillant A.

Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center,
3333 Burnet Ave., Cincinnati, OH 45229, USA. david.bernstein@cchmc.org

Phosphorothioated oligonucleotides have a sequence-independent antiviral activity
as amphipathic polymers (APs). The activity of these agents against herpesvirus
infections in vitro and in vivo was investigated. The previously established
sequence-independent, phosphorothioation-dependent antiviral activity of APs was 
confirmed in vitro by showing that a variety of equivalently sized homo- and
heteropolymeric AP sequences were similarly active against herpes simplex virus
type 1 (HSV-1) infection in vitro compared to the 40mer degenerate parent
compound (REP 9), while the absence of phosphorothioation resulted in the loss of
antiviral activity. In addition, REP 9 demonstrated in vitro activity against a
broad spectrum of other herpesviruses: HSV-2 (50% effective concentration
[EC(50)], 0.02 to 0.06 microM), human cytomegalovirus (EC(50), 0.02 to 0.13
microM), varicella zoster virus (EC(50), <0.02 microM), Epstein-Barr virus
(EC(50), 14.7 microM) and human herpesvirus types 6A/B (EC(50), 2.9 to 10.2
microM). The murine microbicide model of genital HSV-2 was then used to evaluate 
in vivo activity. REP 9 (275 mg/ml) protected 75% of animals from disease and
infection when provided 5 or 30 min prior to vaginal challenge. When an
acid-stable analog (REP 9C) was used, 75% of mice were protected when treated
with 240 mg/ml 5 min prior to infection (P < 0.001), while a lower dose (100
mg/ml) protected 100% of the mice (P < 0.001). The acid stable REP 9C formulation
also provided protection at 30 min (83%, P < 0.001) and 60 min (50%, P = 0.07)
against disease. These observations suggest that APs may have microbicidal
activity and potential as broad-spectrum antiherpetic agents and represent a
novel class of agents that should be studied further.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 18505857 [PubMed - indexed for MEDLINE]

262: J Drugs Dermatol. 2008 May;7(5):457-62.

Herpes zoster in eastern Saudi Arabia: clinical presentation and management.

Alakloby OM, AlJabre SH, Randhawa MA, Alzahrani AJ, AlWunais KM, Bukhari IA.

Department of Dermatology, College of Medicine, King Faisal University, Dammam,
Saudi Arabia. oakloby1@yahoo.com

BACKGROUND: Herpes zoster (HZ), caused by varicella zoster virus (VZV), initially
produces chicken-pox, then the virus lies dormant in the dorsal root ganglia. The
virus can reactivate after many years and results in HZ along ganglion's
distribution. Old age, trauma, stress, diabetes mellitus, and immune suppression 
are important risk factors for the reactivation. Herpes zoster is characterized
by unilateral radicular pain and vesicular eruption that is generally limited to 
the dermatome innervated by the affected ganglion. In immunocompromised
individuals, disseminated zoster may develop. The aims of therapy in HZ are to
control pain or reduce its severity by the use of analgesics, reduce the duration
and eruption of new lesions, and prevent complications, particularly postherpetic
neuralgia (PHN) by appropriate antiviral therapy. METHODS: All cases of HZ seen
in the dermatology clinic at King Fahd Hospital of the University (KFHU) from
1988 to 2006 were included in the study. Their diagnoses were based on the
clinical presentation. The following parameters were collected and analyzed: age,
sex, nationality, symptoms, dermatomal distribution, complications, coexisting
diseases, and disease management. RESULTS: Of 22 749 new cases seen in the
dermatology clinic over 18 years, 141 were HZ, with an occurrence of 0.62%. Male 
to female ratio was 2:1 and the age ranged from 14 months to 80 years. The
thoracic dermatomes were the most commonly involved. The most frequent coexisting
disease was diabetes mellitus, and the most common complication of HZ was PHN.
Most patients with HZ ophthalmicus developed eye complications. CONCLUSION: The
occurrence of HZ is 0.62% in patients reporting to the dermatology clinic of the 
hospital. Males are little more affected than females. The thoracic dermatomes
are the most frequently involved. Diabetes mellitus is the most frequent
coexisting disease. Postherpetic neuralgia is the most common complication of HZ.

PMID: 18505138 [PubMed - indexed for MEDLINE]

263: Ann Rheum Dis. 2008 Jun 2. [Epub ahead of print]

Risk factors for major infections in Wegener's granulomatosis: analysis of 113
patients.

Charlier C, Henegar C, Launay O, Pagnoux C, Berezne A, Bienvenu B, Cohen P,
Mouthon L, Guillevin L.

Assistance Publique - Hopitaux de Paris, Hopital Cochin, France.

OBJECTIVE: To characterize major infectious complications and analyze potential
risk factors in Wegener's granulomatosis (WG) patients. METHODS: Data from 113 WG
patients (69 men) followed at least once between January 1984 and March 2006 in
our internal medicine department were analyzed retrospectively. RESULTS: Thirty
five patients (mean age at WG diagnosis: 50.2 (+/-13.05) years) developed 53
major infections. Infections were: bronchopneumonias (n = 19), herpes zoster
recurrences (n = 9), cellulitis (n = 4), prostatitis (n = 4), spondylodiscitis
and septic arthritis (n = 3), digestive tract infections (n = 2), Enterococcus
faecalis or Staphylococcus aureus septicemia (n = 2), viral hepatitis B
reactivations (n = 2), post-transfusion HIV infection with fatal cerebral
toxoplasmosis, esophageal candidiasis, disseminated herpes simplex and
cytomegalovirus infection, cytomegalovirus retinitis, herpetic keratitis,
herpetic stomatitis, Serratia sp. node suppuration and fever resolving under
broad spectrum antibiotics (n = 1 each). Half of the major infectious episodes
occurred within the 3 years after WG diagnosis. Eight (7%) patients died, with
two (2%) infection-related deaths. Patients diagnosed with WG before 1996 had a
significantly higher rate of infections than those diagnosed later (48% vs. 24%, 
p = 0.02). Cyclophosphamide and corticosteroids were independently associated
with significantly higher risk of major infection (p<0.05 and <0.001
respectively). All patients treated since 1993 received anti-pneumocystosis
prophylaxis. CONCLUSION: Cyclophosphamide and corticosteroids were associated
with higher risk of infection. Despite systematic cotrimoxazole prophylaxis,
major infections, mostly bronchopneumonias and herpes zoster recurrences, were
still common in the course of WG.

PMID: 18504289 [PubMed - as supplied by publisher]

264: Jpn J Infect Dis. 2008 May;61(3):205-9.

Immune reconstitution inflammatory syndrome among HIV/AIDS patients during highly
active antiretroviral therapy in Addis Ababa, Ethiopia.

Huruy K, Mulu A, Mengistu G, Shewa-Amare A, Akalu A, Kassu A, Andargie G, Elias
D, Torben W.

Department of Medical Laboratory Technology, College of Medicine and Health
Sciences, University of Gondar, Gondar, Ethiopia. kasaye88@yahoo.com

Suppression of viral replication is followed by increases in CD4+ lymphocytes,
and this has been shown to result in decreased susceptibility to opportunists
after initiation of highly active antiretroviral therapy (HAART). However,
clinical aggravations after the initiation of HAART have been thought to be due
to the restored ability to mount an inflammatory response, or the immune
reconstitution inflammatory syndrome (IRIS). The degree of IRIS observed in human
immunodeficiency virus (HIV)-infected patients following initiation of HAART is
variable. This prospective study was aimed at determining the proportion of IRIS 
and the pattern of opportunistic infections among 186 HIV/AIDS patients receiving
HAART between December 2006 and July 2007 at Zewditu Memorial Hospital, Addis
Ababa, Ethiopia. The proportion of IRIS was 17.2% (32/186). The mean number of
days of IRIS occurrence for each disease ranged from 26 to 122 days with a mean
of 80. Opportunistic diseases associated with IRIS were tuberculosis (68.8%,
22/32), herpes zoster rash (12.5%, 4/32), cryptococcosis (9.4%, 3/32),
toxoplasmosis (6.3%, 2/32) and bacterial pneumonia (3.1%, 1/32). Compared to
baseline readings there were significant increases in CD4 count, aspartate
aminotransferase and alanine aminotransferase levels while hemoglobin values
decreased during the development of IRIS. In summary, the proportion of IRIS and 
the pattern of opportunistic infections in HAART-treated patients in Ethiopia
mirrored those reported in other countries. Further prospective surveys on
epidemiological, immunological, microbial and clinical studies are imperative to 
assess the proportion and pattern of IRIS and effect of HAART in Ethiopia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18503170 [PubMed - indexed for MEDLINE]

265: Medicina (B Aires). 2008;68(2):125-8.

[Clinical and epidemiological aspects of herpes zoster]

[Article in Spanish]

Vujacich C, Poggi E, Cecchini D, Luchetti P, Stamboulian D.

Fundacion del Centro de Estudios Infectologicos, Buenos Aires, Argentina.
cvujacich@funcei.org.ar

Herpes zoster (HZ) is a public health problem worldwide. Although, there is
paucity of data of this disease from South American countries. The objective of
this study was to evaluate clinical and epidemiological aspects of HZ in a
population of patients from South America. We underwent a retrospective analysis 
of clinical charts of an infectious diseases reference center (period:
2000-2005). Univariate analysis was performed to assess variables related to post
herpetic neuralgia (PHN). From a total of 302 cases, 62% were in women. The
median age was 57 years: 16.1% of the patients had a predisposing condition for
the development of HZ. Most frequent dermatomes involved were: thoracic,
ophthalmic and lumbar; 93.5% of the patients received antiviral drugs and 94%
complementary medications. The most frequent complication was PHN and was related
with age over 50 years. Clinical and epidemiological aspects of HZ and the
frequency of complications in our population were similar to data from developed 
countries.

Publication Types: 
    English Abstract

PMID: 18499960 [PubMed - in process]

266: An Sist Sanit Navar. 2008 Jan-Apr;31(1):71-80.

[Varicella and herpes zoster incidence prior to the introduction of systematic
child vaccination in Navarre, 2005-2006]

[Article in Spanish]

Garcia Cenoz M, Castilla J, Montes Y, Moran J, Salaberri A, Elia F, Floristan Y, 
Rodrigo I, Irisarri F, Arriazu M, Zabala A, Barricarte A.

Instituto de Salud Publica de Navarra, 31003 Pamplona, Spain.
mgcenoz@cfnavarra.es

Varicella is an acute and highly contagious disease produced by the
varicella-zoster virus, which leaves lasting immunity. Herpes zoster is produced 
by reactivation of a latent infection of the same virus. The introduction of
systematic and free vaccination against varicella in children of 15 months in
Navarre from 2007 onwards can be expected to produce important epidemiological
changes. For this reason we describe the previous epidemiological situation in
the period from 2005 to 2006. We analysed all cases of varicella and herpes
zoster registered in the electronic clinical files of primary care, in the
database of hospital discharges and in the mortality register. Between 2005 and
2006, 9,908 cases of varicella were diagnosed (8.29 annually per 1,000
inhabitants), with 90% in children under 15 years old. There were 80 hospital
admissions (8 for every 1,000 cases), complications in 2.5 out of every 1,000
cases, and there was one death due to this cause (0.1 per 1,000 cases). In the
same period, 4,959 cases of herpes zoster were diagnosed (4.15 cases per 1,000
inhabitants), half in people over 55 years old. There were 179 hospital
admissions (36 per 1,000 cases), whose average age was 77, and 83 presented
complications (16.7 per 1,000 cases). This epidemiological pattern is similar to 
that found in other places before the introduction of the vaccine.

Publication Types: 
    English Abstract

PMID: 18496581 [PubMed - indexed for MEDLINE]

267: J Virol. 2008 Aug;82(15):7443-55. Epub 2008 May 21.

Herpes simplex virus type 1 ICP27 regulates expression of a variant, secreted
form of glycoprotein C by an intron retention mechanism.

Sedlackova L, Perkins KD, Lengyel J, Strain AK, van Santen VL, Rice SA.

Department of Microbiology, University of Minnesota Medical School, Minneapolis, 
MN 55455, USA.

We previously showed that herpes simplex virus type 1 (HSV-1) immediate-early
(IE) protein ICP27 can posttranscriptionally stimulate mRNA accumulation from a
transfected viral late gene encoding glycoprotein C (gC) (K. D. Perkins, J.
Gregonis, S. Borge, and S. A. Rice, J. Virol. 77:9872-9884, 2003). We began this 
study by asking whether ICP27 homologs from other herpesviruses can also mediate 
this activity. Although the homologs from varicella-zoster virus (VZV) and human 
cytomegalovirus (HCMV) were inactive, the homolog from bovine herpesvirus 4
(BHV-4), termed HORF1/2, was a very efficient transactivator. Surprisingly, most 
of the mRNA produced via HORF1/2 transactivation was 225 nucleotides shorter than
expected due to the removal of a previously undescribed intron from the gC
transcript. We found that the gC mRNA produced in the absence of transactivation 
was also mostly spliced. In contrast, gC mRNA produced by ICP27 transactivation
was predominantly unspliced. Based on these results, we conclude that ICP27 has
two distinct effects on the transfected gC gene: it (i) stimulates mRNA
accumulation and (ii) promotes the retention of an intron. Interestingly, the
spliced transcript encodes a variant of gC that lacks its transmembrane domain
and is secreted from transfected cells. As the gC splicing signals are conserved 
among several HSV-1 strains, we investigated whether the variant gC is expressed 
during viral infection. We report here that both the spliced transcript and its
encoded protein are readily detected in Vero cells infected with three different 
laboratory strains of wild-type HSV-1. Moreover, the variant gC is efficiently
secreted from infected cells. We have designated this alternate form of the
protein as gCsec. As the extracellular domain of gC is known to bind heparan
sulfate-containing proteoglycans and to inhibit the complement cascade via an
interaction with complement component C3b, we speculate that gCsec could function
as a secreted virulence factor.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 18495765 [PubMed - indexed for MEDLINE]

268: Clin Infect Dis. 2008 Jul 1;47(1):e4-6.

Tularemia with vesicular skin lesions may be mistaken for infection with herpes
viruses.

Byington CL, Bender JM, Ampofo K, Pavia AT, Korgenski K, Daly J, Christenson JC, 
Adderson E.

Department of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA.
Carrie.byington@hsc.utah.edu

The original reports of human infection with Francisella tularensis noted
vesicular skin rash as a manifestation. We present 2 cases of tularemia initially
diagnosed as herpes simplex or varicella zoster infection. Clinicians must
recognize the cutaneous manifestations of tularemia and be able to distinguish
these from lesions seen with herpes viruses.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural

PMID: 18491968 [PubMed - indexed for MEDLINE]

269: Clin Infect Dis. 2008 Jul 1;47(1):e1-3.

Varicella-zoster virus and cerebral aneurysm: case report and review of the
literature.

Bhayani N, Ranade P, Clark NM, McGuinn M.

Division of Infectious Diseases, University of Illinois at Chicago, Chicago, IL
60607, USA.

We report a case of varicella-zoster vasculopathy that occurred in a 42-year-old 
renal transplant recipient with concurrent vertebral artery aneurysm and
dissection. The patient was successfully treated with embolization and acyclovir 
therapy. Here, we review the English literature regarding the association of
varicella-zoster virus infection with cerebral aneurysm.

Publication Types: 
    Case Reports
    Review

PMID: 18491962 [PubMed - indexed for MEDLINE]

270: Arch Dermatol. 2008 May;144(5):603-8.

Family history as a risk factor for herpes zoster: a case-control study.

Hicks LD, Cook-Norris RH, Mendoza N, Madkan V, Arora A, Tyring SK.

University of Texas Medical School at Houston, USA. Lindsey.D.Hicks@uth.tmc.edu

OBJECTIVE: To assess risk factors for herpes zoster beyond age and
immunosuppression, especially the association with a family history of herpes
zoster, since a preventative herpes zoster and postherpetic neuralgia vaccine is 
now available. DESIGN: We undertook a case-control study of herpes zoster, which 
represents reactivation of latent varicella zoster virus residing in dorsal root 
ganglia following primary infection, involving 504 patients and 523 controls.
Interviews were conducted by trained medical investigators using a structured
questionnaire. SETTING: The Center for Clinical Studies, an outpatient clinic and
research center in Houston, Texas. PARTICIPANTS: Nonimmunocompromised patients
with confirmed cases of herpes zoster were included in the study. Controls were
nonimmunocompromised clinic patients with new diagnoses of skin diseases other
than herpes zoster. RESULTS: Cases were more likely to report blood relatives
with a history of zoster (39%) compared with controls (11%; P < .001). Risk was
increased with multiple blood relatives (odds ratio, 13.77; 95% confidence
interval, 5.85-32.39) compared with single blood relatives (odds ratio, 4.50; 95%
confidence interval, 3.15-6.41). CONCLUSIONS: The results suggest an association 
between herpes zoster and family history of zoster. Future studies will be needed
to investigate this association.

PMID: 18490586 [PubMed - indexed for MEDLINE]

271: Mol Gen Mikrobiol Virusol. 2008;(2):37-41.

[Mutational pressure in genomes of alphaherpesviruses infecting human]

[Article in Russian]

Khrustalev VV, Barkovskii EV.

Genomes of the herpes simplex viruses are extremely enriched with GC. Elevated
G+C level in genomes of the simplex viruses is a result of their long-term
evolution under the influence of the mutational pressure. We counted the rates of
nucleotide substitutions from gene coding major capsid protein (MCP) (G+C = 0.68,
3GC = 0.89) of human simplex virus 1 (HSV-1) to the MCP gene (G+C = 0.70, 3GC =
0.91) of HSV-2 (the first pair of genes) and from the same MCP gene of HSV-1 to
the homologous gene (G+C = 0.73, 3GC = 0.99) from cercopithecine herpes virus 16 
(the second pair of genes). The rates of transitions from A-T to G-C base pairs
increases 2.17-, 3.09-, and 1.27-fold in the first, second, and third codon
positions, respectively, if compared those rates between the second and first
pair of genes (the growth of GC-richness is only 3%). This effect is due to an
approximately 90% GC-richness of the third codon positions in all those genes.
Transitions caused by the strong mutational pressure (from A-T to G-C base pairs)
have a low probability to occur in the third positions, but high probability to
occur in the first and second positions. For MCP gene of human herpes 3, the
probability of the occurrence of transition caused by mutational pressure in the 
third codon position is 2.36 times higher than in MCP gene of HSV1, and 3 times
higher than in MCP gene of HSV2. These data could provide an explanation of
rarely occurring relapses of herpes Zoster infection and frequently occurring
relapses of herpes simplex infection.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 18488448 [PubMed - indexed for MEDLINE]

272: Cancer Epidemiol Biomarkers Prev. 2008 May;17(5):1277-81.

Long-term anti-inflammatory and antihistamine medication use and adult glioma
risk.

Scheurer ME, El-Zein R, Thompson PA, Aldape KD, Levin VA, Gilbert MR, Weinberg
JS, Bondy ML.

Department of Epidemiology, University of Texas MD. Anderson Cancer Center, PO
Box 301439, Houston, TX 77230-1439, USA. mbondy@mdanderson.org.

A personal history of asthma or allergy has been associated with a reduced risk
for adult malignant gliomas. Recent reports on the use of nonsteroidal
anti-inflammatory drugs (NSAID) and the presence of risk alleles in asthma
susceptibility genes showed similar inverse associations. To further explore the 
relationship between immune mediators and gliomas, we examined the use of NSAID
and antihistamines, history of asthma or allergy, and infection in 325 glioma
cases and 600 frequency-matched controls from the metropolitan area of Houston,
TX (2001-2006). The regular use of NSAID was associated with a 33% reduction in
the risk for glioma, suggestive of possible antitumor activity. Surprisingly,
regular long-term antihistamine use among those reporting a history of asthma or 
allergies was significantly associated with a 3.5-fold increase in the risk for
glioma. Similar to previous reports, cases in our study were less likely to have 
reported asthma, allergy, or a history of a number of viral infections
(chickenpox or shingles, oral herpes, and mononucleosis) than controls. We
therefore speculate that the observed positive association with antihistamine use
may reflect an alteration of protective immune factors in susceptible
individuals. Our results lend additional support for an important but unknown
link between malignant brain tumors and immune mediators.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 18483351 [PubMed - indexed for MEDLINE]

273: Spec Care Dentist. 2000 Nov-Dec;20(6):245-9.

The issues and challenges of orofacial pain in the elderly.

Cox MO.

University of Colorado School of Dentistry, USA.

Dental pain is among the most prevalent of all pain complaints, and pain is
frequently given as a common reason for both avoiding and seeking dental care.
Pain is frequently an essential component in the differential diagnosis of many
diseases; however, in the elderly, diagnosis is more difficult due to a greater
frequency of multiple chronic diseases and an altered pain response. It is
important to understand the nature and prevalence of pain in this group, and one 
should be cautious to avoid the oversimplification that "pain decreases with
age." Current studies involving the differences in assessing pain and therapeutic
pain control between younger and older age groups are discussed. Pain prevalence 
is discussed along with herpes zoster, post-herpetic neuralgia, fibromyalgia,
toothache pain, burning mouth syndrome, and trigeminal neuralgia as they relate
to the elderly. Pain assessment can be made by means of pain scales and specific 
open- and closed-ended questions. There is evidence that some practitioners may
be underestimating the severity of pain in the elderly, and thus not prescribing 
adequate analgesics when indicated. When analgesics are prescribed, a thorough
analysis of the patients' current medications and condition should lead to a
customized prescription and dosage.

Publication Types: 
    Review

PMID: 18481416 [PubMed - indexed for MEDLINE]

274: Int J Dermatol. 2008 Jun;47(6):640-1.

Herpes zoster after varicella vaccination in a healthy young child.

Obieta MP, Jacinto SS.

Publication Types: 
    Case Reports
    Letter

PMID: 18477170 [PubMed - indexed for MEDLINE]

275: Nephrology (Carlton). 2008 Jun;13(4):331-6.

Efficacy of enteric-coated mycophenolate sodium in patients with active lupus
nephritis.

Mak SK, Lo KY, Lo MW, Chan SF, Tong GM, Wong PN, Wong AK.

Renal Unit, Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon,
Hong Kong. maksk@ha.org.hk

BACKGROUND: The ideal treatment of lupus nephritis has yet to be defined. Both
cyclophosphamide and mycophenolate mofetil have been used with encouraging
results, but adverse events are frequently seen. There are no data on the use of 
enteric-coated mycophenolate sodium. METHODS: We retrospectively reviewed 12
patients with active forms of lupus nephritis (1 class III, 7 class IV and 4
class V) treated with enteric-coated mycophenolate sodium combined with
corticosteroids. RESULTS: The mean age of the patients was 32.3 +/- 11.2 years
and the average length of follow up was 25.9 +/- 8.9 months. The mean serum
creatinine clearance was 93 +/- 30.1 mL/min per 1.73 m(2) and the mean
proteinuria level was 4.5 +/- 3.6 g/day. All had features that warranted
aggressive treatment. Mycophenolate sodium was given for 12.9 +/- 9.7 months with
an averaged starting dose of 1350 +/- 163 mg/day. Six patients attained complete 
remission and six attained partial remission with treatment. The mean interval to
attain first remission (complete or partial) was 8.3 +/- 5.7 weeks. At last
follow up, all patients were in complete or partial remission. Apart from herpes 
zoster that developed in one patient, no other significant side-effects were
encountered. CONCLUSION: Enteric-coated mycophenolate sodium was effective and
well-tolerated in the treatment of active lupus nephritis.

PMID: 18476916 [PubMed - indexed for MEDLINE]

276: Rev Recent Clin Trials. 2007 Jan;2(1):1.

Most recent prevention strategies.

Weinberg JM.

Publication Types: 
    Editorial

PMID: 18473982 [PubMed - indexed for MEDLINE]

277: Ther Clin Risk Manag. 2007 Aug;3(4):633-9.

Prevention of shingles: safety and efficacy of live zoster vaccine.

Quan D, Cohrs RJ, Mahalingam R, Gilden DH.

Primary infection with varicella zoster virus (VZV) causes chickenpox (varicella)
after which virus becomes latent in cranial nerve, dorsal root and autonomic
ganglia along the entire neuraxis. Virus may later reactivate, causing shingles
(zoster), characterized by pain and rash restricted to 1-3 dermatomes. More than 
40% of zoster patients over age 60 develop postherpetic neuralgia (PHN), pain
that persists for months to years. The socioeconomic impact of primary varicella 
infection has been lessened by introduction of VZV vaccine for children. However,
the effect of childhood vaccination on the incidence of zoster is unknown. Virus 
reactivation correlates with waning cell-mediated immunity (CMI) to VZV with
normal aging. Adults exposed to children with varicella may have a boost in CMI
to VZV. For at least several more decades, the incidence of zoster may increase
as the elderly population grows. The anticipated increase in zoster burden of
illness in future decades was a major impetus for the Shingles Prevention Study, 
a prospective, double-blind, placebo-controlled trial of attenuated VZV vaccine
to prevent zoster in older adults. This review discusses clinical and virological
aspects of zoster and its complications, current treatment options, and VZV
vaccine development along with its future role in disease prevention.

PMID: 18472986 [PubMed - in process]

278: Virology. 2008 Jul 5;376(2):339-45. Epub 2008 May 8.

Plasma membrane cholesterol is required for efficient pseudorabies virus entry.

Desplanques AS, Nauwynck HJ, Vercauteren D, Geens T, Favoreel HW.

Department of Virology, Parasitology and Immunology, Faculty of Veterinary
Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
Ann.Desplanques@UGent.be

Alphaherpesviruses comprise closely related viruses of man and animal, including 
herpes simplex virus, varicella-zoster virus and pseudorabies virus (PRV). Here, 
using methyl-beta-cyclodextrin and fluorescently tagged PRV, we directly show
that depletion of cholesterol from the plasma membrane of host cells
significantly reduces PRV entry. Cholesterol depletion did not reduce PRV
attachment, but stalled virus particles at the plasma membrane before penetration
of the cell. Cholesterol depletion results in destabilization of lipid raft
microdomains in the plasma membrane, which have been shown before to be involved 
in efficient entry of different viruses. A significant fraction of PRV virions
appears to localize juxtaposed to GM1, a lipid raft marker, during entry.
Together, these data indicate that cholesterol and possibly cholesterol-rich
lipid rafts may be important during PRV entry.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18471850 [PubMed - indexed for MEDLINE]

279: Epidemiol Infect. 2009 Jan;137(1):38-47. Epub 2008 May 9.

Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United 
Kingdom.

Gauthier A, Breuer J, Carrington D, Martin M, Remy V.

i3 Innovus, Uxbridge, Middlesex, UK. aline.gauthier@i3nnovus.com

Recent information on epidemiology and management of herpes zoster (HZ) and
post-herpetic neuralgia (PHN), a painful complication of HZ, is scarce. The
objective of this study was to document the burden of HZ and PHN in the United
Kingdom. This retrospective analysis of the UK General Practice Research Database
aimed to estimate HZ incidence and proportion of HZ patients developing PHN and
to assess management costs in immunocompetent individuals aged 50 years. A cohort
of 27 225 HZ patients was selected, corresponding to an incidence of 5.23/1000
person-years. Respectively 19.5% and 13.7% of patients developed PHN at least 1
and 3 months after HZ diagnosis. Mean direct cost was pound103 per HZ patient and
pound341 and pound397 per PHN episode (1- and 3-month definition respectively).
Both HZ and PHN costs increased markedly with pain severity. This study confirms 
that HZ and PHN are frequent and costly diseases in the United Kingdom.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18466661 [PubMed - indexed for MEDLINE]

280: Endocr Pract. 2008 Apr;14(3):392.

Visual vignette. Postherpetic neuralgia and galactorrhea.

Paul TV, Spurgeon R, Jebasingh F.

Department of Endocrinology, Christian Medical College and Hospital, Vellore,
Tamil, Nadu, India.

Publication Types: 
    Case Reports

PMID: 18463051 [PubMed - indexed for MEDLINE]

281: Cent Eur J Public Health. 2008 Mar;16(1):41-4.

Seroprevalence of antibodies to varicella-zoster virus in Madrid (Spain) in the
absence of vaccination.

Perez-Farinos N, Garcia-Comas L, Ramirez-Fernandez R, Sanz JC, Barranco D,
Garcia-Fernandez C, Ordobas M.

Epidemiology Department, Madrid Public Health Institute, Madrid, Spain.
napo@napo.jazztel.es

OBJECTIVE: to ascertain the seroprevalence of antibodies to varicella-zoster
virus in the Madrid population prior to the introduction of vaccination. STUDY
DESIGN: Cross-sectional antibody seroprevalence study. METHODS: Population:
persons aged 2 to 40 years in Madrid. Field work: September 1999 to April 2000.
Data were collected on demographic and socio-economic variables and on a number
of exposures. IgG antibodies were determined using Enzyme Linked ImmunoSorbent
Assay (ELISA), and antibody prevalence broken down by age group. Logistic
regression was used to analyse the association between the presence of antibodies
and the respective study variables. The results were compared against those of an
earlier seroprevalence survey in Madrid (1993). RESULTS: A total of 2,131
subjects were included, with a non-response rate of 20.4%. Antibody prevalence
was estimated at 90.2%; the 90% mark was reached at 11 years of age and almost
100% of adults presented with antibodies. In the case of children, school
attendance associated with the presence of antibodies. No significant differences
were observed vis-a-vis the results of the earlier survey. CONCLUSIONS: The
seroprevalence profile coincides with those of other Spanish regions and European
countries, and remains stable over time. Antibody presence rises sharply in
children from aged 2 years to adolescence. Further seroprevalence studies are
called for to study the disease trend and assess preventive measures.

PMID: 18459480 [PubMed - indexed for MEDLINE]

282: Ann Dermatol Venereol. 2008 May;135(5):429-31. Epub 2008 Apr 21.

[Herpes, varicella and zona]

[Article in French]

Marinho E.

Service d'anatomie et cytologie pathologiques, hopital Bichat-Claude-Bernard, 46 
rue Henri-Huchard, Paris, France. eduardo.marinho@bch.ap-hop-paris.fr

PMID: 18457737 [PubMed - indexed for MEDLINE]

283: Infection. 2008 Jun;36(3):226-30. Epub 2008 May 3.

Diabetes as a risk factor for herpes zoster infection: results of a
population-based study in Israel.

Heymann AD, Chodick G, Karpati T, Kamer L, Kremer E, Green MS, Kokia E, Shalev V.

Medical Division, Maccabi Healthcare Services, 27 HaMered St, Tel Aviv, 68125,
Israel.

BACKGROUND: Studies showed that diabetes mellitus (DM) is often accompanied by
impaired cell-mediated immunity, which potentially may increase the risk for
infectious diseases, including herpes zoster (HZ). However, data on the relation 
between DM and HZ are scarce. This case-control study explored the association
between DM and HZ. PATIENTS AND METHODS: This study was nested within a cohort of
all members of a large health maintenance organization (HMO) in Israel. Cases
totaled 22,294 members who were diagnosed with HZ between 2002 and 2006. Controls
(n=88,895) were randomly selected from the remaining HMO population using
frequency-matched age, sex, and duration of follow-up. Personal data on history
of DM, lymphoma, leukemia, or AIDS, were obtained from computerized medical
records. RESULTS: Adjusted analyses showed that the risk of HZ was associated
with history of leukemia, lymphoma, use of steroids or antineoplastic
medications, and AIDS, particularly among patients below 45 years of age. In a
multivariate analysis, DM was associated with an increased risk of HZ (OR=1.53;
95% CI: 1.44-1.62). CONCLUSIONS: The data suggest that individuals with DM are at
increased risk of HZ. Well-designed cohort studies may help to clarify the nature
of this association.

PMID: 18454342 [PubMed - indexed for MEDLINE]

284: J Infect Dis. 2008 Mar 1;197 Suppl 2:S61-5.

A model of lytic, latent, and reactivating varicella-zoster virus infections in
isolated enteric neurons.

Gershon AA, Chen J, Gershon MD.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, New York 10032, USA. aag1@columbia.Edu

Because human primary afferent neurons are not readily obtained, we sought to
develop a model in which the lytic, latent, and reactivating phases of
varicella-zoster virus (VZV) infection were recapitulated in neurons from an
animal source. Enteric neurons were obtained from the small intestine of adult
guinea pigs and from the bowel of fetal mice. Latency was established when these 
neurons were infected by cell-free VZV in the absence of fibroblasts or other
cells of mesodermal origin. In contrast, lytic infection ensued when fibroblasts 
were present or when the enteric neurons were infected by cell-associated VZV.
Latency was associated with the expression of a limited subset of viral genes,
the products of which were restricted to the cytoplasm. Lysis was associated with
the expression of viral glycoproteins, nuclear translocation of
latency-associated gene products, and rapid cell death. Reactivation was
accomplished by expressing VZV open reading frame (ORF) 61p or herpes simplex
virus ICP0 in latently infected neurons. Isolated enteric neurons from guinea
pigs and mice recapitulate latent gene expression in human cranial nerve and
dorsal root ganglia. Expression of latency-associated VZV gene products was
detected in 88% of samples of adult human intestine, suggesting that VZV not only
infects enteric neurons but also is latent in the human enteric nervous system.
This in vitro model should facilitate further understanding of latency and
reactivation of VZV.

Publication Types: 
    Evaluation Studies
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18419411 [PubMed - indexed for MEDLINE]

285: J Infect Dis. 2008 Mar 1;197 Suppl 2:S58-60.

Humoral and cellular immunity to varicella-zoster virus: an overview.

Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford,
California 94305, USA. aarvin@stanford.edu

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18419410 [PubMed - indexed for MEDLINE]

286: J Infect Dis. 2008 Mar 1;197 Suppl 2:S54-7.

Vaccine Oka variants and sequence variability in vaccine-related skin lesions.

Breuer J, Schmid DS.

Skin Virus Laboratory, Centre for Cutaneous Research, St. Bartholomew's and The
Royal London School of Medicine and Dentistry, Queen Mary College, London, United
Kingdom.

As with most live attenuated viral vaccines, varicella vaccine comprises a
mixture of variant strains. Knowledge about the pathogenic potential of
individual strains in the varicella vaccine is limited. Vaccination against
chickenpox causes a usually modified varicella-like rash in a small percentage of
healthy children, and vaccine virus reactivates on rare occasions to cause herpes
zoster (HZ). In several published studies, our respective laboratories have
analyzed genomic variation among specimens from cases of postvaccination rash and
HZ in vaccine recipients, focusing on polymorphisms between vaccine Oka strains
and the parental Oka strain. In most respects, these studies were in close
agreement, identifying the set of wild-type markers among vaccine adverse event
isolates, each occurring at similar frequencies. The same 3 universally present
vaccine markers, at positions 106262, 107252, and 108111, were also identified by
both laboratories. One notable difference has been the observation of mostly
clonal vaccine virus among isolates examined by one laboratory and mostly mixed
viruses in isolates examined by the other. In addition to reviewing and comparing
our combined observations, we propose possible explanations for our contrasting
findings and propose future studies to reconcile them.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18419409 [PubMed - indexed for MEDLINE]

287: J Infect Dis. 2008 Mar 1;197 Suppl 2:S41-4.

Development of varicella vaccine.

Takahashi M, Asano Y, Kamiya H, Baba K, Ozaki T, Otsuka T, Yamanishi K.

Department of Virology, Research Institute for Microbial Diseases, Osaka
University, Suita, Osaka, Japan. mtakahashi@mail.biken.or.jp

The Oka strain of varicella-zoster virus (VZV) was first isolated from vesicles
of an otherwise healthy 3-year-old boy with typical varicella. The virus was
passaged 11 times in human embryonic lung fibroblasts at 34 degrees C and 12
times in guinea pig embryo fibroblasts (GPEFs) at 37 degrees C. GPEFs were the
only nonprimate cells tested in which some degree of viral replication occurred. 
The resultant virus was temperature sensitive and showed host dependency,
measured as better replication in GPEFs than that shown by the parental virus.
The passaged virus was used as a candidate varicella vaccine and proved safe and 
effective for healthy and immunocompromised children. During the follow-up of
vaccinated children with acute lymphocytic leukemia, the incidence of herpes
zoster (HZ) was significantly lower among children who did not have a rash after 
vaccination, compared with those who had a rash caused by VZV (6 [2.3%] of 260
vs. 12 [17.1%] of 70, respectively). Because of the pathogenesis of VZV, the
incidence of latency and of HZ is predicted to be lower among vaccine recipients 
than among individuals who have experienced varicella.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18419406 [PubMed - indexed for MEDLINE]

288: J Infect Dis. 2008 Mar 1;197 Suppl 2:S39-40.

Erratum in:
    J Infect Dis. 2008 Jun 15;197(12):1783.

Varicella vaccine in the United States: a decade of prevention and the way
forward.

Gershon AA, Arvin AM, Levin MJ, Seward JF, Schmid DS.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, New York, USA. aag1@columbia.edu

Publication Types: 
    Introductory Journal Article
    Research Support, Non-U.S. Gov't

PMID: 18419405 [PubMed - indexed for MEDLINE]

289: J Infect Dis. 2008 Mar 1;197 Suppl 2:S242-5.

Perspective on live varicella vaccine.

Gershon AA, Katz SL.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, New York 10032, USA. aag1@columbia.edu

The attenuation of varicella-zoster virus (VZV) by Takahashi in 1974 was a
remarkable achievement. It swiftly led to development of a live vaccine against
chickenpox, which was initially tested in Japan. With its successful employment
in immunocompromised children to prevent morbidity and mortality due to
varicella, the vaccine began to be tested in healthy children in Japan and
elsewhere. In the United States, vaccine use progressed from extensive clinical
trials that demonstrated safety and efficacy to universal immunization of healthy
infants and children. In the past 10 years, >30 million healthy American
individuals, mostly children, have been vaccinated. With increasing use of
vaccine, there has been a concomitant decrease in the incidence of disease, along
with decreases in hospitalizations and deaths due to VZV. To improve protection, 
however, a 2-dose schedule of immunization was recommended for routine use in all
children by the Centers for Disease Control and Prevention in June 2006. At
roughly the same time, licensure of the combined measles-mumps-rubella-varicella 
vaccine was completed, which allowed harmonization of immunization against these 
4 viruses with 1 injection given twice in childhood. Concomitantly, a version of 
the varicella vaccine with 10 times the titer was developed for immunization of
healthy individuals >60 years of age against herpes zoster (HZ). Although
elimination of VZV from human populations may not yet be possible, the combined
approach of immunization against both varicella in childhood and HZ in adulthood 
in the developed world are predicted to dramatically increase our control of this
troublesome virus.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18419404 [PubMed - indexed for MEDLINE]

290: J Infect Dis. 2008 Mar 1;197 Suppl 2:S237-41.

Strategies for herpes zoster vaccination of immunocompromised patients.

Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA.
jcohen@niaid.nih.gov

A vaccine to prevent herpes zoster (HZ) in adults > or =60 years of age with
healthy immune systems was recently approved by the US Food and Drug
Administration. This vaccine is contraindicated in persons with certain
immunodeficiency states or who are receiving immunosuppressive therapy. On the
basis of studies of the varicella vaccine in healthy and immunosuppressed
children and studies of HZ vaccine in healthy adults before its licensure, a
series of strategies are proposed for evaluating the live HZ vaccine in
immunosuppressed persons. In addition, the use of other vaccines, including
heat-inactivated or replication-defective varicella-zoster virus to prevent HZ in
immunocompromised persons, is also discussed.

Publication Types: 
    Research Support, N.I.H., Intramural
    Research Support, Non-U.S. Gov't
    Review

PMID: 18419403 [PubMed - indexed for MEDLINE]

291: J Infect Dis. 2008 Mar 1;197 Suppl 2:S228-36.

Vaccination against Herpes Zoster and Postherpetic Neuralgia.

Oxman MN, Levin MJ; Shingles Prevention Study Group.

Collaborators: Oxman MN, Arbeit RD, Barry P, Beisel C, Boardman KD, Colling CL,
Davis LE, Gelb LD, Gershon AA, Hayward AR, Irwin MR, Johnson GR, Levin MJ,
Peduzzi PN, Schmader KE, Simberkoff MS, Straus SE, Weinberg A, Williams HM,
Annunziato P, Chan CY, Chan IS, Silber JL.

VA San Diego Healthcare System, San Diego, California, USA. mnoxman@ucsd.edu

BACKGROUND: Herpes zoster (HZ) and postherpetic neuralgia (PHN) cause significant
morbidity in older adults. The incidence and severity of HZ and PHN increase with
age in association with an age-related decline in varicella-zoster virus
(VZV)-specific cell-mediated immunity (VZV-CMI). VZV vaccines can boost VZV-CMI. 
Therefore, we tested the hypothesis that VZV vaccination would protect older
adults against HZ and PHN. METHODS: We enrolled 38,546 adults > or =60 years of
age in a randomized, double-blind, placebo-controlled trial of an investigational
HZ vaccine and actively followed subjects for the development of HZ. The primary 
end point was the burden of illness due to HZ (HZ BOI), a composite measure of
the incidence, severity, and duration of pain and discomfort caused by HZ. The
secondary end point was the incidence of PHN. RESULTS: Subject retention was
>95%. HZ vaccine reduced the HZ BOI by 61.1% (95% confidence interval [CI],
51.1%-69.1%; P<.001) and reduced the incidence of PHN by 66.5% (95% CI,
47.5%-79.2%; P<.001). The incidence of HZ was also reduced by 51.3% (95% CI,
44.2%-57.6%; P<.001). HZ vaccine was well tolerated; injection site reactions
were generally mild. HZ vaccine neither caused nor induced HZ. CONCLUSION: The
Shingles Prevention Study demonstrated that HZ vaccine significantly reduced the 
morbidity due to HZ and PHN in older adults.

Publication Types: 
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 18419402 [PubMed - indexed for MEDLINE]

292: J Infect Dis. 2008 Mar 1;197 Suppl 2:S224-7.

The impact of the varicella vaccination program on herpes zoster epidemiology in 
the United States: a review.

Reynolds MA, Chaves SS, Harpaz R, Lopez AS, Seward JF.

Division of Viral Diseases, National Center for Immunization and Respiratory
Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333,
USA. mtr6@cdc.gov

Speculation that a universal varicella vaccination program might lead to an
increase in herpes zoster (HZ) incidence has been supported by modeling studies
that assume that exposure to varicella boosts immunity and protects against
reactivation of varicella-zoster virus (VZV) as HZ. Such studies predict an
increase in HZ incidence until the adult population becomes predominantly
composed of individuals with vaccine-induced immunity who do not harbor wild-type
VZV. In the United States, a varicella vaccination program was implemented in
1995. Since then, studies monitoring HZ incidence have shown inconsistent
findings: 2 studies have shown no increase in overall incidence, whereas 1 study 
has shown an increase. Studies from Canada and the United Kingdom have shown
increasing rates of HZ incidence in the absence of a varicella vaccination
program. Data suggest that heretofore unidentified risk factors for HZ also are
changing over time. Further studies are needed to identify these factors, to
isolate possible additional effects from a varicella vaccination program.
Untangling the contribution of these different factors on HZ epidemiology will be
challenging.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18419401 [PubMed - indexed for MEDLINE]

293: J Infect Dis. 2008 Mar 1;197 Suppl 2:S216-23.

National survey of primary care physicians regarding herpes zoster and the herpes
zoster vaccine.

Hurley LP, Harpaz R, Daley MF, Crane LA, Beaty BL, Barrow J, Babbel C, Marin M,
Steiner JF, Davidson A, Dickinson LM, Kempe A.

Department of General Internal Medicine, University of Colorado at Denver and
Health Sciences Center, The Children's Hospital, Denver, Colorado, USA.
Laura.Hurly@dhha.org

BACKGROUND: This study describes physicians' perception of burden associated with
herpes zoster (HZ) and postherpetic neuralgia (PHN), intentions for recommending 
the HZ vaccine, and perceived barriers to vaccination. METHODS: A national survey
of 438 general internal medicine (GIM) and 433 family medicine (FM) physicians
was conducted during November-December 2005. RESULTS: The survey response rate
was 69%. Approximately 35% of GIM and FM physicians strongly agreed that HZ and
PHN caused a significant burden of disease. For patients 60-79 years of age, > or
=80% of GIM and FM physicians were somewhat or very likely to recommend HZ
vaccine. In multivariate analyses, physicians who strongly agreed that HZ and PHN
cause significant burden were more likely to recommend the vaccine to patients
60-79 years of age (odds ratio [OR], 2.75 [95% confidence interval [CI],
1.85-4.09]), whereas those who felt there was insufficient information about
duration of protection (OR, 0.40 [CI, 0.24-0.67]), that the need to store HZ
vaccine in a freezer was a definite barrier (OR, 0.31 [CI, 0.13-0.75]), or that
their patients would not pay for the vaccine if it was not covered by insurance
(OR, 0.57 [CI, 0.38-0.86]) were less likely to recommend it. CONCLUSIONS: Primary
care physicians perceived a high level of burden from HZ and PHN and generally
favored the HZ vaccine.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 18419400 [PubMed - indexed for MEDLINE]

294: J Infect Dis. 2008 Mar 1;197 Suppl 2:S207-15.

The epidemiological, clinical, and pathological rationale for the herpes zoster
vaccine.

Schmader K, Gnann JW Jr, Watson CP.

Center for the Study of Aging and Human Development and Division of Geriatrics,
Department of Medicine, Duke University Medical Center, North Carolina, USA.
schma001@mc.duke.edu

Worldwide, herpes zoster (HZ) affects millions of patients (particularly older
adults) annually and causes significant suffering due to acute and chronic pain, 
or postherpetic neuralgia (PHN). The objective of this article is to explain the 
rationale for the HZ vaccine by summarizing data on the epidemiology of HZ in the
immunocompetent host, with a focus on recent incidence and risk factor studies;
to review information on the burden of HZ; and to discuss the challenges of
lessening the morbidity of the disease. The incidence and severity of HZ and PHN 
are highest in older adults. Given the central nervous system damage caused by
HZ, the difficulty of adequately treating HZ to prevent PHN, and the
intractability of PHN, the advent of the HZ vaccine appears to be a crucial
innovation for preventing HZ and PHN.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review

PMID: 18419399 [PubMed - indexed for MEDLINE]

295: J Infect Dis. 2008 Mar 1;197 Suppl 2:S196-9.

Risk of herpes zoster in adults immunized with varicella vaccine.

Hambleton S, Steinberg SP, Larussa PS, Shapiro ED, Gershon AA.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, New York, USA. shambleton@doctors.org.uk

A program of routine varicella vaccination of children 12-18 months of age, begun
in the United States in 1995, has been very successful in reducing the incidence 
of varicella. Varicella-zoster virus (VZV), in both wild-type and live attenuated
forms, is notable for its ability to produce latent infection of sensory neurons 
from which it can later reactivate to cause herpes zoster (HZ). Therefore, the
effects of vaccination on this secondary VZV-related disease are important to
consider; in practice, however, such studies are complicated by the typically
long delay between acquisition of the virus and its reactivation. Studies of
immunocompromised children have shown that vaccination is relatively protective
against HZ in this highly vulnerable group. We now present long-term follow-up
data on a group of individuals who received varicella vaccine as healthy young
adults 10-26 years ago and who have been followed prospectively by means of
active surveillance. Among some 2000 person-years of follow-up, 2 cases of HZ
have occurred, for a rate of 1.00 case/1000 person-years. Overall, the incidence 
of HZ in this cohort, therefore, is similar to published data for the US
population in the prevaccine era.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18419397 [PubMed - indexed for MEDLINE]

296: J Infect Dis. 2008 Mar 1;197 Suppl 2:S170-7.

Safety of varicella vaccine after licensure in the United States: experience from
reports to the vaccine adverse event reporting system, 1995-2005.

Chaves SS, Haber P, Walton K, Wise RP, Izurieta HS, Schmid DS, Seward JF.

Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
schaves@cdc.gov

Widespread use of varicella vaccine in the United States could enable detection
of rare adverse events not identified previously. We reviewed data from 1995 to
2005 from the Vaccine Adverse Event Reporting System, including data from
laboratory analyses, to distinguish adverse events associated with wild-type
varicella-zoster virus (VZV) versus those associated with vaccine strain. Almost 
48 million doses of varicella vaccine were distributed between 1995 and 2005.
There were 25,306 adverse events reported (52.7/100,000 doses distributed); 5.0% 
were classified as serious (2.6/100,000 doses distributed). Adverse events
associated with evidence of vaccine-strain VZV included meningitis in patients
with concurrent herpes zoster. Patients with genetic predispositions may rarely
have disease triggered by receipt of varicella vaccine. Overall, serious adverse 
events reported after varicella vaccination continue to be rare and must be
considered relative to the substantial benefits of varicella vaccination. Ongoing
safety surveillance and further studies may shed light on some of the
hypothesized associations.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18419393 [PubMed - indexed for MEDLINE]

297: J Infect Dis. 2008 Mar 1;197 Suppl 2:S165-9.

The safety profile of varicella vaccine: a 10-year review.

Galea SA, Sweet A, Beninger P, Steinberg SP, Larussa PS, Gershon AA, Sharrar RG.

Merck Research Laboratories, Clinical Risk Management and Safety Surveillance,
North Wales, Pennsylvania 19454-1099, USA. susan_galea@merck.com

Varivax (varicella virus vaccine live [Oka/Merck]; Merck), a live attenuated
varicella vaccine, is indicated for vaccination against varicella in appropriate 
individuals > or =12 months of age. The 10-year safety profile for Varivax is
described using data submitted to Merck from routine global postmarketing
surveillance, combined with information from a Varicella Zoster Virus
Identification Program, which uses polymerase chain reaction (PCR) analysis to
identify the presence and strain of VZV in selected specimens. There were 16,683 
reports worldwide voluntarily submitted to Merck, for an overall reporting rate
of 3.4 reports/10,000 doses of vaccine distributed. PCR analysis of vesicular
rashes that occurred within the first 2 weeks after vaccination was more likely
to identify wild-type varicella-zoster virus (VZV), whereas the presence of Oka
VZV was generally associated with vesicular rashes that occurred 15-42 days after
vaccination. Reports of breakthrough varicella that occurred >42 days after
vaccination were associated with wild-type VZV. Among 697 herpes zoster reports, 
PCR analysis identified Oka VZV in 57 reports and wild-type VZV in 38 reports.
There were no primary neurologic adverse events associated with Oka VZV.
Secondary transmission of Oka VZV from vaccine recipients with postvaccination
vesicular rashes was identified in 3 susceptible household contacts. Disseminated
Oka VZV was identified in 6 immunocompromised patients and 1 patient with Down
syndrome. This review has shown that the vaccine is generally safe and well
tolerated.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18419392 [PubMed - indexed for MEDLINE]

298: Kulak Burun Bogaz Ihtis Derg. 2008;18(1):40-3.

[A case of herpetic facial paralysis in which cochleovestibular symptoms outweigh
facial nerve symptoms]

[Article in Turkish]

Avci S, Kansu L, Akkuzu B, Ozgirgin N, Ozluoglu L.

Department of Otolaryngology, Baskent University Alanya Hospital, Antalya,
Turkey. suat_avci2002@yahoo.com

A 42-year-old man presented with sensorineural hearing loss of acute onset,
tinnitus, and vertigo. Physical examination revealed slight asymmetry in facial
nerve functions and spontaneous nystagmus. Magnetic resonance imaging of the
internal acoustic canal showed contrast enhancement consistent with
edema-inflammation, being notable and diffuse in the seventh and eighth cranial
nerve complex, and minimal in the cochlea. Non-hydropic cochleovestibular
syndrome was considered and the patient was treated with antiviral and
corticosteroid medications. A week later, facial paralysis improved and the acute
hearing loss reversed. On the twelfth day of presentation, he had no complaints
other than mild imbalance on abrupt changes in movement. In this type of herpetic
facial paralysis in which cochleovestibular symptoms outweigh facial nerve
symptoms, it might be argued that varicella zoster virus reactivation occurs in
the spiral and/or vestibular ganglion.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18443402 [PubMed - indexed for MEDLINE]

299: MMW Fortschr Med. 2005 Feb 24;147(8):31-2, 34-5.

[Varicella vaccination: who should be vaccinated these days?]

[Article in German]

Hugle B, Suchowerskyj P, Schuster V.

Universitatsklinik fur Kinder und Jugendliche, Leipzig.
boris.huegle@medizin.uni-leipzig.de

In July 2004 the STIKO (German National Commission for Vaccinations) recommended 
routine varicella vaccination (together with the first MMR vaccination) for all
healthy infants. The previous recommendations for vaccination of adolescents with
no history of varicella and patient groups at risk remain valid. In persons with 
severely depressed cellular immunity or pregnant women vaccination with live
attenuated VZV vaccines is contraindicated. Experience gained in the United
States show that widespread introduction of VZV vaccination results in a decrease
in both the incidence of varicella and concomitant complications including herpes
zoster.

Publication Types: 
    Comparative Study
    English Abstract
    Review

PMID: 18441563 [PubMed - indexed for MEDLINE]

300: J Clin Virol. 2008 Aug;42(4):326-34. Epub 2008 Apr 24.

Challenges in designing a Taqman-based multiplex assay for the simultaneous
detection of Herpes simplex virus types 1 and 2 and Varicella-zoster virus.

Weidmann M, Armbruster K, Hufert FT.

Institute of Virology, University of Gottingen, Gottingen, Germany.
mweidma@gwdg.de

To optimise molecular detection of herpesviruses an internally controlled
multiplex Taqman-PCR for the detection of Herpes simplex virus 1 (HSV1), Herpes
simplex virus 2 (HSV2) and Varicella-zoster virus (VZV) was developed. The
selection of the dye combination working on the ABI 7700 cycler for this
multiplex PCR revealed crosstalk phenomena between several combinations of
reference dyes and reporter dyes. A final dye combination with CY5 as reference
dye and FAM/JOE/TXR as reporter dyes was selected. The influence of the
concentration of the internal positive control (IPC) concentration on the
quantitative results of HSV1, HSV2 and VZV positive patient samples was analysed.
The results indicate that high IPC concentrations are detrimental for the
sensitivity of the multiplex assay and that the presence of the IPC molecule
narrows the dynamic range of the duplex PCRs between any of the virus PCRs and
the IPC-PCR. The optimised multiplex assay detecting HSV1, HSV2 and VZV using
10(3) IPC molecules showed a performance and sensitivity comparable to that of
the individual assays.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 18439871 [PubMed - indexed for MEDLINE]

301: Can J Public Health. 2008 Jan-Feb;99(1):41-5.

Health disparities in chickenpox or shingles in Alberta?

Russell ML, Schopflocher DP, Svenson LW.

Department of Community Health Sciences, University of Calgary, Calgary, AB.
mlrussel@ucalgary.ca

OBJECTIVE: Exploring for evidence of socio-economic health disparities in
chickenpox and shingles in Alberta, Canada. METHODS: Chickenpox and shingles
cases were identified from administrative data from Alberta's universal health
care insurance system for 1994-2002. Incident cases were those with the earliest 
dated utilization of a health service (chickenpox: ICD9-CM 052/ICD10-CA B01;
shingles: ICD9-CM 053/ ICD10-CA B02). Crude and age-specific rates were estimated
for each year by an indicator of socio-demographic status based upon the nature
of the payer and eligibility for health care premium subsidy (SES-proxy) for the 
provincial health care insurance system. RESULTS: Among young children there is a
gradient of disparity in chickenpox rates prior to the year in which publicly
funded vaccination programs were implemented. After this point, disparities
decline but less so for First Nations children than for others. There was no
evidence of disparity by SES-proxy for shingles. CONCLUSION: Publicly funded
vaccination programs may effectively contribute to reduction in disease
disparities for vaccine-preventable diseases. Further study is required to
ascertain why disparities continue for First Nations children.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18435390 [PubMed - indexed for MEDLINE]

302: Am J Clin Dermatol. 2008;9(3):163-8.

Occult herpes simplex virus colonization of bullous dermatitides.

Nikkels AF, Delvenne P, Herfs M, Pierard GE.

Department of Dermatopathology, University Hospital of Liege, Liege, Belgium.
af.nikkels@chu.ulg.ac.be

BACKGROUND: Acantholytic disorders, including pemphigus vulgaris, chronic benign 
familial pemphigus (Hailey-Hailey disease, superficial pemphigus), Darier
disease, and Grover transient acantholytic dermatosis, as well as other
vesiculo-bullous disorders, including bullous pemphigoid, epidermolysis bullosa, 
and atopic dermatitis, are prone to florid infections by herpes simplex virus
(HSV)-I and -II, and, more rarely, by varicella-zoster virus (VZV). As these
infections are difficult to recognize clinically and histologically, their
frequency remains unknown. A possible occult viral colonization has never been
documented in these disorders. The manner in which the primary bullous disorders 
are contaminated by herpesviridae remains unclear. OBJECTIVE: To retrospectively 
assess the possible presence of HSV and VZV in a series of biopsies of
acantholytic disorders and bullous pemphigoid. METHOD: The typical
alpha-herpesviridae-related cytopathic signs were searched for by conventional
microscopy in skin biopsies of patients with bullous pemphigoid (n = 20),
pemphigus vulgaris (n = 19), Darier disease (n = 18), chronic benign familial
pemphigus (n = 3), and Grover transient acantholytic dermatosis (n = 3).
Immunohistochemistry (IHC) targeted specific HSV-I, HSV-II, and VZV antigens.
Polymerase chain reaction (PCR) was used for detecting HSV- and VZV-specific DNA 
sequences. RESULTS: No cytopathic signs suggestive of HSV or VZV infection were
detected. However, IHC revealed HSV antigens in Darier disease (1/18, HSV-I),
Grover transient acantholytic dermatosis (1/3, HSV-I), pemphigus vulgaris (1/19, 
HSV-I), and bullous pemphigoid (2/20, HSV-I and HSV-II). In these IHC-positive
cases, PCR amplified specific HSV primers in Darier disease (1/18), pemphigus
vulgaris (1/19), and bullous pemphigoid (1/20). VZV antigens and nucleic acids
were never identified. The HSV antigens were nearly always restricted to the
upper part of the granular layer and thus differed from the usual HSV
distribution during cutaneous infection. Negative and positive controls yielded
consistently positive and negative results, respectively. CONCLUSION: This report
shows for the first time that clinically and histologically occult HSV
colonization may occur in Darier disease, Grover transient acantholytic disease, 
pemphigus vulgaris, and bullous pemphigoid. Given the frequent use of
immunosuppressive treatments for primary bullous disorders, greater awareness of 
HSV colonization and infection is recommended in these patients.

PMID: 18429645 [PubMed - indexed for MEDLINE]

303: Bull Mem Acad R Med Belg. 2007;162(7-9):371-9; discussion 379-80.

[Genetic variation and recombination have profound medical implications]

[Article in French]

Thiry E, Alvarez MM, Colombo M, Foidart JM.

Virologie et pathologie des maladies virales, departement des maladies
infectieuses et parasitaires, Faculte de Medecine veterinaire, U.Lg.

In the family Herpesviridae, the subfamily Alphaherpesvirinae contains numerous
pathogenic viruses, i.e. herpes simplex and varicella-zoster viruses. These
double-stranded DNA viruses exhibit a complex cycle combining lytic and latent
infections. Moreover, both intranuclear replication and a sophisticated DNA
replication machinery allow an efficient proof-reading mechanism of correction. A
low mutation rate is therefore encountered by these viruses. Recombination can be
identified as a key element of the genetic biodiversity of alphaherpesviruses,
together with mutations. The experimental data recently obtained in the bovine
herpesvirus 1 homologous model support the importance of recombination in
alphaherpesvirus evolution and its role in the mechanisms involved by the virus
to escape from medical tools of prevention and treatment.

Publication Types: 
    English Abstract

PMID: 18429486 [PubMed - indexed for MEDLINE]

304: J Med Virol. 2008 Jun;80(6):1123-30.

Genotypes of varicella-zoster virus wild-type strains in Germany.

Sauerbrei A, Zell R, Philipps A, Wutzler P.

Institute of Virology and Antiviral Therapy, Friedrich-Schiller University of
Jena, Jena, Germany. andreas.sauerbrei@med.uni-jena.de

Surveillance of varicella-zoster virus (VZV) genotypes is indicated in Germany
after implementation of universal varicella vaccination. This article reports
genotyping data of 77 VZV strains obtained from 54 patients with varicella, 1
newborn with congenital varicella syndrome, 2 fetuses with intrauterine VZV
infection and 20 cases with zoster. Fragments of the open reading frames (ORF) 1,
21, 22, 37, 50, 54, and 60 were analyzed by sequencing. In addition, the PstI
polymorphism of the ORF 38 was characterized. Thirty strains, 22 from varicella
and 8 from zoster, had the genetic markers of genotype E2, 2 of them carried new 
single nucleotide polymorphisms (SNP). Twenty-nine VZV isolates, 17 from
varicella, and 12 from zoster, could be analyzed as E1 strains, 6 of them as E1
variants containing individual SNPs. Finally, 17 strains taken from primary VZV
infection were classified as genotype M1, 13 of which belonged to the M1 subtype 
1, 3 to the M1 subtype 2, and 1 to the M1 subtype 3. One strain was regarded as
potential E2/J recombinant. In conclusion, VZV genotypes E2, E1, and M1 can be
found in nearly equal incidence in varicella in Germany. The most frequent group 
is attributed to the genotype E2. Genotype M1 strains can only be detected after 
primary VZV infection and not in zoster cases. The possible recombinant could not
be classified definitely by the scattered SNP method used and, therefore, has to 
be confirmed by full-genome sequencing studies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18428135 [PubMed - indexed for MEDLINE]

305: J Med Virol. 2008 Jun;80(6):1042-50.

DNA microarray technology for simultaneous detection and species identification
of seven human herpes viruses.

Zheng ZB, Wu YD, Yu XL, Shang SQ.

Laboratory Center, Children's Hospital, Zhejiang University School of Medicine,
Hangzhou, China.

The aim of the study was to develop a multiplex PCR-based DNA microarray
technology for simultaneous detection and species identification of seven human
herpes viruses, namely herpes simplex virus type 1, type 2 (HSV-1, HSV-2),
varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV),
and human herpes virus 6 (HHV-6A, HHV-6B), and to apply this technology to
accurate diagnosis of herpesvirus-associated diseases. Primers and
oligonucleotide probes were designed and synthesized based on the highly
conserved regions of the DNA polymerase gene in human herpes viruses. DNA
microarrays were made by printing the oligonucleotide probes onto special glass
slides. After amplification and labeling with CY5, the PCR products were
hybridized with the DNA microarrays and species identified. Sixty-one
cerebrospinal fluid (CSF) and 132 blood specimens were analyzed by this
technique, and the results were compared with those of TaqMan PCR. Several
specimens were sequenced further after cloning. The PCR products of the seven
human herpes viruses ranged from 224 to 252 bp, and could be species identified
with DNA microarrays. The detection limits were 10(1) copies/microl for each
virus. And the test showed no cross-reaction to DNA extracted from S. aureus, E. 
coli, hepatitis B virus, Cryptococcus neoformans, Candida albicans and human
genome. Among 132 blood and 61 CSF specimens, 55 were tested positive for human
herpes virus DNA. Compared with the results of TaqMan PCR, the sensitivity and
specificity of the DNA microarray technology was 96.2% and 99.3%, respectively.
This multiplex PCR-based DNA microarray technology, which is rapid, specific and 
sensitive, serves as an effective technique for simultaneous detection and
species identification of seven human herpes viruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18428126 [PubMed - indexed for MEDLINE]

306: J Med Virol. 2008 Jun;80(6):1116-22.

Asymptomatic reactivation and shed of infectious varicella zoster virus in
astronauts.

Cohrs RJ, Mehta SK, Schmid DS, Gilden DH, Pierson DL.

Department of Neurology, University of Colorado School of Medicine, Denver,
Colorado 80262, USA. randall.cohrs@uchsc.edu

Varicella zoster virus (VZV) causes varicella (chickenpox), after which virus
becomes latent in ganglia along the entire neuraxis. Virus reactivation produces 
zoster (shingles). Infectious VZV is found in vesicles of patients with zoster
and varicella, but virus shed in the absence of disease has not been documented. 
VZV DNA was previously detected in saliva of astronauts during and after
spaceflight, a uniquely stressful environment in which cell mediated immunity
(CMI) is temporally dampened. The decline in CMI to VZV associated with zoster
led to the hypothesis that infectious VZV would also be present in the saliva of 
astronauts subjected to stress of spaceflight. Herein, not only was the detection
of salivary VZV DNA associated with spaceflight validated, but also infectious
virus was detected in saliva from 2 of 3 astronauts. This is the first
demonstration of shed of infectious VZV in the absence of disease.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 18428120 [PubMed - indexed for MEDLINE]

307: Clin J Pain. 2008 May;24(4):366-8.

Post herpetic itching--a treatment dilemma.

Semionov V, Shvartzman P.

Pain and Palliative Care Unit, Siaal Research Center for Family Medicine and
Primary Care, Ben-Gurion University of the Negev, Clalit Health Services-Southern
District, Beer-Sheva, Israel. valsem2002@yahoo.com

OBJECTIVES: To present a case of severe disabling postherpetic itching (PHI) and 
discuss possible mechanisms and management. METHODS: We report on a 22-year-old
male patient with a history of non-Hodgkin lymphoma, chronic renal failure
peritoneal dialysis dependent, presented with a disabling pruritus around his
left eye and forehead. Two months before, he was diagnosed with herpes zoster
ophtalmicus. His itching intensity was 10/10 on a visual analog scale and he
reported no pain. The neurologic examination showed a hyposensitivity to touch
around his left eye. RESULTS: Our patient suffered of PHI who responded
successfully to a combination of antihistamine and an antiepileptic agent.
DISCUSSION: The mechanism of postherpetic neuralgia and PHI are not well
understood and no single best treatment for postherpetic neuralgia and PHI is
known. Clinical experience suggested that neuropathic itch may be more resistant 
to treatment than neuropathic pain. This immunocompromized patient with a severe 
disabling PHI responded to antihistaminic and anticonvulsant treatment.

Publication Types: 
    Case Reports

PMID: 18427235 [PubMed - indexed for MEDLINE]

308: Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003774.

Update of:
    Cochrane Database Syst Rev. 2005;(4):CD003774.

Antiviral medications for preventing cytomegalovirus disease in solid organ
transplant recipients.

Hodson EM, Craig JC, Strippoli GF, Webster AC.

Children's Hospital at Westmead, Centre for Kidney Research, Locked Bag 4001,
Westmead, NSW, Australia, 2145. Elisah@chw.edu.au

BACKGROUND: The risk of cytomegalovirus (CMV) infection in solid organ transplant
recipients has resulted in the frequent use of prophylaxis with the aim of
preventing the clinical syndrome associated with CMV infection. OBJECTIVES: To
determine the benefits and harms of antiviral medications to prevent CMV disease 
and all-cause mortality in solid organ transplant recipients. SEARCH STRATEGY: We
searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE,
reference lists and abstracts from conference proceedings without language
restriction.Date of last search: February 2007 SELECTION CRITERIA: Randomised
controlled trials (RCTs) and quasi-RCTs comparing antiviral medications with
placebo or no treatment, comparing different antiviral medications and comparing 
different regimens of the same antiviral medications in recipients of any solid
organ transplant. DATA COLLECTION AND ANALYSIS: Statistical analyses were
performed using the random effects model and results expressed as relative risk
(RR) for dichotomous outcomes with 95% confidence intervals (CI). Subgroup
analysis and univariate meta-regression were performed using restricted
maximum-likelihood to estimate the between study variance. Multivariate
meta-regression was performed to investigate whether the results were altered
after allowing for differences in drugs used, organ transplanted and recipient
CMV serostatus at the time of transplantation. MAIN RESULTS: Thirty four studies 
(3850 participants) were identified. Prophylaxis with aciclovir, ganciclovir or
valaciclovir compared with placebo or no treatment significantly reduced the risk
for CMV disease (19 studies; RR 0.42, 95% CI 0.34 to 0.52), CMV infection (17
studies; RR 0.61, 95% CI 0.48 to 0.77), and all-cause mortality (17 studies; RR
0.63, 95% CI 0.43 to 0.92) primarily due to reduced mortality from CMV disease (7
studies; RR 0.26, 95% CI 0.08 to 0.78). Prophylaxis reduced the risk of herpes
simplex and herpes zoster disease, bacterial and protozoal infections but not
fungal infection, acute rejection or graft loss. Meta-regression showed no
significant difference in the relative benefit of treatment (risk of CMV disease 
or all-cause mortality) by organ transplanted or CMV serostatus; no conclusions
were possible for CMV negative recipients of negative organs. In direct
comparison studies, ganciclovir was more effective than aciclovir in preventing
CMV disease (7 studies; RR 0.37, 95% CI 0.23 to 0.60). Valganciclovir and IV
ganciclovir were as effective as oral ganciclovir. AUTHORS' CONCLUSIONS:
Prophylaxis with antiviral medications reduces CMV disease and CMV-associated
mortality in solid organ transplant recipients. They should be used routinely in 
CMV positive recipients and in CMV negative recipients of CMV positive organ
transplants.

Publication Types: 
    Meta-Analysis
    Review

PMID: 18425894 [PubMed - indexed for MEDLINE]

309: Eur J Dermatol. 2008 Mar-Apr;18(2):205-6.

Erythema annulare centrifugum associated with herpes zoster.

Sugita K, Kabashima K, Tokura Y.

Publication Types: 
    Case Reports
    Letter

PMID: 18424397 [PubMed - indexed for MEDLINE]

310: J Am Acad Dermatol. 2008 May;58(5):872-3.

The herpes zoster vaccine.

Heymann WR.

PMID: 18423262 [PubMed - indexed for MEDLINE]

311: Transfusion. 2008 Jun;48(6):1180-7. Epub 2008 Apr 15.

Herpesvirus prevalence and viral load in healthy blood donors by quantitative
real-time polymerase chain reaction.

Hudnall SD, Chen T, Allison P, Tyring SK, Heath A.

Department of Pathology and Laboratory Medicine, University of Texas Medical
Branch, Galveston, TX 77555-0741, USA. shudnall@utmb.edu

BACKGROUND: After primary infection, human herpesviruses (HHVs) maintain
long-term latent persistence, often punctuated years later by sporadic episodes
of symptomatic lytic activation. Also, blood-borne herpesvirus from healthy
persistently infected blood donors can lead to active primary infection of
immunocompromised transfusion recipients. STUDY DESIGN AND METHODS: Utilizing a
set of newly developed real-time polymerase chain reaction assays for detection
and quantification of all eight human herpesviruses, the prevalence and viral DNA
load of white cell-enriched blood from 100 randomly selected blood donors from
the southeast Texas region are reported. RESULTS: Herpes simplex viruses 1 and 2 
(HSV-1 and HSV-2), varicella-zoster virus (VZV), and HHV-8 DNA were not detected 
in any donor sample. In contrast, Epstein-Barr virus (EBV) (72%) and HHV-7 (65%) 
were commonly detected, HHV-6 (30%) was often detected (Type B only), and
cytomegalovirus (CMV; 1%) was rarely detected. Median viral loads of positive
samples (per milliliter of blood) ranged from 4278 for HHV-6 to less than 46 for 
EBV. CONCLUSIONS: These results suggest that the potential for
transfusion-mediated transmission of herpesviruses from healthy adult blood
donors is high for EBV and HHV-7; moderately high for HHV-6; uncommon for CMV;
and rare for HSV-1, HSV-2, VZV, and HHV-8. Perhaps the most remarkable finding in
this study was the detection of a single donor sample with greater than 6.1 x
10(7) HHV-6 Type B genome equivalents per mL blood. Given that this
extraordinarily high level of HHV-6 DNA was obtained from a healthy adult blood
donor, this phenomenon is likely unrelated to active infection or
immunodeficiency.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18422852 [PubMed - indexed for MEDLINE]

312: J Eur Acad Dermatol Venereol. 2008 Nov;22(11):1373-5. Epub 2008 Apr 14.

Herpes zoster virus associated 'sparing phenomenon': is it an innate possess of
HZV or keratinocyte cytokine(s) mediated or combination?

Kannangara AP, Fleischer AB Jr, Yosipovitch G, Ragunathan RW.

Publication Types: 
    Case Reports
    Letter

PMID: 18422536 [PubMed - indexed for MEDLINE]

313: J Infect Dis. 2008 May 1;197(9):1289-95.

Double-blind study comparing 2 dosages of valacyclovir hydrochloride for the
treatment of uncomplicated herpes zoster in immunocompromised patients 18 years
of age and older.

Arora A, Mendoza N, Brantley J, Yates B, Dix L, Tyring S.

Department of Dermatology, University of Texas-Houston School of Medicine,
Houston, TX 77030, USA. aarora1979@gmail.com

A dosage of 1 g of valacyclovir 3 times per day (TID) for 7 days has already been
shown to be superior to an oral dosage of 800 mg acyclovir 5 times per day for 7 
days in immunocompetent individuals. The objective of this study was to assess
the safety and efficacy of an oral dosage of valacyclovir, 1 g TID versus 2 g
TID, for the treatment of herpes zoster in immunocompromised patients > or =18
years of age. The oral dosage schedule of 2 g of valacyclovir TID reaches
acyclovir plasma levels similar to those achieved with intravenous acyclovir
therapy given to immunocompromised patients (10 mg/kg every 8 h for 7 days). In
this double-blind study, 87 immunocompromised patients with clinical evidence of 
localized herpes zoster were randomized to receive oral valacyclovir therapy for 
7 days, either 1 g TID or 2 g TID, within 72 h after onset of zoster rash.
Patients were seen and assessed for cutaneous healing, zoster-associated pain
(ZAP), and/or zoster-associated abnormal sensations (ZAAS), up to 24 weeks.
Participants in both arms of the study demonstrated similar median times to full 
crusting of the rash (8 days), and both dosages were safe and effective therapies
for reduction of ZAP and ZAAS in the immunocompromised patient population.

Publication Types: 
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 18422441 [PubMed - indexed for MEDLINE]

314: Clin Infect Dis. 2008 May 1;46(9):1452-4.

Comment in:
    Clin Infect Dis. 2008 Nov 1;47(9):1235-6; author reply 1236-7.

Shingles (varicella zoster) outbreaks in patients with hyperparathyroidism and
their relationship to hypercalcemia.

Norman J, Politz D.

Norman Parathyroid Clinic, Tampa, Florida 33613, USA. jnorman@parathyroid.com

Shingles (varicella zoster) can be a presenting symptom of hyperparathyroidism
and occurs twice as often (rate, 3.7%) among patients with hypercalcemia than in 
age-matched cohorts of patients >40 years of age who have normal calcium levels. 
The incidence of shingles increased in a linear fashion, from an annual rate of
1.5% among patients with serum calcium levels <10.5 mg/dL to 11% among patients
whose calcium levels reached 13 mg/dL (P<.05), a rate that is 6 times greater
than that among age-matched historical control individuals (P<.05).

PMID: 18419453 [PubMed - indexed for MEDLINE]

315: J Infect Dis. 2008 Mar 15;197(6):825-35.

Varicella-zoster virus-specific immune responses in elderly recipients of a
herpes zoster vaccine.

Levin MJ, Oxman MN, Zhang JH, Johnson GR, Stanley H, Hayward AR, Caulfield MJ,
Irwin MR, Smith JG, Clair J, Chan IS, Williams H, Harbecke R, Marchese R, Straus 
SE, Gershon A, Weinberg A; Veterans Affairs Cooperative Studies Program Shingles 
Prevention Study Investigators.

Collaborators: Oxman MN, Arbeit R, Barry P, Beisel C, Boardman KD, Colling CL,
Davis L, Gelb L, Gershon AA, Hayward AR, Irwin MR, Johnson GR, Levin MJ, Peduzzi 
PN, Schmader K, Simberkoff MS, Straus SE, Weinberg A, Williams HM, Silber JL,
Annunziato P, Chan CY, Chan IS, Davis LE, Kauffman CA, Keay SK, Marques AR, Soto 
NE, Brunell P, Gnann JW, Serrao R, Cotton DJ, Goodman RP, Arbeit RD, Pachucki CT,
Levin MJ, Schmader KE, Keitel WA, Greenberg RN, Morrison VA, Wright PF, Griffin
MR, Simberkoff MS, Yeh SS, Lobo Z, Holodniy M, Loutit J, Betts RF, Gelb LD,
Crawford GE, Guatelli J, Brooks PA, Neuzil KM, Toney JF.

University of Colorado Health Sciences Center, Denver, Colorado, USA.
myron.levin@uchsc.edu

BACKGROUND: A double-blind, placebo-controlled trial that involved 38,546
subjects > or =60 years old demonstrated efficacy of a high-potency
live-attenuated Oka/Merck varicella-zoster virus (VZV) vaccine. The trial
included an immunology substudy to determine the relationship of VZV-specific
immune responses to vaccination and clinical outcome. METHODS: The immunology
substudy enrolled 1395 subjects at 2 sites where blood samples obtained prior to 
vaccination, at 6 weeks after vaccination, and at 1, 2, and 3 years thereafter
were tested for VZV-specific cell-mediated immunity (VZV-CMI) by gamma-interferon
ELISPOT and responder cell frequency assays and for VZV antibody by glycoprotein 
ELISA. RESULTS: VZV-CMI and VZV antibodies were significantly increased in
vaccine recipients at 6 weeks after vaccination. The vaccine-induced increases in
VZV-CMI persisted during the 3 years of follow-up, although their magnitude
decreased over time. The magnitude of these VZV-specific immune responses was
greater in subjects 60-69 years old than in subjects > or =70 years old.
CONCLUSIONS: The zoster vaccine induced a significant increase in VZV-CMI and VZV
antibody. The magnitude and duration of the boost in VZV-CMI in vaccine
recipients and the relationship of this boost to age paralleled the clinical
effects of the vaccine observed during the efficacy trial. These findings support
the hypothesis that boosting VZV-CMI protects older adults against herpes zoster 
and postherpetic neuralgia.

Publication Types: 
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18419349 [PubMed - indexed for MEDLINE]

316: Cesk Slov Oftalmol. 2008 Mar;64(2):47-51.

[Applying the DNA diagnostics in patients with superficial keratitis of viral
origin]

[Article in Czech]

Hlinomazova Z, Sery O, Horackova M, Pitelova R, Loukotova V, Vlkova E.

Ocni klinika LF MU a FN, Brno-Bohunice. zhlinom@fnbrno.cz

AIM: The authors evaluate the significance of the DNA diagnostics in patients
with superficial keratitis of viral origin and their capability to be used for
monitoring of the treatment effectiveness in the follow-up. The presence of
herpes simplex virus 1 and 2, varicella zoster virus (HSV 1, HSV 2, VZV), and
adenoviruses was assessed by means of the DNA analysis. MATERIAL AND METHODS: The
group consisted of 54 patients (33 men and 21 women), mean age 45.6 +/- 9.5
years, who were treated at the Eye Department for superficial keratitis or
keratouveitis of viral origin. A sample from the involved place was taken with a 
cotton swab and a sample of approx. 50 microL of tears was taken from the
conjunctival sac with a single-use micropipette. The cotton swab and the tears
were shaken with the EliDNA Store Kit (ELISABETH PHARMACON, Czech Republic)
buffer, which prevents the DNA degradation and allows the storage and transport
of samples at the room temperature. After the transportation in to the
laboratory, the DNA was isolated by means of the UltraClean DNA Tissue Kit
(MoBio, U.S.A.). The isolated DNA was used for HSV 1, HSV 2, VZV, and
adenoviruses detection by means of PCR (polymerase chain reaction). All samples
were screened for the HSV1 presence using the in-house RealTime method with
TaqMan probe and the Applied Biosystems RealTime System 7300 device. In case of
positive result of the DNA analysis, control samples were taken in 7 - 10 days
periods until negative result was obtained; another sample was taken in case of
suspected relapse. The control examination was also performed by means of
cultivation from the same sample by another laboratory. RESULTS: Altogether 82
samples were taken and 230 DNA analyses were performed. The DNA diagnostics
proved the presence of HSV 1 DNA in 28 patients, in one case, VZV DNA was
detected, and 16 patients were positive on adenoviruses. The HSV 1 positive
samples were confirmed by means of in-house RealTime PCR method as well as
commercially available in vitro diagnostic healthcare device End-Point PCR HSV1/2
(Nanogen Advanced Diagnostics, Italy). All cultivation control examinations
performed in another laboratory were negative. The samples were taken repeatedly 
in 9 patients to monitor the efficacy of the treatment. SUMMARY: The DNA
diagnostics seem to be a fast and reliable method to determine the etiological
agent in patients with superficial keratitis and allow very accurate monitoring
of the treatment efficacy.

Publication Types: 
    English Abstract

PMID: 18419101 [PubMed - indexed for MEDLINE]

317: Scand J Infect Dis. 2008;40(5):428-30.

Breakthrough VZV infection after immunization, presenting as herpes zoster.

Schade RP, Bakkers J, Cornelissen M, Koster-Kamphuis L, Melchers WJ, Galama JM.

Department of Medical Microbiology, Nijmegen, The Netherlands.
r.schade@mmb.umcn.nl

An immunocompromized, VZV-vaccinated child had a breakthrough infection with VZV,
acquired at a day-care centre during a chickenpox outbreak. Interestingly, the
infection manifested as herpes zoster of 1 dermatome. Typing showed wild-type
virus, which suggests that exogenous reinfection with a new strain may present as
herpes zoster.

Publication Types: 
    Case Reports

PMID: 18418805 [PubMed - indexed for MEDLINE]

318: J Pain. 2008 Jul;9(7):658-65. Epub 2008 Apr 15.

Widespread unilateral pain associated with herpes simplex virus infections.

Kallio-Laine K, Seppanen M, Lokki ML, Lappalainen M, Notkola IL, Seppala I,
Koskinen M, Valtonen V, Kalso E.

Pain Clinic, Department of Anesthesiology and Intensive Care Medicine, Helsinki
University Central Hospital, HUS, Helsinki, Finland. katariina.kalliolaine@hus.fi

We describe a patient group with unexplained widespread pain on one side of the
body and pain exacerbations during active labial or genital herpes and during
herpetic central nervous system infections. The patients had no visible lesion of
the central nervous system on magnetic resonance imaging or abnormality in
electrophysiological studies. To understand the nature of the pain and its
possible relation to herpes simplex virus (HSV) infections, a clinical
neurological examination was performed and quantitative sensory testing and skin 
biopsies were assessed in 17 patients. The levels of serum total immunoglobulins 
and IgG subclasses and the frequencies of the immune response genes at the IGH@, 
HLA-A, -B, -DRB1, C4A, and C4B loci were analyzed in the patients and in control 
subjects. The patients manifested a uniform clinical syndrome with unilateral
pain that was best described as neuropathic and that was exacerbated by HSV
reactivations. Low plasma IgG3 concentrations, the presence of either low plasma 
IgG1 or IgG3 or both, and high anti-HSV-2-IgG titers were more common in the
patients than in the control subjects, which rendered the patients more
vulnerable to HSV recurrences. PERSPECTIVE: We suggest that low immunoglobulin
subclass levels and certain MHC alleles render the patients susceptible to
recurring HSV infections. HSV reactivations and the accompanying inflammatory
process cause dysfunction of the central nervous system that manifests as
neuropathic pain. Studies using functional brain imaging are needed to clarify
this syndrome.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18417422 [PubMed - indexed for MEDLINE]

319: Niger Postgrad Med J. 2008 Mar;15(1):24-7.

HIV/AIDS in ophthalmic patients: The Guinness Eye Centre Onitsha experience.

Nwosu NN.

Guinness Eye Center Onitsha Nigeria. sabenwosu@yahoo.com

OBJECTIVES: To determine the incidence and pattern of ocular problems of HIV/AIDS
at the Guinness Eye Centre Onitsha, Nigeria. METHODS: The case files of all
patients who had HIV test at the Guinness Eye Centre Onitsha over a 6-year period
were examined. Those who tested positive for HIV were further analysed.
Information obtained included patients' demographic characteristics, clinical
diagnosis, ocular and systemic co-morbidity, visual acuity and follow-up.
RESULTS: Of 1011 patients, 100 (9.9%), 51 males and 49 females, were confirmed
HIV-positive. The age range was 21 - 80 years; median -31 years. Fifty-five
patients (55%) were or had been married; 45 (45%) were single. Herpetic eye
disease constituted 50% of the cases with herpes zoster ophthalmicus accounting
for 48%. Bilateral ocular disease occurred in 19 patients (19%) viz:
cytomegalovirus (CMV) retinitis (6%); corneal ulcers (6%); uveitis (4%); ocular
motor palsy (2%) and ocular gunshot injury (1%). Non-HIV ocular lesions occurred 
in 20 patients (20%) as follows: bacterial corneal ulcer (8%); globe laceration
(6%); non-CMV associated rhegmatogenous retinal detachment, cataract, and
secondary orbital tumour (2% each). Systemic co-morbidities were present in 10
patients (10%), namely, emaciation (6%), pulmonary tuberculosis and abdominal
malignancy with orbital metastases (2% each).Twenty three patients (23%) had
bilateral blindness; 45 (45%) had uniocular blindness; 73.4% of the affected eyes
were blind at presentation with 25% having no light perception (NPL).
CONCLUSIONS: The incidence of HIV seropositivity doubled in the hospital over
nearly 10-year period. Herpes zoster ophthalmicus remains the commonest ocular
manifestation although CMV retinitis is becoming common. Since 20% of the
patients had non-HIV ocular lesions, eye-health workers are advised to always
take universal precautions in order to prevent the spread of the infection within
and outside the hospital.

PMID: 18408779 [PubMed - indexed for MEDLINE]

320: Rev Med Interne. 2008 Nov;29(11):932-5. Epub 2008 Apr 10.

[Sciatica with motor loss revealing meningoradiculitis due to varicella-zoster
virus]

[Article in French]

Abourazzak F, Couchouron T, Meadeb J, Perdriger A, Tattevin P, Moutel A, Le Goff 
B, Hajjaj-Hassouni N, Chales G.

Service de rhumatologie, CHU de Rabat-Sale, hopital El-Ayachi, Maroc.
abourazakf@yahoo.fr

Herpes zoster is a disease which occurs secondary to the reactivation of
varicella-zoster virus. Motor involvement in acute herpes zoster is rare. We
report a case of sciatica L5 due to herpes zoster infection with motor loss.
Typical skin lesions occurred one week before the sciatica. Radiological finding 
did not explain the paresis. The diagnosis of zoster sciatica with motor
involvement was suspected. Serological tests and cerebrospinal fluid examination 
established the diagnosis. The antiviral and physical treatment was conducted in 
order to improve functional outcome.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18406019 [PubMed - indexed for MEDLINE]

321: Zhongguo Zhen Jiu. 2008 Feb;28(2):147-50.

[Evaluation of literature quality of acupuncture for treatment of herpes zoster
and approach to the laws of treatment]

[Article in Chinese]

Peng WN, Liu ZS, Deng YH, Mao M, Yu JN, Du Y.

Section of Acupuncture, Guang'anmen Hospital, China Academy of Chinese Medical
Sciences, Beijing 100053, China. wnpeng@hotmail.com

OBJECTIVE: To assess the quality of literature of clinical studies on acupuncture
in treatment of herpes zoster. METHODS: The literatures between 1994-2006 were
searched by means of electronic retrieval. Type and methodology, general
condition, diagnosis of diseases and enrolled and excluded criteria, assessment
of sample content, treatment condition, criteria for assessment of therapeutic
effects, following-up, etc. in clinical studies are evaluated according to
principles and methods of clinical epidemiology and evidence-based medicine.
RESULTS: Of the 399 literatures enrolled, only 8 were authentic randomized
controlled trials (RCTs), 20 quasi-randomized controlled trials, 66
non-randomized concurrent controlled trials and 277 narrative studies, 70 had
clear diagnostic criteria, 16 mentioned enrolled or excluded criteria, 287 had
clear criteria for therapeutic effects, 107 reported follow-up, 2 had the
description of health economical index, 9 reported adverse reaction. CONCLUSION: 
At present, correct randomization, concealment, blinding and placebo-control, and
the RCTs with generally accepted criteria for assessment of diagnosis and
therapeutic effects, safety evaluation and rational design of follow-up are
needed. It is indicated by preliminary study of the literatures that
blood-letting puncture and cupping at Ashi points are main methods for treatment 
of herpes zoster.

Publication Types: 
    English Abstract
    Review

PMID: 18405162 [PubMed - indexed for MEDLINE]

322: J Pediatr Ophthalmol Strabismus. 2008 Mar-Apr;45(2):116-7.

Ring corneal infiltrate and progressive ring thinning following primary varicella
infection.

Khan AO, Al-Assiri A, Wagoner MD.

Division of Pediatric Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh,
Saudi Arabia.

Unilateral stromal keratitis is a known rare sequela of primary varicella
infection. The authors describe a unique case of immunological (Wessely) ring
formation and progressive ring thinning following primary varicella infection in 
a 6-year-old girl.

Publication Types: 
    Case Reports

PMID: 18404961 [PubMed - indexed for MEDLINE]

323: J Clin Virol. 2008 Jul;42(3):254-9. Epub 2008 Apr 9.

Calu-3/A-549 mixed cells as a replacement for primary rhesus monkey kidney cells 
for virus detection.

Fening SW, Jollick JA, Huang YT.

Case Western Reserve University, 2085 Adelbert Road, Cleveland, OH 44106, United 
States.

BACKGROUND: Primary kidney cells derived from rhesus macaques (pRhMK) are heavily
relied upon for the detection and culture of a wide range of clinically relevant 
viruses. The use of these cultures is problematic due to the possible presence of
endogenous viruses, the need to sacrifice a primate, and the inherent variance
found in primary cultures. OBJECTIVE: To develop a continuous cell line or mixed 
cell co-culture that could replace dependence on pRhMK cells. STUDY DESIGN: Cells
from the Calu-3 and A-549 cell lines were used to prepare mixed cell monolayers
that were compared to pRhMK cells for their ability to detect respiratory
viruses, measles, mumps, enteroviruses, and herpes viruses. Clinically derived
and laboratory virus strains were used for these comparisons in culture plates or
16 mm tubes. RESULTS: Calu-3/A-549 cells are more sensitive than pRhMK for the
detection of adenovirus, enteroviruses and herpes simplex virus and are about
equally sensitive for the detection of other respiratory viruses, measles, mumps 
and varicella-zoster virus. CONCLUSIONS: Calu-3/A-549 cells are an equivalent or 
better alternative to pRhMK cells for the detection of many clinically relevant
viruses.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 18403257 [PubMed - indexed for MEDLINE]

324: Bull Acad Natl Med. 2007 Jun;191(6):1051-64; discussion 1064-7.

[Immunization against varicella and zoster]

[Article in French]

Floret D.

Universite Claude Bernard LYON 1, Service d'Urgence et de Reanimation
Pediatrique, Hopital Edouard Herriot, Place d'Arsonval 69437 Lyon.

Two vaccines against varicella-zoster virus are available in France. These live
attenuated vaccines are derived from the Oka strain used in Japan since 1974.
They are indicated for healthy subjects from 12 months of age, at a dose of one
injection until 12 years of age, and two injections 4-8 weeks apart for older
children and adults. Seroconversion occurs in 95% of cases and the antibodies
persist beyond 5 years. Clinical efficacy is about 85% against all forms of
varicella and nearly 100% against severe forms. Post-exposure vaccination within 
3 days may also prevent the disease. A universal immunization program against
varicella was implemented in the USA in 1995. Now, with vaccine coverage at about
80%, the incidence of the disease has been reduced by 85%, with the largest
decrease in 1- to 4-year-olds. Tolerability is generally good, with only mild
reactions at the injection site and moderate fever The length of protection is
not yet known. A two-dose schedule seems advisable to avoid breakthrough
varicella, which occurs in 4% of vaccinees each year. Insufficient coverage is
expected to lead to later disease onset, with more severe cases in adolescents
and adults. Universal immunization could also increase the incidence of zoster.
These problems indeed seem to be emerging in the United States. France has
adopted restrictive guidelines on VZV vaccination, but they are expected to be
revised when the combined MMR-V vaccine becomes available. Zoster vaccine,
prepared with the same strain but at a higher concentration, has moderate
efficacy on zoster and on post-zoster neuralgia in patients over 70. This vaccine
is not yet recommended in France, because the length of protection is not known
and there is a potential risk of delaying the occurrence of zoster and, thus, of 
increasing the risk of post zoster neuralgia.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 18402164 [PubMed - indexed for MEDLINE]

325: Otol Neurotol. 2008 Jun;29(4):470-4.

Soluble intercellular adhesion molecule 1 and soluble vascular cell adhesion
molecule 1 in sudden hearing loss.

Quaranta N, Ramunni A, Brescia P, D'Elia A, Vacca A, Ria R.

Otolaryngology G. Lugli, Otologic and Neurotologic Surgery, University of Bari,
Bari, Italy. nicola.quaranta@orl.uniba.it

HYPOTHESIS: The aim of the present study was to evaluate the concentration of
soluble intercellular adhesion molecule 1 and soluble vascular cell adhesion
molecule 1 in patients affected by sudden sensorineural hearing loss (SSHL).
STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS:
Patients affected by SSHL were evaluated. Inclusion criteria for this study were 
hearing loss of more than 30 dB hearing level affecting at least 3 contiguous
frequencies, normal hearing on the contralateral ear, negative history of hearing
loss or ear surgery in the affected ear, and magnetic resonance with gadolinium
negative for VIII cranial nerve pathologic findings. INTERVENTION: Circulating
levels of soluble intercellular adhesion molecule 1 and soluble vascular cell
adhesion molecule (VCAM) 1 were evaluated by means of enzyme-linked immunosorbent
assay. MAIN OUTCOME MEASURES: The levels of adhesion molecules in SSHL patients
were compared with those of a control group. RESULTS: Intercellular adhesion
molecule 1 and VCAM-1 levels in sera of patients with SSHL were significantly
higher than those of the matched control subjects (p < 0.001). Statistical
analysis did not show significant differences between the 2 groups in terms of
the known vascular risk factors such as total and fractionated cholesterol,
triglycerides, fibrinogen, erythrocyte sedimentation rate smoking, and diabetes. 
CONCLUSION: The results of this study show that in SSHL patients, there is an
increased expression of circulating adhesion molecules confirming the existence
of an endothelial dysfunction and supporting the vascular involvement in the
pathogenesis of the disease. The identification of high levels of adhesion
molecules and of the endothelial dysfunction open the way to selective
pharmacologic treatments able to correct the activation of endothelial cells.

PMID: 18401280 [PubMed - indexed for MEDLINE]

326: Dtsch Med Wochenschr. 2008 Apr;133(16):831-2.

[Dermatoma complicating Herpes zoster during immunosuppression]

[Article in German]

Dorsch O.

Kfh Nierenzentrum Kronach, Friesener Str. 37a, 96317 Kronach.
oliver.dorsch@kfh-dialyse.de

Publication Types: 
    Case Reports

PMID: 18398791 [PubMed - indexed for MEDLINE]

327: Hum Vaccin. 2008 Jul-Aug;4(4):316-9. Epub 2008 Feb 19.

Protective immunity following vaccination: how is it defined?

Amanna IJ, Messaoudi I, Slifka MK.

Vaccine and Gene Therapy Institute, Oregon Health & Science University,
Beaverton, Oregon 97006, USA.

Vaccination represents an important medical breakthrough pioneered by Edward
Jenner over 200 years ago when he developed the world's first vaccine against
smallpox. To this day, vaccination remains the most effective means available for
combating infectious disease. There are currently over 20 vaccines licensed for
use within the US with many more vaccines in the R&D pipeline. Although vaccines 
must demonstrate clinical efficacy in order to receive FDA approval, the
correlates of immunity vary remarkably between different vaccines and may be
based primarily on animal studies, clinical evidence, or a combination of these
sources of information. Correlates of protection are critical for measuring
vaccine efficacy but researchers should know the history and limitations of these
values. As vaccine technologies advance, the way in which we measure and define
protective correlates may need to evolve as well. Here, we describe the
correlates of protective immunity for vaccines against smallpox, tetanus, yellow 
fever and measles and compare these to a more recently introduced vaccine against
varicella zoster virus, wherein a strict correlate of immunity has yet to be
fully defined.

PMID: 18398296 [PubMed - indexed for MEDLINE]

328: Hell J Nucl Med. 2008 Jan-Apr;11(1):51-2.

Pitfall of 18F-FDG-PET imaging in oncology: herpes zoster with axillary
lymphadenopathy.

Sharma R, Jaimini A, Mondal A, Tripathi M.

Publication Types: 
    Case Reports
    Letter

PMID: 18392232 [PubMed - indexed for MEDLINE]

329: Sex Transm Infect. 2008 Aug;84(4):306-11. Epub 2008 Apr 2.

Prevalence and risk factors for carcinogenic human papillomavirus infections in
rural Rakai, Uganda.

Safaeian M, Kiddugavu M, Gravitt PE, Gange SJ, Ssekasanvu J, Murokora D, Sklar M,
Serwadda D, Wawer MJ, Shah KV, Gray R.

Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public 
Health, Baltimore, MD, USA. safaeianm@mail.nih.gov

OBJECTIVE: To investigate self-administered vaginal swabs for assessing
prevalence and correlates of carcinogenic human papillomavirus (HPV) infection in
rural Rakai, Uganda. METHODS: 1003 sexually experienced women enrolled in a
community cohort provided self-administered vaginal swabs collected at annual,
home-based surveys. Carcinogenic HPV prevalence, adjusted odds ratios (AOR), 95% 
confidence intervals (CI) and associated risk factors were determined. RESULTS:
Carcinogenic HPV prevalence was 19.2%: 46.6% among HIV positive and 14.8% among
HIV negative women (p<0.001). Type-specific prevalence ranged from 2.0% (HPV 16
and 52) to 0.2% (HPV 31). Age-specific HPV prevalence decreased significantly
(p<0.001) among HIV negative women; however, the decrease among HIV positive
women was not as pronounced (p = 0.1). Factors independently associated with
carcinogenic HPV infection were HIV (AOR 4.82, CI 3.10 to 7.53), age (AOR 4.97,
95% CI 2.19 to 11.26 for 15-19 year olds compared to 40+ years), more than two
sex partners in the past year (AOR 2.21, CI 1.10 to 4.43) and self-reported
herpes zoster, candidiasis or tuberculosis (AOR 4.52, CI 1.01 to 20.31). Married 
women were less likely to have prevalent carcinogenic HPV (AOR 0.46, CI 0.30 to
0.70). CONCLUSIONS: HPV prevalence and correlates measured using
self-administered vaginal swabs were similar to studies that use cervical
samples. Thus, self-collection can be used as a substitute for cervical specimens
and provide an important tool for research in populations unwilling to undergo
pelvic exam.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18385223 [PubMed - indexed for MEDLINE]

330: Hum Vaccin. 2008 Jan 25;4(3). [Epub ahead of print]

The potential cost-effectiveness of vaccination against herpes zoster and
post-herpetic neuralgia.

Brisson M, Pellissier JM, Camden S, Quach C, De Wals P.

Departement de medecine sociale et preventive, Universite Laval, Quebec, Canada; 
Unite de recherche en sante des populations, Centre hospitalier affilie
universitaire de Quebec, Quebec, Canada.

A clinical trial has shown that a live-attenuated varicella-zoster virus vaccine 
is effective against herpes zoster (HZ) and post-herpetic neuralgia (PHN). The
aim of this study was to examine the cost-effectiveness of vaccination against HZ
and PHN in Canada. A cohort model was developed to estimate the burden of HZ and 
the cost-effectiveness of HZ vaccination, using Canadian population-based data.
Different ages at vaccination were examined and probabilistic sensitivity
analysis was performed. The economic evaluation was conducted from the ministry
of health perspective and 5% discounting was used for costs and benefits. In
Canada (population=30 million), we estimate that each year there are 130,000 new 
cases of HZ, 17,000 cases of PHN and 20 deaths. Most of the pain and suffering is
borne by adults over the age of 60 years and is due to PHN. Vaccinating
65-year-olds (HZ efficacy=63%, PHN efficacy=67%, no waning, cost/course=$150) is 
estimated to cost $33,000 per QALY-gained (90%CrI: 19,000-63,000). Assuming the
cost per course of HZ vaccination is $150, probabilistic sensitivity analysis
suggest that vaccinating between 65 and 75 years of age will likely yield
cost-effectiveness ratios below $40,000 per Quality- Adjusted Life-Year (QALY)
gained, while vaccinating adults older than 75 years will yield ratios less than 
$70,000 per QALY-gained. These results are most sensitive to the duration of
vaccine protection and the cost of vaccination. In conclusion, results suggest
that vaccinating adults between the ages of 65 and 75 years is likely to be
cost-effective and thus to be a judicious use of scarce health care resources.

PMID: 18382137 [PubMed - as supplied by publisher]

331: Hong Kong Med J. 2008 Apr;14(2):142-4.

Comment in:
    Hong Kong Med J. 2008 Jun;14(3):246.

Good's syndrome in a patient with cytomegalovirus retinitis.

Yong DS, Tsang MK, Chan EY, Tse DM.

Department of Medicine and Geriatrics, Caritas Medical Centre, Shamshuipo,
Kowloon, Hong Kong.

Thymoma-related adult-onset immunodeficiency or Good's syndrome is an uncommon
condition. This case, of a 50-year-old woman who was human immunodeficiency
virus-negative and developed herpes zoster and severe cytomegalovirus retinitis 6
months after removal of a thymoma, is the first to be reported in Hong Kong.
Immunological investigations revealed no B cells, hypogammaglobulinaemia, a low
CD4 count, and a low CD4/CD8 ratio. We recommend that immunological
investigations, including T-cell subsets, B cells, and quantitative
immunoglobulins, should be part of the routine diagnostic evaluation of patients 
with thymoma and infections.

Publication Types: 
    Case Reports

PMID: 18382022 [PubMed - indexed for MEDLINE]

332: Ann Dermatol Venereol. 2008 Mar;135(3):187-93. Epub 2008 Mar 7.

[Prevalence of skin disorders in HIV patients in Senegal and relationship to
degree of immunosuppression]

[Article in French]

Monsel G, Ly F, Canestri A, Diousse P, Ndiaye B, Caumes E.

Service des maladies infectieuses et tropicales, groupe hospitalier de la
Pitie-Salpetriere, Assistance publique-Hopitaux de Paris, 47-83, boulevard de
l'Hopital, 75651 Paris cedex 13, France.

BACKGROUND: The aim was to evaluate the association between dermatological
findings in HIV-infected patients in Senegal and degree of immunosuppression and 
HIV stage. PATIENTS AND METHODS: All consecutive HIV infected patients followed
up at three dermatology centres in Senegal from 01 January 2004 to 01 January
2006 were evaluated retrospectively regarding dermatological findings, CD4 cell
count and HIV stage. PATIENTS AND METHODS: One hundred and forty-nine patients
with 331 skin diseases were evaluated. The most common forms of dermatosis were
oral candidiasis (53%), herpes zoster (24%), prurigo (24%) and dermatophytosis
(16%). An increasing number of skin diseases was significantly associated with
CD4 counts of below 200 per cubic millimeter and Aids diagnosis. A significant
association (p<0.05) was found between two types of dermatosis (oral candidiasis 
and chromonychia) and CD4 counts of below 200 per cubic millimeter and between
four types of dermatosis (straightened hair, herpes, oral candidiasis and
xerosis) and Aids diagnosis. CONCLUSION: Dermatological findings are of great
diagnostic and prognostic significance. We found some features specific to black 
skin: longitudinal melanonychia and blue ungueal pigmentation potentially related
to immunosuppression and straightened hair, associated with Aids, probably
resulting from denutrition.

Publication Types: 
    English Abstract

PMID: 18374849 [PubMed - indexed for MEDLINE]

333: J Gravit Physiol. 2007 Jul;14(1):P21-5.

Monitoring immune system function and reactivation of latent viruses in the
Artificial Gravity Pilot Study.

Mehta SK, Crucian B, Pierson DL, Sams C, Stowe RP.

Enterprise Advisory Servtices, Inc. 6671 SW Freeway, Houston, TX, USA.
satish.k.mehta@nasa.gov

Numerous studies have indicated that dysregulation of the immune system occurs
during or after spaceflight. Using 21 day 6 head-down tilt bed rest as a
spaceflight analog, this study describes the effects of a daily artificial
gravity (AG) countermeasure treatment on immunity, stress, and reactivation of
clinically important latent herpes viruses. Blood, saliva, and urine samples were
collected from each of the 15 male test subjects (8 treatment, 7 control)
periodically throughout the study. The immune assessment consisted of a
comprehensive peripheral immunophenotype analysis, intracellular cytokine
profiles, and measurement of T cell function. With the exception of mild
reactivation of Epstein-Barr (EBV) and Varicella zoster (VZV) viruses, no
significant changes in immune function were observed, suggesting that the AG
countermeasure and the 21 day head-down tilt bed rest regimen had no adverse
effect on immune function.

Publication Types: 
    Controlled Clinical Trial
    Multicenter Study
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 18372687 [PubMed - indexed for MEDLINE]

334: Acta Otolaryngol. 2008 Apr;128(4):460-4.

Human herpesvirus-6 and -7 DNA in cerebrospinal fluid of facial palsy patients.

Kanerva M, Jaaskelainen AJ, Suvela M, Piiparinen H, Vaheri A, Pitkaranta A.

Department of Otorhinolaryngology, Helsinki University Central Hospital,
Helsinki, Finland. mervi.kanerva@fimnet.fi

CONCLUSIONS: Finding human herpesvirus (HHV)-7 and dual HHV-6A and -6B DNA in
cerebrospinal fluid (CSF) of two facial palsy (FP) patients is intriguing but
does not allow etiologic conclusions as such. HHV-6 or -7 DNA was revealed in 10%
of the CSF samples tested from 70 immunocompetent adolescents and adults; a
highly unusual result. How these findings are associated with the diseases they
accompany remains to be defined. OBJECTIVE: To determine whether herpes simplex
virus (HSV)-1 and -2, varicella-zoster virus (VZV), HHV-6A, -6B, and -7,
Epstein-Barr virus (EBV), and cytomegalovirus (CMV) DNA could be found in CSF of 
FP patients or controls. SUBJECTS AND METHODS: In all, 33 peripheral FP patients 
(26 idiopathic, 5 with herpesvirus infection, 1 puerperal, 1 Melkersson-Rosenthal
syndrome) (34 CSF samples) and 36 controls (16 nonidiopathic FP, 7 hearing loss, 
6 vertigo, 5 headache, 2 other) previously tested for HSV-1, VZV, and HHV-6 DNA
by polymerase chain reaction (PCR) were tested with highly sensitive
multiplex-PCR and an oligonucleotide microarray method. RESULTS: One FP patient
had HHV-7 DNA and another had HHV-6A and -6B DNA simultaneously. In the control
group, one HHV-7, one HHV-6A, and three HHV-6B DNA-positive specimens were found.

Publication Types: 
    Comparative Study

PMID: 18368583 [PubMed - indexed for MEDLINE]

335: Pain Med. 2008 Apr;9(3):348-53.

Health care expenditure burden of persisting herpes zoster pain.

Dworkin RH, White R, O'Connor AB, Hawkins K.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, Rochester, New York 14642, USA. robert_dworkin@urmc.rochester.edu

OBJECTIVES: Pain can persist long after the resolution of herpes zoster, but
little is known regarding its health care costs. The objective of this study was 
to determine the health care expenditures associated with persisting pain
following herpes zoster by comparing expenditures for patients with postherpetic 
neuralgia or subacute herpetic neuralgia with a control group without these
conditions. METHODS: Health care expenditures attributable to persisting pain in 
herpes zoster patients were calculated using Thomson-Medstat's MarketScan
databases to examine commercial, Medicare, and Medicaid claims for inpatient and 
outpatient services and outpatient prescription drugs. RESULTS: Excess annualized
costs were $4,917 for commercially insured patients, $2,696 for Medicare
patients, and $9,310 for Medicaid patients. CONCLUSIONS: The substantial health
care costs associated with persisting pain in herpes zoster have important public
health implications given evidence that the incidence of herpes zoster is
increasing and that the population is aging in the United States. The results
provide a basis for evaluating the cost-effectiveness of existing treatments and 
emerging prevention strategies.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18366512 [PubMed - indexed for MEDLINE]

336: Fetal Pediatr Pathol. 2007 Sep-Dec;26(5-6):243-54.

Inflammatory myofibroblastic tumor of the midesophagus.

Goldin SB, Osborne D, Paidas C, Iannello J, Gilbert-Barness E, Karl R, Wilsey MJ 
Jr.

Department of Surgery, University of South Florida College of Medicine, Tampa,
Florida, USA. sgoldin@hsc.usf.edu

An inflammatory myofibroblastic tumor (IMFT) is a rare entity that can arise in a
multiplicity of organs including the lung, liver, and at any location within the 
gastrointestinal tract. Typically, an IMFT presents as a localized mass with
clinical symptoms dependent upon its site of origin. IMFTs pathologically
resemble a neoplastic process but are theorized to arise from an unknown
inflammatory event. We present a case of a midesophageal IMFT in a 12-year-old
female.

Publication Types: 
    Case Reports

PMID: 18363157 [PubMed - indexed for MEDLINE]

337: Cornea. 2008 Apr;27(3):292-6.

Deep corneal calcification associated with preservative-free eyedrops and
persistent epithelial defects.

Lake D, Tarn A, Ayliffe W.

Croydon Eye Unit, Mayday University Hospital, London, UK. lakedomian@hotmalil.com

PURPOSE: To describe the formation of deep calcareous degeneration of the cornea 
associated with the use of preservative-free eyedrops in patients with a
persistent epithelial defect and active ocular surface inflammation. METHODS: A
case series of 6 patients with persistent epithelial defects (1 with diabetes, 3 
with penetrating keratoplasty, and 2 with herpes zoster) treated with
preservative-free medications was reviewed over 18 months. Each patient
subsequently developed deep calcareous corneal degeneration. Data regarding
underlying etiology, diagnosis, clinical findings, and medications used were
recorded. Each medication used was analyzed for phosphate levels by using a Roche
917 analyzer. RESULTS: All 6 cases of calcareous degeneration of the cornea had
persistent epithelial defects, treated with preservative-free medications
(timolol, dexamethasone, and prednisolone), in the presence of active
inflammation on the ocular surface. The mean levels of phosphate were 130, 42.9, 
and 22.9 mM in timolol, dexamethasone, and prednisolone, respectively. All 6
patients had some degree of corneal opacification and reduced visual acuity.
CONCLUSIONS: A contributory factor in our case series seems to be the use of
preservative-free medications in persistent epithelial defects. The
preservative-free medications we measured had high levels of phosphate, which may
not be common knowledge.

Publication Types: 
    Case Reports

PMID: 18362655 [PubMed - indexed for MEDLINE]

338: Neurology. 2008 Mar 25;70(13):1049-51.

Ramsay hunt syndrome followed by multifocal vasculopathy and posterior
circulation strokes.

Ortiz GA, Koch S, Forteza A, Romano J.

Jackson Memorial Hospital, University of Miami, Miller School of Medicine, Miami,
FL 33136, USA.

Publication Types: 
    Case Reports

PMID: 18362285 [PubMed - indexed for MEDLINE]

339: Eur J Dermatol. 2008 Jan-Feb;18(1):108-11.

Skin diseases with high public health impact. Herpes simplex and zoster.

Diaz-Ramon JL, Dlaz-Perez JL.

PMID: 18360933 [PubMed - indexed for MEDLINE]

340: Mod Rheumatol. 2008;18(3):301-5. Epub 2008 Mar 25.

Varicella-zoster virus hepatitis in polymyositis.

Mizoguchi F, Nakamura S, Iwai H, Kubota T, Miyasaka N.

Department of Medicine and Rheumatology, Graduate School, Tokyo Medical and
Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.

A 31-year-old woman had recurrent mild flare-ups of polymyositis for years.
Fourteen days after low-dose methotrexate was added in an attempt to taper the
corticosteroid, she began to feel abdominal and lower back pain, followed by
generalized pustulosis, severe liver dysfunction, and disseminated intravascular 
coagulation. On the diagnosis of varicella-zoster virus (VZV) hepatitis,
acyclovir, immune globulin and plasmapheresis were given with a favorable
outcome. Physicians should be aware that VZV infection could complicate severe
hepatitis in immuno-suppressed patients.

Publication Types: 
    Case Reports

PMID: 18360803 [PubMed - indexed for MEDLINE]

341: Ophthal Plast Reconstr Surg. 2008 Mar-Apr;24(2):162-4.

Palpebral subconjunctival hemorrhages in herpes zoster ophthalmicus.

Najjar DM, Youssef OH, Flanagan JC.

Department of Ophthalmology, Temple University Hospital, Philadelphia, PA 19140, 
USA. danynajjar@hotmail.com

A 75-year-old previously healthy woman was referred for evaluation of pain and
foreign body sensation in her left eye of 4 days' duration. Two weeks before
presentation she was diagnosed with herpes zoster involving the left forehead and
temple area and started on famciclovir treatment. Examination of her left cornea 
revealed inferior superficial punctate keratitis, but no dendrites or
pseudodendrites. Upper eyelid eversion disclosed unusual raised palpebral
subconjunctival hemorrhages on the left side. She was started on topical
prednisolone eyedrops in the left eye, and her symptoms improved over the
following week. Herpes zoster ophthalmicus can initially present in the eyelids. 
Careful follow-up with particular attention to the eyelids and eyelid eversion is
recommended in any patient presenting with herpes zoster to detect early ocular
involvement.

Publication Types: 
    Case Reports

PMID: 18356732 [PubMed - indexed for MEDLINE]

342: J Eur Acad Dermatol Venereol. 2009 Jan;23(1):90-2. Epub 2008 Mar 18.

Wolf's isotopic response: zosteriform morphea appearing at the site of healed
herpes zoster in a HIV patient.

Lopez N, Alcaraz I, Cid-Manas J, Camacho E, Herrera-Acosta E, Matilla A, Herrera 
E.

Publication Types: 
    Letter

PMID: 18355190 [PubMed - in process]

343: Klin Monatsbl Augenheilkd. 2008 Mar;225(3):236-9.

[Atypical ocular toxoplasmosis with concomitant ocular reactivation of
varicella-zoster virus and cytomegalovirus in an immunocompromised host]

[Article in German]

Hasselbach HC, Fickenscher H, Nolle B, Roider J.

Klinik fur Ophthalmologie, Universitatsklinikum Schleswig-Holstein, Campus Kiel. 
hhasselbach@ophthalmol.uni-kiel.de

BACKGROUND: Necrotising retinopathy in immunocompromised hosts is characterised
by an unfavourable course often with unspecific clinical features. Therefore,
differential diagnosis can be critical. HISTORY AND SIGNS: A case of an initially
therapy-resistant, necrotizing retinopathy is presented in a 65-year-old
immunocompromised male patient suffering from chronic B-cell leukemia. THERAPY
AND OUTCOME: Despite demonstration of cytomegalovirus and Varicella-Zoster-Virus 
DNA by polymerase chain reaction in vitreous, aqueous humour samples and from
retinal biopsy with specific antiviral therapy, a progression of retinal necrosis
was noted. Finally Toxoplasma gondii DNA was detected and retinal necrosis
resolved after specific treatment. However, visual acuity remains poor because of
optic nerve atrophy. CONCLUSIONS: The polymerase chain reaction is an important
diagnostic tool for differential diagnosis in immunocompromised patients
suffering from necrotising retinopathy. If resistance to therapy is noted
atypical ocular toxoplasmosis should be considered. The presented case report
shows that even multiple infections are possible in the same host.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18351539 [PubMed - indexed for MEDLINE]

344: Reprod Health. 2008 Mar 18;5:1.

Reproductive health issues in rural Western Kenya.

van Eijk AM, Lindblade KA, Odhiambo F, Peterson E, Sikuku E, Ayisi JG, Ouma P,
Rosen DH, Slutsker L.

Department of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical
Centre, University of Amsterdam, The Netherlands. amvaneijk@yahoo.com.

ABSTRACT: BACKGROUND: We describe reproductive health issues among pregnant women
in a rural area of Kenya with a high coverage of insecticide treated nets (ITNs) 
and high prevalence of HIV (15%). METHODS: We conducted a community-based
cross-sectional survey among rural pregnant women in western Kenya. A medical,
obstetric and reproductive history was obtained. Blood was obtained for a malaria
smear and haemoglobin level, and stool was examined for geohelminths. Height and 
weight were measured. RESULTS: Of 673 participants, 87% were multigravidae and
50% were in their third trimester; 41% had started antenatal clinic visits at the
time of interview and 69% reported ITN-use. Malaria parasitemia and anaemia
(haemoglobin < 11 g/dl) were detected among 36% and 53% of the women,
respectively. Geohelminth infections were detected among 76% of the 390 women who
gave a stool sample. Twenty percent of women were underweight, and sixteen
percent reported symptoms of herpes zoster or oral thrush in the last two months.
Nineteen percent of all women reported using a contraceptive method to delay or
prevent pregnancy before the current pregnancy (injection 10%, pill 8%, condom
0.4%). Twenty-three percent of multigravidae conceived their current pregnancy
within a year of the previous pregnancy. More than half of the multigravidae
(55%) had ever lost a live born child and 21% had lost their last singleton live 
born child at the time of interview. CONCLUSION: In this rural area with a high
HIV prevalence, the reported use of condoms before pregnancy was extremely low.
Pregnancy health was not optimal with a high prevalence of malaria, geohelminth
infections, anaemia and underweight. Chances of losing a child after birth were
high. Multiple interventions are needed to improve reproductive health in this
area.

PMID: 18348726 [PubMed - in process]

345: Ann Epidemiol. 2008 Jun;18(6):433-9. Epub 2008 Mar 17.

Personal and family medical history correlates of rheumatoid arthritis.

de Roos AJ, Cooper GS, Alavanja MC, Sandler DP.

Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and
Department of Epidemiology, University of Washington, Seattle, WA 98109, USA.
deroos@u.washington.edu

PURPOSE: Patients with rheumatoid arthritis (RA) often have comorbidities related
to immune dysfunction, however, the timing of comorbidities relative to RA
diagnosis and treatment is not clear. We studied personal and family medical
history correlates of incident and prevalent RA in women. METHODS: We used a
nested case-control design including women in the Agricultural Health Study
(AHS). Physician-confirmed cases of RA (n = 135) were matched to five controls
each (n = 675) by birth date. We used logistic regression to examine associations
between conditions listed in personal and family medical histories and both
incident and prevalent RA, as estimated by odds ratios (ORs) and 95% confidence
intervals (CIs). RESULTS: The risk of incident RA was associated with personal
medical history of nonmelanoma skin cancer (OR = 4.4, 95% CI: 1.4-14.1), asthma
or reactive lung disease (OR = 3.7, 95% CI: 1.3-10.5), and cataract (OR = 3.3,
95% CI: 1.0-10.8). Personal history of herpes zoster was associated with
prevalent RA (OR = 2.4, 95% CI: 1.2-4.8), but not with incident RA. There were no
consistent associations between family medical history and RA. CONCLUSIONS:
Patients with medical conditions indicating compromised immunity are at increased
risk of developing RA. These results may indicate common pathogenesis of an
environmental or genetic nature between such diseases.

Publication Types: 
    Research Support, N.I.H., Intramural

PMID: 18346911 [PubMed - indexed for MEDLINE]

346: Oral Maxillofac Surg Clin North Am. 2008 May;20(2):237-54, vii.

Neuropathic orofacial pain.

Benoliel R, Eliav E.

Department of Oral Medicine, Hebrew University-Hadassah, POB 12272, Jerusalem,
Israel 91120. benoliel@cc.huji.ac.il

Neuropathic orofacial pain is a general term employed to describe a number of
clinical syndromes, which may be spontaneous or triggered by local trauma or
systemic disorders. Symptomatically these painful syndromes may be episodic or
continuous and are often difficult to distinguish from dental pathology. In the
present article, we review the diagnosis, pathophysiology and therapeutic
approaches to trigeminal and glossopharyngeal neuralgias, orofacial pain
associated with herpetic infection, persistent idiopathic facial pain (previously
termed atypical facial pain), post-traumatic orofacial neuropathy and neuritis.

Publication Types: 
    Review

PMID: 18343328 [PubMed - indexed for MEDLINE]

347: J Clin Epidemiol. 2008 Jul;61(7):671-8. Epub 2008 Mar 14.

Feasibility and validity were demonstrated of an online case-control study using 
the prototype of recent-onset systemic lupus erythematosus.

McAlindon T, Wang J, Formica M, Kay A, Tighiouart H, Chaisson C, Fletcher J.

Division of Rheumatology, Tufts-New England Medical Center, 750 Washington
Street, Box 406, Boston, MA 02111, USA. tmcalindon@tufts-nemc.org

OBJECTIVE: To test the feasibility and validity of the online case-control study 
design through the empirical deployment of a prototype study of recent-onset
systemic lupus erythematosus (SLE). STUDY DESIGN AND SETTING: We conducted an
Internet-based case-control study of SLE during 2003-2005. The source population 
comprised Google users searching on medical key terms, solicited using sponsored 
links. Cases fulfilled a self-administered algorithm for SLE diagnosed within 5
years. A subset underwent confirmation by medical record review. Controls were
matched to cases using a propensity score. RESULTS: Four hundred and two cases
and 693 control applicants finished the questionnaires, yielding 389 matched
case-control pairs. Eighty-two percentage of the records documented a clinical
diagnosis of SLE, and 61% documented >or=4 American College of Rheumatology
criteria for SLE. Control applicants resembled Internet users, with the
exceptions of comprising more women (86% vs. 52%) and fewer minority individuals 
(e.g., 5% vs. 9% for African-Americans). There was a broad representation of
clinical manifestations. SLE was associated with miscarriage (odds ratio
[OR]=3.0, 95% confidence interval [CI]=2.0-4.7), allergy to sulfonamides (OR=2.2,
CI=1.5-3.2), hives (OR=1.9, CI=1.4-2.5), and shingles (OR=2.3, CI=1.4-3.7).
CONCLUSION: It is possible to perform case-control studies over the Internet
using an internally valid design, obtain reliable information from participants, 
and confirm established associations.

Publication Types: 
    Research Support, N.I.H., Extramural
    Validation Studies

PMID: 18342488 [PubMed - indexed for MEDLINE]

348: Can Fam Physician. 2008 Mar;54(3):373-7.

Treatment of herpes zoster.

Opstelten W, Eekhof J, Neven AK, Verheij T.

Julius Center for Health Sciences and Primary Care, University Medical Center
Utrecht, Utrecht, The Netherlands. W.Opstelten@umcutrecht.nl

OBJECTIVE: To review the evidence regarding treatment of herpes zoster (HZ) in
the short-term, focusing on the prevention of postherpetic neuralgia (PHN).
QUALITY OF EVIDENCE: The evidence relating to treatment of HZ is derived mainly
from randomized controlled trials (level I evidence). MAIN MESSAGE: Antiviral
drugs might have some effect on the severity of acute pain and on the duration of
skin lesions. Corticosteroids also alleviate acute pain. Oral antiviral
medication reduces the risk of eye complications in patients with ophthalmic HZ. 
There is no convincing evidence that antiviral medication reduces the risk of
PHN. Some studies, however, have shown that famciclovir and valacyclovir shorten 
the duration of PHN. The effectiveness of amitriptyline or cutaneous and
percutaneous interventions in preventing PHN has not been proven. CONCLUSION:
Oral antiviral drugs should be prescribed to elderly HZ patients with high risk
of PHN. Moreover, these drugs should be prescribed to all patients at the first
signs of ophthalmic HZ, irrespective of age or severity of symptoms.

Publication Types: 
    Review

PMID: 18337531 [PubMed - indexed for MEDLINE]

349: Neurology. 2008 Mar 11;70(11):853-60.

The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic 
features.

Nagel MA, Cohrs RJ, Mahalingam R, Wellish MC, Forghani B, Schiller A, Safdieh JE,
Kamenkovich E, Ostrow LW, Levy M, Greenberg B, Russman AN, Katzan I, Gardner CJ, 
Hausler M, Nau R, Saraya T, Wada H, Goto H, de Martino M, Ueno M, Brown WD,
Terborg C, Gilden DH.

Department of Neurology, Mail Stop B182, University of Colorado Health Sciences
Center, 4200 E. 9th Ave., Denver, CO 80262, USA.

BACKGROUND: Varicella zoster virus (VZV) vasculopathy produces stroke secondary
to viral infection of cerebral arteries. Not all patients have rash before
cerebral ischemia or stroke. Furthermore, other vasculitides produce similar
clinical features and comparable imaging, angiographic, and CSF abnormalities.
METHODS: We review our 23 published cases and 7 unpublished cases of VZV
vasculopathy. All CSFs were tested for VZV DNA by PCR and anti-VZV IgG antibody
and were positive for either or both. RESULTS: Among 30 patients, rash occurred
in 19 (63%), CSF pleocytosis in 20 (67%), and imaging abnormalities in 29 (97%). 
Angiography in 23 patients revealed abnormalities in 16 (70%). Large and small
arteries were involved in 15 (50%), small arteries in 11 (37%), and large
arteries in only 4 (13%) of 30 patients. Average time from rash to neurologic
symptoms and signs was 4.1 months, and from neurologic symptoms and signs to CSF 
virologic analysis was 4.2 months. CSF of 9 (30%) patients contained VZV DNA
while 28 (93%) had anti-VZV IgG antibody in CSF; in each of these patients,
reduced serum/CSF ratio of VZV IgG confirmed intrathecal synthesis. CONCLUSIONS: 
Rash or CSF pleocytosis is not required to diagnose varicella zoster virus (VZV) 
vasculopathy, whereas MRI/CT abnormalities are seen in almost all patients. Most 
patients had mixed large and small artery involvement. Detection of anti-VZV IgG 
antibody in CSF was a more sensitive indicator of VZV vasculopathy than detection
of VZV DNA (p < 0.001). Determination of optimal antiviral treatment and benefit 
of concurrent steroid therapy awaits studies with larger case numbers.

Publication Types: 
    Research Support, N.I.H., Extramural
    Review

PMID: 18332343 [PubMed - indexed for MEDLINE]

350: Dermatol Online J. 2007 Jul 13;13(3):29.

[Herpes zoster and polyradiculopathy: report of a case]

[Article in Portuguese]

Silva de Almeida KJ, Tavares CB, Campos-Sousa RN.

Universidade Federal do Piaui - Departamento de Neurologia.

Polyradiculopathy that develops as a result of herpes zoster is rare. When it
does occur, it usually follows the cutaneous eruption. However, we present a case
of nerve impairment (motor, sensatory, and autonomic) that occurred prior to the 
cutaneous herpes zoster eruption.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18328223 [PubMed - indexed for MEDLINE]

351: Ethiop Med J. 2007 Oct;45(4):327-34.

Ophthalmic manifestation of aids in Armed Forces General Teaching Hospital, Addis
Ababa.

T/Giorgis A, Melka F, G/Mariam A.

Department of Ophthalmology, Faculty of Medicine, Addis Ababa University. P.O.
Box 8079, Addis Ababa, Ethiopia. abebatgiorgis@yahoo.com

BACKGROUND: The eye is one of the commonly affected organs by HIV/AIDS. However, 
data on HIV/AIDS related ophthalmic lesion is scarce in Ethiopia and in other
sub-Saharan Africa countries, where two-third of the world-infected people are
living. OBJECTIVE: To determine the proportion, describe the pattern, and assess 
the visual impairment of AIDS related ophthalmic lesions in comparison to CD+
T-lymphocyte count. METHODS: This is a cross-sectional descriptive study
conducted on AIDS patients. Consecutive patients whose CD4+ T-lymphocyte count
was 200 cell/microl and below, diagnosed to have AIDS and not started on
Antiretroviral therapy (ART) were evaluated for ophthalmic lesions over a period 
of one year. RESULTS: A total of 186 (26 females and 160 males) with mean age
34.3 +/- 7.6 years were examined CD4+ T-lymphocyte was ranging from 1 to 200
cell/microl. Sixty-one (32.8%) patients were found to have HIV/AIDS related
ophthalmic lesions. Four of them had more than one lesion. Among the lesions,
microvasculopathy (64% of them having CD4 less than 50) was by far the commonest 
accounting for 25/65 (38.1%), followed by Molluscum contageosum of the eyelids
10/65 (15%). Herpes Zoster Opthalmicus (HZO), uveitis, CMV retinitis were next
common 4/65 (6.2% each). Eleven unilaterally and two bilaterally were blind. The 
leading cause of blindness was cytomegalovirus retinitis followed by HZO, uveitis
and presumed toxoplasmisis chorioretinitis. The likelihood of having HIV/AIDS
related lesion was higher among cases with CD4+ T-lymphocyte count of 50 and
below (Adjusted OR = 12.25; 95% CI; 1.09, 4.63). CONCLUSION: The presence of
visual threatening ophthalmic lesions in highly immunocompromised AIDS patient
shows the importance of early detection and treatment. ART could have impact on
the pattern of the ophthalmic lesions, hence further study is recommended.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 18326342 [PubMed - indexed for MEDLINE]

352: Int J Infect Dis. 2007 Nov;11 Suppl 2:S43-8.

Prevention of herpes zoster and its painful and debilitating complications.

Johnson R, McElhaney J, Pedalino B, Levin M.

r.w.johnson@bris.ac.uk

BACKGROUND: Reactivation of latent varicella-zoster virus in sensory neurons to
cause herpes zoster (shingles) is common in adults 50 years of age and older;
half of adults experience an episode by age 85 years. Herpes zoster is
attributable to the progressive decline in the VZV-specific cell-mediated
immunity that occurs with aging or other conditions that cause immune compromise.
Herpes zoster and complications, such as postherpetic neuralgia (PHN), can have a
substantial negative impact on quality of life. DISCUSSION: The incidence of
herpes zoster and its associated morbidity is increasing worldwide as the
population ages. Nevertheless, the severity and impact of this condition, and its
painful sequelae, are often unrecognized. Many patients delay seeking medical
attention, complicating both diagnosis and treatment. Prevention appears to be
the best option. A new herpes zoster vaccine significantly reduced the burden of 
illness (61.1%), the incidence of PHN (66.5%), and the incidence of herpes zoster
(51.3%) (p < 0.001). Vaccine tolerability was good, with minor local injection
site reactions the most common adverse event. CONCLUSIONS: Herpes zoster and PHN 
represent a substantial burden in terms of suffering and associated costs.
Immunization of older adults is a good option to prevent herpes zoster and PHN.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18162246 [PubMed - indexed for MEDLINE]

353: Internist (Berl). 2008 Jun;49(6):737-42.

[A 52-year-old woman with acute shock and purpura fulminans. Pneumococcal sepsis]

[Article in German]

Jochum E, Perez-Bouza A, Baumanns S, vom Dahl J, Janssen U.

Klinik fur Kardiologie, Nephrologie und internistische Intensivmedizin,
Krankenhaus St. Franziskus, Kliniken Maria Hilf GmbH, Viersener Strasse 450,
41063, Monchengladbach, Germany. Eric.Jochum@mariahilf.de

We report a 52-year-old female patient admitted with fever, chills, and myalgias 
since the previous day. On the day of admission she had a generalized seizure.
The patient had no previous illnesses. Laboratory investigations showed
consumptive coagulopathy with clinical manifestations of shock and development of
multiple organ failure. Pneumococci were detected in blood cultures. Furthermore 
the skin showed purpura fulminans all over. The patient died within 24 h after
admission in the intensive care unit. On autopsy, in addition to adrenal and
myocardial hemorrhages, hypoplasia of the spleen was found. Fulminant
pneumococcal sepsis is a life-threatening disease that occurs in patients with
risk factors like splenic hypoplasia or asplenia. Sometimes a fulminant
pneumococcal sepsis may be the first clinical manifestation of a hitherto unknown
splenic hypoplasia. In this context the general recommendation of vaccination
against pneumococci in patients with risk factors like splenic hypoplasia or
asplenia, in patients older than 60, and in children from 2 months onward has to 
be emphasized.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18322667 [PubMed - indexed for MEDLINE]

354: Iran J Immunol. 2008 Mar;5(1):64-7.

Co-existence of common variable immunodeficiency (CVID) with idiopathic
thrombocytopenic purpura (ITP).

Hegazi MO, Kumar R, Alajmi M, Ibrahim E.

Department of Medicine, Al Adan Hospital, Kuwait. drosama02@gmail.com

Publication Types: 
    Case Reports

PMID: 18319527 [PubMed - indexed for MEDLINE]

355: J Natl Compr Canc Netw. 2008 Feb;6(2):191-201.

Prevention and early treatment of opportunistic viral infections in patients with
leukemia and allogeneic stem cell transplantation recipients.

Angarone M, Ison MG.

Division of Infectious Diseases, Northwestern University Feinberg School of
Medicine, Chicago, IL 60611, USA.

A leading complication of leukemia therapy and stem cell transplantation is
opportunistic viral infections. Infections caused by cytomegalovirus, herpes
simplex, varicella-zoster, Epstein-Barr, and the community respiratory viruses
are associated with significant morbidity and mortality in this highly
immunosuppressed population. Fortunately, a growing armamentarium is allowing
more effective prophylaxis of these pathogens. This article reviews the
epidemiology and prophylactic strategies available for these common opportunistic
viral pathogens.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18319051 [PubMed - indexed for MEDLINE]

356: Dermatol Online J. 2008 Jan 15;14(1):1.

Pattern of non-venereal dermatoses of female external genitalia in South India.

Singh N, Thappa DM, Jaisankar TJ, Habeebullah S.

Department of Dermatology and Sexually Transmitted Diseases, Jawaharlal Institute
of Postgraduate Medical Education and Research, Pondicherry, India.

Non-venereal dermatoses tend to be confused with venereal diseases, which may be 
responsible for mental distress and guilt feelings in patients. We conducted the 
study to find the pattern of non-venereal dermatoses of female external genitalia
and to correlate non-venereal dermatoses with various clinical parameters. The
study included 120 female patients with non-venereal dermatoses of female
external genitalia presenting over a period of 22 months from September 2005 to
June 2007. The demographic characteristics and clinical findings were recorded.
Cases having venereal diseases were excluded from the study. A total of nineteen 
non-venereal dermatoses were noted in the study. The most common non-venereal
dermatoses were lichen sclerosus (26 cases or 21.7%), vitiligo (19 cases or
15.8%), lichen simplex chronicus (16 cases or 13.3%), and vulval candidiasis (11 
or 9.2%). Other dermatoses included lymphedema, invasive squamous cell carcinoma,
tinea cruris, psoriasis, furuncle, folliculitis, lichen planus, epidermal
inclusion cyst, herpes zoster, irritant contact dermatitis, acrochordon,
Bartholin cyst, fibroepithelial stromal polyp, molluscum contagiosum
(autoinoculated), and streptococcal vulvitis. This study highlights the
importance of diagnosing non-venereal dermatoses and refutes the general
misconception that all vulval itching is the result of fungal infection. The two 
most common causes of vulval itching observed in the study were lichen sclerosus 
and lichen simplex chronicus.

PMID: 18319018 [PubMed - indexed for MEDLINE]

357: Epidemiol Infect. 2008 Apr;136(4):449; author reply 449-50.

Comment on:
    Epidemiol Infect. 2007 Aug;135(6):908-13.

Re: secular trends in the epidemiology of shingles in Alberta.

Gagliotti C.

Publication Types: 
    Comment
    Letter

PMID: 18318919 [PubMed - indexed for MEDLINE]

358: Nippon Ganka Gakkai Zasshi. 2008 Feb;112(2):136-40.

[Clinical features of acute retinal necrosis at Hokkaido University Hospital]

[Article in Japanese]

Mizuuchi K, Namba K, Kotake S, Ohno S.

Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate
School of Medicine, Sapporo, Japan. mizuuchi@peach.plala.or.jp

PURPOSE: To study clinical features of acute retinal necrosis (ARN) at Hokkaido
University Hospital. METHODS: Twenty-one eyes of 19 patients with ARN (10 male
and 9 female patients) who were treated at Hokkaido University Hospital between
1992 and 2006 were retrospectively examined from clinical records. RESULTS: The
average age of the patients was 53.4 years (range, 13 to 91 years). 17 cases were
unilateral and 2 were bilateral. The pathogenic virus was herpes simplex virus-1 
(HSV-1) in 2 patients, and varicella-zoster virus (VZV) in 17 patients. Clinical 
severity was assessed from spreading speed and area of the retinal exudation, and
5 eyes were judged as fulminant cases (4 VZV eyes, 1 HSV eye), 6 eyes as severe
cases (6 VZV eyes), and 10 eyes as mild cases (9 VZV eyes, 1 HSV eye). The range 
of retinal exudation was 1 to 2 quadrants in 7 eyes, 3 to 4 quadrants in 3 eyes, 
and increased to all quadrants in 11 eyes. Retinal detachment (RD) was observed
in 8 eyes (38%), and the final visual acuity was less than 0.1 in 9 eyes (43%).
CONCLUSIONS: The leading cause of ARN at Hokkaido University Hospital was VZV,
and no HSV-2 ARN was seen. Compared with other areas in Japan, ARN at Hokkaido
University Hospital seems to show less frequent RD, but the same prognosis for
final visual acuity.

Publication Types: 
    English Abstract

PMID: 18318274 [PubMed - indexed for MEDLINE]

359: Nippon Ganka Gakkai Zasshi. 2008 Feb;112(2):105-6.

[Acute retinal necrosis--today, past and future]

[Article in Japanese]

Goto H.

Publication Types: 
    Editorial

PMID: 18318270 [PubMed - indexed for MEDLINE]

360: AIDS. 2008 Mar 12;22(5):601-10.

Comment in:
    AIDS. 2008 Mar 12;22(5):643-5.

Incidence and risk factors for the immune reconstitution inflammatory syndrome in
HIV patients in South Africa: a prospective study.

Murdoch DM, Venter WD, Feldman C, Van Rie A.

Division of Pulmonary and Critical Care Medicine, Duke University Medical Center,
Durham, North Carolina NC 27710, USA. dmurdoch@email.unc.edu

OBJECTIVE: To determine the incidence, clinical manifestations, risk factors and 
outcome of immune reconstitution inflammatory syndrome (IRIS) in South Africa.
DESIGN: Prospective surveillance cohort and nested case-control study in a large,
University hospital-based antiretroviral therapy (ART) clinic. METHODS: A total
of 423 ART-naive HIV-infected South African patients were followed for signs and 
symptoms IRIS during the first 6 months of ART. We also performed a nested
case-control study with controls matched to IRIS cases on ART duration. RESULTS: 
During the first 6 months of ART, 44 (10.4%) patients experienced IRIS for an
overall incidence rate of 25.1 cases per 100 patient-years. Diagnoses included
tuberculosis (18/44, 41%), abscess formation and suppurative folliculitis (8/44, 
18.2%), varicella zoster (6/44, 13.6%), herpes simplex (4/44, 9.1%), cryptococcal
meningitis (3/44, 6.8%), molluscum contagiosum (3/44, 6.8%), and Kaposi's sarcoma
(2/44, 4.5%). Median IRIS onset was 48 days (interquartile range, 29-99) from ART
initiation. In comparison with controls, IRIS cases had significantly lower CD4
cell counts at baseline (79 versus 142 cells/microl; P = 0.02) and at IRIS
diagnosis (183 versus 263 cells/microl; P = 0.05), but similar virological and
immunological response to ART. In multivariable analyses, higher baseline CD4
cell count was protective of developing IRIS (HR 0.72 per 50 cells/microl
increase). Most IRIS cases were mild, with ART discontinued in three (6.8%)
patients, corticosteroids administered to four (9.1%) patients, and
hospitalization required in 12 (27.3%) patients. Two deaths were attributable to 
IRIS. CONCLUSIONS: IRIS may affect 10% of patients initiating ART in Africa,
particularly those with advanced immunosuppression, but severe, life-threatening 
IRIS is uncommon.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 18317001 [PubMed - indexed for MEDLINE]

361: J Eur Acad Dermatol Venereol. 2008 Jun;22(6):722-8. Epub 2008 Feb 25.

Identification and characterization of 20 immunocompetent patients with
simultaneous varicella zoster and herpes simplex virus infection.

Giehl KA, Muller-Sander E, Rottenkolber M, Degitz K, Volkenandt M, Berking C.

Department of Dermatology, Ludwig-Maximilian University of Munich, Munich,
Germany.

BACKGROUND: It has been shown that varicella zoster virus (VZV) and herpes
simplex virus (HSV) can co-localize to the same sensory ganglion. However, only a
few case reports on VZV/HSV co-infections exist. Objective To identify and
characterize patients with concurrent VZV and HSV infection at the same body
site. SUBJECTS/METHODS: In 1718 patients, the presence of VZV and HSV in
suspicious skin lesions was investigated by polymerase chain reaction analysis.
Clinical characteristics of co-infected patients were compared with matched
control patients infected with either VZV or HSV. The data are discussed in the
context of an extensive review of the literature. RESULTS: Twenty (1.2%) of 1718 
patients were infected with both VZV and HSV at the same body site. The mean age 
was 54 years (range, 2-83). The clinical diagnosis was zoster in 65%, herpes
simplex in 20%, varicella in 10% and erythema multiforme in 5% of cases. The
trigeminus region was affected in 60% and the trunk in 25%. Involvement of the
head was most commonly associated with a severe course of disease and with older 
age. CONCLUSION: Simultaneous VZV/HSV infection is rare but can occur in
immunocompetent patients, which is often overlooked. The majority of cases is
localized to the trigeminus region and affects elderly people.

PMID: 18312326 [PubMed - indexed for MEDLINE]

362: Intern Med. 2008;47(5):463-5. Epub 2008 Mar 3.

Herpes zoster ophthalmicus and syndrome of inappropriate antidiuretic hormone
secretion.

Kucukardali Y, Solmazgul E, Terekeci H, Oncul O, Turhan V.

Department of Internal Medicine, Gulhane School of Medicine, Haydarpasa Training 
Hospital, Istanbul, Turkey.

The syndrome of inappropriate antidiuretic hormone (SIADH) secretion is a common 
consequence of neurologic and pulmonary infections as well as drug intake and
many other clinical situations. This report describes SIADH that developed in an 
elderly woman with single dermatomal herpes varicella zoster ophthalmicus without
evidence of varicella zoster encephalitis or dissemination. A 76-year-old woman
was admitted to our department for evaluation of left facial pain, confusion and 
disorientation. Further investigation revealed hyponatremia 112 mEq/L, low serum 
osmolality, high urine osmolality, normal renal function, normal adrenal and
thyroid hormones, and high plasma vasopressin 40 pg/mL. These results indicate
that the hyponatremia in this case was due to SIADH and that SIADH was caused by 
an increased release of vasopressin probably because of the antiviral drug
(acyclovir) or infection of varicella zoster virus (VZV) in a single dermatome.

Publication Types: 
    Case Reports
    Review

PMID: 18310984 [PubMed - indexed for MEDLINE]

363: Cutis. 2008 Jan;81(1):71-2.

Monodermatomal herpes zoster in a pseudodisseminated distribution following
breast reconstruction surgery.

Tuchman M, Weinberg JM.

New York Medical College, New York, USA.

A 45-year-old woman underwent a modified radical mastectomy with transverse
rectus abdominis myocutaneous (TRAM) flap reconstruction for newly diagnosed
stage III breast cancer. Three months after beginning chemotherapy, she developed
an erythematous, vesicular, painful rash along the right side of her abdomen that
extended to the right side of her chest. Although the rash had the qualities of
herpes zoster, the distribution was not dermatomal in nature; instead, it crossed
multiple dermatomes. The initial presentation was suspicious for disseminated
herpes zoster because of its clinical presentation and her clinical history. A
more extensive examination revealed the patient had monodermatomal herpes zoster 
masquerading as disseminated herpes zoster secondary to her TRAM flap procedure
whereby the nerves were realigned and created this pseudodisseminated appearance 
of the rash.

Publication Types: 
    Case Reports

PMID: 18306852 [PubMed - indexed for MEDLINE]

364: Singapore Med J. 2008 Feb;49(2):e59-60.

Zosteriform herpes simplex.

Koh MJ, Seah PP, Teo RY.

Department of Dermatology, Changi General Hospital, 2 Simei Street 3, Singapore
529889. docmark@pacific.net.sg

Herpes simplex virus (HSV) infection, though most commonly seen in the oral,
perioral and genital areas, can occur anywhere on the body. After primary
infection, HSV then establishes latency in sensory nerve ganglia and reactivates 
intermittently, precipitated by various factors. These reactivations may be
recurrent and appear in a dermatomal distribution, mimicking herpes zoster, often
leading to misdiagnosis if no confirmatory laboratory tests are carried out. We
report a 65-year-old man who presented with recurrent episodes of a "zosteriform 
eruption", who was initially clinically diagnosed and treated as for recurrent
herpes zoster, but was subsequently found to have recurrent herpes simplex virus 
type 2 after laboratory investigations.

PMID: 18301829 [PubMed - indexed for MEDLINE]

365: Nepal Med Coll J. 2007 Dec;9(4):281-3.

Herpes zoster in a five month old infant subsequent to intrauterine exposure to
varicella infection.

Jha A, Kumar A, Paudel U, Neupane S, Pokhrel DB, Badal KP.

Department of Pathology, Tribhuvan University Teaching Hospital, Maharajgunj
Campus, Maharajgunj, Kathmandu, Nepal. jhaabhimanyu@yahoo.com

Herpes zoster is characterized by painful vesicular eruption in a dermatomal
distribution of sensory nerves as a result of reactivation of latent herpes
zoster virus in posterior root ganglia. The primary varicella infection is
usually acquired in childhood and reactivation usually is seen in elderly. In
rare instances herpes zoster can also occur in infancy as a result of
reactivation of primary varicella infection acquired in utero or in early
infancy. Here, we report a rare case of herpes zoster in a 5 month baby who
acquired primary infection in utero from mother who had varicella infection at 6 
months of gestation.

Publication Types: 
    Case Reports

PMID: 18298022 [PubMed - indexed for MEDLINE]

366: Rev Alerg Mex. 2007 Jul-Aug;54(4):134-9.

Indications, usage, and dosage of the transfer factor.

Berron-Perez R, Chavez-Sanchez R, Estrada-Garcia I, Espinosa-Padilla S,
Cortez-Gomez R, Serrano-Miranda E, Ondarza-Aguilera R, Perez-Tapia M, Pineda
Olvera B, Jimenez-Martinez Mdel C, Portugues A, Rodriguez A, Cano L, Pacheco PU, 
Barrientos J, Chacon R, Serafin J, Mendez P, Monges A, Cervantes E, Estrada-Parra
S.

Servicio de Inmunologia, Instituto Nacional de Pediatria, S.S.

The transfer factor (TF) was described in 1955 by S. Lawrence. In 1992
Kirkpatrick characterized the specific TF at molecular level. The TF is
constituted by a group of numerous molecules, of low molecular weight, from 1.0
to 6.0 kDa. The 5 kDa fraction corresponds to the TF specific to antigens. There 
are a number of publications about the clinical indications of the TF for diverse
diseases, in particular those where the cellular immune response is compromised
or in those where there is a deficient regulation of the immune response. In this
article we present our clinical and basic experiences, especially regarding the
indications, usage and dosage of the TF. Our group demonstrated that the TF
increases the expression of IFN-gamma and RANTES, while decreases the expression 
of osteopontine. Using animal models we have worked with M. tuberculosis, and
with a model of glioma with good therapeutic results. In the clinical setting we 
have worked with herpes zoster, herpes simplex type I, herpetic keratitis, atopic
dermatitis, osteosarcoma, tuberculosis, asthma, post-herpetic neuritis, anergic
coccidioidomycosis, leishmaniasis, toxoplasmosis, mucocutaneous candidiasis,
pediatric infections produced by diverse pathogen germs, sinusitis, pharyngitis, 
and otits media. All of these diseases were studied through protocols which main 
goals were to study the therapeutic effects of the TF, and to establish in a
systematic way diverse dosage schema and time for treatment to guide the
prescription of the TF.

Publication Types: 
    Review

PMID: 18297853 [PubMed - indexed for MEDLINE]

367: J Clin Virol. 2008 Jun;42(2):172-5. Epub 2008 Mar 4.

Improved multiplex-PCR and microarray for herpesvirus detection from CSF.

Jaaskelainen AJ, Piiparinen H, Lappalainen M, Vaheri A.

Department of Virology, Haartman Institute, FIN-00014 University of Helsinki,
Finland. anne.jaaskelainen@helsinki.fi

BACKGROUND: A multiplex-PCR and microarray-based method was designed for
detection of eight herpesviruses from clinical specimens. OBJECTIVES: To improve 
the method, especially for detection of herpes simplex (HSV) and varicella-zoster
viruses (VZV), and to update and validate the method using positive cerebrospinal
fluid (CSF) samples. STUDY DESIGN: A new primer pair for HSV-PCR and four
detection oligonucleotides for HSVs were designed. Two new detection
oligonucleotides for VZV and additional oligonucleotides for CMV, EBV, HHV-6 and 
-7 were designed. The new and previous multiplex-PCR and microarray method were
tested in parallel with dilution series of commercial herpesvirus DNAs and 20 CSF
specimens positive for HSV-1, HSV-2, or VZV. RESULTS: New method was more
sensitive for detection of HSVs and both two new detection oligonucleotides for
VZV functioned well at low levels of viral DNA. CONCLUSIONS: The revised HSV-PCR 
and new HSV- and VZV-oligonucleotides were found to function well and be more
sensitive, thereby increasing reliability of the method.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 18295539 [PubMed - indexed for MEDLINE]

368: Niger J Clin Pract. 2007 Dec;10(4):283-6.

Ocular disorders in patients infected with the human immunodeficiency virus at
the University of Benin Teaching Hospital, Benin City, Nigeria.

Osahon AI, Onunu AN.

Department of Ophthalmology, University of Benin Teaching Hospital, Benin City,
Nigeria. osahonai@yahoo.com

AIMS: Ocular diseases occur at all stages of HIV infection. Reports have
documented that the prevalence of these diseases vary from region to region. Thus
the objective of this study is to determine the prevalence of these ocular
disorders among people infected with HIV at the University of Benin Teaching
Hospital, Benin City, Nigeria METHODS: The study was prospective in design and
all patients who tested positive for HIV antibodies over a 5-year period from
September 1997 to August 2002 in Dermatology and Ophthalmology Units at the
University of Benin Teaching Hospital (UBTH), Benin City, Nigeria, were examined 
for the presence of ocular disease. RESULTS: Twenty-one of the 526 HIV-positive
patients had ocular disease, giving a prevalence rate of 4.0%. Their mean age was
39.5 +/- 10.5 years. Fourteen patients (2.7%) had Herpes zoster ophthalmicus,
four (0.8%) had Squamuos cell carcinoma, two (0.4%) had Kaposi's sarcoma while
one (0.2%) had Cytomegalovirus retinitis. The signs seen on ocular examination
were vesicular rash (66.7%) diminished vision (57.1%) corneal ulcers (38.0%),
conjunctival injection (38.0%), and eyelid nodules (28.6%), preauricular
lymphadenopathy (28.6%), purulent eye discharge (19.0), conjunctival nodules
(9.5%), papilledema (9.5%), ptosis (9.5%), sudden visual loss in both eyes
(9.5%), pupillary dilatation (4.8%), chemosis (4.8%), uveitis (4.8%), and retinal
hemorrhage (4.8%). CONCLUSIONS: In this study the prevalence of ocular disorders 
was 4.0% in the 526 HIV-positive patients studied. Herpes zoster ophthalmicus was
the commonest ocular disease encountered, occurring in 2.7% of the study
population. This is in keeping with reports from other parts of the world. We
recommend that young patients presenting with Herpes zoster ophthalmicus,
conjunctival Squamuos cell carcinoma and sudden onset bilateral blindness should 
be screened for HIV infection.

PMID: 18293635 [PubMed - indexed for MEDLINE]

369: J Gen Intern Med. 2008 May;23(5):648-9. Epub 2008 Feb 20.

Live, attenuated varicella zoster vaccination of an immunocompromised patient.

Curtis KK, Connolly MK, Northfelt DW.

Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ, USA.

A vaccine for the prevention of herpes zoster outbreaks in adults over the age of
60 years has recently been approved. A 76-year-old white female with a history of
recurrent left axillary breast cancer undergoing chemotherapy was given a
Zostavax injection by her primary care physician. Eight days later, the patient
developed a rash. Given the recent administration of live, attenuated varicella
zoster virus (VZV), a diagnosis of disseminated cutaneous herpes zoster was made.
The patient was treated successfully with a course of famciclovir for 10 days and
cephalexin for 7 days for a secondary bacterial infection. A review of the
medical literature disclosed no reports of Zostavax given to adult cancer
patients immunocompromised by systemic chemotherapy. Therefore, we believe this
report is the first to describe the consequences of Zostavax administration to
such a host. Clinicians should take care to review contraindications and
precautions prior to administering the Zostavax vaccine.

Publication Types: 
    Case Reports

PMID: 18286341 [PubMed - indexed for MEDLINE]

370: Br J Dermatol. 2008 May;158(5):1145-6. Epub 2008 Feb 16.

Primary manifestation of a zosteriform lichen planus: isotopic response following
herpes zoster sine herpete?

Mohrenschlager M, Engst R, Hein R, Ring J.

Publication Types: 
    Case Reports
    Letter

PMID: 18284381 [PubMed - indexed for MEDLINE]

371: Pharmacoeconomics. 2008;26(3):235-49.

Community and patient values for preventing herpes zoster.

Lieu TA, Ortega-Sanchez I, Ray GT, Rusinak D, Yih WK, Choo PW, Shui I, Kleinman
K, Harpaz R, Prosser LA.

Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and
Harvard Medical School, Boston, MA 02215, USA. tracey.lieu@harvardpilgrim.org

OBJECTIVES: The US Advisory Committee on Immunization Practices has recently
recommended a new vaccine against herpes zoster (shingles) for routine use in
adults aged > or =60 years. However, estimates of the cost effectiveness of this 
vaccine vary widely, in part because of gaps in the data on the value of
preventing herpes zoster. Our aims were to (i) generate comprehensive information
on the value of preventing a range of outcomes of herpes zoster; (ii) compare
these values among community members and patients with shingles and post-herpetic
neuralgia (PHN); and (iii) identify clinical and demographic characteristics that
explain the variation in these values. METHODS: Community members drawn from a
nationally representative survey research panel (n = 527) completed an
Internet-based survey using time trade-off and willingness-to-pay questions to
value a series of scenarios that described cases of herpes zoster with varying
pain intensities (on a scale of 0 to 10, where 0 represents no pain and 10
represents the worst imaginable pain) and duration (30 days to 1 year). Patients 
with shingles (n = 382) or PHN (n = 137) [defined as having symptoms for > or =90
days] from two large healthcare systems completed telephone interviews with
similar questions to the Internet-based survey and also answered questions about 
their current experience with herpes zoster. We constructed generalized linear
mixed models to evaluate the associations between demographic and clinical
characteristics, the length and intensity of the health states and time trade-off
and willingness-to-pay values. RESULTS: In time trade-off questions, community
members offered a mean of 89 (95% CI 24, 182) discounted days to avoid the least 
severe scenario (pain level of 3 for 1 month) and a mean of 162 (95% CI 88, 259) 
discounted days to avoid the most severe scenario (pain level of 8 for 12
months). Compared with patients with shingles, community members traded more days
to avoid low-severity scenarios but similar numbers of days to avoid
high-severity scenarios. Compared with patients with PHN, community members
traded fewer days to avoid high-severity scenarios. In multivariate analyses,
older age was the only characteristic significantly associated with higher time
trade-off values.In willingness-to-pay questions, community members offered a
mean of $US450 (95% CI 203, 893) to avoid pain of level 3 for 1 month and a mean 
of $US1384 (95% CI 873, 2050) [year 2005 values] to avoid pain of level 8 for 12 
months. Community members traded less money than patients with either shingles or
PHN to avoid both low- and high-severity scenarios (p-values <0.05 to <0.001). In
multivariate models, male gender, higher income and having experienced shingles
or PHN were associated with higher willingness to pay to avoid herpes zoster.When
patients were asked to assign a value to avoiding their own case of herpes
zoster, those with shingles assigned a mean of 67 days or $US2319, while those
with PHN assigned a mean of 206 days or $US18 184. Both the time and monetary
value traded were associated with the maximum intensity of the pain the
individual had experienced, but neither was associated with the duration of the
pain. CONCLUSIONS: We believe that this study provides the most comprehensive
information to date on the value individuals place on preventing herpes zoster,
and it includes the only such valuation from nationally representative community 
members as well as patients with herpes zoster. Community members would trade
substantial amounts of time or money to avoid herpes zoster, even in the least
severe scenarios. The time trade-off results in this study may differ from those 
in other studies because of important differences in methods of assessing health 
utilities. Consideration of both community and patient perspectives is crucial to
help decision makers fully determine the implications of their policies now that 
a vaccine against herpes zoster is available.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 18282017 [PubMed - indexed for MEDLINE]

372: J Am Acad Dermatol. 2008 Mar;58(3):361-70.

Comment in:
    J Am Acad Dermatol. 2008 Dec;59(6):1090-1.

New viral vaccines for dermatologic disease.

Urman CO, Gottlieb AB.

Tufts University School of Medicine, Boston, Massachusetts, USA.
Christine.Orlova@tufts.edu

Two new viral vaccines have recently been approved by the Food and Drug
Administration. Human papillomavirus (HPV) vaccine is intended to reduce
infection with the most common HPV types that cause anogenital disease, including
cervical cancer and genital warts. Herpes zoster (HZ) vaccine is intended to
prevent shingles and its complications. The use of these two vaccines will
immediately begin to impact dermatologic practice throughout the world and will
reduce the healthcare burden associated with the diseases caused by the two
viruses. The following review summarizes the relevant pathophysiology and
epidemiology of genital warts, cervical neoplasia, and herpes zoster and
describes the recent trials that have demonstrated efficacy and safety of the HPV
and HZ vaccines. LEARNING OBJECTIVES: Following the completion of this learning
activity, the participant will be able to describe the mechanisms of HPV and
varicella zoster virus infection as well as pathogenesis, identify key aspects of
the immune system involved in clearing the infection, and prescribe HPV and HZ
vaccines for prevention of disease.

Publication Types: 
    Review

PMID: 18280332 [PubMed - indexed for MEDLINE]

373: Pediatr Infect Dis J. 2008 Mar;27(3):265-8.

Triad of severe abdominal pain, inappropriate antidiuretic hormone secretion, and
disseminated varicella-zoster virus infection preceding cutaneous manifestations 
after hematopoietic stem cell transplantation: utility of PCR for early
recognition and therapy.

Rau R, Fitzhugh CD, Baird K, Cortez KJ, Li L, Fischer SH, Cowen EW, Balow JE,
Walsh TJ, Cohen JI, Wayne AS.

Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute,
National Institutes of Health, Bethesda, MD 20892-1104, USA.

A hematopoietic stem cell transplant recipient developed abdominal pain,
pneumatosis intestinalis, hepatitis, pancreatitis, and inappropriate antidiuretic
hormone secretion. Blood for varicella-zoster virus (VZV) DNA polymerase chain
reaction was positive. She was treated with acyclovir and subsequently developed 
VZV antigen-positive zoster. Detection of VZV DNA in blood may be useful for
early diagnosis in immunocompromised hosts who present with zoster without skin
lesions.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Intramural

PMID: 18277922 [PubMed - indexed for MEDLINE]

374: J Prev Med Hyg. 2007 Sep;48(3):65-71.

VZV infection: epidemiology and prevention.

Gabutti G.

Publication Types: 
    Editorial
    Review

PMID: 18274340 [PubMed - indexed for MEDLINE]

375: BJOG. 2008 Mar;115(4):492-500.

Fetal exposure to herpesviruses may be associated with pregnancy-induced
hypertensive disorders and preterm birth in a Caucasian population.

Gibson CS, Goldwater PN, MacLennan AH, Haan EA, Priest K, Dekker GA; South
Australian Cerebral Palsy Research Group.

Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide,
South Australia, Australia. catherine.s.gibson@adelaide.edu.au

OBJECTIVE: To investigate the role of fetal viral infection in the development of
a range of adverse pregnancy outcomes (APOs), including pregnancy-induced
hypertensive disorders (PIHD), antepartum haemorrhage (APH), birthweight <10th
percentile (small for gestational age, SGA) and preterm birth (PTB). DESIGN:
Population-based case-control study. SETTING: Laboratory-based study. POPULATION:
The newborn screening cards of 717 adverse pregnancy cases and 609 controls.
METHODS: Newborn screening cards were tested for RNA from enteroviruses and DNA
from herpesviruses using polymerase chain reaction (PCR). The herpesviruses were 
detected using two PCRs, one detecting nucleic acids from herpes simplex virus
(HSV)-1, HSV-2, Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human
herpesvirus (HHV)-8, hereafter designated Herpes PCR group A viruses, and the
other detecting nucleic acids from varicella-zoster virus (VZV), HHV-6 and HHV-7,
hereafter designated Herpes PCR group B viruses. MAIN OUTCOME MEASURE: Odds
ratios and 95% CIs for specific APOs. RESULTS: For both term and PTBs, the risk
of developing PIHD was increased in the presence of DNA from Herpes PCR group B
viruses (OR 3.57, 95% CI 1.10-11.70), CMV (OR 3.89, 95% CI 1.67-9.06), any
herpesvirus (OR 5.70, 95% CI 1.85-17.57) and any virus (OR 5.17, 95% CI
1.68-15.94). The presence of CMV was associated with PTB (OR 1.61, 95% CI
1.14-2.27). No significant association was observed between SGA or APH and
exposure to viral infection. CONCLUSIONS: Fetal exposure to herpesvirus infection
was associated with PIHD for both term and PTBs in this exploratory study.
Exposure to CMV may also be associated with PTB. These findings need confirmation
in future studies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18271886 [PubMed - indexed for MEDLINE]

376: Ophthalmology. 2008 Feb;115(2 Suppl):S35-8.

Preventing herpes zoster through vaccination.

Gelb LD.

Division of Infectious Disease, Washington University School of Medicine,
Department of Internal Medicine, Barnes-Jewish Medical Center, St. Louis,
Missouri 63110, USA. ldgelb@swbell.net

TOPIC: The role of the zoster vaccine in the prevention of herpes zoster and its 
sequelae, including postherpetic neuralgia (PHN) and herpes zoster ophthalmicus. 
CLINICAL RELEVANCE: Wide administration of the herpes zoster vaccine in
accordance with the recommendations of the Centers for Disease Control and
Prevention Advisory Committee on Immunization Practices (ACIP) will lead to a
decline in the incidence and morbidity of herpes zoster and its complications,
including PHN. METHODS: The key study leading to the approval of the zoster
vaccine for use, the Centers for Disease Control and Prevention ACIP's
recommendations for appropriate use of the zoster vaccine, and predictions
regarding the cost efficacy of a zoster vaccination program are reviewed.
RESULTS: The Shingles Prevention Study established that the zoster vaccine was
safe, well tolerated, and effective in reducing the burden of illness due to
herpes zoster and the incidence of PHN. The ACIP recommended that the zoster
vaccine be given to adults 60 and older for the prevention of herpes zoster.
Cost-efficacy analyses suggest that the greatest gain in quality-adjusted
life-years can be gained by vaccinating individuals at the younger end of the
ACIP-recommended age range. CONCLUSION: The zoster vaccine promises to reduce the
morbidity and mortality of herpes zoster. Administering the vaccine at the
younger end of the age range may offer a greater cost benefit.

Publication Types: 
    Review

PMID: 18243932 [PubMed - indexed for MEDLINE]

377: Ophthalmology. 2008 Feb;115(2 Suppl):S33-4.

Use of photorefractive keratectomy in a patient with a corneal scar secondary to 
herpes zoster ophthalmicus.

Kaufman SC.

Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota
55455, USA. corneamd2000@yahoo.com

TOPIC: The use of LASIK surgery to correct vision in a patient with postzoster
corneal scarring. CLINICAL RELEVANCE: The cornea is commonly involved in cases of
herpes zoster ophthalmicus, and as a result, corneal scarring after a
varicella-zoster virus corneal infection is common. Corneal scars can be treated 
by lamellar keratoplasty or keratectomy, which may be performed using a
microkeratome or excimer laser phototherapeutic keratectomy (PTK). However,
articles on studies concerning the treatment of postherpetic scars by PTK have
been published, offering conflicting results. LASIK surgery may offer an
additional therapeutic approach to corneal scarring. METHODS: A patient seeking
corrective surgery to improve vision was found to have corneal scarring. RESULTS:
The patient experienced successful vision correction. CONCLUSION: LASIK surgery
can be conducted even in a patient with postzoster corneal scarring. No
complications were apparent in this case.

Publication Types: 
    Case Reports

PMID: 18243931 [PubMed - indexed for MEDLINE]

378: Ophthalmology. 2008 Feb;115(2 Suppl):S3-12.

Herpes zoster ophthalmicus natural history, risk factors, clinical presentation, 
and morbidity.

Liesegang TJ.

Mayo Clinic College of Medicine, Jacksonville, Florida 32224, USA.
tliesegang@mayo.edu

TOPIC: The incidence and morbidity of herpes zoster (HZ) and HZ ophthalmicus
(HZO), and the potential impact of varicella vaccine on their epidemiology.
CLINICAL RELEVANCE: Herpes zoster affects 20% to 30% of the population at some
point in their lifetime; approximately 10% to 20% of these individuals will have 
HZO. METHODS: The peer-reviewed literature published from 1865 to the present was
reviewed. RESULTS: Herpes zoster is the second clinical manifestation of
varicella-zoster virus (VZV). The incidence and severity of HZ increase with
advancing age. Varicella-zoster virus-specific cell-mediated immunity, which
keeps latent VZV in check and is boosted by periodic reexposure to VZV, is an
important mechanism in preventing VZV reactivation as zoster. Thus, widespread
varicella vaccination may change the epidemiology of HZ. Herpes zoster
ophthalmicus occurs when HZ presents in the ophthalmic division of the fifth
cranial nerve. Ocular involvement occurs in approximately 50% of HZ patients
without the use of antiviral therapy. There is a long list of complications from 
HZ, including those that involve the optic nerve and retina in HZO, but the most 
frequent and debilitating complication of HZ regardless of dermatomal
distribution is postherpetic neuralgia (PHN), a neuropathic pain syndrome that
persists or develops after the zoster rash has resolved. The main risk factor for
PHN is advancing age; other risk factors include severe acute zoster pain and
rash, a painful prodrome, and ocular involvement. Many cases of HZ, HZO, and PHN 
can be prevented with the zoster vaccine. CONCLUSION: Vaccination is key to
preventing HZ, HZO, and PHN, but strategies for both varicella and HZ vaccines
will need to be evaluated and adjusted periodically as changes in the
epidemiology of these VZV diseases become more evident.

Publication Types: 
    Review

PMID: 18243930 [PubMed - indexed for MEDLINE]

379: Ophthalmology. 2008 Feb;115(2 Suppl):S24-32.

Anterior segment complications of herpes zoster ophthalmicus.

Kaufman SC.

Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota
55455, USA. corneamd2000@yahoo.com

TOPIC: The clinical features and management strategies for varicella-zoster virus
(VZV) infections of the cornea, lids, and adnexa. CLINICAL RELEVANCE: Herpes
zoster ophthalmicus (HZO) can result in a myriad of chronic and recurrent
complications that may be sight threatening. Surgical intervention is the
mainstay of treatment, and advancements in this area may lessen the complications
of HZO if correctly implemented. METHODS: Literature review of pertinent topics, 
authors, and journals utilizing the National Institutes of Health PubMed service.
RESULTS: A higher rate of treatment success for VZV-related complications was
obtained when any preexisting ocular inflammation, increased intraocular
pressure, lagophthalmos, dry eye, exposure, or neurotrophic keratitis was treated
and under control before attempting ocular surgery. CONCLUSION: Options are
available to manage ophthalmic complications of HZO and reduce the risk of
treatment failure.

Publication Types: 
    Review

PMID: 18243929 [PubMed - indexed for MEDLINE]

380: Ophthalmology. 2008 Feb;115(2 Suppl):S21-3.

Boston keratoprosthesis treatment of herpes zoster neurotrophic keratopathy.

Pavan-Langston D, Dohlman CH.

Massachusetts Eye And Ear Infirmary, Harvard Medical School, Boston,
Massachusetts 02114, USA. deborah.langston@schepens.harvard.edu

TOPIC: The successful use of the Boston keratoprosthesis in a severely inflamed
ulcer in herpes zoster neurotrophic keratopathy. CLINICAL RELEVANCE:
Approximately 10% to 20% of patients with herpes zoster will develop herpes
zoster ophthalmicus (HZO). Antiviral medication forms the foundation of
pharmacologic treatment for acute herpes zoster, but management of HZO is
supplemented with topical and systemic antimicrobials and corticosteroid agents
as well as surgical interventions. However, HZO is associated with poor healing, 
as evidenced by a high occurrence of ulceration, superinfection, and surgical
failure. METHODS: A 95-year-old man was referred for corneal edema in the right
eye. There was a history of acute herpes zoster in the right eye 10 months
previously. Slit-lamp examination revealed lagophthalmos, ectropion, total
corneal anesthesia, and marked inferior corneal edema. Despite surgical repair of
all lid abnormalities and aggressive lubrication and management of rosacea
blepharitis, the corneal surface remained unhealthy. Four months later, the
patient presented with an inflamed hypopyon ulcer, culture positive for abundant 
Pseudomonas and Candida albicans. The ulcer progressed to descemetocele in the
face of aggressive antimicrobial therapy, vision was light perception (LP), and
perforation became imminent. A Boston keratoprosthesis was used to replace the
severely damaged cornea, and extracapsular cataract extraction of a mature
cataract was also performed. RESULTS: One week after surgery, the inflammation
was almost entirely resolved, and cultures of the host button were negative for
any organisms. Vision gradually increased from LP to 20/60 over the ensuing 4
months. CONCLUSION: The Boston keratoprosthesis procedure successfully salvaged
and restored vision in this high-risk herpes zoster eye in which standard
keratoplasty would almost certainly have failed.

Publication Types: 
    Case Reports

PMID: 18243928 [PubMed - indexed for MEDLINE]

381: Ophthalmology. 2008 Feb;115(2 Suppl):S13-20.

Herpes zoster antivirals and pain management.

Pavan-Langston D.

Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston,
Massachusetts 02114, USA. deborah.langston@meei.harvard.edu

TOPIC: Evaluation of evidence-based strategies for managing herpes zoster (HZ)
and the pain of postherpetic neuralgia (PHN). CLINICAL RELEVANCE: Approximately
20% of the world's population suffers from herpes zoster at least once in a
lifetime, with 10% to 20% having ophthalmic involvement. Treatment of the acute
disease with oral antivirals may reduce the incidence and severity of
complications but does not reliably prevent PHN or postherpetic itch (PHI). The
acute pain abates as the acute phase resolves; the long-term pain of PHN or PHI
may be severe and difficult to manage. Although many therapeutic agents have
efficacy in the management of these complications, relief is frequently partial
for months to the remainder of the lifetime. METHODS: Literature review was
performed using the resources of the Harvard Medical School/Massachusetts Eye and
Ear Infirmary Ophthalmic library as well as the National Library of Medicine and 
the National Institutes of Health PubMed service searching by pertinent topics,
authors, and journals. RESULTS: If started within 72 hours of the onset of the
acute HZ rash, the oral antiviral agents acyclovir, valacyclovir, and famciclovir
significantly shorten the periods of acute pain, virus shedding, rash, acute and 
late-onset anterior segment complications, and, in the case of valacyclovir and
famciclovir, the incidence and severity of PHN. However, these medications do not
prevent PHN, which remains a common and debilitating complication of HZ in older 
patients, requiring assiduous pain management. Tricyclic antidepressants,
antiseizure drugs, opioids, and topical analgesics all offer some pain relief,
and may be combined. CONCLUSION: Options are available to manage HZ and reduce
the pain of PHN. However, prevention, now possible with the HZ vaccine, is
preferable to treatment.

Publication Types: 
    Review

PMID: 18243927 [PubMed - indexed for MEDLINE]

382: Am J Hematol. 2008 Jun;83(6):472-6.

Long-term ultra-low-dose acyclovir against varicella-zoster virus reactivation
after allogeneic hematopoietic stem cell transplantation.

Asano-Mori Y, Kanda Y, Oshima K, Kako S, Shinohara A, Nakasone H, Sato H,
Watanabe T, Hosoya N, Izutsu K, Asai T, Hangaishi A, Motokura T, Chiba S,
Kurokawa M.

Department of Hematology and Oncology, Graduate School of Medicine, University of
Tokyo, Tokyo, Japan.

To evaluate the efficacy of long-term prophylaxis with ultra-low-dose acyclovir
against varicella-zoster virus (VZV) reactivation, we analyzed the records of 242
Japanese adult patients who underwent allogeneic hematopoietic stem cell
transplantation for the first time from 1995 to 2006 at our hospital. We started 
long-term oral acyclovir at 200 mg/day in July 2001. Acyclovir was continued
until the end of immunosuppressive therapy and at least 1 year after
transplantation. Sixty-six patients developed VZV reactivation at a median of 248
days after HSCT, with a cumulative incidence of 34.7%. Only one breakthrough
reactivation occurred during long-term acyclovir, which responded well to
therapeutic dose of valacyclovir. The use of long-term acyclovir was the only
independent determinant that significantly decreased the overall incidence of VZV
reactivation (20% vs. 50%, P < 0.0001). With this prophylaxis, visceral
dissemination and serious complications other than post-herpetic neuralgia was
completely eliminated, and thereby need for hospitalization was significantly
reduced (21% vs. 71%, P = 0.0034). Fifteen of the 57 patients who discontinued
acyclovir developed VZV reactivation, with a cumulative incidence of 32.1%. VZV
reactivation following discontinuation tended to occur in patients who were
receiving immunosuppressive therapy at the cessation of acyclovir. These findings
suggested that long-term prophylaxis of ultra-low-dose acyclovir resulted in a
successful prevention of severe VZV-related symptoms and death, with a
significantly decreased overall incidence of VZV reactivation. Prolongation of
prophylactic acyclovir on profound immunosuppression might be important for
thorough suppression of VZV reactivation. Copyright 2008 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18266207 [PubMed - indexed for MEDLINE]

383: J Infect Dis. 2008 Mar 1;197(5):654-7.

Comment in:
    J Infect Dis. 2008 Mar 1;197(5):635-7.    J Infect Dis. 2008 Mar 1;197(5):646-53.

Varicella-zoster virus in the saliva of patients with herpes zoster.

Mehta SK, Tyring SK, Gilden DH, Cohrs RJ, Leal MJ, Castro VA, Feiveson AH, Ott
CM, Pierson DL.

Enterprise Advisory Services, Inc., USA.

Fifty-four patients with herpes zoster were treated with valacyclovir. On
treatment days 1, 8, and 15, pain was scored and saliva examined for
varicella-zoster virus (VZV) DNA. VZV DNA was found in every patient the day
treatment was started and later disappeared in 82%. There was a positive
correlation between the presence of VZV DNA and pain and between VZV DNA copy
number and pain (P <.0005). VZV DNA was present in 1 patient before rash and in 4
after pain resolved and was not present in any of 6 subjects with chronic pain or
in 14 healthy subjects. Analysis of human saliva has potential usefulness in the 
diagnosis of neurological disease produced by VZV without rash.

Publication Types: 
    Evaluation Studies
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 18260763 [PubMed - indexed for MEDLINE]

384: J Infect Dis. 2008 Mar 1;197(5):635-7.

Comment on:
    J Infect Dis. 2008 Mar 1;197(5):646-53.    J Infect Dis. 2008 Mar 1;197(5):654-7.

Herpes zoster: new insights provide an important wake-up call for management of
nosocomial transmission.

Breuer J.

Publication Types: 
    Comment
    Editorial

PMID: 18260760 [PubMed - indexed for MEDLINE]

385: J Infect Dis. 2008 Mar 1;197(5):646-53.

Comment in:
    J Infect Dis. 2008 Mar 1;197(5):635-7.

Comment on:
    J Infect Dis. 2008 Mar 1;197(5):654-7.

Transmission of a newly characterized strain of varicella-zoster virus from a
patient with herpes zoster in a long-term-care facility, West Virginia, 2004.

Lopez AS, Burnett-Hartman A, Nambiar R, Ritz L, Owens P, Loparev VN, Guris D,
Schmid DS.

National Center for Immunizations and Respiratory Diseases, Centers for Disease
Control and Prevention, Atlanta, Georgia, USA. alopez@cdc.gov

We investigated a small outbreak of varicella in a long-term-care facility after 
a case of herpes zoster. Clinical specimens and environmental samples were
collected from all case patients and from surfaces in the case patients' rooms
and other common-use areas. Wild-type varicella-zoster virus (VZV) DNA was
identified in all 3 varicella case patients, and high concentrations of VZV DNA
were detected in environmental samples from the room of the herpes zoster case
patient. Genotypic analysis showed that the identical VZV strain was present in
all samples; moreover, the strain was a unique Mosaic genotype isolate that
included a stable Oka vaccine marker that had hitherto never been observed in a
wild-type strain of VZV. This study provides evidence for the value of including 
environmental sampling during the investigation of varicella outbreaks and
illustrates the importance of evaluating multiple vaccine-associated markers for 
the discrimination of vaccine virus from wild-type VZV.

Publication Types: 
    Comment

PMID: 18260757 [PubMed - indexed for MEDLINE]

386: Zhongguo Zhen Jiu. 2007 Oct;27(10):729-30.

[Observation on therapeutic effect of pricking blood therapy combined with
acupuncture on herpes zoster]

[Article in Chinese]

Huo HM, Yang XP.

Department of Dermatology, Jimo Third People's Hospital, Shandong 266200, China.

OBJECTIVE: To compare the therapeutic effects of pricking blood therapy combined 
with acupuncture and routine western medicine on herpes zoster. METHODS: Two
hundred and forty cases were randomly divided into 2 groups, 120 cases in each
group. The treatment group were treated with acupuncture combined with pricking
blood therapy on the point with the most pain, and cupping and surround needling;
the control group with external application and oral administration of Aciclovir 
plaster and Aciclovir tablets, respectively. Their therapeutic effects were
compared. RESULTS: The total effective rate was 92.5% in the treatment group and 
55.8% in the control group with a very significant difference between the two
groups (P < 0.01). The time of producing killing pain, stopping vesication and
scabbing in the treatment group was shorter than that in the control group.
CONCLUSION: The pricking blood therapy combined with acupuncture is an effective 
therapy for herpes zoster.

Publication Types: 
    English Abstract
    Randomized Controlled Trial

PMID: 18257346 [PubMed - indexed for MEDLINE]

387: Drug Ther Bull. 2008 Feb;46(2):14-6.

Lidocaine plasters for postherpetic neuralgia?

BMJ Group.

Each year in the UK, about 1 in 2,500 people experiences neuropathic pain that is
still present 3-6 months after acute herpes zoster (shingles). This condition,
known as postherpetic neuralgia, is the most common complication of herpes zoster
and can be chronic, intractable and distressing. Treatments used in an attempt to
reduce postherpetic neuralgia include tricyclic antidepressants (e.g.
amitriptyline--an unlicensed indication), antiepileptics (e.g. gabapentin) and
opioid analgesics, as well as topical treatments such as capsaicin. However, such
treatments may only provide partial pain relief, and tolerability can be a
problem, particularly in older patients. Versatis (Grunenthal Ltd), a topical
preparation of lidocaine formulated in a plaster, has recently been licensed for 
treating patients with postherpetic neuralgia. Does it offer useful benefit?

PMID: 18256177 [PubMed - indexed for MEDLINE]

388: J Virol. 2008 Apr;82(8):3971-83. Epub 2008 Feb 6.

Mechanisms of varicella-zoster virus neuropathogenesis in human dorsal root
ganglia.

Reichelt M, Zerboni L, Arvin AM.

Stanford University School of Medicine, 300 Pasteur Dr., Grant Bldg., Room S356, 
Stanford, CA 94305, USA. reichelt@stanford.edu

Varicella-zoster virus (VZV) is a human alphaherpesvirus that infects sensory
ganglia and reactivates from latency to cause herpes zoster. VZV replication was 
examined in human dorsal root ganglion (DRG) xenografts in mice with severe
combined immunodeficiency using multiscale correlative immunofluorescence and
electron microscopy. These experiments showed the presence of VZV genomic DNA,
viral proteins, and virion production in both neurons and satellite cells within 
DRG. Furthermore, the multiscale analysis of VZV-host cell interactions revealed 
virus-induced cell-cell fusion and polykaryon formation between neurons and
satellite cells during VZV replication in DRG in vivo. Satellite cell infection
and polykaryon formation in neuron-satellite cell complexes provide mechanisms to
amplify VZV entry into neuronal cell bodies, which is necessary for VZV transfer 
to skin in the affected dermatome during herpes zoster. These mechanisms of VZV
neuropathogenesis help to account for the often severe neurologic consequences of
herpes zoster.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18256143 [PubMed - indexed for MEDLINE]

389: Cochrane Database Syst Rev. 2008 Jan 23;(1):CD005582.

Corticosteroids for preventing postherpetic neuralgia.

He L, Zhang D, Zhou M, Zhu C.

West China Hospital, Sichuan University, Department of Neurology, Wai Nan Guo Xue
Xiang #37, Chengdu, Sichuan, China, 610041. hlwsy@hotmail.com

BACKGROUND: Postherpetic neuralgia is a common serious complication of herpes
zoster. Corticosteroids are anti-inflammatory and might be beneficial.
OBJECTIVES: To examine the efficacy of corticosteroids in preventing postherpetic
neuralgia. SEARCH STRATEGY: Search for randomised or quasi-randomised controlled 
trials for corticosteroids for preventing postherpetic neuralgia in MEDLINE (1950
to 2006), EMBASE (1980 to 2006), LILACS (1982 to 2005), the Chinese Biomedical
Retrieval System (1978 to 2006) and the Cochrane Register of Controlled Trials
(CENTRAL) (Cochrane Library Issue 3, 2006). Date of most recent search: September
2006. SELECTION CRITERIA: Types of studies: quasi-randomised or randomised
controlled trials. Types of participants: people of all ages with herpes zoster
of all degrees of severity within seven days after onset. Types of interventions:
all kinds of corticosteroids given by oral, intramuscular or intravenous routes
during the acute stage (starting within one week of onset of the rash) compared
with no treatment or placebo, but not with other treatments. We also included
trials which compared corticosteroids plus routine treatment with placebo plus
routine treatment. Types of outcome measures: Primary: the presence of
postherpetic neuralgia six months after the onset of the acute herpetic rash.
Secondary: pain severity measured by a validated visual analogue scale or
numerical descriptive scale after three, six and 12 months; quality of life
measured with the short form 36 questionnaire after six months; adverse events
during or within two weeks after stopping treatment. DATA COLLECTION AND
ANALYSIS: Data were extracted by two independent reviewers. MAIN RESULTS: Five
trials were included with altogether 787 participants. All were randomised,
double-blind, placebo-controlled parallel group studies. Our primary outcome
measure was the presence of postherpetic neuralgia six months after the onset of 
the acute herpetic rash. There was no significant difference between the
corticosteroid and control groups for the primary outcome (RR 1.27, 95% CI 0.20
to 7.97). There was also no significant difference between the corticosteroid
plus antiviral agents and placebo plus antiviral agents groups for the primary
outcome (RR 0.90, 95% CI 0.40 to 2.03). No included trials evaluated pain
severity with a validated visual analogue scale or numerical descriptive scale
and also no trials measured quality of life with the Short Form 36 questionnaire.
Adverse events during or within two weeks after stopping treatment were reported 
by all five included trials, but after meta-analysis, there was no significant
difference in any serious adverse event (death, acute cardiac insufficiency, rash
dissemination, bacterial pneumonia or haematemesis) or non serious adverse event 
(dizziness, nausea, vomiting, hypertension or hyperglycaemia). AUTHORS'
CONCLUSIONS: There was insufficient evidence to conclude that corticosteroids are
safe or effective in the prevention of postherpetic neuralgia. More randomised
controlled trials with a greater number of participants are needed to determine
reliably whether there is real benefit (or harm) from the use of corticosteroid
therapy to prevent postherpetic neuralgia. Future trials should measure function 
and quality of life.

Publication Types: 
    Meta-Analysis
    Review

PMID: 18254083 [PubMed - indexed for MEDLINE]

390: Br J Clin Pharmacol. 2008 Feb;65(2):203-9.

Nonsteroidal anti-inflammatory drug use and the risk of severe skin and soft
tissue complications in patients with varicella or zoster disease.

Mikaeloff Y, Kezouh A, Suissa S.

Pediatric Department, Assistance publique-Hopitaux de Paris, Bicetre University
Hospital, Le Kremlin Bicetre, France.

What is already known about this subject: Three previous epidemiological studies 
found an increased risk of severe skin and soft tissue infectious complications
associated with exposure to NSAIDs in children with varicella. In vitro studies
demonstrated that decreases in defences against infections induced by NSAIDs
could be due to impairment of neutrophil blood cell function. What this study
adds: The use of NSAIDs is associated with an increased risk of severe skin and
soft tissue complication of varicella in children. The use of NSAIDs is also
associated with a small increased risk of such complications in zoster disease in
adults and the elderly. This study supports the limited prescription of NSAIDs in
VZV infection. AIMS: To assess the risk of severe skin and soft tissue
complications associated with the use of nonsteroidal anti-inflammatory drugs
(NSAIDs) in treating patients with varicella zoster virus infection. METHODS: The
design was a nested case-control study, with matching for age and practice. The
setting was primary care in the United Kingdom (United Kingdom's General Practice
Research Database). Two population-based cohorts of all patients with a primary
varicella (n = 140,111) or zoster (n = 108,257) diagnosis during 1994-2005 were
followed up for 2 months after diagnosis. Main outcome measures of severe skin or
soft tissue complications (mostly cellulitis and abscess) associated with current
NSAID or paracetamol use were estimated, and adjusted for potential confounding
factors, including sex, drug use, and comorbidity. RESULTS: In patients with
varicella, there were 386 cases of severe skin or soft tissue complications (rate
2.8 per 1000) during the 2 month follow-up period (mean age 10.7 years). The rate
of complications associated with exposure to NSAIDs was increased (rate ratio
4.9; 95% CI 2.1, 11.4). In patients with zoster disease, there were 681 cases of 
severe skin or soft tissue complications (rate 6.3 per 1000) during the 2 month
follow-up (mean age 60.9 years). The rate ratio of complications associated with 
exposure to NSAIDs was 1.6 (95% CI 1.1, 2.4). In both conditions, there was no
increased risk of complication associated with a current exposure to paracetamol.
CONCLUSIONS: The use of NSAIDs is associated with an elevated risk of severe skin
and soft tissue complications of varicella zoster virus infection, mostly in
children with varicella.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 18251759 [PubMed - indexed for MEDLINE]

391: Emerg Med Clin North Am. 2008 Feb;26(1):217-31, viii.

Ophthalmologic complications of systemic disease.

Klig JE.

Division of Pediatric Emergency Medicine, Boston University School of Medicine,
Boston Medical Center, MA 02118, USA. jean.klig@bmc.org

The human eye, as an organ, can offer critical clues to the presence of systemic 
disease. This article discusses the various ophthalmologic manifestations of
systemic disease that can be evident on examination by an emergency department
provider, as well as some findings that can be discerned with specialty
consultation. The following topics are reviewed with respect to potential ocular 
signs and complications: syphilis, herpes zoster, Lyme disease, acquired
immunodeficiency syndrome, Reiter's syndrome, Kawasaki's disease, temporal
arteritis, endocarditis, hypertension, and diabetes mellitus. Indications for
emergent ophthalmologic consultation are also emphasized.

Publication Types: 
    Review

PMID: 18249264 [PubMed - indexed for MEDLINE]

392: J Fam Pract. 2008 Feb;57(2):81.

Comment on:
    J Fam Pract. 2007 Jul;56(7):551-3.

Diagnostic tips for ophthalmic zoster.

Opstelten W, Zaal MJ.

Publication Types: 
    Comment
    Letter

PMID: 18248726 [PubMed - indexed for MEDLINE]

393: Cornea. 2008 Jan;27(1):103-6.

Three cases of idiopathic "multiple-parallel-line" endotheliitis.

Hori Y, Maeda N, Kosaki R, Inoue T, Tano Y.

Department of Ophthalmology, Osaka University Medical School, Suita, Japan.
hori@ophthal.med.osaka-u.ac.jp

PURPOSE: To report 3 cases of idiopathic endotheliitis that appeared clinically
as multiple parallel lines of keratic precipitates on the corneal endothelium.
METHODS: Interventional case reports. RESULTS: Slit-lamp examinations of the 3
patients showed several parallel dotted lines of keratic precipitates on the
corneal endothelium. Although all cases were managed successfully by topical
steroid in 1 week, corneal endothelial cell damage occurred. No virus (herpes
simplex virus 1, varicella zoster virus, or cytomegalovirus) could be detected by
reverse transcriptase polymerase chain reaction in the aqueous humor of 1 of the 
3 patients. CONCLUSIONS: This series of cases presented a unique type of
idiopathic endotheliitis with the clinical appearance of multiple and parallel
lines of keratic precipitates. The expression patterns of the keratic
precipitates were distinct from those of previously reported linear
endotheliitis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 18245976 [PubMed - indexed for MEDLINE]

394: Br J Ophthalmol. 2008 Apr;92(4):505-8. Epub 2008 Feb 1.

Association of varicella zoster virus load in the aqueous humor with clinical
manifestations of anterior uveitis in herpes zoster ophthalmicus and zoster sine 
herpete.

Kido S, Sugita S, Horie S, Miyanaga M, Miyata K, Shimizu N, Morio T, Mochizuki M.

Department of Ophthalmology & Visual Science, Tokyo Medical and Dental University
Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

AIM: To investigative whether clinical manifestations of anterior uveitis are
associated with the viral load of varicella zoster virus (VZV) in the aqueous
humor in patients with herpes zoster ophthalmicus (HZO) and zoster sine herpete
(ZSH). METHODS: After informed consent was given, an aliquot of aqueous humor was
collected from patients with VZV anterior uveitis (n = 8). Genomic DNA of the
human herpes viruses was measured in the aqueous humor by two PCR assays: a
qualitative multiplex PCR and a quantitative real-time PCR. RESULTS: All patients
had unilateral acute anterior uveitis with high intraocular pressure, mutton fat 
keratic precipitates with some pigmentation, and trabecular meshwork
pigmentation. Multiplex PCR demonstrated VZV genomic DNA in all of the samples,
but not in other human herpes virus samples (human simplex virus types 1 and 2,
Epstein-Barr virus, cytomegalovirus and human herpes virus types 6, 7 and 8).
Real-time PCR revealed a high copy number of VZV DNA in the aqueous humor. After 
the initial onset of anterior uveitis, iris atrophy and distorted pupil with
paralytic mydriasis developed. The intensity of iris atrophy and pupil
distortion, but not ocular hypertension, correlated with the viral load of VZV in
the aqueous humor. CONCLUSION: VZV viral load in the aqueous humor correlated
significantly with damage to the iris (iris atrophy and pupil distortion) in
patients with HZO and ZSH.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18245272 [PubMed - indexed for MEDLINE]

395: Med J Aust. 2008 Feb 4;188(3):171-6.

Comment in:
    Med J Aust. 2008 Sep 15;189(6):347.

The prevention and management of herpes zoster.

Cunningham AL, Breuer J, Dwyer DE, Gronow DW, Helme RD, Litt JC, Levin MJ,
Macintyre CR.

University of Sydney, Sydney, NSW, Australia. tony_cunningham@wmi.usyd.edu.au

The burden of illness from herpes zoster (HZ) and postherpetic neuralgia (PHN) in
the Australian community is high. The incidence and severity of HZ and PHN
increase with age in association with a progressive decline in cell-mediated
immunity to varicella-zoster virus (VZV). Antiviral medications (valaciclovir,
famciclovir, aciclovir) have been shown to be effective in reducing much but not 
all of the morbidity associated with HZ and PHN, but are consistently
underprescribed in Australia. Zoster-associated pain should be treated early and 
aggressively, as it is more difficult to treat once established. Clinicians
should be proactive in their follow-up of individuals at high risk of developing 
PHN, and refer patients to a specialist pain clinic earlier, rather than later. A
live, attenuated VZV vaccine (Oka/Merck strain, Zostavax [Merck Sharp & Dohme])
has proven to be efficacious in reducing the incidence of and morbidity
associated with HZ and PHN in older adults. The vaccine's efficacy has been shown
to persist for at least 4 years, but is likely to last a lot longer. Ongoing
surveillance will determine the duration of protection and whether a booster dose
is required. Clinicians should consider recommending the vaccine, which can be
safely administered at the same time as the inactivated influenza vaccine, to all
immunocompetent patients aged 60 years or older. Clinicians should refer to the
Australian immunisation handbook for advice on the use of the live vaccine in
immunosuppressed individuals.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18241179 [PubMed - indexed for MEDLINE]

396: Nippon Ganka Gakkai Zasshi. 2008 Jan;112(1):30-8.

[Detection of herpesvirus genome by multiplex polymerase chain reaction (PCR) and
real-time PCR in ocular fluids of patients with acute retinal necrosis]

[Article in Japanese]

Sugita S, Iwanaga Y, Kawaguchi T, Futagami Y, Horie S, Usui T, Yamamoto S,
Sugamoto Y, Mochizuki M, Shimizu N, Watanabe K, Mizukami M, Morio T.

Department of Ophthalmology & Visual Science, Tokyo Medical and Dental
University, Japan.

PURPOSE: The human herpesvirus (HHV) family consists of types 1 to 8 (HHV1-8).
The purpose of this study was to investigate the detection of HHV DNA, especially
HSV1 (herpes simplex virus 1, HHV1), HSV2 (herpes simplex virus 2, HHV2), and VZV
(varicella-zoster virus, HHV3) in ocular fluids of patients with acute retinal
necrosis(ARN). METHODS: The intraocular genome for HHV1-8 was determined in 19
ocular fluid samples (12 vitreous fluid and 7 aqueous humor samples) taken from
ARN patients (n=14). The samples were tested for the presence of virus DNA by two
systems of polymerase chain reaction (PCR): the multiplex PCR screening test and 
real-time quantitative PCR. RESULTS: Multiplex PCR demonstrated VZV (n=16, 84%), 
HSV1 (n = 1.5%) or HSV2 (n = 2.11%)genomic DNA in all the samples. In real-time
PCR, a high copy number of virus DNA was detected. The virus DNA-positive samples
contained Epstein-Barr virus (EBV, HHV4) DNA in 9 of 19 samples (47%). No HHV6-8 
DNA was detected in the ocular samples, and no virus DNA was detected in the
serum samples. CONCLUSIONS: The genome for HHV1-3 was detected in the patients
with ARN. All cases contained a high copy number for the virus DNA that indicates
viral replication. PCR systems are useful for determing whether virus infections 
are associated with uveitis.

Publication Types: 
    English Abstract

PMID: 18240601 [PubMed - indexed for MEDLINE]

397: Harv Womens Health Watch. 2007 Oct;15(2):8.

By the way, doctor. I'm 67 and had shingles four years ago. Am I immune to it
now? If not, should I get the new shingles vaccine?

Robb-Nicholson C.

PMID: 18240445 [PubMed - indexed for MEDLINE]

398: Blood. 2008 Apr 1;111(7):3388-94. Epub 2008 Jan 31.

Risk of multiple myeloma and monoclonal gammopathy of undetermined significance
among white and black male United States veterans with prior autoimmune,
infectious, inflammatory, and allergic disorders.

Brown LM, Gridley G, Check D, Landgren O.

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National
Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
lindabrown@rti.org

In a retrospective cohort of more than 4 million white and black male United
States (US) veterans, we explored the role of specific prior autoimmune,
infectious, inflammatory, and allergic disorders in the etiology of multiple
myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS).
Patients were selected from computerized inpatient discharge records at US
Veterans Affairs hospitals. The analysis included 4641 patients (3040 white, 1601
black) and 2046 patients (1312 white; 734 black) with a discharge diagnosis of MM
and MGUS, respectively. Using Poisson regression, we calculated age-adjusted
relative risks (RRs) and 95% confidence intervals (CIs) for the relationship
between MM, MGUS, and specific prior medical conditions. Significantly elevated
risks of MM were associated with broad categories of autoimmune (RR, 1.15; 95%
CI, 1.02-1.28), infectious (RR, 1.29; 95% CI, 1.20-1.38), and inflammatory
disorders (RR, 1.18; 95% CI, 1.10-1.27) and specific prior autoimmune
(polymyositis/dermatomyositis, systemic sclerosis, autoimmune hemolytic anemia,
pernicious anemia, and ankylosing spondylitis), infectious (pneumonia, hepatitis,
meningitis, septicemia, herpes zoster, and poliomyelitis), and inflammatory
(glomerulonephritis, nephrotic syndrome, and osteoarthritis) disorders. Risks for
MGUS were generally of similar magnitude. Our results indicate that various types
of immune-mediated conditions might act as triggers for MM/MGUS development.

Publication Types: 
    Multicenter Study
    Research Support, N.I.H., Intramural

PMID: 18239085 [PubMed - indexed for MEDLINE]

399: Perspect Infirm. 2007 Nov-Dec;5(2):21; quiz 30-4.

[Recognizing shingles in order to prevent postherpetic neuropathy]

[Article in French]

Bourgault P, Lacombe G.

l'Ecole des sciences infirmieres de l'Universite de Sherbrooke.

Publication Types: 
    Case Reports
    Review

PMID: 18236882 [PubMed - indexed for MEDLINE]

400: ORL J Otorhinolaryngol Relat Spec. 2008;70(1):28-31; discussion 31. Epub
2008 Feb 1.

Herpes virus and Meniere's disease.

Gartner M, Bossart W, Linder T.

Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Luzern,
Luzern, Switzerland.

OBJECTIVE: The main goal of this study was to examine the vestibular ganglia from
patients with intractable classic Meniere's disease (MD) for the presence or
absence of DNA from three neurotropic viruses herpes simplex virus 1 and 2 (HSV1,
HSV2) and varicella zoster virus (VZV) and to investigate the hypothesis that MD 
is associated with virus reactivation within Scarpa's ganglion. STUDY DESIGN:
Polymerase chain reaction (PCR) was performed with nested primer sets specific
for viral genomic DNA of HSV1, HSV2 and VZV in biopsies of the ganglion scarpae
of patients with MD who underwent vestibular neurectomy. Included were patients
with MD classified as definite MD according to American Academy of
Otolaryngology/Head and Neck Surgery criteria. The ganglion scarpae and ganglion 
geniculi harvested at autopsy from patients without history of MD or facial palsy
served as control specimens. RESULTS: No viral DNA was detected in the vestibular
ganglion of 7 patients with definite MD. In 34% of the vestibular ganglia of the 
control group we detected either HSV1 or VZV. Only one Scarpa's ganglion had both
viruses present at the same time. Thirty-two out of 34 ganglia from the
geniculate segment of the facial nerve contained either HSV1 and/or VZV genomic
DNA. Eight specimens contained both viruses simultaneously. Altogether viral DNA 
was found in 94% of ganglia. Viral genomic DNA of HSV2 was not detected.
CONCLUSION: Although HSV and VZV appear to be present in many ganglion cells
throughout the human body, we were unable to find genomic DNA of these viruses in
patients with definite MD and disabling vertigo, who underwent vestibular
neurectomy. Based on these results, reactivation of HSV1 and VZV in the
vestibular ganglion does not seem to play a role in the pathogenesis of MD. (c)
2008 S. Karger AG, Basel

PMID: 18235203 [PubMed - indexed for MEDLINE]

401: Brain Nerve. 2008 Jan;60(1):79-83.

[Case of varicella myelitis in nursing care worker]

[Article in Japanese]

Takei-Suzuki M, Hayashi Y, Kimura A, Nagasawa M, Koumura A, Sakurai T, Tanaka Y, 
Hozumi I, Inuzuka T.

Department of Neurology and Geriatrics, Gifu University Graduate School of
Medicine, Yanagido, Japan.

Varicella myelitis is very rarely observed in healthy adult. We report the case
of 25-year-old nursing care worker who suffered from chickenpox for the first
time. Approximately 2 weeks prior to the development of the symptoms, she cared
for an old man who suffered from herpes zoster. She was admitted to our hospital,
and she complained of weakness and paresthesia in the lower limbs. Subsequently, 
she experienced vesicorectal disorders: this was followed 5 days later by the
appearance of a rash. Spinal T2-weighted MR images showed a high-intensity lesion
in the spinal cord at the level of Th9/10, and both IgM-type anti-VZV antibodies 
and VZV-DNA were present in her cerebrospinal fluid. Treatment comprising a
combination of acyclovir at 1,500 mg/day for 14 days and gamma-globulin with high
titer of IgG-type anti-VZV antibodies at 5 g/day for 5 days result in remarkable 
improvement. She was able to walk again. The high-intensity lesion in the spinal 
T2-weighted MR images disappeared. Urinary dysfunction disappeared completely
after 5 months. Care persons without anti-IgG antibodies against VZV are at a
high risk of contracting varicella infection. Guidelines for infection control in
home care, as well as hospitals, are necessary for caregivers.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 18232335 [PubMed - indexed for MEDLINE]

402: Int Tinnitus J. 2007;13(2):90-3.

Viral infection and serum antibodies to heat shock protein 70 in the acute phase 
of Meniere's disease.

DiBerardino F, Cesarani A, Hahn A, Alpini D.

Department of Audiology-Ear, Nose, and Throat, I.R.C.C.S. Fondazione Policlinico,
Mangiagalli e Regina Elena, University of Milan, Italy.
federica.diberardino@unimi.it

Meniere's disease (MD) is an idiopathic inner-ear disorder characterized by
fluctuating hearing loss, episodic vertigo, and tinnitus. Though MD's etiology is
unknown, growing evidence suggests that autoimmunity may be involved in its
development. The aim of this prospective study was to investigate the presence of
anti-heat shock protein 70 (anti-HSP70) antibodies during the acute phase of MD
and to relate its presence to the antibody pattern. We examined the sera of 13
patients by Western blot immunoassays for reactivity to bovine inner-ear antigen 
(anti-HSP70) antibodies. The presence of viral antibodies and autoantibodies
(herpes simplex, types 1, 2; herpes zoster; cytomegalovirus; Epstein-Barr; IgM;
IgG; cardiolipin; thyroglobulin and thyroperoxidase; and antinuclear,
antimitochondrial, and anti-smooth-cell antibodies) were also tested. We found
reactivity to HSP70 in only 1 of the 13 MD patients (7.7%), and it occurred
during herpes zoster reactivation. We found no relationship between the presence 
of antibodies to HSP70 and immunological or viral testing.

PMID: 18229786 [PubMed - indexed for MEDLINE]

403: Mayo Clin Health Lett. 2007 Oct;25(10):4.

Vaccine cuts by half the risk of developing shingles.

[No authors listed]

Publication Types: 
    News

PMID: 18229411 [PubMed - indexed for MEDLINE]

404: J Pain. 2008 Jan;9(1 Suppl 1):S37-44.

Diagnosis and assessment of pain associated with herpes zoster and postherpetic
neuralgia.

Dworkin RH, Gnann JW Jr, Oaklander AL, Raja SN, Schmader KE, Whitley RJ.

Department of Anesthesiology and Neurology, University of Rochester School of
Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, USA.
robert_dworkin@urmc.rochester.edu

Accurate evaluation of pain plays a critical role in identifying new
interventions for the treatment and prevention of herpes zoster and postherpetic 
neuralgia (PHN). Different types of pain and other sensory symptoms are found in 
patients with herpes zoster, and these vary greatly with respect to their
presence, location, duration, intensity, and quality. The results of recent
studies of herpes zoster and PHN and the development of new methods for assessing
neuropathic pain provide a foundation for diagnosing and assessing the pain
associated with herpes zoster. We review the results of recent research to
identify the essential components that must be considered in developing an
evidence-based description of pain associated with herpes zoster and PHN.
PERSPECTIVE: Comprehensive assessments of pain are necessary for clinical
research on the epidemiology, natural history, pathophysiologic mechanisms,
treatment, and prevention of pain in herpes zoster and PHN.

Publication Types: 
    Review

PMID: 18166464 [PubMed - indexed for MEDLINE]

405: J Pain. 2008 Jan;9(1 Suppl 1):S31-6.

Vaccination to prevent herpes zoster in older adults.

Gnann JW Jr.

Departments of Medicine, Pediatrics, and Microbiology, University of Alabama at
Birmingham, 908 20th Street South, Birmingham, AL 35294, USA. jgnann@uab.edu

Herpes zoster causes substantial morbidity, especially among older adults.
Although the acute cutaneous manifestations can be painful and troublesome, the
most important consequence of herpes zoster (shingles) is the chronic pain
syndrome known as postherpetic neuralgia (PHN). Previous studies have suggested
that declining varicella-zoster virus (VZV)-specific cell-mediated immune (CMI)
responses account for the increased frequency of herpes zoster seen in older
adults. This led to the idea that immunization designed to boost VZV-specific CMI
responses might reduce the risk of herpes zoster. This hypothesis was tested in a
large, randomized, placebo-controlled clinical trial called the Shingles
Prevention Study (SPS). Compared with the placebo group, herpes zoster vaccine
recipients had a 61.1% reduction in zoster "burden of illness" (an index
incorporating incidence and severity of herpes zoster); a 66.5% reduction in the 
incidence of postherpetic neuralgia; and a 51.3% reduction in the incidence of
herpes zoster. The incidence of serious adverse events was not different between 
the overall vaccine and placebo populations. The most frequently encountered
adverse event among vaccine recipients was local reactogenicity, with
self-limited and generally mild tenderness, warmth, or erythema occurring at the 
injection site in about one-half of vaccine recipients. The zoster vaccine was
approved by the US Food and Drug Administration in 2006 and is indicated for
prevention of herpes zoster in immunocompetent persons aged 60 years and older.
PERSPECTIVE: The herpes zoster vaccine provides physicians with an effective
means for reducing a patient's risk for developing shingles and its attendant
complications. No significant safety concerns regarding the vaccine have been
identified. Indications for use of the attenuated-virus vaccine in special
subpopulations continue to evolve.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18166463 [PubMed - indexed for MEDLINE]

406: J Pain. 2008 Jan;9(1 Suppl 1):S19-30.

An update on the treatment of postherpetic neuralgia.

Wu CL, Raja SN.

Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins
University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA.

Like other types of neuropathic pain, postherpetic neuralgia (PHN) can be
resistant to many types of pharmacologic and interventional therapies. Although
many analgesic agents have been used for the treatment of other types of
neuropathic pain, tricyclic antidepressants, antiepileptic drugs, opioids, and
lidocaine patch appear to demonstrate relative analgesic efficacy for the
treatment of pain from PHN. There are fewer studies on the use of interventional 
options for the treatment of pain from PHN. The majority of interventional
therapies show equivocal analgesic efficacy although some data indicate that
intrathecal methylprednisolone may be effective. Further randomized, controlled
trials will be needed to confirm the analgesic efficacy of analgesic and
interventional therapies to determine their role in the overall treatment of
patients with PHN. PERSPECTIVE: This article reviews the analgesic options for
the treatment of PHN and suggests that tricyclic antidepressants, membrane
stabilizers, opioids, and lidocaine patch may demonstrate analgesic efficacy in
this group of patients. These data may potentially help clinicians who attempt to
provide analgesia in patients with PHN.

Publication Types: 
    Research Support, N.I.H., Extramural
    Review

PMID: 18166462 [PubMed - indexed for MEDLINE]

407: J Pain. 2008 Jan;9(1 Suppl 1):S10-8.

Mechanisms of pain and itch caused by herpes zoster (shingles).

Oaklander AL.

Departments of Neurology and Pathology, Massachusetts General Hospital, Harvard
Medical School, 275 Charles Street, Boston, MA 02114, USA.
aoaklander@partners.org

Study of humans with shingles or postherpetic neuralgia (PHN) is providing
insights into pain mechanisms. Shingles pain is a combination of normal and
neuropathic pain that reflects acute tissue and neural injury. PHN pain, which
lasts after tissues have healed, is caused by persistent neural injuries.
Spontaneous C-nociceptor activity has been documented in painful polyneuropathies
and probably occurs in shingles as well, although there are no microneurographic 
studies of either shingles or PHN. It is uncertain if this persists in PHN since 
pathological examination of PHN-affected nerves and ganglia show chronic neuronal
loss and quiescent scarring without inflammation. Skin-biopsy study has
correlated the presence of PHN with the severity of persistent distal nociceptive
axon loss, and autopsy has correlated pain persistence with segmental atrophy of 
the spinal cord dorsal horn, highlighting the importance of central responses to 
nerve injury. Pathological studies of tissues from patients with trigeminal
neuralgia suggest that brief lancinating pains reflect ephaptic neurotransmission
between adjacent denuded axons. The mechanisms of chronic spontaneous pain and
mechanical allodynia remain uncertain despite considerable indirect evidence from
animal models. Postherpetic itch is presumably caused by unprovoked firing of the
peripheral and/or central neurons that mediate itch. If it occurs in neurons
innervating skin left severely deafferented from shingles ("numb"), patients can 
give themselves painless injuries from scratching. Further human study, by
electrophysiological recording, by structural and functional imaging, and by
autopsy, should continue to provide much-needed insights. PERSPECTIVE: Many
patients continue to have chronic pain and/or itch after shingles that is
unrelieved by current treatments. Many will gladly volunteer for clinical
studies, including autopsy, to try and improve understanding of these common and 
disabling conditions. Their prevalence makes highly powered studies feasible.
Funding and organization are the current bottlenecks.

Publication Types: 
    Historical Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review

PMID: 18166461 [PubMed - indexed for MEDLINE]

408: J Pain. 2008 Jan;9(1 Suppl 1):S3-9.

Natural history and treatment of herpes zoster.

Schmader KE, Dworkin RH.

Division of Geriatrics, Department of Medicine, Duke University Medical Center
and Geriatric Research, Education and Clinical Center, Durham VA Medical Center, 
Durham, NC 27705, USA. schma001@mc.duke.edu

The objective of this article is to provide an overview of the natural history
and treatment of herpes zoster, with a focus on pain management. Herpes zoster
has the highest incidence of all neurological diseases, occurring annually in
approximately 1 million people in the United States. A basic feature of herpes
zoster is a marked increase in incidence with aging and with diseases and drugs
that impair cellular immunity. Herpes zoster begins with reactivation of
varicella zoster virus in dorsal root or cranial nerve ganglia, which is often
accompanied by a prodrome of dermatomal pain or abnormal sensations. Varicella
zoster virus spreads in the affected primary afferent nerve to the skin and
produces a characteristic dermatomal maculopapular and vesicular rash and pain.
Herpes zoster acute pain lowers quality of life and interferes with activities of
daily living. Antiviral therapy and scheduled analgesics form the
pharmacotherapeutic foundation for herpes zoster acute pain reduction. If
moderate to severe herpes zoster pain is not adequately relieved by antiviral
agents in combination with oral analgesic medications, then corticosteroids,
anticonvulsants (eg, gabapentin or pregabalin), tricyclic antidepressants (eg,
nortriptyline or desipramine), or neural blockade can be considered. PERSPECTIVE:
This article presents information on the clinical features and treatment of
herpes zoster. This information will help clinicians diagnose and manage herpes
zoster pain.

Publication Types: 
    Review

PMID: 18166460 [PubMed - indexed for MEDLINE]

409: Schmerz. 2008 Feb;22 Suppl 1:22-30.

[Headache in the elderly]

[Article in German]

Reinisch VM, Schankin CJ, Felbinger J, Sostak P, Straube A.

Oberbayerisches Kopfschmerzzentrum, Neurologische Klinik und Poliklinik, Klinikum
Grosshadern der Ludwig-Maximilians-Universitat Munchen, Marchioninistrasse 15,
81377, Munchen, Germany. veronika.reinisch@med.uni-muenchen.de

Chronic headache is still a frequent problem in old age, affecting about 10% of
all women and 5% of all men older than 70 years. The incidence of primary
headache decreases with advancing age, while that of secondary headache
increases. The clinical characteristics of migraine can also change with age; for
example, vegetative symptoms are less prominent, and less intense migrainous pain
localized predominantly in the neck is frequently reported. Migraine aura can
also be experienced more frequently in isolation, without a headache. Hypnic
headache is a rare primary headache syndrome that occurs almost exclusively in
the elderly. Most of the secondary headache syndromes that occur more frequently 
in old age present clinically as tension-type headache. Examples of rather common
reasons for secondary headache syndromes in the elderly are intracranial
space-occupying lesions, ophthalmological problems and autoimmune diseases such
as giant cell arteritis. Elderly patients are especially likely to have a number 
of illnesses at any one time for which they take various medications each day, so
that headaches can also quite often be caused by their medication or by
withdrawal of these. As a result of such multimorbidity the homeostasis is
disturbed in such patients, leading to various conditions that can entail
concomitant headaches (sleep apnoea syndrome, dialysis headache, headache
attributed to arterial hypertension or hypothyroidism). Familiar facial
neuralgias, such as trigeminal neuralgia or postherpetic neuralgia following
manifest herpes zoster affecting the face, become markedly more frequent with
age. In general, in the treatment of headaches in the elderly it is essential to 
pay careful attention to potential interactions with the multiple drugs needed
because of other diseases; in addition, the comorbidities themselves have to be
taken into account, especially depression, anxiety and cognitive impairment,
necessitating multimodal, interdisciplinary therapy plans.

Publication Types: 
    Comparative Study
    English Abstract
    Review

PMID: 18228047 [PubMed - indexed for MEDLINE]

410: Am J Ophthalmol. 2008 Apr;145(4):682-6. Epub 2008 Jan 28.

Vitreous penetration of orally administered valacyclovir.

Huynh TH, Johnson MW, Comer GM, Fish DN.

WK Kellogg Eye Center, Department of Ophthalmology and Visual Sciences,
University of Michigan, Ann Arbor, Michigan 48105, USA.

PURPOSE: To investigate the vitreous penetration of acyclovir, the active
metabolite of valacyclovir, after oral administration of valacyclovir. DESIGN:
Prospective, interventional case series. METHODS: Ten patients scheduled for
elective pars plana vitrectomy at a single academic institution were given three 
oral doses of valacyclovir 1000 mg eight hours apart the day before surgery, with
a fourth dose on the morning of surgery. Blood and undiluted vitreous samples
were obtained during surgery and subsequently were analyzed with high-performance
liquid chromatography to determine the concentrations of acyclovir present.
RESULTS: Ten eyes of 10 subjects ranging in age from 46 to 83 years were
included. All patients had normal renal and hepatic function as confirmed by
metabolic panels obtained before surgery. Mean serum acyclovir concentration +/- 
standard deviation was 4.41 +/- 0.88 microg/ml (range, 3.18 to 5.92 microg/ml),
mean vitreous acyclovir concentration was 1.03 +/- 0.23 microg/ml (range, 0.67 to
1.33 microg/ml), and mean vitreous-to-serum concentration ratio of acyclovir was 
0.24 +/- 0.06 (range, 0.16 to 0.34). CONCLUSIONS: Orally administered
valacyclovir results in substantial vitreous penetration of acyclovir. The
vitreous concentrations achieved in noninflamed eyes are within the reported
inhibitory ranges for most strains of herpes simplex 1, herpes simplex 2, and
varicella zoster virus. This suggests that orally administered valacyclovir may
be an alternative to intravenous acyclovir in the treatment of acute retinal
necrosis.

PMID: 18226802 [PubMed - indexed for MEDLINE]

411: Ear Nose Throat J. 2007 Nov;86(11):649; author reply 649-50.

Comment on:
    Ear Nose Throat J. 2007 Mar;86(3):138, 140.

Less common MRI findings in ramsay hunt syndrome type I.

Anton E.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 18225616 [PubMed - indexed for MEDLINE]

412: Swiss Med Wkly. 2008 Jan 26;138(3-4):47-51.

Serology and serum DNA detection in shingles.

Dobec M, Bossart W, Kaeppeli F, Mueller-Schoop J.

Medizinische Laboratorien Dr. F. Kaeppeli, Zurich, Switzerland.
m.dobec@medica-labor.ch

AIM: To investigate the sensitivity of various laboratory approaches in the
diagnosis of herpes zoster from patient serum. METHODS: Paired sera from 53
consecutive adult patients with acute herpes zoster were tested for the presence 
of varicella-zoster virus (VZV) antibodies. All acute sera were tested
subsequently by real-time polymerase chain reaction (PCR) for the presence of VZV
DNA. In addition, convalescent sera of patients who tested initially positive for
VZV DNA underwent PCR analysis. RESULTS: VZV IgM antibodies were found by enzyme 
immunoassay (EIA) in 5 acute (9%) and 20 convalescent (38%) zoster sera. VZV DNA 
was detected by PCR in 21 (40%) acute zoster sera and was no longer detectable in
the convalescent samples. A seroconversion or a fourfold or greater titre
increase was found by complement fixation (CF) test in 41 (77%), by IgG indirect 
fluorescent antibody assay (IgG IFA) in 43 (81%) and by CF and IgG IFA combined
in 45 of 53 (85%) paired zoster sera. The combination of all serological methods 
detected 51 (96%) and PCR combined with serology identified 52 (98%) of 53
patients. CONCLUSIONS: Optimal laboratory sensitivity in the diagnosis of herpes 
zoster from serum can be achieved by the combination of PCR and serology of
paired serum samples. Serological methods alone are of limited value for early
diagnosis of zoster when therapy can be initiated, because CF and IgG IFA need
convalescent serum and IgM test sensitivity is insufficient. Early diagnosis of
VZV reactivation is possible from serum by PCR in the first days of illness and
test sensitivity needs further improvement. The findings highlight the need for
future studies into the usefulness of PCR and serology in atypical cases of VZV
reactivation.

PMID: 18224496 [PubMed - indexed for MEDLINE]

413: Adv Ther. 2008 Jan;25(1):59-66.

Prolactin levels and examination with breast ultrasound or mammography.

Sarac F, Tutuncuoglu P, Ozgen AG, Saygili F, Yilmaz C, Bilgen I, Memis A.

Department of Endocrinology and Metabolism, Ege University Hospital, 5th floor,
Bornova, Izmir, 35100, Turkey. fuldensarac@yahoo.com

OBJECTIVE: Stresses including surgery, exercise, nipple stimulation, and chest
wall injury such as mechanical trauma, burns, surgery, herpes zoster of thoracic 
dermatomes, hypoglycaemia and acute myocardial infarction cause significant
elevation of prolactin levels. The aim of the present study was to evaluate the
changes in prolactin level during mammography and ultrasonographic examination.
MATERIALS AND METHODS: Seventy-four premenopausal (mean age, 32.1+/-7.3 y) and 81
post-menopausal women (mean age, 48.3+/-8.9 y) were enrolled into the study.
Premenopausal women were evaluated with ultrasound (Senographe 600 T [General
Electric]) and post-menopausal women were examined with mammography (Mammomat
3000 [Siemens]). Blood samples for prolactin were taken prior to ultrasound or
mammography and 15, 30 and 45 min after ultrasound or mammography. RESULTS: Mean 
baseline serum prolactin level was 7.2+/-0.9 ng/ml in premenopausal women before 
ultrasound. Mean baseline serum prolactin level was 5.4+/-0.4 ng/ml in
post-menopausal women before mammography. It was found that there were no
significant changes in prolactin levels after ultrasound or mammography (P >
0.05). Mean levels of baseline prolactin were statistically significant higher in
premenopausal than in post-menopausal women (P = 0.03). CONCLUSION: Mammography
and ultrasonographic examination have no acute effect on serum prolactin levels
in either group. There is no need to wait before measuring the prolactin level
after mammographic or ultrasonographic breast examination.

PMID: 18224292 [PubMed - indexed for MEDLINE]

414: Acta Ophthalmol. 2008 Nov;86(7):806-9. Epub 2008 Jan 24.

Central nervous system involvement after herpes zoster ophthalmicus.

Haargaard B, Lund-Andersen H, Milea D.

Department of Ophthalmology, Glostrup University Hospital, Copenhagen, Denmark.
birgitte@haargaard.dk

PURPOSE: To report central nervous system involvement after varicella zoster
virus infection. METHODS: We evaluated the frequency and type of neurological
complications in patients initially presenting with ophthalmic herpes zoster at
an ophthalmological department in a Danish university hospital, over a 7-year
period. RESULTS: Of the 110 immunocompetent patients who presented with initial
ophthalmic zoster, six (5.5%) suffered from neurological complications other than
post-herpetic neuralgia. Four experienced isolated cranial motor nerve palsies,
one patient had meningitis with a favourable outcome and one patient had severe
encephalitis with a poor clinical outcome. CONCLUSIONS: Central nervous system
involvement after varicella zoster virus infection is an uncommon, but
potentially life-threatening, complication. Early recognition of neurological
complications prompts acute, appropriate antiviral treatment.

PMID: 18221497 [PubMed - indexed for MEDLINE]

415: Can J Ophthalmol. 2008 Feb;43(1):124-5.

Macular infarction after intravitreal ganciclovir injection in a patient with
acute retinal necrosis.

Kim SW, Oh J, Huh K.

Publication Types: 
    Case Reports
    Letter

PMID: 18219358 [PubMed - indexed for MEDLINE]

416: Jpn J Infect Dis. 2008 Jan;61(1):65-7.

Molecular characterization of clinical varicella-zoster strains from India and
differentiation from the oka vaccine strain.

Kaushik KS, Lahiri KK, Chumber SK, Gupta RM, Kumar S, Kapila K, Karade S.

Department of Microbiology, Armed Forces Medical College, Pune, India.
mahakaroo@yahoo.com

With the introduction of varicella vaccination in India, surveillance of
circulating varicella-zoster strains has gained significance. The aim of the
present study was to achieve molecular characterization of circulating
varicella-zoster virus (VZV) strains and differentiation from the Oka vaccine
strain. In this study, the genotype of 100 clinical VZV strains was analyzed.
Vesicle fluid was collected from patients with VZV infections (92 cases of
varicella and 8 cases of herpes zoster). The PCR-RFLP analysis of two polymorphic
loci--a PstI restriction site in ORF 38 and a BglI restriction site in ORF 54 was
used to characterize and differentiate them from the vaccine strain. All the
wild-type strains were positive for the PstI restriction site in ORF 38. This
differentiated them from the Oka vaccine strain, which is PstI negative. The
wild-type strains as well as the Oka vaccine strain were positive for the BglI
restriction site in ORF 54. Thus, the genotype of all the VZV strains examined
had the wild-type pattern represented as PstI(+) BglI(+). None of the strains had
the PstI(-) BglI(+) genotype characteristic of the Oka strain or the PstI(+)
BglI(-) wild-type pattern. To conclude, PstI and BglI serve as good reference
markers in the genotyping of circulating varicella strains in India and serve to 
differentiate them from the vaccine strain as well as other wild-type strains.

PMID: 18219137 [PubMed - indexed for MEDLINE]

417: Am Fam Physician. 2007 Dec 15;76(12):1757.

Coping with the pain.

Wellbery C.

wellberc@georgetown.edu

Publication Types: 
    Case Reports

PMID: 18217515 [PubMed - indexed for MEDLINE]

418: J Egypt Public Health Assoc. 2007;82(1-2):1-19.

Microbial study of meningitis and encephalitis cases.

Selim HS, El-Barrawy MA, Rakha ME, Yingst SL, Baskharoun MF.

Microbiology Department, High Institute of Public Health, Alexandria University. 
drhebaselim@yahoo.com

Meningitis and/or encephalitis can pose a serious public health problem
especially during outbreaks. A rapid and accurate diagnosis is important for
effective earlier treatment. This study aimed to identify the possible microbial 
causes of meningitis and/or encephalitis cases. CSF and serum samples were
collected from 322 patients who had signs and symptoms suggestive of meningitis
and/or encephalitis. Out of 250 cases with confirmed clinical diagnosis, 83
(33.2%) were definitely diagnosed as bacterial meningitis and/or encephalitis
cases (by using CSF culture, biochemical tests, latex agglutination test, and CSF
stain), 17 (6.8%) were definitely diagnosed as having viral causes ( by viral
isolation on tissue culture, PCR and ELISA), and one (0.4%) was diagnosed as
fungal meningitis case (by India ink stain, culture, and biochemical tests).
Also, there was one encephalitis case with positive serum ELISA IgM antibodies
against Sandfly scilian virus. N. meningitidis, S. pneumonia and M. tuberculosis 
were the most frequently detected bacterial agents, while Enteroviruses, herpes
simplex viruses and varicella zoster viruses were the most common viral agents
encountered. Further studies are needed to assess the role of different microbial
agents in CNS infections and their effective methods of diagnosis.

PMID: 18217322 [PubMed - indexed for MEDLINE]

419: Ig Sanita Pubbl. 2007 Mar-Apr;63(2):191-5.

[Is it possible to prevent herpes zoster through vaccination?]

[Article in Italian]

Franco E, Zaratti L, Ambrosini-Spinella S.

Dipartimento di Sanita Pubblica, Universita Tor Vergata, Roma.

The annualized incidence of herpes zoster, due to the endogenous reactivation of 
varicella zoster virus (VZV), varies between 2 and 5 cases per 1,000 persons with
a clear increase over 60 years of age. Mass vaccination against varicella in
infants could decrease natural boosters with an increase in zoster incidence.
Efficacy of a high titre VZV vaccine in preventing zoster and its sequelae was
demonstrated in a multicentric study on over 38.000 older adults. The
availability of a specific anti zoster vaccine, recently approved by FDA, could
offer an important tool to reduce health problems and improve quality of life in 
the elderly.

Publication Types: 
    English Abstract

PMID: 18216893 [PubMed - in process]

420: J Virol Methods. 2008 Mar;148(1-2):197-204. Epub 2008 Jan 22.

A highly efficient protocol of generating and analyzing VZV ORF deletion mutants 
based on a newly developed luciferase VZV BAC system.

Zhang Z, Huang Y, Zhu H.

Department of Microbiology and Molecular Genetics, UMDNJ-New Jersey Medical
School, 225 Warren Street, Newark, NJ 07101-1709, USA.

Varicella Zoster Virus (VZV) is the causative agent for both varicella (chicken
pox) and herpes zoster (shingles). As a member of the human herpesvirus family,
VZV contains a large DNA genome, encoding 70 unique open reading frames (ORFs).
The functions of the majority of these ORFs remain unknown. Recently, the
full-length VZV (P-Oka strain) genome was cloned as a VZV bacteria artificial
chromosome (BAC) and additionally a firefly luciferase cassette was inserted to
generate a novel luciferase VZV BAC. In this study, a highly efficient protocol
has been developed exploiting the new luciferase VZV BAC system to rapidly
isolate and characterize VZV ORF deletion mutants by growth curve analysis in
cell culture.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18215429 [PubMed - indexed for MEDLINE]

421: Ann Emerg Med. 2008 Feb;51(2):211, 219.

Erratum in:
    Ann Emerg Med. 2008 Sep;52(3):273.

Images in emergency medicine. Herpes zoster ophthalmicus with ocular involvement.

Hahn B, Arnold N, Roth N.

Department of Emergency Medicine, Staten Island University Hospital, Staten
Island, NY, USA.

Publication Types: 
    Case Reports

PMID: 18206556 [PubMed - indexed for MEDLINE]

422: Heart Lung. 2008 Jan-Feb;37(1):61-6.

Atypical presentation of varicella-zoster virus encephalitis in an
immunocompetent adult.

Mpaka M, Karantanas AH, Zakynthinos E.

Intensive Care Unit, University of Thessaly, Larissa, Greece.

BACKGROUND: Varicella-zoster virus encephalitis is uncommon, but not rare, in
immunocompetent adults. Typically, patients develop stroke with hemiplegia caused
by large vessel vasculopathy days to weeks after herpes zoster ophthalmicus.
METHOD: A previously healthy 66-year-old man developed obtundation deteriorating 
to coma within 24 hours. He had lymphocytic meningitis and multiple bilateral
edematous and hemorrhagic lesions predominantly in the white matter, and
intraventricular and subarachnoid hemorrhage. Treatment with acyclovir and
dexamethasone was readily administered. The diagnosis of varicella-zoster virus
encephalitis was confirmed by polymerase chain reaction analysis of the
cerebrospinal fluid. No zosteriform rash preceded or followed encephalitis. Two
years later, the patient is in good health, and no relapse or sign of
immunosuppression has been reported. CONCLUSION: This is a case of
varicella-zoster virus encephalitis in an immunocompetent patient presenting
without typical rash and with clinicoradiologic features of multifocal
encephalitis, which characterize immunosuppression.

Publication Types: 
    Case Reports

PMID: 18206528 [PubMed - indexed for MEDLINE]

423: J Med Virol. 2008 Mar;80(3):467-77.

Erratum in:
    J Med Virol. 2008 Aug;80(8):1505.    J Med Virol. 2008 Dec;80(12):2177.

Rapid quantitative PCR assays for the simultaneous detection of herpes simplex
virus, varicella zoster virus, cytomegalovirus, Epstein-Barr virus, and human
herpesvirus 6 DNA in blood and other clinical specimens.

Engelmann I, Petzold DR, Kosinska A, Hepkema BG, Schulz TF, Heim A.

Institut fur Virologie, Medizinische Hochschule Hannover, Hannover, Germany.
engelmann.ilka@mh-hannover.de

Rapid diagnosis of human herpesvirus primary infections or reactivations is
facilitated by quantitative PCRs. Quantitative PCR assays with a standard thermal
cycling profile permitting simultaneous detection of herpes simplex virus (HSV), 
varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV),
and human herpesvirus 6 (HHV6) DNA were developed and validated for diagnostic
use. High specificity and sensitivity were achieved and the new PCR assays
correlated well with commercial PCR assays. Twenty two thousand eight hundred
sixty eight PCR tests were undertaken on specimens obtained from immunosuppressed
patients. DNAemia was frequent with EBV (43.5%), HHV6 (32.4%), CMV (12.8%), and
VZV (12.9%). As already described for EBV and CMV, high virus loads of HHV6 and
VZV were associated with clinical symptoms and poor clinical outcome, for
example, three of four patients with VZV virus loads >10(5) copies/ml died. A
high proportion of lower respiratory specimens was positive for EBV- (38.8%),
HHV6- (29.4%), and CMV-DNA (18.2%). For CMV, infection was confirmed in 66.7% of 
patients by virus isolation or positive pp65 antigenaemia. Differentiation of
HHV6A, -B and HSV-1, -2 by melting curve analysis revealed that HHV6A and HSV-2
represented only 1.8% and 3.3% of all positive specimens, respectively. In
conclusion, these results indicate significant improvements for the early
diagnosis of primary infections or reactivations of five human herpesviruses
especially in immunosuppressed patients. Detection of coinfections with multiple 
herpesviruses is facilitated. Quantitative results enable monitoring of virus
load during antiviral therapy. A standard thermal cycling profile permits time
and cost effective use in a routine diagnostic setting.

PMID: 18205230 [PubMed - indexed for MEDLINE]

424: N Engl J Med. 2008 Jan 17;358(3):306; author reply 307.

Comment on:
    N Engl J Med. 2007 Oct 18;357(16):1598-607.

Prednisolone or acyclovir in Bell's palsy.

Leiner S.

Publication Types: 
    Comment
    Letter

PMID: 18203331 [PubMed - indexed for MEDLINE]

425: Pathology. 2008 Feb;40(2):149-60.

Viruses and other infections in stillbirth: what is the evidence and what should 
we be doing?

Rawlinson WD, Hall B, Jones CA, Jeffery HE, Arbuckle SM, Graf N, Howard J, Morris
JM.

Microbiology SEALS, Prince of Wales Hospital, Randwick, Australia.
w.rawlinson@unsw.edu.au

In Australia, as in other developed countries, approximately 40-50% of
stillbirths are of unknown aetiology. Emerging evidence suggests stillbirths are 
often multifactorial. The absence of a known cause leads to uncertainty regarding
the risk of recurrence, which can cause extreme anguish for parents that may
manifest as guilt, anger or bewilderment. Further, clinical endeavours to prevent
recurrences in future pregnancies are impaired by lack of a defined aetiology.
Therefore, efforts to provide an aetiological diagnosis of stillbirth impact upon
all aspects of care of the mother, and inform many parts of clinical decision
making. Despite the magnitude of the problem, that is 7 stillbirths per 1000
births in Australia, diagnostic efforts to discover viral aetiologies are often
minimal. Viruses and other difficult to culture organisms have been postulated as
the aetiology of a number of obstetric and paediatric conditions of unknown
cause, including stillbirth. Reasons forwarded for testing stillbirth cases for
infectious agents are non-medical factors, including addressing all parents' need
for diagnostic closure, identifying infectious agents as a sporadic cause of
stillbirth to reassure parents and clinicians regarding risk for future
pregnancies, and to reduce unnecessary testing. It is clear that viral agents
including rubella, human cytomegalovirus (CMV), parvovirus B19, herpes simplex
virus (HSV), lymphocytic choriomeningitis virus (LCMV), and varicella zoster
virus (VZV) may cause intrauterine deaths. Evidence for many other agents is that
minimal or asymptomatic infections also occur, so improved markers of adverse
outcomes are needed. The role of other viruses and difficult-to-culture organisms
in stillbirth is uncertain, and needs more research. However, testing stillborn
babies for some viral agents remains a useful adjunct to histopathological and
other examinations at autopsy. Modern molecular techniques such as multiplex PCR,
allow searches for multiple agents. Now that such testing is available, it is
important to assess the clinical usefulness of such testing.

Publication Types: 
    Review

PMID: 18203037 [PubMed - indexed for MEDLINE]

426: Saudi J Kidney Dis Transpl. 2004 Jan-Mar;15(1):50-2.

Neuropsychiatric manifestations in a patient undergoing hemodialysis caused by
treatment with oral acyclovir.

Skhiri H, Achour A, Skhiri S, Frih A, Bouraoui S, Dhia NB, Elmay M.

Department of Nephrology, Monastir Hospital, Monastir 5000, Tunisia.

A 50-year-old woman who was being treated with hemodialysis was admitted for
severe neuropsychiatric symptoms. She tested positive for antibody to hepatitis C
virus. Her medical history revealed ophthalmic herpes zoster four days before her
admission for which she was started on oral acyclovir (800 mg three times daily).
Four days later, she became disoriented and agitated. She had visual
hallucinations and myoclonus. She was diagnosed as having acyclovir toxicity and 
was instituted on vigorous dialysis. The serum acyclovir levels normalized and
the patient became asymptomatic with three dialysis sessions. Our case further
reinforces that the dose of acyclovir should be reduced in patients with renal
failure and that dialysis is a good form of treatment for over dosage.

PMID: 18202466 [PubMed - in process]

427: N Engl J Med. 2008 Jan 17;358(3):306; author reply 307.

Comment on:
    N Engl J Med. 2007 Oct 18;357(16):1598-607.

Prednisolone or acyclovir in Bell's palsy.

Beutner D.

Publication Types: 
    Comment
    Letter

PMID: 18199872 [PubMed - indexed for MEDLINE]

428: Rev Neurol Dis. 2007 Fall;4(4):203-8.

Management of acute shingles (herpes zoster).

Tyler KL, Beckham JD.

University of Colorado Health Sciences Center, Denver, CO, USA.

Practical, evidence-based recommendations for the management of acute shingles
(herpes zoster) were published this year in Clinical Infectious Diseases. These
guidelines were the result of a consensus meeting of several groups with an
interest in neuropathic pain and varicella-zoster virus research. This article
summarizes the key findings and recommendations that were generated from this
meeting and reviews some of the research on which these guidelines are based.

Publication Types: 
    Review

PMID: 18195672 [PubMed - indexed for MEDLINE]

429: Neurologist. 2008 Jan;14(1):52-5.

Transient facial palsy in two cases of benign, very rare middle ear tumors
(carcinoid tumor and myxoma).

Zehlicke T, Punke C, Boltze C, Pau HW.

Department of Otorhinolaryngology, Head and Neck Surgery Otto Koerner, University
of Rostock, Rostock, Germany. thorsten.zehlicke@med.uni-rostock.de

OBJECTIVE: Presentation of the clinical features of 2 very rare middle ear tumors
in which the guiding symptom was facial palsy. MATERIAL AND METHODS: Illustrative
case reports about a myxoma and a carcinoid tumor of the middle ear associated
with peripheral facial palsy. RESULTS: The facial palsy was transient in either
case, and its pathomechanism is open for discussion. In both cases, the initial
symptoms were typical for an inflammatory process. Moreover, both tumor entities 
are typically found in organs other than the ear; if located in the middle ear,
those neoplasms grow rather superficially. In those cases, a surgical exposure of
the middle ear is indicated. CONCLUSION: The etiopathology of an acute peripheral
facial palsy is often hard to identify. If the facial weakness starts together
with symptoms suggesting an inflammatory process, the differential diagnosis may 
be focused first on diseases like herpes zoster oticus and a severe course of
acute purulent otitis media. We report the cases of 2 rare middle ear tumors
causing facial palsy. Treatment of choice should be complete surgical excision.

Publication Types: 
    Case Reports

PMID: 18195660 [PubMed - indexed for MEDLINE]

430: Adv Exp Med Biol. 2008;609:216-32.

Therapy of herpes virus infections in children.

Whitley RJ.

The University of Alabama at Birmingham, AL 35233, USA. RWhitley@peds.uab.edu

Significant progress has been made in the treatment of viral infections in
children, particularly those caused by HSV, varicella-zoster virus and
cytomegalovirus. While not discussed in this review, licensed therapies are
available for influenza infection in children as well. However, and notably so,
numerous viral diseases of children represent unmet medical needs and warrant
dedicated drug discovery efforts, including hepatitis B and C, and respiratory
syncytial virus, among others.

Publication Types: 
    Review

PMID: 18193668 [PubMed - indexed for MEDLINE]

431: Z Gastroenterol. 2008 Jan;46(1):45-7.

Postoperative fulminant varicella zoster virus hepatitis with fatal outcome: a
case report.

Drebber U, Preuss SF, Kasper HU, Wieland U, Dienes HP.

Institute of Pathology, University of Cologne, Cologne, Germany.
u.drebber@uni-koeln.de

INTRODUCTION: Fulminant hepatitis due to varicella zoster virus (VZV) infection
has a poor prognosis although an effective treatment is available. CASE REPORT:
We present a case of fulminant hepatic failure (FHF) as a result of disseminated 
VZV infection in a long-term alcoholic patient who underwent laryngectomy and
radical neck dissection due to squamous cell carcinoma of the larynx. Post-mortem
examination revealed the diagnosis of fulminant hepatitis and infection with VZV.
Viral inclusion bodies were found in the hypopharyngeal mucosa as well as in the 
liver tissue. In these tissues VZV was detected by PCR. The clinical presentation
is suggestive for a reactivation of VZV without cutaneous signs of herpes zoster 
during a state of immunosuppression. DISCUSSION: Differential diagnosis comprises
hepatitis by other Herpes group viruses and toxic hepatic injury.

Publication Types: 
    Case Reports

PMID: 18188815 [PubMed - indexed for MEDLINE]

432: Kulak Burun Bogaz Ihtis Derg. 2007;17(5):287-9.

A case of herpes zoster presenting as orbital cellulitis.

Al-Rikabi A, Trotter MI, Khan H, Raut VV.

Head and Neck Department, Russells Hall Hospital, Dudley Group of Hospitals,
Dudley, UK. alikamil30@yahoo.com

We presented an unusual case of ophthalmic herpes zoster masquerading as orbital 
cellulitis, resulting in delay in appropriate treatment. A 65-year-old woman
presented with left periorbital pain and swelling of a week duration. Examination
revealed periorbital edema and inflammation but no proptosis. The erythema
extended onto the brow. There was no change in visual acuity and cranial nerve
function was normal. She was apyrexial and all other parameters were within
normal limits. The patient was admitted with an initial diagnosis of sinusitis
with orbital cellulitis/dacryocystitis and intravenous co-amoxiclav and a
non-steroidal anti-inflammatory drug were administered. The following day, there 
was little change in her condition with the ocular movements being normal and
vision remaining unaffected. She was apyrexial but the periorbital swelling
persisted. Computed tomography of the sinuses did not show sinusitis or a
periorbital collection. The third day after admission and 10 days after the
initial appearance of pain, vesicles appeared on the left forehead, which enabled
a diagnosis of herpes zoster of the ophthalmic branch of the trigeminal nerve.
She was then treated with acyclovir with a good result.

Publication Types: 
    Case Reports

PMID: 18187989 [PubMed - indexed for MEDLINE]

433: Indian J Dermatol Venereol Leprol. 2008 Jan-Feb;74(1):23-7.

Many faces of cutaneous leishmaniasis.

Bari AU, Rahman SB.

Department of Dermatology, Combined Military Hospital, Muzaffarabad, AJK,
Pakistan. albariul@yahoo.com

BACKGROUND: Cutaneous leishmaniasis (CL) is known for its clinical diversity and 
increasing numbers of new and rare variants of the disease are being reported
these days. AIM: The aim of this descriptive study was to look for and report the
atypical presentations of this common disease occurring in Pakistan. METHODS: The
study was carried out in three hospitals (MH, Rawalpindi; PAF Hospital, Sargodha;
and CMH, Muzaffarabad) from 2002 to 2006. Military and civilian patients of all
ages, both males and females, belonging to central and north Punjab province and 
Kashmir were included in the study. Clinical as well as parasitological features 
of cutaneous leishmaniasis were studied. The unusual lesions were photographed
and categorized accordingly using simple descriptive statistics. RESULTS: Out of 
718 patients of cutaneous leishmaniasis, 41 (5.7%) had unusual presentations. The
commonest among unusual morphologies was lupoid leishmaniasis 14 (34.1%),
followed by sporotrichoid 5 (12.1%), paronychial 3 (7.3%), lid leishmaniasis 2
(4.9%), psoriasiform 2 (4.9%), mycetoma-like 2 (4.9%), erysipeloid 2 (4.9%),
chancriform 2 (4.9%), whitlow 1 (2.4%), scar leishmaniasis 1 (2.4%), DLE-like 1
(2.4%), 'squamous cell carcinoma'-like 1 (2.4%), zosteriform 1 (2.4%), eczematous
1 (2.4%), verrucous 1 (2.4%), palmar/plantar 1 (2.4%) and mucocutaneous 1 (2.4%).
CONCLUSION: In Pakistan, an endemic country for CL, the possibility of CL should 
be kept in mind while diagnosing common dermatological diseases like erysipelas, 
chronic eczema, herpes zoster, paronychia; and uncommon disorders like lupus
vulgaris, squamous cell carcinoma, sporotrichosis, mycetoma and other deep
mycoses.

Publication Types: 
    Multicenter Study

PMID: 18187818 [PubMed - indexed for MEDLINE]

434: J Heart Lung Transplant. 2008 Jan;27(1):11-6.

Incidence and clinical characteristics of herpes zoster after lung
transplantation.

Manuel O, Kumar D, Singer LG, Cobos I, Humar A.

Department of Transplant Infectious Diseases, University of Alberta, Edmonton,
Alberta, Canada. o.manuel@provlab.ab.ca

BACKGROUND: Solid-organ transplant recipients are at high risk for the
development of herpes zoster. Epidemiologic data in lung transplant recipients
are lacking. We determined the incidence and clinical characteristics of herpes
zoster, and the risk factors for developing herpes zoster, after lung
transplantation. METHODS: We retrospectively reviewed all adult (>18 years old)
lung transplants performed at our institution between January 2001 and December
2005. Clinical characteristics of herpes zoster and potential risk factors
associated with herpes zoster were assessed. RESULTS: Two hundred thirty-nine
lung transplant recipients were included in the analysis. Median time of
follow-up was 722 days (range 18 to 1,943 days). Thirty-five episodes of herpes
zoster occurred in 29 patients, with a calculated incidence of 55.1 cases per
1,000 person-years of follow-up. The cumulative probability of herpes zoster was 
5.8% at 1 year, 18.1% at 3 years and 20.2% at 5 years post-transplant. Only 2 of 
the 35 (5.7%) patients had disseminated cutaneous infection and none had visceral
involvement. Recurrence of herpes zoster was seen in 13.8% of patients.
Post-herpetic neuralgia was detected in 20% of cases. Anti-viral prophylaxis,
primarily for cytomegalovirus (CMV), was protective against herpes zoster. No
significant epidemiologic risk factors associated with herpes zoster could be
identified. CONCLUSIONS: Herpes zoster is a common complication after lung
transplantation with a peak incidence at between 1 and 4 years post-transplant.
Preventive strategies would be beneficial for this population.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 18187081 [PubMed - indexed for MEDLINE]

435: Cir Cir. 2007 Nov-Dec;75(6):491-7.

[Normal variants and frequent pitfalls with (18)FDG PET/CT study]

[Article in Spanish]

Del Rocio Estrada-Sanchez G, Altamirano-Ley J, Ochoa-Carrillo FJ.

Unidad PET/CT, C.T. Scanner del Sur, Mexico, D.F., Mexico. dragiselaus@yahoo.com

BACKGROUND: Fluordeoxyglucose ((18)FDG) is the most common radiotracer used for
PET/CT studies. It enters the cell because of the glucose transporter proteins
(GLUTs): 1) erythrocytic membrane, skeletal muscle, lymphocytes, ovaries, breast;
2) pancreas, retina, erythrocytes; 3) adipocytes, ovaries, testis; 4) skeletal
muscle, adipocytes, ovaries, myocardium; 5) breast, small intestine, testis,
kidney, erythrocytes; 6) spleen, leucocytes, brain; 7) liver; 8) testis, brain;
9) liver, kidney; 10) liver, pancreas; 11) heart, muscle; 12) heart, prostate;
13) brain. We undertook this study to expand the knowledge about physiological
uptake. Physiological uptake of (18)FDG was in brain, Waldeyer ring (adenoids,
palatine tonsils, lingual tonsils), salivary glands (parotids, submandibular),
tongue, vocal cords, cricoarythenoid muscle, thyroid, brown fat (supraclavicular,
mediastinal, neck, pericardial fat, around kidney, around great vessels in the
thorax, subdiaphragmatic, intercostals, paravertebral), myocardium, breast,
thymus, contractive muscles, liver, spleen (similar to the liver), stomach,
intestine, kidneys, bladder, uterus, ovaries, testes, bone marrow, esophagus, and
atherosclerotic inflammatory plaque. DISCUSSION: False positives were as follows:
pneumoniae, tuberculosis, sarcoidosis, cryptococcosis, thrombosis, bronchitis,
costochondritis, radiation pneumonitis, misregistration for respiratory
movements, catheters, thyroid and adrenal adenomas, osteophytes, fractures,
abscess, foreign body, surgical wounds, ostomies, prosthesis, degenerative joint 
diseases, osteomyelitis, amyloidosis, pancreatitis, myositis, gastritis, colitis,
herpes zoster. (18)FDG should be injected 4-6 h after insulin administration
because it will be concentrated in the muscles. The brown fat raises its uptake
50% in late images. CONCLUSIONS: It is vital to know the most frequent sites of
physiological uptake in the (18)FDG PET/CT studies to identify those regions that
occasionally present hypermetabolism but that are not related to neoplastic
tumors. This must be taken into consideration in the evaluation of PET/CT
studies.

Publication Types: 
    English Abstract

PMID: 18177573 [PubMed - indexed for MEDLINE]

436: Pediatr Infect Dis J. 2008 Feb;27(2):112-8.

The epidemiology of children hospitalized with herpes zoster in Canada:
Immunization Monitoring Program, Active (IMPACT), 1991-2005.

Wootton SH, Law B, Tan B, Mozel M, Scheifele DW, Halperin S; IMPACT
Investigators.

University of British Columbia, Vancouver, British Columbia, Canada.

BACKGROUND: Varicella zoster virus causes varicella (chickenpox) and can
reactivate to cause herpes zoster (HZ). In Canada, live attenuated varicella
vaccine was recommended for routine use among healthy susceptible children age 1 
year and older, in 1999. Varicella vaccine has had a profound impact on the
incidence of varicella; however the impact on HZ remains uncertain. METHODS:
Surveillance for HZ admissions was conducted by the Immunization Monitoring
Program, Active (IMPACT) surveillance network comprising 12 centers representing 
over 90% of pediatric tertiary care beds in Canada. Active surveillance for HZ
was undertaken in 1991-1996 and reintroduced in 1999. A clinical diagnosis was
accepted, with or without laboratory confirmation. For each case, a detailed case
report form was completed. RESULTS: In total, 648 children were admitted with HZ;
342 (52.8%) were boys and the mean age was 9.9 +/- 4.4 years. Five hundred
seventy-seven (89.0%) were immunocompromised and 71 immunocompetent (10.8%). Five
hundred seventy-one (88.1%) had a history of varicella zoster virus infection.
Varicella vaccination was documented in 4 children before admission. Most (85.5%)
presented with localized disease. Immunocompetent children were more likely than 
immunocompromised children to be hospitalized with ophthalmic disease (odds ratio
5.1, P < 0.001) or with at least 1 complication (odds ratio 3.0, P < 0.001). Only
1 death was attributable to HZ. CONCLUSIONS: Immunocompromised children
represented the overwhelming majority of IMPACT hospitalized cases. Complications
directly resulting from HZ were common in immunocompetent children. As varicella 
vaccine use becomes more widespread, the IMPACT network will continue to play an 
important role in monitoring the changing epidemiology of HZ in children.

PMID: 18174867 [PubMed - indexed for MEDLINE]

437: Int J Dermatol. 2008 Jan;47(1):36-9.

Herpes zoster-associated voiding dysfunction in hematopoietic malignancy
patients.

Imafuku S, Takahara M, Uenotsuchi T, Iwato K, Furue M.

Division of Dermatology and Hematology, Hiroshima Red Cross and Atomic Bomb
Survivor's Hospital, and Department of Dermatology, Graduate School of Medical
Sciences, Kyushu University. dermatologist@mac.com

BACKGROUND: Voiding dysfunction is a rare but important complication of
lumbo-sacral herpes zoster. Although the symptoms are transient, the clinical
impact on immunocompromised patients cannot be overlooked. METHODS: To clarify
the time course of voiding dysfunction in herpes zoster, 13 herpes zoster
patients with voiding dysfunction were retrospectively analyzed. RESULTS: Of 13
patients, 12 had background disease, and six of these were hematopoietic
malignancies; four of these patients were hematopoietic stem cell transplant
(HSCT) recipients. Ten patients had sacral lesions, two had lumbar, and one had
thoracic lesions. Interestingly, patients with severe rash, or with hematopoietic
malignancy had later onset of urinary retention than did patients with mild skin 
symptoms (Mann-Whitney U analysis, P = 0.053) or with other background disease (P
= 0.0082). Patients with severe skin rash also had longer durations (P = 0.035). 
In one case, acute urinary retention occurred as late as 19 days after the onset 
of skin rash. CONCLUSIONS: In immune compromised subjects, attention should be
paid to patients with herpes zoster in the lumbo-sacral area for late onset of
acute urinary retention even after the resolution of skin symptoms.

Publication Types: 
    Case Reports

PMID: 18173598 [PubMed - indexed for MEDLINE]

438: Pediatr Rev. 2008 Jan;29(1):5-10; quiz 11.

Varicella-zoster virus infections.

Gershon AA.

Columbia University College of Physicians and Surgeons, New York, NY, USA.

Publication Types: 
    Review

PMID: 18166616 [PubMed - indexed for MEDLINE]

439: Pain. 2008 Aug 15;138(1):61-9. Epub 2007 Dec 31.

Novel histamine H3 receptor antagonists GSK189254 and GSK334429 are efficacious
in surgically-induced and virally-induced rat models of neuropathic pain.

Medhurst SJ, Collins SD, Billinton A, Bingham S, Dalziel RG, Brass A, Roberts JC,
Medhurst AD, Chessell IP.

Neurology and GI Centre of Excellence for Drug Discovery, GlaxoSmithKline, Third 
Avenue, Harlow, Essex CM19 5AW, UK. stephen.j.medhurst@gsk.com

Several studies have implicated a potential role for histamine H(3) receptors in 
pain processing, although the data are somewhat conflicting. In the present study
we investigated the effects of the novel potent and highly selective H(3)
receptor antagonists GSK189254
(6-[(3-cyclobutyl-2,3,4,5-tetrahydro-1H-3-benzazepin-7-yl)oxy]-N-methyl-3-pyridin
ecarboxamide hydrochloride) and GSK334429
(1-(1-methylethyl)-4-([1-[6-(trifluoromethyl)-3-pyridinyl]-4-piperidinyl]carbonyl
)hexahydro-1H-1,4-diazepine) in two rat models of neuropathic pain, namely the
chronic constriction injury (CCI) model and the varicella-zoster virus (VZV)
model. Both GSK189254 (0.3, 3 and/or 10mg/kg p.o.) and GSK334429 (1, 3 and
10mg/kg p.o.) significantly reversed the CCI-induced decrease in paw withdrawal
threshold (PWT) measured using an analgesymeter and/or von Frey hairs. In
addition, GSK189254 (3mg/kg p.o.) and GSK334429 (10mg/kg p.o.) both reversed the 
VZV-induced decrease in PWT using von Frey hairs. We also investigated the
potential site of action of this analgesic effect of H(3) antagonists using
autoradiography. Specific binding to H(3) receptors was demonstrated with
[(3)H]-GSK189254 in the dorsal horn of the human and rat spinal cord, and in
human dorsal root ganglion (DRG), consistent with the potential involvement of
H(3) receptors in pain processing. In conclusion, we have shown for the first
time that chronic oral administration of selective H(3) antagonists is effective 
in reversing neuropathic hypersensitivity in disease-related models, and that
specific H(3) receptor binding sites are present in the human DRG and dorsal horn
of the spinal cord. These data suggest that H(3) antagonists such as GSK189254
and GSK334429 may be useful for the treatment of neuropathic pain.

PMID: 18164820 [PubMed - indexed for MEDLINE]

440: Can Commun Dis Rep. 2007 Nov 1;33(11):1-15.

The burden of varicella and zoster in British Columbia 1994-2003: baseline
assessment prior to universal vaccination.

[Article in English, French]

Edgar BL, Galanis E, Kay C, Skowronski D, Naus M, Patrick D.

Epidemiology Services, BC Centre for Disease Control, Vancouver, British
Columbia, Canada.

PMID: 18163240 [PubMed - indexed for MEDLINE]

441: MMW Fortschr Med. 2007 Nov 29;149(48):60.

[Chickenpox misjudged for a long time. No real pustules, but still very dangerous
]

[Article in German]

Gerardy KF.

Publication Types: 
    Historical Article

PMID: 18161440 [PubMed - indexed for MEDLINE]

442: Ned Tijdschr Geneeskd. 2007 Nov 24;151(47):2631-4.

[Relationship between rubella virus and Fuchs heterochromic uveitis; 2 patients]

[Article in Dutch]

de Groot-Mijnes JD, ten Dam-van Loon NH, Weersink AJ, van Loon AM, Rothova A.

Universitair Medisch Centrum Utrecht, afd. Medische Microbiologie, Utrecht.
j.d.f.degroot@umcutrecht.nl

Two otherwise healthy men, aged 26 and 29 years, were diagnosed with Fuchs
heterochromic uveitis (FHU) on the basis of the presence of iris heterochromia or
iris atrophy, stellate corneal precipitates, and/or cataract. Microbiological
investigation of aqueous humour demonstrated intraocular antibody production
against rubella virus, but not against Toxoplasma gondii, herpes simplex virus or
varicella zoster virus. Microbial nucleic acid detection was negative for all
pathogens. Some time later, both patients underwent cataract surgery, which
improved their vision considerably. FHU is a chronic, generally unilateral
iridocyclitis, accompanied by the above-mentioned ophthalmologic manifestations
in the absence of systemic disease. Little is known about the pathogenesis ofFHU,
but recent publications have provided evidence for the possible involvement of
the rubella virus.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18161266 [PubMed - indexed for MEDLINE]

443: Yonsei Med J. 2007 Dec 31;48(6):963-8.

Correlation between MRI and operative findings in Bell's palsy and Ramsay Hunt
syndrome.

Kim IS, Shin SH, Kim J, Lee WS, Lee HK.

Department of Otorhinolaryngology, Yonsei University College of Medicine, 612
Eonjuro, Gangnam-gu, Seoul, Korea. hoki@yuhs.ac.

PURPOSE: To investigate the correlation between gadolinium enhanced magnetic
resonance image (MRI) results and surgical findings of facial nerves in Bell's
palsy and Ramsay Hunt syndrome. MATERIALS AND METHODS: From 1995 to 2004, MRI was
performed on 13 patients with Bell's palsy or Ramsay Hunt syndrome, who were
offered with surgical decompression of the facial nerve through the middle
cranial fossa approach. Gadolinium enhanced MRI was performed on all patients and
the enhancement of the facial nerve was evaluated by radiology specialists.
Operative findings including the degree of the facial nerve segment swelling were
examined. Furthermore, the time interval from the onset of palsy to surgery was
evaluated. RESULTS: Swelling of facial nerve segments was found in patients with 
enhanced facial nerves from MRI. The swelling of the facial nerve in the
labyrinthine segment in particular was identified in all patients with enhanced
labyrinthine segments in MRI. The intraoperative swelling of geniculate ganglion 
of facial nerve was found in 78% of patients with enhanced facial segment in MRI 
(p=0.01). The intraoperative swelling of tympanic segment was observed from
fourth to ninth weeks after the onset of palsy. CONCLUSION: MRI enhancement of
facial nerves in Bell's palsy and Ramsay Hunt syndrome is associated with the
extent of intratemporal lesions of facial nerves, especially in the labyrinthine 
segment.

PMID: 18159587 [PubMed - indexed for MEDLINE]

444: Arq Bras Oftalmol. 2007 Sep-Oct;70(5):767-70.

[Ophthalmologic findings in cardiac transplant recipients]

[Article in Portuguese]

Pires CS, Remigio MC, Aguiar MI, Tenorio D, Moraes CR, Cavalcanti HD.

Fundacao Altino Ventura, Recife, PE, Brazil. fav@fundacaoaltinoventura.org.br

PURPOSE: To evaluate findings of ophthalmologic examinations in cardiac
transplant recipients, searching especially for changes in the retinal nerve
fiber layer by means of Scanning Laser Polarimetry. METHODS: Fifteen cardiac
transplant recipients were examined from September 2003 to July 2004. All of them
underwent ophthalmologic examination, which consisted of visual acuity (VA),
biomicroscopy, tonometry and fundoscopy. Fiber layer analyzer-GDx-examination was
performed in eleven patients. Twelve patients were men. The mean age was
55.0+/-13.5 years. The follow-up since transplantation lasted from 3 to 74
months; mean value 29.7+/-20.8 months. RESULTS: VA with best correction in all
patients attained at least 20/40. Subcapsular posterior cataract was seen in one 
patient; another presented corneal nubeculae secondary to herpes zoster. In one
case a scar suggesting retinocoroiditis was seen at fundoscopy. Biomicroscopic
and the fundoscopic findings were expected because of immunosuppressive
treatment, following transplantation. GDx examination disclosed loss of fibers in
the superior retinal fiber layer in 12 of the 22 examined eyes. CONCLUSION: These
results support the hypothesis that reduction of oxygen inflow in retinal
circulation before or during heart transplantation could lead to loss of fibers
in the retinal nerve fiber layer.

Publication Types: 
    English Abstract

PMID: 18157299 [PubMed - indexed for MEDLINE]

445: Adv Skin Wound Care. 2008 Jan;21(1):13; author reply 13.

Comment on:
    Adv Skin Wound Care. 2007 Jul;20(7):408-12.

Expanding the rationale for occlusion?

Bolton LL.

Publication Types: 
    Comment
    Letter

PMID: 18156819 [PubMed - indexed for MEDLINE]

446: BMJ. 2007 Dec 22;335(7633):1305.

Death delusion.

Hellden A, Odar-Cederlof I, Larsson K, Fehrman-Ekholm I, Linden T.

Division of Clinical Pharmacology/Pharmacovigilance, Department of Laboratory
Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm,
Sweden. anders.hellden@ki.se

Publication Types: 
    Case Reports

PMID: 18156240 [PubMed - indexed for MEDLINE]

447: Dent Clin North Am. 2008 Jan;52(1):203-30, x.

Oral manifestations of internal malignancy and paraneoplastic syndromes.

Woo VL, Abdelsayed R.

Columbia University College of Dental Medicine, 630 West 168th Street, PH 1562
West, New York, NY 10032, USA. vlw2104@columbia.edu

Malignant tumors of visceral organs are a fundamental feature of familial cancer 
and paraneoplastic syndromes. In many instances, the presence of an internal and 
often occult malignancy may be forewarned by various external manifestations.
Several of these findings are preferentially localized to the head and neck
region, including the oral cavity proper. This places the dental practitioner in 
a unique position to detect these "markers" of occult neoplastic involvement.
Because these markers may present before an established syndrome or cancer
diagnosis, even representing the first expression of disease in some cases, early
recognition by a dentist may lead to timely diagnosis and management of these
cancer-associated syndromes.

Publication Types: 
    Review

PMID: 18154871 [PubMed - indexed for MEDLINE]

448: Rev Iberoam Micol. 2007 Dec 31;24(4):330-1.

[Clinical cases in Medical Mycology. Case No. 30]

[Article in Spanish]

Maiolo E, Arechavala AI, Santiso G, Bianchi MH, Troglio F, Orduna T, Negroni R.

Unidad Micologia, Hospital de Infecciosas Francisco Javier Muniz, Buenos Aires,
Argentina.

Publication Types: 
    Case Reports
    Clinical Conference

PMID: 18095773 [PubMed - indexed for MEDLINE]

449: J Ark Med Soc. 2007 Dec;104(6):139.

An unusual case of shingles.

Dildy DW Jr, McLeane LR.

Publication Types: 
    Case Reports

PMID: 18092499 [PubMed - indexed for MEDLINE]

450: Am J Med Sci. 2007 Dec;334(6):481-6.

Immunization for the elderly.

Bader MS.

Division of Infectious Diseases, Memorial University School of Medicine, St.
John's, Newfoundland, Canada. msbader1@hotmail.com

The morbidity and mortality of vaccine-preventable diseases among older adults
are high. Despite the benefits of elderly vaccination, vaccination rates remain
low and especially among some minority groups. Specific strategies for improving 
the rate of vaccination have been developed for medical offices and clinics,
hospitals, and other health care institutions. There are vaccines that are
recommended routinely for the elderly while other vaccines are recommended in
certain circumstances. Knowing the indications, contraindications, and adverse
reactions to the recommended vaccines for the elderly is very important to the
primary care physicians.

Publication Types: 
    Review

PMID: 18091370 [PubMed - indexed for MEDLINE]

451: J Neuropathol Exp Neurol. 2007 Dec;66(12):1100-17.

A novel cerebral microangiopathy with endothelial cell atypia and multifocal
white matter lesions: a direct mycoplasmal infection?

Zu-Rhein GM, Lo SC, Hulette CM, Powers JM.

Department of Pathology, University of Wisconsin Medical School, Madison,
Wisconsin, USA.

We present 3 sporadic cases of a subacute to chronic, progressive motor (i.e.
weakness, ataxia, spasticity, dysarthria, and dysphagia) and cognitive disorder
in adults of both sexes, without proven immunocompromise or malignancy.
Neuroimaging studies revealed tiny calcifications with atrophy of the cerebrum,
pons, and midbrain in 1 patient, cerebral atrophy in another, and cerebral
atrophy and periventricular white matter hyperintensities in the third. Clinical 
diagnoses included cortico-pontine-cerebellar degeneration, mixed
neurodegenerative disorder, progressive supranuclear palsy, diffuse Lewy body
disease, and Lyme disease. One atrophic brain revealed widely disseminated,
millimeter-sized gray lesions in cerebral white matter and obscured anatomic
markings of the basis pontis. The most conspicuous microscopic feature in all was
capillaries with focally piled up endothelial nuclei, some of which appeared to
be multinucleated, or enlarged, hyperchromatic crescentic single nuclei. Although
seen mostly without associated damage, they were also noted with white matter
lesions displaying vacuolation, demyelination, spheroids, necrosis, vascular
fibrosis, and mineralization; these were most severe in the basis pontis.
Immunostains and probes to herpes simplex virus-I, -II, and -8; adenovirus,
cytomegalovirus, varicella-zoster, Epstein-Barr virus, measles, JC virus, and
herpes hominis virus-6 were negative. Electron microscopy revealed no virions in 
endothelial cells with multilobed or multiple nuclei and duplicated basal
laminae. However, mycoplasma-like bodies, mostly 400 to 600 nm in size, were
found in endothelial cell cytoplasm and capillary lumina. Platelets adhered to
affected endothelial cells. Polymerase chain reaction and immunohistochemistry of
fixed samples for Mycoplasma fermentans were negative; other species of
Mycoplasma remain viable pathogenic candidates.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural

PMID: 18090919 [PubMed - indexed for MEDLINE]

452: Laryngoscope. 2008 Mar;118(3):394-7.

Prognostic value of electroneurography and electromyography in facial palsy.

Grosheva M, Wittekindt C, Guntinas-Lichius O.

Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 
Cologne, Germany.

OBJECTIVES: To compare the prognostic value of electroneurography (ENG) and
needle electromyography (EMG) to estimate facial function outcome after acute
facial palsy. STUDY DESIGN: Retrospective study using electrodiagnostic data and 
medical chart review. METHODS: Two hundred one patients treated 1995 to 2004 were
included. Initial and final facial function was established clinically by the
House-Brackmann (HB) scale. ENG results were classified into amplitude loss less 
than 75% and amplitude loss 75% or greater to predict complete recovery and
defective healing, respectively. Initial and follow-up EMG results were
classified into neurapraxia and predicted complete recovery. In contrast,
axonotmesis/neurotmesis and mixed lesions predicted, by definition, defective
healing. RESULTS:: Initial HB was II to IV in 154 patients and V to VI in 47
patients. The etiology was idiopathic palsy in 139, iatrogenic lesion in 29,
traumatic in 18, and herpes zoster in 15 patients. Finally, 134 (67%) patients
showed a full recovery. Sixty-seven (33%) patients showed signs of defective
healing. ENG presented a sensitivity, specificity, accuracy, positive predictive 
value (to predict defective healing), and negative predictive value of 60%, 79%, 
73%, 59%, and 80%, respectively. The values for the initial EMG were 66%, 98%,
89%, 91%, and 89%. The best results showed the follow-up EMG with 85%, 100%, 97%,
100%, and 96%. EMG results were not classifiable in 32 (16%) patients.
CONCLUSIONS: EMG showed higher prognostic values than ENG, especially when
repeated during the time course of the facial palsy. ENG might be helpful if the 
EMG result is not classifiable.

Publication Types: 
    Comparative Study

PMID: 18090862 [PubMed - indexed for MEDLINE]

453: Transplant Proc. 2007 Dec;39(10):3347-57.

Allogeneic stem cell transplantation in hematological disorders: single center
experience from Pakistan.

Ullah K, Ahmed P, Raza S, Satti T, Nisa Q, Mirza S, Akhtar F, Kamal MK, Akhtar
FM.

Armed Forces Bone Marrow Transplant Center, Rawalpindi, Pakistan.

One hundred and fifty-four patients received allogeneic stem cell
transplantations from HLA-matched siblings for various hematological disorders
from July 2001 to September 2006. Indications for transplantation included
aplastic anemia (n=66), beta-thalassemia major (n=40), CML (n=33), acute leukemia
(n=8), and miscellaneous disorders (n=7). One hundred and twenty patients were
males and 34 were females. Median patient age was 14 years (range, 1(1/4)-54
years). All patients achieved successful engraftment. Median time to engraftment 
(ANC>0.5x10(9)/L) was 14 days. Posttransplant complications encountered in our
patients included acute graft versus host disease (GvHD) (grade II-IV) 28.5%,
chronic GvHD 15.5%, hemorrhagic cystitis 9.7%, VOD liver 5.1%, acute renal
failure 3.2%, bacterial infections 51.2%, fungal infections 15.0%,
cytomegalovirus (CMV) infection 4%, herpes zoster 4%, tuberculosis 2.6%,
Pneumocystis jirovicii infection 0.6%, malaria 0.6% patients, graft rejection
5.2% patients, and relapse in 4% patients. Certain unexpected and rare
posttransplant complications were also observed in our patients. These included
Hickman catheter embolization, Guillain-Barre (GB) syndrome, deep vein
thrombosis, hemorrhagic pericarditis with clots leading to cardiac tamponade,
idiopathic polycythemia, dengue fever, and cyclosporine-induced neurotoxicity.
Mortality was observed in 27.2% patients. Major causes of mortality were GvHD,
VOD, disease relapse, intracranial hemorrhage, acute renal failure, pseudomonas
septicemia, tuberculosis, disseminated aspergillosis, and CMV infection. At 5
years, overall survival (OS) and disease-free survival (DFS) rates were 72.5% and
70.7%, respectively.

PMID: 18089384 [PubMed - indexed for MEDLINE]

454: Transplant Proc. 2007 Dec;39(10):3098-100.

Posttransplantation conversion to sirolimus-based immunosuppression: a single
center experience.

Saber LT, Ikeda MY, Almeida JM.

Renal Transplant Unit, Hospital das Clinicas, University of Sao Paulo-Ribeirao
Preto, Sao Paulo, Brazil.

Sirolimus (SRL) has become an option in kidney transplantation, especially among 
patients who develop chronic allograft nephropathy (CAN). This study sought to
evaluate the safety and efficacy of SRL in 103 kidney recipients of mean age 40
years, including 78 recipients of organs from deceased donors. The major reason
for conversion was calcineurin inhibitor (CNI) nephrotoxicity (42.3%) followed by
CAN (35.4%). A preconversion kidney biopsy was performed in 89 patients with CAN 
diagnosed in 51. Mean time to conversion was 40.5 months. The new therapy was:
SRL/mycophenolate mofetil (MMF)/prednisone (Pred) in 79 patients; SRL/tacrolimus 
(TAC)/Pred in 15; and other SRL combinations in 9. The target SRL trough level
was 5.0 to 8.0 ng/mL. To evaluate the impact of conversion on renal function, we 
compared the proteinuria and inverse serum creatinine at 3 months before
conversion, at conversion, and at 1, 3, 6, 12, and 24 months postconversion. The 
overall mean follow-up time was 13.2 months. The analysis showed significant
improvement in renal function at month 1 postconversion (P<.05) with
stabilization thereafter. The SRL/MMF combination frequently induced anemia
and/or leukopenia (n=23). Infections included pneumonia (n=10), herpes zoster
(n=7), herpes simplex (n=3), cytomegalovirus (n=2), histoplasmosis (n=2),
tuberculosis (n=2), and neurocryptococcosis (n=1). Reasons for SRL
discontinuation were myelotoxicity (n=4), infection (n=3), nephrotoxicity (n=3), 
gastrointestinal intolerance (n=3), myopathy (n=1), pneumonitis (n=1),
hyperlipidemia (n=1), and other reasons (n=3). Graft loss occurred in 29 patients
due to CAN (n=21) followed by death (cardiovascular, n=2; infectious, n=2), acute
rejection (n=3), and infection following immunosuppression withdrawal (n=1). We
concluded that SRL represented an option but reducing associated
immunosuppression should strongly be considered to minimize the frequent side
effects, especially infections.

PMID: 18089330 [PubMed - indexed for MEDLINE]

455: Arch Dermatol. 2007 Dec;143(12):1599-600.

A case of zosteriform pigmented purpuric dermatosis.

Hamada T, Inoue Y, Nakama T, Hashimoto T.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't

PMID: 18087025 [PubMed - indexed for MEDLINE]

456: Pediatrics. 2008 Jan;121(1):e150-6. Epub 2007 Dec 17.

Primary varicella and herpes zoster among HIV-infected children from 1989 to
2006.

Wood SM, Shah SS, Steenhoff AP, Rutstein RM.

Special Immunology Service, Children's Hospital of Philadelphia, 34th Street and 
Civic Center Boulevard, Philadelphia, PA 19104, USA.

OBJECTIVES: The primary objective of this study was to determine the incidence of
herpes zoster in perinatally HIV-infected children. Secondary objectives included
assessing the impact of highly active antiretroviral therapy and varicella zoster
virus immunization on primary varicella and herpes zoster incidence and
identifying risk factors for herpes zoster. We hypothesized that the incidence of
herpes zoster has decreased in this population as a result of highly active
antiretroviral therapy and routine varicella zoster virus immunization. PATIENTS 
AND METHODS: This retrospective cohort study included HIV-infected children at a 
pediatric HIV clinic from 1989 to 2006. Incidence rates for 3 intervals
(1989-1996, 1997-1999, and 2000-2006) were compared on the basis of introduction 
of highly active antiretroviral therapy (1996) and varicella zoster virus
vaccination (1999). A Cox proportional-hazards regression model was developed for
the time to herpes zoster among the subset of patients with primary varicella
infection. RESULTS: In 356 patients followed for 1721 person-years, the incidence
of herpes zoster according to period was 30.0 per 1000 person-years in 1989-1996,
31.9 per 1000 person-years in 1997-1999, and 6.5 per 1000 person-years in
2000-2006. There was no difference in incidence-rate ratio between 1989-1996 and 
1997-1999. However, there was a significant difference in herpes zoster incidence
when comparing 1989-1999 with 2000-2006. The incidence of primary varicella
zoster virus infection and herpes zoster in the 57 patients who received the
varicella zoster virus vaccine was 22.3 per 1000 and 4.5 per 1000 person-years,
respectively. Highly active antiretroviral therapy at the time of primary
varicella zoster virus infection was protective against herpes zoster and
increased herpes zoster-free survival. CONCLUSIONS: The incidence of herpes
zoster has decreased since 1989. The decline occurred after 2000, likely
representing the combined effect of immunization and highly active antiretroviral
therapy. The use of highly active antiretroviral therapy at the time of primary
varicella zoster virus infection decreased the risk of herpes zoster and
increased herpes zoster-free survival. Varicella zoster virus immunization was
effective in preventing both primary varicella zoster virus and herpes zoster in 
this cohort.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 18086820 [PubMed - indexed for MEDLINE]

457: Eur J Dermatol. 2008 Jan-Feb;18(1):101-2. Epub 2007 Dec 18.

Zosteriform cutaneous localizations of B-cell chronic lymphocytic leukaemia.

Claeys A, Pouaha J, Christian B, Froment N, Truchetet F.

Publication Types: 
    Case Reports
    Letter

PMID: 18086615 [PubMed - indexed for MEDLINE]

458: Transpl Infect Dis. 2008 Jul;10(4):260-8. Epub 2007 Dec 11.

Varicella zoster virus-associated disease in adult kidney transplant recipients: 
incidence and risk-factor analysis.

Arness T, Pedersen R, Dierkhising R, Kremers W, Patel R.

Mayo Medical School, Mayo Clinic College of Medicine, Rochester, Minnesota 55905,
USA.

Varicella zoster virus (VZV)-related disease, particularly herpes zoster, is a
complication of organ transplantation due to long-term immunosuppression. We
determined the incidence and risk factors for post-transplant VZV infection by
retrospectively reviewing the medical records of a cohort of 612 adult renal
transplant recipients transplanted at Mayo Clinic Rochester between October 1,
2001 and October 1, 2004. Thirty-seven subjects developed herpes zoster,
corresponding to a follow-up time-adjusted incidence of 11.2% at 4 years post
transplant. The incidence rate of zoster was relatively constant between 6 months
and 4 years, yielding an average incidence of approximately 28 per 1000
person-years. The risk of developing post-transplant zoster increased with
increasing age at transplant, with each decade conferring a 1.42-fold (P=0.009)
increase in risk of zoster development. Seronegativity at time of transplant
conferred over 3 times the risk of development of post-transplant zoster (hazard 
ratio 3.4; P=0.04) compared with seropositivity. Adult kidney transplant
recipients are at high risk for the development of post-transplant zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18086277 [PubMed - indexed for MEDLINE]

459: Ocul Immunol Inflamm. 2007 Nov-Dec;15(6):425-7.

Long-term preservation of vision in progressive outer retinal necrosis treated
with combination antiviral drugs and highly active antiretroviral therapy.

Kim SJ, Equi R, Belair ML, Fine HF, Dunn JP.

The Johns Hopkins Hospital, The Wilmer Eye Institute, Ophthalmology, Baltimore
21205, USA.

PURPOSE: To report the successful long-term treatment of varicella zoster
virus-associated progressive outer retinal necrosis (VZV-PORN) with aggressive
antiviral combination drugs along with highly active antiretroviral therapy
(HAART). DESIGN: Interventional case report. METHODS: Combined treatment of
progressive outer retinal necrosis in a university-based tertiary eye hospital
with ganciclovir implant, intravenous acyclovir (10 mg/kg every 8 h),
intravitreal foscarnet (2.4 mg), and HAART. RESULTS: Successful treatment of
progressive outer retinal necrosis with disease remission and preservation of
20/20 visual acuity out to 1 year. CONCLUSIONS: Combination antiviral therapy and
HAART may improve long-term visual outcomes for VZV-PORN.

Publication Types: 
    Case Reports

PMID: 18085485 [PubMed - indexed for MEDLINE]

460: Zhongguo Zhen Jiu. 2007 Nov;27(11):807-9.

[Treatment of residual neuralgia of herpes zoster by ear point taping and
pressing therapy combined with acupoint-injection]

[Article in Chinese]

Wu B, Jiang CH, Zhou QY, Chen QM, Shu Y, Li X, Lu YH.

Chengdu City Second People's Hospital, Sichuan 610017, China.
wu731210@hotmail.com

OBJECTIVE: To Assess therapeutic effect of ear point taping and pressing therapy 
combined with acupoint-injection on residual neuralgia of herpes zoster. METHODS:
One hundred and sixteen cases were randomly divided into a comprehensive group (n
= 60) and a medication group (n = 56). The medication group were treated with
routine western medicine, and the comprehensive group with ear point taping and
pressing therapy combined with acupoint-injection besides the routine western
medicine. Auricular points selected for ear point taping and pressing were
Shemen, Neifenmi (endorine), Pizhixia (subcortex), Gan (liver), Dan
(gallbladder), Fei (lung) and corresponding auricular points to the lesion parts,
with the two ears alternatively used, pressing each day; points selected for
point-injection of VitB12 were Zusanli (ST 36), Neiguan (PC 6), Quchi (LI 11),
Taichong (LR 3). The pain degrees, the time of pain alleviation and pain ceasing 
of the patient were regularly recorded. RESULTS: The average time of pain
alleviation and pain ceasing of the patient in the comprehensive group were
significantly shorter than those in the medication group (P < 0.01). The cured
rate and the cured and markedly effective rate were 60.0% and 83.3% in the
comprehensive group, and 28.6% and 50.0% in the medication group, with
significant difference between the two groups (P < 0.05). CONCLUSION: Ear point
taping and pressing therapy combined with acupoint-injection is effective and
safe for treatment of residual neuralgia of herpes zoster.

Publication Types: 
    English Abstract
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 18085141 [PubMed - indexed for MEDLINE]

461: J Okla State Med Assoc. 2007 Oct;100(10):388-95.

Part XIV. Antiviral agents other than antiretrovirals: therapy for herpesvirus
infections, viral hepatitis, and influenza.

Lockhart SM, Salvaggio MR, Bronze MS, Greenfield RA.

College of Pharmacy Building, Oklahoma City, OK 73117, USA.
Staci-Lockhart@ouhsc.edu

The incidences of viral infectious diseases are increasing at an alarming rate in
the US and worldwide. Antiviral therapy is challenging because viruses subsume
normal host cellular mechanisms for many functions, have rapid replication rates,
have poor error scanning when reading genetic code, and undergo frequent drug
target mutations. This article will focus on antiviral drugs and principles of
treatment for infections due to herpes simplex viruses (HSV1 and HSV2), varicella
zoster virus (VZV), cytomegalovirus (CMV), hepatitis B and hepatitis C viruses,
and influenza virus. Therapy for human immunodeficiency virus (HIV) infection
will be discussed in the next symposium segment.

PMID: 18085096 [PubMed - indexed for MEDLINE]

462: Blood. 2008 Feb 15;111(4):1848-54. Epub 2007 Dec 13.

A phase 1 multidose study of SGN-30 immunotherapy in patients with refractory or 
recurrent CD30+ hematologic malignancies.

Bartlett NL, Younes A, Carabasi MH, Forero A, Rosenblatt JD, Leonard JP,
Bernstein SH, Bociek RG, Lorenz JM, Hart BW, Barton J.

Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
63110, USA. nbartlet@wustl.edu

Phase 1 testing of SGN-30, a chimeric monoclonal antibody for the treatment of
CD30(+) malignancies, was conducted in a multicenter study. To explore the safety
profile and establish the maximum tolerated dose (MTD), 24 patients with
refractory or relapsed Hodgkin lymphoma or CD30(+) non-Hodgkin lymphoma received 
6 weekly doses of intravenous SGN-30 at 4 dose levels (2, 4, 8, or 12 mg/kg).
Serum concentrations of SGN-30 rose rapidly and were dose dependent. Adverse
events were mild, with nausea, fatigue, and fever attributed to study treatment. 
One episode of hypersensitivity rash was reported. The MTD was not reached.
Serious adverse events included herpes zoster (n = 2), influenza, and pneumonia. 
One patient with cutaneous anaplastic large cell lymphoma (8 mg/kg) achieved a
complete response. Six patients, of whom 4 had Hodgkin lymphoma, achieved stable 
disease with durations ranging from 6 to 16 months. The pharmacokinetic profile
of SGN-30 showed a biphasic disposition, and estimated half-lives ranging between
1 to 3 weeks. The 6 weekly infusions of SGN-30 resulted in approximately 2- to
3-fold accumulation in serum exposures consistently across the dose range. These 
results demonstrate that weekly administration of SGN-30 is safe and has modest
clinical activity in patients with CD30(+) tumors. This trial is registered at
http://www.ClinicalTrials.gov as no. NCT00051597.

Publication Types: 
    Clinical Trial, Phase I
    Multicenter Study

PMID: 18079362 [PubMed - indexed for MEDLINE]

463: Clin Vaccine Immunol. 2008 Feb;15(2):314-9. Epub 2007 Dec 12.

A double-blind, randomized, controlled, multicenter safety and immunogenicity
study of a refrigerator-stable formulation of Zostavax.

Gilderman LI, Lawless JF, Nolen TM, Sterling T, Rutledge RZ, Fernsler DA, Azrolan
N, Sutradhar SC, Wang WW, Chan IS, Schlienger K, Schodel F, Silber JL; Zostavax
Protocol 010 Study Group.

University Clinical Research, Pembroke Pines, Florida, USA.

The vaccine Zostavax has been shown to prevent herpes zoster (HZ) and
postherpetic neuralgia and is recommended for individuals > or =60 years of age. 
This study compared the safety and the immunogenicity of a refrigerator-stable
formulation (Zostavax refrigerated) with those of the current formulation
(Zostavax frozen) in subjects > or =50 years of age. Subjects with a negative
history for HZ were randomized 1:1 to receive one dose of either formulation.
Enrollment was stratified 1:2 by age (50 to 59 years and > or =60 years). Safety 
was evaluated for 28 days postvaccination. Varicella-zoster virus (VZV) antibody 
responses were measured by a glycoprotein enzyme-linked immunosorbent assay
(gpELISA). The primary endpoints were the VZV antibody geometric mean titer (GMT;
day 28), the VZV antibody geometric mean rise (GMR; days 1 to 28), and the
incidence of vaccine-related serious adverse experiences (AEs) over 28 days. The 
refrigerated (n = 182) and frozen (n = 185) formulations induced similar GMTs
(727.4 and 834.4 gpELISA units/ml, respectively); the estimated GMT ratio
(refrigerated formulation/frozen formulation) was 0.87 (95% confidence interval, 
0.71 to 1.07). The GMRs were 2.6- and 2.9-fold, respectively. No vaccine-related 
serious AEs were reported in either group, and the safety profiles of the
formulations were generally similar. The frequencies of injection-site AEs during
follow-up were 35.6% and 46.4% in the refrigerated and the frozen formulation
groups, respectively, and were generally mild. The frequencies of systemic AEs
were similar in the two groups, and those of vaccine-related AEs were
approximately 6% in both groups. The refrigerator-stable formulation of Zostavax 
has an acceptable safety profile and is as immunogenic as the frozen formulation;
thus, the vaccine may be used in clinical settings where freezer availability is 
limited.

Publication Types: 
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 18077611 [PubMed - indexed for MEDLINE]

464: Nippon Rinsho. 2007 Oct 28;65 Suppl 8:233-41.

[Adverse effects of antiviral agents]

[Article in Japanese]

Moriuchi M, Moriuchi H.

Department of Molecular Microbiology and Immunology, Nagasaki University Graduate
School of Biomedical Sciences.

Publication Types: 
    Review

PMID: 18074544 [PubMed - indexed for MEDLINE]

465: Nephrol Dial Transplant. 2008 Apr;23(4):1307-12. Epub 2007 Dec 8.

Mycophenolate mofetil versus cyclophosphamide for inducing remission of ANCA
vasculitis with moderate renal involvement.

Hu W, Liu C, Xie H, Chen H, Liu Z, Li L.

Research Institute of Nephrology, Jingling Hospital, Nanjing University School of
Medicine, Nanjing 210002, Jiangsu, People's Republic of China.
huwx64@medmail.com.cn

OBJECTIVE: We performed a single-centre non-blinded clinical trial to compare the
clinical efficacies of mycophenolate mofetil (MMF) and intermittent
cyclophosphamide (CTX) pulse therapy as induction treatments in patients with
antineutrophil cytoplasmic antibody (ANCA) vasculitis (AAV) and moderate renal
involvement. METHODS: Patients with active AAV and serum creatinine <500
micromol/L received either MMF treatment (MMF group) or monthly CTX pulse therapy
(CTX group) for 6 months. Disease activity was assessed using the Birmingham
Vasculitis Activity Score (BVAS). The disease activity, remission rate, renal
function and adverse reactions were compared between the two groups. RESULTS: A
total of 35 patients (15 male, 20 female: aged 49.1 +/- 12.2 years) were
enrolled, with 18 in the MMF group and 17 in the CTX group. Of the 35 patients,
28 were MPO-ANCA positive and 2 were PR3-ANCA positive. Four patients were lost
to follow-up in the CTX group. At Month 6, BVAS scores were much lower in the MMF
group than in the CTX group (0.2 +/- 0.89 versus 2.6 +/- 1.7, P < 0.05). In the
intent-to-treatment analysis, 14 of 18 patients (77.8%) treated with MMF and 8 of
17 patients receiving CTX (47.1%) had complete remission with an absolute
difference of 30.7%. Eight of 18 patients (44.4%) in the MMF group and 2 of 17
patients (15.4%) in the CTX group recovered renal function. Serum ANCA decreased 
to normal in 41.7% of patients in the MMF group and in 16.7% in the CTX group.
Side effects in the MMF group were pneumonia (1), herpes zoster (1) and
gastrointestinal symptoms (2), and in the CTX group were leukocytopenia (1),
gastrointestinal distress (4) and pneumonia (1). CONCLUSION: Our study suggests
that MMF effectively ameliorates disease activity and considerably improves renal
function in patients with AAV. Further large-scale multicentre prospective
randomized controlled trials will be needed to confirm these findings.

Publication Types: 
    Comparative Study
    Randomized Controlled Trial

PMID: 18065810 [PubMed - indexed for MEDLINE]

466: Am J Ophthalmol. 2008 Feb;145(2):369-74. Epub 2007 Dec 3.

Diagnosis of ocular toxocariasis by establishing intraocular antibody production.

de Visser L, Rothova A, de Boer JH, van Loon AM, Kerkhoff FT, Canninga-van Dijk
MR, Weersink AY, de Groot-Mijnes JD.

Department of Medical Microbiology, University Medical Center Utrecht,
Heidelberglaan 100, Utrecht, The Netherlands. L.devisser-6@umcutrecht.nl

PURPOSE: To investigate the role of Toxocara canis in posterior uveitis of
undetermined origin. DESIGN: Retrospective case-study. METHODS: Paired ocular
fluid (47 aqueous humor [AH] and two vitreous fluids) and serum samples of 37
adults and 12 children with undetermined posterior uveitis were retrospectively
analyzed for intraocular IgG antibody production against Toxocara canis by
enzyme-linked immunosorbent assay and Goldmann-Witmer coefficient (GWC)
determination. Previous diagnostic investigation by polymerase chain reaction and
GWC for Herpes simplex virus, Varicella zoster virus, and Toxoplasma gondii had
not provided a cause of the posterior uveitis. RESULTS: Three of 12 (25%)
children showed intraocular IgG production against Toxocara canis. One child had 
vitritis, one presented with a low-grade uveitis and a peripheral retinal lesion,
and the third had posterior uveitis and a chorioretinal scar. All three children 
had AH IgG titers exceeding those of the corresponding serum. In fact, two
children had low Toxocara serum IgG titers (<1:32) and would have been considered
seronegative upon routine serology screening. Intraocular antibody production
against Toxocara canis was absent in all 37 adults, including five seropositive
patients. CONCLUSIONS: Our results indicate that ocular toxocariasis is mainly a 
pediatric disease. Serological screening is not informative for the diagnosis of 
intraocular Toxocara infection. Toxocara GWC analysis, however, can be of value
when diagnosing patients with posterior focal lesions or vitritis of unknown
etiology.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 18061138 [PubMed - indexed for MEDLINE]

467: Can J Ophthalmol. 2007 Dec;42(6):881.

Macular optical coherence tomography findings in progressive outer retinal
necrosis.

Almony A, Dhalla MS, Feiner L, Shah GK.

Publication Types: 
    Case Reports
    Letter

PMID: 18059519 [PubMed - indexed for MEDLINE]

468: Ophthalmology. 2007 Dec;114(12):2367; author reply 2367-8.

Comment on:
    Ophthalmology. 2007 Feb;114(2):307-12.

Oral drugs for viral retinitis.

Garner HR, Latkany P.

Publication Types: 
    Comment
    Letter

PMID: 18054655 [PubMed - indexed for MEDLINE]

469: Mayo Clin Proc. 2007 Dec;82(12):1562-5.

66-year-old man with inarticulate speech.

Curtis KK, Vikram HR.

Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic,
Scottsdale, AZ, USA.

Publication Types: 
    Case Reports

PMID: 18053466 [PubMed - indexed for MEDLINE]

470: Virol J. 2007 Dec 3;4:130.

Determination of suitable housekeeping genes for normalisation of quantitative
real time PCR analysis of cells infected with human immunodeficiency virus and
herpes viruses.

Watson S, Mercier S, Bye C, Wilkinson J, Cunningham AL, Harman AN.

Centre for Virus Research, Westmead Millennium Institute, Sydney, Australia.
sarahlouise53@hotmail.com

The choice of an appropriate housekeeping gene for normalisation purposes has now
become an essential requirement when designing QPCR experiments. This is of
particular importance when using QPCR to measure viral and cellular gene
transcription levels in the context of viral infections as viruses can
significantly interfere with host cell pathways, the components of which
traditional housekeeping genes often encode. In this study we have determined the
reliability of 10 housekeeping genes in context of four heavily studied viral
infections; human immunodeficiency virus type 1, herpes simplex virus type 1,
cytomegalovirus and varicella zoster virus infections using a variety of cell
types and virus strains. This provides researchers of these viruses with a
shortlist of potential housekeeping genes to use as normalisers for QPCR
experiments.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18053162 [PubMed - indexed for MEDLINE]

471: MMW Fortschr Med. 2007 Nov 8;149(45):5.

[Unexpected diagnosis in a child. Herpes zoster]

[Article in German]

Escher W.

Publication Types: 
    Case Reports

PMID: 18050590 [PubMed - indexed for MEDLINE]

472: Ann Otolaryngol Chir Cervicofac. 2007 Oct;124 Suppl 1:S74-83.

[Pain associated with craniofacial and cervical herpes zoster]

[Article in French]

George B, Lory C.

Service d'anesthesie-reanimation chirurgicale, unite d'evaluation et de
traitement de la douleur, hopital Saint-Louis, 75010 Paris, France.

Ophthalmological and cervical involvement of herpes zoster virus ranks second and
third, respectively, in terms of localization frequency. Involvement of the
cranial nerves is a particular sign of complications, notably ocular
complications, possibly compromising the visual or facial prognosis through
involvement of the VIIth nerve, which is responsible for facial paralysis. These 
types of involvement should be rapidly diagnosed and treated so as to limit these
complications. The pain associated with herpes zoster remains frequent and
difficult to treat, even if today the criteria for defining postzoster pain is
increasingly refined. Antalgic and antiviral treatment should be initiated early,
from the very first signs, to attempt to reduce the incidence of this postzoster 
pain. The risk factors, associated with the development of postzoster pain are
age over 50 years, the severity of the skin rash and the intensity of the acute
pain, and the existence of a prodromic pain phase before onset. The European
Federation of Neurological Societies has recently published guidelines on the
pharmacological treatments for postzoster pain. Nerve block treatments remain at 
a limited evidence level. Patients with postzoster pain should be managed by
teams specializing in pain management as soon as conventional treatments fail.

Publication Types: 
    English Abstract
    Review

PMID: 18047868 [PubMed - indexed for MEDLINE]

473: J Am Acad Dermatol. 2007 Dec;57(6 Suppl):S143-7.

Vaccination strategies for the prevention of herpes zoster and postherpetic
neuralgia.

Betts RF.

Infectious Diseases Unit, University of Rochester School of Medicine and
Dentistry, Rochester, New York, USA. robert_betts@urmc.rochester.edu

Herpes zoster disease and its most common complication, postherpetic neuralgia,
are associated with significant morbidity in the elderly. The zoster vaccine
boosts cell-mediated immunity to varicella-zoster virus, the virus that causes
both varicella and herpes zoster. This vaccine has demonstrated the ability to
reduce the zoster-related burden of illness and the incidence of both zoster and 
postherpetic neuralgia in a randomized, controlled trial conducted in individuals
aged 60 years and older, an age group at increased risk of herpes zoster.
Widespread use of this vaccine could prevent as many as a quarter of a million
cases of zoster disease each year. The design and outcomes of the Shingles
Prevention Study, which examined the efficacy and safety of the vaccine, and the 
rationale for widespread immunization against varicella-zoster virus, are
presented here.

Publication Types: 
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 18021866 [PubMed - indexed for MEDLINE]

474: J Am Acad Dermatol. 2007 Dec;57(6 Suppl):S136-42.

Management of herpes zoster and postherpetic neuralgia.

Tyring SK.

Department of Dermatology, The University of Texas, Houston, Texas, USA.
styring@ccstexas.com

Patients with herpes zoster experience severe pain and potential lasting
complications such as postherpetic neuralgia, ophthalmic disease/damage, and,
rarely, skin complications (eg, infection of rash area). Treatment for acute
zoster aims to accelerate healing, control pain, and, when possible, reduce the
risk of complications. Early intervention with antivirals can accelerate rash
healing, reduce rash severity, and reduce the risk of some complications. The
addition of corticosteroids to antiviral medication may further alleviate
short-term zoster pain, but is associated with an increased risk of serious
adverse effects, especially among older adults. If a patient does develop
postherpetic neuralgia, gabapentin, pregabalin, opioids, tricyclic
antidepressants, lidocaine patch 5%, and capsaicin may all be considered as
palliative treatments. For individuals with treatment-refractory postherpetic
neuralgia, nonpharmacologic approaches may be considered and a pain-management
specialist should be consulted. There is a need for more effective agents to
treat herpes zoster and postherpetic neuralgia.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18021865 [PubMed - indexed for MEDLINE]

475: J Am Acad Dermatol. 2007 Dec;57(6 Suppl):S130-5.

Herpes zoster: epidemiology, natural history, and common complications.

Weinberg JM.

Clinical Research Center, Department of Dermatology, St. Luke's-Roosevelt
Hospital Center, and Columbia University College of Physicians and Surgeons, New 
York, New York 10025, USA. jmw27@columbia.edu

Herpes zoster is a disease associated with aging that can significantly impair
quality of life for affected individuals. Anyone infected with varicella
(chickenpox) virus in childhood is at risk for reactivation of dormant virus and 
the onset of zoster disease, although it occurs with increasing frequency in the 
elderly as a result of waning of cell-mediated immunity. The most common
complication of herpes zoster is postherpetic neuralgia, which can cause chronic 
and debilitating pain. Current treatments can decrease the severity of zoster
rash and pain but cannot prevent disease onset or completely eliminate the most
frequent symptoms. The zoster vaccine may help prevent the onset of herpes zoster
in the target population of those age 60 years and older. This summary reviews
the epidemiology, pathogenesis, natural history, and common symptoms of zoster
disease.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 18021864 [PubMed - indexed for MEDLINE]

476: Arthritis Rheum. 2007 Dec 15;57(8):1431-8.

The risk of herpes zoster in patients with rheumatoid arthritis in the United
States and the United Kingdom.

Smitten AL, Choi HK, Hochberg MC, Suissa S, Simon TA, Testa MA, Chan KA.

Harvard School of Public Health, Boston, Massachusetts 02115, USA.

OBJECTIVE: To determine whether the incidence of herpes zoster is elevated in
patients with rheumatoid arthritis (RA) and whether herpes zoster is associated
with use of disease-modifying antirheumatic drugs (DMARDs) in patients with RA.
METHODS: Two retrospective cohort studies were conducted using data from a US
integrated managed care database (PharMetrics claims database) from 1998-2002 and
the UK General Practice Research Database (GPRD) between 1990-2001. Rates of
herpes zoster among patients with RA and randomly sampled non-RA patients were
compared. A nested case-control analysis was performed within each RA cohort to
examine the effect of current treatment on herpes zoster risk. RESULTS: A total
of 122,272 patients with RA from the PharMetrics database and 38,621 from the
GPRD were included. The adjusted hazard ratios of herpes zoster for patients with
RA compared with non-RA patients were 1.91 (95% confidence interval [95% CI]
1.80-2.03) in the PharMetrics database and 1.65 (95% CI 1.57-1.75) in the GPRD.
In the PharMetrics database, current use of biologic DMARDs alone was associated 
with herpes zoster (odds ratio [OR] 1.54, 95% CI 1.04-2.29), as was current use
of traditional DMARDs alone (OR 1.37, 95% CI 1.18-1.59). In the GPRD, current use
of traditional DMARDs was associated with herpes zoster (OR 1.27, 95% CI
1.10-1.48). In both data sources, use of oral corticosteroids was associated with
herpes zoster regardless of concomitant therapies. CONCLUSION: Data from 2 large 
databases suggested that patients with RA are at increased risk of herpes zoster.
Among patients with RA, DMARDs and/or use of oral corticosteroids appeared to be 
associated with herpes zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18050184 [PubMed - indexed for MEDLINE]

477: Arch Phys Med Rehabil. 2007 Dec;88(12):1742-3; author reply 1743-4.

Comment on:
    Arch Phys Med Rehabil. 2007 Feb;88(2):255-8.

Safety of cervical transforaminal steroid injections.

Shankar H.

Publication Types: 
    Comment
    Letter

PMID: 18047902 [PubMed - indexed for MEDLINE]

478: Fukuoka Igaku Zasshi. 2007 Oct;98(10):364-72.

Possible roles of transcription factors of pseudorabies virus in
neuropathogenicity.

Ono E, Tomioka Y, Taharaguchi S.

Laboratory of Biomedicine, Center of Biomedical Research, Graduate School of
Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
etsuro@qda.med.kyushu-u.ac.jp

Pseudorabies virus (PRV) is also known by its taxonomic name, suid herpesvirus 1,
or by its original name, Aujeszky's disease virus. PRV is a swine herpesvirus of 
the Alphaherpesvirinae subfamily to which varicella-zoster virus (VZV) and herpes
simplex virus type 1 (HSV-1) and type 2 (HSV-2) belong. PRV is a pathogen of
swine resulting in devastating disease and economic losses worldwide. It causes
severe neurological disorders in infected piglets and latent infection in
surviving pigs. PRV also causes acute and often fatal infection in other domestic
and wild animals. PRV has been of interest to virologists and neurobiologists.
This herpesvirus has served as a useful model organism for the study of
herpesvirus biology. The virus has also been used as a "live" tracer of neuronal 
pathways, making use of its remarkable propensity to infect synaptically
connected neurons. Transcription factors of alphaherpesviruses not only control
the expression of their own viral genes, but also influence the gene expression
of other viruses and mammalian cells. This review focuses on recent reports
regarding the use of transgenic mice to study the contributions of PRV
transcription factors to the neuropathogenicity and the functions of their
transcriptional regulatory elements.

Publication Types: 
    Review

PMID: 18046989 [PubMed - indexed for MEDLINE]

479: Retina. 2007 Nov-Dec;27(9):1313-4.

Optical coherence tomography of progressive outer retinal necrosis.

Blair MP, Goldstein DA, Shapiro MJ.

Department of Ophthalmology and Visual Science, University of Illinois at
Chicago, USA. mblair2@uic.edu

Publication Types: 
    Case Reports

PMID: 18046245 [PubMed - indexed for MEDLINE]

480: Herpes. 2007 Sep;14 Suppl 2:52-5.

Factors affecting an economic model for zoster vaccination.

Fattore G.

Centre for Research on Healthcare Management (CERGAS), Bocconi University, Milan,
Italy. giovanni.fattore@unibocconi.it

Results from the recent Shingles Prevention Study indicate that zoster
vaccination can reduce the incidence and severity of herpes zoster and
post-herpetic neuralgia (PHN), raising the possibility of a widespread
vaccination programme. Such a programme would incur substantial costs, mandating 
the need for rigorous cost-effectiveness analyses prior to implementation.
Suitably robust analyses of the cost benefits of zoster vaccination, capturing
the duration of benefits and impact on quality of life resulting from
vaccination, are lacking. Any economic model would need to consider current
estimates of the economic burden of zoster and PHN in unvaccinated populations,
as well the predicted effects of zoster vaccination on health improvements (e.g. 
reductions in zoster and PHN morbidity, improved quality of life, incidence of
adverse effects), and costs for the health system and society at large (e.g.
reductions in healthcare costs, variations in the costs of administering the
vaccine) in different regions. Economic estimates of the burden of zoster and PHN
in unvaccinated populations are scarce, and further studies are needed to measure
the impact of these prevention strategies in different regions of the world.

Publication Types: 
    Review

PMID: 17939898 [PubMed - indexed for MEDLINE]

481: Herpes. 2007 Sep;14 Suppl 2:48-51.

Prevention strategies: experience of varicella vaccination programmes.

Patrick D.

University of British Columbia, Centre for Disease Control, Vancouver, BC,
Canada. david.patrick@bccdc.ca

Widespread immunization programmes have had a dramatic effect on the morbidity
associated with varicella in the USA; mortality has declined by 66% (from 0.41 to
0.14 deaths / million population) and the reduction in hospitalizations is at
least 4-fold (from 2.7 to 0.6/100,000 population) compared with the
pre-vaccination era. Although varicella outbreaks have occurred in vaccination
areas, these data may underestimate the true efficacy of the varicella vaccine,
and there is still the potential for two-dose programmes, which have not yet been
fully explored in the USA or Canada. Catch-up vaccination programmes have also
been regarded as an important approach in susceptible individuals, including
women of childbearing potential. Periodic exposure (boosts) to vaccines may
potentially help prevent the reactivation of herpes zoster and accumulation of
susceptibility in these at-risk groups. Pregnant women may also benefit from
prophylaxis with varicella zoster immunoglobulin (VZIG) or possibly with
aciclovir. Ongoing surveillance for the reactivation of herpes zoster and safety 
programmes are also highlighted as key recommendations.

PMID: 17939897 [PubMed - indexed for MEDLINE]

482: Herpes. 2007 Sep;14 Suppl 2:45-7.

Prevention strategies: herpes zoster, post-herpetic neuralgia and immunogenicity.

Levin MJ, Schmader K.

Section of Pediatric Infectious Diseases, Department of Pediatrics, University of
Colorado School of Medicine, Denver, CO 80262, USA. myron.levin@uchsc.edu

Herpes zoster is a common condition that can have a significant impact on quality
of life among older adults. A significant proportion of older subjects with
herpes zoster develop post-herpetic neuralgia (PHN), a chronic condition that is 
difficult to treat. The Shingles Prevention Study was a large-scale clinical
trial to determine the efficacy of a live, attenuated varicella zoster virus
(VZV) vaccine ('zoster vaccine') for preventing or attenuating herpes zoster in
subjects aged > or =60 years. A total of 38 546 subjects were given either zoster
vaccine or placebo. The burden of illness (pain severity-by-duration), incidence 
of herpes zoster, and PHN decreased by 61.1%, 51.3% and 66.5% (all P<0.001),
respectively, following vaccination. Vaccine efficacy was maintained for a 4-year
follow-up period. A sub-study of the vaccine trial evaluated VZV-specific
immunity in approximately 1200 vaccine or placebo recipients prior to
vaccination, at 3 months and annually for 3 years. VZV-specific cell-mediated
immunity (CMI) was boosted significantly by the zoster vaccine. This boost
remained substantially intact for the 3 years of follow-up. It is likely that the
vaccine-induced boost in VZV-specific CMI reversed the natural decline in these
responses that occurs as part of the ageing process, thereby protecting vaccine
recipients against herpes zoster and its complications.

Publication Types: 
    Review

PMID: 17939896 [PubMed - indexed for MEDLINE]

483: Herpes. 2007 Sep;14 Suppl 2:40-4.

Epidemiology and burden of herpes zoster and post-herpetic neuralgia in
Australia, Asia and South America.

Araujo LQ, Macintyre CR, Vujacich C.

Federal University of Sao Paulo, UNIFESP, Sao Paulo, SP, Brazil.
lara.mqaraujo@gmail.com

Following the development of a herpes zoster vaccine and the successful
introduction of widespread varicella vaccination in the USA, many countries are
considering similar vaccination programmes. However, before implementing such
programmes, it is important to describe the regional baselines of varicella and
herpes zoster epidemiology, both to aid the design of vaccination strategies and 
to observe trends after the introduction of vaccination. In many areas of the
world, this information is difficult to gather, and the epidemiology of herpes
zoster and post-herpetic neuralgia in these regions is poorly understood. In
Australia, available national data sources of varicella and herpes zoster,
including serological data, provide reliable estimates of disease and reveal
similar rates of incidence and complications to those in Europe and the USA.
However, the average age of infection in Australia is higher than in Europe and
in the USA. Epidemiological data from Asia and South America are scarce.
Unexpectedly for tropical countries, the incidences of herpes zoster in Asia and 
South America also appear to be comparable with those in Europe and the USA,
despite the delayed acquisition of varicella-zoster virus infection in Asia. In
Brazil, there is some evidence for higher than expected incidence rates for
herpes zoster in young adults. The epidemiology of herpes zoster in Asia and
South America suggests that recommendations on treatment and prevention from
Europe and the USA may be relevant to these countries.

Publication Types: 
    Review

PMID: 17939895 [PubMed - indexed for MEDLINE]

484: Herpes. 2007 Sep;14 Suppl 2:35-9.

Severe complications of herpes zoster.

Volpi A.

Department of Public Health, University of Rome Tor Vergata, Rome, Italy.
volpi@med.uniroma2.it

The usual presentation of herpes zoster is as a self-limiting vesicular rash,
often accompanied by post-herpetic neuralgia (PHN), its most common complication.
However, herpes zoster can give rise to other complications, many of which have
unusual presentations and serious sequelae. The incidence and burden of many of
these less common complications are poorly understood. Ocular complications of
ophthalmic zoster are relatively frequent but, with early antiviral therapy, need
not be sight-threatening. Delayed contralateral hemiparesis is a rare
complication of ophthalmic zoster that may present as stroke, temporally remote
from the zoster episode. Ramsay Hunt syndrome is caused by reactivation of
varicella zoster virus (VZV) involving the facial nerve; facial paralysis, ear
pain and vesicles in the ear are diagnostic. Facial paralysis in the absence of
vesicles may indicate zoster sine herpete, which can be mistaken for Bell's
palsy. Herpetic facial palsies may respond to combination therapy with an
antiviral plus steroid, but further research is needed to determine the benefit
of such treatments.

Publication Types: 
    Review

PMID: 17939894 [PubMed - indexed for MEDLINE]

485: Herpes. 2007 Sep;14 Suppl 2:30-4.

Zoster-associated pain: what is known, who is at risk and how can it be managed?

Johnson RW.

University of Bristol, Bristol, UK. r.w.johnson@bris.ac.uk

Herpes zoster episodes commence with a prodromal period of about 4 days with
symptoms including pain and malaise. This is followed by a rash lasting
approximately 2-4 weeks, with possible subacute herpetic neuralgia for up to 3
months, followed, in some patients, by a period of post-herpetic neuralgia (PHN) 
lasting months or possibly years. Severe acute pain is more likely in older
females and those with a prodrome or severe rash. Two separate mechanisms of PHN 
have been proposed: the first is that the excitability of primary afferent
neurons is increased after nerve damage, causing irritable nociceptors and
central sensitization, resulting in pain and allodynia; the second involves the
degeneration of nociceptive neurons, which leads to deafferentation with central 
hyperactivity, causing pain but without allodynia. Both mechanisms may co-exist
in an individual patient. Treatments for acute herpes zoster and PHN include
established antivirals, alone or in combination with steroids, analgesics and
neural blockade with local anaesthetics. Commonly used pain relief includes
acetaminophen/paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), opioid
analgesics, tricyclic antidepressants, gabapentin, pregabalin and topical
analgesics. Effective and long-lasting pain relief in herpes zoster and PHN
remains a largely unmet medical need.

Publication Types: 
    Review

PMID: 17939893 [PubMed - indexed for MEDLINE]

486: Herpes. 2007 Sep;14 Suppl 2:25-9.

Erratum in:
    Herpes. 2007 Dec;14(3):74.

Varicella zoster virus: natural history and current therapies of varicella and
herpes zoster.

Breuer J, Whitley R.

Centre for Infectious Disease, Institute of Cell and Molecular Science, Barts,
UK. j.breuer@qmul.ac.uk

The natural history of varicella zoster virus (VZV) infection and the molecular
mechanisms of viral pathogenesis are incompletely understood. Although no animal 
model yet reproduces all aspects of VZV infection, recently developed models of
VZV infection, and the creation of genetically altered VZV recombinants, are
yielding new information about primary viraemia and latency. During viraemia,
T-cells transport VZV to the skin, where cell-free viral replication facilitates 
person-to-person spread and transmission to the neurons where latency is
established. The alternate viral pathways of lytic infection or latency appear to
be cell-type determined and involve both host and viral components. Antiviral
therapy for varicella is safe and efficacious, and as varicella in children is
usually mild, treatment is generally recommended only for adolescents and adults 
with varicella. Treatment is recommended for all individuals with herpes zoster, 
especially those aged over 50 years. For some varicella and zoster cases,
aciclovir, the original standard, is being replaced by valaciclovir and
famciclovir as preferred therapies. For herpes zoster, bromovinyl deoxyuridine
(brivudin) has been added to the list of treatment options for immunocompetent
individuals, but is contraindicated in patients with cancer. Antiviral therapy
will still have a role in the treatment of disease caused by VZV even after the
widespread implementation of vaccination programmes for both chickenpox and
herpes zoster.

PMID: 17939892 [PubMed - indexed for MEDLINE]

487: Herpes. 2007 Sep;14 Suppl 2:24.

Global strategies to prevent herpes zoster and its associated complications.

Johnson RW, Griffiths P.

Publication Types: 
    Editorial

PMID: 17939891 [PubMed - indexed for MEDLINE]

488: Arch Dis Child. 2008 May;93(5):401-6. Epub 2007 Nov 26.

B cell depletion therapy for 19 patients with refractory systemic lupus
erythematosus.

Podolskaya A, Stadermann M, Pilkington C, Marks SD, Tullus K.

Department of Paediatric Nephrology, Great Ormond Street Hospital for Children
NHS Trust, London, WC1N 3JH, UK.

OBJECTIVE: B cell dysregulation is involved in the development of childhood-onset
systemic lupus erythematosus (SLE). The safety and efficacy of B cell depletion
therapy is evaluated in the the largest series of children to be presented in the
literature. METHODS: 19 children (89% female) with SLE, aged 6-16 (median 14)
years, treated with rituximab in a single centre were retrospectively reviewed.
The British Isles Lupus Assessment Group (BILAG) index and biochemical,
haematological and immunological parameters were evaluated before and after
treatment, with the primary outcome assessed as normal results. Rituximab therapy
was used for acute life- or organ-threatening symptoms or symptoms that had not
responded to standard treatment. The range of symptoms included lupus nephritis, 
cerebral lupus and severe general symptoms. Rituximab 750 mg/m(2) was given
intravenously twice, usually within a 2-week period. Patients were followed up
for 6-38 (median 20) months. RESULTS: Rapid reduction of SLE disease activity was
observed within the first month, represented by a reduction of BILAG scores (14
to 6, p<0.005) and an improvement in renal function (estimated glomerular
filtration rate of 54 to 68 ml/min/1.73 m(2), p = 0.07), immunological
(complement C3: 0.46 to 0.83 g/l, p = 0.02) and haematological (haemoglobin: 9.7 
to 10.3 g/dl, p = 0.04) parameters. No serious side effects were observed, except
for herpes zoster in five cases. CONCLUSION: In our cohort of children, rituximab
was safe and effective when used in combination with standard immunosuppressive
agents. Randomised controlled studies are needed to further evaluate the safety
and efficacy of rituximab therapy.

PMID: 18039744 [PubMed - indexed for MEDLINE]

489: JAAPA. 2007 Nov;20(11):21-5.

Herpes zoster in 2007: treatment and prevention.

Friel FJ.

Idaho Army National Guard, USA.

Publication Types: 
    Review

PMID: 18035759 [PubMed - indexed for MEDLINE]

490: Reg Anesth Pain Med. 2007 Nov-Dec;32(6):533-5.

Bee stings--a remedy for postherpetic neuralgia? A case report.

Janik JE, Wania-Galicia L, Kalauokalani D.

Department of Anesthesiology and Pain, University of California Davis Medical
Center, Sacramento, CA, USA. james.janik@chw.edu

OBJECTIVE: This case report describes the effects of bee stings on painful
postherpetic neuralgia in a 51-year-old man. CASE REPORT: The patient was stung
by 3 bees in the distribution in which he had been experiencing postherpetic
neuralgia. One day after the bee stings, the patient's painful postherpetic
neuralgia was completely relieved, and the relief lasted for 1 and a half months.
Subsequently, the patient's pain returned, but at significantly less intensity
and frequency than what he had experienced prior to the bee stings. CONCLUSIONS: 
Bee venom and bee sting therapy have been shown to have both antinociceptive and 
anti-inflammatory properties, which may explain why the bee stings relieved the
patient's postherpetic neuralgia. Bee sting or bee venom therapy should be
further investigated as a potential treatment modality for postherpetic
neuralgia.

Publication Types: 
    Case Reports

PMID: 18035302 [PubMed - indexed for MEDLINE]

491: J Stroke Cerebrovasc Dis. 2007 Nov-Dec;16(6):268-72.

Case of moyamoya disease in a patient with advanced acquired immunodeficiency
syndrome.

Sharfstein SR, Ahmed S, Islam MQ, Najjar MI, Ratushny V.

Department of Neurology, SUNY Downstate Medical Center, New York, NY 11203, USA. 
Sophia.Sharfstein@Downstate.edu

BACKGROUND: Moyamoya disease is an occlusion of the terminal portion of internal 
carotid arteries and proximal portion of middle and anterior cerebral arteries of
unknown origin. Moyamoya syndrome is associated with meningitis, tuberculosis,
syphilis, head trauma, head irradiation, brain tumor, von Recklinghausen's
disease, tuberous sclerosis, Marfan syndrome, sickle cell anemia,
arteriosclerosis, hypertension, and oral contraceptive use. To our knowledge,
acquired immunodeficiency syndrome (AIDS) as a cause of moyamoya syndrome has not
been reported in an adult population. OBJECTIVE: We report a case of moyamoya
syndrome in a patient with AIDS and without other conditions associated with
occlusion of the circle of Willis and formation of collateral network at the base
of the brain and basal ganglia. METHODS: We present a case report. RESULTS: A
29-year-old woman with an 8-year history of AIDS on multiple antiretroviral
medications presented with recurrent tingling of the left extremities which 1
month later progressed to mild hemiparesis and dysarthria. During the next few
months the patient developed progressive cognitive decline and on-and-off
fluctuations in the degree of hemiparesis. Brain magnetic resonance imaging
showed multiple small subcortical infarct's in both parietal lobes. Magnetic
resonance angiography showed occlusion of middle cerebral arteries distal
internal carotid arteries, with prominent collateral network. Cerebral
angiography confirmed moyamoya pattern. Lumbar puncture showed: white blood cell 
count 1, red blood cell count 418, protein 56, glucose 53, negative bacterial and
acid-fast bacilli smear and culture, negative VDRL test, India ink, cryptococcal 
antigen, cytology and negative polymerase chain reaction for cytomegalovirus,
Epstein-Barr virus, varicella-zoster virus, and herpes simplex virus type 1 and
2. Electroencephalography showed diffuse background slowing. CONCLUSIONS: We
hypothesize that human immunodeficiency virus (HIV) caused central nervous system
vasculitis, which eventually led to formation of moyamoya pattern. No other
definite causes of central nervous system vasculitis were found in our patient.
Cerebrovascular disorders should be considered in patients with HIV/AIDS with
focal neurologic deficit. Moyamoya syndrome as a cause of stroke should be
considered in patients with HIV/AIDS, especially as survival improves.

Publication Types: 
    Case Reports

PMID: 18035245 [PubMed - indexed for MEDLINE]

492: Clin Ther. 2007 Sep;29(9):2022-30.

A randomized, double-blind, placebo-controlled, two-period, crossover, pilot
trial of lamotrigine in patients with central pain due to multiple sclerosis.

Breuer B, Pappagallo M, Knotkova H, Guleyupoglu N, Wallenstein S, Portenoy RK.

Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New 
York, New York 1003, USA. bbreuer@chpnet.org

BACKGROUND: Approximately 30% of patients with multiple sclerosis (MS) have
central pain (CP). The anticonvulsant lamotrigine has been shown to be
efficacious in some types of CP, but its efficacy in MS-related CP has not been
confirmed. OBJECTIVE: The aim of this pilot trial was to provide preliminary data
for a planned larger trial. METHODS: A randomized, double-blind,
placebo-controlled, 2-period, crossover pilot study was conducted in a sample of 
patients aged > or =18 years with CP due to MS. The 2 treatment periods began
with an 8-week, double-blind titration period, during which the number of pills
of study drug was increased until either total pain relief was achieved, 1 or
more unmanageable adverse events were reported, or a maximum of 16 pills (400 mg 
of lamotrigine) were used daily. A 3-week maintenance period at the final
prescribed amount was followed by a 2-week tapering period; there was a 2-week
washout between the 2 treatment periods, after which patients were administered
the alternate drug. Outcomes before, during, and after each study period were
assessed using validated measures of pain and quality of life (the Brief Pain
Inventory [BH], the Neuropathic Pain Scale [NPS], and the 54-item MS Quality of
Life [MSQOL-54] questionnaire). Throughout the trial, patients completed a daily 
diary consisting of questions from the BPI-Short Form, as well as questions about
the use of other analgesic drugs, changes in health, and the occurrence of
adverse events. The BPI and NPS were completed weekly during telephone calls with
the research coordinator, and the MSQOL-54 was administered during clinic visits 
(ie, visits at screening, baseline, end of period 1, and termination). The
primary outcome measure was the mean pain intensity score during the final
maintenance week of each of the 2 study periods. RESULTS: A total of 12 patients 
were enrolled and completed at least the first period of the study. Ten patients 
were women. The mean (SD) age was 49.3 (11.7) years, and the mean (SD) weight was
76.5 (19.9) kg. The analysis revealed no significant differences between the
lamotrigine and placebo periods in any of the study outcomes related to pain or
quality of life. Regarding adverse events, 1 patient developed a moderate rash
during the study, but the physician attributed this lesion to herpes zoster; this
patient completed the study. While other adverse events were mild, 2 patients
were withdrawn from the study after experiencing adverse events during the first 
study period; 1 had been receiving lamotrigine and the other placebo. CONCLUSION:
The results from this pilot trial did not support either the use of lamotrigine
in patients with MS-related CP or the need for a larger trial.

Publication Types: 
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 18035201 [PubMed - indexed for MEDLINE]

493: J Clin Microbiol. 2008 Jan;46(1):325-7. Epub 2007 Nov 21.

Novel varicella-zoster virus glycoprotein E gene mutations associated with
genotypes A and D.

Schmidt-Chanasit J, Bleymehl K, Schad SG, Gross G, Ulrich RG, Doerr HW.

Institute of Medical Virology, Hospital of the Johann Wolfgang Goethe University,
D-60596 Frankfurt am Main, Germany. jonassi@gmx.de

Here, we describe the association of certain varicella-zoster virus (VZV)
genotypes with unique glycoprotein E (gE) gene mutations. Within 45 analyzed VZV 
wild-type strains of genotypes A and D, five novel gE mutations were discovered. 
A statistically significant (P < 0.0001) association of certain gE mutations with
VZV genotype D was found.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18032615 [PubMed - indexed for MEDLINE]

494: J Pain Palliat Care Pharmacother. 2007;21(3):99-100.

Is there a role for herpes zoster vaccine in chronic pain management?.

Lindberg EG.

Publication Types: 
    Letter

PMID: 18032366 [PubMed - indexed for MEDLINE]

495: Can J Microbiol. 2007 Oct;53(10):1117-22.

Development of a multiplex polymerase chain reaction for detection and typing of 
major human herpesviruses in cerebrospinal fluid.

Bergallo M, Costa C, Margio S, Sidoti F, Terlizzi ME, Cavallo R.

University of Turin, Department of Public Health and Microbiology, Virology Unit,
Via Santena 9 - 10126 Turin, Italy.

Infections of the central nervous system (CNS) represent a difficult diagnostic
problem for both clinicians and microbiologists. In particular, the Herpesviridae
family plays a central etiological role in CNS viral infections. These diseases
have acquired growing importance in the past few years owing to the increasing
number of immunocompromised patients and the availability of new antiviral drugs.
Prompt detection and diagnosis of CNS viral infections are critical because most 
infections are treatable, while a delayed recognition may lead to
life-threatening conditions or severe sequelae. The traditional methods for
detection of herpesviruses in CNS infections exhibit several drawbacks, whereas
the polymerase chain reaction (PCR) on cerebrospinal fluid has revolutionized the
neurovirology and is becoming an essential part of the diagnostic work-up of
patients with suspected CNS viral infections. A sensitive multiplex PCR method
was developed for the simultaneous detection of 6 human herpesviruses (human
cytomegalovirus, herpes simplex virus 1, herpes simplex virus 2, Epstein-Barr
virus, varicella-zoster virus, and human herpesvirus 6) with the aim of
simplifying detection and reducing time and costs. The accuracy, reproducibility,
specificity, and sensitivity of these assays were established.

Publication Types: 
    Evaluation Studies

PMID: 18026203 [PubMed - indexed for MEDLINE]

496: Mol Cancer Ther. 2007 Nov;6(11):2891-9.

Nonimmunosuppressive chemotherapy: EM011-treated mice mount normal T-cell
responses to an acute lymphocytic choriomeningitis virus infection.

Aneja R, Kalia V, Ahmed R, Joshi HC.

Laboratory for Drug Discovery, Design, and Research, Department of Cell Biology, 
Emory University School of Medicine, Atlanta, GA 30322, USA. raneja@emory.edu

Myelosuppression and associated immunosuppression are major problems in cancer
chemotherapy. Thus, infection remains a significant source of morbidity and
mortality during chemotherapy of cancer patients. Viral infections, particularly 
herpes simplex virus, varicella zoster virus, and cytomegalovirus, result either 
due to reactivation of latent viruses or new infections as sequelae of
chemotherapy and debilitated cell-mediated immunity. Ultimately, the resolution
of these infections can only be achieved after the control of malignancy and
regaining the patient's ability to mount adequate immune responses. We show here 
that EM011, a tubulin-binding, nontoxic, orally available anticancer agent, does 
not alter absolute CD4(+), CD8(+), B220(+), and NK1.1(+) cell counts in
immunocompetent mice. More importantly, EM011 treatment at tumor-suppressive
dosages (300 mg/kg) does not suppress cell-mediated immune responses in mice
experimentally challenged with acute lymphocytic choriomeningitis virus
infection, in that mice mount robust virus-specific CD8(+) and CD4(+) T-cell
immune responses while maintained on daily drug treatment. Thus, CD8(+) and
CD4(+) T-cell expansion and acquisition of effector functions is not perturbed by
EM011 treatment. These data provide compelling evidence to support the
nonimmunosuppressive nature of EM011 therapy and provide strong impetus for
combining chemotherapy with immunotherapy as a novel anticancer strategy.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 18025274 [PubMed - indexed for MEDLINE]

497: J Am Acad Dermatol. 2007 Dec;57(6):1102-3.

Ramsay Hunt syndrome: a case report with cranial nerve XII involvement.

Izumi AK, Kitagawa K.

Publication Types: 
    Case Reports
    Letter

PMID: 18021862 [PubMed - indexed for MEDLINE]

498: Cir Pediatr. 2007 Jul;20(3):151-5.

[Aplasia cutis congenita: surgical treatment and results in 36 cases]

[Article in Spanish]

Suarez O, Lopez-Gutierrez JC, Andres A, Barrena S, Encinas JL, Luis A,
Soto-Bauregard C, Diaz M, Ros Z.

Servicio de Cirugia Plastica, Departamento de Cirugia Pediatrica, Hospital
Infantil Universitario La Paz, Madrid. queminfantil.hulp@salud.madrid.org

INTRODUCTION: Aplasia cutis congenita is a rare congenital absence of skin most
commonly affecting the scalp. Although most defects are small and superficial,
approximately 20% of cases involve absence of the skull. Such defects expose the 
brain and sagital sinus, with concomitant risk of fatal hemorrage, infection, or 
both. This anomaly most commonly presents as a solitary defect, but sometimes it 
may occur as multiple lesions. The lesions are noninflammatory and well
demarcated, and range is variable from 0.5 cm to 10 cm or more. Although the
majority of these scalp defects occurs sporadically, many family cases have been 
reported. Multiple causes have been suggested for aplasia cutis: genetic causes, 
syndromes and teratogens, intrauterine infection -varicella zoster virus, herpes 
simplex virus-, fetal exposure to cocaine, heroin, alcohol or antithyroid drugs. 
MATERIALS AND METHODS: A retrospective study of children with Aplasia Cutis
Congenita who received treatment in Hospital La Paz, in Madrid between 1995 and
2005 was undertaken. We checked location, moment of the surgery, type of surgery 
and aesthetic results. RESULTS: In the 20 year period between 1985-2005, we
treated 36 patients with Aplasia Cutis. 33 of them have the scalp affected and
only in 3 cases the trunk was involved. In 4 cases there was an absence of the
skull, two slight and two severe. 3 patients had Adams-Oliver and one Cutis
Marmorata Telangiectasica syndrome. Fifteen patients were operated in neonatal
period with direct closure or advancement or rotational flaps, and in 17 cases
the late treatment included use of tissue expanders to cover definitely the
defect. One of the patients died for bleeding of the sagital sinus while was
waiting for the secondary closure of the wound, and other patient required
complex skull reconstruction to achieve a complete coverage. CONCLUSIONS: In view
of our experience and results, we believe that early surgery prevents vital
risks, reduces local complications and makes easier the final reconstruction.

Publication Types: 
    English Abstract

PMID: 18018742 [PubMed - indexed for MEDLINE]

499: Bull Soc Belge Ophtalmol. 2007;(305):7-12.

[Ocular complications of HIV/AIDS in Cameroon: is there is any correlation with
the level of CD4 lymphocytes count?]

[Article in French]

Ebana Mvogo C, Ellong A, Bella AL, Luma H, Achu Joko H.

Faculte de Medecine et des Sciences Biomedicales, Universite de Yaounde I.
Cameroun ebanamvogo@yahoo.fr

PURPOSE: This study aimed to identify the ocular complications of HIV/AIDS in
Cameroon and to determine if there is any correlation between their occurrence
and the level of CD4 lymphocytes count. MATERIAL AND METHODS: This prospective
study was carried out at the General Hospital, Douala, from October 2004 to
September 2005. All HIV positive patients with known CD4 count were retained for 
the study. Each patient had an exhaustive ocular examination. RESULTS: A total of
57 patients including 30 females (52.9%) and 27 males (47.4%) were examined. The 
mean age was 38.9 years +/- 10.3. The eye examination was pathological in 36
patients (63.2%) and normal in 21 patients (36.8%). An ocular complaint was the
inaugural manifestation of the disease in 31.6% of patients. The principal
lesions of the anterior segment were herpetic keratitis (10.5%) and herpes zoster
ophthalmicus (12.3%). The most common posterior segment lesions were
cytomegalovirus retinitis (14%) and uveitis (15.8%). The mean CD4 count in our
series was 118.3/mm3 +/- 106.7. 91.7% of patients with ocular complications have 
a CD4 count of less than 200/mm3. A non linear correlation was found between the 
CD4 level and the occurrence of ocular complications. CONCLUSION: With the
improvement of access to antiretroviral treatment, the ocular complications of
HIV/AIDS are more common. The role of the ophthalmologist is therefore essential 
in the diagnosis and management of these patients.

Publication Types: 
    English Abstract

PMID: 18018421 [PubMed - indexed for MEDLINE]

500: J Infect Dis. 2007 Nov 15;196(10):1455-8.

Immunocompetent children account for the majority of complications in childhood
herpes zoster.

Grote V, von Kries R, Rosenfeld E, Belohradsky BH, Liese J.

Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilian
University, Heiglhofstrasse 63, Munich, Germany. veit.grote@med.uni-muenchen.de

In a 2-year-long active surveillance conducted in all German pediatric hospitals,
the incidence of hospitalization because of herpes zoster and the clinical
picture of complications in children were assessed. Herpes zoster resulted in
hospitalization of 244 children, 78 of whom were considered to be
immunocompromised. Zoster ophthalmicus (n=29), meningoencephalitis (n=22), and
zoster oticus (n=23) (11 cases had Ramsay Hunt syndrome) accounted for 59% of all
complications (n=115). The incidence of hospitalization suggests that at least 1 
in every 100 children with herpes zoster is hospitalized and that at least 1 in
every 250 immunocompetent children with herpes zoster is hospitalized with
complications.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 18008223 [PubMed - indexed for MEDLINE]

501: J Laryngol Otol. 2008 Feb;122(2):170-6. Epub 2007 Nov 16.

Unilateral associated laryngeal paralysis due to varicella-zoster virus: virus
antibody testing and videofluoroscopic findings.

Chitose SI, Umeno H, Hamakawa S, Nakashima T, Shoji H.

Department of Otolaryngology-Head and Neck Surgery, Kurume University School of
Medicine, Fukuoka, Japan. yonekawa@med.kurume-u.ac.jp

The relationship between varicella-zoster virus and idiopathic associated
laryngeal paralysis was examined in five patients, using complement fixation or
enzyme immunoassay testing. In all cases, significant changes in serum levels of 
varicella-zoster virus antibody were observed. Videofluoroscopy was useful in
assessing the severity of the dysphagia and in making an accurate diagnosis; both
laryngeal elevation and weakness of pharyngeal wall contraction were also
observed. In two cases in which antiviral therapy was delayed, the outcome was
poor, with increased levels of varicella-zoster virus immunoglobulin M found on
enzyme immunoassay. The outcome of the condition may thus depend both on the
speed of antiviral therapy commencement following onset of symptoms, and on the
levels of varicella-zoster virus immunoglobulin M antibody (measured by enzyme
immunoassay). Our study suggests that varicella-zoster virus should be considered
in the differential diagnosis of patients with idiopathic associated laryngeal
paralysis, and rapid antiviral therapy should be initiated when necessary.

PMID: 18005500 [PubMed - indexed for MEDLINE]

502: Clin Vaccine Immunol. 2008 Jan;15(1):159-63. Epub 2007 Nov 14.

Rapid, sensitive, and specific lateral-flow immunochromatographic point-of-care
device for detection of herpes simplex virus type 2-specific immunoglobulin G
antibodies in serum and whole blood.

Laderman EI, Whitworth E, Dumaual E, Jones M, Hudak A, Hogrefe W, Carney J, Groen
J.

Research and Development Department, Focus Diagnostics, Inc., Cypress,
California, USA. bethlad@gmail.com

Herpes simplex virus type 2 (HSV-2) is a common human pathogen that can cause a
variety of clinical manifestations in humans. In order to provide near-patient
results to allow for faster counseling and treatment, a rapid point-of-care test 
that is accurate and simple to use is desirable. Here, we describe the
development and evaluation of an HSV-2 immunoglobulin G (IgG)-specific antibody
lateral-flow immunochromatographic assay (LFIA) based on colloidal gold
nanoparticles. A total of 359 serum samples and 100 whole-blood samples were
tested in the newly developed HSV-2 LFIA. Serum results were compared to those
from the HerpeSelect HSV-2 enzyme-linked immunosorbent assay (ELISA), and
whole-blood sample results were compared to those of both ELISA and HerpeSelect
HSV-1 and -2 immunoblotting (IB). The sensitivity of the HSV-2 LFIA compared to
that of the HerpeSelect ELISA was 100% (89/89), and the specificity was 97.3%
(257/264). Cross-reactivity with HSV-1 IgG-positive serum samples was observed in
2.6% (5/196) of samples, 2.9% (1/34) for rubella virus, and 6.2% (1/16) for
Epstein-Barr virus. No cross-reactivity in varicella-zoster virus or
cytomegalovirus IgG-positive serum samples was observed. No interference was
observed from bilirubin-, triglyceride-, albumin-, or hemoglobin-spiked samples. 
The concordance of the LFIA results between capillary whole blood, EDTA-treated
venous whole blood, heparin-treated venous whole blood, and serum was 99%
(99/100). In conclusion, the LFIA for HSV-2 IgG-specific antibodies demonstrated 
excellent sensitivity, specificity, and concordance for both serum and
whole-blood samples compared to the sensitivity, specificity, and concordance of 
both HSV-2 ELISA and IB.

PMID: 18003814 [PubMed - indexed for MEDLINE]

503: Aten Primaria. 2007 Nov;39(11):622.

[Parsonage-Turner syndrome]

[Article in Spanish]

Valdivieso EF, Sanz SM, Lazaro CD.

Publication Types: 
    Case Reports
    Letter

PMID: 18001648 [PubMed - indexed for MEDLINE]

504: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2007
Nov;50(11):1399-403.

[Nosocomial transmission of viruses to pregnant women by infected medical
personnel]

[Article in German]

Ross RS.

Universitat Duisburg-Essen, Universitatsklinikum Essen, BRD.
stefan.ross@uni-due.de

Virus-infected medical personnel under certain circumstances might represent a
risk for pregnant women. With regard to such nosocomial provider-to-patient
transmissions, the pathogens rubella virus, herpes viruses and the hepatitis B
and hepatitis C viruses are of particular concern. It will become clear from the 
following short communication that in this context one should strive to achieve
optimal protection for the expectant mothers without restricting the professional
activities of virus-infected members of the medical staff in an unjustified way. 
In this respect it always has to be kept in mind that the risk of
provider-to-patient transmissions of viruses in obstetrics and neonatology can be
significantly reduced by vaccinating all personnel working in these departments
against infections by the rubella, varicella-zoster, and hepatitis B viruses, and
that additional strict adherence to so-called universal hygienic precautions will
add more than an incremental benefit.

Publication Types: 
    English Abstract
    Review

PMID: 17999133 [PubMed - indexed for MEDLINE]

505: Expert Rev Neurother. 2007 Nov;7(11):1581-95.

Postherpetic neuralgia: epidemiology, pathophysiology and management.

Johnson RW, Wasner G, Saddier P, Baron R.

Bristol Royal Infirmary, University of Bristol, Bristol, UK.
r.w.johnson@bris.ac.uk

Postherpetic neuralgia (PHN) is a neuropathic pain syndrome and is the most
common complication of herpes zoster (HZ; shingles). PHN occurs mainly in HZ
patients 60 years of age and older, in particular in those suffering from more
severe acute pain and rash. Administration of antiviral drugs reduces the
duration of pain associated with HZ. The pathophysiology of PHN may be distinctly
different between patients with either reduced or increased skin sensitivity.
Therapy is with tricyclic drugs (e.g., nortriptyline), alpha 2 delta-ligands
(e.g., gabapentin) or opiates with adjunctive topical lidocaine or capsaicin.
Mechanism-based therapy is a desirable goal but so far proves elusive. The
incidence of HZ, and therefore that of PHN, is likely to increase as a result of 
greater longevity and increasing numbers of patients receiving treatment that
compromises cell-mediated immunity. A zoster vaccine for administration to adults
reduces the incidence of HZ and PHN, as well as the burden of illness associated 
with these conditions.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 17997705 [PubMed - indexed for MEDLINE]

506: J Clin Virol. 2007 Dec;40(4):325-9. Epub 2007 Nov 9.

Identification and genotyping of molluscum contagiosum virus from genital swab
samples by real-time PCR and Pyrosequencing.

Trama JP, Adelson ME, Mordechai E.

Molecular and Cellular Biology Division, Medical Diagnostic Laboratories LLC,
2439 Kuser Road, Hamilton, NJ 08690, United States. jtrama@mdlab.com

BACKGROUND: Laboratory diagnosis of molluscum contagiosum virus (MCV) is
important as lesions can be confused with those caused by Cryptococcus
neoformans, herpes simplex virus, human papillomavirus, and varicella-zoster
virus. OBJECTIVES: To develop a rapid method for identifying patients infected
with MCV via swab sampling. STUDY DESIGN: Two dual-labeled probe real-time PCR
assays, one homologous to the p43K gene and one to the MC080R gene, were
designed. The p43K PCR was designed to be used in conjunction with Pyrosequencing
for confirmation of PCR products and discrimination between MCV1 and MCV2.
RESULTS: Both PCR assays were optimized with respect to reaction components,
thermocycling parameters, and primer and probe concentrations. The specificities 
of both PCR assays were confirmed by non-amplification of 38 known human
pathogens. Sensitivity assays demonstrated detection of as few as 10 copies per
reaction. Testing 703 swabs, concordance between the two real-time PCR assays was
99.9%. Under the developed conditions, Pyrosequencing of the p43K PCR product was
capable of providing enough nucleotide sequence to definitively differentiate
MCV1 and MCV2. CONCLUSIONS: These real-time PCR assays can be used for the rapid,
sensitive, and specific detection of MCV and, when combined with Pyrosequencing, 
can further discriminate between MCV1 and MCV2.

PMID: 17997134 [PubMed - indexed for MEDLINE]

507: J Dtsch Dermatol Ges. 2008 Feb;6(2):98-105. Epub 2007 Nov 9.

Skin infections in organ transplant recipients.

[Article in English, German]

Ulrich C, Hackethal M, Meyer T, Geusau A, Nindl I, Ulrich M, Forschner T, Sterry 
W, Stockfleth E.

Department of Dermatology, Allergy, Venereology, Charite University Hospital,
Berlin, Germany.

In contrast to the well-described high risk of skin cancer in organ transplant
recipients, skin infections in these patients are not as well explored. Skin
infections caused by viruses, bacteria or fungi represent a growing diagnostic
and therapeutic challenge in the dermatological aftercare of organ transplant
recipients. Differing immunosuppressive drugs and their variable dosage in
chronologic sequence after transplantation probably influence the type and
appearance of skin infections. The typical chronology of skin infections are
wound infections, pyoderma or the reactivation of herpes viruses in the first
month post-transplant; the main problems in months 2-5 are opportunistic
infections and reactivation of varicella-zoster virus. After 6 months as
immunosuppression is reduced, the spectrum of causative organisms approaches that
of the general population; mycoses and human papilloma virus (HPV) infections
dominate. A causal connection exists between infection with oncogenic viruses
such as HPV, Epstein-Barr virus and human herpesvirus 8 and specific skin cancers
(squamous cell carcinoma, Kaposi sarcoma and post-transplant lymphoproliferative 
disorders). Dermatological care of organ transplant recipients using appropriate 
diagnostic methods adapted to the modified clinical pattern may lead to early
adequate treatment.

Publication Types: 
    Review

PMID: 17995969 [PubMed - indexed for MEDLINE]

508: J Biomed Opt. 2007 Sep-Oct;12(5):051603.

In vivo documentation of cutaneous inflammation using spectral imaging.

Stamatas GN, Kollias N.

Johnson & Johnson Consumer Products Company, Division of Johnson & Johnson
Consumer Companies, Inc., Methods and Models Development, Skillman, New Jersey
08558, USA. gstamat@cpcus.jnj.com

Typical manifestations of cutaneous inflammation include erythema and edema.
While erythema is the result of capillary dilation and local increase of
oxygenated hemoglobin concentration, edema is characterized by an increase in
extracellular fluid in the dermis, leading to local tissue swelling. Both of
these inflammatory reactions are typically graded visually. We demonstrate the
potential of spectral imaging as an objective noninvasive method for quantitative
documentation of both erythema and edema. As examples of dermatological
conditions that exhibit skin inflammation we applied this method on patients
suffering from (1) allergic dermatitis (poison ivy rashes), (2) inflammatory
acne, and (3) viral infection (herpes zoster). Spectral images are acquired in
the visible and near-IR part of the spectrum. Based on a spectral decomposition
algorithm, apparent concentrations maps are constructed for oxyhemoglobin,
deoxyhemoglobin, melanin, optical scattering, and water. In each dermatological
condition examined, the concentration maps of oxyhemoglobin and water represent
quantitative visualizations of the intensity and extent of erythema and cutaneous
edema, correspondingly. We demonstrate that spectral imaging can be used to
quantitatively document parameters relevant to skin inflammation. Applications
may include monitoring of disease progression as well as screening for efficacy
of treatments.

Publication Types: 
    Evaluation Studies

PMID: 17994872 [PubMed - indexed for MEDLINE]

509: J Neurovirol. 2007 Oct;13(5):462-7.

The prevalence of human herpesvirus 6 in human sensory ganglia and its
co-occurrence with alpha-herpesviruses.

Hufner K, Arbusow V, Himmelein S, Derfuss T, Sinicina I, Strupp M, Brandt T,
Theil D.

Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University,
Marchioninistrasse 23, Munich, Germany.

Human herpesvirus 6 (HHV-6) persists in the central nervous system, but its
prevalence in the peripheral nervous system, a preferred latency site for
herpesviruses, has not been studied. Using nested polymerase chain reaction
(PCR), the authors determined the distribution of HHV-6 in human sensory ganglia.
HHV-6 was present in 30% of trigeminal, 40% of geniculate, 25% of vestibular, and
55% of dorsal root ganglia. It co-occurred with alpha-herpesviruses (herpes
simplex virus type 1 or varicella-zoster virus) in 91% of the ganglia. As HHV-6
positivity did not depend on the presence of inflammatory cells, known to harbor 
the virus, HHV-6 probably resides in the ganglia themselves.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17994431 [PubMed - indexed for MEDLINE]

510: J Neurovirol. 2007 Oct;13(5):446-51.

The effect of highly active antiretroviral therapy on outcome of central nervous 
system herpesviruses infection in Cuban human immunodeficiency virus-infected
individuals.

Martinez PA, Diaz R, Gonzalez D, Oropesa L, Gonzalez R, Perez L, Viera J, Kouri
V.

Virology Department, Institute of Tropical Medicine Pedro Kouri (IPK), Marianao
13, Ciudad Habana, Cuba.

With the rapid progress in the development of highly active antiretroviral
therapy (HAART), the observed patterns in human immunodeficiency virus (HIV)
encephalitis has changed, allowing herpesvirus (HV) infection to be controlled.
HAART was first administered to HIV patients in Cuba in 2001. Consequently with
the aim of investigate the behavior of the HVs causing neurological disorders in 
this population in the post-HAART era, the authors perform a clinical evaluation 
by a multiplex nested polymerase chain reaction (PCR) assay for simultaneous
detection of human HVs--herpes simplex virus (HSV), varicella-zoster virus (VZV),
cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), and Epstein-Barr virus (EBV).
The authors studied 241 samples of cerebrospinal fluid (CSF) received at the
Sexually Transmitted Diseases Laboratory between 2001 and 2005 inclusive. Of the 
241 CSF studied, 10.4% resulted positive for HV infections. Of these, 92% of
patients were acquired immunodeficiency syndrome (AIDS) individuals at the C3
stage. CMV (44%), EBV (28%), and dual-HV (16%) infections were the most important
agents identified. The principal clinical manifestations were fever, headache,
vomiting, and focal abnormalities; the latter being associated with an increased 
risk of death. A statistically significant result was observed when central
nervous system (CNS) disease evolution was compared between patients who were
under HAART against those who were not, before they developed encephalitis. It
was therefore concluded that it is more likely that HIV individuals receiving
HAART have a better recovery of CNS infections than those who are not receiving
it.

PMID: 17994429 [PubMed - indexed for MEDLINE]

511: Clin Infect Dis. 2007 Dec 1;45(11):1527-9.

Comment on:
    Clin Infect Dis. 2007 May 15;44(10):1280-8.

Cost-effectiveness of herpes zoster vaccine: flawed assumptions regarding
efficacy against postherpetic neuralgia.

Brisson M, Pellissier JM, Levin MJ.

Publication Types: 
    Comment
    Letter

PMID: 17990240 [PubMed - indexed for MEDLINE]

512: J Neurol. 2007 Dec;254(12):1750-1. Epub 2007 Nov 9.

Vagus nerve palsy caused by varicella zoster virus infection without rash.

Irioka T, Ohta K, Machida A, Kawashima M, Ishikawa K, Mizusawa H.

Publication Types: 
    Letter

PMID: 17990059 [PubMed - indexed for MEDLINE]

513: Int J Dermatol. 2007 Nov;46(11):1177-9.

Comparison of the Tzanck test and polymerase chain reaction in the diagnosis of
cutaneous herpes simplex and varicella zoster virus infections.

Ozcan A, Senol M, Saglam H, Seyhan M, Durmaz R, Aktas E, Ozerol IH.

Department of Dermatology, Inonu University School of Medicine, Malatya, Turkey.

Background: Although the diagnosis of herpes simplex virus (HSV) and varicella
zoster virus (VZV) infections is usually made clinically, the Tzanck test,
electron microscopy, viral culture, polymerase chain reaction (PCR), and
serologic tests can be utilized to verify the diagnosis. METHODS: We conducted a 
study on a total of 98 patients (77 patients with recurrent herpes simplex and 21
patients with herpes zoster) to evaluate the reliability and reproducibility of
the Tzanck test in comparison with PCR. RESULTS: In herpes virus infections, the 
general positivity rates of the Tzanck test and PCR were 61.2% and 79.6%,
respectively. The difference between the positivity rates of the two tests was
statistically significant. The positivity rates of the tests differed according
to the type and duration of the lesions. CONCLUSIONS: Although PCR was superior
to the Tzanck test, the Tzanck test has also been proven to be a reliable
diagnostic method, with a sensitivity of 76.9% and a specificity of 100%. We
recommend the use of this easy, quick, reproducible, and inexpensive diagnostic
test more often in dermatologic practice, especially in cutaneous herpes virus
infections.

Publication Types: 
    Comparative Study

PMID: 17988338 [PubMed - indexed for MEDLINE]

514: Int J Dermatol. 2007 Nov;46(11):1141-5.

Isotopic response of fungal granuloma following facial herpes zoster infections -
report of three cases.

Huang CW, Tu ME, Wu YH, Lin YC.

Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan.

BACKGROUND: An isotopic response is the occurrence of a new skin disease at the
site of another unrelated, healed skin disorder. METHODS: We report three cases
of unilateral granulomatous fungal infection in immunocompetent patients at sites
of resolved herpes zoster on the face. Diagnoses were made by potassium hydroxide
preparation, histopathologic findings, and fungal culture. Two patients had
Candida albicans folliculitis, and the other was infected with both
Epidermophyton floccosum and Trichophyton mentagrophytes. RESULTS: The patients
responded well to antifungal therapy. CONCLUSIONS: Localized isotopic fungal
infections, although rare, can occur in immunocompetent patients.

Publication Types: 
    Case Reports

PMID: 17988332 [PubMed - indexed for MEDLINE]

515: Int J Lab Hematol. 2007 Dec;29(6):426-32.

Chronic lymphoid leukaemia: clinico-haematological correlation and outcome in a
single institution in Niger Delta region of Nigeria.

Omoti CE, Awodu OA, Bazuaye GN.

Department of Haematology, University of Benin Teaching Hospital, Benin city,
Nigeria. ediomoti@yahoo.com

Sixty patients were prospectively studied with the aim of analyzing the clinical 
and laboratory features and outcome of patients diagnosed with chronic
lymphocytic leukaemia (CLL) in a major referral center in Niger Delta region of
Nigeria for 10 years (1995-2005). The peripheral blood, bone marrow cytology,
clinical features and stage at diagnosis were studied. Treatment modalities,
response to treatment and survival outcome of the patients were analysed. Sixty
patients (15 men and 45 women) were seen, with female preponderance (M : F
ratio,1 : 3). The CLL incidence was 36.4% of total leukaemias. The median age was
56 years with peak age group at 51-60 years while 15% were below 40 years. Major 
clinical findings include lymphadenopathy (91.7%), anaemia (58.3%), abdominal
swelling (58.3%), and splenomegaly (50%) with 53 patients (88.3%) presenting as
International (Binet) stage B and C while only seven patients (11.7%) were seen
in stage A. The least clinical presentation includes Richter's syndrome in 3.3%
of cases and herpes Zoster skin manifestations in two patients (3.3%). There was 
a strong association between the blood counts at diagnosis and outcome of
therapy. The 2-year survival for young (<55 years) and older (>55 years) CLL
patients was 27.2% and 28.9%, respectively, which is still very poor because of a
number of strong limiting factors. CLL is not rare in Southern Nigeria and its
presentations are similar to cases seen worldwide. Contrary to existing
literature a female predominance was observed in this study with majority of
patients seeking medical intervention late. It is therefore recommended that
future research into the genetic make up/HLA typing of patients of African
descent is needed to clarify some of the differences observed.

PMID: 17988297 [PubMed - indexed for MEDLINE]

516: Afr J Reprod Health. 2007 Apr;11(1):133-6.

Maxillary herpes zoster with corneal involvement in a HIV positive pregnant
woman.

Omoti AE, Omoti CE.

Department of Opthalmology, University of Benin Teaching Hospital, Benin City.
Afeomoti@Yahoo.com

Corneal involvement in maxillary herpes zoster is very rare. This report presents
the case of a 32 years old 7 months pregnant para2+1 female, who presented with
vesiculopapular rashes with hyperpigmented crusts over the maxillary area of the 
face on the left side with periocular oedema, conjunctivitis and mild punctate
keratitis in the left eye. She was HIV positive and was on treatment with the
highly active antiretroviral therapy. She was treated with topical and systemic
acyclovir with rapid resolution of the ocular features.

Publication Types: 
    Case Reports

PMID: 17982956 [PubMed - indexed for MEDLINE]

517: J Korean Med Sci. 2007 Oct;22(5):905-7.

A case of herpes zoster with abducens palsy.

Shin MK, Choi CP, Lee MH.

Department of Dermatology, College of Medicine, Kyunghee University, Seoul,
Korea.

Only a few reports have focused on ocular motor paralysis in herpes zoster
ophthalmicus. We report a case of ocular motor paralysis resulting from herpes
zoster. The patient, an 80-yr-old woman, presented with grouped vesicles,
papules, and crusting in the left temporal area and scalp, with diplopia,
impaired gaze, and severe pain. Her cerebrospinal fluid analysis was positive for
varicellar zoster virus IgM. Magnetic resonance imaging was performed to rule out
other diseases causing diplopia; there were no specific findings other than old
infarctions in the pons and basal ganglia. Therefore, she was diagnosed of
abducens nerve palsy caused by herpes zoster ophthalmicus. After 5 days of
systemic antiviral therapy, the skin lesions improved markedly, and the paralysis
was cleared 7 weeks later without extra treatment.

Publication Types: 
    Case Reports

PMID: 17982243 [PubMed - indexed for MEDLINE]

518: Front Biosci. 2008 Jan 1;13:2696-704.

Prevention of varicella and zoster by live attenuated VZV vaccine.

Hambleton S.

Children's Bone Marrow Transplant Unit, Newcastle General Hospital, Westgate
Road, Newcastle upon Tyne, NE4 6BE, United Kingdom. shambleton@doctors.org.uk

An effective and safe live attenuated vaccine against varicella zoster virus was 
developed in Japan in the 1970s and has been in widespread use since the
mid-1990s. In the United States, universal vaccination has brought about striking
reductions in varicella incidence together with associated hospitalizations and
mortality. However, it is clear that varicella will continue to occur even in
highly immunized populations, owing to the ability of VZV to reactivate as
zoster. In addressing this challenge, attention is currently focused on efforts
to minimize the proportion of susceptible individuals by administering a second
dose of vaccine to children. The potential of the newly licensed zoster vaccine
to reduce viral circulation still further has yet to be evaluated.

Publication Types: 
    Review

PMID: 17981744 [PubMed - indexed for MEDLINE]

519: Vaccine. 2007 Nov 28;25(49):8326-37. Epub 2007 Oct 17.

Comment in:
    Vaccine. 2008 Sep 26;26(41):5244; author reply 5245.

Evaluation of the cost-effectiveness in the United States of a vaccine to prevent
herpes zoster and postherpetic neuralgia in older adults.

Pellissier JM, Brisson M, Levin MJ.

Merck Research Laboratories, Blue Bell, PA, United States.
james_pellissier@merck.com

CONTEXT: A live-attenuated varicella-zoster virus vaccine, demonstrated to reduce
the incidence of herpes zoster (HZ) and postherpetic neuralgia (PHN) and the
morbidity associated with incident HZ and its sequelae, has recently been
approved for use in the United States (U.S.). OBJECTIVE: To examine the potential
value of zoster vaccine for society and payers. DESIGN, SETTING AND POPULATION:
An age-specific decision analytic model was designed to estimate the lifetime
costs and outcomes associated with HZ, PHN and other HZ-related complications for
vaccinated and non-vaccinated cohorts aged >or=60 years. Clinical trial data,
published literature and other primary studies were used to inform the model.
Robustness of results to key model parameters was explored through a series of
one-way, multivariate and probabilistic sensitivity analyses. Both societal and
payer perspectives were considered. MAIN OUTCOME MEASURE: Incremental cost per
quality-adjusted life year (QALY) gained. RESULTS: For a representative cohort of
1,000,000 U.S. vaccine recipients aged >or=60 years, use of the zoster vaccine
was projected to eliminate 75,548-88,928HZ cases and over 20,000 PHN cases. Over 
300,000 outpatient visits, 375,000 prescriptions, 9,700 ER visits and 10,000
hospitalizations were projected to be eliminated with the vaccine translating
into savings of US$ 82 million to US$ 103 million in healthcare costs associated 
with the diagnosis and treatment of HZ, PHN and other HZ-related complications.
Cost-effectiveness ratios range from US$ 16,229 to US$ 27,609 per QALY gained,
depending on the input data source and analytic perspective. Results were most
sensitive to PHN costs, duration of vaccine efficacy, vaccine efficacy against
PHN and HZ, QALY loss associated with pain states and complication costs.
CONCLUSIONS: The zoster vaccine at a price of US$ 150 is likely to be
cost-effective for a cohort of immunocompetent U.S. vaccine recipients aged
>or=60 years using commonly cited thresholds for judging cost-effectiveness.
Conclusions are robust over plausible ranges of input parameter values and a
broad range of scenarios and age cohorts.

PMID: 17980938 [PubMed - indexed for MEDLINE]

520: Waste Manag. 2008 Nov;28(11):2091-6. Epub 2007 Nov 5.

Measuring the gypsum content of C&D debris fines.

Musson SE, Xu Q, Townsend TG.

Department of Environmental Engineering Sciences, University of Florida,
Gainesville, FL 32611-6450, USA.

Construction and demolition (C&D) debris recycling facilities often produce a
screened material intended for use as alternative daily cover (ADC) at active
landfills or for shaping and grading at closed landfills. This product contains
soil and small pieces of wood, concrete, gypsum drywall, shingles and other
components of C&D debris. Concerns have been raised over the contribution of
gypsum drywall in C&D debris fines to odor problems at landfills where the
product is used. To address such concerns, limitations may be placed on the
percentage of gypsum (or sulfate) that can occur, and standardized testing
procedures are required to permit valid compliance testing. A test procedure was 
developed for measuring the gypsum content in C&D debris fines. The concentration
of sulfate leached in an aqueous solution was used to estimate the initial gypsum
content of the sample. The impact of sample size and leaching time were
evaluated. Precision and accuracy increased with increasing gypsum content.
Results from replicate samples had an average relative standard deviation of 9%. 
The gypsum content of fines obtained from different facilities in the US varied
widely from 1% to over 25%. These variations not only occurred between differing 
facilities, but within batches produced within a single facility.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17980573 [PubMed - indexed for MEDLINE]

521: Blood Cells Mol Dis. 2008 Jan-Feb;40(1):76-83. Epub 2007 Nov 5.

Photodynamic purging of alloreactive T cells for adoptive immunotherapy after
haploidentical stem cell transplantation.

Perruccio K, Topini F, Tosti A, Carotti A, Aloisi T, Aversa F, Martelli MF,
Velardi A.

Department of Clinical and Experimental Medicine, IRCCS Foundation on
Transplantation Biotechnologies, University of Perugia, Via Brunamonti 51, 06123,
Italy.

After haploidentical stem cell transplantation immune recovery is inevitably slow
and infectious related mortality is about 30-40%. Immune reconstitution could be 
improved by infusing donor T cells, but the obstacle is graft-versus-host
disease. In a mixed lymphocyte reaction, alloantigen-stimulated T cells uptake
4,5-dibromorhodamine methyl ester (TH9402), a compound that is structurally
similar to rhodamine. TH9402 preferentially localizes in mitochondria and when
exposed to 500- to 600-nm wavelength visible light delivered through the Theralux
device (Kiadis Pharma, Amsterdam, The Netherlands), it becomes highly cytotoxic
through oxidative damage. This study investigated a range of parameters, and
combinations thereof, with the aim of achieving optimal T cell allodepletion and 
preservation of pathogen-specific responses. We report on 11 clinical scale dry
runs which reproducibly yielded the following results. Blood mononuclear cells
were stimulated with haploidentical irradiated (20 Gy). Blood mononuclear cells
in a mixed lymphocyte reaction. Cells were then incubated with TH9402 and exposed
to light delivered through the Theralux device. Optimal conditions for T cell
allodepletion emerged as (1) duration of mixed lymphocyte reaction: 24 h; (2)
responder cell concentration: 3-5x10(6)/ml; (3) TH9402 concentration: 5 microM;
(4) quantity of internalized TH9402, as measured by mean fluorescence intensity
(MFI): 20,000-25,000 MFI; (5) energy delivered: 0.1 J/cm(2). Only under these
conditions were the frequencies (by limiting dilution analyses) of
alloantigen-specific T cells maximally reduced, i.e., 2467+/-639 (mean+/-SD)
times, when compared with non-TH9402-treated cells. Pathogen-specific responses
to pathogen antigens such as Cytomegalovirus, Adenovirus, Varicella Zoster Virus,
Herpes Simplex Virus, Aspergillus fumigatus, Candida albicans, Toxoplasma gondii 
were retained, although with a 19+/-9.7 times reduction in frequency. This
remarkable drop in frequency of alloreactive T cells is expected to allow safe
infusion of relatively large numbers of T cells across histocompatibility
barriers for adoptive transfer of donor immunity. Consequently, a clinical trial 
is planned to incorporate infusion of photo-allodepleted donor T cells after
haploidentical stem cell transplantation with the aim of decreasing
infection-related mortality.

PMID: 17977031 [PubMed - indexed for MEDLINE]

522: Rev Med Interne. 2008 Feb;29(2):152-4. Epub 2007 Sep 21.

[Should we care about pregabalin for elderly patients with a history of cardiac
dysrhythmia?]

[Article in French]

Laville MA, de la Gastine B, Husson B, Le Boisselier R, Mosquet B, Coquerel A.

Centre regional de pharmacovigilance de Basse-Normandie, CHRU Cote-de-Nacre,
14033 Caen cedex, France. lavillema@yahoo.fr <lavillema@yahoo.fr>

Pregabalin is similar in structure to gamma-aminobutyric acid. It is used for
neuropathic pain, generalized anxiety disorders and as an adjunct therapy for
partial seizures. Tachycardia is a rare side-effect. A 92-year-old patient with a
history of paroxystic fibrillation was hospitalised for zoster. She developed a
sinusal tachycardia followed by atrial fibrillation and congestive heart failure 
15 h after a first dose of pregabalin. The imputation was considered as
plausible. Even though the mechanism remains unclear, pregabalin might induce
tachycardia in predisposed old patients.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17976866 [PubMed - indexed for MEDLINE]

523: Mayo Clin Proc. 2007 Nov;82(11):1341-9.

Erratum in:
    Mayo Clin Proc. 2008 Feb;83(2):255.

A population-based study of the incidence and complication rates of herpes zoster
before zoster vaccine introduction.

Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS.

Department of Research, Olmsted Medical Center, 210 Ninth St SE, Rochester, MN,
USA. yawnx002@umn.edu

OBJECTIVE: To establish accurate, up-to-date, baseline epidemiological data for
herpes zoster (HZ) before the introduction of the recently licensed HZ vaccine.
METHODS: Using data from January 1, 1996, to October 15, 2005, we conducted a
population-based study of adult residents (Greater than or equal to 22 years) of 
Olmsted County, MN, to determine (by medical record review) the incidence of HZ
and the rate of HZ-related complications. Incidence rates were determined by age 
and sex and adjusted to the US population. RESULTS: A total of 1669 adult
residents with a confirmed diagnosis of HZ were identified between January 1,
1996, and December 31, 2001. Most (92%) of these patients were immunocompetent
and 60% were women. When adjusted to the US adult population, the incidence of HZ
was 3.6 per 1000 person-years (95% confidence interval, 3.4-3.7), with a temporal
increase from 3.2 to 4.1 per 1000 person-years from 1996 to 2001. The incidence
of HZ and the rate of HZ-associated complications increased with age, with 68% of
cases occurring in those aged 50 years and older. Postherpetic neuralgia occurred
in 18% of adult patients with HZ and in 33% of those aged 79 years and older.
Overall, 10% of all patients with HZ experienced 1 or more nonpain complications.
CONCLUSIONS: Our population-based data suggest that HZ primarily affects
immunocompetent adults older than 50 years; 1 in 4 experiences some type of
HZ-related complication.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17976353 [PubMed - indexed for MEDLINE]

524: Ocul Immunol Inflamm. 2007 Sep-Oct;15(5):399-401.

A case of hypertensive keratouveitis with endotheliitis associated with
cytomegalovirus.

Yamauchi Y, Suzuki J, Sakai J, Sakamoto S, Iwasaki T, Usui M.

Department of Ophthalmology, Tokyo Medical University Hospital, Shinjuku, Tokyo, 
Japan. phthisis@nifty.com

AIM: While cytomegalovirus is well known as a pathogenic organism of retinitis,
especially associated with human immunodeficiency virus infection, there are few 
reports of anterior uveitis associated with cytomegalovirus. METHODS: The authors
present a case of keratouveitis associated with cytomegalovirus. RESULTS: A
70-year-old Japanese man was referred to the authors because of poorly controlled
hypertensive keratouveitis in the left eye. The patient had a history of
recurrent hypertensive anterior uveitis. At presentation, the corneal stroma was 
edematous, with Descemet's folds and pigmented keratic precipitates. The anterior
chamber angle was depigmented compared to the fellow eye. Even though pupil
dilation and posterior synechiae were absent, iris atrophy was not evident. His
right eye appeared normal except for moderate cataract. Funduscopy of the left
eye was hazy, with the optic disc showing a normal color but poorly defined
details, and no apparent exdative retinitis. The best-corrected decimal visual
acuity of the right and left eyes was 0.4 and 0.02, respectively. Intraocular
pressure was 11 mmHg in the right eye and 35 mmHg in the left, despite maximum
medical therapy. Systemic acyclovir and prednisolone for a month did not improve 
the hypertensive keratouveitis. The aqueous humor was investigated for herpes
simplex virus, varicella-zoster virus and cytomegalovirus. Cytomegalovius genome 
was detected by polymerase chain reaction analysis. Oral valganciclovir rapidly
reduced ocular hypertension within a week. CMV DNA disappeared 3 months after the
initiation of valganciclovir. CONCLUSION: The authors reported a case of
hypertensive keratouveitis with endotheliitis associated with cytomegalovirus.

Publication Types: 
    Case Reports

PMID: 17972225 [PubMed - indexed for MEDLINE]

525: Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2007 Sep;21(3):285-7.

[Zoster Chinese medicine treatment]

[Article in Chinese]

Chen HM.

Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing,
China.

OBJECTIVE: Clinical diagnosis will clear any part of the human herpes zoster,
patients as soon as possible to alleviate the pain and suffering chinese soups
with oral treatment. METHODS: Will be advised by the People's Republic of China
Chinese medicine industry standards, TCM diagnosis of dermatological diseases
efficacy standards, Herpes Zoster State Administration of Traditional Chinese
Medicine 1994-06-28 approved, 1995-01-01 implementation Randomly divided into two
groups. Treatment and control groups, Treatment groups treated with Chinese
herbs. The control group were treated with WM. Since the proposed unification
formula, tell patients with customized soups boiling method. Add inguisitor first
slices, just cold water soaking, four hours after the use of force opened five,
slow fire just 10 minutes after each bowl, when oral temperature, twice good,
morning fasting drink, a throw into before falling asleep after serving
temperature. Treatment for a week, clinical observation. RESULTS: The group of
Chinese medicine is better than western medicine. CONCLUSION: Although Chinese
medicine in the diagnosis and treatment of the current lack of scientific and
quantitative criteria, but Chinese medicine in the treatment of skin diseases are
effectual, we will be in the modernization of Chinese medicine to do more
exploration.

Publication Types: 
    English Abstract
    Randomized Controlled Trial

PMID: 17971948 [PubMed - indexed for MEDLINE]

526: Clin Pharmacol Ther. 2007 Dec;82(6):764-8. Epub 2007 Oct 31.

Financing immunization of adults in the United States.

Orenstein WA, Mootrey GT, Pazol K, Hinman AR.

Emory University School of Medicine, Atlanta, Georgia, USA. worenst@emory.edu

Immunization is one of the most effective and cost-effective prevention measures 
available. As a result of universal vaccination of children, polio has been
eliminated in the United States and much of the world, measles and rubella are no
longer endemic diseases in the United States, and most of the other
vaccine-preventable diseases of childhood are at or near record lows. A recent
review of clinical preventive services by Partnership for Prevention gave
childhood immunization a perfect score of 10, based on clinically preventable
burden and cost-effectiveness.

Publication Types: 
    Review

PMID: 17971821 [PubMed - indexed for MEDLINE]

527: Kansenshogaku Zasshi. 2007 Sep;81(5):549-54.

[Development of multiplex real-time PCR assay for the detection of herpes simplex
virus types 1 and 2]

[Article in Japanese]

Nagashima M, Sadamasu K, Shinkai T, Yoshida Y, Yamada S.

Department of Microbiology, Tokyo Metropolitan Institute of Public Health.

We developed a multiplex real-time PCR assay to simultaneously detect herpes
simplex virus-1 (HSV-1) and HSV-2 genomes. TaqMan PCR primer pairs and
fluologenic probes targeting the HSV-1 or HSV-2 gpD region were originally
designed. The detection limit was 15 copies/tube, and the quantitative range was 
from 15 to 1.5 x 10(6) copies/tube of HSV-1 or HSV-2 DNA. The sensitivity of this
assay was 10(3) times higher than the conventional PCR assay. No other herpes
virus DNA-Cytomegalovirus, Epstein-Barr virus, human herpes virus 6, human herpes
virus 7, or varicella-zoster virus-were detected by this assay. These results
indicated that the multiplex real-time PCR assay is useful for rapidly diagnosing
HSV-1 and HSV-2.

Publication Types: 
    English Abstract

PMID: 17966636 [PubMed - indexed for MEDLINE]

528: J Cataract Refract Surg. 2007 Nov;33(11):1855-9.

Comment in:
    J Cataract Refract Surg. 2008 May;34(5):718; author reply 718-9.

Laser in situ keratomileusis in patients with a history of ocular herpes.

de Rojas Silva V, Rodriguez-Conde R, Cobo-Soriano R, Beltran J, Llovet F, Baviera
J.

Clinica Baviera, Instituto Oftalmologico Europeo, Madrid, Spain.
vderojas@terra.es

PURPOSE: To report the outcomes of laser in situ keratomileusis (LASIK) in
patients with a history of ocular herpes simplex virus (HSV) or herpes zoster
ophthalmicus (HZO). SETTING: Clinica Baviera, Instituto Oftalmologico Europeo,
Madrid, Spain. METHODS: In this retrospective case series, the records of eyes
with a history of ocular herpes that had LASIK from 2003 through 2005 were
reviewed. The main outcome measure was postoperative recurrence of ocular herpes.
RESULTS: Forty-nine eyes (48 patients) with a history of ocular herpes (HSV
keratitis, 28 eyes; HSV eyelid lesions, 17 eyes; HZO, 4 eyes) were identified.
All LASIK procedures were uneventful. Herpetic disease was inactive at the time
of surgery in all eyes and for more than 1 year in 31 eyes. Perioperative
antiviral systemic prophylaxis was used in 13 patients with a history of HSV
keratitis. No eye developed reactivation of herpetic keratitis during the
follow-up (range 1 to 28 months). CONCLUSIONS: Laser in situ keratomileusis was
safe in patients with a history of ocular herpes; no recurrences occurred during 
the follow-up period. However, candidates should be selected with caution and
surgery performed only in eyes in which the herpes has been inactive for 1 year
before surgery, without stromal disease, and with regular topography and
pachymetry maps and normal corneal sensitivity. The most reasonable clinical
strategy is perioperative systemic antiviral prophylaxis.

PMID: 17964388 [PubMed - indexed for MEDLINE]

529: Pediatr Dermatol. 2007 Sep-Oct;24(5):557-8.

Zosteriform connective tissue nevus in a pediatric patient.

Brazzelli V, Muzio F, Barbagallo T, Fornara L, Donadini F, Guerci B, Mancini L,
Calcaterra V, Larizza D, Borroni G.

Department of Human and Hereditary Pathology, Institute of Dermatology,
University of Pavia, Fondazione, IRCCS Policlinico S. Matteo, Pavia, Italy.
vbrazzelli@libero.it <vbrazzelli@libero.it>

We report an 8-year-old girl affected by hypochromic, asymptomatic, acquired
lesions with a paving-stone aspect on the right lumbosacral area and proximal
right leg. The results of serum and urine biochemical screening were normal, as
was the bone survey A biopsy was performed. The clinical and histologic aspects
led to the diagnosis of connective tissue nevus with zosteriform distribution.

Publication Types: 
    Case Reports

PMID: 17958812 [PubMed - indexed for MEDLINE]

530: J Antimicrob Chemother. 2007 Dec;60(6):1316-30. Epub 2007 Oct 22.

Preclinical development of bicyclic nucleoside analogues as potent and selective 
inhibitors of varicella zoster virus.

McGuigan C, Pathirana RN, Migliore M, Adak R, Luoni G, Jones AT, Diez-Torrubia A,
Camarasa MJ, Velazquez S, Henson G, Verbeken E, Sienaert R, Naesens L, Snoeck R, 
Andrei G, Balzarini J.

Welsh School of Pharmacy, Cardiff University, King Edward VII Avenue, Cardiff
CF10 3XF, UK. mcguigan@cardiff.ac.uk

OBJECTIVES: To progress the anti-varicella-zoster-virus (VZV) aryl bicyclic
nucleoside analogues (BCNAs) to the point of Phase 1 clinical trial for herpes
zoster. METHODS: A new chromatography-free synthetic access to the lead anti-VZV 
aryl BCNAs is reported. The anti-VZV activity of lead Cf1743 was evaluated in
monolayer cell cultures and organotypic epithelial raft cultures of primary human
keratinocytes. Oral dosing in rodents and preliminary pharmacokinetics assessment
was made, followed by an exploration of alternative formulations and the
preparation of pro-drugs. We also studied uptake into cells of both parent drug
and pro-drug using fluorescent microscopy and biological assays. RESULTS: Cf1743 
proved to be significantly more potent than all reference anti-VZV compounds as
measured either by inhibition of infectious virus particles and/or by viral DNA
load. However, the very low water solubility of this compound gave poor oral
bioavailability (approximately 14%). A Captisol admixture and the
5'-monophosphate pro-drug of Cf1743 greatly boosted water solubility but did not 
significantly improve oral bioavailability. The most promising pro-drug to emerge
was the HCl salt of the 5'-valyl ester, designated as FV-100. Its uptake into
cells studied using fluorescent microscopy and biological assays indicated that
the compound is taken up by the cells after a short period of incubation and
limited exposure to drug in vivo may have beneficial effects. CONCLUSIONS: On the
basis of its favourable antiviral and pharmacokinetic properties, FV-100 is now
being pursued as the clinical BCNA candidate for the treatment of VZV shingles.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17956908 [PubMed - indexed for MEDLINE]

531: J Manag Care Pharm. 2007 Sep;13(7 Suppl B):S7-11.

Pharmacy management of vaccines.

Cannon HE.

SelectHealth, Intermountain Healthcare, Salt Lake City, Utah 84130, USA.
Eric.Cannon@selecthealth.org

BACKGROUND: Although standard vaccines have traditionally been granted full
coverage in managed care, the recent introduction of several novel vaccine
products has necessitated the revision of pharmacy management strategies
throughout the nation. OBJECTIVE: To review pharmacy management strategies for a 
number of emerging vaccines, with unique plan perspectives from SelectHealth, an 
Intermountain Healthcare company serving approximately 500,000 members in Utah.
SUMMARY: Because several recently introduced vaccines target previously
unaddressed diseases and carry higher costs than traditional vaccines, several
plans have adapted a novel approach to manage vaccine coverage on an individual
product basis. At SelectHealth, recently introduced vaccines for rotavirus,
respiratory syncytial virus (RSV), herpes zoster, and human papillomavirus (HPV) 
have required special attention in terms of pharmacy management. After carefully 
weighing acquisition and administration costs, anticipated uptake and use, direct
and indirect health care costs averted, and quality of life issues, plan
leadership decided to cover many of the new vaccines (i.e., rotavirus, RSV, and
herpes zoster) under a nonstandard vaccination benefit. However, because
substantial cost savings and high use of the quadrivalent HPV vaccine was
anticipated within SelectHealth, the plan decided to fully cover the product.
CONCLUSION: Although they complicate traditional pharmacy management, novel
vaccines provide clinical benefit that managed care organizations cannot ignore. 
One universal strategy will not suffice in managing all the different vaccines
entering the market, and a tailored approach should be employed based on the
individual characteristics and use of each product.

PMID: 17955623 [PubMed - indexed for MEDLINE]

532: Neth J Med. 2007 Oct;65(9):333-8.

Experience with alemtuzumab in treatment of chronic lymphocytic leukaemia in the 
Netherlands.

Laros-van Gorkom BA, Huisman CA, Wijermans PW, Schipperus MR.

Department of Haematology, Haga Hospital, location Leyenburg, The Hague, the
Netherlands. B.Laros-vanGorkom@HEMAT.umcn.nl

BACKGROUND: Alemtuzumab (MabCampath) is a monoclonal antibody against CD52,
indicated as third-line treatment of chronic lymphocytic leukaemia (CLL). As most
important side effect opportunistic infections are mentioned. It is, however,
unknown whether these complications often lead to problems in general patient
care in the Netherlands. METHODS: To gain insight into the use and complications 
of alemtuzumab therapy, the alemtuzumab-treated CLL patients in 15 hospitals in
the Netherlands were evaluated by means of a questionnaire. RESULTS: In the
period from 31 October 2001 until 17 November 2005, 27 patients with CLL or
prolymphocytic leukaemia (PLL), RAI stage I to IV, Binet stage A to C, received
32 treatments with alemtuzumab. The time from diagnosis until start of
alemtuzumab treatment was 6 +/- 4.5 years (mean +/- SD ). The treatment lasted 11
+/- 7 weeks. Of the treatments, 41% could be administered for the full 12 weeks. 
The most frequent adverse events were fever (72%), shivering (47%), fatigue (22%)
and dyspnoea (16%). Haematological side effects consisted of leucopenia (75%),
thrombocytopenia (44%), and anaemia (13%). Infectious complications occurred in
12 of 32 (38%) treatments: pneumonia (25%; of which one Pneumocystis carini
pneumonia and four Aspergillus infections), sepsis (9%; of which one Listeria),
herpes zoster (9%), herpes simplex (6%), CMV reactivation (6%), meningitis (3%)
and Guillain Barre (3%). The overall response was 53%, with complete remission in
13%, partial remission in 41%, stable disease in 25% and progressive disease in
13%, and lasted for 8.3 +/- 7.3 months. CONCLUSION: Treatment with alemtuzumab is
often terminated prematurely, leading to a suboptimal treatment effect. Fear of
severe uncontrollable opportunistic infections seems unjustified.

Publication Types: 
    Evaluation Studies

PMID: 17954952 [PubMed - indexed for MEDLINE]

533: Clin Microbiol Infect. 2007 Dec;13(12):1217-9. Epub 2007 Oct 22.

High variability in viral load in cerebrospinal fluid from patients with herpes
simplex and varicella-zoster infections of the central nervous system.

Ruzek D, Piskunova N, Zampachova E.

Institute of Parasitology, Biology Centre of the Academy of Sciences of the Czech
Republic and Faculty of Biological Sciences, University of South Bohemia, Ceske
Budejovice, Czech Republic. ruzekd@paru.cas.cz

Infections of the central nervous system (CNS) caused by herpes viruses can
result in severe diseases, often with a fatal outcome. In this study, the viral
load in the cerebrospinal fluid (CSF) of patients with herpes simplex or
varicella-zoster infections of the CNS was measured using a quantitative
real-time PCR. The results suggest a high variability in viral load, with
relatively mild disease associated with a high viral load in CSF and vice versa. 
Determination of the viral load in CSF does not therefore seem to be useful in
assessing the prognosis of disease caused by these viruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17953699 [PubMed - indexed for MEDLINE]

534: Int J Infect Dis. 2008 May;12(3):245-7. Epub 2007 Oct 18.

Incidence of herpes zoster and seroprevalence of varicella-zoster virus in young 
adults of South Korea.

Kang CI, Choi CM, Park TS, Lee DJ, Oh MD, Choe KW.

Department of Internal Medicine, Armed Forces Capital Hospital, San 13-4
Yul-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-040, Republic of Korea.
collacin@hotmail.com

OBJECTIVES: This study was performed to determine the incidence of herpes zoster 
and seroprevalence of varicella-zoster virus (VZV) in young adults of South
Korea, where VZV seroprevalence remains relatively high. METHODS: In South Korea,
military service is compulsory for all healthy young men and hence those in
military service might provide a reflection of the general population. The
computerized database of the Armed Forces Medical Command was examined to
identify the number of reported herpes zoster cases. In order to evaluate VZV
seroprevalence, serum samples were obtained from randomly selected subjects among
those who had been admitted to the Armed Forces Capital Hospital. RESULTS: A
total of 705 cases of herpes zoster were reported between June 2004 and May 2005.
The annual incidence rate of herpes zoster was 141 (95% CI 131.0-151.8) per
100000 population. A total of 192 subjects were enrolled for the analysis of VZV 
seroprevalence. All subjects were male and their median age was 21 (range 19-24) 
years. The overall anti-VZV IgG seropositivity prevalence was 92.7% (178/192, 95%
CI 88.0-95.7%). CONCLUSION: We have described a population-based study of the
epidemiology of VZV infections in the military personnel of South Korea.

PMID: 17950022 [PubMed - indexed for MEDLINE]

535: J Fam Pract. 2007 Oct;56(10 Suppl A):51A-57A; quiz 58A.

Preventing herpes zoster and postherpetic neuralgia through vaccination.

High KP.

Section on Infectious Diseases, Department of Internal Medicine, Wake Forest
University School of Medicine, Winston-Salem, NC, USA.

Publication Types: 
    Review

PMID: 17949604 [PubMed - indexed for MEDLINE]

536: Lancet Neurol. 2007 Nov;6(11):1015-28.

The neurotropic herpes viruses: herpes simplex and varicella-zoster.

Steiner I, Kennedy PG, Pachner AR.

Neurological Sciences Unit, Hadassah University Hospital, Mount Scopus,
Jerusalem, Israel. isteiner@md2.huji.ac.il

Herpes simplex viruses types 1 and 2 (HSV1 and HSV2) and varicella-zoster virus
(VZV) establish latent infection in dorsal root ganglia for the entire life of
the host. From this reservoir they can reactivate to cause human morbidity and
mortality. Although the viruses vary in the clinical disorders they cause and in 
their molecular structure, they share several features that affect the course of 
infection of the human nervous system. HSV1 is the causative agent of
encephalitis, corneal blindness, and several disorders of the peripheral nervous 
system; HSV2 is responsible for meningoencephalitis in neonates and meningitis in
adults. Reactivation of VZV, the pathogen of varicella (chickenpox), is
associated with herpes zoster (shingles) and central nervous system complications
such as myelitis and focal vasculopathies. We review the biological, medical, and
neurological aspects of acute, latent, and reactivated infections with the
neurotropic herpes viruses.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 17945155 [PubMed - indexed for MEDLINE]

537: Mult Scler. 2008 Jan;14(1):136-9. Epub 2007 Oct 17.

Comment in:
    Mult Scler. 2008 Jan;14(1):4-5.

Common infectious agents in multiple sclerosis: a case-control study in children.

Krone B, Pohl D, Rostasy K, Kahler E, Brunner E, Oeffner F, Grange JM, Gartner J,
Hanefeld F.

Department of Virology, Georg August University Goettingen,Germany.
bkrone@gwdg.de

Environmental factors, in particular infections, have been linked with the risk
of developing multiple sclerosis (MS). The association of Epstein-Barr virus
infection with childhood onset of MS has been recently recognized. As other
infections characteristically experienced during childhood have not yet been
studied in larger cohorts of paediatric MS, we conducted a study on 152 German
children with MS (age at onset <16 years) and matched controls in the hope of
gaining evidence for their possible aetiological role in MS. Patterns of antibody
responses were determined to a range of infections which, in prior studies
principally on adult patients, had revealed possible associations with MS. In
this study on children the serology of several infections showed associations
with MS. In the exceptional case of Chlamydia pneumoniae there was a
significantly higher prevalence of IgM antibody but, more typically, as in the
case of influenza A, measles, parainfluenza 2, varicella/zoster viruses and
particularly to the herpes simplex virus type 2 (HSV-2) lysate antigen, there
were significantly higher concentrations of IgG antibody. Additional
investigations, however, make it highly unlikely that a relevant number of
children have experienced infections with HSV-2. In general this study supports
and emphasizes a complex infectious and immunologic background of MS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17942525 [PubMed - indexed for MEDLINE]

538: Br J Haematol. 2007 Dec;139(5):791-8. Epub 2007 Oct 17.

Acquired immune-related and inflammatory conditions and subsequent chronic
lymphocytic leukaemia.

Landgren O, Gridley G, Check D, Caporaso NE, Morris Brown L.

Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics,
National Cancer Institute, NIH, Bethesda, MD, USA. landgreo@mail.nih.gov

Immune-mediated pathways have been recognized to be of importance in the
pathogenesis of chronic lymphocytic leukaemia (CLL). We assessed a broad variety 
of immune-related and inflammatory conditions and subsequent CLL development
among 4 million adult male veterans admitted to VA hospitals. We identified 3,680
CLL cases with up to 27 years of follow-up. Using Poisson regression analyses
restricted to immune-related or inflammatory conditions that occurred more than
one year before CLL, we estimated relative risk (RR) and 95% confidence intervals
for CLL risk. Elevated CLL risk was found among individuals with prior chronic
sinusitis (RR = 1.27, 1.01-1.61). Pneumonia had a borderline (RR = 1.13,
1.00-1.27) association with CLL; the risk was further elevated (RR = 1.35,
1.07-1.72) for latency <5 years. Conversely, chronic non-rheumatic valvular heart
disease was associated with 0.76-fold (0.58-0.99) decreased risk. Herpes zoster
and simplex were associated with increased (RR = 1.98, 1.40-2.79) and borderline 
increased (RR = 1.69, 0.96-2.98) CLL risk. There was no general association
between autoimmunity and CLL; however, autoimmune haemolytic anaemia was
associated with 3.86-fold (1.93-7.74) elevated CLL risk. Individuals with chronic
osteoarthritis and prostatitis had 1.14-fold (1.03-1.25) and 1.64-fold
(1.14-2.37) elevated CLL risk. These association patterns suggest primary focus
on infectious agents rather than autoantigens for future aetiologic CLL studies.

Publication Types: 
    Multicenter Study
    Research Support, N.I.H., Intramural

PMID: 17941950 [PubMed - indexed for MEDLINE]

539: Gan To Kagaku Ryoho. 2007 Oct;34(10):1623-7.

[Combination therapy with rituximab and cladribine for patients with follicular
lymphoma]

[Article in Japanese]

Kobayashi Y, Murotani Y, Sawai N, Akaogi T, Sako M, Hayashi H, Matsumoto Y,
Kuroda J, Nomura K, Horiike S, Shimazaki C, Kimura S, Yoshikawa T, Taniwaki M.

Dept. of Hematology and Immunology, Kyoto Second Red Cross Hospital.

Treatment strategies for follicular lymphoma have not been established. We report
the outcome after combination therapy with rituximab and cladribine (RC) for 8
patients with follicular lymphoma treated between January 2005 and December 2006 
in our hospitals. Median patient age was 57 (range 42 approximately 73) years.
There were 4 males and 4 females. Only 1 patient had refractory disease, while
the others had untreated disease. On the follicular lymphoma international
prognostic index, 4 patients were in the low-risk group, 3 in the
intermediate-risk group and 1 in the high-risk group. The median follow-up period
was 36 (range 22 approximately 90) weeks. The RC protocol consisted of
intravenous rituximab at a dose of 375 mg/m (2) on day 1 and cladribine at a dose
of 0.1 mg /kg per day for 2-hours on day 1 through 5. The median number of RC
courses was 5 (range 3 approximately 8). The median interval between the 2
courses was 7 (range 3 approximately 26) weeks. The overall response rate was
87.5%. Grade 3 neutropenia was observed in 50% patients, although G-CSF was not
needed. There was no apparent thrombocytopenia or anemia. Herpes zoster was
observed after treatment in 1 patient. RC is considered highly effective and well
tolerated.

Publication Types: 
    English Abstract

PMID: 17940377 [PubMed - indexed for MEDLINE]

540: Herpes. 2007 Sep;14(2):45-7.

Case reports: zoster pain in haematological malignancies: effective pain relief
with oxycodone in patients unresponsive to other analgesic measures.

Niscola P, Perrotti AP, del Poeta G, Romani C, Palombi M, Piccioni D, Scaramucci 
L, Tolu B, Tendas A, Cupelli L, Abruzzese E, D'Elia GM, Brunetti GA, Maurillo L, 
Giovannini M, Cartoni C, de Fabritiis P.

Haematology Division, Sant'Eugenio Hospital, Tor Vergata University, Rome, Italy.
pasquale.niscola@uniroma2.it

Varicella zoster virus (VZV) outbreak is a significant cause of morbidity in
patients suffering from blood-related malignancies, occurring mostly among those 
affected by lymphoproliferative disorders and in those receiving haematopoietic
stem-cell transplantation. The elucidated pathological mechanisms of VZV-related 
painful complications have provided the rationale for acute zoster pain (AZP) and
post-herpetic neuralgia (PHN) treatment with antiviral therapy combined with
neuroactive agents, such as tricyclic or anticonvulsant agents. The role of
opioids in this setting is less clearly established. We successfully treated
(with oxycodone) 12 consecutive patients suffering from AZP and long-lasting PHN 
resistant to several agents, including anticonvulsants and analgesics. Our
experience is reported together with a brief overview of the management of these 
often distressing and intractable complications.

Publication Types: 
    Case Reports

PMID: 17939903 [PubMed - indexed for MEDLINE]

541: Herpes. 2007 Sep;14(2):32-6.

Managing herpes zoster in immunocompromised patients.

Ahmed AM, Brantley JS, Madkan V, Mendoza N, Tyring SK.

Baylor College of Medicine, Houston, TX, USA.

Herpes zoster infections are more common and often more complicated in
immunocompromised patients. The key clinical objective in these patients is to
reduce the incidence of cutaneous and visceral dissemination that can lead to
life-threatening complications. This is best achieved with prompt antiviral
therapy, which should be instituted in all immunosuppressed zoster patients if
presentation occurs within 1 week of rash onset or any time before full crusting 
of lesions. For localized disease, most patients can be treated with oral
valaciclovir, famciclovir or aciclovir, with close outpatient follow-up.
Intravenous aciclovir therapy is reserved for those with disseminated varicella
zoster virus infection, ophthalmic involvement, very severe immunosuppression or 
the inability to take oral medications. Foscarnet is the drug of choice to treat 
aciclovir-resistant herpes zoster. Appropriate analgesic therapy should be
combined with early antiviral treatment to reduce the incidence and severity of
acute zoster pain and post-herpetic neuralgia.

Publication Types: 
    Review

PMID: 17939900 [PubMed - indexed for MEDLINE]

542: Herpes. 2007 Sep;14(2):31.

Herpes zoster in immunocompromised patients.

Volpi A, Stanberry L.

Publication Types: 
    Editorial

PMID: 17939899 [PubMed - indexed for MEDLINE]

543: Rev Med Suisse. 2007 Sep 19;3(125):2116-22, 2124-9.

[Swiss recommendations for the management of varicella-zoster virus infections]

[Article in French]

Meylan P, Gerber S, Kempf W, Nadal D; Swiss Herpes Management Forum.

Institut de microbiologie et Division des maladies infectieuses, CHUV, Lausanne. 
pascal.meylan@chuv.ch

Infections with varicella zoster virus (VZV) are common viral infections
associated with significant morbidity. Diagnosis and management are complex,
particularly in immunocompromised patients and during pregnancy. The present
recommendations have been established by a multidisciplinary panel of specialists
and endorsed by numerous Swiss medical societies involved in the medical care of 
such patients (Appendix). The aim is to improve the care of affected patients and
to reduce complications.

Publication Types: 
    English Abstract
    Review

PMID: 17939531 [PubMed - indexed for MEDLINE]

544: J Rheumatol. 2007 Nov;34(11):2201-3. Epub 2007 Oct 15.

Leflunomide-associated infections in rheumatoid arthritis.

Jenks KA, Stamp LK, O'Donnell JL, Savage RL, Chapman PT.

Department of Rheumatology, Immunology and Allergy, Christchurch Hospital,
Christchurch, New Zealand.

OBJECTIVE: To determine the prevalence of severe infections in patients with
rheumatoid arthritis (RA) prescribed leflunomide in North Canterbury, New
Zealand. METHODS: A case-note audit of all Christchurch Hospital patients with RA
prescribed leflunomide between 2002 and 2006 was performed. The criterion for
severe infection was inpatient hospitalization. Relevant reports to the national 
Pharmacovigilance Centre were also examined. RESULTS: Since January 2002, 171
patients with RA have commenced taking leflunomide. Ninety-nine of 171 (57.9%)
patients were also prescribed prednisone. Combination disease modifying
antirheumatic drug therapy was common, with 82/171 (48.0%) taking methotrexate
(MTX), 15/171 (8.8%) hydroxy-chloroquine, 11/171 (6.4%) sulfasalazine, and 8/171 
(4.7%) anti-tumor necrosis factor therapy. Eleven patients developed infection
requiring hospitalization while taking leflunomide including: lower respiratory
tract infections (3), cellulitis (2), disseminated herpes zoster (2), probable TB
liver (1), abdominal sepsis (1), mycotic aneurysm (1) and gastroenteritis (1).
Nine of the 11 patients were also taking corticosteroids or corticosteroids with 
MTX. The 171 patients were treated for a total of 4005 months, giving an
incidence for severe infection of 3.30/100 patient-years (95% CI 1.65-5.90).
Patients at increased risk were those with severe disease and taking concomitant 
MTX and corticosteroids. The NZ Pharmacovigilance Centre has received 7
additional reports of severe infections in patients with RA taking leflunomide.
Reported cases include probable pulmonary TB (1), pneumocystis pneumonia (1),
other pulmonary infection (2), and septicemia (3) including a case of infective
endocarditis. Four occurred in combination with MTX, one with adalimumab. All 5
patients were also taking -corticosteroids. CONCLUSION: We believe this observed 
rate of serious infection is acceptable in the context of optimally treating
active RA. Patients with severe disease and taking combination MTX and
corticosteroids are at greatest risk. In our experience, once established,
infections may rapidly progress in patients with RA taking leflunomide, and early
cholestyramine washout is strongly recommended.

Publication Types: 
    Case Reports

PMID: 17937473 [PubMed - indexed for MEDLINE]

545: Anaesthesia. 2007 Nov;62(11):1143-53.

Comment in:
    Anaesthesia. 2008 May;63(5):551; author reply 551-2.    Anaesthesia. 2008 May;63(5):552-3; author reply 553.    Anaesthesia. 2008 May;63(5):553.

Interpleural block - part 2.

Dravid RM, Paul RE.

Kettering General Hospital, Kettering General Hospital, Rothwell Road, Kettering 
NN16 8UZ, UK. Ravi.Dravid@kgh.nhs.uk

Interpleural blockade is effective in treating unilateral surgical and
non-surgical pain from the chest and upper abdomen in both the acute and chronic 
settings. It has been shown to provide safe, high-quality analgesia after
cholecystectomy, thoracotomy, renal and breast surgery, and for certain invasive 
radiological procedures of the renal and hepatobiliary systems. It has also been 
used successfully in the treatment of pain from multiple rib fractures, herpes
zoster, complex regional pain syndromes, thoracic and abdominal cancer, and
pancreatitis. The technique is simple to learn and has both few
contra-indications and a low incidence of complications. In the second of two
reviews, the authors cover the applications, complications, contra-indications
and areas for future research.

Publication Types: 
    Review

PMID: 17924896 [PubMed - indexed for MEDLINE]

546: Indian J Dermatol Venereol Leprol. 2007 Sep-Oct;73(5):352-3.

Persistent hiccups: a rare prodromal manifestation of herpes zoster.

Reddy BV, Sethi G, Aggarwal A.

Publication Types: 
    Case Reports
    Letter

PMID: 17921622 [PubMed - indexed for MEDLINE]

547: Lancet. 2007 Oct 6;370(9594):1240.

How shingles can be beached.

Ludwig RJ, Kaufmann R.

Department of Dermatology, Johann Wolfgang Goethe-Universitat, Frankfurt,
Germany. r.ludwig@em.uni-frankfurt.de

Publication Types: 
    Case Reports

PMID: 17920919 [PubMed - indexed for MEDLINE]

548: Vaccine. 2007 Nov 7;25(45):7866-72. Epub 2007 Aug 8.

The comparative sero-epidemiology of varicella zoster virus in 11 countries in
the European region.

Nardone A, de Ory F, Carton M, Cohen D, van Damme P, Davidkin I, Rota MC, de
Melker H, Mossong J, Slacikova M, Tischer A, Andrews N, Berbers G, Gabutti G, Gay
N, Jones L, Jokinen S, Kafatos G, de Aragon MV, Schneider F, Smetana Z, Vargova
B, Vranckx R, Miller E.

Health Protection Agency, Centre for Infections, London, UK.
a.nardone@invs.sante.fr

The European sero-epidemiology network (ESEN2) aims to standardise serological
surveillance of varicella zoster virus (VZV) in 11 participant countries. In each
country, serum banks were collected between 1996 and 2003 and tested for VZV
antibodies. Assay results were standardised so that international comparisons
could be made. Age-specific forces of infection were calculated for three age
groups (<5, 5-9 and >or=10 years of age) and used to estimate the base
reproduction number (R(0)) and the herd immunity threshold (H). Most VZV
infection occurred in childhood, but there was a wide variation in
transmissibility, with R(0) ranging from 16.9 in the Netherlands to 3.3 in Italy.
Herd immunity thresholds varied from 70% in Italy to 94% in the Netherlands.
There are substantial differences in VZV sero-epidemiology within the European
region, which will need to be taken into account in designing national policies
regarding VZV vaccination.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17919788 [PubMed - indexed for MEDLINE]

549: Actas Dermosifiliogr. 2007 Oct;98(8):576-8.

[Psoriasis at the site of healed herpes zoster: Wolf's isotopic response.]

[Article in Spanish]

Allegue F, Fachal C, Romo M, Lopez-Miragaya MI, Perez S.

Publication Types: 
    Letter

PMID: 17919439 [PubMed - indexed for MEDLINE]

550: Adv Pediatr. 2007;54:135-71.

Immunization update.

Mirza A, Rathore MH.

Pediatric Infectious Diseases and Immunology, University of Florida, 653-1 West
8th Street, L-13, Jacksonville, FL 32209, USA.

Although the development and licensure of new vaccines over the last 2 years has 
generated a lot of excitement as well as debate, there is a lot more to come. Not
discussed in this article. licensure of another long-awaited vaccine albeit for
use in adults was that for herpes zoster. The second HPV and rotavirus vaccines
are awaiting approval in the US. Next in line are the vaccines both prophylactic 
as well as therapeutic against HIV. Topics of debate over the new vaccines
include discussions amongst practices as to the affordability and cost of the new
vaccines as well as the ethical debate amongst lawmakers and the general public
regarding the rights and wrongs of compulsory vaccination against HPV. Another
ongoing discussion is regarding the availability of approved vaccines. Shortages 
have been seen with several of the childhood vaccines including heptavalent
pneumococcal conjugate vaccine, tetravalent meningococcal conjugate vaccine,
hepatitis A vaccine, as well as the ongoing saga with influenza vaccines. Across 
the globe while the struggle against polio continues, there is encouraging news
regarding the reduction in measles-related deaths, particularly in Africa. The
last few years have indeed been landmark years in infectious disease research as 
the search continues for better and safer vaccines globally.

Publication Types: 
    Review

PMID: 17918470 [PubMed - indexed for MEDLINE]

551: J Virol. 2007 Dec;81(23):13200-8. Epub 2007 Oct 3.

A self-excisable infectious bacterial artificial chromosome clone of
varicella-zoster virus allows analysis of the essential tegument protein encoded 
by ORF9.

Tischer BK, Kaufer BB, Sommer M, Wussow F, Arvin AM, Osterrieder N.

Department of Microbiology and Immunology, College of Veterinary Medicine,
Cornell University, Ithaca, NY 14853, USA.

In order to facilitate the generation of mutant viruses of varicella-zoster virus
(VZV), the agent causing varicella (chicken pox) and herpes zoster (shingles), we
generated a full-length infectious bacterial artificial chromosome (BAC) clone of
the P-Oka strain. First, mini-F sequences were inserted into a preexisting VZV
cosmid, and the SuperCos replicon was removed. Subsequently, mini-F-containing
recombinant virus was generated from overlapping cosmid clones, and full-length
VZV DNA recovered from the recombinant virus was established in Escherichia coli 
as an infectious BAC. An inverted duplication of VZV genomic sequences within the
mini-F replicon resulted in markerless excision of vector sequences upon virus
reconstitution in eukaryotic cells. Using the novel tool, the role in VZV
replication of the major tegument protein encoded by ORF9 was investigated. A
markerless point mutation introduced in the start codon by two-step en passant
Red mutagenesis abrogated ORF9 expression and resulted in a dramatic growth
defect that was not observed in a revertant virus. The essential nature of ORF9
for VZV replication was ultimately confirmed by restoration of the growth of the 
ORF9-deficient mutant virus using trans-complementation via baculovirus-mediated 
gene transfer.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17913822 [PubMed - indexed for MEDLINE]

552: Int J Dermatol. 2007 Oct;46(10):1005-10.

Recent advances in medical dermatology.

Clark LN, Lebwohl M.

Department of Dermatology, Mount Sinai School of Medicine, New York, NY 10029,
USA. lily.clark@mssm.edu

Collectively, new developments in the field of medical dermatology will
ultimately lead to improved patient care. We review several new findings in the
dermatologic literature including the following: new questions regarding the
malignant potential of anti-tumor necrosis factor agents, which are widely used
for the treatment of moderate to severe psoriasis as well as psoriatic arthritis;
anti-interleulin-12, a promising anticytokine for the treatment of psoriasis;
diagnostic advances in the detection of latent Mycobacterium tuberculosis;
advances in the primary prevention of human papillomavirus and herpes zoster; and
new therapeutic options with existing medications for neuropathic pain and
pruritus.

Publication Types: 
    Review

PMID: 17910704 [PubMed - indexed for MEDLINE]

553: Pediatr Transplant. 2007 Nov;11(7):777-80.

Sirolimus in chronic allograft nephropathy in pediatric recipients.

Ibanez JP, Monteverde ML, Diaz MA, Goldberg J, Turconi AF.

Nephrology Unit, Hospital de Pediatria Prof Dr Juan P Garrahan Buenos Aires,
Argentina. juanibanez@sinectis.com.ar

CAN is a common cause of late graft loss. Nephrotoxicity due to CNIs is known to 
contribute to CAN. We retrospectively evaluated the efficacy and safety of SRL in
pediatric renal Tx recipients showing CAN in their allograft biopsy. Twenty-one
patients aged 10.4 +/- 4.6 yr at Tx time receiving CNIs as primary
immunosuppression were converted to SRL at 58.9 +/- 49.1 months after Tx, due to 
progressive decline of renal function and biopsy proven CAN. Mean follow-up after
switch was 19.7 +/- 9.5 months. All patients received CsA as part of the
immunosuppressive regimen, at a mean dose 4.4 +/- 1.2 mg/kg/day. Mean daily dose 
of SRL three month after conversion was 2.6 +/- 0.8 mg/body surface area/day and 
the mean through levels where 6.9 +/- 2.5 ng/mL. Graft biopsies showed Grade I
CAN in 12 children and Grade II CAN in nine. After SRL introduction, there were
neither acute rejection episodes nor graft losses. GFR improved at three months
and was sustained thereafter only in children with Grade I CAN. Post-Tx time at
conversion was the only significant variable between patients who had Grade I CAN
and Grade II CAN (33.6 +/- 33.3 vs. 92.7 +/- 47.5 months, p = 0.003). Nine
patients had no AEs, six patients had nine SAE: five diarrhea, one herpes zoster,
one pancreatic pseudo cyst, one pneumonia, and one Influenza A infection; 11
patients had 13 AEs: six oral aphthous ulcers, three urinary tract infections,
two herpes simplex, one lymphedema, and one nephrotic proteinuria. Significant
improvement of GFR occurred in Grade I CAN group at three months from conversion 
and was sustained during follow-up. Those who had Grade II CAN experienced no
change in GFR. The incidence of AEs and SAE is of concern and further studies are
necessary to assess their relevance.

PMID: 17910656 [PubMed - indexed for MEDLINE]

554: J Am Geriatr Soc. 2007 Oct;55(10):1499-507.

Safety and immunogenicity profile of the concomitant administration of ZOSTAVAX
and inactivated influenza vaccine in adults aged 50 and older.

Kerzner B, Murray AV, Cheng E, Ifle R, Harvey PR, Tomlinson M, Barben JL, Rarrick
K, Stek JE, Chung MO, Schodel FP, Wang WW, Xu J, Chan IS, Silber JL, Schlienger
K.

Health Trends Research, Baltimore, Maryland, USA.

OBJECTIVES: To evaluate the safety and immunogenicity of ZOSTAVAX administered
concomitantly with inactivated influenza vaccine or sequentially in adults aged
50 and older. DESIGN: Randomized, blinded, placebo-controlled study. SETTING:
Thirteen U.S. and seven European study sites. PARTICIPANTS: Three hundred
eighty-two concomitantly, 380 sequentially vaccinated subjects. INTERVENTION: The
concomitant vaccination group received influenza vaccine and ZOSTAVAX at separate
injection sites on Day 1 and placebo at Week 4. The nonconcomitant vaccination
group received influenza vaccine and placebo at separate injection sites on Day 1
and ZOSTAVAX at Week 4. MEASUREMENTS: Primary safety endpoints: vaccine-related
serious adverse experiences (AEs) within 28 days postvaccination (PV); and diary 
card-prompted local and systemic AEs. Primary immunogenicity endpoints: geometric
mean titer (GMT) and geometric mean fold rise (GMFR) from baseline of
varicella-zoster virus (VZV) antibody (Ab) at 4 weeks PV according to
glycoprotein enzyme-linked immunosorbent assay (gpELISA) and GMT of influenza Ab 
for the three vaccine strains (2005-2006 influenza season) at 4 weeks PV
according to hemagglutination inhibition assay. Secondary immunogenicity
endpoint: influenza seroconversion rates (SCRs). RESULTS: No serious AEs related 
to ZOSTAVAX were observed during the study. VZV Ab GMTs 4 weeks PV for the
concomitant and sequential groups were 554 and 597 gpELISA U/mL, respectively.
The estimated VZV Ab GMT ratio was 0.9 (95% confidence interval (CI)=0.8-1.0),
indicating noninferior (P<.001 for the null hypothesis of GMT ratio <0.67)
responses. Estimated VZV Ab GMFR from baseline in the concomitant group was 2.1
(95% CI=2.0-2.3), indicating acceptable fold rise. Estimated GMT ratios
(concomitant/sequential) for influenza strains A(H1N1), A(H3N2), and B were 0.9
(95% CI=0.8-1.1), 1.1 (95% CI=0.9-1.3), and 0.9 (95% CI=0.8-1.1), respectively,
and SCRs were comparable across both groups, with more than 85% achieving titers 
of 1:40 or greater, meeting regulatory criteria. CONCLUSION: ZOSTAVAX and
influenza vaccine given concomitantly are generally well tolerated in adults aged
50 and older. Ab responses were similar whether ZOSTAVAX and influenza vaccine
were given concomitantly or sequentially.

Publication Types: 
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 17908055 [PubMed - indexed for MEDLINE]

555: J Am Coll Surg. 2007 Oct;205(4):625. Epub 2007 Jul 20.

Metastatic colon adenocarcinoma mimicking herpes zoster.

Goodwin TL, Wren SM.

Stanford University School of Medicine, Stanford, CA, USA.

Publication Types: 
    Case Reports

PMID: 17903740 [PubMed - indexed for MEDLINE]

556: Med Sci Monit. 2007 Oct;13(10):CS128-31.

Varicella zoster-associated severe aplastic anemia in a child and its successful 
treatment with peripheral blood stem cell transplantation from HLA-5/6-identical 
donor.

Kuskonmaz B, Cetin M, Uckan D, Yetgin S.

Division of Pediatric Hematology, Department of Pediatrics, Hacettepe University 
Faculty of Medicine, Sihhiye, Ankara, Turkey.

BACKGROUND: Varicella zoster virus is very rarely associated with aplastic
anemia. Bone marrow transplantation from an HLA-identical sibling is the
treatment of choice. CASE REPORT: A seven-year-old boy presented with aplastic
anemia (AA) following chicken pox infection. No clinical improvement was observed
with pharmaceutical therapy and peripheral blood stem cell transplantation
(PBSCT) was performed from his HLA 5/6 identical mother. Since the
transplantation, the patient has had a durable, trilineage hematological response
for 12 months. CONCLUSIONS: The present case with varicella zoster-associated
aplastic anemia was non-responsive to conventional therapies (ATG protocol, ALG
protocol, oxymethalone, and cyclosporine A) and successfully treated with bone
marrow transplantation from his 5/6 identical mother.

Publication Types: 
    Case Reports

PMID: 17901857 [PubMed - indexed for MEDLINE]

557: Anesth Analg. 2007 Oct;105(4):1127-9, table of contents.

A unique case of recurrent asystole secondary to paroxysmal pain of acute
herpetic ophthalmicus.

Cheung MY, Viney M.

Geelong Hospital, Victoria, Australia. manyiucheung@yahoo.com

Postherpetic neuralgia is considered to be the most common and debilitating
complication of acute herpes zoster and its incidence and duration of symptoms
increase with age. We describe an unusual, but life-threatening complication of
postherpetic neuralgia. The following case report is the first to describe a
patient who developed unexpected asystolic episodes as a result of complicating
pain secondary to acute herpetic ophthalmicus. The underlying pathogenesis of her
cardiovascular disturbance coinciding with her painful paroxysms is unclear. This
uncommon phenomenon may be explained by an exaggerated vasovagal response or even
by the oculocardiac reflex rarely observed outside ocular or maxillofacial
surgery. Her severe paroxysmal pain and asystole were eventually managed with
oxycontin, amitriptyline, gabapentin, and intranasal fentanyl spray.

Publication Types: 
    Case Reports

PMID: 17898398 [PubMed - indexed for MEDLINE]

558: J Virol. 2007 Dec;81(23):12758-65. Epub 2007 Sep 26.

Identification of five major and two minor genotypes of varicella-zoster virus
strains: a practical two-amplicon approach used to genotype clinical isolates in 
Australia and New Zealand.

Loparev VN, Rubtcova EN, Bostik V, Govil D, Birch CJ, Druce JD, Schmid DS,
Croxson MC.

Centers for Disease Control and Prevention, National Center for Preparedness,
Detection, and Control of Infectious Diseases, Atlanta, Georgia 30333, USA.

Whole genome phylogenetic analysis in this study resolved a total of five major
genotypes among the 22 varicella-zoster virus (VZV) strains or isolates for which
complete genomic sequences are available. Consistent with earlier publications we
have designated these genotypes European 1 (E1), European 2 (E2), Japanese (J),
mosaic 1 (M1), and mosaic 2 (M2). Single nucleotide polymorphism (SNP) analysis
performed in a whole-genome alignment revealed that VZV isolates of all five
genotypes can be accurately genotyped using SNPs from two amplicons: open reading
frame 22 (ORF22) and either ORF21 or ORF50. This modified approach identifies all
of the genotypes observed using any of the published genotyping protocols. Of 165
clinical varicella and zoster isolates from Australia and New Zealand typed using
this approach, 67 of 127 eastern Australian isolates were E1, 30 were E2, 16 were
J, 10 were M1, and 4 were M2; 25 of 38 New Zealand isolates were E1, 8 were E2,
and 5 were M1. VZV strain diversity in eastern Australia is thus broader than has
been described for any other region, including Europe, Africa, and North America.
J strains were far more prevalent than previously observed in countries other
than Japan. Two-amplicon typing was in complete accord with genotypes derived
using SNP in multiple ORFs (ORFs 1, 21, 22, 38, 50, 54, and 62). Two additional
minor genotypes, M3 and M4, could also be resolved using two-amplicon typing.

Publication Types: 
    Evaluation Studies

PMID: 17898056 [PubMed - indexed for MEDLINE]

559: Bull Soc Belge Ophtalmol. 2007;(303):23-6.

Herpes zoster ophthalmicus complicated by complete ophthalmoplegia and signs of
pilocarpine hypersensitivity. A case report and literature review.

Pion B, Salu P.

Dept. of Ophthalmology, Academic Hospital of the Free University of Brussels,
Laarbeeklaan 101, B-1090 Jette. bartpion@hotmail.com

We report a case of zona ophthalmica complicated with a complete ophthalmoplegia.
In the literature only 19 cases have been reported the last 30 years, with a
variety of possible pathophysiological mechanisms. Our patient's mydriasis
reacted to diluted pilocarpine 0.125% which is a sign of Adie's pupil and is not 
supposed to occur in mydriasis caused by a third nerve palsy. We review the
literature on the possible pathogenesis of this hypersensitivity.

Publication Types: 
    Case Reports
    Review

PMID: 17894283 [PubMed - indexed for MEDLINE]

560: Anesthesiology. 2007 Oct;107(4):678-9.

Cost effectiveness of epidural injection of steroids and local anesthetics for
relief of zoster-associated pain.

Opstelten W, van Wijck AJ, van Essen GA, Moons KG, Verheij TJ, Kalkman CJ, van
Hout BA.

Publication Types: 
    Letter

PMID: 17893478 [PubMed - indexed for MEDLINE]

561: Evid Based Dent. 2007;8(3):85-6.

Comment on:
    Cochrane Database Syst Rev. 2007;(2):CD004846.

Insufficient evidence to recommend topical lidocaine as first-line treatment for 
postherpetic neuralgia.

Zakrzewska JM.

Division of Diagnostic, Surgical and Medical Sciences, Eastman Dental Hospital,
University College London NHS Foundation Trust, London, UK.

DATA SOURCES: The Cochrane Pain, Palliative and Supportive Care Group Trials
Register, Cochrane Central Register of Controlled Trials, Medline, Embase, LILACS
(Latin American and Caribbean Health Sciences), SIGLE (System for Information on 
Grey Literature in Europe)(for conference proceedings) and Science Citation Index
were searched, along with the reference lists of all eligible trials, key
textbooks and previous systematic reviews. Authors of all identified trials were 
contacted. STUDY SELECTION: Studies of interest were randomised controlled trials
(RCT) or quasi-RCT comparing all topical applications of lidocaine, including
gels and patches in people of all ages suffering from postherpetic neuralgia
(PHN; pain persisting at the site of shingles at least 1 month after the onset of
the acute rash). DATA EXTRACTION AND SYNTHESIS: Data were extracted independently
by two authors with disputes resolved by a third reviewer. A meta-analysis was
conducted using a fixed-effect approach. RESULTS: Three trials were included,
giving a total of 182 individuals who used topical lidocaine and 132 controls.
Two trials provided data on pain relief, and the remaining study provided data on
secondary outcome measures. The largest trial published as an abstract compared a
topical lidocaine patch to a placebo patch and accounted for 150 of the 314
patients (48%). A meta-analysis combining two of the three studies identified a
significant difference between the topical lidocaine and control groups for the
primary outcome measure: a mean improvement in pain relief according to a pain
relief scale. Topical lidocaine relieved pain better than placebo (P 0.003).
There was a statistical difference between the groups for the secondary outcome
measure of mean score-reduction on a visual analogue scale (P 0.030), but this
was only for a single small trial. There were a similar number of adverse skin
reactions in both treatment and placebo groups. CONCLUSIONS: There is
insufficient evidence to recommend topical lidocaine as a first-line agent in the
treatment of PHN with allodynia. Further research should be undertaken on the
efficacy of topical lidocaine for other chronic neuropathic pain disorders, and
also to compare different classes of drugs (eg, topical anaesthetics versus
anti-epileptics).

Publication Types: 
    Comment

PMID: 17891129 [PubMed]

562: Vaccine. 2007 Oct 23;25(43):7598-604. Epub 2007 Aug 15.

Epidemiology and costs of herpes zoster: background data to estimate the impact
of vaccination.

Di Legami V, Gianino MM, Atti MC, Massari M, Migliardi A, Tomba GS, Zotti C;
Zoster Study Group.

Dipartimento di Sanita Pubblica e di Microbiologia, Universita degli Studi di
Torino, via Santena 5 bis, 10126 Torino, Italy. valeria.dilegami@unito.it

In 2004, we conducted a study in Piemonte (Italy), in order to describe
incidence, treatment, hospitalizations and costs of herpes zoster (HZ), in
population over 14 years of age. Twenty-four regional general practitioners, with
26,394 patients >14 years in charge (0.71% of the regional population), reported 
prospectively all diagnosed HZ cases. In addition, all regional hospital
discharge records were reviewed. Forty-six HZ cases treated at home were
reported, accounting for a total incidence of 1.74 cases/1000 population >14
years per year. HZ rate standardized by age on regional population 14 years older
is 1.59/1000. The cost per observed home case was 136.06 euros. The incidence of 
hospital admissions was 0.12/1000 inhabitants. The mean cost of hospitalized
cases was 4082.59 euros. These results contribute to depict the impact of HZ in
the general population, and to provide background data for setting-up either
mathematical models aimed to estimate the impact of vaccination on HZ, and the
cost-benefit analyses of various preventive and therapeutic scenarios.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17889410 [PubMed - indexed for MEDLINE]

563: Ophthal Plast Reconstr Surg. 2007 Sep-Oct;23(5):411-3.

Orbital myositis involving the oblique muscles associated with herpes zoster
ophthalmicus.

Badilla J, Dolman PJ.

Department of Ophthalmology, University of British Columbia, Vancouver, Canada.

An 81-year-old woman with right orbital inflammation and acute retinal necrosis
following Herpes zoster ophthalmicus was evaluated and treated. CT showed right
massive superior and inferior oblique enlargement and moderate enlargement of the
remaining extraocular muscles with tendon sparing. The myositis and acute retinal
necrosis dramatically improved following prednisone and intravenous acyclovir
therapy.

Publication Types: 
    Case Reports

PMID: 17881997 [PubMed - indexed for MEDLINE]

564: J Virol. 2007 Dec;81(23):13158-67. Epub 2007 Sep 19.

Divergence and recombination of clinical herpes simplex virus type 2 isolates.

Norberg P, Kasubi MJ, Haarr L, Bergstrom T, Liljeqvist JA.

Department of Virology, University of Goteborg, Guldhedsgatan 10 B, S-413 46
Goteborg, Sweden. peter.norberg@microbio.gu.se

Herpes simplex virus type 2 (HSV-2) infects the genital mucosa and is one of the 
most common sexually transmitted viruses. Here we sequenced a segment comprising 
3.5% of the HSV-2 genome, including genes coding for glycoproteins G, I, and E,
from 27 clinical isolates from Tanzania, 10 isolates from Norway, and 10 isolates
from Sweden. The sequence variation was low compared to that described for
clinical HSV-1 isolates, with an overall similarity of 99.6% between the two most
distant HSV-2 isolates. Phylogenetic analysis revealed a divergence into at least
two genogroups arbitrarily designated A and B, supported by high bootstrap values
and evolutionarily separated at the root. Genogroup A contained isolates
collected in Tanzania, and genogroup B contained isolates collected in Tanzania
and Scandinavia, implying that the genetic variability of HSV-2 is higher in
Tanzania than in Scandinavia. Recombination network analysis and bootscan
analysis revealed a complex pattern of phylogenetically conflicting informative
sites in the sequence alignments. These signals were present in synonymous and
nonsynonymous sites in all three genes and were not accumulated in specific
regions, observations arguing against positive selection. Since the PHI test
applied solely to synonymous sites revealed a high statistical probability of
recombination, we suggest as a novel finding that homologous recombination is, as
reported earlier for HSV-1 and varicella-zoster virus, a prominent feature in the
evolution of HSV-2.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17881457 [PubMed - indexed for MEDLINE]

565: Bull Math Biol. 1999 Nov;61(6):1031-64.

Modeling the effects of varicella vaccination programs on the incidence of
chickenpox and shingles.

Schuette MC, Hethcote HW.

Applied Mathematical and Computational Sciences, University of Iowa, Iowa City,
IA 52242, USA.

Two possible dangers of an extensive varicella vaccination program are more
varicella (chickenpox) cases in adults, when the complication rates are higher,
and an increase in cases of zoster (shingles). Here an age-structured
epidemiologic-demographic model with vaccination is developed for varicella and
zoster. Parameters are estimated from epidemiological data. This mathematical and
computer simulation model is used to evaluate the effects of varicella
vaccination programs. Although the age distribution of varicella cases does shift
in the simulations, this does not seem to be a danger because many of the adult
cases occur after vaccine-induced immunity wanes, so they are mild varicella
cases with fewer complications. In the simulations, zoster incidence increases in
the first three decades after initiation of a vaccination program, because people
who had varicella in childhood age without boosting, but then it decreases. Thus 
the simulations validate the second danger of more zoster cases.

PMID: 17879870 [PubMed - indexed for MEDLINE]

566: Pol Merkur Lekarski. 2005 Feb;18(104):229-32.

[Prophylaxis and treatment of viral infections. Part I--infections caused by DNA 
viruses]

[Article in Polish]

Strycharz M, Bartecka K, Polz-Dacewicz M.

Zaklad Wirusologii AM w Lublinie.

The amount of antiviral drugs have increased recently. Many viruses treated as a 
mild pathogens has turned out to cause different complications and severe
diseaseses in elderly people and immunocomprised patients. The authors have made 
an attempt of presenting on the basis of scientific reports the principles of
antiviral prophylaxis and treatment. The first part is focused on infections
caused by DNA viruses.

Publication Types: 
    English Abstract
    Review

PMID: 17877138 [PubMed - indexed for MEDLINE]

567: Curr Med Res Opin. 2007 Oct;23(10):2585-96.

Cost-effectiveness analysis of pregabalin versus gabapentin in the management of 
neuropathic pain due to diabetic polyneuropathy or post-herpetic neuralgia.

Rodriguez MJ, Diaz S, Vera-Llonch M, Dukes E, Rejas J.

Pain and Palliative Care Unit, Carlos Haya University Hospital, Malaga, Spain.
maje1946@yahoo.es

OBJECTIVE: To estimate the cost-effectiveness of branded pregabalin (PGB) versus 
generic gabapentin (GBP) in patients with neuropathic pain (NeP) due to painful
diabetic polyneuropathy (DPN) or post-herpetic neuralgia (PHN) in Spain. METHODS:
Using stochastic simulation, we estimated the cost-effectiveness of PGB 150-600
mg/d vs. GBP 900-3600 mg/d in a hypothetical cohort of 1000 patients. The model
used data from three randomized controlled clinical trials. Pain was evaluated
using a 0-10 scale. Mean baseline pain was 6.9 in both treatment groups. The
model assigned untreated pain scores over 84 days. Treated scores were calculated
using weekly changes in pain scores from trials. Outcomes included the numbers of
days with no or mild pain (score < 4), days with >or= 30% and >or= 50% reductions
in pain intensity, quality-adjusted life-years (QALYs), and estimated health
costs. RESULTS: Compared with GBP, PGB yielded an estimated mean of 8 (standard
error, 0.4) additional days with no or mild pain, 6 (0.4) days with >or= 30%
reduction in pain intensity, 9 (0.5) days with >or= 50% reduction in pain
intensity, and a gain of 0.1186 (0.0002) QALYs for 12 weeks. The estimated total 
health costs of therapies were euro 1049 (euro 35) for PGB and euro 951 (euro 38)
for GBP, respectively. Incremental cost-effectiveness ratio (ICER) for PGB versus
GBP were a mean of euro 12 (95% confidence interval, euro 1-24) per additional
day with no or mild pain, euro 431 (dominant-euro 876) per additional patient
with no or mild pain, and euro 20 535 (euro 1607-40 345) per QALY gained.
CONCLUSIONS: According with data used in this modeling in patients with NeP due
to DPN and/or PHN, PGB was shown to be more cost-effective than generic
gabapentin in Spain.

Publication Types: 
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 17875242 [PubMed - indexed for MEDLINE]

568: Med Mal Infect. 2007 Dec;37(12):792-5. Epub 2007 Sep 17.

Infection in systemic lupus erythematosus.

Khalifa M, Kaabia N, Bahri F, Ben Jazia E, Bouajina E, Omezzine Letaief A.

Department of Internal Medicine and Infectious Diseases, University Hospital
Center Farhat-Hached, 4000 Sousse, Tunisia. mabrouk.khalifa@rns.tn

BACKGROUND: Infections are common in patients with systemic lupus erythematosus
(SLE) throughout the course of their disease and remain a source of mortality.
The aim of this study was to determine the prevalence of infections, to describe 
their nature, and analyze their risk factors in adults with SLE. PATIENTS AND
METHODS: We performed a descriptive study, at the Farhat-Hached Hospital in
Sousse, and retrospectively analyzed the charts of 75 patients with SLE seen
between 1990 and 2004. The group of patients with documented infections was
compared to a control group. A logistic regression analysis was performed to
determine risk factors associated with infection. RESULTS: Our study included 64 
women and 11 men (median age of 31.4 years). Forty-three patients (57.5%) had 82 
infectious episodes: 23 patients had at least two infectious episodes. Most
infections were community acquired, and 80% were severe. The most common
infections involved the urinary tract (28%), the skin and soft tissue (26.8%),
and the respiratory tract (18.3%). Documented pathogens were: 45 common bacteria,
11 Candida albicans and four Mycobacterium tuberculosis. Localized herpes zoster 
was noted in three cases. Factors associated with infection, found in univariate 
analysis, were renal involvement, serum albumin lower than 25 g/l, and
corticosteroids treatment. Only corticosteroids therapy remained statistically
significant after multivariate analysis.

PMID: 17870271 [PubMed - indexed for MEDLINE]

569: Virus Res. 2007 Nov;129(2):200-11. Epub 2007 Sep 14.

The Varicella-zoster virus DNA encapsidation genes: Identification and
characterization of the putative terminase subunits.

Visalli RJ, Nicolosi DM, Irven KL, Goshorn B, Khan T, Visalli MA.

Department of Biology, Indiana University Purdue University Fort Wayne, 2101 E.
Coliseum Blvd., Fort Wayne, IN 46805-1499, USA. visallir@ipfw.edu

The putative DNA encapsidation genes encoded by open reading frames (ORFs) 25,
26, 30, 34, 43, 45/42 and 54 were cloned from Varicella-zoster virus (VZV) strain
Ellen. Sequencing revealed that the Ellen ORFs were highly conserved at the amino
acid level when compared to those of 19 previously published VZV isolates.
Additionally, RT-PCR provided the first evidence that ORF45/42 was expressed as a
spliced transcript in VZV-infected cells. All seven ORFs were expressed in vitro 
and full length products were identified using a C-terminal V5 epitope tag. The
in vitro products of the putative VZV terminase subunits encoded by ORFs 30 and
45/42 proved useful in protein-protein interaction assays. Previous studies have 
reported the formation of a heterodimeric terminase complex involved in DNA
encapsidation for both herpes simplex virus-type 1 (HSV-1) and human
cytomegalovirus (HCMV). Here we report that the C-terminal portion of exon II of 
ORF45/42 (ORF42-C269) interacted in GST-pull down experiments with in vitro
synthesized ORF30 and ORF45/42. The interactions were maintained in the presence 
of anionic detergents and in buffers of increasing ionic strength. Cells
transiently transfected with epitope tagged ORF45/42 or ORF30 showed primarily
cytoplasmic staining. In contrast, an antiserum directed to the N-terminal
portion of ORF45 showed nearly exclusive nuclear localization of the ORF45/42
gene product in infected cells. An ORF30 specific antiserum detected an 87 kDa
protein in both the cytoplasmic and nuclear fractions of VZV infected cells. The 
results were consistent with the localization and function of herpesviral
terminase subunits. This is the first study aimed at the identification and
characterization of the VZV DNA encapsidation gene products.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 17868947 [PubMed - indexed for MEDLINE]

570: J Clin Microbiol. 2007 Dec;45(12):3909-14. Epub 2007 Sep 12.

Effect of viral load on the outcome of herpes zoster.

Quinlivan ML, Ayres K, Ran H, McElwaine S, Leedham-Green M, Scott FT, Johnson RW,
Breuer J.

Centre for Infectious Disease, Institute of Cell and Molecular Science, Barts,
and the London School of Medicine and Dentistry, Queen Mary College, London, UK.

Varicella-zoster virus (VZV) is a member of the Herpesviridae family, primary
infection with which causes varicella, more commonly known as chicken pox.
Characteristic of members of the alphaherpesvirus subfamily, VZV is neurotropic
and establishes latency in sensory neurons. Reactivation of VZV causes herpes
zoster, also known as shingles. The most frequent complication following zoster
is chronic and often debilitating pain called postherpetic neuralgia (PHN), which
can last for months after the disappearance of a rash. During episodes of acute
zoster, VZV viremia occurs in some, but not all, patients; however, the effect of
the viral load on the disease outcome is not known. Here we describe the
development of a highly specific, sensitive, and reproducible real-time PCR assay
to investigate the factors that may contribute to the presence and levels of
baseline viremia in patients with zoster and to determine the relationship
between viremia and the development and persistence of PHN. VZV DNA was detected 
in the peripheral blood mononuclear cells (PBMCs) of 78% of patients with acute
zoster and in 9% of healthy asymptomatic blood donors. The presence of VZV in the
PBMCs of patients with acute zoster was independently associated with age and
being on antivirals but not with gender, immune status, extent of rash, the age
of the rash at the time of blood sampling, having a history of prodromal pain, or
the extent of acute pain. Prodromal pain was significantly associated with higher
baseline viral loads. Viral load levels were not associated with the development 
or persistence of PHN at 6, 12, or 26 weeks.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17855575 [PubMed - indexed for MEDLINE]

571: J Virol. 2007 Nov;81(22):12654-65. Epub 2007 Sep 12.

Deletion in open reading frame 49 of varicella-zoster virus reduces virus growth 
in human malignant melanoma cells but not in human embryonic fibroblasts.

Sadaoka T, Yoshii H, Imazawa T, Yamanishi K, Mori Y.

Laboratory of Virology and Vaccinology, Division of Biomedical Research, National
Institute of Biomedical Innovation, 7-6-8, Saito-Asagi, Ibaraki, Osaka, Japan.

The ORF49 gene product (ORF49p) of the varicella-zoster virus (VZV) is likely a
myristylated tegument protein, and its homologs are conserved across the
herpesvirus subfamilies. The UL11 gene of herpes simplex virus type 1 and of
pseudorabies virus and the UL99 gene of human cytomegalovirus are the homologs of
ORF49 and have been well characterized by using mutant viruses; however, little
research on the VZV ORF49 gene has been reported. Here we report on VZV ORF49p
expression, subcellular localization, and effect on viral spread in vitro. ORF49p
was expressed during the late phase of infection and located in the juxtanuclear 
region of the cytoplasm, where it colocalized mainly with the trans-Golgi
network-associated protein. ORF49p was incorporated into virions and showed a
molecular mass of 13 kDa in VZV-infected cells and virions. To elucidate the role
of the ORF49 gene, we constructed a mutant virus that lacked a functional ORF49. 
No differences in plaque size or cell-cell spread were observed in human
embryonic fibroblast cells, MRC-5 cells, infected with the wild-type or the
mutant virus. However, the mutant virus showed diminished cell-cell infection in 
a human malignant melanoma cell line, MeWo cells. Therefore, VZV ORF49p is
important for virus growth in MeWo cells, but not in MRC-5 cells. VZV may use
different mechanisms for virus growth in MeWo and MRC-5 cells. If so,
understanding the role of ORF49p should help elucidate how VZV accomplishes
cell-cell infections in different cell types.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17855513 [PubMed - indexed for MEDLINE]

572: J Paediatr Child Health. 2007 Oct;43(10):713-5.

Herpes zoster due to Oka vaccine strain of varicella zoster virus in an
immunosuppressed child post cord blood transplant.

Chan Y, Smith D, Sadlon T, Scott JX, Goldwater PN.

Department of Infectious Diseases and Microbiology, Women's and Children's
Hospital, 72 King William Road, North Adelaide, SA 5006, Australia.

A 5-year-old boy was vaccinated with the Oka strain of varicella zoster virus
vaccine before cord blood transplant for chronic granulomatous disease in 2005.
In 2006, he developed herpes zoster on his left arm. DNA from the vesicular rash 
confirmed the Oka vaccine strain of varicella zoster virus caused this
complication. He responded well to 10 days of aciclovir treatment.

Publication Types: 
    Case Reports

PMID: 17854459 [PubMed - indexed for MEDLINE]

573: Eur Arch Otorhinolaryngol. 2008 Mar;265(3):365-7. Epub 2007 Sep 12.

Laryngeal zoster with multiple cranial nerve palsies.

Van Den Bossche P, Van Den Bossche K, Vanpoucke H.

Department of Internal Medicine, H Hartziekenhuis Roeselare Menen vzw, Rijselse
straat, 71, 8930 Menen, Belgium. paul-vandenbossche@skynet.be

A young immunocompetent patient is presented with a very rare presentation of a
common viral illness: herpes zoster of the left hemilarynx with sensorial and
motoric neuropathy of three ipsilateral lower cranial nerves: IX, X and XI. The
mucosal lesions were discovered during upper gastrointestinal endoscopy. PCR of
erosional exsudate confirmed the clinical diagnosis. Antiviral therapy and
corticosteroids possibly contributed to the prosperous evolution with complete
healing.

Publication Types: 
    Case Reports

PMID: 17849136 [PubMed - indexed for MEDLINE]

574: Neurologist. 2007 Sep;13(5):313-7.

Segmental zoster paresis of limbs: report of three cases and review of
literature.

Kawajiri S, Tani M, Noda K, Fujishima K, Hattori N, Okuma Y.

Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.

OBJECTIVES: Segmental zoster paresis is a relatively rare complication
characterized by focal motor weakness, which may occur in limbs affected by
herpes zoster. We demonstrate the clinical characteristics of segmental zoster
paresis by reviewing the cases of 138 patients, including 3 of our patients. CASE
REPORT AND REVIEW SUMMARY: We report 3 patients with zoster paresis of the limbs.
Patients 1 and 3 showed motor weakness in the left shoulder and arm after
developing a herpetic rash in the left C5-C6 dermatomes. Patient 2 showed
weakness in the right thigh and groin after a right L2-L3 herpetic eruption. The 
electromyograms of all 3 patients showed abnormal spontaneous activity in the
affected muscles. Intravenous acyclovir and corticosteroid pulse therapy were
added to oral antiviral drugs for patients 1 and 2. All 3 patients recovered
favorably. Our review of the literature revealed that antiviral treatment may
prevent the occurrence of zoster paresis; however, there is insufficient evidence
to show what treatment hastens recovery from zoster paresis. CONCLUSIONS:
Segmental zoster paresis is still underrecognized by neurologists. Awareness of
this disorder is important because it may eliminate unnecessary invasive
investigations and lead to appropriate treatment. Further studies on the
treatment are necessary.

Publication Types: 
    Case Reports

PMID: 17848871 [PubMed - indexed for MEDLINE]

575: Herpes. 2007 Jun;14(1):4-10.

Herpetic retinitis.

Cordero-Coma M, Anzaar F, Yilmaz T, Foster CS.

Massachusetts Eye Research and Surgery Institute, Cambridge, MA 02142, USA.

This paper provides an appreciation of the various forms and consequences of
retinal inflammation caused by human herpesviruses. Herpes simplex virus types 1 
and 2, varicella zoster virus, cytomegalovirus and Epstein-Barr virus are known
to cause retinitis. The prognosis of herpetic retinitis remains poor because it
is associated with a high incidence of complications, both during and after the
acute disease phase. On diagnosis of retinal necrosis, antiviral treatment must
be started promptly to limit disease progression; following this, prophylactic
maintenance therapy may be required.

Publication Types: 
    Review

PMID: 17848212 [PubMed - indexed for MEDLINE]

576: J Am Med Dir Assoc. 2007 Sep;8(7):419-20.

How should nursing homes use vaccine to prevent zoster?

Drinka PJ.

Publication Types: 
    Editorial

PMID: 17845943 [PubMed - indexed for MEDLINE]

577: Anaesthesia. 2007 Oct;62(10):1039-49.

Erratum in:
    Anaesthesia. 2007 Nov;62(11):1197.

Comment in:
    Anaesthesia. 2008 May;63(5):551; author reply 551-2.    Anaesthesia. 2008 May;63(5):552-3; author reply 553.    Anaesthesia. 2008 May;63(5):553.

Interpleural block - part 1.

Dravid RM, Paul RE.

Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK.
ravi.Dravid@kgh.nhs.uk

Interpleural blockade is effective in treating unilateral surgical and
nonsurgical pain from the chest and upper abdomen in both the acute and chronic
settings. It has been shown to provide safe, high-quality analgesia after
cholecystectomy, thoracotomy, renal and breast surgery, and for certain invasive 
radiological procedures of the renal and hepatobiliary systems. It has also been 
used successfully in the treatment of pain from multiple rib fractures, herpes
zoster, complex regional pain syndromes, thoracic and abdominal cancer, and
pancreatitis. The technique is simple to learn and has both few
contra-indications and a low incidence of complications. In the first of two
reviews, the authors cover the history, taxonomy and anatomical considerations,
the spread of local anaesthetic, and the mechanism of action, physiological,
pharmacological and technical considerations in the performance of the block.

Publication Types: 
    Review

PMID: 17845657 [PubMed - indexed for MEDLINE]

578: Intern Med. 2007;46(17):1487-8. Epub 2007 Sep 3.

Constipation and segmental abdominal paresis followed by herpes zoster.

Maeda K, Furukawa K, Sanada M, Kawai H, Yasuda H.

Division of Neurology, Department of Medicine, Shiga University of Medical
Science. kengo@belle.shiga-med.ac.jp

Publication Types: 
    Case Reports

PMID: 17827858 [PubMed - indexed for MEDLINE]

579: Clin Ther. 2007 Jul;29(7):1491-507.

Cost-effectiveness of a lidocaine 5% medicated plaster relative to gabapentin for
postherpetic neuralgia in the United Kingdom.

Dakin H, Nuijten M, Liedgens H, Nautrup BP.

Abacus International, Bicester, Oxfordshire, United Kingdom.
helen.dakin@abacusint.com

BACKGROUND: Approximately 50% of elderly patients develop postherpetic neuralgia 
(PHN) after herpes zoster infection (shingles). A lidocaine 5% medicated plaster 
marketed in the United Kingdom in January 2007 has been shown to be an effective 
topical treatment for PHN with minimal risk of systemic adverse effects.
OBJECTIVE: This paper assessed the cost-effectiveness of using a lidocaine
plaster in place of gabapentin in English primary care practice to treat those
PHN patients who had insufficient pain relief with standard analgesics and could 
not tolerate or had contraindications to tricyclic antidepressants (TCAs). The
analysis took the perspective of the National Health Service (NHS). METHODS: The 
costs and benefits of gabapentin and the lidocaine plaster were calculated over a
6-month time horizon using a Markov model. The model structure allowed for
differences in costs, utilities, and transition probabilities between the initial
30-day run-in period and maintenance therapy and also accounted for add-in
medications and drugs received by patients who discontinued therapy. Most
transition probabilities were based on non-head-to-head clinical trials
identified through a systematic review. Data on resource utilization,
discontinuation rates, and add-in or switch medications were obtained from a
Delphi panel; cost data were from official price tariffs. Published utilities
were adjusted for age and were supplemented and validated by the Delphi panel.
RESULTS: Six months of therapy with the lidocaine plaster cost pound 549 per
patient, compared with pound 718 for gabapentin, and generated 0.05 more
quality-adjusted life-years (QALYs). The lidocaine plaster therefore dominated
gabapentin (95% CI, dominant- pound 2163/QALY gained). Probabilistic sensitivity 
analysis showed that there was a 90.15% chance that the lidocaine plaster was
both less costly and more effective than gabapentin and a 99.99% chance that it
cost < pound 20,000/QALY relative to gabapentin. Extensive deterministic
sensitivity analyses confirmed the robustness of the conclusions. CONCLUSION:
This study found that the lidocaine 5% medicated plaster was a cost-effective
alternative to gabapentin for PHN patients who were intolerant to TCAs and in
whom analgesics were ineffective, from the perspective of the NHS.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 17825701 [PubMed - indexed for MEDLINE]

580: Rev Inst Med Trop Sao Paulo. 2007 Jul-Aug;49(4):267-70.

Soft tissue abscess and lymphadenitis due to Mycobacterium avium complex as an
expression of immune reconstitution inflammatory syndrome after a second scheme
of highly active antiretroviral therapy.

Corti M, Villafane MF, Ambroggi M, Sawicki M, Gancedo E.

Division of HIV/AIDS, Infectious Diseases F. J. Muniz Hospital, Buenos Aires,
Argentina. marcelocorti@fibertel.com.ar

Immune reconstitution inflammatory syndrome (IRIS) is an atypical and unexpected 
reaction related to highly active antiretroviral therapy (HAART) in human
immunodeficiency virus (HIV) infected patients. IRIS includes an atypical
response to an opportunistic pathogen (generally Mycobacterium tuberculosis,
Mycobacterium avium complex, cytomegalovirus and herpes varicella-zoster), in
patients responding to HAART with a reduction of plasma viral load and evidence
of immune restoration based on increase of CD4+ T-cell count. We reported a case 
of a patient with AIDS which, after a first failure of HAART, developed a
subcutaneous abscess and supraclavicular lymphadenitis as an expression of IRIS
due to Mycobacterium avium complex after starting a second scheme of HAART.

Publication Types: 
    Case Reports

PMID: 17823760 [PubMed - indexed for MEDLINE]

581: Clin Exp Immunol. 2007 Nov;150(2):306-11. Epub 2007 Sep 5.

Anti-tumour necrosis factor-alpha therapy for severe enteropathy in patients with
common variable immunodeficiency (CVID).

Chua I, Standish R, Lear S, Harbord M, Eren E, Raeiszadeh M, Workman S, Webster
D.

Department of Immunology, Royal Free Hospital Hampstead, London, UK.
cichua@hotmail.com

We present three common variable immunodeficiency (CVID) patients with severe
inflammatory bowel disease of unknown aetiology, resistant to steroid treatment, 
treated with infliximab. After exclusion of any infection, infliximab was given
at a dose of 5 mg/kg every 4 weeks for a 3 month induction followed by every 4-8 
weeks depending on clinical response. Two of these patients had predominantly
small bowel disease; they both showed clinical response to infliximab with weight
gain and improvement of quality of life scores. The third patient had large bowel
involvement with profuse watery diarrhea; this patient improved dramatically
within 48 hours of having infliximab treatment. All three patients have been
maintained on infliximab treatment for between 5 and 53 months (mean 37 months)
with no evidence of increased susceptibility to infections in the patients with
small bowel disease, although the third patient developed two urinary tract
infections and a herpes zoster infection following therapy. This is the first
small case series to show that infliximab is a useful addition to current therapy
in this rare group of patients with potentially life threatening enteritis.

Publication Types: 
    Case Reports

PMID: 17822445 [PubMed - indexed for MEDLINE]

582: J Indian Med Assoc. 2007 Apr;105(4):216-7.

Human immunodeficiency virus infection in a child presenting as herpes zoster
ophthalmicus.

Pandey N, Chandrakar AK, Adile SL, Garg ML, Patel S.

Department of Ophthalmology, Pt JNM Medical College, Raipur 492009.

Herpes zoster is mainly a disease of the elderly. Its occurrence in younger age
should be viewed with suspicion. A 9-year-old boy presented with herpes zoster
ophthalmicus. He had a history of abdominal surgery one and half years back
during which he had received blood transfusion. A year following the surgery he
developed general malaise and fever with progressive weight loss. He was treated 
by local doctors. Subsequently he developed eruptions of blisters around right
eye for a duration of 8 days, with which he presented to the department of
ophthalmology, Pt JNM Medical College, Raipur. On investigations he was found to 
have infected with human immunodeficiency virus. Systemic acyclovir along with
antiretroviral treatment was started, to which he showed favourable response.

Publication Types: 
    Case Reports

PMID: 17822193 [PubMed - indexed for MEDLINE]

583: Indian J Pediatr. 2007 Aug;74(8):774-6.

Recurrent herpes zoster in early childhood.

Ganga Devi NP, Rathinam SN, Ramachandran R, Swaminathan S.

Tuberculosis Research Centre, Chennai, India.

Herpes Zoster is produced by reactivation of latent Varicella Zoster Virus from
the dorsal root ganglion of sensory nerves. It is common in older individuals and
rarely described in the pediatric age group. We report a case of recurrent herpes
zoster in a 3-year-old HIV positive child involving T4 dermatome on the first
occasion and subsequently involving T10 dermatome. The child responded well to
oral acyclovir.

Publication Types: 
    Case Reports

PMID: 17785904 [PubMed - indexed for MEDLINE]

584: J Immunol. 2007 Sep 15;179(6):4219-30.

Impaired plasmacytoid dendritic cell innate immune responses in patients with
herpes virus-associated acute retinal necrosis.

Kittan NA, Bergua A, Haupt S, Donhauser N, Schuster P, Korn K, Harrer T, Schmidt 
B.

Institute of Clinical and Molecular Virology, German National Reference Centre
for Retroviruses, Erlangen, Germany.

Plasmacytoid dendritic cells (PDC), the main producers of type I IFNs in the
blood, are important for the recognition and control of viral and bacterial
infections. Because several viruses induce IFN-alpha production, severe courses
of herpes virus infections in nonimmunocompromised patients may be related to
numerical or functional PDC deficits. To evaluate this hypothesis, PBMC and PDC
were repeatedly isolated from nine patients with acute retinal necrosis (ARN),
caused by herpes simplex or varicella zoster virus. The patients experienced
meningitis/encephalitis and frequent infections in childhood (n = 2), recurrent
herpes virus infections at unusual localizations (n = 2), ocular surgery (n = 1),
infections (n = 4), and stress around ARN (n = 6). The median percentage of
isolated PDC was significantly lower in patients compared with 18 age-matched
healthy controls (p < 0.001), confirmed by FACS analysis using peripheral blood, 
and was extremely low during acute disease. PDC counts dropped in five controls
suffering from respiratory infections or diarrhea. IFN-alpha production in PDC
and PBMC exposed to different stimuli was significantly lower in patients than in
controls (p < 0.05). Anergy to these stimuli was observed on four occasions, in
particular during acute disease. PDC of patients showed up-regulated IFN
regulatory factor-7 mRNA levels and evidence of in vivo activation (CD80) and
maturation (CD83) (p < 0.05). CD8+ cell responses were significantly lower in
patients vs controls (p = 0.04). These data support a risk factor model in which 
numerical and functional deficits in PDC-mediated innate immune responses
contribute to an impaired control of latent herpes virus infections and
subsequent development of ARN.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 17785862 [PubMed - indexed for MEDLINE]

585: Med Oral Patol Oral Cir Bucal. 2007 Sep 1;12(5):E360-4.

Maxillary necrosis by mucormycosis. a case report and literature review.

Auluck A.

Department of Oral Medicine and Radiology, Manipal College of Dental, Sciences,
Happankata, Mangalore, Karnataka, India. drajitauluck@gmail.com

The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary
necrosis can occur due to bacterial infections such as osteomyelitis, viral
infections such as herpes zoster or fungal infections such as mucormycosis,
aspergillosis etc. Mucormycosis is an opportunistic fulminant fungal infection,
which mainly infects immunocompromised patients. The infection begins in the nose
and paranasal sinuses due to inhalation of fungal spores. The infection can
spread to orbital and intracranial structures either by direct invasion or
through the blood vessels. The fungus invades the arteries leading to thrombosis 
that subsequently causes necrosis of hard and soft tissues. We report a case of
maxillary necrosis by mucormycosis in an uncontrolled diabetic patient to
emphasize early diagnosis of this potentially fatal fungal infection. We briefly 
discuss different diseases which can lead to maxillary necrosis and review the
current concepts in management of mucormycosis. Early diagnosis and prompt
treatment can reduce the mortality and morbidity of this lethal fungal infection.

Publication Types: 
    Case Reports
    Review

PMID: 17767099 [PubMed - indexed for MEDLINE]

586: Pediatr Rev. 2007 Sep;28(9):343-51.

Index of suspicion.

Rapson A, Rappaport DI, Holman L, Michaud L, Doyne E, Durrani A, Lanuza K, Ang J,
Kamat D, Silver ES.

Jefferson Medical College, Philadelphia, PA, USA.

Publication Types: 
    Case Reports

PMID: 17766593 [PubMed - indexed for MEDLINE]

587: Vaccine. 2007 Oct 10;25(41):7087-93. Epub 2007 Aug 15.

Phenotypic and functional characterization of ex vivo T cell responses to the
live attenuated herpes zoster vaccine.

Patterson-Bartlett J, Levin MJ, Lang N, Schodel FP, Vessey R, Weinberg A.

Department of Pediatrics of the University of Colorado School of Medicine,
Denver, CO 80262, USA.

To define the phenotypic characteristics and kinetics of T cell responses to a
shingles vaccine in elderly individuals, 20 subjects > or =60 years of age
received two doses of vaccine or placebo 6 weeks apart. VZV-specific T cell
phenotypes and intracellular cytokines were determined by flow cytometry on blood
mononuclear cells obtained pre-vaccination and up to 6 months after the second
immunization. Results were compared with responses of five unvaccinated young
adults. Pre-vaccination, elderly individuals had significantly lower VZV-specific
effectors and cytokine-producing T cells compared with young adults. The vaccine 
significantly increased VZV-specific Th1, memory, early effector, and cutaneous
homing receptor-bearing T cells.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural

PMID: 17766015 [PubMed - indexed for MEDLINE]

588: J Infect Dis. 2007 Oct 1;196(7):1014-20. Epub 2007 Aug 29.

Varicella-zoster-virus genotypes in East London: a prospective study in patients 
with herpes zoster.

Sengupta N, Taha Y, Scott FT, Leedham-Green ME, Quinlivan M, Breuer J.

Department of Virology, Centre for Infectious Diseases, Institute of Cell
Molecular Sciences, Queen Mary School of Medicine and Dentistry, Barts,
Whitechapel, London, E1 2AT, United Kingdom. n.sengupta@qmul.ac.uk

A total of 298 patients with herpes zoster were recruited as part of 2
community-based studies in East London between 1998 and 2003. Single
nucleotide-polymorphism analysis of 4 regions (genes 1, 21, 37, and 60) found
that most genotypes were European strains C and B, representing 58% and 21% of
all samples collected. No change in the proportion of these European clades has
occurred during the past 80 years, strongly supporting the hypothesis that these 
strains are indigenous to the United Kingdom. White patients almost exclusively
had reactivation of genotypes C (66%) and B (21%), whereas patients from Africa, 
Asia, or the Caribbean mainly had reactivation of genotypes A and J. An increase 
in BglI-positive A and J genotypes in UK cases of zoster is only partly explained
by immigration from endemic regions. The data presented provide a baseline
against which to evaluate changes in the molecular epidemiology of
varicella-zoster virus and the effect of immunization with the Japanese Oka
vaccine strain.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17763323 [PubMed - indexed for MEDLINE]

589: Brain. 2007 Oct;130(Pt 10):2688-702. Epub 2007 Aug 30.

Characterization of rodent models of HIV-gp120 and anti-retroviral-associated
neuropathic pain.

Wallace VC, Blackbeard J, Segerdahl AR, Hasnie F, Pheby T, McMahon SB, Rice AS.

Pain Research Group, Department of Anaesthetics Pain Medicine and Intensive Care,
Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital
Campus, London SW10 9NH, UK.

A distal symmetrical sensory peripheral neuropathy is frequently observed in
people living with Human Immunodeficiency Virus Type 1 (HIV-1). This neuropathy
can be associated with viral infection alone, probably involving a role for the
envelope glycoprotein gp120; or a drug-induced toxic neuropathy associated with
the use of nucleoside analogue reverse transcriptase inhibitors as a component of
highly active anti-retroviral therapy. In order to elucidate the mechanisms
underlying drug-induced neuropathy in the context of HIV infection, we have
characterized pathological events in the peripheral and central nervous system
following systemic treatment with the anti-retroviral agent, ddC (Zalcitabine)
with or without the concomitant delivery of HIV-gp120 to the rat sciatic nerve
(gp120+ddC). Systemic ddC treatment alone is associated with a persistent
mechanical hypersensitivity (33% decrease in limb withdrawal threshold) that when
combined with perineural HIV-gp120 is exacerbated (48% decrease in threshold) and
both treatments result in thigmotactic (anxiety-like) behaviour.
Immunohistochemical studies revealed little ddC-associated alteration in DRG
phenotype, as compared with known changes following perineural HIV-gp120.
However, the chemokine CCL2 is significantly expressed in the DRG of rats treated
with perineural HIV-gp120 and/or ddC and there is a reduction in intraepidermal
nerve fibre density, comparable to that seen in herpes zoster infection.
Moreover, a spinal gliosis is apparent at times of peak behavioural sensitivity
that is exacerbated in gp120+ddC as compared to either treatment alone. Treatment
with the microglial inhibitor, minocycline, is associated with delayed onset of
hypersensitivity to mechanical stimuli in the gp120+ddC model and reversal of
some measures of thigmotaxis. Finally, the hypersensitivity to mechanical stimuli
was sensitive to systemic treatment with gabapentin, morphine and the cannabinoid
WIN 55,212-2, but not with amitriptyline. These data suggests that both
neuropathic pain models display many features of HIV- and anti-retroviral-related
peripheral neuropathy. They therefore merit further investigation for the
elucidation of underlying mechanisms and may prove useful for preclinical
assessment of drugs for the treatment of HIV-related peripheral neuropathic pain.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17761732 [PubMed - indexed for MEDLINE]

590: Rev Chilena Infectol. 2007 Aug;24(4):323-6. Epub 2007 Aug 20.

[Acute retinal necrosis in an acute leukemia pediatric patient]

[Article in Spanish]

Torres T JP, Concha V E, Lopez G JP, Cofre G J.

Departamento de Pediatria Oriente, Universidad de Chile, Santiago, Chile.
jptorres@med.uchile.cl

Acute retinal necrosis (ARN) is a serious condition that can impair vision. It
mostly occurs in adult patients, especially those severely immunocompromised, in 
association with a reactivation of a herpes virus infection. We present a 4 years
old patient with high risk acute leukemia, whom during a course of intense
chemotherapy acquired chickenpox with visceral involvement that affected the
retina, causing unilateral blindness. Varicella-zoster virus was detected by PCR 
in the vitreous humor, in spite of previous acyclovir treatment. The
contralateral vision remained undamaged.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17728923 [PubMed - indexed for MEDLINE]

591: J Clin Virol. 2007 Oct;40(2):129-34. Epub 2007 Aug 28.

Detection and differentiation of wild-type and vaccine mutant varicella-zoster
viruses using an Invader Plus method.

Tang YW, Allawi HT, DeLeon-Carnes M, Li H, Day SP, Schmid DS.

Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
37232, USA. yiwei.tang@vanderbilt.edu

We report the use of a prototype Invader Plus method (Third Wave Technologies,
Inc., Madison, WI) for the qualitative detection of varicella-zoster virus (VZV) 
and differentiation of wild-type and Oka vaccine VZV. The analytical sensitivity 
of the VZV Invader Plus reagents is at 10 copies per reaction. A total of 174
skin and mucous swab specimens were used to validate the assay's performance. The
sensitivity and specificity were 98.3% and 98.1%, respectively, in comparison to 
a PCR-EIA assay. A perfect 100% agreement was obtained when VZV wild-type and
vaccine differentiation was performed on 54 VZV-positive swab specimens against
an allele-specific FRET real-time assay. The Invader Plus method provides another
reliable tool for qualitative detection of VZV and differentiation of wild-type
and vaccine virus.

PMID: 17728179 [PubMed - indexed for MEDLINE]

592: Cardiology. 2008;109(3):193-5. Epub 2007 Aug 28.

When an MI is not an MI: a case of varicella zoster myocarditis.

Kelly E, Cullen G, McGurk C.

St. Luke's Hospital, Kilkenny, Ireland. emerkelly@rcsi.ie

A sixteen-year-old male presented with symptoms and investigations suggestive of 
acute myocardial infarction. The patient had suffered from a varicella zoster
infection 5 days prior to presentation. Varicella myocarditis was suspected and
diagnosed following treatment and positive varicella serology. This case
highlights a rare but serious cardiac presentation of a common condition.
Copyright 2007 S. Karger AG, Basel.

Publication Types: 
    Case Reports

PMID: 17726320 [PubMed - indexed for MEDLINE]

593: Cutis. 2007 Jul;80(1):77-81.

Famciclovir for cutaneous herpesvirus infections: an update and review of new
single-day dosing indications.

Chacko M, Weinberg JM.

Department of Dermatology, St. Luke's-Roosevelt Hospital Center, 1090 Amsterdam
Ave, New York, NY 10025, USA.

Infections with herpes simplex virus (HSV) types 1 and 2 and herpes zoster are
common and a substantial public health issue. Famciclovir is an effective
treatment for herpes simplex and herpes zoster. We review studies evaluating the 
efficacy of single-day doses of famciclovir for the treatment of recurrent herpes
labialis (cold sores) and genital herpes. Famciclovir has received single-day
dosing indications for both of these entities. The studies leading to these new
indications are reviewed.

Publication Types: 
    Review

PMID: 17725069 [PubMed - indexed for MEDLINE]

594: Zhongguo Zhen Jiu. 2007 Jul;27(7):536-40.

[Systematic assessment of acupuncture for treatment of herpes zoster in domestic 
clinical studies]

[Article in Chinese]

Yu XM, Zhu GM, Chen YL, Fang M, Chen YN.

Acupuncture Department, Yueyang Hospital of Integrated TCM and Western Medicine
Affiliated to Shanghai University of TCM, China.

OBJECTIVE: To assess the effectiveness of acupuncture for treatment of herpes
zoster. METHODS: According to the requirement of evidence-based medicine,
acupuncture, body acupuncture, electroacupuncture, head acupuncture, three edged 
needle, plum-blossom needle, fire needle, elongated needle, encircling needling, 
herpes zoster, etc. were selected as subject words to retrieve the relative
medical database at home, and clinically randomized controlled trials were used
as enrolled criteria, the treatment group were treated with acupuncture or
acupuncture plus other therapies, and the control group with medicine, the cured 
rate and the time of killing pain for herpes zoster were used as assessment
indexes. Altogether 43 papers were enrolled. Among them 10 papers were conducted 
for Meta-analysis by RevMan 4.2.9. RESULTS: The total OR was 4.27 with 95% CI
[2.90, 6.29] of the clinically cured rate in the 10 studies, and the total OR was
-7.64 with 95% CI [-8.12, -7.15] of the time of killing pain in the 4 studies.
The therapeutic effect in the treatment group on herpes zoster was superior to
that of the western medicine (P < 0.01). CONCLUSION: Acupuncture therapy for
herpes zoster is effective, but more high-quality studies are required to prove
this view point.

Publication Types: 
    English Abstract
    Meta-Analysis

PMID: 17722838 [PubMed - indexed for MEDLINE]

595: J Infect Chemother. 2007 Aug;13(4):270-2. Epub 2007 Aug 27.

Varicella zoster virus meningoencephalitis accompanied by sporadic skin lesions
in an older immunocompetent adult.

Sugisaki K, Yoshida H.

Department of Internal Medicine, Jusendo General Hospital, 1-8-16 Ekimae,
Koriyama, Fukushima 963-8585, Japan. kota_sugisaki@ryumachi-jp.com

A previously healthy 75-year-old man complained of persistent fever, headache,
nausea, mild gait disturbance, memory disorder, and sporadic vesicular skin
lesions. Viral meningoencephalitis was diagnosed, based on cerebrospinal fluid
(CSF) analysis. Intensive CSF analysis suggested that the patient's illness was
caused by varicella zoster virus (VZV). The patient recovered completely after
treatment with intravenous acyclovir. VZV infection should be considered as a
possible cause of central nervous system disease, even in an immunocompetent
patient. VZV reactivation was strongly suspected because of the results of
anti-VZV antibody evaluations in serum and CSF, although the skin lesions were
not similar to those of herpes zoster.

Publication Types: 
    Case Reports

PMID: 17721692 [PubMed - indexed for MEDLINE]

596: Nurse Pract. 2007 Sep;32(9):19-24, quiz, 24-5.

Republished in:
    Adv Skin Wound Care. 2008 Dec;21(12):582-8; quiz 589-90.

Herpes zoster: prevention, diagnosis, and treatment.

Wilson DD.

Mennonite College of Nursing, Illinois State University, Normal, IL, USA.

Publication Types: 
    Review

PMID: 17721355 [PubMed - indexed for MEDLINE]

597: Harv Health Lett. 2007 Aug;32(10):1-2.

The shingles vaccine. Why hasn't it caught on? The cost and other factors are to 
blame.

[No authors listed]

PMID: 17717891 [PubMed - indexed for MEDLINE]

598: Epidemiol Infect. 2007 Aug;135(6):883-6.

Vaccination to prevent zoster in the elderly.

Gershon AA.

Publication Types: 
    Editorial

PMID: 17717853 [PubMed - indexed for MEDLINE]

599: J Eur Acad Dermatol Venereol. 2007 Sep;21(8):1112-4.

Postzoster cutaneous pseudolymphoma in a patient with B-cell chronic lymphocytic 
leukaemia.

Moreira E, Lisboa C, Azevedo F, Principe F, Lima M.

Publication Types: 
    Case Reports
    Letter

PMID: 17714139 [PubMed - indexed for MEDLINE]

600: Consult Pharm. 2007 Jul;22(7):593-8.

Postherpetic neuralgia in an elderly patient.

Cappuzzo KA, Krogsund RR.

Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
23298-0533, USA. kacappuzzo@vcu.edu

A 67-year-old patient presented to the community pharmacy with poorly controlled 
postherpetic neuralgia (PHN) pain following an episode of herpes zoster. The
clinical pharmacist did a medication review and found that, although the patient 
was receiving medications proven effective in the treatment of PHN, she was not
receiving optimal therapy. Additionally, the patient was experiencing intolerable
side effects. The pharmacist provided recommendations to the patient's primary
care physician that ultimately improved the patient's pain control. Managing PHN 
pain requires practitioners to be vigilant in titrating pain regimens and trying 
various combinations of therapies with different mechanisms of action. Such an
approach is one that tailors medication therapy to each individual patient,
provides the most relief, and restores a patient's quality of life.

Publication Types: 
    Case Reports

PMID: 17714004 [PubMed - indexed for MEDLINE]

601: Proc Natl Acad Sci U S A. 2007 Aug 28;104(35):14086-91. Epub 2007 Aug 20.

Aberrant infection and persistence of varicella-zoster virus in human dorsal root
ganglia in vivo in the absence of glycoprotein I.

Zerboni L, Reichelt M, Jones CD, Zehnder JL, Ito H, Arvin AM.

Departments of Pediatrics, Stanford University School of Medicine, Stanford, CA
94305, USA. zerboni@stanford.edu

Varicella-zoster virus (VZV) causes varicella, establishes latency in sensory
ganglia, and reactivates as herpes zoster. Human dorsal root ganglia (DRGs)
xenografts in immunodeficient mice provide a model for evaluating VZV
neuropathogenesis. Our investigation of the role of glycoprotein I (gI), which is
dispensable in vitro, examines the functions of a VZV gene product during
infection of human neural cells in vivo. Whereas intact recombinant Oka (rOka)
initiated a short replicative phase followed by persistence in DRGs, the gI
deletion mutant, rOkaDeltagI, showed prolonged replication with no transition to 
persistence up to 70 days after infection. Only a few varicella-zoster
nucleocapsids and cytoplasmic virions were observed in neurons, and the major VZV
glycoprotein, gE, was retained in the rough endoplasmic reticulum in the absence 
of gI. VZV neurotropism was not disrupted when DRG xenografts were infected with 
rOka mutants lacking gI promoter elements that bind cellular transactivators,
specificity factor 1 (Sp1) and upstream stimulatory factor (USF). Because gI is
essential and Sp1 and USF contribute to VZV pathogenesis in skin and T cells in
vivo, these DRG experiments indicate that the genetic requirements for VZV
infection are less stringent in neural cells in vivo. The observations
demonstrate that gI is important for VZV neurotropism and suggest that a strategy
to reduce neurovirulence by deleting gI could prolong active infection in human
DRGs.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17709745 [PubMed - indexed for MEDLINE]

602: Am J Ophthalmol. 2007 Nov;144(5):781-5. Epub 2007 Aug 20.

Infectious uveitis in immunocompromised patients and the diagnostic value of
polymerase chain reaction and Goldmann-Witmer coefficient in aqueous analysis.

Westeneng AC, Rothova A, de Boer JH, de Groot-Mijnes JD.

F. C. Donders Institute of Ophthalmology, Utrecht, The Netherlands.

PURPOSE: To establish the causes of uveitis in immunocompromised patients and to 
determine the contribution of polymerase chain reaction (PCR) and Goldmann-Witmer
coefficient (GWC) analysis of aqueous humor in patients with an infectious
etiology. DESIGN: Retrospective case series of 56 consecutive immunocompromised
patients with uveitis. METHODS: All patients underwent full ophthalmologic
examination and laboratory blood analysis for uveitis. Aqueous humor analyses
were performed using PCR and GWC for cytomegalovirus (CMV), herpes simplex virus 
(HSV), varicella zoster virus (VZV), and Toxoplasma gondii. RESULTS: Of 56
immunocompromised patients, 43 (77%), all posterior and panuveitis, had
intraocular infections. Twenty-one (49%) had CMV, three (7%) had VZV, 11 (26%)
had T. gondii, six (14%) had Treponema pallidum, and one (2%) each had
Aspergillus and Candida. In AIDS patients, CMV was the most common cause. A
strong correlation between AIDS and ocular syphilis was also observed (P = .007).
In nonAIDS immunocompromised patients, T. gondii was most frequently detected.
Twenty-seven patients were examined by both PCR and GWC; five (18.5%) were
positive by both assays, 15 (55.5%) were positive by PCR alone and seven (26%) by
GWC alone. Viral infections were detected by PCR in 16 of 17 (94%) cases; T.
gondii in four of 10 (40%) patients. Using GWC, a viral infection was diagnosed
in three of 17 (18%) and T. gondii in nine of 10 (90%) cases. CONCLUSIONS: In
immunocompromised patients, PCR is superior in diagnosing viral infections.
Analysis of intraocular antibody production played a decisive role in the
diagnosis of ocular toxoplasmosis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17707328 [PubMed - indexed for MEDLINE]

603: Klin Mikrobiol Infekc Lek. 2007 Jun;13(3):109-14.

[Detection of active varicella-zoster virus (VZV) infection in patients with
neurological complications]

[Article in Czech]

Roubalova K, Suchankova A, Bojar M, Glosova L, Machova H, Soltysova K.

National Institute of Public Health Prague, Czech Republic. herpesvir@szu.cz

OBJECTIVES: When introduced into routine virological diagnosis of nervous system 
infections, PCR detection of viral DNA revealed the varicella-zoster virus (VZV) 
in cerebrospinal fluid (CSF) at much higher rates than expected. The aim of the
study was to evaluate the frequency of VZV DNA detection in CSF of patients with 
neurological symptoms in correlation with their VZV-specific serological findings
and clinical symptoms. MATERIAL AND METHODS: A total of 438 patients followed up 
in the neurology departments of the Motol and Kralovske Vinohrady University
Hospitals and the Department of Infectious Diseases of the Bulovka University
Hospital were screened for the presence of VZV-specific antibodies in serum and
intrathecal antibodies in CSF. A home-brew nested PCR assay was used for
detection of VZV DNA in CSF. Positive results were correlated with clinical
findings. RESULTS: Intrathecal antibodies against VZV were detected in 19.6 % of 
the studied patients, VZV-specific IgM antibodies were present in serum of 17.3 %
of the patients and VZV DNA was recorded in CSF of 9.4 % of the patients. The
clinical diagnosis was confirmed in 16 patients positive for VZV DNA in CSF:
encephalitis as a complication of neonatal varicella in a 2-week child;
encephalitis or meningoencephalitis in 5 adult patients of whom three had a
history of herpes zoster, one suffered from severe haemorrhagic focal
encephalitis with fatal complications and one had encephalitis and myelitis;
neuropathies in 4 patients, two with inflammatory polyneuropathy of unknown
origin and two with brachial plexopathy, in one case preceded by herpes zoster;
epileptic symptoms in 2 patients; multiple sclerosis in 3 patients and
nonspecific symptoms of chronic fatigue in one patient. CONCLUSIONS: 1) PCR
proved to be a suitable method for diagnosing VZV-mediated nervous system
infections. 2) VZV DNA can be present in CSF of patients with a wide range of
neurological symptoms, even with no history of either herpes zoster or varicella.
3) VZV DNA detection in CSF needs to be interpreted with caution and in
correlation with case histories, clinical findings and electrophysiological and
imaging data, especially in patients with chronic inflammatory disease receiving 
immunosuppressive therapy.

Publication Types: 
    English Abstract

PMID: 17703403 [PubMed - indexed for MEDLINE]

604: Mymensingh Med J. 2007 Jul;16(2):221-4.

Erratum in:
    Mymensingh Med J. 2008 Jan;17(1):111.

Herpes zoster ophthalmicus in an otherwise healthy 7 years child.

Akhanda AH, Quayum MA, Uddin A, Ahmed N, Uddin T, Ahmed T.

Department of Ophthalmology, Mymensingh Medical College, Mymensingh, Bangladesh.

A 07 years otherwise healthy child, non vaccinated for chickenpox and with a
history of chickenpox infection at 02 years of age presented with red colored
lesions in right upper lid, right side of forehead, vertex and right side of nose
and defective vision in right eye in Mymensingh Medical College Hospital, 20 days
after the appearance of blister in the same region. On examination granulation
tissue was present on the same area. There was no hair and skin over that area.
Lesion was strictly limited to right side of midline. Eyelashes of right upper
lid were absent and there was defective closure of eyelids. Best corrected visual
acuity of right eye was 3/60 and of left eye was 6/6. There was ciliary
congestion of right eye with haziness of cornea at interpalpebral region of right
eye. Corneal sensitivity was reduced and there was uniform fluorescein staining
at central part of cornea. Mild flare and cells were present in anterior chamber.
Fundus examination revealed no abnormality. He was treated with systemic
acyclovir, antibiotics, topical acyclovir, antibiotic and atropine. Corneal ulcer
and skin lesions were healed, but the patient developed cicatricial ectropion of 
right upper lid and best corrected visual acuity of right eye was reduced to 6/60
due to corneal opacity. So early diagnosis and treatment of herpes zoster
ophthalmicus is mandatory to prevent sight threatening complications.

Publication Types: 
    Case Reports

PMID: 17703164 [PubMed - indexed for MEDLINE]

605: JAAPA. 2007 Jul;20(7):56.

Patient information. Should I get the shingles vaccine?

[No authors listed]

PMID: 17695100 [PubMed - indexed for MEDLINE]

606: JAAPA. 2007 Jul;20(7):55.

Should I get the shingles vaccine?

Iverson K.

Emergency Treatment Center, University of Iowa Hospitals and Clinics, Iowa City, 
USA.

PMID: 17695099 [PubMed - indexed for MEDLINE]

607: J Assoc Physicians India. 2007 Apr;55:308-9.

Ramsay Hunt syndrome presenting as cranial polyneuropathy.

Padhiary KN, Mishra A, Routray P.

Publication Types: 
    Case Reports
    Letter

PMID: 17695066 [PubMed - indexed for MEDLINE]

608: Acta Anaesthesiol Taiwan. 2007 Jun;45(2):95-101.

Clinical experience of pain treatment for postherpetic neuralgia in elderly
patients.

Chau SW, Soo LY, Lu DV, Chen TI, Cheng KI, Chu KS.

Department of Anesthesiology, Faculty of Medicine, College of Medicine, Kaohsiung
Medical University, Taiwan, ROC. siwach@kmu.edu.tw

BACKGROUND: Postherpetic neuralgia (PHN) is a neuropathic pain syndrome that
occurs following acute herpes zoster infection. The main clinical problem is
intractable pain which interferes with activity of daily life and reduces the
quality of life in the elderly patients. This retrospective study was to evaluate
the outcome of pain treatment for the elderly patients with PHN at the Pain
Clinic of Kaohsiung Medical University Hospital. METHODS: Fifty-eight elderly
outpatients with PHN were studied from January 2004 to June 2006. The pain
intensity before and after treatment were assessed by patients themselves with
numeric pain scale (NPS). The pain treatment included (1) medication with
anticonvulsants, opioids and nonsteroidal anti-inflammatory drugs (NSAIDs); (2)
nerve block with 0.25% bupivacaine or 1% lidocaine twice a week at the beginning 
of the treatment. The therapeutic outcome was expressed by pain relief. The
reduction of pain and residual pain intensity were evaluated subjectively by the 
patients themselves with patients' global impression and NPS, respectively, after
treatment for one and three months (or last visit). The adverse events throughout
the treatment course were analyzed. RESULTS: (1) The mean age of the patients was
75.1 yr. The number of female PHN sufferers was higher than that of male in all
aged groups and the highest incidence was found in the age group of 70-79
(65.5%). The most commonly involved dermatomes were in the thoracic region
(82.7%). (2) All patients suffered from severe pain (NPS 8-10) before treatment. 
(3) The pain management was a combination of medication and nerve block at the
beginning of the treatment. Among the medications, gabapentin was prescribed to
all the patients and almost all of them (98.3%) required opioids simultaneously
and some of them needed additional NSAIDs at the beginning of the treatment. (4) 
The most common adverse event was somnolence (24.1%). (5) Among the sympathetic
blocks, the intercostal nerve block was performed commonly (84.5%). (6) The
therapeutic outcome was expressed by pain relief. As to the reduction of pain, 46
cases (79.3%) and 57 cases (98.3%) felt moderate and much improvement after
treatment for one and three months (or last visit), respectively. As to residual 
pain intensity, although none of them got complete pain relief, however, there
were 12 cases (20.7%) and 45 cases (77.6%) felt the pain intensity was mild (NPS 
1-3) after treatment for one and three months respectively. (7) There was a
statistically significant decrease in the pain intensity between before treatment
and after treatment for one month and three months. CONCLUSIONS: Our study
results showed that the concurrent combination therapy with proper medications
and appropriate nerve blocks could offer satisfactory pain relief in the majority
of elderly patients with PHN.

PMID: 17694685 [PubMed - indexed for MEDLINE]

609: Clin Ther. 2007 Jun;29(6):1146-52.

Bioavailability of two oral suspension and two oral tablet formulations of
acyclovir 400 mg: two single-dose, open-label, randomized, two-period crossover
comparisons in healthy Mexican adult subjects.

Palma-Aguirre JA, Absalon-Reyes JA, Novoa-Heckel G, de Lago A, Oliva I, Rodriguez
Z, Gonzalez-de la Parra M, Burke-Fraga V, Namur S.

Centro de Estudios Cientificos y Clinicos Pharma, S.A. de C.V., Mexico City,
Mexico.

BACKGROUND: Acyclovir is an important antiviral drug, used extensively for
treatment of herpes simplex and varicella zoster. Six oral generic formulations
of acyclovir are available in Mexico; however, a literature search failed to
identify data information concerning the bioavailability of these formulations in
the Mexican population. OBJECTIVE: The aim of these 2 studies was to compare the 
bioavailability of 4 oral formulations of acyclovir 400 mg--2 tablet formulations
and 2 suspension formulations--with their corresponding listed drug references in
Mexico (a list issued by Mexican Health Authorities). METHODS: Two separate,
single-dose, open-label, randomized, 2-period crossover studies were conducted at
the Centro de Estudios Cientificos y Clinicos Pharma, S.A. de C.V. (clinical
unit), Mexico City, Mexico. For each study, a different set of eligible subjects 
were selected. They included healthy Mexican volunteers of either sex. For each
study, subjects were randomly assigned to receive 1 test formulation of acyclovir
400 mg followed by the reference formulation, or vice versa, with a 1-week
washout period between doses. After a 12-hour (overnight) fast, subjects received
a single 400-mg dose (tablet or 10-mL suspension) of the corresponding
formulation. For the analysis of pharmacokinetic properties, including C(max),
AUC from time 0 (baseline) to time t (AUC(0-t)), and AUC from baseline to
infinity (AUC(0-infinity)), blood samples were drawn at baseline, 0.25, 0.5,
0.75, 1.0, 1.25, 1.5, 1.75, 2, 3, 4, 6, 8, 12, and 24 hours after dosing. The
formulations were considered bioequivalent if the natural logarithm
(ln)-transformed ratios of Cmax and AUC were within the predetermined equivalence
range of 80% to 125% and if P <or= 0.05 for the 90% CIs. Tolerability was
assessed by monitoring vital signs, laboratory analysis results, and subject
interviews. RESULTS: Twenty-six subjects were enrolled in the study for the
suspension dosage form and 25 completed it (13 men, 12 women; mean age, 22.2
years). Subjects in the suspension-dosage form study had the following
characteristics: age range, 18 to 48 years; weight range, 46 to 86 kg; and height
range, 145 to 179 cm. Thirteen subjects received the suspension-test formulation 
first. Twenty-four subjects were enrolled in the study for the tablet dosage
form; all of them concluded the study (13 men, 11 women; mean age, 24.7 years).
Subjects had the following characteristics for the tablet-dosage form study: age 
range, 18 to 49 years; weight range, 46 to 84 kg; and height range, 147 to 185
cm. Twelve subjects received the tablet-test formulation first. No period or
sequence effect was observed in either study. For the suspension dosage form, the
90% CIs for the corresponding ratios of ln Cmax, ln AuC(0-t), and ln
AUC(0-infinity) were 106.55 to 116.11, 99.29 to 113.19, and 98.37 to 112.04,
respectively (all, P < 0.05). For the tablet dosage form, the 90% CIs for the
corresponding ratios of ln Cmax, ln AUC(0-t), and ln AUC(0-infinity) were 83.46
to 103.64, 86.16 to 111.05, and 87.77 to 109.99, respectively (all, P < 0.05).
CONCLUSIONS: In these 2 studies in healthy subjects, single, 400-mg doses of the 
test brand of acyclovir administered either in tablet or suspension form,
appeared to be bioequivalent to the reference brand based on the rate and extent 
of absorption in accordance with the definition of the US Food and Drug
Administration. All formulations were well tolerated.

Publication Types: 
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 17692728 [PubMed - indexed for MEDLINE]

610: Transpl Infect Dis. 2007 Sep;9(3):237-40.

Unusual presentation of central nervous system manifestations of Varicella zoster
virus vasculopathy in renal transplant recipients.

Hovens MM, Vaessen N, Sijpkens YW, de Fijter JW.

Department of General Internal Medicine, Leiden University Medical Centre,
Leiden, The Netherlands. m.m.c.hovens@lumc.nl

We describe 2 renal transplant recipients with severe but reversible neurological
manifestations related to Varicella zoster virus (VZV) cerebral vasculopathy. To 
the best of our knowledge, this is the first description of cerebral VZV
vasculopathy in solid organ transplant recipients. We review the published
literature on the clinical presentation, diagnosis and treatment. In solid organ 
transplant recipients presenting with neurological signs and symptoms, a
diagnosis of VZV-associated vasculopathy should be considered.

Publication Types: 
    Case Reports

PMID: 17692072 [PubMed - indexed for MEDLINE]

611: Lancet Neurol. 2007 Sep;6(9):773-81.

Clinical features and viral serologies in children with multiple sclerosis: a
multinational observational study.

Banwell B, Krupp L, Kennedy J, Tellier R, Tenembaum S, Ness J, Belman A, Boiko A,
Bykova O, Waubant E, Mah JK, Stoian C, Kremenchutzky M, Bardini MR, Ruggieri M,
Rensel M, Hahn J, Weinstock-Guttman B, Yeh EA, Farrell K, Freedman M, Iivanainen 
M, Sevon M, Bhan V, Dilenge ME, Stephens D, Bar-Or A.

Division of Neurology, The Hospital for Sick Children, University of Toronto, ON,
Canada. brenda.banwell@sickkids.ca

BACKGROUND: The full spectrum of clinical manifestations and outcome, and the
potential importance of regional or demographic features or viral triggers in
paediatric multiple sclerosis (MS), has yet to be fully characterised. Our aim
was to determine some of these characteristics in children with MS. METHODS: 137 
children with MS and 96 control participants matched by age and geographical
region were recruited in a multinational study. They underwent structured
clinical-demographic interviews, review of academic performance, physical
examination, disability assessment (MS patients only), and standardised assays
for IgG antibodies directed against Epstein-Barr virus, cytomegalovirus,
parvovirus B19, varicella zoster virus, and herpes simplex virus. FINDINGS: MS
was relapsing-remitting at diagnosis in 136 (99%) children. The first MS attack
resembled acute disseminated encephalomyelitis (ADEM) in 22 (16%) of the
children, most under 10 years old (mean age 7.4 [SD 4.2] years). Children with
ADEM-like presentations were significantly younger than were children with
polyfocal (11.2 [4.5] years; p<0.0001) or monofocal (12.0 [3.8] years; p=0.0005) 
presentations. Permanent physical disability (EDSS>or=4.0) developed within 5
years in 15 (13%) of the 120 children for whom EDSS score was available. 23 (17%)
had impaired academic performance, which was associated with increasing disease
duration (p=0.02). Over 108 (86%) of the children with MS, irrespective of
geographical residence, were seropositive for remote EBV infection, compared with
only 61 (64%) of matched controls (p=0.025, adjusted for multiple comparisons).
Children with MS did not differ from controls in seroprevalence of the other
childhood viruses studied, nor with respect to month of birth, sibling number,
sibling rank, or exposure to young siblings. INTERPRETATION: Paediatric MS is a
relapsing-remitting disease, with presenting features that vary by age at onset. 
MS in children might be associated with exposure to EBV, suggesting a possible
role for EBV in MS pathobiology.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 17689148 [PubMed - indexed for MEDLINE]

612: Harv Mens Health Watch. 2007 Jul;11(12):8.

On call. Your article on new immunizations for adults was very helpful. I already
got my booster for tetanus, diphtheria, and whooping cough, but even though I'm
61, my doctor didn't want to give me the shingles because I've already had
shingles. Should I get the vaccine?

Simon HB.

PMID: 17687797 [PubMed - indexed for MEDLINE]

613: Acta Otorrinolaringol Esp. 2007 Aug-Sep;58(7):311-5.

[Viral infection of herpes simplex, Epstein-Barr, varicela zoster, human
papilloma, cytomegalovirus, or adenovirus are not related to sinonasal
adenocarcinomas]

[Article in Spanish]

Perez Escuredo J, Llorente JL, Melon S, de Ona M, Garcia Martinez J, Alvarez
Marcos C, Hermsen M.

Departamento de Otorrinolaringologia, IUOPA, Hospital Universitario Central de
Asturias, Oviedo, Asturias, Espana.

OBJECTIVE: Several types of virus have been implicated in the development of head
and neck tumors. However, until now sinonasal adenocarcinomas (ACN) have not been
studied. The aim of this study is to screen a series of ACN for the presence of a
number of viruses known to play a role in cancer. MATERIAL AND METHOD: Viral DNA 
sequences of herpes simplex virus, Epstein-Barr, varicela zoster, human
papilloma, cytomegalovirus, and adenovirus were analysed by PCR in 37 primary
ACN. RESULTS: Three tumors (8.1%) were positive for Epstein-Barr virus and 1 case
(2.7%) for cytomegalovirus. CONCLUSIONS: Viral infections do not seem to play a
role in the etiology of ACN.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 17683698 [PubMed - indexed for MEDLINE]

614: Cleve Clin J Med. 2007 Jul;74(7):489-94, 496, 498-9 passim.

Comment in:
    Cleve Clin J Med. 2007 Jul;74(7):472.

The protean neurologic manifestations of varicella-zoster virus infection.

Nagel MA, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA.

Multiple neurologic complications may follow the reactivation of varicella-zoster
virus (VZV), including herpes zoster (also known as zoster or shingles),
postherpetic neuralgia, vasculopathy, myelitis, necrotizing retinitis, and zoster
sine herpete (pain without rash). These conditions can be difficult to recognize,
especially as several can occur without rash.

Publication Types: 
    Research Support, N.I.H., Extramural
    Review

PMID: 17682626 [PubMed - indexed for MEDLINE]

615: Cleve Clin J Med. 2007 Jul;74(7):472.

Comment on:
    Cleve Clin J Med. 2007 Jul;74(7):489-94, 496, 498-9 passim.

Zoster is more than 'just' a viral infection.

Mandell BF.

Publication Types: 
    Comment
    Editorial

PMID: 17682624 [PubMed - indexed for MEDLINE]

616: Neuropsychol Rehabil. 2007 Aug-Oct;17(4-5):429-49.

A medical overview of encephalitis.

Stone MJ, Hawkins CP.

Department of Neurology, University Hospital of North Staffordshire,
Stoke-on-Trent, UK. mark.stone@uhns.nhs.uk

Encephalitis is uncommon but is a neurological emergency which must be considered
in a patient presenting with altered consciousness. Encephalitis is a diffuse
inflammatory process of the brain parenchyma associated with evidence of brain
dysfunction. The presentation of encephalitis can be acute or chronic. The
aetiology of encephalitis can be broadly divided into two major subtypes. (1)
Infection-related encephalitis which is a direct consequence of pathogenic viral,
bacterial or parasitic agents. Herpes simplex virus (HSV) and varicella-zoster
virus (VZV) are the most common cause of acute infectious encephalitis. (2)
Autoimmune-mediated encephalitis which is mediated by an aberrant immune
response. This can be triggered by a recent viral infection or vaccination. An
example of this would be acute disseminated encephalitis (ADEM). This article
will focus on the medical management of acute encephalitis. This will involve an 
extensive overview of the literature reviewing the diagnosis, investigation and
treatment of acute viral encephalitis, ADEM and acute haemorrhagic
leukoencephalopathy (AHLE). Encephalitis can also present chronically, and some
of the different types of chronic encephalitis will be discussed.

Publication Types: 
    Review

PMID: 17676529 [PubMed - indexed for MEDLINE]

617: Lakartidningen. 2007 Jun 13-26;104(24-25):1916-20.

[Risk of CNS adverse effects of aciclovir and valaciclovir. Watch the renal
function in treatment of herpes simplex and herpes zoster]

[Article in Swedish]

Hellden A, Bergman U, Dwyer R, Medin C, Molanaei H, Stahle L, Thylen P,
Odar-Cederlof I.

Institutionen for laboratoriemedicin, Karolinska institutet.
anders.hellden@karolinska.se

Publication Types: 
    Case Reports

PMID: 17674672 [PubMed - indexed for MEDLINE]

618: Eur J Ophthalmol. 2007 Jul-Aug;17(4):683-4.

Herpetic optic neuritis associated with herpetic keratitis.

Saenz-Frances F, Calvo-Gonzalez C, Jimenez-Santos M, Mendez-Hernandez C,
Fernandez-Vidal AM, Martinez-de-la-Casa JM, Garcia-Sanchez J, Garcia-Feijoo J.

Department of Ophthalmology, Hospital Clinico Universitario San
Carlos-Universidad Complutense, 28003 Madrid, Spain.
federicosaenzfrancessb@gmail.com

PURPOSE: To report a case of herpetic optic neuritis associated with herpetic
keratitis. METHODS: A 65 year old woman presented with oedema in the nasal sector
of his right papilla. Blood biochemistry, a haemogram, erythrocyte sedimentation 
rate and C-reactive protein were all normal. The patient was diagnosed as having 
a non-arteritic anterior ischaemic optic neuropathy. One week later slit lamp
examination showed diffuse stromal corneal oedema and a dendritic lesion in the
nasal zone of the corneal epithelium. RESULTS: Serology for varicela-zoster virus
was positive. Treatment was started with valacyclovir given orally and topical
acyclovir ointment. A week later, the optic disc swelling and corneal lesions had
resolved. CONCLUSIONS: The precise mechanism through which the papilla and cornea
were successively affected in our patient is unclear but the sensitive
innervation of both these structures is provided by the nasal branch of the
nasociliary nerve and the spread of herpes via this nerve could affect both
sites.

Publication Types: 
    Case Reports

PMID: 17671953 [PubMed - indexed for MEDLINE]

619: J Dermatolog Treat. 2007;18(4):255.

Herpes zoster, bacterial superinfections and antibiotics.

Veraldi S, Schianchi R.

Publication Types: 
    Letter

PMID: 17671888 [PubMed - indexed for MEDLINE]

620: Ophthalmology. 2008 Feb;115(2):292-297.e3. Epub 2007 Jul 31.

Cytomegalovirus as an etiologic factor in corneal endotheliitis.

Koizumi N, Suzuki T, Uno T, Chihara H, Shiraishi A, Hara Y, Inatomi T, Sotozono
C, Kawasaki S, Yamasaki K, Mochida C, Ohashi Y, Kinoshita S.

Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto,
Japan. nkoizumi@ophth.kpu-m.ac.jp

PURPOSE: To investigate clinical manifestations and response to antiviral therapy
of 8 patients with cytomegalovirus (CMV)-induced corneal endotheliitis who were
diagnosed and treated at 2 university hospitals in Japan. DESIGN: Retrospective, 
consecutive, multicenter case series. PARTICIPANTS: Eight eyes of 8 patients
diagnosed with active CMV corneal endotheliitis at Kyoto Prefectural University
of Medicine and Ehime University School of Medicine. The diagnosis was made based
on the detection by polymerase chain reaction assay of CMV, but not herpes
simplex virus (HSV) and varicella zoster virus (VZV) DNA, in the aqueous humor
from the affected eye. METHODS: Retrospective review of the clinical
manifestations and responses to antiviral treatment. MAIN OUTCOME MEASURES:
Patient profiles, including duration of corneal endotheliitis, systemic disease, 
intraocular pressure, and clinical manifestation of anterior and posterior
segments. The clinical response to systemic and topical antiviral treatment was
evaluated by slit-lamp examination. Corneal endothelial density was examined by
specular microscopy. RESULTS: The average observation period after CMV detection 
was 10.4 months (range, 2-24 months). None of the patients had systemic
immunodeficiency. Corneal manifestations included linear keratic precipitates
associated with multiple coin-shaped lesions and local corneal stromal edema. Of 
the 8 patients, 4 had undergone penetrating corneal transplantation. Systemic
ganciclovir therapy was used in 7 patients, and in 1 patient, valacyclovir was
administered, with the corneal endotheliitis responding quickly to the early
administration of galovir. At the final examination, 6 eyes had a clear cornea,
but 2 eyes had bullous keratopathy. CONCLUSIONS: Besides HSV and VZV, CMV must be
considered as an etiologic agent in patients with corneal endotheliitis.
Cytomegalovirus corneal endotheliitis may be a newly identified clinical entity
of reactivated CMV in the anterior chamber of individuals free of accompanying
systemic symptoms.

Publication Types: 
    Case Reports
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 17669498 [PubMed - indexed for MEDLINE]

621: Ophthalmology. 2008 Feb;115(2):306-11. Epub 2007 Jul 31.

Usefulness of aqueous humor analysis for the diagnosis of posterior uveitis.

Rothova A, de Boer JH, Ten Dam-van Loon NH, Postma G, de Visser L, Zuurveen SJ,
Schuller M, Weersink AJ, van Loon AM, de Groot-Mijnes JD.

Department of Ophthalmology, University Medical Center Utrecht, Utrecht,
Netherlands. a.rothova@umcutrecht.nl

PURPOSE: To assess the clinical usefulness of aqueous fluid analysis for the
diagnosis and treatment of patients suspected of having infectious posterior
uveitis (PU). DESIGN: Case-control study. PARTICIPANTS: From 2002 through 2005,
152 eyes from 152 patients with active PU (16 of whom were immunosuppressed)
underwent diagnostic aqueous testing. As controls, 20 patients with Fuchs'
heterochromic uveitis and 20 patients with age-related cataract were included.
METHODS: Aqueous samples were examined by real-time polymerase chain reaction
(PCR) and by pathogen-specific analysis of intraocular antibody production
(Goldmann-Witmer coefficient [GWC]) for herpes simplex virus (HSV), varicella
zoster virus (VZV), cytomegalovirus (CMV), and the parasite Toxoplasma gondii.
MAIN OUTCOME MEASURES: Results of aqueous analysis and any adverse effects of
aqueous sampling. Correlations between the results of aqueous testing and
clinical characteristics as well as the treatment of patients. RESULTS: Of 152
patients, 44 (29%) had positive results for at least one diagnostic assay (37/136
[28%] immunocompetent and 7/16 [44%] immunocompromised patients). None of the
controls had positive results using PCR or GWC. A positive result was obtained
predominantly in patients with focal chorioretinitis (37/87 [40%]) and in
extensive retinitis (7/9 [78%]), whereas in multifocal chorioretinitis,
neuroretinitis, and retinal vasculitis only a few samples demonstrated positive
results (2/19, 1/29, and 0/10, respectively). Of 37 immunocompetent PU patients
with positive results, 28 (76%) cases were caused by T. gondii, whereas viral
infections were most common in immunocompromised patients (5/7 [71%]). In
immunocompetent and toxoplasmosis PU patients, GWC was the most informative assay
(34/37 [92%] and 28/30 [93%], respectively), in contrast to immunosuppressed
patients (PCR positive in 5/7 and GWC positive in 4/7). Independent of the immune
status of patients, positive PCR results were observed more frequently in viral
infections than in toxoplasmosis (P<0.001). As a consequence of aqueous analysis,
change of treatment was necessary in 36 patients (24%). None of the patients
experienced complications during or after aqueous sampling. CONCLUSIONS: Despite 
the posterior location of inflammation, aqueous analyses with PCR and GWC for
HSV, VZV, CMV, and T. gondii revealed an infectious cause in 29% of patients with
PU.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17669497 [PubMed - indexed for MEDLINE]

622: Actas Dermosifiliogr. 2007 Sep;98(7):494-6.

[Zosteriform cutaneous leiomyoma. Satisfactory treatment with oral doxazosin]

[Article in Spanish]

Chaves AJ, Fernandez-Recio JM, de Argila D, Rodriguez-Nevado I, Catalina M.

Unidad de Dermatologia, Hospital Universitario Infanta Cristina, Badajoz, Espana.
antoniojchaves@yahoo.es

We report a 50-year-old man that presented a zosteriform cutaneous leiomyoma in
the left facial region, intensely painful, that showed great improvement after
the administration of a daily dose of 4 mg of oral doxasozin. The therapy was
well tolerated and did not present any associated adverse effect. In the English 
medical literature only two cases successfully treated with doxasozin have been
reported.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17669306 [PubMed - indexed for MEDLINE]

623: Rev Neurol. 2007 Aug 16-31;45(4):233-5.

[Mononeuropathy in chronic lymphatic leukaemia]

[Article in Spanish]

Escolar E, Garcia-Vela J, Aladro Y, Martinez-Menendez B, Martin A.

Servicio de Neurologia, Hospital Universitario de Getafe, 28905 Getafe, Espana.
escolaredu@hotmail.com

INTRODUCTION: Chronic lymphatic leukaemia (CLL) is the most frequent form of
leukaemia in the adult population in western countries. Only 7.2% of the
complications of CLL are neurological and most of them are secondary to an
infection by herpes zoster virus. CASE REPORT: We report the case of a
71-year-old female with B-type CLL in stage IV or type C that was progressing and
becoming diffuse large B-cell lymphoma (Richter's syndrome), who developed an
incomplete axonotmesis of the left peroneal nerve and numerous violet-coloured
nodules under the skin in the left knee. Magnetic resonance imaging showed signs 
of diffuse infiltration into the subcutaneous tissue and the muscles of the left 
leg; a biopsy study of one of the subcutaneous nodules revealed a lymphoid
infiltration by large B-cells. In this patient, the injury to the left peroneal
nerve was probably secondary to a lymphoid infiltration of the nerve from
adjacent infiltrated soft tissues. CONCLUSION: Peripheral neuropathy due to
direct infiltration can be a neurological complication of CLL that has not be
reported to date, but which is known to occur in other lymphoproliferative
processes.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17668406 [PubMed - indexed for MEDLINE]

624: Eur J Epidemiol. 2007;22(9):641-6. Epub 2007 Aug 1.

Comparison of the dynamics and correlates of transmission of Herpes Simplex
Virus-1 (HSV-1) and Varicella-Zoster Virus (VZV) in a sample of the Israeli
population.

Davidovici BB, Balicer RD, Klement E, Green MS, Mendelson E, Smetana Z, Cohen DI.

Department of Epidemiology and Preventive Medicine, School of Public Health,
Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978,
Israel.

Herpes simplex virus types-1 (HSV-1) and Varicella-zoster virus (VZV) are herpes 
viruses that share many characteristics. However, HSV-1 spreads by close contact 
while VZV spreads mainly by the airborne route. In this study we compared the
dynamics and correlates of transmission of these viruses in the same population. 
In 2000-2001, 1555 sera from an age-stratified general population sample were
tested using commercial ELISA kits to measure type-specific HSV-1 and varicella
IgG antibodies. The VZV seroprevalence increased rapidly with age reaching 50%
seropositivity by the age of 3 years, while HSV-1 reached 50% seropositivity at
the age of 14 years. The highest VZV force of infection was in the 3.5-5.5-year
age group followed by the 5.5-10.5 years age group, while for HSV-1 the age
specific force of infection was substantially lower and stable over the various
age groups. Multivariate analysis revealed that HSV-1 seroprevalence was
significantly, independently associated with age, country of birth, country of
origin, ethnicity, socio-economic status and VZV sero-status. Only age, country
of origin and HSV-1 sero-status were found to be associated with VZV
seropositivity. In developed countries such as Israel the transmission of VZV is 
much quicker and less dependent on socioeconomic status as compared with HSV-1.

Publication Types: 
    Comparative Study

PMID: 17668279 [PubMed - indexed for MEDLINE]

625: Indian J Dermatol Venereol Leprol. 2001 Jan-Feb;67(1):39-40.

Abdominal hernia following abdominal herpes zoster.

Sharma PK, Gautam RK, Basistha C, Jain RK, Kar HK.

Department of Dermatology and S.T.D, Dr. K M L Hospital, New Delhi-110001, India.

We report a case of abdominal hernia in TIO and 11 segments following herpes
zoster at T11 segment.

PMID: 17664701 [PubMed]

626: Ann Fam Med. 2007 Jul-Aug;5(4):305-9.

Clinical diagnosis of herpes zoster in family practice.

Opstelten W, van Loon AM, Schuller M, van Wijck AJ, van Essen GA, Moons KG,
Verheij TJ.

Julius Center for Health Sciences and Primary Care, University Medical Center
Utrecht, The Netherlands. w.opstelten@umcutrecht.nl

PURPOSE: Family physicians usually diagnose herpes zoster on clinical grounds
only, possibly resulting in false-positive diagnoses and unnecessary treatment.
We wanted to determine the positive predictive value of the physicians' judgment 
in diagnosing herpes zoster and to assess the applicability of dried blood spot
analysis for diagnosis of herpes zoster in family practice. METHODS: Our study
population consisted of 272 patients older than 50 years with herpes zoster (rash
for less than 7 days). Dried blood spot samples were collected from all patients 
and sent by mail to the laboratory. Baseline measurements included clinical signs
(localization, severity, and duration of rash) and symptoms (duration and
severity of pain). Varicella-zoster virus antibodies were determined at baseline 
and 5 to 10 days later. Multivariate logistic regression was used to assess
independent associations between clinical variables and serological confirmation 
of herpes zoster. RESULTS: Dried blood spot analysis was possible in 260 patients
(96%). In 236 the diagnosis of herpes zoster was confirmed serologically
(positive predictive value of clinical judgment 90.8%; 95% confidence interval,
87.3%-94.3%). Independent clinical variables for serologically confirmed herpes
zoster were severity and duration of rash at first examination. CONCLUSION:
Family physicians have good clinical judgment when diagnosing herpes zoster in
older patients. Dried blood spot analysis is a logistically convenient method for
serological investigation of patients in family practice, but it is rarely needed
for diagnosing herpes zoster.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 17664496 [PubMed - indexed for MEDLINE]

627: J Neurol Sci. 2007 Nov 15;262(1-2):113-6. Epub 2007 Jul 30.

On the viral hypothesis of multiple sclerosis: participation of varicella-zoster 
virus.

Sotelo J.

Neuroimmunology Unit, National Institute of Neurology and Neurosurgery, Mexico
City, Mexico. jsotelo@servidor.unam.mx

Recent studies, including our own, have accumulated evidence suggesting the
etiological participation of varicella-zoster virus in multiple sclerosis. If
confirmed, complex issues of individual susceptibility and immunopathogenesis
would have to be unveiled.

Publication Types: 
    Review

PMID: 17663004 [PubMed - indexed for MEDLINE]

628: Arch Pediatr. 2007 Sep;14(9):1092-3. Epub 2007 Jul 26.

[Infantile herpes zoster]

[Article in French]

Atmani S, Elouardi M, Bouharrou A, Hida M.

Departement de pediatrie, hopital universitaire de Fes, faculte de medecine et de
pharmacie de Fes, route Sidi-Hrazem, km 2,200, BP 1893, 30000 Fes, Maroc.
samir.atmani8@caramail.com

Herpes zoster occurs seldom in infants, especially in the absence of exposure to 
maternal varicella either intrauterine or postnatal. We report on a case in a
3-month-old infant admitted for herpes zoster in the sciatic nerve territory. No 
cutaneous eruption was found in the mother or in people who were in contact with 
the patient. This rare clinical situation is here reviewed, showing that the
absence of antenatal or postnatal exposure to herpes viruses does not preclude
the occurrence of herpes zoster infection in early infancy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17662580 [PubMed - indexed for MEDLINE]

629: J Am Geriatr Soc. 2007 Aug;55(8):1168-75.

Healthcare costs of acute and chronic pain associated with a diagnosis of herpes 
zoster.

Dworkin RH, White R, O'Connor AB, Baser O, Hawkins K.

Department of Anesthesiology, School of Medicine and Dentistry, University of
Rochester, Rochester, New York 14642, USA. robert_dworkin@urmc.rochester.edu

OBJECTIVES: To determine the healthcare costs of acute and chronic pain
associated with herpes zoster. DESIGN: Retrospective cohort analysis. SETTING:
Inpatient and outpatient care. PARTICIPANTS: Patients were selected from
Medicare, commercial insurance, and Medicaid claims databases if they had a
diagnosis of herpes zoster or postherpetic neuralgia (PHN) or were prescribed
analgesics after a diagnosis of herpes zoster (possible PHN) and were matched to 
controls for demographic and clinical factors using propensity scores.
MEASUREMENTS: One-year excess healthcare expenditures attributable to herpes
zoster pain or PHN were calculated for inpatient, outpatient, and prescription
drug services. RESULTS: For the Medicare cohort, the average excess cost per
patient was $1,300 in the year after a diagnosis of herpes zoster with 30 days or
fewer of analgesic use and ranged from $2,200 to $2,300 per patient with PHN or
possible PHN. Patients with possible PHN were 53% more prevalent than patients
with PHN in the Medicare cohort and accounted for half of all excess
expenditures. Findings were similar in the younger cohorts with commercial
insurance and Medicaid except that costs attributable to PHN and possible PHN
were higher, and patients with possible PHN were three to five times as prevalent
as patients with PHN. CONCLUSION: Healthcare costs associated with PHN were
substantially greater than those associated with herpes zoster pain that resolved
within 30 days. The data suggest that as many as 80% of patients with PHN may not
be diagnosed with PHN and that these patients account for at least half of PHN
expenditures.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17661954 [PubMed - indexed for MEDLINE]

630: Indian J Dermatol Venereol Leprol. 2002 Sep-Oct;68(5):295.

Rare sequelae of herpes zoster in HIV positive patient.

Goel SK, Kuruvila M.

Department of Skin and VD KMC, Mangalore-575 001, India.

A 34 year -old woman, who was diagnosed to be HIV positive 4 years back,
presented with zoster along T-6 dermatome followed by development of keloid.

PMID: 17656976 [PubMed]

631: Indian J Dermatol Venereol Leprol. 2002 Jul-Aug;68(4):222-4.

Many faces of Koebner phenomenon in psoriasis.

Gupta S.

Department of Dermatology, Venereology and Leprology Postgraduate Institute of
Medical Education and Research, Chandigarh, India. someshgupta@yahoo.com

Two patients with unusual skin stimuli causing koebner phenomenon in psoriasis
are reported. First patient, a 33-year-old man, had psoriasis and multiple
keloids for the last 26-years. At few places, the lesions of psoriasis and
multiple keloids for the last 26-years. At few places, the lesions of psoriasis
healed with keloid formation, and psoriatic plaques appeared selectively on the
top of the keloids in addition to palms, soles and scalp. In the second patient
(a 67-year -old man), the psoriatic lesions appeared at the site of healing
herpes zoster lesions. Koebner phenomenon in psoriasis due to herpes zoster or
varicella is rare, while that due to keloid has not been reported.

PMID: 17656943 [PubMed]

632: Indian J Dermatol Venereol Leprol. 2002 Jan-Feb;68(1):48-9.

Bilateral herpes--Zoster of widely separated dermatomes in a
non-immunocompromised female.

Brar BK, Gupta RR, Saghni SS.

Department of Dermatology, Venereology and Leprology, Government Medical College,
Faridkot, India.

Herpes zoster involving simultaneously left maxillary dermatome and right 2nd
lumbar dermatome in a non-immunocopromised 24-year-old female is being reported
due to its rarity.

PMID: 17656872 [PubMed]

633: Invest Ophthalmol Vis Sci. 2007 Aug;48(8):3689-97.

Identification of viral antigens recognized by ocular infiltrating T cells from
patients with varicella zoster virus-induced uveitis.

Milikan JC, Kinchington PR, Baarsma GS, Kuijpers RW, Osterhaus AD, Verjans GM.

Institute of Virology, Erasmus Medical Center, Rotterdam.

PURPOSE: Varicella zoster virus (VZV) is a common cause of infectious uveitis
associated with an intraocular inflammatory response involving virus-specific T
cells. In the current study, the functional characteristics and the antigen
specificity of VZV-reactive T cells recovered from intraocular fluid (IOF)
samples of five patients with VZV were determined. METHODS: B-cell lines were
infected with a comprehensive panel of recombinant vaccinia viruses expressing 11
individual VZV open reading frames (ORFs), or alternatively pulsed with the
corresponding peptides to generate antigen-presenting cells (APCs). T-cell
responsiveness of the IOF-derived VZV-specific T cells toward APCs was monitored 
by interferon (IFN)-gamma enzyme-linked immunosorbent spot-forming assays on bulk
T-cell cultures and subsequently T-cell clones (TCCs). The cytokine-secretion
profile and cytotoxicity of the VZV-specific TCCs was determined by ELISA and
flow cytometry, respectively. RESULTS: T-cell reactivity to VZV proteins encoded 
by ORF4, -10, -14, -18, -29, -31, -61, -62, -63, -67, and -68 was demonstrated,
but specificity varied individually. T-cell epitopes on ORF62 and -68 were
delineated. The TCCs secreted IFNgamma, but relatively low levels of
interleukin-4 and -5, in response to VZV antigen-expressing APCs. The TCCs
induced antigen-specific cytotoxic T-cell activity. CONCLUSIONS: The results
suggest that the intraocular VZV-specific T-cell response in the patients with
VZV analyzed is directed to a broad spectrum of VZV antigens, including the
latency-associated VZV proteins from ORFs 4, 29, 63, and particularly ORF62. This
local T-cell response was in part mediated by cytotoxic CD4(+) T cells with a
Th1/0-like effector memory phenotype.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17652740 [PubMed - indexed for MEDLINE]

634: Int J Dermatol. 2007 Aug;46(8):883-4.

Acyclovir-induced neuropsychosis successfully recovered after immediate
hemodialysis in an end-stage renal disease patient.

Yang HH, Hsiao YP, Shih HC, Yang JH.

Department of Dermatology, Chung Shan Medical University Hospital, Taichung,
Taiwan 402.

A 70-year-old man developed herpes zoster over the right L5-S2 region for 3 days 
and was admitted for acyclovir therapy. He had a medical history of rectal cancer
status post-colostomy and end-stage renal disease undergoing thrice weekly
hemodialysis. Without a prior loading dose, acyclovir 500 mg (7.7 mg/kg) daily
was given intravenously in two divided doses. On the third dosage, the patient
became confused and agitated and developed insomnia. Within the following 24 h,
delirium, visual and auditory hallucinations, disorientation to place and time,
as well as impaired recent memory occurred. At the same time, a transient low
grade fever (38 degrees C) was noted but resolved spontaneously after ice pillow 
(Fig. 1). The etiology was vigorously explored. He had no history of any
neurological or psychiatric disorders. Drug history was reviewed, but no other
medications besides acyclovir were currently being used. Physical examination
revealed neither meningeal signs nor focal neurological deficits. Serum blood
urea nitrogen, glucose, and electrolytes were within normal limits except for an 
elevated creatinine level at 6.2 and 5.7 mg/dl (before and after neuropsychotic
symptoms, respectively). Complete blood count with differentiation was also
unremarkable. Cerebrospinal fluid examination was not possible as the patient's
family refused the lumbar puncture. Moreover, an electroencephalograph study and 
head computed tomography scan disclosed no abnormalities. Acyclovir-induced
neurotoxicity was suspected. Therefore, acyclovir was discontinued. Subsequently,
serum acyclovir and CMMG were checked by enzyme-linked immunosorbent assay. Serum
acyclovir level was 1.6 mg/l (normal therapeutic level, 0.12-10.8 mg/l) and CMMG 
level was 5 mg/l. Emergent hemodialysis (4-h/session) was given; the
neuropsychotic symptoms, including agitation, delirium, and visual and auditory
hallucinations, greatly abated after the second session. The patient fully
recovered after three consecutive days of hemodialysis; the serum was rechecked
and revealed that the acyclovir level was below 0.5 mg/l and the CMMG level was
undetectable. At the same time, his herpetic skin lesions resolved well.

Publication Types: 
    Case Reports

PMID: 17651180 [PubMed - indexed for MEDLINE]

635: Neurology. 2007 Jul 24;69(4):398-400.

VZV spinal cord infarction identified by diffusion-weighted MRI (DWI).

Orme HT, Smith AG, Nagel MA, Bert RJ, Mickelson TS, Gilden DH.

Department of Neurology, University of Utah School of Medicine, Salt Lake City,
UT, USA.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural

PMID: 17646633 [PubMed - indexed for MEDLINE]

636: Am J Clin Dermatol. 2007;8(4):221-33.

Dermatologic adverse effects of antiretroviral therapy: recognition and
management.

Luther J, Glesby MJ.

Upstate Medical School, State University of New York, Syracuse, New York, USA.

Despite the decrease in opportunistic infections associated with HIV in the
highly active antiretroviral treatment (HAART) era, a significant number of
patients still present with skin pathology, some of which can be attributed
directly or indirectly to antiretroviral therapy. The non-nucleoside reverse
transcriptase inhibitors exhibit a class effect with regard to skin adverse
manifestations, and the spectrum of disease can vary from a mild morbilliform
rash to Stevens-Johnson syndrome. Certain protease inhibitors are associated with
rash, and indinavir causes retinoid-like manifestations such as paronychia,
alopecia, ingrown toe-nails, and curling of straight hair. Abacavir, a nucleoside
reverse transcriptase inhibitor, is notorious for causing a hypersensitivity
reaction in select patients. The fusion inhibitor enfuvirtide causes
injection-site reactions in the overwhelming majority of patients, although a new
method of delivery has decreased the rate and severity of these reactions. A
syndrome of lipoatrophy with or without lipohypertrophy, often termed
lipodystrophy, has been described in patients receiving HAART. Potential
management of lipoatrophy includes switching antiretrovirals and surgical
treatment with facial fillers. Lastly, skin manifestations of the immune
reconstitution inflammatory syndrome, including herpes zoster and warts, must be 
recognized and treated accordingly. In the evaluation of the individual
HIV-infected patient receiving antiretroviral therapy who presents with a skin
disorder, clinicians should consider the CD4 cell count as a marker of the degree
of immunodeficiency, the specific antiretrovirals used, and the timing of the
initiation of antiretroviral therapy in order to formulate a rational
differential diagnosis. Management should be individualized based on the specific
drug that is implicated and the severity of the reaction.

Publication Types: 
    Research Support, N.I.H., Extramural
    Review

PMID: 17645377 [PubMed - indexed for MEDLINE]

637: Indian J Dermatol Venereol Leprol. 2003 Mar-Apr;69(2):194.

Myiasis complicating herpes zoster in an immuno compromised patient.

Murthy SC, Udagari MM.

Publication Types: 
    Letter

PMID: 17642882 [PubMed]

638: Indian J Dermatol Venereol Leprol. 2003 Mar-Apr;69(2):116-9.

HIV prevalence in patients with herpes zoster.

Kar PK, Ramasastry CV.

Dept. of Dermatology, 167 Millitary Hospital, C/o. 56 APO.

To monitor HIV seroprevalence and to determine the sexual risk behaviour of men
with herpes zoster (HZ), a study was conducted from Jan 98 to Dec 99 among 115
men of 21 to 55 years of age suffering from HZ. The diagnosis of HZ was clinical 
and relevant investigations when indicated were carried out to exclude
immunodeficiency state. None of the cases were on immunosuppressive drugs. All
cases were tested for HIV by immunocomb method and if found positive were
confirmed by Western blot assay. Out of 115 cases of HZ 11 (9.5%) were found to
be HIV positive. 11 (10.8%) of HIV positive cases were 21-40 years of age. More
than one dermatome was involved in 7 (63.6%) HIV positive and in 2 (1.9%) HIV
negative cases. 2 HIV positive cases had multiple cranial nerve involvement and
one had generalized HZ. None of the cases showed evidence of progression to
symptomatic HIV disease. Out of 11 HIV positive cases 9 (81.8%) gave history of
multiple unprotected sexual exposures with female commercial sex workers and 2
(18.1%) with amateurs. None of our cases had used condom during sexual
intercourse. None gave history of blood transfusion in the past or intravenous
drug use.

PMID: 17642851 [PubMed]

639: Indian J Dermatol Venereol Leprol. 2003 Mar-Apr;69(2):105-8.

Cutaneous manifestation of diabetes mellitus.

Mahajan S, Koranne RV, Sharma SK.

Dept. of Dermato-Venereology, Lady Harding Medical College and Hospitals, New
Delhi.

One hundred consecutive diabetes mellitus patients attending the diabetic clinic 
of the hospital constituted the study group. One hundred age and sex matched
non-diabetics were taken as controls. The majority, 63%, belonged to the 41-60
years age group and 98% had non-insulin dependent diabetes. Among the study
group, 64% had one or more cutaneous manifestations as compared to 22% in the
controls. This was statistically highly significant (p < 0.001). Infections
comprised the largest group affecting 35 of the 64 cases. Among the bacterial
infections, pyodermas were observed in 11 and erythrasma in one. Fungal
infections were seen in 21, dermatophytoses in 11, and candidiasis in 10. Herpes 
zoster was seen in 2 cases. Pruritus was observed in 10, neurological
abnormalities in the form of paresthesias was seen in 6, mal perforans in one,
and meralgia paresthetica in one. Diabetic dermopathy was seen in 6 and rubeosis 
in 4. Six dermatoses strongly associated with DM were seen, namely one each of
waxy skin syndrome, granuloma annulare, eruptive xanthoma, scleredema adultorum, 
and 2 cases of diabetic bulla. Ten patients exhibited other dermotoses less
associated with diabetics: xanthelasmo palpebrarum in 5 patients, acrochordi in
4, and pigmented purpuric dermatoses in one. Likewise syndromes of insulin
resistance were seen in 4 patients of whom 3 had aconthosis nigricans and one had
congenital lipodystrophy. Furthermore, 9 patients had dermatoses known to be
associated with an increased incidence of diabetes; vitiligo in 4, acquired
perforating dermatoses in 3, and lichen planus in 2. Four patients had dermatoses
known to be associated with diabetes: psoriasis in 3 and diffuse alopecia in one.
Three had adverse drug reactions to anti-diabetic therapy.

PMID: 17642848 [PubMed]

640: Indian J Dermatol Venereol Leprol. 2004 Jul-Aug;70(4):221-5.

Skin changes in internal malignancy.

Rajagopal R, Arora PN, Ramasastry CV, Kar PK.

Dept of Dermatology, 5 Air Force Hospital, C/o 99 APO, India.
ravi_rajagopal@rediffmail.com

BACKGROUND: Internal malignancies are accompanied by various skin changes which
may be specific infiltrates or non-specific changes. This study is aimed at
determining the frequency of such changes in malignant disease treatment center
attendees in India. METHODS: A study of 300 confirmed cases of internal
malignancy at a malignant disease treatment center was undertaken to evaluate
these skin changes. Specific infiltrates were confirmed by histopathology.
Statistical methods were employed to calculate significance in non-specific
lesions by comparing with 300 controls not suffering from internal malignancy.
RESULTS: Skin changes were present in 82 (27.3%). Cutaneous metastases were found
in 19 (6.3%); non-contiguous in 5 (1.6%); contiguous in 14 (4.3%). Non-specific
skin lesions numbered 74 (11.6%) in 52 patients. Statistically significant
non-specific skin changes were acquired ichthyosis, herpes zoster and generalized
pruritus. CONCLUSION: Metastases usually occurred late in internal malignancy
(17, 5.6%) except in a case each of histiocytic lymphoma and non-Hodgkin's
lymphoma (2, 0.7%) where the lesions preceded malignancy by 3 months and 1 month 
respectively. Contiguous nodules were a marker of relapse after surgery in 3
(1%).

PMID: 17642619 [PubMed]

641: Indian J Dermatol Venereol Leprol. 2004 Mar-Apr;70(2):82-6.

Mucocutaneous manifestations of HIV infection.

Shobhana A, Guha SK, Neogi DK.

Department of Tropical Medicine, School of Tropical Medicine, Kolkata.

BACKGROUND AND AIMS: Human immunodeficiency virus (HIV) is associated with
various mucocutaneous features, which may be the first pointer towards the
existence of HIV infection. This study was done to note the different
mucocutaneous lesions present in the HIV population in eastern India. METHODS:
Four hundred and ten HIV seropositive patients attending the outpatient and
inpatient departments were included in the study. RESULTS: Out of 410 HIV
positives, 40% had mucocutaneous involvement at presentation. The mean age of the
study population was 29 years and male to female ratio was 2.5:1. The common
mucocutaneous morbidities included oral candidiasis (36%), dermatophytosis and
gingivitis (13% each), herpes zoster (6%), herpes simplex and scabies (5% each). 
A striking feature, noted in 36% males, was straightening of hairs. Genital
herpes was the commonest genital ulcer disease. Lesions associated with declining
immunity included oral candidiasis, oral hairy leukoplakia and herpes zoster with
median CD4 counts of 98, 62 and 198/ L respectively. CONCLUSION: Early
recognition of mucocutaneous manifestations and associated STDs help in better
management of HIV/AIDS.

PMID: 17642571 [PubMed]

642: Oncology. 2006;71(3-4):164-7. Epub 2007 Jul 18.

Herpes infections in breast cancer patients treated with adjuvant chemotherapy.

Masci G, Magagnoli M, Gullo G, Morenghi E, Garassino I, Simonelli M, Santoro A.

Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Milan,
Italy. giovanna.masci@humanitas.it

OBJECTIVE: There is little information on Herpes zoster infection in breast
cancer patients as a complication during adjuvant chemotherapy. The aim of this
study is to evaluate the incidence of Herpes zoster and simplex infections in
this patients setting. METHODS: We analyzed 623 early-stage breast cancer
patients in our Institute over a period of 7 years (1998-2005). Four-hundred and 
sixty-one patients were treated with anthracycline-based chemotherapy, 116 with
CMF and 46 with taxane-containing regimens. RESULTS: Twelve (1.9%) developed
herpes zoster; 9 patients, receiving anthracycline-based chemotherapy, two
taxane-containing regimens, and one CMF regimen. Herpes zoster infection required
treatment delay in 6 patients. Adjuvant chemotherapy was delayed for 1 week in 2 
patients, while in 4 patients with more severe symptoms chemotherapy was delayed 
for 2 weeks. One patient, despite i.v. acyclovir, had severe postherpetic motor
neuropathy with a permanent ambulation impairment, and chemotherapy was stopped. 
In our study, herpes zoster occurred in 55/1,000 cases/year. The reported
incidence in the general population varies between 2.2 and 4.1 per 1,000
patients/year; therefore, the risk of developing herpes zoster in these patients 
may be 13- to 25-fold higher compared to the incidence in the general population.
In addition, 13 of 623 patients developed herpes simplex. CONCLUSION: Our
findings suggest that adjuvant chemotherapy can facilitate reactivation of herpes
infection.

PMID: 17641534 [PubMed - indexed for MEDLINE]

643: Rev Fac Cien Med Univ Nac Cordoba. 2006;63(3):39-46.

[Rescue therapy in lupus nephritis patients with mycophenolate mofetil]

[Article in Spanish]

Pretini VB, Avila Lopez GE, Sesin AM, Dotto BH, Sanchez Freytes M, Sesin J,
Vergottini JC.

Servicio de Nefrologia y Medio Interno del Hospital Nacional de Clinicas,
Universidad Nacional de Cordoba.

BACKGROUND: Long term cyclophosfamide combinated steroids therapy improves renal 
survival in patients with Proliferate Lupus Nephritis, with considerable toxic
effects. In lately years MMF, a immune suppressor used in transplant, seems to be
effective in selected cases of Lupus Nephritis. METHODS: We will describe six
patients with Lupus Nephritis class IV and V (OMS Classification), that what
different causes they must be treated with MMF like rescue drug. This stabilizes 
the renal function, controls LES activity and allows reductions or end of
corticoids. RESULTS: In tree cases we achievement total remission, two show
partial remission and we had a fail because plaquetopenia and severe leucopenia
with serious sepsis to give rise to neumopaty; this patient broke off the
treatment. One presented Zoster Herpes that was treated with Aciclovir and
temporary treatment break off. CONCLUSION: MMF was effective to get remission in 
NL and maintain inactive LES, so it must to be considering as rescue therapy, or 
maintenance treatment after cyclosphosfamide induction. In patients where
fertility is important must be considering like elective drug. Is necessary long 
time patients follow up to asses' effectiveness in renal survival, like
cyclophosfamide.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17639816 [PubMed - indexed for MEDLINE]

644: J Neurol Neurosurg Psychiatry. 2007 Aug;78(8):818.

Neurological picture. Herpes zoster duplex bilateralis.

Peretz A, Nowatzky J, Steiner I.

Department of Internal Medicine, Hadassah University Hospital Mount Scopus,
Jerusalem 91240, Israel. asafp@bgu.ac.il

Publication Types: 
    Case Reports

PMID: 17635977 [PubMed - indexed for MEDLINE]

645: J Neurooncol. 2008 Jan;86(1):55-6. Epub 2007 Jul 19.

Ramsay Hunt syndrome in a patient with metastatic lung cancer to brain.

Alcalay RN, Shulman JM, Plotkin SR.

Department of Neurology, Massachusetts General Hospital, Boston, MA, 02114, USA. 
royalcalay@gmail.com

Publication Types: 
    Case Reports

PMID: 17634859 [PubMed - indexed for MEDLINE]

646: Clin Geriatr Med. 2007 Aug;23(3):615-32, vii-viii.

Herpes zoster and postherpetic neuralgia in older adults.

Schmader K.

Center for the Study of Aging and Human Development and Division of Geriatrics,
Department of Medicine, Duke University Medical Center, Box 3469, Durham, NC
27710, USA. schma001@mc.duke.edu

Herpes zoster (HZ) afflicts millions of older adults annually and causes
significant suffering from acute and chronic pain, or postherpetic neuralgia
(PHN). HZ is caused by the reactivation of varicella-zoster virus (VZV) in
sensory ganglia in the setting of age, disease, and drug-related decline in
cellular immunity. VZV-induced neuronal destruction and inflammation cause the
pain, interference with activities of daily living, and reduced quality of life. 
The optimal treatment of HZ requires early antiviral therapy and pain management.
For PHN, evidence-based pharmacotherapy can reduce pain burden. The zoster
vaccine is effective in reducing pain burden and preventing HZ and PHN in older
adults.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.
    Review

PMID: 17631237 [PubMed - indexed for MEDLINE]

647: Med Arh. 2007;61(2):128-30.

[Retrobulbar optic neuritis as first sign of HIV infection]

[Article in Bosnian]

Alimanovic-Halilovic E, Ibisevic M.

Klinika za ocne bolesti, KCU Sarajevo. ilda@bih.net.ba

This case is about a unilateral retrobulbar optic neuritis, as rare and first
sing of HIV infection. A young woman had came at Eye Clinic because suddenly she 
lost her sight on the right eye completely. At the visual field, we found
anopsia, but at the stereoscopic fundus examination the situation was almost
normal. After complete clinical examination we conclude that she is
immunodeficiency person, HIV-positive, with clinical manifestation retrobulbar
neuritis and with skin manifestation varicella zoster infection in region of the 
left arm.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17629153 [PubMed - indexed for MEDLINE]

648: RN. 2007 Jun;70(6):27-31; quiz 32.

Shingles: what you should know.

Novatnack E, Schweon S.

St. Luke's Hospital, Bethlehem, PA, USA.

Publication Types: 
    Review

PMID: 17624059 [PubMed - indexed for MEDLINE]

649: J Ethnobiol Ethnomed. 2007 Jul 10;3:29.

Use of traditional medicines in the management of HIV/AIDS opportunistic
infections in Tanzania: a case in the Bukoba rural district.

Kisangau DP, Lyaruu HV, Hosea KM, Joseph CC.

Department of Botany, University of Dar es Salaam, Dar es Salaam, Tanzania.
kisangau@yahoo.com

BACKGROUND: Ethnobotanical surveys were carried out to document herbal remedies
used in the management of HIV/AIDS opportunistic infections in Bukoba Rural
district, Tanzania. The district is currently an epicenter of HIV/AIDS and
although over 90% of the population in the district relies on traditional
medicines to manage the disease, this knowledge is impressionistic and not well
documented. The HIV/AIDS opportunistic conditions considered during the study
were Tuberculosis (TB), Herpes zoster (Shingles), Herpes simplex (Genital
herpes), Oral candidiasis and Cryptococcal meningitis. Other symptomatic but
undefined conditions considered were skin rashes and chronic diarrhea. METHODS:
An open-ended semi-structured questionnaire was used in collecting field
information. Descriptive statistics were used to analyze the ethnobotanical data 
collected. Factor of informant consensus (Fic) was used to analyze the
ethnobotanical importance of the plants. RESULTS: In the present study, 75 plant 
species belonging to 66 genera and 41 families were found to be used to treat one
or more HIV/AIDS related infections in the district. The study revealed that TB
and oral candidiasis were the most common manifestations of HIV/AIDS
opportunistic infections affecting most of the population in the area. It unveils
the first detailed account of ethnomedical documentation of plants focusing the
management of HIV/AIDS related infections in the district. CONCLUSION: It is
concluded that the ethnopharmacological information reported forms a basis for
further research to identify and isolate bioactive constituents that can be
developed to drugs for the management of the HIV/AIDS opportunistic infections.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 17623081 [PubMed - indexed for MEDLINE]

650: Time. 2006 Mar 20;167(12):77-9.

The new cancer fighter (and other hot drugs on the way).

Park A.

Publication Types: 
    News

PMID: 17621712 [PubMed - indexed for MEDLINE]

651: MMW Fortschr Med. 2006 Oct 26;148(43):41-3.

[Stepped analgesic approach to herpes zoster pain]

[Article in German]

Ludwig J, Baron R.

Klinik fur Neurologie, Universitatsklinikum Schleswig-Holstein, Kiel.

PMID: 17619424 [PubMed - indexed for MEDLINE]

652: Exp Clin Transplant. 2007 Jun;5(1):604-6.

An outbreak of chickenpox in adult renal transplant recipients.

Shahbazian H, Ehsanpour A.

Department of Nephrology and Kidney Transplantation, Ahwaz Jondi Shapour Medical 
University, Ahwaz, Iran. shahbazian_he@yahoo.com

Infection with the varicella-zoster virus, the etiologic agent of chickenpox and 
herpes zoster, is more serious in immunosuppressed renal transplant recipients
than it is in the general population. Chickenpox is a rare infection in adult
renal transplant recipients; however, it is significant owing to the severity of 
its clinical features and its associated high mortality rate. To date, there are 
no reported outbreaks of primary varicella-zoster virus infection in adult renal 
transplant recipients. Here, we report 3 patients with chickenpox who presented
to our center between May 2006 and June 2006.

Publication Types: 
    Case Reports

PMID: 17617051 [PubMed - indexed for MEDLINE]

653: N Engl J Med. 2007 Jul 5;357(1):89-90.

Comment on:
    N Engl J Med. 2007 Mar 29;356(13):1338-43.

Varicella-zoster vaccine.

Senanayake SN.

Publication Types: 
    Comment
    Letter

PMID: 17615639 [PubMed - indexed for MEDLINE]

654: N Engl J Med. 2007 Jul 5;357(1):89.

Comment on:
    N Engl J Med. 2007 Mar 29;356(13):1338-43.

Varicella-zoster vaccine.

Lang PO, Herrmann F, Michel JP.

Publication Types: 
    Comment
    Letter

PMID: 17615638 [PubMed - indexed for MEDLINE]

655: N Engl J Med. 2007 Jul 5;357(1):89.

Comment on:
    N Engl J Med. 2005 Jun 2;352(22):2271-84.    N Engl J Med. 2007 Mar 29;356(13):1338-43.

Varicella-zoster vaccine.

Good CB.

Publication Types: 
    Comment
    Letter

PMID: 17615637 [PubMed - indexed for MEDLINE]

656: N Engl J Med. 2007 Jul 5;357(1):89.

Comment on:
    N Engl J Med. 2007 Mar 29;356(13):1338-43.

Varicella-zoster vaccine.

Keller DL.

Publication Types: 
    Comment
    Letter

PMID: 17615636 [PubMed - indexed for MEDLINE]

657: Br J Haematol. 2007 Aug;138(3):330-7.

Comment in:
    Br J Haematol. 2008 Jan;140(1):115-6.

Bortezomib in combination with intermediate-dose dexamethasone and continuous
low-dose oral cyclophosphamide for relapsed multiple myeloma.

Kropff M, Bisping G, Schuck E, Liebisch P, Lang N, Hentrich M, Dechow T, Kroger
N, Salwender H, Metzner B, Sezer O, Engelhardt M, Wolf HH, Einsele H, Volpert S, 
Heinecke A, Berdel WE, Kienast J; Deutsche Studiengruppe Multiples Myelom,.

Department of Medicine/Haematology and Oncology, University of Muenster,
Muenster, Germany.

A phase 2 trial was performed to study the combination of bortezomib (VELCADE)
with intermediate-dose dexamethasone (DEX), and continuous low-dose oral
cyclophosphamide (CY) in patients with relapsed multiple myeloma (MM). Fifty-four
patients with advanced MM were enroled to receive eight 3-week treatment cycles
with bortezomib 1.3 mg/m(2) on days 1, 4, 8, and 11, followed by three 5-week
cycles with bortezomib 1.3 mg/m(2) on days 1, 8, 15, and 22. Within all cycles,
DEX 20 mg/d was given orally on the day of bortezomib injection and the day
thereafter. In addition, patients received CY continuous oral treatment at a dose
of 50 mg/d p.o. once daily. Fifty patients completing at least one treatment
cycle were evaluable for response. Complete, partial, and minor responses
occurred in 16%, 66% and 8% of patients, respectively; overall response rate 90% 
(efficacy analysis). Median event-free survival was 12 months, with a median
overall survival of 22 months. Adverse events (AE) of grades 3 or 4 occurring in 
at least 10% of patients comprised leucopenia, infection, herpes zoster,
thrombocytopenia, neuropathy and fatigue. Bortezomib combined with DEX and CY is 
a highly effective treatment for relapsed MM at an acceptable rate of grade 3/4
AE. Antiviral prophylaxis appears to be mandatory.

Publication Types: 
    Clinical Trial, Phase II
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 17614819 [PubMed - indexed for MEDLINE]

658: Ocul Immunol Inflamm. 2007 May-Jun;15(3):241-8.

Evidence for antigen-specific immune deviation in patients with acute retinal
necrosis. 2001.

Kezuka T, Sakai JI, Usui N, Streilein JW, Usui M.

Publication Types: 
    Biography
    Classical Article
    Historical Article

Personal Name as Subject: 
    Kezuka T
    Sakai JI
    Usui N
    Streilein JW

PMID: 17613838 [PubMed - indexed for MEDLINE]

659: Cancer Invest. 2007 Jun;25(4):249-55.

Selective lymphopenia and opportunistic infections in neuroendocrine tumor
patients receiving temozolomide.

Schwarzberg AB, Stover EH, Sengupta T, Michelini A, Vincitore M, Baden LR, Kulke 
MH.

Harvard Medical School, Boston, Massachusetts, USA. aschwarzberg@partners.org

Temozolomide is utilized as a treatment for a variety of solid tumors and has
been associated with the development of selective lymphopenia. We evaluated the
incidence of lymphopenia and opportunistic infections during treatment and up to 
12 months following treatment discontinuation in a cohort of 39 patients
receiving temozolomide for advanced neuroendocrine tumors. The incidence of Grade
3-4 lymphopenia was 46 percent after 4 months of therapy and remained at 30
percent or greater for 12 months following treatment discontinuation. The overall
incidence of opportunistic infections was 10 percent, while among patients
receiving therapy for > or =7 months, the incidence was 20 percent. Prophylaxis
for Pneumocystis jiroveci pneumonia and varicella-zoster, as well as
cytomegalovirus monitoring, should be considered in patients receiving
temozolomide-based treatment.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17612935 [PubMed - indexed for MEDLINE]

660: MMW Fortschr Med. 2007 Mar 1;149(9):10-2.

[Properly managing leg pain]

[Article in German]

Wepner U.

Publication Types: 
    Case Reports
    News

PMID: 17612241 [PubMed - indexed for MEDLINE]

661: Eur Arch Otorhinolaryngol. 2007 Dec;264(12):1491-5. Epub 2007 Jul 5.

Significance of electromyography to predict and evaluate facial function outcome 
after acute peripheral facial palsy.

Grosheva M, Guntinas-Lichius O.

Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 
Cologne, Germany.

The prognostic value of electromyography (EMG) and its significance to estimate
facial function outcome after acute facial palsy is still unclear. We
retrospectively analysed the EMG reports of 494 patients with acute facial palsy 
treated from 1995 to 2005 in a tertiary referral centre. Initial and final facial
functions were assessed by the House-Brackmann (HB) scale. Serial EMG results
were classified into neurapraxia, axonotmesis/neurotmesis, mixed lesion, complete
recovery, defective healing, or not classifiable. Initial HB was II-IV in 321
patients and V-VI in 173 cases. The aetiology was idiopathic palsy in 294,
iatrogenic lesion in 86, traumatic in 52, Herpes zoster in 37, and of various
origin in 25 patients. EMG revealed neurapraxia in 300 patients,
axonotmesis/neurotmesis in 95 patients, and mixed lesion in 23 cases. EMG was not
meaningful in 76 patients. The follow-up time ranged from 0.3-264 months. Final
EMG revealed a full recovery in 160 patients, whereas 219 patients showed signs
of defective healing. In 155 patients, EMG was not significant to classify the
final outcome. The predictive EMG value for poor outcome was 77-86% and for
recovery 53%. The mean EMG recovery time was 2.3 months. Mean time for defective 
healing was 4.3 months. Final HB was normal (HB I) in 323 patients, HB II-IV in
115 patients, and V-VI in 46 patients. We conclude that EMG has a high predictive
value for unfavourable outcome after acute facial palsy. EMG is more sensible to 
detect signs of defective healing than clinical evaluation of facial function.

PMID: 17611766 [PubMed - indexed for MEDLINE]

662: N Engl J Med. 2007 Jul 5;357(1):88.

Comment on:
    N Engl J Med. 2007 Mar 29;356(13):1338-43.

Varicella-zoster vaccine.

Woo EJ, Ball R, Braun MM.

Publication Types: 
    Comment
    Letter

PMID: 17611214 [PubMed - indexed for MEDLINE]

663: J Fam Pract. 2007 Jul;56(7):551-3.

Comment in:
    J Fam Pract. 2008 Feb;57(2):81.

A young girl with blisters on her forehead.

Sarabi K, Selim A, Khachemoune A.

Loma Linda University Medical School, Loma Linda, CA, USA.

Publication Types: 
    Case Reports

PMID: 17605947 [PubMed - indexed for MEDLINE]

664: Transpl Infect Dis. 2008 Apr;10(2):90-8. Epub 2007 Jul 1.

Factors influencing varicella zoster virus infection after allogeneic peripheral 
blood stem cell transplantation: low-dose acyclovir prophylaxis and
pre-transplant diagnosis of lymphoproliferative disorders.

Kim DH, Messner H, Minden M, Gupta V, Kuruvilla J, Wright J, Lipton J.

Blood and Marrow Transplant Program, Princess Margaret Hospital, University of
Toronto, Toronto, Ontario, Canada.

Varicella zoster virus (VZV) infection is one of the frequent opportunistic
infections after allogeneic bone marrow transplantation, with a high incidence of
30-50%. However, no data have been reported on VZV infection after allogeneic
peripheral blood stem cell transplantation (PBSCT). PATIENTS AND METHODS: We
report a retrospective analysis of VZV infection in 192 allogeneic PBSCT
recipients. Twenty-seven patients (14%) received long-term prophylaxis of
low-dose acyclovir (200 mg twice daily orally > or =3 months) for recurrent oral 
(n=21) or genital herpes simplex virus infection (n=5) or for a previous history 
of recurrent VZV infection (n=1). RESULTS: Forty-two patients (22%) developed VZV
infections: localized (n=37) and disseminated infection (n=5). The incidence of
VZV infection at 1 and 3 years was 19.3+/-3.3% and 36.8+/-5.2%, respectively.
Complications included post-herpetic neuralgia (n=18, 43%), secondary bacterial
infections (n=3), and intracranial hemorrhage (n=1) with 2 deaths. A higher risk 
factor for VZV infection was pre-transplant diagnosis of a lymphoproliferative
disorder (LPD): chronic lymphocytic leukemia, Hodgkin's disease, or non-Hodgkin's
lymphoma (P=0.021, 52.5% in LPD vs. 32.6% in non-LPD group). The use of low-dose 
acyclovir prophylaxis (P=0.043, 14.7% in acyclovir vs. 41.6% in nonacyclovir
group) was found to be protective. Although no VZV infection episodes were noted 
during the period of acyclovir prophylaxis, 3 episodes of VZV infection were
noted after acyclovir cessation. CONCLUSION: The incidence of VZV infection after
PBSCT was high at 36.8%, with patients transplanted for LPDs at higher risk. The 
long-term use of low-dose acyclovir may be protective for VZV infection, although
it does not completely prevent rebound of late VZV infection.

PMID: 17605742 [PubMed - indexed for MEDLINE]

665: J Clin Virol. 2007 Aug;39(4):322-5. Epub 2007 Jun 28.

Ramsay Hunt syndrome complicated by a brainstem lesion.

Kim JH, Chung PW, Oh S, Hong SB, Chung CS, Jung CW, Kim ST, Hong SD, Seo DW.

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School
of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710, Republic of Korea.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 17604687 [PubMed - indexed for MEDLINE]

666: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Oct;104(4):455-60.
Epub 2007 Jun 29.

Herpes zoster infection as an immune reconstitution inflammatory syndrome in
HIV-seropositive subjects: a review.

Feller L, Wood NH, Lemmer J.

Department of Periodontology and Oral Medicine, School of Dentistry, Faculty of
Health Sciences, University of Limpopo, Medunsa Campus, South Africa.
lfeller@medunsa.ac.za

The use of highly active antiretroviral therapy (HAART) in the management of
human immunodeficiency virus (HIV) infection has resulted paradoxically in the
worsening of clinical symptoms of previously subclinical infections, such as
herpes zoster (HZ), herpes simplex, angular cheilitis, warts, tuberculosis,
hepatitis B and C, cytomegalovirus retinitis, and others, as a result of
substantial reconstitution of the host's immune responses. This phenomenon is
referred to as immune reconstitution inflammatory syndrome (IRIS). It may affect 
up to 32% of HIV-seropositive subjects within a wide range of time after the
initiation of HAART, but mainly after 8-12 weeks. Mucocutaneous HZ accounts for
7%-12% of the diseases associated with HIV infection that become worse again when
the subject's immunity improves from the administration of HAART. It usually
occurs after 4 weeks from the initiation of HAART, and under these circumstances 
the clinical symptoms and natural course of mucocutaneous HZ are similar to those
in HIV-seropositive subjects who do not manifest IRIS.

Publication Types: 
    Review

PMID: 17604657 [PubMed - indexed for MEDLINE]

667: Nursing. 2007 Jul;37(7):29.

Myths and facts...about shingles.

Quillen TF.

PMID: 17603352 [PubMed - indexed for MEDLINE]

668: Urol J. 2005 Fall;2(4):193-6.

Frequency of infectious skin lesions in kidney transplant recipients.

Alimagham M, Amini-Afshar S, Farahmand S, Pour-Kazemi A, Pour-Reza-Gholi F,
Masood S.

Department of Infectious Diseases, Shaheed Labbafinejad Medical Center, Shaheed
Beheshti University of Medical Sciences, Tehran, Iran.
dr.mahnazaalimagham@yahoo.com.

INTRODUCTION: This study was performed to evaluate the frequency of skin lesions 
in kidney transplant recipients. MATERIALS AND METHODS: A total of 681 kidney
transplant recipients were followed at Shaheed Labbafinejad transplant center in 
Tehran, Iran. Skin lesions were evaluated, and diagnoses were made clinically and
confirmed by lesion smear, tissue biopsy, tissue culture, and serologic
examinations, as indicated. RESULTS: Skin lesions were found in 54 patients
(7.9%), and their frequencies were as follows: dermatomal herpes zoster (18
patients, 2.6%, 13 men and 5 women), herpes simplex infection of face and lips
(15 patients, 2.2%, 5 men and 10 women), chickenpox (6 patients, 0.9%, 5 men and 
1 woman), Kaposi's sarcoma (5 patients, 0.7%, 3 men and 2 women), warts (4 women,
2 of whom had genital warts), pyoderma gangrenosum (1 man, 0.14%), multiple
fungal abscesses of the leg (1 man, 0.14%), mucormycosis (1 man, 0.14%), and
molluscum contagiosum (1 man, 0.14%). Moreover, 2 women (0.3%) had generalized
herpes simplex lesions. CONCLUSION: Frequencies of herpes zoster (3.5%), herpes
simplex (2.5%), and human papillomavirus (0.6%) infections in our kidney
transplant recipients were low. We recommend that all kidney transplant
candidates be evaluated and immunized for herpes zoster virus before
transplantation, all herpetic-form lesions of these patients be reported to
physicians (even mild lesions), and finally, that all human papillomavirus
lesions be diagnosed and treated promptly to prevent more serious lesions such as
malignancies.

PMID: 17602428 [PubMed - in process]

669: Perit Dial Int. 2007 Jul-Aug;27(4):391-4.

Herpes zoster-associated encephalitis in a patient undergoing CAPD: case report
and literature review.

Sigaloff KC, de Fijter CW.

Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The
Netherlands. sigaloff@yahoo.com

Neurological complications of varicella zoster virus (VZV) reactivation have
rarely been described in dialysis patients. We report a case of a continuous
ambulatory peritoneal dialysis (CAPD) patient who developed herpes zoster
encephalitis. The patient was treated with acyclovir and steroids and had a slow 
but complete return to her prior cognitive status. The available literature is
reviewed and the differential diagnosis with acyclovir toxicity is discussed.

Publication Types: 
    Case Reports

PMID: 17602144 [PubMed - indexed for MEDLINE]

670: Niger Postgrad Med J. 2007 Jun;14(2):163-5.

HIV seropositivity and related eye diseases in Uith, Ilorin.

Adepoju FG, Olawumi HO, Adekoya BJ.

Department of Ophthalmology, College of Medicine, University of Ilorin.

INTRODUCTION: HIV is assuming an alarming pandemic worldwide and presently in
Nigeria it is a source of concern to all and sundry. AIM: To review the
demography of cases positive for HIV in the eye clinic over a 5-year period and
to identify ocular diseases that have high predictive value for HIV. METHODS: A
retrospective study of all the patients that were screened for HIV in the eye
clinic over a 5-year period was done. Screening was by ELISA method with
confirmation by Western blot test. RESULTS: A total of 60 patients were screened 
and 26 (43.3%) of them were HIV positive. The male to female ratio of HIV
positive patients was 1:1. All the seropositive patients were between the ages of
20-49 years and about a third were students from the higher institutions. Half of
the patients were single. Diagnoses with high predictive values were Herpes
Zoster Ophthalmicus (62%), Steven Johnson syndrome (50%), HIV retinopathy (75%), 
Bilateral Unresolving Toxoplasmosis (42%). The common presentations however are
Herpes Zoster Ophthalmicus (HZO) and unresolving bilateral Uveitis. CONCLUSION:
HIV and ocular involvement is increasing in Ilorin. The high-risk groups among
patients presenting to the hospital are students of higher institutions and
Soldiers. Diseases of high predictive indices are Herpes zoster Ophthalmicus,
Steven Johnson's syndrome, HIV retinopathy.

PMID: 17599118 [PubMed - indexed for MEDLINE]

671: J Pharmacol Sci. 2007 Jul;104(3):218-24. Epub 2007 Jun 29.

Effects of loperamide on mechanical allodynia induced by herpes simplex virus
type-1 in mice.

Sasaki A, Nakashima Y, Takasaki I, Andoh T, Shiraki K, Kuraishi Y.

Department of Applied Pharmacology, Graduate School of Medicine and
Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama 930-0194,
Japan.

In the present study, we investigated whether the peripherally acting
micro-opioid receptor agonist loperamide would inhibit allodynia in the
non-inflamed dermatome of mice with herpetic pain. Subcutaneous (s.c.) injection 
of loperamide (1 and 3 mg/kg) inhibited allodynia. Local (intraplantar) injection
of loperamide (1 and 5 microg/site) also produced an anti-allodynic effect. The
peripheral opioid receptor antagonist naloxone methiodide (0.1 mg/kg, s.c.) and
the micro-opioid receptor-selective antagonist beta-funaltrexamine (40 nmol/site,
intraplantar and 20 mg /kg, s.c.) antagonized the anti-allodynic effects of
systemic and local loperamide. Local injection of loperamide into the
contralateral hind paw was without effect, suggesting that the effect is mediated
through local action, not systemic action. Acute and subacute tolerance did not
develop to the anti-allodynic effect of loperamide. In addition, there were no
cross-tolerance between local opioids (morphine and loperamide) and systemic
morphine. These results suggest that stimulation of peripheral micro-opioid
receptors suppresses herpetic allodynia without tolerance development. The
non-narcotic micro-opioid receptor agonist loperamide may relieve acute herpetic 
pain in patients with herpes zoster.

PMID: 17598951 [PubMed - indexed for MEDLINE]

672: Pharmacotherapy. 2007 Jul;27(7):1013-9.

Zoster vaccine live.

Kockler DR, McCarthy MW.

Drug Information Services, Virginia Commonwealth University Health System-Medical
College of Virginia Hospitals, and the Virginia Commonwealth University School of
Pharmacy, Charlottesville, Virginia 23298-0042, USA. dkockler@mcvh-vcu.edu

Herpes zoster is a neurocutaneous disease caused by the varicella-zoster virus
and is associated with significant morbidity and long-term sequelae in older
adults. Until recently, treatment options for these complications have been
primarily targeted at disease state management and symptom relief. Zoster vaccine
live is the first vaccine approved for the prevention of herpes zoster. The
vaccine was approved by the United States Food and Drug Administration for adults
aged 60 years or older. Results of the Shingles Prevention Study demonstrated
that in older individuals, administration of zoster vaccine live reduces the
burden of illness associated with herpes zoster by 61.1%, the frequency of herpes
zoster pain and discomfort by 51.3%, and the frequency of postherpetic neuralgia 
by 66.5%. Overall, adverse events reported in clinical trials of zoster vaccine
live were classified as mild. Events that occurred more frequently in zoster
vaccine live recipients than in placebo recipients included injection site
reactions, headache, respiratory infections, fever, flu syndrome, diarrhea,
rhinitis, skin disorders, respiratory disorders, and asthenia. The Centers for
Disease Control and Prevention's Advisory Committee on Immunization Practices
recently recommended universal vaccination for those 60 years of age and older,
including those who have experienced previous episodes of shingles.

Publication Types: 
    Review

PMID: 17594207 [PubMed - indexed for MEDLINE]

673: Arq Bras Oftalmol. 2007 Mar-Apr;70(2):189-94.

Laboratory results in ocular viral diseases: implications in clinical-laboratory 
correlation.

Marangon FB, Miller D, Alfonso E.

Universidade Federal de Sao Paulo, Sao Paulo, SP, Brasil. fbmarangon@yahoo.com.br

PURPOSE: To document etiology and predictive value of clinical diagnosis in
laboratory confirmed viral diseases. METHODS: Reports of culture-positive cases
of samples collected from patients presenting from January 1987 - December 2001
were evaluated. RESULTS: One thousand nine hundred and sixty-four (1964) cultures
were submitted during 1987-2001. Twenty-six percent were positive (514). Human
herpesvirus 1 was the most frequent agent isolated from all positive culture
(56%). Adenovirus was the most common virus isolated from conjunctiva (66%),
human herpesvirus 1 from lid and cornea (76%, 88%) and cytomegalovirus from
vitreous (27%). Some unusual pathogens were recovered from conjunctiva as
cytomegalovirus and from cornea as adenovirus, enterovirus and cytomegalovirus.
Recognition of common viral syndromes was human herpesvirus 1 (88%), epidemic
keratoconjunctivitis (88%), acute hemorrhagic conjunctivitis (70%) and varicella 
zoster virus (100%). However, some misdiagnosed cases were observed. Thirteen
percent of conjunctivitis thought to be caused by herpes were due to adenovirus, 
3.2% to Enterovirus, 3.2% to varicella zoster virus and 3.2% to human
cytomegalovirus. Also, 5% of cases with a clinical diagnosis of herpes keratitis 
were caused by adenovirus and 2.7% by enterovirus. Finally, 4.8% of cases thought
to be adenovirus conjunctivitis were herpes conjunctivitis. CONCLUSIONS: Human
herpesvirus 1 remains the most frequently isolated virus from ocular sites in
general (56%). Nonherpetic corneal isolates were in decreasing order: adenovirus,
enterovirus and cytomegalovirus. Clinical and laboratory correlation was less
than 90%. The most misdiagnosed cases were herpes conjunctivitis and keratitis,
some cases of adenovirus conjunctivitis some cases of acute hemorrhagic
conjunctivitis. It is essential that a rapid and specific diagnosis is offered
under atypical viral presentation for the institution of specific antiviral
therapy and to avoid complications that can be a result of misdiagnosis and
inappropriate treatment. Also it is important to do viral testing in order to
confirm clinical diagnosis, report emerging infections, resistance and change in 
the epidemiology.

PMID: 17589685 [PubMed - indexed for MEDLINE]

674: MMWR Recomm Rep. 2007 Jun 22;56(RR-4):1-40.

Prevention of varicella: recommendations of the Advisory Committee on
Immunization Practices (ACIP).

Marin M, Guris D, Chaves SS, Schmid S, Seward JF; Advisory Committee on
Immunization Practices, Centers for Disease Control and Prevention (CDC).

Division of Viral Diseases, National Center for Immunization and Respiratory
Diseases, CDC, Atlanta, GA 30333, USA. mmarin@cdc.gov

Two live, attenuated varicella zoster virus-containing vaccines are available in 
the United States for prevention of varicella: 1) a single-antigen varicella
vaccine (VARIVAX, Merck & Co., Inc., Whitehouse Station, New Jersey), which was
licensed in the United States in 1995 for use among healthy children aged > or = 
12 months, adolescents, and adults; and 2) a combination measles, mumps, rubella,
and varicella vaccine (ProQuad, Merck & Co., Inc., Whitehouse Station, New
Jersey), which was licensed in the United States in 2005 for use among healthy
children aged 12 months-12 years. Initial Advisory Committee on Immunization
Practices (ACIP) recommendations for prevention of varicella issued in 1995 (CDC.
Prevention of varicella: recommendations of the Advisory Committee on
Immunization Practices [ACIP]. MMWR 1996;45 [No. RR-11]) included routine
vaccination of children aged 12-18 months, catch-up vaccination of susceptible
children aged 19 months-12 years, and vaccination of susceptible persons who have
close contact with persons at high risk for serious complications (e.g.,
health-care personnel and family contacts of immunocompromised persons). One dose
of vaccine was recommended for children aged 12 months-12 years and 2 doses, 4-8 
weeks apart, for persons aged > or = 13 years. In 1999, ACIP updated the
recommendations (CDC. Prevention of varicella: updated recommendations of the
Advisory Committee on Immunization Practices [ACIP]. MMWR 1999;48 [No. RR-6]) to 
include establishing child care and school entry requirements, use of the vaccine
following exposure and for outbreak control, use of the vaccine for certain
children infected with human immunodeficiency virus, and vaccination of
adolescents and adults at high risk for exposure or transmission. In June 2005
and June 2006, ACIP adopted new recommendations regarding the use of live,
attenuated varicella vaccines for prevention of varicella. This report revises,
updates, and replaces the 1996 and 1999 ACIP statements for prevention of
varicella. The new recommendations include 1) implementation of a routine 2-dose 
varicella vaccination program for children, with the first dose administered at
age 12-15 months and the second dose at age 4-6 years; 2) a second dose catch-up 
varicella vaccination for children, adolescents, and adults who previously had
received 1 dose; 3) routine vaccination of all healthy persons aged > or = 13
years without evidence of immunity; 4) prenatal assessment and postpartum
vaccination; 5) expanding the use of the varicella vaccine for HIV-infected
children with age-specific CD4+ T lymphocyte percentages of 15%-24% and
adolescents and adults with CD4+ T lymphocyte counts > or = 200 cells/microL; and
6) establishing middle school, high school, and college entry vaccination
requirements. ACIP also approved criteria for evidence of immunity to varicella.

Publication Types: 
    Practice Guideline

PMID: 17585291 [PubMed - indexed for MEDLINE]

675: Indian J Med Microbiol. 2007 Apr;25(2):126-32.

Estimation of CD4+ and CD8+ T-lymphocytes in human immunodeficiency virus
infection and acquired immunodeficiency syndrome patients in Manipur.

Singh HR, Singh NG, Singh TB.

Department of Microbiology, Regional Institute of Medical Sciences, Imphal - 795 
004, Manipur, India. dr_rebachandra@yahoo.com

PURPOSE: To estimate and stratify CD4 + and CD8 + T-lymphocyte levels in human
immunodeficiency virus (HIV) infected (asymptomatic) and acquired
immunodeficiency syndrome (AIDS) patients (symptomatic) and correlate the
clinical features of the patients with CD4+ and CD8+ lymphocyte level. METHODS:
Between April 2002 and September 2003, a total of 415 HIV seropositive adult
patients (297 males and 118 females) attending Regional Institute of Medical
Sciences (RIMS) hospitals were tested for CD4+ and CD8+ T-lymphocytes by
fluorescent activated cell sorter (FACS) counter (Becton Dickinson). Symptomatic 
patients were diagnosed as per NACO clinical case definition. RESULTS: Ranges of 
0-50, 51-100, 101-200, 201-300, 301-400, 401-500 and above 500 CD4+ T-lymphocyte 
per microlitre were seen in 68, 52, 101, 73, 47, 31 and 43 patients respectively 
whereas CD8+ T-lymphocyte ranges of 0-300, 301-600, 601-900, 901-1500, 1501-2000,
2001-3500 per microlitre were seen in 29, 84, 92, 145, 40 and 25 patients
respectively. One hundred and fifty patients were asymptomatic and 265 were
symptomatic. CD4/CD8 ratio in asymptomatics and symptomatics were 0.13-1.69 and
0.01-0.93 respectively. Tuberculosis and candidiasis occurred in CD4+
T-lymphocyte categories between 0-400 cells per mL in symptomatics. However,
cryptosporidiosis, toxoplasmosis, herpes zoster, cryptococcal meningitis,
Pneumocystis carinii pneumonia, penicilliosis and cytomegalovirus retinitis were 
seen in patients having CD4+ T-lymphocyte less than 200 per mL. CONCLUSIONS: CD4+
T-lymphocyte was decreased in both asymptomatic and symptomatic HIV patients, The
decrease was greater in symptomatics while CD8+ T-lymphocyte was increased in
both except advanced stage symptomatics. CD4:CD8 ratio was reversed in both
groups. Opportunistic infections correlated with different CD4+ T-lymphocyte
categories.

PMID: 17582182 [PubMed - indexed for MEDLINE]

676: J Virol. 2007 Sep;81(17):9024-33. Epub 2007 Jun 20.

Genetic analysis of varicella-zoster virus ORF0 to ORF4 by use of a novel
luciferase bacterial artificial chromosome system.

Zhang Z, Rowe J, Wang W, Sommer M, Arvin A, Moffat J, Zhu H.

Department of Microbiology and Molecular Genetics, UMDNJ-New Jersey Medical
School, 225 Warren Street, Newark, NJ 07101-1709, USA.

To efficiently generate varicella-zoster virus (VZV) mutants, we inserted a
bacterial artificial chromosome (BAC) vector in the pOka genome. We showed that
the recombinant VZV (VZV(BAC)) strain was produced efficiently from the BAC DNA
and behaved indistinguishably from wild-type virus. Moreover, VZV's
cell-associated nature makes characterizing VZV mutant growth kinetics difficult,
especially when attempts are made to monitor viral replication in vivo. To
overcome this problem, we then created a VZV strain carrying the luciferase gene 
(VZV(Luc)). This virus grew like the wild-type virus, and the resulting
luciferase activity could be quantified both in vitro and in vivo. Using
PCR-based mutagenesis, open reading frames (ORF) 0 to 4 were individually deleted
from VZV(Luc) genomes. The deletion mutant viruses appeared after transfection
into MeWo cells, except for ORF4, which was essential. Growth curve analysis
using MeWo cells and SCID-hu mice indicated that ORF1, ORF2, and ORF3 were
dispensable for VZV replication both in vitro and in vivo. Interestingly, the
ORF0 deletion virus showed severely retarded growth both in vitro and in vivo.
The growth defects of the ORF0 and ORF4 mutants could be fully rescued by
introducing wild-type copies of these genes back into their native genome loci.
This work has validated and justified the use of the novel luciferase VZV BAC
system to efficiently generate recombinant VZV variants and ease subsequent viral
growth kinetic analysis both in vitro and in vivo.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17581997 [PubMed - indexed for MEDLINE]

677: Clin Pediatr (Phila). 2007 Sep;46(7):646-9. Epub 2007 Jun 19.

Herpes zoster in an infant.

Dent AE, Baetz-Greenwalt BA.

Rainbow Babies and Children's Hospital, Department of Pediatrics, Division of
Pediatric Infectious Diseases and Rheumatology, Cleveland, Ohio 44106, USA.
arlene.dent@case.edu

Publication Types: 
    Case Reports

PMID: 17579095 [PubMed - indexed for MEDLINE]

678: Proc Natl Acad Sci U S A. 2007 Jun 26;104(26):10835-40. Epub 2007 Jun 19.

The coactivator host cell factor-1 mediates Set1 and MLL1 H3K4 trimethylation at 
herpesvirus immediate early promoters for initiation of infection.

Narayanan A, Ruyechan WT, Kristie TM.

Laboratory of Viral Diseases, National Institute of Allergy and Infectious
Diseases, National Institutes of Health, Building 4-131, 4 Center Drive,
Bethesda, MD 20892, USA.

Originally identified as an essential component of the herpes simplex virus
immediate early (IE) gene enhancer complex, the transcriptional coactivator host 
cell factor-1 (HCF-1) has been implicated in a broad range of cellular regulatory
circuits. The protein mediates activation through multiple interactions with
transcriptional activators, coactivators, and chromatin remodeling complexes.
However, the mechanisms involved in HCF-1-dependent transcriptional stimulation
were undefined. By using a minimal HCF-1-dependent promoter and a model
activator, the varicella zoster IE62 protein, it was determined that HCF-1 was
not required for the assembly of the RNAPII basal complex, which depended solely 
on IE62 in conjunction with the cellular factor Sp1. In contrast, HCF-1 was
required for recruitment of the histone methyltransferases Set1 and MLL1
(mixed-lineage leukemia 1), leading to histone H3K4 trimethylation and
transcriptional activation. Similarly, in a varicella zoster virus lytic
infection, HCF-1, Set1, and MLL1 were recruited to the viral genomic IE promoter,
suggesting an essential role for HCF-1 in chromatin modification and remodeling
during initiation of lytic infection. The results indicate that one biological
rationale for the incorporation of the viral IE activators in the viral particle 
is to recruit HCF-1/histone methyltransferase complexes and promote assembly of
the viral IE gene promoters into transcriptionally active chromatin. These
studies also contribute to the model whereby the induced nuclear transport of
HCF-1 in sensory neurons may be critical to the reactivation of latent
herpesviruses by promoting the activation of chromatin modifications.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, N.I.H., Intramural

PMID: 17578910 [PubMed - indexed for MEDLINE]

679: Acta Paediatr. 2007 Jul;96(7):1099-100.

Consequences of varicella in pregnancy: a report of four cases.

Narkeviciute I.

Clinic of Children's Diseases of Vilnius University, Vilnius, Lithuania.
irena.narkeviciute@vuvl.lt

Four infants are reported with varicella-Zoster virus (VZV) infection, whose
mothers had varicella during the second-third trimester of pregnancy. Two
newborns had neonatal varicella. One of them, whose mother contracted varicella 5
days before delivery, had a severe and complicated form of the disease. The
infants who had herpes zoster did not have specific VZV-IgG antibodies at the
onset of the disease. CONCLUSION: These cases showed that varicella during the
second-third trimester of pregnancy may have serious consequence for infants.

Publication Types: 
    Case Reports

PMID: 17577346 [PubMed - indexed for MEDLINE]

680: Clin J Pain. 2007 Jul-Aug;23(6):490-6.

The impact of acute herpes zoster pain and discomfort on functional status and
quality of life in older adults.

Schmader KE, Sloane R, Pieper C, Coplan PM, Nikas A, Saddier P, Chan IS, Choo P, 
Levin MJ, Johnson G, Williams HM, Oxman MN.

Duke University, Durham, NC, USA. schma001@mc.duke.edu

OBJECTIVES: To describe the interference of herpes zoster (HZ) pain and
discomfort with activities of daily living (ADLs) and health-related quality of
life (HRQL) during the acute rash phase, and to quantify the relationship between
acute HZ pain and discomfort and impaired ADLs and HRQL in older persons.
METHODS: Prospective, observational study of 160 HZ outpatients age > or =60 at 4
US study sites who completed the Zoster Brief Pain Inventory (ZBPI), Zoster
Impact Questionnaire (ZIQ), McGill Pain Questionnaire, EuroQol, and SF-12
questionnaires on a predetermined schedule. Patients rated interference on a 0 to
10 scale for ADL items in the ZBPI and the ZIQ. Interference scores were averaged
to create summary measures for the ZBPI items (ZBPI ADLI) and ZIQ items (ZIQ
ADLI). A composite pain score was used in mixed-effects models analyses of the
association between pain and discomfort and ADLI and HRQL measures during the
first 35 days after HZ rash onset. RESULTS: HZ pain interfered with all ADLs but 
interference was greatest for enjoyment of life, sleep, general activity, leisure
activities, getting out of the house, and shopping. For every 1.0 point increase 
in pain and discomfort intensity, there was a 0.69 and 0.53 point increase in
ZBPI and ZIQ interference, respectively, and a 2.81 point, 1.57 point, and 1.95
point decrease in EuroQol, SF-12 physical, and SF-12 mental scales, respectively.
DISCUSSION: Acute zoster pain and discomfort has a significant negative impact on
functional status and HRQL in older adults. The magnitude of interference
increases with increasing pain and discomfort intensity.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 17575488 [PubMed - indexed for MEDLINE]

681: Acta Otolaryngol. 2007 Jul;127(7):775-9.

Search for Herpesviruses in cerebrospinal fluid of facial palsy patients by PCR.

Kanerva M, Mannonen L, Piiparinen H, Peltomaa M, Vaheri A, Pitkaranta A.

Department of Otorhinolaryngology, Helsinki University Central Hospital,
Helsinki, Finland. mervi.kanerva@fimnet.fi

CONCLUSIONS: Herpes simplex virus 1 (HSV-1) and varicella-zoster virus (VZV) DNA 
were not detected in the cerebrospinal fluid (CSF) of patients with acute
idiopathic peripheral facial palsy (Bell's palsy). Our results indicate either
the absence of these viruses or the presence of technical shortcomings. The role 
of human herpesvirus 6 (HHV-6) in this disorder and the significance of a
positive HHV-6 DNA finding in the central nervous system need further
investigation. OBJECTIVE: Our goal was to determine whether DNA of HSV-1, VZV, or
HHV-6 can be found by polymerase chain reaction (PCR) in the CSF of peripheral
facial palsy patients. MATERIALS AND METHODS: We used PCR to detect the presence 
of HSV-1, VZV, and HHV-6 DNA in CSF. This was a retrospective case control study 
with 33 peripheral facial palsy patients (34 CSF samples) in the study group (26 
with Bell's palsy, 5 with simultaneously diagnosed herpesvirus infection, 1 with 
puerperal facial palsy, 1 with Melkersson-Rosenthal syndrome). The control group 
included 36 patients, most with diagnosed or suspected Borreliosis and facial
palsy or sudden deafness. RESULTS: One patient with Bell's palsy had HHV-6 DNA in
CSF. Neither HSV-1 nor VZV DNA was detected in patients or controls.

PMID: 17573575 [PubMed - indexed for MEDLINE]

682: Pediatr Radiol. 2007 Oct;37(10):949-63. Epub 2007 May 22.

Comment in:
    Pediatr Radiol. 2008 Mar;38(3):354-5.

Neuroimaging of herpesvirus infections in children.

Baskin HJ, Hedlund G.

Department of Radiology, Cincinnati Children's Medical Center, 3333 Burnet Ave., 
Cincinnati, OH 45229-3039, USA. baskinhj@gmail.com

Six members of the herpesvirus family cause well-described neurologic disease in 
children: herpes simplex virus-1 (HSV-1), herpes simplex virus-2 (HSV-2),
varicella-zoster (VZV), Epstein-Barr (EBV), cytomegalovirus (CMV), and human
herpes virus-6 (HHV-6). When herpesviruses infect the central nervous system
(CNS), the clinical presentation is non-specific and often confounding. The
clinical urgency is often underscored by progressive neurologic deficits,
seizures, or even death, and prompt diagnosis and treatment rely heavily on
neuroimaging. This review focuses on the spectrum of cerebral manifestations
caused by these viruses, particularly on non-congenital presentations. Recent
advances in our understanding of these viruses are discussed, including new
polymerase chain reaction techniques that allow parallel detection, which has
improved our recognition that the herpesviruses are neurotropic and involve the
CNS more often than previously thought. Evolving knowledge has also better
elucidated viral neuropathology, particularly the role of VZV vasculitis in the
brain, HHV-6 in febrile seizures, and herpesvirus reactivation in
immunosuppressed patients. The virology, clinical course, and CNS manifestations 
of each virus are reviewed, followed by descriptions of neuroimaging findings
when these agents infect the brain. Characteristic but often subtle imaging
findings are discussed, as well as technical pearls covering appropriate use of
MRI and MRI adjuncts to help differentiate viral infection from mimics.

Publication Types: 
    Review

PMID: 17572889 [PubMed - indexed for MEDLINE]

683: BMC Infect Dis. 2007 Jun 15;7:59.

Varicella and herpes zoster in Madrid, based on the Sentinel General Practitioner
Network: 1997-2004.

Perez-Farinos N, Ordobas M, Garcia-Fernandez C, Garcia-Comas L, Canellas S,
Rodero I, Gutierrez-Rodriguez A, Garcia-Gutierrez J, Ramirez R.

Department of Epidemiology, Madrid Public Health Institute, Julian Camarillo 4B, 
Madrid, Spain. napoleon.perez@salud.madrid.org

BACKGROUND: Varicella (chickenpox) is the primary disease caused by
varicella-zoster virus. It is extremely contagious and is frequent in children.
Indeed, in the absence of vaccination, a high proportion of the population is
liable to contract it. Herpes zoster -more frequent among adults- is caused by
reactivation of the latent virus. The objective of this study is to describe the 
status of and time trend for varicella and herpes zoster in the Madrid Autonomous
Region prior to the introduction of the vaccine to the general population.
METHODS: Data source: individualised varicella and herpes zoster case records
kept by the Madrid Autonomous Region Sentinel General Practitioner Network for
the period 1997-2004. Cumulative incidences, crude and standardised incidence
rates, and age-specific rates of varicella and herpes zoster were calculated for 
each year. Kendall's Tau-b correlation coefficient was calculated to evaluate
whether incidence displayed a time trend. Spectral density in the time series of 
weekly incidences was estimated using a periodogram. RESULTS: Standardised annual
varicella incidence rates ranged from 742.5 (95% CI: 687.2-797.7) to 1239.6 (95% 
CI: 1164.5-1313.4) cases per 100 000 person-years. Most cases affected children, 
though complications were more frequent in adults. Varicella incidence displayed 
an annual periodicity but no trend over time. Most herpes zoster cases occurred
at advanced ages, with incidence registering a rising annual trend but no
seasonality factor. CONCLUSION: In the absence of vaccination, no significant
changes in varicella incidence were in evidence recent years, though these were
observed in the incidence of herpes zoster. Sentinel general practitioner
networks are a valid instrument for surveillance of diseases such as varicella.
Further varicella vaccination-coverage and vaccine-efficacy studies are called
for.

PMID: 17570859 [PubMed - indexed for MEDLINE]

684: Rev Soc Bras Med Trop. 2007 Mar-Apr;40(2):234-5.

Abdominal wall protrusion following herpes zoster.

Ruiz Junior FB, Shinosaki JS, Marques Junior W, Ferreira MS.

Servico de Neurologia, Hospital das Clinicas, Universidade Federal de Uberlandia,
Uberlandia, MG. facundo_burgos@uol.com.br

We present the case of a 62-year-old woman with abdominal segmental paresis
consequent to radiculopathy caused by zoster, which was confirmed by
electroneuromyography. The paresis resolved completely within three months.
Recognition of this complication caused by zoster, which is easily misdiagnosed
as abdominal herniation, is important for diagnosing this self-limited condition 
and avoiding unnecessary procedures.

Publication Types: 
    Case Reports

PMID: 17568896 [PubMed - indexed for MEDLINE]

685: J Clin Microbiol. 2007 Aug;45(8):2516-20. Epub 2007 Jun 13.

Increased detection rate in diagnosis of herpes simplex virus type 2 meningitis
by real-time PCR using cerebrospinal fluid samples.

Franzen-Rohl E, Tiveljung-Lindell A, Grillner L, Aurelius E.

Infectious Diseases Unit, Department of Medicine, Solna, Karolinska University
Hospital Solna, SE-171 76 Stockholm, Sweden. elisabeth.franzen-rohl@karolinska.se

Efficient and sensitive diagnostic methods are needed in the management of virus 
infections in the central nervous system. There is a demand for an evaluation of 
the sensitivity of PCR methods for early diagnosis of meningitis due to herpes
simplex type 2 (HSV-2) and varicella-zoster virus (VZV). The objective of this
study was to evaluate real-time PCR in the detection of HSV-2 and VZV DNA from
cerebrospinal fluid (CSF) for etiological diagnoses in clinically
well-characterized cases of primary and recurrent aseptic meningitis. Samples
from 110 patients, 65 of whom were diagnosed with or were strongly suspected of
having HSV-2 meningitis and 45 with acute aseptic meningitis of unknown causes,
were analyzed. Results were compared with the outcome of nested PCR for HSV-2
infection. Clinical parameters were analyzed in relation to CSF viral load. With 
real-time PCR, HSV-2 DNA was found in CSF from 80% (52/65) of patients with
clinical HSV-2 meningitis compared to 72% (47/65) found by nested PCR. The
sensitivity of real-time HSV-2 PCR was found to be 87% (33/38) in primary and 70%
(19/27) in recurrent meningitis. The HSV-2 viral load was significantly higher in
primary than in recurrent meningitis and correlated with the degree of
inflammation. VZV DNA was detected in 2 of 45 samples (4.4%). Real-time PCR for
the diagnosis of HSV-2 meningitis was evaluated in a large, clinically
well-characterized sample of material and found to identify more cases than
nested PCR in the group of patients with recurrent meningitis. Quantification of 
DNA enables further research of disease prognosis and treatment.

Publication Types: 
    Comparative Study
    Evaluation Studies

PMID: 17567785 [PubMed - indexed for MEDLINE]

686: Virol J. 2007 Jun 12;4:59.

Usefulness of Herpes Consensus PCR methodology to routine diagnostic testing for 
herpesviruses infections in clinical specimens.

Vrioni G, Kalogeropoulos C, Gartzonika C, Priavali E, Levidiotou S.

Department of Microbiology, Medical School, University of Ioannina, Greece.
gvrioni@med.uoa.gr

The purposes of the study were to assess the usefulness of simultaneously
amplifying herpes simplex virus 1 and 2, varicella-zoster virus, cytomegalovirus,
Epstein-Barr virus and human herpesvirus 6 DNA in various clinical specimens and 
to analyze clinical events in patients presenting positive results. A total of
763 clinical samples obtained from 758 patients, including 115 cerebrospinal
fluids, 102 aqueous fluids, 445 swabs from genital (152), oro-facial (138) and
other (155) skin lesions, 96 eye swabs and 5 bronchoalveolar lavages, were tested
by using the Consensus polymerase chain reaction methodology. The clinical files 
of the patients were consulted retrospectively. 171 of the 758 patients (22.5%)
were positive for at least one of the six target viruses: herpes simplex virus 1 
(n = 95), varicella-zoster virus (n = 40), herpes simplex virus 2 (n = 21),
herpes simplex virus 1 plus herpes simplex virus 2 (n = 8), cytomegalovirus (n = 
4), Epstein-Barr virus (n = 1), human herpesvirus 6 (n = 1), and herpes simplex
virus 1 plus human herpesvirus 6 (n = 1). The Consensus methodology enabled the
rapid and accurate detection of herpesviruses in various clinical specimens and
provided a reliable tool in the diagnosis of herpetic infections.

PMID: 17562023 [PubMed - indexed for MEDLINE]

687: J Oral Pathol Med. 2007 Jul;36(6):347-50.

Evaluation of the sensation in patients with trigeminal post-herpetic neuralgia.

Alvarez FK, de Siqueira SR, Okada M, Teixeira MJ, de Siqueira JT.

Orofacial Pain Team, Dentistry Division, Hospital das Clinicas, Medical School,
University of Sao Paulo, SP, Brazil.

BACKGROUND: Post-herpetic neuralgia (PHN) is one complication after herpes zoster
infection, which may affect the facial superficial sensitivity. METHODS: Eighteen
patients with PHN were interviewed and evaluated according to a systematized
sensitivity approach, including mechanical, thermal and pain. RESULTS: The pain
location was V1 in 15 patients. All trigeminal branches from both facial sides
were evaluated; we compared the affected with the opposite side. There was a
significant difference at V1 with cold (P=0.038), vonFrey (P=0.008) and pinpricks
(P=0.022); at V2, the statistical difference occurred with cold (P=0.034), heat
(P=0.019) and pinpricks (P=0.037); at V3, differences occurred with cold
(P=0.042) and heat (P=0.036). Only V1 and oral mucosa (V2-3) presented pain
threshold differences between both sides (P=0.001, P=0.021). CONCLUSION: Age,
predominance of trigeminal PHN in V1 and continuous burning pain was common and
similar to literature. Sensation was hampered with evident deficits of all
sensory modalities in the affected trigeminal areas, especially V1.

PMID: 17559496 [PubMed - indexed for MEDLINE]

688: Swiss Med Wkly. 2007 May 5;137(17-18):239-51.

Swiss recommendations for the management of varicella zoster virus infections.

Kempf W, Meylan P, Gerber S, Aebi C, Agosti R, Buchner S, Coradi B, Garweg J,
Hirsch H, Kind C, Lauper U, Lautenschlager S, Reusser P, Ruef C, Wunderli W,
Nadal D.

Dermatologische Klinik, Universitatsspital Zurich, CH-8091 Zurich, Switzerland.
kempf@derm.unizh.ch

Infections with varicella zoster virus (VZV) are common viral infections
associated with significant morbidity. Diagnosis and management are complex,
particularly in immunocompromised patients and during pregnancy. The present
recommendations have been established by a multidisciplinary panel of specialists
and endorsed by numerous Swiss medical societies involved in the medical care of 
such patients (Appendix). The aim was to improve the care of affected patients
and to reduce complications.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 17557214 [PubMed - indexed for MEDLINE]

689: Nurse Pract. 2007 Jun;32(6):6-7.

Prevent shingles with Zostavax.

Laustsen G, Neilson T.

Oregon Health and Science University, School of Nursing, La Grande, OR, USA.

PMID: 17557014 [PubMed - indexed for MEDLINE]

690: BMJ. 2007 Jun 9;334(7605):1211-5.

Herpes zoster.

Wareham DW, Breuer J.

Centre for Infectious Disease, Institute of Cell and Molecular Science, Barts and
the London, Queen Mary's School of Medicine and Dentistry. d.w.wareham@qmul.ac.uk

Publication Types: 
    Review

PMID: 17556477 [PubMed - indexed for MEDLINE]

691: J Clin Virol. 2007 Jul;39(3):238-9. Epub 2007 Jun 6.

Comment on:
    J Clin Virol. 2007 Apr;38(4):275-9.

Correlates of acute pain in herpes zoster.

Opstelten W, van Loon AM, van Wijck AJ, Moons KG.

Publication Types: 
    Comment
    Letter

PMID: 17556015 [PubMed - indexed for MEDLINE]

692: J Virol. 2007 Aug;81(16):8525-32. Epub 2007 Jun 6.

The amino terminus of varicella-zoster virus (VZV) glycoprotein E is required for
binding to insulin-degrading enzyme, a VZV receptor.

Li Q, Krogmann T, Ali MA, Tang WJ, Cohen JI.

Laboratory of Clinical Infectious Diseases, National Institutes of Health, 10
Center Drive, Bethesda, MD 20892, USA.

Varicella-zoster virus (VZV) glycoprotein E (gE) is required for VZV infection.
Although gE is well conserved among alphaherpesviruses, the amino terminus of VZV
gE is unique. Previously, we showed that gE interacts with insulin-degrading
enzyme (IDE) and facilitates VZV infection and cell-to-cell spread of the virus. 
Here we define the region of VZV gE required to bind IDE. Deletion of amino acids
32 to 71 of gE, located immediately after the predicted signal peptide, resulted 
in loss of the ability of gE to bind IDE. A synthetic peptide corresponding to
amino acids 24 to 50 of gE blocked its interaction with IDE in a
concentration-dependent manner. However, a chimeric gE in which amino acids 1 to 
71 of VZV gE were fused to amino acids 30 to 545 of herpes simplex virus type 2
gE did not show an increased level of binding to IDE compared with that of
full-length HSV gE. Thus, amino acids 24 to 71 of gE are required for IDE
binding, and the secondary structure of gE is critical for the interaction. VZV
gE also forms a heterodimer with glycoprotein gI. Deletion of amino acids 163 to 
208 of gE severely reduced its ability to form a complex with gI. The amino
portion of IDE, as well an IDE mutant in the catalytic domain of the protein,
bound to gE. Therefore, distinct motifs of VZV gE are important for binding to
IDE or to gI.

Publication Types: 
    Research Support, N.I.H., Intramural

PMID: 17553876 [PubMed - indexed for MEDLINE]

693: Ophthalmologe. 2008 May;105(5):480-4.

[Scleromalacia associated with varicella-zoster virus]

[Article in German]

Yoeruek E, Deuter CM, Szurman P, Tatar O, Zierhut M.

Abteilung I, Universitatsaugenklinik der Eberhard-Karls-Universitat Tubingen,
Schleichstrasse 12, 72076 Tubingen. Efdal.Yoeruek@med.uni-tuebingen.de

BACKGROUND: Scleromalacia usually appears following vasculitis in systemic
rheumatoid diseases, especially as a late symptom of rheumatoid arthritis. CASE
REPORT: A 67-year-old woman was referred to our hospital for further evaluation
with the diagnosis of a "fast-growing tumor" of the left eye. Sixteen months ago 
she had suffered from herpes zoster ophthalmicus-associated keratouveitis and
trabeculitis in the same eye. Scleromalacia associated with varicella-zoster
virus (VZV) was diagnosed after the biomicroscopic and gonioscopic examination of
the eye was completed and a systemic disease had been ruled out. One week after
beginning systemic application of acyclovir (5 x 800 mg daily) and prednisolone
(30 mg daily), the anterior chamber inflammation regressed and a fibrosis seemed 
to appear in the atrophic scleral area. CONCLUSION: Although scleral atrophy
mostly appears as a late sign of systemic rheumatoid diseases, it might also
develop secondary to infectious diseases. Scleromalacia associated with
varicella-zoster virus has been previously described only in a few cases.
Scleromalacia is a vision-threatening complication of zoster ophthalmicus which
responds well to combination therapy with systemic antiviral and
anti-inflammatory agents.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17549494 [PubMed - indexed for MEDLINE]

694: Otolaryngol Head Neck Surg. 2007 Jun;136(6):1027.

Comment on:
    Otolaryngol Head Neck Surg. 2007 Feb;136(2):313-4.

Hutchinson sign and herpes zoster.

Opstelten W, Zaal MJ.

Publication Types: 
    Comment
    Letter

PMID: 17548004 [PubMed - indexed for MEDLINE]

695: J Vestib Res. 2006;16(4-5):217-22.

The lesion site of vestibular dysfunction in Ramsay Hunt syndrome: a study by
click and galvanic VEMP.

Ozeki H, Iwasaki S, Ushio M, Takeuchi N, Murofushi T.

Department of Otolaryngology and Head and Neck Surgery, University of Tokyo,
Tokyo, Japan.

Ramsay Hunt syndrome (RHS) is characterized by vestibulocochlear dysfunction in
addition to facial paralysis and auricular vesicles. The present study
investigated the lesion site of vestibular dysfunction in a group of 10 RHS
patients. Caloric testing, vestibular evoked myogenic potentials by click sound
(cVEMP) and by galvanic stimulation (gVEMP) were used to assess the function of
the lateral semicircular canal, saccule, and their afferents. The results of
caloric testing (all 10 cases showed canal paresis) mean the existence of lesion 
sites in lateral semicircular canal and/or superior vestibular nerve (SVN).
Abnormal cVEMPs in 7 patients mean the existence of lesions in saccule and/or
inferior vestibular nerve (IVN). Four of the 6 patients with absent cVEMP also
underwent gVEMP. The results of gVEMP (2 absent and 2 normal) mean that the
former 2 have lesions of the vestibular nerve, and the latter 2 have only
saccular lesions concerning the pathway of VEMPs. Thus, our study suggested that 
lesion sites of vestibular symptoms in RHS could be in the vestibular nerve
and/or labyrinth, and in SVN and/or IVN. In other words, in the light of
vestibular symptoms, there is the diversity of lesion sites.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17538211 [PubMed - indexed for MEDLINE]

696: Acta Paediatr. 2007 Jun;96(6):794-5.

Comment on:
    Acta Paediatr. 2007 Jun;96(6):861-3.

General vaccination of children against varicella?--Yes!

Trollfors B.

Birger East Hospital, Goteborg 41685, Sweden. birger.trollfors@vgregion.se

Publication Types: 
    Comment

PMID: 17537004 [PubMed - indexed for MEDLINE]

697: Community Pract. 2007 May;80(5):9.

Shingles.

Wyndham M.

PMID: 17536461 [PubMed - indexed for MEDLINE]

698: BMC Neurol. 2007 May 29;7:12.

Detection of virus-specific intrathecally synthesised immunoglobulin G with a
fully automated enzyme immunoassay system.

Schubert J, Weissbrich B.

Institute of Virology and Immunology, University of Wurzburg, Wurzburg, Germany. 
schubert@vim.uni-wuerzburg.de <schubert@vim.uni-wuerzburg.de>

BACKGROUND: The determination of virus-specific immunoglobulin G (IgG) antibodies
in cerebrospinal fluid (CSF) is useful for the diagnosis of virus associated
diseases of the central nervous system (CNS) and for the detection of a
polyspecific intrathecal immune response in patients with multiple sclerosis.
Quantification of virus-specific IgG in the CSF is frequently performed by
calculation of a virus-specific antibody index (AI). Determination of the AI is a
demanding and labour-intensive technique and therefore automation is desirable.
We evaluated the precision and the diagnostic value of a fully automated enzyme
immunoassay for the detection of virus-specific IgG in serum and CSF using the
analyser BEP2000 (Dade Behring). METHODS: The AI for measles, rubella,
varicella-zoster, and herpes simplex virus IgG was determined from pairs of serum
and CSF samples of patients with viral CNS infections, multiple sclerosis and of 
control patients. CSF and serum samples were tested simultaneously with reference
to a standard curve. Starting dilutions were 1:6 and 1:36 for CSF and 1:1386 and 
1:8316 for serum samples. RESULTS: The interassay coefficient of variation was
below 10% for all parameters tested. There was good agreement between AIs
obtained with the BEP2000 and AIs derived from the semi-automated reference
method. CONCLUSION: Determination of virus-specific IgG in serum-CSF-pairs for
calculation of AI has been successfully automated on the BEP2000. Current
limitations of the assay layout imposed by the analyser software should be solved
in future versions to offer more convenience in comparison to manual or
semi-automated methods.

Publication Types: 
    Comparative Study

PMID: 17535416 [PubMed - indexed for MEDLINE]

699: Eur J Epidemiol. 2007;22(6):405-9. Epub 2007 May 30.

Seroprevalence of varicella antibodies among pregnant women in Lyon-France.

Saadatian-Elahi M, Mekki Y, Del Signore C, Lina B, Derrough T, Caulin E, Thierry 
J, Vanhems P.

Laboratoire d'Epidemiologie et de Sante Publique, Universite de Lyon, F-69003,
Lyon, France.

The purpose of the study was to calculate the seroprevalence of immunity to the
varicella-zoster virus (VZV) infection and to evaluate the positive predictive
value (PPV) and the negative predictive value (NPV) of the self-reported history 
of VZV infection in pregnant women. A cross sectional study was conducted in 18
private medical analysis laboratories. Information on socio-demographic
characteristics and past history of varicella or zoster were collected using a
questionnaire. Blood samples were obtained to determine the serological levels of
past exposure to VZV. Overall, 486 pregnant women were recruited. The
seroprevalence of VZV antibodies was 98.8%. Six women were seronegative, of whom 
four were primiparous. The PPV was high (99.5%) while the NPV was only 10.3%. The
PPV is a reliable marker of prior VZV infection. In contrast, a negative history 
does not predict lack of immunity and should be completed by serological analysis
which might be introduced to routine antenatal blood tests.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17534728 [PubMed - indexed for MEDLINE]

700: Transplant Proc. 2007 May;39(4):1190-4.

Dermatologic complications after liver transplantation: a single-center
experience.

Hassan G, Khalaf H, Mourad W.

Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, King
Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

OBJECTIVE: To report our experience with dermatological complications after both 
deceased donor liver transplantation (DDLT) and living-donor liver
transplantation (LDLT). PATIENTS AND METHODS: Between April 2001 and November
2006, a total of 116 liver transplantation (LT) procedures were performed (73
DDLTs and 43 LDLTs) in 112 patients (4 re-transplants). Posttransplant
dermatological problems were recorded. RESULTS: Among 112 OLT recipients, 14
patients (12.5%) experienced dermatologic problems: epidermolysis bullosa
acquisita in one patient, which was self-limiting; graft-versus-host-disease in
one patient treated with high-dose steroids; Kaposi sarcoma in one patient
treated with surgical excision and conversion to sirolimus-based
immunosuppression; drug-induced cutaneous vasculitis with deep thigh ulcer
formation treated by drug discontinuation and surgical excision of the ulcer;
herpes zoster in one patient treated with intravenous antiviral therapy; herpes
simplex in two patients treated with local antiviral cream; cyclosporine-induced 
gingival hyperplasia treated with conversion to FK506; cyclosporine-induced
hypertrichosis treated with conversion to FK506; steroid-induced skin
hyperpigmentation in one patient treated with steroid withdrawal;
hypomagnesemia-induced hair loss treated with daily oral magnesium supplement;
pressure-induced alopecia areata in two patients that was self-limiting; and
finally, one patient with a pressure-induced heel ulcer that was treated
conservatively. In 8 of 14 patients (57%) who suffered from dermatologic
problems, the complication was primarily related to immunosuppressive drugs.
CONCLUSIONS: In our experience, dermatologic complications following LT are not
uncommon and usually related to immunosuppressive therapy. Most complications
could be prevented by optimizing immunosuppression. The majority of complications
were easily managed by simple adjustment of immunosuppression.

PMID: 17524929 [PubMed - indexed for MEDLINE]

701: Sex Health. 2007 Jun;4(2):141-2.

Famciclovir or valaciclovir in the management of herpes simplex and varicella
zoster infections: an attitudinal survey of clinician perceptions of differential
activity.

Smith DE, Gold J.

Publication Types: 
    Letter

PMID: 17524295 [PubMed - indexed for MEDLINE]

702: J Virol. 2007 Aug;81(15):8016-24. Epub 2007 May 23.

Epstein-Barr virus induces MCP-1 secretion by human monocytes via TLR2.

Gaudreault E, Fiola S, Olivier M, Gosselin J.

Viral Immunology Laboratory, CHUL Research Center (CHUQ), 2705 boul. Laurier,
Room T 1-49, Quebec, QC, Canada G1V 4G2.

Epstein-Barr virus (EBV) is a gammaherpesvirus infecting the majority of the
human adult population in the world. TLR2, a member of the Toll-like receptor
(TLR) family, has been implicated in the immune responses to different viruses
including members of the herpesvirus family, such as human cytomegalovirus,
herpes simplex virus type 1, and varicella-zoster virus. In this report, we
demonstrate that infectious and UV-inactivated EBV virions lead to the activation
of NF-kappaB through TLR2 using HEK293 cells cotransfected with TLR2-expressing
vector along with NF-kappaB-Luc reporter plasmid. NF-kappaB activation in
HEK293-TLR2 cells (HEK293 cells transfected with TLR2) by EBV was not enhanced by
the presence of CD14. The effect of EBV was abrogated by pretreating HEK293-TLR2 
cells with blocking anti-TLR2 antibodies or by preincubating viral particles with
neutralizing anti-EBV antibodies 72A1. In addition, EBV infection of primary
human monocytes induced the release of MCP-1 (monocyte chemotactic protein 1),
and the use of small interfering RNA targeting TLR2 significantly reduced such a 
chemokine response to EBV. Taken together, these results indicate that TLR2 may
be an important pattern recognition receptor in the immune response directed
against EBV infection.

PMID: 17522215 [PubMed - indexed for MEDLINE]

703: Am J Dermatopathol. 2007 Jun;29(3):303-5.

Zosteriform connective tissue nevus: a case report.

Amjadi M, Khorrami-Arani N, Mashman G, Allen PW.

School of Medicine, Flinders University of South Australia, South Australia,
Australia. amja0002@flinders.edu.au

Zosteriform connective tissue nevus is a rare form of connective tissue
hamartomas, which arises from cells of mesodermal origin. Despite similar
clinical appearance of many connective tissue nevi, they can be differentiated
histochemically and/or biochemically on the basis of the primary connective
tissue element present. There are only 3 reported cases of zosteriform connective
tissue nevi in the worldwide literature. We report a case occurring in a
25-year-old male with approximately 40 nodules and smaller papules distributed in
a zosteriform fashion on the right lower lumbar region and upper gluteal region. 
The identification of the lesion by deep biopsy excluded the important
differential diagnosis of segmental neurofibromatosis.

Publication Types: 
    Case Reports

PMID: 17519633 [PubMed - indexed for MEDLINE]

704: J Med Chem. 2007 Jun 14;50(12):2851-7. Epub 2007 May 23.

5-alkynyl analogs of arabinouridine and 2'-deoxyuridine: cytostatic activity
against herpes simplex virus and varicella-zoster thymidine kinase
gene-transfected cells.

Cristofoli WA, Wiebe LI, De Clercq E, Andrei G, Snoeck R, Balzarini J, Knaus EE.

Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton,
Alberta, Canada T6G 2N8.

A group of arabinouridines (TMSEAU, EAU, IEAU-TA) and 2'-deoxyuridines (TMSEDU,
EDU, IEDU) having a variety of substituents at the uracil C-5 position
(trimethylsilylethynyl, TMSE; ethynyl, E; or iodoethynyl, IE), and the sugar C-2'
position (2'-arabino OH in arabinouridine, AU; or 2'-deoxyribo H in
2'-deoxyuridine, DU) were prepared to acquire antiviral structure-activity
relationships. A broad-spectrum viral panel screen showed that these
5-alkynylarabino/deoxy-uridines exhibit moderate anti-HSV-1 activity, with no
difference in potency between arabinouridines and 2'-deoxyuridines. The
2'-deoxyuridines TMSEDU, EDU, and IEDU, unlike the arabinouridines, exhibited
potent antiviral activity against cytomegalovirus, but they were also highly
cytostatic. The abilities of the 5-alkynylarabino/deoxy-uridines to inhibit
nontransfected (wild-type or thymidine kinase-deficient, tk-) and viral gene
transfected (HSV-1, HSV-2, or VZV thymidine kinase-positive, tk+) FM3A and OST
(osteosarcoma) cells were determined. This group of
5-alkynylarabino/deoxy-uridines showed an enhanced ability to inhibit cells
transfected with a viral thymidine kinase gene (HSV-1tk+, HSV-2tk+, VZVtk+)
relative to wild-type or thymidine kinase-deficient (tk-) cells.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17518459 [PubMed - indexed for MEDLINE]

705: J Med Virol. 2007 Jul;79(7):1025-31.

Different genotype pattern of varicella-zoster virus obtained from patients with 
varicella and zoster in Germany.

Sauerbrei A, Wutzler P.

Institute of Virology and Antiviral Therapy, Friedrich-Schiller University of
Jena, Jena, Germany. Andreas.Sauerbrei@med.uni-jena.de

The general use of the varicella vaccine requires the surveillance of
varicella-zoster virus (VZV) strains in patients infected with VZV. This paper
reports the data achieved from a prospective study of genotyping VZV in Germany, 
analyzing the restriction fragment length polymorphism (RFLP) of the open reading
frames (ORF) 38, 54, and 62 as well as the polymorphism of the R5 repeat region. 
The study included 177 patients with varicella. Seventy-eight patients with
zoster served as controls. Results revealed that 78% of VZV strains in patients
with varicella had the genetic profile of the dominant wild-genotype occurring in
Europe and 22% had the markers of African or Asian strains. Varicella patients
with the profile of African or Asian strains were significantly younger than
patients with varicella caused by the dominant genotype. By contrast, all zoster 
patients exhibited strains representing the majority of wild-type strains in
Europe. In conclusion, VZV strains from patients with varicella have a
significantly higher genetic variability than viral strains from zoster patients.
Since variants with the markers of African or Asian strains could only be found
in young children with chickenpox, the results suggest a changing scene of VZV
genotypes in Germany. As reasons, the spread of viruses, which may be imported
originally by persons immigrating from warmer climates, or the recombination
between wild-and vaccine-type viruses have to be considered.

Publication Types: 
    Comparative Study

PMID: 17516537 [PubMed - indexed for MEDLINE]

706: Pract Neurol. 2007 Jun;7(3):182-5.

Some syndromes of James Ramsay Hunt.

Pearce JM.

Emeritus Department of Neurology, Hull Royal Infirmary, Hull, UK.
jmsp@freenet.co.uk

Publication Types: 
    Historical Article
    Portraits
    Review

PMID: 17515597 [PubMed - indexed for MEDLINE]

707: Blood. 2007 Oct 15;110(8):3071-7. Epub 2007 May 21.

One-year acyclovir prophylaxis for preventing varicella-zoster virus disease
after hematopoietic cell transplantation: no evidence of rebound varicella-zoster
virus disease after drug discontinuation.

Erard V, Guthrie KA, Varley C, Heugel J, Wald A, Flowers ME, Corey L, Boeckh M.

Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle,
WA 98109-1024, USA.

No consensus exists on whether acyclovir prophylaxis should be given for
varicella-zoster virus (VZV) prophylaxis after hematopoietic cell transplantation
because of the concern of "rebound" VZV disease after discontinuation of
prophylaxis. To determine whether rebound VZV disease is an important clinical
problem and whether prolonging prophylaxis beyond 1 year is beneficial, we
examined 3 sequential cohorts receiving acyclovir from day of transplantation
until engraftment for prevention of herpes simplex virus reactivation (n = 932); 
acyclovir or valacyclovir 1 year (n = 1117); or acyclovir/valacyclovir for at
least 1 year or longer if patients remained on immunosuppressive drugs (n = 586).
In multivariable statistical models, prophylaxis given for 1 year significantly
reduced VZV disease (P < .001) without evidence of rebound VZV disease.
Continuation of prophylaxis beyond 1 year in allogeneic recipients who remained
on immunosuppressive drugs led to a further reduction in VZV disease (P = .01)
but VZV disease developed in 6.1% during the second year while receiving this
strategy. In conclusion, acyclovir/valacyclovir prophylaxis given for 1 year led 
to a persistent benefit after drug discontinuation and no evidence of a rebound
effect. To effectively prevent VZV disease in long-term hematopoietic cell
transplantation survivors, additional approaches such as vaccination will
probably be required.

Publication Types: 
    Clinical Trial
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17515400 [PubMed - indexed for MEDLINE]

708: J Cutan Med Surg. 2007 May-Jun;11(3):89-98.

Open-label study of valacyclovir 1.5 g twice daily for the treatment of
uncomplicated herpes zoster in immunocompetent patients 18 years of age or older.

Madkan VK, Arora A, Babb-Tarbox M, Aboutlabeti S, Tyring S.

Department of Dermatology, University of Texas School of Medicine, Center for
Clinical Studies, Houston, TX 77030, USA.

BACKGROUND: Herpes zoster (shingles) is a common disease caused by a reactivation
of the latent varicella-zoster virus (chickenpox), which resides in the dorsal
root ganglia. Valacyclovir HCl, the L-valyl ester of acyclovir, is an antiviral
drug that is used to accelerate the resolution of the herpes zoster rash and
associated pain and reduce the duration of postherpetic neuralgia. OBJECTIVE: To 
demonstrate the safety and efficacy of oral valacyclovir 1.5 g twice daily (bid) 
for the treatment of uncomplicated herpes zoster in immunocompetent patients over
18 years of age. The dosing schedule of bid versus three times daily is desirable
for enhancing patient compliance and to subsequently reduce the incidence of
viral resistance. METHODS: One treatment group of 125 patients was administered
oral valacyclovir 1.5 g bid for 7 days. Administration of the first dose occurred
within 72 hours after onset of rash. Patients were seen and assessed for
cutaneous healing, zoster-associated pain (ZAP), and/or zoster-associated
abnormal sensations (ZAAS). Patients under 50 years of age were followed for 4
weeks and patients 50 years of age and older were followed for a total of 24
weeks. Patients >or= 50 years were also asked to record a daily diary on pain and
abnormal sensations throughout the 24-week study period. Responses to resource
use and quality of life questions were also collected. Safety was monitored by
means of routine hematologic and biochemical assessments and reporting of adverse
experiences. RESULTS: Data from this study were compared with historical control 
groups both for three times daily antiviral therapy and for placebo. The results 
showed that twice-daily dosing was as safe and effective as three times daily
dosing for the reduction of ZAP and ZAAS. Adverse-effect profiles were similar
between the two different regimens, and both treatment groups showed better
outcomes than the historical placebo group. Because it is standard of care to
administer antivirals for the treatment of acute herpes zoster, a
placebo-controlled trial is not possible, necessitating the use of historical
controls. CONCLUSION: Oral valacyclovir 1.5 g bid is safe and effective for the
treatment of uncomplicated herpes zoster in immunocompetent patients over 18
years of age. Twice-daily dosing may help increase patient compliance and
therefore increase the effectiveness of treatment of the acute herpes zoster rash
and the prevention of ZAP.

Publication Types: 
    Clinical Trial
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 17511925 [PubMed - indexed for MEDLINE]

709: Am J Transplant. 2007 Jun;7(6):1666-71.

BK virus associated renal cell carcinoma: case presentation with optimized PCR
and other diagnostic tests.

Narayanan M, Szymanski J, Slavcheva E, Rao A, Kelly A, Jones K, Jaffers G.

Division of Nephrology, Scott & White Memorial Hospital and Clinic, Temple, TX,
USA. mnarayanan@swmail.sw.org

Polyomaviruses, including BK and JC viruses, have been associated with graft
failure, but have not commonly been associated with malignancy. We present a case
of renal cell carcinoma arising in an allograft kidney, in which the tumor and
metastasis contain viral DNA. Tumor and biopsy specimens from this patient were
examined with hematoxylin & eosin, immunohistochemistry (IHC) and in situ
hybridization (ISH). The results were confirmed by real-time polymerase chain
reaction (PCR) analysis with BKV primers. Other viruses including herpes simplex 
1-2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and varicella zoster were
not detected. The presence of BKV DNA in a renal cell carcinoma, including a
metastatic focus, adds to the evidence that this virus may play a role in cancers
of the kidney and urinary tract.

Publication Types: 
    Case Reports

PMID: 17511691 [PubMed - indexed for MEDLINE]

710: Rinsho Shinkeigaku. 2007 Feb-Mar;47(2-3):112-5.

[Case of Hashimoto's encephalopathy with diffuse white matter lesions on
diffusion-weighted MRI]

[Article in Japanese]

Okamoto K, Mori C, Kamogawa K, Tominaga K, Okuda B.

Department of Neurology, Ehime Prefectural Central Hospital.

A 65-year-old woman was admitted to our hospital because of subacute
deterioration of cognitive function. On admission, she presented with marked
disorientation of time and place and inability to carry out commands. Mini-Mental
State Examination score was 5/30. Although routine laboratory examinations
including thyroid function, vitamin B1 and B12, serum syphilitic reaction, sIL-2 
receptor level, titers of herpes simplex and zoster viruses, and HIV antibody
were normal, titers of anti-thyroglobulin (TG) antibodies and thyroid peroxidase 
(TPO) antibodies were elevated. Cerebrospinal fluid showed normal findings. Brain
MRI revealed diffuse high intensity in the white matter on diffusion- and
T2-weighted images, mimicking leukoencephalopathy. We made a diagnosis of
Hashimoto's encephalopathy, based on clinical features and high titers of
anti-thyroid antibodies. Following administration of steroid hormone, her
cognitive impairment gradually improved, associated with decrease of the white
matter abnormality on MRI. Hashimoto's encephalopathy should be kept in mind in
the differential diagnosis of subacute leukoencephalopathy with cognitive
decline.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17511280 [PubMed - indexed for MEDLINE]

711: Rinsho Shinkeigaku. 2007 Feb-Mar;47(2-3):105-8.

[Case of Horner's syndrome associated with ophthalmic herpes zoster]

[Article in Japanese]

Kobayashi Y, Yamamoto T.

Department of Rehabilitation, Fukui General Hospital.

We reported a 74-year-old man with right Horner's syndrome associated with
ophthalmic herpes zoster. He presented acute onset of pain, swelling, vesicular
cutaneous eruption around the right eyelid. A diagnosis of herpes zoster
ophthalmicus was made and he was started on acyclovir 750 mg/day. Seven days
later he manifested right abduction deficit On admission nine days later, the
right eyelid became ptotic and the right pupil was smaller than the left There
was gradual improvement over the next 10 days in ptosis and miosis, and over the 
next 3 weeks in the right abduction deficit. As the sympathetic nerve runs with
the carotid artery, it partially joins the sixth nerve within the cavernous
sinus. We have identified a patient in whom herpes zoster ophthalmicus has
resulted in a syndrome involving the sympathetic nerves, the sixth nerve, and the
first division of the fifth cranial nerve. As the Horner's syndrome was
transient, we might miss the symptom in the early stage, so we should carefully
examine the patients.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17511278 [PubMed - indexed for MEDLINE]

712: J Virol. 2007 Aug;81(15):8149-56. Epub 2007 May 16.

Simian varicella virus expresses a latency-associated transcript that is
antisense to open reading frame 61 (ICP0) mRNA in neural ganglia of latently
infected monkeys.

Ou Y, Davis KA, Traina-Dorge V, Gray WL.

Dept. of Microbiology and Immunology, Slot 511, University of Arkansas for
Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA.

Simian varicella virus (SVV) and varicella-zoster virus (VZV) are closely related
alphaherpesviruses that cause varicella (chickenpox) in nonhuman primates and
humans, respectively. After resolution of the primary disease, SVV and VZV
establish latent infection of neural ganglia and may later reactivate to cause a 
secondary disease (herpes zoster). This study investigated SVV gene expression in
neural ganglia derived from latently infected vervet monkeys. SVV transcripts
were detected in neural ganglia, but not in liver or lung tissues, of latently
infected animals. A transcript mapping to open reading frame (ORF) 61 (herpes
simplex virus type 1 [HSV-1] ICP0 homolog) was consistently detected in latently 
infected trigeminal, cervical, and lumbar ganglia by reverse transcriptase PCR.
Further analysis confirmed that this SVV latency-associated transcript (LAT) was 
oriented antisense to the gene 61 mRNA. SVV ORF 21 transcripts were also detected
in 42% of neural ganglia during latency. In contrast, SVV ORF 28, 29, 31, 62, and
63 transcripts were not detected in ganglia, liver, or lung tissues of latently
infected animals. The results demonstrate that viral gene expression is limited
during SVV latency and that a LAT antisense to an ICP0 homolog is expressed. In
this regard, SVV gene expression during latency is similar to that of HSV-1 and
other neurotropic animal alphaherpesviruses but differs from that reported for
VZV.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17507490 [PubMed - indexed for MEDLINE]

713: J Virol. 2007 Aug;81(15):7844-51. Epub 2007 May 16.

Varicella-Zoster virus IE63, a major viral latency protein, is required to
inhibit the alpha interferon-induced antiviral response.

Ambagala AP, Cohen JI.

Laboratory of Clinical Infectious Diseases, National Institutes of Health,
Bethesda, MD 20892, USA.

Varicella-zoster virus (VZV) open reading frame 63 (ORF63) is the most abundant
transcript expressed during latency in human sensory ganglia. VZV with ORF63
deleted is impaired for replication in melanoma cells and fibroblasts and for
latency in rodents. We found that replication of the ORF63 deletion mutant is
fully complemented in U2OS cells, which have been shown to complement the growth 
of herpes simplex virus type 1 (HSV-1) ICP0 mutants. Since HSV-1 ICP0 mutants are
hypersensitive to alpha interferon (IFN-alpha), we examined the effect of
IFN-alpha on VZV replication. Replication of the ORF63 mutant in melanoma cells
was severely inhibited in the presence of IFN-alpha, in contrast to other VZV
mutants that were similarly impaired for replication or to parental virus. The
VZV ORF63 mutant was not hypersensitive to IFN-gamma. IFN-alpha inhibited
viral-gene expression in cells infected with the ORF63 mutant at a
posttranscriptional level. Since IFN-alpha stimulates gene products that can
phosphorylate the alpha subunit of eukaryotic initiation factor 2 (eIF-2alpha)
and inhibit translation, we determined whether cells infected with the ORF63
mutant had increased phosphorylation of eIF-2alpha compared with cells infected
with parental virus. While phosphorylated eIF-2alpha was undetectable in
uninfected cells or cells infected with parental virus, it was present in cells
infected with the ORF63 mutant. Conversely, expression of IE63 (encoded by ORF63)
in the absence of other viral proteins inhibited phosphorylation of eIF-2alpha.
Since IFN-alpha has been shown to limit VZV replication in human skin xenografts,
the ability of VZV IE63 to block the effects of the cytokine may play a critical 
role in VZV pathogenesis.

Publication Types: 
    Research Support, N.I.H., Intramural

PMID: 17507475 [PubMed - indexed for MEDLINE]

714: Arq Bras Oftalmol. 2007 Jan-Feb;70(1):109-14.

Correlation between clinical diagnosis and PCR analysis of serum, aqueous, and
vitreous samples in patients with inflammatory eye disease.

Matos K, Muccioli C, Belfort Junior R, Rizzo LV.

Setor de Uveite e AIDS, Universidade Federal de Sao Paulo, Rua Pintassilgo 480,
Sao Paulo, SP, CEP 04514-032, Brazil. kimblematos@hotmail.com

PURPOSE: To study the applicability (sensitivity, specificity) of polymerase
chain reaction (PCR) tests in the detection of cytomegalovirus (CMV), herpes
virus (HSV) and varicella zoster (VZV), Epstein-Barr virus (EBV), Mycobacterium
sp and Toxoplasma gondii in the diagnosis of patients with or without AIDS, with 
presumably infectious uveitis, using serum, aqueous humor and vitreous humor
samples. METHODS: Twenty individuals with uveitis of presumed infectious origin
were evaluated. Sixteen of them had AIDS, four were immunocompetent individuals. 
We also evaluated 4 normal controls who underwent vitrectomy surgery. Clinical
evaluation of the patients was performed together by three clinicians. PCR
evaluations of the serum, aqueous, and vitreous humor were performed in a masked 
fashion by the laboratory staff. RESULTS: Twelve patients had a clinical
diagnosis of CMV retinitis. Of these 6 (50%) had a positive PCR for CMV in the
vitreous, three (25%) had a positive PCR for CMV in the serum, and none were
positive in the aqueous. Five patients had a clinical diagnosis of acute retinal 
necrosis (ARN). Three (60%) of these had positive PCR for HSV/VZV in the
vitreous. One of these patients had a positive PCR reaction for both EBV and
HSV/VZV in the vitreous samples. One patient with cutaneous herpes zoster had a
positive PCR reaction for HSV/VZV in the serum. Four patients had a presumed
diagnosis of ocular toxoplasmosis, one patient (25%) had a positive PCR for
Toxoplasma gondii in the serum, 3 (75%) had positive results in the aqueous, and 
2 (50%) had positive results in the vitreous. One patient with presumed ocular
tuberculosis had a positive PCR reaction both in the serum and in the vitreous
samples. Finally, none of the four control individuals revealed any positive PCR 
reaction. CONCLUSION: PCR is an auxiliary diagnostic procedure that should be
evaluated together with ophthalmological aspects of the patient.

PMID: 17505729 [PubMed - indexed for MEDLINE]

715: Minerva Ginecol. 2007 Apr;59(2):159-74.

Viral infections in pregnancy.

Haun L, Kwan N, Hollier LM.

Division of Maternal-Fetal Medicine, Department of Obstetrics, University of
Texas-Houston Medical School, Lyndon Baines Johnson General Hospital, 5656 Kelley
Street, Houston, TX 77026, USA.

Viral infections are a common complication of pregnancy and in some cases, can
have profound effects for the unborn fetus. The human herpesvirus family is
composed of large, enveloped DNA viruses that have close structural similarity.
The family includes the herpes simplex viruses types 1 and 2, varicella zoster
virus, Epstein Barr virus, cytomegalovirus (CMV), and human herpes viruses types 
6, 7 and 8. These viruses all share the ability to establish latency and
reactivate at a later time. Structural fetal abnormalities can result from
intrauterine infection and transmission of the infection during the pregnancy or 
at the time of delivery can result in important neonatal disease. Human
parvovirus B19 is a DNA virus with strong tropism for erythroid precursors and
infection during pregnancy can result in fetal hydrops and stillbirth. The
causative agents of hepatitis are hepatotropic viruses termed hepatitis A, B, C, 
D (deltavirus) and E. All except hepatitis B virus are RNA viruses. Vertical
transmission of maternal infection with hepatitis B and C can result in
significant long term sequelae.

Publication Types: 
    Review

PMID: 17505458 [PubMed - indexed for MEDLINE]

716: Br J Ophthalmol. 2007 Nov;91(11):1452-5. Epub 2007 May 15.

Acute retinal necrosis: a national population-based study to assess the
incidence, methods of diagnosis, treatment strategies and outcomes in the UK.

Muthiah MN, Michaelides M, Child CS, Mitchell SM.

The Western Eye Hospital, Marylebone Road, London NW1 5YE, UK.

AIM: To determine the incidence, methods of diagnosis, treatment strategies and
outcomes for acute retinal necrosis (ARN) in the UK. METHODS: A 12-month active
case ascertainment study was carried out between March 2001 and March 2002 to
record cases of ARN presenting to ophthalmologists via the British
Ophthalmological Surveillance Unit (BOSU) reporting system. Questionnaires were
sent to the reporting consultants, requesting data on patient characteristics,
presentation, clinical findings, investigations and treatment. Diagnosis was made
using the American Uveitis Society diagnostic criteria. Further questionnaires
were sent at 2 weeks and 6 months to assess outcome and therapies. RESULTS: 74
cases of ARN were reported by 58 consultants between March 2001 and March 2002.
Questionnaires were returned for 49 cases (66.2%), of which 18 (36.7%) were
excluded. Of the 31 cases included, 22 (71.0%) were male and 9 (29.0%) were
female. The age range was 13 to 85 years (mean 54.3 years). 28 cases (90.3%) were
unilateral, with 3 patients (9.7%) presenting with bilateral ARN. An aqueous or
vitreous biopsy was performed in only 18 patients, with one patient having both. 
Herpes viral DNA analysis was performed on all 19 biopsies, with identification
of the viral DNA in 16; results from 3 biopsies were not documented. Varicella
zoster virus (VZV) was the commonest cause identified in 10 patients (56%). Of
the 31 subjects, 27 (87.1%) were treated for ARN with systemic antiviral
treatment: with intravenous antiviral in 23 cases (85.2%) and oral antiviral in 4
cases (14.8%). 21 of these patients went on to receive oral antiviral maintenance
therapy. In addition to antiviral treatment, systemic steroids were given to 16
subjects (51.6%). Surgical intervention for retinal detachment was performed on 5
patients. CONCLUSIONS: During the 12-month study period, 31 cases of ARN met the 
diagnostic criteria set by the American Uveitis Society. The incidence in the UK 
based on this study is approximately 1 case per 1.6 to 2.0 million population per
year. We have ascertained that the management of ARN throughout the UK is
variable, suggesting that national guidelines would be of benefit.

Publication Types: 
    Multicenter Study

PMID: 17504853 [PubMed - indexed for MEDLINE]

717: Headache. 2007 May;47(5):728-30.

Sympathetic nerve blocks in mandibular herpes zoster and postherpetic neuralgia.

Gomes RT, de Nazareth Pedras RB, da Silva JF, de Aguiar MC.

Pain Clinic, Hospital das Clinicas Federal, University of Minas Gerais, Belo
Horizonte, MG, Brazil.

Sympathetic blocks have been indicated for the diagnosis and treatment of painful
neuropathic conditions, such as herpes zoster (HZ) and postherpetic neuralgia
(PHN). The purpose of this article is to report a case of mandibular HZ and PHN
in an HIV-positive patient, and discuss the efficacy of sympathetic nerve blocks 
for pain relief and prevention of PHN.

PMID: 17501858 [PubMed - indexed for MEDLINE]

718: Dermatol Online J. 2007 May 1;13(2):2.

Why do so many clinicians believe that recurrent zoster is common?

Chien AJ, Olerud JE.

The University of Washington Department of Medicine, Division of Dermatology,
Seattle, USA. andchien@u.washington.edu

PMID: 17498421 [PubMed - indexed for MEDLINE]

719: Nippon Rinsho. 2007 Mar 28;65 Suppl 3:326-30.

[Varicella-zoster virus infection]

[Article in Japanese]

Suzuki K, Suga S, Asano Y.

Department of Pediatrics, Toyokawa City Hospital.

Publication Types: 
    Review

PMID: 17494161 [PubMed - indexed for MEDLINE]

720: Wien Klin Wochenschr. 2007;119(7-8):217.

Hemorrhagic herpes zoster.

Steininger C, Huber J, Hauswirth A.

Department of Medicine I, Medical University Vienna, Vienna, Austria.
christoph.steininger@meduniwien.ac.at

Publication Types: 
    Case Reports

PMID: 17492347 [PubMed - indexed for MEDLINE]

721: Community Eye Health. 2003;16(47):35-6.

Herpes Zoster Ophthalmicus in HIV/AIDS.

Wiafe B.

Consultant Ophthalmologist, Medical Director, Lusaka Eye Hospital, Lusaka,
Zambia.

PMID: 17491842 [PubMed - in process]

722: J Am Osteopath Assoc. 2007 Mar;107(3 Suppl 1):S8-S13.

Management strategies for herpes zoster and postherpetic neuralgia.

Galluzzi KE.

Philadelphia College of Osteopathic Medicine, 4190 City Avenue, Philadelphia, PA 
19131-1633, USA. katherineg@pcom.edu

Evidence-based strategies for the management of herpes zoster and postherpetic
neuralgia (PHN) include the use of antiviral agents in acute zoster and specific 
analgesics in PHN. Antiviral agents are effective in reducing the severity and
duration of acute herpes zoster when given within 72 hours of rash onset, but
they do not prevent PHN. Anticonvulsants, tricyclic antidepressants, opioids, and
topical treatment modalities such as lidocaine-containing patches and capsaicin
cream offer moderate pain relief to some patients with PHN, but they may be
associated with adverse events that limit their use. Therefore, prevention of
herpes zoster and PHN with prophylactic vaccination using the zoster virus
vaccine is an effective strategy to reduce the morbidity of these conditions.
Treatment modalities are available, however, that may shorten the duration of
acute herpes zoster and alleviate the pain of PHN.

Publication Types: 
    Review

PMID: 17488885 [PubMed - indexed for MEDLINE]

723: J Am Osteopath Assoc. 2007 Mar;107(3 Suppl 1):S2-7.

The burden of herpes zoster and postherpetic neuralgia in the United States.

Weaver BA.

Armor Correctional Health Services, Hillsborough County Jail Medical Clinic, 520 
Falkenburg Road, Tampa, FL 33619, USA. bethanyg@myuw.net

Herpes zoster (shingles), a painful and disabling disease, affects an estimated 1
million individuals in the United States annually and results in significant
morbidity, lost productivity, and diminished quality of life. Herpes zoster
constitutes the reactivation of varicella-zoster virus (VZV), the same virus that
causes chickenpox. After resolution of chickenpox, VZV remains dormant in dorsal 
root ganglia. Varicella-zoster-specific cell-mediated immunity wanes naturally
with advancing age or earlier in the setting of an altered immune status, which
can result in the reactivation of VZV as herpes zoster. The pain associated with 
the rash caused by herpes zoster is often described as burning, stabbing,
itching, or aching. Postherpetic neuralgia, the most common complication of
herpes zoster, occurs after the zoster rash has resolved, affecting up to a third
of patients. Herpes zoster is associated with significant morbidity, especially
in the elderly. Herpes zoster is both more common and more severe among older
adults. In both acute herpes zoster and postherpetic neuralgia, pain is the
primary cause of morbidity.

Publication Types: 
    Review

PMID: 17488884 [PubMed - indexed for MEDLINE]

724: J Am Osteopath Assoc. 2007 Mar;107(3 Suppl 1):S14-8.

Herpes zoster vaccine: clinical trial evidence and implications for medical
practice.

Burke MS.

Internal Medicine Clinical Care Center, Lankenau Hospital, 100 Lancaster Avenue, 
Area B15, Wynnewood, PA 19096-3450, USA. burkes@mlhs.org

This review of the data from the Shingles Prevention Study (SPS) highlights the
efficacy and safety of a high-titer live attenuated herpes zoster virus vaccine
in preventing herpes zoster and postherpetic neuralgia (PHN) in adults aged 60
years or older. In the SPS, the vaccine reduced the burden of illness due to
herpes zoster disease by 61.1% and the incidence of its most common and
debilitating sequela, PHN, by 66.5%. In addition, vaccination was associated with
a 51.3% reduction in the overall incidence of herpes zoster. Also, subjects in
whom herpes zoster did develop had decreased pain and discomfort. The vaccine was
safe in the SPS population, with little differentiation from the safety profile
of placebo other than an increased risk for reactions at the injection site.
Rates of serious adverse events, systemic adverse events, hospitalization, and
death were low and similar to those observed in the group that received placebo.

Publication Types: 
    Review

PMID: 17488883 [PubMed - indexed for MEDLINE]

725: Nat Biotechnol. 2007 Jun;25(6):663-8. Epub 2007 May 7.

Comment in:
    Nat Biotechnol. 2007 Jun;25(6):645-6.

Genome-scale analysis of in vivo spatiotemporal promoter activity in
Caenorhabditis elegans.

Dupuy D, Bertin N, Hidalgo CA, Venkatesan K, Tu D, Lee D, Rosenberg J, Svrzikapa 
N, Blanc A, Carnec A, Carvunis AR, Pulak R, Shingles J, Reece-Hoyes J,
Hunt-Newbury R, Viveiros R, Mohler WA, Tasan M, Roth FP, Le Peuch C, Hope IA,
Johnsen R, Moerman DG, Barabasi AL, Baillie D, Vidal M.

Center for Cancer Systems Biology, Department of Cancer Biology, Dana-Farber
Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115, USA.

Differential regulation of gene expression is essential for cell fate
specification in metazoans. Characterizing the transcriptional activity of gene
promoters, in time and in space, is therefore a critical step toward
understanding complex biological systems. Here we present an in vivo
spatiotemporal analysis for approximately 900 predicted C. elegans promoters
(approximately 5% of the predicted protein-coding genes), each driving the
expression of green fluorescent protein (GFP). Using a flow-cytometer adapted for
nematode profiling, we generated 'chronograms', two-dimensional representations
of fluorescence intensity along the body axis and throughout development from
early larvae to adults. Automated comparison and clustering of the obtained in
vivo expression patterns show that genes coexpressed in space and time tend to
belong to common functional categories. Moreover, integration of this data set
with C. elegans protein-protein interactome data sets enables prediction of
anatomical and temporal interaction territories between protein partners.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 17486083 [PubMed - indexed for MEDLINE]

726: JAAPA. 2007 Apr;20(4):16.

New drug information. Product: Zostavax.

[No authors listed]

PMID: 17484325 [PubMed - indexed for MEDLINE]

727: Int J Hematol. 2007 Apr;85(3):242-5.

Quantification of circulating varicella-zoster virus DNA for follow-up in a case 
of visceral varicella-zoster infection ameliorated with intravenous acyclovir.

Ishizawa J, Fujita H, Iguchi M, Tachibana T, Taguchi J, Ishigatsubo Y.

Department of Hematology, Shizuoka Red Cross Hospital, Shizuoka, Japan.

We describe a patient with acute lymphocytic leukemia (ALL) who developed
visceral varicella-zoster virus (VZV) infection following cord blood stem cell
transplantation (CBSCT) and was successfully treated with intravenous acyclovir
(ACV). A 24-year-old woman with ALL developed severe epigastric pain 168 days
after CBSCT, followed by blistering eruptions 2 days later. A diagnosis of
visceral varicella-zoster disease was made, and early intravenous ACV therapy
successfully alleviated the epigastric pain and skin lesions within 2 weeks.
Polymerase chain reaction analysis of the serum showed dramatic decreases in the 
viral DNA copy number and revealed large viral concentrations prior to the skin
manifestations. The viral DNA copy number in whole blood remained positive,
however, but was reduced. Further treatment with intravenous ACV led to VZV DNA
becoming undetectable in whole blood, a result not achieved with oral
valacyclovir.

Publication Types: 
    Case Reports

PMID: 17483062 [PubMed - indexed for MEDLINE]

728: Am J Prev Med. 2007 May;32(5):370-4.

Preventive misconception: its nature, presence, and ethical implications for
research.

Simon AE, Wu AW, Lavori PW, Sugarman J.

National Center for Health Statistics, Centers for Disease Control and
Prevention, Hyattsville, Maryland, USA.

BACKGROUND: Ethical aspects of prevention trials, as they differ from therapeutic
trials, have not been fully explored. This article aims to define and demonstrate
the existence of "preventive misconception" (PM), a misunderstanding in which
research participants in prevention trials make an "overestimate in probability
or level of personal protection that is afforded by being enrolled in a trial of 
a preventive intervention." METHODS: A rating tool was developed to evaluate PM, 
using data collected between August 2000 and July 2002 as part of a nationwide
study of the quality of informed consent in a trial of a shingles vaccine. During
2005-2006, two pair of raters assessed the responses of 50 participants to
questions asked after the participants had given consent to participate in the
shingles trial. Two pair of raters evaluated the response for the presence and
type of PM. Each pair of raters adjudicated their responses and inter-rater
reliability was assessed. RESULTS: Adjudicated pairs of raters agreed that 32%
(CI: 20.7%-45.9%) of participants showed evidence of PM (kappa=0.71, CI:
0.52-0.90); that 12% (CI: 5.2%-24.2%) of participants underestimated the
probability of receiving placebo (kappa=0.53, CI: 0.24-0.83); and that 24% (CI:
14.2%-37.6%) overestimated the likely personal effectiveness of the experimental 
intervention (kappa=0.42, CI: 0.08-0.76). CONCLUSIONS: This study newly describes
the concept of preventive misconception and empirically demonstrates its
existence in trials of prevention. Study participants may overestimate the
protection that they receive by being enrolled in a trial of prevention, which
poses ethical challenges for research.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17478261 [PubMed - indexed for MEDLINE]

729: Inflamm Bowel Dis. 2007 Sep;13(9):1178-9.

Comment on:
    Clin Gastroenterol Hepatol. 2006 Dec;4(12):1483-90.

Nailing down the shingles in IBD.

Kotton CN.

Infectious Diseases Division, Massachusetts General Hospital, 55 Fruit Street Cox
5, Boston, MA 02114, USA.

Publication Types: 
    Comment

PMID: 17476676 [PubMed]

730: J Fam Pract. 2007 May;56(5):377-80.

Immunization update: latest recommendations from the CDC.

Campos-Outcalt D.

Department of Family and Community Medicine, University of Arizona College of
Medicine, Phoenix, USA. dougco@u.arizona.edu

PMID: 17475169 [PubMed - indexed for MEDLINE]

731: Philos Trans R Soc Lond B Biol Sci. 2007 Nov 29;362(1487):2105-21.

Hypoxia and the antipredator behaviours of fishes.

Domenici P, Lefrancois C, Shingles A.

CNR-IAMC, c/o International Marine Centre, Localita Sa Mardini, 09072
Torregrande, Oristano, Italy. paolo.domenici@iamc.cnr.it

Hypoxia is a phenomenon occurring in marine coastal areas with increasing
frequency. While hypoxia has been documented to affect fish activity and
metabolism, recent evidence shows that hypoxia can also have a detrimental effect
on various antipredator behaviours. Here, we review such evidence with a focus on
the effect of hypoxia on fish escape responses, its modulation by aquatic surface
respiration (ASR) and schooling behaviour. The main effect of hypoxia on escape
behaviour was found in responsiveness and directionality. Locomotor performance
in escapes was expected to be relatively independent of hypoxia, since escape
responses are fuelled anaerobically. However, hypoxia decreased locomotor
performance in some species (Mugilidae) although only in the absence of ASR in
severe hypoxia. ASR allows fish to show higher escape performance than fish
staying in the water column where hypoxia occurs. This situation provides a
trade-off whereby fish may perform ASR in order to avoid the detrimental effects 
of hypoxia, although they would be subjected to higher exposure to aerial
predation. As a result of this trade-off, fishes appear to minimize surfacing
behaviour in the presence of aerial predators and to surface near shelters, where
possible. For many fish species, schooling can be an effective antipredator
behaviour. Severe hypoxia may lead to the disruption of the school unit. At
moderate levels, hypoxia can increase school volume and can change the shuffling 
behaviour of individuals. By altering school structure and dynamics, hypoxia may 
affect the well functioning of schooling in terms of synchronization and
execution of antipredator manoeuvres. School structure and volume appear to be
the results of numerous trade-offs, where school shape may be dictated by the
presence of predators, the need for energy saving via hydrodynamic advantages and
oxygen level. The effects of hypoxia on aquatic organisms can be taxon specific. 
While hypoxia may not necessarily increase the vulnerability of fish subject to
predation by other fish (since feeding in fish also decreases in hypoxia),
predators from other taxa such as birds, jellyfish or aquatic mammals may take
advantage of the detrimental effects of hypoxia on fish escape ability.
Therefore, the effect of hypoxia on fish antipredator behaviours may have major
consequences for the composition of aquatic communities.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 17472921 [PubMed - indexed for MEDLINE]

732: Int J Dermatol. 2007 May;46(5):500-2.

Comment in:
    Int J Dermatol. 2008 Oct;47(10):1087.

Localized linear IgA dermatosis induced by UV light-treatment for herpes zoster.

He C, Xu H, Xiao T, Geng L, Chen HD.

Department of Dermatology, No. 1 Hospital of China Medical University, Shenyang, 
China.

We report a case of localized linear IgA dermatosis (LID). The patient suffered
from herpes zoster on the right waist and received three localized ultraviolet
(UV) light treatments. One month later he presented with bullae on the same site.
Direct immunofluorescence showed deposition of linear IgA and weak C3 along the
basement membrane zone. Indirect immunofluorescence on the salt-split human skin 
demonstrated that IgA antibodies were bound to the epidermal side. To our
knowledge, this is the first case of localized LID induced by UV light treatment 
for herpes zoster. It is also the third case of LID induced by UV light.

Publication Types: 
    Case Reports

PMID: 17472682 [PubMed - indexed for MEDLINE]

733: Holist Nurs Pract. 2007 May-Jun;21(3):124-34.

Postherpetic neuralgia in older adults: culture, quality of life, and the use of 
alternative/complementary therapies.

Young MK, Wood M, Jean-Noel N.

Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades
Road, Boca Raton, FL 33431, USA. myoung@pbiho.net

The purpose of this article is to describe current knowledge and standards of
care for postherpetic neuralgia (PHN) among older persons. Three influencing
factors are considered: cultural implications, quality of life (QOL), and current
practice of alternative/complementary therapy. A review of literature published
between 2001 and 2006 was conducted. The findings indicate that PHN has
debilitating effects on older adults regardless of culture. The impact of PHN on 
culture and ethnicity, particularly on the relationship between culture and
patient's self-report of herpes zoster and/or PHN, has not been well investigated
as evidenced in the literature. PHN is found to be associated with decreased
health-related QOL among the elderly, with the most affected domains being sleep,
mood, and general activity. Alternative and complementary therapy offers many
advantages such as ease of use, availability, and low cost. However, due to lack 
of controlled trials and insufficient evidence, alternative therapy is not
currently used widely and recommended. As the US population ages, the incidence
of herpes zoster and PHN is expected to rise. Clinical trials that explore the
response of the culturally diverse older adults to current treatment guidelines, 
strategies for prevention of PHN and its corresponding decrease in QOL, as well
as controlled trials of alternative/complementary remedies should be considered.

Publication Types: 
    Review

PMID: 17471050 [PubMed - indexed for MEDLINE]

734: J Cataract Refract Surg. 2007 May;33(5):925-6.

Spontaneous intraocular lens extrusion in a patient with scleromalacia secondary 
to herpes zoster ophthalmicus.

Ahmed TY, Carrim ZI, Diaper CJ, Wykes WN.

Department of Ophthalmology, Southern General Hospital, Glasgow, Scotland.
tahaahmed@doctors.org.uk

We report a case of spontaneous intraocular lens (IOL) extrusion in association
with scleromalacia 10 years after uneventful endocapsular surgery. The patient
had a history of iridocyclitis secondary to herpes zoster ophthalmicus in the
affected eye. A minimally invasive approach involving repositioning the IOL and
closure with a conjunctival flap resulted in restoration of visual acuity.

Publication Types: 
    Case Reports

PMID: 17466876 [PubMed - indexed for MEDLINE]

735: J Pediatr Gastroenterol Nutr. 2007 May;44(5):637-9.

Varicella recurrence complicated by pneumonia after liver transplantation for
APECED.

Batra A, Davison S, Rajwal S, Hale A, Stringer MD, McClean P.

Children's Liver & GI Unit, St James's University Hospital, Leeds, UK.

Publication Types: 
    Case Reports

PMID: 17460500 [PubMed - indexed for MEDLINE]

736: Korean J Ophthalmol. 2007 Mar;21(1):51-4.

Progressive outer retinal necrosis combined with vitreous hemorrhage in a patient
with acquired immunodeficiency syndrome.

You YS, Lee SJ, Lee SH, Park CH, Kwon OW.

NUNE Eye Hospital, Seoul, Korea.

PURPOSE: To describe an unusual case of rapidly progressive outer retinal
necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired
immunodeficiency syndrome (AIDS), who had retinitis developed from what was
probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes
simplex type 1,2, as proven by the polymerase chain reaction restriction fragment
length polymorphism method (PCR-RFLP). METHODS: This study is a case report
detailing clinical follow-up and an aqueous humor test by PCR-RFLP. RESULTS: The 
deep, white retinal lesions coalesced and progressively expanded in a
circumferential manner, with sparing of the perivascular retina. However, retinal
and vitreous hemorrhages, unusual findings for PORN, could be noted around the
optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes
simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR.
CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic
retinopathy, occurring particularly in patients with AIDS. Although the etiologic
agent has been reported to be VZV, concurrent or combined etiologic agents can
include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral
therapy with acyclovir and ganciclovir could be more reasonable as an initial
therapy.

Publication Types: 
    Case Reports

PMID: 17460434 [PubMed - indexed for MEDLINE]

737: Klin Monatsbl Augenheilkd. 2007 Apr;224(4):360-3.

Retinal detachment in patients with acute retinal necrosis: a case series.

Abegg M, Kurz-Levin M, Helbig H.

Department of Ophthalmology, University Hospital Zurich, Switzerland.
mhabegg@hispeed.ch

BACKGROUND: Acute retinal necrosis is a rare and severe infectious ocular disease
frequently complicated by retinal detachment. PATIENTS AND METHODS: Records of
six consecutive eyes from five patients with acute retinal necrosis were
reviewed. RESULTS: PCR analysis of intraocular fluids was positive for Varizella 
zoster virus, Herpes virus 1 or 2. Treatment consisted of systemic acyclovir,
systemic and local corticosteroids as well as aspirin. Progression of the
necrosis could be effectively controlled, however all eyes developed retinal
detachment within 55 +/- 24 days. Retinal surgery including pars plana
vitrectomy, encircling scleral buckling, liquid silicone or gas filling led to
retinal reattachment in all patients during the follow-up time (590 +/- 242
days). The mean visual acuity at the end of the follow-up time was 0.4 +/- 0.3.
CONCLUSIONS: The diagnosis of acute retinal necrosis is reliably confirmed using 
PCR analysis of intraocular fluids. Currently available treatments are effective 
in stopping progression of the necrosis. There is, however, a high risk of
retinal detachment, which can be successfully treated with vitreoretinal surgery.

Publication Types: 
    Case Reports

PMID: 17458815 [PubMed - indexed for MEDLINE]

738: Nippon Rinsho. 2007 Feb 28;65 Suppl 2 Pt. 1:480-6.

[Antiviral resistance of herpes simplex virus and varicella-zoster virus]

[Article in Japanese]

Daikoku T, Shiraki K.

Department of Virology, University of Toyama.

Publication Types: 
    Review

PMID: 17455667 [PubMed - indexed for MEDLINE]

739: Rev Chilena Infectol. 2007 Apr;24(2):106-10. Epub 2007 Apr 12.

[Erroneous prescriptions of aciclovir and valaciclovir in herpes zoster
treatment]

[Article in Spanish]

Fica C A, Jadue A C, Donaire R L.

Seccion de Infectologia, Hospital Clinico, Universidad de Chile, Departamento de 
Medicina, Santiago, Chile. afica@redclinicauchile.cl

Medical prescription errors are frequent in community settings and information
exploring its magnitude during antiviral treatment of herpes zoster is scarce. A 
questionnaire was applied to 31 physicians working in hospital- or
community-based settings in Santiago, Chile in order to characterize their dosing
and timing preferences for aciclovir or valaciclovir prescriptions. Aciclovir was
more often prescribed than valaciclovir (71.9 and 28.1%, respectively), but less 
than a third of prescription (27.3%) fulfilled the minimal aciclovir dosing and
timing criteria for clinical efficacy (4 gr per day and <72 hours since rash
initiation). The limited size of the simple prevented exploring factors linked to
a misleading prescription. Appropriate knowledge on dosing and timing of
aciclovir/valaciclovir therapy for herpes zoster was infrequent in a sample of
physicians working in various clinical settings in Chile.

Publication Types: 
    English Abstract

PMID: 17453067 [PubMed - indexed for MEDLINE]

740: Pain. 2007 Sep;131(1-2):214-8. Epub 2007 Apr 23.

Relief of post-herpetic neuralgia by surgical removal of painful skin: 5 years
later.

Petersen KL, Rowbotham MC.

UCSF Pain Clinical Research Center, Department of Neurology, University of
California, San Francisco, CA 94115, USA. karin.petersen@ucsf.edu

Surgical removal of painful skin was first attempted as a treatment for chronic
intractable post-herpetic neuralgia (PHN) more than a century ago, but long-term 
follow-up has rarely been reported. A patient who underwent surgical excision of 
294cm(2) of thoracic skin comprising the entire area of pain and allodynia in
October 2000 has been followed for 5.5years post-surgery. Our initial report
presented evidence of benefit in the form of reduced pain, elimination of
allodynia, and reduced medication consumption during the first post-operative
year. Unfortunately, pain steadily increased and now exceeds pre-surgery levels
despite increased medication use. Pain topography and characteristics are
different from pre-surgery and may relate to the pathophysiology of PHN. Skin
resection cannot be recommended as a treatment for PHN.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17451877 [PubMed - indexed for MEDLINE]

741: J Eur Acad Dermatol Venereol. 2007 May;21(5):712-3.

Ambilateral reactivation of herpes zoster V2 following cataract operation of both
eyes.

Korber A, Franckson T, Grabbe S, Dissemond J.

Publication Types: 
    Case Reports
    Letter

PMID: 17448008 [PubMed - indexed for MEDLINE]

742: J Eur Acad Dermatol Venereol. 2007 May;21(5):711-2.

Prurigo nodularis in healed herpes zoster scar: an isotopic response.

De D, Dogra S, Kanwar AJ.

Publication Types: 
    Case Reports
    Letter

PMID: 17448007 [PubMed - indexed for MEDLINE]

743: J Microbiol Immunol Infect. 2007 Apr;40(2):116-22.

Coinfection and clinical manifestations of tuberculosis in human immunodeficiency
virus-infected and -uninfected adults at a teaching hospital, northwest Ethiopia.

Kassu A, Mengistu G, Ayele B, Diro E, Mekonnen F, Ketema D, Moges F, Mesfin T,
Getachew A, Ergicho B, Elias D, Aseffa A, Wondmikun Y, Ota F.

Department of Microbiology and Parasitology, University of Gondar, Gondar,
Ethiopia. afeworkkassu@yahoo.com

BACKGROUND AND PURPOSE: The pattern of clinical presentations of tuberculosis
(TB) is reflected in the microbiological, radiological, and histological
characteristics of the disease. However, coinfection with human immunodeficiency 
virus (HIV) poses special diagnostic and therapeutic challenges. This study was
aimed at assessing the clinical manifestations of TB in patients with or without 
HIV coinfection in a hospital-based cross-sectional study in Gondar, Ethiopia.
METHODS: TB was diagnosed following standard clinical, bacteriological,
radiological, and histological procedures. HIV serostatus was checked by
enzyme-linked immunosorbent assay. RESULTS: This study included 257 TB patients, 
of whom 52.1% were coinfected with HIV. Pulmonary TB and extrapulmonary TB were
diagnosed in 64.2% and 35.8% of the patients, respectively. No significant
association was found between sputum smear positivity and HIV serostatus.
One-fifth of the patients reported hemoptysis. More than one-third had chest
pain, and >90% reported fever and weight loss. Night sweats and cough were
reported by 86% and 82.5%, respectively. Coarse crepitations were the most
frequent auscultatory finding (33.9%). Sputum smear positivity rate was 26.8%.
Cavitation was significantly associated with sputum smear positivity (odds ratio 
= 9.0, 95% confidence interval = 2.4-34.1). Wasting, cough of <or=5 months'
duration, crepitation, chronic diarrhea, and herpes zoster scar were
significantly associated with HIV-positive serology. CONCLUSION: Coinfection with
HIV was very high in patients with TB. The presence of herpes zoster scar,
chronic diarrhea, coarse crepitations, and cough of <or=5 months' duration may
assist in identifying TB patients with HIV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17446959 [PubMed - indexed for MEDLINE]

744: Cochrane Database Syst Rev. 2007 Apr 18;(2):CD004846.

Comment in:
    Evid Based Dent. 2007;8(3):85-6.

Topical lidocaine for the treatment of postherpetic neuralgia.

Khaliq W, Alam S, Puri N.

BACKGROUND: The cause of postherpetic neuralgia is damage to peripheral neurons, 
dorsal root ganglia, and the dorsal horn of the spinal cord, secondary to herpes 
zoster infection (shingles). In postherpetic neuralgia, peripheral neurons
discharge spontaneously and have lowered activation thresholds, and exhibit an
exaggerated response to stimuli. Topical lidocaine dampens peripheral nociceptor 
sensitisation and central nervous system hyperexcitability, and may benefit
patients with postherpetic neuralgia. OBJECTIVES: To examine the efficacy and
safety of topical lidocaine in the treatment of postherpetic neuralgia. SEARCH
STRATEGY: We searched the Cochrane Pain, Palliative and Supportive Care Group
Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL),
MEDLINE, EMBASE, and LILACS, SIGLE for conference proceedings, Citation Index,
the reference lists of all eligible trials, key textbooks, and previous
systematic reviews. We also wrote to authors of all identified trials. SELECTION 
CRITERIA: Randomised or quasi-randomised trials comparing all topical
applications of lidocaine, including gels and patches in patients of all ages
with postherpetic neuralgia (pain persisting at the site of shingles at least one
month after the onset of the acute rash). DATA COLLECTION AND ANALYSIS: Two
review authors extracted data, and a third checked them. We obtained some missing
data from the US Food and Drugs Administration. MAIN RESULTS: Three trials
involving 182 topical lidocaine treated participants and 132 control participants
were included. Two trials gave data on pain relief, and the remaining study
provided data on secondary outcome measures. The largest trial published as an
abstract compared topical lidocaine patch to a placebo patch and accounted for
150 of the 314 patients (48%).A meta-analysis combining two of the three studies 
identified a significant difference between the topical lidocaine and control
groups for the primary outcome measure: a mean improvement in pain relief
according to a pain relief scale. Topical lidocaine relieved pain better than
placebo (P = 0.003).There was a statistical difference between the groups for the
secondary outcome measure of mean VAS score reduction (P = 0.03), but this was
only for a single small trial. There were a similar number of adverse skin
reactions in both treatment and placebo groups.The highest recorded blood
lidocaine concentration varied between 59 ng/ml and 431 ng/ml between trials. The
latter figure is high and the authors of the study suggest that the sample had
been contaminated during the assay procedure. AUTHORS' CONCLUSIONS: There is
insufficient evidence to recommend topical lidocaine as a first-line agent in the
treatment of postherpetic neuralgia with allodynia. Further research should be
undertaken on the efficacy of topical lidocaine for other chronic neuropathic
pain disorders, and also to compare different classes of drugs (e.g. topical
anaesthetics versus anti-epileptics).

Publication Types: 
    Meta-Analysis
    Review

PMID: 17443559 [PubMed - indexed for MEDLINE]

745: Clin Infect Dis. 2007 May 15;44(10):1280-8. Epub 2007 Apr 3.

Comment in:
    Clin Infect Dis. 2007 Dec 1;45(11):1527-9.

Cost-effectiveness of a vaccine to prevent herpes zoster and postherpetic
neuralgia in older adults.

Rothberg MB, Virapongse A, Smith KJ.

Division of General Medicine and Geriatrics, Department of Medicine, Baystate
Medical Center, Springfield, MA 01199, USA. Michael.Rothberg@bhs.org

BACKGROUND: A vaccine to prevent herpes zoster was recently approved by the
United States Food and Drug Administration. We sought to determine the
cost-effectiveness of this vaccine for different age groups. METHODS: We
constructed a cost-effectiveness model, based on the Shingles Prevention Study,
to compare varicella zoster vaccination with usual care for healthy adults aged
>60 years. Outcomes included cost in 2005 US dollars and quality-adjusted life
expectancy. Costs and natural history data were drawn from the published
literature; vaccine efficacy was assumed to persist for 10 years. RESULTS: For
the base case analysis, compared with usual care, vaccination increased
quality-adjusted life expectancy by 0.0007-0.0024 quality-adjusted life years per
person, depending on age at vaccination and sex. These increases came almost
exclusively as a result of prevention of acute pain associated with herpes zoster
and postherpetic neuralgia. Vaccination also increased costs by $94-$135 per
person, compared with no vaccination. The incremental cost-effectiveness ranged
from $44,000 per quality-adjusted life year saved for a 70-year-old woman to
$191,000 per quality-adjusted life year saved for an 80-year-old man. For the
sensitivity analysis, the decision was most sensitive to vaccine cost. At a cost 
of $46 per dose, vaccination cost <$50,000 per quality-adjusted life year saved
for all adults >60 years of age. Other variables related to the vaccine
(duration, efficacy, and adverse effects), postherpetic neuralgia (incidence,
duration, and utility), herpes zoster (incidence and severity), and the discount 
rate all affected the cost-effectiveness ratio by >20%. CONCLUSIONS: The
cost-effectiveness of the varicella zoster vaccine varies substantially with
patient age and often exceeds $100,000 per quality-adjusted life year saved. Age 
should be considered in vaccine recommendations.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17443464 [PubMed - indexed for MEDLINE]

746: Intern Med. 2007;46(8):535-6. Epub 2007 Apr 17.

Isolated trochlear nerve palsy in herpes zoster ophthalmicus.

Tsuda H, Ito T, Yoshioka M, Ishihara N, Sekine Y.

The Department of Internal Medicine, National Health Insurance Minamitama
Hospital, Tokyo. tsuda@minamitama.jp

Publication Types: 
    Case Reports

PMID: 17443053 [PubMed - indexed for MEDLINE]

747: Br J Dermatol. 2007 Jun;156(6):1369-71. Epub 2007 Apr 17.

Multiple dermatomal daughter lesions of postzoster granuloma.

Araki E, Kambe N, Takahashi K, Miyachi Y, Utani A.

Publication Types: 
    Case Reports
    Letter

PMID: 17441956 [PubMed - indexed for MEDLINE]

748: Br J Neurosurg. 2006 Dec;20(6):423-6.

Herpes zoster of the trigeminal nerve following microvascular decompression.

Simms HN, Dunn LT.

Department of Neurosurgery, Institute of Neurological Science, Southern General
Hospital, Glasgow, UK.

A patient developed herpes zoster of the maxillary division of the trigeminal
nerve after microvascular decompression. Varicella zoster virus lies dormant in
the Gasserian ganglion until reactivation and can cause herpes zoster
ophthalmicus. This can result in serious ocular complications including
blindness. Antiviral agents are effective if commenced promptly.

Publication Types: 
    Case Reports

PMID: 17439097 [PubMed - indexed for MEDLINE]

749: Rev Med Chir Soc Med Nat Iasi. 2006 Oct-Dec;110(4):852-5.

[Varicella-zoster infection--extreme clinical aspects]

[Article in Romanian]

Maniciuc C, Dorobat C, Hurmuzache M, Mihalache D, Luca V.

Facultatea de Medicina, Universitatea de Medicina "Gr.T. Popa", Iasi.

Infections with the varicella-zoster (VZ) virus are a constant of our everyday
practice. The aim of the present study is that of underlining unusual aspects of 
the infection with the VZ virus--primary infection in adults and herpes zoster in
children. If varicella, or chickenpox, has been traditionally considered a
childhood disease, nowadays, an increased number of adults are affected by
primary infections. On the contrary, more and more children present the secondary
form of the infection, which appears as herpes zoster, a disease usually
diagnosed in adults. MATERIAL AND METHODS: We studied the observation papers of
adult patients with varicella, hospitalized in our clinic during 2004-2005 and we
analyzed the herpes zoster manifestations in non-HIV children, diagnosed with the
disease during the same period of time. RESULTS: During 2004-2005, 34 adult
patients were diagnosed with varicella, while 10 children presented herpes
zoster. 16 of the adults with varicella were 25-34 years old. One of the children
with herpes zoster was less than one year old. All the adults with varicella were
treated with acyclovir; in 14 cases, the therapy was supplemented with
rifampicin. All the children with herpes zoster came from rural areas. The
pathology that determined the decrease of general immunity was represented by
neoplasia (3 cases), malnutrition and rickets (2 cases), associated infectious
pathologies--bronchopneumonia (3 cases). CONCLUSIONS: Varicella in adults has an 
increased incidence, which is underestimated, in our opinion. Its loud clinical
manifestations impose the therapy with acyclovir. Herpes zoster in children
reveals significant subsidiary pathologies and a depressed immune system that
impose special medical care and many days of hospitalization.

Publication Types: 
    English Abstract

PMID: 17438887 [PubMed - indexed for MEDLINE]

750: Medicine (Baltimore). 2007 Mar;86(2):78-92.

Cryptococcosis and idiopathic CD4 lymphocytopenia.

Zonios DI, Falloon J, Huang CY, Chaitt D, Bennett JE.

Clinical Mycology Section, Laboratory of Clinical Infectious Diseases, National
Institute of Allergy and Infectious Diseases, National Institutes of Health,
Bethesda, Maryland 20892, USA. zoniosd@niaid.nih.gov

We reviewed the cases of 11 patients with cryptococcosis and idiopathic CD4
lymphocytopenia (ICL) referred to our institution in the previous 12 years, as
well as 42 similar cases reported in the literature, to assess the
characteristics of the infection in this population. Cryptococcosis in 53
patients with ICL had features in common with cryptococcosis in previously normal
patients. ICL patients had a slight male predominance (1.2:1) and a median age of
presentation of 41 years (range, 4.5-85 yr). Initial cerebrospinal fluid findings
showed glucose below 40 mg/dL in 60% of the patients, a median pleocytosis of 59 
white blood cells/mm (range, 0-884), and protein of 156 mg/dL (range, 25-402
mg/dL). The median CD4 count at diagnosis of ICL and at the last available
measurement was 82 (range, 7-292) and 132 (range, 13-892) cells/mm, respectively,
for an average follow-up of 32 months in 46 patients. Unlike previously normal
patients with cryptococcosis, those with ICL had an excess incidence of
dermatomal zoster (7 episodes in 46 ICL cases). Pneumocystis pneumonia was rare
(1 case), casting doubt on the need for prophylaxis in patients with ICL. A
favorable outcome (cured or improved) may be more common in ICL patients than in 
previously normal patients with cryptococcal meningitis and no predisposing
factors. Identification of ICL in patients who were apparently normal before the 
onset of cryptococcosis appears to be useful because it predicts a favorable
outcome. Patients with cryptococcal infection and ICL have an increased
likelihood of developing dermatomal zoster. The long-term follow-up of these
patients offers some reassurance regarding favorable prognosis.

PMID: 17435588 [PubMed - indexed for MEDLINE]

751: Am J Ophthalmol. 2007 Jun;143(6):1003-1008. Epub 2007 Apr 16.

Multifocal posterior necrotizing retinitis.

Margolis R, Brasil OF, Lowder CY, Smith SD, Moshfeghi DM, Sears JE, Kaiser PK.

Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

PURPOSE: To describe the clinical features of an acute, inflammatory, and
progressive retinal necrosis that affects primarily the posterior pole. DESIGN:
Retrospective, interventional case series. METHODS: Twenty-seven eyes of 24
patients diagnosed with and treated for acute retinal necrosis (ARN) were
categorized into two groups according to the predominant location of retinitis at
presentation: either in the peripheral retina or in the posterior pole. Clinical 
features, disease progression, visual outcomes, and complications of these two
groups were compared. RESULTS: Fifteen eyes demonstrated the known peripheral
retinitis pattern, and 12 eyes exhibited a pattern of retinitis that affected
mainly the posterior pole. Eyes with peripheral retinitis showed focal,
well-demarcated areas of retinal necrosis in the periphery with rapid
circumferential progression and rare involvement of the posterior pole. All eyes 
with posterior pole retinitis had multifocal deep lesions posterior to the vortex
veins at presentation, and half of these eyes had lesions in the macula. These
lesions progressed to patches of confluent retinitis in both the periphery and
the posterior pole. There was no significant difference between the two groups in
the incidence of anterior chamber and vitreous cells, vascular sheathing, retinal
hemorrhages, or optic disk edema. Patients with posterior retinitis involvement
seemed to have a worse visual outcome during the first two years after diagnosis.
The Cox proportional hazards model suggested a higher incidence of retinal
detachment in patients with posterior retinitis (P = .07). CONCLUSIONS: The
authors report a pattern of herpetic retinitis that affects predominantly the
posterior pole and may have a worse visual prognosis and a higher rate of retinal
detachment.

PMID: 17434436 [PubMed - indexed for MEDLINE]

752: Bioorg Med Chem Lett. 2007 Jun 15;17(12):3349-53. Epub 2007 Apr 5.

2-Aryl-2-hydroxyethylamine substituted 4-oxo-4,7-dihydrothieno[2,3-b]pyridines as
broad-spectrum inhibitors of human herpesvirus polymerases.

Schnute ME, Anderson DJ, Brideau RJ, Ciske FL, Collier SA, Cudahy MM, Eggen M,
Genin MJ, Hopkins TA, Judge TM, Kim EJ, Knechtel ML, Nair SK, Nieman JA, Oien NL,
Scott A, Tanis SP, Vaillancourt VA, Wathen MW, Wieber JL.

Global Research and Development, Pfizer Inc., 700 Chesterfield Parkway West, St. 
Louis, MO 63017, USA. mark.e.schnute@pfizer.com

A novel series of 2-aryl-2-hydroxyethylamine substituted
4-oxo-4,7-dihydrothieno[2,3-b]pyridine-5-carboxamides have been identified as
potent antivirals against human herpesviruses. These compounds demonstrate
broad-spectrum inhibition of the herpesvirus polymerases HCMV, HSV-1, EBV, and
VZV with high specificity compared to human DNA polymerases.

Publication Types: 
    Comparative Study

PMID: 17434304 [PubMed - indexed for MEDLINE]

753: Med Sci (Paris). 2007 Apr;23(4):423-7.

[Preventing papillomavirus infectious and herpes zoster: new vaccines]

[Article in French]

Silbermann B, Launay O.

CIC de vaccinologie Cochin-Pasteur, Pole de medecine interne, Hopital Cochin 27, 
rue du Faubourg Saint-Jacques, 75014 Paris, France.

Two new vaccines have been recently licensed : a quadrivalent vaccine against
Human papillomavirus infections (HPV) 6, 11, 16 and 18, recommended to children
from 9 years old and to young adults under the age of 26 years, and a vaccine
against herpes zoster for adults from 60 years old onwards. A bivalent vaccine
against HPV 16 and 18 will be shortly available. HPV vaccines are composed of the
L1 structural proteins of 2 or 4 HPV genotypes, produced by genetic engineering
and self-assembled. These inert vaccines are devoid of genetic materials and
mimic the viral particle (virus-like particle, VLP). They allow, as suggested by 
the 4.5 to 5 years follow-up, to prevent HPV infections and the onset of
pre-cancerous lesions associated with genotypes contained within the vaccine.
They represent a major overhang in the vaccinology field, and, as anti-hepatitis 
B vaccine, will probably be effective in cancer prevention. Their use must be
associated with the continued detection of cervix cancer by smears and also with 
the prevention of other sexually transmitted diseases. The herpes zoster vaccine 
is a living attenuated vaccine produced from the OKA/Merck strain already used in
the vaccine against varicella. Its safety is good among persons 50 years old and 
over and its efficiency on lowering herpes zoster incidence, on the burden of
illness and on post-herpetic neuralgia has been demonstrated in persons over 60
years old.

Publication Types: 
    English Abstract
    Review

PMID: 17433234 [PubMed - indexed for MEDLINE]

754: Cent Afr J Med. 2005 May-Jun;51(5-6):53-8.

Preterm delivery risk in relation to maternal HIV infection, history of malaria
and other infections among urban Zimbabwean women.

Noble A, Ning Y, Woelk GB, Mahomed K, Williams MA.

Department Of Epidemiology, University of Washington School of Public Health and 
Community Medicine, Seattle, USA.

OBJECTIVE: To examine preterm delivery risk in relation to maternal HIV
infection, malaria history, and other infections among Zimbabwean women. DESIGN: 
Hospital based, cross sectional study. SETTING: Harare Maternity Hospital,
Harare, Zimbabwe. SUBJECTS: A convenient sample of 500 pregnant women. MAIN
OUTCOME MEASURE: Preterm delivery. THE STUDY FACTORS: Maternal socio-demographic 
information, and infectious disease history (during the year before pregnancy).
METHOD: Between July 1998 and March 1999 data were collected for a cross
sectional study of pregnant women who delivered at the Harare Maternal Hospital. 
The association of maternal HIV infection, history of malaria, and other
infections with preterm delivery were determined using multivariate analysis.
RESULTS: Overall, 497 women were studied, 444 (89.3%) delivered at term and 53
women (10.7%) delivered preterm. Women who delivered preterm were less likely to 
be HIV seropositive compared with others (odds ratio [OR] = 0.75. 95% confidence 
interval (CI): 0.38 to 21.48). Preterm delivery was associated with having
tuberculosis infections in the year prior to the pregnancy (OR = 10.15, 95% CI:
1.15 to 89.87). Other infections associated with preterm delivery were malaria
(OR = 2.39, 95% CI: 1.07 to 5.31), chest infections (OR = 2.63, 95% CI: 0.76 to
9.17), and Herpes (shingles) infection (OR = 2.58, 95% CI: 0.56 to 11.85).
Overall, a positive history of any of the non-sexually transmitted infections (in
aggregate) was associated with a 3.20 fold increase risk for preterm delivery (OR
= 3.20. 95% CI: 1.59 to 6.43). Women with a history of infection and who did not 
use iron supplements during pregnancy, compared with women without such an
history and who used iron supplements, experienced the highest risk for preterm
delivery (OR = 8.34, 95% CI: 3.30 to 21.07). CONCLUSION: Maternal non-STD
infections, (i.e., tuberculosis, malaria, and chest infections) occurring in the 
year prior to pregnancy were associated with an increased risk of preterm
delivery. The association of non-sexually transmitted infections and preterm
delivery was particularly strong among women who did not use iron supplements
during pregnancy.

PMID: 17432432 [PubMed - indexed for MEDLINE]

755: Ear Nose Throat J. 2007 Mar;86(3):138, 140.

Comment in:
    Ear Nose Throat J. 2007 Nov;86(11):649; author reply 649-50.

Ramsay Hunt syndrome, type I.

Gupta J, Hutchins T, Palacios E.

Department of Radiology, Tulane University Hospital and Clinics, New Orleans,
USA.

PMID: 17427772 [PubMed - indexed for MEDLINE]

756: Cont Lens Anterior Eye. 2007 Jul;30(3):204-6. Epub 2007 Apr 8.

Neurotrophic ulcer after extra-capsular cataract operation.

Yulek F, Cakmak HB, Cagil N, Orhan N, Altintas AG, Simsek S.

SB Ataturk Egitim ve Arastirma Hastanesi, Ankara, Turkey. fatmayulek@yahoo.com.tr

Although neurotrophic ulcers due to herpes zoster are seldom, there may be
challenging cases. Especially neurotrophic corneal ulcers after cataract
operations should arise the possibility of a previous herpes zoster attack and
the treatment plan should be prepared accordingly. This case highlights the
importance of thorough evaluation of cataract patients in order not to miss a
previous diagnosis of herpes.

Publication Types: 
    Case Reports

PMID: 17420151 [PubMed - indexed for MEDLINE]

757: Bone Marrow Transplant. 2007 Jun;39(11):661-5. Epub 2007 Apr 9.

Safety of vaccinating sibling donors with live-attenuated varicella zoster
vaccine before hematopoietic stem cell transplantation.

Leung AY, Chow HC, Kwok JS, Lui CK, Cheng VC, Yuen KY, Lie AK, Liang R.

Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong
Kong, China. ayhleung@hku.hk

Reactivation of varicella zoster virus (VZV), clinically manifested as herpes
zoster (HZ) is a common complication after hematopoietic stem cell
transplantation (HSCT). The optimum prophylaxis for this disease has not been
defined. In this study, we examined the effects of vaccinating donors with a
live-attenuated vaccine with particular reference to their immune responses and
the outcome of HSCT patients. Forty prospective HLA-matched sibling donors were
vaccinated before HSCT. There were humoral immune responses in both sero-positive
(P<0.01) and sero-negative (P=0.058) donors. Cellular immune response was assayed
in 26 donors. Significant correlation was observed between cellular immune
responses as enumerated by thymidine incorporation and interferon gamma secretion
(P<0.001) and the latter was used in subsequent analyses. Significant response
was observed in sero-negative (6/26) and a group of sero-positive (13/26) donors 
while 7/26 sero-positive donors showed no response. Thirty-four HSCT were
performed. These patients have a lower, albeit insignificant, risk of HZ compared
with historical controls and only 3/34 patients developed single dermatomal HZ at
6, 9 and 28 months after HSCT. No patients developed VZV-related mortality.
Vaccinating donors with live-attenuated VZV vaccine was safe, but whether it
confers a significant protection to the patients would require further study.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17417658 [PubMed - indexed for MEDLINE]

758: Cornea. 2007 Apr;26(3):370-2.

DNA of cytomegalovirus detected by PCR in aqueous of patient with corneal
endotheliitis after penetrating keratoplasty.

Suzuki T, Hara Y, Uno T, Ohashi Y.

Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan.
s-t-ishizuchi@orion.ocn.ne.jp

PURPOSE: Corneal endotheliitis often leads to severe endothelial dysfunction and 
can be caused by herpes simplex virus (HSV), varicella zoster virus (VZV), and
other viruses (eg, the mumps virus). We report a case of corneal endotheliitis
caused by cytomegalovirus (CMV) that developed after a penetrating keratoplasty. 
METHODS: A complete ophthalmologic examination was performed on a patient with
corneal endotheliitis that developed after a penetrating keratoplasty. To
determine the cause of the endotheliitis, polymerase chain reaction (PCR) was
used to amplify the DNA of HSV, VZV, and CMV in samples of the aqueous humor.
RESULTS: Slit-lamp biomicroscopy showed a moderate stromal edema in the upper
temporal part of the transplanted cornea along with keratic precipitates (KPs)
arranged in a coin-shaped pattern. Repeated treatments with steroids and
acyclovir were only temporarily successful. PCR detected the DNA of CMV in an
aqueous sample, and the treatment was switched to topical and systemic
application of ganciclovir. This resulted in the disappearance of the KPs and
resolution of the stromal edema within 2 weeks. CONCLUSIONS: From the PCR results
and the favorable response to ganciclovir, the corneal endotheliitis was most
likely caused by cytomegalovirus in this case.

Publication Types: 
    Case Reports

PMID: 17413969 [PubMed - indexed for MEDLINE]

759: J Virol. 2007 Jun;81(12):6752-6. Epub 2007 Apr 4.

Productive varicella-zoster virus infection of cultured intact human ganglia.

Gowrishankar K, Slobedman B, Cunningham AL, Miranda-Saksena M, Boadle RA,
Abendroth A.

Center for Virus Research, Westmead Millenium Institute, and Department of
Infectious Diseases and Immunology, University of Sydney, Blackburn Building,
2006 NSW, Australia.

Varicella-zoster virus (VZV) is a species-specific herpesvirus which infects
sensory ganglia. We have developed a model of infection of human intact explant
dorsal root ganglia (DRG). Following exposure of DRG to VZV, viral antigens were 
detected in neurons and nonneuronal cells. Enveloped virions were visualized by
transmission electron microscopy in neurons and nonneuronal cells and within the 
extracellular space. Moreover, rather than remaining highly cell associated
during infection of cultured cells, such as fibroblasts, cell-free VZV was
released from infected DRG. This model enables VZV infection of ganglionic cells 
to be studied in the context of intact DRG.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17409155 [PubMed - indexed for MEDLINE]

760: J Dermatol. 2007 May;34(5):349-52.

Isolated double herpes zoster paresis involving the left facial nerve and the
right peroneal nerve following disseminated herpes zoster.

Takahama H, Tsukahara N, Hirayama M, Ito S, Sakuramoto C.

Department of Dermatology, Machida Municipal Hospital, Machida, Tokyo, Japan.
hdt2taka@rose.ocn.ne.jp

A 72-year-old Japanese male developed disseminated herpes zoster and could not
easily walk due to right drop foot and pain. He soon developed numbness and pain 
on the left side of his face, and noticed difficulty closing his left eye. The
left angle of his mouth dropped. The patient was diagnosed as having a double
mononeuropathy (a left facial nerve paresis and a right peroneal nerve paresis)
following disseminated herpes zoster. Given that the patient was elderly and had 
diabetes mellitus, the patient appeared to be an immunocompromised host. We also 
describe other rare complications of herpes zoster from the published work.

Publication Types: 
    Case Reports

PMID: 17408447 [PubMed - indexed for MEDLINE]

761: Nephrol Dial Transplant. 2007 Jul;22(7):1933-42. Epub 2007 Apr 3.

Mycophenolate mofetil in induction and maintenance therapy of severe lupus
nephritis: a meta-analysis of randomized controlled trials.

Zhu B, Chen N, Lin Y, Ren H, Zhang W, Wang W, Pan X, Yu H.

Department of Nephrology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong 
University, Shanghai 200025, China.

BACKGROUND: The outcomes of previous trials of mycophenolate mofetil (MMF) in
treating severe lupus nephritis (LN) are not in exact agreement. This
meta-analysis of randomized controlled trials (RCTs) assesses the benefits and
harms of MMF in the induction and maintenance therapy of severe LN. METHODS: We
searched Medline, EMBASE and the Cochrane Collaboration Database for RCTs that
compared MMF with other immunorepressive regimens for treating lupus nephritis
and extracted data for remissions, side effects and prognosis in induction
therapy and prognosis and side effects in maintenance therapy, and we summarized 
the combined results of the data of the RCTs as relative risk (RR). RESULTS: We
analysed five RCTs with 307 patients-four RCTS providing the data for comparing
MMF with cyclophosphamide (CYC) for induction therapy and two RCTs providing the 
data for comparing MMF with azathioprine (AZA) for maintenance therapy of severe 
LN. Overall, compared with CYC, induction therapy with MMF reduced the risk of
infection significantly (RR 0.65, P<0.001). It also significantly increased the
complete remission rate compared with intravenous CYC (RR 3.10, P=0.006).
Compared with intravenous CYC, induction therapy with MMF reduced the incidence
of leucopenia significantly (RR 0.66, P=0.04). The prognosis and other side
effects were not significantly different between MMF and CYC induction therapies.
There was no significant difference between the patients receiving MMF and those 
receiving AZA for maintenance therapy in prognosis or the risks of amenorrhoea
and herpes zoster. CONCLUSIONS: MMF has higher efficacy in inducing remission in 
severe LN than pulsed intravenous therapy with CYC. Induction therapy with MMF is
also associated with fewer side effects than induction therapy with CYC. Compared
with AZA, MMF also is an alternative for maintenance therapy of severe LN without
significant difference in the prognosis or risks of amenorrhoea and herpes
zoster.

Publication Types: 
    Comparative Study
    Meta-Analysis
    Review

PMID: 17405792 [PubMed - indexed for MEDLINE]

762: J Heart Lung Transplant. 2007 Apr;26(4):399-402.

Varicella infection after heart and lung transplantation: a single-center
experience.

Carby M, Jones A, Burke M, Hall A, Banner N.

Department of Transplantation, Harefield Hospital, Harefield, Middlesex, United
Kingdom. m.carby@rbht.nhs.uk

Disseminated varicella-zoster virus infection after organ transplantation in
adults is a rare but serious event causing significant morbidity and mortality.
We describe our 10-year experience of 13 cases in a single center, including risk
factors for infection, lack of protection from pre-existing anti-varicella-zoster
virus antibodies, and unusual modes of presentation, including disseminated
intravascular coagulation. We also report our preliminary observation of
resolution of infection without sequelae in 4 patients with severe disseminated
varicella-zoster virus infection who were treated with the combination of
intravenous acyclovir and polyspecific intravenous immunoglobulin.

PMID: 17403483 [PubMed - indexed for MEDLINE]

763: Expert Rev Anti Infect Ther. 2007 Apr;5(2):217-30.

Current non-AIDS antiviral chemotherapy.

Rottinghaus ST, Whitley RJ.

Infectious Diseases, The University of Alabama at Birmingham, Department of
Medicine, 1530 Third Avenue South, Birmingham, AL 35294-0006, USA. str@uab.edu

The evolution of antiviral therapy began with developments in the management of
influenza and herpes simplex keratitis in the 1960s and early 1970s. However, the
field exploded with the successful treatment of herpes simplex encephalitis,
herpes zoster and genital herpes simplex virus infections, all occurring in the
late 1970s and early 1980s. These advances have contributed to the development of
therapies for HIV that have transformed the lives of infected patients in recent 
years. The clinical fruit of all of these research advances has been an
armamentarium of drugs that can be used to successfully treat a variety of viral 
illnesses. In addition to HIV/AIDS, current antiviral therapy focuses primarily
on herpesviruses, hepatitis viruses and influenza. Notably, considerable progress
remains to be made in these areas. Moreover, a variety of additional viral
diseases currently require the development of specific therapies.

Publication Types: 
    Review

PMID: 17402837 [PubMed - indexed for MEDLINE]

764: J Neurol. 2007 Apr;254(4):493-500. Epub 2007 Mar 31.

Varicella-zoster virus at relapses of multiple sclerosis.

Sotelo J, Ordonez G, Pineda B.

Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico,
Insurgentes Sur 3877, 14269 Mexico City, Mexico. jsotelo@servidor.unam.mx

The possible participation of different herpes viruses was studied during
exacerbations of multiple sclerosis (MS). We searched for the presence of DNA
from the following herpes viruses: varicella zoster virus (VZV), herpes-simplex
viruses 1 and 2; Epstein-Barr virus (EBV) and human herpes-virus-6 (HHV6) in
mononuclear cells from patients with MS during relapse (n = 40), MS during
remission (n = 131) and controls (n = 125). Additionally, immune cells containing
viral antigens were quantified by flow cytometry, and VZV load was determined by 
real time PCR in 2 MS patients at various times during relapse and remission. DNA
from VZV was found in 95% of MS patients during relapse and in 17% during
remission; all controls were negative; by contrast, DNA from HHV6 was found in
24% of MS patients during relapse and in 2% during remission; DNA from herpes
simplex viruses was not found in any subject; and DNA from EBV was found in a
similar percentage of subjects from all groups. Sequential quantification of
VZV-load showed a curve that increased during relapse and disappeared at
remission. Also, VZV antigens were found inside a large number of immune cells
from MS patients during relapse as compared with MS patients on remission and
controls. In the typical forms of VZV infection, varicella and herpes-zoster, DNA
from VZV is found in mononuclear cells exclusively during brief periods at the
beginning of the active infection, but not during latency; thus, the conspicuous 
presence of VZV during relapses of MS may indicate a period of active infection
and suggests the participation of VZV in the pathogenesis of MS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17401519 [PubMed - indexed for MEDLINE]

765: J Am Geriatr Soc. 2007 Apr;55(4):511-7.

Augmenting immune responses to varicella zoster virus in older adults: a
randomized, controlled trial of Tai Chi.

Irwin MR, Olmstead R, Oxman MN.

Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience,
University of California at Los Angeles, Los Angeles, California, USA.
mirwin1@ucla.edu

OBJECTIVES: To evaluate the effects of a behavioral intervention, Tai Chi, on
resting and vaccine-stimulated levels of cell-mediated immunity (CMI) to
varicella zoster virus (VZV) and on health functioning in older adults. DESIGN: A
prospective, randomized, controlled trial with allocation to two arms (Tai Chi
and health education) for 25 weeks. After 16 weeks of intervention, subjects were
vaccinated with VARIVAX, the live attenuated Oka/Merck VZV vaccine licensed to
prevent varicella. SETTING: Two urban U.S. communities between 2001 and 2005.
PARTICIPANTS: A total of 112 healthy older adults aged 59 to 86. MEASUREMENTS:
The primary endpoint was a quantitative measure of VZV-CMI. Secondary outcomes
were scores on the Medical Outcomes Study 36-item Short-Form Health Survey
(SF-36). RESULTS: The Tai Chi group showed higher levels of VZV-CMI than the
health education group (P<.05), with a significant rate of increase (P<.001) that
was nearly twice that found in the health education group. Tai Chi alone induced 
an increase in VZV-CMI that was comparable in magnitude with that induced by
varicella vaccine, and the two were additive; Tai Chi, together with vaccine,
produced a substantially higher level of VZV-CMI than vaccine alone. The Tai Chi 
group also showed significant improvements in SF-36 scores for physical
functioning, bodily pain, vitality, and mental health (P<.05). CONCLUSION: Tai
Chi augments resting levels of VZV-specific CMI and boosts VZV-CMI of the
varicella vaccine.

Publication Types: 
    Multicenter Study
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 17397428 [PubMed - indexed for MEDLINE]

766: N Engl J Med. 2007 Mar 29;356(13):1338-43.

Comment in:
    N Engl J Med. 2007 Jul 5;357(1):88.    N Engl J Med. 2007 Jul 5;357(1):89.    N Engl J Med. 2007 Jul 5;357(1):89.    N Engl J Med. 2007 Jul 5;357(1):89.    N Engl J Med. 2007 Jul 5;357(1):89-90.

Varicella-zoster vaccine for the prevention of herpes zoster.

Kimberlin DW, Whitley RJ.

Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
35233, USA. dkimberlin@peds.uab.edu

Publication Types: 
    Review

PMID: 17392303 [PubMed - indexed for MEDLINE]

767: Am J Transplant. 2007 Apr;7(4):741-7.

Herpes simplex and varicella zoster viruses: forgotten but not gone.

Miller GG, Dummer JS.

Department of Medicine, Division of Infectious Diseases, Vanderbilt University
Medical Center, Nashville, Tennessee, USA. geraldine.miller@vanderbilt.edu

Herpesvirus infections are common complications of organ transplantation. The
most frequent herpesvirus infections are caused by cytomegalovirus (CMV), herpes 
simplex (HSV) and varicella zoster (VZV). Despite expansion of the therapeutic
armamentarium, HSV and VZV continue to cause morbidity and occasional mortality
in transplant recipients. Here we review the incidence and risk factors for HSV
and VZV disease, their clinical presentation, effects of newer immunosuppressive 
regimens and prophylaxis for HSV and VZV in solid organ transplant recipients.

Publication Types: 
    Review

PMID: 17391119 [PubMed - indexed for MEDLINE]

768: Br J Ophthalmol. 2007 Aug;91(8):1038-41. Epub 2007 Mar 27.

The role of common viral ocular pathogens in Thygeson's superficial punctate
keratitis.

Connell PP, O'Reilly J, Coughlan S, Collum LM, Power WJ.

Royal Victoria Eye and Ear Hospital, Adelaide Rd, Ballsbridge, Dublin 4.
drpaulconnell@gmail.com

BACKGROUND/AIMS: The aetiology of Thygeson's superficial punctate keratitis
(TSPK) remains elusive. A viral aetiology has been suggested by the absence of
bacterial infection and clinical resemblance to other viral keratopathies. We
report the results of polymerase chain reaction analysis for the detection of
herpes simplex virus (HSV) 1 and 2, herpes zoster virus, varicella zoster virus
(VZV) and adenovirus from corneal epithelial samples from patients with active
signs and symptoms of TSPK. METHODS: Schirmer strip impressions were taken from
the epithelium of eight patients with a known history of TSPK and symptoms and
signs of active disease. Three patients were recruited as positive controls (two 
with herpes simplex keratitis and one with herpes zoster ophthalmicus). Samples
from a further three patients acted as negative controls. All 14 samples
underwent polymerase chain reaction testing for HSV 1, HSV 2, VZV and adenovirus.
RESULTS: DNA corresponding to the expected viral DNA was amplified from all three
positive control samples. The three negative control samples showed no evidence
of viral DNA. Similarly, all samples from patients with TSPK showed no evidence
of the presence of HSV 1, HSV 2, VZV or adenovirus. CONCLUSION: We conclude that 
HSV, VZV and adenovirus are not present in the epithelium of patients with TSPK. 
These results are considered in light of existing theories regarding the
aetiology and treatment of this condition.

PMID: 17389746 [PubMed - indexed for MEDLINE]

769: Eur J Neurol. 2007 Apr;14(4):e7-8.

Acquired prothrombotic state due to protein-losing enteropathy as a rare cause
for ischemic stroke?

Amtage F, Marouf W, Hetzel A, Schubert M.

Publication Types: 
    Case Reports
    Letter

PMID: 17388979 [PubMed - indexed for MEDLINE]

770: Pain Physician. 2007 Mar;10(2):301-4.

Seven zoster reactivations in an immune competent patient: how many is too many?

Rashid RM, Candido KD, Ibrahim S.

Loyola University Medical Center, Maywood, IL, USA. RashidRashid.MDPhD@yahoo.com

Herpes zoster virus (HZV) reactivation is commonly reported in elderly or immune 
compromised patients. However, certain presentations are rarely reported in
immune competent patients. Here we report a rare case of recalcitrant HZV
infection, including 7 reactivations over 3 years, in an immune competent
patient. Due to the pain experienced, this patient self-referred to our clinic,
and thus bypassed other specialties. As pain management specialists, it is
critical to be aware of such presentations, the clinical implications involved,
and management options to consider.

Publication Types: 
    Case Reports

PMID: 17387352 [PubMed - indexed for MEDLINE]

771: J Med Virol. 2007 May;79(5):597-604.

Quantitative detection of herpes simplex virus DNA in the lower respiratory
tract.

Gooskens J, Templeton KE, Claas EC, van Bussel MJ, Smit VT, Kroes AC.

Department of Medical Microbiology, Center of Infectious Diseases, Leiden,
University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
j.gooskens@lumc.nl

Quantitation of herpes simplex virus (HSV) DNA in bronchoalveolar lavage
specimens could indicate an infectious role in the lower respiratory tract. The
aim of this study was to compare quantitative HSV DNA results from adult
bronchoalveolar lavage specimens to clinical outcome. Quantitative real-time PCR 
assays targeting HSV and other herpes viruses were performed on adult
bronchoalveolar lavage specimens obtained from a largely immunocompromised
population during a 1-year period. The results were compared to patient
characteristics and outcome. HSV DNA was detected in 11 (19%) of 57
bronchoalveolar lavage specimens with a mean viral level of 5.6 log genome
equivalents/ml (range, 2.9-8.1 log). A threshold of HSV DNA levels equal or
higher than 5.0 log (n = 7) was associated with mortality within 28 days
following hospital admission (odds ratio [OR], 6.8; 95% confidence interval [CI],
1.2-39.2). A threshold level of 5.5 log was associated with mortality within 28
days of sampling (OR 8.5; 95% CI 1.2-62.1), only after excluding patients
receiving specific antiviral medication. Patients with HSV DNA levels equal or
higher than 7.5 log had severe respiratory failure. Viral pneumonia was
histologically proven in one patient with 8.0 log at autopsy. No patient with HSV
DNA levels below 5.5 log (n = 5) or DNA levels higher than 5.0 log of
cytomegalovirus (CMV) (n = 3), Epstein-Barr virus (EBV) (n = 9), varicella-zoster
virus (VZV) (n = 1), or human herpesvirus 6 (HHV-6) (n = 0) died within 28 days
of hospital admission. We conclude that quantitative detection of HSV DNA in
bronchoalveolar lavage fluid is a potential diagnostic tool for detection of
relevant viral infection of the lower respiratory tract.

PMID: 17385683 [PubMed - indexed for MEDLINE]

772: Br J Dermatol. 2007 May;156(5):1084-6. Epub 2007 Mar 23.

A case of herpes zoster in a child with congenital insensitivity to pain with
anhidrosis.

Ogata M, Misago N, Suzuki Y, Hirashima N, Inoue T, Yamasaki M, Narisawa Y.

Publication Types: 
    Case Reports
    Letter

PMID: 17381455 [PubMed - indexed for MEDLINE]

773: Tex Dent J. 2007 Jan;124(1):132, 136-8.

Oral and maxillofacial pathology case of the month. Herpes zoster (shingles).

Bouquot JE, Horn N, Wan SF.

Department of Diagnostic Sciences, University of Texas Dental Branch at Houston, 
USA.

Publication Types: 
    Case Reports

PMID: 17380914 [PubMed - indexed for MEDLINE]

774: Pain. 2007 Nov;132 Suppl 1:S52-9. Epub 2007 Mar 26.

Predicting postherpetic neuralgia in elderly primary care patients with herpes
zoster: prospective prognostic study.

Opstelten W, Zuithoff NP, van Essen GA, van Loon AM, van Wijck AJ, Kalkman CJ,
Verheij TJ, Moons KG.

Julius Center for Health Sciences and Primary Care, University Medical Center
Utrecht, P.O. Box 85060, 3500 AB Utrecht, The Netherlands.
w.opstelten@umcutrecht.nl

Postherpetic neuralgia (PHN) is the most frequent complication of herpes zoster
(HZ) and difficult to treat. Timely identification of high-risk HZ-patients
enables physicians to focus on PHN prevention. To assess which simple to measure 
factors are independent predictors of PHN, and whether psychosocial and
serological/virological parameters have additional predictive value, a
prospective cohort study in primary care was conducted. We included 598 elderly
(>50 years) consecutive patients with acute HZ (rash <7 days) below sixth
cervical dermatome. At baseline demographic, clinical (e.g., duration and
severity of pain and rash), psychological (Pain Cognition List [PCL] and
Spielberger's Anxiety Inventory), serological (VZV-antibodies) and virological
(viremia presence) variables were measured. Blood tests were performed in a
random subset of 218 patients. Primary outcome was significant pain (VAS >30 on
0-100 scale) after three months. The final prediction model obtained from
multivariable logistic regression was (internally) validated using bootstrapping 
techniques, and adjusted for optimism. Forty-six (7.7%) patients developed PHN.
Independent predictors were age (odds ratio [OR]=1.08 per year), acute pain
severity (OR=1.02 per unit), presence of severe rash (OR=2.31), and rash duration
before consultation (OR=0.78 per day): area under
receiver-operating-characteristic curve [ROC area]=0.77 (95% CI: 0.71-0.82). Of
the five PCL scores, only factor V ('trust in healthcare') was an additional
predictor (OR=1.01 per unit), though it increased the ROC area with only 0.01 to 
0.78. The Spielberger's anxiety scores and serological and virological variables 
were no additional predictors. Thus, four simple variables can help physicians to
timely identify elderly HZ-patients at risk of PHN.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17379412 [PubMed - indexed for MEDLINE]

775: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Mar;103
Suppl:S50.e1-23.

Management of oral lesions in HIV-positive patients.

Baccaglini L, Atkinson JC, Patton LL, Glick M, Ficarra G, Peterson DE.

Department of Community Dentistry and Behavioral Science, College of Dentistry,
University of Florida, Gainesville, FL 32610-3628, USA.
lbaccaglini@dental.ufl.edu

HIV/AIDS is currently the leading cause of death in Africa and the fourth leading
cause of death worldwide. This systematic review of the literature was conducted 
to evaluate the evidence for treatment of the most common oral lesions associated
with HIV: oral candidiasis with or without oropharyngeal involvement (OPC), oral 
hairy leukoplakia (OHL), recurrent aphthous-like ulcerations (RAU), oral Kaposi's
sarcoma (OKS), orolabial herpes simplex infection (HSV), oral herpes zoster
infection (VZV), intraoral or perioral warts (HPV), and HIV-associated
periodontal diseases. Treatment of HIV-associated salivary gland disease is
addressed in a different section of this World Workshop. We found the largest
body of evidence for treatment of OPC in HIV patients. Future trials will be
needed to test drugs currently in development for treatment of Candida strains
that are resistant to existing therapies. There were no double blind,
placebo-controlled randomized clinical trials (RCT) for topical treatment of OHL,
and only one RCT for systemic treatment of the lesion with desciclovir. Systemic 
thalidomide was the only drug tested in RCT for treatment or prevention of RAU.
Only 1 double-blind RCT comparing vinblastine and sodium tetradecyl sulfate was
identified for localized treatment of OKS. Three drugs (famciclovir, acyclovir,
and valaciclovir) were shown to be effective in randomized, double-blind trials
for treatment or suppression of mucocutaneous HSV lesions in HIV patients. In all
3 trials, the effects of these medications on orolabial HSV lesions were not
reported separately. There were no double-blind, placebo-controlled RCT testing
topical treatments for orolabial HSV lesions in HIV patients. No trials testing
treatments of oral VZV were identified. There were no double-blind,
placebo-controlled RCT for treatment of HIV-associated intraoral or perioral
warts or periodontal diseases. In conclusion, there is a need for well-designed
RCTs to assess the safety and efficacy of topical and systemic treatments of most
oral mucosal and perioral lesions in HIV patients. There is also a need to
develop newer drugs for treatment of resistant fungal and viral microorganisms.
Finally, standardized outcome measures should be developed for future clinical
trials to allow comparisons of studies using different populations.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review

PMID: 17379155 [PubMed - indexed for MEDLINE]

776: Mich Med. 2007 Jan-Feb;106(1):12-3.

ACIP recommends vaccine to prevent shingles.

[No authors listed]

PMID: 17375694 [PubMed - indexed for MEDLINE]

777: An Med Interna. 2007 Jan;24(1):31-4.

[Ramsay-Hunt syndrome]

[Article in Spanish]

Martinez Oviedo A, Lahoz Zamarro MT, Uroz del Hoyo JJ.

Medicina Familiar y Comunitaria, Hospital General Obispo Polanco, C/Jaca 4, 44002
Teruel. amoviedo25@yahoo.es

Ramsay-Hunt syndrome is a peripheral facial nerve palsy accompanied by an
erythematous vesicular rash on the ear or in the mouth; it is caused by varicella
zoster virus that affects the geniculate ganglion. The zoster oticus is the
second most common cause of atraumatic peripheral facial paralysis. We present a 
review of zoster oticus identified in our hospital among 2001-2005. We show
various atypical cases with multiple cranial nerve involvement; cerebellum and
spinal cord was affected in one patient. 3/10 cases were complicated with
pneumonia. So, we think that some grade of immunodeficiency may be present in
these cases. Treatment with acyclovir and prednisone has been successfully to
improve the outcome in the most of patients. Compared with Bell s palsy, patients
with zoster oticus often have more severe paralysis at onset and are less likely 
to recover completely.

Publication Types: 
    English Abstract

PMID: 17373867 [PubMed - indexed for MEDLINE]

778: J Drugs Dermatol. 2006 Nov-Dec;5(10):938-41.

Post-herpetic neuralgia: a review of advances in treatment and prevention.

Young L.

Department of Medicine, Dermatology Division, David Geffen School of Medicine at 
the University of California, Los Angeles, CA 90095, USA. lcyoung@mednet.ucla.edu

Post-herpetic neuralgia (PHN) is primarily a disease of the elderly and often
refractory to treatment. Randomized and controlled trials have yielded several
significant advances in the treatment and prevention of this disease. Treatment
advances include the lidocaine patch, opioid analgesics, nortriptyline,
amitriptyline, and gabapentin. However, no treatment regimen fully eliminates the
pain. Improvements in prevention include prompt recognition and treatment of
high-risk herpes zoster (HZ) patients with antiviral and analgesic therapies.
Even with these advances, PHN remains a debilitating and painful disease.
Vaccines offer the greatest promise of relief. The childhood vaccine against
varicella zoster virus offers long-lasting immunity, largely preventing HZ and
PHN. But most adults have already had varicella and are at risk for HZ and PHN as
they age. Therefore, a more potent vaccine against varicella has been developed
for use in adults. This vaccine offers a new and significant advance in the
prevention of HZ and its most noteworthy complication, PHN.

Publication Types: 
    Review

PMID: 17373141 [PubMed - indexed for MEDLINE]

779: Euro Surveill. 2007 Feb 20;12(2). [Epub ahead of print]

Surveillance of varicella and herpes zoster in Slovenia, 1996 - 2005.

Socan M, Blasko M.

Centre for Communicable Diseases, Institute of Public Health of Republic of
Slovenia, Ljubljana, Slovenia.

In Slovenia, varicella and herpes zoster infections are case-based mandatorily
notifiable diseases. We present surveillance data for a period of ten years (1996
- 2005). Incidences of varicella ranged from 456 to 777 per 100 000 population in
all age groups. As many as 75% of varicella cases reported were in pre-school
children, with children aged three and four years being most affected. The
incidence of varicella increased between October and January and was lowest in
August and September; the seasonal pattern matches patterns in the school
calendar. Herpes zoster was declared a reportable disease in 1995. In 2005, 1627 
cases were notified (81.3/100 000). Female cases outnumbered male. The highest
incidence of herpes zoster was noted in elderly individuals over 70 years of age.
Complications, such as zoster meningitis and meningoencephalitis, were rarely
reported (3.05/1 000 000).

PMID: 17370981 [PubMed - as supplied by publisher]

780: Zhongguo Zhen Jiu. 2007 Feb;27(2):123-5.

[Observation on therapeutic effect of surround needling plus surround moxibustion
on herpes zoster]

[Article in Chinese]

Zhang M, Qiu L, Zhang J.

Chengdu Hospital of Integrated Chinese and Western Medicine, Chengdu First
People's Hospital, Sichuan 610016, China. zm859@163.com

OBJECTIVE: To search for a better therapy for herpes zoster. METHODS: Seventy-two
cases of herpes zoster were randomly divided into a treatment group of 38 cases
treated with surround needling plus surround moxibustion (direct moxibustion at
the area of surround needling), and a control group of 34 cases treated with
surround needling the margin of the herpes zoster from "the head" to "the tail"
of the herpes zoster respectively. RESULTS: The 38 cases in the treatment group
were cured within 3 days with an effective rate of 97.4%, which was better than
85.3% in the control group (P<0.05), with the herpes stopping and scab time
shorten, and incidence of residual neuralgia reduced. CONCLUSION: Surround
needling plus surround moxibustion has obvious therapeutic effect on herpes
zoster.

Publication Types: 
    English Abstract
    Randomized Controlled Trial

PMID: 17370497 [PubMed - indexed for MEDLINE]

781: Ethiop Med J. 2006 Oct;44(4):401-4.

Ramsay Hunt syndrome.

T/Selasic H, Zenebe G.

Tikur Anbessa Specialized Hospital, Addis Ababa University P.O.Box 5657, Addis
Ababa, Ethiopia.

Ramsay Hunt Syndrome was described in a 58 years old woman from Addis Ababa. The 
woman presented with vesicular eruptions in the right ear which was followed by
weakness of the same side of face & otalgia. The objective of this case report is
to address herpes zoster & its complications with the treatment modalities & an
uncommon clinical entity, Ramsay hunt syndrome.

Publication Types: 
    Case Reports

PMID: 17370442 [PubMed - indexed for MEDLINE]

782: Med Mal Infect. 2007 Apr;37(4):208-14. Epub 2007 Mar 26.

[Acute encephalitis: report on 32 consecutive pediatric cases observed in one
hospital]

[Article in French]

Vial C, Pozzetto B, Essid A, Stephan JL, Chabrier S.

Service de pediatrie, Hopital Nord, CHU de Saint-Etienne, 42055 Saint-Etienne
cedex, France.

We report 32 cases of acute encephalitis consecutively hospitalized in one
hospital, from January 1991 to December 2002. The causative agent was identified 
in 26 cases (81%). The main associated viruses were varicella-zoster (10
children; 31%), Herpes simplex (6 children; 19%), and enteroviruses (4 children; 
13%). At the acute phase, the most relevant biological findings were
electroencephalogram results and CSF analysis. The initial encephalic imaging was
primarily helpful to exclude other acute neurological diseases whereas long-term 
imaging was a prognostic factor for necrotizing encephalitis. The microbiological
diagnosis required several days or weeks to be determined. It did not influence
the initial management. In addition to the 6 cases of herpetic encephalitis, 19
children (78% altogether) were then treated by acyclovir before a definitive
diagnosis was made. Twenty-two children (69%) had a favorable outcome, 2 (6%) had
moderate sequels, 2 (6%) had important ones, and 5 (16%) had major ones. One (3%)
child died. The outcome was highly dependant on the causative agent and the
mechanism of encephalitis. This series gives information on the epidemiology of
encephalitis in children in our region over a period of 12 years.

Publication Types: 
    English Abstract

PMID: 17368784 [PubMed - indexed for MEDLINE]

783: J Am Acad Dermatol. 2007 Apr;56(4):675-6.

New opportunities in preventative dermatology: how far should we go?

Zhang AY, Elmets CA, Camp WL, Elewski BE.

Skin Diseases Research Center and the Department of Dermatology, University of
Alabama at Birmingham, USA.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 17367617 [PubMed - indexed for MEDLINE]

784: Scand J Infect Dis. 2007;39(1):90-3.

Unusual onset of varicella zoster reactivation with meningoencephalitis, followed
by rhabdomyolysis and renal failure in a young, immunocompetent patient.

Pirounaki M, Liatsos G, Elefsiniotis I, Skounakis M, Moulakakis A.

Department of Internal Medicine, Hippokration General Hospital., Athens,
Vasilissis Sofias 114, Greece.

We present an unusual onset of meningoencephalitis due to VZV reactivation, with 
increased intrathecal production of IgG VZV antibodies and negative PCR, in a
young, immunocompetent adult. Herpes zoster erupted 5 d later. Rare complication 
of VZV-related rhabdomyolysis occurred, with subsequent ARF, in combination with 
acyclovir and ceftriaxone. The patient recovered fully and remained healthy.

Publication Types: 
    Case Reports

PMID: 17366023 [PubMed - indexed for MEDLINE]

785: Graefes Arch Clin Exp Ophthalmol. 2007 Sep;245(9):1397-9. Epub 2007 Mar 16.

Tuberculous uveitis after treatment with etanercept.

Fonollosa A, Segura A, Giralt J, Garcia-Arumi J.

Hospital Vall d'Hebron, Barcelona, Spain. 36427afc@combs.es

BACKGROUND: Etanercept is a tumor necrosis factor (TNF) inhibitor that has been
licensed in the United States for the treatment of adult and juvenile rheumatoid 
arthritis as well as psoriatic arthritis. Reactivation of tuberculosis is a
complication of its use. We report the first case of tuberculous uveitis due to
etanercept. METHODS: We performed a clinical chart review. CASE: A 58-year-old
Caucasian woman was referred to our hospital for chronic unilateral granulomatous
panuveitis of the right eye (RE). She was on etanercept and methotrexate for
rheumatoid arthritis. Since the patient was immunosuppressed with etanercept and 
since the uveitis was granulomatous we considered tuberculosis as a possible
etiology. An aqueous humor tap was performed and sent for polymerase chain
reaction analyses of Herpes simplex, Herpes zoster, and Mycobacterium
tuberculosis (MT). This last test was positive. Another aqueous humor sample was 
taken and sent for microscopic examination of sputum for acid-fast bacilli and
culture, both of which were positive for MT. A diagnosis of tuberculous uveitis
was established; the patient was treated with rifampin, isoniazid pyrazinamide,
and ethambutol and etanercept was stopped. Four months later there were no cells 
in the anterior chamber and the vitreous was clear. DISCUSSION: To our knowledge 
this is the first reported case of tuberculous uveitis following treatment with
etanercept. This etiology has to be considered in patients taking this drug who
present with intraocular inflammation.

Publication Types: 
    Case Reports

PMID: 17364199 [PubMed - indexed for MEDLINE]

786: Int J Clin Pract. 2007 Jul;61(7):1223-9. Epub 2007 Mar 16.

The change in zoster-associated pain treated with oral valaciclovir in
immunocompetent patients with acute herpes zoster.

Kurokawa I, Murakawa K, Kumano K.

Department of Dermatology, Mie University Graduate School of Medicine, Tsu, Mie, 
Japan. kuroichi@clin.medic.mie-u.ac.jp

We have analysed zoster-associated pain treated with valaciclovir (VCV) in
immunocompetent patients with acute herpes zoster over 6 months, and evaluated
the safety of VCV. We know of no reports that evaluate postherpetic neuralgia
(PHN) treated with VCV for 6 months. Predisposing factors that influence PHN were
age (over 60 years), clustered vesicles, severity of eruption, sleep disturbance,
and hypesthesia. Timing of the administration of VCV before or after the onset of
rash did not influence the incidence of PHN. No serious adverse reactions were
observed during the administration of VCV.

Publication Types: 
    Review

PMID: 17362479 [PubMed - indexed for MEDLINE]

787: Ned Tijdschr Tandheelkd. 2007 Feb;114(2):98-103.

[An unusual skin disorder after tooth extraction]

[Article in Dutch]

van Gemert JT, Koole R.

Tandheelkunde van het Universitair Medisch Centrum Utrecht.
J.T.M.vanGemert@umcutrecht.nl

A 72-year-old woman was referred to a department of oral and maxillofacial
surgery because of a unilateral skin eruption of the face after extraction of the
right first upper molar, a few days earlier. She had been diagnosed with chronic 
lymphocytic leukaemia some years before. It appeared to be herpes zoster
or'shingles'from the second branch of the trigeminal nerve. Treatment included
hospital admission with intravenous antiviral therapy and analgetics. Herpes
zoster of the face is a severe infection and requires early treatment. Post
herpetic neuralgia is a serious complication of herpes zoster and may adversely
affect the quality of life.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17361787 [PubMed - indexed for MEDLINE]

788: Can J Ophthalmol. 2007 Feb;42(1):152-3.

Herpes zoster ophthalmicus and sixth nerve palsy in a pediatric patient.

Liao W, Chu G, Hutnik CM.

Publication Types: 
    Case Reports
    Letter

PMID: 17361269 [PubMed - indexed for MEDLINE]

789: Proc Natl Acad Sci U S A. 2007 Feb 27;104(9):3496-501. Epub 2007 Feb 20.

Selective retention of herpes simplex virus-specific T cells in latently infected
human trigeminal ganglia.

Verjans GM, Hintzen RQ, van Dun JM, Poot A, Milikan JC, Laman JD, Langerak AW,
Kinchington PR, Osterhaus AD.

Department of Virology, Erasmus Medical Center, Dr. Molewaterplein 50, 3015 GE,
Rotterdam, The Netherlands. g.verjans@erasmusmc.nl

Primary infection with herpes simplex virus 1 (HSV-1) and varicella zoster virus 
(VZV) results in lifelong latent infections of neurons in sensory ganglia such as
the trigeminal ganglia (TG). It has been postulated that T cells retained in TG
inhibit reactivation of latent virus. The acquisition of TG specimens of
individuals within hours after death offered the unique opportunity to
characterize the phenotype and specificity of TG-resident T cells in humans. High
numbers of activated CD8(+) T cells expressing a late effector memory phenotype
were found to reside in latently infected TG. The T cell infiltrate was
oligoclonal, and T cells selectively clustered around HSV-1 but not VZV latently 
infected neurons. Neuronal damage was not observed despite granzyme B expression 
by the neuron-interacting CD8(+) T cells. The TG-resident T cells, mainly CD8(+) 
T cells, were directed against HSV-1 and not to VZV, despite neuronal expression 
of VZV proteins. The results implicate that herpesvirus latency in human TG is
associated with a local, persistent T cell response, comprising activated late
effector memory CD8(+) T cells that appear to control HSV-1 latency by
noncytolytic pathways. In contrast, T cells do not seem to be directly involved
in controlling VZV latency in human TG.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17360672 [PubMed - indexed for MEDLINE]

790: Public Health Rep. 2007 Mar-Apr;122(2):155-9.

Chickenpox exposure and herpes zoster disease incidence in older adults in the
U.S.

Chaves SS, Santibanez TA, Gargiullo P, Guris D.

Viral Diseases Division, Centers for Disease Control and Prevention,1600 Clifton 
Rd., NE; MS-A-47, Atlanta, GA, 30333, USA. schaves@cdc.gov

OBJECTIVES: Exposure to varicella zoster virus through close contact with people 
with chickenpox was suggested to boost specific immunity, reducing the risk of
herpes zoster (HZ). Since the introduction of the varicella immunization program 
in the US in 1995, varicella morbidity has decreased substantially. This article 
examines incidence and risk factors associated with self-reported HZ disease and 
whether exposure to chickenpox within the previous decade reduces the risk of
shingles in this age group. METHODS: In 2004, a national random-digit dial
telephone survey was used to obtain information on self-reported HZ disease,
demographic characteristics, and exposure to children with chickenpox in the past
decade. National estimates of the incidence of shingles disease were calculated. 
RESULTS: Incidence rate of self-reported HZ was 19 per 1,000 population per year.
White individuals were 3.5 times more likely to report shingles than Hispanic
individuals (p<0.01). Previous exposure to chickenpox did not protect against HZ 
disease in this population. Seven percent of adults > or =65 years of age
reported exposure to children with chickenpox in the past decade. CONCLUSIONS:
Incidence of HZ among individuals > or =65 years of age in the U.S. may be higher
than previously described in the literature, with whites being at higher risk for
the disease. Currently, the potential contribution of exposure to chickenpox as a
mechanism for maintaining cell-mediated immunity against HZ may be limited to a
small percentage of the population. Vaccination against HZ may represent the best
means of decreasing this disease burden.

PMID: 17357357 [PubMed - indexed for MEDLINE]

791: Eur J Hum Genet. 2007 Jun;15(6):672-8. Epub 2007 Mar 14.

Does apolipoprotein E determine outcome of infection by varicella zoster virus
and by Epstein Barr virus?

Wozniak MA, Shipley SJ, Dobson CB, Parker SP, Scott FT, Leedham-Green M, Breuer
J, Itzhaki RF.

Faculty of Life Sciences, The University of Manchester, Manchester, UK.

Over 90% of the population are infected with varicella zoster virus (VZV) but
only some develop shingles - caused when the virus reactivates from latency, and 
only some shingles patients develop post-herpetic neuralgia (PHN), defined as
pain continuing for more than about 4 months. Epstein Barr virus (EBV) similarly 
infects over 90% of the population; some of those infected during teenage or
young adult years develop infectious mononucleosis (IM). The reason for these
disparities between numbers infected and numbers affected by illness is unknown, 
but presumably reflects host factor(s). Our previous results showed that
apolipoprotein E (APOE) genotype determines susceptibility to, or outcome of,
infection in the case of several diseases of known infectious cause. Therefore,
we investigated APOE genotypes of shingles, PHN, and IM patients. Our rationale
for the previous studies and for investigating VZV was that these micro-organisms
use for cell binding and entry the same sites in the cell surface as does the
protein apoE, and that consequently, competition with apoE could affect the
pathogen's extent of entry and hence extent of the damage caused. The APOE
genotypes of shingles and PHN sufferers, and of IM sufferers were determined
using restriction fragment length polymorphism. In females, epsilon4 homozygosity
confers a risk of shingles and also of IM, and the APOE-epsilon4 allele is
protective against PHN whereas APOE-epsilon3 allele is a risk. Our results
showing that a host genetic factor influences the development of shingles and PHN
in females have clinical significance: they could lead to identification of those
(female) patients at greater risk of PHN, thus enabling these people to be
targeted for treatment with the most effective drugs.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17356546 [PubMed - indexed for MEDLINE]

792: Rev Med Suisse. 2007 Jan 10;3(93):14-7.

[Geriatrics]

[Article in French]

Bula C, Gold G.

Service de geriatrie et readaptation geriatrique, Centre universitaire de
traitements et de readaptation (CUTR) Sylvana, Departement de medecine, CHUV CUTR
Sylvana, 1066 Epalinges. christophe.bula@chuv.ch

A new vaccine reduces the incidence and severity of zoster and its complications 
in older persons. A cost-effectiveness analysis highlights the implication of
CDC's recent recommendation to vaccinate all persons aged 60 years and over. A
meta-analysis confirms that the chronic use of sedatives in older persons
provides modest benefits and important risks. Unfortunately, melatonin does not
seem to be a useful alternative. A systematic review of interventions to prevent 
pressure ulcers provides scientific support to measures empirically used in most 
institutions. Finally, a randomized controlled trial questions the clinical
benefit of atypical neuroleptics in Alzheimer's disease and a comprehensive
review of pharmacological trials in mild cognitive impairment reports no benefit 
of any of the tested drugs on conversion rate to Alzheimer's disease.

Publication Types: 
    English Abstract

PMID: 17354654 [PubMed - indexed for MEDLINE]

793: Harefuah. 2007 Feb;146(2):89-91, 167.

[Varicella zoster virus infection involving the maxillary branch of the
trigeminal nerve]

[Article in Hebrew]

Warman M, Halperin D.

Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center,
Rehovot. meirwa@clalit.org.il

Herpes zoster is an infection caused by reactivation of the latent varicella
virus in the sensory ganglia. The mechanisms responsible for Varicella zoster
virus (VZV) reactivation are poorly understood. Yet, it is believed that
decreased cellular immunity can be a trigger for it's reactivation. The
occurrence of herpes zoster in young people may point to an underlying
immunodeficiency. Therefore, the possibility of concomitant HIV infection must be
eliminated. Herpes zoster manifests as a vesicular rash along a sensory
dermatome, usually preceded by pain or paresthesia of the involved cutaneous
area. The most commonly affected dermatomes are those of the thorax and abdomen, 
followed by the cranial nerves, especially the trigeminal nerve. The maxillary
nerve is the least frequently affected branch of the trigeminal nerve and only
rarely causes ocular injury. This is a case history of a young patient infected
with VZV involving the maxillary branch of the trigeminal nerve, complicated by
secondary bacterial infection of the ipsilateral hemiface. The literature
regarding the epidemiology, pathogenesis, complications and the proper treatment 
of herpes zoster is reviewed with an emphasis on the involvement of cranial
nerves.

Publication Types: 
    English Abstract

PMID: 17352273 [PubMed - indexed for MEDLINE]

794: Nihon Kokyuki Gakkai Zasshi. 2007 Feb;45(2):166-9.

[A case of diaphragmatic paralysis caused by herpes zoster after anticancer
chemotherapy]

[Article in Japanese]

Morinaga R, Matsunaga N, Iwata A, Kishi K, Tokimatsu I, Nagai H, Kadota J.

Second Department of Internal Medicine, Oita University Faculty of Medicine.

A 61-year-old woman who had been followed up after resection of lung cancer
(adenosquamous cell carcinoma), was admitted to our hospital because of
recurrence. She received systemic anticancer chemotherapy and the chief adverse
event was leukopenia (Grade 3). Nineteen days after initiating chemotherapy, she 
suffered painful vesicular eruption on the right upper limb and the right upper
hemithorax which was diagnosed as herpes zoster. After treatment with anti-viral 
drugs the vesicular eruption disappeared, but chest X-ray film revealed a right
diaphragmatic relaxation. Although herpes zoster virus usually affects sensory
nerves and causes painful vesicular eruption, it can also damage motor nerves.
Herpes zoster virus almost affects cranial nerves, but it should be considered as
the cause of diaphragmatic paralysis in this case.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17352174 [PubMed - indexed for MEDLINE]

795: J Neurol. 2007 Mar;254(3):400-1. Epub 2007 Mar 7.

Posterior horn varicella-zoster virus myelitis.

Toledano R, Lopez-Sendon J, Gilo F, Riva E, Martinez-San Millan J, Masjuan J.

Publication Types: 
    Case Reports
    Letter

PMID: 17345034 [PubMed - indexed for MEDLINE]

796: J Virol. 2007 May;81(10):5091-101. Epub 2007 Mar 7.

Herpes simplex virus immediate-early protein ICP22 triggers loss of serine
2-phosphorylated RNA polymerase II.

Fraser KA, Rice SA.

Department of Microbiology, University of Minnesota Medical School, Minneapolis, 
MN 55455, USA.

During eukaryotic mRNA transcription, the synthetic activity and mRNA processing 
factor interactions of RNA polymerase II (RNAP II) are regulated by
phosphorylation of its carboxyl-terminal domain (CTD), with modification
occurring primarily on serines 2 and 5 of the CTD. We previously showed that
herpes simplex virus type 1 (HSV-1) infection rapidly triggers the loss of RNAP
II forms bearing serine 2 phosphorylation (Ser-2P RNAP II). Here we show that the
HSV-1 immediate-early (IE) protein ICP22 is responsible for this effect during
the IE phase of infection. This activity does not require the viral UL13 protein 
kinase, which is required for several other regulatory functions of ICP22.
Additionally, we show that transient expression of ICP22 can trigger the loss of 
Ser-2P RNAP II in transfected cells. Thus, the ability of ICP22 to cause the loss
of Ser-2 RNAP II does not require other viral factors or the context of the
infected cell. Expression of the HSV-1 ICP22-related protein US1.5, which
corresponds to residues 147 to 420 of ICP22, also triggers a loss of Ser-2P RNAP 
II in transfected cells, whereas expression of the varicella-zoster virus ICP22
homolog, ORF63, does not. Our study also provides evidence for a second, viral
late gene-dependent pathway that triggers loss of Ser-2P RNAP II in infected
cells, consistent with the recent work of Dai-Ju et al. (J. Q. Dai-Ju, L. Li, L. 
A. Johnson, and R. M. Sandri-Goldin, J. Virol. 80:3567-3581, 2006). Therefore, it
appears that HSV-1 has evolved redundant mechanisms for triggering the loss of a 
specific phosphorylated form of RNAP II.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17344289 [PubMed - indexed for MEDLINE]

797: Mov Disord. 2007 May 15;22(7):1024-6.

PRKCG mutation (SCA-14) causing a Ramsay Hunt phenotype.

Visser JE, Bloem BR, van de Warrenburg BP.

Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen,
The Netherlands. j.visser@neuro.umcn.nl

Progressive myoclonic ataxia, also referred to as Ramsay Hunt syndrome, is
characterized by a combination of myoclonus and cerebellar ataxia, infrequently
accompanied by tonic-clonic seizures. Its differential diagnosis overlaps with
progressive myoclonic epilepsy, a syndrome with myoclonus, tonic-clonic seizures,
progressive ataxia and dementia. In patients with progressive myoclonic epilepsy,
specific diseases can frequently be recognized, but the diagnostic yield in
progressive myoclonic ataxia is much lower. We describe a patient who presented
with multifocal myoclonus in his thirties and who later developed cerebellar
ataxia and focal dystonia. His father was similarly affected. Genetic studies
revealed a mutation in the protein kinase C gamma (PRKCG) gene, known to cause
spinocerebellar ataxia type 14 (SCA-14). This case illustrates that both
myoclonus and dystonia are part of the clinical spectrum in SCA-14 and that
myoclonus can even be the presenting symptom. We suggest that SCA-14 should be
considered in the differential diagnosis of progressive myoclonic ataxia. (c)
2007 Movement Disorder Society.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 17343273 [PubMed - indexed for MEDLINE]

798: Rev Med Liege. 2007 Jan;62(1):44-7.

[How I prevent...herpes zoster by vaccination]

[Article in French]

Nikkels AF, Pierard GE.

Service de Dermatopathologie, CHU Sart Tilman, Liege, Belgique.

Herpes zoster (HZ) results from reactivation of the varicella-zoster virus (VZV),
which remains latent in the dorsal root ganglia after varicella. HZ predominantly
affects people over 50 years of age without gender distinction, and its incidence
increases with age. The most feared complication of HZ is the zoster-associated
pains (ZAP), which encompasses the prodromal, concomitant and post-zoster
persistent pains. The latter neuralgias are particularly invalidating and
notoriously difficult, or even impossible to abate with current therapies. Until 
now, the best ZAP prevention was achieved by antiviral treatment given during the
earliest phase of the eruption. This treatment certainly reduces the duration and
intensity of ZAP, but exerts little influence on post-zoster persistent pains. A 
vaccination boosting the specific anti-VZV immunity in order to decrease the HZ
incidence and post-zoster pains appears promising. A recent study performed on
38.546 immunocompetent patients aged over 60 years assessed the efficacy of a
single injection of an anti-zoster vaccine (Zostavax). The incidence of HZ and
post-zoster pain was decreased by 50% and 66%, respectively. Vaccination could be
considered as a valuable option to alleviate the feared complications of HZ.

Publication Types: 
    English Abstract
    Review

PMID: 17343129 [PubMed - indexed for MEDLINE]

799: CBE Life Sci Educ. 2007 Spring;6(1):65-73.

Exploring DNA structure with Cn3D.

Porter SG, Day J, McCarty RE, Shearn A, Shingles R, Fletcher L, Murphy S,
Pearlman R.

Geospiza, Inc., Seattle, WA 98107, USA. sandy@geospiza.com

Researchers in the field of bioinformatics have developed a number of analytical 
programs and databases that are increasingly important for advancing biological
research. Because bioinformatics programs are used to analyze, visualize, and/or 
compare biological data, it is likely that the use of these programs will have a 
positive impact on biology education. Over the past years, we have been working
to help biology instructors introduce bioinformatics activities into their
curricula by providing them with instructional materials that use bioinformatics 
programs and databases as educational tools. In this study, we measured the
impact of a set of these materials on student learning. The activities in these
materials asked students to use the molecular structure visualization program
Cn3D to locate, identify, or analyze diverse features in DNA structures. Both the
experimental groups of college and high school students showed significant
increases in learning relative to control groups. Further, learning gains by the 
college students were correlated with the number of activities assigned. We
conclude that working with Cn3D was important for improving student understanding
of DNA structure. This study is one example of how a bioinformatics program for
visualization can be used to support student learning.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 17339395 [PubMed - indexed for MEDLINE]

800: J Clin Virol. 2007 Apr;38(4):275-9. Epub 2007 Mar 6.

Comment in:
    J Clin Virol. 2007 Jul;39(3):238-9.

Clinical and psychosocial correlates of acute pain in herpes zoster.

Volpi A, Gatti A, Serafini G, Costa B, Suligoi B, Pica F, Marsella LT, Sabato E, 
Sabato AF.

Department of Public Health, University of Rome Tor Vergata, Italy.
volpi@med.uniroma2.it <volpi@med.uniroma2.it>

BACKGROUND: Acute and persistent pain are the most significant clinical
manifestations of herpes zoster (HZ), but the characteristics of acute pain in HZ
patients have been inadequately investigated. OBJECTIVES: To correlate the
severity of acute pain with clinical, demographic and psychosocial
characteristics of HZ patients. STUDY DESIGN: Five hundred thirty-three patients 
with acute HZ were recruited by 119 dermatologists who collected medical and
demographic data at diagnosis, provided counselling and therapy where appropriate
and asked the patients to complete the Short Italian Questionnaire designed for
comprehensive evaluation of HZ patients. RESULTS: In a univariate analysis,
greater acute pain severity was significantly associated with female gender,
number of dermatomes affected, presence of prodromal pain, abnormal sensations
(dysesthesia), education level, anxiety and depression. Quality of life, even if 
greatly reduced, did not correlate with the intensity of pain. In a multivariate 
model, the intensity of pain was independently associated with the extent of rash
(p=0.042), presence of prodromal pain (p=0.005), dysesthesia, education level
(p=0.040), and depression (p<0.001), but not with gender, anxiety or quality of
life. CONCLUSIONS: This study suggests that in patients with acute HZ the
severity of the disease and depression at presentation are the main correlates of
pain intensity.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17339131 [PubMed - indexed for MEDLINE]

801: Eur J Pediatr. 2008 Jan;167(1):47-55. Epub 2007 Mar 3.

Varicella vaccination in Europe: are we ready for a universal childhood
programme?

Sengupta N, Booy R, Schmitt HJ, Peltola H, Van-Damme P, Schumacher RF, Campins M,
Rodrigo C, Heikkinen T, Seward J, Jumaan A, Finn A, Olcen P, Thiry N,
Weil-Olivier C, Breuer J.

Centre for Child Health, Royal London Hospital, 38 New Road, Whitechapel, London,
E1 2AX, UK. n.sengupta@qmul.ac.uk

Safe and effective vaccines against varicella zoster virus (VZV), the
aetiological agent of varicella and shingles, have been available in Europe for
the last 5-10 years. The USA has had a universal childhood vaccination policy
since 1995 and this has resulted in a dramatic decrease in the incidence,
morbidity and mortality related to varicella. The economic and medical burden of 
VZV has led to discussions regarding both the desirability and feasibility of a
similar routine immunisation policy for all European children. This article
examines the epidemiology of varicella in Europe and how the data emerging from
the USA can be used to achieve adequate prevention of the disease. It looks into 
the current evidence of the health economic evaluation of universal varicella
vaccination and explores the concerns surrounding such a policy, including the
postulated impact on the incidence of zoster. In conclusion, the Society of
Independent European Vaccination Experts (SIEVE) recommends that the immunisation
of susceptible adolescents needs to be urgently implemented, in addition to the
current recommendations targeting high-risk patients, their close contacts with a
negative history of varicella and seronegative health-care workers. A universal
policy, optimally incorporating a two-dose schedule, will be needed to finally
reduce the burden of disease of varicella from a societal point of view. The
SIEVE recommends the implementation of such a policy as soon as financially and
practically possible.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17334784 [PubMed - indexed for MEDLINE]

802: Trop Doct. 2007 Jan;37(1):45-7.

Clinical screening for HIV in a health centre setting in urban Kenya: an entry
point for voluntary counselling, HIV testing and early diagnosis of HIV
infection?

Arendt V, Mossong J, Zachariah R, Inwani C, Farah B, Robert I, Waelbrouck A,
Fonck K.

Medecins Sans Frontieres, Mission Kenya, Brussels Operational Centre, Brussels,
Belgium.

A study was conducted among patients attending a public health centre in Nairobi,
Kenya in order to (a) verify the prevalence of HIV, (b) identify clinical risk
factors associated with HIV and (c) determine clinical markers for clinical
screening of HIV infection at the health centre level. Of 304 individuals
involved in the study,107(35%) were HIV positive. A clinical screening algorithm 
based on four clinical markers, namely oral thrush, past or present TB, past or
present herpes zoster and prurigo would pick out 61 (57%) of the 107 HIV-positive
individuals. In a resource-poor setting, introducing a clinical screening
algorithm for HIV at the health centre level could provide an opportunity for
targeting voluntary counselling and HIV testing, and early access to a range of
prevention and care interventions.

Publication Types: 
    Evaluation Studies

PMID: 17326892 [PubMed - indexed for MEDLINE]

803: FDA Consum. 2006 Sep-Oct;40(5):38-9.

Vaccine approved for shingles in older people.

[No authors listed]

A new vaccine called Zostavax is available to reduce the risk of shingles (herpes
zoster) in people ages 60 and older.

PMID: 17326312 [PubMed - indexed for MEDLINE]

804: Antimicrob Agents Chemother. 2007 May;51(5):1795-803. Epub 2007 Feb 26.

Selective phosphorylation of antiviral drugs by vaccinia virus thymidine kinase.

Prichard MN, Keith KA, Johnson MP, Harden EA, McBrayer A, Luo M, Qiu S,
Chattopadhyay D, Fan X, Torrence PF, Kern ER.

Department of Pediatrics, University of Alabama School of Medicine, Birmingham,
AL 35233, USA. mprichard@peds.uab.edu

The antiviral activity of a new series of thymidine analogs was determined
against vaccinia virus (VV), cowpox virus (CV), herpes simplex virus, and
varicella-zoster virus. Several compounds were identified that had good activity 
against each of the viruses, including a set of novel 5-substituted deoxyuridine 
analogs. To investigate the possibility that these drugs might be phosphorylated 
preferentially by the viral thymidine kinase (TK) homologs, the antiviral
activities of these compounds were also assessed using TK-deficient strains of
some of these viruses. Some of these compounds were shown to be much less
effective in the absence of a functional TK gene in CV, which was unexpected
given the high degree of amino acid identity between this enzyme and its cellular
homolog. This unanticipated result suggested that the CV TK was important in the 
mechanism of action of these compounds and also that it might phosphorylate a
wider variety of substrates than other type II enzymes. To confirm these data, we
expressed the VV TK and human TK1 in bacteria and isolated the purified enzymes. 
Enzymatic assays demonstrated that the viral TK could efficiently phosphorylate
many of these compounds, whereas most of the compounds were very poor substrates 
for the cellular kinase, TK1. Thus, the specific phosphorylation of these
compounds by the viral kinase may be sufficient to explain the TK dependence.
This unexpected result suggests that selective phosphorylation by the viral
kinase may be a promising new approach in the discovery of highly selective
inhibitors of orthopoxvirus replication.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 17325220 [PubMed - indexed for MEDLINE]

805: Rheumatology (Oxford). 2007 Jun;46(6):952-6. Epub 2007 Feb 22.

Long-term effects of combination treatment with fludarabine and low-dose pulse
cyclophosphamide in patients with lupus nephritis.

Illei GG, Yarboro CH, Kuroiwa T, Schlimgen R, Austin HA, Tisdale JF, Chitkara P, 
Fleisher T, Klippel JH, Balow JE, Boumpas DT.

National Institute of Dental and Craniofacial Research, National Institutes of
Health, Bethesda, MD 20892, USA. illeig@mail.nih.gov

OBJECTIVES: To determine the safety and efficacy of a short course of fludarabine
combined with cyclophoshamide in lupus nephritis. METHODS: A phase I/II open
label pilot study. Thirteen patients with active proliferative lupus nephritis
received monthly oral boluses of low-dose cyclophoshamide (0.5 gm/m(2) on day 1) 
and subcutaneous fludarabine (30 mg/m(2) on days 1-3) for 3-6 cycles. Concomitant
prednisone was aggressively tapered from 0.5 mg/kg/day to a low-dose,
alternate-day schedule. Patients were followed for at least 24 months after
therapy. The primary outcome was the number of patients achieving renal remission
defined as stable creatinine, proteinuria <1 gm/day and inactive urine sediment
for at least 6 months. RESULTS: The study was terminated early because of bone
marrow toxicity. Eleven patients who received at least three cycles were
evaluated for efficacy. Ten patients improved markedly with seven patients
achieving complete remission and three patients achieving partial remission.
There were three serious haematological adverse events during the treatment with 
one death due to transfusion-associated graft vs host disease. Profound and
prolonged CD4 (mean CD4: 98/microl at 7 months and 251/microl at 12 months) and
CD20 lymphocytopenia was noted in most patients. Three patients developed Herpes 
zoster infections. CONCLUSIONS: A short course of low-dose fludarabine and
cyclophoshamide can induce long-lasting remissions in patients with proliferative
lupus nephritis, but severe myelosuppression limits its widespread use.

Publication Types: 
    Clinical Trial, Phase I
    Clinical Trial, Phase II

PMID: 17317716 [PubMed - indexed for MEDLINE]

806: Am J Ophthalmol. 2007 Mar;143(3):536-8. Epub 2006 Nov 28.

Two patients with the von Szily reaction: herpetic keratitis and contralateral
retinal necrosis.

Smith LK, Kurz PA, Wilson DJ, Flaxel CJ, Rosenbaum JT.

Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97239, 
USA.

PURPOSE: To present two patients with prior unilateral, herpetic keratitis who
developed acute retinal necrosis (ARN) in the contralateral eye. These cases have
noticeable similarities to the von Szily reaction. This describes the development
of a contralateral retinitis subsequent to an anterior chamber injection of
herpes simplex virus (HSV). DESIGN: Interventional case series. METHODS:
Retrospective chart and literature review. RESULTS: The first patient had
neonatally acquired herpetic keratitis and developed ARN at age 21. Polymerase
chain reaction of a vitreous biopsy detected HSV type-2 (HSV-2). The second
patient was clinically diagnosed with ARN contralateral to varicella zoster
keratitis. A detailed literature search located seven prior case reports with a
von Szily reaction. These resembled our two cases except none had HSV-2 or years 
of latency from keratitis to retinitis. CONCLUSIONS: Clinicians need to be
cognizant of the von Szily reaction.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 17317412 [PubMed - indexed for MEDLINE]

807: Neurologia. 2007 Jan-Feb;22(1):46.

[Trigeminal herpes zoster. Pons hypersignal in magnetic resonance imaging]

[Article in Spanish]

Perez Navarro JM, Escamilla Sevilla F, Pastor Rull J.

Servicio de Neurologia, Hospital Universitario Virgen de las Nieves, Granada.
majosepn@fundacionhvn.org

Publication Types: 
    Case Reports

PMID: 17315102 [PubMed - indexed for MEDLINE]

808: J Med Virol. 2007 Apr;79(4):413-25.

Infection and direct injury in human hepatocyte explants and a hepatoblastoma
cell line due to hepatiticomimetic (non-hepatitis) viruses.

Phromjai J, Aiba N, Suzuki M, Sato H, Takahara T, Kondo S, Shiraki K.

Department of Virology, University of Toyama, Sugitani, Toyama, Japan.

Hepatitis is caused by hepatitis viruses, but hepatitis or hepatocellular enzyme 
abnormalities is sometimes associated with infection by the hepatiticomimetic
viruses. The direct and indirect effects of infection with hepatiticomimetic
viruses were examined in two human hepatocyte systems. Poliovirus, adenovirus,
and herpes simplex virus (HSV) induced cytopathology in Hep G2 cells. Measles
virus caused no change in hepatocytes. Poliovirus infection did not affect
cellular protein synthesis, and the peak of hepatocellular enzyme release
coincided with the peak of virus release. The increase in adenovirus protein
synthesis correlated with the decrease of transferrin synthesis, and enzyme
release was not prominent. HSV induced viral protein synthesis with enhanced
processing and inhibition of synthesis of alpha1-antitrypsin. The peak of enzyme 
release was later than the peak of virus release. In primary hepatocytes,
poliovirus, adenovirus, and induced extensive cytopathology and enzyme release,
and VZV caused cytopathology and significant but minute enzyme release. The ratio
of lactate dehydrogenase to aspartate aminotransferase release was larger in
poliovirus infection in both hepatocytes than in HSV or VZV infection. Although
poliovirus and adenovirus are released by cytolysis and HSV and VZV are secreted 
by exocytosis of cytoplasmic vacuoles, enzyme release was independent of the type
of virus release. Adenovirus showed strong cytotoxicity but did not modify the
membrane nor cause enzyme release. Enzyme release was associated with
modification of the surface membrane due to apoptosis with poliovirus and
necrosis with HSV. Consequently hepatocellular injury by viral infection did not 
reflect the amount or pattern of hepatocellular enzyme release. (c) 2007
Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17311334 [PubMed - indexed for MEDLINE]

809: J Eur Acad Dermatol Venereol. 2007 Mar;21(3):431-2.

Occurrence of acne comedones over healed linear scar of herpes zoster: a
neurogenic perception.

Sardana K, Relhan V, Sehgal VN, Garg VK, Kochhar AM.

Publication Types: 
    Case Reports
    Letter

PMID: 17309494 [PubMed - indexed for MEDLINE]

810: Bull World Health Organ. 2007 Feb;85(2):116-23.

Progression to WHO criteria for antiretroviral therapy in a 7-year cohort of
adult HIV-1 seroconverters in Abidjan, Cote d'Ivoire.

Minga A, Danel C, Abo Y, Dohoun L, Bonard D, Coulibaly A, Duvignac J, Dabis F,
Salamon R, Anglaret X; ANRS 1220 Study Group.

Programme PAC-CI, Abidjan, Cote d'Ivoire. minga.albert@caramail.com

OBJECTIVE: To estimate the probability of reaching the criteria for starting
highly active antiretroviral therapy (HAART) in a prospective cohort of adult
HIV-1 seroconverters in Abidjan, Cote d'Ivoire. METHODS: We recruited
participants from HIV-positive donors at the blood bank of Abidjan for whom the
delay since the estimated date of seroconversion (midpoint between last negative 
and first positive HIV-1 test) was < 36 months. Participants were offered early
trimethoprim-sulfamethoxazole (cotrimoxazole) prophylaxis, twice-yearly
measurement of CD4 count and we made standardized records of morbidity. We used
the Kaplan-Meier method to estimate the probability of reaching the criteria for 
starting HAART according to WHO 2006 guidelines. FINDINGS: 217 adults (77 women
(35%)) were followed up during 668 person-years (PY). The most frequent diseases 
recorded were mild bacterial diseases (6.0 per 100 PY), malaria (3.6/100 PY),
herpes zoster (3.4/100 PY), severe bacterial diseases (3.1/100 PY) and
tuberculosis (2.1/100 PY). The probability of reaching the WHO 2006 criteria for 
HAART initiation was estimated at 0.09, 0.16, 0.24, 0.36 and 0.44 at 1, 2, 3, 4
and 5 years, respectively. CONCLUSION: Our data underline the incidence of the
early HIV morbidity in an Ivorian adult population and provide support for HIV
testing to be made more readily available and for early follow-up of HIV-infected
adults in West Africa.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17308732 [PubMed - indexed for MEDLINE]

811: Rev Neurol (Paris). 2007 Jan;163(1):89-92.

[VZV-related myelitis: a pathophysiological hypothesis]

[Article in French]

Outteryck O, Deramecourt V, Bombois S, Mackowiak-Cordoliani MA, Pasquier F.

Clinique Neurologique, Hopital Roger Salengro, CHRU de Lille, 59037 Lille Cedex.

INTRODUCTION: Complications of VZV infection in the central nervous system are
multiple. VZV-related myelitis is an uncommon complication of herpes zoster.
OBSERVATION: We report the case of a 55-year old man with intercostal herpes
zoster who presented a subacute medullar syndrome. MRI demonstrated an extended
cervico-thoracic medullar hyperintensity on the T2-weighted images. Cerebrospinal
fluid (CSF) analysis showed 100 leukocytes/mm3, 0.94 g/L protein, negative VZV
PCR, elevated rate of anti-VZV IgG and no oligoclonal bands. Clinical, biological
and radiological presentations were compatible with the diagnosis of VZV-related 
myelitis with three potential pathophysiological mechanisms: infectious, immune
post-infectious, vascular. The course was partially favorable after a 3-day
regimen of corticosteroid and 3 weeks of acyclovir infusions. DISCUSSION:
Parainfectious myelitis is often the consequence of a viral infection with a
post-infectious pathogenesis. Most often, the clinical outcome is good. In this
case report, we highlight the VZV vascular tropism and its more severe outcome.
CONCLUSION: VZV-related myelitis should be diagnosed early. The combination of
aciclovir and corticoids infusions seems to be beneficial.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17304177 [PubMed - indexed for MEDLINE]

812: Iran J Allergy Asthma Immunol. 2005 Jun;4(2):95-8.

The Seroepidemiology of Varicella Zoster Virus (VZV) in Different Age Groups in
Tehran, Iran.

Sharifi Z, Emadi Ghanjin S.

Research Center of Iranian Blood Transfusion Organization (IBTO), Tehran, Iran.
sharifiz@yahoo.com.

Varicella zoster virus (VZV), the causative agent of chicken pox and shingles,
can cause severe systemic infections of the CNS and the respiratory tract in
immunocompetent individuals as well as in immunocompromized patients.The aim of
this cross-sectional study was to assess the prevalence of antibody Varicella
zoster virus in different age groups.The enzyme linked immunosorbent assay
(ELISA) method was used to assess the presence of anti -VZV antibody.A total of
635 serum samples were collected. Age specific prevalence of IgG antibody to VZV 
showed a progressive increase with age in both males and females. The overall
seroprevalence rate was 83.6%. Prevalence of antibodies was 59.7% in the age
group of less than 10 years, 60.4 % in 10-14 years, 87.5 % in 15-19 years, 88 %
in 20-24 years, 89.4 % in 25-29 years and 87.9 % in 30-39 years.The data show
that children should be considered as a target group for prevention programs
against VZV infection.

PMID: 17301429 [PubMed - in process]

813: Pediatr Dermatol. 2007 Jan-Feb;24(1):34-7.

Ramsay Hunt syndrome in a 3-month-old infant.

Balatsouras DG, Rallis E, Homsioglou E, Fiska A, Korres SG.

ENT Department, Tzanion General Hospital, Piraeus, Greece. balats@panafonet.gr

Ramsay Hunt syndrome is a disorder characterized by herpetic eruptions on the
auricle, facial paralysis, and vestibulocochlear dysfunction, and is attributed
to varicella zoster virus infection in the geniculate ganglion. Although it is a 
common cause of acute peripheral facial paralysis, children are not usually
affected. We describe Ramsay Hunt syndrome in a 3-month-old infant who was
referred because of a 2-day-old appearance of herpetic blisters on the right
auricle and along the distribution of the right facial nerve. His mother had been
infected with chickenpox during the second trimester of pregnancy. The infant
presented with right facial palsy and was anxious, but had no fever. Otoscopy
revealed herpetic eruptions in the right ear canal. Otoacoustic emissions were
absent in the right ear and auditory brainstem responses confirmed moderate
sensorineural hearing loss. Appropriate treatment resulted in slight improvement 
after the first week and complete recovery within 4 months. Infection with
varicella zoster virus was proved by a significant increase in the serum
anti-varicella zoster virus antibody titer during the convalescent phase of the
disease.

Publication Types: 
    Case Reports

PMID: 17300646 [PubMed - indexed for MEDLINE]

814: Hum Vaccin. 2007 Mar-Apr;3(2):64-8. Epub 2007 Mar 23.

Vaccination to prevent herpes zoster and postherpetic neuralgia.

Oxman MN.

University of California San Diego, VA San Diego Healthcare System, San Diego,
California, USA. mnoxman@ucsd.edu

Publication Types: 
    Review

PMID: 17299270 [PubMed - indexed for MEDLINE]

815: J Med Chem. 2007 Mar 8;50(5):1069-77. Epub 2007 Feb 14.

Antiviral activity of triazine analogues of
1-(S)-[3-hydroxy-2-(phosphonomethoxy)propyl]cytosine (cidofovir) and related
compounds.

Krecmerova M, Holy A, Piskala A, Masojidkova M, Andrei G, Naesens L, Neyts J,
Balzarini J, De Clercq E, Snoeck R.

Gilead Sciences & IOCB Research Centre, Centre for New Antivirals and
Antineoplastics (IOCB), Institute of Organic Chemistry and Biochemistry, Academy 
of Sciences of the Czech Republic. marcela@uochb.cas.cz

Treatment of 5-azacytosine sodium salt with diisopropyl
[(2-chloroethoxy)methyl]phosphonate followed by removal of ester groups with
BrSi(CH3)3 afforded 1-[2-(phosphonomethoxy)ethyl]-5-azacytosine (3). Reaction of 
5-azacytosine with [(trityloxy)methyl]-(2S)-oxirane followed by etherification
with diisopropyl (bromomethyl)phosphonate and removal of ester groups gave
1-(S)-[3-hydroxy-2-(phosphonomethoxy)propyl]-5-azacytosine (1). The synthesis of 
6-azacytosine congener 2 was analogous using N4-benzoylated intermediates.
Compound 1 was shown to exert strong activity against a broad spectrum of DNA
viruses including adenoviruses, poxviruses, and herpesviruses (i.e., herpes
simplex viruses, varicella zoster virus, and human cytomegalovirus).
Decomposition of 1 in alkaline solutions resulted in products 17 and 18. While
the N-formylguanidine derivative 17 proved active, the carbamyolguanidine
derivative 18 was devoid of antiviral activity.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17298047 [PubMed - indexed for MEDLINE]

816: J Environ Sci (China). 2006;18(6):1193-8.

Investigation on Fe, Mn, Zn, Cu, Pb and Cd fractions in the natural surface
coating samples and surficial sediments in the Songhua River, China.

Guo SH, Wang XL, Li Y, Chen JJ, Yang JC.

Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang 110016,
China. shuhaiguo@iae.ac.cn

Natural surface coating samples (NSCSs) from the surface of shingles and
surficial sediments (SSs) in the Songhua River, China were employed to
investigate the relationship between NSCSs and SSs in fractions of heavy metals
(Fe, Mn, Zn, Cu, Pb, and Cd) using the modified sequential extraction procedure
(MSEP). The results show that the differences between NSCSs and SSs in Fe
fractions were insignificant and Fe was dominantly present as residual phase
(76.22% for NSCSs and 80.88% for SSs) and Fe-oxides phase (20.33% for NSCSs and
16.15% for SSs). Significant variation of Mn distribution patterns between NSCSs 
and SSs was observed with Mn in NSCSs mainly present in Mn-oxides phase (48.27%) 
and that in SSs present as residual phase (45.44%). Zn, Cu, Pb and Cd were found 
dominantly in residual fractions (>48%), and next in solid oxides/hydroxides for 
Zn, Pb and Cd and in easily oxidizable solids/compounds form for Cu,
respectively. The heavy metal distribution patterns implied that Fe/Mn oxides
both in NSCSs and SSs were more important sinks for binding and adsorption of Zn,
Pb and Cd than organic matter (OM), and inversely, higher affinity of Cu to OM
than Fe/Mn oxides in NSCSs and SSs was obtained. Meanwhile, it was found that the
distributions of heavy metals in NSCSs and SSs were similar to each other and the
pseudo-total concentrations of Zn, Cu, Pb and Cd in NSCSs were greater than those
in SSs, highlighting the more importance for NSCSs than SSs in controlling
behaviours of heavy metals in aquatic environments.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17294964 [PubMed - indexed for MEDLINE]

817: J Hum Lact. 2007 Feb;23(1):70-1.

Herpes zoster in the T4 dermatome: a possible cause of breastfeeding strike.

Mathers LJ, Mathers RA, Brotherton DR.

University of Pittsburgh School of Medicine, Waukesha Family Practice Residency
Program, Pittsburgh, PA, USA.

The authors report a case of breastfeeding strike temporally related to the onset
of a herpes zoster prodrome involving the left breast.

Publication Types: 
    Case Reports

PMID: 17293553 [PubMed - indexed for MEDLINE]

818: Epidemiol Infect. 2007 Aug;135(6):908-13. Epub 2007 Feb 12.

Comment in:
    Epidemiol Infect. 2008 Apr;136(4):449; author reply 449-50.

Secular trends in the epidemiology of shingles in Alberta.

Russell ML, Schopflocher DP, Svenson L, Virani SN.

Department of Community Health Sciences, University of Calgary, Calgary, Canada. 
mlrussel@ucalgary.ca

Varicella vaccine was licensed in Canada in 1998, and a publicly funded
vaccination programme introduced in the province of Alberta in 2001. In theory
the vaccination programme might increase the burden of disease from shingles,
making it important to develop baseline data against which future comparisons can
be made. The study's aim was to describe the epidemiology of non-fatal cases of
shingles for which publicly funded health services were utilized for the period
1986-2002. Shingles cases were identified from the records of Alberta's
universal, publicly funded health-care insurance system for 1986-2002. The
earliest dated health service utilizations for ICD-9-CM codes of 053 or ICD-10-CA
codes of B02 were classified as incident. Diagnostic codes at least 180 days
after the first were classified as recurrent episodes. Denominators for rates
were estimated using mid-year population estimates from the Alberta Health Care
Insurance Plan Registry. Annual age- and sex-specific rates were estimated. We
explored the pattern of rates for sex, age and year effects and their
interactions. Shingles rates increased between 1986 and 2002. There was a sex
effect and evidence of an age-sex interaction. Females had higher rates than
males at every age; however, the difference between females and males was
greatest for the 50-54 years age group and declined for older age groups. The
increased rate of shingles in Alberta began before varicella vaccine was licensed
or publicly funded in Alberta, and thus cannot be attributed to vaccination.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17291380 [PubMed - indexed for MEDLINE]

819: Dermatol Nurs. 2006 Dec;18(6):529.

More advances for dermatology patients.

Hill MJ.

Publication Types: 
    Editorial

PMID: 17286153 [PubMed - indexed for MEDLINE]

820: Am J Dermatopathol. 2007 Feb;29(1):109-11.

Comment on:
    Am J Dermatopathol. 2006 Apr;28(2):181-6.

The many faces of alpha-herpesviridae infections.

Nikkels AF, Pierard GE.

Publication Types: 
    Comment
    Letter

PMID: 17284977 [PubMed - indexed for MEDLINE]

821: Am J Dermatopathol. 2007 Feb;29(1):32-43.

Cutaneous vasculitis update: neutrophilic muscular vessel and eosinophilic,
granulomatous, and lymphocytic vasculitis syndromes.

Carlson JA, Chen KR.

Division of Dermatology, Albany Medical College, MC-81, Albany, NY 12208, USA.
carlsoa@mail.amc.edu

Most biopsies of cutaneous vasculitis will exhibit a small vessel neutrophilic
vasculitis [leukocytoclastic vasculitis (LCV)] that is associated with immune
complexes on direct immunofluorescence examination or, less commonly,
antineutrophilic cytoplasmic antibodies (ANCA) by indirect immunofluorescence
testing. Is in uncommon for skin biopsy to reveal solely a neutrophilic arteritis
signifying the presence of cutaneous polyarteritis nodosa or, if accompanied by
significant lobular panniculitis, nodular vasculitis/erythema induratum. In other
cases, cutaneous vascular damage (fibrinoid necrosis, muscular vessel wall
disruption, or endarteritis obliterans) will be mediated by a nonneutrophilic
inflammatory infiltrate. Eosinophilic vasculitis can be a primary (idiopathic)
process that overlaps with hypereosinophilic syndrome, or it can be a secondary
vasculitis associated with connective tissue disease or parasite infestation.
Authentic cutaneous granulomatous vasculitis (versus vasculitis with
extravascular granulomas) can represent a cutaneous manifestation of giant cell
arteritis, an eruption secondary to systemic disease such as Crohn's disease or
sarcoidosis, or a localized disorder, often a post-herpes zoster (HZ) phenomenon.
Lymphocytic vasculitis is a histologic reaction pattern that correlates with
broad clinical differential diagnosis, which includes connective tissue disease -
mostly systemic lupus erythematosus (SLE), endothelial infection by Rickettsia
and viruses, idiopathic lichenoid dermatoses such as perniosis or ulcerative
necrotic Mucha-Habermann disease, and angiocentric cutaneous T-cell lymphomas.
Skin biopsy extending into the subcutis, identifying the dominant inflammatory
cell and caliber of vessels affected, extravascular histologic clues such as
presence of lichenoid dermatitis or panniculitis, and correlation with clinical
data allows for accurate diagnosis of these uncommon vasculitic entities.

Publication Types: 
    Review

PMID: 17284960 [PubMed - indexed for MEDLINE]

822: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006 Nov;41(11):821-4.

[Bilateral facial nerve paralysis-diagnosis and treatment]

[Article in Chinese]

Wang H, Gao ZQ, Li YL, Liu W, Quan SM.

Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing 100730,
China.

OBJECTIVE: To observe the ways of diagnosis and treatment of bilateral facial
nerve palsy. METHODS: Seven cases of bilateral facial nerve paralysis in 1996 -
2003 were retrospectively reviewed, and then the ways of diagnosis and therapies 
of these cases were analyzed. There were 6 patients with doubtless diagnosis.
They were diagnosed as acute leukaemia, Vogt-Koyanagi-Harada disease (VKH),
Machado-Jesoph disease, bilateral mandible fractures, Guillain-Barre syndrome,
and Bell's palsy. The last one was diagnosed as Herpes zoster virus infection or 
Lyme disease. In all these cases, there were 4 of 5 positive cerebrospinal fluids
test, 1 of 6 positive lyme antibody test, 2 of 5 positive images test, 7 of 7 EMG
and Br test showed that the paralysis was peripheral palsy. All the 7 cases were 
treated with steroid and vitamin. RESULTS: House-Brackmann I was defined as
complete recovery, after up to 2 months follow up, there were four cases got
completely recovery while 2 cases incomplete recovery, and 1 case was not reacted
to the therapy. CONCLUSIONS: Bilateral facial nerve paralysis was rare, and it
was difficult to diagnosis and differentiation, while diagnostic mistakes would
be serious. More attention should be paid to it in clinic.

Publication Types: 
    English Abstract

PMID: 17283534 [PubMed - in process]

823: J Clin Virol. 2007 Mar;38(3):254-9. Epub 2007 Feb 5.

Progressive outer retinal necrosis in the era of highly active antiretroviral
therapy: successful management with intravitreal injections and monitoring with
quantitative PCR.

Yin PD, Kurup SK, Fischer SH, Rhee HH, Byrnes GA, Levy-Clarke GA, Buggage RR,
Nussenblatt RB, Mican JM, Wright ME.

National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
pdyin@mail.nih.gov

BACKGROUND: Progressive outer retinal necrosis (PORN) is an ocular disease in
individuals with AIDS and is associated with substantial morbidity. The optimal
management of PORN and its clinical course in the HAART era is unclear.
OBJECTIVE: We report a case of successfully managed PORN that provides insight
into the monitoring and treatment of this disease. STUDY DESIGN: Intravitreal
injections and intravenous therapy targeted towards varicella zoster virus (VZV) 
were used to treat PORN. HAART was initiated for HIV-1 therapy. Serial PCR for
VZV was performed on aqueous humor to monitor the clinical course. RESULTS: The
presence of VZV DNA from aqueous humor correlated with clinical exacerbations of 
disease. Initiation of twice weekly intravitreal injections with dual antiviral
drugs appeared to be an important therapeutic intervention that resulted in
remission of PORN. Secondary prophylaxis against VZV was successfully withdrawn
after HAART induced partial immune recovery. CONCLUSION: In addition to
aggressive therapy with intravitreal injections, HAART and quantitative
measurements of VZV DNA from aqueous humor have important roles in the management
of PORN. A multidisciplinary approach involving specialists in infectious
diseases, ophthalmology, and clinical microbiology will improve the chances for
successful long-term outcomes.

Publication Types: 
    Case Reports

PMID: 17280866 [PubMed - indexed for MEDLINE]

824: Otolaryngol Head Neck Surg. 2007 Feb;136(2):313-4.

Comment in:
    Otolaryngol Head Neck Surg. 2007 Jun;136(6):1027.

Hutchinson sign and herpes zoster.

Murrell GL, Hayes BH.

Naval Hospital Camp Pendleton California, Camp Pendleton, CA, and Uniformed
Services University of the Health Sciences, Bethesda, MD, USA.
glmurrell@cpen.med.navy.mil

Publication Types: 
    Case Reports

PMID: 17275563 [PubMed - indexed for MEDLINE]

825: Arch Phys Med Rehabil. 2007 Feb;88(2):255-8.

Comment in:
    Arch Phys Med Rehabil. 2007 Dec;88(12):1742-3; author reply 1743-4.

Postherpetic neuralgia involving the right C5 dermatome treated with a cervical
transforaminal epidural steroid injection: a case report.

Shakir A, Kimbrough DA, Mehta B.

Western Reserve Spine and Pain Institute, Kent, OH 44240, USA.
docshakir@hotmail.com

A 66-year-old woman presented with 2 weeks of debilitating right upper-limb pain 
with a vesicular rash over the right C5 dermatome secondary to herpes zoster. Her
pain failed to improve with: oral narcotics, divalproex, gabapentin, pregabalin, 
and topical 2% lidocaine cream. Six weeks postonset, a right C5 transforaminal
epidural steroid injection (TESI) under fluoroscopic guidance was performed.
Prior to the injection, her numeric pain intensity was rated as 9 to 10/10, and
15 minutes after the injection, it was reduced to 3/10. At 2 weeks, her pain had 
maintained an intensity of 3/10 and over another 2 weeks had resolved. She
remained pain-free 3 months later. In this case, the use of a cervical TESI
provided dramatic results in the treatment of debilitating postherpetic neuralgia
(PHN). Further investigation is needed to determine the efficacy of TESI in the
early management of PHN.

Publication Types: 
    Case Reports

PMID: 17270526 [PubMed - indexed for MEDLINE]

826: Rev Med Interne. 2007 Mar;28(3):166-72. Epub 2007 Jan 17.

[Immunization of adults against varicella and herpes zoster]

[Article in French]

Hanslik T, Blanchon T, Alvarez FP.

Service de Medecine Interne, Hopital Ambroise-Pare, Universite
Versailles-Saint-Quentin-en-Yvelines, Assistance publique-Hopitaux de Paris, 9,
avenue Charles-de-Gaulle, 92104 Boulogne Billancourt cedex, France.
thomas.hanslik@apr.aphp.fr

PURPOSE: Following the commercialisation in France of the varicella vaccine and
the European marketing authorization for a vaccine against zoster, this article
intends to review the epidemiology of varicella and herpes zoster, to expose the 
characteristics of the available vaccines, and to consider the advantages and
caveats of the different immunisation strategies. CURRENT KNOWLEDGE AND KEY
POINTS: In France, from 550.000 to 750.000 cases of varicella are reported each
year, which result in more than 3.500 hospitalizations and about 20 deaths.
Subjects>or=15 years old represent 8.3% of the total number of cases of
varicella, 26% of varicella-related hospitalisations and 69% of all
varicella-related deaths. The susceptibility rate for the 15 years old is 10,3
and 79% of these non-immune subjects are expected to contract varicella. The
vaccines currently marketed against varicella are safe, have a good
immunogenicity and remain effective over the evaluated periods. Two vaccination
strategies are considered: a generalized vaccination of the infants and children,
or a vaccination targeted against high-risk populations and non-immune teenagers 
and adults. The incidence of herpes zoster is estimated in France at 235.000 new 
cases per year, from which 1% is hospitalized. A live attenuated vaccine using
the same strain as the varicella vaccine, but at a much higher dose, proved its
efficacy in terms of reducing shingles and postherpetic neuralgia incidences, of 
51 and 67% respectively. This vaccine received a marketing authorisation in
France, for adults>or=60 years old. FUTURE PROSPECTS: Uncertainties about the
impact of vaccination on varicella and herpes zoster epidemiology have yet to be 
solved, such as the potential increase in herpes zoster incidence or in the
absolute number of diagnosed varicella cases in older age groups, or the loss of 
vaccination-induced immunity with time. These questions demonstrate the need for 
an operational real-time surveillance network to monitor varicella and herpes
zoster incidence in the setting of general population immunisation.

Publication Types: 
    English Abstract
    Review

PMID: 17270316 [PubMed - indexed for MEDLINE]

827: Pediatr Ann. 2007 Jan;36(1):21-9.

Childhood viral exanthems.

Dyer JA.

Department of Dermatology, University of Missorui, Columbia, MO, USA.
dyerja@health.missouri.edu

Many viral infections exhibit cutaneous lesions. Recognition of the exanthems
associated with these infections and the broader clinical scenarios in which they
occur can lead to more rapid diagnosis and appropriate treatment for affected
patients.

PMID: 17269280 [PubMed - indexed for MEDLINE]

828: Med Mal Infect. 2007 Feb;37(2):95-102. Epub 2007 Jan 30.

[Infectious encephalitis in France from 2000 to 2002: the hospital database is a 
valuable but limited source of information for epidemiological studies]

[Article in French]

Mailles A, Vaillant V, Stahl JP.

Institut de Veille Sanitaire, 12-14, rue du val-d'Osne, 94415 Saint-Maurice
cedex, France. a.mailles@invs.sante.fr

Many virus and bacteria can cause encephalitis but are rarely identified as the
aetiological agent by individual diagnosis. In France, the only continuous source
of information about encephalitis is the national hospital medical database
(NHMD). Data from the VIH-negative patients recorded in mainland France between
2000 and 2002 with a diagnosis of encephalitis were extracted and analysed
according to demographic, geographical and temporal distribution. Hospitalisation
details were described. An average of 1200 patients was recorded each year. They 
were residents of all French districts and equally hospitalized in university
hospitals and non university hospitals. Their mean age was 38, and most were men.
The aetiological diagnosis was unknown for 80%. The most frequent aetiological
diagnosis was herpes simplex virus in adults, and VZV virus in children. These
results give us some clues to design a national study on encephalitis. The study 
will be implemented in mainland France in 2007 and will last one year. We invite 
all voluntary hospitals to include their encephalitic patients in our study.

Publication Types: 
    English Abstract

PMID: 17267156 [PubMed - indexed for MEDLINE]

829: Nurse Pract. 2007 Feb;32(2):43-51; quiz 51-2.

Drug approvals.

Laustsen G, Gilbert M, Wimett L.

School of Nursing, Oregon Health and Science University, La Grande, OR, USA.

PMID: 17264794 [PubMed - indexed for MEDLINE]

830: Chem Immunol Allergy. 2007;92:244-53.

Acute retinal necrosis.

Kezuka T, Atherton SS.

Department of Ophthalmology, Tokyo Medical University Hospital, Tokyo, Japan.

Acute retinal necrosis (ARN) is a rare disease that is usually caused by one of
the three neurotropic human herpesviruses - herpes simplex virus type 1(HSV-1),
HSV-2 and varicella-zoster virus (VZV). Although much is known about the clinical
course of the disease and its treatment and about the viruses that cause it,
comparatively little is known about its pathogenesis. This article will review
the history of ARN, the typical clinical findings, and methods of diagnosis.
Information from studies of the mouse model of ARN including development of
anterior chamber-associated immune deviation (ACAID) and routes of spread will be
reconsidered, and the combined information from human and mouse studies will be
discussed to suggest mechanisms that contribute to the pathogenesis of ARN in
human patients. Finally, puzzles and questions about the disease will be
considered.

Publication Types: 
    Review

PMID: 17264500 [PubMed - indexed for MEDLINE]

831: Georgian Med News. 2006 Dec;(141):50-3.

Peculiarities of herpes zoster in immunocompetent and immunocompromised hosts.

Sharvadze L, Tsertsvadze T, Gochitashvili N, Bolokadze N, Dolmazashvili E.

Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi,
Georgia.

The aim of five years (2000-2005) study was to investigate the peculiarities of
Herpes Zoster in immunocompromised and immunocompetent patients. For this purpose
we have investigated the clinical course of Herpes Zoster, disease duration,
complications of disease, as in acute phase as well as postherpetic neuralgia in 
74 HIV positive (1st group) and 74 HIV negative (2nd group) groups of patients.
In both group of patients we have studied the prevalence of the following
complications: 1. Acute complications of Herpes Zoster: a) Neurological: motor
neuropathy, cranial neuritis, meningoencephalitis, transverse myelitis. b)
Ophthalmic: keratitis, iritis, retinitis, visual impairment c) Cutaneous:
bacterial superinfection, scarring, disfigurement. d) Visceral: pneumonitis,
hepatitis. e) Multidermatomal. 2. The complications of after resolution of
infection: a) Postherpetic neuralgia and various duration of pain associated with
postherpetic neuralgia such as : < month, 1-6 months, 6-12 months and >1 year
durations. b) Recurrent herpes zoster. Herpes Zoster infection was diagnosed
based on clinical symptoms and by detection of VZV specific IgM and IgG by ELISA.
HIV infection was diagnosed by ELISA method and was confirmed by Western Blot. We
found that Herpes Zoster may develop as in HIV positive as well as HIV negative
population. Study showed that severe cases of disease (Herpes Zoster), long
duration and rate of complications are much higher in HIV/AIDS than in HIV
negative group patients. Rate of hospitalization is also higher in HIV/AIDS
patients with Herpes Zoster than in HIV negative patients with Herpes Zoster.
Frequency of recurrent Herpes Zoster is much higher in HIV/AIDS patients than in 
HIV negative patients. The postherpetic neuralgia is very frequent complication
for both group (HIV positive and HIV negative) Herpes Zoster patients, but its
duration longer in HIV/AIDS patients in comparison HIV negative group. There were
no significant difference in disease severity, duration and complications among
male and female patients.

PMID: 17261887 [PubMed - indexed for MEDLINE]

832: Neurology. 2007 Jan 30;68(5):E4.

Spinal myoclonus following herpes zoster radiculitis.

Estraneo A, Saltalamacchia AM, Loreto V.

Salvatore Maugeri Foundation, IRCCS Via Bagni Vecchi, 82037 Telese Terme (BN),
Italy. aestraneo@fsm.it

Publication Types: 
    Case Reports

PMID: 17261675 [PubMed - indexed for MEDLINE]

833: Enferm Infecc Microbiol Clin. 2007 Jan;25(1):69-70.

[Ramsay-Hunt syndrome complicated with cerebral venous thrombosis in an
HIV-1-infected patient]

[Article in Spanish]

Pazos-Anon R, Machado-Costa C, Farto E Abreu J.

Publication Types: 
    Case Reports
    Letter

PMID: 17261251 [PubMed - indexed for MEDLINE]

834: Manag Care. 2006 Dec;15(12):57-8.

Herpes zoster vaccine brings relief for the elderly.

Morrow T.

Genentech Inc.

PMID: 17260848 [PubMed - indexed for MEDLINE]

835: Rinsho Shinkeigaku. 2006 Sep;46(9):668-70.

[Case of zoster sine herpete presenting with dysphagia diagnosed by PCR analysis 
of VZV DNA in auricular skin exudates]

[Article in Japanese]

Yaguchi H, Hisatomi M, Sekine T, Matsui K, Nagatomo M, Inoue K.

Department of Neurology, The Jikei University Kashiwa Hospital.

A 66-year-old woman was admitted to our hospital because of hoarseness and
dysphagia after right earache and pharyngalgia. She showed right glossopharyngeal
nerve and vagus nerve palsies, but no other neurological deficits. There was no
skin rash within the regions of her ear, oral cavity, pharynx and larynx. Slight 
increase of mononuclear cells was noted in the cerebrospinal fluid. MR brain
imaging was normal. We diagnosed her as zoster sine herpete (ZSH) and treated her
with acyclovir, after which she almost completely recovered. The examination of
antibodies and DNA of varicella zoster virus (VZV) in the serum and cerebrospinal
fluid revealed a pattern of previous zoster infection without evidences of
reactivation. However, VZV DNA was detected in auricular skin exudates with PCR. 
We conclude that PCR analysis of VZV DNA in auricular skin exudates can be a
useful diagnostic tool for the diagnosis of zoster sine herpete presenting with
painful glossopharyngeal nerve and vagus nerve palsies.

Publication Types: 
    English Abstract

PMID: 17260814 [PubMed - indexed for MEDLINE]

836: Rinsho Shinkeigaku. 2006 Sep;46(9):664-7.

[Case of herpes zoster associated Guillain-Barre syndrome with a relapse of
eruptions after intravenous immunoglobulin therapy]

[Article in Japanese]

Nagane Y, Utsugisawa K, Obara D.

Department of Neurology, Hanamaki General Hospital.

A 77-year-old woman developed progressive dysesthesia, hypesthesia and weakness
in four extremities immediately after improvement of herpes zoster in the left
Th10 dermatome area. Examination of the cerebrospinal fluid (CSF) showed an
increase in protein concentrations. Evidence of demyelinating polyneuropathy was 
demonstrated by nerve conduction studies. Her hypesthesia and weakness in the
extremities were gradually improved following intravenous immunoglobulin therapy 
(IVIg). Varicella zoster virus (VZV) titer levels in CSF well correlated both
with neurological symptoms and CSF protein concentrations. VZV DNA in the CSF was
not detectable. These findings suggested autoimmune Guillain-Barre syndrome (GBS)
associated with herpes zoster. An interesting finding in the present patient is
that one day after the completion of IVIg, when the neurological symptoms in the 
extremities were apparently ameliorating, the herpes zoster eruptions again
emerged in the left L3 dermatome area. By treatment with intravenous acyclovir,
the vesicular eruptions were improved. We assume that IVIg might suppress the
immune response against VZV and promote the recurrence of eruptions.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17260813 [PubMed - indexed for MEDLINE]

837: Cornea. 2007 Feb;26(2):190-3.

Corneal buttons obtained from patients with HSK harbor high copy numbers of the
HSV genome.

Shimomura Y, Deai T, Fukuda M, Higaki S, Hooper LC, Hayashi K.

Department of Ophthalmology, Kinki University School of Medicine, Osaka-Sayama,
Japan. yoshis@med.kindai.ac.jp

PURPOSE: To detect herpes simplex virus (HSV) genome in the cornea, we sampled
the limbal corneas and scleras of the imported eye bank eyes and recipient's
corneal buttons and quantitated HSV genome in them by real-time polymerase chain 
reaction (PCR). METHODS: Forty-four recipient corneas including 7 corneas with
and 37 corneas without a history of herpetic keratitis, 70 eye bank donor limbal 
corneas, and 35 eye bank donor scleras were obtained. Primers for real-time PCR
were synthesized using the HSV-1 and -2 common regions of the viral DNA
polymerase. Primers for conventional PCR were designed to detect HSV-1 and -2 and
varicella zoster virus (VZV). RESULTS: Significantly higher copy number of HSV
DNA was detected in corneas with a history of herpetic keratitis 85.7% (6/7),
with an average of 1.6 x 10(4) copies/mg tissue weight than in corneas without a 
history of herpetic keratitis 10.8% (4/37), with an average of 8.7 copies/mg
tissue weight (P < 0.05, Mann-Whitney U test). HSV DNA was detected in 5.7%
(4/70) of the eye bank donor corneas, with an average of 4.9 x 10(2) copies/mg
tissue weight, and in 8.6% (3/35) of the donor scleras, with an average of 10.6
copies/mg tissue weight. HSV-2 and VZV-DNA were not detected in these samples.
CONCLUSIONS: Real-time PCR quantitated HSV genome in the cornea even at a
quiescent phase of infection. HSV genome was detected in the corneas and scleras 
without a past history of herpetic keratitis by this method.

PMID: 17251811 [PubMed - indexed for MEDLINE]

838: Vaccine. 2007 Mar 1;25(11):2139-44. Epub 2006 Nov 27.

Safety and immunogenicity of a zoster vaccine in varicella-zoster virus
seronegative and low-seropositive healthy adults.

Macaladad N, Marcano T, Guzman M, Moya J, Jurado F, Thompson M, Meechan C, Li D, 
Schlienger K, Chan I, Sadoff J, Schodel F, Silber JL.

De la Salle University Medical Center, Cavite, Philippines.

OBJECTIVE: To evaluate immunogenicity and tolerability of a live attenuated
zoster vaccine in varicella-zoster virus (VZV) seronegative or low-seropositive
adults > or = 30 years of age. STUDY DESIGN: Double-blind, placebo-controlled,
randomized, multicenter study. Subjects were enrolled in two stages by
prescreened serostatus. Subjects with a low VZV antibody titer (< or = 5 gpELISA 
units/mL) were enrolled in Stage 1. Subjects with undetecable VZV antibodies and 
no safety issues identified during Stage 1 were enrolled in Stage 2. All enrolled
subjects were randomized 4:1 to receive one dose (approximately 50,000 PFU) of
zoster vaccine or placebo and were followed for safety for 42 days
postvaccination. Primary objectives/hypotheses: (1) no vaccine-related serious
adverse experiences (AE); (2) < or = 1 laboratory-confirmed varicella-like rash
with > 50 lesions within 42 days postvaccination. Secondary objective: summarize 
the VZV antibody response postvaccination. RESULTS: Twenty-one subjects (age 27
to 69 years; median 34) enrolled (1148 prescreened); 18 (including 4 seronegative
subjects) received vaccine and 3 (including 1 seronegative subject) received
placebo. Twenty subjects completed the study; one subject withdrew for reasons
unrelated to safety. No serious vaccine-related AE or laboratory-confirmed
varicella-like rashes with > 50 lesions were reported. In the zoster vaccine
group, all 4 of the initially seronegative subjects (age 32 to 36 years; median
33.5) seroconverted and 6 of the 13 (46.2%) initially seropositive subjects had a
> or = 4-fold rise in VZV-specific antibody titer at 6 weeks postvaccination.
CONCLUSIONS: The zoster vaccine appears to be immunogenic and generally well
tolerated in healthy adults > or = 30 years of age, regardless of initial VZV
antibody serostatus.

Publication Types: 
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 17250932 [PubMed - indexed for MEDLINE]

839: Pediatr Int. 2007 Feb;49(1):36-9.

Presence of herpesviruses in middle ear fluid of children with otitis media with 
effusion.

Bulut Y, Karlidag T, Seyrek A, Keles E, Toraman ZA.

Department of Microbiology, College of Medicine, Firat University, Elazig,
Turkey. ybulut@firat.edu.tr

BACKGROUND: Otitis media with effusion (OME) is a disease that frequently occurs 
in children. Etiopathogenesis of the diseases has not been completely elucidated.
There are limited numbers of studies on the presence of herpesviruses in otitis
media cases with OME. The present study was undertaken to determine the rate of
some herpesviruses in OME cases of children. METHODS: A total of 92-middle ear
fluids were collected from 51 children. The samples were analyzed using
polymerase chain reaction (PCR) for detection of herpesviruses including Herpes
simplex virus (HSV), cytomegalovirus (CMV), Varicella zoster virus (VZV), and
Epstein-Barr virus (EBV). RESULTS: PCR analysis of the 92 samples showed that
genomes of EBV in 12 (13.04%), HSV in seven (7.60%), CMV in five (5.43%), and VZV
in three (3.26%) were present. Two of these samples were positive for both HSV
and EBV genomes. Therefore, 25 (27.17%) of the samples were determined to be
infected with any of the herpesviruses tested. CONCLUSIONS: In the present study,
herpesviruses were determined at a high rate in middle ear fluids of children
with OME. However, the present study is a preliminary study and more extensive
studies, especially experimental studies, are required to elucidate the role of
herpesviruses in pathogenesis of OME and whether there is a relation between rate
of herpesviruses in OME cases, and the reactivation of latent infections.

PMID: 17250503 [PubMed - indexed for MEDLINE]

840: Pharmacoeconomics. 2007;25(2):155-69.

Acute/subacute herpes zoster: healthcare resource utilisation and costs in a
group of US health plans.

Insinga RP, Itzler RF, Pellissier JM.

Department of Health Economic Statistics, Merck Research Laboratories, North
Wales, Pennsylvania 19454-1099, USA. ralph_insinga@merck.com

BACKGROUND: Although there are estimated to be nearly 1 million cases of herpes
zoster diagnosed in the US each year, the economic costs associated with herpes
zoster in the US have not been well described. OBJECTIVE: To describe the
healthcare resource utilisation and costs associated with physician-diagnosed
acute/subacute herpes zoster, from a payer perspective, using a large US
healthcare claims database. METHODS: Data for the period 2000-1 were obtained
from the Medstat Marketscan healthcare claims database. The duration of
acute/subacute herpes zoster was considered to include the 21 days preceding, and
90 days following, the initial herpes zoster diagnosis. Resource utilisation was 
examined for individuals with newly diagnosed acute/subacute herpes zoster (n =
8741) and compared, through regression analyses, with that observed for control
individuals from the same population (n = 50,000). Similar analyses were
conducted for costs; the costs included reflected healthcare payments from
patients, insurers and other sources. Regression analyses controlled for
demographics (age, gender), conditions that have been observed with greater
frequency among patients with acute/subacute herpes zoster in prior studies
(cancer, HIV infection, organ transplantation, other immunosuppressive conditions
and therapies) and the number of billed services within each of seven categories 
of care that were potentially related to acute/subacute herpes zoster and that
were utilised within the 30-180 days prior to the diagnosis for affected
patients, and over an analogous period for controls. RESULTS: The acute/subacute 
phase of herpes zoster was estimated to result in an average of 1.7 (standard
error [SE] 0.02) additional physician and hospital outpatient visits, 0.05 (SE
0.003) additional emergency room visits, 0.03 (SE 0.003) additional inpatient
hospital admissions, 2.1 (SE 0.03) additional prescriptions filled and $US431 (SE
17.60) in additional healthcare costs per patient. Among patients with
acute/subacute herpes zoster, 21.1% had a diagnosis code with a designation for a
herpes zoster-related complication, and 9.4% had three or more outpatient visits 
with a diagnosis code for herpes zoster. The average estimated incremental costs 
per patient with acute/subacute disease increased with age, ranging from $US258
(SE 37.70) among patients aged < or =19 years to $US805 (SE 106.30) among those
aged > or =80 years. The numbers of additional outpatient visits, inpatient
admissions, prescriptions filled for pain medications and coded complications
were also substantially higher among older than younger patients with
acute/subacute herpes zoster. CONCLUSIONS: The management of acute/subacute
herpes zoster was found to result in substantial healthcare costs, with
outpatient care and prescription drugs comprising the majority of the cost
burden. To more fully understand the overall cost of herpes zoster disease to
society, future studies should examine the healthcare costs associated with
post-herpetic neuralgia and productivity losses due to herpes zoster and
post-herpetic neuralgia.

PMID: 17249857 [PubMed - indexed for MEDLINE]

841: Singapore Med J. 2007 Jan;48(1):e16-8.

Herpes zoster complicating imatinib mesylate for gastrointestinal stromal tumour.

Durosinmi MA, Ogbe PO, Salawu L, Oyekunle AA.

Departments of Haematology and Blood Transfusion, Obafemi Awolowo University
Teaching Hospital, Ile-Ife, Nigeria. mdurosin@yahoo.com

Varicella zoster virus (VZV) infection is uncommon in patients with
gastrointestinal stromal tumour (GIST) and who have not been exposed to extensive
radiotherapy and/or high-dose chemotherapy. We report a 56-year-old Nigerian man 
with GIST who developed VZV infection while on imatinib mesylate therapy. From
August 2003 to November 2005, 64 patients (GIST/CML = 6/58) were enrolled into an
ongoing Glivec (imatinib mesylate) international patient-assistance programme
therapy for Philadelphia/bcr-abl-positive chronic myeloid leukaemia (CML) and
CD117-positive GIST patients at Obafemi Awolowo University Teaching Hospitals
Complex, Ile-Ife, Nigeria. The patient developed herpes zoster (HZ) infection 23 
months into therapy with Glivec. With his absolute lymphocyte count at 2,774
cells per microlitre and CD4 count at 950 cells per microlitre, no obvious
immunological defect was observed. Prompt resolution of symptoms without sequelae
was achieved by treating with acyclovir, analgesic and dressing of lesions with
desiccant. To our knowledge, this is the first reported case of HZ infection in a
patient with GIST on Glivec therapy, and the response is similar to that of CML
patients who developed VZV while on similar therapy.

Publication Types: 
    Case Reports

PMID: 17245498 [PubMed - indexed for MEDLINE]

842: BMC Genomics. 2007 Jan 23;8:27.

Insight into transcription factor gene duplication from Caenorhabditis elegans
Promoterome-driven expression patterns.

Reece-Hoyes JS, Shingles J, Dupuy D, Grove CA, Walhout AJ, Vidal M, Hope IA.

Institute of Integrative and Comparative Biology, Faculty of Biological Sciences,
University of Leeds, Clarendon Way, Leeds, LS2 9JT, West Yorkshire, UK.
John.Reece-Hoyes@umassmed.edu <John.Reece-Hoyes@umassmed.edu>

BACKGROUND: The C. elegans Promoterome is a powerful resource for revealing the
regulatory mechanisms by which transcription is controlled pan-genomically.
Transcription factors will form the core of any systems biology model of genome
control and therefore the promoter activity of Promoterome inserts for C. elegans
transcription factor genes was examined, in vivo, with a reporter gene approach. 
RESULTS: Transgenic C. elegans strains were generated for 366 transcription
factor promoter/gfp reporter gene fusions. GFP distributions were determined, and
then summarized with reference to developmental stage and cell type. Reliability 
of these data was demonstrated by comparison to previously described gene product
distributions. A detailed consideration of the results for one C. elegans
transcription factor gene family, the Six family, comprising ceh-32, ceh-33,
ceh-34 and unc-39 illustrates the value of these analyses. The high proportion of
Promoterome reporter fusions that drove GFP expression, compared to previous
studies, led to the hypothesis that transcription factor genes might be involved 
in local gene duplication events less frequently than other genes. Comparison of 
transcription factor genes of C. elegans and Caenorhabditis briggsae was
therefore carried out and revealed very few examples of functional gene
duplication since the divergence of these species for most, but not all,
transcription factor gene families. CONCLUSION: Examining reporter expression
patterns for hundreds of promoters informs, and thereby improves, interpretation 
of this data type. Genes encoding transcription factors involved in intrinsic
developmental control processes appear acutely sensitive to changes in gene
dosage through local gene duplication, on an evolutionary time scale.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17244357 [PubMed - indexed for MEDLINE]

843: Pain Med. 2007 Jan-Feb;8(1):36-40.

Effectiveness of prostaglandin E1 for the treatment of patients with neuropathic 
pain following herpes zoster.

Kanai A, Osawa S, Suzuki A, Ishimaru R, Hoka S.

Department of Anesthesiology, Kitasato University School of Medicine, Japan.
Kanaiakifumi@aol.com

OBJECTIVE: Postherpetic neuralgia (PHN) is one of the most painful neuropathic
conditions, the mechanism of which remains unclear. There is no universally
accepted treatment. The pain in PHN is often relieved by bathing, heating, or
sympathetic blockade, suggesting a circulation-dependent property of the pain.
Therefore, we examined the effectiveness of prostaglandin E(1) (PGE(1)), which
has an analgesic effect via improvement of peripheral blood circulation, for
patients with PHN. DESIGN: A total of 27 patients with PHN underwent intravenous 
administration of 60 microg of PGE(1) dissolved in 100 mL of physiological saline
and 5 mL of 8.4% sodium bicarbonate solution at an infusion rate of 0.02
microg/kg/min. Oral administration of PGE(1), limaprost alfadex, was followed at 
doses of 30 microg/day for 2 weeks. Pain at rest and tactile allodynia before and
after the treatment was evaluated with visual analog scale (VAS). RESULTS:
Intravenous PGE(1) significantly decreased VAS in rest pain and tactile allodynia
without severe adverse effects. The analgesic effect of PGE(1) continued during
the 2 weeks of oral administration of PGE(1). Oral PGE(1) caused nausea in seven 
cases, diarrhea in three, and abdominal distention in one subject. All subjects, 
except for two cases of nausea, continued the treatment until the end of the
study, although some required a decrease in the dose to 15 microg/day. During the
2-week oral administration, the VAS did not change remarkably in the three
patients whose VAS were not decreased by at least 80% during the initial
infusion. CONCLUSIONS: The results of the present study indicate that oral PGE(1)
following the intravenous administration produces prompt and continuous analgesia
in patients with PHN. Moreover, the intravenous treatment using PGE(1) appears
useful for predicting the analgesic effect of PGE(1) in the patients.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 17244102 [PubMed - indexed for MEDLINE]

844: Cutis. 2006 Dec;78(6):418-22.

Scar sarcoidosis: a case report and brief review.

Selim A, Ehrsam E, Atassi MB, Khachemoune A.

Endocrine Unit, Department of Internal Medicine, Massachusetts General Hospital, 
Harvard Medical School, Boston, USA.

Scar sarcoidosis refers to lesions of cutaneous sarcoidosis that appear in
preexisting scars. This condition may be caused by mechanical trauma such as skin
cuts or venipuncture, scars caused by infection such as herpes zoster, and
tattoos. We present a case of a 34-year-old man who developed scar sarcoidosis
following minor trauma to the left calf. We review the epidemiology, clinical
presentations, pathophysiology, and treatment options for scar sarcoidosis.

Publication Types: 
    Case Reports
    Review

PMID: 17243430 [PubMed - indexed for MEDLINE]

845: J Cutan Med Surg. 2006 May-Jun;10(3):139-41.

Cutaneous lupus erythematosus limited to the site of a laceration.

Timani S, Mutasim DF.

Department of Dermatology, University of Cincinnati College of Medicine,
Cincinnati, OH 45267-0592, USA.

BACKGROUND: Cutaneous lupus erythematosus is known to occur at sites of trauma or
inflammation of the skin, including sites of tattoo, frostbite, herpes zoster
scar, burn scar, and implantation by windshield glass. OBJECTIVE: We report a
32-year-old white man who developed cutaneous lupus erythematosus at the site of 
a laceration. The diagnosis was confirmed by histologic and immunofluorescence
examination. The patient responded to intralesional corticosteroid and
hydroxychloroquine therapy. CONCLUSION: Lupus erythematosus may be induced by
trauma.

Publication Types: 
    Case Reports

PMID: 17241591 [PubMed - indexed for MEDLINE]

846: J Travel Med. 2007 Jan-Feb;14(1):65-6.

Herpes zoster after yellow fever vaccination.

Bayas JM, Gonzalez-Alvarez R, Guinovart C.

Preventive Medicine Service, International Vaccination Centre, Hospital
Clinic-IDIBAPS, Barcelona, Spain. jmbayas@cliic.ub.es

An immunocompetent 64-year-old women presented with brachial herpes zoster (HZ)
infection 3 days after vaccination against yellow fever (YF). The lesions
disappeared after antiviral treatment. There are very few reports of a possible
association between YF vaccination and HZ infection. This case supports the
importance of continuing surveillance of vaccine adverse events.

Publication Types: 
    Case Reports

PMID: 17241257 [PubMed - indexed for MEDLINE]

847: Pain. 2007 Mar;128(1-2):189-90; author reply 190-2. Epub 2007 Jan 19.

Comment on:
    Pain. 2007 Mar;128(1-2):148-56.

Inadequate evidence for a revised definition of postherpetic neuralgia (PHN).

Dworkin RH.

Publication Types: 
    Comment
    Letter

PMID: 17240068 [PubMed - indexed for MEDLINE]

848: Top HIV Med. 2006 Dec-2007 Jan;14(5):154-8.

Immunizations for HIV-infected adults: indications, timing, and response.

Spach DH.

University of Washington, Seattle, WA, USA.

Vaccines routinely recommended for HIV-infected adults include those for
influenza, hepatitis A virus, hepatitis B virus, pneumococcal infection, and
tetanus. Responses to vaccination may be affected by CD4+ cell count and viral
load. A number of live vaccines are contraindicated in the HIV-infected
population. This article summarizes a presentation on immunization in
HIV-infected adults made by David H. Spach, MD, at the 9th Annual Ryan White CARE
Act Clinical Update in Washington, DC, in August 2006. The original presentation 
is available as a Webcast at www.iasusa.org.

Publication Types: 
    Case Reports

PMID: 17237556 [PubMed - indexed for MEDLINE]

849: Drugs Aging. 2007;24(1):1-19.

Post-herpetic neuralgia in older adults: evidence-based approaches to clinical
management.

Christo PJ, Hobelmann G, Maine DN.

Department of Anesthesiology and Critical Care Medicine, Division of Pain
Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
21205, USA. pchristo@jhmi.edu

Many individuals across the globe have been exposed to the varicella-zoster virus
(VZV) that causes chickenpox. After chickenpox has resolved, the virus remains
latent in the dorsal root ganglia where it can re-emerge later in life as herpes 
zoster, otherwise known as shingles. Herpes zoster is a transient disease
characterised by a dermatomal rash that is usually associated with significant
pain. Post-herpetic neuralgia (PHN) is the term used for the condition that
exists if the pain persists after the rash has resolved. Advanced age and
compromised cell-mediated immunity are significant risk factors for reactivation 
of herpes zoster and the subsequent development of PHN. Though the
pathophysiology of PHN is unclear, studies suggest peripheral and central
demyelination as well as neuronal destruction are involved. Both the vaccine
against VZV (Varivax) and the newly released vaccine against herpes zoster
(Zostavax) may lead to substantial reductions in morbidity from herpes zoster and
PHN. In addition, current evidence suggests that multiple medications are
effective in reducing the pain associated with PHN. These include tricyclic
antidepressants, antiepileptics, opioids, NMDA receptor antagonists as well as
topical lidocaine (lignocaine) and capsaicin. Reasonable evidence supports the
use of intrathecal corticosteroids, but the potential for neurological sequelae
should prompt caution with their application. Epidural corticosteroids have not
been shown to provide effective analgesia for PHN. Sympathetic blockade may
assist in treating the pain of herpes zoster or PHN. For intractable PHN pain,
practitioners have performed delicate surgeries and attempted novel therapies.
Although such therapies may help reduce pain, they have been associated with
disappointing results, with up to 50% of patients failing to receive acceptable
pain relief. Hence, it is likely that the most effective future treatment for
this disease will focus on prevention of VZV infection and immunisation against
herpes zoster infection with a novel vaccine.

Publication Types: 
    Review

PMID: 17233544 [PubMed - indexed for MEDLINE]

850: J Infect Dis. 2007 Feb 15;195(4):502-10. Epub 2007 Jan 10.

Comment in:
    J Infect Dis. 2007 Sep 1;196(5):801-2; author reply 802-3.

DNA sequence variability in isolates recovered from patients with postvaccination
rash or herpes zoster caused by Oka varicella vaccine.

Loparev VN, Rubtcova E, Seward JF, Levin MJ, Schmid DS.

National Center for Immunizations and Respiratory Diseases, Centers for Disease
Control and Prevention, Atlanta, GA 30333, USA.

Little is known about the pathogenic potential of individual strains in the
varicella vaccine. We analyzed genomic variation among specimens obtained from
vaccine recipients with postvaccination rash or herpes zoster (HZ), focusing on
polymorphisms between live attenuated varicella vaccine virus and wild-type
varicella-zoster virus. Eleven of 18 postvaccination HZ specimens contained >1
strain, and 7 of 18 appeared to be clonal. All 21 postvaccination rash specimens 
contained mixtures of vaccine strains. Four single-nucleotide polymorphisms
(SNPs) consistently occurred in every isolate; all were polymorphisms in
open-reading frame (ORF) 62, and 2 confer amino acid substitutions in the
immediate-early protein 62. Four wild-type SNPs occurred in every isolate: one
each occurred in ORF 10, ORF 21, ORF 62, and a noncoding region upstream of ORF
64. The frequencies of the remaining wild-type SNPs were variable, with the SNPs 
uniformly expressed (even in mixtures) in 20.5%-97.4% of isolates (mean
frequency, 67.7%). No 2 clinical isolates had identical SNP profiles; as such,
vaccine latency usually involves >1 strain.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 17230409 [PubMed - indexed for MEDLINE]

851: Health News. 2006 Nov;12(11):12.

I've had one bout with shingles. Can I get it again? Can I prevent it?

[No authors listed]

PMID: 17228401 [PubMed - indexed for MEDLINE]

852: Vaccine. 2007 Feb 26;25(10):1877-83. Epub 2006 Oct 30.

Safety and tolerability of a high-potency zoster vaccine in adults >/= 50 or
years of age.

Tyring SK, Diaz-Mitoma F, Padget LG, Nunez M, Poland G, Cassidy WM, Bundick ND,
Li J, Chan IS, Stek JE, Annunziato PW; Protocol 009 Study Group.

University of Texas Health Science Center, Houston, TX, USA.

BACKGROUND: Herpes zoster (HZ) incidence rises with age, especially after 50
years of age, probably due to waning varicella-zoster virus (VZV)-specific
immunity. The Shingles Prevention Study [Oxman MN, Levin MJ, Johnson GR, Schmader
KE, Straus SE, Gelb LD, et al. A vaccine to prevent herpes zoster and
postherpetic neuralgia in older adults, N Engl J Med 2005;352:2271-84], enrolled 
people >/= 60 or years of age and showed that zoster vaccine prevents HZ and
postherpetic neuralgia (PHN), presumably through boosting VZV-specific immunity. 
This study of people >/= 50 or years of age compared the safety and tolerability 
of two zoster vaccine potencies. METHODS: Adults >/= 50 or years old enrolled in 
a randomized, double-blind, multicenter study to compare the safety and
tolerability of one dose of two zoster vaccine potencies, approximately 58,000
and approximately 207,000 plaque-forming units/dose. Adverse experiences (AEs)
were recorded on a standardized Vaccination Report Card for 42 days
postvaccination. For assessment of injection-site AEs, clinically acceptable
tolerability was predefined based on experience with PNEUMOVAX 23, a licensed
vaccine recommended for use in older people. RESULTS: Six hundred and
ninety-eight subjects (age 50-90 years, median 64 years) were enrolled. No
serious vaccine-related AEs were reported. Similar AE rates were observed in the 
higher and lower potency groups (overall systemic AEs: 37.5 and 39.3%,
vaccine-related systemic AEs: 10.9 and 13.2%, injection-site AEs: 63.0 and
59.8%). Rates for a combined endpoint of moderate or severe injection-site
pain/tenderness/soreness and swelling were 17.2% (95% CI 13.9, 21.0) and 9.0%
(95% CI 5.6, 13.4), respectively. Most combined endpoint events were reported as 
moderate in intensity. CONCLUSIONS: Both vaccine potencies were generally well
tolerated in this study of people > or years of age. Although rates of some
moderate or severe injection-site AEs were greater in the higher potency group,
all rates met the prespecified criteria for clinically acceptable tolerability.

Publication Types: 
    Multicenter Study
    Randomized Controlled Trial

PMID: 17227688 [PubMed - indexed for MEDLINE]

853: J Headache Pain. 2007 Feb;8(1):19-27. Epub 2007 Jan 15.

The rare, unilateral headaches. Vaga study of headache epidemiology.

Sjaastad O, Bakketeig LS.

Department of Neurology, St. Olavs Hospital, Trondheim University Hospitals
(NTNU), N-7006, Trondheim, Norway. tora.rui@ntnu.no

In the Vaga study of headache epidemiology, 1838 parishioners in the age group
18-65 years were included (88.6% of the relevant population). Each individual was
questioned in a face-to-face situation. In this population, a search of rare
unilateral headaches was also made, in spite of their presumed rarity. Trigeminal
neuralgia was present in two cases. Two individuals with SUNCT traits were
observed. Hemicrania continua may have been present in one individual. Also
observed were: optic neuritis (n=1), herpes zoster (n=4); a case of unilateral
headache upon neck rotation (chronic paroxysmal hemicrania variant? or "forme
fruste" of the neck-tongue syndrome?); masseter muscle spasm (n=1);
temporo-mandibular joint dislocation (n=1); and possible carotidynia (n=3). A
particularly intriguing form of headache was a unilateral, neuralgiform (?) pain,
associated with ipsilateral, regular jabs and allodynia, a combination observed
in eight females. A couple of conditions that entirely defy rubrication are also 
reported.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17221345 [PubMed - indexed for MEDLINE]

854: Am J Med Sci. 2007 Jan;333(1):56-7.

Herpes zoster ophthalmicus and syndrome of inappropriate antidiuretic hormone
secretion.

Dhawan SS.

Department of Internal Medicine, University of Tennessee Health Science Center,
Memphis, Tennessee 38103, USA. csaurabh@gmail.com

Presented here is a case of syndrome of inappropriate antidiuretic hormone
secretion (SIADH) that developed in an elderly woman with single dermatomal
herpes varicella zoster ophthalmicus without evidence of varicella-zoster
encephalitis or dissemination. This is only the third such case reported in the
English language literature to date, and it affirms that SIADH can develop in
patients with herpetic involvement of just a single dermatome and corrects with
resolution of the herpetic lesions.

Publication Types: 
    Case Reports
    Review

PMID: 17220695 [PubMed - indexed for MEDLINE]

855: Ostomy Wound Manage. 2006 Dec;52(12):14-6.

Use of an atraumatic dressing in the treatment of a painful wound resulting from 
herpes zoster.

Serena TE.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 17219697 [PubMed - indexed for MEDLINE]

856: Dtsch Med Wochenschr. 2007 Jan 19;132(3):95-6.

[Reactivation of varicella-zoster-virus in the area of the left vagus nerve
(herpes zoster)]

[Article in German]

Helmstaedter V, Preuss SF.

Publication Types: 
    Case Reports

PMID: 17219343 [PubMed - indexed for MEDLINE]

857: Neurologist. 2007 Jan;13(1):43-4.

Shingles.

Kernich CA.

Department of Medicine, University Hospitals Medical Group, University Hospitals,
Cleveland, Ohio, USA.

PMID: 17215727 [PubMed - indexed for MEDLINE]

858: Clin Ther. 2006 Nov;28(11):1922-34.

Cost-effectiveness of pregabalin for the management of neuropathic pain
associated with diabetic peripheral neuropathy and postherpetic neuralgia: a
Canadian perspective.

Tarride JE, Gordon A, Vera-Llonch M, Dukes E, Rousseau C.

Program for Assessment of Technology in Health, St Joseph's Healthcare, Hamilton,
Ontario, Canada.

BACKGROUND: Neuropathic pain (NeP) is a chronic condition that occurs frequently 
with diabetes and herpes zoster infection. In addition to potentially lasting
many years, the relationship between chronic pain, anxiety/depression, and sleep,
also referred to as the triad of pain, causes functional impairment in many areas
of life. OBJECTIVE: The aim of this study was to examine the 12-week
cost-effectiveness of 2 treatments of NeP, pregabalin versus gabapentin, in
managing diabetic peripheral neuropathy (DPN) and postherpetic neuralgia (PHN) in
a Canadian setting. METHODS: A stochastic simulation model evaluating NeP
treatment was adapted to the Canadian setting. Using data from clinical trials of
pregabalin (150-600 mg/d) and gabapentin (900-3600 mg/d), the model simulated
12-week treatment outcomes for patients with DPN or PHN. Resource utilization was
identified through an Internet-based survey among 80 Canadian physicians. Utility
values (as measured using the EuroQol EQ-5D) were obtained from 126 NeP patients 
participating in a cross-sectional study conducted at Canadian primary care
sites. The economic analysis was expressed as incremental cost per
quality-adjusted life year (QALY) gained and as incremental cost per day with no 
or mild pain. Model sensitivity to changes in key parameters was assessed.
RESULTS: Following 12-week treatment, compared with gabapentin, pregabalin was
projected to result in 6 and 9 additional days with no or mild pain for patients 
with DPN and PHN, respectively. Pregabalin therapy was estimated to provide an
additional 0.0047 QALY and 0.0086 QALY over gabapentin administration, for DPN
and PHN, respectively. Mean (SE) direct costs per DPN patient were estimated as
837.53 Can dollars (37.31 dollars) (2004 dollars) with gabapentin and 818.49
dollars (36.50 dollars) with pregabalin, and per PHN patient as 720.61 dollars
(33.70 dollars) with gabapentin and 667.07 dollars (25.33 dollars) with
pregabalin. Model findings were sensitive to variation in the dose and
corresponding cost of the comparator, but not in other parameters. CONCLUSION:
Based on the results of this analysis, in the treatment of NeP associated with
DPN or PHN, pregabalin was a dominant or cost-effective treatment strategy
compared with gabapentin.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 17213013 [PubMed - indexed for MEDLINE]

859: Lakartidningen. 2006 Nov 22-28;103(47):3702-3.

[Sensory innervation of the back incorrectly described in dermatomal maps]

[Article in Swedish]

Dahlgren N.

Onkologiska kliniken, Universitetssjukhuset i Lund. helgonavagen18@msn.com

PMID: 17212317 [PubMed - indexed for MEDLINE]

860: Saudi Med J. 2007 Jan;28(1):125-7.

Sudden onset of herpes zoster following chemotherapy for orbital lymphoma in a
HIV positive patient.

Omoti AE, Omoti CE.

Department of Ophthalmology, University of Benin Teaching Hospital, Benin City,
Nigeria. ediomoti@yahoo.com

We report a 38-year-old HIV positive female, who developed an acute attack of
herpes zoster HZ involving the mandibular, C2, C3, C4, T1, and T2 dermatomes, 9
days after the commencement of the first cycle of chemotherapy regimen for
non-Hodgkin's lymphoma NHL. She had developed NHL of the ovary approximately 6
months earlier, followed by metastasis to the left orbit resulting in proptosis
of the left eye. A combination of a positive HIV status, lymphoma, and
chemotherapy can predispose a patient to an attack of HZ involving many
dermatomes.

Publication Types: 
    Case Reports

PMID: 17206304 [PubMed - indexed for MEDLINE]

861: Ned Tijdschr Geneeskd. 2006 Dec 2;150(48):2649-55.

Comment in:
    Ned Tijdschr Geneeskd. 2006 Dec 2;150(48):2633-6.

[Treatment of patients with herpes zoster by epidural injection of steroids and
local anaesthetics: less pain after 1 month, but no effect on long-term
postherpetic neuralgia--a randomised trial]

[Article in Dutch]

Opstelten W, van Wijck AJ, Moons KG, van Essen GA, Stolker RJ, Kalkman CJ,
Verheij TJ.

Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde,
Universitair Medisch Centrum Utrecht, Postbus 85.060, 3508 AB Utrecht.
w.opstelten@umcutrecht.nl

OBJECTIVE: To assess the effectiveness of a single epidural injection of steroids
and local anaesthetics, as a supplement to the standard treatment, for the
prevention ofpostherpetic neuralgia in older patients with herpes zoster. DESIGN:
Open randomised trial. METHOD: In the period September 2001-February 2004, 598
patients, aged > 50 years, with acute herpes zoster (rash for < 7 days) below
dermatome C6, were randomly assigned to receive either standard therapy (oral
antiviral agents and analgesics) alone or standard therapy plus an additional
single epidural injection of 80 mg methylprednisolone and 10 mg bupivacaine. The 
primary endpoint was the proportion of patients with zoster-associated pain one
month after inclusion. The presence and severity of zoster-associated pain at
other time points were secondary endpoints. RESULTS: At one month, pain was
reported by 137 (48%) patients in the injection group versus 164 (58%) in the
control group (relative risk; RR: 0.83; 95% CI: 0.71-0.97; p = 0.02). After three
months, these values were 58 (21%) and 63 (24%), respectively (RR: 0.89; 95% CI: 
0.65-1-21; p = 0.47), and at 6 months: 39 (15%) and 44 (17%) (RR: 0.85; 95% CI:
0.57-1-13; p = 0.43). No subgroups were detectable in which the relative risk for
pain at one month after inclusion substantially differed from the overall
estimate. At one month, the median severity of pain in the injection group was 2 
(on a 100-points scale) versus 6 in the control group (p = 0.02). At later
follow-up, there was no longer any statistically significant difference in the
severity of pain between the two groups. No patient had major adverse events
related to the epidural injection. CONCLUSION: A single epidural injection of
steroids and local anaesthetics in the acute phase of herpes zoster resulted in a
modest decrease in zoster-associated pain in the first month. This treatment did 
not, however, prevent long-term postherpetic neuralgia.

Publication Types: 
    Duplicate Publication
    English Abstract
    Randomized Controlled Trial

PMID: 17205943 [PubMed - indexed for MEDLINE]

862: Ned Tijdschr Geneeskd. 2006 Dec 2;150(48):2630-2.

Comment in:
    Ned Tijdschr Geneeskd. 2006 Dec 2;150(48):2625-9.    Ned Tijdschr Geneeskd. 2007 Apr 21;151(16):941; author reply 941-2.

[Chickenpox: sufficient reasons for the introduction of vaccination]

[Article in Dutch]

Rumke H, de Groot R.

Vaxinostics (Universitair Vaccincentrum Rotterdam Nijmegen), p/a Erasmus MC,
kamer Ee1931, Postbus 2040, 3000 CA Rotterdam. rumke@vaxinostics.com

The incidence of chickenpox and its complications is high enough to favour
introducing varicella vaccination into the Dutch immunisation programme for
children, although current Dutch figures may even underestimate the incidence.
Safe and effective MMRV vaccines, in which varicella (V) vaccine is combined with
measles, mumps and rubella (MMR), could well replace the MMR vaccine used at
present. MMRV vaccines should be administered subcutaneously in two doses. Ten
years after the introduction of varicella vaccination in the United States of
America, the incidence of complications has decreased impressively. An effect on 
the incidence of herpes zoster has not (yet) been seen.

Publication Types: 
    English Abstract

PMID: 17205937 [PubMed - indexed for MEDLINE]

863: J Dermatol Sci. 2007 Mar;45(3):213-5. Epub 2007 Jan 3.

Polymorphism of the IL-10 gene is associated with susceptibility to herpes zoster
in Korea.

Cho JW, Shin DH, Lee KS.

Publication Types: 
    Letter
    Research Support, Non-U.S. Gov't

PMID: 17204399 [PubMed - indexed for MEDLINE]

864: J Dermatol. 2007 Jan;34(1):68-73.

Zosteriform skin involvement of nodal T-cell lymphoma: a review of the published 
work of cutaneous malignancies mimicking herpes zoster.

Niiyama S, Satoh K, Kaneko S, Aiba S, Takahashi M, Mukai H.

Department of Dermatology, Yokohama Rosai Hospital, and Kitasato University,
Kanagawa, Japan. sniiyama@aol.com

A 77-year-old Japanese woman initially presented with non-Hodgkin's lymphoma
involving her neck, axillary and inguen lymph nodes. She had edematous erythema
and nodules limited to the skin in zosteriform distribution on the left side
chest wall along the T4-5 dermatome. In addition, since 1970, we have mainly been
collecting English-language articles on malignant skin tumors and skin metastasis
described as zosteriform in the title, and we have reviewed a total of 29 cases, 
including our own. It should be mentioned that 59% of the cases reported had been
diagnosed with herpes zoster at the time of the initial examination and that many
of them had received drug therapy (e.g. acyclovir). We wish to add the dermatomic
eruption mimicking zoster sine herpete to the list of possible presentations of
cutaneous malignancies.

Publication Types: 
    Case Reports
    Review

PMID: 17204106 [PubMed - indexed for MEDLINE]

865: Ideggyogy Sz. 2006 Nov 20;59(11-12):400-5.

[Clinical analysis of patients with peripheral facial palsy]

[Article in Hungarian]

Ilniczky S.

Semmelweis Egyetem, Altalanos Orvostudomanyi Kar, Neurologiai Klinika, Budapest. 
sandor@neur.sote.hu

Peripheral facial palsy is one of the most frequent neurological symptoms. In two
thirds of the cases the cause is unknown, this is called "idiopathic peripheral
facial palsy or Bell's palsy", but several different diseases have to be
considered in the differential diagnosis. In this paper we reviewed the case
histories of 110 patients treated for "peripheral facial palsy" in the Department
of Neurology, Semmelweis University, Budapest in a five year period, 2000-2004.
We studied the age, gender distribution, seasonal occurrence, comorbidities,
sidedness, symptoms, circumstances of referral to the hospital, the initial
diagnoses and therapeutic options. We also discuss the probable causes and
consequences of diagnostic failures. RESULTS: the proportion of males and females
was equal. There was no considerable difference between sexes regarding
age-distribution. Of the 110 patients 106 was diagnosed with idiopathic Bell's
palsy, three cases with otic herpes zoster and one patient with Lyme disease. In 
our material, peripheral facial palsy was significantly more frequent in the cold
period of late autumn, winter, and early spring. Diabetes mellitus and
hypertension were more frequent than in the general population. 74% of the
patients were admitted within two days from the onset of the symptoms. In 37%
preliminary diagnosis was unavailable. In 15% cerebrovascular insult was the
first, incorrect diagnosis, the correct diagnosis of "Bell's palsy" was provided 
only in 16%. The probable causes of diagnostic failures may be the misleading
symptoms and accompanying conditions. We examined the different therapies applied
and reviewed the literature in this topic. We conclude that intravenous
corticosteroid treatment in the early stage of the disease is the therapy of
choice.

Publication Types: 
    English Abstract

PMID: 17203875 [PubMed - indexed for MEDLINE]

866: Laryngoscope. 2007 Jan;117(1):147-56.

Reactivation of herpes simplex virus type 1 and varicella-zoster virus and
therapeutic effects of combination therapy with prednisolone and valacyclovir in 
patients with Bell's palsy.

Kawaguchi K, Inamura H, Abe Y, Koshu H, Takashita E, Muraki Y, Matsuzaki Y,
Nishimura H, Ishikawa H, Fukao A, Hongo S, Aoyagi M.

Department of Otolaryngology, Yamagata University School of Medicine, Yamagata,
Japan. kazukawa@med.id.yamagata-u.ac.jp

OBJECTIVES: To determine whether reactivation of herpes simplex virus (HSV) type 
1 or varicella-zoster virus (VZV) is the main cause of Bell's palsy and whether
antiviral drugs bring about recovery from Bell's palsy. STUDY DESIGN: Randomized,
multicenter, controlled study. METHODS: One hundred fifty patients with Bell's
palsy were enrolled in this study. The patients were randomly assigned to a
prednisolone group or a prednisolone-valacyclovir group, in whom virologic
examinations for HSV-1 and VZV were performed by simple randomization scheme in
sealed envelopes. The recovery rates among various groups were analyzed using the
Kaplan-Meier method and the Cox proportional hazards model. RESULTS: Reactivation
of HSV-1, VZV, and both viruses was detected in 15.3%, 14.7%, and 4.0% of
patients, respectively. There was no significant difference in recovery rates
between the prednisolone group and the prednisolone-valacyclovir group, although 
recovery in the patients with HSV-1 reactivation tended to be higher in the
prednisolone-valacyclovir group than in the prednisolone group. There was a
significant difference in recovery among age groups and between individuals with 
complete and incomplete paralysis. CONCLUSIONS: Reactivation of HSV-1 or VZV was 
observed in 34% of the patients with Bell's palsy. The effect of combination
therapy with prednisolone and valacyclovir on recovery was not significantly
higher than that with prednisolone alone.

Publication Types: 
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 17202945 [PubMed - indexed for MEDLINE]

867: J Infect. 2007 Jun;54(6):589-96. Epub 2007 Jan 2.

Viral infections of the central nervous system in Brazil.

Mendoza LP, Bronzoni RV, Takayanagui OM, Aquino VH, Figueiredo LT.

Virus Research Unit, School of Medicine of Ribeirao Preto, University of Sao
Paulo, Av. Bandeirantes 3900, 14049-000 Ribeirao Preto, SP, Brazil.
lauramt@rpm.fmrp.usp.br <lauramt@rpm.fmrp.usp.br>

OBJECTIVE: Epidemiological studies have shown that most central nervous system
(CNS) infections are viral. The objective of this study is to contribute to the
knowledge base concerning viral CNS infections in Ribeirao Preto, Brazil.
METHODS: Two hundred cerebrospinal fluid (CSF) samples were taken from patients
with clinically suspected viral CNS infection and analyzed for herpesvirus,
enterovirus, alphavirus and flavivirus using PCR assays. RESULTS: Viral genome
was detected in 43 CSF samples (23.34%): 6% cytomegalovirus (CMV), 5% herpes
simplex virus type 1 (HSV-1), 0.5% each varicella-zoster virus (VZV) and
Epstein-Barr virus (EBV), and 11.34% enterovirus. Co-infections (CMV-enterovirus 
and CMV-HSV-1) were found in 3 patients. CSF parameters such as cytology and
protein level were normal in many patients with viral genome-positive CSF.
CONCLUSIONS: Data obtained in this study contribute to the knowledge base
concerning viral CNS infections in Brazil. This information will have a major
impact on the clinical management of patients with CNS disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17198733 [PubMed - indexed for MEDLINE]

868: Cornea. 2007 Jan;26(1):107-8.

Perforated corneal ulcer with subsequent endophthalmitis in a patient with
graft-versus-host disease.

Adrean SD, Puklin JE.

Kresge Eye Institute, Department of Ophthalmology, Detroit, MI, USA.

PURPOSE: To describe a case of a perforated corneal ulcer leading to a bacterial 
endophthalmitis in a patient with graft-versus-host disease (GVHD). METHODS:
Clinical history and examination; slit-lamp photography; surgical intervention;
laboratory evaluation including microbiology, polymerase chain reaction (PCR),
flow cytometry, and cytopathology. RESULTS: A diagnostic and therapeutic pars
plana vitrectomy was performed. The vitreous aspirate was evaluated with
microbiology; PCR for herpes simplex, herpes zoster, and cytomegalovirus; flow
cytometry; and cytopathology. The patient received intravitreal antibiotics and
antifungal and antiviral medication. The vitreous culture grew Staphylococcus
epidermidis. CONCLUSION: Patients with GVHD are at risk for corneal ulcers with
subsequent perforation. Commensal ocular flora may seed the vitreous and cause an
endophthalmitis. Patients with GVHD may develop a vitritis from many causes
including viral, fungal, and bacterial etiologies or a relapse of their original 
disease. When patients with GVHD present with vitritis, consideration should be
given to obtaining a large vitreous aspirate to establish the etiology.

Publication Types: 
    Case Reports

PMID: 17198025 [PubMed - indexed for MEDLINE]

869: Neuroscience. 2007 Feb 23;144(4):1495-508. Epub 2006 Dec 29.

Further characterization of a rat model of varicella zoster virus-associated
pain: Relationship between mechanical hypersensitivity and anxiety-related
behavior, and the influence of analgesic drugs.

Hasnie FS, Breuer J, Parker S, Wallace V, Blackbeard J, Lever I, Kinchington PR, 
Dickenson AH, Pheby T, Rice AS.

Pain Research Group, Department of Anaesthetics, Pain Medicine and Intensive
Care, Faculty of Medicine, Imperial College Chelsea and Westminster Hospital
Campus, 369 Fulham Road, London SW10 9NH, UK.

Persistent herpes zoster-associated pain is a significant clinical problem and an
area of largely unmet therapeutic need. Progress in elucidating the underlying
pathophysiology of zoster-associated pain and related co-morbidity behavior, in
addition to appropriately targeted drug development has been hindered by the lack
of an appropriate animal model. This study further characterizes a recently
developed rat model of zoster-associated hypersensitivity and investigates (a)
response to different viral strains; (b) relationship between viral inoculum
concentration ('dose') and mechanical hypersensitivity ('response'); (c)
attenuation of virus-associated mechanical hypersensitivity by clinically useful 
analgesic drugs; and (d) measurement of pain co-morbidity (anxiety-like behavior)
and pharmacological intervention in the open field paradigm (in parallel with
models of traumatic peripheral nerve injury). Varicella zoster virus was
propagated on fibroblast cells before s.c. injection into the glabrous footpad of
the left hind limb of adult male Wistar rats. Control animals received injection 
of uninfected fibroblast cells. Hind-limb reflex withdrawal thresholds to
mechanical, noxious thermal and cooling stimuli were recorded at specified
intervals post-infection. Infection with all viral strains was associated with a 
dose-dependent mechanical hypersensitivity but not a thermal or cool
hypersensitivity. Systemic treatment with i.p. morphine (2.5 mg/kg),
amitriptyline (10 mg/kg), gabapentin (30 mg/kg), (S)-(+)-ibuprofen (20 mg/kg) and
the cannabinoid WIN55,212-2 (2 mg/kg) but not the antiviral, acyclovir (50
mg/kg), was associated with a reversal of mechanical paw withdrawal thresholds.
In the open field paradigm, virus-infected and nerve-injured animals demonstrated
an anxiety-like pattern of ambulation (reduced entry into the central area of the
open arena) which was positively correlated with mechanical hypersensitivity.
This may reflect pain-related co-morbidity. Further, anxiety-like behavior was
attenuated by acute i.p. administration of gabapentin (30 mg/kg) in
nerve-injured, but not virus-infected animals. This model will prove useful in
elucidating the pathophysiology of zoster-associated pain and provide a tool for 
pre-clinical screening of analgesic drugs.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17197105 [PubMed - indexed for MEDLINE]

870: Dakar Med. 2007;52(3):236-43.

[Herpes zoster and human imunodeficiency virus in the medical centers of
Ouagadougou]

[Article in French]

Barro-Traore F, Traore A, Ilboudo L, Ouedraogo LT, Kabore J.

Service de Dermatologie du Centre Hospitalier Universitaire Yalgado Ouedraogo de 
Ouagadougou. fatou_barro@yahoo.fr

Herpes zoster is an acute posterior ganglio-radiculitis related to the
reactivation of the chicken pox-herpes zoster virus remained quiescent in the
neurons of the nerve-knots. It usually occurs at the subject after 60 years old. 
For young patient, it is closely related to the infection by the HIV. Our
exploratory descriptive and analytical study was carried out from 1 October 2002 
to 30 September 2003, in order to describe the epidemiological, clinical aspects 
of the herpes zoster in the medical formations of the town of Ouagadougou
(Burkina Faso) and to determine the prevalence of the infection by the HIV in the
patients. We have collected 118 patients who have a herpes zoster through 6500
consultants. There were 79 women and 39 men. The average age was 34.4 years. The 
age bracket from 20 to 40 years was the most touched. The blistered eruption was 
the first reason for consultation; the light with type of burn, intermittent pain
prevailed. The lesions healed in one month but there were 28 ulcerated necrotic
cases. Post zoster pains have been observed in 33 cases. The localizations were
the members in 44 cases (37.29%), the head in 35 cases (29.66%) and the trunk in 
40 cases (33.90%). We have observed a case with double localization of herpes
zoster. On 65 patients tested for the HIV, 58 (89.2%) were infected. The age
bracket from 20 to 40 was the most concerned. A case of corneal necrosis
isolated, with blindness and another with an opposed, spasmodic and total hemi
paresis were notified. Fourteen patients having an antecedent of herpes zoster
were all infected by HIV. Since the pandemic infection by the HIV, the incidence 
of the herpes zoster increases within the young population. The high frequency of
HIV infection among our patients (89.2%) showed that the herpes zoster is closely
related to this disease.

Publication Types: 
    English Abstract

PMID: 19097409 [PubMed - indexed for MEDLINE]

871: Open Rheumatol J. 2007;1:12-7. Epub 2007 Nov 8.

Infections are not increased in scleroderma compared to non-inflammatory
musculoskeletal disorders prior to disease onset.

Pope JE, Goodwin JL, Ouimet JM, Krizova A, Laskin M.

Division of Rheumatology, Department of Medicine, The University of Western
Ontario, London, Canada.

The etiology of scleroderma (SSc) is unknown; immunogenic stimuli such as
infections and vaccinations could theoretically be risk factors for scleroderma. 
Our objective was to assess the relationship between viral and bacterial
infec-tions, and vaccinations, prior to diagnosis of SSc compared to
non-inflammatory controls. METHODS: A questionnaire was sent to individuals with 
SSc (n =83) and controls (n=351) with non-inflammatory musculoskeletal (MSK)
disorders (os-teoarthritis, n = 204; tendonitis, n = 58; fibromyalgia, n= 89)
from a rheumatology practice. Questions ascertained past in-fections, exposure to
infectious agents and vaccination history. RESULTS: The response rate was 78%
(SSc) and 56% (MSK controls). The mean age was 56 +/- 1.6 (SSc) and 58 +/- 0.9
(MSK); 88% (SSc) and 82% (MSK) were female. No association between prior
infections and SSc was observed. In fact, controls were more likely than SSc
subjects to report any infec-tion within 1-year prior to disease diagnosis (35%
vs. 16%, p<0.006), or to have suffered a trauma to affected joints prior to
diagnosis (44% vs. 19%, p<0.0002). Within the 1-year prior to disease diagnosis, 
controls reported slightly more strep-tococcal infections (p<0.2), infections
with diarrhea and vomiting (p<0.3), and antibiotic use (p<0.09), although none of
these results were statistically significant. Histories of any hepatitis,
rubella, any bacterial infection, and having had a pre-vious positive
tuberculosis skin test were not significantly different between groups and were
actually more often reported by the control subjects. SSc reported slightly more 
hepatitis B (p<0.08), more rheumatic fever (p<0.8) in past, and herpes zoster
(p<0.4), although no differences reached significance. CONCLUSION: This study
does not support that self-report of symptomatic infections are more likely to
occur ever (prior to diagnosis) or within 1-year prior to symptom onset of SSc,
or that vaccinations in adulthood trigger SSc.

PMID: 19088895 [PubMed - in process]

872: Chem Biodivers. 2006 May;3(5):515-26.

Nitroimidazoles, part 2: Synthesis, antiviral and antitumor activity of new
4-nitroimidazoles.

Al-Masoudi NA, Al-Soud YA, Kalogerakis A, Pannecouque C, De Clercq E.

Fachbereich Chemie, Universitat Konstanz, Postfach 5560, D-78457 Konstanz.
info@al-masoudi.de

A series of 5-alkylamino and 5-alkylsulfanyl derivatives of
1-aryl-2-alkyl-4-nitro-1H-imidazoles 12-21, 31, and 34 were synthesized by a
simple method with the aim to develop novel HIV non-nucleoside reverse
transcriptase inhibitors (NNRTIs). All the new compounds were tested against
HIV-1 and HIV-2 in MT-4 cells. Compound 21, with an arylsulfanyl group at C(5) of
the 4-nitro-1H-imidazole backbone showed an EC(50) value of 0.22 microg/ml
against HIV-1 with a therapeutic index of 13. This means that compound 21 was
cytotoxic to MT-4 cells at a CC(50) value of 2.57 microg/ml; also compounds 8,
22-25, 28, and 29 were cytotoxic to MT-4 cells within the 0.4-4 microg/ml
concentration range. Compounds 8, and 12-21 were evaluated, as a rule, but found 
inactive at non-toxic concentrations against hepatitis C virus, herpes simplex
type 1 and 2, cytomegalovirus (CMV), varicella-zoster virus (VZV), vaccinia
virus, and vesicular stomatitis virus, and a number of other viruses. Yet, the
therapeutic index of compounds 17 and 21 for CMV and VZV approached the tenfold
cut-off point. Compounds 8 and 21 exhibited some cytostatic activity against
leukemia and melanoma cell lines.

PMID: 17193287 [PubMed - indexed for MEDLINE]

873: Z Orthop Ihre Grenzgeb. 2006 Nov-Dec;144(6):583-6.

[Rare differential diagnosis of a radicular spine syndrome: herpes zoster
radiculitis]

[Article in German]

Koch P, Diedrich O, Pennekamp PH, Schmitz A.

Klinik und Poliklinik fur Orthopadie, Universitatsklinikum Bonn, Germany.
peter.koch@ukb.uni-bonn.de

We report on the case of a 66-year-old patient who was hospitalized because of
intractable low back pain radiating into the right leg. Leg pain was accompanied 
by a numbness and muscle weakness which was clearly assigned to the L5 dermatome.
Concerning the patient's medical history a nucleotomy L4/5 and a
osteomyelofibrosis were known. MRI of the lumbar spine revealed a multisegmental 
stenosis which was pronounced on the level L4/5. One day after admission of the
patient to the hospital a typical zoster exanthema involving the L5 dermatome
appeared. Varicella-zoster virus (VZV) was detected in the fluid of the vesicular
skin lesions by polymerase chain reaction. Intravenous administration of
aciclovir lead to rapid decrease of pain and exanthema. A few months later the
patient died because of an acute myeloid leukemia as a complication of the known 
osteomyelofibrosis. This case report shows that a herpes zoster infection can
imitate a radicular spine syndrome usually caused by degenerative changes.
Especially in immunocompromised patients, a zoster radiculitis should be included
in the differential diagnosis of radiculopathy. VZV infection might also occur
without skin lesions (zoster sine herpete) so that serological assays for the
early detection of virus DNA can be useful.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17187332 [PubMed - indexed for MEDLINE]

874: Neurobiol Dis. 2007 Mar;25(3):553-60. Epub 2006 Dec 20.

Two alphaherpesvirus latency-associated gene products influence calcitonin
gene-related peptide levels in rat trigeminal neurons.

Hamza MA, Higgins DM, Ruyechan WT.

Department of Pharmacology and Toxicology, SUNY, Buffalo, NY 14214, USA.

Herpes simplex virus type-1 (HSV-1) initially infects mucoepithelial tissues of
the eye and the orofacial region. Subsequently, the virus is retrogradely
transported through the axons of the trigeminal sensory neurons. HSV-1
establishes a life-long latent infection in these neurons, during which the
transcription of the viral genome is silent, except for the sequences encoding
the latency-associated transcript (LAT). To determine if HSV-1 latency might
affect calcitonin gene-related peptide (CGRP) expression in trigeminal sensory
neurons, we transfected primary neuronal cultures of trigeminal ganglia from rat 
embryos with plasmids expressing LAT. In the presence of Bone Morphogenetic
Protein-7 (BMP7), CGRP was expressed in 49% of sensory neurons. However, this
percentage was reduced to 19% in neurons transfected with LAT expressing
plasmids. We also found that transfection of the IE63 gene of varicella-zoster
virus (VZV) reduced the percentage of trigeminal neurons containing CGRP.
However, the observed effect of IE63 in contrast to that of LAT was completely
reversed by treatment of cultures with MgCl2, which indicates that the effect of 
IE63 was due to increased release of CGRP from trigeminal neurons. We provide
here the first evidence that HSV-1 LAT decreases the level of CGRP in trigeminal 
neurons. These effects may be important for reducing the neuroinflammatory
response, thus protecting host neuronal cells during HSV-1 latency in trigeminal 
neurons. In contrast, increased release of CGRP in the presence of IE63 protein
may contribute to the neuralgias associated with VZV infection.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17184994 [PubMed - indexed for MEDLINE]

875: Ophthalmology. 2007 Apr;114(4):756-62. Epub 2006 Dec 20.

Comment in:
    Ophthalmology. 2008 Jun;115(6):1104-5; author reply 1105-6.

Acute retinal necrosis features, management, and outcomes.

Lau CH, Missotten T, Salzmann J, Lightman SL.

Department of Clinical Ophthalmology, Institute of Ophthalmology and Moorfields
Eye Hospital, London, United Kingdom.

OBJECTIVE: To determine the viral diagnosis and factors affecting the visual
outcome of eyes with acute retinal necrosis. DESIGN: Nonrandomized,
retrospective, interventional, noncomparative series. PARTICIPANTS: A cohort of
22 human immunodeficiency virus-negative patients with acute retinal necrosis
(ARN). There were 17 unilateral and 5 bilateral cases. INTERVENTION: Diagnostic
vitreous biopsy for polymerase chain reaction (PCR) viral DNA analysis,
prophylactic barrier laser posterior to necrotic retina to try to prevent
rhegmatogenous retinal detachment (RD), intravenous acyclovir in combination with
oral, and vitrectomy for RD repair. MAIN OUTCOME MEASURES: Results of PCR viral
DNA analysis, relationship between prophylactic barrier argon laser
photocoagulation and occurrence of RD, and visual acuities at presentation and
follow-up. RESULTS: Varicella-zoster virus (VZV) was detected in 66.7% (12/18) of
eyes (66.7% of patients [10/15]) with vitreous biopsy and herpes simplex virus
(HSV) in 22.2% (4/18) of eyes (20% of patients [3/15]). Epstein-Barr virus (EBV) 
was detected in 16.7% (3/18) of eyes (20% of patients [3/15]), and all the
EBV-positive eyes were also positive for VZV. Polymerase chain reaction results
were identical in both eyes of bilateral cases (5 patients) and were negative in 
11.1% (2/18) of eyes (13.3% of patients [2/15]) biopsied. Systemic corticosteroid
treatment given before ARN diagnosis did not appear to increase the risk of
developing RD (P = 0.69). Rhegmatogenous RD occurred in 35.3% (6/17) of eyes
given prophylactic argon laser treatment and in 80% (8/10) of eyes that could not
be lasered prohylactically. Of RDs, 96.3% (13/14) occurred after the third week
and up to 5 months from onset of symptoms. The VA after surgical repair of RD
improved relative to the presentation acuity in 33.3% (4/12) of eyes. CONCLUSION:
Varicella-zoster virus is the leading cause of ARN. We recommend the management
of ARN to include prompt diagnosis; prophylactic argon laser retinopexy,
preferably within the first 2 weeks to reduce risk of RD; systemic acyclovir; and
corticosteroids to control the severe inflammation associated with ARN. Despite
the guarded visual prognosis, RD repair may result in improved visual outcomes.

PMID: 17184841 [PubMed - indexed for MEDLINE]

876: J Pain Palliat Care Pharmacother. 2006;20(4):41-2.

Zoster vaccine to prevent postherpetic neuralgia.

Sederholm B, Peterson D.

Drug Information Service, University of Utah, Salt Lake City, UT 84108, USA.

In 2006, the U.S. Food and Drug Administration approved the first vaccine for the
prevention of acute herpes zoster neuralgia (shingles). This vaccine has
important implications in reducing the incidence and severity of the common
neuropathic pain condition postherpetic neuralgia. The new vaccine is described.

Publication Types: 
    Randomized Controlled Trial

PMID: 17182505 [PubMed - indexed for MEDLINE]

877: Drugs. 2006;66(18):2397-416.

Famciclovir: a review of its use in herpes zoster and genital and orolabial
herpes.

Simpson D, Lyseng-Williamson KA.

Wolters Kluwer Health | Adis, Auckland, New Zealand. demail@adis.co.nz

Famciclovir (Famvir) is the oral prodrug of penciclovir, an agent that has
demonstrated antiviral activity against herpes simplex viruses, type 1 (HSV-1)
and 2 (HSV-2) [which cause orolabial and/or genital herpes simplex], and against 
varicella zoster virus (VZV) [a reactivation of which leads to herpes zoster].
Famciclovir has efficacy similar to that of aciclovir (in immunocompetent or
immunocompromised patients) or valaciclovir (in immunocompetent patients) in the 
treatment of herpes zoster, and efficacy similar to aciclovir in the treatment of
first or recurrent episodes of genital herpes (in immunocompetent or
immunocompromised patients). Famciclovir also has efficacy in the suppression of 
recurrent episodes of genital herpes, and in the treatment of orolabial herpes,
in immunocompetent patients. As such, famciclovir is a well tolerated first-line 
option for the treatment of herpes zoster and the treatment and suppression of
genital herpes, and is approved for the treatment of recurrent orolabial herpes. 
Convenient patient-initiated single-day (for recurrent genital herpes) and
single-dose (for orolabial herpes) dosage regimens may contribute to treatment
compliance, patient acceptability and subsequent treatment outcomes.

Publication Types: 
    Review

PMID: 17181386 [PubMed - indexed for MEDLINE]

878: Infection. 2006 Dec;34(6):352-4.

Coexistence of Ramsay Hunt syndrome and varicella-zoster virus encephalitis.

Kin T, Hirano M, Tonomura Y, Ueno S.

Dept. of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara
634-8522, Japan.

We describe a patient with Ramsay Hunt syndrome and varicella-zoster virus
encephalitis. The coexistence of these conditions is rare and to our knowledge
has not been clearly documented in the English-language literature. We summarize 
the clinical characteristics of our patient and seven similar patients described 
in previous reports, including those published in Japanese. Although concomitant 
diseases such as diabetes and chronic renal failure may lead to an aggressive
course, all patients described in detail have had good outcomes.

Publication Types: 
    Case Reports
    Review

PMID: 17180593 [PubMed - indexed for MEDLINE]

879: Med Microbiol Immunol. 2007 Jun;196(2):95-102. Epub 2006 Dec 16.

Herpes simplex and varicella-zoster virus infections during pregnancy: current
concepts of prevention, diagnosis and therapy. Part 2: Varicella-zoster virus
infections.

Sauerbrei A, Wutzler P.

Institute of Virology and Antiviral Therapy, Friedrich-Schiller University of
Jena, Hans-Knoell-Strasse 2, 07745 Jena, Germany.
Andreas.Sauerbrei@med.uni-jena.de

Varicella during pregnancy can be associated with severe illnesses for both the
mother and her neonate. Varicella pneumonia must be regarded as a medical
emergency, since pregnant women are at risk of life-threatening ventilatory
compromise and death. After maternal chickenpox in the first and second
trimesters, congenital varicella syndrome may occur in nearly 2% of the cases.
The characteristic symptoms consist of skin lesions in dermatomal distribution,
neurological defects, eye diseases and skeletal anomalies. If the mother develops
varicella rashes between day 4 (5) antepartum and day 2 postpartum, generalized
neonatal varicella leading to death in about 20% of the cases has to be expected.
Normal zoster has not been shown to be associated with maternal pneumonia, birth 
defects or problems in the perinatal period. On the basis of the clinical
consequences of varicella-zoster virus infections during pregnancy, the present
paper summarizes the currently available concepts of prevention, diagnosis and
therapy.

Publication Types: 
    Review

PMID: 17180380 [PubMed - indexed for MEDLINE]

880: Pain Pract. 2005 Dec;5(4):327-40.

Postherpetic neuralgia: the never-ending challenge.

Niv D, Maltsman-Tseikhin A.

Center for Pain Medicine, Tel-Aviv Sourasky Medical Center, Sackler Faculty of
Medicine, Tel-Aviv University, Tel-Aviv, Israel. davidniv@tasmc.health.gov.il

Postherpetic neuralgia (PHN) is defined as pain that persists 1 to 3 months
following the rash of herpes zoster (HZ). PHN affects about 50% of patients over 
60 years of age and 15% of all HZ patients. Patients with PHN may experience two 
types of pain: a steady, aching, boring pain and a paroxysmal lancinating pain,
usually exacerbated by contact with the involved skin. Herpes zoster is initially
a clinical diagnosis, based on the observation of a typical dermatomal
distribution of rash and radicular pain. HZ is pathologically characterized by
inflammatory necrosis of dorsal root ganglia, occasionally associated with
evidence of neuritis, leptomeningitis, and segmental unilateral degeneration of
related motor and sensory roots. Although acyclovir has been used successfully as
standard therapy for varicella zoster virus (VZV) infection in the past decade,
resistant strains of VZV are often recognized in immunocompromised patients.
Therapy with acyclovir and the use of corticosteroids have been reported to
prevent PHN in up to 60% of HZ patients. Management of chronic pain in PHN is
more problematic. The only therapy proven effective for PHN in controlled study
is the use of tricyclic antidepressants, including amitriptyline and desipramine.
There is good evidence of efficacy from randomized trials that gabapentin and
pregabalin (new anticonvulsant drugs) are of benefit in the reduction of pain
from PHN. As alternative therapies, topical agents such as capsaicin, lidocaine
or opioid analgesic treatment may give satisfactory results. Interventions with
low risk, such as transcutaneous electrical nerve stimulation (TENS), are
appropriate. Evidence is scant for the value of surgical and procedural
interventions in general, although there are numerous, small studies supporting
the use of specific interventions such as nerve blocks, neurosurgical procedures,
and neuroaugmentation. Although antiviral agents are appropriate for acute HZ,
and the use of neural blockade and sympathetic blockade may be helpful in
reducing pain in selected patients with HZ, there is little evidence that these
interventions will reduce the likelihood of developing PHN. Postherpetic
neuralgia remains a difficult pain problem. This review describes the
epidemiology and pathophysiology of PHN and discusses proposed mechanisms of pain
generation with emphasis on the various pharmacological treatments and invasive
modalities currently available.

PMID: 17177766 [PubMed]

881: J Med Virol. 2007 Feb;79(2):192-9.

Increased prevalence of varicella zoster virus DNA in cerebrospinal fluid from
patients with multiple sclerosis.

Mancuso R, Delbue S, Borghi E, Pagani E, Calvo MG, Caputo D, Granieri E, Ferrante
P.

Laboratory of Molecular Medicine and Biotechnology, Don C. Gnocchi Foundation,
IRCCS, Milan, Italy.

In order to investigate the possible involvement of viruses in Multiple Sclerosis
(MS), the study evaluated the presence of viral genomic sequences in
cerebrospinal fluid (CSF), as markers of viral replication within the central
nervous system (CNS). A total of 85 CSF samples were collected from 38 MS
patients, 28 patients with other neurological diseases and 19 subjects without
neurological diseases. Using nested-PCR, the investigation focused on the
presence of human herpes virus DNA, including herpes simplex virus 1 (HSV-1) and 
2 (HSV-2), the Epstein-Barr virus (EBV), varicella zoster virus (VZV), human
cytomegalovirus (HCMV), human herpes virus 6 (HHV-6) and JC virus (JCV). All the 
CSF samples from the individuals without neurological diseases were negative for 
viral DNA. Genomic sequences of HSV-1, HCMV, EBV, HHV6, and JCV were found in
patients with MS and other neurological diseases without significant differences 
between the two groups. VZV DNA was detected more frequently (P < 0.05) in the MS
group (31.6%), particularly among the relapsing-remitting MS patients (43.5%),
compared with patients with other neurological diseases (10.7%). In addition, the
results indicated that JCV and HHV-6 were replicating actively in the CNS of a
small, but significant number of patients with MS and other neurological
diseases. Most importantly, the study revealed a high frequency of VZV DNA in the
CSF of patients with MS, suggesting a possible role of this virus in the
pathogenesis of MS.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17177306 [PubMed - indexed for MEDLINE]

882: Invest Clin. 2006 Dec;47(4):337-47.

[Use of polymerase chain reaction for the diagnosis of central nervous system
infections]

[Article in Spanish]

Zambrano Y, Chiarello A, Soca A, Villalobos I, Marrero M, Soler M, Laferte J,
Alvarez M.

Laboratorio Genomik, Maracay, Venezuela. genomik@cantv.net

In the present work, the polymerase chain reaction (PCR) assay and his variants
RT-PCR and Multiplex PCR were applied for the detection of specific sequences of 
Enterovirus, Human Herpes viruses (Herpes simple virus, Human Herpes virus type
6, Cytomegalovirus, Epstein Barr virus, and Varicella Zoster), Human
Immunodeficiency virus, Toxoplasma gondii, Mycobacterium tuberculosis and
Mycoplasma pneumoniae in patients' cohorts grouped by medical suspicion of
meningoencephalitis. Of 326 samples of processed cerebrospinal fluid (CSF), 93
samples (28.5%) were positive for the different infectious agents. In the group
of patients with clinical diagnosis of viral meningoencephalitis (n=212), there
was obtained a whole of 73 positive samples (34.4%), of which 37 patients were
positive to Enterovirus (50.7%), 19 were positive to VHS (26%) and 10 patients
(13.7%) were positive to CMV. Other viral agents as VZV, EBV and HVH6 were
detected in minor frequency. The 114 remaining samples were analyzed applying
specific PCR to each pathogen for strict medical indication, being able to detect
the presence of Human Immunodeficiency Virus (40%), Mycoplasma pneumoniae (40%), 
Toxoplasma gondii (14%) and Mycobacterium tuberculosis (12%) in CSF samples. The 
results obtained in this study demonstrate the convenience of the application of 
the molecular assays in the laboratory diagnosis of the meningoencefalitis of
different etiology. Besides this, it is also a very valuable tool for the
clinical management of the patients and for the execution of the epidemiological 
studies.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 17176902 [PubMed - indexed for MEDLINE]

883: Mayo Clin Health Lett. 2006 Oct;24(10):8.

My granddaughter was recently visiting and she had chickenpox. I've already had
chickenpox, but I'm concerned about getting shingles because I know the two
diseases are related. Can I catch shingles from her?

[No authors listed]

PMID: 17176523 [PubMed - indexed for MEDLINE]

884: J Gen Virol. 2007 Jan;88(Pt 1):275-85.

Antiviral activity obtained from aqueous extracts of the Chilean soapbark tree
(Quillaja saponaria Molina).

Roner MR, Sprayberry J, Spinks M, Dhanji S.

Department of Biology, The University of Texas Arlington, Arlington, TX 76019,
USA. roner@uta.edu

Natural, aqueous extracts of Quillaja saponaria, the Chilean soapbark tree,
contain several physiologically active triterpenoid saponins that display strong 
adjuvant activity when used in either human or animal vaccines. In this paper, we
describe studies that demonstrate a novel antiviral activity of Quillaja extracts
against six viruses: vaccinia virus, herpes simplex virus type 1, varicella
zoster virus, human immunodeficiency viruses 1 and 2 (HIV-1, HIV-2) and reovirus.
We demonstrate that microgram amounts of extract, while exhibiting no cell
cytotoxicity or direct virucidal activity, prevent each of the six viruses tested
from infecting their host cells. In addition, the presence of residual amounts of
extract continue to block virus infection and render cells resistant to infection
for at least 16 h after the removal of the extract from the cell culture medium. 
We demonstrate that a Quillaja extract possesses strong antiviral activity at
concentrations more than 100-fold lower than concentrations that exhibit cell
cytotoxicity. Extract concentrations as high as 100 microg ml(-1) are not
cytotoxic, but concentrations as low as 0.1 microg ml(-1) are able to block HIV-1
and HIV-2 virus attachment and infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17170461 [PubMed - indexed for MEDLINE]

885: Med Microbiol Immunol. 2007 Jun;196(2):89-94. Epub 2006 Dec 13.

Herpes simplex and varicella-zoster virus infections during pregnancy: current
concepts of prevention, diagnosis and therapy. Part 1: herpes simplex virus
infections.

Sauerbrei A, Wutzler P.

Institute of Virology and Antiviral Therapy, Friedrich-Schiller University of
Jena, Hans-Knoell-Strasse 2, 07745 Jena, Germany.
Andreas.Sauerbrei@med.uni-jena.de

Primary herpes simplex virus (HSV) infection may lead to severe illness in
pregnancy and may be associated with transplacental virus transmission and fetal 
infection. The consequences may be abortion, stillbirth and congenital
malformations. In neonates, the clinical findings after intrauterine HSV
infection are characterized by skin lesions, diseases of the eye and neurologic
damage. Herpes genitalis of pregnant women at the time of labor may result in
life-threatening neonatal herpes. Currently, neither active nor passive
immunization is available to prevent HSV infections during pregnancy and in the
newborn infant. Therefore, antiviral treatment using aciclovir and/or
valaciclovir must be considered in all primary episodes of genital herpes as well
as in neonates who show signs of either infection. Clinical herpes lesions of the
genitalia and/or positive test for virus detection at the time of delivery are an
indication for cesarean section. However, this surgical intervention may be
reduced by suppressive treatment of recurrent genital herpes with aciclovir or
valaciclovir.

Publication Types: 
    Review

PMID: 17165093 [PubMed - indexed for MEDLINE]

886: Intervirology. 2007;50(1):40-4. Epub 2006 Nov 24.

Analysis of repeat units in the R2 region among different Oka varicella-zoster
virus vaccine strains and wild-type strains in Germany.

Sauerbrei A, Zell R, Wutzler P.

Institute of Virology and Antiviral Therapy, Friedrich Schiller University of
Jena, Jena, Germany. Andreas.Sauerbrei@med.uni-jena.de

OBJECTIVE: The present study compared the number of R2 repeat units in six
different Oka strains and in 54 varicella-zoster virus (VZV) wild-type strains
isolated from patients with varicella or zoster in Germany. METHODS: The R2
genomic region was characterized by polymerase chain reaction and sequencing
methods. RESULTS: Five VZV Oka vaccine strains showed a number of seven 42-bp
units and, in one, eight repeats were found. In 11 VZV wild-type strains isolated
from patients with varicella, the copy number ranged between four and eight, and 
in 43 strains from zoster a similar range between four and nine copies was
observed. About 80% of all strains showed between five and seven repeated units. 
More than one third of strains revealed seven repeats like Oka. CONCLUSIONS: The 
size of the R2 repeat region can also be different in single Oka vaccine strains.
In German VZV wild-type strains, the R2 fragment seems to be not as variable as
in Japanese wild-type strains. Copyright 2007 S. Karger AG, Basel.

PMID: 17164556 [PubMed - indexed for MEDLINE]

887: Clin Gastroenterol Hepatol. 2006 Dec;4(12):1483-90.

Comment in:
    Inflamm Bowel Dis. 2007 Sep;13(9):1178-9.

Incidence and risk factors for herpes zoster among patients with inflammatory
bowel disease.

Gupta G, Lautenbach E, Lewis JD.

Center for Clinical Epidemiology and Biostatistics, Department of Internal
Medicine, University of Pennsylvania School of Medicine, Philadelphia,
Pennsylvania 19104-6021, USA.

BACKGROUND & AIMS: An increased risk of herpes zoster in patients with
inflammatory bowel disease (IBD) is hypothesized based on altered immune
function, especially among patients receiving immunosuppressive medications.
METHODS: We performed a retrospective cohort study and a retrospective nested
case-control study using 1988-1997 data from the General Practice Research
Database. In the cohort study, 7823 Crohn's disease (CD) and 11,930 ulcerative
colitis (UC) patients were matched on age, sex, and primary care practice to
79,563 randomly selected controls without CD or UC. In the nested case-control
study, 185 CD patients with zoster and 266 UC patients with zoster were matched
on sex and year of birth to 1787 IBD patients without zoster. RESULTS: In the
cohort study, the incidence of zoster was higher in patients with CD and UC
compared with their matched controls (UC incidence rate ratio, 1.21; 95%
confidence interval [CI], 1.05-1.40; CD incidence rate ratio, 1.61; 95% CI,
1.35-1.92). In the nested case-control study, receipt of a prescription for
corticosteroids (adjusted odds ratio, 1.5; 95% CI, 1.1-2.2) or
azathioprine/6-mercaptopurine (adjusted odds ratio, 3.1; 95% CI, 1.7-5.6) were
both associated with zoster. CONCLUSIONS: Patients with IBD, especially those on 
immunosuppressive medications, are at higher risk for herpes zoster compared with
the general population. Future studies should clarify the relative risk
associated with anti-tumor necrosis factor alpha therapies and determine the use 
of the new zoster vaccine for patients with IBD.

PMID: 17162240 [PubMed - indexed for MEDLINE]

888: Biol Blood Marrow Transplant. 2006 Dec;12(12):1335-42.

Antigen-specific T-lymphocyte function after cord blood transplantation.

Cohen G, Carter SL, Weinberg KI, Masinsin B, Guinan E, Kurtzberg J, Wagner JE,
Kernan NA, Parkman R.

The EMMES Corporation, Rockville, Maryland, USA.

It has not been possible to determine the singular contribution of naive T
lymphocytes to antigen-specific immunity after hematopoietic stem cell
transplantation (HSCT), because of the confounding effects of donor-derived
antigen-specific T lymphocytes present in most hematopoietic stem cell (HSC)
products. Because umbilical cord blood contains only naive T lymphocytes, we
longitudinally evaluated the recipients of unrelated cord blood transplantation
(UCBT) for the presence of T lymphocytes with specificity for herpesviruses, to
determine the contribution of the naive T lymphocytes to antigen-specific immune 
reconstitution after HSCT. Antigen-specific T lymphocytes were detected early
after UCBT (herpes simplex virus on day 29; cytomegalovirus on day 44; varicella 
zoster virus on day 94). Overall, 66 of 153 UCBT recipients developed
antigen-specific T lymphocytes to 1 or more herpesviruses during the evaluation
period. The likelihood of developing antigen-specific T lymphocyte function was
not associated with immunophenotypic T lymphocyte reconstitution, transplant cell
dose, primary disease, or acute and chronic graft-versus-host disease. These
results indicate that naive T lymphocytes present in the HSC inoculum can
contribute to the generation of antigen-specific T-lymphocyte immunity early
after transplantation.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17162216 [PubMed - indexed for MEDLINE]

889: Eur J Paediatr Neurol. 2007 Mar;11(2):104-7. Epub 2006 Dec 11.

Anti-basal ganglia antibodies and acute movement disorder following herpes zoster
and streptococcal infections.

Basheer SN, Wadsworth LD, Bjornson BH.

Division of Neurology, British Columbia Children's Hospital and the University of
British Columbia, Vancouver, British Columbia, Canada. sn.basheer@hey.nhs.uk

Anti-basal ganglia antibodies (ABGA) have been associated with poststreptococcal 
encephalitis similar to encephalitis lethargica (EL). We report two children with
parainfectious encephalitis of similar phenotype and IgG ABGA. However, the
associated pathogens in the two cases differed; beta-hemolytic streptococcus and 
herpes zoster. ABGA may not be specific to poststreptococcal encephalitis, but
rather a surrogate marker of an inflammatory mediated movement disorder, which
may respond to immunotherapy.

Publication Types: 
    Case Reports

PMID: 17161966 [PubMed - indexed for MEDLINE]

890: Pain. 2007 Mar;128(1-2):3-5. Epub 2006 Dec 11.

Comment in:
    Pain. 2007 Jul;130(1-2):195-6.

Pain following herpes zoster: the influence of changing population
characteristics and medical developments.

Johnson RW, Rice AS.

Publication Types: 
    Editorial

PMID: 17161531 [PubMed - indexed for MEDLINE]

891: Pain Pract. 2002 Dec;2(4):295-307.

Postherpetic neuralgia.

Watson CP, Oaklander AL.

University of Toronto, Toronto, Ontario, Canada.

This article reviews the definition, epidemiology, pathology, clinical features, 
and treatment of postherpetic neuralgia (PHN). Much of this information is well
established. However, there is some important new information about the pathology
that may shed light on the pathogenesis of this disorder. The exciting prospect
exists of the prevention of PHN by vaccination and by early, aggressive treatment
of herpes zoster. This is important because current treatment approaches have
significant limitations. We now have certain antidepressants, anticonvulsants,
opioids, and the topical agent lidocaine that have been scientifically shown by
randomized controlled trials to be effective in this disorder. However, all of
these have a modest effect at best and newer treatments are necessary. Prevention
may be very important for the 30% to 50% of the patients who either do not
respond at all or do not respond well. Regional anesthetic procedures do not have
a good scientific basis for either acute zoster or established PHN, but remain a 
reasonable alternative for some patients. This article addresses the issue of how
effective the current treatments really are and gives practical guidelines for
management.

PMID: 17156037 [PubMed]

892: Harv Mens Health Watch. 2006 Oct;11(3):5-6.

New immunizations for adults.

[No authors listed]

PMID: 17153759 [PubMed - indexed for MEDLINE]

893: Otolaryngol Pol. 2006;60(4):611-4.

[Paresis of the vagus and accessory nerve in the course of the herpes zoster]

[Article in Polish]

Dabrowska A, Tarnowska C, Jalowinski R, Amernik K, Stankiewicz J, Grzelec H.

Katedra i Klinika otolaryngologii i Onkologii Laryngologicznej Pomorskiej AM
anna.d@wp.pl

INTRODUCTION: The cephalic zoster is a cranial neuritis, with great tendency to
diffusion along the nerves. The objective of this article is both to report a
case of cranial polineuritis due to herpes zoster infection with laryngeal
involvement and review of the relevant literature. MATERIAL AND METHODS: The case
of 57-years-old man with unilateral laryngeal mucosal eruptions and complete left
vocal paralysis is reported. Laryngeal symptoms, diagnostic criteria and
therapeutic result are described. CONCLUSION: 1. In cases of head and neck herpes
zoster, the investigations of all cranial nerves should be carried out, and the
larynx must always be examinated; 2. Co-occurrence of the neuralgic pain
(radiating especially to the ear or the occipital region) with unilateral
laryngeal palsy should raise a suspicion that herpes zoster infection may by the 
causative factor; 3. The explanation of the etiologic cause of a vocal fold
paralysis in idiopathic cases, may yield not only diagnostic, but also
therapeutic value.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17152819 [PubMed - indexed for MEDLINE]

894: Herpes. 2006 Nov;13(3):75-80.

Investigations of the pathogenesis of Varicella zoster virus infection in the
SCIDhu mouse model.

Arvin AM.

Departments of Pediatrics, and Microbiology and Immunology, Stanford University
School of Medicine, Stanford, CA 94305, USA. aarvin@stanford.edu

Varicella zoster virus (VZV) is a medically important human herpesvirus that
causes varicella, establishes latency in sensory ganglia and may reactivate to
cause herpes zoster in healthy and immunocompromised patients. Experiments in the
severe combined immunodeficiency (SCID) mouse model have provided new insights
about VZV pathogenesis. In addition, the evaluation of VZV recombinant viruses,
with targeted mutations of viral genes or their promoters in SCIDhu skin, T-cell 
and dorsal root ganglia xenografts, has the potential to identify options for the
design of a recombinant 'second-generation' VZV vaccine. This would be
characterized by the retention of infectivity in skin combined with a restricted 
tropism for T-cells and neurons within sensory ganglia.

Publication Types: 
    Review

PMID: 17147912 [PubMed - indexed for MEDLINE]

895: Herpes. 2006 Nov;13(3):59.

Varicella Pathogenesis: from Hox to Mutated gE glycoproteins.

Grose C.

Publication Types: 
    Editorial
    Research Support, Non-U.S. Gov't

PMID: 17147909 [PubMed - indexed for MEDLINE]

896: Herpes. 2006 Nov;13(3):60-5.

Prevention of VZV infection in immunosuppressed patients using antiviral agents.

Boeckh M.

Fred Hutchinson Cancer Research Center, Program in Infectious Diseases,
University of Washington, Seattle, WA 98109, USA. mboeckh@fhcrc.org

Antiviral agents play a key role in the prevention and treatment of varicella
zoster virus (VZV) disease in immunosuppressed patients. Randomized trials show
that aciclovir is effective in preventing VZV reactivation disease; however, no
consensus exists on dose, duration and patient population for its use. The recent
shortage of VZV-specific immunoglobulin has generated renewed interest in the use
of antiviral agents as post-exposure prophylaxis. The use of antiviral agents for
post-exposure prophylaxis is not supported by randomized trials, but uncontrolled
experience suggests that it might be a reasonable alternative if
varicella-specific immunoglobulin is not available. Current evidence on the use
of antiviral agents in the prevention of reactivation disease and management of
exposure to VZV is discussed.

Publication Types: 
    Research Support, N.I.H., Extramural
    Review

PMID: 17147908 [PubMed - indexed for MEDLINE]

897: Eur J Paediatr Neurol. 2007 Jan;11(1):29-34. Epub 2006 Dec 4.

Intrathecal synthesis of anti-viral antibodies in pediatric patients.

Denne C, Kleines M, Dieckhofer A, Ritter K, Scheithauer S, Merz U, Hausler M.

Department of Pediatrics, RWTH, University Hospital of Aachen, Pauwelsstrasse 30,
52064 Aachen, Germany. denne.christian@gmx.net

INTRODUCTION: Detection of intrathecal synthesis of specific antibodies (antibody
index (AI)) is an established method to prove cerebral viral infection.
Experience on its clinical application in large patient groups, however, is
sparse. METHODS: Retrospective analysis of pediatric patients with positive viral
AI treated at RWTH Aachen University Hospital between 1999 and 2005. RESULTS: 63 
patients were studied, including 14 with encephalitis, 12 with neuritis, nine
with cerebral vasculitis, six with multiple sclerosis (MS), five with severe
cephalgia, five with psychiatric symptoms, three with hearing loss, two with
seizures, three with white matter diseases, two with movement disorders, one with
meningococcal meningitis and one with sinus venous thrombosis. Seven had several 
positive AI among them only one patient with MS. Of the 51 patients with a single
positive AI and not having MS, 16 showed a positive AI for herpes simplex-, 13
for varicella zoster-, nine for Epstein-Barr-, four for cytomegalo-, four for
mumps-, three for rubella- and two for measles virus. Frequent combinations were 
varicella zoster virus (VZV) and vasculitis (n = 8), herpes simplex virus (HSV)
and neuritis (n = 6), Epstein-Barr virus (EBV) (n = 5), respectively, VZV (n = 4)
and encephalitis as wells as mumps virus (n = 2) and hearing loss. Matched
polymerase chain reaction (PCR) and AI data were available in 25 patients. PCR
was simultaneously positive in three cases only. DISCUSSION: AI testing
identifies a similar spectrum of pathogens as known from cerebrospinal fluid
(CSF) PCR studies. It complements the PCR and increases the chance for adequate
diagnosis and treatment of patients with assumed cerebral viral infections.

PMID: 17145191 [PubMed - indexed for MEDLINE]

898: Clin Infect Dis. 2007 Jan 1;44 Suppl 1:S1-26.

Recommendations for the management of herpes zoster.

Dworkin RH, Johnson RW, Breuer J, Gnann JW, Levin MJ, Backonja M, Betts RF,
Gershon AA, Haanpaa ML, McKendrick MW, Nurmikko TJ, Oaklander AL, Oxman MN,
Pavan-Langston D, Petersen KL, Rowbotham MC, Schmader KE, Stacey BR, Tyring SK,
van Wijck AJ, Wallace MS, Wassilew SW, Whitley RJ.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, Rochester, NY, 14642, USA. robert_dworkin@urmc.rochester.edu.

The objective of this article is to provide evidence-based recommendations for
the management of patients with herpes zoster (HZ) that take into account
clinical efficacy, adverse effects, impact on quality of life, and costs of
treatment. Systematic literature reviews, published randomized clinical trials,
existing guidelines, and the authors' clinical and research experience relevant
to the management of patients with HZ were reviewed at a consensus meeting. The
results of controlled trials and the clinical experience of the authors support
the use of acyclovir, brivudin (where available), famciclovir, and valacyclovir
as first-line antiviral therapy for the treatment of patients with HZ. Specific
recommendations for the use of these medications are provided. In addition,
suggestions are made for treatments that, when used in combination with antiviral
therapy, may further reduce pain and other complications of HZ.

Publication Types: 
    Practice Guideline
    Research Support, Non-U.S. Gov't
    Review

PMID: 17143845 [PubMed - indexed for MEDLINE]

899: J Clin Pathol. 2006 Dec;59(12):1331-3.

Herpetiform cutaneous metastases from transitional cell carcinoma of the urinary 
bladder: immunohistochemical analysis.

Somani BK, Prita D, Grant S, Nabi G, N'dow J.

Department of Urology, Aberdeen Royal Infirmary Hospital, Aberdeen, Scotland, UK.

The case of an 83-year-old woman with an uncommon presentation of cutaneous
metastases from muscle-invasive transitional cell carcinoma of the urinary
bladder is reported. The band-like eruption of the metastatic lesion can often be
misdiagnosed and treated initially as herpes zoster. A detailed
immunohistochemical analysis is also described to differentiate metastatic
lesions from other sources.

Publication Types: 
    Case Reports

PMID: 17142578 [PubMed - indexed for MEDLINE]

900: Arch Phys Med Rehabil. 2006 Dec;87(12):1653-5.

Monoparesis with complex regional pain syndrome-like symptoms due to brachial
plexopathy caused by the varicella zoster virus: a case report.

Eyigor S, Durmaz B, Karapolat H.

Department of Physical Medicine and Rehabilitation, University of Ege, Medical
Faculty, Bornova, Izmir, Turkey. eyigor@hotmail.com

Viral invasion of the motoneurons and the subsequent inflammation in the anterior
horn cells by the varicella zoster virus results in a weakness in the area of the
cutaneous eruption. The exact mechanism of zoster paresis is uncertain. The
occurrence of symptoms resembling complex regional pain syndrome (CRPS) is common
in subjects where the herpes zoster (HZ) outbreak affects an extremity,
particularly if it is the distal extremity that is involved. We report the case
of a 54-year-old man with monoparesis, hyperalgesia, allodynia, edema, and both
color and skin-temperature changes in his left arm after a skin eruption.
Electrophysiologic examination revealed the partial degeneration of the superior,
middle, and inferior truncus in the brachial plexus, with evidence of HZ
infection. Magnetic resonance imaging of the cervical spine and brachial plexus
showed degenerative changes without any evidence of nerve root compression.
Brachial plexopathy may be the direct cause of the reversible upper-limb paresis 
resulting from HZ with CRPS-like symptoms.

Publication Types: 
    Case Reports

PMID: 17141648 [PubMed - indexed for MEDLINE]

901: Magn Reson Med Sci. 2006 Oct;5(3):151-5.

Prompt contrast enhancement of cerebrospinal fluid space in the fundus of the
internal auditory canal: observations in patients with meningeal diseases on
3D-FLAIR images at 3 Tesla.

Naganawa S, Sugiura M, Kawamura M, Fukatsu H, Nakashima T, Maruyama K.

Department of Radiology, Nagoya University Graduate School of Medicine, Japan.
naganawa@med.nagoya-u.ac.jp

We speculated that meningeal pathologies might facilitate the permeability of
cranial nerves at the fundus of the internal auditory canal (IAC), causing prompt
enhancement after administration of Gd-DTPA. Using a 3D- fluid-attenuated
inversion recovery (FLAIR) sequence, we evaluated the enhancement of the
cerebrospinal fluid (CSF) space in the IAC fundus 10 min after Gd-DTPA
administration in patients with meningeal diseases. Twenty patients (aged 22 to
79 years) were divided into 2 groups, a group with meningeal disease comprising 9
patients with meningeal abnormalities (6, tumor dissemination; 3, infection) and 
a control group of 11 patients with unilateral IAC pathology whose healthy sides 
were included as controls. Six of the 9 patients in the group with meningeal
disease showed bilateral enhancement; one showed unilateral enhancement. None of 
the control group showed enhancement in the healthy side. One patient with
Ramsay-Hunt syndrome showed only ipsilateral enhancement. Enhancement in the IAC 
fundus was frequently observed in patients with meningeal disease, even just 10
min after administration of contrast agent. This enhancement in the IAC fundus
was never visible on T1-weighted 3D-FLASH images.

Publication Types: 
    Evaluation Studies

PMID: 17139141 [PubMed - indexed for MEDLINE]

902: Intern Med. 2006;45(21):1209-12. Epub 2006 Dec 1.

Adult meningism and viral meningitis, 1997-2004: clinical data and cerebrospinal 
fluid cytokines.

Nagafuchi M, Nagafuchi Y, Sato R, Imaizumi T, Ayabe M, Shoji H, Ichiyama T.

The Division of Respirology, Neurology and Rheumatology, Department of Medicine, 
Kurume University School of Medicine, Kurume.

OBJECTIVE: Although meningism manifesting acute headache has been observed to be 
associated with common viral and bacterial infections, its definition and
pathogenesis have not been clarified. Clinical findings and cerebrospinal fluid
(CSF) cytokines in adult patients with meningism were investigated and compared
with those in viral meningitis. PATIENTS AND METHODS: Among the adult inpatients 
in our hospital from 1997 to 2004, 5 with meningism and 17 with viral meningitis 
were identified according to the criteria described in this study, and their
clinical data were analyzed. In the CSF samples of the 5 patients with meningism 
and the 17 with viral meningitis, the concentrations of interferon-gamma
(IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2), IL-4,
IL-6, and IL-10 were determined using a cytometric bead array. RESULTS: The five 
patients with meningism all showed fever and meningeal signs such as severe
headache and nuchal stiffness without CSF pleocytosis (<5 cells/mm3). Four
patients were associated with herpetic Kaposi's eczema, herpes simplex, or herpes
zoster, and all five patients had favorable outcomes. The levels of all CSF
cytokines in patients with meningism were below normal values, whereas IFN-gamma 
and IL-6 in patients with viral meningitis were moderately elevated. CONCLUSION: 
The normal cytokine levels in meningism may possibly reflect the lack of direct
viral infection and may be helpful in differentiating both meningism and viral
meningitis at an early stage.

Publication Types: 
    Comparative Study

PMID: 17139119 [PubMed - indexed for MEDLINE]

903: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Dec;102(6):e37-9.
Epub 2006 Oct 2.

Ramsay-Hunt syndrome with vesicular stomatitis in a 4-year-old infant.

Koga C, Iwamoto O, Aoki M, Nakamura C, Kusukawa J, Matsuishi T.

Kurume University School of Medicine, Kurume, Japan. ckoga@med.kurume-u.ac.jp
<ckoga@med.kurume-u.ac.jp>

Ramsay-Hunt syndrome (RHS) usually affects adults, but rare cases of preschool
children with RHS have been reported. We report a case of RHS in a healthy
4-year-old girl. At the age of 4 years and 5 months, she complained of pain in
her mouth and herpes zoster vesicles were noted on the left soft palate and
tongue without left pinna, and complete left facial paralysis subsequently
developed. She was treated with acyclovir and steroids. Six months later, her
facial paralysis had almost fully resolved.

Publication Types: 
    Case Reports

PMID: 17138164 [PubMed - indexed for MEDLINE]

904: Clin Exp Dermatol. 2007 Mar;32(2):162-4. Epub 2006 Nov 27.

Complete ophthalmoplegia after herpes zoster.

Im M, Kim BJ, Seo YJ, Park JK, Lee JH.

Department of Dermatology, College of Medicine, Chungnam National University,
Daejeon, Korea.

Motor loss caused by herpes zoster is infrequent, and only a few studies have
focused on ocular motor paralysis in ophthalmic herpes zoster. We report a case
of complete ophthalmoplegia resulting from ophthalmic herpes zoster. A
69-year-old man presented with complete left-side ptosis with total
ophthalmoplegia 7 days after the onset of left ophthalmic herpes zoster. The
patient was treated with aciclovir and prednisolone. Five months later, the
ptosis had resolved and the extraocular motility had almost returned to normal.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 17137485 [PubMed - indexed for MEDLINE]

905: J Clin Microbiol. 2007 Feb;45(2):559-63. Epub 2006 Nov 29.

Toward universal varicella-zoster virus (VZV) genotyping: diversity of VZV
strains from France and Spain.

Loparev V, Martro E, Rubtcova E, Rodrigo C, Piette JC, Caumes E, Vernant JP,
Schmid DS, Fillet AM.

Biotechnology Core Facility, Coordinating Center for Infectious Diseases, Centers
for Disease Control and Prevention, Atlanta, GA 30333, USA.

Thirty-one isolates from France and Spain were genotyped using a published method
analyzing DNA sequence variation in open reading frame (ORF) 22, together with an
evaluation of three well-characterized single nucleotide polymorphisms (SNP) in
ORF 38, 54, and 62. Nineteen were allocated to the European (E) genotype, six
were mosaic-1 (M1), and two were mosaic-2 (M2). Four strains were assigned to a
new genotype, mosaic-4 (M4). All isolates were wild type, with no Oka
vaccine-associated markers. No isolates of the mosaic-3 (M3) or Japanese (J)
genotype were observed. We also evaluated 13 selected isolates of E, J, M1, and
M2 strains (9 of the 31 described above) using an alternative genotyping method
based on the assessment of multiple SNP located in ORF 1, 9, 10, 21, 31, 50, 54, 
62, and 68. This method assigns wild-type varicella-zoster virus (VZV) strains to
seven genotypes: A1, A2, J1, B1, B2, C, and C1. VZV isolates identified as E
(ORF22 method) had the genetic signature of genotype C VZV strains, M1 strains
were A1, and M2 were A2. No J strains were detected, but parental Oka and vaccine
Oka (genotype J) corresponded to genotype J1. M4 isolates (B) share the SNP array
observed for M1 and E viruses, and probably represent recombinants between
African-Asian (M1) and European (E) viruses. The two genotyping methods, using
entirely different genomic targets, produced identical clusters for the strains
examined, suggesting robust phylogenetic linkages among VZV strains circulating
in Europe.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 17135433 [PubMed - indexed for MEDLINE]

906: J Virol Methods. 2007 Feb;139(2):227-9. Epub 2006 Nov 28.

Different real-time PCR assays could lead to a different result of detection of
varicella-zoster virus in facial palsy.

Yamakawa K, Hamada M, Takeda T.

Department of Otolaryngology, Kochi Medical School, Kohasu, Oko-chou, Kochi
783-8505, Japan. yamakawk@med.kochi-u.ac.jp

Real-time PCR is a useful tool for rapid detection of viral genomic DNA. However,
there are many types of real-time PCR, and this variation may induce different
results. The sensitivity of two different real-time PCR assays was evaluated for 
the detection of the varicella-zoster virus (VZV) genome: LightCycler PCR and
TaqMan PCR. Auricular skin cells and saliva were sampled from 201 patients with
facial nerve paralysis. A hundred and seventy-one of these patients were
diagnosed clinically with Bell's palsy, and the remaining 30 with Ramsay Hunt
syndrome. In 30 specimens obtained from Ramsay Hunt syndrome patients, VZV DNA
was detected in 26 skin and 3 saliva specimens using the LightCycler PCR, while
28 skin and 9 saliva specimens were positive using the TaqMan PCR. None of the
patients with Bell's palsy were positive for VZV by the LightCycler PCR, whereas 
five of these patients were positive by the TaqMan PCR. The TaqMan PCR assay has 
a better sensitivity compared to the LightCycler PCR for the detection of VZV
genome from patients with facial palsy. Further study is required to develop a
more sensitive real-time PCR.

PMID: 17134766 [PubMed - indexed for MEDLINE]

907: Surv Ophthalmol. 2006 Nov-Dec;51(6):550-60.

Madarosis.

Khong JJ, Casson RJ, Huilgol SC, Selva D.

Oculoplastic and Orbital Unit, Department of Ophthalmology and Visual Science,
Royal Adelaide Hospital, University of Adelaide, North Terrace, Adelaide, SA
5000, Australia.

Madarosis may be a presenting feature of a number of vision and life-threatening 
conditions, including herpes zoster, leprosy, HIV/AIDS, trachoma, malignant
eyelid tumors, discoid lupus, scleroderma, and hypothyroidism. It may occur via
two broad pathogenic pathways: scarring and non-scarring, which indicates the
potential for lash re-growth. Madarosis may occur as an isolated finding or
together with loss of other body and scalp hair. The etiology of madarosis can be
further divided into dermatological, infection, endocrine, neoplastic,
drug-related, congenital, and trauma. This report includes salient points in the 
clinical history and examination of patients with madarosis, with an emphasis on 
excluding or diagnosing visual or life threatening disorders associated with
madarosis.

Publication Types: 
    Review

PMID: 17134645 [PubMed - indexed for MEDLINE]

908: Am J Hematol. 2007 May;82(5):403-4.

The high incidence of varicella herpes zoster with the use of bortezomib in 10
patients.

Tong Y, Qian J, Li Y, Meng H, Jin J.

Department of Hematology, The First Affiliated Hospital of Zhejiang University,
Hangzhou, Zhejiang, China.

Bortezomib, a proteasome inhibitor, has been used for patients with refractory
and relapsed multiple myeloma, lymphoma and leukemia. We used bortezomib in ten
refractory or relapsed patients (seven of multiple myeloma, two of lymphoma and
one of acute myeloblastic leukemia). Six out of ten (60%) patients developed
varicella herpes zoster after the complete of one cycle of bortezomib. The
incidence of varicella herpes zoster was higher than reported in the literature. 
It may be due to immunosuppression caused by the combination of high-dose
dexamethasone or other drugs. We considered that prophylactic antiviral
medication could be used in predisposed patients to reduce the incidence of
varicella herpes zoster. (c) 2006 Wiley-Liss, Inc.

PMID: 17133426 [PubMed - indexed for MEDLINE]

909: Ann Hematol. 2007 Apr;86(4):301-2. Epub 2006 Nov 25.

Late onset of bortezomib-associated cutaneous reaction following herpes zoster.

Varettoni M, Vassallo C, Borroni G, Mangiacavalli S, Zappasodi P, Rosso R,
Lazzarino M, Corso A.

Publication Types: 
    Case Reports
    Letter

PMID: 17131123 [PubMed - indexed for MEDLINE]

910: Eur Arch Otorhinolaryngol. 2007 May;264(5):505-7. Epub 2006 Nov 24.

Herpes zoster laryngitis: case report and serological profile.

Watelet JB, Evrard AS, Lawson G, Bonte K, Remacle M, Van Cauwenberge P,
Vermeersch H.

Department of Otorhinolaryngology and Head & Neck Surgery, Ghent University
Hospital, Ghent, Belgium. jeanbaptiste.watelet@ugent.be

Compared to herpes zoster oticus, varicella zoster virus (VZV) reactivations in
immunocompetent patients are rare in laryngeal region. Usually, associated vocal 
cord paralyses are reported. Herein is a case report of a patient with laryngeal 
zoster without any associated motor disorders. An attempt is made to assign the
distribution of mucosal eruptions to the appropriate neuroanatomical structures. 
A description of the serological course of VZV IgM and IgG are provided. Vesicles
were found on the left sensory distribution areas of the superior laryngeal
nerve. VZV IgM and IgG antibodies reached their peak 1 month after initial
symptoms. Attentive follow-up and no antiviral therapy were advocated because of 
the absence of any immune deficiency or endoscopic suspicion of malignancy. In
this case of VZV reactivation in the sensitive area of the superior laryngeal
nerve, serological profiles of VZV IgM and IgG were profoundly modified up to the
fourth month.

Publication Types: 
    Case Reports

PMID: 17124598 [PubMed - indexed for MEDLINE]

911: Hematology Am Soc Hematol Educ Program. 2006:368-74.

Viral infections in patients with hematological malignancies.

Wade JC.

Medical College of Wisconsin, 9200 W. WI Ave., FEC 3963A, Milwaukee WI 53226,
USA. jwade@mcw.edu

Viral infections are important causes of morbidity and mortality for patients
with a hematological malignancy. However, the true incidence and consequences of 
viral infections for these patients who undergo conventional nontransplant
therapy are poorly defined. The difference in incidence and outcome of viral
infections among patient groups is wide, but dependent upon the intensity and
duration of T-cell-mediated immune suppression. Infections caused by
cytomegalovirus (CMV), herpes simplex virus (HSV), varicella-zoster virus (VZV), 
respiratory syncytial virus (RSV), parainfluenza viruses and influenza viruses
have been intensely studied, yet newly recognized aspects of these viral
infections including late CMV infection; the emergence of new viral pathogens
(human herpesvirus-6, BK virus, adenovirus, and human metapneumovirus); the
development of molecular diagnostic techniques, and the potential of new agents
for viral prophylaxis (maribavir), or preemptive therapy (valganciclovir) form
the basis of this review. Well-designed prospective studies are needed to better 
clarify the spectrum of these viral infections and develop effective prevention
and treatment strategies. Yet the increased use of agents like alemtuzumab that
induce profound T-cell depletion demands that we develop a better understanding
of viral infections that occur in patients with hematological malignancy who
receive nontransplant therapy.

Publication Types: 
    Review

PMID: 17124085 [PubMed - indexed for MEDLINE]

912: Ophthalmology. 2007 Feb;114(2):307-12. Epub 2006 Nov 21.

Comment in:
    Ophthalmology. 2007 Dec;114(12):2367; author reply 2367-8.

Treatment of acute retinal necrosis syndrome with oral antiviral medications.

Aizman A, Johnson MW, Elner SG.

W. K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences,
University of Michigan School of Medicine, Ann Arbor, Michigan 48105, USA.

OBJECTIVE: Acute retinal necrosis (ARN) is a distinct ocular viral syndrome
traditionally treated with intravenous acyclovir followed by oral acyclovir. We
investigated the use of the oral antiviral medications valacyclovir and
famciclovir as the sole treatment for patients with newly diagnosed ARN syndrome.
DESIGN: Retrospective, uncontrolled, interventional case series. PARTICIPANTS:
Eight consecutive patients with newly diagnosed ARN treated solely with oral
antiviral medications. INTERVENTION: All patients received famciclovir or
valacyclovir without antecedent intravenous therapy. One patient with bilateral
ARN treated with famciclovir received a single intravitreal injection of
foscarnet in the more severely involved eye. MAIN OUTCOME MEASURES: Clinically
and photographically documented complete resolution of retinitis and
best-corrected visual acuity on final follow-up. RESULTS: Active retinitis
resolved completely in 10/10 (100%) affected eyes. Initial response to treatment 
was seen as early as 4 days (in 5 eyes), with a median time to complete
resolution of 14 days. At the last examination, visual acuity was improved (> or 
= 2 Snellen lines) in 6 (60%) eyes, stable in 2 (20%) eyes, and worse in 2 (20%) 
eyes. Over a mean follow-up of 36 weeks (range, 7-72 weeks), 3 eyes developed
rhegmatogenous retinal detachment that was successfully repaired with 1
vitrectomy surgery. No patient with initially unilateral involvement developed
disease in the contralateral eye. CONCLUSIONS: In this pilot study, the use of
the oral drugs valacyclovir and famciclovir resulted in complete regression of
herpetic necrotizing retinitis. Additional studies are necessary to evaluate the 
role of these antiherpetic medications in the treatment of the ARN syndrome.

Publication Types: 
    Case Reports

PMID: 17123607 [PubMed - indexed for MEDLINE]

913: Cephalalgia. 2006 Dec;26(12):1483-4.

Secondary intermedius neuralgia-like pain in a young child.

da Silva HM, Boullosa JL, Arruda MA.

Instituto de Neurologia e Cefaleia, Rua Casemiro de Abreu 544, Ribeirao Preto,
CEP 14030-060 Sao Paulo, RP, Brazil.

Publication Types: 
    Case Reports

PMID: 17116099 [PubMed - indexed for MEDLINE]

914: Headache. 2006 Nov-Dec;46(10):1590-1.

Occipital neuralgia evoked by facial herpes zoster infection.

Kihara T, Shimohama S.

Department of Neuroscience for Drug Discovery, Graduate School of Pharmaceutical 
Sciences, Kyoto University, Yoshida-Shimoadachi-cho 46-29, Sakyo-ku, Kyoto
606-8501, Japan.

Occipital neuralgia is a pain syndrome which may usually be induced by spasms of 
the cervical muscles or trauma to the greater or lesser occipital nerves. We
report a patient with occipital neuralgia followed by facial herpes lesion. A
74-year-old male experienced sudden-onset severe headache in the occipital area. 
The pain was localized to the distribution of the right side of the greater
occipital nerve, and palpation of the right greater occipital nerve reproduces
the pain. He was diagnosed with occipital neuralgia according to ICHD-II
criteria. A few days later, the occipital pain was followed by reddening of the
skin and the appearance, of varying size, of vesicles on the right side of his
face (the maxillary nerve and the mandibular nerve region). This was diagnosed as
herpes zoster. This case represents a combination of facial herpes lesions and
pain in the C2 and C3 regions. The pain syndromes can be confusing, and the
classic herpes zoster infection should be considered even when no skin lesions
are established.

Publication Types: 
    Case Reports

PMID: 17115995 [PubMed - indexed for MEDLINE]

915: Arch Virol. 2007;152(3):553-63. Epub 2006 Nov 20.

Simian varicella virus gene 61 encodes a viral transactivator but is
non-essential for in vitro replication.

Gray WL, Davis K, Ou Y, Ashburn C, Ward TM.

Department of Microbiology and Immunology, University of Arkansas for Medical
Sciences, Little Rock, AR 72205, USA. graywaynel@uams.edu

Simian varicella virus (SVV) is closely related to varicella-zoster virus (VZV), 
the causative agent of chickenpox and shingles. The SVV and VZV gene 61
polypeptides are homologs of the HSV-1 ICP0, a viral transactivator which appears
to play a role in viral latency and reactivation. In this study, the molecular
properties of the SVV 61 were characterized. The SVV open reading frame (ORF) 61 
encodes a 54.1-kDa polypeptide with 37% amino acid identity to the VZV 61.
Homology to the HSV-1 ICP-0 is limited to a conserved RING finger motif at the
amino terminus of the protein. A nuclear localization sequence (nls) at the
carboxy-terminus directs the SVV 61 to the cell nucleus, while a SVV 61nls(-)
mutant is confined to the cell cytoplasm. The SVV 61 transactivates its own
promoter as well as SVV immediate early (IE, ORF 62), early (ORFs 28 and 29), and
late (ORF 68) gene promoters in transfected Vero cells. The RING finger and nls
motifs are required for efficient SVV 61 transactivation. The SVV 61 has no
effect on the ability of the major SVV transactivator (IE62) to induce SVV
promoters. Generation and propagation of a SVV gene 61 deletion mutant
demonstrated that the SVV 61 is non-essential for in vitro replication. SVV gene 
61 is expressed in liver, lung, and neural ganglia of infected monkeys during
acute simian varicella.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17115302 [PubMed - indexed for MEDLINE]

916: HNO. 2008 Feb;56(2):165-8.

[Myxoma of the middle ear-a rare cause of facial palsy]

[Article in German]

Zehlicke T, Punke C, Haase K, Boltze C, Pau HW.

Universitatsklinik und Poliklinik fur Hals-, Nasen-, Ohrenheilkunde, Kopf- und
Halschirurgie Otto Korner, Doberaner Strasse 137-139, 18057 Rostock.
thorsten.zehlicke@web.de

In case of the co-occurrence of facial palsy and inflammation-like symptoms of
the same ear, the differential diagnosis is focused on viral (herpes zoster) or
bacterial diseases. We report a patient for whom the surgical exploration of the 
middle ear revealed a benign tumor: a myxoma. These neoplasias are rare tumors in
the head and neck region. The typical tumor site is the atrium of heart. In the
ear, the tumor grows slowly and remains asymptomatic unless it irritates
structures such as the facial nerve or the vestibular organ. Histologically, the 
tumor presents a "myxoid" matrix that is rich in acid mucopolysaccarides. The
treatment of choice is complete surgical resection. Using the case presented, we 
discuss the causality between the tumor and the facial palsy, although during the
operation the bony canal of the nerve was found to be intact. In any cases with
clinically and radiologically unclear findings of the ear in connection with
facial palsy, surgical exposure should be considered.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17115088 [PubMed - indexed for MEDLINE]

917: J Pediatr Hematol Oncol. 2006 Nov;28(11):757-9.

Concomitant Candida epiglottitis and disseminated Varicella zoster virus
infection associated with acute lymphoblastic leukemia.

Chiou CC, Seibel NL, Derito FA, Bulas D, Walsh TJ, Groll AH.

Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer
Institute, Bethesda, MD 20892, USA.

Acute epiglottitis by nonbacterial pathogens is an uncommon but life-threatening 
clinical entity. Herein, we report the concomitant occurrence of Candida
epiglottitis and mucosal and visceral Varicella zoster virus infection in a child
with acute lymphoblastic leukemia. Both infections were atypical in their
presentation, occurred in a severely immunocompromised host, and required
invasive procedures for diagnosis.

Publication Types: 
    Case Reports

PMID: 17114965 [PubMed - indexed for MEDLINE]

918: Med Hypotheses. 2007;68(5):1059-64. Epub 2006 Nov 17.

Alzheimer's disease Braak Stage progressions: reexamined and redefined as
Borrelia infection transmission through neural circuits.

MacDonald AB.

St. Catherine of Siena Medical Center, Department of Pathology, 50 Rte 25 A,
Smithtown, NY 11787, USA. inmacdonald@yahoo.com

Brain structure in health is a dynamic energized equation incorporating
chemistry, neuronal structure, and circuitry components. The chemistry "piece" is
represented by multiple neurotransmitters such as Acetylcholine, Serotonin, and
Dopamine. The neuronal structure "piece" incorporates synapses and their
connections. And finally circuits of neurons establish "architectural blueprints"
of anatomic wiring diagrams of the higher order of brain neuron organizations. In
Alzheimer's disease, there are progressive losses in all of these components.
Brain structure crumbles. The deterioration in Alzheimer's is ordered,
reproducible, and stepwise. Drs. Braak and Braak have described stages in the
Alzheimer disease continuum. "Progressions" through Braak Stages benchmark
"Regressions" in Cognitive function. Under the microscope, the Stages of Braak
commence in brain regions near to the hippocampus, and over time, like a tsunami 
wave of destruction, overturn healthy brain regions, with neurofibrillary tangle 
damaged neurons "marching" through the temporal lobe, neocortex and occipital
cortex. In effect the destruction ascends from the limbic regions to
progressively destroy the higher brain centers. Rabies infection also "begins low
and finishes high" in its wave of destruction of brain tissue. Herpes Zoster
infections offer the paradigm of clinical latency of infection inside of nerves
before the "marching commences". Varicella Zoster virus enters neurons in the
pediatric years. Dormant virus remains inside the neurons for 50-80 years, tissue
damage late in life (shingles) demonstrates the "march of the infection" down
neural pathways (dermatomes) as linear areas of painful blisters loaded with
virus from a childhood infection. Amalgamation of Zoster with Rabies models
produces a hybrid model to explain all of the Braak Stages of Alzheimer's disease
under a new paradigm, namely "Alzheimer's neuroborreliosis" in which latent
Borrelia infections ascend neural circuits through the hippocampus to the higher 
brain centers, creating a trail of neurofibrillary tangle injured neurons in
neural circuits of cholinergic neurons by transsynaptic transmission of infection
from nerve to nerve.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17113237 [PubMed - indexed for MEDLINE]

919: J Can Dent Assoc. 2006 Nov;72(9):829-32.

Unilateral facial swelling caused by Ramsay Hunt syndrome resembles odontogenic
infection.

Jan AM, McGuire TP, Clokie CM, Sandor GK.

Division of oral and maxillofacial surgery, University of Toronto, Toronto,
Ontario, Canada.

Facial cellulitis and swellings of the head and neck are worrisome signs of
odontogenic infection, which can be life threatening. Most head and neck
infections are caused by bacterial pathogens. When treating such infections,
dentists must also be aware of possible viral or fungal causes and their
associated presentations. This report documents a case of viral infection that
initially resembled a bacterial odontogenic infection. It is intended to
familiarize dentists with the Ramsay Hunt syndrome and the need for prompt
recognition and early definitive treatment.

Publication Types: 
    Case Reports

PMID: 17109804 [PubMed - indexed for MEDLINE]

920: Dev Med Child Neurol. 2006 Dec;48(12):991-3.

Recurrent hemiplegia associated with cerebral vasculopathy following third
trimester maternal herpes zoster infection.

West SL, Newton RW, Baildam EM, Turner AJ, Arkwright PD.

Royal Manchester Children's Hospital, Manchester, UK.
Siobhan.wykes@doctors.org.uk

The chickenpox virus (varicella zoster virus; VZV) is known to cause large and
small vessel central nervous system vasculopathies that may be associated with
strokes in both adults and children. We present the case of a female aged 2 years
6 months who developed a chronic progressive small-vessel vasculopathy with
radiological features of moyamoya disease as a manifestation of congenital
varicella syndrome. Clinically, the condition was characterized by recurrent
ischaemic strokes, which were brought under control using intravenous acyclovir. 
The case is unique in that it is the first report of congenital varicella
syndrome to occur after a maternal herpes zoster infection. Furthermore, it is
the first case of symptomatic VZV infection in a child to occur after a maternal 
infection occurring in the third trimester of pregnancy.

Publication Types: 
    Case Reports

PMID: 17109789 [PubMed - indexed for MEDLINE]

921: J Int Assoc Physicians AIDS Care (Chic Ill). 2006 Dec;5(4):157-60.

Immune reconstitution syndrome presenting with cerebral varicella zoster
vasculitis in HIV-1-infected patient: a case report.

Patel AK, Patel KK, Shah SD, Desai J.

Infectious Diseases Clinic, Ahmedabad, India. atulpatel65@gmail.com

Neurologic dysfunction complicating HIV infection may occur in up to 70% of AIDS 
patients. The advent of highly active antiretroviral therapy has reduced central 
nervous system opportunistic infections. Immune reconstitutions after highly
active antiretroviral therapy also lead to atypical presentations of neurologic
opportunistic infections. We report a man who developed an encephalitic illness
10 months after institution of highly active antiretroviral therapy and
improvement in his CD4 count. Varicella zoster vasculitis involving the brain was
suspected. Acyclovir therapy resulted in complete clinical and radiologic
recovery. Symptomatic reactivation of varicella zoster infection within the
encephalon during therapeutic immunologic reconstitution is rare and should be
suspected, especially in patients with neurologic syndrome consistent with
encephalitis with recent history of herpes zoster and multiple, discrete areas of
infarct or demyelination on brain magnetic resonance imaging. The clinical and
neuroradiologic features of this condition and its relevance to the immune
reconstitution syndrome are discussed.

Publication Types: 
    Case Reports

PMID: 17101808 [PubMed - indexed for MEDLINE]

922: Autoimmunity. 2006 Nov;39(7):601-7.

Comment in:
    Autoimmunity. 2006 Nov;39(7):521-30.

IVIg selectively and rapidly decreases circulating pathogenic autoantibodies in
pemphigus vulgaris.

Bystryn JC, Jiao D.

The Ronald O. Perelman Department of Dermatology, New York University School of
Medicine, New York, NY, USA. bystryn@nyu.edu

BACKGROUND: Intraveneous immunoglobulin (IVIg) is increasingly used to treat
pemphigus vulgaris (PV). The mechanism by which it does so is not known. The
following study was conducted to confirm the effectiveness of IVIg for the acute 
control of active PV and to elucidate the mechanism by which it does. METHODS:
Twelve patients with active and severe PV unresponsive to conventional therapy
with high doses of systemic steroids together with or without a cytotoxic drug
were treated with a single dose of IVIg (400 mg/kg/day for 5 days). All patients 
were concurrently given cyclophosphamide or azathioprine of not already on one of
these two drugs. The primary end-points were healing of skin lesions, changes in 
serum levels of intercelular (IC) autoantibodies and in steroid doses one to 3
weeks after initiation of IVIg. RESULTS: Within 1 week of initiating IVIg the
activity of PV was controlled in most cases. Within 3 weeks the average baseline 
dose of systemic steroid was reduced by 40%. Serum levels of IC antibodies
rapidly declined by an average of 59% within 1 week of initiating IVIg and by 70%
within 2 weeks. The decrease was selective, as the average serum levels of
antibody to varicella-herpes zoster did not decrease in the 4 patients in whom
they were measured. The decrease in IC antibodies was inversely related to serum 
levels of total inmmunoglobulin (IgG). The decrease in IC antibodies was not due 
to blocking factors in the IVIg preparation and was too rapid to be due to
suppression of IgG synthesis, suggesting that it resulted from increased
catabolism. CONCLUSIONS: IVIg can rapidly control active PV unresponsive to
conventional therapy by causing a selective and very rapid decline in the
autoantibodies that mediate the disease. We believe it does so by increasing the 
catabolism of all serum IgG antibodies, and that this results in a selective
decrease in only abnormal autoantibodies as catabolized normal anti bodies are
replaced by those present in the IVIg preparation. IVIg is the first treatment
that achieves the ideal therapeutic goal in auto-antibody diseases, the selective
removal of the pathogenic antibodies without affecting the level of normal
antibodies.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17101504 [PubMed - indexed for MEDLINE]

923: J Med Assoc Thai. 2006 Sep;89(9):1521-7.

Encephalitis lethargica like illness: case report and literature review.

Sridam N, Phanthumchinda K.

Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn
University, Bangkok 10330, Thailand.

Recent studies have revealed that encephalitis lethargica (EL) may not be related
to influenza virus infection but more likely to be a post-infectious autoimmune
disease. The diagnostic clinical criteria for EL like illness include subacute
hypersomnolence and ophthalmoparesis followed by Parkinsonism, oculogyric crisis,
neuropsychiatric disorders and central respiratory abnormality. Recently,
Magnetic Resonance Imaging (MRI), which depicts hypersignal intensity on T2
weighted, and FLAIR images at midbrain, tegmentum, and basal ganglia, have been
very helpful diagnostic tests in EL like illness. Nevertheless, EL like illness
has never been reported in Thailand. A 17 year-old man presented with
hypersomnolence one week before admission. Physical examination revealed
drowsiness and ophthalmoparesis. MRI showed bilateral hypersignal intensity
lesions on T2 weighted and FLAIR images at midbrain, basal ganglia and temporal
lobes. CSF studies showed normal profiles. CSF-PCR for herpes simplex virus,
varicella zoster virus, cytomegalovirus, Epstein-Barr virus, Pan-Enterovirus and 
Westnile virus were negative. CSF Dengue and Japanese encephalitis virus
hemagglutination test were negative. He was treated with intravenous
dexamethasone and immunoglobulin. Somnolence and ophthalmoparesis were improved. 
Two months later, he developed schizophreniform features and Parkinsonism. MRI
revealed improvement of midbrain and basal ganglia lesions. CSF studies showed
normal CSF profiles while oligoclonal bands were positive. Autoimmune profiles
and serological tests for post-streptococcal infection as well as syphilis were
negative. Thyroid function tests and serum ceruloplasmin were within normal
limits. Levo-Dopa, clonazepam and sodium valproate had been prescribed and the
clinical syndrome was gradually improved.

Publication Types: 
    Case Reports

PMID: 17100395 [PubMed - indexed for MEDLINE]

924: Transplant Proc. 2006 Oct;38(8):2480-1.

Efficacy and safety of monotherapy with mycophenolate mofetil in liver
transplantation.

Jimenez-Perez M, Lozano Rey JM, Marin Garcia D, Olmedo Martin R, de la Cruz
Lombardo J, Rodrigo Lopez JM.

Hepatology-Liver Transplant Unit, Hospital Universitario Carlos Haya, Malaga,
Spain. mjimenezp@medynet.com

AIM: To analyze the efficacy and safety of mycophenolate mofetil (MMF) as
monotherapy in liver transplant patients who have adverse effects associated with
calcineurin inhibitors (CNIs). PATIENTS AND METHODS: Seventeen patients, 13 men
and four women, mean age 62 years, who received a liver transplant between 1998
and 2003 and initial immunosuppressive therapy with CNIs (10 tacrolimus and seven
cyclosporine), were converted to monotherapy with MMF due to adverse events
associated with CNIs: chronic renal failure in 16 patients (four with diabetes
mellitus and seven with hypertension) and neurotoxicity in one patient. The mean 
time between transplant and starting monotherapy was 32 months (range: 18 to 70) 
and the mean follow-up time on monotherapy was 20 months (range: 8 to 39). MMF
was introduced gradually at the same time as the CNIs were reduced. RESULTS:
There was a progressive decrease in creatinine during the initial months.
Compared with baseline levels, the differences at 3 and 6 months of monotherapy
were significant (P < .001), remaining so throughout the follow-up period. Renal 
function improved in 15 of 17 patients (88%) and normalized in 10 of 17 (60%).
The patient with neurotoxicity due to CNI improved. One patient (6%) had moderate
rejection that was corrected after reintroducing tacrolimus. In two patients it
was necessary to suspend MMF, one due to gastrointestinal intolerance and the
other due to severe myelotoxicity and Pneumocystis jiroveci infection. Other,
minor adverse events were corrected by adjusting the dose: one herpes zoster, two
diarrhea, and two anemia. CONCLUSIONS: Monotherapy with MMF efficiently and
safely corrected renal dysfunction associated with CNIs, with few side effects
and a low incidence of rejection.

PMID: 17097974 [PubMed - indexed for MEDLINE]

925: Transplant Proc. 2006 Oct;38(8):2416-8.

Varicella infection in adult renal allograft recipients: experience at one
center.

Rodriguez-Moreno A, Sanchez-Fructuoso AI, Calvo N, Ridao N, Conesa J, Marques M, 
Prats D, Barrientos A.

Department of Nephrology, Hospital Clinico San Carlos, Madrid, Spain.
arodriguez@friat.es

Disseminated varicella-zoster virus (VZV) infection in adult renal allograft
recipients is a rare but potentially fatal illness. We retrospectively collected 
the cases of VZV infection that occurred in 812 adult renal transplant
recipients, performed between 1995 and 2004 at our institution. Eight patients
developed varicella (1%), seven men and one woman. The overall median age was 38 
years (range = 31 to 64). The median time from transplantation to infection was
32 months (range = 2 to 92). Four cases were primary infections and four
disseminated VZV reactivations. Immunosuppression consisted of prednisone (PDN) +
cyclosporine (CSA) + mycophenolate (MF; n = 4); PDN + CSA + azathioprine (n = 1);
PDN + tacrolimus (FK) + MF (n = 1); FK + MF (n = 1); PDN + rapamycin + MF (n =
1). Seven patients (87%) required hospital admission for a median duration of 11 
days (range = 3 to 21). Four patients were previously diagnosed with chronic
hepatitis virus infection: two type B (HBV) and two type C (HCV). The last cohort
required longer admission than the negative patients (11.5 +/- 3 vs 7.5 +/- 9
days; P = .1). The only clinical manifestation in four patients was general
malaise, fever, and a disseminated vesicular rash; the other four patients also
showed visceral involvement: two pneumonitis, one hepatitis, and thrombotic
microangiopathy, and one developed multiorgan failure and died due to a delayed
diagnosis in a patient positive for HBVs. The diagnosis was established according
to the symptoms, IgG-IgM seroconversion and VZV polymerase chain reaction
quantification in vesicle contents. Treatment consisted of reduced
immunosuppression, antiviral drugs (acyclovir or gancyclovir), and in six
patients, a varicella-zoster immunoglobulin dose. We concluded that varicella
infection in adult renal allograft recipients is unusual but highly morbid. A
vaccination program in seronegative pretransplant candidates should be attempted.
Early diagnosis and treatment may improve the prognosis. Although further studies
are required, chronic HBV or HCV infection seemed to be a risk factor for the
disease.

PMID: 17097954 [PubMed - indexed for MEDLINE]

926: An Otorrinolaringol Ibero Am. 2006;33(5):489-94.

[Ramsay-Hunt syndrome associated to unilateral recurrential paralysis]

[Article in Spanish]

Pino Rivero V, Gonzalez Palomino A, Pantoja Hernandez CG, Mora Santos ME,
Trinidad Ramos G, Blasco Huelva A.

Complejo Hospitalario Infanta Cristina, Facultativo Especialista de
Otorrinolaringologia, Badajoz. vicentepinorivero@terra.com

Varicella herpes zoster (VZV) virus reactivaction can produce multiple
neuropathies of the cranial and cervical region being the peripheral facial
paralysys the most common one. We report one case of Ramsay-Hunt syndrome with
eruption of vesicles on left auricular pinna and face besides facial palsy which 
associated to ipsilateral laryngeal or recurrential paralysis nonexisting
previously. Our patient was treated by oral aciclovir (800 mg, 5 times daily) for
1 week. 3 months later she returned to Emergencies due to another cause and the
ENT exploration showed a recovery in the mobility of the left cord but it
persisted the affectation of VII pair, specially the inferior branch or
cervicofacial. It is advised that the larynx should be examined in all cases of
herpes zoster that involve the head and neck.

Publication Types: 
    Case Reports
    English Abstract

PMID: 17091862 [PubMed - indexed for MEDLINE]

927: J Burn Care Res. 2006 Nov-Dec;27(6):914-6.

Misdiagnosis of burns: herpes zoster ophthalmicus.

Sawyer AR, Williams G.

Burns Unit, Chelsea and Westminster Hospital, London, United Kingdom.

Many conditions can mimic the presentation of burns. We present an interesting
case in which the initial diagnosis of a chemical burn was later confirmed to be 
herpes zoster ophthalmicus.

Publication Types: 
    Case Reports

PMID: 17091093 [PubMed - indexed for MEDLINE]

928: J Clin Microbiol. 2006 Nov;44(11):3911-4.

Genotyping of varicella-zoster virus and the discrimination of Oka vaccine
strains by TaqMan real-time PCR.

Parker SP, Quinlivan M, Taha Y, Breuer J.

Skin Virus Laboratory, Centre for Infectious Disease, Institute of Cell and
Molecular Science, Barts and the London school of Medicine and Dentistry, 4
Newark St., London E1 2AT, England.

Single nucleotide polymorphisms (SNPs) in five genes have been used to identify
four major subtypes of wild-type varicella-zoster virus (VZV) A, B, C, and J.
Additional SNPs, located in the IE62 major transactivating gene can be used to
differentiate the Oka vaccine strain (vOka) from wild-type VZV. Primer-probe sets
for the detection of the five polymorphic loci were designed by Applied
Biosystems for the ABI 7900HT platform. Probes for each allele were labeled with 
VIC or 6-carboxyfluorescein fluorogenic markers. Each primer-probe set was
validated to establish assay sensitivity and specificity using VZV DNA of
predetermined copy number and genotype. Further evaluation was carried out using 
DNA samples from the vesicle fluid or skin swab of the rash of adult patients
with herpes zoster or rashes due to vOka. Assay sensitivity ranged from 10 and
10(8) copies/ml of VZV DNA (equivalent to 2 to 20 copies per reaction).
Statistical analyses showed that for each genotype, a set of two probes clearly
differentiated the nucleotide present (allele) at that locus (P < 0.0001). It was
possible to determine the genotype of wild-type VZV using one of four SNP assays 
and also to differentiate wild type from vOka using a single SNP assay. The assay
can be used for diagnostic and epidemiological studies of VZV, including the
differentiation of vOka from wild-type strains, investigation of breakthrough
infections, and varicella outbreaks following immunization.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17088366 [PubMed - indexed for MEDLINE]

929: J Med Liban. 2006 Apr-Jun;54(2):91-6.

Viral opportunistic infections in HIV-infected adults.

Tsigrelis C, Berbari E, Temesgen Z.

Mayo Clinic College of Medicine, Rochester, MN, USA.

Despite the development of highly active antiretroviral therapy (HAART),
opportunistic infections continue to be seen in HIV-infected patients throughout 
the world. The primary reason for this is the lack of access to HAART for most
people living with HIV/AIDS. For patients that have access to HAART, some may not
have an effective response to therapy, due to reasons such as medication
toxicity, poor adherence, or drug-resistant strains of HIV. Viral infections, in 
particular, are a major cause of opportunistic infections in HIV-infected adults,
and can lead to significant morbidity and mortality. We have reviewed the
epidemiology, clinical manifestations, diagnosis, and treatment of the most
common viral opportunistic infections, including cytomegalovirus, JC virus,
varicella-zoster virus, herpes simplex virus, and human papillomavirus.

Publication Types: 
    Review

PMID: 17087000 [PubMed - indexed for MEDLINE]

930: Biol Blood Marrow Transplant. 2006 Oct;12(10):1096-7.

Postexposure prophylaxis against varicella zoster virus infection among
hematopoietic stem cell transplant recipients.

Weinstock DM, Boeckh M, Sepkowitz KA.

Publication Types: 
    Letter

PMID: 17084374 [PubMed - indexed for MEDLINE]

931: J Virol. 2007 Jan;81(2):761-74. Epub 2006 Nov 1.

The varicella-zoster virus (VZV) ORF9 protein interacts with the IE62 major VZV
transactivator.

Cilloniz C, Jackson W, Grose C, Czechowski D, Hay J, Ruyechan WT.

Department of Microbiology, Witebsky Center for Microbial Pathogenesis and
Immunology, University at Buffalo, SUNY, Buffalo, NY 14214, USA.

The varicella-zoster virus (VZV) ORF9 protein is a member of the herpesvirus UL49
gene family but shares limited identity and similarity with the UL49 prototype,
herpes simplex virus type 1 VP22. ORF9 mRNA is the most abundantly expressed
message during VZV infection; however, little is known concerning the functions
of the ORF9 protein. We have found that the VZV major transactivator IE62 and the
ORF9 protein can be coprecipitated from infected cells. Yeast two-hybrid analysis
localized the region of the ORF9 protein required for interaction with IE62 to
the middle third of the protein encompassing amino acids 117 to 186. Protein
pull-down assays with GST-IE62 fusion proteins containing N-terminal IE62
sequences showed that amino acids 1 to 43 of the acidic transcriptional
activation domain of IE62 can bind recombinant ORF9 protein. Confocal microscopy 
of transiently transfected cells showed that in the absence of other viral
proteins, the ORF9 protein was localized in the cytoplasm while IE62 was
localized in the nucleus. In VZV-infected cells, the ORF9 protein was localized
to the cytoplasm whereas IE62 exhibited both nuclear and cytoplasmic
localization. Cotransfection of plasmids expressing ORF9, IE62, and the viral
ORF66 kinase resulted in significant colocalization of ORF9 and IE62 in the
cytoplasm. Coimmunoprecipitation experiments with antitubulin antibodies indicate
the presence of ORF9-IE62-tubulin complexes in infected cells. Colocalization of 
ORF9 and tubulin in transfected cells was visualized by confocal microscopy.
These data suggest a model for ORF9 protein function involving complex formation 
with IE62 and possibly other tegument proteins in the cytoplasm at late times in 
infection.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 17079304 [PubMed - indexed for MEDLINE]

932: Cornea. 2006 Jul;25(6):742-4.

"Steel wool keratopathy": a clinical sign of chronic inflammation.

Seitzman GD, Strauss EC, Margolis TP.

Francis I Proctor Foundation and Department of Ophthalmology, University of
California San Francisco, San Francisco, CA, USA.

PURPOSE: To introduce into the clinical nomenclature a sign frequently observed
in our patients with persistent corneal inflammation associated with herpetic
stromal keratitis. METHODS: Case reports and review of the literature. RESULTS:
Four representative patients with herpesvirus stromal keratitis are presented.
Herpes simplex virus-1 (HSV-1) was confirmed by culture in 1 case and by
polymerase chain reaction in a second case. In the remaining 2 cases, the
diagnosis was made based on characteristic clinical findings for herpes simplex
virus and varicella zoster virus (VZV). On clinical examination, all 4
representative cases of stromal keratitis revealed a well-defined, localized
region of intertwined, metallic-like, polychromatic material in the corneal
stroma, a sign we have termed steel wool keratopathy. We have only rarely
observed this finding in patients with stromal keratitis not caused by a
herpesvirus. CONCLUSION: Steel wool keratopathy seems to represent a focal region
of stromal degeneration or deposition associated with chronic inflammation.
Although we most often observe this finding in patients with stromal keratitis
secondary to HSV or VZV, we cannot exclude the possibility that this sign
represents the sequelae of chronic/recurrent inflammation rather than a specific 
pathologic response to herpetic antigens.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17077672 [PubMed - indexed for MEDLINE]

933: Pain. 2007 Mar;128(1-2):148-56. Epub 2006 Oct 27.

Comment in:
    Pain. 2007 Mar;128(1-2):189-90; author reply 190-2.

Natural history of pain following herpes zoster.

Thyregod HG, Rowbotham MC, Peters M, Possehn J, Berro M, Petersen KL.

UCSF Pain Clinical Research Center, Department of Neurology, University of
California, San Francisco, CA 94115, USA.

In a longitudinal observational study of 94 patients (39 M:55 F, mean age 69) at 
elevated risk for developing post herpetic neuralgia (PHN), the natural history
of pain during the first 6 months after herpes zoster (HZ) rash onset was
determined. Pain severity and impact were rated using pain-VAS, SF-MPQ, and MPI. 
Applying a definition of PHN of average daily pain >0/100 on the pain VAS during 
the last 48 h, 30 subjects had PHN at 6 months. These 30 subjects reported more
pain and a higher SF-MPQ score (p<0.01) at study inclusion than the 64 subjects
whose pain completely resolved by 6 months. At 6 months, mean daily pain in the
PHN group was 11/100 (95% CI 5,16) and only nine of these subjects were still
taking prescription medication for HZ pain. The rate of recovery (pain severity
over time) was the same in the PHN and no-pain groups. At study inclusion, the
SF-MPQ and MPI scores in our PHN group were similar to historical controls with
chronic severe PHN enrolled in clinical trials, but by 6 months the scores in our
PHN subjects were significantly lower than historic controls. Only two subjects
met the more stringent criteria for 'clinically meaningful' PHN at 6 months (> or
= 30/100 on the pain VAS). Defining PHN as average daily pain >0/100 at 6 months 
after rash onset appears to substantially overestimate the number of HZ patients 
negatively impacted by ongoing pain and disability.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 17070998 [PubMed - indexed for MEDLINE]

934: Mich Nurse. 2006 Sep-Oct;79(5):19, 21.

What's new with immunizations?

Wolicki B, Wolicki J.

Michigan Department of Community Health, USA.

PMID: 17066597 [PubMed - indexed for MEDLINE]

935: J Med Virol. 2006 Dec;78(12):1679-87.

The optimization and validation of the glycoprotein ELISA assay for quantitative 
varicella-zoster virus (VZV) antibody detection.

Hammond O, Wang Y, Green T, Antonello J, Kuhn R, Motley C, Stump P, Rich B,
Chirmule N, Marchese RD.

Vaccine and Biologics Research, Merck Research Laboratories, Wayne, Pennsylvania,
USA.

Varicella is a highly contagious viral disease found throughout the world. A
live-attenuated Varicella-Zoster virus (VZV) vaccine (Oka/Merck strain),
VARIVAXtrade mark, was licensed in the United States (US) in 1995 and was made a 
part of the US recommended childhood vaccination schedule in 1996. The immune
response to VZV-containing vaccines has been measured using an enzyme-linked
immunosorbent assay (ELISA) to detect antibodies to glycoproteins from VZV. A
correlate for protective immunity has been established between anti-VZV
glycoprotein antibody levels and protection against breakthrough varicella in
children, and this correlate is used as the primary immunogenicity endpoint in
clinical trials with VZV-containing vaccines. The performance of the "first
generation" validated version of the assay was recently reevaluated in order to
identify areas for improvement. Specific format and reagent changes were
implemented, with the goal of improving assay consistency by maintaining tighter 
control over assay processes and reagents. An extensive validation of the "second
generation" gpELISA was undertaken in order to characterize the updated assay. In
this article, we describe the gpELISA method, detail the procedures used to
evaluate assay performance, and present the operating characteristics of the
second generation gpELISA. (c) 2006 Wiley-Liss, Inc.

Publication Types: 
    Validation Studies

PMID: 17063506 [PubMed - indexed for MEDLINE]

936: J Laryngol Otol. 2007 Feb;121(2):163-5. Epub 2006 Oct 24.

A case of glossopharyngeal zoster diagnosed by detecting viral specific antigen
in the pharyngeal mucous membrane.

Nakagawa H, Nagasao M, Kusuyama T, Fukuda H, Ogawa K.

Department of Otolaryngology, Seibo International Catholic Hospital, Tokyo,
Japan. hnakagawa@seibokai.or.jp

Glossopharyngeal nerve paralysis caused by varicella zoster virus reactivation is
rare. We present a case of glossopharyngeal zoster confirmed by direct
immunofluorescence staining for virus antigens. A 35-year-old man presented with 
right-sided, severe swallowing pain and dysgeusia. Physical examination showed a 
loss of ipsilateral gag reflex. White spots on the posterior wall of the right
pyriform sinus were seen by laryngofibroscopy, and a loss of taste on the right
posterior part of the tongue was confirmed by gustometry using the filter paper
disc method. The varicella zoster virus antigen was revealed by direct
immunofluorescence staining by fluorescein isothiocyanate labelled mouse
monoclonal antibody specific for varicella zoster virus glycoprotein, using
samples obtained from the mucosal lesion by abrasion with a cotton swab. The
patient was treated by intravenous administration of acyclovir. His throat pain
and dysgeusia completely resolved. We discuss the advantages of direct
immunofluorescence staining for varicella zoster virus antigen for the diagnosis 
of glossopharyngeal zoster.

Publication Types: 
    Case Reports

PMID: 17059621 [PubMed - indexed for MEDLINE]

937: Clin Exp Dermatol. 2007 Jan;32(1):23-7. Epub 2006 Oct 24.

Mycophenolate mofetil therapy for moderate to severe atopic dermatitis.

Murray ML, Cohen JB.

Methodist Medical Center and University of Texas South-western Medical Center
Dallas, TX, USA.

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory disease of the skin 
that can be refractory to topical and systemic corticosteroids, phototherapy,
topical immunomodulators and systemic immunosuppressive drugs. Recent studies
have shown promise for the use of mycophenolate mofetil (MMF) to treat
recalcitrant AD. AIM: To assess the effectiveness and adverse effects of MMF used
for moderate to severe AD in a university outpatient dermatology clinic. METHODS:
A retrospective chart review of 20 patient charts was conducted for patient age, 
gender, duration of disease, prior therapies, concomitant therapy, clinical
response and adverse side-effects. RESULTS: Of the 20 patients, 17 improved
within 4 weeks of starting MMF therapy. Ten patients had disease remission and
were subsequently able to discontinue MMF. Seven attained satisfactory control of
their AD using MMF as maintenance therapy. Overall, MMF was well tolerated, with 
mild headaches, gastrointestinal complaints and fatigue as the commonest
side-effects. During therapy, herpes zoster developed in four patients,
Staphylococcus aureus cutaneous infections in two, and herpes simplex in one. One
patient discontinued MMF because of insufficient control of pruritus. CONCLUSION:
MMF can be rapidly effective and well tolerated in patients with moderate to
severe AD resistant to conventional therapies. The limitations of this
retrospective study include no control group and a lack of a standardized scoring
index to assess improvement, and the concomitant use of adjuvant therapies makes 
the contribution of MMF alone difficult to assess. Larger controlled studies are 
needed.

PMID: 17059445 [PubMed - indexed for MEDLINE]

938: MMW Fortschr Med. 2006 Sep 28;148(39):48-9.

[Burning pain on one side of the body and blisters filled with clear fluid.
Tentative diagnosis: shingles]

[Article in German]

Mohrenschlager M, Ring J, Hofmann H.

Klinik und Poliklinik fur Dermatologie und Allergologie am Biederstein,
Technische Universitat Munchen. moehrenschlager@lrz.tum.de

Publication Types: 
    Case Reports

PMID: 17059198 [PubMed - indexed for MEDLINE]

939: Hautarzt. 2006 Nov;57(11):975-84, 986-7.

[Frequent and rare dermatological diseases in HIV patients]

[Article in German]

Hengge UR, Mota R, Marini A.

Hautklinik der Heinrich-Heine-Universitat, Dusseldorf, Germany.
ulrich.hengge@uni-duesseldorf.de

HIV patients develop a variety of infectious and non-infectious diseases of the
skin and mucous membranes. Some of these serve as indicator diseases for a
weakening immune system. While none of the dermatological complications is
pathognomonic, conditions such as oral hairy leukoplakia, herpes zoster, thrush, 
and eosinophilic folliculitis should make physicians consider the possibility of 
underlying HIV disease. Moreover, one has to consider HIV if these skin diseases 
take an atypical or severe course, or if they do not respond properly to
appropriate medication. Frequent and rare dermatoses occurring in HIV infection
are discussed.

Publication Types: 
    Comparative Study
    English Abstract
    Review

PMID: 17058053 [PubMed - indexed for MEDLINE]

940: Ocul Immunol Inflamm. 2006 Oct;14(5):317-9.

Necrotizing scleritis due to varicella zoster infection: a case report.

Gungor IU, Ariturk N, Beden U, Darka O.

Department of Ophthalmology, School of Medicine, Ondokuz Mayis University,
Samsun, Turkey. ligungor@omu.edu.tr

PURPOSE: To report a case with necrotizing scleritis due to varicella-zoster
infection. METHODS: The patient records were evaluated. The present literature
was investigated using MEDLINE. A six-year-old boy with varicella infection was
admitted to our clinic with redness, pain, and lid edema on the right eye. Slit
lamp examination revealed lid edema, purulent secretion, conjunctival injection
and chemosis, and inferotemporal scleral necrosis. Sclera was avascular and the
conjunctiva was spontaneously detached from sclera in the necrotic region.
RESULTS: Systemic and topical acyclovir treatment was started and a rapid
improvement achieved in signs and symptoms. CONCLUSIONS: Ophthalmic
manifestations of varicella infection are potentially blinding especially in the 
absence of appropriate diagnosis and medical intervention. Distinctive skin
eruptions are specifically helpful in the early diagnosis of the disease.

Publication Types: 
    Case Reports

PMID: 17056468 [PubMed - indexed for MEDLINE]

941: Cell. 2006 Oct 20;127(2):305-16.

Insulin degrading enzyme is a cellular receptor mediating varicella-zoster virus 
infection and cell-to-cell spread.

Li Q, Ali MA, Cohen JI.

Laboratory of Clinical Infectious Diseases, Medical Virology Section, National
Institutes of Health, Bethesda, MD, 20892 USA.

Varicella-zoster virus (VZV) causes chickenpox and shingles. While varicella is
likely spread as cell-free virus to susceptible hosts, the virus is transmitted
by cell-to-cell spread in the body and in vitro. Since VZV glycoprotein E (gE) is
essential for virus infection, we postulated that gE binds to a cellular
receptor. We found that insulin-degrading enzyme (IDE) interacts with gE through 
its extracellular domain. Downregulation of IDE by siRNA, or blocking of IDE with
antibody, with soluble IDE protein extracted from liver, or with bacitracin
inhibited VZV infection. Cell-to-cell spread of virus was also impaired by
blocking IDE. Transfection of cell lines impaired for VZV infection with a
plasmid expressing human IDE resulted in increased entry and enhanced infection
with cell-free and cell-associated virus. These studies indicate that IDE is a
cellular receptor for both cell-free and cell-associated VZV.

Publication Types: 
    Research Support, N.I.H., Intramural

PMID: 17055432 [PubMed - indexed for MEDLINE]

942: Auris Nasus Larynx. 2007 Jun;34(2):159-64. Epub 2006 Oct 19.

Analysis of prognostic factors in Bell's palsy and Ramsay Hunt syndrome.

Yeo SW, Lee DH, Jun BC, Chang KH, Park YS.

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The
Catholic University of Korea, 505 Banpo-dong, Secho-gu, Seoul 137-701, Republic
of Korea.

OBJECTIVE: This study evaluated the prognostic factors in Bell's palsy and Ramsay
Hunt syndrome (HZO). METHODS: A retrospective, institutional review
board-approved study at a university-based hospital. A total of 81 patients
consisting of 55 Bell's palsy patients and 26 HZO patients were enrolled in this 
study. The treatment consisted uniformly in all cases, and acyclovir was
administered in the case of Ramsay Hunt syndrome. All patients were followed up
until they recovered or for least up 6 months. RESULTS: The recovery rates to
House-Brackmann grade II or better were 96.3% in those with Bell's palsy and
84.6% in those with HZO. In the HZO cases, older patients had a poorer initial
and final status, and less chance of making a complete recovery than the younger 
patients. The HZO patients without diabetes mellitus had a higher chance of
recovery, a higher chance of complete recovery, and a better final status. In
addition, HZO patients without essential hypertension had a higher degree of
recovery. HZO patients not suffering from vertigo had a higher chance of
recovery. CONCLUSION: There was no prognostic factor found in the Bell's palsy
patients in this study. The prognostic factors of HZO were age, diabetus
mellitus, essential hypertension and vertigo.

PMID: 17055202 [PubMed - indexed for MEDLINE]

943: Clin Infect Dis. 2006 Nov 15;43(10):1301-3. Epub 2006 Oct 11.

Reactivation of 2 genetically distinct varicella-zoster viruses in the same
individual.

Taha Y, Scott FT, Parker SP, Syndercombe Court D, Quinlivan ML, Breuer J.

Skin Virus Laboratory, Centre for Infectious Diseases Research, Barts and the
London School of Medicine and Dentistry, London, E1 2AT, United Kingdom.

Varicella-zoster viruses recovered from 2 episodes of herpes zoster in an
immunocompetent man were found to be different genotypes. The fact that the 2
isolates came from the same individual was confirmed by DNA fingerprinting.
Immunity following chickenpox may not always protect against systemic
reinfection. This finding raises questions about varicella-zoster virus
pathogenesis and may have an impact on public health policy.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 17051496 [PubMed - indexed for MEDLINE]

944: Clin Infect Dis. 2006 Nov 15;43(10):1257-63. Epub 2006 Oct 16.

Dermatological findings in 3 generations of a family with a high prevalence of
human T cell lymphotropic virus type 1 infection in Brazil.

Nobre V, Guedes AC, Martins ML, Barbosa-Stancioli EF, Serufo JC, Proietti FA,
Ribas JG, Ferreira CE, Lambertucci JR; GIPH Interdisciplinary Group on HTLV-1/2
Research.

Infectious Diseases Branch, Federal University of Minas Gerais, Minas Gerais,
Brazil. vandack@gmail.com

BACKGROUND: Dermatologic manifestations are quite common in patients with adult T
cell leukemia and lymphoma and patients with myelopathy and/or tropical spastic
paraparesis associated with human T cell lymphotropic virus type 1 (HTLV-1). The 
aim of this study was to investigate dermatological findings presented by 30
members of a Brazilian family, half of whom are infected with HTLV-1 (as
confirmed by enzyme-linked immunosorbent assay and Western blot). METHODS: The
subjects underwent dermatologic examination and laboratory assessment, which
included the search for the HTLV-1 genome in peripheral blood mononuclear cells
(PBMCs) by qualitative and semiquantitative polymerase chain reaction (PCR) and
in skin samples by nested qualitative PCR and immunofluorescence assay. RESULTS: 
We found that cases of xerotic dermatological alterations, including 3 cases of
acquired ichthyosis, were more frequent among the infected patients (7 cases vs. 
none among the uninfected individuals; P=.0063). Other lesions observed in this
group included impetigo, scabies, epidermal nevus, herpes zoster scar, rosacea,
and juvenile acne. One HTLV-1-infected individual presented with concurrently
acquired ichthyosis, impetigo, scabies, dermatophytosis, and seborrheic
dermatitis. The PCR performed on PBMCs and skin samples from 24 patients
confirmed the serological results in all cases. Additionally, the HTLV-1 proviral
load was higher in patients with >1 skin lesion. Finally, HTLV-1 could be
identified in the skin by immunofluorescence assay, which, by use of PCR as the
gold standard, showed a sensitivity and specificity of 61.5% and 100%,
respectively. CONCLUSIONS: Altogether, these clinical and laboratory findings
point to an HTLV-1 tropism toward the skin, even in HTLV-1 carriers without adult
T cell leukemia/lymphoma or HTLV-1-associated myelopathy and/or tropical spastic 
paraparesis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17051489 [PubMed - indexed for MEDLINE]

945: Vaccine. 2006 Nov 17;24(47-48):6875-85. Epub 2006 Jul 7.

Safety, tolerability, and immunogenicity of a two-dose regimen of high-titer
varicella vaccine in subjects > or =13 years of age.

Diaz C, Dentico P, Gonzalez R, Mendez RG, Cinquetti S, Barben JL, Harmon A,
Chalikonda I, Smith JG, Stek JE, Robertson A, Caulfield MJ, Biasio LR, Silber JL,
Chan CY, Vessey R, Sadoff J, Chan IS, Matthews H, Wang W, Schlienger K, Schodel
FP; Protocol 049 Study Group.

University of Puerto Rico School of Medicine, San Juan, Puerto Rico.

A new manufacturing process, known as process upgrade varicella vaccine (PUVV)
was developed for a refrigerated formulation of varicella vaccine and for an
investigational zoster vaccine. Safety and tolerability of a two-dose regimen of 
high-titered (approximately 50,000 PFU) PUVV were compared to a lower-titer
formulation (approximately 5400 PFU) of VARIVAX; in 1366 healthy subjects > or
=13 years old. Only one vaccine-related clinical serious adverse experience
(pruritus; no hospitalization) was reported, in the VARIVAX group. Injection-site
adverse experiences following any dose were higher in the PUVV group, 70.0%, than
in the VARIVAX group, 56.2%, but generally were mild. Immunogenicity were similar
in both groups in seronegative subjects. PUVV was generally well tolerated, and
elicited an immune response similar to that induced by the marketed formulation
of VARIVAX.

Publication Types: 
    Multicenter Study
    Randomized Controlled Trial

PMID: 17050042 [PubMed - indexed for MEDLINE]

946: Mayo Clin Womens Healthsource. 2006 Nov;10(11):3.

FDA approves shingles vaccine for older adults.

[No authors listed]

Publication Types: 
    News

PMID: 17047564 [PubMed - indexed for MEDLINE]

947: Lancet. 2006 Oct 14;368(9544):1365-76.

Erratum in:
    Lancet. 2007 Feb 17;369(9561):558.

Comment in:
    Lancet. 2006 Dec 23;368(9554):2208.    Lancet. 2006 Dec 23;368(9554):2208-9.

Varicella.

Heininger U, Seward JF.

Division of Paediatric Infectious Diseases and Vaccinology, University Children's
Hospital, Basel, Switzerland. Ulrich.Heininger@unibas.ch

Varicella-zoster virus, a herpesvirus, causes varicella (chickenpox) and, after
endogenous reactivation, herpes zoster (shingles). Varicella, which is recognised
by a characteristic vesicular rash, arises mainly in young children, although
older individuals can be affected. In immunocompetent patients, symptoms are
usually mild to moderate, but an uncomplicated severe case can have more than
1000 lesions and severe constitutional symptoms. Serious complications--including
central nervous system involvement, pneumonia, secondary bacterial infections,
and death--are sometimes seen. Varicella can be prevented by vaccination. Vaccine
is about 80-85% effective against all disease and highly (more than 95%)
effective in prevention of severe disease. In the USA, a routine childhood
immunisation programme has reduced disease incidence, complications, hospital
admissions, and deaths in children and in the general population, indicating
strong herd immunity. Similar immunisation programmes have been adopted by some
other countries, including Uruguay, Germany, Taiwan, Canada, and Australia, and
are expected to be implemented more widely in future.

Publication Types: 
    Review

PMID: 17046469 [PubMed - indexed for MEDLINE]

948: Cleve Clin J Med. 2006 Oct;73(10):922-8.

Headaches in older patients: special problems and concerns.

Kunkel RS.

Cleveland Clinic Headache Center, Cleveland Clinic Foundation, OH 44195, USA.
kunkelr@ccf.org

Any patient older than 50 years who develops headaches for the first time or who 
has a change in a chronic headache pattern should be investigated for an
underlying cause or exacerbating condition. Several headache syndromes occur
almost exclusively in older people. One of these, temporal arteritis, needs to be
recognized and promptly treated with corticosteroids to avoid permanent visual
loss. Other causes of headache that are more common in older people include
subdural hematomas, trigeminal neuralgia, herpes zoster infection, and
malignancies.

Publication Types: 
    Review

PMID: 17044317 [PubMed - indexed for MEDLINE]

949: Haematologica. 2006 Nov;91(11):1498-505. Epub 2006 Oct 17.

Bortezomib plus dexamethasone as induction treatment prior to autologous stem
cell transplantation in patients with newly diagnosed multiple myeloma: results
of an IFM phase II study.

Harousseau JL, Attal M, Leleu X, Troncy J, Pegourie B, Stoppa AM, Hulin C,
Benboubker L, Fuzibet JG, Renaud M, Moreau P, Avet-Loiseau H.

Hopital Hotel-Dieu, Place Alexis Ricordeau, Nantes Cedex 44093, France.
jlharousseau@sante.univ-nantes.fr

BACKGROUND AND OBJECTIVES. Induction regimens prior to autologous stem cell
transplantation (ASCT) in newly diagnosed multiple myeloma patients usually
result in complete remission (CR) rates of <10%. The use of novel agents may
increase the CR rate before ASCT, which may improve post-transplantation response
and survival. DESIGN AND METHODS. This was a phase II, open-label trial of
bortezomib (1.3 mg/m(2), days 1,4,8,11) and dexamethasone (40 mg,days 1-4 and
9-12 for cycles 1-2,days 1-4 for cycles 3-4) administered for four 21-day cycles 
as induction therapy in chemotherapy-naive myeloma patients. RESULTS. Of 52
recruited patients, 48 were eligible for the study. The overall response rate was
66% including 21% CR and 10% very good partial remission (>90% reduction of the
M-component). Four patients had a minimal response, six had stable disease and
five had progression. One patient died after salvage therapy with VAD. The most
common side effects were gastrointestinal symptoms, peripheral neuropathy, and
fatigue. These were usually mild. Peripheral neuropathy was observed in 15 cases 
but was grade 2-3 in only seven cases (14%). There was no deep vein thrombosis
and no hematologic toxicity greater than grade 2. Grade 3 infections were
recorded in five patients including three who had herpes zoster infections. Stem 
cell collection was programmed in 44 cases and all patients had sufficient CD34+ 
cells to perform one ASCT (> 2 x 10(6)/kg). INTERPRETATION AND CONCLUSION. This
regimen of bortezomib plus dexamethasone appears effective and well tolerated in 
newly diagnosed myeloma patients.

Publication Types: 
    Clinical Trial, Phase II
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 17043025 [PubMed - indexed for MEDLINE]

950: Nurs Older People. 2006 Oct;18(9):20-2.

Shingles: relief at last.

Dinsdale P.

PMID: 17042348 [PubMed - indexed for MEDLINE]

951: J Virol. 2006 Nov;80(21):10325-34.

Postentry events are responsible for restriction of productive varicella-zoster
virus infection in Chinese hamster ovary cells.

Finnen RL, Mizokami KR, Banfield BW, Cai GY, Simpson SA, Pizer LI, Levin MJ.

Department of Pediatrics, Infectious Diseases Section, Biomedical Research
Building 851, C227, University of Colorado Health Sciences Center, 4200 East
Ninth Avenue, Denver, CO 80262, USA. renee.finnen@uchsc.edu

Productive infection of varicella-zoster virus (VZV) in vitro is restricted
almost exclusively to cells derived from humans and other primates. We
demonstrate that the restriction of productive VZV infection in CHO-K1 cells
occurs downstream of virus entry. Entry of VZV into CHO-K1 cells was
characterized by utilizing an ICP4/beta-galactosidase reporter gene that has been
used previously to study herpes simplex virus type 1 entry. Entry of VZV into
CHO-K1 cells involved cell surface interactions with heparan sulfate
glycosaminoglycans and a cation-independent mannose-6-phosphate receptor.
Lysosomotropic agents inhibited the entry of VZV into CHO-K1 cells, consistent
with a low-pH-dependent endocytic mechanism of entry. Infection of CHO-K1 cells
by VZV resulted in the production of both immediate early and late gene products,
indicating that a block to progeny virus production occurs after the initiation
of virus gene expression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17041213 [PubMed - indexed for MEDLINE]

952: J Dermatol. 2006 Oct;33(10):705-8.

Drug eruption caused by the nonionic contrast medium iohexol. "Recall-like
phenomenon" appearing on an area previously affected by herpes zoster.

Matsumura T, Watanabe H, Batchelor J, Sueki H, Iijima M.

Department of Dermatology, Showa University School of Medicine, 1-5-8 Hatanodai, 
Shinagawa-ku, Tokyo 142-8666, Japan.

We report a case of "recall-like phenomenon" caused by nonionic contrast medium. 
A 62-year-old woman suffering from postherpetic neuralgia developed erythematous 
plaques 12 h after an intercostal nerve block under X-ray guidance using iohexol 
(Omnipaque) as contrast medium. The erythematous plaques were preferentially
located in the sites where she had experienced herpes zoster 4 months previously.
The lesions cleared spontaneously leaving no pigmentation. Both patch testing and
intradermal testing with iohexol and ioversol were positive. We postulate that
local immunological changes in the skin, such as an increased number and/or
accelerated activity of Langerhans cells and mast cells in the herpes zoster
lesions, were responsible for this phenomenon. This "recall-like phenomenon",
occurring preferentially in skin previously affected by herpes zoster, could
facilitate understanding of the pathology of drug eruptions.

Publication Types: 
    Case Reports

PMID: 17040501 [PubMed - indexed for MEDLINE]

953: J Drugs Dermatol. 2006 Oct;5(9):863-6.

A novel vaccine (Zostavax) to prevent herpes zoster and postherpetic neuralgia.

Holcomb K, Weinberg JM.

Department of Dermatology, St. Luke's-Roosevelt Hospital Center and Beth Israel
Medical Center, New York, NY 10025, USA.

Varicella-zoster virus is the causal agent of varicella and herpes zoster in
humans. Herpes zoster results from reactivation of latent varicella-zoster virus 
(VZV) within the sensory ganglia. The incidence and severity of herpes zoster
increase with advancing age. More than half of all persons in whom herpes zoster 
develops are older than 60 years. The most frequent debilitating complication is 
postherpetic neuralgia, a neuropathic pain syndrome that persists or develops
after the dermatomal rash has healed and can be prolonged and disabling. There
are many limitations of current therapies for herpes zoster and postherpetic
neuralgia. A live attenuated VZV vaccine has been developed and recently approved
by the FDA for the prevention of herpes zoster in individuals 60 years of age and
older. In a randomized, double-blind, placebo-controlled trial with 38,546
patients 60 years of age or older, the use of the zoster vaccine reduced the
burden of illness due to herpes zoster by 61.1% (P < .001), reduced the incidence
of postherpetic neuralgia by 66.5% (P < .001), and reduced the incidence of
herpes zoster by 51.3% (P < .001). In this review, we will discuss the history of
the use of the varicella vaccine in children, and the subsequent development of
the new zoster vaccine.

Publication Types: 
    Review

PMID: 17039651 [PubMed - indexed for MEDLINE]

954: J Am Pharm Assoc (2003). 2006 Sep-Oct;46(5):647-9.

Shingles prevention: vaccine presents opportunity to pharmacists.

Hayney MS.

School of Pharmacy, University of Wisconsin, Madsion, USA.
mshayney@pharmacy.wisc.edu

PMID: 17036653 [PubMed - indexed for MEDLINE]

955: Paediatr Respir Rev. 2006;7 Suppl 1:S328.

CR8-194--A case of fulminated fatal disseminated Varicella Zoster virus infection
with severe pulmonary damage.

Kobayashi Y, Watanabe T, Inoue Y, Arakawa H, Mochizuki H, Tokuyama K, Morikawa A.

Gunma University Graduate School of Medicine, Pediatrics and Developmental
Medicine, Maebashi, Gunma, Japan.

Publication Types: 
    Case Reports

PMID: 17036409 [PubMed - indexed for MEDLINE]

956: J Clin Microbiol. 2006 Dec;44(12):4441-3. Epub 2006 Oct 11.

Relationship between preexisting anti-varicella-zoster virus (VZV) antibody and
clinical VZV reactivation in hematopoietic stem cell transplantation recipients.

Onozawa M, Hashino S, Takahata M, Fujisawa F, Kawamura T, Nakagawa M, Kahata K,
Kondo T, Ota S, Tanaka J, Imamura M, Asaka M.

Department of Gastroenterology and Hematology, Hokkaido University Graduate
School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
masahiro.onozawa@nifty.ne.jp

Reactivation of latent varicella-zoster virus (VZV), presenting as localized
zoster or as disseminated infection, is a common and potentially serious
complication in hematopoietic stem cell transplantation (HSCT) recipients. We
retrospectively studied anti-VZV immunoglobulin G titers by the immune adherence 
hemagglutination method after HSCT and also studied VZV DNA by real-time PCR
during clinical VZV reactivation using cryopreserved serum samples. No
significant difference was found between anti-VZV titers in 13 patients with VZV 
infection (localized zoster in 11 patients and disseminated zoster in 2 patients)
and in 13 subjects without VZV infection at each time point after HSCT.
Preexisting anti-VZV titers of disseminated zoster cases tended to be lower than 
those of localized zoster cases (P=0.10). Serum VZV DNA copy numbers at the onset
of disseminated zoster cases tended to be higher than those of localized zoster
cases (P=0.09). A strong inverse correlation was found between preexisting
anti-VZV titer and serum VZV DNA at onset (r=-0.90, P=0.006). In HSCT recipients,
preexisting antibody does not prevent the development of VZV reactivation but may
contribute to decreased viral load at onset, resulting in a mild clinical course.

PMID: 17035500 [PubMed - indexed for MEDLINE]

957: Curr Opin Infect Dis. 1998 Apr;11(2):125-9.

Dermatological infections in the immunocompromised host.

Bachelez H.

Institut de Recherche sur la Peau et Service de Dermatologie 1, Hopital
Saint-Louis, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France.
h.bachelez@chu-stlouis.fr

The data from the most recent studies concerning infection with human herpes
virus 8 strongly support a pathogenic role for this virus in the tumoral
hyperplasia which is a feature of Kaposi's sarcoma. The results from the first
studies of the sensitivity of human herpes virus 8 to antiviral drugs were also
published last year. This review also concerns bacterial and mycobacterial
infections showing unusual presentation, important trials in the prevention of
infection with varicella zoster virus by using vaccination in children with
leukemia, and a controlled therapeutic study in HIV-infected patients presenting 
with early syphilis.

PMID: 17033375 [PubMed]

958: Indian Pediatr. 2006 Sep;43(9):804-8.

Clinical profile and morbidity pattern of infants born to HIV infected mothers in
Durban South Africa.

Adhikari M, Kauchali S, Moodley A.

Department of Pediatrics, Nelson R Mandela School of Medicine, University of
KwaZulu-Natal, Congella 4013, South Africa. adhikari@ukzn.ac.za

This study describes the clinical characteristics and co-infections in infants
born to HIV infected women being followed up in a high risk clinic of South
Africa Sixty three percent (302 out of 476) of mothers attended clinic for
varying periods during follow-up. Sixty four per cent of babies had physical
clinical signs suggestive of HIV infection. In the majority of babies, persistent
signs resolved by 9 months of age. In those with persistent signs, 20 percent
tested positive for HIV infection. Among the HIV exposed infants, co-infections
with TB, CMV, syphilis and Herpes zoster were diagnosed which appeared
independent of their ultimate seroconversion status.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17033119 [PubMed - indexed for MEDLINE]

959: Otol Neurotol. 2007 Jan;28(1):100-3.

Infective causes of facial nerve paralysis.

Makeham TP, Croxson GR, Coulson S.

Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

OBJECTIVE: To review the functional recovery in a cohort of patients with facial 
nerve paralysis (FNP) due to infective cause. STUDY DESIGN: Retrospective review 
based on patients identified from a prospectively maintained database of patients
with FNP. The case notes of identified patients were reviewed. SETTING: Tertiary 
referral center. PATIENTS: The patients were identified from a database of 1074
patients with FNP. One hundred twenty of the 150 patients identified as having
FNP due to an infectious disease caused by herpes zoster oticus were excluded
from the study. The remaining 30 patients were included in the study.
INTERVENTIONS: Patients were treated both operatively and nonoperatively.
Operative treatment included myringotomy and ventilation tube placement, cortical
mastoidectomy, modified radical (canal wall down) mastoidectomy, petrous
apicectomy, and lateral temporal bone resection. MAIN OUTCOME MEASURES: This
study used the House-Brackmann (HB) grade of facial function at 1 year after
initial assessment. The patients were identified from a prospectively maintained 
database of all patients presenting with FNP to a single specialist
otolaryngologist (G.R.C.) between June 1988 and April 2005. The database contains
information including demographic details, dates of presentation, diagnostic
modalities used, diagnosis, interventions, and HB grade. The patients in this
series presented between August 4, 1989 and August 26, 2003. RESULTS: Twenty-nine
patients with 30 facial nerve paralyses were identified. The causes of FNP were
acute otitis media (n = 10); cholesteatoma (n = 10 [acquired, 7; congenital, 3]);
mastoid cavity infections (n = 2); malignant otitis externa (n = 2);
noncholesteatomatous chronic suppurative otitis media (CSOM; n = 2); tuberculous 
mastoiditis (n = 1); suppurative parotitis (n = 1); and chronic granulomatosis (n
= 1). The patients with noncholesteatomatous CSOM who presented sooner after the 
onset of facial nerve symptoms had greater facial nerve recovery when assessed
using the HB grade at 1 year. CONCLUSION: FNP due to infective causes other than 
herpes zoster oticus is rare. Patients with noncholesteatomatous CSOM and FNP
have a better outcome than those with FNP due to cholesteatoma. Patients with FNP
due to acute otitis media tend to have a good prognosis without surgical
decompression of the facial nerve being required.

Publication Types: 
    Case Reports

PMID: 17031324 [PubMed - indexed for MEDLINE]

960: J Med Microbiol. 2006 Nov;55(Pt 11):1587-90.

Comment in:
    J Med Microbiol. 2007 Sep;56(Pt 9):1253; author reply 1254.

Intractable colitis associated with chronic granulomatous disease.

Arimura Y, Goto A, Yamashita K, Endo T, Ikeda H, Tanaka K, Tsutsumi H, Shinomura 
Y, Imai K.

First Department of Internal Medicine, Sapporo Medical University, S-1, W-16,
Chuo-ku, Sapporo 060-8543, Japan. arimura@sapmed.ac.jp

The case of a 20-year-old Japanese man, diagnosed as having autosomal recessive
chronic granulomatous disease (CGD), who was being treated with corticosteroids
for intractable unclassified colitis, is described. He died from multiple organ
failure following disseminated intravascular coagulation secondary to
disseminated varicella-zoster virus (VZV) infection. He was diagnosed as an index
case of CGD when 2 years old, was inoculated against VZV at the age of 5 years
and had had an unremarkable course for 19 years. He was admitted to hospital
because of a third episode of recurrent bloody diarrhoea. Clinical remission for 
each episode was achieved by intravenous corticosteroid therapy. Unclassified
colitis associated with CGD was diagnosed based on a colonic biopsy demonstrating
characteristic macrophages with lipofuscin deposits. From a treatment viewpoint, 
idiopathic inflammatory bowel disease (IBD) should be differentiated from
secondary IBD occurring in CGD, in which immunosuppressive drugs including
corticosteroids, still the mainstay of IBD treatment, should be avoided.

Publication Types: 
    Case Reports

PMID: 17030921 [PubMed - indexed for MEDLINE]

961: Rev Neurol (Paris). 2006 Sep;162(8-9):879-87.

[Neurological complications of Herpes zoster]

[Article in French]

Mathis S, Gil R, Neau JP.

Clinique Neurologique, CHU La Miletrie, Poitiers.

INTRODUCTION: Herpes zoster is a disease which occurs secondary to the
reactivation of varicella-zoster virus (VZV). Its frequency is high in the
general population. STATE OF ART: Herpes zoster leads to numerous complications, 
among which there were neurological peripheral or central lesions. Antiviral
treatment must be instituted, particularly if neurological complications develop,
as soon as possible. Corticosteroid therapy can be used, especially in
Ramsay-Hunt syndrome or central nervous system involvement. CONCLUSION:
Herpes-zoster is a frequent disease which can lead to serious neurological
complications. Early treatment is necessary in order to improve functional
outcome.

Publication Types: 
    English Abstract
    Review

PMID: 17028554 [PubMed - indexed for MEDLINE]

962: Skin Res Technol. 2006 Nov;12(4):228-34.

Acyclovir concentrations in the skin of humans after a single oral dose assessed 
by in vivo cutaneous microdialysis.

Farfal S, Klimowicz A, Bielecka-Grzela S.

Department of Dermatology, Division of Dermatopharmacotherapy, Pomeranian Medical
University, Szczecin, Poland.

BACKGROUND/PURPOSE: Acyclovir is a synthetic deoxyguanosine analogue used in the 
treatment of certain viral diseases. This drug is effective primarily against
Herpes simplex virus, Varicella zoster virus and to a lesser extent against
Epstein-Barr virus and cytomegalovirus. The aim of the study was to determine the
acyclovir concentrations in plasma and skin (cutaneous microdialysate) and to
compare its penetration into real (skin) and theoretical peripheral compartment
after administration of a single 0.4 g oral dose. METHODS: To evaluate the skin
concentrations of the examined agent in 10 healthy male volunteers linear
microdialysis probes with 2 kDa molecular-weight cut-off were inserted
intradermally and were perfused with Ringer solution up to 6 h after drug
ingestion. RESULTS: The mean maximum acyclovir concentrations in the plasma, skin
and theoretical peripheral compartment were 3.16+/-0.86, 0.94+/-0.34 and
1.85+/-0.69 micromol/L, respectively, and were achieved after 1.6+/-0.4,
2.4+/-0.3 and 3.7+/-0.7 h. The degree of penetration into the real (skin) and
theoretical peripheral compartment was 0.36+/-0.15 and 0.74+/-0.12, respectively,
and the differences were statistically significant. Similarly, also, the maximum 
concentration, time to maximum concentration and area under the
concentration-time curve differed significantly between the plasma and skin as
well as between the skin and the theoretical peripheral compartment. CONCLUSIONS:
In selected cases skin concentrations should be determined rather than those in
blood plasma when studying the distribution of orally administered drugs.
Evaluation of acyclovir concentrations in the skin cannot be replaced by the
calculation of the theoretical peripheral compartment.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 17026652 [PubMed - indexed for MEDLINE]

963: J Exp Biol. 2006 Oct;209(Pt 20):4174-84.

Escape responses in juvenile Atlantic cod Gadus morhua L.: the effects of
turbidity and predator speed.

Meager JJ, Domenici P, Shingles A, Utne-Palm AC.

Department of Biology, University of Bergen, PO Box 7800, Bergen N-5020, Norway. 
Justin.Meager@bio.uib.no

We examined the effect of turbidity (0.5-14 beam attenuation m(-1)) and predator 
attack speed (150 and 296 cm s(-1)) on escape responses of juvenile cod Gadus
morhua in the laboratory. We triggered escape responses using a predator model
and measured escape timing, direction and locomotor performance. We also measured
responsiveness and estimated the likelihood of fish escaping the ;predator
attack' (putative escape success, PES). Turbidity affected both PES and the type 
of escape response used by the fish, but these effects depended on predator
speed. PES for the fast predator attack declined from 73% in clear water to 21%
in highly turbid water, due to decreased responsiveness and poorly timed escapes.
Intermediate turbidity enhanced PES and responsiveness to the slow predator
attack. Locomotor performance was reduced by turbidity, whereas predator speed
had the opposite effect. Our results suggest that both predator attack speed and 
turbidity have important roles in determining the vulnerability of fish attacked 
by piscivorous predators.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 17023610 [PubMed - indexed for MEDLINE]

964: J Neuropathol Exp Neurol. 2006 Oct;65(10):1022-30.

Latency of alpha-herpes viruses is accompanied by a chronic inflammation in human
trigeminal ganglia but not in dorsal root ganglia.

Hufner K, Derfuss T, Herberger S, Sunami K, Russell S, Sinicina I, Arbusow V,
Strupp M, Brandt T, Theil D.

Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University,
Munich, Germany.

The immune response to latent herpesvirus infections was compared in human
trigeminal ganglia (TG) and dorsal root ganglia (DRG) of 15 dead individuals. On 
the basis of our previous findings, we hypothesized that T-cells would be
attracted to sensory neurons latently infected with herpes simplex virus type 1
(HSV-1), but not to those harboring latent varicella zoster virus (VZV). We
showed that the TG contain a positive hybridization signal for HSV-1
latency-associated transcript (LAT), whereas the DRG from the same individuals
lack detectable LAT. In contrast, immunohistochemistry revealed that latent VZV
protein 62 stained positive in the vast majority of all tested TG and DRG. T-cell
infiltrates prominently surrounded individual neurons in the TG but not in the
DRG. TaqMan polymerase chain reaction also showed higher expression of CD8 and
RANTES transcripts in the TG versus DRG. Only the infiltrates in the TG, but not 
in the DRG, produced RANTES at the protein level. Because it has been shown that 
RANTES protein is produced only after T-cell receptor stimulation, we assume that
T-cell infiltration is associated with antigen recognition in the TG but not in
the DRG.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 17021407 [PubMed - indexed for MEDLINE]

965: Aust Fam Physician. 2006 Oct;35(10):789-90.

Localised herpes zoster infection and SIADH.

O'Rourke F, Chilov M.

Aged Care and Rehabilitation, Bankstown- Lidcombe Hospital, New South Wales,
Australia. fintan.o'rourke@swsahs.nsw.gov.au

Localised herpes zoster infection ('shingles') in older patients is a common
presentation to primary, and sometimes secondary, care physicians. However,
symptoms of hyponatraemia, caused by the rare complication of 'syndrome of
inappropriate antidiuretic hormone secretion' (SIADH), may be mistaken for
constitutional symptoms of the infection itself. Such patients may require closer
monitoring or hospitalisation.

Publication Types: 
    Case Reports

PMID: 17019453 [PubMed - indexed for MEDLINE]

966: Neuron. 2006 Oct 5;52(1):77-92.

Mechanisms of neuropathic pain.

Campbell JN, Meyer RA.

Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
jcampbell@jhmi.edu

Neuropathic pain refers to pain that originates from pathology of the nervous
system. Diabetes, infection (herpes zoster), nerve compression, nerve trauma,
"channelopathies," and autoimmune disease are examples of diseases that may cause
neuropathic pain. The development of both animal models and newer pharmacological
strategies has led to an explosion of interest in the underlying mechanisms.
Neuropathic pain reflects both peripheral and central sensitization mechanisms.
Abnormal signals arise not only from injured axons but also from the intact
nociceptors that share the innervation territory of the injured nerve. This
review focuses on how both human studies and animal models are helping to
elucidate the mechanisms underlying these surprisingly common disorders. The
rapid gain in knowledge about abnormal signaling promises breakthroughs in the
treatment of these often debilitating disorders.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review

PMID: 17015228 [PubMed - indexed for MEDLINE]

967: Dermatol Clin. 2006 Oct;24(4):549-70, vii.

Dermatologic manifestations of the immune reconstitution inflammatory syndrome.

Lehloenya R, Meintjes G.

Division of Dermatology, Department of Medicine, University of Cape Town, Groote 
Schuur Hospital, Observatory, 7925, South Africa.

The immune reconstitution inflammatory syndrome (IRIS) represents a diverse range
of immunopathologic reactions resulting in clinical deterioration that may occur 
as immune function is partially restored in HIV-infected patients receiving
highly active antiretroviral therapy. Approximately half of IRIS events are
dermatologic, and dermatologic IRIS is described in relation to a wide range of
conditions, the commonest being herpes zoster and herpes simplex. Most cases of
IRIS result in mild and moderate symptoms, but non-dermatologic manifestations
related to IRIS have resulted in death. This article covers certain general
issues related to IRIS and then focuses on the spectrum of dermatologic
manifestations.

Publication Types: 
    Review

PMID: 17010783 [PubMed - indexed for MEDLINE]

968: J Dtsch Dermatol Ges. 2006 Oct;4(10):871-9; quiz 880-1.

Zoster-associated neuralgias.

[Article in English, German]

Wassilew SW.

Dermatology Clinic, Krefeld, Germany. dermatologie@klinikum-krefeld.de

Publication Types: 
    Review

PMID: 17010178 [PubMed - indexed for MEDLINE]

969: Int Wound J. 2006 Jun;3(2):145-6.

Nocturnal sedation in a child with facial ulceration.

Patel GK, Motley RJ.

Welsh Institute of Dermatology, University Hospital of Wales, Heath Park,
Cardiff, UK. patelgk@cf.ac.uk

Mostly, herpes zoster affects adults and therefore childhood presentation can
represent a diagnostic challenge. Childhood herpes zoster, when it occurs, can
also be associated with peripheral nerve complications, as illustrated by this
case. A 3-year-old child who had herpes zoster developed a nasolabial scar
resulting in a shallow non-healing ulcer from being repeatedly picked. Healing
was only achieved after nocturnal sedation, with chloral hydrate.

Publication Types: 
    Case Reports

PMID: 17007345 [PubMed - indexed for MEDLINE]

970: J Child Neurol. 2006 Oct;21(10):910-2.

Childhood encephalitis in Crete, Greece.

Ilias A, Galanakis E, Raissaki M, Kalmanti M.

Department of Pediatrics, University of Crete, Heraklion, Crete, Greece.

This study included all 18 cases of children hospitalized for encephalitis in the
referral university hospital of Heraklion, Crete, Greece, during the 5-year
period from 2000 to 2004. Encephalitis was attributed to viral infection
(echovirus, herpes simplex virus 1, varicella-zoster virus, cytomegalovirus, and 
influenza A) in eight children and to bacteria (Mycoplasma pneumoniae, group A
beta-hemolytic streptococcus, and Rickettsia typhi) in a further five cases.
Multiple hyperintense brain lesions on magnetic resonance imaging (MRI) were
associated with a severe clinical presentation but not with a guarded long-term
outcome. Five children still presented with mild to moderate sequelae after 1.5
to 5.3 (median 4.0) years. Our findings confirm the elimination of measles,
mumps, and rubella-associated encephalitis in the postvaccine era. MRI appeared
to be of great diagnostic value. Although no fatalities were observed, deficits
did persist in several patients.

PMID: 17005114 [PubMed - indexed for MEDLINE]

971: Pancreas. 2006 Oct;33(3):314-5.

Shingles-associated Pancreatitis.

Famularo G, Minisola G, Nicotra GC.

Publication Types: 
    Case Reports
    Letter

PMID: 17003657 [PubMed - indexed for MEDLINE]

972: Rheumatology (Oxford). 2006 Nov;45(11):1370-5. Epub 2006 Sep 26.

Rates and predictors of herpes zoster in patients with rheumatoid arthritis and
non-inflammatory musculoskeletal disorders.

Wolfe F, Michaud K, Chakravarty EF.

National Data Bank for Rheumatic Diseases, Arthritis Research Center Foundation, 
1035 N. Emporia, Suite 230 Wichita, KS 67214, USA. fwolfe@arthritis-research.org

OBJECTIVES: Herpes zoster (HZ) is a common disorder that causes substantial pain 
and morbidity. We examined its rate and predictors in rheumatoid arthritis (RA)
and non-inflammatory musculoskeletal (MSK) disorders to determine if HZ was
increased in RA and whether treatment contributed to the risk of HZ. METHODS:
After excluding patients witzh prior HZ, we assessed 10 614 RA and 1721 MSK
patients by semi-annual questionnaires during 33 825 patient-years of follow-up. 
Predictors of HZ were determined by Cox regression and expressed as hazard ratios
(HR) and 95% confidence intervals (CI). RESULTS: The annualized incidence rate
per 1000 patient-years was 13.2 (95% CI 11.9-14.5) in RA and 14.6 (95% CI
11.2-18.1) in MSK, and did not differ significantly after adjustment for age and 
sex. HZ was predicted by impaired functional status, as measured by the Health
Assessment Questionnaire (HAQ), [HR 1.3 (95% CI 1.1-1.5)] and by the use of
COX-2-specific non-steroidal anti-inflammatory drugs (NSAIDs) [HR 1.3 (95% CI
1.1-1.6)] in RA and MSK. In multivariable analyses in patients with RA,
cyclophosphamide HR 4.2 (95% CI 1.6-11.5), azathioprine HR 2.0 (1.2-3.3),
prednisone HR 1.5 (1.2-1.8), leflunomide HR 1.4 (1.1-1.8) and COX-2 NSAIDs HR 1.3
(95% CI 1.1-1.6) were significant predictors of HZ. CONCLUSION: The incidence of 
HZ is increased in RA and MSK compared with population-based rates. However, the 
rate of HZ in RA is not increased compared with MSK. After adjustment for
severity, various treatments, but not methotrexate or biologics, were risk
factors for HZ.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 17003175 [PubMed - indexed for MEDLINE]

973: J Virol Methods. 2006 Dec;138(1-2):123-30. Epub 2006 Sep 26.

Rapid detection, serotyping and quantitation of dengue viruses by TaqMan
real-time one-step RT-PCR.

Kong YY, Thay CH, Tin TC, Devi S.

Department of Medical Microbiology, Faculty of Medicine, University of Malaya,
50603 Kuala Lumpur, Malaysia.

The use of the polymerase chain reaction (PCR) in molecular diagnosis is now
accepted worldwide and has become an essential tool in the research laboratory.
In the laboratory, a rapid detection, serotyping and quantitation, one-step
real-time RT-PCR assay was developed for dengue virus using TaqMan probes. In
this assay, a set of forward and reverse primers were designed targeting the
serotype conserved region at the NS5 gene, at the same time flanking a variable
region for all four serotypes which were used to design the serotype-specific
TaqMan probes. This multiplex one-step RT-PCR assay was evaluated using 376
samples collected during the year 2003. These groups included RNA from prototype 
dengue virus (1-4), RNA from acute serum from which dengue virus was isolated,
RNA from tissue culture supernatants of dengue virus isolated, RNA from
seronegative acute samples (which were culture and IgM negative) and RNA from
samples of dengue IgM positive sera. The specificity of this assay was also
evaluated using a panel of sera which were positive for other common tropical
disease agents including herpes simplex virus, cytomegalovirus, measles virus,
varicella-zoster virus, rubella virus, mumps virus, WWF, West Nile virus,
Japanese encephalitis virus, S. typhi, Legionella, Leptospira, Chlamydia, and
Mycoplasma. The sensitivity, specificity and real-time PCR efficiency of this
assay were 89.54%, 100% and 91.5%, respectively.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 17000012 [PubMed - indexed for MEDLINE]

974: Acta Dermatovenerol Alp Panonica Adriat. 2006 Jun;15(2):94-7.

Zosteriform lichen planus-like eruption.

Miljkovic J, Belic M, Godic A, Klemenc P, Marin J.

Department of Dermatology and Venereology, General Hospital Maribor, Ljubljanska 
5, 2000 Maribor, Corresponding author. miljkovic.j@sb-mb.si.

Lichen planus (LP) is a relatively common papulosquamous skin disease of unknown 
etiology, it is believed to be a T-cell mediated disorder. In addition to the
cutaneous eruptions it may also affect mucous membranes, nails or cause scarring 
alopecia. Lichen planus appears in various clinical variants which are
categorized according to the morphology and configuration of lesions. We present 
a 34-year-old man who developed a papular eruption localized unilaterally on the 
right side of the body in a linear-zosteriform pattern within the L5-S1 nerve
segments. The skin lesions clinically and histologically mimicked LP. Topical
treatment with betamethason ointment for one month led to remarkable improvement,
but a zosteriform hiperpigmentation persisted. According to the clinical findings
in our patient and a review of the literature, we believe that
lichenoidzosteriform eruption is a variant of lichen planus or a herpes zoster
infection.

PMID: 16998610 [PubMed - in process]

975: Ophthalmology. 2006 Dec;113(12):2259-61. Epub 2006 Sep 25.

Primary treatment of acute retinal necrosis with oral antiviral therapy.

Emerson GG, Smith JR, Wilson DJ, Rosenbaum JT, Flaxel CJ.

Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.

PURPOSE: To explore the possibility of oral antiviral therapy in lieu of
intravenous acyclovir for treating acute retinal necrosis (ARN), a necrotizing
retinopathy caused by herpes simplex virus type 1 or 2 or by varicella zoster
virus. DESIGN: Retrospective, interventional, small case series. PARTICIPANTS:
Four patients (6 eyes). METHODS: Patients were treated with oral antiviral
therapy. Medications included valacyclovir (1 g 3 times daily), oral famciclovir 
(500 mg 3 times daily), and topical and oral corticosteroids. MAIN OUTCOME
MEASURES: Improvement of symptoms, including photophobia, blurred vision, ocular 
discomfort, and floaters; increase in visual acuity; and resolution of vitreitis,
retinitis, and retinal vasculitis, where present. RESULTS: Symptoms and visual
acuity improved within 2 weeks to 1 month in 3 of 4 patients (75%) treated with
oral antiviral medication. One patient required surgical treatment for
asymptomatic retinal detachment after 3 weeks of treatment; retinal detachment in
the fellow eye was repaired 2 months later. Duration of antiviral therapy ranged 
from 5 weeks to 3 months. CONCLUSIONS: For 4 patients with relatively indolent
cases of ARN, oral antiviral therapy alone was effective in eliminating signs and
symptoms of the disease. In particular, oral valacyclovir and famciclovir
appeared to be effective, although further study is necessary to determine
whether these drugs are as effective as intravenous acyclovir for initial
treatment of ARN.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 16996614 [PubMed - indexed for MEDLINE]

976: Exp Parasitol. 2007 Feb;115(2):114-20. Epub 2006 Sep 22.

Meloidogyne incognita: molecular and biochemical characterisation of a cathepsin 
L cysteine proteinase and the effect on parasitism following RNAi.

Shingles J, Lilley CJ, Atkinson HJ, Urwin PE.

Centre for Plant Sciences, University of Leeds, Leeds LS2 9JT, UK.

RNA interference has been used to investigate the function of a cathepsin L
cysteine proteinase Mi-cpl-1, in the plant-parasitic nematode Meloidogyne
incognita. A reduction in gene transcript was observed and the number of
nematodes infecting plants was reduced by almost 60% as was the number of
established females producing eggs at 21 days post-infection. The cysteine
proteinase activity of M. incognita, reported by the substrate GLUpNA, was
inhibited by the cysteine proteinase inhibitor Oc-IDeltaD86. A reduction in
cysteine proteinase activity was also seen following RNAi of Mi-cpl-1 in J2 stage
nematodes. In situ hybridization analysis in young and mature female nematodes
has shown that Mi-cpl-1 is expressed in the intestine, which suggests that its
product is a digestive enzyme. The effects of knocking-out Mi-cpl-1gene function 
were consistent with a reduction in feeding efficiency. Here, we have shown a
correlation between transcript abundance proteinase activity and parasitic
success of M. incognita.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16996059 [PubMed - indexed for MEDLINE]

977: Expert Rev Vaccines. 2006 Aug;5(4):431-43.

Prevention of shingles by varicella zoster virus vaccination.

Holodniy M.

VA Palo Alto Health Care System, 3801 Miranda Ave. (132), Palo Alto, CA 94306,
USA. mark.holodniy@va.gov

Herpes zoster is caused by reactivation from previous varicella zoster virus
(VZV) infection, and affects millions of people worldwide. It primarily affects
older adults and those with immune system dysfunction, most likely as a result of
reduced or lost VZV-specific cell-mediated immunity. Complications include
post-herpetic neuralgia, a potentially debilitating and chronic pain syndrome.
Current treatment of herpes zoster and post-herpetic neuralgia involves antiviral
agents and analgesics, and is associated with significant economic cost. Results 
from several clinical trials have determined that a live, attenuated VZV vaccine 
using the Oka/Merck strain (Zostavax) is safe, elevates VZV-specific
cell-mediated immunity, and significantly reduces the incidence of herpes zoster 
and post-herpetic neuralgia in people over 60 years of age. Regulatory approval
has recently been obtained and once launched, it is expected that this vaccine
will significantly reduce the morbidity and financial costs associated with
herpes zoster. Durability of vaccine response and possible booster vaccination
will still need to be determined.

Publication Types: 
    Review

PMID: 16989624 [PubMed - indexed for MEDLINE]

978: Masui. 2006 Sep;55(9):1104-11.

[Equipment for low reactive level laser therapy including that for light therapy]

[Article in Japanese]

Saeki S.

Department of Anesthesiology, Nihon University School of Medicine (Surugadai
Nihon University Hospital), Tokyo.

Equipments used for light therapy include machinery used for irradiation by low
reactive level laser, xenon light and linear polarized infra-red ray. Low
reactive level laser is divided into two types of laser according to the medium
by which laser is obtained ; semiconductor laser and helium-neon laser. Low
reactive level laser has only one wave length and produces analgesia by action of
light itself. On the other hands, Xenon light and linear polarized infra-red ray 
produce analgesia by warming effect induced by light in addition to the action of
light itself. There are four methods of irradiation by these light sources;
irradiation of acupuncture points, of trigger points, along nerves causing pain
and of stellate ganglion area. Indication for light therapy includes various
kinds of diseases such as herpes zoster, post herpetic neuralgia, cervical pain, 
lumbago due to muscle contracture, complex regional pain syndrome, arthralgia
etc. However, we have to know that light therapy does not exert analgesic effects
equally to all patients. But light therapy does not accompany pain and rarely
shows any side effects. Therefore it is thought to be an alternative for patients
who reject injection or patients who are not indicated for nerve block because of
patients' conditions such as bleeding tendency.

Publication Types: 
    English Abstract

PMID: 16984008 [PubMed - indexed for MEDLINE]

979: Consum Rep. 2006 Oct;71(10):62.

Vaccines: more reasons to immunize.

[No authors listed]

PMID: 16981311 [PubMed - indexed for MEDLINE]

980: Toxicon. 2006 Dec 1;48(7):810-29. Epub 2006 Jul 15.

Therapeutic applications of conotoxins that target the neuronal nicotinic
acetylcholine receptor.

Livett BG, Sandall DW, Keays D, Down J, Gayler KR, Satkunanathan N, Khalil Z.

Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and
Biotechnology Institute, University of Melbourne, Victoria 3010, Australia.
b.livett@unimelb.edu.au

Pain therapeutics discovered by molecular mining of the expressed genome of
Australian predatory cone snails are providing lead compounds for the treatment
of neurological diseases such as multiple sclerosis, shingles, diabetic
neuropathy and other painful neurological conditions. The high specificity
exhibited by these novel compounds for neuronal receptors and ion channels in the
brain and nervous system indicates the high degree of selectivity that this class
of neuropeptides can be expected to show when used therapeutically in humans. A
lead compound, ACV1 (conotoxin Vc1.1 from Conus victoriae), has entered Phase II 
clinical trials and is being developed for the treatment for neuropathic pain.
ACV1 will be targeted initially for the treatment of sciatica, shingles and
diabetic neuropathy. The compound is a 16 amino acid peptide [Sandall et al.,
2003. A novel alpha-conotoxin identified by gene sequencing is active in
suppressing the vascular response to selective stimulation of sensory nerves in
vivo. Biochemistry 42, 6904-6911], an antagonist of neuronal nicotinic
acetylcholine receptors. It has potent analgesic activity following subcutaneous 
or intramuscular administration in several preclinical animal models of human
neuropathic pain [Satkunanathan et al., 2005. Alpha conotoxin Vc1.1 alleviates
neuropathic pain and accelerates functional recovery of injured neurons. Brain.
Res. 1059, 149-158]. ACV1 may act as an analgesic by decreasing ectopic
excitation in sensory nerves. In addition ACV1 appears to accelerate the recovery
of injured nerves and tissues.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 16979678 [PubMed - indexed for MEDLINE]

981: Med Lett Drugs Ther. 2006 Sep 11;48(1243):73-4.

Herpes zoster vaccine (Zostavax).

[No authors listed]

A live attenuated varicella-zoster vaccine (Zostavax--Merck) has been approved by
the FDA for prevention of herpes zoster (HZ; zoster; shingles) in persons > or = 
60 years old. Each dose of Zostavax contains about 14 times as much
varicella-zoster virus (VZV) as Varivax, which has been used in the US since 1995
to vaccinate against varicella (chicken pox).

PMID: 16977285 [PubMed - indexed for MEDLINE]

982: J Virol. 2006 Dec;80(23):11806-16. Epub 2006 Sep 13.

ORF66 protein kinase function is required for T-cell tropism of varicella-zoster 
virus in vivo.

Schaap-Nutt A, Sommer M, Che X, Zerboni L, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, 300 Pasteur
Drive, Stanford, CA 94305-5208, USA. anne.s.nutt@gmail.com

Several functions have been attributed to the serine/threonine protein kinase
encoded by open reading frame 66 (ORF66) of varicella-zoster virus (VZV),
including modulation of the apoptosis and interferon pathways, down-regulation of
major histocompatibility complex class I cell surface expression, and regulation 
of IE62 localization. The amino acid sequence of the ORF66 protein contains a
recognizable conserved kinase domain. Point mutations were introduced into
conserved protein kinase motifs to evaluate their importance to ORF66 protein
functions. Two substitution mutants were generated, including a G102A
substitution, which blocked autophosphorylation and altered IE62 localization,
and an S250P substitution, which had no effect on either autophosphorylation or
IE62 localization. Both kinase domain mutants grew to titers equivalent to
recombinant parent Oka (pOka) in vitro. pOka66G102A had slightly reduced growth
in skin, which was comparable to the reduction observed when ORF66 translation
was prevented by stop codon insertions in pOka66S. In contrast, infection of
T-cell xenografts with pOka66G102A was associated with a significant decrease in 
infectious virus production equivalent to the impaired T-cell tropism found with 
pOka66S infection of T-cell xenografts in vivo. Disrupting kinase activity with
the G102A mutation did not alter IE62 cytoplasmic localization in VZV-infected T 
cells, suggesting that decreased T-cell tropism is due to other ORF66 protein
functions. The G102A mutation reduced the antiapoptotic effects of VZV infection 
of T cells. These experiments indicate that the T-cell tropism of VZV depends
upon intact ORF66 protein kinase function.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16971426 [PubMed - indexed for MEDLINE]

983: J Clin Virol. 2006 Oct;37(2):118-23. Epub 2006 Sep 12.

Changes in seroprevalence to four herpesviruses over 30 years in Swedish children
aged 9-12 years.

Svahn A, Berggren J, Parke A, Storsaeter J, Thorstensson R, Linde A.

Department of Virology, Swedish Institute for Infectious Disease Control, Solna, 
Sweden. anita.svahn@swipnet.se

BACKGROUND: Changing social conditions and life-styles in Sweden may have
affected the spread of varicella-zoster virus (VZV), herpes simplex virus (HSV), 
cytomegalovirus (CMV), and Epstein-Barr virus (EBV). OBJECTIVES: To study
possible changes over 30 years in prevalence of antibodies against VZV, HSV, CMV,
and EBV in Swedish children, using modern serological methods. STUDY DESIGN:
Serum samples from 819 Swedish children who were 9-12 years old in 1967-1968, in 
1977-1978 (two cohorts), and in 1997, respectively, were examined. IgG antibodies
against VZV, HSV, and CMV were measured by well validated enzyme-linked
immunosorbent assays and against EBV by indirect immunoflourescense. RESULTS: The
seropositivity for VZV for 9-12 years old children was 50% in 1967-1968, 74-82%
in 1977-1978, and 98% in 1997. The corresponding figures were 31%, 53%, 50%, and 
58% for CMV, 35%, 35%, 32%, and 38% for HSV, and 64% in 1967-1968 and in
1977-1978 (both cohorts), and 62% in 1997 for EBV. CONCLUSIONS: The
seroprevalence for VZV increased significantly from 1967-1968 to 1997, and there 
was also a significant but smaller increase in the CMV seroprevalence, while
seroprevalence to HSV and EBV remained relatively stable.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16971177 [PubMed - indexed for MEDLINE]

984: Arch Neurol. 2006 Sep;63(9):1327.

Abdominal pseudohernia caused by herpes zoster truncal D12 radiculoneuropathy.

Mancuso M, Virgili MP, Pizzanelli C, Chiari A, Geri G, Michelassi MC, Galli R.

Unit of Neurophysiopathology, Hospital Lotti, 56126 Pontedera, Italy.
mmancuso@inwind.it

Publication Types: 
    Case Reports

PMID: 16966515 [PubMed - indexed for MEDLINE]

985: Ann Oncol. 2006 Sep;17(9):1424-7.

High incidence of non-neutropenic infections induced by rituximab plus
fludarabine and associated with hypogammaglobulinemia: a frequently unrecognized 
and easily treatable complication.

Cabanillas F, Liboy I, Pavia O, Rivera E.

Auxilio Mutuo Cancer Center, Hospital Auxilio Mutuo, San Juan, Puerto Rico.
fcabanil@mdanderson.org

BACKGROUND: Rituximab is associated with low incidence of hypogammaglobulinemia
and little morbidity. Our experience with the combination of rituximab +
chemotherapy suggested the opposite. PATIENTS AND METHODS: We analyzed our
experience with rituximab plus chemotherapy in 97 patients to determine:
frequency and type of non-neutropenic infection (NNI); frequency and type of
hypogammaglobulinemia; response to gammaglobulin therapy; and factors associated 
with NNI. RESULTS: We observed 40 episodes of NNI in 19 of 97 (20%) patients. By 
3 years, 43% of patients treated with rituximab + chemotherapy were projected to 
have developed at least one NNI. Of 19 with NNI, 15 had Ig levels studied and all
15 had hypogammaglobulinemia. Most frequently affected Ig were IgG (14 of 15) and
IgM (13 of 14). IgA was usually spared (six of 14 cases affected). NNIs observed 
were 18 bronchitis, 16 sinusitis, four pneumonias, three otitis media, two fevers
of unknown origin (FUOs) and three herpes zoster. Hospitalization was required in
seven of 19. Ten received gammaglobulin infusions and all responded promptly.
Gammaglobulin was given only when NNIs recurred. We examined sex, age, histology,
type of rituximab-chemotherapy (fludarabine + rituximab versus other chemotherapy
+ rituximab) for correlation with NNI. CONCLUSIONS: Indolent histology, female
sex and fludarabine + rituximab significantly correlated with frequency of NNI
but multivariate analysis picked fludarabine + rituximab followed by female
gender as the only two independent variables predictive of NNI.

Publication Types: 
    Evaluation Studies

PMID: 16966368 [PubMed - indexed for MEDLINE]

986: Mol Cell Probes. 2007 Feb;21(1):24-30. Epub 2006 Jul 29.

Development of an internally controlled, homogeneous polymerase chain reaction
assay for the simultaneous detection and discrimination of herpes simplex virus
types 1 and 2 and varicella-zoster virus.

Hobson-Peters J, O'loughlin P, Toye P.

Research Department, AGEN Biomedical Limited, P.O. Box 391, Acacia Ridge Q 4110, 
Australia.

Homogeneous polymerase chain reaction (PCR) technology is being used increasingly
in the diagnosis of infectious disease. The sensitivity and specificity of PCR is
being coupled to the ease-of-use and multiplexing capacity of homogeneous
methodologies to provide rapid and accurate differential diagnoses. This
technology is applicable to the diagnosis of infections with the human herpes
viruses, herpes simplex virus 1 (HSV 1), HSV 2 and varicella-zoster virus (VZV). 
Our aim was to develop and evaluate a homogeneous PCR assay which combines the
following features: the assay can detect and distinguish HSV types 1 and 2 and
VZV, can be performed on untreated clinical samples, contains internal control
reagents to monitor for inhibitors in the sample and allows automatic assignment 
of viral genotypes. Primers and probes specific for HSV and VZV genes were
combined and optimized in a multiplex PCR. An internal control was designed which
allowed use of the VZV primers and a human factor V gene DNA template. The assay 
was evaluated on an initial cohort of 66 clinical swab samples, with results
determined by visual inspection of melt curves. Parameters obtained from this
study were used to assign genotypes automatically to a second group of 85
clinical swab samples. Optimization of reagents produced melt curve peaks of
sufficient height and symmetry for automatic genotype assignment. In the initial 
cohort of 66 samples, 63 returned concordant results, one sample produced an
aberrant peak due to sequence variation and the remaining two samples were
positive on re-test. Automatic genotype assignment of the second group of 85
samples resulted in correct identification of 79 samples, with two further
aberrant peaks, and two samples positive on retest. The development of this assay
should facilitate the rapid detection of herpes viruses from clinical swab
samples.

PMID: 16963223 [PubMed - indexed for MEDLINE]

987: J Pediatr Health Care. 2006 Sep-Oct;20(5):300-3.

Herpes zoster in childhood.

Leung AK, Robson WL, Leong AG.

Department of Pediatrics, University of Calgary, Alberta, Canada.

Herpes zoster is caused by reactivation of latent varicella-zoster virus that
resides in a dorsal root ganglion. Herpes zoster can develop any time after a
primary infection. Because varicella vaccine is a live attenuated virus, herpes
zoster can develop in a vaccine recipient. The incidence of herpes zoster among
vaccine recipients is about 14 cases per 100,000 person-years. In young children,
herpes zoster has a predilection for areas supplied by the cervical and sacral
dermatomes. The most common complications are secondary bacterial infection,
depigmentation, and scarring. Although the diagnosis of herpes zoster is based on
a distinct clinical appearance, viral DNA analysis of the lesion by polymerase
chain reaction or restriction fragment length polymorphism is necessary to
differentiate wild from vaccine-type viruses. Acyclovir is the treatment of
choice for herpes zoster.

Publication Types: 
    Review

PMID: 16962434 [PubMed - indexed for MEDLINE]

988: Dermatol Online J. 2006 Sep 8;12(5):3.

Zosteriform lichen planus.

Perry D, Fazel N.

University of California Davis, Department of Dermatology, USA.

A 95-year-old woman presented with a 4-month history of a pruritic eruption
involving her trunk, medial thighs, and lesions limited to the C5 dermatome of
the left upper extremity. Punch biopsy supported a clinical diagnosis of
zosteriform lichen planus. Linear lichen planus refers to lichen planus with a
unilateral linear distribution. This variant may present as an example of the
Wolf isotopic response, or more rarely, a de novo eruption on previously-normal
skin. In very rare instances linear lichen planus presents in a segmental fashion
corresponding to a dermatome and is termed zosteriform lichen planus.

Publication Types: 
    Case Reports

PMID: 16962018 [PubMed - indexed for MEDLINE]

989: Ann Intern Med. 2006 Sep 5;145(5):386-7.

Comment on:
    Ann Intern Med. 2006 Sep 5;145(5):317-25.

Shingles vaccine: effective and costly or cost-effective?

Koplan JP, Harpaz R.

Publication Types: 
    Comment
    Editorial

PMID: 16954362 [PubMed - indexed for MEDLINE]

990: Ann Intern Med. 2006 Sep 5;145(5):317-25.

Comment in:
    Ann Intern Med. 2006 Sep 5;145(5):386-7.

Summary for patients in:
    Ann Intern Med. 2006 Sep 5;145(5):I14.

Cost-effectiveness of a vaccine to prevent herpes zoster and postherpetic
neuralgia in older adults.

Hornberger J, Robertus K.

SPHERE Institute and Acumen LLC, Burlingame, California 94010, USA.
jhornberger@acumen-llc.com

BACKGROUND: The Shingles Prevention Study showed that a varicella-zoster virus
(VZV) vaccine administered to adults 60 years of age or older reduced the
incidence of herpes zoster from 11.12 to 5.42 cases per 1000 person-years. Median
follow-up was 3.1 years, and relative risk reduction was 51.3% (95% CI, 44.2% to 
57.6%). OBJECTIVE: To assess the extent to which clinical and cost variables
influence the cost-effectiveness of VZV vaccination for preventing herpes zoster 
in immunocompetent older adults. DESIGN: Decision theoretical model. DATA
SOURCES: English-language data published to March 2006 identified from MEDLINE on
herpes zoster rates, vaccine effectiveness, quality of life, medical resource
use, and unit costs. Target Population: Immunocompetent adults 60 years of age or
older with a history of VZV infection. Time Horizon: Lifetime. Perspective: U.S. 
societal. Interventions: Varicella-zoster virus vaccination versus no
vaccination. Outcome Measures: Incremental quality-adjusted survival and cost per
quality-adjusted life-year (QALY) gained. Results of Base-Case Analysis: By
reducing incidence and severity of herpes zoster, vaccination can increase
quality-adjusted survival by 0.6 day compared with no vaccination. One scenario
in which vaccination costs less than 100,000 dollars per QALY gained is when 1)
the unit cost of vaccination is less than 200 dollars, 2) the age at vaccination 
is less than 70 years, and 3) the duration of vaccine efficacy is more than 30
years. Results of Sensitivity Analysis: Vaccination would be more cost-effective 
in "younger" older adults (age 60 to 64 years) than in "older" older adults (age 
> or =80 years). Longer life expectancy and a higher level of vaccine efficacy
offset a lower risk for herpes zoster in the younger group. Other factors
influencing cost-effectiveness include quality-of-life adjustments for acute
zoster, unit cost of the vaccine, risk for herpes zoster, and duration of vaccine
efficacy. LIMITATIONS: The effectiveness of VZV vaccination remains uncertain
beyond the median 3.1-year duration of follow-up in the Shingles Prevention
Study. CONCLUSIONS: Varicella-zoster virus vaccination to prevent herpes zoster
in older adults would increase QALYs compared with no vaccination. Resolution of 
uncertainties about the average quality-of-life effects of acute zoster and the
duration of vaccine efficacy is needed to better determine the cost-effectiveness
of zoster vaccination in older adults.

PMID: 16954357 [PubMed - indexed for MEDLINE]

991: Ann Intern Med. 2006 Sep 5;145(5):I14.

Original report in:
    Ann Intern Med. 2006 Sep 5;145(5):317-25.

Summaries for patients. Cost-effectiveness of a vaccine to prevent herpes zoster 
(shingles) in older adults.

[No authors listed]

Publication Types: 
    Patient Education Handout

PMID: 16954354 [PubMed - indexed for MEDLINE]

992: J Clin Microbiol. 2006 Sep;44(9):3094-7.

Serological detection of varicella-zoster virus-specific immunoglobulin G by an
enzyme-linked immunosorbent assay using glycoprotein antigen.

Sauerbrei A, Wutzler P.

Institute of Virology and Antiviral Therapy, University Clinic of Jena, Postfach,
Hans-Knoell-Strasse 2, D-07745 Jena, Germany. Andreas.Sauerbrei@med.uni-jena.de

Since the introduction of varicella vaccination in several countries, there has
been an urgent need for commercially available test procedures that allow highly 
sensitive and specific quantitative determination of the varicella-zoster virus
(VZV)-specific immune status, including immunity postimmunization. This study
compared the performance of two enzyme-linked immunosorbent assays (ELISAs) for
the sensitive and specific determination of VZV-specific immunoglobulin G (IgG)
in seronegative and latently infected persons, as well as in vaccinees. One ELISA
is based on the detection of antibody to VZV-specific envelope glycoproteins
(gp), and the other comprises the whole antigen extract prepared from
VZV-infected cells. A modified standard fluorescent-antibody-to-membrane-antigen 
(FAMA) assay was used as a reference. An excellent sensitivity (100%) in relation
to FAMA was demonstrated for the gpELISA (Virion\Serion), while the non-gpELISA
(Dade Behring) had a lower sensitivity (83%) when sera from latently infected
persons were tested. After postvaccinal immunity was measured, a sensitivity of
87% was achieved with gpELISA, whereas the ELISA incorporating antigen extract of
VZV-infected cells had a sensitivity of 78%. Excellent specificity (100%) was
calculated for both the gpELISA and the non-gpELISA. In conclusion, SERION ELISA 
classic VZV IgG is useful for the sensitive and specific quantitative
determination of VZV immune status after natural infection. The test can also be 
recommended for measuring antibody response after varicella vaccination,
particularly after the cutoff value was optimized.

Publication Types: 
    Comparative Study
    Evaluation Studies

PMID: 16954232 [PubMed - indexed for MEDLINE]

993: Nursing. 2006 Sep;36(9):25-6.

Heading off the pain of postherpetic neuralgia.

D'Arcy Y.

Pain Management and Palliative Care, Suburban Hospital, Bethesda, MD, USA.

PMID: 16951600 [PubMed - indexed for MEDLINE]

994: Photodermatol Photoimmunol Photomed. 2006 Oct;22(5):232-7.

Broad-band ultraviolet B phototherapy in zoster patients may reduce the incidence
and severity of postherpetic neuralgia.

Jalali MH, Ansarin H, Soltani-Arabshahi R.

Department of Dermatology, Hazrat-e Rasool University Hospital, Iran University
of Medical Sciences, Tehran, Iran.

BACKGROUND: Postherpetic neuralgia (PHN) is one of the common complications of
herpes zoster infection, particularly in the elderly. Current therapeutic
measures are only partially effective in the affected patients. As inflammatory
mediators released by different cells play an important role in the pathogenesis 
of this neuropathic pain and with regard to the immunomodulatory effects of
ultraviolet B (UVB) spectrum, we presumed that UVB phototherapy might be
effective in the prevention of PHN. METHOD: This study was performed in two
phases. Phase I was a prospective open controlled trial. Twenty-five patients
with severe pain in the first 7 days of zoster rash were divided into two groups:
the prevention group (n=12) received oral acyclovir (800 mg five times a day for 
10 days) plus broad-band UVB to the affected dermatomes, starting with 20
mJ/cm(2) and gradually increasing the dose by 10 mJ/cm(2) each session to a
maximum dose of 100 mJ/cm(2). Treatment sessions were repeated three times a week
until pain relief or to a maximum of 15 sessions. The control group (n=13), who
had disease characteristics similar to the prevention group, received only oral
acyclovir with the same dose. All patients reported their severity of pain on a
verbal rating scale (VRS, score 0-4) before treatment and at 1 and 3 months'
follow-up. In phase II of the study, five patients with established PHN (more
than 3 months after rash onset) received UVB with the above-mentioned protocol.
RESULTS: A total of 17 patients older than 40 (10 females, seven males; mean age,
65.5 years; range: 47-82 years) who had intractable pain due to zoster infection 
received UVB in two phases of the study. In patients who received phototherapy in
the first 7 days of rash, 58.33% and 83.33% were completely pain free at 1-and
3-month follow-up, respectively. The corresponding figure in the control group
was significantly lower (38.46% at 1 month and 53.85% at 3 months). The severity 
of pain was also lower in the phototherapy group than the control group (mean VRS
2.50 vs. 3.28 at 3 months). None of the patients who were treated more than 3
months after rash onset (established PHN) experienced significant (more than 50%)
pain relief. CONCLUSION: UVB phototherapy in the acute stage of zoster rash might
reduce the incidence and severity of PHN. Treatment after 3 months does not seem 
to have a significant beneficial effect.

Publication Types: 
    Controlled Clinical Trial

PMID: 16948824 [PubMed - indexed for MEDLINE]

995: S D Med. 2006 Aug;59(8):349-50.

Shingles vaccine: who should get it?

Johnson AM.

South Dakota State University, VA Medical Center, Sioux Falls, USA.

PMID: 16941852 [PubMed - indexed for MEDLINE]

996: Yonsei Med J. 2006 Aug 31;47(4):475-9.

Epstein-Barr virus antibodies in Kawasaki disease.

Lee SJ, Lee KY, Han JW, Lee JS, Whang KT.

Department of Pediatrics, The Catholic University of Korea, Seoul, Korea.
leekyungyil@catholic.ac.kr.

The prevalent ages at onset for Kawasaki Disease (KD) and Epstein-Barr virus
(EBV) infection are known to be similar in Korea and Japan. We evaluated the
correlation between EBV infection and KD. The antibodies to EBV such as
anti-viral capsid antigen (VCA) IgG and IgM, anti-diffuse and restricted early
antigen IgG (anti-EADR IgG), and the anti-EBV determined nuclear antigen IgG
(anti-EBNA IgG) were examined in 29 KD patients at five separate times
sequentially during a period of one year, and also in 14 other children with a
past history of KD. The results of each group were compared with those of
age-matched controls. The positive rates of anti-VCA IgG and IgM at presentation 
in the KD patients were 41.4% (12/29) and 0% (0/29), respectively. Only one
patient was found to be anti-VCA IgM-positive within two months. There were no
cases of anti-VCA IgG except one, anti-EADR IgG and anti-EBNA IgG positive to
negative seroconversion during the year. The children with a past history of KD
showed higher anti-EBNA IgG-positive rates than the controls (p=0.04). There was 
no difference in the seropositive rates of the antibodies to EBV,
cytomegalovirus, herpes simplex virus and herpes zoster virus. In conclusion,
children with KD were noted to have normal immune responses to EBV infection.
Children with a past history of KD seemed to be infected with EBV at a later age 
than children with no history of KD.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16941735 [PubMed - indexed for MEDLINE]

997: Int J Toxicol. 2006 Sep-Oct;25(5):313-7.

The case against universal varicella vaccination.

Goldman GS.

Medical Veritas International Inc., Pearblossom, California 93553, USA.
pearblossominc@aol.com

In 1995, the United States became the first country to implement a Universal
Varicella Vaccination Program. Several questions remain: Is the varicella
(chickenpox) vaccine needed? Is it cost effective as a routine immunization for
all susceptible children? Or is it more beneficial for the disease to remain
endemic so that adults may receive periodic exogenous exposures (boosts) that
help suppress the reactivation of herpes zoster (shingles). In addition, as
vaccination coverage becomes widespread, does loss of immunologic boosting cause 
a decline in vaccine efficacy and result in a reduced period of immunity?
Scientific literature regarding safety of the varicella vaccine and its
associated cost-benefit analysis have often reported optimistic evaluations based
on ideal assumptions. Deleterious outcomes and their associated costs must be
included when making a circumspect assessment of the Universal Varicella
Vaccination Program.

PMID: 16940003 [PubMed - indexed for MEDLINE]

998: J Laryngol Otol. 2006 Sep;120(9):745-8.

Delayed facial nerve palsy following tympano-mastoid surgery: incidence,
aetiology and prognosis.

Safdar A, Gendy S, Hilal A, Walshe P, Burns H.

Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin,
Republic of Ireland. adnan_safdar@hotmail.com

OBJECTIVE: To establish the frequency of occurrence of delayed facial nerve
paralysis following tympano-mastoid surgery in our department and to determine
the aetiological factors and long term prognosis. SETTING: Tertiary care academic
centre. MATERIALS AND METHODS: A retrospective review of all patients who had
undergone tympano-mastoid surgery in our department over the previous five years 
was carried out. A total of 219 patients were included in the study. Only two
patients were identified as having delayed onset facial nerve palsy over this
period of time. The patients' medical records were reviewed and the patients
clinically assessed. RESULTS: The frequency of delayed onset facial nerve palsy
following tympano-mastoid surgery in our series was 0.91 per cent. Facial
weakness set in on day eight and day 14 in the two patients. Serological
investigations in both patients revealed raised titres of immunoglobulin (Ig) M
and IgG to varicella-zoster virus, confirming the presence of varicella-zoster
infection. In our experience, the combined use of prednisone and acyclovir was an
effective form of treatment for both patients, whose facial nerve function fully 
recovered within six months of onset. CONCLUSION: The incidence of delayed facial
nerve palsy following tympano-mastoid surgery is low. It can occur up to two
weeks after the surgery. Our two cases confirm viral reactivation to be an
important aetiological factor in the development of delayed onset facial nerve
palsy. The overall prognosis for delayed facial nerve palsy following
tympano-mastoid surgery appears to be good.

PMID: 16939665 [PubMed - indexed for MEDLINE]

999: Br J Nurs. 2006 Aug 10-Sep 13;15(15):814-8.

Managing pain after shingles: a nursing perspective.

Hawksley H.

Chronic Pain Management Services, Chronic Pain Management Department, Ashford and
St Peter's Hospitals NHS Trust, Chertsey, Surrey.

Post-herpetic neuralgia (PHN) is the neuropathic pain syndrome that may develop
following an attack of shingles. While for many the symptoms subside, there can
be long-term pain problems for up to 40% of those affected with PHN, and for 3%
of these, symptoms can be severe (Dworkin and Portenoy, 1996). Knowledge and
understanding of the symptoms and various treatments and approaches available is 
important to enable nurses and patients to work together in partnership to
achieve the best outcomes. Realizing that more than one approach may be needed
can allow for treatments which are complementary and for optimization of both
biomedical and self-care approaches.

Publication Types: 
    Review

PMID: 16936604 [PubMed - indexed for MEDLINE]

1000: Ann Rheum Dis. 2007 Feb;66(2):228-34. Epub 2006 Aug 25.

Selective costimulation modulation using abatacept in patients with active
rheumatoid arthritis while receiving etanercept: a randomised clinical trial.

Weinblatt M, Schiff M, Goldman A, Kremer J, Luggen M, Li T, Chen D, Becker JC.

Rheumatology and Immunology, Brigham and Women's Hospital, 75 Francis Street,
Boston, MA 02115, USA. mweinblatt@partners.org

OBJECTIVE: To investigate the efficacy and safety of abatacept in combination
with etanercept in patients with active rheumatoid arthritis during a 1-year,
randomised, placebo-controlled, double-blind phase, followed by an open-label,
long-term extension (LTE). METHODS: Patients continued etanercept (25 mg twice
weekly) and were randomised to receive abatacept 2 mg/kg (n = 85) or placebo (n =
36). As the effective dose of abatacept was established as 10 mg/kg in a separate
trial, all patients received abatacept 10 mg/kg and etanercept during the LTE.
RESULTS: A total of 121 patients were randomised; 80 completed double-blind
treatment and entered the LTE. During double-blind treatment, the difference in
the percentage of patients achieving the primary end point (modified American
College of Rheumatology (ACR) 20 response at 6 months) was not significant
between groups (48.2% v 30.6%; p = 0.072). At 1 year, no notable changes in
modified ACR responses were observed. Subsequent to the dosing change, similar
modified ACR responses were seen during the LTE. Significant improvements in
quality of life were observed with abatacept and etanercept versus placebo and
etanercept in five of the eight short-form 36 subscales at 1 year. More abatacept
and etanercept-treated patients experienced serious adverse events (SAEs) at 1
year than patients receiving placebo and etanercept (16.5% v 2.8%), with 3.5% v
0% experiencing serious infections. CONCLUSION: The combination of abatacept (at 
a dose of 2 mg/kg during the double-blind phase and 10 mg/kg during the LTE) and 
etanercept was associated with an increase in SAEs, including serious infections,
with limited clinical effect. On the basis of the limited efficacy findings and
safety concerns, abatacept in combination with etanercept should not be used for 
rheumatoid arthritis treatment.

Publication Types: 
    Clinical Trial, Phase II
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 16935912 [PubMed - indexed for MEDLINE]

1001: Am J Ophthalmol. 2006 Sep;142(3):393-9.

Herpes zoster ophthalmicus in otherwise healthy children.

De Freitas D, Martins EN, Adan C, Alvarenga LS, Pavan-Langston D.

Department of Ophthalmology, Federal University of Sao Paulo, SP, Rua Botucatu,
Sao Paulo, Brazil.

PURPOSE: To evaluate the complications of herpes zoster ophthalmicus (HZO) in
children. DESIGN: Prospective-observational case series. METHODS: Ten healthy
patients (five boys, five girls) with HZO were prospectively followed. Data
regarding best-corrected visual acuity, biomicroscopy, intraocular pressure,
corneal sensitivity, and funduscopy were collected. The median duration of
follow-up was 19 months (range eight to 78 months). RESULTS: The mean age at
presentation was 8.7 years (range two to 14 years +/-3.95). At last visit, two
patients (20%) had decreased visual acuity and nine (90%) had some degree of
abnormal corneal sensitivity and corneal opacity despite good final visual
acuity. CONCLUSION: In general, HZO seems to have a good prognosis in healthy
children; nonetheless, some cases can present severe eye complications causing
visual loss.

PMID: 16935582 [PubMed - indexed for MEDLINE]

1002: Arch Virol. 2006 Dec;151(12):2495-501. Epub 2006 Aug 21.

Ionic Contra-Viral Therapy (ICVT); a new approach to the treatment of DNA virus
infections.

Hartley C, Hartley M, Pardoe I, Knight A.

Henderson Morley Plc, Moseley, Birmingham, UK. ch@henderson-morley.com

The sequestration of cellular K(+) has been shown elsewhere to elicit a broad
spectrum of antiviral activity. The obligatory, coupled cotransports of Na(+),
K(+) and Cl(-) (NKCC1) and of Na(+) and K(+) (NKATPase) effect net cellular K(+) 
influx. We examined the effects of specific inhibitors of these transports; a
cardiac glycoside (Digoxin) and a loop diuretic (Furosemide) on virus replication
in vitro. The replication of the DNA viruses, herpes simplex virus, varicella
zoster virus, human cytomegalovirus and adenovirus was inhibited. There was
normal replication of the RNA virus encephalomyocarditis virus. Antiviral
activities of both drugs were influenced by extracellular K(+). Antiviral effects
were most potent when Digoxin and Furosemide were used in combination. Targeting 
the host cell in this way is fundamentally different to other antiviral drug
developments to date and we propose the descriptive term Ionic Contra Viral
Therapy (ICVT) for the purpose of definition. We believe that specific inhibitors
of coupled K(+) transports merit controlled clinical trial for a broad spectrum
of DNA virus infections by local application.

PMID: 16932984 [PubMed - indexed for MEDLINE]

1003: Nat Clin Pract Neurol. 2006 Jun;2(6):298-9.

Does acute pain associated with herpes zoster respond to treatment with
gabapentin?

Moulin D.

Department of Clinical Neurological Sciences, University of Western Ontario,
London, ON, Canada. dwight.moulin@lhsc.on.ca

PMID: 16932569 [PubMed - indexed for MEDLINE]

1004: Nat Clin Pract Neurol. 2005 Nov;1(1):18-9.

Comment on:
    N Engl J Med. 2005 Jun 2;352(22):2271-84.

Can vaccinating older adults against varicella zoster virus prevent herpes zoster
and postherpetic neuralgia?

Steiner I.

Department of Neurology, Hadassah University Hospital, Jerusalem, Israel.
isteiner@md2.huji.ac.il

Publication Types: 
    Comment

PMID: 16932487 [PubMed]

1005: J Virol. 2006 Nov;80(21):10871-3. Epub 2006 Aug 23.

Pseudorabies virus EP0 protein counteracts an interferon-induced antiviral state 
in a species-specific manner.

Brukman A, Enquist LW.

Department of Molecular Biology, Princeton University, Princeton, NJ 08544, USA.

Pseudorabies virus (PRV), an alphaherpesvirus related to herpes simplex virus
type 1 and varicella-zoster virus, infects a broad host range of mammals. A
striking characteristic of PRV infection is the different symptoms and outcomes
of infection in natural and nonnatural hosts. Adult pigs, the natural hosts of
PRV, survive infection with only mild respiratory symptoms, while nonnatural
hosts, including rodents and cattle, invariably die after exhibiting neurological
symptoms. Here, we show that the PRV EP0 protein is necessary to overcome an
interferon-mediated antiviral response in primary cells from the natural host of 
PRV but is not necessary in nonnatural-host cells.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 16928746 [PubMed - indexed for MEDLINE]

1006: Clin J Oncol Nurs. 2006 Aug;10(4):463-4.

Rash: is it shingles?

Marrs JA.

Hematology and Oncology Associates, Dayton, Ohio, USA. joycemrn@sbcglobal.net

CASE PRESENTATION: Mrs. Smith, a 56-year-old Caucasian woman, was seen in the
office for complaints of a rash at her waist. She completed three cycles of
dose-dense cyclophosphamide and doxorubicin chemotherapy for stage III breast
cancer. The third cycle was 10 days prior. Grade III neutropenia was the only
complete blood count abnormality.

Publication Types: 
    Case Reports

PMID: 16927898 [PubMed - indexed for MEDLINE]

1007: J Med Virol. 2006 Oct;78(10):1325-40.

Microarray assay for detection and discrimination of Orthopoxvirus species.

Ryabinin VA, Shundrin LA, Kostina EB, Laassri M, Chizhikov V, Shchelkunov SN,
Chumakov K, Sinyakov AN.

State Research Center of Virology and Biotechnology Vector, Novosibirsk Region,
Kol'tsovo, Russia.

A microarray method was developed for simultaneous detection and identification
of six species of Orthopoxvirus (OPV) including Variola, Monkeypox, Cowpox,
Camelpox, Vaccinia, and Ectromelia viruses. The method allowed us to discriminate
OPV species from varicella-zoster virus (VZV), Herpes Simplex 1 virus (HSV-1),
and Herpes Simplex 2 virus (HSV-2) that cause infections with clinical
manifestations similar to OPV infections. The nucleotide sequences of the
C23L/B29R and the B19R genes identified for 86 and 72 different OPV strains,
respectively, were used to design species-specific microarray oligonucleotide
probes (oligoprobes). The microarray also contained several oligoprobes selected 
from the ORF31, US4, and US5 genes of VZV, HSV-1, and HSV-2, respectively. The
samples (from HSVs or OPVs) of ssDNAs for analyses were prepared by using
asymmetric PCR followed by chemical labeling of ssDNA with Cy3 dye. DNA from 52
samples of various OPV species, two isolates of VZV, two of HSV-1, and three of
HSV-2 were tested using the developed microarray assay; all tested viruses were
accurately identified. To ensure the robustness of the microarray assay, three
additional unrelated variola virus strains with unknown sequences of the
C23L/B29R and the B19R genes were tested. In each instance the microarray
unambiguously identified them as Variola virus species. The results obtained in
this study demonstrated that this new microarray method is a valuable tool for
the rapid and accurate detection and differentiation of these important viral
pathogens.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16927285 [PubMed - indexed for MEDLINE]

1008: J Microbiol Immunol Infect. 2006 Aug;39(4):310-5.

Opportunistic infections in adults with acquired immunodeficiency syndrome: a
comparison of clinical and autopsy findings.

Tang HJ, Liu YC, Yen MY, Chen YS, Wann SR, Lin HH, Lee SS, Lin WR, Huang CK, Su
BA, Chang PC, Li CM, Tseng HH.

Section of Infectious Diseases, Department of Internal Medicine, Chi-Mei Medical 
Center, Tainan, Taiwan.

BACKGROUND AND PURPOSE: Many opportunistic infections causing death in acquired
immunodeficiency syndrome (AIDS) patients are often not diagnosed prior to death.
The objective of this study was to compare the premortem and postmortem diagnoses
of opportunistic infections and tumors among 15 AIDS patients treated in a
hospital in southern Taiwan. METHODS: Total autopsy (brain, chest and abdominal
cavity) was performed in 2 patients, and partial autopsy in 13. RESULTS:
Pneumocystis carinii pneumonia, candidiasis, lymphoma, Kaposi's sarcoma,
toxoplasmosis and salmonellosis were more commonly diagnosed before death than at
autopsy. By contrast, cytomegalovirus (CMV) infections and herpes simplex virus
or varicella-zoster virus infections were more frequently diagnosed at postmortem
examinations than prior to death. CONCLUSIONS: In conclusion, this study found
substantial discrepancies between autopsy findings and premortem clinical
diagnoses in AIDS patients, especially for CMV infection.

PMID: 16926977 [PubMed - indexed for MEDLINE]

1009: Dent Update. 2006 Jul-Aug;33(6):378.

Comment on:
    Dent Update. 2006 May;33(4):252.

Physical signs for the general dental practitioner: case 34, Herpes zoster (Dent 
Update 2006; 33: 252).

Hodges S.

Publication Types: 
    Comment
    Letter

PMID: 16924733 [PubMed - indexed for MEDLINE]

1010: Arch Dermatol. 2006 Aug;142(8):1069.

Comment on:
    Arch Dermatol. 2006 Feb;142(2):264.

A unique pattern of hyperhidrosis and herpes zoster.

Wu JJ, Murase JE, Huang DB, Tyring SK.

Publication Types: 
    Comment
    Letter

PMID: 16924065 [PubMed - indexed for MEDLINE]

1011: Health News. 2006 Aug;12(8):2.

Shingles vaccine gets the FDA nod.

[No authors listed]

Publication Types: 
    News

PMID: 16917965 [PubMed - indexed for MEDLINE]

1012: Am J Health Syst Pharm. 2006 Sep 1;63(17):1582-4.

Erratum in:
    Am J Health Syst Pharm. 2006 Nov 1;63(21):2044.

Vaccination not just for kids anymore, experts say.

Traynor K.

Publication Types: 
    News

PMID: 16914623 [PubMed - indexed for MEDLINE]

1013: An Med Interna. 2006 May;23(5):249-50.

[Acute cerebellar ataxia in an adult]

[Article in Spanish]

Campos Franco J, Rodriguez Framil M, Martinez Rey C, Pose Reino A.

Publication Types: 
    Case Reports
    Letter

PMID: 16913074 [PubMed - indexed for MEDLINE]

1014: Oral Dis. 2006 Sep;12(5):500-5.

Herpes zoster in HIV infection with osteonecrosis of the jaw and tooth
exfoliation.

Siwamogstham P, Kuansuwan C, Reichart PA.

Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.

BACKGROUND: Herpes zoster (HZ) infection of the trigeminal nerve is associated
with complications such as postherpetic neuralgia, facial scarring, loss of
hearing ability and conjunctivitis. Until 2005, postherpetic alveolar necrosis
and spontaneous tooth exfoliation have been described in 20 cases unrelated to
HIV infection. OBJECTIVE: The aim of this study was to describe HIV infection in 
patients (two women, two men, average age 30 years) who suffered from HZ attacks 
to their trigeminal nerves. MAIN OUTCOME MEASURES: None of the patients had
received antiherpetic medications or antiretroviral therapy. HIV infection was
only diagnosed after the development of HZ. Facial scarring with depigmentation
and hyperesthesia (postherpetic neuralgia) was diagnosed in all four patients.
Oral findings consisted of spontaneous loss of both maxillary or mandibular
teeth. Osteonecrosis of varying extent was also found. Treatment consisted of
extractions of teeth and administration of antibiotics and analgesics. Healing of
alveolar wounds was unremarkable. CONCLUSION: Complications affecting the
alveolar bone and teeth seem to be rare in HIV-infected patients.

Publication Types: 
    Case Reports

PMID: 16910922 [PubMed - indexed for MEDLINE]

1015: Odontostomatol Trop. 2006 Jun;29(114):23-7.

[Oro-facial manifestations during AIDS/HIV infection. Apropos of 60 cases seen at
the Ambulatory Treatment Center in Ouagadougou and at the Yalgado University
Hospital Center]

[Article in French]

Konsem T, Ouedraogo D, Gare JV, Ouattara D, Ouoba K.

Chirurgien Maxillo-facial, CHU-YO.

The opportinistics complaints of the AIDS occur all along the episode of the
infection and depend on the individual's body immunity and on the existence or no
of an anti-retroviral treatment. The buccal appearences on the face are
relatively frequent. They are dominated by the buccal mycosis, the lymphatic
ganglion's complaints, the inflammation of gums and buccal mucous, and the tooth 
decay in our context. Some authors suggest a classification that can make easy
their study and treatment. Complaints like the herpes simplex infection, the
herpes zoster infection, are usually found during the symptomatic stage non AIDS,
whereas others like KAPOSI's disease are typical to AIDS disease. The
availlability of an anti-retroviral treatment and a specialized one strenghten
the efficiency of the reimbursement and improve the prognosis.

Publication Types: 
    English Abstract

PMID: 16910114 [PubMed - indexed for MEDLINE]

1016: Arch Ophthalmol. 2006 Aug;124(8):1135-9.

Evaluation of the SmartCycler II system for real-time detection of viruses and
Chlamydia from ocular specimens.

Kowalski RP, Thompson PP, Kinchington PR, Gordon YJ.

Charles T. Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh 
Medical Eye Center, Ophthalmology and Visual Sciences Research Center, University
of Pittsburgh School of Medicine, Pittsburgh, Pa. 15213, USA.

OBJECTIVE: To compare the SmartCycler II system (Cepheid, Sunnyvale, Calif)
results with those of standard cell culture, to compare the SmartCycler II system
results with those of a dedicated polymerase chain reaction facility, and to
establish the SmartCycler II system as a polymerase chain reaction method for
detecting viral and chlamydial DNA from ocular specimens. METHODS: True-positive 
samples (test-positive specimens based on standard testing) and true-negative
samples (test-negative specimens based on standard testing) were processed for
polymerase chain reaction using the SmartCycler II system for adenovirus, herpes 
simplex virus type 1, varicella-zoster virus, and Chlamydia trachomatis.
Sensitivity, specificity, positive predictive value, negative predictive value,
and efficiency were based on the testing of true-positive and true-negative
specimens. RESULTS: The descriptive statistics for adenovirus, herpes simplex
virus type 1, varicella-zoster virus, and C trachomatis were, respectively, as
follows: sensitivity, 85%, 98%, 100%, and 94%; specificity, 98%, 100%, 100%, and 
100%; positive predictive value, 98%, 100%, 100%, and 100%; negative predictive
value, 85%, 91%, 100%, and 98%; and efficiency, 92%, 95%, 100%, and 99%. Test
sensitivity for the SmartCycler II system was equivalent to that from a central
molecular laboratory. CONCLUSION: The descriptive statistics of the SmartCycler
II system obtained in a small laboratory were comparable to those of a central
molecular laboratory for detecting viruses and Chlamydia species.Clinical
Relevance Polymerase chain reaction has great potential in the routine diagnosis 
of ocular infections in any conventional laboratory.

Publication Types: 
    Comparative Study
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 16908816 [PubMed - indexed for MEDLINE]

1017: Clin Exp Dermatol. 2006 Sep;31(5):714-5.

Tufted angioma in site of healed herpes zoster: isotopic response.

Kim CY, Nam YH, Kim GD, Oh CW.

Publication Types: 
    Case Reports
    Letter

PMID: 16901320 [PubMed - indexed for MEDLINE]

1018: Br J Ophthalmol. 2006 Nov;90(11):1354-6. Epub 2006 Aug 9.

Effects of topical anaesthetics and fluorescein on the real-time PCR used for the
diagnosis of Herpesviruses and Acanthamoeba keratitis.

Goldschmidt P, Rostane H, Saint-Jean C, Batellier L, Alouch C, Zito E, Bourcier
T, Laroche L, Chaumeil C.

Laboratoire du Centre Hospitalier National d'Ophtalmologie des Quinze Vingts, 28 
rue de Charenton, Paris 75012, France. pablogol@aol.com

BACKGROUND: The early microbiological diagnosis of corneal infections may prevent
the condition from worsening. AIM: To study the potential interferences of
oxybuprocain and fluorescein solutions used by ophthalmologists on the
performances of the real-time polymerase chain reaction (PCR) carried out as
routine test for diagnosis of keratitis. METHODS: Quantified suspensions of
Herpes simplex virus (HSV1), Varicella zoster virus (VZV), Cytomegalovirus (CMV) 
and Acanthamoeba with and without oxybuprocain or fluorescein added before DNA
extraction were tested by real-time PCR. RESULTS: The capacities of the real-time
PCR to detect HSV, VZV, CMV and Acanthamoeba were reduced by oxybuprocain and
fluorescein. Both products diluted to 1/16 reduced the PCR detection capacities
for more than 2 logs (DNA copies/sample). CONCLUSIONS: The simultaneous
introduction of fluorescein or topical anaesthetics into the tubes containing the
specimens to be tested by PCR may lead to false negative results. Because corneal
specimens for microbiological diagnosis of keratitis are obtained after topical
administration of anaesthetics and corneal staining with fluorescein,
ophthalmologists should be aware to rinse the eye surface intensively with
appropriate eye solutions to minimise the risks of misdiagnosis.

PMID: 16899529 [PubMed - indexed for MEDLINE]

1019: Lakartidningen. 2006 Jul 12-25;103(28-29):2164.

[An unusual case]

[Article in Swedish]

Blixt L.

Publication Types: 
    Letter

PMID: 16897847 [PubMed - indexed for MEDLINE]

1020: Herpes. 2006 Aug;13(2):32-6.

Varicella zoster virus: out of Africa and into the research laboratory.

Grose C.

Department of Pediatrics, Children's Hospital of Iowa, University of Iowa, Iowa
City, IA 52242, USA.

This review updates on numerous topics relating to the evolutionary origins of
varicella zoster virus (VZV), the replication cycle, virion assembly and the
recent genomic analyses. VZV is one of eight human herpesviruses that have
existed for at least 400 million years. It has co-evolved with humankind and is
present in all nationalities globally. The pathogenesis of varicella (chickenpox)
is dependent on viral replication and dispersion through the body in
T-lymphocytes. VZV replication is similar to that of herpes simplex virus. A
complete analysis of VZV transcripts has identified their relative abundance,
with transcripts for the regulatory proteins (open reading frame) ORF62 and ORF63
among the greatest. Studies of virion assembly have shown that endocytosis
pathways are involved in the envelopment process by the viral glycoproteins. The 
complete sequencing of five VZV strains has identified numerous single nucleotide
polymorphisms, and in turn, VZV strains have been segregated into European/North 
American and Asian clades. Furthermore, a small number of mutant VZV strains have
been identified. These results suggest more diversity between VZV strains than
previously recognized.

Publication Types: 
    Research Support, N.I.H., Extramural
    Review

PMID: 16895651 [PubMed - indexed for MEDLINE]

1021: Med Hypotheses. 2006;67(6):1411-3. Epub 2006 Aug 4.

Role of bacterial superinfections in the pathogenesis of postzosteric neuralgia.

Bassukas ID, Kiorpelidou D.

Department of Skin and Venereal Diseases, University Hospital of Ioannina,
University of Ioannina, Medical School, S. Niarhos Avenue, 45500 Ioannina,
Greece. ibassuka@cc.uoi.gr

Varicella-zoster virus (VZV) is an alpha-herpes virus that causes varicella
(chickenpox), establishes latency in dorsal root ganglia and may reactivate to
cause herpes zoster (shingles). Postherpetic neuralgia is the most common
debilitating complication of herpes zoster. It is currently supposed that
scarring of the dorsal root ganglia and atrophy of the dorsal horn as a result of
intense inflammation may play a central role in the pathogenesis of this
condition. The exact pathogenesis of the inflammatory reaction leading to
persistent ganglion damage is still poorly understood. However, immune
suppression is a recognized risk factor for the development of postzosteric
neuralgia in zoster patients (increased risk, e.g., in aged patients over 80
years or diabetes mellitus patients). There is some evidence that remote
streptococcal and staphylococcal infections may induce immunologic disease
mechanisms consequently affecting the central nervous system. Since streptococcal
and/or staphylococcal superinfection of skin lesions is common in herpes zoster, 
we present a hypothesis of immunopathogenesis of postzosteric neuralgia, i.e., as
the result of augmentation of local ganglion inflammation due to bacteria-driven 
clonal expansion of VZV-specific T-cell subsets in the affected skin. Based on
the aforementioned hypothesis it is interesting: (1) to study the impact of
concomitant systemic antibiotic treatment to the standard antiviral regimen on
the rate and severity of both bacterial superinfection of zoster skin lesions and
postzosteric neuralgia and (2) to quantify the VZV-specific T-cell response as a 
function of the degree of bacterial superinfection of zoster skin lesions.
Challenging of the present hypothesis should provide an effective means of
preventing postherpetic neuralgia by preventing and consequently treating the
bacterial superinfection of zoster skin lesions.

PMID: 16890379 [PubMed - indexed for MEDLINE]

1022: J Travel Med. 2006 Jul-Aug;13(4):244-7.

Extensive cutaneous larva migrans with folliculitis mimicking multimetameric
herpes zoster presentation in an adult traveler returning from Thailand.

Malvy D, Ezzedine K, Pistone T, Receveur MC, Longy-Boursier M.

Travel Clinics and Tropical Disease Unit, Department of Internal Medicine,
Infectious Diseases and Tropical Medicine, University Hospital Center, Bordeaux, 
France.

Hookworm-related cutaneous larva migrans (CLM) is a frequent cutaneous disease
among travelers returning from the tropics. It can be misdiagnosed or treated
incorrectly. We present a 42-year-old French patient who contracted the disease
during a holiday in Thailand and who experienced an extensive CLM syndrome with a
less frequent abdominal localization and a pseudo-multimetameric homolateral
topography. The condition was late diagnosed and secondarily efficiently cured by
a unique administration of ivermectin. Simple anamnestic information--often
revealing beach activities--and clinical aspect of the creeping eruption allow to
prevent diagnosis delay and to avoid aggressive or inadequate intervention.

Publication Types: 
    Case Reports

PMID: 16884408 [PubMed - indexed for MEDLINE]

1023: PLoS Med. 2006 Aug;3(8):e312.

Creating and validating an algorithm to measure AIDS mortality in the adult
population using verbal autopsy.

Lopman BA, Barnabas RV, Boerma JT, Chawira G, Gaitskell K, Harrop T, Mason P,
Donnelly CA, Garnett GP, Nyamukapa C, Gregson S.

Department of Infectious Disease Epidemiology, Imperial College London, London,
United Kingdom. b.lopman@imperial.ac.uk

BACKGROUND: Vital registration and cause of death reporting is incomplete in the 
countries in which the HIV epidemic is most severe. A reliable tool that is
independent of HIV status is needed for measuring the frequency of AIDS deaths
and ultimately the impact of antiretroviral therapy on mortality. METHODS AND
FINDINGS: A verbal autopsy questionnaire was administered to caregivers of 381
adults of known HIV status who died between 1998 and 2003 in Manicaland, eastern 
Zimbabwe. Individuals who were HIV positive and did not die in an accident or
during childbirth (74%; n = 282) were considered to have died of AIDS in the gold
standard. Verbal autopsies were randomly allocated to a training dataset (n =
279) to generate classification criteria or a test dataset (n = 102) to verify
criteria. A rule-based algorithm created to minimise false positives had a
specificity of 66% and a sensitivity of 76%. Eight predictors (weight loss,
wasting, jaundice, herpes zoster, presence of abscesses or sores, oral
candidiasis, acute respiratory tract infections, and vaginal tumours) were
included in the algorithm. In the test dataset of verbal autopsies, 69% of deaths
were correctly classified as AIDS/non-AIDS, and it was not necessary to invoke a 
differential diagnosis of tuberculosis. Presence of any one of these criteria
gave a post-test probability of AIDS death of 0.84. CONCLUSIONS: Analysis of
verbal autopsy data in this rural Zimbabwean population revealed a distinct
pattern of signs and symptoms associated with AIDS mortality. Using these signs
and symptoms, demographic surveillance data on AIDS deaths may allow for the
estimation of AIDS mortality and even HIV prevalence.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Validation Studies

PMID: 16881730 [PubMed - indexed for MEDLINE]

1024: An Otorrinolaringol Ibero Am. 2006;33(3):225-9.

[Bogorad syndrome or crocodile tears after Ramsay-Hunt]

[Article in Spanish]

Pino Rivero V, Gonzalez Palomino A, Trinidad Ramos G, Pantoja Hernandez CG,
Marcos Garcia M, Keituqwa Yanez T, Blasco Huelva A.

Complejo Hospitalario Infanta Cristina, Badajoz. vicentepinorivero@terra.com

Crocodile tears or Bogorad Syndrome describes a complication or sequel after
facial palsy with incomplete recovery characterized by an excessive
hyperlacrimation during the food ingestion. We report the case of a 50 years old 
female with that pathology associated to facial syncinesias secondary to suffer a
right Ramsay-Hunt syndrome. Its pathogenesis and different treatment modalities
are analysed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16881549 [PubMed - indexed for MEDLINE]

1025: Indian J Dermatol Venereol Leprol. 2006 Jul-Aug;72(4):270-5.

Refining criteria for diagnosis of cutaneous infections caused by herpes viruses 
through correlation of morphology with molecular pathology.

Boer A, Herder N, Blodorn-Schlicht N, Steinkraus V, Falk TM.

Division of Dermatopathology, Dermatologikum, Hamburg, Germany.
boer@dermatologikum.de

BACKGROUND: Infections of the skin by herpes viruses do not always present
themselves in typical fashion. Early diagnosis, however, is crucial for
appropriate treatment. Polymerase chain reaction (PCR) allows diagnosis and
differential diagnosis of herpes virus infections, but the method is not yet
available in large parts of the world, where diagnosis is made based on
morphology alone. AIM: To refine criteria for the diagnosis of herpes virus
infections of the skin by way of correlation of clinical and histopathologic
findings with results of PCR studies. METHODS: We studied 75 clinically diagnosed
patients of "zoster," "varicella," and "herpes simplex", to correlate clinical
and histopathological findings with results of PCR studies on paraffin embedded
biopsy specimens. RESULTS: Clinical suspicion of infection by herpes viruses was 
confirmed by histopathology in 37% of the cases and by PCR studies in 65% of the 
cases. Zoster was frequently misdiagnosed as infection with herpes simplex
viruses (30%). When diagnostic signs of herpes virus infection were encountered
histopathologically, PCR confirmed the diagnosis in 94%. By way of correlation
with results of PCR studies, initial lesions of herpes virus infections could be 
identified to have a distinctive histopathological pattern. Herpetic folliculitis
appeared to be a rather common finding in zoster, it occurring in 28% of the
cases. CONCLUSION: We conclude that correlation of clinical and histopathological
features with results of PCR studies on one and the same paraffin embedded
specimen permits identification of characteristic morphologic patterns and helps 
to refine criteria for diagnosis both clinically and histopathologically.

Publication Types: 
    Comparative Study

PMID: 16880572 [PubMed - indexed for MEDLINE]

1026: HIV Clin Trials. 2006 May-Jun;7(3):125-41.

Reporting and evaluation of HIV-related clinical endpoints in two multicenter
international clinical trials.

Lifson AR, Rhame FS, Belloso WH, Dragsted UB, El-Sadr WM, Gatell JM, Hoy JF, Krum
EA, Nelson R, Pedersen C, Pett SL, Davey RT Jr.

Department of Epidemiology and Community Health, University of Minnesota, 1300
South Second Street, Minneapolis, MN 55454, USA. lifso001@umn.edu

PURPOSE: The processes for reporting and review of progression of HIV disease
clinical endpoints are described for two large phase III international clinical
trials. METHOD: SILCAAT and ESPRIT are multicenter randomized HIV trials
evaluating the impact of interleukin-2 on disease progression and death in
HIV-infected patients receiving antiretroviral therapy. We report definitions
used for HIV progression of disease endpoints, procedures for site reporting of
such events, processes for independent review of reported events by an Endpoint
Review Committee (ERC), and the procedure for adjudication of differences of
opinion between reviewers. RESULTS: Of 473 events reported through May 1, 2006,
28% were judged by an ERC to meet "confirmed" criteria and 38% to meet "probable"
criteria; 34% were classified "does not meet criteria." For diseases with >5 case
reports, the proportion accepted as either "confirmed" or "probable" events was
highest for cervical cancer (100%), non-Hodgkin's lymphoma (88%), cryptococcosis 
(82%), and cryptosporidiosis (80%) and was lowest for HIV encephalopathy (25%),
HIV wasting syndrome (33%), and multidermatomal herpes zoster (35%). 25% of cases
required adjudication between reviewers before diagnostic certainty was assigned.
CONCLUSION: Important requirements for HIV trials using clinical endpoints
include objective definitions of "confirmed" and "probable," a formal reporting
process with adequate information and supporting source documentation, evaluation
by independent blinded reviewers, and procedures for adjudication.

Publication Types: 
    Evaluation Studies
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16880169 [PubMed - indexed for MEDLINE]

1027: Pediatr Infect Dis J. 2006 Aug;25(8):728-32.

Herpes zoster in juvenile-onset systemic lupus erythematosus: incidence, clinical
characteristics and risk factors.

Lee PP, Lee TL, Ho MH, Wong WH, Lau YL.

Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Queen
Mary Hospital, Pokfulam, Hong Kong, China.

BACKGROUND: Herpes zoster (HZ) is common in systemic lupus erythematosus (SLE)
patients, but its clinical features and risk factors in juvenile-onset SLE have
not been well described before. METHODS: A retrospective review of the clinical
course and infections in pediatric SLE patients managed in our institution from
1988-2004 was performed. Clinical characteristics and potential risk factors for 
HZ were analyzed. RESULTS: Forty-nine children with SLE were identified. Nineteen
episodes of HZ were recorded in 15 patients, and 2 of them had recurrent HZ. The 
incidence rate was 58.7 episodes/1000 patient-years. No patient had disseminated 
HZ, postherpetic neuralgia, or cutaneous scarring, and no death was attributed to
HZ. Most (63.2%) HZ occurred within 6 months from onset of SLE or disease
flare-up. There was no significant difference in age of onset of SLE, gender,
disease duration, use of high dose steroid, or other immunosuppressive agents in 
patients with and without HZ. Patients with HZ were more likely to have prior or 
concurrent lupus nephritis (86.7%) than those without HZ (58.5%) (P = 0.096).
Occurrence of other major infections was also significantly more common in those 
who had HZ (80.0%) than those without (32.3%) (P = 0.006). CONCLUSIONS: Herpes
zoster was common in juvenile-onset SLE patients. Most were benign, without
systemic dissemination and postherpetic neuralgia. SLE patients with renal
involvement and heightened lupus activity were at greater risk of having HZ.
Those with HZ were also more likely to have other major infections during their
disease course.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16874173 [PubMed - indexed for MEDLINE]

1028: J Clin Virol. 2006 Oct;37(2):83-90. Epub 2006 Jul 26.

Multiplex-PCR and oligonucleotide microarray for detection of eight different
herpesviruses from clinical specimens.

Jaaskelainen AJ, Piiparinen H, Lappalainen M, Koskiniemi M, Vaheri A.

Department of Virology, Haartman Institute, PO Box 21, University of Helsinki,
FIN-00014 Helsinki, Finland. anne.jaaskelainen@helsinki.fi

BACKGROUND: Human herpesviruses cause clinically important diseases, e.g.
infections of the central nervous system. New diagnostic tools are required for
rapid and reliable detection of these viruses. OBJECTIVES: A microarray-based
method was designed for detection of eight human herpesviruses in cerebrospinal
fluid (CSF), whole blood, plasma, serum and proficiency-testing specimens. STUDY 
DESIGN: Herpes simplex type 1 and 2, varicella-zoster, cytomegalo-, Epstein-Barr 
and human herpes viruses 6A, 6B and 7 were amplified from clinical specimens by
two multiplex-PCRs and transcribed to single-stranded RNAs which were hybridized 
to oligonucleotides on microarray. The results were compared to those from
conventional PCR. In total, 227 specimens were tested including 23 CSF, 10 whole 
blood, 73 plasma, 10 proficiency-testing samples and 111 negative control
samples. RESULTS: Concordant results were obtained in 214/227 (94%). Microarray
detected 10 possible double and one triple infection. Negative control samples
(70 serum, 30 CSF and 11 proficiency-testing samples) were all negative.
CONCLUSIONS: Microarray is suitable for detection of multiple herpesviruses in
clinical samples.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16872894 [PubMed - indexed for MEDLINE]

1029: Drugs Aging. 2006;23(6):525-31; discussion 532-3.

Zoster vaccine live (Oka/Merck).

Robinson DM, Perry CM.

Adis International Limited, Auckland, New Zealand. demail@adis.co.nz

A subcutaneously administered, live, high-titre (18,700-60,000 plaque-forming
units per dose) varicella zoster virus (VZV) vaccine (zoster vaccine) of the
Oka/Merck strain has been evaluated for the prevention of herpes zoster and the
reduction of zoster-associated pain in adults aged > or =60 years. Zoster
vaccine, when compared with placebo, reduced the burden of herpes zoster illness 
by 61%, the incidence of herpes zoster by 51% and the incidence of postherpetic
neuralgia by 67% during more than 3 years of surveillance. The zoster vaccine
caused an initial 1.7-fold rise in VZV antibody titre after 6 weeks that declined
progressively over 3 years. Increases in gamma-interferon-secreting peripheral
blood mononuclear cells were 2.2-fold greater with the zoster vaccine than with
placebo 6 weeks after vaccination. Zoster vaccine was generally well tolerated.
The most frequently reported adverse reactions following vaccination were
injection-site reactions; the only systemic adverse event with zoster vaccine
that differed significantly in incidence from that with placebo was headache.

Publication Types: 
    Review

PMID: 16872235 [PubMed - indexed for MEDLINE]

1030: MMW Fortschr Med. 2006;Spec no.1:16.

[Two U.S. experts discuss the consequences of the "Shingles Prevention Study". Is
senior vaccination worthwhile in the practice?]

[Article in German]

[No authors listed]

PMID: 16872128 [PubMed - indexed for MEDLINE]

1031: MMW Fortschr Med. 2006;Spec no.1:14-5.

[Study tests Varicella-Zoster vaccine for over 60-years-old persons. Protection
from Herpes zoster and postherpetic neuralgia]

[Article in German]

[No authors listed]

Publication Types: 
    Comparative Study

PMID: 16872127 [PubMed - indexed for MEDLINE]

1032: MMW Fortschr Med. 2006;Spec no.1:7-12; quiz 13.

[Varicella-zoster virus infections--2: Zoster pain -- therapy and prevention]

[Article in German]

Wassilew SW.

Dermatologische Klinik, Klinikum Krefeld.
SWassilew.Dermatologie@klinikum-krefeld.de

Publication Types: 
    Comparative Study
    Review

PMID: 16872126 [PubMed - indexed for MEDLINE]

1033: MMW Fortschr Med. 2006;Spec no.1:1-5; quiz 6.

[Varicella-zoster virus infections. 1: Chickenpox and shingles. Treatment and
prevention]

[Article in German]

Wassilew SW.

Dermatologische Klinik, Klinikum Krefeld.
SWassilew.Dermatologie@klinikum-krefeld.de

Publication Types: 
    Review

PMID: 16872125 [PubMed - indexed for MEDLINE]

1034: Pain Physician. 2004 Apr;7(2):239-47.

Postherpetic neuralgia: what do we know and where are we heading?

Niv D, Maltsman-Tseikhin A, Lang E.

Center for Pain Medicine, Tel Aviv Sourasky Medical Center, 6 Weizman Street,
Tel-Aviv, Israel 64239. davidniv@tasmc.health.gov.il

Postherpetic neuralgia (PHN) remains a difficult pain problem for patients and
physicians alike. This review describes the epidemiology and pathophysiology of
PHN and discusses proposed mechanisms of pain generation and the various
treatments currently available. Evidence is scant for the value of surgical and
procedural interventions in general, although there are numerous small studies
supporting the use of specific interventions such as nerve blocks, neurosurgical 
procedures and neuroaugmentation. Medical interventions, particularly the use of 
antidepressants and anticonvulsants remain the best-documented therapies for
treating pain associated with PHN. There is good evidence that amitriptyline and 
gabapentin reduce pain with PHN. Topical local anesthetics, such a lidocaine, may
also be helpful. The decision to use a particular agent or intervention may
depend on whether there is spontaneous pain, burning or lancinating pain or
numbness. Interventions with low risk, such as TENS are appropriate. Although
prevention of postherpetic neuralgia appears to be an appropriate strategy, there
is little evidence to support the position that medical or interventional
approaches (nerve blocks) will prevent PHN after a patient develops acute herpes 
zoster (HZ). Although antivirals are appropriate for acute HZ, and the use of
neural blockade and sympathetic blockade may be helpful in reducing pain in
selected patients with HZ, there is little evidence that these interventions will
reduce the likelihood of developing PHN.

PMID: 16868598 [PubMed]

1035: Forsch Komplementmed. 2006 Jun;13(3):184-6. Epub 2006 Jun 26.

[Recurrent herpes zoster with neuralgia]

[Article in German]

Schwickert M, Saha J.

Klinik fur Innere Medizin V / Naturheilkunde und Integrative Medizin, Kliniken
Essen-Mitte/ Knappschaftskrankenhaus, Essen, Deutschland.
myriam.schwickert@kliniken-essen-mitte.de

We present the case of a 40-year-old female patient suffering from recurrent
herpes zoster and postherpetic neuralgia. Herpes zoster has recurred several
times per year for more than 15 years. At admission, rash localised on the right 
sacral region and accompanied by neuralgia had lasted for 3 months. Standard
out-patient treatment remained unsuccessful. A multimodal integrative therapy
regimen including fasting, hydrotherapy, leech application and treatment with
autologous blood led to rapid healing of herpetic lesions and persistent pain
relief. The case is discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16868364 [PubMed - indexed for MEDLINE]

1036: Int J Hematol. 2006 Jul;84(1):79-82.

Varicella-zoster virus encephalitis in a patient undergoing unrelated cord blood 
transplantation for myelodysplastic syndrome-overt leukemia.

Fukuno K, Tomonari A, Takahashi S, Ooi J, Takasugi K, Tsukada N, Konuma T, Iseki 
T, Moriwaki H, Tojo A, Asano S.

Department of Hematology/Oncology, The Institute of Medical Science, The
University of Tokyo, Shirokanidae, Tokyo.

Varicella-zoster virus (VZV) infection of the central nervous system (CNS) is
rare after hematopoietic stem cell transplantation (SCT). Here, we describe the
first patient who developed VZV encephalitis after cord blood transplantation
(CBT). A 35-year-old man with myelodysplastic syndrome-overt leukemia underwent
CBT. On day +23, a neutrophil count consistently greater than 0.5 x 10(9)/L was
achieved. On day +42, 1 mg/kg per day of prednisolone therapy was initiated for
grade III acute graft-versus-host disease (GVHD). Then, the dose of prednisolone 
was slowly reduced. For exacerbation of chronic GVHD, the dose of prednisolone
was again increased to 1 mg/kg per day on day +231. On day +265, localized
cutaneous zoster in the left thoracic region occurred, but soon resolved after
acyclovir therapy. On day +309, he suddenly developed diplopia. Subsequently,
right facial palsy and hearing impairment occurred. No skin rash was observed.
Magnetic resonance imaging (MRI) scans revealed multifocal abnormal high-signal
intensity in the CNS. A high level of VZV DNA was detected in a cerebrospinal
fluid specimen. He was diagnosed with VZV encephalitis. Acyclovir was given
intravenously for 40 days. Four months after the onset, the neurologic symptoms
had incompletely resolved. MRI scans showed substantial resolution but with mild 
residual lesions. The present report indicates that VZV should be considered as a
possible causative agent in patients who develop multifocal neurologic symptoms
of the CNS after SCT.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 16867908 [PubMed - indexed for MEDLINE]

1037: Australas J Dermatol. 2006 Aug;47(3):189-91.

Wolf's isotopic response: rosacea appearing at the site of healed herpes zoster.

Sezer E, Koseoglu RD, Filiz N.

Department of Dermatology, Gaziosmanpasa University Scholn of Medicine, Tokat,
Turkey. eseze@yahoo.com

A 40-year-old man developed an erythematous rash on the right side of his face 3 
weeks after a herpes zoster infection at the same location. Examination revealed 
an erythematous papular eruption and telangiectasias along the ophthalmic and
maxillary divisions of the right trigeminal nerve, exactly at the site of the
consistent with previous herpes zoster infection, Wolf's isotopic response.
Histological examination showed vascular ectatic dilatation and perivascular and 
perifollicular infiltration of lymphocytes and histiocytes consistent with
rosacea. The rash was resistant to oral doxycycline and topical metronidazole 1% 
cream and resolved with oral isotretinoin therapy.

Publication Types: 
    Case Reports

PMID: 16867001 [PubMed - indexed for MEDLINE]

1038: Health News. 2006 Jul;12(7):5-6.

Easing the pain of shingles.

[No authors listed]

Publication Types: 
    News

PMID: 16858750 [PubMed - indexed for MEDLINE]

1039: Pain Physician. 2004 Jul;7(3):345-7.

Response of intractable post herpetic neuralgia to intrathecal baclofen.

Hosny A, Simopoulos T, Collins B.

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
ahosny@svcmcny.org

An intractable case of Post-herpetic Neuralgia (PHN) in which all other treatment
options were exhausted was successfully treated with intrathecal baclofen
infusion with a complex continuous delivery mode. A 72-year old man presented to 
the pain clinic with a 4-year history of left lower extremity PHN. He had seen
multiple experts in the field, failed numerous pharmacological therapies, and
interventional techniques. After multiple neuraxial medications were tried,
baclofen was chosen and an intrathecal drug delivery system was implanted. Eight 
months after the procedure he continues to have 80 % pain relief. PHN is a
devastating complication of shingles. Fortunately, most cases respond to
conventional therapies. For intractable cases intrathecal baclofen appears to be 
a safe and effective therapeutic modality.

PMID: 16858473 [PubMed]

1040: JAMA. 2006 Jul 19;296(3):292-300.

Comment in:
    JAMA. 2006 Jul 19;296(3):330-1.

Incidence of opportunistic and other infections in HIV-infected children in the
HAART era.

Gona P, Van Dyke RB, Williams PL, Dankner WM, Chernoff MC, Nachman SA, Seage GR
3rd.

Center for Biostatistics in AIDS Research, Harvard School of Public Health,
Boston, Mass, USA. philgona@math.bu.edu

CONTEXT: Combination anti-retroviral therapy or highly active antiretroviral
therapy (HAART) has resulted in a dramatic decline in the incidence of
opportunistic and other infections in human immunodeficiency virus (HIV)-infected
adults and children. OBJECTIVES: To estimate the incidence of 29 targeted
opportunistic and other infections occurring in the era of HAART-between January 
1, 2001, and December 31, 2004-in HIV-infected infants, children, and adolescents
followed up in Pediatric AIDS Clinical Trials Group (PACTG) 219C; to compare
incidence rates in the HAART era to those of the pre-HAART era; and to test for
linear trends over time in the HAART era. DESIGN, SETTING, AND PARTICIPANTS:
Ongoing, multicenter, prospective cohort study designed to examine long-term
outcomes in HIV-infected children. The study population included 2767 children
enrolled between September 15, 2000, and December 31, 2004, with information
entered in the database up to August 1, 2005, when data analysis was conducted.
The pre-HAART era comparison population included 3331 children enrolled in 13
PACTG protocols from October 1988 to August 1998. MAIN OUTCOME MEASURES: First
occurrence of each of the 29 targeted infections. RESULTS: Seventy-five percent
of the children were enrolled in 2000 and 2001, 90% acquired HIV perinatally, 52%
were girls, and 59% were black. The median age was 8.2 years (range, 6-13 years).
The median duration of follow-up was 3.4 years. Overall, 553 first episodes of a 
specific infection occurred among 395 (14%) of the study participants. The number
of events for the 4 most common first-time infections and their incidence rates
(IRs) per 100 person-years were 123 bacterial pneumonia (IR, 2.15; 95% confidence
interval [CI], 1.79-2.56), 77 herpes zoster (IR, 1.11; 95% CI, 0.88-1.39), 57
dermatophyte infections (IR, 0.88; 0.67-1.14), and 52 oral candidiasis (IR, 0.93;
95% CI, 0.70-1.22). Incidence rates of first bacteremia, Pneumocystis jeroveci
pneumonia, disseminated Mycobacterium avium complex, lymphoid interstitial
pneumonitis, systemic fungal infection, cytomegalovirus retinitis, and
tuberculosis were all less than 0.50 per 100 person-years. There were no
statistically significant linear trends in incidence for any of the 29 infections
over the 4 calendar years. However, infection rates were significantly lower than
those reported in the PACTG in the pre-HAART era. The pre-HAART IRs were as
follows: for bacterial pneumonia, IR, 11.1; 95% CI, 10.3-12.0; bacteremia, IR,
3.3; 95% CI, 2.9-3.8; herpes zoster, IR, 2.9; 95% CI, 2.6-3.3; disseminated M
avium complex, IR, 1.8; 95% CI, 1.5-2.1; P jeroveci, IR, 1.3; 95% CI, 1.1-1.6;
oral candidiasis, IR, 1.2; 95% CI, 1.0-1.5; cytomegalovirus retinitis, IR, 0.5;
95% CI, 0.3-0.6; and tuberculosis, IR, 0.2; 95% CI, 0.1-0.4. CONCLUSIONS:
Opportunistic infections and other related infections are uncommon in children in
the HAART era, and infection rates continue to be lower than those reported in
the pre-HAART era. Continued surveillance is important to assess the long-term
effect of HAART on the occurrence of opportunistic and other related infections
in children.

Publication Types: 
    Multicenter Study
    Research Support, N.I.H., Extramural

PMID: 16849662 [PubMed - indexed for MEDLINE]

1041: Breast J. 2006 Jul-Aug;12(4):385.

Ulcerative carcinoma of the breast with zosteriform skin metastases.

Torchia D, Palleschi GM, Terranova M, Antiga E, Melani L, Caproni M, Fabbri P.

Department of Dermatological Sciences, University of Florence, Florence, Italy.

Publication Types: 
    Case Reports

PMID: 16848856 [PubMed - indexed for MEDLINE]

1042: Acta Med Croatica. 2006;60(2):145-8.

[Acute retinal necrosis]

[Article in Croatian]

Vukojevic N, Popovic Suic S, Sikic J, Katusic D, Curkovic T, Saric B, Jukic T.

Klinika za ocne bolesti, Klinicki bolnicki centar Zagreb, Zagreb, Hrvatska.
nenad.vukojevic@zq.htnet.hr

AIM: To draw attention to this relatively common disease, which may cause major
visual function impairment, and to present our own experience in the diagnosis,
treatment and follow-up of acute retinal necrosis patients. METHODS: The
manifestation, detection, treatment options and complications of unilateral acute
retinal necrosis are illustrated by six case reports. RESULTS: Five patients were
immunocompetent, whereas the sixth one suffered from chronic leukemia. In two
patients the disease developed in association with herpes zoster, whereas the
remaining four showed no signs of herpes disease. Systemic therapy with
acyclovir, corticosteroids, salicylates and photocoagulation produced favorable
response in five patients. Therapy had to be discontinued in leukemia patient for
complications, which resulted in the disease recurrence with retinal detachment
and proliferative vitreoretinopathy. Other patients remained stable with
preserved visual function and only minor complications. DISCUSSION: In all six
patients, the accurate diagnosis was reached relatively late. Obviously, anterior
uveitis alone attracted ophthalmologists' attention, and their diagnostic and
therapeutic efforts had mostly been focused on anterior uveitis impairment in the
visual acuity developed. Appropriate therapy with virostatics, which is necessary
in the treatment of this disease, was introduced relatively late, however, all
patients responded favorably to this therapy, which also held for the
immunocompromised patients administered a half usual dose of acyclovir. Our
experience confirmed that virostatic therapy for acute retinal necrosis should be
administered for at least 6 weeks. Retinal photocoagulation for prevention of
rhegmatogenous retinal detachment appers to be beneficial, as this type of
retinal detachment did not develop in these patients. The patient who did not
undergo laser photocoagulation of retina did not develop rhegmatogenous retinal
detachment but did develop proliferative vitreoretinopathy. CONCLUSION: Acute
retinal necrosis is a relatively common disease affecting visual function, which 
occurs in both immunocompetent and immunocompromised subjects. The disease with
its typical clinical picture and many complications should be taken in
consideration on the differential diagnosis of uveitis. Therapy for acute retinal
necrosis is complex, long-term and associated with frequent systemic
complications that may threaten the patient's general health status.

Publication Types: 
    English Abstract

PMID: 16848208 [PubMed - indexed for MEDLINE]

1043: J Neurol Neurosurg Psychiatry. 2006 Aug;77(8):938-42. Epub 2006 Apr 25.

Comment in:
    J Neurol Neurosurg Psychiatry. 2006 Aug;77(8):901.

Polymerase chain reaction analysis and oligoclonal antibody in the cerebrospinal 
fluid from 34 patients with varicella-zoster virus infection of the nervous
system.

Gregoire SM, van Pesch V, Goffette S, Peeters A, Sindic CJ.

Department of Neurology, Universite catholique de Louvain, Cliniques
Universitaires Saint-Luc, Brussels, Belgium.

OBJECTIVE: To study cerebrospinal fluid (CSF) and serum samples from 34
consecutive patients suspected of having varicella-zoster virus (VZV) infection
of the central nervous system (CNS). Population and METHODS: The patients were
divided into three groups. The first group consisted of 27 patients with a rash
in one to three dermatomes and clinical suspicion of meningitis and radiculitis; 
among them, three subgroups were distinguished according to the affected
dermatome: ophthalmicus (n = 9), oticus (n = 11) and cervico-thoraco-lumbar
zoster (n = 7). Four cases of zoster sine herpete (ZSH) were included in the
second group: these patients presented with either radiculitis (n = 2) or
meningoencephalitis (n = 2), without cutaneous eruption. The third group
consisted of three patients with a generalised rash and encephalitis. A
polymerase chain reaction (PCR) for VZV DNA and antigen-driven immunoblots for
oligoclonal anti-VZV antibodies were carried out on all CSF samples. RESULTS: PCR
of the CSF was positive in 44% of the patients from the first group, mainly
within the first 7 days after eruption. In addition, intrathecal synthesis of
anti-VZV antibodies was detected in 37% of patients, always after an interval of 
7 days (p<0.0001). Among the four patients with ZSH, a positive VZV PCR was
detected in three patients and CSF-specific oligoclonal anti-VZV antibodies in
two. PCR was also positive in the CSF of two of the three patients with
generalised rash and encephalitis; local production of anti-VZV antibodies was
seen in a second CSF sample in one patient, and was also present in the third
patient. CONCLUSION: Amplification of VZV DNA by PCR in the CSF and
antigen-driven immunoblots have important diagnostic value in suspected VZV
infection, although their presence depends on the timing of the CSF sampling. VZV
is thought to be a causative agent in unexplained cases of meningitis associated 
with radiculitis or focal CNS symptoms, even in the absence of skin
manifestations. In such patients, rapid diagnosis by this combined approach
permits early antiviral treatment.

PMID: 16844949 [PubMed - indexed for MEDLINE]

1044: Prim Dent Care. 2006 Jul;13(3):114-6.

Spontaneous tooth exfoliation, maxillary osteomyelitis and facial scarring
following trigeminal herpes zoster infection.

Pillai KG, Nayar K, Rawal YB.

SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India.
gopal@trinidad.net

A case of trigeminal herpes zoster (HZ) infection affecting the left maxillary
and ophthalmic divisions of the fifth cranial nerve in an immuno-competent
patient is presented. Extremely rare complications such as osteonecrosis,
spontaneous tooth exfoliation, secondary osteomyelitis and facial scarring were
observed. Sequestrectomy, aciclovir and erythromycin stearate were effectively
used in managing the case.

Publication Types: 
    Case Reports

PMID: 16836817 [PubMed - indexed for MEDLINE]

1045: JAMA. 2006 Jul 12;296(2):157-8.

FDA approves shingles vaccine: herpes zoster vaccine targets older adults.

Mitka M.

Publication Types: 
    News

PMID: 16835412 [PubMed - indexed for MEDLINE]

1046: J Dtsch Dermatol Ges. 2006 Jul;4(7):540-3.

[Varicella vaccination update]

[Article in German]

Nurnberg W, Schneeweiss B.

Ostseeklinik Kuhlungsborn, Germany. info@ostseeklinik-kuehlungsborn.de

Varicella is the most common infection which is preventable by vaccination. Even 
though varicella usually runs a mild course, some patients require
hospitalization and a small number die. The German Immunization Commission
(STIKO) in 2004 recommended varicella vaccination for all children.The discussion
remains controversial. We review the most frequently asked questions about
varicella vaccination, with emphasis on its effectiveness with the possibilities 
for use after incubation or exposure to limit the spread, as well as its effects 
on the prevalence of herpes zoster. The average age of varicella patients has not
increased in the USA after 10 years of childhood vaccination. In addition, there 
has not been an expected increase of herpes zoster in non-immunized individuals. 
Vaccinated children have a lower incidence of herpes zoster than those who have
had varicella. Finally, a recent study using a live zoster vaccine with increased
antigenicity in older adults halved the incidence of herpes zoster and reduced
that of post-herpetic neuralgia to one-third.

Publication Types: 
    English Abstract
    Review

PMID: 16827911 [PubMed - indexed for MEDLINE]

1047: N Engl J Med. 2006 Jul 6;355(1):e1.

Images in clinical medicine. Abdominal pseudohernia due to herpes zoster.

Tagg NT, Tsao JW.

Walter Reed Army Medical Center, Washington, DC 20307, USA.

Publication Types: 
    Case Reports

PMID: 16822989 [PubMed - indexed for MEDLINE]

1048: MMW Fortschr Med. 2006 Jun 1;148(22):53.

[Painful vesicles of the ear]

[Article in German]

Leunig A.

Oberarzt, Klinik und Poliklinik fur Hals-Nasen-Ohren-Heilkunde der
Ludwig-Maximilians-Universitat Munchen.

Publication Types: 
    Case Reports

PMID: 16821584 [PubMed - indexed for MEDLINE]

1049: Kidney Int. 2006 Aug;70(4):732-42. Epub 2006 Jul 5.

Comment in:
    Kidney Int. 2006 Aug;70(4):616-8.

Azathioprine/methylprednisolone versus cyclophosphamide in proliferative lupus
nephritis. A randomized controlled trial.

Grootscholten C, Ligtenberg G, Hagen EC, van den Wall Bake AW, de Glas-Vos JW,
Bijl M, Assmann KJ, Bruijn JA, Weening JJ, van Houwelingen HC, Derksen RH, Berden
JH; Dutch Working Party on Systemic Lupus Erythematosus.

Division of Nephrology, Radboud University Nijmegen Medical Center, Nijmegen, The
Netherlands. m.grootscholten@aig.umcn.nl

Until recently, intravenous cyclophosphamide pulses with oral corticosteroids
were regarded standard therapy for proliferative lupus nephritis (LN).
Azathioprine, a less toxic alternative, was never proven to be inferior. In the
first Dutch lupus nephritis study (enrollment between 1995 and 2001), we
randomized 87 proliferative LN patients to either cyclophosphamide pulses (750
mg/m(2), 13 pulses in 2 years) combined with oral prednisone (CY) or to
azathioprine (2 mg/kg/day in 2 years) combined with intravenous pulses of
methylprednisolone (3 x 3 pulses of 1000 mg) and oral prednisone (AZA). After a
median follow-up of 5.7 years (interquartile range 4.1-7.2 years), doubling of
serum creatinine was more frequent in the AZA group, although not statistically
significant (relative risk (RR): 4.1, with 95% confidence interval (95% CI):
0.8-20.4). Relapses occurred more often in the AZA group (RR: 8.8, 95% CI:
1.5-31.8). Creatinine and proteinuria at last visit did not differ between the
two treatment arms. Moreover, 88.4% of the patients in the AZA arm were still
free of cyclophosphamide treatment. During the first 2 years, the frequency of
remission was not different, but infections, especially herpes zoster virus
infections (HZV) were more frequent in the AZA group. Parameters for ovarian
function did not differ between the two groups. In conclusion, in this open-label
randomized controlled trial, cyclophosphamide was superior to azathioprine with
regard to renal relapses and HZV. At last follow-up, there were no differences in
serum creatinine or proteinuria between the two groups. However, since our study 
lacked sufficient power, longer follow-up is needed to reveal putative
differences.

Publication Types: 
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 16820790 [PubMed - indexed for MEDLINE]

1050: Indian J Pediatr. 2006 Apr;73(4):313-21.

New antiviral agents.

Abdel-Haq N, Chearskul P, Al-Tatari H, Asmar B.

Division of Infectious Diseases, Children's Hospital of Michigan, Carman and Ann 
Adams, Department of Pediatrics, Wayne State University, School of Medicine,
Detroit 48201, USA. nabdel@dmc.org

During the last three decades, a better understanding of viral replication and
disease states caused by viral infections have led to the development of newer
antiviral agents with enhanced activity and better tolerability. This review
focuses on newer systemic and topical antiviral agents that are used in treatment
of herpes viruses including herpes simplex type-1 (HSV-1) and type-2 (HSV-2),
varicella-zoster virus (VZV) and cytomegalovirus CMV) as well as the human
papilloma virus (HPV). Included in this article are the agents famciclovir,
penciclovir, valganciclovir, imiquimod, docosanole and brivudin.

Publication Types: 
    Review

PMID: 16816493 [PubMed - indexed for MEDLINE]

1051: Altern Med Rev. 2006 Jun;11(2):102-13.

Herpes zoster and postherpetic neuralgia: diagnosis and therapeutic
considerations.

Roxas M.

Thorne Research, PO Box 25, Dover, ID 83825, USA. m.roxas@comcast.net.

Herpes zoster (HZ), also known as shingles, is a painful vesicular rash resulting
from reactivation of the virus that also causes chickenpox - Varicella zoster
virus (VZV). Typically, the rash runs its course in a matter of 4-5 weeks. The
pain, however, may persist months, even years, after the skin heals. This
phenomenon is known as postherpetic neuralgia (PHN). Often described as an
intense burning, itching sensation, this pain can be significant to the point of 
being debilitating, and as such can greatly affect quality of life. Although
shingles is generally regarded as a self-limited condition, the fact it can take 
several weeks to resolve and has the potential for development of complications
such as PHN presents a challenge to clinicians. Many treatment options are
available, each offering variable levels of efficacy. Conventional therapies
include prescription antivirals, corticosteroids, and analgesics, both oral and
topical. Other considerations include use of over-the-counter anti-inflammatory
agents, physiotherapy, and nerve block injections. This article reviews herpes
zoster and postherpetic neuralgia, and presents the most effective conventional
treatment options currently available, as well as select botanical, nutritional, 
and other considerations that may be beneficial in the management of this
condition.

Publication Types: 
    Review

PMID: 16813460 [PubMed - indexed for MEDLINE]

1052: Acta Haematol. 2006;116(1):58-61.

Acute abdomen by varicella zoster virus induced gastritis after autologous
peripheral blood stem cell transplantation in a patient with non-Hodgkin's
lymphoma.

Scholl S, Hocke M, Hoffken K, Sayer HG.

Department of Internal Medicine II
(Oncology/Hematology/Gastroenterology/Infectious Disease), Medical Faculty,
Friedrich Schiller University, Jena, Germany. sebastian.scholl@med.uni-jena.de

We report on a 54-year-old male patient with an aggressive T cell non-Hodgkin's
lymphoma with abdominal manifestation undergoing autologous peripheral blood stem
cell transplantation after high-dose chemotherapy in April 2003. About 4 months
after transplantation, he developed severe upper abdominal pain. Ultrasound
examination, X-ray, computed tomography of the abdomen and cardiac diagnostics
could not explain the symptoms. While empiric therapy with high-dose acyclovir
was started, we could document herpetic lesions in the gastric antrum by
endoscopy. The epigastric pain rapidly decreased within several days after the
start of acyclovir therapy. No herpetic skin lesions were observed at any time
during the disease. This report demonstrates the importance of viral-induced
gastritis in the differential diagnosis of severe abdominal pain in patients
receiving autologous peripheral blood stem cell transplantation.

Publication Types: 
    Case Reports

PMID: 16809891 [PubMed - indexed for MEDLINE]

1053: Acta Virol. 2006;50(2):121-8.

JC polyomavirus reactivation is not associated with herpes zoster.

Jeong BH, Park SJ, Koo DW, Kim YS.

Ilsong Institute of Life Science, Hallym University, Kyonggi-do, South Korea.

Herpes zoster (HZ) is a neurocutaneous disease caused by Varicella-zoster virus
(VZV) as a consequence of declined cell-mediated immunity, immune suppression and
immunodeficiency. As reactivation of JC polyomavirus (JCPyV) might be linked with
immunodeficiency or immunosuppressive therapy, the relationship between HZ and
JCPyV reactivation was investigated. The incidence of JCPyV in urine samples from
102 patients with HZ and 100 healthy individuals from South Korea was determined 
by PCR. The incidence values for HZ patients and control individuals did not
differ significantly (24.5% vs. 20.0%, respectively, P = 0.5391). When different 
age groups were monitored, the positivity values of 21.1%, 20.0%, and 30% were
found for 20-39, 40-59 and over 60 year-old patients, respectively. In order to
determine the genotype of JCPyV isolates, their VP1-large T antigen
(VT)-intergenic region was PCR amplified, sequenced and analyzed. Three distinct 
types, namely 1, 2A and 7B were found in 8%, 24%, and 68% of were found among 25 
isolates from HZ patients. Using phylogenetic analysis, the type 1 isolates were 
assigned to the 1C subtype. These results indicate that HZ does not play an
important role in JCPyV reactivation and is not associated with JCPyV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16808330 [PubMed - indexed for MEDLINE]

1054: Acta Neurochir (Wien). 2006 Aug;148(8):839-43; discussion 843. Epub 2006
Jun 29.

Frequency and prognosis of delayed facial palsy after microvascular decompression
for hemifacial spasm.

Rhee DJ, Kong DS, Park K, Lee JA.

Deparment of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School
of Medicine, Seoul, Korea.

BACKGROUND: Microvascular decompression (MVD) for hemifacial spasm (HFS) provides
a long-term cure rate. Delayed facial palsy (DFP) is not an unusual complication,
but it has only been sporadically described in the literature. The purpose of
this report is to evaluate the incidence of delayed facial palsy after MVD and
its clinical course and final results. METHODS: From January, 1998 to April,
2004, 410 patients underwent microvascular decompression for hemifacial spasm at 
our Institute. During this time, 21 patients (5.4%) developed delayed facial
weakness; eighteen of them were given steroid medication and they were followed
up in the out-patient clinic. FINDINGS: Twenty-one patients developed DFP after
microvascular decompression an incidence of 5.4%. There were seventeen women
(81.0%) among the 21 patients with DFP who were included in this study. In twenty
of them, the symptoms of HFS improved completely after the operation, but the
spasm remained with one of them. The onset of palsy occurred between
postoperative day 7 and 23 (average: 12.1 days). The palsy was at least Grade II 
or worse on the House-Brackmann (HB) scale. The time to recovery averaged 5.7
weeks (range: 25 days-17 weeks); 20 patients improved to complete recovery and 1 
patient remained with minimal weakness, as Grade II on the HB scale, at the
follow-up examination. CONCLUSION: Our findings demonstrated that the incidence
of DFP was not so low as has been reported the literature, and it did not have
any striking predisposing factors. Even though the degree of facial palsy was
variable, almost all patients exhibited a complete recovery without any further
special treatment. The etiology of DFP and its association with herpes infection 
should be further clarified.

PMID: 16804640 [PubMed - indexed for MEDLINE]

1055: Anaesth Intensive Care. 2006 Jun;34(3):382-3.

Development of bilateral herpes zoster following thoracoscopic splanchnicectomy.

Brandon EL, Akers J, Rapeport D.

Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Western
Australia.

A 39-year-old female presented for elective bilateral thoracoscopic
splanchnicectomy for chronic severe visceral pain. Surgery and anaesthesia were
uneventful and she gained good symptomatic relief. Postoperative recovery was
complicated by the development on day four of bilateral herpes zoster at the T8
dermatome level. This was treated immediately with oral acyclovir. She
subsequently developed severe post-herpetic neuralgia requiring the
recommencement of gabapentin and amitriptyline. Further benefit was gained from a
course of calcitonin. This case report examines the possible causative factors in
the development of post-surgical herpes zoster.

Publication Types: 
    Case Reports

PMID: 16802497 [PubMed - indexed for MEDLINE]

1056: J Neurovirol. 2006 Apr;12(2):90-9.

Comment in:
    J Neurovirol. 2007;13(1):85; author reply 86-7.

Lack of association of herpesviruses with brain tumors.

Poltermann S, Schlehofer B, Steindorf K, Schnitzler P, Geletneky K, Schlehofer
JR.

Unit of Environmental Epidemiology, German Cancer Research Center, Heidelberg,
Germany.

Gliomas are the most frequent primary brain tumors in humans. Many studies have
been carried out on their etiology; however, the only confirmed risk factors are 
hereditary predisposing conditions and high dose of ionizing radiation. Recently,
human cytomegalovirus (HCMV) gene products and nucleic acids were reported to be 
present in all of 27 glioma samples investigated in contrast to other brain
tissues, and it was hypothesized that HCMV might play a role in glioma
pathogenesis. To evaluate these findings, samples of 40 gliomas, 31 meningiomas, 
and 6 acoustic neurinomas (ACNs) were analyzed for the presence of HCMV
macromolecules using polymerase chain reaction (PCR) and immunohistochemistry.
Additionally, corresponding blood samples from 72 patients were analyzed for the 
presence of HCMV DNA to check for a possible contamination of tumor tissues with 
HCMV-infected blood cells. No HCMV DNA sequences were found, neither in brain
tumor tissues nor in corresponding blood samples. Immunohistochemistry did not
detect HCMV-specific proteins. Addressing a possible role of other herpesviruses 
as has been suggested in seroepidemiological studies, seroprevalence of
antibodies to HCMV, herpes simplex virus (HSV), Epstein-Barr virus (EBV), and
varicella-zoster virus (VZV) were determined by enzyme-linked immunosorbent assay
(ELISA). Serological analyses of brain tumor patients showed no significant
differences in the prevalences of antibodies to HCMV, HSV, EBV, or VZV compared
to the general population. Thus, the data of the present study do not support the
hypothesis of an association of herpesviruses with the development of primary
brain tumors.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16798670 [PubMed - indexed for MEDLINE]

1057: Antiviral Res. 2006 Nov;72(2):157-61. Epub 2006 May 30.

Synergistic antiviral activity of acyclovir and vidarabine against herpes simplex
virus types 1 and 2 and varicella-zoster virus.

Suzuki M, Okuda T, Shiraki K.

Department of Virology, University of Toyama, 2630 Sugitani, Toyama 930-0194,
Japan.

Acyclovir and vidarabine both exhibit anti-herpetic activity. Because different
mechanisms of action of vidarabine and acyclovir have been reported, we analyzed 
their combined anti-herpetic activity on plaque formation of herpes simplex virus
(HSV)-1, HSV-2, and varicella-zoster virus (VZV) by isobolograms. The results
indicate that acyclovir and vidarabine have a synergistic effect on wild type
HSV-1, HSV-2, and VZV. The susceptibility of thymidine kinase-deficient HSV-1 to 
vidarabine was not affected by the presence of acyclovir, suggesting that
phosphorylation of acyclovir is essential for synergism. The combined anti-HSV
activity of acyclovir and vidarabine against phosphonoacetic acid-resistant HSV-1
with DNA polymerase mutation did not show synergism in contrast to that against
wild-type herpesviruses. Alteration of the substrate specificity of viral DNA
polymerase to acyclovir and vidarabine annihilated the synergism. Thus, the
nature of their binding sites on DNA polymerase is important to the synergistic
anti-herpesvirus activity of acyclovir and vidarabine.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16797734 [PubMed - indexed for MEDLINE]

1058: Actas Dermosifiliogr. 2006 Apr;97(3):206-7.

[Cutaneous metastases of rectal adenocarcinoma in a herpetiform distribution]

[Article in Spanish]

Torne J, Bonaut B, Sanz C, Martinez C, Torrero MV, Miranda-Romero A.

Servicio de Dermatologia, Hospital Clinico Universitario, Valladolid, Espana.
itorne@aedv.es

We present the case of a 62-year-old male with cutaneous metastases of a rectal
adenocarcinoma located on the groin and left thigh. Due to their clinical
similarity, the lesions were initially diagnosed and treated as herpes zoster.
Cutaneous metastases have variable clinical presentation patterns. They may mimic
benign skin lesions like epidermoid cysts, lipomas, erysipelas or, as in our
case, herpes zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16796970 [PubMed - indexed for MEDLINE]

1059: Enferm Infecc Microbiol Clin. 2006 Jun-Jul;24(6):392-7; quiz 398.

[Hepatitis due to herpes group viruses]

[Article in Spanish]

Cisneros-Herreros JM, Herrero-Romero M.

Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocio,
Sevilla, Espana. cisnerosjm@telefonica.net

In immunocompetent patients, primary infection by herpes simplex virus (HSV),
varicella-zoster virus (VZV), cytomegalovirus (CMV), human herpesvirus 6, and
Epstein-Barr virus (EBV) generally produces mild, self-limited hepatitis. Primary
infection by HSV in neonates and pregnant women, and infection by VZV in
hematological and bone marrow recipients can cause fulminant hepatitis without
characteristic skin lesions. In liver transplant recipients, hepatitis is the
most common expression of CMV infection and the related symptoms are
indistinguishable from those of acute rejection. Persistent hepatitis is a
manifestation of the syndrome of active chronic infection by the EBV. Fulminating
hepatitis due to herpes virus can be treated effectively if therapy is started
early; hence, a high degree of clinical suspicion and inclusion of herpes virus
in the differential diagnosis of this syndrome is necessary.

Publication Types: 
    English Abstract
    Review

PMID: 16792943 [PubMed - indexed for MEDLINE]

1060: Rev Med Virol. 2006 Jul-Aug;16(4):225-50.

Molecular studies of Varicella zoster virus.

Quinlivan M, Breuer J.

Centre for Infectious Diseases, Institute for Cell and Molecular Science, 4
Newark Street, Whitechapel, London, E1 2AT, UK. m_quinlivan@hotmail.com

VZV is a highly cell-associated member of the Herpesviridae family and one of the
eight herpesviruses to infect humans. The virus is ubiquitous in most populations
worldwide, primary infection with which causes varicella, more commonly known as 
chickenpox. Characteristic of members of the alphaherpesvirus sub-family, VZV is 
neurotropic and establishes latency in sensory neurones. Reactivation from
latency, usually during periods of impaired cellular immunity, causes herpes
zoster (shingles). Despite being one of the most genetically stable human
herpesviruses, nucleotide alterations in the virus genome have been used to
classify VZV strains from different geographical regions into distinct clades.
Such studies have also provided evidence that, despite pre-existing immunity to
VZV, subclinical reinfection and reactivation of reinfecting strains to cause
zoster is also occurring. During both primary infection and reactivation, VZV
infects several PBMC and skin cell lineages. Difficulties in studying the
pathogenesis of VZV because of its high cell association and narrow host range
have been overcome through the development of the VZV severe combined
immunodeficient mouse model carrying human tissue implants. This model has
provided a valuable tool for studying the importance of individual viral proteins
during both the complex intracellular replication and assembly of new virions and
for understanding the underlying mechanism of attenuation of the live varicella
vaccine. In addition, a rat model has been developed and successfully used to
uncover which viral proteins are important for both the establishment and
maintenance of latent VZV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 16791838 [PubMed - indexed for MEDLINE]

1061: Euro Surveill. 2005 Jun 9;10(6):E050609.4.

Research shows that highly potent vaccine reduces the burden of herpes zoster and
the incidence of postherpetic neuralgia in older adults.

Ciancio BC.

European Programme Intervention Epidemiology Training (EPIET), London, England.
bruno.ciancio@hpa.org.uk

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 16783098 [PubMed - indexed for MEDLINE]

1062: Explore (NY). 2005 Jan;1(1):74.

Postherpetic neuralgia in the left buttock after a case of shingles.

Nielsen A.

Continuum Center for Health and Healing, Beth Israel, USA.

PMID: 16781505 [PubMed - indexed for MEDLINE]

1063: Beijing Da Xue Xue Bao. 2006 Jun 18;38(3):324-5.

[Rheumatoid leptomeningitis: a case report and literature review]

[Article in Chinese]

Zheng RL, Lv H, Zhang W, Yu MX, Yuan Y.

Department of Neurology, Peking University First Hospital, Beijing 100034, China.

To report the clinical, radiological and neuropathological findings of a patient 
with rheumatoid meningitis. The patient was a 71-year-old Chinese man with a
two-year history of rheumatoid arthritis and no other significant medical
history, who presented to our hospital recurrent weakness of his left
extremities, dysarthria and a continuous bilateral hand tremor. Cerebrospinal
fluid (CSF) and serum examinations were normal apart from a mildly raised serum
perinuclear antineutrophil cytoplasmic autoantibody (p-ANCA). Brain magnetic
resonance imaging (MRI) showed leptomeningeal enhancement in both frontal and
parietal lobes, in addition to several old white matter infarcts. Meningeal
biopsy showed numerous infiltrating macrophages and lymphocytes within the
leptomeninges. The patient responded clinically and radiologically to
corticosteroid and cyclophosphamide therapy. The patient subsequently developed
herpes zoster over his left chest as a complication of his immunosuppressive
treatment. His cyclophosphamide was ceased and intravenous immunoglobulin (IVIG) 
therapy was commenced, with good clinical response to both the herpes zoster and 
meningitis. According to the result of the biopsy, aseptic meningitis was
considered the MRI results and the patient's clinical history were given, and a
diagnosis of rheumatoid meningitis was made. The patient was p-ANCA positive.
Although there was no evidence for cerebral vasculitis on biopsy, it remains a
possibility that the patient's recurrent minor cerebral infarcts visible on MRI
were vasculitic in nature.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 16778982 [PubMed - indexed for MEDLINE]

1064: J Spinal Disord Tech. 2006 Jun;19(4):299-301.

Herpes zoster--varicella complicating anterior thoracic surgery: 2 case reports.

Godfrey EK, Brown C, Stambough JL.

University of Cincinnati College of Nursing, Cincinnati, OH, USA.

This article reviews the reactivation of the latent varicella-zoster virus
infection within the sensory dorsal root ganglia resulting in shingles. Although 
the association between surgery and reactivation of the varicella-zoster virus is
known, we feel it is important to keep the diagnosis of shingles in mind
especially in a patient with sudden onset of increased pain after surgery. Our
purpose is to report 2 rare clinical presentations of shingles after spinal
surgery in which the patient's initial diagnosis was not clear until the
classical rash was observed. Two case reports are presented in which 1 patient
developed shingles 5 days after surgery with distribution of the maculopapular
rash in a surgical incision, whereas the second patient did not present until 4
weeks after surgery with a disseminated picture. Early recognition of this
postoperative problem is imperative for prompt and appropriate management, as
misdiagnosis can lead to short-term and long-term pain control issues,
postherpetic neuralgia, neuropathic pain, or other related sequelae.

Publication Types: 
    Case Reports

PMID: 16778668 [PubMed - indexed for MEDLINE]

1065: Am J Dermatopathol. 2006 Jun;28(3):194-6.

Nodular herpes zoster with herpetic syringitis and no epidermal involvement in a 
patient with Burkitt lymphoma.

Alonso-Perez A, Fraga J, Delgado Y, Aragues M, Nam-Cha S, Garcia-Diez A.

Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain. 
palomalav@yahoo.es

Herpes zoster (HZ) occurs with an increased incidence in immunosuppressed
patients, in whom it frequently displays atypical clinical presentations.
Herpetic syringitis, the involvement of the eccrine epithelium by herpes virus
infection, is an infrequently described histologic pattern that has been rarely
and almost exclusively reported in HIV-infected patients. We report the case of a
woman with Burkitt lymphoma who developed 2 nodular, asymptomatic lesions while
receiving treatment with chemotherapy and radiotherapy for her hematological
disease. Histology showed viropathic changes in the epithelium of eccrine glands 
not in the epidermis. PCR was positive for varicella-zoster virus (VZV). Nodular 
herpes zoster seems to be an exceptional clinical presentation. We report another
such case which is, as far as we know, the first report of herpetic syringitis
with no concomitant epidermal involvement.

Publication Types: 
    Case Reports

PMID: 16778483 [PubMed - indexed for MEDLINE]

1066: Med Trop (Mars). 2006 Apr;66(2):167-71.

[Opportunistic diseases in HIV-infected patients at the Jeanne Ebori Foundation
in Libreville, Gabon]

[Article in French]

Okome-Nkoumou M, Boguikouma JB, Kombila M.

Departement de medecine interne et specialites medicales, Universite des Sciences
de la Sante , Libreville, Gabon. okomem@hotmail.com

The purpose of this study was to determine the frequencies of opportunistic
diseases among AIDS patients at the Jeanne Ebori Foundation (JEF) in Libreville, 
Gabon. A total 6313 file of patients treated in the internal medicine unit
between 1994 and 1998 were analyzed. Findings showed that the main diseases
related to AIDS classified according to seroprevalence were as follows: purigo
(100%), cerebral toxoplasmosis (100%), oral candidiaisis (88%), bacteremia
(87.8%), shingles (84.6%), minor salmonelosis (72%), and tuberclosis. The main
diagnoses unrelated to AIDS at the JEF according to seroprevalene were typhoid
(9.4%), common pneumonia (28%), bacterial meningitis (26.3%, hepatitis B (20.0%),
and malaria (14%). In addition to these diseases there were nine cases of
Kaposi's sarcoma, four cases of isosporosis, two cases of cryptococcosis, two
cases of herpes Varicella, one case of cryptosporidiosis, and one case of
isosporosis. The incidence of opportunistic disease was high in our study and
must be taken in drug procurement.

Publication Types: 
    English Abstract

PMID: 16775941 [PubMed - indexed for MEDLINE]

1067: J Virol. 2006 Jul;80(13):6345-56.

Suppression of the interferon-mediated innate immune response by pseudorabies
virus.

Brukman A, Enquist LW.

Department of Molecular Biology, Princeton University, Princeton, NJ 08544, USA.

Pseudorabies virus (PRV) is an alphaherpesvirus related to the human pathogens
herpes simplex virus type 1 (HSV-1) and varicella-zoster virus. PRV is capable of
infecting and killing a wide variety of mammals. How it avoids innate immune
defenses in so many hosts is not understood. While the anti-interferon (IFN)
strategies of HSV-1 have been studied, little is known about how PRV evades the
IFN-mediated immune response. In this study, we determined if wild-type PRV
infection can overcome the establishment of a beta interferon (IFN-beta)-induced 
antiviral state in primary rat fibroblasts. Using microarray technology, we found
that the expression of a subset of genes normally induced by IFN-beta in these
cells was not induced when the cells were simultaneously infected with a
wild-type PRV strain. Expression of transcripts associated with major
histocompatibility complex class I antigen presentation and NK cell activation
was reduced, while transcripts associated with inflammation either were
unaffected or were induced by viral infection. This suppression of IFN-stimulated
gene expression occurred because IFN signal transduction, in particular the
phosphorylation of STAT1, became less effective in PRV-infected cells. At least
one virion-associated protein is involved in inhibition of STAT1 tyrosine
phosphorylation. This ability to disarm the IFN-beta response offers an
explanation for the uniform lethality of virulent PRV infection of nonnatural
hosts.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16775323 [PubMed - indexed for MEDLINE]

1068: Am J Manag Care. 2006 Jun;12(9 Suppl):S256-62.

Differential diagnosis: nociceptive and neuropathic pain.

Nicholson B.

Penn State School of Medicine, Division of Pain Medicine, Lehigh Valley Hospital 
and Health Network, 1240 S Cedar Crest Blvd, Ste 307, Allentown, PA 18103, USA.
bruce.nicholson@lvh.com

Pain, both acute and chronic, affects millions of people in the United States.
Pain can be categorized along a variety of dimensions, including one of the most 
important divisions, nociceptive versus neuropathic pain (NP). Nociceptive pain
results from activity in neural pathways secondary to actual tissue damage or
potentially tissue-damaging stimuli. NP is chronic pain that is initiated by
nervous system lesions or dysfunction and can be maintained by a number of
different mechanisms. Three common conditions that are often associated with
acute and chronic NP are painful diabetic peripheral neuropathy (DPN), painful
postherpetic neuralgia (PHN), and cancer. Although estimates of DPN vary widely
depending on the assessment criteria employed, as many as 50% of people with
diabetes have some degree of DPN. PHN develops secondary to herpes zoster
infection, and there are 600,000 to 800,000 cases of herpes zoster in the United 
States each year, with 9% to 24% of patients progressing to PHN. Acute or chronic
NP may occur in more than 50% of patients with cancer pain. Patients with painful
DPN, PHN, or cancer may present with a variety of acute or chronic NP symptoms,
and it is important to distinguish these conditions from other pain syndromes so 
that appropriate therapy can be initiated.

PMID: 16774457 [PubMed - indexed for MEDLINE]

1069: J Ayub Med Coll Abbottabad. 2006 Jan-Mar;18(1):64-5.

Simultaneous onset of herpes zoster in a father and son.

Raza N, Dar NR, Ejaz A.

Department of Dermatology, Combined Military Hospital, Abbottabad.
naeemraza561@hotmail.com

The Varicella Zoster virus persists in sensory nerve ganglion cells after chicken
pox and gets reactivated to cause herpes zoster after variable periods of time as
a result of waning of specific cellular immunity. Susceptible contacts of herpes 
zoster can develop chicken pox and very rarely herpes zoster. We report an
interesting case of a father and his son who developed herpes zoster
simultaneously without any obvious common predisposition and discuss the possible
underlying mechanism.

Publication Types: 
    Case Reports

PMID: 16773975 [PubMed - indexed for MEDLINE]

1070: Expert Rev Anti Infect Ther. 2006 Jun;4(3):367-76.

Valacyclovir for the treatment of genital herpes.

Brantley JS, Hicks L, Sra K, Tyring SK.

The University of Texas Medical Branch, Department of Dermatology, 301 University
Boulevard, Galveston, TX 77555-0783, USA. jsbrantl@utmb.edu

Genital herpes is the most prevalent sexually transmitted infection in the USA.
While sometimes mild in severity, it can be a distressing and painful chronic
condition. Likewise, herpes labialis and herpes zoster can be both physically and
psychologically painful. While there is no cure for these conditions, treatment
to alleviate symptoms, suppress recurrences and reduce transmission has been
drastically improved over the past 20 years with the use of guanine nucleoside
antivirals, such as valacyclovir hydrochloride (Valtrex), GlaxoSmithKline) the
highly bioavailable prodrug of acyclovir (Zovirax((R)), GlaxoSmithKline), and
famciclovir (Famvir, Novartis), a highly bioavailable prodrug of penciclovir
(Denavir, Novartis). Clinical trials involving approximately 10,000 patients
(including patients from nongenital herpes studies, such as herpes zoster) have
assessed the safety and efficacy of valacyclovir in the treatment of initial
genital herpes outbreaks, episodic treatment of recurrent episodes and daily
suppressive therapy. It was shown that valacyclovir has similar efficacy to
acyclovir in the episodic and suppressive treatment of genital herpes.
Valacyclovir is the only antiviral drug approved for a once-daily dose of
suppressive therapy for genital herpes, as well as the only antiviral drug US FDA
approved for a 3-day regimen of episodic treatment of recurrent genital herpes.
In addition, valacyclovir is also indicated in the reduction of the sexual
transmission of herpes simplex virus infection and for the treatment of herpes
labialis. In herpes zoster, valacyclovir is more effective than acyclovir or
placebo (and as equally effective as famciclovir) in shortening the length and
severity of herpes zoster-associated pain and postherpetic neuralgia.
Valacyclovir has an acceptable safety profile in patients with herpes simplex and
herpes zoster. The less frequent dosing regimen makes it an attractive option in 
the treatment of genital herpes and other viral infections, and may contribute to
increased patient adherence to therapy.

Publication Types: 
    Review

PMID: 16771614 [PubMed - indexed for MEDLINE]

1071: Hernia. 2006 Aug;10(4):364-6; discussion 293. Epub 2006 Jun 13.

Abdominal-wall postherpetic pseudohernia.

Oliveira PD, dos Santos Filho PV, de Menezes Ettinger JE, Oliveira IC.

Department of Surgery, Escola Bahiana de Medicina e Saude Publica, Salvador,
Bahia, Brazil. pedroebm@gmail.com

Herpes zoster affects 10-20% of the general population. Motor complications
sometimes occur in the segments corresponding to the involved sensory dermatomes 
causing abdominal wall pseudohernias. We present a case of a 57-year-old woman
with herpes zoster characteristical rash following T11-T12 right dermatomes. Ten 
days after dermatologic manifestations onset, she had developed a protrusion at
the abdominal wall on the right flank. The electroneuromyography confirmed axonal
motor commitment, and morphological defects were ruled out by ultrasonography.
The bulge totally disappeared after 4 months of observation. Postherpetic
pseudohernia must be suspected when a patient develops signs and symptoms of
motor dysfunction that coincide with or follow a herpes zoster eruption resulting
in abdominal-wall herniation. A review of the literature concerning these
extremely exceptional sequelae of herpes zoster is presented.

Publication Types: 
    Case Reports

PMID: 16770518 [PubMed - indexed for MEDLINE]

1072: Cardiology. 2007;107(1):63-7. Epub 2006 Jun 7.

Herpes zoster and its cardiovascular complications in the elderly--another look
at a dormant virus.

Ma TS, Collins TC, Habib G, Bredikis A, Carabello BA.

Section of Cardiology, Department of Medicine, Michael E. DeBakey VA Medical
Center and Baylor College of Medicine, Houston, TX 77030, USA. tma@bcm.tmc.edu

Herpes zoster (shingles) is a reactivation of latent Varicella-zoster virus
(VZV). We present a case of pleuropericarditis simulating acute myocardial
infarction and another with complete heart block in the setting of acute/recent
VZV reactivation. These cases are consistent with a modified concept: (1) the VZV
dormancy is comprised of multiple foci of infections in the sensory and autonomic
ganglia, and (2) the VZV reactivation could involve co-incident activations of
two or more loci. Recognition of this possibility of cardiovascular complications
of VZV should be helpful in the clinical management of the elderly, in the
differential diagnosis of chest pain, ST elevation, and heart block etiology in
the setting of acute or recent VZV reactivation.

Publication Types: 
    Case Reports

PMID: 16763386 [PubMed - indexed for MEDLINE]

1073: Eur J Ophthalmol. 2006 May-Jun;16(3):484-6.

Unilateral recurrent acute retinal necrosis syndrome caused by cytomegalovirus in
an immune-competent adult.

Voros GM, Pandit R, Snow M, Griffiths PG.

Dept. of Ophthalmology, Royal Victoria Infirmary, Univ. of Newcastle upon Tyne,
Newcastle upon Tyne, UK. gvorosgr@doctors.org.uk

PURPOSE: To report an immune-competent patient with unilateral recurrent acute
retinal necrosis syndrome caused by cytomegalovirus, and to highlight the
importance of diagnostic vitreous biopsy and specific antiviral therapy in this
condition. METHODS: Case report. RESULTS: A 75-year-old man with good general
health had two episodes of acute retinal necrosis syndrome affecting his left
eye. Vitreous biopsy was performed in each episode, and polymerase chain reaction
analysis on the vitreous specimen was positive for cytomegalovirus and negative
for varicella zoster virus and herpes simplex virus 1 and 2. On each occasion,
investigations indicated past cytomegalovirus infection but no evidence of a
systemic re-activation. No indication of immunodeficiency was found over a 2-year
follow-up period. His management, which included systemic and intravitreal
antiviral therapy, is discussed. CONCLUSIONS: To the authors' knowledge, only two
other cases of acute retinal necrosis syndrome caused by cytomegalovirus have
been reported previously in immune-competent patients. This case illustrates the 
importance of vitreous biopsy for viral polymerase chain re-action studies in
cases of acute retinal necrosis syndrome, in order to direct appropriate
antiviral treatment. It also illustrates the role of an intravitreal antiviral
drug that is effective against all three herpetic viruses.

Publication Types: 
    Case Reports

PMID: 16761257 [PubMed - indexed for MEDLINE]

1074: Dent Update. 2006 May;33(4):252.

Comment in:
    Dent Update. 2006 Jul-Aug;33(6):378.

Physical signs for the general dental practitioner.

Bain S.

University of Wales, Swansea.

PMID: 16756242 [PubMed - indexed for MEDLINE]

1075: Dtsch Med Wochenschr. 2006 Jun 2;131(22):1290; author reply 1290.

Comment on:
    Dtsch Med Wochenschr. 2006 Feb 24;131(8):384-6.

[Herpes zoster generalisatus in diabetes mellitus]

[Article in German]

Schiller D.

Publication Types: 
    Comment
    Letter

PMID: 16755431 [PubMed - indexed for MEDLINE]

1076: Epidemiol Infect. 2007 Jan;135(1):131-8. Epub 2006 Jun 2.

Epidemiology of hospital admissions for paediatric varicella infections: a
one-year prospective survey in the pre-vaccine era.

Dubos F, Grandbastien B, Hue V; Hospital Network for Evaluating Management of
Common Childhood Diseases, Martinot A.

Paediatric Emergency Department, Jeanne de Flandre University Hospital, Lille,
France.

To evaluate the epidemiology of hospital admissions for varicella in children, a 
1-year prospective multicentre study was done in Northern France in the
pre-varicella vaccine era. The 405 children aged <16 years seen at local
hospitals for varicella or herpes zoster were included. Among them, 143 who had
varicella and resided in the district were admitted. Admission incidence rates
were 28/100000 children aged <16 years (149/100000 infants aged <1 year,
69/100000 children aged 1-4 years, and 2/100000 children aged 5-15 years). Most
admissions (57%) were related to complications, usually skin infection (47%).
Independent risk factors for admission were place of residence outside the
district [adjusted odds ratio (aOR) 8.7], complication at admission (aOR 5.8),
recurrent fever (aOR 4.5), recent varicella in a sibling (aOR 4.0), and previous 
physician visit for the same condition (aOR 2.0).

Publication Types: 
    Multicenter Study

PMID: 16740185 [PubMed - indexed for MEDLINE]

1077: Exp Hematol. 2006 Jun;34(6):770-5.

Bortezomib after dose-reduced allogeneic stem cell transplantation for multiple
myeloma to enhance or maintain remission status.

Kroger N, Zabelina T, Ayuk F, Atanackovic D, Schieder H, Renges H, Zander A.

Department of Bone Marrow Transplantation, Transplant Center, University Medical 
Center Hamburg-Eppendorf, Hamburg, Germany. nkroeger@uke.uni-hamburg.de

OBJECTIVE: We investigated the effect of at least two cycles of bortezomib (1.3
mg/m(2) intravenously, days 1, 4, 8, and 11) after dose-reduced allogeneic stem
cell transplantation (SCT) on toxicity, CD3(+) cells, graft-versus-host disease
(GvHD), and response in patients with multiple myeloma. METHODS: Eighteen
patients with multiple myeloma without progressive disease were included. The
proteasome inhibitor was given at median of 8 months after allografting to
enhance or maintain remission status. RESULTS: Fourteen patients (78%) completed 
the proposed two cycles. Four patients had to discontinue therapy due to
neurotoxicity (n = 3) or gastrointestinal toxicity (n = 1). Severe grade III/IV
toxicity was seen for thrombocytopenia (50%), leukopenia (17%), or neuropathy
(17%), which was more often seen in patients treated concomitantly with
cyclosporine (p = 0.06). The median circulating CD3(+) cells decreased during
treatment from 550 muL to 438 muL (p = 0.03), resulting in herpes zoster
infection in three patients (17%). In three patients, a mild aggravation of
existing acute or chronic GvHD of the skin, and in one patient de novo skin grade
I acute GvHD was noted. In patients with measurable disease, complete remission, 
partial remission, and minor response was seen in 3 (30%), 5 (50%), and 2 (20%)
patients, respective. CONCLUSION: Bortezomib after allogeneic SCT is effective
but further studies are needed to balance the efficacy with potential hazards
such as infectious complications, aggravation of GvHD, and neurotoxicity.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 16728282 [PubMed - indexed for MEDLINE]

1078: J Pediatr (Rio J). 2006 Jul;82(3 Suppl):S115-24. Epub 2006 May 19.

Vaccines under development: group B streptococcus, herpes-zoster, HIV, malaria
and dengue.

da Silva LJ, Richtmann R.

Diciplina de Infectologia, Departamento de clinica Medica, Universidade Estadual 
de Campinas (UNICAMP), Campinas, SP, Brazil. ljsilva@unicamp.br

OBJECTIVES: To review the current state of development of streptococcus B,
herpes-zoster, HIV, malaria and dengue vaccines. These vaccines were selected
both because of imminent commercial release and because of specific problems with
their development. SOURCES OF DATA: A review of the literature was performed by
means of a MEDLINE search, on the period 1996 to 2006, for the epidemiology and
immunology of these diseases, analyzing both the greatest obstacles to creating a
vaccine and the current state of research, with emphasis on studies in the most
advanced stages. SUMMARY OF THE FINDINGS: Each of the five diseases chosen
presents specific problems for vaccine development. Nevertheless, in the majority
of cases these have been or are in sight of being resolved, allowing for the
prediction that a safe and effective vaccine - or vaccines - will be available in
the near future. CONCLUSIONS: Despite the problems faced in developing these
vaccines, advances in molecular biology and immunology have made it possible to
overcome most obstacles, opening up the prospects for new vaccines.

Publication Types: 
    Review

PMID: 16721441 [PubMed - indexed for MEDLINE]

1079: Bone Marrow Transplant. 2006 Jul;38(1):41-6. Epub 2006 May 22.

Clinical relevance of quantitative varicella-zoster virus (VZV) DNA detection in 
plasma after stem cell transplantation.

Kalpoe JS, Kroes AC, Verkerk S, Claas EC, Barge RM, Beersma MF.

Department of Medical Microbiology, Leiden University Medical Center, Leiden, The
Netherlands.

Detection of Varicella-Zoster virus (VZV) DNA in plasma can facilitate the early 
recognition of complicated VZV-infection in immunocompromised hosts. The
correlation of VZV-DNA in plasma with clinical presentations of VZV-infection and
subsequent aciclovir treatment in allogeneic stem cell transplant (allo-SCT)
recipients was studied. In 81 consecutive VZV-IgG positive allo-SCT recipients,
VZV-DNA was measured at regular time points (1, 2 and 4 months) following
allo-SCT and patient records were screened for VZV-related symptoms and aciclovir
treatment. Subsequently, possible VZV-cases were studied in detail for the course
of VZV-DNA and treatment effects. During the initial screening, VZV-DNA was
detectable in seven patients. The survey of VZV-related symptoms revealed five
additional possible VZV-cases. In cases where suitable plasma samples were
available (10 out of 12), VZV-DNA was present almost simultaneously with the
first clinical manifestations. No evidence of a preceding phase detectable by
VZV-DNA only could be observed. Treatment with aciclovir was associated with a
prompt reduction of VZV-DNA load. Detection of VZV-DNA in plasma in allo-SCT
recipients accurately reflected the clinical presentation of VZV-infection and
treatment with aciclovir. VZV-DNA detection in plasma of allo-SCT recipients
appears clinically relevant as this may support early recognition and therapeutic
management of VZV-infections following allo-SCT.

PMID: 16715108 [PubMed - indexed for MEDLINE]

1080: Ann Emerg Med. 2006 Jun;47(6):579, 584. Epub 2006 Feb 2.

Images in emergency medicine. Ramsay Hunt syndrome: a rare entity.

Bhagra A, Stead LG.

Mayo Clinic, Rochester, MN, USA.

Publication Types: 
    Case Reports

PMID: 16713790 [PubMed - indexed for MEDLINE]

1081: Pain Med. 2006 May-Jun;7(3):243-9; discussion 250.

Postherpetic pain: more than sensory neuralgia?

Weiner DK, Schmader KE.

Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15206,
USA. dweiner@pitt.edu

OBJECTIVE: To describe a series of older adult patients with postherpetic
myofascial pain, a heretofore rarely described complication of herpes zoster.
DESIGN: Case series. SETTING: Outpatient older adult pain clinic. PATIENTS: Five 
older adults are presented with myofascial pain that developed as a complication 
of herpes zoster. RESULTS: Pain duration at the time of presentation ranged from 
4 months to 7 years. All patients reported functional impairment from pain
despite oral analgesics. Myofascial pathology was diagnosed by the presence of
taut bands and trigger points in the affected myotome. Upon successful treatment 
of the myofascial pain with nonpharmacologic modalities (e.g., physical therapy, 
trigger point injections, dry needling, and/or percutaneous electrical nerve
stimulation), all patients reported symptomatic improvement, and four out of five
were able to significantly reduce or discontinue their opioids. CONCLUSION:
Postherpetic pain is traditionally conceptualized as a purely sensory phenomenon.
Identification of the intrusion of a myofascial component may be worthwhile, both
from the standpoint of enhanced pain relief and reduction in the need for oral
analgesics. Formal exploration of this phenomenon is needed.

Publication Types: 
    Case Reports

PMID: 16712624 [PubMed - indexed for MEDLINE]

1082: Cutis. 2006 Apr;77(4):208.

Two ounces of prevention.

Weinberg JM.

Publication Types: 
    Editorial

PMID: 16706234 [PubMed - indexed for MEDLINE]

1083: J Intern Med. 2006 Jun;259(6):615-8.

Critical aneurysmal dilatation of the thoracic aorta in young adolescents with
variant hyperimmunoglobulin E syndrome.

van der meer JW, Weemaes CM, van Krieken JH, Blomjous CE, van Die CE, Netea MG,
Bredie SJ.

Department of General Internal Medicine, Radboud University Nijmegen Medical
Centre, Nijmegen, The Netherlands.

The autosomal-dominant (AD) form of the hyperimmunoglobulin E syndrome (HIES) has
been described as a multisystem disorder including immune, skeletal and dental
abnormalities. Recently, the evaluation of patients from families in which HIES
was inherited in a manner more consistent with autosomal-recessive (AR)
inheritance, showed that AR-HIES is a clinically distinct disease entity. In
addition to classical immunologic findings of AD-HIES, the AR form presents with 
severe recurrent fungal and viral infections with herpes zoster, herpes simplex
and characteristic mollusca contagiosa. Furthermore, cerebral vascular sequelae, 
including vasculitis, infarction and haemorrhage were noted. In this report, we
describe the clinical picture of two patients who showed remarkable resemblance
to the description of AR-HIES, but also developed fatal aneurysmal dilatation of 
the thoracic aorta in adolescence. This finding may further consummate the
clinical picture of AR-HIES and emphasize the possibility to develop early
aortitis, most likely preceding the critical aneurysm formation at older age.
This process should be anticipated during childhood in cases with AR-HIES.

Publication Types: 
    Case Reports

PMID: 16704563 [PubMed - indexed for MEDLINE]

1084: J Plast Reconstr Aesthet Surg. 2006;59(2):206-7.

An unusual cause of trismus: Ramsay Hunt syndrome.

Akyol A, Kiylioglu N, Copcu E.

Publication Types: 
    Case Reports
    Letter

PMID: 16703870 [PubMed - indexed for MEDLINE]

1085: Eur J Epidemiol. 2006;21(6):469-73. Epub 2006 May 16.

Impact of CCR5 Delta32/+ deletion on herpes zoster among HIV-1-infected
homosexual men.

Krol A, Lensen R, Veenstra J, Prins M, Schuitemaker H, Coutinho RA.

Department of Research, Health Service of Amsterdam, Cluster, Infectious
Diseases, Amsterdam, The Netherlands. akrol@ggd.amsterdam.nl

The association between the presence of CCR5 Delta32 heterozygosity and incidence
of clinical herpes zoster was studied among 296 homosexual men from the Amsterdam
cohort study (ACS) infected with human immunodeficiency virus type I (HIV-1) with
an estimated date of seroconversion. Of them 63 were CCR5 Delta32 heterozygotes
and 233 CCR5 wild-type. The incidence rate of a first episode of herpes zoster
was 4.2% and 5.3% per person-year, respectively. A higher occurrence of herpes
zoster was strongly related to a lower CD4 + cell count. After adjustment for
age, presence of CCR2b 64I heterozygosity, HIV RNA load, time since
seroconversion, and CD4 + cell count, the rate ratio for herpes zoster of CCR5
Delta32 was 0.9 (95%CI 0.5-1.6). In conclusion, in HIV-1-infected homosexual men,
a CCR5 Delta32 heterozygous genotype has no protective effect on the incidence of
herpes zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16703416 [PubMed - indexed for MEDLINE]

1086: Drugs Today (Barc). 2006 Apr;42(4):249-54.

Varicella-zoster virus vaccine: a review of its use in the prevention of herpes
zoster in older adults.

Caple J.

Medical Information Department, Prous Science, Barcelona, Spain.
journals@prous.com

Current strategies for managing herpes zoster show variable efficacy and do not
prevent its appearance. Varicella-zoster virus vaccine, or "zoster vaccine" is a 
more potent form of the varicella-zoster virus vaccine currently approved for use
in the prevention of varicella in children. Zoster vaccine decreases the
incidence of herpes zoster and burden of illness in adults aged 60 years and
older and appears more efficacious in patients aged 60-69 than in those over 70
years. Importantly, the incidence of postherpetic neuralgia is significantly
reduced in patients who receive zoster vaccine, irrespective of age or sex. The
duration of postherpetic neuralgia is also significantly reduced. Zoster vaccine 
has a favorable safety profile; most treatment-related adverse events are related
to the site of injection. This review summarizes the current data on the clinical
efficacy and safety of zoster vaccine in adults aged 60 years and older.
Copyright (c) 2006 Prous Science. All rights reserved.

Publication Types: 
    Review

PMID: 16703121 [PubMed - indexed for MEDLINE]

1087: J Virol. 2006 Jun;80(11):5113-24.

Inhibition of the NF-kappaB pathway by varicella-zoster virus in vitro and in
human epidermal cells in vivo.

Jones JO, Arvin AM.

Stanford University School of Medicine, 300 Pasteur Drive, Rm. G312, Stanford, CA
94305-5208, USA. jeremy.jones@ucsf.edu

Varicella-zoster virus (VZV) is an alphaherpesvirus that causes varicella and
herpes zoster. Using human cellular DNA microarrays, we found that many nuclear
factor kappa B (NF-kappaB)-responsive genes were down-regulated in VZV-infected
fibroblasts, suggesting that VZV infection inhibited the NF-kappaB pathway. The
activation of this pathway causes a cellular antiviral response, including the
production of alpha/beta interferon, cytokines, and other proteins that restrict 
viral infection. In these experiments, we demonstrated that VZV interferes with
NF-kappaB activation in cultured fibroblasts and in differentiated epidermal
cells in skin xenografts of SCIDhu mice infected in vivo. VZV infection of
fibroblasts caused a transient nuclear translocation of p50 and p65, the
canonical NF-kappaB family members. In a process that was dependent upon the
presence of infectious VZV, these proteins rapidly became sequestered in the
cytoplasm of VZV-infected cells. Exclusion of NF-kappaB proteins from nuclei was 
associated with the continued presence of IkappaBalpha, which binds p50 and p65
and prevents their nuclear accumulation. IkappaBalpha levels did not diminish
even though the protein became phosphorylated and ubiquitinated, as determined
based on detection of the characteristic high-molecular-weight form of the
protein, and the 26S proteasome remained functional in VZV-infected cells. VZV
infection also inhibited the characteristic degradation of IkappaBalpha that is
induced by exposure of fibroblasts to tumor necrosis factor alpha. As expected,
herpes simplex virus 1 caused the persistent nuclear translocation of NF-kappaB
proteins, which has been shown to facilitate its replication, whereas VZV
infection progressed without persistent NF-kappaB nuclear localization. We
suggest that VZV has evolved a mechanism to limit host cell antiviral defenses by
sequestering NF-kappaB proteins in the cytoplasm, a strategy that appears to be
unique among the herpesviruses.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 16698992 [PubMed - indexed for MEDLINE]

1088: Acta Otolaryngol. 2006 May;126(5):460-6.

Inner ear and facial nerve complications of acute otitis media with focus on
bacteriology and virology.

Hyden D, Akerlind B, Peebo M.

Department of Otolaryngology, Linkoping University Hospital, Linkoping, Sweden.
dag.hyden@lio.se

CONCLUSION: Among 20 patients with inner ear complications and/or peripheral
facial palsy secondary to acute otitis media (AOM) a proven or probable
bacteriological cause was found in 13 (65%). In seven patients (35%), a proven or
probable viral cause was found. Only two of the patients (10%), with a proven
bacterial AOM and a clinical picture of a purulent labyrinthitis in both,
together with a facial palsy in one, had a substantial degree of dysfunction.
Although the number of patients in this study is relatively low our findings show
that inner ear complications and facial palsy due to AOM can be of both bacterial
and viral origin. Severe sequelae were found only where a bacterial origin was
proven. OBJECTIVES: Inner ear complications and/or peripheral facial palsy
secondary to AOM are rare. The general understanding is that they are due to
bacterial infections. However, in some of these patients there are no clinical or
laboratory signs of bacterial infections and they have negative bacterial
cultures. During recent years different viruses have been isolated from the
middle ear or serologically proven in AOM patients and are thought to play a
pathogenetic role. We suggest that in some cases of AOM complications from the
inner ear and the facial nerve can be caused by viruses. The purpose of our study
was to analyze infectious agents present in patients with inner ear complications
and/or facial palsy arising from AOM. PATIENTS AND METHODS: The medical records
of 20 patients who had inner ear complications and/or facial palsy following AOM 
( unilateral in 18, bilateral in 2) between January 1989 and March 2003 were
evaluated. Bacterial cultures were carried out for all patients. Sera from 12 of 
the patients were stored and tested for a battery of specific viral antibodies.
In three patients, investigated between November 2002 and March 2003, viral
cultures were also performed on samples from the middle ear and nasopharynx.
RESULTS: Nineteen patients had inner ear symptoms. Eight of them had a unilateral
sensorineural hearing loss and vertigo, three had vertigo as an isolated symptom 
and one, with bilateral AOM, had bilateral sensorineural hearing loss. Seven
patients had a combination of facial palsy and inner ear symptoms (unilateral
sensorineural hearing loss in three, unilateral sensorineural hearing loss and
vertigo in two, bilateral sensorineural hearing loss and vertigo in one, with
bilateral AOM, and vertigo alone in one). One patient had an isolated facial
palsy. Healing was complete in 11 of the 20 patients. In seven patients a minor
defect remained at follow-up (a sensorineural hearing loss at higher frequencies 
in all). Only two patients had obvious defects (a pronounced hearing loss in
combination with a moderate to severe facial palsy (House-Brackman grade 4) in
one, distinct vestibular symptoms and a total caloric loss in combination with a 
high-frequency loss in the other. Eight patients had positive bacteriological
cultures from middle ear contents: Streptococcus pneumoniae in two,
beta-hemolytic Streptococcus group A in two, beta-hemolytic Streptococcus group A
together with Staphylococcus aureus in one, Staph. aureus alone in one and
coagulase-negative staphylococci (interpreted as pathogens) in two. In the 12
patients with negative cultures, there was a probable bacteriological cause due
to the outcome in SR/CRP and leukocyte count in five. In four patients
serological testing showed a concomitant viral infection that was interpreted to 
be the cause (varicella zoster virus in two, herpes simplex virus in one and
adenovirus in one.) In three there was a probable viral cause despite negative
viral antibody test due to normal outcome in SR/CRP, normal leukocyte count,
serous fluid at myringotomy and a relatively short pre-complication antibiotic
treatment period.

PMID: 16698694 [PubMed - indexed for MEDLINE]

1089: Neurol Res. 2006 Apr;28(3):262-9.

Positivity of cytomegalovirus antibodies predicts a better clinical and
radiological outcome in multiple sclerosis patients.

Zivadinov R, Nasuelli D, Tommasi MA, Serafin M, Bratina A, Ukmar M, Pirko I,
Johnson AJ, Furlan C, Pozzi-Mucelli RS, Monti-Bragadin L, Grop A, Zambon M,
Antonello RM, Cazzato G, Zorzon M.

Buffalo Neuroimaging Analysis Center, Department of Neurology, The Jacobs
Neurological Institute, University at Buffalo, State University of New York,
14203, USA. rzivadinov@thejni.org

OBJECTIVES: To establish the relationship between the presence and titer of
virus-specific serum- and cerebrospinal fluid (CSF)-antibodies in multiple
sclerosis (MS) patients and disease severity measured with different quantitative
magnetic resonance imaging (MRI) techniques. METHODS: We investigated an
association between clinical and MRI measures of disease activity and the
presence and titer of IgG antibodies against seven common viruses (measles,
rubella, herpes simplex virus type 1 and 2, varicella zoster virus,
cytomegalovirus (CMV) and Epstein-Barr virus). One hundred and forty (90
female/50 male) patients with definite MS and 131 age and sex-matched controls
participated in the study. Antibody positivity and titer were ascertained by the 
enzyme linked immunosorbent assay (ELISA) technique and clinical assessment was
performed by evaluating the expanded disability status scale (EDSS) score and the
lifetime relapse rate (LRR). T1- and T2-lesion loads (LL) and the brain
parenchymal fraction (BPF) were calculated. RESULTS: Multiple analyses showed
that there was an association between antibody positivity against CMV and higher 
titer and better clinical and MRI outcomes. The cluster analyses indicated that
patients positive for antibodies against CMV had significantly older age at onset
(uncorr p = 0.001 and corr p = 0.009), lower LRR (uncorr p = 0.003 and corr p =
0.03) and higher BPF (uncorr p = 0.004 and pcorr p = 0.04). CMV-positive patients
who had higher antibody titer showed lower T2-LL (uncorr p = 0.003 and corr p =
0.03) and higher BPF (uncorr p = 0.006 and corr p = 0.05). DISCUSSION:
Surprisingly, our results focused attention on the 'protective' role of a
particular virus. CMV is probably capable of triggering some
immunomodulating/immune evasion mechanisms which may decrease immune reactivity
in MS patients. Further studies are needed to confirm and elucidate our study
results on a larger sample of MS patients and in animal model studies.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 16687051 [PubMed - indexed for MEDLINE]

1090: Acta Otorrinolaringol Esp. 2006 Apr;57(4):189-92.

[Varicella-zoster infection with isolated cochleovestibular affectation (without 
facial palsy)]

[Article in Spanish]

Gundin G, Monedero G, Teba JM, Perez Esteban L, Sanz R.

Servicio de Otorrinolaringologia, Hospital Universitario de Getafe, Madrid.

Otological complications of Ramsay Hunt syndrome include facial paralysis,
tinnitus, hearing loss, vertigo, dysgeusia, and skin eruption. The lower cranial 
nerves sometimes are affected by this neuritis. A case is reported of a man
without immune-system impairment who had a cranial mononeuritis with unilateral
involment of the VIII and VII cranial nerves after infection with
varicella-zoster without herpetic lesions.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16686230 [PubMed - indexed for MEDLINE]

1091: Arch Neurol. 2006 Jul;63(7):940-2. Epub 2006 May 8.

Improvement of postherpetic neuralgia after treatment with intravenous acyclovir 
followed by oral valacyclovir.

Quan D, Hammack BN, Kittelson J, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA.

BACKGROUND: Postherpetic neuralgia (PHN) is a complication of shingles (herpes
zoster), a painful rash due to varicella-zoster virus reactivation. Studies of
patients with PHN and zoster sine herpete (radicular pain without rash) support
the notion that low-grade viral ganglionitis contributes to pain. If chronic pain
reflects active infection, then antiviral therapy may help patients with PHN.
OBJECTIVE: To determine whether antiviral treatment helps reduce PHN-associated
pain. DESIGN: Prospective, open-label phase I/II clinical trial. SETTING:
Tertiary care university hospital. PATIENTS: Fifteen patients with moderate to
severe PHN. INTERVENTIONS: Intravenous acyclovir at a dosage of 10 mg/kg every 8 
hours for 14 days followed by oral valacyclovir at a dosage of 1000 mg 3 times
per day for 1 month. MAIN OUTCOME MEASURE: Numeric Rating Scale for Pain score.
RESULTS: As defined by a decrease of 2 or more points on the Numeric Rating Scale
for Pain, 8 (53%) of 15 patients reported improvement. CONCLUSION: Clinical
improvement reported by most of our patients warrants further investigation in a 
larger, randomized, double-blind, placebo-controlled trial.

Publication Types: 
    Clinical Trial, Phase I
    Clinical Trial, Phase II
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16682531 [PubMed - indexed for MEDLINE]

1092: J Neurol. 2006 Aug;253(8):1103-10. Epub 2006 May 6.

Comment in:
    J Neurol. 2006 Aug;253(8):1102.

Acute urinary retention due to benign inflammatory nervous diseases.

Sakakibara R, Yamanishi T, Uchiyama T, Hattori T.

Department of Neurology, Chiba University, 1-8-1 Inohana Chuo-ku, 260-8670 Chiba,
Japan. sakakibara@faculty.chiba-u.jp

Both neurologists and urologists might encounter patients with acute urinary
retention due to benign inflammatory nervous diseases. Based on the mechanism of 
urinary retention, these disorders can be divided into two subgroups: disorders
of the peripheral nervous system (e.g., sacral herpes) or the central nervous
system (e.g., meningitis-retention syndrome [MRS]). Laboratory abnormalities
include increased herpes virus titers in sacral herpes, and increased myelin
basic protein in the cerebrospinal fluid (CSF) in some cases with MRS. Urodynamic
abnormality in both conditions is detrusor areflexia; the putative mechanism of
it is direct involvement of the pelvic nerves in sacral herpes; and acute spinal 
shock in MRS. There are few cases with CSF abnormality alone. Although these
cases have a benign course, management of the acute urinary retention is
necessary to avoid bladder injury due to overdistension. Clinical features of
sacral herpes or MRS differ markedly from those of the original "Elsberg
syndrome" cases.

PMID: 16680560 [PubMed - indexed for MEDLINE]

1093: J Postgrad Med. 2006 Apr-Jun;52(2):153-4.

Cicatricial ectropion due to herpes zoster ophthalmicus.

Sanghvi CA, Leatherbarrow B, Ataullah S.

Department of Ophthalmology, Royal Eye Hospital, Oxford Road, Manchester M13 9WH,
United Kingdom. casanghvi@yahoo.co.uk.

Publication Types: 
    Letter

PMID: 16679689 [PubMed - in process]

1094: Postgrad Med J. 2006 May;82(967):351-2.

Chickenpox, chickenpox vaccination, and shingles.

Welsby PD.

Infectious Diseases Unit, Western General Hospital, Edinburgh EH4 2XU, UK.
P.Welsby@ed.ac.uk

Chickenpox in the United Kingdom, where vaccination is not undertaken, has had a 
stable epidemiology for decades and is a routine childhood illness. Because of
vaccination, chickenpox is now a rarity in the USA. In the UK vaccination is not 
done because introduction of a routine childhood vaccination might drive up the
age at which those who are non-immune get the illness (chickenpox tends to be
more severe the older you are), and the incidence of shingles may increase. The
United Kingdom is waiting to see what happens in countries where vaccination is
routine.

Publication Types: 
    Review

PMID: 16679476 [PubMed - indexed for MEDLINE]

1095: Postgrad Med J. 2006 May;82(967):e6.

A 2 year old with a rash.

Martin K, Elias-Jones A.

Department of Neonatology, Leicester General Hospital, Leicester LE5 4PW, UK.

Publication Types: 
    Case Reports
    Review

PMID: 16679462 [PubMed - indexed for MEDLINE]

1096: Dermatol Clin. 2006 Apr;24(2):271-80, viii.

Dermatologic problems of older women.

Roberts WE.

Loma Linda University Medical School, Loma Linda, and Desert Dermatology Medical 
Associates, 39-700 Bob Hope Drive, Suite 115, Rancho Mirage, CA 92270, USA.
drwerderm@aol.com

Women are living longer today, composing the majority of persons aged 65 and
over. Their dermatologic needs are unique and cross ethnic and cultural lines.
With this increased life expectancy comes an increased occurrence of skin
disorders. The identification and treatment of these conditions is important for 
the practicing clinician. This article reviews some of the more common
dermatologic disorders of older women, and discusses the latest treatments and
issues facing this geriatric population.

Publication Types: 
    Review

PMID: 16677973 [PubMed - indexed for MEDLINE]

1097: Ann Otol Rhinol Laryngol. 2006 Apr;115(4):306-11.

Detection of herpes simplex and varicella-zoster viruses in patients with Bell's 
palsy by the polymerase chain reaction technique.

Stjernquist-Desatnik A, Skoog E, Aurelius E.

Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of
Lund, Lund, Sweden.

OBJECTIVES: Infectious causes of peripheral facial paralysis are well known.
Bell's palsy, however, is an idiopathic facial paralysis, and the genesis is
still unknown. Herpes simplex virus type 1 (HSV-1) and varicella-zoster virus
(VZV) have been suggested as etiologic agents. METHODS: Twenty consecutive adult 
patients with Bell's palsy were included in the study. Ten adult patients
operated on for chronic otitis served as controls. A biopsy specimen from the
posterior auricular muscle was resected within 72 hours after the onset of Bell's
palsy and was analyzed together with cerebrospinal fluid (CSF) by nested
polymerase chain reaction for HSV-1 and VZV DNA. Serum samples were analyzed for 
antibodies to HSV-1 and VZV. RESULTS: HSV-1 DNA was found in the muscle biopsy
specimen from 1 of the 20 patients, but was not found in any of the CSF samples. 
VZV DNA was detected in the muscle biopsy as well as the CSF from 1 other
patient. All controls were negative. Seventeen of 19 patients had stationary
serum antibody concentrations to HSV-1, and none displayed an antibody titer
rise. A significant antibody titer rise to VZV was found in 1 of 19 patients,
whereas 17 of 19 had stationary antibody levels. CONCLUSIONS: HSV-1 or VZV DNA
was detected in 10% of patients with Bell's palsy in the present study. Viral
replication might already have declined in many cases at the onset of the palsy. 
Use of an HSV-1/VZV polymerase chain reaction on a muscle biopsy specimen or CSF 
does not seem to be the method of choice for rapid etiologic diagnosis in the
acute phase of Bell's palsy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16676828 [PubMed - indexed for MEDLINE]

1098: Mayo Clin Womens Healthsource. 2006 Jun;10(6):6.

Shingles. The return of the chickenpox virus.

[No authors listed]

PMID: 16675921 [PubMed - indexed for MEDLINE]

1099: Encephale. 2005 Oct;31 Pt 2:S71-2.

[Atypical hypersomnia]

[Article in French]

Marchand F, Pelatan C, Legout A.

Service Hospitalo-Universitaire, Hopital Sainte-Anne, 1, rue Cabanis, 75014
Paris.

Publication Types: 
    Case Reports

PMID: 16673716 [PubMed - indexed for MEDLINE]

1100: Aliment Pharmacol Ther. 2006 May 15;23(10):1435-42.

Basiliximab for the treatment of steroid-resistant ulcerative colitis: further
experience in moderate and severe disease.

Creed TJ, Probert CS, Norman MN, Moorghen M, Shepherd NA, Hearing SD, Dayan CM;
BASBUC INVESTIGATORS.

Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology,
Dorothy Hodgkin Building, Bristol, UK. t.j.creed@bristol.ac.uk

BACKGROUND: Preliminary data have suggested that interleukin-2 receptor blockade 
with basiliximab may increase steroid sensitivity. We have previously reported a 
small case series demonstrating the potential of basiliximab as a novel agent for
the treatment of steroid-resistant ulcerative colitis. AIM: To report further
experience of the efficacy and safety of treatment with the interleukin-2
receptor blocking monoclonal antibody basiliximab, in addition to steroids, for
the treatment of severe and moderate steroid-resistant ulcerative colitis.
METHODS: Twenty patients were enrolled - 13 patients with moderate
steroid-resistant ulcerative colitis (Ulcerative Colitis Symptom Score: >or=6)
and seven patients with severe steroid-resistant ulcerative colitis. All were
given a single dose of 40 mg basiliximab plus standard steroid therapy in an
open-label, uncontrolled trial. Primary end point was clinical remission within 8
weeks (Ulcerative Colitis Symptom Score: <or=2). RESULTS: Within 8 weeks, 10 of
20 (50%) patients achieved clinical remission (seven of 13 moderate, and three of
seven severe). At 24 weeks, 13 of 20 (65%) patients were in clinical remission.
Five patients required colectomy (four severe, one moderate ulcerative colitis)
and one required rescue ciclosporin (moderate ulcerative colitis). Two patients
developed herpes zoster, but treatment was generally well tolerated. CONCLUSIONS:
Basiliximab appears to promote prolonged remission after a single treatment.
Taken in combination with previously reported data, basiliximab shows particular 
promise in moderate steroid-resistant ulcerative colitis.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 16669958 [PubMed - indexed for MEDLINE]

1101: Clin Infect Dis. 2006 Jun 1;42(11):1639-46. Epub 2006 Apr 28.

Comment in:
    Clin Infect Dis. 2007 Jan 1;44(1):147-8; author reply 148-9.

Immune reconstitution syndrome in HIV: validating a case definition and
identifying clinical predictors in persons initiating antiretroviral therapy.

Robertson J, Meier M, Wall J, Ying J, Fichtenbaum CJ.

Department of Internal Medicine, Division of Infectious Diseases, University of
Cincinnati College of Medicine, Cincinnati, Ohio 45267-0560, USA.
roberj5@ucmail.uc.edu

BACKGROUND: Clinical deterioration after initiation of antiretroviral therapy may
result from restored immunity. There is no standard clinical definition for
immune reconstitution syndrome. The objectives of this study were to validate a
proposed definition and to identify factors predictive of immune reconstitution
syndrome. METHODS: This was a retrospective case-control study from an academic
university medical practice. Cases were matched to > or =2 control subjects by
CD4+ cell count at the time of initiation of antiretroviral therapy. Cases and
"mock cases" were blindly reviewed by 2 human immunodeficiency virus (HIV)
experts. RESULTS: Twenty possible cases of immune reconstitution syndrome were
identified; HIV experts excluded all cases of herpes zoster (shingles), with
agreement on real and mock cases of 92%. For 14 confirmed case patients (compared
with 40 control subjects), immune reconstitution syndrome was associated with a
higher number of prior opportunistic infections (P=.003) and higher CD8+ cell
counts at baseline (P=.05) and at week 12 (P=.02). Immune reconstitution syndrome
was associated with lower baseline levels of alanine aminotransferase (P=.05) and
hemoglobin (P=.02). On multivariate analysis, the number of prior opportunistic
infections (odds ratio, 2.7; P=.007) and lower hemoglobin level at baseline (odds
ratio, 0.8; P=.003) were independently associated with development of immune
reconstitution syndrome. A predictive model was defined by classification and
regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%,
respectively, for an importance score of > or =4 (on a scale of 0.0 to 100.0),
and 92.86% and 80.00%, respectively, for a score of > or =2, using the number of 
prior opportunistic infections, CD8+ cell count, and hemoglobin level.
CONCLUSIONS: A standard definition for immune reconstitution syndrome is
possible. Patients with a greater severity of illness at initiation of
antiretroviral therapy are at risk for immune reconstitution syndrome. The model 
defined by classification and regression tree analysis may provide a basis for
risk stratification before initiation of antiretroviral therapy.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16652323 [PubMed - indexed for MEDLINE]

1102: Indian Pediatr. 2006 Apr;43(4):353-6.

Herpes zoster with dissemination.

Singal A, Mehta S, Pandhi D.

Department of Dermatology and STD, University College of Medical Sciences and GTB
Hospital, Delhi 110 095, India.

Herpes zoster or shingles is an acute vesico-bullous cutaneous infection
characterized by dermatomal distribution, predominantly in adults. Extensive
cutaneous dissemination has been reported in immunocompromised patients. However,
its existence is documented in immunocompetent individuals as well. We report two
children with disseminated herpes zoster, one of whom was immunocompromised
secondary to severe mal-nutrition and had associated orbital septal cellulitis.

Publication Types: 
    Case Reports

PMID: 16651676 [PubMed - indexed for MEDLINE]

1103: Anesthesiology. 2006 May;104(5):1063-9.

Major histocompatibility complex haplotype is associated with postherpetic pain
in mice.

Sato-Takeda M, Takasaki I, Takeda K, Sasaki A, Andoh T, Nojima H, Shiraki K,
Kuraishi Y, Hanaoka K, Tokunaga K, Yabe T.

Department of Anesthesiology, Graduate School of Medicine, University of Tokyo,
Tokyo, Japan. masakost@tg7.so-net.ne.jp

BACKGROUND: Postherpetic neuralgia is one of the major complications of herpes
zoster caused by the reactivation of varicella-zoster virus and is characterized 
by severe pain. The authors previously showed the association of a human major
histocompatibility complex (MHC) haplotype with postherpetic neuralgia. This
study was performed to experimentally confirm the role of MHC haplotype in the
development of postherpetic pain using a mouse model of postherpetic pain, which 
corresponds to postherpetic neuralgia. METHODS: BALB/c mice (MHC haplotype: H-2),
C57BL/6 mice (MHC haplotype: H-2), and BALB/b mice, a congenic BALB/c strain with
H-2, were used. Herpes simplex virus type I was transdermally inoculated on the
hind paw. Unilaterally zosteriform skin lesion and pain-related responses (acute 
herpetic pain) were caused, and some mice showed pain-related responses
(postherpetic pain) after the cure of skin lesions. Herpes simplex virus type I
antigen and CD3-positive cells were immunostained in the dorsal root ganglion in 
the acute phase. RESULTS: The incidence (78%) of postherpetic pain in C57BL/6
mice was significantly higher than that (35%) in BALB/c mice (P = 0.004, odds
ratio = 6.7). Furthermore, the incidence of postherpetic pain in BALB/b (H-2) was
similar to that in C57BL/6. Herpes simplex virus type I antigen-positive cells
were less in the dorsal root ganglion of C57BL/6 mice than that of BALB/c mice.
CD3-positive T cells were more in the dorsal root ganglion of C57BL/6 mice than
BALB/c mice. CONCLUSIONS: These results suggest that the MHC haplotype (H-2) is
involved in the incidence of postherpetic pain, and CD3-positive T cells may play
a role in its pathogenesis.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 16645460 [PubMed - indexed for MEDLINE]

1104: J Eur Acad Dermatol Venereol. 2006 Apr;20(4):470-2.

Cutaneous multifocal melanoma metastases clinically resembling herpes zoster.

Kondras K, Zalewska A, Janowski P, Kordek R.

Publication Types: 
    Case Reports
    Letter

PMID: 16643157 [PubMed - indexed for MEDLINE]

1105: J Biol Chem. 2006 Jun 30;281(26):18193-200. Epub 2006 Apr 24.

Crystal structure of the herpes simplex virus 1 DNA polymerase.

Liu S, Knafels JD, Chang JS, Waszak GA, Baldwin ET, Deibel MR Jr, Thomsen DR,
Homa FL, Wells PA, Tory MC, Poorman RA, Gao H, Qiu X, Seddon AP.

Exploratory Medicinal Sciences, Pfizer Inc., Eastern Point Road, Groton, CT
06340, USA. shenping.liu@pfizer.com

Herpesviruses are the second leading cause of human viral diseases. Herpes
Simplex Virus types 1 and 2 and Varicella-zoster virus produce neurotropic
infections such as cutaneous and genital herpes, chickenpox, and shingles.
Infections of a lymphotropic nature are caused by cytomegalovirus, HSV-6, HSV-7, 
and Epstein-Barr virus producing lymphoma, carcinoma, and congenital
abnormalities. Yet another series of serious health problems are posed by
infections in immunocompromised individuals. Common therapies for herpes viral
infections employ nucleoside analogs, such as Acyclovir, and target the viral DNA
polymerase, essential for viral DNA replication. Although clinically useful, this
class of drugs exhibits a narrow antiviral spectrum, and resistance to these
agents is an emerging problem for disease management. A better understanding of
herpes virus replication will help the development of new safe and effective
broad spectrum anti-herpetic drugs that fill an unmet need. Here, we present the 
first crystal structure of a herpesvirus polymerase, the Herpes Simplex Virus
type 1 DNA polymerase, at 2.7 A resolution. The structural similarity of this
polymerase to other alpha polymerases has allowed us to construct high confidence
models of a replication complex of the polymerase and of Acyclovir as a DNA chain
terminator. We propose a novel inhibition mechanism in which a representative of 
a series of non-nucleosidic viral polymerase inhibitors, the
4-oxo-dihydroquinolines, binds at the polymerase active site interacting
non-covalently with both the polymerase and the DNA duplex.

PMID: 16638752 [PubMed - indexed for MEDLINE]

1106: J Gastroenterol Hepatol. 2006 Mar;21(3):620.

Gastrointestinal: Zosteriform metastases to the skin.

Kamisawa T, Takahashi M, Nakajima H, Egawa N.

Publication Types: 
    Case Reports

PMID: 16638112 [PubMed - indexed for MEDLINE]

1107: Georgian Med News. 2006 Mar;(132):60-4.

Hiv prevalence among high risk behavior group persons with herpes zoster
infection.

Sharvadze L, Tsertsvadze T, Gochitashvili N, Stvilia K, Dolmazashvili E.

Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi,
Georgia.

The aim of the two year (2003-2005) study was to study the HIV prevalence among
high risk behavior groups of persons with Herpes Zoster infection. For this
purpose we have investigated the high risk group patients: 1257 prisoners (1st
group), 1543 IDUs (2nd group) and 1350 persons including: homosexuals, persons
with history of frequent unprotected sex and persons with hepatitis B and C (3rd 
group). We revealed the persons with current or previous history of Herpes
Zoster, and studied HIV prevalence among them. Besides, we have studied the
immune status of revealed HIV positive persons, relationship between disease
(Herpes Zoster) severity and CD4 count. Herpes Zoster infection was diagnosed
based on clinical symptoms, anamnesis and by detection of VZV specific IgM and
IgG by ELISA. HIV infection was diagnosed by ELISA method and was confirmed by
Western Blot. CD4 count was detected by immunophenotyping technique and was
analyzed using a FACSCalibur flow cytometer. The total prevalence of HIV
infection among high risk behavior group persons with Herpes Zoster infection was
18,9% (31 HIV cases out of 164). The disease (Herpes Zoster) severity and
duration was associated with decreased rate of cellular immunity, CD4 count.
Herpes Zoster has a positive predictive value for HIV infection, predominantly
recurrent Herpes Zoster. Herpes Zoster should be recognized as a marker condition
indicating the necessity of screening for HIV, especially in Georgia, the region 
where the problem of IDU exists.

PMID: 16636383 [PubMed - indexed for MEDLINE]

1108: Am J Kidney Dis. 2006 May;47(5):915-22.

Fatal relapse of ANCA-associated glomerulonephritis triggered by successive
Epstein-Barr and varicella zoster virus infections.

Schned AR, Ornvold K, Tsongalis GJ, Chobanian MC.

Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756,
USA. alan.schned@dartmouth.edu

Publication Types: 
    Case Reports

PMID: 16632033 [PubMed - indexed for MEDLINE]

1109: Rinsho Ketsueki. 2006 Mar;47(3):210-3.

[Acyclovir combined with plasma exchange for disseminated varicella-zoster virus 
infection after bone marrow transplantation]

[Article in Japanese]

Lee C, Koike M, Oshimi K, Terakura S, Kodera Y.

Department of Hematology, Juntendo University, Shizuoka Hospital.

In 2001, a 45-year-old man with severe aplastic anemia received a bone marrow
transplantation from his HLA-identical sister, 2.5 years after which he developed
severe liver dysfunction together with abdominal pain, disturbance of
consciousness and generalized vesicles. Disseminated varicella-zoster virus
infection was diagnosed by the detection of VZV DNA. Acyclovir and plasma
exchange rapidly controlled his VZV-related symptoms and signs. Disseminated VZV 
infection is often fatal, but acyclovir and plasma exchange may be useful for
such infection by reducing the circulating viral load.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16629486 [PubMed - indexed for MEDLINE]

1110: Am J Dermatopathol. 2006 Apr;28(2):181-6.

Comment in:
    Am J Dermatopathol. 2007 Feb;29(1):109-11.

Herpes incognito most commonly is herpes zoster and its histopathologic pattern
is distinctive!

Boer A, Herder N, Blodorn-Schlicht N, Falk T.

Dermatologikum Hamburg, Stephansplatz 5, 20354 Hamburg, Germany.
boer@dermatologikum.de

Infections of the skin by herpesviruses do not always present themselves in
typical fashion. Conventional microscopy is used routinely to confirm infection
by herpesviruses, but sometimes typical signs such as multinucleated epithelial
cells or "ghosts" of them are not encountered in a specimen (so-called herpes
incognito). We studied 35 patients in whom infection with herpesviruses was
differentially diagnosed clinically but in whom a biopsy specimen had been taken 
for confirmation. Only those patients in whom histopathologic findings had been
interpreted as being "not diagnostic" of herpesvirus infection by 2 independent
dermatopathologists were included. Clinical and histopathologic findings were
correlated with results from polymerase chain reaction studies on formalin-fixed 
paraffin-embedded tissue. Polymerase chain reaction revealed herpesvirus-specific
DNA in 12 of 35 specimens, 10 being varicella zoster virus (VZV) positive, 1
herpes simplex virus (HSV)-2 positive, and 1 HSV-1 positive. Ten of these 12
cases presented themselves in very similar fashion (8 VZV, 1 HSV-1, 1 HSV-2). All
lesions were macular or papular and typified mostly by dense perivascular and
sparse interstitial superficial and deep infiltrates of lymphocytes, sometimes
assuming a patchy lichenoid pattern. Infiltrates were prominent in and around
adnexal structures, often peppering follicles, sebaceous glands, and eccrine
glands. Lymphocytes were also found in the lower part of the epidermis
accompanied by a combination of spongiosis and vacuolar alteration. The papillary
dermis was often edematous; extravasated erythrocytes in variable numbers were a 
common finding. Lymphocytes sometimes had large and polygonal nuclei. Neutrophils
and nuclear dust were present occasionally; eosinophils were rare. We conclude
that herpes incognito most commonly is herpes zoster and its histopathologic
pattern is distinctive.

PMID: 16625086 [PubMed]

1111: Suppl Clin Neurophysiol. 2006;58:153-70.

Neuropathic facial pain.

Haanpaa M, Truini A.

Pain Clinic, Department of Neurosurgery, Helsinki University Hospital, 00029 HUS,
Helsinki, Finland. maija.haanpaa@hus.fi

Publication Types: 
    Review

PMID: 16623329 [PubMed - indexed for MEDLINE]

1112: Int J Antimicrob Agents. 2006 May;27(5):423-30. Epub 2006 Apr 18.

Antiviral activity of cyclosaligenyl prodrugs of the nucleoside analogue
bromovinyldeoxyuridine against herpes viruses.

Meerbach A, Meier C, Sauerbrei A, Meckel HM, Wutzler P.

Institute of Virology and Antiviral Therapy, Friedrich-Schiller University Jena, 
Hans-Knoell-Strasse 2, D-07745 Jena, Germany. Astrid.Meerbach@med.uni-jena.de

A series of 42 lipophilic bromovinyldeoxyuridine monophosphates (BVDUMPs) are
presented as potential prodrugs of the antiviral agent
(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU). The 5'-cycloSal-masking group
technique has been applied to this cyclic nucleoside analogue to achieve delivery
of the monophosphate of BVDU inside the target cells. The new substances have
been tested for their antiviral activity against herpes simplex virus types 1 and
2 (HSV-1 and -2), thymidine kinase-deficient (TK(-)) HSV-1, varicella-zoster
virus (VZV), human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV). The
XTT-based tetrazolium reduction assay EZ4U (for HSV), the plaque inhibition test 
(for VZV and HCMV) and a DNA hybridisation assay (for EBV) were used to assess
antiviral activity. The results indicate that cycloSal-BVDUMP triesters proved to
be potent and selective inhibitors of HSV-1 comparable with aciclovir. VZV
replication was inhibited by very low concentrations, and two substances had a
slightly better anti-VZV activity than the parent compound BVDU. No antiviral
effect could be demonstrated against TK(-)-HSV-1, HSV-2 and HCMV, most likely
owing to the lack of phosphorylation to BVDU diphosphate. Most remarkably,
several cycloSal-BVDUMP triesters yielded promising anti-EBV activity whereas the
parent compound BVDU was entirely inactive.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16621459 [PubMed - indexed for MEDLINE]

1113: Clin Otolaryngol. 2006 Apr;31(2):144-8.

Prognostic value of electroneurography in Bell's palsy and Ramsay-Hunt's
syndrome.

Lee DH, Chae SY, Park YS, Yeo SW.

Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The
Catholic University of Korea, Seoul, South Korea. leedh0814@catholic.ac.kr

OBJECTIVES: This study evaluated the accuracy of electroneurography to predict
the prognosis of Bell's palsy and Ramsay-Hunt's syndrome. DESIGN: A
retrospective, institutional review board-approved study. SETTING: A secondary
referral and a university-based centre. PARTICIPANTS: The patients had been
treated for a sudden onset unilateral facial paralysis over the past 10 years
(1994-2004). This retrospective study included only those patients who had been
followed up for at least 3 months or if they had reached a complete recovery
before then. MAIN OUTCOMES MEASURES: House-Backmann grade versus
electroneurography value. RESULTS: The recovery rates to House-Brackmann grade II
or better were 95% in those with Bell's palsy and 84% in those with herpes zoster
oticus. The electroneurography value of the recovery and non-recovery groups from
those with either Bell's palsy or herpes zoster oticus was similar. The logistic 
regression model between the electroneurography values and the probability of
recovery showed no correlation in those with Bell's palsy or with herpes zoster
oticus. This study did not identify the proper electroneurography value that had 
enough appropriate sensitivity and specificity to predict the prognosis of
paralysis accurately in Bell's palsy or in herpes zoster oticus patients.
CONCLUSION: Electroneurography performed between day 7 and 10 for Bell's palsy or
day 10 and 14 for herpes zoster oticus does not provide accurate information on
the prognosis or recovery rate of the facial paralysis.

PMID: 16620335 [PubMed - indexed for MEDLINE]

1114: J Dermatol. 2006 Mar;33(3):233-5.

Postherpetic paresis of the lower limb.

Okamoto O, Kiyomoto Y, Okazaki T, Fujiwara S.

Publication Types: 
    Case Reports
    Letter

PMID: 16620237 [PubMed - indexed for MEDLINE]

1115: J Clin Virol. 2006 Jun;36(2):111-8. Epub 2006 Apr 17.

European seroepidemiology network 2: Standardisation of assays for
seroepidemiology of varicella zoster virus.

de Ory F, Echevarria JM, Kafatos G, Anastassopoulou C, Andrews N, Backhouse J,
Berbers G, Bruckova B, Cohen DI, de Melker H, Davidkin I, Gabutti G, Hesketh LM, 
Johansen K, Jokinen S, Jones L, Linde A, Miller E, Mossong J, Nardone A, Rota MC,
Sauerbrei A, Schneider F, Smetana Z, Tischer A, Tsakris A, Vranckx R.

Centro Nacional de Microbiologia, Instituto de Salud Carlos III, Majadahonda,
Madrid, Spain. fory@isciii.es

BACKGROUND: The aim of the European Sero-Epidemiology Network (ESEN2) is to
harmonise the serological surveillance of vaccine-preventable diseases in Europe.
OBJECTIVE: To allow comparison of antibody prevalence in different countries by
standardising results into common units. STUDY DESIGN: For varicella zoster virus
(VZV), a reference laboratory established a panel of 148 samples, characterised
by indirect enzyme-immunoassay (ELISA), indirect immunofluorescence, and
complement fixation test. Fifty-seven samples were also studied by the
fluorescence antibody to membrane antigen test. The geometric mean of the
antibody activity (GMAA) obtained from four ELISA determinations was used to
characterise each sample of the panel as positive (GMAA: >100 mIU/ml), equivocal 
(GMAA: 50-100 mIU/ml) or negative (GMAA: <50 mIU/ml) for antibody to VZV
(anti-VZV). Thirteen laboratories, using five different ELISA tests, tested the
panel. RESULTS: Agreement with the reference laboratory was above 85% in all
cases, and the R(2) values obtained from regression analysis of the quantitative 
results were always higher than 0.87. Finally, the regression equations could be 
used to convert national values into a common unitage. CONCLUSION: This study
confirmed that results for anti-VZV obtained by different ELISA methods can be
converted into common units, enabling the comparison of the seroprevalence
profiles obtained in the participant countries.

Publication Types: 
    Comparative Study
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 16616612 [PubMed - indexed for MEDLINE]

1116: Nippon Rinsho. 2006 Mar;64 Suppl 3:321-5.

[Varicella vaccine]

[Article in Japanese]

Kamiya H.

National Hospital Organization Mie National Hospital.

Publication Types: 
    Review

PMID: 16615492 [PubMed - indexed for MEDLINE]

1117: Nippon Rinsho. 2006 Mar;64 Suppl 3:311-5.

[Treatment of alpha herpesvirus infections in ophthalmology]

[Article in Japanese]

Shiota H, Nakahira T.

Department of Ophthalmology & Visual Neuroscience, Institute of Health
Biosciences, The University of Tokushima Graduate School.

Publication Types: 
    Review

PMID: 16615490 [PubMed - indexed for MEDLINE]

1118: Nippon Rinsho. 2006 Mar;64 Suppl 3:306-10.

[Treatment of alpha-herpes virus infections]

[Article in Japanese]

Honda M.

Department of Dermatology, Aoto Hospital, Jikei University School of Medicine.

Publication Types: 
    Review

PMID: 16615489 [PubMed - indexed for MEDLINE]

1119: Nippon Rinsho. 2006 Mar;64 Suppl 3:285-9.

[Postherpetic neuralgia]

[Article in Japanese]

Miyazaki T, Tanabe Y, Iseki M.

Department of Anesthesiology & Pain Medicine, Juntendo University, School of
Medicine.

Publication Types: 
    Review

PMID: 16615485 [PubMed - indexed for MEDLINE]

1120: Nippon Rinsho. 2006 Mar;64 Suppl 3:281-4.

[Ramsay Hunt syndrome]

[Article in Japanese]

Furuta Y.

Department of Otolaryngology Head & Neck Surgery, Hokkaido University Graduate
School of Medicine.

Publication Types: 
    Review

PMID: 16615484 [PubMed - indexed for MEDLINE]

1121: Nippon Rinsho. 2006 Mar;64 Suppl 3:272-5.

[Meningitis]

[Article in Japanese]

Nakajima H.

First Department of Internal Medicine, Osaka Medical College.

Publication Types: 
    Review

PMID: 16615482 [PubMed - indexed for MEDLINE]

1122: Nippon Rinsho. 2006 Mar;64 Suppl 3:260-3.

[Herpes zoster]

[Article in Japanese]

Yoshida M.

First Department of Dermatology, School of Medicine, Toho University.

Publication Types: 
    Review

PMID: 16615479 [PubMed - indexed for MEDLINE]

1123: Nippon Rinsho. 2006 Mar;64 Suppl 3:243-51.

[Acute retinal necrosis due to herpesviridae infections]

[Article in Japanese]

Usui N.

Department of Ophthalmology, Shinkawabashi Hospital.

Publication Types: 
    Review

PMID: 16615476 [PubMed - indexed for MEDLINE]

1124: Nippon Rinsho. 2006 Mar;64 Suppl 3:239-42.

[Keratoconjunctivitis due to alphaherpesvirinae]

[Article in Japanese]

Shimomura Y.

Department of Ophthalmology, Kinki University School of Medicine.

Publication Types: 
    Review

PMID: 16615475 [PubMed - indexed for MEDLINE]

1125: Nippon Rinsho. 2006 Mar;64 Suppl 3:234-8.

[Serodiagnosis for alphaherpesvirinae infections]

[Article in Japanese]

Saito Y.

Department of Infection and Immunology, SRL, Inc.

Publication Types: 
    Review

PMID: 16615474 [PubMed - indexed for MEDLINE]

1126: Nippon Rinsho. 2006 Mar;64 Suppl 3:230-3.

[Diagnosis of VZV infection]

[Article in Japanese]

Ozaki T.

Department of Pediatrics, Showa Hospital.

Publication Types: 
    Review

PMID: 16615473 [PubMed - indexed for MEDLINE]

1127: Nippon Rinsho. 2006 Mar;64 Suppl 3:221-5.

[Epidemiology of VZV infection]

[Article in Japanese]

Suga S.

Department of Pediatrics, Banbuntanehotokukai Hospital, Fujita Health University.

Publication Types: 
    Review

PMID: 16615471 [PubMed - indexed for MEDLINE]

1128: Nippon Rinsho. 2006 Mar;64 Suppl 3:184-7.

[Immune responses to varicella-zoster virus infection]

[Article in Japanese]

Yasumoto S.

Department of Dermatology, Kurume University School of Medicine.

Publication Types: 
    Review

PMID: 16615464 [PubMed - indexed for MEDLINE]

1129: Nippon Rinsho. 2006 Mar;64 Suppl 3:133-9.

[Varicella-zoster virus genome and the genes]

[Article in Japanese]

Okuno T.

Department of Microbiology, Hyogo College of Medicine.

Publication Types: 
    Review

PMID: 16615454 [PubMed - indexed for MEDLINE]

1130: Nippon Rinsho. 2006 Mar;64 Suppl 3:95-8.

[Herpesvirus infections in dermatology]

[Article in Japanese]

Honda M.

Department of Dermatology, Aoto Hospital, Jikei University School of Medicine.

Publication Types: 
    Review

PMID: 16615448 [PubMed - indexed for MEDLINE]

1131: Nippon Rinsho. 2006 Mar;64 Suppl 3:86-9.

[Herpesvirus infection in the field of ophthalmology]

[Article in Japanese]

Shimomura Y.

Department of Ophthalmology, Kinki University School of Medicine.

Publication Types: 
    Review

PMID: 16615446 [PubMed - indexed for MEDLINE]

1132: Nippon Rinsho. 2006 Mar;64 Suppl 3:81-5.

[Herpes virus infection in obstetrics and gynecology]

[Article in Japanese]

Kawana T.

Department of Obstetrics and Gynecology, Teikyo University School of Medicine,
Mizonokuchi Hospital.

Publication Types: 
    Review

PMID: 16615445 [PubMed - indexed for MEDLINE]

1133: Nippon Rinsho. 2006 Mar;64 Suppl 3:73-6.

[Herpesvirus infections in hematological diseases]

[Article in Japanese]

Karasuno T, Hiraoka A.

Hematology/Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases.

Publication Types: 
    Review

PMID: 16615443 [PubMed - indexed for MEDLINE]

1134: Pediatr Blood Cancer. 2007 Jun 15;48(7):716.

Comment on:
    Pediatr Blood Cancer. 2005 Aug;45(2):191-4.

Disseminated Varicella-Zoster virus infection in a girl with T-lineage acute
lymphoblastic leukemia.

Akiyama M, Kobayashi N, Fujisawa K, Eto Y.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 16607647 [PubMed - indexed for MEDLINE]

1135: Am J Trop Med Hyg. 2006 Apr;74(4):591-2.

Varicella zoster virus meningitis complicating sodium stibogluconate treatment
for cutaneous leishmaniasis.

Hartzell JD, Aronson NE, Nagaraja S, Whitman T, Hawkes CA, Wortmann G.

Department of Internal Medicine, Walter Reed Army Medical Center, Washington, DC 
20307-5001, USA. Joshua.hartzell@na.amedd.army.mil

Sodium stibogluconate (Pentostam(R); GlaxoSmithKline) is a pentavalent antimonial
compound used in the treatment of leishmaniasis, which has an association with
reactivation of varicella zoster virus (VZV). We report the first known case of
an immunocompetent adult who developed VZV aseptic meningitis and dermatomal
herpes zoster during treatment with sodium stibogluconate.

Publication Types: 
    Case Reports

PMID: 16606989 [PubMed - indexed for MEDLINE]

1136: Bone Marrow Transplant. 2006 Jun;37(11):1051-9.

Mesenchymal stem cells are susceptible to human herpesviruses, but viral DNA
cannot be detected in the healthy seropositive individual.

Sundin M, Orvell C, Rasmusson I, Sundberg B, Ringden O, Le Blanc K.

Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska
Institutet, Karolinska University Hospital Huddinge, SE-141 86 Stockholm, Sweden.
mikael.sundin@ki.se

Allogeneic stem cell transplantation is often complicated by reactivation of
herpesviruses. Mesenchymal stem cells (MSC) are immunomodulatory and may be used 
to treat graft-versus-host disease. We investigated if herpesviruses infect and
can be transmitted by MSC, and if MSC suppress immune responses to various
infectious agents. Mesenchymal stem cells from healthy seropositive donors were
evaluated with polymerase chain reaction for the most common herpesviruses:
cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1), herpes simplex virus 
type 2, Epstein-Barr virus (EBV) and varicella zoster virus. The cytopathological
effect (CPE) was investigated and viral antigens analyzed by immunofluorescence
after in vitro exposure to CMV, HSV-1 and EBV. We also studied MSC effect on
lymphocyte stimulation induced by various infectious agents. No viral DNA could
be detected in MSC isolated from healthy seropositive individuals. However, a CPE
was noted and intracellular viral antigens detected after infection in vitro by
CMV and HSV-1, but not by EBV. The CMV and HSV-1 infections were productive.
Lymphocyte proliferation by herpesviruses, candida mannan and protein A from
Staphylococcus aureus was suppressed by MSC. The data indicate that the risk of
herpesvirus transmission by transplantation of MSC from healthy seropositive
donors is low. However, MSC may be susceptible to infection if infused in a
patient with CMV or HSV-1 viremia. MSC transplantation may compromise the host's 
defense against infectious agents.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't

PMID: 16604097 [PubMed - indexed for MEDLINE]

1137: Actas Dermosifiliogr. 2006 Mar;97(2):103-14.

[Update in the treatment of herpes zoster]

[Article in Spanish]

Espana A, Redondo P.

Departamento de Dermatologia, Clinica Universitaria de Navarra, Facultad de
Medicina, Spain.

The systemic treatment of herpes zoster shortens the healing process, and
prevents or alleviates pain and other acute or chronic complications, especially 
when it is administered in the first 72 hours after symptoms appear. This
treatment is especially indicated in patients over the age of 50 and in those
who, regardless of age, have head and neck involvement, especially in herpes
zoster ophthalmicus. The drugs approved in Europe for the systemic treatment of
herpes zoster are aciclovir, valaciclovir, famciclovir and brivudine. Brivudine
shows greater effectiveness against the varicella-zoster virus than aciclovir and
its derivatives, and can be given just once a day for seven days, compared to
multiple doses of the latter. As opposed to the others, brivudine is a
non-nephrotoxic drug that should not be administered to immunodepressed patients 
or to those being treated with 5-fluorouracil. The treatment of herpes zoster to 
reduce pain should be combined with analgesics and neuroactive agents
(amitriptyline, gabapentin, etc). While corticosteroids are of dubious efficacy
in the treatment of post-herpes neuralgia, the intensity and duration of the pain
can be reduced with some topical treatments (capsaicin, lidocaine patches, etc). 
Finally, this review discusses treatment guidelines for special locations
(cranial nerves) and different subpopulations (children, pregnant women,
immunodepressed patients, etc).

Publication Types: 
    English Abstract
    Review

PMID: 16595111 [PubMed - indexed for MEDLINE]

1138: Acta Derm Venereol. 2006;86(1):73-4.

Postherpetic paresis mimicking an abdominal herniation.

Giuliani A, Galati G, Parisi L, Ricciardulli T, Bartolo M, Tartaglia E, Grimaldi 
M, Pranteda G.

Publication Types: 
    Case Reports
    Letter

PMID: 16586000 [PubMed - indexed for MEDLINE]

1139: Ann Intern Med. 2006 Apr 4;144(7):535-7.

Evidence for vascular spread of varicella zoster-associated vasculopathy.

Saraya T, Shimura C, Wada H, Aoshima M, Goto H.

Publication Types: 
    Case Reports
    Letter

PMID: 16585673 [PubMed - indexed for MEDLINE]

1140: Nursing. 2006 Apr;36(4):18-9.

Shutting down shingles.

Snow M.

CNA Edicational Services, Kaysville, Utah, USA.

PMID: 16582721 [PubMed - indexed for MEDLINE]

1141: Ann Otol Rhinol Laryngol. 2006 Mar;115(3):233-8.

Varicella-zoster virus load and cochleovestibular symptoms in Ramsay Hunt
syndrome.

Ohtani F, Furuta Y, Aizawa H, Fukuda S.

Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate 
School of Medicine, Sapporo, Japan.

OBJECTIVES: The mechanism by which varicella-zoster virus (VZV) reactivation
causes cochleovestibular symptoms (CVSs) in patients with Ramsay Hunt syndrome
(RHS) remains to be elucidated. The present study analyzed the relationship
between VZV load and the onset of CVSs in RHS. METHODS: The subjects consisted of
56 patients with RHS; 29 exhibited CVSs and facial paralysis (FP; group 1), and
27 exhibited FP without CVSs (group 2). The VZV DNA copy number in the saliva was
measured with a quantitative polymerase chain reaction. Anti-VZV antibodies were 
assayed by an enzyme-linked immunosorbent assay with paired sera. RESULTS: There 
was no significant difference in maximum viral copy number between the two
groups. In group 1, CVSs occurred at various times between the early phase and
the regression phase of VZV reactivation. In some patients, CVSs occurred in the 
early phase of VZV reactivation, before the onset of zoster lesions and FP.
CONCLUSIONS: There are various different patterns in the development of eighth
cranial nerve dysfunction, which is caused by progression of neuritis or
labyrinthitis following VZV reactivation. Our data suggest that CVSs in RHS may
also be caused by reactivation of VZV in the spiral and/or vestibular ganglia.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 16572614 [PubMed - indexed for MEDLINE]

1142: Am J Ophthalmol. 2006 Apr;141(4):782; author reply 782.

Comment on:
    Am J Ophthalmol. 2005 Jun;139(6):1135-6.

Chronic recurrent varicella-zoster virus keratitis confirmed by polymerase chain 
reaction testing.

Mortemousque B.

Publication Types: 
    Comment
    Letter

PMID: 16564841 [PubMed - indexed for MEDLINE]

1143: Am J Ophthalmol. 2006 Apr;141(4):756-8.

Rose bengal and lissamine green inhibit detection of herpes simplex virus by PCR.

Seitzman GD, Cevallos V, Margolis TP.

Francis I. Proctor Foundation, Department of Ophthalmology, University of
California, San Francisco, California, USA.

PURPOSE: To determine whether rose bengal and lissamine green affect polymerase
chain reaction (PCR) detection of herpes simplex virus (HSV). DESIGN: Laboratory 
investigation. METHODS: Diagnostic corneal scrapings were evaluated for PCR
inhibitory activity. Dacron swabs inoculated with rose bengal and lissamine green
were processed as clinical samples, inoculated with control HSV, varicella zoster
(VZV), cytomegalovirus (CMV), and toxoplasma DNA and prepared for PCR. The
effects of calcium alginate and cotton swabs were also evaluated. RESULTS: Rose
bengal, lissamine green, and calcium alginate not only inhibit PCR detection of
HSV DNA, but also detection of VZV, CMV, and toxoplasma DNA. This inhibition
could be overcome by serial dilution and by DNA purification of the sample before
PCR. CONCLUSIONS: Rose bengal, lissamine green, and calcium alginate can inhibit 
PCR detection of HSV DNA. Clinical scrapings to be sent for PCR diagnostic
testing should be taken before instillation of rose bengal or lissamine green.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16564821 [PubMed - indexed for MEDLINE]

1144: Reprod Toxicol. 2006 May;21(4):350-82. Epub 2006 Mar 27.

Laboratory assessment and diagnosis of congenital viral infections: Rubella,
cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), 
parvovirus B19 and human immunodeficiency virus (HIV).

Mendelson E, Aboudy Y, Smetana Z, Tepperberg M, Grossman Z.

Central Virology Laboratory, Ministry of Health and Faculty of Life Sciences,
Bar-Ilan University, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
ellamen@sheba.health.gov.il

Viral infections during pregnancy may cause fetal or neonatal damage. Clinical
intervention, which is required for certain viral infections, relies on
laboratory tests performed during pregnancy and at the neonatal stage. This
review describes traditional and advanced laboratory approaches and testing
methods used for assessment of the six most significant viral infections during
pregnancy: rubella virus (RV), cytomegalovirus (CMV), varicella-zoster virus
(VZV), herpes simplex virus (HSV), parvovirus B19 and human immunodeficiency
virus (HIV). Interpretation of the laboratory tests results according to studies 
published in recent years is discussed.

Publication Types: 
    Review

PMID: 16564672 [PubMed - indexed for MEDLINE]

1145: Vaccine. 2006 May 1;24(18):3946-52. Epub 2006 Feb 24.

The epidemiology of varicella and herpes zoster in The Netherlands: implications 
for varicella zoster virus vaccination.

de Melker H, Berbers G, Hahne S, Rumke H, van den Hof S, de Wit A, Boot H.

Centre for Infectious Disease Epidemiology, National Institute of Public Health
and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
h.de.melker@rivm.nl

We studied the epidemiology of varicella (chickenpox) and herpes zoster
(shingles) in The Netherlands to assess the desirability to implement routine
varicella zoster virus vaccination in The Netherlands. Data on seroprevalence of 
varicella zoster virus in the general population (1995-1996), consultations of
general practitioners for varicella (2000-2002) and herpes zoster (1998-2001) and
hospital admissions due to varicella (1994-2001) and herpes zoster (1994-2001) in
The Netherlands were analysed. The seropositivity increased sharply with age from
18.4% for both 0- and 1-year-olds, to 48.9%, 59.0%, 75.7% and 93.0% for 2-, 3-,
4- and 5-year-olds, respectively, and varied between 97.5% and 100% for older age
groups. The average annual incidence of GP-consultations amounted to 253.5 and
325.0 per 100,000 for varicella and herpes zoster, respectively. The incidence of
hospital admission due to varicella and herpes zoster was 1.3 (2.3 including side
diagnosis) and 2.7 (5.8) per 100,000, respectively. Whilst for varicella, the
incidence of GP-consultations and hospital admissions were highest in childhood, 
for herpes zoster, these were highest in elderly. Insight into epidemiology of
varicella zoster is needed for the assessment of the desirability of introduction
of routine varicella zoster vaccination.

PMID: 16564115 [PubMed - indexed for MEDLINE]

1146: J Ark Med Soc. 2006 Mar;102(9):237.

Call to action: Adult immunization.

Hopkins R.

PMID: 16562758 [PubMed - indexed for MEDLINE]

1147: Nippon Ganka Gakkai Zasshi. 2006 Mar;110(3):193-8.

[Case of herpes zoster ophthalmicus with abducent palsy: the cause and magnetic
resonance imaging findings]

[Article in Japanese]

Iwao K, Kobayashi H, Okinami S.

Department of Ophthalmology, Faculty of Medicine, Saga University, Japan.

PURPOSE: To report the cause and magnetic resonance imaging (MRI) findings in a
case of abducent palsy following herpes zoster ophthalmicus. CASE: A 76-year-old 
man presented with acute onset of pain, a vesicular cutaneous eruption and herpes
zoster ophthalmicus on the right side. He developed complete abducent palsy on
the right side two weeks after onset. MRI with gadolinium enhancement showed
Meckel's sinus, which contains the trigeminal ganglion, and the abducent nerve on
the right side. The patient was treated with intravenous acyclovir and
methylprednisolone. The abnormal enhancement shown on MRI vanished immediately
and the ophthalmoplegia resolved significantly. CONCLUSION: This is the first
reported case where an affected cranial nerve was detected next to the
inflammatory cavernous sinus in ophthalmoplegia following herpes zoster
ophthalmicus. These MRI findings showed that this ophthlamoplegia was induced by 
direct viral invasion or extension of inflammation to the ipsilateral cranial
nerve. Further studies need to be performed to clarify the role of specific
antiviral therapy or anti-inflammatory agents in treating this complication of
herpes zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16562507 [PubMed - indexed for MEDLINE]

1148: Mol Pharmacol. 2006 Jun;69(6):1891-6. Epub 2006 Mar 23.

Mutations distal to the substrate site can affect varicella zoster virus
thymidine kinase activity: implications for drug design.

El Omari K, Liekens S, Bird LE, Balzarini J, Stammers DK.

Division of Structural Biology, The Wellcome Trust Centre for Human Genetics,
University of Oxford, Roosevelt Drive, Oxford, OX3 7BN, UK.

Varicella zoster virus encodes a thymidine kinase responsible for the activation 
of antiherpetic nucleoside prodrugs such as acyclovir. In addition, herpes virus 
thymidine kinases are being explored in gene/chemotherapy strategies aimed at
developing novel antitumor therapies. To investigate and improve compound
selectivity, we report here structure-based site-directed mutagenesis studies of 
varicella zoster virus thymidine kinase (VZVTK). Earlier reports showed that
mutating residues at the core of the VZVTK active site invariably destroyed
activity; hence, we targeted more distal residues. Based on the VZVTK crystal
structure, we constructed six mutants (E59S, R84V, H97Y/A, and Y21H/E) and tested
substrate activity and competitive inhibition for several compound series. All
VZVTK mutants tested retained significant phosphorylation activity with dThd as
substrate, apart from Y21E (350-fold diminution in the k(cat)/K(m)). Some
mutations give slightly improved affinities: bicyclic nucleoside analogs (BCNAs) 
with a p-alkyl-substituted phenyl group seem to require aromatic ring stacking
interactions with residue 97 for optimal inhibitory effect. Mutation Y21E
decreased the IC(50) value for the BCNA
3-(2'-deoxy-beta-D-ribofuranosyl)-6-octyl-2,3-dihydrofuro[2,3-d]pyrimidin-2-one
(Cf1368) 4-fold, whereas mutation Y21H increased the IC(50) value by more than
15-fold. These results suggest that residue 21 is important for BCNA selectivity 
and might explain why HSV1TK is unable to bind BCNAs. Other mutants, such as the 
E59S and R84V thymidine kinases, which in wild-type VZVTK stabilize the dimer
interface, give opposite results regarding the level of sensitivity to BCNAs. The
work described here shows that distal mutations that affect the VZVTK active-site
may help in the design of more selective substrates for gene suicide therapy or
as anti-varicella zoster virus drugs.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16556772 [PubMed - indexed for MEDLINE]

1149: Diagn Cytopathol. 2006 Mar;34(3):232-4.

Cytologic findings in Demodex folliculitis: a case report and review of the
literature.

Dong H, Duncan LD.

Department of Pathology, University of Tennessee Medical Center, Knoxville,
Tennessee 37920, USA.

Infectious folliculitis of the head and neck has various etiologies, including
bacteria, viruses, fungi, and parasites. Accurate morphologic recognition of
microorganisms in biopsy and cytologic specimens is paramount in facilitating
appropriate therapy. We report a case of a 37-yr-old white male with Demodex
folliculitis, who presented with an extensive and painful erythematous pustular
skin lesion along the right face and scalp in a dermatome pattern clinically
suggestive of Varicella zoster. Examination of scraped smears obtained from one
of these pustules revealed numerous parasitic organisms having morphologic
features typical of Demodex. Herein, we describe the patient's clinical
presentation, discuss the cytologic findings of scrape smears, and briefly review
the literature. 2006 Wiley-Liss, Inc.

Publication Types: 
    Case Reports

PMID: 16548003 [PubMed - indexed for MEDLINE]

1150: J Virol. 2006 Apr;80(7):3238-48.

Varicella-zoster virus open reading frame 10 is a virulence determinant in skin
cells but not in T cells in vivo.

Che X, Zerboni L, Sommer MH, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
94305-5208, USA. xibing@stanford.edu

The open reading frame 10 (ORF10) of varicella-zoster virus (VZV) encodes a
tegument protein that enhances transactivation of VZV genes and has homology to
herpes simplex virus type 1 (HSV-1) VP16. While VP16 is essential for HSV
replication, ORF10 is dispensable for vaccine OKA (VOKA) growth in vitro. We used
parent OKA (POKA) cosmids to delete ORF10, producing POKA delta10; point
mutations that disrupted the acidic activation domain and the putative motif for 
binding human cellular factor 1 (HCF-1) in ORF10 protein yielded POKA10-Phe28Ala,
POKA10-Phe28Ser, and POKA10-mHCF viruses. Deleting ORF10 or mutating these two
functional domains had no effect on VZV replication, immediate-early gene
transcription, or virion assembly in vitro. However, deleting ORF10 reduced viral
titers and the extent of cutaneous lesions significantly in SCIDhu skin
xenografts in vivo compared to POKA. Epidermal cells infected with POKA delta10
had significantly fewer DNA-containing nucleocapsids and complete virions
compared to POKA; extensive aggregates of intracytoplasmic viral particles were
also observed. Altering the activation or the putative HCF-1 domains of ORF10
protein had no consequences for VZV replication in vivo. Thus, the decreased
pathogenic potential of POKA delta10 in skin could not be attributed to absence
of these ORF10 protein functions. In contrast to skin cells, deleting ORF10 did
not impair VZV T-cell tropism in vivo, as assessed by infectious virus yields. We
conclude that ORF10 protein is required for efficient VZV virion assembly and is 
a specific determinant of VZV virulence in epidermal and dermal cells in vivo.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16537591 [PubMed - indexed for MEDLINE]

1151: Br J Dermatol. 2006 Apr;154(4):743-6.

Herpes folliculitis: clinical, histopathological, and molecular pathologic
observations.

Boer A, Herder N, Winter K, Falk T.

Dermatologikum Hamburg, Stephansplatz 5, 20354 Hamburg, Germany.
boer@dermatologikum.de

BACKGROUND: Herpes folliculitis is a rare manifestation of herpes virus infection
and it is often misdiagnosed. Diagnostic criteria are not well established, only 
24 patients being reported in the literature. Recently it has been suggested that
herpetic folliculitis is more common in infections with varicella zoster (VZV)
than in those with herpes simplex viruses (HSV-1 and -2). OBJECTIVES: To refine
diagnostic criteria for folliculitis caused by VZV, HSV-1 and HSV-2, and to study
whether follicular involvement enables morphological differentiation between VZV 
and HSV infections. PATIENTS AND METHODS: Twenty-one patients with herpetic
infection of follicular epithelium were assessed clinically and
histopathologically. Polymerase chain reaction (PCR) studies for specific DNA of 
herpes viruses were performed on paraffin-embedded biopsy specimens. RESULTS: In 
17 of our cases PCR was positive for VZV, four were positive for HSV-1, none for 
HSV-2. The clinical presentation of herpes folliculitis often lacked vesicles or 
pustules (14/21). Histopathological features were often devoid of ballooning
(12/21), multinucleated giant cells (12/21) and keratinocytes with steel grey
nuclei (15/21). The most consistent findings were lymphocytic folliculitis and
perifolliculitis (20/21) and necrotic keratinocytes in follicular epithelium
(12/21). In zoster, but not in varicella eruption or HSV infections, follicular
involvement was unaccompanied by marked changes in the epidermal surface.
CONCLUSIONS: In biopsy specimens taken from herpes virus infections, involvement 
of follicular units is more commonly encountered in VZV infections compared with 
HSV infections. Early in the course, herpes folliculitis presents as lymphocytic 
folliculitis devoid of epithelial changes considered to be diagnostic of herpes
virus infections. Exclusive involvement of follicles is rather typical of zoster.

PMID: 16536821 [PubMed - indexed for MEDLINE]

1152: Curr Drug Targets Infect Disord. 2005 Dec;5(4):307-400.

Developments in antiviral drug design, discovery and development in 2004.

Meanwell NA, Belema M, Carini DJ, D'Andrea SV, Kadow JF, Krystal M, Naidu BN,
Regueiro-Ren A, Scola PM, Sit SY, Walker MA, Wang T, Yeung KS.

Department of Chemistry, The Bristol-Myers Squibb Pharmaceutical Research
Institute, Wallingford, CT 06492, USA. Nicholas.Meanwell@bms.com

This article summarizes key aspects of progress made during 2004 toward the
design, discovery and development of antiviral agents for clinical use. Important
developments in the identification, characterization and clinical utility of
inhibitors of human immunodeficiency virus; the hepatitis viruses, hepatitis B,
hepatitis C; the herpes family of viruses, herpes simplex viruses 1 and 2,
varicella zoster virus, Epstein-Barr virus and human cytomegalovirus; the
respiratory viruses, influenza, respiratory syncytial virus, human
metapneumovirus, picornaviruses, measles and the severe acute respiratory
syndrome coronavirus; human papilloma virus; rotavirus; Ebola virus and West Nile
virus, are reviewed.

Publication Types: 
    Review

PMID: 16535860 [PubMed - indexed for MEDLINE]

1153: Transplantation. 2006 Mar 15;81(5):809-10.

Nonspecific immunoglobulin and granulocyte-macrophage colony-stimulating factor
use in complicated varicella zoster: the first case report in a renal transplant 
recipient.

Vales-Albertos LJ, Andrade-Sierra J, Gomez-Navarro B, Monteon-Ramos F,
Rodriguez-Perez M, Torres-Lozano C, Cueto-Manzano AM.

Publication Types: 
    Case Reports
    Letter

PMID: 16534489 [PubMed - indexed for MEDLINE]

1154: Int J Dermatol. 2006 Mar;45(3):280-4.

Patterns of skin manifestations and their relationships with CD4 counts among
HIV/AIDS patients in Cameroon.

Josephine M, Issac E, George A, Ngole M, Albert SE.

Department of Internal Medicine, Faculty of Medicine and Biomedical Sciences,
University of Yaounde, Cameroon.

BACKGROUND: Skin manifestations are common clinical features among
HIV/AIDS-positive patients. Their frequencies, patterns and associated factors
have been shown to vary from region to region. The present study is aimed at
documenting skin manifestations and their relationships with CD4 cell counts
among HIV/AIDS patients in Cameroon. METHODS: This study lasted for 16 months
(from September 2001 to December 2002). After informed consent, data on skin
disorders, HIV status, CD4 and viral load were obtained by physical examination
and laboratory methods. RESULTS: Of the 384 subjects studied, 236 (61.5%) were
females and 148 (38.5%) were males. Up to 264 (68.8%) patients presented with at 
least one type of skin problem. Generalized prurigo, oral candidiasis, herpes
zoster, and vaginal candidiasis were the most common skin problems. Mean CD4 cell
count (128 +/- 85 cells/mm(3)) and mean viral load (79,433 copies/mL) in patients
with herpes zoster were higher (P < 0.001). Patients with oral candidiasis and
vaginal candidiasis had significantly lower (109 +/- 127 cells/mm(3), P < 0.02)
and higher (131 +/- 85 cells/mm(3), P < 0.05) mean CD4 cell counts, respectively.
Prurigo was associated with higher mean viral load (31,623 +/- 20 copies/mL, P < 
0.04). Viral lesions were associated with high mean CD4 cell count (123 +/- 83
cells/mm(3), P < 0.001). Kaposi's sarcoma and parasitic lesions (crusted scabies)
were both, respectively, associated with lower mean CD4 cell counts [(78 +/- 66
cells/mm(3), P < 0.001) (6 +/- 0 cells/mm(3), P < 0.04)]. CONCLUSION: We
conclude, first that skin problems are common in HIV-infected individuals in
Cameroon and that patients with advanced stages of these problems have relatively
very low mean CD4 cell counts. Second, that mucocutaneous disorders like vaginal 
candidiasis and herpes zoster occur early in HIV infection while Kaposi's sarcoma
is common in advanced HIV infection.

PMID: 16533229 [PubMed - indexed for MEDLINE]

1155: Pain Med. 2006 Jan-Feb;7(1):89-91.

Botulinum toxin A relieved neuropathic pain in a case of post-herpetic neuralgia.

Liu HT, Tsai SK, Kao MC, Hu JS.

Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan.

Botulinum toxin type A (BTX-A) has been widely used in many clinical disorders
including migraine, cervical dystonia, etc. The use of BTX-A in neuropathic pain,
however, is uncommon, and the application of the anti-nociceptive effect of
botulinum toxin is emerging. Here we report a case of an 80-year-old man who
suffered from severe pain of post-herpetic neuralgia which was refractory to the 
usual therapies. However, this neuropathic pain was dramatically relieved by
multiple BTX-A injection and the pain relief lasted 52 days.

Publication Types: 
    Case Reports

PMID: 16533208 [PubMed - indexed for MEDLINE]

1156: Exp Eye Res. 2006 Jul;83(1):69-75. Epub 2006 Mar 10.

Characterization of the varicella zoster virus (VZV)-specific intra-ocular T-cell
response in patients with VZV-induced uveitis.

Milikan JC, Kuijpers RW, Baarsma GS, Osterhaus AD, Verjans GM.

Institute of Virology, Erasmus Medical Center, PO Box 1738, 3000 DR, Rotterdam,
The Netherlands.

Varicella zoster virus (VZV) is a well-known cause of infectious uveitis. The aim
of this study was to characterize the VZV-specific T-cell response in eyes of
patients with VZV-induced uveitis. T-cell lines (TCL) were generated by mitogenic
stimulation of intra-ocular fluid (IOF) samples obtained from eight patients with
VZV-induced uveitis. Two patients with herpes simplex virus (HSV)-induced uveitis
were included as disease controls. Characterization of individual T-cells in the 
TCL was performed by stimulating the TCL with mock, HSV-1 and VZV antigen pulsed 
autologous B cells and subsequent flow cytometric analyses. Virus specificity and
phenotype of the T-cells were identified by simultaneous detection of
intracellular gamma interferon and cell surface markers CD4, CD8, CD3 or T-cell
receptor (TCR) beta chain variable region (TCRBV) usage. The TCL obtained from
patients with HSV-1-induced uveitis contained higher numbers of T-cells reactive 
to HSV-1 compared to VZV. VZV-specific T-cells were detected in all TCL of the
patients diagnosed with VZV-induced uveitis. Four out of six TCL obtained from
patients with VZV-induced uveitis that were assayed for both viruses, contained
higher numbers of T-cells reactive to VZV compared to HSV-1. Detailed analyses of
the TCL of two patients demonstrated that the VZV reactivity within the assayed
TCL was dominated by T-cells expressing one specific TCRBV gene. The data
implicate that VZV-reactive T-cells infiltrate and participate in the local
inflammatory response in eyes of patients with VZV-induced uveitis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16530754 [PubMed - indexed for MEDLINE]

1157: J Immunol Methods. 2006 Apr 20;311(1-2):81-6. Epub 2006 Feb 24.

A screening assay to detect antigen-specific antibodies within cerebrospinal
fluid.

Morris P, Davies NW, Keir G.

Department of Neuroimmunology, National Hospital for Neurology and Neurosurgery, 
Queen Square, London, WC1N 3BG, UK.

Identification of the aetiology of central nervous system infections requires the
detection of either the organism or a microbe-specific immune response within the
brain or cerebrospinal fluid. We describe a screening assay to detect herpes
simplex virus, varicella zoster virus, cytomegalovirus, measles and Toxoplasma
gondii specific antibodies in cerebrospinal fluid. Antigen-specific
immunoblotting of oligoclonal IgG and IgM was used to confirm the presence of
antibody. Of 51 consecutive cerebrospinal fluid samples received by the
laboratory from patients with suspected central nervous system infection 18 (35%)
were screen positive for one or more antigen. In only 7 of these were
antigen-specific oligoclonal IgG or IgM bands confirmed. The assay provides a
simple, cheap assay to screen for microbial-specific antibody in the
cerebrospinal fluid samples of patients with suspected neurological infections.

PMID: 16530215 [PubMed - indexed for MEDLINE]

1158: Am Fam Physician. 2006 Mar 1;73(5):882-4.

Treatment of herpes zoster.

Holten KB.

Clinton Memorial Hospital, University of Cincinnati Family Medicine Residency,
Wilmington, Ohio, USA. keholtenmd@cmhregional.com

PMID: 16529096 [PubMed - indexed for MEDLINE]

1159: Mod Pathol. 2006 May;19(5):726-37.

Anatomical mapping of human herpesvirus reservoirs of infection.

Chen T, Hudnall SD.

Department of Pathology and Laboratory Medicine, University of Texas Medical
Branch, Galveston, TX 77555-0741, USA.

Following primary infection, all eight human herpesviruses persist lifelong in
the human host. However, a mapping of all anatomic sites of human herpesvirus
persistence is lacking. Fresh tissue specimens representing approximately 40
major anatomic sites from eight autopsies were screened using a recently
developed real-time PCR method for detection of all eight human herpesviruses.
Patients with evidence of active herpesvirus infection (herpes simplex 1 (HSV-1),
herpes simplex 2 (HSV-2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV),
cytomegalovirus (CMV), herpesvirus 6 (HHV-6), herpesvirus 7 (HHV-7), and
herpesvirus 8 (HHV-8)) at the time of death were excluded to avoid detection of
widely disseminated infection. Despite this precaution, widespread HSV-1
positivity (with blood positivity) was detected in one case-an elderly male who
died of cardiac arrest. In a middle-aged male with HIV-AIDS, HSV-1 was found in
neural and pharyngeal tissues, skin, cartilage, bone, and urinary bladder,
whereas in two other cases, HSV-1 was restricted to neural tissues. HSV-2 was
detected in a single site, the anus, in the male with HIV-AIDS. VZV was detected 
only twice, once in the adrenal gland and once in the small intestine. CMV was
detected in three cases, most commonly in nasal mucosa, trachea, thyroid,
intestine, and liver. EBV was detected in all eight cases, especially in nasal
mucosa, tonsil, spleen, lymph node, tongue, and intestine, but in only two of six
whole-blood specimens. HHV-6, like EBV, was detected in all eight cases, most
commonly in salivary glands, thyroid, stomach, intestines, liver, and pancreas.
HHV-7, like EBV and HHV-6, was detected in all eight cases, most commonly in
salivary glands, tonsil, lymph nodes, and bone marrow. HHV-8 was detected in only
two sites (both lymph nodes) from two cases. Herpesviruses were detected in three
of six whole-blood specimens, including HSV-1, EBV, HHV-6, and HHV-7. These
results represent the most comprehensive mapping of herpesvirus tissue
distribution in humans reported to date.

PMID: 16528368 [PubMed - indexed for MEDLINE]

1160: Rev Clin Esp. 2006 Jan;206(1):48-9.

[Update on chickenpox]

[Article in Spanish]

Amela Heras C, Pena-Rey I, Pachon del Amo I, Martinez de Aragon MV.

Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid.

Primary infection by varicella-zoster virus causes chickenpox and herpes zoster. 
At 14 years of age, 91% of the population have already suffered the illness and
after 30 years, more than 95% have done so. In 1999, the hospitalization rate was
2.4 per 1,000 chickenpox cases in those under 14 and 15.5 per 1,000 cases in
those over 14. A total of 73% of deaths recorded during the period 1991-2000 were
in the older than 14 year old group. Efficacy of varicella vaccine after a 7-8
years period is 87%; a milder case of chickenpox (breakthrough) can appear in
vaccinated people 42 days after vaccination. The introduction of the vaccine may 
be proposed to stop or decrease virus circulation among the population or to
decrease complications and mortality from chickenpox. According to the objective 
proposed, different strategies that imply risks and benefits should be conducted.

Publication Types: 
    English Abstract
    Review

PMID: 16527049 [PubMed - indexed for MEDLINE]

1161: Rev Stomatol Chir Maxillofac. 2006 Feb;107(1):57-8.

[Unusual presentation of a common disease]

[Article in French]

Loeb I, Shahla M.

Service de Stomatologie et Chirurgie Maxillo-faciale, CHU Saint-Pierre,
Bruxelles, Belgique. isabelleloeb@yahoo.fr

Publication Types: 
    Case Reports

PMID: 16523180 [PubMed - indexed for MEDLINE]

1162: Int Urogynecol J Pelvic Floor Dysfunct. 2007 Jan;18(1):103-4. Epub 2006 Mar
7.

Herpes zoster-associated acute urinary retention: a case report.

Julia JJ, Cholhan HJ.

Women's Continence Center of Greater Rochester, Rochester, NY, USA.
jjjulia73@hotmail.com

An 87-year-old woman presents with a 4-week history of urinary incontinence
during which she had been treated for disseminated herpes zoster virus (HZV). On 
physical exam painful vesicles involving the entire vulvar region with mainly
right sacral distribution were found. A catheterized volume exceeded 600 ml of
retained urine after the patient failed to void spontaneously. Multichannel
voiding-pressure urodynamic studies revealed an acontractile neurogenic bladder
with overflow incontinence. The patient was discharged on a conservative regimen 
with arrangement for visiting nurse services to perform intermittent
self-catheterization twice daily. Urodynamic testing was repeated 10 weeks after 
initial symptoms. During voiding cystometry a biphasic increase in detrusor
pressure of 15 cm H2O was observed with no increase in abdominal pressure. The
patient emptied 400 ml with a postvoid residual of 300 ml. Recovery from
HZV-associated bladder emptying dysfunction can be achieved usually through
conservative management, including intermittent self-catheterization. Complete
recovery time ranges from 4 to 10 weeks.

Publication Types: 
    Case Reports

PMID: 16520890 [PubMed - indexed for MEDLINE]

1163: Kansenshogaku Zasshi. 2006 Jan;80(1):46-50.

[Varicella-zoster virus symptoms and polyneuropathy in a patient with human
immunodeficiency virus infection not improved until highly active anti-retroviral
therapy added to acyclovir therapy]

[Article in Japanese]

Takeoka H, Chong Y, Murata M, Furusyo N, Nabeshima S, Yamaji K, Kishihara Y,
Hayashi J.

Department of Environmental Medicine and Infectoius Desease, Faculity of Medical 
Sciences, Kyushu University.

In March 2003, a 34-year-old man with left facial palsy, dysphagia, and
hoarseness treated with acyclovir suffered worsened dermatological and
neurological problems. A routine blood test in early April showed the patient to 
be HIV-antibody positive, so he was transferred to our hospital. Blood analysis
showed serum HIV-RNA at 96,000 copies/mL and a CD 4 count of 170/microL. Brain
MRI taken on admission showed a T 2 high lesion in their left medulla. Acyclovir 
was thought to be ineffective due to reduced cell-mediated immunity because of
the HIV infection, and HAART therapy was begun. After two months of HAART, skin
lesions and the T 2 high lesion in left medulla improred. HIV-RNA became
undetectable and the CD 4 count exceeded 500/microL. Intracellular cytokine
analysis by flow cytometry showed a shift from Th 2 to Th 1 dominance. The
elimination of VZV may thus have been promoted by the combination of acyclovir
and HAART.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16519124 [PubMed - indexed for MEDLINE]

1164: Nepal Med Coll J. 2005 Dec;7(2):129-30.

Otosclerosis--do we have a viral aetiology?

Singh MP, Ratho RK, Panda N, Mishra B.

Department of Virology, Postgraduate Institute of Medical, Education & Research, 
Chandigarh, India.

The etiology of otosclerosis remains an enigma though there are evidences
suggesting a viral involvement. This study aimed to find out the relationship
between viral infections and otosclerosis. Twenty two patients with otosclerosis 
and 10 healthy controls were included in the study. IgM antibodies to varicella
zoster virus (VZV), measles, rubella, human cytomegalovirus (HCMV) and herpes
simplex virus (HSV) were detected using micro ELISA. Paul Bunnel Davidsohn test
was performed to rule out Ebstein Barr virus (EBV) infection. Overall, 5(22.7%)
patients showed antibodies to one or more viruses. IgM antibodies against measles
and VZV could be demonstrated in 4(18.1%) and 1(4.5%) patients respectively. None
of the samples were found to be positive for HSV, HCMV, rubella and EBV
antibodies. Controls were negative for all the viruses tested. The difference in 
seropositivity between the patient and control group was not statistically
significant (p>0.05). Thus, this study suggests that otosclerosis is not commonly
associated with a systemic viral infection.

PMID: 16519080 [PubMed - indexed for MEDLINE]

1165: J Neuroophthalmol. 2006 Mar;26(1):47-8.

Magnetic resonance imaging of third cranial nerve palsy and trigeminal sensory
loss caused by herpes zoster.

Quisling SV, Shah VA, Lee HK, Policeni B, Smoker WR, Martin C, Lee AG.

Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City,
Iowa, USA.

A 44-year-old man with right-sided herpes zoster ophthalmicus (HZO) developed
ipsilateral third and sixth cranial nerve palsies and first-division trigeminal
(fifth cranial nerve) sensory loss. MRI revealed contrast enhancement of the
cisternal and cavernous portions of the third cranial nerve and high signal on a 
FLAIR sequence within the ipsilateral medulla at the presumed location of the
trigeminal nucleus and tract. To our knowledge, this is the first report of the
combination of these imaging findings in HZO.

Publication Types: 
    Case Reports

PMID: 16518167 [PubMed - indexed for MEDLINE]

1166: J Pediatr Surg. 2006 Mar;41(3):e29-31.

Acquired intestinal aganglionosis after a lytic infection with varicella-zoster
virus.

Holland-Cunz S, Goppl M, Rauch U, Bar C, Klotz M, Schafer KH.

Department of Pediatric Surgery, University of Heidelberg, 69120 Heidelberg,
Germany. stefan_holland-cunz@med.uni-heidelberg.de

BACKGROUND AND PURPOSE: In this report, we present the first case of an
immunologically impaired child surviving a lytic varicella-zoster virus infection
affecting the enteric nervous system. In histological findings, myenteric and
submucous enteric ganglia were nearly completely absent owing to virus infection.
METHODS: A 3-year-old girl with acute lymphoblastic leukemia and generalized
varicella-zoster infection developed an ileus. She underwent multiple
laparotomies in which histological sections of the entire small intestine could
be obtained. RESULTS: The histological evaluation of these samples showed a
generalized aganglionosis with inflammatory residuals. A more detailed
immunohistochemical analysis using neuronal (PGP, enolase), glial (S100), and
lymphocytic (LCA) antibodies demonstrated a nearly complete neuronal loss.
CONCLUSION: To our knowledge, this is the first case of a secondary intestinal
aganglionosis after varicella-zoster virus infection.

Publication Types: 
    Case Reports

PMID: 16516611 [PubMed - indexed for MEDLINE]

1167: Ann Epidemiol. 2006 Sep;16(9):692-5. Epub 2006 Mar 3.

Gender as an independent risk factor for herpes zoster: a population-based
prospective study.

Opstelten W, Van Essen GA, Schellevis F, Verheij TJ, Moons KG.

University Medical Center Utrecht, The Netherlands. w.opstelten@umcutrecht.nl

PURPOSE: Several studies reported a difference in herpes zoster (HZ) incidence
between males and females, but limitations in design and analysis impeded the
assessment of gender as an independent risk factor for HZ. This study examines
the independent etiologic association between gender and HZ. METHODS: A total of 
335,714 persons were observed prospectively during 2001. We registered gender and
HZ occurrence, as well as other risk factors for HZ. We calculated overall crude 
and adjusted odds ratios (ORs) and stratified to age. RESULTS: The HZ incidence
in females was 3.9/1000 patients/year (95% confidence interval [CI], 3.6-4.2),
and in males, 2.5/1000 patients/year (95% CI, 2.3-2.8), with a crude OR of 1.53
(95% CI, 1.36-1.74). After adjustment for potential confounders, the adjusted OR 
was 1.38 (95% CI, 1.22-1.56). The incidence was greater in females in the
middle-aged (age, 25 to 64 years; OR range, 1.36 to 1.83) and youngest group (OR,
1.31; 95% CI, 0.90-1.89). Gender effect was inverse in young adults (age, 15 to
24 years; OR, 0.64; 95% CI, 0.41-1.03). CONCLUSION: Female gender is an
independent risk factor for HZ in the 25- to 64-year-old age groups.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16516488 [PubMed - indexed for MEDLINE]

1168: Hautarzt. 2006 Mar;57(3):207-12, 214-6.

[Infections with herpes simplex and varicella-zoster viruses during pregnancy]

[Article in German]

Marculescu R, Richter L, Rappersberger K.

Abteilung fur Dermatologie, Krankenanstalt Rudolfstiftung, Wien.

Primary infections with herpes simplex virus (HSV) and varicella-zoster virus
(VZV) may lead to severe illness in pregnancy. Both diseases may be associated
with transplacental virus transmission and fetal infection. Such infections can
lead to intrauterine death, severe malformations and premature birth; the
fetal/congenital varicella syndrome is well-defined. Herpes genitalis and
varicella at the time of labor may lead to life threatening neonatal-herpes or
varicella of the newborn. Currently neither active immunization nor neutralizing 
immunoglobulin is available for HSV infections. VZV-seronegative women in
child-bearing age can be vaccinated and pregnant women exposed to VZV can be
given specific immunoglobulins. While an infection is rarely blocked, the
severity is generally reduced. For severe disease antiviral treatment is
necessary, with valacyclovir and acyclovir represents the drugs of choice.
Primary or recurrent overt disease of the genital tract at the time of delivery
an indication for caesarean section. Suppression of recurrent genital herpes
during the last weeks of pregnancy with valacyclovir and acyclovir reduces the
need for surgical intervention. Neonates exposed to VZV should receive specific
immunoglobulin. If neonates show signs of either infection, immediate treatment
with acyclovir must be initiated.

Publication Types: 
    English Abstract
    Review

PMID: 16514526 [PubMed - indexed for MEDLINE]

1169: Brain Dev. 2006 Jul;28(6):410-2. Epub 2006 Feb 28.

A child with vestibular neuritis. is adenovirus implicated?

Zannolli R, Zazzi M, Muraca MC, Macucci F, Buoni S, Nuti D.

Department of Pediatrics, Section of Pediatric Neurology, Policlinico Le Scotte, 
University of Siena, Siena, Italy. zannolli@unisi.it

Vertigo in children is relatively under examined in the literature. Among its
causes, vestibular neuritis (VN) represents only 2% of cases, with its etiology
remaining unknown. We report for the first time a 4-year-old boy with vestibular 
neuritis and serological results compatible with adenoviral infection.
Serological diagnosis was performed on the basis of a rise and consequent
normalization of complement fixation (CF) titers of the plasma antibodies.
Although we were not able to detect exactly when the infection started, we were
able to detect an increased level of adenovirus antibodies by CF titers, followed
by a decrease (i.e. 1/16, then 1/8, then <1/4) during the recovery. This is
typical of a resolving infection. Furthermore, that this increase in antibodies
was specific to an adenovirus infection was suggested by the observation that we 
did not detect increases in antibodies to other common viruses (i.e. herpes
simplex and zoster viruses, Epstein-Barr virus, cytomegalovirus, influenza and
parainfluenza viruses). This allows us to exclude the chance of nonspecific
antibody activation. We concluded that, although our data do not formally
demonstrate an involvement of adenovirus in VN, they suggest such an involvement.
This may be of interest, given that a viral etiology for VN has been proposed but
not definitively proven.

Publication Types: 
    Case Reports

PMID: 16504444 [PubMed - indexed for MEDLINE]

1170: J Eur Acad Dermatol Venereol. 2006 Mar;20(3):314-7.

Granuloma annulare on herpes zoster scars in a Hodgkin's disease patient
following autologous peripheral stem cell transplantation.

Sanli HE, Kocyigit P, Arica E, Kurtyuksel M, Heper AO, Ozcan M.

Department of Dermatology, Ankara University School of Medicine, Ankara, Turkey.

Various cutaneous lesions including granulomatous reactions may occur at sites of
resolved herpes zoster infection. A 46-year-old man with Hodgkin's disease
developed localized granuloma annulare lesions on herpes zoster scars 3 months
after allogeneic peripheral stem cell transplantation. This is the first case of 
granuloma annulare localized on herpes zoster scars that developed following
peripheral stem cell transplantation.

Publication Types: 
    Case Reports

PMID: 16503895 [PubMed - indexed for MEDLINE]

1171: Scand J Infect Dis. 2006;38(3):227-8.

Varicella-zoster virus infection under administration of ganciclovir after
allogeneic bone marrow transplantation.

Mori T, Shimizu T, Yamazaki R, Aisa Y, Nakazato T, Ikeda Y, Okamoto S.

Division of Hematology, Department of Medicine, Keio University School of
Medicine, Shinanomachi, Tokyo, Japan. tmori@sc.itc.keio.ac.jp

PMID: 16500790 [PubMed - indexed for MEDLINE]

1172: Odontostomatol Trop. 2005 Dec;28(112):19-23.

Group II and III lesions in HIV positive Nigerians attending the General Hospital
Lagos, Nigeria.

Wright AA, Agbelusi GA.

Department of Preventive Dentistry, Lagos University Teaching Hospital, Lagos,
Nigeria.

OBJECTIVE: To document the prevalence of Group II and Ill oral lesions of HIV in 
adult seropositive Nigerians. STUDY DESIGN: A longitudinal study of 100 HIV
infected adult Nigerian patients attending the HIV Clinic of the General
Hospital, Lagos, Nigeria. STUDY PERIOD: January 2001 to October 2002. METHOD:
Oral lesions were diagnosed based on documented diagnostic criteria by GREENSPAN 
et al, for oral manifestation of HIV. WHO classification of oral lesions based on
the degree of association with HIV infection was also used. Oral lesions were
treated using established treatment protocols. RESULTS: Seventy patients had oral
lesions of HIV, of these fourteen (20%) patients had Group II and III oral
lesions of HIV infection: Five (7%) patients had recurrent aphthous ulcers (RAU),
4 (6%) had herpes zoster of the trigeminal nerve. Majority of patients presented 
with oral symptoms severe enough to require use of appropriate medication.
Recurrence of oral lesions occurred in all cases of RAU seen. CONCLUSION: Group
II and III lesions are less prevalent than group I lesions in HIV infected adult 
Nigerians. They may be the presenting oral lesions of HIV/AIDS. These oral
lesions of HIV are associated with a lot of pain, morbidity and may also
compromise aesthetics. By compromising adequate nutrition and practice of good
oral hygiene, they may lead to further deterioration of the health of the patient
and can accelerate the course of the disease. Early recognition and diagnosis of 
these lesions by the oral clinician and/or trained dental practitioner affords
the patient the opportunity of receiving prompt and appropriate medical treatment
as well as counseling.

PMID: 16491918 [PubMed - indexed for MEDLINE]

1173: Korean J Ophthalmol. 2005 Dec;19(4):302-4.

A case of complete ophthalmoplegia in herpes zoster ophthalmicus.

Shin HM, Lew H, Yun YS.

Department of Ophthalmology, Pochun CHA University College of Medicine, Pundang
CHA Hospital, Sungnam, Korea.

PURPOSE: To report a case with complete ophthalmoplegia after herpes zoster
ophthalmicus. METHODS: A 70-year-old male patient visited a clinic because of
vesicular eruptions over the left side of his face with severe pain. Drooping and
severe swelling of the left eyelid were present, along with keratitis and
uveitis. While the lid swelling and uveitis were improving, external
ophthalmoplegia and exophthalmos were discovered. Intramuscular injections of
dexamethasone 5 mg were given for 10 days, followed by oral administration of
prednisolone at a dosage of 15 mg for two weeks and 10 mg for two weeks. RESULTS:
The patient was fully recovered from the complete ophthalmoplegia and
exophthalmos six months after the onset of the cutaneous lesion. CONCLUSIONS:
Complete ophthalmoplegia is a rare ophthalmic complication of herpes zoster
infection. Therefore, an evaluation of extraocular muscle and lid function should
be performed during the examination of herpes zoster patients in order to screen 
for ophthalmoplegia.

Publication Types: 
    Case Reports

PMID: 16491822 [PubMed - indexed for MEDLINE]

1174: Arch Dermatol. 2006 Feb;142(2):250-1.

Postherpetic poliosis.

Wu JJ, Huang DB, Tyring SK.

Publication Types: 
    Case Reports
    Letter

PMID: 16490864 [PubMed - indexed for MEDLINE]

1175: Am J Ophthalmol. 2006 Mar;141(3):584-5.

Correlation between clinical suspicion and polymerase chain reaction verification
of infectious vitritis.

Acharya N, Lietman T, Cevallos V, Whitcher JP, Saidel M, Stone D, Duncan J,
Margolis TP.

Proctor Foundation, Department of Ophthalmology, University of California-San
Francisco, 95 Kirkham Street, San Francisco, CA 94143, USA.
nisha@stanfordalumni.org

PURPOSE: To compare polymerase chain reaction (PCR) results to presumptive
clinical diagnosis in patients with vitritis. DESIGN: Retrospective review of PCR
laboratory records from vitreous samples. METHODS: Fifty consecutive laboratory
records of vitreous samples sent for PCR testing were reviewed. Three reviewers
with uveitis training ranked the clinical suspicion of a specific diagnosis using
a classification system (scale of 1 to 4) and were masked to the PCR results.
RESULTS: The degree of clinical suspicion of a particular diagnosis was
significantly associated with a positive PCR result (P = .048). Higher clinical
suspicion was significantly more associated with a positive PCR result compared
with cases with lower clinical suspicion (P = .01). CONCLUSIONS: If the clinical 
suspicion of a specific diagnosis is low, the PCR for any infectious etiology is 
unlikely to be positive.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16490520 [PubMed - indexed for MEDLINE]

1176: Am J Ophthalmol. 2006 Mar;141(3):564-5.

Cytomegalovirus in aqueous humor from an eye with corneal endotheliitis.

Koizumi N, Yamasaki K, Kawasaki S, Sotozono C, Inatomi T, Mochida C, Kinoshita S.

Department of Ophthalmology, Kyoto Prefectural University of Medicine,
Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-0841, Japan.
nkoizumi@ophth.kpu-m.ac.jp

PURPOSE: To report cytomegalovirus (CMV) DNA in aqueous humor from a patient with
unilateral corneal endotheliitis. DESIGN: Case report. METHODS: A 51-year-old man
presented with unilateral corneal endotheliitis with linear keratic precipitates 
and coin-shaped lesions. Tear and aqueous humor samples were subjected to
polymerase chain reaction to look for DNA from herpes simplex virus (HSV),
varicella zoster virus (VZV), and CMV. RESULTS: Aqueous humor from the diseased
eye contained DNA from CMV but not HSV or VZV. Its specificity was confirmed by
Southern blot tests. Intravenous ganciclovir treatment resulted in the
localization of his corneal edema and the reduction in keratic precipitates.
There was severe destruction of corneal endothelial cells. CMV DNA was not
detected in tears or control samples. CONCLUSIONS: In this healthy man with
corneal endotheliitis, we detected CMV DNA in aqueous humor from the affected
eye, but not HSV or VZV. This suggests that CMV may cause corneal endotheliitis
in patients without immunodeficiency.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 16490509 [PubMed - indexed for MEDLINE]

1177: Am J Clin Dermatol. 2006;7(1):13-29.

Viral infections affecting the skin in organ transplant recipients: epidemiology 
and current management strategies.

Tan HH, Goh CL.

National Skin Centre, Singapore.

Viral skin infections are common findings in organ transplant recipients. The
most important etiological agents are the group of human herpesviruses (HHV),
human papillomaviruses (HPV), and molluscum contagiosum virus. HHV that are
important in this group of patients are herpes simplex virus (HSV) types 1 and 2,
varicella-zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV),
HHV-6 and -7, and HHV-8, which causes Kaposi sarcoma (KS). HSV infections are
characterized by their ability to establish latency and then reactivate at a
later date. The most common manifestations of HSV infection in organ transplant
recipients are mucocutaneous lesions of the oropharynx or genital regions.
Treatment is usually with acyclovir, valaciclovir, or famciclovir. Acyclovir
resistance may arise although the majority of acyclovir-resistant strains have
been isolated from AIDS patients and not organ transplant recipients. In such
cases, alternatives such as foscarnet, cidofovir, or trifluridine may have to be 
considered. VZV causes chickenpox as well as herpes zoster. In organ transplant
recipients, recurrent herpes zoster can occur. Acute chickenpox in organ
transplant patients should be treated with intravenous acyclovir. CMV infection
occurs in 20-60% of all transplant recipients. Cutaneous manifestations, which
include nonspecific macular rashes, ulcers, purpuric eruptions, and
vesiculobullous lesions, are seen in 10-20% of patients with systemic infection
and signify a poor prognosis. The present gold standard for treatment is
ganciclovir, but newer drugs such as valganciclovir appear promising. EBV is
responsible for some cases of post-transplant lymphoproliferative disorder, which
represents the greatest risk of serious EBV disease in transplant recipients.
HHV-6 and HHV-7 are two relatively newly discovered viruses and, at present, the 
body of information concerning these two agents is still fairly limited. KS is
caused by HHV-8, which is the most recently discovered lymphotrophic HHV.
Iatrogenic KS is seen in solid-organ transplant recipients, with a prevalence of 
0.5-5% depending on the patient's country of origin. HPV is ubiquitous, and organ
transplant recipients may never totally clear HPV infections, which are the most 
frequently recurring infections in renal transplant recipients. HPV infection in 
transplant recipients is important because of its link to the development of
certain skin cancers, in particular, squamous cell carcinoma. Regular
surveillance, sun avoidance, and patient education are important aspects of the
management strategy.

Publication Types: 
    Review

PMID: 16489840 [PubMed - indexed for MEDLINE]

1178: J Drugs Dermatol. 2006 Feb;5(2):182-5.

The incidence of recurrent herpes simplex and herpes zoster infection during
treatment with arsenic trioxide.

Nouri K, Ricotti CA Jr, Bouzari N, Chen H, Ahn E, Bach A.

Department of Dermatology and Cutaneous Surgery, University of Miami, Miller
School of Medicine, Miami, Florida, USA. knouri@med.miami.edu

We report the incidence of varicella zoster virus (VZV) and herpes simplex virus 
(HSV) infection in patients with multiple myeloma and colon cancer who were
treated with arsenic trioxide for their disease. In this report, we discuss the
effects of arsenic on immune system, and suggest arsenic compounds as a possible 
predisposing factor for viral reactivation in these patients.

Publication Types: 
    Case Reports

PMID: 16485889 [PubMed - indexed for MEDLINE]

1179: Scand J Gastroenterol. 2006 Feb;41(2):242-4.

Visceral varicella zoster virus infection after stem cell transplantation: a
possible cause of severe abdominal pain.

Leena M, Ville V, Veli-Jukka A.

Department of Medicine, Division of Infectious Diseases, Helsinki University
Central Hospital, Finland. leena.mattila@hus.fi

Reactivation of varicella zoster virus (VZV) is a common event after stem cell
transplantation (SCT). When activated in the abdominal cavity, the infection may 
be life threatening. Visceral presentation with VZV infection is uncommon,
although probably an under-diagnosed event in post-SCT patients. The interval
from onset of abdominal pain to the development of skin eruptions may delay the
initiation of specific antiviral therapy and symptoms may be incorrectly
diagnosed as surgical disease or graft-versus-host disease. We describe the case 
of a 53-year-old man who had undergone stem cell autograft for multiple myeloma
and developed visceral VZV infection with hepatitis, melaena and subileus 7
months later.

Publication Types: 
    Case Reports

PMID: 16484131 [PubMed - indexed for MEDLINE]

1180: J Med Virol. 2006 Apr;78(4):514-6.

Two cases of varicella zoster virus meningitis found in pediatric patients after 
bone marrow transplantation despite valaciclovir prophylaxis and without skin
lesions.

Leveque N, Galambrun C, Najioullah F, Bleyzac N, Pages MP, Bertrand Y.

Laboratoire de virologie, Hopital E. Herriot, Hospices civils de Lyon, Lyon,
France.

Two cases of varicella zoster virus (VZV) meningitis are described in an
18-year-old girl and an 18-year-old boy. They occurred, respectively, 9 days and 
9 months after allogeneic bone marrow transplantation. VZV nucleic acid was
detected in the cerebrospinal fluid during the 1st week of illness. This
recurrence occurred despite valaciclovir prophylaxis and without skin lesions.
The two patients received aciclovir intravenously and immunoglobulins infusion.
They responded to treatment and their clinical state improved rapidly. Copyright 
2006 Wiley-Liss, Inc.

Publication Types: 
    Case Reports

PMID: 16482541 [PubMed - indexed for MEDLINE]

1181: Dtsch Med Wochenschr. 2006 Feb 24;131(8):384-6.

Comment in:
    Dtsch Med Wochenschr. 2006 Jun 2;131(22):1290; author reply 1290.

[Disseminated herpes zoster in diabetes mellitus]

[Article in German]

Graue N, Grabbe S, Dissemond J.

Universitatsklinikum Essen, Klinik und Poliklinik fur Dermatologie, Venerologie
und Allergologie, Hufelandstrasse 55, 45147 Essen.

HISTORY AND ADMISSION FINDINGS: A 71-year old man presented with painful
hemorrhagic vesicles and papules over the entire body that had persisted for
three days. Type 2 diabetes mellitus type 2 had been diagnosed 20 years ago and
had not been treated for the last 5 years. Therapy had been discontinued by the
patient. INVESTIGATIONS: HbA1c (11,9%) and blood glucose levels (up to 360 mg/dl)
were abnormal. Varicella-zoster-DNA was replicated by PCR from the vesicle fluid.
DIAGNOSIS AND TREATMENT: After the clinical diagnosis of disseminated herpes
zoster had been confirmed systemic therapy with aciclovir 10 mg/kg day was
started. There was no evidence of malignancy. Insulin therapy was initiated.
CONCLUSION: Dissemination is a rare complication of herpes zoster, aided by
immunosuppression. In the presented case there was no evidence of malignancy or
other cause of immunosuppression, but the patient also had type 2 diabetes with
very high blood glucose levels. The diabetes was thought to be causally related
to the ineffective immune response to varicella zoster virus. There has been no
previous published report of this relationship.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 16479469 [PubMed - indexed for MEDLINE]

1182: Clin Infect Dis. 2006 Mar 15;42(6):810-7. Epub 2006 Feb 8.

A tale of 2 alpha-herpesviruses: lessons for vaccinologists.

Rouse BT, Kaistha SD.

Department of Microbiology, College of Veterinary Medicine, University of
Tennessee, Knoxville, TN 37996, USA. btr@utk.edu

Of the 8 known herpesviruses that affect human beings, we only have successful
vaccines against varicella zoster virus. This brief review compares the
pathogenesis of varicella zoster virus with that of the closely related
alpha-herpesviruses herpes simplex virus 1 and 2, for which we have no
satisfactory vaccines. The main objective of this review is to learn lessons from
the success of varicella zoster virus vaccine that could be exploited for the
development of successful vaccines against herpes simplex virus and perhaps
against other herpes viruses.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural
    Review

PMID: 16477558 [PubMed - indexed for MEDLINE]

1183: Rev Med Suisse. 2006 Jan 4;2(47):30-4.

[Infectious disease]

[Article in French]

Erard P.

Departement de medecine Hopital Pourtales 2000 Neuchatel. ph.erard@net2000.ch

Several articles published in 2005 offer new knowledge in infectious diseases
treated by practitioners. This paper discusses viral (influenza) and bacterial
(pneumococci and legionella) respiratory infections. Resistant staphylococci,
different from healthcare-associated MRSA, are now found in community. The
article assesses that epidemics of Norovirus infections are common during winter 
time. The screening for treatment of asymptomatic bacteriuria is not recommended.
The possible development of a successful vaccine to prevent herpes zoster is
finally reminded.

Publication Types: 
    English Abstract
    Review

PMID: 16465942 [PubMed - indexed for MEDLINE]

1184: Haematologica. 2005 Dec;90(12 Suppl):EIM04.

Ophthalmic zoster sine herpete presenting as oculomotor palsy after marrow
transplantation for acute myeloid leukemia.

Hon C, Au WY, Cheng VC.

Department of Ophthalmology and Visual Sciences, Lee Kar Shing Specialist Block
Prince of Wales Hospital, Shatin, Hong Kong. honc@ha.org.hk

Publication Types: 
    Case Reports

PMID: 16464763 [PubMed - indexed for MEDLINE]

1185: Rev Med Suisse. 2006 Jan 11;2(48):107-8, 111-3.

[Dermatology]

[Article in French]

Kuenzli S, Saurat JH.

We are going over therapeutic acquisitions in a club-journal including relevant
publications in different fields: mecanism of action, therapeutic perspectives in
a near future, and side effects.

Publication Types: 
    English Abstract

PMID: 16463794 [PubMed - indexed for MEDLINE]

1186: Rev Chilena Infectol. 2006 Mar;23(1):56-9. Epub 2006 Feb 2.

[Varicella vaccine]

[Article in Spanish]

Abarca Villaseca K.

Facultad de Medicina, Departamento de Pediatria, Unidad de Infectologia,
Pontificia Universidad Catolica de Chile. kabarca@med.puc.cl

Varicella and herpes zoster represent a significant public health problem. Safe
and highly effective varicella vaccines against severe and moderate varicella are
currently available. Vaccine efficacy is lower and more variable against mild
disease and several risk factors have been associated with mild breakthrough
disease. Experts are currently discussing the need for a second vaccine dose.
Universal varicella vaccination has been highly effective in reducing morbidity
and hospitalizations due to varicella, a strategy that has proven to be cost
effective in many regions when the societal-perspective is considered in the
analysis. Recent data suggests that varicella vaccination may be associated with 
an increased incidence of herpes zoster in the elderly. Immunity conferred by
varicella vaccination seems to be longlasting but a continued evaluation is
needed in order to asses the effect of the changing epidemiology associated with 
universal immunization.

Publication Types: 
    English Abstract

PMID: 16462966 [PubMed - indexed for MEDLINE]

1187: Am J Ophthalmol. 2006 Feb;141(2):409-12.

Rapid progression of diabetic retinopathy in eyes with posterior uveitis.

Knol JA, van Kooij B, de Valk HW, Rothova A.

Uveitis Center, FC Donders Institute of Ophthalmology, University Medical Center 
Utrecht, Utrecht, The Netherlands.

PURPOSE: To report on two patients who developed rapid progression of asymmetric 
diabetic retinopathy (DRP) in eyes affected by posterior uveitis in contrast to
their fellow eyes not affected by uveitis. DESIGN: Observational case report.
METHODS: Two patients with diabetes mellitus (DM) and unilateral uveitis
underwent repeated ophthalmologic examinations and fluorescein angiography.
RESULTS: Two patients with DM and unilateral posterior uveitis developed
proliferative DRP in eyes with previous uveitis within 3 months after the uveitis
subsided. In contrast, the retinal findings of nonuveitic eyes remained unchanged
on follow-up of several years. CONCLUSIONS: Since the pathogenesis of intraocular
inflammation and diabetic retinopathy acts through similar biochemical mediators 
and pathways, it is feasible that posterior uveitis accelerates the progression
of diabetic retinopathy. Our results support this hypothesis and point out a risk
for rapid retinopathy development in eyes affected with posterior uveitis.

Publication Types: 
    Case Reports

PMID: 16458715 [PubMed - indexed for MEDLINE]

1188: Am J Ophthalmol. 2006 Feb;141(2):313-8.

Polymerase chain reaction and Goldmann-Witmer coefficient analysis are
complimentary for the diagnosis of infectious uveitis.

De Groot-Mijnes JD, Rothova A, Van Loon AM, Schuller M, Ten Dam-Van Loon NH, De
Boer JH, Schuurman R, Weersink AJ.

Department of Virology, Eijkman-Winkler Center, and F.C. Donders Institute of
Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands.
j.d.f.degroot@azu.nl

PURPOSE: To determine the relative contribution of the analysis of intraocular
antibody production and the polymerase chain reaction (PCR) in aqueous humor (AH)
to the diagnosis of infectious uveitis. DESIGN: Retrospective case-control study.
METHODS: Paired AH and serum samples from 230 patients suspected of infectious
uveitis were examined for intraocular antibody production against herpes simplex 
virus (HSV), varicella zoster virus (VZV), and Toxoplasma gondii by calculating
the Goldmann-Witmer coefficient (GWC). In addition, AH samples were investigated 
by real-time PCR to determine the presence of microbial DNA. RESULTS: Positive
results were obtained in 54 cases (23%): 13 HSV (24%), 16 VZV (30%), and 25 T
gondii (46%). Of these, 23 (43%) were positive for both GWC and PCR, 26 (48%)
only for GWC, and 5 (9%) only for PCR. With PCR as the sole diagnostic approach, 
a correct diagnosis of the infectious etiology would have been missed in 34% of
cases for the herpes viruses and in 64% for T gondii. Analysis of the
relationship between a positive laboratory diagnosis and the time of sampling
after onset of ocular disease demonstrated that intraocular antibody production
was found throughout the course of the diseases. Viral DNA was more readily
detected early in infection. In contrast, T gondii nucleic acid was not detected 
until 3 weeks after onset of ocular disease. CONCLUSIONS: Analysis of intraocular
antibody production contributed considerably to the etiological diagnosis of
infectious uveitis, most notably of ocular toxoplasmosis early after onset of
disease. Therefore, both PCR and GWC determination might be performed for
comprehensive diagnosis of intraocular infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16458686 [PubMed - indexed for MEDLINE]

1189: Environ Pollut. 2006 Sep;143(2):221-7. Epub 2006 Feb 7.

Cu and Zn adsorption onto non-residual and residual components in the natural
surface coatings samples (NSCSs) in the Songhua River, China.

Li Y, Wang X, Guo S, Dong D.

Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang, Shenyang
110016, PR China. liyuxx@mail.jlu.edu.cn

Natural surface coatings samples (NSCSs) from the surface of river shingles were 
employed to investigate the roles of non-residual and residual components of the 
NSCSs in controlling Cu and Zn adsorption via the selective extraction techniques
and statistical analysis. The results indicate that the greatest contribution to 
metals adsorption on a molar basis was from Mn oxides in the non-residual
fraction. Metals adsorption capacities of Mn oxides exceeded those of Fe oxides
by one order of magnitude, fewer roles were found attributing to adsorption by
organic materials (OM), and the estimated contribution of the residual fraction
to metals adsorption was insignificant. These results implied that Mn oxides were
the most important component in controlling heavy metals in aquatic environments.
Experiments with Cu and Zn adsorption measured together showed that Cu severely
interfered with Zn adsorption to the NSCSs and vice versa under the conditions of
the two coexisted ions adsorption.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16457916 [PubMed - indexed for MEDLINE]

1190: Exp Clin Endocrinol Diabetes. 2006 Jan;114(1):31-4.

Diabetes insipidus due to herpes encephalitis in a patient with diffuse large
cell lymphoma. A case report.

Scheinpflug K, Schalk E, Reschke K, Franke A, Mohren M.

Department of Hematology and Oncology, Otto-von-Guericke-University, Magdeburg,
Germany.

The major causes of central diabetes insipidus are neoplastic or infiltrative
lesions of the hypothalamus or pituitary, severe head injuries and pituitary or
hypothalamic surgery. Central diabetes insipidus caused by viral infections has
been rarely reported in immunosuppressed patients, such as those with acquired
immunodeficiency syndrome or Cushing's syndrome. We report the case of a
48-year-old woman suffering from diffuse large cell lymphoma, who developed
hypotonic polyuria, hypernatriaemia and somnolence after the first course of
chemotherapy with CHOEP and rituximab. Diabetes insipidus was diagnosed by low
urine osmolarity and an undetectable vasopressin concentration. MRI revealed no
pituitary abnormalities but encephalitis, and lumbar punction confirmed herpes
zoster infection. To the best of our knowledge this is the first description of
central diabetes insipidus in a lymphoma patient caused by an opportunistic
CNS-infection.

Publication Types: 
    Case Reports

PMID: 16450314 [PubMed - indexed for MEDLINE]

1191: Rinsho Ketsueki. 2005 Nov;46(11):1229-32.

[Elderly patient with varicella-zoster virus-associated hemophagocytic syndrome
refractory to steroid therapy]

[Article in Japanese]

Yoshida I, Yoshino T, Takeuchi M.

Division of Hematology, National Hospital Organization, Minami-Okayama Medical
Center.

We experienced a case of virus-associated hemophagocytic syndrome (VAHS) after
varicella-zoster virus (VZV) infection. The patient, a 101-year-old man,
presented with anemia, thrombocytopenia and jaundice two weeks after successful
antiviral treatment for the VZV. Histiocytes were detected in the bone marrow
examination (2.2%); however, hepatomegaly and triglycemia remained unobserved
throughout the course. Reactivation of VZV was detected serologically. The
patient died after five weeks because of persistent cytopenia and liver failure
refractory to steroid treatment. An autopsy revealed hemophagocytosis in the bone
marrow, lung, spleen and liver.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16440810 [PubMed - indexed for MEDLINE]

1192: SADJ. 2005 Nov;60(10):432, 436-7.

Herpes zoster post-herpetic neuralgia.

Feller L, Jadwat Y, Bouckaert M.

Department of Periodontology and Oral Medicine, Medunsa Oral Health Centre,
Faculty of Dentistry, University of Limpopo, Medunsa Campus. lfeller@ul.ac.za

Post-herpetic neuralgia (PHN) is the most frequent complication of herpes zoster 
and often results in significant morbidity and a reduction in the patient's
quality of life. The peripheral nerve injury that occurs during the acute phase
of herpes zoster (HZ) leads to an abnormal tonic impulse discharge from primary
nociceptive afferent neurons which induce slow temporal summation.This "wind-up" 
phenomenon is responsible for continuous partial depolarisation of second-order
neurons with increased spontaneous impulse discharge and expanded receptive
fields within the dorsal horn nociceptive neurons.The abnormal central processing
involves the activation of N-methyl-D-aspartate (NMDA) receptors resulting in
neuropathic pain, characterized by spontaneous pain, hyperalgesia and allodynia
which is typical of PHN. In addition, tonic input from non-nociceptive AB
afferent neurons, maintained by sympathetic efferent activity, contribute to the 
development and maintenance of neuropathic pain in general, and a burning
sensation in particular.

PMID: 16438359 [PubMed - indexed for MEDLINE]

1193: Nucleosides Nucleotides Nucleic Acids. 2005;24(10-12):1763-74.

Phosphoralaninate pronucleotides of pyrimidine methylenecyclopropane analogues of
nucleosides: synthesis and antiviral activity.

Ambrose A, Zemlicka J, Kern ER, Drach JC, Gullen E, Cheng YC.

Department of Chemistry, Developmental Therapeutics Program, Barbara Ann Karmanos
Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan
48201-1379, USA.

The Z- and E-thymine and cytosine pronucleotides 3d, 4d, 3e, and 4e of
methylenecyclopropane nucleosides analogues were synthesized, evaluated for their
antiviral activity against human cytomegalovirus (HCMV), herpes simplex virus 1
and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), Epstein-Barr virus (EBV), 
human immunodeficiency virus type 1 (HSV-1), and hepatitis B virus (HBV) and
their potency was compared with the parent compounds 1d, 2d, 1e, and 2e. Prodrugs
3d and 4d were obtained by phosphorylation of parent analogues 1d or 2d with
reagent 8. A similar phosphorylation of N4-benzoylcytosine methylenecyclopropanes
9a and 9b gave intermediates 11a and 11b. Deprotection with hydrazine in
pyridine-acetic acid gave pronucleotides 3e and 4e. The Z-cytosine analogue 3e
was active against HCMV and EBV The cytosine E-isomer 4e was moderately effective
against EBV.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16438046 [PubMed - indexed for MEDLINE]

1194: Br J Dermatol. 2006 Feb;154(2):365-7.

Linear Darier disease with herpes zoster superinfection treated successfully by
brivudine.

Abraham S, Jones A, Toutous-Trellu L, Kerl-Bullani K, Chavaz P, Saurat JH, Piguet
V.

Department of Dermatology and Venereology, University Hospital Geneva, 24 rue
Micheli-du-Crest, CH-1211 Geneva 14, Switzerland.

We report the case of a human immunodeficiency virus-positive patient presenting 
linear Darier disease with varicella-zoster virus superinfection following the
lines of Blaschko. The lesions healed after treatment with brivudine.

Publication Types: 
    Case Reports

PMID: 16433812 [PubMed - indexed for MEDLINE]

1195: Br J Anaesth. 2006 Mar;96(3):381-3. Epub 2006 Jan 23.

Repetitive paravertebral nerve block using a catheter technique for pain relief
in post-herpetic neuralgia.

Naja ZM, Maaliki H, Al-Tannir MA, El-Rajab M, Ziade F, Zeidan A.

Department of Anaesthesia and Pain Medicine, Research Unit and Paediatric
Intensive Care, Makassed General Hospital, Beirut, Lebanon. zouhnaja@yahoo.com

We described in this report a case of post-herpetic neuralgia refractory to
medical therapy that was successfully treated with repetitive injections of local
aesthetic mixture (bupivacaine 0.5% 19 ml and clonidine 150 microg ml(-1) 1 ml)
every 48 h for 3 weeks using a paravertebral catheter inserted at T2-T3 level.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 16431881 [PubMed - indexed for MEDLINE]

1196: Age Ageing. 2006 Mar;35(2):132-7. Epub 2006 Jan 23.

A cross-sectional survey of health state impairment and treatment patterns in
patients with postherpetic neuralgia.

van Seventer R, Sadosky A, Lucero M, Dukes E.

Amphia Ziekenhuis, Department of Anaesthesiology, Breda, The Netherlands.

BACKGROUND: Postherpetic neuralgia (PHN) develops in 8-24% of patients with
herpes zoster. Few studies have evaluated the patient burden and treatment of PHN
in general practice. OBJECTIVES: To determine the patient burden of PHN with
respect to pain intensity and impact on patient functioning and to characterise
treatment patterns and health resource utilisation in general practice. METHODS: 
Eighty-four patients with PHN were identified in general practice settings during
an observational survey of neuropathic pain syndromes in six European countries. 
Patients answered a questionnaire that included: pain severity and interference
items from the modified short form brief pain inventory (mBPI-SF); EuroQol
(EQ-5D) survey; and questions related to current treatment, health status and
resource utilisation. Physicians provided information on medications prescribed
for PHN and pain-related co-morbidities (anxiety, depression and sleep
disturbance). RESULTS: Mean patient age was 71.0 +/- 12.8 years, 76% were > or = 
65 years and 45% of patients had PHN > or = 1 year. The mean pain severity index 
was 4.2, reflecting moderate pain despite 89% of patients taking prescription
medications for PHN. Few medications with demonstrated efficacy against PHN (e.g.
carbamazepine and gabapentin) were prescribed, often at suboptimal doses. Pain
severity was associated with reduced EQ-5D health state valuation (P<0.001),
greater pain interference on all domains (P<0.001) and increased health resource 
utilisation (P = 0.008). CONCLUSIONS: PHN causes substantial patient burden
expressed as interference with daily functioning and reduced health status
associated with pain severity. This burden may result in part from suboptimal
management strategies and suggests a need for more effective pain management.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16431855 [PubMed - indexed for MEDLINE]

1197: Clin Rheumatol. 2007 May;26(5):779-80. Epub 2006 Jan 21.

Remission of rheumatoid arthritis after acute disseminated varicella-zoster
infection.

Agarwal V, Singh R, Chauhan S.

Department of Medicine, Government Medical College & Hospital, Chandigarh, India.
vikasagr@sgpgi.ac.in

A 65-year-old immunocompetent male presented with symmetric polyarthritis of 12
weeks and paresthesias in the distribution of the left median nerve distribution 
of 4 weeks duration. He had tender joint count of 20 and swollen joint count of
12. He was positive for rheumatoid factor and his erythrocyte sedimentation rate 
was 52 mm. Nerve conduction study demonstrated polyneuropathy. Radiographs showed
severe juxta articular osteopenia at the wrist and the metacarpophalangeal
joints. He received methotrexate of 10 mg/week and prednisolone of 0.15 mg/kg/day
along with nonsteroidal antiinflammatory drugs (NSAIDs) with a diagnosis of
seropositive rheumatoid arthritis (RA). Thirteen weeks after therapy, he
presented to the outpatient clinic with disseminated vesicular eruptions all over
his body with erythematous base and pneumonia involving the left upper lobe.
Tzanck smear from the lesions and serology (IgG) for varicella-virus infection
were positive. A diagnosis of acute disseminated varicella zoster with pneumonia 
was made. The patient improved on parenteral acyclovir and broad-spectrum
antibiotics. With the improvement in rash and pneumonia after 2 weeks, the
patient noticed a marked improvement in the joint symptoms. Arthritis remained in
remission without the need for any disease-modifying drug or NSAID for next the
24 months and continued to be so until the last follow-up. Our case presents a
unique phenomenon of RA remission after disseminated varicella-zoster infection
in an immunocompetent individual.

Publication Types: 
    Case Reports

PMID: 16429237 [PubMed - indexed for MEDLINE]

1198: Eur J Pain. 2006 Nov;10(8):695-700. Epub 2006 Jan 20.

Predicting and preventing post-herpetic neuralgia: are current risk factors
useful in clinical practice?

Coen PG, Scott F, Leedham-Green M, Nia T, Jamil A, Johnson RW, Breuer J.

Queen Mary's School of Medicine and Dentistry, University of London, Department
of Medical Microbiology, 25-29 Ashfield Street, London E1 1BB, UK.

Post-herpetic neuralgia (PHN) following acute herpes zoster remains a significant
cause of neuropathic pain especially in the elderly. Early treatment of the
zoster rash with antiviral agents, such as aciclovir remains one of the few
measures proven to reduce the incidence and duration of PHN albeit only in a
subset of patients. It is therefore crucial that the physician who first sees a
case of zoster identifies those patients who are most likely to develop long-term
pain and treats them accordingly. In particular, prodrugs such as famciclovir and
valaciclvoir may be more beneficial in reducing PHN than the shorter acting
aciclovir, but can be more expensive. Measures that could be used to predict
patients likely to develop PHN would also facilitate the evaluation of early use 
of antiepileptic, anti-inflammatory and analgesic agents in the prevention of
PHN. In a prospective study of 280 herpes zoster (HZ) cases seen by the general
practitioner (GP) we evaluated the predictive value of five clinical factors
identified in clinical trials as associated with a higher likelihood of PHN. A
visual analogue score (VAS) over 5 and/or age over 50 correctly identified all
subjects with PHN at 3 and 6 months, respectively. However, the specificity of
this prediction was low because as many as 81% and 85% of those aged over 50
recovered within 3 and 6 months, respectively. Better methods are needed to
identify patients over 50 at most risk of PHN that enable GPs to better allocate 
their resources with respect to HZ treatment.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16427792 [PubMed - indexed for MEDLINE]

1199: Lancet. 2006 Jan 21;367(9506):219-24.

Comment in:
    Lancet. 2006 Jan 21;367(9506):186-8.

The PINE study of epidural steroids and local anaesthetics to prevent
postherpetic neuralgia: a randomised controlled trial.

van Wijck AJ, Opstelten W, Moons KG, van Essen GA, Stolker RJ, Kalkman CJ,
Verheij TJ.

Pain Clinic, Department of Anaesthesiology, University Medical Center Utrecht, PO
Box 85500, 3508 GA Utrecht, Netherlands. a.vanwijck@umcutrecht.nl

BACKGROUND: Postherpetic neuralgia is the most frequent complication of herpes
zoster. Treatment of this neuropathic pain syndrome is difficult and often
disappointing. We assessed the effectiveness of a single epidural injection of
steroids and local anaesthetics for prevention of postherpetic neuralgia in older
patients with herpes zoster. METHODS: We randomly assigned 598 patients older
than 50 years, with acute herpes zoster (rash <7 days) below dermatome C6, to
receive either standard therapy (oral antivirals and analgesics) or standard
therapy with one additional epidural injection of 80 mg methylprednisolone
acetate and 10 mg bupivacaine. The primary endpoint was the proportion of
patients with zoster-associated pain 1 month after inclusion. Analyses were by
intention-to-treat. This study is registered as an International Standard
Randomised Controlled Trial, number ISRCTN32866390. FINDINGS: At 1 month, 137
(48%) patients in the epidural group reported pain compared with 164 (58%) in the
control group (relative risk [RR] 0.83, 95% CI 0.71-0.97, p=0.02). After 3 months
these values were 58 (21%) and 63 (24%) respectively (0.89, 0.65-1.21, p=0.47)
and, at 6 months, 39 (15%) and 44 (17%; 0.85, 0.57-1.13, p=0.43). We detected no 
subgroups in which the relative risk for pain 1 month after inclusion
substantially differed from the overall estimate. No patient had major adverse
events related to epidural injection. INTERPRETATION: A single epidural injection
of steroids and local anaesthetics in the acute phase of herpes zoster has a
modest effect in reducing zoster-associated pain for 1 month. This treatment is
not effective for prevention of long-term postherpetic neuralgia.

Publication Types: 
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 16427490 [PubMed - indexed for MEDLINE]

1200: Clin Nucl Med. 2006 Feb;31(2):104-5.

Herpes Zoster mimicking recurrence of lymphoma on PET/CT.

Joyce JM, Carlos T.

Division of Nuclear Medicine, Department of Radiology, University of Pittsburgh
Medical Center, Pittsburgh, PA 15213, USA. joycejm@upmc.edu

Publication Types: 
    Case Reports

PMID: 16424700 [PubMed - indexed for MEDLINE]

1201: J Clin Oncol. 2006 Jan 20;24(3):401-6.

Phase II study of temozolomide and thalidomide in patients with metastatic
neuroendocrine tumors.

Kulke MH, Stuart K, Enzinger PC, Ryan DP, Clark JW, Muzikansky A, Vincitore M,
Michelini A, Fuchs CS.

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115,
USA. matthew_kulke@dfci.harvard.edu

PURPOSE: Standard, intravenous chemotherapy regimens for neuroendocrine tumors
have been associated with limited response rates and significant toxicity. We
evaluated the efficacy of an oral regimen of temozolomide and thalidomide in
patients with metastatic carcinoid, pheochromocytoma, or pancreatic
neuroendocrine tumors. PATIENTS AND METHODS: Twenty-nine patients were treated
with a combination of temozolomide, administered at a dose of 150 mg/m2 for 7
days, every other week, and thalidomide at doses of 50 to 400 mg daily. Patients 
were followed for evidence of toxicity, biochemical response, radiologic
response, and survival. RESULTS: Treatment with temozolomide and thalidomide was 
associated with an objective biochemical (chromogranin A) response rate of 40%,
and a radiologic response rate of 25% (45% among pancreatic endocrine tumors, 33%
among pheochromocytomas, and 7% among carcinoid tumors). The median duration of
response was 13.5 months, 1-year survival was 79%, and 2-year survival was 61%.
The median administered dose of temozolomide was 150 mg/m(2), and the median
administered dose of thalidomide was 100 mg daily. Grade 3-4 toxicities were
uncommon, with the exception of grade 3-4 lymphopenia, which developed in 69% of 
the patient population. Opportunistic infections occurred in three patients (10%)
during the time of lymphopenia, and included single cases of Pneumocystis carinii
pneumonia, disseminated varicella zoster virus, and herpes simplex virus.
CONCLUSION: Orally administered temozolomide and thalidomide seems to be an
active regimen for the treatment of neuroendocrine tumors. In this 29-patient
study, this regimen appeared more active in pancreatic endocrine tumors than in
carcinoid tumors.

Publication Types: 
    Clinical Trial, Phase II
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16421420 [PubMed - indexed for MEDLINE]

1202: Genome Biol. 2005;6(13):R110. Epub 2005 Dec 30.

A compendium of Caenorhabditis elegans regulatory transcription factors: a
resource for mapping transcription regulatory networks.

Reece-Hoyes JS, Deplancke B, Shingles J, Grove CA, Hope IA, Walhout AJ.

Institute of Integrative and Comparative Biology, Faculty of Biological Sciences,
School of Biology, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
bgyjsr@leeds.ac.uk

BACKGROUND: Transcription regulatory networks are composed of interactions
between transcription factors and their target genes. Whereas unicellular
networks have been studied extensively, metazoan transcription regulatory
networks remain largely unexplored. Caenorhabditis elegans provides a powerful
model to study such metazoan networks because its genome is completely sequenced 
and many functional genomic tools are available. While C. elegans gene
predictions have undergone continuous refinement, this is not true for the
annotation of functional transcription factors. The comprehensive identification 
of transcription factors is essential for the systematic mapping of transcription
regulatory networks because it enables the creation of physical transcription
factor resources that can be used in assays to map interactions between
transcription factors and their target genes. RESULTS: By computational searches 
and extensive manual curation, we have identified a compendium of 934
transcription factor genes (referred to as wTF2.0). We find that manual curation 
drastically reduces the number of both false positive and false negative
transcription factor predictions. We discuss how transcription factor splice
variants and dimer formation may affect the total number of functional
transcription factors. In contrast to mouse transcription factor genes, we find
that C. elegans transcription factor genes do not undergo significantly more
splicing than other genes. This difference may contribute to differences in
organism complexity. We identify candidate redundant worm transcription factor
genes and orthologous worm and human transcription factor pairs. Finally, we
discuss how wTF2.0 can be used together with physical transcription factor clone 
resources to facilitate the systematic mapping of C. elegans transcription
regulatory networks. CONCLUSION: wTF2.0 provides a starting point to decipher the
transcription regulatory networks that control metazoan development and function.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16420670 [PubMed - indexed for MEDLINE]

1203: Ann Dermatol Venereol. 2005 Oct;132(10 Suppl):7S28-7S34.

[Item no 84: herpes virus infections in immunocompetent children and adults:
varicella and zona]

[Article in French]

[No authors listed]

PMID: 16419517 [PubMed - indexed for MEDLINE]

1204: Virus Res. 2006 May;117(2):202-8. Epub 2006 Jan 18.

The why's of Y-based motifs in alphaherpesvirus envelope proteins.

Favoreel HW.

Laboratory of Virology and Laboratory of Immunology, Faculty of Veterinary
Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
Herman.Favoreel@UGent.be

The Alphaherpesvirinae are large DNA viruses and represent the largest subfamily 
of the Herpesviridae with closely related members of man and animal, including
herpes simplex virus, varicella-zoster virus, pseudorabies virus, bovine
herpesvirus 1, and many others. The viral envelope proteins of alphaherpesviruses
are remarkably diverse and are incorporated in the ER, Golgi, and plasma membrane
of infected cells. The cytoplasmic domain of many of these envelope proteins
contain specific tyrosine-based amino acids. During recent years, accumulating
evidence indicates that these tyrosine-based motifs serve different important
functions during the virus life cycle, and are implicated in endocytosis
processes, intracellular trafficking, basolateral and axonal sorting, and signal 
transduction events. The current minireview will discuss the functions associated
with these tyrosine-based motifs in alphaherpesvirus envelope proteins.

Publication Types: 
    Review

PMID: 16417939 [PubMed - indexed for MEDLINE]

1205: Dev Med Child Neurol. 2006 Feb;48(2):139-42.

Post-varicella intracranial haemorrhage in a child.

Danchaivijitr N, Miravet E, Saunders DE, Cox T, Ganesan V.

Department of Radiology, Great Ormond Street Hospital, UK.

We report a case of a 7-month-old male with primary intracranial haemorrhage 2
months after infection with varicella zoster virus (VZV). His initial clinical
course was complicated by seizures and right hemiparesis; when last seen at 22
months the only positive finding was of left hand preference. Although the
literature has recently established the association of arterial ischaemic stroke 
and VZV infection, primary intracranial haemorrhage has been reported only in one
case. The child reported here had anterior interhemispheric haemorrhage due to a 
focal arteritis of the left anterior cerebral artery. The vascular abnormality
was transient and had radiological features compatible with either a focal
arteritis or vasospasm as a direct result of blood surrounding the vessels. We
postulate that direct invasion of VZV caused extensive inflammation of the vessel
wall and aggressive tissue penetration resulting in necrotizing angiitis and
intracranial haemorrhage. We suggest that VZV infection should be considered a
potential risk factor for intracranial haemorrhage in children.

Publication Types: 
    Case Reports

PMID: 16417671 [PubMed - indexed for MEDLINE]

1206: Aust Dent J. 2005 Dec;50(4 Suppl 2):S31-5.

Oral viral infections and the therapeutic use of antiviral agents in dentistry.

McCullough MJ, Savage NW.

Oral Medicine, School of Dental Science, The University of Melbourne.
m.mccullough@unimelb.edu.au

This paper reviews the current concepts of viral classification, infection and
replication. The clinical presentation of common oral viral infections
encountered in the dental practice are discussed, including: herpes simplex virus
types 1 and 2; Epstein-Barr virus; varicella-zoster virus; Coxsackie virus; human
papilloma virus; and human immunodeficiency virus. The diagnosis, principles of
management and pharmacological agents available for the treatment of oral viral
infections are also discussed.

Publication Types: 
    Review

PMID: 16416715 [PubMed - indexed for MEDLINE]

1207: J Virol. 2006 Feb;80(3):1497-512.

The cellular localization pattern of Varicella-Zoster virus ORF29p is influenced 
by proteasome-mediated degradation.

Stallings CL, Duigou GJ, Gershon AA, Gershon MD, Silverstein SJ.

Integrated Program in Cellular, Molecular and Biophysical Studies, and Department
of Microbiology, Columbia University College of Physicians and Surgeons, 701 W.
168th Street, New York, NY 10032, USA.

Varicella-zoster virus (VZV) open reading frame 29 (ORF29) encodes a
single-stranded DNA binding protein. During lytic infection, ORF29p is localized 
primarily to infected-cell nuclei, whereas during latency it appears in the
cytoplasm of infected neurons. Following reactivation, ORF29p accumulates in the 
nucleus. In this report, we analyze the cellular localization patterns of ORF29p 
during VZV infection and during autonomous expression. Our results demonstrate
that ORF29p is excluded from the nucleus in a cell-type-specific manner and that 
its cellular localization pattern may be altered by subsequent expression of VZV 
ORF61p or herpes simplex virus type 1 ICP0. In these cases, ORF61p and ICP0
induce nuclear accumulation of ORF29p in cell lines where it normally remains
cytoplasmic. One cellular system utilized by ICP0 to influence protein abundance 
is the proteasome degradation pathway. Inhibition of the 26S proteasome, but not 
heat shock treatment, resulted in accumulation of ORF29p in the nucleus, similar 
to the effect of ICP0 expression. Immunofluorescence microscopy and pulse-chase
experiments reveal that stabilization of ORF29p correlates with its nuclear
accumulation and is dependent on a functional nuclear localization signal. ORF29p
nuclear translocation in cultured enteric neurons and cells derived from an
astrocytoma is reversible, as the protein's distribution and stability revert to 
the previous states when the proteasomal activity is restored. Thus,
stabilization of ORF29p leads to its nuclear accumulation. Although proteasome
inhibition induces ORF29p nuclear accumulation, this is not sufficient to
reactivate latent VZV or target the immediate-early protein ORF62p to the nucleus
in cultured guinea pig enteric neurons.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16415026 [PubMed - indexed for MEDLINE]

1208: J AAPOS. 2005 Dec;9(6):597-8.

Herpes zoster ophthalmicus in an otherwise-healthy child.

Binder NR, Holland GN, Hosea S, Silverberg ML.

Sansum Santa Barbara Medical Foundation Clinic, Santa Barbara, California 93101, 
USA.

Herpes zoster ophthalmicus, although not uncommon in adults, is rarely found in
children. Herein we present a case of pediatric herpes zoster ophthalmicus that
is unique in 2 ways. First, the child had been vaccinated against varicella and
otherwise had no known exposure to varicella-zoster virus. Second, the initial
presentation of herpes zoster ophthalmicus was a painful and diffuse
subconjunctival hemorrhage that appeared before any of its classic signs were
observed. We report this case to document the possible occurrence of herpes
zoster ophthalmicus in children who have been vaccinated against varicella and
the possibility of a diffuse, painful subconjunctival hemorrhage as a presenting 
sign.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 16414532 [PubMed - indexed for MEDLINE]

1209: Lancet. 2006 Jan 14;367(9505):182.

Varicella zoster virus cerebellitis in a 66-year-old patient without herpes
zoster.

Ratzka P, Schlachetzki JC, Bahr M, Nau R.

Department of Neurology, University of Gottingen, Robert-Koch-Strasse 40, 37099
Gottingen, Germany. peter@ratzka-online.de

Publication Types: 
    Case Reports

PMID: 16413882 [PubMed - indexed for MEDLINE]

1210: Ann Oncol. 2006 Jul;17(7):1051-9. Epub 2006 Jan 12.

Antiviral prophylaxis in patients with haematological malignancies and solid
tumours: Guidelines of the Infectious Diseases Working Party (AGIHO) of the
German Society for Hematology and Oncology (DGHO).

Sandherr M, Einsele H, Hebart H, Kahl C, Kern W, Kiehl M, Massenkeil G, Penack O,
Schiel X, Schuettrumpf S, Ullmann AJ, Cornely OA; Infectious Diseases Working
Party, German Society for Hematology and Oncology.

Medizinische Klinik, Klinikum Augsburg, Germany. michael.sandherr@lrz.tum.de

Morbidity and mortality in patients with malignancies are increased by viral
infections. These mostly are reactivations of asymptomatic latent infections.
They primarily concern clinical entities associated with the reactivation of
herpes viruses, such as varicella zoster virus (VZV) and cytomegalovirus (CMV).
Respiratory tract infections caused by influenza, parainfluenza or respiratory
syncytial virus (RSV) are less common. Since reactivation of latent infections
has major clinical impact, antiviral prophylaxis is an attractive approach for
patients expecting immunosuppression. The main risk factor for clinically
relevant reactivation is profound disruption of cellular immune response.
Duration and severity of chemotherapy induced neutropenia are of lesser
importance. The risk of viral complications rises significantly in the presence
of sustained suppression of T-cell function, e.g. in recipients of allogeneic
stem cell transplants or of alemtuzumab (Campath-1H) antibody therapy. The
objective of this guideline is to review the basis of prophylactic strategies and
to provide recommendations for clinicians treating patients with haematological
malignancies and solid tumors.

Publication Types: 
    Practice Guideline

PMID: 16410361 [PubMed - indexed for MEDLINE]

1211: Dermatol Online J. 2005 Dec 1;11(3):26.

Dermatomal vesicular eruption in an asymptomatic infant.

Bhushan P, Sardana K, Mahajan S.

Department of Dermatology and STD, Lady Hardinge Medical College, KSCH Hospital, 
New Delhi, India.

We present a case of infantile herpes zoster without clinical evidence of
varicella infection in the mother or apparent exposure in the child; our
patient's diagnosis was confirmed by serology and by Tzanck smear. We briefly
review the etiopathogenesis factors of this condition. We emphasize the benign
course and spontaneous uneventful resolution.

Publication Types: 
    Case Reports

PMID: 16409922 [PubMed - indexed for MEDLINE]

1212: Dermatol Online J. 2005 Dec 1;11(3):8.

Infections in the elderly.

Scheinfeld N.

St Lukes Roosevelt Hospital Center, New York, USA. NSS32@Columbia.edu

As people age they experience more illness and this applies in particular to skin
infections. Pathogenic states that provide the milieu for infection are more
common in the elderly. Infections that occur more common in the elderly include
Gram-positive bacterial infections of the skin, intertriginous infections, herpes
zoster/shingles and onychomycosis. These will be reviewed in the article. Newer
treatments such as valacyclovir, famcyclovir, terbinafine and linezolid exist to 
treat these infections. Recognizing the varying presentations enhances the health
and treatment of disease of elderly patients.

Publication Types: 
    Review

PMID: 16409904 [PubMed - indexed for MEDLINE]

1213: Skin Therapy Lett. 2005 Dec-2006 Jan;10(10):5-7.

Famciclovir for the treatment of recurrent genital and labial herpes lesions.

Langley RG.

Division of Dermatology, Department of Medicine, and Centre for Clinical
Research, Dalhousie University, Halifax, NS, Canada.

Famciclovir (Famvir, Novartis) is an effective treatment for herpes zoster and
herpes simplex. Two separate studies recently examined the effectiveness of
single high doses of famciclovir for treating recurrent genital herpes and labial
herpes (cold sores). In the randomized, placebo-controlled studies, patients
initiated treatment at the first onset of symptoms. For the treatment of genital 
herpes, a 1,000 mg b.i.d. dose of famciclovir had significant advantages over the
placebo, reducing the time required to heal the lesions, preventing the
development of lesions beyond the papule stage, and improving the time to
resolution of all symptoms. For the treatment of labial herpes, a single 1,500 mg
dose of famciclovir shortened the lesion healing time, shortened the time to
normal skin, and resulted in faster resolution of pain and tenderness.

PMID: 16408140 [PubMed - indexed for MEDLINE]

1214: J Athl Train. 2005 Oct-Dec;40(4):365-9.

Celiac disease symptoms in a female collegiate tennis player: a case report.

Leone JE, Gray KA, Massie JE, Rossi JM.

Department of Physical Education, Southern Illinois University at Carbondale,
1075 S. Normal Avenue, Carbondale, IL 62901-4310, USA. Jleone@siu.edu

OBJECTIVE: To present the case of a collegiate tennis player with celiac disease 
symptoms. BACKGROUND: Celiac disease is a common intestinal disorder that is
often confused with other conditions. It causes severe intestinal damage
manifested by several uncomfortable signs and symptoms. Failure by the sports
medicine staff to recognize symptoms consistent with celiac disease and treat
them appropriately can have deleterious consequences for the athlete.
DIFFERENTIAL DIAGNOSIS: Irritable bowel syndrome, Crohn disease, Addison disease,
lupus erythematosus, juvenile rheumatoid arthritis, lactose intolerance, herpes
zoster, psychogenic disorder (depression), fibromyalgia, complex regional pain
syndrome, hyperthyroidism, anemia, type I diabetes. TREATMENT: The athlete
underwent a series of blood and allergen tests to confirm or refute a diagnosis
of celiac disease. When celiac disease was suspected, dietary modifications were 
made to eliminate all wheat-based and gluten-based products from the athlete's
diet. UNIQUENESS: The athlete was able to fully compete in a competitive National
Collegiate Athletic Association Division I tennis program while experiencing the 
debilitating effects associated with celiac disease. The immediacy of symptom
onset was notable because the athlete had no history of similar complaints.
CONCLUSIONS: Celiac disease is a potentially life-threatening condition that
affects more people than reported. A properly educated sports medicine staff can 
help to identify symptoms consistent with celiac disease early, so damage to the 
intestine is minimized. Prompt recognition and appropriate management allow the
athlete to adjust the diet accordingly, compete at a high-caliber level, and
enjoy a healthier quality of life.

PMID: 16404460 [PubMed]

1215: Clin Experiment Ophthalmol. 2005 Dec;33(6):636-8.

Herpes zoster ophthalmicus: presenting as giant-cell arteritis.

de Castro LE, Petersen AM, Givre SJ, Solomon KD, Vroman DT.

Magill Research Center for Vision Correction, Storm Eye Institute, Medical
University of South Carolina, Charleston, SC 29425, USA.

A 74-year-old woman was referred to the authors' clinic with a 1-week suspicion
of giant-cell arteritis. Uncomplicated, bilateral temporal artery biopsies were
performed 3 days after admission for therapy. Four hours after the procedure she 
developed vesicular lesions of the face compatible with herpes zoster
ophthalmicus. The temporal artery biopsy revealed perineural lymphocytic
aggregation. Both giant-cell arteritis and herpes zoster ophthalmicus form part
of the differential diagnosis in elderly patients with headache. In such cases,
clues from a temporal artery biopsy may aid in diagnosis of herpes zoster. In
addition, the patient in this case developed the rash 10 days after onset of
symptoms, which is rare as the average time from onset of symptoms to rash in
zoster is 3-5 days.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16402958 [PubMed - indexed for MEDLINE]

1216: Neurology. 2006 Jan 10;66(1):75-80.

Etiology of aseptic meningitis and encephalitis in an adult population.

Kupila L, Vuorinen T, Vainionpaa R, Hukkanen V, Marttila RJ, Kotilainen P.

Department of Neurology, Turku University Hospital, Turku, Finland.
laura.kupila@tyks.fi

OBJECTIVE: To investigate the etiology of aseptic meningitis and encephalitis in 
an adult population using modern microbiologic methods. METHODS: Consecutive
patients (ages > or =16) with aseptic meningitis or encephalitis treated in Turku
University Hospital, Finland, during 1999 to 2003 were included in the study.
Microbiologic tests were performed, including CSF PCR tests for enteroviruses,
herpes simplex virus (HSV) 1, HSV-2, and varicella zoster virus (VZV), as well as
serum and CSF antibody analysis for these viruses. Antibody testing was also
performed for other pathogens commonly involved in neurologic infections. Virus
culture was performed on CSF, fecal, and throat swab specimens. RESULTS: Etiology
was defined in 95 of 144 (66%) patients with aseptic meningitis. Enteroviruses
were the major causative agents (26%), followed by HSV-2 (17% of all, 25% of
females) and VZV (8%). Etiology was identified in 15 of 42 (36%) patients with
encephalitis, VZV (12%), HSV-1 (9%), and tick-borne encephalitis virus (9%) being
the most commonly involved pathogens. Etiologic diagnosis was achieved by PCR in 
43% of the patients with meningitis and in 17% of those with encephalitis.
CONCLUSIONS: Enteroviruses and HSV-2 are the leading causes of adult aseptic
meningitis, and PCR is of diagnostic value. However, in most cases of
encephalitis, the etiology remains undefined.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16401850 [PubMed - indexed for MEDLINE]

1217: MMW Fortschr Med. 2005 Dec 8;147(49-50):76-8.

[Neuropathic pain]

[Article in German]

Ludwig J, Baron R.

Sektion Neurologische Schmerzforschung und Therapie, Klinik fur Neurologie,
Universitatsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 10,
D-24105 Kiel. j.ludwig@neurologie.uni-kiel.de

Arises after an injury to nociceptive systems. Examples of the most common causes
are polyneuropathies, acute zoster neuralgia, and postherpetic neuralgia. The
differential diagnosis and management are discussed.

Publication Types: 
    English Abstract

PMID: 16401018 [PubMed - indexed for MEDLINE]

1218: BMJ. 2006 Jan 14;332(7533):76-80. Epub 2006 Jan 6.

Comment in:
    BMJ. 2006 Jan 14;332(7533):63-4.

Neurotropic viruses and cerebral palsy: population based case-control study.

Gibson CS, MacLennan AH, Goldwater PN, Haan EA, Priest K, Dekker GA; South
Australian Cerebral Palsy Research Group.

Department of Obstetrics and Gynaecology, University of Adelaide, Women's and
Children's Hospital, 1st Floor Queen Victoria Building, 72 King William Road,
Adelaide, SA 5006, Australia. catherine.s.gibson@adelaide.edu.au

OBJECTIVE: To investigate the association between cerebral palsy and direct
evidence for perinatal exposure to neurotropic viruses. DESIGN: Population based 
case-control study. SETTING: Adelaide Women's and Children's Hospital Research
Laboratory. PARTICIPANTS AND MAIN OUTCOME MEASURES: Newborn screening cards of
443 white case patients with cerebral palsy and 883 white controls were tested
for viral nucleic acids from enteroviruses and herpes viruses by using polymerase
chain reaction. Herpes group A viruses included herpes simplex viruses 1 and 2
(HSV-1 and HSV-2), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human
herpes virus 8 (HHV-8), and herpes group B viruses included varicella zoster
virus (VZV) and human herpes viruses 6 and 7 (HHV-6 and HHV-7). RESULTS: The
prevalence of viral nucleic acids in the control population was high: 39.8% of
controls tested positive, and the prevalence was highest in preterm babies. The
detection of herpes group B viral nucleic acids increased the risk of developing 
cerebral palsy (odds ratio 1.68, 95% confidence interval 1.09 to 2.59).
CONCLUSIONS: Perinatal exposure to neurotropic viruses is associated with preterm
delivery and cerebral palsy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16399770 [PubMed - indexed for MEDLINE]

1219: J Paediatr Child Health. 2005 Nov;41(11):544-52.

Comment in:
    J Paediatr Child Health. 2005 Nov;41(11):541-2.

Varicella vaccination in Australia.

Macartney KK, Beutels P, McIntyre P, Burgess MA.

National Centre for Immunisation Research and Surveillance of Vaccine Preventable
Diseases (NCIRS), The Children's Hospital at Westmead, New South Wales,
Australia. kristinm@chw.edu.au

Varicella zoster virus (VZV) causes both chickenpox and herpes zoster and is
responsible for a significant disease burden, including hospitalizations and
deaths, in Australian children and adults. Varicella vaccine has been available
in Australia for 5 years; however, from November 2005, it will be funded for use 
in all susceptible children at 18 months and 10-13 years of age under the
National Immunisation Program. Experience with universal varicella vaccination of
children in the USA over the last 10 years has shown that the vaccine is safe and
highly effective in reducing varicella-related disease. This review summarizes
the epidemiology of VZV-related disease in Australia, the use of varicella
vaccine and the international experience with vaccine efficacy and safety. The
potential impact of varicella vaccination on the incidence of herpes zoster is
also discussed.

Publication Types: 
    Review

PMID: 16398834 [PubMed - indexed for MEDLINE]

1220: Infez Med. 2005 Sep;13(3):192-5.

A rare case of HSV-2 encephalitis.

Oztekin A, Turhan O, Mutlu D, Inan D, Colak D, Yalcin AN.

Department of Infectious Diseases and Clinical Microbiology and Department of
Medical Microbiology, Medicine Faculty, Akdeniz University, Antalya, Turkey.

Herpes simplex viruses (HSV), and especially HSV-1, are the most common cause of 
acute, sporadic viral encephalitis. HSV-2 is an uncommon cause of encephalitis.
We report a rare case of HSV-2 encephalitis that was free of genital lesions. In 
terms of the patient's case history, she had a Cesarean section four months
before, herpes labialis 30 days before, varicella zoster 20 days before. We
discuss the possibility that postpartum stress may be one of the factors in this 
case.

Publication Types: 
    Case Reports

PMID: 16397423 [PubMed - indexed for MEDLINE]

1221: Acta Ophthalmol Scand. 2005 Dec;83(6):758-60.

Peripheral retinal changes in acute retinal necrosis imaged by ultra widefield
scanning laser ophthalmoscopy.

Neubauer AS, Yu A, Haritoglou C, Ulbig MW.

Publication Types: 
    Case Reports
    Letter

PMID: 16396659 [PubMed - indexed for MEDLINE]

1222: Pediatr Infect Dis J. 2006 Jan;25(1):53-8.

Immune reconstitution syndrome after highly active antiretroviral therapy in
human immunodeficiency virus-infected thai children.

Puthanakit T, Oberdorfer P, Akarathum N, Wannarit P, Sirisanthana T, Sirisanthana
V.

Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

BACKGROUND: There is little information about the immune reconstitution syndrome 
(IRS) in children, especially from resource-poor countries. OBJECTIVE: To
determine the incidence and spectrum of IRS in advanced stage human
immunodeficiency virus (HIV)-infected children after initiation of highly active 
antiretroviral therapy (HAART). METHODS: Between May 2002 and April 2004, 153
symptomatic HIV-infected children who had CD4 lymphocyte percentage < or =15%
initiated HAART in a national antiretroviral drug access program. All patients
were followed for 48 weeks. In this study, IRS was defined as a disease event
caused by microorganisms or conditions previously reported to be associated with 
IRS in patients having immunologic and/or virologic response to HAART. RESULTS:
The incidence of IRS was 19% (95% confidence interval, 13.1-26.1). The median
time of onset was 4 weeks after start of HAART (range, 2-31). There were 32
episodes of IRS, including 14 caused by mycobacterial organisms, 7 by
varicella-zoster virus, 7 by herpes simplex virus, 3 by Cryptococcus neoformans
and 1 episode of Guillain-Barre syndrome. Patients who had IRS develop had lower 
baseline CD4 lymphocyte percentages compared with those who did not (P = 0.02).
CONCLUSIONS: IRS is common among HIV-infected children who received HAART in
their advanced stage of disease. Educational programs for patients and health
care workers on recognizing and treating these conditions should be integrated
into antiretroviral treatment access programs.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16395104 [PubMed - indexed for MEDLINE]

1223: Pediatr Infect Dis J. 2006 Jan;25(1):41-4.

Comment in:
    Pediatr Infect Dis J. 2006 Jan;25(1):45-6.

Seroprevalence of varicella in the French population.

Khoshnood B, Debruyne M, Lancon F, Emery C, Fagnani F, Durand I, Floret D.

Cemka-Eval, Bourg La Reine, France.

OBJECTIVES: To assess the age-specific seroprevalence of varicella in the French 
population and to explore age-adjusted differences according to gender and
geographic region. METHODS: Data were obtained from 1257 randomly selected,
frozen serum samples, from subjects 1-30 years of age, that were sent to the
Pasteur-Cerba laboratory in November 2003 to January 2004 for the following
clinical indications: allergies, respiratory infections, herpes virus infections 
excluding varicella and endocrinologic tests. IgG concentrations were tested with
an indirect enzyme immunoassay. Statistical analyses included use of locally
weighted, scatterplot smoothers. RESULTS: Age-specific seroprevalence of
varicella increased by >6-fold between 1 and 8 years of age, ie, from 15.0% (95% 
confidence interval, 8.6-23.5%) for subjects 1-2 years of age to 89.0% (95%
confidence interval, 81.0-94.3%) for those 7-8 years of age. The smoothed curve
of age-specific seroprevalence suggested that the steepest rate of increase
occurred between 1 and 8 years of age, followed by a considerable slowing in the 
rate of increase, reaching a prevalence of approximately 95% by age 30. Varicella
seroprevalence rates were similar for the samples referred for the 4 clinical
indications, as follows: allergies, 76.2%; respiratory infections, 74.0%; herpes 
virus infections excluding varicella, 73.3%; endocrinologic tests, 73.7% (P =
0.84). CONCLUSIONS: Most varicella-zoster virus infections occur during early
childhood. Seroprevalence rates reach approximately 50% by 4 years of age and
approximately 90% by 8 years. Therefore, the best strategy to reduce the
prevalence of wild-type varicella-zoster virus in the French population would be 
to immunize children 12-18 months of age, as is currently performed in the United
States.

PMID: 16395101 [PubMed - indexed for MEDLINE]

1224: Indian J Dermatol Venereol Leprol. 2005 May-Jun;71(3):210-1.

Multidermatomal herpes zoster in an immunocompetent female.

Gupta LK, Kuldeep CM, Mittal A, Singhal H.

Publication Types: 
    Case Reports
    Letter

PMID: 16394421 [PubMed - indexed for MEDLINE]

1225: Herpes. 2005 Dec;12(3):59.

Varicella immunization and herpes zoster.

Volpi A.

Publication Types: 
    Editorial

PMID: 16393520 [PubMed - indexed for MEDLINE]

1226: Clin Infect Dis. 2006 Feb 1;42(3):418-27. Epub 2005 Dec 28.

Incidence and risk factors for immune reconstitution inflammatory syndrome in an 
ethnically diverse HIV type 1-infected cohort.

Ratnam I, Chiu C, Kandala NB, Easterbrook PJ.

Department of HIV/Genitourinary Medicine, King's College London, Guy's, King's
College and St. Thomas' Hospitals, London, United Kingdom.

BACKGROUND: It is estimated that 10%-25% of patients who start highly active
antiretroviral therapy (HAART) experience immune reconstitution inflammatory
syndrome (IRIS). Our objective was to determine the incidence, clinical spectrum,
and predictors of IRIS in an ethnically diverse cohort of patients initiating
HAART. METHODS: A retrospective study of all patients starting HAART between 1
January 2000 and 31 August 2002 at a human immunodeficiency virus (HIV) clinic in
London was performed. All laboratory measurements and data on antiretroviral
therapies were obtained from the clinic database. Medical records were reviewed
to identify clinical events consistent with IRIS during the 6 months after HAART 
was initiated. RESULTS: A total of 199 patients were included, of whom 50.8% were
male, 59.3% were black African, 29.1% were white, and 10.5% were black Caribbean.
The median baseline CD4 cell count and HIV RNA load were 174x10(6) cells/L
(interquartile range [IQR], 82-285x10(6) cells/L) and 37,830 copies/mL (IQR,
4809-149,653 copies/mL), respectively. Forty-four patients (22.7%) experienced an
IRIS event at a median of 12 weeks after HAART initiation (IQR, 4-24 weeks after 
initiation); 22 events (50%) involved genital herpes, 10 (23%) involved genital
warts, 4 (9.0%) involved molluscum contagiosum, and 4 (9.0%) involved varicella
zoster virus infection. Five patients had mycobacterial infections, 4 had
hepatitis B, 1 had Pneumocystis jirovecci infection, and 1 had Kaposi sarcoma.
The strongest independent predictors of IRIS were younger age at initiation of
HAART (P=.003), baseline CD4 cell percentage of <10% (odds ratio [OR], 2.97; IQR,
1.17-7.55) compared with >15%, and ratio of CD4 cell percentage to CD8 cell
percentage of <0.15 (OR, 3.45; 95% confidence interval, 1.27-9.1) compared with
>0.3. CONCLUSIONS: Approximately one-quarter of patients who start HAART
experience an IRIS event. The majority are dermatological, in particular genital 
herpes and warts. Patients with advanced immunodeficiency at HAART initiation are
at greatest risk of developing IRIS and should be appropriately screened and
monitored.

PMID: 16392092 [PubMed - indexed for MEDLINE]

1227: Transpl Infect Dis. 2005 Sep-Dec;7(3-4):116-21.

Comment in:
    Transpl Infect Dis. 2005 Sep-Dec;7(3-4):97-8.

Retrospective analysis of varicella zoster virus (VZV) copy DNA numbers in plasma
of immunocompetent patients with herpes zoster, of immunocompromised patients
with disseminated VZV disease, and of asymptomatic solid organ transplant
recipients.

Kronenberg A, Bossart W, Wuthrich RP, Cao C, Lautenschlager S, Wiegand ND,
Mullhaupt B, Noll G, Mueller NJ, Speck RF.

Division of Infectious Diseases and Hospital Epidemiology, Department of Internal
Medicine, University Hospital of Zurich, Zurich, Switzerland.

BACKGROUND: Varicella zoster virus (VZV) causes significant morbidity and
mortality in immunocompromised patients. Subclinical reactivation has been
described in solid organ recipients and has been associated with graft versus
host disease in bone marrow transplantation. Newer studies assessing the
prevalence and impact of subclinical VZV reactivation in solid organ transplant
(SOT) recipients are lacking. METHODS AND RESULTS: In a first step we developed a
highly sensitive quantitative polymerase chain reaction (qPCR) assay for VZV DNA 
with a detection limit of < or = 20 copies/mL. Using this assay, we
retrospectively analyzed plasma samples of different patient groups for VZV DNA. 
VZV DNA was found in 10/10 plasma samples of immunocompetent patients with herpes
zoster (VZV copy numbers/mL: mean+/-SEM 1710+/-1018), in 1/1 sample of a human
immunodeficiency virus-infected patient with primary VZV disease (15,192
copies/mL) and in 4/4 plasma samples of immunocompromised patients with visceral 
VZV disease (mean of first value 214,214+/-178,572). All 108 plasma samples of
asymptomatic SOT recipients off any antiviral therapy, randomly sampled over 1
year, were negative for VZV DNA. CONCLUSION: Our qPCR assay proved to be highly
sensitive (100%) in symptomatic VZV disease. We did not detect subclinical
reactivation in asymptomatic SOT recipients during the first post-transplant
year. Thus, subclinical VZV reactivation is either a rare event or does not
exist. These data need to be confirmed in larger prospective trials.

Publication Types: 
    Evaluation Studies

PMID: 16390399 [PubMed - indexed for MEDLINE]

1228: J Clin Virol. 2006 Apr;35(4):458-62. Epub 2006 Jan 4.

Atypical symptoms in patients with herpesvirus DNA detected by PCR in
cerebrospinal fluid.

Schvoerer E, Frechin V, Fritsch S, Freitag R, Fuchs A, Gut JP, Stoll-Keller F.

Laboratoire de Virologie, Faculte de Medecine et Hopitaux Universitaires de
Strasbourg, 3 Rue Koeberle, 67000 Strasbourg Cedex, France.
Evelyne.Schvoerer@viro-ulp.u-strasbg.fr

BACKGROUND: Polymerase chain reaction (PCR) detection of herpesvirus DNA in
cerebrospinal fluid (CSF) is an important tool in the diagnosis of central
nervous system (CNS) syndromes. The corresponding viral infections present with
diverse clinical signs, which are often classical although no sign can be
considered as specific. This retrospective study aims to describe atypical
symptoms in patients with herpesvirus DNA detected in CSF by PCR. A total of 3452
cerebrospinal fluid samples from patients with suspected herpesvirus infection of
the CNS were investigated between 1998 and 2003 in our clinical virology
laboratory. "In-house" PCRs for each herpesvirus [herpes simplex virus (HSV),
varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein Barr virus (EBV), or
human herpes virus 6 (HHV6)] were used until 2001 and a commercially available
"Herpes Consensus PCR" was used thereafter. One of the five herpesviruses
investigated in this study was found in 71 (2.1%) of CSF samples (37 HSV, 14 VZV,
1 CMV, 9 EBV and 10 HHV6). These samples were obtained from 62 patients whose
clinical findings were generally consistent with the PCR data. However, some
little known features of herpesvirus-related symptoms, such as partial seizure
associated with HSV infection, and unusual VZV or HHV6-related myelitis were also
observed.

PMID: 16387545 [PubMed - indexed for MEDLINE]

1229: Am J Ophthalmol. 2006 Jan;141(1):212-214.

Rubella virus is associated with fuchs heterochromic iridocyclitis.

de Groot-Mijnes JD, de Visser L, Rothova A, Schuller M, van Loon AM, Weersink AJ.

Department of Virology, Eijkman-Winkler Center, University Medical Center
Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
j.d.f.degroot@azu.nl

PURPOSE: To determine whether rubella virus (RV) is involved in the pathogenesis 
of Fuchs heterochromic iridocyclitis (FHI). DESIGN: Retrospective
patient-controlled study. METHODS: Intraocular immunoglobulin G production
against RV, herpes simplex virus (HSV), varicella zoster virus (VZV), and
Toxoplasma gondii was determined in the aqueous humor of 14 patients with FHI, 13
control subjects with herpetic uveitis anterior, and 19 control subjects with
ocular toxoplasmosis by calculation of the Goldmann-Witmer coefficient (GWC).
RESULTS: All patients and control subjects were seropositive for RV. Intraocular 
antibody production (GWC >3) against RV was found in 13 of 14 patients (93%) with
FHI. Intraocular antibody production against HSV, VZV, or T gondii was not
detected. None of the control subjects with herpetic uveitis anterior or with
toxoplasma chorioretinitis had a positive GWC for rubella virus (P < .0001,
Fisher exact test). CONCLUSION: Rubella virus, but not HSV, VZV, or T gondii, is 
associated with FHI.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16387009 [PubMed - indexed for MEDLINE]

1230: Transplant Proc. 2005 Nov;37(9):3760-3.

Cytomegalovirus replication and "herpesvirus burden" as risk factor of
cardiovascular events in the first year after renal transplantation.

Gomez E, Laures A, Baltar JM, Melon S, Diez B, de Ona M.

Nephrology Service, Hospital Universitario Central de Asturias, Oviedo, Spain.

Cytomegalovirus (CMV) infection alone or in combination with other pathogens
("pathogen burden") has been postulated as a factor producing arteriosclerosis in
some solid organ transplant recipients. The aim of this study was to assess
whether the patients with CMV replication and/or "herpesvirus burden" experienced
a greater incidence of cardiovascular events during the first year after kidney
transplantation. One hundred twenty-one consecutive transplant recipients were
prospectively studied for CMV replication using antigenemia and polymerase chain 
reaction (PCR) weekly during the 4 first months, and monthly thereafter for 1
year. Simultaneously, nested-PCR for human herpes virus (HHV)-6 and HHV-7 were
performed to yield a herpesvirus burden (as determined by seropositivity),
including CMV, herpes simplex virus (HSV), varicella-zoster virus (VZV), and
Epstein-Barr virus (EBV). The following additional parameters were analyzed:
gender, age, smoking, duration of dialysis, preexistent diabetes, and preexistent
cardiovascular events. After 1 year posttransplantation cardiovascular events,
body mass index, arterial hypertension, number of antihypertensive drugs, use of 
ACE and/or ARBs inhibitors, diabetes, anemia, homocysteine, creatinine,
cholesterol, HDLc, LDLc, PTH-i, proteinuria, and immunosuppression with
cyclosporine or tacrolimus. CMV replication was present in 79 (65.3%) patients.
Among 121 renal transplant recipients, 13 presented cardiovascular events, all
associated with CMV replication (P = .004). Neither HHV-6 or HHV-7 replication
influenced this complication. All patients with these events were seropositive
for CMV, HSV, VZV, and EBV, as opposed to 64.8% without them (P = .009). Other
factors that showed differences between patients with versus without events were 
as follows: preexistent events (76.9% vs 14.8%; P = .000), age (60 +/- 10 vs 49
+/- 14; P = .002), serum triglyceride value (191 +/- 82 vs 135 +/- 72; P = .02), 
and anemia (23.1% vs 5.6%; P = .05). Multiple logistic regression analysis for
statistically significant variables only showed that preexistent events
influenced the development of posttransplantation events (odds ratio, 27; 95%
confidence interval, 4.7-154; P = .0005). In conclusion, cardiovascular events
within 1 year after transplantation were more frequent among patients with CMV
replication and seropositivity for other herpesviruses. An important risk factor 
was the presence of preexistent events.

PMID: 16386530 [PubMed - indexed for MEDLINE]

1231: Stat Med. 2006 Jan 30;25(2):359-60.

Comment on:
    Stat Med. 2001 Aug 30;20(16):2429-39.

Phase specific analysis of herpes zoster associated pain data: a new statistical 
approach by R. B. Arani, S.-J. Soong, H. L. Weiss, M. J. Wood, P. A. Fiddian, J. 
W. Gnann and R. Whitley, Statistics in Medicine 2001; 20:2429-2439.

Kay R.

Publication Types: 
    Comment
    Letter

PMID: 16381077 [PubMed - indexed for MEDLINE]

1232: J Virol. 2006 Jan;80(2):769-84.

UL54-null pseudorabies virus is attenuated in mice but productively infects cells
in culture.

Schwartz JA, Brittle EE, Reynolds AE, Enquist LW, Silverstein SJ.

Department of Microbiology, Columbia University, 701 W. 168th St., New York, NY
10032, USA.

The pseudorabies virus (PRV) UL54 homologs are important multifunctional proteins
with roles in shutoff of host protein synthesis, transactivation of virus and
cellular genes, and regulation of splicing and translation. Here we describe the 
first genetic characterization of UL54. We constructed UL54 null mutations in a
PRV bacterial artificial chromosome using sugar suicide and lambdaRed allele
exchange systems. Surprisingly, UL54 is dispensable for growth in tissue culture 
but exhibits a small-plaque phenotype that can be complemented in trans by both
the herpes simplex virus type 1 ICP27 and varicella-zoster virus open reading
frame 4 proteins. Deletion of UL54 in the virus vJSdelta54 had no effect on the
ability of the virus to shut off host cell protein synthesis but did affect virus
gene expression. The glycoprotein gC accumulated to lower levels in cells
infected with vJSdelta54 compared to those infected with wild-type virus, while
gK levels were undetectable. Other late gene products, gB, gE, and Us9,
accumulated to higher levels than those seen in cells infected with wild-type
virus in a multiplicity-dependent manner. DNA replication is also reduced in
cells infected with vJSdelta54. UL54 appears to regulate UL53 and UL52 at the
transcriptional level as their respective RNAs are decreased in cells infected
with vJSdelta54. Interestingly, vJSdelta54 is highly attenuated in a mouse model 
of PRV infection. Animals infected with vJSdelta54 survive twice as long as
animals infected with wild-type virus, and this results in delayed accumulation
of virus-specific antigens in skin, dorsal root ganglia, and spinal cord tissues.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16378979 [PubMed - indexed for MEDLINE]

1233: Am J Med. 2005 Dec;118(12):1416.

Herpes zoster in immunocompromised patients: incidence, timing, and risk factors.

Wung PK, Holbrook JT, Hoffman GS, Tibbs AK, Specks U, Min YI, Merkel PA, Spiera
R, Davis JC, St Clair EW, McCune J, Ytterberg SR, Allen NB, Stone JH; WGET
Research Group.

Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore,
Md, USA.

PURPOSE: To evaluate the risk factors for herpes zoster as well as the incidence 
and timing of this complication in patients who were treated with
immunosuppression because of active Wegener's granulomatosis. SUBJECTS AND
METHODS: We studied the 180 Wegener's granulomatosis patients in the Wegener's
Granulomatosis Etanercept Trial (WGET). Herpes zoster events during WGET were
documented prospectively. Follow-up questionnaires were employed to describe the 
location, treatment, and complication(s) of herpes zoster and its therapy.
Univariate and multivariate analyses were performed to evaluate risk factors,
including history of herpes zoster, for the occurrence of herpes zoster during
the trial. All analyses were based on the time to first occurrence of herpes
zoster. RESULTS: Eighteen patients (10% of the WGET cohort) suffered a total of
19 herpes zoster episodes over a mean follow-up period of 27 months. The annual
incidence of herpes zoster in the WGET cohort was 45 cases/1000 patient-years
(95% confidence interval [CI]: 27, 70). The median time from enrollment to the
occurrence of herpes zoster in the subgroup of patients with that complication
was 16.5 months (+/- 9.4). Fifteen of the 19 herpes zoster events (79%) occurred 
between months 6 and 36, many months after the period of most intensive
immunosuppression. In univariate analyses, history of serum creatinine > or =1.5 
mg/dL before enrollment was associated with a relative risk (RR) of 3.0 (95% CI: 
1.1, 7.8) for herpes zoster during WGET (P=.03). In multivariate analyses, serum 
creatinine > or =1.5 mg/dL was associated with an RR of 6.3 (95% CI: 2.0, 19.8;
P=.002), and female sex with an RR of 4.6 (95% CI: 1.6, 13.2; P=.004).
CONCLUSION: Renal dysfunction and female sex were consistently strong risk
factors for herpes zoster events in this population. Contrary to expectation,
most herpes zoster events did not occur during periods of most intensive
immunosuppression. These data may inform studies of interventions designed to
prevent herpes zoster in patients on treatment for immune-mediated diseases.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 16378799 [PubMed - indexed for MEDLINE]

1234: MedGenMed. 2005 Jul 13;7(3):63.

A 26-year-old woman presented to Kijabe Mission Hospital with a diffuse rash and 
dyspnea.

Fielder JF.

Africa Inland Church Kijabe Hospital, Kijabe, Kenya, Africa. jfielder@kijabe.net

Publication Types: 
    Case Reports

PMID: 16369289 [PubMed - indexed for MEDLINE]

1235: Jpn J Ophthalmol. 2005 Nov-Dec;49(6):536-8.

Herpes zoster panuveitis progression despite acyclovir treatment in a patient
following bone marrow transplantation.

Fujiwara O, Mitamura Y, Ohtsuka K.

Publication Types: 
    Case Reports
    Letter

PMID: 16365806 [PubMed - indexed for MEDLINE]

1236: J Dermatol. 2005 Nov;32(11):933-4.

Sequential development of herpes zoster duplex unilateralis during oral
famciclovir treatment.

Goo B, Cho SB, Chung KY.

Publication Types: 
    Case Reports
    Letter

PMID: 16361760 [PubMed - indexed for MEDLINE]

1237: J Gen Virol. 2006 Jan;87(Pt 1):11-9.

Isolation and characterization of a chimpanzee alphaherpesvirus.

Luebcke E, Dubovi E, Black D, Ohsawa K, Eberle R.

Department of Veterinary Pathobiology, Center for Veterinary Health Sciences,
Oklahoma State University, Stillwater, 74078, USA.

Although both beta- and gammaherpesviruses indigenous to great-ape species have
been isolated, to date all alphaherpesviruses isolated from apes have proven to
be human viruses [herpes simplex virus types 1 (HSV1) and 2 (HSV2) or
varicella-zoster virus]. If the alphaherpesviruses have co-evolved with their
host species, some if not all ape species should harbour their own
alphaherpesviruses. Here, the isolation and characterization of an
alphaherpesvirus from a chimpanzee (ChHV) are described. Sequencing of a number
of genes throughout the ChHV genome indicates that it is collinear with that of
HSV. Phylogenetic analyses place ChHV in a clade with HSV1 and HSV2, the
alphaherpesviruses of Old World monkeys comprising a separate clade. Analysis of 
reactivity patterns of HSV2-immune human sera and ChHV-immune chimpanzee sera by 
competition ELISA support this relationship. Phylogenetic analyses also place
ChHV rather than HSV1 as the closest relative of HSV2.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16361413 [PubMed - indexed for MEDLINE]

1238: Optometry. 2005 Dec;76(12):713-9.

Recurrent corneal erosion (RCE) secondary to lattice dystrophy in a patient with 
acquired immune deficiency syndrome (AIDS).

Chronister CL, Wasilauski ME.

The Eye Institute of the Pennsylvania College of Optometry, Philadelphia,
Pennsylvania. cchronister@pco.edu

BACKGROUND: We present a case of an Acquired Immune Deficiency Syndrome (AIDS)
patient with recurrent erosion (RCE) secondary to lattice corneal dystrophy. As a
human immunodeficiency virus (HIV)-infected patient becomes more
immunocompromised, the ocular surface defense mechanisms may be compromised.
Lattice dystrophy, RCE, and modifying approaches to the management of RCE in an
HIV-positive or AIDS patient are reviewed. CASE REPORT: A 49-year-old man
presented with RCE. His ocular history included lattice corneal dystrophy OU,
recurrent corneal erosion O.S., and herpes simplex virus keratitis O.S. Systemic 
history included hepatitis C and HIV infection with a diagnosis of AIDS with
secondary Pneumocystis carinii pneumonia. Viral load was 35533 HIV-RNA
(ribonucleic acid) molecules/ml of plasma and CD4 lymphocyte count 99 cells/mm3. 
Acuities were O.D. 20/80 and O.S. 20/50. The abrasion was treated with
cycloplegia and bacitracin/polymyxin B ointment q.i.d. O.S. and it resolved in 3 
days. CONCLUSION: Management of lattice dystrophy with secondary RCE in an AIDS
patient requires that the clinician be familiar with the patient's immune status.
As the CD4 count declines and the viral load increases, the patient is at higher 
risk for opportunistic anterior segment infections. Clinicians need to monitor
these patients closely for potential complicating ocular sequelae of AIDS such as
herpes zoster ophthalmicus, herpes simplex keratitis, fungal/bacterial keratitis,
and keratoconjunctivitis sicca. Our patient responded well to antibiotic therapy 
and cycloplegia. The importance of daily monitoring of immunocompromised patients
is emphasized.

Publication Types: 
    Case Reports

PMID: 16361033 [PubMed - indexed for MEDLINE]

1239: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jan;101(1):70-5.
Epub 2005 Oct 5.

Mandibular osteomyelitis and tooth exfoliation following zoster-CMV co-infection.

Meer S, Coleman H, Altini M, Alexander T.

Division of Oral Pathology, Department of Anatomical Pathology, University of the
Witwatersrand, Johannesburg, South Africa. shabnum.meer@nhls.ac.za

Herpes zoster is a common viral infection, the oral soft tissue manifestations of
which are widely known and recognized. Reports of spontaneous tooth exfoliation
and jaw osteonecrosis following herpes zoster infection in the distribution of
the trigeminal nerve are extremely infrequent and sporadic, with only 39 cases
being reported in the literature. We report an additional case of mandibular
osteomyelitis and spontaneous tooth exfoliation following herpes zoster
infection, which occurred in the left mandible of a 70-year-old diabetic man;
however, our case also showed CMV co-infection. The role of CMV in the
pathogenesis of the osteonecrosis remains uncertain. Awareness of the possibility
of CMV co-infection in various oral diseases including oral ulcers, Kaposi's
sarcoma, and herpes zoster infections especially in immunocompromised patients is
important, since spread of the CMV can easily occur to other sites with
potentially fatal consequences. Early diagnosis can lead to effective treatment
and prevention of complications.

Publication Types: 
    Case Reports

PMID: 16360610 [PubMed - indexed for MEDLINE]

1240: Mikrobiyol Bul. 2005 Jul;39(3):339-43.

[Short communication: retrospective analysis of 21 HIV/AIDS cases]

[Article in Turkish]

Akalin H, Heper Y, Yilmaz E, Kazak E, Oral B, Mistik R, Helvaci S, Tore O.

Uludag Universitesi Tip Fakultesi Mikrobiyoloji ve Enfeksiyon Hastaliklari
Anabilim Dali, Bursa.

In this study, 21 HIV/AIDS cases (18 male, 3 female; age range 17-64 years),
followed up in the Department of Infectious Diseases of Uludag University Medical
Faculty between 1997-2003 have been analyzed retrospectively, by means of
epidemiological, clinical and laboratory aspects. Nineteen (90%) of them were
heterosexual, and in 9 cases the diagnosis was coincidental during the blood
donations or routine testing. The non-compliance rate of patients to
antiretroviral treatment was found as 76%, and the most important factor for
non-compliance was the difficulty in providing antiretroviral drugs. The most
frequently encountered opportunistic infections were oropharyngeal candidiasis
(n:5), herpes zoster (n:4) and community acquired pneumonia (n:4).

Publication Types: 
    English Abstract

PMID: 16358494 [PubMed - indexed for MEDLINE]

1241: Vestn Otorinolaringol. 2005;(6):10-3.

[Viral diseases as a predisposing factor of developing secondary oto- and
rhinogenic bacterial meningitis]

[Article in Russian]

Antoniv VF, Mal'ginova NA, Kovalenko EV, Lebedeva IuA.

Effects of viruses and bacterial associations are suggested to promote secondary 
purulent intracranial complications in ENT patients. Fundamental aspects of
pathogenesis of viral neuroinfections and pathogenetic mechanisms of different
conditions provoked by viral factors promoting bacterial complications are
presented. Hemoculture, and cerebrospinal fluid in 24 patients with secondary
purulent rhinogenic and otogenic meningitis were studied with polymerase chain
reaction for enteroviruses, cytomegaloviruses, Epstein-Barr, herpes, zoster
viruses. The viruses were present in the studied media in 29.4% samples.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 16353000 [PubMed - indexed for MEDLINE]

1242: Vaccine. 2006 Feb 27;24(9):1308-14. Epub 2005 Sep 30.

The burden of Herpes Zoster: a prospective population based study.

Scott FT, Johnson RW, Leedham-Green M, Davies E, Edmunds WJ, Breuer J.

Skin Virus Laboratory, Institute for Cell and Molecular Science, 25-29 Ashfield
Street, E1 1BB, UK.

We analysed prospectively the medical, societal and economic burden among
patients from 18 general practices in East London, serving 158,716 patients who
presented to their general practitioners with acute Herpes Zoster over an 8-month
period. One hundred and eighty-six patients with HZ were seen by GPs during the
study period, of whom 96 were referred, 70 enrolled and 65 completed. PHN
occurred in 13.4% of patients. The average overall cost of HZ in the first 6
months was calculated at pound524 per patient. Medical costs were highest in
those aged over 65 and societal costs highest in those aged under 65 years.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16352376 [PubMed - indexed for MEDLINE]

1243: BMC Fam Pract. 2005 Dec 14;6:50.

A rare case of disseminated cutaneous zoster in an immunocompetent patient.

Gupta S, Jain A, Gardiner C, Tyring SK.

Department of Medicine, University of Texas Health Science Center at Houston,
6431 Fannin, Houston 77030, USA. sachin.gupta@uth.tmc.edu

BACKGROUND: Disseminated cutaneous herpes zoster in healthy persons is uncommon, 
though it has been described in immunocompromised patients. CASE PRESENTATION: We
describe a case of disseminated cutaneous herpes zoster in an elderly man with no
apparent immunosuppressive condition. The patient was treated successfully with
intravenous Acyclovir. CONCLUSION: We suggest that disseminated zoster can occur 
in an immunocompetent host and should be promptly recognized and treated to
prevent serious complications.

Publication Types: 
    Case Reports

PMID: 16351732 [PubMed - indexed for MEDLINE]

1244: Ultrasound Q. 2005 Dec;21(4):295-308.

Ultrasound markers of fetal infection part 1: viral infections.

Bailao LA, Osborne NG, Rizzi MC, Bonilla-Musoles F, Duarte G, Bailao TC.

Department of Obstetrics and Gynecology, School of Medicine, University of Sao
Paulo, Brazil.

Diagnosis of fetal infection has depended on identification of pathogens by means
of microbiological cultures, immunologic techniques, and special molecular
biology techniques that can identify organisms known or suspected of being
associated with adverse outcomes of pregnancy. Rubella, cytomegalovirus (CMV),
herpes simplex virus (HSV), and human immunodeficiency virus (HIV), for example, 
are capable of gaining access to the amniotic cavity and producing fetal
infection, even when amniotic membranes are intact. Intrauterine invasion by
viruses can be associated with maternal symptoms of infection or can be
completely silent. In many instances extensive fetal compromise with irreversible
structural damage or fetal death will have occurred by the time infection is
confirmed by culture or other histopathological methods. The evidence of fetal
infection may be as subtle as nascent intrauterine growth restriction (IUGR),
mildly inappropriate calcification of fetal organs, placenta, cord, and
membranes, and failure to adequately develop fetal fat reserves. The evidence of 
infection may be as dramatic as obvious fetal malformation, severe central
nervous system structural damage, or fetal death. Sonography is capable of
detecting most of the grave alterations and some of the subtle effects that are
typical of fetal infection.

Publication Types: 
    Comparative Study
    Review

PMID: 16344748 [PubMed - indexed for MEDLINE]

1245: Neurology. 2005 Dec 13;65(11):1812.

MRI of trigeminal zoster.

Aribandi M, Aribandi L.

Department of Radiology, Geisinger Medical Center, Danville, PA 17822, USA.
maribandi1@geisinger.edu

Publication Types: 
    Case Reports

PMID: 16344530 [PubMed - indexed for MEDLINE]

1246: Kinderkrankenschwester. 2005 Nov;24(11):478-9.

[News from the "vaccine kitchen": herpes zoster, measles, mumps, rubella and
varicella, rotaviruses, papillomaviruses]

[Article in German]

Deutsches Grunes Kreuz e.V.

PMID: 16334650 [PubMed - indexed for MEDLINE]

1247: Am J Surg Pathol. 2006 Jan;30(1):50-8.

Histopathologic features of cutaneous herpes virus infections (herpes simplex,
herpes varicella/zoster): a broad spectrum of presentations with common
pseudolymphomatous aspects.

Leinweber B, Kerl H, Cerroni L.

Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036
Graz, Austria.

Cutaneous eruptions caused by herpes simplex 1/2 (HSV-1/2) and herpes
varicella/zoster (VZV) represent common dermatoses. In some cases, they present
with atypical clinical and/or histopathologic features, including presence of
dense lymphoid infiltrates with atypical lymphocytes simulating cutaneous
lymphomas. In this study, we reviewed the biopsy specimens of 65 patients (33
males, 32 females; mean age, 61.2 years; median age, 62 years; age range, 19-96
years) with cutaneous eruptions caused by HSV-1/2 or VZV. Histologic examination 
revealed several atypical findings, including presence of dense lymphoid
infiltrates, angiotropism, and atypical lymphocytes simulating malignant
lymphoma. Immunohistochemistry performed in 22 cases showed a predominant T-cell 
infiltrate, in the majority of cases with variable numbers of CD30+ and CD56+
cells. Two cases with a pseudolymphomatous appearance and small clusters of CD30+
cells revealed a monoclonal population of T lymphocytes by PCR analysis,
underlying the difficulties in classifying some of these cases correctly. Our
study indicates that cutaneous herpes infections can exhibit several atypical
histopathologic, immunohistochemical, and molecular features, and that in given
cases accurate clinicopathologic correlation and short-term follow-up controls
are necessary for differentiation from cutaneous lymphomas.

PMID: 16330942 [PubMed - indexed for MEDLINE]

1248: CMAJ. 2005 Dec 6;173(12):1490; author reply 1490.

Comment on:
    CMAJ. 2005 Jul 5;173(1):33.

Giant cell arteritis.

Varnholt H.

Publication Types: 
    Comment
    Letter

PMID: 16330647 [PubMed - indexed for MEDLINE]

1249: Int J Epidemiol. 2006 Apr;35(2):307-14. Epub 2005 Dec 5.

Micronutrient intake and the risk of herpes zoster: a case-control study.

Thomas SL, Wheeler JG, Hall AJ.

Department of Infectious and Tropical Diseases, London School of Hygiene and
Tropical Medicine, London, UK. sara.thomas@lshtm.ac.uk

BACKGROUND: Herpes zoster can seriously impair quality of life and may also be a 
marker for age-related immune decline (immunosenescence). Diets low in
micronutrients may increase the risk of zoster by temporarily compromising
cell-mediated immune function or by hastening immunosenescence. METHODS: Primary 
objectives were to examine the association between risk of zoster and (i) dietary
intake of vitamins A, B(6), C, E, folic acid, zinc, and iron, and (ii) fruit and 
vegetable consumption. We conducted a community-based case-control study. Cases
were adults with incident zoster presenting to 22 general practices in London.
Controls were individuals with no zoster history, matched to cases by age, sex,
and general practice. Diet was ascertained for 243 cases and 483 controls using
an interviewer-administered food-frequency questionnaire. We used conditional
logistic regression to estimate odds ratios. RESULTS: There was a strong graded
association between lower fruit intake and increasing zoster risk; in adjusted
analysis, individuals who ate less than one piece of fruit per week had more than
three times the risk of zoster compared with individuals who ate more than three 
portions per day. None of the dietary intakes of the seven micronutrients
examined had a statistically significant association with zoster risk when
considered singly. However, amongst individuals aged >60 years, a measure of
combined micronutrient intake and vegetable intake showed similar dose-related
associations with zoster risk. CONCLUSION: A cocktail of nutrients such as those 
found in fruit and vegetables may act together, particularly in older
individuals, to maintain immune health and prevent zoster.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 16330478 [PubMed - indexed for MEDLINE]

1250: Malays J Pathol. 2001 Jun;23(1):47-8.

Herpes zoster in children with cancer.

Menon BS, Wan Maziah WM.

Department of Paediatrics, Universiti Sains Malaysia, Kubang Kerian, Kelantan,
Malaysia. radi@tm.net.my

The aim of this study was to determine the incidence and outcome of herpes zoster
hospitalised children with cancer in Kota Baru. It was a retrospective review
from January 1994 to December 1998. The diagnosis of herpes zoster was a clinical
one. Herpes zoster was diagnosed in 10 of 188 (5%) children with malignancy. The 
most common malignancy was leukaemia. Nine children were treated with acyclovir. 
No child developed visceral dissemination and there were no deaths.

PMID: 16329548 [PubMed - indexed for MEDLINE]

1251: Postgrad Med. 2005 Nov;118(5):45-8, 51-4.

Viral infections in the elderly. The challenges of managing herpes zoster,
influenza, and RSV.

Bader MS, McKinsey DS.

Memorial University of Newfoundland Health Sciences Center, St John's, Canada.
msbader1@hotmail.com

Viral diseases are an important cause of morbidity and mortality in elderly
patients, whether they live in the community or in long-term care facilities.
Management of viral infections in older adults is complicated by factors that
include the infrequency or absence of common signs and symptoms of infection and 
adverse drug reactions. In this article, Drs Bader and McKinsey discuss the
clinical features and treatment of herpes zoster and the respiratory diseases
caused by influenza and respiratory syncytial virus (RSV).

Publication Types: 
    Review

PMID: 16329530 [PubMed - indexed for MEDLINE]

1252: Indian J Med Microbiol. 2005 Oct;23(4):239-44.

Application of polymerase chain reaction to differentiate herpes simplex virus 1 
and 2 serotypes in culture negative intraocular aspirates.

Shyamal G, Sowmya P, Sudha B, Malathi J, Therese LK, Madhavan HN.

Vision Reaserch Foundation, Sankar Nethralaya, Chennai-600 006, TN, India.

PURPOSE: To standardize and apply a polymerase chain reaction (PCR) on the
glycoprotein D gene to differentiate Herpes simplex virus (HSV) 1 & 2 serotypes
in culture negative intraocular specimens. METHODS: Twenty-one intraocular fluids
collected from 19 patients were subjected to cultures for HSV and uniplex PCR
(uPCR) for DNA polymerase gene. To differentiate HSV serotypes, as 1 & 2, a
seminested PCR (snPCR) targeting the glycoprotein D gene was standardised and
applied onto 21 intraocular fluids. The specificity of the snPCR was verified by 
application onto ATCC strains of HSV 1 and 2, clinical isolates and DNA
sequencing of the amplified products. All specimens were also tested for the
presence of cytomegalovirus (CMV) and varicella zoster virus (VZV) by nucleic
acid amplification methods. RESULTS: Four of the 21 intraocular fluids were
positive for HSV by uPCR. snPCR detected HSV in three additional specimens (total
of seven specimens), and identified three as HSV 1 and four as HSV 2. DNA
sequencing of PCR products showed 100% homology with the standard strains of HSV 
1 and 2 respectively. None of the samples were positive in culture. Among the
other patients, CMV DNA was detected in two and VZV DNA in five others.
CONCLUSIONS: The standardized snPCR can be applied directly onto the culture
negative specimens for rapid differentiation of HSV serotypes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16327119 [PubMed - indexed for MEDLINE]

1253: J Pain. 2005 Dec;6(12):782-90.

Psychosocial risk factors for postherpetic neuralgia: a prospective study of
patients with herpes zoster.

Katz J, McDermott MP, Cooper EM, Walther RR, Sweeney EW, Dworkin RH.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, Rochester, NY 14642, USA.

The results of previous studies using retrospective methods or small samples have
suggested that there may be psychosocial risk factors for postherpetic neuralgia 
(PHN). We conducted a prospective study in which 110 patients with herpes zoster 
were assessed within the first month after rash onset with measures of acute pain
and five broad domains of psychosocial functioning-physical, role, social, and
emotional functioning, and stress and social support. Twenty of the 102 patients 
with follow-up data were diagnosed with PHN, defined as pain that had persisted
for 4 months after rash onset. Measures of role functioning, personality disorder
symptoms, and disease conviction during herpes zoster each made independent
contributions to predicting either presence or intensity of PHN in logistic and
linear regression analyses that controlled for relevant demographic and clinical 
variables, including age and acute pain intensity. These findings indicate that
psychosocial variables are risk factors for the development of PHN. PERSPECTIVE: 
The results of this prospective study of patients with herpes zoster suggest that
future research on the mechanisms and prevention of PHN should consider
psychosocial as well as neurobiologic processes.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16326366 [PubMed - indexed for MEDLINE]

1254: Ocul Immunol Inflamm. 2005 Dec;13(6):475-8.

CMV retinitis in a patient with good syndrome.

Sen HN, Robinson MR, Fischer SH.

National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA.
SenH@nei.nih.gov

PURPOSE: To describe cytomegalovirus (CMV) retinitis in a patient with Good
syndrome. METHODS: A 48-year-old patient with Good syndrome presented with a
necrotizing retinitis in the left eye. Quantitative touchdown real-time
polymerase chain reaction (PCR) was performed on aqueous fluid. RESULTS:
Quantitative PCR showed 152 copies of CMV per ml and was negative for varicella
zoster virus (VZV), Epstein-Barr virus (EBV), herpes simplex virus (HSV-1), and
HSV-2. The positive CMV PCR suggested CMV retinitis and the patient was treated
with intravitreal ganciclovir injections (2.5 mg/0.05 ml), followed by
ganciclovir implant. The retinal lesions showed decreasing activity two weeks
after the onset of the therapy. A repeat PCR showed a decreasing number of CMV
copies at one and two weeks (122 copies/ml and 0 copies/ml, respectively) that
correlated clinically with the decreasing retinitis activity. CONCLUSIONS:
Quantitative PCR can be useful in diagnosing as well as assessing the response to
therapy of CMV retinitis in patients with Good syndrome.

Publication Types: 
    Case Reports

PMID: 16321895 [PubMed - indexed for MEDLINE]

1255: J Ayub Med Coll Abbottabad. 2005 Jul-Sep;17(3):80-1.

Recurrence of herpes zoster in an immunocompetent adult male.

Raza N, Iqbal P, Anwer J.

Combined Military Hospital, Abbottabad. naeemraza561@hotmail.com

Repeated and disseminated eruptions herpes zoster are frequently detected in
immunocompromised patients, but are rare in immuno-competent individuals. We
report a case of recurrent herpes zoster in a young healthy male, who redeveloped
herpes zoster in a different dermatome after one year.

Publication Types: 
    Case Reports

PMID: 16320806 [PubMed - indexed for MEDLINE]

1256: SADJ. 2005 Oct;60(9):386-7.

Eye signs that alert the clinician to a diagnosis of AIDS.

Meyer D.

Department of Ophthalmology, University of Stellenbosch. dm2@sun.ac.za

One of the hallmarks of progressive immune deficiency is a steady decline in the 
absolute number of CD4+ T-lymphocytes. As the immune response thus becomes
suppressed, opportunistic systemic infections such as protozoal (Pneumocystis
carinii pneumonia, disseminated toxoplasmosis), viral (Cytomegalovirus
pneumonitis and colitis and persistent invasive herpes simplex lesions), fungal
(cryptococcossis and esophageal candidiasis) and bacterial infections (atypical
mycobacterial and extrapulmonary tuberculosis) set in to claim their toll. Ocular
complications occur in about 75% of AIDS patients and may be divided into four
categories: Retinal microangiopathy, Opportunistic infections, Tumours,
Neuro-ophthalmological lesions. Only the most frequently occurring manifestations
will be highlighted.

PMID: 16320530 [PubMed - indexed for MEDLINE]

1257: SADJ. 2005 Oct;60(9):380-2, 384.

Herpes zoster: a review of the literature and report of a case.

Feller L, Jadwat Y.

Department of Periodontology and Oral Medicine, Medunsa Oral Health Centre,
Faculty of Dentistry, Medunsa Campus, University of Limpopo. lfeller@ul.ac.za

Publication Types: 
    Case Reports
    Review

PMID: 16320529 [PubMed - indexed for MEDLINE]

1258: Clin Exp Dermatol. 2006 Jan;31(1):30-2.

Acquired port-wine stain related to acoustic neuroma.

Kulac M, Karaca S, Acar M, Albayrak R, Songur A.

Department of Dermatology, Faculty of Medicine, Afyon Kocatepe University, Afyon,
Turkey. mustafakulac@yahoo.com

Port-wine stains are frequently seen congenital vascular malformations consisting
of ectatic dermal capillaries. Acquired port-wine stain that develops later in
life is an uncommon vascular lesion that is morphologically identical to a
congenital port-wine stain. In the majority of acquired port-wine stains, the
aetiology is unknown, but trauma is an important causative factor. Other proposed
aetiologies include chronic sun exposure, hormonal changes, frostbite injury,
obstruction of the peritoneovenous shunt, herpes zoster infection, and cerebral
arteriovenous malformation. Here we report the first case of a patient who had an
acquired port-wine stain related to a solid brain tumour.

Publication Types: 
    Case Reports

PMID: 16309474 [PubMed - indexed for MEDLINE]

1259: Br J Dermatol. 2005 Dec;153(6):1241-3.

Erythema annulare centrifugum following herpes zoster infection: Wolf's isotopic 
response?

Lee HW, Lee DK, Rhee DY, Chang SE, Choi JH, Moon KC, Koh JK.

Publication Types: 
    Case Reports
    Letter

PMID: 16307675 [PubMed - indexed for MEDLINE]

1260: Curr Top Med Chem. 2005;5(13):1191-203.

Recent advances in antiviral nucleoside and nucleotide therapeutics.

Simons C, Wu Q, Htar TT.

Medicinal Chemistry Division, Welsh School of Pharmacy, Cardiff University, King 
Edward VII Avenue, Cardiff CF10 3XF, UK. SimonsC@Cardiff.ac.uk

Recent developments in nucleoside/nucleotide therapeutics and antiviral drug
targets are described covering progress in the development of
nucleoside/nucleotide mimetics for the treatment of influenza virus, human
immunodeficiency virus type 1, hepatitis B and C virus, herpes virus infections; 
including herpes simplex virus, cytomegalovirus and varicella zoster virus
infections, and the highly pathogenic poxviruses (variola, vaccinia and monkey
pox) and filoviruses (Ebola and Marburg).

Publication Types: 
    Review

PMID: 16305526 [PubMed - indexed for MEDLINE]

1261: J Pak Med Assoc. 2005 Nov;55(11):478-82.

Allogeneic stem cell transplantation in chronic myeloid leukaemia--2 1/2 year
experience.

Hashmi K, Khan B, Ahmed P, Hussain I, Raza S, Iqbal H, Malik HS, Kamal MK, Anwar 
M.

Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan.

OBJECTIVE: To evaluate out come of allogeneic Stem Cell Transplantation (SCT) in 
chronic myeloid leukaemia (CMC) at Armed Forces Bone Marrow Transplant Centre,
Rawalpindi from April 2002 to October 2004. METHODS: Twenty-two patients with CML
underwent allogeneic SCT from HLA matched siblings. Patients were divided into
standard (n=14) and high-risk (n=8) groups. Patients were subjected to
conditioning regimens consisting of Busulphan and Cyclophosphamide. Cyclosporin, 
Prednisolone and Methotrexate were given for GvHD prophylaxis. All donors were
subjected to PBSC harvest after G-CSF therapy for five days. All received G-CSF
from Day+5 until ANC >0.5 x 10(9)/l. RESULTS: The median age of the patients was 
29 years (range 7-53 years) with a male to female ratio of 6.3:1. Engraftment was
achieved in all patients. Median time to achieve neutrophil (ANC 0.5 x 10(9)/l)
and platelet (20 x 10(9)/l) recovery was 13 days and 12 days respectively. Median
stay in hospital was 18 days. Acute GvHD (Grade-II-IV) was observed in eleven
patients (50%) while chronic GvHD was seen in four patients (18%). One patient
relapsed 8 months post transplant. Two patients (9%) developed Veno-occlusive
disease (VOD) liver. One patient had haemorrhagic cystitis. Four patients (18%)
had post transplant infectious complications, which included pseudomonas
septicemia, aspergillosis, tuberculous pleural effusion and herpes zoster.
Overall mortality was 22.7% (n=5). The major causes of mortality were VOD liver, 
GvHD grade IV, Pseudomonas septicaemia and aspergillosis. Overall survival was
77.2% (n=17) and disease free survival was (n=16) 72.7%. Follow up ranges were
from 23 to 828 days (median 212 days). CONCLUSION: The preliminary results of SCT
in this small series of patients with CML are very encouraging. To improve the
long-term survival it is imperative that patients are transplanted early after
diagnosis and conditioning regimens are selected carefully.

PMID: 16304866 [PubMed - indexed for MEDLINE]

1262: Eye. 2005 Oct;19(10):1035-6.

Comment in:
    Eye. 2006 Dec;20(12):1414-5; author reply 1415.

Management of blinding disease: loss of immunity and superinfection.

Evans BG.

Communicable Disease Surveillance Centre, London, UK. barry.evans@hpa.org.uk

Globally the most important loss of immunity currently occurs with HIV disease.
The effects of HIV on the eye, since the advent of highly active antiretroviral
therapy, have been less in countries where such treatment is available but even
in such situations ophthalmic zoster can occur at higher CD4 cell counts and can 
still cause problems. Other opportunistic infections such as CMV retinitis tend
to occur at lower CD4 cell counts. However, globally treatment is not universally
available in resource poor countries where it is most needed. A major impact of
HIV in such situations is on premature mortality affecting the health care and
education workforce, which indirectly has an impact on blinding disease. In
addition, loss of family income due to illness or death of parents can affect
nutritional status of remaining family members especially children as well as the
direct effect of opportunistic infections in the eyes of those infected with HIV.

Publication Types: 
    Review

PMID: 16304581 [PubMed - indexed for MEDLINE]

1263: Indian J Pathol Microbiol. 2004 Oct;47(4):453-68.

Current perspectives of herpesviral retinitis and choroiditis.

Madhavan HN, Priya K, Biswas J.

Microbiology Research Centre, Vision Research Foundation, Sankara Nethralaya,
Chennai, Tamil Nadu. drhnm@sankaranethralaya.org

Vision-threatening viral retinitis are primarily caused by members of the
herpesvirus family. The biology and molecular characterization of herpesviruses, 
clinical presentations of retinopathies, pathology and pathogenesis including the
host responses, epidemiology and the laboratory methods of aetiological diagnosis
of these diseases are described. Clinical syndromes are acute retinal necrosis
(ARN), progressive outer retinal necrosis (PORN), cytomegalovirus (CMV)
retinitis, multifocal choroiditis and serpiginous choroiditis besides other viral
retinopathies. Herpes simplex virus (HSV) retinitis is more common in
immunocompetent persons while varicella zoster virus (VZV) affects both
immunocompetent and immunosuppressed patients equally. CMV retinitis is most
common among patients with AIDS. The currently employed laboratory methods of
antigen detection, virus isolation and antibody detection by enzyme linked
immuno-sorbent assay (ELISA) have low sensitivity. Polymerase chain reaction
(PCR) has increased the value of diagnosis due to its high clinical sensitivity
and absolute specificity in detection of herpesviruses in intraocular specimens.

Publication Types: 
    Review

PMID: 16295367 [PubMed - indexed for MEDLINE]

1264: Am J Emerg Med. 2005 Nov;23(7):899-900.

Emergent hemodialysis for acyclovir toxicity.

Hsu CC, Lai TI, Lien WC, Chen WJ, Fang CC.

Department of Emergency Medicine, National Taiwan University Hospital, and
National Taiwan University, College of Medicine, Taipei 100, Taiwan.

Publication Types: 
    Case Reports

PMID: 16291450 [PubMed - indexed for MEDLINE]

1265: J Virol Methods. 2006 Mar;132(1-2):216-21. Epub 2005 Nov 11.

Development of the loop-mediated isothermal amplification method for rapid
detection of cytomegalovirus DNA.

Suzuki R, Yoshikawa T, Ihira M, Enomoto Y, Inagaki S, Matsumoto K, Kato K, Kudo
K, Kojima S, Asano Y.

Division of Pharmacy, Fujita Health University Hospital, Toyoake, Aichi, Japan.

Cytomegalovirus (CMV) loop-mediated isothermal amplification (LAMP) was performed
on DNA extracted from CMV (AD-169)-, herpes simplex virus (HSV) 1 (KOS)-, HSV-2
(186)-, varicella-zoster virus (Oka-vaccine)-, human herpesvirus (HHV)-6 A
(U1102)-, HHV-6 B (Z29)-, and HHV-7 (RK)-infected cells. Although amplified CMV
demonstrated typical ladder patterns, no LAMP product was detected in reactions
performed with other viral DNAs. The sensitivity of the CMV LAMP was 500
copies/tube, as determined by either agarose gel electrophoresis or turbidity
assay. To determine whether CMV LAMP could be used for quantitative analysis of
viral DNA, threshold times, defined as the time (in seconds) to reach the
threshold level (0.1), were measured by amplification of serial dilutions of the 
plasmid DNA. The standard curve exhibited a correlation coefficient of 0.944, a
slope of -208.1, and a y-intercept of 3261.4. Following these initial validation 
experiments, we analyzed 180 samples collected serially from 20 pediatric
hematopoietic stem cell transplant recipients. Detection of CMV DNA in whole
blood (WB) was tested by CMV LAMP and real-time polymerase chain reaction (PCR). 
When >500 copies/tube (>5000 copies/200 microl of WB) was defined as positive for
CMV infection, the sensitivity, specificity, positive predictive value, and
negative predictive values of the CMV LAMP were 80.0, 98.9, 66.7, and 99.4%,
respectively.

Publication Types: 
    Comparative Study
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 16289345 [PubMed - indexed for MEDLINE]

1266: Arch Neurol. 2005 Nov;62(11):1774-5.

Petrositis in Ramsay Hunt syndrome with multiple cranial neuropathies.

Espay AJ, Bull RL.

Department of Neurology, University of Cincinnati, OH 45267, USA.
alberto.espay@uc.edu

Publication Types: 
    Case Reports

PMID: 16286554 [PubMed - indexed for MEDLINE]

1267: AIDS. 2005 Dec 2;19(18):2183-4.

Alveolar bone necrosis and tooth exfoliation secondary to herpes zoster in the
setting of HIV/AIDS.

van Heerden WF, McEachen SE, Boy SC.

Publication Types: 
    Letter

PMID: 16284476 [PubMed - indexed for MEDLINE]

1268: Blood. 2006 Mar 1;107(5):1800-5. Epub 2005 Nov 10.

Long-term acyclovir for prevention of varicella zoster virus disease after
allogeneic hematopoietic cell transplantation--a randomized double-blind
placebo-controlled study.

Boeckh M, Kim HW, Flowers ME, Meyers JD, Bowden RA.

Fred Hutchinson Cancer Research Center, Program in Infectious Diseases, 1100
Fairview Ave N, Seattle, WA 98109, USA. mboeckh@fhcrc.org

Varicella-zoster virus (VZV) disease occurs in 30% of allogeneic hematopoietic
cell transplant recipients who had a history of VZV infection. A safe and
effective prevention strategy has not been established. In a double-blind
controlled trial, 77 hematopoietic cell transplant recipients at risk for VZV
reactivation were randomized to acyclovir 800 mg twice daily or placebo given
from 1 to 2 months until 1 year after transplantation. VZV disease at 1 year was 
the primary end point; VZV disease after discontinuation of prophylaxis,
VZV-specific T-cell immunity, herpes simplex virus (HSV) infection,
cytomegalovirus (CMV) disease, survival, and safety were secondary end points.
Acyclovir significantly reduced VZV infections at 1 year after transplantation
(HR, 0.16; 95% CI, 0.035-0.74; P = .006). In the post-intervention observation
period, this difference was not statistically significant (2 years: HR, 0.52; 95%
CI, 0.21-1.3; 5 years: HR, 0.76; 95% CI, 0.36-1.6). There was no statistically
significant difference in reconstitution of VZV-specific T-helper cell responses,
HSV infections, CMV disease, chronic graft-versus-host disease, and overall
survival between the groups. Acyclovir was well tolerated. Post-study VZV disease
predominantly occurred in patients with continued need for systemic
immunosuppression. In conclusion, acyclovir effectively and safely prevents VZV
disease during the first year after hematopoietic cell transplantation. Periods
of prophylaxis longer than 12 months may be beneficial for those hematopoietic
cell transplant recipients on continued immune suppression.

Publication Types: 
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16282339 [PubMed - indexed for MEDLINE]

1269: Semin Ophthalmol. 2005 Jul-Sep;20(3):155-60.

Acute retinal necrosis.

Bonfioli AA, Eller AW.

University of Pittsburgh Eye Center, University of Pittsburgh School of Medicine,
Pittsburgh, PA 15213, USA.

Acute retinal necrosis (ARN) is an uncommon intraocular inflammatory syndrome
characterized by severe and diffuse uveitis, retinal vasculitis, and retinal
necrosis. It is typically described to occur in immunocompetent patients, but can
also be found in immunocompromised subjects. Varicella-zoster virus (VZV), herpes
simplex virus (HSV 1 and 2), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) 
have been implicated in the etiology of ARN. The characteristic features of the
disease include iridocyclitis, vitritis, retinal vasculitis, and retinal
necrosis. Bilateral involvement occurs in two-thirds of the patients, frequently 
in the first six weeks, but sometimes months to years later. Retinal detachment
occurs in 75% of the cases. The diagnosis of ARN is usually based in clinical
features. The use of polymerase chain reaction (PCR) in aqueous humor samples is 
useful to identify the etiology of the disease. The treatment of ARN includes
intravenous acyclovir, corticosteroids and aspirin. To prevent fellow eye
involvement, intravenous acyclovir is followed by oral acyclovir for 14 weeks.
Alternatives to acyclovir include ganciclovir, foscarnet, famcyclovir, brivudine,
and valgancyclovir.

Publication Types: 
    Review

PMID: 16282149 [PubMed - indexed for MEDLINE]

1270: Acta Neurol Scand. 2005 Dec;112(6):417-9.

Frequent association of multiple sclerosis with varicella and zoster.

Perez-Cesari C, Saniger MM, Sotelo J.

Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico,
Mexico City, Mexico.

BACKGROUND: A possible association of multiple sclerosis (MS) with viral diseases
has been postulated; in previous studies we have found that in Mexican mestizos
the antecedent of varicella during childhood represents a risk factor for the
development of MS during adulthood. AIM: We conducted a retrospective search for 
varicella and zoster infections associated with the development of MS. METHODS
AND RESULTS: In a cohort of 82 consecutive patients with MS we found six cases,
four of varicella and two of zoster, that were concurrent with the development or
the progress of MS. CONCLUSIONS: The association of these pathologies is higher
than expected and suggests a possible etiological relationship of the varicella
zoster virus with MS.

PMID: 16281927 [PubMed - indexed for MEDLINE]

1271: J Dtsch Dermatol Ges. 2004 Nov;2(11):931-4.

[Zosteriform pigmented purpura of Schamberg: case report and differential
diagnosis of zosteriform skin lesions]

[Article in German]

Babilas P, Roesch A, Szeimies RM, Landthaler M, Vogt T.

Klinik und Poliklinik fur Dermatologie, Klinikum der Universitat Regensburg.
philipp.babilas@klinik.uni-regensburg.de

A 13-year-old boy presented with progressive pigmented purpura of Schamberg in an
unusual zosteriform distribution. He recently has taken methylphenidate which has
not been described as a cause of Schamberg disease. Many different skin diseases 
can present in a zosteriform distribution. They are reviewed systematically and
sorted by pathogenetic criteria.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 16281612 [PubMed - indexed for MEDLINE]

1272: J Dtsch Dermatol Ges. 2004 Sep;2(9):770-2.

[Granulomatous dermatitis following herpes zoster with detection of varicella
zoster virus DNA]

[Article in German]

Gesierich A, Krahl D, Weiss H, Brocker EB, Rose C.

Universitat-Hautklinik Wurzburg.

The occurrence of a granulomatous inflammation following herpes zoster infection 
is uncommon and its pathogenesis is unclear. A 74-year-old male patient developed
multiple red-brown papules following a secondary generalized infection with
varicella zoster virus in the same area. The patient was suffering from a chronic
lymphocytic B-cell leukaemia. Histopathologically, granulomatous dermatitis with 
multinucleate giant cells was found. Varicella zoster virus DNA was identified by
polymerase chain reaction in the tissue. After a renewed antiviral therapy, skin 
lesions disappeared completely.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16279222 [PubMed - indexed for MEDLINE]

1273: MMW Fortschr Med. 2005 Oct 13;147(41):34, 36.

[Immunization in the elderly--necessary, helpful, superfluous?]

[Article in German]

Popp W.

GESUNDE LUNGE - Institut fur Atemwegs- und Lungenerkrankungen Wien.
wolfgang.popp@wienkav.at

For all adults, vaccinations against tetanus, diphtheria, poliomyelitis,
pertussis, TBE (in endemic regions) and specific vaccinations for travelers are
recommended. In addition to this standard protection, the Robert-Koch Institute
also recommends--in particular for over-60-year-olds--an annual vaccination
against influenza, as well as against pneumococci that must be repeated every six
years.

Publication Types: 
    English Abstract

PMID: 16270509 [PubMed - indexed for MEDLINE]

1274: MMW Fortschr Med. 2005 Oct 13;147(41):15-6.

[Always consider complications in facial erythema]

[Article in German]

Paukstadt W.

Publication Types: 
    Case Reports
    News

PMID: 16270504 [PubMed - indexed for MEDLINE]

1275: Support Care Cancer. 2006 Mar;14(3):277-84. Epub 2005 Nov 4.

Infections in a pediatric patient cohort with acute lymphoblastic leukemia during
the entire course of treatment.

Katsimpardi K, Papadakis V, Pangalis A, Parcharidou A, Panagiotou JP, Soutis M,
Papandreou E, Polychronopoulou S, Haidas S.

Department of Pediatric Hematology--Oncology, Aghia Sophia Children's Hospital,
Thivon & Livadias Ave, Goudi, Athens, 11527, Greece.

GOALS: To assess the type, frequency, severity, and outcome of all infectious
episodes in a pediatric patient cohort with acute lymphoblastic leukemia (ALL)
from a single institution during the entire length of leukemia treatment.
PATIENTS AND METHODS: Eighty-six patients were treated according to a modified
ALL Berlin-Frankfurt-Munster protocol. Retrospective analysis of all types of
infections according to the treatment phase and the degree of neutropenia is
presented. RESULTS: A total of 610 infectious episodes were recorded. Most
infections were documented during maintenance (57%), followed by the induction
phase (20.3%). During maintenance, 347 episodes were encountered, with
nonspecific viral upper respiratory tract infections (URIs) being the commonest
diagnosis (40.0%). Additionally, 38 of 58 total specific viral infections
occurred during maintenance: 16 herpes simplex, 7 varicella, 10 herpes zoster
infections [varicella-zoster virus (VZV), 45%]. The majority of bacteremia and
fever of unknown origin occurred during induction (20%). The number of
Gram-negative bacteremia was 50% of the total (26 of 52). The majority of the
infections (59.5%) occurred without neutropenia [absolute neutrophil count (ANC) 
>1,000 microl(-1)]. Fewer infections (9.3%) were recorded with concurrent very
severe neutropenia (ANC <100 microl(-1)), although 38.5% of positive blood
cultures were documented with severe neutropenia. No infection-related fatality
occurred. CONCLUSIONS: Most of the severe infections occurred during induction.
Gram-positive bacteremia and Gram-negative bacteremia were almost equal. URIs
were the commonest infections during the entire treatment and during maintenance.
Specific viral infections represented a smaller percentage of the total (VZV was 
the commonest pathogen). Infectious complications represented a significant
morbidity factor, but notably, mortality was negligible.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16270193 [PubMed - indexed for MEDLINE]

1276: Oral Dis. 2005 Nov;11(6):370-3.

Oral lesions as indicators of HIV infection among routine dental patients in
Lagos, Nigeria.

Agbelusi GA, Wright AA.

Department of Preventive Dentistry, College of Medicine, University of Lagos,
Lagos, Nigeria. gbemisola4life2004@yahoo.com

OBJECTIVES: To document the incidental oral lesions of human immunodeficiency
virus (HIV) infection, the pattern and frequency of the lesions based on clinical
presentation and oral manifestations in routine dental patients who tested
positive in Nigeria. SUBJECTS AND METHODS: The study was conducted at the Oral
Diagnosis/Oral Medicine clinic of the Lagos University Teaching Hospital, Lagos, 
Nigeria between May 2002 and April 2003. During this period, all patients with
oral lesions suggestive of HIV/acquired immunodeficiency syndrome (AIDS) as
described in the EEC-WHO Classification and diagnostic criteria of oral lesions
of HIV were counseled and offered voluntary HIV testing. All the 35 patients who 
consented and tested positive were included in this study. RESULTS: Of a total of
700 patients 53 patients with oral lesions suggestive of HIV/AIDS were seen,
thirty-eight (72%) consented to HIV screening, 15 patients (28%) refused.
Thirty-five patients (92%), mean age 36 +/- 13 years were confirmed positive for 
HIV. Oral candidiasis was the commonest lesion seen (43%) the second common being
Herpes zoster (23%). Other lesions seen included erythema multiforme in two (6%),
facial palsy in two (6%) and oral hairy leukoplakia in one (3%). CONCLUSION: An
oral mucosal lesion may be the presenting lesion of HIV/AIDS in routine patients 
attending the dental clinic. Oral health care workers should practice optimal
infection control based on the Centers for Disease Control 'Standard Precautions'
guidelines on infection control for all patients to minimize occupational
transmission of HIV.

PMID: 16269028 [PubMed - indexed for MEDLINE]

1277: J Eur Acad Dermatol Venereol. 2005 Nov;19(6):774-5.

Mondor's disease probably due to herpes zoster.

Yang JH, Lee UH, Jang SJ, Choi JC.

Publication Types: 
    Case Reports
    Letter

PMID: 16268897 [PubMed - indexed for MEDLINE]

1278: Bull Soc Pathol Exot. 2005 Sep;98(3):187-92.

[Dermatologic manifestations associated with immune reconstitution syndrome in
HIV+ patients starting HAART: a retrospective study in French Guiana]

[Article in French]

Sarazin E, Nacher M, Toure Y, Clyti E, El Guedj M, Aznar C, Vaz T, Sainte-Marie
D, Sobesky M, Carme B, Couppie P.

Service de dermatologie, Centre hospitalier Andree-Rosemon, Avenue des
Flamboyants, 97306, Cayenne, Guyane francaise.

Immune reconstitution syndrome (IRIS) is an unusual inflammatory reaction to an
opportunistic infection in an HIV-positive patient. This syndrome occurs when
immunity is restored in the first months of an effective highly active
antiretroviral treatment (HAART). First, we described all patients with a
cutaneous form of IRIS. Then, between 1992 and 2004 we conducted a retrospective 
cohort study comparing Herpes Zoster and Herpes Simplex infections among
untreated patients, patients treated by HAART for < or = six months, and patients
treated for > six months. We observed three cases of atypical leprosy and three
original observations: two of these were fistulisation of lymph node
histoplasmosis and tuberculosis, the third one reports the recurrence of a
treated cutaneous leishmaniasis. Multivariate analysis showed that, after
controlling for age, sex and CD4 counts, patients receiving HAART for < or = six 
months were more likely to develop Herpes Zoster or herpes simplex infections (p 
< 0.005). Herpes Simplex and Herpes Zoster infections are the two most frequent
dermatological manifestations in our tropical setting. Although mycobacterial
infections are more rarely observed than in visceral IRIS, the increased
incidence of leprosy may be quite significant when the availability of HAART
spreads to developing countries.

Publication Types: 
    Case Reports
    English Abstract
    Multicenter Study

PMID: 16267958 [PubMed - indexed for MEDLINE]

1279: Curr Neurol Neurosci Rep. 2005 Nov;5(6):427-8.

A vaccine to prevent herpes zoster and post-herpetic neuralgia in older adults.

Jubelt B.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 16263052 [PubMed - indexed for MEDLINE]

1280: ACP J Club. 2005 Nov-Dec;143(3):61.

Comment on:
    N Engl J Med. 2005 Jun 2;352(22):2271-84.

A varicella-zoster virus vaccine reduced the burden of illness of herpes zoster
in older adults.

Fekete T.

Temple University School of Medicine, Philadelphia, Pennsylvania, USA.

Publication Types: 
    Comment

PMID: 16262218 [PubMed]

1281: J Virol. 2005 Nov;79(22):14079-87.

Laser-capture microdissection: refining estimates of the quantity and
distribution of latent herpes simplex virus 1 and varicella-zoster virus DNA in
human trigeminal Ganglia at the single-cell level.

Wang K, Lau TY, Morales M, Mont EK, Straus SE.

Medical Virology Section, Laboratory of Clinical Infectious Diseases, National
Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA.
kwang@niaid.nih.gov

There remains uncertainty and some controversy about the percentages and types of
cells in human sensory nerve ganglia that harbor latent herpes simplex virus 1
(HSV-1) and varicella-zoster virus (VZV) DNA. We developed and validated
laser-capture microdissection and real-time PCR (LCM/PCR) assays for the presence
and copy numbers of HSV-1 gG and VZV gene 62 sequences in single cells recovered 
from sections of human trigeminal ganglia (TG) obtained at autopsy. Among 970
individual sensory neurons from five subjects, 2.0 to 10.5% were positive for
HSV-1 DNA, with a median of 11.3 copies/positive cell, compared with 0.2 to 1.5% 
of neurons found to be positive by in situ hybridization (ISH) for HSV-1
latency-associated transcripts (LAT), the classical surrogate marker for HSV
latency. This indicates a more pervasive latent HSV-1 infection of human TG
neurons than originally thought. Combined ISH/LCM/PCR assays revealed that the
majority of the latently infected neurons do not accumulate LAT to detectable
levels. We detected VZV DNA in 1.0 to 6.9% of individual neurons from 10
subjects. Of the total 1,722 neurons tested, 4.1% were VZV DNA positive, with a
median of 6.9 viral genomes/positive cell. After removal by LCM of all visible
neurons on a slide, all surrounding nonneuronal cells were harvested and assayed:
21 copies of HSV-1 DNA were detected in approximately 5,200 nonneuronal cells,
while nine VZV genomes were detected in approximately 14,200 nonneuronal cells.
These data indicate that both HSV-1 and VZV DNAs persist in human TG primarily,
if not exclusively, in a moderate percentage of neuronal cells.

Publication Types: 
    Research Support, N.I.H., Intramural

PMID: 16254342 [PubMed - indexed for MEDLINE]

1282: Am J Clin Dermatol. 2005;6(5):317-25.

Current management of herpes zoster: the European view.

Volpi A, Gross G, Hercogova J, Johnson RW.

Department of Public Health, University of Rome, Rome, Italy.
volpi@med.uniroma2.it

The overall incidence of herpes zoster in Europe is approximately 3 per 1000
people per year and more than 10 per 1000 people per year in those aged >80
years. Post herpetic neuralgia (PHN) is a common debilitating complication of
herpes zoster, particularly in patients aged >50 years, in persons with severe
pain or rash at presentation, and in those with significant prodromal symptoms.
Antiviral drugs can effectively control acute symptoms and, if used early enough 
in the course of the illness, can help prevent the development of PHN and other
complications. However, despite this, many patients do not receive such
treatment. The economic impact of zoster and PHN is largely underestimated in
Europe. Furthermore, there is considerable variation throughout Europe in the
management of herpes zoster. Use of antiviral therapy including the newer potent 
antiviral agents such as brivudin, which requires less frequent administration
than acyclovir, is improving patient outcomes in some European countries.
However, in many countries, patient awareness of herpes zoster and, as a result, 
overall antiviral use is low. Guidelines recommending the use of antiviral
agents, particularly in patients at risk of developing PHN, are available but are
not widely used. More needs to be done to educate the general public and increase
awareness among primary healthcare providers of the benefits of timely and
appropriate pharmacological therapy in patients with herpes zoster.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Review

PMID: 16252931 [PubMed - indexed for MEDLINE]

1283: Med J Aust. 2005 Sep 5;183(5):278-9.

Comment on:
    Med J Aust. 2005 Sep 5;183(5):277-9.

Universal varicella vaccination. Comment.

Macartney K, Mcintyre P.

Publication Types: 
    Comment
    Letter

PMID: 16252446 [PubMed - indexed for MEDLINE]

1284: FDA Consum. 2005 Jul-Aug;39(4):7.

Experimental shingles vaccine proves effective in nationwide study.

[No authors listed]

PMID: 16252393 [PubMed - indexed for MEDLINE]

1285: Antimicrob Agents Chemother. 2005 Nov;49(11):4671-80.

Organotypic epithelial raft cultures as a model for evaluating compounds against 
alphaherpesviruses.

Andrei G, van den Oord J, Fiten P, Opdenakker G, De Wolf-Peeters C, De Clercq E, 
Snoeck R.

Rega Institute for Medical Research, Catholic University of Leuven,
Minderbroedersstraat 10, B-3000 Leuven, Belgium. graciela.andrei@rega.kuleuven.be

The course of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) and
varicella-zoster virus (VZV) infections in squamous epithelial cells cultured in 
a three-dimensional organotypic raft culture was tested. In these raft cultures, 
normal human keratinocytes isolated from neonatal foreskins grown at the
air-liquid interface stratified and differentiated, reproducing a fully
differentiated epithelium. Typical cytopathic changes identical to those found in
the squamous epithelium in vivo, including ballooning and reticular degeneration 
with the formation of multinucleate cells, were observed throughout the raft
following infection with HSV and VZV at different times after lifting the
cultures to the air-liquid interface. For VZV, the aspects of the lesions
depended on the stage of differentiation of the organotypic cultures. The
activity of reference antiviral agents, acyclovir (ACV), penciclovir (PCV),
brivudin (BVDU), foscarnet (PFA), and cidofovir (CDV), was evaluated against
wild-type and thymidine kinase (TK) mutants of HSV and VZV in the raft cultures. 
ACV, PCV, and BVDU protected the epithelium against cytopathic effect induced by 
wild-type viruses in a concentration-dependent manner, while treatment with CDV
and PFA proved protective against the cytodestructive effects induced by both TK+
and TK- strains. The quantification of the antiviral effects in the rafts were
accomplished by measuring viral titers by plaque assay for HSV and by measuring
viral DNA load by real-time PCR for VZV. A correlation between the degree of
protection as determined by histological examination and viral quantification
could be demonstrated The three-dimensional epithelial raft culture represents a 
novel model for the study of antiviral agents active against HSV and VZV. Since
no animal model is available for the evaluation of antiviral agents against VZV, 
the organotypic cultures may be considered a model to evaluate the efficacy of
new anti-VZV antivirals before clinical trials.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16251311 [PubMed - indexed for MEDLINE]

1286: Bone Marrow Transplant. 2006 Jan;37(1):73-80.

Herpes zoster infection in the post-hematopoietic stem cell transplant pediatric 
population may be preceded by transaminitis: an institutional experience.

Berman JN, Wang M, Berry W, Neuberg DS, Guinan EC.

Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02115,
USA.

Herpes zoster (HZ), a varicella-zoster virus reactivation, frequently complicates
hematopoietic stem cell transplantation (HSCT). Its incidence, complications, and
associated risk factors in 310 children undergoing HSCT were reviewed. In all, 61
of 201(32%) patients who had undergone allogeneic and 10 of 109 (9%) patients who
had undergone autologous HSCT developed HZ. Of 90 VZV seropositive allogeneic
patients, 50 (53%) developed HZ. Seven (17%) of 41 VZV seropositive autologous
patients developed HZ. Although a substantial number of patients develop HZ in
the early post-HSCT period, risk for HZ persists and HZ can occur up to 5 years
post-HSCT. Risk factors for HZ included age >10 years (P<0.0001), allogeneic HSCT
(P<0.001), and total body irradiation (TBI) (P<0.059) in allogeneic recipients.
Of 37, 22 (59%) patients experienced an elevated alanine aminotransferase (ALT), 
unassociated with GVHD, in the month preceding HZ. Of the 48/64 patients (75%)
hospitalized for treatment (median stay, 6 days; range, 2-39), length of stay was
unaffected by donor type but increased by cutaneous dissemination and visceral
involvement (P=0.023 and 0.034, respectively) in allogeneic patients.
Consideration of HZ infection particularly in patients >10 years of age with
elevated ALT after TBI-conditioned allogeneic HSCT may permit earlier diagnosis
and therapeutic intervention.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16247423 [PubMed - indexed for MEDLINE]

1287: Rev Neurol (Paris). 2005 Sep;161(8-9):836-9.

[Cerebral vasculitis secondary to Varicella-Zoster virus infection]

[Article in French]

Outteryck O, Senechal O, Berteloot D, Delalande I, Mounier-Vehier F.

Service de Neurologie, Hopital Dr Schaffner, Lens.

INTRODUCTION: Central nervous system infection by the varicella-zoster virus
(VZV) can be responsible for myelitis, meningitis, ventriculitis and large and
small-vessels encephalitis. CASE REPORT: We report the case of a 57-year-old-man 
hospitalized for deteriorating general health. Physical examination revealed
likely encephalitis associated with headache without meningeal syndrome.
Successive cerebral MRIs showed bilateral necrosis of the amygdaloid bodies and
multiple deep and sub-cortical infarcts suggestive of vasculitis. Cerebral
arteriography was normal. Three cerebral fluid examinations disclosed mononuclear
pleiocytosis with few red blood cells. PCR analysis for VZV was only positive at 
the third time. DISCUSSION: The diagnosis of VZV encephalitis is difficult
without the rash typical of zoster and because of the low sensitivity of PCR VZV 
in comparison with PCR HSV. CONCLUSION: In active viral disease, where the
prognosis depends on early treatment, we highlight the usefulness of repeated PCR
analysis and the search for antibodies in blood and cerebrospinal fluid.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16244567 [PubMed - indexed for MEDLINE]

1288: J Am Acad Dermatol. 2005 Nov;53(5):890-2.

Frequent varicella zoster reactivation associated with therapeutic use of arsenic
trioxide: portents of an old scourge.

Au WY, Kwong YL.

University Department of Medicine, Queen Mary Hospital, Hong Kong.

In 44 patients treated with arsenic trioxide (As2(O3)) for acute promyelocytic
leukemia, 11 developed varicella zoster virus (VZV) reactivation (median 56 days 
[range 15-299]) after treatment. There was no preferential dermatome involvement 
or systemic spread. The actuarial risk of VZV reactivation at 1 year was 26%. No 
VZV reactivation occurred after the first year of initial treatment with As2(O3).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16243151 [PubMed - indexed for MEDLINE]

1289: Ophthalmology. 2005 Dec;112(12):2184-8. Epub 2005 Oct 20.

Herpetic eye disease in diabetic patients.

Kaiserman I, Kaiserman N, Nakar S, Vinker S.

Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
igor@dr-kaiserman.com

PURPOSE: To study the incidence of herpetic eye disease (HED) of the ocular
surface in diabetics. DESIGN: Observational historical cohort study. SETTING: A
district of the largest health maintenance organization in Israel (the Central
District of Clalit Health Services). PARTICIPANTS: We reviewed the electronic
medical records of all patients older than 50 years (159634 patients) in the
district, and of these, 22382 (14.0%) patients had diabetes mellitus. METHODS:
All filled prescriptions for acyclovir eye ointment between January 1, 2001 and
December 31, 2003 (1483 tubes) and all hemoglobin A1c laboratory tests during
2003 (41910 tests) were documented. An ocular surface HED event was defined when 
a patient consumed at least 1 tube of topical acyclovir per month, whereas no
acyclovir use was documented 3 months before and 3 months after that event. MAIN 
OUTCOME MEASURES: Incidence of ocular surface HED events in diabetics compared
with nondiabetics adjusted for age and gender. RESULTS: After age and gender
adjustment, significantly more diabetics had ocular surface HED (5.21 per
thousand) compared with nondiabetics (4.27 per thousand; P<0.0001).
Stratification by age revealed a significantly higher prevalence of HED in
diabetics, aged 60 to 79 years. Recurrent herpetic events occurred during the
study period in 25.2% of HED-affected diabetics, and in 16.6% of HED-affected
nondiabetics (P = 0.05). Diabetics with poor glycemic control (mean annual
hemoglobin A1c > 9%) consumed significantly more ocular acyclovir (P = 0.01).
Multivariate analysis revealed this effect to be independent of age, gender,
place of birth, or place of residency. CONCLUSIONS: Ocular surface HED is
significantly more common among patients with diabetes mellitus. Poor glycemic
control correlates with increased consumption of ocular acyclovir in diabetic
patients.

PMID: 16242779 [PubMed - indexed for MEDLINE]

1290: Int Psychogeriatr. 2005;17 Suppl 1:S65-77.

Dementia associated with infectious diseases.

Almeida OP, Lautenschlager NT.

University of Western Australia, School of Psychiatry and Clinical Neurosciences,
Mail Delivery Point M573, 35 Stirling Highway, Crawley, Perth, WA 6009,
Australia. osvalm@cyllene.uwa.edu.au

At the turn of the last century, infectious diseases represented an important
cause of health morbidity and behavioral changes. Neurosyphilis, for example, was
relatively common at the time and often led to the development of cognitive
impairment and dementia. With the advent of effective antibiotic treatment, the
association between infectious diseases and dementia became increasingly less
frequent, although a resurgence of interest in this area has taken place during
the past 15 years with the emergence of acquired immunodeficiency syndrome (AIDS)
and variant Creutzfeldt-Jakob disease (vCJD). This paper reviews the most
frequent infectious causes of dementia, including prion diseases, as well as
infections caused by herpes virus, human immunodeficiency virus (HIV),
toxoplasmosis, cryptococcus, cytomegalovirus, syphilis, borrelia and
cysticercosis.

Publication Types: 
    Review

PMID: 16240484 [PubMed - indexed for MEDLINE]

1291: N Engl J Med. 2005 Oct 20;353(16):e14.

Images in clinical medicine. Left sixth cranial nerve palsy with herpes zoster
ophthalmicus.

Jude E, Chakraborty A.

Tameside General Hospital, Ashton-under-Lyne OL6 9RW, United Kingdom.

Publication Types: 
    Case Reports

PMID: 16236731 [PubMed - indexed for MEDLINE]

1292: Int J Clin Pract. 2005 Nov;59(11):1326-33.

Comment in:
    Int J Clin Pract. 2005 Nov;59(11):1248-50.

Is Europe ready to embrace a policy of universal varicella vaccination?

Ramet J, Weil-Olivier C, Sedlak W; Confederation of the European Specialists of
Paediatrics (CESP)/European Academy of Paediatrics (EAP) CESP/EAP.

Universiteit Antwerpen, UZA and Paola Kinderziekenhuis ZNA, Antwerp, Belgium.
jose.ramet@zna.be

For the first time, a live attenuated varicella vaccine with an indication for
universal vaccination is licensed in all EU countries. It is now time to consider
whether in Europe there should be widespread vaccination against varicella to
prevent this common and highly infectious disease. Increasing numbers of
countries are adopting vaccination programmes against the disease. In those
countries where a routine vaccination policy has been adopted, the success of the
vaccine has been significant. The USA, which prior to the launch of a universal
vaccination programme in 1995 had 4 million cases of varicella per year, has seen
a dramatic reduction in varicella morbidity and mortality rates. A universal
varicella vaccination policy is an option that needs to be considered for Europe 
not only in medical terms but also because it would be socially and economically 
appropriate.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 16236088 [PubMed - indexed for MEDLINE]

1293: Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003774.

Update in:
    Cochrane Database Syst Rev. 2008;(2):CD003774.

Antiviral medications for preventing cytomegalovirus disease in solid organ
transplant recipients.

Hodson EM, Barclay PG, Craig JC, Jones C, Kable K, Strippoli GF, Vimalachandra D,
Webster AC.

Children's Hospital at Westmead, Centre for Kidney Research, Locked Bag 4001,
Westmead, NSW, Australia 2145. Elisah@chw.edu.au

BACKGROUND: The risk of cytomegalovirus (CMV) infection in solid organ transplant
recipients has resulted in the frequent use of prophylaxis with the aim of
preventing the clinical syndrome associated with CMV infection. OBJECTIVES: To
determine the benefits and harms of antiviral medications to prevent CMV disease 
and all-cause mortality in solid organ transplant recipients. SEARCH STRATEGY: We
searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE,
reference lists and abstracts from conference proceedings without language
restriction. SELECTION CRITERIA: Randomised and quasi-randomised controlled
trials comparing antiviral medications with placebo or no treatment, trials
comparing different antiviral medications and trials comparing different regimens
of the same antiviral medications in recipients of any solid organ transplant.
DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality 
and extracted data from each trial. Statistical analyses were performed using the
random effects model and results expressed as relative risk (RR) for dichotomous 
outcomes with 95% confidence intervals (CI). Subgroup analysis and univariate
meta-regression were performed using restricted maximum-likelihood to estimate
the between study variance. Multivariate meta-regression was performed to
investigate whether the results were altered after allowing for differences in
drugs used, organ transplanted and recipient CMV serostatus at the time of
transplantation. MAIN RESULTS: Thirty two trials (3737 participants) were
identified. Prophylaxis with aciclovir, ganciclovir or valaciclovir compared with
placebo or no treatment significantly reduced the risk for CMV disease (19
trials; RR 0.42, 95% CI 0.34 to 0.52), CMV infection (17 trials; RR 0.61, 95% CI 
0.48 to 0.77), and all-cause mortality (17 trials; RR 0.63, 95% CI 0.43 to 0.92) 
primarily due to reduced mortality from CMV disease (seven trials; RR 0.26, 95%
CI 0.08 to 0.78). Prophylaxis reduced the risk of herpes simplex and herpes
zoster disease, bacterial and protozoal infections but not fungal infection,
acute rejection or graft loss. Meta-regression showed no significant difference
in the risk of CMV disease or all-cause mortality by organ transplanted or CMV
serostatus; no conclusions were possible for CMV negative recipients of negative 
organs. In direct comparison trials, ganciclovir was more effective than
aciclovir in preventing CMV disease (seven trials; RR 0.37, 95% Cl 0.23 to 0.60).
Valganciclovir and intravenous ganciclovir were as effective as oral ganciclovir.
AUTHORS' CONCLUSIONS: Prophylaxis with antiviral medications reduces CMV disease 
and CMV-associated mortality in solid organ transplant recipients. They should be
used routinely in CMV positive recipients and in CMV negative recipients of CMV
positive organ transplants.

Publication Types: 
    Meta-Analysis
    Review

PMID: 16235341 [PubMed - indexed for MEDLINE]

1294: Drugs Today (Barc). 2005 Aug;41(8):509-16.

Pregabalin: a new agent for the treatment of neuropathic pain.

Zareba G.

Department of Environmental Medicine, University of Rochester, School of Medicine
and Dentistry, Rochester, New York 14642, USA. grazyna_zareba@urmc.rochester.edu

Pregabalin (Lyrica, Pfizer) is a GABA analog with similar structure and actions
to gabapentin. It has antiepileptic, analgesic and anxiolytic activity.
Pregabalin is indicated for the management of neuropathic pain associated with
diabetic neuropathy and post-herpetic neuralgia. Peak plasma levels occur
approximately 1 hour after oral doses and oral bioavailability is about 90%.
Based on AUC data, food does not significantly affect the extent of absorption.
Pregabalin is not protein-bound and exhibits a plasma half-life of about 6 hours,
which is not dose-dependent. Hepatic metabolism is negligible, and most of the
oral dose (95%) appears unchanged in the urine. Pregabalin is a safe and
well-tolerated new treatment for neuropathic pain. Furthermore, pregabalin has
proven efficacy in adjunctive therapy of refractory partial seizures and in the
treatment of acute pain, generalized anxiety disorder and social phobia.

Publication Types: 
    Review

PMID: 16234874 [PubMed - indexed for MEDLINE]

1295: Rheumatology (Oxford). 2006 Apr;45(4):425-9. Epub 2005 Oct 18.

Outcome of protein-losing gastroenteropathy in systemic lupus erythematosus
treated with prednisolone and azathioprine.

Mok CC, Ying KY, Mak A, To CH, Szeto ML.

Department of Medicine, Tuen Mun Hospital, Tsing Chung Koon Road, New
Territories, Hong Kong, SAR, China. ccmok2005@yahoo.com

OBJECTIVES: To report the efficacy of prednisolone and azathioprine (AZA) in the 
treatment of systemic lupus erythematosus (SLE)-related protein-losing
gastroenteropathy (PLGE). METHODS: Between 1995 and 2002, 16 consecutive patients
with SLE-related PLGE were treated with a regimen consisting of high-dose
prednisolone (0.8-1 mg/kg/day for 6 weeks, then tapered to < or =10 mg/day) and
AZA (2 mg/kg/day). Protein leakage from the gastrointestinal tract was confirmed 
by 99mTc-labelled human serum albumin scintigraphy and significant urinary loss
of protein was excluded. Clinical response at 6 months of therapy was assessed
and patients were followed for relapse of PLGE. RESULTS: Clinical characteristics
of our patients at the time of PLGE were: age 36.2 +/- 8.7 (s.d.) yr; female:male
ratio 15 : 1; mean SLE duration 29.6 +/- 65 months. Twelve patients had PLGE as
the initial presentation of SLE. Fifteen (94%) patients had concomitant activity 
in other organs. All patients presented with oedema and eight patients (50%) had 
non-bloody diarrhoea. The mean serum albumin level was 22.8 +/- 5.7 g/dl. Protein
leakage was at the small bowel in 11 (69%) patients and the large bowel in 5
(31%) patients. At 6 months of therapy, 14 (88%) patients had complete clinical
response, 1 (6%) patient responded partially and 1 patient (6%) was
treatment-refractory. Patients who responded were maintained on low-dose
prednisolone (7.8 +/- 6.1 mg/day) and AZA (56.3 +/- 37 mg/day). Over a mean
follow-up of 57.5 months, 1 (6%) patient had relapse of PLGE which responded to
augmentation of prednisolone dosage. No patients developed alternative
gastrointestinal diagnoses. Corticosteroid-induced psychosis, AZA-induced
pancytopenia and herpes zoster occurred in three patients. CONCLUSION: PLGE is an
uncommon manifestation of SLE. Treatment with a combination of prednisolone and
AZA is effective and well tolerated.

PMID: 16234272 [PubMed - indexed for MEDLINE]

1296: J Neurol Neurosurg Psychiatry. 2005 Nov;76(11):1604-5.

Conduction block in the forearm associated with acute varicella zoster virus
infection.

Raasch US, Heath JP.

Publication Types: 
    Case Reports
    Letter

PMID: 16227564 [PubMed - indexed for MEDLINE]

1297: Clin Neurol Neurosurg. 2006 Dec;108(8):772-4. Epub 2005 Oct 13.

An extremely unusual presentation of varicella zoster viral infection of cranial 
nerves mimicking Garcin syndrome.

Nishioka K, Fujishima K, Kobayashi H, Mizuno Y, Okuma Y.

Department of Neurology, Juntendo University Shizuoka Hospital, 1129 Nagaoka,
Inzunokuni, Shizuoka 410-2295, Japan.

We report a patient with the varicella zoster viral (VZV) infection of multiple
cranial nerves mimicking Garcin syndrome, who initially presented with Ramsay
Hunt syndrome (herpes zoster oticus). A 78-year-old man showed left facial palsy 
with zosteric eruptions in his left auricle and dysphagia, followed by left total
ophthalmoplegia. His serum anti-VZV antibody titer was elevated. Cerebrospinal
fluid examination revealed pleocytosis with a slightly elevated protein level. He
was treated with intravenous acyclovir and corticosteroids. His tongue weakness
resolved, and then ocular movement improved. The improvement of facial palsy and 
swallowing difficulty was delayed. VZV infection should be considered even in
patients who show unilateral multiple cranial neuropathy mimicking Garcin
syndrome because it is treatable.

Publication Types: 
    Case Reports

PMID: 16226370 [PubMed - indexed for MEDLINE]

1298: Br J Dermatol. 2005 Nov;153(5):981-6.

The role of CD4 and CD8 cytotoxic T lymphocytes in the formation of viral
vesicles.

Morizane S, Suzuki D, Tsuji K, Oono T, Iwatsuki K.

Department of Dermatology, Okayama University Graduate School of Medicine and
Dentistry, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
gmd14058@cc.okayama-u.ac.jp

BACKGROUND: Herpetic vesicles caused by herpes simplex virus and varicella zoster
virus, and hydroa vacciniforme (HV) are characterized by umbilicated vesicule
formation. OBJECTIVES: To understand the histogenesis of umbilicated vesicles in 
herpetic vesicles and HV, we demonstrated the presence of the virus-associated
molecules in the lesions, and the pathogenic role of cytotoxic T-lymphocyte (CTL)
immune responses. METHODS: Phenotyping of infiltrating cells was carried out in
biopsy specimens from herpes simplex, varicella, herpes zoster and HV, and
compared with nonviral contact dermatitis. Viral antigens and Epstein-Barr
virus-encoded small nuclear RNA (EBER) were detected by immunostaining and by in 
situ hybridization, respectively. Infiltrating CTLs expressing granzyme B and
granulysin were determined by double immunostaining using confocal laser scanning
microscopy. RESULTS: In all herpetic vesicles, the corresponding viral antigens
were observed in the cytopathic keratinocytes, and infiltration of lymphoid cells
was present in the upper dermis and around the vessels. In all HV lesions
studied, EBER+ T cells made up 5-10% of the dermal infiltrates and the dermal
infiltrates contained almost no CD56 cells. CTLs expressing granzyme B and
granulysin were present in both herpetic and HV lesions, in which they made up
10-30% of the total dermal infiltrates, whereas they comprised less than 5% of
the infiltrates of biopsy specimens from nonviral contact dermatitis. Confocal
laser microscopic examination demonstrated that both CD4+ and CD8+ T cells
expressed granzyme B and granulysin. CONCLUSIONS: CD4+ and/or CD8+ CTLs reactive 
to the virus-infected cells might be responsible for the histogenesis of herpetic
and HV lesions characterized by umbilicated vesicles.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16225610 [PubMed - indexed for MEDLINE]

1299: Expert Rev Vaccines. 2005 Oct;4(5):629-43.

Review of the Varilrix varicella vaccine.

Chiu SS, Lau YL.

Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The
University of Hong Kong, Hong Kong SAR, China. ssschiu@hkucc.hku.hk

Varicella zoster virus causes an acute infection that affects most children
globally, but the age of infection can be greater in residents of tropical areas.
It has generally been considered a mild disease, although there are accumulating 
data to show that it can cause significant morbidity and mortality in
immunocompetent as well as immunocompromised children and adults. Oka-strain live
attenuated varicella vaccines were developed in the 1970s. Varilrix developed by 
GlaxoSmithKline Biologicals (Rixensart, Belgium), is one of the vaccines produced
and marketed in over 80 countries. Similar to the other Oka-strain vaccines,
Varilrix is safe, immunogenic and efficacious in both immunocompromised and
immunocompetent children and adults.

Publication Types: 
    Comparative Study
    Review

PMID: 16221065 [PubMed - indexed for MEDLINE]

1300: Hong Kong Med J. 2005 Oct;11(5):399-402.

Herpetic shoulder paresis in a Chinese elderly patient.

Tam TC, Chan KY, Ho SL, Luk JK, Chu LW.

Acute Geriatrics Unit, Grantham Hospital, Wong Chuk Hang, Hong Kong.

A patient with left shoulder girdle weakness secondary to herpetic myotomal
paresis is reported. Needle electromyography revealed denervational discharge
from the left supraspinatus, deltoid, and brachioradialis muscles, compatible
with a radiculopathy that was relevant to his myotomes affected by zoster
infection. The patient was managed with range-of-movement and strengthening
exercises as well as pain relief for post-herpetic neuralgia. Further studies are
required to determine whether antiviral treatment can limit the extent of motor
deficit and hasten recovery. Zoster paresis should be one of the differential
diagnoses of girdle muscle weakness.

Publication Types: 
    Case Reports

PMID: 16219961 [PubMed - indexed for MEDLINE]

1301: Otolaryngol Head Neck Surg. 2005 Oct;133(4):647.

Laryngeal zoster mimicking a laryngeal cancer.

Higuchi E, Nakamaru Y, Ohwatari R, Sakashita T, Mesuda Y, Homma A, Furuta Y,
Fukuda S.

Publication Types: 
    Case Reports

PMID: 16213968 [PubMed - indexed for MEDLINE]

1302: Pain. 2005 Nov;118(1-2):97-111. Epub 2005 Oct 5.

Varicella zoster virus induces neuropathic changes in rat dorsal root ganglia and
behavioral reflex sensitisation that is attenuated by gabapentin or sodium
channel blocking drugs.

Garry EM, Delaney A, Anderson HA, Sirinathsinghji EC, Clapp RH, Martin WJ,
Kinchington PR, Krah DL, Abbadie C, Fleetwood-Walker SM.

Division of Veterinary Biomedical Sciences, Centre for Neuroscience Research,
University of Edinburgh, Summerhall, Edinburgh EH9 1QH, UK.

Reactivation of latent varicella zoster virus (VZV) within sensory trigeminal and
dorsal root ganglia (DRG) neurons produces shingles (zoster), often accompanied
by a chronic neuropathic pain state, post-herpetic neuralgia (PHN). PHN persists 
despite latency of the virus within human sensory ganglia and is often
unresponsive to current analgesic or antiviral agents. To study the basis of
varicella zoster-induced pain, we have utilised a recently developed model of
chronic VZV infection in rodents. Immunohistochemical analysis of DRG following
VZV infection showed the presence of a viral immediate early gene protein (IE62) 
co-expressed with markers of A- (neurofilament-200; NF-200) and C- (peripherin)
afferent sensory neurons. There was increased expression of neuropeptide Y (NPY) 
in neurons co-expressing NF-200. In addition, there was an increased expression
of alpha2delta1 calcium channel, Na(v)1.3 and Na(v)1.8 sodium channels, the
neuropeptide galanin and the nerve injury marker, Activating Transcription
Factor-3 (ATF-3) as determined by Western blotting in DRG of VZV-infected rats.
VZV infection induced increased behavioral reflex responsiveness to both noxious 
thermal and mechanical stimuli ipsilateral to injection (lasting up to 10 weeks
post-infection) that is mediated by spinal NMDA receptors. These changes were
reversed by systemic administration of gabapentin or the sodium channel blockers,
mexiletine and lamotrigine, but not by the non-steroidal anti-inflammatory agent,
diclofenac. This is the first time that the profile of VZV infection-induced
phenotypic changes in DRG has been shown in rodents and reveals that this profile
appears to be broadly similar (but not identical) to changes in other neuropathic
pain models.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

PMID: 16213091 [PubMed - indexed for MEDLINE]

1303: Int J STD AIDS. 2005 Oct;16(10):673-6.

Herpes zoster in HIV-1-infected patients in the era of highly active
antiretroviral therapy: a prospective observational study.

Hung CC, Hsiao CF, Wang JL, Chen MY, Hsieh SM, Sheng WH, Chang SC.

Department of Internal Medicine, National Taiwan University Hospital and National
Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, Taiwan.
hcc0401@ha.mc.ntu.edu.tw

Between June 1994 and May 2003, 93 of 716 (13.0%) HIV-infected patients with a
median baseline cell differentiation CD4+ count of 61 x 10(6) cells/L (range,
1-1206 x 10(6) cells/L) developed 103 episodes of herpes zoster [HZ], with an
incidence of 5.67 per 100 person-years (PY). The incidence of HZ in the
pre-highly active antiretroviral therapy (HAART) era (17.21 per 100 PY) was
significantly higher than that in the post-HAART era (5.05 per 100 PY) (P <
0.0001). In the first six months of enrollment, the incidence of HZ was
significantly higher than that between six and 12 months both in the pre-HAART
(27.65 per 100 PY versus 8.43 per 100 PY, P = 0.02) and post-HAART era (17.79 per
100 PY versus 3.39 per 100 PY, P < 0.0001). In multivariate analyses, only
baseline CD4+ count remained a significant risk factor associated with HZ. HZ did
not increase mortality rate either in the pre-HAART or post-HAART era, although
the risk for HIV progression was significantly higher in patients with HZ
(adjusted odds ratio [OR], 1.747, 95% confidence interval, 1.037-2.943). We
conclude that the incidence of HZ was highest in the first six months of
enrollment in patients at late stage of HIV infection, which did not increase
with the introduction of HAART. Baseline CD4+ lymphocyte count was the most
significant risk factor associated with development of HZ. HZ was associated with
increased risk for HIV progression, but not mortality.

PMID: 16212714 [PubMed - indexed for MEDLINE]

1304: Clin Diagn Lab Immunol. 2005 Oct;12(10):1168-76.

Cryptococcus neoformans-reactive and total immunoglobulin profiles of human
immunodeficiency virus-infected and uninfected Ugandans.

Subramaniam K, French N, Pirofski LA.

Department of Microbiology and Immunology, Division of Infectious Diseases,
Albert Einstein College of Medicine, Room 709 Forchheimer, 1300 Morris Park
Avenue, Bronx, New York 10461, USA.

We determined total and Cryptococcus neoformans glucuronoxylomannan
(GXM)-reactive antibody repertoires of human immunodeficiency virus
(HIV)-infected and HIV-uninfected Ugandans in a retrospective, case-control study
of participants in a randomized controlled trial of pneumococcal vaccination. The
study included 192 adults: 48 who subsequently developed cryptococcal meningitis 
(CM); (HIV+ CM+); 2 individuals who matched them in CD4+ T-cell level, stage of
HIV disease, and age but did not develop CM (HIV+ CM-); and 48 HIV-uninfected
individuals. Total serum immunoglobulin concentrations and titers of
immunoglobulin M (IgM), IgG, and IgA to GXM, pneumococcal polysaccharides, and
antibodies expressing certain V(H)3 idiotypes were determined with banked sera
obtained before the development of cryptococcosis for HIV+ CM+ subjects. The
results showed that HIV-infected subjects had significantly lower levels of IgM
to GXM but higher levels of total immunoglobulin and IgG and IgA to GXM than
those of HIV-uninfected subjects. HIV-infected subjects with a history of
pneumonia had higher levels, and those with a history of herpes zoster had lower 
levels of GXM-binding antibodies than subjects with no history of either disease.
Minimal to no cross-reactivity was demonstrated between antibodies to GXM and
polysaccharides in a pneumococcal vaccine. No significant differences between the
antibody repertoires of HIV+ CM+ and HIV+ CM- subjects were identified, but among
subjects without a history of pneumonia, there was a trend towards lower
V(H)3-positive antibody levels among HIV+ CM+ than among HIV+ CM- subjects. Our
findings demonstrate an association between previous infectious diseases and
differences in the total and GXM-reactive antibody repertoires of HIV-infected
subjects and suggest the question of whether certain microbes modulate subsequent
antibody responses to GXM deserves further study.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 16210479 [PubMed - indexed for MEDLINE]

1305: Herpes. 2005 Oct;12(2):33-7.

Comment in:
    Herpes. 2005 Oct;12(2):32.

Analysis of the cost-effectiveness of varicella vaccine programmes based on an
observational survey in the Latium region of Italy.

Gialloreti LE, Divizia M, Pica F, Volpi A.

Department of Public Health, University of Rome Tor Vergata, Via Montpellier 1,
00133 Rome, Italy.

Varicella is the most widespread childhood disease in Italy. However, as in many 
parts of the world, the country does not yet have a unified approach to the
management of the disease. A cost-effectiveness analysis of varicella vaccination
strategies, using the Latium region in Italy as a case study, was undertaken.
Mass vaccination is only recommended if the immunization programme can achieve
coverage of over 85% in a short time. However, experience in Italy with
non-compulsory vaccinations has shown this is difficult to achieve. Consequently,
eradication of the disease is not seen as an attainable short-term goal. For mass
varicella vaccination to be successful, it must be run at a national as well as
regional level in combination with education programmes, and a reliable
surveillance system. The interaction between varicella and herpes zoster must
also be taken into account when considering vaccination strategies, as zoster
vaccination strategies may have an impact on varicella coverage.

PMID: 16209858 [PubMed - indexed for MEDLINE]

1306: Herpes. 2005 Oct;12(2):32.

Comment on:
    Herpes. 2005 Oct;12(2):33-7.

Selective versus universal vaccination for varicella zoster virus infection: what
holds the key to successful disease control?

Schleiss M.

Publication Types: 
    Comment
    Editorial

PMID: 16209857 [PubMed - indexed for MEDLINE]

1307: Health News. 2005 Sep;11(9):5-6.

Shingles vaccine found effective; could offer relief to millions. Zoster vaccine 
could be available as early as next year to prevent this painful skin and nerve
condition.

[No authors listed]

PMID: 16208806 [PubMed - indexed for MEDLINE]

1308: Harv Womens Health Watch. 2005 Aug;12(12):5.

Shingles vaccine shows promise in large trial.

[No authors listed]

Publication Types: 
    News

PMID: 16208771 [PubMed - indexed for MEDLINE]

1309: J Clin Microbiol. 2005 Oct;43(10):5102-10.

Development of multiplex PCRs for detection of common viral pathogens and agents 
of congenital infections.

McIver CJ, Jacques CF, Chow SS, Munro SC, Scott GM, Roberts JA, Craig ME,
Rawlinson WD.

Department of Microbiology, South Eastern Area Laboratory Service, Prince of
Wales Hospital, New South Wales 2031, Australia.

Potential causes of congenital infection include Toxoplasma gondii and viruses
such as cytomegalovirus (CMV), enterovirus, hepatitis C virus, herpes simplex
virus types 1 and 2 (HSV-1 and -2), human herpesvirus types 6, 7, and 8,
lymphocytic choriomeningitis virus, parvovirus, rubella virus, and
varicella-zoster virus. Testing for each of these agents using nucleic acid tests
is time consuming and the availability of clinical samples such as amniotic fluid
or neonatal blood is often limited. The aim of this study was to develop
multiplex PCRs (mPCRs) for detection of DNA and RNA agents in the investigation
of congenital infection and an mPCR for the viruses most commonly requested in a 
diagnostic virology laboratory (CMV, Epstein-Barr virus, enterovirus, HSV-1,
HSV-2, and varicella-zoster virus). The assays were assessed using known
pathogen-positive tissues (cultures, placentae, plasma, and amniotic fluid) and
limits of detection were determined for all the agents studied using serial
dilutions of plasmid targets. Nested PCR was performed as the most sensitive
assay currently available, and detection of the amplicons using hybridization to 
labeled probes and enzyme-linked immunosorbent assay detection was incorporated
into three of the four assays. This allowed detection of 10 to 10(2) copies of
each agent in the samples processed. In several patients, an unexpected infection
was diagnosed, including a case of encephalitis where HSV was the initial
clinical suspicion but CMV was detected. In the majority of these cases the
alternative agent could be confirmed using reference culture, serology, or
fluorescence methods and was of relevance to clinical care of the patient. The
methods described here provide useful techniques for diagnosing congenital
infections and a paradigm for assessment of new multiplex PCRs for use in the
diagnostic laboratory.

Publication Types: 
    Evaluation Studies

PMID: 16207970 [PubMed - indexed for MEDLINE]

1310: Harv Health Lett. 2005 Aug;30(10):4-5.

These shots aren't just kid stuff. Adults may soon be rolling up their sleeves to
get vaccinated for shingles and whooping cough.

[No authors listed]

PMID: 16206387 [PubMed - indexed for MEDLINE]

1311: Ann Intern Med. 2005 Oct 4;143(7):539-41.

The growing paradigm of preventing disease: vaccines to prevent herpes zoster and
pertussis in adults.

Poland GA.

Publication Types: 
    Editorial

PMID: 16204167 [PubMed - indexed for MEDLINE]

1312: Environ Health Perspect. 2005 Oct;113(10):1373-5.

Case report: occupationally related recurrent varicella (chickenpox) in a
hospital nurse.

Ku CH, Liu YT, Christiani DC.

School of Public Health, National Defense Medical Center, National Defense
University, Taipei, Taiwan.

Commonly accepted outcomes of varicella-zoster virus (VZV) infections include
chickenpox (primary) and shingles (recurrence or latency), as well lifetime
immunity against chickenpox. We report the case of a registered nurse who worked 
in a neurologic surgery ward in a general hospital in Taipei, Taiwan. While
working there for approximately 1 year, she developed recurrent chickenpox after 
caring for a paraparesis patient, who had herpes zoster during hospitalization in
August 2002. The varicella incubation period was 10 days, which matched the range
(10-21 days). Recently negative specific serum IgM and positive specific serum
IgG indicated a past VZV infection. The nurse did not get herpes zoster from the 
second episode of varicella on 9 August 2002 to 4 April 2005 and is now
convalescing. We conclude that occupational VZV hazards exist in the health care 
environment and suggest testing for VZV antibody and a VZV vaccination program
for susceptible health care workers. Key words: chickenpox, indirect fluroscent
antibody, occupational exposure, polymerase chain reaction, shingles, Taiwan,
varicella-zoster virus.

Publication Types: 
    Case Reports

PMID: 16203249 [PubMed - indexed for MEDLINE]

1313: Zhonghua Nei Ke Za Zhi. 2005 Sep;44(9):672-6.

[Treatment of proliferative lupus nephritis with leflunomide and steroid: a
prospective multi-center controlled clinical trial]

[Article in Chinese]

Cui TG, Hou FF, Ni ZH, Chen XM, Zhang FS, Zhu TY, Zhao XZ, Bao CD, Zhao MH, Wang 
GB, Qian JQ, Cai GY, Li YN, Lu FM, Mei CL, Zou WZ, Wang HY.

Renal Division and Institute of Nephrology, First Hospital, Peking University,
Beijing 100034, China.

OBJECTIVE: Leflunomide (LEF) is a selective inhibitor of de novo pyrimidine
synthesis, currently used in the treatment of rheumatoid arthritis. To evaluate
the efficacy and safety of LEF in the treatment of proliferative lupus nephritis,
a prospective multi-center controlled clinical trial was conducted. METHODS:
Patients with biopsy-confirmed proliferative lupus nephritis were recruited.
Patients of recent onset who had not used any immunosuppressive drug were given
either oral LEF (group A) or IV cyclophosphamide (group B); relapsed patients who
had received immunosuppressive therapy 3 months before were given LEF (group C). 
Efficacy and safety were evaluated at 6 months after treatment. RESULTS: Total 51
patients were enrolled, 4 patients withdrew due to adverse events. For those
initial treated patients, total response rate were 80% in group A and 75% in
group B, complete remission rate were 40% and 25% respectively, not statistically
different. Renal parameters (proteinuria, serum albumin and serum creatinine) and
systemic lupus erythematosus disease activity index (SLEDAI) improved similarly
in both groups. For 14 relapsed patients, total response rate was 60% and
complete remission rate was 6.7%. Major adverse events reported in LEF treated
patients were infection and alopecia. Herpes zoster was the most often type among
infectious events, and one case of severe lung infection was reported.
CONCLUSION: LEF combined with steroid was effective in the induction therapy of
proliferative lupus nephritis. LEF was generally well-tolerated, its efficacy in 
maintenance therapy and long-term safety remains to be clarified.

Publication Types: 
    Controlled Clinical Trial
    English Abstract
    Multicenter Study

PMID: 16202258 [PubMed - indexed for MEDLINE]

1314: Br J Hosp Med (Lond). 2005 Sep;66(9):542-3.

Unusual presentation of Ramsay-Hunt syndrome without-facial nerve palsy.

Leong SC, Karkanevatos A.

Department of Otolaryngology, Royal Liverpool University Hospital, Liverpool L7
8XP.

Publication Types: 
    Case Reports

PMID: 16200803 [PubMed - indexed for MEDLINE]

1315: Clin Exp Dermatol. 2005 Nov;30(6):643-5.

Coexistence of psoriasis and linear IgA disease in a patient with recent herpes
zoster infection.

Cooke N, Jenkinson H, Wojnarowska F, McKenna K, Alderdice J.

Department of Dermatology, Royal Victoria Hospital, UK. nicolacooke36@hotmail.com

We report the case of a 29-year-old man with chronic plaque psoriasis who
developed linear IgA disease following herpes zoster infection. There has only
been one previous report describing the coexistence of psoriasis and linear IgA
disease, which was confirmed by immunopathological studies. In our patient,
immunoblotting studies identified IgA antibodies binding to BP180 and BP230
antigens, and IgG autoantibodies binding weakly to the BP180 antigen. This is an 
interesting case that we believe is an example of epitope spreading in the
development of autoimmune subepidermal bullous diseases.

Publication Types: 
    Case Reports

PMID: 16197377 [PubMed - indexed for MEDLINE]

1316: N Engl J Med. 2005 Sep 29;353(13):1414-5; author reply 1414-5.

Comment on:
    N Engl J Med. 2005 Jun 2;352(22):2271-84.

A vaccine to prevent herpes zoster.

Carroll I, Gaeta R, Mackey S.

Publication Types: 
    Comment
    Letter

PMID: 16196123 [PubMed - indexed for MEDLINE]

1317: N Engl J Med. 2005 Sep 29;353(13):1414-5; author reply 1414-5.

Comment on:
    N Engl J Med. 2005 Jun 2;352(22):2271-84.    N Engl J Med. 2005 Jun 2;352(22):2344-6.

A vaccine to prevent herpes zoster.

Kessler KM.

Publication Types: 
    Comment
    Letter

PMID: 16192493 [PubMed - indexed for MEDLINE]

1318: Scand J Infect Dis. 2005;37(10):774-6.

Concomitant disseminated herpes simplex virus type 2 infection and varicella
zoster virus primoinfection in a pregnant woman.

Godet C, Beby-Defaux A, Landron C, Moal GL, Becq-Giraudon B, Agius G.

From the Department of Internal Medicine and Infectious Diseases, CHU La
Miletrie, Poitiers, France.

We report the first case of a HSV and VZV coinfection during pregnancy. VZV
infection was diagnosed by a seroconversion and PCR. HSV 2 infection was
diagnosed by cell culture. The mother and the newborn received no treatment and
did not develop any complication. This case report highlights the need for
increased surveillance of pregnant women with herpes virus infections.

PMID: 16191900 [PubMed - indexed for MEDLINE]

1319: Am Fam Physician. 2005 Sep 15;72(6):1082.

Information from your family doctor. Shingles: easing the pain.

American Academy of Family Physicians.

Publication Types: 
    Patient Education Handout

PMID: 16190506 [PubMed - indexed for MEDLINE]

1320: Am Fam Physician. 2005 Sep 15;72(6):1075-80.

Comment in:
    Am Fam Physician. 2006 Aug 1;74(3):378; author reply 381.

Herpes zoster and postherpetic neuralgia: prevention and management.

Mounsey AL, Matthew LG, Slawson DC.

Department of Family Medicine, University of Virginia, Charlottesville, Virginia 
22908, USA.

The recognizable appearance and the dermatomal distribution of herpes zoster
lesions usually enable a clinical diagnosis to be made easily. Herpes zoster and 
postherpetic neuralgia occur mainly in older patients. The role of the varicella 
vaccine in preventing herpes zoster is uncertain, but is being studied. There is 
evidence to support using antiviral therapy and possibly low-dose tricyclic
antidepressants to prevent postherpetic neuralgia. There is good evidence that
treating herpes zoster with antiviral medication is beneficial, particularly in
patients older than 50 years with severe outbreaks. The use of steroids has an
unfavorable risk-benefit ratio. In patients who develop postherpetic neuralgia,
there is good evidence to support treatment with gabapentin and tricyclic
antidepressants. More evidence for treatment with capsaicin cream, lidocaine
patch, and opioids is needed. Intrathecal methylprednisolone is an option for
patients with persistent pain.

PMID: 16190505 [PubMed - indexed for MEDLINE]

1321: J Fam Pract. 2005 Sep;54(9):757.

Herpes zoster vaccine safe and effective for older adults.

[No authors listed]

PMID: 16189893 [PubMed]

1322: J Virol. 2005 Oct;79(20):13070-81.

Dissection of a novel nuclear localization signal in open reading frame 29 of
varicella-zoster virus.

Stallings CL, Silverstein S.

Integrated Program in Cellular, Molecular and Biophysical Studies and the
Department of Microbiology, Columbia University, College of Physicians and
Surgeons, New York, New York 10032, USA.

Open reading frame 29 (ORF29) of varicella-zoster virus (VZV) encodes a 120-kDa
single-stranded DNA binding protein (ORF29p) that is not packaged in the virion
and is expressed during latency. During lytic infection, ORF29p is localized
primarily to infected cell nuclei. In contrast, ORF29p is found exclusively in
the cytoplasm in neurons of the dorsal root ganglia obtained at autopsy from
seropositive latently infected patients. ORF29p accumulates in the nuclei of
neurons in dorsal root ganglia obtained at autopsy from patients with active
zoster. The localization of this protein is, therefore, tightly correlated with
the proposed VZV lytic/latent switch. In this report, we have investigated the
nuclear import mechanism of ORF29p. We identified a novel nuclear targeting
domain bounded by amino acids 9 to 154 of ORF29p that functions independent of
other VZV-encoded factors. In vitro import assays in digitonin-permeabilized HeLa
cells reveal that ORF29p is transported into the nucleus by a Ran-, karyopherin
alpha- and beta-dependent mechanism. These data are further supported by the
demonstration that a glutathione S-transferase-karyopherin alpha fusion interacts
with ORF29p, but not with a protein containing a point mutation in its nuclear
localization signal (NLS). Therefore, the region of ORF29p responsible for its
nuclear targeting is also involved in the association with karyopherin alpha. As 
a result of this interaction, this noncanonical NLS appears to hijack the
classical cellular nuclear import machinery. Elucidation of the mechanisms
governing ORF29p nuclear targeting could shed light on the VZV reactivation
process.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.

PMID: 16189009 [PubMed - indexed for MEDLINE]

1323: J Virol. 2005 Oct;79(20):12921-33.

T-cell tropism and the role of ORF66 protein in pathogenesis of varicella-zoster 
virus infection.

Schaap A, Fortin JF, Sommer M, Zerboni L, Stamatis S, Ku CC, Nolan GP, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, CA 94305-5208, 
USA. aschaap@stanford.edu

The pathogenesis of varicella-zoster virus (VZV) involves a cell-associated
viremia during which infectious virus is carried from sites of respiratory
mucosal inoculation to the skin. We now demonstrate that VZV infection of T cells
is associated with robust virion production and modulation of the apoptosis and
interferon pathways within these cells. The VZV serine/threonine protein kinase
encoded by ORF66 is essential for the efficient replication of VZV in T cells.
Preventing ORF66 protein expression by stop codon insertion (pOka66S) impaired
the growth of the parent Oka (pOka) strain in T cells in SCID-hu T-cell
xenografts in vivo and reduced formation of VZV virions. The lack of ORF66
protein also increased the susceptibility of infected T cells to apoptosis and
reduced the capacity of the virus to interfere with induction of the interferon
(IFN) signaling pathway following exposure to IFN-gamma. However, preventing
ORF66 protein expression only slightly reduced growth in melanoma cells in
culture and did not diminish virion formation in these cells. The pOka66S virus
showed only a slight defect in growth in SCID-hu skin implants compared with
intact pOka. These observations suggest that the ORF66 kinase plays a unique role
during infection of T cells and supports VZV T-cell tropism by contributing to
immune evasion and enhancing survival of infected T cells.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 16188994 [PubMed - indexed for MEDLINE]

1324: J Virol. 2005 Oct;79(20):12658-66.

Varicella-zoster virus activates inflammatory cytokines in human monocytes and
macrophages via Toll-like receptor 2.

Wang JP, Kurt-Jones EA, Shin OS, Manchak MD, Levin MJ, Finberg RW.

Department of Medicine, University of Massachusetts Medical Center, Worcester,
01605, USA. jennifer.wang@umassmed.edu

The pattern recognition receptor Toll-like receptor 2 (TLR2) has been implicated 
in the response to several human viruses, including herpes simplex viruses (types
1 and 2) and cytomegalovirus. We demonstrated that varicella-zoster virus (VZV)
activates inflammatory cytokine responses via TLR2. VZV specifically induced
interleukin-6 (IL-6) in human monocytes via TLR2-dependent activation of
NF-kappaB, and small interfering RNA designed to suppress TLR2 mRNA reduced the
IL-6 response to VZV in human monocyte-derived macrophages. Unlike other
herpesviruses, the cytokine response to VZV was species specific. VZV did not
induce cytokines in murine embryonic fibroblasts or in a mouse cell line,
although VZV did activate NF-kappaB in a human cell line expressing a murine TLR2
construct. Together, these results suggest that TLR2 may play a role in the
inflammatory response to VZV infection.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.

PMID: 16188968 [PubMed - indexed for MEDLINE]

1325: J Acquir Immune Defic Syndr. 2005 Oct 1;40(2):169-74.

The incidence of, risk factors for, and sequelae of herpes zoster among HIV
patients in the highly active antiretroviral therapy era.

Gebo KA, Kalyani R, Moore RD, Polydefkis MJ.

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore,
MD 21287, USA. kgebo@jhmi.edu

BACKGROUND: Whereas the incidence, risk factors, and clinical sequelae of herpes 
zoster have been studied in the general population and in HIV patients in the era
before highly active antiretroviral therapy (HAART), they have yet to be fully
understood in the current era of HAART. METHODS: We conducted a retrospective
cohort study of patients enrolled in an urban HIV clinic between January 1, 1997 
and December 31, 2001. Patients with an episode of herpes zoster during this
period were identified, and their charts were reviewed. A nested case-control
analysis was used to assess factors associated with an initial episode of herpes 
zoster. Multivariate conditional logistic regression analyses were used to assess
risk factors for zoster. Logistic regression was performed to assess factors
associated with complicated zoster. RESULTS: Two hundred eighty-two episodes of
herpes zoster were identified in 239 patients. Of these episodes, 158 were new
occurrences of zoster and 124 were recurrent zoster events. The incidence of
zoster during the study period was 3.2 per 100 person-years of follow-up. The
incident cases reflected the clinic population, with most patients being male
(63%) and African American (77%) and having injection drug use as their HIV risk 
factor (49%). The mean age of the patients was 41 years. Sixty-seven percent of
patients had single dermatomal involvement, and the thorax was involved in 41%.
In multivariate regression, being on HAART (odds ratio [OR] = 2.39, 95%
confidence interval [CI]: 1.65 to 3.49) and a CD4 count of 50 to 200 cells/mm (OR
= 2.69, 95% CI: 1.44 to 5.01) compared with a CD4 count less than 50 cells/mm
were associated with an increased risk of zoster. Twenty-eight patients (18%)
developed post-herpetic neuralgia (PHN), and 29 patients (18%) had other
complications. Male-to-male sex as an HIV risk factor (P = 0.02) and being on
HAART at a zoster episode (P = 0.03) were protective against complicated zoster. 
CONCLUSIONS: Our results suggest that zoster infection rates have not changed in 
the current HAART era but that a significant percentage of patients develop
complications, particularly PHN, which is quite remarkable considering the young 
age of our population.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 16186734 [PubMed - indexed for MEDLINE]

1326: J Gen Virol. 2005 Oct;86(Pt 10):2673-84.

Transcriptomal analysis of varicella-zoster virus infection using long
oligonucleotide-based microarrays.

Kennedy PG, Grinfeld E, Craigon M, Vierlinger K, Roy D, Forster T, Ghazal P.

Glasgow University Department of Neurology, Southern General Hospital, Institute 
of Neurological Sciences, Glasgow G51 4TF, UK. P.G.Kennedy@clinmed.gla.ac.uk

Varicella-zoster virus (VZV) is a human herpes virus that causes varicella as a
primary infection and herpes zoster following reactivation of the virus from a
latent state in trigeminal and spinal ganglia. In order to study the global
pattern of VZV gene transcription, VZV microarrays using 75-base oligomers to 71 
VZV open reading frames (ORFs) were designed and validated. The
long-oligonucleotide approach maximizes the stringency of detection and polarity 
of gene expression. To optimize sensitivity, microarrays were hybridized to
target RNA and the extent of hybridization measured using resonance light
scattering. Microarray data were normalized to a subset of invariant ranked
host-encoded positive-control genes and the data subjected to robust formal
statistical analysis. The programme of viral gene expression was determined for
VZV (Dumas strain)-infected MeWo cells and SVG cells (an immortalized human
astrocyte cell line) 72 h post-infection. Marked quantitative and qualitative
differences in the viral transcriptome were observed between the two different
cell types using the Dumas laboratory-adapted strain. Oligonucleotide-based VZV
arrays have considerable promise as a valuable tool in the analysis of viral gene
transcription during both lytic and latent infections, and the observed
heterogeneity in the global pattern of viral gene transcription may also have
diagnostic potential.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16186220 [PubMed - indexed for MEDLINE]

1327: Health News. 2005 Aug;11(8):2.

Shingles vaccine proves highly effective.

[No authors listed]

Publication Types: 
    News

PMID: 16184636 [PubMed - indexed for MEDLINE]

1328: Transplant Proc. 2005 Jul-Aug;37(6):2527-8.

Cutaneous manifestations in Italian kidney transplant recipients.

Formicone F, Fargnoli MC, Pisani F, Rascente M, Famulari A, Peris K.

Department of Dermatology, University of L'Aquila, L'Aquila, Italy.

Several cutaneous disorders may occur in organ transplant recipients. We examined
the incidence and the clinical spectrum of cutaneous manifestations among kidney 
transplant recipients. One hundred nine patients (70 males and 39 females), aged 
19 to 69 years (mean: 42.5 years), were consecutively examined as outpatients
between June 2000 and August 2004. The mean interval after kidney transplantation
was 61 months (range: 2 to 120 months). The immunosuppressive regimen consisted
of combinations including cyclosporine, systemic corticosteroids, azathioprine,
tacrolimus, mycophenolate mofetil, antivirals, and antibiotics. Ninety-one
cutaneous manifestations were identified in 60 of 109 (55.0%) kidney transplant
patients over a 4-year period. Sixteen (17.5%) cutaneous viral infections
identified in 11 patients (10.0%) included verruca vulgaris (n = 9), herpes
zoster (n = 5) and herpes simplex (n = 2). Thirteen (11.9%) patients showed 19
(20.8%) superficial fungal infections, consisting of dermatophytosis (n = 6),
onycomycosis (n = 6), pityriasis versicolor (n = 5) and mucocutaneous candidiasis
(n = 2). Twenty (22%) nonmelanoma skin cancers were identified in seven (6.4%)
patients, six basal cell carcinomas (BCC) in four patients, two squamous cell
carcinomas (SCC) in two patients, and 11 BCCs in addition to one SCC in one
patient. Twenty-six (23.8%) patients developed 32 (35.4%) drug-related
manifestations, including acneiform eruption (n = 14), gingival hypertrophy (n = 
6), hypertrichosis (n = 6), ecchymosis (n = 3), and plantar hyperkeratosis (n =
3). In addition, psoriasis and seborrheic dermatitis, which had been diagnosed
before kidney transplantation, were observed in five and three patients,
respectively. Our results emphasize the importance of dermatologic examinations
and monitoring kidney transplant recipients to obtain an early diagnosis and
treatment of cutaneous manifestations.

PMID: 16182734 [PubMed - indexed for MEDLINE]

1329: Hua Xi Kou Qiang Yi Xue Za Zhi. 2005 Aug;23(4):338-40.

[Investigation on oral lesions in 64 Chinese HIV/AIDS patients in Guangxi
province]

[Article in Chinese]

Tao RC, Deng HJ, Ya ZK, Guo SZ, Liang SX, Liu W.

Dept. of Oral Medicine, Affiliated Stomatology Hospital of Guangxi Medical
University, Nanning 530021, China.

OBJECTIVE: To investigate the prevalence, age and gender distribution and
clinical features of HIV/AIDS oral lesions in patients in Guangxi province, and
to provide the epidemiological information for prevention and treatment of these 
diseases in the certain population. METHODS: A total of 64 HIV/AIDS patients were
included in this study. All patients HIV serum-status was confirmed in Guangxi
Center of Disease Control (GXCDC). Oral examination was carried out by
standardized specialists. HIV/AIDS orofacial lesions were recorded and diagnosed 
using the EC Clearing House Criteria on Oral Problems related to HIV Infection
(1992). RESULTS: Among the total of 64 HIV/AIDS patients included in this study, 
there were 53 males and 11 females, with mean age of 36.1 years. Candidiasis was 
the most common lesion with the pseudomembranous type predominating. High
prevalences of xerostomia, 11 oral ulceration and 7 HIV related periodontitis
were noted. 6 Herpetic stomatitis and 3 herpes zoster, 2 oral hairy leukoplakia
and 1 Kaposi's sarcoma and 1 lymphadentitis also were found. CONCLUSION: This
study shows a high prevalence of candidiasis, salivary gland disease. Maybe oral 
ulceration prevalence is not increased, but lesion severity is increased with
more severe heperiform or major RAU. It suggested that HIV/AIDS usually shows
oral lesion and partly can appear in early phase.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 16178201 [PubMed - in process]

1330: Neurocrit Care. 2004;1(3):371-4.

Pseudo-subarachnoid hemorrhage: report of three cases and review of the
literature.

Cucchiara B, Sinson G, Kasner SE, Chalela JA.

Department of Neurology, University of Pennsylvania Medical Center, Philadelphia,
PA 19104, USA. cucchiar@mail.med.upenn.edu

Subarachnoid hemorrhage (SAH) appears on CT as hyperdensity in the subarachnoid
space. In rare circumstances a similar appearance may occur in the absence of
subarachnoid blood, a finding that has been termed "pseudo-subarachnoid
hemorrhage." We describe three patients who presented with abrupt alterations in 
mental status in whom CT falsely suggested SAH, and we review the literature
regarding this imaging finding. In contrast to prior reports, all three of our
patients had a favorable outcome.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review

PMID: 16174937 [PubMed - indexed for MEDLINE]

1331: Am J Chin Med. 2005;33(4):517-23.

Effect of an herbal formula containing Ganoderma lucidum on reduction of herpes
zoster pain: a pilot clinical trial.

Hijikata Y, Yasuhara A, Sahashi Y.

Toyodo Hijikata Clinic, Osaka 567-0031, Japan. hijikata@osb.att.ne.jp

Administration of hot water extracts of a herbal formula containing Ganoderma
lucidum, WTMCGEPP (Wisteria floribunda 0.38, Trapa natans 0.38, Miristica agrans 
0.38, Coix lachryma-jobi 0.75, cultivated Ganoderma lucidum 0.75, Elfuinga
applanata 0.38, tissue cultured Panax ginseng 0.3, and Punica granatum 0.38:
numerals designate dry weight gram/dose), decreased herpes zoster pain for five
Japanese patients suffering from shingles. Pain relief started within a few days 
of intake and was almost complete within 10 days. Two acute herpes zoster with
manifestations including trigeminal nerve ophthalmia (both 74 years old), lower
body zoster (70 years old), herpes zoster oticus (17 years old), and leg herpes
(28 years old), responded quickly to treatment and no patient developed
post-herpetic neuralgia (PHN) after more than one year of follow-up.

Publication Types: 
    Clinical Trial

PMID: 16173526 [PubMed - indexed for MEDLINE]

1332: Rev Med Virol. 2005 Nov-Dec;15(6):393-406.

Herpes simplex virus and varicella-zoster virus: why do these human
alphaherpesviruses behave so differently from one another?

Mori I, Nishiyama Y.

Department of Microbiology and Immunology, Aichi Medical University School of
Medicine, Nagakute, Aichi 480-1195, Japan. isamor@aichi-med-u.ac.jp

Members of the Herpesviridae family of viruses are classified into the alpha,
beta and gamma subfamilies. The alpha subfamily is estimated to have diverged
from the beta and gamma subfamilies 200-220 million years ago. The ancestors of
the herpes simplex virus (HSV) and the varicella-zoster virus (VZV), two
ubiquitous and clinically important human pathogens, appeared 70-80 million years
ago. As these viruses coevolved with their specific primate hosts, genetic
rearrangements led to the development of the contemporary alphaherpesviruses and 
their distinct complement of genes. Here the distinct features of HSV and VZV are
discussed in terms of their transmissibility, clinical picture, tissue tropism,
establishment of latency/reactivation and immune evasion, which can, at least in 
part, be explained by differences in their genomes.

Publication Types: 
    Comparative Study
    Review

PMID: 16173110 [PubMed - indexed for MEDLINE]

1333: Cell Mol Biol (Noisy-le-grand). 2005 Sep 2;51(1):37-48.

Identification of factors important for the success of suicide gene therapy after
a comparative study of Varicella zoster and Herpes simplex viral thymidine
kinases efficacy on breast cancer cells.

Grignet-Debrus C, Noel A, Foidart JM, Calberg-Bacq CM.

Laboratory of Tumor and Development Biology, Center of Experimental Cancer
Research, University of Liege, Sart-Tilman, 4000 Liege, Belgium.

One of the most frequently studied therapeutic strategies in the field of suicide
gene therapy is based on the expression by tumor cells of the Herpes simplex
virus thymidine kinase gene (HSVtk) followed by a ganciclovir (GCV) treatment. In
order to investigate the potential of other enzyme/prodrug strategies, we studied
in vitro and in vivo the ability of the Varicella zoster virus thymidine kinase
gene (VZVtk) to act as a suicide gene and to kill non-transduced bystander cells,
and compared this activity to that of its HSV counterpart. Four different
antiviral compounds were tested as prodrugs. Our comparative study demonstrates
the superiority of the HSVtk/GCV system among the different combinations tested
and underlines the importance of both the tumor cell type and the prodrug in the 
success of a prodrug/suicide gene strategy.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Review

PMID: 16171563 [PubMed - indexed for MEDLINE]

1334: Schizophr Bull. 2006 Apr;32(2):396-400. Epub 2005 Sep 15.

Deficit schizophrenia: association with serum antibodies to cytomegalovirus.

Dickerson F, Kirkpatrick B, Boronow J, Stallings C, Origoni A, Yolken R.

Stanley Research Center at Sheppard Pratt, 6501 North Charles St., Baltimore, MD 
21204, USA. fdickerson@sheppardpratt.org

BACKGROUND: Patients with deficit schizophrenia differ from nondeficit patients
with schizophrenia relative to several neurobiological correlates and relative to
the risk factors of family history and season of birth. Exposure to human
herpesviruses is a possible risk factor for schizophrenia. We hypothesized that
there would be deficit/nondeficit difference in the prevalence of serum
antibodies to human herpesviruses. METHODS: In deficit (N = 88) and nondeficit (N
= 235) schizophrenia patients, we measured IgG class antibodies to the 6 known
human herpesviruses: herpes simplex virus type 1, herpes simplex virus type 2,
cytomegalovirus, Epstein-Barr virus, human herpes virus 6, and varicella-zoster
virus. RESULTS: Deficit categorization was associated with the presence of serum 
antibodies to cytomegalovirus (odds ratio = 2.01, p = .006). This association
remained significant after covarying for positive psychotic symptoms and
demographic features known to be associated with cytomegalovirus seropositivity
and after correcting for multiple comparisons. An association between herpes
simplex virus type 1 and deficit status was not significant after covarying for
potentially confounding variables. No other human herpesvirus was significantly
associated with deficit versus nondeficit categorization. CONCLUSIONS: The
association between deficit schizophrenia and cytomegalovirus antibody
seropositivity provides further evidence for differences in etiopathophysiology
between deficit and nondeficit schizophrenia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16166610 [PubMed - indexed for MEDLINE]

1335: J Eur Acad Dermatol Venereol. 2005 Sep;19(5):593-6.

Zosteriform cutaneous metastases from breast adenocarcinoma.

Bassioukas K, Nakuci M, Dimou S, Kanellopoulou M, Alexis I.

Department of Skin and Veneral Diseases, Medical School, University of Ioannina, 
Greece. konabass@cc.uoi.gr

Cutaneous metastases from breast adenocarcinoma are usually nodular, single or
multiple. Their zosteriform distribution is very rare. We present a 54-year-old
woman with cutaneous zosteriform nodular metastases on the right side of her
thorax, and infiltration of the corresponding arm, 3 months after the excision of
adenocarcinoma of her right breast.

Publication Types: 
    Case Reports

PMID: 16164715 [PubMed - indexed for MEDLINE]

1336: Neurologia. 2005 Sep;20(7):374-6.

[Brachial plexitis and myelitis and herpes-zoster lumbar plexus disorder in
patient treated with infliximab]

[Article in Spanish]

Arias M, Arias-Rivas S, Dapena D, Mera A.

Servicio de Neurologia, Complejo Hospitalario Universitario de Santiago de
Compostela, La Coruna. mariasg@meditex.es

Infliximab, a chimeric monoclonal antibody, is a TNF-a inhibitor approved for use
in refractory rheumatoid arthritis and Crohn s disease. We present the case of a 
patient affected by severe rheumatoid arthritis who was successfully treated with
infliximab. She suffered diverse neurological complications: brachial plexitis,
asymptomatic thoracic myelitis with extensive lesions in MRI study, and herpes
zoster lumbar plexitis. We review the neurological adverse effects of infliximab 
(aseptic meningitis, opportunistic germs infections, disseminated herpes zoster) 
and focus in their potential adverse effect to induce central and peripheral
nervous system demyelination.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16163582 [PubMed - indexed for MEDLINE]

1337: Zhong Xi Yi Jie He Xue Bao. 2005 Sep;3(5):400-1.

[Clinical observation on treatment of herpes zoster with collateral-pricking and 
healthy energy strengthening therapy]

[Article in Chinese]

Yu F, Xu SW, Zhang W.

Department of Acupuncture-Moxibustion, First People's Hospital, Shanghai Jiao
Tong University, Shanghai 200080, China.

PMID: 16159579 [PubMed - indexed for MEDLINE]

1338: J Med Assoc Thai. 2005 May;88(5):678-81.

Herpes zoster, clinical course and associated diseases: A 5-year retrospective
study at Tamathibodi Hospital.

Tunsuriyawong S, Puavilai S.

Department of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Rd,
Bangkok 10400, Thailand.

OBJECTIVE: Herpes zoster was more frequently found in immunocompromised hosts and
elderly persons than in general population. The aim of this study is to find out 
the distributions of skin lesions, treatments, complications of herpes zoster and
associated diseases that occur in concomitant with or after herpes zoster
infections. MATERIAL AND METHOD: The medical records of the patients diagnosed as
herpes zoster between January 1995 - December 2000 were reviewed. Only the
patients who were followed up regularly at Ramathibodi hospital for at least 3
years after the first diagnosis of herpes zoster were enrolled into the study.
Demographic data, distribution of skin lesions, treatments, complications of
herpes zoster and associated diseases were recorded. RESULTS: Three hundred and
ninety-nine cases were enrolled in the study. Three hundred and ninety-eight
patients (99.7%) had one dermatomal involvement. Sixty-seven patients (16.8%) had
postherpetic neuralgia. Fifty-six patients had associated HIV infection. In 3
years followed up, 17 patients developed HIV infection, 3 patients developed
acute leukemia, 2 patients developed mycosis fungoides.

PMID: 16149688 [PubMed - indexed for MEDLINE]

1339: Am J Dermatopathol. 2005 Oct;27(5):411-7.

Varicella-zoster-virus folliculitis promoted clonal cutaneous lymphoid
hyperplasia.

Aram G, Rohwedder A, Nazeer T, Shoss R, Fisher A, Carlson JA.

Department of Pathology, Albany Medical College, Albany, New York 12208, USA.

Post herpes zoster (HZ) reactions have been associated with panoply of
neoplastic, inflammatory, and fibro-inflammatory cutaneous disorders. Varicella
zoster virus (VZV) DNA has not been identified in most of these reports. After an
episode of HZ, a healthy, active 90-year-old female developed ulcerative nodules 
in the affected trigeminal V1 dermatome and the contra-lateral trigeminal region 
over a 1-year period. Excision and/or biopsy of all these lesions showed similar 
pathologic changes that consisted of herpetic folliculitis, adjacent dense mixed 
nodular lymphocytic infiltrates with germinal centers (cutaneous lymphoid
hyperplasia (CLH)), and in the deeper excision specimens, an obliterative
vasculitis of a vessel with smooth muscle in its wall. Immunophenotype analysis
revealed a mixed, predominate T- and B-cell population without loss of pan-T cell
antigens or aberrant expression by B cells of T-cell antigens. Polymerase chain
reaction for herpetic DNA was positive for VZV DNA. Lymphocyte gene rearrangement
analysis revealed 2 distinct, anatomically and chronologically, monoclonal B-cell
populations and a monoclonal T-cell population in one nodule. Treatment with
valacyclovir has lead to almost complete resolution of her cutaneous nodules
after 6 months of therapy. In this case, it can be surmised that persistence of
VZV infection and lack of effective cell-mediated immunity lead to development of
both immunopathology (vasculitis) and excessive lymphoid cell proliferation
(CLH).

Publication Types: 
    Case Reports

PMID: 16148411 [PubMed - indexed for MEDLINE]

1340: Presse Med. 2005 Jul 23;34(13):916-8.

Infliximab in the treatment of posterior uveitis in Behcet's disease. Long term
follow up in four patients.

Lanthier N, Parc C, Scavennec R, Dhote R, Brezin AP, Guillevi L.

Department of ophthalmology, University Rene Descartes, Paris, Frane.

OBJECTIVE: To evaluate the efficacy of infliximab as adjuvant therapy for
refractory uveitis in Behcet's disease. METHODS: Retrospective evaluation of 4
patients with Behcet's disease and severe uveitis, refractory to conventional
corticosteroid and immunosuppressant regimens, to which infliximab (anti-tumor
necrosis factor-alpha (TNFalpha) antibodies) was added. The outcome measures were
intraocular inflammation, visual acuity, reduction of daily corticosteroid dose, 
and adverse effects. RESULTS: The mean follow-up period was 11 months (range:
2-29 months). Patients received a mean of 8 (range: 3-16) infliximab infusions.
TNFalpha blockade with infliximab was effective for 2 of our 4 patients: the
effect for them was rapid but transient. One patient experienced a thoracic
herpes zoster, a severe adverse effect not previously reported. CONCLUSIONS:
Response to infliximab was variable in patients with Behcet's disease for whom
conventional immunosuppression had failed. Infliximab allowed the daily
corticosteroid dose to be reduced for some patients but required repeated
infusions.

Publication Types: 
    Case Reports

PMID: 16142147 [PubMed - indexed for MEDLINE]

1341: Med J Aust. 2005 Sep 5;183(5):277-9.

Comment in:
    Med J Aust. 2005 Sep 5;183(5):278-9.

Universal varicella vaccination.

Mackenzie GA.

Publication Types: 
    Letter

PMID: 16138807 [PubMed - indexed for MEDLINE]

1342: J Med Chem. 2005 Sep 8;48(18):5794-804.

4-Oxo-4,7-dihydrothieno[2,3-b]pyridines as non-nucleoside inhibitors of human
cytomegalovirus and related herpesvirus polymerases.

Schnute ME, Cudahy MM, Brideau RJ, Homa FL, Hopkins TA, Knechtel ML, Oien NL,
Pitts TW, Poorman RA, Wathen MW, Wieber JL.

Medicinal Chemistry and Infectious Diseases Biology, Pharmacia Corporation, 301
Henrietta Street, Kalamazoo, Michigan 49001, USA. mark.e.schnute@ pfizer.com

A novel series of 4-oxo-4,7-dihydrothieno[2,3-b]pyridine-5-carboxamides have been
identified as potential antivirals against human herpesvirus infections resulting
from human cytomegalovirus (HCMV), herpes simplex virus type 1 (HSV-1), and
varicella-zoster virus (VZV). Compounds 10c and 14 demonstrated broad-spectrum
inhibition of the herpesvirus polymerases HCMV, HSV-1, and VZV. High specificity 
for the viral polymerases was observed compared to human alpha polymerase. The
antiviral activity of 10c and 14, as determined by plaque reduction assay, was
comparable or superior to that of existing antiherpes drugs, ganciclovir (for
HCMV) and acyclovir (for HSV-1 and VZV). Drug resistance to compound 14
correlated to point mutations in conserved domain III of the herpesvirus DNA
polymerase, but these mutations do not confer resistance to existing nucleoside
therapy. In addition, compound 14 maintained potent antiviral activity against
acyclovir-resistant HSV-1 strains. Substitution to the pyridone nitrogen (N7) was
found to be critical for enhanced in vitro antiviral activity.

PMID: 16134946 [PubMed - indexed for MEDLINE]

1343: Pediatr Nephrol. 2005 Dec;20(12):1750-5. Epub 2005 Aug 24.

Infection in children with lupus nephritis receiving pulse and oral
cyclophosphamide therapy.

Opastirakul S, Chartapisak W.

Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, 
Chiang Mai University, Thailand. sopastir@mail.med.cmu.ac.th

Infection is the major complication of cyclophosphamide therapy in patients with 
lupus nephritis. The objectives of this study were to report and compare the rate
of infection between children with lupus nephritis who had received intravenous
pulse cyclophosphamide (IVCY) and those who had received oral cyclophosphamide
(OCY) and to determine the risk factors for infection during treatment with
cyclophosphamide in these groups. Records of nine patients who had received IVCY 
from the beginning [pure intravenous cyclophosphamide (PIVCY) group], 11 patients
who had received prior oral cyclophosphamide and later switched to IVCY [combined
intravenous cyclophosphamide (CIVCY) group] and 41 patients who had received OCY 
were reviewed. Infection occurred in 21 of 61 patients (34%). In the PIVCY group,
four episodes of infection occurred in three of nine patients (33%). In the CIVCY
group, six episodes of infection occurred in four of 11 patients (36%). In the
OCY group, 18 episodes of infection occurred in 14 of 41 patients (34%). The rate
of infection between these groups was not different (P=0.99). None of the
following parameters were risk factors for infection: cumulative dose of
cyclophosphamide, leukopenia and neutropenia. On the contrary, white blood cell
(WBC) count and polymorphonuclear cell (PMN) count were significantly less in the
no-infection group (P=<0.001, P<0.001, respectively), with odds ratios for
leukopenia (WBCs <4,000 mm(3)) and neutropenia (PMNs <1,500 mm(3)) between the
infection and the no-infection group equal to 0.18 (95%CI 0.05-0.63) and 0 (95%CI
0-0.19), respectively. Most of the patients who had infection received
prednisolone at a dosage of more than 0.5 mg/kg per day (67% of the PIVCY group, 
50% of the CIVCY group and 83% of the OCY group). Fatal infections occurred in
two patients who had concomitant active systemic lupus erythematosus (SLE).
Although lymphopenia (lymphocyte count <1,500/mm(3)) was not the risk factor for 
infection, it was observed that six of seven patients with herpes zoster had
lymphopenia. Herpes zoster seemed to occur more frequently in the OCY group (15%)
than in the whole IVCY group (5%), but there was no statistical difference
(P=0.41). We conclude that the rate of infection in the IVCY and OCY group was
not different. Infection is likely to occur in patients receiving a concomitant
high dose of prednisolone. The occurrence of fatal infection in patients with
active disease should be noted. No single risk factor was detected in this study.

Publication Types: 
    Comparative Study

PMID: 16133037 [PubMed - indexed for MEDLINE]

1344: Therapie. 2005 May-Jun;60(3):275-82.

[Immunisation against varicella]

[Article in French]

Floret D.

Urgence et Reanimation Pediatriques, Hopital Edouard Herriot, Lyon, France.
daniel.floret@chu-lyon.fr

Two vaccines against varicella are now being licensed in France, both deriving
from the Oka strain. Seroconversion has been obtained in almost 100% of the cases
after one dose in toddlers and children, and two doses in adolescents and adults.
Efficacy has been mainly established from the US experience, where a universal
immunisation programme of children aged > 12 months with a catch-up for
susceptible adolescents and adults was begun in 1995. The incidence of varicella 
has decreased by about 85% over all age groups. The safety of the vaccine is
good, and most adverse events are represented by fever, reactions at the
injection site and varicella-like rashes. For the time being, France has adopted 
restrictive recommendations for the use of this vaccine because of uncertainties 
with respect to the duration of protection, a shift of the disease towards older 
age and the potential increase of the incidence of herpes-zoster.

Publication Types: 
    English Abstract
    Review

PMID: 16128271 [PubMed - indexed for MEDLINE]

1345: Antimicrob Agents Chemother. 2005 Sep;49(9):3724-33.

Comparative activities of lipid esters of cidofovir and cyclic cidofovir against 
replication of herpesviruses in vitro.

Williams-Aziz SL, Hartline CB, Harden EA, Daily SL, Prichard MN, Kushner NL,
Beadle JR, Wan WB, Hostetler KY, Kern ER.

University of Alabama School of Medicine, 1600 6th Ave. South, 128 Children's
Harbor Bldg., Birmingham, AL 35233, USA.

Cidofovir (CDV) is an effective therapy for certain human cytomegalovirus (HCMV) 
infections in immunocompromised patients that are resistant to other antiviral
drugs, but the compound is not active orally. To improve oral bioavailability, a 
series of lipid analogs of CDV and cyclic CDV (cCDV), including
hexadecyloxypropyl-CDV and -cCDV and octadecyloxyethyl-CDV and -cCDV, were
synthesized and found to have multiple-log-unit enhanced activity against HCMV in
vitro. On the basis of the activity observed with these analogs, additional lipid
esters were synthesized and evaluated for their activity against herpes simplex
virus (HSV) types 1 and 2, human cytomegalovirus, murine cytomegalovirus,
varicella-zoster virus (VZV), Epstein-Barr virus (EBV), human herpesvirus 6
(HHV-6), and HHV-8. Using several different in vitro assays, concentrations of
drug as low as 0.001 microM reduced herpesvirus replication by 50% (EC50) with
the CDV analogs, whereas the cCDV compounds were generally less active. In most
of the assays performed, the EC50 values of the lipid esters were at least
100-fold lower than the EC50 values for unmodified CDV or cCDV. The lipid analogs
were also active against isolates that were resistant to CDV, ganciclovir, or
foscarnet. These results indicate that the lipid ester analogs are considerably
more active than CDV itself against HSV, VZV, CMV, EBV, HHV-6, and HHV-8 in
vitro, suggesting that they may have potential for the treatment of infections
caused by a variety of herpesviruses.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 16127046 [PubMed - indexed for MEDLINE]

1346: Ann Rheum Dis. 2006 Apr;65(4):508-14. Epub 2005 Aug 26.

A phase I-II trial of autologous peripheral blood stem cell transplantation in
the treatment of refractory autoimmune disease.

Tsukamoto H, Nagafuji K, Horiuchi T, Miyamoto T, Aoki K, Takase K, Henzan H,
Himeji D, Koyama T, Miyake K, Inoue Y, Nakashima H, Otsuka T, Tanaka Y, Nagasawa 
K, Harada M.

Medicine and Biosystemic Science, Kyushu University Graduate School of Medical
Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
tsukamot@intmed1.med.kyushu-u.ac.jp

OBJECTIVES: To carry out a phase I-II trial to elucidate the feasibility and
efficacy of high dose cyclophosphamide (CY) supported by autologous peripheral
blood stem cell transplantation (PBSCT) in the treatment of severe and refractory
autoimmune disease (AD). METHODS: Peripheral blood stem cells (PBSCs) were
mobilised during haematological recovery after relatively high dose CY (2 g/m2)
for 2 days, followed by administration of granulocyte colony stimulating factor. 
After collecting PBSCs--more than 2x10(6) CD34+ cells/kg--by apheresis, CD34+
cells were immunologically selected and cryopreserved. Eight patients were
enrolled--five had systemic sclerosis (SSc) alone, one had SSc with systemic
lupus erythematosus, one amyopathic dermatomyositis (ADM), and one Wegener's
granulomatosis (WG). All of the patients were treated with high dose CY (50
mg/kg) for 4 days and autologous PBSCT. RESULTS: Haematopoietic reconstitution
was rapid and sustained. Toxicity due to the regimen included various infections 
such as pneumonia, sepsis, cystitis, herpes zoster, and acute heart failure.
However, there was no treatment related mortality. Encouraging results were
obtained after autologous PBSCT. Sclerosis of the skin was markedly improved in
all of the patients with SSc. Interstitial pneumonia (IP), evaluated by PaO2,
serum KL-6 levels, and pulmonary high resolution computed tomography, improved
significantly. In a patient with ADM, severe and progressive IP also improved
markedly. In a patient with WG, the size of the left orbital granuloma decreased 
substantially, resulting in reduction of the exophthalmos. CONCLUSIONS: These
observations suggest that high dose CY with autologous PBSCT is feasible and may 
be effective in the treatment of severe and refractory AD.

Publication Types: 
    Clinical Trial, Phase I
    Clinical Trial, Phase II
    Research Support, Non-U.S. Gov't

PMID: 16126798 [PubMed - indexed for MEDLINE]

1347: Int J Toxicol. 2005 Jul-Aug;24(4):205-13.

Universal varicella vaccination: efficacy trends and effect on herpes zoster.

Goldman GS.

Medical Veritas International (MVI), Pearblossom, California 93553, USA.
pearblossominc@aol.com

In 1995, the Varicella Active Surveillance Project (VASP) was established in
Antelope Valley (California), a geographically distinct high-desert community of 
300,000 residents, as one of three sites in the nation in a cooperative agreement
with the Centers for Disease Control and Prevention (CDC) to collect baseline
demographic and clinical data and to monitor trends in varicella (chickenpox)
following introduction of varicella vaccine. Herpes zoster (shingles) was added
to the active surveillance January 1, 2000. The universal varicella program has
proven effective in terms of reducing the number of reported verified varicella
cases by 85%, from 2,934 in 1995 to 412 in 2002. Prior to this dramatic
reduction, immunologic boosting due to exogenous exposures to wild-type
varicella-zoster virus (VZV) in the community (1) caused mean serum anti-VZV
levels among vaccines to increase with time after vaccination and (2) served as a
mechanism that helped suppress the reactivation of herpes zoster (HZ), especially
among individuals with a previous history of wild-type varicella.That immunologic
boosting might play a significant role in both varicella and the closely related 
HZ epidemiology is evidenced by (1) a decline in vaccine efficacy by over 20%,
from 95.7% (95% C.I., 82.7% to 98.9%) in 1999 to 73.9% (95% C.I., 57.9% to 83.8%)
in 2001 and (2) an unexpectedly high cumulative (2000 to 2003) true incidence
rate of 223 (95% C.I. 180-273) per 100,000 person-years (p-y) among children <10 
years old with a previous history of varicella. Because capture-recapture methods
demonstrate a likely lower bound of 50% underreporting, the actual rate is likely
double or 446 per 100,000 p-y, approaching the HZ rate reported among older
adults. Other recent studies based on VASP data have mitigated against discovery 
of the above trends that challenge several initial assumptions inherent to the
universal varicella program, namely, (1) a single dose confers long-term immunity
and (2) there is no immunologically mediated link between varicella and HZ
incidence. As vaccinated children replace those with a prior history of wild-type
varicella in the <10 age group, increasing HZ incidence among this cohort will be
of less concern in the near future. However, previous scientific studies,
including the present preliminary results from active surveillance indicate that 
HZ may be increasing among adults. It may be difficult to design booster
interventions that are cost-effective and meet or exceed the level of protection 
provided by immunologic boosting that existed naturally in the community in the
prelicensure era.

PMID: 16126614 [PubMed - indexed for MEDLINE]

1348: Curr Opin Microbiol. 2005 Oct;8(5):552-60.

Recent highlights in the development of new antiviral drugs.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven,
Minderbroedersstraat 10, B-3000 Leuven, Belgium. erik.declercq@rega.kuleuven.be

Twenty antiviral drugs, that is about half of those that are currently approved, 
are formally licensed for clinical use in the treatment of human immunodeficiency
virus infections (acquired immune deficiency syndrome). The others are used in
the treatment of herpesvirus (e.g. herpes simplex virus, varicella zoster virus
and cytomegalo virus), hepatitis B virus, hepatitis C virus or influenza virus
infections. Recent endeavours have focussed on the development of improved
antiviral therapies for virus infections that have already proved amenable to
antiviral drug treatment, as well as for virus infections for which, at present, 
no antiviral drugs have been formally approved (i.e. human papilloma viruses,
adenoviruses, human herpesvirus type 6, poxviruses, severe acute respiratory
syndrome coronavirus and hemorrhagic fever viruses).

Publication Types: 
    Review

PMID: 16125443 [PubMed - indexed for MEDLINE]

1349: Ophthalmologica. 2005 Sep-Oct;219(5):272-5.

Ocular findings in Japanese patients with varicella-zoster virus infection.

Yoshida M, Hayasaka S, Yamada T, Yanagisawa S, Hayasaka Y, Nakamura N, Mihara M.

Department of Ophthalmology, Toyama Medical and Pharmaceutical University,
Toyama, Japan. ophthal@ms.toyama-mpu.ac.jp

PURPOSE: To examine ocular findings in Japanese patients with varicella, herpes
zoster ophthalmicus, and acute retinal necrosis. METHODS: A retrospective study
was conducted. Information on the ocular, cutaneous, systemic, and virologic
findings on pediatric and adult patients was obtained from medical records.
RESULTS: A total of 77 (45 male and 32 female) patients were enrolled in the
study: 4 children had varicella, 68 adults had herpes zoster ophthalmicus, and 5 
adults had acute retinal necrosis. Children with varicella had eruptions on the
eyelid. Patients with herpes zoster ophthalmicus had eruptions, conjunctivitis,
keratitis, iridocyclitis, and other findings. Patients with acute retinal
necrosis had intracameral cells and retinal lesions. Some patients with herpes
zoster ophthalmicus had malignancy, type 2 diabetes mellitus, or other disease.
One pregnant woman developed acute retinal necrosis shortly after varicella
infection. A total of 48% of patients with negative Hutchinson sign had ocular
lesions, while all patients with positive sign showed ocular lesions. Patients
with varicella and herpes zoster ophthalmicus had good visual acuity at the last 
visit. Some patients with acute retinal necrosis had poor visual acuity at the
last visit. CONCLUSIONS: Patients with varicella, herpes zoster ophthalmicus, and
acute retinal necrosis had several ocular complications. Some patients with acute
retinal necrosis had poor visual outcomes. Ophthalmologists should be aware that 
acute retinal necrosis may develop shortly after varicella infection. Copyright
2005 S. Karger AG, Basel.

PMID: 16123552 [PubMed - indexed for MEDLINE]

1350: Antiviral Res. 2005 Nov;68(2):56-65. Epub 2005 Aug 9.

Viral and cellular gene transcription in fibroblasts infected with small plaque
mutants of varicella-zoster virus.

Jones JO, Arvin AM.

Department of Pediatrics, Stanford University, 300 Pasteur Drive, Rm G312,
Stanford, CA, USA. jjones@stanford.edu

Varicella-zoster virus (VZV) is an alphaherpesvirus that causes varicella and
herpes zoster. In these experiments, cDNA corresponding to 69 VZV open reading
frames was added to 42K human cDNA microarrays and used to examine viral as well 
as cellular gene transcription concurrently in fibroblasts infected with two
genetically distinct small plaque VZV mutants, rOka/ORF63rev[T171] and
rOkaDeltagI. rOka/ORF63rev[T171] has a point mutation in ORF63, which encodes the
immediate early regulatory protein, IE63, and rOkaDeltagI has a deletion of
ORF67, encoding glycoprotein I (gI). rOka/ORF63rev[T171] was deficient in the
transcription of several viral genes compared to the recombinant rOka control
virus. Deletion of ORF67 had minimal effects on viral gene transcription. Effects
of rOka/ORF63rev[T171] and rOkaDeltagI on host cell gene transcription were
similar to the rOka control, but a few host cell genes were regulated differently
in rOkaDeltagI-infected cells. Infection of fibroblasts with intact or small
plaque VZV mutants was associated with down-regulation of NF-kappaB and
interferon responsive genes, down-regulation of TGF-beta responsive genes
accompanied by reduced amounts of fibrotic/wound healing response genes (e.g.
collagens, follistatin) and activation of cellular proliferation genes, and
alteration of neuronal growth markers, as well as cellular genes encoding
proteins important in protein and vesicle trafficking. These observations suggest
that replication of VZV small plaque mutant viruses and intact VZV have similar
consequences for host cell gene transcription in infected cells, and that the
small plaque phenotype in these mutants reflects deficiencies in viral gene
expression.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 16118026 [PubMed - indexed for MEDLINE]

1351: Clin J Oncol Nurs. 2005 Aug;9(4):443-6.

Herpes zoster: medical and nursing management.

Sandy MC.

msandy@kumc.edu

Herpes zoster, the latent descendent of the varicella zoster virus, commonly is
seen in clinical practice. Healthcare providers must recognize and treat the
virus to decrease the incidence of postherpetic neuralgic pain syndrome.
Treatment with an antiviral medication regimen should be initiated rapidly for
patients who have had lesions for up to 72 hours. Acyclovir has been the
treatment of choice for herpes zoster in the past, but newer drugs, such as
valacyclovir, a prodrug of acyclovir, and famciclovir, are as effective for
treating the virus and have more convenient dosing regimens and decreased
incidence of postherpetic neuralgia.

Publication Types: 
    Review

PMID: 16117211 [PubMed - indexed for MEDLINE]

1352: J Cutan Pathol. 2005 Sep;32(8):581-4.

'Specific' cutaneous infiltrate of B-cell chronic lymphocytic leukemia at the
site of a florid herpes simplex infection.

Ziemer M, Bornkessel A, Hahnfeld S, Weyers W.

Department of Dermatology, Friedrich-Schiller-University of Jena, Freiburg,
Germany. mirjana.ziemer@derma.uni-jena.de

Background: Specific cutaneous infiltrates in patients with leukemia generally
carry a grim prognosis. However, non-neoplastic skin diseases may be associated
with recruitment of normal and neoplastic leukocytes circulating in the
peripheral blood. In those instances, neoplastic cells may be detected in skin
lesions without an adverse effect on prognosis. Methods: In a patient with B-cell
chronic lymphocytic leukemia, a specific infiltrate developed at the site of a
florid herpes simplex infection. Clinically, the lesion presented itself as an
ulcerated tumor. Results: Histopathologically, the lesion was characterized by a 
dense, diffuse infiltrate of small hyperchromatic lymphocytes throughout the
entire dermis. Lymphocytes showed an aberrant CD20(+)/CD43(+)/CD5(+) phenotype of
neoplastic B cells, and monoclonal rearrangement of immunoglobulin gamma genes
could be demonstrated by polymerase chain reaction. Although criteria for
leukemia cutis were fulfilled, the patient did well. Conclusions: The cutaneous
infiltrate of neoplastic cells seemed to be part of a physiologic response to the
antigenic stimulus, rather than indicating an exacerbation of leukemia. Ziemer M,
Bornkessel A, Hahnfeld S, Weyers W. 'Specific' cutaneous infiltrate of B-cell
chronic lymphocytic leukemia at the site of a florid herpes simplex infection.

Publication Types: 
    Case Reports

PMID: 16115059 [PubMed - indexed for MEDLINE]

1353: Rev Saude Publica. 2005 Aug;39(4):687-90. Epub 2005 Aug 16.

[Varicella outbreak in childcare centers and schools of the of 22nd Regional
Health Division, June 2005]

[Article in Portuguese]

EPISUS-SES/SP.

Publication Types: 
    Technical Report

PMID: 16113924 [PubMed - indexed for MEDLINE]

1354: Nippon Rinsho. 2005 Jul;63 Suppl 7:294-6.

[Diagnostic tests: Varicella-zoster virus]

[Article in Japanese]

Yamashita T.

Department of Dermatology, Sapporo Medical University, School of Medicine.

Publication Types: 
    Review

PMID: 16111254 [PubMed - indexed for MEDLINE]

1355: J Neurol Neurosurg Psychiatry. 2005 Sep;76(9):1308-9.

Erratum in:
    J Neurol Neurosurg Psychiatry. 2005 Dec;76(12):1747. Mahad, D [corrected to
Mahad, DJ].

Aciclovir induced posterior leucoencephalopathy.

Mahad DJ, Hellden A, Jarvis J, Mitra D, Gholkar A, Chinnery PF.

Publication Types: 
    Case Reports
    Letter

PMID: 16107379 [PubMed - indexed for MEDLINE]

1356: Curr Infect Dis Rep. 2005 Sep;7(5):359-64.

Skin manifestations of herpesvirus infections.

Toney JF.

Division of Infectious and Tropical Medicine, Department of Internal Medicine,
University of South Florida College of Medicine, 13000 Bruce B. Downs Boulevard, 
Tampa, FL 33612, USA. jtoney@hsc.usf.edu

Currently there are eight human herpesviruses identified that cause disease in
both adults and children. Although the manifestations of disease differ with each
herpesvirus, cutaneous presentations are common among almost all of them. These
skin manifestations may be visually similar among several of these viruses,
occasionally making it challenging to diagnose the patient's illness. Laboratory 
diagnostic testing is commercially available for most of these viruses. Because
many herpesvirus infections are self-limiting in immunocompetent hosts, patients 
require only supportive care. Effective antiviral therapy is available for the
more severe cases of infection caused by herpes simplex virus (HSV), varicella
zoster virus (VZV), or cytomegalovirus (CMV). Healthcare practitioners should
become familiar with the different cutaneous manifestations these viruses may
exhibit.

PMID: 16107233 [PubMed]

1357: Rev Iberoam Micol. 2005 Jun;22(2):125-6.

[Clinical cases in medical mycology. Case No. 16]

[Article in Spanish]

Negroni R, Tuculet MA.

Unidad de Micologia, Hospital de Infecciosas Francisco Javier Muniz, Uspallata
2272 1282, Buenos Aires, Argentina. hmmicologia@intramed.net

Publication Types: 
    Case Reports

PMID: 16107174 [PubMed - indexed for MEDLINE]

1358: Adv Exp Med Biol. 2005;568:11-24.

Chickenpox party or varicella vaccine?

Hambleton S, Arvin AM.

Columbia University, Department of Pediatrics, New York, NY 10032, USA.

The most compelling rationale for introducing universal vaccination against
varicella was the predicted benefits to healthy children. Current evidence from
the US experience indicates that these benefits are being realized. As is true
for any new vaccine, implementation of such a program necessitates disease
surveillance and modifications of the vaccine regimen as needed. In the case of
VZV, the epidemiology of herpes zoster must be tracked as well as varicella
disease trends. The prevention of herpes zoster may be another use of live
attenuated or inactivated varicella vaccines.

Publication Types: 
    Review

PMID: 16107063 [PubMed - indexed for MEDLINE]

1359: Rev Neurol (Paris). 2005 May;161(5):590-2.

[Complete ophthalmoplegia complicating ophthalmic herpes zoster]

[Article in French]

Papeix C, Dumurgier J, Milea D, Pierrot DC.

Service de Neurologie 1, Hopital de la Pitie-Salpetriere (AP-HP), Paris.
caroline.papeix@psl.ap-hop-paris.fr

We report a case of a 73-year-old patient with complete ophthalmoplegia following
an episode of ophthalmic herpes zoster. MRI showed an associated ipsilateral
temporal meningioma with cavernous sinus extension. We discuss the possible
responsibility of these two conditions in the ocular motor signs.

Publication Types: 
    Case Reports
    English Abstract

PMID: 16106813 [PubMed - indexed for MEDLINE]

1360: Eur J Haematol. 2005 Sep;75(3):234-40.

Effect of varicella zoster virus infection on bone marrow function.

Al-Anazi KA, Al-Jasser AM, Evans DA.

Section of Adult Haematology and Bone Marrow Transplant, King Faisal Cancer
Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi
Arabia. khalid_alanazi@yahoo.com

BACKGROUND: Most viral infections are known to exert adverse effects on bone
marrow function. However, certain viruses have recently been found to be
therapeutically beneficial in the treatment of some malignant disorders. METHODS 
AND MATERIALS: A retrospective study was conducted at the Armed Forces Hospital, 
Riyadh, Saudi Arabia. The changes in the hematological parameters following
varicella-zoster virus (VZV) infection in patients with a variety of
hematological disorders were compared with those in a control group having the
same spectrum of disorders and treated in the same unit over the same period of
time but never had VZV infection. Both groups of patients received the same
treatment protocols for their primary hematological disorders. Definitive
treatment (DT) such as chemotherapy alone, anti-thymocyte globulin or bone marrow
transplant was also employed in the management of patients belonging to both
groups. RESULTS: White blood cell counts, platelet counts and hemoglobin
concentrations in the study group started to increase 40 d after chickenpox or
herpes zoster infection and these increases lasted for periods as long as 1050 d.
The changes in platelet counts were more pronounced than those in other
hematological parameters. There was a significant difference (P < 0.0001) between
the two groups of patients in the values of platelet counts achieved between 280 
and 1050 d after DT (mean platelet count: 262 x 10(9)/L in the study group vs.
180 x 10(9)/L in the control group, median: 288.17 x 10(9)/L in the study group
vs. 180 x 10(9)/L in the control group, range: 102 to 415 x 10(9)/L in the study 
group vs. 26 to 365 x 10(9)/L in the control group of patients). Compared to the 
control group, the study group of patients achieved their maximum blood counts
much earlier after DT. The maximum leucocytic count was achieved at a mean
duration of 269.21 d in the study group and 349.61 d in the control group. The
maximum hemoglobin level was achieved at a mean duration of 319.5 d in the study 
group and 402.6 d in the control group. The maximum platelet count was achieved
at a mean duration of 271.4 d in the study group and 318.9 d in the control group
of patients. CONCLUSION: VZV may behave differently from other members of the
herpes group of viruses e.g. human cytomegalovirus and Epstein-Barr virus. Our
observations suggest that VZV infection causes stimulation of bone marrow
activity. Copyright Blackwell Munksgaard 2005.

PMID: 16104880 [PubMed - indexed for MEDLINE]

1361: J Virol. 2005 Sep;79(17):11501-6.

Replication of varicella-zoster virus in human skin organ culture.

Taylor SL, Moffat JF.

Department of Microbiology and Immunology, SUNY Upstate Medical University,
Syracuse, NY 13210, USA.

Varicella-zoster virus (VZV) infection is restricted to humans, which hinders
studies of its pathogenesis in rodent models of disease. To facilitate the study 
of VZV skin tropism, we developed an ex vivo system using human fetal skin organ 
culture (SOC). VZV replication was analyzed by plaque assay, transmission
electron microscopy, and histology. The yield of infectious VZV from SOC
increased approximately 100-fold over 6 days, virions were abundant, and lesions 
developed that contained VZV antigens and resembled varicella and zoster lesions.
The SOC system for VZV replication has applications for testing virus mutants and
antiviral drugs.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 16103201 [PubMed - indexed for MEDLINE]

1362: Diabetes Res Clin Pract. 2005 Sep;69(3):256-61. Epub 2005 Mar 23.

Hospital admission for selected single virus infections prior to diabetes
mellitus.

Goldacre MJ, Wotton CJ, Yeates D, Seagroatt V, Neil A.

Unit of Health-Care Epidemiology, University of Oxford, Old Road Campus, Oxford
OX37LF, UK.

AIMS: To determine whether hospital admission for a range of specified virus
infections was followed by a raised admission rate for diabetes mellitus; and, if
raised, whether the increase is compatible with the hypothesis that virus
infection is a cause of diabetes. METHODS: Analysis of a database of hospital
statistics including admissions for people with diabetes mellitus before the age 
of 30 years. RESULTS: There was no evidence of excess risk of diabetes after
measles, mumps, rubella, infectious mononucleosis, influenza, infectious
hepatitis, varicella and herpes zoster, herpes simplex, aseptic meningitis or
bronchiolitis. For example, of 1433 patients admitted for measles, 6 were later
admitted with diabetes (risk ratio 1.32; 95% confidence interval 0.5-2.9); of 866
patients admitted for mumps, 2 were later admitted for diabetes (risk ratio 0.74;
0.1-2.7). Numbers of people with diabetes subsequent to infection were too few,
however, to rule out the possibility of small effects. CONCLUSIONS: Our findings 
do not support the hypothesis that any of these virus infections initiate the
processes that lead to the development of diabetes, or that these infections act 
as a trigger to precipitate active disease in those whose diabetes is already
present but latent.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16098922 [PubMed - indexed for MEDLINE]

1363: Pain. 2005 Sep;117(1-2):154-61.

Tactile allodynia in patients with postherpetic neuralgia: lack of change in skin
blood flow upon dynamic stimulation.

Besson M, Brook P, Chizh BA, Pickering AE.

Pain Clinic, Bristol Royal Infirmary, Bristol BS2 8HW, UK.

Tactile allodynia is a common, troublesome feature of neuropathic pain. Allodynia
has been proposed to involve abnormal Abeta-afferent coupling in the dorsal horn 
resulting in C-fibre activation and increased skin blood flow (SBF). Thus,
changes in SBF could provide an objective measure of allodynia. We searched for
this mechanism in patients with postherpetic neuralgia (PHN) with varying degrees
of cutaneous sensory loss. We mapped the allodynic area in PHN patients using
cotton buds and von Frey hairs. Quantitative thermal testing was performed to
assess small fibre function in the affected and mirror-image areas. At a
subsequent visit the area of allodynia was remapped. Then the SBF in the affected
and control areas was quantified before and after allodynic stimulation using
laser Doppler imaging and subsequent single point continuous monitoring to detect
rapid changes. We enrolled 10 PHN patients (medians: age 77 yrs, duration 20
months, ongoing pain 5). The allodynic area (range 11-546 cm2) was stable across 
the sessions. Thermal testing showed similar (n=5) or reduced (n=5) warmth and
pain sensation in the affected versus control area. Following allodynic
stimulation (median evoked pain-5) we saw no changes in SBF using either imaging 
(repeated measures ANOVA, P=0.73) or single point monitoring. This was the case
for all patients regardless of the degree of sensory impairment in the affected
dermatome. In conclusion, in a representative population of PHN patients we found
no evidence of changes in SBF in response to allodynic stimulation. Hence, SBF
measurements are not suitable for assessing allodynia.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 16098664 [PubMed - indexed for MEDLINE]

1364: Expert Rev Mol Med. 2005 Aug 10;7(15):1-24.

Molecular and therapeutic aspects of varicella-zoster virus infection.

Quinlivan M, Breuer J.

Skin Virus Laboratory, Institute of Cell and Molecular Science, 4 Newark Street, 
Whitechapel, London, E1 28E, UK. m_quinlivan@hotmail.com

Varicella-zoster virus (VZV) is a highly species-specific member of the
Herpesviridae family. The virus exhibits multiple cell tropisms, infecting
peripheral blood mononuclear cells and skin cells before establishing latency in 
sensory neurons. Such tropisms are essential both for primary infection, which
manifests itself as chickenpox (varicella), and subsequent reactivation to cause 
herpes zoster (shingles). The highly cell-associated nature of the virus, coupled
with its narrow host range, has resulted in the lack of an animal model that
mimics its diseases in humans, thereby greatly hindering the study of events in
VZV pathogenesis. Despite this, extensive studies both in vitro and in vivo in
small-animal models have provided a fascinating insight into molecular events
that govern VZV diseases. In addition, VZV has become the first human herpes
virus for which a live attenuated vaccine has been developed.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review

PMID: 16098235 [PubMed - indexed for MEDLINE]

1365: J Ky Med Assoc. 2005 Jul;103(7):303-6.

Case report on motor neuropathy associated with herpes zoster.

Murphy P.

University of Louisville, Department of Family and Geriatric Medicine, KY 40202, 
USA. pjmurph01@gwise.louisville.edu

BACKGROUND: Complications associated with herpes zoster are primarily sensory,
but motor involvement, especially in late life, can be part of the symptom
complex. CASE REPORT: We report a case of herpes zoster with motor neuropathy in 
a 66-year-old female. Eighteen months after diagnosis and treatment, the patient 
is regaining muscular strength in the affected limb. DISCUSSION: Treatment of
motor neuropathy mainly consists of physical and occupational therapy. Most
patients achieve functional recovery.

Publication Types: 
    Case Reports

PMID: 16095260 [PubMed - indexed for MEDLINE]

1366: Emerg Med Australas. 2005 Aug;17(4):330-40.

Evidence-based emergency medicine at the 'coal face'.

Than M, Bidwell S, Davison C, Phibbs R, Walker M.

Clinical Decision Support Unit and Centre for Evidence-Based Health Care,
Christchurch, New Zealand. martin.than@cdhb.govt.nz

While evidence-based medicine may be trumpeted by zealots, managers and
politicians, incorporating it into clinical practice is easier said than done.
The present article aims to show that it can be achieved and gives some clinical 
examples to illustrate this. An appendix contains a summary of useful databases
and websites for accessing good medical information and evidence, quickly and
reliably near the bedside.

Publication Types: 
    Case Reports

PMID: 16091095 [PubMed - indexed for MEDLINE]

1367: Neurology. 2005 Aug 9;65(3):444-7.

Comment in:
    Neurology. 2005 Aug 9;65(3):349-50.

A single dose of gabapentin reduces acute pain and allodynia in patients with
herpes zoster.

Berry JD, Petersen KL.

UCSF Pain Clinical Research Center, Department of Neurology, University of
California, San Francisco, CA, USA.

This randomized, double-blind, placebo-controlled crossover study measured the
effect of a single dose of oral gabapentin (900 mg) on pain and allodynia
associated with herpes zoster. Pain severity decreased by 66% with gabapentin
compared to 33% with placebo. Reductions in allodynia area and severity, and
overall pain relief, were also greater with gabapentin.

Publication Types: 
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 16087911 [PubMed - indexed for MEDLINE]

1368: Neurology. 2005 Aug 9;65(3):349-50.

Comment on:
    Neurology. 2005 Aug 9;65(3):444-7.

Herpes zoster and the prevention of postherpetic neuralgia: beyond antiviral
therapy.

Tenser RB, Dworkin RH.

Publication Types: 
    Comment
    Editorial

PMID: 16087894 [PubMed - indexed for MEDLINE]

1369: Biochem Biophys Res Commun. 2005 Sep 23;335(2):505-11.

dsRNA-mediated innate immunity of epidermal keratinocytes.

Tohyama M, Dai X, Sayama K, Yamasaki K, Shirakata Y, Hanakawa Y, Tokumaru S,
Yahata Y, Yang L, Nagai H, Takashima A, Hashimoto K.

Department of Dermatology, Ehime University School of Medicine, Shitsukawa,
Toon-city, Ehime 791-0295, Japan.

MIP-1alpha, a CC chemokine, recruits monocytes, natural killer cells,
lymphocytes, and neutrophils, and plays a critical role in viral infection.
Since, the lesional epidermis of herpes zoster expressed MIP-1alpha, we
hypothesized that keratinocytes produce MIP-1alpha in response to
virus-associated dsRNA via TLR3. To investigate this, we examined cultured human 
keratinocytes for MIP-1alpha production induced by poly(I:C), a TLR3 ligand.
Poly(I:C) treatment induced MIP-1alpha production, interestingly,
poly(I:C)-induced IFN-alpha and -beta production preceded MIP-1alpha production. 
A neutralizing antibody for IFN-beta significantly inhibited the
poly(I:C)-induced MIP-1alpha production indicating that MIP-1alpha production is 
via IFN-beta. IFN-alpha priming enhanced TLR3 expression and MIP-1alpha
production in poly(I:C)-treated keratinocytes. This suggests that IFN-alpha
enhanced the TLR3 expression and reinforced the response of keratinocytes to
poly(I:C), which resulted in an increase in MIP-1alpha production. In conclusion,
normal human keratinocytes produce MIP-1alpha in response to dsRNA via TLR3, and 
this production is regulated by IFN-alpha/beta.

PMID: 16087162 [PubMed - indexed for MEDLINE]

1370: Clin Perinatol. 2005 Sep;32(3):671-96.

Human herpes viruses in pregnancy: cytomegalovirus, Epstein-Barr virus, and
varicella zoster virus.

Hollier LM, Grissom H.

Department of Obstetrics, Gynecology and Reproductive Sciences, University of
Texas Houston Medical School, Lyndon B. Johnson General Hospital, 5656 Kelley
Street, Houston, TX 77026, USA. lisa.m.hollier@uth.tmc.edu

Viruses of the human herpesvirus family can have profound effects on pregnancy.
Primary maternal infection with cytomegalovirus (CMV) and varicella during
pregnancy has been associated with fetal abnormalities and neonatal disease.
Public awareness of the role of cytomegalovirus in the etiology of developmental 
disorders and chronic disabilities needs to increase. With time, we may see new
interventions for treatment of infected pregnant women and prevention of
long-term effects. Attention must be focused on development of a safe and
effective vaccine. With the introduction of an efficacious varicella vaccine, the
rate of varicella in pregnancy is expected to decrease dramatically. Physicians
caring for women have the opportunity to prevent the complications of varicella
by identifying and vaccinating susceptible women.

Publication Types: 
    Review

PMID: 16085026 [PubMed - indexed for MEDLINE]

1371: J Allergy Clin Immunol. 2005 Aug;116(2):438-44.

Does early EBV infection protect against IgE sensitization?

Nilsson C, Linde A, Montgomery SM, Gustafsson L, Nasman P, Blomberg MT, Lilja G.

Department of Pediatrics, Sachs' Children's Hospital, Stockholm South Hospital,
Stockholm, Sweden. caroline.nilsson@sodersjukhuset.se

BACKGROUND: There is indirect evidence that an increased infectious burden is
associated with a decreased prevalence of IgE-mediated allergy during childhood. 
OBJECTIVE: To determine whether there is a relation between the serostatus of 13 
different viruses and parentally reported infections and IgE sensitization in
2-year-old children. To investigate whether there is an interaction between
cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in relation to IgE
sensitization. METHODS: A total of 246 infants were followed prospectively to 2
years of age with clinical examinations, skin prick test, and specific IgE
analyses and through analysis of seropositivity against adenovirus, influenza,
parainfluenza, respiratory syncytial virus, CMV, EBV, herpes simplex virus, human
herpesvirus 6, and varicella-zoster virus. RESULTS: There was some evidence that 
IgE sensitization (24%) tended to be more common among children who were
seropositive against few compared with children who were seropositive against
many viruses, but this was not statistically significant, and there was no
consistent trend across the groups. IgE sensitization was statistically
significantly less prevalent at 2 years of age among infants who were
seropositive against EBV but not other viruses (adjusted odds ratio, 0.34; 95%
CI, 0.14-0.86). The interaction of seropositivity against both CMV and EBV
antibodies indicated a further reduction in the risk for IgE sensitization
(adjusted odds ratio for interaction, 0.10; 95% CI, 0.01-0.92), indicating effect
modification associated with seropositivity against CMV. CONCLUSION: Our results 
indicate that acquisition of EBV infection during the first 2 years of life is
associated with a reduced risk of IgE sensitization, and this effect is enhanced 
by CMV coinfection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16083803 [PubMed - indexed for MEDLINE]

1372: Niger J Med. 2005 Apr-Jun;14(2):121-31.

The neurology of HIV infection--a review of the literature.

Imam I.

Department of Medicine, State House Clinic, P. M. B. 316, Abuja.

BACKGROUND: The nervous system is widely involved in the course of infection with
the human immunodeficiency virus (HIV). The manifestation may be a direct effect 
of the virus, the result of opportunistic infections or secondary malignancies,
or a result of the therapy of various aspects of the disease. This review looks
at these neurological consequences of HIV infection. METHODS: The review was
sourced mainly by Medline search using the search terms HIV, AIDS and neurology. 
Relevant journals were subsequently studied. RESULTS: The major neurological
manifestations of HIV infection are toxoplasmosis, cryptococcal meningitis, AIDS 
dementia complex, primary lymphoma, tuberculosis, progressive multifocal
leukoencephalopathy, herpes zoster, Bells palsy, peripheral neuropathy, and
vacuolar myelopathy. The overall effect of these is the acceleration of
progression of the disease. About 30% of the mortality in HIV infection is
attributed to neurological diseases. CONCLUSION: The nervous system is
significantly affected in HIV infection and the impact on morbidity and mortality
is profound. All effort should be made to ensure early recognition and
amelioration of the various nervous systems complications of HIV infection.

Publication Types: 
    Review

PMID: 16083233 [PubMed - indexed for MEDLINE]

1373: J Clin Microbiol. 2005 Aug;43(8):4172-4.

Prevalence of herpes simplex virus (types 1 and 2), varicella-zoster virus,
cytomegalovirus, and human herpesvirus 6 and 7 DNA in cerebrospinal fluid of
Middle Eastern patients with encephalitis.

Ibrahim AI, Obeid MT, Jouma MJ, Roemer K, Mueller-Lantzsch N, Gartner BC.

Department of Clinical Chemistry and Microbiology, University of Damascus, Syria.

HSV-1 DNA was detected in 32 (30%) of 106 cerebrospinal fluid samples from
patients with encephalitis. Cytomegalovirus, varicella-zoster virus, and human
herpesvirus 6 (HHV-6) DNAs were each detected in three patients (3%); herpes
simplex virus type 2 (HSV-2) and HHV-7 PCRs were negative. HSV detection was
associated with seizure (P = 0.02), especially focal seizure (P = 0.0002), and
pathological computed tomography (P = 0.02) with focal lesions (P = 0.0004).

PMID: 16081968 [PubMed - indexed for MEDLINE]

1374: CMAJ. 2005 Aug 2;173(3):249.

Vaccination boosts adult immunity to varicella zoster virus.

Weir E.

PMID: 16076818 [PubMed - indexed for MEDLINE]

1375: Int J Pediatr Otorhinolaryngol. 2005 Sep;69(9):1275-8. Epub 2005 Apr 22.

A case of holoprosencephaly and cebocephaly associated to torch infection.

Kilic N, Yazici Z.

Department of Paediatric Surgery, The Medical Faculty of Uludag University, 16059
Gorukle, Bursa, Turkey. nizam@uludag.edu.tr

Cebocephaly is a very rare congenital anomaly combining a severe midline facial
malformation and holoprosencephaly. Here we report on first case of cebocephaly
with semilobar holoprosencephaly, hypotelorism, and a single nostril due to
intrauterine TORCH infection (Toxoplasmosis, other [syphilis, varicella-zoster,
parvovirus B19], Rubella, Cytomegalovirus [CMV], and Herpes infections) in the
English language literature. Chromosomal analysis showed normal karyotyping.

Publication Types: 
    Case Reports

PMID: 16061113 [PubMed - indexed for MEDLINE]

1376: Acta Anaesthesiol Taiwan. 2005 Jun;43(2):73-7.

Starting dose of gabapentin for patients with post-herpetic neuralgia--a
dose-response study.

Jean WH, Wu CC, Mok MS, Sun WZ.

Department Anaesthesiology, Far Eastern Memorial Hospital, Taipei, Taiwan, ROC.

BACKGROUND: Gabapentin has been shown to provide pain relief for post-herpetic
neuralgia at dosage of 1200 to 2400 mg/day. However, the initial dosing strategy 
has not been thoroughly investigated. The purpose of this study was to establish 
the initial dosing strategy in the treatment of the gabapentin-naive patients
with post-herpetic neuralgia. METHODS: This clinical study was an open-label,
randomized, time-sequence and controlled trial. Each gabapentin-naive subject was
allocated to receive either 200 mg (100 mg, twice daily), 400 mg (100 mg, four
times daily), or 600 mg (200 mg, three times daily) of gabapentin for three days.
The analgesic effect and occurrence of dizziness, drowsiness, and fatigue were
assessed at day 0 and day 3. RESULTS: A total of 61 subjects (32 male/29 female) 
were enrolled in this study. The intensity of pain was greatly improved in all
three groups after three days of treatment (visual analog scale decreased from
6.5 +/- 1.6 to 4.5 +/- 2.1, P < 0.05). There was no statistically significant
difference among subjects taking 200 mg, 400 mg, or 600 mg with respect to
dizziness, drowsiness or fatigue. CONCLUSIONS: This study shows that elderly
gabapentin-naive subjects no matter whether receiving 200, 400 or 600 mg/day of
gabapentin benefited a moderate pain relief with minimal side effects at the
first three days of treatment. Since starting with a minimal dose of 200 mg/day
did not offer a better reduction of side effects, we suggest that 600 mg/day
gabapentin could be a safe and effective starting dose for patients with
post-herpetic neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 16060401 [PubMed - indexed for MEDLINE]

1377: Br J Oral Maxillofac Surg. 2007 Jan;45(1):71-3. Epub 2005 Jul 28.

Herpes zoster associated with tooth resorption and periapical lesions.

Ramchandani PL, Mellor TK.

Department of Oral and Maxillofacial Surgery, Poole General Hospital, Longfleet
Road, Poole, Dorset, UK. parkashr@msn.com

A 72-year-old woman presented with multiple periapical lesions and resorption of 
teeth in a single quadrant 17 years after an attack of herpes zoster (shingles)
of the maxillary division of the trigeminal nerve. It is possible that cases of
tooth resorption that were previously classified as idiopathic may have a viral
aetiology and we suggest that these patients should be asked about a previous
attack of shingles.

Publication Types: 
    Case Reports

PMID: 16054735 [PubMed - indexed for MEDLINE]

1378: Physiol Biochem Zool. 2005 Sep-Oct;78(5):744-55. Epub 2005 Jul 28.

Reflex cardioventilatory responses to hypoxia in the flathead gray mullet (Mugil 
cephalus) and their behavioral modulation by perceived threat of predation and
water turbidity.

Shingles A, McKenzie DJ, Claireaux G, Domenici P.

International Marine Centre, Localita Sa Mardini, 09072 Torregrande (Or), Italy. 
alexandrashingles@yahoo.co.uk

In hypoxia, gray mullet surface to ventilate well-oxygenated water in contact
with air, an adaptive response known as aquatic surface respiration (ASR). Reflex
control of ASR and its behavioral modulation by perceived threat of aerial
predation and turbid water were studied on mullet in a partly sheltered aquarium 
with free surface access. Injections of sodium cyanide (NaCN) into either the
bloodstream (internal) or ventilatory water stream (external) revealed that ASR, 
hypoxic bradycardia, and branchial hyperventilation were stimulated by
chemoreceptors sensitive to both systemic and water O2 levels. Sight of a model
avian predator elicited bradycardia and hypoventilation, a fear response that
inhibited reflex hyperventilation following external NaCN. The time lag to
initiation of ASR following NaCN increased, but response intensity (number of
events, time at the surface) was unchanged. Mullet, however, modified their
behavior to surface under shelter or near the aquarium edges. Turbid water
abolished the fear response and effects of the predator on gill ventilation and
timing of ASR following external NaCN, presumably because of reduced visibility. 
However, in turbidity, mullet consistently performed ASR under shelter or near
the aquarium edges. These adaptive modulations of ASR behavior would allow mullet
to retain advantages of the chemoreflex when threatened by avian predators or
when unable to perceive potential threats in turbidity.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 16052452 [PubMed - indexed for MEDLINE]

1379: J Gen Intern Med. 2005 Aug;20(8):748-53.

The incidence of herpes zoster in a United States administrative database.

Insinga RP, Itzler RF, Pellissier JM, Saddier P, Nikas AA.

Department of Health Economic Statistics, Merck Research Laboratories, Blue Bell,
PA, USA. ralph_insinga@merck.com

BACKGROUND: Few recent studies have reported data on the incidence of herpes
zoster (HZ) in U.S. general clinical practice. OBJECTIVE: To estimate the age-
and sex-specific incidence of HZ among U.S. health plan enrollees. DESIGN: Data
for the years 2000 to 2001 were obtained from the Medstat MarketScan database,
containing health insurance enrollment and claims data from over 4 million U.S.
individuals. Incident HZ cases were identified through HZ diagnosis codes on
health care claims. The burden of HZ among high-risk individuals with recent care
for cancer, HIV, or transplantation was examined in sub-analyses. Overall
incidence rates were age- and sex-adjusted to the 2000 U.S. population.
PARTICIPANTS: MarketScan U.S. health plan enrollees of all ages. MEASUREMENTS AND
MAIN RESULTS: We identified 9,152 incident cases of HZ (3.2 per 1,000
person-years) (95% confidence interval [CI], 3.1 to 3.2 per 1,000). Annual HZ
rates per 1,000 person-years were higher among females (3.8) than males (2.6)
(P<.0001). HZ rates rose sharply with age, and were highest among individuals
over age 80 (10.9 per 1,000 person-years) (95% CI, 10.2 to 11.6). The incidence
of HZ per 1,000 person-years among patients with evidence of recent care for
transplantation, HIV infection, or cancer (10.3) was greater than for individuals
without recent care for these conditions (3.0) (P<.0001). CONCLUSIONS: The
overall incidence of HZ reported in the present study was found to be similar to 
rates observed in U.S. analyses conducted 10 to 20 years earlier, after age- and 
sex-standardizing estimates from all studies to the 2000 U.S. population. The
higher rate of HZ in females compared with males contrasts with prior U.S.
studies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16050886 [PubMed - indexed for MEDLINE]

1380: Drug Saf. 2005;28(8):741; author reply 742.

Comment on:
    Drug Saf. 2004;27(15):1217-33.

Tolerability of treatments for postherpetic neuralgia.

Alvarez NA.

Publication Types: 
    Comment
    Letter

PMID: 16048359 [PubMed - indexed for MEDLINE]

1381: Pediatr Blood Cancer. 2005 Dec;45(7):945-51.

Few but severe viral infections in children with cancer: a prospective RT-PCR and
PCR-based 12-month study.

Christensen MS, Nielsen LP, Hasle H.

Department of Pediatric Oncology, Skejby Hospital, Aarhus University Hospital,
Denmark. stubkjaer@ki.au.dk

BACKGROUND: Treatment of low-risk febrile episodes with oral administered
antibiotics at home is a new approach in pediatric oncology and protective
isolation is loosened in more centers. The impact of viral respiratory infections
in febrile diseases in this population is still unclear in terms of occurrence
and morbidity. PROCEDURE: A prospective follow-up study of all febrile episodes
during 12 months in a pediatric oncology department with a high level of
protective isolation was set-up with expanded molecular viral examinations.
Reverse transcriptase polymerase chain reaction (RT-PCR) and PCR diagnostics of
ten viruses, two atypical bacteria, and one fungus were performed and clinical
information on all infections was registered. RESULTS: A total of 250 febrile
episodes in 66 patients were registered. In all, 198 respiratory secretions,
predominantly oral washes, and 165 anal swabs were analyzed. Twenty-two
infections were diagnosed: 7 rhinovirus infections, 4 respiratory syncytial virus
(RSV) infections, 2 herpes simplex virus (HSV) infections, 2
varicella-zoster-virus (VZV) infections, 1 influenza B virus infection, 1
parainfluenza virus type 3 infection (PIV3), 1 human metapneumovirus (HMPV)
infection, 1 enterovirus infection, 0 adenovirus infections, 0 influenza A virus 
infections, and 3 non-viral pneumonias: 1 M. Pneumonia, 1 C. Pneumonia, and 1 P. 
Carinii. The detected pathogens correlated well to the clinical disease. Patients
with viral infections were as affected as patients with bacteria in the blood.
One of 19 viral infections was lethal, a RSV pneumonia. C-reactive protein
concentrations were not able to distinguish viral infections from bacteremias.
CONCLUSIONS: The applied sampling method was acceptable and molecular diagnosis
of viruses, atypical bacteria and P. Carinii increased the microbiological
verification of infections by 35%. Viral infections were few in our protected
population but caused severe infectious complications in these patients. 2005
Wiley-Liss, Inc.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 16047356 [PubMed - indexed for MEDLINE]

1382: Antiviral Res. 2005 Aug;67(2):56-75.

Antiviral drug discovery and development: where chemistry meets with biomedicine.

De Clercq E.

Rega Institute for Medical Research, K.U. Leuven, Minderbroedersstraat 10, B-3000
Leuven, Belgium. erik.declercq@rega.kuleuven.ac.be

The successful development of antiviral drugs is highly dependent on a close
interaction and collaboration between the chemist and the biologist (biomedic).
This is illustrated by a number of representative examples:
S-adenosylhomocysteine (SAH) hydrolase inhibitors which display broad-spectrum
antiviral activity, bromovinyldeoxyuridine (BVDU) and derivatives thereof, that
are highly selective inhibitors of varicella-zoster virus (VZV),
(dideoxy)nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside
reverse transcriptase inhibitors (NNRTIs) which are now widely used in the
treatment of HIV infections (AIDS), the bicyclams (i.e. AMD3100) which were
originally discovered as anti-HIV agents, then found to be potent CXCR4
antagonists and now being pursued for a number of indications such as stem cell
mobilization, and the acyclic nucleoside phosphonates which have heralded a new
strategy for the treatment of various DNA virus (herpes-, adeno-, pox-,
papillomavirus) infections (cidofovir), hepatitis B (adefovir) and AIDS
(tenofovir).

Publication Types: 
    Review

PMID: 16046240 [PubMed - indexed for MEDLINE]

1383: Graefes Arch Clin Exp Ophthalmol. 2006 Feb;244(2):210-5. Epub 2005 Jul 26.

Specific antibody production in herpes keratitis: intraocular inflammation and
corneal neovascularisation as predicting factors.

Robert PY, Liekfeld A, Metzner S, Ranger-Rogez S, Adenis JP, Denis F, Hartmann C,
Pleyer U.

Department of Ophthalmology, CHU Dupuytren, 2 av. Martin Luther King, 87042,
Limoges Cedex, France.

PURPOSE: The purpose of the study is to investigate whether analysis of specific 
antibody synthesis can aid the diagnosis of herpes keratitis. METHODS: Aqueous
humor was collected from 39 patients with presumed recurrent herpes keratitis,
including 23 consulting for keratitis and 16 patients scheduled for penetrating
keratoplasty. Local antibody production was ascertained by analysis of paired
aqueous humor/serum samples, using a modified micro-ELISA technique. RESULTS:
Local production of antibodies was found in 32 patients (82%): anti-herpes
simplex virus (HSV) antibodies in 26 (67%) and anti-varicella zoster virus (VZV) 
antibodies in 11 (28%). Twenty of 23 patients with active keratitis (87%), and 12
of 16 undergoing keratoplasty (75%), tested positive. Five patients had local
production of both anti-HSV and anti-VZV antibodies, whereas seven patients
tested negative. Local antibody production was significantly associated with
intraocular inflammation (P<0.05), corneal neovascularisation (P<0.05), and
positive response to anti-viral treatment (P<0.05). No complications were
encountered in sampling aqueous humor. CONCLUSIONS: Assessment of local anti-HSV 
and -VZV antibody production is a safe and reliable diagnostic procedure for
recurrent herpes keratitis. It might be particularly helpful in patients
presenting with intraocular inflammation and neovascularisation since it
discriminates between herpes and non-herpes pathologies and may therefore be
useful for preventive and therapeutic strategies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16044329 [PubMed - indexed for MEDLINE]

1384: J Virol Methods. 2005 Dec;130(1-2):89-94. Epub 2005 Jul 25.

A cosmid-based system for inserting mutations and foreign genes into the simian
varicella virus genome.

Gray WL, Mahalingam R.

Department of Microbiology and Immunology, Slot 511, University of Arkansas for
Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205, USA.
:graywaynel@uams.edu

Simian varicella is a natural varicella-like disease of nonhuman primates. The
etiologic agent, simian varicella virus (SVV), is genetically related to
varicella-zoster virus (VZV) and SVV infection of nonhuman primates is a useful
model to investigate VZV pathogenesis and latency. In this study, we report
development of a cosmid-based genetic system to generate SVV mutant viruses. SVV 
subgenomic DNA fragments (32-38kb) that span the viral genome were cloned into
cosmid vectors. Co-transfection of Vero cells with four overlapping cosmid clones
representing the entire SVV genome resulted in recombination and generation of
infectious virus. SVV mutants were produced by manipulation of one cosmid and
substitution into the genetic system. This genetic approach was used to insert a 
site-specific mutation within the SVV open reading frame 14 which encodes the
nonessential glycoprotein C gene. In a subsequent experiment, the green
fluorescent protein (GFP) gene was inserted into the SVV genome within ORF 14.
These SVV mutants replicate as efficiently as wild-type SVV in cell culture. This
cosmid-based genetic system will be useful to investigate the effect of viral
mutations on SVV pathogenesis and latency and also to develop and evaluate
recombinant varicella vaccines that express foreign antigens.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16043236 [PubMed - indexed for MEDLINE]

1385: Graefes Arch Clin Exp Ophthalmol. 2006 Feb;244(2):268-70. Epub 2005 Jul 23.

Periorbital necrotising fasciitis after minor trauma.

Balaggan KS, Goolamali SI.

Division of Molecular Therapy, Institute of Ophthalmology, 11-43 Bath Street,
London, EC1V 9EL, UK. kambalaggan@yahoo.co.uk

INTRODUCTION: Necrotising fasciitis or streptococcal gangrene is a rare and often
fatal soft tissue infection usually affecting the limbs and trunk. Facial
involvement is exceedingly rare due to the excellent blood supply of this region.
METHODS: We report a case of initially misdiagnosed streptococcal gangrene of the
eyelids precipitated by minor trauma and which progressed despite intensive
medical therapy. RESULTS: A 53-year-old man with a history of alcohol abuse
developed rapidly increasing left-sided periorbital oedema, erythema and skin
vesicles soon after sustaining a laceration to his left upper lid. It was
initially treated as herpes zoster ophthalmicus complicated by a secondary
bacterial cellulitis. Bacterial cultures grew group A beta haemolytic
Streptococcus pyogenes. Despite 8 days of high-dose parenteral antibiotic therapy
and oral acyclovir, characteristic blisters formed and necrosis of the
periorbital skin and subcutaneous tissues ensued. Surgical debridement was
performed and the fasciitis rapidly resolved. CONCLUSION: Physicians and
ophthalmologists must be aware of the risk factors, although rare, for
periorbital necrotising fasciitis and the cardinal signs that differentiate this 
condition from common non-necrotising preseptal cellulitis. Prompt recognition
and early surgical debridement are crucial in limiting the morbidity and
mortality from severe forms of this disease.

Publication Types: 
    Case Reports

PMID: 16041587 [PubMed - indexed for MEDLINE]

1386: Acta Derm Venereol. 2005;85(3):279-80.

Zosteriform morphea: a new pattern.

Joshi A, Al-Mutairi N.

Publication Types: 
    Case Reports
    Letter

PMID: 16040427 [PubMed - indexed for MEDLINE]

1387: J Clin Virol. 2006 Feb;35(2):141-6. Epub 2005 Jul 21.

QIAamp MinElute virus kit effectively extracts viral nucleic acids from
cerebrospinal fluids and nasopharyngeal swabs.

Sefers SE, Rickmyre J, Blackman A, Li H, Edwards K, Tang YW.

Department of Pathology, Vanderbilt University School of Medicine, Nashville, TN 
37232, USA.

BACKGROUND: Nucleic acid preparation from a variety of clinical specimens
requires efficient target recovery and amplification inhibitor removal and is
critical for successful molecular diagnosis. The QIAamp MinElute Virus kit
(Qiagen Inc., Valencia, CA) was compared to the two existing methods currently
used in our laboratory, IsoQuick (Orca Research Inc., Bothell, WA) for DNA
extraction and RNAzol B (Leedo Laboratories Inc., Houston, TX) for RNA
extraction, of viral nucleic acids. STUDY DESIGN: A total of 150 clinical
specimens, including cerebrospinal fluid (CSF) and nasopharyngeal swabs (NPS),
were used to determine the extraction efficiency of the MinElute compared to the 
other two methods. Nucleic acid recovery, hands-on time, turn-around-time and
cost were compared across all kits. RESULTS: There was complete concordance
between the MinElute and IsoQuick/RNAzol kits when herpes simplex virus (HSV),
Epstein-Barr virus (EBV), varicella-zoster virus (VZV), influenza A virus or
enteroviruses were detected using a colorimetric microtiter plate PCR system. The
kits were equivalent in their ability to detect either DNA or RNA with superior
ability to recover a high quality and quantity of RNA. With the potential to
process larger specimen volumes, the MinElute kit can significantly shorten
processing time from 2h to 50-55min. CONCLUSIONS: Although relatively high test
kit costs were noted, the MinElute kit provides another rapid and user-friendly
specimen processing tool in the diagnostic molecular microbiology laboratory.

Publication Types: 
    Evaluation Studies

PMID: 16039902 [PubMed - indexed for MEDLINE]

1388: Microbes Infect. 2005 Dec;7(15):1519-29. Epub 2005 Jul 1.

The varicella-zoster virus-mediated delayed host shutoff: open reading frame 17
has no major function, whereas immediate-early 63 protein represses heterologous 
gene expression.

Desloges N, Rahaus M, Wolff MH.

Institute of Microbiology and Virology, Private University of Witten/Herdecke,
Stockumer Street 10, D-58448, Germany.

We reported that varicella-zoster virus (VZV) causes a delayed host shutoff
during its replicative cycle. VZV open reading frame 17 (ORF17) is the homologue 
of the herpes simplex virus (HSV) UL41 gene encoding the virion host shutoff
(vhs) protein which is responsible for the shutoff effect observed in
HSV-infected cells. In the present study, we demonstrated that ORF17 is expressed
as a late protein during the VZV replicative cycle in different infected
permissive cell lines which showed a delayed shutoff of cellular RNA. A cell line
with stable expression of VZV ORF17 was infected with VZV. In these cells, VZV
replication and delayed host shutoff remained unchanged when compared to normal
infected cells. ORF17 was not capable of repressing the expression of the
beta-gal reporter gene under the control of the human cytomegalovirus
immediate-early gene promoter or to inhibit the expression of a CAT reporter gene
under the control of the human GAPDH promoter, indicating that ORF17 has no major
function in the VZV-mediated delayed host shutoff. To determine whether other
viral factors are involved in the host shutoff, a series of cotransfection assays
was performed. We found that the immediate-early 63 protein (IE63) was able to
downregulate the expression of reporter genes under the control of the two
heterologous promoters, indicating that this viral factor can be involved in the 
VZV-mediated delayed host shutoff. Other factors can be also implicated to
modulate the repressing action of IE63 to achieve a precise balance between the
viral and cellular gene expression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16039898 [PubMed - indexed for MEDLINE]

1389: Korean J Gastroenterol. 2005 Jul;46(1):48-55.

[Efficacy and safety of treatment with infliximab in Crohn's disease-the
experience of single center in Korea]

[Article in Korean]

Choi KD, Song HJ, Kim JS, Jung HC, Song IS.

Department of Internal Medicine and Liver Research Institute, Seoul National
University College of Medicine, Chongno-gu, Seoul, Korea.

BACKGROUND/AIMS: Infliximab has been shown to be effective and safe for treating 
refractory luminal and fistulizing Crohn's disease (CD). The aim of this study
was to report the efficacy and adverse effect of infliximab therapy in patients
with CD at our center. METHODS: Medical records of thirteen patients who were
treated with infliximab for refractory luminal or fistulizing CD were reviewed.
Clinical response was classified as complete response, partial response and
nonresponse. RESULTS: Seven patients were treated for fistulizing CD, four
patients for luminal CD, and two for both. The mean time of follow-up was 13.1
months (3.3-28.1 months). Clinical response was seen in 10/13 (77%); complete
response 7/13 (54%), partial response 3/13 (23%), nonresponse 3/13 (23%). Mean
time to response was 27.1 days (10-41 days). 4 of 10 responders (40%) maintained 
remission over 30 weeks. Those who started on immunosuppressive treatment more
than 3 months before infliximab infusion achieved lower early recurrence rate
(14%) compared with those less than 3 months (67%) (p=0.039). Steroid tapering
was successful in 7/12 (58%). Five patients required surgical therapy; three
nonresponders, one partial responder and one who recurred after initial complete 
response. Initial responders required less surgery than nonresponders (p=0.035). 
Acute infusion reactions were seen in 2/40 infusions (5%). One patient developed 
herpes zoster 20 weeks after infliximab infusion. During follow-up peried, no
patient developed serious infection, tuberculosis or malignancy. CONCLUSIONS:
Infliximab is effective and safe in clinical practice. Concurrent
immunosuppressive use is associated with lower rate of early recurrence.

Publication Types: 
    English Abstract

PMID: 16030404 [PubMed - indexed for MEDLINE]

1390: Nephrol Dial Transplant. 2005 Oct;20(10):2226-30. Epub 2005 Jul 19.

Leukocyte phenotype and function predicts infection risk in renal transplant
recipients.

Blazik M, Hutchinson P, Jose MD, Polkinghorne KR, Holdsworth SR, Atkins RC,
Chadban SJ.

Department of Renal Medicine, Royal Darwin Hospital, PO Box 41326, Casuarina, NT 
0811, Australia.

BACKGROUND: The degree to which transplant recipients are immunosuppressed
influences their risks of rejection, infection and cancer. Current measures of
immune suppression are crude (clinical events) or indirect (drug exposure). We
assessed a direct measure of immune status, leukocyte phenotype and function
(LPF, a composite measure of five aspects of peripheral blood leukocyte phenotype
and function), as a predictor of infection. METHODS: A double-blind, prospective,
cohort study was conducted, to determine the burden of infection in stable renal 
transplant recipients with moderate-severe (Group I, n = 34) or minimal (Group
II, n = 36) impairment of LPF, a composite score of: (i) CD4 count; (ii)
lymphocyte proliferation in response to phytohaemagglutinin A (PHA); (iii) serum 
Ig concentrations; (iv) neutrophil phagocytic function; and (v) reactive oxygen
species generation. Subjects completed a 6 month diary and each recorded
infection was scored 1-4: 1, minor undefined infection (e.g. URTI); 2, minor,
microbiologically defined infection (e.g. UTI); 3, major defined infection
(requiring hospitalization); 4, opportunistic infection (e.g. Herpes zoster).
Final infection score was the sum of all infective episodes. Subjects were then
followed-up for 5 years for outcome measures. RESULTS: Groups were well matched
for age, sex, diabetes, serum creatinine, rejection and trough cyclosporin
concentrations. Group I (moderate to severe impairment of LPF) recorded a higher 
infection score, 2.4+/-2.8 vs 1.2+/-1.2 for Group II, P = 0.02, due to a higher
incidence of moderate to severe infection. This relationship was confirmed by
multivariate analysis (OR 1.83, CI 1.08, 3.11, P = 0.03 per unit increase in
infection score). During the 5 year follow-up period they had significantly more 
episodes of admission to hospital, and twice as many admissions due to
infections, but no difference in malignancy, graft or patient outcome.
CONCLUSION: LPF testing prospectively identified a cohort who incurred a higher
burden of infection. Further studies are required to determine the predictive
value of LPF for acute rejection, infection and cancer, and to determine whether 
adjustments to therapy on the basis of LPF can lead to improved outcomes.

PMID: 16030032 [PubMed - indexed for MEDLINE]

1391: Virus Genes. 2005 Oct;31(2):223-7.

Distribution of latent herpes simplex virus type-1 and varicella zoster virus DNA
in human trigeminal Ganglia.

Cohrs RJ, Laguardia JJ, Gilden D.

Departments of Neurology, University of Colorado Health Sciences Center, 4200 E. 
9th Avenue, Mail Stop B182, Denver, CO 80262, USA. randall.cohrs@uchsc.edu

Trigeminal ganglia removed at autopsy from immunocompetent individuals without
cutaneous signs of herpesvirus infection were fixed, cut into 5-microm sections, 
and screened at 100-microm intervals (20 adjacent sections) by PCR for latent
herpes simplex type 1(HSV-1) and varicella zoster virus (VZV) DNA. Sections that 
contained >5 neurons with nuclei stained by hematoxylin/eosin revealed HSV-1 DNA 
in most samples and VZV DNA in approximately 50% of samples. HSV-1 and VZV DNA
were distributed throughout each latently infected ganglion.

Publication Types: 
    Research Support, N.I.H., Extramural

PMID: 16025248 [PubMed - indexed for MEDLINE]

1392: Clin Neurophysiol. 2005 Sep;116(9):2051-7.

Diagnostic relevance of transcranial magnetic and electric stimulation of the
facial nerve in the management of facial palsy.

Nowak DA, Linder S, Topka H.

Department of Psychiatry III, University of Ulm, Germany. dr.dennis.nowak@gmx.de

OBJECTIVE: Earlier investigations have suggested that isolated conduction block
of the facial nerve to transcranial magnetic stimulation early in the disorder
represents a very sensitive and potentially specific finding in Bell's palsy
differentiating the disease from other etiologies. METHODS: Stimulation of the
facial nerve was performed electrically at the stylomastoid foramen and
magnetically at the labyrinthine segment of the Fallopian channel within 3 days
from symptom onset in 65 patients with Bell's palsy, five patients with Zoster
oticus, one patient with neuroborreliosis and one patient with nuclear facial
nerve palsy due to multiple sclerosis. RESULTS: Absence or decreased amplitudes
of muscle responses to early transcranial magnetic stimulation was not specific
for Bell's palsy, but also evident in all cases of Zoster oticus and in the case 
of neuroborreliosis. Amplitudes of electrically evoked muscle responses were more
markedly reduced in Zoster oticus as compared to Bell's palsy, most likely due to
a more severe degree of axonal degeneration. The degree of amplitude reduction of
the muscle response to electrical stimulation reliably correlated with the
severity of facial palsy. CONCLUSIONS: Transcranial magnetic stimulation in the
early diagnosis of Bell's palsy is less specific than previously thought. While
not specific with respect to the etiology of facial palsy, transcranial magnetic 
stimulation seems capable of localizing the site of lesion within the Fallopian
channel. SIGNIFICANCE: Combined with transcranial magnetic stimulation, early
electrical stimulation of the facial nerve at the stylomastoid foramen may help
to establish correct diagnosis and prognosis.

Publication Types: 
    Clinical Trial

PMID: 16024292 [PubMed - indexed for MEDLINE]

1393: Med Clin (Barc). 2005 Jul 9;125(6):215-20.

[Treatment and prevention in herpes zoster]

[Article in Spanish]

Garcia A, Guerra-Tapia A, Torregrosa JV.

Hospital Universitario La Princesa, Madrid, Spain.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 16022835 [PubMed - indexed for MEDLINE]

1394: BMJ. 2005 Jul 16;331(7509):147-51.

Managing ophthalmic herpes zoster in primary care.

Opstelten W, Zaal MJ.

Julius Center for Health Sciences and Primary Care, University Medical Center
Utrecht, Netherlands. W.Opstelten@umcutrecht.nl

Publication Types: 
    Review

PMID: 16020856 [PubMed - indexed for MEDLINE]

1395: Acta Chir Iugosl. 2004;51(4):53-7.

[DREZ (dorsal root entry zone) surgery for the treatment of the postherpetic
intercostal neuralgia]

[Article in Serbian]

Spaic M, Ivanovic S, Slavik E, Antic B.

Klinika za neurohirurgiju, Vojnomedicinska akademija, Beograd.

Postherpetic intercostal neuralgia proved to be an incapacitating pain often
recalcitrant to therapy. Acute pain that accompanied Herpes zoster usually
subsides spontaneously but in 10% of patients the pain persists and intensifies. 
The incidence of postherpetic neuralgia incrises up to 50% among elder patients. 
We report the case of the two 42 and 48 yers old male patient who were succesfuly
relieved from the chronic postherpetic intercostal neuralgia employing the DREZ
surgery (Dorzal Root Entry Zone lesion). DREZ surgicall treatment of this pain
should be considered when medical therapies failed in controling pain. Subjective
sensory nature of the pain should play an important role in setting the
indication for DREZ surgical treatment. The most favourable pain pattern for DREZ
operation is the pain of intermittent rhythm, confined theritory accompanied with
the phenomenon of alodinic pain that could be provoked from the pain theritory.

Publication Types: 
    English Abstract

PMID: 16018410 [PubMed - indexed for MEDLINE]

1396: Acta Chir Iugosl. 2004;51(4):39-43.

[Neuralgias of the lower cranial nerves: microsurgical posterior fossa
exploration]

[Article in Serbian]

Antic B, Peric P, Ivanovic S, Spaic M.

Klinika za neurohirurgiju, Vojnomedicinska akademija, Beograd.

Neuralgias of the lower cranial nerves are trigeminal neuralgia (TN),
glossopharingeal neuralgia (GphN), and geniculate neuralgia (GN). Microsurgical
posterior fossa exploration with its variations microvascular decompression
(MVD), partial sensory rhisotomy (PSR), and total sensory rhisotomy (TSR) is one 
of the most efficient ways of treating these neuralgias. It was performed 130
operations in 125 patients with TN, 3 in GphN patients, 1 in GN patient, 1 in
GN/TN patients, 1 in GphN/GN patient, and 2 in GN/hemifacial spasm patients. Of
total of 125 patients with TN, MVD was performed in 63, PSR in 18, and MVD+PSR in
44 cases. In 5 patients with recidivate TN PSR was performed. Of total 3 patients
with GphN MVD was performed in 2 cases, and extirpation of a small meningeoma in 
1 case (it was not seen on CT). In the patients with GN TSR of intermediate nerve
was performed, in GN/TN patients TSR of intermediate nerve and PSR of trigeminal 
nerve was performed, in the GN/GphN patients MVD of glossopharingeal and TSR of
intermediate nerve were performed, and in the GN/hemifacial spasm patients TSR of
intermediate and MVD of facial nerve were performed. The results of TN patients
are: excellent in 82.4%, good in 12%, and poor in 5.6% of patients. There is no
difference in complete pain relief, rate of recurrence, and complications between
MVD, MVD+PSR and PSR operative groups (p0.05). Among patients with other
neuralgias the following results are noted: excellent in 4, good in 3, and poor
in 1 patient. Microsurgical posterior fossa exploration is the method of choice
in the treatment of the neuralgias of the lower cranial nerves.

Publication Types: 
    English Abstract

PMID: 16018407 [PubMed - indexed for MEDLINE]

1397: Acta Chir Iugosl. 2004;51(4):9-14.

Cancer pain (classification and pain syndromes).

Slavik E, Ivanovic S, Grujicic D.

Institute of Neurosurgery, Clinical Center of Serbia, Belgrade.

Inspite the new informations about the physiology and biochemistry of pain, it
remains true that pain is only partially understood. Cancer pain is often
experienced as several different types of pain, with combined somatic and
neuropathic types the most frequently. If the acute cancer pain does not subside 
with initial therapy, patients experience pain of more constant nature, the
characteristics of wich vary with the cause and the involved sites. Chronic pain 
related to cancer can be considered as tumor-induced pain, chemotherapy-induced
pain, and radiation therapy-induced pain. Certain pain mechanisms are present in 
cancer patients. These include inflammation due to infection, such as local
sepsis or the pain of herpes zoster, and pain due to the obstruction or occlusion
of a hollow organ, such as that caused by large bowel in cancer of colon. Pain
also is commonly due to destruction of tissue, such as is often seen with bony
metastases. Bony metastases also produce pain because of periostal irritation,
medullary pressure, and fractures. Pain may be produced by the growth of tumor in
a closed area richly supplied with pain receptors (nociceptors). Examples are
tumors growing within the capsule of an organ such as the pancreas. Chest pain
occurring after tumor of the lung or the mediastinum due to invasion of the
pleura. Certain tumors produce characteristic types of pain. For example, back
pain is seen with multiple myeloma, and severe shoulder pain and arm pain is seen
with Pancoast tumors.

Publication Types: 
    Review

PMID: 16018403 [PubMed - indexed for MEDLINE]

1398: PLoS Med. 2005 Jul;2(7):e164. Epub 2005 Jul 26.

Analgesic therapy in postherpetic neuralgia: a quantitative systematic review.

Hempenstall K, Nurmikko TJ, Johnson RW, A'Hern RP, Rice AS.

Royal Hampshire County Hospital, Winchester, United Kingdom.

BACKGROUND: Postherpetic neuralgia (PHN) is a complication of acute herpes
zoster, which is emerging as a preferred clinical trial model for chronic
neuropathic pain. Although there are published meta-analyses of analgesic therapy
in PHN, and neuropathic pain in general, the evidence base has been substantially
enhanced by the recent publication of several major trials. Therefore, we have
conducted a systematic review and meta-analysis for both efficacy and adverse
events of analgesic therapy for PHN. METHODS AND FINDINGS: We systematically
searched databases (MEDLINE 1966-2004, EMBASE 1988-2004, CINAHL 1982-2002, and
PubMed [29 October 2004]) for trials of PHN. We also searched references of
retrieved studies and review articles for further trials. We included trials that
examined adult patients with PHN of greater duration than 3 mo, that were
blinded, randomised, and had at least one measure of pain outcome. Dichotomous
pain outcome data were extracted for 50% decrease in baseline pain using a
hierarchy of pain/pain-relief measurement tools. Where available, dichotomous
data were also collected for adverse events. Calculated estimates of efficacy
included relative benefit and number needed to treat. Of 62 studies identified,
35 were randomised controlled trials. Of these, 31 were placebo controlled and
suitable for meta-analysis, from which it was possible to extract dichotomous
efficacy outcome data from 25. This meta-analysis revealed that there is evidence
to support the use of the following orally administered therapies: tricyclic
antidepressants, "strong" opioids, gabapentin, tramadol, and pregabalin. Topical 
therapies associated with efficacy were lidocaine 5% patch and capsaicin.
Finally, a single study of spinal intrathecal administration of lidocaine and
methyl prednisolone demonstrated efficacy, although this has yet to be
replicated. Data suggest that the following therapies are not associated with
efficacy in PHN: certain NMDA receptor antagonists (e.g., oral memantine, oral
dextromethorphan, intravenous ketamine), codeine, ibuprofen, lorazepam, certain
5HT1 receptor agonists, and acyclovir. Topical administration of benzydamine,
diclofenac/diethyl ether, and vincristine (iontophoresis) are similarly not
associated with efficacy, nor are intrathecal administration of lidocaine alone
or epidural administration of lidocaine and methylprednisolone, intravenous
therapy with lidocaine, subcutaneous injection of Cronassial, or acupuncture.
However, many of the trials that demonstrated a lack of efficacy represented
comparatively low numbers of patient episodes or were single-dose studies, so it 
may be appropriate to regard such interventions as "not yet adequately tested"
rather than demonstrating "no evidence of efficacy." Topical aspirin/diethyl
ether has not been adequately tested. CONCLUSION: The evidence base supports the 
oral use of tricyclic antidepressants, certain opioids, and gabapentinoids in
PHN. Topical therapy with lidocaine patches and capsaicin is similarly supported.
Intrathecal administration of methylprednisolone appears to be associated with
high efficacy, but its safety requires further evaluation.

Publication Types: 
    Review

PMID: 16013891 [PubMed - indexed for MEDLINE]

1399: Neurology. 2005 Jul 12;65(1):170.

Delayed oculomotor nerve palsy after bilateral cervical zoster in an
immunocompetent patient.

Karmon Y, Gadoth N.

Department of Neurology, Meir General Hospital, Kfar Saba 44281, Israel.

Publication Types: 
    Case Reports

PMID: 16009918 [PubMed - indexed for MEDLINE]

1400: Clin Transplant. 2005 Aug;19(4):566-70.

Fatal varicella zoster virus encephalitis in two patients following allogeneic
hematopoietic stem cell transplantation.

Hackanson B, Zeiser R, Bley TA, Pantazis G, Huzly D, Bertz H, Finke J.

Department of Hematology/Oncology, Freiburg University Medical Center, Freiburg, 
Germany. hackanson@mm11.ukl.uni-freiburg.de

BACKGROUND: Reduced cellular immunocompetence following allogeneic hematopoietic 
stem cell transplantation (aHSCT) increases susceptibility to viral infections.
Varicella zoster virus (VZV) reactivation in this setting most commonly manifests
as dermatomal herpes zoster but in some cases life-threatening VZV encephalitis
occurs. STUDY DESIGN/RESULTS: We describe the cases of two patients who presented
with shingles 3 and 18 months, respectively, after HLA-matched peripheral blood
stem cell transplantation (PBSCT). Unfortunately, in the further clinical course 
both patients developed fatal VZV encephalitis, despite initial high-dose
intravenous therapy with acyclovir and in one case with additional
VZV-immunoglobulin. CONCLUSION: These two cases suggest that rapid intervention
with systemic treatment is warranted and raise the question whether initial
combination therapy with intravenous acyclovir and foscarnet, VZV vaccination or 
long-term low-dose acyclovir are needed to improve treatment and clinical outcome
in immunocompromised patients, having undergone allogeneic HSCT.

Publication Types: 
    Case Reports

PMID: 16008607 [PubMed - indexed for MEDLINE]

1401: Fam Pract. 2005 Oct;22(5):523-8. Epub 2005 Jul 8.

Do herpes zoster patients receive antivirals? A Dutch National Survey in General 
Practice.

Opstelten W, van Essen GA, Moons KG, van Wijck AJ, Schellevis FG, Kalkman CJ,
Verheij TJ.

Julius Center for Health Sciences and Primary Care, University Medical Center
Utrecht, The Netherlands. w.opstelten@med.uu.nl

BACKGROUND: The main complications of herpes zoster (HZ) are postherpetic
neuralgia and, in case of HZ ophthalmicus, eye disorders. Antiviral treatment may
modify the course of disease and reduce the risk of complications. OBJECTIVE: To 
assess which doctors' and patients' characteristics were related to prescription 
of antiviral therapy for HZ. METHODS: Ninety general practices (358 008 patients)
in The Netherlands registered all patient contacts in a database for one year as 
part of the Second Dutch National Survey of General Practice. The present study
used ICPC code S70 to search that database for patients with a new diagnosis of
HZ. The full-text medical records of the selected patients were then reviewed and
the potential determinants for the prescription of antiviral drugs (including
characteristics of patients, GPs, and practices) analysed using multilevel
logistic regression modelling. RESULTS: Of the 1129 patients diagnosed with HZ
(incidence 3.2/1000 patients/year), 22.5% received antiviral drugs. Independent
determinants for prescription of antiviral therapy were age [45-54 years:
adjusted odds ratio (OR) 2.9 (95% CI 1.6-5.0); 55-64 years: OR 4.2 (95% CI
2.4-7.6); 65-74 years: OR 5.1 (95% CI 2.7-9.6); > or =75 years: OR 8.1 (95% CI
4.4-15.1)], ophthalmic localisation of the shingles (OR 3.2, 95% CI 1.6-6.7), and
the presence of asthma/COPD (OR 1.6, 95% CI 1.0-2.6). GPs who reported to
strongly adhere to professional guidelines prescribe more frequently antiviral
drugs (OR 1.9, 95% CI 1.2-3.1). CONCLUSIONS: A minority of HZ patients were
prescribed antiviral treatment. Increasing age, ophthalmic localisation, presence
of asthma/COPD, and adherence to professional guidelines were factors favouring
prescription. More information on the determinants of GPs' treatment decisions is
necessary for successful implementation of HZ guidelines.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16006497 [PubMed - indexed for MEDLINE]

1402: J Virol Methods. 2005 Oct;129(1):97-100.

Rapid, differential diagnosis of orthopox- and herpesviruses based upon real-time
PCR product melting temperature and restriction enzyme analysis of amplicons.

Carletti F, Di Caro A, Calcaterra S, Grolla A, Czub M, Ippolito G, Capobianchi
MR, Horejsh D.

Laboratory of Virology, National Institute for Infectious Diseases Lazzaro
Spallanzani - IRCCS, Via Portuense, 292, 00149 Rome, Italy.

Orthopoxviruses tend to have non-specific early symptoms that cannot be
differentiated readily from other infectious exanthemas, such as varicella-zoster
virus (VZV) or disseminated herpes simplex virus (HSV) infections. A rapid assay 
was developed for the differential diagnosis of orthopoxviruses and herpesviruses
based upon the melting temperatures of real-time PCR amplicons. A mean melting
temperature difference of 8.7 degrees C was observed between the products
amplified from the two virus families. Further identification of individual
pathogens was made using restriction enzyme analysis. The assay was able to
identify correctly viruses from quality control panels of herpes and
orthopoxviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16005086 [PubMed - indexed for MEDLINE]

1403: Int J STD AIDS. 2005 Jul;16(7):475-8.

Herpes zoster as an immune restoration disease in AIDS patients during therapy
including protease inhibitors.

Dunic I, Djurkovic-Djakovic O, Vesic S, Zerjav S, Jevtovic D.

Institute of Dermatovenereology, School of Medicine, University of Belgrade,
Belgrade. iva001@eunet.yu

A prospective study to evaluate the incidence of herpes zoster (HZ) as an immune 
restoration disease in patients with AIDS during highly active antiretroviral
therapy (HAART) was conducted in a series of 115 patients diagnosed with AIDS
initiated on HAART between 1 January 2000 and 31 July 2001. Of these, a single
dermatomal HZ episode occurred in 14 (12%) patients within one and 15 months of
HAART (median eight months). The HZ patients were similar to the non-HZ patients 
in age, sex, and HIV transmission risk factor, but had a more advanced disease.
Compared with the baseline values, the viral loads significantly (P<0.01)
decreased, while the mean CD4+ T-cell counts increased by almost four-fold
(P<0.01) in both groups at the time of the HZ episode (or equivalent in non-HZ), 
but remained below 400/mL in the HZ patients. HZ during HAART is an
immunopathological consequence of the improvement of the host immuneresponse,
correlating with the beginning of immune restoration.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 16004625 [PubMed - indexed for MEDLINE]

1404: Antivir Chem Chemother. 2005;16(3):155-68.

Achievements and challenges in antiviral drug discovery.

Littler E, Oberg B.

Medivir UK, Little Chesterford, Essex, UK. eddy.littler@medivir.com

The last 40 years have seen the development of several antiviral drugs with
therapeutic value in treating life-threatening or debilitating diseases such as
those caused by HIV, hepatitis B virus, herpesviruses (such as herpes simplex
virus and varicella zoster virus) and influenza virus. These relatively recent
advances have been due to technical breakthroughs in the cultivation of viruses
in the laboratory, identification of viral enzymes and, more recently, their
molecular biology. We describe here the antecedence of several of the existing
antivirals and their strengths and weaknesses. We indicate where the major
challenges lie for future improvements of current therapies and possible new
indications, such as hepatitis C virus and papillomavirus. We also describe how
current antiviral therapies are restricted to a rather limited number of viral
diseases of sufficient interest to the pharmaceutical industry. Finally we
describe the potential threat of emerging viruses and bio-weapons and the
challenges that they present to therapy.

Publication Types: 
    Review

PMID: 16004079 [PubMed - indexed for MEDLINE]

1405: Arch Phys Med Rehabil. 2005 Jul;86(7):1492-4.

Segmental zoster paresis of the upper extremity: a case report.

Yoleri O, Olmez N, Oztura I, Sengul I, Gunaydin R, Memis A.

Physical Medicine and Rehabilitation department, Ataturk Training and Research
Hospital, Izmir, Turkey. yoleri@superonline.com

Segmental zoster paresis, a rare complication of herpes zoster, is characterized 
by focal, asymmetric motor weakness in the myotome that corresponds to the
dermatome of the rash. The pathogenesis of segmental zoster paresis is
inflammation caused by the spread of the herpes virus. Motor damage may affect
the root, plexus, or peripheral nerve. A woman in her early seventies with right 
shoulder pain and shoulder girdle muscle weakness was diagnosed with involvement 
of the C5-7 motor roots and upper truncus of the brachial plexus as a
complication of herpes zoster. Recognition of herpes zoster as a cause of acute
motor weakness is important in avoiding unnecessary interventions as well as in
determining the treatment and outcome of the patient. This case is presented to
emphasize that herpes zoster infection may be complicated by segmental paresis,
which should be considered in the differential diagnosis of acute painful motor
weakness of the upper extremity.

Publication Types: 
    Case Reports

PMID: 16003688 [PubMed - indexed for MEDLINE]

1406: Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2005 Apr;19(7):297-9.

[Auditory brain stem response assessment in Ramsay Hunt syndrome]

[Article in Chinese]

Wu H, Yin S, Lu W, Yi H.

Department of Otorhinolaryngology and Ear Laboratory, Affiliated Sixth People's
Hospital of Shanghai Jiaotong University, Shanghai Hearing Measuring Center,
Shanghai, 200233, China.

OBJECTIVE: To discuss the changes of the auditory brain stem response in patients
with Ramsay Hunt syndrome. METHOD: Thirty-six patients of Ramsay Hunt
syndrome,who have only unilateral involvement with contralateral good ear, were
studied with pure tone test and auditory brain stem response. The latencies of
peaks I, III and V and interpeak latencies of I-III, I-V and III-V in bilateral
ears were analyzed by SPSS 10.0 for windows. RESULT: Compared to the
controlateral, the affected ears were significantly increased in latencies of II,
V and interpeak latencies of I-III, I-V ( P < 0.05). CONCLUSION: The audiological
data suggested that cochlear or retrocochlear involvement or involvement at more 
than one site along the auditory pathway existed in Ramsay Hunt syndrome, but
pure cochlear hearing loss is not common.

Publication Types: 
    English Abstract

PMID: 16001894 [PubMed - indexed for MEDLINE]

1407: An Otorrinolaringol Ibero Am. 2005;32(3):253-9.

Postoperative Ramsay-Hunt syndrome after acoustic neuroma resection. Viral
reactivation.

Magliulo G, D'Amico R, Celebrini A, Cuiuli G.

Otorhinolaryngology, Audiology And Phoniatrics Department, G. Ferreri, University
La Sapienza, Rome, Italy.

The aim of this paper is to present a patient suffering from acoustic neuroma and
operated on with immediate postoperative hearing and facial function preservation
who developed delayed Ramsay-Hunt syndrome. To our knowledge, this is the first
case in whom a postoperative delayed facial palsy and hearing loss occurred. The 
patient gave an history of previously diagnosed herpes zoster reactivation
limited to chest one-year before. This is undoubtdetly a predisposing factor for 
development of delayed facial palsy. It must not be underestimated and it obliges
to consider a prophylaxis. Theoretically, the prophylactic antiviral therapy
might prevent the evolution towards the herpes zoster oticus or reduce the
severity of the symptoms allowing the preservation of the hearing function. It
would be pointed out that the delayed facial plasy has favourable prognosis,
while the hearing impairment may recover with a greater difficulty even after an 
antiviral treatment as in our case.

Publication Types: 
    Case Reports

PMID: 16001695 [PubMed - indexed for MEDLINE]

1408: Nucl Med Commun. 2005 Aug;26(8):689-94.

Potential pitfalls of 18F-FDG PET in a large series of patients treated for
malignant lymphoma: prevalence and scan interpretation.

Castellucci P, Nanni C, Farsad M, Alinari L, Zinzani P, Stefoni V, Battista G,
Valentini D, Pettinato C, Marengo M, Boschi S, Canini R, Baccarani M, Monetti N, 
Franchi R, Rampin L, Fanti S, Rubello D.

Nuclear Medicine Department, S. Orsola-Malpighi Hospital, Bologna, Italy.

OBJECTIVE: To evaluate the prevalence and scan interpretation criteria useful in 
identifying non-tumoural F-FDG focal uptakes (potential pitfalls) in patients who
had been previously treated for a malignant lymphoma studied by positron emission
tomography (PET). MATERIALS: Nine hundred and ninety-six consecutive PET scans
obtained in 706 patients with malignant lymphoma were reviewed. All patients had 
been previously treated by first-line chemo-radiotherapy, plus surgery when
required, and were then studied by FDG PET to investigate suspected recurrence at
doubtful or inconclusive conventional radiological imaging (ultrasound, computed 
tomography, magnetic resonance imaging). PET was obtained with patients in the
fasted condition and after i.v. injection of 370 MBq of F-FDG; imaging was
acquired 60-90 min later. In patients with focal FDG uptake the final diagnosis
was reached on the basis of histological findings or long-term follow-up.
RESULTS: Thirty-one of 134 PET scans (23.1%) showing focal FDG uptake were
diagnosed as non-tumoural radiotracer uptake, related to the presence of brown
fat in seven cases, thymic hyperplasia in five, muscles contraction in four,
lymph node unspecific inflammation in four, mediastinal/pulmonary unspecific
inflammation in four, gastritis in two, colitis in two, bacterial abscess in one,
lactating breast in one, and herpes zoster in one. Each of the above cited
situations has been reported in the literature, generally in the form of sporadic
reports, as a potential cause of misinterpretation (false positive) in reading a 
PET scan with the potential for incorrect patient management. An accurate
diagnosis in these patients was important for the following therapeutic decision 
making. CONCLUSIONS: In the whole series of patients with treated malignant
lymphoma, the prevalence of non-tumoural FDG focal uptake during follow-up was
relatively low (3.1%); conversely, it was relatively high when considering the
sub-group of 'positive' PET only (23.1%). The importance of knowing these
situations in order to avoid misinterpretation in reading PET scans needs to be
emphasized. In this light, an accurate patient's history and a skilful nuclear
medicine physician are very important factors. For the same purpose, it is
reasonable to think that the use of hybrid PET/CT tomographs could also play an
important role in helping to identify non-tumoural FDG focal uptake.

PMID: 16000986 [PubMed - indexed for MEDLINE]

1409: J Clin Microbiol. 2005 Jul;43(7):3290-6.

Sensitive and rapid detection of herpes simplex virus and varicella-zoster virus 
DNA by loop-mediated isothermal amplification.

Kaneko H, Iida T, Aoki K, Ohno S, Suzutani T.

Department of Microbiology, Fukushima Medical University School of Medicine, 1
Hikarigaoka, Fukushima 960-1295, Japan.

Loop-mediated isothermal amplification (LAMP) is a novel nucleic acid
amplification method in which reagents react rapidly and efficiently, with a high
specificity, under isothermal conditions. We used a LAMP assay for the detection 
of herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), and 
varicella-zoster virus (VZV). The virus specificities of primers were confirmed
by using 50 HSV-1, 50 HSV-2, and 8 VZV strains. The assay was performed for 45
min at 65 degrees C. The LAMP assay had a 10-fold higher sensitivity than a PCR
assay. An analysis of nucleotide sequence variations in the target and primer
regions used for the LAMP assay indicated that 3 of 50 HSV-1 strains had single
nucleotide polymorphisms. No HSV-2 or VZV strains had nucleotide polymorphisms.
Regardless of the sequence variation, there were no differences in sensitivity
with the HSV-1-specific LAMP assay. To evaluate the application of the LAMP assay
for clinical diagnosis, we tested clinical samples from 40 genital herpes
patients and 20 ocular herpes patients. With the LAMP assay, 41 samples with DNA 
extraction and 26 direct samples without DNA extraction were identified as
positive for HSV-1 or HSV-2, although 37 samples with DNA extraction and just one
without DNA extraction were positive by a PCR assay. Thus, the LAMP assay was
less influenced than the PCR assay by the presence of inhibitory substances in
clinical samples. These observations indicate that the LAMP assay is very useful 
for the diagnosis of HSV-1, HSV-2, and VZV infections.

Publication Types: 
    Evaluation Studies

PMID: 16000450 [PubMed - indexed for MEDLINE]

1410: J Neurol. 2005 Jul;252(7):869-71.

Vaccination against herpes zoster, small RNA against ALS and IgG antibodies in
stiff-person syndrome.

Strupp M.

Dept. of Neurology, Ludwig-Maximilians University, Klinikum Grosshadern,
Marchioninistr. 15, 81366 Munich, Germany. Michael.Strupp@med.uni-muenchen.de

Publication Types: 
    Comparative Study

PMID: 15999237 [PubMed - indexed for MEDLINE]

1411: Haematologica. 2005 Jul;90(7):996-7.

Analysis of the efficacy and toxicity of bortezomib for treatment of relapsed or 
refractory multiple myeloma in community practice.

Wu KL, van Wieringen W, Vellenga E, Zweegman S, Lokhorst HM, Sonneveld P.

The clinical data on the efficacy and toxicity of bortezomib as treatment for
multiple myeloma patients are restricted to prospective phase II studies in
expert myeloma centers. Here we report a multi-institutional analysis of the
efficacy and toxicity of bortezomib in patients with relapsed or refractory
multiple myeloma who were treated in community centers in a compassionate need
program.

Publication Types: 
    Clinical Trial
    Letter

PMID: 15996946 [PubMed - indexed for MEDLINE]

1412: Med Sci Monit. 2005 Jul;11(7):BR200-5. Epub 2005 Jun 29.

Liquid-liquid systems for acid hydrolysis of glycoalkaloids from Solanum
tuberosum L. tuber sprouts and solanidine extraction.

Nikolic NC, Stankovic MZ, Markovic DZ.

Faculty of Technology, University of Nish, Leskovac, Serbia and Montenegro.
nikolac_n2002@yahoo.com

BACKGROUND: Potato sprouts (Solanum tuberosum L.) contain steroidal
glycoalkaloids containing solanidine, an important precursor for hormone
synthesis. Glycoalkaloids are reported to inactivate the Herpes simplex, Herpes
zoster and Herpes genitalis viruses in humans, while Aglyones, including
solasodine, may protect against skin cancer. Extracts of glycoalkaloids or
solanidine can be used to obtain a potential skin cancer preparation for clinical
research. MATERIAL/METHODS: Dried potato sprouts were used to obtain
glycoalkaloids and solanidine. The hydrolysis of glycoalkaloids in a
liquid-liquid system was performed using a reflux condenser, obtaining extracts
of glycolakaloids from dried and milled potato tuber sprouts. Hydrochloric acid
was then added to the extract to form the first (aqueous) phase, and chloroform, 
trichloroethylene or carbon tetrachloride to form the second (organic) phase of
the liquid-liquid system. In this way, glycoalkaloid hydrolysis to solanidine and
solanidine extraction in the organic liquid phase were combined into a single
step. IR and GC/MS analysis of solanidine was also conducted. RESULTS: Based on
the results we obtained, the optimal liquid-liquid system was found to be 2% w/v 
hydrochloric acid in a 50% (volume) methanolic extract of glycoalkaloids from
tuber sprouts, as the first phase, and chloroform as the second phase. Using this
system, a yield of 1.46 g solanidine per 100 g of dried potato sprouts can be
achieved. CONCLUSIONS: Glycoalkaloid hydrolysis in a liquid-liquid system yields 
the aglycone solanidine can be obtained from dried potato sprouts. The yield of
solanidine is higher than that obtained using solid-liquid-liquid systems for
glycoalkaloid hydrolysis from potato vines.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15990680 [PubMed - indexed for MEDLINE]

1413: Neurologist. 2005 Jul;11(4):244-9.

Facial pain.

Hentschel K, Capobianco DJ, Dodick DW.

Mayo Clinic College of Medicine, Mayo Graduate School of Medicine, Jacksonville, 
FL, USA.

Facial pain is a common symptom that may be a feature of a primary headache
disorder or a secondary feature of organic disease. A thorough clinical history
and physical examination may reveal the characteristic clinical features and
assist in diagnosis. However, in some cases, the etiology may remain
indeterminate.

Publication Types: 
    Case Reports
    Review

PMID: 15989697 [PubMed - indexed for MEDLINE]

1414: J Microbiol Immunol Infect. 2005 Jun;38(3):218-20.

Thymoma and hypogammaglobulinemia (Good's syndrome): a case report.

Tsai YG, Lai JH, Kuo SY, Chen HC, Chang DM.

Department of Pediatrics, Christian Hospital, Institute of Medical Research,
Chang Jung Christian University, Changhua, Taiwan.

Good's syndrome is extremely rare and refers to an acquired B and T cell
immunodeficiency in thymoma patients. We report a 51-year-old female thymoma
patient who presented with recurrent herpes zoster, pneumonia, diarrhea and
opportunistic infections. She was found to have acquired hypogammaglobulinemia
with absent B cells. Despite repeat intravenous immunoglobulin replacement and
antibiotic therapy, she died of bacterial pneumonia-induced acute respiratory
distress syndrome. Clinicians should look for evidence of immunologic dysfunction
in thymoma patients presenting with recurrent infections.

Publication Types: 
    Case Reports

PMID: 15986073 [PubMed - indexed for MEDLINE]

1415: Reprod Toxicol. 2006 May;21(4):410-20. Epub 2005 Jun 23.

Chickenpox in pregnancy: revisited.

Tan MP, Koren G.

The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The
Hospital for Sick Children, University of Toronto, Ont., Canada.

Varicella infection during the first and second trimester of pregnancy may
increase the risk for congenital varicella syndrome 0.5-1.5% above the baseline
risk for major malformation. Third trimester infection may lead to maternal
pneumonia which can be life threatening if not treated appropriately.
Varicella-zoster immune globulin (VZIG) should be administered as soon as
possible preferably within 96 h from exposure to prevent maternal infection or
subsequent complications. Later than 96 h, the effectiveness of VZIG has not been
evaluated. Neonatal varicella is more severe if maternal rash appears 5 days
prior to or 2 days after delivery. The newborn should be given VZIG immediately. 
Intravenous acyclovir is recommended for maternal pneumonia and severely affected
neonate. No controlled study has yet evaluated the effectiveness of acyclovir or 
valacyclovir for postexposure prophylaxis to pregnant women or neonates. Unlike
primary varicella infection in pregnancy, herpes zoster has not been documented
to cause complications unless in the disseminated form. The advent of advanced
imaging techniques and molecular biotechniques has improved prenatal diagnosis.
With increase use of vaccination, the incidence of chickenpox in pregnancy is
expected to decline in the future.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 15979274 [PubMed - indexed for MEDLINE]

1416: Prescrire Int. 2005 Jun;14(77):85-91.

Chickenpox vaccines: new drugs. A favourable risk-benefit balance in some
situations.

[No authors listed]

(1) Chickenpox is generally mild. Most severe cases of chickenpox occur in
immunocompromised patients, adults, and pregnant women (and their foetuses). (2) 
Two live attenuated chickenpox vaccines derived from the same strain of varicella
virus (Oka) are marketed in France, under the trade names Varilrix and Varivax.
(3) They have not been adequately evaluated in immunocompromised children. (4)
The impact of routine vaccination of women of child-bearing age on complications 
of chickenpox during pregnancy has not been studied. (5) Immunogenicity studies
in several thousand immunocompetent children aged from 1 to 12 years show that
the vaccine is almost always immunogenic after a single injection. Other
comparative studies in adolescents and adults show that two injections are
needed, at least two months apart. (6) A double-blind placebo-controlled trial
including 513 immunocompetent children showed that Varilrix prevented 88% of
cases of chickenpox after a median follow-up of 29 months, but no data on severe 
chickenpox were reported. A study that followed up 9202 children aged 1 to 12
years for more than 13 years showed that vaccination with Varivax failed to
prevent chickenpox in 12.5% of cases and that 1.7% of these cases were severe.
(7) Immunocompetent children vaccinated within three days after exposure to the
virus are partially protected, according to one study of Varilrix (104 children) 
and two small studies of Varivax (10 and 42 children). There are no equivalent
studies in adults. (8) Local adverse effects such as fever and rash are common in
immunocompetent vaccinees. The rash is sometimes varicella-like and is due to
infection by the vaccine strain. Pharmacovigilance studies of Varivax have shown 
no serious adverse effects. (9) Disseminated and/or persistent infection caused
by the vaccine strain has been reported in immunocompromised patients. (10)
Vaccination of immunocompetent subjects does not appear to result in a risk of
chickenpox transmission to subsequent contacts. There seems to be no increase in 
the risk of herpes zoster in vaccinated children nor is there any firm evidence
that chickenpox vaccination increases the incidence of herpes zoster in the
general population. (11) Little information is available on vaccination during
pregnancy. As a precaution, however, pregnant women should not be vaccinated.
(12) Mass vaccination does not appear to be justified: chickenpox is generally
mild during childhood, and several questions concerning the effects of the
vaccine remain unanswered. (13) Chickenpox vaccination should be restricted to
specific groups of non immune immunocompetent adults who are in a position to
transmit chickenpox to immunodeficient contacts (e.g. health care personnel and
kindergarten staff); adults who have been in contact with a case of chickenpox
within the past three days; and children awaiting transplantation. The potential 
benefits and risks of vaccinating immunocompromised patients should be assessed
on a case by case basis.

Publication Types: 
    Comparative Study

PMID: 15977369 [PubMed - indexed for MEDLINE]

1417: Time. 2005 Jun 13;165(24):67.

A shingles vaccine.

Gorman C.

Publication Types: 
    News

PMID: 15974024 [PubMed - indexed for MEDLINE]

1418: J Neurol Sci. 2005 Oct 15;237(1-2):97-101.

Unilateral retrobulbar optic neuritis due to varicella zoster virus in a patient 
with AIDS: a case report and review of the literature.

Liu JZ, Brown P, Tselis A.

Department of Anesthesiology, Detroit Medical Center, Wayne State University,
Detroit, MI 48201, United States.

Unilateral retrobulbar optic neuritis developed in a 43-year-old man with
acquired immune deficiency syndrome (AIDS). This was secondary to varicella
zoster virus (VZV) as confirmed by cerebrospinal fluid (CSF) polymerase chain
reaction (PCR) detection of VZV in the cerebrospinal fluid. There was no typical 
cutaneous infection and no evidence of retinitis. The onset of unexplained visual
loss due to optic neuritis in HIV positive individuals may be due to VZV
infection. Prompt recognition, and early intervention with antiVZV therapy may
preserve vision. Retrobulbar optic neuritis secondary to VZV infection should be 
considered in immunocompromised patients even in the absence of cutaneous or
retinal lesions. Previous cases are reviewed and the varied nature of viral
transport in the nervous system is noted.

Publication Types: 
    Case Reports

PMID: 15972220 [PubMed - indexed for MEDLINE]

1419: Br J Ophthalmol. 2005 Jul;89(7):923-4.

"Ecstasy" induced immunosuppression and herpes zoster ophthalmicus.

Zwick OM, Fischer DH, Flanagan JC.

Publication Types: 
    Case Reports
    Letter

PMID: 15965183 [PubMed - indexed for MEDLINE]

1420: Lancet. 2005 Jun 18-24;365(9477):2105-15.

Comment in:
    Lancet. 2005 Sep 3-9;366(9488):806-7; author reply 807.

Antiviral medications to prevent cytomegalovirus disease and early death in
recipients of solid-organ transplants: a systematic review of randomised
controlled trials.

Hodson EM, Jones CA, Webster AC, Strippoli GF, Barclay PG, Kable K, Vimalachandra
D, Craig JC.

National Health and Medical Research Council Centre for Clinical Research
Excellence, Centre for Kidney Research, The Children's Hospital at Westmead,
Sydney, Australia. Elisah@chw.edu.au

BACKGROUND: Antiviral prophylaxis is commonly used in recipients of solid-organ
transplants with the aim of preventing the clinical syndrome associated with
cytomegalovirus infection. We undertook a systematic review to investigate
whether this approach affects risks of cytomegalovirus disease and death.
METHODS: Randomised controlled trials of prophylaxis with antiviral medications
for cytomegalovirus disease in solid-organ-transplant recipients were identified.
Data were combined in meta-analyses by a random-effects model. FINDINGS: Compared
with placebo or no treatment, prophylaxis with aciclovir, ganciclovir, or
valaciclovir significantly reduced the risks of cytomegalovirus disease (19
trials, 1981 patients; relative risk 0.42 [95% CI 0.34-0.52]), cytomegalovirus
infection (17 trials, 1786 patients; 0.61 [0.48-0.77]), and all-cause mortality
(17 trials, 1838 patients; 0.63 [0.43-0.92]), mainly owing to lower mortality
from cytomegalovirus disease (seven trials, 1300 patients; 0.26 [0.08-0.78]).
Prophylaxis also lowered the risks of disease caused by herpes simplex or zoster 
virus, bacterial infections, and protozoal infections, but not fungal infection, 
acute rejection, or graft loss. Meta-regression showed no significant difference 
in the risk of cytomegalovirus disease or all-cause mortality by organ
transplanted or cytomegalovirus serostatus; no conclusions were possible for
cytomegalovirus-negative recipients of negative organs. In trials of direct
comparisons, ganciclovir was more effective than aciclovir in preventing
cytomegalovirus disease. Valganciclovir and intravenous ganciclovir were as
effective as oral ganciclovir. INTERPRETATION: Prophylaxis with antiviral
medications reduces the risk of cytomegalovirus disease and associated mortality 
in recipients of solid-organ transplants. This approach should be used routinely 
in cytomegalovirus-positive recipients and in cytomegalovirus-negative recipients
of organs positive for the virus.

Publication Types: 
    Review

PMID: 15964447 [PubMed - indexed for MEDLINE]

1421: J Virol Methods. 2005 Sep;128(1-2):162-7.

Development and evaluation of Varicella zoster virus ELISA for oral fluid
suitable for epidemiological studies.

Talukder Y, Gopal R, Andrews N, Glenn M, Breuer J, Brown D.

Centre for Infectious Disease, Department of Virology, Barts and The London
School of Medicine and Dentistry, 25-29 Ashfield St., London E1 1BB, UK.
ingrej@gmail.com

An enzyme-linked immunosorbent assay (ELISA) for detection of Varicella zoster
virus (VZV) antibodies in oral fluid is described. The assay was optimised and
evaluated using paired serum and oral fluid from healthy adult volunteers (n =
205) and preschool children (n = 98), oral fluid samples collected for routine
measles, mumps and rubella testing (n = 537) and samples from a study of atopic
dermatitis (n = 252). As chickenpox is predominantly a childhood disease and most
adults are immune, it was crucial to have samples from children aged 1-5 years to
evaluate the assay. Mixture modelling of the oral fluid results was used to
determine the optimum cut-off, sensitivity and specificity of the assay. Compared
to paired sera tested by the same ELISA the sensitivity of the oral fluid assay
was 93% and specificity 95.7% overall, varying slightly with age group. The assay
was shown to have good potential for use in large-scale epidemiological studies.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 15961168 [PubMed - indexed for MEDLINE]

1422: Herpes. 2004 Dec;11(3):63-5.

Pain following herpes zoster: implications for management.

Johnson RW.

Pain Management Clinic, Level 4, Bristol Royal Infirmary, Bristol BS2 8HW, UK.
rwjbristol@doctors.org.uk

At the 11th Annual Meeting of the International Herpes Management Forum (IHMF),
held 27-29 February 2004, I delivered the Martin Wood Memorial Lecture on the
management of herpes zoster-associated pain. Prevention of post-herpetic
neuralgia is an important goal in the management of herpes zoster. Recognition of
individuals at high risk of progression, followed by prompt intervention with
antiviral agents, helps to reduce the disability, distress and healthcare
resource utilization caused by this disease and its consequences. In established 
cases of post-herpetic neuralgia, first line therapy with tricyclic
antidepressants and second line therapy with some anticonvulsants and opioids
have both shown efficacy in many patients, but development of more effective
treatments is needed for optimal outcomes.

Publication Types: 
    Review

PMID: 15960902 [PubMed - indexed for MEDLINE]

1423: BMC Public Health. 2005 Jun 16;5:68.

The incidence of varicella and herpes zoster in Massachusetts as measured by the 
Behavioral Risk Factor Surveillance System (BRFSS) during a period of increasing 
varicella vaccine coverage, 1998-2003.

Yih WK, Brooks DR, Lett SM, Jumaan AO, Zhang Z, Clements KM, Seward JF.

Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard 
Pilgrim Health Care, Boston, USA. katherine_yih@harvardpilgrim.org

BACKGROUND: The authors sought to monitor the impact of widespread varicella
vaccination on the epidemiology of varicella and herpes zoster. While varicella
incidence would be expected to decrease, mathematical models predict an initial
increase in herpes zoster incidence if re-exposure to varicella protects against 
reactivation of the varicella zoster virus. METHODS: In 1998-2003, as varicella
vaccine uptake increased, incidence of varicella and herpes zoster in
Massachusetts was monitored using the random-digit-dial Behavioral Risk Factor
Surveillance System. RESULTS: Between 1998 and 2003, varicella incidence declined
from 16.5/1,000 to 3.5/1,000 (79%) overall with > or = 66% decreases for all age 
groups except adults (27% decrease). Age-standardized estimates of overall herpes
zoster occurrence increased from 2.77/1,000 to 5.25/1,000 (90%) in the period
1999-2003, and the trend in both crude and adjusted rates was highly significant 
(p < 0.001). Annual age-specific rates were somewhat unstable, but all increased,
and the trend was significant for the 25-44 year and 65+ year age groups.
CONCLUSION: As varicella vaccine coverage in children increased, the incidence of
varicella decreased and the occurrence of herpes zoster increased. If the
observed increase in herpes zoster incidence is real, widespread vaccination of
children is only one of several possible explanations. Further studies are needed
to understand secular trends in herpes zoster before and after use of varicella
vaccine in the United States and other countries.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15960856 [PubMed - indexed for MEDLINE]

1424: Med Monatsschr Pharm. 2005 Jun;28(6):188-92.

[Chickenpox (Varicella) and shingles (Herpes zoster)]

[Article in German]

[No authors listed]

PMID: 15960420 [PubMed - indexed for MEDLINE]

1425: Nippon Rinsho. 2005 May;63 Suppl 5:619-24.

[Varicella-zoster virus vaccine]

[Article in Japanese]

Asano Y.

Department of Pediatrics, Fujita Health University School of Medicine.

Publication Types: 
    Review

PMID: 15954419 [PubMed - indexed for MEDLINE]

1426: Clin Neurophysiol. 2005 Jul;116(7):1542-54.

Excitability of facial nucleus and related brain-stem reflexes in hemifacial
spasm, post-facial palsy synkinesis and facial myokymia.

Oge AE, Yayla V, Demir GA, Eraksoy M.

Department of Neurology, Istanbul University, Istanbul Faculty of Medicine, Capa 
34390, Istanbul, Turkey. aemreoge@superonline.com

OBJECTIVE: To compare the electrophysiological excitability characteristics of
the facial nucleus and related structures in hemifacial spasm (HFS), post-facial 
palsy synkinesis (PFPS) and facial myokymia (FM). METHODS: Facial F-waves, blink 
reflex recoveries and magnetically elicited silent periods (SP) were
prospectively studied in 17 HFS, 17 PFPS, 8 FM cases and in 13 controls. Earlier 
unpublished observations on abnormal impulse transmission in 36 HFS and 29 PFPS
cases were also included. RESULTS: Enhanced F-waves were recorded on the
symptomatic side in PFPS and HFS cases with a tendency to be more pronounced in
PFPS. HFS and PFPS groups both showed an earlier blink reflex recovery, more
prominent in PFPS patients, when stimulated and/or recorded on the symptomatic
side. Unelicitable SPs were encountered after 24/39 stimulations in 5 patients
with PFPS and rarely in HFS cases. Duration of elicitable SPs did not change
remarkably. FM group had similar characteristics as normal controls in the 3
electrophysiological tests. Latencies of the lateral and synkinetic spread
responses were significantly prolonged in the earlier PFPS group as compared to
HFS. In two-point stimulation, both groups showed a greater latency shift in late
responses, again more pronounced in PFPS. CONCLUSIONS: PFPS and HFS cases had
similar enhanced excitability patterns at the facial nucleus and related
brain-stem structures, more marked on the symptomatic side and more obvious in
the PFPS group. Findings elicited in the FM group were thought to be caused by
asynchronous hyperactivity of facial motoneurons. SIGNIFICANCE: In this
comparative electrophysiological study, similar excitability patterns were found 
in HFS and PFPS groups, albeit with different intensities.

Publication Types: 
    Comparative Study

PMID: 15953558 [PubMed - indexed for MEDLINE]

1427: Am J Ophthalmol. 2005 Jun;139(6):1135-6.

Comment in:
    Am J Ophthalmol. 2006 Apr;141(4):782; author reply 782.

Chronic recurrent varicella-zoster virus keratitis confirmed by polymerase chain 
reaction testing.

Magone MT, Nasser RE, Cevallos AV, Margolis TP.

Francis I. Proctor Foundation, University of California-San Francisco, San
Francisco, CA 94143-0944, USA. tm@magones.com

PURPOSE: To report a case of chronic recurrent varicella virus epithelial
keratitis in a child. DESIGN: Case report. METHODS: Clinical examination and
polymerase chain reaction analysis of corneal epithelium. RESULTS: A 10-year-old 
healthy child developed chronic recurrent varicella virus keratitis with
pseudodendrites after recovering from systemic varicella. Analysis of the
debrided pseudodendrites was repeatedly positive for VZV DNA and negative for HSV
DNA. Treatment with oral acyclovir and topical corticosteroid drops was effective
in eliminating the pseudodendrites; however, recurrences occurred once the
medications were discontinued. CONCLUSIONS: Varicella virus epithelial keratitis 
in children can be a recurrent chronic condition requiring prolonged treatment.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 15953460 [PubMed - indexed for MEDLINE]

1428: Saudi Med J. 2005 May;26(5):869-71.

Congenital varicella-zoster virus infection. A rare case of severe brain and
ocular malformations without limb or cutaneous involvement in a newborn after
maternal subclinical infection.

Al-Katawee YA, Al-Hasoun YA, Taha MN, Al-Moslem K.

Department of Neonatology Al-Yamamah Hospital, PO Box 106208, Riyadh 11666,
Kingdom of Saudi Arabia. yrshmh@hotmail.com

Although congenital varicella-zoster virus VZV infection is rare, it carries
serious morbidity and mortality to the fetus and newborn infant. We report a full
term female newborn infant, born to a multipara unbooked mother who had VZV
subclinical infection during the first trimester of pregnancy. Routine newborn
examination showed cystic malformation of the left eye, and absence of the right 
eye globe. Radiological work up revealed severe brain and eye malformations,
serological studies of both mother and baby were positive for VZV. The baby
underwent palliative surgery to the eyes, upon discharge, a plan of
multidisciplinary team was made for follow up including neurologist,
ophthalmologist, pediatrician and social worker. Congenital VZV infection can be 
severe enough to cause catastrophic fetal anomalies and damage to the vital
organs as many of those infants die in infancy.

Publication Types: 
    Case Reports

PMID: 15951887 [PubMed - indexed for MEDLINE]

1429: J Hand Surg [Br]. 2005 Aug;30(4):355-7.

Herpes zoster in the ulnar nerve distribution.

Athwal GS, Bartsich SA, Weiland AJ.

Hand and Upper Limb Centre, University of Western Ontario, London, Ontario,
Canada.

Varicella zoster is a ubiquitous virus which usually affects school-aged children
as Chicken Pox. While the initial disease is self-limiting and seldom severe, the
virus remains in the body. It lies dormant in the dorsal root ganglia and
reactivation may occur years later with variable presentations as Herpes Zoster, 
or Shingles. While Shingles is common, it rarely presents exclusively in the
upper extremity. It is important that hand surgeons recognize the possibility of 
zoster infection, with or without a rash, when evaluating the onset of neuralgia 
in a dermatomal distribution in the upper limb. Early diagnosis allows rapid and 
appropriate treatment, with a lower risk of complications. We report on a case of
Herpes Zoster isolated to the ulnar nerve distribution in a young woman.

Publication Types: 
    Case Reports

PMID: 15950335 [PubMed - indexed for MEDLINE]

1430: J Pain. 2005 Jun;6(6):356-63.

Pain, medication use, and health-related quality of life in older persons with
postherpetic neuralgia: results from a population-based survey.

Oster G, Harding G, Dukes E, Edelsberg J, Cleary PD.

Policy Analysis Inc, Brookline, Massachusetts 02445, USA. goster@pai2.com

Persons aged >65 years with pain caused by postherpetic neuralgia (PHN) were
recruited via advertisements in 24 US newspapers and were mailed a questionnaire 
that addressed pain intensity (average, worst, least, current), pain interference
(with general activity, mood, relations with other people, sleep, enjoyment of
life), and health-related quality of life (using the EuroQoL health measure
[EQ-5D] and a global rating scale). Respondents also were asked about their use
of medication for shingles pain. A total of 385 persons completed the survey; 61%
were >75 years of age. Mean (+/-standard deviation) duration of PHN was 3.3
(+/-4.0) years. Only about one half had taken prescription medication for
shingles pain during the prior week; dosages were typically low. Mean average,
worst, least, and current pain caused by shingles (0- to 10-point scale) was 4.6 
(+/-2.1), 6.0 (+/-2.4), 2.9 (+/-2.3), and 4.0 (+/-2.7), respectively. Mean pain
interference with general activity, mood, relations with other people, sleep, and
enjoyment of life (0- to 10-point scale) was 3.7 (+/-3.1), 4.3 (+/-2.9), 3.0
(+/-2.8), 3.8 (+/-2.9), and 4.5 (+/-3.1), respectively. The mean EQ-5D health
index score was 0.61; respondents rated their overall health as 65.7 (+/-21.1) on
a 100-point scale. PHN causes substantial pain, dysfunction, and poor
health-related quality of life in older persons, many of whom might be
suboptimally treated. PERSPECTIVE: Many older persons (age >65 years) with PHN
experience longstanding, severe, and debilitating pain and poor health-related
quality of life; levels of dissatisfaction with treatment are high. Our study
highlights the need for improved management of this disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15943957 [PubMed - indexed for MEDLINE]

1431: Am J Transplant. 2005 Jul;5(7):1777-80.

Concurrent verrucous and varicelliform rashes following renal transplantation.

Jeyaratnam D, Robson AM, Hextall JM, Wong W, MacMahon E.

Department of Infection, St John's Institute of Dermatology, St Thomas' Hospital,
London SE1 7EH, UK.

Verrucous rashes associated with varicella zoster virus (VZV) infection are well 
recognized in HIV infection. Seen rarely in transplant patients, no
histologically confirmed case has been published in the transplant setting. We
now report chronic, localized, verrucous VZV in a renal transplant recipient
presenting with cutaneous dissemination. This case highlights the need to
consider chronic VZV infection in the differential diagnosis of skin lesions even
in the VZV seronegative transplant recipient without substantial exposure to
antiviral agents.

Publication Types: 
    Case Reports
    Review

PMID: 15943639 [PubMed - indexed for MEDLINE]

1432: Int J Dermatol. 2005 Jun;44(6):524-5.

Morphea with features of lichen sclerosus et atrophicus at the site of a herpes
zoster scar: another case of an isotopic response.

Forschner A, Metzler G, Rassner G, Fierlbeck G.

Publication Types: 
    Case Reports
    Letter

PMID: 15941448 [PubMed - indexed for MEDLINE]

1433: MMW Fortschr Med. 2005 May 5;147(18):35-8.

[Problems and diseases of the aging skin]

[Article in German]

Goebeler M, Brocker EB.

Klinik fur Dermatologie, Venerologie und Allergologie, Klinikum Mannheim gGmbH,
Universitatsklinikum, Ruprecht-Karls-Universitat Heidelberg.

Publication Types: 
    Review

PMID: 15934586 [PubMed - indexed for MEDLINE]

1434: N Engl J Med. 2005 Jun 2;352(22):2344-6.

Comment in:
    N Engl J Med. 2005 Sep 29;353(13):1414-5; author reply 1414-5.

Comment on:
    N Engl J Med. 2005 Jun 2;352(22):2271-84.

Varicella-zoster virus vaccine--grown-ups need it, too.

Gilden DH.

Publication Types: 
    Comment
    Editorial

PMID: 15930426 [PubMed - indexed for MEDLINE]

1435: N Engl J Med. 2005 Jun 2;352(22):2271-84.

Comment in:
    ACP J Club. 2005 Nov-Dec;143(3):61.    N Engl J Med. 2005 Jun 2;352(22):2266-7.    N Engl J Med. 2005 Jun 2;352(22):2344-6.    N Engl J Med. 2005 Sep 29;353(13):1414-5; author reply 1414-5.    N Engl J Med. 2005 Sep 29;353(13):1414-5; author reply 1414-5.    N Engl J Med. 2007 Jul 5;357(1):89.    Nat Clin Pract Neurol. 2005 Nov;1(1):18-9.

A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.

Oxman MN, Levin MJ, Johnson GR, Schmader KE, Straus SE, Gelb LD, Arbeit RD,
Simberkoff MS, Gershon AA, Davis LE, Weinberg A, Boardman KD, Williams HM, Zhang 
JH, Peduzzi PN, Beisel CE, Morrison VA, Guatelli JC, Brooks PA, Kauffman CA,
Pachucki CT, Neuzil KM, Betts RF, Wright PF, Griffin MR, Brunell P, Soto NE,
Marques AR, Keay SK, Goodman RP, Cotton DJ, Gnann JW Jr, Loutit J, Holodniy M,
Keitel WA, Crawford GE, Yeh SS, Lobo Z, Toney JF, Greenberg RN, Keller PM,
Harbecke R, Hayward AR, Irwin MR, Kyriakides TC, Chan CY, Chan IS, Wang WW,
Annunziato PW, Silber JL; Shingles Prevention Study Group.

Shingles Prevention Study (Mail code 111F-1), VA San Diego Healthcare System,
3350 La Jolla Village Dr., San Diego, CA 92161,USA. mnoxman@ucsd.edu

BACKGROUND: The incidence and severity of herpes zoster and postherpetic
neuralgia increase with age in association with a progressive decline in
cell-mediated immunity to varicella-zoster virus (VZV). We tested the hypothesis 
that vaccination against VZV would decrease the incidence, severity, or both of
herpes zoster and postherpetic neuralgia among older adults. METHODS: We enrolled
38,546 adults 60 years of age or older in a randomized, double-blind,
placebo-controlled trial of an investigational live attenuated Oka/Merck VZV
vaccine ("zoster vaccine"). Herpes zoster was diagnosed according to clinical and
laboratory criteria. The pain and discomfort associated with herpes zoster were
measured repeatedly for six months. The primary end point was the burden of
illness due to herpes zoster, a measure affected by the incidence, severity, and 
duration of the associated pain and discomfort. The secondary end point was the
incidence of postherpetic neuralgia. RESULTS: More than 95 percent of the
subjects continued in the study to its completion, with a median of 3.12 years of
surveillance for herpes zoster. A total of 957 confirmed cases of herpes zoster
(315 among vaccine recipients and 642 among placebo recipients) and 107 cases of 
postherpetic neuralgia (27 among vaccine recipients and 80 among placebo
recipients) were included in the efficacy analysis. The use of the zoster vaccine
reduced the burden of illness due to herpes zoster by 61.1 percent (P<0.001),
reduced the incidence of postherpetic neuralgia by 66.5 percent (P<0.001), and
reduced the incidence of herpes zoster by 51.3 percent (P<0.001). Reactions at
the injection site were more frequent among vaccine recipients but were generally
mild. CONCLUSIONS: The zoster vaccine markedly reduced morbidity from herpes
zoster and postherpetic neuralgia among older adults. Copyright 2005
Massachusetts Medical Society.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 15930418 [PubMed - indexed for MEDLINE]

1436: N Engl J Med. 2005 Jun 2;352(22):2266-7.

Comment on:
    N Engl J Med. 2005 Jun 2;352(22):2271-84.

Aging, immunity, and the varicella-zoster virus.

Arvin A.

Stanford University School of Medicine, Stanford, Calif, USA.

Publication Types: 
    Comment

PMID: 15930416 [PubMed - indexed for MEDLINE]

1437: Neurol Sci. 2005 May;26 Suppl 2:s68-70.

Typical facial neuralgias.

Aguggia M.

Neurological Department, Via Edilio Raggio 12, I-15057, Novi Ligure AL, Italy.
aguggiamarco@tiscali.it

Neuralgia denotes a sharp, shooting, lancinating pain that is momentary but
characteristically recurs. It may be precipitated by touch to a sensitive area
("trigger zone"), or may occur spontaneously. Cranial neuralgias are commonly
distinct in two groups: typical neuralgias and atypical facial pain. Unlike
headache syndromes, which are mediated centrally, neuralgias are more
characteristic of peripheral nerve localisation. Neuralgias may follow nerve
trauma, herpes zoster infections or may arise spontaneously. The management of
this group of painful conditions is complicated by the area of the body involved 
and the interaction of organic and psychological factors.

Publication Types: 
    Review

PMID: 15926024 [PubMed - indexed for MEDLINE]

1438: Neuropharmacology. 2005 Sep;49(3):283-92.

Involvement of cyclooxygenase-2 and EP3 prostaglandin receptor in acute herpetic 
but not postherpetic pain in mice.

Takasaki I, Nojima H, Shiraki K, Sugimoto Y, Ichikawa A, Ushikubi F, Narumiya S, 
Kuraishi Y.

Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, Toyama
Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
takasaki@ms.toyama-mpu.ac.jp

The precise mechanisms of zoster-associated pain and postherpetic neuralgia
remain unknown. Inoculation of mice with herpes simplex virus type-1 elicits
acute herpetic pain- and delayed postherpetic pain-related responses. We
investigated the role of prostaglandins (PGs) and their synthases in both types
of pain. Deficiency in EP3 but not EP1, IP or TP prostanoid receptor markedly
diminished the acute herpetic pain and resulted in the decrease of the incidence 
of the delayed postherpetic pain. Preventive but not therapeutic administration
of the EP3 antagonist ONO-AE3-240 inhibited the acute herpetic pain. The
non-selective cyclooxygenase (COX) inhibitor diclofenac and the selective COX-2
inhibitors NS-398 and JTE-522 dose dependently reduced the acute herpetic pain,
and NS-398 was without effect on delayed postherpetic pain. COX-2 was induced and
PGE2 content was increased in the affected dorsal root ganglia at the stage of
acute herpetic pain. COX-2-like immunoreactivities were found around the nuclear 
membrane of many dorsal root ganglion neurons that were negative for herpesvirus 
antigen. COX-2 mRNA expression and PGE2 content in the affected dorsal root
ganglia at the stage of delayed postherpetic pain were similar to those of naive 
mice. The propagation of herpes virus in dorsal root ganglion may induce COX-2
and produce PGE2 in uninfected neurons. The results suggest the important roles
of COX-2 induction and the PGE2-EP3 receptor system in the dorsal root ganglia in
the development but not maintenance of acute herpetic pain. It was further
confirmed that the PG systems do not play a key role in delayed postherpetic
pain.

PMID: 15925391 [PubMed - indexed for MEDLINE]

1439: Minerva Stomatol. 2005 Mar;54(3):161-3.

Systemic B-cell chronic lymphocytic leukemia first presenting as a cutaneous
infiltrate arising at the site of a herpes simplex scar.

Kakagia D, Tamiolakis D, Lambropoulou M, Kakagia A, Grekou A, Papadopoulos N.

Department of Surgery, Thraki Medical Center, Alexandroupolis, Greece.

Cutaneous infection by Herpes virus (simplex or zoster) is a common non-specific 
skin manifestation in patients affected by B-cell chronic lymphocytic leukemia
(B-CLL) or other malignant lymphomas and is attributed to the patients'
immunodeficiency. Persistent or shortly recurrent lesions, however, may represent
specific cutaneous infiltrates of systemic B-CLL of several months' duration. The
occurrence of these lesions as first manifestation of B-CLL is rare and
previously reported only on herpes zoster scars. A case of a 63-year-old male
patient with cutaneous B-CLL infiltrate of the right oral commissure at the site 
of herpes simplex scar as first sign of the disease is herein reported.

Publication Types: 
    Case Reports

PMID: 15920448 [PubMed - indexed for MEDLINE]

1440: Transplant Proc. 2005 May;37(4):1806-7.

Splenic radiation and double-filtration plasmapheresis in crossmatch-positive
live renal transplantation.

Ravichandran P, Nataraj T, Jaganath C.

Institute of Organ Transplantation, St. Thomas Hospital, Chennai, India.
ravirekah@hotmail.com

Double-filtration plasmapheresis (DFPP) and splenectomy prior to transplant is
used in a few centers for high-risk transplantations. We undertook a prospective 
study to examine the outcome of 16 kidney transplantations in crossmatch-positive
patients using splenic radiation and DFPP as pretransplant immunomodification
procedures. All patients received a single dose of Zenapax (50 mg intravenously
[IV] 8 hours before transplant), before treatment with cyclosporine,
mycophenolate mofetil, and steroids immediately posttransplant. Follow-up ranged 
from 3 months to 1 year. Hyperacute rejection requiring graft nephrectomy was
necessary in one patient; acute rejection, which was seen in three patients, was 
reversed with five doses of Iort3 at 1-month posttransplant the mean creatinine
was 1.3 +/- 0.6 mg/dL in patients who did not have rejection and 1.9 +/- 0.3
mg/dL in the three patients who had acute rejection. Six patients were switched
from cyclosporine to sirolimus. At the end of 3 months the mean creatinine levels
was 1.4 +/- 0.3 mg%. The infections included oral candida (n = 2), urinary tract 
infection (UTI) (n = 1), bacterial pneumonia (n = 1), and herpes zoster (n = 1). 
With the advent of modern immunosuppressants, pretransplant immunomodification
with DFPP and splenic radiation is safe and effective. Splenic radiation is
devoid of surgical risk and more acceptable to patients.

Publication Types: 
    Clinical Trial

PMID: 15919473 [PubMed - indexed for MEDLINE]

1441: Cell Biol Educ. 2005 Summer;4(2):123-37.

Points of view: a survey of survey courses: are they effective?

Eisen A, Batzli JM, Becker D, Fambrough DM, Pearlman R, Shingles R, Brosnan R,
Ledbetter ML, Campbell AM.

Department of Biology, Emory University, Atlanta, GA 30322, USA.

PMID: 15917871 [PubMed - indexed for MEDLINE]

1442: JAMA. 2005 May 25;293(20):2459-60.

When shingles wanes but pain does not: researchers target chronic postherpetic
neuralgia.

Hampton T.

Publication Types: 
    News

PMID: 15914732 [PubMed - indexed for MEDLINE]

1443: Neurosurg Focus. 2005 May 15;18(5):E3.

Trigeminal neuralgia: definition and classification.

Eller JL, Raslan AM, Burchiel KJ.

Department of Neurological Surgery, Oregon Health and Science University,
Portland, Oregon 97239-3098, USA.

Based on specific, objective, and reproducible criteria, a classification scheme 
for trigeminal neuralgia (TN) and related facial pain syndromes is proposed. Such
a classification scheme is based on information provided in the patient's history
and incorporates seven diagnostic criteria, as follows. 1) and 2) Trigeminal
neuralgia Types 1 and 2 (TN1 and TN2) refer to idiopathic, spontaneous facial
pain that is either predominantly episodic (as in TN1) or constant (as in TN2) in
nature. 3) Trigeminal neuropathic pain results from unintentional injury to the
trigeminal nerve from trauma or surgery. 4) Trigeminal deafferentation pain
results from intentional injury to the nerve by peripheral nerve ablation,
gangliolysis, or rhizotomy in an attempt to treat either TN or other related
facial pain. 5) Symptomatic TN results from multiple sclerosis. 6) Postherpetic
TN follows a cutaneous herpes zoster outbreak in the trigeminal distribution. 7) 
The category of atypical facial pain is reserved for facial pain secondary to a
somatoform pain disorder and requires psychological testing for diagnostic
confirmation. The purpose of a classification scheme like this is to advocate a
more rigorous, standardized natural history and outcome studies for TN and
related facial pain syndromes.

PMID: 15913279 [PubMed - indexed for MEDLINE]

1444: Neurology. 2005 May 24;64(10):1682-8.

Characteristics and clinical applications of vestibular-evoked myogenic
potentials.

Welgampola MS, Colebatch JG.

Institute of Neurological Sciences, Prince of Wales Hospital and School of
Medicine, University of New South Wales, Sydney, Australia.
m.welgampola@unsw.edu.au

A recent technique of assessing vestibular function, the vestibular-evoked
myogenic potential (VEMP), is an otolith-mediated, short-latency reflex recorded 
from averaged sternocleidomastoid electromyography in response to intense
auditory clicks delivered via headphones. Since their first description 10 years 
ago, VEMPs are now being used by investigators worldwide, and characteristic
changes observed with aging and in a variety of peripheral and central
vestibulopathies have been described. Additional methods of evoking VEMPs, which 
use air- and bone-conducted short-tone bursts, forehead taps, and short-duration 
transmastoid direct current (DC) stimulation, have been described, and these
complement the original technique. Click-evoked VEMPs are attenuated or absent in
a proportion of patients with vestibular neuritis, herpes zoster oticus, late
Meniere disease, and vestibular schwannomas; their amplitudes are increased and
thresholds are pathologically lowered in superior semicircular canal dehiscence
presenting with the Tullio phenomenon. VEMPs evoked by clicks and DC are useful
when monitoring the efficacy of intratympanic gentamicin therapy used for
chemical vestibular ablation. Prolonged p13 and n23 peak latencies and decreased 
amplitudes have been observed in association with central vestibulopathy. VEMPs
evoked by clicks are a robust, reproducible screening test of otolith function.
DC stimulation enables differentiation of labyrinthine from retrolabyrinthine
lesions; bone-conducted stimuli permit VEMP recording despite conductive hearing 
loss and deliver a relatively larger vestibular stimulus for a given level of
auditory perception.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 15911791 [PubMed - indexed for MEDLINE]

1445: Am J Dermatopathol. 2005 Jun;27(3):189-94.

Exclusive involvement of folliculosebaceous units by herpes: a reflection of
early herpes zoster.

Walsh N, Boutilier R, Glasgow D, Shaffelburg M.

Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.
noreen.walsh@cdha.nshealth.ca

The histopathological changes of herpes simplex, herpes zoster, and varicella are
considered to be indistinguishable from one another. Evaluation of the clinical
setting, with adjunctive studies if necessary, generally clarifies the specific
diagnosis. Vesicular lesions in all three conditions can involve epidermal and
adnexal epithelium with characteristic cytopathic features. We describe three
patients with non-vesicular eruptions on the head and neck whose biopsies
revealed exclusive folliculosebaceous involvement by herpes. All three patients
developed typical herpes zoster within days of the biopsy. There is compelling
scientific evidence in the literature indicating that, in herpes zoster, the
virus is transported from dorsal root or trigeminal ganglia via myelinated nerves
to the skin. These terminate at the isthmus of hair follicles and primary
infection of follicular and sebaceous epithelium occurs. Spread of infection to
the epidermis follows. In contrast, data pertaining to recurrent herpes simplex
indicates that axonal transport of the virus from sensory ganglia to the skin is 
directed primarily to the epidermis, via terminal non-myelinated nerve twigs. The
clinical evolution of our three cases and scientific data in the literature
indicate that exclusive folliculosebaceous involvement by herpes, in the setting 
of a non-vesicular eruption, represents early herpes zoster.

Publication Types: 
    Case Reports

PMID: 15900120 [PubMed - indexed for MEDLINE]

1446: J Infect Dis. 2005 Jun 15;191(12):2002-7. Epub 2005 May 12.

Comment in:
    J Infect Dis. 2005 Jun 15;191(12):1999-2001.

Incidence of herpes zoster, before and after varicella-vaccination-associated
decreases in the incidence of varicella, 1992-2002.

Jumaan AO, Yu O, Jackson LA, Bohlke K, Galil K, Seward JF.

Centers for Disease Control and Prevention, Atlanta, Georgia 30345, USA.
ajumaan@cdc.gov

BACKGROUND: Varicella zoster virus (VZV) causes varicella and, later in the life 
of the host, may reactivate to cause herpes zoster (HZ). Because it is
hypothesized that exposure to varicella may boost immunity to latent VZV, the
vaccination-associated decrease in varicella disease has led some to suggest that
the incidence of HZ might increase. We assessed the impact that varicella
vaccination has on the incidence of varicella and of HZ. METHODS: Codes for cases
of varicella and of HZ in an HMO were determined in automated databases of
inpatients and outpatients, on the basis of the Ninth Revision of the
International Classification of Diseases. We calculated the incidence, during
1992-2002, of varicella and of HZ. RESULTS: The incidence of HZ remained stable
as the incidence of varicella decreased. Age-adjusted and -specific annual
incidence rates of varicella decreased steadily, starting with 1999. The
age-adjusted rates decreased from 2.63 cases/1000 person-years during 1995 to
0.92 cases/1000 person-years during 2002; among children 1-4 years old, there was
a 75% decrease between 1992-1996 and 2002. Age-adjusted and -specific annual
incidence rates of HZ fluctuated slightly over time; the age-adjusted rate was
highest, at 4.05 cases/1000 person-years, in 1992, and was 3.71 cases/1000
person-years in 2002. CONCLUSIONS: Our findings revealed that the
vaccination-associated decrease in varicella disease did not result in an
increase in the incidence of HZ. These early findings will have to be confirmed
as the incidence of varicella disease continues to decrease.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15897984 [PubMed - indexed for MEDLINE]

1447: J Infect Dis. 2005 Jun 15;191(12):1999-2001. Epub 2005 May 12.

Comment on:
    J Infect Dis. 2005 Jun 15;191(12):2002-7.

Changing dynamics of varicella-zoster virus infections in the 21st century: the
impact of vaccination.

Whitley RJ.

Publication Types: 
    Comment
    Editorial

PMID: 15897983 [PubMed - indexed for MEDLINE]

1448: J Heart Lung Transplant. 2005 May;24(5):517-25.

Three-year results of a randomized, double-blind, controlled trial of
mycophenolate mofetil versus azathioprine in cardiac transplant recipients.

Eisen HJ, Kobashigawa J, Keogh A, Bourge R, Renlund D, Mentzer R, Alderman E,
Valantine H, Dureau G, Mancini D, Mamelok R, Gordon R, Wang W, Mehra M, Constanzo
MR, Hummel M, Johnson J; Mycophenolate Mofetil Cardiac Study Investigators.

Division of Cardiology, Drexel University College of Medicine, Philadelphia,
Pennsylvania 19102-1192, USA. heisen@drexelmed.edu

BACKGROUND: This study reports the 36-month results of a randomized,
double-blind, active-controlled trial of mycophenolate mofetil (MMF) vs
azathioprine (AZA) in heart transplant patients. METHODS: Patients were
randomized at the time of transplant to receive MMF (1,500 mg twice a day, N =
327) or AZA (1.5 to 3 mg/kg in 4 daily doses, N = 323) in addition to
cyclosporine and corticosteroids; 289 patients in each group received study drug.
Data were analyzed in all randomized patients (enrolled) and in patients who
received study medications (treated). Clinical and graft assessments continued
for 36 months. RESULTS: For the co-primary end-point, 53 of 289 (18.3%)
AZA-treated patients either died or received another transplant compared with 34 
of 289 (11.8%) MMF-treated patients (p < 0.01). Time to re-transplantation or
patient death was significantly shorter for AZA- than MMF-treated patients (p =
0.029). In patients undergoing intravascular ultrasound, the change in mean
maximal intimal thickness was less for the MMF group than for the AZA group (0.06
+/- 0.03 mm vs 0.13 +/- 0.03 mm, respectively; p = 0.056). No significant
differences between treatments were observed in quantitative coronary
angiographic measurements of transplant coronary vasculopathy. Congestive heart
failure, atrial arrhythmia and leukopenia were more common in the AZA group,
whereas diarrhea, esophagitis, Herpes simplex, Herpes zoster and cytomegalovirus 
(CMV) tissue invasion were more common in MMF-treated patients. CONCLUSION: MMF
reduces mortality and graft loss up to 36 months after transplantation.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 15896747 [PubMed - indexed for MEDLINE]

1449: Exp Mol Pathol. 2005 Jun;78(3):221-7.

Etheric biology.

Martin WJ.

Center for Complex Infectious Diseases, 3328 Stevens Avenue, Rosemead CA 91770,
USA. s3support@email.com

Several observations made during the course of studies on stealth-adapted viruses
are explainable by a pervasive, energy-rich, ether environment. Activation of an 
alternative cellular energy (ACE) pathway provides stealth virus damaged cells
with a repair mechanism that is independent of the cellular immune response. ACE 
activation can also assist in the systemic healing of infections caused by
conventional viruses such as Herpes simplex virus, Herpes zoster virus and human 
papillomavirus. ACE pigments convert conventional forms of physical energies into
a biological cell healing energy, the nature of which is still uncertain. More
recent studies suggest that ACE pigments may also capture etheric energy. In
addition to cellular repair, ACE pigment activation can lead to the biogenesis of
lipid-like chemical structures. ACE pigment and virus culture healing activities 
were also seen with several natural products, including a homeopathic
formulation. A colloidal silver solution appeared to facilitate the transmission 
of ACE and to enhance its biosynthetic activity. These results open a window into
a greater understanding of a fundamental force of nature of potential therapeutic
importance.

Publication Types: 
    Review

PMID: 15893748 [PubMed - indexed for MEDLINE]

1450: J Virol. 2005 Jun;79(11):7248-54.

Pseudorabies virus glycoprotein gD contains a functional endocytosis motif that
acts in concert with an endocytosis motif in gB to drive internalization of
antibody-antigen complexes from the surface of infected monocytes.

Ficinska J, Van Minnebruggen G, Nauwynck HJ, Bienkowska-Szewczyk K, Favoreel HW.

Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University,
Salisburylaan 133, 9820 Merelbeke, Belgium.

Viral glycoproteins gB and gD of the swine alphaherpesvirus pseudorabies virus
(PRV), which is closely related to human herpes simplex virus and
varicella-zoster virus, are able to drive internalization of antibody-antigen
complexes that may form at the cell surface of infected monocytes, thereby
protecting these cells from efficient antibody-mediated lysis. We found earlier
that gB relies on an endocytosis motif in its cytoplasmic domain for its function
during this internalization process. Here, we report that the PRV gD protein also
contains a functional endocytosis motif (YRLL) in its cytoplasmic domain that
drives spontaneous endocytosis of gD from the cell surface early in infection and
that acts in concert with the endocytosis motif in gB to contribute to efficient 
internalization of antibody-antigen complexes in PRV-infected monocytes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15890963 [PubMed - indexed for MEDLINE]

1451: J Virol. 2005 Jun;79(11):6969-75.

Varicella-zoster virus ORF4 latency-associated protein is important for
establishment of latency.

Cohen JI, Krogmann T, Ross JP, Pesnicak L, Prikhod'ko EA.

Medical Virology Section, Laboratory of Clinical Infectious Diseases, National
Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
jcohen@niaid.nih.gov

Varicella-zoster virus (VZV) encodes at least six genes that are expressed during
latency. One of the genes, ORF4, encodes an immediate-early protein that is
present in the virion tegument. ORF4 RNA and protein have been detected in
latently infected human ganglia. We have constructed a VZV mutant deleted for
ORF4 and have shown that the gene is essential for replication in vitro. The ORF4
mutant virus could be propagated when grown in cells infected with baculovirus
expressing the ORF4 protein under the human cytomegalovirus immediate-early
promoter. In contrast, the VZV ORF4 deletion mutant could not be complemented in 
cells expressing herpes simplex virus type 1 (HSV-1) ICP27, the homolog of ORF4. 
Cells infected with baculovirus expressing ORF4 did not complement an HSV-1 ICP27
deletion mutant. VZV-infected cotton rats have been used as a model for latency; 
viral DNA and latency-associated transcripts are expressed in dorsal root ganglia
1 month or more after experimental infection. Cotton rats inoculated with VZV
lacking ORF4 showed reduced frequency of latency compared to animals infected
with the parental or ORF4-rescued virus. Thus, in addition to VZV ORF63, which
was previously shown to be critical for efficient establishment of latency, ORF4 
is also important for latent infection.

PMID: 15890936 [PubMed - indexed for MEDLINE]

1452: Arch Pediatr. 2005 May;12(5):526-32.

[Infectious complications postengrafment in the first year after autologous stem 
cell transplantation in children]

[Article in French]

Ben Salah H, Coze C, Gentet JC, Lautraite C, Andre N, Bernard JL.

Service d'oncologie pediatrique, hopital d'enfants de la Timone, 264, rue
Saint-Pierre, 13385 Marseille cedex 05, France. hassen.bensalah@planet.tn

BACKGROUND: Studies on the infectious complications postengrafment in pediatric
stem cell transplantation patients are rare. The aim of this study was to assess 
the incidence, types, outcome and factors affecting late infections. PATIENTS AND
METHODS: A single-institution retrospective analysis was done of infections
recorded in the first year following engrafment in children who underwent
autologous stem cell transplantation for solid tumors from January 1991 to
December 2000. A systematic antimicrobial chemoprophylaxis of TMP/SMX was
administered. Patients who were at high risk for varicella-zona virus infection
received prophylactic acyclovir. RESULTS: Eighty-four assessable patients were
enrolled. Fifty-four patients (64%) underwent autologous peripheral blood stem
cell transplantation and 30 patients (36%) underwent bone marrow transplantation.
Forty-nine episodes of infections were documented in 39 patients (46%) of whom 27
patients (32%) developed infections after the first 100 days post
transplantation. Bacterial septicemia occurred in nine patients of whom four
patients had a catheter-related septicemia. Twelve patients (14%) developed
localized herpes zoster infection. Local fungal infection occurred in five
patients. Infection-related death occurred in one patient with non-documented
pneumonitis. Univariable analysis showed a correlation between the CD34(+) cell
dose <7.5 10(6)/kg and the development of infections (P =0.04). Patients who did 
not go into remission after transplantation where at high risk for septicemia (P 
=0.007). Multivariate analysis showed that a history of varicella or
pretransplant varicella-zona positivity was the only significant factor for
development zoster infection (P =0.01). CONCLUSION: Our study shows that
infections in the first year postengrafment following autologous stem cell
transplantation for solid tumors have a good prognosis and that the use of
TMP/SMX should be the single systematic antimicrobial prophylaxis. The CD34(+)
cell dose seems to play a role in preventing late infections.

Publication Types: 
    English Abstract

PMID: 15885541 [PubMed - indexed for MEDLINE]

1453: Pediatr Infect Dis J. 2005 May;24(5):476-7.

Varicella zoster virus encephalitis in a previously healthy five-year-old child
with herpes zoster ophthalmicus.

Ofek-Shlomai N, Averbuch D, Wolf DG, Engelhard D.

Publication Types: 
    Case Reports
    Letter

PMID: 15876958 [PubMed - indexed for MEDLINE]

1454: J Clin Microbiol. 2005 May;43(5):2173-80.

Effect of prophylactic valacyclovir on the presence of human herpesvirus DNA in
saliva of healthy individuals after dental treatment.

Miller CS, Avdiushko SA, Kryscio RJ, Danaher RJ, Jacob RJ.

Department of Microbiology, Immunology & MOlecular Genetics, University of
Kentucky College of Medicine and College of Dentistry, Lexington, KY, USA.
cmiller@uky.edu

Human herpesviruses (HHVs) are ubiquitous pathogens that intermittently
reactivate from latency. Transmission is believed to be facilitated by their
frequent appearance in saliva. This study sought to understand the factors that
influence the appearance of these viruses in saliva by examining the prevalence, 
pattern, and quantity of all eight HHVs in saliva of immunocompetent adults with 
a history of recurrent oral herpes simplex virus (HSV) infections following
dental treatment and antiviral therapy. Valacyclovir or matched placebo was given
(2 g twice on the day of treatment and 1 g twice the following day) to 125
patients in a randomized, double-blind controlled trial. Saliva, collected on the
day of dental treatment and 3 and 7 days later, was analyzed using real-time
quantitative PCR. At all visits, HHVs coinfected saliva. Over the course of the
week, the DNAs of HHV-6 and HHV-7 were detected significantly more often (97% to 
99% of patients) than Epstein-Barr virus (EBV; 64.8%), HSV-1 (13.0%), HHV-8
(3.2%), cytomegalovirus (2.4%), HSV-2 (0%), and varicella-zoster virus (0%),
irrespective of drug treatment (P < 0.002). Mean genome copy numbers were highest
for HSV-1 and HHV-6. Dental treatment did not influence asymptomatic viral
shedding patterns. However, valacyclovir treatment resulted in significantly
fewer patients shedding EBV at both postoperative visits compared with placebo (P
< 0.008). These results suggest that HHVs are simultaneously present in the
saliva of healthy adults at levels that could facilitate transmission, and
valacyclovir therapy decreases the prevalence of EBV in saliva but has little
effect on HHV-6 and HHV-7.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 15872238 [PubMed - indexed for MEDLINE]

1455: Am J Epidemiol. 2005 May 15;161(10):929-38.

History of chickenpox and shingles and prevalence of antibodies to
varicella-zoster virus and three other herpesviruses among adults with glioma and
controls.

Wrensch M, Weinberg A, Wiencke J, Miike R, Sison J, Wiemels J, Barger G,
DeLorenze G, Aldape K, Kelsey K.

Department of Neurological Surgery, School of Medicine, University of California,
San Francisco, CA 94102, USA. wrensch@itsa.ucsf.edu

Whether viruses or immunologic factors might cause or prevent human brain cancer 
is of interest. Statistically significant inverse associations of adult glioma
with history of chickenpox and immunoglobulin G antibodies to varicella-zoster
virus have been reported. The authors evaluate associations of immunoglobulin G
antibodies to varicella-zoster virus and three other herpesviruses among 229
adults with glioma and 289 controls in the San Francisco Bay Area Adult Glioma
Study (1997-2000). Cases were less likely than controls to report a history of
chickenpox (for self-reported cases vs. controls: the age-, gender-, and
ethnicity-adjusted odds ratio = 0.59, 95% confidence interval: 0.40, 0.86), and
they also had lower levels of immunoglobulin G to varicella-zoster virus (for
being in the highest quartile vs. the lowest quartile: the age-, gender-, and
ethnicity-adjusted odds ratio = 0.41, 95% confidence interval: 0.24, 0.70). The
inverse association with anti-varicella-zoster virus immunoglobulin G was most
marked for glioblastoma multiforme cases versus controls and was only somewhat
attenuated by excluding subjects taking high-dose steroids and other medications.
Cases and controls did not differ notably for positivity to three other
herpesviruses, Epstein-Barr virus, cytomegalovirus, and herpes simplex virus.
Cohort studies may help to clarify the nature of the association between immunity
to and/or clinical manifestations of varicella-zoster virus and glioblastoma.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.

PMID: 15870157 [PubMed - indexed for MEDLINE]

1456: Ir Med J. 2005 Mar;98(3):68.

Is it time to introduce varicella vaccination?

Murphy JF.

PMID: 15869059 [PubMed - indexed for MEDLINE]

1457: Clin Evid. 2004 Dec;(12):1182-93.

Update in:
    Clin Evid. 2005 Dec;(14):1017-25.

Update of:
    Clin Evid. 2003 Dec;(10):942-52.

Postherpetic neuralgia.

Wareham D.

Queen Mary University of London & Barts & The London NHS Trust, London, UK.

Publication Types: 
    Review

PMID: 15865712 [PubMed - indexed for MEDLINE]

1458: Curr Opin Infect Dis. 2005 Jun;18(3):235-40.

Chickenpox.

Hambleton S.

Department of pediatrics, Columbia University, College of Physicians & Surgeons, 
New York, NY 10032, USA. sh2253@columbia.edu

PURPOSE OF REVIEW: Varicella-zoster virus (VZV) remains a public health issue
around the globe despite the availability of a live attenuated vaccine and
several highly active antiviral agents. A program of universal infant vaccination
against varicella was introduced in the US almost 10 years ago. Epidemiological
data continue to accumulate that will inform decision-making on vaccine use
elsewhere. These findings, together with relevant advances in VZV virology, form 
the substance of this review. RECENT FINDINGS: Understanding of the pathogenesis 
of varicella has significantly advanced with the demonstration that the
cation-independent mannose 6-phosphate receptor is critical to both entry and
egress of enveloped VZV. While our knowledge of intervening events remains
sketchy, the future study of VZV will be facilitated by the recent successful
cloning of the VZV genome into a bacterial artificial chromosome. Models of
latency and reactivation are also being developed, which may help us to
understand the epidemiology of herpes zoster in vaccinated populations. Continued
evidence of decline in the incidence of varicella, associated hospitalizations
and deaths suggests that the vaccine as used in the US is highly effective.
However, rates of breakthrough disease are significant and sufficient to sustain 
outbreaks, even among highly vaccinated populations. This is so despite the
generally reduced infectiousness of varicella occurring in vaccinated
individuals. There is some evidence of attrition of the immune response over time
following immunization in a small proportion of vaccinees. SUMMARY: Our ability
to prevent and treat varicella still outstrips our knowledge of pathogenetic and 
immune mechanisms. Further clinical advances are likely to arise from growing
understanding of VZV biology.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 15864101 [PubMed - indexed for MEDLINE]

1459: J Dermatol. 2005 Apr;32(4):311-2.

Giant annular lichen planus: wolf's isotopic response.

Choi HJ, Kim KJ, Lee MW, Choi JH, Moon KC, Koh JK.

Publication Types: 
    Case Reports
    Letter

PMID: 15863859 [PubMed - indexed for MEDLINE]

1460: Acta Paediatr. 2005 Jan;94(1):38-43.

Determination of the six major human herpesviruses in cerebrospinal fluid and
blood specimens of children.

Dong G, Shang S, Liang L, Yu X.

Department of Infectious Medicine, Children's Hospital of Zhejiang University,
School of Medicine, Hangzhou, China. dongguanp@yahoo.com.cn

AIM: To detect and differentiate six major human herpesviruses in the
cerebrospinal fluid (CSF) and blood of children by polymerase chain reaction
restriction fragment length polymorphism (PCR-RFLP). METHODS: We synthesized two 
pairs of primers in the well-conserved regions of the DNA polymerase gene in
human herpesviruses. One pair was designed to amplify cytomegalovirus (CMV),
Epstein-Barr virus (EBV), herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2),
and the other pair to amplify varicella-zoster virus (VZV) and human herpesvirus 
6 (HHV-6) by PCR. Virus species identification was achieved by restriction enzyme
digestion with BamHI and BstUI. Ninety-eight CSF and 75 blood specimens were
analysed by this technique. At the same time, all blood specimens were also
examined by enzyme-linked immunosorbent assay (ELISA). RESULTS: Thirteen (13.3%) 
of 98 CSF specimens and 26 (34.7%) of 75 blood specimens were positive for
herpesvirus DNA in this PCR assay. Only 10 (13.3%) of the blood specimens were
positive in ELISA for virus-IgM antibody. Sensitivity, specificity, positive
predictive value (PPV) and negative predictive value (NPV) of PCR in detecting
herpesvirus infections compared with ELISA were 100% (10/10), 75.4% (49/65),
38.5% (10/26) and 100% (49/49), respectively. These results indicate that the
positive rate of PCR was significantly higher than that of ELISA (p < 0.05). The 
herpesvirus type of these positive specimens was rapidly detected using
restriction enzyme digestion with BamHI and BstUI. CONCLUSIONS: PCR-RFLP is a
specific, sensitive and accurate technique for the identification of herpesvirus 
infections in the CSF and blood of children.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 15858958 [PubMed - indexed for MEDLINE]

1461: Proc Natl Acad Sci U S A. 2005 May 3;102(18):6490-5. Epub 2005 Apr 25.

Varicella-zoster virus infection of human dorsal root ganglia in vivo.

Zerboni L, Ku CC, Jones CD, Zehnder JL, Arvin AM.

Department of Pediatrics,Stanford University School of Medicine, Stanford, CA
94305, USA. zerboni@stanford.edu

Varicella-zoster virus (VZV) causes varicella and establishes latency in sensory 
ganglia. VZV reactivation results in herpes zoster. We developed a model using
human dorsal root ganglion (DRG) xenografts in severe combined immunodeficient
(SCID) mice to investigate VZV infection of differentiated neurons and satellite 
cells in vivo. DRG engrafted under the kidney capsule and contained neurons and
satellite cells within a typical DRG architecture. VZV clinical isolates infected
the neurons within DRG. At 14 days postinfection, VZ virions were detected by
electron microscopy in neuronal cell nuclei and cytoplasm but not in satellite
cells. The VZV genome copy number was 7.1 x 10(7) to 8.0 x 10(8) copies per 10(5)
cells, and infectious virus was recovered. This initial phase of viral
replication was followed within 4-8 weeks by a transition to VZV latency,
characterized by the absence of infectious virus release, the cessation of virion
assembly, and a reduction in VZV genome copies to 3.7 x 10(5) to 4.7 x 10(6) per 
10(5) cells. VZV persistence in DRG was achieved without any requirement for
VZV-specific adaptive immunity and was associated with continued transcription of
the ORF63 regulatory gene. The live attenuated varicella vaccine virus exhibited 
the same pattern of short-term replication, persistence of viral DNA, and
prominent ORF63 transcription as the clinical isolates. VZV-infected T cells
transferred virus from the circulation into DRG, suggesting that VZV
lymphotropism facilitates its neurotropism. DRG xenografts may be useful for
investigating neuropathogenic mechanisms of other human viruses.

Publication Types: 
    Comparative Study
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.

PMID: 15851670 [PubMed - indexed for MEDLINE]

1462: Clin Infect Dis. 2005 May 15;40(10):1545-7. Epub 2005 Apr 13.

A case of Ramsay Hunt-like syndrome caused by herpes simplex virus type 2.

Diaz GA, Rakita RM, Koelle DM.

Department of Medicine, University of Washington, Seattle, WA, USA.
geodiaz@u.washington.edu

We report an immunocompetent patient with recurrent auricular and facial vesicles
associated with painful paresthesias and facial paralysis, consistent with Ramsay
Hunt syndrome, due to herpes simplex virus (HSV) type 2. Clinical and
laboratory-proven acyclovir resistance developed during therapy. Immunologic
assays revealed normal reactivity to HSV-2.

Publication Types: 
    Case Reports

PMID: 15844081 [PubMed - indexed for MEDLINE]

1463: Emerg Med J. 2005 May;22(5):384-6.

The reawakening of a sleeping little giant.

Goddard R.

General Surgery, Queen Elizabeth and Queen Mary Hospitals, East Kent Hospitals
NHS Trust. goddard1998@aol.com

This case report and literature review highlights the classical signs and
symptoms of herpes zoster infection involving the trigeminal nerve. Incorrect
diagnosis leads to delay in providing effective treatment and could result in
failure to identify potentially hazardous ocular complications and to prevent
chronic post-herpetic pain.

Publication Types: 
    Case Reports
    Review

PMID: 15843717 [PubMed - indexed for MEDLINE]

1464: Evid Based Complement Alternat Med. 2005 Mar;2(1):113-116.

Mind-Body, Ki (Qi) and the Skin: Commentary on Irwin's 'Shingles Immunity and
Health Functioning in the Elderly: Tai Chi Chih as a Behavioral Treatment'

Kobayashi H, Ishii M.

PMID: 15841287 [PubMed - as supplied by publisher]

1465: Evid Based Complement Alternat Med. 2004 Dec;1(3):223-232. Epub 2004 Dec 1.

Shingles Immunity and Health Functioning in the Elderly: Tai Chi Chih as a
Behavioral Treatment.

Irwin M, Pike J, Oxman M.

Both the incidence and severity of herpes zoster (HZ) or shingles increase
markedly with increasing age in association with a decline in varicella zoster
virus (VZV)-specific immunity. Considerable evidence shows that behavioral
stressors, prevalent in older adults, correlate with impairments of cellular
immunity. Moreover, the presence of depressive symptoms in older adults is
associated with declines in VZV-responder cell frequency (VZV-RCF), an
immunological marker of shingles risk. In this review, we discuss recent findings
that administration of a relaxation response-based intervention, tai chi chih
(TCC), results in improvements in health functioning and immunity to VZV in older
adults as compared with a control group. TCC is a slow moving meditation
consisting of 20 separate standardized movements which can be readily used in
elderly and medically compromised individuals. TCC offers standardized training
and practice schedules, lending an important advantage over prior relaxation
response-based therapies. Focus on older adults at increased risk for HZ and
assay of VZV-specific immunity have implications for understanding the impact of 
behavioral factors and a behavioral intervention on a clinically relevant
end-point and on the response of the immune system to infectious pathogens.

PMID: 15841255 [PubMed - as supplied by publisher]

1466: Vaccine. 2005 May 9;23(25):3349-55.

Cost-benefit analysis of universal varicella vaccination in the U.S. taking into 
account the closely related herpes-zoster epidemiology.

Goldman GS.

Medical Veritas International (MVI), Pearblossom, CA 93553, USA.
pearblossominc@aol.com

Many models concur that universal varicella vaccination of children is beneficial
from the perspective of reducing societal costs. Yet, the majority of such cost
analyses have been modeled under the assumption that varicella vaccination has no
adverse effect on the closely related herpes-zoster (HZ) epidemiology. Historical
models have assumed that asymptomatic endogenous reactivation is the chief
mechanism of boosting that suppresses the reactivation of HZ and that immunity
wanes due to the aging process. Recent studies suggest instead that periodic
exogenous exposures to wild-type varicella are the predominant factor influencing
the curve of increasing HZ incidence rate with advancing age among individuals
<50, after which an age-related decline dominates in the elderly. Based on a
realistic age-structured model, we compare differences in outcomes of the number 
of HZ cases and direct medical costs associated with the population existing in
2000 and as it ages (according to the mortality given in the 2000 U.S. census)
during the following 50 years with and without implementation of universal
varicella vaccination. Under universal varicella vaccination, we assume that 15
years post-licensure, the boosting mechanism known as asymptomatic endogenous
reactivation principally serves to limit HZ incidence to 550 per 100,000
person-years in unvaccinated individuals <50 with a previous history of natural
varicella--since there has been a vaccine-induced decline in exogenous boosting. 
We estimate universal varicella vaccination has the impact of an additional 14.6 
million (42%) HZ cases among adults aged <50 years during a 50 year time span at 
a substantial cost burden of 4.1 billion US dollars or 80 million US dollars
annually utilizing an estimated mean healthcare provider cost of 280 US dollars
per HZ case.

PMID: 15837242 [PubMed - indexed for MEDLINE]

1467: Dermatol Clin. 2005 Apr;23(2):313-22.

Advances in antiviral therapy.

Wu JJ, Pang KR, Huang DB, Tyring SK.

Department of Dermatology, University of California at Irvine, 92697-2400, USA.

Infections with five of the herpesviruses (herpes simplex virus 1 [HSV-1], HSV-2,
varicella zoster virus, Epstein-Barr virus, and cytomegalovirus) are treated with
topical or systemic antiviral therapies. There are more than 100 genotypes of
human papillomaviruses (HPVs), which may manifest as warts, skin cancers,
cervical cancer, anogenital cancers, and upper digestive tract cancers. Molluscum
contagiosum (MC) is a common, benign viral infection of the skin.
Immunomodulating agents, such as imiquimod, act on HPV and MC indirectly by
inducing host immune responses, such as cytokines and cell-mediated immunity, and
thereby reduce recurrences. There are multiple vaccines available for certain
viral diseases and others in development for HSV-2 and HPV.

Publication Types: 
    Review

PMID: 15837157 [PubMed - indexed for MEDLINE]

1468: Ann Rheum Dis. 2005 May;64(5):780-2.

Human parvovirus B19, varicella zoster virus, and human herpes virus 6 in
temporal artery biopsy specimens of patients with giant cell arteritis: analysis 
with quantitative real time polymerase chain reaction.

Alvarez-Lafuente R, Fernandez-Gutierrez B, Jover JA, Judez E, Loza E, Clemente D,
Garcia-Asenjo JA, Lamas JR.

Rheumatology Service, Hospital Clinico San Carlos, Madrid, Spain.

OBJECTIVE: To evaluate the role of parvovirus B19 (B19), varicella zoster virus
(VZV), and human herpes virus 6 (HHV-6) in the aetiopathology of giant cell
arteritis (GCA). METHODS: Temporal artery biopsy specimens from 57 patients with 
GCA and 56 controls were investigated. DNA was obtained by biopsy, and
quantitative real time polymerase chain reaction assay performed to establish the
prevalence and viral load of B19, VZV, and HHV-6. Amplification of the human
beta-globin gene was used as internal positive control. RESULTS: (a) B19 was
detected in 31/57 (54%) patients (median viral load 45.2 (25th-75th centiles
0-180.2) copies/microg DNA) v 21/56 (38%) controls (median viral load 0 (0-66.7) 
copies/microg of DNA; p = 0.07 for DNA prevalence, p = 0.007 for viral load.
Among 31 B19 positive samples, 21 (68%) patients with biopsy proven GCA had
>10(2) B19 copies/microg of DNA v 5/21 (24%) controls; p = 0.001. (b) No
significant difference was found for VZV (p = 0.94 for DNA prevalence; p = 0.76
for viral load) and HHV-6 (p = 0.89 for DNA prevalence; p = 0.64 for viral load) 
in the GCA group compared with controls. CONCLUSION: B19 may have a role in the
aetiopathology of GCA, particularly in those patients with high viral load; no
evidence was found for VZV and HHV-6.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15834059 [PubMed - indexed for MEDLINE]

1469: J Trop Pediatr. 2005 Jun;51(3):141-4. Epub 2005 Apr 14.

Varicella zoster seroprevalence in children less than 5 years old.

Ozkan S, Maral I, Ilhan F, Aycan S, Cirak MY, Beyazova U, Aygun R.

Gazi University Faculty of Medicine, Department of Public Health, Ankara, Turkey.
ozkans@gazi.edu.tr

This study was designed to evaluate the age-specific varicella-zoster virus (VZV)
seroprevalence in children less than 5 years old who presented at a healthy child
outpatient clinic and to compare the results with the data from other countries. 
The study was a cross-sectional study determining the prevalence of serum IgG
against VZV in children who presented to the Healthy Child Outpatient Clinic of
the Gazi University Medical Faculty and who were aged between 9 months and 5
years, in the 3rd--97th percentile as regards height and weight, not suffering
from any disease, and without a history of vaccination against varicella. The
information on the children was obtained from a questionnaire, by physical
examination, and from patient files. Serum samples were obtained from babies and 
children at 9, 15, 24, 36, 48, and 60 months. The 295 serum samples were kept at 
--20 degrees C following centrifugation until used for serologic analysis
(ELISA). The 292 children of the study group consisted of 168 males (57.5 per
cent) and 124 females (42.5 per cent). VZV antibodies were found to be positive
in 65 children aged between 9 months and 5 years (22.3 per cent); 22.0 per cent
in males and 22.6 per cent in females with no statistically significant
difference between the sexes (p>0.05). The VZV seroprevalence was highest at the 
48th and 60th months and this difference was statistically significant (p=0.000).

Publication Types: 
    Comparative Study

PMID: 15831668 [PubMed - indexed for MEDLINE]

1470: J Periodontol. 2005 Jan;76(1):148-53.

Alveolar bone necrosis and tooth exfoliation following herpes zoster infection: a
review of the literature and case report.

Mendieta C, Miranda J, Brunet LI, Gargallo J, Berini L.

Dental Faculty, University of Barcelona, Barcelona, Spain. cmendieta@ub.edu

BACKGROUND: Herpes zoster (HZ) presents as a cutaneous vesicular eruption in the 
area innervated by the affected sensory nerve, usually associated with severe
pain. Oral manifestations of HZ appear when the mandibular or maxillary divisions
of the trigeminal nerve are affected. METHODS: This is a case report of a
63-year-old woman with HZ infection with trigeminal nerve involvement that led to
a rapid loss of alveolar bone and exfoliation of two teeth. RESULTS: The initial 
intraoral examination showed redness of the alveolar mucosa and gingiva of the
lower right quadrant with multiple well-delimited and painful erosive lesions
affecting the attached gingiva around the teeth. Two weeks later, teeth number 27
(lower right canine) and 28 (lower right first premolar) had class III mobility, 
flow of purulent exudate from the gingival sulcus, and deep pockets (>11 mm). The
radiological examination showed advanced alveolar bone loss around both teeth.
The prognosis for teeth number 27 and 28 was considered hopeless, and they were
extracted. Due to extensive necrosis there was no interdental alveolar bone. The 
case is presented with a review of clinical data from patients with trigeminal HZ
infection associated with osteonecrosis or exfoliation of teeth previously
reported in the literature. The mechanisms by which the HZ infection leads to the
alveolar bone necrosis are discussed. CONCLUSIONS: Extensive osteonecrosis and
exfoliation of teeth in the area innervated by the nerve affected by HZ has been 
reported after HZ infection. Clinicians should be aware of this possible outcome 
after a trigeminal HZ infection.

Publication Types: 
    Case Reports
    Review

PMID: 15830651 [PubMed - indexed for MEDLINE]

1471: J Virol. 2005 May;79(9):5315-25.

Array analysis of simian varicella virus gene transcription in productively
infected cells in tissue culture.

Deitch SB, Gilden DH, Wellish M, Smith J, Cohrs RJ, Mahalingam R.

Department of Neurology, Mail Stop B182, 4200 E. 9th Avenue, Denver, CO 80262,
USA.

Simian varicella virus (SVV) is a neurotropic alphaherpesvirus of monkeys that is
a model for varicella pathogenesis and latency. Like human varicella-zoster virus
(VZV), SVV causes chicken pox (varicella), becomes latent in ganglia along the
entire neuraxis, and reactivates to produce shingles (zoster). We developed
macroarrays to determine the extent of viral transcription from all 70 predicted 
SVV open reading frames (ORFs) in infected cells in tissue culture. Cloned
fragments (200 to 400 bp) from the 5' and 3' ends of each ORF were PCR amplified,
quantitated, spotted onto nylon membranes, and fixed by UV cross-linking. Using a
cDNA probe prepared from poly(A)+ RNA extracted from SVV-infected Vero cells at
the height of the cytopathic effect (3 days after infection) and
chemiluminescence for detection, transcripts corresponding to all SVV ORFs were
identified. The abundance of each SVV transcript was compared with that
previously demonstrated for VZV in infected tissue culture cells.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.

PMID: 15827146 [PubMed - indexed for MEDLINE]

1472: Neurology. 2005 Apr 12;64(7):1138.

MRI of segmental zoster paresis.

Samuraki M, Yoshita M, Yamada M.

Publication Types: 
    Case Reports

PMID: 15824336 [PubMed - indexed for MEDLINE]

1473: Epidemiol Infect. 2005 Apr;133(2):245-53.

Incidence of herpes zoster, 1997-2002.

Mullooly JP, Riedlinger K, Chun C, Weinmann S, Houston H.

Kaiser Permanente Center for Health Research, Northwest Region, 3800 N.
Interstate Drive, Portland, OR 97227-1098, USA. john.mullooly@kpchr.org

We estimated age-specific herpes zoster (HZ) incidence rates in the Kaiser
Permanente Northwest Health Plan (KPNW) during 1997-2002 and tested for secular
trends and differences between residents of two states with different varicella
vaccine coverage rates. The cumulative proportions of 2-year-olds vaccinated
increased from 35% in 1997 to 85% in 2002 in Oregon, and from 25% in 1997 to 82% 
in 2002 in Washington. Age-specific HZ incidence rates in KPNW during 1997-2002
were compared with published rates in the Harvard Community Health Plan (HCHP)
during 1990-1992. The overall HZ incidence rate in KPNW during 1997-2002
(369/100,000 person-years) was slightly higher than HCHP's 1990-1992 rate when
adjusted for age differences. For children 6-14 years old, KPNW's rates (182 for 
females, 123 for males) were more than three times HCHP's rates (54 for females, 
39 for males). This increase appears to be associated with increased exposure of 
children to oral corticosteroids. The percentage of KPNW children exposed to oral
corticosteroids increased from 2.2% in 1991 to 3.6% in 2002. Oregon residents had
slightly higher steroid exposure rates during 1997-2002 than Washington
residents. There were significant increases in HZ incidence rates in Oregon and
Washington during 1997-2002 among children aged 10-17 years, associated with
increased exposure to oral steroids.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15816149 [PubMed - indexed for MEDLINE]

1474: J Ethnopharmacol. 2005 Apr 26;98(3):323-7.

Antiviral activity in vitro of Urtica dioica L., Parietaria diffusa M. et K. and 
Sambucus nigra L.

Uncini Manganelli RE, Zaccaro L, Tomei PE.

Department of Agronomia e Gestione dell'Agroecosistema, University of Pisa, Via
S. Michele degli Scalzi 2, Pisa 56100, Italy. ritely@agr.unipi.it

Parietaria diffusa M. et K., Urtica dioica L. (Urticaceae) and Sambucus nigra L. 
(Caprifoliaceae) are plants usually used in popular medicine of central Italy for
treating numerous diseases, first of all Herpes zoster. Several plant products
have been described as potential antiviral agents, with special attention being
devoted to those having retroviruses as etiological agents, including acquired
immunodeficiency syndrome (AIDS), in which a retrovirus, the designated human
immunodeficiency virus HIV, has been clearly identified as the primary cause of
this disease. The present study proposes a preliminary screening of the antiviral
activity of Parietaria diffusa, Sambucus nigra and Urtica dioica preparation
against the feline immunodeficiency virus (FIV) infection. The feline
immunodeficiency virus is a widespread lentivirus of domestic cats sharing
numerous biological and pathogenic features with the human immunodeficiency virus
(HIV). FIV infection in cats has therefore been proposed as an animal model for
AIDS studies with respect to pathogenesis, chemotherapy, and vaccine development 
[Pedersen, N.C., 1993. Feline immunodeficiency virus infection. In: Levy, J.A.
(Ed.), The Retroviridae. Plenum Press, New York; Bendinelli, M., Pistello, M.,
Lombardi, S., Poli, A., Garzelli, C., Matteucci, D., Ceccherini-Nelli, L.,
Malvaldi, G., Tozzini, F., 1995. Feline immunodeficiency virus: an interesting
model for AIDS studies and an important cat pathogen. Clinical Microbiology Revue
8, 87-112; North, T.W., LaCasse, R.A., 1995. Testing anti-HIV drugs in the FIV
model. Nature Medicine 1, 410-411; Matteucci, D., Pistello, M., Mazzetti, P.,
Giannechini, S., Isola, P., Merico, A., Zaccaro, L., Rizzati, A., Bendinelli, M.,
2000. AIDS vaccination studies using feline immunodeficiency virus as a model:
immunisation with inactivated whole virus suppresses viraemia levels following
intravaginal challenge with infected cells but non-following intravenous
challenge with cell-free virus. Vaccine 18, 119-130]. Early studies showed that
some of them presented antiviral activity against infection of FIV as assayed by 
syncytia formation using feline kidney Crandell cells (CrFK).

PMID: 15814267 [PubMed - indexed for MEDLINE]

1475: Nat Med. 2005 Apr;11(4 Suppl):S16-9.

The process development challenge for a new vaccine.

Buckland BC.

Merck Research Laboratories, West Point, Pennsylvania 19486, USA.
barry_buckland@merck.com

The challenges of vaccine development are not limited to identification of
suitable antigens, adjuvants and delivery methods, but include regulatory,
technical and manufacturing hurdles in translating a vaccine candidate to the
clinic. Process development is the technological foundation that underlies the
manufacture of new vaccines and is central to successful commercialization.

PMID: 15812483 [PubMed - indexed for MEDLINE]

1476: HIV Med. 2005 Mar;6(2):140-3.

The prevalence and risk of immune restoration disease in HIV-infected patients
treated with highly active antiretroviral therapy.

Jevtovic DJ, Salemovic D, Ranin J, Pesic I, Zerjav S, Djurkovic-Djakovic O.

Institute for Infectious & Tropical Diseases, Clinical Centre of Serbia,
Belgrade, Serbia & Montenegro.

BACKGROUND: It is becoming increasingly clear that, during successful highly
active antiretroviral therapy (HAART), a proportion of treated patients develop
opportunistic infections (OIs), referred to in this setting as immune restoration
disease (IRD). We examined the risk of developing IRD in HAART-treated
HIV-infected patients. METHODS: A retrospective study of a cohort including all
389 patients treated with HAART between 1 January 1998 and 31 May 2004 in our HIV
unit was performed to evaluate the occurrence of and risk factors for IRD during 
HAART. Baseline and follow-up values of CD4 T-cell counts and plasma viral loads 
(pVLs) were compared to assess the success of HAART. RESULTS: During successful
HAART (significant increase in CD4 T-cell counts and decrease in pVL), at least
one IRD episode occurred in 65 patients (16.7%). The median time to IRD was 4.6
months (range 2-12 months). IRDs included dermatomal herpes zoster (26 patients),
pulmonary tuberculosis (four patients), tuberculous exudative pericarditis (two
patients), tuberculous lymphadenitis (two patients), cerebral toxoplasmosis (one 
patient), progressive multifocal leucoencephalopathy (PML) (one patient),
inflamed molluscum (one patient), inflamed Candida albicans angular cheilitis
(three patients), genital herpes simplex (two patients), tinea corporis (two
patients), cytomegalovirus (CMV) retinitis (two patients), CMV vitritis (one
patient) and hepatitis B (three patients) or C (fifteen patients). A baseline CD4
T-cell count below 100 cells/microL was shown to be the single predictor [odds
ratio (OR) 2.5, 95% confidence interval (CI) 0.9-6.4] of IRD, while a CD4 T-cell 
count increase to >400 cells/microL, but not undetectable pVL, was a negative
predictor of IRD (OR 0.3, 95% CI 0.1-0.8). CONCLUSIONS: To avoid IRD in advanced 
patients, HAART should be initiated before the CD4 T-cell count falls below 100
cells/microL.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15807721 [PubMed - indexed for MEDLINE]

1477: Bone Marrow Transplant. 2005 Jun;35(11):1065-9.

The effect of low-dose aciclovir on reactivation of varicella zoster virus after 
allogeneic haemopoietic stem cell transplantation.

Thomson KJ, Hart DP, Banerjee L, Ward KN, Peggs KS, Mackinnon S.

Department of Haematology, University College London Hospitals, 98 Chenies Mews, 
London WC1E 6HX, UK. kirsty.thomson@uclh.org

Patients undergoing haemopoietic stem cell transplants (HSCT) are at high risk of
varicella zoster virus (VZV) reactivation, with a significant incidence of
dissemination. This study reports a retrospective analysis of 247 allogeneic HSCT
recipients receiving anti-viral prophylaxis with low-dose oral aciclovir 400
mg/day, administered until immunosuppression was discontinued and the CD4(+) cell
count exceeded 200/mm(3). Viral reactivation was successfully suppressed by
aciclovir prophylaxis, with only one case of breakthrough infection. The
cumulative incidence of zoster infection at 1 year post transplant was 2% and at 
5 years 34%. In all, 64 patients discontinued prophylaxis. Zoster developed in 26
of these, giving a cumulative incidence of infection at 1 year after stopping
aciclovir of 39% and at 3 years 44%. Infection occurred in a localised dermatomal
distribution in 93% of cases. This supports previous findings that aciclovir
prophylaxis prevents early VZV reactivation, although the long-term incidence is 
not affected as infection occurs once prophylaxis is discontinued. Such
infection, however, is mild and localised. This study does not support the idea
that use of such low-dose aciclovir regimens reduces the zoster incidence by
permitting subclinical reactivation during prophylaxis, and therefore the
re-establishment of protective anti-viral immunity.

PMID: 15806119 [PubMed - indexed for MEDLINE]

1478: Ocul Immunol Inflamm. 2005 Feb;13(1):87-9.

Ocular tuberculosis in acquired immune deficiency syndrome (AIDS).

Mehta S, Gilada IS.

Lilavati Hospital and Research Center, Mumbai, India. doc@retinaconsultant.com

AIM: To determine the prevalence and clinical features of ocular tuberculosis in 
patients with the acquired immune deficiency syndrome (AIDS). DESIGN: Prospective
cross-sectional study. METHODS: Detailed history and ocular examination of 46
patients (92 eyes) in the outpatient department of an AIDS clinic. RESULTS:
Seventeen of 46 (36.9%) patients had clinical and radiological evidence of
pulmonary tuberculosis. Of these, four (23.5%) showed findings consistent with
ocular tuberculosis. Lesions included tubercles (1 eye of 3 patients) and
chorioretinitis (1 eye of 1 patient). Commonly, these patients had evidence of
abdominal tuberculosis. Hemorrhages, cotton-wool spots, herpes zoster
ophthalmicus (HZO), cytomegalovirus retinitis (CMVR), and disc edema were other
non-tubercular AIDS-related lesions and were seen in seven of the remaining 42
patients (16.2%). CONCLUSION: Ocular tuberculosis was a common finding in this
study and was found in profoundly immunocompromised patients with disseminated
tuberculosis. Diagnosis of ocular tuberculosis may help reduce HIV/tuberculosis
co-infection mortality.

PMID: 15804776 [PubMed - indexed for MEDLINE]

1479: Eur J Neurol. 2005 May;12(5):331-43.

Viral encephalitis: a review of diagnostic methods and guidelines for management.

Steiner I, Budka H, Chaudhuri A, Koskiniemi M, Sainio K, Salonen O, Kennedy PG.

Laboratory of Neurovirology, Department of Neurology, Hadassah University
Hospital, Jerusalem, Israel. isteiner@md2.huji.ac.il

Viral encephalitis is a medical emergency. The spectrum of brain involvement and 
the prognosis are dependent mainly on the specific pathogen and the immunological
state of the host. Although specific therapy is limited to only several viral
agents, correct immediate diagnosis and introduction of symptomatic and specific 
therapy has a dramatic influence upon survival and reduces the extent of
permanent brain injury in survivors. We searched MEDLINE (National Library of
Medicine) for relevant literature from 1966 to May 2004. Review articles and book
chapters were also included. Recommendations are based on this literature based
on our judgment of the relevance of the references to the subject.
Recommendations were reached by consensus. Where there was lack of evidence but
consensus was clear we have stated our opinion as good practice points. Diagnosis
should be based on medical history, examination followed by analysis of
cerebrospinal fluid for protein and glucose contents, cellular analysis and
identification of the pathogen by polymerase chain reaction (PCR) amplification
(recommendation level A) and serology (recommendation level B). Neuroimaging,
preferably by magnetic resonance imaging, is an essential aspect of evaluation
(recommendation level B). Lumbar puncture can follow neuroimaging when
immediately available, but if this cannot be obtained at the shortest span of
time it should be delayed only in the presence of strict contraindications. Brain
biopsy should be reserved only for unusual and diagnostically difficult cases.
All encephalitis cases must be hospitalized with an access to intensive care
units. Supportive therapy is an important basis of management. Specific,
evidence-based, anti-viral therapy, acyclovir, is available for herpes
encephalitis (recommendation level A). Acyclovir might also be effective for
varicella-zoster virus encephalitis, gancyclovir and foscarnet for
cytomegalovirus encephalitis and pleconaril for enterovirus encephalitis (IV
class of evidence). Corticosteroids as an adjunct treatment for acute viral
encephalitis are not generally considered to be effective and their use is
controversial. Surgical decompression is indicated for impending uncal herniation
or increased intracranial pressure refractory to medical management.

Publication Types: 
    Review

PMID: 15804262 [PubMed - indexed for MEDLINE]

1480: J Neurol. 2005 Aug;252(8):987-8. Epub 2005 Apr 4.

Hypoglycorrhachia in herpes zoster associated encephalitis of an immunocompetent 
young male: an unusual presentation.

Chan CW, Tam KM, To WK, Law TC, Kwan WK.

Publication Types: 
    Case Reports
    Letter

PMID: 15795793 [PubMed - indexed for MEDLINE]

1481: Int Ophthalmol Clin. 2005 Spring;45(2):89-97.

Herpetic posterior uveitis.

Zamir E.

Ocular Immunology Service, The Royal Victorian Eye and Ear Hospital, 32 Gisborne 
Street, East Melbourne, Victoria 3002, Australia.

Publication Types: 
    Review

PMID: 15791160 [PubMed - indexed for MEDLINE]

1482: Int Ophthalmol Clin. 2005 Spring;45(2):41-55.

Polymerase chain reaction in the diagnosis of uveitis.

Chan CC, Shen D, Tuo J.

Section of Immunopathology, Laboratory of Immunology, National Eye Institute/NIH,
Bldg. 10, Rm. 10N103, 10 Center Drive, Bethesda, MD 20892-1857, USA.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 15791157 [PubMed - indexed for MEDLINE]

1483: Br J Dermatol. 2005 Mar;152(3):569-70.

Reactivation of ophthalmic herpes zoster following pulsed-dye laser treatment for
inflammatory acne vulgaris.

Clayton TH, Stables GI.

Publication Types: 
    Case Reports
    Letter

PMID: 15787833 [PubMed - indexed for MEDLINE]

1484: G Ital Nefrol. 2005 Jan-Feb;22(1):66-9.

[On the mailing list: use of acyclovir in patients on hemodialysis]

[Article in Italian]

D'Amico M, Fraticelli M, Limido A.

Unita' Operativa di Nefrologia, Azienda Ospedaliera S. Anna, Como - Italy.

In the SIN Mailing List a message published in May 2004 gave rise to an
interesting debate as to the use and dosage of acyclovir in dialysis patients for
the treatment of varicella-zoster infection, considering the side effects (mainly
neurological) reported in patients affected by renal insufficiency. In this
issue, we summarised the main pharmacological characteristics of acyclovir and
the clinical indications for using this drug. Finally, we analysed the literature
data concerning acyclovir side effects in the setting of renal insufficiency. As 
they indicate that acyclovir-induced neurotoxicity in renal insufficiency
patients may be unpredictable even at reduced dosages, this should discourage the
use of acyclovir when severe renal insufficiency is present, unless severe herpes
infection is present and after evaluating carefully the risk-benefit. In this
case, the patient has to be kept under strict medical control to detect the
acyclovir-induced side effects early. The use of new antiviral drugs, such as
famciclovir or brivudine, to treat herpes virus infections in patients with renal
insufficiency is currently not supported by sufficient data for a critical
review.

Publication Types: 
    English Abstract
    Review

PMID: 15786379 [PubMed - indexed for MEDLINE]

1485: Klin Monatsbl Augenheilkd. 2005 Mar;222(3):264-6.

Varicella-zoster virus retinitis: successful evolution with a combination of
antiviral therapies.

Oueghlani E, Baglivo E, Durakovic O, Safran AB.

Clinique d'Ophtalmologie, Hopitaux Universitaires de Geneve, Geneva, Switzerland.

BACKGROUND: We present the description of a successful outcome in a case of
varicella-zoster virus (VZV) acute retinal necrosis (ARN). HISTORY AND SIGNS: A
healthy 40-year-old patient was admitted for a VZV retinitis. THERAPY AND
OUTCOME: 10 days after the onset of intravenous (i. v.) acyclovir treatment, new 
small peripheral retinal necrotic lesions appeared in the right eye. A viral
resistance was suspected and the acyclovir therapy was optimised with i. v.
foscarnet combined with 2 intravitreal injections of ganciclovir. The outcome was
favourable with a final vision of 1.0 after a follow-up of 30 months. No systemic
or local complications were observed. CONCLUSIONS: VZV ARN is a severe infection 
with a poor prognosis. This case demonstrates that combination of antiviral
therapies given intravenously (acyclovir + foscarnet) and in the vitreous
(ganciclovir) may be safe and efficacious in the management of necrotising
herpetic retinopathies affecting immunocompetent patients.

Publication Types: 
    Case Reports

PMID: 15785997 [PubMed - indexed for MEDLINE]

1486: Hybridoma (Larchmt). 2005 Feb;24(1):50-4.

A chimeric antibody to varicella-zoster virus glycoprotein e.

Shankar V, Kools JJ, Armour KL, Clark MR.

Biologics Branch, Scientific Resources Program, Centers for Disease Control and
Prevention, Atlanta, Georgia 30333, USA. vbs2@cdc.gov

Varicella-Zoster virus (VZV) immune globulin (VZIG) derived from pooled human
serum is currently used in immunotherapy of VZV-associated complications of
chickenpox and shingles. We developed a mouse-human chimeric antibody against a
VZV glycoprotein E (gE) epitope as a safer replacement for VZIG. Variable (V)
heavy- and V kappa light-chain exons, derived from an anti-VZV gE antibody
secreting mouse hybridoma cell line, were cloned into expression vectors
containing an immunoglobulin promoter and enhancer, and human IgG1 or kappa
constant (C) region genes. The expression vectors were cotransfected into mouse
myeloma cell line (NSO), generating transformants that secreted chimeric
human-mouse IgGs. The chimeric and the parent mouse antibody were
indistinguishable in their antigen binding specificity. VZV gE chimeric antibody 
may prove to be a prophylactic antibody that could provide significant advantages
over VZIG in having defined specificity, lessened possibility of contamination
with viral pathogens, and consistent availability.

Publication Types: 
    Comparative Study

PMID: 15785209 [PubMed - indexed for MEDLINE]

1487: Oftalmologia. 2004;48(4):70-6.

[The Bioptron light therapy]

[Article in Romanian]

Dediulescu L.

Spitalul Municipal Ramnicul Sarat, Daniela Florentina Dediulescu Absolventa
U.M.F. Iuliu Hatieganu, Cluj-Napoca.

The Bioptron light therapy system acts naturally, upholding the capacity of
regeneration of the body. Since the discovery of the therapeutical effects of the
Bioptron light, over 20 years ago, its use as treatment has been developed for a 
large variety of diseases, among which also the eye-diseases (simplex and zoster 
herpes, conjunctivitis).

Publication Types: 
    English Abstract
    Review

PMID: 15782767 [PubMed - indexed for MEDLINE]

1488: Acta Otorrinolaringol Esp. 2005 Feb;56(2):83-5.

[Idiopathic Frey's syndrome under the appearance of a recurrent otitis externa]

[Article in Spanish]

Santa Cruz Ruiz S, Munoz Herrera A, Santa Cruz Ruiz P, Gil Melcon M, Batuecas
Caletrio A.

Servicio de ORL, Hospital Universitario de Salamanca.

Frey syndrome has been observed especially in patients who have undergone a
parotidectomy operation, but also in zoster herpes, in parotiditis, condilea
fractures, obstetric traumatisms with forceps and in surgery of the meningioma of
the cerebellopontine angle. It also appears without previous surgery, like in our
case. In these circumstances it is believed that a clinical neuritis, primary or 
secondary to a neighbouring inflammation may cause the start of this disorder.
Several treatments have been suggested which highlights the difficulty of them.
The most effective one is the intradermic injection of botulinum toxin type A.
Its use in Frey's syndrome was initiated by Drobik and Laskawi in 1995. Since
then the references to its use are numerous. Nevertheless, it is a treatment
which has been introduced very few times in our country.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15782648 [PubMed - indexed for MEDLINE]

1489: Neurology. 2005 Mar 22;64(6):1007.

CNS myelomatosis.

Lupu VD, Saini N, Balish M.

EMG section, National Institute of Neurologic Disorders and Stroke, NIH, Bldg.
10, Room 5C101, 10 Center Drive MSC-1404, Bethesda, MD 20892-1404, USA.
lupuv@ninds.nih.gov

Publication Types: 
    Case Reports

PMID: 15781817 [PubMed - indexed for MEDLINE]

1490: J Neurol. 2005 Jun;252(6):677-86. Epub 2005 Mar 23.

Postherpetic neuralgia: topical lidocaine is effective in nociceptor-deprived
skin.

Wasner G, Kleinert A, Binder A, Schattschneider J, Baron R.

Dept. of Neurological Pain Research and Therapy, Neurological Clinic,
Universitatsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstrasse 10,
24105 Kiel, Germany. g.wasner@neurologie.uni-kiel.de

OBJECTIVES: Topical lidocaine is effective in postherpetic neuralgia (PHN). The
aim of the present investigation was to classify patients according to their
predominant peripheral nociceptor function and to compare these data with the
results of a controlled study using dermal lidocaine patch. METHODS: Within the
skin area of maximal pain QST (thermotest) and QCART (histamine iontophoresis and
laser Doppler flowmetry) were performed prospectively in 18 PHN patients. A
controlled study using cutaneous lidocaine (lidocaine 5% patch, IBSA) followed.
RESULTS: Six patients (group I, sensitised nociceptors) had no sensory loss. Heat
pain thresholds were equal or lower than on the contralateral side.
Histamine-induced flare and axon reflex vasodilatation were not different on both
sides. Histamine evoked pain increased. In 12 patients (group II, nociceptor
impairment) heat pain thresholds were higher than contralateral.
Histamine-induced flare was impaired or abolished. Histamine did not induce any
sensation. Lidocaine was efficacious in the entire group of patients. Subgroup
analysis revealed that patients with impairment of nociceptor function had
significantly greater pain reduction under lidocaine vs placebo. Patients with
preserved and sensitised nociceptors demonstrated no significant pain relief.
CONCLUSIONS: PHN patients differ concerning their cutaneous nociceptor function: 
In the group I pain is caused by pathologically sensitised nociceptors. In subset
II there is a loss of function of cutaneous C-nociceptors within the allodynic
skin. Patients responded well to topical lidocaine even if the skin was
completely deprived of nociceptors. Different underlying mechanisms of lidocaine 
action in nociceptor-deprived skin are discussed.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 15778907 [PubMed - indexed for MEDLINE]

1491: Arch Med Res. 2005 Jan-Feb;36(1):24-31.

Clinical profile of pediatric HIV infection from India.

Shah SR, Tullu MS, Kamat JR.

Department of Pediatrics, Seth G.S. Medical College and KEM Hospital, Parel,
Mumbai, Maharashtra, India.

BACKGROUND: Our aim was to study the clinical profile of pediatric patients
admitted with HIV infection. METHODS: The prospective study was conducted from
January 2000 to October 2001 at a tertiary care referral teaching hospital in
Mumbai, India. Admitted in-patients (aged 1 month to 12 years) detected to be
HIV-positive (on triple ELISA test) were enrolled in the study. HIV status of
patients < 18 months of age was confirmed by DNA-PCR testing. Demographic data,
clinical features, investigations and outcome were recorded in a pre-designed
proforma. RESULTS: Fifty HIV-positive children (31 males and 19 females; M:F =
1.6:1) were enrolled. Thirty cases were completely immunized, 9 were partially
immunized while 11 were not immunized. Forty-two were perinatally infected, while
eight cases were infected via blood transfusion (patients with thalassemia major 
on chronic transfusion therapy). Clinical features at presentation in 42
symptomatic cases included protein-energy malnutrition (90%), fever > 1 month
(50%), weight loss > 1 month (50%), persistent generalized lymphadenopathy (24%) 
and skin manifestations (79%). The gastrointestinal (62%) and respiratory (52%)
were the most commonly involved organ systems. Opportunistic infections noted
included tuberculosis (19 cases), candidiasis (6 cases), Pneumocystis carinii
pneumonia (4 cases), herpes zoster (3 cases) and giardiasis (1 case). Six
patients died (mortality, 14%). CONCLUSIONS: Perinatal transmission is the most
common mode of acquiring HIV in the pediatric age group. Most patients have
protein-energy malnutrition. Tuberculosis is common in HIV-infected Indian
children. Patients with HIV-encephalopathy have a poor outcome.

PMID: 15777991 [PubMed - indexed for MEDLINE]

1492: Eye. 2006 Feb;20(2):247.

Comment on:
    Eye. 2004 May;18(5):544-5.

High dosage of oral valaciclovir as an alternative treatment of varicella zoster 
acute retinal necrosis syndrome.

Guex-Crosier Y, Meylan PR.

Publication Types: 
    Comment
    Letter

PMID: 15776013 [PubMed - indexed for MEDLINE]

1493: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):572.

Post herpetic neuralgia.

Pearce JM.

jmsp@freenet.co.uk

Publication Types: 
    Historical Article

PMID: 15774448 [PubMed - indexed for MEDLINE]

1494: Percept Mot Skills. 2005 Feb;100(1):258-62.

Lateralization of squamous cell carcinomas in the head-neck region.

Dane S, Karasen M, Sahin O, Oztop E.

Department of Physiology, Faculty of Medicine, Ataturk University, Erzurum,
Turkey.

Earlier studies have shown the lateralization of several immune disorders,
including herpes zoster infection and breast cancer. We investigated whether
there is lateralization of squamous cell carcinomas in the head-neck region and a
relation of handedness with this cancer. Analysis showed right-sided
lateralization of head-heck cancers in right-handed patients and vice versa in
left-handed ones and a higher rate of left-handedness in patients with squamous
cell cancer. Associations among left-handedness, squamous cell carcinoma, and its
lateralization may result from a genetic togetherness.

PMID: 15773716 [PubMed - indexed for MEDLINE]

1495: Treat Guidel Med Lett. 2005 Apr;3(32):23-32.

Erratum in:
    Treat Guidel Med Lett. 2005 May;3(33):38.

Drugs for non-HIV viral infections.

[No authors listed]

PMID: 15767977 [PubMed - indexed for MEDLINE]

1496: J Virol. 2005 Apr;79(7):3987-97.

The protein encoded by the US3 orthologue of Marek's disease virus is required
for efficient de-envelopment of perinuclear virions and involved in actin stress 
fiber breakdown.

Schumacher D, Tischer BK, Trapp S, Osterrieder N.

Department of Microbiology & Immunology, College of Veterinary Medicine, Cornell 
University, Ithaca, NY 14853, USA.

Marek's disease virus (MDV) encodes a protein exhibiting high amino acid
similarity to the US3 protein of herpes simplex virus type 1 and the gene 66
product of varicella-zoster virus. The MDV US3 orthologue was replaced with a
kanamycin resistance gene in the infectious bacterial artificial chromosome clone
BAC20. After transfection of US3-negative BAC20 DNA (20DeltaUS3), the resulting
recombinant 20DeltaUS3 virus exhibited markedly reduced growth kinetics. Virus
titers on chicken embryo cells were reduced by approximately 10-fold, and plaque 
sizes were significantly smaller (65% reduction) compared to parental BAC20
virus. The defect of the US3-negative MDV was completely restored in a revertant 
virus (20US3*) expressing a US3 protein with a carboxy-terminal FLAG tag.
Electron microscopical studies revealed that the defect of the 20DeltaUS3 mutant 
to efficiently spread from cell to cell was concomitant with an accumulation in
the perinuclear space of primarily enveloped virions in characteristic vesicles
containing several virus particles, which resulted in reduced numbers of
particles in the cytoplasm. The formation of these vesicles was not observed in
cells infected with either parental BAC20 virus or the 20US3* revertant virus.
The role of the MDV US3 protein in actin stress fiber breakdown was investigated 
by visualizing actin with phalloidin-Alexa 488 after infection or transfection of
a US3 expression plasmid. Addition of the actin-depolymerizing drug cytochalasin 
D to cells transfected or infected with BAC20 resulted in complete inhibition of 
plaque formation with as little as 50 nM of the drug, while concentrations of
nocodazole as high as 50 microM only had a relatively minor effect on MDV plaque 
formation. The results indicated that the MDV US3 serine-threonine protein kinase
is transiently involved in MDV-mediated stress fiber breakdown and that
polymerization of actin, but not microtubules, plays an important role in MDV
cell-to-cell spread.

PMID: 15767401 [PubMed - indexed for MEDLINE]

1497: S Afr Med J. 2005 Jan;95(1):30-1.

Herpes zoster ophthalmicus.

Dawodu OA, Osahon AI, Alikah AA, Bakare CE.

Opthalmology Department, University of Benin Teaching Hospital, PMB 1111, Benin
City, Nigeria.

PMID: 15762243 [PubMed - indexed for MEDLINE]

1498: J Pediatr. 2005 Mar;146(3):423-5.

Comment in:
    J Pediatr. 2006 Apr;148(4):563-4; author reply 564.    J Pediatr. 2006 Apr;148(4):563; author reply 564.

Fatal varicella associated with selective natural killer cell deficiency.

Etzioni A, Eidenschenk C, Katz R, Beck R, Casanova JL, Pollack S.

Meyer Children's Hospital, Department of Immunology, B. Rappaport Medical School,
Technion, Haifa, Israel. etzioni@rambam.health.gov.il

A 2-year-old girl with recurrent severe varicella infections had a fatal outcome.
Studies of cellular and humoral immunity were normal. No natural killer (NK)
cells were detected, and NK activity was markedly decreased. The interleukin
(IL)15/IL15R signaling pathway was intact. This case emphasizes the role of NK
cells in controlling herpes viral infection.

Publication Types: 
    Case Reports

PMID: 15756234 [PubMed - indexed for MEDLINE]

1499: Eur J Pediatr. 2005 Jun;164(6):366-70. Epub 2005 Mar 4.

Prospective surveillance of hospitalisations associated with varicella-zoster
virus infections in children and adolescents.

Bonhoeffer J, Baer G, Muehleisen B, Aebi C, Nadal D, Schaad UB, Heininger U.

Division of Paediatric Infectious Diseases, University Children's Hospital, P.O. 
Box, 4005, Basel, Switzerland.

Our goal was to determine the epidemiology of severe varicella-zoster virus (VZV)
infections in hospitalised paediatric patients. Admissions associated with VZV
infection of patients aged 0-16 years were reported by all 38 paediatric units in
Switzerland to the Swiss Paediatric Surveillance Unit (SPSU) during 3 consecutive
years (4/2000-3/2003). We verified completeness of reporting by capture-recapture
analysis with patient records identified by ICD-10 codes. Outcome of illness was 
assessed 6 months after hospitalisation. A total of 335 cases (235 identified by 
SPSU reports, 100 by ICD-10 code) were included in this study. Mean age of
patients was 4.1 years (median 3.5 years, range 0-16 years); 54% were male. Some 
293 (87%) patients presented with chickenpox, 42 (13%) with herpes zoster and 291
(87%) patients were not immunocompromised. A total of 319 complications occurred 
in 237 (71%) patients: secondary bacterial infections (n =109); central nervous
system involvement (n =76); VZV pneumonitis (n =7); others (n =127). Eleven (3%) 
patients required intensive care and three died. On follow-up, 303 (96%) of 315
patients had completely recovered; sequelae were present in 12 (4%) patients. The
calculated hospitalisation rate was 13 per 10(4) cases. CONCLUSION: This study
describes a sizeable hospitalisation and complication rate of varicella-zoster
virus infections and provides a solid basis for future immunisation
recommendations in Switzerland.

PMID: 15747132 [PubMed - indexed for MEDLINE]

1500: Acta Neurol Scand. 2005 Apr;111(4):229-32.

Oxcarbazepine monotherapy in postherpetic neuralgia unresponsive to carbamazepine
and gabapentin.

Criscuolo S, Auletta C, Lippi S, Brogi F, Brogi A.

U.O.C. Terapia Antalgica e Terapia Postoperatoria, Azienda Ospedaliera Senese
Policlinico Le Scotte Siena, Italy.

OBJECTIVES: We present the results of a preliminary, open-label trial to evaluate
the efficacy and tolerability of oxcarbazepine in postherpetic neuralgia (PHN)
unresponsive to treatment with antiepileptic drugs (carbamazepine and gabapentin)
and local anesthetic blocks. MATERIALS AND METHODS: Twenty-four patients were
treated with oxcarbazepine monotherapy for 8 weeks. Starting dose was 150 mg/day,
subsequently increased by 150 mg/day every 2 days until a maintenance dose of 900
mg/day. Pain was assessed using a visual analog scale (VAS). RESULTS: There was a
significant decrease in the mean VAS score following 8 weeks of treatment
(Delta=5.33; paired t-test: P <0.0001) compared with baseline. Oxcarbazepine was 
effective from the first week of treatment. There was a significant reduction in 
allodynia, leading to improvements in patients' functioning and quality of life. 
Oxcarbazepine was generally well tolerated. CONCLUSION: Oxcarbazepine appears to 
be a promising alternative monotherapeutic approach for patients affected by PHN.

Publication Types: 
    Clinical Trial

PMID: 15740573 [PubMed - indexed for MEDLINE]

1501: Eur J Pain. 2005 Apr;9(2):167-71.

Use of the Rydel-Seiffer graduated tuning fork in the assessment of vibration
threshold in postherpetic neuralgia patients and healthy controls.

Whitton TL, Johnson RW, Lovell AT.

United Bristol Healthcare Trust, Bristol, UK.

BACKGROUND AND AIMS: Afferent large fibre impairment has been reported as a
useful predictor of postherpetic neuralgia (PHN) in patients with acute herpes
zoster infection, using an electromechanical device to provide quantitative
vibrametry. We aimed to demonstrate a clinically significant increase in
vibration threshold in individuals with PHN compared to age-matched controls,
using the portable and affordable Rydel-Seiffer graduated tuning fork. METHODS:
We studied 45 PHN subjects aged over 55 years, and 45 age-matched controls with
no history of herpes zoster infection. We excluded subjects with a history of
disorders associated with neuropathy or immunocompromise. Measurements were
performed at the ulnar styloid process and the head of the first metatarsal on
the right side, in a warm room with the subject seated. Readings were taken in
triplicate and the data analysed by a repeated measures design. RESULTS: We
observed a significant difference in vibration threshold at both wrist and toe
between the PHN and control groups (p < 0.001). Age-stratification of subjects
produced an increased and clinically useful difference between the two groups at 
both sites in subjects between 55 and 70 years (p < 0.0001). CONCLUSIONS: We have
shown a statistically significant decrease in vibration sensitivity in
individuals with PHN aged 55-70 years compared to age-matched healthy controls,
using the Rydel-Seiffer graduated tuning fork. A prospective study of patients
with acute zoster infection is needed to determine the sensitivity and
specificity of the graduated tuning fork in predicting PHN in patients with acute
zoster infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15737809 [PubMed - indexed for MEDLINE]

1502: Pediatr Neurol. 2005 Mar;32(3):211-2.

Zoster-associated intracranial hypertension.

Millichap JJ, Freeman JL.

Departments of Pediatrics and Internal Medicine, Brody School of Medicine at East
Carolina University, Greenville, NC, USA.

A 14-year-old female presented with headache, vomiting, and a rash. She was found
to have papilledema and herpes zoster. Examination of the cerebrospinal fluid
revealed pleocytosis and an elevated protein concentration. Varicella-zoster
virus deoxyribonucleic acid was detected in the cerebrospinal fluid by polymerase
chain reaction. Intracranial hypertension was treated by repeated lumbar puncture
and with acetazolamide. This case represents an unusual complication of the
reactivation of varicella-zoster virus.

Publication Types: 
    Case Reports

PMID: 15730906 [PubMed - indexed for MEDLINE]

1503: West Afr J Med. 2004 Oct-Dec;23(4):300-4.

Clinical spectrum of herpes zoster in HIV-infected versus non-HIV infected
patients in Benin City, Nigeria.

Onunu AN, Uhunmwangho A.

Department of Medicine, University of Benin Teaching Hospital, Benin City,
Nigeria.

BACKGROUND: Herpes zoster is due to reactivation of the varicella-zoster virus
(VZV) at the sensory nerve ganglia. Some reports indicate that there might be
differences in the pattern of presentation of herpes zoster in HIV infected
patients. The objective of this study therefore, is to compare the clinical
spectrum of herpes zoster in HIV-infected versus non-HIV infected patients. STUDY
DESIGN: In this prospective study all patients presenting with clinical features 
of Herpes zoster had serological test (ELISA) for Human immunodeficiency viral
(HIV) antibodies done and confirmed by the Double/Triple test algorithm. They
were examined clinically to determine the dermatome(s) involved, the severity of 
the disease and the presence of any complication. The patients were categorized
according to their HIV-status for the purpose of statistical analysis. RESULTS:
Fifty-two out of the seventy-three patients seen during the study period were
evaluated: 22 male (42.3 %) and 30 female (57.7 %) patients. Thirty-six (69.2 %) 
patients were HIV-positive while 16 (30.8%) were HIV-negative. The age
distribution of the patients was bimodal; the mean age of patients in the
HIV-positive group was 36.1+/-16.14 years while that of the HIV-negative group
was 56.3+/-17.51 years. Multidermatomal involvement, affectation of the
Trigeminal nerve dermatome and the presence of systemic symptoms such as fever
and weakness correlated significantly with the presence of HIV infection. Mean
times to cessation of new vesicle formation, crusting, and resolution of
zoster-associated pain were also significantly longer in the HIV-positive
patients. There were no statistically significant differences in the incidence of
post-herpetic neuralgia, keloids, and bacterial super-infection in both groups.
CONCLUSION: Herpes zoster was generally more severe in the presence of HIV
infection.

Publication Types: 
    Comparative Study

PMID: 15730088 [PubMed - indexed for MEDLINE]

1504: Antimicrob Agents Chemother. 2005 Mar;49(3):1081-6.

Susceptibilities of several clinical varicella-zoster virus (VZV) isolates and
drug-resistant VZV strains to bicyclic furano pyrimidine nucleosides.

Andrei G, Sienaert R, McGuigan C, De Clercq E, Balzarini J, Snoeck R.

Rega Institute for Medical Research, Minderbroedersstraat 10, B-3000 Leuven,
Belgium. graciela.andrei@rega.kuleuven.ac.be

Varicella-zoster virus (VZV) is responsible for primary infections as well as
reactivations after latency in the dorsal root ganglia. The treatment of such
infections is mandatory for immunocompromised patients and highly recommended for
elderly patients with herpes zoster infections (also called zona or shingles).
The treatment of choice is presently based on four molecules, acyclovir (ACV),
valaciclovir, famciclovir, and (in Europe) brivudine (BVDU). We present here our 
data on the antiviral activity of a new class of potent and selective anti-VZV
compounds, bicylic pyrimidine nucleoside analogues (BCNAs), against a broad
variety of clinical isolates and different drug-resistant virus strains. The
results show that the BCNAs are far more potent inhibitors than ACV and BVDU
against clinical VZV isolates as well as the VZV reference strains Oka and YS.
The BCNAs were not active against ACV- and BVDU-resistant VZV strains bearing
mutations in the viral thymidine kinase gene but kept their inhibitory potential 
against virus strains with mutations in the VZV DNA polymerase gene. Mutant virus
strains selected in the presence of the BCNAs were solely cross-resistant to
drugs, such as ACV and BVDU, that depend for their antiviral action on metabolic 
activation by the viral thymidine kinase.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15728906 [PubMed - indexed for MEDLINE]

1505: Antimicrob Agents Chemother. 2005 Mar;49(3):1039-45.

In vitro activity and mechanism of action of methylenecyclopropane analogs of
nucleosides against herpesvirus replication.

Kern ER, Kushner NL, Hartline CB, Williams-Aziz SL, Harden EA, Zhou S, Zemlicka
J, Prichard MN.

The University of Alabama at Birmingham, Department of Pediatrics, 128 Children's
Harbor Building, 1600 6th Ave. South, Birmingham, AL 35233, USA. kern@uab.edu

We have reported previously that methylenecyclopropane analogs of nucleosides
have excellent activity against certain members of the herpesvirus family. A
second generation, the 2,2-bis-hydroxymethyl derivatives, were synthesized, and
18 compounds were tested for activity in vitro against herpes simplex virus types
1 and 2 (HSV-1 and HSV-2), human and murine cytomegalovirus (HCMV and MCMV),
varicella-zoster virus (VZV), and Epstein-Barr virus (EBV). Selected analogs were
also evaluated against human herpesvirus type 6 (HHV-6) and HHV-8. None of the 18
compounds had activity against HSV-1 or HSV-2, but four were active against VZV
by plaque reduction (PR) assay at 50% effective concentration (EC(50)) levels of 
< or =50 microM. Six of the 18 compounds were active against HCMV by cytopathic
effect or PR assays with EC(50)s of 0.5 to 44 microM, and all were active against
MCMV by PR (0.3 to 54 microM). Four of the compounds were active against EBV by
enzyme-linked immunosorbent assay (<0.3 to 4.4 microM). Four compounds with CMV
activity were also active against HHV-6A and HHV-6B (0.7 to 28 microM), and three
compounds were active against HHV-8 (5.5 to 16 microM). One of these, ZSM-I-62,
had particularly good activity against CMV, HHV-6, and HHV-8, with EC(50)s of 0.7
to 8 microM. Toxicity was evaluated in adherent and nonadherent cells, and
minimal cytotoxicity was observed. Mechanism of action studies with HCMV
suggested that these compounds are phosphorylated by the ppUL97
phosphotransferase and are potent inhibitors of viral DNA synthesis. These
results indicate that at least one of these compounds may have potential for use 
in treating CMV and other herpesvirus infections in humans.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15728900 [PubMed - indexed for MEDLINE]

1506: J Pediatr Ophthalmol Strabismus. 2005 Jan-Feb;42(1):57-8.

Ophthalmic herpes zoster in an 18-month-old child.

Gandhewar J, Birchall W, Kwartz J.

Eye Unit, Royal Bolton Hospital, Bolton, England.

We present a case of herpes zoster ophthalmicus in an 18-month-old child. Early
exposure to varicella zoster virus while being breast-fed appears to account for 
this clinical presentation. The incidence of herpes zoster in children younger
than age 2 years is discussed.

Publication Types: 
    Case Reports

PMID: 15724901 [PubMed - indexed for MEDLINE]

1507: Br J Gen Pract. 2005 Feb;55(511):102-7.

Is herpes zoster a marker for occult or subsequent malignancy?

Buntinx F, Wachana R, Bartholomeeusen S, Sweldens K, Geys H.

Department of General Practice, University of Leuven, Leuven, Belgium.
Frank.buntinx@med.kuleuven.ac.be

BACKGROUND: It has been suggested that herpes zoster may be a marker for occult
malignancy. AIM: To examine the emergence of a subsequent cancer diagnosis in
patients with and without herpes zoster. DESIGN OF STUDY: Retrospective cohort
study. SETTING: Results were based on the database of Intego, an ongoing Belgian 
general practice-based morbidity registry, covering 37 general practitioners and 
including about 311 000 patient years between the years 1994 and 2000. METHOD:
Survival analysis comparing the emergence of malignancy in patients with and
without herpes zoster. RESULTS: The number of patients below the age of 65 years 
with herpes zoster, cancer or both was too low to draw any sensible conclusions. 
Above the age of 65 years we identified a significant increase of cancer
emergence in the whole group and in females (hazard ratio = 2.65, 95% confidence 
interval = 1.43 to 4.90), but not in males. No difference could be identified in 
the first year after the herpes zoster infection. CONCLUSION: Our results do not 
justify extensive testing for cancer in herpes zoster patients. The association
we identified, however, leaves open a number of questions with respect to the
physiopathology behind it.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15720930 [PubMed - indexed for MEDLINE]

1508: Liver Transpl. 2005 Mar;11(3):320-5.

Herpes zoster infection after liver transplantation: a case-control study.

Levitsky J, Kalil A, Meza JL, Hurst GE, Freifeld A.

Department of Internal Medicine/Gastroenterology, University of Nebraska Medical 
Center, University of Nebraska, Omaha, Nebraska, 68198-5400, USA.

Prior case series have suggested that herpes zoster (HZ) after orthotopic liver
transplantation (OLT) may lead to serious complications due to visceral
involvement. We sought to determine the incidence, risk factors, and long term
outcomes of HZ after OLT. Clinical data from September 1993 to April 2004 were
collected on all cases of HZ after OLT, and at the same post-OLT time points in
age, gender, and transplant-year-matched HZ-negative controls. Risk factors for
HZ infection and long-term outcomes were compared between cases and controls. A
total of 29 patients developed HZ at a median of 4.9 years (range .5-12.9) after 
OLT. All HZ infections except 1 were localized to a single dermatome. Only 8
(28%) were hospitalized and 16 (55%) were treated with oral antivirals alone. No 
patients developed visceral involvement or died of HZ infection. No risk factors 
for HZ infection were identified on multivariate analysis. Of the long-term
outcomes, the estimated 10-year survival was lower (P = .05) for cases than
controls. The lower survival in HZ cases was not directly attributable to HZ
infection. In conclusion, this study is the largest series on HZ after OLT. HZ is
neither a common nor a serious infection after OLT and can be managed with
antiviral therapy with a low likelihood of visceral dissemination.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15719387 [PubMed - indexed for MEDLINE]

1509: Klin Monatsbl Augenheilkd. 2005 Feb;222(2):81-9.

[Anti-infective drug therapy in ophthalmology--Part 2: viral infections]

[Article in German]

Reinhard T, Hansen LL, Pache M, Behrens-Baumann W.

Augenklinik des Universitatsklinikums, Freiburg. Reinhard@aug.ukl.uni-freiburg.de

In this review ophthalmological diseases caused by herpes simplex virus,
varicella zoster virus, Epstein-Barr virus, cytomegaly virus or adenovirus are
described briefly. The main therapeutic options are discussed placing emphasis
especially on prospective randomised trials.

Publication Types: 
    English Abstract
    Review

PMID: 15719312 [PubMed - indexed for MEDLINE]

1510: Exp Mol Pathol. 2005 Apr;78(2):131-4. Epub 2005 Jan 5.

Symptomatic relief of herpetic skin lesions utilizing an energy-based approach to
healing.

Martin WJ, Stoneburner J.

Center for Complex Infectious Diseases, 3328 Stevens Avenue, Rosemead, CA 91770, 
USA. s3support@email.com

Herpes simplex virus induced oral and genital ulcerating lesions will fluoresce
brightly yellow and yellow-orange, respectively, if treated with a chlorinated
solution of neutral red and exposed to ultraviolet-A light. An orange to red
fluorescence is seen with similarly treated and illuminated Herpes zoster virus
induced shingles; while treated human papillomavirus induced genital warts
display more of a purplish fluorescence. Pain and discomfort commonly disappear
soon after the treatment and all lesions undergo expedited healing that is
readily observable within 24 h. The mechanism of healing is thought to involve an
interaction between neutral red and alternative cellular energy pigments (ACE
pigments) present within the viral lesions that enhances responsiveness to
ultraviolet light energy. The healing effects are not restricted to the treated
lesions and may involve transmission of a biological energy throughout the body. 
Beyond its obvious clinical and diagnostic utility, this model system may help
usher in a new era of energy-based medicine.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 15713438 [PubMed - indexed for MEDLINE]

1511: Nippon Jibiinkoka Gakkai Kaiho. 2005 Jan;108(1):1-7.

[Accuracy of the prognostic diagnosis in acute peripheral facial palsy]

[Article in Japanese]

Aoyagi M.

Department of Otolaryngology, Head and Neck Surgery, Course of Biological
Structure and Cognitive Integration Science, Yamagata University School of
Medicine, Yamagata.

The important factors in the prognostic diagnosis of acute peripheral facial
palsy are (1) the causal disease, (2) the site of injury and (3) the degree of
injury, although the age of the patient, complication, treatment method and
initial day of treatment are also important. Among these 3 factors, the degree of
injury is most strongly related to the prognosis. However, the diagnosis of
etiology is the most important for the selection of the treatment method. Above
all, the differential diagnosis between Bell's palsy and zoster sine herpete
(Ramsay Hunt syndrome), is the most significant. However, it is impossible to
diagnose all patients with complete accuracy within 3 days after the onset of
palsy, even using molecular biological examination including polymerase chain
reaction analysis. The diagnosis of the site of injury does not contribute to the
prediction of prognosis or the selection of treatment method, except for the
determination of the approaching route of the facial nerve decompression for
traumatic facial palsy. The scoring system of facial movement (40-point method), 
nerve excitability test (NET), electroneurography (ENoG), transcranial magnetic
stimulation (TMS) and stapedial reflex (SR) are commonly used to estimate the
degree of injury. To estimate the accuracy of these examinations, sensitivity and
specificity of the tests were calculated according to the findings within 3 days 
after the onset of palsy and the outcome of 116 patients with Bell's palsy and 31
with Ramsay Hunt syndrome. According to the results, none of these tests seem to 
be a perfect diagnostic examination for the completely precise prediction of
prognosis. However, a patient is predicted to have a good prognosis, if the
following 3 findings are observed: (1) more than 10 points in the 40-point
scoring system of facial movement, (2) a positive response to TMS and (3) a
positive response to SR. An antidromic facial nerve response probably contributes
to a precise prediction of prognosis within 3 days after the onset of facial
palsy.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't
    Review

PMID: 15712490 [PubMed - indexed for MEDLINE]

1512: J Virol. 2005 Mar;79(5):2931-40.

Erratum in:
    J Virol. 2007 Mar;81(5):2539.

The ectodomain of herpes simplex virus glycoprotein H contains a membrane
alpha-helix with attributes of an internal fusion peptide, positionally conserved
in the herpesviridae family.

Gianni T, Martelli PL, Casadio R, Campadelli-Fiume G.

Department of Experimental Pathology, Section on Microbiology and Virology,
University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy.

Human herpesviruses enter cells by fusion with target membranes, a process that
requires three conserved glycoproteins: gB, gH, and gL. How these glycoproteins
execute fusion is unknown. Neural network bioinformatics predicted a membrane
alpha-helix contained within the ectodomain of herpes simplex virus (HSV) gH,
positionally conserved in the gH of all examined herpesviruses. Evidence that it 
has attributes of an internal fusion peptide rests on the following lines of
evidence. (i) The predicted membrane alpha-helix has the attribute of a membrane 
segment, since it transformed a soluble form of gD into a membrane-bound gD. (ii)
It represents a critical domain of gH. Its partial or entire deletion, or
substitution of critical residues inhibited HSV infectivity and fusion in the
cell-cell fusion assay. (iii) Its replacement with the fusion peptide from human 
immunodeficiency virus gp41 or from vesicular stomatitis virus G partially
rescued HSV infectivity and cell-cell fusion. The corresponding antisense
sequences did not. (iv) The predicted alpha-helix located in the varicella-zoster
virus gH ectodomain can functionally substitute the native HSV gH membrane
alpha-helix, suggesting a conserved function in the human herpesviruses. We
conclude that HSV gH exhibits features typical of viral fusion glycoproteins and 
that this property is likely conserved in the Herpesviridae family.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15709012 [PubMed - indexed for MEDLINE]

1513: Antiviral Res. 2005 Feb;65(2):97-105.

Inhibition of herpesvirus replication by a series of 4-oxo-dihydroquinolines with
viral polymerase activity.

Hartline CB, Harden EA, Williams-Aziz SL, Kushner NL, Brideau RJ, Kern ER.

Department of Pediatrics, The University of Alabama School of Medicine, 128 CHB, 
1600 6th Avenue South, Birmingham, AL 35233, USA.

Herpesviruses cause a wide variety of human diseases ranging from cold sores and 
genital herpes to encephalitis, congenital infections and lymphoproliferative
diseases. These opportunistic viruses cause major problems in immunocompromised
individuals such as transplant recipients, cancer patients, and HIV-infected
persons. The current treatment of these infections is not optimal and there is a 
need for more active, less toxic compounds that might be used in place of or in
addition to current therapies. We have evaluated a new series of
4-oxo-dihydroquinolines, which have a different mechanism of action than
nucleosides and have activity against multiple herpesviruses. Of the four new
compounds evaluated, two (PHA-529311 and PHA-570886) had greater activity than
the parent, PHA-183792, against several herpesviruses and one (PHA-568561) was as
effective as the parent. A fourth, PHA-243672, was considerably less effective.
They had greater efficacy against cytomegalovirus (CMV) than the other
herpesviruses tested and also had activity against acyclovir-resistant herpes
simplex virus and varicella-zoster virus isolates and ganciclovir or
foscarnet-resistant CMV isolates. These results confirm the broad-spectrum
efficacy of these compounds against multiple herpesviruses and suggest that
members of this class may have a potential role for treatment of a variety of
herpesvirus infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15708636 [PubMed - indexed for MEDLINE]

1514: J Biopharm Stat. 2005;15(1):165-78.

Responder cell frequency estimation and binomial three-level nonlinear mixed
effects model in limiting dilution assays.

Ellison MC, Zerbe GO, Levin MJ.

Division of Biostatistics, National Jewish Medical and Research Center, Denver,
Colorado 80206, USA. ellisonm@njc.org

Responder cell frequencies (RCF), which describe vaccine-boosted immune responses
in herpes zoster (HZ) prevention studies, have been estimated by using limiting
dilution assays (LDA). The theoretical linearity assumption between the logarithm
of the proportion of nonresponding wells (s) and the cell concentration (N) (or
dilution level) in LDA, based on the single-hit Poisson model, is often violated 
with observed data resulting in biased estimates of RCF. In this article, the
Poisson assumption is modified by applying a mixture of Poisson and gamma
distributions, resulting in a negative binomial assumption, which presents a
better fit between s and N. In LDA for HZ prevention studies, binary responses
(responder or non-responder wells) are measured repeatedly at different cell
concentrations and over time. To account for the correlation between responses to
varying dilution levels from individuals, and the correlation between repeated
assays of individuals over time simultaneously, a binomial three-level nonlinear 
mixed-effects model is proposed. For parameter estimation, a maximum likelihood
method is applied via adaptive Gaussian quadrature. There is a lack of
non-Gaussian multilevel nonlinear mixed-effects software, which can execute such 
a complicated fit. In this article, an algorithm for the three-level nonlinear
mixed-effects model, which can be inserted into the code in the SAS procedure
NLMIXED, is suggested.

Publication Types: 
    Comparative Study
    Validation Studies

PMID: 15702611 [PubMed - indexed for MEDLINE]

1515: Pediatr Infect Dis J. 2005 Feb;24(2):102-7.

Varicella zoster in Guinea-Bissau: intensity of exposure and severity of
infection.

Poulsen A, Cabral F, Nielsen J, Roth A, Lisse IM, Vestergaard BF, Aaby P.

Projecto de Saude de Bandim, Guinea-Bissau, Statens Serum Institut, Copenhagen,
Denmark. anja@dadlnet.dk

OBJECTIVE: To describe the epidemiology of and risk factors for severe chickenpox
in Guinea- Bissau. METHODS: A prospective household study in a semiurban area of 
the capital. Severity was assessed by number of pox, fever response and presence 
of pneumonia. Severity was compared for the first case in a house, that is, the
index case, and the secondary cases infected at home. RESULT: We identified 1539 
cases of chickenpox. The median age was lower for boys and secondary cases (both 
P < 0.03); 44.6% of children were 1-4 years of age. The likely minimum interval
between index and secondary cases was 10 days; most secondary cases occurred
14-17 days after the index case. The length of the incubation period was related 
to the intensity of exposure (P < 0.01). The number of pox was higher for
secondary cases (P < 0.01) and was related to intensity of exposure (P < 0.01).
Secondary cases had higher fever and more frequently pneumonia (relative risk,
2.17; 95% confidence interval, 1.54-3.08). Children with pneumonia were younger
and had more pox. Nutritional status was not related to severity. CONCLUSIONS:
Age and intensity of exposure are important determinants for severity of
chickenpox infection. The length of the incubation period depends on intensity of
exposure, suggesting that the dose of infection might be important.

PMID: 15702036 [PubMed - indexed for MEDLINE]

1516: Pediatr Infect Dis J. 2005 Feb;24(2):97-101.

Varicella-zoster virus reactivation is an important cause of acute peripheral
facial paralysis in children.

Furuta Y, Ohtani F, Aizawa H, Fukuda S, Kawabata H, Bergstrom T.

Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate 
School of Medicine, Sapporo, Japan. yfuruta@med.hokudai.ac.jp

BACKGROUND: Reactivation of herpes simplex virus type 1 is thought to be a major 
cause of adult idiopathic peripheral facial paralysis or Bell's palsy. However,
few studies have examined the pathogenesis of this condition in children.
Serologic assays and polymerase chain reaction (PCR) analysis of paired sera and 
saliva samples were used here to investigate the causes of acute peripheral
facial paralysis in pediatric patients. METHODS: A total of 30 children with
acute peripheral facial paralysis were recruited. Paired sera were assayed for
evidence of herpesvirus, mumps virus or Borrelia infection. PCR was used to
detect herpes simplex virus type 1 and varicella-zoster virus (VZV) DNA in saliva
samples. RESULTS: Ramsay Hunt syndrome with accompanying zoster lesions was
diagnosed clinically in 2 patients, and VZV reactivation was confirmed
serologically. VZV reactivation in the absence of zoster (zoster sine herpete)
was diagnosed in 9 patients with either serologic assays or PCR. Thus VZV
reactivation was demonstrated in 11 of 30 (37%) patients. The prevalence of VZV
reactivation among patients between 6 and 15 years of age was significantly
higher than in those younger than 5 years of age (53% versus 9%, P = 0.023).
CONCLUSIONS: Our data indicate that VZV reactivation is an important cause of
acute peripheral facial paralysis in children, especially those between 6 and 15 
years of age.

PMID: 15702035 [PubMed - indexed for MEDLINE]

1517: J Pediatr Hematol Oncol. 2005 Feb;27(2):106-8.

Varicella-zoster reactivation in a patient receiving routine revaccinations after
an allogeneic hemopoietic progenitors transplant.

Patel SR, Ortin M.

Royal Marsden Hospital, Sutton, UK. soonier@hotmail.com

Primary varicella-zoster virus (VZV) infection and herpes zoster are important
infectious complications after an allogeneic hemopoietic progenitors transplant
(HPT). The authors describe a girl with second relapse of acute lymphoblastic
leukemia who received an HPT at age 13 years. Two years after the HPT she started
a revaccination program of routine childhood vaccines. With each course of
vaccines she developed herpes zoster of the C6 dermatome, initially with the rash
and later zoster sine herpete. The vaccinations appear to have triggered VZV
reactivation by vaccine-induced immunomodulation in this HPT recipient.

Publication Types: 
    Case Reports

PMID: 15701988 [PubMed - indexed for MEDLINE]

1518: Euro Surveill. 2005 Jan;10(1):43-5.

Varicella zoster virus vaccination policies and surveillance strategies in
Europe.

Pinot de Moira A, Nardone A; ESEN2 group.

Immunisation Department, Health Protection Agency, CDSC, London, United Kingdom.

The incorporation of varicella zoster virus (ZVV) vaccination in childhood
immunisation schedules is becoming an increasingly common option in Europe. The
current study forms part of the European Sero-Epidemiology Network 2 (ESEN2)
organisational analysis for VZV and describes current passive immunisation
policies, as well as current and proposed active immunisation strategies, and
existing surveillance systems for diseases caused by the varicella zoster virus
in ESEN countries. A questionnaire was compiled and distributed to 23
participating countries. A VZV vaccine is currently licensed in 14 of the 20
participating ESEN countries. Germany is the only country to have incorporated
VZV vaccination into its routine childhood immunisation programme. Three further 
countries currently recommend vaccination of children against VZV and five
countries are also considering introducing routine immunisation against VZV for
children. However, of the eight countries with or considering introducing
childhood VZV immunisation, only six have case-based mandatory notification of
varicella, and only two countries have primary care surveillance data available
for herpes zoster.

PMID: 15701939 [PubMed - indexed for MEDLINE]

1519: Hautarzt. 2005 Mar;56(3):241-50.

[Evidence-based treatment of skin diseases caused by herpesvirus]

[Article in German]

Mahler V.

Dermatologische Klinik mit Poliklinik, Universitatsklinikum, Erlangen.
Vera.mahler@derma.imed.uni-erlangen.de

Six questions regarding varicella-zoster virus-related skin diseases are
addressed. The Cochran Library, MEDLINE, Clinical Evidence and several guideline 
providers were searched for evidence. The level of evidence in papers was
appraised according to the Oxford Centre for Evidence-based Medicine Levels of
Evidence. The current evidence for antiviral therapy of chickenpox in
immunocompetent children, adults and pregnancy, recommendation of varicella
vaccination, effect of time of initiation of antiviral therapy in acute zoster as
well as route of treatment with regard to onset of post-zoster neuralgia are
covered.

Publication Types: 
    English Abstract

PMID: 15700155 [PubMed - indexed for MEDLINE]

1520: Otol Neurotol. 2005 Jan;26(1):109-13.

Bell's palsy and Herpes simplex virus: fact or mystery?

Linder T, Bossart W, Bodmer D.

Clinic for Otolaryngology, Head and Neck Surgery, Kantonsspital Luzern,
Switzerland. thomas.linder@ksl.ch

HYPOTHESIS AND BACKGROUND: In recent years, progress has been made in the
understanding of Bell's palsy, the most common form of acute facial weakness.
Herpes simplex virus (HSV) reactivation within the geniculate ganglion with
subsequent inflammation and entrapment of the nerve at the meatal foramen has
been proposed to be the pathogenetic mechanism. We challenged its accuracy by
analyzing our own data on the presence of viral genomic DNA of HSV-1 and 2, human
herpes virus (HHV)-6A/B, as well as varizella zoster virus (VZV) in patients with
Bell's palsy and in control patients without the disease. METHODS: Polymerase
chain reaction was performed with primer sets specific for viral genomic DNA of
HSV-1, HSV-2, and VZV in facial muscle biopsy specimens from patients with Bell's
palsy. As control specimens, the Scarpa's ganglion of patients with Meniere's
disease and the geniculate ganglion harvested at autopsy from patients without
history of facial palsy. In a second study, we used polymerase chain reaction
with primers specific for HSV-1, -2, and HHV-6A, -6B to analyze for the presence 
of these viruses in tear fluid samples from control patients and patients with
acute Bell's palsy. RESULTS: HSV-1 and VZV genomic DNA were detected in 86 and
43%, respectively, of geniculate ganglion preparations from control specimen. We 
were not able to detect the presence of HSV-1, HSV-2, or VZV genomic DNA in
ganglion scarpae or muscle biopsy results in control and Bell's palsy patients.
HHV-6A could be detected in tear fluid samples in 40% of control patients and 30%
of Bell's palsy patients. CONCLUSIONS: The sole presence of HSV genomic DNA
within the sensory ganglion along the facial nerve does not explain the direct
association with Bell's palsy. The missing link would be the identification of an
active replicating virus, an investigation that has not yet been carried out.

PMID: 15699730 [PubMed - indexed for MEDLINE]

1521: Indian J Ophthalmol. 2004 Dec;52(4):323-4.

Maxillary zoster with corneal involvement.

Jain S, Rathore MK.

Department of Ophthalmology, S S Medical College, Rewa, India.

A case, of maxillary zoster with corneal involvement in a young patient is
described. Corneal involvement in maxillary zoster (Medline search) is rare.

Publication Types: 
    Case Reports

PMID: 15693326 [PubMed - indexed for MEDLINE]

1522: Zhejiang Da Xue Xue Bao Yi Xue Ban. 2005 Jan;34(1):60-4.

[Determination of six major human herpes viruses in cerebrospinal fluid and blood
of children with consensus primers]

[Article in Chinese]

Dong GP, Shang SQ, Yu ZS, Liang L, Yu XL.

The Children's Hospital, College of Medicine, Zhejiang University, Hangzhou
310003, China.

OBJECTIVE: To identify 6 major human herpesviruses with consensus primers and to 
explore its clinical application. METHODS: Based on the highly-homogeneous
regions of DNA polymerase gene in human herpesviruses,Two pairs of primer were
synthesized. One pair was designed to amplify herpes simplex virus type 1, type
2, Epstein-Barr virus and cytomegalovirus; and another was used to amplify
varicella-zoster virus or human herpesvirus 6. Virus species identification was
performed by restriction enzyme digestion with BamH I and BstU I. Thirty-eight
CSF specimens of clinically diagnosed viral encephalitis,and 49 blood specimens
from 27 confirmed cases and 22 clinically diagnosed ones were tested for herpes
virus DNA using the PCR-RFLP assay with these primers. RESULTS: Thirteen out of
38 CSF specimens (34.2%) were herpes virus positive. All blood specimens from 27 
confirmed cases showed positive results, while for 22 clinically diagnosed cases 
16 (72.7%) were positive. The types of herpes virus were determined using
restriction enzyme digestion with BamH I and BstU I. Two CSF specimens from the
patients, who were treated with aciclovir for 2 - 3 days, were still positive for
herpes virus DNA by this method. None of the control blood or CSF controls were
positive for herpesvirus by PCR. CONCLUSION: The PCR-RFLP method used in this
study is a specific, sensitive and practicable one for diagnosis of herpes virus 
infection.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 15693126 [PubMed - indexed for MEDLINE]

1523: Jpn J Ophthalmol. 2005 Jan-Feb;49(1):63-4.

Polymerase chain reaction during the treatment of acute retinal necrosis.

Kaneko H, Matsuzaki S, Okazaki Y, Kudo D.

Publication Types: 
    Case Reports
    Letter

PMID: 15692780 [PubMed - indexed for MEDLINE]

1524: J Am Acad Dermatol. 2005 Feb;52(2):375.

Comment on:
    J Am Acad Dermatol. 2004 Apr;50(4):653-4.

Linear lichen planus of the face and neck versus amalgam-induced "isotopic"
cutaneous lichen planus.

Happle R.

Publication Types: 
    Comment
    Letter

PMID: 15692500 [PubMed - indexed for MEDLINE]

1525: Plast Reconstr Surg. 2005 Feb;115(2):669-71.

A novel internal nasal prosthesis to maintain three-dimensional stability after
reconstruction of the nose.

Anderson AR, Whitaker IS, Fynes D, Telfer MR.

Publication Types: 
    Case Reports
    Letter

PMID: 15692397 [PubMed - indexed for MEDLINE]

1526: Acta Neurol Scand. 2005 Mar;111(3):185-90.

Immunoglobulins and virus-specific antibodies in patients with Creutzfeldt-Jakob 
disease.

Jacobi C, Arlt S, Reiber H, Westner I, Kretzschmar HA, Poser S, Zerr I.

Department of Neurology, University of Gottingen, Gottingen, Germany.

OBJECTIVES: Cerebrospinal fluid (CSF) pattern in patients with
neuropathologically diagnosed Creutzfeldt-Jakob disease was analyzed. MATERIAL
AND METHODS: Routine tests included white blood cells count, protein, albumin,
immunoglobulins and the presence of oligoclonal immunoglobulin G (IgG) in the CSF
as well as the calculation of intrathecal synthesis of immunoglobulins by
standard methods. In addition, antibodies against neurotropic viruses such as
measles, rubella, varicella zoster and herpes simplex were measured and the
specific antibody index was calculated. RESULTS: A blood-CSF barrier dysfunction 
was observed in six of 25 cases. In CSF/serum quotient diagrams, no patient had
intrathecally synthesized immunoglobulins, but in two of 25 patients oligoclonal 
bands were detected. Two patients had intrathecally synthesized antibodies
against varicella zoster and three against herpes simplex virus. CONCLUSION: In
conclusion, in the routine diagnosis, the CSF in CJD is normal in most cases. In 
some patients, abnormalities include the blood-CSF barrier dysfunction, mild
pleocytosis, oligoclonal bands and intrathecally synthesized viral antibodies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15691288 [PubMed - indexed for MEDLINE]

1527: N Engl J Med. 2005 Feb 3;352(5):439-40.

Comment on:
    N Engl J Med. 2005 Feb 3;352(5):450-8.

Varicella vaccine and infection with varicella-zoster virus.

Vazquez M, Shapiro ED.

Department of Pediatrics, Yale University School of Medicine, New Haven, Conn,
USA.

Publication Types: 
    Comment

PMID: 15689581 [PubMed - indexed for MEDLINE]

1528: Semin Pediatr Infect Dis. 2005 Jan;16(1):38-43.

The impact of varicella vaccination in the United States.

Hambleton S, Gershon AA.

Department of Pediatrics, Columbia University, New York, NY 10032, USA.

The addition of varicella vaccine to the universal childhood immunization
schedule in the United States in 1995 can be seen as a bold step. Shown to be
safe and efficacious against varicella in extensive prelicensure studies, it is
nonetheless the first vaccine against a herpesvirus and, furthermore, it is a
live, attenuated vaccine. Both wild-type and vaccine strain varicella zoster
virus (VZV) are noteworthy for their ability to establish latent infection within
the host, with the subsequent possibility of reactivation. Therefore, at the
population level, a successful vaccination program could result in the eventual
displacement of wild-type VZV by the attenuated vaccine virus. The immediate
objective of universal vaccination, however, was to reduce the significant
morbidity and mortality associated with primary VZV infection. Data now
accumulating suggest that the varicella vaccine as used in the United States has 
so far been highly effective. The challenge for the future is to predict how the 
resulting substantial reduction in circulation of VZV will affect immunity among 
both vaccinees and the unvaccinated. Vaccination strategies likely will need to
be adjusted as the epidemiology of VZV in the United States continues to evolve.

Publication Types: 
    Review

PMID: 15685148 [PubMed - indexed for MEDLINE]

1529: Can J Anaesth. 2005 Feb;52(2):186-90.

Relief of pain in acute herpes zoster by nerve blocks and possible prevention of 
post-herpetic neuralgia.

Hardy D.

Department of Anesthesiology, The Ottawa Hospital-Civic Campus, 1053 Carling
Avenue, Ottawa, Ontario K1Y 4E9, Canada. dhardy@ottawahospital.on.ca

PURPOSE: This report describes two cases of acute herpes zoster (AHZ) treated by 
nerve block resulting in immediate pain relief and possible prevention of
post-herpetic neuralgia (PHN). CLINICAL FEATURES: Two elderly females with AHZ of
cervical dermatomes and severe pain received deep cervical and greater occipital 
nerve blocks with a local anesthetic, epinephrine and steroid. In both patients, 
pain resolved immediately and permanently (one year follow-up) after a single
treatment.Case #1: A 79-yr-old female with a mechanical mitral valve and
anticoagulated with warfarin presented with AHZ of 17 days duration of the right 
C2, 3, 4 dermatomes and severe pain. A stellate ganglion block was not performed 
because of anticoagulation. Rather, a deep cervical root block at C3 and a
greater occipital nerve block were performed with bupivacaine, epinephrine and
methylprednisolone. No adverse events were evident. Case #2: A 73-yr-old female
with a history of osteoarthritis and Meniere's disease presented with AHZ of
seven days duration of the left C2, 3, 4 dermatomes and severe pain. Deep
cervical root blocks at C3 and C4 and a greater occipital nerve block were
performed with bupivacaine, epinephrine and methylprednisolone. Side effects of
dizziness, hoarseness, hypertension and Horner's syndrome resolved in a few
hours. A mild sensation of itching persisted for two weeks. CONCLUSION: This
report illustrates the potential of nerve blocks in severe AHZ to treat acute
pain and possibly prevent PHN.

Publication Types: 
    Case Reports

PMID: 15684261 [PubMed - indexed for MEDLINE]

1530: J Clin Oncol. 2005 Feb 1;23(4):694-704.

Rituximab in combination with fludarabine chemotherapy in low-grade or follicular
lymphoma.

Czuczman MS, Koryzna A, Mohr A, Stewart C, Donohue K, Blumenson L, Bernstein ZP, 
McCarthy P, Alam A, Hernandez-Ilizaliturri F, Skipper M, Brown K, Chanan-Khan A, 
Klippenstein D, Loud P, Rock MK, Benyunes M, Grillo-Lopez A, Bernstein SH.

Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
myron.czuczman@roswellpark.org

PURPOSE: To evaluate the safety and efficacy of fludarabine plus rituximab in
treatment-naive or relapsed patients with low-grade and/or follicular
non-Hodgkin's lymphoma. PATIENTS AND METHODS: This was an open-label, single-arm,
single-center phase II study enrolling 40 patients. During the first week of the 
study, patients received two infusions of rituximab 375 mg/m2 administered 4 days
apart. Seventy-two hours after the second infusion of rituximab, patients
received the first of six cycles of fludarabine chemotherapy (25 mg/m2/d for 5
days on a 28-day cycle). Single infusions of rituximab were administered 72 hours
before the second, fourth, and sixth cycles of fludarabine, and two infusions of 
rituximab were given 4 weeks after the last cycle of fludarabine. Treatment
duration was 26 weeks. RESULTS: An overall response rate of 90% (80% complete
response rate) was achieved in the intent-to-treat population. Similar response
rates were seen in treatment-naive and previously treated patients. The median
duration of response has not been reached at 40+ months. The median follow-up
time in this study is 44 months (range, 15 to 66 months). In patients positive
for the 14;18 translocation in blood and/or marrow at enrollment, molecular
remission was achieved in 88% of cases, with patients remaining negative for up
to 4 years to date. Hematologic toxicity was manageable, and except for a 15%
incidence of herpes simplex/zoster infections, infectious complications were
rare. Nonhematologic toxicities were minimal. CONCLUSION: Rituximab plus
fludarabine was well tolerated and associated with an excellent complete response
rate, including molecular remissions, in patients with low-grade or follicular
lymphoma.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II
    Research Support, Non-U.S. Gov't

PMID: 15681517 [PubMed - indexed for MEDLINE]

1531: Eur J Epidemiol. 2004;19(12):1113-8.

The consistency of shingles and its significance for health monitoring.

Fleming DM, Bartelds A, Chapman RS, Cross KW.

Royal College of General Practitioners, Harborne, Birmingham, UK.
dfleming@rcgpbhamresunit.nhs.uk

Accurate estimation of monitored populations is essential for epidemiological
study. Many countries do not have systems of patient registration and routine
disease surveillance is thereby hindered. We studied the incidence of shingles
over time and investigated the hypothesis that the incidence is consistent and
could be used as a proxy for estimating the monitored population. Annual
incidence rates of shingles reported in the Weekly Returns Service (WRS) since
1970 and in the Dutch Sentinel Network (DSN) over the period 1998--2001 were
studied. Gender specific annual rates (1998--2001) were compared after
standardising for age. The population in the DSN was estimated by applying the
WRS incidence rates to the numbers of DSN incident cases. The incidence of
shingles was annually and seasonally consistent. Incidence in males was similar
in both networks and in females approximately 18% greater in the WRS: in age
groups 15-64 years, incidence was similar in both networks, but in children 0-14 
years and in persons 65 years and over, it was higher in the WRS. The total
populations in the DSN estimated from average age/gender specific rates in the
WRS were within 12% of the observed in each of the 4 years surveyed. The
incidence of shingles in the two countries was sufficiently close to estimate the
surveyed population aged 15-64 years from knowledge of incident cases in the
community. Routine monitoring of shingles in sentinel practice networks is
commended as a method of assuring recording quality and as a means of estimating 
the survey population where the registered population is not known.

PMID: 15678791 [PubMed - indexed for MEDLINE]

1532: West Indian Med J. 2004 Oct;53(5):346-51.

Tuberculosis, chickenpox and scabies outbreaks in an orphanage for children with 
HIV/AIDS in Jamaica.

Geoghagen M, Pierre R, Evans-Gilbert T, Rodriguez B, Christie CD.

The University of the West Indies, Kingston, Jamaica.

OBJECTIVES: The aim of this study is to describe the investigation and management
of outbreaks of acute tuberculosis, varicella zoster virus and scabies in a
residential facility for children with HIV/AIDS. METHOD: A review of the results 
and management for diagnosed cases of acute TB (four between 2001 and 2002) as
well as varicella zoster virus (15) and scabies (14) (concurrent in March--June
2003), in a residential facility housing 24 abandoned children with HIV/AIDS was 
conducted. Outbreak control methods and challenges are described The modified WHO
criteria were used for TB diagnosis. The diagnoses of varicella and scabies were 
entirely clinical. RESULTS: Of the surviving 22 children, 12 (mean age 8 years 2 
months) were female, and 10 (mean age 5 years 6 months) were male. Full
immunization (primary series) was documented for 16 children, partial in one
child, unknown status was documented in five children. One child had received
varicella vaccine previously. Eleven (50%) children had been receiving
antiretroviral triple therapy since 2002 (all in Centers for Diseases Control
immunological categories 2-3). Two of the four children with tuberculosis died
between 2001 and 2002; these were not on antiretroviral therapy--the 2 survivors 
are still on antiretroviral therapy. All staff mantoux test results were
negative. Fifteen (68%) children developed chickenpox as well as three
caregivers. The index case was a 13-year-old resident attending a nearby school
with HIV negative children. This varicella outbreak went on to affect household
members for the caregivers as well as other residential facilities nearby.
Scabies affected 14 children (no caregivers); the index cases were most likely
three new child residents who entered the institution in 2002 (from other homes) 
with histories of scabies infestation. Chickenpox and scabies dual infection
occurred in seven (31%) of residents. No cases of herpes zoster, disseminated
varicella infection or death because of varicella occurred Diagnosed cases of
chickenpox were treated with oral acyclovir Knowledge about these disease
outbreaks and their control was generally lacking. CONCLUSIONS: Improvement in
immunization coverage for children and staff as well as educating staff about
infectious disease outbreaks, is necessary for effective control. Appropriate
screening for infection/disease for all susceptible persons is essential along
with timely reporting of outbreaks/reportable diseases. There is need for
increased awareness of acute opportunistic infections in children with HIV/AIDS
living in close proximity.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15675502 [PubMed - indexed for MEDLINE]

1533: Australas J Dermatol. 2005 Feb;46(1):42-3.

Herpes zoster following cryosurgery.

Lee MR, Ryman W.

Department of Dermatology, Royal North Shore Hospital, St Leonards, New South
Wales, Australia. mick155@bigpond.net.au

A 56-year-old man developed reactivation of herpes zoster infection on his right 
forehead after treatment of several solar keratoses with cryosurgery. The rash
was blistering and painful. Treatment with oral aciclovir was instituted and the 
lesions healed within 2 weeks. Known risk factors for reactivation include age
and decreased immunity. Previous case reports have indicated trauma may be a risk
factor in herpes zoster. We report a case of herpes zoster as a complication of
cryosurgery.

Publication Types: 
    Case Reports

PMID: 15670178 [PubMed - indexed for MEDLINE]

1534: Intern Med J. 2005 Jan;35(1):69-70.

Acalculous cholecystitis, multifocal gastrointestinal infarction and pancreatitis
resulting from Varicella-zoster virus.

Kurtovic J, Webster GJ, Singh-Grewal I, Bullpitt P, Haindl W, Wakefield D,
Riordan SM.

Publication Types: 
    Letter

PMID: 15667476 [PubMed - indexed for MEDLINE]

1535: BJOG. 2005 Jan;112(1):50-6.

Seroprevalence, incidence of prenatal infections and reliability of maternal
history of varicella zoster virus, cytomegalovirus, herpes simplex virus and
parvovirus B19 infection in South-Western Finland.

Alanen A, Kahala K, Vahlberg T, Koskela P, Vainionpaa R.

Department of Obstetrics and Gynaecology, University of Turku, Finland.

OBJECTIVE: To study seroprevalence and incidence and fetal transmission of
varicella zoster virus (VZV), cytomegalovirus (CMV), herpes simplex virus (HSV)
types 1 and 2 and parvovirus B19 infections during pregnancy and to evaluate the 
reliability of maternal past history of VZV, HSV and parvovirus infections.
DESIGN: Prospective study of parturient women. SETTING: South-Western Finland.
PARTICIPANTS: Five hundred and fifty-eight parturient women. METHODS: IgG and IgM
antibodies against VZV, CMV, HSV-1 and -2, and parvovirus B19 were measured from 
maternal serum in the first trimester and at delivery and from cord serum,
mother's own information of her past infections was compared with her serological
status. MAIN OUTCOME MEASURES: Seroprevalence, seroconversions and fetal
transmission of VZV, CMV, HSV and parvovirus B19, reliability of maternal history
of VZV, HSV and parvovirus B19. RESULTS: Seroprevalences were 96.2% for VZV,
56.3% for CMV, 54.3% for HSV, 46.8% for HSV-1, 9.3% for HSV-2 and 58.6% for
parvovirus B19. Parity was associated with CMV seropositivity, maternal age
differed only between HSV-2 seropositive and seronegative women, while area of
residence (urban or rural) had no effect. Six seroconversions were observed: two 
VZV, one CMV and three parvovirus infections. No cases of primary HSV infections 
occurred. Fetal transmission was observed in two cases of parvovirus infection.
No infants with anti-CMV IgM antibodies were born to CMV immunised women. False
positive history of chickenpox was given only by 1.5% of the women, history of
herpes infections was less reliable, and history of parvovirus infection was
unreliable. CONCLUSIONS: Seroprevalence and the risk of viral infections during
pregnancy cannot be extrapolated from one pregnant population to another.

PMID: 15663397 [PubMed - indexed for MEDLINE]

1536: J Neurosurg. 2005 Jan;102 Suppl:276-82.

Gamma knife surgery for refractory postherpetic trigeminal neuralgia: targeting
in one session both the retrogasserian trigeminal nerve and the centromedian
nucleus of the thalamus.

Keep MF, DeMare PA, Ashby LS.

The Gamma Knife Center of the Pacific, Honolulu, Hawaii, USA. mkeep@salud.unm.edu

OBJECT: The authors tested the hypothesis that two targets are needed to treat
postherpetic trigeminal neuralgia (TN): one in the trigeminal nerve for the
direct sharp pain and one in the thalamus for the diffuse burning pain. METHODS: 
Three patients with refractory postherpetic TN were treated with gamma knife
surgery (GKS) through a novel two-target approach. In a single treatment session,
both the trigeminal nerve and centromedian nucleus were targeted. First, the
trigeminal nerve, ipsilateral to the facial pain, was treated with 60 to 80 Gy.
Second, the centromedian nucleus was localized using standard coordinates and by 
comparing magnetic resonance images with a stereotactic atlas. A single dose of
120 to 140 Gy was delivered to the target point with a single 4-mm isocenter.
Patients were followed clinically and with neuroimaging studies. Pain relief was 
scored as excellent (75-100%), good (50-75%), poor (25-50%); or none (0-25%).
Follow up ranged from 6 to 53 months. There were no GKS-related complications.
Two patients died of unrelated medical illnesses but had good or excellent pain
relief until death. One patient continues to survive with 44 months follow up and
no decrease in pain intensity, but with a decreased area of pain. CONCLUSIONS:
Combined GKS of the centromedian nucleus and trigeminal nerve in a single
treatment session is feasible and safe, and the effect was promising. A larger
study is required to confirm and expand these results.

Publication Types: 
    Case Reports

PMID: 15662825 [PubMed - indexed for MEDLINE]

1537: Virology. 2005 Feb 5;332(1):337-46.

Analysis of varicella zoster virus attenuation by evaluation of chimeric parent
Oka/vaccine Oka recombinant viruses in skin xenografts in the SCIDhu mouse model.

Zerboni L, Hinchliffe S, Sommer MH, Ito H, Besser J, Stamatis S, Cheng J,
Distefano D, Kraiouchkine N, Shaw A, Arvin AM.

Department of Pediatrics, S-356, Stanford University School of Medicine, 300
Pasteur Drive, Stanford, CA 94305-5208, USA. zerboni@stanford.edu

Varicella-zoster virus (VZV) is the only human herpes virus for which a vaccine
has been licensed. A clinical VZV isolate, designated the parent Oka (pOka)
strain was passed in human and non-human fibroblasts to produce vaccine Oka
(vOka). The pOka and vOka viruses exhibit similar infectivity in cultured cells
but healthy susceptible individuals given vaccines derived from vOka rarely
develop the cutaneous vesicular lesions characteristic of varicella. Inoculation 
of skin xenografts in the SCIDhu mouse model of VZV pathogenesis demonstrated
that vOka had a reduced capacity to replicate in differentiated human epidermal
cells in vivo (Moffat, J.F., Zerboni, L., Kinchington, P.R., Grose, C.,
Kaneshima, H., Arvin A.M., 1998a. Attenuation of the vaccine Oka strain of
varicella-zoster virus and role of glycoprotein C in alphaherpesvirus virulence
demonstrated in the SCID-hu mouse. J Virol. 72:965-74). In order to investigate
the attenuation of vOka in skin, we made chimeric pOka and vOka recombinant
viruses from VZV cosmids. Six chimeric pOka/vOka viruses were generated using
cosmid sets that incorporate linear overlapping fragments of VZV DNA from cells
infected with pOka or vOka. The cosmid sets consist of pOka and vOka DNA segments
that have identical restriction sites. As expected, the growth kinetics and
plaque morphologies of the six chimeric pOka/vOka viruses were indistinguishable 
in vitro. However, the chimeric viruses exhibited varying capacities to replicate
when evaluated in skin xenografts in vivo. The presence of ORFs 30-55 from the
pOka genome was sufficient to maintain wild-type infectivity in skin. Chimeric
viruses containing different vOka components retained the attenuation phenotype, 
suggesting that vOka attenuation is multi-factorial and can be produced by genes 
from different regions of the vOka genome.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15661165 [PubMed - indexed for MEDLINE]

1538: Clin Microbiol Rev. 2005 Jan;18(1):70-80.

Preventing varicella-zoster disease.

Hambleton S, Gershon AA.

Columbia University College of Physicians and Surgeons, 650 W. 168th Street, New 
York, NY 10032, USA.

Varicella-zoster virus (VZV), the cause of chickenpox and shingles, is a pathogen
in retreat following the introduction of mass vaccination in the United States in
1995. The live attenuated Oka vaccine, which is safe and immunogenic, gives good 
protection against both varicella and zoster in the short to medium term. It has 
undoubtedly been highly effective to date in reducing all forms of varicella,
especially severe disease. However, the huge pool of latent wild-type virus in
the population represents a continuing threat. Both the biology and the
epidemiology of VZV disease suggest that new vaccination strategies will be
required over time.

Publication Types: 
    Review

PMID: 15653819 [PubMed - indexed for MEDLINE]

1539: Vestn Ross Akad Med Nauk. 2004;(11):18-21.

[Results of Befnorin clinical trails in healthy volunteers]

[Article in Russian]

Masycheva VI, Shirinskii VS, Starostina NM, Kozhevnikov VS, Meledina IV, Novikova
LM, Meniaeva EV, Kristosova NV, Shevchuk NI, Evsiukova EV, Danilenko ED,
Pustoshilova NM, Kozlov VA.

Clinical trails of Befnorin based on the human recombinant TNF-beta elaborated at
the Research Design and Technology Institute of Biologically Active Substances,
"Vector" State Research Center of Virology and Biotechnology, were carried out on
healthy volunteers in compliance with a decision passed by the Committee of
Medical and Immunobiological Preparations, Russia's Health Ministry. Single
Befnorin doses of 5-10(4) U, 10(5) U, 5-10(5) U, and 10(6) U were administered as
intramuscular injections. Clinical, biochemical and immunological parameters were
registered for 7 days after a single dose. The drug had an impact on the below
immunity indices: Fc-phagocytosis of monocytes, migration index and migration
inhibition index. The dose of 10(5) U was proven to be most effective and safe.
Supposedly, the drug can be effective in the treatment of herpetic diseases.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 15651658 [PubMed - indexed for MEDLINE]

1540: J Eur Acad Dermatol Venereol. 2005 Jan;19(1):47-55.

Brivudin compared with famciclovir in the treatment of herpes zoster: effects in 
acute disease and chronic pain in immunocompetent patients. A randomized,
double-blind, multinational study.

Wassilew S; Collaborative Brivudin PHN Study Group.

Dermatological Department, Klinikum Krefeld, Krefeld, Germany.
swassilew.dermatologie@klinikum-krefeld.de

OBJECTIVE: This was a double-blind, randomized multicentre trial comparing
efficacy and safety of brivudin (125 mg, once a day) and famciclovir (250 mg,
three times a day), both given orally for 7 days, in the treatment of herpes
zoster. METHODS: A total of 2027 immunocompetent zoster patients>or=50 years with
zoster-related pain at presentation were included. Outcome measures embraced
prevalence of postherpetic neuralgia (PHN), defined as at least moderate pain 3
months after treatment initiation, duration of PHN, prevalence and duration of
zoster-associated pain (ZAP), duration of vesicle formation and rash healing.
RESULTS: The prevalence of PHN at month 3 was 11.3% with brivudin and 9.6% with
famciclovir [per-protocol (PP) population]. Equivalence of the two drugs could be
demonstrated (P=0.01, PP and intention-to-treat analysis). The median duration of
PHN was 46.5 days with brivudin and 58 days with famciclovir (P=0.54, PP
analysis). Prevalence and duration of ZAP did not differ significantly between
treatment groups. The prevalence of PHN was higher in patients>or=65 years
(brivudin: 16.4%, famciclovir: 16.4%), and in patients with severe rash
(brivudin: 13.4%, famciclovir: 15.7%), without significant differences between
treatment groups. In patients>or=65 years, median duration of PHN was shorter
with brivudin than with famciclovir (39.5 vs. 57.5 days), although the difference
was not statistically significant. The two drugs had equivalent efficacy in being
able to accelerate the stop of vesicle formation, and lesion healing. Adverse
events were similar in nature and prevalence among groups. CONCLUSIONS: The study
demonstrated equivalent efficacy of brivudin and famciclovir in the treatment of 
herpes zoster regarding the prevention of chronic pain and the resolution of
signs and symptoms of acute herpes zoster. Compared with famciclovir, brivudin
provides equivalent efficacy and safety at a more convenient once-daily dose
schedule.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 15649191 [PubMed - indexed for MEDLINE]

1541: Antivir Chem Chemother. 2004 Nov;15(6):319-28.

Analogues of acyclic nucleosides derived from tris-(hydroxymethyl)phosphine oxide
or bis-(hydroxymethyl)phosphinic acid coupled to DNA nucleobases.

Nawrot B, Michalak O, De Clercq E, Stec WJ.

Department of Bioorganic Chemistry, Centre of Molecular and Macromolecular
Studies, Polish Academy of Sciences, Lodz, Poland. bnawrot@bio.cbmm.lodz.pl

A series of novel acyclic nucleoside analogues containing
bis-(hydroxymethyl)phosphinic acid (BHPA) or tris(hydroxymethyl)phosphine oxide
(THPO) coupled with DNA nucleobases or with 5-fluorouracil were prepared and
their antiviral activity was studied against cytomegalovirus (CMV),
varicella-zoster virus (VZV), parainfluenza-virus type 3, reovirus-type 1,
sindbis, coxsackie B4, punta toro, vesicular stomatitis and respiratory syncytial
virus, herpes simplex virus-type 1 (KOS) and type 2 (G), vaccinia virus and
herpes simplex virus-1 (TK- KOS ACVr). No specific antiviral effects were noted
for any of test compounds against viruses evaluated, except thymine, cytosine and
adenine derivatives of BHPA exerting borderline activity against respiratory
syncytial virus at the 80 mg/ml concentration.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15646645 [PubMed - indexed for MEDLINE]

1542: Neurology. 2005 Jan 11;64(1):21-5.

VZV vasculopathy and postherpetic neuralgia: progress and perspective on
antiviral therapy.

Gilden DH, Cohrs RJ, Mahalingam R.

Department of Neurology, Mail Stop B182, University of Colorado Health Sciences
Center, 4200 East 9th Avenue, Denver, CO 8026, USA. don.gilden@uchsc.edu

Two serious complications of varicella-zoster virus (VZV) reactivation are
vasculopathy and postherpetic neuralgia (PHN). Clinical-virologic analyses have
proven that VZV vasculopathy is caused by chronic active virus infection in
cerebral arteries. Conclusive evidence that PHN is caused by persistent or
productive VZV infection is less compelling because human ganglia are not
accessible during life for pathologic and virologic examination. However, the
notion that PHN may reflect a smoldering VZV ganglionitis is supported by 1) the 
detection of VZV DNA and proteins in peripheral blood mononuclear cells of many
patients with PHN; 2) studies of multiple patients with zoster sine herpete,
which indicate a productive VZV ganglionitis; and 3) a favorable response of some
patients with zoster sine herpete and PHN to antiviral treatment. Few studies
have used antiviral therapy to manage PHN with conflicting results. Larger,
double-blind studies, which give IV antiviral drug, are needed.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 15642898 [PubMed - indexed for MEDLINE]

1543: J Orofac Pain. 2004 Fall;18(4):366-73.

Management issues of neuropathic trigeminal pain from a medical perspective.

Watson CP.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

The purpose of this article is to review the pharmacological treatment of
neuropathic trigeminal pain by means of a systematic review. A number of
randomized controlled trials and important historical and uncontrolled studies in
trigeminal neuralgia and postherpetic neuralgia were identified. Trigeminal
neuralgia is a unique neuropathic pain disorder with a specific therapy. It does 
not respond to the usual drugs used for other neuropathic pains. The drug therapy
of trigeminal postherpetic neuralgia is similar to that of other neuropathic
trigeminal pain conditions.

Publication Types: 
    Review

PMID: 15636022 [PubMed - indexed for MEDLINE]

1544: J Orofac Pain. 2004 Fall;18(4):281-6.

Neuropathic pain in the orofacial region: clinical and research challenges.

Bennett GJ.

Canada Research Chair, Department of Anesthesia, Faculty of Dentistry, and Centre
for Research on Pain, McGill University, Montreal, Quebec, Canada.
gary.bennett@mcgill.ca

Neuropathic pain in the orofacial region poses a difficult challenge to the
treating physician. In some cases diagnosis is far from easy. Common causes of
orofacial neuropathic pain are reviewed here, with a focus on the 2 most common: 
postherpetic neuralgia and posttraumatic painful peripheral neuropathy. In
addition, the discussion includes idiopathic trigeminal neuralgia (tic
douloureux), a neuropathic pain syndrome that is nearly unique to the trigeminal 
distribution (very rarely, it has also been reported in the glossopharyngeal
region). Brief summaries of major research problems and successes are also
provided.

PMID: 15636009 [PubMed - indexed for MEDLINE]

1545: Wien Klin Wochenschr. 2004 Nov 30;116(21-22):716-24.

Immunoadsorption (IAS) as a rescue therapy in SLE: considerations on safety and
efficacy.

Stummvoll GH, Aringer M, Jansen M, Smolen JS, Derfler K, Graninger WB.

Deptartment of Rheumatology, University of Vienna, Vienna General Hospital,
Vienna, Austria. Georg.Stummvoll@akh-wien.ac.at

OBJECTIVE: In SLE, extracorporeal procedures aiming at reduction of
immunoglobulin (Ig) and immune complexes (IC) are used as a rescue therapy.
Plasma exchange (PE) has not been proven overall effective in SLE, and long-term 
treatment in particular has been associated with severe bacterial and viral
infections. Immunoadsorption (IAS), in contrast, selectively removes Ig and IC
and may thus be safer. We therefore investigated the rate of infections in SLE
patients who were undergoing long-term IAS. METHODS: 16 SLE patients were treated
with > or = 10 courses of IAS, and nine patients with highly active disease
received pulse cyclophosphamide (IVCP) therapy in parallel. We retrospectively
analysed the records of all these patients for the occurrence of infections.
Patients receiving IAS therapy plus IVCP were compared with 25 patients with
similarly active disease treated with standard IVCP therapy within the same
observation period. Patients receiving IAS without additional IVCP were compared 
with patients with similarly moderate disease activity receiving neither IAS nor 
IVCP. RESULTS: No potentially life-threatening viral infection occurred in
IAS-treated patients and episodes of herpes zoster were equally distributed. No
severe infection was observed during IAS without concomittant cyclophosphamide.
As expected, more patients with highly active disease receiving IVCP experienced 
infections than those with less active disease (16 of 34 [47%] vs. 2 of 22 [9%], 
p < 0.04). On comparing the two groups with highly active disease, infections
were similar (IAS+IVCP: 3 of 9 patients [33%], IVCP only: 5 of 25 [20%]), but one
patient receiving IAS+IVCP died of septicaemia. Disease activity significantly
decreased in both groups treated with IAS. CONCLUSION: IAS has an acceptable
safety profile with regard to severe infections and appears safe with regard to
severe viral disease. Highly active disease and IVCP therapy increase the risk of
severe infections in SLE.

PMID: 15628641 [PubMed - indexed for MEDLINE]

1546: Pol Merkur Lekarski. 2004 Sep;17(99):275-7.

[Diagnostic problems in the course of varicella-zoster virus reactivation leading
to meningitis and hepatitis--case report]

[Article in Polish]

Skwara P, Biesiada G, Postawa-Klosinska B, Mach T.

Katedra i Klinika Chorob Zakaznych Collegium Medicum UJ. pawels@mp.pl

Reactivation of varicella-zoster virus (VZV) usually leads to developing of
characteristic skin lesions with dermatomal distribution. In very rare cases
typical clinical picture can be absent, which impairs diagnostic procedure.
Atypical case of young non HIV infected man was described. Clinical picture of
meningitis and hepatitis due to VZV reactivation without typical skin eruptions
resulted in diagnostic problems and required differentiation with proliterative
process. Essential role of serologic testing in such cases was emphasized.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15628058 [PubMed - indexed for MEDLINE]

1547: Rev Neurol. 2004 Dec 16-31;39(12):1199.

[Horner's syndrome secondary to thoracic herpes zoster]

[Article in Spanish]

Agudo R, Lopez-Ramos E, Alonso H, Gomez-Escalonilla CI, Garcia-Albea E,
Jimenez-Jimenez FJ.

Departamento de Medicina-Neurologia, Hospital Principe de Asturias, Universidad
de Alcala, Alcala, Spain.

Publication Types: 
    Case Reports

PMID: 15625644 [PubMed - indexed for MEDLINE]

1548: QJM. 2005 Jan;98(1):29-34.

Divalproex sodium in the management of post-herpetic neuralgia: a randomized
double-blind placebo-controlled study.

Kochar DK, Garg P, Bumb RA, Kochar SK, Mehta RD, Beniwal R, Rawat N.

C-54, Sadul Ganj, Bikaner (Raj) 334003, India. drdkkochar@indiatimes.com

BACKGROUND: Post-herpetic neuralgia is difficult to treat. Divalproex sodium
(valproic acid and sodium valproate in molar ratio 1:1) has been used
successfully in the management of various painful neuropathies. AIM: To study the
effectiveness and safety of divalproex sodium in the management of post-herpetic 
neuralgia. DESIGN: Randomized double-blind placebo-controlled trial. METHODS: We 
enrolled 48 consecutively attending out-patients with post-herpetic neuralgia,
out of whom three were excluded (two had insufficient pain, one withdrew
consent). Quantification of pain was by Short Form-McGill pain questionnaire
(SF-MPQ), visual analogue scale (VAS), present pain intensity score (PPI) and 11 
point Likert scale (11 PLS) at the beginning of the study, after 2 weeks, 4 weeks
and at the end of the study (8 weeks). We also assessed patients' global
impression of change by questionnaire at the end of the study. RESULTS: After 8
weeks treatment with 1000 mg/day divalproex sodium, there was significant
reduction in pain: SF-MPQ, 20.47 +/- 2.29 to 11.90 +/- 6.52 (p < 0.0001); PPI 4.0
+/- 0.52 to 1.95 +/- 1.29 (p < 0.0001); VAS 70.17 +/- 9.21 to 31.27 +/- 29.74 (p 
< 0.0001) and 11 PLS 6.97 +/- 0.73 to 3.63 +/- 2.34 (p < 0.0001) in comparison to
placebo (means +/- SEM). The 'global impression of change' questionnaire showed
much or moderate improvement in pain in 58.2% of patients receiving divalproex
vs. 14.8% of those receiving placebo. The drug was well tolerated by all
patients, except one who developed severe vertigo after 10 days of treatment.
DISCUSSION: Divalproex sodium provides significant pain relief in patients of
post-herpetic neuralgia, with very little incidence of adverse reactions. These
data provide a basis for longer trials in a larger group of patients.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 15625351 [PubMed - indexed for MEDLINE]

1549: Dermatol Nurs. 2004 Oct;16(5):431-2.

What's your assessment? Herpes zoster.

Bielan B.

Dermatology, Kaiser Permanente, San Francisco, CA, USA.

Publication Types: 
    Case Reports

PMID: 15624707 [PubMed - indexed for MEDLINE]

1550: Neurology. 2004 Dec 28;63(12):2423-5.

Comment in:
    Neurology. 2005 Nov 22;65(10):1682-3.

Progressive outer retinal necrosis presenting with isolated optic neuropathy.

Nakamoto BK, Dorotheo EU, Biousse V, Tang RA, Schiffman JS, Newman NJ.

Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA,
USA.

Progressive outer retinal necrosis is a necrotizing herpetic retinopathy usually 
seen in immunocompromised patients. The authors describe two patients with this
disease who initially had findings suggestive of an optic neuropathy. Vision
declined after treatment with methylprednisolone, after which fundus examination 
became consistent with progressive outer retinal necrosis. These cases underscore
the importance of careful examination of the retinal periphery before management 
of any presumed optic neuropathy with steroids.

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 15623719 [PubMed - indexed for MEDLINE]

1551: Cell. 2004 Dec 29;119(7):915-26.

Mannose 6-phosphate receptor dependence of varicella zoster virus infection in
vitro and in the epidermis during varicella and zoster.

Chen JJ, Zhu Z, Gershon AA, Gershon MD.

Department of Anatomy & Cell Biology, Columbia University, P&S, New York, NY
10032, USA.

Varicella zoster virus (VZV) is a highly infectious human pathogen; nevertheless,
infectious virions are not released in vitro where infection is cell associated. 
Four VZV envelope glycoproteins contain mannose 6-phosphate (Man 6-P), and Man
6-P blocks infection of cells by cell-free VZV. Expression of antisense cDNA or
siRNA-like transcripts were used to generate five stable human cell lines
deficient in cation-independent mannose 6-phosphate receptors (MPRci). All 5
MPRci-deficient lines resisted infection by cell-free, but not cell-associated,
VZV, secreted lysosomal enzymes, and released infectious virions when infected by
cell-associated VZV. Intracellular MPRci thus appear to divert newly enveloped
VZV to late endosomes, and plasmalemmal MPRci are necessary for entry by
cell-free VZV. Biopsies from VZV-infected human skin supported the idea that
because MPRci expression is naturally lost in maturing superficial epidermal
cells, these cells do not divert VZV to endosomes and constitutively secrete
infectious VZV.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15620351 [PubMed - indexed for MEDLINE]

1552: Swiss Med Wkly. 2004 Nov 27;134(47-48):700-4.

Diagnostic significance of intrathecally produced herpes simplex and
varizella-zoster virus-specific antibodies in central nervous system infections.

Schultze D, Weder B, Cassinotti P, Vitek L, Krausse K, Fierz W.

Institute for Clinical Microbiology and Immunology, St. Gallen, Switzerland.
detlev.schultze@ikmi.ch

BACKGROUND AND OBJECTIVES: The optimal strategy for the diagnosis of herpes
simplex virus (HSV) and varizella-zoster virus (VZV) disease of the central
nervous system is the detection of viral DNA by polymerase chain reaction assay
(PCR) in cerebrospinal fluid (CSF) and the examination of intrathecal production 
of specific antibodies. However, in acute neurological disease caused by either
HSV or VZV, dual intrathecal synthesis of HSV-1, 2- as well as VZV-specific
antibodies may be detectable and thus can hamper accurate aetiological diagnosis.
This paper illustrates such equivocal findings in two case reports, investigates 
their frequency and discusses the possible reasons. METHODS: Consecutive
CSF/serum pairs of two patients with central nervous system (CNS) disease were
tested by HSV-1-, HSV-2-, and VZV-specific PCR and by different serological
assays for detection of neurotropic viruses and bacteria. Additionally, the
results of microbiological investigations of 1'155 CSF/serum samples were
retrospectively analyzed for coincident intrathecal antibody synthesis against
HSV-1, 2 and VZV. RESULTS: Although only HSV-1 and VZV-specific DNA was
detectable in the CSF of two patients with encephalitis and chronic meningitis,
respectively, increasing intrathecal antibody production against both virus
species could be demonstrated. Retrospective analysis of 1155 CSF/serum pairs
revealed 55 (4.8%) pairs with evidence for intrathecally produced antibodies
against either HSV-1, 2 (30/55) or VZV (14/55). Eleven of these 55 (20%) pairs
showed intrathecal antibody-production against both virus species. CONCLUSIONS:
Patients with CNS infection with HSV and VZV can be diagnosed by detecting
intrathecally produced virus-specific antibodies, in addition to virus-specific
PCR. However, in an appreciable proportion of patients a correct diagnosis is
hampered by coincidentally detected antibodies in CSF against both virus species.
Possible reasons for these equivocal findings are given.

Publication Types: 
    Case Reports

PMID: 15616903 [PubMed - indexed for MEDLINE]

1553: Presse Med. 2004 Nov 6;33(19 Pt 2):1371-84.

[Vasculitis associated with viral infections]

[Article in French]

Cohen P, Guillevin L.

Service de medecine interne, Hopital Avicenne, Bobigny (93).

VIRUSES, THE CAUSE OF VASCULITIS: Although the majority of systemic vasculitis
are of unknown causes, the responsibility of a viral infection has been formally 
demonstrated in some of them and specific treatment can permanently cure them.
Each virus incriminated accounts for a particular type of vasculitis. HEPATITIS B
VIRAL INFECTION (HBV): Is the cause of polyarteritis nodosa in 36 to 50% of
cases. The onset of the symptomatology is acute, usually within a few months
following the infection; it is comparable to that observed in the absence of HBV 
infection. CRYOGLOBULINEMIA RELATED TO THE HEPATITIS C VIRUS (HCV): The clinical 
manifestations are those of systemic vasculitis with particular tropism for the
skin (involvement generally inaugural and almost constant), peripheral nerves and
the glomerula. They occur fairly late during the infection. VASCULITIS ASSOCIATED
WITH HIV INFECTION: There is strong tropism for the peripheral (multi-neuritis)
and central nervous system. During acute parvovirus B19 infection Vasculitis
lesions have occasionally been reported following the viremic phase, generally
limited to one or several flares of vascular purpura predominating on the lower
limbs. FOLLOWING VARICELLA-HERPES ZOSTER INFECTION: Vasculitis occasionally
develops in the form of a central neurological deficiency (locomotor deficiency
with or without aphasia around one month after an ophthalmologic herpes zoster)
or involving the retina or, more rarely, the skin or the kidneys. VASCULITIS
ASSOCIATED WITH CYTOMEGALOVIRAL INFECTION: Predominantly observed in
immunodepressed patients, vasculitis after CMV infection is diffuse and basically
involving the digestive tube, notably the colon, the central nervous system and
the skin. A RARE COMPLICATION OF AN HTLV1 INFECTION: Vasculitis of the retina
often in the form of necrotic retinitis is often associated with spasmodic
paraparessia. THERAPEUTIC STRATEGY: For many vasculitis of viral origin,
corticosteroid and immunosuppressive treatments are only indicated in second
intention following failure with antiviral agents and the combination of
antivirals and plasma exchanges.

Publication Types: 
    English Abstract
    Review

PMID: 15615248 [PubMed - indexed for MEDLINE]

1554: Curr Oncol Rep. 2005 Jan;7(1):66-73.

Leukemia and the nervous system.

Chamberlain MC.

Department of Neurology, University of Southern California, Norris Comprehensive 
Cancer Center and Hospital, 1441 Eastlake Avenue, Room 3459, Los Angeles, CA
90033, USA. chamberl@usc.edu

Leukemia affects the central and peripheral nervous system. Neurologic
complications are a consequence of direct leukemic infiltration, as occurs with
leukemic meningitis, and due to complications of either antileukemic treatment
(thrombocytopenic or disseminated intravascular coagulation-related intracranial 
hemorrhage, steroid myopathy, vinca alkaloid peripheral neuropathy) or immune
compromise (Herpes zoster shingles or Aspergillus meningitis).

Publication Types: 
    Review

PMID: 15610689 [PubMed - indexed for MEDLINE]

1555: Drugs. 2005;65(1):111-8; discussion 119-20.

Pregabalin: in the treatment of postherpetic neuralgia.

Frampton JE, Foster RH.

Adis International Limited, Auckland, New Zealand. demail@adis.co.nz

Pregabalin, the pharmacologically active S-enantiomer of
3-aminomethyl-5-methyl-hexanoic acid, has a similar pharmacological profile to
that of its developmental predecessor gabapentin, but showed greater analgesic
activity in rodent models of neuropathic pain. The exact mechanism of action of
pregabalin is unclear, although it may reduce excitatory neurotransmitter release
by binding to the alpha2-delta protein subunit of voltage-gated calcium channels.
Oral pregabalin 150-600 mg/day, administered twice or three times daily, was
superior to placebo in relieving pain and improving pain-related sleep
interference in three randomised, double-blind, placebo-controlled, multicentre
studies of 8-13 weeks' duration in a total of 776 evaluable patients with
postherpetic neuralgia (PHN). Weekly mean pain scores (primary endpoint; assessed
in all three studies) and weekly mean sleep interference scores (assessed in two 
studies) were significantly improved at 1 week. In two studies, significant
improvements in daily mean pain scores were apparent on the first or second day
of treatment with pregabalin administered three times daily. Pregabalin was
generally well tolerated when force-titrated over 1 week to fixed dosages
(maximum 600 mg/day) in clinical trials that enrolled most elderly PHN patients. 
Dizziness, somnolence and peripheral oedema of mild-to-moderate intensity were
the most common adverse events.

Publication Types: 
    Review

PMID: 15610058 [PubMed - indexed for MEDLINE]

1556: J Infect Dis. 2005 Jan 15;191(2):234-7. Epub 2004 Dec 10.

Dual infections of the central nervous system with Epstein-Barr virus.

Weinberg A, Bloch KC, Li S, Tang YW, Palmer M, Tyler KL.

Department of Pediatrics, University of Colorado Medical School, Denver, CO
80262, USA. adriana.weinberg@uchsc.edu

We describe clinical and laboratory characteristics of 16 patients with central
nervous system (CNS) infection caused by Epstein-Barr virus (EBV) and another
pathogen. Seven of 10 immunocompromised patients had coinfection with viruses (3 
with cytomegalovirus, 2 with JC virus, and 2 with varicella zoster virus) and 3
with nonviral pathogens (2 with pneumococcus and 1 with Cryptococcus species).
Three of 6 immunocompetent patients had coinfections with viruses (1 each with
herpes simplex virus, varicella zoster virus, and West Nile virus), and 3 had
coinfections with nonviral pathogens (2 with Ehrlichia chaffeensis and 1 with
Mycoplasma pneumoniae). The EBV load was similar in immunocompromised and
immunocompetent patients and in patients with viral and nonviral coinfections.
EBV lytic-cycle mRNA was detected in the cerebrospinal fluid of 5 of 6 tested
samples, indicating EBV replication in the CNS during coinfection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15609233 [PubMed - indexed for MEDLINE]

1557: J Acquir Immune Defic Syndr. 2005 Jan 1;38(1):111-3.

The incidence of herpes zoster is less likely than other opportunistic infections
to be reduced by highly active antiretroviral therapy.

Vanhems P, Voisin L, Gayet-Ageron A, Trepo C, Cotte L, Peyramond D, Chidiac C,
Touraine JL, Livrozet JM, Fabry J, Voirin N.

Publication Types: 
    Letter

PMID: 15608535 [PubMed - indexed for MEDLINE]

1558: J Gen Virol. 2005 Jan;86(Pt 1):1-6.

Role of the protein kinase PKR in the inhibition of varicella-zoster virus
replication by beta interferon and gamma interferon.

Desloges N, Rahaus M, Wolff MH.

University of Witten/Herdecke, Institute of Microbiology and Virology, Stockumer 
Str. 10, D-58448 Witten, Germany.

Varicella-zoster virus (VZV) is sensitive to type I and type II interferons
(IFNs), which mediate antiviral effects. In this study, it was demonstrated that 
IFN-beta and IFN-gamma inhibited the replication of VZV in vitro. Although
IFN-beta was more effective than IFN-gamma, the level of inhibition of VZV
replication achieved by the combination of both IFNs was more than additive and
it was concluded that these two cytokines acted synergistically. Expression of
the IFN-induced, double-stranded RNA-activated protein kinase PKR and its
phosphorylation level were not modulated strongly during ongoing replication of
VZV. However, in the presence of IFN-beta, but not IFN-gamma, PKR expression and 
its phosphorylation were increased, explaining in part the inhibition of virus
replication by IFNs. The expression of herpes simplex virus Us11, a viral protein
with several functions, including prevention of PKR activation, strongly
increased the level of VZV replication.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 15604425 [PubMed - indexed for MEDLINE]

1559: East Mediterr Health J. 2002 Jul-Sep;8(4-5):574-8.

Frequency and types of skin disorders and associated diabetes mellitus in elderly
Jordanians.

Najdawi F, Fa'ouri M.

Jordanian Board of Family Medicine, Royal Medical Services, Jordan.

A retrospective study of 232 elderly patients seen between August 1998 and April 
2000 at the skin clinic in Princess Haya hospital, Aqaba, was undertaken to
determine the prevalence of skin disorders, and those most commonly associated
with diabetes mellitus, in the elderly. Eczema/dermatitis was the commonest skin 
disorder seen (25.9% of cases), followed by pruritus without skin lesions
(15.1%), viral infection (14.7%, most commonly herpes zoster), fungal infection
(13.8%), and bacterial infection (10.3%). Bacterial infection was the commonest
skin disorder in patients with diabetes mellitus (62.5%), followed by fungal
infection (50.0%). Skin diseases cause considerable morbidity in elderly people; 
health promotion and education can do much to reduce the risks of these disorders
in the elderly, especially those with diabetes.

PMID: 15603040 [PubMed - indexed for MEDLINE]

1560: Arch Neurol. 2004 Dec;61(12):1974-7.

Erratum in:
    Arch Neurol. 2005 Apr;62(4):687. Traynor, Bryan [corrected to Traynor, Bryan J].

The neurology of varicella-zoster virus: a historical perspective.

Nogueira RG, Traynor BJ.

Department of Neurology, Massachusetts General Hospital, Blake 1291, Harvard
Medical School, 55 Fruit Street, Boston, MA 02114, USA. rnogueira@partners.org

Publication Types: 
    Historical Article

PMID: 15596626 [PubMed - indexed for MEDLINE]

1561: Arch Ophthalmol. 2004 Dec;122(12):1773-81.

In vivo confocal microscopy of keratic precipitates.

Wertheim MS, Mathers WD, Planck SJ, Martin TM, Suhler EB, Smith JR, Rosenbaum JT.

Casey Eye Institute, Oregon Health & Science University, Portland 97201, USA.
rosenbaj@ohsu.edu

OBJECTIVE: To evaluate the heterogeneity of keratic precipitates (KP) in varying 
subtypes of uveitis by in vivo confocal microscopy (IVCM). METHODS: The KP were
viewed with a scanning confocal microscope in patients (n = 33) who sought care
at a tertiary referral uveitis service for immune-mediated and infectious forms
of uveitis, including HLA-B27-associated uveitis, sarcoidosis,
Vogt-Koyanagi-Harada syndrome, juvenile chronic arthritis, Fuchs heterochromic
iridocyclitis, cytomegalovirus retinitis, herpes zoster ophthalmicus, ocular
toxoplasmosis, and idiopathic uveitis. Images were captured and digitalized in
real time. RESULTS: Forty-two eyes of 33 patients were examined in this study.
Patient age ranged from 22 to 84 years, with a mean age of 49.4 years. Seventeen 
(52%) of the patients were women, and 16 patients (48%) were men. The KP ranged
in diameter from 10 to 350 mum. We observed the following absolute and
speculative outcomes: KP are markedly heterogeneous and variable as documented by
IVCM; KP in individual patients are consistent throughout the cornea; the
morphologic features of KP change across time; infectious vs noninfectious causes
of uveitis seem to be readily distinguishable by using IVCM; and KP may have
consistency for specific disease states and therefore may have diagnostic
importance. CONCLUSIONS: To our knowledge, this is the first time that IVCM has
been used to describe the architecture and heterogeneity of KP in uveitis. Such
observations reveal a heterogeneity that could not be appreciated by conventional
slitlamp microscopy and may have diagnostic relevance.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15596579 [PubMed - indexed for MEDLINE]

1562: Clin Dermatol. 2004 Nov-Dec;22(6):487-98.

Cutaneous markers of HIV infection.

Rigopoulos D, Paparizos V, Katsambas A.

Department of Dermatology, University of Athens, A. Sygros Hospital, Athens,
Greece.

Despite the development of laboratory methods, dermatological symptoms are a
basic index of the presence and physical course of HIV infection. HIV infection
usually undergoes a long latent period, proceeds to a period of
immunodeficiency-related symptoms, and ends in an advanced immunodeficiency state
characterized by opportunistic infections and neoplasms. Occasionally,
dermatological manifestations can be the first signs of asymptomatic disease,
indices of advanced immunodeficiency, or symptoms of opportunistic infections or 
neoplasms. The variety of symptoms and signs for the skin during the course of
HIV infection is a consequence of the progressing immunodeficiency and therefore 
indicates the underlying disorder. The use of these manifestations is a challenge
for clinical praxis.

Publication Types: 
    Review

PMID: 15596320 [PubMed - indexed for MEDLINE]

1563: Joint Bone Spine. 2004 Nov;71(6):588-91.

Herpes zoster sciatica with paresis preceding the skin lesions. Three
case-reports.

Wendling D, Langlois S, Lohse A, Toussirot E, Michel F.

Rheumatology Department, Jean Minjoz Teaching Hospital, Boulevard Fleming, 25030 
Besancon, France. daniel.wendling@ufc-chu.univ-fcomte.fr

We report three cases of herpes zoster sciatica with motor loss preceding the
typical skin lesions. Serological tests and cerebrospinal fluid examination
established the diagnosis. Two patients had residual motor loss after 1 and 3
months, respectively. Immunodepression and other risk factors should be looked
for routinely. Early diagnosis and treatment may improve the prognosis. Tests for
antibodies or viral DNA in cerebrospinal fluid can be helpful, although negative 
results do not rule out the diagnosis.

Publication Types: 
    Case Reports

PMID: 15589447 [PubMed - indexed for MEDLINE]

1564: J Pain Symptom Manage. 2004 Dec;28(6):535-6.

Oxcarbazepine (Trileptal) monotherapy dramatically improves quality of life in
two patients with postherpetic neuralgia refractory to carbamazepine and
gabapentin.

Criscuolo S, Auletta C, Lippi S, Brogi F, Brogi A.

Publication Types: 
    Case Reports
    Letter

PMID: 15589078 [PubMed - indexed for MEDLINE]

1565: Drug Saf. 2004;27(15):1217-33.

Comment in:
    Drug Saf. 2005;28(8):741; author reply 742.

Tolerability of treatments for postherpetic neuralgia.

Douglas MW, Johnson RW, Cunningham AL.

Centre for Virus Research, Westmead Millennium Institute, Westmead Hospital and
University of Sydney, Westmead, Australia.

Herpes zoster occurs in up to 20% of people infected with varicella-zoster virus,
due to reactivation of the virus from latently infected sensory ganglia. Although
pain is a typical feature of acute zoster, pain persisting for more than a month 
after resolution of the rash is less common and is termed postherpetic neuralgia 
(PHN). The pain associated with PHN is neuropathic in origin and is notoriously
difficult to treat. The incidence of herpes zoster and its associated
complications both increase with age, so PHN should be seen more commonly in an
aging population. Vaccination with live, attenuated varicella vaccine is safe and
efficacious, particularly in children. It decreases the incidence of acute
varicella and subsequent herpes zoster. Aciclovir is well tolerated, with renal
toxicity only at high intravenous doses. Treatment of acute varicella with
aciclovir attenuates acute illness but does not prevent herpes zoster. Treatment 
of herpes zoster with aciclovir or its derivatives minimises symptoms and may
reduce the rate of PHN. Foscarnet is an alternative for an aciclovir-resistant
virus but its use is limited by renal and CNS toxicity. Corticosteroids reduce
acute pain in herpes zoster but do not affect the incidence of PHN. Their use in 
some patients may be limited by adverse effects such as gastritis and impaired
glucose tolerance. Treatment of established PHN is difficult and may require a
holistic approach. Tricyclic antidepressants and gabapentin are the systemic
agents with the most proven benefit, although opioids such as oxycodone and NMDA 
receptor antagonists such as ketamine may be useful in some people. Adverse
effects from tricyclic antidepressants are common but usually mild, while
gabapentin is generally well tolerated. Although effective, the relatively common
adverse effects of opioids and ketamine limit their usefulness in treating PHN.
Topical treatment with 5% lidocaine patch or capsaicin is of benefit in some
patients and is generally well tolerated. Intrathecal methyl prednisolone may be 
considered for intractable pain but efficacy and safety have not been confirmed.

Publication Types: 
    Comparative Study
    Review

PMID: 15588117 [PubMed - indexed for MEDLINE]

1566: Nippon Ganka Gakkai Zasshi. 2004 Nov;108(11):649-53.

[Ocular inflammation with varicella-zoster virus and immune privilege]

[Article in Japanese]

Kezuka T.

Department of Ophthalmology, Tokyo Medical University, Japan.

Mice with experimental acute retinal necrosis (ARN) induced by herpes simplex
virus fail to acquire virus-specific delayed hypersensitivity (DH), even though
they produce antiviral antibodies. We investigated whether there was a similar
correlation for patients with varicella zoster virus(VZV)-induced ARN or patients
with anterior uveitis caused by VZV. Patients with acute, VZV-induced ARN, with
anterior uveitis with dermatitis(herpes zoster ophthalmicus, ZO-AU), or with
anterior uveitis without dermatitis(zoster sine herpete, ZSH-AU) were skin-tested
with VZV to evaluate DH. All patients with VZV-induced skin disease alone(control
group) displayed intense DH when tested with VZV antigen. In contrast, subsets of
patients with ARN or ZO-AU displayed absent VZV-specific DH. Patients with the
most severe ARN or ZO-AU had the lowest DH responses to VZV antigens. Serum
anti-VZV antibody titers were higher in ARN patients than in normal subjects, and
anti-viral titer correlated inversely with intensity of anti-VZV DH responses.
VZV-specific DH responses were restored in patients who recovered from ARN or
from anterior uveitis caused by VZV. Patients with ZSH-AU also failed to display 
VZV-specific DH. Absence of DH reactivity to VZV antigens appears to be a
concomitant feature of VZV-uveitis of high intensity.

Publication Types: 
    English Abstract
    Review

PMID: 15584349 [PubMed - indexed for MEDLINE]

1567: J Clin Microbiol. 2004 Dec;42(12):5811-8.

DNA microarrays for virus detection in cases of central nervous system infection.

Boriskin YS, Rice PS, Stabler RA, Hinds J, Al-Ghusein H, Vass K, Butcher PD.

Department of Medical Microbiology, St. George's Hospital Medical School, Cranmer
Terrace, London SW17 ORE, United Kingdom.

A low-density, high-resolution diagnostic DNA microarray comprising 38 gene
targets for 13 viral causes of meningitis and encephalitis was constructed. The
array has been used for the detection of multiplex PCR-amplified viruses in
cerebrospinal fluid (CSF) and non-CSF specimens. A total of 41 clinical specimens
were positive for echoviruses (23 samples), herpes simplex virus type 2 (4
samples), varicella-zoster virus (4 samples), human herpesvirus 7 (1 sample),
human herpesvirus 6A (1 sample) and 6B (2 samples), Epstein-Barr virus (three
samples), polyomavirus JC (1 sample), and cytomegalovirus (2 samples). Probes for
herpes simplex virus type 1, polyomavirus BK, and mumps and measles viruses were 
also included on the array. Three samples were false negative by the microarray
assay due to discordant results between the multiplex PCR for all 13 viruses
simultaneously and the virus-specific PCR alone. Fifteen CSF specimens were true 
negative. The clinical sensitivity, specificity, and negative and positive
predictive values of the assay were 93, 100, 100, and 83%, respectively, when the
results were compared to those of the single-virus PCR, which was used as the
"gold standard." The microarray-based virus detection assay is qualitative and
provides a single-format diagnostic tool for the detection of panviral CNS
infections.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 15583316 [PubMed - indexed for MEDLINE]

1568: J Clin Microbiol. 2004 Dec;42(12):5698-704.

Varicella seroprevalence and molecular epidemiology of varicella-zoster virus in 
Argentina, 2002.

Dayan GH, Panero MS, Debbag R, Urquiza A, Molina M, Prieto S, Del Carmen Perego
M, Scagliotti G, Galimberti D, Carroli G, Wolff C, Schmid DS, Loparev V, Guris D,
Seward J.

Epidemiology and Surveillance Division, National Immunization Program, Centers
for Disease Control and Prevention, MS E-61, 1600 Clifton Rd., Atlanta, GA 30333,
USA. gdayan@cdc.gov

There is limited data on immunity against varicella-zoster virus (VZV) in adults 
in different parts of Argentina, and it is not known which VZV strains are
circulating in Argentina. The objectives of this study were as follows: (i) to
evaluate seroprevalence of varicella among adults, assessing the accuracy of
clinical history and determining the sociodemographic factors associated with
seropositivity; and (ii) to determine the VZV strains circulating in Argentina. A
cross-sectional serological survey enrolling 2,807 women aged 15 to 49 years
attending public health-care settings in four cities in Argentina (i.e., Buenos
Aires, Salta, Mendoza, and Rosario) and one rural area was conducted from August 
to November 2002. Specimens for identification of VZV strains were obtained from 
vesicular lesions from 13 pediatric patients with varicella from different areas 
of the country. PCR amplification was used for genotyping. The overall
seroprevalence of varicella antibodies was 98.5% (95% confidence interval, 98.0
to 98.9), ranging from 97.2% in central Buenos Aires to 99.3% in southern Buenos 
Aires and Salta. Varicella seroprevalence increased with age. Crowding and length
of residence in the same place were associated with seropositivity. The positive 
predictive value of varicella history for immunity to varicella was 99.4%;
however, the negative predictive value was 2.5%. The European genotype was
identified in all viral specimens. In Argentina, seroprevalence in women more
than 15 years old was high regardless of the area of residence. Negative or
uncertain varicella history was not a good predictor of immunity. VZV genotype
was stable in all areas of the country.

PMID: 15583301 [PubMed - indexed for MEDLINE]

1569: J Clin Microbiol. 2004 Dec;42(12):5604-8.

Comment in:
    J Clin Microbiol. 2005 Oct;43(10):5415-6; author reply 5416-7.

Genetic profile of an Oka varicella vaccine virus variant isolated from an infant
with zoster.

Sauerbrei A, Rubtcova E, Wutzler P, Schmid DS, Loparev VN.

Institute of Virology and Antiviral Therapy, Friedrich-Schiller University, Jena,
Germany.

Varicella virus vaccine strain Oka (V-Oka) has in rare cases caused zoster in
vaccinated people. Despite broad usage of V-Oka, little is known about
varicella-zoster virus genomic sequence variation of strains in vaccine and
isolates from patients with vaccine adverse events. Direct sequencing of 20
regions of V-Oka-GSK was compared to the sequences of the original V-Oka-Biken,
GlaxoSmithKline Oka vaccine (V-Oka-GSK), and Oka-parental (P-Oka) strains. We
analyzed single nucleotide polymorphisms (SNP) differentiating the Oka parental
and Oka vaccine strains identified in open reading frames (ORFs) 6, 9A, 10, 21,
31, 39, 50, 51, 52, 54, 55, and 59 and eight base substitutions within ORF 62.
Sixteen of these SNP impose an amino acid change in the corresponding gene
product. The genotypic analysis revealed that (i) both V-Oka-GSK and V-Oka-Biken 
comprise mixtures of strains represented in variable proportion from lot to lot; 
(ii) V-Oka-GSK/zoster isolated from the zoster patient had six wild-type SNP in
ORF 9A, 10, 21, 52, 55, and 62 (mutation 108838); (iii) none of the six revertant
SNP would reliably discriminate Oka vaccine from the wild type; and (iv) the
genomic variation found in V-Oka/zoster might be associated with changes in the
biological behavior of the virus. Further studies will be needed to identify
potential virulence factors in variant vaccine strains.

PMID: 15583288 [PubMed - indexed for MEDLINE]

1570: Bol Asoc Med P R. 2004 Mar-Apr;96(2):71-4, 77-83.

Herpes simplex uveitis.

Santos C.

Department of Ophthalmology University of Puerto Rico School of Medicine.

BACKGROUND: Uveitis in herpes simplex virus (HSV) ocular disease is usually
associated with corneal stromal disease. It has generally been believed that
herpetic uveitis in the absence of corneal disease is very rare. When seen it is 
usually attributed to varicella zoster virus (VZV) infections. The diagnosis of
uveitis caused by herpes simplex is often not diagnosed resulting in inadequate
treatment and a poor visual result. METHODS: Seven patients from a large uveitis 
practice who presented with a clinical picture of: anterior uveitis and sectoral 
iris atrophy without keratitis, a syndrome highly suggestive of herpetic
infection, are reported. Polymerase chain reaction (PCR) was done in the aqueous 
of four of them and was positive for HSV. One patient had bilateral disease. Most
of the patients also had severe secondary glaucoma. RESULTS: Of the seven
patients presented five had no history of any previous corneal disease. Two had a
history of previous dendritic keratitis which was not active at the time of
uveitis development. One patient with bilateral disease was immunosuppressed at
the time when the uveitis developed. Six of the seven patients had elevated
intraocular pressures at the time of uveitis and five required glaucoma surgery. 
Intractable glaucoma developed in two patients leading to rapid and severe visual
loss despite aggressive management. CONCLUSION: Findings suggest that uveitis
without corneal involvement may be a more frequent manifestation of ocular herpes
simplex disease than previously thought. Absence of corneal involvement delays a 
correct diagnosis and may worsen visual outcome. Primary herpetic uveitis (when
there is no history of previous corneal disease) seems to be more severe than the
uveitis in patients with previous corneal recurrences. The associated glaucoma
may be a devastating complication.

Publication Types: 
    Case Reports
    Review

PMID: 15580909 [PubMed - indexed for MEDLINE]

1571: MMWR Recomm Rep. 2004 Dec 3;53(RR-14):1-92.

Erratum in:
    MMWR Morb Mortal Wkly Rep. 2006 Aug 4;55(30):824. dosage error in text.

Treating opportunistic infections among HIV-exposed and infected children:
recommendations from CDC, the National Institutes of Health, and the Infectious
Diseases Society of America.

Mofenson LM, Oleske J, Serchuck L, Van Dyke R, Wilfert C; CDC; National
Institutes of Health; Infectious Diseases Society of America.

Pediatric, Adolescent and Maternal AIDS Branch, National Institute of Child
Health and Human Development, National Institutes of Health, Bethesda, Maryland
20852, USA.

In 2001, CDC, the National Institutes of Health, and the Infectious Diseases
Society of America convened a working group to develop guidelines for therapy of 
human immunodeficiency virus (HIV)-associated opportunistic infections to serve
as a companion to the Guidelines for Prevention of Opportunistic Infections Among
HIV-Infected Persons. In recognition of unique considerations related to HIV
infection among infants, children, and adolescents, a separate pediatric working 
group was established. Because HIV-infected women coinfected with opportunistic
pathogens might be more likely to transmit these infections to their infants than
women without HIV infection, guidelines for treating opportunistic pathogens
among children should consider treatment of congentially acquired infections
among both HIV-exposed but uninfected children and those with HIV infection. In
addition, the natural history of opportunistic infections among HIV-infected
children might differ from that among adults. Compared with opportunistic
infections among HIV-infected adults, which are often caused by reactivation of
pathogens acquired before HIV infection when host immunity was intact,
opportunistic infections among children often reflect primary acquisition of the 
pathogen and, among children with perinatal HIV infection, infection acquired
after HIV infection has been established and begun to compromise an already
immature immune system. Laboratory diagnosis of opportunistic infections can be
more difficult with children. Finally, treatment recommendations should consider 
differences between adults and children in terms of drug pharmacokinetics,
dosing, formulations, administration, and toxicities. This report focuses on
treatment of opportunistic infections that are common in HIV-exposed and infected
infants, children, and adolescents in the United States.

Publication Types: 
    Guideline
    Practice Guideline

PMID: 15577752 [PubMed - indexed for MEDLINE]

1572: J Acquir Immune Defic Syndr. 2004 Dec 15;37(5):1604-9.

Herpes zoster in women with and at risk for HIV: data from the Women's
Interagency HIV Study.

Glesby MJ, Hoover DR, Tan T, Shi Q, Gao W, French AL, Maurer T, Young M, Dehovitz
J, Ru J, Anastos K.

Division of International Medicine and Infectious Diseases, Department of
Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.
mag2005@med.cornell.edu

BACKGROUND: Herpes zoster occurs at all CD4 cell counts in HIV-infected adults.
It was hypothesized that even in the era of highly active antiretroviral therapy 
(HAART), zoster risk is higher in HIV-infected than uninfected women. METHODS:
Generalized estimating equations modeled self-reported occurrence of zoster
between semiannual visits among 1832 HIV-infected and 489 HIV-uninfected women in
the Women's Interagency HIV Study followed for up to 7.5 years. RESULTS: A total 
of 337 (18.4%) HIV-infected and 7 (1.4%) HIV-uninfected women reported zoster at 
some time during follow-up. Using HIV-infected women with CD4 >750 cells/microL
as the reference category, the odds ratios for reporting zoster since the prior
visit were: 1.43 (95% CI 0.86-2.37) for CD4 500-749 cells/microL, 2.07 (95% CI
1.27-3.38) for CD4 350-499 cells/microL, 2.72 (95% CI 1.66-4.46) for CD4 200-349 
cells/microL, and 3.16 (95% CI 1.92-5.18) for CD4 <200 cells/microL, compared
with 0.11 (95% CI 0.046-0.26) for HIV-uninfected women. In multivariate analyses 
using visits from all HIV-infected women and only those who initiated HAART,
lower CD4 cell count was more strongly associated with zoster incidence than were
other clinical indicators. CONCLUSIONS: Herpes zoster is associated with degree
of immunosuppression in HIV-infected women, but even women with high CD4 counts
are at greater risk of zoster than HIV-uninfected women.

Publication Types: 
    Comparative Study
    Multicenter Study
    Research Support, N.I.H., Extramural

PMID: 15577417 [PubMed - indexed for MEDLINE]

1573: BMC Ear Nose Throat Disord. 2004 Dec 2;4(1):3.

Bilateral Ramsay Hunt syndrome in a diabetic patient.

Syal R, Tyagi I, Goyal A.

Neuro-otology Unit, Department of Neuro-surgery, Sanjay Gandhi Post Graduate
Institute of Medical Sciences, Raibarely Road, Lucknow (UP) – 226 014 INDIA.
drrajansyal@indiatimes.com.

BACKGROUND: Herpes zoster oticus accounts for about 10% cases of facial palsy,
which is usually unilateral and complete and full recovery occurs in only about
20% of untreated patients. Bilateral herpes zoster oticus can sometime occur in
immunocompromised patients, though incidence is very rare. CASE PRESENTATION:
Diabetic male, 57 year old presented to us with bilateral facial palsy due to
herpes zoster oticus. Patient was having bilateral mild to moderate sensorineural
hearing loss. Patient was treated with appropriate metabolic control,
anti-inflammatory drugs and intravenous acyclovir. Due to uncontrolled diabetes, 
glucocorticoids were not used in this patient. Significant improvement in hearing
status and facial nerve functions were seen in this patient. CONCLUSIONS: Herpes 
zoster causes severe infections in diabetic patients and can be a cause of
bilateral facial palsy and bilateral Ramsay Hunt syndrome. Herpes zoster in
diabetic patients should be treated with appropriate metabolic control, NSAIDS
and intravenous acyclovir, which we feel should be started at the earliest.
Glucocorticoids should be avoided in diabetic patients.

PMID: 15575957 [PubMed - as supplied by publisher]

1574: Expert Opin Emerg Drugs. 2004 Nov;9(2):237-56.

Emerging therapies for herpes viral infections (types 1 - 8).

Chakrabarty A, Pang KR, Wu JJ, Narvaez J, Rauser M, Huang DB, Beutner KR, Tyring 
SK.

Solano Clinical Research, Davis, California, USA.

There are eight members of the herpesviridae family: herpes simplex virus-1
(HSV-1), HSV-2, varicella-zoster virus, Epstein-Barr virus, cytomegalovirus,
human herpes virus-6, human herpes virus-7 and human herpes virus-8. The diseases
caused by viruses of the herpesviridae family are treated with and managed by
systemic and topical antiviral therapies and immunomodulating drugs. Because
these viruses establish a latent state in hosts, antiherpetic agents, such as
nucleoside analogues, only control symptoms of disease or prevent outbreaks, and 
cannot cure the infections. There is a need for treatments that require less
frequent dosing, can be taken even when lesions are more advanced than the first 
signs or symptoms, and can treat resistant strains of the viruses without the
toxicities of existing therapies. Immunomodulating agents, such as resiquimod,
can act on the viruses indirectly by inducing host production of cytokines, and
can thereby reduce recurrences of herpes. The new helicase primase inhibitors,
which are the first non-nucleoside antiviral compounds, are being investigated
for treatment of HSV disease, including infections resistant to existing therapy.

Publication Types: 
    Review

PMID: 15571482 [PubMed - indexed for MEDLINE]

1575: AJNR Am J Neuroradiol. 2004 Nov-Dec;25(10):1722-9.

CNS MR and CT findings associated with a clinical presentation of herpetic acute 
retinal necrosis and herpetic retrobulbar optic neuritis: five HIV-infected and
one non-infected patients.

Bert RJ, Samawareerwa R, Melhem ER.

Boston Medical Center, Jamaica Plain, MA, USA.

INTRODUCTION: This report demonstrates the spectrum of central nervous system
(CNS) abnormalities observed on MR imaging and CT studies in 6 patients with
clinical or pathologic diagnoses of acute retinal necrosis (ARN) and retrobulbar 
optic neuritis (RBON-H) resulting from Herpes Zoster Virus and Cytomegalovirus.
We discuss the etiologic and pathophysiologic implications regarding these
findings. METHODS: Standard MR imaging sequences of the whole brain and selected 
high-resolution images of the orbits and globes, from 6 patients, were reviewed
by three neuroradiologists for consensus interpretation of the findings. Special 
sequences augmenting disease were obtained in individual cases. Axial CT images
were obtained from two patients using 5mm sequential slices. RESULTS: MR imaging 
findings showed both T2 signal brightening and contrast enhancement in one or
both optic nerves, optic tracts and lateral geniculate bodies, as well as the
postsynaptic optic radiations and optic cortex. Similar findings were observed in
the superior colliculus, lateral midbrain and cerebellum, with multiple potential
etiologic possibilities regarding pathways of dissemination. Low T2* signal
(indicating magnetic field susceptibility effects) and CT hyperdensity,
consistent with prior hemorrhage, were also observed in the optic tracts, optic
radiations and lateral geniculate bodies. Post-contrast enhancement was observed 
in the meninges and Meckle's cave in one HIV negative patient. CONCLUSION: These 
cases demonstrate CNS imaging findings associated with RBON that are
temporally-related to ARN. They support the hypothesis that RBON can either
precede or follow ARN and implicate transneuronal, transsynaptic and/or
transcerebrospinal fluid viral spread by the herpetic family.

Publication Types: 
    Case Reports

PMID: 15569737 [PubMed - indexed for MEDLINE]

1576: Anesthesiology. 2004 Dec;101(6):1472-4.

Comment in:
    Anesthesiology. 2005 Jul;103(1):211-2.    Anesthesiology. 2005 Jul;103(1):212; author reply 212-3.

Sacral postherpetic neuralgia and successful treatment using a paramedial
approach to the ganglion impar.

McAllister RK, Carpentier BW, Malkuch G.

Department of Anesthesiology, Scott and White Memorial Hospital and Clinic,
Temple, Texas, USA. mcallister@swmail.sw.org

Publication Types: 
    Case Reports

PMID: 15564959 [PubMed - indexed for MEDLINE]

1577: Curr Med Res Opin. 2004;20 Suppl 2:S21-8.

Effectiveness of the lidocaine patch 5% on pain qualities in three chronic pain
states: assessment with the Neuropathic Pain Scale.

Argoff CE, Galer BS, Jensen MP, Oleka N, Gammaitoni AR.

Cohn Pain Management Center, North Shore University Hospital/NYU School of
Medicine, Bethpage, NY 11714, USA. pargoff@optonline.net

OBJECTIVE: To determine the impact of the lidocaine patch 5% on pain qualities
associated with chronic pain from postherpetic neuralgia (PHN), painful diabetic 
neuropathy (DN), and low-back pain (LBP), using the Neuropathic Pain Scale (NPS).
PATIENTS AND METHODS: Patients with PHN, painful DN, and LBP were enrolled if
they had partial response to gabapentin-containing analgesic regimens and if they
reported moderate-to-severe pain on the NPS at study enrollment. Eligible
patients were included in an open-label, non-randomized, prospective, 2-week
study across 7 clinical trial sites in the United States. The lidocaine patch 5% 
was applied to the area of maximal pain, using no more than a total of 4 patches 
changed every 24 h. Patients were maintained on their other analgesic regimens
with no dose adjustment or additions allowed. Treatment effect was measured by
change from baseline to Week 2 in 4 composite measures of the NPS: NPS-10, NPS-4,
NPS-8, and NPS-non-allodynia. Safety was assessed by adverse events (AEs), dermal
assessment of application site(s), and skin sensory testing. RESULTS: In the
combined patient population (n = 77), 2 weeks of treatment with the lidocaine
patch 5% significantly improved all 4 composite measures (p < 0.01). In the
subgroup analyses, the lidocaine patch 5% demonstrated numerical advantage for
all 4 NPS composite measures for the PHN patients (n = 8), and significantly
improved all 4 composite measures for the painful DN patients (n = 41; p < 0.001)
and LBP patients (n = 28; p < or = 0.005). Overall, 8 patients (10%) experienced 
mild-to-moderate treatment-related AEs. CONCLUSIONS: The lidocaine patch 5%
effectively reduces the intensity of all common pain qualities in patients with
moderate-to-severe chronic pain resulting from PHN, painful DN, or LBP. Treatment
is well tolerated in combination with other analgesic regimens, with no reports
of serious AEs or adverse drug interactions. Assessment scales such as the NPS
may offer the possibility to differentiate between various pain states and to
assess treatment outcomes for various pain qualities associated with a given pain
state.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 15563743 [PubMed - indexed for MEDLINE]

1578: Drugs. 2004;64(24):2763-92.

Viral prophylaxis in organ transplant patients.

Slifkin M, Doron S, Snydman DR.

Division of Infectious Diseases, Tufts-New England Medical Center, Boston,
Massachusetts, USA.

Viral pathogens have emerged as the most important microbial agents having
deleterious effects on solid organ transplant (SOT) recipients. Antiviral
chemoprophylaxis involves the administration of medications to abort transmission
of, avoid reactivation of, or prevent progression to disease from, active viral
infection. Cytomegalovirus (CMV) is the major microbial pathogen having a
negative effect on SOT recipients. CMV causes infectious disease syndromes,
augments iatrogenic immunosuppression and is commonly associated with
opportunistic superinfection. CMV has also been implicated in the pathogenesis of
rejection. Chemoprophylactic regimens for CMV have included oral aciclovir
(acyclovir) at medium and high doses, intravenous and oral ganciclovir, and the
prodrugs valaciclovir (valacyclovir) and valganciclovir. CMV prophylactic
strategies should be stratified, with the highest-risk patients receiving the
most 'potent' prophylactic regimens. Herpes simplex virus (HSV) reactivation in
SOT recipients is more frequent, may become more invasive, takes longer to heal, 
and has greater potential for dissemination to visceral organs than it does in
the immunocompetent host. Prophylactic regimens for CMV are also effective
chemoprophylaxis against HSV; in the absence of CMV prophylaxis, aciclovir,
valaciclovir or famciclovir should be used as HSV prophylaxis in seropositive
recipients. Primary varicella-zoster virus (VZV) after SOT is rare and most
commonly seen in the paediatric transplant population because of VZV
epidemiology. Zoster occurs in 5-15% of patients, usually after the sixth
post-transplant month. Prophylactic regimens for zoster are neither practical nor
cost effective after SOT because of the late onset of disease and low proportion 
of affected individuals. All SOT recipients should receive VZV immune globulin
after contact with either varicella or zoster. Epstein-Barr virus has its most
significant effect in SOT as the precipitating factor in the development of
post-transplant lymphoproliferative disorders. Antiviral agents that could be
effective are the same as those used for CMV, but indications for and
effectiveness of prophylaxis are poorly established. Hepatitis B virus (HBV) and 
hepatitis C virus (HCV) are important pathogens in the SOT population as
indications for transplantation. So-called 'prophylaxis' for recurrent HBV and
HCV after liver transplantation is controversial, suppressive rather than
preventive, and potentially lifelong. Influenza infection after SOT is acquired
by person-to-person contact. During epidemic periods of influenza, transplant
populations experience a relatively high frequency of infection, and influenza
may affect immunosuppressed SOT recipients more adversely than immunocompetent
individuals. Antiviral medications for prevention of influenza are administered
as post-exposure prophylaxis to SOT recipients, in addition to yearly vaccine, in
circumstances such as influenza epidemics and nosocomial outbreaks, and after
exposure to a symptomatic individual during 'flu season'.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 15563248 [PubMed - indexed for MEDLINE]

1579: Am J Geriatr Pharmacother. 2004 Sep;2(3):157-62.

Gabapentin: a pooled analysis of adverse events from three clinical trials in
patients with postherpetic neuralgia.

Parsons B, Tive L, Huang S.

Pfizer Inc., New York, NY 10017-5755, USA.

BACKGROUND: Gabapentin has been shown to be well tolerated and effective in the
management of the pain associated with postherpetic neuralgia (PHN). It is
assumed that adverse events occurring with gabapentin are dose related, their
frequency and severity increasing with increasing doses. OBJECTIVE: The aim of
this study was to assess the dose dependence of adverse events with gabapentin by
determining the relationship between increasing doses of gabapentin and the onset
and/or worsening of adverse events in patients with PHN. METHODS: Data were
pooled from 3 randomized, double-blind, placebo-controlled, parallel-group
studies of gabapentin that focused on or included patients with PHN. Gabapentin
was initiated at 300 mg/d and titrated to maintenance doses of 1800 to 3600 mg/d 
by day 12 to 24. The analysis of adverse events was based on 3 distinct groups:
patients who received gabapentin <1800 mg/d, those who received gabapentin
>or=1800 mg/d, and those who received placebo. Patients who were given higher
doses of gabapentin had already received lower doses. An adverse event was
recorded at the dose of its first onset and recorded again if its severity
worsened at a higher dose. RESULTS: This study included data from 603 patients
with PHN: 358 patients (196 [54.7%] women, 162 [45.3%] men; mean [SD] age, 72.3
[10.3] years) received gabapentin, and 245 (133 [54.3%] women, 112 [45.7%] men;
mean [SD] age, 73.3 [10.7] years) received placebo. The 3 most common adverse
events were dizziness, somnolence, and peripheral edema. Patients receiving
gabapentin >or=1800 mg/d had a higher incidence of peripheral edema (7.5%) than
those receiving gabapentin <1800 mg/d (1.4%) or placebo (1.6%) (P<0.002,
gabapentin >or=1800 mg/d vs placebo). In contrast, the incidence of dizziness and
somnolence was not higher in patients receiving gabapentin >or=1800 mg/d compared
with those in the other groups. Compared with placebo recipients, patients
receiving gabapentin <1800 mg/d reported a significantly greater frequency of
dizziness (20.2% gabapentin <1800 mg/d vs 7.4% placebo; P<0.002) and somnolence
(14.9% vs 5.8%, respectively; P=0.005). However, at >or=1800 mg/d, rates of
dizziness (9.7%) and somnolence (6.9%) were comparable to those with placebo.
Discontinuation rates were comparable between patients receiving gabapentin and
those receiving placebo. CONCLUSIONS: In this pooled analysis of adverse-event
data from 3 clinical trials in patients with PHN, the incidence of peripheral
edema was increased when gabapentin was titrated to >or=1800 mg/d. Dizziness and 
somnolence, the other most commonly occurring adverse events, were transient and 
did not occur more frequently or worsen with titration to >or=1800 mg/d. Based on
these findings, it does not appear that safety concerns should limit titration of
gabapentin to achieve optimal efficacy.

Publication Types: 
    Comparative Study
    Meta-Analysis

PMID: 15561647 [PubMed - indexed for MEDLINE]

1580: Ann Thorac Surg. 2004 Dec;78(6):2159-61.

Acute postoperative shingles after thoracic sympathectomy for hyperhidrosis.

Massad MG, Navarro RA, Rubeiz H, Kpodonu J, Karol J, Blacha M, Evans A.

Division of Cardiothoracic Surgery, Department of Surgery, The University of
Illinois at Chicago, Chicago, Illinois 60612, USA. mmassad@uic.edu

Shingles secondary to reactivation of a previous varicella-zoster virus infection
has been reported to develop within surgical wounds and after trauma. We report
the case of a 17-year-old girl with history of chicken pox in childhood who had
acute postoperative shingles develop along the T3-T4 dermatomes after thoracic
sympathectomy for hyperhidrosis. The possible causes and precipitating factors
are discussed.

Publication Types: 
    Case Reports

PMID: 15561060 [PubMed - indexed for MEDLINE]

1581: J Gen Virol. 2004 Dec;85(Pt 12):3493-500.

Neutralizing human antibodies to varicella-zoster virus (VZV) derived from a VZV 
patient recombinant antibody library.

Kausmally L, Waalen K, Lobersli I, Hvattum E, Berntsen G, Michaelsen TE, Brekke
OH.

Affitech AS, Oslo Research Park, Gaustadalleen 21, 0349 Oslo, Norway.

Varicella-zoster virus (VZV), the causative agent of chickenpox and herpes
zoster, can be life-threatening in prematurely born children and in children with
immune defects or who are under immunosuppressive treatment. Therefore agents for
passive immunization, such as VZV-specific immunoglobulin preparations (VZIG)
derived from convalescent plasma, are crucial in the prophylaxis of VZV
infection. This study describes the isolation of human VZV-neutralizing
recombinant antibodies. A human single-chain variable fragment (scFv) phage
display library was generated from RNA extracted from peripheral blood
lymphocytes of a convalescent varicella patient. Specific phage antibodies were
selected against VZV-infected human fibroblasts, and eight unique clones were
further expressed as soluble scFv in Escherichia coli. They all showed binding
characteristics to varicella antigens with affinities in the K(D) range 0.1-0.2
muM. Two of the scFv antibodies, VZV4 and VZV5, showed dose-dependent in vitro
neutralization of VZV. VZV39 also showed a neutralizing effect as scFv, an effect
that was increased 4000-fold by conversion into IgG and was further increased by 
the addition of complement. This is possibly the first time that monovalent scFv 
antibodies have been shown to neutralize VZV in vitro. This finding will have an 
impact on the production of new prophylactic antibodies, as such antibody
fragments can be cost-effectively produced in E. coli. The antibodies isolated
bind both complement-dependent and -independent epitopes for neutralization, thus
they may prove useful tools for the study of VZV virulence mechanisms.

PMID: 15557222 [PubMed - indexed for MEDLINE]

1582: J Immunol. 2004 Dec 1;173(11):6592-602.

Plasmacytoid dendritic cell recruitment by immobilized CXCR3 ligands.

Kohrgruber N, Groger M, Meraner P, Kriehuber E, Petzelbauer P, Brandt S, Stingl
G, Rot A, Maurer D.

Division of Immunology, Allergy and Infectious Diseases, Department of
Dermatology, Medical University of Vienna, Vienna, Austria.

Plasmacytoid dendritic cells (pDCs) recognize microbes, viruses in particular,
and provide unique means of innate defense against them. The mechanism of pDC
tissue recruitment remained enigmatic because the ligands of CXCR3, the cardinal 
chemokine receptor on pDCs, have failed to induce in vitro chemotaxis of pDCs in 
the absence of additional chemokines. In this study, we demonstrate that CXCR3 is
sufficient to induce pDC migration, however, by a migratory mechanism that
amalgamates the features of haptotaxis and chemorepulsion. To mediate
"haptorepulsion" of pDCs, CXCR3 requires the encounter of its cognate ligands
immobilized, optimally by heparan sulfate, in a form of a negative gradient. This
is the first report of the absolute requirement of chemokine immobilization and
presentation for its in vitro promigratory activity. The paradigmatic example of 
pDC haptorepulsion described here may represent a new pathophysiologically
relevant migratory mechanism potentially used by other cells in response to other
chemokines.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15557149 [PubMed - indexed for MEDLINE]

1583: Clin Evid. 2003 Dec;(10):942-52.

Update in:
    Clin Evid. 2004 Dec;(12):1182-93.

Update of:
    Clin Evid. 2003 Jun;(9):890-900.

Postherpetic neuralgia.

Wareham D.

Queen Mary University of London & Barts & The London NHS Trust, London, UK.

Publication Types: 
    Review

PMID: 15555130 [PubMed - indexed for MEDLINE]

1584: Clin Evid. 2003 Dec;(10):809-30.

Update in:
    Clin Evid. 2005 Jun;(13):834-53.

Update of:
    Clin Evid. 2003 Jun;(9):795-816.

HIV: prevention of opportunistic infections.

Ioannidis J, Wilkinson D.

Department of Hygiene and Epidemiology University of Ioannina School of Medicine,
Ioannina, Greece.

Publication Types: 
    Review

PMID: 15555123 [PubMed - indexed for MEDLINE]

1585: Rinsho Ketsueki. 2004 Oct;45(10):1095-9.

[Splenic marginal zone lymphoma associated with antiphospholipid antibodies]

[Article in Japanese]

Yokoi T, Mori S, Sugimoto H, Komiyama Y, Uemura Y, Tanijiri R, Nakai K, Matsumoto
N, Zen K, Amakawa R, Kishimoto Y, Ieko M, Takahashi H, Fukuhara S.

First Department of Internal Medicine, Kansai Medical University.

A 61-year-old woman experienced a high fever with anemia and APTT prolongation
after suffering a herpes zoster virus infection. Physical examination revealed a 
large splenomegaly without lymphadenopathy. Laboratory evaluations were positive 
for lupus anticoagulant (LA) and monoclonal IgM-kappa protein. LA was associated 
with the presence of anti-beta2GPI antibody, anti-cardiolipin antibody, and
anti-prothrombin antibody. Moreover, the results of factors IX, XI, and XII
assays and CRP and FDP-E were disturbed. A splenectomy was performed, and a
splenic marginal zone lymphoma (SMZL) was diagnosed. All hematological findings
rapidly recovered after the splenectomy. No thrombotic events occurred after the 
splenectomy even though thrombosis prophylaxis was not performed. The clinical
course suggested that the SMZL-producing antibody induced immunological
abnormalities in the labolatory tests. Since the patient suffered disease
progression soon after the splenectomy, an autologous peripheral stem cell
transplantation with rituximab administration was performed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15553043 [PubMed - indexed for MEDLINE]

1586: Rinsho Ketsueki. 2004 Oct;45(10):1090-4.

[Analysis of varicella zoster virus infection following allogeneic stem cell
transplants]

[Article in Japanese]

Doki N, Hoshino T, Irisawa H, Sakura T, Miyawaki S.

Division of Hematology, Saiseikai Maebashi Hospital.

The purpose of this study was to evaluate patients who contracted the varicella
zoster virus infection (VZV) following their allogeneic stem cell transplants. We
retrospectively reviewed the incidence and the timing of varicella zoster virus
(VZV) infections, including the clinical course, complications, and associated
clinical risk factors. Between January 1998 and April 2003, a total of 71
patients received allogeneic stem cell transplants in our hospital. For
prophylaxis of the herpes virus infection, all patients were given a daily oral
1000 mg dose of acyclovir from day -7 to day +35. Among the 71 patients, 28 of
them (39.4%) developed VZV infection between day 77 and day 980 (median 182 days)
following their allogeneic stem cell transplants. In 21 of these infected
patients (75%) the occurrence was within the first 300 days after the transplant.
Twenty-two patients (78.5%) were under treatment with immunosuppressive agents.
Twenty-six patients developed only one episode of the VZV infection after their
transplants, but two other patients developed two episodes. Twenty one patients
(75%) stricken with the VZV infections had cutaneous reactivation infections of a
single dermatome, and in one patient two dermatomes were affected. Five patients 
(17.8%) developed disseminated cutaneous zoster, and one patient (3.6%) developed
a visceral infection. Treatment with acyclovir (oral or drip infusion) was
successful in 25 patients. Two patients improved with vidarabine treatment,
however the patient with the visceral infection died despite the use of
acyclovir. The incidence of visceral infection was low, but the one case was
fatal.

Publication Types: 
    English Abstract

PMID: 15553042 [PubMed - indexed for MEDLINE]

1587: Skin Therapy Lett. 2004 Oct;9(8):1-4.

Treatment of postherpetic neuralgia.

Sra KK, Tyring SK.

University of Texas, Health Sciences Center, Houston, Texas, USA.

Postherpetic neuralgia (PHN) is a serious complication of herpes zoster that has 
a predilection for older individuals. PHN is often associated with significant
morbidity, and it can cause insomnia, fatigue, depression and interference with
daily activities in affected individuals. Treatment for PHN is initiated with
antivirals during the acute herpes zoster outbreak. Acyclovir (Zoviraxr,
GlaxoSmithKline), valacyclovir (Valtrex, GlaxoSmithKline) or famciclovir (Famvir,
Novartis) can be used to treat herpes zoster, and all three have been shown to
reduce the duration of the herpetic rash and zoster-associated pain. These
antivirals are most effective when used within the first 72 hours of the onset of
the rash. Side-effects of these antivirals are low and include nausea, vomiting, 
abdominal pain and headache. Other treatment options for PHN include topical
analgesics, opioid analgesics, tricyclic antidepressants and gabapentin. Because 
of the complexity of PHN, most patients require a combination of treatment
modalities for adequate pain relief.

Publication Types: 
    Comparative Study

PMID: 15550990 [PubMed - indexed for MEDLINE]

1588: Cells Tissues Organs. 2004;178(1):48-59.

Changes in the epithelium of the vaginal complex during the estrous cycle of the 
marsupial Monodelphis domestica. 2. Scanning electron microscopy study.

Kress A, Regli C, Spornitz UM, Morson G.

Institute of Anatomy, University of Basel, Basel, Switzerland.
annetrudi.kress@unibas.ch

The four stages of the estrous cycle in Monodelphis domestica, namely proestrus, 
estrus, postestrus and the transitional metestrus, were analyzed with the
scanning electron microscope and compared with the results of the previously
published transmission electron-microscopic paper [Cells Tissues Organs
2002;172:276-296]. During the estrous cycle the vaginal epithelium undergoes
dramatic changes from a nonkeratinized to a highly keratinized epithelium. The
predominant feature of proestrus with the beginning of keratinization is the
presence of polygonal flat cells with pavement-like appearance, bordered by
raised ridges and covered with microvilli. The epithelium is fully keratinized in
estrus, and the superficial layers overlap like shingles. Many cells are still
densely covered by microvilli, whereas others develop a complex pattern of
microridges. In postestrus different epithelial structures are revealed depending
on the actual stage of desquamation. In early postestrus surface cells resemble
those present during estrus. In late postestrus, when only few keratinized cells 
are left, the nonkeratinized cells become exposed to the lumen through
desquamation. These cells border the lumen during metestrus, a cycle stage during
which numerous leukocytes migrate into the vaginal canal. A number of these
uppermost cells is probably not yet prepared to function as metestrus cells and
are therefore sloughed off as well. During metestrus compact cell masses stick in
the vaginal furrows. Epithelial surface cells are highly irregular and bulging
with their microvilli covered surfaces in the vaginal lumen. This study
represents the first comprehensive description of alterations on the surface
ultrastructure of a marsupial vagina during the estrous cycle, demonstrating
considerable differences in comparison to many eutherians. 2004 S. Karger AG,
Basel.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15550759 [PubMed - indexed for MEDLINE]

1589: Biochem Pharmacol. 2004 Dec 15;68(12):2301-15.

Discovery and development of BVDU (brivudin) as a therapeutic for the treatment
of herpes zoster.

De Clercq E.

Department of Microbiology and Immunology, Rega Institute for Medical Research,
Katholieke Universiteit Leuven, Minderbroedersstraat B-3000 Leuven, Belgium.
erik.declercq@rega.kuleuven.ac.be

This Commentary is dedicated to the memory of Dr. Jacques Gielen, the late Editor
of Biochemical Pharmacology, whom I have known as both an author and reviewer for
the Journal for about 25 years. This is, quite incidentally, about the time it
took for bringing brivudin (BVDU) [(E)-5-(2-bromovinyl)-2'-deoxyuridine] from its
original description as an antiviral agent to the market place (in a number of
European countries, including Germany and Italy) for the treatment of herpes
zoster in immunocompetent persons. BVDU is exquisitely active and selective
against varicella-zoster virus (VZV) and herpes simplex virus type 1 (HSV-1).
BVDU owes this high selectivity and activity profile to a specific
phosphorylation by the virus-encoded thymidine kinase, followed by a potent
interaction with the viral DNA polymerase. The (E)-5-(2-bromovinyl)-substituent
can be considered as the hallmark for the activity of BVDU against VZV and HSV-1.
Extensive clinical studies have indicated that BVDU as a single (oral) daily dose
of 125 mg (for no more than 7 days) is effective in the treatment of herpes
zoster, as regards both short-term (suppression of new lesion formation) and
long-term effects (prevention of post-herpetic neuralgia). In this sense, BVDU is
as efficient and/or convenient, if not more so, than the other drugs (acyclovir, 
valaciclovir, famciclovir) that have been licensed for the treatment of herpes
zoster. There is one caveat; however, BVDU should not be given to patients under 
5-fluorouracil therapy, as the degradation product of BVDU, namely
(E)-5-(2-bromovinyl)uracil (BVU), may potentiate the toxicity of 5-fluorouracil, 
due to inhibition of dihydropyrimidine dehydrogenase, the enzyme involved in the 
catabolism of 5-fluorouracil.

Publication Types: 
    Review

PMID: 15548377 [PubMed - indexed for MEDLINE]

1590: Am J Otolaryngol. 2004 Nov-Dec;25(6):401-6.

The role of viruses in idiopathic peripheral facial palsy and cellular immune
response.

Kaygusuz I, Godekmerdan A, Keles E, Karlidag T, Yalcin S, Yildiz M, Tazegul A.

Department of Otorhinolaryngology, Firat University Medical Center, 23200 Elazig,
Turkey. kaygusuz_67@yahoo.com

PURPOSE: The purpose of this study is to investigate the role of viruses on the
idiopathic peripheral facial palsy and show the interaction of immune system.
MATERIALS AND METHODS: The levels of immunoglobulin (Ig) G and IgM antibodies
against to varicella-zoster virus (VZV), herpes simplex virus (HSV),
cytomegalovirus (CMV), Ebstein-Barr virus (EBV), and mumps virus in venous blood 
taken from patients in the amount of 10 mL have been investigated by
enzyme-linked immunosorbent assay method. Tumor necrosis factor-alpha
(TNF-alpha), interferon-gamma (IFN-gamma), and transforming growth factor-beta
(TGF-beta) were also examined. Of lymphocyte subpopulation, antibodies of CD3(+),
CD4(+), CD8(+), CD19(+), and CD16(+) plus 56(+) were analyzed. RESULTS: Ten of
the patients had HSV-1 IgG; 1 of the patients IgM, 5 of the patients EBV IgG, 6
of the patients VZV IgG, 1 of the patients IgM, 9 of the patients mumps IgG, 1 of
the patients IgM, and finally in 7 of the patients CMV IgG antibodies were
obtained. It was found that CD4(+) cell and ratio of CD4(+)/CD8(+) lower and the 
percentage of the CD8(+) and CD16(+) plus 56(+) cells higher compared with the
control group (P < .05). The levels of TNF-alpha were lower, whereas IFN-gamma
and TGF-beta1 were higher. CONCLUSION: It may be concluded from these results
that VZV, HSV-1, CMV, EBV, and mumps virus play a significant role in the
etiology of idiopathic peripheral facial palsy and activate the cellular
immunity.

PMID: 15547808 [PubMed - indexed for MEDLINE]

1591: Otol Neurotol. 2004 Nov;25(6):1020-6.

Agreement between the Sunnybrook, House-Brackmann, and Yanagihara facial nerve
grading systems in Bell's palsy.

Berg T, Jonsson L, Engstrom M.

Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery,
University Hospital, Uppsala, Sweden. thomas.moe.berg@akademiska.se

OBJECTIVE: To assess the agreement between the Sunnybrook facial nerve grading
system and the House-Brackmann and Yanagihara systems. STUDY DESIGN: Prospective 
clinical facial nerve grading. SETTING: Tertiary referral center. PATIENTS:
One-hundred assessments, 94 in patients with Bell's palsy and 6 with herpes
zoster. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: Evaluation according to 
the weighted regional Sunnybrook system, the gross House-Brackmann system, and
the unweighted regional Yanagihara system. Weighted kappa statistics was used to 
measure agreement between the grading systems. RESULTS: The average weighted
kappa value between the Sunny-brook, House-Brackmann, and Yanagihara grading
systems was 0.65; kappa values increased temporally (but not statistically
significantly) up to day 180. The highest agreement value, 0.72, was found
between the Sunnybrook and Yanagihara grading systems. The weighted kappa value
between the Sunnybrook and House-Brackmann systems was 0.59. In Sunnybrook
gradings less than 63, there was an overlap between House-Brackmann scores of III
to VI. Reliable conversion tables between the gross House-Brackmann system and
the regional Sunnybrook and Yanagihara systems could not be established.
CONCLUSION: The Sunnybrook system scores at the same agreement level as the
House-Brackmann and Yanagihara grading systems. There is an evaluative difference
between the weighted regional Sunnybrook and the gross House-Brackmann systems.
Substantial agreement was found between the regional Sunnybrook and Yanagihara
scales. Sunnybrook grading is easy and quick. By adding objective measurements
and additional secondary defects, the Sunnybrook system can be an alternative to 
the other predominating grading systems.

PMID: 15547437 [PubMed - indexed for MEDLINE]

1592: Curr Med Chem. 2004 Oct;11(20):2749-66.

5-(1-Substituted) alkyl pyrimidine nucleosides as antiviral (herpes) agents.

Kumar R.

Department of Medical Microbiology and Immunology, Faculty of Medicine and
Dentistry, University of Alberta, Edmonton, AB, Canada T6G 2H7.
rakesh.kumar@ualberta.ca.

The treatment of viral diseases remains one of the major challenges to modern
medicine. During the past two decades there has been increased recognition of the
consequences of serious viral illnesses that are not controlled by vaccination.
These illnesses include human immunodeficiency virus, human herpes viruses, and
viruses that cause hepatitis. There are now eight pathogens recognized in the
herpes virus family that cause infections in humans. Infections by the herpes
viruses are opportunistic and often life-threatening, leading to significant
morbidity and mortality in the increasing number of chronically immune
compromised individuals such as AIDS patients, cancer patients and transplant
recipients on immunosuppressive therapy. Nearly all individuals with AIDS are
infected with one or more of the herpes viruses. Antiviral therapy with guanosine
nucleoside analogs acyclovir and ganciclovir has had a major impact on diseases
caused by herpes simplex virus type-1 and type-2 (HSV-1, HSV-2), Varicella zoster
virus (VZV), and human cytomegalovirus (HCMV) but development of resistant virus 
strains and the absence of any effective treatment for other members of the
herpes family provide a stimulus for increased search of new agents effective
against various herpes viruses. Pyrimidine nucleosides have taken up an important
role in the therapy of virus infection. Significant progress in the study of
anti-herpes nucleosides has been made by the advent of 5-substituted pyrimidine
nucleosides such as 5-iodo-, 5-ethyl-, 5-(2-chloroethyl)-, and
(E)-5-(2-bromovinyl)- derivatives of 2'-deoxyuridine. These are highly specific
inhibitors of HSV-1, HSV-2, and/or VZV infections. However, Epstein Barr virus
(EBV) and HCMV are much less sensitive to these agents. In 5-substituted
pyrimidine nucleosides the nature of substituents, particularly at the C-5
position, has been found to be an important determinant of anti-herpes activity. 
Structural requirements at the C-2 carbon of the 5-substituent of pyrimidine
nucleosides have been well established for anti-herpes activity. However, there
is little qualitative or mechanistic knowledge of the derivatives with
substitution at the C-1 carbon of the 5-substituent of pyrimidine nucleosides.
During the last few years of our research, we have investigated a variety of C-1 
functionalized substituents at the 5-position of the pyrimidine nucleosides to
determine their usefulness as antiviral (herpes) agents. In the 5-(1-substituted)
group of pyrimidine nucleosides, we demonstrated that novel substituents present 
at the C-1 carbon of the 5-side chain of the pyrimidine nucleosides are important
determinants of potent and broad spectrum antiviral (herpes) activity including
EBV and HCMV. In this article the work on design, synthesis and structure
activity relationships of several 5-[(1-substituted) alkyl (or vinyl)] pyrimidine
nucleoside derivatives as potential inhibitors of herpes viruses is reviewed.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 15544474 [PubMed - indexed for MEDLINE]

1593: J Med Virol. 2005 Jan;75(1):47-53.

Association between enterovirus endomyocardial infection and late severe cardiac 
events in some adult patients receiving heart transplants.

Douche-Aourik F, Bourlet T, Mosnier JF, Jacques J, Decoene C, Stankowiak C,
Pozzetto B, Andreoletti L.

Laboratoire de Virologie, Centre Hospitalier Universitaire, St Etienne, France.

Enteroviruses and other cardiotropic viruses have been associated with the
development of late severe adverse cardiac events in infants receiving heart
transplants. However, the source and the chronology of cardiac allograft
infection by an enterovirus in patients receiving heart transplants remain
unknown. Using RT-PCR and immunohistochemistry assays, endomyocardial tissue
samples of 30 adult patients were tested to detect the presence of specific
enterovirus 5' non-coding (5'NC) sequences and of VP1 capsid protein, and this at
the time of cardiac transplantation and at the 12-month biopsy for graft
rejection control. Moreover, the endomyocardial detection of genomic sequences of
enteroviruses, Epstein-Barr virus, herpes simplex virus, cytomegalovirus (CMV),
varicella-zoster virus, adenoviruses, and parvovirus B19 was carried out by
RT-PCR and polymerase chain reaction (PCR) assays at the time of late severe
cardiac events. Enterovirus RNA and VP1 antigen were both detected in 4 (13%) of 
30 patients at the time of the 12-month biopsy for graft rejection control,
whereas no enterovirus component was detected in the explanted and implanted
heart tissues taken from these 4 patients at the time of transplantation. At the 
time when severe cardiac events were developed, within 3 months after the
positive enterovirus cardiac detection, these four patients demonstrated the
presence of endomyocardial enterovirus RNA sequences whereas they were tested
negative for the endomyocardial detection of genomic sequences from DNA viruses
(except for CMV in two cases), and for a significant level of pp65 CMV
antigenemia. Taken together, these findings indicate that enteroviruses could be 
acquired as a new endomyocardial infection within 12 months after transplantation
in adults receiving heart transplants, and suggest that this infection might be
an etiological cause for unexplained late severe adverse cardiac events in the
heart-transplantated adults. Copyright 2005 Wiley-Liss, Inc.

PMID: 15543592 [PubMed - indexed for MEDLINE]

1594: Vaccine. 2004 Dec 21;23(6):755-61.

The burden and cost of hospitalised varicella and zoster in Australian children.

Carapetis JR, Russell DM, Curtis N.

Department of Paediatrics, Murdoch Children's Research Institute, Royal
Children's Hospital, University of Melbourne, Melbourne, Australia.
jonathan.carapetis@rch.org.au

BACKGROUND: Economic analyses of varicella-zoster virus (VZV) immunisation are
sensitive to the costs of hospitalised cases, so there is a need to validate VZV 
hospitalisation data. AIMS: To assess the accuracy of hospital VZV coding data
and to apply these parameters to a population-based sample to estimate incidence 
and costs. METHODS: A 3-year retrospective chart review from one hospital to
document clinical features and validate coding data. A separate 9-year analysis
of discharge data from two hospitals draining a defined region of suburban
Melbourne, with adjustment for miscoding and estimates of direct hospital costs. 
RESULTS: After correction for miscoding, 224 patients were admitted to one
hospital over 3 years, 79% with varicella and 21% with zoster. Miscoding resulted
in a 15% underestimate of zoster cases and a 4% overestimate of varicella cases. 
Thirty-six percent of varicella admissions compared to 80% of zoster admissions
were immunocompromised and/or had chronic disease. Compared to otherwise-healthy 
patients, immunocompromised patients were admitted earlier in their illness and
had lower complication rates. Forty-two percent of immunocompromised/chronic
disease patients with varicella had a known exposure, usually from a family
member. The incidence of hospitalised varicella and zoster in under 15-year olds 
was 15.7 and 1.8 per 100,000 per year, respectively. This suggests that there are
615 varicella hospitalisations and 72 zoster hospitalisations in this age group
each year in Australia, at a total direct cost of over 2.2 million AU dollars.
CONCLUSION: These results highlight the considerable burden of hospitalised
zoster and the importance of immunising non-immune contacts of immunocompromised 
individuals. They also support previous estimates of the incidence of
hospitalised varicella in Australian children and adolescents, although direct
medical costs may be higher than those previously estimated.

PMID: 15542199 [PubMed - indexed for MEDLINE]

1595: MMW Fortschr Med. 2004 Jul 22;146(29-30):60.

[Appearance diagnosis. Facial shingles]

[Article in German]

Mehling P.

Allgemeinmedizin, Hochberg.

Publication Types: 
    Case Reports

PMID: 15540566 [PubMed - indexed for MEDLINE]

1596: Postgrad Med J. 2004 Nov;80(949):679, 681.

Shortness of breath.

Dawson JS, Hetherington CJ.

Division of Anaesthesia and Intensive Care, Queen's Medical Centre, University
Hospital NHS Trust, Nottingham NG7 2UH, UK. james@dawson.me.uk

Publication Types: 
    Case Reports

PMID: 15537859 [PubMed - indexed for MEDLINE]

1597: Agri. 2004 Oct;16(4):64.

Comment on:
    Agri. 2004 Jul;16(3):17-24.

Comment on: Isin Unal Cevik: Postherpetic neuralgia. Agri 2004; 16(3): 17-24.

[Article in English, Turkish]

Cimen A.

Publication Types: 
    Comment
    Letter

PMID: 15536576 [PubMed - indexed for MEDLINE]

1598: Antivir Chem Chemother. 2004 Sep;15(5):251-3.

Recent clinical experience with famciclovir--a "third generation" nucleoside
prodrug.

Chakrabarty A, Tyring SK, Beutner K, Rauser M.

Solano Research, Davis, Calif, USA. chakak3@yahoo.com

The herpesviruses continue to produce considerable morbidity in man. Once
infected with herpes simplex (HSV), the virus remains dormant within the nervous 
system and may reactivate if provoked by stress, trauma and/or other factors. To 
date, there is no cure, but antiviral medication can reduce duration and severity
of symptoms and prophylaxis can suppress recurrent episodes of disease. The
second-generation guanosine nucleosides, acyclovir and penciclovir, are effective
inhibitors with low toxicity; both, however, have relatively low oral
bioavailability. Subsequently, the orally bioavailable prodrugs valaciclovir and 
famciclovir have been introduced. These compounds offer high oral bioavailabilty 
and deliver acyclovir and penciclovir, respectively, to the target cells by means
of more convenient dosing schedules. This short review points to recent
experience with famciclovir in the management of HSV and varicella-zoster virus.

Publication Types: 
    Review

PMID: 15535046 [PubMed - indexed for MEDLINE]

1599: Cranio. 2004 Oct;22(4):304-13.

Craniofacial neural disorders: a guide for diagnosis and management.

Kilpatrick SR.

2909 S. 74th Street Fort Smith, AR 72903, USA. srkaacp@swbell.net

The purpose of this article is to provide a succinct diagnosis and management
regimen for neural disorders of the craniofacial region. This guide is an attempt
to organize available data in a format for use by the craniofacial pain
practitioner. The management regimens are brief because the management of many of
these disorders may be outside the scope of dentistry. Also, the purpose of this 
guide is to be user-friendly and complete. Terminology is based on a literature
review so individual disorders may be researched more completely.

Publication Types: 
    Review

PMID: 15532315 [PubMed - indexed for MEDLINE]

1600: J Environ Manage. 2004 Dec;73(4):307-15.

Roofing as a source of nonpoint water pollution.

Chang M, McBroom MW, Scott Beasley R.

Arthur Temple College of Forestry, Stephen F. Austin State University,
Nacogdoches, TX 75962, USA. mchang@sfasu.edu

Sixteen wooden structures with two roofs each were installed to study runoff
quality for four commonly used roofing materials (wood shingle, composition
shingle, painted aluminum, and galvanized iron) at Nacogdoches, Texas. Each roof,
either facing NW or SE, was 1.22 m wide x 3.66 m long with a 25.8% roof slope.
Thus, there were 32 alternatively arranged roofs, consisting of four roof types x
two aspects x four replicates, in the study. Runoff from the roofs was collected 
through galvanized gutters, downspouts, and splitters. The roof runoff was
compared to rainwater collected by a wet/dry acid rain collector for the
concentrations of eight water quality variables, i.e. Cu(2+), Mn(2+), Pb(2+),
Zn(2+), Mg(2+), Al(3+), EC and pH. Based on 31 storms collected between October
1997 and December 1998, the results showed: (1) concentrations of pH, Cu, and Zn 
in rainwater already exceed the EPA freshwater quality standards even without
pollutant inputs from roofs, (2) Zn and Cu, the two most serious pollutants in
roof runoff, exceeded the EPA national freshwater water quality standards in
virtually 100% and more than 60% of the samples, respectively, (3) pH, EC, and Zn
were the only three variables significantly affected by roofing materials, (4)
differences in Zn concentrations were significant among all roof types and
between all roof runoff and rainwater samples, (5) although there were no
differences in Cu concentrations among all roof types and between roof runoff and
rainwater, all means and medians of runoff and rainwater exceeded the national
water quality standards, (6) water quality from wood shingles was the worst among
the roof types studied, and (7) although SE is the most frequent and NW the least
frequent direction for incoming storms, only EC, Mg, Mn, and Zn in wood shingle
runoff from the SE were significantly higher than those from the NW; the two
aspects affected no other elements in runoff from the other three roof types.
Also, Zn concentrations from new wood-shingle roofs were significantly higher
than those from aged roofs of a previous study. The study demonstrated that roofs
could be a serious source of nonpoint water pollution. Since Zn is the most
serious water pollutant and wood shingle is the worst of the four roof types,
using less compounds and materials associated with Zn along with good care and
maintenance of roofs are critical in reducing Zn pollution in roof runoff.

PMID: 15531389 [PubMed - indexed for MEDLINE]

1601: Dermatol Online J. 2004 Oct 15;10(2):20.

Facial cellulitis associated with Pseudomonas aeruginosa complicating ophthalmic 
herpes zoster.

Atzori L, Ferreli C, Zucca M, Fanni D, Aste N.

Clinica Dermatologica, Universita di Cagliari, Italy. lauratzori@tin.it

Cellulitis is a rare and severe soft-tissue infection characterized by acute,
diffuse, spreading inflammation, often associated with systemic symptoms such as 
malaise and fever. Surgery of the head and neck, dental infections, sinusitis,
upper respiratory tract infections, and trauma are the most common portal of
entry for pathogens in facial cellulitis. A very unusual case complicating an
ophthalmic herpes zoster in a 74-year-old woman was observed at the department of
dermatology, Cagliari University (Italy). Culture of skin swabs showed growth of 
numerous Gram-negative bacilli, further identified as Pseudomonas aeruginosa.
Therapy with intravenous ciprofloxacin was promptly instituted on the basis of
the culture and sensitivity report. She was initially treated with daily drainage
and twice-daily topical fusidic acid. The lesion completely resolved in 4 weeks, 
and no general complications or recurrence have been observed for 6 months. Early
recognition and management of facial cellulitis is mandatory to avoid serious and
generalized complications. Pseudomonas aeruginosa is rarely reported in facial
cellulitis; there are apparently no reports of this infection occurring as a
complication of ophthalmic herpes zoster. Herpetic damage of the anatomic barrier
as well as impairment of defense mechanisms because of decompensated diabetes
mellitus may have facilitated the colonization and proliferation of this
opportunistic pathogen in our patient.

Publication Types: 
    Case Reports

PMID: 15530310 [PubMed - indexed for MEDLINE]

1602: J Clin Microbiol. 2004 Nov;42(11):5189-98.

Real-time quantitative PCR assays for detection and monitoring of pathogenic
human viruses in immunosuppressed pediatric patients.

Watzinger F, Suda M, Preuner S, Baumgartinger R, Ebner K, Baskova L, Niesters HG,
Lawitschka A, Lion T.

Division of Molecular Microbiology and Development of Genetic Diagnostics,
Children's Cancer Research Institute, Vienna, Austria.

A panel of 23 real-time PCR assays based on TaqMan technology has been developed 
for the detection and monitoring of 16 different viruses and virus families
including human polyomaviruses BK virus and JC virus, human herpesviruses 6, 7,
and 8, human adenoviruses, herpes simplex viruses 1 and 2, varicella-zoster
virus, cytomegalovirus, Epstein-Barr virus, parvovirus B19, influenza A and B
viruses, parainfluenza viruses 1 to 3, enteroviruses, and respiratory syncytial
virus. The test systems presented have a broad dynamic range and display high
sensitivity, reproducibility, and specificity. Moreover, the assays allow precise
quantification of viral load in a variety of clinical specimens. The ability to
use uniform PCR conditions for all assays permits simultaneous processing and
detection of many different viruses, thus economizing the diagnostic work. Our
observations based on more than 50,000 assays reveal the potential of the
real-time PCR tests to facilitate early diagnosis of infection and to monitor the
kinetics of viral proliferation and the response to treatment. We demonstrate
that, in immunosuppressed patients with invasive virus infections, surveillance
by the assays described may permit detection of increasing viral load several
days to weeks prior to the onset of clinical symptoms. In virus infections for
which specific treatment is available, the quantitative PCR assays presented
provide reliable diagnostic tools for timely initiation of appropriate therapy
and for rapid assessment of the efficacy of antiviral treatment strategies.

Publication Types: 
    Evaluation Studies

PMID: 15528714 [PubMed - indexed for MEDLINE]

1603: J Neurooncol. 2004 Oct;70(1):91-5.

Phase II study of concurrent continuous Temozolomide (TMZ) and Tamoxifen (TMX)
for recurrent malignant astrocytic gliomas.

Spence AM, Peterson RA, Scharnhorst JD, Silbergeld DL, Rostomily RC.

Departments of Neurology, University of Washington School of Medicine, Seattle,
WA 98195, USA. aspence@u.washington.edu

PURPOSE AND BACKGROUND: The aim of this study was to assess the frequency of
response and toxicity in adults with recurrent anaplastic astrocytoma (AA) or
glioblastoma multiforme (GM) treated with concurrent continuous TMZ and TMX.
METHODS: In addition to histology, eligibility included age > 18 years, Karnovsky
score > or = 60, normal laboratory parameters, no radiotherapy (RT) for 4 weeks, 
measurable disease and normal EKG. The chief exclusions were: previous TMZ, TMX
or dacarbazine (DTIC); nitrosourea within 6 weeks; history of deep venous
thrombosis or pulmonary emboli. All patients (pts) had received prior RT. TMZ was
given at 75 mg/M2/day for 6 weeks, repeated every 10 weeks, maximum 5 cycles.
Four pts received 60 mg/M2/day for 6 weeks due to extensive prior chemotherapy
exposure. TMX was started at 40 mg twice daily (b.i.d.) for 1 week and then was
increased in three successive weeks to 60, then 80, then 100 mg b.i.d. Response
was assessed before every cycle with MRI +/- gadolinium (Gd). RESULTS: Sixteen
pts enrolled: GM 10, AA 6; female 6, male 10; median age 48 (21-58); prior
chemotherapy 7. There was one partial response and one stable disease. Eleven pts
progressed by the end of cycle 1; three pts failed due to toxicity before
completing cycle 1. Median time to treatment failure was 10 weeks. The main
toxicities were: transaminitis, pancytopenia, 1st division herpes zoster, deep
vein thrombosis and fatigue. The study was closed due to the low response rate
and frequency of toxicity.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II
    Research Support, Non-U.S. Gov't

PMID: 15527114 [PubMed - indexed for MEDLINE]

1604: MMW Fortschr Med. 2004 Jul 8;146(27-28):4-5.

[Not only diabetics have experienced the pain... distressing neuralgia]

[Article in German]

Wepner U.

Publication Types: 
    News

PMID: 15526649 [PubMed - indexed for MEDLINE]

1605: Curr Opin Ophthalmol. 2004 Dec;15(6):531-6.

Herpes zoster virus infection.

Liesegang TJ.

Mayo Clinic Medical School, Jacksonville, Florida, USA. tliesegang@mayo.edu

PURPOSE OF REVIEW: The virology, pathophysiology, and treatment of the varicella 
zoster virus (VZV) have been investigated for many years now. Infection with VZV 
has different ramifications for people of different ages and immune status. The
various aspects of VZV disease make it difficult to treat. Selected aspects of
VZV disease that pertain to ocular disease are presented. RECENT FINDINGS: The
risk factors for VZV disease in the different age spectrums and with concomitant 
immunodeficiencies have been further clarified. Studies suggest that the VZV may 
persist for prolonged periods on the cornea after herpes zoster ophthalmicus
(HZO). Herpes Simplex Virus (HSV) or VZV may cause many cases of idiopathic
uveitis with sectoral iris atrophy. The different patterns of retinal disease
caused by VZV may relate to the immune status. Systemic antiviral medications for
herpes zoster should be instituted within 72 hours of the rash but could be used 
later. Systemic antivirals combined with systemic corticosteroids improve the
early quality of life in HZ patients. Postherpetic neuralgia is not prevented by 
early systemic antivirals or corticosteroids. Present systemic antivirals are all
effective, but Famvir offers the best dosing schedule. The VZV vaccine is
effective but there are some issues that suggest the need for a different
vaccination regimen. SUMMARY: Further research must be performed on the clinical 
and therapeutic aspects of the VZV disease. Although both the vaccine and
systemic antivirals have brought tremendous improvements, the disease persists.
Therapy lessens but does not eliminate many of the complications. The disease may
manifest in unpredictable patterns in this era of vaccination.

Publication Types: 
    Review

PMID: 15523199 [PubMed - indexed for MEDLINE]

1606: J Biol Chem. 2005 Jan 14;280(2):1369-75. Epub 2004 Nov 1.

Combinatorial transcription of herpes simplex virus and varicella zoster virus
immediate early genes is strictly determined by the cellular coactivator HCF-1.

Narayanan A, Nogueira ML, Ruyechan WT, Kristie TM.

Laboratory of Viral Diseases, NIAID, National Institutes of Health, Bethesda,
Maryland 20892, USA.

The mammalian transcriptional coactivator host cell factor-1 (HCF-1) functions in
concert with Oct-1 and VP16 to assemble the herpes simplex virus (HSV) immediate 
early (IE) transcription enhancer core complexes that mediate the high level
transcription of these genes upon infection. Although this transcriptional model 
has been well characterized in vitro, the requirements and significance of the
components have not been addressed. Oct-1 was previously determined to be
critical but not essential for HSV IE gene expression. In contrast, RNA
interference-mediated depletion of HCF-1 resulted in abrogation of HSV IE gene
expression. The HSV IE gene enhancer domain is a model of combinatorial
transcription and consists of the core enhancer and multiple binding sites for
factors such as Sp1 and GA-binding protein. It was striking that HCF-1 was
strictly required for VP16-mediated transcriptional induction via the core
enhancer as well as for basal level transcription mediated by GA-binding protein 
and Sp1. HCF-1 was also found to be essential for the induction of varicella
zoster virus IE gene expression by ORF10, the VZV ortholog of the HSV IE
transactivator VP16, and the autostimulatory IE62 protein. The critical
dependence upon HCF-1 demonstrates that this cellular component is a key factor
for control of HSV and VZV IE gene expression by functioning as the common
element for distinct factors cooperating at the IE gene enhancers. The
requirements for this protein supports the model whereby the regulated transport 
of HCF-1 from the cytoplasm to the nucleus in sensory neurons may control IE gene
expression and reactivation of these viruses from the latent state.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15522876 [PubMed - indexed for MEDLINE]

1607: Ophthalmology. 2004 Nov;111(11):2071-5.

Lack of herpes virus DNA in choroidal tissues of a patient with serpiginous
choroiditis.

Akpek EK, Chan CC, Shen D, Green WR.

The Wilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore,
Maryland 21287-9238, USA. esakpek@jhmi.edu

OBJECTIVE: To investigate the role of herpes viruses in the etiology of
serpiginous choroiditis. DESIGN: Interventional case report. PARTICIPANT: A
59-year-old male patient with long-term history of serpiginous choroiditis.
INTERVENTION: The patient's affected eye was obtained during autopsy. Polymerase 
chain reaction was performed in the microdissected choroidal tissues. RESULTS:
Histopathologic examination demonstrated active inflammation with lymphocytic
infiltration of the choroid. No viral DNA was amplified using pairs of herpes
simplex virus (HSV) P1/P2 (for HSV-1, HSV-2, Epstein-Barr virus [EBV],
cytomegalovirus [CMV] and human herpes virus [HHV]-8), and varicella-zoster virus
[VZV] P1/P2 (for VZV, HHV-6, HHV-7) in the infiltrating lymphocytes or choroidal 
tissues. CONCLUSIONS: The current observation suggests a lack of a role for
herpetic viral etiology in the etiopathogenesis of serpiginous choroiditis.

Publication Types: 
    Case Reports

PMID: 15522374 [PubMed - indexed for MEDLINE]

1608: Clin Microbiol Infect. 2004 Nov;10(11):954-60.

Effects of varicella vaccination on herpes zoster incidence.

Wagenpfeil S, Neiss A, Wutzler P.

Institute for Medical Statistics and Epidemiology, Technical University of
Munich, Munich, Germany. Stefan.Wagenpfeil@imse.med.tu-muenchen.de

The effects of a general varicella vaccination programme on the incidence of
herpes zoster are of major public health importance. This review focuses on two
key aspects, namely the relationship between wild-type virus spread and the
incidence of herpes zoster, as obtained from recent surveys, surveillance and
observational studies, and the results from mathematical population models.
Although knowledge is limited, close contact with varicella cases seems to have a
protective effect. Thus, an increase in zoster incidence after varicella
immunisation is possible, but the extent is unknown because of the influence of
other factors independent of immunisation. Currently, vaccination effects
estimated from mathematical modelling depend strongly on pre-specified
assumptions. In order to obtain more precise predictions, the results of ongoing 
monitoring and clinical studies are awaited and further studies are suggested.
Vaccination recommendations can be adapted at any time to take account of further
findings in this area.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15521996 [PubMed - indexed for MEDLINE]

1609: Transplant Proc. 2004 Sep;36(7):2162-4.

Mucocutaneous lesions in transplant recipient in a tropical country.

Prakash J, Singh S, Prashant GK, Kar B, Tripathi K, Singh PB.

Department of Nephrology, Institute of Medical Science, Banaras Hindu University,
Varanasi, India. jaiprakashbhu@hotmail.com

Dermatological manifestations are common in renal transplant patients, but differ
markedly with ethnic group and geographical location. We studied mucocutaneous
lesions in 54 renal allograft recipients (related donors = 30; unrelated donors =
24) living in tropical atmospheres. Their gender was 50 males, and 4 females
ranging in age between 15 and 63 years (mean = 37.84 years). The mean duration of
follow-up was 124 months (range = 4 to 173 months). All patients received kidneys
from living donors and were kept on immunosupression with mean daily doses of
prednisolone, azathioprine, and cyclosporine of 10.2 mg, 68.6 mg, and 252 mg,
respectively. The mean trough concentration of cyclosporine was 185 ng/mL. The
mucocutaneous lesions were divided into four groups: drug-induced (n = 24,
44.4%), fungal (n = 18, 33.3%), viral (n = 9, 16.6%), and bacterial (n = 10,
18.5%). Cushingoid features, gum hypertrophy, and hypertrichosis were seen in 7
(12.9%) patients. Steroid acne was seen in three cases. Pityriasis versicolor was
the most common (20.3%) fungal infection of the skin. In addition, Tinea unguium 
and mucocutaneous candidiasis were noted in four and three cases respectively.
Herpes virus infection (Herpes zoster 5; Herpes simplex 2) was noted in 7 (12.9%)
cases. Chicken pox at 5 years posttransplant and cutaneous vasculitis associated 
with cytomegalovirus disease at 6 months posttransplant were seen in one case
each. We have not seen warts in our patients. Pyogenic bacterial infection of
skin in the form of abscess (n = 6), cellulitis (n = 3), and pyoderma (n = 1)
were observed in 10 (18.5%) patients. Thus, drug-induced mucocutaneous side
effects and skin fungal infections are the most common dermatological
manifestations among renal transplant recipients living in a tropical country.

PMID: 15518786 [PubMed - indexed for MEDLINE]

1610: Transplant Proc. 2004 Sep;36(7):2118-9.

Viral infection following kidney transplantation: long-term follow-up in a single
center.

Hwang EA, Kang MJ, Han SY, Park SB, Kim HC.

Department of Internal Medicine, Keimyung University School of Medicine, Keimyung
University Kidney Institute, Daegu, Korea.

INTRODUCTION: Viral infections are a leading cause of posttransplantation
morbidity and mortality. The use of more potent immunosuppressive agents is
responsible in part for the increasing incidence of some viral infections. This
study summarized our experience with viral infections in 561 kidney transplant
recipients. METHODS: The spectrum of viral infections in 561 consecutive kidney
transplant recipients was examined retrospectively from November 1982 to November
2002. RESULTS: During a mean follow-up of 64.0 months, 193 virus infections in
156 of 561 kidney transplant recipients were recorded, an incidence of 34.2%. The
most common viruses were cytomegalovirus (36.3%), varicella zoster virus (29.0%),
herpes simplex virus (23.8%), BK virus (4.7%), hepatitis B virus (3.6%), and
hepatitis C virus (2.6%). Among the CMV infections, 77.1% developed subclinical
CMV infection and 22.9% had CMV disease. Generalized herpes zoster infection
occurred in three cases and chicken pox in six cases. During a mean follow-up of 
64.0 months, two of 159 patients died of CMV pneumonia. CONCLUSION: Viral
infections among the kidney transplant recipients continue to be a major problem 
despite significant progress in understanding the pathogenesis of viral infection
and the advent of antiviral therapy.

PMID: 15518767 [PubMed - indexed for MEDLINE]

1611: Acta Otorhinolaryngol Belg. 2004;58(1):61-6.

Varicella zoster virus: beyond facial paralysis.

Van de Steene V, Kuhweide R, Vlaminck S, Casselman J.

Department of ENT, Head and Neck Surgery, AZ St-Jan Hospital, Bruges, Belgium.

J. Ramsay Hunt's hypothesis that herpes zoster oticus results from a reactivation
of the herpes zoster virus in the geniculate ganglion, has been supported by the 
demonstration of varicella zoster viral DNA in the geniculate ganglion of the
side with facial paralysis in patients with Ramsay Hunt syndrome, with the use of
the polymerase chain reaction. Similarly, DNA of the varicella zoster virus has
been identified in the spiral and vestibular ganglion as well. We report on three
patients with cochleovestibular symptoms as the first manifestations of Ramsay
Hunt syndrome. A 64-year old woman and a 72-year old man presented with vertigo
and an auricular herpetiform eruption. Only the woman developed later on a mild
facial paralysis. A 58-year old man presented with an acute cochleovestibular
syndrome, serologically proven to be a varicella zoster viral reactivation, which
was followed three weeks later by the typical cutaneous recrudescence. We believe
that these cases result from reactivation of latent varicella zoster virus in the
spiral and/or vestibular ganglion. As the varicella zoster virus is dormant in
the non-neuronal satellite cells, the facial symptoms in our patients as well as 
the high incidence of cochleovestibular symptoms in classical Ramsay Hunt
syndrome can be explained by viral transmission across the nerves inside the
internal auditory canal. Therefore, we think there are grounds to recommend a
prompt treatment with an antiviral and a corticosteroid agent, not only in case
of an acute facial paralysis but also when confronted with an acute
cochleovestibular syndrome.

Publication Types: 
    Case Reports

PMID: 15517838 [PubMed - indexed for MEDLINE]

1612: J Rheumatol. 2004 Nov;31(11):2151-5.

Association of reduced CD4 T cell responses specific to varicella zoster virus
with high incidence of herpes zoster in patients with systemic lupus
erythematosus.

Park HB, Kim KC, Park JH, Kang TY, Lee HS, Kim TH, Jun JB, Bae SC, Yoo DH, Craft 
J, Jung S.

Department of Internal Medicine, The Hospital for Rheumatic Diseases, Hanyang
University College of Medicine, Seoul, Korea.

OBJECTIVE: To examine whether the high incidence of herpes zoster in patients
with systemic lupus erythematosus (SLE) is associated with the frequency of
memory T cells specific to varicella zoster virus (VZV). METHODS: Whole blood
samples from 47 subjects [24 patients with SLE, 11 with rheumatoid arthritis (RA)
as a disease control, and 12 healthy negative controls] were stimulated with VZV 
antigen, stained for surface CD4 and CD8 and intracellularly stained for the
cytokines interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), 
interleukin 4 (IL-4), and IL-10, followed by flow cytometry analyses.
Correlations of VZV-specific T cell frequencies with the clinical status of
patients were analyzed. RESULTS: Percentage of IFN-gamma-positive CD4 T cells was
significantly lower in patients with SLE (0.043 +/- 0.009%) than in RA (0.102 +/-
0.019%) and healthy controls (0.126 +/- 0.025%) upon VZV stimulation. A similar
pattern was seen in TNF-alpha-positive CD4 T cell responses. These low
frequencies of VZV-specific CD4 T cells in patients with SLE were significantly
related with disease activity (r = -0.435, p = 0.043). CONCLUSION: These data
suggest that the high incidence of herpes zoster in patients with SLE was related
to the intrinsic defects in controlling VZV reactivation, and thus VZV-specific
CD4 T cell frequency could be another practical risk factor of herpes zoster in
patients with SLE.

PMID: 15517626 [PubMed - indexed for MEDLINE]

1613: Rinsho Ketsueki. 2004 Sep;45(9):1053-7.

[Fatal acute visceral disseminated varicella-zoster virus infection in a patient 
with chronic graft-versus-host disease]

[Article in Japanese]

Yamazaki E, Kamijoh A, Taguchi J, Hyoh R, Motomura S, Kodama F, Kobayashi S,
Maruta A, Nagao T, Ishigatsubo Y.

Division of Hematology, Kanagawa Cancer Center.

A 34-year-old woman was admitted for chronic graft-versus-host disease ten months
after an unrelated bone marrow transplantation. Cytomegalovirus (CMV) antigenemia
on day 5 of hospitalization was negative. Thrombocytopenia occurred on day 9.
Laboratory findings revealed severe liver dysfunction on day 13. On day 14, the
patient developed interstitial pneumonia and disseminated intravascular
coagulation, and died from progressive respiratory failure. Multinucleated giant 
cells were found in the lung, liver, spleen, esophagus, pancreas and intestine
obtained at autopsy. Varicella-zoster virus (VZV) was detected in the blood using
the polymerase chain reaction (PCR) technique. CMV, herpes virus type 6 and
Epstein-Barr virus were detected in the liver and lung with the PCR technique. We
concluded visceral VZV infection was the main cause of her death because of her
aggressive clinical course and the histology at autopsy. In this case, chronic
GVHD and its immunosuppressive treatment resulted in her fatal VZV reactivation.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15510835 [PubMed - indexed for MEDLINE]

1614: East Afr Med J. 2004 May;81(5):226-9.

Assessment of clinical case-definition for HIV/AIDS in Tanzania.

Amirali W, Moshiro C, Ramaiya K.

Medical Department, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania.

OBJECTIVE: To evaluate the usefulness of World Health Organisation (WHO's)
clinical case-definition (CCD) for AIDS in a private hospital. DESIGN: A
prospective study. SETTING: Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania.
SUBJECTS: A total of 601 patients (> 14 years) were studied from January 1995 to 
December 1997. METHODS: Using HIV test results as a reference standard,
sensitivity, specificity, positive predictive values (PPV) and negative
predictive values of signs and symptoms were calculated. Multiple logistic
regression was used to determine a set of predictive symptoms and signs. Stepwise
logistic regression modelling was used to choose the final model. RESULTS: The
frequently occurring signs and symptoms among the 473 sero-positive patients were
fever (226), oral candidiasis (167), weight loss (161), chronic cough (157),
diarrhoea (100) and pulmonary tuberculosis in 69 cases. The presence of anorectal
lesions and the rarity of pneumocystis carinii pneumonia in this study are
important findings. Seven clinical characteristics predicted HIV infection. These
included pulmonary tuberculosis (p=0.009), lymphadenopathy (p=0.007), diarrhoea
(p=0.000), chronic cough (p=0.001), dermatitis (p=0.003), herpes zoster (p=0.01) 
and oral candidiasis (p=0.000). CONCLUSIONS: A greater number of HIV positive
patients presented with signs and symptoms different from those proposed by WHO's
CCD were observed in this study. With environmental pathogens varying from one
geographical region to another and new ones appearing, opportunistic disease
cannot be constant in AIDS patients. Therefore, AIDS diagnosis based on clinical 
case definition alone without at least one positive HIV antibody test is
inaccurate and no longer justified.

Publication Types: 
    Validation Studies

PMID: 15508335 [PubMed - indexed for MEDLINE]

1615: Neurology. 2004 Oct 26;63(8):1538-9.

MRI abnormalities in chronic active varicella zoster infection.

Blumenthal DT, Salzman KL, Baringer JR, Forghani B, Gilden DH.

Department of Neurology, University of Utah School of Medicine, Salt Lake City,
UT, USA. deborah.blumenthal@hsc.utah.edu

Publication Types: 
    Case Reports
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.

PMID: 15505191 [PubMed - indexed for MEDLINE]

1616: Clin Experiment Ophthalmol. 2004 Oct;32(5):468-71.

Comment in:
    Clin Experiment Ophthalmol. 2005 Jun;33(3):336; author reply 336-7.

Paediatric uveitis: a Sydney clinic experience.

Azar D, Martin F.

The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
domitazar@student.usyd.edu.au

PURPOSE: The aim of this study was to retrospectively review uveitis cases at The
Children's Hospital at Westmead, Sydney, since its inception in 1997 to 2001,
including patients presenting at the Camperdown, Sydney, campus between 1989 and 
1997 attending Westmead for further care. Comparison is made with international
centres. METHODS: Information was obtained from medical records. RESULTS: Forty
patients (53 eyes) presented, of whom 23 (57.5%) were female and 17 (42.5%) were 
male (mean age 6.7 years). Of 53 eyes, 35 (66%) had anterior uveitis, three
(5.7%) intermediate uveitis, seven (13.2%) posterior uveitis and eight (15.1%)
panuveitis. Twenty-seven (67.5%) patients had disease unilaterally and 13 (32.5%)
bilaterally. Twenty-four (60%) cases were idiopathic. Seven (17.5%) cases were
associated with juvenile rheumatoid arthritis, three (7.5%) with herpes zoster,
two (5%) with herpes simplex, two (5%) with toxocara, one (2.5%) with toxoplasma,
and one (2.5%) with ulcerative colitis. Complications included cataract in 14
(26.4%) eyes; band keratopathy in four (7.5%) eyes; macular scarring in three
(5.7%) eyes; and glaucoma in four (7.5%) eyes. Last measured acuity was 6/6 for
19 (35.8%) eyes, < or =6/18 for 15 (28.3%) eyes and <6/60 for eight (15.1%) eyes.
CONCLUSIONS: Despite small numbers, the comparisons of this study with some
international studies, and its contrasts with other studies, are due to
similarities and differences amongst these studies with respect to factors of
referral bias, and the aetiological basis of disease.

PMID: 15498056 [PubMed - indexed for MEDLINE]

1617: Emerg Med J. 2004 Nov;21(6):752-3.

Acute urinary retention attributable to sacral herpes zoster.

Acheson J, Mudd D.

Department of Surgery, Antrim Area Hospital, 45 Bush Road, Antrim BT28 3QE,
Northern Ireland. achesonjonny@hotmail.com

Acute urinary retention in women is uncommon. A 63 year old woman presented with 
suprapubic pain, a palpable bladder, and multiple grouped vesicles on the right
buttock. Catheterisation showed a residual of 2000 ml. A case is reported of
acute urinary retention secondary to herpes zoster infection of the sacral nerves
(S2-4).

Publication Types: 
    Case Reports

PMID: 15496718 [PubMed - indexed for MEDLINE]

1618: Johns Hopkins Med Lett Health After 50. 2004 Sep;17(7):8.

I was diagnosed with shingles several months ago, and although the rash has
healed, I continue to experience pain. How long can this pain persist, is it
treatable, and is it possible I could have another outbreak of shingles?

[No authors listed]

PMID: 15495356 [PubMed - indexed for MEDLINE]

1619: Rev Neurol (Paris). 2004 Oct;160(10):980-2.

[Facial palsy and central nervous system infection with varicella virus following
adult chickenpox]

[Article in French]

Nouh A, Landais A, Segondy M, Blard JM, Pages M.

Service de Neurologie, Centre Gui de Chauliac, Hopital Saint Eloi, CHU,
Montpellier.

INTRODUCTION: VZV virus-related peripheral neuropathies usually occur after
shingles in adults and more rarely after chickenpox in childhood. CASE REPORT: A 
54-year-old patient presented with a right VIIth nerve palsy following a
chickenpox rash and recovered after antiviral treatment. CSF analysis revealed
lymphocytic meningitis and the virus was identified by PCR. CONCLUSIONS: Although
previous chickenpox was not found in the patient's past history, the probability 
of reinfection is likely. The virus can be assumed to affect the nervous system
directly; the axonal or demyelinating mechanism of the neuropathy may be
discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15492726 [PubMed - indexed for MEDLINE]

1620: Arch Dermatol. 2004 Oct;140(10):1268-72.

Herpes zoster in the first year of life following postnatal exposure to
varicella-zoster virus: four case reports and a review of infantile herpes
zoster.

Kurlan JG, Connelly BL, Lucky AW.

Department of Dermatology, Wright State University, Dayton, Ohio, USA.

BACKGROUND: Herpes zoster, a painful vesicular dermatomal eruption, is the result
of reactivation of the varicella-zoster virus (VZV) from infected sensory
ganglia. Traditionally, it is considered to be a disease of adults, in contrast
to primary infection with VZV, which tends to occur mainly in children.
OBSERVATIONS: We report 4 cases of infantile herpes zoster in healthy
immunocompetent children, all of whom were exposed to primary varicella infection
within the first few months of life. A review of 62 cases from the literature
reveals that postnatally acquired herpes zoster is less common than intrauterine 
infection (31% [n = 19] vs 69% [n = 43]) and that there is a 1.5:1 male
predominance. All dermatomes are equally affected. CONCLUSIONS: Although
uncommon, herpes zoster can develop in immunocompetent children as young as a few
weeks of age and should be considered in the differential diagnosis of vesicular 
eruptions in infants. Most frequently, it is the result of intrauterine VZV
infection, but it can be secondary to postnatal exposure to VZV at an early age.

Publication Types: 
    Case Reports
    Review

PMID: 15492192 [PubMed - indexed for MEDLINE]

1621: MMW Fortschr Med. 2003 Oct 9;145 Suppl 3:71-6.

[Controlled-release oxycodone--a therapeutic option for severe neuropathic pain. 
Two multicenter observational studies]

[Article in German]

Worz R, Frank M, Achenbach U.

Medizinische Abteilung Mundi- pharma GmbH, Limburg (Lahn).
woerz.roland@t-online.de

Two postmarketing studies (PMS) involving 603 patients with neuropathic pain
treated with controlled-release oxycodone were performed. Pain intensity and
impairment of performance were evaluated using a numeric rating scale (NRS)
ranging from 0 to 10 (0 = no pain/impairment, 10 = most severe pain/impairment)
measured at the start of the study, and at one week and some three weeks into the
study. Mean pain intensity decreased from more than 6 at the start of the PMS to 
about 4 after one week, and under 3 after three weeks, of treatment. The mean
dose of oxycodone after three weeks was slightly more than 40 mg per day.
Impairment, quality of life and performance (daily activities, mood, sleep
quality and joie de vivre) improved substantially.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 15490770 [PubMed - indexed for MEDLINE]

1622: Int J Dermatol. 2004 Oct;43(10):779-80.

Herpes zoster and pruritus.

Ozdemir M, Tuzun Y.

Publication Types: 
    Letter

PMID: 15485542 [PubMed - indexed for MEDLINE]

1623: Med Clin (Barc). 2004 Sep 25;123(10):399.

[Epilepticus status and valaciclovir in chronic renal failure]

[Article in Spanish]

Rodriguez Uranga JJ, Franco Macias E, Delgado Lopez F, Villalobos Chavez F.

Publication Types: 
    Case Reports
    Letter

PMID: 15482711 [PubMed - indexed for MEDLINE]

1624: Expert Rev Anti Infect Ther. 2004 Oct;2(5):761-9.

Antimicrobial prophylaxis in solid-organ transplantation.

Bassetti M, Righi E, Bassetti D.

Ospedale Universita, Clinica Malattie Infettive, A.O. San Martino di Genova,
Largo R.Benzi 10, 16132 Genova, Italy. mattba@tin.it

Solid-organ transplantation has become a widely accepted treatment modality for
end-stage diseases. With the advent of newer and more potent immunosuppressive
regimens, graft survival has improved, but at the expense of an increased risk
for the development of infections secondary to bacterial, fungal, viral and
parasitic pathogens. Prevention of such infectious complications with effective, 
well-tolerated and cost-effective antimicrobials would be ideal to improve the
outcome of transplant patients. Cytomegalovirus is the most common cause of viral
infections. Herpes simplex virus, Varicella-zoster virus, Epstein-Barr virus and 
others are also significant pathogens. Fungal infections are associated with the 
highest mortality rates. This review summarizes the most relevant data pertaining
to the current understanding of infection prevention for solid-organ transplant
recipients.

Publication Types: 
    Review

PMID: 15482238 [PubMed - indexed for MEDLINE]

1625: Expert Rev Anti Infect Ther. 2003 Aug;1(2):283-95.

Review of antiviral therapy for herpes labialis, genital herpes and herpes
zoster.

Moomaw MD, Cornea P, Rathbun RC, Wendel KA.

Oklahoma University Health Science Center Department of Internal Medicine,
Section Infectious Diseases, Oklahoma City, OK, USA.

Acyclovir (Zovirax) was approved for the treatment of herpesvirus infections
almost two decades ago. It was the first agent in a novel group of antiviral
medications that now include valacyclovir (Valtrex), penciclovir (Denavir and
famciclovir (Famvir). These agents have made a dramatic impact on the morbidity
associated with herpes simplex virus infections and herpes zoster. Topical and
oral antiviral use have shown modest but statistically significant efficacy in
treating herpes labialis with most studies demonstrating a significant reduction 
in episode length and/or healing time. Oral acyclovir, valacyclovir and
famciclovir are efficacious and safe for the treatment of the first episode and
recurrent genital herpes and are useful as suppressive therapy for individuals
with frequent genital herpes recurrences. In addition, high doses of oral
acyclovir, valacyclovir and famciclovir have been shown to speed the healing of
herpes zoster, and data suggests that these agents also decrease associated acute
and chronic pain in people of 50 years of age or older. Further research is
required to clarify the safety of these agents in pregnant women with genital
herpes, the role of antiviral therapy in decreasing the sexual transmission of
genital herpes, and the efficacy and cost-effectiveness of these agents in
treating herpes zoster in people below the age of 50 years.

Publication Types: 
    Review

PMID: 15482124 [PubMed - indexed for MEDLINE]

1626: Expert Rev Anti Infect Ther. 2003 Jun;1(1):21-43.

Potential of acyclic nucleoside phosphonates in the treatment of DNA virus and
retrovirus infections.

De Clercq E.

Rega Institute for Medical Research, Minderbroedersstraat 10, B-3000 Leuven,
Belgium. erik.declerq@rega.kuleuven.ac.be

The acyclic nucleoside phosphonates [HPMPC: cidofovir, Vistide; PMEA: adefovir
dipivoxil, Hepsera; and PMPA: tenofovir, Viread] have proven to be effective in
vitro (cell culture systems) and in vivo (animal models and clinical studies)
against a wide variety of DNA virus and retrovirus infections, for example,
cidofovir against herpesvirus [herpes simplex virus type 1 and 2,
varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, human herpesvirus
type 6, 7 and 8), polyoma-, papilloma-, adeno- and poxvirus (variola virus,
cowpox virus, vaccinia virus, molluscum contagiosum virus and orf) infections;
adefovir against herpesvirus, hepadnavirus [human hepatitis B virus] and
retrovirus [HIV type-1 and 2, simian immunodeficiency virus and feline
immunodeficiency virus] infections; and tenofovir against both hepadna- and
retrovirus infections. Cidofovir has been officially approved for the treatment
of cytomegalovirus retinitis in AIDS patients, tenofovir disoproxil fumarate
(Viread) for the treatment of HIV infections (i.e., AIDS) and adefovir dipivoxil 
for the treatment of chronic hepatitis B.

Publication Types: 
    Review

PMID: 15482100 [PubMed - indexed for MEDLINE]

1627: J Med Chem. 2004 Oct 21;47(22):5482-91.

6-azapyrimidine-2'-deoxy-4'-thionucleosides: antiviral agents against TK+ and TK-
HSV and VZV strains.

Maslen HL, Hughes D, Hursthouse M, De Clercq E, Balzarini J, Simons C.

Medicinal Chemistry Division, Welsh School of Pharmacy, Cardiff University, King 
Edward VII Avenue, Cardiff CF10 3XF, UK.

The synthesis of a series of novel
1-(2-deoxy-4-thio-beta-D-erythro-pentofuranosyl)-(6-azapyrimidine) nucleosides is
described. X-ray crystallographic data of the thymidine derivative allowed
conformational analysis, which indicated a twist (3T2) sugar conformation.
Hydrogen-bonded assemblies for the crystal structure were determined using PLATON
software to allow further interpretation of the crystal packing and base
interactions. The 6-azapyrimidine nucleosides described were evaluated against a 
range of viral strains. The thymidine analogue showed pronounced activity against
herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), varicella-zoster virus
(VZV), and vaccinia virus. This compound lost only 5- to 10-fold of its antiviral
activity against thymidine kinase (TK)-deficient HSV-1 and VZV strains. These
observations suggest that the compounds may not entirely depend on viral
TK-catalyzed phosphorylation for antiviral activity and/or use an alternative
metabolic activation pathway, and/or display a unique mechanism of antiviral
action by the unmetabolized nucleoside analogue.

PMID: 15481985 [PubMed - indexed for MEDLINE]

1628: Commun Dis Public Health. 2004 Sep;7(3):164-8.

Comment in:
    Commun Dis Public Health. 2004 Sep;7(3):162-3.

Fatal outbreak of chickenpox (varicella-zoster virus infection) among
institutionalised adults with learning difficulties.

Noorda J, Hoebe CJ.

Department of Infectious Diseases, Western and Eastern South Limburg Municipal
Health Service, Heerlen, The Netherlands.

Most adults are not susceptible to chickenpox. We present a report of an outbreak
of chickenpox among institutionalised adults with learning difficulties. An
inventory of exposed and possible affected residents was done after three adult
males were diagnosed with chickenpox following a case of zoster. Individuals with
a recent history of chickenpox rash or herpes zoster were included as cases.
Medical files were used to derive background information. Serum samples of the
first two patients were tested for IgM varicella-zoster virus (VZV) antibodies.
Eventually ten cases of chickenpox (eight residents and one group leader and her 
partner) and two residents with herpes zoster were registered over a period of
four months in 2001. The first two patients tested positive in serum. One
resident with chickenpox died. This outbreak suggests a higher risk from
chickenpox for institutionalised adults with learning difficulties in comparison 
with the general Dutch population, probably due to limited contacts with the
general population. Further research into varicella-zoster seroprevalence,
preferably with low-invasive diagnostic methods, is necessary to determine if
this potential risk is present elsewhere, since the risk of life-threatening
chickenpox in adults could be reduced by the now available live attenuated VZV
vaccine.

PMID: 15481205 [PubMed - indexed for MEDLINE]

1629: Eur J Clin Microbiol Infect Dis. 2004 Nov;23(11):857-8. Epub 2004 Oct 8.

Prevalence of herpes simplex virus, varicella zoster virus and cytomegalovirus in
HIV-positive and HIV-negative patients with viral retinitis in India.

Priya K, Mahalakshmi B, Malathi J, Biswas J, Sukumar B, Madhavan HN.

Larsen and Toubro Microbiology Research Centre, Vision Research Foundation,
Sankara Nethralaya, 600006 Chennai, India.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15480882 [PubMed - indexed for MEDLINE]

1630: J Virol. 2004 Nov;78(21):11833-40.

The varicella-zoster virus open reading frame 63 latency-associated protein is
critical for establishment of latency.

Cohen JI, Cox E, Pesnicak L, Srinivas S, Krogmann T.

Medical Virology Section, Laboratory of Clinical Infectious Diseases, Bldg. 10,
Room 11N228, National Institutes of Health, 10 Center Dr., Bethesda, MD 20892,
USA. jcohen@niaid.nih.gov.

Varicella-zoster virus (VZV) expresses at least six viral transcripts during
latency. One of these transcripts, derived from open reading frame 63 (ORF63), is
one of the most abundant viral RNAs expressed during latency. The VZV ORF63
protein has been detected in human and experimentally infected rodent ganglia by 
several laboratories. We have deleted >90% of both copies of the ORF63 gene from 
the VZV genome. Animals inoculated with the ORF63 mutant virus had lower mean
copy numbers of latent VZV genomes in the dorsal root ganglia 5 to 6 weeks after 
infection than animals inoculated with parental or rescued virus, and the
frequency of latently infected animals was significantly lower in animals
infected with the ORF63 mutant virus than in animals inoculated with parental or 
rescued virus. In contrast, the frequency of animals latently infected with viral
mutants in other genes that are equally or more impaired for replication in
vitro, compared with the ORF63 mutant, is similar to that of animals latently
infected with parental VZV. Examination of dorsal root ganglia 3 days after
infection showed high levels of VZV DNA in animals infected with either ORF63
mutant or parental virus; however, by days 6 and 10 after infection, the level of
viral DNA in animals infected with the ORF63 mutant was significantly lower than 
that in animals infected with parental virus. Thus, ORF63 is not required for VZV
to enter ganglia but is the first VZV gene shown to be critical for establishment
of latency. Since the present vaccine can reactivate and cause shingles, a VZV
vaccine based on the ORF63 mutant virus might be safer.

PMID: 15479825 [PubMed - indexed for MEDLINE]

1631: CMAJ. 2004 Oct 12;171(8):859.

Fever after aortic valve replacement in a 71-year-old man.

Schattner A, Cohen J, Zimhony O.

Addenbrookes Hospital, University of Cambridge, Cambridge, UK.

Publication Types: 
    Case Reports

PMID: 15477623 [PubMed - indexed for MEDLINE]

1632: Arch Neurol. 2004 Oct;61(10):1553-7.

Recurrent lymphocytic meningitis: the role of herpesviruses.

Kupila L, Vainionpaa R, Vuorinen T, Marttila RJ, Kotilainen P.

Departments of Neurology, Turku University Central Hospital, 20520 Turku,
Finland. laura.kupila@tyks.fi

BACKGROUND: Herpes simplex virus 2 (HSV-2) and HSV-1 have been recognized as
causes of recurrent aseptic lymphocytic meningitis (RALM). However, the role of
other herpesviruses has not been systematically assessed. OBJECTIVES: To evaluate
the cause of RALM by using polymerase chain reaction (PCR) tests detecting
varicella-zoster virus (VZV), cytomegalovirus (CMV), or human herpesvirus 6
(HHV-6), in addition to HSV, on cerebrospinal fluid (CSF) samples; and to assess 
the utility of PCR and antibody analyses in consecutive episodes of RALM. DESIGN:
The PCR and antibody results for herpesviruses were analyzed from 14 patients
having 48 episodes of RALM. RESULTS: The CSF PCR results for VZV, CMV, and HHV-6 
were negative in 12, 10, and 11 patients investigated, respectively, and
antibodies against VZV, CMV, and HHV-6 showed only old immunity. Herpes simplex
virus 2 was detected from the CSF in 10 patients, and HSV-1 in 1 patient. In 6 of
these 11 patients, the HSV PCR result was positive in more than one disease
episode. A significant increase of serum antibodies for HSV was seen in only 1 of
15 episodes examined. An intrathecal antibody response to HSV was not recognized 
in 9 episodes investigated in these 11 patients. CONCLUSIONS: We could not find
evidence of VZV, CMV, or HHV-6 in the pathogenesis of RALM, although most
patients were previously infected by those viruses. Herpes simplex virus 2 was
detected from the CSF in most patients, and often repeatedly, which further
confirms the role of this virus in RALM. The causative diagnosis was obtained
only by PCR, whereas antibody analysis was not clinically useful.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 15477509 [PubMed - indexed for MEDLINE]

1633: J Pain Symptom Manage. 2004 Oct;28(4):396-411.

Treatment of postherpetic neuralgia: a review of therapeutic options.

Argoff CE, Katz N, Backonja M.

Cohn Pain Management Center, North Shore University Hospital, Cohn Pain
Management Center, Bethpage, New York 11714, USA.

Postherpetic neuralgia (PHN) is a disabling consequence of the reactivation of
the varicella zoster infection. The observation that patients with PHN experience
various types of pain suggests that multiple pathophysiologic mechanisms are
involved, which may include the peripheral and central nervous systems. A
reasonable initial strategy would involve selecting from among multiple agents
that have complementary mechanisms of action and that have been proven effective 
in controlled clinical trials, such as the lidocaine patch 5%, gabapentin,
tricyclic antidepressants, and opioids. Based on initial assessment and ongoing
reassessment, sequential trials should be undertaken until adequate pain relief
is achieved. This may ultimately lead to therapy with more than one medication.
Safety and tolerability are important considerations in choosing initial therapy,
particularly in older patients. Physicians can either add another agent to the
current regimen or switch to a new type of monotherapy if there is inadequate
response to initial therapy. Alternative therapies, (i.e., ketamine, intrathecal 
corticosteroid injections) have not been adequately studied. Well-designed,
multicenter, controlled clinical trials are needed to develop a treatment
algorithm that provides an evidence-based, rational approach to treating PHN.

Publication Types: 
    Review

PMID: 15471658 [PubMed - indexed for MEDLINE]

1634: Dermatol Nurs. 2004 Aug;16(4):362.

Herpes zoster.

Barthel D, Crutchfield CE.

Crutchfield Dermatology, Eagan, MN, USA.

Publication Types: 
    Case Reports

PMID: 15471051 [PubMed - indexed for MEDLINE]

1635: Brain Res Brain Res Rev. 2004 Oct;46(2):234-42.

Allodynia in rats infected with varicella zoster virus--a small animal model for 
post-herpetic neuralgia.

Dalziel RG, Bingham S, Sutton D, Grant D, Champion JM, Dennis SA, Quinn JP,
Bountra C, Mark MA.

Center for Infectious Disease, School of Veterinary Medicine, Division of
Veterinary Biomedical Sciences, University of Edinburgh, Edinburgh EH9 1QH, UK.
bd1@staffmail.ed.ac.uk

The most common complication of herpes zoster is post-herpetic neuralgia (PHN),
which has been defined as severe pain occurring 1 month after rash onset or
persisting for greater than 3 months. PHN is classed as a neuropathic pain that
is associated with mechanical allodynia where normally innocuous tactile stimuli 
are perceived as painful. The development of therapies to treat PHN has been
hampered by the lack of animal models, which mimic the clinical situation. We
have previously reported that varicella zoster virus (VZV) infection in the rat
results in mechanical allodynia and thermal hyperalgesia. Here, we report that
following VZV infection of the left footpad rats develop a chronic mechanical
allodynia, which is present for longer than 60 days post-infection and which
resolves by 100 days PI. The model is robust and reproducible with animals
consistently developing allodynia by 3 days PI and continuing to present with
symptoms for at least 30 days. The reproducible nature of the induction and
course of the allodynia allows the use of this model to determine the effect of
various compounds on, and to investigate the pathogenic mechanisms underlying the
development of VZV-induced allodynia. Comparative studies using HSV-1 show that
the induction of the chronic allodynia is VZV-specific and is not a result is of 
virus replication-induced tissue damage or accompanying inflammation. Therefore, 
we propose that the rat VZV infection model could prove useful in studying the
mechanisms underlying post-herpetic neuralgia.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 15464211 [PubMed - indexed for MEDLINE]

1636: Postgrad Med. 2004 Sep;116(3):16-8, 21-4, 31-2 passim.

Three common neuralgias. How to manage trigeminal, occipital, and postherpetic
pain.

Ashkenazi A, Levin M.

Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, PA
19107, USA. avi.ashkenazi@mail.tju.edu

The pain experienced by patients with trigeminal, occipital, or postherpetic
neuralgia is often severe, chronic, and difficult to treat. In this article, Drs 
Ashkenazi and Levin outline the pathologic mechanisms of pain in these common
neuralgias and discuss individually tailored pharmacologic and surgical
approaches to their treatment.

Publication Types: 
    Review

PMID: 15460087 [PubMed - indexed for MEDLINE]

1637: Ann Otol Rhinol Laryngol. 2004 Sep;113(9):700-5.

Varicella-zoster virus DNA level and facial paralysis in Ramsay Hunt syndrome.

Furuta Y, Aizawa H, Ohtani F, Sawa H, Fukuda S.

Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate 
School of Medicine, Sapporo, Japan.

We have investigated whether the copy number of varicella-zoster virus (VZV) in
saliva correlates with the clinical symptoms in patients with Ramsay Hunt
syndrome. A real-time quantitative polymerase chain reaction assay was used to
examine the VZV DNA copy number in saliva samples from 37 patients. We detected
VZV DNA in 6 of the 7 patients with oropharyngeal zoster lesions (86%) and in 17 
of the 30 patients who had zoster lesions only on the skin (57%). Patients with
oropharyngeal zoster lesions had a high VZV load in their saliva, and the
difference between the copy number in patients with oropharyngeal zoster lesions 
and those without was around 10,000 copies per 50 microL. In addition, patients
with oropharyngeal zoster lesions showed worse recovery of facial function than
those without. It seems that the VZV DNA level in saliva reflects the kinetics of
viral reactivation in the facial nerve, as well as in the oropharyngeal
epithelium, in patients with Ramsay Hunt syndrome.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 15453526 [PubMed - indexed for MEDLINE]

1638: Praxis (Bern 1994). 2004 Jul 28;93(31-32):1253-5.

[A 59-year old patient with herpes zoster V1-V2]

[Article in German]

Hartsleben CH.

Medizinische Universitatspoliklinik, Departement Innere Medizin, Kantonsspital,
Basel.

Publication Types: 
    Case Reports

PMID: 15453148 [PubMed - indexed for MEDLINE]

1639: Eur J Health Econ. 2004 Feb;5(1):54-7.

Do costs of varicella justify routine infant vaccination? Pharmacoeconomic and
clinical considerations.

Postma MJ, Bos JM, Welte R, de Groot R, Luytjes W, Rumke HC, Beutels P.

Groningen University Institute for Drug Exploration/University of Groningen
Research Institute of Pharmacy, 9713 AV Groningen, The Netherlands.
m.postma@farm.rug.nl

PMID: 15452765 [PubMed - indexed for MEDLINE]

1640: Ann Hematol. 2005 Jan;84(1):59-60. Epub 2004 Sep 25.

Concomitant zoster myelitis and cerebral leukemia relapse after stem cell
transplantation.

Au WY, Hon C, Cheng VC, Ma ES.

Publication Types: 
    Case Reports
    Letter

PMID: 15452668 [PubMed - indexed for MEDLINE]

1641: Neurology. 2004 Sep 28;63(6):959-65.

Practice parameter: treatment of postherpetic neuralgia: an evidence-based report
of the Quality Standards Subcommittee of the American Academy of Neurology.

Dubinsky RM, Kabbani H, El-Chami Z, Boutwell C, Ali H; Quality Standards
Subcommittee of the American Academy of Neurology.

A systematic review of the literature on postherpetic neuralgia was performed.
The authors identified studies using the National Library of Medicine's Medline
database and Cochrane Library database. The authors determined absolute reduction
rate, number needed to treat (NNT), 95% CI for NNT, and number needed to harm
(NNH) for successful therapies of postherpetic neuralgia. Tricyclic
antidepressants, gabapentin, pregabalin, opioids, and lidocaine patch were found 
to be effective in reducing the pain of postherpetic neuralgia.

Publication Types: 
    Review

PMID: 15452284 [PubMed - indexed for MEDLINE]

1642: J Exp Med. 2004 Oct 4;200(7):917-25. Epub 2004 Sep 27.

Varicella-zoster virus transfer to skin by T Cells and modulation of viral
replication by epidermal cell interferon-alpha.

Ku CC, Zerboni L, Ito H, Graham BS, Wallace M, Arvin AM.

Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA
94305, USA. cck@stanford.edu

Primary infection with varicella-zoster virus (VZV) causes the characteristic
syndrome of varicella, or chickenpox. Experiments in severe combined
immunodeficiency mice with human skin grafts (SCIDhu mice) indicate that VZV
infection of T cells can mediate transfer of infectious virus to skin.
VZV-infected T cells reached epithelial sites of replication within 24 h after
entering the circulation. Memory CD4+ T cells were the predominant population
recovered from skin in SCIDhu mice given uninfected or infected mononuclear
cells, suggesting that immune surveillance by memory T cells may facilitate VZV
transfer. The increased susceptibility of memory T cells to VZV infection may
further enhance their role in VZV pathogenesis. During VZV skin infection, viral 
gene products down-regulated interferon-alpha to permit focal replication,
whereas adjacent epidermal cells mounted a potent interferon-alpha response
against cell-cell spread. Interleukin-1alpha, although activated in VZV-infected 
cells, did not trigger expression of endothelial adhesion molecules, thereby
avoiding early recruitment of inflammatory cells. The prolonged varicella
incubation period appears to represent the time required for VZV to overcome
antiviral responses of epidermal cells and generate vesicles at the skin surface.
Modulation of VZV replication by cutaneous innate immunity may avoid an
incapacitating infection of the host that would limit opportunities for VZV
transmission.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15452178 [PubMed - indexed for MEDLINE]

1643: Med Res Rev. 2005 Jan;25(1):1-20.

(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU).

De Clercq E.

Department of Microbiology and Immunology, Division of Virology and Chemotherapy,
Rega Institute for Medical Research, Katholieke Universiteit Leuven, B-3000
Leuven, Belgium. erik.declercq@rega.kuleuven.ac.be

(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU, Brivudin, Zostex, Zerpex, Zonavir),
now more than 20 years after its discovery, still stands out as a highly potent
and selective inhibitor of herpes simplex virus type 1 (HSV-1) and
varicella-zoster virus (VZV) infections. It has been used in the topical
treatment of herpetic keratitis and recurrent herpes labialis and the systemic
(oral) treatment of herpes zoster (zona, shingles). The high selectivity of BVDU 
towards HSV-1 and VZV depends primarily on a specific phosphorylation of BVDU to 
its 5'-diphosphate (DP) by the virus-encoded thymidine kinase (TK). After further
phosphorylation (by cellular enzymes), to the 5'-triphosphate (TP), the compound 
interferes as a competitive inhibitor/alternate substrate with the viral DNA
polymerase. The specific phosphorylation by the HSV- and VZV-induced TK also
explains the marked cytostatic activity of BVDU against tumor cells that have
been transduced by the viral TK genes. This finding offers considerable potential
in a combined gene therapy/chemotherapy approach for cancer. To the extent that
BVDU or its analogues (i.e., BVaraU) are degraded (by thymidine phosphorylase) to
(E)-5-(2-bromovinyl)uracil (BVU), they may potentiate the anticancer potency, as 
well as toxicity, of 5-fluorouracil. This ensues from the direct inactivating
effect of BVU on dihydropyrimidine dehydrogenase, the enzyme that initiates the
degradative pathway of 5-fluorouracil. The prime determinant in the unique
behavior of BVDU is its (E)-5-(2-bromovinyl) substituent. Numerous BVDU analogues
have been described that, when equipped with this particular pharmacophore,
demonstrate an activity spectrum characteristic of BVDU, including selective
anti-VZV activity. 2004 Wiley Periodicals, Inc.

Publication Types: 
    Review

PMID: 15389733 [PubMed - indexed for MEDLINE]

1644: Rev Med Virol. 2004 Nov-Dec;14(6):363-81.

Simian varicella: a model for human varicella-zoster virus infections.

Gray WL.

Department of Microbiology and Immunology, 4301 West Markham Street, University
of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
graywayne1@uams.edu

Simian varicella virus (SVV) causes a natural varicella-like disease in nonhuman 
primates. Epizootics of simian varicella occur sporadically in facilities housing
Old World monkeys. SVV is antigenically and genetically related to
varicella-zoster virus (VZV), the etiologic agent of varicella (chickenpox) and
herpes zoster (shingles) in humans. The SVV and VZV genomes are similar in size
and structure, share 70%-75% DNA homology and are co-linear with respect to gene 
organisation. Simian varicella is a highly contagious disease characterised by
fever and vesicular skin rash and may progress to pneumonia and hepatitis.
Infected monkeys may resolve the disease within 2 weeks although epizootics are
sometimes associated with high morbidity and mortality. SVV, like VZV,
establishes life-long latent infection, as indicated by detection of viral DNA
within neural ganglia. Subsequently, SVV may reactivate to cause secondary
disease and spread of the virus to susceptible monkeys. The relatedness of VZV
and SVV and the similarities in the clinical symptoms and pathogenesis of human
and simian varicella make SVV infection of nonhuman primates an excellent animal 
model to investigate VZV pathogenesis and latency, and to evaluate potential
antiviral strategies. 2004 John Wiley & Sons, Ltd.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 15386593 [PubMed - indexed for MEDLINE]

1645: Arch Dis Child. 2004 Oct;89(10):966-9.

Declining incidence of chickenpox in the absence of universal childhood
immunisation.

Lowe GL, Salmon RL, Thomas DR, Evans MR.

National Public Health Service Communicable Disease Surveillance Centre, Abton
House, Cardiff CF14 3QX, UK. Gwen.lowe@nphs.wales.nhs.uk

OBJECTIVE: To examine the epidemiology of chickenpox in Wales from 1986 to 2001. 
DESIGN: Descriptive analysis of chickenpox consultations reported by the Welsh
general practice sentinel surveillance scheme for infectious diseases, compared
with annual shingles consultation rates from the same scheme to exclude reporting
fatigue and data from a general practice morbidity database to validate results. 
SETTING: A total of 226,884 patients registered with one of 30 volunteer general 
practices participating in the sentinel surveillance scheme. MAIN OUTCOME
MEASURES: Age standardised and age specific incidence of chickenpox. RESULTS:
Crude and age standardised consultation rates for chickenpox declined from 1986
to 2001, with loss of epidemic cycling. Rates remained stable in 0-4 year olds
but declined in all older age groups, particularly those aged 5-14 years.
Shingles consultation rates remained constant over the same period. Data from the
morbidity database displayed similar trends. CONCLUSION: General practitioner
consultation rates for chickenpox are declining in Wales except in pre-school
children. These findings are unlikely to be a reporting artefact but may be
explained either by an overall decline in transmission or increased social mixing
in those under 5 years old, through formal child care and earlier school entry,
and associated increasing rates of mild or subclinical infection in this age
group. Further investigation, particularly by serological surveillance, is
necessary before universal varicella immunisation can be considered in the UK.

PMID: 15383443 [PubMed - indexed for MEDLINE]

1646: Pediatr Blood Cancer. 2004 Oct;43(5):580-6.

Outcome of children with B cell lymphoma in Venezuela with the LMB-89 protocol.

Acquatella G, Insausti CL, Garcia R, Gomez R, Hernandez M, Carneiro M, Santos S, 
Nouel A.

BADAN Transversal 2, Los Cortijos de Lourdes, Edificio Centro Los Cortijos,
Caracas, Venezuela. asesoria@badan.org

BACKGROUND: We analyzed the results of the LMB-89 protocol performed in seven
centers in Venezuela in 96 children having B-cell non-Hodgkin lymphoma treated
from 1995 to 2002. PROCEDURE: Mean age was 7.1 years with 71 (74%) been male.
Eighty-two patients (85%) had diffuse small cell lymphoma Burkitt and
Burkitt-like, and 14 (15%) had diffuse large B-cell lymphoma. Initial disease
sites included the abdomen in 67%, peripheral nodes in 8%, and mediastinal in 4%.
Treatment was directed to risk groups as described for LMB-89 protocol. Group A: 
seven patients (7%), group B: 80 patients (83%), and group C: nine patients (9%).
RESULTS: Mean follow-up was 35 +/- 31 months. Complete remission (CR) occurred in
70 patients (73%); four patients (6%) had relapse during the first year and ten
patients (10%) had progressive disease. Overall survival (OS) and event free
survival (EFS) were 85 and 80% at 1 year, and 82 and 75% at 2 years,
respectively. The EFS by therapeutic groups at 3 years was A: 100%; B: 76%, and
C: 56%. Toxicity: neutropenia in 75%, thrombocytopenia in 63%, febrile
neutropenia in 39%. Viral infections: hepatitis B in 20%, hepatitis C in 2%, and 
Herpes zoster in 3%. Tumor lysis syndrome (TLS) occurred in 9% during induction
phase with a high mortality of 44% (urate-oxidase was available only at the end
of the study). CONCLUSIONS: The high mortality rate during induction phase
prohibited a better EFS. Prophylactic use of xantine-oxidase may improve future
results. The high incidence of hepatitis B requires a vaccination program.
Copyright 2004 Wiley-Liss, Inc.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 15382276 [PubMed - indexed for MEDLINE]

1647: Agri. 2004 Jul;16(3):17-24.

Comment in:
    Agri. 2004 Oct;16(4):64.

[Postherpetic neuralgia]

[Article in Turkish]

Cevik IU.

Harvard Medical School, Massachusetts General Hospital, Pain Center, Boston, MA
02114, USA. icevik@partners.org

Following chicken pox infection, varicella-zoster virus stays as a latent
infection in sensory root ganglia. After many years, the reactivation of this
latent virus in sensory ganglia causes "herpes zoster". Herpes zoster (shingles) 
is an unilateral, dermatomal, localised, painful, vesicular, and contagious skin 
infection. In elderly and immunocompromised patients, shingles can cause
complications such as postherpetic neuralgia (PHN) and direct central nervous
system invasion. Early intervention with antiviral treatment, analgesic therapy
and antidepressant therapy may reduce the risk of these complications. The
treatment of PHN is same as for other neuropathic pain syndromes. The clinical
importance of PHN is due to the severity and chronicity of pain which is usually 
not responsive to many treatments, and quality of life may be adversely affected 
by PHN.

Publication Types: 
    English Abstract
    Review

PMID: 15382001 [PubMed - indexed for MEDLINE]

1648: Can J Urol. 2004 Aug;11(4):2314; discussion 2314.

Comment on:
    Can J Urol. 2003 Jun;10(3):1912-3.

Herpes zoster infection: a rare cause of urinary retention.

Darabi K, Segal AM, Torres G.

Publication Types: 
    Comment
    Letter

PMID: 15380052 [PubMed - indexed for MEDLINE]

1649: Reg Anesth Pain Med. 2004 Sep-Oct;29(5):454-61.

Neuraxial and sympathetic blocks in herpes zoster and postherpetic neuralgia: an 
appraisal of current evidence.

Kumar V, Krone K, Mathieu A.

Olentangy Pain Clinic, Columbus, OH 43235, USA. vkumarmd@att.net

BACKGROUND AND OBJECTIVES: Epidural, intrathecal, and sympathetic blocks are used
for the treatment of pain caused by herpes zoster (HZ) and postherpetic neuralgia
(PHN). This study was undertaken to evaluate and synthesize existing evidence for
using these nerve blocks with various injectates (local anesthetic [LA] alone, LA
+ steroids) in treating pain of HZ, PHN (>6 months), and its prevention. METHODS:
A computerized search of published trials in the English language from 1966 to
2001 was carried out on Medline, EMBASE, and Cochrane Clinical Trial databases.
Levels of evidence and grades of recommendations were made based on criteria
published by the Oxford Centre for Evidence-Based Medicine. RESULTS: Among the
studies meeting inclusion criteria, treatment was initiated during acute pain in 
71% (15/21) and PHN in 29% (6/21). Randomized controlled trials (RCTs, level 1b
evidence) constituted 19% (4/21), individual cohort (levels 2b, 3b) 29% (6/21),
and case series (level 4) 43% (9/21). Overall, 80% (15/21) of trials showed a
positive outcome with these blocks. The use of sympathetic (LA) and epidural
blocks (LA + steroid) for pain of HZ was supported by 1 RCT each, and intrathecal
block (LA + steroid) for PHN was supported by 2 RCTs. CONCLUSIONS: Evidence for
the beneficial effect of epidural LA + steroid in HZ, and intrathecal LA +
steroid in PHN appears to be consistent (grade A). If given within 2 months of
HZ, epidural LA + steroid may reduce the incidence of PHN after 1 year (grade A).
Evidence for use of sympathetic blocks in HZ and PHN, although generally useful
(Grade B), requires RCTs for validation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 15372391 [PubMed - indexed for MEDLINE]

1650: Acta Dermatovenerol Croat. 2004;12(3):166-8.

Unusual presentation of herpes zoster in an immunocompromised patient: case
report.

Kovacevic Vojtusek I, Sabljar Matovinovic M, Planinic G, Vuckovic Rebrina S,
Kardum Skelin I, Knotek M, Skegro D.

Vuk Vrhovac Institute for Diabetes, Endocrinology and Metabolism, Dugi dol 4a,
10000 Zagreb, Croatia. ivana.kovacevic-vojtusek@zg.hinet.hr

We present a case of an immunocompromised patient with unusual presentation of
herpes zoster infection. After having been treated with corticosteroids for
several weeks, the patient developed the zoster infection with atypical clinical 
course and skin localization. Parenteral treatment with acyclovir for 10 days
resulted in a complete clinical resolution of the skin lesions. Similar cases of 
unusual presentation of herpes zoster have been described in immunocompromised
patients.

Publication Types: 
    Case Reports

PMID: 15369641 [PubMed - indexed for MEDLINE]

1651: Clin Evid. 2003 Jun;(9):890-900.

Update in:
    Clin Evid. 2003 Dec;(10):942-52.

Update of:
    Clin Evid. 2002 Jun;(7):738-46.

Postherpetic neuralgia.

Lancaster T, Wareham D, Yaphe J.

Department of Primary Health Care, University of Oxford, Oxford, UK.

Publication Types: 
    Review

PMID: 15366174 [PubMed - indexed for MEDLINE]

1652: Vaccine. 2004 Sep 28;22(29-30):3947-51.

Epidemiology of severe varicella-zoster virus infection in Spain.

Gil A, San-Martin M, Carrasco P, Gonzalez A.

Department of Health Sciences, Rey Juan Carlos University, Avda de Atenas s/n,
28922 Alcorcon, Madrid, Spain. a.gildemiguel@cs.urjc.es

Data of hospitalizations for varicella and herpes zoster in Spain during the
1999-2000 period were obtained from the national surveillance system for hospital
data. A total of 3083 hospitalizations for varicella and 6324 for herpes zoster
were identified, representing an annual incidence of 4.1 and 8.4 per 100,000
persons per year, respectively. Almost half of patients hospitalized for
varicella were children under 5 years of age. In contrast, 78% of
hospitalizations for zoster occurred in adults >50 years of age. Hospitalizations
for varicella and herpes zoster resulted annually in 11,141 and 40,090 days of
hospitalization and a cost of 3.2 and 7.0 million, respectively.

PMID: 15364443 [PubMed - indexed for MEDLINE]

1653: Clin Infect Dis. 2004 Sep 1;39(5):630-5. Epub 2004 Aug 11.

Multiple-year experience in the diagnosis of viral central nervous system
infections with a panel of polymerase chain reaction assays for detection of 11
viruses.

Huang C, Morse D, Slater B, Anand M, Tobin E, Smith P, Dupuis M, Hull R, Ferrera 
R, Rosen B, Grady L.

Wadsworth Center, New York State Department of Health, Albany, NY 12201-0509,
USA. cinnia@nycap.rr.com

BACKGROUND: Polymerase chain reaction (PCR) is becoming more common in diagnostic
laboratories. In some instances, its value has been established. In other cases, 
assays exist, but their beneficial use has not been determined. This article
summarizes findings from 3485 patients who underwent testing over a 6-year period
in our laboratory. METHODS: A panel of PCR assays was used for the detection of a
range of viruses associated with central nervous system (CNS) infections. PCR
results were analyzed in conjunction with information about patient age and sex, 
the time between onset and specimen collection, and other variables. Medical
chart review was conducted for 280 patients to gain diagnostic and epidemiologic 
insight with regard to cases of unresolved encephalitis. RESULTS: A total of 498 
PCR-positive samples (14.3%) were detected. Enteroviruses accounted for the
largest number (360 [72.3%]) of positive PCR results, followed by herpes simplex 
virus (76 [15.3%]), varicella-zoster virus (29 [5.82%]), and West Nile virus
(WNV) (18 [3.61%]). Of 360 patients who tested positive for enterovirus, only 46 
met the Centers for Disease Control and Prevention's encephalitis definition. It 
resulted in the greatest decrease (87.2%) in positive PCR results. Overall, the
PCR positivity rate for specimens collected within 5 days after illness onset was
17.2%, compared with 8.6% for specimens collected > or =6 days after onset.
CONCLUSIONS: The value of PCR in the diagnosis of viral infections has been
established. PCR is of lower value in the detection of WNV in CNS, compared with 
serological testing, but is of greater value in the detection of other
arboviruses, particularly viruses in the California serogroup. Medical chart
reviews indicated that apparent CNS infection resolves in approximately 50% of
cases.

Publication Types: 
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, P.H.S.

PMID: 15356774 [PubMed - indexed for MEDLINE]

1654: BMC Infect Dis. 2004 Sep 8;4:33.

A new method for determination of varicella-zoster virus immunoglobulin G avidity
in serum and cerebrospinal fluid.

Kneitz RH, Schubert J, Tollmann F, Zens W, Hedman K, Weissbrich B.

Institute of Virology and Immunobiology, University of Wurzburg, Versbacher Str. 
7, 97078 Wurzburg, Germany. ralf.kneitz@gmx.de

BACKGROUND: Avidity determination of antigen-specific immunoglobulin G (IgG)
antibodies is an established serological method to differentiate acute from past 
infections. In order to compare the avidity of varicella-zoster virus (VZV) IgG
in pairs of serum and cerebrospinal fluid (CSF) samples, we developed a new
technique of avidity testing, the results of which are not influenced by the
concentration of specific IgG. METHODS: The modifications introduced for the new 
VZV IgG avidity method included the use of urea hydrogen peroxide as denaturing
reagent, the adaptation of the assay parameters in order to increase the
sensitivity for the detection of low-level VZV IgG in CSF, and the use of a new
calculation method for avidity results. The calculation method is based on the
observation that the relationship between the absorbance values of the enzyme
immunoassays with and without denaturing washing step is linear. From this
relationship, a virtual absorbance ratio can be calculated. To evaluate the new
method, a panel of serum samples from patients with acute and past VZV infection 
was tested as well as pairs of serum and CSF. RESULTS: For the serum panel,
avidity determination with the modified assay gave results comparable to standard
avidity methods. Based on the coefficient of variation, the new calculation
method was superior to established methods of avidity calculation. CONCLUSIONS:
The new avidity method permits a meaningful comparison of VZV IgG avidity in
serum and CSF and should be of general applicability for easy determination of
avidity results, which are not affected by the concentration of specific IgG.

PMID: 15355548 [PubMed - indexed for MEDLINE]

1655: Otol Neurotol. 2004 Sep;25(5):805-10.

Delayed facial paralysis after vestibular schwannoma surgery: role of herpes
viruses reactivation--our experience in eight cases.

Franco-Vidal V, Nguyen DQ, Guerin J, Darrouzet V.

Department of Otolaryngology, University Hospital of Bordeaux, France.

OBJECTIVES: The objectives of this study were to study the role of herpes virus
reactivation in the onset of delayed facial paralysis (DFP) occurring more than
72 hours after vestibular schwannoma (VS) surgery and to advocate specific
medical management. STUDY DESIGN: We conducted a retrospective case review.
SETTING: University-based, tertiary care center. PATIENTS: Eight patients managed
for DFP in a series of 348 patients operated for a VS. INTERVENTIONS: Patients
were evaluated and graded according to the House and Brackmann grading system and
followed up for 1 year. A serologic search for specific antiherpes simplex
viruses type 1 and 2 (HSV-2) and varicella zoster virus (VZV) antibodies at the
onset of DFP and 2 weeks later was possible in three cases. Seven of the eight
patients were given intravenous acyclovir (30 mg/kg/ for 5 days) and
methylprednisolone (2 mg.kg/ for 7 days). RESULTS: Mean delay of DFP onset was
8.75 days. All treated patients had a House and Brackmann Grade 1 recovery: mean 
time to recovery was 40.4 days. The last one had only a Grade 3 recovery because 
he could not be treated because of postoperative transient psychiatric problems. 
Serologic testing in those patients in whom it could be done revealed either a
high level of anti HSV or VZV antibodies at the time of onset or a dramatic
increase in anti-HSV or anti-VZV antibodies between the two samples, strongly
suggesting an HSV or VZV reactivation. CONCLUSION: HSV or VZV reactivation might 
be responsible for most cases of DFPs, thus suggesting the usefulness of
immediate steroid and acyclovir administration to obtain total recovery. The
viral reactivation mechanism is comparable to that already suspected in DFP
occurring with the same delay in middle ear surgical procedures.

PMID: 15354015 [PubMed - indexed for MEDLINE]

1656: Curr Opin Pharmacol. 2004 Oct;4(5):453-64.

Antivirals against DNA viruses (hepatitis B and the herpes viruses).

Hewlett G, Hallenberger S, Rubsamen-Waigmann H.

hbsc, Krutscheider Weg 96, 42327 Wuppertal, Germany.

Antiviral drugs against DNA viruses are widely used for the management of
diseases caused by infections with the Herpes viruses and have recently been
introduced for Hepatitis B. There are also several emerging treatments (i.e.
those that are in clinical development) and novel treatments that are still in
the preclinical phase. Although the majority of emerging drugs are nucleoside
analogues, there is a trend towards the development of non-nucleosidic drugs with
unique mechanisms of action, in the hope that efficacy will be maximised and drug
resistance and viral rebound minimised.

Publication Types: 
    Review

PMID: 15351349 [PubMed - indexed for MEDLINE]

1657: Exp Mol Pathol. 2004 Oct;77(2):89-97.

Enhancing sensitivity of human herpes virus diagnosis with DNA microarrays using 
dendrimers.

Striebel HM, Birch-Hirschfeld E, Egerer R, Foldes-Papp Z, Tilz GP, Stelzner A.

Institute for Molecular Biotechnology, Jena D-07745, Germany.

DNA microarray technology has become a promising new tool for the detection and
identification of viral pathogens in human plasma and cell cultures. For
exploration of this technology, we have developed DNA microarrays that encode
capture oligonucleotide probes for different human herpes viruses: herpes simplex
virus (HSV) HSV-1, HSV-2, varicella zoster virus (VZV), Epstein-Barr virus (EBV),
cytomegalovirus (CMV), and HHV-6. The on-chip hybridization is accomplished with 
the PCR amplicons of the respective human herpes virus types. In this original
article, we attached multiple Cy3-fluorophores to the branched 5' ends of the
labeling oligonucleotide primers. For the first time, we experimentally
demonstrated that the self-designed, knowledge-based, and focused microarrays
specifically hybridized to fluorophore-labeled pathogenic DNAs using dendrimer
technology. The fluorescence signal enhancement via the dendrimers was up to 30
times compared with the quenched single Cy3-fluorophore-labeled HSV-1 DNA. The
on-chip signal-amplifying effect depended upon the number of branches and the
concentration of fluorophore-labeled pathogenic DNAs. Treblers were superior to
doublers, as trebler-labeled nucleic acids had fluorescence-signal-enhancing
effects over a broad range of labeled DNA concentrations exemplified for the
quenched single Cy3-fluorophore-labeled HSV-1 and non-quenched single
Cy3-fluorophore-labeled CMV DNAs.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 15351231 [PubMed - indexed for MEDLINE]

1658: Liver Transpl. 2004 Sep;10(9):1140-3.

Herpes zoster after liver transplantation: incidence, risk factors, and
complications.

Herrero JI, Quiroga J, Sangro B, Pardo F, Rotellar F, Alvarez-Cienfuegos J,
Prieto J.

Liver Unit, Clinica Universitaria de Navarra, Pamplona, Spain. iherrero@unav.es

Herpes zoster is the consequence of the reactivation of latent varicella-zoster
infection. Immunosuppression may be a predisposing factor for herpes zoster. We
have retrospectively assessed the risk of herpes zoster, the risk factors for its
occurrence, and its evolution in a population of 209 consecutive liver transplant
recipients. Herpes zoster developed in 25 (12%) of patients. One-, 3-, 5-, and
10-year actuarial rates of herpes zoster were 3%, 10%, 14%, and 18%,
respectively. In a case-control study, patients developing herpes zoster were
younger, received a higher number of immunosuppressive drugs, and were more
frequently receiving mycophenolate mofetil or azathioprine. In multivariate
analysis, the only factor related to herpes zoster occurrence was treatment with 
mycophenolate mofetil or azathioprine. Eight patients (31%) developed
postherpetic neuralgia. In conclusion, herpes zoster is a relatively common
complication after liver transplantation. It is related to immunosuppressive
therapy. Postherpetic neuralgia develops in one third of patients with
posttransplant herpes zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15350004 [PubMed - indexed for MEDLINE]

1659: J Pediatr Hematol Oncol. 2004 Sep;26(9):587-90.

Bullous herpes zoster in a child with leukemia: case report and review of the
literature.

Haimi M, Ben-Arush MW, Kassis I, Postovsky S, Kra-Oz Z, Elhasid R.

Department of Pediatric Hemato-Oncology, Meyer Children's Hospital, Rambam
Medical Center, Haifa, Israel. morx@netvision.net.il

Blistering disorders in childhood are usually difficult to diagnose and pose
complicated management dilemmas. The incidence of herpes zoster in children with 
malignancy and immunodeficiency is greatly increased compared to normal children 
of comparable age. Although herpes zoster is known to occur in children with
malignancy, the bullous form of herpes zoster is rare; to the authors' knowledge,
there was no previous report of this phenomenon in children in general and in
children with cancer in particular. The authors describe a 3.5-year-old girl who 
was diagnosed with acute lymphoblastic leukemia; 7 months after presentation,
during chemotherapy treatment, she developed the bullous form of herpes zoster on
her right hand. The authors describe the method of diagnosis and provide a review
of the literature concerning this rare phenomenon. Recognizing this entity and
differentiating it from other bullomatous conditions enable the application of
appropriate treatment, without unnecessary delay.

Publication Types: 
    Case Reports
    Review

PMID: 15342986 [PubMed - indexed for MEDLINE]

1660: Am J Cardiol. 2004 Sep 1;94(5):602-5.

Evidence of viral infection in the myocardium of American and Japanese patients
with idiopathic dilated cardiomyopathy.

Fujioka S, Kitaura Y, Deguchi H, Shimizu A, Isomura T, Suma H, Sabbah HN.

Third Division, Department of Internal Medicine, Central Clinical Laboratory,
Osaka Medical College, Takatsuki, Japan.

Enteroviruses have been implicated in the pathogenesis of idiopathic dilated
cardiomyopathy (IDC). Recently, the association of adenovirus or parvovirus with 
IDC has been reported. Viral infection in the myocardium of American and Japanese
patients with end-stage IDC was evaluated. Myocardial specimens from 30 American 
patients with IDC and 47 Japanese patients with IDC were analyzed for the
presence of cardiotropic viruses. The strand-specific detection of enteroviral
ribonucleic acid (RNA) was performed to determine viral activity in hearts with
IDC. Established reverse transcription-polymerase chain reaction (PCR) or PCR
techniques were used to detect genomic sequences of influenza viruses, mumps
virus, adenovirus, parvovirus, herpes simplex viruses, varicella-zoster virus,
and Epstein-Barr virus. Enteroviral RNA was detected in 7 of the 30 American
patients (23%) and in 15 of the 47 Japanese patients (32%). Minus-strand
enteroviral RNA, an indicator of active enteroviral RNA replication, was
demonstrated in 5 of 7 plus-strand-positive American patients (71%) and in 12 of 
15 plus-strand-positive Japanese patients (80%). Sequence analysis revealed that 
the viruses detected were Coxsackie B viruses. No genomic sequences of other
viruses were detected in the myocardium of either American or Japanese patients
with IDC. Therefore, active group B Coxsackie virus RNA replication in the
myocardium was demonstrated in a significant proportion of American and Japanese 
patients with end-stage IDC. There was no evidence of persistent infection by
other viruses in hearts with IDC. Specific therapy should be designed for
Coxsackie virus positive patients with IDC. Copyright 2004 Excerpta Medica, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15342290 [PubMed - indexed for MEDLINE]

1661: Drugs. 2004;64(18):2091-7; discussion 2098-9.

Brivudin (bromovinyl deoxyuridine).

Keam SJ, Chapman TM, Figgitt DP.

Adis International Limited, Auckland, New Zealand. demail@adis.co.nz

Brivudin is an oral thymidine analogue indicated for the early treatment of acute
herpes zoster in immunocompetent adults. It has high, selective activity against 
varicella zoster virus (VZV), inhibiting VZV replication, possibly through
competitive inhibition of viral DNA polymerase, or by acting as an alternative
substrate to deoxythymidine triphosphate, causing viral DNA strand breakage. In a
large, 7-day, phase III trial in immunocompetent patients with herpes zoster,
once-daily brivudin 125mg was significantly more effective than oral acyclovir
800mg five times daily in reducing the mean time from start of treatment to last 
vesicular eruption, and was as effective as acyclovir at healing lesions and
alleviating acute zoster-related pain. The likelihood of developing post-herpetic
neuralgia (PHN) in immunocompetent patients aged > or =50 years was significantly
lower with brivudin than with acyclovir. Brivudin was as effective as oral
famciclovir 250mg three times daily in terms of the prevalence of PHN, the time
to last vesicular eruption and lesion healing in another large, 7-day, phase III 
study in immunocompetent patients with herpes zoster. Oral brivudin is generally 
well tolerated, with a similar tolerability profile to those of oral acyclovir or
famciclovir. Nausea was the most commonly reported adverse event.

Publication Types: 
    Review

PMID: 15341504 [PubMed - indexed for MEDLINE]

1662: J Pain. 2004 Aug;5(6):344-56.

Development of a measure of the burden of pain due to herpes zoster and
postherpetic neuralgia for prevention trials: adaptation of the brief pain
inventory.

Coplan PM, Schmader K, Nikas A, Chan IS, Choo P, Levin MJ, Johnson G, Bauer M,
Williams HM, Kaplan KM, Guess HA, Oxman MN.

Merck Research Laboratories, West Point, Pennsylvania 19486, USA.
alexander_nikas@merck.com

In preparation for clinical trials of a vaccine against herpes zoster (HZ), we
conducted a prospective, observational study to evaluate (1) the Zoster Brief
Pain Inventory (ZBPI), an HZ-specific questionnaire to quantify HZ pain and
discomfort, (2) an operational definition of postherpetic neuralgia (PHN), and
(3) a severity-duration measure of the burden of illness caused by HZ. HZ
patients aged 60 years or older (n = 121) were enrolled within 14 days of rash
onset and completed ZBPI, McGill Pain Questionnaire Present Pain Intensity (PPI),
quality of life (QoL), and activities of daily living (ADL) questionnaires on a
predetermined schedule. Reliability, measured by intraclass correlation
coefficients within 14 days of rash onset, ranged between 0.63 and 0.78. ZBPI
pain scores were strongly correlated with other pain measures, interference with 
ADL, and worsening QoL. The operational definition of PHN, a ZBPI pain score of 3
or greater occurring 90 or more days after rash onset, had high agreement with
pain worse than mild on the PPI (kappa = 0.72). The ZBPI pain severity-duration
measure had high correlations with severity-duration measures of ADL
interference, worsening QoL, and other pain scales. These findings support the
validity and utility of the ZBPI, the definition of PHN, and the
severity-duration measure of the burden of HZ illness. PERSPECTIVE: Herpes zoster
pain, as measured by the ZBPI severity-duration measure, is associated with
impairment in daily living activities and quality of life. The ZBPI measure
appears useful for quantifying herpes zoster pain, postherpetic neuralgia, and
impairment in daily living activities for clinical trials of herpes zoster
prevention.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Validation Studies

PMID: 15336639 [PubMed - indexed for MEDLINE]

1663: Am J Otolaryngol. 2004 Sep-Oct;25(5):357-60.

Lateral sinus thrombosis associated with zoster sine herpete.

Chan J, Bergstrom RT, Lanza DC, Oas JG.

Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic
Foundation, Cleveland, OH 44195, USA.

Herpes zoster results from reactivation of the varicella zoster virus (VZV).
Zoster sine herpete (ZSH) is an uncommon manifestation of VZV infection and
presents with similar symptoms but without the vesicular rash. We describe an
unusual case of lateral sinus thrombosis (LST) that developed during the clinical
course of ZSH in the C2 distribution. A 55-year-old woman presented with a 3-day 
history of left temporal and postauricular pain, nausea, vomiting, and mild
photophobia. She denied otalgia, otorrhea, and hearing loss. Examination revealed
hyperesthesia in the left C2 nerve root distribution without evidence of herpetic
rash. A computed tomography scan showed minimal fluid in the left mastoid cavity 
(not mastoiditis) and thrombus within the left lateral and sigmoid dural sinus.
Magnetic resonance imaging and magnetic resonance angiogram confirmed these
findings. Laboratory studies revealed elevated neurotrophic immunoglobulin G
levels to VZV. Hypercoagulable studies were normal. She was subsequently treated 
with Neurontin, acyclovir, and anticoagulation. Her symptoms improved, and she
was discharged 3 days later. LST is generally a complication of middle ear
infection. Nonseptic LST, however, may result from dehydration, oral
contraceptive use, coagulopathy, or thyroid disease. This unusual case raises the
suspicion that thrombosis resulted from VZV associated thrombophlebitis in the
ipsilateral cerebral venous sinuses along the second cervical nerve root
distribution. A high index of suspicion is necessary in such cases so that a
different treatment course can be identified and antiviral medication initiated
promptly.

Publication Types: 
    Case Reports

PMID: 15334402 [PubMed - indexed for MEDLINE]

1664: Br J Cancer. 2004 Oct 4;91(7):1275-9.

The risk and prognosis of cancer after hospitalisation for herpes zoster: a
population-based follow-up study.

Sorensen HT, Olsen JH, Jepsen P, Johnsen SP, Schonheyder HC, Mellemkjaer L.

Department of Clinical Epidemiology, Aarhus University Hospital, Vennelyst
Boulevard 6, Building 260, 8000 Aarhus C, Denmark. hts@soci.au.dk

We examined the risk of cancer and survival in a cohort of patients hospitalised 
with herpes zoster between 1977 and 1996, drawn from the Danish National Registry
of Patients. Through linkage with the Danish Cancer Registry, we compared the
observed number of cancers with the expected number on the basis of national
age-, gender-, and site-specific incidence rates. The survival of herpes zoster
patients with cancer was compared with that of non-herpes zoster patients with
cancer. Among the 10 588 patients hospitalised with herpes zoster whom we
identified, 1427 cancers were observed compared with 1239 expected (relative
risk=1.2, 95% confidence interval 1.1-1.2). The risk was substantially elevated
during the first year of follow-up, mainly for haematological cancer. Patients
with cancer within 1 year of follow-up had a higher prevalence of distant
metastases than controls, although the mortality was similar. For those with
haematological cancer, however, the mortality was higher for herpes zoster
patients than for controls. Haematological cancer following hospitalisation for
herpes zoster has a poorer prognosis than in non-herpes zoster patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15328522 [PubMed - indexed for MEDLINE]

1665: Med Pregl. 2004 Jan-Feb;57(1-2):18-21.

[Corticosteroid therapy of zoster-associated pain]

[Article in Serbian]

Cvjetovic D, Jovanovic J, Hrnjakovic-Cvjetkovic I, Dordevic-Aleksic M, Radojcic
A, Bogdanovic M.

INTRODUCTION: Lack of exact clinical studies on effects of corticosteroids in
therapy and prevention of herpes zoster-related pain, elicited many controversies
in the past. The aim of our study was to estimate effects of prednisone on
frequency, intensity and duration of postherpetic neuralgia. MATERIAL AND
METHODS: 68 immunocompetent herpes zoster patients, 8-90 years of age (37 females
and 31 males, mean age 55.7 years) were enrolled for study; 30 patients were
treated with acyclovir (5 x 800 mg daily for a 7-day period) and prednisone
(initial daily dose 60 mg, tapering over 14 days), and the control group of 38
patients with acyclovir only. Patients were clinically followed up for 3 months
after complete resolution of skin lesions. Chi-square test was used in
statistical data analysis. RESULTS: The difference regarding incidence of
postherpetic neuralgia in acyclovir/prednisone group and acyclovir group
(although slightly less in the former one) was not significant. Duration of
postherpetic neuralgia over 3 months was similar in both groups. Mild
postherpetic pain was more common in the acyclovir/prednisone group (44.4%) than 
in the acyclovir group (28.6%); however, statistical validation requires more
patients to be studied. DISCUSSION: Results of our study didn't confirm
efficiency of prednisone regarding occurrence and characteristics of postherpetic
neuralgia. Failure of prednisone therapy may be partly contributed to advanced
age of patients and delayed onset of therapy. CONCLUSION: Use of corticosteroids 
in zoster patients gives neither reliable protection from appearance of
postherpetic neuralgia, nor shortens its duration. Further investigations are
necessary to estimate their effects on postherpetic pain.

Publication Types: 
    English Abstract

PMID: 15327184 [PubMed - indexed for MEDLINE]

1666: Int J Infect Dis. 2004 Sep;8(5):259-70.

A review of the varicella vaccine in immunocompromised individuals.

Sartori AM.

Clinic of Infectious and Parasitic Diseases, Hospital das Clinicas, University of
Sao Paulo School of Medicine, Sao Paulo, SP, Brazil. amsartori@sti.com.br

BACKGROUND: Individuals with underlying cell-mediated immunodeficiency disorders 
are at high risk of developing severe, life-threatening illness associated with
varicella-zoster virus infection. A live-attenuated varicella vaccine is
recommended for routine childhood immunisation in some countries. In healthy
children, the vaccine is efficacious and safe but because immunocompromised
individuals may be unable to limit replication of live-attenuated vaccine
viruses, the varicella vaccine is not recommended for them and there are few
exceptions. OBJECTIVES: The purpose of this paper is to review the published
studies addressing the use of the varicella vaccine in people with cell-mediated 
immunodeficiency disorders. METHODS: A computerised search on the PubMed database
was used to collect the relevant papers published up to March 2003. RESULTS: The 
varicella vaccine has been extensively studied in susceptible children with acute
lymphoblastic leukaemia in remission, but studies involving individuals with
other immunodeficiency disorders are scarce. Some of the current recommendations 
are based on very few and small studies with short follow-up. Immunocompromised
individuals should be given the varicella vaccine only with complete knowledge of
their clinical and immunological conditions and after considering the risks of
natural infection and vaccination.

Publication Types: 
    Review

PMID: 15325594 [PubMed - indexed for MEDLINE]

1667: Gac Sanit. 2004 Jul-Aug;18(4):287-94.

[Cost-effectiveness of varicella vaccination in Spanish adolescents]

[Article in Spanish]

Pena-Rey I, Perez-Farinos N, Cortes-Garcia M, Amela-Heras C.

Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain.
sabela@isciii.es

INTRODUCTION: Varicella is a highly contagious disease. In Spain, in 1996, 91% of
the population aged 13 years old had been infected. The complications of
varicella are more frequent in adults. Herpes zoster infection can be reactivated
after the initial infection in 15%. A vaccine against varicella has recently been
authorized in Spain for use in individuals aged more than 13 years old with
negative serology. OBJECTIVE: To determine the cost-effectiveness of vaccination 
of the cohort aged 13 years old in 2001 and to perform a sensitivity analysis of 
the parameters that are affected. MATERIAL AND METHOD: Tree decision: Decision
Analysis by Tree-Age program. Probabilities and costs were calculated using
Microsoft Excel. Population size was obtained from the 2001 Census of the
National Institute of Statistics to which we applied the percentage of
susceptibility from the seroepidemiological study in Spain. Probabilities were
calculated by the Bayes Theorem, using the incidence rates by age of a country in
the northern hemisphere. Hospital-related data were obtained from the minimum
data set. We used the effectiveness of the vaccine licensed in the USA, with a
total effectiveness of 71% and a partial effectiveness of 24%, represented by
milder varicella in vaccinated individuals (breakthrough varicella). Only direct 
costs were considered. Costs were obtained by direct consultation of different
sources. A discount rate of 3% was used. RESULTS: Varicella vaccination could
prevent 27,278 cases of the disease. Prevention of one case would cost the public
health system 131 Euros. DISCUSSION: This study constitutes an approach to the
cost of introducing varicella vaccination in the Spanish vaccination schedule,
from the payer's perspective. However, to take a decision, some unknown factors, 
such as the effect of vaccination on the incidence of herpes zoster, should be
assessed. With currently available data, the introduction of vaccination in
adolescence would seem to be the best strategy, but further studies are needed.

Publication Types: 
    English Abstract

PMID: 15324639 [PubMed - indexed for MEDLINE]

1668: Gastroenterol Hepatol. 2000 Jun-Jul;23(6):313-4.

[Abdominal pain as initial clinical presentation of herpes zoster in an
immunocompetent adult]

[Article in Spanish]

Muelas MS, Menasalvas AI, Ramos J.

Publication Types: 
    Case Reports
    Letter

PMID: 15324632 [PubMed - indexed for MEDLINE]

1669: Clin J Pain. 2004 Sep-Oct;20(5):302-8.

Optimum pain relief with continuous epidural infusion of local anesthetics
shortens the duration of zoster-associated pain.

Manabe H, Dan K, Hirata K, Hori K, Shono S, Tateshi S, Ishino H, Higa K.

Department of Anesthesiology, Kitakyushu Municipal Medical Center, Bashaku,
Kokurakita-ku, Japan. hymanabe@mx7.tiki.ne.jp

OBJECTIVE: To investigate effects of continuous epidural infusion (CEI) of 0.5%
bupivacaine added to intermittent epidural boluses (IEB) on the duration of
zoster-associated pain (ZAP), as compared with continuous infusion of normal
saline placebo added to IEB. DESIGN: A prospective, double-blind, randomized,
placebo-controlled study. SETTING: A university hospital and an affiliated clinic
in Japan from 1996 through 1999. PATIENTS: 56 immunocompetent herpes zoster (HZ) 
patients, 50 years or older, within 10 days of rash onset and with severe pain
and eruption. INTERVENTIONS: Patients were hospitalized and randomly allocated
into 2 groups. CEI group given CEI of 0.5% bupivacaine (0.5-1.0 mL/h) plus IEB of
0.5% bupivacaine 4 times daily (n = 29). IEB group given normal saline infusion
plus IEB of 0.5% bupivacaine 4 times daily (n = 27). All patients received oral
acyclovir 800 mg, 5 times daily, for 7 days. OUTCOME MEASURES: The number of days
required for complete cessation of ZAP and the proportion of subjects with
allodynia beyond 30 days. RESULTS: The median time to cessation of ZAP was
significantly shorter in the CEI group than in the IEB group (29 days vs. 40
days, P = 0.002). The number of patients whose allodynia persisted beyond 30 days
of treatment was significantly lower in the CEI group than in the IEB group (10% 
vs. 37%, P = 0.027). CONCLUSIONS: CEI of 0.5% bupivacaine plus IEB was associated
with a shorter duration of ZAP and fewer patients with allodynia beyond 30 days, 
compared with IEB plus normal saline infusion. Patients at high risk for
developing postherpetic neuralgia (PHN) can be managed with intensive therapies
at the early stage of disease, such as CEI, which maintains effective analgesia
and may reduce the burden of PHN.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 15322436 [PubMed - indexed for MEDLINE]

1670: J Pediatr Gastroenterol Nutr. 2004 Sep;39(3):265-9.

Safety of infliximab treatment in pediatric patients with inflammatory bowel
disease.

Friesen CA, Calabro C, Christenson K, Carpenter E, Welchert E, Daniel JF, Haslag 
S, Roberts CC.

Section of Gastroenterology, The Children's Mercy Hospital and Clinics, Kansas
City, Missouri 64108, USA. cfriesen@cmh.edu

BACKGROUND: Infliximab appears to be efficacious in the treatment of pediatric
Crohn disease (CD). There are few large-scale pediatric studies on the
complications of infliximab therapy. METHODS: A retrospective review of all
infliximab infusions administered to IBD patients at a tertiary children's
hospital was undertaken. Data was obtained from an infliximab infusion database
maintained in the section of Pediatric Gastroenterology, pharmacy records and
patient charts. RESULTS: 594 infusions were administered to 111 IBD patients (88 
CD and 23 UC; 55 male and 56 female; ages 4 to 20 years; mean age, 13.4 years).
The number of infusions ranged from 1 to 24 with a mean of 5.4/patient. Infusion 
reactions occurred in 8.1% of patients (seven early and two delayed) and in 1.5% 
of all infusions. Reactions occurred more frequently in female patients (14%
versus 2%; P = 0.03). All reactions were mild and responded rapidly to treatment.
Four patients had infections deemed unusual, including three cutaneous tinea
infections and one case of shingles. CONCLUSION: Infliximab is safe in pediatric 
IBD patients with a low incidence of generally mild reactions that respond
rapidly to intervention. Infusion reactions are more common in female patients.
Our patients had no serious infectious complications, although cutaneous tinea
infection may represent a newly reported associated complication.

PMID: 15319627 [PubMed - indexed for MEDLINE]

1671: Eur Neurol. 2004;52(2):121-2. Epub 2004 Aug 18.

Recurrent varicella-zoster virus myelitis in an immunocompetent patient.

Jacobus Gilhuis H, Visser CE, Portegies P.

Department of Neurology, Reinier de Graaf Group, Delft, The Netherlands.
gilhuis@rdgg.nl

Publication Types: 
    Case Reports
    Comparative Study

PMID: 15319558 [PubMed - indexed for MEDLINE]

1672: Herpes. 2004 Jun;11 Suppl 2:89A-94A.

Varicella zoster virus and central nervous system syndromes.

Gilden D.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA. don.gilden@ushsc.edu

Varicella zoster virus (VZV) causes chicken pox (varicella) after which it
establishes latency and can subsequently reactivate to cause herpes zoster.
Central nervous system (CNS) complications can follow both primary infection and 
reactivation of VZV. The more serious manifestations arise when VZV invades the
spinal cord or cerebral arteries after reactivation of the virus, causing
diseases such as myelitis and focal vasculopathies. The International Herpes
Management Forum (IHMF) has developed guidelines to aid in the diagnosis and
management of CNS syndromes associated with VZV and these have focused on VZV
vasculopathy. The new guidelines recommend that where VZV vasculopathy is
suspected, cerebrospinal fluid (CSF) should be analysed by polymerase chain
reaction (PCR) for VZV DNA. As VZV antibodies may be present in the CSF in the
presence or absence of detectable VZV DNA, CSF should also be analysed for
VZV-specific antibody if there is a high likelihood of CNS disease. Early
diagnosis of these serious complications is important, as aggressive antiviral
treatment can be effective. Patients with VZV focal vasculopathy should be
treated with intravenous aciclovir (10 mg/kg every 8 h for adults, 500 mg/m2 body
surface area for children) for 7 days. The immunocompromised patient may require 
longer treatment. However, treatment should be discontinued if negative results
are obtained for both VZV DNA and anti-VZV antibody in CSF. Steroid therapy
(prednisone 60-80 mg/day for 3-5 days) should be considered in VZV vasculopathy
to reduce inflammation.

Publication Types: 
    Review

PMID: 15319095 [PubMed - indexed for MEDLINE]

1673: Herpes. 2004 Jun;11 Suppl 2:48A-56A.

Diagnosis of herpesvirus infections of the central nervous system.

Boivin G.

Laboratoire d'infectiologie, Pavillon CHUL, Universite Laval, Canada.
guy.boivin@crchul.ulaval.ca

The International Herpes Management Forum (IHMF) has produced guidelines to
promote improved diagnosis of herpesvirus infections of the central nervous
system (CNS). Recommendations include using polymerase chain reaction (PCR)
analysis of cerebrospinal fluid (CSF) to help diagnose herpes simplex virus
(HSV), varicella zoster virus (VZV) and cytomegalovirus (CMV) infections of the
CNS. Laboratories routinely using such tests should participate in a proficiency 
testing programme. For retrospective diagnosis of herpesvirus infections of the
CNS, intrathecal antibody detection can be used as an adjunct to PCR, assuming
all appropriate controls are utilized. For suspected cases of herpes simplex
encephalitis (HSE), a sensitive HSV PCR test of the CSF should be used in
preference to other methods. Cultures are not recommended for HSE except as an
adjunctive test in suspected neonatal HSV infections. While research continues
into the role of PCR with VZV infections of the CNS, studies demonstrate that the
technique is useful for diagnosing varicella-associated CNS syndromes but further
research is required for its role in zoster-associated syndromes. For CMV CNS
infections, PCR represents the most sensitive diagnostic method and can be used
in conjunction with virus culture to determine suspected cases of CMV myelitis.
For CNS infections with lymphotropic herpesviruses, a positive PCR test is
suggestive, but not definitive, evidence of virus encephalitis. PCR analysis of
CSF for Epstein-Barr virus can be useful for diagnosing AIDS-associated primary
CNS lymphoma. This article presents the current evidence for these and other
guidelines for the diagnosis of herpesvirus infections of the CNS.

Publication Types: 
    Review

PMID: 15319090 [PubMed - indexed for MEDLINE]

1674: Hautarzt. 2004 Sep;55(9):831-40.

[Varicella-zoster virus infections]

[Article in German]

Lilie HM, Wassilew SW.

Dermatologische Klinik, Klinikum Krefeld, Lutherplatz 40, 47805 Krefeld, Germany.
lilie@klinikum-krefeld.de

The primary infection with varicella-zoster virus (VZV) is manifest clinically as
varicella. It is a common very contagious disease, normally appearing in
childhood. VZV is a ubiquitous virus with a high prevalence. Clinically it is
characterized by pleomorphic skin lesions. Normally antiviral therapy is
necessary only in severe cases, in adults or in immunosuppressed patients. Herpes
zoster, also caused by (VZV), is a neurodermal disease representing the
endogenous relapse of the primary varicella infection. Herpes zoster is
characterized by lesions concentrated in the innervation region of a cranial or
spinal nerve. One of the most feared manifestations of herpes zoster is pain.
Several antiviral drugs are approved and many studies have shown that antiviral
therapy, started early in the course of disease, can significantly reduce risk
and duration of postherpetic neuralgia in elderly patients. Therefore, antiviral 
therapy in combination with an adequate pain management should be given to all
elderly patients as soon as herpes zoster is diagnosed.

Publication Types: 
    English Abstract
    Review

PMID: 15316637 [PubMed - indexed for MEDLINE]

1675: J Immunother. 2004 Sep-Oct;27(5):389-93.

Quantitative molecular evaluation of minimal residual disease in patients with
chronic lymphocytic leukemia: efficacy of in vivo purging by alemtuzumab
(Campath-1H).

Galimberti S, Cervetti G, Cecconi N, Fazzi R, Pacini S, Guerrini F, Manetti C,
Caracciolo F, Petrini M.

Department of Oncology, Transplant and Advances in Medicine, Section of
Hematology, University of Pisa, Pisa, Italy.

Although novel therapies for chronic lymphocytic leukemia have resulted in higher
hematologic response rates, the complete eradication of disease rarely occurs.
Alemtuzumab (Campath-1H) seems to be extremely effective in this role in
pretreated patients. The authors used a molecular semiquantitative polymerase
chain reaction (PCR) method to assess the ability of alemtuzumab to induce PCR
negativity in eight patients pretreated with fludarabine. IgH rearrangement was
coamplified with a housekeeping gene and fluorescent PCR products were analyzed
on a DNA automatic sequencer. Each patient was evaluated at diagnosis, after
fludarabine, and after Campath-1H. The median interval between the last therapy
course with fludarabine and the start of Campath-1H was 14 weeks. Patients
received subcutaneous doses up to 10 mg, three times a week, for 12 weeks, with a
median dose of 190 mg. After six cycles with fludarabine, only one patient
(12.5%) achieved molecular remission, and in three other patients IgH levels
decreased by 0.5 to 1 log. At the beginning of Campath-1H administration, all
patients were PCR positive, including the one previously found to be negative. At
the end of treatment, five patients achieved molecular remission (62.5%), four of
them within 1 month after the end of therapy. Seventy-two percent of responses,
with 43% of complete responses, were documented on bone marrow smears. A
significant reduction of lymph node and spleen diameters was noted in 50% and 33%
of patients, respectively. Four patients showed grade 2 skin reaction at the site
of the subcutaneous injection and grade 1 or 2 fever. Two patients developed
neutropenia (grade 2 and 3) and two hemolytic episodes. Three patients showed
cytomegalovirus and one herpes zoster and Epstein-Barr virus reactivation. These 
results show that Campath-1H represents an efficacious in vivo purging tool with 
a safe profile. Copyright 2004 Lippincott Williams & Wilkins

Publication Types: 
    Clinical Trial

PMID: 15314547 [PubMed - indexed for MEDLINE]

1676: Am Heart J. 2004 Aug;148(2):e9.

Oral rapamycin to prevent human coronary stent restenosis: a pilot study.

Guarda E, Marchant E, Fajuri A, Martinez A, Moran S, Mendez M, Uriarte P,
Valenzuela E, Lazen R.

Departamento de Enfermedades Cardiovasculares, Pontificia Universidad Catolica de
Chile, Santiago, Chile. eguarda@med.puc.cl

BACKGROUND: Recent human trials with rapamycin-eluting stents have shown very low
restenosis rates. However, the high costs of these devices preclude their use in 
routine angioplasty, especially when considering multiple stenting. We evaluated 
whether orally administered rapamycin inhibits in-stent neointimal growth in
patients with unstable angina. METHODS: We enrolled 15 patients successfully
treated with the implantation of a single stent in a single de novo lesion in
native coronary arteries. Correct stent expansion and apposition were
corroborated with intravascular ultrasound scanning in all patients. Patients
received aspirin, clopidogrel, and atorvastatin for 6 months. Rapamycin was
administered in a loading dose of 5 mg, followed by 2 mg/day for 4 weeks.
RESULTS: The reference diameter was 3.4 +/- 0.4 mm, lesion length was 11.2 +/- 2 
mm, lesion type B1 was 36%, and lesion type B2 was 64%. After the procedure,
in-stent minimal lumen diameter and diameter stenosis (DS) were 3.3 +/- 0.4 mm
and 0.3% +/- 7.5%, respectively. At 10 days, plasma levels of rapamycin were 7.95
+/- 2.6 ng/mL. At 6 months, angiographic determinations demonstrated an in-stent 
minimal lumen diameter of 2 +/- 1 mm, an in-stent DS of 41.3% +/- 28.0%, and an
in-stent late loss of 1.4 +/- 1.1 mm. Binary restenosis (>50% DS) was present in 
6 of 15 patients (40%). Target lesion revascularization (coronary artery bypass
grafting) was performed in 2 of 15 patients (13.3%). There were no serious
adverse events during the 6-month period of follow-up, but 1 patient had severe
heartburn caused by esophagitis, and another patient had herpes zoster at the end
of the protocol. CONCLUSIONS: Oral rapamycin was well tolerated, but did not
suppress in-stent neointimal growth in this small group of patients.

Publication Types: 
    Clinical Trial

PMID: 15309012 [PubMed - indexed for MEDLINE]

1677: J Korean Med Sci. 2004 Aug;19(4):598-600.

Concurrent reactivation of varicella zoster virus and herpes simplex virus in an 
immunocompetent child.

Park HH, Lee MH.

Department of Dermatology, College of Medicine, Kyunghee University, Seoul,
Korea.

Latency within the nervous system is a characteristic feature of herpesviridae
infection. It is reactivated by triggering factors such as UV exposure, stress,
and trauma. Simultaneous reactivation of herpes simplex and herpes zoster is
uncommon, however, an observation provably explained by differences in the
triggering mechanism. Concurrent reactivation of herpes simplex virus (HSV) and
varicella zoster virus (VZV) is occasionally encountered in immunosuppressed
patients; on the other hand, it is rarely reported in immunocompetent
individuals. We present the case of an immunocompetent 8-yr-old female patient
with concurrent reactivation of HSV on the face and VZV on the right L2
dermatome. Copyright The Korean Academy of Medical Sciences

Publication Types: 
    Case Reports

PMID: 15308854 [PubMed - indexed for MEDLINE]

1678: Vaccine. 2004 Sep 3;22(25-26):3228-31; author reply 3232-6.

Comment on:
    Vaccine. 2003 Oct 1;21(27-30):4238-42.    Vaccine. 2003 Oct 1;21(27-30):4243-9.    Vaccine. 2003 Oct 1;21(27-30):4250-5.

Scientific commentary.

Jumaan A, Schmid DS, Gargiullo P, Seward J.

Publication Types: 
    Comment
    Letter

PMID: 15308342 [PubMed - indexed for MEDLINE]

1679: Clin Infect Dis. 2004 Aug 1;39(3):342-8. Epub 2004 Jul 19.

Acute pain in herpes zoster and its impact on health-related quality of life.

Katz J, Cooper EM, Walther RR, Sweeney EW, Dworkin RH.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, Rochester, NY, 14642, USA.

Although the effects of postherpetic neuralgia on physical and emotional
functioning have been examined in a number of studies, the impact of acute pain
in herpes zoster ("shingles") on health-related quality of life has been
neglected. We describe the characteristics of herpes zoster pain and examine its 
relationship to physical, role, social, and emotional functioning in 110 patients
with herpes zoster. When we controlled for relevant covariates, we found that
greater pain burden, as assessed by the product of pain intensity and duration,
was associated with poorer physical functioning, increased emotional distress,
and decreased role and social functioning. The results demonstrate that herpes
zoster pain has broad effects on the daily lives of patients and on their
emotional health. The increasing incidence of herpes zoster that can be
anticipated as the population ages requires that clinical trials that examine
interventions to prevent or treat herpes zoster pain be given a high priority.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15307000 [PubMed - indexed for MEDLINE]

1680: Lancet. 2004 Aug 7-13;364(9433):502.

Povidone-iodine for herpes zoster.

Shann F.

Publication Types: 
    Letter

PMID: 15302192 [PubMed - indexed for MEDLINE]

1681: Mayo Clin Proc. 2004 Aug;79(8):1055-8.

80-year-old man with fever and ear pain.

Lim LS, Takahashi PY.

Mayo Graduate School of Medicine, Mayo Clinic College of Medicine, Rochester,
Minn 55905, USA.

Publication Types: 
    Case Reports
    Review

PMID: 15301334 [PubMed - indexed for MEDLINE]

1682: Nervenarzt. 2004 Jul;75(7):688-90.

[Coenaesthesia after infection with Varicella zoster virus. The psychodynamic
meaning of suffering a children's disease at adult age]

[Article in German]

Bruggemann BR, Machleidt W.

Abteilung Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover.
Brueggemann.Bernd@MH-Hannover.de

The case report is presented of a 33-year-old male who developed coenaesthesia
after suffering from chickenpox. While central nervous involvement of the herpes 
zoster virus infection was not found, suffering a children's disease at an adult 
age proved an important psychodynamic factor for release of the coenaesthetic
symptomatology.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15300325 [PubMed - indexed for MEDLINE]

1683: J Anesth. 2004;18(3):177-80.

Systemic ATP infusion improves spontaneous pain and tactile allodynia, but not
tactile hypesthesia, in patients with postherpetic neuralgia.

Moriyama M, Kitamura A, Ikezaki H, Nakanishi K, Kim C, Sakamoto A, Ogawa R.

Department of Anesthesia, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku,
113-8603 Tokyo, Japan.

PURPOSE: Activation of purinoceptors may improve neuropathic pain. Accordingly,
the effects of systemic ATP infusion were assessed in patients with postherpetic 
neuralgia (PHN). METHODS: Eight patients with PHN lasting over 3 months were
enrolled. Initially, patients received the vehicle (20% dextrose) or ATP (at a
dose of 1 mg x kg(-1) in 20% dextrose) infused intravenously for 60 min on two
separate occasions in a single-blinded manner. The levels of spontaneous
continuous pain, paroxysmal pain, and tactile allodynia were assessed by a visual
analogue scale (VAS), and tactile hypesthesia was assessed by Semmes-Weinstein
monofilament before and after infusion. Subsequently, the eight patients received
an ATP infusion (1 mg.kg(-1) in 20% dextrose) once a week for 5-12 weeks in an
open-label manner, and changes in the above parameters were assessed. RESULTS: In
the initial study, VAS for spontaneous continuous pain and tactile allodynia
decreased significantly with ATP infusion but not with placebo infusion. After
repeated ATP infusions for 5-12 weeks, the median VAS for spontaneous continuous 
pain, paroxysmal pain, and tactile allodynia decreased significantly from 32.1 to
13.0, from 46.9 to 17.5, and from 49.5 to 15.6 respectively. However tactile
hypesthesia did not improve significantly. CONCLUSION: This study demonstrated
that repetitive intravenous ATP infusion could improve spontaneous continuous
pain and paroxysmal pain, as well as improving tactile allodynia, but did not
influence tactile hypesthesia.

Publication Types: 
    Clinical Trial

PMID: 15290415 [PubMed - indexed for MEDLINE]

1684: J Clin Virol. 2004 Sep;31(1):11-5.

No detection of parvovirus B19 or herpesvirus DNA in giant cell arteritis.

Rodriguez-Pla A, Bosch-Gil JA, Echevarria-Mayo JE, Rossello-Urgell J,
Solans-Laque R, Huguet-Redecilla P, Stone JH, Vilardell-Tarres M.

Pediatrics Department, Stanley Division of Developmental Neurovirology, Johns
Hopkins University, Baltimore, MD 21287-4933, USA. arodri12@jhmi.edu

BACKGROUND: Compelling arguments exist for a role of infectious agent in giant
cell arteritis (GCA). Parvovirus B19 and several herpesviruses have focussed the 
attention in recent years, but the few studies to date have yielded inconsistent 
results. OBJECTIVES: To study the relationship between the presence of parvovirus
B19 DNA or major known herpesviruses and the histopathological features of GCA.
STUDY DESIGN: Between January 1997 and March 2002, 147 consecutive temporal
artery biopsies were performed in our center because of a clinical suspicion of
GCA. Using polymerase chain reaction (PCR) procedures validated by the World
Health Organization and employed routinely by our laboratory, we examined the
paraffin-embedded specimens for DNA from parvovirus B19, herpes simplex viruses
(HSV) 1 and 2, Epstein-Barr virus (EBV), varicella-zoster virus (VZV), human
cytomegalovirus (HCMV), and human herpesvirus 6 (HHV-6). We investigated positive
results further with immunohistochemistry studies. RESULTS: Fifty of the 147
temporal artery biopsies (34%) showed histological features of GCA. Three
biopsies (2.5%) were initially PCR positive for parvovirus B19. None of the
herpesvirus PCR assays were positive. Upon repeat testing by both PCR and
immunohistochemistry, none of the three initially positive parvovirus B19 assays 
were confirmed. The results of both positive and negative control assays in these
studies validated these findings. We confirmed the presence of amplifiable DNA in
the temporal artery biopsy specimens using PCR primers for beta-globin and
indoleamine 2,3-dioxygenase (IDO). CONCLUSIONS: The results of our study do not
support a role in the etiopathogenesis of GCA for either parvovirus B19 or any of
these six herpesviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15288607 [PubMed - indexed for MEDLINE]

1685: Virus Genes. 2004 Oct;29(2):267-77.

The reading frame BPLF1 of Epstein-Barr virus: a homologue of herpes simplex
virus protein VP16.

Schmaus S, Wolf H, Schwarzmann F.

Antisense Pharma GmbH, Josef-Engert-Strasse 9, D-93053 Regensburg, Germany.

The open reading frame BPLF1 of Epstein-Barr virus (EBV) shows homology to the
Herpes simplex virus 1 (HSV1) protein VP16. This protein is a structural tegument
component playing a pivotal role for HSV replication as trans-activator of viral 
immediate-early genes. An EBV gene with a comparable function has not been
described so far. However, computer analysis indicated that BPLF1 may be a
tegument protein homologous to VP16. This is the first report on the
characterisation of the BPLF1 gene, its transcription, and expression of its gene
product in vitro and in vivo. Using RT-PCR and Northern blot assays we
demonstrated that the BPLF1 gene belongs to the class of late lytic cycle genes
of EBV. Besides a full length transcript of 9.5 kb also a polyadenylated
transcript of approximately 3 kb is synthesised. However, no consensus splice
sites could be identified. Northern blot experiments using partially overlapping 
probes and sequencing of a BPLF1-specific cDNA revealed 1,550 nucleotides of the 
BPLF1 transcript, collinear in sequence with the viral genome from position 64547
to 66097. A recombinant Western blot assay detected BPLF1-specific antibodies in 
seropositive individuals, in particular in cases with elevated viral replication 
like infectious mononucleosis, chronic active infection, and nasopharyngeal
carcinoma. This demonstrated expression of the BPLF1 protein in vivo. Thus,
experimental data and computer analysis strongly support the hypothesis of BPLF1 
being a tegument protein of the EBV homologous to VP16 of HSV1 and ORF22 of
Varicella zoster virus.

PMID: 15284487 [PubMed - indexed for MEDLINE]

1686: AIDS. 2004 Aug 20;18(12):1615-27.

Immune restoration disease after antiretroviral therapy.

French MA, Price P, Stone SF.

Department of Clinical Immunology and Biochemical Genetics, Royal Perth Hospital 
and School of Surgery and Pathology, University of Western Australia, Perth,
Australia. martyn.french@health.wa.gov.au

Suppression of HIV replication by highly active antiretroviral therapy (HAART)
often restores protective pathogen-specific immune responses, but in some
patients the restored immune response is immunopathological and causes disease
[immune restoration disease (IRD)]. Infections by mycobacteria, cryptococci,
herpesviruses, hepatitis B and C virus, and JC virus are the most common
pathogens associated with infectious IRD. Sarcoid IRD and autoimmune IRD occur
less commonly. Infectious IRD presenting during the first 3 months of therapy
appears to reflect an immune response against an active (often quiescent)
infection by opportunistic pathogens whereas late IRD may result from an immune
response against the antigens of non-viable pathogens. Data on the
immunopathogenesis of IRD is limited but it suggests that immunopathogenic
mechanisms are determined by the pathogen. For example, mycobacterial IRD is
associated with delayed-type hypersensitivity responses to mycobacterial antigens
whereas there is evidence of a CD8 T-cell response in herpesvirus IRD.
Furthermore, the association of different cytokine gene polymorphisms with
mycobacterial or herpesvirus IRD provides evidence of different pathogenic
mechanisms as well as indicating a genetic susceptibility to IRD. Differentiation
of IRD from an opportunistic infection is important because IRD indicates a
successful, albeit undesirable, effect of HAART. It is also important to
differentiate IRD from drug toxicity to avoid unnecessary cessation of HAART. The
management of IRD often requires the use of anti-microbial and/or
anti-inflammatory therapy. Investigation of strategies to prevent IRD is a
priority, particularly in developing countries, and requires the development of
risk assessment methods and diagnostic criteria.

Publication Types: 
    Review

PMID: 15280772 [PubMed - indexed for MEDLINE]

1687: Pediatr Clin North Am. 2004 Aug;51(4):889-908, viii.

Herpesviridae infections in newborns: varicella zoster virus, herpes simplex
virus, and cytomegalovirus.

Enright AM, Prober CG.

Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA 94301, USA.
EnrighA@pamf.org

Varicella zoster virus (VZV), herpes simplex virus (HSV) and cytomegalovirus
(CMV) are all members of the Herpesviridae family.Humans are the only source of
infection for these double stranded DNA viruses. Infants may acquire these
infections in utero, peripartum, or postnatally, resulting in a variety of
clinical syndromes, ranging from asymptomatic infection to severe infection,with 
high mortality rates and significant long-term morbidity.This article presents
the epidemiology, clinical characteristics, treatment,and prevention strategies
for VZV, HSV, and CMV infections in infants.

Publication Types: 
    Review

PMID: 15275980 [PubMed - indexed for MEDLINE]

1688: Pain. 2004 Jul;110(1-2):329-36.

The human histocompatibility leukocyte antigen (HLA) haplotype is associated with
the onset of postherpetic neuralgia after herpes zoster.

Sato-Takeda M, Ihn H, Ohashi J, Tsuchiya N, Satake M, Arita H, Tamaki K, Hanaoka 
K, Tokunaga K, Yabe T.

Department of Anesthesiology and Pain Relief Center, University of Tokyo
Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

In some herpes zoster patients, pain persists for more than 3 months or more
after healing of vesicular eruptions; this condition is termed postherpetic
neuralgia (PHN). We have recently reported the association of the human
histocompatibility leukocyte antigens (HLA) haplotype,
HLA-A*3303-B*4403-DRB1*1302 with PHN patients; however, it has not been
determined whether the haplotype is also associated with herpes zoster that did
not develop subsequent PHN. To distinguish whether the haplotype is associated
with herpes zoster or the development of PHN, we examined if herpes zoster
patients without subsequently PHN are also associated with the HLA haplotype or
not. Herpes zoster patients were followed up for more than 6 months, and HLA
alleles and haplotypes were compared among the PHN patients (n = 52) the herpes
zoster patients who did not develop PHN (n = 42) and healthy controls (n = 125). 
The frequencies of the risk haplotype in the PHN patients, in the healthy
controls and in the herpes zoster patients without subsequent PHN were 16.3, 5.2 
and 4.8%, respectively. While the frequency of the risk haplotype was
significantly higher in the PHN patients than in the healthy controls (P =
0.0006) no difference was observed between the herpes zoster patients without
subsequent PHN and the healthy controls. No significant association was found
between the duration of symptoms or the site of herpes zoster and the HLA alleles
and the haplotype. These results suggest that the HLA-A*3303-B*4403-DRB1*1302
haplotype plays an important role in the development of PHN after herpes zoster, 
but not in the onset of herpes zoster.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 15275783 [PubMed - indexed for MEDLINE]

1689: Pain. 2004 Jul;110(1-2):e1-12.

Complex regional pain syndrome-like symptoms during herpes zoster.

Berry JD, Rowbotham MC, Petersen KL.

UCSF Pain Clinical Research Center, University of California, San Francisco
94115, USA.

Complex Regional Pain Syndrome (CRPS) associated with herpes zoster (HZ) was
first reported by Sudeck in 1901 (Sudeck, 1901) and is recognized clinically.
However, only 13 cases have been published in the literature, and nothing is
known about the incidence, prevalence, or natural history (Chester, 1992; Foster 
et al., 1989; Grosslight et al., 1986; Ketz and Schliack,1968; Kishimoto et al., 
1995; Querol and Cisneros, 2001; Sudeck, 1901; Visitsunthorn and Prete, 1981).
The aim of the present study was to determine the prevalence of CRPS-like
symptoms in a prospectively gathered cohort of subjects with HZ and to follow the
natural history of their pain and sensory disturbance during the first 6 months
after onset of HZ. Subjects were evaluated at four time points after HZ: 2-6
weeks, 6-8 weeks, 3 months, and 6 months. Only subjects aged 50 or older with
pain VAS ratings of >/=20/100 at 2-6 weeks were eligible. The first (screening)
visit included a neurological and physical examination that was updated at each
subsequent visit. Assessments included ratings of pain intensity, allodynia
severity, and rash severity. The neurological exam included determination of
presence or absence of the following CRPS-like symptoms: (1) increased sweating, 
(2) color changes, (3) skin temperature changes, (4) weakness of the affected
area based on physical exam, (5) edema, and (6) extension of CRPS-like symptoms
outside the affected dermatome. For subjects with HZ in dermatomes that can
include the limbs (C4-T2 and L1-S2), extremity involvement was considered present
if allodynia or rash extended beyond the neck of the humerus (upper extremity),
the inguinal ligament (anterior lower extremity), or gluteal sulcus (posterior
lower extremity). Involvement of the extremity was considered proximal if neither
HZ rash nor allodynia extended past the elbow (upper extremity) or knee (lower
extremity). Of the first 75 subjects recruited, 25 had HZ outbreaks in dermatomes
that extended into the extremities (C4-T2 and L1-S2). In this group, 8 subjects
had no extremity involvement, 8 had proximal extremity involvement, and 9 had
distal extremity involvement. Subjects with distal extremity HZ reported more
pain across the four visits (p < 0.05). At 3 months, more subjects with distal
extremity involvement met criteria for PHN (8 out of 9, 89%), while only 4 out of
8 (50%) with proximal involvement and 2 out of 8 (25%) of subjects without
extremity involvement met criteria for PHN (Chi-square test: p < 0.05). Only 25
out of the remaining 50 (50%) subjects with outbreaks in dermatomes that do not
include the extremities met criteria for PHN at 3 months (Chi-square test: p <
0.05). Six months after onset of HZ, 6 out of 9 subjects with distal extremity
involvement met PHN criteria compared with 2 out of 8 (25%) with proximal
involvement and 2 out of 8 (25%) without extremity involvement (Chi-square test: 
p = 0.12). Fifteen out of 50 (30%) subjects with outbreaks in dermatomes that do 
not include the extremities met criteria for PHN (Chi-square test: p < 0.05). No 
subject had all six CRPS-like symptoms. Of the 17 subjects with extremity
involvement, 9 subjects had '0-2 CRPS-like symptoms' and 8 had '3-5 CRPS-like
symptoms'. None of the eight subjects without extremity involvement had any
CRPS-like symptoms. Of the 50 subjects with HZ outside the extremity, only one
had abdominal weakness. Pain ratings were higher in subjects with '3-5 CRPS-like 
symptoms'. More subjects with '3-5 CRPS-like symptoms' met criteria for PHN at 3 
months (7 out of 8, 88%), compared to 5 out of 9 (55%) of subjects with '0-2
CRPS-like symptoms' (p = 0.07). At 6 months, 2 out of 9 (22%) of subjects with
'0-2 CRPS-like symptoms' met criteria for PHN, compared with 6 out of 8 (75%) of 
subjects with '3-5 CRPS-like symptoms' (Chi-square test: p < 0.03). Two
case-reports are presented. In summary, the occurrence of CRPS-like symptoms is
common in subjects with HZ outbreaks affecting the extremity, particularly if the
distal extremity is involved. It is uncertain if the pathophysiology underlying
the CRPS-like symptoms observed in this study is similar to that of CRPS from
other causes, or if it is relatively specific to HZ. Development of PHN is common
in subjects who have experienced CRPS-like symptoms. More aggressive preventive
treatments may be justified in this high-risk subset of HZ subjects to prevent
development of PHN. Prospective randomized controlled studies are needed to
determine which subjects are most likely to benefit and when treatment should
begin.

Publication Types: 
    Comparative Study

PMID: 15275746 [PubMed - indexed for MEDLINE]

1690: J Infect Dis. 2004 Aug 15;190(4):793-6. Epub 2004 Jul 15.

Rashes occurring after immunization with a mixture of viruses in the Oka vaccine 
are derived from single clones of virus.

Quinlivan ML, Gershon AA, Steinberg SP, Breuer J.

Skin Virus Laboratory, Institute of Cell and Molecular Medicine, London, United
Kingdom.

Vaccination against chickenpox causes a varicella-like rash in up to 5% of
healthy children and 50% of children with leukemia. The vaccine may establish
latency and reactivate to cause herpes zoster, albeit more rarely than wild-type 
virus. All vaccine preparations are composed of a mixture of varicella-zoster
virus strains that show genotypic variation at several loci. We have shown, by
DNA sequencing of 40 polymorphic loci, that viruses sampled from vesicles in
varicella-like and herpes zoster rashes are single clones. This finding suggests 
that, between the time of inoculation of the vaccine and development of rash,
selection of single strains occurs. The results have general implications for the
pathogenesis of varicella-zoster virus.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15272408 [PubMed - indexed for MEDLINE]

1691: Expert Rev Vaccines. 2004 Aug;3(4):391-6.

Vaccines and vaccination strategies.

Odio C.

Hospital Nacional de Ninos, Apartado 1654-1000, San Jose, Costa Rica.
codio@hnn.sa.cr

PMID: 15270643 [PubMed - indexed for MEDLINE]

1692: Rev Neurol (Paris). 2004 May;160(5 Pt 1):579-81.

[Ischemic stroke and herpes simplex virus type-1 associated meningoencephalitis]

[Article in French]

Alexandri NM, Tavernarakis A, Potagas C, Molari H, Koutra H.

Service de Neurologie, Hopital General Evangelismos, Athenes, Grece.

The etiology of stroke in young patients is often unknown. Although systemic
infections as well as specific infection agents, like herpes zoster virus or
cysticercus, are often considered as risk factors, there are no indications that 
herpes simplex type 1 plays a role in the pathogenesis of stroke. We present the 
case of a young patient who suffered a stroke during a meningoencephalitis due to
herpes simplex 1 and we review the relevant literature for a possible relation
between the two entities.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15269679 [PubMed - indexed for MEDLINE]

1693: Indian J Lepr. 2003 Jul-Sep;75(3):263-4.

Leprosy and herpes zoster; an association or dissociation?

Jain R, Dogra S, Kaur I, Kumar B.

Department of Dermatology, Venereology and Leprology, Post-graduate Institute of 
Medical Education and Research, Chandigarh 160 012, India.

Nerve involvement is common to the pathogenesis of both leprosy and herpes
zoster. We report two cases of borderline leprosy in which the skin lesions
characteristically spared the healed zoster scar. Possible mechanisms and
relationship are discussed.

Publication Types: 
    Case Reports

PMID: 15267196 [PubMed - indexed for MEDLINE]

1694: Antivir Chem Chemother. 2004 May;15(3):135-40.

Helicase primase: targeting the Achilles heel of herpes simplex viruses.

Kleymann G.

Gerald.Kleymann@freenet.de

The majority of the population is infected by several herpesviruses. Once these
infections are established the viruses persist for life. Therefore, current
therapy may at best reduce symptoms but does not cure the infection. Moreover,
the only classes of compounds licensed for systemic treatment of disease are
nucleoside, nucleotide and pyrophosphate analogues; all of these ultimately
target the herpesvirus DNA polymerase. A vaccine against varicella zoster virus
(VZV) is available, but so far no effective vaccines against other human
herpesviruses have been launched. At the same time, rising resistance to current 
medication, especially in the immunocompromised patient population, is a concern.
For these reasons, there is an urgent need for new treatment options. Recently,
some promising new drugs have been discovered; one of these compounds, developed 
at Bayer HealthCare under the name BAY 57-1293, is a potent HSV helicase primase 
inhibitor.

Publication Types: 
    Review

PMID: 15266895 [PubMed - indexed for MEDLINE]

1695: J Natl Cancer Inst Monogr. 2004;(32):23-31.

Evidence report on the treatment of pain in cancer patients.

Carr DB, Goudas LC, Balk EM, Bloch R, Ioannidis JP, Lau J.

Department of Anesthesia, Tufts-New England Medical Center, Boston, MA 02111,
USA. daniel.carr@tufts.edu

Pain associated with cancer is of widespread concern. We conducted a systematic
review to evaluate the best available evidence on the efficacy of treatments of
cancer-related pain. The sources used were MEDLINE, CancerLit, and the Cochrane
Library from 1966 through April 2001, as well as bibliographies of meta-analyses 
and review articles. We selected randomized controlled trials (RCTs) reporting on
cancer pain treatment. We recorded the study characteristics, patient and disease
characteristics, treatment comparisons, outcome measures, and results. The
methodological quality, applicability, and magnitude of treatment effect for each
study were graded. We screened 24 822 titles and selected 213 RCTs to address
specific questions. RCTs of cancer pain control often enroll few subjects, have
low methodological quality, offer little detail about pain characteristics and
mechanisms, and involve heterogeneous interventions and outcomes. Nonsteroidal
anti-inflammatory drugs (NSAIDs), opioids, selected adjuvant medications,
bisphosphonates, radionuclides, external radiation, palliative chemotherapy, and 
neurolytic celiac plexus block are each efficacious in relieving cancer pain.
However, the retrieved RCTs indicate no difference in the analgesic efficacies of
NSAIDs versus other NSAIDs, NSAIDs plus opioids versus NSAIDs alone, or NSAIDs
versus opioids. Studies of adjuvant medications and behavioral therapies are too 
few and varied to synthesize. RCTs of the analgesic effects of corticosteroids
were not retrieved in our review, although we did conduct supplemental evidence
reviews concerning pain control in oral mucositis, acute herpes zoster, or
postherpetic neuralgia. RCTs confirm the efficacy of diverse interventions in
relieving cancer pain. The optimal initial and subsequent sequence of choices
among analgesic drug types cannot be inferred from the retrieved RCTs. Patient
preferences, the relative efficacy of different routes of drug administration,
the side effects of analgesics, and the relation of pain control to quality of
life have not been studied comprehensively. The quantity and quality of
scientific evidence on cancer pain relief compare unfavorably with evidence
related to treatment of other high-impact conditions, including cancer itself.
One contributor to this gap is the heterogeneity of outcomes instruments
employed: of 218 retrieved trials, there were 125 distinct pain outcomes
assessed. In the current era of patient-centered care, improving the quality and 
combinability of trials on cancer pain relief should be a high research priority.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 15263038 [PubMed - indexed for MEDLINE]

1696: J Med Virol. 2004 Sep;74(1):102-6.

Prevalence and distribution of HSV-1, VZV, and HHV-6 in human cranial nerve
nuclei III, IV, VI, VII, and XII.

Theil D, Horn AK, Derfuss T, Strupp M, Arbusow V, Brandt T.

Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University,
Munich, Germany. dtheil@brain.nefo.uni-muenchen.de

The etiology of idiopathic cranial nerve palsies often remains unresolved. It has
been hypothesised that viral reactivation of herpesviruses in the corresponding
nuclei in the brainstem is the cause. We investigated the distribution of herpes 
simplex virus type 1 (HSV-1) and varicella zoster virus (VZV) in nuclei that are 
associated with peripheral sensory ganglia [oculomotor (nIII), facial (nVII)
nuclei] and in nuclei that are not associated with peripheral sensory ganglia
[trochlear (nIV), abducens (nVI), and hypoglossal (nXII) nuclei] of five human
brainstems. Samples of the cranial nerve nuclei and adjacent control tissue were 
taken from histological sections after precise identification of every single
nucleus and control tissue. DNA and RNA amplification methods were used to
determine the prevalence and distribution of HSV-1 and VZV. The distribution of
human herpes virus type 6 (HHV-6) was also determined and served as a control,
since HHV-6 infection has never been associated with idiopathic cranial nerve
palsies. HSV-1 was distributed at random in all cranial nerve nuclei and control 
tissue, whereas VZV DNA was not detected in any of the samples examined.
Surprisingly, HHV-6 was present in almost all samples where HSV-1 was also
present, however, the latency associated transcript (LAT) of HSV-1 was not found 
in any of the samples positive for HSV-1 DNA. The absence of LAT in the samples
positive for HSV-1 and the distribution of HSV-1 and HHV-6 do not support the
hypothesis that idiopathic cranial nerve palsies result from viral reactivation
in the brainstem nuclei.

PMID: 15258975 [PubMed - indexed for MEDLINE]

1697: Br J Ophthalmol. 2004 Aug;88(8):998-1001.

Penetrating keratoplasty: indications over a 10 year period.

Al-Yousuf N, Mavrikakis I, Mavrikakis E, Daya SM.

Corneoplastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, West
Sussex RH19 3DZ, UK.

AIMS: To determine the indications for penetrating keratoplasty (PK) at the
Corneoplastic Unit and Eye Bank, UK, a tertiary referral centre, over a 10 year
period. METHODS: Records of all patients who underwent PK at our institution
between 1990 and 1999 were reviewed retrospectively. Of the 1096 procedures
performed in this period, 784 records were available for evaluation (72%).
RESULTS: Regrafting was the most common indication, accounting for 40.9% of all
cases. Keratoconus was the second most common indication (15%), followed by
Fuchs' endothelial dystrophy (9.3%), pseudophakic bullous keratopathy (7.6%), and
viral keratitis (5.9%), which included both herpes simplex and herpes zoster and 
showed a statistically significant decreasing trend using regression analysis
(p<0.005). Among the regraft subgroup, viral keratitis accounted for 21.2% as the
underlying primary diagnosis. The most common cause for graft failure in the
regraft subgroup was endothelial failure (41.8%). CONCLUSION: Regrafting is the
leading indication for PK; viral disease-although declining-is the leading
primary diagnosis.

PMID: 15258012 [PubMed - indexed for MEDLINE]

1698: Rev Neurol. 2004 Jul 1-15;39(1):95-6.

[Central nervous system disorders caused by the herpes virus. Magnetic resonance 
imaging findings]

[Article in Spanish]

Montull-Ferrer C, Peri-Nogues J, Mercader-Sobreques JM, Aracil-Martinez MA,
Baquero M.

Centre Radiologic Computaritzat (CRC)-CRMV, Barcelona, Spain. cmontull@crccorp.es

Publication Types: 
    Case Reports

PMID: 15257534 [PubMed - indexed for MEDLINE]

1699: Korean J Ophthalmol. 2004 Jun;18(1):65-9.

A case of atypical progressive outer retinal necrosis after highly active
antiretroviral therapy.

Woo SJ, Yu HG, Chung H.

Department of Ophthalmology, College of Medicine, Seoul National University,
Seoul, Korea.

This is a report of an atypical case of progressive outer retinal necrosis (PORN)
and the effect of highly active antiretroviral therapy (HAART) on the clinical
course of viral retinitis in an acquired immunodeficiency syndrome (AIDS)
patient. A 22-year-old male patient infected with human immunodeficiency virus
(HIV) presented with unilaterally reduced visual acuity and a dense cataract.
After cataract extraction, retinal lesions involving the peripheral and macular
areas were found with perivascular sparing and the mud-cracked, characteristic
appearance of PORN. He was diagnosed as having PORN based on clinical features
and was given combined antiviral treatment. With concurrent HAART, the retinal
lesions regressed, with the regression being accelerated by further treatment
with intravenous acyclovir and ganciclovir. This case suggests that HAART may
change the clinical course of PORN in AIDS patients by improving host immunity.
PORN should be included in the differential diagnosis of acute unilateral
cataract in AIDS patients.

Publication Types: 
    Case Reports

PMID: 15255240 [PubMed - indexed for MEDLINE]

1700: Spectrochim Acta A Mol Biomol Spectrosc. 2004 Aug;60(10):2355-61.

The use of FTIR microscopy for evaluation of herpes viruses infection development
kinetics.

Erukhimovitch V, Mukmanov I, Talyshinsky M, Souprun Y, Huleihel M.

The Institute for Applied Biosciences, Ben-Gurion University of the Negev,
Beer-Sheva, Israel. evitaly@bgumail.bgu.ac.il

The kinetics of Herpes simplex infection development was studied using an FTIR
microscopy (FTIR-M) method. The family of herpes viruses includes several members
like H. simplex types I and II (HSV I, II), Varicella zoster (VZV) viruses which 
are involved in various human and animal infections of different parts of the
body. In our previous study, we found significant spectral differences between
normal uninfected cells in cultures and cells infected with herpes viruses at
early stages of the infection. In the present study, cells in cultures were
infected with either HSV-I or VZV and at various times post-infection they were
examined either by optical microscopy or by advanced FTIR-M. Spectroscopic
measurements show a consistent decrease in the intensity of the carbohydrate peak
in correlation with the viral infection development, observed by optical
microscopy. This decrease in cellular carbohydrate level was used as indicator
for herpes viruses infection kinetics. This parameter could be used as a basis
for applying a spectroscopic method for the evaluation of herpes virus infection 
development. Our results show also that the development kinetics of viral
infection has an exponential character for these viruses.

PMID: 15249025 [PubMed - indexed for MEDLINE]

1701: Rev Neurol (Paris). 2004 Jul;160(6-7):721-5.

[Thoughts on the definition of postherpetic pain: the time criterion adds
nothing]

[Article in French]

Groupe d'Experts Douleurs Neuropathiques.

In postherpetic neuralgia, as in all types of neuropathic pain, it is generally
accepted that outcome can be affected early management with specific analgesics. 
However, when one looks at the diagnostic criteria appearing in the literature,
there is no consensus. Authors use the notion of latency to situate the onset of 
postherpetic neuralgia within the continuum of herpetic pain. Depending on the
Author, this latency period ranges from one to six Months after the skin
eruption. This latency is poorly compatible with early intervention and not
well-adapted to everyday practice. With the aim of finding ways to improve the
management of pain, the Neuropathic Pain Expert Group agreed upon a new
definition. Postherpetic neuralgia is pain in the involved site after the skin
eruption has healed and which displays the features of neuropathic pain. This
definition, which does away with the latency criterion, is based on the
identification of one or more clinical features of neuropathic pain in a
situation of treatment failure, namely: presence of chronic unsolicited pain
(burning, tightness, pressure) and/or paroxysmal pain (tingling, stabbing pain)
and/or mechanical hyperalgia/allodynia (to friction or pressure) and/or
temperature sensitivity (to heat and/or cold). Such pain occurs in circumscribed 
neurologic zones in which a sensory deficit can be demonstrated and is usually
associated with dysesthesia and/or paresthesia.

Publication Types: 
    English Abstract
    Review

PMID: 15247865 [PubMed - indexed for MEDLINE]

1702: Proc Natl Acad Sci U S A. 2004 Jul 20;101(29):10792-7. Epub 2004 Jul 9.

Varicella-zoster virus infection of human neural cells in vivo.

Baiker A, Fabel K, Cozzio A, Zerboni L, Fabel K, Sommer M, Uchida N, He D,
Weissman I, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
94305, USA.

Varicella-zoster virus (VZV) establishes latency in sensory ganglia and causes
herpes zoster upon reactivation. These investigations in a nonobese diabetic
severe combined immunodeficient mouse-human neural cell model showed that VZV
infected both neurons and glial cells and spread efficiently from cell to cell in
vivo. Neural cell morphology and protein synthesis were preserved, in contrast to
destruction of epithelial cells by VZV. Expression of VZV genes in neural cells
was characterized by nuclear retention of the major viral transactivating protein
and a block in synthesis of the predominant envelope glycoprotein. The attenuated
VZV vaccine strain retained infectivity for neurons and glial cells in vivo. VZV 
gene expression in differentiated human neural cells in vivo differs from neural 
infection by herpes simplex virus, which is characterized by latency-associated
transcripts, and from lytic VZV replication in skin. The chimeric nonobese
diabetic severe combined immunodeficient mouse model may be useful for
investigating other neurotropic human viruses.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15247414 [PubMed - indexed for MEDLINE]

1703: J Biol Chem. 2004 Sep 10;279(37):38325-30. Epub 2004 Jul 5.

ORF36 protein kinase of Kaposi's sarcoma herpesvirus activates the c-Jun
N-terminal kinase signaling pathway.

Hamza MS, Reyes RA, Izumiya Y, Wisdom R, Kung HJ, Luciw PA.

Center for Comparative Medicine, University of California, Davis, California
95616, USA.

alpha-, beta-, and gamma-Herpesviruses encode putative viral protein kinases. The
herpes simplex virus UL13, varicella-zoster virus ORF47, and Epstein-Barr virus
BGLF4 genes all show protein kinase domains in their protein sequences.
Mutational analysis of these herpesviruses demonstrated that the viral kinase is 
important for optimal virus growth. Previous studies have shown that ORF36 of
Kaposi's sarcoma herpesvirus (KSHV) has protein kinase activity and is
autophosphorylated on serine. The gene for ORF36 is expressed during lytic growth
of the virus and has been classified as a late gene. Inspection of the ORF36
sequence indicated potential motifs that could be involved in activation of
cellular transcription factors. To analyze the function of ORF36, the cDNA for
this viral gene was tagged with the FLAG epitope and inserted into an expression 
vector for mammalian cells. Transfection experiments in 293T and SLK cells
demonstrated that expression of ORF36 resulted in phosphorylation of the c-Jun
N-terminal kinase. Autophosphorylation of ORF36 is important for JNK activation
because a mutation in the predicted catalytic domain of ORF36 blocked its ability
to phosphorylate JNK. Western blot analysis, using phosphospecific antibodies,
revealed that mitogen-activated kinases MKK4 and MKK7 were phosphorylated by
ORF36 but not by the kinase-negative mutant. Binding experiments in transfected
cells also demonstrated that both the wild type and kinase-negative mutant of
ORF36 form a complex with JNK, MKK4, and MKK7. In addition, using a
tetracycline-inducible Rta BCBL-1 cell line (TREx BCBL1-Rta), JNK was
phosphorylated during lytic replication, and inhibition of JNK activation blocked
late viral gene expression but not early viral gene expression. In summary, these
studies demonstrate that KSHV ORF36 activates the JNK pathway; thus this cell
signaling pathway may function in the KSHV life cycle by regulating viral and/or 
cellular transcription.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15247271 [PubMed - indexed for MEDLINE]

1704: Clin Exp Dermatol. 2004 Jul;29(4):366-8.

A granulomatous response to tribal medicine as a feature of the immune
reconstitution syndrome.

Farrant P, Higgins E.

Kings College, London, UK. sonal@shankar-lall.freeserve.co.uk

Summary Immune reconstitution is a well recognized phenomenon associated with the
use of highly active antiretroviral therapy (HAART) for HIV infection. After the 
administration of HAART there is a rise in CD4 T-cell count in the circulation
brought about by cessation of HIV replication. This allows the body to respond to
antigens that it previously ignored. This manifests itself most commonly as an
overt illness to previously ignored pre-existing infections such as Mycobacterium
tuberculosis, herpes simplex virus, varicella zoster virus, hepatitis B and C
viruses, cytomegalovirus, cryptococcal infection, human papilloma virus and
molluscum contagiosum. There are further reports of reactions to sarcoid and
tattoo pigment and one previous case reported of a granulomatous reaction to a
foreign body. We report another case of a foreign body granuloma reaction, to
tribal medicine implanted in tribal marks made in childhood in a Zimbabwean
woman. This reaction is part of the immune reconstitution syndrome.

Publication Types: 
    Case Reports

PMID: 15245531 [PubMed - indexed for MEDLINE]

1705: Wien Med Wochenschr. 2004 May;154(9-10):209-17.

[Opportunistic infections after treatment with monoclonal antibodies]

[Article in German]

Cornely OA, Ullmann AJ, Karthaus M.

Hamatologie, Onkologie, Klinische Infektiologie, Klinikum der Universitat Koln,
Deutschland. oliver.cornely@uni-koeln.de

During recent years the therapeutic indications of monoclonal antibodies are on
the increase. Most monoclonal antibodies are immunosuppressants. Thus,
therapeutic successes are accompanied by an increase of serious infections.
Closest cooperation between the haematologist/oncologist and the infectious
diseases specialist is a prerequisite for the successful outcome of treatment of 
the individual patient. Rituximab and alemtuzumab especially pave the way for a
variety of opportunistic infections. Prophylactic drugs directed against
bacterial infections and invasive fungal infections have not been proven to be
useful. Although the efficacy of prophylactic cotrimoxazole against Pneumocystis 
carinii pneumonia has not been thoroughly examined in this setting, it is usually
given at a dose of two double-strength tablets every other day. Whether
reactivation of herpes simplex and varizella zoster can be influenced
prophylactically has not been studied in randomised trials. In case of fever and 
detection of cytomegalovirus reactivation preemptive therapy should be given.

Publication Types: 
    Comparative Study
    English Abstract
    Review

PMID: 15244046 [PubMed - indexed for MEDLINE]

1706: Rev Laryngol Otol Rhinol (Bord). 2004;125(1):23-9.

[Delayed facial palsy after vestibular schwannoma resection: the role of viral
reactivation. Our experience in 8 cases]

[Article in French]

Nguyen DQ, Franco-Vidal V, Guerin J, Darrouzet V.

CHU de Grenoble, Hopital La Tronche, Service ORL, F-38000 Grenoble, France.

OBJECTIVE: To study the role of herpes virus reactivation in the onset of more
than three days-delayed facial paralysis (FP) following vestibular schwannoma
(VS) surgery and advocate a specific medical management. MATERIAL AND METHODS:
Retrospective study on 8 cases from a series of 348 patients operated on of a VS 
between 1996 and 2002. Seven of the eight patients were given intravenously
acyclovir (30 mg x kg(-1) x d(-1) for 5 days) and methyl-prednisolone (2 mg x
kg(-1) x d(-1) for 7 days). A serologic testing looking for specific anti-herpes 
simplex viruses type 1 and 2 (HSV-2) and varicella-zoster virus (VZV) antibodies 
at the onset of the FP and 2 weeks later could be done in only 3 cases. RESULTS: 
Mean delay of FP onset was 8.75 days. Mean time for recovery with intravenous
treatment was 90 days. All treated patients had a House and Brackmann grade 1
recovery. The last one had only a grade 3 after 400 days of evolution: he could
not be treated because of postoperative transient psychiatric problems. Serologic
testing revealed in those patients in whom it could be done either a high level
of anti-HSV or -VZV antibodies at the time of onset or a dramatic increase in
anti-HSV or anti-VZV antibodies between the two samples, strongly suggesting a
HSV or VZV reactivation. CONCLUSION: HSV or VZV reactivation can be evocated in
most cases of delayed FPs arising in the postoperative course of VSs, suggesting 
usefulness of emergency-given steroid and acyclovir intravenous regimen to block 
virus replication and fight secondary oedema and inflammation causative of nerve 
lesions. Evoked reactivation mechanism is comparable to that already suspected in
delayed FP arising with the same delay in middle ear surgical procedures.

Publication Types: 
    English Abstract

PMID: 15244025 [PubMed - indexed for MEDLINE]

1707: J Am Acad Dermatol. 2004 Jul;51(1):123-6.

Cutaneous T-cell lymphoma sparing resolving dermatomal herpes zoster lesions: an 
unusual phenomenon and implications for pathophysiology.

Twersky JM, Nordlund JJ.

Department of Dermatology, University of Cincinnati Medical Center, USA.

Exclusion of cutaneous T-cell lymphoma (CTCL) by another dermatosis has not been 
reported. The mechanism for the epidermotropism of helper T lymphocytes in this
indolent malignancy is not known. Although there is evidence that Langerhans
cells (LC) play a role in the epidermotropism of lymphocytes in CTCL, clinical or
in vivo support is lacking. We describe a patient with CTCL who developed herpes 
zoster involving the left T8 dermatome. When his CTCL became widespread after the
herpes zoster healed, the previously affected areas of herpes zoster and their
periphery were clinically free of lymphoma. Immunohistochemical analysis of a
clinically uninvolved patch revealed absence of CD1a(+) cells in the epidermis,
consistent with loss of LC in the areas spared by CTCL. There was no loss of LC
in areas affected by CTCL. This is an unusual inhibition of CTCL by a prior viral
infection. The loss of LC in the clinically spared skin suggests a role for LC in
the epidermotropism of lymphocytes in CTCL.

Publication Types: 
    Case Reports

PMID: 15243537 [PubMed - indexed for MEDLINE]

1708: J Cutan Pathol. 2004 Aug;31(7):465-70.

Laser-capture microdissection: applications in routine molecular
dermatopathology.

Yazdi AS, Puchta U, Flaig MJ, Sander CA.

Department of Dermatology, Ludwig- Maximilians-University, Munich, Germany.

Advances in molecular pathology with the introduction of the Southern blot
technique and the polymerase chain reaction (PCR) have emerged as important
tools, which are frequently used in routine dermato-histopathology. Applications 
for PCR-based diagnostics are particularly helpful for the determination of
clonality in cutaneous lymphocytic infiltrates and for detection of infectious
agents, such as herpes simplex virus (HSV), varicella zoster virus (VZV),
Borrelia burgdorferi, Mycobacteria, Leishmania, and Treponema pallidum. As
biopsies are always composed of different cells, the cells of interest are often 
only a minor population. As a consequence, their specific DNA is diluted by the
majority of contaminating cells. Another problem is the time- and labor-intensive
DNA extraction, because usually only formalin-fixed, paraffin-embedded tissue is 
available, which makes molecular diagnostics a time and labor consuming, and
consequently a cost-intensive procedure. To overcome these shortcomings and to
eventually shorten the time to generate a result, we introduce a laser-capture
microdissection (LCM)-based method for the detection of infectious agents and
clonality. Only the cells of interest for the particular indication are
microdissected (e.g. epidermal cells for HSV and VZV and lymphocytes for
clonality analysis) and subjected to PCR amplification. Due to an accelerated
DNA-extraction procedure which generates DNA in 5 h (compared to 3-4 days using
conventional DNA extraction), we are able to generate a result within one working
day.

Publication Types: 
    Review

PMID: 15239675 [PubMed - indexed for MEDLINE]

1709: Health News. 2004 Jul;10(7):9.

Older women face higher risk of post-shingles pain.

[No authors listed]

Publication Types: 
    News

PMID: 15239158 [PubMed - indexed for MEDLINE]

1710: No To Shinkei. 2004 Apr;56(4):339-43.

[Dramatic improvement of urinary retention and the left lower limb paresis with
methylprednisolone in a case of regional encephalitis following varicella zoster 
infection]

[Article in Japanese]

Kubota M, Kawamura M.

Department of Pediatrics, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo
113-8655, Japan.

We report a previously well 14-year-old male who developed left-sided
hemiconvulsion, urinary retention and hemiplegia 1 months after varicella-zoster 
virus (VZV) infection. Brain T2-weighted MRI showed hyperintensity in medial
fronto-parietal area including cyngulate gyrus, foot division of the motor
cortex, para-central lobule and corpus callosum with right predominance, which
corresponded to hyperperfusion area in SPECT study. MR angiography revealed no
occlusion or narrowing of vessels. Cerebrospinal fluid (CSF) showed mononuclear
pleocytosis. After methylprednisolone pulse tharapy under diagnosis of regional
encephalitis, the patient recovered completely. Although polymerase chain
reaction(PCR) could not detect VZV-DNA in CSF, antecedent VZV infection might be 
closely related to pathomechanism of the regional encephalitis. Dramatic response
to steroid, rapid recovery on MRI and good prognosis supported that the
underlying pathology was mainly vasogenic edema rather than cytotoxic edema.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15237726 [PubMed - indexed for MEDLINE]

1711: Eur Arch Otorhinolaryngol. 2005 Apr;262(4):331-4. Epub 2004 Jul 2.

Incidence of virus infection as a cause of Meniere's disease or endolymphatic
hydrops assessed by electrocochleography.

Selmani Z, Marttila T, Pyykko I.

Department of Otolaryngology, Central Hospital of Satakunta, Sairaalantie 3,
28130, Pori, Finland. ziane_selmani@hotmail.com

Meniere's disease (MD) may follow viral infection such as by neurotropic viruses 
known to invade the endolymphatic sac (ES) and provoke endolymphatic hydrops
(EH). The objective of this study was to investigate whether neurotropic viruses 
may cause infection of the inner ear and provoke EH. Antiviral immunoglobulin
(IgG) assay against herpes simplex 1 (HSV1), herpes simplex 2 (HSV2), adenovirus 
(ADV), varicella zoster virus (VZV) and cytomegalovirus (CMV) were performed in
109 patients with an advanced stage of MD and compared with those obtained from
26 patients operated on because of vestibular schwannoma (VS), who served as a
control group, to evaluate whether there is an association between the IgG levels
and the ECoGs summating potential/action potential ratio (SP/AP ratio) in the MD 
group. In MD patients, the IgG titre against VZV and ADV were significantly
higher than in the control (schwannoma) group. However, no correlation was found 
between the IgG levels against ADV and VZV with the SP/AP ratio. Neurotropic
viruses such VZV and ADV may play a role in the pathogenesis of MD, despite the
absence of association between the levels of IgG titres and the SP/AP ratio.

PMID: 15235799 [PubMed - indexed for MEDLINE]

1712: Am J Ophthalmol. 2004 Jul;138(1):46-54.

Comment in:
    Am J Ophthalmol. 2004 Dec;138(6):1087; editor reply 1087.    Am J Ophthalmol. 2004 Jul;138(1):133-4.

Fuchs heterochromic cyclitis: rubella virus antibodies and genome in aqueous
humor.

Quentin CD, Reiber H.

Department of Ophthalmology, Georg-August University, Robert-Koch-Strasse 40,
37075 Gottingen, Germany.

PURPOSE: To characterize the polyspecific intraocular antibody synthesis in
aqueous humor of patients with chronic inflammatory diseases of the eye and to
detect the causative antigen in Fuchs heterochromic cyclitis (FHC). DESIGN:
Retrospective case-control study. METHODS: Intraocular antibody synthesis is
detected in aqueous humor with the Antibody Index [AI] (improved Goldmann-Witmer 
Index) and quantified as specific antibody fraction, F(s) (intraocular specific
antibody concentration in percent of intraocular total immunoglobulin G in
aqueous humor). Virus detection is by nested polymerase chain reaction. RESULTS: 
Fifty-two eyes of 52 patients with clinically defined FHC (aged 16-73 years) had 
an intraocular synthesis of rubella antibodies (AI > or =1.5). The rubella genome
was detected in 5 (18%) of 28 aqueous humor samples investigated, or in 5 (56%)
of 9 patients aged <40 years. Oligoclonal IgG was synthesized in 34 (87%) of 39
eyes. Unaffected fellow eyes (n = 3) or cerebrospinal fluid (n = 2) were normal. 
In FHC the median rubella AI = 20.6 (total range 1.5-309) was seven times higher 
than in multiple sclerosis (MS) patients (n = 15) with uveitis intermedia or
periphlebitis retinae. In MS the intraocular rubella antibody synthesis
(frequency 73%) is part of a polyspecific immune response (increased measles AI
in 80%, varicella zoster virus AI in 47%, herpes simplex virus AI in 23%). The
median rubella-F(s) = 2.6% in FHC (range = 0.14%-45.9%) was approximately 40
times higher than in MS, consistent with a virus-driven antibody response in FHC.
Noninflammatory controls (50 senile cataracts) had neither an intraocular rubella
antibody synthesis (normal AI < or =1.4) nor rubella antigen in aqueous humor.
The rubella AI was normal in all patients with an intraocular toxoplasmosis (n = 
24), anterior uveitis (n = 27), herpes simplex virus iritis (n = 25), and
varicella zoster virus iritis (n = 14). CONCLUSIONS: Fuchs heterochromic cyclitis
is a rubella virus-driven disease with persistence of the virus preferentially
detected in the younger patients. The proposed laboratory supported diagnosis of 
FHC is based on the increased rubella Antibody Index. The virus etiology gives a 
rationale for omitting the ineffective corticosteroid therapy of FHC.

PMID: 15234281 [PubMed - indexed for MEDLINE]

1713: Kaohsiung J Med Sci. 2004 May;20(5):216-24.

Cutaneous manifestations of human immunodeficiency virus infection in Taiwan.

Tzung TY, Yang CY, Chao SC, Lee JY.

Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung,
Taiwan.

Cutaneous manifestations are common and often the presenting feature of human
immunodeficiency virus (HIV) infection, but a comprehensive study of
HIV-associated skin lesions is not available in Taiwan. We reviewed all skin
lesions in all HIV patients diagnosed in our department between 1990 and 1998 to 
document the spectrum of skin manifestations, the frequency of each disorder, and
their relationship with CD4 counts. A total of 64 HIV patients were studied,
including 38 with acquired immunodeficiency syndrome (AIDS) (CD4 < 200 x 10(6)
cells/L) and 26 who had not developed AIDS (non-AIDS). There were 142 episodes of
skin conditions representing 25 different skin diseases, including oral
candidiasis (15% in non-AIDS vs 71% in AIDS patients), drug eruptions, herpes
simplex, seborrheic dermatitis, dermatophytosis, herpes zoster, secondary
syphilis, condyloma acuminatum, Kaposi's sarcoma (16% among AIDS patients), hairy
leukoplakia, and molluscum contagiosum (13% among AIDS patients), in decreasing
order. Several unusual cases are briefly described, including verrucous herpes
infection, condyloma-like molluscum contagiosum, and AIDS-associated pigmented
erythroderma. In our study, 70% of all HIV patients had skin diseases, with an
average of 2.2 conditions per patient (3.2 in AIDS patients vs 0.7 in non-AIDS
patients; p < 0.001). A broad spectrum of HIV-associated skin diseases was
observed in our series. The frequency of HIV-associated skin disease was 92% in
AIDS patients and 39% in non-AIDS patients; 78% of skin lesions in AIDS patients 
were diagnosed when CD4 counts were below 100 x 10(6) cells/L.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15233232 [PubMed - indexed for MEDLINE]

1714: Eye. 2005 Feb;19(2):224-6.

Horner's syndrome and sixth nerve palsy due to herpes zoster ophthalmicus
arteritis.

Pandey PK, Garg D, Bhatia A, Jain V.

Publication Types: 
    Case Reports
    Letter

PMID: 15232597 [PubMed - indexed for MEDLINE]

1715: Mol Diagn. 2004;8(1):1-9.

Detection of multiple human herpes viruses by DNA microarray technology.

Foldes-Papp Z, Egerer R, Birch-Hirschfeld E, Striebel HM, Demel U, Tilz GP,
Wutzler P.

Clinical Immunology and Jean Dausset Laboratory, Graz University Medical School, 
Graz, Austria. Zeno.Foldes-Papp@uni-graz.at

BACKGROUND: The detailed characterization of virus DNA is a challenge, and the
genotyping that has been achieved to date has only been possible because
researchers have sent a great deal of time and effort to do so. Instead of the
simultaneous detection of hundreds of viruses on a single high-density DNA-chip
at very high costs per chip, we present here an alternative approach using a
well-designed and tailored microarray which can establish whether or not a
handful of viral genes are present in a clinical sample. METHODS: In this study
we applied a new concept of microarray-based, optimized and robust biochemistry
for molecular diagnostics of the herpesviruses. For comparison, all samples were 
genotyped using standard procedures. RESULTS: The biochemical procedure of a
knowledge-based, low-density microarray was established based on the molecular
diagnostics of human herpes viruses: herpes simplex virus (HSV) HSV-1, HSV-2,
varicella zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV),
and HHV-6. The study attempted to optimize parameters of microarray design,
surface chemistry, oligonucleotide probe spotting, sample labeling and DNA
hybridization to the developed DNA microarray. The results of 12 900
hybridization reactions on about 150 configured herpes virus microarrays showed
that the established microarray-based typing procedure was reproducible,
virus-specific and sufficiently sensitive with a lower limit of 100 viral copies 
per mL sample. CONCLUSIONS: The developed method utilizes low-fluorescence
background coverslips, epoxy surface chemistry, standardized oligonucleotide
probe spotting, PCR-labeling with Cy3 of isolated DNA, array hybridization, and
detecting of specific spot fluorescence by an automatic microarray reader. We
expect the configured microarray approach to be the method for high-throughput
associated studies on human herpes viruses.

Publication Types: 
    Comparative Study

PMID: 15230636 [PubMed - indexed for MEDLINE]

1716: J Pediatr Health Care. 2004 Jul-Aug;18(4):192-7; quiz 198-9.

Childhood immunizations (part two).

Whitehill J, Raucci J, Sandritter T.

Children's Mercy Hospital, 2401 Gillham Rd., Kansas City, MO 64108, USA.

Publication Types: 
    Review

PMID: 15224044 [PubMed - indexed for MEDLINE]

1717: J Med Virol. 2004 Aug;73(4):631-5.

Are false negative direct immnufluorescence assays caused by varicella zoster
virus gE mutant strains?

Taha YA, Quinlivan M, Scott FT, Leedham-Green M, Hawrami K, Thomas JM, Breuer J.

Skin Virus Laboratory, Centre for Cutaneous Research, St Bartholomew's and The
Royal London School of Medicine and Dentistry, Queen Mary College, London, United
Kingdom.

Strains of Varicella zoster virus (VZV) have been described recently in which a
single base mutation in the gE epitope abrogates binding of the 3B3 monoclonal
antibody, which is widely used for virus detection in diagnostic laboratories.
These strains, named VZV-MSP, are associated with a distinct phenotype in both in
vitro culture and in SCID-hu mice. We investigated the possibility that negative 
direct immunofluorescence results, using the 3B3 antibody, where the presence of 
virus was confirmed by polymerase chain reaction (PCR) or tissue culture are due 
in some cases to the MSP strain of VZV. A total of 249 vesicle fluid specimens
from people with suspected shingles were examined using direct
immunofluorescence, tissue culture and a nested multiplex PCR for VZV, herpes
simplex virus type 1 (HSV-1) and 2 (HSV-2). VZV was detected in 218 of 249
(87.6%) cases. Forty-five confirmed VZV specimens, but with negative (30) or
indeterminate (15) immunofluorescence results, were analysed further. PCR was
used to amplify a fragment in ORF 68 that encodes the VZV gE ectodmain recognised
by 3B3 antibody. The fragments were sequenced and analysed for the single base
change G448A (D150N), which is present in VZV-MSP as compared with the reference 
Dumas strain. No VZV gE mutant (MSP/MSP-like) was detected. Overall, PCR was
found to be the most sensitive method of confirming VZV infection. False negative
VZV immunofluorescence results are unlikely to be due to virus variants.
Copyright 2004 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15221911 [PubMed - indexed for MEDLINE]

1718: Anesthesiology. 2004 Jul;101(1):244-7.

Spinal alcohol neurolysis for intractable thoracic postherpetic neuralgia after
test bupivacaine spinal analgesia.

Lauretti GR, Trevelin WR, Frade LC, Lima IC.

Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo,
Brazil. grlauret@fmrp.usp.br

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 15220798 [PubMed - indexed for MEDLINE]

1719: Nefrologia. 2004;24 Suppl 3:26-9.

[Multiple complications after renal transplantation]

[Article in Spanish]

Manrique J, Rossich E, Hernandez Sierra A.

Servicio de Nefrologia, Clinica Universitaria de Navarra, Pamplona.
jmanrique@unav.es

This is the case of a 32-year-old male patient, diagnosed with end stage renal
disease secondary to a focal and segmental glomerulonephritis. After four years
of haemodialysis, he received a renal graft from a cadaveric donor. During the
following sixteen years, he developped many different complications. In the early
post-transplant period, he developed a severe acute tubular necrosis and two
episodes of acute rejection took place, both of them with later recovery. Among
the outstanding infectious complications were a virus herpes zoster dorsal
infection and a Pseudomonas aeruginosa nosocomial pneumonia. Twelve months later,
a series of severe digestive complications took place: cholecystitis that
required cholecystectomy, pancreatic pseudocyst which required laparotomy because
of an abdominal complication, two separate episodes of upper digestive bleeding
that finally required gastric surgery, and an hemorrhagic subphrenic abscess that
required a second laparotomy. Currently he has developed a calcified chronic
pancreatitis. Moreover, metabolic complications must be mentioned carbohydrate
intolerance, cataracts and an avascular bone necrosis, all of them closely
related to the immunosuppressive therapy. In spite of these multiple
complications, he mantains a good renal function and his quality of life is
acceptable.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15219064 [PubMed - indexed for MEDLINE]

1720: J Oral Maxillofac Surg. 2004 Jul;62(7):840-4.

The use of botulinum toxin type A in the treatment of Frey and crocodile tears
syndromes.

Kyrmizakis DE, Pangalos A, Papadakis CE, Logothetis J, Maroudias NJ, Helidonis
ES.

Department of Otolaryngology, University of Crete School of Medicine, Heraklion, 
Crete, Greece. dkyrmiz@yahoo.com

PURPOSE: We sought to investigate the efficacy of botulinum toxin type A in the
treatment of Frey and crocodile tears syndromes. Frey syndrome is a common
complication after surgical intervention or injury in the region of the parotid
gland. Crocodile tears syndrome is unusual and manifests after facial nerve
paralysis and other causes such as head trauma. PATIENTS AND METHODS: This was a 
prospective nonrandomized, nonblinded study. We used botulinum toxin type A for
the treatment of 11 patients with gustatory sweating and 2 patients with
crocodile tears syndrome. RESULTS: The follow-up (6 to 23 months) of patients
with gustatory sweating syndrome showed complete absence of sweating in the
affected regions. One patient had recurrence after 16 months and was retreated
successfully. At 1 and 24 weeks after treatment of the patients with the
crocodile tears syndrome, the Schirmer test showed a reduction of stimulated
lacrimation on the impaired side approaching the normal values of the unaffected 
side. CONCLUSIONS: Our study supports the widely accepted aspect that botulinum
toxin type A could be the treatment of choice for gustatory sweating syndrome. We
also propose the toxin as a valuable treatment for crocodile tears syndrome.

Publication Types: 
    Clinical Trial

PMID: 15218563 [PubMed - indexed for MEDLINE]

1721: Prog Urol. 2004 Apr;14(2):224-6; discussion 226.

[Urinary retention secondary to herpes zoster infection]

[Article in French]

Game X, Bigay-Game L, Bialek D, Sailler L, Astudillo L, Rischmann P.

Service d'Urologie, d'Andrologie et de Transplantation Renale, CHU Rangueil,
Toulouse, France. xaviergame@hotmail.com

The authors report the cases of 67-year-old male patient who suddenly developed
urinary retention concomitant with herpes zoster of the left buttock. Urodynamic 
assessment showed a hyposensitive and atonic bladder. Voiding gradually returned 
after 10 weeks and, after 14 weeks, the patient no longer presented any voiding
disorders. This case illustrates a rare complication of herpes zoster. It can
occur in any site of infection, but is more frequent in the case of lumbosacral
lesions. Urinary retention is spontaneously reversible over a mean interval of 6 
to 10 weeks and treatment is based on self-catheterization.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15217143 [PubMed - indexed for MEDLINE]

1722: Ginecol Obstet Mex. 2004 Feb;72:63-7.

[Herpes zoster in immunocompetent pregnant women and their perinatal outcome]

[Article in Spanish]

Casanova Roman G, Reyna Figueroa J, Figueroa Damian R, Ortiz Ibarra J.

Departamento de Infectologia e Inmunologia Perinatal, Instituto Nacional de
Perinatologia.

A prospective and descriptive study was done in pregnant women diagnosed with
herpes zoster, to know the demographic characteristics and clinical
manifestations as well as maternal and/or neonatal complications to cause by this
viral infection during pregnancy. The study included all pregnant women diagnosed
with herpes zoster at the Department of Infectious Diseases of the Instituto
Nacional de Perinatologia Mexico, between 1994 and 2002. A total of 17 women were
included in the study. All were given clinical and ultrasound follow-up to
discard any maternal or fetal complications also at the moment of birth. A review
in the newborn was made to establish the demographic, anthropometric and clinical
characteristics; also the data collected included mother's age, gestational age
at the moment of diagnosis with herpes zoster, anatomical lesion site, treatments
administered, ultrasound characteristics, newborn's gestational age, weight,
height, Apgar at birth and type of delivery. The most frequent site (58.8%) for
herpes zoster lesions on the mother was the intercostal area, followed by the
scapular region, the lumbar region and the limbs. None of the patients
experienced complications during pregnancy, including post-herpetic pain. Sixteen
of the newborns had no complications and one was a stillborn due to 60% of
placental separation. These findings suggest a benign evolution of herpes zoster 
during pregnancy, supporting similar findings in the literature. No complications
during pregnancy are suggested, and no phenotypical alterations occurred in the
child at the moment of birth.

Publication Types: 
    English Abstract

PMID: 15216903 [PubMed - indexed for MEDLINE]

1723: J Infect Dis. 2004 Jul 15;190(2):267-70. Epub 2004 Jun 9.

Varicella-Zoster virus-specific cell-mediated immunity in HIV-infected children
receiving highly active antiretroviral therapy.

Weinberg A, Wiznia AA, LaFleur BJ, Shah S, Levin MJ.

Section of Pediatric Infectious Diseases, and Department of Medicine, University 
of Colorado School of Medicine, Denver, Colorado, USA. adriana.weinberg@uchsc.edu

Herpes zoster (HZ) is a frequent complication of advanced human immunodeficiency 
virus (HIV) infection. We determined the effect of highly active antiretroviral
therapy (HAART) on reconstitution of varicella-zoster virus (VZV)-specific
cell-mediated immunity (VZV-CMI) in 56 VZV- and HIV-infected children. VZV-CMI
did not change over the course of >/=3 years of observation, despite a reduction 
in HIV load. VZV-CMI correlated with lower HIV load but not with CD4 cell
percentage. The incidence of HZ was unaffected by HAART. None of 5 patients who
developed HZ during the study had VZV-CMI before developing HZ. After developing 
HZ, only the 2 HAART-compliant patients developed VZV-CMI. Thus, VZV-specific
immune reconstitution in HIV infection may require antigenic reexposure, in
addition to control of HIV replication.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15216460 [PubMed - indexed for MEDLINE]

1724: Neurosurgery. 2004 Jul;55(1):135-41; discussion 141-2.

Peripheral stimulation for treatment of trigeminal postherpetic neuralgia and
trigeminal posttraumatic neuropathic pain: a pilot study.

Johnson MD, Burchiel KJ.

Department of Neurological Surgery, Harvard Medical School and Brigham and
Women's Hospital, Boston, Massachusetts, USA.

OBJECTIVE: Trigeminal neuropathic pain (TNP) after facial trauma or herpes zoster
infection is often refractory to treatment. Peripheral nerve stimulation has been
used to treat occipital neuralgia; however, efficacy in controlling facial TNP or
postherpetic neuralgia is unknown. A retrospective case series of patients who
underwent subcutaneous placement of stimulating electrodes for treatment of V(1) 
or V(2) TNP secondary to herpetic infection or facial trauma is presented.
METHODS: Ten patients received implanted subcutaneous pulse generators and
quadripolar electrodes for peripheral stimulation of the trigeminal nerve
supraorbital or infraorbital branches. Long-term treatment results were
determined by retrospective review of medical records (1998-2003) and by
independent observers interviewing patients using a standard questionnaire.
Surgical complication rate, preoperative symptom duration, degree of pain relief,
preoperative and postoperative work status, postoperative changes in medication
usage, and overall degree of therapy satisfaction were assessed. Mean follow-up
was 26.6 +/- 4.7 months. RESULTS: Peripheral nerve stimulation provided at least 
50% pain relief in 70% of patients with TNP or postherpetic neuralgia. Medication
use declined in 70% of patients, and 80% indicated that they were mostly or
completely satisfied with treatment overall. There were no treatment failures
(<50% pain relief and a lack of decrease in medication use) in the posttraumatic 
group, and two failures (50%) occurred in the postherpetic group. The
complication rate requiring reoperation was 30%. CONCLUSION: Peripheral nerve
stimulation of the supraorbital or infraorbital branches of the trigeminal nerve 
is an effective method for relief of TNP after facial trauma or herpetic
infection. A prospective trial using this novel approach to treat these disorders
is thus warranted.

Publication Types: 
    Clinical Trial

PMID: 15214982 [PubMed - indexed for MEDLINE]

1725: Br J Dermatol. 2004 Jun;150(6):1129-35.

Cutaneous findings in chronic lymphocytic leukaemia.

Agnew KL, Ruchlemer R, Catovsky D, Matutes E, Bunker CB.

Department of Dermatology The Royal Marsden Hospital, London SW3 6JJ, U.K.
karenagnew@lineone.net

BACKGROUND: Chronic lymphocytic leukaemia (CLL) is a malignancy characterized by 
clonal expansion of B lymphocytes with distinct morphology and immunophenotype.
The dermatological literature relating to CLL is sparse. A global descriptive
survey of a large number of CLL patients has not previously been published.
OBJECTIVES: To report the spectrum of dermatological conditions seen in a large
series of CLL patients. METHODS: Skin complications in patients with established 
CLL were identified retrospectively from clinical and photographic records,
principally a database of over 750 consecutive cases. These events were
classified, enumerated and compared. RESULTS: Forty patients with 125 skin
manifestations were identified and studied. Forty-one manifestations had
documented clinical or histological atypia. In 21 of these 41 complications there
had been no prior immunosuppressive therapy. We observed that cutaneous
malignancies frequently presented atypically both clinically and histologically. 
There were 18 patients with 56 instances of basal cell carcinoma (BCC) or
squamous cell carcinoma (SCC), and clinical atypia was more common with SCC than 
with BCC. Other cutaneous findings included varicella zoster (n = 6), leukaemia
cutis (n = 3), acute graft-versus-host disease (n = 5), cutaneous drug eruptions 
(n = 9), multiple warts (n = 3), herpes simplex (n = 3), cutaneous T-cell
lymphoma (n = 2), eosinophilic folliculitis (n = 2), malignant melanoma (n = 2)
and Merkel cell tumour (n = 2). CONCLUSIONS: We have identified a range of
dermatological conditions in CLL patients, with a tendency to atypical
presentations. The atypia was independent of prior chemotherapy.

PMID: 15214899 [PubMed - indexed for MEDLINE]

1726: Neurology. 2004 Jun 22;62(12):2277-82.

An altered immune response to Epstein-Barr virus in multiple sclerosis: a
prospective study.

Sundstrom P, Juto P, Wadell G, Hallmans G, Svenningsson A, Nystrom L, Dillner J, 
Forsgren L.

Department of Neurology, Umea University Hospital, Sweden.
peter.sundstrom@neuro.umu.se

OBJECTIVE: To investigate the association between human herpesviruses and
multiple sclerosis (MS), as well as between measles virus and MS. METHODS: The
authors identified prospectively collected serum samples from 73 MS cases and
retrospective sera from 161 MS cases in two population-based serum bank
registers. Analyses of IgG antibody responses in cases and matched referents were
performed for Epstein-Barr virus (EBV [EBNA-1 and VCA]), human herpesvirus 6
(HHV-6), herpes simplex virus (HSV), varicella zoster virus (VZV), and measles.
RESULTS: All cases showed signs of past EBV infection. High activity to EBNA-1
and HHV-6 significantly (borderline significance for HHV-6) increased the risk
for MS in prospective sera. A discrepancy between activities to EBNA-1 and VCA
was striking in MS samples collected less than 5 years before relapsing-remitting
MS onset, where high activity to EBNA-1 significantly increased, and high VCA
activity significantly decreased the risk for MS. There was no support for major 
causal roles for HSV, VZV, or measles. CONCLUSION: Individuals who will develop
MS exhibit an altered immune response against the EBV virus characterized by a
high IgG activity to EBNA-1 in the absence of high activity to VCA, this being
most pronounced in the 5-year period preceding MS onset.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15210894 [PubMed - indexed for MEDLINE]

1727: Neuromuscul Disord. 2004 Jul;14(7):438-41.

External ophthalmoplegia due to ocular myositis in a patient with ophthalmic
herpes zoster.

Krasnianski M, Sievert M, Bau V, Zierz S.

Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle
(Saale), Germany. sekretariat.neurologie@medizin.uni-halle.de

External ocular muscle palsies in patients with ophthalmic zoster are
traditionally interpreted as diseases of III, IV or VI cranial nerves. Orbital
myositis associated with zoster ophthalmicus has been diagnosed only rarely. We
describe a patient with ophthalmic zoster and external ophthalmoplegia due to
ocular myositis demonstrated by MR imaging. Treatment with acyclovir and
cortisone resulted in a rapid improvement of the ophthalmoplegia. In ophthalmic
herpes zoster associated with external ocular muscle palsies, ocular myositis is 
an important differential diagnosis to inflammatory involvement of the cranial
nerves III, IV, and VI.

Publication Types: 
    Case Reports

PMID: 15210167 [PubMed - indexed for MEDLINE]

1728: J Am Geriatr Soc. 2004 Jul;52(7):1221-2.

Squamous cell carcinoma occurring at site of prior herpes zoster of the scalp:
case report of Marjolin ulcer.

Mishra D, Raji MA.

Publication Types: 
    Case Reports
    Letter

PMID: 15209673 [PubMed - indexed for MEDLINE]

1729: Ocul Immunol Inflamm. 2004 Mar;12(1):17-24.

Immune deviation and ocular infections with varicella zoster virus.

Kezuka T.

Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.
tkezuka@tokyo-med.ac.jp

Since experimental, herpes simplex virus-induced acute retinal necrosis (ARN)
develops in mice only if the mice fail to acquire virus-specific delayed
hypersensitivity (DH) and despite their production of anti-viral antibodies (i.e.
ACAID), I investigated whether a similar situation exists for patients with
either varicella zoster virus (VZV)-induced ARN or anterior uveitis caused by
VZV. Patients with either acute VZV-induced ARN, anterior uveitis with dermatitis
(herpes zoster ophthalmicus, ZO-AU), or anterior uveitis without dermatitis
(zoster sine herpete, ZSH-AU) were skin-tested with VZV to evaluate DH. The
formal diagnoses of ARN associated with VZV, ZO-AU, and ZSH-AU were established
by PCR analysis of the ocular samples and/or by the Goldmann-Witmer coefficient
to determine levels of local antibody production. ARN, ZO-AU, and ZSH-AU activity
were assessed clinically, and DH skin tests were repeated three months after
onset when ocular recovery had taken place. All patients with VZV-induced skin
disease alone (control group) displayed intense DH when tested with VZV antigen. 
In contrast, subsets of patients with ARN or ZO-AU displayed loss of VZV-specific
DH. Patients with the most severe ARN or ZO-AU had the lowest DH responses to VZV
antigens. Serum anti-VZV antibody titers were higher in ARN patients than in
normal controls, and the anti-viral titer correlated inversely with the intensity
of anti-VZV DH responses. VZV-specific DH responses were restored in patients who
recovered from ARN. Patients with ZSH-AU also failed to display VZV-specific DH. 
The absence of DH reactivity to VZV antigens (i.e. immune deviation) appears to
be a concomitant feature of VZV uveitis of high intensity, implying that
virus-specific DH may interfere with the emergence of VZV-induced ARN or anterior
uveitis.

PMID: 15209460 [PubMed - indexed for MEDLINE]

1730: J Drug Target. 2003 Aug;11(7):433-41.

Targeted dermal delivery of highly potent anti-varicella zoster virus nucleoside 
analogues from saturated solutions and ethanolic oil-in-water creams.

Jarvis CA, Heard CM, McGuigan C.

Welsh School of Pharmacy, Cardiff University, Cardiff CF10 3XF, UK.

Varicella zoster virus (VZV) is responsible for causing chickenpox and shingles
infections, the latter of which can lead to long-term post-herpetic neuralgia
(PHN), the most common complication of VZV infections. A class of anti-VZV
nucleoside analogues has been synthesised that shows up to 30,000 times the
potency of aciclovir in vitro. The relatively high lipophilicities exhibited by
the compounds led them to be selected for dermal delivery. The aim was to assess 
the relative penetration and permeation of the compounds into and through the
skin, ideally targeting the region of skin in which the reactivated virus
replicates. By targeting the skin it should be possible to reduce the viral load 
that causes damage to the nerves, thereby limiting zoster-associated pain, in
particular PHN. Three compounds, as saturated solutions or as ethanol-based
creams, were applied to full-thickness pig ear skin in Franz-type diffusion
cells. An ethanolic and water receptor phases were compared. Samples of the
receptor phase were taken at specific intervals, followed by tape stripping and
separation of the remaining membrane at the end of the experiment. Analysis of
the samples showed that all three compounds penetrated into the ethanolic
receptor phase to a considerable degree, while only the least lipophilic compound
entered the water receptor phase. The effects of the organic solvent in the
receptor phase were visible in both the penetration and permeation of the
compounds. All three compounds were distributed throughout the membrane in a
manner that indicates that the site of viral replication in the skin is reached.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't

PMID: 15203932 [PubMed - indexed for MEDLINE]

1731: Laryngorhinootologie. 2004 Jun;83(6):355-62.

[Herpes zoster oticus: symptom constellation and serological diagnosis]

[Article in German]

Walther LE, Prosowsky K, Walther A, Gudziol H.

Universitats-HNO-Klinik, Friedrich-Schiller-Universitat Jena.
LWalther@ukaachen.de

BACKGROUND: Herpes zoster oticus is a rare illness with cutaneous symptoms
(eruptions) and a colored picture of brain nerve failures. The clinical symptoms,
the symptom constellation, diagnostics and therapy, however, have been examined
till now only in few studies. PATIENTS AND METHODS: In this study 91 cases of a
zoster oticus were looked at in retrospect from the complete archives of the
university ENT clinic Jena/Germany in the period from 1932 to 2001. Inclusion
criterion was the occurrence eruptions in the ear region. The demographic data,
subjective and objective symptoms, the symptom constellations, diagnostic methods
and the therapy were arranged. RESULTS: Women (68.1 %) were concerned more
frequently than men (31.9 %). The average illness age was 51.2 days. The
prodromal stage lasted for 2.2 days in the average. Earache (50.2 %) and headache
(11.0 %) were the most frequent first symptoms. No prodroma appeared in 27.5 % of
the cases. The facial nerve (86.8 %) was most frequently affected, the vestibular
nerve in 76.9 % and the cochlear nerve in 36.3 %. Other brain nerve damages were 
extremly rare. The therapy success was identical with regard to the brain nerve
regeneration at all times. A positive antibody titer for VZV-IgM and/or IgA or an
IgG is a sign for an acute infektion. VZV-IgA antibody titers appeared more
constantly, frequent and early than an IgM. CONCLUSIONS: Women have a greater
risk of falling ill at a zoster oticus than men. Although more than 72 hours is
behind the beginning of the symptoms in this study, treatment with virostatic
drugs should always be carried out in zoster oticus. Different therapy methods do
not have any influence to the success therapy of the therapy. The facial nerve
showed the best cure trend. A postzosteric pain develops approximately the half
of the cases at the zoster oticus. The serological diagnostic is not necessary in
clinically clear cases.

Publication Types: 
    English Abstract

PMID: 15197674 [PubMed - indexed for MEDLINE]

1732: Vaccine. 2004 Jun 30;22(20):2558-65.

Varicella-zoster virus expressing HSV-2 glycoproteins B and D induces protection 
against HSV-2 challenge.

Heineman TC, Pesnicak L, Ali MA, Krogmann T, Krudwig N, Cohen JI.

Division of Infectious Diseases and Immunology, School of Medicine, Saint Louis
University, St. Louis, MO, USA.

A recombinant Oka (ROka) varicella-zoster virus (VZV) vaccine was constructed
that expresses herpes simplex virus type 2 (HSV-2) glycoproteins B (gB) and D
(gD). Guinea pigs received one of four inocula: (a). uninfected cells, (b).
recombinant Oka VZV infected cells, (c). recombinant Oka VZV expressing HSV-2
gB/gD (ROka-gB2/gD2) infected cells, or (d) heat-inactivated ROka-gB2/gD2
infected cells. Only animals inoculated with ROka-gB2/gD2 developed high titers
of neutralizing antibodies to HSV-2. Animals immunized with ROka-gB2/gD2 had
reduced mortality after intravaginal challenge with HSV-2 compared with animals
that received ROka or heat-inactivated ROka-gB2/gD2. Animals immunized with
ROka-gB2/gD2 had reduced lesions scores for the first 2 weeks after challenge,
and reduced shedding of HSV-2 on Days 5 and 7 after challenge, compared to the
other two groups. These data show that recombinant VZV expressing HSV-2 antigens 
must be infectious to offer significant protection against challenge with HSV-2, 
and that ROka-gB2/gD2 has promise as a candidate HSV-2 vaccine.

PMID: 15193381 [PubMed - indexed for MEDLINE]

1733: Med J Malaysia. 2003 Dec;58(5):771-3.

Bilateral optic neuritis in pregnancy.

Suraiya MS, Norazlina B, Carmen C, Muhaya M.

Department of Ophthalmology, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 
Bandar Tun Razak, 56000 Cheras, Kuala Lumpur.

A 25-year old primigravida at 11-weeks period of amenorrhoea presented with
bilateral optic neuritis following Varicella Zoster viral (VZV) infection. She
was serologically positive for systemic lupus erythematosus but negative for
virus. The exact pathogenesis of the patient's severe optic neuritis, adduction
and neurological deficit was unknown. The initiation of high dose steroids for
optic neuritis was a big clinical dilemma in a pregnant patient with viral
infection. The patient was treated with high dose steroids after three days of
commencement of antiviral treatment. At 6 months after presentation, her visual
acuity in the right eye was 6/36 with perception to light in the left.

Publication Types: 
    Case Reports

PMID: 15190668 [PubMed - indexed for MEDLINE]

1734: AIDS Patient Care STDS. 2004 May;18(5):255-7.

Failure of valacyclovir for herpes zoster in a moderately immunocompromised
HIV-infected patient.

Breton G, Bouldouyre MA, Gervais A, Duval X, Longuet P, Leport C, Vilde JL.

Department of Infectious and Tropical Diseases Bichat Claude Bernard Hospital,
Paris, France. guillaume.breton@bch.ap-hop-paris.fr

Whereas valacyclovir is widely used and is recommended by some authors in
moderately immunocompromised HIV-infected patients, its use has not been
validated by clinical studies. We report a case of herpes zoster in an
HIV-infected patient for whom neurologic complication was not avoided despite
valacyclovir therapy. Clinical outcome was favorable after intravenous acyclovir.
This case suggests careful monitoring of valacyclovir in HIV-infected patients is
necessary.

Publication Types: 
    Case Reports

PMID: 15186709 [PubMed - indexed for MEDLINE]

1735: Eye. 2005 Jun;19(6):692-3.

Comment on:
    Eye. 2003 Jul;17(5):656-8.

A hypopyon is a sign of post-trabeculectomy endophthalmitis or not?

Kaburaki T, Sato S, Kawashima H, Sakurai M, Numaga J, Fujino Y, Araie M.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 15184940 [PubMed - indexed for MEDLINE]

1736: J Microbiol Immunol Infect. 2004 Apr;37(2):75-81.

Double-blind, randomized, acyclovir-controlled, parallel-group trial comparing
the safety and efficacy of famciclovir and acyclovir in patients with
uncomplicated herpes zoster.

Shen MC, Lin HH, Lee SS, Chen YS, Chiang PC, Liu YC.

Section of Infectious Diseases, Department of Medicine, Kaohsiung Veterans
General Hospital, 386 Ta-chung 1st Road, Kaohsiung, Taiwan 813, ROC.

This randomized, double-blind, parallel-group study compared the efficacy and
safety of famciclovir administered at 250 mg thrice daily with acyclovir 800 mg 5
times daily for the treatment of acute uncomplicated herpes zoster in
immunocompetent adults. A total of 55 patients participated in this trial. Twenty
seven patients (49.1%) were randomized into the famciclovir plus placebo
treatment group and 28 (50.9%) into the acyclovir plus placebo group. Six of the 
55 patients did not complete the study. Two of these patients were in the
famciclovir plus placebo group and dropped out due to deviation from the study
protocol. Four patients in the acyclovir plus placebo group did not complete the 
study protocol due to adverse events (n = 2), deviation from the protocol (n =
1), or loss to follow-up (n = 1). Treatment was initiated within 72 h of onset of
the zoster rash and was continued for 7 days. When treatment was initiated within
72 h, famciclovir was as effective as acyclovir for healing the cutaneous lesion,
as indicated by the time to full crusting, loss of acute phase pain, loss of
vesicles, and loss of crusts. Famciclovir was well tolerated and had a more
favorable adverse event profile compared to acyclovir. Constipation, hematuria,
and glycosuria were the most commonly reported adverse events, but only
constipation was considered to have a possible relationship to the treatment. In 
conclusion, famciclovir, administered less frequently and at lower unit doses
than acyclovir, is an effective treatment for uncomplicated herpes zoster.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 15181487 [PubMed - indexed for MEDLINE]

1737: J Fr Ophtalmol. 2004 May;27(5):538-46.

[Necrotic herpetic retinitis]

[Article in French]

Fardeau C.

Service d'Ophtalmologie, Hopital Pitie-Salpetriere, 91, boulevard de l'Hopital,
75013 Paris.

The diagnosis of necrotic herpetic retinitis is suggested on clinical grounds,
prompting urgent appropriate intravenous and intravitreal treatment. PCR on
ocular samples is most often successful in identifying the herpetic agent.
Classic acute retinal necrosis syndrome caused by herpes simplex or zoster virus 
and the different clinical forms present in immunocompetent or immunodepressed
patients are described. The differential diagnosis includes atypical presentation
of retinal necrosis caused by toxoplasmosis, syphilis, or ocular lymphoma; the
ocular samples are useful in establishing the etiological diagnosis. We describe 
the different therapeutic strategies in the acute phase and as secondary
prophylactic treatment. The clinical outcome appears to be influenced by rapid,
appropriate treatment, limiting the extension of the retinal necrosis.

Publication Types: 
    English Abstract
    Review

PMID: 15179313 [PubMed - indexed for MEDLINE]

1738: Environ Health Perspect. 2004 Jun;112(8):840-6.

Cellular and humoral immune abnormalities in Gulf War veterans.

Vojdani A, Thrasher JD.

Section of Neuroimmunology, Immunosciences Lab Inc., 8693 Wilshire Boulevard,
Suite 200, Beverly Hills, CA 90211, USA. drari@msn.com

We examined 100 symptomatic Gulf War veterans (patients) and 100 controls for
immunologic assays. The veterans and controls were compared for the percentage of
T cells (CD3); B cells (CD19); helper:suppressor (CD4:CD8) ratio; natural killer 
(NK) cell activity; mitogenic response to phytohemagglutin (PHA) and pokeweed
mitogen (PWM); level of immune complexes; myelin basic protein (MBP) and striated
and smooth muscle autoantibodies; and antibodies against Epstein-Barr virus,
cytomegalovirus, herpes simplex virus type 1 (HSV-1), HSV-2, human herpes Type 6 
(HHV-6), and Varicella zoster virus (VZV). The percentage of T cells in patients 
versus controls was not significantly different, whereas a significantly higher
proportion of patients had elevated T cells compared with controls. The
percentage of B cells was significantly elevated in the patients versus the
controls. The NK cell (NK) activity was significantly decreased in the patients
(24.8 +/- 16.5 lytic units) versus the controls (37.3 +/- 26.4 lytic units). The 
percentage of patients with lower than normal response to PHA and PWM was
significantly different from controls. Immune complexes were significantly
increased in the patients (53.1 +/- 18.6, mean +/- SD) versus controls (34.6 +/- 
14.3). Autoantibody titers directed against MBP and striated or smooth muscle
were significantly greater in patients versus controls. Finally, the patients had
significantly greater titers of antibodies to the viruses compared with the
controls (p < 0.001). These immune alterations were detected 2-8 years after
participation in the Gulf War. The immune alterations are consistent with
exposure to different environmental factors. We conclude that Gulf War syndrome
is a multifaceted illness with immune function alterations that may be induced by
various factors and are probably associated with chronic fatigue syndrome.

PMID: 15175170 [PubMed - indexed for MEDLINE]

1739: AIDS. 2004 May 21;18(8):1218-21.

Compartmentalization of the immune response in varicella zoster virus immune
restoration disease causing transverse myelitis.

Clark BM, Krueger RG, Price P, French MA.

Publication Types: 
    Case Reports
    Letter

PMID: 15166543 [PubMed - indexed for MEDLINE]

1740: Virology. 2004 May 20;323(1):85-90.

Varicella-Zoster virus proteins encoded by open reading frames 14 and 67 are both
dispensable for the establishment of latency in a rat model.

Grinfeld E, Sadzot-Delvaux C, Kennedy PG.

Department of Neurology, Division of Clinical Neurosciences, Institute of
Neurological Sciences, Southern General Hospital, Glasgow, Scotland, UK.

A rat model of Varicella-Zoster virus (VZV) provides a system in which to
investigate the molecular determinants of viral latency in dorsal root ganglia
(DRG). In this study, we determined whether the VZV glycoproteins gC and gI,
corresponding to VZV open reading frames (ORFs) 14 and 67, respectively, were
required for the establishment of latency in this model. A VZV gI deletion mutant
(DeltagI) derived from a recombinant Oka (rOka) cosmid and a gC null mutant
obtained from a clinical isolate were inoculated into the footpads of 6-week-old 
rats, and the presence of viral DNA and eight different VZV RNA transcripts
corresponding to the three classes of genes was investigated by in situ RT-PCR
amplification and in situ hybridization (ISH) in the DRG at 1 week, 1 month, and 
18-24 months after infection. VZV DNA and restricted RNA expression was
established with both deletion mutants as well as the parental rOka virus. Both
VZV DNA and RNA were detected in neurons and non-neuronal cells. The pattern of
viral RNA expression detected with both gC and gI mutants was restricted with
transcripts for VZV genes 62 and 63 most frequently expressed 18-24 months after 
infection. Transcripts for VZV genes 18, 28, and 29 were also detected at these
time points but at a slightly lower frequency. Transcripts for the late gene 40
were never detected. We conclude that VZV ORFs 14 and 67 are dispensable for the 
establishment of a latent infection in this model.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15165821 [PubMed - indexed for MEDLINE]

1741: Pediatr Dermatol. 2004 May-Jun;21(3):279-80.

Childhood herpes zoster complicated by neurogenic bladder dysfunction.

Pandhi D, Reddy BS.

Publication Types: 
    Case Reports
    Letter

PMID: 15165218 [PubMed - indexed for MEDLINE]

1742: Nihon Shinkei Seishin Yakurigaku Zasshi. 2004 Apr;24(2):79-81.

[Postherpetic neuralgia alleviated by an SSRI fluvoxamine: two cases of PHN
accompanied with depression were treated with fluvoxamine]

[Article in Japanese]

Ohyama S, Kuniyoshi M, Nishi S, Inanaga K.

Chikusuikai Hospital, 1191, Yoshida, Yame, 834-0006 Japan.

Case 1: female, age 76. Fluvoxamine (50 mg/day) initiated a reduction of pain on 
the 14th day of administration and completely ameliorated pain as well as
depression. Case 2: female, age 76. Fluvoxamine (25 mg/day) was administered with
tandospirone (15 mg/day) which augments the effect of an SSRI. This combination
regimen induced a reduction of PHN-pain on the 10th day and as the analgesic
effect attained nearly 50%, there occurred a reflaming of pain on the 35th day.
Increasing fluvoxamine to 50 mg/day reameliorated pain on the 49th day, and a
further increase to 75 mg/day finally eliminated pain and depression at the end
of the 3rd month. The long latency of fluvoxamine action, its shortening by
tandospirone and the parallel changes of PHN and depression are all indicative of
that the same mechanism, namely renormalization of the dysfunctioned central
serotonergic transmission would be underlying both the anti-PHN and
antidepressant actions. It would be concluded that fluvoxamine alleviates PHN by 
restoration of the descending serotonergic inhibition of primary afferent
activity that carries pain impulses.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15164615 [PubMed - indexed for MEDLINE]

1743: Ageing Res Rev. 2004 Jan;3(1):69-89.

Skin infections and ageing.

Laube S.

Department of Dermatology, University Hospital of North Staffordshire, Central
Out-Patients, Hartshill Road, Stoke-on-Trent ST4 7PA, UK. slaube@doctors.org.uk

Elderly individuals have an increased susceptibility to skin infections due to
age-related anatomical, physiological and environmental factors. The types of
organisms that cause primary skin and soft tissue infections are diverse, and
include bacterial, viral and fungal pathogens as well as parasites. In the
elderly, these infections and infestations may present with atypical signs and
symptoms or may complicate underlying chronic skin disorders. Clinical features, 
investigations and management of the following important and common skin
infections are described in more detail: cellulitis, erysipelas, necrotizing
fasciitis, impetigo, folliculitis, furunculosis and carbunculosis, erythrasma,
herpes zoster and postherpetic neuralgia, herpes simplex, warts, molluscum
contagiosum, dermatophytosis of the skin, hair and nails, candidiasis, and
scabies. Treatment should be based on the results of the appropriate diagnostic
tests. Correct diagnosis and therapy of skin infections lead to satisfactory
outcome in the majority of elderly patients.

Publication Types: 
    Review

PMID: 15163103 [PubMed - indexed for MEDLINE]

1744: Emerg Nurse. 2004 May;12(2):14-21.

Cranial nerve damage.

Cox CL, Boswell GM, McGrath A, Reynolds T, Cole E.

City University, St Bartholomew's School of Nursing and Midwifery, London.

Publication Types: 
    Review

PMID: 15160588 [PubMed - indexed for MEDLINE]

1745: Harv Womens Health Watch. 2004 May;11(9):6-7.

Managing shingles and postherpetic neuralgia. Reactivation of the chickenpox
virus causes severe pain and rash in older adults.

[No authors listed]

PMID: 15153382 [PubMed - indexed for MEDLINE]

1746: Cent Eur J Public Health. 2004 Mar;12 Suppl:S94-6.

Surprises and omissions in toxicology.

Raskova H, Zidek Z.

Charles University, Prague, Czech Republic.

The paper describes expected and unexpected results gained from studies performed
decades ago, and so to say - forgotten. 1. Different bacterial toxins can induce 
considerable changes in pharmacokinetics and pharmacodynamics of applied drugs.
To admit clinical trials, only results from healthy human volunteers are
required, however. 2. Antagonists to the toxicity of bacterial toxins in general 
have to be administered prior to the toxin. However, adenosine triphosphate (ATP)
is effective also when applied after toxins. ATP is "in" again in contemporary
research. 3. A controlled clinical trial revealed substantial differences between
the D- and D,L-form of cycloserin. 4. The antimetabolite 6-azauracil riboside and
eventually its triacetate derivative was claimed to possess antitumor properties.
However, a controlled clinical trial did not confirm its potency in this aspect. 
On the other hand, the tolerance was excellent. This finding encouraged clinical 
trials in psoriasis, a disease of autoimmune etiology. Moreover, beneficial
effects and tolerance of the compound was described in herpes zoster and even in 
smallpox. On the basis of these results a controlled clinical trial in rheumatoid
arthritis, also judged to be an autoimmune disease, was started. Because of early
high toxicity, the study was discontinued. 5. High doses of the compound induce
ocular lesions in animals. The above examples justify the titel of this paper.

Publication Types: 
    Addresses

PMID: 15141993 [PubMed - indexed for MEDLINE]

1747: Neurology. 2004 May 11;62(9):1545-51.

Risk factors for postherpetic neuralgia in patients with herpes zoster.

Jung BF, Johnson RW, Griffin DR, Dworkin RH.

University of Rochester School of Medicine and Dentistry, Rochester, NY 14642,
USA.

OBJECTIVES: To identify risk factors for postherpetic neuralgia (PHN) using a
validated definition of this chronic neuropathic pain syndrome, to determine
combinations of risk factors that identify patients with a high risk of
developing PHN, and to examine the characteristics of patients with subacute
herpetic neuralgia, that is, pain that persists beyond the acute phase of herpes 
zoster but that resolves before PHN can be diagnosed. METHODS: The authors
examined baseline and follow-up data from 965 herpes zoster patients enrolled
within 72 hours of rash onset in two clinical trials of famciclovir. RESULTS:
Univariate and multivariate analyses indicated that older age, female sex,
presence of a prodrome, greater rash severity, and greater acute pain severity
made independent contributions to identifying which patients developed PHN.
Patients with subacute herpetic neuralgia who did not develop PHN were
significantly younger and had less severe acute pain than PHN patients but were
significantly more likely to have severe and widespread rash than patients
without persisting pain. CONCLUSIONS: The independent contributions to the
prediction of PHN made by older age, female sex, presence of a prodrome, greater 
rash severity, and greater acute pain severity suggest that these risk factors
reflect different mechanisms that each contribute to the development of PHN.
Subacute herpetic neuralgia that does not progress to PHN may reflect peripheral 
tissue damage and inflammation caused by a particularly severe or widespread
rash.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 15136679 [PubMed - indexed for MEDLINE]

1748: Eur J Ophthalmol. 2004 Mar-Apr;14(2):85-93.

Corneal surface changes in Thygeson's superficial punctate keratitis: a clinical 
and non-contact photomicrographic in vivo study in the human cornea.

Tabery HM.

Department of Ophthalmology, Malmo University Hospital, Malmo, Sweden.
helena.tabery@skane.se

PURPOSE: To elucidate mechanisms behind the morphology of Thygeson's superficial 
punctate keratitis (TSPK). METHODS: Sixteen patients were examined with the slit 
lamp and photographed by non-contact photomicrography. The results were compared 
with morphology of epithelial keratitis in herpes simplex type 1 (HSV1),
varicella zoster (VZV), and adenovirus type 8 (Ad8) infections, all previously
studied by the same method, and with published histologic findings in TSPK.
RESULTS: In the photographs, the corneal epithelium showed various numbers of
abnormal subsurface cells measuring about 10-15 microm in diameter, present
individually, in small groups, or aggregated in larger lesions (coarse lesions
with the slit lamp). The surface epithelium was well preserved, except in larger 
lesions, which showed surface debris. The morphology was unlike HSV1 and VZV
epithelial keratitis, but strongly resembled epithelial changes occurring in Ad8 
infections on day 5, and later, after the onset of symptoms. CONCLUSIONS: TSPK
shows a more widespread epithelial involvement than suspected with the slit lamp.
Its morphology seems to reflect an action of a noxious agent targeted at the
deeper epithelial layers, with the appearance of abnormal cells as a result.
These might represent invading inflammatory cells, damaged intraepithelial ones, 
or both. The coarse lesions visualize areas of major involvement showing
discernible signs of cell destruction. The similarity to Ad8 keratitis suggests
that the source of the noxious agent might be located outside the cornea. The
morphology, in conjunction with clinical features, is compatible with an
immunologically mediated injury. The etiology remains unknown.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 15134103 [PubMed - indexed for MEDLINE]

1749: Skinmed. 2004 May-Jun;3(3):130-1.

Ramsay Hunt syndrome revisited.

Mishriki YY.

The Pennsylvania State University School of Medicine and Division of General
Internal Medicine, Lehigh Valley Hospital, Allentown, PA 18103, USA.
yehia.miskriki@lvh.com

PMID: 15133391 [PubMed - indexed for MEDLINE]

1750: Eye. 2004 May;18(5):544-5.

Comment in:
    Eye. 2006 Feb;20(2):247.

Oral valganciclovir treatment of varicella zoster virus acute retinal necrosis.

Savant V, Saeed T, Denniston A, Murray PI.

Publication Types: 
    Case Reports
    Letter

PMID: 15131692 [PubMed - indexed for MEDLINE]

1751: Pediatr Infect Dis J. 2004 May;23(5):451-7; quiz 458-60.

Herpes zoster in otherwise healthy children.

Feder HM Jr, Hoss DM.

Department of Pediatrics, University of Connecticut Health Center, Farmington,
CT, USA.

In normal infants and children, zoster can occur at any time after varicella or
varicella vaccination. It is usually diagnosed clinically: a unilateral vesicular
eruption following a dermatome or dermatomes. The incidence of zoster increases
with age, although children who have had varicella during the first year of life 
(or in utero) are at increased risk of developing zoster. The incidence of zoster
is less after varicella vaccination than after natural infection. Zoster in
children is frequently mild, postzoster neuralgia rarely if ever occurs, and
antiviral therapy is usually not needed. In a previously normal child with
zoster, if the history and physical examination are normal, a laboratory search
for occult immunodeficiency or malignancy is not needed. We present five cases of
zoster in healthy children and review zoster in the pediatric age group.

Publication Types: 
    Case Reports
    Review

PMID: 15131470 [PubMed - indexed for MEDLINE]

1752: Pediatr Infect Dis J. 2004 May;23(5):379-89.

Consensus: varicella vaccination of healthy children--a challenge for Europe.

Rentier B, Gershon AA; European Working Group on Varicella.

Fundamental Virology Unit, University of Liege, Belgium. brentier@ulg.ac.be

The seriousness of varicella-zoster virus (VZV) infection as a public health
issue is becoming clearer as country-specific epidemiologic and pharmacoeconomic 
data become available. In Germany, for example, studies have shown that >5.5% of 
immunologically healthy individuals develop varicella-related complications such 
as bacterial superinfections, acute neurologic disorders, pneumonia, bronchitis
and otitis media; whereas in Italy, 3.5 to 5% of childhood cases of varicella
cause complications such as upper respiratory tract and cutaneous
infections.Varicella vaccines are now available. These live attenuated Oka strain
vaccines have been shown in extensive studies to be highly immunogenic and
well-tolerated in immunocompetent and immunocompromised children, with
seroconversion rates ranging from 94 to 100% and 53 to 100%, respectively. These 
vaccines are also highly effective against clinical disease.These considerations 
led to a reevaluation of varicella vaccination policies. A routine varicella
vaccination program targeting healthy children has already been implemented in
the US, and data produced are encouraging and valuable. Similar strategies have
not yet been adopted across Europe. The European Working Group on Varicella
(EuroVar) was formed in 1998 to address the issues surrounding varicella
epidemiology in Europe. After a series of meetings, the EuroVar members prepared 
a consensus statement recommending routine varicella vaccination for all healthy 
children between 12 and 18 months and to all susceptible children before their
13th birthday, in addition to catch-up vaccination in older children and adults
who have no reliable history of varicella and who are at high risk of
transmission and exposure. However, such a policy is recommended only if a very
high coverage rate can be achieved. This could be reached with a
measles-mumps-rubella-varicella combined vaccine.

Publication Types: 
    Consensus Development Conference
    Research Support, Non-U.S. Gov't
    Review

PMID: 15131459 [PubMed - indexed for MEDLINE]

1753: J Clin Virol. 2004 Jun;30(2):115-33.

Antiviral drugs in current clinical use.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven,
Minderbroedersstraat 10, B-3000 Leuven, Belgium.
erik.declercq@rega.kuleuven.ac.be

The current armamentarium for the chemotherapy of viral infections consists of 37
licensed antiviral drugs. For the treatment of human immunodeficiency virus (HIV)
infections, 19 compounds have been formally approved: (i) the nucleoside reverse 
transcriptase inhibitors (NRTIs) zidovudine, didanosine, zalcitabine, stavudine, 
lamivudine, abacavir and emtricitabine; (ii) the nucleotide reverse transcriptase
inhibitor (NtRTI) tenofovir disoproxil fumarate; (iii) the non-nucleoside reverse
transcriptase inhibitors (NNRTIs) nevirapine, delavirdine and efavirenz; (iv) the
protease inhibitors saquinavir, ritonavir, indinavir, nelfinavir, amprenavir,
lopinavir (combined with ritonavir at a 4/1 ratio) and atazanavir; and the viral 
entry inhibitor enfuvirtide. For the treatment of chronic hepatitis B virus (HBV)
infections, lamivudine as well as adefovir dipivoxil have been approved. Among
the anti-herpesvirus agents, acyclovir, valaciclovir, penciclovir (when applied
topically), famciclovir, idoxuridine and trifluridine (both applied topically) as
well as brivudin are used in the treatment of herpes simplex virus (HSV) and/or
varicella-zoster virus (VZV) infections; and ganciclovir, valganciclovir,
foscarnet, cidofovir and fomivirsen (the latter upon intravitreal injection) have
proven useful in the treatment of cytomegalovirus (CMV) infections in
immunosuppressed patients (i.e. AIDS patients with CMV retinitis). Following
amantadine and rimantadine, the neuraminidase inhibitors zanamivir and
oseltamivir have recently become available for the therapy (and prophylaxis) of
influenza virus infections. Ribavirin has been used (topically, as aerosol) in
the treatment of respiratory syncytial virus (RSV) infections, and the
combination of ribavirin with (pegylated) interferon-alpha has received increased
acceptance for the treatment of hepatitis C virus (HCV) infections.

Publication Types: 
    Review

PMID: 15125867 [PubMed - indexed for MEDLINE]

1754: Int J Dermatol. 2004 Feb;43(2):136-7.

Mandibular alveolar bone necrosis after trigeminal herpes zoster.

Arikawa J, Mizushima J, Higaki Y, Hoshino J, Kawashima M.

Department of Dermatology, Tokyo Women's Medical University, and Hoshino Dental
Clinic, Tokyo, Japan. jun-ari@derm.twmu.ac.jp

Publication Types: 
    Case Reports

PMID: 15125505 [PubMed - indexed for MEDLINE]

1755: Int J Dermatol. 2004 Feb;43(2):126-8.

Zosteriform skin metastases.

LeSueur BW, Abraham RJ, DiCaudo DJ, O'Connor WJ.

Mayo Clinic Scottsdale, Department of Dermatology, Scottsdale, AZ 85259, USA.
benjamin.lesueur@mayo.edu

Publication Types: 
    Case Reports

PMID: 15125503 [PubMed - indexed for MEDLINE]

1756: Ceylon Med J. 2003 Dec;48(4):119-21.

Varicella-zoster virus infection in the Infectious Diseases Hospital, Sri Lanka.

Welgama U, Wickramasinghe C, Perera J.

Infectious Diseases Hospital, Sri Lanka.

OBJECTIVES: To determine the morbidity and mortality patterns of varicella and
risk factors affecting its outcome, and the facilities available at the
Infectious Diseases Hospital (IDH), Sri Lanka. METHODS: A retrospective study on 
all patients admitted with varicella-zoster virus (VZV) infection to the IDH from
August 2000 to July 2001. Data were collected from the hospital records. RESULTS:
Among the 1690 patients admitted during the study period, 1090 (64.9%) were due
to VZV infection. Nine hundred and eighty nine (90.7%) had varicella and 101
(9.3%) herpes zoster. Common complications were secondary bacterial infection
(62.1%), neurological complications (3.4%), pneumonia (9.1%) and carditis
(1.01%). They were significantly commoner in patients with coexisting diseases.
Hospital stay was significantly shorter in patients who received early aciclovir,
which was not available on a regular basis. Forty one patients died and mortality
was highest in the elderly. The commonest cause of death was pneumonia.
CONCLUSIONS: Varicella related complications are high in patients with coexisting
diseases. Mortality rates are higher than reported elsewhere. Health care
facilities available at IDH are quite inadequate, and should be improved.

PMID: 15125402 [PubMed - indexed for MEDLINE]

1757: J Rheumatol. 2004 May;31(5):925-30.

Unique angiopathy after herpes virus infection.

Shimizu J, Inatsu A, Oshima S, Kubota T.

Department of Medicine, the Japan Self Defense Forces Central Hospital, Tokyo,
Japan. hemijun@nyc.odn.ne.jp

OBJECTIVE: We describe 3 Japanese patients with peculiar renal and/or coronary
arterial stenosis and/or multiple aneurysms after herpes virus infection,
following ischemic symptoms. We investigated for viral antigens and viral DNA in 
situ, and for shared abnormalities of cellular immunity. METHODS:
Panarteriography was performed diagnostically, and patients were grouped as
follows: 3 patients with peculiar renal and/or coronary artery narrowing and/or
multiple aneurysms; another 3 patients with renal fibromuscular dysplasia; and
other young adults with effort angina, with no history of herpes virus infection,
as controls. Detection of viral antigens and viral DNA in situ was done by
polymerase chain reaction method and immunohistochemical staining. Cellular
immunity was examined at the time of ischemic symptoms. RESULTS: Viral antigens
and DNA were scarcely detected, except in herpes zoster skin lesion with
leukocytoclastic vasculitis. However, shared abnormalities of cellular immunity, 
such as a decreased CD4+ T cell number and reduced natural killer cell activity, 
were more prominent in the 3 patients with unique vasculopathy after herpes virus
infection. CONCLUSION: Unique vasculopathy following herpes virus infection might
be a more severe and extensive disease. We speculate that sustained viral
infection, repetitive activation of virus related antigens, and suppressed immune
state might contribute to formation of peculiar vascular alterations.

Publication Types: 
    Case Reports

PMID: 15124252 [PubMed - indexed for MEDLINE]

1758: Plant Physiol. 2004 May;135(1):145-51. Epub 2004 Apr 30.

Copper transport across pea thylakoid membranes.

Shingles R, Wimmers LE, McCarty RE.

Department of Biology, Johns Hopkins University, Baltimore, Maryland 21218-2685, 
USA. shingles@jhu.edu

The initial rate of Cu2+ movement across the thylakoid membrane of pea (Pisum
sativum) chloroplasts was directly measured by stopped-flow spectrofluorometry
using membranes loaded with the Cu(2+)-sensitive fluorophore Phen Green SK. Cu2+ 
transport was rapid, reaching completion within 0.5 s. The initial rate of uptake
was dependent upon Cu2+ concentration and saturated at about 0.6 microm total
Cu2+. Cu2+ uptake was maximal at a thylakoid lumen pH of 7.0. Cu2+ transport was 
inhibited by Zn2+ but was largely unaffected by Mn2+ and Cu+. Zn2+ inhibited Cu2+
transport to a maximum of 60%, indicating that there may be more than one
transporter for copper in pea thylakoid membranes.

PMID: 15122011 [PubMed - indexed for MEDLINE]

1759: J Tradit Chin Med. 2004 Mar;24(1):51-2.

Acupuncture treatment of 3 difficult cases according to Dr. Xu Benren's
experience.

Zhang Z.

Qingdao Sanatorium of the Air Force, Qingdao, Shandong Province 266071.

Publication Types: 
    Case Reports

PMID: 15119177 [PubMed - indexed for MEDLINE]

1760: J Tradit Chin Med. 2004 Mar;24(1):24-5.

Clinical application of moxibustion.

Wang S, Wei H.

Central Hospital of Handan City, Hebei Province, 056001.

Publication Types: 
    Case Reports

PMID: 15119165 [PubMed - indexed for MEDLINE]

1761: Dermatology. 2004;208(3):206-16.

Systematic overview of the pharmacological management of postherpetic neuralgia. 
An evaluation of the clinical value of critically selected drug treatments based 
on efficacy and safety outcomes from randomized controlled studies.

Plaghki L, Adriaensen H, Morlion B, Lossignol D, Devulder J.

Cliniques universitaires Saint-Luc, Universite catholique de Louvain, Brussels,
Belgium. plaghki@read.ucl.ac.be

OBJECTIVE: This study systematically reviews current evidence on drug treatments 
commonly used in postherpetic neuralgia. METHODS: Randomized controlled trials
were critically selected using predefined search criteria. Efficacy was evaluated
as percentage of improvement in pain intensity between baseline and endpoint,
tolerability by number of study discontinuations because of adverse events and
incidence of adverse events. RESULTS: Currently published trials enrolled
different patient populations and small patient numbers. The great variability in
doses, titration schemes, designs and washout periods together with other design 
flaws made comparison between different studies scientifically impossible.
CONCLUSIONS: There is a real need for well-performed clinical trials with
standardization in design and reporting. Development of adequate and validated
questionnaires for evaluation and comparison of efficacy and safety of treatments
is also needed. Based on the evaluation of individual studies, it is concluded
that only gabapentin is studied in large (over 200 patients), placebo-controlled 
studies showing good efficacy and safety. Copyright 2004 S. Karger AG, Basel

Publication Types: 
    Meta-Analysis
    Review

PMID: 15118369 [PubMed - indexed for MEDLINE]

1762: Clin Exp Dermatol. 2004 May;29(3):323; author reply 324.

Comment on:
    Clin Exp Dermatol. 2002 Mar;27(2):132-4.

Which term should be used to describe drug eruptions confined to sites of
previous herpes zoster lesions, 'isotopic response' or 'recall phenomenon'?

Mizukawa Y, Shiohara T.

Publication Types: 
    Comment
    Letter

PMID: 15115529 [PubMed - indexed for MEDLINE]

1763: Plast Reconstr Surg. 2004 May;113(6):1838-40.

Herpes zoster as a rare complication of liposuction.

Andrews TR, Perdikis G, Shack RB.

Departments of Plastic and Reconstructive Surgery, Mayo Clinic Jacksonville, 4500
San Pablo Road, Jacksonville, FL 32224, USA.

Liposuction typically has a low incidence of complications and is associated with
significant cosmetic benefit. In this case, the patient developed a dermatomal
rash with vesicles on an erythematous base consistent with herpes zoster 8 days
after liposuction to the back and flanks. To the authors' knowledge, herpes
zoster has not been previously reported as a complication of liposuction.
Although the precise relationship of herpes zoster infection to the liposuction
procedure is difficult to determine, mechanical irritation most likely
reactivated the varicella zoster virus in the involved dermatomal distribution.
The patient was treated with antiviral and analgesic medications and healed
without any further complications.

Publication Types: 
    Case Reports

PMID: 15114155 [PubMed - indexed for MEDLINE]

1764: J Virol Methods. 2004 Jul;119(1):25-30.

Immunofluorescence test for sensitive detection of varicella-zoster
virus-specific IgG: an alternative to fluorescent antibody to membrane antigen
test.

Sauerbrei A, Farber I, Brandstadt A, Schacke M, Wutzler P.

Institute of Virology and Antiviral Therapy, Friedrich-Schiller University of
Jena, Postfach, D-07740 Jena, Germany. Andreas.Sauerbrei@med.uni-jena.de

A highly sensitive indirect fluorescence antibody test (IFAT) has been developed 
on the basis of varicella-zoster virus (VZV)-infected human lung carcinoma (A549)
cells and evaluated for the determination of immunity to VZV. Different serum
panels with negative, low, moderate or high anti-VZV IgG levels detected by the
fluorescent antibody to membrane antigen (FAMA) assay were investigated. As a
result, the sensitivity and the specificity of IFAT were 100% compared to FAMA
test. In anti-VZV IgG-positive sera, a significant correlation between the
results of FAMA procedure and IFAT could be shown. However, there were
considerably higher antibody titers by the IFAT than by FAMA. Whereas the FAMA
test had a detection limit of 250 mIU/ml anti-VZV IgG, the limit of detection of 
IFAT was 50 mIU/ml. In conclusion, the IFAT using VZV-infected A549 cells as
antigen allows a highly sensitive, specific, and rapid detection of anti-VZV IgG 
class antibodies. This simple technique can replace the labor-intensive FAMA
procedure for laboratory determination of immunity to VZV.

Publication Types: 
    Comparative Study

PMID: 15109817 [PubMed - indexed for MEDLINE]

1765: Geriatr Nurs. 2004 Mar-Apr;25(2):120-1.

Pharmacology update-managing postherpetic neuralgia.

Luggen AS.

Northern Kentuckey University, Highland Heights, USA.

Publication Types: 
    Review

PMID: 15107799 [PubMed - indexed for MEDLINE]

1766: Antibiot Khimioter. 2003;48(11):7-9.

[Effect of L-lysine-alpha-oxidase gel on development of ophthalmic herpes and
herpetic skin lesions in rabbit]

[Article in Russian]

Smirnova IP, Alekseev SB, Podboronov VM.

Russian Peoples' Friendship University, Moscow. N.F. Gamaleya Research Institute 
of Epidemiology and Microbiology, Russian Academy of Medical Sciences, Moscow.

The effect of various doses of L-lysine-alpha-oxidase gel (1.4-3.5 and 70 mcg/ml)
on development of eye and skin herpetic lesions due to type 1 herpes simplex
virus was studied on rabbits. The doses of 1.4 to 3.5 mcg/ml were not sufficient 
for the therapeutic effect. The dose of 70 mcg/ml provided complete healing of
the lesions in 3 to 4 days. The results were confirmed by the immunological
tests.

Publication Types: 
    English Abstract

PMID: 15106305 [PubMed - indexed for MEDLINE]

1767: Rinsho Ketsueki. 2004 Mar;45(3):250-1.

[Progressive outer retinal necrosis in a patient with malignant lymphoma]

[Article in Japanese]

Takei Y, Usui N, Dobashi N, Hagino T, Okawa Y, Takahara S, Asai O, Kobayashi M.

Division of Hematology and Oncology, Department of Internal Medicine, Jikei
University School of Medicine.

A 29-year-old man with diffuse large B-cell lymphoma treated by radiotherapy for 
his relapsed lesion followed by 4 doses of weekly rituximab was admitted to our
hospital with interstitial pneumonia. After steroid pulse therapy, he had
contraction of the left visual field. He was diagnosed as having progressive
outer retinal necrosis due to a varicella-zoster virus that was detected from the
left vitreous sample. Systemic antiviral treatment failed to prevent rapid
development of whole layer necrosis of the left retina. Vitrectomy with silicone 
oil tamponade saved his final visual acuity. This unusual event might be related 
to rituximab causing deterioration of humoral immunity.

Publication Types: 
    Case Reports
    English Abstract

PMID: 15103942 [PubMed - indexed for MEDLINE]

1768: Kansenshogaku Zasshi. 2004 Jan;78(1):64-9.

A case of fatal varicella zoster infection with refractory abdominal pain as an
early symptom.

Yakushijin Y, Minamoto Y, Takada K, Otsuka M, Yasukawa M, Fujita S.

First Department of Internal Medicine, Ehime University School of Medicine,
Onsen-gun, Shigenobu-cho, Ehime 791-0295, Japan.

Publication Types: 
    Case Reports

PMID: 15103896 [PubMed - indexed for MEDLINE]

1769: Drugs. 2004;64(9):937-47.

Review of lidocaine patch 5% studies in the treatment of postherpetic neuralgia.

Davies PS, Galer BS.

Department of Neurology, Seattle Veterans' Medical Center, Seattle, Washington,
USA.

Postherpetic neuralgia (PHN) is a chronic pain syndrome that disproportionately
affects the elderly; its incidence is anticipated to increase as the population
ages. PHN presents as pain (continuous burning or intense paroxysmal), most often
with tactile allodynia, which may be severe and disabling, resulting in poor
quality of life and depression. Traditional treatments have included tricyclic
antidepressants, anticonvulsants and opioids; however, adverse systemic effects
associated with these agents have led to the development of a newer and
potentially safer agent, the topical lidocaine patch 5% (Lidoderm), a targeted
peripheral analgesic.This article reviews the clinical pharmacology of the
lidocaine patch 5% for the treatment of PHN and summarises data from clinical
trials of its safety, tolerability and efficacy. The Medline search terms
"lidocaine" and "patch" were used to search for English-language articles on the 
pharmacokinetics of the lidocaine patch 5% and its clinical use for the treatment
of PHN. Additional published studies not identified by the database search but
performed by the authors or their colleagues were also included in the review.The
systemic absorption of lidocaine from the patch was minimal in healthy adults
when four patches were applied for up to 24 hours/day, and lidocaine absorption
was even lower among PHN patients than healthy adults at the currently
recommended dose. Vehicle-controlled and open-label trials found the lidocaine
patch 5%, either alone or in combination with other agents, to be effective in
the treatment of PHN. Most adverse events were at patch application sites; no
clinically significant systemic adverse effects were noted, including when used
long term or in an elderly population.In patients with PHN, the lidocaine patch
5% has demonstrated relief of pain and tactile allodynia with a minimal risk of
systemic adverse effects or drug-drug interactions. Because of its proven
efficacy and safety profile, the lidocaine patch 5% has been recommended as a
first-line therapy for the treatment of the neuropathic pain of PHN.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 15101784 [PubMed - indexed for MEDLINE]

1770: J Allergy Clin Immunol. 2004 Apr;113(4):742-6.

Varicella zoster as a manifestation of immune restoration disease in HIV-infected
children.

Tangsinmankong N, Kamchaisatian W, Lujan-Zilbermann J, Brown CL, Sleasman JW,
Emmanuel PJ.

Division of Allergy and Immunology, Department of Pediatrics, University of South
Florida/All Children's Hospital, 801 Sixth Street South, Box 9350, St Petersburg,
FL 33701, USA. tangsinn@allkids.org

BACKGROUND: Exacerbation of opportunistic infections in HIV-infected patients
shortly after initiation of highly active antiretroviral therapy (HAART) has been
named immune restoration disease (IRD). Thus far, IRD has not been reported in
children. OBJECTIVE: We describe the clinical and immune characteristics of IRD
in HIV-infected children treated with HAART. METHODS: A historical cohort study
was conducted in a tertiary HIV center in perinatally HIV-infected children who
were started on a first stable HAART between January 1996 and July 2002. The
incidence of opportunistic infections, newly AIDS-defining events or death after 
initiation of HAART, and virologic and immunologic information was evaluated at
baseline and every 3 months post-HAART. RESULTS: Sixty-one perinatally
HIV-infected children were started and maintained on HAART for >6 months. Seven
episodes of IRD occurred. All were cutaneous herpes zoster (HZ). Children who
developed HZ had significantly lower baseline CD4+ and CD8+ T-cell numbers
compared with children who did not. HZ occurred only in children (7 of 34
subjects) with virological and immunological success to HAART. In children with a
previous history of varicella infection, the risk of developing HZ after HAART
was higher in those without a protective level of varicella-specific IgG (50%, or
5 of 10 subjects) compared with those with seroprotection (10%, or 2 of 20).
CONCLUSION: Herpes zoster is a common manifestation of IRD in HIV-infected
children after the initiation of HAART. Risks for developing HZ include no
protective varicella-specific antibody despite previous varicella infection,
severe immunodeficiency at baseline, and vigorous immunologic and virologic
responses to HAART.

PMID: 15100682 [PubMed - indexed for MEDLINE]

1771: JAMA. 2004 Apr 21;291(15):1875-9.

Epstein-Barr virus in pediatric multiple sclerosis.

Alotaibi S, Kennedy J, Tellier R, Stephens D, Banwell B.

Department of Pediatrics(Neurology), Al-Sabah Hospital, Shuwaikh, Kuwait.

CONTEXT: Infection with common viruses, particularly Epstein-Barr virus (EBV),
has been postulated to contribute to the pathobiology of multiple sclerosis (MS).
Detailed virological studies in pediatric MS have not been previously reported.
OBJECTIVE: To evaluate whether children with MS are more likely to be
seropositive for EBV or other common viruses than their healthy age-matched
peers. DESIGN, SETTING, AND PATIENTS: Case-control study of viral samples
collected from March 1994 to February 2003 from 30 pediatric MS patients, 90
emergency department controls matched 3:1 with the MS patients by year of birth, 
and 53 healthy control children. MAIN OUTCOME MEASURES: Archived serum samples
were analyzed for the presence of IgG antibodies directed against EBV viral
capsid antigens, nuclear antigens, and early antigens, cytomegalovirus,
parvovirus B19, herpes simplex virus, and varicella zoster. RESULTS: Serological 
evidence for remote EBV infection was present in 83% of pediatric MS patients
compared with 42% of emergency department and healthy controls (P<.001). Five
pediatric MS patients were negative for all 3 EBV antigens. Pediatric MS patients
were less likely than controls to have been exposed to herpes simplex virus (P
=.003), while seropositivity for cytomegalovirus, parvovirus B19, and varicella
zoster did not differ between MS patients and controls. CONCLUSION: These results
suggest an association between EBV infection and pediatric MS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15100207 [PubMed - indexed for MEDLINE]

1772: Pain Med. 2002 Dec;3(4):324-32.

Lidocaine patch 5% reduces pain intensity and interference with quality of life
in patients with postherpetic neuralgia: an effectiveness trial.

Katz NP, Gammaitoni AR, Davis MW, Dworkin RH; Lidoderm Patch Study Group.

Harvard Medical School, Boston, Massachusetts, USA. NatPaulKatz@aol.com

OBJECTIVE: To assess the effectiveness of the lidocaine patch 5% (Lidoderm), a
targeted peripheral analgesic, in reducing pain intensity/interference with
quality of life (QOL) among patients with postherpetic neuralgia (PHN). DESIGN:
Open-label, nonrandomized, effectiveness study; up to three patches applied to
area of greatest pain for 12 hours per day for 28 days. SETTING: Forty-two
centers consisting of large institutional primary care programs and academic
centers, including pain centers, neurologists, and pain specialists affiliated
with a university. PATIENTS: Patients with PHN (N = 332). OUTCOME MEASURES:
Patients completed the Brief Pain Inventory Short Form and global pain
assessments at baseline, Days 7 and 14, and study conclusion. Physicians
completed global assessments at baseline and study conclusion. RESULTS: The mean 
time from onset of herpes zoster to treatment was 28 months. Use of the lidocaine
patch 5% was associated with reductions in all mean pain intensity, pain
interference with QOL, and composite scores at all time points (P = 0.0001).
Overall, 66% of patients reported improvement in pain intensity, and 74% reported
improved QOL by Day 7; approximately 43% who did not respond by Day 7 experienced
improvement in pain intensity by Day 14. For all measures of pain intensity,
relief, and interference with QOL, improvements from baseline were equally
significant regardless of time since shingles onset. In all, approximately 60% of
patients reported moderate to complete pain relief at final evaluation. The
lidocaine patch 5% was well tolerated. CONCLUSIONS: Based on results of previous 
randomized, controlled trials and the current study, designed to gauge response
in the clinical practice setting, the lidocaine patch 5% should be considered a
first-line therapy, alone or in combination with other agents, for PHN due to its
efficacy, safety, minimal systemic side effects and drug interactions, and ease
of administration. Although the lidocaine patch 5% was equally effective in
longstanding PHN, it would appear prudent to begin therapy as early in the course
of PHN as possible.

PMID: 15099237 [PubMed]

1773: J Long Term Eff Med Implants. 2004;14(2):131-64.

Prevention of residential roof fires by use of a class "A" fire rated roof
system.

Edlich RF, Winters KL, Long WB, Britt LD.

University of Virginia Health System, Charlottesville, Virginia, USA.

Because residential roof fires remain a life-threatening danger to residential
homeowners in the United States, we describe in detail a national fire prevention
program for reducing residential roof fires by use of an Underwriters
Laboratories Inc. (UL) and National Fire Protection Association Class A fire
rated roof system. This Class A system should comply with the test requirements
for fire resistance of roof coverings, as outlined in UL 790 or in ASTM
International (ASTM) E-108. Both the Asphalt Roofing Manufacturer's Association
(ARMA) and the National Roofing Contractors Association (NRCA) have set up
guidelines for selecting a new roof for the homeowner. Class A, fiber-glass-based
asphalt roofing shingles represent an overwhelming share of the United States
residential roofing market, and, as such, the Class A rated roofing system
remains an excellent alternative to wood shingles and shakes. Fortunately, the
Class A fire rating is available for certain wood shingle products that
incorporate a factory-applied, fire resistant treatment. However, in this
circumstance, wood products labeled as Class B shakes or shingles must be
installed over spaced or solid sheathing that have been covered either with one
layer of 1/4 in. (6.4 mm) thick noncombustible roof board, or with one layer of
minimum 72-lb. fiber-glass-based mineral surfaced cap sheet, or with another
specialty roofing sheet to obtain the Class A fire rating. Clay, tile, slate, and
metal have been assigned Class A fire ratings in the codes (but often without
testing). These alternative roofing materials are often considerably more
expensive. Proper application, ventilation, and insulation of roofing systems are
required to prevent heat and moisture buildup in the attic, which can damage the 
roofing system, making it more susceptible to water leakage as well as ignition
in the event of a fire. The NRCA has devised excellent recommendations for the
homeowner to prequalify the contractor. In addition, a warranty for any new
roofing material is important for the homeowner to ensure that the roofing can be
repaired by the contractor or manufacturer during the specified warranty period, 
in case of contractor error or a manufacturing defect. In addition, the homeowner
should ensure that the warranty is transferable to any future owner of the home
to allow the buyer to have the same warranty benefits as the original owner. The 
State of California has mandated strict roofing requirements to prevent
residential fires. In the absence of this legislation in other states, the
homeowner must follow the guidelines outlined in this collective review to ensure
that a roofing system with Class A fire protection is installed. Other fire
safety precautions that should also be considered mandatory are to include smoke 
alarms, escape plans, and retrofit fire sprinklers.

PMID: 15099189 [PubMed - indexed for MEDLINE]

1774: J Drugs Dermatol. 2004 Mar-Apr;3(2):127-9.

Veni, VD, vici: twelve points about herpes that need to be conquered.

Burkhart CG, Burkhart CN.

Publication Types: 
    Letter

PMID: 15098964 [PubMed - indexed for MEDLINE]

1775: Ann Acad Med Singapore. 2004 Mar;33(2):243-7.

Varicella screening and vaccination for healthcare workers at KK Women's and
Children's Hospital.

Chong CY, Lim SH, Ng WY, Tee N, Lin RV.

Infectious Disease Service, Department of Paediatrics, KK Women's and Children's 
Hospital, Singapore. cychong@kkh.com.sg

INTRODUCTION: Varicella is a highly contagious disease with significant morbidity
and mortality, especially in adults. It can lead to nosocomial transmission with 
dire consequences, especially in a healthcare facility where children and
pregnant women form the majority of patients. At KK Women's and Children's
Hospital, we embarked on a programme in 2 phases, between 1997 and 1999, to
screen healthcare workers (HCWs) for varicella immunity and to offer varicella
vaccination to those who tested negative for antibody. MATERIALS AND METHODS:
HCWs were initially screened via a questionnaire; those with no previous history 
of chickenpox underwent a blood test for varicella zoster antibody. Varicella
vaccine was offered to those who tested negative for antibody and they were
monitored for adverse reactions. RESULTS: Of the HCWs surveyed, 14.7% and 26.9%
in phases 1 and 2, respectively, had no previous history of chickenpox. Of these,
55.3% in phase 1 and 26.1% in phase 2 tested negative for antibodies. Thus, the
overall seronegativity of all HCWs surveyed was between 6.5% and 7.6%. Among
those who tested negative for antibodies, 42.9% in phase 1 and 74% in phase 2
were vaccinated. Hence, the overall vaccination rate in HCWs was 3.2% and 4.8% in
phases 1 and 2, respectively. Adverse reactions were observed in 2 (22.2%) HCWs
in phase 1 and in 9 (9.3%) in phase 2, consisting mostly of maculopapular rashes 
or vesicles around the injection site. CONCLUSIONS: Our study shows that 26% to
55% of HCWs with no history of chickenpox and who tested negative for antibody
against varicella required vaccination. Hence, in healthcare facilities,
varicella screening and vaccination should be offered to all HCWs.

Publication Types: 
    Evaluation Studies

PMID: 15098642 [PubMed - indexed for MEDLINE]

1776: Arch Neurol. 2004 Apr;61(4):529-32.

Brief presence of varicella-zoster vral DNA in mononuclear cells during relapses 
of multiple sclerosis.

Ordonez G, Pineda B, Garcia-Navarrete R, Sotelo J.

Neuroimmunology Unit, National Institute of Neurology and Neurosurgery of Mexico,
Mexico City.

BACKGROUND: A possible viral cause for multiple sclerosis (MS) has long been
suspected. A progressive increase in MS has been reported in Mexico during the
past 20 years; a conspicuous antecedent of varicella infection during childhood
has been the most relevant finding in the medical history of patients with MS.
OBJECTIVE: To investigate the possible participation of varicella-zoster virus
(VZV) in the etiopathogenesis of MS. DESIGN, SETTING, AND PATIENTS: We searched, 
by polymerase chain reaction (PCR), for VZV DNA in peripheral mononuclear cells
of 82 patients with relapsing-remitting MS. Additionally, genes gD from herpes
simplex viruses 1 and 2 were sought by PCR, as well as IgG and IgM serum
antibodies to VZV. RESULTS: Viral DNA from the genes open reading frame (ORF)31, 
ORF62, ORF63, and ORF67 of VZV was found in mononuclear cells from 13 (87%) of 15
patients with MS who were tested during acute relapse. All patients who were
tested during remission (n = 67) were negative for the DNA, including patients
who were initially positive and were tested again after 2 months of remission.
All control patients with a comprehensive variety of neurologic diseases (n =
100) and healthy controls (n = 20) also tested negative. All subjects were
negative for herpes simplex viruses 1 and 2 DNA, and no differences were found in
serum antibodies to VZV. CONCLUSIONS: The finding of genes of VZV in peripheral
mononuclear cells, restricted to a brief period during clinical relapse of MS,
suggests either its participation in the etiopathogenesis of MS or an
epiphenomenon of viral activation simultaneous with the relapse of MS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15096401 [PubMed - indexed for MEDLINE]

1777: Postgrad Med. 2004 Apr;115(4):63-5.

Childhood shingles. Herpes zoster can occur in healthy children too.

Brodell RT, Zurakowski JE.

Northeastern Ohio Universities College of Medicine, Rootstown, OH, USA.
rtb@neoucom

Publication Types: 
    Review

PMID: 15095537 [PubMed - indexed for MEDLINE]

1778: Int J Dermatol. 2004 Apr;43(4):298-9.

Subcutaneous granuloma annulare following herpes zoster.

Chang SE, Bae GY, Moon KC, Do SH, Lim YJ.

Department of Dermatology, Asan Medical Center, College of Medicine, University
of Ulsan, Seoul, South Korea. cse@snu.md

Publication Types: 
    Case Reports

PMID: 15090019 [PubMed - indexed for MEDLINE]

1779: Int J Dermatol. 2004 Apr;43(4):265-8.

Prevalence of dermatological disorders in Thai HIV-infected patients correlated
with different CD4 lymphocyte count statuses: a note on 120 cases.

Wiwanitkit V.

Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University,
Bangkok, Thailand. wviroj@pioner.netserve.chula.ac.th

BACKGROUND: Skin disease is one health problem among human immunodeficiency virus
(HIV)-seropositive patients. Several dermatological findings in HIV-infected
patients have been investigated. In this study, the skin lesions of 120
HIV-infected patients with different CD4 count statuses in Bangkok, Thailand, are
studied. METHODS: This study was performed as a cross-sectional descriptive
study. All subjects had a complete physical examination to detect their
dermatological disorders and carried out the necessary diagnostic procedures by
consultation with the dermatologist. RESULTS: Eighty percent of all patients were
observed to have one or more skin disorders. Xerosis (73.33%) and oral
candidiasis (54.17%) were the most common skin disorders, followed by seborrheic 
dermatitis (46.67%), pruritic papular eruption (36.67%), oral hairy leucoplakia
(12.50%), folliculitis (11.67%), herpes zoster (9.17%), and alopecia (6.67%).
CONCLUSION: Although the pattern of cutaneous lesions was comparable with
previous reports, the strikingly lower prevalence of skin tumor and drug eruption
was reviewed. Patients with advanced HIV infection were found to have
significantly more skin disorders than those with early stage HIV.

PMID: 15090008 [PubMed - indexed for MEDLINE]

1780: Pain. 2004 May;109(1-2):26-35.

Pregabalin reduces pain and improves sleep and mood disturbances in patients with
post-herpetic neuralgia: results of a randomised, placebo-controlled clinical
trial.

Sabatowski R, Galvez R, Cherry DA, Jacquot F, Vincent E, Maisonobe P, Versavel M;
1008-045 Study Group.

Department of Anaesthesiology, University of Cologne, Cologne, Germany.
rainer.sabatowski@uni-koeln.de

This study was designed to assess the efficacy and safety of pregabalin-a novel
alpha(2)-delta ligand with analgesic, anxiolytic, and anticonvulsant activity-for
treating neuropathic pain in patients with post-herpetic neuralgia (PHN). Two
hundred and thirty-eight patients were randomised into this multicentre,
doubleblind, placebo-controlled trial to receive 150 (n=81), 300 mg/day (n=76)
pregabalin, or placebo (n=81) for 8 weeks. Among the exclusion criteria was
failure to respond to previous treatment for PHN with gabapentin at doses > or
=1200 mg/day. Endpoint mean pain scores were significantly reduced in patients
receiving 150 or 300 mg/day pregabalin compared with placebo. Efficacy was
observed as early as week 1 and was maintained throughout the study.
Significantly more patients in both pregabalin groups (150 mg, 26%; 300 mg, 28%) 
were responders (> or =50% decrease in mean pain score from baseline to endpoint)
than in the placebo group (10%). Additionally, by week 1 and for the study's
duration, 150 and 300 mg/day pregabalin significantly reduced weekly mean sleep
interference scores. More pregabalin-treated patients than placebo-treated
patients reported that they were 'much improved' or 'very much improved'.
Health-related quality-of-life (HRQoL) measurements using the SF-36 Health Survey
demonstrated improvement in the mental health domain for both pregabalin dosages,
and bodily pain and vitality domains were improved in the 300 mg/day group. The
most frequent adverse events were dizziness, somnolence, peripheral oedema,
headache, and dry mouth. Pregabalin efficaciously treated the neuropathic pain of
PHN. Additionally, pregabalin was associated with decreased sleep interference
and significant improvements in HRQoL measures.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 15082123 [PubMed - indexed for MEDLINE]

1781: J Pediatr Gastroenterol Nutr. 2004 Mar;38(3):298-301.

Comment in:
    J Pediatr Gastroenterol Nutr. 2004 Mar;38(3):247-9.

Infliximab in pediatric ulcerative colitis: two-year follow-up.

Mamula P, Markowitz JE, Cohen LJ, von Allmen D, Baldassano RN.

Division of GI & Nutrition, The Children's Hospital of Philadelphia,
Philadelphia, Pennsylvania 19104, USA. Mamula@email.chop.edu

OBJECTIVES: The role of infliximab in treating pediatric ulcerative colitis (UC) 
is not defined. The authors previously have described their experience with the
open label use of infliximab in nine children with moderate to severe UC. The aim
of this study was to describe the outcome of these patients after a minimum
2-year follow-up and to describe the responses of eight additional patients to
this medication. METHODS: The authors reviewed all pediatric patients with UC who
received infliximab at The Children's Hospital of Philadelphia from its first use
until February 2003. Tolerance of the infusions and adverse events were recorded.
RESULTS: Follow-up information for a minimum of 2 years was reviewed for the nine
initial patients. A total of 73 infliximab infusions were administered to these
patients. Seven of nine (78%) patients were considered to be responders to the
initial dose of infliximab. Two of these patients became nonresponders within 9
months of the first dose of infliximab and underwent colectomy. Of the remaining 
five (56%) patients with sustained response, two continue to receive infliximab
infusions and three are doing well without infliximab. One patient experienced an
infusion reaction, and one experienced herpes zoster infection. We have treated
eight additional UC patients with infliximab. Seven (88%) patients were
considered responders. One responder experienced relapse within 2 months.
Overall, a short-term improvement was seen in 14 of 17 (82%) patients, and
sustained improvement in 10 of 16 (63%) patients followed up for more than 9
months. All five patients with severe or fulminant UC, unresponsive to 2 weeks of
intravenous corticosteroid therapy, experienced improvement with infliximab.
Infliximab was well tolerated. CONCLUSION: Infliximab is associated with short-
and long-term clinical improvement in children and adolescents with moderate to
severe UC.

PMID: 15076630 [PubMed - indexed for MEDLINE]

1782: J Clin Virol. 2004 May;30(1):39-44.

Routine use of a highly automated and internally controlled real-time PCR assay
for the diagnosis of herpes simplex and varicella-zoster virus infections.

Stranska R, Schuurman R, de Vos M, van Loon AM.

Department of Virology, Eijkman-Winkler Center, University Medical Center
Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. r.stranska@azu.nl

BACKGROUND: Detection of herpes viruses can be significantly improved by PCR. The
development of real-time PCR, which has overcome several limitations of
conventional PCR, improved the prospects for implementation of PCR-based assays
in diagnostic laboratory. OBJECTIVES: To compare the diagnostic performance of an
automated sample extraction procedure in combination with an internally
controlled real-time PCR assay for detection of herpes simplex virus (HSV) and
varicella-zoster virus (VZV) to conventional shell vial culture. STUDY DESIGN:
One hundred eighty-two consecutive specimens from patients suspected of HSV or
VZV infection were examined by internally controlled PCR and shell vial culture. 
An internal control consisting of phocine herpes virus was processed along with
the specimens during the entire procedure and permitted to monitor extraction and
amplification efficiency, including inhibition. RESULTS: A total of 48 (26.4%)
specimens were positive for HSV or VZV by culture, and 77 (42.3%) by real-time
PCR. Thus, overall sensitivity increased by 60.4%. All culture-positive specimens
were detected and typed correctly by PCR, except for a single specimen that
contained PCR inhibitors. Specifically, the real-time PCR assay increased the
detection rate for HSV-1 and HSV-2 by 43.9% and 62.5%, respectively. In
PCR-positive specimens, lower levels of viral DNA were found in culture-negative 
than in culture-positive specimens. The increase of HSV detection rates by PCR
varied with the origin of specimen and was particularly significant for skin
specimens (7/14 versus 3/14 detected by culture) and bronchoalveolar lavages (8/8
versus 1/8). In addition, real-time PCR significantly increased the detection
rate for VZV. CONCLUSIONS: Compared to shell vial culture, our real-time PCR
assay demonstrated a superior sensitivity and an added value of using internal
control for checking the quality of examination of each specimen. These results
provide a solid basis for implementation of real-time PCR in the routine
diagnosis of HSV and VZV infections in various clinical specimens.

Publication Types: 
    Comparative Study
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 15072752 [PubMed - indexed for MEDLINE]

1783: Leukemia. 2004 Jun;18(6):1093-101.

Consolidation with alemtuzumab in patients with chronic lymphocytic leukemia
(CLL) in first remission--experience on safety and efficacy within a randomized
multicenter phase III trial of the German CLL Study Group (GCLLSG).

Wendtner CM, Ritgen M, Schweighofer CD, Fingerle-Rowson G, Campe H, Jager G,
Eichhorst B, Busch R, Diem H, Engert A, Stilgenbauer S, Dohner H, Kneba M,
Emmerich B, Hallek M; German CLL Study Group (GCLLSG).

Klinikum Grosshadern, Medical Clinic III, Ludwig-Maximilians-University, Munich, 
Germany.

Patients with CLL responding to initial chemotherapy with fludarabine alone (F)
or in combination with cyclophosphamide (FC) were randomized for treatment with
alemtuzumab (30 mg i.v. TIW, 12 weeks) or observation. Of 21 evaluable patients, 
11 were randomized to alemtuzumab before the study was stopped due to severe
infections in seven of 11 patients. These infections (one life-threatening
pulmonary aspergillosis IV; four CMV reactivations III requiring i.v.
ganciclovir; one pulmonary tuberculosis III; one herpes zoster III) were
successfully treated and not associated with cumulative dose of alemtuzumab. In
the observation arm, one herpes zoster infection II and one sinusitis I were
documented. At 6 months after randomization, two patients in the alemtuzumab arm 
converted to CR, while three patients in the observation arm progressed. After
alemtuzumab treatment, five of six patients achieved a molecular remission in
peripheral blood while all patients in the observation arm remained MRD-positive 
(P=0.048). At 21.4 months median follow-up, patients receiving alemtuzumab showed
a significant longer progression-free survival (no progression vs mean 24.7
months; P=0.036). In conclusion, a consolidation therapy with alemtuzumab is able
to achieve molecular remissions and longer survival in CLL, but a safe treatment 
regimen needs to be determined.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase III
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 15071604 [PubMed - indexed for MEDLINE]

1784: J Clin Microbiol. 2004 Apr;42(4):1409-13.

Detection and genotyping of varicella-zoster virus by TaqMan allelic
discrimination real-time PCR.

Campsall PA, Au NH, Prendiville JS, Speert DP, Tan R, Thomas EE.

Department of Pathology and Laboratory Medicine, University of British Columbia
and Children's & Women's Health Centre of British Columbia, Canada.

A proportion of individuals vaccinated with live attenuated Oka varicella-zoster 
virus (VZV) vaccine subsequently develop attenuated chicken pox and/or herpes
zoster. To determine whether postvaccination varicella infections are caused by
vaccine or wild-type virus, a simple method for distinguishing the vaccine strain
from wild-type virus is required. We have developed a TaqMan real-time PCR assay 
to detect and differentiate wild-type virus from Oka vaccine strains of VZV. The 
assay utilized two fluorogenic, minor groove binding probes targeted to a single 
nucleotide polymorphism in open reading frame 62 that distinguishes the Oka
vaccine from wild-type strains. VZV DNA could be genotyped and quantified within 
minutes of thermocycling completion due to real-time monitoring of PCR product
formation and allelic discrimination analysis. The allelic discrimination assay
was performed in parallel with two standard PCR-restriction fragment length
polymorphism (RFLP) methods on 136 clinical and laboratory VZV strains from
Canada, Australia, and Japan. The TaqMan assay exhibited a genotyping accuracy of
100% and, when compared to both PCR-RFLP methods, was 100 times more sensitive.
In addition, the method was technically simpler and more rapid. The TaqMan assay 
also allows for high-throughput genotyping, making it ideal for epidemiologic
study of the live attenuated varicella vaccine.

Publication Types: 
    Evaluation Studies

PMID: 15070981 [PubMed - indexed for MEDLINE]

1785: J Pediatr. 2004 Apr;144(4):505-11.

Immunodeficiency and infections in ataxia-telangiectasia.

Nowak-Wegrzyn A, Crawford TO, Winkelstein JA, Carson KA, Lederman HM.

Eudowood Division of Pediatric Allergy and Immunology, Johns Hopkins University
School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287-3923, USA.

OBJECTIVE: To characterize the immunodeficiency in ataxia-telangiectasia (A-T)
and to determine whether the immunodeficiency is progressive and associated with 
increased susceptibility to infections. STUDY DESIGN: Records of 100 consecutive 
patients with A-T from the Johns Hopkins Ataxia-Telangiectasia Clinical Center
(ATCC) were reviewed. RESULTS: Immunoglobulin (Ig) deficiencies are common,
affecting IgG4 in 65% of patients, IgA in 63%, IgG2 in 48%, IgE in 23%, and IgG
in 18%. Lymphopenia affected 71% of patients, with reduced B-lymphocyte number in
75%, CD4 T lymphocytes in 69%, and CD8 T lymphocytes in 51%. There was no trend
for increased frequency or severity of immune abnormalities with age. Recurrent
upper and lower respiratory tract infections were frequent: otitis media in 46%
of patients, sinusitis in 27%, bronchitis in 19%, and pneumonia in 15%. Sepsis
occurred in 5 patients, in 2 patients concurrent with cancer chemotherapy. Warts 
affected 17% of patients, herpes simplex 8%, molluscum contagiosum 5%, candidal
esophagitis 3%, and herpes zoster 2%. Uncomplicated varicella infection occurred 
in 44% of patients; 2 patients had more than one clinical episode. No patient had
Pneumocystis jerovici pneumonia or a complication of live viral vaccine.
CONCLUSIONS: In spite of the high prevalence of laboratory immunologic
abnormalities, systemic bacterial, severe viral, and opportunistic infections are
uncommon in A-T. Cross-sectional analysis suggests that the immune defect is
rarely progressive.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15069401 [PubMed - indexed for MEDLINE]

1786: Ann Hematol. 2004 Mar;83(3):198-200. Epub 2003 Oct 8.

Comment in:
    Ann Hematol. 2004 Jun;83(6):408.

Herpes zoster during treatment with arsenic trioxide.

Tanvetyanon T, Nand S.

Cardinal Bernardin Cancer Center, 2160 S First Avenue, Maywood, IL 60153-3304,
USA. ttanve@lumc.edu

In vitro data suggest that arsenic compounds can suppress cell-mediated immunity 
by inducing apoptosis of T helper lymphocytes. We describe an occurrence of
herpes zoster during treatment with arsenic trioxide (ATO) in two patients who
were already in remission from acute promyelocytic leukemia and received ATO as
consolidation treatment. During this complication, their leukocyte counts and
differentials were within normal limits. Our report suggested the
immunosuppressive effect of ATO in vivo. Both patients responded well to an oral 
antiviral. Clinicians should be aware of this complication during treatment with 
ATO since early antiviral treatment may help avoid complications including
post-herpetic neuralgia.

Publication Types: 
    Case Reports

PMID: 15064871 [PubMed - indexed for MEDLINE]

1787: Eur J Neurol. 2004 Apr;11 Suppl 1:3-11.

Post-herpetic neuralgia case study: optimizing pain control.

Baron R.

Neurological Clinic, Christian-Albrechts-Universitat zu Kiel, Kiel, Germany.
r.baron@neurologie.uni-kiel.de

Post-herpetic neuralgia (PHN) is a chronic pain syndrome associated with the
reactivation of a primary infection with varicella zoster virus (chicken pox),
which leads to a chronic infection of the dorsal root ganglia. Under various
clinical circumstances, including immunosuppressive diseases or treatments and
certain cancers, reactivation of the infection can occur in adults as shingles.
Other factors such as psychological distress and stressful life events also
appear to play a role in the onset of shingles and the development of PHN. The
most common risk factor for shingles and its potential sequela, PHN, is advanced 
age. For a significant number of patients, the pain following healing of shingles
can persist for months to years; this pain is classified as PHN if it persists
longer than 3 months. PHN often leads to depression, disrupted sleep, decreased
functioning and increased healthcare utilization. Prompt use of antiviral therapy
appears to reduce the period of pain following an episode of shingles by about
half and may possibly reduce the overall incidence of PHN. Damage to a variety of
neurologic pathways as a result of herpes zoster reactivation suggests that
intervention with multiple agents having divergent mechanisms of action is an
appropriate treatment approach. Current treatment options aimed at relieving the 
symptoms of PHN include antidepressants, opioids, anticonvulsants and topical
analgesics. It is important for the clinician to establish a baseline pain
intensity and character as well as quality of life measures against which to
judge the effectiveness of any treatment. This review article features a case
study of a patient with PHN to illustrate current diagnostic and treatment
approaches.

Publication Types: 
    Case Reports
    Comparative Study
    Review

PMID: 15061819 [PubMed - indexed for MEDLINE]

1788: Leuk Lymphoma. 2004 Jan;45(1):79-84.

Pentostatin, chlorambucil and prednisone therapy for B-chronic lymphocytic
leukemia: a phase I/II study by the Eastern Cooperative Oncology Group study
E1488.

Oken MM, Lee S, Kay NE, Knospe W, Cassileth PA.

Hubert H. Humphrey Cancer Center, University of Minnesota, Minneapolis, MN, USA.

Pentostatin is a purine nucleoside analog with demonstrated activity in low-grade
lymphoid malignancies. The purpose of this study was to determine the dose of
pentostatin (dCF) that could be combined with chlorambucil and prednisone to
treat chronic lymphocytic leukemia (CLL), evaluate the toxicity of the resulting 
regimen and to estimate its efficacy. This was a multi-institutional Eastern
Cooperative Oncology Group (ECOG) phase I-II study. Individuals with active B-CLL
were eligible if they had no prior treatment or were in sensitive first relapse, 
provided they had normal renal and hepatic function. Pentostatin was evaluated in
combination with orally administered chlorambucil 30 mg/m2 and prednisone 80
mg/day, 1-5 of each 14-day cycle. The pentostatin dose was 2 mg/m2 IV, day 1 for 
the first 6 patients; 3 mg/m2 IV, day 1 for the next 6 patients; and 4 mg/m2 IV, 
day 1 for the last set of 6 patients. Fifty-five patients were entered. Because
of increasing toxicity with no apparent improvement in clinical efficacy on
escalation of the pentostatin dose, 2 mg/m2 was chosen as the phase II dose, and 
43 patients were treated at this level. Thirty-nine of these patients were
eligible, of which 38 were evaluable for response, 36 of these 38 had no prior
treatment. Complete response (CR) manifested by normal bone marrow morphology,
peripheral blood counts and resolution of any lymphadenopathy or
hepatosplenomegaly occurred in 17 patients (45%). The overall objective response 
rate was 87%. The median response duration was 33 months and the median survival 
5 years. The median time to treatment failure is 32 months. Severe (Grade 3+)
infections were seen in 31% of patients and included bacterial pneumonia (n = 4),
Pneumocystis pneumonia (n = 1), fungal pneumonia (n = 2), urinary tract infection
with sepsis (n = 1) and Herpes Zoster (n = 5). Overall, 11 patients had H. Zoster
while on study. Due to toxicity, 33% of patients stopped therapy. Pentostatin,
chlorambucil and prednisone is a highly active regimen in CLL but cannot be
recommended in present form because of an unacceptable incidence of opportunistic
infections. These findings add to other recent reports which suggest combination 
therapy with pentostatin and alkylators are active in B-CLL. However, these
combination chemotherapies will need to be combined with appropriate addition of 
anti-bacterial and anti-viral prophylaxis to reduce infection risk for B-CLL
patients.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase I
    Clinical Trial, Phase II

PMID: 15061201 [PubMed - indexed for MEDLINE]

1789: Eur J Haematol. 2004 May;72(5):353-7.

Immunogenicity of a two-dose regime of varicella vaccine in children with
cancers.

Leung TF, Li CK, Hung EC, Chan PK, Mo CW, Wong RP, Chik KW.

Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales
Hospital, Shatin, Hong Kong SAR, China. leung2142@cuhk.edu.hk

OBJECTIVE: Live-attenuated varicella vaccine is effective and safe in
immunocompetent children. In this study, we assess the immunogenicity and adverse
events following varicella vaccination in immunosuppressed cancer children.
METHODS: Varicella-zoster virus (VZV)-seronegative cancer children received two
doses of live-attenuated VZV vaccine (Varilrix) in a span of 3 months. Patients
with acute lymphoblastic leukaemia (ALL) were in the maintenance phase of
chemotherapy, whereas those with solid tumours joined the study around 3-6 months
from treatment discontinuation. VZV-specific cellular and humoral immune
responses were measured before and after VZV vaccination. RESULTS: The median
(range) age of the 17 patients was 4.4 yr (2.0-14.5). Thirteen had ALL, one had
myelodysplastic syndrome and three had solid tumours. Following vaccination, the 
VZV-specific stimulation index (SI) increased from 1.7 (0.9-2.9) to 17.9
(5.9-36.0) (P < 0.001). Similarly, SI to phytohaemagglutinin mitogen increased
from 1136 (499-1930) to 1714 (848-2518) (P = 0.028). There were also significant 
increases in CD4+ cells and CD4:CD8 ratio as well as a reduction in CD16/56+
cells in peripheral blood lymphocytes. Seroconversion rate to VZV was 19% after
one dose and increased to 94% after the second dose of VZV vaccine. Serum
VZV-specific IgG concentrations also increased significantly following two doses 
when compared with one dose of VZV vaccine (P = 0.0004). One subject developed
possibly vaccine-related chickenpox with self-limiting hepatitis at 5 wk
following vaccination. None of the patients developed herpes-zoster at a median
(range) follow-up of 27.5 months (24.0-30.0). CONCLUSIONS: Non-immune cancer
children can be effectively vaccinated against chickenpox at the defined period. 
However, the safety of chickenpox vaccine in these immunosuppressed children
needs to be further studied. Copyright Blackwell Munksgaard 2004.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15059071 [PubMed - indexed for MEDLINE]

1790: Enferm Infecc Microbiol Clin. 2004 Apr;22(4):253-4.

[Infection due to acyclovir-resistant varicella-zoster herpes virus in a patient 
with AIDS]

[Article in Spanish]

Ramos C, Lajusticia J.

Publication Types: 
    Case Reports
    Letter

PMID: 15056447 [PubMed - indexed for MEDLINE]

1791: Gen Dent. 2003 May-Jun;51(3):281-6; quiz 287.

Herpes simplex and varicella-zoster infections: clinical and laboratory
diagnosis.

Stoopler ET, Pinto A, DeRossi SS, Sollecito TP.

University of Pennsylvania, School of Dental Medicine, Philadelphia, USA.

One of a dentist's most common diagnostic challenges is determining the cause of 
vesiculo-ulcerative disorders of the oral cavity. The most common etiology of
oral vesicles is herpes simplex virus (HSV) infection. Varicella-zoster virus
(VZV) is a less common etiology of vesicles in the oral cavity. Dentists often
are able to differentiate these two viruses based on the clinical presentation of
infectious symptoms; however, further laboratory testing is required to identify 
herpetically induced vesiculo-ulcerative lesions definitively. This article
reviews the basic clinical signs and symptoms of HSV and VZV infection and
describes the various laboratory tests that can determine the definitive etiology
of the vesiculo-ulcerative disorder.

Publication Types: 
    Review

PMID: 15055715 [PubMed - indexed for MEDLINE]

1792: J Am Acad Nurse Pract. 2003 Dec;15(12 Suppl):16-21; quiz 22-4.

Managing the comorbidities of postherpetic neuralgia.

McCarberg B.

Chronic Pain Management Program, Kaiser Permanente, California, USA.

PURPOSE: To discuss the impact of pain and its associated comorbidities in
elderly patients with postherpetic neuralgia (PHN).To review the pharmacologic
treatments available for patients with chronic pain and concurrent sleep
disturbance, depression, and/or anxiety. DATA SOURCES: Relevant clinical
literature pertaining to the management of common comorbid conditions in patients
with PHN and chronic pain syndromes. CONCLUSIONS: Chronic pain strongly
influences physical and psychological function in elderly patients. Comorbid
illnesses, such as insomnia, depression, or anxiety, often develop in patients
with chronic pain and complicate overall pain management and worsen prognosis.
Pharmacologic treatment strategies that reduce pain frequently result in
concurrent improvements in common pain-associated comorbidities. Pharmacologic
treatment should be selected based on the efficacy of the selected agent(s),
potential for adverse effects, and impact on pain-associated comorbidity. A
multidisciplinary pain care management approach is essential to alleviate pain,
manage pain-associated comorbidities, and improve function and quality of life.
IMPLICATIONS FOR PRACTICE: Elderly patients who often deny their chronic pain are
at increased risk for such conditions as sleep disturbance, depression, and/or
anxiety. Nurses and nurse practitioners are in a unique position to improve pain 
care management by recognizing pain and its associated comorbidities early,
educating patients regarding their perception of pain, and facilitating rational 
pharmacotherapy with the goal to improve function and quality of life.

Publication Types: 
    Review

PMID: 15055385 [PubMed - indexed for MEDLINE]

1793: J Am Acad Nurse Pract. 2003 Dec;15(12 Suppl):10-5.

Diagnosis and treatment of herpes zoster: role of the nurse practitioner.

Wright WL.

Merrimack Village Family Practice Center, New Hampshire, USA.

DATA SOURCES: Case example and review of clinical trials, meta-analyses, and
reviews provide relevant data regarding the management of herpes zoster.
CONCLUSIONS: Herpes zoster is a relatively common disease in elderly patients. It
results from reactivation of varicella zoster virus (chickenpox). Characteristic 
vesicular lesions are often accompanied by significant acute pain.The risk of
complications, such as postherpetic neuralgia (PHN), increases when patients age 
or are inadequately treated. IMPLICATIONS FOR PRACTICE: Appropriate diagnosis and
management of herpes zoster may shorten the overall disease course, accelerate
cutaneous healing, and reduce the risk of PHN, a chronically painful
complication. Greater understanding of the epidemiology, clinical manifestations,
diagnosis, and available treatment options is essential for nurse practitioners
and other primary care providers to initiate early treatment in patients with
suspected herpes zoster infection.

Publication Types: 
    Review

PMID: 15055384 [PubMed - indexed for MEDLINE]

1794: J Am Acad Nurse Pract. 2003 Dec;15(12 Suppl):3-9.

Diagnosis and management of neuropathic pain: a balanced approach to treatment.

Nicholson BD.

Division of Pain Medicine and Hospice, Lehigh Valley Hospital and Health Network,
Allentown, Pennsylvania, USA.

PURPOSE: To provide nurse practitioners with a conceptual framework from which to
diagnose and manage chronic neuropathic pain, specifically postherpetic neuralgia
(PHN). A current review of the available treatment options for the management of 
neuropathic pain and PHN is provided. DATA SOURCES: A comprehensive literature
review was conducted. Clinical articles, meta-analyses, and reviews were selected
for their relevance to the diagnosis and management of chronic neuropathic pain
and PHN. CONCLUSIONS: Managing patients with chronic neuropathic pain is a common
clinical challenge due to variability in individual symptoms, mechanisms, and
treatment responses. In patients with PHN, a balanced treatment approach focusing
on efficacy, safety, and tolerability is recommended. With appropriate treatment,
most patients are able to achieve clinically significant relief from neuropathic 
pain. IMPLICATIONS FOR PRACTICE: Diagnosis and management of neuropathic pain
syndromes is challenging. Because of the complexity of chronic pain, successful
long-term treatment can be especially difficult (Nicholson, 2003b). While most
acute pain is nociceptive (i.e., a response to noxious stimuli), chronic pain can
be nociceptive, neuropathic, or of mixed origin. PHN is a chronic pain syndrome
that can last for years, causing physical and social disability and psychological
distress (Kanazi, 2000). Despite major recent advances in the treatment of PHN,
many patients remain refractory to current therapy (Dworkin, 2003). For
practicing clinicians, including nurse practitioners, viewing pain as a disease
rather than a symptom is the first step towards its successful management.
Understanding the pathophysiology of chronic pain and emerging treatment
paradigms for the management of neuropathic pain and PHN is critical to optimal
care.

Publication Types: 
    Review

PMID: 15055383 [PubMed - indexed for MEDLINE]

1795: J Neurol Sci. 2004 Apr 15;219(1-2):147-50.

Painful legs and moving toes syndrome associated with herpes zoster myelitis.

Ikeda K, Deguchi K, Touge T, Sasaki I, Tsukaguchi M, Shimamura M, Komatsu E,
Takeuchi H, Kuriyama S.

Third Department of Internal Medicine, Kagawa University School of Medicine,
1750-1 Ikenobe, Miki-cho, Kita-gun, 761-0793 Kagawa, Japan.

A 75-year-old woman developed painful legs and moving toes syndrome (PLMT) 16
months after the onset of herpes zoster (HZ) myelitis. Although the scattered
extensive lesions due to HZ myelitis were observed to be eccentric near the
posterior horn on MRI, these changes had disappeared upon the development of
PLMT. Combined median and tibial nerve somatosensory evoked potentials
demonstrated abnormal findings only in the tibial nerve stimuli, suggesting that 
a severe alteration occurred in the somatosensory fibers coming selectively from 
the lower legs. These findings suggest plasticity in the ascending somatosensory 
pathway including the posterior horn cells, probably involving the interneuron
networks, for the lower legs may underlie the development of PLMT associated with
HZ myelitis.

Publication Types: 
    Case Reports

PMID: 15050450 [PubMed - indexed for MEDLINE]

1796: Shanghai Kou Qiang Yi Xue. 1999 Jun;8(2):107.

[Treatment of severe pain caused by herpes zoster of the head and face by
blocking the astroganglion]

[Article in Chinese]

Xu H, Zhu YS, Huang Y.

Department of Anaesthesia, Shanghai Second Medical University. Shanghai
200011,China.

PMID: 15048286 [PubMed - as supplied by publisher]

1797: J Virol. 2004 Apr;78(8):3872-9.

Superinfection prevents recombination of the alphaherpesvirus bovine herpesvirus 
1.

Meurens F, Schynts F, Keil GM, Muylkens B, Vanderplasschen A, Gallego P, Thiry E.

Department of Infectious and Parasitic Diseases, Virology, and Immunology,
Faculty of Veterinary Medicine, University of Liege, B-4000 Liege, Belgium.

Homologous recombination between strains of the same alphaherpesvirus species
occurs frequently both in vitro and in vivo. This process has been described
between strains of herpes simplex virus type 1, herpes simplex virus type 2,
pseudorabies virus, feline herpesvirus 1, varicella-zoster virus, and bovine
herpesvirus 1 (BoHV-1). In vivo, the rise of recombinant viruses can be modulated
by different factors, such as the dose of the inoculated viruses, the distance
between inoculation sites, the time interval between inoculation of the first and
the second virus, and the genes in which the mutations are located. The effect of
the time interval between infections with two distinguishable BoHV-1 on
recombination was studied in three ways: (i) recombination at the level of
progeny viruses, (ii) interference induced by the first virus infection on
beta-galactosidase gene expression of a superinfecting virus, and (iii)
recombination at the level of concatemeric DNA. A time interval of 2 to 8 h
between two successive infections allows the establishment of a barrier, which
reduces or prevents any successful superinfection needed to generate recombinant 
viruses. The dramatic effect of the time interval on the rise of recombinant
viruses is particularly important for the risk assessment of recombination
between glycoprotein E-negative marker vaccine and field strains that could
threaten BoHV-1 control and eradication programs.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 15047803 [PubMed - indexed for MEDLINE]

1798: Nucleosides Nucleotides Nucleic Acids. 2004;23(1-2):67-76.

L-deaza-5'-noraisteromycin.

Yin X, Schneller SW.

Department of Chemistry, Auburn University, Auburn, Alabama 36849, USA.

(+/-)-1-Deazaaristeromycin (4) has been reported to be an inactivator of
S-adenosylhomocysteine (AdoHcy) hydrolase and, as a consequence, to affect
S-adenosylmethionine (AdoMet) mediated macromolecular biomethylations. To extend 
this to our program focused on 5'-noraristeromycin derivatives as inhibitors of
the same hydrolase enzyme as potential antiviral agents, both enantiomers of
1-deaza-5'-noraristeromycin (5 and 20) have been prepared. Compounds 5 and 20
were evaluated against the following viruses: vaccinia, cowpox, monkeypox, Ebola,
herpes simplex type 1 and 2, human cytomegalovirus, Epstein Barr, varicella
zoster, hepatitis B, hepatitis C, HIV-1 and HIV-2, adenovirus type 1, measles,
Pichinde, parainfluenza type 3, influenza A (H1N1 and H3N2), influenza B,
Venezuelan equine encephalitis, rhinovirus type 2, respiratory syncytial, yellow 
fever, and West Nile. No activity was found nor was there any cytotoxicity to the
viral host cells.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 15043137 [PubMed - indexed for MEDLINE]

1799: J Med Virol. 2004 May;73(1):137-46.

Prevalence of viral infection markers by polymerase chain reaction amplification 
and interferon-alpha measurements among patients undergoing lumbar puncture in an
emergency department.

Hausfater P, Fillet AM, Rozenberg F, Arthaud M, Trystram D, Huraux JM, Lebon P,
Riou B.

Service d'Accueil des Urgences, CHU Pitie-Salpetriere, AP-HP, Universite Pierre
et Marie Curie, Paris, France. pierre.hausfater@psl.ap-hop-paris.fr

Aseptic meningitis is a frequent diagnosis in emergency departments.
Nevertheless, viral investigations are not carried out currently and the viral
etiology in adult population has not been studied extensively. We conducted a
prospective study including all consecutive patients undergoing lumbar puncture
during a 15 months period in an adult emergency department. Bloody and purulent
cerebrospinal fluid (CSF) were excluded. The main tests undertaken were: CSF
genomic amplification by the polymerase chain reaction (PCR) for neurotropic
viruses and serum and CSF interferon-alpha (IFN-alpha) measurements. Among 194
patients included, 45 had and 149 did not have aseptic meningitis. Of 45 patients
with aseptic meningitis, 10 had alternative non-virological final diagnosis, and 
35/45 were presumed to have neurological disorders of viral origin. Patients
(27/35) completed virological analysis: 21/27 (78%) had either positive viral PCR
(enterovirus: 8 patients, Varicella zoster virus (VZV): 5, Epstein-Barr virus
(EBV): 2, herpes simplex virus (HSV): 1, human herpes virus 6: 1) or only raised 
serum or CSF IFN-alpha (4 patients). Overall, 59% of patients with a positive
viral PCR had either CSF or serum raised IFN-alpha. Twentyone patients without
meningitis had either positive viral PCR (enterovirus: 3 patients) or only high
serum IFN-alpha level (18 patients). In the setting of aseptic meningitis
diagnosed in an adult emergency department, viruses are the most common agents
encountered, with enterovirus and VZV as the two main etiological agents. Current
CSF viral genome amplification and IFN-alpha measurement are informative and
could be useful to confirm the viral origin of various neurological disorders,
although the sensitivity and specificity of IFN-alpha measurement for the
diagnosis of viral infection need further confirmation. Copyright 2004
Wiley-Liss, Inc.

PMID: 15042661 [PubMed - indexed for MEDLINE]

1800: J Med Virol. 2004 May;73(1):131-6.

Genetic variation in clinical varicella-zoster virus isolates collected in
Ireland between 2002 and 2003.

Carr MJ, McCormack GP, Crowley B.

Department of Clinical Microbiology, St. James's Hospital, Dublin, Ireland.

Analysis of genetic variation in 16 varicella-zoster virus (VZV) isolates
selected at random and circulating in the Irish population between March 2002 and
February 2003 was carried out. A 919 bp fragment of the glycoprotein E gene (open
reading frame 68) encompassing codon 150, at which a non-synonymous mutation
defines the escape mutant VZV-MSP, and including two other epitope regions e1 and
c1, was sequenced. No new single nucleotide polymorphisms (SNPs) were detected,
indicating stability of these epitopes in clinical isolates of VZV. However, when
four informative polymorphic markers consisting of defined regions from genes 1, 
21, 50, and 54 were sequenced 14 variable nucleotide positions were identified.
Phylogenetic analysis showed the presence of three highly supported clades A, B, 
and C circulating in the Irish population. Approximately one third (6/16; 37.5%) 
of the Irish VZV isolates in this study belonged to genotype C, 4/16 (25%) to
genotype A, and 4/16 (25%) to genotype B. A smaller number 2/16 (12.5%) belonged 
to genotype J1. This indicates remarkable heterogeneity in the Irish population
given the small sample size. No evidence was found to suggest any of the 16
isolates was a recombinant. These findings have implications for the model of
geographic isolation of VZV clades to certain regions as the circulating Irish
VZV population appears to comprise approximately equal numbers of each of the
main genotypes. This data is inconsistent with a model of strict geographical
separation of VZV genotypes and suggests that VZV diversity is more pronounced in
certain areas than had been thought previously. Copyright 2004 Wiley-Liss, Inc.

PMID: 15042660 [PubMed - indexed for MEDLINE]

1801: Minerva Stomatol. 2004 Jan-Feb;53(1-2):49-59.

[Herpes zoster of the trigeminal nerve: a case report and review of the
literature]

[Article in Italian]

Carbone V, Leonardi A, Pavese M, Raviola E, Giordano M.

UOADU di Odontostomatologia, ASO S. Luigi Gonzaga, Orbassano, Turin.

Herpes zoster (shingles) is caused when the varicella zoster virus that has
remained latent since an earlier varicella infection (chicken-pox) is
reactivated. Herpes Zoster is a less common and endemic disease than varicella:
factors causing reactivation are still not well known, but it occurs in older
and/or immunocompromised individuals. Following reactivation, centrifugal
migration of herpes zoster virus (HZV) occurs along sensory nerves to produce a
characteristic painful cutaneous or mucocutaneous vesicular eruption that is
generally limited to the single affected dermatome. Herpes zoster may affect any 
sensory ganglia and its cutaneous nerve: the most common sites affected are
thoracic dermatomes (56%), followed by cranial nerves (13%) and lumbar (13%),
cervical (11%) and sacral nerves (4%). Among cranial nerves, the trigeminal and
facial nerves are the most affected due to reactivation of HZV latent in
gasserian and geniculated ganglia. The 1st division of the trigeminal nerve is
commonly affected, whereas the 2nd and the 3rd are rarely involved. During the
prodromal stage, the only presenting symptom may be odontalgia, which may prove
to be a diagnostic challenge for the dentist, since many diseases can cause
orofacial pain, and the diagnosis must be established before final treatment. A
literature review of herpes zoster of the trigeminal nerve is presented and the
clinical presentation, differential diagnosis and treatment modalities are
underlined. A case report is presented.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 15041920 [PubMed - indexed for MEDLINE]

1802: Life Sci. 2004 Apr 9;74(21):2619-26.

Effects of the suppression of acute herpetic pain by gabapentin and amitriptyline
on the incidence of delayed postherpetic pain in mice.

Kuraishi Y, Takasaki I, Nojima H, Shiraki K, Takahata H.

Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, Toyama
Medical and Pharmaceutical University, 2630 Sugitani, Toyama 930-0194, Japan.
kiraisiy@ms.toyama-mpu.ac.jp

The inoculation of mice with herpes simplex virus type-1 (HSV-1) causes herpes
zoster-like skin lesions and pain-related responses (tactile allodynia and
mechanical hyperalgesia) from day 5 after inoculation. Skin lesions completely
heal by day 15 after inoculation, but about half of mice with acute herpetic pain
show pain-related responses long after the lesions heal. Using this mouse model, 
we examined the effects of repeated administration of gabapentin and
amitriptyline on the acute herpetic pain and the incidence of postherpetic pain. 
Gabapentin and amitriptyline were administered three times daily from day 5 to 11
after inoculation. Postherpetic pain-related responses were assessed on day 30
after inoculation. Gabapentin (10-100 mg/kg) produced the dose-dependent
inhibition of acute herpetic pain-related responses. This medication produced
marked reduction in the incidence of delayed postherpetic pain and the dose of
100 mg/kg produced the complete inhibition. Amitriptyline (10 mg/kg) did not
affect the acute pain-related responses in the initial 3- and 2-day periods and
then gradually inhibited them. This dosage produced a substantial but
non-significant decrease in the incidence of postherpetic pain-related responses.
Amitriptyline (1 and 3 mg/kg) was without effects on acute herpetic and
postherpetic pain-related responses. The results strongly support the idea that
the severity of the acute herpetic pain is a risk factor of postherpetic
neuralgia. It may be worth testing the effects of gabapentin on acute herpetic
pain and the incidence of postherpetic neuralgia in human subjects.

Publication Types: 
    Comparative Study

PMID: 15041444 [PubMed - indexed for MEDLINE]

1803: Can J Ophthalmol. 2004 Feb;39(1):74-6.

Management of ophthalmic zoster mucous plaque keratopathy: report of three cases.

Al-Muammar A, Jackson WB.

University of Ottawa Eye Institute, Ottawa, Ont.

Publication Types: 
    Case Reports

PMID: 15040618 [PubMed - indexed for MEDLINE]

1804: J Fr Ophtalmol. 2004 Mar;27(3):223-36.

[Viral cause and management of necrotizing herpetic retinopathies]

[Article in French]

Tran TH, Bodaghi B, Rozenberg F, Cassoux N, Fardeau C, LeHoang P.

Service d'Ophtalmologie, Hopital Pitie Salpetiere, 47-83, boulevard de l'Hopital,
75013 Paris.

PURPOSE: To study the viral cause and present the management of necrotizing
herpetic retinopathies. METHODS: Charts of patients presenting with acute retinal
necrosis (ARN) or progressive outer retinal necrosis (PORN) diagnosed between
March 1997 and June 2001 were retrospectively reviewed. Intraocular specimens
were obtained in 33 cases to determine the viral cause using polymerase chain
reaction-based assays and/or detection of intraocular antibody production.
RESULTS: The mean age was 43.4 Years. Herpesvirus genome was identified in 29
patients (80.5%). In the ARN group (32 patients, 38 eyes), herpes simplex virus
(HSV) DNA was found in 11 patients (34.4%), varicella-zoster virus (VZV) in nine 
patients (28.1%), and cytomegalovirus (CMV) in four patients (12.5%). One patient
(3.1%) presented an Epstein-Barr virus (EBV) infection. ARN was bilateral at
initial examination in six patients and secondary bilateralization was observed
in four patients. In the PORN group (four patients, eight eyes), the retinitis
was bilateral and VZV DNA was detected in all cases. Two patients were treated
with intravenous acyclovir, six with foscarnet alone, ten with intravenous
foscarnet + acyclovir, 18 with intravenous foscarnet and intravitreous
ganciclovir injections. Complications of necrotizing herpetic retinitis were
cataract (26%), optic nerve atrophy (23.9%), and retinal detachment (17.4%).
Final visual acuity was less or equal to 20/200 in 47.8% of cases. CONCLUSIONS:
It is important to determine the specific viral etiology since progression and
prognosis may be different in herpetic necrotizing retinitis caused by HSV, VZV, 
or CMV. Visual prognosis is improved by intensive antiviral therapy, but remains 
poor if complications occur.

Publication Types: 
    English Abstract

PMID: 15039624 [PubMed - indexed for MEDLINE]

1805: Clin Infect Dis. 2004 Apr 1;38(7):e57-62. Epub 2004 Mar 12.

Lower-limb hypoplasia due to intrauterine infection with herpes simplex virus
type 2: possible confusion with intrauterine varicella-zoster syndrome.

Johansson AB, Rassart A, Blum D, Van Beers D, Liesnard C.

Neonatal Intensive Care Unit, Hopital Universitaire des Enfants Reine Fabiola,
Brussels, Belgium. anne-britt.johansson@huderf.be

A neonate with lower-limb hypoplasia, cutaneous scars, bilateral chorioretinitis,
and multiple brain abnormalities is presented. Intrauterine herpes simplex virus 
type 2 (HSV-2) infection was established on the basis of serological testing of
the mother and viral cultures of the child's cutaneous lesions, obtained soon
after birth. This is, to the best of our knowledge, the first case of a patient
with in utero-acquired HSV-2 infection presenting with a limb hypoplasia. It
illustrates that, in addition to congenital varicella-zoster syndrome, HSV-2
infection should also be considered in patients presenting with limb hypoplasia.

Publication Types: 
    Case Reports

PMID: 15034848 [PubMed - indexed for MEDLINE]

1806: Ann Hematol. 2004 Jun;83(6):408. Epub 2004 Mar 18.

Comment on:
    Ann Hematol. 2004 Mar;83(3):198-200.

Herpes zoster during treatment with arsenic trioxide.

Lanska DJ.

Publication Types: 
    Comment
    Letter

PMID: 15034759 [PubMed - indexed for MEDLINE]

1807: J Am Acad Dermatol. 2004 Apr;50(4):495-528; quiz 529-32.

Vaccines and immunotherapies for the prevention of infectious diseases having
cutaneous manifestations.

Wu JJ, Huang DB, Pang KR, Tyring SK.

Center for Clinical Studies, Houston, Texas, USA.

Although the development of antimicrobial drugs has advanced rapidly in the past 
several years, such agents act against only certain groups of microbes and are
associated with increasing rates of resistance. These limitations of treatment
force physicians to continue to rely on prevention, which is more effective and
cost-effective than therapy. From the use of the smallpox vaccine by Jenner in
the 1700s to the current concerns about biologic warfare, the technology for
vaccine development has seen numerous advances. The currently available vaccines 
for viral illnesses include Dryvax for smallpox; the combination measles, mumps, 
and rubella vaccine; inactivated vaccine for hepatitis A; plasma-derived vaccine 
for hepatitis B; and the live attenuated Oka strain vaccine for varicella zoster.
Vaccines available against bacterial illnesses include those for anthrax,
Haemophilus influenzae, and Neisseria meningitidis. Currently in development for 
both prophylactic and therapeutic purposes are vaccines for HIV, herpes simplex
virus, and human papillomavirus. Other vaccines being investigated for prevention
are those for cytomegalovirus, respiratory syncytial virus, parainfluenza virus, 
hepatitis C, and dengue fever, among many others. Fungal and protozoan diseases
are also subjects of vaccine research. Among immunoglobulins approved for
prophylactic and therapeutic use are those against cytomegalovirus, hepatitis A
and B, measles, rabies, and tetanus. With this progress, it is hoped that
effective vaccines soon will be developed for many more infectious diseases with 
cutaneous manifestations.

Publication Types: 
    Review

PMID: 15034501 [PubMed - indexed for MEDLINE]

1808: Recenti Prog Med. 2004 Jan;95(1):47-50.

[Saint Anthony's fire and herpes zoster in various pages of Antonio Tabucchi]

[Article in Italian]

Giusti G.

II Universita, Napoli.

Publication Types: 
    Portraits

PMID: 15032342 [PubMed - indexed for MEDLINE]

1809: Biochim Biophys Acta. 2004 Mar 11;1697(1-2):169-80.

The UL97 protein kinase of human cytomegalovirus and homologues in other
herpesviruses: impact on virus and host.

Michel D, Mertens T.

Universitatsklinikum Ulm, Abteilung Virologie, Albert-Einstein-Allee 11, 89081
Ulm, Germany. detlef.michel@medizin.uni-ulm.de

The human herpesviruses, herpes simplex virus 1 (HSV-1), HSV-2, varicella zoster 
virus (VZV), Epstein-Barr virus (EBV), human cytomegalovirus (HCMV), human
herpesvirus 6A (HHV-6A), HHV-6B, HHV-7 and HHV-8, establish persistent infections
with possible recurrence during immunosuppression. HCMV replication is inhibited 
by the nucleoside analogue ganciclovir (GCV), the compound of choice for the
treatment of HCMV diseases and preemptive treatment of infections. The viral UL97
protein (pUL97) which shares homologies with protein kinases and bacterial
phosphotransferases is able to monophosphorylate GCV. Homologues of pUL97 are
found in HSV (UL13), VZV (ORF47), EBV (BGLF4), HHV-6 (U69), HHV-8 (ORF36) as well
as in murine CMV (M97) or rat CMV (R97). Several indolocarbazoles have been
reported to be specific inhibitors of pUL97. The protein is important for
efficient replication of the virus. Autophosphorylation of pUL97 was observed
using different experimental systems. Most recently, it has been shown that pUL97
interacts with the DNA polymerase processivity factor pUL44. Indolocarbazole
protein kinase inhibitors are promising lead compounds for the development of
more specific inhibitors of HCMV.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 15023359 [PubMed - indexed for MEDLINE]

1810: Ophthalmology. 2004 Mar;111(3):501-6.

Comment in:
    Ophthalmology. 2007 Jun;114(6):1232.

Evaluation of patients with scleritis for systemic disease.

Akpek EK, Thorne JE, Qazi FA, Do DV, Jabs DA.

The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 North 
Wolfe Street, Maumenee Building #321, Baltimore, MD 21287-9238, USA.
esakpek@jhmi.edu

OBJECTIVE: To evaluate the relationship between associated medical conditions and
scleritis-particularly, the timing of the diagnosis of these diseases. DESIGN:
Retrospective case series. PARTICIPANTS: Patients with scleritis presenting to a 
single center over an 18-year period. METHODS: Medical records were reviewed for 
the presence of an associated infectious or rheumatic disease and for the timing 
of the diagnosis of the systemic disease relative to the presentation for
evaluation of the scleritis. MAIN OUTCOME MEASURES: Presence of an associated
medical condition and timing of diagnosis relative to that of scleritis. RESULTS:
In a series of 243 patients with scleritis, 44.0% had an associated medical
condition: 7.0%, an infection, and 37.0%, a rheumatic disease. The most frequent 
infection was herpes zoster, and the most frequent rheumatic disease was
rheumatoid arthritis, present in 4.5% and 15.2% of patients, respectively. Of the
107 patients with an underlying disease, 77.6% had a previously diagnosed
disease, 14.0% had their conditions diagnosed as a result of the initial
evaluation, and 8.4% developed a systemic disease during follow-up. Systemic
vasculitis was less likely to have been previously diagnosed than other rheumatic
diseases (59.1% vs. 83.8%, P = 0.015) and more likely to be diagnosed by the
initial diagnostic evaluation (27.3% vs. 8.8%, P = 0.027). Ten patients (4.1%)
had a positive antineutrophil cytoplasmic antibody (ANCA) test result without
clinical evidence of a systemic vasculitis. Four of 5 patients with a positive
cytoplasmic ANCA test result but no clinical evidence of systemic vasculitis
required immunosuppressive drugs for control of the scleritis, whereas 1 of the 5
patients with a positive perinuclear ANCA test result required immunosuppressive 
drugs. Among patients with no evident systemic disease after the initial
diagnostic evaluation, the rate of occurrence of a rheumatic disease was 4% per
person-year. CONCLUSIONS: Although associated systemic diseases are frequent
among patients with scleritis, the majority are previously diagnosed. Systemic
vasculitis is less likely than other rheumatic diseases to have been previously
diagnosed. Because vasculitis is a potentially life-threatening disorder, it
should be a focus of the diagnostic evaluation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 15019326 [PubMed - indexed for MEDLINE]

1811: J Clin Virol. 2004 Apr;29(4):248-53.

Once, twice, or three times daily famciclovir compared with aciclovir for the
oral treatment of herpes zoster in immunocompetent adults: a randomized,
multicenter, double-blind clinical trial.

Shafran SD, Tyring SK, Ashton R, Decroix J, Forszpaniak C, Wade A, Paulet C,
Candaele D.

Division of Infectious Diseases, Department of Medicine, 2E4.16 Walter C.
Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440-112
Street, Edmonton, Alta., Canada T6G 2B7. sshafran@ualberta.ca

BACKGROUND: Famciclovir, the well absorbed oral pro-drug of penciclovir, is
effective in the treatment of herpes zoster when given three times daily. Because
the intracellular half-life of penciclovir triphosphate in varicella-zoster virus
(VZV)-infected cells (7h) is considerably longer than that of aciclovir
triphosphate (1h), it may be possible to administer famciclovir less frequently
than three times daily for herpes zoster: aciclovir is administered five times
daily. METHODS: 559 immunocompetent adults presenting with herpes zoster whose
skin lesions were present for less than 72 h were randomized to receive
famciclovir 750 mg once daily (od), 500 mg twice daily (bid), or 250 mg three
times daily (tid), or aciclovir 800 mg five times daily. All treatments were
given for 7 days. Participants were evaluated until complete healing or for 4
weeks, whichever occurred first. RESULTS: There were no significant differences
between the four treatment groups with respect to times to full crusting; loss of
vesicles, ulcers and crusts; cessation of new lesion formation; a 50% reduction
in the area of affected skin; and the loss of acute pain. CONCLUSIONS:
Famciclovir 750 mg once daily, 500 mg twice daily and 250 mg daily, and aciclovir
800 mg five times daily are three times comparable in efficacy with respect to
the cutaneous healing of herpes zoster. The current study was not designed to
assess the effects of the treatments on postherpetic neuralgia (PHN).

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 15018852 [PubMed - indexed for MEDLINE]

1812: Pharm World Sci. 2004 Feb;26(1):10-1.

Medication error due to ambiguous labelling of a commercial product.

Guchelaar HJ, Kalmeijer MD, Jansen ME.

Department of Clinical Pharmacy & Toxicology, Leiden University Medical Centre,
Albinusdreef 2, 2300 RC Leiden, The Netherlands. h.j.guchelaar@lumc.nl

Medication errors may involve prescribing, dispensing, preparation and
administration of drugs. We report a case in which an administration error
occurred due to ambiguous labelling of a commercial drug. Tablets were packed in 
sets of two tablets per blister with the print on the blister 'Zelitrex 500',
making the amount of drug per tablet unclear. A short survey among nurses and
pharmacy technicians showed that the majority interpreted the strength of the
tablets incorrectly. This case shows that, despite regulations for controlling
and accepting labelling before marketing, ambiguous labelling may occur and can
lead to medication errors.

Publication Types: 
    Case Reports

PMID: 15018253 [PubMed - indexed for MEDLINE]

1813: Pharm World Sci. 2004 Feb;26(1):8-9.

Clostridium difficile colitis associated with valaciclovir.

De Andres S, Ferreiro D, Ibanez M, Ballesteros A, Garcia B, Agud JL.

Pharmacy Service, Severo Ochoa Hospital, 28911 Leganes (Madrid), Spain.

OBJECTIVE: To report a case of Clostridium difficile colitis associated with
valaciclovir treatment. CASE SUMMARY: A 73-year-old man with lumbar herpes-zoster
started valaciclovir 1 g tid. After three days he began vomiting and developed
diarrhea, three to four stools per day. Symptoms worsened over the following days
and he was admitted. Valaciclovir was stopped and fluid and electrolyte
replacement was started. He continued 6 days later with diarrhea of 7 to 13
stools per day and a stool test for diagnosis of C. difficile infection was
performed with a positive result. The patient received oral metronidazole (500
mg/t.i.d. for 10 days) and rapid improvement and eventual resolution of his
diarrhea was observed after 3 days of therapy. DISCUSSION: Although no conclusive
reports of this reaction exist, we think this is a case of C difficile colitis
that appeared three days after valaciclovir was initiated. Colitis improved with 
metronidazole. Other causes of diarrhea were excluded, such as diabetes mellitus,
renal failure, intestinal surgery and intestinal obstruction. Infection was
confirmed by a positive test for C. difficile. The application of Naranjo's
algorithm asserts the reaction as 'probable'. CONCLUSIONS:
Valaciclovir-associated C. difficile colitis, although rare, can have severe
consequences for the patient's health. It should be included as a possible
adverse effect of valaciclovir treatment by health professionals.

Publication Types: 
    Case Reports

PMID: 15018252 [PubMed - indexed for MEDLINE]

1814: Dermatol Clin. 2004 Jan;22(1):51-61.

Skin infections in the elderly.

Weinberg JM, Vafaie J, Scheinfeld NS.

Department of Dermatology, St. Luke's-Roosevelt Hospital Center, 1090 Amsterdam
Avenue, Suite 11D, New York, NY 10025, USA. jmw27@columbia.edu

The diagnosis and management of viral diseases of the skin are significant issues
in the elderly population. With advances in these areas, there are new tools to
combat these diseases and limit morbidity. It is important for clinicians to
monitor and treat these diseases aggressively in the elderly because of the
potential for immunosuppression in this population. Further advances in antiviral
therapy and the potential for the development of antiviral vaccines will aid in
the therapy of these diseases. Onychomycosis is found more frequently in the
elderly. In this population, the most common clinical presentations are distal
and lateral subungual onychomycosis (which usually affects the great or first
toe) and white superficial onychomycosis (which generally involves the third or
fourth toes). Over the past several years, new treatments for this disorder have 
emerged that offer shorter courses of therapy and greater efficacy than previous 
therapies. The treatment of bacterial skin and skin structure infections in the
elderly is an important issue. There has been an alarming increase in the
incidence of gram-positive infections, including resistant bacteria, such as MRSA
and drug-resistant pneumococci. Although vancomycin has been considered the drug 
of last defense against gram-positive multidrug-resistant bacteria, the late
1980s saw a rise in vancomycin-resistant bacteria, including VRE. With treatment 
options limited, it has become critical to identify antibiotics with novel
mechanisms of activity. Several new drugs have emerged as possible therapeutic
alternatives, including linezolid and quinupristin-dalfopristin.

Publication Types: 
    Review

PMID: 15018009 [PubMed - indexed for MEDLINE]

1815: Expert Opin Pharmacother. 2004 Mar;5(3):551-9.

Management of herpes zoster (shingles) and postherpetic neuralgia.

Johnson RW, Whitton TL.

Pain Management Clinic, Bristol Royal Infirmary, Bristol, UK.
rwjbristol@doctors.org.uk

Herpes zoster (HZ) results from recrudescence of varicella zoster virus latent
since primary infection (varicella). The overall incidence of HZ is approximately
3/1000 of the population per year rising to 10/1000 per year by 80 years of age. 
Approximately 50% of individuals reaching 90 years of age will have had HZ. In
approximately 6%, a second attack may occur (usually several decades after the
first). Patients with HZ can transmit the virus to a non-immune individual
causing varicella. HZ is not contracted from individuals with varicella or HZ.
Reduced cell-mediated immunity to HZ occurs with ageing, explaining the increased
incidence in the elderly and from other causes such as tumours, HIV and
immunosuppressant drugs. Diagnosis is usually clinical from typical unilateral
dermatomal pain and rash. Prodromal symptoms, pain, itching and malaise, are
common. The most common complication of HZ is postherpetic neuralgia (PHN),
defined as significant pain or dysaesthesia present >or= 3 months after HZ. PHN
results from damage and secondary changes within components of the nervous system
subserving pain. Some motor deficit is common; severe and long-lasting paresis
may rarely accompany HZ. More than 5% of elderly patients have PHN at 1 year
after acute HZ. Predictors of PHN are, greater age, acute pain and rash severity,
prodromal pain, the presence of virus in peripheral blood as well as adverse
psychosocial factors. Therapy for acute HZ is intended to reduce acute pain,
hasten rash healing and reduce the risk of PHN and other complications. Antiviral
drugs are close to achieving these aims but do not entirely remove risk of PHN.
Oral steroids show no protective effect against PHN. Adequate analgesia during
the acute phase may require strong opioid drugs. Nerve blocks and tricyclic
antidepressants (TCAs) may reduce the risk of PHN although firm evidence is
lacking. PHN requires thorough evaluation and development of a management
strategy for each individual patient. Initial therapy is with TCAs (e.g.,
nortriptyline) or the anticonvulsant gabapentin. Topical lidocaine patches
frequently reduce allodynia. Strong opioids are sometimes required. Topical
capsaicin cream is beneficial for a small proportion of patients but is poorly
tolerated. NMDA antagonists have not proved beneficial with the exception of
ketamine. Transcutaneous Electrical Nerve Stimulation (TENS) may be effective in 
some cases. HZ is a common condition. Severe complications such as stroke,
encephalitis and myelitis are relatively rare whereas sight threatening
complications of ophthalmic HZ are more common. PHN is common, distressing and
often intractable. Good management improves outcome.

Publication Types: 
    Review

PMID: 15013924 [PubMed - indexed for MEDLINE]

1816: Headache. 2004 Mar;44(3):286-8.

Herpes zoster ophthalmicus, ophthalmoplegia, and trauma.

Evans RW, Lee AG.

Department of Ophthalmology, The University of Iowa Hospital and Clinics, Iowa
City 52242, USA.

Publication Types: 
    Case Reports

PMID: 15012669 [PubMed - indexed for MEDLINE]

1817: Clin Chem. 2004 May;50(5):819-25. Epub 2004 Mar 9.

Comment in:
    Clin Chem. 2004 May;50(5):801-2.

Simple technique for internal control of real-time amplification assays.

Burggraf S, Olgemoller B.

Labor Becker, Olgemoller und Kollegen, Fuhrichstrasse 70, 81671 Munchen, Germany.
sburggraf@labor-bo.de

BACKGROUND: In real-time PCR assays, the most accurate way to identify
false-negative results, e.g., those caused by PCR inhibitors, is to add to
samples an internal control that will be coamplified with the target (e.g.,
pathogen) DNA. Current internal control procedures, however, which usually
involve the introduction of a DNA fragment, are complex, time-consuming, and
expensive. METHODS: Single-stranded oligonucleotides, which contain little more
than primer and probe binding sites, were used as internal controls in real-time 
PCR assays. Mismatches were included in the probe-binding region of the internal 
control oligonucleotide (ICO) to prevent probe-control hybridization during the
fluorescence acquisition step of the PCR. Amplified ICOs were detected by melting
point analysis. ICOs could be added directly to the sample material before DNA
extraction. RESULTS: To demonstrate the feasibility of the new approach, we
designed ICOs for the LightCycler hybridization probe assays for Mycobacterium
tuberculosis complex, hepatitis B virus, herpes simplex virus, and varicella
zoster virus. In each case, the controls did not interfere with detection of the 
pathogen, but were clearly detectable during a subsequent melting point analysis.
CONCLUSIONS: A single-stranded oligonucleotide that mimics the target region of
the pathogen but is clearly distinguishable from the target during melting point 
analysis can serve as a simple, cost-effective internal control for real-time
amplification assays. Such control oligonucleotides are easy to design and
inexpensive. A costly second probe system is not necessary. Moreover, the
internally controlled assay uses only one fluorescence detection channel of the
instrument, leaving the second channel free for multiplex applications.

PMID: 15010426 [PubMed - indexed for MEDLINE]

1818: BMC Anesthesiol. 2004 Jan 26;4(1):2.

The PINE study: rationale and design of a randomised comparison of epidural
injection of local anaesthetics and steroids versus care-as-usual to prevent
postherpetic neuralgia in the elderly [ISRCTN32866390].

Opstelten W, Van Wijck AJ, Van Essen GA, Buskens E, Bak AA, Kalkman CJ, Verheij
TJ, Moons KG.

Julius Center for Health Sciences and Primary Care, University Medical Center
Utrecht, PO Box 85060, 3500 AB Utrecht, The Netherlands. w.opstelten@med.uu.nl

BACKGROUND: Postherpetic neuralgia (PHN) is by far the most common complication
of herpes zoster (HZ) and one of the most intractable pain disorders. Since PHN
is seen most often in the elderly, the number of patients with this disorder is
expected to increase in our ageing society. PHN may last for months to years and 
has a high impact on the quality of life. The results of PHN treatment are rather
disappointing. Epidural injection of local anaesthetics and steroids in the acute
phase of HZ is a promising therapy for the prevention of PHN. Since randomised
trials on the effectiveness of this intervention are lacking, the PINE
(Prevention by epidural Injection of postherpetic Neuralgia in the Elderly) study
was set up. The PINE study compares the effectiveness and cost-effectiveness of a
single epidural injection of local anaesthetics and steroids during the acute
phase of HZ with that of care-as-usual (i.e. antivirals and analgesics) in
preventing PHN in elderly patients. METHODS / DESIGN: The PINE study is an open, 
multicenter clinical trial in which 550 elderly (age >/= 50 yr.) patients who
consult their general practitioner in the acute phase of HZ (rash < 7 days) are
randomised to one of the treatment groups. The primary clinical endpoint is the
presence of HZ-related pain one month after the onset of the rash. Secondary
endpoints include duration and severity of pain, re-interventions aiming to treat
the existing pain, side effects, quality of life, and cost-effectiveness.
CONCLUSION: The PINE study is aimed to quantify the (cost-) effectiveness of a
single epidural injection during the acute phase of HZ on the prevention of PHN.

PMID: 15005813 [PubMed - as supplied by publisher]

1819: Eye. 2004 Mar;18(3):304-5.

PCR for varicella zoster virus genome negative in corneal epithelial cells of
patients with Thygeson's superficial punctate keratitis.

Reinhard T, Roggendorf M, Fengler I, Sundmacher R.

Eye Hospital, Heinrich-Heine University, Dusseldorf, Germany.
thomas.reinhard@uni-duesseldorf.de

PURPOSE: To find out if varicella zoster virus is the causative agent of
Thygeson's superficial punctuate keratitis. METHODS: Epithelial cells were
harvested from the punctuate epithelial lesions 9 patients with Thygeson's
superficial punctate keratitis. After DNA extraction polymerase chain reaction
was carried out with varicella zoster virus primers. RESULTS: All samples were
negative with regard to varicella zoster virus genome. CONCLUSIONS: This result
suggests that varicella zoster virus is most probably not the causative agent of 
Thygeson's superficial punctate keratitis.

PMID: 15004582 [PubMed - indexed for MEDLINE]

1820: J Clin Virol. 2004 Mar;29(3):206-9.

Monitoring herpesvirus DNA in three cases of acute retinal necrosis by real-time 
PCR.

Asano S, Yoshikawa T, Kimura H, Enomoto Y, Ohashi M, Terasaki H, Nishiyama Y.

Department of Ophthalmology, Nagoya University School of Medicine, Nagoya, Aichi 
4668550, Japan.

BACKGROUND: It is not clear whether quantitative analysis of viral DNA in ocular 
specimens is correlated with disease activities of acute retinal necrosis (ARN). 
OBJECTIVES: To monitor viral load in ocular specimens collected from patients
with ARN by real-time polymerase chain reaction (PCR). STUDY DESIGN: Ocular
samples (aqueous humor and vitreous) were serially collected from three patients 
with ARN. Viral load in those samples was evaluated by real-time PCR. RESULTS AND
CONCLUSION: In case 1, large amounts of varicella zoster virus (VZV) DNA (4.8 x
10(6) to 5.5 x 10(6) copies/ml) were detected in aqueous humor during the first 2
weeks after admission. The viral load in vitreous was higher than that in aqueous
humor at the time of vitrectomy. As ophthamoscopic findings and visual acuity
improved through acyclovir (ACV) treatment, the viral load in aqueous humor
decreased dramatically. In case 2, the patient was treated with intravenous ACV
at first, but clinical features did not improve. The herpes simplex virus (HSV)-2
viral load in aqueous humor remained stable (2.3 x 10(3) to 2.8 x 10(3)
copies/ml) during the first 3 weeks after admission. The amount of HSV-2 DNA in
vitreous was again higher than that in aqueous humor. Although neither clinical
features nor viral load had changed by ACV, intra-ocular ganciclovir (GCV)
injection improved clinical features, and decreased viral load to undetectable
levels. In case 3, the patient developed ARN within 1 month after the onset of
varicella and demonstrated only mild clinical symptoms. She was treated with ACV 
administration alone and recovered quickly. In contrast to case 1, the copy
number of VZV DNA at the time of admission was low (9 x 10(2) copies/ml), and
decreased quickly in response to the treatment. Correlation between viral load in
ocular specimens and clinical course of the disease was demonstrated in these
patients.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 15002491 [PubMed - indexed for MEDLINE]

1821: J Infect Dis. 2004 Mar 15;189(6):1009-12. Epub 2004 Feb 27.

Detection of aerosolized varicella-zoster virus DNA in patients with localized
herpes zoster.

Suzuki K, Yoshikawa T, Tomitaka A, Matsunaga K, Asano Y.

Department of Dermatology, Fujita Health University School of Medicine, Toyoake, 
Japan. kayokos@fujita-hu.ac.jp

We examined the excretion of varicella zoster virus (VZV) in hospitalized
patients with herpes zoster localized to the thoracic region whose skin lesions
were covered with either hydrocolloid dressing agents (hydrocolloid group) or
conventional gauze bandages (gauze group). The presence of VZV DNA in swab
samples from lesion coverings, the throat, and filters of air purifiers was
examined by use of a sensitive polymerase chain reaction assay. For the
hydrocolloid group, VZV was detected in none of the samples from lesion coverings
or air purifier filters; for the gauze group, VZV DNA was detected in samples
from gauze coverings and air purifier filters for all 6 patients. VZV DNA was
detected less frequently in throat samples from patients in the hydrocolloid
group than in those from patients in the gauze group. The results of the present 
study suggest that hydrocolloid dressing agents prevent excretion of aerosolized 
VZV DNA from skin lesions of patients with localized herpes zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14999603 [PubMed - indexed for MEDLINE]

1822: Ophthalmologe. 2004 Sep;101(9):941-4.

[HIV seroprevalence in ophthalmologic patients of Cameroon]

[Article in German]

Wilhelm F, Herz E, McArthur C, Werschnik C.

Universitatsklinik und Poliklinik fur Augenheilkunde, Martin-Luther-Universitat, 
Halle/Saale.

BACKGROUND: It is difficult to estimate the exact HIV infection rates in
countries such as Cameroon because of diagnostic and statistical problems. The
majority of people seek help from traditional healers outside the health system. 
PATIENTS AND METHODS: A screening for human immunodeficiency virus type 1 (HIV-1)
and type 2 (HIV-2) was performed on 2452 patients of the western province of
Cameroon. All data were evaluated regarding HIV seroprevalence and
ophthalmological findings in HIV-seropositive patients. The test covered all
patients who came for cataract surgery (group 1), all outpatients with suspicious
ophthalmological findings (group 2), and all remarkable patients of the
collaborating department of general medicine (group 3) between 20 September 2000 
and 20 September 2001. RESULTS: Of the 2452 screened patients, 467 (19.0%) were
HIV seropositive. A positive test result was obtained in 29 (5.5%) of the 525
patients in group 1, 154 (35.6%) of the 433 patients in group 2, and 284 (19.0%) 
of the 1494 patients in group 3. The main ocular manifestations of the 154
HIV-seropositive patients in group 2 were uveitis (17.6%), squamous cell
carcinoma of the conjunctiva (14.9%), zoster ophthalmicus (14.9%), and corneal
ulcers (11.0%). CONCLUSIONS: This study shows that the seroprevalence of the
screened population of Cameroon lies between 5.5% (results of group 1) and 19.0% 
(results of group 3).

Publication Types: 
    English Abstract

PMID: 14999411 [PubMed - indexed for MEDLINE]

1823: Acupunct Electrother Res. 2003;28(3-4):183-92.

Does a viral infection cause complex regional pain syndrome?

Muneshige H, Toda K, Kimura H, Asou T.

Department of Rehabilitation, Hiroshima University Hospital, 1-2-3 Kasumi,
Minami-ku, Hiroshima, Japan 734-8551.

In 1990 Omura, Y. reported that Herpes Simplex Virus Type 1 as the major cause of
chronic intractable pain and its effective treatment using mixture of EPA & DHA
with Selective Drug Uptake Enhancement Method. Subsequently among the other
causes of pain, he included Chlamydia Trachomatis, Borrelia Burgdorferi,
Mycobacterium Tuberculosis, human Herpes Virus type 6, and Circulatory
Disturbances. In order to test possible involvement of viral infection in Complex
Regional Pain Syndrome (CRPS), a disease which usually occurs in the extremities,
we did a study of 17 patients with CRPS. They were examined for Herpes Simplex
Virus (HSV) and Varicella Zoster Virus (VZV) by measuring IgG and IgM antibody
titers, and 14 of these patients were also examined for Cytomegalo-Virus (CMV).
As a control group 100 healthy Japanese employees at SRL, Inc. were also studied.
In CRPS group, HSV IgG was positive in 12 of the 17 patients with an average
antibody titer of 90.0 EIA value. VZV IgG was positive in all 17 patients with an
average antibody titer of 26.8 EIA value. CMV IgG was positive in all 14 patients
with an average antibody titer of 66.6 UA/ml. In control group, HSV IgG was
positive in 54 subjects with an average antibody titer of 42.3 EIA value. VZV IgG
was positive in 97 subjects with an average antibody titer of 26.2 EIA value. CMV
IgG was positive in 82 subjects. There were no significant differences of
positive rate of IgG antibody for the three viruses between patient and control
groups. Although the difference was not significant, the average antibody titers 
of HSV in CRPS group were more than twice of those in healthy group. Antibody
titers were almost equal in both groups for VZV. Possibly, some people in the
control group who had latent virus, were also asymptomatic. In 2000, Takasaki, I.
et al. in a separate animal study, inoculated with HSV Type-I the shin of the
mouse causing allodynia and hyperalgesia (which are some of the characteristic
findings seen in CRPS in humans). Also, VZV, which causes shingles which is
sometimes followed by Post-Herpetic Neuralgia (PHN), is in the same family of
HSV. As PHN resembles CRPS in symptoms, it is possible that HSV contributes to
CRPS. Therefore, virus infection theory is an attractive hypothesis that accounts
for many enigmas of CRPS.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 14998056 [PubMed - indexed for MEDLINE]

1824: Med Microbiol Immunol. 2005 Jan;194(1-2):7-12. Epub 2004 Mar 2.

Quantitative real time PCR detection of Varicella-zoster virus DNA in
cerebrospinal fluid in patients with neurological disease.

Aberle SW, Aberle JH, Steininger C, Puchhammer-Stockl E.

Institute of Virology, Medical University of Vienna, Kinderspitalgasse 15, 1095, 
Vienna, Austria. stephan.aberle@meduniwien.ac.at

Varicella-zoster virus (VZV) reactivation can lead to the development of
neurological disease. Diagnosis has been based on the detection of VZV DNA in
cerebrospinal fluid (CSF) by PCR-based methods. The aim of this study was to
determine whether the VZV DNA copy number in the CSF correlates with the course
of the disease and to determine its prognostic relevance. VZV DNA was quantified 
in CSF samples obtained from 30 patients with neurological disease due to VZV
reactivation using real time PCR, and the VZV DNA copy number was correlated to
the clinical and laboratory findings for each case. Viral loads ranged from 50
copies/ml to 2.6 x 10(8) copies/ml. Significantly higher viral loads [geometric
mean (GM): 7.2 x 10(4) copies/ml] were found in patients with encephalitis
compared to patients with meningitis (GM: 4.1 x 10(3) copies/ml) (P=0.01,
Mann-Whitney U test). In eight patients without zoster dermal lesions no
significant difference in viral load (GM: 4.6 x 10(3)) was detected compared to
patients exhibiting dermal lesions (GM: 2.2 x 10(4)) (P=0.14). High copy numbers 
of VZV DNA in CSF were clearly associated with the severity of neurological
disease and none of the patients with a VZV viral load below 10(4) copies had a
disease course which required intensive care.

PMID: 14997388 [PubMed - indexed for MEDLINE]

1825: Br J Dermatol. 2004 Feb;150(2):365-6.

Herpes zoster occurring as a solitary nodule on the index finger.

Izu K, Yamamoto O, Yasumoto S, Hashimoto T, Sata T, Tokura Y.

Department of Dermatology, School of Medicine, University of Occupational and
Environmental Health, Kitakyushu 807-8555, Japan. k-izu@med.uoeh-u.ac.jp

Publication Types: 
    Case Reports

PMID: 14996113 [PubMed - indexed for MEDLINE]

1826: Ann Otol Rhinol Laryngol. 2004 Feb;113(2):113-4.

Herpes zoster laryngis with prelaryngeal skin erythema.

Wu CL, Linne OC, Chiang CW.

Dept of Otorhinolaryngology-Head and Neck Surgery, Lo-Tung Poh-Ai Hospital, 83
Nan Chang St, Lo-Tung 265, I-Lan, Taiwan.

A 74-year-old man came to our hospital with complete left vocal cord paralysis
and erythema of the prelaryngeal skin. The patient also had mucosal swelling and 
erosions in the left arytenoid cartilage, aryepiglottic fold, and pyriform sinus.
Herpetic vesicles developed over the prelaryngeal erythema 4 days after
admission. An increase in the varicella-zoster immunoglobulin G level to 3,294
IU/mL confirmed varicella-zoster virus infection of the larynx and prelaryngeal
skin. The patient was treated with acyclovir without marked effect. Nevertheless,
in cases of unilateral vocal cord paralysis and erythema of the ipsilateral
prelaryngeal skin, we advise that herpes zoster laryngis must be considered and
treatment with early intravenous acyclovir started.

Publication Types: 
    Case Reports

PMID: 14994764 [PubMed - indexed for MEDLINE]

1827: J Anesth. 2004;18(1):36-8.

Intravenous infusion of adenosine 5"-triphosphate alleviated a disabling
postherpetic neuralgia.

Hayashida M, Sato K, Fukunaga A, Fukuda K, Sekiyama H, Sawamura S, Arita H,
Hanaoka K.

Department of Anesthesiology and Pain Relief Center, The University of Tokyo
Hospital, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.

Publication Types: 
    Case Reports

PMID: 14991473 [PubMed - indexed for MEDLINE]

1828: Eur Arch Psychiatry Clin Neurosci. 2004 Feb;254(1):4-8.

Antibodies to infectious agents in individuals with recent onset schizophrenia.

Leweke FM, Gerth CW, Koethe D, Klosterkotter J, Ruslanova I, Krivogorsky B,
Torrey EF, Yolken RH.

Dept. of Psychiatry and Psychotherapy, University of Cologne, Cologne, France.

We investigated the levels of antibodies to infectious agents in the serum and
cerebral spinal fluids (CSFs) of individuals with recent onset schizophrenia and 
compared these levels to those of controls without psychiatric disease. We found 
that untreated individuals with recent onset schizophrenia had significantly
increased levels of serum and CSF IgG antibody to cytomegalovirus and Toxoplasma 
gondii as compared to controls. The levels of serum IgM class antibodies to these
agents were not increased. Untreated individuals with recent onset schizophrenia 
also had significantly lower levels of serum antibody to human herpesvirus type 6
and varicella zoster virus as compared to controls. Levels of antibodies to
herpes simplex virus type 1, herpes simplex virus type 2, and Epstein Barr virus,
and did not differ from cases and controls.We also found that treatment status
had a major effect on the levels of antibodies in this population. Individuals
who were receiving treatment had lower levels of antibodies to cytomegalovirus
and Toxoplasma gondii, and higher levels of serum antibodies to human herpesvirus
type 6 as compared to untreated individuals. The level of antibodies to
Toxoplasma and human herpesvirus type 6 measured in treated individuals did not
differ from the levels measured in controls. In the case of cytomegalovirus, the 
levels of CSF antibodies in treated individuals did not differ from those of
controls, while the level of serum IgG antibodies to CMV remained slightly
greater than controls in this population.Our studies indicate that untreated
individuals with recent onset schizophrenia have altered levels of antibodies to 
cytomegalovirus, Toxoplasma gondii, and human herpesvirus type 6 while the levels
of these antibodies in treated individuals with recent onset schizophrenia are
similar to those of controls. These findings indicate that infectious agents may 
play a role in the etiopathogenesis of some cases of schizophrenia.

Publication Types: 
    Comparative Study

PMID: 14991372 [PubMed - indexed for MEDLINE]

1829: Ann Pharmacother. 2004 Apr;38(4):550-6. Epub 2004 Feb 27.

Pharmaceutical care for HIV patients on directly observed therapy.

Foisy MM, Akai PS.

Northern Alberta HIV Program, Royal Alexandra Hospital and DOT for HAART Program,
Boyle McCauley Health Centre, Edmonton, Alberta, Canada. michellefoisy@shaw.ca

BACKGROUND: Inner-city patients infected with HIV can be a challenging group to
treat. Homelessness, mental illness, substance abuse, and hepatitis C infection
may serve as barriers to effective treatment. A multidisciplinary team including 
the pharmacist can impact upon the delivery of care to the inner-city HIV patient
population. OBJECTIVE: To describe the implementation and provision of
pharmaceutical care to inner-city patients taking directly observed therapy
(DOT), as well as drug-related problems (DRPs) and their respective outcomes.
METHODS: Pharmaceutical care, including the prospective identification and
management of DRPs, was provided by a clinical pharmacist. RESULTS: Fifty-seven
patients were followed over a 14-month period. Overall, 149 DRPs were identified 
and >95% were resolved. Those included (1) adverse effects (n = 56;
gastrointestinal, central nervous system effects, allergies, laboratory
abnormalities), (2) drug interactions (n = 32), (3) drugs indicated for
comorbidities (n = 24; safety in pregnancy, tuberculosis, Pneumocystis carinii
pneumonia prophylaxis, oral candidiasis, herpes zoster, nutritional supplements),
(4) adherence issues (n = 20; altering timing of medication, changing
formulation, decreasing pill burden), (5) drugs no longer indicated (n = 10;
opportunistic infection prophylaxis, treatment of primary infection), and (6)
dosage adjustment (n = 7) for weight and renal insufficiency. CONCLUSIONS: In the
provision of pharmaceutical care to HIV-infected patients on DOT, an HIV
pharmacist significantly contributed to antiretroviral selection, monitoring of
drug therapy, and managing DRPs. An HIV pharmacist can assist in promoting
patient adherence and improved outcomes in this setting.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14990778 [PubMed - indexed for MEDLINE]

1830: Enferm Infecc Microbiol Clin. 2004 Mar;22(3):150-5.

[Value of the polymerase chain reaction in the diagnosis of herpes infections of 
the nervous system]

[Article in Spanish]

Garcia-Bardeci D, Pena MJ, Suarez-Bordon P, Aladro Y, Perez-Gonzalez C, Lafarga
B.

Servicio de Microbiologia, Hospital de Gran Canaria Dr. Negrin, Las Palmas de
Gran Canaria, Spain.

OBJECTIVE: To assess the performance of a polymerase chain reaction (PCR) method 
in cerebrospinal fluid (CSF) for the diagnosis of nervous system infections
caused by herpesvirus, and to estimate the incidence of encephalitis due to
herpes simplex virus type 1 in the adult population of the island of Gran
Canaria. METHODS: We studied 330 CSF specimens from 312 patients (281
HIV-negative and 31 HIV-positive) remitted to investigate clinically suspected
encephalitis or meningitis, or to study neuropathy or demyelinating disease. A
multiplex PCR technique was used to detect herpes simplex virus types 1 and 2
(HSV-1 and HSV-2), varicella-zoster virus (VZV), human cytomegalovirus (CMV),
Epstein-Barr virus and human herpesvirus type 6. The patients' clinical records
were reviewed to establish the definite diagnosis. RESULTS: Nine samples from
eight patients (2.6%) showed positive results (9.7% of patients with pathological
CSF and none with normal CSF). The eight patients had clinical and analytic
findings of herpesvirus nervous system infection: HSV-1 DNA in four patients with
encephalitis, HSV-2 DNA in one patient with meningitis, VZV DNA in two patients
with meningitis and CMV DNA in one HIV-positive patient with encephalitis.
Herpesvirus was the cause of 50% of encephalitis cases and 10% of meningitis
cases. The incidence of HSV-1 encephalitis was five cases per million inhabitants
per year. CONCLUSIONS: Diagnosis of herpesvirus nervous system infections by PCR 
in CSF is not appropriate when CSF parameters are normal. We found a higher
incidence of herpesvirus encephalitis than has been reported in other studies.

Publication Types: 
    English Abstract
    Evaluation Studies

PMID: 14987535 [PubMed - indexed for MEDLINE]

1831: An Pediatr (Barc). 2004 Mar;60(3):282-3.

[Herpes zoster in a 2-month-old infant, intragestational varicella and reexposure
to exogenous varicella zoster]

[Article in Spanish]

Guerrero-Fernandez J, Guerrero Vazquez J, Russo de la Torre F, Luengo Casasola
JL, de Paz Aparicio P.

Publication Types: 
    Case Reports
    Letter

PMID: 14987525 [PubMed - indexed for MEDLINE]

1832: Rheumatol Int. 2004 Nov;24(6):359-61. Epub 2004 Feb 18.

Meningitis in mixed connective tissue disease complicated by herpes virus
infection: case report.

Bodolay E, Dioszeghy P, Demeter J, Banyai A, Csipo I, Szegedi G, Szekanecz Z.

Division of Clinical Immunology, Third Department of Internal Medicine,
University of Debrecen Medical and Health Science Center, 4004 Debrecen, Moricz
Zs. 22., Hungary. bodolai@iiibel.dote.hu

The authors report a rare case of a female patient diagnosed with mixed
connective tissue disease (MCTD). After a few years in remission, the patient
acquired herpes zoster infection followed by a disease flare. Disease activity
was accompanied by the development of meningitis. To determine whether the
meningitis was caused by the previous herpes virus infection or was aseptic
meningitis associated with the activity of MCTD raised important differential
diagnostic issues. Repeated laboratory assessments of the patient's sera and
cerebrospinal fluid revealed leukocytopenia, high anti-U1 ribonucleoprotein
autoantibody level, increased immune complex, and decreased complement
concentrations. The administration of corticosteroids resulted in rapid
improvements in clinical symptoms and laboratory indicators.

Publication Types: 
    Case Reports

PMID: 14986060 [PubMed - indexed for MEDLINE]

1833: Am J Med. 2004 Mar 1;116(5):318-24.

Cerebrospinal fluid interleukin 8 concentrations and the subsequent development
of postherpetic neuralgia.

Kotani N, Kudo R, Sakurai Y, Sawamura D, Sessler DI, Okada H, Nakayama H,
Yamagata T, Yasujima M, Matsuki A.

Department of Anesthesiology, Yamagata University, Japan.
kotani@med.id.yamagata-u.ac.jp

PURPOSE: Other than age, the risk factors for postherpetic neuralgia are not well
established. We studied whether the concentration of interleukin 8 in the
cerebrospinal fluid is associated with the risk of postherpetic neuralgia.
METHODS: We enrolled 170 patients more than 50 years old who had a typical
painful and nontrigeminal herpetic rash. Patients were treated with acyclovir; no
corticosteroids were given. Cerebrospinal fluid was taken for analysis of
interleukin 8 during and at full crusting of the herpetic rash. Age, sex,
comorbid conditions, prodromal pain, localization and severity of herpetic rash, 
number of skin lesions, and degree of pain were recorded. We used multivariate
logistic regression modeling to identify significant predictive factors. Receiver
operating characteristic (ROC) curves were evaluated to determine the
contribution of each factor. RESULTS: Six months after healing, 31 patients (18%)
had postherpetic neuralgia; 27 patients still had it after 1 year. Only three
variables-age (odds ratio [OR] = 2.7 per 10-year increase; 95% confidence
interval [CI]: 1.2 to 6.2), acute pain (OR = 1.8 per unit increase in visual
analog scale; 95% CI: 1.2 to 2.8), and interleukin 8 concentration in the
cerebrospinal fluid at full crusting of the herpetic rash (OR = 1.6 per
20-microg/L increase; 95% CI: 1.3 to 2.0)-were significant predictors of
postherpetic neuralgia at 1 year. Interleukin 8 concentration also had the
highest area under the ROC curve at these evaluation points (P <0.001).
CONCLUSION: Our results suggest that interleukin 8 concentration in the
cerebrospinal fluid at full crusting of herpetic rash may be useful for
identifying patients who are likely to develop intractable postherpetic
neuralgia.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 14984817 [PubMed - indexed for MEDLINE]

1834: Anaesthesia. 2004 Mar;59(3):213-5.

Design issues for studies into prevention of chronic pain: lessons from
post-herpetic neuralgia.

Opstelten W, van Wijck AJ, Moons KG.

PMID: 14984516 [PubMed - indexed for MEDLINE]

1835: J Med Virol. 2004 Apr;72(4):625-9.

Are enterovirus infections a co-factor in sudden hearing loss?

Mentel R, Kaftan H, Wegner U, Reissmann A, Gurtler L.

Friedrich-Loeffler-Institute of Medical Microbiology,
Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany.
Renate.Mentel@uni-greifswald.de

Since viral infections are believed to be one of the causes of sudden hearing
loss we have used serological assays for herpes simplex virus (HSV), varicella
zoster virus (VZV), and enterovirus as well as polymerase chain reaction for
enterovirus to test 55 sudden hearing loss patients for viral infections.
Serological screening of these patients for HSV and VZV failed to reveal
significant differences between the patient group and the controls. In contrast, 
enterovirus sequences were detected by RT-PCR in 40% of the patient group, but in
none of the controls, suggesting that enterovirus infections may be associated
with sudden hearing loss. Copyright 2004 Wiley-Liss, Inc.

PMID: 14981765 [PubMed - indexed for MEDLINE]

1836: Epidemiol Infect. 2004 Jan;132(1):1-5.

Gender difference in the incidence of shingles.

Fleming DM, Cross KW, Cobb WA, Chapman RS.

Birmingham Research Unit of the Royal College of General Practitioners, 54
Lordswood Road, Harborne, Birmingham B17 9DB, UK.

We investigated age- and gender-specific incidence of shingles reported in a
large sentinel practice network monitoring a defined population over the years
1994-2001. In total, 5915 male and 8617 female incident cases were studied. For
each age group, we calculated the relative risk of females to males presenting
with shingles. Incidence rates of chickenpox and herpes simplex were examined
similarly. Shingles incidence was greater in females in each age group (except
for 15-24 years). Relative risks (female to male) were greatest in age groups
45-64 years (1.48) and 0-14 years (1.43). There were no gender differences in the
incidence of chickenpox except in the 15-24 years age group (female excess): for 
herpes simplex there were female excesses in all age groups. Gender-specific
age-standardized incidence rates of shingles were calculated for each year and
showed a consistent female excess in each of the 8 years (average annual excess
28%).

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 14979582 [PubMed - indexed for MEDLINE]

1837: Int J Hematol. 2004 Jan;79(1):85-91.

Hemopoietic recovery and infectious complications in breast cancer and multiple
myeloma after autologous CD34+ cell-selected peripheral blood progenitor cell
transplantation.

De Rosa L, Anghel G, Pandolfi A, Riccardi M, Amodeo R, Majolino I.

Hematology and Bone Marrow Transplantation Unit, Azienda Ospedaliera San
Camillo-Forlanini, Rome, Italy. l.derosa@tin.it

Autografting with CD34+ cell-selected peripheral blood progenitor cells (PBPC) is
often associated with a prolonged recovery time and a higher incidence of
infections. The aim of our study was to evaluate whether underlying disease
influences hemopoietic recovery and the infectious complications occurring after 
transplantation. We studied 19 breast cancer (BC) patients and 17 multiple
myeloma (MM) patients entered in a high-dose chemotherapy (HDC) program of tandem
autografting with CD34+ cell-selected PBPC. PBPC were collected after mobilizing 
chemotherapy plus granulocyte colony-stimulating factor and were processed for
selection of CD34+ cells. After selection, a median of 53% CD34+ cells was
recovered with a median final purity of 92% with no significant differences
between the MM (52% and 92%, respectively) and BC (53% and 89%, respectively)
patients. Medians of 4.5 x 10(6)/kg CD34+ cells (BC, 4.4 x 10(6)/kg; MM, 5.4 x
10(6)/kg) and 18 x 10(4)/kg colony-forming units-granulocyte-macrophage (BC, 21 x
10(4)/kg: MM, 16 x 10(4)/kg) were reinfused after each HDC. Twenty-six patients
(10 MM and 16 BC) underwent tandem autografting, and 10 patients received only 1 
autograft because of inadequate collection (5 patients), clinical condition (3
patients), and refusal (2 patients). In the BC patients, the HDC regimen included
a high-dose melphalan course followed by an ICE (ifosfamide, carboplatin, and
etoposide) course. In the MM patients, the regimen consisted of a course of
high-dose melphalan therapy and a course of ICBV (idarubicin, cyclophosphamide
[Cytoxan], BCNU, and etoposide) or total body irradiation, etoposide, and
Cytoxan. We found a significantly prolonged time for neutrophil recovery to >
500/microL in the MM patients (13 days versus 10 days; P < .002), whereas the
times for platelet recovery to > 20,000/microL in the two groups were not
different (13 days versus 12 days; not significant). No late engraftment failures
and no toxic deaths were observed. The incidences of extrahematologic toxicity
were similar for the two patient groups. All patients received similar
anti-infection prophylaxis for 3 months after transplantation. After 12 months of
observation, we found a statistically significant higher incidence of bacterial
infections in MM patients in both the early (77.8% versus 48.6%; P < .034) and
the late (41.1% versus 0%; P < .014) posttransplantation periods, whereas the
incidences of fungal infections were similar in the two groups. Viral infections 
consisted of herpes zoster virus infection in 2 patients of each group, and
cytomegalovirus infection was observed in 3 MM patients and no BC patients. Our
experience demonstrates a prolonged neutrophil recovery time and higher
incidences of bacterial and viral infections in MM patients compared with BC
patients. These observations, although limited by the small sample size, suggest 
that the underlying disease may influence the incidence of infections after CD34-
cell-selected transplantation and should be considered in the planning of
appropriate antimicrobial prophylaxis in the autologous transplantation setting.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 14979484 [PubMed - indexed for MEDLINE]

1838: J Am Soc Nephrol. 2004 Mar;15(3):809-17.

Long-term benefits with sirolimus-based therapy after early cyclosporine
withdrawal.

Kreis H, Oberbauer R, Campistol JM, Mathew T, Daloze P, Schena FP, Burke JT,
Brault Y, Gioud-Paquet M, Scarola JA, Neylan JF; Rapamune Maintenance Regimen
Trial.

Hopital Necker, Paris, France. kreis@necker.fr

Graft function at 6 or 12 mo is positively correlated with renal transplant
survival. The 36-mo results of a study that tested whether withdrawing
cyclosporine (CsA) from a sirolimus (SRL)-CsA-steroid (ST) regimen would affect
renal graft survival are reported. Eligible patients (n = 430) who were receiving
SRL-CsA-ST were randomly assigned at 3 mo to remain on SRL-CsA-ST or to have CsA 
withdrawn (SRL-ST group). At 36 mo, the calculated GFR was significantly better
with SRL-ST (47.3 versus 59.4 ml/min; P < 0.001) as was the slope of the GFR
(-3.6 versus 0.8 ml/min; P < 0.001). This was accompanied by growing trend for
improved graft survival in the SRL-ST group (85.1% versus 91.2%, P = 0.052 at 36 
mo; 81.4% versus 91.2%, P = 0.015 in a cumulative data analysis up to 54 mo),
despite numerically more biopsy-proven acute rejections after randomization (5.6%
versus 10.2%; P = 0.107). Lipid parameters were similar between groups, whereas
both systolic and diastolic BP were significantly lower in the SRL-ST group.
Investigator-reported hypertension, abnormal kidney function, edema,
hyperuricemia, hyperkalemia, gingival hyperplasia, and Herpes zoster occurred
significantly more often in SRL-CsA-ST patients. Abnormal liver function test
results, hypokalemia, thrombocytopenia, and abnormal healing were reported
significantly more often with SRL-ST. The discontinuation rate was significantly 
higher for SRL-CsA-ST (48% versus 38%; P = 0.041). In conclusion, withdrawing CsA
from a SRL-CsA-ST regimen at 3 mo after transplantation resulted in long-term
benefits for renal transplant recipients.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 14978184 [PubMed - indexed for MEDLINE]

1839: J Reprod Med. 2004 Jan;49(1):38-40.

Outcome of IgM- and IgG-seropositive cases of varicella zoster in pregnancy.

Barak M, Weinberger R.

Central Laboratory, Faculty of Medicine, Technion, Haifa, Israel.

OBJECTIVE: To study the outcome of IgG- and IgM-seropositive cases of varicella
zoster virus (VZV) in pregnancy. STUDY DESIGN: The VZV immune status of 120
pregnant women who had been exposed to VZV and did not recall a history of VZV
infection was determined, and 109 were VZV immune. Eleven women were both IgG and
IgM seropositive, and the outcomes of their pregnancies were studied. RESULTS:
Nine of the 11 VZV IgM-, IgG-seropositive pregnant women were asymptomatic,
without fetal damage. CONCLUSION: The majority of the women were asymptomatic,
but no statement about the relative risk of being affected by the virus can be
made.

PMID: 14976794 [PubMed - indexed for MEDLINE]

1840: An Med Interna. 2004 Feb;21(2):100-1.

[Deep venous thrombosis associated with varicella pneumonia and anticardiolipin
antibody]

[Article in Spanish]

Maldonado JA, Belinda Manzano M, Rodriguez Vidigal FF.

Publication Types: 
    Case Reports
    Letter

PMID: 14974901 [PubMed - indexed for MEDLINE]

1841: Wiad Lek. 2003;56(7-8):375-7.

[Ramsay Hunt syndrome--a case study]

[Article in Polish]

Fota-Markowska HZ, Rolla-Szczepanska R, Modrzewska R, Kiciak SG.

Katedry i Kliniki Chorob Zakaznych Akademii Medycznej w Lublinie.

In this work we present a patient, aged 40 with Ramsay Hunt syndrome, who was
treated at the Department of Infectious Disease, Medical Academy in Lublin
(Poland). The diagnosis of the disease was based on the anamnesis concerning
epidemiology of the disease, the course and three major symptoms: facial
paralysis, neuralgia, herpetic eruption in the mouth and on the ear. The combined
treatment with antiviral drugs and corticosteroids was partially successful and
did not resolve the seventh nerve palsy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 14969168 [PubMed - indexed for MEDLINE]

1842: Nippon Ganka Gakkai Zasshi. 2004 Jan;108(1):55-64.

[Program for Continuing Professional Education in Ophthalmology. A review 17
viral eye diseases]

[Article in Japanese]

Shimomura Y.

Publication Types: 
    Review

PMID: 14969094 [PubMed - indexed for MEDLINE]

1843: J Fr Ophtalmol. 2004 Jan;27(1):7-13.

[Acute retinal necrosis: clinical presentation, treatment, and prognosis in a
series of 22 patients]

[Article in French]

Morel C, Metge F, Roman S, Scheer S, Larricart P, Monin C, Laroche L.

Centre Hospitalier des Quinze-Vingts, Paris. morel@quinze-vingts.fr

PURPOSE: To evaluate the clinical outcome and medical management in a series of
patients diagnosed with acute retinal necrosis. MATERIAL AND METHODS: Between
1993 and 2000, 22 patients suffering from acute retinal necrosis were referred to
our department. We retrospectively reviewed the clinical course, delay between
diagnosis and first clinical manifestation, biological profiles, treatment and
complications. RESULTS: All patients had vitreous inflammation; retinitis was
seen upon examination in 82% of the cases. Nevertheless, for six patients (27% of
the cases), failure to recognize the diagnosis led to delay (mean, 5.5 days)
between the first ophthalmological examination and antiviral therapy. Nineteen
patients underwent laboratory evaluation, and virological diagnosis was made in
16 of them: varicella zoster virus was found in 11 cases, herpes simplex type 1
in three cases, and herpes simplex type 2 and cytomegalovirus in one case each.
Nine patients were treated with a combination of aciclovir and foscarnet and 13
with aciclovir alone. Among the 16 patients who received aciclovir, one did not
respond to therapy after 2 days and was cured only after foscarnet was added.
Recurrence occurred at the end of treatment in only one patient. Retinal
detachment complicated the course for 11 patients and was always associated with 
proliferative vitreoretinopathy. Among those, seven of the ten patients who
accepted surgery were successfully treated. Eleven out of 22 patients had a final
visual acuity up to 20/200 and two up to 20/40. CONCLUSION: In our series,
acyclovir alone was sufficient to cure the majority of cases. Even with antiviral
therapy, the prognosis of acute retinal necrosis remains poor. Retinal detachment
is the main complication.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 14968071 [PubMed - indexed for MEDLINE]

1844: J Korean Med Sci. 2004 Feb;19(1):137-41.

Adult-onset Still's disease with disseminated intravascular coagulation and
multiple organ dysfunctions dramatically treated with cyclosporine A.

Park JH, Bae JH, Choi YS, Lee HS, Jun JB, Jung S, Yoo DH, Bae SC, Kim TH.

Division of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University
Medical Center, Seoul, Korea.

Severe systemic manifestations of adult onset Still's disease (AOSD) are often
fatal and occasionally related to hemophagocytic syndrome (HS). We describe the
case of a 49-yr-old woman with AOSD presenting with non-remitting high fever,
confusion, jaundice, hepatosplenomegaly, serositis, azotemia, pancytopenia,
coagulopathy with disseminated intravascular coagulation (DIC),
hyperferritinemia, acute acalculous cholecystitis and ileocolitis noted in
computed tomographic images. The patient had a history of herpes zoster developed
prior to the admission, but there is no history of diarrhea or abdominal pain.
Although bone marrow examination was not performed due to hemorrhagic diathesis, 
we suspected AOSD-associated HS on the basis of clinical course without
detectable infectious agents in cultures or serologic studies. Intravenous
immunoglobulin, pulse methylprednisolone, oral cyclosporine A (CsA) and
ceftriaxone brought about transient improvement of fever and confusion, but the
disease progressed. After increasing CsA dose, all previously mentioned
abnormalities disappeared rapidly. Accordingly, we believe that DIC and multiple 
organ dysfunctions might have been the complications of HS but not that of
sepsis, and that CsA can be used as a first-line therapy in case of
life-threatening situations.

Publication Types: 
    Case Reports

PMID: 14966357 [PubMed - indexed for MEDLINE]

1845: Can Commun Dis Rep. 2004 Feb 1;30:1-26.

National Advisory Committee on Immunization (NACI) update on varicella.

[Article in English, French]

[No authors listed]

Publication Types: 
    Review

PMID: 14964716 [PubMed - indexed for MEDLINE]

1846: J Clin Virol. 2004 Mar;29(3):171-8.

Automated detection of five human herpes virus DNAs by a set of LightCycler PCRs 
complemented with a single multiple internal control.

Stocher M, Holzl G, Stekel H, Berg J.

Department of Laboratory Medicine (Zentral-Labor), Institute of Laboratory
Medicine, General Hospital Linz, Allgemeines Krankenhaus, Krankenhausstrasse 9,
A-4020 Linz, Austria.

BACKGROUND: Herpes viruses represent important causes of morbidity and mortality 
especially in immuno-compromised patients. To assist in rapid diagnosis real-time
PCR assays have been developed for the detection of herpes virus DNA in patient
specimens. A recently described set of real-time PCR assays using LightCycler
technology enabled parallel detection of DNA from cytomegalovirus (CMV),
Epstein-Barr virus (EBV), herpes simplex virus type 1 and 2 (HSV-1/-2), and
varicella-zoster virus (VZV) by using a single LightCycler program [J. Clin.
Virol. 26 (2003) 85]. The set of assays lacked automation of DNA purification and
of PCR mixture preparation, and was not furnished with measures to monitor for
sample adequacy. OBJECTIVES: Development of a set of automated LightCycler-PCR
assays for the detection CMV-, EBV-, HSV-1/-2- and VZV-DNA in plasma samples and 
complementation of the assays with internal amplification controls (ICs). STUDY
DESIGN: The MagNA Pure LC instrument was used for automated DNA purification and 
automated preparation of PCR mixtures. A single multiple IC-DNA specific for all 
four herpes virus type-specific PCRs was generated and used in all four
LightCycler assays. Detection limits were determined and clinical samples were
evaluated. RESULTS: With quantified herpes virus type-specific reference DNA
spiked into EDTA plasma, the detection limits were found at 250 copies/ml of
CMV-, EBV-, HSV-1/-2-DNA and at 500 copies/ml of VZV-DNA. The novel set of assays
was evaluated by testing 112 EDTA plasma samples. The use of the IC led to the
detection of PCR-inhibited samples. CONCLUSION: The set of automated LightCycler 
assays was found rapid, markedly labour saving and suitable for the routine
diagnostic laboratory. The use of the one internal control molecule simplified
the assay protocol and allowed monitoring for sample adequacy.

Publication Types: 
    Evaluation Studies

PMID: 14962786 [PubMed - indexed for MEDLINE]

1847: N Engl J Med. 2004 Feb 12;350(7):e6.

Images in clinical medicine. Use of multinucleated giant cells to diagnose a
viral eruption.

Koranda FC.

University of Kansas Medical Center, Kansas City, KS 66160, USA.

Publication Types: 
    Case Reports

PMID: 14960757 [PubMed - indexed for MEDLINE]

1848: Pediatr Infect Dis J. 2004 Feb;23(2):132-7.

Comment in:
    Pediatr Infect Dis J. 2008 Feb;27(2):190; author reply 190-1.

Ten year follow-up of healthy children who received one or two injections of
varicella vaccine.

Kuter B, Matthews H, Shinefield H, Black S, Dennehy P, Watson B, Reisinger K, Kim
LL, Lupinacci L, Hartzel J, Chan I; Study Group for Varivax.

Merck Research Laboratories, PO Box 4, West Point, PA 19486, USA.
barbara_kuter@merck.com

BACKGROUND: The rate of varicella and persistence of varicella antibody after a
one dose vs. a two dose regimen of varicella virus vaccine live Oka/Merck
(VARIVAX; Merck & Co., Inc., West Point, PA) in approximately 2000 children were 
compared during a 9- to 10-year follow-up period. METHODS: Children 12 months to 
12 years of age with a negative history of varicella were randomized in late 1991
to early 1993 to receive either one or two injections of varicella vaccine given 
3 months apart. Subjects were actively followed for varicella, any varicella-like
illness or zoster and any exposures to varicella or zoster on a yearly basis for 
10 years after vaccination. Persistence of varicella antibody was measured yearly
for 9 years. RESULTS: Most cases of varicella reported in recipients of one or
two injections of vaccine were mild. The risk of developing varicella >42 days
postvaccination during the 10-year observation period was 3.3-fold lower (P <
0.001) in children who received two injections than in those who received one
injection (2.2% vs. 7.3%, respectively). The estimated vaccine efficacy for the
10-year observation period was 94.4% for one injection and 98.3% for two
injections (P < 0.001). Measurable serum antibody persisted for 9 years in all
subjects. CONCLUSIONS: Administration of either one or two injections of
varicella vaccine to healthy children results in long term protection against
most varicella disease. The two dose regimen was significantly more effective
than a single injection.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 14872179 [PubMed - indexed for MEDLINE]

1849: Pediatr Dermatol. 2004 Jan-Feb;21(1):18-23.

Revisiting childhood herpes zoster.

Nikkels AF, Nikkels-Tassoudji N, Pierard GE.

Department of Dermatopathology, University Medical Center of Liege, Liege,
Belgium. af.nikkels@chu.ulg.ac.be

Herpes zoster is rare in otherwise healthy children, but it is more common in
association with immunosuppression. Maternal varicella infection during pregnancy
and varicella occurring in the newborn represent risk factors for childhood
herpes zoster. However, some controversies persist about risk factors, diagnosis,
and the natural history of childhood disease. In a 2-year prospective study, 18
children with herpes zoster were clinically diagnosed in outpatient consultations
in a hospital dermatology unit. Data about age, dermatome involvement, underlying
disease, and history of previous varicella were recorded. Tzanck smears, biopsy
specimens, and sera were obtained from 18, 4, and 10 children, respectively. The 
varicella zoster virus major envelope glycoprotein gE was detected in 16 of 18
smears and all four biopsies. Herpes simplex virus I was demonstrated in one of
the smears. The established risk factors for childhood herpes zoster were only
found in one child. Evidence for previous full-blown varicella and varicella with
few lesions was recorded in 7 and 4 of the 17 immunocompetent children,
respectively. No history of varicella was recalled in 6 of 17 cases, although a
serologic clue of past varicella infection (IgM negative, IgG positive) was
disclosed. Recurrent herpes zoster was diagnosed in one immunocompromised child. 
Zoster-associated pain was localized and the disease severity remained mild in
all children. Established risk factors for childhood herpes zoster were only
rarely found in our series of patients. In contrast, unrecognized varicella and
varicella with few lesions were frequently recorded and may represent additional 
risk factors for shingles in childhood. Zosteriform herpes simplex virus
infections should be differentiated from childhood herpes zoster, emphasizing the
importance of precise viral identification.

PMID: 14871320 [PubMed - indexed for MEDLINE]

1850: J Clin Microbiol. 2004 Feb;42(2):601-9.

Smallpox and pan-orthopox virus detection by real-time 3'-minor groove binder
TaqMan assays on the roche LightCycler and the Cepheid smart Cycler platforms.

Kulesh DA, Baker RO, Loveless BM, Norwood D, Zwiers SH, Mucker E, Hartmann C,
Herrera R, Miller D, Christensen D, Wasieloski LP Jr, Huggins J, Jahrling PB.

Diagnostic Systems Division, US Army Medical Research Institute of Infectious
Diseases, Fort Detrick, Maryland 21702-5011, USA.David.Kulesh@amedd.army.mil

We designed, optimized, and extensively tested several sensitive and specific
real-time PCR assays for rapid detection of both smallpox and pan-orthopox virus 
DNAs. The assays are based on TaqMan 3'-minor groove binder chemistry and were
performed on both the rapid-cycling Roche LightCycler and the Cepheid Smart
Cycler platforms. The hemagglutinin (HA) J7R, B9R, and B10R genes were used as
targets for the variola virus-specific assays, and the HA and DNA polymerase-E9L 
genes were used as targets for the pan-orthopox virus assays. The five orthopox
virus assays were tested against a panel of orthopox virus DNAs (both genomic and
cloned) at the U.S. Army Medical Research Institute of Infectious Diseases
(USAMRIID). The results indicated that each assay was capable of detecting both
the appropriate cloned gene and genomic DNA. The assays showed no
cross-reactivity to the 78 DNAs in the USAMRIID bacterial cross-reactivity panel.
The limit of detection (LOD) of each assay was determined to be between 12 and 25
copies of target DNA. The assays were also run against a blind panel of DNAs at
the Centers for Disease Control and Prevention (CDC) on both the LightCycler and 
the Smart Cycler. The panel consisted of eight different variola virus isolates, 
five non-variola virus orthopox virus isolates, two varicella-zoster virus
isolates, and one herpes simplex virus isolate. Each sample was tested in
triplicate at 2.5 ng, 25 pg, 250 fg, and 2.5 fg, which represent 1.24 x 10(7),
1.24 x 10(5), 1.24 x 10(3), and 1.24 x 10(1) genome equivalents, respectively.
The results indicated that each of the five assays was 100% specific (no false
positives) when tested against both the USAMRIID panels and the CDC blind panel. 
With the CDC blind panel, the LightCycler was capable of detecting 96.2% of the
orthopox virus DNAs and 93.8% of the variola virus DNAs. The Smart Cycler was
capable of detecting 92.3% of the orthopox virus DNAs and between 75 and 93.8% of
the variola virus DNAs. However, all five assays had nearly 100% sensitivity on
both machines with samples above the LOD (>12 gene copies). These real-time PCR
assays represent a battery of tests to screen for and confirm the presence of
variola virus DNA. The early detection of a smallpox outbreak is crucial whether 
the incident is an act of bioterrorism or an accidental occurrence.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 14766823 [PubMed - indexed for MEDLINE]

1851: Front Biosci. 2004 Jan 1;9:751-62.

Varicella zoster virus latency, neurological disease and experimental models: an 
update.

Cohrs RJ, Gilden DH, Mahalingam R.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
CO 80262, USA.

Varicella zoster virus (VZV), a ubiquitous neurotropic human herpesvirus, causes 
chickenpox (varicella) and then remains latent for decades in cranial nerve,
dorsal root and autonomic nervous system ganglia along the entire neuraxis. Virus
reactivation, most often after age 60, produces shingles (zoster), characterized 
by pain and rash usually restricted to 1-3 dermatomes. In elderly individuals,
zoster is frequently complicated by postherpetic neuralgia (PHN), pain that
persists for months to years after the resolution of rash. Virus may also spread 
beyond ganglia to the spinal cord to cause myelitis, as well as to blood vessels 
of the brain, producing a unifocal or multifocal vasculopathy. The increased
incidence of zoster in the elderly and immunocompromised individuals appears to
be due to a VZV-specific host immunodeficiency. Recent studies indicate that PHN 
may be due to a chronic active VZV ganglionitis, and that VZV vasculopathy is
caused by a productive virus infection in cerebral arteries. Since neurological
disease produced by VZV is due to reactivation from ganglia, the physical state
of viral nucleic acid and expression during latency as well as the possible
mechanisms by which VZV latency is maintained and reactivates are discussed.
Finally, VZV is an exclusively human herpesvirus, and experimental infection of
animals with VZV does not produce disease nor does VZV reactivate from ganglia.
Two varicella models in primates have proven useful: one that mimics varicella
latency in humans, and one that can be used to study the efficacy of antiviral
agent in driving varicella virus back to a latent state.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 14766405 [PubMed - indexed for MEDLINE]

1852: Clin Infect Dis. 2004 Feb 15;38(4):579-84. Epub 2004 Jan 30.

The effect of highly active antiretroviral therapy on dermatologic disease in a
longitudinal study of HIV type 1-infected women.

Maurer T, Rodrigues LK, Ameli N, Phanuphak N, Gange SJ, DeHovitz J, French AL,
Glesby M, Jordan C, Khalsa A, Hessol NA.

Department of Dermatology, University of California, San Francisco, California,
USA. tmaurer@itsa.ucsf.edu

The effect of highly active antiretroviral therapy (HAART) on skin diseases was
evaluated in 878 human immunodeficiency virus type 1 (HIV-1)-infected women in
the Women's Interagency HIV Study, a multicenter prospective study.
HIV-1-infected women receiving HAART were less likely to have eczema,
folliculitis, tinea pedis, and xerosis than were women who had not initiated
HAART, independent of CD4+ cell count. Participants who had a prior history of a 
nadir CD4+ cell count of <200 cells/microL and recent CD4+ cell counts of 200-349
cells/microL were more likely to have eczema and xerosis than were women with a
nadir CD4+ cell count of >200 cells/microL and recent CD4+ cell counts of >349
cells/microL. An HIV-1 RNA load of >100,000 copies/mL was associated with
increased prevalence of herpes zoster infection (odds ratio, 6.10; 95% confidence
interval, 2.00-18.65). History of injection drug use was associated with a higher
prevalence of onychomycosis, tinea pedis, and xerosis. Molluscum contagiosum was 
more prevalent among younger women.

Publication Types: 
    Multicenter Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 14765353 [PubMed - indexed for MEDLINE]

1853: J Eur Acad Dermatol Venereol. 2003 Nov;17(6):686-8.

Granuloma annulare in a site of healed herpes zoster: Wolf's isotopic response.

Ruocco E, Baroni A, Cutri FT, Filioli FG.

Department of Dermatology, Second University of Naples, Naples, Italy.

A case of granuloma annulare that developed in a site of healed herpes zoster is 
reported. Polymerase chain reaction failed to detect VZV DNA in a biopsy
specimen. The occurrence of different types of cutaneous reactions in a body area
previously affected by herpes virus infection is known as Wolf's isotopic
response. Pathogenesis may be due to a local neuroimmune dysregulation set off by
herpesvirus-induced lesions of dermal sensory nerve fibres.

Publication Types: 
    Case Reports

PMID: 14761138 [PubMed - indexed for MEDLINE]

1854: Saudi Med J. 2004 Jan;25(1):112-4.

Ramsay Hunt syndrome in focal segmental glomerulosclerosis.

Cheema KM, Kanu MK, Kutaiba M, Sohail M.

ENT Department, Huraymala General Hospital, Huraymala, Kingdom of Saudi Arabia.
khalid_cheema@hotmail.com

Publication Types: 
    Case Reports

PMID: 14758395 [PubMed - indexed for MEDLINE]

1855: Curr Opin Pediatr. 2004 Feb;16(1):80-4.

Varicella zoster virus infections in children after the introduction of live
attenuated varicella vaccine.

Vazquez M.

Department of Pediatrics, Yale University School of Medicine, New Haven,
Connecticut 06520-8064, USA. Marietta.Vazquez@yale.edu

PURPOSE OF REVIEW: Varicella zoster virus is the cause of both varicella
(chickenpox) and herpes zoster (shingles). A live attenuated varicella vaccine
was developed in 1974 and was approved in 1995 by the United States Food and Drug
Administration for administration to both healthy children (>12 months of age)
and adults who are susceptible to varicella. Many studies have shown varicella
vaccine to be highly effective. Widespread use of the varicella vaccine in the
United States has led to important changes in the epidemiology of the infection. 
The purpose of this review is to summarize the most recent and important findings
regarding the impact that the widespread use of varicella vaccine has had on the 
epidemiology of varicella zoster infections in children. RECENT FINDINGS: Data
from the United States Centers for Disease Control and Prevention have shown a
dramatic decline in the incidence of varicella (76 to 87% from 1995 to 2000),
with the greatest decline observed in preschool children, as well as a reduction 
in the number of hospitalizations for cases of varicella. However, as the
proportion of children in the United States who have received the varicella
vaccine has increased there have been several recent reports in which the
effectiveness of the vaccine was substantially lower than expected. In
particular, reports during outbreaks of varicella in children have noted
increases in breakthrough disease in children who were vaccinated before the age 
of 15 months, in children with asthma, in those who received the varicella
vaccine soon after the measles, mumps, and rubella vaccine (<28 days), and in
children who received the vaccine more than 3 years before the development of
disease. SUMMARY: Although reports of outbreaks of chickenpox in highly immunized
groups have raised questions regarding the need for changes to the current
vaccination policy, data undeniably indicate that immunization with varicella
vaccine has been and continues to be successful in reducing the burden of disease
in children and that universal immunization should continue to be a priority in
the United States

Publication Types: 
    Review

PMID: 14758119 [PubMed - indexed for MEDLINE]

1856: Clin Transplant. 2003 Dec;17(6):522-7.

Skin infections in renal transplant recipients and the relation with solar
ultraviolet radiation.

Termorshuizen F, Hogewoning AA, Bouwes Bavinck JN, Goettsch WG, de Fijter JW, van
Loveren H.

Laboratory for Toxicology, Pathology and Genetics, National Institute of Public
Health and the Environment (RIVM), Bilthoven, The Netherlands.

BACKGROUND: Ultraviolet radiation (UVR) is an important risk factor for skin
cancer in transplant recipients. In view of the potential suppressive effect of
UVR on host resistance it was examined whether exposure to UVR was also
associated with the occurrence of various skin infections. METHODS: In a cohort
of renal transplant recipients (n = 137), lifetime exposure was assessed by means
of a retrospective questionnaire on cumulative sunlight exposure. Diagnosed skin 
infections since renal transplantation were extracted from the patient's medical 
charts. Season of diagnosis was regarded as indicative of short-term exposure.
RESULTS: In comparison with winter a high rate of herpes simplex infections was
found in spring [rate ratio (RR) = 4.09, 95% confidence interval (CI) 1.2-14.5], 
and high rates of herpes zoster infections (RR = 1.6, 95% CI: 0.8-3.5) and
fungal/yeast infections in summer (RR = 2.1, 95% CI: 1.3-3.4). A higher lifetime 
exposure (RR = 2.31, 95% CI: 1.04-5.1) and a greater cumulative number of
reported sunburns (RR = 2.3, 95% CI: 1.1-5.1) were independently associated with 
a higher risk of bacterial infections. CONCLUSIONS: The seasonal association with
the occurrence of clinical herpes infections indicates an effect of short-term
UVR. Our data suggest that the number of sunburn episodes in the past is also
relevant for the susceptibility to certain skin infections.

PMID: 14756268 [PubMed - indexed for MEDLINE]

1857: J Rheumatol. 2004 Feb;31(2):274-9.

Close association of herpes zoster reactivation and systemic lupus erythematosus 
(SLE) diagnosis: case-control study of patients with SLE or noninflammatory
nusculoskeletal disorders.

Pope JE, Krizova A, Ouimet JM, Goodwin JL, Lankin M.

Division of Rheumatology, Department of Medicine, The University of Western
Ontario, London, Ontario, Canada. janet.pope@sjhc.london.on.ca

OBJECTIVE: To investigate the prevalence of infections, particularly the
frequency of shingles and the timing of varicella zoster virus (VZV)
reactivation, and antibiotic use, vaccinations, and joint trauma prior to and at 
diagnosis of systemic lupus erythematosus (SLE). METHODS: We sent questionnaires 
to patients with SLE (n = 93) and controls with noninflammatory musculoskeletal
disorders (MSK; n = 353) including osteoarthritis, fibromyalgia, and tendonitis. 
We matched SLE patients to controls for sex (up to 1:3). RESULTS: The response
rate in SLE was 66% and in controls 69% (p < 0.53). Four of 61 SLE patients and
12 of 173 controls were men. The mean disease duration in the SLE group was 8 +/-
1 years compared to 10 +/- 1 years in controls (p < 0.23). SLE patients were
significantly younger than controls (mean age of SLE patients 49 +/- 2 vs 57 +/- 
1 years for controls; p < 0.0004), and results were adjusted for age. A
significantly higher proportion of SLE participants had a history of VZV
(shingles) (19% vs 7%, respectively; OR 2.98, p < 0.003), whereas rubella was
reported less in SLE (23% vs 42%; OR 0.43, p < 0.03). VZV infections were
clustered just prior to or after diagnosis in SLE but were more widely spaced
temporally in the controls (1 +/- 4.5 years after the diagnosis of SLE vs -14.7
+/- 4 years before the diagnosis of noninflammatory MSK disorder; p < 0.003).
Diagnosis of shingles was observed in 6 of 11 SLE patients within +/- 2 years of 
SLE diagnosis, whereas only 2 of 15 controls had shingles within +/- 2 years of
diagnosis (OR 7.2, p < 0.03). Only 2 patients with SLE were taking
immunosuppressive drugs or steroids at time of shingles, so immunosuppressive
therapy was not usually concomitant at time of VZV reactivation. Common
infections (respiratory, urinary tract, ear, and eye) in the SLE group exceeded
controls, but not significantly (23% vs 9%; OR 2.98, p < 0.06) and SLE patients
were more likely to have been vaccinated since 18 years of age with any type of
vaccine (69% vs 51%; OR 2.21, p < 0.04). SLE patients were less likely than
controls to report joint trauma within one year prior to their diagnosis (25% vs 
40%; OR 0.49, p < 0.04). There were no differences with respect to streptococcal 
throat infection (p < 0.96), diarrhea/vomiting (p < 0.84), rash with fever (p <
0.07), parvovirus infection (p < 0.16), infection after surgery (p < 0.58),
respiratory tract infection (p < 0.71), or ear (p < 0.09) and eye infection (p < 
0.68) one year prior to diagnosis. A higher proportion of SLE patients had a
history of urinary tract infections (46% vs 25%), but this was not significant (p
< 0.17), nor was it significant one year prior to diagnosis (p < 0.63). Overall, 
the likelihood of having any infection one year prior to diagnosis was not
significantly higher in the SLE group (p < 0.56). There were no differences one
year prior to diagnosis in travel history (p < 0.69), hospitalizations (p <
0.47), use of antibiotics (p < 0.54), history of rheumatic fever, positive TB
skin test, or hepatitis A, B or C infection. CONCLUSION: Varicella reactivation
as shingles is increased in patients with SLE and clusters around diagnosis.
Vaccinations are increased in those with SLE compared to controls. Common
infections are not significantly increased in SLE patients prior to onset of
symptoms. We cannot determine if VZV infections are causally associated with SLE 
in some people, are from an abnormal immune system response due to the lupus
itself or from the use of steroids or other immunosuppressive drugs to control
the disease, or are spurious.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14760796 [PubMed - indexed for MEDLINE]

1858: Postgrad Med J. 2004 Jan;80(939):26.

Severe herpes zoster after infliximab infusion.

Kinder A, Stephens S, Mortimer N, Sheldon P.

Leicester Royal Infirmary, UK. alisonkinder@dsl.pipex.com

Publication Types: 
    Case Reports

PMID: 14760175 [PubMed - indexed for MEDLINE]

1859: Ann Pathol. 2003 Oct;23(5):408-23.

[The neuropathology of HIV infection in the era of highly active antiretroviral
therapy]

[Article in French]

Vallat-Decouvelaere AV, Chretien F, Lorin de la Grandmaison G, Carlier R, Force
G, Gray F.

Service d'Anatomie et Cytologie Pathologiques, Hopital Calmette, Lille.

Introduction of Highly Active Antiretroviral Treatment (HAART) which is available
for most AIDS patients in France since 1996, has resulted in a dramatic
improvement of the disease course. From the survey of our autopsy series of
(AIDS) cases and the review of other neuropathological studies from different
developed countries, we found quantitative and qualitative changes in the pattern
of human immunodeficiency virus (HIV) neuropathology. Quantitatively, there was a
dramatic decrease in the number of autopsy cases but brain involvement remained a
major cause of death in AIDS patients. There was an overall decrease of cerebral 
toxoplasmosis, cytomegalovirus encephalitis (CMVE) and HIV encephalitis (HIVE)
for which successful treatment is available. This contrasted with the unchanged
incidence of progressive multifocal leucoencephalopathy (PML) and primary
malignant non Hodgkin brain lymphomas (PMBL). However, when looking closer at the
last three years, the incidence of diseases affecting patients with severe
immunodepression (CMVE, PML, PMBL) decreased in 2000-2002, whereas infections
occurring in patients with milder immunodeficiency (toxoplasmosis,
varicella-zoster encephalitis (VZVE) or herpes simplex virus encephalitis (HSVE) 
became more frequent. Qualitatively, there were uncommon types of brain
infections, such as BK virus encephalitis or general paresis. Finally, new forms 
of HIVE were reported: severe leukoencephalopathy with intense perivascular
macrophage and lymphocyte infiltration possibly due to an exaggerated response
from a newly reconstituted immune system; and also chronic "burnt out" forms of
HIVE as VZVE, toxoplasmosis, or PML in which no inflammation and no infectious
agent could be detected, likely due to prolonged survival.

Publication Types: 
    English Abstract
    Review

PMID: 14752384 [PubMed - indexed for MEDLINE]

1860: Am J Kidney Dis. 2004 Feb;43(2):197-208.

Comment in:
    Am J Kidney Dis. 2004 Feb;43(2):383-5.

Treatment of diffuse proliferative lupus nephritis: a meta-analysis of randomized
controlled trials.

Flanc RS, Roberts MA, Strippoli GF, Chadban SJ, Kerr PG, Atkins RC.

Department of Nephrology, Monash Medical Centre, Clayton, Victoria, Australia.
robert.flanc@med.monash.edu.au

BACKGROUND: In this systematic review of randomized controlled trials (RCTs), we 
assess the benefits and harm of current treatments for diffuse proliferative
lupus nephritis (DPLN). METHODS: The Cochrane Controlled Trial Registry, MEDLINE,
and EMBASE were searched for RCTs of treatment for DPLN. All available RCTs of
patients with biopsy-proven DPLN were included, and data were extracted for
overall mortality, end-stage renal disease, doubling of serum creatinine level,
relapse, major infection, herpes zoster infection, ovarian failure, malignancy,
and bladder toxicity. Treatment effects on these outcomes were summarized as
relative risk (RR) with 95% confidence interval (CI) and pooled by using a
random-effects model. RESULTS: Twenty-five of 920 articles identified were
eligible RCTs and were included. The majority compared cyclophosphamide or
azathioprine plus steroids versus steroids alone. Cyclophosphamide plus steroids 
reduced the risk for doubling of serum creatinine level (4 RCTs, 228 patients;
RR, 0.59; 95% CI, 0.40 to 0.88) compared with steroids alone, but had no impact
on overall mortality (5 RCTs, 226 patients; RR, 0.98; 95% CI, 0.53 to 1.82).
However, risk for ovarian failure was increased significantly (3 RCTs, 147
patients; RR, 2.18; 95% CI, 1.10 to 4.34). In studies from the 1970s,
azathioprine plus steroids reduced the risk for all-cause mortality compared with
steroids alone (3 RCTs, 78 patients; RR, 0.60; 95% CI, 0.36 to 0.99), but had no 
effect on renal outcomes. Neither therapy was associated with increased risk for 
major infection. The addition of plasma exchange to these treatments offered no
benefit, and information on other agents, including mycophenolate mofetil, was
insufficient for analysis. CONCLUSION: Until future RCTs of newer agents are
completed, the current use of cyclophosphamide combined with steroids remains the
best option to preserve renal function in patients with DPLN. The smallest
effective dose and shortest duration of treatment should be used to minimize
gonadal toxicity without compromising efficacy.

Publication Types: 
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review

PMID: 14750085 [PubMed - indexed for MEDLINE]

1861: J Clin Virol. 2004 Feb;29(2):120-6.

Detection of herpes simplex virus type 1, herpes simplex virus type 2 and
varicella-zoster virus in skin lesions. Comparison of real-time PCR, nested PCR
and virus isolation.

Schmutzhard J, Merete Riedel H, Zweygberg Wirgart B, Grillner L.

Department of Clinical Microbiology, Section of Virology, Karolinska Hospital,
SE-17176 Stockholm, Sweden.

BACKGROUND: Herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2
(HSV-2) and varicella-zoster virus (VZV) cause a wide range of signs and
symptoms, varying from trivial mucocutaneous lesions to life-threatening
infections, especially in immuno-suppressed patients. Since antiviral drugs are
available, rapid and sensitive laboratory diagnosis of these virus infections is 
important. OBJECTIVE: To set up and evaluate HSV-1, HSV-2 and VZV qualitative
real-time PCR on the Lightcycler system and to compare the results with those of 
the 'in-house' nested PCR and virus isolation. STUDY DESIGN: 110 consecutive
samples from dermal or genital lesions from patients suspected of having HSV
infections and another 110 samples from patients with suspected VZV infections
were tested with real-time PCR, nested PCR and virus isolation. RESULTS: 24
samples (22%) were positive for HSV-1 by virus isolation and nested PCR, whereas 
26 (24%) were positive by real-time PCR. HSV-2 was detected in 28 samples (25%)
by virus isolation, in 41 (37%) by nested PCR and in 40 (36%) by real-time PCR.
VZV was isolated in 15 samples (14%) and VZV DNA was detected in 51 samples (46%)
by nested PCR as well as by real-time PCR. Nucleic acid amplification increased
the detection rate of HSV-2 and VZV DNA in particular compared to virus
isolation. No significant difference in sensitivity was found between real-time
PCR and nested PCR. CONCLUSION: Real-time PCR has the advantage of rapid
amplification, a reduced risk for contamination and it is a suitable method for
diagnosis of VZV and HSV in specimens from skin lesions.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 14747031 [PubMed - indexed for MEDLINE]

1862: J Clin Virol. 2004 Feb;29(2):113-9.

New method of differentiating wild-type varicella-zoster virus (VZV) strains from
Oka varicella vaccine strain by VZV ORF 6-based PCR and restriction fragment
length polymorphism analysis.

Takayama M, Takayama N.

Department of Virology I, National Institute of Infectious Diseases, 1-23-1,
Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.

A new method was developed to distinguish accurately wild-type varicella-zoster
virus (VZV) strains from the Oka vaccine strain. Several DNA fragments covering
open reading frame (ORF) 1-37 were amplified from wild-type VZV strains including
the Oka parent strain and from the Oka vaccine strain. Restriction fragment
length polymorphisms of these regions were compared, and nucleotide differences
between the vaccine virus and other wild-type VZV strains were noted in ORFs 6,
10, and 35. In addition, variations of the R2 and R4 reiterated structures of the
vaccine and its parent strains were examined. The Oka vaccine strain used in
Japan was shown to be a mixture of viruses with different nucleotide sequences
that had variations in at least three nucleotide positions in ORF 1-37 and had
variable polymorphisms at R2 and R4 repeat regions (two and three patterns,
respectively). The Oka parent strain on the other hand showed a single sequence
and had only one reiterated structure at these regions. When VZV ORF 6 was
amplified and its product was digested with AluI, the Oka vaccine strain could be
precisely differentiated from its parent and from 56 other Japanese clinical
isolates.

PMID: 14747030 [PubMed - indexed for MEDLINE]

1863: Br J Dermatol. 2004 Jan;150(1):158-9; author reply 159.

Comment on:
    Br J Dermatol. 2002 Nov;147(5):1042-4.

Lisinopril and Kaposi's sarcoma.

Di Carlo A.

Publication Types: 
    Comment
    Letter

PMID: 14746638 [PubMed - indexed for MEDLINE]

1864: Neurol Neurochir Pol. 2003;37(4):943-53.

[The DREZ lesion as an effective treatment for chronic hypothetically
post-herpetic neuropathic pain. Case report and review of literature]

[Article in Polish]

Koszewski W, Jarosz J, Pernak-De Gast J.

Kliniki Neurochirurgii A.M. w Warszawie.

The authors present a case of a 54-year-old woman with a 3-year history of
chronic pain syndrome, probably of postherapeutic origin, with diffuse segmentary
dermatome characteristics, both somatic and autonomic. The former were
exemplified by a constant "burning" skin pain in the representation of Th8-LI
dermatomes unilaterally, while the latter by a unilateral visceral pain within
the abdominal cavity. Electrophysiological examination indicated a neuropathic
origin of the pain, despite the lack of clinically evident sensory deficits
and/or hypersensitivity. The pain was so intense that normal walking was
difficult for the patient and ineffectiveness of her treatment made her suicidal.
Since both pharmacological treatment (non-steroid analgesics, opioids,
antidepressants, and anticonvulsants including gabapentin) and minimally invasive
methods of treatment (blockades, thermolesions) failed to control pain, she was
subjected to surgery. A right-sided DREZ lesion within the Th8-LI dermatomes
resulted in a complete pain relief, both within the somatic and autonomic
innervation projections, and in the patient's functional recovery.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 14746252 [PubMed - indexed for MEDLINE]

1865: Rinsho Byori. 2003 Dec;51(12):1167-73.

[Levels of granzyme B, perforin and Fas ligand antigens and mRNAs in patients
following allogeneic hematopoietic stem cell transplantation]

[Article in Japanese]

Takahashi A, Horie O, Murayama T, Ryo R, Saigo K.

Faculty of Health Science, Kobe University School of Medicine, Kobe 654-0142.

In order to monitor the immunological status of patients after allogeneic
hematopoietic stem cell transplantation(HSCT), granzyme B(GrB), perforin(PRF) and
Fas ligand(L) antigens and mRNAs were measured by flow cytometry and real time
RT-PCR, respectively. Cytoplasmic antigens were detected in whole blood after
fixation and pretreatment with saponin. Real time PCR was carried out using
extracted RNA from buffy coat. We measured these substances in a cytotoxic T cell
clone, a natural killer cell line, and peripheral blood collected from 11
patients after HSCT. Although changes in antigen levels were not detected,
increased levels of GrB and Fas L mRNAs were quantitatively measured in CTLs and 
NK cells stimulated by IL-2 combined with IL-12. Increased levels of GrB and/or
PRF antigens were detected in four of five patients with chronic GVHD. Increased 
mRNA levels were also observed in one or more of GrB, PRF or Fas L in four of
five patients with cGVHD, although there was a discrepancy between antigen and
mRNA positivity. Four of six patients without cGVHD were positive for
apoptosis-inducing factors, either by antigen detection or RT-PCR. One of these
four had relapsing leukemia, and another had herpes zoster infection, while the
reasons for positive results in the other two patients are not clear. Although
changes in antigen levels did not parallel those in mRNA, measurement of these
parameters may assist in predicting GVHD, GVL and infections following HSCT.

Publication Types: 
    English Abstract

PMID: 14743738 [PubMed - indexed for MEDLINE]

1866: BMJ. 2004 Feb 21;328(7437):439. Epub 2004 Jan 23.

Case-control study of the effect of mechanical trauma on the risk of herpes
zoster.

Thomas SL, Wheeler JG, Hall AJ.

Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical
Medicine, London WC1E 7HT. sara.thomas@lshtm.ac.uk

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14742350 [PubMed - indexed for MEDLINE]

1867: J Dermatol. 2003 Dec;30(12):929-30.

Zosteriform herpetic folliculitis involving eccrine gland.

Kim KJ, Choi HJ, Suh HS, Lee MW, Choi JH, Moon KC, Koh JK.

Publication Types: 
    Case Reports
    Letter

PMID: 14739524 [PubMed - indexed for MEDLINE]

1868: Pain. 2004 Feb;107(3):202-6.

Interventions to prevent postherpetic neuralgia: cutaneous and percutaneous
techniques.

Opstelten W, van Wijck AJ, Stolker RJ.

Julius Center for Health Sciences and Primary Care, University Medical Center
Utrecht, P.O. Box 85060, 3500 AB, Utrecht, The Netherlands. w.opstelten@med.uu.nl

Publication Types: 
    Review

PMID: 14736581 [PubMed - indexed for MEDLINE]

1869: J Med Chem. 2004 Jan 29;47(3):566-75.

Synthesis and antiviral activity of (Z)- and
(E)-2,2-[bis(hydroxymethyl)cyclopropylidene]methylpurines and -pyrimidines:
second-generation methylenecyclopropane analogues of nucleosides.

Zhou S, Breitenbach JM, Borysko KZ, Drach JC, Kern ER, Gullen E, Cheng YC,
Zemlicka J.

Department of Chemistry, Developmental Therapeutics Program, Barbara Ann Karmanos
Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan
48201-1379, USA.

The second generation of methylenecyclopropane analogues of nucleosides 5a-5i and
6a-6i was synthesized and evaluated for antiviral activity. The
2,2-bis(hydroxymethyl)methylenecyclopropane (11) was converted to dibromo
derivative 7 via acetate 12. Alkylation-elimination of adenine (16) with 7
afforded the Z/E mixture of acetates 17 + 18, which was deacetylated to give
analogues 5a and 6a separated by chromatography. A similar reaction with
2-amino-6-chloropurine (19) afforded acetates 20 + 21 and, after deprotection and
separation, isomers 5f and 6f. The latter served as starting materials for
synthesis of analogues 5b, 5e, 5g-5i and 6b, 6e, 6g-6i. Alkylation-elimination of
N(4)-acetylcytosine (22) with 7 afforded a mixture of isomers 5c + 6c which were 
separated via N(4)-benzoyl derivatives 23 and 24. Deprotection furnished
analogues 5c and 6c. Alkylation of 2,4-bis(trimethylsilyloxy)-5-methylpyrimidine 
(25) with 7 led to bromo derivative 26. Elimination of HBr followed by
deacetylation and separation gave thymine analogues 5d and 6d. The guanine
Z-isomer 5b was the most effective against human and murine cytomegalovirus (HCMV
and MCMV) with EC(50) = 0.27-0.49 microM and no cytotoxicity. The 6-methoxy
analogue 5g was also active (EC(50) = 2.0-3.5 microM) whereas adenine Z-isomer 5a
was less potent (EC(50) = 3.6-11.7 microM). Cytosine analogue 5c was moderately
effective, but 2-amino-6-cyclopropylamino derivative 5e was inactive. All
E-isomers were devoid of anti-CMV activity, and none of the analogues was
significantly active against herpes simplex viruses (HSV-1 or HSV-2). The potency
against Epstein-Barr virus (EBV) was assay-dependent. In Daudi cells, the
E-isomers of 2-amino-6-cyclopropylamino- and 2,6-diaminopurine derivatives 6e and
6h were the most potent (EC(50) approximately 0.3 microM), whereas only the
thymine Z-isomer 5d was active (EC(50) = 4.6 microM). Guanine Z-derivative 5b was
the most effective compound in H-1 cells (EC(50) = 7 microM). In the Z-series,
the 2-amino-6-methoxypurine analogue 5g was the most effective against varicella 
zoster virus (VZV, EC(50) = 3.3 microM) and 2,6-diaminopurine 5h against
hepatitis B virus (HBV, EC(50) = 4 microM). Adenine analogues 5a and 6a were
moderately active as substrates for adenosine deaminase.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 14736238 [PubMed - indexed for MEDLINE]

1870: Trop Med Int Health. 2004 Jan;9(1):178-86.

Lay diagnosis of causes of death for monitoring AIDS mortality in Addis Ababa,
Ethiopia.

Araya T, Reniers G, Schaap A, Kebede D, Kumie A, Nagelkerke N, Coutinho R,
Sanders E.

Department of Community Health, Addis Ababa University, Addis Ababa, Ethiopia.

Lay diagnoses of death collected at burial sites were validated against two 'gold
standards': the hospital discharge diagnosis of causes of death obtained by a
surveillance of hospital deaths (including autopsy results) and the physician
review of verbal autopsies (VAs) that were carried out for a sample of cemetery
records. The diagnostic indicators of the lay diagnoses were then used to provide
estimates of the share of AIDS-attribuTable mortality. The verbal autopsy results
provide an independent estimate of the percentage of AIDS deaths. From a total of
21,274 burial records, 2546 hospital discharge diagnoses, 1480 outcomes of
autopsies and 200 adult verbal autopsies were gathered over a period of 1 year
starting from February 2001. Independent of the gold standard, lay diagnoses such
as lung disease and cold have a specificity of about 90% and a combined
sensitivity of about 55% in determining AIDS mortality. Without a significant
loss in specificity, the sensitivity increases to 60-65% when diarrhoea, TB,
herpes zoster and mental or nerve problem are included. We thus conclude that
even in the presence of a reluctance to talk of HIV/AIDS, lay diagnosis of causes
of death can be used for monitoring AIDS mortality. Lung disease and cold, in
particular, have become well-known euphemisms for AIDS in the community. The
share of AIDS deaths in the adult population (20-54) is estimated at 68%, without
noticeable differences between men and women. Our results confirm the high impact
of HIV/AIDS on mortality as was estimated by epidemiological projections for
Addis Ababa.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14728623 [PubMed - indexed for MEDLINE]

1871: Reg Anesth Pain Med. 2004 Jan-Feb;29(1):75; author reply 75.

Comment on:
    Reg Anesth Pain Med. 2003 Jul-Aug;28(4):289-93.

Clarifying the use of lidoderm patch to treat pain associated with postherpetic
neuralgia.

Alvarez NA.

Publication Types: 
    Comment
    Letter

PMID: 14727292 [PubMed - indexed for MEDLINE]

1872: Am J Dermatopathol. 2004 Feb;26(1):27-32.

Absence of intercellular adhesion molecule 1 expression in varicella zoster
virus-infected keratinocytes during herpes zoster: another immune evasion
strategy?

Nikkels AF, Sadzot-Delvaux C, Pierard GE.

Department of Dermatopathology, University of Liege, Liege, Belgium.
af.nikkels@chu.ulg.ac.be

Downregulation of major histocompatibility complex (MHC) class I, MHC-II, and
intercellular adhesion molecule 1 (ICAM-1) expression in infected cell lines
allows some viruses to escape host immunity. In skin lesions of varicella zoster 
virus (VZV), MHC-II transcripts were demonstrated in keratinocytes around
vesicles, but not in VZV-infected cells. Whether other immunoevasive mechanisms
are present during herpes zoster (HZ) is not yet elucidated. The aim of the study
was to disclose the temporal immunohistochemical expression of immune escape
mechanisms during HZ. Sequential skin biopsies were performed in 5 HZ patients.
VZV IE63, CD1a, CD3, CD4, CD8, CD56, CD68, L1, HLA-DR, HLA-ABC, interleukin
(IL)-6, IL-10, interferon gamma (IFNgamma), tumor necrosis factor alpha
(TNFalpha), and ICAM-1 expressions were assessed on frozen sections using
immunohistochemistry. Controls consisted of normal skin, herpes simplex virus
(HSV) skin infections, and other distinct bullous skin diseases. HLA-DR and
ICAM-1 expressions were not observed in VZV- and HSV-infected keratinocytes,
contrasting with their upregulation in the surrounding epidermis and inside
nonviral blisters. However, HLA-ABC expressions were not inhibited in
VZV-infected keratinocytes. Furthermore, the CD4/CD8 ratio remained unmodified
during the infection evolution, and this ratio was variable among patients.
Increased IFNgamma, TNFalpha, and IL-6 expressions were present, but IL-10
expression only increased in later stages. In contrast to in vitro MHC-I and
MHC-II downregulation, VZV infection is related to MHC-II but not MHC-I
expression on infected keratinocytes. The absence of ICAM-1 expression on
infected keratinocytes may reduce their antigen presentation capacities to LFA-1 
ligand-bearing T cells. This may represent another VZV-associated immune escape
mechanism. Increased IFNgamma, TNFalpha, and IL-6 expressions suggest a TH1
profile.

PMID: 14726820 [PubMed - indexed for MEDLINE]

1873: J Pediatr. 2004 Jan;144(1):93-9.

Autosomal recessive hyperimmunoglobulin E syndrome: a distinct disease entity.

Renner ED, Puck JM, Holland SM, Schmitt M, Weiss M, Frosch M, Bergmann M, Davis
J, Belohradsky BH, Grimbacher B.

Department of Infectious Diseases and Clinical Immunology, University Children's 
Hospital, Dr v. Haunersches Kinderspital, Munich, Germany.

OBJECTIVE: The autosomal-dominant form of the hyperimmunoglobulin E syndrome
(AD-HIES) has been described as a multisystem disorder including immune,
skeletal, and dental abnormalities. Variants of AD-HIES are known but not well
defined. METHODS: We evaluated 13 human immunodeficiency virus-seronegative
patients from six consanguineous families with an autosomal-recessive form of
hyperimmunoglobulin E syndrome (AR-HIES) and 68 of their relatives. RESULTS:
Persons affected with AR-HIES presented with the classical immunologic findings
of hyperimmunoglobulin E syndrome, including recurrent staphylococcal infections 
of the skin and respiratory tract, eczema, elevated serum immunoglobulin E, and
hypereosinophilia. In addition, severe recurrent fungal and viral infections with
molluscum contagiosum, herpes zoster, and herpes simplex were noted. Autoimmunity
was seen in two patients. Central nervous system sequelae, including hemiplegia, 
ischemic infarction, and subarachnoid hemorrhages, were common and contributed to
high mortality. Notably, patients with AR-HIES did not have skeletal or dental
abnormalities and did not develop pneumatoceles, as seen in AD-HIES. In
lymphocyte proliferation assays, patients' cells responded poorly to mitogens and
failed to proliferate in response to antigens, despite the presence of normal
numbers of lymphocyte subpopulations. CONCLUSION: The autosomal-recessive form of
hyperimmunoglobulin E syndrome is a primary immunodeficiency with elevated
immunoglobulin E, eosinophilia, vasculitis, autoimmunity, central nervous system 
symptoms, and high mortality. AR-HIES lacks several of the key findings of
AD-HIES and therefore represents a different, previously unrecognized disease
entity.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14722525 [PubMed - indexed for MEDLINE]

1874: Rheumatology (Oxford). 2004 Apr;43(4):491-6. Epub 2004 Jan 13.

Intravenous cyclophosphamide pulse therapy in juvenile dermatomyositis. A review 
of efficacy and safety.

Riley P, Maillard SM, Wedderburn LR, Woo P, Murray KJ, Pilkington CA.

Juvenile Dermatomyositis Research Centre, Institute of Child Health, Great Ormond
Street, London, UK.

OBJECTIVES: To assess the efficacy and safety of intravenous cyclophosphamide
(CYP) used in severe and refractory juvenile dermatomyositis (JDM). METHODS:
Retrospective case note review of the outcome of 12 patients. RESULTS: Assessment
at 6 months of therapy in 10 of the 12 patients showed a significant improvement 
in muscle function as assessed by the Childhood Myositis Assessment Scale (CMAS) 
(P = 0.012), muscle strength (P = 0.008), global extramuscular disease score (P =
0.008), skin disease severity (P = 0.015) and lactate dehydrogenase (P = 0.028). 
There were reductions in creatine kinase, alanine aminotransferase, prednisolone 
dose and ESR, but these did not reach statistical significance. Clinical
improvement was maintained after CYP until the most recent follow-up (between 6
months and 7 yr) and no severe side-effects were seen. Reversible complications
included lymphopenia, herpes zoster infections and alopecia. The median
cumulative dose was 4.6 g/m(2) (range 3-9 g/m(2)). The available evidence
suggests that, at the doses required, risks of malignancy, infertility and
gonadal failure are low. Two patients with severe treatment-resistant disease
died after one dose of CYP, both of whom were ventilated prior to commencement of
CYP and were thought to have died as a result of their severe disease process,
and too early for clinical benefit to be obtained from the drug. CONCLUSIONS: In 
this cohort of children with severe and refractory JDM, CYP appeared to have
provided major clinical benefit with no evidence of serious toxicity in the short
term.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14722349 [PubMed - indexed for MEDLINE]

1875: J Virol. 2004 Feb;78(3):1181-94.

The immediate-early 63 protein of Varicella-Zoster virus: analysis of functional 
domains required for replication in vitro and for T-cell and skin tropism in the 
SCIDhu model in vivo.

Baiker A, Bagowski C, Ito H, Sommer M, Zerboni L, Fabel K, Hay J, Ruyechan W,
Arvin AM.

Departments of Pediatrics and Microbiology & Immunology, Stanford University
School of Medicine, Stanford, California, USA.

The immediate-early 63-kDa (IE63) protein of varicella-zoster virus (VZV) is a
phosphoprotein encoded by open reading frame (ORF) ORF63/ORF70. To identify
functional domains, 22 ORF63 mutations were evaluated for effects on IE63 binding
to the major VZV transactivator, IE62, and on IE63 phosphorylation and nuclear
localization in transient transfections, and after insertion into the viral
genome with VZV cosmids. The IE62 binding site was mapped to IE63 amino acids 55 
to 67, with R59/L60 being critical residues. Alanine substitutions within the
IE63 center region showed that S165, S173, and S185 were phosphorylated by
cellular kinases. Four mutations that changed two putative nuclear localization
signal (NLS) sequences altered IE63 distribution to a cytoplasmic/nuclear
pattern. Only three of 22 mutations in ORF63 were compatible with recovery of
infectious VZV from our cosmids, but infectivity was restored by inserting intact
ORF63 into each mutated cosmid. The viable IE63 mutants had a single alanine
substitution, altering T171, S181, or S185. These mutants, rOKA/ORF63rev[T171],
rOKA/ORF63rev[S181], and rOKA/ORF63rev[S185], produced less infectious virus and 
had a decreased plaque phenotype in vitro. ORF47 kinase protein and glycoprotein 
E (gE) synthesis was reduced, indicating that IE63 contributed to optimal
expression of early and late gene products. The three IE63 mutants replicated in 
skin xenografts in the SCIDhu mouse model, but virulence was markedly attenuated.
In contrast, infectivity in T-cell xenografts was not altered. Comparative
analysis suggested that IE63 resembled the herpes simplex virus type 1 U(S)1.5
protein, which is expressed colinearly with ICP22 (U(S)1). In summary, most
mutations of ORF63 made with our VZV cosmid system were lethal for infectivity.
The few IE63 changes that were tolerated resulted in VZV mutants with an impaired
capacity to replicate in vitro. However, the IE63 mutants were attenuated in skin
but not T cells in vivo, indicating that the contribution of the IE63
tegument/regulatory protein to VZV pathogenesis depends upon the differentiated
human cell type which is targeted for infection within the intact tissue
microenvironment.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 14722273 [PubMed - indexed for MEDLINE]

1876: Lancet Infect Dis. 2004 Jan;4(1):26-33.

What does epidemiology tell us about risk factors for herpes zoster?

Thomas SL, Hall AJ.

Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical
Medicine, Keppel Street, London, UK. sara.thomas@lshtm.ac.uk

Reactivation of latent varicella zoster virus as herpes zoster is thought to
result from waning of specific cell-mediated immunity, but little is known about 
its determinants in individuals with no underlying immunosuppression. We
systematically reviewed studies of zoster epidemiology in adults and analysed
data from a large morbidity study to identify factors that might be modulated to 
reduce the risk of zoster. Annual zoster incidence in population-based studies
varied from 3.6-14.2/10(3) in the oldest individuals. Risk factors identified in 
analytical studies that could explain this variation included age, sex,
ethnicity, genetic susceptibility, exogenous boosting of immunity from varicella 
contacts, underlying cell-mediated immune disorders, mechanical trauma,
psychological stress, and immunotoxin exposure. Our review highlights the lack of
information about risk factors for zoster. We suggest areas of research that
could lead to interventions to limit the incidence of zoster. Such research might
also help to identify risk factors for age-related immune decline.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 14720565 [PubMed - indexed for MEDLINE]

1877: J Infect. 2004 Feb;48(2):119-33.

Cost containment analysis of childhood vaccination against varicella in Israel.

Ginsberg GM, Somekh E.

Department of Medical Technology Assessment, Ministry of Health, Ben Tbai 2,
Jerusalem 93591, Israel.

OBJECTIVES: The low cost of safe and effective vaccines prompted a
cost-containment evaluation of a nationwide vaccination campaign against
varicella. METHODS: A model incorporating demographic, epidemiologic and economic
data from Israeli sources (supplemented by data from International literature)
was constructed to estimate the decrease in morbidity and the consequent
reductions in treatment costs and time-off work of a nationwide programme
vaccinating children at 12 months. RESULTS: A policy of aiming to immunize a
cohort of all 1-year-olds in Israel in the year 2002, for an annual cost of $1.10
million to the health services and $1.27 million to society (including lost work 
and transport costs), would reduce the number of cases of varicella during the
lifetime of a cohort from 123,984 to 10,170 cases. This morbidity reduction would
reduce national expenditures by $1.80 million in health service resources alone
and by $24.5 million to society, mainly due to inaverted work absences. In
addition an estimated 0.93 lives, representing 38.6 life years will be saved in
the cohort. CONCLUSIONS: Under an assumption of neutrality relating to the
potential effects of vaccination on herpes zoster virus, our model based
calculations show that a national varicella vaccination programme is likely to be
cost saving, not only from a societal perspective but also from the narrower
health service perspective.

Publication Types: 
    Review

PMID: 14720487 [PubMed - indexed for MEDLINE]

1878: Adv Virus Res. 2003;62:1-17.

Varicella virus-mononuclear cell interaction.

White TM, Gilden DH.

Departments of Neurology and Microbiology, University of Colorado Health Sciences
Center, Denver, Colorado 80262, USA.

Varicella zoster virus (VZV) causes varicella (chickenpox), becomes latent in
cranial nerve, dorsal root, and autonomic ganglia; and reactivates decades later 
to produce zoster (shingles). The main complication of zoster is postherpetic
neuralgia (PHN), pain that persists for months and often years after zoster. VZV 
also causes chronic radicular pain without rash (zoster sine herpete). Viremia is
associated with each stage of VZV infection. Viral DNA has been found in
peripheral blood mononuclear cells (MNCs) of patients with varicella, zoster,
PHN, and zoster sine herpete. In varicella, viremia contributes to the widespread
distribution of skin lesions and infection of multiple organs. Although the role 
of viremia in other VZV-associated diseases is not as clear, the detection of VZV
DNA (and sometimes VZV RNA and proteins) helps diagnose neurological diseases
produced by VZV, has indicated that PHN may reflect a chronic VZV ganglionitis,
and has established that VZV reactivates subclinically, especially in
immunocompromised humans. In vitro studies have established that VZV can
productively infect MNCs for a short time and have identified the subpopulations 
of MNCs that are infected. Finally, simian varicella virus (SVV) infection of
nonhuman primates shares clinical, pathological, and virologic features with VZV 
in humans. Like VZV, SV viremia in nonhuman primates during acute infection plays
an important role in the pathogenesis of SVV. Infectious virus can be isolated
from MNCs, and SVV DNA can be detected in MNCs during varicella. Further, SVV DNA
can be detected for months in MNCs of monkeys after experimental infection with
SVV. Herein, we review the current literature related to VZV infection of MNCs
during naturally occurring varicella, PHN, and zoster sine herpete in humans,
including studies of experimental infection of human MNCs with VZV. We also
review SVV MNC interaction during naturally occurring simian varicella and after 
experimental infection of primates with SVV.

Publication Types: 
    In Vitro
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 14719363 [PubMed - indexed for MEDLINE]

1879: Nucleosides Nucleotides Nucleic Acids. 2003 Dec;22(12):2105-19.

Efficacy of methylenecyclopropane analogs of nucleosides against herpesvirus
replication in vitro.

Kushner NL, Williams SL, Hartline CB, Harden EA, Bidanset DJ, Chen X, Zemlicka J,
Kern ER.

The University of Alabama School of Medicine, Birmingham, Alabama, USA.

We have reported previously that purine methylenecyclopropane analogs are potent 
agents against cytomegaloviruses. In an attempt to extend the activity of these
compounds, the 2-amino-6-cyclopropylaminopurine analog, QYL-1064, was selected
for further study by modifying the purine 6 substituent. A total of 22 analogs
were tested against herpes simplex virus types 1 and 2 (HSV-1, HSV-2), varicella 
zoster virus (VZV), human cytomegalovirus (HCMV), murine cytomegalovirus (MCMV), 
Epstein-Barr virus (EBV), human herpesvirus type 6 (HHV-6) and human herpesvirus 
type 8 (HHV-8). Ten of the analogs had activity against at least one of the
viruses tested. One compound had moderate activity against HSV-1 and six had
activity against VZV. All but one compound was active against HCMV with a mean
EC50 of 2.1 +/- 0.6 microM, compared with a mean EC50 of 3.9 +/- 0.8 microM for
ganciclovir. Of special interest was the fact that eight of the ten compounds
were active against both HHV-6A and HHV-6B with mean EC50 values of 6.0 +/- 5.2
mciroM and <2.4 +/- 1.5 microM, respectively. Only two compounds had activity
against EBV, whereas all but one compound was active against HHV-8 with a mean
EC50 of 3.1 +/- 1.7 microM. These results indicate that members of this series of
methylenecyclopropane analogs are highly active against HCMV, HHV-6, and HHV-8
but are less active against HSV, VZV, and EBV.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 14714760 [PubMed - indexed for MEDLINE]

1880: Vestn Oftalmol. 2003 Nov-Dec;119(6):35-8.

[Clinical forms and treatment of keratitis caused by varicella-zoster virus]

[Article in Russian]

Maichuk IuF.

Publication Types: 
    Comparative Study

PMID: 14708173 [PubMed - indexed for MEDLINE]

1881: Br J Oral Maxillofac Surg. 2004 Feb;42(1):55-7.

Comment in:
    Br J Oral Maxillofac Surg. 2004 Aug;42(4):371.

Subdural empyema and herpes zoster syndrome (Hunt syndrome) complicating removal 
of third molars.

Ramchandani PL, Sabesan T, Peters WJ.

Maxillofacial Unit, Poole General Hospital, Longfleet Road, Poole, Dorset BH15
2JB, UK. parkash.r@ukgateway.net

We report a case of subdural empyema and herpes zoster syndrome (Hunt syndrome)
complicating routine removal of third molars. Subdural empyema is an extremely
rare but life-threatening complication of dental sepsis arising spontaneously or 
after dental surgery. The clinician should be familiar with its presentation and 
have a high index of suspicion, because late recognition and delay in its
treatment can increase the associated morbidity and mortality. Surgical
procedures and in particular maxillofacial surgery have also been known to
trigger varicella zoster reactivation resulting in Hunt syndrome. Some patients
develop the characteristic rash several days after the onset of facial weakness, 
so that Hunt syndrome may initially be misdiagnosed as Bell's palsy. We highlight
the difficulties in diagnosing Hunt syndrome and argue the case for early
treatment of all patients with Hunt syndrome and Bell's palsy with a combination 
of systemic steroids and antiviral drugs.

Publication Types: 
    Case Reports

PMID: 14706303 [PubMed - indexed for MEDLINE]

1882: Jpn J Infect Dis. 2003 Oct-Dec;56(5-6):193-9.

Encephalitis in Taiwan: a prospective hospital-based study.

Lee TC, Tsai CP, Yuan CL, Wei CY, Tsao WL, Lee RJ, Cheih SY, Huang IT, Chen KT.

Department of Agronomy, Biometry Division, National Taiwan University, Taipei
106, Taiwan. cptsai@vghtpe.gov.tw

To investigate encephalitis in Taiwan, a multicenter study was conducted with
patients who had acute severe neurological dysfunction and suspected encephalitis
from May 2000 to December 2001. Demographic data such as age, sex, and seasons
were analyzed. Polymerase chain reaction analyses were performed to determine the
microbiologic diagnosis. The patients included 73 males and 54 females, with a
peak age of 10-40 years old. Microbiologic diagnoses in 86 (69%) of 124 cases
involved herpes simplex virus (HSV, 45 cases), varicella zoster (16 cases),
Mycobacterium tuberculosis (10 cases), cytomegalovirus (8 cases), adenovirus (5
cases), influenza (1 case), and enterovirus (1 case). Pathogens were found in 69%
of the cases. Encephalitis was most likely to occur in June and July. Based on
the results, HSV is still the major viral cause of encephalitis in Taiwan.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 14695429 [PubMed - indexed for MEDLINE]

1883: Clin Ther. 2003 Nov;25(11):2809-21.

Change in opioid use after the initiation of gabapentin therapy in patients with 
postherpetic neuralgia.

Berger A, Dukes E, McCarberg B, Liss M, Oster G.

Policy Analysis Inc., Brookline, Massachusetts 02445, USA.

BACKGROUND: Postherpetic neuralgia (PHN) is a chronic painful disorder that
sometimes develops after an acute episode of herpes zoster infection (shingles)
and can be difficult to treat. Although opioids are sometimes effective for
chronic neuropathic pain, adverse effects are common, particularly among the
elderly, and may cause many patients to discontinue therapy. OBJECTIVE: This
study examined changes in opioid use after the initiation of gabapentin therapy
in patients with PHN. METHODS: A health insurance claims database was used to
identify all persons aged >or= 18 years who began therapy with gabapentin in 2000
or 2001 and had either (1) >or=2 medical claims with a diagnosis of PHN during
the 6-month period before the first receipt of gabapentin (index date) or (2) 1
such claim <or=14 days before the index date. Persons who were not continuously
eligible for medical and drug benefits for 6 months before and after the index
date (pretreatment and follow-up, respectively) were dropped from the study
sample. Use of opioids, including both short- and long-acting formulations, was
compared between pretreatment and follow-up. Patients were stratified in the
study analyses by whether they received 1 or >or=2 prescriptions for gabapentin. 
RESULTS: Forty-five patients with PHN began therapy with gabapentin during the
period of interest; 35 (77.8%) received >or=2 prescriptions for gabapentin. The
proportion of patients receiving opioids decreased significantly between
pretreatment and follow-up (from 88.9% to 71.1%; P = 0.03); the mean number of
opioid prescriptions per patient also decreased significantly (from 3.9 to 3.0; P
= 0.03). These reductions were observed only in patients who received >or=2
prescriptions for gabapentin; there was no significant change in opioid use among
those who received only 1 prescription for gabapentin. CONCLUSION: In this study,
initiation of gabapentin therapy in patients with PHN was associated with a
reduction in the use of opioid analgesics.

PMID: 14693306 [PubMed - indexed for MEDLINE]

1884: Eur J Neurol. 2004 Jan;11(1):68-9.

Neurotoxicity of acyclovir and valacyclovir in a hemodialyzed patient.

Strumia S, De Mitri P, Bionda E.

Publication Types: 
    Case Reports
    Letter

PMID: 14692893 [PubMed - indexed for MEDLINE]

1885: Leuk Lymphoma. 2003 Oct;44(10):1793-5.

Varicella-zoster viral meningitis mimicking lymphoma.

Park S, Leymarie V, Agbalika F, Galicier L, Oksenhendler E, Sigaux F, Noguera ME.

Laboratoire d'hematologie, Hopital Saint-Louis, 1 av Claude Vellefaux, 75010
Paris, France. parksophie@yahoo.com

We report the case of a 30-year-old HIV-infected man admitted for a meningeal
syndrome and a zoster rash. The CSF had cytological features suggesting a primary
CNS lymphoma (PCNSL). The large lymphoid cells had a fine chromatin with
nucleoli, a basophilic cytoplasm with azurophilic granules and high mitotic
activity. Several arguments demonstrated the viral origin of the meningitis: the 
large lymphoid cells were of T origin with no evidence of clonal TCR gamma gene
rearrangement. The PCR was positive for Varicella-Zoster Virus (VZV) and EBV DNA.
Clinical evolution was favorable under acyclovir. We should be cautious in the
differential diagnosis between viral meningitis and PCNSL.

Publication Types: 
    Case Reports

PMID: 14692535 [PubMed - indexed for MEDLINE]

1886: Prof Nurse. 2003 Dec;19(4):195-6.

Varicella-zoster virus, shingles and postherpetic neuralgia.

Shuttleworth A.

Publication Types: 
    Review

PMID: 14692251 [PubMed - indexed for MEDLINE]

1887: J Pediatr (Rio J). 1997 Sep-Oct;73(5):299-304.

[Methotrexate for steroid-dependent asthmatic children and adolescents]

[Article in Portuguese]

Zella MJ, Pastorino AC, Jacob CM, Grumach AS.

Instituto da Crianca do Hospital de Clinicas, Faculdade de Medicina da
Universidade de Sao Paulo.

INTRODUCTION: The administration of methotrexate as an antiinflammatory drug in
asthma has been discussed and most of the studies were developed in adults. Its
indication is restricted to steroid-dependent or steroid-resistant asthmatic
patients. OBJECTIVE: This study evaluates the clinical and espirometric
parameters of steroid-dependent asthmatic children, receiving methotrexate
therapy. METHODS: Perennial steroid-dependent asthmatic patients (prednisone 30
or 40 mg/dia), without associated disease, were evaluated by means of clinical
and spirometric parameters. A maintenance dose of 10 to 17.5 mg/ week of
methotrexate was administered. RESULTS: Six patients (3M;3F), aged 7 to 13 years 
old were included. There was improvement of clinical symptoms during the
administration of methotrexate, in all patients, without significant change in
the pulmonary function. During the use of methotrexate therapy three patients
presented adverse reactions: leukopenia (1/3), vomiting (1/3) or Herpes zoster
(1/3). The dose of prednisone was reduced in all patients, with total exclusion
of prednisone in 3. Afterwards, there was a worsening of asthmatic symptoms in
all patients, with reintroduction of corticosteroids. CONCLUSION: Methotrexate
represents an alternative therapy for steroid-dependent asthmatics, and it may
help to control symptoms of asthma and steroids use. Nevertheless, double-blind
studies should be developed in children. Adverse effects must be considered
before its indication, restricting its use to specialized centers.

Publication Types: 
    English Abstract

PMID: 14685381 [PubMed]

1888: Clin Dermatol. 2003 Sep-Oct;21(5):426-46.

Changing paradigms in dermatology: antivirals in dermatology.

Lin P, Torres G, Tyring SK.

Department of Dermatology, Northwestern University School of Medicine, Chicago,
Illinois, USA.

Almost all of the approved antiviral drugs have become available during the past 
two decades. Approximately one half of these agents are for the treatment of
human immunodeficiency virus (HIV) infections and comprise five classes. The
first three classes all act to inhibit reverse transcriptase: nucleoside analogs;
nonnucleoside analogs; and nucleotide analogs. The fourth class, protease
inhibitors, prevent viral packaging; the fifth class, fusion inhibitors, prevent 
fusion between HIV and the target cell. Four nucleoside analogs, acyclovir,
valacyclovir, famciclovir and penciclovir, are approved for the therapy of herpes
simplex and varicella zoster infections. Interferon alpha is approved in the
injectable form for condyloma acuminatum and Kaposi's sarcoma, but the more
efficient method of delivering this agent is via interferon induction following
topical use of imiquimod cream. Antiviral agents are also approved for infections
with cytomegalovirus, hepatitis B and C, respiratory syncytial virus, and
influenza viruses. Most of these antiviral drugs are virastatic and not
viracidal. Vaccines and public health measures are much more effective and cost
effective than antiviral drugs and must be promoted accordingly in the defense
against viral infections.

Publication Types: 
    Review

PMID: 14678723 [PubMed - indexed for MEDLINE]

1889: Am J Transplant. 2004 Jan;4(1):108-15.

Herpes zoster infection following solid organ transplantation: incidence, risk
factors and outcomes in the current immunosuppressive era.

Gourishankar S, McDermid JC, Jhangri GS, Preiksaitis JK.

Department of Medicine, Division of Nephrology & Transplantation Immunology,
University of Alberta, Edmonton, Alberta, Canada. sitag@ualberta.ca

Herpes zoster (HZ) infection is a frequent and serious complication of organ
transplantation that has not been examined in the current era of
immunosuppression. All solid organ transplants performed between 1994 and 1999 (n
= 869) at our center were analyzed to determine the incidence, complications and 
risk factors for developing HZ. The overall incidence of HZ was 8.6% (liver 5.7%,
renal 7.4%, lung 15.1% and heart 16.8%). The median time of onset was 9.0 months.
We observed high rates of cutaneous scarring (18.7%) and post-herpetic neuralgia 
(42.7%). Independent organ-specific risk factors included: female gender and
mycophenolate mofetil therapy (liver), and antiviral treatment other than
prolonged cytomegalovirus (CMV) prophylaxis (renal and heart). For all organs
combined, induction therapy and antiviral treatment other than prolonged CMV
prophylaxis were independent predictors for the development of HZ. Herpes zoster 
is common and results in significant morbidity for solid organ transplant
recipients. Risk factors include induction therapy and antiviral drug therapy
other than CMV prophylaxis. The latter variable identifies a subpopulation that
is likely at increased risk of latent herpesvirus reactivation. The high
first-year post-transplant incidence rate suggests immunization pretransplant,
even in varicella zoster virus immunoglobulin seropositive individuals, may be
preventative.

PMID: 14678041 [PubMed - indexed for MEDLINE]

1890: J Neurol. 2003 Dec;250(12):1492-3.

Zoster paresis with Horner's syndrome.

Gabriel CM, Gale AN, Rossor MN.

Publication Types: 
    Letter

PMID: 14673585 [PubMed - indexed for MEDLINE]

1891: Skinmed. 2003 Jul-Aug;2(4):253-5.

Herpes zoster: reassessment of isolation-precautions in hospitals.

Burkhart CN, Barnett R.

The Department of Immunology and Microbiology, Medical College of Ohio at Toledo,
Toledo, OH 43623, USA. cburkhart@mco.edu

Publication Types: 
    Case Reports

PMID: 14673281 [PubMed - indexed for MEDLINE]

1892: Clin Ther. 2003 Oct;25(10):2597-608.

Use of gabapentin for postherpetic neuralgia: results of two randomized,
placebo-controlled studies.

Stacey BR, Glanzman RL.

Pain Management Center, Oregon Health & Science University, 3181 SW Sam Jackson
Park Road, Portland, OR 97239, USA. staceyb@ohsu.edu

BACKGROUND: Postherpetic neuralgia (PHN), which affects up to 70% of elderly
persons with herpes zoster, can have debilitating effects, including physical and
social disability and significant psychological distress. A variety of agents
have been used, either singly or in combination, to control PHN, including
topical and oral analgesics, antidepressants, and antiepileptic drugs (AEDs).
However, PHN often proves refractory to these therapies. OBJECTIVE: This article 
reviews available data on the use of the newer AED gabapentin for the control of 
PHN. METHODS: A MEDLINE search was undertaken to identify all randomized,
placebo-controlled trials on the use of gabapentin in PHN. The search terms were 
gabapentin and postherpetic neuralgia. RESULTS: The literature search identified 
2 published studies of the efficacy of gabapentin in a total of 563 patients with
PHN that had persisted for at least 3 months after the healing of herpes zoster
rash. The studies employed multiple outcome measures, including visual analog and
Likert scales for pain intensity, and quality-of-life and functional measures
that included the Medical Outcomes Study 36-item Short Form Health Survey (SF-36)
and the Profile of Mood States. At maximum target dosages of 1800 to 3600 mg/d,
gabapentin produced significant reductions in mean daily pain scores compared
with placebo on both visual analog(P < 0.001) and Likert scales (P < 0.01).
Improvements were also seen on the SF-36 subscales for physical functioning,
bodily pain, vitality, and mental health(P < 0.01). CONCLUSION: Gabapentin may
provide benefits in terms of alleviation of pain and overall quality of life in
patients with chronic PHN.

Publication Types: 
    Comparative Study
    Review

PMID: 14667960 [PubMed - indexed for MEDLINE]

1893: J Oral Maxillofac Surg. 2003 Dec;61(12):1505; author reply 1505.

Comment on:
    J Oral Maxillofac Surg. 2003 Apr;61(4):489-93.

Etiology of maxillary necrosis.

Penarrocha-Diago M, Uribe-Origone R.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 14666937 [PubMed - indexed for MEDLINE]

1894: Klin Med (Mosk). 2003;81(10):63-4.

[Documented case of recurrent herpes zoster]

[Article in Russian]

Shishov AS, Virych IE, Rudometov IuP, Kupriianova LV.

The paper presents a comparative description of the clinical picture of herpes
zoster observed in a patient twice in 1989 and 1997. For its differential
diagnosis with herpes simplex, emphasis is laid on a difference between the
concepts "relapse" and "recurrence".

Publication Types: 
    Case Reports
    English Abstract

PMID: 14664179 [PubMed - indexed for MEDLINE]

1895: Ann N Y Acad Sci. 2003 Oct;1004:142-57.

Mathematical model predicts clinical ocular motor syndromes.

Dieterich M, Glasauer S, Brandt T.

Department of Neurology and Center of Sensorimotor Research, Klinikum
Grosshadern, Ludwig-Maximilians University, Munich, Germany.
dietrich@neurologie.klinik.uni-mainz.de

Clinical ocular motor syndromes were compared with ocular motor syndromes
simulated by a mathematical model of the vestibuloocular reflex. The mathematical
sensorimotor feedforward model of otolith control of three-dimensional binocular 
eye position is based on relevant anatomical connections of the vestibuloocular
reflex from the utricles to extraocular eye muscles. This is the first attempt to
simulate static ocular motor syndromes for unilateral utricular or vestibular
nerve failure, lesions of the vestibular nucleus, and lesions of the ascending
vestibuloocular reflex pathways. Comparison of the predicted syndromes with those
found in patients with unilateral disorders of the vestibular nerve (herpes
zoster neuritis), the vestibular nucleus (medullary infarction), and the medial
longitudinal fasciculus (pontine infarction) showed good agreement as regards the
direction of horizontal, vertical, and torsional eye deviations. The ability of
the model to simulate complete or incomplete failures of single elements or
entire pathways allows us to pose direct clinical questions about as yet unknown 
ocular motor syndromes or about the localization of the damage as well as the
mechanism involved in syndromes already known.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14662455 [PubMed - indexed for MEDLINE]

1896: J Gene Med. 2003 Dec;5(12):1018-27.

Ganciclovir nucleotides accumulate in mitochondria of rat liver cells expressing 
the herpes simplex virus thymidine kinase gene.

van der Eb MM, Geutskens SB, van Kuilenburg AB, van Lenthe H, van Dierendonck JH,
Kuppen PJ, van Ormondt H, van de Velde CJ, Wanders RJ, van Gennip AH, Hoeben RC.

Department of Molecular Cell Biology, Leiden University Medical Center, Leiden,
The Netherlands.

BACKGROUND: Ganciclovir exhibits broad-spectrum activity against DNA viruses such
as cytomegaloviruses, herpes simplex viruses, varicella-zoster virus,
Epstein-Barr virus and human herpes virus-6. Ganciclovir is widely applied for
anti-herpetic treatment, cytomegalovirus prophylaxis after organ transplantation,
and, more recently, in experimental gene therapy to eradicate cycling cells that 
express the herpes simplex virus thymidine kinase gene. Although ganciclovir
supposedly acts as a chain terminator, there is compelling evidence demonstrating
the presence of ganciclovir, but not of acyclovir, incorporated internally into
DNA, leaving the precise mechanism by which ganciclovir inhibits DNA synthesis
enigmatic. METHODS: To study the potential involvement of mitochondria in the
ganciclovir nucleotide cytotoxicity, we used adenovirus-mediated gene transfer to
express herpes simplex virus thymidine kinase in rat liver and administered
ganciclovir 2 days post-infection. The integrity and function of mitochondria in 
the rat liver cells were evaluated by several techniques. In addition, we
analyzed the nucleotide pools in cellular extracts and in isolated mitochondria. 
RESULTS: We show that ganciclovir nucleotides are abundantly present in the
mitochondria of rat livers that express the HSVtk gene. Already 48 h after
administration, 10-30% of the total mitochondrial nucleotide pool consists of
ganciclovir nucleotides. Their presence is correlated with a lower amount of
mitochondrial DNA, a reduced mitochondrial-membrane potential, morphological
abnormalities, and liver dysfunction. CONCLUSIONS: These data provide evidence
for the involvement of mitochondria in the hepatotoxicity of the HStk/ganciclovir
combination. This may explain the toxicity of the HSVtk/gancilovir combination in
some metabolically active but non-proliferating cells, such as liver cells. This 
toxicity limits the applicability of this enzyme/prodrug combination. Copyright
2003 John Wiley & Sons, Ltd.

PMID: 14661177 [PubMed - indexed for MEDLINE]

1897: MMW Fortschr Med. 2003 Oct 30;145(44):37.

[Efficacy and tolerability of gabapentin in the treatment of patients with
neuropathic pain. Results of an observational study involving 5620 patients]

[Article in German]

Junker U, Brunnmuller U.

Abt. Spezielle Schmerztherapie und Palliativmedizin Sana Klinikum Remscheid GmbH 
Hans-Potyka-Str. 28, D-42827 Remscheid.

Publication Types: 
    Comparative Study

PMID: 14655505 [PubMed - indexed for MEDLINE]

1898: Hunan Yi Ke Da Xue Xue Bao. 2003 Aug;28(4):412-4.

[Etiology of infectious diseases in the central nervous system]

[Article in Chinese]

Yu JL, Liu SP, Luo MH.

Department of Microbiology, Xiangya School of Medicine, Central South University,
Changsha 410078, China.

OBJECTIVE: To determine the etiological characteristics of infectious diseases in
the central neural system (CNS). METHODS: The serum and cerebral spinal fluid of 
acute patients in the CNS were detected for virus-specific IgM, IgG and pathogens
with enzyme-linked immunosorbent assay as well as traditional bacterial and
fungal culture. RESULTS: Of the 823 patients, 126 (15.3%) patients were positive 
herpes simplex virus (HSV)-specific IgM and/or IgG, of which the maximum
morbidity was under 10 years; 10(1.2%) were positive cytomegalovirus specific IgM
and/or IgG; 8 (0.97%) were positive varicella-zoster virus specific IgM and/or
IgG; 7 (0.85%) were diagnosed as tubercular meningitis; 6 (0.72%) as
cryptocococes meningitis and 1 (0.12%) as meningococcic meningitis. CONCLUSION:
Viruses, especially herpes simplex viruses are the common causative agents of
infectious diseases of the CNS, in which mycobacterium tuberculosis and
cryptocococcus neoformans are conspicuous.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 14653134 [PubMed - indexed for MEDLINE]

1899: J Pediatr (Rio J). 2000 Jul-Aug;76(4):281-6.

[Hodgkins disease in childhood: a sixteen year experience in a single
institution]

[Article in Portuguese]

Oliveira BM, Viana MB, Cunha KC.

Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

OBJECTIVES: To report the experience in the treatment of Hodgkins lymphoma in
children at Hospital das Clinicas, UFMG, Brazil.METHODS: 31 children with
Hodgkins lymphoma were retrospectively followed up from 1983 to 1999. Fifteen
children were treated according to HD-85, a protocol based on German-Austrian
studies; the 16 remaining children were treated otherwise.RESULTS: The age at
diagnosis varied from 3 to 15 years (median 9 years). There were 28 male
patients. The follow-up period ranged from 2 months to 16 years (median 3 years
and 7 months). Mixed cellularity was the predominant (61%) histological subtype; 
58% had advanced disease (stages III or IV) at diagnosis. Staging abdominal
surgery was necessary in 61%. No reduction in the frequency of staging surgeries 
was observed after starting standardized HD-85 protocol in 1994. Herpes simplex
and zoster infections were the most common complications. The estimated
probability of disease-free survival (DFS) was 55.6%-/+11.7% at 5 years. Overall 
survival probability was 96.5%-/+3.5%. No difference in DFS was apparent between 
children treated with HD-85 and those treated otherwise.CONCLUSIONS: The overall 
results in DFS are worse than those reported in the literature. The predominance 
of mixed cellularity subtype, and early age and advanced disease at diagnosis are
commonly reported in developing countries and do not fully explain the observed
results. A longer follow-up is necessary to evaluate the influence of treatment
standardization on the outcome of these children.

PMID: 14647656 [PubMed - as supplied by publisher]

1900: Melanoma Res. 2003 Dec;13(6):635-9.

Cutaneous zosteriform melanoma metastases arising after herpes zoster infection: 
a case report and review of the literature.

Zalaudek I, Leinweber B, Richtig E, Smolle J, Hofmann-Wellenhof R.

Publication Types: 
    Case Reports
    Letter

PMID: 14646630 [PubMed - indexed for MEDLINE]

1901: Arch Pediatr. 2003 Dec;10(12):1113-8.

[Chickenpox during pregnancy]

[Article in French]

Mirlesse V, Lebon P.

Centre de diagnostique prenatal et de medecine foetale, institut de puericulture,
Paris, France. mirlesse.v@free.fr

Varicella during pregnancy is a rare occurrence because of a high rate of
spontaneous immunisation in the population. When a pregnant woman presents a
typical rash, maternal complications, mainly respiratory distress, can occur and 
be life threatening. Fetal complications include two types of consequences.
Before 24 weeks of gestation, transplacental transmission is estimated around 6%,
with about one third of infected fetuses presenting clinical manifestations.
Congenital varicella syndrome includes growth retardation, neurological effects
as microcephaly, limbs malposition, lung or bowel hyperechogenicity. But most
infected fetuses will not show any anomaly. A very few might develop shingles in 
the first year of life. Peripartum contamination brings a much higher risk of
transmission (around 25%). Neonatal varicella infection can be life threatening
for the new born baby, especially if premature. A specific treatment should be
started as soon as the contamination is discovered. Zoster during pregnancy does 
not lead to a risk of fetal infection.

Publication Types: 
    English Abstract
    Review

PMID: 14643554 [PubMed - indexed for MEDLINE]

1902: MMW Fortschr Med. 2003 Sep 25;145(39):45.

[Controlled-release oxycodone -- a therapeutic option for severe neuropathic
pain]

[Article in German]

Worz R, Frank M, Achenbach U.

woerz.roland@t-online.de

Publication Types: 
    Comparative Study

PMID: 14649073 [PubMed - indexed for MEDLINE]

1903: Clin Experiment Ophthalmol. 2003 Dec;31(6):496-504.

Prescribing trends in infectious keratitis: a survey of New Zealand
ophthalmologists.

McAllum PJ, McGhee CN.

Discipline of Ophthalmology, University of Auckland, Auckland, New Zealand.

PURPOSE: To obtain an overview of the treatment of infectious diseases of the
cornea by New Zealand ophthalmologists and to analyse the data in the context of 
evidence-based treatment recommendations. METHODS: A questionnaire was sent to
all New Zealand ophthalmologists. It comprised 23 multiple-choice questions
pertaining to the characteristics of the respondents, the nature of their
practice and their prescribing preferences in infectious conjunctivitis and
keratitis. RESULTS: Of the 93 ophthalmologists surveyed, 80.6% returned the
questionnaire. Of those in clinical practice, 91.4% regularly treated patients
with corneal disease. A subspecialty interest in cornea was stated by 12.5% of
these. This paper reports observations for adenoviral conjunctivitis and
adenoviral, Herpes simplex, varicella zoster, bacterial, acanthamoebal and fungal
keratitis. In some conditions prescribing practice varied dramatically, such as
in adenoviral conjunctivitis where 50% of respondents prescribed a corticosteroid
and 51.6% an antibiotic, whereas 37.5% prescribed only lubrication or no topical 
treatment. In other conditions there was a high degree of agreement between
ophthalmologists; indeed, all ophthalmologists treated Herpes simplex dendritic
keratitis with topical acyclovir. No statistically significant differences in
prescribing habits were identified between subspecialist and non-subspecialist
groups, although some important clinical differences emerged. There were
occasional marked differences in response when the age group of respondents was
considered, particularly in relation to the management of adenoviral infections
and bacterial keratitis. CONCLUSIONS: The findings of this survey suggest that
the majority of New Zealand ophthalmologists generally follow international
guidelines for the management of infectious keratitis. The identified variations 
in management provide a foundation for informed clinical debate and the
development of treatment guidelines, in line with evidence-based recommendations.

PMID: 14641157 [PubMed - indexed for MEDLINE]

1904: Bull Mem Acad R Med Belg. 2003;158(3-4):169-73; discussion 174-5.

[Mysteries of viral latency and reactivation]

[Article in French]

Rentier B.

Varicella-zoster virus is a Herpesvirus responsible for three distinct clinical
features: chicken pox (varicella), shingles (herpes zoster) and post-zosterian
pain (post-herpetic neuralgia). Neurological features of these diseases such as
complications of chicken pox, viral latency in sensory ganglia and reactivation
as shingles with concurrent and possibly subsequent prolonged pain, are the
sequels of the invasion of the peripheral nervous system during primary
infection. Prevention is achieved by vaccination with a live attenuated virus
strain and therapy calls for specific antiviral agents. In many respects, vzv
behaves differently from close relatives. In particular, viral latency in the
nervous system is basically different from that of other Herpesviridae. The
recent discovery of the expression of some viral regulatory proteins during
latency, although it had always been considered that vzv latency was silent, and 
demonstration that these proteins are immunogenic open new avenues concerning the
immune control of vzv reactivation.

Publication Types: 
    English Abstract

PMID: 14639872 [PubMed - indexed for MEDLINE]

1905: J Am Acad Dermatol. 2003 Dec;49(6):1121-4.

Hiccups, eructation, and other uncommon prodromal manifestations of herpes
zoster.

Berlin AL, Muhn CY, Billick RC.

Department of Dermatology, the University of Illinois College of Medicine,
Chicago, Illinois, USA.

Although the most frequent presentation of herpes zoster involves sensory
neurons, motor and autonomic symptomatology is also known to occur in this
disease. An unusual symptom of hiccups is described here. Other infrequent
manifestations of this common illness, including the Ramsay Hunt syndrome, herpes
zoster ophthalmicus, urinary and fecal retention, sexual dysfunction, and zoster 
sine herpete, are reviewed. Greater awareness of unusual presentations of herpes 
zoster is necessary for proper diagnosis and timely management of complications
that may otherwise lead to disability and serious long-term sequelae.

Publication Types: 
    Case Reports

PMID: 14639397 [PubMed - indexed for MEDLINE]

1906: Mayo Clin Womens Healthsource. 2001 May;5(5):6.

Shingles.

[No authors listed]

PMID: 14639308 [PubMed - in process]

1907: Int J Dermatol. 2003 Nov;42(11):919-20.

Topical tretinoin in Indian male with zosteriform porokeratosis.

Agrawal SK, Gandhi V, Madan V, Bhattacharya SN.

Publication Types: 
    Case Reports
    Letter

PMID: 14636214 [PubMed - indexed for MEDLINE]

1908: Microsc Res Tech. 2003 Dec 15;62(6):508-13.

Age-related changes in the function of T cells.

Aspinall R.

Department of Immunology, Faculty of Medicine, Imperial College, Chelsea &
Westminster Hospital, London SW10 9NH, United Kingdom. r.aspinall@ic.ac.uk

At the start of the last century in the United Kingdom, only 24% of the 587,830
deaths registered were of individuals over 65, but by the end of the century
these figures had changed markedly. Of the 558,052 deaths in 1997, 84% were in
the population over 65. This "right shift" in the survival curve is projected to 
continue. The UK Government Actuary's Department forecast that by 2020, 11.75
million people (19% of the population) will be over 65 rising to 15.1 million
people (25% of the population) by 2040. Older members of society show infections 
of the urinary tract, respiratory tract, skin, soft tissue or intra-abdominal
region, infectious endocarditis, bacterial meningitis, tuberculosis, and herpes
zoster, at a higher incidence than among younger adults. Moreover, mortality
rates for these diseases are often 2-3 times higher among elderly patients than
younger individuals with the same disease. The higher morbidity and mortality
from these infections, plus the increased prevalence of specific cancers and
certain autoimmune diseases point to an immune system deteriorating with age. At 
the core of the immune system are the T cells and this review analyses possible
causes for the changes in T cell function that may account for the deterioration 
of the immune system. Any intervention to reverse the decline in the immune
system must have a rational basis built on a hypothesis-driven inquiry, and one
such intervention process is presented here. Copyright 2003 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 14635144 [PubMed - indexed for MEDLINE]

1909: J Med Virol. 2004 Jan;72(1):174-9.

Stress-induced subclinical reactivation of varicella zoster virus in astronauts.

Mehta SK, Cohrs RJ, Forghani B, Zerbe G, Gilden DH, Pierson DL.

Enterprise Advisory Services Inc., Lyndon B. Johnson Space Center, Houston,
Texas.

Varicella zoster virus (VZV) becomes latent in human ganglia after primary
infection. VZV reactivation occurs primarily in elderly individuals, organ
transplant recipients, and patients with cancer and AIDS, correlating with a
specific decline in cell-mediated immunity to the virus. VZV can also reactivate 
after surgical stress. The unexpected occurrence of thoracic zoster 2 days before
space flight in a 47-year-old healthy astronaut from a pool of 81 physically fit 
astronauts prompted our search for VZV reactivation during times of stress to
determine whether VZV can also reactivate after non-surgical stress. We examined 
total DNA extracted from 312 saliva samples of eight astronauts before, during,
and after space flight for VZV DNA by polymerase chain reaction: 112 samples were
obtained 234-265 days before flight, 84 samples on days 2 through 13 of space
flight, and 116 samples on days 1 through 15 after flight. Before space flight,
only one of the 112 saliva samples from a single astronaut was positive for VZV
DNA. In contrast, during and after space flight, 61 of 200 (30%) saliva samples
were positive in all eight astronauts. No VZV DNA was detected in any of 88
saliva samples from 10 healthy control subjects. These results indicate that VZV 
can reactivate subclinically in healthy individuals after non-surgical stress.
Copyright 2004 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 14635028 [PubMed - indexed for MEDLINE]

1910: Am J Pathol. 2003 Dec;163(6):2407-12.

Herpes simplex virus type 1 infection associated with atrial myxoma.

Li Y, Pan Z, Ji Y, Sheppard M, Jeffries DJ, Archard LC, Zhang H.

Division of Biomedical Sciences, Imperial College Faculty of Medicine, London,
United Kingdom.

Some findings suggest an infectious factor in cardiac myxoma and certain
histopathological features indicate herpes simplex virus type 1 (HSV-1)
infection. We hypothesized that HSV-1 may be involved in the pathogenesis of
cardiac myxoma. Paraffin-embedded tissue samples from 17 patients with atrial
myxoma were investigated for HSV-1 antigen by immunohistochemistry and viral
genomic DNA by nested polymerase chain reaction. The histogenesis and oncogenesis
of atrial myxoma were assessed by the expression of calretinin, Ki67, and p53
protein, respectively. Autopsy myocardial samples, including endocardium from 12 
patients who died by accident or other conditions, were used for comparison.
HSV-1 antigen was detected in atrial myxoma from 12 of 17 patients: 8 of these 12
samples were positive also for HSV-1 DNA. No HSV-1 antigen or DNA was found in
tissue from the comparison group. Antigens of HSV-2, varicella-zoster virus,
Epstein-Barr virus, and cytomegalovirus were not found in atrial myxoma.
Calretinin was found in myxoma cells of all 17 cases but Ki67 was present only in
smooth muscle cells or infiltrating cells in some cases. p53 was not detectable
in any myxoma. Most infiltrating cells were cytotoxic T lymphocytes. These data
suggest that HSV-1 infection is associated with some cases of sporadic atrial
myxoma and that these may result from a chronic inflammatory lesion of
endocardium.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14633612 [PubMed - indexed for MEDLINE]

1911: Am J Pathol. 2003 Dec;163(6):2179-84.

Latent herpesvirus infection in human trigeminal ganglia causes chronic immune
response.

Theil D, Derfuss T, Paripovic I, Herberger S, Meinl E, Schueler O, Strupp M,
Arbusow V, Brandt T.

Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University,
Munich, Germany. dtheil@brain.nefo.med.uni-muenchen.de

The majority of trigeminal ganglia (TGs) are latently infected with
alpha-herpesviruses [herpes simplex virus type-1 (HSV-1) and varicella-zoster
virus (VZV)]. Whereas HSV-1 periodically reactivates in the TGs, VZV reactivates 
very rarely. The goal of this study was to determine whether herpesvirus latency 
is linked to a local immune cell infiltration in human TGs. T cells positive for 
the CD3 and CD8 markers, and CD68-positive macrophages were found in 30 of 42
examined TGs from 21 healthy individuals. The presence of immune cells correlated
constantly with the occurrence of the HSV-1 latency-associated transcript (LAT)
and only irregularly with the presence of latent VZV protein. In contrast,
uninfected TGs showed no immune cell infiltration. Quantitative RT-PCR revealed
that CD8, interferon-gamma, tumor necrosis factor-alpha, IP-10, and RANTES
transcripts were significantly induced in TGs latently infected with HSV-1 but
not in uninfected TGs. The persisting lymphocytic cell infiltration and the
elevated CD8 and cytokine/chemokine expression in the TGs demonstrate for the
first time that latent herpesviral infection in humans is accompanied by a
chronic inflammatory process at an immunoprivileged site but without any neuronal
destruction. The chronic immune response seems to maintain viral latency and
influence viral reactivation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14633592 [PubMed - indexed for MEDLINE]

1912: Curr Eye Res. 2003 Aug;27(2):85-90.

Multiplex polymerase chain reaction for the detection of herpes simplex virus,
varicella-zoster virus and cytomegalovirus in ocular specimens.

Chichili GR, Athmanathan S, Farhatullah S, Gangopadhyay N, Jalali S, Pasricha G, 
Sharma S.

Jhaveri Microbiology Center, Hyderabad Eye Research Foundation, L.V. Prasad Eye
Institute, L.V Prasad Marg, Banjara Hills, Hyderabad, India.

PURPOSE: A majority of ocular viral diseases are caused by herpes group of
viruses. Such infections, especially atypical herpetic keratitis, iridocyclitis
and intra-ocular inflammations, can often present with overlapping clinical
manifestations misleading the diagnosis. Molecular techniques are most useful in 
such instances for an accurate and rapid diagnosis since conventional methods are
time consuming and less sensitive. A multiplex PCR was developed and used for the
detection of herpes simplex virus (HSV), varicella zoster virus (VZV), and
cytomegalovirus (CMV) in ocular samples. METHODS: One hundred and forty six
ocular samples (corneal scrapings - 52, aqueous fluid - 36, vitreous fluid - 31, 
tissues - 26, skin vesicle scraping - 1) were included in the study. The
sensitivity of the assay was determined using serial dilutions of standard
strains of HSV, VZV, and CMV vis-a-vis plaque forming assay. RESULTS: The
sensitivity of the assay was 4, 4 and 12 PFU/ml or 20, 20 and 60 genome copy
numbers of HSV, VZV and CMV respectively. Using DNA from various sources (fungal,
bacterial, human leukocytes, tissues) along with standard positive controls, the 
assay was found to be highly specific. HSV DNA was detected in majority of the
clinical samples (33.6%), most frequent being corneal samples. Comparatively, VZV
and CMV infections were detected in small number of samples (VZV-3, CMV-2).
CONCLUSIONS: We found the assay very useful in our set-up whenever a differential
diagnosis of herpetic infections was suggested by the ophthalmologist. The
multiplex PCR we have described here can be of greater value in clinics with
larger number of patients suspected of having HSV, VZV or CMV infections.

PMID: 14632159 [PubMed - indexed for MEDLINE]

1913: Rev Mal Respir. 2003 Nov;20(5 Pt 1):773-6.

[Severe varicella zoster pneumonia during the course of treatment with
azathioprine for Crohn's disease]

[Article in French]

Lemyze M, Tavernier JY, Chevalon B, Lamblin C.

Service de Pneumologie, Centre Hospitalier, Lens, France.

INTRODUCTION: Disseminated varicella zoster infection has only rarely been
reported in patients with inflammatory bowel disease, despite the frequent use of
azathioprine for this disorder. CASE REPORT: We report the case of an 18-year-old
woman who developed severe varicella zoster pneumonia 9 months after starting
azathioprine for Crohn's disease. The patient recovered after prompt treatment
with acyclovir and discontinuation of the azathioprine. CONCLUSIONS: Strategies
concerning the treatment and the prevention of varicella infection in the
immunocompromised patient are discussed.

Publication Types: 
    English Abstract

PMID: 14631259 [PubMed - indexed for MEDLINE]

1914: J Hist Neurosci. 2003 Sep;12(3):266-75.

A biography of James Ramsay Hunt (1874-1937).

Louis ED, Williams M.

Gertrude H. Sergievsky Center, Department of Neurology, College of Physicians and
Surgeons, Columbia University, New York, NY, USA. EDL2@columbia.edu

James Ramsay Hunt (1874-1937) was a pre-eminent twentieth-century American
neurologist. The name of Ramsay Hunt is known today because several neurological 
disorders bear his name, including the herpetic geniculate ganglion syndrome and 
a form of ataxia and myoclonus. Despite his importance in the field of neurology,
few biographical details have been recorded about Hunt's life. One of the authors
of this report recently located Hunt's daughter. This biographical sketch was
based on interviews conducted with her and review of documents in her possession,
including letters written by Hunt. Details are depicted about Hunt's family
background and childhood, medical education and early professional development,
courtship and marriage, wartime experiences, family and social life, daily
routine and professional development, as well as illness and death.

Publication Types: 
    Biography
    Historical Article
    Portraits

Personal Name as Subject: 
    Hunt JR

PMID: 14628542 [PubMed - indexed for MEDLINE]

1915: J Am Pharm Assoc (2003). 2003 Sep-Oct;43(5 Suppl 1):S22-3.

New options in herpes management.

Knodel L, Goad J.

University of Texas Health Sciences Center at San Antonio, USA.

Herpesviruses in the alpha group--HSV-1, HSV-2, and VZV (i.e., HSV-3)--are
ubiquitous in American society. HSV-1 is associated primarily with herpes
labialis, while HSV-2 is involved in about 70% of cases of genital herpes.
Varicellazoster virus causes chickenpox in unvaccinated children and others, and 
latent virus produces shingles later in life. Since many patients with HSV-1 and 
HSV-2 infections are asymptomatic, testing is important in determining presence
of the viruses. Several antiviral agents effective against HSV have been
marketed. While the infection cannot be cured, the available medications are
effective for reducing the duration of outbreaks, recurrences, and possibly viral
transmission.

Publication Types: 
    Congresses

PMID: 14626519 [PubMed - indexed for MEDLINE]

1916: J Lab Clin Med. 2003 Oct;142(4):246-51.

Laboratory diagnosis to differentiate smallpox, vaccinia, and other
vesicular/pustular illnesses.

Besser JM, Crouch NA, Sullivan M.

Public Health Laboratory, Minnesota Department of Public Health, Minneapolis, MN 
55414, USA.

Publication Types: 
    Review

PMID: 14625530 [PubMed - indexed for MEDLINE]

1917: Arch Neurol. 2003 Nov;60(11):1607-9.

Multifocal varicella-zoster virus vasculopathy without rash.

Russman AN, Lederman RJ, Calabrese LH, Embi PJ, Forghani B, Gilden DH.

Department of Neurology, The Cleveland Clinic Foundation, Cleveland, OH 44195,
USA. russmaa@ccf.org

A 51-year-old woman with CREST syndrome (calcinosis, Raynaud phenomenon,
esophageal dysmotility, sclerodactyly, and telangiectasia) developed stepwise
progressive focal neurological deficits without zoster rash. Multifocal ischemic 
infarcts were seen on magnetic resonance imaging, and cerebral angiography
revealed focal stenosis of arteries affecting the intracranial circulation. A
brain biopsy was nondiagnostic. Virological etiology of the disease was verified 
by the detection of varicella-zoster virus antibody in cerebrospinal fluid and by
reduced serum-cerebrospinal fluid varicella-zoster virus IgG ratios (compared
with normally high ratios of total IgG and albumin). Treatment with intravenous
acyclovir stabilized but did not significantly improve her neurological deficits.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 14623735 [PubMed - indexed for MEDLINE]

1918: J Pain. 2003 Aug;4(6):338-43.

Herpes zoster itch: preliminary epidemiologic data.

Oaklander AL, Bowsher D, Galer B, Haanpaa M, Jensen MP.

Nerve Injury Unit, Department of Anesthesiology, Massachusetts General Hospital, 
Harvard Medical School, Boston, MA 02114, USA. aoaklander@partners.org

The best-known complication of shingles (herpes zoster) is postherpetic neuralgia
(PHN). PHN is commonly studied to investigate causes of and treatments for
neuropathic pain. However, many patients with shingles experience neuropathic
itch accompanying, or instead of, pain. Some report severe disabling postherpetic
itch (PHI), and though it is rare, some patients injure themselves by scratching 
itchy skin that has lost protective sensation. To date, there is virtually no
mention of PHI in the medical literature; neither epidemiologic, anatomic,
physiologic, nor treatment studies. We analyzed 3 independent existing sets of
data from 586 adults with shingles or PHN to glean epidemiologic information
about pruritus during and after shingles. All data refer to itch localized to
shingles-affected areas and initiated by shingles. They indicate that pruritus,
usually mild or moderate, commonly accompanies both acute zoster and PHN. There
was no significant difference in age between subjects with and without PHI. In
one group, but not in another, there was an increased number of women with PHI.
Subjects whose shingles affected the head, face, and neck were more likely to
experience PHI than those whose shingles affected the torso. These findings
indicate a need for research on zoster-associated itch, including prospective
studies on frequency, impact, and treatment.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 14622691 [PubMed - indexed for MEDLINE]

1919: Clin Exp Dermatol. 2003 Nov;28(6):661-5.

Dermatological disorders in Johannesburg, South Africa.

Hartshorne ST.

Division of Dermatology, Department of Medicine, University of Witwatersrand,
Johannesburg, South Africa. vdhandel@iafrica.com

During 1999, a survey of dermatological outpatients was undertaken in the five
academic hospitals serving the public sector in the Johannesburg area. The
relative frequency of dermatological diseases was calculated as the percentage of
new dermatological outpatients. A total of 7029 patients was surveyed of whom
5355 (76.1%) were black, 770 (10.9%) white, 474 (6.7%) Indian and 430 (6.1%)
coloured (mixed race). Eczema was the commonest disease accounting for one-third 
of all diagnoses in the total population surveyed. In black patients the
commonest skin diseases were eczema (32.7%), acne (17.5%) and superficial fungal 
infections (5.7%). In white patients the commonest skin diseases were benign skin
tumours (29.7%), eczema (17.8%) and malignant tumours (15%). In Indian patients
the commonest skin diseases were eczema (30.4%), superficial fungal infections
(11.8%) and psoriasis (9.6%) and in coloured patients the commonest skin diseases
were eczema (34.5%), acne (13.9%) and warts (8.1%). The prevalence of seborrhoeic
dermatitis, Kaposi's sarcoma and herpes zoster has increased markedly since the
last South African survey in 1982. This increase may be ascribed to the epidemic 
of HIV infection, first diagnosed in South Africa in 1982.

PMID: 14616837 [PubMed - indexed for MEDLINE]

1920: Br J Dermatol. 2003 Oct;149(4):862-5.

Disseminated zoster, hyponatraemia, severe abdominal pain and leukaemia relapse: 
recognition of a new clinical quartet after bone marrow transplantation.

Au WY, Ma SY, Cheng VC, Ooi CG, Lie AK.

Department of Medicine, Queen Mary Hospital, University of Hong Kong, Pokfulam
Road, Hong Kong SAR, China. auwing@hotmail.com

Reactivation of varicella-zoster virus (VZV) is one of the commonest
complications after stem cell transplantation, and often presents with atypical
manifestations. We describe two unusual cases of occult disseminated zoster in
allogeneic stem cell transplant recipients, presenting as severe abdominal pain
and syndrome of inappropriate antidiuretic hormone secretion/hyponatraemia, and
accompanied by leukaemia relapse. There was complete clinical recovery with
high-dose aciclovir and intravenous immunoglobulin. Prompt treatment of leukaemia
relapse also resulted in complete remission. A possible immunological link
between concurrent breakdown of immune control of VZV and leukaemia is discussed.

Publication Types: 
    Case Reports
    Review

PMID: 14616382 [PubMed - indexed for MEDLINE]

1921: Ther Umsch. 2003 Oct;60(10):605-14.

[Herpes simplex and varicella zoster virus infections]

[Article in German]

Lautenschlager S.

Dermatologisches Ambulatorium des Stadtspitals Triemli Zurich.
stephan.lautenschlager@triemli.stzh.ch

Herpes simplex virus (HSV) and varicella-zoster virus (VZV) are both human
alpha-herpes viruses. They are capable of establishing latent infections in
neural tissues and to reactive from these sites, determining the clinical
features of the disease (primary infection versus recurrences). Infections with
these viruses are common; an increased number of elderly and immunocompromised
individuals will likely lead to an even higher prevalence. HSV infection--in its 
typical form characterized by grouped vesicles--is frequently inapparent or
atypical in both primary and recurrent disease. The clinical spectrum is wide,
ranging from trivial labial blisters to the most severe fatal sporadic
encephalitis and neonatal infection. Seroprevalence studies in the Western world 
demonstrate a much higher percentage of people infected with HSV-2 than are
currently identified by clinical studies. Since undiagnosed genital herpes
infections are the major factor in fueling the genital herpes epidemic, awareness
and more accurate diagnosis followed by therapy and counseling are mandatory.
Primary VZV infection and herpes zoster are usually diagnosed clinically, but can
be confirmed by virus detection methods from swabs of lesions or antibody tests. 
Antiviral therapy should be considered in varicella if the disease is
complicated. In herpes zoster antiviral therapy should be given within 72 hours
in immunocompromised patients and those at risk of postherpetic neuralgia. The
availability of effective antiviral therapy makes early diagnosis most important.

Publication Types: 
    English Abstract

PMID: 14610899 [PubMed - indexed for MEDLINE]

1922: MMW Fortschr Med. 2002 Dec 12;144(50):12.

[Does vaccination for chickenpox prevent herpes zoster? (interview by Waldtraut
Paukstadt)]

[Article in German]

Doerr HW.

Publication Types: 
    Interview

PMID: 14610859 [PubMed - indexed for MEDLINE]

1923: MMW Fortschr Med. 2002 Dec 12;144(50):8-10.

[Current guidelines for therapy of herpes zoster. Preventing chronification of
pain]

[Article in German]

Paukstadt W.

Publication Types: 
    News

PMID: 14610858 [PubMed - indexed for MEDLINE]

1924: Minerva Urol Nefrol. 2003 Sep;55(3):157-72.

Antiviral drug-induced kidney and electrolytes disorders.

Izzedine H, Launay-Vacher V, Isnard-Bagnis C, Deray G.

Department of Nephrology, Pitie-Salpetriere Hospital, Paris, France.
hassan.izzedine@psl.ap-hop-paris.fr

HIV patients are at a high risk for nephrotoxicity (HIV-induced nephrotoxicity,
HIVAN). As a result, renal insufficiency, tubular dysfunction and renal-related
biological disorders are frequently observed in those patients. However, in some 
cases those defects or anomalies in renal function may be related to antiviral
therapies rather than the disease itself. This article reviews the incidence,
presentation, prevention and management of antiviral drug-induced renal
dysfunction.

Publication Types: 
    Review

PMID: 14610435 [PubMed - indexed for MEDLINE]

1925: J Virol. 2003 Dec;77(23):12603-16.

The differential requirement for cyclin-dependent kinase activities distinguishes
two functions of herpes simplex virus type 1 ICP0.

Davido DJ, Von Zagorski WF, Maul GG, Schaffer PA.

Department of Medicine, Harvard Medical School at the Beth Israel Deaconess
Medical Center, Boston, Massachusetts 02215, USA.

Herpes simplex virus type 1 (HSV-1) ICP0 directs the degradation of cellular
proteins associated with nuclear structures called ND10, a function thought to be
closely associated with its broad transactivating activity. Roscovitine (Rosco), 
an inhibitor of cyclin-dependent kinases (cdks), inhibits the replication of
HSV-1, HSV-2, human cytomegalovirus, varicella-zoster virus, and human
immunodeficiency virus type 1 by inhibiting specific steps or activities of viral
regulatory proteins, indicating the broad and pleiotropic effects that cdks have 
on the replication of these viruses. We previously demonstrated that Rosco
inhibits the transactivating activity of ICP0. In the present study, we asked
whether Rosco also affects the ability of ICP0 to direct the degradation of
ND10-associated proteins. For this purpose, WI-38 cells treated with
cycloheximide (CHX) were mock infected or infected with wild-type HSV-1 or an
ICP0(-) mutant (7134). After release from the CHX block, the infections were
allowed to proceed for 2 h in the presence or absence of Rosco at a concentration
known to inhibit ICP0's transactivating activity. The cells were then examined
for the presence of ICP0 and selected ND10-associated antigens (promyelocytic
leukemia antigen [PML], sp100, hDaxx, and NDP55) by immunofluorescence. Staining 
for the ND10-associated antigens was detected in </=20% of KOS-infected cells in 
the presence or absence of Rosco, demonstrating that Rosco-sensitive kinases are 
not required for ICP0's ability to direct the dispersal or degradation of these
antigens. In contrast, >90% of 7134- and mock-infected cells stained positive for
all ND10-associated antigens in the presence or absence of Rosco. Similar results
were obtained with a non-ND10-associated antigen, DNA-PK(cs), a known target of
ICP0-directed degradation. The results of the PML and DNA-PK(cs)
immunofluorescence studies correlated with a decrease in the levels of these
proteins as determined by Western blotting. Thus, the differential requirement
for Rosco-sensitive cdk activities distinguishes ICP0's ability to direct the
dispersal or degradation of cellular proteins from its transactivating activity.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 14610183 [PubMed - indexed for MEDLINE]

1926: Neurology. 2003 Nov 11;61(9):1306-7.

Ramsay Hunt syndrome associated with spinal trigeminal nucleus and tract
involvement on MRI.

Nogueira RG, Seeley WW.

Massachusetts General Hospital, Boston, MA 02114, USA. rnogueira@partners org

Publication Types: 
    Case Reports

PMID: 14610151 [PubMed - indexed for MEDLINE]

1927: Indian J Med Res. 2003 May;117:205-10.

Use of uniplex polymerase chain reaction & evaluation of multiplex PCR in the
rapid diagnosis of viral retinitis.

Priya K, Madhavan HN, Malathi J.

L&T Microbiology Research Centre, Vision Research Foundation, Sankara Nethralaya,
Chennai, India.

BACKGROUND & OBJECTIVES: Polymerase chain reaction (PCR) has been known to be a
rapid and accurate diagnostic test for causative viruses of viral retinitis, but 
cost is the limiting factor. In the present study an attempt was made to
standardize a multiplex PCR (mPCR) on intraocular specimens from patients with
viral retinitis for the detection of one or more viruses [herpes simplex virus
(HSV), varicella zoster virus (VZV) or cytomegalovirus (CMV)] in order to reduce 
the period of time required for uniplex polymerase chain reaction (uPCR).
METHODS: Using the uniplex PCR (uPCR) primers, a nested mPCR was developed and
standardized for the simultaneous detection of HSV, VZV and CMV. mPCR and uPCRs
were applied on 9 stored specimens and 38 prospective specimens obtained from
patients with viral retinitis. RESULTS: The specificity and sensitivity of the
mPCR were concordant with that of uPCRs. Clinical specificity and sensitivity of 
mPCR was further confirmed by the detection of the same herpes viral DNA on the 9
stored specimens. Of the 38 specimens collected prospectively, mPCR detected HSV 
in 3 (7.9%), VZV in 9 (23.7%), CMV in 5 (13.2%) and both VZV and CMV in 2 (5.3%).
Co-infections of two viruses were found in 7 (14.89%) of the 47 specimens.
INTERPRETATION & CONCLUSION: mPCR is a rapid, specific and sensitive diagnostic
tool in viral retinitis. Compared to uPCR, mPCR is less time-consuming and cost
effective.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 14609048 [PubMed - indexed for MEDLINE]

1928: Scand J Infect Dis. 2003;35(10):770-2.

A case of chronic renal dysfunction following treatment with oral acyclovir.

Sodhi PK, Ratan SK.

Department of Ophthalmology, Safdarjung Hospital, New Delhi, India.
hardeep333@hotmail.com

Nephrotoxicity is a well-known side effect of intravenous acyclovir treatment but
occurs rarely by oral treatment. A 76-y-old healthy male, with normal baseline
renal functions (blood creatinine 0.6 mg%), received oral acyclovir at a dose of 
800 mg five times daily for 10 days for treatment of herpes zoster ophthalmicus. 
He developed renal failure with blood creatinine levels of 3 mg% and his renal
function failed to improve within eight months of end of treatment. Affection of 
renal function has to be considered also in relation to oral acyclovir treatment,
especially in elderly subjects.

Publication Types: 
    Case Reports

PMID: 14606623 [PubMed - indexed for MEDLINE]

1929: Scand J Infect Dis. 2003;35(10):750-3.

Development of antibodies against cytomegalovirus, varicella-zoster virus and
herpes simplex virus in Finland during the first eight years of life: a
prospective study.

Aarnisalo J, Ilonen J, Vainionpaa R, Volanen I, Kaitosaari T, Simell O.

Department of Virology, University of Turku, Turku, Finland.
johanna.aarnisalo@utu.fi

To clarify when antibodies against cytomegalovirus (CMV), varicella-zoster virus 
(VZV) and herpes simplex virus (HSV) develop among young children, 1206 serum
samples collected prospectively from 199 children born in 1989 and 1990 were
studied. The samples were drawn at the ages of 7 and 13 months, then yearly until
the age of 5 y and then at 7 and 8 y. In each age group at least 106 samples were
collected. Immunoglobulin G class antibodies to the 3 viruses were measured using
an enzyme immunoassay. At the age of 7 months 27% of the children had CMV
antibodies, whereas only 3% had antibodies against VZV and 2% against HSV. The
prevalence of seropositivity for CMV increased slowly to 41% by the age of 8 y.
Seroconversions to VZV antibody positivity occurred frequently after 2 y of age, 
so that by 8 y 83% of children had VZV antibodies. The proportion of children
with HSV antibodies remained low throughout the study, as only 17% of children
had HSV antibodies at the age of 8 y. The data show that HSV infection is
becoming acquired later in life and the proportion of uninfected children is
increasing. The proportion of CMV infections during the perinatal period and
early infancy remains high, in one-third of the children, and most children also 
have VZV infection during the early years of life.

PMID: 14606615 [PubMed - indexed for MEDLINE]

1930: Tech Coloproctol. 2003 Jul;7(2):105-7.

Massive zosteriform cutaneous metastasis from rectal carcinoma.

Damin DC, Lazzaron AR, Tarta C, Cartel A, Rosito MA.

Department of Coloproctologic Surgery, Hospital de Clinicas de Porto Alegre,
Federal University of Rio Grande do Sul, Porto Alegre, Brazil. damin@terra.com.br

A 44-year-old man presented with a large and rapidly growing skin lesion
approximately six months after resection of a rectal carcinoma. The lesion
measured 40 cm in size, extended from the suprapubic area to the proximal half of
the left groin, and showed a particular zosteriform aspect. Biopsy confirmed a
metastatic skin adenocarcinoma. Cutaneous metastases from rectal cancer are very 
uncommon. Their gross appearance is not distinctive, although the skin tumors are
usually solid, small (less than 5 cm) and painless nodules or papules. Early
biopsies for suspicious skin lesions are needed in patients with a history of
colorectal cancer.

Publication Types: 
    Case Reports

PMID: 14605930 [PubMed - indexed for MEDLINE]

1931: Br J Gen Pract. 2003 Oct;53(495):778-83.

Comment in:
    Br J Gen Pract. 2004 Feb;54(499):132; author reply 132-3.

The reducing incidence of respiratory tract infection and its relation to
antibiotic prescribing.

Fleming DM, Ross AM, Cross KW, Kendall H.

Birmingham Research Unit, Royal College of General Practitioners, 54 Lordswood
Road, Harborne, Birmingham B17 9DB. dfleming@rcgpbhamresunit.nhs.uk

BACKGROUND: There is good evidence of reduced prescribing of antibiotics in
recent years, but the reason for this has not been established. AIM: To study the
incidence of respiratory tract infections presenting to general practitioners
(GPs) in England and Wales in relation to the incidence of other infections and
to the prescription of antibiotics. SETTING: Sentinel practices in England and
Wales who contribute to the Weekly Returns Service (WRS) of the Royal College of 
General Practitioners. DESIGN: Time-series analysis of disease incidence data
reported by the practices and of antibiotic prescription data from the
Prescription Pricing Authority (PPA) during the years 1994-2000. METHOD:
Incidence data reported weekly from 73 practices in England and Wales, serving a 
population of 600,000, for acute respiratory tract infections, otitis media,
infectious mononucleosis, shingles, urinary tract infections, and skin
infections, were consolidated into quarterly datasets and examined graphically
for evidence of secular and seasonal trends. Trends in antibiotic prescription
items (data for England only were supplied by the PPA) were examined for
association after adjustment for seasonal variation. RESULTS: The incidence of
respiratory tract infections and antibiotic prescribing showed virtually
identical seasonal variation, with both declining from 1995: respiratory tract
infections by 48% in winter and 38% in summer, and antibiotic prescriptions by
34% and 21%, respectively. Trends in both were very highly correlated. The
incidence of shingles and skin infections was constant. The incidence of urinary 
tract infections declined by 10%. The incidence of otitis media in children and
acute bronchitis in the elderly followed the all-age trend in the reduction of
respiratory tract infections. CONCLUSION: The considerable reduction in the
incidence of respiratory tract infections between 1995 and 2000 is the main
reason for the decline in antibiotic prescribing rather than changing prescribing
thresholds for antibiotics.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 14601353 [PubMed - indexed for MEDLINE]

1932: Tidsskr Nor Laegeforen. 2003 Oct 23;123(20):2871-3.

[Meningitis associated with reactivation of varicella-zoster virus]

[Article in Norwegian]

Morch K, Fylkesnes SI, Haukenes G.

Avdeling for mikrobiologi og immunologi, Haukeland Universitetssykehus, Bergen.
kristine.moerch@helse-bergen.no

BACKGROUND: Reactivation of varicella-zostervirus (VZV) can manifest as infection
of the central nervous system. The detection of VZV DNA in cerebrospinal fluid by
polymerase chain reaction has extended our knowledge about the frequency of
various clinical manifestations in the immunocompetent host, also without the
typical rash of shingles. MATERIAL AND METHODS: Over a period of three years,
1999 through 2001, we performed VZV polymerase chain reaction in cerebrospinal
fluid in 364 patients with suspected infection of the central nervous system.
RESULTS: We detected VZV DNA in the cerebrospinal fluid in five patients. Four of
the patients had reactivated VZV infection. Meningitis was seen in two young
immunocompetent individuals; one of them without shingles. One patient had
myelitis without shingles and one had zoster radiculitis. One patient was a child
with encephalitis and primary infection. INTERPRETATION: Our results are similar 
to results from other investigators that have found VZV DNA in the cerebrospinal 
fluid in immunocompetent patients with meningitis or encephalitis as the most
common clinical manifestation, with or without shingles.

Publication Types: 
    Case Reports
    English Abstract

PMID: 14600712 [PubMed - indexed for MEDLINE]

1933: Am J Med. 2003 Nov;115(7):586-7.

Temporary relief of postherpetic neuralgia pain with topical geranium oil.

Greenway FL, Frome BM, Engels TM 3rd, McLellan A.

Publication Types: 
    Clinical Trial
    Letter
    Multicenter Study
    Randomized Controlled Trial

PMID: 14599644 [PubMed - indexed for MEDLINE]

1934: Spine J. 2002 Jan-Feb;2(1):85.

From the dermatology clinic...postherpetic neuralgia, in which the source of
radiculopathy is revealed by examination of the skin.

Fardon D.

Publication Types: 
    Case Reports

PMID: 14598807 [PubMed - indexed for MEDLINE]

1935: Ryumachi. 2003 Oct;43(4):703-9.

[Successfully treated case with microscopic polyangiitis complicated severe
varicella zoster virus infection including encephalitis and disseminated
varicella zoster]

[Article in Japanese]

Matsumoto J, Nakajima A, Suwa A, Yasuki Y, Yasui T, Inada S.

Division of Rheumatic Diseases, Tokyo Metropolitan Otsuka Hospital, Tokyo.

We report a case with microscopic polyangiitis (MPA) complicated by varicella
zoster encephalitis. A 60-year-old woman caught a common cold and had acute
otitis media in April 1998. Proteinuria and hematuria with hyaline cast were
noted at the routine medical check in May, and she was referred to our hospital
because of high fever and chest pain. MPA was diagnosed with acute progressive
renal failure, pleuritis and elevated anti-neutrophil cytoplasmic myeloperoxidase
antibody (MPO-ANCA). Corticosteroid therapy was administered under hemodialysis
but MPA was flared several times with various symptoms including interstitial
pneumonitis, alveolar hemorrhage and erythema multiforme exudativum. During the
course of the disease she developed disseminated varicella zoster and
encephalitis. Positive polymerase chain reaction to varicella zoster in
cerebrospinal fluid helped to differentiate her encephalitis from central nervous
system symptoms due to microscopic angiitis and herpes simplex encephalitis.
Combination of corticosteroid and acyclovir therapies for MPA and varicella
zoster encephalitis under hemodialysis were successful. The diagnostic process
and therapies to these complicated contexts were thought to be very important.

Publication Types: 
    Case Reports
    English Abstract

PMID: 14598666 [PubMed - indexed for MEDLINE]

1936: Ann Neurol. 2003 Nov;54(5):678-82.

Dually infected (HSV-1/VZV) single neurons in human trigeminal ganglia.

Theil D, Paripovic I, Derfuss T, Herberger S, Strupp M, Arbusow V, Brandt T.

Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University,
Marchioninistrasse 23, 81377 Munich, Germany.
dtheil@brain.nefo.med.uni-muenchen.de

Human trigeminal ganglia were tested by double fluorescence in situ hybridization
for the presence and distribution of herpes simplex virus type 1 (HSV-1) and
varicella-zoster virus (VZV) latency. Latency transcripts of both viruses were
detected in common areas within the ganglia. Also, a few single neurons were
shown to harbor HSV-1 and VZV together.

PMID: 14595659 [PubMed - indexed for MEDLINE]

1937: Pediatr Rev. 2003 Nov;24(11):372-9.

Varicella.

English R.

Louisiana State University Health Sciences Center, New Orleans, LA, USA.

Publication Types: 
    Review

PMID: 14595034 [PubMed - indexed for MEDLINE]

1938: J Microencapsul. 2003 Nov-Dec;20(6):799-810.

Poly (D,L-lactide-co-glycolide) microspheres for long-term intravitreal delivery 
of aciclovir: influence of fatty and non-fatty additives.

Martinez-Sancho C, Herrero-Vanrell R, Negro S.

Departamento de Farmacia y Tecnologia Farmaceutica, Facultad de Farmacia,
Universidad Complutense de Madrid, Spain.

Aciclovir (acicloguanosine) has been demonstrated to be effective in the
treatment of intraocular pathologies such as herpes simplex virus retinitis and
acute retinal necrosis. Although intravitreal injections have been used with
fewer side-effects than intravenous administration, the risk of complications
increases with the frequency of intravitreous injections. For this reason, a
biodegradable drug-delivery system, such as microspheres, able to promote
prolonged release of the drug, offers a good alternative to multiple intraocular 
administrations. In this work, aciclovir-containing poly
(D,L-lactide-co-glycolide) microspheres were prepared by the solvent evaporation 
method. Seven additives were incorporated in the microspheres to modulate the in 
vitro release rate of the drug: four non-fatty substances (polyethylene glycol
300, polyethylene glycol 1500, hydroxypropyl methylcellulose and gelatin) and
three fatty substances (isopropyl myristate, vitamin E and Labrafil M 1944 CS).
Morphology of microspheres was evaluated by scanning electron microscopy.
Granulometric analysis showed that particle size distribution was significantly
influenced by the incorporation of additives. Loading efficiency decreased when
fatty substances were added, whereas non-fatty additives promoted higher
incorporation of the drug. Infrared and differential scanning calorimetry
analyses indicated that microspheres prepared by the solvent evaporation process 
were not influenced by the type of additive used. In all cases, the initial burst
resulted less than 5%. Additive-free microspheres showed a slow release within
the first days, but when additives were incorporated, in general, the release
rates of the drug were increased. Best release results were obtained for
gelatin-containing microspheres. The release of aciclovir from these microspheres
was adjusted to a zero-order kinetic from 1 to 49 days with a release constant of
1.13 microg/day/mg microspheres. A dose of 0.74 mg microspheres would be
therapeutic for the herpes simplex and Epstein-Barr viruses (MIC 0.1 microg/ml)
and 7.4 mg for varicella zoster virus (MIC 1 microg/ml) treatment in an animal
model.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14594668 [PubMed - indexed for MEDLINE]

1939: J Infect Dis. 2003 Nov 1;188(9):1336-44. Epub 2003 Oct 17.

Decline in varicella-zoster virus (VZV)-specific cell-mediated immunity with
increasing age and boosting with a high-dose VZV vaccine.

Levin MJ, Smith JG, Kaufhold RM, Barber D, Hayward AR, Chan CY, Chan IS, Li DJ,
Wang W, Keller PM, Shaw A, Silber JL, Schlienger K, Chalikonda I, Vessey SJ,
Caulfield MJ.

Department of Pediatrics, Section of Infectious Diseases, University of Colorado 
School of Medicine, Denver, Colorado, USA. myron.levin@uchsc.edu.

The safety and immunogenecity of a booster dose of live attenuated
varicella-zoster virus (VZV) vaccine was evaluated in 196 healthy subjects,
>or=60 years old, who had already received a VZV vaccine >5 years before. This
repeat booster dose was well tolerated. Cell-mediated immunity (CMI) to VZV was
measured by an interferon-gamma (IFN-gamma) enzyme-linked immunosorbent
spot-forming cell (ELISPOT) assay and a limiting dilution responder cell
frequency (RCF) assay. Prevaccination responses decreased as a function of
increasing age but were detectable in all subjects by use of the IFN-gamma
ELISPOT assay. In most subjects, VZV-specific CMI was increased at 6 weeks
postvaccination. The magnitude of the vaccine-induced IFN-gamma ELISPOT response 
was inversely related to prevaccination values. Although there was a significant 
correlation between the IFN-gamma ELISPOT and RCF assays, the ELISPOT assay had
greater sensitivity and a wider dynamic range. A live attenuated VZV vaccine is
safe and immunogenic in an elderly population, and the vaccine-induced immunity
may be monitored by the IFN-gamma ELISPOT assay.

PMID: 14593591 [PubMed - indexed for MEDLINE]

1940: Rheumatol Int. 2005 Mar;25(2):97-102. Epub 2003 Oct 31.

Clinical and genetic risk factors of herpes zoster in patients with systemic
lupus erythematosus.

Kang TY, Lee HS, Kim TH, Jun JB, Yoo DH.

Hospital for Rheumatic Diseases, Hanyang University Hospital, 17 Haengdang-dong, 
Seong Dong-ku, Seoul 133-792, Republic of Korea.

OBJECTIVE: The aim of this study was to determine the clinical and genetic risk
factors that influence herpes zoster occurrence in patients with systemic lupus
erythematosus (SLE). METHODS: Three hundred three SLE patients meeting the
American College of Rheumatology criteria were enrolled in this study. Herpes
zoster was diagnosed when classic grouped vesicles were noted. Medical records
were reviewed retrospectively to collect clinical information. For Fc gamma
receptor IIa (Fc gamma RIIa) and Fc gamma RIIIa genotyping, polymerase chain
reaction (PCR) using allele-specific primers was performed. The PCR
sequence-specific oligonucleotide probe method was utilized in human HLA-DRB1
genotyping. RESULTS: Forty-two cases (13.9%) of zoster occurred among 303 SLE
patients. The incidence of zoster in patients with SLE was 32.5/1,000 patients
per year. Patients who developed zoster had higher rates of lupus nephritis (P = 
0.018) and positive anti-Sm antibody (P = 0.019). However, Fc gamma RIIa and Fc
gamma RIIIa polymorphism and the HLA-DRB1 genotype did not influence herpes
zoster occurrence. CONCLUSION: Systemic lupus erythematosus patients with lupus
nephritis or anti-Sm antibody are at higher risk of herpes zoster. Fc gamma RIIa 
(H/R131), Fc gamma RIIIa (F/V176), and HLA-DRB1 genetic polymorphisms did not
influence the occurrence of herpes zoster in these patients.

PMID: 14593495 [PubMed - indexed for MEDLINE]

1941: Med Hypotheses. 2003 Nov-Dec;61(5-6):533-4.

Varicella inoculation to prevent shingles, and cytomegalovirus inoculation to
prevent cytomegalovirus associated graft failures.

Altschuler EL.

Mount Sinai School of Medicine, New York, New York 10029, USA.
eric.altschuler@mssm.edu

I suggest varicella virus inoculation be considered to reduce the risk of herpes 
zoster (the shingles), and cytomegalovirus (CMV) inoculation be considered to
reduce the risk of CMV associated transplant graft failure. Such inoculations are
inexpensive and easy to implement, and are simple potential solutions to common
and often severe medical problems with suboptimal current treatments.

PMID: 14592783 [PubMed - indexed for MEDLINE]

1942: J Med Chem. 2003 Nov 6;46(23):5064-73.

5-Substituted-2,4-diamino-6-[2-(phosphonomethoxy)ethoxy]pyrimidines-acyclic
nucleoside phosphonate analogues with antiviral activity.

Hockova D, Holy A, Masojidkova M, Andrei G, Snoeck R, De Clercq E, Balzarini J.

Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech
Republic, Flemingovo nam. 2, CZ-166 10, Prague 6, Czech Republic.
holy@uochb.cas.cz

2,4-Diamino-6-hydroxypyrimidines substituted in position 5 by an allyl, benzyl,
cyanomethyl, ethoxycarbonylmethyl, phenyl, cyclopropyl, or methyl group were
prepared either by C5-alkylation or by formation of the pyrimidine ring by
cyclization. Their alkylation with 2-[(diisopropoxyphosphoryl)methoxy]ethyl
tosylate afforded N1- and O6-regioisomers that were separated and converted to
the free phosphonic acids by treatment with bromotrimethylsilane followed by
hydrolysis. Reaction of
2,4-diamino-6-[[(diisopropoxyphosphoryl)methoxy]ethoxy]pyrimidine with elemental 
bromine, N-chloro-, or N-iodosuccinimide gave the corresponding
phosphorus-protected 5-bromo-, 5-chloro-, and 5-iodo derivatives, respectively.
Their deprotection afforded 2,4-diamino-5-bromo- and
-5-chloro-6-[2-(phosphonomethoxy)ethoxy]pyrimidines.
2,4-Diamino-5-methyl-6-[2-(phosphonomethoxy)ethoxy]pyrimidine was synthesized
also by cross-coupling of the 5-bromo compound with AlMe(3), followed by
deprotection. The compounds showed poor, if any, inhibitory activity against DNA 
viruses such as herpes simplex virus type 1 and type 2, cytomegalovirus,
varicella-zoster virus, and vaccinia virus. In contrast, several 5-substituted
2,4-diaminopyrimidine derivatives markedly inhibited retrovirus replication in
cell culture. The 5-methyl derivative was exquisitely inhibitory to human
immunodeficiency virus and Moloney murine sarcoma virus-induced cytopathicity in 
cell culture (EC(50) approximately 0.00018 mumol/mL) but also cytostatic to CEM
cell cultures. In contrast, the 5-halogen-substituted derivatives showed
pronounced antiretroviral activity (EC(50) = 0.0023-0.0110 mumol/mL), comparable 
to that of the reference drugs adefovir and tenofovir, but were devoid of
measurable toxicity at 0.3 mumol/mL.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14584956 [PubMed - indexed for MEDLINE]

1943: J Med Chem. 2003 Nov 6;46(23):5045-54.

Synthesis and biological evaluation of 5-substituted derivatives of the potent
antiherpes agent (north)-methanocarbathymine.

Russ P, Schelling P, Scapozza L, Folkers G, Clercq ED, Marquez VE.

Laboratory of Medicinal Chemistry, Center for Cancer Research, National Cancer
Institute at Frederick, 376 Boyles St., Frederick, Maryland 21702, USA.

The conformationally locked nucleoside, (north)-methanocarbathymine (1a), is a
potent and selective anti-herpes agent effective against herpes simplex type 1
(HSV1) and type 2 (HSV2) viruses. Hereby, we report on the synthesis and
biological evaluation of a small set of 5-substituted pyrimidine nucleosides
belonging to the same class of bicyclo[3.1.0]hexane nucleosides. Both the
5-bromovinyl (4) and the 5-bromo analogue (3) appeared to be exclusive substrates
of HSV1 thymidine kinase (TK), contrasting with the 5-iodo analogue (2), which
was significantly phosphorylated by the human cytosolic TK. The binding affinity 
constant and catalytic turnover for HSV1 TK were measured to assess the influence
of the substitution on these parameters. In the plaque reduction and cytotoxicity
assays, the 5-bromo analogue (3) showed good activity against HSV1 and HSV2 with 
less general toxicity than 1a. Against varicella-zoster virus (VZV), the
north-locked 5-bromovinyl analogue (4) proved to be as potent as its
conformationally unlocked 2'-deoxyriboside equivalent BVDU. The three compounds
were also tested in vitro as prodrugs used in a gene therapy context on three
osteosarcoma cell lines, either deficient in TK (TK(-)), nontransduced, or stably
transduced with HSV1 TK. The 5-iodo compound (2, CC(50) 25 +/- 7 microM) was more
efficient than ganciclovir (GCV, CC(50) 75 +/- 35 microM) in inhibiting growth of
HSV1-TK transfected cells and less inhibitory than GCV toward TK(-) cells,
whereas compound 3 inhibited transfected and nontransfected cell lines in a
relatively similar dose-dependent manner.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14584954 [PubMed - indexed for MEDLINE]

1944: Viral Immunol. 2003;16(3):243-58.

Clinical and molecular pathogenesis of varicella virus infection.

Gilden DH, Cohrs RJ, Mahalingam R.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA. don.gilden@uchsc.edu

Varicella zoster virus (VZV) is a neurotropic human herpesvirus that infects
nearly all humans and causes chickenpox (varicella). After chickenpox, VZV
becomes latent in cranial nerve, dorsal root, and autonomic nervous system
ganglia along the entire neuraxis. Virus reactivation produces shingles (zoster),
characterized by pain and rash usually restricted to 1-3 dermatomes. Zoster is
often complicated by postherpetic neuralgia (PHN), pain that persists for months 
to years after rash resolves. Virus may also spread to the spinal cord and blood 
vessels of the brain, producing a unifocal or multifocal vasculopathy,
particularly in immunocompromised individuals. The increased incidence of zoster 
in elderly and immunocompromised individuals appears to be due to a VZV-specific 
host immunodeficiency. PHN may reflect a chronic VZV ganglionitis, and VZV
vasculopathy is due to productive virus infection in cerebral arteries.
Strategies that might boost host cell-mediated immunity to VZV are discussed, as 
well as the physical state of viral nucleic acid during latency and the possible 
mechanisms by which herpesvirus latency is maintained and virus is reactivated. A
current summary of varicella latency and pathogenesis produced by simian
varicella virus (SVV), the counterpart of human VZV, points to the usefulness of 
a primate model of natural infection to study varicella latency, as well as the
experimental model of intratracheal inoculation to study the effectiveness of
antiviral agents in driving persistent varicella virus into a latent state.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 14583142 [PubMed - indexed for MEDLINE]

1945: Rinsho Shinkeigaku. 2003 Jul;43(7):431.

[Consideration on spreading mechanisms of cranial neuropathy in Ramsay Hunt
syndrome: possibility of the vascular mechanism]

[Article in Japanese]

Segawa F, Kuroiwa Y.

Publication Types: 
    Letter

PMID: 14582371 [PubMed - indexed for MEDLINE]

1946: Adv Anat Pathol. 2003 Nov;10(6):328-37.

Ocular surface impression cytology.

McKelvie P.

Department of Anatomical Pathology, St. Vincent's Hospital, Victoria, Australia. 
mckelvpa.svhm.org.au

Impression cytology, either using cellulose acetate strips or the Biopore
membrane device, is a simple, noninvasive technique that aids in the diagnosis of
several disorders of the ocular surface. These disorders include ocular surface
squamous neoplasia, dry eye syndrome, limbal stem-cell deficiency, specific viral
infections, vitamin A deficiency, allergic disorders, conjunctival melanosis, and
malignant melanoma. Another advantage is the preservation of limbal stem cells,
which occur in the basal layer of the limbal epithelium and are responsible for
renewal of the corneal epithelium. The Biopore membrane device is particularly
user friendly, with little expertise required and adequate specimens obtained in 
a very high percentage of cases. The most common applications in diagnostic
ocular pathology are:(i) primary diagnosis and follow-up of ocular surface
squamous neoplasia, including after therapy with topical mitomycin C. The
sensitivity is high (78-87%); and (ii) dry eye syndrome where squamous metaplasia
and/ or hyperkeratosis are noted. Certain limitations of the technique for
diagnosis of squamous neoplasia include the fact that dysplasias are often
keratinizing and may yield very few or even no dysplastic cells with impression
cytology. Secondly, no definite cytologic criteria reliably distinguish invasive 
SCC of ocular surface from in situ disease. Other applications include the rapid 
specific diagnosis of ocular surface infections with herpes simplex, adeno-, and 
varicella zoster viruses. Impression cytology samples may also be used to obtain 
mRNA, cells for phenotyping by flow cytometry, and proteins for Western blotting 
for research studies.

Publication Types: 
    Review

PMID: 14581822 [PubMed - indexed for MEDLINE]

1947: Adv Skin Wound Care. 2003 Sep-Oct;16(5):236-43.

Herpesvirus infections and herpetic wounds.

Trent JT, Kirsner RS.

Department of Dermatology and Cutaneous Surgery, University of Miami School of
Medicine, Miami, FL, USA.

PMID: 14581815 [PubMed - indexed for MEDLINE]

1948: Neurology. 2003 Oct 28;61(8):1153-4.

Conduction block of varicella zoster virus neuropathy.

Murakami T, Shibazaki K, Kurokawa K, Ichikawa Y, Ohsawa Y, Sunada Y.

Division of Neurology, Department of Internal Medicine, Kawasaki Medical School, 
Kurashiki City, Okayama, Japan. tatsum@med.kawasaki-m.ac.jp

Publication Types: 
    Case Reports

PMID: 14581691 [PubMed - indexed for MEDLINE]

1949: Neurosurgery. 2003 Nov;53(5):1164-6; discussion 1166-7.

A new classification for facial pain.

Burchiel KJ.

Department of Neurological Surgery, Oregon Health and Science University,
Portland, Oregon 97239, USA. burchiek@ohsu.edu

PURPOSE: A patient-oriented classification scheme for facial pains commonly
encountered in neurosurgical practice is proposed. CONCEPT: This classification
is driven principally by the patient's history. RATIONALE: The scheme
incorporates descriptions for so-called "atypical" trigeminal neuralgias and
facial pains but minimizes the pejorative, accepting that the physiology of
neuropathic pains could reasonably encompass a variety of pain sensations, both
episodic and constant. Seven diagnostic labels result: trigeminal neuralgia Types
1 and 2 refer to patients with the spontaneous onset of facial pain and either
predominant episodic or constant pain, respectively. Trigeminal neuropathic pain 
results from unintentional injury to the trigeminal nerve from trauma or surgery,
whereas trigeminal deafferentation pain results from injury to the nerve by
peripheral nerve ablation, gangliolysis, or rhizotomy in an intentional attempt
to treat either trigeminal neuralgia or other facial pain. Postherpetic neuralgia
follows a cutaneous herpes zoster outbreak (shingles) in the trigeminal
distribution, and symptomatic trigeminal neuralgia results from multiple
sclerosis. The final category, atypical facial pain, is synonymous with facial
pain secondary to a somatoform pain disorder. Atypical facial pain can be
suspected but not diagnosed by history and can be diagnosed only with detailed
and objective psychological testing. CONCLUSION: This diagnostic classification
would allow more rigorous and objective natural history and outcome studies of
facial pain in the future.

Publication Types: 
    Review

PMID: 14580284 [PubMed - indexed for MEDLINE]

1950: Herpes. 2003 Aug;10(2):46-52.

New antiviral drugs that target herpesvirus helicase primase enzymes.

Kleymann G.

Leopoldshoherstrasse 7, D-32107 Bad-Salzuflen, Germany.
Gerald.Kleymann@freenet.de

Herpesviruses have infected the majority of the world's population and the
associated diseases have plagued humanity since ancient times. Nine causative
human herpesviruses have been identified so far. The first antiviral drug was
launched in 1962, and since then several drugs for treating herpesvirus
infections, which work via different mechanisms, have been developed. Current
treatments abrogate or suppress disease symptoms but are not curative. A vaccine 
based on the OKA strain of varicella zoster virus is being marketed, but to date 
no therapeutic or prophylactic herpes vaccinations that can treat or stop spread 
of other herpes diseases are available. Herpes simplex virus causes mucocutaneous
infections such as herpes genitalis (genital herpes) and herpes labialis (cold
sores), the potentially sight-impairing herpetic eye disease, and
life-threatening herpes encephalitis or disseminated disease. Recently, reports
of helicase primase inhibitors, the first non-nucleosidic antiviral compounds,
which are superior in pre-clinical profile to current herpes simplex virus
medication, have been published. This review summarizes the data on helicase
primase inhibitors and compares their pre-clinical profile with the established
medical standard.

Publication Types: 
    Review

PMID: 14577954 [PubMed - indexed for MEDLINE]

1951: Herpes. 2003 Aug;10(2):38-45.

Herpes zoster in the immunocompetent patient: management of post-herpetic
neuralgia.

Johnson RW.

Pain Management Clinic, University of Bristol and Bristol Royal Infirmary,
Bristol, UK. RWJBRISTROL@aol.com

Post-herpetic neuralgia (PHN) is the most common complication of herpes zoster
(HZ, shingles), particularly in the elderly and those with severe acute phase
symptoms. Unless or until varicella vaccination reduces the incidence of HZ and
attenuates the risk and/or severity of complications, PHN will continue to result
in patient suffering and remain a significant cause of healthcare and social
support resource consumption. There have been useful advances in PHN management
(e.g. use of the anticonvulsant gabapentin and topical local anaesthetic
patches), but some cases remain intractable. Prevention is an important strategy,
and antiviral drugs, while not totally effective, provide the most accepted
method. Other acute interventions require further evaluation (nerve blocks, acute
phase use of tricyclic antidepressants or anticonvulsants). As prevention of PHN 
requires early recognition and prompt management of at-risk patients presenting
with acute HZ, public education and provision of information to relevant
healthcare personnel are important. This article discusses issues relevant to PHN
management and prevention, and provides a review of the pertinent literature.

Publication Types: 
    Review

PMID: 14577953 [PubMed - indexed for MEDLINE]

1952: Herpes. 2003 Aug;10(2):32-7.

Antiviral therapy in children with varicella zoster virus and herpes simplex
virus infections.

Enright AM, Prober C.

Stanford University Medical Center, Stanford, CA 94305, USA.

A small number of antiviral drugs are available for the treatment of varicella
zoster virus (VZV) and herpes simplex virus (HSV) infections in children. This
review presents pharmacokinetic data on the following selected antiviral agents: 
aciclovir, valaciclovir, famciclovir, cidofovir and foscarnet. Support and
current recommendations for the treatment of selected VZV and HSV infections in
children will also be reviewed.

Publication Types: 
    Review

PMID: 14577952 [PubMed - indexed for MEDLINE]

1953: Klin Monatsbl Augenheilkd. 2003 Oct;220(10):710-5.

[Brivudine as an alternative systemic therapy to aciclovir and ganciclovir in
acute retinal necrosis syndrome due to varicella-zoster virus]

[Article in German]

Vij O, Bornfeld N, Roggendorf M, Fiedler M, Schilling H.

Abteilung fur Erkrankungen des hinteren Augenabschnitts, Zentrum fur
Augenheilkunde der Universitat Essen.

BACKGROUND: Two cases of acute retinal necrosis (ARN-) syndrome caused by an
infection with varicella zoster virus (VZV) are demonstrated. VZV-DNA was
detected in vitreous biopsies by polymerase-chain-reaction (PCR). The course of
retinal necrosis was decisively improved by changing antiviral therapy from
aciclovir and/or ganciclovir to brivudine. MATERIAL AND METHODS: Patient 1: 51
years, male, initial visual acuity 20/40; patient 2: 17 years, female, initial
visual acuity 20/30. Both patients were immunocompetent and presented with an
unilateral acute retinal necrosis syndrome with peripheral chorioretinitis,
retinal vasculitis, vitreous inflammation and optic disc swelling, which resulted
in progressive visual loss in a few days. RESULTS: In both patients VZV-DNA was
detected in vitreous biopsies with PCR. A regression of intraocular inflammation 
and necrotic retinal foci was only observed after changing the initial systemic
therapy from aciclovir (Zovirax) intravenously 1500 mg/day) and/or ganciclovir
(Cymeven) intravenously 250 mg/day) to brivudine (Zostex) per os 500 mg/day).
Vitreoretinal surgery was necessary in both patients because of rhegmatogenous
retinal detachment. Visual acuity stabilised in patient 1 to 20/200 and in
patient 2 to 20/25 during a follow-up of 16 or 32 months, respectively.
CONCLUSION: Brivudine represents an alternative therapy, if standard treatment
with aciclovir and/or ganciclovir failed in cases of ARN-syndrome due to presumed
drug-resistant varicella zoster virus-subtypes. Complete remission and
preservation of a satisfactory function can be achieved.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 14577039 [PubMed - indexed for MEDLINE]

1954: Otolaryngol Head Neck Surg. 2003 Oct;129(4):379-81.

Acyclovir in the treatment of Ramsay Hunt syndrome.

Uri N, Greenberg E, Kitzes-Cohen R, Doweck I.

Otolaryngology-Head and Neck Surgery, Carmel Medical Center, 7 Michal St, Haifa
34362, Israel. druri@netvision.net.il

Ramsay Hunt syndrome is an herpetic disease with ominous prognosis regarding the 
facial nerve. Treatment with acyclovir, a well-known virostatic agent, has been
given in a small number of patients in recent years with excellent results. We
report on the administration of acyclovir intravenously for 7 days in 31 patients
with Ramsay Hunt syndrome, with overall recovery rate of 82.6%. There were no
side effects regarding this treatment.

Publication Types: 
    Clinical Trial

PMID: 14574292 [PubMed - indexed for MEDLINE]

1955: Retina. 2003 Oct;23(5):716-7.

Posterior scleritis presenting with annular choroidal detachment as a
complication of herpes zoster ophthalmicus.

Tranos PG, Ong T, Nolan W, Manzouri B, Forbes J.

Department of Opthalmology, Royal Free Hampstead NHS Trust, London, UK.
ptranos@hotmail.com

Publication Types: 
    Case Reports

PMID: 14574263 [PubMed - indexed for MEDLINE]

1956: Nucleosides Nucleotides Nucleic Acids. 2003 May-Aug;22(5-8):833-6.

Synthesis and antiviral activity assay of novel
(E)-3',5'-diamino-5-(2-bromovinyl)-2',3',5'-trideoxyuridine.

Lavandera I, Fernandez S, Ferrero M, De Clercq E, Gotor V.

Departamento de Quimica Organica e Inorganica, Facultad de Quimica, Universidad
de Oviedo, Oviedo, Spain.

(E)-3',5'-diamino-5-(2-bromovinyl)-2',3',5'-trideoxyuridine (5), the diamino
analogue of BVDU (1), was synthesized from BVDU. In contrast with BVDU, compound 
5 did not show activity against herpes simplex virus or varicella-zoster virus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14565290 [PubMed - indexed for MEDLINE]

1957: J Anesth. 1999 Oct 30;13(4):230-2.

A case of herpes zoster affecting the glossopharyngeal nerve.

Tamakawa S, Takada M.

Department of Anesthesia, Asahikawa Kosei General Hospital, 1-jo 24-chome,
Asahikawa, 078-8211, Japan.

PMID: 14564620 [PubMed]

1958: J Virol. 2003 Nov;77(21):11718-32.

Array analysis of viral gene transcription during lytic infection of cells in
tissue culture with Varicella-Zoster virus.

Cohrs RJ, Hurley MP, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA. randall.cohrs@uchsc.edu

Varicella-zoster virus (VZV), a neurotropic alphaherpesvirus, causes childhood
chickenpox (varicella), becomes latent in dorsal root and autonomic ganglia, and 
reactivates decades later to cause shingles (zoster) and other neurologic
complications. Although the sequence and configuration of VZV DNA have been
determined, relatively little is known about viral gene expression in
productively infected cells. This is in part because VZV is highly cell
associated, and sufficient titers of cell-free virus for use in synchronizing
infection do not develop. PCR-based transcriptional arrays were constructed to
simultaneously determine the relative abundance of the approximately 70 predicted
VZV open reading frames (ORFs). Fragments (250 to 600 bp) from the 5' and 3' end 
of each ORF were PCR amplified and inserted into plasmid vectors. The virus DNA
inserts were amplified, quantitated, and spotted onto nylon membranes. Probing
the arrays with radiolabeled cDNA synthesized from VZV-infected cells revealed an
increase in the magnitude of the expressed VZV genes from days 1 to 3 after
low-multiplicity virus infection but little change in their relative abundance.
The most abundant VZV transcripts mapped to ORFs 9/9A, 64, 33/33A, and 49, of
which only ORF 9 corresponded to a previously identified structural gene. Array
analysis also mapped transcripts to three large intergenic regions previously
thought to be transcriptionally silent, results subsequently confirmed by
Northern blot and reverse transcription-PCR analysis. Array analysis provides a
formidable tool to analyze transcription of an important ubiquitous human
pathogen.

Publication Types: 
    Evaluation Studies
    Research Support, U.S. Gov't, P.H.S.

PMID: 14557657 [PubMed - indexed for MEDLINE]

1959: Clin Microbiol Rev. 2003 Oct;16(4):569-96.

Clinical potential of the acyclic nucleoside phosphonates cidofovir, adefovir,
and tenofovir in treatment of DNA virus and retrovirus infections.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, B-3000
Leuven, Belgium. erik.declercq@rega.kuleuven.ac.be

The acyclic nucleoside phosphonates HPMPC (cidofovir), PMEA (adefovir), and PMPA 
(tenofovir) have proved to be effective in vitro (cell culture systems) and in
vivo (animal models and clinical studies) against a wide variety of DNA virus and
retrovirus infections: cidofovir against herpesvirus (herpes simplex virus types 
1 and 2 varicella-zoster virus, cytomegalovirus [CMV], Epstein-Barr virus, and
human herpesviruses 6, 7, and 8), polyomavirus, papillomavirus, adenovirus, and
poxvirus (variola virus, cowpox virus, vaccinia virus, molluscum contagiosum
virus, and orf virus) infections; adefovir against herpesvirus, hepadnavirus
(human hepatitis B virus), and retrovirus (human immunodeficiency virus types 1
[HIV-1] and 2 [HIV-2], simian immunodeficiency virus, and feline immunodeficiency
virus) infections; and tenofovir against both hepadnavirus and retrovirus
infections. Cidofovir (Vistide) has been officially approved for the treatment of
CMV retinitis in AIDS patients, tenofovir disoproxil fumarate (Viread) has been
approved for the treatment of HIV infections (i.e., AIDS), and adefovir dipivoxil
(Hepsera) has been approved for the treatment of chronic hepatitis B.
Nephrotoxicity is the dose-limiting side effect for cidofovir (Vistide) when used
intravenously (5 mg/kg); no toxic side effects have been described for adefovir
dipivoxil and tenofovir disoproxil fumarate, at the approved doses (Hepsera at 10
mg orally daily and Viread at 300 mg orally daily).

Publication Types: 
    Review

PMID: 14557287 [PubMed - indexed for MEDLINE]

1960: J Med Virol. 2003 Dec;71(4):557-60.

Real-time nested multiplex PCR for the detection of herpes simplex virus types 1 
and 2 and varicella zoster virus.

O'Neill HJ, Wyatt DE, Coyle PV, McCaughey C, Mitchell F.

Regional Virus Laboratory, Royal Victoria Hospital, Belfast, Northern Ireland,
United Kingdom. hugh.oneill@bll.n-i.nhs.uk

One hundred forty-nine specimens were tested in a LightCycler nested multiplex
polymerase chain reaction (LCnmPCR) for Herpes simplex virus (HSV)1, HSV2, and
VZV. Eighty-one were from genitourinary medicine (GUM) patients and the other 68 
specimens were from other patients with skin lesions. The results were compared
to a conventional multiplex nested PCR (nmPCR) using agarose gel electrophoresis.
Twenty-five specimens were positive in both assays for HSV1 and 29 were positive 
for VZV. For HSV2 there were 27 positive in the LCnmPCR and 26 positive in the
nmPCR assay. The melting temperatures (Tms) of each target were different with a 
mean of 84.75 degrees C for HSV1, 88.57 degrees C for HSV2, and 83.62 degrees C
for VZV. The melting curves of positive specimens directly overlaid the melting
curves of the positive controls in the assay. The LCnmPCR assay is a convenient
alternative to conventional PCR using agarose gel electrophoresis. It improves
specimen turnaround time by eliminating the need for gel electrophoresis,
transillumination, and gel photography. It also shows increased sensitivity for
HSV2 over our standard assay. This LCnmPCR reduces further the possibility of
amplicon contamination with nested PCR protocols. Copyright 2003 Wiley-Liss, Inc.

Publication Types: 
    Comparative Study
    Evaluation Studies

PMID: 14556269 [PubMed - indexed for MEDLINE]

1961: CNS Drugs. 2003;17(13):983.

Comment on:
    CNS Drugs. 2003;17(13):975-82.

Gabapentin: a viewpoint by Brett R. Stacey.

Stacey BR.

Oregon Health Sciences University, Portland, Oregon, USA.

Publication Types: 
    Comment
    Review

PMID: 14533948 [PubMed - indexed for MEDLINE]

1962: CNS Drugs. 2003;17(13):975-82.

Comment in:
    CNS Drugs. 2003;17(13):983.    CNS Drugs. 2003;17(13):983-4.

Gabapentin: in postherpetic neuralgia.

Curran MP, Wagstaff AJ.

Adis International Limited, Auckland, New Zealand. demail@adis.co.nz

Gabapentin is a structural analogue of the neurotransmitter gamma-aminobutyric
acid (GABA) approved for use in adults with postherpetic neuralgia. Gabapentin
does not bind to GABA(A) or GABA(B) receptors. Its mechanism of action in humans 
is unclear, but may involve binding to alpha2delta calcium channel subunits in
animal models. Reductions in the mean daily pain score from baseline to week 7 or
8 of treatment (primary endpoint) were significantly greater with gabapentin
1800-3600 mg/day than placebo therapy in two well designed trials in patients
with postherpetic neuralgia. The proportion of responders (patients showing a >
or =50% reduction in mean daily pain score at endpoint versus baseline) was
significantly greater with gabapentin than placebo. Daily sleep rating scores,
the Short Form McGill Pain Questionnaire (total pain scores), Patient and
Clinician Global Impression of Change and measures on the Short Form-36 Health
Survey (including physical functioning, role-physical, bodily pain, vitality or
mental health) improved to a significantly greater extent with gabapentin than
placebo. Adverse events associated with gabapentin in patients with postherpetic 
neuralgia were usually mild to moderate in intensity, with dizziness, somnolence 
and peripheral oedema being commonly reported.

Publication Types: 
    Review

PMID: 14533947 [PubMed - indexed for MEDLINE]

1963: Rev Neurol. 2003 Sep 1-15;37(5):481-5.

[Diseases of the peripheral and visual nervous system during infection with human
immunodeficiency virus]

[Article in Spanish]

Casanova-Sotolongo P, Casanova-Carrillo P, Casanova-Carrillo C.

Neurologia, Policlinico Docente, La Habana, Cuba. pcasanov@infomed.sld.cu

INTRODUCTION: Infection with human immunodeficiency virus (HIV) is often
accompanied by neurological complications. One of these includes disorders
affecting the peripheral and visual nervous system, especially during the
acquired immunodeficiency syndrome (AIDS) stage. DEVELOPMENT: The peripheral
neuropathies associated with infection by HIV are an assorted group of disorders,
which include acute or chronic inflammatory demyelinating polyneuropathy,
multiple mononeuropathy and neuropathies related to the herpes zoster virus or
cytomegalovirus. The most common and clinically important of the neuropathies is 
painful distal sensory polyneuropathy (DSP). The most severely affected cranial
nerves are V and VII. The isolation of HIV from the affected nerves suggests a
direct role, but an immune mechanism is also possible. Although cytomegalovirus
may be associated with a variety of peripheral nerve syndromes, its clinical
presentation as a primary demyelinating polyneuropathy is unusual. CONCLUSIONS:
DSP and antiretroviral toxic neuropathy are the most common HIV-associated
neuropathies. Both HIV infection, by itself, and the neurotoxicity of certain
drugs in tritherapy contribute to the development of painful peripheral sensory
neuropathy. In researching into the cause of HIV-associated neuropathy further
studies are needed to determine the relative roles played by the viral infection 
and the activation of the immunological factors that contribute to the
pathogenesis of the damage done in axons, the dorsal root ganglion and in the
sensory pathways in the spinal cord.

Publication Types: 
    English Abstract
    Review

PMID: 14533099 [PubMed - indexed for MEDLINE]

1964: Ocul Immunol Inflamm. 2003 Jun;11(2):141-4.

Successful treatment with combination of systemic antiviral drugs and
intravitreal ganciclovir injections in the management of severe necrotizing
herpetic retinitis.

Chau Tran TH, Cassoux N, Bodaghi B, Lehoang P.

Department of Ophthalmology, Hopital Pitie-Salpetriere, Paris, France.

PURPOSE: To report the use of intravenous (IV) antiviral agents and intravitreal 
ganciclovir injections in three immunocompetent patients with severe acute
retinal necrosis (ARN). METHOD: Case series. RESULTS: Three immunocompetent
patients, who had lost vision in the first eye due to ARN, received intensive
treatment with IV foscarnet or acyclovir or ganciclovir and intravitreal
ganciclovir injections for the treatment of severe ARN involving the fellow eye. 
The retinitis resolved and final visual acuity of the fellow eye improved to
20/20 in all three cases after a mean follow-up of 17 months. CONCLUSIONS:
Intensive treatment with a combination of two intravenous antiviral drugs and
intravitreal ganciclovir injections was successful in the management of patients 
with acyclovir-resistant ARN and monocular status.

Publication Types: 
    Case Reports

PMID: 14533033 [PubMed - indexed for MEDLINE]

1965: J Travel Med. 2003 Sep-Oct;10(5):290-2.

Irrational prescribing in South Asia: a case of fluoroquinolone-associated
phototoxicity.

Cave W, Pandey P, Chatterjee S.

The CIWEC Clinic Travel Medicine Center, Kathmandu, Nepal.

Prescribing habits in South Asian countries have been subjected to some
scrutiny.1-6 Most studies conclude that the quality of prescribing is poor, with 
overuse of antimicrobials and irrational use of fixed-dose combination therapy,
particularly in the private sector.1 Prescriptions for multiple drugs are the
rule rather than the exception, with up to seven items being prescribed for a
single disease entity. Analgesics, anti-inflammatories and drugs of uncertain
pharmacologic efficacy, such as vitamins, minerals and glucose water, are also
frequently prescribed.

Publication Types: 
    Case Reports

PMID: 14531983 [PubMed - indexed for MEDLINE]

1966: Br J Haematol. 2003 Oct;123(2):271-7.

Chlorambucil in combination with induction and maintenance rituximab is feasible 
and active in indolent non-Hodgkin's lymphoma.

Martinelli G, Laszlo D, Bertolini F, Pastano R, Mancuso P, Calleri A, Vanazzi A, 
Santoro P, Cavalli F, Zucca E.

European Institute of Oncology, Milan, Italy. giovanni.martinelli@ieo.it

We investigated the toxicity and efficacy of the chimaeric anti-CD20 antibody
rituximab in combination with standard-dose chlorambucil in newly diagnosed and
relapsed/refractory indolent B-cell lymphoma patients. A total of 29 patients (15
newly diagnosed and 14 relapsed/refractory) with low-grade or follicular B-cell
non-Hodgkin's lymphoma (NHL) were included in this phase II study. Therapy
consisted of chlorambucil 6 mg/m2/d for 6 consecutive weeks in combination with a
standard 4-weekly rituximab administration schedule in the induction phase.
Patients responding to the induction therapy received four additional cycles with
chlorambucil (6 mg/m2/d for 2 weeks/month) plus rituximab (once a month).
Twenty-six patients (89%) completed the treatment; only one patient discontinued 
treatment because of haematological toxicity. At the end of the study, the dose
of chlorambucil had to be reduced in seven patients (27%) and six patients (23%) 
required a delay in further treatment, as a result of toxicity during
consolidation therapy. Only one patient was withdrawn from the study because of
progressive disease; the 27 patients evaluable for response at the end of
consolidation achieved a clinical response (63% complete response and 26% partial
response). A significant CD4+ and CD56+ depletion was observed after induction
and during consolidation therapy; two herpes zoster virus infections and one
perianal abscess represented major infectious morbidities registered during the
study. Based on our preliminary data, the combination of chlorambucil with
rituximab seemed to be well tolerated and active. Its definitive role in the
treatment of low-grade NHL should be further evaluated in randomized trials.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II

PMID: 14531908 [PubMed - indexed for MEDLINE]

1967: Hong Kong Med J. 2003 Oct;9(5):363-8.

Thrombotic thrombocytopenic purpura as a rare complication in childhood systemic 
lupus erythematosus: case report and literature review.

Chak WK, Lam DS, Lo WH, Hui CM, Wong SN.

Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Tsing Chung
Koon Road, Tuen Mun, Hong Kong, ROC.

Thrombotic thrombocytopenic purpura is a rare but serious condition in childhood.
It can be idiopathic or a complication of other diseases or drug therapy. We
report on a 12-year-old Chinese girl who presented with fulminant systemic lupus 
erythematosus with progressive renal failure, pancytopenia, and cerebral
dysfunction due to thrombotic thrombocytopenic purpura. The patient also had
Pneumocystis carinii pneumonia, Pseudomonas septicaemia, and Herpes zoster
infections as a result of immunosuppressive treatment. She responded to combined 
therapy with pulse methylprednisolone, cyclophosphamide, plasmapheresis, and
intensive care support, and completely recovered renal and neurological function.
A review of the English-language medical literature since 1968 identified 20
other paediatric cases of systemic lupus erythematosus and thrombotic
thrombocytopenic purpura. Clinical features, treatment, and outcome of these
cases are presented and discussed. Early recognition is important, and although
plasmapheresis is not of proven benefit in severe cases of systemic lupus
erythematosus, it is life-saving in lupus-related thrombotic thrombocytopenic
purpura and must be instituted early to avoid a poor outcome.

Publication Types: 
    Review

PMID: 14530532 [PubMed - indexed for MEDLINE]

1968: West Afr J Med. 2003 Jun;22(2):136-8.

Herpes zoster infection and HIV seropositivity among eye patients--University of 
Ilorin Teaching Hospital experience.

Owoeye JF, Ademola-Popoola DS.

Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin,
Nigeria.

This paper reports cases of Herpes Zoster Ophthalmicus (HZO) seen in 10 Nigerian 
adults at the Eye clinic of the University of Ilorin Teaching Hospital (UITH),
Ilorin, Kwara State, Nigeria, some of whom tested positive to HIV infection using
ELISA method with confirmation using the Western blot test. There were 6 female
and 4 male patients. Five (50%) of the patients tested positive for HIV. A high
index of suspicion should be maintained among Ophthalmologists when confronted
with patients with HZO who are healthy looking.

PMID: 14529222 [PubMed - indexed for MEDLINE]

1969: J Dermatolog Treat. 2003 Sep;14(3):177-8.

Skin rash and splinter hemorrhages from ganciclovir.

Lorenzi S, D'Antuono A, Iorizzo M, Tosti A.

Department of Dermatology, University of Bologna, Via Massarenti, Bologna, Italy.

Ganciclovir is a nucleotide-analogue similar to acyclovir, which has an in vitro 
activity against herpes simplex type 1, herpes simplex type 2 and varicella
zoster virus. Numerous studies suggest that ganciclovir has clinical efficacy
against cytomegalovirus disease, as well as an in vivo antiviral effect, and that
this agent reduces morbidity of serious cytomegalovirus infections in
immunocompromised patients. Generalised cutaneous rash associated with
ganciclovir therapy has rarely been reported in literature.

Publication Types: 
    Case Reports

PMID: 14522628 [PubMed - indexed for MEDLINE]

1970: Public Health. 2003 Nov;117(6):446-51.

Pox in the docks: varicella outbreak in an Australian prison system.

Levy MH, Quilty S, Young LC, Hunt W, Matthews R, Robertson PW.

Corrections Health Service, Long Bay Prison Hospital, Matraville, NSW 2036,
Australia. levym@chs.health.nsw.gov.au

OBJECTIVES: 1. Describe an outbreak of varicella in a prison system. 2. Highlight
the risks of disease transmission within the prison environment. 3. Promote
infection control guidelines for high-risk sub-groups within the prison system,
including the application of quarantine. SETTING: Four prisons, one prison
hospital, the prison transport system, one courthouse. MAIN OUTCOME MEASURES:
Number of cases of varicella infection; reported varicella immunity status of
cases and contacts; immunity status of known HIV antibody positive inmates.
RESULTS: Five cases of chickenpox were identified. There were 23 contacts of the 
Index Case occurring during transport between prison and court and whilst being
held in the court holding cells. Two of these contacts developed chickenpox
despite having given a prior history of infection. There were over 300 inmates
exposed to varicella zoster virus (VZV) during the outbreak, including one HIV
antibody positive inmate who had serologically confirmed immunity. This inmate
developed shingles following exposure to VZV from one of the cases. CONCLUSIONS: 
There is an elevated risk of respiratory transmission of infections such as
chickenpox in prisons. Clear guidelines should be in place to protect HIV
antibody positive people, pregnant women, and others who are at increased risk of
complications from such infections. In the case of varicella, all inmates and
staff without documented immunity should be screened to determine immunity, and
if non-immune, should be offered VZV vaccination. Every effort should be made to 
prevent HIV antibody positive inmates being exposed to varicella, regardless of
their varicella immunity status. If an HIV antibody positive inmate, who is known
to be non-immune is exposed to varicella, Varicella Zoster immunoglobulin should 
be given within 96 h.

Publication Types: 
    Multicenter Study

PMID: 14522161 [PubMed - indexed for MEDLINE]

1971: Ann Neurol. 2003 Oct;54(4):459-63.

Oligoclonal immunoglobulins in cerebrospinal fluid during varicella zoster virus 
(VZV) vasculopathy are directed against VZV.

Burgoon MP, Hammack BN, Owens GP, Maybach AL, Eikelenboom MJ, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
CO 80262, USA. mark.burgoon@uchsc.edu

Limited analyses of cerebrospinal fluid from patients with central nervous system
infections have shown that the oligoclonal IgG is antibody directed against the
agent that causes disease. Using a new method involving binding of IgG to beads
coated with lysates prepared from candidate infectious antigens, we showed that
the oligoclonal IgG in cerebrospinal fluid of a patient with chronic varicella
zoster virus vasculopathy is directed against the causative virus. This approach 
holds promise in identifying and purifying the relevant oligoclonal IgGs in
inflammatory central nervous system diseases of unknown cause.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 14520657 [PubMed - indexed for MEDLINE]

1972: Chang Gung Med J. 2003 Jul;26(7):525-9.

Transitional cell carcinoma metastasis to arm skin from the renal pelvis.

Lin CY, Lee CT, Huang JS, Chang LC.

Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.

Metastases of renal pelvic transitional cell carcinoma (TCC) to the skin and
subcutaneous tissues are extremely rare. Similar to metastases from other
genitourinary tract organs, they commonly affect middle-aged or elderly men,
generally herald a rapid progression, and are associated with a poor outcome.
Skin metastatic lesions present as painful or nontender nodules, and a vascular
or even a zosteriform appearance may occasionally be noted. The latter is often
confused with herpes zoster infection. The diagnosis is usually confirmed by
histopathological findings of biopsy specimens. Cutaneous metastases generally
carry a dismal prognosis, with survival of only several months. We herein present
a case of renal pelvic TCC with cutaneous metastases to the bilateral arms and
epigastric region 1.5 years after diagnosis of the primary lesion. The patient's 
condition rapidly deteriorated, and she expired 4 weeks later. We present this
rare case to highlight the possibility of cutaneous metastases from renal pelvis 
TCC and with the hope to increase awareness of the rapidly fatal course of such
patients.

Publication Types: 
    Case Reports

PMID: 14515977 [PubMed - indexed for MEDLINE]

1973: Rev Med Chil. 2003 Jul;131(7):759-64.

[Infections caused by Varicella Zoster virus in children with cancer aged less
than 15 years old]

[Article in Spanish]

Folatre I, Zolezzi P, Schmidt D, Marin F, Tager M.

Instituto de Hematologia R. Virchow, Instituto de Pediatria, Facultad de
Medicina, Universidad Austral de Chile, Casilla 567-Valdivia. ifolatre@telsur.cl

BACKGROUND: Infections caused by Varicella Zoster virus in children with cancer
have a high rate of complications and mortality. AIM: To report the outcome of
this infection in children with cancer. PATIENTS AND METHODS: Retrospective
analysis of medical records of 216 children aged less than 15 years old with the 
diagnosis of an hematological or solid tumor, admitted to the National Program of
Antineoplastic Drugs (PINDA). RESULTS: Eighty seven children had a Varicella
Zoster virus infections, 73 (84%) had varicella, 8 (9%) had herpes zoster and 6
(7%) had varicella and herpes zoster. Ninety four percent acquired the infection 
during antineoplastic treatment and 78% received Acyclovir as antiviral therapy. 
During a nosocomial outbreak of varicella, three patients with an Acute
Lymphoblastic leukemia died in the initial phase of chemotherapy, in spite of an 
early administration of Acyclovir. No patient with herpes zoster died.
CONCLUSIONS: The incidence of varicella was higher in children with leukemia or
lymphoma than in children with other types of cancer. Virus reactivation was
uncommon and had a benign course. Varicella mortality in these children could be 
favorably modified through an active immunization of immunocompetent children.

Publication Types: 
    English Abstract

PMID: 14513696 [PubMed - indexed for MEDLINE]

1974: J Infect Dis. 2003 Oct 1;188(7):954-9. Epub 2003 Sep 26.

Comment in:
    J Infect Dis. 2003 Oct 1;188(7):945-7.

Development of resistance to acyclovir during chronic infection with the Oka
vaccine strain of varicella-zoster virus, in an immunosuppressed child.

Levin MJ, Dahl KM, Weinberg A, Giller R, Patel A, Krause PR.

Section of Pediatric Infectious Diseases, University of Colorado Health Sciences 
Center, Denver, Colorado 80262, USA. myron.levin@uchsc.edu

A 1-year-old boy was vaccinated with the Oka strain of varicella just prior to
the discovery of a tumor that required intensive antitumor therapy. Three months 
later he developed herpes zoster, which developed into chronic verrucous lesions 
that were refractory to treatment with acyclovir and which subsequently
disseminated. DNA from a biopsy specimen of a chronic herpes-zoster lesion
indicated that the Oka vaccine strain of the the virus caused this severe
complication. Analysis of this viral DNA demonstrated a mutation in the viral
thymidine kinase gene. Plasmids containing this altered gene were unable to
produce functional thymidine kinase in an in vitro translation system. The
presence of this mutation would explain the clinical resistance to acyclovir.
This is the first report of Oka-strain varicella virus causing severe disease
after reactivation and of resistance to acyclovir during an infection caused by
this virus.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 14513413 [PubMed - indexed for MEDLINE]

1975: J Infect Dis. 2003 Oct 1;188(7):948-53. Epub 2003 Sep 26.

Comment in:
    J Infect Dis. 2003 Oct 1;188(7):945-7.

Disseminated varicella infection due to the vaccine strain of varicella-zoster
virus, in a patient with a novel deficiency in natural killer T cells.

Levy O, Orange JS, Hibberd P, Steinberg S, LaRussa P, Weinberg A, Wilson SB,
Shaulov A, Fleisher G, Geha RS, Bonilla FA, Exley M.

Division Infectious Diseases, Children's Hospital, Harvard Medical School,
Boston, Massachusetts 02115, USA.

An 11-year-old girl presented with a papulovesicular rash and severe respiratory 
distress 5 weeks after receiving varicella vaccine. Restriction fragment
length-polymorphism analysis of virus isolated from an endotracheal-tube aspirate
and from bronchoalveolar lavage revealed that this patient's illness was due to
the Oka vaccine strain of varicella. An extensive immunologic analysis failed to 
identify a known diagnostic entity to explain her susceptibility to this
attenuated vaccine strain. Analysis of her lymphocytes on separate occasions,
months after recovery from her illness, revealed a profound deficiency of natural
killer T (NKT) cells and of NKT-cell activity, suggesting that NKT cells
contribute to host defense against varicella virus.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 14513412 [PubMed - indexed for MEDLINE]

1976: J Virol. 2003 Oct;77(20):11180-5.

Varicella-zoster virus ORF47 protein kinase, which is required for replication in
human T cells, and ORF66 protein kinase, which is expressed during latency, are
dispensable for establishment of latency.

Sato H, Pesnicak L, Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892-1888, USA.

Varicella-zoster virus (VZV) results in a lifelong latent infection in human
sensory and cranial nerve ganglia after primary infection. VZV open reading frame
47 (ORF47) and ORF66 encode protein kinases that phosphorylate several viral
proteins, including VZV glycoprotein gE and ORF32, ORF62, and ORF63 proteins.
Here we show that the ORF47 protein kinase also phosphorylates gI. While ORF47 is
essential for virus replication in human T cells and skin, we found the gene to
be dispensable for establishment of latent infection in dorsal root ganglia of
rodents. ORF66 protein is expressed during latency. Rodents infected with VZV
unable to express ORF66 developed latent infection at a rate similar to that for 
the parental virus. ORF63 transcripts, a hallmark of VZV latency, were also
detected in similar numbers of animals infected with the ORF47 and ORF66 mutants 
and with the parental virus. VZV mutants unable to express four of the six genes 
that do not have herpes simplex virus (HSV) homologs (ORFs 1, 13, 32, 57) were
also unimpaired for establishment of latency. While a truncated HSV VP16 mutant
was previously reported to be unable to establish latency in a mouse model, we
found that VZV with a deletion of ORF10, the homolog of HSV VP16, was dispensable
for establishment of latency. Thus, seven genes, including one expressed during
latency, are dispensable for establishing latent VZV infection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 14512565 [PubMed - indexed for MEDLINE]

1977: Int J STD AIDS. 2003 Sep;14(9):638-9.

Multiple opportunistic AIDS-associated disorders strictly related to
immunodeficiency levels, in a girl with congenital HIV infection.

Manfredi R, Calza L, Chiodo F.

Department of Clinical and Experimental Medicine, Division of Infectious
Diseases, University of Bologna, Alma Mater Studiorum, S Orsola Hospital, Via
Massarenti 11, I-40138 Bologna, Italy. manfredi@med.unibo.it

A 16-year-old girl with vertical HIV disease treated since birth suffered from
six different AIDS-defining disorders until now. Even during the highly active
antiretroviral therapy, multiple AIDS-related opportunistic infections may
complicate the course of long-term congenital HIV disease, showing a strict
relationship with immunological deterioration, which occurs shortly after
virologic failure, due to an extensive genotypic resistance to all available
antiretroviral compounds.

Publication Types: 
    Case Reports

PMID: 14511504 [PubMed - indexed for MEDLINE]

1978: Dermatol Ther. 2003;16(3):195-205.

Cutaneous infections in the elderly: diagnosis and management.

Weinberg JM, Scheinfeld NS.

Department of Dermatology, St. Luke's-Roosevelt Hospital Center, New York, New
York, USA. jmw27@columbia.edu

Over the past several years there have been many advances in the diagnosis and
treatment of cutaneous infectious diseases. This review focuses on the three
major topics of interest in the geriatric population: herpes zoster and
postherpetic neuralgia (PHN), onychomycosis, and recent advances in antibacterial
therapy. Herpes zoster in adults is caused by reactivation of the
varicella-zoster virus (VZV) that causes chickenpox in children. For many years
acyclovir was the gold standard of antiviral therapy for the treatment of
patients with herpes zoster. Famciclovir and valacyclovir, newer antivirals for
herpes zoster, offer less frequent dosing. PHN refers to pain lasting > or = 2
months after an acute attack of herpes zoster. The pain may be constant or
intermittent and may occur spontaneously or be caused by seemingly innocuous
stimuli such as a light touch. Treatment of established PHN through pharmacologic
and nonpharmacologic therapy will be discussed. In addition, therapeutic
strategies to prevent PHN will be reviewed. These include the use of oral
corticosteroids, nerve blocks, and treatment with standard antiviral therapy.
Onychomycosis, or tinea unguium, is caused by dermatophytes in the majority of
cases, but can also be caused by Candida and nondermatophyte molds. Onychomycosis
is found more frequently in the elderly and in more males than females. There are
four types of onychomycosis: distal subungual onychomycosis, proximal subungual
onychomycosis, white superficial onychomycosis, and candidal onychomycosis. Over 
the past several years, new treatments for this disorder have emerged which offer
shorter courses of therapy and greater efficacy than previous therapies. The
treatment of bacterial skin and skin structure infections in the elderly is an
important issue. There has been an alarming increase in the incidence of
gram-positive infections, including resistant bacteria such as
methicillin-resistant Staphylococcus aureus (MRSA) and drug-resistant
pneumococci. While vancomycin has been considered the drug of last defense
against gram-positive multidrug-resistant bacteria, the late 1980s saw an
increase in vancomycin-resistant bacteria, including vancomycin-resistant
enterococci (VRE). More recently, strains of vancomycin-intermediate resistant S.
aureus (VISA) have been isolated. Gram-positive bacteria, such as S. aureus and
Streptococcus pyogenes are often the cause of skin and skin structure infections,
ranging from mild pyodermas to complicated infections including postsurgical
wound infections, severe carbunculosis, and erysipelas. With limited treatment
options, it has become critical to identify antibiotics with novel mechanisms of 
activity. Several new drugs have emerged as possible therapeutic alternatives,
including linezolid and quinupristin/dalfopristin.

Publication Types: 
    Review

PMID: 14510876 [PubMed - indexed for MEDLINE]

1979: Psychosom Med. 2003 Sep-Oct;65(5):824-30.

Effects of a behavioral intervention, Tai Chi Chih, on varicella-zoster virus
specific immunity and health functioning in older adults.

Irwin MR, Pike JL, Cole JC, Oxman MN.

Cousins Center for Psychoneuroimmunonology, UCLA Neuropsychiatric Institute,
University of California, Los Angeles 90095-7057, USA. mirwin1@ucla.edu

OBJECTIVE: Both the incidence and severity of herpes zoster (shingles) increase
markedly with increasing age in association with a decline in varicella-zoster
virus (VZV) specific cell-mediated immunity (CMI). This study examined whether a 
behavioral intervention, Tai Chi Chih (TCC), affects VZV specific immunity and
health functioning in older adults who, on average, show impairments of health
status and are at risk for shingles. METHODS: Thirty-six men and women (age > or 
=60 years) were assigned randomly to a 15-week program of TCC instruction (three 
45 minute classes per week; N = 18) or a wait list control condition (N = 18).
VZV-specific CMI was measured at baseline and at 1-week postintervention. Health 
functioning (Medical Outcome scale: SF-36) was assessed at baseline, and at 5,
10, and 15 weeks during the intervention, and at 1-week postintervention.
RESULTS: In the intent-to-treat sample, VZV-specific CMI increased 50% from
baseline to 1-week postintervention in the TCC group (p < 0.05) but was unchanged
in the wait list control group. In those who completed the study, 1-week
postintervention SF-36 scale scores for role-physical (p < 0.05) and physical
functioning (p < 0.05) were higher in the TCC group (N = 14) as compared with
controls (N = 17). Older adults who had impairments of physical status at
baseline showed the greatest increases of SF-36 role-physical (p < 0.01) and
physical functioning (p < 0.001) during the TCC intervention. CONCLUSIONS:
Administration of TCC for 15 weeks led to an increase in VZV-specific CMI. Gains 
in health functioning were found in participants who received TCC and were most
marked in those older adults who had the greatest impairments of health status.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 14508027 [PubMed - indexed for MEDLINE]

1980: Br J Ophthalmol. 2003 Oct;87(10):1215-9.

Management of acute ulcerative and necrotising herpes simplex and zoster
keratitis with amniotic membrane transplantation.

Heiligenhaus A, Li H, Hernandez Galindo EE, Koch JM, Steuhl KP, Meller D.

Department of Ophthalmology, St Franziskus Hospital, Hohenzollernring 74, 48145
Muenster, Germany. arnd.heiligenhaus@t-online.de

AIM: To report promoted healing of acute ulcerative and necrotising herpetic
keratitis after amniotic membrane transplantation (AMT). METHODS: Retrospective, 
non-comparative case series of seven patients with acute ulcerative and
necrotising herpetic stromal keratitis. Single or multilayer AMT with epithelial 
side facing up was performed. The main outcome measures were wound healing of the
corneal ulcers and decrease of stromal inflammation. RESULTS: The mean follow up 
was 10.7 (SEM 1.4) months (range 5-15 months). AMT was performed once in five
cases, and twice in further two. Improvement of stromal inflammation was noted
within 16.4 (2.5) days (range 7-28 days). Epithelial defects healed within a mean
of 17 (2.7) days (range 7-28 days). Vision improved in all but two patients. No
serious side effects occurred during the follow up. CONCLUSIONS: Although
performed in an uncontrolled and non-randomised series of patients, these
findings indicate that the AMT shows promise in selected cases for the
restoration of ocular surface integrity, reduction of stromal inflammation, and
improvement of vision in acute ulcerative and necrotising herpetic keratitis.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 14507749 [PubMed - indexed for MEDLINE]

1981: Harv Health Lett. 2003 Sep;28(11):4-5.

Shingles: When a slumbering virus stirs.

[No authors listed]

PMID: 14505966 [PubMed - indexed for MEDLINE]

1982: Vaccine. 2003 Oct 1;21(27-30):4243-9.

Comment in:
    Vaccine. 2004 Sep 3;22(25-26):3228-31; author reply 3232-6.

Incidence of herpes zoster among children and adolescents in a community with
moderate varicella vaccination coverage.

Goldman GS.

P.O. Box 847, Pearblossom, CA 93553, USA. pearblossominc@aol.com

Active surveillance for herpes zoster (HZ) was conducted for 2 years (2000-2001) 
in the Antelope Valley community of 312,000 residents among 290 public and
private schools, daycares, and healthcare providers. The true
ascertainment-adjusted HZ incidence rate is 307 per 100,000 person-years and 138 
per 100,000 person-years among children <10 and individuals aged 10-19,
respectively. The unadjusted rate among vaccinated children is 9.5 per 100,000
person-years and an estimated 22 per 100,000 vaccine doses. Unvaccinated children
with a previous history of varicella may have greater sensitivity to exogenous
exposures (boosting) and a poorer cell-mediated response following primary
infection relative to older age groups.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 14505905 [PubMed - indexed for MEDLINE]

1983: Vaccine. 2003 Oct 1;21(27-30):4238-42.

Comment in:
    Vaccine. 2004 Sep 3;22(25-26):3228-31; author reply 3232-6.

Varicella susceptibility and incidence of herpes zoster among children and
adolescents in a community under active surveillance.

Goldman GS.

P.O. Box 847, Pearblossom, CA 93553, USA. pearblossominc@aol.com

Licensure of varicella vaccine by the US Food and Drug Administration in March
1995 has given rise to concerns that include a potential shift in varicella
incidence to susceptible adults and increase in herpes zoster (HZ) incidence.
Baseline values prior to widespread vaccination were obtained through
distribution of an adolescent survey to all 13 public middle (seventh and eighth 
grade) schools in the Antelope Valley, CA health district. Based on 4216
respondents aged 10-14 years, varicella susceptibility is 7.7% (95% CI, 6.9-8.5%)
and true cumulative (1987-2000) HZ incidence rate is 133 per 100,000 person-years
(95% CI, 95-182 per 100,000 person-years).

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 14505904 [PubMed - indexed for MEDLINE]

1984: Vaccine. 2003 Oct 1;21(27-30):4119.

Human immunodeficiency virus transmitted through sheep brain anti-rabies
vaccination.

Singh S.

Publication Types: 
    Case Reports
    Letter

PMID: 14505888 [PubMed - indexed for MEDLINE]

1985: J Cutan Med Surg. 2003 Sep-Oct;7(5):372-81. Epub 2003 Sep 24.

Valacyclovir in the treatment of herpes simplex, herpes zoster, and other viral
infections.

Wu JJ, Brentjens MH, Torres G, Yeung-Yue K, Lee P, Tyring SK.

Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.

BACKGROUND: Genital herpes and herpes labialis are prevalent, physically and
psychologically painful, and often disabling. Herpes zoster is often very painful
and may result in months or years of postherpetic neuralgia (PHN). Over the past 
two decades, the treatment of these conditions has been transformed by guanosine 
nucleoside antivirals such as valacyclovir (Valtrex, a highly bioavailable
prodrug of acyclovir (Zovirax, and famciclovir (Famvir), a highly bioavailable
prodrug of penciclovir (Denavir). OBJECTIVE: We describe the pharmacology,
pharmacokinetics, and clinical efficacy of valacyclovir for the treatment of
herpes simplex, herpes zoster, and other viral infections. Valacyclovir is also
compared with acyclovir and famciclovir. METHODS: All published literature
containing the word "valacyclovir" was reviewed and summarized. RESULTS:
Valacyclovir is the only oral antiviral agent approved for therapy of herpes
labialis, the only antiviral drug approved for a 3-day course in the episodic
treatment of recurrent genital herpes, as well as the only antiviral drug
approved for once daily dosing for suppressive therapy. In herpes zoster,
valacyclovir is more effective than acyclovir and equally effective as
famciclovir at hastening the healing of zoster-associated pain and PHN.
CONCLUSION: Valacyclovir is safe and effective in the therapy of patients with
herpes simplex and herpes zoster and may be useful in other viral infections.

Publication Types: 
    Review

PMID: 14505192 [PubMed - indexed for MEDLINE]

1986: Neurology. 2003 Sep 23;61(6):866-7.

Pilot tolerability and effectiveness study of levetiracetam for postherpetic
neuralgia.

Rowbotham MC, Manville NS, Ren J.

UCSF Pain Clinical Research Center, Department of Neurology, School of Medicine, 
University of California San Francisco, CA 94115, USA. mcrwind@itsa.ucsf.edu

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 14504347 [PubMed - indexed for MEDLINE]

1987: Am J Nurs. 2003 Sep;103(9):75, 77-8.

Lidocaine patch 5%.

Pasero C.

cpasero@aol.com

Publication Types: 
    Review

PMID: 14501479 [PubMed - indexed for MEDLINE]

1988: Arch Dis Child. 2003 Oct;88(10):862-9.

Varicella vaccination in England and Wales: cost-utility analysis.

Brisson M, Edmunds WJ.

Immunisation Division, PHLS Communicable Disease Surveillance Centre, London NW9 
5EQ, UK.

AIMS: To assess the cost-effectiveness of varicella vaccination, taking into
account its impact on zoster. METHODS: An age structured transmission dynamic
model was used to predict the future incidence of varicella and zoster. Data from
national and sentinel surveillance systems were used to estimate age specific
physician consultation, hospitalisation, and mortality rates. Unit costs, taken
from standard sources, were applied to the predicted health outcomes. RESULTS: In
England and Wales, the annual burden of VZV related disease is substantial, with 
an estimated 651 000 cases of varicella and 189 000 cases of zoster, resulting in
approximately 18 000 QALYs lost. The model predicts that although the overall
burden of varicella will significantly be reduced following mass infant
vaccination, these benefits will be offset by a significant rise in zoster
morbidity. Under base case assumptions, infant vaccination is estimated to
produce an overall loss of 54 000 discounted QALYs over 80 years and to result in
a net cost from the health provider (NHS) and the societal perspectives. These
results rest heavily on the impact of vaccination on zoster. Adolescent
vaccination is estimated to cost approximately 18 000 pounds sterling per QALY
gained from the NHS perspective. CONCLUSION: Routine infant varicella vaccination
is unlikely to be cost-effective and may produce an increase in overall
morbidity. Adolescent vaccination is the safest and most cost-effective strategy,
but has the least overall impact on varicella.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 14500303 [PubMed - indexed for MEDLINE]

1989: Anesth Analg. 2003 Oct;97(4):1117-8, table of contents.

Severe acute visceral pain from varicella zoster virus.

Hyland JM, Butterworth J.

Department of Anesthesiology, Wake Forest University School of Medicine,
Winston-Salem, North Carolina 27157-1009, USA.

Varicella zoster virus infection often will not present in the characteristic
dermatomal distribution of vesicles in patients who have undergone bone marrow
transplantation. We cared for a 51-yr-old man with severe abdominal pain after
bone marrow transplantation for non-Hodgkin's lymphoma. The diagnosis of
varicella zoster was not entertained until he developed a diffuse vesicular rash 
several days after the onset of pain. We report this case to alert others who may
be consulted regarding pain management options for similar oncology patients.
IMPLICATIONS: We report a patient with lymphoma, prior bone marrow transplant,
and acute visceral pain for whom IV opioids in large doses proved inadequate. An 
interventional pain management technique was considered until characteristic
varicella vesicles appeared over the patient's trunk. We report this case to
alert others who treat oncology patients that the diagnosis of visceral zoster
should be considered when patients who have undergone bone marrow transplantation
present with severe visceral pain.

Publication Types: 
    Case Reports

PMID: 14500167 [PubMed - indexed for MEDLINE]

1990: Support Care Cancer. 2003 Nov;11(11):739-41. Epub 2003 Sep 17.

Vaccination of autologous stem cell transplant recipients with live varicella
vaccine: a pilot study.

Ljungman P, Wang FZ, Nilsson C, Solheim V, Linde A.

Department of Hematology, Huddinge University Hospital, 14186, Stockholm, Sweden.
Per.Ljungman@medhs.ki.se

A pilot study of vaccination with live, attenuated varicella vaccine for
prevention of zoster was performed in autologous stem cell transplant (SCT)
recipients. Nine patients were vaccinated between 3-4 months after
transplantation. The antigen-specific immune response was studied by lymphocyte
proliferation. No systemic side effects were seen. One of nine patients developed
herpes zoster HZ during follow-up. There was a tendency for a strengthened
specific immune response after SCT ( p=0.12). This pilot study shows that
vaccination with live, attenuated varicella vaccine can be performed safely 3-4
months after autologous stem cell transplantation. Additional studies are needed 
to assess efficacy of this approach in the prevention of HZ.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 13680325 [PubMed - indexed for MEDLINE]

1991: Gynecol Oncol. 2003 Sep;90(3):670-2.

Inflammatory skin metastases from ovarian carcinoma--a case report and review of 
the literature.

Schonmann R, Altaras M, Biron T, Bernheim J, Fishman A.

Department of Obstetrics and Gynecology, Meir Hospital-Sapir Medical Center,
Sackler School of Medicine, Tel-Aviv University, Kfar-Saba, Israel.

BACKGROUND: Skin metastases from ovarian carcinoma are rarely reported. Most
cases present as cutaneous nodules, generally as periumbilical Sister Joseph's
nodules. An uncommon presentation of cutaneous metastases from ovarian epithelial
carcinoma is the inflammatory pattern, which mimics herpetiform lesions to the
skin. CASE: A 48-year-old patient with refractory ovarian carcinoma, complicated 
by groin lymph node metastatic disease developed edema, in the form of "Peau
d'orange," over the lower abdominal skin, the upper aspects of the lower
extremities, and the gluteal skin. Large areas of multiple erythematous vesicular
appearance that resembled herpes zoster lesions were noted. Biopsy of the skin
lesions revealed ovarian skin metastases. CONCLUSIONS: The diagnosis of ovarian
skin metastases is uncommon. It mimics inflammatory viral infection as herpes
zoster lesions. Supportive care is needed due to painful presentation.

Publication Types: 
    Case Reports
    Review

PMID: 13678744 [PubMed - indexed for MEDLINE]

1992: Ophthalmology. 2003 Sep;110(9):1737-43.

Nonnecrotizing herpetic retinopathies masquerading as severe posterior uveitis.

Bodaghi B, Rozenberg F, Cassoux N, Fardeau C, LeHoang P.

Department of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France.

OBJECTIVE: Aqueous humor analysis can be performed in severe atypical forms of
posterior uveitis unresponsive to conventional treatment to exclude a viral
infection. DESIGN: Noncomparative interventional case series. PARTICIPANTS:
Thirty-seven immunocompetent patients seen with corticosteroid-resistant forms of
posterior uveitis underwent extensive evaluation, including anterior chamber
paracentesis, to rule out a nonnecrotizing viral retinopathy. INTERVENTION:
Aqueous fluid samples were prospectively obtained. Polymerase chain reaction
(PCR) and serologic evaluation of intraocular antibody production against
herpesviruses were performed by molecular techniques and enzyme-linked
immunosorbent assay. MAIN OUTCOME MEASURES: Polymerase chain reaction and local
antibody production for herpes simplex virus types 1 and 2, varicella-zoster
virus, cytomegalovirus, and Epstein-Barr virus were determined on aqueous fluid
samples. RESULTS: Viral infection was confirmed in 5 cases (13.5%). Clinical
presentation included birdshot-like retinochoroidopathy, occlusive bilateral
vasculitis, and cystoid macular edema. An antiviral regimen was initiated in all 
cases. Inflammation was stabilized, and steroid dosage could be significantly
reduced. CONCLUSIONS: Identification of a viral agent during severe posterior
uveitis can dramatically change therapeutic management.

Publication Types: 
    Case Reports

PMID: 13129871 [PubMed - indexed for MEDLINE]

1993: Retina. 2003 Aug;23(4):567-9.

Herpes zoster vasculitis presenting as giant cell arteritis with choroidal
infarction.

Al-Abdulla NA, Kelley JS, Green WR, Miller NR.

Wilmer Eye Institute of the Johns Hopkins Hospital, 600 North Wolfe Street,
Baltimore, MD 21287, USA.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12972779 [PubMed - indexed for MEDLINE]

1994: J Coll Physicians Surg Pak. 2003 Sep;13(9):524-5.

Bilateral symmetrical herpes zoster in an immunocompetent patient (Herpes zoster 
duplex symmetricus).

Arfan-ul-Bari, Iftikhar N, ber Rahman S.

Department of Dermatology, PAF Hospital, Sargodha, Pakistan. albariul@yahoo.com

Herpes zoster is a common disease of adulthood. Its incidence is low in childhood
and adolescence. Certain risk factors like hematological malignancies or
immunosuppression due to any cause may lead to onset at an early age. There is a 
unilateral appearance of grouped vesicular eruption on an erythematous background
which may involve contiguous dermatomes. Rarely the lesions may occur bilaterally
in an otherwise healthy individual. We present a case of herpes zoster, with
lesions having atypical distribution involving bilaterally symmetrical dermatomes
over the lower chest.

Publication Types: 
    Case Reports

PMID: 12971875 [PubMed - indexed for MEDLINE]

1995: Am J Ophthalmol. 2003 Sep;136(3):574-5.

An unusual presentation of herpes zoster ophthalmicus: orbital myositis preceding
vesicular eruption.

Kawasaki A, Borruat FX.

Department of Neuro-ophthalmology, Hopital Ophthalmique Jules Gonin, Lausanne,
Switzerland. aki-kawasaki@ophthal.vd.ch

PURPOSE: To present a case of orbital myositis associated with herpes zoster
ophthalmicus. DESIGN: Observational case report. METHODS: A 47-year-old woman
with acute retrobulbar eye pain and diplopia preceding the vesicular rash of
herpes zoster ophthalmicus was evaluated and treated. RESULTS: Magnetic resonance
imaging showed enlargement and enhancement of extraocular muscles consistent with
an inflammatory myopathy. Following acyclovir and prednisone treatment, all
symptoms resolved, and neuralgia did not develop. CONCLUSIONS: Herpes zoster may 
cause symptoms and signs of orbital myositis before eruption of cutaneous skin
lesions and thus should be considered in the differential diagnosis of an acute
orbital myositis.

Publication Types: 
    Case Reports

PMID: 12967827 [PubMed - indexed for MEDLINE]

1996: J Pain Symptom Manage. 2003 Sep;26(3):788-90.

Post-surgical herpes zoster of the plantar aspect of the foot.

Muche JA, Raghavendra M.

Publication Types: 
    Case Reports
    Letter

PMID: 12967727 [PubMed - indexed for MEDLINE]

1997: Transplant Proc. 2003 Aug;35(5):2004-5.

Characteristics and repercussion of varicella-zoster virus infection in cardiac
transplant.

Cabezon Ruiz S, Cisneros JM, Lage Galle E, Ordonez A, Hinojosa RF, Moran Risco
JE, Hernandez A.

Generally, the need for information about varicella-zoster virus (VVZ) infection 
in cardiac transplantation (CT) is greater than that for other organ transplants.
All cases of VVZ infection among the 175 CT patients included herpes zoster as
the clinical syndrome in all 11 cases (men, 90.9%; mean age, 50.3+/-5 years;
incidence, 6.3%). The infection was limited to one dermatome in seven patients
(63.6%: thoracic, 6%; ophthalmic, 1), or two contiguous dermatomes in four
patients (36.4%). The infection onset was after the first semester in seven
patients (63.6%). All patients received three drug immunosuppressive therapy.
Cardiac rejection during the three previous months occurred in one patient (3A
grade). Previous CMV disease was observed in three patients (27.3%: range, 7-14
months). Intravenous acyclovir was administered to five patients (ophthalmic and 
several dermatome forms), and oral therapy for the rest. All the patients
recovered; there were no complications or postherpetic neuralgia (mean follow-up:
16.5 months). VVZ infection, a frequent late infection among CT recipients,
presents as a clinical syndrome of herpes zoster, frequently in patients with
previous CMV infection. In CT, herpes zoster frequently affects two dermatomes,
but the clinical courses and responses to treatment are favorable. There was no
postherpetic neuralgia.

PMID: 12962877 [PubMed - indexed for MEDLINE]

1998: Transplant Proc. 2003 Aug;35(5):1758-9.

Disseminated varicella infection in adult renal allograft recipients: role of
mycophenolate mofetil.

Lauzurica R, Bayes B, Frias C, Fontsere N, Hernandez A, Matas L, Jimenez A, Bonet
J, Romero R.

Nephrology Department, Kidney Transplant Unit, Hospital Universitari Germans
Trias i Pujol, Badalona, Spain. rlauzu@ns.hugtip.scs.es

Disseminated varicella zoster virus (VZV) infection is a rare complication after 
renal transplantation in adults. We report 4 cases diagnosed in our transplant
patients. One of which was a primary infection (chicken pox) with multivisceral
involvement (hepatitis, pneumonitis, myocarditis, and disseminated intravascular 
coagulation). The other 3 patients VZV-seropositive before transplantation
suffered from disseminated zoster. No immunosuppressive drug was significantly
associated with a higher risk of disseminated VZV infection. However, from our
experience, we believe that mycophenolate mofetil (MMF), plays a part in the
clinical presentation of the disease. Early treatment with high doses of
acyclovir is fundamental in infection control. It is essential to perform a
pretransplantation serological VZV study on all patients.

PMID: 12962784 [PubMed - indexed for MEDLINE]

1999: J Clin Gastroenterol. 2003 Sep;37(3):220-5.

Cumulative experience with short- and long-term toxicity to 6-mercaptopurine in
the treatment of Crohn's disease and ulcerative colitis.

Warman JI, Korelitz BI, Fleisher MR, Janardhanam R.

Department of Medicine, Lenox Hill Hospital, New York, New York 10021, USA.

BACKGROUND AND AIMS: The efficacy of 6-mercaptopurine (6-MP) in the treatment and
long-term maintenance of remission of inflammatory bowel disease and prevention
of recurrence after resection in Crohn's disease have been established. Concern
about 6-MP toxicity remains, especially the development of neoplasm. The aim of
this study is to determine the incidence of all short- and long-term toxicity by 
follow-up of all patients with inflammatory bowel disease treated with 6-MP over 
a 20-year period. MATERIALS AND METHODS: We reviewed the office and hospital
records and also determined the recent status of 410 patients with inflammatory
bowel disease treated with 6-MP from 1980 to 1999. All toxicity was recorded.
RESULTS: There was a low incidence of early drug-related allergic reactions
(3.9%) and pancreatitis (1.2%). Desensitization to either 6-MP or azathioprine is
often successful with the same or the other drug. Significant leukopenia
(<or=3500) was observed in 11.5%. In some cases, this was caused purposefully.
Infectious complications occurred at different times during treatment with 6-MP
in 14%, including pneumonia in 3.9% and herpes zoster in 3%. We now establish
diabetes as a 6-MP-related complication. No significant difference in the
incidence of neoplasm was seen from our earlier study or from patients not
treated with 6-MP. We have now seen three lymphomas and two leukemias, again not 
greater in incidence than the overall inflammatory bowel disease population.
CONCLUSIONS: Our data support the long-term safety of 6-MP in the management of
patients with inflammatory bowel disease. Earlier development of a neoplasm in a 
patient predisposed, without a change in incidence, remains possible.

PMID: 12960720 [PubMed - indexed for MEDLINE]

2000: Curr Opin Rheumatol. 2003 Sep;15(5):528-34.

Infectious complications in SLE after immunosuppressive therapies.

Kang I, Park SH.

Section of Rheumatology, Yale University School of Medicine, New Haven,
Connecticut 06520, USA. insoo.kang@yale.edu

Immunosuppressive drugs have become the gold standard for the treatment of major 
organ involvement in systemic lupus erythematosus. The use of immunosuppressive
therapy in systemic lupus erythematosus carries significant risks for infection. 
This article reviews infectious complications in systemic lupus erythematosus,
focusing on effects of immunosuppressive therapy. Patients with systemic lupus
erythematosus appear to carry an intrinsically increased risk for infection.
Recent studies support this notion further by showing increased risk for serious 
infections in patients with systemic lupus erythematosus who had mannose-binding 
lectin deficiency associated with homozygous mannose-binding lectin variant
alleles. Patients with systemic lupus erythematosus who were homozygous for
mannose-binding lectin variant alleles had a fourfold increase in the incidence
of infections, requiring hospitalization. In terms of extrinsic risk factors for 
infection, use of steroids and cyclophosphamide are the strongest risk factors.
The effect of these drugs on infection is also dose dependent. The incidence of
infectious complications in patients treated with mycophenolate mofetil, a newly 
used immunosuppressive drug in systemic lupus erythematosus, appears less
frequent compared with cyclophosphamide. Herpes zoster is still the most common
viral infection in patients with systemic lupus erythematosus treated with
cyclophosphamide and mycophenolate mofetil. Overall data indicate that patients
with systemic lupus erythematosus may have intrinsically increased risks for
infection that are augmented by immunosuppressive therapies. Cyclophosphamide, in
particular in combination with high-dose glucocorticoids, has the strongest
effect in suppressing the immune responses against microorganisms. Careful
monitoring of infectious complications is warranted in patients with systemic
lupus erythematosus receiving immunosuppressive therapies, in particular those on
high-dose glucocorticoids and cytotoxic drugs.

Publication Types: 
    Review

PMID: 12960476 [PubMed - indexed for MEDLINE]

2001: Clin Exp Dermatol. 2003 Sep;28(5):555-6.

Comment on:
    Int J Dermatol. 1995 May;34(5):341-8.

Multiple epidermoid cysts occurring at site of healed herpes zoster in a renal
transplant recipient: an isotopic response?

Sandhu K, Saraswat A, Handa S.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 12950353 [PubMed - indexed for MEDLINE]

2002: Epidemiol Infect. 2003 Aug;131(1):675-82.

Use of hospitalization and pharmaceutical prescribing data to compare the
prevaccination burden of varicella and herpes zoster in Australia.

MacIntyre CR, Chu CP, Burgess MA.

National Center for Immunisation Research and Surveillance of Vaccine Preventable
Diseases, Children's Hospital at Westmead, Westmead, NSW, Australia 2145.

The aims of the study were to compare the burden of varicella and herpes zoster
in Australia. No national surveillance exists for varicella or herpes zoster. We 
used hospital morbidity data from 1993-9 and pharmaceutical prescribing data from
1995-9. In the financial year 1998/99, there were 4718 hospitalizations for
zoster compared to 1991 for varicella. For varicella the mean age of patients was
15 years compared to 69 years for zoster. The mean length of stay in hospital was
4.2 days for varicella and 12.7 days for zoster. Varicella accounted for 8396
(3726 with principal diagnosis varicella) bed days compared to 26 266 (5382 with 
principal diagnosis of zoster) for zoster. The in-hospital case-fatality rate was
0.4% for varicella and 1% for zoster. In 1999, 59 200 community-based cases of
zoster were treated with antivirals. We estimate that 157 266 cases of zoster
occurred in the community in 1999, a rate of 830 per 100 000 population. Herpes
zoster has a higher burden of disease than varicella, and must be a component of 
disease surveillance in order to determine the full impact of vaccination on the 
epidemiology of varicella zoster virus (VZV).

PMID: 12948367 [PubMed - indexed for MEDLINE]

2003: Reg Anesth Pain Med. 2003 Jul-Aug;28(4):344-6.

Epidural clonidine relieves intractable neuropathic itch associated with herpes
zoster-related pain.

Elkersh MA, Simopoulos TT, Malik AB, Cho EH, Bajwa ZH.

Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline
Avenue, Boston, MA 02445, USA. elkershmd@hotmail.com

OBJECTIVE: We present a case of intense herpes zoster-related pain and itching in
the ophthalmic division of the trigeminal nerve (V1). Successful pain and itch
management was achieved after insertion of a high thoracic epidural catheter with
a continuous infusion of bupivacaine and clonidine. CASE REPORT: A 73-year-old
woman with metastatic malignant melanoma developed acute herpes zoster-related
pain and itching unresponsive to conventional oral medications. The patient
described severe and frequent attacks of lancinating pain occurring in the
dermatomal distribution of the left ophthalmic division of the trigeminal nerve. 
She also had a disturbing itch in the same distribution as her pain. The patient 
had significant reduction in the frequency and intensity of the lancinating
attacks after placement of a thoracic epidural catheter with continuous infusion 
of 1 microg/mL clonidine and 0.05% bupivacaine. The itching resolved completely
as well. CONCLUSION: High thoracic epidural infusion of bupivacaine and clonidine
was beneficial in relieving neuropathic itch in a patient with acute herpes
zoster-related pain in the distribution of the trigeminal nerve.

Publication Types: 
    Case Reports

PMID: 12945030 [PubMed - indexed for MEDLINE]

2004: Reg Anesth Pain Med. 2003 Jul-Aug;28(4):315-20.

Postherpetic neuralgia: a descriptive analysis of patients seen in pain clinics.

Lazaro C, Caseras X, Banos JE; Catalonian Group for the Study of Postherpetic
Neuralgia.

Department of Pharmacology, Therapeutics and Toxicology, Universitat Autonoma de 
Barcelona, Barcelona, Spain.

BACKGROUND AND OBJECTIVE: Postherpetic neuralgia (PHN) is a common ailment that
pain specialists must often cope with. The goal of the present survey is to
investigate the pain characteristics of 119 PHN patients with persistent pain
seen at different pain clinics. Methods information on demographic features, pain
characteristics (MPQ-SV, VAS, VRS), and treatment was recorded by means of a
standard case report form. RESULTS: Gender, age, location, and treatment were
consistent with previous reports. Antidepressant, antiepileptic, and analgesic
drugs were the most commonly used by patients. The patients seen in pain clinics 
are probably a subset of severe cases of PHN, where delayed referral to these
units plays an important role. The most frequent qualitative features of the
disease were the McGill Pain Questionnaire-Spanish Version (MPQ-SV). These
features may change in relation to illness evolution; electric shocklike pain and
emotional distress were significantly higher after 6 months of evolution and age 
(those younger than 70 were more able to locate painful areas and to feel pain as
pricking or sharp), and gender (men selected spatial pressure and traction
pressure more frequently). None of the explored variables was relevant to
predicting pain intensity. CONCLUSIONS: This study reveals a subset of patients, 
mostly suffering from long-term PHN, where pain persists. The most frequent
qualitative traits of PHN patients are described. Some variables were involved in
modulation of pain characteristics in these patients. The effect of study design 
in interpretation of results is discussed.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 12945025 [PubMed - indexed for MEDLINE]

2005: Lancet Neurol. 2003 Sep;2(9):567-71.

An unusual cause of trigeminal-distribution pain and tumour.

Hevner R, Vilela M, Rostomily R, Cohrs R, Mahalingam R, Wellish M, Gilden DH.

Department of Pathology, University of Washington, Seattle, WA, USA.

Publication Types: 
    Clinical Conference
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12941580 [PubMed - indexed for MEDLINE]

2006: J Pharmacol Sci. 2003 Aug;92(4):329-36.

Roles of alpha-adrenoceptors and sympathetic nerve in acute herpetic pain induced
by herpes simplex virus inoculation in mice.

Sasaki A, Takasaki I, Andoh T, Nojima H, Shiraki K, Kuraishi Y.

Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, Toyama
Medical and Pharmaceutical University, Toyama, Japan.

Percutaneous inoculation with herpes simplex virus type-1 brings about herpes
zoster-like skin lesions, tactile allodynia, and mechanical hyperalgesia in mice.
This study was conducted to determine whether the sympathetic nervous system and 
alpha-adrenoceptors would be involved in these pain-related responses and whether
the alpha(2)-adrenoceptor agonist clonidine would suppress these responses. The
adrenergic neuron blocker guanethidine and the non-selective alpha-adrenoceptor
antagonist phentolamine did not affect the pain-related responses, although these
agents suppressed the pain-related responses induced by partial ligation of the
sciatic nerve. The pain-related responses induced by herpetic inoculation was
suppressed by intraperitoneal and intrathecal injections, but not by intraplantar
and intracerebroventricular injections, of clonidine. The suppressive effect of
an intraperitoneal injection of clonidine (0.1 mg/kg) was antagonized by
intrathecal injections of phentolamine and the alpha(2)-adrenoceptor antagonist
yohimbine, but not the alpha(1)-adrenoceptor antagonist prazosin. The results
suggest that sympathetic nerves and alpha-adrenoceptors are not involved in the
pain-related responses induced by herpetic infection. Clonidine suppresses the
responses probably through the action on alpha(2)-adrenoceptors in the dorsal
horn.

Publication Types: 
    Comparative Study

PMID: 12939517 [PubMed - indexed for MEDLINE]

2007: J Med Virol. 2003 Oct;71(2):313-9.

Molecular characterisation of varicella-zoster virus strains in Germany and
differentiation from the Oka vaccine strain.

Sauerbrei A, Eichhorn U, Gawellek S, Egerer R, Schacke M, Wutzler P.

Institute of Virology and Therapy, Friedrich-Schiller University of Jena, Jena,
Germany. Andreas.Sauerbrei@med.uni-jena.edu

With the introduction of varicella vaccination, surveillance of varicella-zoster 
virus (VZV) strains occurring in cases of chickenpox or zoster should be
considered. Differentiating Oka vaccine strain from wild-type VZV can be achieved
only using molecular genotyping. In the present study, the VZV genotype was
examined in 53 VZV strains isolated from patients with varicella or zoster and in
73 samples from skin eruptions, cerebrospinal fluid, and throat swabs obtained
from patients with VZV infections in Germany. The polymerase chain reaction and
restriction fragment length polymorphisms analysis using DNA fragments of the
open reading frames 38, 54, 62, and the R5 repeat region were used. Whereas all
VZV isolates could be typed, direct genotyping of viral DNA in patients' samples 
was achieved in 63 of 73 cases (86.3%). The dominant genotype of VZV found in
88.8% of 116 patients had the wild-type pattern PstI(+) BglI(-) R5A followed by
the wild-genotype PstI(+) BglI(+) R5A in 6.0%, the wild-genotype PstI(+) BglI(-) 
R5B in 3.4%, the wild-genotype PstI(+) BglI(-) R5C and the Oka vaccine genotype
PstI(-) BglI(+) R5B in 0.9% of patients each. BglI(-) wild-types were found in
90.7% of patients with zoster and in 9.3% of patients with varicella. By
contrast, the BglI(+) wild-type was diagnosed in five patients with varicella and
in two patients with zoster. In conclusion, VZV strains found in Germany are
similar to strains circulating in the United States and the United Kingdom. VZV
wild-type strains containing a BglI restriction site in ORF 54 as well as Oka
vaccine strains can rarely be detected. Copyright 2003 Wiley-Liss, Inc.

PMID: 12938208 [PubMed - indexed for MEDLINE]

2008: Asian Pac J Allergy Immunol. 2003 Mar;21(1):63-8.

Varicella infection in a pediatric AIDS patient presenting as umbilicated
papules.

Umpuchineewan J, Wananukul S, Sakulwira K, Poovoravan Y.

Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok,
Thailand.

An 8-year-old girl with acquired immunodeficiency syndrome presented with fever
and alteration of consciousness. She had a history of persistent cryptococcal
meningitis. She developed multiple discrete umbilicated papules that resembled
cutaneous cryptococcosis on the second day of admission. Skin biopsy revealed an 
ulcer with a wedge-shaped necrosis of the dermis. The edge of the ulcer showed
intracellular edema, margination of nucleoplasm and multinucleated cells,
consistent with herpes infection. The diagnosis of varicella-zoster virus
infection was confirmed by the identification of herpesvirus DNA from the lesion 
and differentiation from other herpesviruses by restriction fragment length
polymorphism (RFLP) method. Intravenous acyclovir was given at a dose of 500
mg/m2, three times daily for 14 days which resulted in resolution of the skin
lesions within 2 weeks.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12931753 [PubMed - indexed for MEDLINE]

2009: Rinsho Ketsueki. 2003 Jul;44(7):451-5.

[Successful treatment with foscarnet for disseminated varicella-zoster infection 
after reduced intensity stem cell transplantation in a case of relapsed
refractory central nervous system lymphoma]

[Article in Japanese]

Aoyama Y, Yamamura R, Shima E, Nakamae H, Makita K, Hasegawa T, Sakamoto C,
Terada Y, Kho G, Ohta K, Yamane T, Takubo T, Hino M.

Graduate School of Medicine, Osaka City University.

Visceral disseminated varicella-zoster virus (VZV) infection occurred with acute 
graft-versus-host disease in a 33-year-old Japanese male with non-Hodgkin
lymphoma who had undergone allogeneic stem cell transplantation from an
HLA-identical sibling after reduced intensity conditioning chemotherapy. Although
ganciclovir and acyclovir treatment was effective temporarily, the number of
VZV-DNA copies in the blood remained at a high level, and the hepatitis was
prolonged. The patient was treated with foscarnet, which led to improvement of
the VZV viremia and the hepatic dysfunction. Foscarnet therapy should be
considered for acyclovir-resistant VZV infection in the setting of allogeneic
hematopoietic stem cell transplantation.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12931563 [PubMed - indexed for MEDLINE]

2010: Br J Haematol. 2003 Sep;122(5):802-5.

Varicella-zoster virus infection in adult patients after unrelated cord blood
transplantation: a single institute experience in Japan.

Tomonari A, Iseki T, Takahashi S, Ooi J, Takasugi K, Shimohakamada Y, Ohno N,
Nagamura F, Uchimaru K, Tani K, Tojo A, Asano S.

Department of Hematology/Oncology, The Institute of Medical Science, The
University of Tokyo, Tokyo, Japan. atomonar@ims.u-tokyo.ac.jp

Varicella-zoster virus (VZV) infection was studied in 40 adult patients who
underwent cord blood transplantation (CBT) from unrelated donors. Twenty-five
patients developed VZV reactivation at a median of 5 months after CBT (range
1.7-26 months). The cumulative incidence of VZV reactivation after CBT was 80% at
30 months. Twenty-two patients developed localized herpes zoster. The remaining
three patients developed atypical non-localized herpes zoster, which was
associated with visceral dissemination in one patient. All the patients responded
well to antiviral therapy. Unexpectedly, the absence of grade II-IV acute
graft-versus-host disease (GVHD) was associated with a higher rate of VZV
reactivation after CBT (100% versus 55%, P=0.01). These results suggest that
recovery of VZV-specific immune responses after CBT is delayed even in patients
without severe acute GVHD.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12930392 [PubMed - indexed for MEDLINE]

2011: Natl Med J India. 2003 May-Jun;16(3):126-31.

The natural history of human immunodeficiency virus infection among adults in
Mumbai.

Hira SK, Shroff HJ, Lanjewar DN, Dholkia YN, Bhatia VP, Dupont HL.

AIDS Research and Control Centre (ARCON), Sir J.J. Hospital, Mumbai 400008,
Maharashtra, India. subhash_hira@hotmail.com

BACKGROUND: Natural history studies of untreated HIV infection are useful for
clinicians, public health experts and policymakers to improve and monitor care,
plan services and control, and to model the epidemic. Several natural history
studies on homosexual men and intravenous drug users have been published from
developed countries. A few studies have emerged on heterosexual populations from 
Africa. With an emerging epidemic, a similar study was required in India. This
study was designed to determine the progression of HIV disease in a prevalent
cohort of adult HIV-seropositive patients. METHODS: A prevalent cohort of 1009
patients comprising 488 asymptomatic HIV-seropositive persons, 259 with
AIDS-related complex (ARC), and 262 with acquired immunodeficiency syndrome
(AIDS) were recruited for the study at Sir J.J. Hospital, Mumbai. A case-control 
study was conducted to determine the correlation of clinical features and other
factors with disease progression. Disease progression was determined from the
asymptomatic stage to that of ARC and AIDS using time series analysis. The
incubation period from HIV to AIDS was also determined, using Weibull curves.
RESULTS: The median incubation periods for progression were: HIV to AIDS-7.9
years and ARC to AIDS--1.9 years. The median survival after developing AIDS was
19.2 months. A comparison of progressors and non-progressors revealed that
disease progression correlated with clinical features such as chronic fever (OR
5.6), persistent generalized lymphadenopathy (OR 4.7), persistent cough for >1
month (OR 3.5), chronic diarrhoea (OR 3.3), oral candidiasis (OR 3.2), >10% loss 
of body weight within 1 month (OR 2.9), incident tuberculosis (OR 2.8) and herpes
zoster (OR 2.5). The annual incidence of active clinical tuberculosis was 86/1503
person-years (5.7/ 100 person-years), the median time to occurrence of active
tuberculosis was 21.6 months and the annual incidence of mortality was 96/2009
person-years (4.8/100 person-years, 95% CI 3.4, 6.2). CONCLUSION: Progression to 
AIDS and death was faster among the heterosexual cohort in Mumbai than that
reported for homosexual men and haemophiliacs in the USA and Europe. Strategies
need to be developed to prevent the occurrence of tuberculosis among HIV-infected
patients because that would help to reduce the morbidity and mortality. This is
the first large study from the Indian subcontinent of a longitudinal follow up of
HIV-infected persons. The findings will be useful for advocacy and assessing the 
impact of antiretroviral therapy (ART) in India.

PMID: 12929853 [PubMed - indexed for MEDLINE]

2012: Graefes Arch Clin Exp Ophthalmol. 2003 Dec;241(12):982-7. Epub 2003 Aug 20.

Interferon gamma expression and clinical features in patients with acute retinal 
necrosis syndrome.

Abe T, Sato M, Saigo Y, Tamai M.

Department of Ophthalmology, School of Medicine, Tohoku University, Sendai,
980-8574 Miyagi, Japan. toshi@oph.med.tohoku.ac.jp

BACKGROUND: Interferon gamma (IFN-gamma) has been reported to play an important
role during virus infections. The purpose of this study was to examine the
relationship between IFN-gamma expression and the clinical course of patients
with acute retinal necrosis syndrome (ARN) associated with the varicella-zoster
virus (VZV). METHODS: Six patients with ARN were studied. The aqueous and/or
vitreous were examined by reverse transcriptase-polymerase chain reaction
(RT-PCR) and enzyme-linked immunosorbent assay during the follow-up period. The
presence of VZV genome was also determined by PCR. The results were correlated
with the clinical data and features and compared with patients with other ocular 
diseases. RESULTS: A statistically significant higher level of IFN-gamma was
detected in the aqueous and/or vitreous in eyes with ARN than in eyes with other 
ocular diseases. A statistically significant positive correlation was observed
between the level of IFN-gamma in the vitreous and the final visual acuity.
IFN-gamma was reduced to undetectable levels within 30 days after the initial eye
symptoms. Three of five patients had severe inflammation initially, and the
visual acuity gradually recovered with the disappearance of VZV and higher levels
of IFN-gamma. Conversely, the other 2 patients showed mild inflammation, had a
slow decrease of visual acuity with persistent VZV, and lower levels of IFN-gamma
expression. CONCLUSION: Our results suggest that IFN-gamma may be one of the
factors that plays an important role in the clinical course of VZV-associated
ARN.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12928903 [PubMed - indexed for MEDLINE]

2013: J Clin Virol. 2003 Sep;28(1):104-10.

Genomic analysis of varicella-zoster virus: primers for individual open reading
frames.

Wagenaar TR, Grose C, Loparev VN, Schmid DS, Breuer J.

Departments of Microbiology and Pediatrics, University of Iowa Hospital/2501 JCP,
200 Hawkins Drive, Iowa City, IA 52242, USA.

The genome of varicella-zoster virus (VZV) contains nearly 125,000 bp.
Preliminary genomic analysis has revealed that VZV may be less immutable than
once thought. Through the investigation of the VZV genome using specifically
designed oligonucleotides, it has been learned that sequence variation within VZV
open reading frame 62 can distinguish between vaccine and wild-type virus.
Additionally, the presence of single nucleotide polymorphisms within the VZV
genome has identified distinct VZV populations originating from circumscribed
geographic locations. In order for future studies of VZV genetic diversity to be 
carried out, amplifying and sequencing primers for individual VZV genes have been
catalogued. Additionally, this report will facilitate the selection of VZV
primers by which to distinguish clinical VZV isolates from vaccinia virus
isolates.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12927757 [PubMed - indexed for MEDLINE]

2014: Acta Derm Venereol. 2003;83(4):298-9.

Pneumothorax secondary to ipsilateral herpes zoster pectoralis.

Park SW, Kang SH, Lee D, Wang HY, Sung HS.

Publication Types: 
    Case Reports
    Letter

PMID: 12926807 [PubMed - indexed for MEDLINE]

2015: ORL J Otorhinolaryngol Relat Spec. 2003 May-Jun;65(3):162-8.

Detection of viral DNA in the endolymphatic sac in Meniere's disease by in situ
hybridization.

Yazawa Y, Suzuki M, Hanamitsu M, Kimura H, Tooyama I.

Department of Otolaryngology, Shiga University of Medical Science, Seta, Otsu,
Shiga 520-2192, Japan. yazawa@belle.shiga-med.ac.jp

The main purpose of this study is to search for a viral etiology in Meniere's
disease by examining the presence or absence of herpes family virus DNA in the
endolymphatic sac (ES) using the in situ hybridization method. This was a
prospective study with the ES from 10 patients with Meniere's disease and from 7 
control cases without any pre-mortem ear diseases except a case of acoustic
tumor. These 10 patients underwent the ES surgery. The presence of herpes family 
virus DNA, such as herpes simplex virus types 1 and 2 (HSV1&2), varicella-zoster 
virus (VZV), Epstein-Barr virus (EBV) and human cytomegalovirus (CMV), was
examined using the in situ hybridization method. Serum antibody titers against
these viruses just before the ES surgery were studied in these patients. Of the
10 specimens from the patients with Meniere's disease, 7 were positive for VZV, 4
for EBV, 1 for CMV and none for HSV1&2, although the serum antibody titers
against these viruses did not show any significant elevation in these patients
just before the ES surgery. This result suggests that the viral DNA in the ES is 
inactive and is present in a latent form. From the statistical analysis, it can
be postulated that VZV infection in early childhood may reach the ES and play a
role in the pathogenesis of Meniere's disease (p = 0.0235). The double infection 
with both VZV and EBV tended to be another candidate for the pathogenesis of
Meniere's disease (p = 0.0557). Copyright 2003 S. Karger AG, Basel

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12925817 [PubMed - indexed for MEDLINE]

2016: CNS Drugs. 2003;17(11):771-80.

Pharmacological management of postherpetic neuralgia.

Pappagallo M, Haldey EJ.

Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New 
York, NY, USA.

Postherpetic neuralgia, which occurs most typically in older persons, is one of
the most common and serious complications of herpes zoster (or shingles). It is a
chronic neuropathic pain syndrome and remains one of the most difficult pain
disorders to treat. Known beneficial agents include antidepressants,
antiepileptic drugs, opioid analgesics, local anaesthetics, capsaicin and other, 
less applied, modalities. Although monotherapy is commonly applied, no single
best treatment for postherpetic neuralgia has been identified; nevertheless,
gabapentin (antiepileptic) and transdermal lidocaine (anaesthetic) are often used
as the first-choice treatments. Recent research has shed light on possible pain
mechanisms as well as new avenues of treatment, which are discussed in the
article. For patients with pain that is not adequately controlled, individualised
treatment plans must be pursued. It is critical to recognise that postherpetic
neuralgia, while difficult to manage, can be a treatable neuropathic pain
syndrome.

Publication Types: 
    Review

PMID: 12921490 [PubMed - indexed for MEDLINE]

2017: J Occup Environ Med. 2003 Aug;45(8):857-68.

Exposure to animals and selected risk factors among Canadian farm residents with 
Hodgkin's disease, multiple myeloma, or soft tissue sarcoma.

Pahwa P, McDuffie HH, Dosman JA, Robson D, McLaughlin JR, Spinelli JJ, Fincham S.

Institute of Agricultural Rural and Environmental Health, Saskatchewan Cancer
Agency, Saskatoon SK S7N 0W8, Canada.

Exposures to farm animals has been associated with certain rare cancers.
Simultaneously, using the same methodology and control group, we conducted a
six-province incident, population-based study of Hodgkin's disease (HD), multiple
myeloma (MM), and soft tissue sarcoma (STS). Farm residence or work was reported 
by 38% (n = 119) of HD, 45% (n = 178) of MM, 43% (n = 156) of STS cases and 45%
(n = 673) of controls. We conducted conditional logistic regression analyses and 
report odds ratios (OR(adj)) and 95% confidence intervals. After adjustment for
covariates, exposure to farm animals had minimal effect on risk. The independent 
risk factors after adjustment for covariates were a family history of cancer (MM,
STS), occupational uranium exposure (HD), professional driving (MM), and personal
previous cancer (MM) or shingles (HD, MM).

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 12915787 [PubMed - indexed for MEDLINE]

2018: Arch Ophthalmol. 2003 Aug;121(8):1189-93.

Microsurgical approach to the conjunctival flap.

Khodadoust A, Quinter AP.

Connecticut Eyecare Center, New Haven, CT 06519, USA.

OBJECTIVES: To describe a microsurgical approach to a selective pedunculated
conjunctival flap for the treatment of chronic corneal ulceration with or without
corneal perforation, and to present the results of 50 consecutive cases. DESIGN: 
Retrospective, noncomparative case series and case reports.Patients All patients 
who had microsurgical conjunctival flap procedures for the treatment of chronic
corneal ulcers between 1982 and 1996 at the Connecticut Eyecare Center, New
Haven. INTERVENTIONS: Partial pedunculated conjunctival flap surgery. METHODS:
Review of the initial ocular diagnoses and characteristics as well as
retrospective study of the postoperative course. MAIN OUTCOME MEASURES:
Resolution of the corneal ulcer and postoperative stability of the conjunctival
flap. RESULTS: Sixty-two percent of the corneal ulcers treated were
nonperforated, and 38% were perforated. The diagnoses included herpes simplex
virus (14 patients), bacterial ulcer (11 patients), rheumatoid arthritis (8
patients), aphakic bullous keratopathy (6 patients), graft rejection (4
patients), herpes zoster virus (5 patients), and other (2 patients).
Postoperatively, 94% of the conjunctival flaps were stable, and 3% had failed.
The procedures were definitive in 64% of cases and temporary in 36%; 61% of
patients received a corneal transplant 6 to 24 months postoperatively, and in 38%
the flaps were removed 6 to 12 months after the original lesion had healed.
CONCLUSION: A selective pedunculated conjunctival flap is an effective and
practical surgical approach to the treatment of perforated and nonperforated
corneal ulcers that have not responded to other types of medical therapy.

Publication Types: 
    Case Reports

PMID: 12912699 [PubMed - indexed for MEDLINE]

2019: Neurol Neurochir Pol. 2003 Jan-Feb;37(1):243-9.

[Guillain-Barre syndrome following Herpes zoster infection]

[Article in Polish]

Kochanowski J, Stepniak I, Dolinska E.

II Kliniki Neurologii Akademii Medycznej w Warszawie.

A male patient with a bi-phasic Guillain-Barre syndrome is presented in the
paper. Initially a paralysis of his left lower extremity was observed, with
hypotonia and removal of deep reflexes, followed by a flaccid paralysis of the
remaining extremities. This syndrome had been preceded by a Herpes zoster
infection producing symptoms in the left shank and foot. The paresis of his left 
lower extremity had been increasing during the week before his admission, while
the paralysis of the other extremities occurred not earlier than by the end of
the second week of his hospitalization. The diagnosis of the Guillain-Barre
syndrome was based on the clinical course of the disease, and results of EMG
examination and of general laboratory tests of his cerebrospinal fluid.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 12910845 [PubMed - indexed for MEDLINE]

2020: Przegl Epidemiol. 2003;57(2):289-97.

[Clinical picture of Herpesviridae infections among immunocompromised patients:
bone marrow and solid organ transplants recipients]

[Article in Polish]

Simon K, Dziemianko I.

Katedra i Klinika Chorob Zakaznych AM we Wroclawiu.

The human herpes virus (HHV) family (herpesviridae) are large DNA viruses
containing eight important, ubiquitous human pathogens. This group of viruses
encompasses: herpes simplex virus (HSV types 1 and 2), varicella-zoster virus
(VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6, HHV-7 (cause
roseola or exanthema subitum in children) and Kaposi sarcoma herpes
virus--(KSHV). The outstanding property of herpes viruses is lifelong persistence
of infection and potential periodic reactivation, particularly often among
immunocompromised patients. Herpesvirus infections are associated with a wide
spectrum of diseases ranging from local ulceration to serious systemic illnessess
or malignancies. These infections are one of the major cause of morbidity and
mortality in the immunocompromised patients.

Publication Types: 
    English Abstract

PMID: 12910597 [PubMed - indexed for MEDLINE]

2021: Man Ther. 2003 Aug;8(3):180-4.

Post-herpetic neuralgia: possible mechanisms for pain relief with manual therapy.

Rabey MI.

Fulham Physiotherapy, Swan Mews, Parsons Green Lane, SW6 4QT, London, UK.
m.rabey@btinternet.com

Publication Types: 
    Case Reports

PMID: 12909440 [PubMed - indexed for MEDLINE]

2022: Brain Res Bull. 2003 Aug 15;61(3):299-308.

Clinical relevance of polymerase chain reaction (PCR) assays and antigen-driven
immunoblots for the diagnosis of neurological infectious diseases.

Sindic CJ, Van Antwerpen MP, Goffette S.

Laboratoire de Neurochimie, Universite Catholique de Louvain, 1200 Brussels,
Belgium. sindic@nchm.ucl.ac.be

Polymerase chain reaction assays are a powerful tool for detecting the presence
of infectious genomes in the cerebrospinal fluid. Positive results always mean a 
current or pending infection of the central nervous system. Subacute (>7 days) or
chronic infections induce an intrathecal humoral immune response and the
appearance of oligoclonal IgG antibodies directed against the causal infectious
agent. This local synthesis may be observed even in cases of severe systemic
immunodeficiency. The use of polymerase chain reactions in combination with the
detection of a specific intrathecal immune response should represent the most
reliable strategy for the diagnosis of viral and chronic infections of the
central nervous system. The authors describe their experience, using this
approach, in herpetic encephalitis, acute and recurrent herpetic meningitis,
varicella zoster-induced neurological diseases, cytomegalovirus encephalitis,
progressive multifocal leukoencephalitis and tuberculous meningitis.

PMID: 12909300 [PubMed - indexed for MEDLINE]

2023: J Anesth. 2003;17(1):57-8.

Postherpetic neuralgia as a risk factor for classic heatstroke.

Sekiyama H, Sumida T, Hayashida M, Chinzei M, Ide Y, Arita H, Hanaoka K.

Department of Anesthesiology and Pain Relief Center, Faculty of Medicine,
University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Publication Types: 
    Case Reports

PMID: 12908690 [PubMed - indexed for MEDLINE]

2024: J Clin Microbiol. 2003 Aug;41(8):3835-9.

Real-time PCR assay to detect smallpox virus.

Sofi Ibrahim M, Kulesh DA, Saleh SS, Damon IK, Esposito JJ, Schmaljohn AL,
Jahrling PB.

The United States Army Medical Research Institute of Infectious Diseases, Fort
Detrick, Maryland 21702, USA. Sofi.Ibrahim@det.amedd.army.mil

We developed a highly sensitive and specific assay for the rapid detection of
smallpox virus DNA on both the Smart Cycler and LightCycler platforms. The assay 
is based on TaqMan chemistry with the orthopoxvirus hemagglutinin gene used as
the target sequence. With genomic DNA purified from variola virus Bangladesh
1975, the limit of detection was estimated to be approximately 25 copies on both 
machines. The assay was evaluated in a blinded study with 322 coded samples that 
included genomic DNA from 48 different isolates of variola virus; 25 different
strains and isolates of camelpox, cowpox, ectromelia, gerbilpox, herpes,
monkeypox, myxoma, rabbitpox, raccoonpox, skunkpox, vaccinia, and
varicella-zoster viruses; and two rickettsial species at concentrations mostly
ranging from 100 fg/ microl to 1 ng/ microl. Contained within those 322 samples
were variola virus DNA, obtained from purified viral preparations, at
concentrations of 1 fg/ microl to 1 ng/ microl. On the Smart Cycler platform, 2
samples with false-positive results were detected among the 116 samples not
containing variola virus tested; i.e., the overall specificity of the assay was
98.3%. On the LightCycler platform, five samples with false-positive results were
detected (overall specificity, 95.7%). Of the 206 samples that contained variola 
virus DNA ranging in concentrations from 100 fg/ microl to 1 ng/ microl, 8
samples were considered negative on the Smart Cycler platform and 1 sample was
considered negative on the LightCycler platform. Thus, the clinical sensitivities
were 96.1% for the Smart Cycler instrument and 99.5% for the LightCycler
instrument. The vast majority of these samples were derived from virus-infected
cell cultures and variola virus-infected tissues; thus, the DNA material
contained both viral DNA and cellular DNA. Of the 43 samples that contained
purified variola virus DNA ranging in concentration from 1 fg/ microl to 1 ng/
microl, the assay correctly detected the virus in all 43 samples on both the
Smart Cycler and the LightCycler platforms. The assay may be useful for the early
detection of smallpox virus infections should such infections occur as a result
of a deliberate or an accidental recurrence.

PMID: 12904397 [PubMed - indexed for MEDLINE]

2025: Sex Transm Infect. 2003 Aug;79(4):298-300.

Detection of varicella zoster virus in genital specimens using a multiplex
polymerase chain reaction.

Birch CJ, Druce JD, Catton MC, MacGregor L, Read T.

Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia.
chris.birch@mh.org.au

OBJECTIVE: To compare the relative proportions of varicella zoster virus (VZV)
and herpes simplex viruses in specimens obtained from the genital lesions of
adults presenting with presumed genital herpes infection. METHODS: Swabs of
genital lesions from 6210 patients attending general practices, infectious
diseases clinics within hospitals, or sexual health centres for treatment of
their genital lesions were tested using polymerase chain reaction (PCR)
technology. The multiplexed PCR was capable of detecting herpes simplex virus
types 1 and 2 (HSV-1, HSV-2), VZV, and cytomegalovirus in a single sample.
RESULTS: A total of 2225 patients had viruses detected by PCR. HSV-1 was detected
in 36%, HSV-2 in 61%, and VZV in 2.9% of PCR positive samples. Of the 65 patients
with VZV genital infection, many were thought to have HSV infection before
laboratory testing. CONCLUSIONS: The finding of VZV in nearly 3% of virus
positive genital specimens demonstrates that this virus needs to be considered as
a differential diagnosis for genital herpetic lesions. Advice provided to
patients with VZV genital infection regarding the source of infection, likelihood
of recurrence, and potential for transmission of the virus will be different from
that given to patients with HSV infection.

Publication Types: 
    Comparative Study

PMID: 12902579 [PubMed - indexed for MEDLINE]

2026: Antiviral Res. 2003 Jul;59(2):73-87.

DNA encapsidation as a target for anti-herpesvirus drug therapy.

Visalli RJ, van Zeijl M.

Department of Viral Vaccine Research, Wyeth, Pearl River, NY 10965, USA.
vissalir@IPFW.edu

The current repertoire of approved anti-herpesviral drugs consists primarily of
nucleoside analogues that inhibit viral replication by targeting the
virus-encoded DNA polymerase. This class of agents has been critical in
controlling infections by herpes simplex, varicella zoster, and cytomegalovirus. 
However, because nucleoside analogues share a similar mechanism of action,
treatment options are limited once resistance develops. This becomes an important
medical issue with respect to the treatment of disease caused by resistant viral 
strains, particularly in immunocompromised individuals. Furthermore, several of
the currently available therapies can result in mild to severe side effects
making the discovery of less toxic drugs desirable. Efforts over the last decade 
have focused on the identification and development of improved therapies
including less toxic compounds with novel mechanisms of action. Here we review
the progress that has been made in targeting the DNA packaging and encapsidation 
process as a novel target for chemotherapy. Several recently identified compounds
may warrant further development as a medically important group of herpesviral
encapsidation inhibitors.

Publication Types: 
    Review

PMID: 12895691 [PubMed - indexed for MEDLINE]

2027: Anticancer Res. 2003 May-Jun;23(3A):2063-9.

Varicella zoster virus transcription in latently-infected human ganglia.

Cohrs RJ, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, 4200 E.
9th Avenue, Mail Stop B182, Denver, Colorado 80262, USA.

Varicella zoster virus (VZV) causes childhood chickenpox, becomes latent in
cranial, dorsal root and autonomic ganglia, and can reactivate decades later to
cause shingles and other serious neurological complications. Herein, we summarize
investigations conducted over the past decade that have identified virus genes
expressed in latently-infected human ganglia. A model of VZV gene regulation
during latent infection was tested and future directions in the study of VZV
latency are discussed.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 12894579 [PubMed - indexed for MEDLINE]

2028: Can J Urol. 2003 Jun;10(3):1912-3.

Comment in:
    Can J Urol. 2004 Aug;11(4):2314; discussion 2314.

Herpes zoster infection: a rare cause of acute urinary retention.

Chan JE, Kapoor A.

Department of Surgery (Urology), St. Joseph's Hospital, McMaster University,
Hamilton, Ontario, Canada.

Herpes zoster (HZ) infection has been reported as a rare cause of acute urinary
retention. HZ infection involving sacral, thoracolumbar, and rarely high thoracic
dermatomes is believed to occasionally cause motor and sensory neuropathy of the 
bladder. This is specifically achieved by the interruption of the detrusor reflex
causing subsequent bladder atonia. As the course and management of this entity is
quite benign, HZ should remain a diagnostic consideration in the management of
urinary retention. We report a case of acute urinary retention of approximately
2.5 liters associated with HZ infection and review the proposed pathogenesis and 
therapeutic considerations in the management of this entity.

Publication Types: 
    Case Reports

PMID: 12892580 [PubMed - indexed for MEDLINE]

2029: Comp Biochem Physiol A Mol Integr Physiol. 2003 Aug;135(4):515-26.

Sub-lethal plasma ammonia accumulation and the exercise performance of salmonids.

McKenzie DJ, Shingles A, Taylor EW.

School of Biosciences, University of Birmingham, Birmingham, B15 2TT, UK.
david.mckenzie@ifremer.fr

The proposal that plasma ammonia accumulation might impair the swimming
performance of fish was first made over a decade ago, and has now proven to be
the case for a number of salmonid species. The first experimental evidence was
indirect, when a negative linear relationship between plasma ammonia
concentrations and maximum sustainable swimming speed (U(crit)) was found
following the exposure of brown trout (Salmo trutta) to sub-lethal concentrations
of copper in soft acidic water. Since then, negative linear relationships between
plasma ammonia concentration and U(crit) have been demonstrated following
exposure of brown trout, rainbow trout (Oncorhynchus mykiss) and coho salmon
(Oncorhynchus kisutch) to elevated water ammonia. For brown trout, the
relationships between plasma ammonia and U(crit) were remarkably similar
following either exposure to elevated water ammonia or to sub-lethal copper. This
indicates that the impairment of swimming performance resulting from exposure to 
sub-lethal concentrations of heavy metals may be attributable in large part to an
accumulation of endogenous ammonia. The negative relationship between plasma
ammonia concentration and U(crit) was similar in size-matched rainbow and brown
trout but, under similar regimes of ammonia exposure, rainbow trout were able to 
maintain a significantly lower plasma ammonia concentration, revealing
inter-specific differences in ammonia permeability and/or transport. One primary 
mechanism by which ammonia accumulation may impair exercise performance is a
partial depolarisation of membrane potential in tissues such as the brain and
white muscle. This may prejudice the co-ordination of swimming movements and
reduce or abolish the development of muscle tension, thus, compromising swimming 
efficiency and performance at the top end of the range.

Publication Types: 
    Review

PMID: 12890542 [PubMed - indexed for MEDLINE]

2030: Mov Disord. 2003 Aug;18(8):942-8.

Unique form of propriospinal myoclonus as a possible complication of an
enteropathogenic toxin.

Espay AJ, Ashby P, Hanajima R, Jog MS, Lang AE.

Department of Medicine, Division of Neurology, The Toronto Western Hospital,
University of Toronto, Toronto, Ontario, Canada.

Propriospinal myoclonus is an uncommon form of spinal myoclonus propagated,
presumably, by slowly conducting polysynaptic intraspinal pathways. Although most
patients demonstrate no clear etiology, a variety of disorders have been linked
to this abnormal movement, including trauma, multiple sclerosis, tumors, and
infectious disorders such as herpes zoster, human immunodeficiency virus, and
Lyme disease. We describe 2 young male patients from the same town in Northern
Ontario, Canada, exposed to an outbreak of Escherichia coli O157:H7 from
contaminated municipal water, who developed identical clinical and
electrophysiological features suggestive of a rhythmic form of propriospinal
myoclonus with activity alternating between abdominal and paraspinal muscles. A
toxin-mediated microvascular thrombosis is proposed as a possible pathogenic
mechanism underlying this novel association. Copyright 2003 Movement Disorder
Society

Publication Types: 
    Case Reports

PMID: 12889087 [PubMed - indexed for MEDLINE]

2031: Int J Neurosci. 2003 Aug;113(8):1081-6.

Cell-mediated immune hypersensitivity is stronger on noninvolved side than
involved side in patients with herpes zoster.

Erdem T, Dane S, Kadi M.

Department of Dermatology, Medical Faculty, Ataturk University, Erzurum, Turkey.

The difference between involved and noninvolved sides of the body in
cell-mediated immunity was investigated in this work; tuberculin reactions in two
forearms were assessed in men and women with herpes zoster. The tuberculin
reaction was smaller on the involved side than in the noninvolved side of the
body in total sample, men and women. The results suggested that the lower
activity of cell-mediated immune system in one side of the body may be related to
the unilateral involvement of the zona-zoster infection.

Publication Types: 
    Comparative Study

PMID: 12888422 [PubMed - indexed for MEDLINE]

2032: Am J Ophthalmol. 2003 Aug;136(2):343-52.

Ocular complications of smallpox vaccination.

Pepose JS, Margolis TP, LaRussa P, Pavan-Langston D.

Pepose Vision Institute, Chesterfield, Missouri 63017, USA.

PURPOSE: To describe the ocular complications of smallpox vaccination and to
discuss potential therapeutic options. DESIGN: Review of pertinent medical
literature and recent treatment recommendations of the Centers for Disease
Control and Prevention. RESULTS: After immunization against smallpox, vaccinia
infection of the eyelid, conjunctiva, or ocular surface can result from
accidental autoinoculation from a vaccination site before scab formation or from 
contact with a recently vaccinated individual. While uncommon, corneal
involvement can lead to stromal opacification and scarring. Clinical findings of 
ocular and periocular vaccinia must be differentiated from those produced by
other pathogens such as molluscum contagiosum, herpes simplex, varicella zoster, 
and acanthamoeba infections. Clinical diagnosis can be confirmed by electron
microscopy to identify the presence of orthopoxvirus, as well as by virologic
culture, polymerase chain reaction, and/or restriction endonuclease analysis of
viral isolates. CONCLUSIONS: While the majority of ocular complications of
smallpox vaccination in immunocompetent patients are self-limiting, selective
cases may require treatment with trifluridine drops, topical corticosteroids and 
vaccinia immune globulin (VIG). Vaccinia virus does not appear to be sensitive to
acyclovir. Specific treatment recommendations are outlined for the spectrum of
ocular manifestations.

Publication Types: 
    Historical Article
    Research Support, Non-U.S. Gov't
    Review

PMID: 12888060 [PubMed - indexed for MEDLINE]

2033: Trans R Soc Trop Med Hyg. 2003 Jan-Feb;97(1):91-6.

Prevalence and indicators of HIV and AIDS among adults admitted to medical and
surgical wards in Blantyre, Malawi.

Lewis DK, Callaghan M, Phiri K, Chipwete J, Kublin JG, Borgstein E, Zijlstra EE.

Department of Medicine, University of Malawi College of Medicine, Private Bag
360, Chichiri, Blantyre 3, Malawi.

Despite high seroprevalence there are few recent studies of the effect of human
immunodeficiency virus (HIV) on hospitals in sub-Saharan Africa. We examined 1226
consecutive patients admitted to medical and surgical wards in Blantyre, Malawi
during two 2-week periods in October 1999 and January 2000: 70% of medical
patients were HIV-positive and 45% had acquired immune deficiency syndrome
(AIDS); 36% of surgical patients were HIV-positive and 8% had AIDS.
Seroprevalence rose to a peak among 30-40 year olds; 91% of medical, 56% of
surgical and 80% of all patients in this age group were HIV-positive.
Seropositive women were younger than seropositive men (median age 29 vs. 35
years, P < 0.0001). Symptoms strongly indicative of HIV were history of shingles,
chronic diarrhoea or fever or cough, history of tuberculosis (TB), weight loss
and persistent itchy rash (adjusted odds ratios [AORs] all > 5). Clinical signs
strongly indicative of HIV were oral hairy leukoplakia, shingles scar, Kaposi's
sarcoma, oral thrush and hair loss (AORs all > 10). Of surgical patients with
'deep infections' (breast abscess, pyomyositis, osteomyelitis, septic arthritis
and multiple abscesses), 52% were HIV-positive (OR compared with other surgical
patients = 2.4). Severe bacterial infections, TB and AIDS caused 68% of deaths.
HIV dominates adult medicine, is a major part of adult surgery, is the main cause
of death in hospital and affects the economically active age group of the
population.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12886812 [PubMed - indexed for MEDLINE]

2034: An Sist Sanit Navar. 2000 Sep-Dec;23(3):517-9.

[Herpes zoster and post-infection sequels to maternal chicken pox. One case]

[Article in Spanish]

Alcalde S, Salvador A.

Servicio de Pediatria, Centro de Salud Casco Viejo, C/ Compania, 8, 31001
Pamplona.

PMID: 12886304 [PubMed]

2035: Am J Surg. 2003 Aug;186(2):148.

Postherpetic self-limited abdominal wall herniation.

Safadi BY.

Department of Surgery, Stanford University, VA Palo Alto HCS, 3801 Miranda Ave., 
112G, Palo Alto, CA 94304, USA. Bassem.safadi@med.va.gov

Publication Types: 
    Case Reports

PMID: 12885607 [PubMed - indexed for MEDLINE]

2036: Transplantation. 2003 Jul 27;76(2):364-70.

Long-term improvement in renal function with sirolimus after early cyclosporine
withdrawal in renal transplant recipients: 2-year results of the Rapamune
Maintenance Regimen Study.

Oberbauer R, Kreis H, Johnson RW, Mota A, Claesson K, Ruiz JC, Wilczek H,
Jamieson N, Henriques AC, Paczek L, Chapman J, Burke JT; Rapamune Maintenance
Regimen Study Group.

Innere Medizin III-Nephrologie, Allgemeines Krankenhaus, Vienna, Austria.
rainer.oberbauer@akh-wien.ac.at.

INTRODUCTION: The purpose of this study was to evaluate early cyclosporine (CsA) 
withdrawal from a sirolimus (SRL)-CsA-steroid (ST) regimen. METHODS: Within 48 hr
after transplantation, 525 primary (90%) or secondary (10%) renal allograft
recipients with cadaveric (89%) or living (11%) donors received 2 mg of SRL
(troughs >5 ng/mL; immunoassay), CsA, and ST. Those eligible (430) were randomly 
assigned (1:1) at 3 months +/- 2 weeks to remain on triple-drug therapy
(SRL-CsA-ST group) or to have CsA withdrawn and SRL trough concentrations
targeted to 20 to 30 ng/mL (SRL-ST group) until month 12, and 15 to 25 ng/mL
thereafter. RESULTS: At 24 months, there were no statistically significant
differences in patient survival (94.0% vs. 95.3%), graft survival (91.2% vs.
93.5%), acute rejection after randomization (5.1% vs. 9.8%) or discontinuations
(34% vs. 33%) for SRL-CsA-ST versus SRL-ST, respectively. Serum creatinine level 
was significantly better in patients who had CsA withdrawn (167 vs. 128
micromol/L, P<0.001), as was the slope of 1/creatinine. Similarly, systolic blood
pressure was lower in patients who had CsA withdrawn (141 vs. 134 mm Hg,
P<0.001). High-density lipoprotein cholesterol was significantly higher in the
SRL-ST group, whereas total cholesterol, low-density lipoprotein cholesterol, and
triglyceride levels were not significantly different. Hypertension, creatinine
increase, abnormal kidney function, toxic nephropathy, edema, hyperuricemia,
cataracts, Herpes zoster, and malignancy were reported significantly more often
in patients continuing CsA. Thrombocytopenia, hypokalemia, abnormal liver
function tests, abnormal wound healing, ileus, and pneumonia were reported
significantly more frequently with SRL-ST. CONCLUSION: Data at 2 years confirm
that early CsA withdrawal followed by an SRL-ST maintenance regimen results in
long-term improvement in both renal function and blood pressure, without
increased risk of graft loss or late acute rejection.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 12883194 [PubMed - indexed for MEDLINE]

2037: Transpl Int. 2003 Nov;16(11):820-7. Epub 2003 Jul 22.

Calcineurin inhibitor-free immunosuppression based on antithymocyte globulin and 
mycophenolate mofetil in cadaveric kidney transplantation: results after 5 years.

Grinyo JM, Gil-Vernet S, Cruzado JM, Caldes A, Riera L, Seron D, Rama I, Torras
J.

Nephrology Department, Hospital of Bellvitge, CSUB, Feixa Llarga s/n,
L'Hospitalet de Llobregat, 08907, Barcelona, Spain. grinyo@ibernet.com

Kidney grafts from suboptimal donors are more likely to suffer the nephrotoxic
side-effects of cyclosporine than kidneys from standard donors. In an attempt to 
avoid the use of cyclosporine, we carried out a prospective study in
low-immunological risk recipients of suboptimal kidneys, using an
immunosuppressive protocol combining Thymoglobuline in induction with a
bi-therapy of mycophenolate mofetil (MMF) and steroids. Patients with panel
reactive antibodies (PRA) <50% receiving a first renal transplant from a
suboptimal donor (age >or=50, non heart beating, arterial hypertension, or acute 
renal failure) or a kidney at risk of delayed graft function (DGF) because of a
prolonged cold ischaemia time (CIT) of 24 h or more, were eligible for this
trial. Between September 1996 and December 1999, 30 patients were enrolled for
the trial and treated with MMF 2 g orally, pre-operatively, and 3 g daily,
post-operatively; Thymoglobuline 2 mg/kg IV pre-operatively, 1.5 mg/kg IV the
next day, and for doses of 1 mg/kg IV given on alternate days; and prednisolone
0.25 mg/kg per day, reduced progressively from the end of the first month to 0.1 
mg/kg per day by 3 months post-transplant. Cyclosporine was added only if
rejection grade II or higher, or a reduction in MMF below 1 g daily, occurred.
Ten patients (30%) suffered from DGF, and one kidney suffered primary non
function. Seven patients (24%) suffered acute rejection (six were biopsy proven, 
3 grade I and 3 grade II). MMF dosage was reduced in 28 patients because of
adverse events, and calcineurin inhibitors were introduced in 16 patients. There 
were 14 episodes of opportunistic infection (cytomegalovirus (CMV 10), Herpes
zoster 2, Listeria monocytogenes 1, Pseudomonas aeuruginosa 1), and 7
malignancies (skin 2, thyroid 1, lung 1, Kaposi's sarcoma 2, post-transplantation
lymphoproliferative disorder 1). Mean serum creatinine was 178, 199, 213, and 218
micromol/l at 1, 2, 3 and 5 years after transplantation, respectively. Actuarial 
patient and graft (after censoring for death) survival was 94% and 83% after 1
year and 79% and 65% after 5 years, respectively. These results show that with
the combination of MMF, Thymoglobuline and steroids the use of cyclosporine can
be delayed, and in a few cases completely avoided, with good efficacy in terms of
prevention of rejection and recovery of renal function. Regardless of acceptable 
patient and graft survival, side-effects of MMF at the doses used in this
protocol were common and led to overimmunosuppression in the long-term. Starting 
MMF at low dose, MPA monitoring and probably CMV prophylaxis may improve the
results of this regimen.

Publication Types: 
    Clinical Trial

PMID: 12879230 [PubMed - indexed for MEDLINE]

2038: J Clin Virol. 2003 Aug;27(3):308-9.

Comment on:
    J Clin Virol. 2003 Apr;26(3):277-89; discussion 291-3.

Herpes zoster guidelines of the German Dermatological Society.

Gross G, Doerr HW.

Publication Types: 
    Comment
    Letter

PMID: 12878095 [PubMed - indexed for MEDLINE]

2039: Chemosphere. 2003 Sep;52(10):1727-41.

The contribution of particles washed from rooftops to contaminant loading to
urban streams.

Van Metre PC, Mahler BJ.

US Geological Survey, Research and Investigations, 8027 Exchange Dr., Austin, TX 
78754-3898, USA. pcvanmet@usgs.gov

Rooftops are both a source of and a pathway for contaminated runoff in urban
environments. To investigate the importance of particle-associated contamination 
in rooftop runoff, particles washed from asphalt shingle and galvanized metal
roofs at sites 12 and 102 m from a major expressway were analyzed for major and
trace elements and PAHs. Concentrations and yields from rooftops were compared
among locations and roofing material types and to loads monitored during runoff
events in the receiving urban stream to evaluate rooftop sources and their
potential contribution to stream loading. Concentrations of zinc, lead, pyrene,
and chrysene on a mass per mass basis in a majority of rooftop samples exceeded
established sediment quality guidelines for probable toxicity of bed sediments to
benthic biota. Fallout near the expressway was greater than farther away, as
indicated by larger yields of all contaminants investigated, although some
concentrations were lower. Metal roofing was a source of cadmium and zinc and
asphalt shingles a source of lead. The contribution of rooftop washoff to
watershed loading was estimated to range from 6 percent for chromium and arsenic 
to 55 percent for zinc. Estimated contributions from roofing material to total
watershed load were greatest for zinc and lead, contributing about 20 and 18
percent, respectively. The contribution from atmospheric deposition of particles 
onto rooftops to total watershed loads in stormwater was estimated to be greatest
for mercury, contributing about 46 percent.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 12871740 [PubMed - indexed for MEDLINE]

2040: Pediatr Dermatol. 2003 Jul-Aug;20(4):289-94.

Mucocutaneous findings in pediatric AIDS related to degree of immunosuppression.

Wananukul S, Deekajorndech T, Panchareon C, Thisyakorn U.

Department of Pediatrics, Chulalongkorn University, Bangkok, Thailand.
wananusw@hotmail.com

The normal value of the absolute CD4-positive T-lymphocyte count is relatively
high in normal infants and declines steadily until 6 years of age, whereas the
CD4 percentage of the total lymphocyte count is constant. The immunologic
categories according to the 1994 revised pediatric human immunodeficiency virus
(HIV) classification, based on CD4-positive percentage of the total lymphocyte
count, is classified into three categories: no evidence of suppression (> or
=25%), moderate suppression (15-24%), and severe suppression (1-14%). Our
objective was to determine the prevalence of mucocutaneous findings in pediatric 
acquired immunodeficiency syndrome (AIDS) related to the degree of
immunosuppression. We prospectively examined 120 children less than 13 years of
age who were born to HIV-seropositive women and developed definite HIV infection.
The prevalence of mucocutaneous findings in those children who had severe,
moderate, and no evidence of immunosuppression were 62%, 43%, and 20%,
respectively. The mucocutaneous findings in patients in the moderate and severe
suppression groups were significantly more common than in patients without
evidence of immunosuppression (p < 0.001). In the moderate immunosuppression
group, 11% had two mucocutaneous findings while 21% in the severe
immunosuppression group had two or more mucocutaneous findings. The most common
mucocutaneous finding was oral candidiasis (33%), which had a mean corresponding 
CD4 percentage of the total lymphocyte count of 11.3%. Herpes zoster was found in
6% of the patients (mean CD4 percentage of the total lymphocyte count = 13.5%).
Chronic herpes simplex virus (HSV) stomatitis was found in 3% of the patients
(mean CD4 percentage of the total lymphocyte count = 3%). Mucocutaneous
manifestations are common in pediatric AIDS. The majority of these findings have 
an infectious etiology. The prevalence increases as the CD4-positive percentage
of the total lymphocyte count decreases. More than one mucocutaneous finding can 
be found at the same time in patients with moderate or severe immunosuppression.

PMID: 12869145 [PubMed - indexed for MEDLINE]

2041: Drugs Today (Barc). 2003 May;39(5):359-71.

Brivudine: a herpes virostatic with rapid antiviral activity and once-daily
dosing.

Rabasseda X.

Department of Medical Information, Prous Science, S.A., PO Box 540, 08025
Barcelona, Spain. service@prous.com

Brivudine is an analog of thymidine, and is incorporated into the viral DNA. It
blocks the action of DNA polymerases, thus inhibiting viral replication. It has a
stronger antiviral effect against the varicella-zoster virus compared with
reference compounds such as aciclovir or penciclovir. The efficacy of brivudine
has been documented in a number of clinical trials in patients with
herpesvirus-related infections, particularly in patients with herpes-zoster. At a
dose of 125 mg once daily, brivudine has proved to be superior to aciclovir with 
respect to reducing the period of new blister production in patients with
herpes-zoster, and has shortened the duration of post-herpetic neuralgia.
Tolerability was equivalent to that of aciclovir or placebo, with occasional
gastrointestinal disorders leading to treatment withdrawal in a minority of
patients. (c) 2003 Prous Science. All rights reserved.

Publication Types: 
    Review

PMID: 12861349 [PubMed - indexed for MEDLINE]

2042: J Infect. 2003 Aug;47(2):133-8.

Quantification of circulating varicella zoster virus-DNA for the early diagnosis 
of visceral varicella.

Ishizaki Y, Tezuka J, Ohga S, Nomura A, Suga N, Kuromaru R, Kusuhara K, Mizuno Y,
Kasuga N, Hara T.

Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University,
Fukuoka, Japan

Varicella zoster virus (VZV)-DNA was quantified in peripheral blood of 2 patients
with visceral varicella due to endogenous reactivation. An 18-year-old male
contracted varicella following the courses of chemotherapy for T cell lymphoma.
Another 18-year-old male suffered from varicella 16 months after the complete
engraftment of hematopoietic stem cell transplantation. Both patients had past
VZV infection, but no recent contact with the disease. Paralytic ileus and
ascites preceded the skin lesions. Quantitative real-time polymerase chain
reaction revealed >200 copies of VZV per 1 ml of whole blood before or at the
time when cropping vesicles emerged. The viral load reflected their prolonged
clinical courses. Similar levels of VZV-DNA were detected in primary varicella
patients, but not in herpes zoster patients or immunocompromised children without
varicella or zoster. Quantitative monitoring of circulating VZV-DNA may be useful
for the diagnosis and assessing the treatment response of visceral varicella in
immunocompromized hosts.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12860147 [PubMed - indexed for MEDLINE]

2043: Panminerva Med. 2003 Jun;45(2):155-6.

Maternally acquired varicella-zoster virus antibodies disappear at 6 months of
age in prematurely born children.

Akisu M, Yalaz M, Aksu G, Arslanoglu S, Genel F, Kutukculer N, Kultursay N.

Publication Types: 
    Letter

PMID: 12855941 [PubMed - indexed for MEDLINE]

2044: Pain. 2003 Jul;104(1-2):423-4.

Treatment of post-herpetic pain in myasthenia gravis: exacerbation of weakness
due to gabapentin.

Scheschonka A, Beuche W.

Department of Neuroradiology, J.W. Goethe-Universitat Frankfurt, Schleusenweg
2-16, 60528 Frankfurt am Main, Germany. scheschonka@mpih-frankfurt.mpg.de

Here, we present a case of a 64-year-old female suffering from a severe form of
antibody-positive myasthenia gravis. Under an immunosuppressive regimen with
cyclosporine A, she experienced an episode of thoracic herpes zoster followed by 
intense post-herpetic neuralgia. In order to avoid drug interactions as well as
adverse effects of carbamazepine in myasthenia gravis, gabapentin was chosen for 
the treatment of neuropathic pain. Within a few days she noticed increasing
weakness, but continued medication for 8 weeks as gabapentin was not identified
as the hazardous agent by her physician. Acetylcholine receptor antibody levels
remained unchanged, but increased decrement was observed clinically and in
repetitive nerve stimulation. After withdrawal of gabapentin, she recovered
quickly to her previous condition.

Publication Types: 
    Case Reports

PMID: 12855353 [PubMed - indexed for MEDLINE]

2045: Pain. 2003 Jul;104(1-2):323-31.

Tramadol in post-herpetic neuralgia: a randomized, double-blind,
placebo-controlled trial.

Boureau F, Legallicier P, Kabir-Ahmadi M.

Centre d'Evaluation et de Traitement de la Douleur, CHU Saint-Antoine, 184 rue du
Fg Saint Antoine, 75571 Paris, France. francois.boureau@sat.ap-hop-paris.fr

The efficacy and safety of sustained-release tramadol compared to placebo in the 
treatment of post-herpetic neuralgia were evaluated in a multicenter, randomized,
double-blind, parallel-group study in 127 outpatients. Treatment was
administrated for 6 weeks. The dose of tramadol could be increased from 100
mg/day to 400 mg/day (300 mg/day in patients more than 75 years old). Groups were
compared on changes in pain intensity on a Visual Analogue Scale (VAS) between
inclusion and the 6th week of treatment (covariance analysis as main analysis and
repeated measures analysis as complementary analysis) in the per protocol (PP)
population. The randomized population comprised 127 patients aged 35-85 years,
mostly females (72.4%). Groups were comparable at inclusion both in the intent to
treat (ITT) population (63 patients in the tramadol group and 62 patients in the 
placebo group) and in the PP population (53 patients in the tramadol group and 55
patients in the placebo group). Mean pain intensity on day 43 adjusted on day 1
(covariance analysis) was significantly lower in the tramadol group than in the
placebo group in both the PP (P=0.0499), and the ITT (P=0.031) populations. The
two groups significantly differed on change in pain intensity over time (repeated
measures analysis) in the ITT population (P=0.012). The percentage of pain relief
over the 6th week was significantly higher in the tramadol group than in the
placebo group (P=0.017). During the 6th week, patients in the tramadol group
required less rescue medication than patients in the placebo group (P=0.022). No 
significant difference was found between groups either in pain intensity on a
5-point Verbal Scale (VRS) or in quality of life measurements. Tramadol was
administered at an average dosage of 275.5 (89.7) mg/day after a 1-week
dose-adaptation period. Tramadol was well tolerated. No notable difference
appeared between groups either in the percentage of patients with
treatment-associated adverse events (TAAE) (29.7% in the tramadol group and 31.8%
in the placebo group) or in the total number of TAAE (31 in the tramadol group
and 28 in the placebo group).

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 12855342 [PubMed - indexed for MEDLINE]

2046: Ocul Immunol Inflamm. 2002 Dec;10(4):253-61.

Comment in:
    Ocul Immunol Inflamm. 2002 Dec;10(4):235-8.

Association of herpesviruses in the aqueous humor of patients with serpiginous
choroiditis: a polymerase chain reaction-based study.

Priya K, Madhavan HN, Reiser BJ, Biswas J, Saptagirish R, Narayana KM, Rao NA.

Vision Research Foundation, Sankara Nethralaya, Chennai, India.

PURPOSE: To determine the presence of herpesvirus DNA in the aqueous humor (AH)
of patients with serpiginous choroiditis using polymerase chain reaction (PCR).
METHODS: AH from nine patients previously diagnosed with serpiginous choroiditis 
were investigated for herpes simplex virus (HSV), varicella zoster virus (VZV),
and cytomegalovirus (CMV) by conventional virological methods and PCR. The
PCR-positive DNA was gel-purified, extracted, and sequenced using a dye-based
Applied Biosystems procedure. The sequences were processed through the National
Cancer Institute's BLAST inquiry for species identification. RESULTS: Culture and
cytological examination of AH from all nine patients were negative for HSV, VZV, 
and CMV. Five were positive for VZV, one was positive for HSV, and three were
wholly negative using PCR. Subsequent DNA sequencing of the positive samples
authenticated the presence of VZV and HSV DNA in the respective patients.
CONCLUSION: VZV and HSV DNA were detected in a subset of patients with
serpiginous choroiditis, suggesting that these viruses may function in the
pathogenesis of this disease.

PMID: 12854034 [PubMed - indexed for MEDLINE]

2047: J Clin Neurosci. 2003 Jul;10(4):512-4.

Post-herpetic trigeminal neuralgia treated with deep brain stimulation.

Green AL, Nandi D, Armstrong G, Carter H, Aziz T.

Department of Neurosurgery, Radcliffe Infirmary, Woodstock Road, Oxford, UK

Post-herpetic neuralgic affects up to 20% of patients after an attack of
trigeminal Herpes Zoster infection. Past medical and surgical treatments have
been unrewarding. We report the successful treatment of such a case with deep
brain stimulation into the region of the contralateral periventricular grey area 
(PVG) and ventral posterior lateral thalamic nucleus (VPL).

PMID: 12852900 [PubMed - in process]

2048: Clin Ther. 2003 Mar;25(3):852-89.

The use of gabapentin for the treatment of postherpetic neuralgia.

Singh D, Kennedy DH.

Pharmacy Practice, Nova Southeastern University College of Pharmacy-Davie Campus,
Fort Lauderdale, Florida 33328-2018, USA. singh@nova.edu

BACKGROUND: Varicella-zoster virus causes chickenpox and can reemerge later in
life to cause herpes zoster or shingles. One of the most common and disabling
complications of herpes zoster is postherpetic neuralgia (PHN). OBJECTIVES: This 
article reviews the current primary literature about the efficacy and
tolerability of gabapentin for the treatment of PHN. Gabapentin pharmacokinetics 
and drug interactions are also reviewed. METHODS: A literature search in the
English language was conducted using OVID Web, which contained the following
databases: MEDLINE (1966-present), EMBASE (1980-2002), Current Contents/Clinical 
Medicine (1999-2002), Cochrane Controlled Trials Register (1898-present),
Cochrane Database of Systemic Reviews (fourth quarter, 2002), and International
Pharmaceutical Abstracts (1970-2002). Search terms used were postherpetic
neuralgia; zoster; gabapentin; neuropathic pain; pain; pharmacoeconomic; cost;
controlled clinical trial; randomized, controlled trial; postherpetic neuralgia
and gabapentin; gabapentin and pain; treatment and postherpetic neuralgia;
gabapentin and age; gabapentin and gender; gabapentin and ethnicity; and
gabapentin and pharmacokinetics. RESULTS: Gabapentin displays nonlinear
absorption kinetics, is minimally protein bound (< 3%), has a high mean (SD)
volume of distribution (50.4 [8.0] L), and is excreted via the kidneys as
unchanged drug. Two randomized, placebo-controlled, parallel-group, multicenter
clinical trials demonstrated the effectiveness of gabapentin at doses of up to
3600 mg/d to significantly reduce pain (P < 0.01 and P < 0.001), improve sleep (P
< 0.01), and improve some parameters on the Short Form-McGill Pain Questionnaire 
(P < 0.05). Dizziness and somnolence were the most common side effects leading to
withdrawal from the trials. The recommended dosage in adults is 300 mg at bedtime
on day 1,300 mg BID on day 2, and 300 mg TID on day 3, titrating up as needed to 
2400 to 3600 mg/d. To reduce adverse events in patients with renal impairment,
the dose should be adjusted based on the patient's creatinine clearance.
CONCLUSIONS: Gabapentin appears to be effective and well tolerated for the
short-term treatment of PHN. However, future controlled studies are needed to
determine whether the effectiveness of gabapentin for PHN is maintained for > 2
months, to establish the optimal dose of gabapentin for PHN, and to compare the
efficacy of gabapentin with that of other pharmacologic agents used for the
treatment of PHN.

Publication Types: 
    Review

PMID: 12852705 [PubMed - indexed for MEDLINE]

2049: Arthritis Rheum. 2003 Jul;48(7):2019-24.

Anti-tumor necrosis factor alpha therapy in fifteen patients with AA amyloidosis 
secondary to inflammatory arthritides: a followup report of tolerability and
efficacy.

Gottenberg JE, Merle-Vincent F, Bentaberry F, Allanore Y, Berenbaum F, Fautrel B,
Combe B, Durbach A, Sibilia J, Dougados M, Mariette X.

Hopital de Bicetre, Paris, France.

OBJECTIVE: Because anti-tumor necrosis factor alpha (anti-TNF) has emerged as a
highly effective treatment for numerous inflammatory arthritides, which are a
common cause of AA amyloidosis, we retrospectively evaluated the safety and
efficacy of anti-TNF in a nationwide study. METHODS: The rheumatology departments
of all French teaching hospitals were contacted by mail to obtain the files of
patients with histologically proven secondary AA amyloidosis and renal
involvement who were treated with anti-TNF. Efficacy was assessed as a sustained 
decrease in 24-hour proteinuria and a stable/improved glomerular filtration rate 
(GFR). RESULTS: Among the 15 patients studied, the 24-hour proteinuria was 4.5
+/- 3.6 gm (mean +/- SD), creatininemia was 178.4 +/- 74.9 micromoles/liter, and 
GFR was 46 +/- 23 ml/minute before starting anti-TNF. Ten patients received
infliximab, 4 received etanercept, and 1 received both types of treatment. The
mean followup was 10.4 months. No severe adverse events were recorded; one
episode of herpes zoster in the first branch of the trigeminal nerve occurred
after one infusion of infliximab. Amyloidosis progressed in 7 patients and was
stabilized in 5 patients. Three patients (receiving infliximab alone, infliximab 
plus methotrexate [MTX], or etanercept plus MTX) experienced rapid, dramatic, and
sustained decreases in proteinuria (>or=80%), with the GFR increasing 15-78%.
CONCLUSION: Anti-TNF was well-tolerated and safe in the 15 patients with AA
amyloidosis and renal involvement. The pathogenic role of TNF in AA amyloidosis, 
the sustained proteinuria decrease in 3 patients, and the stabilization of renal 
parameters in 5 other patients make anti-TNF a promising candidate to treat AA
amyloidosis secondary to inflammatory arthritides.

PMID: 12847696 [PubMed - indexed for MEDLINE]

2050: Neurology. 2003 Jul 8;61(1):139-40.

Recurrent myelopathy after HAART in a patient with spinal mycobacterial
infection.

Sumner CJ, Newman M, Jay CA.

Department of Neurology, University of California, San Francisco, USA.

Publication Types: 
    Case Reports

PMID: 12847179 [PubMed - indexed for MEDLINE]

2051: Hepatogastroenterology. 2003 Jul-Aug;50(52):1043-6.

Gastrointestinal cancer and herpes zoster in adults.

Yamamoto M, Mine H, Akazawa K, Maehara Y, Sugimachi K.

Department of Gastroenterologic Surgery, Shin-Nakama Hospital, Nakama, Japan.
myamamo@nk-cc.go.jp

BACKGROUND/AIMS: Herpes zoster is associated with immunosuppression, and also has
an increased risk of malignancy. The aim of this study is to determine whether
patients with Herpes zoster are at a higher risk of occult malignancy and
gastrointestinal diseases. METHODOLOGY: We examined 131 of 201 Japanese patients 
who showed evidence of Herpes zoster in the gastrointestinal tract including the 
large intestine using gastrointestinal endoscopy, total colonoscopy and CT
scanning. RESULTS: Six of 131 patients (4.6%) with Herpes zoster, who had
undergone all three examinations, had malignancies. This rate is significantly
higher than the predicted rate (P < 0.05). Five of six patients had
gastrointestinal or colon cancer. Previously, 17 of the 201 patients has been
surgically treated for cancers (17/201 = 8.5%, predictable rate = 8.9%), eleven
of these 17 patients had surgery for gastric cancer, or for colon cancer etc. We 
also diagnosed three patients to have cancers after an episode of Herpes zoster, 
out of the 140 patients who we examined as study prospects (3/140 = 2.1%,
relative risks = 1.75). No significant increases in the malignant rates were
observed before or after the onset of Herpes zoster. CONCLUSIONS: These findings 
are considered to support the policy to investigate patients with Herpes zoster
for the presence of occult malignancies, though the rate of malignancy in such
patients before or after episodes of Herpes zoster was not significantly
different from that of the predictable rate.

PMID: 12845977 [PubMed - indexed for MEDLINE]

2052: J Fr Ophtalmol. 2003 Apr;26(4):350-4.

[Antiviral therapy adjustment in corneal recipients using antibody testing in the
aqueous humor]

[Article in French]

Robert PY, Liekfeld A, Ranger-Rogez S, Jaekel C, Pleyer U, Adenis JP, Hartmann C.

Service d'Ophtalmologie, CHU Dupuytren, Limoges, France.

INTRODUCTION: In corneal recipients with herpes infection, acyclovir given for 1 
year postoperatively prevents viral reactivation and improves graft outcome. The 
indication for prophylactic antiviral therapy relies on the preoperative
diagnosis of herpes. However, many patients present with corneal scars featuring 
sequelae of herpes without a proven history of herpes. Here we report the results
of a prospective study of anti-herpes simplex virus (anti-HSV) and varicella
zoster virus (VZV) antibody testing in the aqueous humor at the time of corneal
transplantation to refine the indication of the antiviral treatment. MATERIAL AND
METHODS: The study involved 33 keratitis corneal graft recipients, 21 of whom had
documented herpes keratitis. A control group was made with 11 cataract patients. 
An anterior chamber puncture was performed just before surgery. The micro-ELISA
test was done on both aqueous humor and serum, and local anti-HSV or VZV antibody
synthesis was acknowledged if the ratio of antibody concentrations was above 4.
RESULTS: Local antibody synthesis to HSV was detected in 22 cases, to VZV in 9
cases, to both HSV and VZV in 6 cases, and no synthesis in 8 cases. The
sensitivity of the test was 65% in patients with a documented history of herpes
(14 cases out of 21). Among non-herpetic patients, the test was positive in 9
patients, who thus benefited from postoperative antiviral therapy. No viral
reactivation was encountered after a minimum follow-up of 1 year. CONCLUSIONS:
Antibody testing in the aqueous humor at the time of keratoplasty is a
convenient, inexpensive diagnostic tool in corneal recipients. It provides useful
information before prescribing a long and expensive postoperative antiviral
therapy.

Publication Types: 
    English Abstract
    Evaluation Studies

PMID: 12843891 [PubMed - indexed for MEDLINE]

2053: J Clin Microbiol. 2003 Jul;41(7):3167-74.

Comparison of LightCycler-based PCR, COBAS amplicor CMV monitor, and pp65
antigenemia assays for quantitative measurement of cytomegalovirus viral load in 
peripheral blood specimens from patients after solid organ transplantation.

Pang XL, Chui L, Fenton J, LeBlanc B, Preiksaitis JK.

Provincial Laboratory for Public Health (Microbiology), University of Alberta
Hospital, University of Alberta, Edmonton, Alberta T6G 2J2, Canada.

In order to evaluate the LightCycler-based PCR (LC-PCR) as a diagnostic assay
technique, a classical pp65 antigenemia assay and the commercially available
COBAS Amplicor CMV Monitor (CACM) assay were compared to the LC-PCR assay for the
detection and quantitation of cytomegalovirus (CMV) load in 404 parallel
specimens of peripheral blood from 66 patients after solid organ transplantation.
A good correlation existed among these three assays (r congruent with 0.6, P <
0.0001). The LC-PCR assay was the most sensitive (54% of specimens positive)
compared to the CACM (48.6%) and the pp65 antigenemia (26%) assays. The LC-PCR
assay detected all samples found positive by using both the CMV pp65 antigenemia 
assay and the CACM assay. The LC-PCR also had the widest dynamic range (from 250 
to 10(7) DNA copies/ml of plasma). No cross-reactions were found among CMV and
Epstein-Barr virus, varicella-zoster virus, or herpes simplex virus in the LC-PCR
by using amplification with specifically designed primer pairs. Precision,
expressed as the coefficient of variation, was <3% with standard DNA from cell
cultures and between 6.55 and 14.1% with clinical specimens in repeat LC-PCR
runs. One run of the LC-PCR took half of the time required for the semiautomated 
CACM procedure. Because of its sensitivity, specificity, cost-effectiveness, and 
simplicity, the LC-PCR assay could replace the pp65 antigenemia and the CACM
assays as the preferred technique for the surveillance, diagnosis, and monitoring
of response of CMV diseases in high-risk populations.

Publication Types: 
    Evaluation Studies

PMID: 12843059 [PubMed - indexed for MEDLINE]

2054: Ugeskr Laeger. 2003 Jun 2;165(23):2387-91.

[Varicella disease and varicella vaccine. A literature review]

[Article in Danish]

Frederiksen MS, Plesner AM, Stellfeld M.

Statens Serum Institut, Medicinsk Afdeling, Sektor for Vaccine, Artillerivej 5,
DK-2300 Kobenhavn.

Varicella is an infectious childhood disease. A safe and effective vaccine is
accessible. The varicella disease usually takes a mild course but studies
performed outside Denmark reveal a considerable occurrence of complications.
There is no Danish account of morbidity and mortality following infection with
varicella-zoster virus. According to experience from the USA, the introduction of
routine vaccination will result in a decreasing incidence of the disease and will
also reduce the frequency of complications caused by the disease. In addition, it
will give indirect protection of non-vaccinated individuals (herd immunity).
Introducing vaccination against varicella involves a potential risk of changing
the epidemiology of the disease. Moreover, routine vaccination may affect the
frequency and the severity of herpes zoster. Experience from the USA will give us
a better basis of deciding whether vaccination against varicella should be
implemented or not in the Danish childhood vaccination programme.

Publication Types: 
    English Abstract
    Review

PMID: 12840997 [PubMed - indexed for MEDLINE]

2055: Int J Dermatol. 2003 Jul;42(7):562-4.

Dermatomal lichenoid graft-versus-host disease within herpes zoster scars.

Sanli H, Anadolu R, Arat M, Ekmekci P, Birol A, Erdem C, Koc H.

Department of Dermatology, Medical Faculty, Ankara University, Ankara, Turkey.

Publication Types: 
    Case Reports

PMID: 12839612 [PubMed - indexed for MEDLINE]

2056: Postgrad Med. 2003 Jun;113(6):87-8.

Patient notes: shingles.

[No authors listed]

Publication Types: 
    Patient Education Handout

PMID: 12838806 [PubMed - indexed for MEDLINE]

2057: Electromyogr Clin Neurophysiol. 2003 Jun;43(4):231-4.

Zoster paresis.

Tilki HE, Mutluer N, Selcuki D, Stalberg E.

Department of Neurology, Ondokuz Mayis University, Medical Faculty, Samsun,
Turkey. hacererdem@superonline.com

Herpes zoster (HZ) is essentially a viral disease of the posterior root ganglia
and sensory nerve fibers, which presents clinically with vesicular eruption of
the skin, radicular pain and sensory changes in the distribution of the affected 
ganglion. However, motor involvement can be seen as well. If classic cutaneous
lesions are present, HZ-related motor paresis is easily diagnosed. Otherwise, the
diagnosis may be suspicious, especially if the weakness occurs before the
cutaneous lesions have appeared, or weeks after they have subsided. We present a 
patient with HZ-related motor paresis due to radiculopathy in the cervical
segments whose motor symptoms and signs appear as major clinical features.

Publication Types: 
    Case Reports

PMID: 12836588 [PubMed - indexed for MEDLINE]

2058: Acta Otorhinolaryngol Belg. 2003;57(2):139-46.

Bilateral simultaneous facial paralysis--differential diagnosis and treatment
options. A case report and review of literature.

Gevers G, Lemkens P.

Department of Otorhinolaryngology, Head and Neck Surgery, Katholieke Universiteit
Leuven, Belgium.

Bilateral facial paralysis or paresis of peripheral origin is a rare condition
and therefore represents a diagnostic challenge. We here present a case of a
previously healthy woman who was hospitalized for symptoms of meningitis. On the 
second day of her hospital stay, she developed bilateral facial paresis. Later,
the patient developed also tachycardia and dysrhythmias. A thorough diagnostic
procedure including lumbar puncture, routine blood investigation with serological
tests, MRI of the brain, Holter monitoring and transoesophageal
echocardiographia, revealed meningitis with radiculitis, facial paresis and
myocarditis. The clinical triad of meningitis, radiculitis and facial palsy is
known as the Bannwarth Syndrome (Lyme disease). The patient was treated with
ceftriaxone and recovered well. Despite repeatedly taken serological tests,
Borrelia burgdorferi immunoglobulins were not detected. Acquired bilateral facial
paralysis can occur in several diseases of infectious, neurological, idiopathic, 
iatrogenic, toxic, neoplastic or traumatic origin. In this article, we review the
differential diagnoses and treatment options of bilateral facial paresis and
present a scheme that is helpful in the diagnostic evaluation of this condition.

Publication Types: 
    Case Reports
    Review

PMID: 12836471 [PubMed - indexed for MEDLINE]

2059: Antiviral Res. 2003 Jun;59(1):57-60.

Oral brivudin in comparison with acyclovir for herpes zoster: a survey study on
postherpetic neuralgia.

Wassilew SW, Wutzler P; Brivddin Herpes Zoster Study Group.

Dermatological Department, Klinikum Krefeld, Lutherplatz 40, D-47805, Krefeld,
Germany. swassilew.dermatologie@klinikum-krefeld.de

This concerns a double-blind survey study on 608 herpes zoster patients treated
with 1x 125 mg oral brivudin (n=309) or 5x 800 mg acyclovir (n=299), both for 7
days, during two prospective, randomised clinical herpes zoster trials. The
survey aimed at evaluating the outcome of the two treatment regimens on
postherpetic neuralgia (PHN). During a follow-up ranging from 8 to 17 months
after start of treatment, former study participants aged >/=50 years were
interviewed for the occurrence of PHN. Neither the investigators nor the patients
were aware of which treatment the patients received during acute herpes zoster.
The incidence of PHN, defined as zoster-associated pain occurring or persisting
after rash healing was significantly lower in brivudin recipients (32.7%) than in
acyclovir recipients (43.5%, P=0.006). Mean duration of PHN was similar with
brivudin (173 days) and acyclovir (164 days, P=0.270). Despite some
methodological disadvantages common to this type of study, the present survey
provides for the first evidence that brivudin treatment during acute herpes
zoster favourably affects the incidence of PHN in immunocompetent elderly herpes 
zoster patients.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 12834861 [PubMed - indexed for MEDLINE]

2060: Antiviral Res. 2003 Jun;59(1):49-56.

Oral brivudin in comparison with acyclovir for improved therapy of herpes zoster 
in immunocompetent patients: results of a randomized, double-blind, multicentered
study.

Wassilew SW, Wutzler P; Brivddin Herpes Zoster Study Group.

Dermatological Department, Klinikum Krefeld, Lutherplatz 40, D-47805, Krefeld,
Germany. swassilew.dermatologie@klinikum-krefeld.de

Brivudin [(E)-5-(2-bromovinyl)-2'-deoxyuridine] is a nucleoside analogue with a
high and selective antiviral activity against varicella-zoster virus (VZV) and
herpes simplex virus type 1 (HSV-1). The double-blind, randomized study presented
here compared efficacy and safety of oral brivudin 1 x 125 mg and acyclovir 5 x
800 mg, both for 7 days, in 1227 immunocompetent patients with herpes zoster.
Main results were as follows: brivudin was superior to acyclovir in accelerating 
the "time to last formation of new vesicles" (primary parameter; risk ratio(ITT):
1.13, P=0.014). Equivalent effects of brivudin and acyclovir were observed for
the secondary parameters "time to first crust" (RR(ITT): 0.93, P=0.004), "time to
full crusting" (risk ratio(ITT): 1.03, P<0.001), and "time to loss of crusts"
(RR(ITT): 0.95, P=0.002). The incidence of potentially treatment-related adverse 
events was similar under brivudin (7.7%) and acyclovir (10.0%). In conclusion,
brivudin proved to be more effective than acyclovir in terminating vesicle
formation, the parameter which reflects the end of viral replication, thus
confirming, in the clinical setting, the greater in vitro antiviral activity of
brivudin. Compared with acyclovir, brivudin provides a similar safety profile and
a significant improvement in efficacy.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 12834860 [PubMed - indexed for MEDLINE]

2061: Am J Ophthalmol. 2003 Jul;136(1):192-4.

Acute retinal necrosis following epidural steroid injections.

Browning DJ.

Charlotte Eye, Ear, Nose, and Throat Associates, Charlotte, North Carolina, USA. 
djbrowning@carolina.rr.com

PURPOSE: To report a side effect of epidural corticosteroid injections for back
pain. DESIGN: Case series. METHODS: Review of clinical charts and photographs.
SETTING:Private retina practice.RESULTS: Two patients developed acute retinal
necrosis syndrome following epidural corticosteroid injections for back pain.
Referral was delayed in one patient. One patient developed bilateral secondary
rhegmatogenous retinal detachment, and both developed secondary macular pucker.
CONCLUSIONS: Acute retinal necrosis can follow epidural corticosteroid
injections. Patients should be warned about this possibility and advised to
report should photopsias, photosensitivity, blurred vision, or new floaters
develop after treatment. Orthopedists should be aware of the complication and
promptly refer patients with symptoms for dilated fundus examination by an
ophthalmologist.

Publication Types: 
    Case Reports

PMID: 12834695 [PubMed - indexed for MEDLINE]

2062: Clin Infect Dis. 2003 Jul 1;37(1):e16-8. Epub 2003 Jun 24.

Multiple cerebral infarcts due to varicella-zoster virus large-vessel
vasculopathy in an immunocompetent adult without skin involvement.

Ahmad NM, Boruchoff SE.

Division of Infectious Diseases, Allergy, and Immunology, University of Medicine 
and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick
08903-0019, USA.

We report the case of a 52-year-old immunocompetent man with varicella-zoster
virus large-vessel vasculopathy and multiple bilateral cerebral infarcts who had 
no history of skin involvement. Etiologic diagnosis was made by isolation of
varicella-zoster virus from a cerebrospinal fluid specimen. The patient had
marked improvement in mental status after acyclovir therapy was initiated.

Publication Types: 
    Case Reports

PMID: 12830433 [PubMed - indexed for MEDLINE]

2063: J Clin Virol. 2003 Jul;27(2):190-9.

Molecular diagnosis of zoster post varicella vaccination.

Sauerbrei A, Uebe B, Wutzler P.

Institute of Virology and Antiviral Therapy, Friedrich-Schiller University of
Jena, Winzerlaer Strasse 10, D-07745, Jena, Germany.
andreas.sauerbrei@med.uni-jena.de

BACKGROUND: Herpes zoster can be caused by endogenous reactivation of both
wild-type virus or vaccine varicella-zoster virus (VZV) becoming latent within
sensory ganglia after natural primary infection or varicella vaccination.
OBJECTIVES: To demonstrate molecular biological methods for reliable
discrimination between wild-type VZV and vaccine strain Oka by an example of
zoster in a vaccinated girl. STUDY DESIGN: VZV was isolated from zoster occurring
16 months after varicella vaccination in a 2-year-old infant. Including VZV
wild-type and different Oka strains as controls, viral DNA fragments located in
the open reading frames (ORF) 38, 54, 62 and the R5 variable repeat region were
characterized by amplification and restriction fragment length polymorphisms
(RFLP) analysis. RESULTS: VZV vaccine strain Oka was definitely proven to be the 
causative virus in this case of zoster post vaccination. CONCLUSIONS: Molecular
procedures for characterization of ORF 38 allow reliable discrimination between
Oka-like and wild-type VZV outside Japan and Japanese communities. To distinguish
Oka vaccine virus from Oka-like wild strains, analysis of DNA fragments located
in the ORF 62 should be included.

Publication Types: 
    Comparative Study

PMID: 12829041 [PubMed - indexed for MEDLINE]

2064: Br J Dermatol. 2003 Jun;148(6):1258-62.

Extramammary Paget's disease with superimposed herpes simplex virus infection:
immunohistochemical comparison with cases of the two respective diseases.

Yamamoto O, Yasuda H.

Department of Dermatology and Occupational Dermatopathology, School of Medicine, 
University of Occupational and Environmental Health Japan.
yamasam@med.uoeh-u.ac.jp

We describe an extremely rare case of genital Paget's disease with superimposed
herpes simplex virus (HSV) infection. We also describe immunohistochemical
comparison of this lesion with 19 cases of genital Paget's disease and 12 cases
of skin lesions caused by HSV or varicella-zoster virus. The Paget cells
expressed simple epithelial keratins (CK7 and CK19) and carcinoembryonic antigen 
(CEA), but did not express stratified epithelial keratins (CK1, CK2e, CK10,
CK5/8, CK14). Conversely, the virus-infected keratinocytes were positive for
stratified epithelial keratins but negative for simple epithelial keratins and
CEA. In the present case, simple epithelial keratins, stratified epithelial
keratins, CEA and HSV were heterogeneously expressed in the ballooning and
multinucleated giant cells. These results suggest that these cells were derived
from keratinocytes and Paget cells and that the production of many multinucleated
giant cells resulted from the virus-mediated cell fusion between Paget cells and 
neighbouring keratinocytes.

Publication Types: 
    Case Reports

PMID: 12828759 [PubMed - indexed for MEDLINE]

2065: J Infect Dis. 2003 Jul 1;188(1):40-52. Epub 2003 Jun 23.

Identification of CD8+ T cell epitopes in the immediate early 62 protein (IE62)
of varicella-zoster virus, and evaluation of frequency of CD8+ T cell response to
IE62, by use of IE62 peptides after varicella vaccination.

Frey CR, Sharp MA, Min AS, Schmid DS, Loparev V, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford,
California, USA, and Faculty of Biosciences, University of Witten/Herdecke,
Witten, Germany.

Varicella-zoster virus (VZV) causes varicella, establishes neuronal latency, and 
can reactivate, resulting in herpes zoster. VZV-specific T cells are important
for controlling infection. VZV immediate early protein 62 (IE62) is recognized by
cytotoxic T cells from immune individuals, but no CD8(+) T cell epitopes have
been defined for any VZV protein. CD8(+) T cell frequencies were assessed by
cytokine flow cytometry (CFC), by use of synthetic-peptide pools corresponding to
the IE62 sequence. IE62 peptide-specific CD8(+) T cells were below the threshold 
of detection, by direct CFC of either whole blood or peripheral blood mononuclear
cells (PBMCs). Activated CD8(+)CD69(+) T cells that produced interferon-gamma
were detectable after in vitro restimulation of PBMCs, and restricted epitopes
were identified for HLA-A*0201-positive subjects. Varicella vaccination of 3
VZV-immune subjects was associated with increases in IE62 peptide-specific CD8(+)
T cells, a finding indicating that in vivo re-exposure boosts memory immunity to 
this important viral protein.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12825169 [PubMed - indexed for MEDLINE]

2066: Antimicrob Agents Chemother. 2003 Jul;47(7):2186-92.

In vitro activities of benzimidazole D- and L-ribonucleosides against
herpesviruses.

Williams SL, Hartline CB, Kushner NL, Harden EA, Bidanset DJ, Drach JC, Townsend 
LB, Underwood MR, Biron KK, Kern ER.

University of Alabama School of Medicine, Birmingham, Alabama 35233, USA.

Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella-zoster virus
(VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6
(HHV-6), and human herpesvirus 8 (HHV-8) are responsible for a number of clinical
manifestations in both normal and immunocompromised individuals. The parent
benzimidazole ribonucleosides evaluated in this series,
2-bromo-5,6-dichloro-1-(beta-D-ribofuranosyl)benzimidazole (BDCRB) and maribavir 
(1263W94), are potent and selective inhibitors of human CMV replication. These
nucleosides act by two different mechanisms. BDCRB blocks the processing and
maturation of viral DNA, whereas 1263W94 inhibits the viral enzyme pUL97 and
interferes with DNA synthesis. In the present study, we have evaluated the in
vitro antiviral activity of BDCRB, an analog, GW275175X (175X), and 1263W94
against the replication of HSV-1, HSV-2, VZV, CMV, EBV, HHV-6, and HHV-8. By
using various methodologies, significant activity was observed against human CMV 
and EBV but not against HSV-1, HSV-2, VZV, HHV-6, or HHV-8. Plaque reduction
assays performed on a variety of laboratory and clinical isolates of human CMV
indicated that all strains, including those resistant to ganciclovir (GCV) and
foscarnet, were sensitive to all three benzimidazole ribonucleosides, with mean
50% effective concentration values of about 1 to 5 microM compared to that of GCV
at 6 microM. The toxicity of these compounds in tissue culture cells appeared to 
be similar to that observed with GCV. These results demonstrate that the
benzimidazole ribonucleosides are active against human CMV and EBV and suggest
that they may be useful for the treatment of infections caused by these
herpesviruses.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12821466 [PubMed - indexed for MEDLINE]

2067: Phytother Res. 2003 Jun;17(6):609-13.

Anti-herpesvirus activity of an extract of Ribes nigrum L.

Suzutani T, Ogasawara M, Yoshida I, Azuma M, Knox YM.

Department of Microbiology, Asahikawa Medical College, 2-1-1-1
Midorigaoka-Higashi, Asahikawa 078-8510, Japan. suzutani@fmu.ac.jp

An extract of Ribes nigrum L., known as blackcurrant in Europe and Kurokarin(R)
in Japan, has been used as an ingredient in a variety of foods and folk medicine.
In this study, the anti-herpesvirus activity of this extract was examined in
vitro. The extract inhibited herpes simplex virus type 1 attachment on the cell
membrane completely at a 100-fold dilution, as well as the plaque formation of
herpes simplex virus types 1 and 2, and varicella-zoster virus by 50% at a
400-fold dilution or lower concentrations. This latter activity, which inhibits
virus replication in cells, was due to the inhibition of protein synthesis in
infected cells from the early stage of infection. Kurokarin is a possible
candidate as a herbal medicine for herpesvirus infectious diseases. Copyright
2003 John Wiley & Sons, Ltd.

PMID: 12820226 [PubMed - indexed for MEDLINE]

2068: Rev Med Virol. 2003 Jul-Aug;13(4):207-22.

Membrane fusion mediated by herpesvirus glycoproteins: the paradigm of
varicella-zoster virus.

Cole NL, Grose C.

Departments of Microbiology and Pediatrics, University of Iowa, Iowa City, Iowa, 
USA.

Varicella-zoster virus (VZV) is well known for its propensity to cause
polykaryons (syncytia) in the vesicles within infected skin. Similarly in
cultured cells, VZV induces extensive syncytial formation by virus-mediated
cell-to-cell fusion. Statistical analyses of fusion parameters demonstrated
three-way interactive effects among all three tested variables (incubation
temperature, cell type and virus strain). For example, fusion was greatly
enhanced at 33 degrees C vs 37 degrees C; also fusion was pronounced in epidermal
cells but negligible in fibroblast cells. As with all herpesviruses, VZV gH was a
major fusogen. VZV cell fusion was inhibited by antibody to gH, but surprisingly 
was enhanced by antibody to gE. Other evidence implicating a role for VZV gE in
the fusion process was provided by two mutant viruses, in which gE cell surface
expression was enhanced. Under transfection conditions, VZV fusion formation
occurred after expression of the gH/gL complex; in contrast, pseudorabies virus
requires expression of gH, gL and gB, while the herpes simplex virus (HSV) types 
1 and 2 require the quartet of gH, gL, gB and gD. VZV has no gD gene and no
apparent gD functional homologue. On the other hand, VZV gE exerts a greater
effect than HSV gE on membrane fusion. Taken together, the data in this review
suggest that VZV has evolved viral glycoprotein machinery more geared toward
cell-to-cell fusion (fusion-from-within) than toward virus-to-cell fusion
(entry/fusion-from-without), as a means for syncytium formation within the human 
epidermis. Copyright 2003 John Wiley & Sons, Ltd.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 12820183 [PubMed - indexed for MEDLINE]

2069: Clin Nucl Med. 2003 Jul;28(7):594-5.

Varicella zoster infection associated rhabdomyolysis demonstrated by Tc-99m MDP
imaging.

Bhargava P, Bhutani C, Feng Q, Alavi A, Zhuang H.

Department of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, 19104, USA.

Publication Types: 
    Case Reports

PMID: 12819419 [PubMed - indexed for MEDLINE]

2070: J Neurol Sci. 2003 Aug 15;212(1-2):7-9.

Chronic active VZV infection manifesting as zoster sine herpete, zoster paresis
and myelopathy.

Morita Y, Osaki Y, Doi Y, Forghani B, Gilden DH.

Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.

After lumbar-distribution zoster, an HTLV-1-seropositive woman developed chronic 
radicular sacral-distribution pain (zoster sine herpete), cervical-distribution
zoster paresis and thoracic-distribution myelopathy. Detection of anti-varicella 
zoster virus (VZV) IgM and VZV IgG antibody in cerebrospinal fluid (CSF), with
reduced serum/CSF ratios of anti-VZV IgG compared to normal serum/CSF ratios for 
albumin and total IgG, proved that VZV caused the protracted neurological
complications. Diagnosis by antibody testing led to aggressive antiviral
treatment and a favorable outcome.

Publication Types: 
    Case Reports
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 12809993 [PubMed - indexed for MEDLINE]

2071: Neurourol Urodyn. 2003;22(4):335-7.

Loss of urinary voiding sensation due to herpes zoster.

Hiraga A, Nagumo K, Sakakibara R, Kojima S, Fujinawa N, Hashimoto T.

Department of Neurology, Matsudo Municipal Hospital, Matsudo, Chiba, Japan.
hiragaa@mail3.alpha-net.ne.jp

A case of sacral herpes zoster infection in a 56-year-old man with the
complication of loss of urinary voiding sensation is presented. He had typical
herpes zoster eruption on the left S2 dermatome, hypalgesia of the S1-S4
dermatomes, and absence of urinary voiding sensation. There was no other urinary 
symptom at the first medical examination. Urinary complications associated with
herpes zoster are uncommon, but two types, acute cystitis and acute retention,
have been recognized. No cases of loss of urinary voiding sensation due to herpes
zoster have been reported. In this case, hypalgesia of the sacral dermatomes was 
mild compared to the marked loss of urethral sensation. This inconsistency is
explained by the hypothesis that the number of urethral fibers is very small as
compared to that of cutaneous fibers, therefore, urethral sensation would be more
severely disturbed than cutaneous sensation. Copyright 2003 Wiley-Liss, Inc.

Publication Types: 
    Case Reports

PMID: 12808709 [PubMed - indexed for MEDLINE]

2072: IDrugs. 2002 Aug;5(8):815-27.

Non-HIV antivirals - a review of the recent patent literature.

Combrink K.

Cumbre Inc, 1502 Viceroy Drive, Dallas, TX 75235-2304, USA.
keith.combrink@cumbre.biz

This review covers the non-HIV antiviral patent literature from December 2001 to 
April 2002. Most of the patent applications describe new compounds for the
treatment of hepatitis C virus (HCV) by inhibition of the NS3 serine protease.
Several examples of both nucleoside and non-nucleoside inhibitors of the HCV
polymerase NS5B have been reported. Hepatitis B virus (HBV) therapy continues to 
be dominated by nucleoside analogs, but several non-nucleoside HBV polymerase
inhibitors have also been reported. In addition, a number of patents describing
non-nucleoside inhibitors of the human cytomegalovirus (HCMV), the herpes simplex
virus (HSV-1 and HSV-2) and the varicella zoster virus (VZV) DNA polymerase are
also reviewed. A number of patents that appeared in 2002 hold promise for the
treatment of respiratory syncytial virus (RSV) with small molecule inhibitors.
Various approaches to the treatment of hepatitis D virus (HDV), picornaviruses
and the human papilloma virus (HPV) are also described.

PMID: 12802698 [PubMed]

2073: Neurologist. 2002 Nov;8(6):339-50.

Current management of postherpetic neuralgia.

Panlilio LM, Christo PJ, Raja SN.

Department of Anesthesiology and Critical Care Medicine, Division of Pain
Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland,
USA. sraja@jhmi.edu

BACKGROUND: The herpes zoster rash occurs when a dormant varicella zoster virus
reactivates in dorsal root and cranial nerve ganglia. Pain that persists in the
region where this rash occurred after the cutaneous lesions have healed is termed
postherpetic neuralgia (PHN). A wide variety of therapies has been used with
varying degrees of success to prevent the occurrence of PHN and to reduce pain
with established PHN. REVIEW SUMMARY: In this review, we discuss the clinical
presentation of PHN, current strategies for the prevention and management of this
disease, and observations that have increased our understanding of the neural
mechanisms involved in PHN. CONCLUSIONS: Several classes of drugs are effective
in attenuating the pain and hyperalgesia caused by PHN, but no single drug leads 
to the complete relief of symptoms. Additional research is needed to improve
treatment strategies and define the role of invasive pain management techniques
in cases where PHN is associated with intractable pain.

PMID: 12801435 [PubMed]

2074: Schmerz. 1998 Aug 27;12(4):276-81.

[Sympathetic nervous system and pain--some open questions]

[Article in German]

Wasner G, Baron R.

Klinik fur Neurologie, Christian-Albrechts-Universitat Kiel.

BACKGROUND: Neuropathic pain syndromes may be treated by intervention at the
sympathetic nervous system. The pain in these syndromes is therefore called
sympathetically maintained pain (SMP). Typical disorders with a SMP component are
complex regional pain syndromes (reflex sympathetic dystrophy and causalgia),
traumatic neuralgias and herpes zoster. RESULTS: Open questions are how the
efferent sympathetic nervous system is capable of influencing pain sensation and 
which mechanisms underly the autonomic dysregulation often observed in these
syndromes.(1) Somatic afferents that project through the sympathetic trunk do not
exist. Therefore, a pure sympathetic block does not block afferent information
arising from the affected extremity. What alternatives are possible? Under
pathophysiological conditions a functional interaction of efferent sympathetic
fibers and afferent nociceptive fibers could be demonstrated in patients and
animal studies. The intensity of this coupling varies considerably between
individual patients and is not necessary for the diagnosis of the disorder. (2)
Sympathetically maintained pain and signs of autonomic dysfunction are
independent clinical and pathophysiological phenomena without any causal
relation. However, it is possible to treat both the SMP and the autonomic
dysfunction with sympathetic blocks.

Publication Types: 
    English Abstract

PMID: 12799968 [PubMed]

2075: Schmerz. 1997 Dec 12;11(6):373-7.

[Prevention of postherpetic neuralgia: does it exist?]

[Article in German]

Wulf H, Baron R.

Klinik fur Anasthesiologie und Operative Intensivmedizin,
Christian-Albrechts-Universitat, Kiel.

THEORETICAL CONSIDERATIONS: Several pathophysiological mechanisms may be
responsible for initiation and maintenance of chronic postherpetic pain. (1)
Peripheral nociceptive fibers can develop abnormal sensitization. Secondary to
this, central nociceptive "second-order" neurons in the spinal cord dorsal horn
can also be sensitized, i.e. they become hyperexcitable and start responding to
non-noxious stimuli. (2) Degeneration of nociceptive neurons may trigger
anatomical sprouting of low-threshold mechanosensitive terminals to form
connections with central nociceptive neurons and may subsequently induce
functional synaptic reorganization in the dorsal horn. According to these
mechanisms theoretical possibilities of therapeutical interventions to prevent
postherpetic neuralgia are (1) adequate analgesia in the acute phase (analgesics,
antidepressants, sympathetic blocks) and (2) prevention of C-fiber degeneration
by reducing the inflammatory reaction (antiviral drugs, corticosteroids,
neurotrophins). CLINICAL EXPERIENCE: The present clinical trials concerning
prevention of postherpetic neuralgia were analyzed. Only for the antiviral drugs 
have valid clinical studies been performed. Using acyclovir a considerable
reduction of acute pain and time to healing could clearly be demonstrated.
However, there was no significant effect on prevention of postherpetic neuralgia.
The second-generation antiviral drugs valaciclovir and famciclovir may be more
effective when applied early in the disease course. Preliminary studies indicate 
that the early onset of therapy with the antidepressant agent amitriptyline may
reduce the incidence of postherpetic neuralgia. These results need to be
confirmed in further studies. CONCLUSION: Although there is no clear evidence in 
favor of a prevention of postherpetic neuralgia for any of the interventions, it 
is definitely reasonable to perform the best analgesia possible during the acute 
phase of herpes zoster.

Publication Types: 
    English Abstract

PMID: 12799794 [PubMed]

2076: Drugs Aging. 2003;20(8):561-70.

The role of antivirals in the management of neuropathic pain in the older patient
with herpes zoster.

Lilie HM, Wassilew S.

Dermatology Department, Klinikum Krefeld, Krefeld, Germany.
lilie@klinikum-krefeld.de

Herpes zoster has been known since ancient times. It is a ubiquitous disease,
occurring sporadically without any seasonal preference and is caused by the
varicella-zoster virus. It may be defined as an endogenous relapse of the primary
infection varicella. Herpes zoster is characterised by typical efflorescences in 
the innervation region of a cranial or spinal nerve and starts and ends with pain
of varying intensity. Currently, several antiviral drugs are approved and many
studies have shown that antiviral therapy, started early in the course of
disease, can significantly reduce the risk and the duration of postherpetic
neuralgia in elderly patients. The effects of all antivirals discussed in this
article, given either orally or intravenously, are comparable with regards to the
resolution of virus replication, prevention of dissemination of skin lesions and 
reduction of acute herpes zoster pain. Valaciclovir (valacyclovir), famciclovir
and brivudine (brivudin) are comparably effective in the reduction of the
incidence and/or prevention of zoster-associated pain and postherpetic neuralgia.
Brivudine 125mg once daily is as effective as famciclovir 250mg three times daily
in reducing the prevalence and the duration of zoster-associated pain and
postherpetic neuralgia, especially if therapy is combined with a structured-pain 
therapy. The intensity of the therapy for pain should depend on the intensity of 
the pain that it is treating. Famciclovir and brivudine offer an advantage over
other antivirals because they are administered less frequently; this is
particularly relevant for elderly patients who may already be taking a number of 
medications for other diseases. Therefore, antiviral therapy in combination with 
adequate pain management should be given to all elderly patients as soon as
herpes zoster is diagnosed.

Publication Types: 
    Review

PMID: 12795624 [PubMed - indexed for MEDLINE]

2077: Nippon Jibiinkoka Gakkai Kaiho. 2003 May;106(5):491-8.

[An assessment of psychological stress in patients with facial palsy]

[Article in Japanese]

Sugiura M, Niina R, Ikeda M, Nakazato H, Abiko Y, Kukimoto N, Ohmae Y.

Department of Otolaryngology, Tokyo Metropolitan Geriatric Hospital, Tokyo.

OBJECTIVES: Facial palsy may cause excessive stress due to the obviousness of its
manifestations. We evaluated psychological stress in patients with facial palsy. 
SUBJECTS AND METHODS: Subjects were 57 patients with Bell's palsy, 12 with Ramsay
Hunt syndrome, and 11 with zoster sine herpete. Eighteen of 50 questions from the
Psychological Stress Response Scale (PSRS) were selected and used to in a
questionnaire completed by each patient on 2 separate occasions the first
hospital visit and after recovery from facial palsy. They also completed a second
bodily condition questionnaire before and after treatment. RESULTS: The
psychological stress response score of patients with facial palsy was high on the
first visit. Intermediate and high psychological stress were observed in 35% on
the first visit. These psychological stress response score decreased after
recovery from facial palsy. The psychological stress response of patients under
65 years of age in those over 65 years. No gender difference was seen in
psychological stress response. Those with herpes zoster showed a higher
psychological stress response than others and this decreased after recovery from 
facial palsy. CONCLUSIONS: Psychological stress response score of patients with
facial palsy was high on the first hospital visit, suggesting that we must treat 
the psychological aspects of this manifestation by adequately explaining
prognosis and pathology, in addition to physical therapy.

Publication Types: 
    English Abstract

PMID: 12795118 [PubMed - indexed for MEDLINE]

2078: Cornea. 2003 May;22(4):371-3.

Sequestered viscoelastic after deep lamellar keratoplasty using viscodissection.

Bhojwani RD, Noble B, Chakrabarty AK, Stewart OG.

General Infirmary at Leeds, Leeds, West Yorkshire, United Kingdom.
bbhojwani@hotmail.com

PURPOSE: Deep lamellar keratoplasty (DLKP) is an intricate procedure that
preserves the host's endothelium, thus eliminating the possibility of endothelial
graft rejection and potentially offering great benefits over penetrating
keratoplasty. DLKP may be performed by a variety of techniques including
viscodelamination, in which the stroma is separated from Descemet's membrane
using viscoelastic. METHODS: Here we present an operative complication of this
technique, which was not initially recognized, that caused significant morbidity 
to our patient and eventually led to the eye requiring a full thickness regraft. 
We also attempt to reproduce the lesion using nonviable cadaver corneas and
illustrate histologically the nature of the corneal stroma and its relationship
to Descemet's membrane following viscoelastic delamination.

Publication Types: 
    Case Reports

PMID: 12792483 [PubMed - indexed for MEDLINE]

2079: J Fam Pract. 2003 Jun;52(6):496-7.

Clinical inquiries. What is the prognosis of postherpetic neuralgia?

Gazewood JD, Meadows S, Halverson L.

University of Virginia, Charlottesville, Virginia, USA.

Publication Types: 
    Review

PMID: 12791234 [PubMed - indexed for MEDLINE]

2080: Prog Drug Res. 2003;60:263-307.

Current and potential therapies for the treatment of herpes-virus infections.

Villarreal EC.

Eli Lilly and Company, Lilly Centre for Women's Health, Indianapolis, IN 46285,
USA. villarreal_elcira_c@lilly.com

Human herpesviruses are found worldwide and are among the most frequent causes of
viral infections in immunocompetent as well as in immunocompromised patients.
During the past decade and a half a better understanding of the replication and
disease-causing state of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2),
varicella zoster virus (VZV), and human cytomegalovirus (HCMV) has been achieved 
due in part to the development of potent antiviral compounds that target these
viruses. While some of these antiviral therapies are considered safe and
efficacious (acyclovir, penciclovir), some have toxicities associated with them
(ganciclovir and foscarnet). In addition, the increased and prolonged use of
these compounds in the clinical setting, especially for the treatment of
immunocompromised patients, has led to the emergence of viral resistance against 
most of these drugs. While resistance is not a serious issue for immunocompetent 
individuals, it is a real concern for immunocompromised patients, especially
those with AIDS and the ones that have undergone organ transplantation. All the
currently approved treatments target the viral DNA polymerase. It is clear that
new drugs that are more efficacious than the present ones, are not toxic, and
target a different viral function would be of great use especially for
immunocompromised patients. Here, an overview is provided of the diseases caused 
by the herpesviruses as well as the replication strategy of the better studied
members of this family for which treatments are available. We also discuss the
various drugs that have been approved for the treatment of some herpesviruses in 
terms of structure, mechanism of action, and development of resistance. Finally, 
we present a discussion of viral targets other than the DNA polymerase, for which
new antiviral compounds are being considered.

Publication Types: 
    Review

PMID: 12790345 [PubMed - indexed for MEDLINE]

2081: Acta Cytol. 2003 May-Jun;47(3):480-4.

Cytology of pleural effusion associated with disseminated infection caused by
varicella-zoster virus in an immunocompromised patient. A case report.

Mori M, Imamura Y, Maegawa H, Yoshida H, Naiki H, Fukuda M.

Department of Surgical Pathology, Fukui Medical University Hospital, Departments 
of Pathology and Clinical Laboratory Medicine, Fukui Medical University,
Matsuoka, Fukui, Japan.

BACKGROUND: Pleural effusion caused by varicella-zoster virus (VZV) is rare. We
report a case of a woman with acute lymphocytic leukemia (ALL) who developed a
pleural effusion caused by VZV infection. CASE: A 55-year-old woman with ALL
treated with consolidation therapy developed skin vesicles and a pleural
effusion. Pleural fluid smears contained numerous mesothelial cells, which had
ground-glass nuclei or eosinophilic nuclear inclusions. Some multinucleated giant
cells were also seen. Electron microscopic examination revealed intranuclear
virus particles, about 150 nm in diameter, in some mesothelial cells. Tissue
samples from the skin, lungs, pleura, liver, pancreas, kidneys and
gastrointestinal tract, obtained at autopsy, contained many virus-infected cells.
They were positive for VZV glyco-protein 1 by immunohistochemistry. CONCLUSION:
VZV infection should be considered in the differential diagnosis of an
unexplained exudative pleural effusion, especially in immunocompromised hosts.

PMID: 12789936 [PubMed - indexed for MEDLINE]

2082: Int J Dermatol. 2003 Jun;42(6):491-5.

The role of gabapentin in treating diseases with cutaneous manifestations and
pain.

Scheinfeld N.

Department of Dermatology, St. Luke's Roosevelt Hospital Center, New York, NY
10025, USA. Scheinfeld@rcn.com

BACKGROUND: Gabapentin was first approved by the FDA in 1993 as an add-on
treatment for partial epileptic seizures. In May of 2002, it was approved as
treatment for post-herpetic neuralgia by the Food and Drug Administration. It
appears to be a promising agent in the treatment of pain, alterations of
sensation and pruritus associated with dermatological disease, but no review of
these uses exists. METHODS: Medline and Google searches were performed for the
words "Gabapentin" and "Neurontin." The articles found were reviewed. Article
identified that contained references to the treatment of skin disease and
neuropathic pain were examined and their contents surveyed. RESULTS:
Approximately 1200 articles were located in Medline that referred to Garbapentin 
or Neurontin. Over 150 articles reviewed its use for neuropathic pain, neuritis
or neuralgia of various sorts. Approximately 20 articles reviewed its use for a
variety of dermatological conditions or diseases with dermatological
manifestations that included: pain control associated with wound dressing
changes, erythromelagia, piloleiomyoma related pain, brachioradial pruritus,
Glossodynia, vulvodynia, and reflex sympathetic dystrophy. Over 100 articles that
related to Gabapentin side effects were reviewed. CONCLUSIONS: Gabapentin is a
very promising medication in the treatment of post-herpetic neuralgia and pain.
Because dermatological patients suffer pain from painful tumors, after surgery,
in conjunction with neuropathic ulcers, during dressing changes involving serious
medical conditions, its applications seem manifold. Future studies must assess
its role in the treatment of pruritus and other dermatological conditions
involving pain or alteration of sensation.

Publication Types: 
    Review

PMID: 12786883 [PubMed - indexed for MEDLINE]

2083: Indian J Pathol Microbiol. 2002 Jul;45(3):269-71.

Role of viral serology in the diagnosis of acute retinal necrosis syndrome.

Grover R, Ratho RK, Gupta V, Mahajan RC, Gupta A.

Department of Virology, PGIMER, Chandigarh.

Due to the devastating nature of acute retinal necrosis syndrome (ARNS), early
diagnosis is essential. 5 cases of clinically diagnosed ARNA were investigated
for CMC, herpes simplex and varicella zoster virus (VZV) infections. Of the three
VZV IgM positive cases, two were positive in acute blood samples and one in
vitreous fluid. Thus VZU can be incriminated as the causative agent of ARNS cases
in North India.

Publication Types: 
    Case Reports

PMID: 12785164 [PubMed - indexed for MEDLINE]

2084: Rev Clin Esp. 2003 Jun;203(6):307-8.

[Fever and cutaneous lesions in leg in a 20 month-old girl]

[Article in Spanish]

Gamo Villegas R, Guerra Tapia A, Iglesias Diez L.

Servicio de Dermatologia. Hospital 12 de Octubre. Madrid. Spain.

Publication Types: 
    Case Reports

PMID: 12783721 [PubMed - indexed for MEDLINE]

2085: Jpn J Ophthalmol. 2003 May-Jun;47(3):260-4.

Multiplex polymerase chain reaction for detection of herpes simplex virus type 1,
type 2, cytomegalovirus, and varicella-zoster virus in ocular viral infections.

Zhang Y, Kimura T, Fujiki K, Sakuma H, Murakami A, Kanai A.

Department of Ophthalmology, Juntendo University School of Medicine, Tokyo,
Japan.

PURPOSE: To detect simultaneously herpes simplex virus type 1 (HSV-1), type 2
(HSV-2), cytomegalovirus (CMV), and varicella-zoster virus (VZV) in ocular
specimens suspected of indicating viral infection, and to compare the results of 
multiplex polymerase chain reaction (PCR) with those of uniplex PCR. METHODS:
Forty specimens, collected from 33 patients with clinically suspected herpes
virus ocular infection, were tested. DNA was extracted from the specimens and
amplified by multiplex and uniplex PCR. RESULTS: Both multiplex PCR and uniplex
PCR gave the same results. Nineteen (19/33, 57.6%) patients were PCR-positive,
among whom HSV-1 was detected in 13 (13/19, 68.4%) patients, and VZV in 6 (6/19, 
31.6%) patients. CONCLUSION: These results demonstrated that multiplex PCR is as 
reliable as uniplex PCR, and is an accurate and a cost-saving method to identify 
several agents from a single specimen.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12782161 [PubMed - indexed for MEDLINE]

2086: Clin Exp Dermatol. 2003 May;28(3):257-9.

Giant lichenification of the scalp.

Arseculeratne G, Altmann P, Millard PR, Todd P, Wojnarowska F.

Department of Dermatology, Churchill Hospital, Oxford, UK.

Lichenification is characterized clinically by thickening of areas of skin as a
result of the itch-scratch cycle and therefore is seen in conditions associated
with chronic pruritus. The characteristic feature of giant lichenification is the
occurrence of tumour-like growths with a warty cribriform surface. We describe a 
renal transplant patient presenting with giant lichenification of the scalp
following an attack of herpes zoster at the same site. Chronic pruritus following
scalp dysaethesia secondary to herpes zoster was considered the most likely
explanation for the occurrence of these lesions.

Publication Types: 
    Case Reports

PMID: 12780706 [PubMed - indexed for MEDLINE]

2087: Acta Ophthalmol Scand. 2003 Jun;81(3):216-20.

Visual prognosis in immunocompetent patients with herpes zoster ophthalmicus.

Zaal MJ, Volker-Dieben HJ, D'Amaro J.

Department of Ophthalmology, VU University Medical Centre, Amsterdam, The
Netherlands. mjw.zaal@vumc.nl

PURPOSE: To determine the normal spectrum of ocular complications and associated 
visual outcome in patients with herpes zoster ophthalmicus. METHODS: This
prospective observational cohort study included 73 immunocompetent adults with
herpes zoster ophthalmicus, referred by their general practitioners within 7 days
of skin rash onset. The follow-up period was 6 months. All patients received a
7-14-day course of systemic aciclovir treatment combined with longterm
application of a lubricating ophthalmic ointment as long as the corneal
epithelium was affected. Topical corticosteroids were strictly avoided in the
acute phase of ocular disease. Acquired visual loss scores at 1, 2 and 6 months
were based on best corrected visual acuity (BCVA) level and evaluation of the
ophthalmological history and findings. RESULTS: Ophthalmic herpes zoster led to a
variety of transient inflammatory reactions within the anterior eye segment of
the involved side in 46 patients (63%), but did not seriously compromise their
ultimate visual outcome. Mild to moderate visual loss, with corrected VA between 
0.3 and 0.8, was found in 17 patients at 1 month (23%), in 10 patients at 2
months (14%) and in seven patients at 6 months follow-up (10%). None of the
patients developed visual loss with a corrected VA of less than 0.3. CONCLUSION: 
Functional vision was retained in all ophthalmic zoster patients referred to the 
ophthalmologist in the acute phase of the disease by vigorous antiviral treatment
and adequate prevention of corneal exposure.

PMID: 12780396 [PubMed - indexed for MEDLINE]

2088: Ultrastruct Pathol. 2003 May-Jun;27(3):133-40.

Bioterrorism and electron microscopic differentiation of poxviruses from
herpesviruses: dos and don'ts.

Miller SE.

Duke University Medical Center, Durham, North Carolina 27710, USA.
sara.miller@duke.edu

With increased threat of terrorism, much attention is being directed toward
readiness for biodefense. Smallpox virus, a deadly and much feared organism, is
among possible bioterrorism agents. Herpesviruses, such as the one that causes
chickenpox and shingles, produce skin lesions that may resemble those seen early 
in smallpox infection. Electron microscopy (EM) is a rapid and reliable method
for differentiating poxviruses from herpesviruses. However, before becoming
involved in the monitoring of potential smallpox cases, a laboratory must
consider several issues, including expertise in virus identification, capacity
for handling biohazards, and health and immune status of laboratory staff.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12775503 [PubMed - indexed for MEDLINE]

2089: J Neurovirol. 2003 Jun;9(3):404-7.

Chronic varicella-zoster virus ganglionitis--a possible cause of postherpetic
neuralgia.

Gilden DH, Cohrs RJ, Hayward AR, Wellish M, Mahalingam R.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado, USA. don.gilden@uchsc.edu

Postherpetic neuralgia (PHN) is dermatomal distribution pain that persists for
months to years after the resolution of herpes zoster rash. The cause of PHN is
unknown. Herein, we report clinical, molecular virological, and immunological
findings over an 11-year period in an immunocompetent elderly woman with PHN.
Initially, blood mononuclear cells (MNCs) contained varicella-zoster virus (VZV) 
DNA on two consecutive occasions. Random testing after treatment with famciclovir
to relieve pain did not detect VZV DNA. However, the patient was reluctant to
continue famciclovir indefinitely and voluntarily stopped drug treatment five
times. Pain always recurred within 1 week, and blood MNCs contained many, but not
all, regions of the VZV genome on all five occasions. Immunological analysis
revealed increased cell-mediated immunity to VZV. Chronic VZV
ganglionitis-induced PHN best explains the recurrence of VZV DNA in MNCs whenever
famciclovir was discontinued; the detection of only some regions of the viral
genome in MNCs, compared to the detection of all regions of the VZV genome in
latently infected ganglia; the increased cell-mediated immunity to VZV; and a
gratifying clinical response to famciclovir. The presence of fragments of VZV DNA
in MNCs likely represents partial degradation of viral DNA in MNCs that
trafficked through ganglia during productive infection.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 12775423 [PubMed - indexed for MEDLINE]

2090: J Neuropathol Exp Neurol. 2003 May;62(5):429-40.

The changing pattern of HIV neuropathology in the HAART era.

Gray F, Chretien F, Vallat-Decouvelaere AV, Scaravilli F.

Laboratoire de Neuropathologie, Faculte de Medecine Paris-Ile de France Ouest,
Garches, France. francoise.gray@rpc.ap-hop-paris.fr

Highly active antiretroviral treatment (HAART), which has been available for most
AIDS patients in France since 1996, has resulted in a dramatic improvement of the
progression of the disease. From the survey of our series of 343 brains with
acquired immunodeficiency syndrome (AIDS) from patients who died between 1985 and
2002, we found both quantitative and qualitative changes in the pattern of human 
immunodeficiency virus (HIV) neuropathology. Quantitatively, despite a dramatic
decrease in the number of autopsies, brain involvement remained a major cause of 
death. There was an overall decrease in incidence of cerebral toxoplasmosis,
cytomegalovirus encephalitis (CMVE), and HIV encephalitis (HIVE), for which
successful treatment is available. This contrasted with the unchanged incidence
of progressive multifocal leukoencephalopathy (PML) and malignant non-Hodgkin
lymphomas (MNHL). However, when looking closer at the 3 last years, the incidence
of diseases affecting patients with severe immunodepression (CMVE, PML, and MNHL)
decreased between 2000 and 2002, whereas infections occurring in patients with
milder immunodeficiency, toxoplasmosis, varicella-zoster encephalitis (VZVE), or 
herpes simplex virus encephalitis (HSVE) became more frequent. In addition, we
found uncommon types of brain infection such as BK virus encephalitis or general 
paresis. Finally, we described new variants of HIVE: severe leukoencephalopathy
with intense perivascular macrophage and lymphocyte infiltration, possibly due to
an exaggerated response from a newly reconstituted immune system, and chronic
"burnt out" forms of HIVE as VZVE, toxoplasmosis, or PML, possibly associated
with prolonged survival, in which neither inflammation nor organisms could be
detected. These findings are compared with those reported in other
neuropathological studies from different developed countries.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12769183 [PubMed - indexed for MEDLINE]

2091: J Virol. 2003 Jun;77(12):6979-87.

Varicella-zoster virus DNA in cells isolated from human trigeminal ganglia.

Levin MJ, Cai GY, Manchak MD, Pizer LI.

Section of Pediatric Infectious Diseases, School of Medicine, University of
Colorado, Denver, Colorado 80262, USA. myron.levin@uchsc.edu

To determine the type of cell(s) that contain latent varicella-zoster virus (VZV)
DNA, we prepared pure populations of neurons and satellite cells from trigeminal 
ganglia of 18 humans who had previously had a VZV infection. VZV DNA was present 
in 34 of 2,226 neurons (1.5%) and in none of 20,700 satellite cells. There was an
average of 4.7 (range of 2 to 9) copies of VZV DNA per latently infected neuron. 
Latent VZV DNA was primarily present in large neurons, whereas the size
distribution of herpes simplex virus DNA was markedly different.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12768016 [PubMed - indexed for MEDLINE]

2092: J Virol. 2003 Jun;77(12):6660-5.

Varicella-zoster virus gene 66 transcription and translation in latently infected
human Ganglia.

Cohrs RJ, Gilden DH, Kinchington PR, Grinfeld E, Kennedy PG.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA. randall.cohrs@uchsc.edu

Latent infection with varicella-zoster virus (VZV) is characterized by restricted
virus gene expression and the absence of virus production. Of the approximately
70 predicted VZV genes, only five (genes 4, 21, 29, 62, and 63) have been shown
by multiple techniques to be transcribed during latency. IE62, the protein
product of VZV gene 62, is the major immediate-early (IE) virus-encoded
transactivator of viral gene transcription and plays a pivotal role in
transactivating viral genes during lytic infection. The protein kinase (66-pk)
encoded by VZV gene 66 phosphorylates IE62, resulting in cytoplasmic accumulation
of IE62 that mitigates nuclear IE62-induced gene activation. Analysis of latently
infected human trigeminal ganglia for 66-pk expression by reverse
transcriptase-dependent nested PCR, including DNA sequence analysis, in situ
hybridization, and immunohistochemistry, revealed VZV open reading frame 66 to be
a previously unrecognized latently expressed virus gene and suggests that
prevention of IE62 import to the nucleus by VZV 66-pk phosphorylation is one
possible mechanism by which VZV latency is maintained.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12767985 [PubMed - indexed for MEDLINE]

2093: Diagn Mol Pathol. 2003 Jun;12(2):103-7.

Rapid diagnosis of smallpox infection and differentiation from its mimics.

Nuovo GJ, Plaza JA, Magro C.

Department of Pathology, The Ohio State University Medical Center S305E Rhodes
Hall, 450 W 10th Avenue Columbus, OH 43210, USA. gnuovomd@pol.net

The potential for a bioterrorism-induced smallpox outbreak has been much
discussed of late. The literature of the late 1960s stressed that the distinction
between smallpox and the other viral-induced vesicle-forming diseases, namely
varicella zoster and disseminated herpes simplex, was difficult to make. Given
that the cutaneous manifestations of smallpox would be among the initial
symptoms, we reviewed 2 cases of smallpox diagnosed in South America in the 1970s
in conjunction with 9 cases of multiple skin vesicles diagnosed as either
disseminated herpes simplex or varicella-zoster. These were examined by routine
hematoxylin and eosin stain (H&E) as well as by in situ hybridization. A blind
review of the cases demonstrated that each showed striking intraepithelial
vesicles containing multinucleated squamous cells exhibiting a ground glass
appearance of the nuclear chromatin. Thus, as expected, routine H&E examination
could not differentiate the 2 smallpox cases from the other 9 samples. In situ
hybridization easily distinguished the 2 cases of smallpox from the other 9
samples, 5 of which contained varicella-zoster (two had been misdiagnosed as
herpes) and the other 4 were disseminated herpes simplex. The in situ test,
readily accomplished in any histology-based molecular laboratory in 4 hours,
allows for the rapid and specific identification of smallpox infection and,
importantly, its distinction from its mimics. Formalin fixation, which is optimal
for in situ hybridization, guarantees the inactivation of the smallpox virus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 12766615 [PubMed - indexed for MEDLINE]

2094: Paediatr Respir Rev. 2003 Jun;4(2):84-90.

The classification of viruses infecting the respiratory tract.

Mackie PL.

Department of Microbiology, Yorkhill NHS Trust, Glasgow, G3 8SJ, UK.
virology@supanet.com

Following the boom in respiratory virology in the 1960s, species of rhinoviruses,
coronaviruses, enteroviruses, adenoviruses, parainfluenza viruses and respiratory
syncytial virus were added to influenza and measles viruses as causes of
respiratory tract infection. In restricted patient groups, such as the
immunocompromised, members of the family of herpesviruses including herpes
simplex, cytomegalovirus, varicella-zoster virus, Epstein-Barr virus and human
herpes virus 6 have also been associated with respiratory disease. This list of
pathogens was extended last year with the discovery of a novel virus, the human
metapneumovirus. More than 200 antigenically distinct viruses have been
documented as causes of sporadic or epidemic respiratory infections in infants,
children and adults. However, this varied and diverse group can be divided among 
six distinct families. Understanding some of the basic biology of these families 
gives an insight into possible strategies for diagnosis, control and therapy.

Publication Types: 
    Review

PMID: 12758044 [PubMed - indexed for MEDLINE]

2095: Eur J Neurol. 2003 May;10(3):271-80.

A retrospective clinical, laboratory and outcome analysis in 43 cases of acute
aseptic meningitis.

Nowak DA, Boehmer R, Fuchs HH.

Departments of Neurology and Clinical Neurophysiology and Medical Microbiology
and Immunology, Academic Hospital Munich-Bogenhausen, Technical University of
Munich, Munich, Germany. DrDennis.Nowak@gmx.de

Forty-three consecutive cases of acute aseptic meningitis (AAM) presenting within
a 24-months period were retrospectively analysed with respect to clinical
symptomatology, cerebrospinal fluid (CSF) findings, clinical course, treatment
and outcome. Nineteen of the 43 AAM cases (44%) were caused by enterovirus, one
by HIV (2%), two by Varicella zoster virus (5%), three due to herpes simplex
virus I (7%), two due to herpes simplex virus II (5%), one due to Central
European encephalitis virus (2%), and in 15 patients (35%) the aetiology of AAM
remained unknown. Headache (100%) and fever (93%) were the presenting symptoms in
the majority of cases. Signs of preceding infection were predominantly
gastrointestinal in the enterovirus subgroup, but were inconsistently observed in
the other subgroups. CSF findings at the first lumbar tap on admission generally 
revealed lymphomonocytic pleocytosis of less than 500 cells per micro l, mild to 
moderately elevated protein and normal lactate and glucose levels. Initial
therapy consisted of an empirical antiviral and antibiotic regimen until a
serological diagnosis was available. Acyclovir, effective only in herpes family
viruses, was initially administered to all AAM cases. Effective therapy for other
viral pathogens are not broadly available and treating AAM of unknown aetiology
imposes a particular problem. The average hospitalization time ranged from 16 to 
31 days. Patients were either discharged home (72%) or transferred to a
rehabilitation centre (28%). The outcome was good (40%) to fair (51%) in the
majority of cases.

PMID: 12752401 [PubMed - indexed for MEDLINE]

2096: N Engl J Med. 2003 May 15;348(20):2044-5; author reply 2044-5.

Comment on:
    N Engl J Med. 2002 Aug 1;347(5):340-6.

Herpes zoster.

Crider EF.

Publication Types: 
    Comment
    Letter

PMID: 12751476 [PubMed - indexed for MEDLINE]

2097: Dermatol Nurs. 2003 Apr;15(2):175.

Herpes zoster.

Roberts EJ, Heitman B.

Publication Types: 
    Case Reports

PMID: 12751354 [PubMed - indexed for MEDLINE]

2098: Eur J Med Chem. 2003 Apr;38(4):413-9.

Homology modelling and docking studies on Varicella Zoster Virus Thymidine
kinase.

Spadola L, Novellino E, Folkers G, Scapozza L.

Dipartimento di Chimica Farmaceutica e Tossicologica, Universita di Napoli, Via
D. Montesano 49, 80131, Napoli, Italy.

Thymidine kinase (TK) is the key enzyme in antiviral and suicide gene therapies. 
While herpes simplex virus type 1 thymidine kinase has been widely studied and
crystallised less is known on Varicella Zoster Virus thymidine kinase (VZV TK)
and its three-dimensional structure. In this paper we report the model of the
three-dimensional structure of VZV TK resulting from a homology modelling study. 
Subsequent docking studies of the natural substrate deoxythymidine (dT) and known
antiviral drugs were performed and shaded new light on the binding
characteristics of the enzyme.

PMID: 12750029 [PubMed - indexed for MEDLINE]

2099: Nephrol Dial Transplant. 2003 Jun;18(6):1135-41.

Comment in:
    Nephrol Dial Transplant. 2003 Dec;18(12):2680; author reply 2680-1.

High serum concentrations of the acyclovir main metabolite
9-carboxymethoxymethylguanine in renal failure patients with acyclovir-related
neuropsychiatric side effects: an observational study.

Hellden A, Odar-Cederlof I, Diener P, Barkholt L, Medin C, Svensson JO, Sawe J,
Stahle L.

Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska 
Institutet, Huddinge University Hospital, Stockholm, Sweden. anders.hellden@hs.se

BACKGROUND: Acyclovir (ACV) has been used for over two decades to treat herpes
virus infections. Serious neurological adverse side effects have occurred during 
ACV treatment in patients with renal failure, but the cause of the symptoms
remains unknown. We hypothesized that increased concentrations of the ACV main
metabolite 9-carboxymethoxymethylguanine (CMMG) correlated to these symptoms.
METHODS: We conducted an observational study from 1991 to mid 1999 based on
samples sent for analysis of ACV concentration from various hospital departments 
in Sweden. Patients with neuropsychiatric symptoms (NS+, n=49) were compared with
patients without symptoms (NS-, n=44). ACV and CMMG concentrations were analysed 
by HPLC. Medical records were analysed for symptoms and compared with pertinent
cases identified from Medline. RESULTS: The serum CMMG levels were significantly 
higher in the NS+ group (mean=34.1 micro mol/l, 95% confidence interval
23.4-46.1) compared with the NS- group (mean=4.7 micro mol/l, 95% confidence
interval 3.3-6.6; P<0.001). CMMG was the strongest predictor in a
receiver-operating characteristics curve analysis (ROC), based on 77 patients, of
ACV-related neuropsychiatric symptoms. The ROC curve for CMMG demonstrated that
neuropsychiatric symptoms could be predicted with a sensitivity of 91% and a
specificity of 93% with the use of a cut-off value of 10.8 micro mol/l of CMMG.
Thirty-five of 49 patients in the NS+ group showed levels exceeding this
concentration compared with only three of 44 of patients in the NS- group
(P<0.001). ACV exposure, ACV concentration, creatinine clearance and creatinine
concentration were weaker but statistically significant predictors. Haemodialysis
reduced CMMG and ACV levels and relieved the symptoms. CONCLUSIONS: The
determination of CMMG levels in serum may be a useful tool in supporting the
diagnosis of ACV-associated neuropsychiatric symptoms. Furthermore, the
monitoring of CMMG levels may prevent the emergence of symptoms.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 12748346 [PubMed - indexed for MEDLINE]

2100: N Engl J Med. 2003 May 15;348(20):2044-5; author reply 2044-5.

Comment on:
    N Engl J Med. 2002 Aug 1;347(5):340-6.

Herpes zoster.

Feder HM Jr.

Publication Types: 
    Comment
    Letter

PMID: 12748328 [PubMed - indexed for MEDLINE]

2101: AJNR Am J Neuroradiol. 2003 May;24(5):971-4.

Varicella-zoster vasculitis presenting with intracranial hemorrhage.

Jain R, Deveikis J, Hickenbottom S, Mukherji SK.

Division of Neuroradiology and Department of Radiology, University of Michigan
Health System, Ann Arbor 48109, USA.

Cerebral vasculitis presenting with intracranial hemorrhage is a rare but known
entity. We discuss here the case of a 61-year-old woman presenting with
subarachnoid hemorrhage. Cerebral angiography showed vasculitic changes involving
the small and medium-sized vessels. She also had a concomitant herpes zoster rash
on her back. A 3-month follow-up angiogram revealed partial resolution of the
vasculitic changes.

Publication Types: 
    Case Reports

PMID: 12748105 [PubMed - indexed for MEDLINE]

2102: Vaccine. 2003 Jun 2;21(19-20):2541-7.

The incidence of shingles and its implications for vaccination policy.

Chapman RS, Cross KW, Fleming DM.

Birmingham Research Unit of the Royal College of General Practitioners, Lordswood
House, 54 Lordswood Road, Harborne, Birmingham B17 9DB, UK.

A vaccine is now available to prevent varicella-zoster infection, but its place
in routine preventive care is not yet determined. The age specific incidence of
shingles was examined separately by gender and age groups (15-24, 25-44, 45-64,
65-74 and 75 years and more) over the years 1994-2001. These incidence data were 
applied to national available data for the UK on current life expectancy to
calculate the risk of shingles infections at varying ages.The potential benefit
of an effective vaccine was estimated using three models of vaccine efficacy
applied separately to males and females at ages 50, 60 and 65 years and assuming 
vaccination at a single age. Similar calculations were made using a two dose
strategy at age 45 and 65 years and at age 50 and 70 years. The cost per case
saved was estimated from a vaccination cost of pound 40 per dose.The probability 
of having had an attack of shingles before age 45 years is 8.6% for males and
10.5% for females, The risk of acquiring shingles over an expected lifetime
(assuming no preventive vaccination) for males aged 45 years is 22% and for
females 32%. Whichever vaccine efficacy model was chosen, a single vaccination
policy at age 65 years was the most favourable option in both males and females. 
A two age vaccination policy was estimated to increase the cost per case saved by
30% over a single age policy but administration at age 50 and 70 years
substantially increased the number of cases saved as compared with a single age
policy and was potentially better than vaccination at 45 and 65 years.

PMID: 12744889 [PubMed - indexed for MEDLINE]

2103: BMJ. 2003 May 10;326(7397):1025-6.

Zosteriform metastasis from melanoma.

Evans AV, Child FJ, Russell-Jones R.

Skin Tumour Unit, St John's Institute of Dermatology, St Thomas's Hospital,
London SE1 7EH. alun@hotmail.com

Publication Types: 
    Case Reports

PMID: 12742928 [PubMed - indexed for MEDLINE]

2104: Arch Gen Psychiatry. 2003 May;60(5):466-72.

Association of serum antibodies to herpes simplex virus 1 with cognitive deficits
in individuals with schizophrenia.

Dickerson FB, Boronow JJ, Stallings C, Origoni AE, Ruslanova I, Yolken RH.

Sheppard Pratt Health System, Baltimore, Md, USA.

BACKGROUND: Cognitive deficits are a characteristic feature of schizophrenia and 
contribute to the profound disabilities associated with this illness. Some of the
cognitive deficits that occur in individuals with schizophrenia are similar to
those found in individuals who have recovered from central nervous system
infections with human herpesviruses. METHODS: We measured cognitive functioning
and serologic evidence of infection with human herpesviruses in 229 outpatients
with schizophrenia. We evaluated cognitive functioning with the Repeatable
Battery for the Assessment of Neuropsychological Status. For each patient, serum 
IgG class antibodies with specificities for the following potentially neurotropic
human herpesviruses were measured by means of a solid-phase immunoassay: herpes
simplex viruses 1 and 2, cytomegalovirus, Epstein-Barr virus, human herpesvirus
6, and varicella-zoster virus. We determined the association between serologic
evidence of herpesviruses infection and cognitive functioning by univariate and
multivariate analyses, including demographic and clinical factors associated with
cognitive functioning. RESULTS: We found that serologic evidence of infection
with herpes simplex virus 1 is an independent predictor of cognitive dysfunction 
in individuals with schizophrenia. Discriminant function analysis indicated that 
much of the difference in cognitive functioning could be attributed to immediate 
memory. We found no significant association between cognitive dysfunction and
serologic evidence of infection with other human herpesviruses. CONCLUSION:
Serologic evidence of herpes simplex virus 1 infection is associated with
cognitive impairment in schizophrenia.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 12742867 [PubMed - indexed for MEDLINE]

2105: Clin Cornerstone. 2001;4(1):39-44.

Common skin disorders in the elderly.

Webster GF.

Department of Dermatology and Cutaneous Biology, Center for Cutaneous
Pharmacology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Skin diseases commonly seen in the elderly are more often than not the effects of
sun damage or vascular disease. The effects of a lifetime of even casual sun
exposure can be dramatic. Chronically sun-exposed skin becomes thin, loses
collagen, and has disrupted elastin and decreased glycosaminoglycans. The result 
is skin that breaks easily, bruises, sags, irritates easily, and itches. The
spots and bumps that patients associate with age are all sun-induced. Consider
how lesionless a 60-year-old's buttock is compared to the extensor forearm. The
reason that bruising attributed to anticoagulation seems to occur exclusively on 
the extensor forearm and not the volar aspect of the arm is that sun-induced
elastin degradation is greatest on the extensor forearm. Even trivial trauma will
cause unsupported capillaries to shear and bleed whether the patient is
anticoagulated or not. This article reviews the primary skin disorders associated
with the elderly and some of the management approaches that the primary care
physician can use.

Publication Types: 
    Review

PMID: 12739321 [PubMed - indexed for MEDLINE]

2106: Ann Hematol. 2003 May;82(5):263-70. Epub 2003 Mar 22.

Cellular and humoral immune reconstitution after autologous peripheral blood stem
cell transplantation (PBSCT).

Reimer P, Kunzmann V, Wilhelm M, Weissbrich B, Kraemer D, Berghammer H,
Weissinger F.

Medizinische Poliklinik, Universitat Wurzburg, Klinikstr. 6-8, 97070, Wurzburg,
Germany. p.reimer@medizin.uni-wuerzburg.de

Immune reconstitution after autologous peripheral blood stem cell transplantation
(PBSCT) is of particular interest because of its importance for clinical outcome.
Despite prolonged immunosuppression, especially of CD4(+) cells, few infections
after neutrophil recovery occur. Only reactivation of varicella zoster virus
(VZV) is more frequent in the first year after transplantation. From August 1997 
to May 2001, we prospectively evaluated 38 patients prior to conditioning and
during follow-up of 12 months post-transplant for virus antibodies [measles,
mumps, rubella, polio, herpes simplex, varicella zoster, mononucleosis,
cytomegalovirus (CMV)] and lymphocyte subpopulations by flow cytometry. CD3(+) T 
lymphocytes, CD8(+) T cells, and B-lymphocyte reconstitution in our study
confirms previous reports. Complete CD4(+) lymphocyte reconstitution was not
achieved in the 12 months post-transplant leading to a suppressed CD4/CD8 ratio. 
IgG antibody titers against measles, mumps, rubella, and polio were present in
almost all patients pretransplant and during 12 months post-transplant,
indicating persistent humoral immunity. CD3(+) and CD8(+) counts of patients with
clinical VZV reactivation ( n=5) post-transplant were significantly higher
(median: 1201/microl and 938/microl, respectively) than in patients without VZV
reactivation (median: 594/microl and 482/microl, respectively) 6-12 months
post-transplant. Positive CMV titers pretransplant ( n=19) were also correlated
with higher CD3(+) and CD8(+) counts 3-6 months post-transplant (median:
1050/microl and 1056/microl, respectively) compared to CMV-negative patients
(738/microl and 584/microl, respectively), although none of the patients suffered
from CMV disease. Therefore, we conclude that persistent viral infections can
contribute to the CD8(+) T-cell reconstitution after PBSCT by oligoclonal
expansion of antigen-specific memory CD8(+) T cells.

PMID: 12739062 [PubMed - indexed for MEDLINE]

2107: IRB. 2002 Sep-Oct;24(5):6-8.

The right of subjects to see the protocol.

Veatch RM.

Kennedy Institute of Ethics, Georgetown University, Washington, DC, USA.

PMID: 12737168 [PubMed - indexed for MEDLINE]

2108: Hua Xi Yi Ke Da Xue Xue Bao. 2001 Mar;32(1):129-30, 139.

[Study on bolus cyclosphamide treatment for 64 cases of lupus nephritis]

[Article in Chinese]

Liu G, Chen Y, Zuo C, Xie Q, Wang Z, Wang L, Lin M.

Department of Clinical Immunology, First Affiliated Hospital, WCUMS, Chengdu
610041, China.

OBJECTIVE: To report on the dosing, efficacy and side-effects of bolus
cyclosphamide treatment for lupus nephritis (LN). METHODS: 64 consecutive cases
of LN with 10 or more erythrocytes per high-power field, proteinuria (> 1 g of
protein per day) and serum creatinine increased (> 133 mumol/L) were treated by
bolus therapy with cyclophosphamide (CTX) given monthly for 6 months and then
quarterly for 18 months. RESULTS: 49 patients had renal remission (defined as <
10 erythrocytes per high-power field, absence of cellular casts, excretion of < 1
g of protein per day and normal serum creatinine). The mean of doses was 1.1 g
for each time (0.6-1.6 g), the mean of times of bolus CTX needed was 3.6 (1-8
times). The adverse events were amenorrhea (in 41% female patients), herpes
zoster (in 13% patients) and hemorrhagic cystitis (in 1 patient). CONCLUSION: The
results indicate that monthly bolus CTX therapy is effective and safe for
patients with LN. Its adverse effect is relatively not a serious problem.

Publication Types: 
    English Abstract

PMID: 12733378 [PubMed - indexed for MEDLINE]

2109: Med Trop (Mars). 2002;62(6):599.

[Ramsay Hunt syndrome]

[Article in French]

Adehossi E, Parola P, Delmont J.

Service des Maladies Infectieuses et Tropicales, Universites-Assistant des
Hopitaux Associe.

Publication Types: 
    Case Reports

PMID: 12731304 [PubMed - indexed for MEDLINE]

2110: Eye. 2003 Apr;17(3):449-51.

Scleromalacia as a complication of herpes zoster ophthalmicus.

Berry-Brincat A, Von Lany H, Evans N.

Publication Types: 
    Case Reports
    Letter

PMID: 12724725 [PubMed - indexed for MEDLINE]

2111: Nippon Rinsho. 2003 Feb;61 Suppl 2:200-4.

[Varicella-zoster virus infection]

[Article in Japanese]

Yoshida M.

First Department of Dermatology, Toho University School of Medicine.

Publication Types: 
    Review

PMID: 12722214 [PubMed - indexed for MEDLINE]

2112: J Virol. 2003 May;77(10):6062-5.

Construction of varicella-zoster virus recombinants from parent Oka cosmids and
demonstration that ORF65 protein is dispensable for infection of human skin and T
cells in the SCID-hu mouse model.

Niizuma T, Zerboni L, Sommer MH, Ito H, Hinchliffe S, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford,
California 94305, USA.

We generated an ORF65 deletion mutant by using a cosmid system constructed from
the genome of a low-passage clinical isolate (P-Oka). Using the SCID-hu mouse
model, we demonstrated that the ORF65 protein is dispensable for viral
replication in skin and T cells, which are critical host cell targets during
primary varicella-zoster virus infection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 12719598 [PubMed - indexed for MEDLINE]

2113: J Virol. 2003 May;77(10):5964-74.

Differentiation of varicella-zoster virus ORF47 protein kinase and IE62 protein
binding domains and their contributions to replication in human skin xenografts
in the SCID-hu mouse.

Besser J, Sommer MH, Zerboni L, Bagowski CP, Ito H, Moffat J, Ku CC, Arvin AM.

Department of Pediatrics and Microbiology, School of Medicine, Stanford
University, Stanford, California 94305, USA. jbesser@stanford.edu

To investigate the role of the ORF47 protein kinase of varicella-zoster virus
(VZV), we constructed VZV recombinants with targeted mutations in conserved
motifs of ORF47 and a truncated ORF47 and characterized these mutants for
replication, phosphorylation, and protein-protein interactions in vitro and for
infectivity in human skin xenografts in the SCID-hu mouse model in vivo. Previous
experiments showed that ROka47S, a null mutant that makes no ORF47 protein, did
not replicate in skin in vivo (J. F. Moffat, L. Zerboni, M. H. Sommer, T. C.
Heineman, J. I. Cohen, H. Kaneshima, and A. M. Arvin, Proc. Natl. Acad. Sci. USA 
95:11969-11974, 1998). The construction of VZV recombinants with targeted ORF47
mutations made it possible to assess the effects on VZV infection of human skin
xenografts of selectively abolishing ORF47 protein kinase activity. ORF47
mutations that resulted in a C-terminal truncation or disrupted the DYS kinase
motif eliminated ORF47 kinase activity and were associated with extensive nuclear
retention of ORF47 and IE62 proteins in vitro. Disrupting ORF47 kinase function
also resulted in a marked decrease in VZV replication and cutaneous lesion
formation in skin xenografts in vivo. However, infectivity in vivo was not
blocked completely as long as the capacity of ORF47 protein to bind IE62 protein 
was preserved, a function that we identified and mapped to the N-terminal domain 
of ORF47 protein. These experiments indicate that ORF47 kinase activity is of
critical importance for VZV infection and cell-cell spread in human skin in vivo 
but suggest that it is the formation of complexes between ORF47 and IE62
proteins, both VZV tegument components, that constitutes the essential
contribution of ORF47 protein to VZV replication in vivo.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 12719588 [PubMed - indexed for MEDLINE]

2114: Ann Dermatol Venereol. 2002 Oct;129(10 Suppl):S37-43.

[Herpes virus infections in immunocompetent children and adults. Varicella and
zona]

[Article in French]

Beylot C, Bagot M, Cambazard F, Berbis P.

PMID: 12718123 [PubMed - indexed for MEDLINE]

2115: Nippon Rinsho. 2003 Mar;61 Suppl 3:575-81.

[Varicella-zoster virus]

[Article in Japanese]

Yoshikawa T, Nishiyama Y.

Laboratory of Virology, Research Institute for Disease Mechanism and Control,
Graduate School of Medicine, Nagoya University.

Publication Types: 
    Review

PMID: 12718031 [PubMed - indexed for MEDLINE]

2116: Neurol Neurochir Pol. 2002 Nov-Dec;36(6):1221-6.

[Neural listeriosis presenting as leptomeningitis: a case report]

[Article in Polish]

Lysiak Z, Litwin T, Baranska-Gieruszczak M, Poniatowska R.

Zakladu Radiologii, II Kliniki Neurologii Instytutu Psychiatrii i Neurologii w
Warszawie.

The Listeria monocytogenes infection is rare and difficult to diagnosis. However,
it is associated with a high mortality in adults. A case is presented of a
78-year-old woman with an immunological deficit following viral infection (herpes
zoster).

Publication Types: 
    Case Reports
    English Abstract

PMID: 12715698 [PubMed - indexed for MEDLINE]

2117: Cytopathology. 2003 Apr;14(2):91-2.

Varicella-zoster virus basophilic meningitis: a case report.

Courtade M, Viguier A, Sailler L, Busato F, Corberand J, Caratero C.

Laboratoire d'Histologie-Cytologie, CHU Rangueil-Larrey, Toulouse Cedex, France. 
courtade@cict.fr

Publication Types: 
    Case Reports

PMID: 12713483 [PubMed - indexed for MEDLINE]

2118: Pediatr Infect Dis J. 2003 Apr;22(4):384-6.

Progressive outer retinal necrosis caused by varicella-zoster virus in children
with acquired immunodeficiency syndrome.

Purdy KW, Heckenlively JR, Church JA, Keller MA.

Division of Infectious Diseases, Department of Pediatrics, Jules Stein Eye
Institute, UCLA School of Medicine, Harbor-UCLA Medical Center, Torrance, CA,
USA.

Publication Types: 
    Case Reports
    Review

PMID: 12712978 [PubMed - indexed for MEDLINE]

2119: Rinsho Shinkeigaku. 2002 Sep;42(9):855-8.

[A case of Ramsay Hunt syndrome initiated with hoarseness and dysphagia:
consideration on spreading mechanisms of cranial neuropathy]

[Article in Japanese]

Miyazaki Y, Tajima Y, Sudo K, Matsumoto A, Kikuchi S, Tashiro K.

Department of Neurology, Sapporo City General Hospital.

A 85-year-old woman was admitted to our hospital because of progressive
hoarseness and dysphagia of two days' duration. Neurological examination on
admission revealed right pharyngeal and vocal cord palsies. After admission,
gradual swelling of her right ear was noted, and on day 6, vesicular eruptions in
her right geniculate zone, the right VII and the VIIIth cranial nerve palsies
were added. On the basis of these findings, she was diagnosed as Ramsay Hunt
syndrome. Varicella zoster virus (VZV) infection was confirmed by the elevation
of serum anti-VZV-antibody titer, and detection of VZV DNA from cerebrospinal
fluid. Ramsay Hunt syndrome associated with multiple cranial neuropathy is not
frequently reported. Reviewing Japanese literatures, we found that the IX and the
Xth cranial nerves were most frequently affected, and the half of these cases
were initiated with cranial neuropathy other than the VIIth. Additionally,
spreading mechanisms of cranial neuropathy, and the early diagnostic problems of 
these conditions were discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12710084 [PubMed - indexed for MEDLINE]

2120: Arch Phys Med Rehabil. 2003 Mar;84(3 Suppl 1):S57-62; quiz S63-8.

Interventions in chronic pain management. 5. Disease-specific issues in chronic
pain.

Rashbaum IG, Lacerte M, Braverman DL, Ericksen JJ.

Department of Rehabilitation Medicine, New York University Medical Center, New
York, NY 10016, USA. rashbi01@endeavor.med.nyu.edu

This self-directed learning module highlights the importance of applying
principles described earlier in the Study Guide to specific diseases encountered 
by practitioners managing chronic pain in order to administer appropriate
treatment. This chapter focuses on several challenging and increasingly common
maladies and attempts to delineate rationales for holistic, comprehensive care.
OVERALL ARTICLE OBJECTIVE: To explore diagnostic concepts and therapeutic
strategies in fibromyalgia syndrome, central pain, multiple sclerosis, complex
regional pain syndrome, and postherpetic neuralgia.

Publication Types: 
    Review

PMID: 12708560 [PubMed - indexed for MEDLINE]

2121: J Neurovirol. 2003 Apr;9(2):194-204.

Herpes simplex virus-1 and varicella-zoster virus latency in ganglia.

Mitchell BM, Bloom DC, Cohrs RJ, Gilden DH, Kennedy PG.

Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.

Two human alpha-herpesviruses, herpes simplex virus (HSV)-1 and varicella zoster 
virus (VZV), account for the most frequent and serious neurologic disease caused 
by any of the eight human herpesviruses. Both HSV-1 and VZV become latent in
ganglia. In this review, the authors describe features of latency for these
viruses, such as distribution, prevalence, abundance, and configuration of viral 
DNA in latently infected human ganglia, as well as transcription, translation,
and cell type infected. Studies of viral latency in animal models are also
discussed. For each virus, remaining questions and future studies to understand
the mechanism of latency are discussed with respect to prevention of serious
cutaneous, ocular, and neurologic disease produced by virus reactivation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 12707850 [PubMed - indexed for MEDLINE]

2122: J Dermatol. 2003 Apr;30(4):348-9.

A rather rare encounter with herpes zoster in a male infant.

Kashima M.

Publication Types: 
    Case Reports
    Letter
    Review

PMID: 12707476 [PubMed - indexed for MEDLINE]

2123: J Dermatol. 2003 Apr;30(4):346-7.

Herpes zoster neonatorum.

Brar BK, Pall A, Gupta RR.

Publication Types: 
    Case Reports
    Letter

PMID: 12707475 [PubMed - indexed for MEDLINE]

2124: Neurology. 2003 Apr 22;60(8):E6-7.

Comment on:
    Neurology. 2003 Apr 22;60(8):1274-83.    Neurology. 2003 Apr 22;60(8):1391-2.

Patient pages. Treatment of postherpetic neuralgia.

Lovitt S.

Publication Types: 
    Comment
    Patient Education Handout

PMID: 12707463 [PubMed - indexed for MEDLINE]

2125: Neurology. 2003 Apr 22;60(8):1391-2.

Comment in:
    Neurology. 2003 Apr 22;60(8):E6-7.

Topical ketamine treatment of postherpetic neuralgia.

Quan D, Wellish M, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 12707455 [PubMed - indexed for MEDLINE]

2126: Neurology. 2003 Apr 22;60(8):1274-83.

Comment in:
    Neurology. 2003 Apr 22;60(8):E6-7.

Pregabalin for the treatment of postherpetic neuralgia: a randomized,
placebo-controlled trial.

Dworkin RH, Corbin AE, Young JP Jr, Sharma U, LaMoreaux L, Bockbrader H, Garofalo
EA, Poole RM.

University of Rochester School of Medicine and Dentistry, Rochester, NY 14642,
USA. robert_dworkin@urmc.rochester.edu

OBJECTIVE: To evaluate the efficacy and safety of pregabalin in the treatment of 
postherpetic neuralgia (PHN). METHODS: The authors conducted a multicenter,
parallel-group, double-blind, placebo-controlled, 8-week, randomized clinical
trial in PHN, defined as pain for 3 or more months following herpes zoster rash
healing. Patients (n = 173) were randomized to treatment with pregabalin or
placebo. Patients randomized to pregabalin received either 600 mg/day (creatinine
clearance > 60 mL/min) or 300 mg/day (creatinine clearance 30 to 60 mL/min). The 
primary efficacy measure was the mean of the last seven daily pain ratings.
Secondary endpoints included additional pain ratings, sleep interference, quality
of life, mood, and patient and clinician ratings of global improvement. RESULTS: 
Pregabalin-treated patients had greater decreases in pain than patients treated
with placebo (endpoint mean scores 3.60 vs 5.29, p = 0.0001). Pain was
significantly reduced in the pregabalin-treated patients after the first full day
of treatment and throughout the study, and significant improvement on the McGill 
Pain Questionnaire total, sensory, and affective pain scores was also found. The 
proportions of patients with >or=30% and >or=50% decreases in mean pain scores
were greater in the pregabalin than in the placebo group (63% vs 25% and 50% vs
20%, p = 0.001). Sleep also improved in patients treated with pregabalin compared
to placebo (p = 0.0001). Both patients and clinicians were more likely to report 
global improvement with pregabalin than placebo (p = 0.001). Given the maximal
dosage studied, pregabalin had acceptable tolerability compared to placebo
despite a greater incidence of side effects, which were generally mild to
moderate in intensity. CONCLUSIONS: Treatment of PHN with pregabalin is safe,
efficacious in relieving pain and sleep interference, and associated with greater
global improvement than treatment with placebo.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 12707429 [PubMed - indexed for MEDLINE]

2127: Arch Neurol. 2003 Apr;60(4):616-7.

Surgical induction of zoster in a contralateral homologous dermatomal
distribution.

Gilden DH, Katz RI.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
80262, USA. don.gilden@uchsc.edu

Herpes zoster occurs most often in elderly and immunocompromised individuals, and
rarely after surgery. We report 2 cases in which zoster developed in the
contralateral dermatome distribution homologous to the surgical site. The
mechanism by which unilateral surgery might affect homologous ganglia is likely
to involve spinal cord pathways above the dermatomal level of surgical trauma.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 12707078 [PubMed - indexed for MEDLINE]

2128: Indian J Ophthalmol. 2003 Mar;51(1):71-5.

The diagnostic significance of enzyme linked immuno-sorbent assay for herpes
simplex, varicella zoster and cytomegalovirus retinitis.

Madhavan HN, Priya K.

L & T Microbiology Centre, Vision Research Foundation, Sankara Nethralaya,
Chennai, India. drhnm@sankaranethralaya.org

PURPOSE: To evaluate the diagnostic usefulness of enzyme linked immuno-sorbent
assay (ELISA) in single serum samples to associate herpes simplex virus (HSV),
varicella zoster virus (VZV) or cytomegalovirus (CMV) with viral retinitis as
against polymerase chain reaction (PCR) on intraocular specimens. It was also
designed to study the seroprevalence in normal healthy individuals, and the
genomic prevalence of HSV, VZV and CMV in patients without an active viral
inflammatory process. METHODS: PCR for the detection of HSV, VZV and CMV genomes 
was done on 33 and 90 intraocular fluids from viral retinal patients and
non-viral controls respectively. ELISA was done on 30 and 100 serum samples from 
viral retinitis patients and normal healthy controls respectively. RESULTS: PCR
did not detect HSV, VZV and CMV genomes except one, in which VZV-DNA was
detected. ELISA showed prevalence rates of 28%, 83% and 90% for antibodies
against HSV, VZV and CMV respectively in the normal population. In the 30 viral
retinitis patients, PCR detected HSV-DNA in 2 (6.7%), VZV-DNA in 7 (23.3%) and
CMV-DNA in 6 (20.0%) patients, while ELISA detected antibodies against HSV, VZV
and CMV in 13 (43.3%), 24 (80.0%) and 23 (76.7%) patients respectively. ELISA was
of value in indirect diagnosis only in 6 (20.0%) as compared to 15 (50.0%) of 30 
patients by PCR, this difference was statistically significant (McNemar test, P
value = 0.005). CONCLUSION: Serology by ELISA is no longer a useful diagnostic
tool to associate HSV, VZV and CMV viruses with viral retinitis.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 12701866 [PubMed - indexed for MEDLINE]

2129: AIDS. 2003 May 2;17(7):1110-1.

Progressive outer retinal necrosis in a 73-year-old man: treatment with
valganciclovir.

Peck R, Gimple SK, Gregory DW, Youree B.

Publication Types: 
    Case Reports
    Letter

PMID: 12700472 [PubMed - indexed for MEDLINE]

2130: Arch Med Res. 2003 Mar-Apr;34(2):116-9.

Nested polymerase chain reaction for Mycobacterium tuberculosis DNA detection in 
aqueous and vitreous of patients with uveitis.

Ortega-Larrocea G, Bobadilla-del-Valle M, Ponce-de-Leon A, Sifuentes-Osornio J.

Clinica de Enfermedades Oculares Inflamatorios, Asociacion para Evitar la Ceguera
en Mexico Luis Sanchez Bulnes, Mexico City, Mexico.

BACKGROUND: Tuberculosis may be a lethal disease. Its ocular manifestations are
commonly associated with severe difficulties in diagnosis and therapy;
furthermore, it may cause blindness. DNA amplification methods may allow early
detection of small amounts of Mycobacterium tuberculosis DNA to afford the
possibility of prompt diagnosis. We evaluated a nested polymerase chain reaction 
(nPCR) assay for detection of Mycobacterium tuberculosis DNA in aqueous and
vitreous. METHODS: In a case-control study, 22 cases of diagnosed TB uveitis
(three HIV-infected patients) and 38 controls (18 HIV-infected patients) with
other types of uveitis (syphilis, nine; cytomegalovirus, seven; toxoplasmosis,
five; herpes simplex, one; autoimmune vasculitis, eight; Vogt-Koyanagi-Harada,
four; pars planitis, one; serpinginous choroiditis, one; Wegener granulomatosis, 
one; and Fuchs iridocyclitis, one studied). Samples from aqueous or vitreous were
cultured and analyzed by nPCR for presence of M. tuberculosis nucleic acids. We
used two sets of primers corresponding to IS6110 region coding for 219 bp and 123
bp DNA sequences. RESULTS: Results were confirmed by Southern blot. All samples
were tested by PCR simultaneously for Herpes simplex I, Herpes zoster,
cytomegalovirus (CMV) and Toxoplasma gondii. nPCR was positive in 17 cases
(77.2%) and only in three controls (8.8%) p = 0.022. All cultures were negative. 
Southern blot confirmed all positive nPCR tests. According to our definition of
cases, there were five false negative results: two in patients with pulmonary
tuberculosis; two in patients with tuberculous lymphadenitis, and one with
positive skin test and hematuria. There were three cases considered false
positives for nPCR: one with autoimmune vasculitis, and two with toxoplasmic
uveitis. CONCLUSIONS: nPCR for TB in ocular fluids was positive in the majority
of cases of ocular TB. This method is useful in early confirmation of ocular
tuberculosis.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12700006 [PubMed - indexed for MEDLINE]

2131: Vestn Ross Akad Med Nauk. 2003;(2):44-9.

[Modern aspects in the treatment of ophthalmic herpes]

[Article in Russian]

Kasparov AA, Vorob'eva OK, Kasparova EA.

The author report about study results conducted in Russia during the recent 30
years and dedicated to the treatment of ocular pathologies caused by the virus of
herpes simplex. Three high-efficiency directions took shape during the mentioned 
period: 1. Non-specific antiviral therapy based on the local and systemic
administration of interferon inductors (poludan--complexes of poly A, poly U
etc.) possessing an extensive spectrum of the antiviral and immune-modeling
actions; 2. Antirecurrent therapy, including the application of herpetic vaccine 
against the virus of herpes simplex, types I and II, combined with
immune-modeling agents. A focal allergic test with herpetic vaccine was offered, 
it made it possible, for the first time, a non-invasive diagnostics of
intraocular herpes. 3. A system of sparing microsurgical methods adapted to the
treatment of an active herpetic keratitis and its outcomes. A synergistic effect 
of interferon inductors and acyclovir was proven both experimentally and
clinically; a method of local autocytokinotherapy (based on poludan), which
turned out to be most effective in the treatment of severe lesions at the cornea 
and of intraocular herpes, was worked out. The authors believe that the methods
and means offered for the treatment of ophthalmoherpes contribute, to a great
extent, to handling with the ocular herpes viral infection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12698890 [PubMed - indexed for MEDLINE]

2132: Z Gastroenterol. 2003 Apr;41(4):325-8.

[Functional asplenia after severe varicella zoster-infection diagnosis by colour 
Doppler ultrasound]

[Article in German]

Diedrich J, Gorg C, Eissele R, Arnold R.

Zentrum fur Innere Medizin, Abteilung fur Innere Medizin mit Schwerpunkt
Gastroenterologie, Stoffwechsel, Endokrinologie, Klinikum der
Philipps-Universitat Marburg.

Infiltrative, inflammatory or thromboembolic processes in the parenchyma of the
spleen can cause a functional loss of the organ. This phenomenon is called
functional asplenia and occurs as a complication especially in sickle cell
disease, lupus erythematosus and after bone marrow transplantation. We present
the case of a patient with Crohn's disease under immunosuppressive therapy who
developed a spontaneous covered spleen rupture in the course of a septic shock
with DIG due to a Varizella zoster infection. Later on, sonography showed a
diminution of the spleen size. No flow signals could be derived by colour doppler
measurements from the spleen. Because of the colour doppler findings we suspected
a functional asplenia which was then verified by spleen scintigraphy and
Howell-Jolly-Bodies in the blood count. Remarkably, the Crohn's disease remains
in complete remission since the development of the functional asplenia (for 4
years now). The underlying pathomechanism remains unclear.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12695938 [PubMed - indexed for MEDLINE]

2133: Praxis (Bern 1994). 2003 Mar 19;92(12):558-61.

[A different headache]

[Article in German]

Fehr J.

Medizinische Universitatspoliklinik, Departement Innere Medizin, Kantonsspital
Basel.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 12693148 [PubMed - indexed for MEDLINE]

2134: J Dermatol. 2003 Feb;30(2):109-15.

Role of neutralizing antibody in the pathogenesis of zoster and the correlation
of severity with anti-gE: gI antibody response.

Matsuo K, Honda M, Shiraki K.

Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan.

Antibody response to varicella-zoster virus glycoproteins and neutralizing
antibodies were examined to correlate them with the severity of the zoster.
Antibody rise to whole viral antigen was observed in 17 of 19 patients, that to
gE: gI was not increased in 7 patients, and antibody to gE: gI in severe cases
was significantly lower compared with mild cases in the convalescent phase than
in the acute phase (p<0.05 Fisher's exact test). Antibody rise to gE: gI was well
correlated with limited development of zoster lesions and, in contrast, antibody 
titer without rise was associated with increased severity and wider development
of zoster lesions. As gE is the most abundant glycoprotein in the infected cells,
the antibodies may be consumed in severe and widespread lesions, resulting in an 
antibody response to gE: gI without a rise. When the ratio of neutralizing
antibody to anti-gE: gI antibody titers in the acute phase was compared with that
in the recovery phase, the former was significantly lower in the severe cases
than the latter (p=0.0082 Student t-test). This suggested that neutralizing
antibody was specifically consumed in the acute phase of zoster among the
anti-VZV antibodies. The role of humoral immunity in the pathogenesis of zoster
might have been reflected in the antibody response to the neutralizing antibody
in the acute phase and antibody to gE: gI in the severe cases.

PMID: 12692377 [PubMed - indexed for MEDLINE]

2135: J Clin Microbiol. 2003 Apr;41(4):1565-8.

Rapid detection of herpes simplex virus and varicella-zoster virus infections by 
real-time PCR.

Weidmann M, Meyer-Konig U, Hufert FT.

Department of Virology, Institute for Medical Microbiology and Hygiene,
University of Freiburg, 79104 Freiburg, Germany.

The herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2) and varicella-zoster
virus (VZV) can cause life-threatening infections of the central nervous system
and lead to severe infections in immunocompromised subjects and newborns. In
these cases, rapid diagnosis is crucial. We developed three different real-time
PCR assays based on TaqMan chemistry for the LightCycler instrument to detect
HSV-1, HSV-2, and VZV. When the TaqMan assays were compared to our in-house
nested PCR assays, the test systems had equal sensitivities of <or=10 plasmid
copies per assay. When clinical samples were investigated by TaqMan PCR to detect
HSV-1, HSV-2, and VZV DNA, 95, 100, and 96% of the samples determined to be
positive by nested PCR, respectively, were positive by the real-time PCR assays. 
The specificities of all PCR assays were almost 100%. Furthermore, the TaqMan PCR
assays could be performed within 2.5 h, whereas nested PCR results were available
after 9 h. In addition to offering more rapid results, the TaqMan PCR assays
appear to be less expensive than nested PCR assays due to less hands-on time. In 
summary, TaqMan PCR is an excellent alternative to conventional nested PCR assays
for the rapid detection of HSV-1, HSV-2, and VZV in clinical samples.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 12682146 [PubMed - indexed for MEDLINE]

2136: An Pediatr (Barc). 2003 Apr;58(4):398-400.

[Limp as the clinical presentation of herpes zoster]

[Article in Spanish]

Iglesias Escalera G, Rodriguez Blanco MA, Suarez Otero G, Martin Morales M,
Periscal U, Naveiro J.

Publication Types: 
    Case Reports
    Letter

PMID: 12681195 [PubMed - indexed for MEDLINE]

2137: Enferm Infecc Microbiol Clin. 2003 Apr;21(4):217-8.

[Infection due to herpes zoster and cryptococcus after initiating high-activity
antiretroviral treatment]

[Article in Spanish]

Fonseca EM, Nuno FJ, Garcia-Alcalde ML, Menendez MJ.

Publication Types: 
    Case Reports
    Letter

PMID: 12681139 [PubMed - indexed for MEDLINE]

2138: J Biol Chem. 2003 Jul 4;278(27):24680-7. Epub 2003 Apr 9.

Crystal structure of varicella zoster virus thymidine kinase.

Bird LE, Ren J, Wright A, Leslie KD, Degreve B, Balzarini J, Stammers DK.

Division of Structural Biology, The Wellcome Trust Centre for Human Genetics,
Henry Wellcome Building of Genomic Medicine, University of Oxford, Roosevelt
Drive, Headington, United Kingdom.

Herpes virus thymidine kinases are responsible for the activation of nucleoside
antiviral drugs including (E)-5-(2-bromovinyl)-2'-deoxyuridine. Such viral
thymidine kinases (tk), beside having a broader substrate specificity compared
with host cell enzymes, also show significant variation in nucleoside
phosphorylation among themselves. We have determined the crystal structure of
Varicella zoster virus (VZV, human herpes virus 3) thymidine kinase complexed
with (E)-5-(2-bromovinyl)-2'-deoxyuridine 5'-monophosphate and ADP. Differences
in the conformation of a loop region (residues 55-61) and the position of two
alpha-helices at the subunit interface of VZV-tk compared with the herpes simplex
virus type 1 (human herpes virus 1) enzyme give rise to changes in the
positioning of residues such as tyrosine 66 and glutamine 90, which hydrogen bond
to the substrate in the active site. Such changes in combination with the
substitution in VZV-tk of two phenylalanine residues (in place of a tyrosine and 
methionine), which sandwich the substrate pyrimidine ring, cause an alteration in
the positioning of the base. The interaction of the
(E)-5-(2-bromovinyl)-2'-deoxyuridine deoxyribose ring with the protein is altered
by substitution of tyrosine 21 and phenylalanine 139 (analagous to herpes simplex
virus type 1 histidine 58 and tyrosine 172), which may explain some of the
differences in nucleoside sugar selectivity between both enzymes. The altered
active site architecture may also account for the differences in the substrate
activity of ganciclovir for the two thymidine kinases. These data should be of
use in the design of novel antiherpes and antitumor drugs.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12686543 [PubMed - indexed for MEDLINE]

2139: Clin Neurophysiol. 2003 Apr;114(4):702-9.

Laser-evoked potentials in post-herpetic neuralgia.

Truini A, Haanpaa M, Zucchi R, Galeotti F, Iannetti GD, Romaniello A, Cruccu G.

Department of Neurological Sciences, University La Sapienza, Viale Universita 30,
00185, Rome, Italy.

OBJECTIVE: We evaluated the reliability of laser-evoked potentials (LEPs) as a
diagnostic tool in patients with post-herpetic neuralgia (PHN), i.e. a chronic
painful condition that causes small-diameter fibre dysfunction. Furthermore, we
sought information on pathophysiology of PHN pain. METHODS: We recorded 'late'
LEPs after stimulation of the supraorbital, upper cervical, lower cervical, upper
thoracic, mid thoracic, and lower thoracic territories in 12 control subjects and
40 patients with PHN. We also determined the correlation of LEP data with age,
duration of disease, and severity and quality of pain. RESULTS: At all
stimulation sites, laser pulses invariably evoked high-amplitude brain potentials
related to small-myelinated (A-delta) fibre activation. The laser perceptive
threshold and LEP latency correlated with the distance of the dermatome from the 
brain (P<0.001). In patients, the perceptive threshold was higher and the LEP
amplitude was lower in the affected dermatome than on the contralateral side
(P<0.001). We found no significant LEP-clinical correlation except for a
correlation between LEP abnormality and age. CONCLUSIONS: Being sensitive and
reliable in assessing sensory function also in proximal dermatomes, LEPs are a
promising diagnostic tool in radiculopathies. Although PHN severely impairs small
myelinated fibres, the lack of a significant correlation between LEP
abnormalities and pain suggests that pain in PHN does not chiefly arise from a
dysfunction of small-myelinated afferents.

Publication Types: 
    Clinical Trial

PMID: 12686278 [PubMed - indexed for MEDLINE]

2140: J Coll Physicians Surg Pak. 2003 Feb;13(2):104-5.

Zosteriform Lichen planus.

Arfan-ul-Bari, Rahman SB.

Department of Dermatology, Military Hospital, Rawalpindi.

Ordinarily, Lichen planus (LP) is as easily recognizable as an old friend of a
dermatologist. But some times it comes in disguise. It has been reported to occur
in the scars of previous herpes zoster lesions. Zosteriform pattern in LP,
without evidence of herpes zoster, is an extremely rare occurrence and such
presentation of the disease over head and neck region, to the best of our
knowledge, was not reported in literature before. We present a patient who had
grouped lichenoid lesions on one side of the neck with no previous or concomitant
history of herpes zoster on the involved site or elsewhere on the body.

Publication Types: 
    Case Reports

PMID: 12685955 [PubMed - indexed for MEDLINE]

2141: Pol Arch Med Wewn. 2002 Nov;108(5):1055-63.

[Analysis of efficacy and safety of multiple intravenous infusion of anti-tumor
necrosis factor-alpha monoclonal antibody (Remicade) combined with methotrexate
compared with sodium aurothiomalate and intramuscular depot methylprednisolone in
rheumatoid arthritis]

[Article in Polish]

Wiland P, Glowska A, Chlebicki A, Szechinski J.

Oddzial Chorob Wewnetrznych i Reumatologii Okregowego Szpitala Kolejowe,
Wroclawiu.

The objective of the paper was compare the effects and tolerability of combined
therapy of multiple intravenous infusions of anti-tumour necrosis factor-alfa
(TNF-alfa) monoclonal antibody (Remicade) with methotrexate versus treatment with
sodium aurothiomalate and intramuscular depot methylprednisolone in rheumatoid
arthritis (RA). We investigate also the interval necessary to obtain the
improvement in both treatment groups. 36 patients commencing intramuscular sodium
aurothiomalate therapy with intramuscular depot methylprednisolone acetate at
weeks 0, 4, 8 and 12 in addition to chrysotherapy were compared in retrospective 
analysis with 32 patients starting with multiple intravenous infusions of
infliximab, anti-TNF-alfa monoclonal antibody (Remicade) and methotrexate at a
stable dose. Patients were assessed by composite clinical score (DAS 28) and
C-reactive protein during 22 weeks of therapy. At week 2 and 6 a significantly
greater percentage of infliximab-treated than gold-treated RA patients achieved
improvement in each clinical measurement of disease activity. At 22 week of
treatment moderate and good response according to EULAR criteria was achieved in 
91% of infliximab-treated patients and 58% gold treated patients (p < 0.001).
Adverse events were more frequently observed in infliximab-treated patients, but 
only gold-treated patients discontinued treatment because adverse events (2
patients due to proteinuria, 2 patients due to mucocutaneous changes and one
patient due to leucopenia). The higher percentage of adverse events in
infliximab-treated patients was caused mainly by the occurrence of infusion
reactions (23 reactions out of 160 infusions); most of them were mild
(somnolentia and headache) and transient. Viral infections (including herpes
simplex and zoster) were more common in patients treated with infliximab and
methotrexate. Combination therapy of infliximab and methotrexate is more
effective in reducing clinical and biochemical disease activity than gold with
methylprednisolone treatment in RA patients during 22 weeks of treatment,
especially in the first 6 weeks.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract

PMID: 12685246 [PubMed - indexed for MEDLINE]

2142: J Oral Maxillofac Surg. 2003 Apr;61(4):489-93.

Comment in:
    J Oral Maxillofac Surg. 2003 Dec;61(12):1505; author reply 1505.

A case of maxillary necrosis.

Pogrel MA, Miller CE.

Department of Oral and Maxillofacial Surgery, University of California, San
Francisco, San Francisco, CA 94143, USA. map@itsa.ucsf.edu

Publication Types: 
    Case Reports
    Clinical Conference

PMID: 12684969 [PubMed - indexed for MEDLINE]

2143: Eur J Pediatr. 2003 Jun;162(6):434-5. Epub 2003 Apr 8.

Herpes zoster and aseptic meningitis in a previously healthy child.

Szinnai G, Farron F, Bar G, Heininger U.

Service de Pediatrie, Hopital regional de Delemont, Switzerland.

Publication Types: 
    Case Reports

PMID: 12684902 [PubMed - indexed for MEDLINE]

2144: Infect Control Hosp Epidemiol. 2003 Mar;24(3):202-6.

A cluster of primary varicella cases among healthcare workers with false-positive
varicella zoster virus titers.

Behrman A, Schmid DS, Crivaro A, Watson B.

Hospital of the University of Pennsylvania, Division of Occupational Medicine,
University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.

BACKGROUND: Five cases of primary varicella zoster virus (VZV) we re diagnosed
among hospital healthcare workers (HCWs). All had complied with a pre-employment 
VZV screening program and had been considered immune. OBJECTIVES: To summarize
the investigation of VZV among un-immunized HCWs and to provide recommendations
for avoiding false-positive serologic tests. DESIGN: Risk of transmission of VZV 
to susceptible HCWs is minimized through serologic screening. Varicella vaccine
is recommended for susceptible HCWs. A commercially available latex bead
agglutination assay (LA) is widely used because it is rapid and easy to perform. 
LA was compared with the whole-cell varicella ELISA standardized in the Centers
for Disease Control and Prevention (CDC) National Herpes Laboratory.
SETTING/POPULATION: Large inner-city, tertiary-employee population. RESULTS: In a
year, 5 HCWs presented with laboratory-confirmed primary varicella infection.
Four had VZV exposures 2 weeks prior to presentation. All had documented positive
VZV titers by LA performed at hire. None were offered VZV vaccination. The
original LAs were judged false-positives. INTERVENTION/FOLLOW-UP INVESTIGATION:
Fifty-three consecutive VZV LA samples from the hospital laboratory were retested
at the CDC. Forty-four samples concurred. Of the remaining 9, 4 were positive by 
hospital LA but negative by CDC IgG ELISA. Four were equivocal by hospital LA but
negative by CDC IgG ELISA and LA. One was positive by hospital LA but negative by
LA and equivocal by ELISA at the CDC. CONCLUSION: LA may be prone to
false-positive results and inappropriate for screening hospital HCWs.

Publication Types: 
    Case Reports

PMID: 12683513 [PubMed - indexed for MEDLINE]

2145: Nurs Times. 2003 Mar 18-24;99(11):28.

What you need to know about... herpes zoster (shingles).

[No authors listed]

PMID: 12683041 [PubMed - indexed for MEDLINE]

2146: Noise Health. 2001;4(13):71-80.

Health profiles for patients with Meniere's disease.

Holgers KM, Finizia C.

Dept of Audiology, Sahlgrenska University Hospital, S-413 45 Goteborg, Sweden,
Email: Kajsa-Mia.Holgers@sahlgrenska.se

The Nottingham Health Profile (NHP) has been used to investigate the health
profiles for many medical conditions, such as herpes zoster infection, migraine, 
cancer and epilepsy. However, so far, it has not been used to investigate the
health profile for patients suffering from Meniere's disease, but only for
patients with dizziness, severe hearing loss and tinnitus. Each of these three
symptoms have shown to have a significant impact on the quality of life. In the
present study, 116 consecutive patients with Meniere's disease, diagnosed
according to the AAO-HNS guidelines, visiting at the department of Audiology were
included in the study. The NHP was used to measure the health related quality of 
life and includes the following subscales: "Sleep", "Energy", "Emotional
reaction", "Pain", "Physical mobility", "Social isolation" and items concerning
daily activity. The Tinnitus Severity Questionnaire (TSQ) was used to measure
symptoms specific to tinnitus. The results showed that the perceived severity of 
tinnitus in patients with Meniere's disease had a significant negative influence 
on their health related quality of life. The patients with Meniere's disease
suffered from more sleep disturbances and social isolation than patients referred
to our clinic due to tinnitus. The quality of life was, on the whole, worse for
patients of working age compared to retired pensioners. Emotional disturbances
could explain 40.3 % of the variance of the tinnitus severity in patients with
Meniere's disease. This can be compared with 20.6% in patients with tinnitus.
This underscores the importance of providing psychological and psychiatric
interventions and support to patients with Meniere's disease.

PMID: 12678936 [PubMed - as supplied by publisher]

2147: N Engl J Med. 2003 Apr 3;348(14):1405-7; author reply 1405-7.

Comment on:
    N Engl J Med. 2002 Dec 12;347(24):1909-15.    N Engl J Med. 2002 Dec 12;347(24):1962-3.

An outbreak of varicella despite vaccination.

Wack RP.

Publication Types: 
    Comment
    Letter

PMID: 12678025 [PubMed - indexed for MEDLINE]

2148: Ugeskr Laeger. 2003 Mar 10;165(11):1144-5.

[Herpes zoster as differential diagnosis of ureterolithiasis]

[Article in Danish]

Sommer T, Poulsen J.

Aalborg Sygehus Nord, Urologisk Afdeling. tbsommer@privat.tdcadsl.dk

Patients with acute loin pain and microscopic hematuria may suffer from diseases 
rarely seen in the urological department. We describe a case where a patient with
symptoms of a ureteral stone turned out to have herpes zoster. She was treated
with aciclovir and recovered well without postherapetic sequelae.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12677995 [PubMed - indexed for MEDLINE]

2149: Nurs Times. 2003 Mar 11-17;99(10):32-4.

Effective pain management of post-herpetic neuralgia.

Johnson L.

Pain Relief Unit, King's College Hospital, London.

Post-herpetic neuralgia is a severe type of pain that can have a devastating
impact on a patient's quality of life. Successful management requires early
recognition and treatment with appropriate drugs, topical agents,
non-pharmacological treatments, and psychological support.

Publication Types: 
    Review

PMID: 12677936 [PubMed - indexed for MEDLINE]

2150: BMJ. 2003 Apr 5;326(7392):748-50.

Treatment of herpes zoster and postherpetic neuralgia.

Johnson RW, Dworkin RH.

Pain Management Clinic, Bristol Royal Infirmary, Bristol BS2 8HW, University of
Rochester Medical Centre, New York, USA.

Publication Types: 
    Review

PMID: 12676845 [PubMed - indexed for MEDLINE]

2151: Cancer. 2003 Apr 15;97(8):1963-8.

Phase I study of temozolomide and escalating doses of oral etoposide for adults
with recurrent malignant glioma.

Korones DN, Benita-Weiss M, Coyle TE, Mechtler L, Bushunow P, Evans B, Reardon
DA, Quinn JA, Friedman H.

James P. Wilmot Cancer Center, University of Rochester School of Medicine and
Dentistry, Rochester, New York, USA. david_korones@urmc.rochester.edu

BACKGROUND: Although temozolomide is active against recurrent malignant glioma,
responses in many patients are modest and short-lived. Temozolomide may prove
more effective in combination with other agents. Therefore, combination oral
chemotherapy for these patients is a particularly attractive approach. METHODS:
The authors conducted a Phase I study of temozolomide in combination with
escalating doses of oral etoposide (VP-16) to determine the maximum tolerated
doses of these two agents when given together. The temozolomide dose was fixed at
150 mg/m(2) per day on Days 1-5. The oral VP-16 was escalated in cohorts of 3 to 
6 patients by numbers of days of VP-16 administered: 50 mg/m(2) per day, Days 1-5
(dose level 1), Days 1-8 (dose level 2), Days 1-12 (dose level 3), Days 1-16
(dose level 4), and Days 1-20 (dose level 5). Therapy was given in 28-day cycles.
RESULTS: Of the 29 patients enrolled, 26 were fully evaluable and 3 were
partially evaluable for toxicity. The 29 patients received a total of 92 cycles. 
The median age of the patients was 49 years (range, 28-76 years). Diagnoses
included glioblastoma (n = 19), gliosarcoma (n = 3), anaplastic astrocytoma (n = 
5), and anaplastic oligoastrocytoma (n = 2). The median time from diagnosis to
disease recurrence was 8 months (3-188 months). Twenty patients were treated at
the first disease recurrence, seven at the second, and two at the third.
Twenty-four patients (83%) were receiving anticonvulsants and 24 were receiving
dexamethasone. All patients had received previous radiation, and 25 of 29 had
been treated with chemotherapy previously. Of the 3 patients at dose level 1,
none had dose-limiting toxicity (DLT). Of the 6 patients at dose level 2, 1
patient had DLT: Grade 3 thrombocytopenia resulting in a > 2-week delay in
starting the next cycle of chemotherapy. Of the 6 patients at dose level 3, 1
patient had DLT: death due to pneumonia. There were 2 DLTs in the 7 patients at
dose level 4: fever, neutropenia, and herpes zoster infection in 1 patient and
death due to pneumonia in another. Seven patients had been started at dose level 
5 when DLT was established at dose level 4: of the 5 fully evaluable and 2
partially evaluable patients at dose level 5, there was no DLT. CONCLUSIONS: The 
maximum tolerated dose of temozolomide and oral VP-16 in this heavily treated
group of patients with recurrent malignant glioma is temozolomide 150 mg/m(2) per
day for 5 days and oral VP-16 50 mg/m(2) per day for 12 days. Copyright 2003
American Cancer Society.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase I
    Research Support, Non-U.S. Gov't

PMID: 12673724 [PubMed - indexed for MEDLINE]

2152: Clin Lymphoma. 2003 Mar;3(4):253-6.

Atypical lymphoid infiltration occurring at the site of a healed varicella zoster
infection.

Talpur R, Duvic M.

Department of Dermatology, The University of Texas M. D. Anderson Cancer Center, 
Houston, Texas, USA.

Herpes zoster infection has been associated with a number of cutaneous reactions.
The authors report the first case of a patient with an atypical epidermotropic
lymphoid infiltrate that arose within skin previously affected by herpes
varicella zoster. The differential diagnosis of such lesions and review of
literature on previous cutaneous infiltrates occurring at sites of zoster
infection are discussed

Publication Types: 
    Case Reports
    Review

PMID: 12672277 [PubMed - indexed for MEDLINE]

2153: J Dermatol Sci. 2003 Apr;31(2):129-33.

Analysis of numbers of repeated units in R2 region among varicella-zoster virus
strains.

Yoshida M, Tamura T, Miyasaka K, Shimizu A, Ohashi N, Itoh M.

First Department of Dermatology, Toho University School of Medicine, Omori-nishi 
5-21-16, Ota-ku, 143-8540, Tokyo, Japan. yoshidam@med.toho-u.ac.jp

BACKGROUND: A variable region, R2, on the varicella-zoster virus (VZV) genome
contains a repeated 42-bp unit. OBJECTIVE: The purpose of this study is the
derivation of significance from tandem reiteration structure in the R2 region.
METHODS: Fifty-two specimens were collected from 52 patients with herpes zoster
in Osaka and Tokyo, Japan. After treatment of the specimens to release viral DNA,
the samples were amplified directly by polymerase chain reaction. In addition, 14
samples were collected from 7 of these zoster patients after valaciclovir or
aciclovir therapy. RESULTS: Analyses of the 52 specimens revealed that the number
of repeats ranged from 4 to 13. Interestingly, the numbers of repeats among
various VZV strains showed a normal distribution pattern, so that 6-9 repeats
were found to be predominant in both Osaka (85%) and Tokyo (72%). The pre- and
post-treatment strains taken from the same individuals showed the same numbers of
repeats (7-9 in 6 cases and 11 in one). CONCLUSION: Our results suggest that the 
6-9 repetitions of the 42-bp unit, with presumed stability, may offer these virus
strains an advantage in virulence to human skin.

PMID: 12670723 [PubMed - indexed for MEDLINE]

2154: Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2002 Sep;16(3):274-7.

[Experimental study on effect of recombined decoction on mumps virus]

[Article in Chinese]

Zhang Z, Yang L, Liu Q, Li G, Lu X.

Department of Stomatology, Shanxi Hospital, Xi'an Jiaotong University, Xi'an
710068, China.

OBJECTIVE: To evaluate possible inactivating effect of recombined decoction in on
mumps virus. METHODS: By adopting tissue cell culturing technology, a group of
viruses including the mumps virus, herpes simplex virus (type I, II), rubella
virus, cytomegalovirus (CMV), herpes zoster virus, influenza virus, parainfluenza
virus, adeno viruses, respiratory syneytial virus (RSV) were cultured. The cells 
infected with the viruses were treated with the decoction. RESULTS: The decoction
showed remarkable inhibitory and killing effects on the mumps virus while had no 
obvious inhibitory and killing effects on host's cells, herpes simplex virus
(type I, II), rubella virus, cytomegalovirus (CMV), herpes zoster virus,
influenza virus, parainfluenza virus, adeno viruses, respiratory syneytial virus 
(RSV). CONCLUSIONS: The decoction had obvious inhibitory and killing effects on
mumps virus during single layer cells culture.

Publication Types: 
    English Abstract

PMID: 12665939 [PubMed - indexed for MEDLINE]

2155: MMW Fortschr Med. 2003 Feb 20;145(8):16.

[Zoster and erysipelas. We family physicians can treat them very well, too]

[Article in German]

Baum E.

Publication Types: 
    Letter

PMID: 12661436 [PubMed - indexed for MEDLINE]

2156: Masui. 2002 Dec;51 Suppl:S89-94.

[Recent progress in therapy for postherpetic neuralgia]

[Article in Japanese]

Kotani N.

Publication Types: 
    Review

PMID: 12655719 [PubMed - indexed for MEDLINE]

2157: Neurology. 2003 Mar 25;60(6):1052-3; author reply 1052-3.

Comment on:
    Neurology. 2002 Oct 8;59(7):1015-21.

Opioids versus antidepressants in postherpetic neuralgia: a randomized,
placebo-controlled trial.

Manfredi PL.

Publication Types: 
    Comment
    Letter

PMID: 12654988 [PubMed - indexed for MEDLINE]

2158: Neurology. 2003 Mar 25;60(6):1049-50.

Ipsilateral truncal sensory deficit in a patient with ophthalmic zoster sine
herpete.

Yamada S, Atsuta N, Tokunaga S, Motegi Y.

Department of Neurology, Nakatsugawa Municipal General Hospital, Nakatsugawa,
Gifu, Japan. y.shinichi@nifty.com

Publication Types: 
    Case Reports

PMID: 12654984 [PubMed - indexed for MEDLINE]

2159: Am J Ophthalmol. 2003 Apr;135(4):551-3.

Progressive outer retinal necrosis in immunocompetent patients treated initially 
for optic neuropathy with systemic corticosteroids.

Benz MS, Glaser JS, Davis JL.

Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami,
Florida 33101, USA.

PURPOSE: To report two cases of progressive outer retinal necrosis occurring in
immunocompetent individuals after treatment with corticosteroids for presumed
optic neuropathy. DESIGN: Observational case report. SETTING: University-based
tertiary eye hospital. METHODS: Retrospective review of existing clinical
records. RESULTS: Two patients were treated empirically with systemic
corticosteroids for suspected inflammatory papillopathy. Subsequently, both were 
diagnosed with necrotizing herpetic retinitis with features of progressive outer 
retinal necrosis. Anterior chamber paracentesis confirmed varicella-zoster
infection. Both patients were human immunodeficiency virus negative; one patient 
with rheumatoid arthritis was taking etanercept. Both became completely blind in 
one eye despite intensive treatment with antiviral medication intravenously and
intravitreally. CONCLUSIONS: Progressive outer retinal necrosis is not confined
to patients with underlying severe immunodeficiency, such as acquired immune
deficiency syndrome. Initial treatment of acute, unexplained vision loss with
systemic corticosteroids may lead to catastrophic visual loss in patients with
evolving necrotizing herpetic retinopathy.

Publication Types: 
    Case Reports

PMID: 12654381 [PubMed - indexed for MEDLINE]

2160: Neuroscience. 2003;117(4):795-809.

Galanin expression in adult human dorsal root ganglion neurons: initial
observations.

Landry M, Aman K, Dostrovsky J, Lozano AM, Carlstedt T, Spenger C, Josephson A,
Wiesenfeld-Hallin Z, Hokfelt T.

Department of Neuroscience, Retzius vag 8, B3:4, Karolinska Institutet, S-171 77,
Stockholm, Sweden.

Human dorsal root ganglia (DRGs) were obtained during various procedures and
processed for single and double in situ hybridisation using oligonucleotide
probes complementary to three peptide mRNAs. Some postmortem ganglia were also
analysed. In donor (unlesioned) DRGs 12.5% of the neuron profiles (NPs) were
galanin mRNA-positive (mRNA(+)), 47.5% calcitonin gene-related peptide (CGRP)
mRNA(+) and 32.7% substance P mRNA(+). The corresponding percentages for
cervical/thoracic DRGs from patients suffering from severe brachial plexus injury
were 32.8%, 57.4% and 34.5%, respectively. In these DRGs a high proportion of the
galanin mRNA(+) NPs contained CGRP mRNA and substance P mRNA. In DRGs from a
patient with migraine-like pain a comparatively small proportion expressed
galanin, whereas in DRGs from a herpes zoster patient galanin mRNA(+) NPs were
comparatively more frequent. The results from human postmortem DRGs revealed only
weak peptide mRNA signals. The present results demonstrate that galanin is
expressed in DRGs not only in a number of animal species including monkey as
previously shown, but also in a considerable proportion of human DRG neurons,
often together with CGRP and substance P, and mostly in small neurons. Thus,
galanin may play a role in processing of sensory information, especially pain, in
human DRGs and dorsal horn. However, to what extent a similarly dramatic
upregulation of galanin expression can be seen after peripheral nerve lesion in
man, as has been reported for rat, mouse and monkey, remains to be analysed.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 12654333 [PubMed - indexed for MEDLINE]

2161: Int J Dermatol. 2003 Mar;42(3):193-6.

A seroepidemiologic survey of the prevalence of varicella-zoster virus in the
pediatric population in two university hospitals in Brazil.

Semenovitch I, Lupi O.

Department of Internal Medicine (Dermatology), Antonio Pedro University Hospital,
Fluminense Federal University, Rio de Janeiro, Brazil.

BACKGROUND: Varicella-zoster virus (VZV) is an alpha-herpesvirus causing
varicella (chickenpox) and herpes zoster (shingles). Varicella results from
primary VZV infection, and is a common childhood illness associated with fever
and a generalized, pruritic, vesicular eruption. Herpes zoster is caused by VZV
reactivation later in life (most cases after the fifth decade), and is
characterized by a localized, painful, and vesicular eruption involving one or
adjacent dermatomes. The incidence of herpes zoster increases with age and
immunosuppression. OBJECTIVE: To estimate the seroprevalence of VZV in the
Brazilian pediatric population by evaluating the prevalence of specific
antibodies to VZV in children from two university hospitals in the state of Rio
de Janeiro. METHODS: A population composed of 160 children derived from two
university hospitals in the state of Rio de Janeiro was included in the study.
All patients completed a questionnaire regarding their socio-epidemiologic
characteristics, and a complete physical examination was performed. All blood
samples were screened using a commercial enzyme-linked fluorescent assay (ELFA)
kit, specific for the detection of immunoglobulin G (IgG) antibodies to VZV.
RESULTS: The seroprevalence of VZV was 58.1% in the overall population, with a
statistically significant correlation between seroprevalence and increasing age
(P < 0.0001). A previous history of measles infection (P < 0.04), previous
history of varicella infection (P < 0.0001), and the presence of skin lesions (P 
< 0.05) were significantly associated with seropositivity to VZV. CONCLUSIONS:
Further studies should be performed in order to evaluate the endemicity of VZV
infections and to establish criteria for the use of the specific vaccine in
Brazil.

PMID: 12653913 [PubMed - indexed for MEDLINE]

2162: Int Endod J. 2002 Dec;35(12):1012-6.

Prodromal herpes zoster--a diagnostic challenge in endodontics.

Fristad I, Bardsen A, Knudsen GC, Molven O.

Department of Odontology - Endodontics, School of Dentistry, University of
Bergen, Bergen, Norway. inge.fristad@odont.uib.no

This case report highlights the diagnostic challenge that herpes zoster
represents if pain develops in the prodromal stage. A 58-year-old male presented 
with pain in the left maxilla. The symptoms had lasted for 7 months. The first
premolar had been extracted soon after the onset, and the second premolar root
filled shortly thereafter. Symptoms were experienced as sudden pain attacks
lasting for several hours and analgesics gave some pain relief. Clinical
examination showed that the second premolar was tender to percussion. No sinus
tract or swelling were present. Radiographic examination showed previously
root-filled second premolar and first molar teeth, and no evidence of apical
pathosis. Due to the uncertainty about the quality of the root filling in the
second premolar and incomplete root filling in the first molar, retreatment was
started prior to prosthetic treatment in the region. The pain continued and
became more intense during the treatment. A diagnosis of herpes zoster was
determined, when an acute attack with oedema and vesicles occurred, 2 months
after retreatment was started. In the present case, therefore, the primary attack
presented itself after months and the herpes zoster diagnosis could not be made
until then. points. Key learning points. * A long lasting prodromal stage is an
unusual event. * Symptoms combined with inadequate technical standard of root
fillings may confuse the diagnostics. * No available data support or suggest the 
use of antiviral treatment as a diagnostic tool.

Publication Types: 
    Case Reports

PMID: 12653320 [PubMed - indexed for MEDLINE]

2163: Clin Infect Dis. 2003 Apr 1;36(7):877-82. Epub 2003 Mar 13.

Treatment and prevention of postherpetic neuralgia.

Dworkin RH, Schmader KE.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, Rochester, NY 14642, USA. robert_dworkin@urmc.rochester.edu

There have been 4 recent major advances in the treatment of postherpetic
neuralgia (PHN) that are based on the results of randomized, controlled trials.
These advances are the demonstrations that gabapentin, the lidocaine patch 5%,
and opioid analgesics are efficacious in patients with PHN, and the report that
nortriptyline and amitriptyline provide equivalent analgesic benefits for
patients with PHN but that nortriptyline is better tolerated. The results of
these clinical trials are briefly reviewed, and their implications for the
treatment of patients with PHN are discussed. Despite these treatment advances,
many patients remain refractory to current therapy, and the prevention of PHN has
therefore become an important focus of current research. Research on
administration of the varicella-zoster vaccine to prevent herpes zoster and on
treatment of patients who have herpes zoster with combined antiviral and
analgesic therapy to prevent PHN is discussed.

Publication Types: 
    Review

PMID: 12652389 [PubMed - indexed for MEDLINE]

2164: Psychosom Med. 2003 Mar-Apr;65(2):194-200.

Herpes viruses, cytokines, and altered hemostasis in vital exhaustion.

van der Ven A, van Diest R, Hamulyak K, Maes M, Bruggeman C, Appels A.

Department of Medical Microbiology, Maastricht University, Maastricht, The
Netherlands.

OBJECTIVE: Infections with herpes viruses have been implicated in the
pathogenesis of atherosclerosis. We tested the hypothesis that vital exhaustion
(VE) is associated with multiple herpesvirus infections, such as herpes simplex
virus, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus, and with 
an increase in pathogen burden (ie, the aggregated seropositivity to
immunoglobulin G antibodies for herpes simplex virus, varicella-zoster virus,
Epstein-Barr virus, and cytomegalovirus). In addition, we examined the
association of VE and pathogen burden with measures of hemostasis and
inflammation. METHODS: Blood samples were drawn from 29 men with VE and 30 male
control subjects, all healthy and nonsmokers, to assess serological evidence of
infection and measures of hemostasis and inflammation. RESULTS: VE is associated 
with a relatively high pathogen burden, altered hemostasis, and higher levels of 
cytokines, such as interleukin-6. Across all subjects, a relatively high pathogen
burden was also associated with altered hemostasis but not with increased
cytokine levels. The interaction of VE with pathogen burden revealed significant 
linear increases in measures of hemostasis and inflammation. Finally,
immunoglobulin G antibody titer levels of individual herpesvirus infections were 
not associated with hemostatic measures or with cytokines. CONCLUSIONS: We
conclude that stress-related alterations in hemostasis and inflammation are not
necessarily linked to one particular herpesvirus infection but rather to an
increase in aggregated seropositivity to herpesvirus infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12651986 [PubMed - indexed for MEDLINE]

2165: Med Res Rev. 2003 May;23(3):253-74.

Highly potent and selective inhibition of varicella-zoster virus replication by
bicyclic furo[2,3-d]pyrimidine nucleoside analogues.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, B-3000
Leuven, Belgium. erik.declercq@rega.kuleuven.ac.be

The bicyclic furo[2,3-d]pyrimidine nucleoside analogues represent an entirely new
class of fused furopyrimidine derivatives with unprecedented selectivity for
varicella-zoster virus (VZV). From extensive structure-activity relationship
(SAR) studies, the 6-(p-alkylphenyl)substituted furopyrimidine derivatives Cf
1742 and Cf 1743 emerged as the most potent inhibitors of VZV replication: they
were found to inhibit both laboratory VZV strains and clinical VZV isolates at
subnanomolar concentrations, while not being toxic to the host cells at
100,000-fold higher concentrations. Although the precise mechanism of action of
these compounds remains to be elucidated, it is clear that for their antiviral
activity they depend on phosphorylation by the VZV-encoded thymidine kinase. The 
furo[2,3-d]pyrimidine nucleoside analogues are not susceptible to degradation by 
human or bacterial thymidine phosphorylase, which may otherwise release the free 
aglycone. Also, the latter is not inhibitory to dihydropyrimidine dehydrogenase, 
an enzyme involved in the degradation of thymine, uracil, and the anticancer
agent 5-fluorouracil. Further development of the furo[2,3-d]pyrimidine nucleoside
analogues as new therapeutic modalities for the treatment of VZV infections
(i.e., varicella and herpes zoster) seems highly justified. Copyright 2003 Wiley 
Periodicals, Inc.

Publication Types: 
    Review

PMID: 12647310 [PubMed - indexed for MEDLINE]

2166: Graefes Arch Clin Exp Ophthalmol. 2003 Mar;241(3):187-91. Epub 2003 Feb 11.

Prognostic value of Hutchinson's sign in acute herpes zoster ophthalmicus.

Zaal MJ, Volker-Dieben HJ, D'Amaro J.

Department of Ophthalmology, VU Medical Center, P.O. Box 7057, 1007 MB Amsterdam,
The Netherlands. mjw.zaal@vumc.nl

PURPOSE: To determine the prognostic value of nasociliary skin lesions
(Hutchinson's sign) for ocular inflammation and corneal sensory denervation in
acute herpes zoster ophthalmicus. METHODS: A longitudinal observational study
with a 2-month follow-up was performed involving 83 non-immunocompromised adults 
with acute herpes zoster ophthalmicus, with a skin rash duration of less than 7
days, referred by their general practitioner. All skin lesions at the tip, the
side and the root of the nose, representing the dermatomes of the external nasal 
and infratrochlear branches of the nasociliary nerve, were documented by taking
photographs and marking anatomical drawings. Ocular inflammatory signs were
observed by slit-lamp biomicroscopy, and corneal sensitivity was measured with
the Cochet-Bonnet esthesiometer at 2-month follow-up. RESULTS: Hutchinson's sign 
was a powerful predictor of ocular inflammation and corneal denervation in herpes
zoster ophthalmicus [relative risks: 3.35 (CI 95%: 1.82-6.15) and 4.02 (CI
95%:1.55-10.42), respectively]. The manifestation of herpes zoster skin lesions
at the dermatomes of both nasociliary branches was invariably associated with the
development of ocular inflammation. CONCLUSION: Clinicians should be alert for
early skin lesions within the complete nasociliary dermatome, because they are a 
reliable prognostic sign of sight-threatening ocular complications in acute
herpes zoster ophthalmicus.

PMID: 12644941 [PubMed - indexed for MEDLINE]

2167: Am Fam Physician. 2003 Mar 1;67(5):1045-6.

Photo quiz. Vesicular rash on the flank and buttock.

Leung AK, Rafaat M.

University of Calgary, Alberta Children's Hospital, Canada.

Publication Types: 
    Case Reports

PMID: 12643365 [PubMed - indexed for MEDLINE]

2168: East Afr Med J. 2002 May;79(5):279-80.

Herpes zoster myelitis: report of two cases.

Amayo EO, Kwasa TO, Otieno CF.

Department of Medicine, College of Health Sciences, University of Nairobi, P. O. 
Box 19676, Nairobi, Kenya.

Two male patients aged 40 and 45 years with HIV infection and paraplegia are
presented. The two had sub-acute onset paraplegia with a sensory level, which
developed 10 days after herpes zoster dermatomal rash. They both had
asymmetrically involvement of the lower limbs. Investigation including imaging of
the spinal cord did not reveal any other cause of the neurological deficit. The
two responded very well to treatment with acyclovir. Herpes zoster myelitis is a 
condition likely to rise with the upsurge of HIV infection and there is a need to
identify the condition early. We also review the literature on the subject.

Publication Types: 
    Case Reports

PMID: 12638816 [PubMed - indexed for MEDLINE]

2169: J Am Acad Dermatol. 2003 Mar;48(3):442-7.

Atypical recurrent varicella in 4 patients with hemopathies.

Nikkels AF, Simonart T, Kentos A, Liesnard C, Sadzot-Delvaux C, Feremans W,
Pierard GE.

Department of Dermatopathology, University Medical Center of Liagege, Belgium.
af.nikkels@chu.ulg.ac.be

Relapsing varicella may occur in children with HIV infection and more rarely in
younger adults. Our aim was to report unusual clinical, histologic, and virologic
aspects of 4 elderly patients with malignant hemopathies who had an unusual form 
of recurrent varicella develop. Conventional microscopy, immunohistochemistry,
and in situ hybridization were applied to smears and skin biopsy specimens. The
patients presented a few dozen, scattered, large, papulovesicular lesions with
central crusting. No zoster-associated pain or dermatomal distribution of the
lesions was noted. Conventional microscopy revealed vascular changes and
epidermal alterations typical for alpha-herpes virus infection. The varicella
zoster virus major viral envelope glycoproteins gE and gB, and the
immediate-early varicella zoster virus IE63 protein and the corresponding genome 
sequence for gE were detected on Tzanck smears; they were localized in
endothelial cells and keratinocytes on skin biopsy specimens. The varicella
zoster virus infection in endothelial cells, the vascular involvement, and the
widespread distribution of the lesions suggest that the reported eruptions are
vascular rather than neural in origin. These findings invalidate the diagnosis of
herpes zoster but strongly support the diagnosis of recurrent varicella in an
indolent and yet unreported presentation. Furthermore, these eruptions differ
from relapsing varicella in children and young adults by the age of the patients,
the paucity of clinical lesions, the larger diameter of the lesions and their
peculiar clinical aspect, the significantly longer time interval between primary 
varicella and the recurrence, the prolonged healing time of the lesions, their
mild disease course, and the fact that all the lesions are in the same stage of
development.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12637928 [PubMed - indexed for MEDLINE]

2170: J Clin Virol. 2003 Apr;26(3):277-89; discussion 291-3.

Comment in:
    J Clin Virol. 2003 Aug;27(3):308-9.

Herpes zoster guideline of the German Dermatology Society (DDG).

Gross G, Schofer H, Wassilew S, Friese K, Timm A, Guthoff R, Pau HW, Malin JP,
Wutzler P, Doerr HW.

Universitatsklinik und Poliklinik fur Dermatologie und Venerologie, Rostock,
Augustenstr. 80-84, D-18055, Rostock, Germany. gerd.gross@med.uni-rostock.de

Varicella zoster virus (VZV) causes varicella (chickenpox), remains dormant in
dorsal root and cranial nerve ganglia and can be reactivated as a consequence of 
declining VZV-specific cellular immunity leading to herpes zoster (shingles).
Patients older than 50 years of age affected by herpes zoster may suffer a
significant decrease of quality of life. These patients and immunocompromised
individuals are at increased risks for severe complications, involving the eye,
the peripheral and the central nervous system (prolonged pain, postherpetic
neuralgia). Such complications occur with and without cutaneous symptoms. The
German Dermatology Society (DDG) has released guidelines in order to guarantee
updated management to anyone affected by herpes zoster. Diagnosis is primarily
clinical. The gold standard of laboratory diagnosis comprises PCR and direct
identification of VZV in cell cultures. Detection of IgM- and IgA-anti VZV
antibodies may be helpful in immunocompromised patients. Therapy has become very 
effective in the last years. Systemic antiviral therapy is able to shorten the
healing process of acute herpes zoster, to prevent or to alleviate pain and other
acute and chronic complications, particularly, when given within 48 h to a
maximum of 72 h after onset of the rash. Systemic antiviral therapy is urgently
indicated in patients beyond the age of 50 years and in patients at any age with 
herpes zoster in the head and neck area, especially in patients with zoster
ophthalmicus. Further urgent indications are severe herpes zoster on the trunk
and on the extremities, herpes zoster in immunosuppressed patients and in
patients with severe atopic dermatitis and severe ekzema. Only relative
indications for antiviral therapy exist in patients younger than 50 years with
zoster on the trunk and on the extremities. In Germany acyclovir, valacyclovir,
famciclovir and brivudin are approved for the systemic antiviral treatment of
herpes zoster. These compounds are all well tolerated by the patients and do not 
differ with regard to efficacy and safety. Brivudin has a markedly higher
anti-VZV potency than oral acyclovir, valacyclovir and famciclovir and thus
offers a simpler dosing regimen. It must be given only once daily during 7 days
in comparison to three and five times dosing per day of valacyclovir, famciclovir
and acyclovir, respectively. Brivudin is an antiviral agent with no nephrotoxic
properties, which is an advantage when compared to acyclovir. The most important 
aim of therapy of herpes zoster is to achieve painlessness. Appropriately dosed
analgesics in combination with a neuroactive agent (i.e. amitriptylin) are very
helpful when given together with antiviral therapy. The additive therapy with
corticosteroids may shorten the degree and duration of acute zoster pain, but has
no essential effect on the development of postherpetic neuralgia, which is a very
difficult condition to treat. Thus early presentation to a pain therapist is
recommended in specific cases.

Publication Types: 
    Guideline
    Practice Guideline

PMID: 12637076 [PubMed - indexed for MEDLINE]

2171: Hautarzt. 2003 Mar;54(3):265-7. Epub 2003 Jan 11.

[Herpetic folliculitis barbae. A rare cause of folliculitis]

[Article in German]

Anliker MD, Itin P.

Dermatologische Abteilung, Medizinische Klinik, Kantonsspital Aarau, Switzerland.
markanliker@hotmail.com

Viral folliculitis is a rare disease usually caused by herpes simplex, herpes
zoster and molluscum contagiosum in immune-compromised patients. An otherwise
healthy 30 year old patient without history of herpes simplex contracted a
folliculitis in the beard region after a flu-like illness. He had no oral or
labial lesions but instead showed a crusty erythematous folliculitis confined to 
the beard region with small grouped vesicles on the neck and reactive cervical
lymph nodes. Bacterial and mycological analysis from swabs were negative. The
culture was positive for herpes simplex virus and the immune fluorescence showed 
HSV type 1. Systemic therapy with valaciclovir 2x 500 mg/d and lotio alba locally
led to rapid improvement. When confronted with folliculitis, non-bacterial causes
such as viral (herpes simplex, herpes zoster, molluscum contagiosum), mycological
(pityrosporon, candida), demodex and eosinophilic follicultitis should be taken
under consideration.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12634996 [PubMed - indexed for MEDLINE]

2172: Pediatr Infect Dis J. 2003 Mar;22(3):295-6.

Comment on:
    Pediatr Infect Dis J. 2001 Sep;20(9):915-6.

Varicella, herpes zoster and dissemination.

Thami GP, Kaur S.

Publication Types: 
    Comment
    Letter

PMID: 12634596 [PubMed - indexed for MEDLINE]

2173: J Virol. 2003 Apr;77(7):4191-204.

A functional YNKI motif in the short cytoplasmic tail of varicella-zoster virus
glycoprotein gH mediates clathrin-dependent and antibody-independent endocytosis.

Pasieka TJ, Maresova L, Grose C.

Department of Microbiology, University of Iowa, Iowa City, USA.

The trafficking of varicella-zoster virus (VZV) gH was investigated under both
infection and transfection conditions. In initial endocytosis assays performed in
infected cells, the three glycoproteins gE, gI, and gB served as positive
controls for internalization from the plasma membrane. Subsequently, we
discovered that gH in VZV-infected cells was also internalized and followed a
similar trafficking pattern. This observation was unexpected because all
herpesvirus gH homologues have short endodomains not known to contain trafficking
motifs. Further investigation demonstrated that VZV gH, when expressed alone with
its chaperone gL, was capable of endocytosis in a clathrin-dependent manner,
independent of gE, gI, or gB. Upon inspection of the short gH cytoplasmic tail,
we discovered a putative tyrosine-based endocytosis motif (YNKI). When the
tyrosine was replaced with an alanine, endocytosis of gH was blocked. Utilizing
an endocytosis assay dependent on biotin labeling, we further documented that
endocytosis of VZV gH was antibody independent. In control experiments, we showed
that gE, gI, and gB also internalized in an antibody-independent manner.
Alignment analysis of the VZV gH cytoplasmic tail to other herpesvirus gH
homologues revealed two important findings: (i) herpes simplex virus type 1 and 2
homologues lacked an endocytosis motif, while all other alphaherpesvirus gH
homologues contained a potential motif, and (ii) the VZV gH and simian varicella 
virus gH cytoplasmic tails were likely longer in length (18 amino acids) than
predicted in the original sequence analyses (12 and 16 amino acids,
respectively). The longer tails provided the proper context for a functional
endocytosis motif.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12634377 [PubMed - indexed for MEDLINE]

2174: Clin Cancer Res. 2003 Mar;9(3):976-80.

Development of Varicella-Zoster virus infection in patients with chronic
myelogenous leukemia treated with imatinib mesylate.

Mattiuzzi GN, Cortes JE, Talpaz M, Reuben J, Rios MB, Shan J, Kontoyiannis D,
Giles FJ, Raad I, Verstovsek S, Ferrajoli A, Kantarjian HM.

Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, 1515
Holcombe Boulevard, Houston, TX 77030, USA. gmattiuz@mdanderson.org

PURPOSE: Infection with Varicella-Zoster virus (VZV) is an exceptionally rare
complication of chronic myelogenous leukemia (CML) without stem cell
transplantation. We report 16 patients with CML who developed VZV infection
during imatinib mesylate therapy. PATIENTS AND METHODS: From July 1998 until
February 2002, 771 patients were included in 11 imatinib mesylate studies for all
CML phases in the Departments of Leukemia and Bioimmunotherapy at The University 
of Texas M. D. Anderson Cancer Center. Sixteen patients developed VZV infection. 
Charts and follow-up information of were reviewed and analyzed. RESULTS: Sixteen 
patients (2%) developed a VZV infection [15 episodes of herpes zoster (HZ), 1
varicella]. The baseline characteristics of the 16 patients with infection do not
differ significantly from those who did not develop VZV infection, except for
time from diagnosis of CML to imatinib (median: 55 versus 25 months, P = 0.0056) 
and the number of prior therapies (3 versus 1, P < 0.001). All patients received 
therapy with antiviral agents with good response. Six patients developed
postherpetic neuralgia. CONCLUSIONS: Our results suggest that imatinib therapy in
CML is associated with low incidence of HZ infection. VZV infection is more
frequent with longer duration of CML disease and with prior therapy, does not
disseminate, responds well to therapy, and does not mandate a recommendation for 
HZ prophylaxis in such patients.

PMID: 12631595 [PubMed - indexed for MEDLINE]

2175: Mayo Clin Proc. 2003 Mar;78(3):301-6.

2-Chlorodeoxyadenosine therapy for disseminated Langerhans cell histiocytosis.

Pardanani A, Phyliky RL, Li CY, Tefferi A.

Division of Hematology and Internal Medicine, Mayo Clinic, 200 First St SW,
Rochester, Minn 55905, USA.

OBJECTIVE: To evaluate the efficacy of 2-chlorodeoxyadenosine (2-CDA), a purine
nucleoside analogue, in treating disseminated Langerhans cell histiocytosis
(LCH). PATIENTS AND METHODS: We retrospectively reviewed the clinical records of 
5 patients who were seen at our institution for histologically confirmed
disseminated LCH, including 1 patient with central nervous system parenchymal
involvement. These patients were treated consecutively with 2-CDA chemotherapy
between December 1994 and January 2001. The patients ranged in age from 19 to 81 
years, and the median pretreatment duration of disease was 23 months. Median
follow-up after initiation of 2-CDA treatment was 33 months.
2-Chlorodeoxyadenosine was used as frontline therapy for 1 patient and as salvage
therapy for the other patients. Patients generally received 0.7 mg/kg over 5 or 7
days; the median number of courses was 4. RESULTS: Complete responses were
achieved in 3 patients, including the patient with central nervous system
disease, which, to our knowledge, has not been described previously. Two other
patients achieved partial responses. The overall response rate was 100%. Toxic
effects consisted mainly of myelosuppression; 1 patient developed dermatomal
herpes zoster infection. CONCLUSION: Our experience confirms the reported
efficacy of 2-CDA in the treatment of LCH; however, the optimal timing and
schedule of therapy remain to be determined.

Publication Types: 
    Case Reports

PMID: 12630583 [PubMed - indexed for MEDLINE]

2176: J Med Virol. 2003;70 Suppl 1:S103-10.

Imaging of the varicella zoster virion in the viral highways: comparison with
herpes simplex viruses 1 and 2, cytomegalovirus, pseudorabies virus, and human
herpes viruses 6 and 7.

Padilla JA, Nii S, Grose C.

Departments of Microbiology and Pediatrics, University of Iowa, 200 Hawkins
Drive, Iowa City, IA 52242, USA.

Imaging by scanning electron microscopy (SEM) can provide insight into viral
egress. At a low magnification level, varicella zoster virions (VZV) emerge from 
an infected cell surface in a distinctive pattern previously described as "viral 
highways." Viral highways consist of thousands of particles arranged in linear
pathways across the syncytial surface. This egress pattern has not been described
with other herpesviruses, but a systematic analysis has not been performed.
Therefore, the characteristic arrangement of VZV egress was compared with that of
six other members of the herpes virus family, including herpes simplex virus
(HSV) types 1 and 2, human cytomegalovirus (CMV), pseudorabies virus (PRV), and
human herpesvirus types 6 and 7 (HHV-6 and HHV-7). Only VZV-infected cells
exhibited viral highways. Subsequent SEM examination of VZ virions at an ultra
high-resolution revealed that more than 70% were aberrant. Further imaging of the
other herpesviruses demonstrated that VZV structure was more closely related to
PRV than HSV-1 or HSV-2. Finally, it is noted that the individual members of the 
herpesvirus family have distinguishable SEM profiles. Copyright 2003 Wiley-Liss, 
Inc.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12627497 [PubMed - indexed for MEDLINE]

2177: J Med Virol. 2003;70 Suppl 1:S82-9.

Varicella-zoster virus isolates, but not the vaccine strain OKA, induce
sensitivity to alpha-1 and beta-1 adrenergic stimulation of sensory neurones in
culture.

Schmidt M, Kress M, Heinemann S, Fickenscher H.

Abteilung Virologie, Hygiene-Institut, Ruprecht-Karls-Universitat Heidelberg, Im 
Neuenheimer Feld 324, D-69120 Heidelberg, Germany.

The reactivation of varicella-zoster virus (VZV) from its persistent state in
sensory neurones causes shingles and induces severe, long-lasting pain and
hyperalgesia that often lead to postherpetic neuralgia. To investigate the
VZV-induced neuropathic changes, we established conditions for the active
infection of sensory neurones from rat dorsal root ganglia in vitro. After 2 days
of culture, up to 50% of the cells expressed viral antigens of the
immediate-early and late replication phase. The intracellular calcium ion
concentration was monitored in individual cells by microfluorimetry. Whereas the 
calcium response to capsaicin was preserved, the VZV-infected neurones gained an 
unusual sensitivity to noradrenaline stimulation in contrast to non-infected
cells. The adrenergic agonists phenylephrine and isoproterenol had a similar
efficacy demonstrating that both alpha(1)- and beta(1)-adrenoreceptors were
involved. The sensitivity to adrenergic stimulation was observed after infection 
with different wildtype isolates, but not with the attenuated vaccine strain OKA.
The lack of noradrenaline sensitivity of vaccine-infected neurones demands a
structural comparison of wildtype and vaccine viruses with and without phenotype.
A partial sequence evaluation (26 kb) of the European OKA vaccine strain
surprisingly revealed a series of nucleotide exchanges in comparison to
presumably identical OKA strains from other sources, although VZV is generally
considered genetically stable. In summary, we report that the infection with
wildtype VZV isolates, but not with the vaccine strain, induces noradrenaline
sensitivity in sensory neurones, which correlates with clinical and experimental 
observations of adrenergic effects involved in VZV-induced neuralgia. Copyright
2003 Wiley-Liss, Inc.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't

PMID: 12627494 [PubMed - indexed for MEDLINE]

2178: J Med Virol. 2003;70 Suppl 1:S79-81.

Use of a rodent model to show that varicella-zoster virus ORF61 is dispensable
for establishment of latency.

Sato H, Pesnicak L, Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases/NIH, Building 10, Room 11N228, 10
Center Drive, Bethesda, MD 20892-1888, USA.

Varicella-zoster virus (VZV) results in a latent infection in humans after
primary infection. Latency has also been established in guinea pigs and rats
after inoculation with the virus. It was found that infection of cotton rats with
the Oka vaccine strain of VZV results in a latent infection. To begin to identify
which genes are required for latency, we infected cotton rats with VZV strain Oka
that is deleted for ORF61. ORF61 protein transactivates certain VZV promoters and
enhances the infectivity of viral DNA in transient transfections. Deletion of
ORF61 results in abnormal syncytia and impairs the growth of VZV in vitro.
Inoculation of cotton rats with ORF61-deleted Oka virus resulted in latent VZV
infection in the nervous system similar to that seen for animals infected with
parental virus. Thus, the cotton rat can be used to study the ability of mutants 
in the Oka vaccine strain of VZV to establish latent infection. Copyright 2003
Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12627493 [PubMed - indexed for MEDLINE]

2179: J Med Virol. 2003;70 Suppl 1:S71-8.

Latent and lytic infection of isolated guinea pig enteric ganglia by varicella
zoster virus.

Chen JJ, Gershon AA, Li ZS, Lungu O, Gershon MD.

Department of Anatomy and Cell Biology, Columbia University of Physicians and
Surgeons, 630 West 168th Street, New York, NY 10032, USA. JC28@columbia.edu

Varicella zoster virus (VZV) has been demonstrated to infect guinea pig enteric
neurons in vitro. Latent infection of isolated enteric neurons is established
when the cultures predominantly consist of neurons and they are exposed to
cell-free VZV. Neurons harboring latent infection survive for weeks in vitro and 
express mRNA encoding ORFs 4, 21, 29, 40, 62, and 63, but not 14(gC) or 68 (gE)
(although DNA encoding the glycoproteins is present). The expressed proteins are 
the same as those that are also expressed in human sensory neurons harboring
latent VZV. In addition to mRNA, the immunoreactivities of ORFs 4, 21, 29, 62,
and 63 can be detected. ORF 62 and 29 proteins are cytoplasmic and not
intranuclear. VZV does not preferentially infect and/or become latent in
intrinsic enteric primary afferent neurons indicating that the virus is latent in
these neurons. Lytic infection occurs when mixed cultures of neurons and
non-neuronal cells of the bowel wall are exposed to cell-free VZV or when
isolated enteric neurons are exposed to cell-associated VZV. When lytic infection
occurs, enteric neurons die within 48 hr. Prior to their death, neurons express
VZV glycoproteins, including gE and gB, and ORF 62 and 29 proteins are
intranuclear. This new animal model should facilitate studies of VZV latency and 
the efficacy of therapies designed to prevent VZV infection, latency, and
reactivation. Copyright 2003 Wiley-Liss, Inc.

Publication Types: 
    In Vitro
    Research Support, U.S. Gov't, P.H.S.

PMID: 12627492 [PubMed - indexed for MEDLINE]

2180: J Med Virol. 2003;70 Suppl 1:S42-7.

Genetic variation of varicella-zoster virus: evidence for geographical separation
of strains.

Barrett-Muir W, Scott FT, Aaby P, John J, Matondo P, Chaudhry QL, Siqueira M,
Poulsen A, Yaminishi K, Breuer J.

Department of Medical Microbiology, Medical and Dental School, Queen Mary
College, 25-29 Ashfield Street, London E1 1BB, England, UK.

Heteroduplex mobility assay was used to identify variants of varicella-zoster
virus (VZV) circulating in the United Kingdom and elsewhere. Forty variable
positions were identified. Sixteen substitutions were non-synonymous, resulting
in an amino acid change, the majority of which were clustered within surface
expressed proteins. Phylogenetic analysis distinguished at least three major
clades (strains A, B, C) supported by significant bootstrap values. Apart from
the United Kingdom and Brazil where all three strains were found, genotypes
appeared to be closely associated with the geographical region in which they were
sampled. Allelic co-segregation of widely spaced single nucleotide polymorphisms 
(SNPs) confirmed the genetic stability of the VZV. Recombination rates were
difficult to calculate because of the low intra genotypic variation. However, one
haplotype originating from Brazil is most parsimoniously explained as a
recombinant between A and C strains, which co-occur in the region. Two further UK
strains appeared to be recombinants between groups B and C. Copyright 2003
Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12627486 [PubMed - indexed for MEDLINE]

2181: J Med Virol. 2003;70 Suppl 1:S31-7.

Varicella vaccination: impact of vaccine efficacy on the epidemiology of VZV.

Brisson M, Edmunds WJ, Gay NJ.

Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61
Colindale Avenue, London NW9 5EQ, United Kingdom. mbrisson@phls.org.uk

In 1995, varicella vaccination was introduced into the infant immunization
schedule of the United States. Currently, many other countries are considering
mass varicella vaccination. Mass vaccination has two dangers: it could increase
the number of varicella cases in adults, where severity is greater, and increase 
cases of zoster. A deterministic, realistic, age-structured model (RAS) was built
to study these concerns. Model parameter estimates were derived from a review of 
the literature and surveillance data from England and Wales. Different vaccine
efficacy scenarios, vaccine coverages, and vaccination strategies were
investigated. The model predicts that, although an upward shift in the age at
infection occurs, the overall morbidity due to varicella is likely to decrease
following mass infant vaccination. On the other hand, cases of zoster may
significantly increase in the first 50 years following vaccination. The model
predicts that, in a population similar to England and Wales (50 m people),
varicella vaccination with 90% coverage would prevent 0.6 m inpatient days due to
varicella but would generate an extra 1.1 m inpatient days due to zoster over the
first 65 years. Thus, under base-case model assumptions, the gain in reduction of
varicella morbidity from infant vaccination is offset in the short-term by the
increases in zoster morbidity (using inpatient days as a proxy). Paradoxically,
less effective vaccines or vaccine programmes can be more effective in reducing
overall morbidity (varicella + zoster) by allowing the virus to circulate more,
which produces a smaller shift in the age at infection and a smaller increase in 
zoster cases. Copyright 2003 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12627484 [PubMed - indexed for MEDLINE]

2182: J Med Virol. 2003;70 Suppl 1:S24-30.

A study of shingles and the development of postherpetic neuralgia in East London.

Scott FT, Leedham-Green ME, Barrett-Muir WY, Hawrami K, Gallagher WJ, Johnson R, 
Breuer J.

Department of Medical Microbiology, Medical and Dental School, Queen Mary
College, 25-29 Ashfield Street, London E1 1BB, England, UK.

The incidence of post-herpetic neuralgia following shingles and the factors that 
are known to predict it were examined in a prospective observational community
study of patients with acute shingles presenting to their family doctors. The
detection of viral DNA in the blood at presentation as a prognostic indicator for
pain was also evaluated. Patients were followed for one year and the persistence 
of pain following rash assessed. Among 165 patients who had completed 6 months,
and 139 one-year follow-up, the prevalence of post herpetic neuralgia was 30% at 
6 weeks 27% at 12 weeks, 15.9% at 6 months, and 9% at one year. Age and severity 
of pain were significantly associated with the persistence of pain beyond 3
months. Viremia at presentation was detected in 66% of patients and was
significantly associated with the presence of pain at six months or beyond.
Antiviral agents were administered to only 50% of those at highest risk of
post-herpetic neuralgia (PHN) mainly because of presentation longer than 72 hours
after the onset of rash. Few patients were prescribed the more potent prodrugs,
Valaciclovir and Famciclovir. In conclusion, treatment of acute shingles in this 
observational community-based study was suboptimal in 50% of cases. More accurate
prediction of which subset of elderly patients are most at risk of PHN may enable
targeted prescribing of the most potent drugs to those most likely to benefit.
Copyright 2003 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12627483 [PubMed - indexed for MEDLINE]

2183: J Med Virol. 2003;70 Suppl 1:S20-3.

Geographic and racial aspects of herpes zoster.

Nagasako EM, Johnson RW, Griffin DR, Elpern DJ, Dworkin RH.

Washington University School of Medicine, St. Louis, Missouri, USA.

Geographic and racial factors have been reported in studies of the epidemiology
of varicella and herpes zoster. To clarify further these relationships, data from
five multicenter clinical trials of the antiviral agent famciclovir were examined
(total N = 2074). Non-Caucasian racial group and tropical region were each
significantly associated with younger age at zoster onset. In analyses of the
non-Caucasian subgroups, Black and Asian patients did not significantly differ in
age or sex; however, Black and Asian patients from tropical regions had
significantly younger mean ages at onset and greater rash duration at enrollment 
than those from temperate regions. Controlling for sex and rash duration at
enrollment, both tropical region and non-Caucasian racial group were found to be 
independently associated with a younger age at zoster onset. These results
suggest that racial group and geographic region may be independent factors
associated with age at onset in patients with herpes zoster. Copyright 2003
Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12627482 [PubMed - indexed for MEDLINE]

2184: J Med Virol. 2003;70 Suppl 1:S9-14.

Epidemiology of Varicella-Zoster Virus in England and Wales.

Brisson M, Edmunds WJ.

Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61
Colindale Avenue, London NW9 5WQ, United Kingdom. mbrisson@phls.org.uk

Many countries are studying currently the possibility of mass vaccination against
varicella. The objective of this study was to provide a complete picture of the
pre-vaccine epidemiology of the Varicella-Zoster Virus in England and Wales to
aid in the design of immunisation programs. Population-based data including
general practitioner sentinel surveillance, hospitalisation data, and death
certificates from England and Wales were analysed. The average incidence rates
for varicella and zoster between 1991 and 2000 were 1,291 and 373 per 100,000
years, respectively. Overall hospitalisation rates were equal for varicella and
zoster (4.5 vs. 4.4 hospitalisation per 100,000 population) with 5 and 8%,
respectively, having underlying immunosuppressive conditions. The age-specific
proportion of cases hospitalised and length of stay were similar between the two 
diseases. However, the overall burden of disease is considerably higher for
zoster. The number of inpatient days and case-fatality due to zoster are roughly 
4 to 6 times greater than for varicella (11 vs. 3 days and 25 vs. 4 deaths per
100,000 case). These results provide base-line estimates should mass varicella
vaccination be introduced in England and Wales. Copyright 2003 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12627480 [PubMed - indexed for MEDLINE]

2185: J Med Virol. 2003;70 Suppl 1:S1-2.

Foreword: The Fourth International Conference on Varicella, Herpes Zoster and
Post-Herpetic Neuralgia (PHN).

Perkin RT.

VZV Research Foundation, 40 East 72nd Street, New York, NY 10021, USA.
vzv@vzvfoundation.org

Publication Types: 
    Congresses

PMID: 12627477 [PubMed - indexed for MEDLINE]

2186: Arch Dermatol Res. 2003 Mar;294(12):529-35. Epub 2002 Dec 13.

Number of Langerhans immune cells in painful and non-painful human skin after
shingles.

Oaklander AL, Stocks EA, Mouton PR.

Department of Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, MD,
USA.

During injury or inflammation, paracrine sensitization of peripheral sensory
neurons by immune cells contributes to the sensation of pain. It is less clear
whether this neural sensitization contributes to neuropathic pain after neural
injury as well. Shingles (herpes zoster) is a common disease that leaves some
patients with prolonged neuropathic pain known as postherpetic neuralgia (PHN).
Sensitization of cutaneous neurons has been hypothesized to contribute to PHN.
Langerhans cells (LC), the Ia(+) macrophages of the skin, contact epidermal
neurites and, when activated, synthesize molecules with the ability to sensitize 
axons. For these reasons, we examined morphological evidence for activation of LC
in subjects with established PHN. We also evaluated the relationship between
numbers of LC and nociceptive epidermal nerve endings; these are markedly reduced
in PHN. We used design-based stereology to estimate the number of CD1a(+) LC in
biopsies of painful and non-painful skin from ten adults with or without PHN
after shingles on the torso. There were no differences in the number of LC in
previously shingles-affected and normal-control skin biopsies. The number of LC
also remained at normal levels in biopsies with near-loss of innervation from
shingles. LC numbers were unrelated to the presence or severity of pain. These
data suggest that neuropathic pain in established PHN is not associated with
increased numbers of cutaneous macrophages, and that the number of cutaneous
macrophages in skin from the human torso is independent of the number of
epidermal nerve endings.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12624778 [PubMed - indexed for MEDLINE]

2187: Hosp Med. 2003 Feb;64(2):115.

Herpes zoster misdiagnosed as testicular torsion.

Kumar TS, Saklani AP, Hockey T.

Department of Surgery, Nevill Hall Hospital, Abergavenny, Monmouthshire.

Publication Types: 
    Case Reports

PMID: 12619344 [PubMed - indexed for MEDLINE]

2188: Arch Ophthalmol. 2003 Mar;121(3):386-90.

Herpes zoster ophthalmicus in olmsted county, Minnesota: have systemic antivirals
made a difference?

Severson EA, Baratz KH, Hodge DO, Burke JP.

Mayo Medical School, Rochester, MN 55905, USA.

OBJECTIVE: To determine the frequency of complications and adverse outcomes due
to herpes zoster ophthalmicus before and after the introduction of oral antiviral
medications in a community-based setting. METHODS: We identified all Olmsted
County, Minnesota, residents diagnosed with acute herpes zoster ophthalmicus from
1976 through 1998. The frequencies of complications within 6 months of disease
onset were compared between untreated patients vs those treated with antivirals. 
MAIN OUTCOME MEASURES: Defined complications were ocular sequelae due to herpes
zoster ophthalmicus. Adverse outcomes included visual acuity of 20/200 or worse, 
trichiasis, or eyelid malposition requiring surgical treatment. RESULTS: A total 
of 202 patients had been treated with antivirals, and 121 had not. Neurotrophic
keratitis was the only complication that was less likely in the treated group
(3.3% vs 0%; P =.02). The probability of an adverse outcome at 5 and 10 years was
8.9% among untreated patients and 2.1% among treated patients (P =.009). Among
patients who had been treated, the mean time from symptom onset to initiation of 
therapy was 4.8 days in those who developed stromal keratitis, corneal edema,
scleritis, uveitis, or glaucoma compared with 3.8 days in those who did not (P
=.006). CONCLUSIONS: Neurotrophic keratitis was less frequent among patients who 
received antiviral therapy. However, among treated patients, development of a
serious inflammatory complication was associated with a delay in therapy. Most
important, adverse outcomes were less probable in the treated group. These data
may support the early and routine use of systemic antiviral therapy for acute
herpes zoster ophthalmicus.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12617710 [PubMed - indexed for MEDLINE]

2189: Ann Intern Med. 2002 Sep 3;137(5 Pt 2):435-78.

Guidelines for preventing opportunistic infections among HIV-infected
persons--2002. Recommendations of the U.S. Public Health Service and the
Infectious Diseases Society of America.

Masur H, Kaplan JE, Holmes KK; U.S. Public Health Service; Infectious Diseases
Society of America.

National Institutes of Health, Bethesda, Maryland, USA.

In 1995, the U.S. Public Health Service (USPHS) and the Infectious Diseases
Society of America (IDSA) developed guidelines for preventing opportunistic
infections (OIs) among persons infected with human immunodeficiency virus (HIV); 
these guidelines were updated in 1997 and 1999. This fourth edition of the
guidelines, made available on the Internet in 2001, is intended for clinicians
and other health-care providers who care for HIV-infected persons. The goal of
these guidelines is to provide evidence-based guidelines for preventing OIs among
HIV-infected adults and adolescents, including pregnant women, and HIV-exposed or
infected children. Nineteen OIs, or groups of OIs, are addressed, and
recommendations are included for preventing exposure to opportunistic pathogens, 
preventing first episodes of disease by chemoprophylaxis or vaccination (primary 
prophylaxis), and preventing disease recurrence (secondary prophylaxis). Major
changes since the last edition of the guidelines include 1) updated
recommendations for discontinuing primary and secondary OI prophylaxis among
persons whose CD4+ T lymphocyte counts have increased in response to
antiretroviral therapy; 2) emphasis on screening all HIV-infected persons for
infection with hepatitis C virus; 3) new information regarding transmission of
human herpesvirus 8 infection; 4) new information regarding drug interactions,
chiefly related to rifamycins and antiretroviral drugs; and 5) revised
recommendations for immunizing HIV-infected adults and adolescents and
HIV-exposed or infected children.

Publication Types: 
    Guideline
    Practice Guideline

PMID: 12617574 [PubMed - indexed for MEDLINE]

2190: J Pain Symptom Manage. 2003 Mar;25(3):198-9.

Herpes zoster: a previously unrecognized complication of epidural steroids in the
treatment of complex regional pain syndrome.

Parsons SJ, Hawboldt GS.

Publication Types: 
    Case Reports
    Letter

PMID: 12614953 [PubMed - indexed for MEDLINE]

2191: Am J Ophthalmol. 2003 Mar;135(3):415-7.

Herpes zoster virus sclerokeratitis and anterior uveitis in a child following
varicella vaccination.

Naseri A, Good WV, Cunningham ET Jr.

Francis I. Proctor Foundation and Department of Ophthalmology, University of
California at San Francisco Medical Center, San Francisco, California, USA.

PURPOSE: To report a case of herpes zoster virus sclerokeratitis with anterior
uveitis following vaccination with live attenuated varicella vaccine (Oka
strain). DESIGN: Case report. METHODS: The case records of the patient were
reviewed retrospectively. Pertinent literature citations were identified using
MEDLINE. RESULTS: A 9-year-old boy presented with herpes zoster ophthalmicus 3
years following vaccination with live attenuated varicella vaccine (Oka strain). 
Examination of the affected eye revealed a moderate follicular response on the
palpebral conjunctiva, decreased corneal sensation, mildly elevated intraocular
pressure, diffuse anterior scleritis with marginal keratitis, and a moderately
severe anterior uveitis. Amplified DNA from fluid taken from the base of a
cutaneous vesicle produced wild-type varicella zoster virus (VZV) DNA, not Oka
strain. CONCLUSIONS: Herpes zoster virus infection needs to be considered in all 
patients who present with scleritis, keratitis, or anterior uveitis, regardless
of their varicella vaccination status. Copyright 2003 by Elsevier Science Inc.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12614776 [PubMed - indexed for MEDLINE]

2192: Am Fam Physician. 2003 Feb 15;67(4):757-62, 675.

Antiviral drugs in the immunocompetent host: part I. Treatment of hepatitis,
cytomegalovirus, and herpes infections.

Colgan R, Michocki R, Greisman L, Moore TA.

Department of Family Medicine, University of Maryland School of Medicine,
Baltimore, Maryland 21201, USA. rcolgan@som.umaryland.edu

Since the release of amantadine in 1966, other agents designed to fight a diverse
range of viral infections have been released. Part I of this two-part article
focuses on agents used to manage hepatitis, cytomegalovirus, and herpes
infections. In patients with chronic hepatitis B, interferon alfa-2b or
lamivudine is the treatment of choice. Pegylated interferon alfa-2a or -2b, along
with ribavirin, is standard treatment for patients with chronic hepatitis C.
Although treatment of cytomegalovirus infections generally is supportive, there
have been reports of severely ill patients who improved after receiving
ganciclovir or foscarnet. Oral antiviral agents for initial and recurrent herpes 
simplex virus infections have been shown to shorten the duration of lesions.
Treatment of herpes zoster infections with antiviral drugs shortens the course of
infection and decreases symptoms. Studies have shown that antiviral treatment can
prevent prolonged post-herpetic neuralgia, although this use remains
controversial.

Publication Types: 
    Review

PMID: 12613729 [PubMed - indexed for MEDLINE]

2193: J Fr Ophtalmol. 2003 Jan;26(1):7-14.

[Facial anesthetic blocks in the treatment of acute pain during ophthalmic
zoster]

[Article in French]

Gain P, Thuret G, Chiquet C, Pascal J, Michaud P, Maugery J, Navez ML.

Service d'Ophtalmologie, Pavillon 50A, Centre Hospitalier Regional et
Universitaire, Saint-Etienne. philippe.gain@univ-st-etienne.fr

BACKGROUND: Ophthalmic zoster is frequently accompanied by severe pain in the
frontal and nasal divisions of the ophthalmic nerve. Treating this pain is often 
difficult, particularly in elderly patients, owing to iatrogenic effects and to
interactions with the pre-existing diseases and treatments frequently present in 
this age group. The aim of our study was to consider the efficacy and toxicity of
the frontal and nasal nerve blocks in the treatment of severe pain during acute
ophthalmic zoster in the elderly. MATERIAL AND METHODS: A prospective study was
conducted on 20 patients (mean age, 76 +/-7 years; range, 63-88) presenting with 
acute ophthalmic zoster with severe pain (less than 1 month since onset), which
had resisted analgesic medication. All patients had a visual analogue score for
pain (VAS) of 4 or more and received one or more anesthetic blocks of a compound 
of bupivacaine with adrenaline associated with clonidine at the frontal branch
and sometimes the nasal branch levels of the ophthalmic nerve. Pain was measured 
daily by VAS for 5 days, and the blocks were repeated if the VAS was still 4 or
higher. Patients were checked for local or systemic side effects. RESULTS: The
number of anesthetic blocks per patient ranged from one to four (mean: 2.3
+/-0.7). All patients experienced less pain after the first injection. The mean
preinjection VAS was 7.4 +/-1 and fell to 4.8 +/-1.0, 4.1 +/-1.1, 3.5 +/-1.0, 3.2
+/-0.6 and 2.8 +/-0.9 at day 1, day 2, day 3, day 4 and day 5, respectively
(p<0.001). It was possible to reduce analgesic medication permanently in all
patients. No local or systemic side effect was observed. CONCLUSION: Anesthetic
blocks of the frontal and nasal branches, repeated if necessary, give fast and
effective relief from the severe pain of acute ophthalmic zoster. They are fully 
tolerated and simple to administer, making them an excellent indication in the
complementary treatment of the pain of hyperalgic acute zoster in the elderly.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 12610404 [PubMed - indexed for MEDLINE]

2194: Ann Biol Clin (Paris). 2003 Jan-Feb;61(1):33-40.

[Contribution of the laboratory in case of resistance to acyclovir of herpes
simplex and varicella zoster virus]

[Article in French]

Morfin F, Frobert E, Thouvenot D.

Laboratoire de virologie des Hospices civils de Lyon, Domaine Rockefeller, 8
avenue Rockefeller, 69373 Lyon cedex 08. fmorfin@rockefeller.univ-lyon1.fr

Herpes simplex virus (HSV) and varicella zoster virus (VZV) are susceptible to
acyclovir which inhibits viral replication through two viral enzymes, thymidine
kinase (TK) and DNA polymerase. Resistance may occur, it is a rare phenomenon
among immunocompetent patients but resistance is more frequent and may be
associated with serious complications among immunocompromised patients.
Virological survey of these at risk patients is needed to detect resistant virus 
as soon as possible through phenotypic tests performed on virus isolated on cell 
cultures. Resistant virus may also be genetically characterised by detection of
mutations within TK and DNA polymerase genes. Pharmacological parameters also
have to be taken into consideration and a determination of acyclovir blood
concentration should be performed in case of unexplained therapeutic failure.
Improvement of immune system, when possible, may resolve these infections.
Alternative treatments using drugs such as foscarnet or cidofovir which have a
different mechanism of action compared to acyclovir, are recommended but these
molecules are often more toxic than acyclovir.

Publication Types: 
    English Abstract
    Review

PMID: 12604384 [PubMed - indexed for MEDLINE]

2195: J Eur Acad Dermatol Venereol. 2003 Jan;17(1):87-90.

Botryomycosis in an HIV-positive subject.

de Vries HJ, van Noesel CJ, Hoekzema R, Hulsebosch HJ.

Department of Dermatology, Academic Medical Centre, University of Amsterdam, POB 
22700, 1100 DE, Amsterdam, The Netherlands. h.j.devries@amc.uva.nl

A 28-year-old male AIDS patient with generalized painful skin ulcers, fever and
malaise presented to us. The differential diagnosis included varicella zoster
infection, herpes simplex infection, actinomycosis, sporotrichosis and
botryomycosis. Histopathology revealed clusters of gram-positive coccoid bacteria
in the deep dermis, surrounded by a mixed dense inflammatory infiltrate. A
bacterial culture grew Staphylococcus aureus. Viral cultures remained negative.
Based on these findings botryomycosis was diagnosed. Large lesions were excised
surgically and with antimicrobial therapy all skin symptoms disappeared. We
discuss this case with reference to a short review of the literature on
botryomycosis in relation to HIV infection.

Publication Types: 
    Case Reports
    Review

PMID: 12602981 [PubMed - indexed for MEDLINE]

2196: Todays FDA. 2003 Jan;15(1):16, 19.

Testing your diagnostic skills. Case no. 1. Herpes zoster.

Hashemian M.

Publication Types: 
    Case Reports

PMID: 12593144 [PubMed - indexed for MEDLINE]

2197: Math Biosci. 2003 Apr;182(2):113-26.

A qualitative analysis of a model for the transmission of varicella-zoster virus.

Schuette MC.

Department of Mathematics and Computer Science, Georgia Southern University,
Statesboro, GA 30460-8093, USA. schuette@gasou.edu

Varicella-zoster virus (VZV) is a herpesvirus which is the known agent for
causing varicella (chickenpox) in its initial manifestation and zoster (shingles)
in a reactivated state. The standard SEIR compartmental model is modified to
include the cycle of shingles acquisition, recovery, and possible reacquisition. 
The basic reproduction number R(0) shows the influence of the zoster cycle and
how shingles can be important in maintaining VZV in populations. The model has
the typical threshold behavior in the sense that when R(0)</=1, the VZV
disappears from the population, and when R(0)>1, the virus persists over time and
so chickenpox and shingles remain endemic.

PMID: 12591619 [PubMed - indexed for MEDLINE]

2198: J Clin Virol. 2003 Jan;26(1):85-93.

Parallel detection of five human herpes virus DNAs by a set of real-time
polymerase chain reactions in a single run.

Stocher M, Leb V, Bozic M, Kessler HH, Halwachs-Baumann G, Landt O, Stekel H,
Berg J.

Institute of Laboratory Medicine, General Hospital Linz, Krankenhausstrasse 9,
A-4020 Linz, Austria.

BACKGROUND: Human herpes viruses cause a spectrum of diseases that are usually
self-limiting but can be reactive during immuno-suppression and may then lead to 
severe or even life-threatening diseases. The LightCycler technology allows rapid
polymerase chain reaction (PCR) including product analysis within a closed
system. This approach has been demonstrated to be suitable for routine diagnostic
virus detection. Several LightCycler PCR assays have been established to the
detection of human herpes viruses. The assays vary in their detection formats and
PCR cycling protocols. So, they cannot be performed within a single LightCycler
run. OBJECTIVES: Development of four LightCycler PCR assays for parallel
detection of DNA derived from human cytomegalovirus (CMV), Epstein-Barr virus
(EBV), herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), 
and varicella-zoster virus (VZV) in a single run. STUDY DESIGN: Primers and
hybridization probes were tailored to suit one LightCycler PCR program.
LightCycler PCRs were established, detection limits were determined, and clinical
samples were evaluated. RESULTS: With quantified herpes virus type specific DNA
spiked into cerebrospinal fluid, serum or EDTA plasma the detection limits were
found either at 500 or 250 viral DNA copies per ml depending on the virus DNA
specific PCR and on the specimen type used. The applicability of the new
LightCycler assays for routine molecular testing was evaluated by testing 96
clinical samples. CONCLUSION: The developed set of LightCycler PCRs permits
parallel detection of CMV, EBV, HSV-1, HSV-2, and VZV in a single LightCycler
run. The new molecular assays can easily be used to the rapid, simple, and
convenient detection of herpes virus DNA in cerebrospinal fluid, serum and EDTA
plasma in the routine diagnostic laboratory.

Publication Types: 
    Comparative Study
    Evaluation Studies

PMID: 12589838 [PubMed - indexed for MEDLINE]

2199: Jpn J Ophthalmol. 2003 Jan-Feb;47(1):107-9.

A case of acute dacryoadenitis associated with herpes zoster ophthalmicus.

Obata H, Yamagami S, Saito S, Sakai O, Tsuru T.

Department of Ophthalmology, Jichi Medical School, Tochigi, Japan.

BACKGROUND: Acute dacryoadenitis is an uncommon disease. CASE: We present what we
believe to be the first reported case of herpes zoster ophthalmicus with the
onset of acute dacryoadenitis. OBSERVATIONS: A 30-year-old man complained of
severe ocular pain and hyperemia in his right eye. Magnetic resonance imaging
(MRI) demonstrated enlargement of the right lacrimal gland and acute
dacryoadenitis was diagnosed. Two days after treatment with systemic antibiotics 
he developed iridocyclitis and skin lesions confined to the first division of the
trigeminal nerve; therefore, herpes zoster ophthalmicus was diagnosed. Treatment 
with acyclovir immediately resolved the ocular pain and swelling of the upper
eyelid. MRI conducted in the 4 months after the initial examination showed there 
was no longer enlargement of the right lacrimal gland. CONCLUSION: Clinicians
should be aware that varicella-zoster virus may cause acute dacryoadenitis.

Publication Types: 
    Case Reports

PMID: 12586188 [PubMed - indexed for MEDLINE]

2200: Med Pregl. 2002 Sep-Oct;55(9-10):412-4.

[Clinical characteristics and prognostic significance of preherpetic neuralgia]

[Article in Croatian]

Cvjetkovic D, Jovanovic J, Hrnjakovic Cvjetkovic I, Aleksic Dordevic M.

Klinika za infektivne bolesti Institut za zastitu zdravlja, Novi Sad.
ivacvj@neobee.net

INTRODUCTION: Herpes zoster is a world-wide disease of older age commonly
presenting with preherpetic pain. The aim of the study was to determine clinical 
characteristics of preherpetic neuralgia and its influence on occurrence of
postherpetic neuralgia. MATERIAL AND METHODS: A prospective, controlled trial
included 88 patients with preherpetic neuralgia. 44 herpes zoster patients
without preherpetic neuralgia were included in the control group. All of them
were clinically followed-up for three months after complete healing of skin
lesions. RESULTS: Older age (> 60 years) was significantly predominant (59.1%)
compared with other age groups (p < 0.01) as well as female sex (59.9%) compared 
with the male sex (p < 0.01). There was no significant predominance of any type
of preherpetic neuralgia (stabbing, burning, itching, dull pain). More intense
preherpetic pain (reported as "severe" and "moderate") was established more often
than mild pain. The mean duration of preherpetic pain was 4.4 days (ranged
between 1-20 days). Postherpetic neuralgia developed in 36/88 patients with
preherpetic neuralgia (affecting predominantly older than 50 years of
age--31/36), but there was no significant difference in proportion of
postherpetic neuralgia (PHN) according to those without preherpetic neuralgia.
DISCUSSION AND CONCLUSION: People older than 60 years are the most common age
group among herpes zoster patients suffering from preherpetic neuralgia. Sex
distribution of patients with preherpetic pain reveals highly significant
predominance of female sex. Opposite to some other authors' reports, preherpetic 
neuralgia and its severity have not been proven as risk factors for postherpetic 
neuralgia in patients involved in our trial.

Publication Types: 
    English Abstract

PMID: 12584895 [PubMed - indexed for MEDLINE]

2201: Eur Arch Otorhinolaryngol. 2003 Feb;260(2):86-90. Epub 2002 Sep 4.

Herpes zoster-associated trigeminal trophic syndrome: a case report and review.

Litschel R, Winkler H, Dazert S, Sudhoff H.

Department of Otorhinolaryngology, Head and Neck Surgery, University of Bochum,
St. Elisabeth Hospital, Germany.

The case of a 75-year-old Caucasian woman with a trigeminal trophic syndrome
(TTS) is presented and discussed. TTS of the ala nasi subsequent to a herpes
zoster infection has not been described previously. We provide a review of the
literature with insights into the pathogenesis and current therapeutic
strategies.

Publication Types: 
    Case Reports
    Review

PMID: 12582785 [PubMed - indexed for MEDLINE]

2202: J Clin Microbiol. 2003 Feb;41(2):576-80.

Diagnosing herpesvirus infections by real-time amplification and rapid culture.

van Doornum GJ, Guldemeester J, Osterhaus AD, Niesters HG.

Department of Virology, Erasmus MC, Rotterdam, The Netherlands.
vandoornum@viro.azr.nl

Procedures using real-time technique were developed to demonstrate the presence
of herpes simplex virus type 1 (HSV-1) and HSV-2, varicella zoster virus (VZV),
and cytomegalovirus (CMV) in miscellaneous clinical specimens. The assays were
compared to rapid culture using centrifugation followed by detection with
monoclonal antibodies. A total of 711 consecutive samples were collected from
different patient groups. Throat swabs were obtained from transplant patients;
dermal or oral specimens were collected from patients suspected for VZV or HSV
infection. Genital specimens were taken from patients who attended the Clinic for
Sexually Transmitted Diseases at the Dijkzigt Hospital Rotterdam presenting with 
symptoms of a primary genital ulcer. Nucleic acid extraction was carried out
using a MagnaPure LC instrument. The amplification steps were performed on the
ABI Prism 7700 sequence detection system. To monitor the process of extraction
and amplification, a universal control consisting of seal herpesvirus type 1
(PhHV-1) was added to the clinical specimens. By culture 127 of 668 (19%) samples
were positive for HSV-1, 72 of 668 (10.8%) specimens were positive for HSV-2, and
17 of 366 (4.6%) were positive for VZV. Using real-time amplification the numbers
of positive specimens were 143 of 668 (21.4%), 97 of 668 (14.5%), and 27 of 366
(7.4%), respectively. Eighty-six specimens were tested for CMV, 12 (14.0%) were
positive by culture, and 17 (19.8%) were positive by real-time PCR. The clinical 
data of the patients with discrepant results were reviewed thoroughly. In all
cases the patients with only real-time PCR-positive results could be considered
as truly infected. We concluded that the real-time amplification technique is
suitable for the detection of human herpesvirus infection. It offers a
semiquantitative and reliable assay with a quick result that is more sensitive
than rapid culture, especially for the diagnosis of HSV-2 and VZV infections.

PMID: 12574249 [PubMed - indexed for MEDLINE]

2203: Clin J Pain. 2002 Nov-Dec;18(6 Suppl):S177-81.

A focused review on the use of botulinum toxins for neuropathic pain.

Argoff CE.

Cohn Pain Management Center, North Shore University Hospital, New York University
School of Medicine, Bethpage, New York 11714, USA. pargoff@optonline.net

Understanding the pathophysiology of a pain syndrome is helpful in selecting
appropriate treatment strategies. Nociceptive pain is related to damage to
tissues due to thermal, chemical, mechanical, or other types of irritants.
Neuropathic pain results from injury to the peripheral or central nervous system.
Common examples of neuropathic pain include postherpetic neuralgia, diabetic
neuropathy, complex regional pain syndrome, and pain associated with spinal cord 
injuries. Nociceptive pain may have similar clinical characteristics to
neuropathic pain. It is also possible for acute nociceptive pain to become
neuropathic in nature, as with myofascial pain syndrome. A clear benefit of
botulinum toxin therapy for treatment of neuropathic pain disorders is that it
often relieves pain symptoms. Although the precise mechanism of pain relief is
not completely understood, the injection of botulinum toxin may reduce various
substances that sensitize nociceptors. As a result, botulinum toxin types A and B
are now being actively studied in nociceptive and neuropathic pain disorders to
better define their roles as analgesics.

Publication Types: 
    Review

PMID: 12569966 [PubMed - indexed for MEDLINE]

2204: Trop Doct. 2003 Jan;33(1):44-8.

The prevalence and pattern of skin diseases in relation to CD4 counts among
HIV-infected police officers in Dar es Salaam.

Muhammad B, Eligius L, Mugusi F, Aris E, Chale S, Magao P, Josiah R, Moshi A,
Swai A, Pallangyo N, Sandstrom E, Mhalu F, Biberfeld G, Pallangyo K.

Muhimbili University College of Health Sciences, PO Box 65001, Dar es Salaam,
Tanzania. mbakari@muchs.ac.tz

Among HIV-infected individuals, skin diseases cause significant morbidity and are
frequently the initial indication of immunosuppression. From an on-going cohort
study to determine prevalence and incidence of HIV infection among police
officers (POs) and their suitability for HIV vaccine trials, a sub-study was
carried out to determine the prevalence and pattern of skin diseases among
HIV-infected POs and relate this to their immunodeficiency status. Consenting
HIV-infected POs and their age and sex-matched HIV-negative officers were
assessed for presence and type of skin diseases at their workplaces. A
questionnaire was used for data collection. Immunodeficiency was measured by
plasma CD4+ lymphocytes using flow cytometry. Between November 1998 and 31
December 2000, 716 POs were assessed. Overall HIV-1 prevalence was 17.7%
(127/716). One hundred and ninety-one POs (26.7%) had at least one skin
diagnosis. HIV-infected POs had significantly higher (41.7%) prevalence of skin
diseases than HIV-uninfected POs (26.4%), P = 0.002. Fungal infections were
common in both HIV-infected and uninfected POs. Among the HIV infected, other
common diseases were: herpes zoster (11.8%); pruritic papular eruption (PPE)
(7.1%); seborrheic dermatitis (5.5%); and Kaposi's sarcoma (KS) (1.6%). KS and
PPE were associated with severe immunodeficiency, with mean absolute (percentage)
CD4+ counts of 75.5 cells/microL (4.0%) and 71.7 cells/microL (4.8%),
respectively. The values for herpes zoster and seborrheic dermatitis were 271.1
cells/micronL (12.4%) and 206.3 cells/microL (11.3%), respectively. Skin diseases
were common among HIV-infected POs. PPE and KS are markers of severe
immunodeficiency due to HIV. PPE, herpes zoster and KS strongly suggest
underlying HIV-related immunodeficiency and patients with these conditions should
be counselled and tested for HIV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12568524 [PubMed - indexed for MEDLINE]

2205: Laryngoscope. 2003 Feb;113(2):307-11.

Vertigo from herpes zoster oticus: superior or inferior vestibular nerve origin?

Lu YC, Young YH.

Department of Otolaryngology, National Taiwan University Hospital, Taipei,
Taiwan.

OBJECTIVE/HYPOTHESIS: This study aims to analyze which division of vestibular
nerve in the internal auditory canal is responsible for inducing vertigo in
patients with herpes zoster oticus (HZO). METHODS: Eight patients (three men and 
five women) suffered from auricular vesicles, otalgia, and facial palsy, and five
of them also had vertigo. Each patient received a battery of tests, including
neurological examination, blood examination, audiometry, caloric test,
electronystagmography, and vestibular evoked myogenic potential (VEMP) test.
RESULTS: All five HZO patients with vertigo had facial palsy on the lesioned side
and spontaneous nystagmus beating toward the healthy side. Absent VEMPs were
noted in five patients, absent caloric response was noted in four, and
sensorineural HL was noted in three. Compared to another three HZO patients
without vertigo, all revealed normal responses in both the caloric test and the
VEMP test. On MRI scan, two out of four had abnormal gadolinium enhancement along
the nerve segments within the internal auditory canal. Six months after
treatment, a follow-up caloric test and VEMP test in these eight patients did not
alter the results compared with before treatment. CONCLUSION: The nerve trunks
within the internal auditory canal are widely affected in HZO patients with
vertigo. Both superior division and inferior division of the vestibular nerve
attribute to the vertiginous attack. Further, large numbers of HZO patients
undergoing caloric testing and VEMP testing are required to support this
tentative conclusion.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12567087 [PubMed - indexed for MEDLINE]

2206: Commun Dis Public Health. 2002 Dec;5(4):343.

Comment on:
    Commun Dis Public Health. 2002 Sep;5(3):185-6.

Varicella vaccination--an ethical issue.

Smithson R.

Publication Types: 
    Comment
    Letter

PMID: 12564257 [PubMed - indexed for MEDLINE]

2207: Clin Exp Immunol. 2003 Feb;131(2):318-23.

Local immune responses and systemic cytokine responses in zoster: relationship to
the development of postherpetic neuralgia.

Zak-Prelich M, McKenzie RC, Sysa-Jedrzejowska A, Norval M.

Dermatology, Medical University of Lodz, Lodz, Poland.

Varicella zoster virus (VZV) causes varicella (chickenpox) as the primary
infection and zoster (shingles) on reactivation from latency, often many years
later. One of the most common and most severe sequela of zoster is postherpetic
neuralgia (PHN). Apart from age, factors which predispose towards PHN are
unknown. In the present study, the concentration of a variety of Th1 and Th2
cytokines in the serum of 30 zoster patients at the time of the acute disease
were correlated with the subsequent development of PHN in nine of these patients,
but no association was found. In addition, although some cytokines such as
IFN-gamma, IL-6 and IL-8 were slightly raised in the zoster group compared with a
group of normal healthy subjects of a similar age distribution, these differences
only verged on significance. Antibody titres to VZV were raised in the zoster
group compared with the controls but these did not differ between the patients
who developed PHN and those who did not. Biopsies of zoster lesions were
collected from nine patients. There were significantly fewer infiltrating
lymphocytes in the lesions of the three patients who subsequently developed PHN
compared with the six who did not, although the expression of the neuropeptide,
substance P, did not differ between the two groups. It is possible that the poor 
inflammatory response at the time of the acute zoster may result in less
effective containment of the VZV and more damage in the dermatome, thus
contributing to the persistence of the neuralgia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12562395 [PubMed - indexed for MEDLINE]

2208: Epidemiol Infect. 2002 Dec;129(3):593-7.

The role of solar ultraviolet irradiation in zoster.

Zak-Prelich M, Borkowski JL, Alexander F, Norval M.

Department of Dermatology, Medical University of Lodz, Lodz, Poland.

Ultraviolet radiation (UVR) suppresses many aspects of cell-mediated immunity but
it is uncertain whether solar UV exposure alters resistance to human infectious
diseases. Varicella-zoster virus (VZV) causes varicella (chickenpox) and can
reactivate from latency to cause zoster (shingles). The monthly incidence of
chickenpox and zoster in a defined Polish population over 2 years was recorded
and ground level solar UV was measured daily. There was a significant seasonality
of UVR. Evidence of seasonal variation was found for all zoster cases and for
zoster in males, with the lowest number of cases in the winter. The number of
zoster cases with lesions occurring on exposed body sites (the face) demonstrated
highly significant seasonality with a peak in July/August. Seasonal models for
UVR and zoster cases showed similar temporal patterns. By contrast, for
varicella, the maximum number of cases was found in March and the minimum in
August/September, probably explained by the respiratory spread of VZV. It is
tempting to speculate that the increase in solar UVR in the summer could induce
suppression of cellular immunity, thus contributing to the corresponding rise in 
the incidence of zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12558343 [PubMed - indexed for MEDLINE]

2209: Cutis. 2003 Jan;71(1):86; author reply 86.

Comment on:
    Cutis. 2001 Jul;68(1):21-3.

Childhood herpes zoster.

Plumb RL.

Publication Types: 
    Comment
    Letter

PMID: 12553636 [PubMed - indexed for MEDLINE]

2210: Pediatr Infect Dis J. 2003 Jan;22(1):96-7.

Comment in:
    Pediatr Infect Dis J. 2004 Feb;23(2):185-6; author reply 186.

Varicella-zoster virus: an overlooked cause of aseptic meningitis.

Jhaveri R, Sankar R, Yazdani S, Cherry JD.

Division of Infectious Diseases, Mattel Children's Hospital at UCLA, Los Angeles,
CA 90095-1752, USA. rjhaveri@ucla.edu

Varicella-zoster virus causes varicella (chickenpox) and zoster (shingles).
Neurologic manifestations occur in both illnesses. We describe a previously
healthy child who had aseptic meningitis without exanthem caused by reactivation 
of varicella-zoster virus. This has not been previously reported in the pediatric
literature.

PMID: 12553305 [PubMed - indexed for MEDLINE]

2211: Anticancer Res. 2002 Nov-Dec;22(6B):3701-8.

Evaluation of infectious complications and immune recovery following high-dose
chemotherapy (HDC) and autologous peripheral blood progenitor cell
transplantation (PBPC-T) in 148 breast cancer patients.

Zambelli A, Montagna D, Da Prada GA, Maccario R, Zibera C, Moretta A, Ponchio L, 
Lozza L, Baiardi P, Maserati R, Marone P, Della Cuna GR.

Area Omogenea Oncologica, Divisione di Oncologia Medica, Fondazione Salvatore
Maugeri, Clinica del Lavoro e della Riabilitazione (IRCCS), Istituto Scientifico 
di Pavia, Italy. azambelli@fsm.it

BACKGROUND AND OBJECTIVES: High-dose chemotherapy (HDC) with autologous PBPC-T
has been reported to be effective in hematological and in selected solid
malignancies. In this setting, infectious complications represent a relevant
cause of morbidity. PATIENTS AND METHODS: To ascertain the incidence, types and
factors influencing the development of early and late infections, we
retrospectively analyzed 148 consecutive breast cancer (BC) patients receiving
HDC and PBPC-T, both for primary high-risk BC (pBC) and metastatic disease (mBC).
RESULTS: Early infection strongly associated with the occurrence of grade 4
mucositis (p < 0.001), was documented in 28 patients (19%). Late re-activation of
varicella zoster virus (VZV) occurred in 14 patients (9%); an inverse correlation
between the VZV re-activation and the total amount of T-cells transferred with
the graft was observed. Evaluation of immune reconstitution, carried out in 10
out of 148 patients, showed a long-lasting CD+ T-cells depression (> 2 year),
mainly involving the naive CD4+ T-cell subset. Conversely, the analysis of the
frequency of proliferating T-lymphocyte precursors, specific for antigens
expressed by 3 different widespread pathogens, demonstrated that, notwithstanding
the delayed recovery of CD4+ cells, many T-lymphocyte functions were within
normal range 1 year after PBPC-T. CONCLUSION: Altogether these results show that 
severe mucositis is associated with early bacterial infections and the infusion
of large numbers of T-cells plays a role in controlling late VZV reactivation.

PMID: 12552979 [PubMed - indexed for MEDLINE]

2212: J Virol. 2003 Feb;77(4):2349-58.

Identification of small molecule compounds that selectively inhibit
varicella-zoster virus replication.

Visalli RJ, Fairhurst J, Srinivas S, Hu W, Feld B, DiGrandi M, Curran K, Ross A, 
Bloom JD, van Zeijl M, Jones TR, O'Connell J, Cohen JI.

Infectious Diseases Section, Department of Molecular Biology/Virology, Wyeth
Vaccines, Pearl River, NY 1096, USA. visallr@wyeth.com

A series of nonnucleoside, N-alpha-methylbenzyl-N'-arylthiourea analogs were
identified which demonstrated selective activity against varicella-zoster virus
(VZV) but were inactive against other human herpesviruses, including herpes
simplex virus. Representative compounds had potent activity against VZV
early-passage clinical isolates and an acyclovir-resistant isolate. Resistant
viruses generated against one inhibitor were also resistant to other compounds in
the series, suggesting that this group of related small molecules was acting on
the same virus-specific target. Sequencing of the VZV ORF54 gene from two
independently derived resistant viruses revealed mutations in ORF54 compared to
the parental VZV strain Ellen sequence. Recombinant VZV in which the wild-type
ORF54 sequence was replaced with the ORF54 gene from either of the resistant
viruses became resistant to the series of inhibitor compounds. Treatment of
VZV-infected cells with the inhibitor impaired morphogenesis of capsids.
Inhibitor-treated cells lacked DNA-containing dense-core capsids in the nucleus, 
and only incomplete virions were present on the cell surface. These data suggest 
that the VZV-specific thiourea inhibitor series block virus replication by
interfering with the function of the ORF54 protein and/or other proteins that
interact with the ORF54 protein.

PMID: 12551972 [PubMed - indexed for MEDLINE]

2213: Commun Dis Intell. 2002;26(4):576-80.

Comment in:
    Commun Dis Intell. 2003;27(1):100-1.

Surveillance of viral pathogens in Australia--varicella-zoster virus.

Roche P, Blumer C, Spencer J.

Surveillance and Epidemiology Section, Department of Health and Ageing, Canberra.

PMID: 12549527 [PubMed - indexed for MEDLINE]

2214: Cancer. 2003 Feb 1;97(3 Suppl):887-92.

A phase I study of AMGN-0007, a recombinant osteoprotegerin construct, in
patients with multiple myeloma or breast carcinoma related bone metastases.

Body JJ, Greipp P, Coleman RE, Facon T, Geurs F, Fermand JP, Harousseau JL,
Lipton A, Mariette X, Williams CD, Nakanishi A, Holloway D, Martin SW, Dunstan
CR, Bekker PJ.

Unit of Endocrinology, Institut Jules Bordet, Brussels, Belgium.

BACKGROUND: Osteoprotegerin (OPG) is a decoy receptor for OPG ligand (OPGL), or
receptor activator of NF-kappaB ligand (RANKL). RANKL/RANK interaction is
important in terminal differentiation and activation of osteoclasts. In binding
to RANKL, OPG blocks differentiation and activation of osteoclasts. AMGN-0007 is 
a recombinant OPG construct developed as a potential therapeutic agent in the
treatment of bone disease. METHODS: A randomized, double-blind, double-dummy,
active-controlled, single-dose, dose escalation study was conducted to determine 
the safety and effect on bone resorption of AMGN-0007 in patients with multiple
myeloma (n = 28) or breast carcinoma (n = 26) with radiologically confirmed lytic
bone lesions. Patients were randomized (3:1 ratio) to receive a single dose of
either AMGN-0007 (subcutaneously [SC]) or pamidronate (90 mg intravenously) and
were followed for 56 days. Medications or other diseases affecting bone
metabolism and chemotherapy within 28 days of dosing were exclusion criteria.
Biologic activity of AMGN-0007 was assessed by measurement of the surrogate
marker of bone resorption, urinary N-telopeptide of collagen (NTX). RESULTS:
AMGN-0007 caused a rapid, sustained, dose-dependent decrease in NTX/creatinine
levels, which was at least comparable to the profile observed with pamidronate.
Four serious adverse events were reported, three in breast carcinoma patients: a 
fracture in the left femur (pamidronate, considered unrelated), extreme fatigue
(0.3 mg/kg AMGN-0007, considered unrelated), and congestive heart failure (1.0
mg/kg AMGN-0007, considered by the investigator to be probably related to
doxorubicin and radiation therapy); one event occurred in a multiple myeloma
patient: Herpes zoster (pamidronate, considered unrelated). Two multiple myeloma 
patients (1.0 mg/kg AMGN-0007) had albumin-adjusted serum calcium levels of 1.9
mmol/L on Day 8 but without clinical symptoms. CONCLUSIONS: A single SC dose of
AMGN-0007 suppressed bone resorption as indicated by a rapid, sustained, and
profound decrease of urinary NTX/creatinine in multiple myeloma and breast
carcinoma patients. Changes were comparable to those with pamidronate. AMGN-0007 
was well tolerated. Copyright 2003 American Cancer Society.DOI 10.1002/cncr.11138

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase I
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 12548591 [PubMed - indexed for MEDLINE]

2215: Zhonghua Gan Zang Bing Za Zhi. 2003 Jan;11(1):37-9.

[Glycocorticosteroid administration prevents fulminant hepatic failure occurrence
in patients with chronic hepatitis B of severe degree]

[Article in Chinese]

Chen CX, Guo SM, Liu B, Yang JH, Xu N, Liu KW.

Department of Infectious Diseases, 105th Hospital of People's Liberation Army,
Hefei 230031, China.

OBJECTIVE: To prevent chronic severe hepatitis, even more fulminant hepatic
failure (FHF) occurrence in patients with chronic hepatitis B of severe degree
using steroid. METHODS: 120 patients were randomized into conventional supporting
treatment and steroid treatment groups. The latter, 62 patients were given
intravenously hydrocortisone sodium succinate at the dose of 150 mg to
approximately 200 mg everyday plus support care. RESULTS: The rate of
deteriorating to chronic severe hepatitis in steroid treatment group was
significantly lower than that of conventional group (22% vs 48%, x(2) =7.60,
P<0.01). 53.6% (15/28) patients with chronic severe hepatitis in conventional
group died, while only 28.6% (4/14) in steroid treatment group succumbed to
terminal liver disease (x(2)=0.02, P>0.05). There was no difference between the
two groups regarding to complications incidence: gastrointestinal bleeding and
infections except for some controllable serious reverse events, such as
candidiasis, diabetes, herpes zoster and pulmonary tuberculosis found in some
patients in steroid-treated group. CONCLUSION: These results suggest that steroid
administration with improved support care not only is likely to prevent chronic
severe hepatitis occurrence in patients with chronic viral hepatitis of severe
degree, but also shows some efficacy for FHF, which warrant further
investigation.

Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 12546741 [PubMed - indexed for MEDLINE]

2216: J Urol. 2003 Feb;169(2):619-20.

Herpes zoster following sacral nerve stimulation for overactive bladder.

Rosenblum N, Eilber KS, Raz S.

Department of Urology, University of California, Los Angeles School of Medicine, 
Los Angeles, California, USA.

Publication Types: 
    Case Reports

PMID: 12544325 [PubMed - indexed for MEDLINE]

2217: Auris Nasus Larynx. 2003 Feb;30 Suppl:S89-92.

Vestibular-evoked myogenic potentials in two patients with Ramsay Hunt syndrome.

Saito S, Ochi K, Kobayashi T, Sugiura N, Komatsuzaki Y, Ohashi T.

Department of Otolaryngology, St. Marianna University School of Medicine, 2-16-1,
Sugao, Miyamae-ku, 216-8511, Kawasaki, Japan.

We report on the function of the inferior vestibular nerve, as monitored by the
vestibular-evoked myogenic potentials (VEMP), in two patients suffering from
Ramsay Hunt syndrome. Both the patients presented canal paresis (CP) and hearing 
loss, but in one patient normal VEMP was recorded while the other presented vagus
nerve paralysis plus no VEMP response at the highest stimulus intensity used in
our institute (i.e., 105 dB nHL).

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12543168 [PubMed - indexed for MEDLINE]

2218: Neuropediatrics. 2002 Oct;33(5):262-5.

Hypercytokinemia in hemiconvulsions-hemiplegia syndrome associated with dual
infection with varicella zoster and Epstein-Barr viruses.

Wakamoto H, Ohta M, Nakano N.

Department of Pediatrics, Ehime Prefecture Niihama Hospital, Ehime, Japan.
wakamot@mail2.netwave.or.jp

Hemiconvulsions-hemiplegia (HH) syndrome is an acquired condition in which
hemiplegia develops after a preceding febrile unilateral status epilepticus in a 
previously healthy child. Although viral encephalitis or vascular diseases may be
the underlying etiology, the pathogenesis remains unknown in the majority of
cases. We measured both plasma and cerebrospinal fluid cytokine levels in a girl 
with HH syndrome, and found elevated plasma concentrations of soluble
interleukin-2 receptor and tumor necrosis factor-alpha, and a slightly increased 
plasma level of interleukin-6. Furthermore, she had a high serum concentration of
soluble E-selectin, which is a marker of inflammatory endothelial activation.
These findings suggest that proinflammatory cytokine-induced cerebrovascular
endothelial injury could play a role in the pathogenesis of HH syndrome.

Publication Types: 
    Case Reports

PMID: 12536369 [PubMed - indexed for MEDLINE]

2219: J Neurol. 2002 Nov;249(11):1612-4.

Good cognitive outcome of patients with herpes zoster encephalitis: a follow-up
study.

Wetzel K, Asholt I, Herrmann E, Kratzer C, Masuhr F, Schielke E.

Publication Types: 
    Letter

PMID: 12532932 [PubMed - indexed for MEDLINE]

2220: Pediatr Dent. 2002 Nov-Dec;24(6):572-4.

Acute onset of facial nerve palsy associated with Lyme disease in a 6 year-old
child.

Siwula JM, Mathieu G.

Department of Pediatric Dentistry, University of Connecticut, Farmington, Conn,
USA.

Pediatric facial nerve palsy (FNP) can result from a variety of etiologies
including Lyme disease, varicella, primary gingivostomatitis, herpes zoster
oticus (Ramsay Hunt syndrome), coxsackievirus, trauma, otitis media, HIV,
diseases causing tumors or demyelinations, compressions, and possibly Epstein
Barr virus. Lyme disease has been implicated as the cause of over 50% of the FNPs
in children. The paralysis of the facial nerve disturbs motor function to the
muscles of facial expression and results in a flaccid appearance of the face
(unilateral or bilateral). This case report derails undiagnosed Lyme disease
presenting as a facial palsy in a 6 year, 5 month-old white female. The palsy was
recognized and consultation with the child's physician prompted definitive
diagnosis and treatment. A review of the literature and the implications of
facial nerve palsy are discussed.

Publication Types: 
    Case Reports
    Review

PMID: 12528951 [PubMed - indexed for MEDLINE]

2221: Mol Pharmacol. 2003 Feb;63(2):439-49.

Apoptosis induced by (E)-5-(2-bromovinyl)-2'-deoxyuridine in varicella zoster
virus thymidine kinase-expressing cells is driven by activation of
c-Jun/activator protein-1 and Fas ligand/caspase-8.

Tomicic MT, Friedrichs C, Christmann M, Wutzler P, Thust R, Kaina B.

Institute of Toxicology, Medical Faculty, University of Mainz, Mainz, Germany.

The molecular mode of cell killing by the antiviral drug
(E)-5-(2-bromovinyl-2'-deoxyuridine (BVDU) was studied in Chinese hamster ovary
(CHO) cells stably transfected with the thymidine kinase gene (tk) of varicella
zoster virus (CHO-VZVtk). The colony-forming ability of the cells was reduced to 
<1% at a concentration of approximately 1 microM BVDU, whereas for nontransfected
cells or cells transfected with tk gene of herpes simplex virus type 1
(CHO-HSVtk), a 1000-fold higher dose was required to achieve the same response.
BVDU inhibited thymidylate synthase in CHO-VZVtk but not in CHO-HSVtk and control
cells. On the other hand, the drug was incorporated into DNA of VZVtk- and
HSVtk-expressing cells to nearly equal amounts. Because coexposure of CHO-VZVtk
cells to exogenous thymidine protected them from BVDU-induced cell killing, the
cells obviously die because of thymidine depletion. At highly cytotoxic BVDU
doses (50 microM) and longer exposure times (24-48 h), VZVtk cells were blocked
to some extent in S and G2/M phase and underwent apoptosis (48-72 h). Not only
apoptosis but also necrosis was induced. The findings also show that the drug
causes the induction of c-Jun and the activation of activator protein-1 resulting
in increased level of Fas ligand (FasL) and caspase-8/-3 activation. Bid and
poly(ADP-ribose) polymerase were cleaved by caspases. Expression of Bax
increased, whereas Bcl-2/Bcl-x(L) remained unchanged. Transfection of
dominant-negative Fas-associated death domain and inhibition of caspase-8 by
N-benzyloxycarbonyl-IETD-fluoromethyl ketone strongly abrogated BVDU-induced
apoptosis, indicating Fas/FasL to be crucially involved. Thus, BVDU-triggered
apoptosis differs significantly from that induced by ganciclovir, which induces
in the same cellular background the mitochondrial damage pathway.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12527816 [PubMed - indexed for MEDLINE]

2222: Eur J Pain. 2003;7(1):1-7.

Erratum in:
    Eur J Pain. 2003;7(2):201.

Factors influencing the features of postherpetic neuralgia and outcome when
treated with tricyclics.

Bowsher D.

Pain Research Institute, Clinical Sciences Building, University Hospital Aintree,
Liverpool L9 7AL, UK. bowsher@liv.ac.uk

This paper retrospectively reviews features of postherpetic neuralgia (PHN) in up
to 279 personal patients in relation to treatment outcome when treated with
tricyclic antidepressants (TCAs). Factors affecting characteristics of PHN: (i)
Patients with allodynia (89%) and/or burning pain (56%) have a much higher visual
analogue pain intensity score than those without; (ii) Acyclovir (ACV) given for 
acute shingles (HZ) does not reduce the incidence of subsequent PHN, but reduces 
the pain intensity in PHN patients with allodynia; (iii) ACV given for acute HZ
reduces the incidence of burning pain in subsequent PHN, but not of allodynia;
(iv) ACV given for acute HZ reduces the incidence of clinically detectable
sensory deficit in subsequent PHN. Factors affecting outcome of TCA-treated PHN: 
(i) The point in time at which TCA treatment is commenced is by far the most
critical factor: started between 3 and 12 months after acute HZ onset, more than 
two-thirds obtain pain relief (NNT=1.8); between 13 and 24 months, two-fifths
(41%) (NNT=3.6); and more than two years, one-third (NNT=8.3). Background and
paroxysmal pain disappear earlier and are more susceptible of relief than
allodynia. (ii) Twice as many (86%) of PHN patients without allodynia obtain pain
relief with TCA treatment than those with (42%); (iii) the use of ACV for acute
HZ more than halves the time-to-relief of PHN patients by TCAs; (iv) PHN patients
with burning pain are significantly less likely to obtain pain relief with TCAs
than those without (p<0.0001).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12527312 [PubMed - indexed for MEDLINE]

2223: Am J Gastroenterol. 2003 Jan;98(1):104-11.

Comment in:
    Am J Gastroenterol. 2003 Dec;98(12):2812-3.    Am J Gastroenterol. 2003 Jan;98(1):5-6.    Am J Gastroenterol. 2003 Oct;98(10):2333-4.

Safety and steroid-sparing experience using infliximab for Crohn's disease at a
pediatric inflammatory bowel disease center.

Stephens MC, Shepanski MA, Mamula P, Markowitz JE, Brown KA, Baldassano RN.

The Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology
and Nutrition at The Children's Hospital of Philadelphia, Pennsylvania 19104,
USA.

OBJECTIVES: The published experience using infliximab (Remicade, Centocor,
Malvern, PA) for the treatment of pediatric Crohn's disease is limited but
suggests utility in the treatment of refractory disease. Experience using
infliximab at a large pediatric center is reviewed. METHODS: A retrospective
review of all infliximab infusions administered to patients with Crohn's disease 
(CD) was undertaken. Data were obtained from database and pharmacy records. Chart
review and interviews with physicians, patients, and families were used to obtain
missing data. RESULTS: A total of 432 infusions were administered to 82 patients 
(34 female and 48 male) with CD. The number of infusions each patient received
ranged from one to 18, with a mean of 5.3 (SD 4.6) and median of 3. Of 33
patients, 19 (57.6%) became independent and remained free of corticosteroids.
There was a statistically significant difference in the steroid dose between 0
and 4 wk and 0 and 8 wk. In all, 23 infusion reactions occurred (5.3%). Three
patients developed herpes zoster, and one developed Listeria monocytogenes
meningitis. No patients were documented to have delayed hypersensitivity
reactions or malignancies. CONCLUSIONS: Infliximab is safe and effective for
treating pediatric patients with CD. A steroid-sparing effect was demonstrated.
The most common adverse reaction to infliximab was infusion reaction. These
reactions did not preclude further use of the agent. Serious infections were seen
in a small number of patients.

PMID: 12526944 [PubMed - indexed for MEDLINE]

2224: J Med Virol. 2003 Mar;69(3):397-400.

Polymerase chain reaction as a rapid diagnostic tool for therapy of acute retinal
necrosis syndrome.

Gargiulo F, De Francesco MA, Nascimbeni G, Turano R, Perandin F, Gandolfo E,
Manca N.

Institute of Microbiology and Virology, Spedali-Civili-University of Brescia,
Brescia, Italy. gargiulo@bshosp.osp.unibs.it

Herpesviruses are involved in the pathogenesis of acute retinal necrosis syndrome
(ARN). A rapid and accurate diagnosis of herpetic infections is crucial for
prompt administration of a specific antiviral therapy. The purpose of this study 
was to evaluate a polymerase chain reaction (PCR)-based assay to detect
herpesvirus DNA in the aqueous humor of clinical samples from ten patients with
uveitis and clinical suspicion of ARN. Samples were assayed for herpes simplex
virus type 1-2 (HSV 1-2), varicella zoster virus (VZV) and cytomegalovirus (CMV).
Clinical suspicion of ARN was confirmed for four patients. Two patients (one with
bilateral ARN) tested PCR-positive for VZV DNA and the other two were positive
for HSV 1-2 DNA. CMV DNA was not detected in any of the samples, and no sample
was positive for DNA from more than one virus. The remaining patients did not
show any evidence of herpesvirus DNA in their aqueous samples. Our findings
demonstrate that the use of PCR for detecting herpesvirus DNA in aqueous humor of
uveitic subjects may be a valuable tool for early diagnosis of acute retinal
necrosis syndrome and for timely administration of a suitable therapy. Copyright 
2003 Wiley-Liss, Inc.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 12526051 [PubMed - indexed for MEDLINE]

2225: J Virol. 2003 Feb;77(3):1868-76.

Amino acid changes within conserved region III of the herpes simplex virus and
human cytomegalovirus DNA polymerases confer resistance to
4-oxo-dihydroquinolines, a novel class of herpesvirus antiviral agents.

Thomsen DR, Oien NL, Hopkins TA, Knechtel ML, Brideau RJ, Wathen MW, Homa FL.

Infectious Disease Biology, Pharmacia Corporation, Kalamazoo, Michigan 49001,
USA.

The 4-oxo-dihydroquinolines (PNU-182171 and PNU-183792) are nonnucleoside
inhibitors of herpesvirus polymerases (R. J. Brideau et al., Antiviral Res.
54:19-28, 2002; N. L. Oien et al., Antimicrob. Agents Chemother. 46:724-730,
2002). In cell culture these compounds inhibit herpes simplex virus type 1
(HSV-1), HSV-2, human cytomegalovirus (HCMV), varicella-zoster virus (VZV), and
human herpesvirus 8 (HHV-8) replication. HSV-1 and HSV-2 mutants resistant to
these drugs were isolated and the resistance mutation was mapped to the DNA
polymerase gene. Drug resistance correlated with a point mutation in conserved
domain III that resulted in a V823A change in the HSV-1 or the equivalent amino
acid in the HSV-2 DNA polymerase. Resistance of HCMV was also found to correlate 
with amino acid changes in conserved domain III (V823A+V824L). V823 is conserved 
in the DNA polymerases of six (HSV-1, HSV-2, HCMV, VZV, Epstein-Barr virus, and
HHV-8) of the eight human herpesviruses; the HHV-6 and HHV-7 polymerases contain 
an alanine at this amino acid. In vitro polymerase assays demonstrated that
HSV-1, HSV-2, HCMV, VZV, and HHV-8 polymerases were inhibited by PNU-183792,
whereas the HHV-6 polymerase was not. Changing this amino acid from valine to
alanine in the HSV-1, HCMV, and HHV-8 polymerases alters the polymerase activity 
so that it is less sensitive to drug inhibition. In contrast, changing the
equivalent amino acid in the HHV-6 polymerase from alanine to valine alters
polymerase activity so that PNU-183792 inhibits this enzyme. The HSV-1, HSV-2,
and HCMV drug-resistant mutants were not altered in their susceptibilities to
nucleoside analogs; in fact, some of the mutants were hypersensitive to several
of the drugs. These results support a mechanism where PNU-183792 inhibits
herpesviruses by interacting with a binding determinant on the viral DNA
polymerase that is less important for the binding of nucleoside analogs and
deoxynucleoside triphosphates.

PMID: 12525621 [PubMed - indexed for MEDLINE]

2226: Gastroenterol Hepatol. 2003 Jan;26(1):19-22.

[Opportunistic infections in patients with inflammatory bowel disease undergoing 
immunosuppressive therapy]

[Article in Spanish]

Bernal I, Domenech E, Garcia-Planella E, Cabre E, Gassull MA.

Servicio de Aparato Digestivo. Hospital Universitari Germans Trias i Pujol.
Badalona. Barcelona. Espana.

Immunosuppressive agents (azathioprine, methotrexate) are increasingly being used
in the treatment of inflammatory bowel disease. The use of immunosuppressive
agents is associated with a greater risk of opportunistic infections, the most
frequent of which are those caused by cytomegalovirus and varicella zoster
virus.We present four cases of opportunistic infections due to Herpesviruses in
patients undergoing immunosuppressive treatment with azathioprine for Crohn's
disease. We also review the literature published on this topic.Two patients
presented cutaneous varicella complicated by pneumonia and esophagitis
respectively, one patient had cutaneous herpes zoster and the other had fatal
pneumonia possibly caused by the Herpesvirus. In the first three the clinical
course of the infection was favorable after withdrawing immunosuppressant
treatment and initiating treatment with aziclovir.In patients Crohn's disease
azathioprine treatment increases the risk of opportunistic infection by
Herpesvirus. However, in the absence of other factors that increase
immunosuppression, these infections usually have a benign course with specific
antiviral therapy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12525323 [PubMed - indexed for MEDLINE]

2227: Curr Pain Headache Rep. 2003 Feb;7(1):24-33.

Antidepressants for chronic neuropathic pain.

Reisner L.

University of California, San Francisco, Department of Clinical Pharmacy, Box
0622, San Francisco, CA 94143, USA. reisnerL@pamf.org

Tricyclic antidepressants have been used to manage pain for several decades, and 
are superior treatments for some patients suffering from neuropathic pain.
Unfortunately, older antidepressants have dose-limiting side effects that can
lead to drug intolerance. The most common are anticholinergic side effects,
although some patients experience sexual dysfunction. Cognitive impairment,
sedation, and orthostatic hypotension also are relatively common. Taking an
overdose of tricyclic antidepressants can be lethal in overdose. Several weeks of
therapy may be required before antinociception occurs, but tricyclic
antidepressants in optimal doses appear to be the most effective treatment for
neuropathic pain; this is supported by systematic reviews comparing them with
other agents. Newer medications such as atypical antidepressants and
anticonvulsants may be overtaking older antidepressants, but they should not be
overlooked as important options for the management of pain.

Publication Types: 
    Comparative Study
    Review

PMID: 12525267 [PubMed - indexed for MEDLINE]

2228: Semin Neurol. 2002 Jun;22(2):133-42.

Infectious myelopathies.

Berger JR, Sabet A.

Department of Neurology, University of Kentucky College of Medicine, Lexington
40536, USA.

Although infectious myelopathies are rare, timely and accurate diagnosis is
essential to improving outcome. There are a number of organisms that may cause
infectious myelopathies, including human immunodeficiency virus (HIV), human
T-cell lymphotropic virus type I (HTLV-I), herpesviruses, enteroviruses,
Treponema pallidum, Mycobacterium tuberculosis, fungi, and parasites. Vacuolar
myelopathy, the most common form of spinal cord disease in HIV-infected
individuals, is underrecognized clinically. The failure to diagnose this
condition is generally a consequence of the attribution of the lower extremity
weakness and paresthesias to general debility and concomitant peripheral
neuropathy. Tropical spastic paraparesis or HTLV-I-associated myelopathy involves
the pyramidal tracts, chiefly at the thoracic level, and results in spastic lower
extremity weakness and a spastic bladder. The herpesviruses (varicella-zoster,
herpes simplex type 2, cytomegalovirus) and the enteroviruses cause myelitis.
Prior to the development of antibiotics, syphilis was the most frequent
infectious cause of spinal cord disease. In light of the broad spectrum of
pathogens that may affect the spinal cord and the variegate fashion in which
these disorders may present, the physician must always consider an infectious
etiology in the differential diagnosis for the patient presenting with
myelopathy. This review addresses the infectious myelopathies by microorganism.

Publication Types: 
    Review

PMID: 12524558 [PubMed - indexed for MEDLINE]

2229: J Voice. 2002 Dec;16(4):560-3.

Laryngeal herpes: a case report.

Pinto JA, Pinto HC, Ramalho Jda R.

Nucleus of Otolaryngology, Head and Neck Surgery of Sao Paulo, Indianopolis, Sao 
Paulo, Brazil. japorl@vol.com.br

Herpetic laryngitis is a rare inflammatory disease caused by herpes simplex or
herpes zoster virus. The propensity for spreading along peripheral nerves and
within the central nervous system, with frank herpetic meningoencephalitis, is a 
rare complication. We present one case of herpetic laryngitis by reactivation of 
varicella zoster, with central nervous system spreading, and discuss the relevant
literature on the pathophysiology, diagnosis, evaluation, and management of this 
disease.

Publication Types: 
    Case Reports
    Review

PMID: 12512643 [PubMed - indexed for MEDLINE]

2230: J Virol Methods. 2003 Feb;107(2):257-60.

Development of a multiplex RT-PCR to detect transcription of varicella-zoster
virus encoded genes.

Rahaus M, Desloges N, Wolff MH.

Institute of Microbiology and Virology, University of Witten/Herdecke, Stockumer 
Str. 10, D-58448, Witten, Germany.

The reverse transcription polymerase chain reaction (RT-PCR) is used commonly to 
analyse transcription of genes. In the field of virology it is an extremely
helpful method to analyse the transcriptional activity of both, DNA and RNA
viruses. The standard RT-PCR allows an investigation of the activity of only one 
gene. Here, we describe the development of a sensitive multiplex RT-PCR assay for
single tube amplification to analyse a set of different genes encoded by the
varicella-zoster virus (VZV), a member of the human-pathogenous herpesviruses.
This multiplex RT-PCR amplifies the genes ORF 4, ORF 21 and ORF 68; each of these
three genes belongs to a distinct class of genes, which is expressed one after
the other within the infectious cycle. This method provides the possibility for
rapid but extensive examination of VZV transcriptional activity and could be used
in both fields, fundamental research as well as clinical diagnostic work.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 12505641 [PubMed - indexed for MEDLINE]

2231: Lancet Infect Dis. 2003 Jan;3(1):12.

Comment on:
    Lancet Infect Dis. 2002 Nov;2(11):699.

Concomitant bilateral herpes zoster ophthalmicus.

MacMahon EM.

Virology Section, Department of Infection, Guy's and St Thomas' Hospital, London,
UK. eithne.macmahon@gstt.sthames.nhs.uk

Publication Types: 
    Comment

PMID: 12505026 [PubMed - indexed for MEDLINE]

2232: J Virol. 2003 Jan;77(2):1211-8.

Varicella-zoster virus open reading frame 21, which is expressed during latency, 
is essential for virus replication but dispensable for establishment of latency.

Xia D, Srinivas S, Sato H, Pesnicak L, Straus SE, Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA.

Varicella-zoster virus (VZV) open reading frame 21 (ORF21) is one of at least
five VZV genes expressed in latently infected human and rodent ganglia. To
determine whether ORF21 is required for latent and lytic infection, we deleted
99% of ORF21 from the viral genome. The ORF21 deletion mutant virus could be
propagated only in a cell line expressing the ORF21 protein. Insertion of the
herpes simplex virus type 1 (HSV-1) homolog of VZV ORF21, HSV-1 UL37, into the
ORF21 deletion mutant failed to complement the mutant for growth in cell culture.
Inoculation of cotton rats with the ORF21 deletion virus resulted in latent
infection in numbers of animals similar to those infected after inoculation with 
the parental virus. The mean numbers of latent VZV genomes were similar in
animals infected with parental and ORF21 deletion viruses. Transcription of
ORF63, another latency-associated gene, was detected in ganglia from similar
numbers of animals infected with the mutant and parental viruses. Thus, ORF21 is 
the first VZV gene expressed during latency that has been shown to be dispensable
for the establishment of latent infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12502838 [PubMed - indexed for MEDLINE]

2233: Emerg Infect Dis. 2002 Dec;8(12):1504-5.

New variant of varicella-zoster virus.

Tipples GA, Stephens GM, Sherlock C, Bowler M, Hoy B, Cook D, Grose C.

National Microbiology Laboratory, Winnipeg, Manitoba, Canada.
graham_tipples@hc-sc.gc.ca

In 1998, a varicella-zoster virus glycoprotein E (gE) mutant virus (VZV-MSP) was 
isolated from a child with chickenpox. VZV-MSP, representing a second VZV
serotype, was considered a rarity. We isolated another VZV-MSP-like virus from an
elderly man with herpes zoster. These gE mutant viruses may have arisen through
independent mutation or may represent a distinct VZV subpopulation that emerged
more than 50 years ago.

Publication Types: 
    Case Reports

PMID: 12498673 [PubMed - indexed for MEDLINE]

2234: J Neurovirol. 2002 Dec;8 Suppl 2:80-4.

Key issues in varicella-zoster virus latency.

Kennedy PG.

Department of Neurology, Glasgow University, and Institute of Neurological
Sciences, Southern General Hospital, Glasgow, Scotland, United Kingdom.
P.G.Kennedy@clinmed.gla.ac.uk

The molecular mechanisms by which varicella-zoster virus (VZV) causes a latent
infection in human trigeminal and spinal ganglia are not well understood. It is
known that VZV establishes latency in ganglia following the primary infection
causing varicella (chickenpox), and that the virus may reactivate after years of 
dormancy to produce herpes zoster (shingles). Two key issues have been the
cell-type localization of latent VZV in human ganglia, and the nature and extent 
of VZV gene expression during latency. Although the cell specificity of latent
VZV has been controversial for almost a decade, it is now widely accepted that
the virus is mainly latent in neuronal cells, with only a small proportion of
non-neuronal cells infected. All of the studies carried out so far have indicated
that VZV gene expression is highly restricted during ganglionic latency. Although
at least four VZV genes have been identified as being expressed, the possibility 
that latent gene expression is significantly greater than this cannot yet be
excluded. There is also evidence for VZV gene-encoded proteins being expressed
during latency, although the precise extent of this is unclear. Advances in this 
difficult field may be expected to arise from both newly developed molecular
technology and more refined animal models of VZV latency.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12491156 [PubMed - indexed for MEDLINE]

2235: J Neurovirol. 2002 Dec;8 Suppl 2:75-9.

The protean manifestations of varicella-zoster virus vasculopathy.

Gilden DH, Mahalingam R, Cohrs RJ, Kleinschmidt-DeMasters BK, Forghani B.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA. don.gilden@uchsc.edu

Varicella-zoster virus (VZV) vasculopathy in the central nervous system (CNS)
affects large and small cerebral vessels. Large-vessel disease is most common in 
immunocompetent individuals, whereas small-vessel disease usually develops in
immunocompromised patients. In some patients, both large and small vessels are
involved. Neurological features are protean. Neurological disease often occurs
months after zoster and sometimes without any history of zoster rash. Magnetic
resonance imaging (MRI) scanning, cerebral angiography, and examination of
cerebrospinal fluid (CSF) with virological analysis are needed to confirm the
diagnosis. VZV vasculopathy patients do not always have VZV DNA in CSF, but
diagnosis can be confirmed by finding anti-VZV antibody in CSF, along with
reduced serum/CSF ratios of VZV immunoglobulin G (IgG) compared to albumin or
total IgG. When VZV vasculopathy develops months after zoster, antiviral
treatment is often effective.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 12491155 [PubMed - indexed for MEDLINE]

2236: J Med Microbiol. 2003 Jan;52(Pt 1):1-3.

Live attenuated vaccine for the prevention of varicella-zoster virus infection:
does it work, is it safe and do we really need it in the UK?

Breuer J.

Publication Types: 
    Editorial

PMID: 12488559 [PubMed - indexed for MEDLINE]

2237: Br J Ophthalmol. 2003 Jan;87(1):79-83.

Polymerase chain reaction analysis of aqueous humour samples in necrotising
retinitis.

Tran TH, Rozenberg F, Cassoux N, Rao NA, LeHoang P, Bodaghi B.

Department of Ophthalmology, Pitie-Salpetriere Hospital, Paris, France.

Aim: To evaluate the diagnostic value of polymerase chain reaction (PCR)
performed on aqueous humour for the detection of viral DNA in patients with
necrotising herpetic retinitis. METHODS: The clinical features and laboratory
results of 22 patients (29 eyes) presenting with necrotising herpetic retinitis
between March 1999 and June 2001 were reviewed retrospectively. Aqueous humour
was obtained after anterior chamber paracentesis and PCR was performed in all
cases. RESULTS: Viral DNA was detected in the aqueous humour of 19 patients
(86.4%). Epstein-Barr virus (EBV) seroconversion was evidenced in one additional 
patient. In the acute retinal necrosis (ARN) group (n = 19), varicella zoster
virus (VZV) DNA was identified in six patients, herpes simplex virus 1 (HSV-1)
DNA in two patients, herpes simplex virus 2 (HSV-2) DNA in four patients, and
cytomegalovirus (CMV) genome in four patients. In the progressive outer retinal
necrosis (PORN) group (n = 3), VZV DNA was detected in all patients. No sample
was positive for more than one virus. CONCLUSIONS: PCR analysis of aqueous humour
in patients with clinical features of necrotising viral retinitis can provide
specific aetiological orientation and the method appears to be safe and highly
sensitive.

Publication Types: 
    Evaluation Studies

PMID: 12488268 [PubMed - indexed for MEDLINE]

2238: Genes Immun. 2002 Dec;3(8):477-81.

Association of HLA-A*3303-B*4403-DRB1*1302 haplotype, but not of TNFA promoter
and NKp30 polymorphism, with postherpetic neuralgia (PHN) in the Japanese
population.

Sato M, Ohashi J, Tsuchiya N, Kashiwase K, Ishikawa Y, Arita H, Hanaoka K,
Tokunaga K, Yabe T.

Department of Research, Tokyo Metropolitan Red Cross Blood Center, Tokyo,
150-0012 Japan.

Herpes zoster is a common disease caused by reactivation of the varicella zoster 
virus (VZV). In a small number of herpes zoster patients, pain persists beyond 4 
weeks or more after healing of vesicular eruptions; this condition is termed
postherpetic neuralgia (PHN). Positive associations of human histocompatibility
leukocyte antigens (HLA) class I antigens, A33 and B44, with PHN in the Japanese 
population have been reported. Our hypothesis is that susceptibility genes to PHN
might exist in the HLA region and the study objective is to further examine
possible associations of genes in HLA class I, II and III regions, HLA-A, -B,
-DRB1, tumor necrosis factor alpha (TNFA) promoter, and a natural killer cell
activating receptor, NKp30 polymorphisms with PHN. Although TNFA or NKp30 in the 
class III region had been considered as a candidate locus, we found no
associations of TNFA promoter or NKp30 polymorphisms with PHN in this study. We
demonstrated that HLA-A*3303, -B*4403 and -DRB1*1302 alleles were significantly
associated with PHN (P = 0.0007 for A*3303, P = 0.001 for B*4403 and P = 0.001
for DRB1*1302). The frequency of the HLA-A*3303-B*4403-DRB1*1302 haplotype was
also significantly higher in the PHN patients than in the healthy controls (P =
0.0039). Our results suggest that this haplotype might be related to the
pathogenesis of PHN.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 12486606 [PubMed - indexed for MEDLINE]

2239: Acta Ophthalmol Scand. 2002 Dec;80(6):612-6.

Detection of herpes simplex virus in pseudoexfoliation syndrome and exfoliation
glaucoma.

Detorakis ET, Kozobolis VP, Pallikaris IG, Spandidos DA.

Department of Opthalmology, University of Crete, Heraklion, Crete, Greece.

PURPOSE: The pathogenesis of pseudoexfoliation syndrome (PEX) remains unknown. An
infection, possibly viral, is one of the proposed pathogenetic mechanisms. This
study examines the presence of herpes simplex virus (HSV) and varicella-zoster
virus (VZV) in iris and anterior capsule specimens of PEX and non-PEX patients.
METHODS: Iris and anterior capsule specimens were obtained from 64 patients with 
PEX (study group, SG) and 61 patients without PEX (control group, CG). The
presence of HSV and VZV DNA was evaluated with a polymerase chain reaction (PCR).
RESULTS: Herpes simplex virus type I was detected significantly more often in
iris specimens from the SG (13.79%), compared to those from the CG (1.75%).
Varicella-zoster virus DNA was not detected in any of the examined specimens.
CONCLUSION: Results imply a possible relationship between HSV type I and PEX,
although no aetiological role of HSV infection in PEX pathogenesis can be
established. Results also advocate against any association between VZV and PEX.

PMID: 12485281 [PubMed - indexed for MEDLINE]

2240: Pharmacoeconomics. 2003;21(1):13-38.

Comment in:
    Pharmacoeconomics. 2004;22(2):133-6; author reply136-8.

Economic evaluations of varicella vaccination programmes: a review of the
literature.

Thiry N, Beutels P, Van Damme P, Van Doorslaer E.

Department of Epidemiology and Social Medicine, Centre for the Evaluation of
Vaccination, University of Antwerp, Antwerp, Belgium. nancy.thiry@ua.ac.be

Chickenpox infections are generally mild but due to their very high incidence
among healthy children they give rise to considerable morbidity and occasional
mortality. With the development of a varicella vaccine in the early 1970s and its
progressive licensing in many countries, interest in the efficiency of varicella 
immunisation programmes grew. The objective of this review was to discuss the
methodological aspects and results of published economic evaluations of varicella
vaccination. From this, we attempted to make recommendations. A computerised
search was carried out; 17 full economic evaluations of varicella vaccination
were retrieved. The review identified the methodological divergences and
similarities between the articles in four areas: study design, epidemiological
data, economic data and model characteristics. We assessed to what extent the
applied methods conform to general guidelines for the economic evaluation of
healthcare interventions and compared the studies' results. The desirability of a
universal vaccination programme depends on whose perspective is taken. Despite
variability in data and model assumptions, the studies suggest that universal
vaccination of infants is attractive to society because large savings occur from 
averted unproductive days for parents. For the healthcare payer, universal
vaccination of infants does not generate savings. Vaccination of susceptible
adolescents has been proposed by some authors as a viable alternative; the
attractiveness of this is highly dependent on the negative predictive value of
anamnestic screening. Targeted vaccination of healthcare workers and
immunocompromised individuals appears relatively cost effective. Findings for
other target groups are either contradictory or provide insufficient evidence for
any unequivocal recommendations to be made. High sensitivity to vaccine price was
reported in most studies. This review highlights that some aspects of these
studies need to be further improved before final recommendations can be made.
First, more transparency, completeness and compliance to general methodological
guidelines are required. Second, because of the increasing severity of varicella 
with age, it is preferable and in some cases essential to use dynamic models for 
the assessment of universal vaccination strategies. Third, most studies focused
on the strategy of vaccinating children only while their results depended heavily
on disputable assumptions (regarding vaccine effectiveness and impact on herpes
zoster). Since violation of these assumptions could have important adverse public
health effects, we suggest pre-adolescent vaccination as a more secure
alternative. This option deserves more attention in future analyses.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12484801 [PubMed - indexed for MEDLINE]

2241: J Dermatol. 2002 Nov;29(11):748-53.

Primary cutaneous T-cell-rich B-cell lymphoma in a zosteriform distribution
associated with Epstein-Barr virus infection.

Watabe H, Kawakami T, Soma Y, Baba T, Mizoguchi M.

Department of Dermatology, St. Marianna University School of Medicine, Kawasaki, 
Kanagawa, Japan.

T-cell-rich B-cell lymphoma (TRBL) is a lately recognized B-cell lymphoma variant
characterized by a minor population of neoplastic B cells existing in a
background of predominant polyclonal T cells. We report an 86-year-old man with
primary cutaneous TRBL associated with Epstein-Barr (EB) virus infection.
Clinically, palpable scaly erythemas were distributed in a zosteriform pattern on
the right abdomen. Histologically, massive cellular infiltrates were located in
the upper- and mid-dermis. Higher magnification showed that the cellular
infiltration was composed mainly of abnormal mononuclear, large lymphoid cells
with clear cytoplasm and scattered mitoses and small lymphocytes, which
represented in excess of 75% of all the infiltrating cells. Immunohistochemical
staining revealed that the large cells were positive for the B cell marker, CD20,
but negative for the T cell marker, CD3. On the other hand, the small cells were 
positive for CD3, but negative for CD20. Polymerase chain reaction (PCR) revealed
EB virus DNA in the skin lesion. Primary cutaneous TRBL has only been reported in
15 cases worldwide. To our knowledge, this is the first case of primary cutaneous
TRBL in a zosteriform distribution reported in the literature and the second case
of primary cutaneous TRBL associated with the EB virus infection. We postulate
that the EB virus may be a contributory pathogenetic event leading to monoclonal 
B-cell proliferation.

Publication Types: 
    Case Reports

PMID: 12484440 [PubMed - indexed for MEDLINE]

2242: Acta Otolaryngol Suppl. 2002;(549):4-30.

Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of 
different etiologies.

Peitersen E.

Department of Otorhinolaryngology-Head & Neck Surgery, Rigshospitalet,
Copenhagen, Denmark. RH01836@rh.dk

OBJECTIVE: The Copenhagen Facial Nerve Study aims to explain the spontaneous
course of idiopathic peripheral facial nerve palsy which occurs without any kind 
of treatment. In this study Bell's palsy and idiopathic palsy are considered to
be synonymous and specify an acute, monosymptomatic, unilateral peripheral facial
paresis of unknown etiology. MATERIAL AND METHODS: The material includes 2,570
cases of peripheral facial nerve palsy studied during a period of 25 years. It
includes 1,701 cases of Bell's palsy and 869 of non-Bell's palsy. In the total
patient sample, 116 had herpes zoster, 76 were diabetic, 46 were pregnant and 169
were neonates. A total of 38 different etiologies were observed. At the first
consultation a standard ENT examination was performed, including a thorough
description of the grade and localization of the paresis, taste, stapedius reflex
and nasolacrimal reflex tests and acoustic-vestibular examination. Follow-up was 
done once a week during the first month and subsequently once a month until
normal function was restored or for up to 1 year. RESULTS: The initial
examination revealed 30% incomplete and 70% complete palsies. Follow-up showed
that in 85% of patients function was returned within 3 weeks and in the remaining
15% after 3-5 months. In 71% of patients normal mimical function was obtained.
Sequelae were slight in 12% of patients, mild in 13% and severe in 4%.
Contracture and associated movements were found in 17% and 16% of patients,
respectively. CONCLUSION: A survey of the literature showed that no kind of
treatment, including prednisone, was able to give a better prognosis. The use of 
prednisone raises a big ethical problem because no evidence of its efficacy
exists and the euphoric side-effect induces a false feeling of benefit in the
patients.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12482166 [PubMed - indexed for MEDLINE]

2243: J Eur Acad Dermatol Venereol. 2002 Nov;16(6):628-30.

Granulomatous folliculitis at sites of herpes zoster scars: Wolf's isotopic
response.

Fernandez-Redondo V, Amrouni B, Varela E, Toribio J.

Department of Dermatology, Complejo Hospitalario Universitario, Faculty of
Medicine, Santiago de Compostela, Spain. mejaime@usc.es

Cutaneous eruptions described on herpes zoster scars are variable. We present a
case of granulomatous folliculitis occurring 4 weeks after an episode of herpes
zoster infection in a woman with cutaneous T-cell lymphoma. The pathogenesis of
the lesions remains unclear. The viral genome was detected only in early lesions.

Publication Types: 
    Case Reports

PMID: 12482051 [PubMed - indexed for MEDLINE]

2244: Viral Immunol. 2002;15(3):507-16.

Memory cytotoxic T cell responses to viral tegument and regulatory proteins
encoded by open reading frames 4, 10, 29, and 62 of varicella-zoster virus.

Arvin AM, Sharp M, Moir M, Kinchington PR, Sadeghi-Zadeh M, Ruyechan WT, Hay J.

Department of Pediatrics Stanford University School of Medicine, Stanford,
California 94305, USA. aarvin@stanford.edu

Cytotoxic T cell recognition of tegument and regulatory proteins encoded by open 
reading frames (ORFs) 4, 10, 29, and 62 of varicella-zoster virus (VZV) was
evaluated using limiting dilution conditions to estimate the precursor
frequencies of memory T cells specific for these proteins in immune subjects.
Responder cell frequencies for ORFs 4, 10, and 62 gene products, which are virion
tegument components and function as immediate early viral transactivating
proteins, were equivalent. CTLp recognition of VZV proteins made in latently
infected cells, which include ORF4 and ORF62 proteins, was not maintained
preferentially when compared to ORF10 protein, which has not been shown to be
expressed during latency. T cell recognition of ORF29 protein, the major DNA
binding protein, which is expressed during replication but not incorporated into 
the virion tegument, was less common than responses to ORFs 4, 10, and 62 gene
products. Older individuals had diminished numbers of memory CTLp that lysed
autologous targets expressing IE62 protein; these responses were increased after 
immunization with live attenuated varicella vaccine to the range observed in
younger adults. Adaptive immunity to VZV is characterized by a broad repertoire
of memory CTL responses to proteins that comprise the virion tegument and
regulate viral gene expression in infected cells.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12479399 [PubMed - indexed for MEDLINE]

2245: N Engl J Med. 2002 Dec 12;347(24):1962-3.

Comment in:
    N Engl J Med. 2003 Apr 3;348(14):1405-7; author reply 1405-7.    N Engl J Med. 2003 Apr 3;348(14):1405-7; author reply 1405-7.    N Engl J Med. 2003 Apr 3;348(14):1405-7; author reply 1405-7.

Comment on:
    N Engl J Med. 2002 Dec 12;347(24):1909-15.

Varicella vaccine--are two doses better than one?

Gershon AA.

Publication Types: 
    Comment
    Editorial
    Research Support, Non-U.S. Gov't

PMID: 12477947 [PubMed - indexed for MEDLINE]

2246: Curr Opin Investig Drugs. 2002 Nov;3(11):1561-6.

Role of cidofovir in the treatment of DNA virus infections, other than CMV
infections, in immunocompromised patients.

Snoeck R, De Clercq E.

Rega Institute for Medical Research, Minderbroedersstraat 10,B-3000 Leuven,
Belgium. robert.snoeck@rega.kuleuven.ac.be

Cidofovir is a nucleotide analog marketed for the treatment of human
cytomegalovirus infections in immunocompromised patients. An increasing number of
reports have appeared on the use of cidofovir for the treatment of other severe
DNA virus infections in immunocompromised patients. The activity of cidofovir
against herpes simplex viruses resistant to classic (acyclovir and/or foscavir)
therapy has been widely documented. Cidofovir has also been used for the
treatment of other herpesvirus infections, such as drug-resistant
varicella-zoster virus, and Epstein-Barr virus-induced proliferative diseases.
For papillomavirus infections, cidofovir represents a valuable alternative to the
conventional therapies, which are mostly based on surgery, as in the treatment of
laryngeal papillomatosis. The role of cidofovir in the treatment of polyomavirus 
infections is more controversial, but here too, cidofovir represents, to date,
the only available efficacious therapeutic modality. Cidofovir has demonstrated
activity against all poxviruses and represents a unique therapeutic modality for 
use against these viruses, particularly in the immunosuppressed host, should this
prove necessary (eg, in a bioterrorism scenario).

Publication Types: 
    Review

PMID: 12476953 [PubMed - indexed for MEDLINE]

2247: Addiction. 2002 Dec;97(12):1505-7.

Comment in:
    Addiction. 2002 Dec;97(12):1509-10.

Comment on:
    Addiction. 2002 Dec;97(12):1493-504.

Death of the 'stepping-stone' hypothesis and the 'gateway' model? Comments on
Morral et al.

Anthony JC.

Mental Hygiene and Epidemiology, Bloomberg School of Public Health, The Johns
Hopkins University, Baltimore, MD 21205, USA. janthony@jhsph.edu

Publication Types: 
    Comment

PMID: 12472631 [PubMed - indexed for MEDLINE]

2248: Clin Exp Optom. 2000 Mar-Apr;83(2):59-64.

Herpes zoster opthalmicus.

Cockburn DM, Douglas IS.

Department of Optometry and Vision Sciences, The University of Melbourne,
Parkville, Victoria, 3052, Australia.

INTRODUCTION: Herpes zoster is a common disease which may cause serious ocular
sequelae when it affects the trigeminal nerve. Although involvement of the
nasociliary branch of the first division of the trigeminal nerve is well
recognised to be associated with serious and direct ocular morbidity, the need
for careful long-term follow-up of cases of frontal branch involvement is perhaps
less well known. METHODS: The pathogenesis, epidemiology, risk factors, clinical 
course and treatment of herpes zoster are discussed with emphasis on trigeminal
nerve involvement. A case report is presented which illustrates the importance of
continuing management when the frontal branch of the trigeminal nerve is
affected. DISCUSSION: Clinical guidelines are suggested for optometric management
of these cases in cooperation with medical practitioners.

PMID: 12472455 [PubMed - as supplied by publisher]

2249: Prescrire Int. 2002 Dec;11(62):184-6.

Treatment of postherpetic neuralgia: tricyclic antidepressants still the
reference.

[No authors listed]

(1) Pain generally disappears when herpes zoster lesions have healed, but the
risk of postherpetic neuralgia, though it is low, increases with age. (2)
Antivirals prescribed during the acute phase do not reduce the risk of
postherpetic neuralgia, but they do reduce its duration. (3) Common non specific 
analgesics such as paracetamol seem inadequate against postherpetic neuralgia.
Amitriptyline and desipramine, despite their limited efficacy, are the reference.
Gabapentin, although somewhat less effective, is a possible second line option.
It is unclear how long treatment should last.

Publication Types: 
    Comparative Study
    Review

PMID: 12472100 [PubMed - indexed for MEDLINE]

2250: Am J Ophthalmol. 2002 Dec;134(6):912-4.

Herpes zoster vasculitis presenting as giant cell arteritis with bilateral
internuclear ophthalmoplegia.

Al-Abdulla NA, Rismondo V, Minkowski JS, Miller NR.

Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.

PURPOSE: To present a case of herpes zoster vasculitis presenting as giant cell
arteritis. DESIGN: Interventional case report. METHODS: A 77-year-old woman
presented with sudden onset of diplopia associated with temple headaches and a
previous history of herpes zoster ophthalmicus. A temporal artery biopsy was
obtained and in-situ hybridization performed for herpes zoster DNA. RESULTS: The 
patient presented with a bilateral internuclear ophthalmoplegia. Initial
diagnostic evaluation, including erythrocyte sedimentation rate, C-reactive
protein, and temporal artery biopsy, was consistent with giant cell arteritis.
However, in-situ hybridization of the temporal artery specimen was positive for
herpes zoster DNA. CONCLUSIONS: Herpes zoster vasculitis may mimic giant cell
arteritis and should be considered in the differential of any patient with
presumed giant cell arteritis with suspicious findings, central nervous system
involvement, or previous herpes zoster infection.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12470766 [PubMed - indexed for MEDLINE]

2251: Herpes. 2002 Dec;9(3):70-3.

Bell's palsy and herpesviruses.

Gilbert SC.

Dermatology and Laser Center NW, 3614 Meridian Suite 200, Bellingham, WA 98225,
USA. stangilb@aol.com

A growing body of evidence links reactivation of herpesviruses (primarily
varicella zoster virus and herpes simplex virus type 1) with the development of a
large proportion of cases of acute peripheral facial palsy, a syndrome commonly
known by its eponym, Bell's palsy. This article reviews the definition and
natural history of the disease, its underlying anatomy and pathophysiology, the
data linking herpetic reactivation with development of signs and symptoms, and
therapeutic trials utilizing antiviral therapy. In addition, it poses the
question, would earlier intervention with antivirals make a larger impact on
outcomes?

Publication Types: 
    Review

PMID: 12470604 [PubMed - indexed for MEDLINE]

2252: J Clin Epidemiol. 2002 Oct;55(10):982-9.

Risk factors for development of systemic lupus erythematosus: allergies,
infections, and family history.

Cooper GS, Dooley MA, Treadwell EL, St Clair EW, Gilkeson GS.

Epidemiology Branch A3-05, National Institute of Environmental Health Sciences,
PO Box 12233, Durham, NC 27709, USA. cooper1@niehs.nih.gov

We examined risk factors for systemic lupus erythematosus (SLE) in 265 recently
diagnosed patients in North Carolina and South Carolina and 355 control subjects 
identified through driver's license records and frequency matched to patients by 
age, sex, and state. Analyses were limited to exposures before diagnosis (cases) 
or reference year (control subjects). SLE patients were more likely than control 
subjects to report a history of allergy to medications (odds ratio [OR] 3.1, 95% 
confidence interval [CI], 2.1-4.5), particularly to antibiotics. SLE risk
increased with history of shingles (OR 2.5, 95% CI 1.1-5.9) and with frequent
(more than once per year) cold sores in the 3 years before diagnosis (OR 2.8, 95%
CI 1.4-5.4). There was little association with history of mononucleosis, a marker
of late infection with Epstein-Barr virus, implanted medical devices, or
hepatitis B vaccination. History of lupus in parents or siblings was associated
with an increased risk (OR 3.3, 95% CI 1.2-8.6). Further research is needed to
clarify whether medication allergies and specific infectious agents are involved 
in the etiology of SLE. Published by Elsevier Science Inc.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 12464374 [PubMed - indexed for MEDLINE]

2253: Clin Transplant. 2002;16 Suppl 8:68-71.

A case of an ABO-incompatible renal transplant with abundant intratubular
basement membrane immune deposits.

Shiozawa S, Ichikawa T, Nakazawa K, Ehara T, Shigematsu H.

Department of Pathology, Saku Central Hospital, Usuda, Japan.

We present a case of a 30-year-old man who received an ABO-incompatible renal
transplant from his mother in 1996 after haemodialysis for 3 years. Although his 
renal function was stable, a renal biopsy was performed while he was in hospital 
for treatment of herpes zoster in 1999. Light microscopy provided no evidence of 
obvious acute or chronic rejection but a double contour pattern was observed in
many tubular basement membranes (TBM). Immunofluorescence microscopy revealed
deposits of IgG and C3 on the TBM in the absence of glomerular deposition.
Massive electron-dense deposits were observed clearly by electron microscopy
within TBM, revealing splitting and lamellation. This implies that the deposits
resulted from the formation of immune complexes, but not from anti-TBM antibody. 
Although the role of TBM deposits in tubular injury is controversial, careful
observation of patients with such deposits may be required because of their
potential ability to induce immune reactions.

Publication Types: 
    Case Reports

PMID: 12464136 [PubMed - indexed for MEDLINE]

2254: Ocul Immunol Inflamm. 2002 Mar;10(1):41-6.

Successful treatment of varicella zoster virus retinitis with aggressive
intravitreal and systemic antiviral therapy.

Zambarakji HJ, Obi AA, Mitchell SM.

Department of Ophthalmology, Chelsea and Westminster Hospital, London, UK.

AIMS: To describe the successful treatment of varicella zoster virus retinitis
(VZVR) using intravenous cidofovir as part of an aggressive management strategy. 
CASE REPORTS: Two patients with bilateral VZVR were treated with a combination of
intravenous cidofovir and ganciclovir with adjuvant intravitreal foscarnet or
ganciclovir. Both patients maintained good vision in the less severely affected
eye. Retinal detachment did not occur in either patient. CONCLUSIONS: VZVR should
be treated aggressively with a combination of intravenous and intravitreal
therapy to improve visual prognosis. Intravenous cidofovir, in the absence of
contra-indications, should be considered as part of this aggressive therapeutic
approach, especially in patients with AIDS in whom the prognosis is particularly 
poor.

Publication Types: 
    Case Reports

PMID: 12461702 [PubMed - indexed for MEDLINE]

2255: J Antimicrob Chemother. 2002 Dec;50(6):779-92.

Cyclin-dependent kinases as cellular targets for antiviral drugs.

Schang LM.

Department of Biochemistry, Signal Transduction Research Group, University of
Alberta, 315C Heritage Medical Research Center, Edmonton, Alberta T6G 2S2,
Canada. luis.schang@ualberta.ca

Cyclin-dependent kinases (cdks) are required for replication of viruses that
replicate only in dividing cells, such as adeno- and papillomaviruses. Recently, 
cdks have been shown to be required also for replication of viruses that can
replicate in non-dividing cells, such as HIV-1 and herpes simplex virus types 1
and 2 (HSV-1 and -2). In these experiments, pharmacological cdk inhibitors (PCIs)
were shown to have potent antiviral activity in vitro against HIV-1, HSV-1 and
-2, human cytomegalovirus, varicella-zoster virus, and to inhibit specific
functions of other viruses. Since two PCIs, flavopiridol and roscovitine, are
proving to be non-toxic in human clinical trials against cancer, PCIs may be
useful as antivirals. As significant advantages, PCIs are active in vitro against
many viruses, including drug-resistant strains of HIV-1 and HSV-1, and mutant
strains of HIV-1 or HSV-1 resistant to PCIs have not been identified in spite of 
intense efforts. Furthermore, the antiviral effects of a PCI and a conventional
antiviral drug are additive. The aetiopathogenesis of several diseases, such as
Kaposi's sarcoma, HPV-induced cervical carcinoma and HIV-associated nephropathy
(HIVAN), among others, includes replication or expression of proteins by viruses 
that require cdks. Thus, PCIs could target both the aetiological agent (the
virus) and the pathogenic mechanisms (cell replication). Two important questions 
regarding the antiviral activities of PCIs are the focus of current research
efforts, (i) the identity of the specific cdks that mediate the antiviral
activities of PCIs, and (ii) whether PCIs have antiviral activity in vivo at
non-toxic doses.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12460995 [PubMed - indexed for MEDLINE]

2256: Pediatr Ann. 2002 Nov;31(11):710-5.

The success of varicella vaccine.

LaRussa P.

College of Physicians and Surgeons, Columbia University, PH 4 West-462, 622 West 
168th St., New York, NY 10032, USA.

Publication Types: 
    Review

PMID: 12455479 [PubMed - indexed for MEDLINE]

2257: Am J Clin Nutr. 2002 Dec;76(6):1358-66.

Low plasma concentrations of retinol and alpha-tocopherol in hematopoietic stem
cell transplant recipients: the effect of mucositis and the risk of infection.

High KP, Legault C, Sinclair JA, Cruz J, Hill K, Hurd DD.

Sections of Infectious Diseases and of Hematology and Oncology and the
Comprehensive Cancer Center, Department of Internal Medicine, Wake Forest
University School of Medicine, Winston-Salem, NC 27157-1042, USA.
khigh@wfubmc.edu

BACKGROUND: Although vitamin deficiencies are rare in the United States, acute
reductions in concentrations of plasma retinol (vitamin A) or alpha-tocopherol
(vitamin E) have been associated with impaired immune responses in some clinical 
settings. OBJECTIVE: The objectives were to determine the plasma concentrations
of retinol and alpha-tocopherol in patients undergoing dose-intensive therapy and
hematopoietic stem cell transplant and to examine the association of plasma
concentrations with clinical outcomes reflecting immunity. DESIGN: This was an
observational trial of 120 consecutive recipients of hematopoietic stem cell
transplant and a multivariate analysis of plasma vitamin concentrations,
mucositis, infections in the first 30 d, and herpes zoster infections in the
first year after hematopoietic stem cell transplant. RESULTS: Plasma retinol and 
alpha-tocopherol concentrations declined from baseline to day 7, typically
recovering without specific replacement toward baseline by day 14. The severity
of mucositis was a strong predictor of low plasma retinol on day 7 (P = 0.001).
Eighty-two patients (68%) had at least one plasma retinol concentration < or =
1.05 micro mol/L, a concentration previously determined to be of immunologic
significance, during the peritransplant period (day -8 to day 14). Men more
frequently acquired herpes zoster than women, and men who developed
hyporetinolemia (< or = 1.05 micro mol/L) had a significantly higher risk of
herpes zoster (OR: 6.6; 95% CI: 1.5, 29.6). Plasma alpha-tocopherol was not
associated with any clinical event measured in this study. CONCLUSION:
Hyporetinolemia is common, particularly in subjects with severe mucositis, and is
associated with an increased risk of herpes zoster infection in recipients of
hematopoietic stem cell transplant. Additional investigations are required to
determine whether these findings indicate a causal relation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12450904 [PubMed - indexed for MEDLINE]

2258: Am Fam Physician. 2002 Nov 1;66(9):1732.

Comment on:
    Am Fam Physician. 2002 Nov 1;66(9):1723-30.

Information from your family doctor. What you should know about HZO.

[No authors listed]

Publication Types: 
    Comment
    Patient Education Handout

PMID: 12449271 [PubMed - indexed for MEDLINE]

2259: Am Fam Physician. 2002 Nov 1;66(9):1723-30.

Comment in:
    Am Fam Physician. 2002 Nov 1;66(9):1732.

Evaluation and management of herpes zoster ophthalmicus.

Shaikh S, Ta CN.

Stanford University Medical Center, California, USA.

Herpes zoster ophthalmicus occurs when the varicella-zoster virus is reactivated 
in the ophthalmic division of the trigeminal nerve. Herpes zoster ophthalmicus
represents up to one fourth of all cases of herpes zoster. Most patients with
herpes zoster ophthalmicus present with a periorbital vesicular rash distributed 
according to the affected dermatome. A minority of patients may also develop
conjunctivitis, keratitis, uveitis, and ocular cranial-nerve palsies. Permanent
sequelae of ophthalmic zoster infection may include chronic ocular inflammation, 
loss of vision, and debilitating pain. Antiviral medications such as acyclovir,
valacyclovir, and famcidovir remain the mainstay of therapy and are most
effective in preventing ocular involvement when begun within 72 hours after the
onset of the rash. Timely diagnosis and management of herpes zoster ophthalmicus.
with referral to an ophthalmologist when ophthalmic involvement is present, are
critical in limiting visual morbidity.

Publication Types: 
    Review

PMID: 12449270 [PubMed - indexed for MEDLINE]

2260: Otolaryngol Head Neck Surg. 2002 Nov;127(5):427-31.

Viral titers and delayed facial palsy after acoustic neuroma surgery.

Gianoli GJ.

Ear and Balance Institute, Baton Rouge, LA 70816, USA. gianoli@bellsouth.net

OBJECTIVE: Delayed facial palsy (DFP) after acoustic neuroma surgery has been
reported to occur in up to one third of cases. Reactivation of latent virus has
been proposed as an etiology for DFP. However, only retrospective case reports
and case series have offered data to support this theory. The objective of this
study was to correlate DFP with change in viral titers. Patients and Methods:
Twenty consecutive patients who underwent acoustic neuroma surgery were
prospectively evaluated for viral titers immediately preoperatively and at 3
weeks postoperatively. Viral titers measured included herpes simplex virus 1
(HSV-1), herpes simplex virus 2 (HSV-2), and varicella zoster virus (VZV) and
included both IgG and IgM titers. The status of facial nerve function was
documented preoperatively and throughout the postoperative period. Patients were 
categorized according to the presence or absence of DFP. RESULTS: Seven patients 
developed DFP after acoustic neuroma surgery, while the remaining 13 patients did
not. There was no difference in preoperative and 3-week postoperative IgG titers 
for any of the 3 viruses tested. However, IgM titers were much higher
postoperatively in DFP patients for all 3 viruses tested. The average HSV-1 IgM
titer rose 92% in DFP patients compared with only 4.5% in the patients who did
not develop DFP. Average HSV-2 IgM titers rose 70% compared with a decline of
8.5% in non-DFP patients. Most strikingly, VZV IgM titers rose an average 495%
postoperatively among DFP patients compared with a decline of 14% in the non-DFP 
patients. CONCLUSION: Elevation of the IgM titers of the viruses measured in this
study implies that recrudescence of the virus has occurred. The absence of this
rise among patients who did not develop DFP implies that viral recrudescence
plays a role in the etiology of DFP. These findings support treatment or
prophylaxis of DFP with antiviral therapy.

PMID: 12447236 [PubMed - indexed for MEDLINE]

2261: Am J Clin Dermatol. 2002;3(9):591-8.

Oral antivirals revisited in the treatment of herpes zoster: what do they
accomplish?

Nikkels AF, Pierard GE.

Department of Dermatopathology, University Medical Center, Sart Tilman, Liege,
Belgium. af.nikkels@chu.ulg.ac.be

Oral antiviral agents currently represent the most important therapeutic keystone
in the treatment of herpes zoster. Three oral antiviral agents are available for 
the treatment of herpes zoster: acyclovir, its derivative valacyclovir, and
famciclovir. Meta-analysis of published data has shown that oral acyclovir
significantly reduces various herpes zoster-related symptoms as well as the
duration, intensity and prevalence of zoster-associated pain (ZAP). However, this
drug does not influence postherpetic neuralgia. The newer agents famciclovir and 
valacyclovir exhibit a better oral bioavailability than acyclovir. These agents
have demonstrated similar efficacy to acyclovir with ZAP and they require less
frequent administration. When initiated within 72 hours, oral antiviral therapy
of herpes zoster is beneficial in selected, elderly immunocompetent patients,
reducing the duration and intensity of ZAP and providing more rapid skin lesion
healing. Oral antivirals are also of benefit in immunocompromised patients with
uncomplicated herpes zoster. However, signs of cutaneous and visceral
dissemination should be monitored; if signs occur, intravenous antiviral therapy 
is indicated.

Publication Types: 
    Review

PMID: 12444801 [PubMed - indexed for MEDLINE]

2262: BMC Complement Altern Med. 2002 Nov 20;2:11. Epub 2002 Nov 20.

GFS, a preparation of Tasmanian Undaria pinnatifida is associated with healing
and inhibition of reactivation of Herpes.

Cooper R, Dragar C, Elliot K, Fitton JH, Godwin J, Thompson K.

Anubha Mountain Health Retreat. 680 Summerleas Road, Kingston, Tasmania,
Australia. anubha@southcom.com.au

BACKGROUND: We sought to assess whether GFS, a proprietary preparation of
Tasmanian Undaria pinnatifida, has effects on healing or re-emergence of Herpetic
infections, and additionally, to assess effects of GFS in vitro. Undaria is the
most commonly eaten seaweed in Japan, and contains sulphated polyanions and other
components with potential anti-viral activity. Herpes simplex virus type 1
(HSV-1) infections have lower reactivation rates and Herpes type 2 (HSV-2)
infections have lower incidence in Japan than in the west. METHODS: Patients with
active (15 subjects) or latent (6 subjects) Herpetic infections (HSV-1, 2, EBV,
Zoster) were monitored for response to ingestion of GFS. GFS extract was tested
in vitro for human T cell mitogenicity and anti-Herpes activity. RESULTS:
Ingestion of GFS was associated with increased healing rates in patients with
active infections. In addition, patients with latent infection remained
asymptomatic whilst ingesting GFS. GFS extract inhibited Herpes viruses in vitro 
and was mitogenic to human T cells in vitro. CONCLUSIONS: Ingestion of GFS has
inhibitory effects on reactivation and is associated with increased rate of
healing after Herpetic outbreaks. GFS extract potently inhibited Herpes virus in 
vitro, and had mitogenic effects on human T cells.

Publication Types: 
    Clinical Trial
    In Vitro

PMID: 12443533 [PubMed - indexed for MEDLINE]

2263: Bull Soc Belge Ophtalmol. 2002;(285):19-23.

Postherpetic ophthalmic neuralgia.

Devulder JE.

Ghent University Hospital, Department of Anesthesia-Section Pain Clinic, B-9000
Ghent, Belgium. jacques.devulder@rug.ac.be

Postherpetic ophthalmic neuralgia is the final stage of a varicella zoster
infection. Many years after chickenpox infection, patients can develop herpes
zoster in one or more specific dermatomal regions. The ophthalmic branch of the
trigeminal nerve and the thoracic nerves are most commonly affected. Younger
patients are less prone to postherpetic neuralgia than the older. Patients with a
depression in cell-mediated immunity are more susceptible to develop postherpetic
pain. Postherpetic ophthalmic neuralgia is a neuropathic pain and can be treated 
by anticonvulsants and tricyclic antidepressants. Neurodestructive procedures are
not recommended as they enhance destruction and neuropathic pain. Sympathetic
nerve blocks can be helpful. Neurostimulation is the last therapeutic resort.

Publication Types: 
    Review

PMID: 12442339 [PubMed - indexed for MEDLINE]

2264: Ann Dermatol Venereol. 2002 Oct;129(10 Pt 1):1134-8.

[Cutaneous complications following liver transplantation: epidemiologic and
clinical study in 86 patients]

[Article in French]

Salard D, Parriaux N, Derancourt C, Aubin F, Bresson-Hadni S, Miguet JP, Laurent 
R.

Service de Dermatologie, CHU Saint-Jacques, Besancon.

INTRODUCTION: Organ transplanted patients exhibit cutaneous lesions caused by
immunosuppressive treatment and/or immunosuppression itself. Several selected
studies concerning kidney transplants have been reported, but few concerning
liver transplants. We report a retrospective study of skin diseases after liver
transplantation. PATIENTS AND METHOD: This study was carried out on liver
transplanted patients at the University hospital in Besancon since 1986. Eighty
six patients were examined between January 1997 and May 1998. Standardized data
obtained at the clinical examination and from past history were compiled
concerning cutaneous side effects of immunosuppressive treatments as well as
infectious and tumoral skin lesions. RESULTS: Cutaneous side effects related to
immunosuppressive treatments: 46.5p. 100 of patients exhibited hypertrichosis,
18.5p. 100 gingival hyperplasia, 8.2p. 100 acne, 23.2p. 100 skin atrophy, 13.9p. 
100 senile purpura and 17.4p. 100 sebaceous hyperplasia. Infectious diseases were
2 erysipelas, 2 folliculitis, 29 p. 100 of common fungal infections, 13.9p. 100
of mucocutaneous herpes simplex infections, 3p. 100 of zoster, 38.3p. 100 of
cutaneous warts (24.4p. 100 of common warts and 7p. 100 of condylomata). Tumoral 
skin lesions were 17.4p. 100 of actinic keratoses, 13.9p. 100 of skin cancer (7
squamous and 11 basal cell carcinoma). A correlation was shown between time past 
graft and the occurrence of skin cancer, between actinic keratoses and skin
cancer and between common warts and squamous cell carcinoma. DISCUSSION: We have 
demonstrated that drug induced skin disorders, infections and tumoral skin
diseases were similar and as frequent in liver as in kidney transplanted
patients. However, a lower frequency of warts was observed in liver transplanted 
patients as well as a higher frequency of basal cell carcinoma, compared with
squamous cell carcinoma. This ratio is reversed in kidney grafted patients. These
results suggest that immunosuppression is lower in liver transplanted patients
with possible age involvement.

Publication Types: 
    English Abstract

PMID: 12442126 [PubMed - indexed for MEDLINE]

2265: Home Healthc Nurse. 2002 Nov;20(11):718-23; quiz 724.

Assessing and treating neuropathic pain.

Cabaleiro J.

Triangle Compounding Pharmacy, Cary, NC 27511, USA. joe@trianglecompounding.com

PMID: 12442041 [PubMed - indexed for MEDLINE]

2266: Clin J Pain. 2002 Nov-Dec;18(6):350-4.

Epidemiology and impact on quality of life of postherpetic neuralgia and painful 
diabetic neuropathy.

Schmader KE.

Department of Medicine, Duke University Medical Center, Durham, North Carolina,
USA. schma001@mc.duke.edu

OBJECTIVE: This article reviews the prevalence, risk factors, natural history,
and impact on quality of life of painful diabetic neuropathy (PDN) and
postherpetic neuralgia (PHN). DISCUSSION: Diabetes mellitus afflicts more than 14
million persons in the U.S. An estimated 20% to 24% of these persons experience
PDN. Data on risk factors for PDN are limited, but duration of diabetes mellitus 
and poor glycemic control are probably important factors. Painful diabetic
neuropathy may interfere with general activity, mood, mobility, work, social
relations, sleep, leisure activities, and enjoyment of life. Herpes zoster
strikes an estimated 800,000 persons each year in the U.S., most of whom are
elderly or immunosuppressed. Using pain at 3 months after rash onset as a
definition of PHN, between 25% and 50% of adults older than 50 years develop PHN,
depending on early antiviral therapy for herpes zoster. Increasing age, greater
pain and rash severity, greater degree of sensory impairment, and psychological
distress are risk factors for PHN. Postherpetic neuralgia may cause fatigue,
insomnia, depression, anxiety, interference with social roles and leisure
activity, and impaired basic and instrumental activities of daily living.
CONCLUSIONS: Both conditions are common complications of their underlying
disorders and can profoundly diminish the quality of life of affected persons.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 12441828 [PubMed - indexed for MEDLINE]

2267: Eye. 2002 Nov;16(6):778-80.

Unilateral varicella zoster virus ophthalmicus and contralateral acute retinal
necrosis.

Matthews BN, Erb N, Gordon C, Callear AB, Murray PI, Salmon M.

Academic Unit of Ophthalmology Division of Immunity and Infection The University 
of Birmingham, Birmingham, UK.

We report two patients who developed varicella zoster virus (VZV) ophthalmicus
complicated by ipsilateral keratouveitis, and within 4 weeks developed acute
retinal necrosis (ARN) in the contralateral eye. The ipsilateral retina was
spared in each case. One patient had systemic lupus erythematosus (SLE) and the
other Hodgkin's disease. Both patients were in remission at the time of
presentation.

Publication Types: 
    Case Reports

PMID: 12439676 [PubMed - indexed for MEDLINE]

2268: J Laryngol Otol. 2002 Oct;116(10):844-8.

Ramsay Hunt syndrome: pathophysiology of cochleovestibular symptoms.

Kuhweide R, Van de Steene V, Vlaminck S, Casselman JW.

Department of Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Jan Hospital,
Brugge, Belgium.

Ramsay Hunt's hypothesis that herpes zoster oticus results from reactivation of
the varicella zoster virus (VZV) in the geniculate ganglion is supported by the
detection of viral genome in archival temporal bones of normals and Ramsay Hunt
patients by the polymerase chain reaction. Ramsay Hunt syndrome is characterized 
by the presence of cochleovestibular symptoms in association with facial
paralysis. VZV has also been demonstrated in the spiral and/or vestibular
ganglion. Two cases are reported in which cochleovestibular symptoms outweighed
the facial nerve symptoms, presumably representing VZV reactivation in the spiral
and/or vestibular ganglion. From these observations and the known dormancy of VZV
in non-neuronal satellite cells, it is argued that the cochleovestibular symptoms
in Ramsay Hunt syndrome may result from VZV transmission across the nerves inside
the internal auditory canal and that prompt treatment with an
antiviral-corticosteroid combination might be justified in the management of any 
acute non-hydropic cochleovestibular syndrome.

Publication Types: 
    Case Reports
    Review

PMID: 12437843 [PubMed - indexed for MEDLINE]

2269: N Engl J Med. 2002 Nov 14;347(20):1624-5; author reply 1624-5.

Comment on:
    N Engl J Med. 2002 Jul 4;347(1):26-34.

Varicella vaccine in recipients of hematopoietic-cell transplants.

Mehta J.

Publication Types: 
    Comment
    Letter

PMID: 12434769 [PubMed - indexed for MEDLINE]

2270: Commun Dis Public Health. 2002 Sep;5(3):240-2.

Susceptibility to varicella-zoster virus in applicants for nurse training in
Scotland.

Waclawski ER, Stewart M.

Argyll and Clyde Occupational Health Service, Hollybush Dykebar Hospital,
Grahamston Road, Paisley PA2 7DE. eugene.waclawski@renver-pct.scot.nhs.uk

We investigated the immunity to varicella-zoster virus (VZV) of a cohort of
applicants for nurse training and determined the relationship between immune
status and history of chickenpox or shingles based on a self-completed
questionnaire. Three hundred and fifty-six applicants for nurse training were
enrolled at an occupational health department in NHS Scotland and 96% were immune
to VZV. The positive predictive value of a history of VZV infection for
seropositivity was 98% (286/292). The negative predictive value was 14% (9/64).
History of chicken pox/shingles had a sensitivity of 84% (286/341) and
specificity of 60% (9/15). Screening using past clinical history compatible with 
VZV infection would have missed 40% of those possibly susceptible to VZV on the
basis of the ELISA IgG test. We conclude absence of past history of chickenpox or
shingles is an unreliable identifier of susceptibility to VZV in healthcare
workers. The Control of Substances Hazardous to Health (COSHH) Regulations 1999
require employers to make effective vaccines available for those employees who
are not already immune to a biological agent to which they are exposed or liable 
to be exposed. Serological testing of healthcare workers would better identify
those who are susceptible to VZV infection.

PMID: 12434695 [PubMed - indexed for MEDLINE]

2271: Commun Dis Public Health. 2002 Sep;5(3):185-6.

Comment in:
    Commun Dis Public Health. 2002 Dec;5(4):343.

Varicella vaccination: a double-edged sword?

Edmunds WJ, Brisson M, Gay NJ, Miller E.

Publication Types: 
    Editorial
    Review

PMID: 12434688 [PubMed - indexed for MEDLINE]

2272: Proc West Pharmacol Soc. 2002;45:73.

Lidocaine and methylprednisolone in management of herpes zoster and post-herpetic
neuralgia.

Gintautas J, Abraham Y, Doss NW, Ghobriel A, Kashem A, Fogler RJ.

Brookdale University Hospital and Medical Center, New York, USA.
gintautasj@aol.com

PMID: 12434534 [PubMed - indexed for MEDLINE]

2273: Med Klin (Munich). 2002 Nov 15;97(11):650-8.

[Late infectious complications after high-dose therapy and autologous blood stem 
cell transplantation]

[Article in German]

Metzner B, Gruneisl R, Gebauer W, Reschke D, Ost E, Muller TH, Reichert D, Rosien
B, Del Valle F, Zirpel I, Kohse KP, Schunter F, Illiger HJ.

Klinik fur Innere Medizin II, Klinikum Oldenburg, Germany.
metzner.bernd@klinikum-oldenburg.de

AIM: Only a few data on frequency and character of late infectious complications 
after high-dose therapy (HDT) and autologous blood stem cell transplantation
(ASCT) have been published. This prospective study was carried out to identify
potential predictive factors for late infections (occurring after discharge
following HDT) and to clarify the usefulness of prophylactic measures. PATIENTS
AND METHODS: Clinical data of 192 consecutive patients treated with HDT and ASCT 
in a single hospital were analyzed on late infectious complications. After
discharge following HDT, the 166 evaluable patients (84 with hematologic
malignancies, 82 with solid tumors) had been examined and interviewed on
infections every 4-12 weeks after ASCT. For Pneumocystis carinii prophylaxis,
inhalation with pentamidine or oral cotrimoxazole was used for 3-4 months
following ASCT. RESULTS: In the first 6 months following ASCT (after discharge)
we saw on average one infectious episode per patient (median, range 0-6), usually
light infections (mostly banal upper airway infections). 17 patients had to be
treated in hospital for infectious (15 of whom with hematologic malignancies),
three of whom (only with hematologic malignancies) died in spite of intensive
care as a result of pneumonias due to opportunistic causative agents (mainly
Pneumocystis carinii [PcP]). In the second half of the year after ASCT, five
patients (with hematologic malignancies) had to be hospitalized due to
infections. No further infection-related death occurred. Early documented
infections (pneumonia, bacteremia or Clostridium difficile colitis) were
associated with an increased risk for late serious infections. Zoster occurred in
18% of patients within 12 months, more frequently after increased pretreatment
(25% vs. 11% after less pretreatment), most frequently in patients with relapsed 
lymphomas (32%). CONCLUSIONS: Significant late infectious complications after
ASCT are uncommon. Patients with hematologic malignancies have a significantly
increased risk of more serious infections and should be observed carefully. For
risk patients with hematologic malignancies and possibly solid tumors, a strict
PcP prophylaxis is required. Patients with relapsed lymphomas could possibly be
treated preventively against zoster with low-dose aciclovir to reduce the extent 
of zoster disease. Each patient should be informed carefully that early signs of 
zoster require an effective zoster treatment as soon as possible.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 12434273 [PubMed - indexed for MEDLINE]

2274: N Engl J Med. 2002 Nov 14;347(20):1624-5; author reply 1624-5.

Comment on:
    N Engl J Med. 2002 Jul 4;347(1):26-34.

Varicella vaccine in recipients of hematopoietic-cell transplants.

Kami M, Kim SW, Takaue Y.

Publication Types: 
    Comment
    Letter

PMID: 12432055 [PubMed - indexed for MEDLINE]

2275: Swiss Med Wkly. 2002 Jul 13;132(27-28):374-8.

Management of viral infections in immunocompromised cancer patients.

Reusser P.

Division of Medicine, Hopital regional, Porrentruy, Switzerland.
pierre.reusser@cgh.ch

Immunocompromised cancer patients are at elevated risk for serious viral disease.
The introduction into clinical use of potent antiviral agents and of rapid
diagnostic tests resulted in the development of efficient management strategies
for infections due to herpes simplex virus, varicellazoster virus, and
cytomegalovirus. The emergence of herpesvirus resistance to acyclovir,
ganciclovir, cidofovir, or foscarnet represents an important challenge. The new
neuraminidase inhibitors zanamivir and oseltamivir are efficacious in the
treatment of influenza in otherwise healthy adults, and need to be investigated
among immunodeficient patients with malignancy. Preliminary data on pleconaril, a
first broad-spectrum anti-picornaviral compound, are promising.

Publication Types: 
    Review

PMID: 12428191 [PubMed - indexed for MEDLINE]

2276: Am J Med. 2002 Oct 15;113(6):462-7.

Novel risk factors for peripheral arterial disease in young women.

Bloemenkamp DG, van den Bosch MA, Mali WP, Tanis BC, Rosendaal FR, Kemmeren JM,
Algra A, Visseren FL, van der Graaf Y.

Julius Center for General Practice and Patient Oriented Research, Department of
Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.

PURPOSE: To investigate traditional and novel risk factors (homocysteine and
C-reactive protein levels, and exposure to infections) for peripheral arterial
disease in young women. SUBJECTS AND METHODS: In a multicenter, population-based,
case-control study, 212 young women (mean [+/- SD] age, 48.2 +/- 7.0 years) with 
peripheral arterial disease and 475 healthy control women (mean age, 45.5 +/- 8.1
years) completed a standardized questionnaire and provided blood samples.
Peripheral arterial disease was angiographically confirmed if a stenotic lesion
(more than 50% reduction of the lumen) was present in at least one major
peripheral artery. Hyperhomocysteinemia was defined as a nonfasting plasma
homocysteine level exceeding the 90th percentile of the control group. History of
infectious diseases was determined by questionnaire. RESULTS: Elevated C-reactive
protein levels were associated with an increased likelihood of peripheral
arterial disease (odds ratio [OR] = 3.9; 95% confidence interval [CI]: 1.8 to 8.5
for women in the third quartile; OR = 3.1; 95% CI: 1.4 to 6.8 for women in the
fourth quartile; both comparisons with women in the first quartile).
Hyperhomocysteinemia was not associated with a significantly increased risk of
peripheral arterial disease (OR = 1.6; 95% CI: 0.9 to 3.0). A history of
chickenpox, shingles, mumps, pneumonia, chronic bronchitis, peptic ulcer, or
periodontitis was independently related to peripheral arterial disease, with
adjusted odds ratios varying from 1.7 (95% CI: 1.0 to 3.1) for mumps to 3.4 (95% 
CI: 1.5 to 7.7) for peptic ulcer. The risk of peripheral arterial disease
increased with the number of these infections; exposure to five or more
infections increased the odds 3.7-fold (95% CI: 1.7 to 8.2). This association was
not affected by the level of C-reactive protein. CONCLUSION: Our results do not
support a strong relation between homocysteine and peripheral arterial disease in
young women. However, an elevated C-reactive protein level and several types of
symptomatic infection were associated with peripheral arterial disease.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 12427494 [PubMed - indexed for MEDLINE]

2277: Arch Ophthalmol. 2002 Nov;120(11):1534-9.

Real-time quantitative polymerase chain reaction diagnosis of infectious
posterior uveitis.

Dworkin LL, Gibler TM, Van Gelder RN.

Department of Ophthalmology and Visual Sciences, Campus Box 8096, Washington
University Medical School, 660 S Euclid Ave, St Louis, MO 63110, USA.

OBJECTIVE: To validate a real-time polymerase chain reaction (PCR) assay allowing
rapid and sensitive detection and quantitation of 4 common infectious posterior
uveitis pathogens. METHODS: A real-time PCR assay using previously validated
primer sets for cytomegalovirus, herpes simplex virus, varicella-zoster virus,
and Toxoplasma gondii was developed. A standard curve for quantitation of
pathogen load was generated for each pathogen using SYBR Green I fluorescence
detection. Ocular samples from patients with posterior uveitis and from negative 
control samples were assayed and compared with standards to identify pathogens
and quantify infectious load. RESULTS: Sensitivity for detection of purified
pathogen DNA by PCR was not reduced by application of the real-time method.
Standard curves for the quantitation of pathogen loads showed sensitivity to
fewer than 10 organisms for all pathogens. The technique was applied to 2
clinical problems. First, sensitivities of existing monoplex and multiplex PCR
were compared by real-time PCR. No significant difference in sensitivity was
observed between multiplex and monoplex techniques. Second, pathogen loads of
vitreous specimens from patients previously diagnosed as having infectious
posterior uveitis were calculated. Pathogen loads were found to be generally
higher for patients with disease caused by varicella-zoster virus than those
caused by cytomegalovirus or herpes simplex virus. CONCLUSIONS: Real-time PCR may
be applied to infectious agents responsible for posterior uveitis. This technique
will likely prove useful for the diagnosis of posterior uveitis as well as the
linkage of pathogen to disease. CLINICAL RELEVANCE: Real-time PCR provides a
rapid technique for quantitatively evaluating ocular samples for the presence of 
infectious pathogens.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Validation Studies

PMID: 12427068 [PubMed - indexed for MEDLINE]

2278: Rinsho Shinkeigaku. 2002 Feb;42(2):167-70.

[A case of acute measles encephalitis with periodic synchronous discharge on
electroencephalography]

[Article in Japanese]

Okamoto K, Okuda B.

Department of Neurology, Ehime Prefectural Central Hospital.

A 18-year-old man was diagnosed as having measles on the basis of cutaneous and
mucosal eruption and high grade fever on May 10, 2001. Six days after the skin
eruption, the patient developed general convulsion (day1). He was admitted to our
hospital because of status epilepticus. We made a diagnosis of acute measles
encephalitis, based on the clinical features and pleocytosis with an increase in 
protein in the cerebrospinal fluid. Under artificial ventilation and sedation, he
received intravenous immunoglobulin and dexamethasone. Electroencephalography
(EEG) on day 4 revealed periodic synchronous discharge (PSD). Significant
elevation of antibody titer for measles virus was found in the serum, but not in 
the cerebrospinal fluid. Polymerase chain reaction method did not show viral
genes of measles virus, herpes simplex virus and herpes zoster virus. Serial EEG 
studies demonstrated a decrease in PSD, followed by irregular spike-wave
complexes within 20 days. He recovered completely one month after the onset. It
should be kept in mind that PSD can emerge on EEG in the early stage of acute
measles encephalitis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12424970 [PubMed - indexed for MEDLINE]

2279: Eur J Pediatr. 2002 Nov;161(11):588-93. Epub 2002 Sep 24.

The seroepidemiology of primary varicella-zoster virus infection in Flanders
(Belgium).

Thiry N, Beutels P, Shkedy Z, Vranckx R, Vandermeulen C, Wielen MV, Damme PV.

Centre for the Evaluation of Vaccination, Department of Epidemiology and
Community Medicine, University of Antwerp, Universiteitsplein 1, 2610 Antwerp,
Belgium. nancy.thiry@ua.ac.be

The age-specific seroprevalence of varicella-zoster virus (VZV) antibodies was
assessed in a sample of the Flemish (Belgian) population. ELISA tests were used
to analyse 1673 sera from subjects aged 1 to 44 years (October 1999-April 2000). 
Chickenpox infections in Flanders appear to affect children at a younger age than
in other European countries since 47.37% (95% CI: 37.33-57.41) is already immune 
at 2 years of age. For older age-groups, the prevalence is similar to that of
most European countries: 80.19% (95% CI: 72.60-87.78) at 5 years, 92.52% (95% CI:
87.54-97.51) at 9 years and 100%> or =40 years. The accuracy of non-positive
recollections of varicella histories among Flemish 10 to 17-year olds was
examined on the basis of a second (residual) serum bank. In this group, VZV
seroprevalence was almost always 100% (or nearly 100%), irrespective of age,
degree of reliability (negative or uncertain answers) or level of ascertainment
(child personally or parents). The limited size of this second data set did not
allow for an accurate assessment of the negative predictive value of such
recollections. CONCLUSION: since varicella-zoster virus predominantly affects
very small children and is generally perceived as benign, the required high
coverage rate of a universal childhood varicella vaccination programme may be
hard to attain. Adolescent strategies can minimise the population risks involved 
but the accuracy of non positive antecedents of chickenpox needs to be documented
to assess the efficiency of such strategies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12424583 [PubMed - indexed for MEDLINE]

2280: Med Princ Pract. 2002 Oct-Dec;11(4):180-2.

TORCH agents in pregnant Saudi women.

Ghazi HO, Telmesani AM, Mahomed MF.

Department of Microbiology, Faculty of Medicine and Medical Sciences, Umm Al-Qura
University, Makkah, Kingdom of Saudi Arabia. hanighazi@hotmail.com

OBJECTIVE: To determine the seroprevalence rates of IgG to common TORCH agents in
pregnant Saudi women using indirect enzyme-linked immunosorbent assay. SUBJECTS
AND METHODS: A total of 926 samples of sera were tested for antibodies to TORCH
agents known to cause serious congenital infections: Toxoplasma gondii, rubella, 
cytomegalovirus (CMV), herpes simplex viruses (HSV-1 and HSV-2), varicella zoster
virus (VZV) and human immunodeficiency virus (HIV-1 and HIV-2). RESULTS:
Toxoplasma IgG antibodies were detected in 35.6%, CMV total IgG antibodies were
found in 92.1%, rubella IgG antibodies in 93.3%, HSV-1 IgG antibodies in 90.9%,
HSV-2 IgG in 27.1%, and VZV IgG antibodies in 74.4%. A 0% seroprevalence rate for
HIV-1 and -2 was found. CONCLUSION: Pregnant Saudi women commonly have IgG
antibodies to rubella, CMV, HSV-1 and -2, VZV, and T. gondii. Serological
evidence of HIV infection was not observed. Copyright 2002 S. Karger AG, Basel

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12424411 [PubMed - indexed for MEDLINE]

2281: J Clin Virol. 2002 Dec;25(3):293-301.

Acute central nervous system complications in varicella zoster virus infections.

Koskiniemi M, Piiparinen H, Rantalaiho T, Eranko P, Farkkila M, Raiha K, Salonen 
EM, Ukkonen P, Vaheri A.

Department of Virology, Haartman Institute, Helenski University, Finland.
marjaleena.koskiniemi@helsinki.fi

BACKGROUND: In a previous multicenter study on central nervous system (CNS) viral
infections varicella zoster virus (VZV) appeared the most frequent etiologic
agent and appeared often without rash. OBJECTIVE: To evaluate the appearance and 
diagnostics of VZV in CNS more thoroughly, we studied the cases systematically by
using sensitive and specific methods to learn the best diagnostic approach in
order to start specific therapy. STUDY DESIGN: We analyzed all serum and
cerebrospinal fluid samples of 174 patients, 88 females and 86 males, with acute 
CNS symptoms associated with VZV infection diagnosed in the multicenter study on 
viral CNS infections. RESULTS: About 38 patients (22%) had chickenpox, 59 (34%)
had shingles, and 77 (44%) had no cutaneous symptoms at all. The mean age of
chickenpox patients was 8.6 years, of the others 46.6 and 41.4 years.
VZV-specific nucleic acid was detected in the CSF in one fourth of the patients
in all groups, primarily during the first week of illness. In serum specimens,
specific IgM was present in two thirds of the patients with chickenpox, whereas
in the others in one third of the cases. In CSF, specific IgM was present in
15-17% of patients with skin manifestations, compared with 6% of those without
rash. CONCLUSIONS: The role of VZV infections in CNS complications seems
remarkable, often presenting without rash. Even these cases should be promptly
recognized in order to conduct proper antiviral therapy. In children, a
combination of PCR and IgM tests is the best approach. In adults, PCR, together
with the measurement of intrathecal antibody production yields best results.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12423693 [PubMed - indexed for MEDLINE]

2282: J Clin Virol. 2002 Dec;25(3):241-66.

Erratum in:
    J Clin Virol. 2003 Jan;26(1):117-120..

Antiviral prophylaxis and treatment (excluding HIV therapy).

Waugh SM, Pillay D, Carrington D, Carman WF.

West of Scotland Specialist Virology Centre, Gartnavel General Hospital, Great
Western Road, Glasgow G12 OYN, UK.

Publication Types: 
    Review

PMID: 12423690 [PubMed - indexed for MEDLINE]

2283: Arch Phys Med Rehabil. 2002 Nov;83(11):1624-8.

Herpes zoster-associated voiding dysfunction: a retrospective study and
literature review.

Chen PH, Hsueh HF, Hong CZ.

Department of Physical Medicine and Rehabilitation, Kuo General Hospital, Tainan,
Taiwan. vspmnr70@yahoo.com.tw

OBJECTIVES: (1) To describe the demographic features of patients with voiding
dysfunction associated with herpes zoster; (2) to discuss the pathophysiology of 
voiding dysfunction associated with herpes zoster; and (3) to suggest the best
management policy. DESIGN: A retrospective study. SETTING: A
university-affiliated medical center in Taiwan. PARTICIPANTS: Four hundred
twenty-three patients (mean age, 55.5y) admitted with the diagnosis of herpes
zoster from 1988 to 2000. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Dermatomal distribution of skin eruptions, urologic symptoms, treatment
(catheterization, urecholine), clinical course of voiding dysfunction, and
outcome. RESULTS: Seventeen (mean age, 61.2+/-14.1y) of 423 patients (4.02%) with
voiding dysfunction related to this virus infection were identified. Ten (58.8%) 
were men, and 7 (41.2%) were women. The incidence of dysfunction was as high as
28.6% if only lumbosacral dermatome-involved patients were considered. We
classified urologic manifestations caused by herpes zoster into 3 groups:
cystitis-associated (n=12), neuritis-associated (n=4), and myelitis-associated
(n=1). Urinalysis revealed pyuria in all patients with cystitis-associated
voiding dysfunction and microscopic hematuria in all patients with
neuritis-associated voiding dysfunction. All patients, although receiving
different treatment regimens for voiding dysfunction, regained a normal or
balanced bladder within 8 weeks. No major urologic sequelae were noted.
CONCLUSION: Voiding dysfunction, although a transient course, is not uncommon in 
patients with herpes zoster involving lumbosacral dermatomes. Treatment with
intermittent catheterization (our preferred choice) or indwelling catheter
placement is recommended if the patients have prolonged difficulty in urination. 
This disease entity usually has a benign clinical course, and almost every
patient will either regain normal voiding or, at least, balanced bladder
function. Copyright 2002 by the American Congress of Rehabilitation Medicine and 
the American Academy of Physical Medicine and Rehabilitation

Publication Types: 
    Review

PMID: 12422336 [PubMed - indexed for MEDLINE]

2284: N Engl J Med. 2002 Nov 7;347(19):1500-3.

Two patients with unusual forms of varicella-zoster virus vasculopathy.

Gilden DH, Lipton HL, Wolf JS, Akenbrandt W, Smith JE, Mahalingam R, Forghani B.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA. don.gilden@uchsc.edu

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 12421892 [PubMed - indexed for MEDLINE]

2285: Indian J Dent Res. 2002 Jan-Mar;13(1):11-4.

Tooth exfoliation, osteonecrosis and neuralgia following herpes zoster of
trigeminal nerve.

Volvoikar P, Patil S, Dinkar A.

Department of Oral Medicine & Radiology, Goa Dental College, Bambolim,
Goa-403202, India.

A case of herpes zoster of the trigeminal nerve with complications of
osteonecrosis and neuralgia in the absence of local or systemic predisposing
factors is presented. The literature is reviewed and the role of varicella zoster
virus in the pathology of tooth exfoliation and osteonecrosis is discussed.

Publication Types: 
    Case Reports
    Review

PMID: 12420562 [PubMed - indexed for MEDLINE]

2286: Indian J Gastroenterol. 2002 Sep-Oct;21(5):203-4.

Colonic pseudo-obstruction due to herpes zoster.

Rodrigues G, Kannaiyan L, Gopasetty M, Rao S, Shenoy R.

Department of General Surgery, Kasturba Medical College and Hospital, Manipal,
Karnataka. gabyrodricks@eudoramail.com

Visceral motor complications are uncommon manifestations of herpes zoster
(varicella zoster). We report a 59-year-old man who developed acute colonic
pseudo-obstruction, which followed the appearance of dermatomal herpes zoster.

Publication Types: 
    Case Reports

PMID: 12416757 [PubMed - indexed for MEDLINE]

2287: Haematologica. 2002 Nov;87(11):ECR33.

Guillain-Barre' syndrome following Varicella zoster reactivation in Chronic
Lymphocytic Leukemia treated with fludarabine.

Laurenti L, Garzia M, Sabatelli M, Piccioni P, Sora' F, Leone G.

Istituto di Ematologia, Universita Cattolica Sacro Cuore, Rome, Italy.
emacat@rm.unicatt.it

Publication Types: 
    Case Reports

PMID: 12414359 [PubMed - indexed for MEDLINE]

2288: Eur J Pain. 2002;6(6):435-45.

Prevention of postherpetic neuralgia with varicella-zoster hyperimmune globulin.

Hugler P, Siebrecht P, Hoffmann K, Stucker M, Windeler J, Altmeyer P, Laubenthal 
H.

Department of Anesthesiology, Miners' Association Hospital Bottrop,
Osterfelderstrasse 156, D-46242 Bottrop, Germany.
peter.e.huegler@ruhr-uni-bochum.de

Recovery after an acute attack of herpes zoster is followed by postherpetic
neuralgia (PHN) in 9-14% of all patients. Depending on the patient's age, the
severity of the acute attack of herpes zoster and the dermatome involved, the
incidence of PHN may be as high as 65%. The purpose of our study was to ascertain
the incidence of PHN after a prophylactic intravenous injection of
varicella-zoster hyperimmune globulin (VZV-IG) (Varitect Biotest Pharma). For
this double-blind placebo-controlled randomised investigation we defined PHN as
pain confined to the dermatome previously affected by herpes zoster, and we
required a pain intensity of at least 15% points on a visual analogue scale (VAS)
for this dermatome. The inclusion criteria were the dermatological diagnosis of
herpes zoster together with age over 50 years. On Day 1, 20 patients received a
single intravenous infusion of VZV-IG in a dose of 2mL/kg body weight, 20
patients (control group) received a single infusion of human albumin 5% in a dose
of 2mL/kg body weight. All patients received acyclovir intravenously in a dose of
15mg/kg body weight per 24h for 5 days. The patients were followed up for a total
of 42 days. The incidence of PHN at Day 42 was selected as the main outcome
criterion for assessing the efficacy of prophylaxis. On reaching a significant
difference between the groups (t test; alpha<0.05) in favour of the active
treatment group, prophylaxis of PHN by VZV-IG was assessed as effective. Pain was
assessed on a VAS and a NAS. As auxiliary outcome criteria, we used the McGill
Pain-Rating Questionnaire in its German version, the revised multidimensional
pain scale (RMSS) and the Freiburg symptom list (FBL). All results were assessed 
by the t test (alpha<0.05). The frequency of PHN in the placebo group was 70%
(14/20), in the active treatment group it was 35% (7/20) at Day 42. The results
of the McGill test showed the variability of the perception of pain in the
placebo group significantly greater. No significant group differences were found 
in the FBL. Being tested with the RMSS, the patients of the placebo group
assessed their pains as significantly "more obstinate" (p=0.047). The results can
be summed up by saying that VZV-IG not only reduces the incidence of PHN, but
also that in certain respects the patients' assessments of their pain experience 
were different. In our study we found a 50% reduction in PHN incidence However,
the outcome time point of our trial was so close to the acute phase of the zoster
illness that spontaneous remissions of PHN still have to be taken into account.
Despite the widely varied approaches to the problem, reliably effective therapy, 
let alone 100% prevention of PHN, is still not feasible.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 12413432 [PubMed - indexed for MEDLINE]

2289: Proc Natl Acad Sci U S A. 2002 Nov 12;99(23):15234-7. Epub 2002 Oct 30.

Herpes viruses hedge their bets.

Stumpf MP, Laidlaw Z, Jansen VA.

Department of Biology, University College London, United Kingdom.
m.stumpf@ucl.ac.uk

Static latency is the hallmark of all herpes viruses. The varicella zoster virus,
for instance, causes varicella (chickenpox), and after a latent phase of between 
5 and 40 years, it can give rise to herpes zoster (shingles). This latency and
the subsequent reactivation has intrigued and puzzled virologists. Although
several factors have been suggested, it is unknown what triggers reactivation.
However, latency can be explained with a simple evolutionary model. Here, we
demonstrate that a simple, yet efficient, bet-hedging strategy might have evolved
in a number of viruses, especially those belonging to the herpes virus family and
most importantly in varicella zoster virus. We show that the evolution of latency
can be explained by the population dynamics of infectious diseases in fluctuating
host populations.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12409612 [PubMed - indexed for MEDLINE]

2290: Lancet Infect Dis. 2002 Nov;2(11):699.

Comment in:
    Lancet Infect Dis. 2003 Jan;3(1):12.

Concomitant bilateral herpes zoster opthalmicus.

Pervez H, Potti A, Mehdi SA.

Department of Internal Medicine, University of North Dakota School of Medicine
and Health Sciences, Fargo, ND 58102, USA.

Publication Types: 
    Case Reports

PMID: 12409051 [PubMed - indexed for MEDLINE]

2291: Aust Fam Physician. 2002 Oct;31(10):887.

Antiherpes zoster treatment.

Bowell G.

Publication Types: 
    Letter

PMID: 12404823 [PubMed - indexed for MEDLINE]

2292: Aust Fam Physician. 2002 Oct;31(10):887.

Antiherpes zoster treatment.

Watson A.

Publication Types: 
    Letter

PMID: 12404822 [PubMed - indexed for MEDLINE]

2293: Presse Med. 2002 Oct 5;31(32):1521-9.

[Ocular infections of the elderly]

[Article in French]

Labetoulle M, Lautier-Frau M, Frau E.

Service d'ophtalmologie Centre hospitalier universitaire de Bicetre AP-HP, Le
Kremlin-Bicetre (94).

A CLINICAL ASPECT DEPENDING ON THE PHYSIOPATHOGENESIS: Ocular infections are a
frequent motive for ophthalmological consultations in geriatric settings because 
of the mechanical factors related to age (modifications in palpebral dynamics and
lacrymal function) and in local and general immune factors leading to the rapid
and/or more severe development of infections. The mechanism of microbial
contamination of the eye also determines the clinical damage: predominantly local
(dirty hands, traumas) with involvement of the surface tissues (conjunctive and
cornea) or general, hematogenic or neurogenic, frequently at the origin of more
internal infections (iris, choroid, retina, optical nerve). CONJUNCTIVITIS AND
KERATITIS: These provoke reddening of the eyes, tears and above all pain when the
corneal epithelium is involved. Microbiological samples are useful in cases of
severe, presumably infectious keratitis or conjunctivitis. Two emergency
situations must be distinguished: any suspicion of herpes for which local
corticosteroids are contraindicated and keratitis or conjunctivitis with the use 
of lenses, often due to Gram negative bacilli, amoeba or fungus, the treatment of
which is intensive and the prognosis often severe. OPHTHALMOLOGICAL HERPES
ZOSTER: The rapid diagnosis and introduction of efficient doses of antivirals
reduces the initial pain, the ocular complications of herpes zoster and
post-zoster pain. The latter, when it exists, requires specialized management.
ACUTE UVEITIS: A context of intra-ocular inflammation in an elderly patient must 
always evoke a pseudo-uveitis syndrome, the principle cause of which is lymphoma.
Conversely, an uveitis occurring in the days or weeks following ocular surgery,
including cataract, must be considered as suggestive of a post-surgical infection
and rapidly referred to a specialist. ACUTE DACRYOCYSTITIS: Is manifested by a
hard and painful tumefaction below the internal angle of the eye. Following
collection, it requires draining through an in incision in the skin, washing and 
packing of the sac, and systemic antibiotherapy. The preventive treatment of
recurrences requires open dacryocystorhinostomy or via endonasal endoscopy.

Publication Types: 
    Comparative Study
    English Abstract
    Review

PMID: 12402761 [PubMed - indexed for MEDLINE]

2294: Presse Med. 2002 Oct 5;31(32):1517-20.

[Characteristics of infectious diseases in the elderly]

[Article in French]

Merrien D.

Service de medecine interne, centre hospitalier de Compiegne 60200 Compiegne.

IN GENERAL: Infectious diseases represent the third cause of mortality in
patients aged over 65. Age-related immune deficiency and underlying diseases
frequently favour infections. The symptoms are often fickle and misleading, delay
diagnosis and worsen the prognosis. THE PRINCIPLE INFECTIONS: Broncho-pulmonary
and urinary infections predominate in this context. More rare but severe
complications specifically related to age are also possible, notably meningitis, 
tuberculosis, herpes zoster and septicemia in the elderly. PREVENTIVE MEASURES:
Influenza and anti-pneumococcal vaccines have demonstrated their efficacy in
limiting the broncho-pulmonary infections in these patients.

Publication Types: 
    Comparative Study
    English Abstract
    Review

PMID: 12402760 [PubMed - indexed for MEDLINE]

2295: J Neurovirol. 2002 Oct;8(5):439-46.

Detection of infectious agents in brain of patients with acute hemorrhagic
leukoencephalitis.

An SF, Groves M, Martinian L, Kuo LT, Scaravilli F.

Department of Molecular Pathogenesis, Division of Neuropathology, Institute of
Neurology, University College London, London, United Kingdom. S.An@ion.ucl.ac.uk

Acute hemorrhagic leukoencephalitis (AHL) is a rare and usually fatal disorder
characterized clinically by an acute onset of neurologic abnormalities. It may
occur in association with a viral illness or vaccination. Radiology and brain
biopsy are essential for the diagnosis. The etiology of AHL is unclear. We
postulated that viral/bacterial infection might be responsible, directly or
through an immune-mediated mechanism, for this acute inflammatory myelinopathy.
Fifteen cases of AHL were studied. Infectious agents, including varicella zoster 
virus (VZV), herpes simplex virus (HSV), human herpes virus-6 (HHV-6),
cytomegalovirus, Epstein-Barr virus, and Mycoplasma, were investigated in brain
specimens using the polymerase chain reaction (PCR), reverse transcriptase
(RT)-PCR, and immunohistochemistry. Using PCR, HSV DNA was found in four cases,
VZV DNA in two, and HHV-6 DNA in one. Among the control cases, two were HSV DNA
positive. Further investigation to detect HSV RNA and antigens in HSV
DNA-positive cases revealed that two cases with AHL were both HSV RNA and antigen
positive. AHL is a hyperacute disease, which is considered the most acute form of
acute disseminated encephalomyelitis (ADEM). Our findings suggests that a viral
infection may be implicated in its pathogenesis, most likely through an indirect 
mechanism; however, as only a few cases of this rare disease were examined,
statistical significance was not achieved. As a number of patients with disorders
of the ADEM group may progress to develop multiple sclerosis (MS), we argue that 
an organism that has produced the former may remain in the brain tissue and be
subsequently involved in the production of a self-sustained disorder such as MS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12402170 [PubMed - indexed for MEDLINE]

2296: Nephrol Dial Transplant. 2002 Nov;17(11):2030-2.

Giant cells and pneumonia in a transplant patient. What is the link?

Kleshinski JF, Rao PS, Duggan J, Zaher A.

Department of Medicine. Department of Pathology, Medical College of Ohio, Toledo,
OH, USA.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12401869 [PubMed - indexed for MEDLINE]

2297: Br J Anaesth. 2002 Nov;89(5):711-4.

Comment in:
    Br J Anaesth. 2003 Aug;91(2):302; author reply 302.

Efficacy of intravenous magnesium in neuropathic pain.

Brill S, Sedgwick PM, Hamann W, Di Vadi PP.

Department of Anaesthetics and Pain Management, University Hospital Lewisham,
Lewisham High Street, London SE13 6LH, UK.

BACKGROUND: Postherpetic neuralgia is a complication of acute herpes zoster
characterized by severe pain and paraesthesia in the skin area affected by the
initial infection. There is evidence that the N-methyl-D-aspartate receptor is
involved in the development of hypersensitivity states and it is known that
magnesium blocks the N-methyl-D-aspartate receptor. METHOD: A double-blind,
placebo-controlled, cross-over study was conducted in which magnesium sulphate
was administered as an i.v. infusion. Spontaneous pain was recorded and
qualitative sensory testing with cotton wool was performed in seven patients with
postherpetic neuralgia before and after the i.v. administration of either
magnesium sulphate 30 mg kg(-1) or saline. RESULTS: During the administration,
pain scores were significantly lower for magnesium compared with placebo at 20
and 30 min (P=0.016) but not at 10 min. I.V. magnesium sulphate was safe,
well-tolerated and effective in patients with postherpetic neuralgia. CONCLUSION:
The present study supports the concept that the N-methyl-D-aspartate receptor is 
involved in the control of postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 12393768 [PubMed - indexed for MEDLINE]

2298: Headache. 2002 Sep;42(8):826-8.

Geniculate neuralgia as a manifestation of neuroborreliosis.

Frese A, Luttmann RJ, Husstedt IW, Ringelstein EB, Evers S.

Department of Neurology, University of Munster, Germany.

Publication Types: 
    Case Reports

PMID: 12390649 [PubMed - indexed for MEDLINE]

2299: J Virol. 2002 Nov;76(22):11425-33.

Tropism of varicella-zoster virus for human tonsillar CD4(+) T lymphocytes that
express activation, memory, and skin homing markers.

Ku CC, Padilla JA, Grose C, Butcher EC, Arvin AM.

Department of Pediatrics, Stanford University, Stanford, California 94305, USA.
cck@stanford.edu

Varicella-zoster virus (VZV) is an alphaherpesvirus with the characteristic
neurotropism of this group, but VZV also infects T cells productively and
downregulates major histocompatibility complex (MHC) class I expression on
infected T cells, as shown in the SCID-hu mouse model. T-cell tropism is likely
to be critical for the cell-associated viremia associated with primary VZV
infection. In these experiments, we found that VZV infects human tonsillar CD4(+)
T cells in culture, with 15 to 25% being positive for VZV proteins as detected by
polyclonal anti-VZV immunoglobulin G (IgG) staining and monitored by flow
cytometry analysis. RNA transcripts for VZV gE, a late gene product, were
detected in T-cell populations that expressed VZV surface proteins, but not in
the VZV-negative cell fraction. Exposure to phorbol myristate acetate resulted in
an increase in VZV-positive T cells, indicating that viral DNA was present within
these cells and that VZV gene expression could be induced by T-cell activation.
By immune scanning electron microscopy, VZV virions were detected in abundance on
the surfaces of infected tonsillar T cells. The predominant CD4(+) T-lymphocyte
subpopulations that became infected were activated CD69(+) T cells with the
CD45RA(-) memory phenotype. Subsets of CD4(+) T cells that expressed skin homing 
markers, cutaneous leukocyte antigen, and chemokine receptor 4 were also infected
with VZV. By chemotaxis assay, VZV-infected T cells migrated to SDF-1,
demonstrating that skin migratory function was intact despite VZV infection. The 
susceptibility of tonsil T cells to VZV suggests that these cells may be
important targets during the initial VZV infection of upper respiratory tract
sites. Viral transfer to migrating T cells in the tonsils may facilitate
cell-associated viremia, and preferential infection of CD4 T cells that express
skin homing markers may enhance VZV transport to cutaneous sites of replication.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 12388703 [PubMed - indexed for MEDLINE]

2300: Infection. 2002 Oct;30(5):320-2.

Rapid molecular discrimination between infection with wild-type varicella-zoster 
virus and varicella vaccine virus.

Lassker U, Harder TC, Hufnagel M, Suttorp M.

Dept. of Pediatrics, Christian-Albrechts-University, Schwanenweg 20, D-24105
Kiel, Germany. laessker@pediatrics.uni-kiel.de

Varicella-zoster virus (VZV) infection is immunocompromised patients may cause
life-threatening complications. Prevention measures include administration of VZV
immuloglobulin, acyclovir and live attenuated varicella vaccine. After
vaccination, a mild varicella-like exanthem appears in up to 5% of vaccinees.
Morphologically this exanthem cannot be differentiated from wild-type (wt)
varicella. The risk of virus transmission after varicella vaccination, in
contrast to wt varicella, is low, even in immunocompromised patients. We report
on a 2-year-old girl with relapse of cereral anaplastic ependymoma, who received 
one dose of varicella vaccine. Two weeks later, a maculopapular rash developed
while she was an inpatient on the oncology ward. Using VZV-specific PCR and
restriction fragment length polymorphism (RFLP) analysis, we were able to
diagnose wt varicella infection. Thus, appropriate prevention measures (VZV
immunoglobulin and acyclovir) were justified for close contacts to prevent virus 
transmission. No secondary cases occurred.

Publication Types: 
    Case Reports

PMID: 12382096 [PubMed - indexed for MEDLINE]

2301: Rev Med Interne. 2002 Sep;23(9):802-3.

[Superficial thrombophlebitis of the scalp preceding zona zoster eruption]

[Article in French]

Gaultier M, Launay J, Koechlin M, Guedj A, Mourad JJ.

Publication Types: 
    Case Reports
    Letter

PMID: 12378839 [PubMed - indexed for MEDLINE]

2302: J Korean Med Sci. 2002 Oct;17(5):655-9.

Prognostic factors of postherpetic neuralgia.

Herr H.

Department of Dermatology, Kangnung Asan Hospital, University of Ulsan College of
Medicine, Kangnung, Korea. herr@knh.co.kr

The investigation was aimed to determine prognostic factors related to
postherpetic neuralgia (PHN), and treatment options for preventing PHN. The data 
showed 34 (17.0%) out of 188 patients with herpes zoster had severe pain after 4 
weeks, and 22 (11.7%) after 8 weeks, compared with 109 (58.0%) at presentation.
The age (>/=50 yr), surface area involved (>/=9%), and duration of severe pain
(>/=4 weeks) might be the main factors that lead to PHN. On the other hand,
gender, dermatomal distribution, accompanied systemic conditions, and interval
between initial pain and initiation of treatment might not be implicated in PHN. 
The subjects were orally received antiviral (valacyclovir), tricyclic
antidepressant (amitriptyline), and analgesic (ibuprofen) as the standard
treatment in the group 1. In addition to the standard medication, lidocaine
solution was sub- and/or perilesionally injected in the group 2, while lidocaine 
plus prilocaine cream was topically applied to the skin lesions in the group 3.
The rates of PHN in the 3 treatment groups were not significantly different,
suggesting adjuvant anesthetics may not be helpful to reduce the severity of
pain.

PMID: 12378018 [PubMed - indexed for MEDLINE]

2303: Science. 2002 Oct 11;298(5592):351-3.

Microbiology. Domino effects from battles against microbes.

Cohen J.

Publication Types: 
    Congresses
    News

PMID: 12376683 [PubMed - indexed for MEDLINE]

2304: Curr Protein Pept Sci. 2001 Dec;2(4):371-9.

The herpesvirus encoded dUTPase as a potential chemotherapeutic target.

Studebaker AW, Balendiran GK, Williams MV.

Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State
University, 2074 Graves Hall, 333 West 10th Avenue, Columbus, OH 43210, USA.

The human herpesviruses are a well characterized group of viruses that are
responsible for a wide spectrum of human diseases. Included in this group of
pathogens are the alphaherpesviruses (herpes simplex types 1 and 2 and
varicella-zoster virus), the betaherpesviruses (cytomegalovirus, human
herpesvirus types 6 and 7) and the gammaherpesviruses (Epstein-Barr virus and
human herpesvirus 8). An important feature of these viruses is that they cause
latent infections that can be reactivated to cause disease. The herpesviruses
encode for a large number of structural and non-structural proteins, and several 
of the non-structural proteins, such as thymidine kinase, DNA polymerase, and
ribonucleotide reductase, have been utilized as targets for the development of
anti-herpesvirus agents. Another herpesvirus encoded enzyme that has received
little attention as a potential target for the development of specific
anti-herpesvirus agents is deoxyuridine triphosphate nucleotidohydrolase
(dUTPase). Furthermore, little is known concerning the role of the herpesviruses'
encoded dUTPases in virus replication and in modulating the chemotherapeutic
efficiency of other anti-herpes agents. Because of recent advances in molecular
virology and biochemistry, it is now possible to rationally develop "designer"
drugs based upon the structural/functional interaction of the drug with a
specific viral protein. The purpose of this review is to describe previous
studies demonstrating the potential use of the herpesvirus encoded dUTPase as a
drug target, to describe problems associated with using the dUTPase as a target
and to discuss new approaches that can be used.

Publication Types: 
    Review

PMID: 12374096 [PubMed - indexed for MEDLINE]

2305: Enferm Infecc Microbiol Clin. 2002 Oct;20(8):415.

[Encephalitis as the first manifestation of herpes zoster]

[Article in Spanish]

Hernandez N, del Castillo F, Garcia-Miguel MJ, Baquero-Artigao F.

Publication Types: 
    Case Reports
    Letter

PMID: 12372242 [PubMed - indexed for MEDLINE]

2306: Neurology. 2002 Oct 8;59(7):1015-21.

Comment in:
    J Fam Pract. 2003 Jul;52(7):517-8.    Neurology. 2003 Mar 25;60(6):1052-3; author reply 1052-3.

Opioids versus antidepressants in postherpetic neuralgia: a randomized,
placebo-controlled trial.

Raja SN, Haythornthwaite JA, Pappagallo M, Clark MR, Travison TG, Sabeen S,
Royall RM, Max MB.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University
School of Medicine, Baltimore, MD, USA. sraja@jhmi.edu

BACKGROUND: Tricyclic antidepressants (TCA) provide less than satisfactory pain
relief for postherpetic neuralgia (PHN), and the role of opioids is
controversial. OBJECTIVE: To compare the analgesic and cognitive effects of
opioids with those of TCA and placebo in the treatment of PHN. METHODS:
Seventy-six patients with PHN were randomized in a double-blind,
placebo-controlled, crossover trial. Each subject was scheduled to undergo three 
treatment periods (opioid, TCA, and placebo), approximately 8 weeks' duration
each. Doses were titrated to maximal relief or intolerable side effects. The
primary outcome measures were pain intensity (0 to 10 scale), pain relief (0 to
100%), and cognitive function. Analyses included patients who provided any pain
ratings after having received at least a single dose of a study medication.
RESULTS: Fifty patients completed two periods, and 44 patients completed all
three. Mean daily maintenance doses were morphine 91 mg or methadone 15 mg and
nortriptyline 89 mg or desipramine 63 mg. Opioids and TCA reduced pain (1.9 and
1.4) more than placebo (0.2; p < 0.001), with no appreciable effect on any
cognitive measure. The trend favoring opioids over TCA fell short of significance
(p = 0.06), and reduction in pain with opioids did not correlate with that
following TCA. Treatment with opioids and TCA resulted in greater pain relief (38
and 32%) compared with placebo (11%; p < 0.001). More patients completing all
three treatments preferred opioids (54%) than TCA (30%; p = 0.02). CONCLUSIONS:
Opioids effectively treat PHN without impairing cognition. Opioids and TCA act
via independent mechanisms and with varied individual effect.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 12370455 [PubMed - indexed for MEDLINE]

2307: Med Monatsschr Pharm. 2002 Sep;25(9):309-16.

[Herpes zoster. Overview, symptoms and treatment]

[Article in German]

Gross G.

Universitat Rostock, Medizinische Fakultat, Klinik und Poliklinik fur
Dermatologie und Venerologie, Augustenstrasse 80-85, 18055 Rostock.

Publication Types: 
    Review

PMID: 12369432 [PubMed - indexed for MEDLINE]

2308: J Virol. 2002 Nov;76(21):11012-23.

Varicella-zoster virus (VZV) ORF17 protein induces RNA cleavage and is critical
for replication of VZV at 37 degrees C but not 33 degrees C.

Sato H, Callanan LD, Pesnicak L, Krogmann T, Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, National Institutes of Health,
Bethesda, Maryland 28092-1888, USA.

Varicella-zoster virus (VZV) open reading frame 17 (ORF17) is homologous to
herpes simplex virus (HSV) UL41, which encodes the viral host shutoff protein
(vhs). HSV vhs induces degradation of mRNA and rapid shutoff of host protein
synthesis. An antibody to ORF17 protein detected a 46-kDa protein in VZV-infected
cells. While HSV vhs is located in virions, VZV ORF17 protein was not detectable 
in virions. ORF17 protein induced RNA cleavage, but to a substantially lesser
extent than HSV-1 vhs. Expression of ORF17 protein did not inhibit expression
from a beta-galactosidase reporter plasmid, while HSV type 1 vhs abolished
reporter expression. Two VZV ORF17 deletion mutants were constructed to examine
the role of ORF17 in virus replication. While the ORF17 VZV mutants grew to peak 
titers that were similar to those of the parental virus at 33 degrees C, the
ORF17 mutants grew to 20- to 35-fold-lower titers than parental virus at 37
degrees C. ORF62 protein was distributed in a different pattern in the nuclei and
cytoplasm of cells infected with an ORF17 deletion mutant at 37 degrees C
compared to 33 degrees C. Inoculation of cotton rats with the ORF17 deletion
mutant resulted in a level of latent infection similar to that produced by
inoculation with the parental virus. The importance of ORF17 protein for viral
replication at 37 degrees C but not at 33 degrees C suggests that this protein
may facilitate the growth of virus in certain tissues in vivo.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12368344 [PubMed - indexed for MEDLINE]

2309: Antiviral Res. 2002 Nov;56(2):153-66.

Synergistic inhibition of herpesvirus replication by docosanol and antiviral
nucleoside analogs.

Marcelletti JF.

Avanir Pharmaceuticals, 11388 Sorrento Valley Road, Suite 200, San Diego, CA
92121, USA. lpope@avanir.com

Interactions between docosanol (n-docosanol, behenyl alcohol) and nucleoside or
pyrophosphate analogs were investigated in vitro. The anti-HSV activity of
acyclovir (ACV) was synergistically enhanced by treatment of cells with docosanol
as judged by inhibition of progeny virus production and plaque formation. This
drug interaction between ACV and docosanol was observed with laboratory strains
of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), oral and genital
clinical isolates of HSV, cytomegalovirus (CMV), and varicella zoster virus
(VZV). Near optimal concentrations of docosanol plus ACV inhibited HSV
replication >99% more than either drug alone, including emergence of
ACV-resistant variants. The response was observed with African Green Monkey
kidney cells, normal human foreskin cells, and normal human lung cells. Treatment
of cells with docosanol also synergistically intensified the inhibition of HSV
production by all tested nucleoside analogs, including trifluorothymidine (TFT), 
adenine arabinoside (Ara-A), and ribavirin. An additive anti-HSV effect was
observed with docosanol and phosphonoformate (PFA). No evidence was found for
either synergistic inhibition of cellular DNA synthesis or induction of overt
cellular toxicity when docosanol was combined with ACV, TFT, Ara-A, ribavirin,
PFA, 8-azaguanine, or 5-fluorouracil. The ability of docosanol treatment to
increase the antiviral activities of nucleoside analog antiviral drugs, coupled
with a lack of toxic interactions, translates to substantial improvements in drug
selectivity ratios. Copyright 2002 Elsevier Science B.V.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12367721 [PubMed - indexed for MEDLINE]

2310: Optometry. 2002 May;73(5):295-302.

Herpes zoster ophthalmicus.

Gurwood AS, Savochka J, Sirgany BJ.

The Eye Institute, Pennsylvania College of Optometry, Philadelphia 19141, USA.
agurwood@pco.edu

BACKGROUND: We examined the literature for the latest information on diagnosis
and management of herpes zoster, and compiled a representative database. METHODS:
Using search engines and library resources, we reviewed pathology, epidemiology, 
pathophysiology, differential diagnosis, and management. RESULTS: The varicella
zoster virus is a member of the herpes virus family that produces an infection
through direct contact with active skin lesions or airborne droplets. The
infection resides latent in the trigeminal ganglion until reactivated, often
affecting the sensory nerve, skin, eye, and adnexa. CONCLUSION: The varicella
zoster virus has the potential to severely disrupt the structures of the eye.
Patients less than 50 years of age should be referred for systemic workup to rule
out an immunocompromised state. In general, management is often palliative and/or
geared toward specific sequelae.

Publication Types: 
    Case Reports
    Review

PMID: 12363229 [PubMed - indexed for MEDLINE]

2311: Pathol Biol (Paris). 2002 Aug;50(7):463-8.

[Atherosclerosis, multiple sclerosis, and Alzheimer's disease: what role for
Herpesviridae?]

[Article in French]

Chidiac C, Braun E.

Service des Maladies Infectieuses et Tropicales, CISIH de Lyon, Hopital de la
Croix-Rousse, F69317 Lyon, France. christian.chidiac@chu-lyon.fr

Herpesviridae are ubiquitous, and are commonly involved in well identified
diseases as genital herpes, chickenpox and herpes zoster, infectious
mononucleosis, exanthem subitum... They are responsible for latent and chronic
infections after primary infection. Atherosclerosis, multiple sclerosis,
Alzheimer's disease are diseases which are very different, and for which
pathogenesis remains unknown. Several authors have hypothesized that
Herpesviridae could play a role in such diseases. The present paper reviews
arguments not only in favour but also against such hypothesis. Any formal
conclusion is impossible, and more extensive studies are warranted.

Publication Types: 
    English Abstract
    Review

PMID: 12360701 [PubMed - indexed for MEDLINE]

2312: Pathol Biol (Paris). 2002 Aug;50(7):452-9.

[Herpes and retinal lesions: what's new?]

[Article in French]

Fardeau C, Slimane H, Lehoang P.

Service d'ophtalmologie, Hopital Pitie-Salpetriere, Paris, France.
christine.fardeau@psl.ap-hop-paris.fr

The viral retinitis are linked to infection by herpes simplex virus (HSV),
varicella zoster virus (VZV), cytomegalovirus (CMV). When the diagnosis is
clinically suspected the antiviral treatment has to be introduced immediately
after performing the ocular sampling to try to identify the infectious agent.
Despite the various antiherpetic drugs available by intravenous routes and
intravitreal injection, the prognostic of the herpetic retinitis remained severe 
because of the occurrence of retinal detachment, optic neuritis, macular
necrosis. Various clinical forms are described: (1) the classical "acute
necrotizing retinitis" (2) a form with a slow progression of the necrotizing
retinitis (3) occlusive retinal arteritis (4) the highly severe "progressive
retinal necrosis". The incidence of the CMV retinitis diminished with the highly 
antiretroviral therapy; however uveitis may occur with no active CMV retinitis.
The various antiherpetic drugs are described with special indications.

Publication Types: 
    English Abstract
    Review

PMID: 12360699 [PubMed - indexed for MEDLINE]

2313: Curr Neurol Neurosci Rep. 2002 Nov;2(6):477-8.

Valacyclovir and famciclovir therapy in herpes zoster.

Jubelt B.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 12359099 [PubMed - indexed for MEDLINE]

2314: Am J Clin Dermatol. 2002;3(8):517-24.

Corticosteroids for herpes zoster: what do they accomplish?

Santee JA.

School of Pharmacy, Division of Pharmacy Practice, University of Missouri-Kansas 
City, 2411 Holmes, Kansas City, MO 64108, USA. santeej@umkc.edu

For some patients, herpes zoster infections not only result in acute pain but
serious consequences, including postherpetic neuralgia and damage to ocular
tissues. Some authors have recommended corticosteroids for the treatment of these
acute symptoms and complications. The literature concerning the use of
corticosteroids for herpes zoster, however, either provides conflicting results
or includes recommendations based on clinical experience rather than clinical
trials. The author performed a search of the literature to address the question
of whether corticosteroids are well tolerated and effective for the
treatment/prevention of the acute pain of herpes zoster, postherpetic neuralgia, 
and/or the ocular complications resulting from herpes zoster. While smaller
trials found oral corticosteroids beneficial for preventing postherpetic
neuralgia, larger, better designed trials have not found oral corticosteroids to 
be more efficacious than placebo in preventing postherpetic neuralgia. Trials
investigating the effect of oral corticosteroids for the acute pain of herpes
zoster have found that corticosteroids provide a statistically significant
improvement. Whether these improvements are clinically significant is uncertain. 
Thus, oral corticosteroids may confer a slight benefit for initial symptoms as
long as the patient is not at risk for complications resulting from
corticosteroid therapy. Most trials of topical and injectable corticosteroids are
limited by several shortcomings. Therefore, topical and most forms of parenteral 
corticosteroids have yet to be proven effective for the treatment of acute pain
or prevention of complications. Two controlled, blinded trials investigating the 
use of intrathecal corticosteroid administration for intractable postherpetic
neuralgia suggest that corticosteroid administration results in a significant
improvement in pain. Despite this, several authors have voiced concern over
possible serious adverse events with the intrathecal administration of
corticosteroids. Intrathecal corticosteroids may provide a benefit for
intractable postherpetic neuralgia, but because of risks of serious
complications, this is a last-line option and should only be administered by
experienced personnel.

Publication Types: 
    Review

PMID: 12358552 [PubMed - indexed for MEDLINE]

2315: Anesthesiology. 2002 Oct;97(4):1009-11.

Thoracic motor paralysis secondary to zoster sine herpete.

McAllister RK, Borum SE, Mitchell DT, Bittenbinder TM.

Department of Anesthesiology, Scott & White Clinic and Memorial Hospital, Scott, 
Sherwood, and Brindley Foundation, The Texas A&M University Health Science Center
College of Medicine, Temple, 76508, U SA. rmcallister@swmail.sw.org

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12357172 [PubMed - indexed for MEDLINE]

2316: Fam Pract. 2002 Oct;19(5):471-5.

Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a
general practice research database.

Opstelten W, Mauritz JW, de Wit NJ, van Wijck AJ, Stalman WA, van Essen GA.

Julius Center for General Practice and Patient Oriented Research, University
Medical Center Utrecht, PO Box 85060, 3500 AB Utrecht, The Netherlands.
w.opstelten@med.uu.nl

BACKGROUND: Postherpetic neuralgia (PHN) is a frequent complication of herpes
zoster (HZ). Treatment results of this severe and long-lasting pain syndrome are 
often disappointing. From the point of view of possible prevention and early
treatment, it is important to identify HZ patients who have an increased risk of 
developing PHN. OBJECTIVES: Our goals were to determine the incidence of HZ and
PHN in a primary care population and to identify risk indicators for the
occurrence of PHN. METHODS: A search for HZ and PHN was conducted in a general
practice research database, comprising 22 general practices and representing 49
000 people, over a 5-year period. Potential risk indicators were analysed using
multivariate logistic regression. RESULTS: A total of 837 patients had been
diagnosed with HZ [incidence 3.4/1000 patients/year, 95% confidence interval (CI)
2.9-3.9]. The risk of developing PHN 1 month after the start of the zoster rash
was 6.5% (95% CI 4.9-8.3). This risk was 11.7% (95% CI 8.5-14.9) for patients
aged > or =55 years. Independent risk indicators for the occurrence of PHN were
age [55-74 years, adjusted odds ratio (OR) 4.2, 95% CI 1.8-9.7; >75 years, OR
10.7, 95% CI 4.6-25.1] and ophthalmic localization (OR 2.3, 95% CI 1.0-4.6).
CONCLUSIONS: The risk of developing PHN increases with age. Preventive strategies
should focus on patients with herpes zoster aged >55 years and with ophthalmic
localization.

PMID: 12356697 [PubMed - indexed for MEDLINE]

2317: Indian J Pediatr. 2002 Aug;69(8):701-6.

Common skin problems.

Thappa DM.

Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical
Education and Research, Pondicherry, India. dmthappa@satyam.net.in

Dermatological problems manifesting as primary and secondary cutaneous
complaints, constitute at least 30% of all outpatient visits to a pediatrician
and 30% of all visits to dermatologists involve patients of pediatric age group. 
There is, however, a paucity of data about pediatric dermatoses in India, which
has been reviewed to the extent possible. A brief account of common
dermatological problems in India mainly infestations (pediculosis capitis,
scabies) and infections (pyoderma, molluscum contagiosum, warts, herpes simplex
infection, varicella, herpes zoster, tinea capitis and corporis, tinea
versicolor, and candidiasis) has been given. At the end, common pediatric
dermatological emergencies have been short-listed. Erythema multiforme and its
variants and acrodermatitis enteropathica are discussed briefly.

PMID: 12356223 [PubMed - indexed for MEDLINE]

2318: Dig Dis Sci. 2002 Sep;47(9):1962-4.

Visceral varicella zoster after bone marrow transplantation: an obscure cause of 
an "acute abdomen".

O'Loughlin CJ, Karnam US, Barkin JS.

University of Miami, School of Medicine/Mount Sinai Medical Center, Division of
Gastroenterology, Florida 33140, USA.

Publication Types: 
    Case Reports

PMID: 12353837 [PubMed - indexed for MEDLINE]

2319: Am J Hematol. 2002 Oct;71(2):140-1.

Allografting of peripheral blood stem cell mobilized from a donor developing
herpes zoster virus infection.

Imai T, Maeda Y, Fujii N, Takenaka K, Shinagawa K, Ishimaru F, Ikeda K, Niiya K, 
Harada M.

Publication Types: 
    Case Reports
    Letter

PMID: 12353321 [PubMed - indexed for MEDLINE]

2320: J Infect Dis. 2002 Oct 15;186 Suppl 1:S123-30.

An investigation of the steady-state pharmacokinetics of oral valacyclovir in
immunocompromised children.

Nadal D, Leverger G, Sokal EM, Floret D, Perel Y, Leibundgut K, Weller S.

Division of Infectious Diseases, University Children's Hospital of Zurich,
CH-8032 Zurich, Switzerland. dnadal@kispi.unizh.ch

Valacyclovir was administered to 28 immunocompromised children (ages 5-12 years) 
to obtain preliminary pharmacokinetic and safety information. Patients were
randomized to valacyclovir regimens of 250 mg (9.4-13.3 mg/kg) or 500 mg
(13.9-27.0 mg/kg) twice daily or 500 mg (13.2-21.7 mg/kg) 3 times a day.
Acyclovir pharmacokinetics were evaluated at steady state. Valacyclovir was
rapidly absorbed and converted to acyclovir. Mean (+/-SD) acyclovir peak
concentrations from 250 mg and 500 mg valacyclovir were 4.11+/-1.41 and
5.19+/-1.96 microg/mL, respectively. Corresponding single dose area-under-curve
values were 12.14+/-6.60 and 14.49+/-4.69h microg/mL. By using historical data
for intravenous acyclovir as reference, the overall estimate of acyclovir
bioavailability from valacyclovir was 48%, 2- to 4-fold greater than for oral
acyclovir. In general, adverse events were not attributable to valacyclovir and
were consistent with disease-related expectations and concomitant therapies.
Dosage options for using valacyclovir in children are discussed.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 12353197 [PubMed - indexed for MEDLINE]

2321: J Infect Dis. 2002 Oct 15;186 Suppl 1:S110-5.

Valacyclovir provides optimum acyclovir exposure for prevention of
cytomegalovirus and related outcomes after organ transplantation.

Fiddian P, Sabin CA, Griffiths PD.

Royal Free and University College Medical School (Royal Free Campus), London NW3 
2PF, United Kingdom. paul.fiddian@which.net

A meta-analysis of 12 randomized trials (1574 patients) examined herpesvirus and 
related outcomes following organ transplantation over a range of acyclovir
exposures (including valacyclovir). Overall, cytomegalovirus (CMV) infection
(odds ratio [OR], 0.44; 95% confidence interval [CI], 0.34-0.57; P<.001), CMV
disease (OR, 0.41; 95% CI, 0.31-0.54; P<.001), death (OR, 0.60; 95% CI,
0.40-0.90; P=.01), opportunistic infection (OR, 0.70; 95% CI, 0.53-0.91; P=.009),
acute graft rejection (OR, 0.67; 95% CI, 0.52-0.86; P<.001), herpes simplex virus
disease (OR, 0.17; 95% CI, 0.12-0.24; P<.001), and varicella-zoster virus disease
(OR, 0.06; 95% CI, 0.01-0.25; P<.001) were significantly reduced. Increased
acyclovir exposure influenced more end points: Maximum efficacy resulted from
valacyclovir (8 g/day). Increasing acyclovir exposure to that achieved with
valacyclovir extends benefits of prophylaxis to include impact on graft rejection
and opportunistic infections.

Publication Types: 
    Comparative Study
    Meta-Analysis
    Research Support, Non-U.S. Gov't

PMID: 12353195 [PubMed - indexed for MEDLINE]

2322: J Infect Dis. 2002 Oct 15;186 Suppl 1:S91-8.

Varicella-zoster virus: atypical presentations and unusual complications.

Gnann JW Jr.

University of Alabama at Birmingham and Birmingham VA Medical Center, Birmingham,
Alabama 35294-2170, USA.

Varicella-zoster virus (VZV) is the etiologic agent of varicella (primary
infection) and herpes zoster (reactivation of latent infection). Although
varicella is most often a relatively benign and self-limited childhood illness,
the disease can be associated with a variety of serious and potentially lethal
complications in both immunocompetent and immunocompromised persons. One
complication of varicella that appears to be increasing in frequency is serious
bacterial soft tissue infections caused by group A streptococci. Issues related
to management of varicella become especially complex when varicella involves
pregnant women or susceptible neonates. Herpes zoster can be associated with a
variety of neurologic complications, including a syndrome of delayed
contralateral hemiparesis. Neurologic complications of herpes zoster, including
chronic encephalitis, occur with increased frequency in AIDS patients. VZV
retinitis is a potentially sight-threatening complication that occurs in both
immunocompetent and immunocompromised persons. Current knowledge regarding
pathogenesis and antiviral therapy is reviewed.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12353193 [PubMed - indexed for MEDLINE]

2323: J Infect Dis. 2002 Oct 15;186 Suppl 1:S83-90.

Consequences and management of pain in herpes zoster.

Johnson RW.

Pain Management Clinic, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.
rwjbristol@aol.com

Postherpetic neuralgia (PHN) is a common complication of herpes zoster,
particularly in the elderly and in persons with severe symptoms at presentation. 
Unless varicella vaccination reduces the incidence of herpes zoster and
attenuates the risk and/or severity of complications, PHN will continue to result
in significant suffering and remain a consumer of health care and related social 
support resources. Although there have been useful advances in the management of 
PHN (e.g., the use of the anticonvulsant gabapentin), some cases remain
intractable. Prevention remains the preferred strategy, and antiviral drugs are
the most well established means of preventing the development of pain. Other
interventions require further evaluation (nerve blocks, acute-phase tricyclic
antidepressant or anticonvulsant use). Because prevention of PHN requires early
recognition and prompt management of patients presenting with herpes zoster,
public education and dissemination of information to all health care personnel
involved with the disease are essential.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12353192 [PubMed - indexed for MEDLINE]

2324: J Infect Dis. 2002 Oct 15;186 Suppl 1:S78-82.

Understanding pain in herpes zoster: an essential for optimizing treatment.

Wood M.

Department of Infection and Tropical Medicine, Heartlands Hospital, Birmingham B9
5SS, United Kingdom. m.j.wood@bham.ac.uk

After herpes zoster, immunocompetent persons frequently experience chronic pain
and considerable suffering. Zoster-associated pain has a complex pathophysiology 
that begins with viral damage and increased sensitization of peripheral sensory
neurons. The enhanced afferent barrage from these neurons sensitizes spinal
neurons and leads to loss of synapses from descending inhibitory fibers,
resulting in central neuropathic pain and allodynia. Antiviral therapy of acute
zoster limits this sequence of pathophysiologic mechanisms. There is no clear
consensus regarding the optimal means of determining the benefits of antiviral
therapy in the management of pain of herpes zoster. A novel statistical approach 
utilizing rates of disappearance of pain of differing pathophysiologic mechanisms
is proposed.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12353191 [PubMed - indexed for MEDLINE]

2325: Artif Organs. 2002 Oct;26(10):879-83.

A two year follow-up study of common virus infections in hemodialysis patients in
Taiwan.

Kao TW, Hsu WA, Chen HS, Chen WY.

Department of Internal Medicine, National Taiwan University Hospital, Taipei,
Republic of China.

The study was designed to determine whether hemodialysis patients in Taiwan had a
different antibody response to common virus infections compared to the normal
population. Serum samples from 18 hemodialysis patients and 21 healthy volunteers
were obtained every 3 months for 2 years. Geometric mean titers (GMTs) of
immunoglobulin G (IgG) antibodies to cytomegalovirus (CMV), herpes simplex virus 
(HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), as well as Type A 
and Type B influenza viruses (Inf. A, Inf. B) were compared between the patient
and the control groups. The prevalence rates and the rates of recurrent infection
were similar in both groups. However, the patient group had a higher percentage
of persons having persistent EBV and CMV infections (p < 0.05) and also higher
GMTs of antibodies nearly the whole year round, especially significant in
September and December (p < 0.05). In patients with hepatitis C, their GMTs of
EBV, VZV, Inf. A, and Inf. B were higher than those without (p < 0.05).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12296929 [PubMed - indexed for MEDLINE]

2326: Afr Health. 1998 Nov;21(1):5-6.

Herpes zoster: an early manifestation of HIV infection.

Leppard B, Naburi AE.

PIP: Herpes zoster, also known as shingles, is a reactivation of a previous
infection with the herpes varicella-zoster virus. A person's first encounter with
the virus causes chicken pox, usually in children. Once the chicken pox has
healed, the virus remains in the posterior root ganglion of the spinal cord for
the rest of the person's life. If a person's immunity is reduced for any reason, 
the virus can be reactivated, travel down one of the sensory nerves to the skin
and cause herpes zoster. Herpes zoster cannot be contracted from someone who has 
it, for the infection always comes from one's own spinal cord. However, chicken
pox can be caught from someone with herpes zoster. Before signs of herpes zoster 
become apparent on the skin, there is pain along the course of one of the sensory
nerves of the skin. A rash then appears 2-3 days later, beginning with grouped
vesicles either confined to 1 dermatome or spread over 2 adjacent dermatomes. The
vesicles will later crust over before healing in 3-4 weeks. The rash remains
painful until it has healed. Herpes zoster-related problems at the eye, tongue,
chest and abdomen, and bladder and bowel are noted. In Africa, the presentation
of a patient with herpes zoster should always lead the clinician to suspect HIV
infection, for since the beginning of the AIDS pandemic, herpes zoster has often 
been the first manifestation of HIV infection. Various treatments with analgesics
and topical and antiretroviral agents are described.

PMID: 12294921 [PubMed - indexed for MEDLINE]

2327: J Am Acad Dermatol. 2002 Oct;47(4):581-99.

Erratum in:
    J Am Acad Dermatol 2002 Dec;47(6):972.

Antiviral agents: Non-antiretroviral [correction of Nonantiviral] drugs.

Brown TJ, McCrary M, Tyring SK.

Department of Dermatology, Microbiology/Immunology and Internal Medicine,
University of Texas Medical Branch, Galveston 77555, USA.

The current arsenal of antiviral agents available to the practitioner is
expanding rapidly, such that by the time this article goes to press, new drugs
may have already been added. Although the majority of approved drugs have been
developed for use in only a few viral infections (eg, HIV, herpesviruses, and
papillomavirus), discoveries made in the development of these drugs may lead to
antiviral agents effective against other viruses. In addition, new uses for the
currently available drugs are under evaluation. This review of antiviral agents
discusses the treatments available for viral infections such as herpes simplex
virus, varicella zoster virus, cytomegalovirus, human papillomavirus, chronic
viral hepatitis, and others.

Publication Types: 
    Review

PMID: 12271305 [PubMed - indexed for MEDLINE]

2328: Acta Otorhinolaryngol Belg. 2002;56(3):319-23.

Ramsay Hunt syndrome presenting as a cranial polyneuropathy.

Xanthopoulos J, Noussios G, Papaioannides D, Exarchakos G, Assimakopoulos D.

Department of Otolaryngology, Hippokration General Hospital, Thessaloniki,
Greece.

Ramsay Hunt syndrome (RHS) is herpes zoster of the facial nerve, frequently
associated with VIII cranial nerve involvement, but on rare occasions other
cranial nerves are affected as well. We present the case of a 63-year-old woman
with RHS with involvement of V, VII, VIII, IX, and XII cranial nerves. The
patient showed significant improvement after treatment with acyclovir and
prednisolone. RHS should be recognized as a polycranial neuritis characterized by
damage to sensory and motor nerves, including the facial nerve and the
auditory-vestibular apparatus. Early institution of treatment with antiviral
agents may help hasten healing. Involvement of the XIIth cranial nerve has not
been reported previously.

Publication Types: 
    Case Reports

PMID: 12244896 [PubMed - indexed for MEDLINE]

2329: Lancet. 2002 Aug 31;360(9334):678-82.

Contacts with varicella or with children and protection against herpes zoster in 
adults: a case-control study.

Thomas SL, Wheeler JG, Hall AJ.

Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical
Medicine, Keppel Street, London WC1E 7HT, UK. Sara.Thomas@lshtm.ac.uk

BACKGROUND: Whether exogenous exposure to varicella-zoster-virus protects
individuals with latent varicella-zoster virus infection against herpes zoster by
boosting immunity is not known. To test the hypothesis that contacts with
children increase exposure to varicella-zoster virus and protect latently
infected adults against zoster, we did a case-control study in south London, UK. 
METHODS: From 22 general practices, we identified patients with recently
diagnosed zoster, and control individuals with no history of zoster, matched to
patients by age, sex, and practice. Participants were asked about contacts with
people with varicella or zoster in the past 10 years, and social and occupational
contacts with children as proxies for varicella contacts. Odds ratios were
estimated with conditional logistic regression. FINDINGS: Data from 244 patients 
and 485 controls were analysed. On multivariable analysis, protection associated 
with contacts with a few children in the household or via childcare seemed to be 
largely mediated by increased access to children outside the household. Social
contacts with many children outside the household and occupational contacts with 
ill children were associated with graded protection against zoster, with less
than a fifth the risk in the most heavily exposed groups compared with the least 
exposed. The strength of protection diminished after controlling for known
varicella contacts; the latter remained significantly protective (odds ratio 0.29
[95% CI 0.10-0.84] for those with five contacts or more). INTERPRETATION:
Re-exposure to varicella-zoster virus via contact with children seems to protect 
latently infected individuals against zoster. Reduction of childhood varicella by
vaccination might lead to increased incidence of adult zoster. Vaccination of the
elderly (if effective) should be considered in countries with childhood varicella
vaccination programmes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12241874 [PubMed - indexed for MEDLINE]

2330: Antivir Chem Chemother. 2002 Mar;13(2):67-82.

Synthesis and antiherpesvirus activities of 5-alkyl-2-thiopyrimidine nucleoside
analogues.

Shigeta S, Mori S, Watanabe F, Takahashi K, Nagata T, Koike N, Wakayama T,
Saneyoshi M.

Department of Microbiology, School of Medicine, Fukushima Medical University,
Japan. sshigeta@fmu.ac.jp

Twenty 5-alkyl-2-thiopyrimidine nucleosides were newly synthesized and examined
for antiviral activities against herpes simplex virus (HSV), varicella-zoster
virus (VZV) and human cytomegalovirus (HCMV). In this study,
2'-deoxy-5-alkyl-2-thiocytidine analogues had lower 50% effective concentration
(EC50) values against HSV-1, and 2'-deoxy-5-alkyl-2-thiouridine analogues showed 
lower EC50 against VZV than their congeners of arabinoside form. Among the
compounds examined, 2'-deoxy-5-ethyl and 5-propyl-2-thiocytidine (TN-53 and
TN-54) were most potent and selective anti-HSV compounds. Their EC50s were 0.04
and 0.15 microM, and selectivity indexes were more than 7,215 and 1,849,
respectively. On the other hand, 2'-deoxy-5-propyl-2-thiouridine (TN-51),
5-bromovinyl-2-thiouracil arabinoside (TN-65) and 5-styryl-2-thiouracil
arabinoside (TN-67) were most potent and selective anti-VZV compounds. Their
EC50s were 3.1, 3.8 and 2.6 pM for CaQu strain of VZV, respectively, and 2.1 to
3.0 times lower than that of acyclovir. All 2-thiopyrimidine nucleoside analogues
did not show antiviral activities against thymidine kinase (TK) negative strains 
of HSV-1 and VZV. Only three 2-thiocytosine arabinoside compounds showed marginal
anti-CMV activities (EC50s were 57-159 pM). All of the five
alkyl-2-thio-pyrimidine nucleoside analogues examined were not cytotoxic to human
lymphoblastoid cells (RPM18226) and human embryonic fibroblast cells (MRC-5) at
240 microM (100 microg/ml) or more. Regarding the structure-activity relationship
of 5-alkyl-2-thiopyrimidine nucleoside analogues, the following remarks will be
noted. Elongation of 5-alkyl chain (methyl to ethyl) of 2-thiocytosine in both
deoxyribosyl and arabinosyl nucleosides increased anti-HSV-1 activity but not
anti-VZV activity. Furthermore, elongation of the same chain (ethyl to propyl) of
2-thiodeoxyuridine increased anti-VZV activity whereas it did not in the case of 
2-thiouracil arabinosides.

PMID: 12238531 [PubMed - indexed for MEDLINE]

2331: Presse Med. 2002 Aug 24;31(27):1270.

[Herpes zoster of the maxillary branch of the trigeminal nerve]

[Article in French]

Sterkers Y, Botterel F, Nicolas M, Bouree P.

Unite de maladies tropicales et parasitaires CHU 78, rue du General Leclerc 94275
Le Kremlin-Bicetre. francoise.botterel@bct.ap-hop-paris.fr

Publication Types: 
    Case Reports

PMID: 12238275 [PubMed - indexed for MEDLINE]

2332: Pediatr Infect Dis J. 2002 Jul;21(7):615-7.

Chickenpox and the geniculate ganglion: facial nerve palsy, Ramsay Hunt syndrome 
and acyclovir treatment.

Grose C, Bonthius D, Afifi AK.

Department of Pediatrics, University of Iowa College of Medicine, Iowa City
52242, USA. charles-grose@uiowa.edu

Facial nerve palsy has long been considered to have an infectious etiology.
Recent diagnostic analyses in children and adults have provided convincing
evidence that reactivation of varicella-zoster virus (VZV), sometimes during
infectious mononucleosis, can lead to cranial nerve VII palsy. The site of
reactivation from latency is the geniculate ganglion. Virus most likely enters
the ganglion during chickenpox, via the sensory branches of the facial nerve
located on the ear and tongue. Retrospective reviews suggest that patients with
VZV-related facial nerve palsy have poorer outcomes than other cases of Bell's
palsy. Therefore treatment with acyclovir is suggested when VZV reactivation i
slikely.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 12237590 [PubMed - indexed for MEDLINE]

2333: Arch Phys Med Rehabil. 2002 Sep;83(9):1215-21.

Herpes zoster of the head and limbs: electroneuromyographic and clinical findings
in 158 consecutive cases.

Mondelli M, Romano C, Rossi S, Cioni R.

Servizio di EMG, ASL 7, Siena, Italy. m.mondelli@us17.toscana.it

OBJECTIVES: To quantify electromyographic and neurographic changes and to
correlate them with the clinical data of outpatients with herpes zoster. DESIGN: 
Prospective case series. SETTING: Outpatient department. PATIENTS: A consecutive,
unselected series of 158 outpatient cases (88 women, 70 men; mean age, 64y) of
herpes zoster of the head and limbs. INTERVENTIONS: Not applicable. MAIN OUTCOME 
MEASURES: Blink reflex and electromyography and motor and sensory nerve
conduction velocities of nerves and muscles corresponding to affected dermatomes.
RESULTS: Postherpetic neuralgia (PHN), segmental zoster paresis, and
polyneuropathy were found in 31%, 19%, and 2.5% of cases, respectively. Absence
or reduction of sensory action potential amplitudes, blink reflex areas, and
compound muscle action potential amplitudes were found in 60%, 31%, and 18% of
cases, respectively. Sensory and motor conduction velocities and motor and blink 
reflex latencies were nearly always normal or only slightly slowed.
Electromyographic signs of abnormal spontaneous activity were found in 36% of the
cases. Electrophysiologic alterations were correlated among themselves, with age,
with presence of segmental zoster paresis, and with absence of antiviral therapy.
The extent of the skin rash (number of dermatomes affected by herpes zoster) was 
the only variable predictive of disappearance or improvement of PHN. CONCLUSIONS:
Sensory axonal neuropathy, often associated with similar motor involvement, can
be shown by classical electrophysiologic methods in herpes zoster. The severity
of damage to motor fibers was related to damage to sensory fibers, but no
relation was found between peripheral axon damage and PHN. The site of motor
system damage may be the ventral roots, plexus, or peripheral nerve. The
probability of complications and the severity of sensory and motor peripheral
axonal damage were increased in older patients. Appropriate antiviral therapy
seems to reduce the incidence of segmental zoster paresis and the severity of
damage to the peripheral fibers. A reduced extent of herpetic rash was the only
factor to correlate with a good outcome of PHN.

PMID: 12235600 [PubMed - indexed for MEDLINE]

2334: J Neurol Neurosurg Psychiatry. 2002 Oct;73(4):457-8.

Amelioration of spinal myoclonus with levetiracetam.

Keswani SC, Kossoff EH, Krauss GL, Hagerty C.

Publication Types: 
    Case Reports
    Letter

PMID: 12235322 [PubMed - indexed for MEDLINE]

2335: J Dermatol Sci. 2002 Sep;29(3):201-5.

Expression of inducible nitric oxide synthase in skin lesions of acute herpes
zoster.

Lim YJ, Chang SE, Choi JH, Sung KJ, Bahk JH, Do SH, Lee DS.

Department of Anesthesiology and Clinical Research Institute, Seoul National
University Hospital, 28 Yongon-dong, Chongno-gu, 110-744 Seoul, South Korea.

Histopathologically, the skin lesions of acute herpes zoster (AHZ) are
characterized by epidermal necrotic vesicles with inflammation. Nitric oxide (NO)
is generated from L-arginine by nitric oxide synthase (NOS), and immune
inflammation involves the activation of NOS in both effector cells and target
cells. NO can cause apoptosis and necrosis of target cells such as keratinocytes.
We proposed that a large burst of NO in AHZ may cause the epidermal necrosis.
Skin biopsies were taken from 13 patients with AHZ. The expression of
inducible-type NOS (iNOS) was examined by immunoperoxidase staining and reverse
transcription-polymerase chain reaction (RT-PCR). In the skin specimen of AHZ,
moderate-to-strong staining for iNOS was observed in inflammatory cells and
necrotic keratinocytes, while weak staining was observed in non-necrotic
peripheral keratinocytes. RT-PCR using skin specimen of AHZ corroborated the
immunoperoxidase findings, yielding bright bands for iNOS. Normal control skin
showed minimal or negative expression both by immunoperoxidase stains and RT-PCR.
Increased expression of iNOS is consistent with the hypothesis that high level of
NO induced by iNOS may be associated with the epidermal necrosis with
inflammation seen in the skin lesions of AHZ.

PMID: 12234710 [PubMed - indexed for MEDLINE]

2336: Duodecim. 2002;118(6):645-7.

[Necrosis of the nose tip]

[Article in Finnish]

Pitkaranta A, Hytonen M.

HYKS:n korva-, nena ja kurkkutautien klinikka PL 220, 00029 Helsinki.
anne.pitkaranta@hus.fi

Publication Types: 
    Case Reports

PMID: 12233008 [PubMed - indexed for MEDLINE]

2337: J Infect Dis. 2002 Oct 1;186(7):888-94. Epub 2002 Sep 13.

The molecular epidemiology of varicella-zoster virus: evidence for geographic
segregation.

Quinlivan M, Hawrami K, Barrett-Muir W, Aaby P, Arvin A, Chow VT, John TJ,
Matondo P, Peiris M, Poulsen A, Siqueira M, Takahashi M, Talukder Y, Yamanishi K,
Leedham-Green M, Scott FT, Thomas SL, Breuer J.

Department of Medical Microbiology, School of Medicine, Queen Mary College,
London, United Kingdom.

Of 75 varicella-zoster virus (VZV) isolates obtained from patients in Africa,
Asia, and the Far East, 74 (98.6%) were found to be positive for a BglI
restriction site in gene 54. By contrast, <22% of strains from patients in the
United Kingdom and in North and South America were positive for the BglI
restriction site. Viruses positive for BglI were significantly more common in
zoster occurring in patients of nonwhite origin (P<.05). Irrespective of the
country in which the sample was obtained, 98% of strains positive for BglI
clustered within a single phylogenetic group, which we termed "group A"; the
exception was 1 strain that appeared to be recombinant genotype C/A. We used the 
BglI site to examine both the spread of type A viruses in the United Kingdom and 
the patterns of VZV infections within persons from different ethnic groups who
grew up in the United Kingdom or abroad.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 12232828 [PubMed - indexed for MEDLINE]

2338: Clin Evid. 2002 Jun;(7):738-46.

Update in:
    Clin Evid. 2003 Jun;(9):890-900.

Postherpetic neuralgia.

Lancaster T, Wareham D, Yaphe J.

Department of Primary Health Care University of Oxford, Oxford, UK.

Publication Types: 
    Comparative Study
    Review

PMID: 12230700 [PubMed - indexed for MEDLINE]

2339: J Eur Acad Dermatol Venereol. 2002 Jul;16(4):357-60.

Varicella zoster viraemia during herpes zoster is not associated with neoplasia.

Bezold G, Lange M, Pillekamp H, Peter RU.

Department of Dermatology, University of Ulm, Germany.

BACKGROUND: Shingles are caused by an endogenous or exogenous reinfection with
varicella zoster virus (VZV). Up to 50% of individuals with Hodgkin's disease
develop herpes zoster; however, no association could be shown between the
occurrence of herpes zoster and underlying subclinical malignancies. OBJECTIVE:
This study was conducted to investigate whether VZV DNA could be detected by
polymerase chain reaction (PCR) in the blood of herpes zoster patients and
whether there was an association between VZV viraemia and previous or concurrent 
neoplasias. METHODS: At least five blood samples from 28 patients with herpes
zoster were investigated by internally controlled PCR enzyme-linked immunosorbent
assay prior to and during therapy with aciclovir. RESULTS: None of 13 patients,
two with a history of neoplasia and two with a neoplasia at the time of the
study, showed any signs of viraemia with VZV, and 14 patients had inconsistent
viraemia, one with a history of neoplasia and two with neoplasia at the time of
the study. In one patient VZV DNA was detected in the blood for 6 days. This
patient died soon after from metastatic malignant melanoma. CONCLUSIONS: VZV
viraemia may occur during herpes zoster episodes, even in patients without
evidence of immunosuppression; however, this viraemia is, in most cases,
inconsistent and does not provide any specific information concerning underlying 
unrecognized malignancies.

Publication Types: 
    Comparative Study

PMID: 12224692 [PubMed - indexed for MEDLINE]

2340: Eur J Ophthalmol. 2002 Jul-Aug;12(4):267-75.

Corneal epithelial keratitis in herpes zoster ophthalmicus: "delayed" and "sine
herpete". A non-contact photomicrographic in vivo study in the human cornea.

Tabery HM.

Department of Ophthalmology, Malmo University Hospital, Sweden.
helena.tabery@oftal.mas.lu.se

PURPOSE: To investigate the origin of corneal epithelial keratitis occurring
without accompanying herpes zoster ophthalmicus (HZO) cutaneous rash. METHODS:
Corneal epithelial lesions in seven patients (four with a history of classical
HZO with cutaneous rash, one of herpes zoster oticus, and two with no history of 
herpes zoster, were examined with the slit lamp and photographed by non-contact
in vivo photomicrography. The findings were compared with lesions in classical
acute HZO. Polymerase chain reaction (PCR) was done in three patients. RESULTS:
Slit lamp appearance, morphology at higher magnification, and kinetics of the
lesions were indistinguishable from classical acute HZO. PCR was positive for
varicella-zoster virus DNA in all three samples. CONCLUSIONS: The findings
strongly suggest that HZO typical corneal epithelial lesions occurring in the
absence of cutaneous rash are in fact recurrent episodes of virus shedding.

Publication Types: 
    Case Reports
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 12219995 [PubMed - indexed for MEDLINE]

2341: Clin J Pain. 2002 Sep-Oct;18(5):297-301.

The lidocaine patch 5% effectively treats all neuropathic pain qualities: results
of a randomized, double-blind, vehicle-controlled, 3-week efficacy study with use
of the neuropathic pain scale.

Galer BS, Jensen MP, Ma T, Davies PS, Rowbotham MC.

Pain Clinical Research, University of Washington Multidisciplinary Pain Center,
Seattle Washington, USA. galer.bradley@endo.com

BACKGROUND: Several controlled clinical trials have demonstrated the efficacy and
safety of the lidocaine patch 5% (LP) for the treatment of postherpetic neuralgia
(PHN). OBJECTIVE: To assess the effects of the LP on distinct neuropathic pain
qualities common to all neuropathic pain conditions, the authors analyzed data
from one of the vehicle-controlled trials in which the Neuropathic Pain Scale
(NPS), the only assessment tool specifically designed to measure the distinct
components of neuropathic pain, was administered. METHODS AND RESULTS: To improve
the sensitivity of the NPS to treatment effects, only patients who, at the time
of enrollment in the study, reported moderate-to-severe pain on the NPS (as
defined by a score > or =4/10 reported for at least 6 of the 10 individual NPS
items) were included in the analysis. Thus, 96 patients were included in this
analysis. After a 3-week, vehicle-controlled study, LP improved all assessed pain
qualities to a greater extent than the placebo patch, as measured by the NPS 10, 
a sum score including all 10 NPS item scores ( = 0.043), and an NPS 8 score,
which included scores for all 8 pain descriptors, excluding "unpleasantness" and 
"global intensity" ( = 0.042). Separate analysis of all 8 items believed not to
reflect allodynia (NPS NA; excluding "skin sensitivity" and "surface pain") also 
demonstrated superiority ( = 0.022), as did analysis of the subitems that are
believed not to be primarily related to peripheral pathophysiological events (the
"NPS 4": "sharp," "hot," "dull," and "deep" pains; = 0.013). CONCLUSIONS: This
study demonstrates that LP reduces the intensity of all common neuropathic pain
qualities and thus may be of potential benefit for nonallodynic neuropathic pain 
states. Furthermore, these findings suggest that peripheral mechanisms may play a
role in the pathophysiological development of pain qualities that heretofore have
been assumed not to involve peripheral mechanisms, such as "dull," "deep,"
"sharp," and "burning" pains.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 12218500 [PubMed - indexed for MEDLINE]

2342: Mod Pathol. 2002 Sep;15(9):914-22.

Histologic and in situ viral findings in the myocardium in cases of sudden,
unexpected death.

Cioc AM, Nuovo GJ.

Department of Pathology, Ohio State University Medical Center, Columbus, Ohio
43210, USA.

The purpose of this study was to do in situ viral detection in myocardial tissues
of individuals who suffered sudden unexpected death and to correlate the results 
with the postmortem histopathologic findings. Thirteen cases were identified and 
the heart tissues were analyzed for adenovirus, cytomegalovirus, Epstein Barr
virus, herpes simplex virus 1 and 2, human immunodeficiency virus 1 (HIV-1),
influenza A, influenza B, parvovirus, rotavirus, picornavirus (including separate
primers for enterovirus and Coxsackie virus A and B), varicella zoster virus, and
respiratory syncytial virus. Thirteen individuals aged 2 to 67 years were
studied. In each case, polymerase chain reaction-amplified viral RNA was detected
in situ: Coxsackie virus B (5 cases), rotavirus (4 cases), HIV-1 (2 cases),
influenza A (1 case), and influenza B (1 case). Immunohistochemical detection of 
viral proteins was found in the five Coxsackie virus cases and four rotavirus
cases. The mononuclear inflammatory infiltrate was diffuse and marked only in the
cases of influenza A and HIV-1, as well as one of the Coxsackie virus and
rotavirus cases, respectively. Immunohistochemical analysis showed that the most 
common cell type in the inflammatory infiltrates was CD68-positive macrophages.
Direct myocyte infection was most prominent in the cases of Coxsackie virus
infection. In summary, in situ viral detection was documented in each case of
idiopathic myocarditis associated with sudden, unexpected death; in 6/13 cases,
the myocarditis was focal and minimal. Although Coxsackie virus was, as expected,
the most common virus noted, other viruses including rotavirus and HIV-1 were
also observed, highlighting the need for comprehensive viral and histologic
analyses in such cases.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12218208 [PubMed - indexed for MEDLINE]

2343: Lancet Oncol. 2002 Sep;3(9):523.

Vaccination with varicella protects against zoster infection.

Ahmad K.

Publication Types: 
    News

PMID: 12217782 [PubMed - indexed for MEDLINE]

2344: Rheumatol Int. 2002 Sep;22(5):213-5. Epub 2002 Jul 16.

Comment in:
    Rheumatol Int. 2005 Mar;25(2):152-3.

Pulmonary alveolar microlithiasis after Varicella zoster infection in a patient
presenting with antiphospholipid syndrome and discoid lupus.

Yilmaz MI, Koc B, Kantarcioglu M, Akinci SB, Ayta H, Bulucu F, Bal S.

Department of Internal Medicine, Gulhane School of Medicine, 06018 Etlik, Ankara,
Turkey. mahmutiyilmaz@yahoo.com

We present a case with diagnosis of pulmonary alveolar microlithiasis that
illustrates the appearance of this rare chronic lung disease on conventional
chest X-ray, high-resolution CT, and transbronchial lung biopsy. This is the
first case reported which developed pulmonary alveolar microlithiasis after
Varicella zoster infection in a patient with antiphospholipid antibodies and
discoid lupus.

Publication Types: 
    Case Reports

PMID: 12215869 [PubMed - indexed for MEDLINE]

2345: Arch Ophthalmol. 2002 Sep;120(9):1219-22.

Intravitreal antivirals in the management of patients with acquired
immunodeficiency syndrome with progressive outer retinal necrosis.

Scott IU, Luu KM, Davis JL.

Bascom Palmer Eye Institute, PO Box 016880, Miami, FL 33101, USA.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12215102 [PubMed - indexed for MEDLINE]

2346: Arch Ophthalmol. 2002 Sep;120(9):1183-8.

A relationship between varicella-zoster virus-specific delayed hypersensitivity
and varicella-zoster virus-induced anterior uveitis.

Kezuka T, Sakai J, Minoda H, Takeuchi M, Keino H, Streilein JW, Usui M.

Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University,
1163, Tate-machi, Hachioji-city, Tokyo, 193-8639, Japan. tkezuka@tokyo-med.ac.jp

BACKGROUND: We recently reported that acute retinal necrosis in humans develops
in a setting where delayed hypersensitivity (DH) to the varicella-zoster virus
(VZV) antigen was absent, implying that virus-specific DH mitigates against acute
retinal necrosis. OBJECTIVE: To determine whether a similar correlation exists
for patients with anterior uveitis caused by VZV. DESIGN: Using VZV and purified 
protein derivative (PPD) antigens to evaluate DH, we skin tested patients with
acute, VZV-induced anterior uveitis (herpes zoster ophthalmicus [ZO-AU]) (n =
12), those with uveitis caused by VZV in the absence of dermatitis (zoster sine
herpete [ZSH-AU]) (n = 3), and age-matched patients whose ophthalmic herpes
zoster was unassociated with uveitis as controls (n = 7). Varicella-zoster
virus-induced anterior uveitis was diagnosed by polymerase chain reaction methods
and serum antibody titration. Serum samples were collected and analyzed for
anti-VZV antibody titers. Anterior uveitis activity was assessed clinically.
Delayed hypersensitivity skin tests were repeated in patients with zoster sine
herpete 3 months after onset, when ocular recovery had taken place. RESULTS: All 
patients with VZV-induced skin disease alone (control group) displayed intense DH
when tested with VZV and PPD antigens. By contrast, only 4 (33%) of 12 patients
with ZO-AU had a positive DH to VZV, whereas 11 (91.6%) of these patients
displayed positive PPD skin reactions. The clinical intensity of anterior uveitis
correlated negatively with VZV DH responses (P<.05). Serum anti-VZV and
anti-herpes simplex virus antibody titers were comparable in DH-positive VZV
cases and in DH-negative patients with uveitis. Patients with uveitis and ZSH-AU 
also displayed absent VZV-specific DH, although their PPD responses were normal. 
MAIN OUTCOME MEASURES: Varicella-zoster virus-specific DH, PPD-specific DH,
VZV-specific antibody titration, and intraocular pressure in patients with ZO-AU.
CONCLUSIONS: Absence (or loss) of DH reactivity to VZV antigens seems to be a
concomitant feature of VZV uveitis of high intensity, implying that
virus-specific DH may interfere with the emergence of VZV-induced anterior
uveitis, as it does for acute retinal necrosis. CLINICAL RELEVANCE: In a clinical
setting, absence of virus-specific DH to anterior uveitis caused by VZV may not
only reveal a possible pathogenic mechanism, but a negative DH response may prove
useful in diagnosing ZSH-AU in the acute stage.

Publication Types: 
    Comparative Study

PMID: 12215092 [PubMed - indexed for MEDLINE]

2347: Hunan Yi Ke Da Xue Xue Bao. 2000 Apr 28;25(2):147-8.

[Study on the etiology of herpes viral encephalitis in Changsha area]

[Article in Chinese]

Liu SP, Xiao YM, Xia ZD.

Department of Microbiology, Hunan Medical University, Changsha, 410078.

OBJECTIVE: To study the relationship between herpes viral infection and viral
encephalitis. METHODS: The cerebral spinal fluid(CSF) and sera of the patients
with viral encephalitis were detected for herpes virus-specific IgG and IgM with 
indirect fluorescent antibody assay (IFA). RESULTS: One hundred and thirty-three 
(14.4%) cases of 921 patients with viral encephalitis were diagnosed as herpes
simplex viral encephalitis, of which the maximum morbidity is under the age of
10, 9(0.98%) cases as cytomegaloviral encephalitis and 12 (1.3%) cases as
varicella-zoster viral encephalitis. CONCLUSION: Herpes simplex viruses are the
common causative agents of viral encephalitis in Changsha area, and IFA is
valuable for the diagnosis of herpes viral encephalitis.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 12212203 [PubMed - indexed for MEDLINE]

2348: Hunan Yi Ke Da Xue Xue Bao. 2000 Jun 28;25(3):310-1.

[Clinical analysis of 134 cases of herpes zoster]

[Article in Chinese]

Xie ZC.

PMID: 12212183 [PubMed - indexed for MEDLINE]

2349: Rev Med Virol. 2002 Sep-Oct;12(5):327-34.

Varicella-zoster virus latency in human ganglia.

Kennedy PG.

Glasgow University Department of Neurology, Institute of Neurological Sciences,
Southern General Hospital, Glasgow G51 4TF, Scotland, UK.
P.G.Kennedy@clinmed.gla.ac.uk

Varicella-zoster virus (VZV) is a human herpesvirus which causes varicella
(chickenpox) as a primary infection, and, following a variable period during
which it remains in latent form in trigeminal and dorsal root ganglia,
reactivates in later life to cause herpes zoster (shingles). VZV is a significant
cause of neurological disease including post-herpetic neuralgia which may be
persistent and highly resistant to treatment, and small and large vessel
encephalitis. VZV infections are more frequent with advancing age and in
immunocompromised individuals. An understanding of the mechanisms of latency is
crucial in developing effective therapies for VZV infections of the nervous
system. Such studies have been hampered by the difficulties in working with the
virus and also the lack of a good animal model of VZV latency. It is known that
the ganglionic VZV burden during latency is low. Two of the key questions that
have been addressed are the cellular site of latent VZV and the identity of the
viral genes which are transcribed during latency. There is now a consensus that
latent VZV resides predominantly in ganglionic neurons with less frequent
infection of non-neuronal satellite cells. There is considerable evidence to show
that at least five viral genes are transcribed during latency. Unlike herpes
simplex virus-1 latency, viral protein expression has been demonstrated during
VZV latency. A precise knowledge of which viral genes are expressed is crucial in
devising novel antiviral therapy using expressed genes as therapeutic targets.
Whether gene expression at both the transcriptional and translational levels is
more extensive than currently reported will require much more work and probably
new molecular technology. Copyright 2002 John Wiley & Sons, Ltd.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12211045 [PubMed - indexed for MEDLINE]

2350: Biopolymers. 2002;67(6):406-12.

FTIR spectroscopic method for detection of cells infected with herpes viruses.

Salman A, Erukhimovitch V, Talyshinsky M, Huleihil M, Huleihel M.

Department of Physics, Ben-Gurion University of the Negev, Beer-Sheva 84105,
Israel.

Microscopic FTIR spectroscopy was used to investigate the spectral differences
between normal cells in culture and cells infected with various members of the
herpes family of viruses [Herpes simplex (HSV) and Varicella zoster (VZV)]. The
main objective of this study is to evaluate the possibility of developing
microscopic FTIR spectroscopy as a sensitive assay for the detection of herpetic 
infections at their early stages. The advantage of this method over conventional 
FTIR spectroscopy is that it facilitates inspection of restricted regions of
tissue. Our results showed significant and consistent differences between all
normal and HSV or VZV infected cells that were tested. Detectable and significant
spectral differences between normal and infected cells are seen as early as 24 h 
postinfection, but the damage of the cells (cytopathic effect), caused by the
infecting virus, can be seen by optical microscope observations at only 3 days
postinfection. An impressive increase in the levels of vital cellular metabolites
was seen in the herpes virus infected cells compared to normal cells. It seems
that this spectral behavior is unique for infection with herpes viruses, because 
when these cells were infected with other viruses from different families like
retroviruses, a considerable decrease in the levels of vital cellular metabolites
was seen in infected cells compared to normal cells. Cluster analysis performed
on FTIR mass chromatography yielded 100% accuracy in classifying control
uninfected and VZV or HSV infected cells. Our data strongly support the
possibility of developing FTIR microscopy as a diagnostic method for early
detection of herpetic infections. Copyright 2002 Wiley Periodicals, Inc.

PMID: 12209448 [PubMed - indexed for MEDLINE]

2351: Int J Dermatol. 2002 Aug;41(8):528.

Recurrent herpes zoster revisited.

Burkhart CN.

Publication Types: 
    Letter

PMID: 12207778 [PubMed - indexed for MEDLINE]

2352: Emerg Med J. 2002 Sep;19(5):460.

An unusual presentation of a lumbar hernia.

Hindmarsh A, Mehta S, Mariathas DA.

Deptartment of Accident and Emergency, Broomfield Hospital, Chelmsford, CM1 7BU, 
UK.

Publication Types: 
    Case Reports

PMID: 12205008 [PubMed - indexed for MEDLINE]

2353: Prescrire Int. 2002 Aug;11(60):111-2.

Gabapentin: new indication. In postherpetic neuralgia when amitriptyline fails.

[No authors listed]

(1) Postherpetic pain is infrequent, but the incidence increases with age. (2)
The reference treatment for postherpetic pain is oral amitriptyline or
desipramine. (3) Gabapentin, an antiepileptic agent, is the first drug to be
granted specific approval in France for the treatment of postherpetic pain. (4)
In two placebo-controlled trials, gabapentin at a dose of between 1 800 and 3 600
mg/day halved the intensity of pain in about one in three patients. In
comparison, pain improved in about 50% of patients taking amitriptyline in
clinical trials. (5) Both gabapentin and amitriptyline provoke sedation, but
dizziness and peripheral oedema are more frequent on gabapentin, while atropinic 
effects predominate with amitriptyline. (6) Daily treatment is 10 times more
costly in France. (7) In practice, the standard treatment of postherpetic pain
remains oral amitriptyline or desipramine. Gabapentin is an alternative, given
its different safety profile.

PMID: 12199264 [PubMed - indexed for MEDLINE]

2354: Med J Aust. 2002 Sep 2;177(5):267-73.

10: Herpes simplex and varicella-zoster virus infections.

Dwyer DE, Cunningham AL.

Centre for Infectious Diseases and Microbiology Laboratory Service, ICPMR,
Westmead Hospital, PO Box 533, Wentworthville, NSW 2145.
dominic_dwyer@wmi.usyd.edu.au

Any new patient with suspected genital herpes should have diagnostic testing with
virus identification. Type-specific serological tests that distinguish between
antibodies for type 1 and type 2 herpes simplex virus (HSV) may be useful to
determine previous exposure but cannot be used to diagnose recurrences of genital
herpes. Initial episodes of genital herpes usually require antiviral therapy,
while recurrences may be treated with continuous antiviral suppression (if
frequent) or episodic therapy; patient counselling and education (including how
to recognise lesions) are essential. Topical or systemic therapy is available for
initial and recurrent non-genital herpes simplex. Primary varicella infection
(chickenpox) and herpes zoster (shingles) are usually diagnosed clinically, but
can be confirmed by detection of varicella-zoster virus antigens or nucleic acid 
from swabs of lesions or by antibody tests. Antiviral therapy should be
considered in chickenpox if disease is complicated or the patient is
immunocompromised. In herpes zoster, antiviral therapy should be given within 72 
hours of onset to patients aged over 50 years or with severe pain or neurological
abnormalities to reduce the likelihood and duration of postherpetic neuralgia.
The availability of effective antiviral therapy makes early diagnosis vital

Publication Types: 
    Case Reports
    Review

PMID: 12197826 [PubMed - indexed for MEDLINE]

2355: G Ital Nefrol. 2002 May-Jun;19(3):316-25.

[Herpetic viruses and renal transplantation]

[Article in Italian]

Morrone LF, Capurso D, D'Elia F, Di Paolo S, Grandaliano G, Marangi AL, Schena A,
Stallone G, Tarantino G; Gruppo di Studio Apulo-Lucano sul Trapianto Renale.

U.O. Nefrologia e Dialisi Policlinico di Bari. lfmorrone@wappi.com

Over the last few years emerging evidence indicate the involvement of herpes
viruses in the pathogenesis of several medical complications in transplanted
patients. Herpes viruses are transmitted via inter-human contact and cause a
primary infection, which commonly fails to give clinical signs and may persist
even for years in a latent state in healthy subjects. In transplanted patients,
herpes viruses may be transmitted through the transplanted organ or may be
reactivated because of the use of powerful immunosuppressive drugs. Moreover, the
persistence of immunosuppression greatly favours the clinical expression and
severity of virus infection. Thus, herpes viruses seem to be involved in both
acute and chronic deterioration of graft function, in the pathogenesis of
post-transplant lymphoproliferative disorders and Kaposi sarcoma, and even in
vessel atherosclerosis. This review will focus on relevant clinical aspects of
herpes-virus infection, namely cytomegalovirus, EBV, herpes simplex 1 and 2,
varicella zoster virus, HHV-6, HHV-7 and HHV-8, in kidney transplanted patients.

Publication Types: 
    English Abstract
    Review

PMID: 12195400 [PubMed - indexed for MEDLINE]

2356: Aust Fam Physician. 2002 Aug;31(8):696.

Antiherpes zoster treatment.

Liberman S.

Publication Types: 
    Letter

PMID: 12189656 [PubMed - indexed for MEDLINE]

2357: Zhonghua Nei Ke Za Zhi. 2002 Jul;41(7):476-9.

Mycophenolate mofetil treatment for diffuse proliferative lupus nephritis: a
multicenter clinical trial in China.

Li L, Wang H, Lin S, Et Al.

Research Institute of Nephrology, Jinling Hospital, Nanjing 210002, China Email: 
lsli1226 @ public1.ptt.js.cn

OBJECTIVE: To investigate the efficacy and side effects of mycophenolate mofetil 
(MMF) in the treatment of diffuse proliferative lupus nephritis( DPLN). METHODS: 
75 patients [13 male,62 female; age (31.0 +/- 10.1)y] with biopsy-proven active
DPLN from nine hospitals in China from Jan. 1999 to Jan. 2000 were enrolled in
this study, of whom 26 patients were refractory to conventional treatment of
steroids and cyclophosphamide. 21 patients presented with relapses and 28
patients were newly diagnosed. All the patients were treated with a combined
regimen of MMF and steroids. Patients who had severe active renal lesions were
initially given intravenous methylprednisolone followed by oral prednisone. The
initial dosage of MMF was 0.5 approximately 2.0 g/d and the administrati on
maintained at least 6 months. 38 patients had repeat renal biopsy after
treatment. SLE disease activity (SLE-DAI) score, renal active index (AI),chronic 
index(CI) and density of immunoglobulins, complement deposition was assessed
before and after MMF treatment. RESULTS: The mean starting dosage of MMF was
(1.26 +/- 0.30) g/d, it was reduced to (1.21 +/- 0.30) g/d and (0.95 +/- 0.33)
g/d at the end of the 3(rd) and 6(th) month respectively. The post-treatment Hb
level increased from (92 +/- 21) g/L to (112 +/- 28) g/L(3 mo) and (116 +/- 21)
g/L(6 mo), while proteinuria decreased from (4.24 +/- 2.66) g/d to (2.18 +/-
3.75) g/d (3 mos, P < 0.05) and (1.54 +/- 1.60) g/d( 6 mos,P < 0.01). Renal
function impairment present in some of the patients also showed marked
improvement. The proportion of patients with positive A-dsDNA antibody and
hypocomplementemia was significantly reduced after 6 months of MMF treatment.
SLE-DAI score in this group of patients decreased from (16.9 +/- 6.7) to (8.1 +/-
4.8) (P < 0.01) by the end of 3 months. Repeat renal biopsy in 38 patients 3
approximately 6 months after the treatment showed a significant decrement of AI (
13.30 +/- 5.51) vs (3.38 +/- 1.98),P < 0.01, and an increment of CI (1.62 +/-
1.48) vs (2.62 +/- 1.85), P > 0.05. Immunoglobulins and complement deposition
scores decreased from (9.39 +/- 3.51) to(6.71 +/- 3.16 ),P < 0.05. During the
study period, 12 episodes of infection (16.0%) were recorded including
pneumonia(2.7%), herpes zoster(8.0 %), urinary tract infection(2.7%), and
tuberculosis(2.7%). Other side effects included gastrointestinal symptoms
(10.7%), hirsutism(6.7%), leukocytopenia (1.3%) and transient elevation of
SGPT(2.7%). CONCLUSION: MMF in a dosage of 0.5 approximately 2.0 g/d combined
with steroids is effective to control the lupus activity of DPLN and well
tolerated by the patients.

PMID: 12189120 [PubMed - in process]

2358: Yakugaku Zasshi. 2002 Aug;122(8):527-35.

[Molecular toxicological mechanism of the lethal interactions of the new
antiviral drug, sorivudine, with 5-fluorouracil prodrugs and genetic deficiency
of dihydropyrimidine dehydrogenase]

[Article in Japanese]

Watabe T, Ogura K, Nishiyama T.

Department of Drug Metabolism and Molecular Toxicology, School of Pharmacy, Tokyo
University of Pharmacy and Life Science, 1432-1 Horinouchi, Hachioji City, Tokyo 
192-0392, Japan. watabet@ps.toyaku.ac.jp

In 1993, there were 18 acute deaths in Japanese patients who had the viral
disease herpes zoster and were treated with the new antiviral drug sorivudine
(SRV, 1-beta-D-arabinofuranosyl-(E)-5-(2-bromovinyl)uracil). All the dead
patients had received a 5-fluorouracil (5-FU) prodrug as anticancer chemotherapy 
concomitant with SRV administration. Studies on toxicokinetics in rats and on
hepatic dihydropyrimidine dehydrogenase (DPD), a rate-limiting enzyme for 5-FU
catabolism in rats and humans, strongly suggested that in the patients who
received both SRV and the 5-FU prodrug, tissue levels of highly toxic 5-FU
markedly increased as a result of irreversible inactivation of DPD in the
presence of NADPH by 5-(2-bromovinyl)uracil (BVU), a metabolite formed from SRV
by gut flora in rats and humans. Recombinant human (h) DPD was also irreversibly 
inactivated by [14C] BVU in the presence of NADPH. MALDI-TOF MS analysis of
radioactive tryptic fragments from the radiolabeled and inactivated hDPD
demonstrated that a Cys residue located at position 671 in the pyrimidine-binding
domain of hDPD was modified with an allyl bromide type of reactive metabolite,
dihydro-BVU. Thus artificial DPD deficiency caused by BVU from SRV led to patient
deaths when coadministered with the 5-FU prodrug. Human population studies using 
healthy volunteers have demonstrated that there are poor and extensive 5-FU
metabolizers who have very low and high DPD activities, respectively.
Administration of a clinical dose of 5-FU or its prodrug to poor 5-FU
metabolizers may cause death unless DPD activity is determined using their
peripheral blood mononuclear cells prior to the administration of the anticancer 
drug.

Publication Types: 
    English Abstract
    Review

PMID: 12187768 [PubMed - indexed for MEDLINE]

2359: Duodecim. 2001;117(13):1339-41.

[A persistent chest pain in a middle-aged woman]

[Article in Finnish]

Pitkapaasi M.

Riihimaen terveyskeskus Penttilankatu 5, 11100 Riihimaki.

Publication Types: 
    Case Reports

PMID: 12184122 [PubMed - indexed for MEDLINE]

2360: Drugs Aging. 2002;19(7):503-14.

Viral skin infections in the elderly: diagnosis and management.

Bansal R, Tutrone WD, Weinberg JM.

Department of Dermatology, St. Luke's-Roosevelt Hospital Center, 1090 Amsterdam
Avenue, New York, NY 10025, USA.

Over the past several years, there have been advances in the diagnosis and
treatment of cutaneous viral diseases in elderly patients. Herpes zoster is
caused by reactivation in adults of the varicella-zoster virus (VZV) that causes 
chickenpox in children. For many years, aciclovir was the gold standard of
antiviral therapy for the treatment of herpes zoster. Famciclovir and
valaciclovir are newer antivirals, which offer less frequent administration.
Postherpetic neuralgia (PHN) refers to pain lasting 2 months or more after an
acute attack of herpes zoster. The pain may be constant or intermittent. The
treatment of established PHN may include topical anaesthetics, analgesics,
tricyclic antidepressants and anticonvulsants, and nonpharmacological therapy may
be used to complement such treatment. Therapeutic strategies to prevent PHN
include the use of oral corticosteroids, nerve blocks, and treatment with
standard antiviral therapy. The three most recently discovered human herpes
viruses (HHV-6, HHV-7 and HHV-8), in common with the other members of the family,
may cause a primary infection, establish latent infection in a specific set of
cells in their host, and then reactivate if conditions of altered immunity
develop. These viruses have been associated with an array of disorders, which are
important for the clinician to recognise. Cytomegalovirus (CMV) is a member of
the herpesvirus family that is very prevalent worldwide. More than 80% of primary
infections and 20% of reactivation-producing symptoms occur in transplant
populations. Treatment options include intravenous administration of ganciclovir,
foscarnet or cidofovir. Herpes simplex virus (HSV) most commonly affects the
genital and perioral regions. In the elderly, HSV infection is typically manifest
at the vermilion border of the lip. The main concern of recurrent herpes labialis
in the elderly is related to potential autoinoculation of the eye or genital
area. Treatment with aciclovir, famciclovir or valaciclovir is indicated for
these infections. Molluscum contagiosum is caused by a poxvirus, which produces
cutaneous lesions that appear as small, firm, umbilicated papules.
Immunocompromised patients often do not respond to the usual destructive
therapies, and intravenous or topical cidofovir may be useful in these patients.

Publication Types: 
    Review

PMID: 12182687 [PubMed - indexed for MEDLINE]

2361: Bone Marrow Transplant. 2002 Apr;29(8):659-66.

Impact of high-dose chemotherapy on antigen-specific T cell immunity in breast
cancer patients. Application of new flow cytometric method.

Svane IM, Nikolajsen K, Hansen SW, Kamby C, Nielsen DL, Johnsen HE.

Department of Oncology, Herlev Hospital/University of Copenhagen, DK-2730 Herlev,
Denmark.

The present study analyses the influence of high-dose chemotherapy (HD) and
autologous stem cell transplantation on natural and vaccine-induced specific
immunity in breast cancer patients. Peripheral blood was collected from five
breast cancer patients at serial time points in connection with treatment and in 
a follow-up period of 1 year. The frequencies of CD8+ and CD4+ T cells responsive
to cytomegalovirus (CMV), varicella zoster virus (VZV), and tetanus in
antigen-activated whole blood were determined by flow cytometric analysis of
CD69, TNF alpha, IFN gamma and IL-4 expression. Mononuclear cells were labelled
with PKH26 dye and the CMV, VZV, and tetanus toxoid-specific proliferation of T
cell subpopulations was analysed by flow cytometry. In none of the patients did
the treatment result in loss of overall T cell reactivity for any of the
antigens. Prior to chemotherapy 5/5 patients possessed TNF alpha expressing T
cells specific for CMV, 4/5 for VZV, and 3/5 for tetanus. One year after stem
cell transplantation all patients possessed TNF alpha expressing T cells specific
for CMV, VZV and tetanus. The highest percentages of cytokine-responding T cells 
were seen after stimulation with CMV antigen. In general, the lowest reactivity
(close to zero) was measured in G-CSF-mobilised blood at the time of
leukapheresis. In spite of a continuously reduced CD4 to CD8 ratio after
transplantation, recovery of CD4+ T cells usually occurred prior to CD8+ recovery
and often to a higher level. The study demonstrates that natural as well as
vaccine-induced specific immunity established prior to HD can be regained after
stem cell transplantation. These data indicate that introduction of a preventive 
cancer vaccination in combination with intensive chemotherapy may be a realistic 
treatment option.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't

PMID: 12180110 [PubMed - indexed for MEDLINE]

2362: Clin Infect Dis. 2002 Sep 1;35(5):518-25. Epub 2002 Jul 31.

Comment in:
    Clin Infect Dis. 2003 Mar 1;36(5):671-2; author reply 672-3.

Markers of viral infection in monozygotic twins discordant for chronic fatigue
syndrome.

Koelle DM, Barcy S, Huang ML, Ashley RL, Corey L, Zeh J, Ashton S, Buchwald D.

Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
dedra@u.washington.edu

To estimate the prevalence of viruses associated with chronic fatigue syndrome
(CFS) and to control for genetic and environmental factors, we conducted a
co-twin control study of 22 monozygotic twin pairs, of which one twin met
criteria for CFS and the other twin was healthy. Levels of antibodies to human
herpesvirus (HHV)-8, cytomegalovirus, herpes simplex virus 1 and 2, and hepatitis
C virus were measured. Polymerase chain reaction (PCR) assays for viral DNA were 
performed on peripheral blood mononuclear cell specimens to detect infection with
HHV-6, HHV-7, HHV-8, cytomegalovirus, Epstein-Barr virus, herpes simplex virus,
varicella zoster virus, JC virus, BK virus, and parvovirus B19. To detect lytic
infection, plasma was tested by PCR for HHV-6, HHV-8, cytomegalovirus, and
Epstein-Barr virus DNA, and saliva was examined for HHV-8 DNA. For all assays,
results did not differ between the group of twins with CFS and the healthy twins.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 12173124 [PubMed - indexed for MEDLINE]

2363: Eur J Pediatr. 2002 Aug;161(8):442-4. Epub 2002 Jun 25.

Herpes zoster by reactivated vaccine varicella zoster virus in a healthy child.

Uebe B, Sauerbrei A, Burdach S, Horneff G.

Department of Paediatrics, University Hospital, Martin-Luther University
Halle-Wittenberg, 06097 Halle, Germany. barbara.uebe@medizin.uni-halle.de

Varicella can be prevented by vaccination using the live-attenuated Oka vaccine
strain of varicella zoster virus (VZV). Only mild breakthrough disease has been
reported in seronegative vaccinees when exposed to the wild-type virus. The
latent varicella vaccine virus has rarely caused herpes zoster in childhood and
adolescence. We report a healthy 2-year-old girl who developed an impressive
herpes zoster infection 16 months after vaccination, localised in three cervical 
dermatoma. As causative virus, VZV vaccine strain was identified by polymerase
chain reaction and analysis of restriction fragment length polymorphisms of the
amplified products. CONCLUSION: vaccine varicella zoster virus can occasionally
reactivate in healthy children and present as herpes zoster. Virus
characterisation is necessary to identify the strain and provide information on
the incidence of occurrence.

Publication Types: 
    Case Reports

PMID: 12172829 [PubMed - indexed for MEDLINE]

2364: Chest. 2002 Aug;122(2):715-7.

Use of endoscopic transthoracic sympathicotomy in intractable postherpetic
neuralgia of the chest.

Matsumoto I, Oda M, Shintani H.

Departments of Surgery, Komatsu Municipal Hospital, Komatsu, Japan.
naochan@f3.dion.ne.jp

Although there are various treatments for postherpetic neuralgia (PHN), none
produces definitive effects. We report a case of 72-year-old woman who developed 
intractable PHN of the chest in which treatment with endoscopic transthoracic
sympathicotomy (ETS) produced long-term effective results. When hyperesthesia of 
the sympathetic nerve participates in PHN, the blocking of sympathetic excitation
seems to be effective for PHN suppression. The method using a single resectoscope
is safe, accurate, yields excellent results cosmetically, and generates minimal
invasion and very little postoperative pain. Although ETS is not always effective
for all cases of PHN, it could be a useful method of treating patients with PHN
that is resistant to conventional therapies.

Publication Types: 
    Case Reports

PMID: 12171855 [PubMed - indexed for MEDLINE]

2365: Cytotherapy. 2001;3(3):165-73.

Infectious complications following T-cell depleted hematopoietic stem-cell
transplantation.

Novitzky N, Rouskova A.

The University of Cape Town Leukaemia Centre, Department of Haematology, Groote
Schuur Hospital, Cape Town, South Africa.

BACKGROUND: Although sepsis is a common complication during stem-cell
transplantation, the prevalence of infections after hematopoietic recovery is
less well known. METHODS: We undertook a retrospective analysis of infectious
episodes in patients who underwent allogeneic BM (n = 77) or PBSC (n = 29)
grafting from HLA identical siblings. T-cell depletion of the stem-cell grafts
with anti CD 52 (CAMPATH-1) Abs was employed for the prevention of GvHD. RESULTS:
Patients' median age was 30 (4-54) years. Antibiotic prophylaxis was with oral
amphotericin, ofloxacin and i.v. or oral acyclovir. Fever was treated empirically
with a third generation cephalosporin and aminoglucosides until results of
microbiological cultures became available. Six patients died of graft failure.
GvHD was observed in 18% but in no case was it > Grade II. Only seven patients
did not develop pyrexia during the initial admission or within 60 days following 
graft infusion. Median duration of pyrexia was 10 (range 2-49) days. A microbial 
source was detected in 42% and it was Gram (+) in 86%, Gram (-) in 11% and fungal
in 3%. In 16 patients, indwelling venous catheters were removed due to severe
infection. Subsequent to the recovery of the blood parameters, the most prevalent
infection was by herpes varicella/zoster in 20; another 17 developed herpes
simplex. In total 40/102 were re-hospitalized for pyrexia, which in four cases
was of unknown origin. Bacterial infections with Staphylococcus Aureus and S.
Epidermitis were seen in 10 and seven patients respectively. CMV was detected in 
seven patients. Thirteen patients died of sepsis and in 10, it was related to
GvHD or graft failure. Another 20 died following recurrence of the malignancy.
Overall, 39 patients died and 63% survived at a median DFS of 1992 (range
623-5092) days. DISCUSSION: We conclude that during the initial neutropenic
period the dominant infections are by Gram (+) organisms, often associated with
indwelling catheters. Once the BM has recovered, the main morbidity is by viral
infections, but Gram+ organisms still remain common bacterial pathogens.

Publication Types: 
    Clinical Trial

PMID: 12171723 [PubMed - indexed for MEDLINE]

2366: J Commun Dis. 2001 Jun;33(2):130-5.

Presentations of cranial nerve involvement in two patients with Herpes zoster
ophthalmicus.

Sodhi PK, Goel JL.

Maulana Azad Medical College and Allied Guru Nanak Eye Centre, New Delhi-110 002,
India.

Two cases of Herpes zoster ophthalmicus complicated by motor nerve palsies are
being reported. The investigations ruled out other diseases which can affect
ocular motor nerves, e.g., diabetes, hypertension, syphilis and malignancy. The
cases are being reported because of the rare presentations of Herpes zoster
ophthalmicus like isolated internal ophthalmoplegia and VI nerve palsy in Case-1 
and absence of iritis with third nerve involvement in Case-2. The probable
etiology for occurrence of these uncommon phenomena has been postulated.

Publication Types: 
    Case Reports

PMID: 12170933 [PubMed - indexed for MEDLINE]

2367: Otol Neurotol. 2002 Jul;23(4):602-7.

Detection of varicella zoster virus DNA in tear fluid and saliva of patients with
Ramsay Hunt syndrome.

Hiroshige K, Ikeda M, Hondo R.

Department of Otolaryngology, Nihon University School of Medicine, 30-1 Oyaguchi,
Itabashi-ku, Tokyo 173-8610, Japan.

OBJECTIVE: To clarify the dynamics of the reactivation of the varicella zoster
virus in Ramsay Hunt syndrome. SUBJECTS AND METHODS: Varicella zoster virus DNA
in the tear fluid, submandibular gland saliva, and parotid gland saliva of 15
patients with Ramsay Hunt syndrome was studied. The presence of varicella zoster 
virus DNA was detected quantitatively by the use of polymerase chain reaction and
a microplate hybridization method. RESULTS: Of 102 specimens of the tear fluid
and saliva collected from 15 patients, varicella zoster virus DNA was detected in
40 specimens (39%) from 12 patients (80%). The detection rate was 72% in the
submandibular saliva, 57% in the parotid saliva, and 27% in the tear fluid.
Varicella zoster virus DNA was detected not only in specimens from the affected
side but also in specimens from the unaffected side at the same rate of
detection, and at nearly the same number of DNA copies. Regarding the parotid
saliva, varicella zoster virus DNA was detected in samples collected at an early 
stage of the disease. In the tear fluid and submandibular saliva, however, the
detection rate was high in samples collected 2 weeks after the onset of disease
or later. CONCLUSIONS: Secretion of varicella zoster virus DNA into the tear
fluid and saliva was confirmed in the patient with Ramsay Hunt syndrome. The
increase and decrease in the detection rate and the number of varicella zoster
virus DNA copies detected in samples collected at different times was considered 
to substantiate varicella zoster virus reactivation in Ramsay Hunt syndrome.
Varicella zoster virus reactivation was thought to occur in the unaffected side
at the same level as in the affected side, and some of the secreted varicella
zoster virus DNA was suspected to be derived from the ganglion trigeminale.

Publication Types: 
    Case Reports

PMID: 12170168 [PubMed - indexed for MEDLINE]

2368: Masui. 2002 Jul;51(7):777-9.

[A case of effective treatment with clonidine ointment for herpetic neuralgia
after bone marrow transplantation in a child]

[Article in Japanese]

Hagihara R, Meno A, Arita H, Hanaoka K.

Department of Anesthesiology and Pain Relief Center, The University of Tokyo
Hospital, Tokyo 113-8655.

We report a case of effective treatment with clonidine ointment for herpetic
neuralgia in a child. Clonidine hydrochloride is an alpha 2-agonist. It is
generally administered intravenously, intramuscularly, intrathecally and orally. 
However, there have been only a few reports on transdermal usage. In our
department, we have investigated the analgesic effect of topical application of
clonidine in adults, and we have obtained sufficient evidence on the effects of
clonidine. Therefore, we decided to use clonidine to a child. A 9-year-old child 
who had undergone BMT and developed herpes zoster was experiencing severe pain,
itch, and insomnia. Many drugs were ineffective in relieving the pain, itch, and 
insomnia. To remove the symptoms, we tried clonidine ointment. Immediate
improvement was observed in all the symptoms. Therefore, clonidine ointment was
thought to be effective and we decided to prescribe clonidine ointment and
amitriptyline hydrochloride. The application of clonidine showed no side effects 
such as bradycardia and low blood pressure. We conclude that clonidine can be
administered to children without causing side effects.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12166288 [PubMed - indexed for MEDLINE]

2369: Surv Ophthalmol. 2002 Jul-Aug;47(4):297-334.

Comment in:
    Surv Ophthalmol. 2003 Mar-Apr;48(2):242; author reply 242-3.

Management of traumatic hyphema.

Walton W, Von Hagen S, Grigorian R, Zarbin M.

Institute of Ophthalmology and Visual Science, New Jersey Medical School, Newark,
New Jersey 01701-1709, USA.

Hyphema (blood in the anterior chamber) can occur after blunt or lacerating
trauma, after intraocular surgery, spontaneously (e.g., in conditions such as
rubeosis iridis, juvenile xanthogranuloma, iris melanoma, myotonic dystrophy,
keratouveitis (e.g., herpes zoster), leukemia, hemophilia, von Willebrand
disease, and in association with the use of substances that alter platelet or
thrombin function (e.g., ethanol, aspirin, warfarin). The purpose of this review 
is to consider the management of hyphemas that occur after closed globe trauma.
Complications of traumatic hyphema include increased intraocular pressure,
peripheral anterior synechiae, optic atrophy, corneal bloodstaining, secondary
hemorrhage, and accommodative impairment. The reported incidence of secondary
anterior chamber hemorrhage, that is, rebleeding, in the setting of traumatic
hyphema ranges from 0% to 38%. The risk of secondary hemorrhage may be higher in 
African-Americans than in whites. Secondary hemorrhage is generally thought to
convey a worse visual prognosis, although the outcome may depend more directly on
the size of the hyphema and the severity of associated ocular injuries. Some
issues involved in managing a patient with hyphema are: use of various
medications (e.g., cycloplegics, systemic or topical steroids, antifibrinolytic
agents, analgesics, and antiglaucoma medications); the patient's activity level; 
use of a patch and shield; outpatient vs. inpatient management; and medical vs.
surgical management. Special considerations obtain in managing children, patients
with hemoglobin S, and patients with hemophilia. It is important to identify and 
treat associated ocular injuries, which often accompany traumatic hyphema. We
consider each of these management issues and refer to the pertinent literature in
formulating the following recommendations. We advise routine use of topical
cycloplegics and corticosteroids, systemic antifibrinolytic agents or
corticosteroids, and a rigid shield. We recommend activity restriction (quiet
ambulation) and interdiction of non-steroidal anti-inflammatory agents. If there 
is no concern regarding compliance (with medication use or activity
restrictions), follow-up, or increased risk for complications (e.g., history of
sickle cell disease, hemophilia), outpatient management can be offered.
Indications for surgical intervention include the presence of corneal blood
staining or dangerously increased intraocular pressure despite maximum tolerated 
medical therapy, among others.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12161209 [PubMed - indexed for MEDLINE]

2370: Ophthalmology. 2002 Aug;109(8):1532-7.

Visual outcome in herpes simplex virus and varicella zoster virus uveitis: a
clinical evaluation and comparison.

Miserocchi E, Waheed NK, Dios E, Christen W, Merayo J, Roque M, Foster CS.

Immunology and Uveitis Service, Department of Ophthalmology, Massachusetts Eye
and Ear Infirmary, Harvard Medical School, Boston 02114, USA.

PURPOSE: To compare clinical characteristics and outcomes in patients with
uveitis caused by herpes simplex virus (HSV) and varicella zoster virus (VZV).
DESIGN: Retrospective comparative study. PARTICIPANTS: Forty patients with HSV
uveitis and 24 patients with VZV uveitis. METHODS: A retrospective study of 40
patients with HSV and 24 patients with VZV uveitis was performed. The patients
were followed between May 1987 and September 1999 (median follow-up time, 46
months). The diagnosis of HSV uveitis was made clinically and serologically, and 
the diagnosis of VZV uveitis was made clinically. MAIN OUTCOME MEASURES: Clinical
presentation of the disease, ocular complications, visual acuity, surgical and
medical treatments needed. RESULTS: Both populations were comparable for gender
and age at disease onset. The course of the disease tended to be remitting and
recurrent in HSV patients and chronic in VZV patients (P = 0.046). The most
frequent ocular complication in both groups was secondary glaucoma (54% HSV, 38% 
VZV). Twenty-five percent of VZV patients developed posterior pole complications 
(cystoid macular edema, epiretinal membrane, papillitis, retinal fibrosis, and
detachment) compared with 8% of HSV patients (P = 0.069). Treatment modalities
selected were generally similar in the two groups, although periocular and
systemic steroids were required more frequently in HSV patients (60% versus 25%; 
P = 0.01). Surgical procedures were required with similar frequency in both
populations. The percentage of eyes that were legally blind at end of follow-up
was also comparable (HSV, 20%; VZV, 21%). The visual outcome was similar in the
studied populations. CONCLUSIONS: This study represents the only direct
comparison of HSV and VZV uveitis patients reported in the literature. HSV
patients were more likely to be treated with periocular and systemic steroids,
and VZV patients were more likely to develop posterior pole complications (a
finding of borderline significance). Other parameters evaluated in this study
were not statistically different in the two patient groups.

Publication Types: 
    Comparative Study

PMID: 12153807 [PubMed - indexed for MEDLINE]

2371: N Engl J Med. 2002 Aug 1;347(5):340-6.

Comment in:
    N Engl J Med. 2003 May 15;348(20):2044-5; author reply 2044-5.    N Engl J Med. 2003 May 15;348(20):2044-5; author reply 2044-5.

Clinical practice. Herpes zoster.

Gnann JW Jr, Whitley RJ.

Departments of Medicine, University of Alabama at Birmingham, Birmingham, Ala
35294-2170, USA.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 12151472 [PubMed - indexed for MEDLINE]

2372: Obstet Gynecol. 2002 Aug;100(2):260-5.

Frequency of congenital varicella syndrome in a prospective cohort of 347
pregnant women.

Harger JH, Ernest JM, Thurnau GR, Moawad A, Thom E, Landon MB, Paul R, Miodovnik 
M, Dombrowski M, Sibai B, Van Dorsten P, McNellis D; National Institute of Child 
Health and Human Development Network of Maternal-Fetal Medicine Units.

University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
jharger@pitt.edu

OBJECTIVE: To estimate the rate of congenital varicella zoster virus syndrome in 
neonates born to women developing varicella zoster virus infections during
pregnancy. METHODS: Pregnant women with clinical varicella zoster virus infection
were enrolled at ten perinatal centers. Maternal and fetal immunoglobulin (Ig) G 
and IgM by fluorescent antibody confirmed 74.3% of cases. Specialists examined
neonates at 0-6 months, 7-18 months, and 19-30 months after delivery to detect
abnormalities of their eyes, hearing, and physical and developmental features. A 
hierarchical set of criteria was used to define congenital varicella syndrome. A 
jury of four investigators assigned the classification of all findings. RESULTS: 
In 362 women enrolled from 1993 to 1996, 15 had herpes zoster, and 347 had
primary varicella zoster virus infection. Varicella zoster virus affected 140
women (38.7%) in the first trimester, 122 (33.7%) in the second trimester, and
100 (27.6%) in the third trimester. Five twin pairs were included. Only one case 
(0.4%) of definite congenital varicella syndrome was found, a 3360-g female
infant having a left retinal macular lesion with typical skin scars after
maternal varicella at 24 weeks. The maternal blood sample at birth was negative
for IgG antibodies to toxoplasmosis and cytomegalovirus. Two cases involved fetal
death at 20 weeks and fetal hydrops at 17 weeks after maternal varicella at 11
and 5 weeks, respectively. We found no cases of limb hypoplasia, microcephalus,
or cataract. CONCLUSION: The frequency of congenital varicella syndrome is very
low (0.4%) in a prospectively studied cohort. Eye examinations of exposed infants
had a low yield.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 12151147 [PubMed - indexed for MEDLINE]

2373: Lancet Infect Dis. 2002 Aug;2(8):454.

Varicella vaccination reduces risk of herpes zoster.

Quirk M.

Publication Types: 
    News

PMID: 12150833 [PubMed - indexed for MEDLINE]

2374: Curr Womens Health Rep. 2002 Aug;2(4):253-8.

TORCH Infections. Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus
B19), Rubella, Cytomegalovirus (CMV), and Herpes infections.

Stegmann BJ, Carey JC.

Department of OB/GYN, Phoenix Integrated Residency in OB/GYN, Maricopa Medical
Center, 2601 E. Roosevelt, Phoenix, AZ 85008, USA. E mail: BJStegmann@aol.com

Perinatal infections account for 2% to 3% of all congenital anomalies. TORCH,
which includes Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19),
Rubella, Cytomegalovirus (CMV), and Herpes infections, are some of the most
common infections associated with congenital anomalies. Most of the TORCH
infections cause mild maternal morbidity, but have serious fetal consequences,
and treatment of maternal infection frequently has no impact on fetal outcome.
Therefore, recognition of maternal disease and fetal monitoring once disease is
recognized are important for all clinicians. Knowledge of these diseases will
help the clinician appropriately counsel mothers on preventive measures to avoid 
these infections, and will aid in counseling parents on the potential for adverse
fetal outcomes when these infections are present.

Publication Types: 
    Review

PMID: 12150751 [PubMed - indexed for MEDLINE]

2375: Anesth Analg. 2002 Aug;95(2):503.

Frontal and nasal nerve blocks in the treatment of severe pain in acute
ophthalmic zoster.

Gain P, Thuret G, Chiquet C, Navez ML, Pascal J.

Publication Types: 
    Clinical Trial
    Letter

PMID: 12145092 [PubMed - indexed for MEDLINE]

2376: Anesth Analg. 2002 Aug;95(2):503; author reply 503-4.

Comment on:
    Anesth Analg. 2001 Nov;93(5):1111-5.

ACEI and renal function after vascular surgery.

Gayatri P.

Publication Types: 
    Clinical Trial
    Comment
    Letter

PMID: 12145091 [PubMed - indexed for MEDLINE]

2377: J Am Acad Dermatol. 2002 Aug;47(2 Suppl):S177-9.

Herpes zoster of the penis: an unusual location for a common eruption.

Spray A, Glaser DA.

Department of Dermatology, St. Louis University School of Medicine, MO 63104,
USA.

Herpes zoster is an acute vesiculobullous eruption estimated to affect 10% to 20%
of the population. The diagnosis usually can be based on clinical features alone,
but laboratory studies may be needed for definitive diagnosis, particularly in
atypical presentations.

Publication Types: 
    Case Reports

PMID: 12140455 [PubMed - indexed for MEDLINE]

2378: J Am Acad Nurse Pract. 2002 Jul;14(7):297-303; quiz 304-6.

Herpes zoster ophthalmicus: how is it identified and treated?

Temple JJ.

Northern Pines Orthopaedic Clinic, Grand Rapids, Minnesota, USA.
Temple@medscape.com

PURPOSE: To describe herpes zoster ophthalmicus in relation to the anatomy,
pathophysiology, course, diagnostic considerations, and management for the
primary care provider. DATA SOURCES: Actual case study supplemented with an
extensive review of current scientific and psychosocial literature. CONCLUSIONS: 
Herpes zoster ophthalmicus (HZO) is an extension of a herpes zoster (HZ)
infection involving the fifth cranial (trigeminal) nerve, which results from the 
reactivation of a latent varicella virus among individuals who had contracted a
varicella infection sometime within their lifespan. IMPLICATIONS FOR PRACTICE:
Due to the vague presenting symptomology of HZO, many patients may be
misdiagnosed lessening the chance for prompt diagnosis and therapeutic
intervention. Educational awareness, listening to psychosocial concerns of the
patients, and immediate referral can decrease potential chronic side effects of
the disorder.

Publication Types: 
    Case Reports
    Review

PMID: 12138524 [PubMed - indexed for MEDLINE]

2379: Drug Resist Updat. 2002 Apr;5(2):88-114.

Resistance of herpesviruses to antiviral drugs: clinical impacts and molecular
mechanisms.

Gilbert C, Bestman-Smith J, Boivin G.

Research Center in Infectious Diseases, Centre Hospitalier Universitaire de
Quebec and Laval University, Quebec City, Canada.

Nucleoside analogues such as acyclovir and ganciclovir have been the mainstay of 
therapy for alphaherpesviruses (herpes simplex virus (HSV) and varicella-zoster
virus (VZV)) and cytomegalovirus (CMV) infections, respectively. Drug-resistant
herpesviruses are found relatively frequently in the clinic, almost exclusively
among severely immunocompromised patients receiving prolonged antiviral therapy. 
For instance, close to 10% of patients with AIDS receiving intravenous
ganciclovir for 3 months excrete a drug-resistant CMV isolate in their blood or
urine and this percentage increases with cumulative drug exposure. Many studies
have reported that at least some of the drug-resistant herpesviruses retain their
pathogenicity and can be associated with progressive or relapsing disease. Viral 
mutations conferring resistance to nucleoside analogues have been found in either
the drug activating/phosphorylating genes (HSV or VZV thymidine kinase, CMV UL97 
kinase) and/or in conserved regions of the viral DNA polymerase. Currently
available second line agents for the treatment of herpesvirus infections--the
pyrophosphate analogue foscarnet and the acyclic nucleoside phosphonate
derivative cidofovir--also inhibit the viral DNA polymerase but are not dependent
on prior viral-specific activation. Hence, viral DNA polymerase mutations may
lead to a variety of drug resistance patterns which are not totally predictable
at the moment due to insufficient information on specific drug binding sites on
the polymerase. Although some CMV and HSV DNA polymerase mutants have been found 
to replicate less efficiently in cell cultures, further research is needed to
correlate viral fitness and clinical outcome. Copyright 2002 Elsevier Science
Ltd.

Publication Types: 
    Review

PMID: 12135584 [PubMed - indexed for MEDLINE]

2380: Neurol India. 2002 Jun;50(2):228-9.

Disseminated zoster with polyneuritis cranialis and motor radiculopathy: letter
to editor.

Mehta J, Mahajan V, Khanna S.

Publication Types: 
    Case Reports
    Letter

PMID: 12134202 [PubMed - indexed for MEDLINE]

2381: Zhonghua Yi Xue Za Zhi. 2002 Jun 25;82(12):796-801.

[A randomized control trial of mycophenolate mofeil treatment in severe IgA
nephropathy]

[Article in Chinese]

Chen X, Chen P, Cai G, Wu J, Cui Y, Zhang Y, Liu S, Tang L.

Department of Nephrology General Hospital of Chinese PLA, Beijing 100853,China.

OBJECTIVE: To investigate the effectiveness safety and tolerance of mycophenolate
mofeil(MMF) in severe IgA nephropathy and evaluate the dosage adjustment and
course for clinical treatment. METHODS: 62 patients with IgA nephropathy
diagnosed by renal biopsy as Lee's grade IV and V with urinary protein > 2.0 g/d 
were enrolled randomly in the trial. The initial dosage of MMF was 1.0 g/d (body 
weight < 50 kg) or 1.5 g/d (body weight > 50 kg). The dosage was reduced to 0.75 
approximately 1.0 g/d after 6 months treatment, the maintaining dosage was 0.5
approximately 0.75 g/d after 12 months. The total course of treatment lasted at
least 12 months. Another 31 patients matched with age gender and severity of
renal damage were given prednisone orally (0.8mg(;)kg(;)d) (control group).Blood 
and urinary tests hepatic and renal function plasma albumin serum triglyceride
and cholesterol 24 h protein excretion urinary NAG enzyme, creatinine
clearance(Ccr) were performed before and 3 6 12 18 months after treatments in
both groups 5 patients in MMF group received repeated renal biopsy. RESULTS: (1) 
After 3 months treatment, decrease of urinary protein (1.9 g/24 h +/- 1.6 g/24 h 
vs 3.2 g/24 h +/- 1.7 g/24 h, P < 0.01) and improvement of plasma albumin (41 g/L
+/- 6 g/L vs 37 g/L +/- 6 g/L, P < 0.01) were observed in MMF groups while in
control group, no significant changes were found in uinary protein (2.3 g/24 h
+/- 1.8 g/24 h vs 2.9 g/24 h +/- 1.5 g/24 h, P < 0.05) and plasma albumin (40 g/L
+/- 6 g/L vs 37 g/L +/- 6 g/L, P < 0.05). After treatment for 6, 12 and 18
months, both group showed obvious alleviation of proteinuria and albumin. At the 
12th and 18th month, the proteinuria in MMF group was significantly improved than
that in control group (0.8 g/24 h +/- 0.8 g/24 h vs 1.4 g/24 h +/- 1.6 g/24 h and
0.6 g/24 h +/- 0.7 g/24 h vs 1.4 g/24 h +/- 1.3 g/24 h, P < 0.05 respectively).
The remission rate and total effective rate of MMF group were higher than those
of the control group (44.4% vs 19.1% and 88.9% vs 61.9%, P < 0.05 respectively). 
Patients were administered with MMF for 13.8 +/- 6.3 months (6 approximately 30
m). (2) Serum cholesterol and triglyceride were remarkably reduced after 6,12 and
18 months treatment in MMF group, no significant difference was found in control 
group(P < 0.05). (3) For the 6 patients with renal insufficiency in MMF group,
MMF treatment was significantly effective in 1 patient, effective in 2 patients, 
not effective in 3 patients with an overall effective rate of 50%. For the 7
patients with renal insufficiency in control group, the treatment was
significantly effective in 1 patient, effective in 1 patient, not effective in 5 
patients and total effective rate is 28.6%. (4) 5 patients in MMF group received 
repeated renal biopsy after 7 approximately 12 months treatment (mean 9.8 +/- 2.3
m). The results showed that the interstitial lesions were alleviated. No special 
drug-induced renal damage was obtained. (5) Side effects: 3 patients in MMF group
suffered from slight diarrhea, 1 patient herpes zoster, all of them got remission
without drug withdrawal. 1 patient suffered nausea in the first weeks. No
significant change was found in hepatic function (P > 0.05). CONCLUSIONS: MMF is 
more effective in reducing proteinuria and serum lipid than the currently
widespread use of prednisone therapy in IgA nephropathy patients with Lee SMK's
grade IV approximately V and urinary protein > 2.0 g/d. Treatment with MMF
associates with less adverse effect and good tolerance.

Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 12126522 [PubMed - indexed for MEDLINE]

2382: J Assoc Physicians India. 2002 Jul;50:977-8.

Granulomatous angiitis of the central nervous system associated with herpes
zoster.

Bhat G, Mathur DS, Saxena GN, Jain S, Singh AP, Bhaduria D.

Department of Medicine, SMS Medical College, Jaipur.

Granulomatous angiitis of central nervous system (CNS) is a rare inflammatory
disease of blood vessels mostly confined to CNS. We describe a case which
presented with right sided hemiplegia with aphasia, after herpes zoster
ophthalmicus. CT scan and MRI brain showed a large left sided infarct in the left
middle cerebral artery (MCA) territory. MRI angiography revealed narrowing and
thinning of left internal carotid artery (ICA) and to a lesser extent, left MCA
suggestive of granulomatous vasculitis. Herpes zoster is often associated with
major CNS involvement and a vascular etiology was previously postulated. Recent
pathological reports suggest that cerebral angiitis secondary to herpes virus
infection may be more common than realised.

Publication Types: 
    Case Reports

PMID: 12126361 [PubMed - indexed for MEDLINE]

2383: J Dermatol. 2002 Jun;29(6):391-3.

IL-12 in varicella zoster and herpes simplex virus infection.

Horiuchi Y, Nishioka K.

Publication Types: 
    Letter

PMID: 12126082 [PubMed - indexed for MEDLINE]

2384: J Dermatol. 2002 Jun;29(6):339-42.

Wolf's isotopic response: a case of zosteriform lichen planus.

Turel A, Ozturkcan S, Sahin MT, Turkdogan P.

Department of Dermatology, Medical Faculty of Celal Bayar University, Manisa,
Turkiye.

Lichen planus is a lichenoid disorder characterized by shiny, flat papules. In
addition to the classical appearance, there are several variants. Zonal or
zosteriform lesions have been described. A 25-year-old male with a complaint of
increasing numbers of erythematous swellings on his left groin for twenty days
was admitted to our out-patient clinic. He had a history of herpes zoster in the 
same localization which had been treated with topical acyclovir two weeks prior
to his admission. Dermatological examination revealed multiple, shiny,
erythematous, umblicated papules localized to the left inguinal region in a
linear pattern. A biopsy was taken from the lesions. According to the clinical
and pathological findings the diagnosis was zosteriform lichen planus.
Zosteriform lichen planus is a rare variant of lichen planus; its differentiation
from zona zoster and other linear dermatoses is difficult. We presented our case 
because of its rarity as a variant of lichen planus and its appearance in the
area of healed herpes zoster as an isotopic response.

Publication Types: 
    Case Reports

PMID: 12126068 [PubMed - indexed for MEDLINE]

2385: Ann Dermatol Venereol. 2002 May;129(5 Pt 1):708-15.

[Valaciclovir]

[Article in French]

Lebrun-Vignes B.

Service de Pharmacologie, Centre Regional de Pharmacovigilance, Groupe
Hospitalier Pitie-Salpetriere, 47, boulevard de l'Hopital, 75013 Paris, France.
benedicte.lebrun-vignes@psl.ap-hop-paris.fr

Valaciclovir is an aciclovir pro-drug considerably improving its oral
availability. Its antiviral activity in vivo is related to that of aciclovir, the
principle target of which is the herpes virus. Following digestive absorption,
valaciclovir is rapidly transformed into aciclovir. The mean absolute
bioavailability of aciclovir is of 54.2% after a single oral dose of 1,000 mg of 
valaciclovir, i.e., a bioavailability 3 to 5-fold greater than after oral
ingestion of aciclovir. The plasma pharmacokinetic profile of valaciclovir and
aciclovir observed in volunteers infected by HIV is superimposable on that of
healthy subjects. In elderly patients, exposure to aciclovir is enhanced,
probably because of the alteration in glomerular filtration. In patients
exhibiting agranulocytosis following poly-chemotherapy, the pharmacokinetic
parameters are superimposable on those observed in healthy patients. In patients 
with hepatic failure, there appears no need to adapt the dose, since exposure to 
aciclovir does not appear altered. However, the dose of valaciclovir must be
adapted to renal function. During the first-episode of herpes genitalis,
valaciclovir, at the dose of 500 or 1,000 mg twice daily, is as effective as 200 
mg of aciclovir five times per day. In recurrent herpes genitalis, 500 mg twice
daily of valaciclovir is as effective as 1,000 mg twice daily or 200 mg five
times a day of aciclovir. Valaciclovir prevents recurrence herpes genitalis with 
a dose-dependent effect, and doses of 500 and 1,000 mg/day are as effective as
400 mg twice daily of aciclovir. There are few studies on the efficacy of
valaciclovir in the treatment of oro-facial herpes. In the treatment of herpes
zoster in patients aged over 50, the principle benefit provided by valaciclovir
at the dose of 1,000 mg twice daily, is the decrease in the percentage of
patients presenting post-zoster pain and its duration. High doses of valaciclovir
(8 capsules/day) provide efficient prevention of infections related to the
cyto-megalo-virus (CMV) in immunodepressed patients due to HIV infection or
following renal transplantation. Tolerance to valaciclovir, like its active
metabolite aciclovir, is generally good. Central neurological toxicity is
frequently observed with high doses, but regresses on withdrawal. The official
indications in France are the curative and preventive treatment of herpes
genitalis infections, the prevention of post-zoster pain and the ocular
complications of ophthalmologic herpes in immunocompetent adults, and the
prevention of CMV infections after organ grafting.

Publication Types: 
    English Abstract
    Review

PMID: 12124513 [PubMed - indexed for MEDLINE]

2386: Prog Transplant. 2002 Jun;12(2):116-24.

Posttransplant viral syndromes in pediatric patients: a review.

Pearlman LS.

Hospital for Sick Children, Toronto, Ontario.

The success of pediatric solid organ transplantation has been largely due to
advancements in surgical techniques, technology, and preoperative and
postoperative care. Potent immunosuppression continues to reduce the incidence
and severity of rejection, and improve long-term survival. However, there is
growing awareness of the role immunosuppression plays in contributing to the
incidence of cytomegalovirus, Epstein-Barr virus, and Epstein-Barr
virus-associated posttransplant lymphoproliferative disease. Herpes viruses such 
as these present as primary or recurrent disease and continue to be a significant
source of morbidity and mortality in transplant recipients. This paper reviews
the predictors of disease, clinical features, diagnosis, and methods of treatment
of these major posttransplant viral syndromes. As part of the human herpes virus 
family, varicella-zoster virus will also be discussed. A case study shows the
delicate balance of treating concomitant varicella infection at the time of
transplantation.

Publication Types: 
    Review

PMID: 12123172 [PubMed - indexed for MEDLINE]

2387: J Am Geriatr Soc. 2002 Jul;50(7 Suppl):S226-9.

Antimicrobial resistance and aging: beginning of the end of the antibiotic era?

Yoshikawa TT.

Department of Internal Medicine, Charles R. Drew University of Medicine and
Science, Los Angeles, California, USA. toyoshik@cdrewu.edu

Throughout the history of mankind, infectious diseases have remained a major
cause of death and disability. Although industrialized nations, such as the
United States, have experienced significant reductions in infection-related
mortality and morbidity since the beginning of the "antibiotic era," death and
complications from infectious diseases remain a serious problem for older
persons. Pneumonia is the major infection-related cause of death in older
persons, and urinary tract infection is the most common bacterial infection seen 
in geriatric patients. Other serious and common infections in older people
include intra-abdominal sepsis, bacterial meningitis, infective endocarditis,
infected pressure ulcers, septic arthritis, tuberculosis, and herpes zoster. As a
consequence, frequent prescribing of antibiotics for older patients is common
practice. The large volume of antibiotics prescribed has contributed to the
emergence of highly resistant pathogens among geriatric patients, including
methicillin-resistant Staphylococcus aureus, penicillin-resistant Streptococcus
pneumoniae, vancomycin-resistant enterococci, and multiple-drug-resistant
gram-negative bacilli. Unless preventive strategies coupled with newer drug
development are established soon, eventually clinicians will be encountering
infections caused by highly resistant pathogens for which no effective
antibiotics will be available. Clinicians could then be experiencing the same
frustrations of not being able to treat infections effectively as were seen in
the "pre-antibiotic era."

Publication Types: 
    Review

PMID: 12121517 [PubMed - indexed for MEDLINE]

2388: Dermatol Clin. 2002 Apr;20(2):267-82.

Clinical manifestations of varicella-zoster virus infection.

Chen TM, George S, Woodruff CA, Hsu S.

Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.

Infections by VZV, the virus that causes chickenpox and herpes zoster, usually
are diagnosed by the classic clinical presentations. In immunocompromised
patients, however, the atypical presentation can make the diagnosis more
challenging. Although varicella typically follows an uncomplicated course in
children, adults and immunocompromised patients can develop complications
involving several organs; some complications may be fatal. Prevention of disease 
with the vaccine is ideal. When varicella or zoster infection does occur, proper 
treatment should be initiated, depending on the age and immune status of the
patient.

Publication Types: 
    Review

PMID: 12120440 [PubMed - indexed for MEDLINE]

2389: Semin Pediatr Infect Dis. 2002 Jan;13(1):12-21.

Antiviral therapy for varicella and herpes zoster.

Arvin AM.

Department of Pediatrics and Microbiology and Immunology, Stanford University
School of Medicine, CA 94305, USA. aarvin@stanford.edu

Varicella-zoster virus (VZV) causes 2 clinical illnesses, varicella (chickenpox) 
and herpes zoster (shingles). The purpose of this review is to describe the role 
of antiviral therapy in the treatment of VZV infections in healthy and
immunocompromised children. Acyclovir is the drug of choice for varicella and
herpes zoster. The route of administration may be intravenous or oral, depending 
on the immunocompetence of the host. The clinical impact of acyclovir therapy is 
related directly to its use early in the clinical course and to the likely
susceptibility of the patient to severe or life-threatening VZV infection.
Patients who have the most clinical benefit are otherwise healthy adolescents
with varicella infection and high-risk populations of immunocompromised children 
who have varicella or herpes zoster. The morbidity and mortality of VZV
infections are reduced substantially by initiating acyclovir treatment early in
the course of the disease.

Publication Types: 
    Review

PMID: 12118839 [PubMed - indexed for MEDLINE]

2390: Mayo Clin Proc. 2002 Jul;77(7):624-8.

Comment in:
    Mayo Clin Proc. 2002 Jul;77(7):619-21.    Mayo Clin Proc. 2004 Aug;79(8):1087.

Detection of vaccinia virus, herpes simplex virus, varicella-zoster virus, and
Bacillus anthracis DNA by LightCycler polymerase chain reaction after
autoclaving: implications for biosafety of bioterrorism agents.

Espy MJ, Uhl JR, Sloan LM, Rosenblatt JE, Cockerill FR 3rd, Smith TF.

Division of Clinical Microbiology, Mayo Clinic, Rochester, MN 55905, USA.

OBJECTIVE: To determine whether autoclaving suspensions of vaccinia virus, herpes
simplex virus (HSV), varicella-zoster virus (VZV), and Bacillus anthracis
inactivate infectivity of these agents but allow detection of target DNA by
LightCycler polymerase chain reaction (PCR). MATERIAL AND METHODS: Swabs were
inserted into tubes containing serial 10-fold dilutions (10(-1) to 10(-5); 500
microL; 6 samples per dilution) of vaccinia virus, HSV, VZV, or a single
suspension of 10(8) colony-forming units of B anthracis (2 samples). One half of 
the samples were autoclaved, and the remainder were not. An aliquot of each not
autoclaved sample served as a control for infectivity. RESULTS: Autoclaving swabs
saturated with suspensions of vaccinia virus, HSV, or VZV eliminated the
infectivity of these agents; however, DNA was detectable in most autoclaved
samples in dilutions of 10(-1) to 10(-4) by LightCycler PCR. All not autoclaved
specimens were detected by culture (infectivity) except for VZV and, in most
dilutions of 10(-1) to 10(-3), by assay of target DNA by LightCycler PCR.
Similarly positive results were obtained for PCR assessment of sporulated B
anthracis. CONCLUSIONS: Standard autoclaving procedures eliminated the
infectivity of viruses (and B anthracis), but target DNA was often retained for
detection by LightCycler PCR. Current recommendations indicate that the
laboratory diagnosis of smallpox virus infection be performed only within
Biosafety Level 4 facilities. We suggest that, in addition to the requirement for
immediate coordination with public health officials, the federal government
consider expanding the existing guidelines for processing these specimens to
encourage immediate collection, autoclaving, and testing by LightCycler PCR to
differentiate smallpox virus from other dermal pathogens such as HSV and VZV by
specific qualified laboratories.

PMID: 12108599 [PubMed - indexed for MEDLINE]

2391: Aten Primaria. 2002 Jun 15;30(1):68-9.

[Treatment of post-herpetic neuralgia with colorpuncture]

[Article in Spanish]

Calvo Sanz JM.

Publication Types: 
    Case Reports
    Letter

PMID: 12106582 [PubMed - indexed for MEDLINE]

2392: J Infect. 2002 May;44(4):220-5.

Varicella: a vaccine preventable disease?

Watson B.

Department of Pediatrics, Albert Einstein Hospital, Division of Disease Control, 
Philadelphia Department of Public Health, PA, USA. barbara.watson@phil.gov

OBJECTIVES: To present a review of varicella disease, vaccine development and
implementation of universal vaccination, discuss common questions about the
vaccine and the epidemiology of the disease since licensure of the varicella
vaccine. METHODS: Review the incidence of complications from varicella disease
prior to vaccine licensure, safety of the varicella vaccine from clinical trials 
and post-marketing surveillance data, the impact of the vaccine on disease
incidence where high vaccine coverage has been achieved, and address some
barriers to vaccination. Raise issues that developed since 1995. RESULTS: The
safety data gathered during the 20-year-gestation period of this vaccine prior to
licensure has been confirmed. The vaccine works-in areas where vaccine coverage
is over 70%, there has been a decline in disease, most marked in the age group
with the best vaccine coverage (the 1-4-year olds), leading to a concern that
unexposed susceptible children may reach adulthood and remain susceptible unless 
better practice of universal vaccination of ALL susceptible is practiced.
CONCLUSIONS: Varicella disease has declined in areas with moderate vaccine
coverage. Continued implementation of existing vaccine policies will lead to
further reductions of varicella morbidity and mortality throughout the USA.
Copyright 2002 The British Infection Society.

PMID: 12099727 [PubMed - indexed for MEDLINE]

2393: J Infect. 2002 May;44(4):211-9.

The effect of vaccination on the epidemiology of varicella zoster virus.

Edmunds WJ, Brisson M.

Immunisation Division, Colindale, London NW9 5EQ, UK. jedmunds@phls.org.uk

Varicella zoster virus (VZV) causes chickenpox (varicella) on primary exposure
and can reactivate later in life to cause shingles (zoster). As primary infection
is more serious in adults than children, and exposure to the virus might boost
the immune response to both chickenpox and shingles, there are two main concerns 
regarding infant VZV vaccination: that it could lead to an increase in adult
disease; and/or that it could lead to a temporary increase in the incidence of
shingles. This paper reviews the evidence for such outcomes. The consensus view
of mathematical modelling studies is that the overall varicella associated burden
is likely to decrease in the long term, regardless of the level of vaccine
coverage. On the other hand, recent evidence suggests that an increase in zoster 
incidence appears likely, and the more effective vaccination is at preventing
varicella, the larger the increase in zoster incidence. Targeted vaccination of
susceptible adolescents and/or the contacts of high-risk individuals can be
effective at preventing disease in these individuals with minimal risk to the
community. However, targeted strategies would not prevent most disease (including
most severe disease), and will not lead to a long-term reduction in the incidence
of zoster. Understanding the mechanisms for maintaining immunity against
varicella and zoster is critical for predicting the long-term effects of
vaccination. Meanwhile sensitive surveillance of both chickenpox and shingles is 
essential in countries that have implemented, or are about to implement,
varicella vaccination. Copyright 2002 The British Infection Society.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 12099726 [PubMed - indexed for MEDLINE]

2394: Pain. 2002 Jul;98(1-2):119-26.

Relief of post-herpetic neuralgia by surgical removal of painful skin.

Petersen KL, Rice FL, Suess F, Berro M, Rowbotham MC.

Department of Neurology, UCSF Pain Clinical Research Center, University of
California-San Francisco, 1701 Divisadero Street, Suite 480, San Francisco, CA
94115, USA. klp@itsa.ucsf.edu

We present a case of longstanding PHN treated by skin excision of the area of
greatest pain (11.3 x 26.0 cm(2)). The operation reduced pain, eliminated tactile
allodynia, and facilitated greatly reduced medication use over a 1-year follow-up
period. Fourteen punch biopsies and 10 strips of skin (each 10 mm long) from the 
excised painful PHN skin were qualitatively assessed by double-label
immunofluorescence using antibodies against protein-gene-product 9.5 (PGP9.5),
200 kDa neurofilament protein (NF), calcitonin gene-related peptide (CGRP) and
vanilloid receptor-1 (VR-1). Compared with a punch biopsy from mirror image skin,
the pattern of cutaneous innervation in PHN skin was consistently and
substantially different. The results may explain the anatomical basis of the
capsaicin-response test and have implications for our understanding of clinical
mechanisms underlying PHN pain.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12098623 [PubMed - indexed for MEDLINE]

2395: Arch Ophthalmol. 2002 Jul;120(7):989-90.

Necrotizing herpetic retinopathy associated with Ramsay Hunt syndrome.

Verm AM, Scott IU, Davis JL.

Bascom Palmer Eye Institute, 900 NW 17th St, Miami, FL 33136, USA.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12096978 [PubMed - indexed for MEDLINE]

2396: Arch Ophthalmol. 2002 Jul;120(7):960-2.

ELVIS: a new 24-hour culture test for detecting herpes simplex virus from ocular 
samples.

Kowalski RP, Karenchak LM, Shah C, Gordon JS.

Charles T. Campbell Ophthalmic Microbiology Laboratory,University of Pittsburgh
Medical Center, Pittsburgh, PA, USA. kowalskirp@msx.upmc.edu

OBJECTIVE: To compare ELVIS (Enzyme Linked Virus Inducible System) (BioWhittaker,
Walkersville, Md), a new, simple, 24-hour cell culture test for detecting herpes 
simplex virus (HSV), with standard cell culture and Herpchek (NEN, Boston, Mass) 
for detecting HSV in ocular specimens. METHODS: Retrospectively, 36 true-positive
frozen-stock ocular samples that were cell-culture positive for HSV, and 25
true-negative samples (varicella-zoster virus, adenovirus, Pseudomonas
aeruginosa, Staphylococcus aureus, and Streptococcus viridans) were tested with
ELVIS. Herpchek was processed at the time of initial clinical laboratory testing.
Prospectively, 422 patients were tested for HSV with standard cell culture,
ELVIS, and Herpchek. The sensitivity, specificity, positive and negative
predictive values, and efficacy of ELVIS based on positive and negative cell
cultures were determined. RESULTS: Retrospectively, ELVIS was 86.1% sensitive
(31/36), 100% specific (25/25), and 91.8% efficient (56/61). The positive
predictive value was 100% (31/31), and the negative predictive value was 83.3%
(25/30). The sensitivity of ELVIS was equivalent to Herpchek (80.5%, 29/36) (P
=.53). Prospectively, the sensitivity of ELVIS (84.8%, 28/33) was equivalent to
that of Herpchek (84.8%, 28/33). CONCLUSIONS: ELVIS is an easy HSV diagnostic
test that can provide faster positive culture results than standard cell culture,
and it is equally sensitive but less time-consuming than Herpchek.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12096968 [PubMed - indexed for MEDLINE]

2397: N Engl J Med. 2002 Jul 4;347(1):26-34.

Comment in:
    N Engl J Med. 2002 Nov 14;347(20):1624-5; author reply 1624-5.    N Engl J Med. 2002 Nov 14;347(20):1624-5; author reply 1624-5.

Use of an inactivated varicella vaccine in recipients of hematopoietic-cell
transplants.

Hata A, Asanuma H, Rinki M, Sharp M, Wong RM, Blume K, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford, Calif
94305-5208, USA.

BACKGROUND: The reactivation of varicella-zoster virus from latency causes zoster
and is common among recipients of hematopoietic-cell transplants. METHODS: We
randomly assigned patients who were scheduled to undergo autologous
hematopoietic-cell transplantation for non-Hodgkin's or Hodgkin's lymphoma to
receive varicella vaccine or no vaccine. Heat-inactivated, live attenuated
varicella vaccine was given within 30 days before transplantation and 30, 60, and
90 days after transplantation. The patients were monitored for zoster and for
immunity against varicella-zoster virus for 12 months. RESULTS: Of the 119
patients enrolled, 111 received a transplant. Zoster developed in 7 of 53
vaccinated patients (13 percent) and in 19 of 58 unvaccinated patients (33
percent) (P=0.01). After two patients in whom zoster developed before
transplantation were excluded, the respective rates were 13 percent and 30
percent (P=0.02). In vitro CD4 T-cell proliferation in response to
varicella-zoster virus (expressed as the mean stimulation index) was greater in
patients who received the vaccine than in those who did not at 90 days, after
three doses (P=0.04); at 120 days, after all four doses (P<0.001); at 6 months
(P=0.004); and at 12 months (P=0.02). The risk of zoster was reduced for each
unit increase in the stimulation index above 1.6; a stimulation index above 5.0
correlated with greater than 93 percent protection. Induration, erythema, or
local pain at the injection site was observed in association with 10 percent of
the doses. CONCLUSIONS: Inactivated varicella vaccine given before
hematopoietic-cell transplantation and during the first 90 days thereafter
reduces the risk of zoster. The protection correlates with reconstitution of CD4 
T-cell immunity against varicella-zoster virus.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 12097537 [PubMed - indexed for MEDLINE]

2398: Clin Microbiol Rev. 2002 Jul;15(3):439-64.

Spectrum of Kaposi's sarcoma-associated herpesvirus, or human herpesvirus 8,
diseases.

Ablashi DV, Chatlynne LG, Whitman JE Jr, Cesarman E.

Advanced Biotechnologies Inc., Columbia, Maryland 21046,USA.
dablashi@abionline.com

Human herpesvirus 8 (HHV-8), also known as Kaposi's sarcoma-associated
herpesvirus (KSHV), discovered in 1994, is a human rhadinovirus (gamma-2
herpesvirus). Unlike other human herpesviruses (herpes simplex virus,
Epstein-Barr virus, varicella-zoster virus, cytomegalovirus, HHV-6, and HHV-7),
it is not widespread in the general population and has many unique proteins.
HHV-8 is strongly associated with all subtypes of Kaposi's sarcoma (KS),
multicentric Castleman's disease, and a rare form of B-cell lymphoma, primary
effusion lymphoma. In addition, HHV-8 DNA sequences have been found in
association with other diseases, but the role of the virus in these diseases is
largely unconfirmed and remains controversial. The seroprevalence of HHV-8, based
on detection of latent and lytic proteins, is 2 to 5% in healthy donors except in
certain geographic areas where the virus is endemic, 80 to 95% in classic KS
patients, and 40 to 50% in HIV-1 patients without KS. This virus can be
transmitted both sexually and through body fluids (e.g., saliva and blood). HHV-8
is a transforming virus, as evidenced by its presence in human malignancies, by
the in vitro transforming properties of several of its viral genes, and by its
ability to transform some primary cells in culture. It is not, however,
sufficient for transformation, and other cofactors such as immunosuppressive
cytokines are involved in the development of HHV-8-associated malignancies. In
this article, we review the biology, molecular virology, epidemiology,
transmission, detection methods, pathogenesis, and antiviral therapy of this
newly discovered human herpesvirus.

Publication Types: 
    Review

PMID: 12097251 [PubMed - indexed for MEDLINE]

2399: J Antimicrob Chemother. 2002 Jul;50(1):5-9.

Bicyclic pyrimidine nucleoside analogues (BCNAs) as highly selective and potent
inhibitors of varicella-zoster virus replication.

Balzarini J, McGuigan C.

Rega Institute for Medical Research, K. U. Leuven, B-3000 Leuven, Belgium.
Jan.Balzarini@rega.kuleuven.ac.be

Bicyclic pyrimidine nucleoside analogues (BCNAs) represent highly potent and
selective inhibitors of varicella-zoster virus (VZV) replication in cell culture.
The compounds inhibit a variety of clinical VZV strains, in the higher picomolar 
range, whilst being non-toxic at micromolar concentrations. The compounds do not 
inhibit the closely related simian varicella virus or any other viruses,
including herpes simplex virus type 1 (HSV-1), HSV-2 and cytomegalovirus. The
BCNAs owe at least part of their antiviral selectivity to a specific
activation/phosphorylation by the VZV-encoded thymidine kinase (TK) and
associated thymidylate kinase (dTMP-K) activity, while being not recognized by
the closely related HSV-1-encoded TK/dTMP-K enzyme. In addition, the
5'-monophosphates of BCNAs are neither a substrate nor an inhibitor of the
cellular dTMP-K, and are not subject of back-conversion to the corresponding
nucleosides by 5'-deoxynucleotidases. In contrast to the anti-HSV-1/VZV drug
(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU), the BCNAs are not catabolized by
human (erythrocyte) or bacterial (Escherichia coli) thymidine phosphorylase to
release the free bicyclic pyrimidine base. Also, unlike BVU (the free base of
BVDU), the BCNA bases do not inhibit dihydropyrimidine dehydrogenase.
Consequently, the catabolism of the anticancer drug 5-fluorouracil (5-FU) is not 
influenced by the BCNA base in cell-free enzyme assays or in mice that were
exposed to combinations of 5-FU with BCNAs or their free base. BCNAs have a good 
oral bioavailability and, owing to their highly lipophilic nature, are assumed to
be able to cross the blood-brain barrier efficiently. Given the above-mentioned
favourable properties, BCNAs may represent a promising novel class of highly
selective anti-VZV drugs that should be further pursued for clinical application.

Publication Types: 
    Review

PMID: 12096000 [PubMed - indexed for MEDLINE]

2400: Eur J Dermatol. 2002 Jul-Aug;12(4):370-2.

Erythema multiforme after resolution of herpes zoster by acyclovir.

Onishi I, Kishimoto S.

Department of Dermatology, Kyoto Min-iren Central Hospital, 16-1
Nishinokyo-Kasuga-cho, Nakagyo-ku, Kyoto 604-8453, Japan.

Publication Types: 
    Case Reports

PMID: 12095886 [PubMed - indexed for MEDLINE]

2401: Drugs Aging. 2002;19(5):343-54.

Prophylaxis of herpesvirus infections in immunocompetent and immunocompromised
older patients.

Fillet AM.

Virology Department, Pitie-Salpetriere Hospital and University, 83 Boulevard de
l'Hopital, 75651 Paris, Cedex 13, France. anne-marie.fillet@psl.ap-hop.paris.fr

In older patients, prophylaxis of herpesvirus infections mainly involves
preventing the recurrence of herpes simplex virus (HSV) and complications of
herpes zoster in immunocompetent patients, while in immunocompromised patients it
is more concerned with the prevention of opportunistic virus reactivation. HSV
ocular infection is the most frequent cause of corneal blindness in the US. The
effectiveness of aciclovir 400mg twice daily in preventing the recurrence of HSV 
eye disease in immunocompetent patients has been well demonstrated. The issue of 
treatment duration for patients with highly recurrent ocular herpes remains
unresolved. Post-herpetic neuralgia (PHN) is one of the most common neuralgic
illnesses worldwide. Some progress in prevention of PHN has been made with a
combination of antiviral therapy (famciclovir or valaciclovir), started within 72
hours of onset of the rash, and analgesic treatment. However, the best prevention
of PHN is the prevention of herpes zoster disease, and the varicella vaccine is
an option which over the next few years will be tested in clinical trials. For
immunocompromised patients of any age, restoring immunity prevents herpesvirus
disease, as demonstrated for cytomegalovirus (CMV) in AIDS patients receiving
highly active antiretroviral therapy. Specific antiviral therapy during the
initial period after transplantation could prevent reactivation of HSV or CMV in 
seropositive recipients. Whether pre-emptive therapy or prophylaxis with
ganciclovir is the optimal approach against CMV remains controversial, and the
relative merits and limitations of each approach may guide the choice. In stem
cell transplantation, pre-emptive therapy with foscarnet avoids the neutropenia
and related complications associated with ganciclovir. In renal transplant
recipients, universal prophylaxis of CMV infection with valaciclovir has the same
efficacy as ganciclovir. Although it is relatively toxic, cidofovir should be
further evaluated because of its in vitro activity against most DNA viruses.

Publication Types: 
    Review

PMID: 12093321 [PubMed - indexed for MEDLINE]

2402: J Clin Virol. 2002 Jul;25 Suppl 1:S87-94.

Herpesviruses and enteroviruses in infections of the central nervous system: a
study using time-resolved fluorometry PCR.

Hukkanen V, Vuorinen T.

Department of Virology, University of Turku, Kiinamyllynkatu 13, FIN-20520 Turku,
Finland. veijo.hukkanen@utu.fi

BACKGROUND: Polymerase chain reaction (PCR) is becoming the new standard for
virological diagnosis of the infections of the central nervous system (CNS).
Varicella-zoster virus (VZV) has been considered as the leading cause of viral
meningitis or encephalitis in Finland, herpes simplex viruses (HSV) and
enteroviruses being the next common causative agents. OBJECTIVES: To elucidate
the roles of viruses in infections of the CNS by use of novel, sensitive
time-resolved fluorescence (TRF) PCR assays. STUDY DESIGN: We have utilized TRF
PCR assays for diagnostics of HSV, VZV, human cytomegalovirus (CMV) and
enteroviruses in infections of the CNS. When relevant, we have also applied virus
culture and CSF IgM antibody determinations to elucidate the involvement of other
viruses in the CNS infections. The material consisted of CSF samples from
hospitals in Western Finland, submitted for diagnostic testing for CNS viral
infections during the years 2000-2001. A total of 922 CSF samples were tested by 
PCR. RESULTS: The PCR assays yielded the virological diagnosis in 72 cases
whereas only 24 samples were positive by virus culture or CSF IgM antibody
assays. Enteroviruses were found in 6.8%, VZV in 5.8% and HSV in 4.6% of the
studied CSF samples. The virus culture and CSF antibody tests yielded 0.5-3.2%
positive findings. CONCLUSIONS: The PCR assays of CSF specimens are most
effective for the virological diagnosis of CNS infections. In our study, HSV was 
the most common causative agent, whereas the diagnostic power of TRF-PCR test was
highest for enteroviruses.

Publication Types: 
    Comparative Study

PMID: 12091086 [PubMed - indexed for MEDLINE]

2403: J Clin Virol. 2002 Jul;25 Suppl 1:S79-85.

Diagnosis of herpesvirus infections of the central nervous system.

Aberle SW, Puchhammer-Stockl E.

Institute of Virology, University of Vienna, Austria, Kinderspitalgasse 15,
A-1095 Vienna, Austria.

BACKGROUND: Human herpesviruses may cause infections of the central nervous
system (CNS). The early diagnosis of herpesvirus-associated neurological diseases
is of high importance. OBJECTIVES: The objective of this paper is to summarize
the experience gained with the diagnosis of herpesvirus infections of the CNS at 
our institute by polymerase chain reaction (PCR)-based assays within the past few
years. STUDY DESIGN: A retrospective analysis of herpesvirus desoxy ribonucleic
acid (DNA)-positive cerebrospinal fluid (CSF) samples was performed, with
particular emphasis on data obtained by quantification of virus DNA in CSF by
newly established real-time quantitative PCR assays. RESULTS: Herpesviruses were 
found in 26.6% of all virus-positive CSF samples detected at our institute
between 1995 and 2001. The overall broad testing for different herpesviruses from
CSF has led to an increase in the detection rate, especially in relation to
varicella zoster virus (VZV)-associated CNS disease. The herpesvirus DNA load in 
CSF was investigated by TaqMan real-time PCR assays that were established for the
individual herpesviruses. The amount of virus varied among the individual
diseases, associated with herpes simplex virus type 1, herpes simplex virus type 
2, VZV and cytomegalovirus, while for Epstein-Barr virus and human herpesvirus
type 6 only low levels of virus were detectable in CSF. CONCLUSIONS: A generally 
broad testing for different herpesviruses in CSF samples is highly recommended.
In addition, determination of the virus DNA level in CSF by quantitative assays
seems to be of high importance for elucidating aspects concerning the prognosis
of disease, the prediction of distinct CNS manifestations, and possibly the
differentiation between specific virus-associated disease and unspecific presence
of virus in CSF, especially in immunocompromised patients.

PMID: 12091085 [PubMed - indexed for MEDLINE]

2404: J Clin Virol. 2002 Jul;25 Suppl 1:S71-8.

Herpes Consensus PCR test: a useful diagnostic approach to the screening of viral
diseases of the central nervous system.

Calvario A, Bozzi A, Scarasciulli M, Ventola C, Seccia R, Stomati D, Brancasi B.

Virology Laboratory, Hygiene, Epidemiology and Public Health Department,
Policlinico, P.za G. Cesare, 11-70124 Bari, Italy. m.quarto@igiene.uniba.it

BACKGROUND: Infections of the central nervous system (CNS) are a difficult
diagnostic problem for both clinicians and microbiologists. Various clinical
signs, such as encephalitis, myelitis, meningitis, may be associated with
herpesviruses. The use of multiplex 'Herpes Consensus' polymerase chain reaction 
(HC-PCR) in association with nested PCR (nPCR), in addition to classical
techniques, made it possible to optimise the management of cerebrospinal fluid
(CSF) and serum samples from patients affected by these viral diseases of the
CNS. OBJECTIVES: To test by HC-PCR by nPCR and cell culture the CSF and sera from
patients with viral infections of the CNS. STUDY DESIGN: We analysed 320 CFS, 154
serum samples and 11 various samples from 286 patients with clinically suspected 
encephalitis, meningitis or other diseases of the CNS by HC-PCR, nPCR and
traditional investigations (cell culture and serological tests). RESULTS: On
molecular analysis with the HC-PCR test, 51 CFS samples (15.9%) were positive for
at least one of the six target Herpes viruses: fourteen for Herpes simplex 1
(HSV-1), seven for HSV-2, 12 for Cytomegalovirus (CMV; one of which was from an
HIV-positive patient), five for Epstein-Barr virus (EBV; four of which were from 
HIV-positive patients), three for Varicella-Zoster virus (VZV), five for Human
Herpes virus type 6 (HHV-6), three for HSV-1 with HHV-6 co-infection (two cases) 
and HSV-2 co-infection (one case), and two for HHV-6 with CMV or EBV co-infection
(both from patients with immune deficiency). A further 12 samples were positive
in nPCR for HHV-7 (8), ADV (1), Enterovirus (1), HSV-1 (1), EBV (1). Of the 154
serum samples, 17 (11.0%) tested positive by HC-PCR for HSV-1 (4), HSV-2 (1),
CMV(1), EBV(1), VZV(3) or HHV-6(6), 1 with co-HSV-2/VZV infection. A further five
samples tested positive for HHV-7 in nPCR. Culture and tests for antibodies did
not supply sufficiently sensitive and specific data. CONCLUSIONS: Our laboratory 
experience shows that herpesviruses play a central aetiological role in viral
infections of the CNS. PCR analysis, especially the HC-PCR test, have
revolutionised the diagnostic approach to such infections, making possible rapid,
specific and highly sensitive baseline screening. In this way, microbiological
investigations can lead to prompt diagnosis, which was limited in the past to a
very small number of cases.

Publication Types: 
    Comparative Study

PMID: 12091084 [PubMed - indexed for MEDLINE]

2405: J Clin Virol. 2002 Jul;25 Suppl 1:S59-70.

Detection of herpesvirus genomes by polymerase chain reaction in cerebrospinal
fluid and clinical findings.

Minjolle S, Arvieux C, Gautier AL, Jusselin I, Thomas R, Michelet C, Colimon R.

Laboratoire de Bacteriologie-Virologie, Universite Rennes 1, 2 avenue, du Pr Leon
Bernard, CS 34317, 35 043 Rennes cedex, France.

BACKGROUND: The viruses of the Herpesviridae family, in particular herpes simplex
virus types 1 (HSV-1) and 2 (HSV-2), cytomegalovirus (CMV), Epstein-Barr virus
(EBV), varicella zoster virus (VZV), and human herpesvirus 6 (HHV-6), are
responsible for numerous infections of the central nervous system (CNS). These
infections manifest as diverse clinical signs, many of which are not specific.
The diagnosis of these infections is necessary to make it possible to adapt
treatment appropriately, as treatment is specific for the particular virus
concerned. OBJECTIVES: To apply a polymerase chain reaction (PCR) technique for
the diagnosis in a single reaction of the six herpesviruses most frequently
detected in the cerebrospinal fluid (CSF) and to analyse clinical events in
patients presenting positive results in PCR for herpesviruses. STUDY DESIGN: We
studied 141 patients, from whom 180 CSF samples were collected. The clinical
files of the patients were consulted retrospectively, and a list of clinical
signs was recorded. After testing by targeted PCR, at the clinician's demand, we 
tested these samples by herpes consensus PCR, which detects six herpesviruses
(HSV-1, HSV-2, CMV, EBV, VZV, HHV-6), in a single PCR. RESULTS: Targeted PCR
tests identified 25 CSF samples (13.9%), corresponding to 18 patients (12%), as
positive. The herpes consensus PCR test detected 49 samples (27.2%) as positive, 
resulting in the identification of 54 individual viruses (four samples displayed 
co-infection) from 39 patients (27%). 130 CSF samples, from 101 patients, tested 
negative by both techniques. 23 HIV-positive patients (30.6%), three HIV-negative
immunocompromised patients (27%), and 14 immunocompetent patients (25%) were CSF 
PCR-positive. In HIV-positive patients, CMV was the virus most frequently
identified (13%), followed by EBV (10.6%), VZV (5.3%) and finally HSV-1 and HSV-2
(both 1.3%). We did not detect HHV-6 in any of these samples. We detected only
HSV-2, EBV and VZV in the 11 HIV-negative immunocompromised patients. CSF samples
of immunocompetent patients contained mostly VZV (9%) and HSV-1 (7.3%).
CONCLUSIONS: The herpes consensus PCR for a given virus was more sensitive than
the standard, targeted PCR used in our laboratory. The clinical signs presented
by patients infected with HSV-1, HSV-2 and CMV were similar to those reported in 
previous studies. For VZV, we report the possibility of mild, transient cerebral 
viral reactivation. Our data on the detection of EBV by PCR suggest that the PCR 
test is of predictive value for cerebral lymphoma in immunocompromised patients. 
The possible role of HHV-6 in a subacute neurological disorder merits further
investigation.

Publication Types: 
    Comparative Study

PMID: 12091083 [PubMed - indexed for MEDLINE]

2406: J Clin Virol. 2002 Jul;25 Suppl 1:S45-51.

Laboratory diagnosis of central nervous system infections caused by
herpesviruses.

Sauerbrei A, Wutzler P.

Institute for Antiviral Chemotherapy, Friedrich-Schiller University Jena,
Winzerlaer Stasse 10, D-07745 Jena, Germany. andreas.sauerbrei@med.uni-jena.de

BACKGROUND: Herpesviruses may be associated with various types of central nervous
system (CNS) infections. Herpes simplex encephalitis (HSE) has to be considered
one of the most severe diseases. As effective antiviral drugs are available,
rapid and reliable diagnosis has become important. OBJECTIVES: To describe
polymerase chain reaction (PCR) and serological methods for the detection of
herpesvirus-induced CNS infections by the example of HSE. STUDY DESIGN: 620
cerebrospinal fluid (CSF) and 2400 serum samples from 2700 selected hospitalized 
patients with clinical suspicion of encephalitis were tested for herpes simplex
virus (HSV) as well as varicella-zoster virus (VZV) DNA and HSV-specific
antibodies, respectively. RESULTS: HSV-1 DNA could be detected in eight and HSV-2
in three patients with focal encephalitis. In addition, HSV-2 DNA was found in
two newborns with encephalitis and two adults suffered from transverse lumbar
myelitis. One VZV DNA-positive patient had developed herpes zoster accompanied by
meningoencephalitis, and in the other an encephalitis without cutaneous rash was 
diagnosed. Intrathecal antibody synthesis could be measured when CSF was cleared 
from viral DNA. CONCLUSIONS: The detection of viral DNA by PCR technique has
become the "gold standard" method for laboratory diagnosis of herpesvirus
infections of CNS. Serodiagnosis may be useful to confirm the diagnosis
retrospectively.

Publication Types: 
    Comparative Study

PMID: 12091081 [PubMed - indexed for MEDLINE]

2407: J Clin Virol. 2002 Jul;25 Suppl 1:S5-11.

Use of PCR for the diagnosis of herpesvirus infections of the central nervous
system.

DeBiasi RL, Kleinschmidt-DeMasters BK, Weinberg A, Tyler KL.

Department of Pediatrics, University of Colorado Health Sciences Center, 4200
East Ninth Avenue, 80262, Denver, CO 80262, USA. roberta.debiasi@uchsc.edu

Polymerase chain reaction (PCR) analysis of cerebrospinal fluid (CSF) has
revolutionized the diagnosis of nervous system viral infections, particularly
those caused by human herpesviruses (HHV). The PCR technique allows the detection
of minute quantities of DNA or RNA in body fluids and tissues. Both fresh-frozen 
and formalin-fixed tissues may be utilized for PCR assays, with the latter making
archival studies possible. CSF PCR has now replaced brain biopsy as the gold
standard for the diagnosis of herpes simplex virus (HSV) encephalitis. PCR
analysis of both CSF and nervous system tissues has also broadened our
understanding of the spectrum of disease caused by HSV-1 and -2, cytomegalovirus 
(CMV), Epstein-Barr virus (EBV), varicella zoster virus (VZV) and HHV-6. PCR
results obtained from tissue specimens must be interpreted cautiously, since this
highly sensitive technique may detect portions of viral genomic material that may
be present even in the absence of active viral infection. Tissue PCR results in
particular must be corroborated with clinical and neuropathologic evidence of
central nervous system (CNS) infection. In several neurological diseases,
negative PCR results have provided evidence against a role for herpesviruses as
the causative agents. This review summarizes the role of CSF PCR in the diagnosis
and therapeutic management of herpesvirus infections of the nervous system,
particularly those caused by HSV and VZV.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Review

PMID: 12091076 [PubMed - indexed for MEDLINE]

2408: Biochim Biophys Acta. 2002 Jul 18;1587(2-3):287-95.

Chemotherapy of varicella-zoster virus by a novel class of highly specific
anti-VZV bicyclic pyrimidine nucleosides.

Balzarini J, McGuigan C.

Rega Institute for Medical Research, Katholieke Universiteit Leuven,
Minderbroedersstraat 10, Leuven, Belgium. jan.balzarini@rega.kuleuven.ac.be

(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) is a potent inhibitor of herpes
simplex virus type 1 (HSV-1) and varicella-zoster virus (VZV). Its mechanism of
action is based on a specific conversion to its 5'-mono- and 5'-diphosphate
derivative by HSV-1- and VZV-encoded thymidine kinase, and after further
conversion to its 5'-triphosphate derivative, inhibition of the viral DNA
polymerase and eventual incorporation into the viral DNA. Recently, a new
structural class of bicyclic pyrimidine nucleoside analogues (designated BCNAs)
with highly specific and selective anti-VZV activity in cell culture has been
discovered. The compounds need a long alkyl or alkylaryl side-chain at the base
moiety for pronounced biological activity. This property makes these compounds
highly lipophilic. They are also endowed with fluorescent properties when exposed
to light with short UV wavelength. In striking contrast to BVDU, the members of
this class of compounds are active only against VZV, but not against any other
virus, including the closely related HSV-1, HSV-2 and cytomegalovirus. The most
active compounds inhibit VZV replication at subnanomolar concentrations and are
not toxic at high micromolar concentrations. The compounds lose their antiviral
activity against thymidine kinase (TK)-deficient VZV strains, pointing to a
pivotal role of the viral TK in their activation (phosphorylation). Kinetic
studies with purified enzymes revealed that the compounds were recognized by VZV 
TK as a substrate, but not by HSV-1 TK, nor by cytosolic or mitochondrial TK. VZV
TK is able to phosphorylate the test compounds not only to their corresponding
5'-mono- but also to their 5'-diphosphate derivatives. These data may readily
explain and rationalize the anti-VZV selectivity of the BCNAs. There is no
clear-cut correlation between the antiviral potency of the compounds and their
affinity for VZV TK, pointing to a different structure/activity relationship of
the eventual antiviral target of these compounds. The compounds are stable in
solution and, in contrast to BVDU, not susceptible to degradation by thymidine
phosphorylase. The bicyclic pyrimidine nucleoside analogues represent an entirely
new class of highly specific anti-VZV compounds that should be further pursued
for clinical development.

Publication Types: 
    Review

PMID: 12084470 [PubMed - indexed for MEDLINE]

2409: Neurologia. 2002 Jun-Jul;17(6):338-41.

[Room tilt illusion: Report of two cases and terminological review]

[Article in Spanish]

Arjona A, Fernandez-Romero E.

Hospital de la Cruz Roja Espanola, Cordoba, Spain.

The room tilt illusion is a transient misperception of the visual image as tilted
on its side or even upside down; in this case it has been termed acute upside
down reversal of vision. We report on two cases of room tilt illusion as
manifestation of VIII nerve neuritis (herpes-zoster infection) and cerebellar
hemorrhage. Room tilt illusion has been reported in association with
vertebrobasilar stroke, migraine, multiple sclerosis, epilepsy and labyrinthine
disorders. The pathophysiology of this rare visual illusion has been related to a
lesion of the visual or vestibulo-otolith pathways. In animals the neurones of
the parieto-insular vestibular cortex areas are multisensory. So, they can
respond to somatosensory, optokinetic and visual stimuli. In humans the knowledge
about vestibular cortex function and localization is less precise than in
animals. However, we propose a disorder of multisensorial vestibular cortex,
resulting from a lession of vestibular pathways or association cortex, as
mechanism of this phenomenon.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12084362 [PubMed - indexed for MEDLINE]

2410: MMWR Recomm Rep. 2002 Jun 14;51(RR-8):1-52.

Guidelines for preventing opportunistic infections among HIV-infected
persons--2002. Recommendations of the U.S. Public Health Service and the
Infectious Diseases Society of America.

Kaplan JE, Masur H, Holmes KK; USPHS; Infectious Disease Society of America.

Division of AIDS, STD, and TB Laboratory Research, National Center for Infectious
Diseases, USA.

In 1995, the U.S. Public Health Service (USPHS) and the Infectious Diseases
Society of America (IDSA) developed guidelines for preventing opportunistic
infections (OIs) among persons infected with human immunodeficiency virus (HIV); 
these guidelines were updated in 1997 and 1999. This fourth edition of the
guidelines, made available on the Internet in 2001, is intended for clinicians
and other health-care providers who care for HIV-infected persons. The goal of
these guidelines is to provide evidence-based guidelines for preventing OIs among
HIV-infected adults and adolescents, including pregnant women, and HIV-exposed or
infected children. Nineteen OIs, or groups of OIs, are addressed, and
recommendations are included for preventing exposure to opportunistic pathogens, 
preventing first episodes of disease by chemoprophylaxis or vaccination (primary 
prophylaxis), and preventing disease recurrence (secondary prophylaxis). Major
changes since the last edition of the guidelines include 1) updated
recommendations for discontinuing primary and secondary OI prophylaxis among
persons whose CD4+ T lymphocyte counts have increased in response to
antiretroviral therapy; 2) emphasis on screening all HIV-infected persons for
infection with hepatitis C virus; 3) new information regarding transmission of
human herpesvirus 8 infection; 4) new information regarding drug interactions,
chiefly related to rifamycins and antiretroviral drugs; and 5) revised
recommendations for immunizing HIV-infected adults and adolescents and
HIV-exposed or infected children.

Publication Types: 
    Guideline
    Practice Guideline

PMID: 12081007 [PubMed - indexed for MEDLINE]

2411: Cutis. 2002 Apr;69(4):277-9.

An epidemicity of Paederus species in Cukurova region.

Uslular C, Kavukcu H, Alptekin D, Acar MA, Denli YG, Memisioglu HR, Kasap H.

Department of Dermatology, Cukurova University Medical School, Adana, Turkey.
cudermadana@hotmail.com

Two hundred four patients (117 females, 87 males; age range: 3-80 y) were
admitted to our facility between May 1995 and June 1997 and studied to determine 
the endemicity of the Paederus species, which has been increasing for the last 6 
years (especially in May and June) in the Cukurova region of southern Turkey.
Clinically, infection with the Paederus species mimics contact dermatitis, herpes
zoster, bullous impetigo, and phytophotodermatitis. Definitive diagnosis is made 
by historical and clinical findings. To determine the main histopathologic
features of this infestation, biopsy specimens were obtained from 9 patients and 
stained with hematoxylin and eosin (H&E). In most patients, the skin lesions were
located on the exposed parts of the body. Clinically, these lesions were linear, 
vesicular, bullous, and/or pustular on erythematous bases and resembled either
phytophotodermatitis, herpes zoster, or impetigo rather than classic insect
bites. Pederin, which is released from the Paederus species, may cause these
lesions. The number of cases has increased markedly during the last 5 years. In
the coming years, we expect this number to increase significantly.

PMID: 12080946 [PubMed - indexed for MEDLINE]

2412: Hunan Yi Ke Da Xue Xue Bao. 1999;24(6):Inside back cover.

[Effect of valociclovir hydrochloride on patients with herpes zoster]

[Article in Chinese]

Li C, Liu Z.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 12080735 [PubMed - indexed for MEDLINE]

2413: Ann Rheum Dis. 2002 Jul;61(7):661.

Shingles following infliximab infusion.

Baumgart DC, Dignass AU.

Publication Types: 
    Case Reports
    Letter

PMID: 12079920 [PubMed - indexed for MEDLINE]

2414: Nervenarzt. 2002 May;73(5):471-4.

[Charles Bonnet syndrome in an elderly patient with bilateral vision loss,
hyperthyroidism and relative digitalis overdose]

[Article in German]

Godecke-Koch T, Schlimme J, Rada D, Emrich HM.

Abteilung Klinische Psychiatrie und Psychotherapie, Medizinische Hochschule
Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover.
Godecke-Koch.Thomas@MH-Hannover.DE

Charles Bonnet syndrome (CBS) is characterized by the presence of visual
hallucinations in elderly, mentally healthy people. We report a visually impaired
90-year-old woman suddenly complaining of visual hallucinations, suffering from
hyperthyroidism and a relative digitalis overdose. The diagnosis of CBS could be 
made after the exclusion of an intoxication and other neurological and
psychiatric syndromes. In this case, visual hallucinations ceased without
specific psychopharmacological therapy. A brief review of this organic
hallucinosis, differential diagnosis, especially hyperthyroidism-induced
psychosis, and digitoxin-induced psychosis is given and current therapeutic
strategies are suggested.

Publication Types: 
    Case Reports
    English Abstract

PMID: 12078028 [PubMed - indexed for MEDLINE]

2415: Adv Otorhinolaryngol. 2002;60:32-53.

Meatal ganglionitis: a pathologic correlate in idiopathic facial paralysis.

Gacek RR, Gacek MR.

Publication Types: 
    Case Reports
    Review

PMID: 12077898 [PubMed - indexed for MEDLINE]

2416: Adv Otorhinolaryngol. 2002;60:1-11.

The biology of neurotropic viruses.

Gacek RR.

Publication Types: 
    Review

PMID: 12077894 [PubMed - indexed for MEDLINE]

2417: J Infect. 2002 Feb;44(2):73-7.

Latency and reactivation of human cytomegalovirus.

Sissons JG, Bain M, Wills MR.

Department of Medicine, School of Clinical Medicine, University of Cambridge, UK.

The sequence analysis of herpesviruses suggests they have been evolving with
their individual vertebrate hosts for millions of years, and their divergence
parallels that of the hosts they infect. Given this time they have been learning 
to live with their individual hosts, it is not surprising that they have become
extremely well adapted to doing so without causing much in the way of obvious
disease. A key feature of their strategy for persisting in the host is the
ability of all herpesviruses to establish latent infection-a state in which no,
or only a very limited set of, viral genes are expressed in cells in which viral 
DNA persists. The alpha herpesviruses (herpes simplex and varicella zoster virus)
establish latency in neuronal cells in sensory ganglia: these are long lived
non-dividing cells and the alpha herpesviruses persist in these with expression
of only the latency associated transcripts-although the function of these RNA
transcripts remains incompletely understood. The principal gamma herpesvirus of
humans, Epstein Barr virus (EBV), is latent mainly in B lymphocytes: EBV
persistence in B cells is associated with expression of a limited set of viral
genes encoding functions necessary for the maintenance of the episomal viral DNA 
as B cells divide.The mechanism by which the principal beta herpesvirus of
humans-human cytomegalovirus (HCMV) persists, is also incompletely understood and
the subject of this review. Understanding how HCMV persists has clinical
relevance in that its transmission to seronegative recipients might be more
easily prevented, and the mechanisms by which it produces disease in the neonate 
and immunocompromised hosts more easily understood, if we knew more about the
cells in which the virus is latent and the way in which it reactivates. Copyright
2002 The British Infection Society.

Publication Types: 
    Review

PMID: 12076064 [PubMed - indexed for MEDLINE]

2418: Kansenshogaku Zasshi. 2002 May;76(5):347-54.

[Long PCR amplification of varicella-zoster virus DNA in clinical specimens from 
the patients with varicella and herpes zoster]

[Article in Japanese]

Takayama M, Takayama N.

Department of Pediatrics, Tokyo Metropolitan Komagome Hospital.

Long PCR amplification of the 7.7 to 33.5 Kbp regions of varicella-zoster virus
(VZV) genomic DNA was performed using template DNAs extracted from clinical
specimens such as vesicle fluid and crusts which had been obtained from varicella
or herpes zoster patients. PCR products of 7.7-14.4 Kbp in length were
efficiently amplified from all of the 14 template DNAs of crust specimens.
Targets of 18.6-20.0 Kbp DNA could be also amplified from 14 crust samples except
one. From all of the 7 samples derived from infected cells, the DNA targets up to
27.2 Kbp in length could be amplified. Whereas, the efficiency of amplification
of 27.2 Kbp DNAs from crust samples was somewhat lower (9/14,64%) than that of
DNAs from infected cells. In 83% (5/6) of target DNAs from infected cells,
amplification of DNA as long as 33.5 Kbp was possible, while only in 40% (2/5) of
these from crust specimens. From crust samples, the efficiency of amplification
of DNA longer than 20 Kbp tended to decline. We also confirmed that long target
DNA was amplifiable directly from vesicle fluid specimens as effective as from
crust specimens. Restriction fragment length polymorphism (RFLP) analyses
combined with R2-nested PCR of the long PCR products allowed classification of
the 14 clinical specimens into 9 groups. Long PCR derived from clinical specimens
was demonstrated to be applicable to RFLP analyses and sequencing without
laborious test of virus isolation. Furthermore, the long PCR method described
here will be useful for studies of the molecular epidemiology of VZV and for
investigating variations among VZV isolates.

Publication Types: 
    English Abstract

PMID: 12073570 [PubMed - indexed for MEDLINE]

2419: J Virol. 2002 Jul;76(14):7228-38.

Characterization of varicella-zoster virus gene 21 and 29 proteins in infected
cells.

Cohrs RJ, Wischer J, Essman C, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA. randall.cohrs@uchsc.edu

Varicella-zoster virus (VZV) transcription is limited in latently infected human 
ganglia. Note that much of the transcriptional capacity of the virus genome has
not been analyzed in detail; to date, only VZV genes mapping to open reading
frames (ORFs) 4, 21, 29, 62, and 63 have been detected. ORF 62 encodes the major 
immediate-early virus transcription transactivator IE62, ORF 29 encodes the major
virus DNA binding protein, and ORF 21 encodes a protein associated with the
developing virus nucleocapsid. We analyzed the cellular location of proteins
encoded by ORF 21 (21p) and ORF 29 (29p), their phosphorylation state during
productive infection, and their ability form a protein-protein complex. The
locations of both 21p and 29p within infected cells mimic those of their herpes
simplex virus type 1 (HSV-1) homologues (UL37 and ICP8); however, unlike these
homologues, 21p is not phosphorylated and neither 21p nor 29p exhibits a
protein-protein interaction. Transient transfection assays to determine the
effect of 21p and 29p on transcription from VZV gene 20, 21, 28, and 29 promoters
revealed no significant activation of transcription by 21p or 29p from any of the
VZV gene promoters tested, and 21p did not significantly modulate the ability of 
IE62 to activate gene transcription. A modest increase in IE62-induced activation
of gene 28 and 29 promoters was seen in the presence of 29p; however,
IE62-induced activation of gene 28 and 29 promoters was reduced in the presence
of 21p. A Saccharomyces cerevisiae two-hybrid analysis of 21p indicated that the 
protein can activate transcription when tethered within a responsive promoter.
Together, the data reveal that while VZV gene 21 and HSV-1 UL37 share homology at
the nucleic acid level, these proteins differ functionally.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 12072522 [PubMed - indexed for MEDLINE]

2420: Transplant Proc. 2002 Jun;34(4):1174-7.

Atypical generalized zoster with suspicious esophageal involvement and early
relapse in an adult renal transplant recepient.

Oh KH, Ahn C, Kim YS, Han JS, Kim S, Lee JS, Kim EC, Oh MD, Chung JH.

Department of Internal Medicine, Seoul National University Hospital, Seoul,
Korea.

Publication Types: 
    Case Reports
    Review

PMID: 12072307 [PubMed - indexed for MEDLINE]

2421: Eur J Haematol. 2002 Apr;68(4):236-8.

Mononucleosis syndrome and acute monocytic leukemia.

Tamayose K, Sugimoto K, Ando M, Oshimi K.

Department of Hematolgy, Juntendo University School of Medicine, Tokyo, Japan.
tamayose@med.juntendo.ac.jp

The association of infectious mononucleosis and an immunocompromised host such as
occurs in acute leukemia is reported. The most common cause of infectious
mononucleosis is Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Patients
with mononucleosis syndrome caused by other agents are rare. We report a case of 
acute monocytic leukemia (AMoL) who developed varicella zoster virus (VZV)
mononucleosis syndrome in the bone marrow recovery phase after myelosuppression
due to high-dose cytarabine. Mononuclear leukocytes appearing during the
mononucleosis syndrome were very similar to the initial leukemic cells. Varicella
zoster virus mononucleosis syndrome was confirmed by delayed herpes zoster rash
with dermatomal distribution.

Publication Types: 
    Case Reports

PMID: 12071940 [PubMed - indexed for MEDLINE]

2422: Commun Dis Public Health. 2002 Mar;5(1):59-71.

Guidelines on the management of, and exposure to, rash illness in pregnancy
(including consideration of relevant antibody screening programmes in pregnancy).

Morgan-Capner P, Crowcroft NS; PHLS Joint Working Party of the Advisory
Committees of Virology and Vaccines and Immunisation.

Preston Public Health Laboratory, Royal Preston Hospital, PO Box 202, Sharoe
Green Lane, Fulwood, Preston, Lancashire PR2 9HG.
peter.morgan-capner@csr-tr.nwest.nhs.uk

These guidelines, produced by the Public Health Laboratory Service (PHLS) aim to 
help decision making in the investigation and management of pregnant women who
have 'a rash compatible with a systemic viral illness', or who have contact with 
a person with such an illness. They address particularly rubella, parvovirus B19,
and varicella-zoster virus infection, but consider other infective causes of rash
illness in the United Kingdom. The guidelines give the magnitude and degrees of
risk to the fetus in terms of outcomes for the gestation at which maternal
infection occurs. Recent changes in epidemiology and management lead to the
following specific advice, which both updates and re-affirms established
guidelines. All pregnant women with a non-vesicular rash illness should be
investigated simultaneously for rubella and parvovirus B19 infection. All
pregnant women who have had significant contact with a person suffering from a
non-vesicular illness should be investigated for asymptomatic parvovirus B19
infection, and for asymptomatic rubella infection unless there is satisfactory
evidence of past rubella infection (vaccine or natural infection). A significant 
contact is defined as being in the same room for over 15 minutes, or face-to-face
contact. Specific investigation to detect asymptomatic rubella reinfection is not
advised. It is essential to confirm by adequate laboratory investigation all
cases of possible rubella and parvovirus B19 infection in pregnancy. Management
of proven rubella in pregnancy should be based on established risks of adverse
outcome. Women with proven parvovirus B19 infection in the first 20 weeks of
pregnancy should be followed by regular, ultrasound scanning, and referred to
Regional Units of Fetal Medicine if hydrops fetalis is detected. Parvovirus B19
antibody screening in pregnancy is not advised, and consensus has been reached on
the procedures to be followed for rubella antibody screening, including the
concentration of antibody that reflects past infection. Oral antiviral treatment 
(aciclovir) is advised with informed consent for pregnant women who present
within 24 hours of onset of varicella. Referral to hospital and intravenous
antiviral treatment is indicated for pregnant women with complications and/or
risk factors, or whose illness continues for six days or more. Pregnant women
exposed to varicella or herpes zoster can be reassured as to their protection if 
they themselves have a history of varicella or herpes zoster. If this history is 
uncertain or not known, susceptibility should be tested, and varicellazoster
immunoglobulin (VZIG) offered to those found susceptible if within 10 days of
first exposure. Infants whose mothers develop varicella 7 days before to 7 days
after delivery should be given VZIG, and aciclovir if onset was 4 days before to 
2 days after delivery.

Publication Types: 
    Guideline
    Practice Guideline

PMID: 12070980 [PubMed - indexed for MEDLINE]

2423: Semin Respir Infect. 2002 Jun;17(2):121-9.

Pneumonia caused by herpesviruses in recipients of hematopoietic cell
transplants.

Taplitz RA, Jordan MC.

Division of Infectious Diseases, Department of Medicine, Oregon Health and
Science University, Portland 97201-3098, USA.

Viral pulmonary infections are a major cause of morbidity and mortality in
recipients of hematopoietic cell transplantation. Members of the
herpesviruses-cytomegalovirus, herpes simplex virus, varicella zoster virus,
Epstein-Barr virus, as well as some of the more recently described herpesviruses 
such as HHV-6 and HHV-8-are frequently implicated in causing pulmonary infection 
in this population. Advances in diagnostic techniques and the use of preventive
or preemptive therapies have altered the epidemiology of infections caused by
some of the herpesviruses; however, these viruses continue to be a significant
cause of morbidity and mortality in hematopoietic cell transplantation. This
article provides an overview of pulmonary herpesvirus infections that occur after
hematopoietic cell transplantation, with an emphasis on new developments in
epidemiology, diagnosis, prophylaxis, and treatment. Copyright 2002, Elsevier
Science (USA). All rights reserved.

Publication Types: 
    Review

PMID: 12070831 [PubMed - indexed for MEDLINE]

2424: Minerva Pediatr. 2002 Jun;54(3):259-62.

Guillain-Barre syndrome after varicella zoster virus infections. A case report.

Pavone P, Maccarrone F, Sorge A, Piccolo G, Greco F, Caruso P, Sorge G.

Dipartimento di Pediatria, Universita degli Studi, Catania, Italy.
ppavone@mbox.unict.it

The case of a 13 year-old patient affected by Guillain-Barre syndrome developed
after varicella zoster virus infection is reported. Cerebrospinal fluid
examination and motor and sensory conduction velocity were consistent with GBS.
Antibodies against gangliosides GM1 were present; it is likely that some of these
may play an important role in the pathogenesis of syndrome after varicella
infection. The therapy was carried out with increasing high-doses of
immunoglobulins, with full clinical recovery.

Publication Types: 
    Case Reports

PMID: 12070486 [PubMed - indexed for MEDLINE]

2425: J Pain Symptom Manage. 2002 Jun;23(6):510-6.

Clinical applications for change-point analysis of herpes zoster pain.

Desmond RA, Weiss HL, Arani RB, Soong SJ, Wood MJ, Fiddian PA, Gnann JW, Whitley 
RJ.

Medical Statistics Section, Department of Medicine, Comprehensive Cancer Center, 
University of Alabama at Birmingham, Birmingham, AL 35294-3300, USA.

Pain is the most frequent and disabling complication of herpes zoster. The
analysis of pain severity data is complicated by the nonlinear rate of
resolution. Further, three distinct phases characterize pain resolution--acute,
subacute, and chronic. Using two clinical trial datasets as the bases for
analyses, the rates of baseline pain resolution were computed across each of
three phases and compared for age, severity of pain at onset, and number of
lesions at baseline. The results defined transition points of 24.4 +/- 3.34 for
the subacute phase and 110.3 +/- 11.9 days for the chronic phase. The model
demonstrated a treatment effect of valiciclovir (VACV) during the subacute phase 
as compared to acyclovir (ACV) (P = 0.006) and supports effects of age, baseline 
pain and number lesions on pain cessation rates in the acute phase. This model
verifies three phases of zoster pain and delineates the impact of treatment and
other factors on the phase-specific rates of pain cessation.

PMID: 12067775 [PubMed - indexed for MEDLINE]

2426: Mayo Clin Health Lett. 2002 Jun;20(6):7.

Shingles. Seek early treatment.

[No authors listed]

Publication Types: 
    Review

PMID: 12066808 [PubMed - indexed for MEDLINE]

2427: Br J Community Nurs. 2002 Jun;7(6):286-7, 290-1.

Life after shingles: the management of postherpetic neuralgia.

Williams H.

Chronic Pain Management, Royal Victoria Infirmary, Newcastle Upon Tyne.

Chronic pain may have devastating effects on the physical and psychological well 
being of many patients (Harden, 1999). Most community nurses are in contact with 
a number of patients with chronic pain and will be asked for advice and
recommendations with regards to its management. Chronic neuropathic pain is a
complex and sometimes intractable condition that patients will seek help for,
from either GPs or from the community nursing teams. This article will examine
one neuropathic pain syndrome - post-herpetic neuralgia - and review the evidence
base in relation to treatment strategies, in an attempt to support community
staff in the management of this difficult to treat pain syndrome.

Publication Types: 
    Review

PMID: 12066061 [PubMed - indexed for MEDLINE]

2428: Ophthalmol Clin North Am. 2002 Mar;15(1):7-15, v.

Varicella-zoster virus: mechanisms of pathogenicity and corneal disease.

Starr CE, Pavan-Langston D.

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical
School, 243 Charles Street, Boston, MA 02114, USA. christopherstarr@hotmail.com

As ophthalmologists, many of our patients suffer from the ravages, both ocular
and non-ocular, of the varicella-zoster virus. This article is a comprehensive
review of the pathogenetic mechanisms of this ubiquitous virus. We review the
basic virology, mechanisms of varicella, zoster, latency, reactivation, and the
host immune response to the virus. Herpes zoster ophthalmicus is discussed with
special attention to the cornea and mechanisms of viral keratitis.

Publication Types: 
    Historical Article
    Review

PMID: 12064084 [PubMed - indexed for MEDLINE]

2429: J Am Acad Dermatol. 2002 Jun;46(6):834-9.

Rash severity in herpes zoster: correlates and relationship to postherpetic
neuralgia.

Nagasako EM, Johnson RW, Griffin DR, Dworkin RH.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, New York, USA.

Baseline and follow-up data from 4 samples of immunocompetent patients with
herpes zoster who participated in clinical trials of the antiviral agent
famciclovir were examined (N = 1778). In both univariate and multivariate
analyses, severe rash (ie, >50 lesions, defined as papules, vesicles, or crusted 
vesicles) was significantly associated with older age, male sex, severe pain,
primary involvement of nontrigeminal dermatomes, and a greater number of affected
dermatomes. In addition, severe rash predicted the presence of pain 3 months
later. The results indicate that severe rash is more common in patients with
herpes zoster who are older and who have more severe acute pain and confirm that 
severe rash is a risk factor for prolonged pain.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12063479 [PubMed - indexed for MEDLINE]

2430: Jpn J Ophthalmol. 2002 May-Jun;46(3):330-5.

Indocyanine green angiographic findings in acute retinal necrosis.

Takei H, Ohno-Matsui K, Hayano M, Mochizuki M.

Department of Ophthalmology and Visual Science, Graduate School, Tokyo Medical
and Dental University, Tokyo, Japan.

PURPOSE: To clarify indocyanine green (IA) angiographic features in patients with
acute retinal necrosis (ARN). METHODS: Two patients with ARN were examined by
fluorescein angiography (FA) and IA, and findings from both were compared.
RESULTS: Fundus examination revealed widespread retinal hemorrhages and
yellowish-white patches in the periphery, characteristic of ARN. In both cases,
FA showed diffuse dye leakage from all retinal veins and the optic disc, and
vascular obstruction in the peripheral fundus. In IA, dye leakage was localized, 
and extravasation of dye was evident only from the lower temporal retinal vein
and the lower half of the optic disc. This pattern of indocyanine green dye
leakage appeared to be continuous from the optic disc toward the lower temporal
retinal vein. Also, IA clearly demonstrated choroidal vascular filling delay in
one case in the early phase of the angiogram. CONCLUSIONS: While FA showed
diffuse dye leakage from all retinal veins, IA identified only the retinal
vessels with the most prominent vascular damage. IA also identified choroidal
vascular lesions in these patients with ARN. The information obtained by IA might
be useful to detect retinal vasculitis with prominent inflammation and to
determine the extent of choroidal inflammation in patients with ARN.

Publication Types: 
    Case Reports

PMID: 12063045 [PubMed - indexed for MEDLINE]

2431: Vaccine. 2002 Jun 7;20(19-20):2500-7.

Exposure to varicella boosts immunity to herpes-zoster: implications for mass
vaccination against chickenpox.

Brisson M, Gay NJ, Edmunds WJ, Andrews NJ.

Immunisation Division, PHLS Communicable Disease Surveillance Centre, London, UK.
mbrisson@phls.org.uk

We present data to confirm that exposure to varicella boosts immunity to
herpes-zoster. We show that exposure to varicella is greater in adults living
with children and that this exposure is highly protective against zoster
(Incidence ratio=0.75, 95% CI, 0.63-0.89). The data is used to parameterise a
mathematical model of varicella zoster virus (VZV) transmission that captures
differences in exposure to varicella in adults living with and without children. 
Under the 'best-fit' model, exposure to varicella is estimated to boost
cell-mediated immunity for an average of 20 years (95% CI, 7-41years). Mass
varicella vaccination is expected to cause a major epidemic of herpes-zoster,
affecting more than 50% of those aged 10-44 years at the introduction of
vaccination.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12057605 [PubMed - indexed for MEDLINE]

2432: Curr Treat Options Oncol. 2001 Jun;2(3):237-44.

Infectious complications in chronic lymphoid malignancy.

Egerer G, Hensel M, Ho AD.

Department of Internal Medicine V, University of Heidelberg, Hospitalstrasse 3,
69115 Heidelberg, Germany.

Taking steps to minimize, prevent, and treat infection in patients with chronic
lymphoid malignancies, especially chronic lymphocytic leukemia, has always been a
challenge. As more patients with these diseases live longer and lead productive
lives upon successful initial treatment, strategies for preventing infections
have become more important. Distinguishing patients at low risk for infection
from those at high risk is a crucial but challenging issue. Unfortunately, there 
are hardly any data on the use of prophylactic antibiotics for patients with
chronic lymphoid malignancy (CLL). If patients cannot be enrolled in a clinical
trial, antibiotics with co-trimoxazole should be administered when steroids are
warranted. They should also be administered in patients who have had a documented
infection early in the treatment course and during neutropenia. Viral infections 
remain another controversial issue in patients with CLL receiving treatment,
especially a purine analogue. Very low CD4 counts (less than 50 cells/mL) might
predict for reactivation for herpes zoster. Outside of depleted CD4 counts, there
are no other means of identifying a high-risk group. Based on limited data, it
would be reasonable to administer herpes zoster prophylaxis to patients with CD4 
counts that are severely depleted or to patients with a prior episode of zoster. 
Controversial issues still remain regarding immunoglobulin treatment,
specifically cost, scarcity of the product, and adequate dose, which has not yet 
been established. We would consider intravenous immunoglobulin (Ig) replacement
in patients with marked hypogammaglobulinemia (IgG less than 400 mg/dL) with more
than two recent severe infections [1]. Lower Ig doses (240 mg/kg) have been shown
to be equivalent to higher ones in this trial [1].

Publication Types: 
    Review

PMID: 12057123 [PubMed - indexed for MEDLINE]

2433: Trans R Soc Trop Med Hyg. 2002 Mar-Apr;96(2):167-72.

A simple clinical and paraclinical score predictive of CD4 cells counts below
400/mm3 in HIV-infected adults in Dakar University Hospital, Senegal.

Pistone T, Kony S, Faye-Niang MA, Ndour CT, Gueye PM, Henzel D, Delaporte E,
Badiane S, N'Doye I, Coulaud JP, Larouze B, Bouchaud O.

Institut de Medecine et d'Epidemiologie Africaines, Centre Hospitalier
Universitaire Bichat-Claude Bernard, Paris, France.

In industrialized countries the decision to start co-trimoxazole (CMX)
prophylaxis of HIV-related opportunistic infections is based on the CD4+ cell
count. The value of CMX prophylaxis has also been demonstrated in Africa, where
CD4+ cell counts are rarely available. We therefore developed a simple score
predictive of a threshold CD4+ cell count (400/mm3) below which CMX prophylaxis
is indicated. In a retrospective cross-sectional study, we collected clinical and
biological data on 211 HIV-infected patients recruited from January 1996 through 
January 1998 at Fann University Hospital in Dakar, Senegal. Several variables
were identified as being predictive of a CD4+ cell count below 400/mm3 by
stepwise logistic regression. Each variable was weighted according to its
regression coefficient, as follows: male sex (+1), weight loss (+2), body mass
index < 22 (+2), herpes zoster (+4), tuberculin induration < 5 mm (+3) and
haemoglobin < or = 10 g/dL (+1). A score of > or = 4 (sum of weights) selected
patients with CD4+ cell counts below 400/mm3 with a sensitivity of 98% and a
negative predictive value of 83%. Such a score should be applicable in the
African context and should facilitate the management of HIV-infected patients,
especially the prescription of CMX prophylaxis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12055807 [PubMed - indexed for MEDLINE]

2434: Retina. 2002 Jun;22(3):352-4.

Oral valacyclovir in the treatment of acute retinal necrosis syndrome.

Aslanides IM, De Souza S, Wong DT, Giavedoni LR, Altomare F, Detorakis ET,
Kymionis GD, Pallikaris IG.

Department of Ophthalmology, St. Michael's Hospital, University of Toronto,
Ontario, Canada. aslanides@hotmail.com

Publication Types: 
    Case Reports

PMID: 12055471 [PubMed - indexed for MEDLINE]

2435: Curr Opin Investig Drugs. 2002 Jan;3(1):54-7.

Varivax (Merck & Co).

Jones T.

Intellivax International Inc, Ville St-Laurent, Quebec, Canada.
tjones@intellivax.com

Varivax is a live-attenuated varicella vaccine developed and launched in the US
by Merck & Co for the treatment of chickenpox [413319]. The vaccine uses the Oka 
strain of the varicella virus licensed from the Biken Institute at Osaka
University in Japan [178223]. By June 2001, Merck was also developing the vaccine
for use in adults for herpes zoster infection [413319]. The FDA required
post-marketing studies as a condition for its approval of Varivax, which was
granted in March 1995 [174416]. The Centers for Disease Control & Prevention
Advisory Committee on Immunization Practices recommended that Varivax should be
administered at the same time as the measles, mumps and rubella vaccine.
Unvaccinated children between the ages of 19 months and 13 years should be
vaccinated by the time they are 13 years old [180148]. Varivax, from its launch
in the spring of 1995 to the end of the third quarter 1995, produced sales of US 
$60 million [196542]. In June 2000, a second generation of Varivax, Varivax II,
was launched for vaccination against chickenpox in individuals 12 months of age
and older. Varivax II prevents the transmission of chickenpox with exactly the
same safety and efficacy profile as Varivax; however, the new Varivax II has the 
advantage of being refrigerator-stable [371871].

Publication Types: 
    Review

PMID: 12054073 [PubMed - indexed for MEDLINE]

2436: Clin J Pain. 2002 May-Jun;18(3):200-2.

A novel treatment of postherpetic neuralgia using peppermint oil.

Davies SJ, Harding LM, Baranowski AP.

The Pain Management Centre, The National Hospital for Neurology and Neurosurgery,
University College London Hospitals NHS Trust, London, UK.

BACKGROUND: Postherpetic neuralgia remains a difficult problem to treat. A number
of therapies have been shown to be effective, but some patients have intractable 
pain. PATIENT: The case of a 76-year-old woman whose pain had been resistant to
standard therapies is described. The pattern of quantitative sensory testing
results for this patient led the authors to believe that she had an "irritable
nociceptor" type of pathophysiology. INTERVENTION: The patient was instructed to 
apply neat peppermint oil (containing 10% menthol) to her skin, resulting in an
almost immediate improvement in her pain. This pain relief persisted for 4-6
hours after application of the oil. RESULTS: The patient was successfully treated
with topical peppermint oil. During 2 months of follow-up she has had only a
minor side effect, with continuing analgesia. The authors believe this is the
first evidence of peppermint oil (or menthol) having a strong analgesic effect on
neuropathic pain. The possible mechanisms of action of peppermint oil are
discussed.

Publication Types: 
    Case Reports

PMID: 12048423 [PubMed - indexed for MEDLINE]

2437: Am J Kidney Dis. 2002 Jun;39(6):1310-2.

Primary varicella after transplantation.

Scanlon-Kohlroser CA, Fan PY, Primack W, Stoff JS.

Division of Renal Medicine and Transplantation Medicine, Department of Medicine
and Pediatrics, University of Massachusetts Medical School and Fallon Clinic,
Worcester, MA, USA.

A 51-year-old white woman 6 months status post cadaveric renal transplant
developed a mild case of primary varicella-zoster (VZ). It is hypothesized that
the limited nature of her illness was due to infection with vaccine-type VZ virus
instead of wild-type VZ. Approximately 1 month prior, she had daily household
contact with a child who had developed a rash after immunization with live
attenuated varicella vaccine. This case highlights several important questions.
Should special precautions be undertaken with renal transplant recipients naive
to varicella infection after vaccination of household contacts? Should
pretransplant immunization with varicella vaccine be performed routinely in naive
patients? Should naive patients transplanted and maintained on immunosuppressive 
therapy be vaccinated? Until there are clinical trials to answer these questions,
it may be instructive to consider the recommendations for pediatric and
immunocompromised patients. Copyright 2002 by the National Kidney Foundation,
Inc.

PMID: 12046047 [PubMed - indexed for MEDLINE]

2438: Orbit. 1999 Sep;18(3):211-215.

Cicatricial entropion caused by asymptomatic allergic conjunctivitis.

Burnstine MA, Putterman AM, Sugar J.

Eye and Ear Infirmary, Department of Ophthalmology, University of Illinois,
Chicago, Illinois, USA

Cicatricial entropion is an acquired process caused by scarring of the inner
eyelid with mechanical shortening of the posterior lamella. We present two
consecutive patients with cicatricial entropion as the heralding sign of allergic
blepharoconjunctivitis. A 12-year-old girl and a 41-year-old man presented to a
referral oculoplastics practice with ocular irritation and conjunctival
symblepharon. Neither patient had a history of allergic ocular symptoms. Slit
lamp examination revealed marked conjunctival scarring of all four eyelids in
each patient. Conjunctival scraping and cell staining revealed eosinophils and
polymorphonuclear leukocytes. No evidence of infection, including Chlamydia and
Herpes zoster, was detected. Asymptomatic allergic blepharoconjunctivitis should 
be included in the differential diagnosis of cicatricial entropion. Conjunctival 
scraping may be helpful in the diagnosis.

PMID: 12045987 [PubMed - as supplied by publisher]

2439: Br J Plast Surg. 2002 Apr;55(3):264.

Painless acyclovir extravasation injury in a diabetic.

De Souza BA, Shibu M.

Publication Types: 
    Case Reports
    Letter

PMID: 12041990 [PubMed - indexed for MEDLINE]

2440: Obstet Gynecol. 2002 Apr;99(4):625-8.

Postherpetic neuralgia after shingles: an under-recognized cause of chronic
vulvar pain.

Oaklander AL, Rissmiller JG.

Neuropathic Pain Study Group, Departments of Anesthesiology, Massachusetts
General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

BACKGROUND: Vulvar shingles, an uncommon presentation of a common disease,
probably affects 1.5 million American women during their lifetime and leaves
about 150,000 with postherpetic neuralgia, a chronic neuropathic pain syndrome.
Prompt diagnosis and treatment can minimize pain severity and duration. CASES:
The case of an 88-year-old woman with sacral shingles is described. Complications
led to her demise. A 35-year-old with a 6-year history of disabling vulvar pain
and many diagnostic procedures was ultimately diagnosed with postherpetic
neuralgia. CONCLUSION: Shingles needs to be included in the differential
diagnosis of vulvar rashes because it is a modifiable risk factor for chronic
vulvar pain. The possibility of postherpetic neuralgia must be considered in
women with unexplained vulvar dysesthesia.

Publication Types: 
    Case Reports

PMID: 12039124 [PubMed - indexed for MEDLINE]

2441: J Clin Microbiol. 2002 Jun;40(6):2302-4.

Disseminated herpes simplex virus and varicella zoster virus coinfection in a
patient taking thalidomide for relapsed multiple myeloma.

Curley MJ, Hussein SA, Hassoun PM.

Pulmonary and Critical Care Division, New England Medical Center, Boston,
Massachusetts 02111, USA.

Disseminated herpes simplex virus (HSV) and varicella zoster virus (VZV) have
been reported individually in immunosuppressed adults. We present a case of
coinfection with disseminated HSV and VZV infection in a patient taking
thalidomide for relapsed multiple myeloma. This is the first report of
opportunistic infection associated with thalidomide.

Publication Types: 
    Case Reports

PMID: 12037117 [PubMed - indexed for MEDLINE]

2442: J Clin Microbiol. 2002 Jun;40(6):1985-8.

Erratum in:
    J Clin Microbiol 2002 Nov;40(11):4405.

Detection of smallpox virus DNA by LightCycler PCR.

Espy MJ, Cockerill III FR, Meyer RF, Bowen MD, Poland GA, Hadfield TL, Smith TF.

Division of Clinical Microbiology, Mayo Clinic and Foundation, Rochester, MN
55905, USA.

A 300-bp plasmid fragment of the hemagglutinin gene was used as target DNA to
develop a rapid real-time LightCycler (Roche Applied Science, Indianapolis, Ind.)
PCR assay for laboratory detection of smallpox virus. PCR primers and probes were
designed specifically for detection of smallpox virus DNA, but all viruses of the
genus Orthopoxvirus tested could be detected by use of the hemagglutinin gene
target sequence. Base pair mismatches in the 204-bp amplicon allowed
discrimination of cowpox virus (melting temperature [T(m)], 56.40 degrees C),
monkeypox virus (T(m), 56.24 degrees C), and vaccinia virus (T(m), 56.72 degrees 
C), including the Dryvax vaccine strain, from smallpox virus (T(m), 62.45 degrees
C) by melting curve analysis. The analytical sensitivity was 5 to 10 copies of
target DNA per sample. The assay was specific for members of the genus
Orthopoxvirus; the DNAs of herpes simplex virus and varicella-zoster virus were
not detected by the smallpox virus LightCycler PCR.

Publication Types: 
    Evaluation Studies

PMID: 12037052 [PubMed - indexed for MEDLINE]

2443: Int J STD AIDS. 1999 Apr;10(4):268-74.

Symptomatic anterior uveitis in HIV-positive patients.

Verma S, Hughes JD, Mabey D, Graham EM.

Department of Genitourinary Medicine, St. Thomas Hospital, London, UK.

Symptomatic anterior uveitis is rare in HIV-positive patients. The uveitis
associated with cytomegalovirus retinitis (CMVR), the commonest ocular
manifestation in AIDS patients, is rarely symptomatic and patients do not
typically present with a red painful eye in conjunction with blurred vision. In
this article we report 12 cases of symptomatic anterior uveitis in HIV-positive
patients and discuss the aetiology. The case notes of all HIV-positive patients
presenting to the eye department with symptoms of uveitis over a 4-year period
were studied retrospectively. The notes were analysed for age, sex, race, risk
factors of HIV, features of the uveitis, concurrent disease and CD4 counts. Only 
12 patients were identified to have symptomatic uveitis out of a total 172
patients. There were 9 males and 3 females with an average age of 35 years. None 
of these patients were taking either rifabutin, protease inhibitors or cidofovir.
Seven out of the 12 patients had granulomatous uveitis. Of these 7 patients, 4
had CD4 counts over 200 and no other concurrent illness whilst 3 patients, with
CD4 counts between 130-200, were subsequently found to have an underlying
aetiology namely lymphoma, tuberculosis and candida. The remaining 5 patients,
all with CD4 counts below 40, had a history of systemic illness with herpes
zoster preceding the onset of the uveitis. HIV-positive patients with symptoms of
uveitis do not have active CMVR and the ophthalmologist must search for other
causes such as tuberculosis or lymphoma in those with granulomatous uveitis or
herpes zoster in those with non-granulomatous uveitis. The CD4 count may be
helpful.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12035782 [PubMed - indexed for MEDLINE]

2444: Servir. 1999 May-Jun;47(3):146-52.

[Herpes zoster in the elderly]

[Article in Portuguese]

Veyssier P.

Servico de medicina interna, Centro Hospitalar de Compiegne, Franca.

Publication Types: 
    Review

PMID: 12035152 [PubMed - indexed for MEDLINE]

2445: Acta Otolaryngol. 2002 Apr;122(3):348-52.

Swelling of the intratemporal facial nerve in Ramsay Hunt syndrome.

Honda N, Yanagihara N, Hato N, Kisak H, Murakami S, Gyo K.

Department of Otolaryngology, Ehime University School of Medicine, Japan.
nobuhon@m.ehime-u.ac.jp

Although Ramsay Hunt syndrome is one of the most important diseases causing
peripheral facial palsy, the detailed pathology of the disease in the
intratemporal facial nerve remains unclear. The purpose of this study was to
increase knowledge of the pathogenesis of the syndrome by means of surgical
findings. Between April 1976 and March 1997 we performed subtotal decompression
of the facial nerve in 74 patients with severe Ramsay Hunt syndrome. The grade of
nerve swelling was assessed using a microscope and recorded in a standardized
form. The relationships between nerve swelling, the timing of surgery and the
swelling of each segment were analyzed. Pronounced neural swelling, involving the
geniculate ganglion and the horizontal segment, was consistent finding in the
acute phase. Although the incidence of pronounced swelling of the horizontal
segment gradually declined with time after onset, in most cases nerve swelling
persisted even beyond the 16th week after onset. These data suggest that diffuse 
viral neuritis occurs throughout the intratemporal facial nerve. We assume that
the viral inflammatory swelling involving the geniculate ganglion and horizontal 
segment is mostly responsible for the acute facial palsy in the acute phase.

Publication Types: 
    Case Reports

PMID: 12030588 [PubMed - indexed for MEDLINE]

2446: J Indian Med Assoc. 2001 Dec;99(12):698-703.

Sympathetic blockade for the relief of chronic pain.

Chaturvedi A, Dash HH.

Department of Neuro-anaesthesiology, Neurosciences Centre, All India Institute of
Medical Sciences, New Delhi.

The sympathetic blocks are useful in many ways for relief of chronic pain. The
sympathetic block can be caused at pre- and paravertebral sympathetic ganglia eg,
stellate ganglia, coeliac plexus and lumbar sympathetic ganglia. Indications for 
sympathetic blockade are: Complex regional pain syndrome, phantom limb pain,
central pain, acute pancreatitis, pancreatic cancer and cancer pain from upper
abdominal viscera. Stellate ganglion blockade is required for the diagnosis,
prognosis and therapy for painful and other conditions associated with
sympathetic dysfunctions of head, neck and upper extremity. Coeliac plexus block 
is indicated in pain due to intra-abdominal cancer, stemming from organs
innervated by coeliac plexus. Lumbar sympathetic block is indicated for
diagnosis, prognosis and therapy for painful and other conditions associated with
sympathetic dysfunctions like complex regional pain syndrome I and II, herpes
zoster, amputation stump pain and inoperable peripheral vascular vasospastic
diseases of the lower limb. Indications for superior hypogastric block are the
prognostic and therapeutic purposes of cancer pelvic organs--uterus, cervix,
bladder, prostate, urethra, testes and ovaries.

Publication Types: 
    Review

PMID: 12022220 [PubMed - indexed for MEDLINE]

2447: Kaohsiung J Med Sci. 2002 Jan;18(1):39-44.

Herpes zoster induced neuropathic bladder--a case report.

Tsai HN, Wu WJ, Huang SP, Su CM, Chen CC, Wang CJ, Chou YH, Huang CH.

Department of Urology, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Rd.,
Kaohsiung 807, Taiwan.

Herpes zoster infection involving the sacral dermatomes has been associated with 
bladder dysfunction and, although rarely, with acute urinary retention. Less than
150 cases have been reported in the literature. After reviewing our institute's
chart records covering a period of time dating from 1991 to 2001, we found that
three of our patients had developed acute urinary retention following herpes
zoster skin lesions of the S2-4 dermatomes. Herein we report our findings. These 
three patients had previously been found to have normal voiding status. However, 
at the time of complaint urodynamic studies revealed detrusor areflexia or
detrusor hyporeflexia with decreased sensation of bladder filling. After
micturation recovery, repeat urodynamic studies revealed detrusor pressure and
bladder sensation recovery. After one to six weeks of treatment, all three
patients could void spontaneously without catheterization. We found that, when
treated with antiviral medication, supportive analgesics, and temporary urinary
drainage, which included urethral catheterization and suprapubic cystostomy,
acute urinary retention associated with herpes zoster has a generally favorable
prognosis. In other words, we found that in spite of its rarity, herpes zoster
induced neuropathic bladder dysfunction is reversible when treated appropriately.

Publication Types: 
    Case Reports

PMID: 12017982 [PubMed - indexed for MEDLINE]

2448: J Chemother. 2002 Apr;14(2):220-2.

Varicella pneumonia: another 'steroid responsive' pneumonia?

Ahmed R, Ahmed QA, Adhami NA, Memish ZA.

Department of Critical Care Medicine, King Fahad National Guard Hospital, Riyadh,
Kingdom of Saudi Arabia.

Varicella-zoster virus (VZV) pneumonitis remains an often-fatal complication of
VZV infection. Antiviral agents and supportive care are widely accepted
therapies. Cautious use of corticosteroids in life-threatening VZV pneumonitis
may be justified. Appropriate patient selection factors are as yet unidentified
and the decision to commence corticosteroid therapy in this setting is clinical.

PMID: 12017381 [PubMed - indexed for MEDLINE]

2449: Nephron. 2002 May;91(1):164-6.

Evaluation of valaciclovir dosage reduction in continuous ambulatory peritoneal
dialysis patients.

Stathoulopoulou F, Dhillon S, Thodis H, Stathakis C, Vargemezis V.

School of Pharmacy, University of London, UK. fsc@otenet.gr

In continuous ambulatory peritoneal dialysis (CAPD) patients, acyclovir-induced
neurotoxicity is reported to be associated with high serum drug levels even when 
following the recommended reduced doses for this renal failure population. In
view of the high oral bioavailability of valaciclovir (the L-valyl ester of
acyclovir) the risk of neurotoxicity becomes more prominent. The present study
was conducted in 12 CAPD patients who were administered a single oral dose of 500
mg valaciclovir. Acyclovir was analyzed by high-performance liquid
chromatography. Relative pharmacokinetic parameters were estimated based on
acyclovir concentrations at 8, 12 and 24 h post-dose. High inter-patient
variations were observed with acyclovir apparent total clearance 7.238 +/- 4 l/h 
and half-life (T1/2) 22.27 +/- 16.82 h. However, dosage simulations confirmed
supratherapeutic acyclovir concentrations for all participants when following the
recommended dose of 1,000 mg valaciclovir/24 h for varicella zoster infections.
Copyright 2002 S. Karger AG, Basel

PMID: 12021536 [PubMed - indexed for MEDLINE]

2450: Bull Soc Pathol Exot. 2002 Mar;95(1):27-30.

[Peripheral neuropathies revealing HIV infection at the Hospital Center of
Bobo-Dioulasso (Burkina Faso)]

[Article in French]

Millogo A, Sawadogo AB, Sawadogo AP, Lankoande D.

Service de medecine interne, Centre hospitalier national Souro Sanou, BP 676,
Bobo-Dioulasso, Burkina Faso. athanase_millogo@hotmail.com

Several peripheral neuropathies are associated with human immuno-deficiency virus
(HIV) infection. In Africa, certain diseases are of particular importance. In the
present work, we report peripheral neurological involvement as revealing signs of
HIV infection within the internal medicine unit of a large city over a 2-year
period. All adult subjects with a positive HIV serology revealed by a peripheral 
neuropathy observed in the National Hospital Centre of Bobo-Dioulasso over a
two-year period (1 January 1999 and 31 December 2000) were included in the study.
46 cases of peripheral neuropathies revealing HIV infection were screened.
Peripheral facial paralysis concerned 25 patients, 15 women and 10 men, in the
early stages of HIV infection. The average age was 34 years. For 80% of the
patients, he CD4 count was over 200. 5/10 cases of polyneuropathy occurred at the
early stage of the HIV infection. Herpes zoster occurred in the early stages in
5/7 cases. 3/4 cases of polyradiculopathy occurred at a later stage with CD4
count under 200. Our study indicates clearly that isolated peripheral facial
paralysis, sensitive polyneuropathy, herpes zoster and polyradiculopathy in young
adults should lead to HIV testing.

Publication Types: 
    English Abstract

PMID: 12012959 [PubMed - indexed for MEDLINE]

2451: Adv Ther. 2002 Jan-Feb;19(1):1-8.

Stavudine-associated peripheral neuropathy in zidovudine-naive patients: effect
of stavudine exposure and antiretroviral experience.

Scarsella A, Coodley G, Shalit P, Anderson R, Fisher RL, Liao Q, Ross LL,
Hernandez JE.

Pacific Oaks Medical Center, Beverly Hills, California 90211, USA.

A post hoc analysis of safety data from study protocol NZT40012 assessed the
incidence of conditions defined by the Centers for Disease Control and Prevention
in 86 zidovudine-naive, antiretroviral-experienced patients with HIV-1 infection 
who responded poorly (plasma HIV-1 RNA > 1000 copies/mL) despite at least 4
months' treatment with stavudine-containing regimens. Peripheral neuropathy
occurred in 21%; other conditions were seen less frequently (candidiasis [13%],
herpes zoster [12%], diarrhea lasting > 1 month [9%], Pneumocystis carinii
pneumonia [9%], and wasting syndrome [8%]). The incidence of peripheral
neuropathy rose significantly with the number of drugs comprising treatment
regimens (> or = 4 vs 1-3; P = .013) and tended to be higher in patients with
longer exposure to stavudine (29% with > or = 24 months' exposure vs 13% with <
24 months). Because peripheral neuropathy was observed with such high frequency, 
vigilance for signs and symptoms of this condition appears warranted if
stavudine-containing regimens are to be continued.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12008857 [PubMed - indexed for MEDLINE]

2452: J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Jun 5;772(2):327-34.

Determination of acyclovir in maternal plasma, amniotic fluid, fetal and
placental tissues by high-performance liquid chromatography.

Brown SD, White CA, Chu CK, Bartlett MG.

Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, The
University of Georgia, Athens, GA 30602-2352, USA.

Acyclovir [9-[(2-hydroxyethoxy)-methyl]-guanosine, Zovirax, ACV] is a synthetic
purine nucleoside analog active against herpes simplex virus types 1 (HSV-1), 2
(HSV-2), and varicella zoster virus. Acyclovir has frequently been used in HSV-2 
seropositive mothers to prevent prenatal transmission of herpes virus to their
unborn children. A fast and reproducible HPLC method for the determination of the
highly polar acyclvoir in maternal rat plasma, amniotic fluid, placental tissue, 
and fetal tissue has been developed and validated. Plasma and amniotic fluid
samples were prepared by protein precipitation using 2 M perchloric acid and
syringe filtering. Tissue samples were homogenized in distilled water,
centrifuged, and extracted using a C(18) solid-phase extraction method prior to
analysis. Baseline resolution was achieved for acyclovir and the internal
standard gancyclovir, an anti-viral of similar structure to acyclovir, using an
Agilent Eclipse XDB C(8) column (150 x 2.1 mm, 5 microm). The mobile phase used
for the plasma and amniotic fluid was 10 mM acetate/citrate buffer-3.7 mM aqueous
octanesulfonic acid (87.5:12.5, v/v) at a flow-rate of 0.2 ml/min. The mobile
phase used for the tissue samples was 30 mM acetate/citrate buffer with 5 mM
octanesulfonic acid-acetonitrile (99:1, v/v). Both aqueous mobile phase portions 
were pH adjusted to 3.08. All separations were done using an Agilent 1100 Series 
HPLC system with UV detection of 254 nm. The assay was validated for each matrix 
over a range of 0.25-100 microg/ml over 3 days using five replicates of three
spiked concentrations. The relative standard deviation and percent error for each
validation data set was <15% for middle and high quality control (QC) points and 
<20% for all low QC points. All calibration curves showed good linearity with an 
R(2)>0.99. The extraction efficiency for recovery of acyclovir from all matrices 
was >80%.

PMID: 12007778 [PubMed - indexed for MEDLINE]

2453: J Am Acad Dermatol. 2002 May;46(5):771-4.

Visceral zoster as the presenting feature of disseminated herpes zoster.

Stratman E.

Department of Dermatology, Marshfield Clinic, Marshfield, WI 54449, USA.

Visceral dissemination of herpes zoster may follow cutaneous dissemination in
immunocompromised patients. The skin is not necessarily the only organ affected
and may not even be the presenting organ. Immunohistochemical stains available
for routine paraffin-embedded tissue biopsy specimens allow for rapid diagnosis
of varicella zoster virus. We describe a patient in whom gastric dissemination of
herpes zoster was proven by immunohistochemistry. Unexplained hepatitis,
pancreatitis, gastritis, or complaints of abdominal pain in immunocompromised
patients with herpes zoster should prompt a high degree of suspicion for visceral
zoster and immediate treatment with intravenous acyclovir.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 12004322 [PubMed - indexed for MEDLINE]

2454: Isr Med Assoc J. 2002 Apr;4(4):262-4.

Acquired neurogenic abdominal wall weakness simulating abdominal hernia.

Kesler A, Galili-Mosberg R, Gadoth N.

Department of Neurology, Meir General Hospital, Kfar Saba, Israel.

Publication Types: 
    Case Reports

PMID: 12001699 [PubMed - indexed for MEDLINE]

2455: Eur J Orthod. 2002 Apr;24(2):205-14.

Unilateral primary or secondary retention of permanent teeth, and dental
malformations.

Becktor KB, Bangstrup MI, Rolling S, Kjaer I.

Department of Orthodontics, School of Dentistry, University of Copenhagen,
Denmark.

The purpose of the present investigation was to describe the dentition in
subjects with local primary or secondary unilateral retention of two or more
permanent teeth, and to elucidate the aetiology by comparing the regions of
retention with the innervation pattern of the jaws. The material comprised
radiographic dental orthopantomograms (OTP) from 12 patients with an age range of
6-18 years (six females and six males). The locations of retention and the dental
morphology in the affected regions were analysed. Comparison with contralateral
teeth was undertaken and the innervation pattern of the affected field was
considered. Varying degrees of dental root malformation were found to be
associated with primary and secondary retention. More pronounced root
malformations were observed in subjects with several affected teeth. A connection
between unilateral retained permanent teeth and temporary or permanent disruption
of the nerve supply to the affected region is suggested.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 12001558 [PubMed - indexed for MEDLINE]

2456: Rinsho Shinkeigaku. 2001 Oct;41(10):695-7.

[A case of Vernet's syndrome due to varicella-zoster virus infection]

[Article in Japanese]

Doi H, Segawa F, Koyano S, Suzuki Y, Kuroiwa Y.

Department of Neurology, Yokohama City University School of Medicine.

We report a 73-year-old man who suffered from an acute onset of dysphagia, cough,
hoarseness and left facial and occipital pain. On the 44 days of illness, he was 
admitted to our clinic. A neurological examination revealed left IX, X and XI
cranial nerve palsy. The diagnosis of Vernet's syndrome due to varicella-zoster
virus (VZV) infection was made, based on the high titers of VZV antibody in
serum. Magnetic resonance imaging revealed a unique nodular lesion with
gadolinium enhancement at the medial side of the left jugular foramen. Clinical
symptoms improved with intravenous high dose pulse methylprednisolone therapy.
The clinical course suggests that the inflammation extended from the left X
cranial nerve ganglion.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11993191 [PubMed - indexed for MEDLINE]

2457: J Dermatol. 2002 Mar;29(3):178-9.

Zosteriform angiolymphoid hyperplasia with eosinophilia.

Dowlati B, Nabai H, Mehregan DR, Mehregan DA, Khaleel J.

Publication Types: 
    Case Reports
    Letter

PMID: 11990257 [PubMed - indexed for MEDLINE]

2458: J Clin Pathol. 2002 May;55(5):399; author reply 399.

Comment on:
    J Clin Pathol. 2001 Oct;54(10):743-7.

Vaccination to prevent varicella and shingles.

Katona SJ.

Publication Types: 
    Comment
    Letter

PMID: 11986353 [PubMed - indexed for MEDLINE]

2459: J Clin Pathol. 2002 May;55(5):397-8.

Oesophagobronchial fistula caused by varicella zoster virus in a patient with
AIDS: a unique case.

Moretti F, Uberti-Foppa C, Quiros-Roldan E, Fanti L, Lillo F, Lazzarin A.

Institute of Infectious and Tropical Diseases, University of Brescia, 25123
Brescia, Italy. francescamoretti@libero.it

Human herpesvirus oesophagitis in human immunodeficiency virus positive patients 
is caused by cytomegalovirus and herpes simplex virus; no cases of oesophagitis
and oesophagobrochial fistula as a result of varicella zoster virus (VZV) have
been reported to date. This report describes the case of a patient with a 2-3 mm 
deep oesophageal ulcer whose viral culture was positive for VZV. The patient was 
treated with acyclovir with resolution of the symptomatology. After the end of
the induction treatment, because of the onset of fever and fits of coughing
during eating, the patient underwent oesophagography, which showed an ulcer with 
an oesophagobronchial fistula in the middle and lower third of the oesophagus.
This case report stresses the role of VZV infection as a possible cause of
oesophagobronchial fistula, a rare but benign condition in patients with AIDS.

Publication Types: 
    Case Reports

PMID: 11986352 [PubMed - indexed for MEDLINE]

2460: Anesthesiology. 2002 May;96(5):1168-74.

Effects of analgesics on delayed postherpetic pain in mice.

Takasaki I, Sasaki A, Andoh T, Nojima H, Shiraki K, Kuraishi Y.

Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, Toyama
Medical and Pharmaceutical University, Toyama, Japan.

BACKGROUND: Postherpetic neuralgia is pain that persists long after the
disappearance of the cutaneous lesions of herpes zoster. However, the mechanisms 
of this delayed pain are unclear. Herpes simplex virus infection induces
cutaneous lesions and pain-related responses in mice. The authors examined
whether such responses would persist after the disappearance of the cutaneous
lesions and whether some analgesics would be effective against them. METHODS:
Female BALB/c mice were inoculated with herpes simplex virus type 1 on the
unilateral hind paw. Pain-related responses of hind paw were determined using von
Frey filaments. Beginning 5 days after inoculation, mice were given perorally the
antiherpes agent acyclovir five times a day for 7 days. Effects of morphine (3-5 
mg/kg subcutaneously), gabapentin (30-100 mg/kg perorally), mexiletine (10-30
mg/kg intraperitoneally), and diclofenac (30 mg/kg intraperitoneally) on
pain-related responses were examined on days 25-35 after inoculation. RESULTS:
Viral inoculation induced cutaneous lesions and pain-related responses beginning 
on day 5 after inoculation. Acyclovir treatment healed all skin lesions by day 15
after inoculation. Approximately half of the mice given acyclovir showed
pain-related responses at least until day 40 after inoculation. Morphine,
gabapentin, and mexiletine dose-dependently inhibited pain-related responses, but
diclofenac had no effects. CONCLUSIONS: The authors show a mouse model of delayed
postherpetic pain. This may be useful for manifesting the mechanisms of
postherpetic neuralgia and the factors contributing to the transition from acute 
herpetic pain to delayed postherpetic pain. This may also be useful for the
development of new analgesics against postherpetic neuralgia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11981158 [PubMed - indexed for MEDLINE]

2461: J Clin Microbiol. 2002 May;40(5):1728-32.

Utility of a multiplex PCR assay for detecting herpesvirus DNA in clinical
samples.

Druce J, Catton M, Chibo D, Minerds K, Tyssen D, Kostecki R, Maskill B,
Leong-Shaw W, Gerrard M, Birch C.

Victorian Infectious Diseases Reference Laboratory (VIDRL), 10 Wreckyn Street,
North Melbourne 3051, Victoria, Australia.

A multiplex PCR was designed to amplify herpes simplex virus types 1 and 2,
cytomegalovirus, and varicella-zoster virus DNA present in a diverse range of
clinical material. The susceptibility of these viruses to in vivo inhibition by
at least one antiviral drug was an important consideration in their inclusion in 
the multiplex detection system. An aliquot of equine herpesvirus was introduced
into each specimen prior to extraction and served as an indicator of potential
inhibitors of the PCR and a detector of suboptimal PCR conditions. Compared to
virus isolation and immunofluorescence-based antigen detection, the multiplex
assay yielded higher detection rates for all viruses represented in the assay.
The turnaround time for performance of the assay was markedly reduced compared to
those for the other techniques used to identify these viruses. More than 21,000
tests have been performed using the assay. Overall, the multiplex PCR enabled the
detection of substantially increased numbers of herpesviruses, in some cases in
specimens or anatomical sites where previously they were rarely if ever
identified using traditional detection methods.

PMID: 11980951 [PubMed - indexed for MEDLINE]

2462: JAMA. 2002 May 1;287(17):2211; author reply 2211-2.

Comment on:
    JAMA. 2002 Feb 6;287(5):606-11.

Varicella vaccine and shingles.

Brisson M, Edmunds WJ, Gay NJ, Miller E.

Publication Types: 
    Comment
    Letter

PMID: 11980518 [PubMed - indexed for MEDLINE]

2463: Bone Marrow Transplant. 2002 Apr;29(7):595-8.

Ganciclovir is effective for prophylaxis and treatment of human herpesvirus-6 in 
allogeneic stem cell transplantation.

Tokimasa S, Hara J, Osugi Y, Ohta H, Matsuda Y, Fujisaki H, Sawada A, Kim JY,
Sashihara J, Amou K, Miyagawa H, Tanaka-Taya K, Yamanishi K, Okada S.

Department of Developmental Medicine (Pediatrics) D-5, Osaka University Graduate 
School of Medicine, Osaka, Japan.

Human herpesvirus 6 (HHV-6) infection and disease are serious complications of
allogeneic hematopoietic stem cell transplantation (allo-SCT). Ganciclovir (GCV) 
is effective against HHV-6 in vitro but the antiviral susceptibility of HHV-6 has
not been well characterized in vivo. We retrospectively compared the HHV-6
reactivation rate in pediatric allo-SCT recipients with and without GCV
prophylaxis. The HHV-6 reactivation rate at 3 weeks after allo-SCT in patients
without prophylactic GCV administration was significantly higher than that in
those receiving prophylactic GCV (11/28 vs 0/13, P < 0.01). Five of 36 patients
without prophylactic GCV showed clinical manifestations including skin rash,
interstitial pneumonitis, persistent thrombocytopenia, enterocolitis and
thrombotic microangiopathy, respectively. HHV-6-associated symptoms were observed
in one of the 13 patients receiving prophylactic GCV. This patient showed fever, 
diarrhea and graft rejection concomitantly with a sudden increase of HHV-6 DNA
copy number. Patients who received GCV for treatment of HHV-6 infection showed an
improvement in symptoms and/or decrease of HHV-6 copy number. Thus, GCV is
effective for treating HHV-6 disease after allo-SCT in vivo.

PMID: 11979309 [PubMed - indexed for MEDLINE]

2464: J Fam Pract. 2002 Feb;51(2):121-8.

Comment in:
    ACP J Club. 2002 Sep-Oct;137(2):52.    J Fam Pract. 2002 Jun;51(6):514.

Treatment of postherpetic neuralgia: a systematic review of the literature.

Alper BS, Lewis PR.

Department of Family & Community Medicine, University of Missouri-Columbia School
of Medicine, Columbia, MO 65212, USA. alperb@health.missouri.edu

OBJECTIVES: We wanted to determine whether any treatment had been shown to reduce
pain or disability from postherpetic neuralgia (PHN), a common sequela of herpes 
zoster in elderly patients. STUDY DESIGN: We undertook a systematic review of
English-language randomized controlled trials (RCTs) of treatments of PHN with
evaluation periods longer than 24 hours. DATA SOURCES: We systematically searched
MEDLINE, Current Contents, and the Cochrane Library. We also searched reference
lists of identified trials and reviews and contacted content experts. OUTCOMES
MEASURED: Two reviewers independently evaluated RCTs for methodologic quality and
data extraction. Outcomes of primary focus were pain and quality of life.
RESULTS: Twenty-seven RCTs met inclusion criteria and were reviewed. Six trials
of tricyclic antidepressants found evidence for clinically meaningful effects
over 6 weeks. All other treatments were evaluated in no more than 2 trials
meeting our inclusion criteria. Topical capsaicin 0.075%, gabapentin, and
controlled-release oxycodone were shown to be effective, but the clinically
meaningful benefit is difficult to quantify. Intrathecal methylprednisolone and
possibly bupivacaine sympathetic blocks are helpful in refractory cases. Other
treatments evaluated, including topical lidocaine, had no evidence or
inconsistent evidence of benefit. CONCLUSIONS: No single best treatment for PHN
is known. Tricyclic antidepressants, topical capsaicin, gabapentin, and oxycodone
are effective for alleviating PHN; however, long-term, clinically meaningful
benefits are uncertain and side effects are common. Patients with PHN refractory 
to these therapies may benefit from intrathecal methylprednisolone. Little
evidence is available regarding treatment of PHN of less than 6 months' duration.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11978209 [PubMed - indexed for MEDLINE]

2465: J Pharm Sci. 2002 May;91(5):1343-50.

Systemic absorption of topical lidocaine in normal volunteers, patients with
post-herpetic neuralgia, and patients with acute herpes zoster.

Campbell BJ, Rowbotham M, Davies PS, Jacob P 3rd, Benowitz NL.

Division of Drug Delivery and Disposition, School of Pharmacy, University of
North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

Topical lidocaine has been recently marketed as a new treatment for post-herpetic
neuralgia. The aim of our study was to characterize the absorption profile of and
systemic exposure to lidocaine from patch and gel formulations in normal
volunteers, patients with post-herpetic neuralgia, and patients with acute herpes
zoster. The bioavailability of lidocaine from the patch formulation averaged 3%, 
and was similar after single and repeated doses. Systemic exposure to lidocaine
and monoethylglycinexylidide (MEGX), the primary active metabolite of lidocaine, 
after application of lidocaine gel or patches was minimal in normal volunteers,
patients with post-herpetic neuralgia, and patients with acute herpes zoster.
Considering the benefit versus risk of topical lidocaine, systemic absorption and
toxicity of lidocaine seems not to be a significant risk. Copyright 2002
Wiley-Liss, Inc. and the American Pharmaceutical Association

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 11977110 [PubMed - indexed for MEDLINE]

2466: HIV Clin Trials. 2002 Mar-Apr;3(2):148-54.

Clinical signs and symptoms in the assessment of immunodeficiency in men with
subtype C HIV infection in Harare, Zimbabwe.

Machekano R, Bassett M, McFarland W, Katzenstein D.

AIDS Clinical Trials, Stanford University Medical School, Stanford, California,
USA. rodmach@stanford.edu

PURPOSE: Providing low-cost interventions such as co-trimoxazole as prophylaxis
against opportunistic infections among HIV-infected individuals depends on the
identification of those at risk. This article describes the prevalence of
self-reported signs and symptoms and CD4 cell counts in a cohort of 447 HIV
seropositive men. A scoring system using self-reported signs and symptoms was
developed and tested in the prediction of low CD4 cell counts. This approach may 
allow health care providers in low-resource settings to predict severe
immunodeficiency and to provide care. METHOD: Data on clinical manifestations of 
HIV infection and blood samples for HIV serology were collected prospectively
from an ambulatory cohort of men seen at their workplace at enrollment and every 
6 months thereafter. CD4+ cell counts were obtained on samples testing positive
on ELISA. Using data reduction techniques and logistic modeling, we developed a
prognostic score system. RESULTS: 20% of the men had CD4+ cell counts below 200. 
All reported signs and symptoms were more frequent in men with less than 200 CD4+
cell counts compared to men with CD4+ cell counts greater than 200. History of
malaria, fever, lymphadenopathy, persistent diarrhea, persistent cough, and skin 
infections robustly predicted low CD4+ count. A scoring system equation was
developed based on the coefficients of the multivariate logistic regression:
1x(tuberculosis) + 3.2x(herpes zoster) + 4.5x(malaria) + 5.7x(fever) +
5.8x(cough) + 8.2x(lymphadenopathy) + 8.5x(skin infection). Setting the score
cutoff value greater than or equal 5, the model had moderately high sensitivity
of 61% and specificity of 72%. The scoring system had an overall classification
error rate of 30%. CONCLUSION: By using this simple scoring system, physicians
can correctly identify 72% of patients who do not require immediate intervention,
thereby channeling scarce resources to those who have both low CD4+ cell counts
and symptoms and are most likely to benefit from prophylactic and antiretroviral 
interventions.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11976993 [PubMed - indexed for MEDLINE]

2467: Ann Hematol. 2002 Apr;81(4):187-91. Epub 2002 Mar 26.

Increased levels of soluble CD27 in the cerebrospinal fluid are not diagnostic
for leptomeningeal involvement by lymphoid malignancies.

van den Bent MJ, Lamers CH, van 't Veer MB, Sillevis Smitt PA, Bolhuis RL,
Gratama JW.

Department of Neuro-Oncology, University Hospital and Daniel den Hoed Cancer
Center, P.O. Box 5201, 3008 AE Rotterdam, Netherlands. bent@neuh.azr.nl

Soluble CD27 (sCD27) reportedly is a sensitive and specific marker for
leptomeningeal involvement (LI) of CD27-expressing lymphoproliferations such as
B-cell non-Hodgkin's lymphoma (B-NHL) or chronic B-lymphocytic leukemia (B-CLL). 
Because morphological analysis of cerebrospinal fluid (CSF) in patients suspected
of LI is false negative in one-third of patients, a diagnostic marker for LI by
B-NHL or B-CLL would be very valuable. sCD27 was determined in the first CSF
sample from each of 102 unselected patients submitted for (immuno)morphologic
detection of malignant cells. The patients were considered to have LI if either
(immuno)morphologic analyses showed tumor cells or if neuroradiological
evaluation showed typical abnormalities consistent with LI. Patients were
suspected of having LI if CSF samples revealed atypical lymphocytes and/or if
clinical symptoms and signs suggestive of LI were present, but clinical follow-up
was shorter than 3 months because of deterioration of the patient. LI was
considered absent if (immuno)morphologic analyses of CSF samples were negative
without evidence for LI during 3 months of clinical follow-up. In patients with
chronic lymphoproliferative disorders [mainly B-non-Hodgkin's lymphoma (NHL)],
sCD27 concentrations were significantly higher in the CSF samples of 16 patients 
with confirmed or suspected LI than in those of 46 patients without LI. However, 
sCD27 was also increased in a variety of other predominantly inflammatory
neurological disorders including herpes simplex and zoster infections. The
positive predictive value of sCD27 determination for LI was only 54%, but the
negative predictive value was 92%. Normal sCD27 concentrations in CSF samples of 
patients with chronic lymphoproliferation makes LI unlikely, but the
determination of CSF sCD27 is not sufficiently specific to serve as a reliable
tumor marker.

Publication Types: 
    Evaluation Studies

PMID: 11976819 [PubMed - indexed for MEDLINE]

2468: Klin Oczna. 2001;103(4-6):207-15.

[Ophthalmic complications in the course of opportunistic infections--part I]

[Article in Polish]

Raczynska K, Ulewicz-Filipowicz J, Owczuk R.

Kliniki Chorob Oczu AM w Gdansku.

One of the most important problem of contemporary medicine appears to be
constantly increasing number of patients with opportunistic infections. The
situation is mainly due to world epidemic of AIDS. The progress in
transplantology, huge number of immunocompromised patients during oncological and
hematological treatment as well as prolongation of life time in children with
congenital immunodeficiencies are successive conditions for the development of
opportunistic infection. Pathogens infecting immunocompromised individuals have
very low virulence, but in these persons disease is often very severe and
potentially lethal. Main agents responsible for opportunistic infections are:
Toxoplasma gondii, Cytomegalovirus hominis, Herpes simplex virus,
Varicella-zoster virus and fungi. In the paper we describe clinical symptoms,
diagnostic methods and therapies of ocular toxoplasmosis and viral infections.
Knowledge of diagnosing methods and treatment of opportunistic infections which, 
when untreated, may quickly lead to vision loss, is necessary in contemporary
ophthalmological practice.

Publication Types: 
    English Abstract
    Review

PMID: 11975020 [PubMed - indexed for MEDLINE]

2469: Kansenshogaku Zasshi. 2002 Mar;76(3):216-9.

[Four cases of pediatric Ramsay Hunt syndrome]

[Article in Japanese]

Takayama N, Takayama M.

Department of Pediatrics, Tokyo Metropolitan Komagome Hospital.

Four cases of the Ramsay Hunt syndrome were admitted to our hospital during the
two years from February 1997 to January 1999. Though one of the 4 patients had
been immunized with varicella vaccine, the causative virus was not a vaccine
strain but a wild-type strain. These patients were not suffering from underlying 
diseases. Because the number of pediatric zoster patient without underlying
diseases who visited our clinic between 1981 and 1999 was 35 cases, the Ramsay
Hunt syndrome turned out not to be extremely rare even among children having no
underlying diseases. The prognosis of the Ramsay Hunt syndrome is assumed to be
good if the treatment begins at the early stage. To begin the treatment at the
early stage, it is necessary to confirm the diagnosis with virological
examinations.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11974892 [PubMed - indexed for MEDLINE]

2470: Hautarzt. 2002 Mar;53(3):223-4.

[4th International Conference on Varicella, Herpes Zoster and Postherpetic
Neuralgia (PHN). 3-5 March 2001, La Jolla, California, USA]

[Article in German]

Lilie HM, Wassilew SW.

Dermatologische Klinik, Klinikum Krefeld, Lutherplatz 40, 47805 Krefeld.
lilie@klinikum-krefeld.de

Publication Types: 
    Congresses

PMID: 11974596 [PubMed - indexed for MEDLINE]

2471: Pain. 2002 Apr;96(3):410-1.

Comment on:
    Pain. 2001 Nov;94(2):131-2.    Pain. 2001 Nov;94(2):149-58.    Pain. 2001 Nov;94(2):215-24.

Comment on Rice ASC, Maton S, the Postherpetic Neuralgia Study Group (UK),
gabapentin in postherpetic neuralgia: a randomized, double blind,
placebo-controlled study.

Gehling M, Tryba M.

Publication Types: 
    Comment
    Letter

PMID: 11973022 [PubMed - indexed for MEDLINE]

2472: Pain. 2002 Apr;96(3):409-10; author reply 411-2.

Comment on:
    Pain. 2001 Nov;94(2):215-24.

Comment on Rice ASC, Maton S, the Postherpetic Neuralgia Study Group (UK),
gabapentin in postherpetic neuralgia: a randomized, double blind,
placebo-controlled study.

Bowsher D.

Publication Types: 
    Comment
    Letter

PMID: 11973021 [PubMed - indexed for MEDLINE]

2473: J Cutan Pathol. 2002 Mar;29(3):142-7.

Specific cutaneous infiltrates of B-cell chronic lymphocytic leukemia (B-CLL) at 
sites typical for Borrelia burgdorferi infection.

Cerroni L, Hofler G, Back B, Wolf P, Maier G, Kerl H.

Department of Dermatology, University of Graz, Austria.
lorenzo.cerroni@kfunigraz.ac.at

BACKGROUND: Cutaneous manifestations of B-cell chronic lymphocytic leukemia
(B-CLL) comprise a wide spectrum of clinicopathologic presentations. In some
cases, onset of skin lesions is triggered by antigenic stimulation, and specific 
skin infiltrates at sites of previous herpes simplex or herpes zoster infection
have been well documented. Specific skin manifestations of B-CLL can also be
observed at sites typical for lymphadenosis benigna cutis (nipple, scrotum,
earlobe), a Borrelia burgdorferi-associated cutaneous B-cell pseudolymphoma.
METHODS: We studied specific skin manifestations of B-CLL arising at sites
typical for B. burgdorferi-induced lymphadenosis benigna cutis, analyzing tissues
for presence of B. burgdorferi DNA using the polymerase chain reaction (PCR)
technique. Six patients with B-CLL (M : F = 4 : 2; mean age: 67.8) presented with
specific skin lesions located on the nipple (four cases) and scrotum (two cases).
RESULTS: Clinically there were solitary erythematous plaques or nodules.
Histology revealed in all cases a dense, monomorphous infiltrate of small
lymphocytes showing an aberrant CD20+/CD43+ phenotype. In all cases monoclonality
was demonstrated by PCR analysis of the JH gene rearrangement. PCR analysis
showed in four of the six cases the presence of DNA sequences specific for
B.burgdorferi. CONCLUSIONS: Our study demonstrates that infection with B.
burgdorferi can trigger the development of specific cutaneous infiltrates in
patients with B-CLL.

PMID: 11972710 [PubMed - indexed for MEDLINE]

2474: Jpn J Infect Dis. 2002 Feb;55(1):6-13.

Herpesvirus infections of the central nervous system.

Shoji H, Wakasugi K, Miura Y, Imaizumi T, Kazuyama Y.

First Department of Internal Medicine, Kurume University School of Medicine,
Kurume 830-0011, Japan. hshoji@med.kurume-u.ac.jp

In recent years, advances in the diagnosis and treatment of herpes simplex
encephalitis (HSE) have been achieved due to the prevalence of antiviral drugs
and the introduction of the polymerase chain reaction (PCR) to test the
cerebrospinal fluid. The several clinical forms of herpes simplex virus type 1
(HSV-1) infections of the central nervous system (CNS), including acute
disseminated encephalomyelitis and brainstem encephalitis, have been clarified.
However, fatal, prolonged, or relapsed cases are still observed, and early
detection and appropriate treatment is necessary to lead to a good prognosis for 
these intractable HSE cases. In adult HSV-2 infections, meningitis and myelitis
associated with genital herpes are common. In the past, HSV-2 myelitis has been
reported as a form of fatal necrotizing myelopathy; however, using PCR and
magnetic resonance imaging studies, mild surviving cases are increasingly likely 
to be identified. Meanwhile, various CNS syndromes resulting from the herpes
group viruses, including varicella-zoster virus and Epstein-Barr virus have also 
been reported. These herpesviruses have several characteristics in common, e.g., 
they exist in the latent state and they occur in both mucocutaneous and CNS
infections. Adult HSV-1 and -2 infections of the CNS are discussed together with 
other herpes group virus infections of the CNS.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11971155 [PubMed - indexed for MEDLINE]

2475: Clin Lymphoma. 2002 Mar;2(4):238-41.

Testicular lymphoma: a literature review and report of a case with a zoster-like 
cutaneous recurrence.

Ingram RM, Williams ME, Fintel WA, Ross M.

Division of Hematology/Oncology and Adult Stem Cell Transplantation Program,
University of Virginia Health System, Charlottesville, VA 22908, USA.
rmi8n@virginia.edu

Testicular lymphoma accounts for approximately 1% of all cases of non-Hodgkin's
lymphoma. This distinct clinical entity can have an aggressive course with a high
rate of systemic relapse. We describe a unique case of a diffuse large B-cell
lymphoma, T-cell-rich variant with cutaneous dermatomal zosteriform recurrence
presenting as neuralgia. This case represents a unique pattern of treatment
failure in this aggressive extranodal lymphoma.

Publication Types: 
    Case Reports
    Review

PMID: 11970763 [PubMed - indexed for MEDLINE]

2476: Ostomy Wound Manage. 2002 Mar;48(3):24-7.

Healing shingles with moist occlusive dressings.

Lee SK.

Publication Types: 
    Case Reports

PMID: 11968892 [PubMed - indexed for MEDLINE]

2477: Medicina (B Aires). 2002;62(1):53-4.

[Abdominal distension due to herpes zoster]

[Article in Spanish]

Barroso FA.

Catedra de Neurologia, Facultad de Ciencias Medicas, Universidad Nacional de
Rosario, Rosario, Argentina. fabiobarroso@uol.com.ar

A case is reported in which an abdominal protrusion appeared in relation with a
zosteric eruption at 11th dorsal dermatome. The motor deficit in zoster is
unusual (2-3% in the reported series) and generally recognized when the
extremities are affected. The frequency with which the abdominal muscles are
involved is estimated to be around 0.17%, according to a clinical series. The aim
of this report is to draw attention to the abdominal wall paresis that can result
when zoster involves the caudal dorsal dermatomyotomes. This in turn, leads to
abdominal distension which needs to be differentiated from other causes.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11965851 [PubMed - indexed for MEDLINE]

2478: Nurs Times. 2000 Dec 14-2001 Jan 3;96(50):36-7.

Shingles: diagnosis and treatment.

Scott F.

Virology Department, Barts and The London NHS Trust.

PMID: 11965804 [PubMed - indexed for MEDLINE]

2479: Rheumatology (Oxford). 2002 Apr;41(4):445-9.

No evidence of parvovirus B19, Chlamydia pneumoniae or human herpes virus
infection in temporal artery biopsies in patients with giant cell arteritis.

Helweg-Larsen J, Tarp B, Obel N, Baslund B.

Department of Infectious Diseases, Hvidovre University Hospital, Denmark.

OBJECTIVES: Recent studies have suggested that infective agents may be involved
in the pathogenesis of giant cell arteritis (GCA), in particular Chlamydia
pneumoniae and parvovirus B19. We investigated temporal arteries from patients
with GCA for these infections as well as human herpes viruses using the
polymerase chain reaction (PCR). METHODS: Thirty temporal artery biopsies from 30
patients suspected of having GCA within a period of 1 yr were examined. Thirteen 
patients had classical GCA, two had biopsy-negative GCA, 10 patients had
polymyalgia rheumatica and five patients had other conditions. DNA was extracted 
from frozen biopsies and PCR was used to amplify genes from Chlamydia pneumoniae,
parvovirus B19 and each of the eight human herpes viruses: herpes simplex viruses
HSV-1 and 2, Epstein-Barr virus, cytomegalovirus, varicella zoster virus and
human herpes viruses HHV-6, -7 and -8. RESULTS: In all 30 biopsies, PCR was
negative for DNAs of parvovirus B19, each of the eight human herpes viruses and
C. pneumoniae. CONCLUSIONS: We found no evidence of DNA from parvovirus B19,
human herpes virus or C. pneumoniae in any of the temporal arteries. These agents
do not seem to play a unique or dominant role in the pathogenesis of GCA.

PMID: 11961176 [PubMed - indexed for MEDLINE]

2480: J Med Chem. 2002 Apr 25;45(9):1918-29.

6-[2-(Phosphonomethoxy)alkoxy]pyrimidines with antiviral activity.

Holy A, Votruba I, Masojidkova M, Andrei G, Snoeck R, Naesens L, De Clercq E,
Balzarini J.

Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech
Republic, Flemingovo nam. 2, CZ-166 10 Praha 6, Czech Republic. holy@uochb.cas.cz

6-Hydroxypyrimidines substituted at positions 2 and 4 by hydrogen, methyl, amino,
cyclopropylamino, dimethylamino, methylsulfanyl, or hydroxyl group afford by the 
reaction with diisopropyl 2-(chloroethoxy)methylphosphonate in the presence of
NaH, Cs(2)CO(3), or DBU a mixture of N(1)- and
O(6)-[2-(diisopropylphosphorylmethoxy)ethyl] isomers which were converted to the 
free phosphonic acids by treatment with bromotrimethylsilane followed by
hydrolysis. Analogously, 2,4-diamino-6-hydroxypyrimidine gave on reaction with
[(R)- and (S)-2-(diisopropylphosphorylmethoxy)propyl] tosylate, followed by
deprotection, the enantiomeric 6-[2-(phosphonomethoxy)propoxy]pyrimidines.
2,4-Diamino-6-sulfanylpyrimidine gave, on treatment with diisopropyl
2-(chloroethoxy)methylphosphonate in the presence of NaH and subsequent
deprotection, 2,4-diamino-6-[[2-(phosphonomethoxy)ethyl]sulfanyl]pyrimidine.
2-Amino-4-hydroxy-6-[2-(phosphonomethoxy)ethyl]pyrimidine was obtained from the
appropriate 2-amino-4-chloropyrimidine derivative by alkaline hydrolysis and
ester cleavage. Direct alkylation of 2-amino-4,6-dihydroxypyrimidine afforded a
mixture of 2-amino-4,6-bis[2-(phosphonomethoxy)ethyl]- and
2-amino-1,4-bis[2-(phosphonomethoxy)ethyl]pyrimidine. None of the
N(1)-[2-(phosphonomethoxy)ethyl] isomers exhibited any antiviral activity against
DNA viruses or RNA viruses tested in vitro. On the contrary, the O(6)-isomers,
namely the compounds derived from 2,4-diamino-, 2-amino-4-hydroxy-, or
2-amino-4-[2-(phosphonomethoxy)ethoxy]-6-hydroxypyrimidine, inhibited the
replication of herpes viruses [herpes simplex type 1 (HSV-1) and type 2 (HSV-2), 
varicella-zoster virus (VZV), and cytomegalovirus (CMV)] and retroviruses
[Moloney sarcoma virus (MSV) and human immunodeficiency virus type 1 (HIV-1) and 
type 2 (HIV-2)], their activity being most pronounced against the latter. The
antiviral activity was lower if the oxygen at the position 6 was replaced by a
sulfur atom, as in 2,4-diamino-6-[2-(phosphonomethoxy)ethylsulfanyl]pyrimidine.
In analogy to N(9)-[2-(phosphonomethoxy)propyl]-2,6-diaminopurine (PMPDAP),
solely the (R)-2,4-diamino-6-[2-(phosphonomethoxy)propoxy]pyrimidine exerted
antiviral activity, whereas its (S)-enantiomer was essentially inactive.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11960502 [PubMed - indexed for MEDLINE]

2481: Transplant Proc. 2002 Feb;34(1):77.

Prevalence of past varicella zoster virus infection in candidates for kidney
transplantation: vaccination in seronegative patients.

Crespo JF, Gorriz JL, Avila A, Sancho A, Gavela E, Cano A, Zanon V, Pallardo LM.

Department of Nephrology and Preventive Medicine, Hospital Universitario Dr
Peset, Valencia, Spain.

PMID: 11959193 [PubMed - indexed for MEDLINE]

2482: Med Klin (Munich). 2002 Mar 15;97(3):123-7.

[Laboratory diagnosis of herpes zoster: virology or serology?]

[Article in German]

Sauerbrei A, Sommer M, Eichhorn U, Wutzler P.

Institut fur Antivirale Chemotherapie, Friedrich-Schiller-Universitat Jena.
Andreas.Sauerbrei@med.uni-jena.de

BACKGROUND: The diagnosis of herpes zoster is mostly based on clinical findings. 
In atypical cases, rapid and reliable virological diagnostics is necessary
because effective antiviral chemotherapy is available. PATIENTS AND METHODS: The 
meaningfulness and practicability of conventional diagnostic methods mostly used 
such as antigen staining, virus isolation and detection of virus-specific
antibodies were compared with polymerase chain reaction (PCR) in 100 patients
with zoster. RESULTS: PCR using oligonucleotides selected from the open reading
frames 28 and 29 of the varicella-zoster virus (VZV) genome showed the highest
sensitivity of 94% and a specificity of 100%. Direct immunofluorescent antigen
staining carried out within few hours had a sensitivity of 82% and a specificity 
of 70%. However, results could only be obtained in 71% of the cases. On the basis
of serologic parameters, an active VZV infection was detected in 61% of the
patients. Virus culture frequently regarded as "gold standard" was successful in 
20%. There was a strong dependence on the time of collecting specimens and the
immunocompetence of the patients. CONCLUSIONS: The study shows that the PCR has
to be considered the method of choice for the diagnostics of zoster with an
atypical course. Serological methods can only be recommended to confirm the
diagnosis retrospectively.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 11957786 [PubMed - indexed for MEDLINE]

2483: AIDS. 2002 May 3;16(7):1045-9.

Aseptic meningitis and optic neuritis preceding varicella-zoster progressive
outer retinal necrosis in a patient with AIDS.

Franco-Paredes C, Bellehemeur T, Merchant A, Sanghi P, DiazGranados C, Rimland D.

Division of Infectious Diseases, Department of Medicine, Veterans Affairs Medical
Center, Emory University School of Medicine, 69 Butler Street, Atlanta, GA 30303,
USA.

Varicella-Zoster Virus (VZV) is the second most common ocular pathogen in
patients with HIV infection. VZV retinitis is estimated to occur in 0.6% of
patients with HIV infection and may occur in one of two clinical syndromes. The
first is the acute retinal necrosis syndrome, which also may be seen in
immunocompetent hosts. The second clinical syndrome occurs in patients with CD4
cell counts typically < 50 x 10(6)/l and is termed progressive outer retinal
necrosis. VZV retinitis has been reported to occur simultaneously with other VZV 
central nervous system manifestations such as encephalitis and myelitis in
HIV-infected patients. In addition, VZV retrobulbar optic neuritis heralding VZV 
retinitis has recently been described in HIV-infected patients who had suffered a
recent episode of dermatomal herpes zoster. Herein we report the case of an
HIV-infected individual who presented with VZV meningitis and retrobulbar optic
neuritis that preceded the onset of progressive outer retinal necrosis. We also
review of the literature of seven additional reported cases of retrobulbar optic 
neuritis preceding the onset of VZV retinitis.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11953471 [PubMed - indexed for MEDLINE]

2484: Clin Exp Dermatol. 2002 Mar;27(2):132-4.

Comment in:
    Clin Exp Dermatol. 2004 May;29(3):323; author reply 324.

Drug eruption secondary to aciclovir with recall phenomenon in a dermatome
previously affected by herpes zoster.

Carrasco L, Pastor MA, Izquierdo MJ, Farina MC, Martin L, Fortes J, Requena L.

Department of Dermatology, Fundacion Jimenez Diaz, Universidad Autonoma, Avda.
Reyes Catolicos No. 2, 28040-Madrid, Spain

Classically, recall dermatitis refers to chemotherapy-induced reactivation of
skin damage caused by radiotherapy months, or even years, earlier. The concept of
recall dermatitis has now been extended to include radiation recall dermatitis
induced by other drugs, ultraviolet radiation, extravasation of drugs, and
allergic contact dermatitis. We now describe recall dermatitis along the residual
cutaneous lesions of a previous thoracic herpes zoster in a patient who developed
a drug eruption after oral administration of aciclovir. The most striking feature
consisted of confluent linear erythema along the dermatomes previously involved
by the herpes zoster episode. Histopathologic study demonstrated small foci of
spongiosis, vacuolar changes involving the basal layer of the epidermis and
single necrotic keratinocytes scattered within the epidermis. The papillary
dermis appeared oedematous and with dilated blood capillaries surrounded by a
sparse inflammatory infiltrate composed mainly of lymphocytes. Serial sections
failed to demonstrate cytologic changes of herpes varicella zoster infection. We 
interpreted this case as an example of recall dermatitis because the widespread
cutaneous eruption secondary to aciclovir was more intense in skin previously
compromised by herpes varicella zoster infection. To the best of our knowledge,
recall dermatitis has not been described before at the site of previous
involvement by herpes zoster.

Publication Types: 
    Case Reports

PMID: 11952706 [PubMed - indexed for MEDLINE]

2485: J Eur Acad Dermatol Venereol. 2002 Jan;16(1):53-7.

Early diagnosis of herpes zoster by polymerase chain reaction.

Lilie HM, Wassilew SW, Wolff MH.

Dermatology Department, Klinikum Krefeld, Germany. lilie@klinikum-krefeld.de

BACKGROUND: Herpes zoster is a common disease caused by the varicella-zoster
virus. The use of virostatic agents as early as possible is necessary in
shortening zoster-associated pain. OBJECTIVES: Rapid diagnosis is necessary for
the optimal efficacy of antiviral therapy. The diagnosis in the early stage of
infection is often difficult. METHODS: In the present study skin biopsies of
patients with herpes zoster and unclear skin changes were analysed by detecting
viral DNA using the polymerase chain reaction (PCR) in order to amplify open
reading frames (ORF) 14, 29 and 63. RESULTS: Varicella-zoster virus DNA could be 
detected with PCR of all three ORF not only from blisters but also from
erythematous skin. CONCLUSIONS: PCR is the method of choice for the viral
diagnosis in herpes zoster before blister eruption.

PMID: 11952291 [PubMed - indexed for MEDLINE]

2486: Drugs Exp Clin Res. 2001;27(5-6):199-208.

Evaluation of efficacy and tolerance of neuramide in the treatment of herpes
zoster and postherpetic neuritis.

Varotti C, Rafanelli A.

University of Bologna, Department of Clinical and Experimental Specialist
Medicine, Clinical Dermatology Section, Bologna, Italy.

Ninety-two patients suffering from herpes zoster were enrolled in a double-blind 
controlled study aimed at evaluating the efficacy and tolerance of the drug
neuramide. Neuramide (N) and placebo (P) were administered to patients
intramuscularly twice daily for 28 days as follows: group N + N (patients always 
treated with neuramide); group N + P (patients treated with neuramide for 1 week,
then with placebo); group P + N (patients treated with placebo for 1 week, then
with neuramide); group P + P (patients always treated with placebo). During the
first week, all patients were also treated with standardized doses of acyclovir. 
The presence and extent of clinical symptoms were evaluated during the first 4
weeks, while the appearance, degree and duration of postherpetic neuralgia were
evaluated both during treatment and over a 6-month follow-up period. There were
no significant differences between the four groups of patients when subjective
parameters (such as pain and paresis at the lesion site) were examined. However, 
clinical examination at the end of treatment showed that treatment with neuramide
was therapeutic. Indeed, the times for recovery and for regeneration of
epithelium were significantly shorter when neuramide was administered for 3 weeks
of the treatment period. Furthermore, the change from vesicles to crusts was
significantly faster in the neuramide group than in the placebo group.
Postherpetic neuritis occurred in the first months of follow-up. However, in
groups N + P and P + P, the symptoms lasted throughout the 6-month observation
period, while in the other groups this period was shorter. Indeed, there were
significant differences (p < 0.05) in terms of the above complications between
the following groups: N + N and N + P; N + N and P + P; N + P and P + N; P + N
and P + P. No significant differences were observed between the N + N and P + N, 
or N + P and P + P groups. Taken together, these data demonstrate that neuramide 
treatment for at least 3 weeks significantly reduces the risk of postherpetic
neuritis development.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 11951578 [PubMed - indexed for MEDLINE]

2487: World J Surg. 2002 Jul;26(7):783-9. Epub 2002 Apr 15.

Current progress in suicide gene therapy for cancer.

Yazawa K, Fisher WE, Brunicardi FC.

Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 6550
Fannin, Suite 1661, Houston, Texas 77030, USA.

Standard chemotherapeutic agents and ionizing radiation destroy dividing cells.
Because tumor cells divide more rapidly than normal cells, there is a therapeutic
index in which damage to the cancer cells is maximized while keeping the toxicity
to the normal host cells acceptable. Suicide gene therapy strives to deliver
genes to the cancer cells, which convert nontoxic prodrugs into active
chemotherapeutic agents. With this strategy, the systemically administered
prodrug is converted to the active chemotherapeutic agent only in cancer cells,
thereby allowing a maximal therapeutic effect while limiting systemic toxicity. A
literature search was conducted using the MEDLINE database from 1990 to 2001 to
identify articles related to suicide gene therapy for cancer. A number of suicide
gene systems have been identified, including the herpes simplex virus thymidine
kinase gene, the cytosine deaminase gene, the varicella-zoster virus thymidine
kinase gene, the nitroreductase gene, the Escherichia coli gpt gene, and the E.
coli Deo gene. Various vectors, including liposomes, retroviruses, and
adenoviruses, have been used to transfer these suicide genes to tumor cells.
These strategies have been effective in cell culture experiments, laboratory
animals, and some early clinical trials. Advances in tissue- and cell-specific
delivery of suicide genes using specific promoters will improve the clinical
utility of suicide gene therapy.

Publication Types: 
    Review

PMID: 11948367 [PubMed - indexed for MEDLINE]

2488: N Engl J Med. 2002 Apr 11;346(15):1127.

Images in clinical medicine. Herpes zoster ophthalmicus followed by contralateral
hemiparesis.

Nogueira RG, Sheen VL.

Brigham and Women's Hospital, Boston, MA 02115, USA.

Publication Types: 
    Case Reports

PMID: 11948272 [PubMed - indexed for MEDLINE]

2489: Haematologica. 2002 Apr;87(4):444-6.

Clinical characteristics of and risk factors for herpes zoster after
hematopoietic stem cell transplantation.

Leung AY, Yuen KY, Cheng VC, Lie AK, Liang R, Kwong YL.

Publication Types: 
    Letter

PMID: 11940491 [PubMed - indexed for MEDLINE]

2490: Ann Dermatol Venereol. 2002 Feb;129(2):251-4.

[Post zoster pain]

[Article in French]

Paul C, Donskoff C, Michel C.

Service de Dermatologie, Hopital E. Muller, 68100 Mulhouse, France.

Publication Types: 
    Comparative Study

PMID: 11937971 [PubMed - indexed for MEDLINE]

2491: Cancer. 2002 Apr 1;94(7):2033-9.

Frequency and type of serious infections in fludarabine-refractory B-cell chronic
lymphocytic leukemia and small lymphocytic lymphoma: implications for clinical
trials in this patient population.

Perkins JG, Flynn JM, Howard RS, Byrd JC.

Department of Medicine, Walter Reed Army Medical Center, Washington, D.C., USA.

BACKGROUND: Treatments for fludarabine-refractory chronic lymphocytic leukemia
(CLL)/small lymphocytic lymphoma (SLL) are limited. Most new therapies being
examined in fludarabine-refractory patients have shown a high frequency of
serious infection. Little data exist regarding the frequency of infections in
this population treated with noninvestigational best supportive care therapies.
METHODS: The infectious courses of 27 patients with fludarabine-refractory
CLL/SLL were retrospectively reviewed. Fludarabine-refractoriness was defined as 
either relapse within six months of completion of or failure to respond to
fludarabine treatment. Infections were documented after patients met National
Cancer Institute criteria for further treatment. Serious infections were defined 
as infections mandating admission to the hospital for intravenous antibiotics.
RESULTS: Patient characteristics included: median age 67 years (range, 40-83),
median 3 chemotherapy treatments (range, 1-8), and hypogammaglobulinemia in 73%
of patients. Pneumocystis carinii prophylaxis was given to 89% of patients.
Serious infections developed in 24 out of 27 patients (89%). Patients had a
median of 2 admissions (range, 0-11) for serious infection occurring at a median 
of 4 months (range, 0-21) from onset of fludarabine-refractoriness. The median
frequency of admission for infection was 0.17 per month. Most common sites for
infection in decreasing frequency were: respiratory tract, urinary tract,
blood/sepsis, and soft tissues. Bacteria caused 69 out of 88 infections (78.4%); 
viruses (varicella-zoster and herpes simplex) caused 11 out of 88 (12.5%); fungi 
caused 4 out of 88 (4.5%); and opportunistic infections caused 4 out of 88
(4.5%). Median survival was 13.0 months (range, 1-44+). CONCLUSIONS: The
frequency of serious infections in patients with fludarabine-refractory CLL/SLL
is high. These findings are relevant to trials with new and highly effective
agents for which the incidence of serious infections after treatment might
otherwise appear to be prohibitively high. Copyright 2002 American Cancer
Society.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 11932906 [PubMed - indexed for MEDLINE]

2492: Pain. 2002 Mar;96(1-2):9-12.

Intractable postherpetic itch and cutaneous deafferentation after facial
shingles.

Oaklander AL, Cohen SP, Raju SV.

Neuropathic Pain Study Group, Department of Anesthesiology, Massachusetts General
Hospital, Harvard Medical School, Boston, MA 02114, USA. aoaklander@partners.org

Some patients develop chronic itch from neurological injuries, and shingles may
be a common cause. Neuropathic itch can lead to self-injury from scratching
desensate skin. A 39-year-old woman experienced severe postherpetic itch, but no 
postherpetic neuralgia, after ophthalmic zoster. Within 1 year, she had
painlessly scratched through her frontal skull into her brain. Sensory testing
and skin biopsies were performed on itchy and normal scalp to generate
preliminary hypotheses about mechanisms of neuropathic itch. Quantitation of
epidermal neurites in PGP9.5-immunolabeled skin biopsies demonstrated loss of 96%
of epidermal innervation in the itchy area. Quantitative sensory testing
indicated severe damage to most sensory modalities except itch. These data
indicate that in this patient, severe postherpetic itch was associated with loss 
of peripheral sensory neurons. Possible mechanisms include electrical
hyperactivity of hypo-afferented central itch-specific neurons, selective
preservation of peripheral itch-fibers from neighboring unaffected dermatomes,
and/or imbalance between excitation and inhibition of second-order sensory
neurons.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 11932056 [PubMed - indexed for MEDLINE]

2493: Virus Genes. 2002;24(1):49-56.

Varicella-zoster virus (VZV) mediates a delayed host shutoff independent of open 
reading frame (ORF) 17 expression.

Waterboer T, Rahaus M, Wolff MH.

Institute of Microbiology and Virology, University of Witten/Herdecke, Germany.

Varicella-zoster virus (VZV) open reading frame 17 (ORF 17) is the gene
corresponding to Herpes simplex-virus (HSV) UL41. The UL41 gene encodes the
virion host shutoff factor (vhs), a RNase that has been the object of detailed
studies. In contrast to HSV, knowledge about VZV mediated shutoff effects and the
role of ORF 17 is poor. We investigated the ORF 17 expression in infected cells
and analyzed shutoff effects. ORF 17 expression could not be proven in infected
human fibroblast cell lines and melanoma (MeWo) cells. Only after induction by
Phorbol 12-myristate 13-acetate an ORF 17 expression became detectable in MeWo
cells. Nevertheless, using stable expressed GAPDH mRNA as a marker for mRNA
degradation, a VZV mediated shutoff, independent of ORF 17 expression, became
measurable. Transfection experiments demonstrated that transient ORF 17
expression did not decrease the cellular GAPDH mRNA level. We examined whether
the VZV shutoff factor is a tegument protein causing an early shutoff or whether 
it needs to be expressed (delayed shutoff). The GAPDH mRNA level in Actinomycin D
pretreated and infected MeWo cells did not decrease even faster than the
theoretical decay rate based on a half-life of 24 h. These findings lead to the
conclusion that the VZV shutoff factor is not a mature protein localized in the
virion and that VZV causes a delayed virion host shutoff effect.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11928988 [PubMed - indexed for MEDLINE]

2494: Scand J Infect Dis. 2002;34(2):112-4.

Polymorphism of the IL-10 gene is associated with susceptibility to herpes
zoster.

Haanpaa M, Nurmikko T, Hurme M.

Department of Neurology and Rehabilitation, Tampere University Hospital, Finland.

Herpes zoster (HZ) is induced by diseases or medical treatments leading to a
decrease in cell-mediated immunity, but in most cases it appears without any
detectable, predisposing condition. We report here that susceptibility to HZ is
genetically determined. The promoter region of the IL-10 gene contains 3
single-nucleotide polymorphisms (G/A at -1082, C/T at -819 and C/A at -592) which
form 3 haplotypes, GCC, ACC and ATA. These haplotypes are known to differ in
terms of their effect on the transcription of the IL-10 gene. In a cohort of 60
HZV patients, the number of carriers of the ATA haplotype was 32 (53%), while in 
blood donors the frequency was 151/400 (38%) (p < 0.05).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11928840 [PubMed - indexed for MEDLINE]

2495: Retina. 2002 Apr;22(2):225-8.

A case of a five-year-old boy with acute retinal necrosis.

Iino Y, Tanaka M, Hatano N, Kiyokawa M, Takebayashi H, Shinohara I, Kobayashi Y, 
Ninomiya H.

Department of Ophthalmology, Juntendo University, Urayasu Hospital, Chiba, Japan.

Publication Types: 
    Case Reports

PMID: 11927861 [PubMed - indexed for MEDLINE]

2496: An Esp Pediatr. 2002 Apr;56(4):366-8.

[Meningitis as a neurological complication of herpes zoster]

[Article in Spanish]

Jimenez Moya A, Garcia Hernandez T, Velez De Guevara TP, Santana Rodriguez C,
Romero Escos D, Herrera Martin M.

Publication Types: 
    Case Reports
    Letter

PMID: 11927087 [PubMed - indexed for MEDLINE]

2497: Aust Fam Physician. 2002 Mar;31(3):217-23.

Eye signs in systemic disease.

Stawell RJ, Hall AJ.

Alfred Hospital and Ocular Immunology Clinic, Royal Victorian Eye and Ear
Hospital, Victoria.

BACKGROUND: The eye provides clues to the diagnosis of many systemic diseases and
many important complications of these diseases occur in the eye. OBJECTIVE: To
review the important ocular pathology seen in some systemic diseases. The ocular 
manifestations of a small number of these diseases will be discussed in detail.
DISCUSSION: Examination of the eye should be a routine and important part of a
general examination in certain systemic diseases.

Publication Types: 
    Review

PMID: 11926152 [PubMed - indexed for MEDLINE]

2498: Nihon Kokyuki Gakkai Zasshi. 2002 Jan;40(1):77-80.

[An adult patient with varicella-zoster pneumonia while under inhaled steroid
treatment]

[Article in Japanese]

Yasuo M, Yamamoto H, Maruyama Y.

Department of Respiratory Medicine, Komoro Kousei General Hospital, 2-31
Yora-cho, Komoro, Nagano 384-8588, Japan.

Bronchial asthma had been diagnosed in a 33-year-old man, and he had then been
treated with a moderate dose of inhaled steroids (fluticason propionate 400
micrograms/day). On year later, he was admitted to our hospital complaining of
sore throat, fever, loss of appetite, and skin eruptions. Despite the
administration of Acyclovir for three days, varicella pneumonia was diagnosed.
Computed tomography of the chest and bronchoscopic examination revealed
characteristic findings: nodules with surrounding ground-glass attenuation and
multiple vesicles with an ulcerativelesion on the bronchial mucosa, respectively.
The demonstration of varicella-zoster virus DNA in a bronchoalveolar lavage
specimen by the polymerase chain reaction technique was useful in the formulation
of a definitive diagnosis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11925924 [PubMed - indexed for MEDLINE]

2499: Masui. 2002 Mar;51(3):293-5.

[The development of methicillin-resistant Staphylococcus aureus sepsis in a
patient with herpes zoster during treatment with continuous epidural infusion]

[Article in Japanese]

Suzuki T, Takemura H, Shida K, Higuchi H, Ohtsuka N, Masuda Y.

Department of Anesthesiology, School of Medicine, Showa University, Tokyo
142-8666.

A 79-year-old man with herpes zoster was referred to our hospital for pain
control. He was a survivor of the atomic bombing of Hiroshima, and had a history 
of cerebral infarction and hypertension. A cervical epidural catheter was placed 
for continuous analgesic infusion. After 20 days of catheterization, he gradually
developed a high fever and confusion, and complained of nausea and headaches. An 
urgent blood examination revealed a white blood cell count of 15,200 mm-3 and a
C-reactive protein of 32.4 mg.dl-1. The catheter was removed and antibiotic
therapy was started. Repeated magnetic resonance imaging could not confirm
epidural abscess formation. The bacterial culture of the cerebrospinal fluid was 
negative, but the cultures of the blood, the catheter tip, and the nasal cavity
swab were positive for methicillin-resistant Staphylococcus aureus. Although
intravenous vancomycin was administered, systemic inflammation persisted. The
patient consecutively suffered varied disorders such as acute renal failure,
disseminated intravascular coagulation, and gastrointestinal bleeding. Although
symptomatic treatment had been prolonging his life, 58 days after the catheter
removal, the patient suddenly developed cerebellopontine infarction, which made
mechanical ventilation necessary. He remained unconscious until his death 117
days after the catheter removal. We discussed the possible pathogenetic
mechanisms of the present case.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11925898 [PubMed - indexed for MEDLINE]

2500: J Investig Dermatol Symp Proc. 2001 Dec;6(3):183-7.

Varicella-zoster virus: a re-emerging infection.

LaGuardia JJ, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA.

Varicella-zoster virus (VZV) causes chickenpox (varicella), becomes latent in
cranial nerve and dorsal root ganglia, and can reactivate many years later to
produce shingles (zoster) and postherpetic neuralgia (PHN). Elderly and
immunocompromised individuals are also at risk for complications of VZV
reactivation involving the central nervous system (CNS), including myelitis,
large-vessel encephalitis/granulomatous arteritis, small-vessel encephalitis,
meningoencephalitis, and ventriculitis. Peripheral nervous system (PNS)
complications range from zoster and postherpetic neuralgia to postinfectious
polyneuritis (Guillain-Barre syndrome, GBS). These complications can occur with
or without cutaneous manifestations. An increase in elderly and immunocompromised
individuals will likely result in a higher prevalence of these conditions;
therefore, VZV can be seen as a "re-emerging" infection of the early twenty-first
century. In this review, we summarize our experience and the existing literature 
on CNS and PNS complications of VZV reactivation. Special attention is paid to
reports of complications without rash, as these entities are more difficult to
diagnose.

Publication Types: 
    Review

PMID: 11924825 [PubMed - indexed for MEDLINE]

2501: East Afr Med J. 2001 Aug;78(8):398-401.

Oral manifestations of HIV/AIDS in a Kenyan provincial hospital.

Butt FM, Chindia ML, Vaghela VP, Mandalia K.

Coast Province General Hospital, Mombasa, Kenya.

BACKGROUND: In Kenya many patients exposed to the HIV infection present with
orofacial lesions as the primary manifestations of the disease and only a few
studies have been performed to document this observation. OBJECTIVE: To
clinically evaluate and document the range and pattern of oral lesions in a group
of hospitalised patients with HIV-infection. DESIGN: A prospective study.
SETTING: Coast Province General Hospital in Mombasa, Kenya, which is the main
referral institution serving a population of approximately two million people.
METHODS: Examination of all the cases included in the study was performed
according to the WHO criteria. Both male and female patients aged 16 years and
above were selected. The criterion of recruitment was based on a suspicion of
immunosuppression, the presence of oral manifestations and the willingness to
participate in the study. Prior to the examination each patient had undergone
counselling followed by two consecutive screening tests using the ELISA
technique. Where indicated incisional biopsy was performed to confirm the
clinical diagnosis of the relevant lesions. In collaboration with the medical
team, treatment was administered as per the needs of the patient in terms of
anti-fungals, antivirals or topical cortisteroids. RESULTS: Of the 61 cases,
25(41%) were males and 36(59%) females with an age range of 19 to 65 years (mean 
= 34.7 years). While all the cases had periodontal disease, over 80% had
candidiasis of the hyperplastic, erythematous and pseudomembraneous types.
Lymphadenopathy and angular cheilitis were each diagnosed in 27.9% of the cases; 
while oral Kaposi's sarcoma was seen in 13% of the patients. Other conditions
seen included persistent oral ulceration (11.5%), oral hairy leukopLakia and
herpes zoster each constituting 4.9%; herpes simplex, mucosal hyperpigmentation, 
parotomegaly and facial palsy each comprised six per cent and oral warts seen in 
one case. In accordance with the pattern and prevalence of oral manifestations in
our study, the results were largely consistent with those documented elsewhere.
CONCLUSION: For the alleviation of the morbidity arising from the commonly
occurring lesions, early detection is mandatory. Furthermore, documentation of
the varied regional patterns of occurrence of these lesions may aid in the
rational application of the emerging treatments.

PMID: 11921559 [PubMed - indexed for MEDLINE]

2502: Ethiop Med J. 2001 Jul;39(3):185-92.

Cryptococcosis in patients from Tikur Anbessa Hospital, Addis Ababa, Ethiopia.

Woldemanuel Y, Haile T.

Department of Medical Microbiology & Parasitology, Faculty of Medicine, Addis
Ababa University, Addis Ababa, Ethiopia.

A study was done to investigate the occurrence of Cryptococcus neoformans
infection in patients admitted to Tikur Anbessa Hospital. Cryptococcus neoformans
is an important opportunistic fungal pathogen in immunocompromised patients. The 
study was done over a period of 18 months, from October 1998 to April 2000.
During this period, a total of 1088 cerebrospinal fluid (CSF) specimens were sent
to the bacteriology laboratory in Tikur Anbessa Hospital, out of which 275 were
subjected for India ink examination. Out of these 19 (7%) were India ink
positive. Additionally one lymph node aspirate was also India ink positive. All
these specimens were culture positive for Cryptococcus neoformans. The medical
records of these patients were retrospectively reviewed and all presenting
clinical symptoms were recorded. In this group of patients with meningitis the
most common presenting were fever and headache. In addition, at the time of
admission, 75% of the patients had other opportunistic infections, such as oral
candidiasis, herpes zoster and Pneumocystis carini pneumonia. The mortality rate 
was high even in patients with appropriate therapy. All the isolates were
identified as C. neoformans var. neoformans. The variety gatti was not isolated
in this study.

PMID: 11921549 [PubMed - indexed for MEDLINE]

2503: J Int Med Res. 2002 Jan-Feb;30(1):56-65.

Clinical correlates of prolonged pain in Japanese patients with acute herpes
zoster.

Kurokawa I, Kumano K, Murakawa K; Hyogo Prefectural PHN Study Group.

Department of Dermatology, Hyogo Prefectural Tsukaguchi Hospital, Hyogo, Japan.
ikuro@alles.or.jp

To determine which risk factors are relevant to the occurrence of post-herpetic
neuralgia in Japanese patients with acute herpes zoster, correlations between the
prolongation of pain and various disease factors were examined in 263 adult
patients presenting within 10 days of the onset of rash at 17 institutions in the
Hyogo region of Japan. All patients in whom pain persisted for more than 3 months
were over 60 years of age. The pain also tended to be more prolonged in those
with clustered vesicles, disturbed sleep and hypanaesthesia. Other factors such
as underlying disease states, critically involved regions, scar tissue,
generalized rash and allodynia were not relevant to the duration of pain.
Although decreased pain persistence was observed in patients in whom acyclovir
therapy was initiated within 72 h of the onset of symptoms in comparison with
those in whom it was initiated after this time, the difference between the two
groups of patients was not statistically significant. Our results suggest that
advanced age, the presence of clustered vesicles, and disturbed sleep and
hypanaesthesia influence the prolongation of herpes zoster pain.

PMID: 11921500 [PubMed - indexed for MEDLINE]

2504: Int J Impot Res. 2001 Dec;13(6):352-3.

Herpes zoster producing temporary erectile dysfunction.

Rix GH, Carroll DN, MacFarlane JR.

Department of Urology, Queen Margaret Hospital NHS Trust, Dunfermline, Fife, UK. 
ghrix@hotmail.com

Varicella Zoster affecting the sacral dermatomes is a rare but well recognised
cause of urinary retention. Only one case of erectile dysfunction associated with
Varicella Zoster has previously been described, which was longstanding, but no
cases of transient erectile dysfunction following Zoster infection are recorded. 
We present one such case.

Publication Types: 
    Case Reports

PMID: 11918252 [PubMed - indexed for MEDLINE]

2505: Dermatol Nurs. 2001 Feb;13(1):51, 54-5.

Shingles update: common questions in caring for a patient with shingles.

Madison LK.

Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Varicella zoster virus (VZV) is a herpes virus that can cause two distinct
clinical diseases, chickenpox and shingles. Primary infection of varicella, often
called chickenpox, results in a generalized eruption of a vesicular exanthematous
rash which is usually seen in children and is highly contagious. This virus (VZV)
can then become latent and later reactivate causing herpes zoster, commonly known
as shingles. Shingles is usually a localized phenomenon often seen in adults and 
is usually less contagious. The following is a discussion of infection control
questions most commonly asked regarding the care of a patient with shingles.

PMID: 11917300 [PubMed - indexed for MEDLINE]

2506: Clin Geriatr Med. 2002 Feb;18(1):89-101, vi.

Skin infections and infestations in geriatric patients.

Elgart ML.

Department of Dermatology, The George Washington University Medical Center,
Washington, DC, USA. mervynelgart@sprintmail.com

Geriatric patients develop infections, but many have a different appearance from 
what usually is expected. The difference depends on the age and immune status of 
the patient and the virulence of the organism. Differences may make recognition
more difficult. Therapy may require different doses. Examples of the more common 
infections are detailed in this article.

Publication Types: 
    Review

PMID: 11913741 [PubMed - indexed for MEDLINE]

2507: J Fr Ophtalmol. 2001 Nov;24(9):930-6.

[Lamellar keratoplasty with air or viscoelastic substance injection]

[Article in French]

Duong MH, Thimel S, Xuan TH.

Service d'Ophtalmologie du Groupe Hospitalier Bichat-Claude Bernard, 46, rue
Henri Huchard, 75877 Paris.

PURPOSE: To analyze the results of very deep lamellar keratoplasty using
dissection with air and a viscoelastic substance. METHODS: This was a prospective
monocentric noncomparative study. Candidates for lamellar keratoplasty were
enrolled between November 1998 and July 2000. Deep lamellar dissection was
performed following air injection into the cornea to create a white emphysema of 
the stroma. The dissection was performed to the Descemet membrane. Whenever a
large bulla was present in the recipient bed, the dissection of the deepest
stromal lamellae was performed by injecting a viscoelastic substance into the
bulla. A full-thickness allogenic corneal button was sutured to the recipient
bed. RESULTS: Fifteen eyes of 14 patients (mean age, 39.3 years) underwent deep
lamellar keratoplasty: keratoconus (11 eyes), atopic keratoconjunctivitis (1
eye), herpes zoster keratitis (1 eye), corneal scar after pterygium surgery (1
eye), and rosacea keratitis (1 eye). Excluded from the analysis of the refractive
outcome were patients who underwent intraoperative perforation (n = 3) and the
patients with postoperative complications affecting the central visual axis: (n =
2 [hemorrhage in the interface and herpetic simplex keratitis]). The mean
preoperative visual acuity was 0.10 (range, 0.05 to 0.3). After a
3.8-month-follow-up, the mean best corrected visual acuity was 0.21 (range, 0.1
to 0.6). The visual results were better in patients with keratoconus (mean best
corrected visual acuity: 0.22; range, 0.1 to 0.6). The mean postoperative
astigmatism was 4.15 diopters (range, 0 to 8). CONCLUSION: Intrastromal air and
viscoelastic substance injection appeared to be very useful for performing a very
deep lamellar keratoplasty. The results of the refractive outcome were
encouraging. Deep lamellar keratoplasty is an interesting alternative to
penetrating keratoplasty, because it cannot induce progressive primary graft
failure and allogenic endothelial graft rejection and it obviates the need to
perform a lamellar dissection of the donor button.

Publication Types: 
    English Abstract

PMID: 11912836 [PubMed - indexed for MEDLINE]

2508: J Pediatr Ophthalmol Strabismus. 2002 Mar-Apr;39(2):123-4.

Central retinal artery occlusion in herpes zoster ophthalmicus.

Ahn M, Cho NC.

Department of Ophthalmology, Chonbuk National University Medical School, Chonju, 
South Korea.

Publication Types: 
    Case Reports

PMID: 11911544 [PubMed - indexed for MEDLINE]

2509: J Formos Med Assoc. 2002 Jan;101(1):73-5.

Natural killer cell deficiency associated with Hodgkin's lymphoma: a case report.

Yang CM, Yang YH, Lin YT, Lu MY, Chiang BL.

Department of Pediatrics, National Taiwan University Hospital, 7 Chung Shan South
Road, Taipei, Taiwan.

Natural killer (NK) cells are large granular lymphocytes that play important
roles in immunity against viral infection. NK cell deficiency is associated with 
recurrent episodes of severe herpes group virus reactivation. Few cases of NK
cell deficiency have been reported. Here, we report the case of a Taiwanese girl 
who had suffered from severe atopic dermatitis since infancy, and recurrent
episodes of herpes virus reactivation since the age of 3 years old. NK cell
deficiency was diagnosed based on the finding of persistently low NK cell counts 
in peripheral blood. Hodgkin's lymphoma developed when she was 6 years old. The
present case suggests that NK cell deficiency may be an important risk factor in 
the development of Hodgkin's lymphoma.

Publication Types: 
    Case Reports

PMID: 11911042 [PubMed - indexed for MEDLINE]

2510: Hautarzt. 2001 Dec;52(12):1111-4.

[Post-zoster granuloma with detection of varicella zoster virus DNA in the
granulomas]

[Article in German]

Gutzmer R, Kiehl P, Hausmann M, Kapp A, Weiss J.

Dermatologische Klinik und Poliklinik der Medizinische Hochschule, Ricklinger
Strasse 5, 30449 Hannover. rgutzmer@gmx.de

Granulomatous skin changes following herpes zoster are uncommon and their
pathogenesis is unclear. We demonstrated varicella-zoster virus in the granuloma 
tissue of an immunocompromised patient with postherpetic granulomas and use this 
finding as basis for discussing the pathogenesis of these lesions.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11910864 [PubMed - indexed for MEDLINE]

2511: J Cutan Med Surg. 2001 Sep-Oct;5(5):409-16.

Reduction of postherpetic neuralgia in herpes zoster.

Vander Straten M, Carrasco D, Lee P, Tyring SK.

Department of Dermatology, University of Texas Medical Branch, UTMB Center for
Clinical Studies, 2060 Space Park Drive, Galveston, TX 77058, USA.

BACKGROUND: Persons 50 years of age and older are not only at increased risk of
developing herpes zoster, they are also more likely to suffer the long-term
morbidity of postherpetic neuralgia (PHN). PHN is pain persisting after the rash 
of herpes zoster has healed. PHN affects at least 40% of all herpes zoster
patients over age 50 and over 75% of herpes zoster patients over age 75; PHN is
the single most common neurologic condition in elderly patients. OBJECTIVE: The
objective of this review is to evaluate interventions that may reduce or even
eliminate PHN. No single therapy has been consistently effective for PHN. The
most effective approach appears to be with the use of antiviral therapy early in 
the course of herpes zoster. The goals of ongoing studies in herpes zoster are to
develop interventions that will further reduce the symptoms of PHN and/or to
eliminate PHN by prophylaxis using the varicella vaccine. CONCLUSIONS: Reduction 
of PHN can best be achieved with the use of antiviral medication early in the
course of herpes zoster; other classes of drugs are minimally effective in
treating established PHN. Widespread use of the varicella vaccine may lead to
secondary reductions in PHN in the distant future.

Publication Types: 
    Review

PMID: 11907852 [PubMed - indexed for MEDLINE]

2512: Support Care Cancer. 2002 Apr;10(3):197-203. Epub 2001 Sep 22.

Challenges and options in the management of viral infections after stem cell
transplantation.

Reusser P.

Division of Medicine, Hopital Regional, CH-2900 Porrentruy, Switzerland.
pierre.reusser@jura.ch

During the period of profound combined immunodeficiency after bone marrow or
peripheral blood stem cell transplantation (SCT), patients are at increased risk 
for serious viral disease. Recent advances in rapid diagnostic methods and the
introduction of potent antiviral compounds have made it possible to establish
efficient management strategies for several herpesviruses. Acyclovir,
valaciclovir, and famciclovir are widely used for the treatment of herpes simplex
virus or varicella zoster virus disease. Intravenous ganciclovir, foscarnet, and 
cidofovir are available for prevention or therapy of cytomegalovirus disease, and
oral valganciclovir could become a valuable alternative to intravenous treatment 
if shown to be effective and safe after SCT. Preliminary data on pleconaril for
therapy of picornaviral disease are promising. Future investigations may help to 
clarify the role of the neuraminidase inhibitors zanamivir and oseltamivir in the
management of influenza in SCT recipients. The emergence of viruses resistant to 
antiviral drugs is of concern, and alternative treatment strategies need to be
defined.

Publication Types: 
    Review

PMID: 11904784 [PubMed - indexed for MEDLINE]

2513: Pathology. 2002 Feb;34(1):88-93.

Meningoencephalomyelitis with vasculitis due to varicella zoster virus: a case
report and review of the literature.

McKelvie PA, Collins S, Thyagarajan D, Trost N, Sheorey H, Byrne E.

Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Victoria,
Australia. mckelvpa@svhm.org.au

Varicella zoster virus (VZV) encephalitis is associated with large or small
vessel vasculopathy. We report the case of a 67-year-old woman with a history of 
non-Hodgkin's lymphoma and cancers of the breast and colon, who presented with a 
zosteriform rash and Brown-Sequard syndrome. Despite 10 days therapy with
intravenous acyclovir, meningoencephalitis developed and the patient died 15 days
after onset of neurological symptoms. Autopsy showed meningoencephalomyelitis
with necrotising vasculitis of leptomeningeal vessels, which is a rare
complication of VZV, and we review the literature of the nine similar published
cases. Polymerase chain reaction of cerebrospinal fluid for VZV was negative 6
days after onset of neurological symptoms, but became positive by day 10. Only
one multinucleated giant cell with intranuclear Cowdry type A inclusions was seen
within an endothelial cell in a leptomeningeal vessel involved by vasculitis.

Publication Types: 
    Case Reports
    Review

PMID: 11902456 [PubMed - indexed for MEDLINE]

2514: Antivir Chem Chemother. 2001 Sep;12(5):293-300.

Synthesis and antiviral evaluation of phosphoramidate derivatives of
(E)-5-(2-bromovinyl)-2'-deoxyuridine.

Harris SA, McGuigan C, Andrei G, Snoeck R, De Clercq E, Balzarini J.

Welsh School of Pharmacy, Cardiff University, UK.

We report the design, synthesis and antiviral evaluation of a number of
lipophilic, masked phosphoramidate derivatives of the antiherpetic agent
(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU), designed to act as membrane soluble 
prodrugs of the free nucleotide. The phosphoramidate derivatives of BVDU that
contain L-alanine exhibited potent anti herpes simplex virus type 1 and
varicella-zoster virus activity but lost marked activity against thymidine
kinase-deficient virus strains. The phosphoramidate derivative bearing the amino 
acid alpha,alpha-dimethylglycine showed poor activity in all cell lines tested.
It appears that successful kinase bypass by phosphoramidates is highly dependent 
on the nucleoside analogue, amino acid and ester structure, as well as the cell
line to which the drugs are exposed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11900348 [PubMed - indexed for MEDLINE]

2515: Biosci Rep. 2001 Aug;21(4):419-44.

Keratitis.

Sharma S.

Jhaveri Microbiology Centre, Hyderabad Eye Research Foundation, L. V. Prasad Eye 
Institute, AP, India. savitri@lvpeye.stph.net

Corneal inflammation or keratitis is a significant cause of ocular morbidity
around the world. Fortunately, the majority of the cases are successfully managed
with medical therapy, but the failure of therapy does occur, leading to
devastating consequences of either losing the vision or the eye. This review
attempts to provide current information on most, though not all, aspects of
keratitis. Corneal inflammation may be ulcerative or nonulcerative and may arise 
because of infectious or noninfectious causes. The nonulcerative corneal
inflammation may be confined to the epithelial layer or to the stroma of the
cornea or may affect both. For clarity, this section has been divided into
nonulcerative superficial keratitis and nonulcerative stromal keratitis. While
the former usually includes hypersensitivity responses to microbial toxins and
unknown agents, the latter can be either infectious or noninfectious. In the
pathogenesis of ulcerative keratitis, microorganisms such as bacteria, fungi,
parasites (Acanthamoeba), or viruses play an important role. Approximately, 12.2%
of all corneal transplantations are done for active infectious keratitis.
Available world literature pertaining to the incidence of microbial keratitis has
been provided special place in this review. On the other hand, noninfectious
ulcerative keratitis can be related to a variety of systemic or local causes,
predominantly of autoimmune origin.

Publication Types: 
    Review

PMID: 11900320 [PubMed - indexed for MEDLINE]

2516: Curr Neurol Neurosci Rep. 2001 Nov;1(6):526-32.

Herpes zoster infection and postherpetic neuralgia.

Tenser RB.

Division of Neurology, Pennsylvania State University College of Medicine, 500
University Drive, Hershey, PA 17033, USA. rtenser@psu.edu

Varicella-zoster virus (VZV), the cause of chicken pox, establishes latent
infection in sensory ganglia. Reactivation results in zoster (shingles),
sometimes complicated by encephalitis (myelitis). Postherpetic neuralgia (PHN) is
the major morbidity of zoster. PHN typically increases in frequency with age. The
VZV vaccine, which was developed for children, may be effective in enhancing VZV 
immune reactivity and decreasing zoster in adults. Early antiviral treatment may 
be effective in decreasing PHN onset. Several other medications may be useful in 
treating established PHN. A recent report discussed intrathecal steroid use.

Publication Types: 
    Case Reports
    Review

PMID: 11898565 [PubMed - indexed for MEDLINE]

2517: J Cutan Med Surg. 2002 Jan-Feb;6(1):19-22. Epub 2002 Jan 9.

Herpetic folliculitis.

Al-Dhafiri SA, Molinari R.

Division of Dermatology, McGill University Health Centre, Montreal General
Hospital, Quebec City, Quebec, Canada. saldha@po-box.mcgill.ca

BACKGROUND: Although herpetic skin infection is very common, herpetic
folliculitis is infrequently reported in the literature. It has varied
presentations, some of which are clinically atypical requiring histopathological 
confirmation of follicular involvement. OBJECTIVE: We describe an otherwise
healthy young adult male with extensive herpetic sycosis of the beard area, which
is a variant of herpetic folliculitis. The diagnosis was confirmed by typical
herpetic cytopathic changes in Tzanck smear and positive viral culture for HSV-1.
METHOD: This article includes a case report and a literature review of herpetic
(simplex and varicella/zoster) folliculitis. Conclusions: More cases of herpetic 
folliculitis should be reported to improve our understanding of this disease
entity. Physicians should consider herpetic or other viral etiology in patients
with folliculitis even if they were healthy, especially if they show resistance
to antibacterial and antifungal therapy.

Publication Types: 
    Case Reports
    Review

PMID: 11896419 [PubMed - indexed for MEDLINE]

2518: Plant Physiol. 2002 Mar;128(3):1022-30.

Ferrous ion transport across chloroplast inner envelope membranes.

Shingles R, North M, McCarty RE.

Department of Biology, Johns Hopkins University, Baltimore, Maryland 21218-2685, 
USA. shingles@jhu.edu

The initial rate of Fe(2+) movement across the inner envelope membrane of pea
(Pisum sativum) chloroplasts was directly measured by stopped-flow
spectrofluorometry using membrane vesicles loaded with the Fe(2+)-sensitive
fluorophore, Phen Green SK. The rate of Fe(2+) transport was rapid, coming to
equilibrium within 3s. The maximal rate and concentration dependence of Fe(2+)
transport in predominantly right-side-out vesicles were nearly equivalent to
those measured in largely inside-out vesicles. Fe(2+) transport was stimulated by
an inwardly directed electrochemical proton gradient across right-side-out
vesicles, an effect that was diminished by the addition of valinomycin in the
presence of K(+). Fe(2+) transport was inhibited by Zn(2+), in a competitive
manner, as well as by Cu(2+) and Mn(2+). These results indicate that
inward-directed Fe(2+) transport across the chloroplast inner envelope occurs by 
a potential-stimulated uniport mechanism.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 11891257 [PubMed - indexed for MEDLINE]

2519: Eur J Med Res. 2002 Feb 21;7(2):57-62.

Dermatological diseases and signs of HIV infection.

Kreuter A, Schugt I, Hartmann M, Rasokat H, Altmeyer P, Brockmeyer NH.

Department of Dermatology, Ruhr-University Bochum, St. Josef-Hospital, Gudrunstr.
56, D-44791 Bochum, Germany.

Therapy of HIV infection has undergone significant changes since the introduction
of highly-active antiretroviral therapy (HAART). Mortality and the appearance of 
opportunistic infections have significantly been reduced. Diseases of the skin
and adjacent mucous membranes often provide the first signs for HIV infection.
The spectrum of dermatologic findings related to HIV includes a variety of
cutaneous and mucocutaneous disorders. The most frequent diagnoses are oral
candidiasis, mollusca contagiosa, oral hairy leuokoplakia, herpes zoster and
herpes simplex, seborrheic dermatitis, and Kaposi's sarcoma. Incompatibility
reactions to drugs are observed on a strikingly frequent basis in HIV infection. 
Such severe incompatibility reactions are much more frequent in HIV patients than
in the normal population. Inducers often include sulfonamides, cotrimoxazole,
tuberculostatics as well as nucleoside-type reverse transcriptase inhibitors.

Publication Types: 
    Review

PMID: 11891145 [PubMed - indexed for MEDLINE]

2520: Brain Dev. 2002 Mar;24(2):106-8.

Unilateral occlusion of the middle cerebral artery after varicella-zoster virus
infection.

Ueno M, Oka A, Koeda T, Okamoto R, Takeshita K.

Division of Child Neurology, Institute of Neurological Sciences, Faculty of
Medicine, Tottori University, 36-1 Nishi-machi, Yonago 683-8504, Japan.
mueno@grape.med.tottori-u.ac.jp

We report a 4-year-old child who developed hemiplegia 6 months after
varicella-zoster virus (VZV) infection. Cerebral angiography showed complete
occlusion of the right middle cerebral artery with basal moyamoya vessels.
Elevation of anti-VZV antibody in the cerebrospinal fluid indicated central
nervous system involvement. The association between VZV cerebral angitis and
unilateral occlusion of right middle cerebral artery is discussed.

Publication Types: 
    Case Reports

PMID: 11891103 [PubMed - indexed for MEDLINE]

2521: Ostomy Wound Manage. 2001 Jun;47(6):28-34.

Common viral and fungal skin infections.

Trent JT, Federman D, Kirsner RS.

Division of General Medicine, VA Connecticut Health Care System, Department of
Internal Medicine, Yale University School of Medicine, New Haven, Conn., USA.

Skin infections account for a significant portion of dermatologic diseases, often
resulting in, or as a consequence of a disruption in the skin's integrity. This
paper covers the presentation, diagnosis, and treatment of the more common viral 
and fungal skin infections. The viral infections presented in this paper include 
herpes simplex virus, herpes zoster, condyloma acuminata, and molluscum
contagiosum. The fungal infections presented include tinea pedis, tinea cruris,
tinea capitis, tinea unguium, tinea versicolor, and candidiasis. Once a diagnosis
is made, treatment with appropriate antifungal, antiviral, destructive, or immune
modifying therapies can be instituted.

Publication Types: 
    Review

PMID: 11890082 [PubMed - indexed for MEDLINE]

2522: Transplantation. 2002 Feb 27;73(4):608-11.

Disseminated varicella infection in adult renal allograft recipients: four cases 
and a review of the literature.

Fehr T, Bossart W, Wahl C, Binswanger U.

Division of Nephrology, Department of Internal Medicine, University Hospital,
Zurich, Switzerland.

Disseminated varicella-zoster (VZV) infection is a rare complication after renal 
allotransplantation in adults. We report four patients, among them one with
combined VZV and cytomegalovirus infection. The main complications were
hepatitis, pneumonitis, and disseminated intravascular coagulation. A review of
the literature from 1981 to 2000 revealed 34 additional cases of disseminated
varicella infection in adult renal allograft recipients with an overall mortality
of 34%. Among these patients 82% suffered from primary varicella, 18% had a
reactivation. High-dose acyclovir therapy combined with reduction of
immunosuppression lead to reduction of mortality from 53% before 1990 to 22%
after 1990. No immunosuppressive drug is significantly associated with a higher
risk of disseminated VZV infection. Immunization against VZV in adults is still a
matter of controversy. Whereas passive immunization is performed only for
prophylactic but not therapeutic purpose, active immunization is routinely
performed in children and may also be recommended for adults before renal
transplantation.

Publication Types: 
    Case Reports

PMID: 11889440 [PubMed - indexed for MEDLINE]

2523: Antiviral Res. 2002 Apr;54(1):19-28.

Broad-spectrum antiviral activity of PNU-183792, a 4-oxo-dihydroquinoline,
against human and animal herpesviruses.

Brideau RJ, Knechtel ML, Huang A, Vaillancourt VA, Vera EE, Oien NL, Hopkins TA, 
Wieber JL, Wilkinson KF, Rush BD, Schwende FJ, Wathen MW.

Pharmacia, 49001, Kalamazoo, MI, USA. roger.j.brideau@pharmacia.com

We identified a novel class of 4-oxo-dihydroquinolines represented by PNU-183792 
which specifically inhibit herpesvirus polymerases. PNU-183792 was highly active 
against human cytomegalovirus (HCMV, IC(50) value 0.69 microM), varicella zoster 
virus (VZV, IC(50) value 0.37 microM) and herpes simplex virus (HSV, IC(50) value
0.58 microM) polymerases but was inactive (IC(50) value >40 microM) against human
alpha (alpha), gamma (gamma), or delta (delta) polymerases. In vitro antiviral
activity against HCMV was determined using cytopathic effect, plaque reduction
and virus yield reduction assays (IC(50) ranging from 0.3 to 2.4 microM).
PNU-183792 antiviral activity against both VZV (IC(50) value 0.1 microM) and HSV 
(IC(50) ranging from 3 to 5 microM) was analyzed using plaque reduction assays.
PNU-183792 was also active (IC(50) ranging 0.1-0.7 microM) in cell culture assays
against simian varicella virus (SVV), murine cytomegalovirus (MCMV) and rat
cytomegalovirus (RCMV). Cell culture activity was compared with the appropriate
licensed drugs ganciclovir (GCV), cidofovir (CDV) and acyclovir (ACV). PNU-183792
was also active against both GCV-resistant and CDV-resistant HCMV and against
ACV-resistant HSV. Toxicity assays using four different species of proliferating 
mammalian cells indicated PNU-183792 was not cytotoxic at relevant drug
concentrations (CC(50) value >100 microM). PNU-183792 was inactive against
unrelated DNA and RNA viruses indicating specificity for herpesviruses. In
animals, PNU-183792 was orally bioavailable and was efficacious in a model of
lethal MCMV infection.

PMID: 11888654 [PubMed - indexed for MEDLINE]

2524: J Virol. 2002 Apr;76(7):3575-8.

Varicella-zoster virus open reading frame 2 encodes a membrane phosphoprotein
that is dispensable for viral replication and for establishment of latency.

Sato H, Pesnicak L, Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892-1888, USA.

Varicella-zoster virus (VZV) encodes six genes that do not have homologs in
herpes simplex virus. One of these genes, VZV open reading frame 2 (ORF2), was
expressed as a 31-kDa phosphoprotein in the membranes of infected cells. Unlike
equine and bovine herpesvirus type 1 ORF2 homologs that are associated with
virions, VZV virions contained no detectable ORF2 protein. The ORF2 deletion
mutant established a latent infection in cotton rats at a frequency and with a
number of VZV genomes similar to that of the parental virus. ORF63 transcripts, a
hallmark of latent infection, were present in ganglia latently infected with both
the ORF2 deletion mutant and parental VZV. Thus, ORF2 is the first VZV gene shown
to be dispensable for establishment of latent infection in an animal model.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11884583 [PubMed - indexed for MEDLINE]

2525: J Virol. 2002 Apr;76(7):3282-91.

Herpes simplex virus tegument protein US11 interacts with conventional kinesin
heavy chain.

Diefenbach RJ, Miranda-Saksena M, Diefenbach E, Holland DJ, Boadle RA, Armati PJ,
Cunningham AL.

Centre for Virus Research and Electron Microscopy Unit, The Westmead Millennium
Institute, Westmead Hospital and University of Sydney, Westmead, New South Wales,
Australia.

Little is known about the mechanisms of transport of neurotropic herpesviruses,
such as herpes simplex virus (HSV), varicella-zoster virus, and pseudorabies
virus, within neurons. For these viruses, which replicate in the nucleus,
anterograde transport from the cell body of dorsal root ganglion (DRG) neurons to
the axon terminus occurs over long distances. In the case of HSV, unenveloped
nucleocapsids in human DRG neurons cocultured with autologous skin were observed 
by immunoelectron microscopy to colocalize with conventional ubiquitous kinesin, 
a microtubule-dependent motor protein, in the cell body and axon during
anterograde axonal transport. Subsequently, four candidate kinesin-binding
structural HSV proteins were identified (VP5, VP16, VP22, and US11) using
oligohistidine-tagged human ubiquitous kinesin heavy chain (uKHC) as bait. Of
these viral proteins, a direct interaction between uKHC and US11 was identified. 
In vitro studies identified residues 867 to 894 as the US11-binding site in uKHC 
located within the proposed heptad repeat cargo-binding domain of uKHC. In
addition, the uKHC-binding site in US11 maps to the C-terminal RNA-binding
domain. US11 is consistently cotransported with kinetics similar to those of the 
capsid protein VP5 into the axons of dissociated rat neurons, unlike the other
tegument proteins VP16 and VP22. These observations suggest a major role for the 
uKHC-US11 interaction in anterograde transport of unenveloped HSV nucleocapsids
in axons.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11884553 [PubMed - indexed for MEDLINE]

2526: Clin Infect Dis. 2002 Apr 1;34(7):885-94. Epub 2002 Feb 19.

Do the benefits of varicella vaccination outweigh the long-term risks? A
decision-analytic model for policymakers and pediatricians.

Rothberg M, Bennish ML, Kao JS, Wong JB.

Division of Clinical Decision Making, Informatics and Telemedicine, Department of
Medicine, New England Medical Center, Tufts University School of Medicine,
Boston, Massachusetts, USA.

Although varicella vaccine is recommended for infants, many physicians and
parents have withheld vaccination from infants because of concerns about the
vaccine's long-term efficacy. We used a decision-analytic Markov model to examine
the effects of decreasing vaccine efficacy on individuals and society. The model 
incorporated published data on age-specific incidence, morbidity, and mortality
rates, as well as data on shifting disease burden from childhood to adulthood as 
vaccine compliance increases. The effects of 2 vaccination
strategies---vaccinating infants at age 12 months and waiting to vaccinate until 
children are 10 years of age---were compared with the effects of no vaccination. 
If the efficacy of the vaccine were to decrease by 75%, then 50% compliance with 
vaccination at age 12 months would save 1800 life-years and 12,800
quality-adjusted life-years annually in the United States. The quality-adjusted
life expectancy of individuals vaccinated at age 12 months would be 63 h longer
than that of nonvaccinated individuals and would increase to 79 h as vaccination 
compliance increases and the burden of chickenpox shifts to adulthood. Varicella 
vaccination of infants at age 12 months appears to be beneficial, even if the
efficacy of the vaccine declines substantially.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11880952 [PubMed - indexed for MEDLINE]

2527: Otol Neurotol. 2002 Mar;23(2):160-2.

Infection screening in sudden and progressive idiopathic sensorineural hearing
loss: a retrospective study of 182 cases.

Gagnebin J, Maire R.

Clinic of Otolaryngology-Head and Neck Surgery, University Hospital, Lausanne,
Switzerland. Joel.Gagnebin@chuv.hospvd.ch

OBJECTIVE: To evaluate a systematic infectious screening program for patients who
present with sudden or progressive sensorineural hearing loss (SHL) of unknown
cause (negative history and clinical examination). METHOD: Retrospective study of
182 patients with idiopathic SHL. One hundred six patients presented with sudden 
SHL, and 76 presented with progressive SHL. Serologies for herpes simplex and
varicella-zoster viruses (immunoglobulin M and immunoglobulin G titers), Lyme
disease (enzyme-linked immunosorbent assay), syphilis (fluorescent treponemal
antibody absorption or microhemagglutination-Treponema pallidum test) and human
immunodeficiency virus were performed. RESULTS: The serologies were negative in
179 patients. Two patients had positive serologies for Lyme disease and another
tested positive for syphilis. Both cases of suspected Lyme disease were later
excluded by Western blot analysis and lumbar puncture (two false-positives). The 
patient with serologic syphilis was diagnosed as having latent syphilis after
neurosyphilis was excluded. CONCLUSION: The infection screening was positive in
only 1 (0.6%) of 182 patients: the patient who was diagnosed with latent
syphilis. On the basis of these results and taking into account the cost of
systematic screening, we propose that serologic tests be limited to patients with
suspect histories or symptomatologies, except for patients with a diagnosis of
syphilis.

PMID: 11875344 [PubMed - indexed for MEDLINE]

2528: Singapore Med J. 2001 Oct;42(10):485-6.

Herpes zoster ophthalmicus and the superior orbital fissure syndrome.

Yong VK, Yip CC, Yong VS.

The Eye Institute, Department of Ophthalmology, Tan Tock Seng Hospital,
Singapore. Vernon_Yong@ttsh.com.sg

Herpes Zoster Ophthalmicus (HZO) is not an uncommon condition in the elderly and 
the immunocompromised. The common ocular manifestations include
blepharoconjunctivitis, keratitis and uveitis. Dramatic presentations like
orbital apex syndrome and superior orbital fissure syndromes occur rarely in
patients with herpes zoster meningo-encephalitis.We report a patient with herpes 
zoster meningo-encephalitis and the superior orbital fissure syndrome (SOFS).

Publication Types: 
    Case Reports

PMID: 11874154 [PubMed - indexed for MEDLINE]

2529: Braz Dent J. 2002;13(1):49-52.

Systemic and oral alterations in Brazilian patients with cutaneous herpes zoster.

Gonzaga HF, Jorge MA, Gonzaga LH, Barbosa CA, Chaves MD.

Research Center-Center of Higher Education of Dracena-CESD, Dracena, SP, Brazil. 
herongonzaga@terra.com.br

Herpes zoster (HZ) is a virotic disease caused by Herpesvirus varicellae. The
objective of this study was to determine the factors that trigger the disease,
and the systemic and oral alterations present in Brazilian patients with herpes
zoster. A total of 30 patients with HZ and 100 control patients with other
diseases were studied. Of the 30 patients with HZ, 13 were male (43.3%) and 17
were female (56.7%), with an average age of 43.2 (range 3-78). The patients were 
submitted to general clinical, dermatological and intraoral examinations. Only
50% of the HZ patients reported emotional stress at the onset of the disease. A
total of 3.7% of the patients were positive for HIV and 11.1% for systemic
malignant neoplasm. Cutaneous lesions were found on the thorax (68.3%), face
(20%), lower limbs (10%) and upper limbs (6.7%). Specific oral involvement such
as oral HZ was not found. The presence of the disease may indicate a
non-diagnosed malignant neoplasm and/or association with AIDS.

PMID: 11870963 [PubMed - indexed for MEDLINE]

2530: Eur Radiol. 2002 Mar;12(3):549-58. Epub 2001 Aug 28.

Comment in:
    Eur Radiol. 2002 Mar;12(3):499-501.

MR imaging in epilepsy that is refractory to medical therapy.

Cakirer S, Basak M, Mutlu A, Galip GM.

Department of Radiology, Istanbul Sisli Etfal Hospital, Istanbul, Turkey.
scakirer@yahoo.com

The aim of this study was the assessment of detection rate on MRI and description
of MRI findings in patients with medically intractable epilepsy. Seventy-three
patients with medically intractable epilepsy between the ages of 0 and 68 years
old were evaluated by MRI, on three planes with spin-echo T1, fast spin-echo T2, 
and fluid-attenuated inversion recovery sequences, and, if necessary, with
contrast-enhanced SE T1 sequences. Cerebral infarct regions with atrophy and
gliosis in 8 patients, cerebral tumors in 5 patients, hippocampal sclerosis in 16
patients, radial microbrain in 1 patient, cortical dysplasia in 3 patients,
pachygyria in 2 patients, subcortical heterotopia in 2 patients, schizencephaly
in 3 patients, cerebral hemiatrophy in 2 patients, tuberous sclerosis in 1
patient, herpes encephalitis in 2 patients, Rasmussen's encephalitis in 1
patient, vascular malformations in 5 patients, and no abnormality in 22 patients 
were detected. Magnetic resonance imaging has a high success rate in detecting
structural brain abnormalities, of both temporal and extratemporal locations,
associated with medically intractable epilepsy syndromes. So MRI plays a primary 
role in planning of the treatment, primarily surgical therapy, by detecting
structural epileptogenic lesions.

PMID: 11870469 [PubMed - indexed for MEDLINE]

2531: Cutis. 2002 Feb;69(2):143-4.

Metameric motor paresis following abdominal herpes zoster.

Molinero J, Nagore E, Obon L, Miquel FJ, Aliaga A.

Department of Dermatology, Hospital General Universitario, Valencia, Spain.

Motor neuropathy is an uncommon complication that may follow an outbreak of
herpes zoster (HZ). About half of the reported cases have involved the cranial
nerves, typically the facial nerve. The remaining cases have affected the nerves 
of the extremities. Interestingly, motor weakness of the thoracic segments is
strikingly rare, even though this is where HZ most frequently occurs. The
dermatologic literature reports only exceptions to this occurence. We report a
new case of motor paresis following HZ infection in an abdominal location, where 
this complication can be easily misdiagnosed as abdominal herniation.

Publication Types: 
    Case Reports

PMID: 11868978 [PubMed - indexed for MEDLINE]

2532: Cutis. 2002 Feb;69(2):140-2.

Cutaneous consequences of photodynamic therapy.

Wolfsen HC, Ng CS.

Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
32224, USA. pdt@mayo.edu

Photodynamic therapy (PDT) has several cutaneous complications: photosensitivity 
is well known, but the other complications are rarely reported, Since late 1997, 
we have studied the dermatologic complications of using porfimer sodium PDT to
treat either Barrett esophagus with high-grade dysplasia or gastroesophageal
cancer in 72 consecutive patients. Cutaneous complications of PDT included
serious phototoxicity requiring oral corticosteroid treatment (22 patients; 31%),
herpes zoster (HZ) requiring hospitalization and intravenous antiviral treatment 
(1 patient; 1%), and erythema multiforme drug reaction related to porfimer sodium
(1 patient; 1%). PDT-associated dermatologic complications were common and were
not related to cutaneous photosensitivity.

PMID: 11868977 [PubMed - indexed for MEDLINE]

2533: Md Med. 2002 Winter;3(1):10-2.

The legacy of Chinese herbal medicine.

Ralph RA.

PMID: 11868484 [PubMed - indexed for MEDLINE]

2534: Anesth Analg. 2002 Mar;94(3):694-700; table of contents.

Spinal cord stimulation in postherpetic neuralgia and in acute herpes zoster
pain.

Harke H, Gretenkort P, Ladleif HU, Koester P, Rahman S.

Department of Anesthesia and Pain Therapy, Klinikum Krefeld, Krefeld, Germany.

We studied the effects of spinal cord stimulation (SCS) on postherpetic neuralgia
(PHN). Data of 28 patients were prospectively investigated over a median period
of 29 (quartiles 9--39) mo. In addition, four patients with acute herpes zoster
(HZ) pain were studied simultaneously. After intractable pain for more than 2 yr,
long-term pain relief was achieved in 23 (82%) PHN patients (median, 70 yr)
during SCS treatment confirmed by a median decrease from 9 to 1 on the visual
analog scale (P < 0.001). In five cases with serious comorbidity, the initial
pain alleviation could not be stabilized. Spontaneous improvement was always
confirmed or excluded by SCS inactivation tests at quarterly intervals. Eight
patients discontinued SCS permanently because of complete pain relief after
stimulation periods of 3--66 mo, whereas 2 reestablished SCS because of
recrudescence after 2 and 6 mo. Considerable impairments in everyday life,
objectified by the pain disability index, were also significantly improved (P <
0.001). In 4 patients with acute HZ pain, SCS was promptly effective and after
periods of 2.5 (quartiles 2--3) months the pain had subsided. SCS seems to offer 
a therapeutic option for pharmacological nonresponders. IMPLICATIONS: In many
patients with postherpetic neuralgia and acute herpes zoster pain is not
satisfactorily alleviated with pharmacological approaches. We report on 23 of 28 
patients with postherpetic neuralgia and 4 of 4 with acute herpes zoster whose
chronic pain was improved by electrical spinal cord stimulation.

PMID: 11867400 [PubMed - indexed for MEDLINE]

2535: Herpes. 2001 Jul;8(2):32-6.

Prevention and treatment of VZV infections in patients with HIV.

Gershon AA.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
650West 168th Street, New York, NY, USA. aag1@columbia.edu

Varicella zoster virus (VZV) infections in human immunodeficiency virus
(HIV)-infected patients are known to have a different disease spectrum from that 
seen in other types of patients. Varicella in children with HIV infection is
likely to be more serious than in otherwise healthy children and routine
antiviral therapy is recommended. There is evidence that the development of
varicella in HIV-infected children is not associated with progression to AIDS,
suggesting that it may be safe to immunize HIV-infected children with live
attenuated varicella vaccine. There are no published data on varicella in
HIV-infected adults, however, probably because most adults have already
experienced varicella prior to HIV infection. Zoster in HIV-infected children
differs somewhat from that in HIV-infected adults. In particular, HIV-infected
children who develop varicella in the setting of severe immunodeficiency are at
an especially high risk to develop zoster. Given the low rate of toxicity of
aciclovir as well as its ease of administration and its efficacy in hastening the
healing of VZV infections, prompt treatment with this antiviral agent is
recommended for both HIV-infected children and adults. Foscarnet should be used
for zoster that is strongly suspected or proven to be caused by
aciclovir-resistant VZV. Patients with HIV for whom there is no evidence of
significant immunosuppression and who have not had varicella should be immunized 
with live attenuated varicella vaccine as a preventative measure for both
varicella and zoster. It is hoped that immunization of VZV seropositive
HIV-infected patients will decrease the incidence of zoster. Studies to determine
this are under way.

Publication Types: 
    Review

PMID: 11867015 [PubMed - indexed for MEDLINE]

2536: Herpes. 2001 Mar;8(1):12-6.

Recent developments in herpesvirus therapy.

Naesens L, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Leuven,
Belgium. lieve.naesens@rega.kuleuven.ac.be

The antiherpes drugs, aciclovir and ganciclovir, are considered the standard
treatments and prophylactic agents for infections caused by herpes simplex virus 
(HSV), varicella zoster virus (VZV) and cytomegalovirus (CMV). Until a decade
ago, the impact of aciclovir on the control of severe and life-threatening
herpesvirus infections was unprecedented. During the past few years, we have
witnessed approval of new therapeutic drugs for infections caused by HSV and VZV 
(i.e. penciclovir and the oral prodrugs, valaciclovir and famciclovir), CMV (i.e.
ganciclovir, cidofovir and fomivirsen) or HSV, VZV and CMV (i.e. foscarnet). A
few agents, such as brivudin and benzimidavir, are in ongoing clinical
development; others have been suspended because of safety concerns. New
antiherpes agents are needed to face clinical issues such as drug resistance,
increased use of antiherpes prophylaxis in transplantation and safety concerns in
small children or pregnant women.

Publication Types: 
    Review

PMID: 11867011 [PubMed - indexed for MEDLINE]

2537: Herpes. 2001 Mar;8(1):8-11.

Potential for immunotherapy in the treatment of herpesvirus infections.

Bernstein DI.

Children's Hospital Medical Center, Division of Infectious Diseases, Cincinnati, 
Ohio 45229, USA. dib@chmcc.org

The concept of using immunotherapy to treat recurrent herpesvirus infections
dates back to the 1930s, although many of the initial studies were seriously
flawed. Since the late-1980s, however, the use of the guinea pig model of genital
herpes has allowed investigators to evaluate carefully several vaccine and
immunomodulatory strategies for the control of recurrent herpesvirus infections. 
These investigations have clearly shown that both approaches can significantly
decrease recurrence rates of genital herpes, and the most effective routes,
adjuvants and treatment regimens have been identified. Similar strategies have
also been shown to decrease herpes simplex virus (HSV)-1 recurrences in animal
models of ocular infection. To date, only moderate success has been reported for 
human trials, although the optimum strategies that were identified in the animal 
models have not yet been evaluated.

Publication Types: 
    Review

PMID: 11867010 [PubMed - indexed for MEDLINE]

2538: Herpes. 2000 Oct;7(3):60-65.

History of Varicella Zoster Virus.

Wood MJ.

Department of Infection and Tropical Medicine, Heartlands Hospital, Birmingham B9
5SS, UK.

The earliest reports of vesicular rashes of the type we now recognize to be
caused by herpes simplex and zoster date to the ancient civilizations. It was not
until 1888, however, that a relationship between herpes zoster and chickenpox was
suggested. Establishing this link represented one of the major hurdles in the
history of varicella zoster virus. There was no animal host and this meant that
much of the evidence needed to be obtained by clinical and epidemiological
observation. Since the link was proven, in the 1950s, the advent of the live
attenuated vaccine virus, in 1974, and aciclovir in the 1980s, has had a huge
impact on prevention and treatment, respectively. The complete DNA sequence of
VZV was established in 1986. A more complete understanding of the VZV genome and 
its gene products may enable recombinant vaccines and specific therapies to be
advanced. We also need to determine the long-term effects of the use of the
varicella vaccine. The ultimate aim: to prevent VZV infection completely.

PMID: 11867004 [PubMed - as supplied by publisher]

2539: CRNA. 2000 Nov;11(4):173-9.

Clinical applications of acupuncture in anesthesia practice.

Reilly MP.

Audie Murphy Division, South Texas Veterans Health Care System, University of
Texas Health Science Center, San Antonio, USA.

The most widely successful use of acupuncture in Western medicine has been in the
treatment of chronic and intractable pain syndromes. Thus, it is especially
important for the nurse anesthetist who is the practice of chronic pain
management to be familiar with this treatment choice. This article provides the
nurse anesthetist with basic information about the practice of acupuncture, the
patient who may ask for acupuncture, application of segmental acupuncture
techniques, and legislative and licensure issues.

Publication Types: 
    Case Reports
    Review

PMID: 11866024 [PubMed - indexed for MEDLINE]

2540: Nephrol Dial Transplant. 2002 Mar;17(3):508-10.

A 67-year-old kidney transplant patient with headache of uncertain origin.

Ostermann ME, Gyawali P, Snowden SA, Eastwood JB, Streather CP.

St George's Hospital, Department of Renal Medicine, London, UK.
marlies@ostermann.freeserve.co.uk

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 11865103 [PubMed - indexed for MEDLINE]

2541: An Esp Pediatr. 2002 Mar;56(3):269-70.

[Ramsay-Hunt syndrome]

[Article in Spanish]

Alcala Minagorre P, Zubiaur Cantalapiedra A, Ronda Perez JM, Herrero Galiana A,
Lopez Bru D, Flores Serrano J.

Publication Types: 
    Case Reports
    Letter

PMID: 11864532 [PubMed - indexed for MEDLINE]

2542: Acta Pharmacol Sin. 2002 Jan;23(1):1-15.

Viral and immunologic follow up of 4 to 9 years of AIDS treatments by quadruple
combinations of virostatics including integrase inhibitors applied in short
sequences differing by drug rotation.

Mathe G, Morette C, Hallard M, Pontiggia P, Blanquet D, Hage F.

Institut de Canc rologie et d'Immunologie & Hopital Suisse de Paris BP 60-92133
Issy les Moulineaux, France.

AIM: To present the 4 to 9 years (median: 6 years) treatment follow up of 10
HIV1-AIDS patients, 9 at AIDS and 1 at A3 stages. METHODS: We have applied from
1992 to 1994, AZT combined with 2 integrase inhibitors, acriflavine and
hydroxy-methyl-ellipticine. We could shift, in 1994, to combinations of 3 drugs
including two more retrotranscriptase inhibitors (RTI), ddI and ddC, and, after
1995, to combinations of 4 drugs including also two other RTI, d4T and 3TC, and 3
protease inhibitors (PI), indinavir, ritonavir, and saquinavir. In 1998, as
cobalamine was shown by an in vitro test, to act as integrase inhibitor, vitamin 
B12 was added in cycles of various lengths. Every three weeks, not only the
investigations were repeated, but the virostatics were changed. RESULTS: No grade
2 virostatics toxicity has been registered. The viral loads (VL) decreased
according to exponential curves. Their initial parts obeyed first order kinetics.
The second parts were and still are asymptotic. The first parts could be
rectilinear or sinuous. The sinuosities were associated to cofactors present
before treatment (chimerism, UV irradiation, hepatitis C or B and C, brain
toxoplasmosis). The asymptotic parts, whose VL were below PCR detectable levels, 
presented discrete, reversible HIV1 rebounds, associated to other cofactors (such
as herpes zoster, herpes 6, CMV, flat condyloma, and influenza). Among
immunologic parameters, the monocyte and CTL numbers increased and presented,
during the rapidly decreasing part of VL curve, a significant inverse correlation
with it. Neither CD4+ nor suppressor T-cell (STC) numbers presented such
correlation. Near 100 % of CTL were CD28+. Later, vitamin B12 applications
increased monocyte and CD28+ CTL numbers, and appeared to reinforce VL
stabilization. CONCLUSION: The combinations of inhibitors affecting 3 retrovirus 
targets, retrotranscriptase, integrase, and protease have given to 10 out of 10
AIDS patients survivals varying today between 4 to 9 years, in excellent
conditions. The UVA-pretreated patient is the only one presenting a not maximally
reduced asymptotic VL, while his CD4+ and STC have been absent for 8 years. Other
patient VL regressed exponentially to become asymptotic, below PCR detectable
levels.

PMID: 11860730 [PubMed - indexed for MEDLINE]

2543: Ann Otol Rhinol Laryngol. 2002 Feb;111(2):103-14.

The three faces of vestibular ganglionitis.

Gacek RR, Gacek MR.

Department of Surgery, University of South Alabama College of Medicine, Mobile
36688-0002, USA.

We present temporal bone and clinical evidence that common syndromes of recurrent
vertigo are caused by a viral infection of the vestibular ganglion. In the
present series, histopathologic and radiologic changes in the vestibular ganglion
and meatal ganglion were consistent with a viral inflammation of ganglion cells
in cases of Meniere's disease, benign paroxysmal positional vertigo, and
vestibular neuronitis. Clinical observations of multiple neuropathies involving
cranial nerves V, VII, and VIII on the same side in patients with recurrent
vertigo are best explained by a cranial polyganglionitis caused by a neurotrophic
virus, which is reactivated by a stressful event later in life. The reactivation 
of the latent virus may manifest as one of the above vertigo syndromes, depending
on the part of the vestibular ganglion that is inflamed, the type and strain of
the virus, and host resistance.

PMID: 11860061 [PubMed - indexed for MEDLINE]

2544: Vaccine. 2002 Feb 22;20(11-12):1593-602.

Immunogenicity of a recombinant varicella-zoster virus gE-IE63 fusion protein, a 
putative vaccine candidate against primary infection and zoster reactivation.

Jacquet A, Haumont M, Massaer M, Garcia L, Mazzu P, Daminet V, Gregoire D, Jacobs
P, Bollen A.

Department of Applied Genetics, Institut de Biologie et de Medecine Moleculaires,
Universite Libre de Bruxelles, Rue des Professeurs Jeener et Brachet 12, B-6041
Gosselies, Belgium. ajacquet@sga.ulb.ac.be

The varicella-zoster virus (VZV) envelope glycoprotein E (gE) and immediate early
protein 63 (IE63) are well known targets for specific humoral and cell-mediated
immune responses during VZV infection and latency, respectively. The present
study evaluated the immunogenicity of an engineered chimeric recombinant gE-IE63 
(recgE-IE63) protein secreted from CHO cells, wherein a soluble form of gE,
deleted of its anchor and cytoplasmic domains was fused to IE63. Guinea pig
vaccinations with adjuvanted recgE-IE63 elicited a strong and specific humoral
immune response directed to each counterpart. Sera from recgE-IE63-immunized
animals neutralized cell-free VZV. This neutralizing capacity was dependent only 
on the recgE moiety as serum depletions on recgE-immobilized sepharose totally
abolished VZV neutralization. The cell-mediated immune response induced by
recgE-IE63 was evaluated in lymphoproliferation assays. An antigen-specific
proliferative response was demonstrated after lymphocyte stimulation with recIE63
but not with recgE. We conclude that recombinant chimeric recgE-IE63 induced both
humoral and cell-mediated immune responses and thus could constitute a putative
subunit vaccine candidate against VZV primary infection and zoster reactivation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11858867 [PubMed - indexed for MEDLINE]

2545: J Med Virol. 2002 Apr;66(4):567-70.

Detection of varicella-zoster virus DNA in throat swabs of patients with herpes
zoster and on air purifier filters.

Suzuki K, Yoshikawa T, Tomitaka A, Suzuki K, Matsunaga K, Asano Y.

Department of Dermatology, Fujita Health University School of Medicine, Toyoake, 
Aichi, Japan. arisu@daidohpior.jp

Zoster patients are considered to be less contagious than those with varicella
because their infectious lesions are localized. However, it is not known when the
spread of varicella-zoster virus (VZV) from zoster patients begins, how long it
continues, and how far the virus spreads from the zoster patients. Twelve cases
of hospitalized zoster patients were studied. The polymerase chain reaction (PCR)
was used to detect VZV DNA in samples taken from the surface of their eruptions, 
throats, and the air purifier filters in their rooms. In all patients, VZV DNA
was detected in the samples from eruptions. VZV DNA was detected in 8 of 12
patients from the throats. VZV DNA was detected for 9 of 12 patients from the
filter samples. This study shows the possibility of a wide distribution of VZV
DNA to the environment from infected patients. VZV may be excreted from cutaneous
eruptions or from the throats of patients. Copyright 2002 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11857538 [PubMed - indexed for MEDLINE]

2546: J Med Virol. 2002 Apr;66(4):506-11.

Multiplex detection of herpesviruses in tear fluid using the "stair primers" PCR 
method: prospective study of 93 patients.

Robert PY, Traccard I, Adenis JP, Denis F, Ranger-Rogez S.

Department of Ophthalmology, CHRU Dupuytren, Limoges, France.

Human herpesviruses can infect the eye and be excreted subsequently in tears. The
aim of the present study was to use a multiplex PCR to detect herpesviruses
(HSV-1, -2, VZV, CMV, EBV, HHV-6) in tears from normal subjects and from patients
with pathological conditions (acute herpes, zoster, papillary conjunctivitis, and
dry eye). Schirmer test strips were used to collect tear fluid from 93 patients, 
sampling both eyes. DNA was then extracted from the 186 samples by
chromatography, and viral DNA amplified using a commercialised multiplex "stair
primer" method. Thirty-four samples (18.3%) contained Taq inhibitors. The
multiplex test gave positive results for HSV and VZV in tear fluid from patients 
with acute dendritic keratitis (3 patients) and acute ocular zoster (4 patients) 
and was, therefore, considered effective in testing samples from patients with
acute lesions. HSV-1 and HSV-2 were found in two samples from patients with
metaherpetic corneal scarring. Among 28 cases of dry eye, two were positive for
HHV-6, the latter being associated with EBV in one patient. HHV-6 was also found 
in 4 out of 54 cases of papillary conjunctivitis. This raised occurrence of HHV-6
in dry eye or papillary conjunctivitis, suggests new clinical patterns for HHV-6 
latency or reactivation. Detection of EBV in 1 out of 80 healthy eyes confirms
previous evidence that lacrimal glands constitute potentially a site for
latent-phase EBV. Copyright 2002 Wiley-Liss, Inc.

PMID: 11857529 [PubMed - indexed for MEDLINE]

2547: Jpn J Ophthalmol. 2002 Jan-Feb;46(1):70-3.

Varicella-zoster viral antigen identified in iridocyclitis patient.

Nakashizuka H, Yamazaki Y, Tokumaru M, Kimura T.

Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.

BACKGROUND: The varicella-zoster virus (VZV) antigen has not been identified
immunohistologically in iridocyclitis due to VZV. CASE: A 65-year-old woman
diagnosed with iridocyclitis and secondary glaucoma underwent trabeculectomy.
Samples of aqueous humor and juxtacanalicular and iris tissue were obtained for
immunohistological and polymerase chain reaction (PCR) study. OBSERVATIONS:
Slit-lamp microscopy revealed ciliary injection, corneal epithelial edema, mutton
fat precipitates, flare, cells, and progressive iris atrophy in the right eye.
Subsequently, scant eruptions on her right upper eyelid appeared and disappeared 
within a week. Although a diagnostic increase in the complement fixation antibody
titer to VZV was not observed, we started medical treatment for VZV, on suspicion
of iridocyclitis due to VZV. Despite medical treatment, the ratio of peripheral
anterior synechia was greater than 60% and iris atrophy progressed in parallel.
The intraocular pressure in the right eye remained above 30 mm Hg at 6 months
after the first visit, so trabeculectomy was performed. VZV-specific DNA was
detected in the aqueous humor by the PCR study. Immunohistological examination
demonstrated numerous VZV antigen-positive cells in the iris stroma, in
particular, vascular endothelial cells. CONCLUSION: To our knowledge, this is the
first report of the detection of VZV antigen in the iris of an iridocyclitis
patient.

Publication Types: 
    Case Reports

PMID: 11853717 [PubMed - indexed for MEDLINE]

2548: Antimicrob Agents Chemother. 2002 Mar;46(3):724-30.

Broad-spectrum antiherpes activities of 4-hydroxyquinoline carboxamides, a novel 
class of herpesvirus polymerase inhibitors.

Oien NL, Brideau RJ, Hopkins TA, Wieber JL, Knechtel ML, Shelly JA, Anstadt RA,
Wells PA, Poorman RA, Huang A, Vaillancourt VA, Clayton TL, Tucker JA, Wathen MW.

Discovery Research, Pharmacia Corp., Kalamazoo, Michigan 49001, USA.

Through broad screening of the compound library at Pharmacia, a naphthalene
carboxamide was identified as a nonnucleoside inhibitor of human cytomegalovirus 
(HCMV) polymerase. Structure-activity relationship studies demonstrated that a
quinoline ring could be substituted for naphthalene, resulting in the discovery
of a 4-hydroxyquinoline-3-carboxamide (4-HQC) class of antiviral agents with
unique biological properties. In vitro assays with the 4-HQCs have demonstrated
potent inhibition of HCMV, herpes simplex virus type 1 (HSV-1), and
varicella-zoster virus (VZV) polymerases but no inhibition of human alpha, delta,
and gamma polymerases. Antiviral cell culture assays have further confirmed that 
these compounds are active against HCMV, HSV-1, HSV-2, VZV, and many animal
herpesviruses. However, these compounds were not active against several
nonherpesviruses representing different DNA and RNA virus families. A strong
correlation between the viral DNA polymerase and antiviral activity for this
class of compounds supports inhibition of the viral polymerase as the mechanism
of antiviral activity. Northern blot analysis of immediate-early and late viral
transcripts also pointed to a block in the viral life cycle consistent with
inhibition of viral DNA replication. In vitro HCMV polymerase assays indicate
that the 4-HQCs are competitive inhibitors of nucleoside binding. However, no
cross-resistance could be detected with ganciclovir-resistant HCMV or
acyclovir-resistant HSV-1 mutants. The unique, broad-spectrum activities of the
4-HQCs may offer new opportunities for treating many of the diseases caused by
herpesviruses.

PMID: 11850254 [PubMed - indexed for MEDLINE]

2549: Roum Arch Microbiol Immunol. 1999 Apr-Jul;58(2):121-30.

ICAM-1, ELAM-1, TNF-alpha and IL-6 in serum and blister liquid of pemphigus
vulgaris patients.

Alecu M, Alecu S, Coman G, Galatescu E, Ursaciuc C.

Dermatology Research Centre, Scarlat Longhin Dermatology Hospital, Cal. Serban
Voda 216, 75202 Bucharest, Romania.

The levels of ICAM-1, ELAM-1, TNF-alpha and IL-6 were determined in 12 patients
with pemphigus vulgaris (PV) both in serum and the blister liquid. As a control, 
the same parameters were determined in 7 patients with herpes zoster (HZ). The
patients with PV presented significantly higher values of ICAM-1 in the blister
liquid, as compared to the serum values. The values of TNF-alpha and IL-6 were
increased both in serum and the blister liquid. The ELAM-1 values did not show
significant differences between serum and the blister liquid. In HZ patients, the
blister liquid values did not significantly exceed the serum values both for
ICAM-1 and ELAM-1. TNF-alpha and IL-6 presented high values both in serum and the
blister liquid. We consider that the high values of ICAM-1 in the blister liquid 
from PV patients suggest the involvement of this adhesion molecule in the PV
pathogenic features. The implication of ICAM-1 could be nonspecific and limited, 
and could possibly represent a reaction to the destruction of the desmosomal
bonds within keratinocytes.

Publication Types: 
    Comparative Study

PMID: 11845451 [PubMed - indexed for MEDLINE]

2550: Clin J Oncol Nurs. 2002 Jan-Feb;6(1):55-8, 61.

Herpes zoster. Treating postherpetic neuralgia.

Baldwin PD.

Patbalwin2@hotmail.com.

PMID: 11842491 [PubMed - indexed for MEDLINE]

2551: Pediatr Infect Dis J. 2002 Feb;21(2):178-9.

Comment on:
    Pediatr Infect Dis J. 2001 Sep;20(9):915-6.

Herpes zoster during varicella.

Baptist EC, Noonan KM.

Publication Types: 
    Comment
    Letter

PMID: 11840094 [PubMed - indexed for MEDLINE]

2552: Semin Arthritis Rheum. 2002 Feb;31(4):256-63.

Viral infections and antiphospholipid antibodies.

Uthman IW, Gharavi AE.

Department of Internal Medicine, Faculty of Medicine, American University of
Beirut, Beirut, Lebanon. iuthman@aub.edu.lb

OBJECTIVE: To study the relationship between viral infections and the induction
of antiphospholipid (aPL) antibodies. METHODS: We reviewed the medical literature
from 1968 until 2000 using MEDLINE and the key words virus, infection,
antiphospholipid, and anticardiolipin. RESULTS: Anticardiolipin antibodies and/or
lupus anticoagulant were associated with a number of viral infections, including 
hepatitis C virus, human immunodeficiency virus, cytomegalovirus, varicella
zoster, Epstein-Barr virus, adenovirus, and parvovirus B. In many instances, the 
presence of these antibodies was associated with thrombosis. CONCLUSION: The
clinical significance of finding aPL antibodies in patients with viral infections
remains unknown. In some patients, these antibodies may be transient and
disappear within 2 or 3 months. In other susceptible individuals, they may
persist and raise the question of whether infections may trigger the development 
of aPL antibodies in autoimmune diseases. Copyright 2002, Elsevier Science (USA).
All rights reserved.

Publication Types: 
    Review

PMID: 11836658 [PubMed - indexed for MEDLINE]

2553: Bioorg Med Chem. 2002 Apr;10(4):883-6.

The enantiomers of carbocyclic 5'-norguanosine: activity towards Epstein-Barr
virus.

Rajappan V, Schneller SW, Williams SL, Kern ER.

Department of Chemistry, Auburn University, Auburn, AL 36849-5312, USA.

(-)-5'-noraristeromycin (1) has shown antiviral activity towards, particularly
cytomegalovirus, vaccinia virus and measles while its (+)-enantiomer (2) is
effective towards hepatitis B virus. To determine if the antiviral
characteristics of 1 and 2 extended to the guanine analogues (3 and 4), these
enantiomers were prepared and evaluated against herpes simplex virus type 1
(HSV-1) and type 2 (HSV-2), cytomegalovirus (CMV), varicella zoster virus (VZV), 
Epstein-Barr virus (EBV), human herpes virus type 6 (HHV-6), human herpes virus
type 8 (HHV-8), vaccinia virus (VV), cowpox virus (CV), vesicular stomatitis
virus (VSV), respiratory syncytial virus (RSV), hepatitis B virus (HBV), and
human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2). The only activity
found for 3 was for Epstein-Barr virus in VCA Elisa (EC50 0.78 microg/mL),
immunofluorescence assay for VCA or gp 350/250 (1.8-4.0 microg/mL) and DNA
hybridization (EC50 0.82 microg/mL) assays with no accompanying toxicity seen in 
the host Daudi cells. No activity was noted for 4.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11836094 [PubMed - indexed for MEDLINE]

2554: Ann Neurol. 2002 Feb;51(2):273-4.

Cranial nerve palsies: herpes simplex virus type 1 and varizella-zoster virus
latency.

Theil D, Derfuss T, Strupp M, Gilden DH, Arbusow V, Brandt T.

Publication Types: 
    Letter

PMID: 11835389 [PubMed - indexed for MEDLINE]

2555: Brain. 2002 Jan;125(Pt 1):159-65.

Epstein-Barr virus myeloradiculitis and encephalomyeloradiculitis.

Majid A, Galetta SL, Sweeney CJ, Robinson C, Mahalingam R, Smith J, Forghani B,
Gilden DH.

Department of Neurology, University of Pennsylvania School of Medicine,
Philadelphia, Pennsylvania, USA.

We provide a comprehensive clinical, radiological and virological analysis of
four patients with Epstein-Barr virus (EBV) infection of the nervous system. One 
patient developed acute myeloradiculitis, one had acute
encephalomyeloradiculitis, one had acute meningoencephalomyeloradiculitis and one
had a subacute meningomyeloradiculitis. The ability of EBV to affect multiple
parts of the entire neuraxis from meninges and brain to the spinal cord and
peripheral nerves was evidenced by combinations of stiff neck and mental status
changes, as well as patterns of weakness and sensory loss due to transverse
myelitis or peripheral nerve disease. The CSF of all four patients contained a
pleocytosis, predominantly mononuclear with elevated levels of protein, but a
normal glucose level. In the two patients with acute myeloradiculitis and
subacute meningomyeloradiculitis, the MRI revealed an increased signal in the
spinal cord and lumbosacral roots, but in the two patients with acute
encephalomyeloradiculitis and acute meningoencephalomyeloradiculitis, the brain
and spinal cord MRIs were normal. In all four patients, EBV DNA, but not
cytomegalovirus (CMV), herpes simplex virus (HSV) or varicella-zoster virus (VZV)
DNA, was found in the CSF. The antibody pattern in serum was consistent with
recent infection, and both EBV immunoglobulin (Ig) M and IgG antibodies, but not 
antibodies to HSV, VZV or CMV, were found in the CSF. Finally, there were reduced
serum/CSF ratios of antibody to EBV, but not to total IgG or albumin, consistent 
with intrathecal antibody synthesis. None of the four patients died and none had 
brain swelling or focal changes according to brain MRI. Residual neurological
deficits were evident. The two patients with acute myeloradiculitis and acute
meningomyeloradiculitis had residual lower extremity weakness, and one of these
patients later developed optic neuritis. The patient with acute
encephalomyeloradiculitis had a moderate flaccid paraparesis, and the patient
with subacute meningomyeloradiculitis was left with sensory loss in the feet.
Compared with neurological disease caused by other herpes viruses, the clinical
features of acute EBV myeloradiculitis, encephalomyeloradiculitis,
encephalomyeloradiculitis and subacute meningomyeloradiculitis are distinctive.
Of the eight human herpesviruses, EBV and VZV produce the most protean
neurological syndromes. The mechanism by which EBV produces neurological disease 
is unknown. More correlative pathological, virological and immunological studies 
are needed in EBV-associated neurological disease.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 11834601 [PubMed - indexed for MEDLINE]

2556: J Vasc Interv Radiol. 2002 Feb;13(2 Pt 1):209-10.

Reactivation of herpes zoster after liver biopsy.

Levy JM, Smyth SH.

Department of Radiology, University of Arizona School of Medicine, Tucson,
Arizona, USA. jlevy@esmil.net

A patient developed reactivation of herpes zoster infection (shingles) after a
routine liver biopsy. Reactivation of herpes is often related to trauma. This
entity should be considered when patients report postbiopsy pain inappropriate to
the procedure. If the typical rash of shingles develops, antiviral therapy should
be considered.

Publication Types: 
    Case Reports

PMID: 11830629 [PubMed - indexed for MEDLINE]

2557: J Refract Surg. 2002 Jan-Feb;18(1):79-80.

Presumed reactivation of herpes zoster ophthalmicus following laser in situ
keratomileusis.

Jarade EF, Tabbara KF.

Eye Center and The Eye Foundation for Research in Ophthalmology, Riyadh, Saudi
Arabia.

PURPOSE: To report a case of herpes zoster ophthalmicus reactivation following
laser in situ keratomileusis (LASIK) for myopia. METHODS: A 54-year-old healthy
male underwent uneventful bilateral LASIK for the correction of myopia and
astigmatism (-5.75 -3.00 x 20 degrees right eye, -5.50 -3.00 x 170 degrees left
eye). Two months following LASIK, an epithelial dendritic lesion appeared in the 
lower third of the corneal flap of the left eye with vesiculoulcerative lesions
of the lateral side of the tip of the nose. RESULTS: The patient was treated with
topical and oral antiviral agents and had complete recovery of the lesions in 10 
days. CONCLUSIONS: Herpes zoster reactivation may occur following LASIK.
Reactivation of herpes zoster in this case could have been coincidental, or
secondary to LASIK and the subsequent use of topical corticosteroids following
LASIK.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 11828912 [PubMed - indexed for MEDLINE]

2558: Ophthalmology. 2002 Feb;109(2):370-7.

Long-term follow-up of patients treated with short-term high-dose chlorambucil
for sight-threatening ocular inflammation.

Goldstein DA, Fontanilla FA, Kaul S, Sahin O, Tessler HH.

Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois
60612, USA.

PURPOSE: To determine the effectiveness of short-term high-dose chlorambucil in
the treatment of sight-threatening uveitis and to ascertain the incidence of
severe side effects, particularly late malignancy. DESIGN: Retrospective,
noncomparative interventional case series. PARTICIPANTS: Fifty-three patients
treated at the University of Illinois at Chicago Eye and Ear Infirmary and the
private office of one of the authors for severe sight-threatening uveitis.
METHODS: Treatment with short-term high-dose chlorambucil (2-9 months of
therapy). MAIN OUTCOME MEASURE: Visual acuity and degree of inflammation were
assessed at every visit. The development of systemic side effects, including
malignancy, was assessed using a detailed questionnaire. RESULTS: Total
cumulative dose of chlorambucil ranged from 392 to 5200 mg with an average of
1429 mg. The maximum daily dose ranged from 10 to 30 mg with an average of 20 mg.
Average duration of treatment was 16 weeks with a range of 7 to 40 weeks.
Seventy-seven percent of patients treated were in remission with an average
follow-up of 4 years (range: 6 months to 24 years). Forty-seven percent had at
least two lines of improvement in Snellen visual acuity after treatment, with an 
average gain of 3.5 lines. Adverse effects include secondary amenorrhea,
nonophthalmic herpes zoster, testicular atrophy, and erectile dysfunction. None
of the patients had developed a malignancy as of their last follow-up.
CONCLUSION: Short-term high-dose chlorambucil therapy may be a reasonable option 
in patients with intractable sight-threatening uveitis.

PMID: 11825825 [PubMed - indexed for MEDLINE]

2559: Paediatr Drugs. 2002;4(1):9-19.

Viral diseases of the skin: diagnosis and antiviral treatment.

Trizna Z.

Department of Dermatology, Health Sciences Center, Texas Tech University, Mail
Drop #9400, 3601 4th Street, Lubbock, TX 79416, USA.
zoltan.trizna@ttmc.ttuhsc.edu

Viral diseases in children can present with characteristic mucocutaneous
manifestations. This article focuses, from a practical clinical point of view, on
the laboratory and clinical diagnoses, and treatment of pediatric dermatological 
diseases that have specific antiviral therapies: herpes virus infections
(including varicella), papillomavirus infections and molluscum contagiosum.
Special issues, such as viral infections in pregnancy, therapy of viral
infections in immunosuppressed children, as well as special problems associated
with the epidemiology of genital herpes and papillomavirus infections in
adolescents are discussed. The antivirals discussed in detail include: aciclovir,
valaciclovir, famciclovir, penciclovir, cidofovir, foscarnet and the immune
response modulator, imiquimod. Since these antiviral drugs generally have not
been evaluated in children, caution should be exercised with their usage.

PMID: 11817982 [PubMed - indexed for MEDLINE]

2560: Int Immunopharmacol. 2002 Feb;2(2-3):263-75.

A review of studies on the effects of ultraviolet irradiation on the resistance
to infections: evidence from rodent infection models and verification by
experimental and observational human studies.

Termorshuizen F, Garssen J, Norval M, Koulu L, Laihia J, Leino L, Jansen CT, De
Gruijl F, Gibbs NK, De Simone C, Van Loveren H.

Laboratory for Pathology and Immunobiology, National Institute of Public Health
and the Environment, Bilthoven, The Netherlands.

Recent studies on the immunosuppressive effects of ultraviolet radiation (UVR)
and the related resistance to infections in rodents and humans are presented. The
waveband dependency of trans-to-cis isomerisation of urocanic acid in the stratum
corneum and the role of DNA damage in UVR-induced erythema and immunosuppression 
were investigated to further elucidate the underlying mechanisms. Furthermore,
human experimental studies on UVR-induced immunomodulation were performed. It
appeared that the doses needed to suppress various immune parameters in humans
(e.g. NK activity, contact hypersensitivity) were higher than those needed in
experiments in rodents. Still, extrapolation of experimental animal data to the
human situation showed that UVR may impair the resistance to different systemic
infections at relevant outdoor doses. In observational human studies we aimed to 
substantiate the relevance of UVR for infections in humans. It was shown that
sunny season was associated with a slightly retarded but clinically non-relevant 
antibody response to hepatitis B vaccination. Furthermore, sunny season appeared 
to be associated with a small decline in the number of CD4+ T-helper cells in a
cohort of HIV-infected persons and a higher recurrence of herpes simplex and
herpes zoster in a cohort of renal transplant recipients. However, in a study
among young children a higher exposure to solar UVR was associated with a lower
occurrence of upper respiratory tract symptoms. As disentangling the effects of
UVR from other relevant factors is often impossible in observational studies,
concise quantitative risk estimations for the human situation cannot be given at 
present.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11811930 [PubMed - indexed for MEDLINE]

2561: J Infect Chemother. 2000 Dec;6(4):196-9.

Anti-retroviral treatment in Nigeria: a review.

Anyiwo CE, Ifeanyichukwu M.

Department of Pathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi,
Nigeria. ceanyiwo@Yahoo.com

Research studies in Nigeria have been done primarily in the areas of
epidemiology, clinical practice, virology, and laboratory diagnosis. Therapy for 
infection with human immunodeficiency virus (HIV) types 1 and 2 has largely
focussed on the treatment of the HIV disease (AIDS) rather than the infection.
Therefore, opportunistic infections such as tuberculosis, diarrhea, Herpes
zoster, and other skin conditions, and tumors (Kaposi's sarcoma) are essentially 
the targets for therapy. Two reasons are responsible for the dearth of data on
anti-retroviral therapy in Nigeria: there was scepticism about zidovudine, the
first anti-retroviral drug to be developed, because of its toxicity, and the
subsequent reluctance of the Federal Government to allow it into the country. The
other reason was the prohibitive cost, making it impossible for patients to
afford. That notwithstanding, there have been several uncoordinated and
unpublished clinical trials by hospitals in the private sector, as expected,
without firm laboratory monitoring or back-up. This review discusses such
attempts and the claims of traditional medicine practitioners, as well as pilot
studies on private patients with the combination therapy of zidovudine and
lamivudine, which agents were allowed into the country in the late 1990s. The
patients showed appreciable rises in their CD4 counts, an indirect way of
monitoring viral load. This finding was corroborated with results of clinical
wellbeing, indicating that they benefitted from the administration of zidovudine 
and lamivudine.

Publication Types: 
    Review

PMID: 11810565 [PubMed - indexed for MEDLINE]

2562: Mol Pharmacol. 2002 Feb;61(2):249-54.

Specific recognition of the bicyclic pyrimidine nucleoside analogs, a new class
of highly potent and selective inhibitors of varicella-zoster virus (VZV), by the
VZV-encoded thymidine kinase.

Sienaert R, Naesens L, Brancale A, De Clercq E, McGuigan C, Balzarini J.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Leuven,
Belgium.

Recently, an entirely new class of bicyclic nucleoside analogs (BCNAs) was found 
to display exquisite potency and selectivity as inhibitors of varicella-zoster
virus (VZV) replication in cell culture. A striking difference in their ability
to convert the BCNAs to their phosphorylated derivatives was observed between the
VZV-encoded thymidine kinase (TK) and the very closely related herpes simplex
virus type 1 (HSV-1) TK. Whereas VZV TK efficiently phosphorylated the BCNAs,
HSV-1 TK was unable to do so. In addition, the thymidylate (dTMP) kinase activity
of VZV TK further converted BCNA-5'-MP to BCNA-5'-DP. The BCNAs (or their
phosphorylated derivatives) were not a substrate for cytosolic TK, mitochondrial 
TK, or cytosolic dTMP kinase. Human erythrocyte nucleoside diphosphate (NDP)
kinase was unable to phosphorylate the BCNA 5'-diphosphates to BCNA
5'-triphosphates. Under the same experimental conditions, the anti-herpetic
(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) derivative was efficiently converted 
to BVDU-MP and BVDU-DP by both VZV TK and HSV-1 TK and further, into BVDU-TP, by 
NDP kinase. Our observations may account for the unprecedented specificity of
BCNAs as anti-VZV agents.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11809847 [PubMed - indexed for MEDLINE]

2563: BMJ. 2002 Jan 26;324(7331):193-6.

Comment in:
    BMJ. 2002 Jan 26;324(7331):197.

Progression to symptomatic disease in people infected with HIV-1 in rural Uganda:
prospective cohort study.

Morgan D, Mahe C, Mayanja B, Whitworth JA.

Medical Research Council Programme on AIDS, Uganda Virus Research Institute, PO
Box 49, Entebbe, Uganda.

OBJECTIVES: To estimate the rate of progression from seroconversion to
symptomatic disease in adults infected with HIV-1, and to establish whether the
background level of signs and symptoms commonly associated with HIV-1 in
uninfected controls are likely to affect progression rates. DESIGN: Longitudinal,
prospective cohort study of people infected with HIV-1 and randomly selected
subjects negative for HIV-1 antibodies identified during population studies.
SETTING: Study clinic with basic medical care in rural Uganda. SUBJECTS: 275
patients infected with HIV-1 (107 prevalent cases and 168 incident cases) and 246
controls negative for HIV-1 antibodies. MAIN OUTCOME MEASURES: Signs and symptoms
of HIV disease, as determined by stages 2 and 3 of the World Health Organization 
clinical staging system. RESULTS: The median time from seroconversion to WHO
stage 2 was 25.4 months and to stage 3 was 45.5 months. 43% of the participants
infected with HIV-1 had signs or symptoms by two years after seroconversion. The 
most common clinical conditions used to define progression of disease were weight
loss, mucocutaneous manifestations, bacterial infections, chronic fever, and
chronic diarrhoea. Although the rates of these conditions (apart from minor
weight loss) were significantly higher in the participants infected with HIV-1,
they were also relatively frequent in the control group. Herpes zoster, oral
candidiasis, and pulmonary tuberculosis were not common events in the control
group and therefore were more indicative of infection with HIV-1. CONCLUSIONS:
Disease progression associated with infection with HIV-1 seems to be rapid in
rural Uganda. This is most likely due to the high prevalence of conditions in the
general population that could be taken as symptoms and signs of infection with
HIV-1.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11809639 [PubMed - indexed for MEDLINE]

2564: Rev Med Interne. 2001 Dec;22(12):1272-4.

[ Varicella-zoster virus encephalitis mimicking herpes simplex encephalitis]

[Article in French]

Philippeau F, Bouhour F, Salord F.

Publication Types: 
    Case Reports
    Letter

PMID: 11794902 [PubMed - indexed for MEDLINE]

2565: J Dermatol. 2001 Dec;28(12):728-33.

Prolonged herpes zoster in a patient infected with the human immunodeficiency
virus.

Matsuo K, Honda M, Shiraki K, Niimura M.

Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan.

In 1983, varicella zoster virus (VZV) disease was first recognized in the context
of infection with the human immunodeficiency virus (HIV). Since that time, there 
have been many reports discussing the occurrence and clinical manifestations of
hepes zoster in HIV-infected patients. We describe the development of prolonged
herpes zoster in a patient with acquired immunodeficiency syndrome (AIDS) over
the course of 104 days. Viral isolates at the three different clinical stages of 
the skin lesions were sensitive in vitro to acyclovir, and supposed to be a same 
strain by polymerase chain reaction (PCR) analysis. We also discuss an effective 
treatment for prolonged cases of zoster.

Publication Types: 
    Case Reports

PMID: 11804069 [PubMed - indexed for MEDLINE]

2566: Bone Marrow Transplant. 2001 Dec;28(12):1105-9.

Immunologic recovery after autologous blood stem cell transplantation in patients
with AL-amyloidosis.

Akpek G, Lenz G, Lee SM, Sanchorawala V, Wright DG, Colarusso T, Waraska K,
Lerner A, Vosburgh E, Skinner M, Comenzo RL.

Section of Hematology and Oncology, Department of Medicine, Boston University
Medical Center, Boston, MA, USA.

We prospectively studied absolute lymphocyte (ALC) and monocyte counts (AMC),
lymphocyte subsets and proliferative in vitro responses to mitogen and antigen in
12 patients with AL-amyloidosis (AL) undergoing autologous blood stem cell
transplantation (SCT) with high-dose i.v. melphalan. Myeloid and lymphoid
recovery (>500 per microl) occurred in a median of 10 days post SCT. While there 
was a continuous decline in the number of CD4+ T cells at 3 months, ALC, AMC, B
cells (CD19+), CD8+ T cells, and NK cells (CD16+/56+) returned to baseline. While
T cell proliferative responses to phytohemagglutinin (PHA) remained depressed, B 
cell function measured by the proliferative response to staphylococcal antigen
returned to baseline by 3 months. To supplement our findings, we retrospectively 
evaluated ALC, AMC and serum immunoglobulin levels in a separate group of
patients treated with the same protocol at our institution. ALC and AMC recovery 
was similar to the pattern observed in the initial study group. Immunoglobulin
levels remained within normal ranges at 3 and 12 months after SCT. Of 50 patients
who were followed for a minimum of 1 year following SCT, seven (14%) developed
shingles and one (2%) had PCP pneumonia. In conclusion, cellular immune function,
reflected by absolute numbers of CD4+ T cells and PHA responsive T cell
proliferation, is significantly suppressed at 3 months after SCT in patients with
AL, and this post-transplant immunosuppression is associated with a low but
clinically meaningful occurrence of opportunistic infections typical of T cell
immunosuppression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11803350 [PubMed - indexed for MEDLINE]

2567: Vaccine. 2002 Jan 15;20(7-8):1113-25.

The cost-effectiveness of varicella vaccination in Canada.

Brisson M, Edmunds WJ.

Immunisation Division, PHLS Communicable Disease Surveillance Center, 61
Colindale Avenue, NW9 5EQ, London, UK. mbrisson@phls.org.uk

A deterministic realistic age-structured model was used to predict the impact of 
vaccination on the incidence of varicella and zoster. Unit costs, estimated from 
literature, were applied to the predicted health outcomes. Various vaccination
programs were investigated and a sensitivity analysis was performed. Assuming no 
impact of vaccination on zoster, varicella vaccination is estimated to cost
45,000 dollars, 51,000 dollars and 18,000 dollars per life-year gained from the
health payer's perspective for infant, infant with catch-up campaign, and preteen
programs, respectively. From the societal perspective, mass infant varicella
vaccination was estimated to be highly cost saving in Canada. Importantly, infant
varicella vaccination could result in a short- to medium-term increase of zoster 
incidence and thus cause vaccination to be highly cost-ineffective (118,000
dollars per life-year gained) under the health payer's perspective. From a health
payer's perspective the preteen vaccination is the only strategy that is deemed
cost-effective. The cost-effectiveness of infant vaccination rests heavily on the
unknown relationship between varicella and zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11803072 [PubMed - indexed for MEDLINE]

2568: Ann Otol Rhinol Laryngol. 2002 Jan;111(1):68-76.

Audiological assessment in Ramsay Hunt syndrome.

Kaberos A, Balatsouras DG, Korres SG, Kandiloros D, Economou C.

Department of Otolaryngology, Tzanion General Hospital, Piraeus, Greece.

Ramsay Hunt syndrome is known to cause symptoms and signs of vestibulocochlear
dysfunction, including sensorineural hearing loss. The present study investigates
the audiological features of a group of 15 patients with this syndrome. A
complete otolaryngological, neurologic, and audiological workup was performed in 
every patient, including auditory brain stem response measurements and recording 
of transiently evoked otoacoustic emissions. In most patients, some degree of
hearing loss was evident, and abnormal latencies and interpeak latencies of the
auditory brain stem response, or even absence of the waves, were observed.
Transiently evoked otoacoustic emissions were present in only 6 cases, and
caloric tests showed unilateral weakness in the majority of the patients. In all 
of the performed tests, abnormalities were present only on the affected side. The
audiological data suggested cochlear or retrocochlear involvement or involvement 
at more than one site along the auditory pathway.

PMID: 11800372 [PubMed - indexed for MEDLINE]

2569: J Virol. 2002 Feb;76(4):1971-9.

Phylogenetic analysis of varicella-zoster virus: evidence of intercontinental
spread of genotypes and recombination.

Muir WB, Nichols R, Breuer J.

School of Medicine, Queen Mary College, University of London, London E1 1BB,
England.

A heteroduplex mobility assay was used to identify variants of varicella-zoster
virus circulating in the United Kingdom and elsewhere. Within the United Kingdom,
58 segregating sites were found out of the 23,266 examined (0.25%), and
nucleotide diversity was estimated to be 0.00063. These are an order of magnitude
smaller than comparable estimates from herpes simplex virus type 1. Sixteen
substitutions were nonsynonymous, the majority of which were clustered within
surface-expressed proteins. Extensive genetic correlation between widely spaced
sites indicated that recombination has been rare. Phylogenetic analysis of
varicella-zoster viruses from four continents distinguished at least three major 
genetic clades. Most geographical regions contained only one of these three
strains, apart from the United Kingdom and Brazil, where two or more strains were
found. There was minimal genetic differentiation (one or fewer substitutions in
1,895 bases surveyed) between the samples collected from Africa (Guinea Bissau,
Zambia) and the Indian subcontinent (Bangladesh, South India), suggesting recent 
rapid spread and/or low mutation rates. The geographic pattern of strain
distribution would favor a major influence of the former. The genetic uniformity 
of most virus populations makes recombination difficult to detect. However, at
least one probable recombinant between two of the major strains was found among
the samples originating from Brazil, where mixtures of genotypes co-occur.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11799191 [PubMed - indexed for MEDLINE]

2570: Ann Rheum Dis. 2002 Feb;61(2):102.

Case Number 22: An interesting case of herpes zoster in rheumatoid arthritis.

Campalani E, Meenagh GK, Finch MB.

Department of Rheumatology, Royal Victoria Hospital, Grosvenor Road, Belfast BT12
6BA, UK.

Publication Types: 
    Case Reports

PMID: 11796393 [PubMed - indexed for MEDLINE]

2571: Neurol Sci. 2001 Nov;22 Suppl 2:S98-102.

The differential diagnosis of multiple sclerosis: classification and clinical
features of relapsing and progressive neurological syndromes.

Trojano M, Paolicelli D.

Department of Neurological and Psychiatric Sciences, University of Bari, Italy.

In the absence of pathognomonic clinical features or a definitive laboratory
test, multiple sclerosis (MS) remains ultimately a diagnosis of exclusion.
Accurate diagnosis is increasingly important with available disease modifying
therapy. Unfortunately the rate of misdiagnosis remains around 5%-10%, indicating
that 1 in 20 patients thought to have MS has, instead, a condition resembling MS.
In this review we describe conditions that may be confused with MS because they
can present as lesions disseminated in time, space, or both. Conditions often
confused with MS may be inflammatory (systemic lupus erythematosus, Sjogren's
syndrome, vasculitis, sarcoidosis, Behcet's disease), infectious (Lyme disease,
syphilis, progressive multifocal leukoencephalopathy, HTLV-1 infection, herpes
zoster), genetic (lysosomal disorders, adrenoleukodystrophy, mitochondrial
disorders, CADASIL), metabolic (vitamin B12 deficiency), neoplastic (CNS
lymphoma) and spinal (degenerative and vascular malformations) diseases. The key 
to the accurate diagnosis of MS is vigilance for atypical features, suggesting
the possibility of an alternative diagnosis.

Publication Types: 
    Review

PMID: 11794488 [PubMed - indexed for MEDLINE]

2572: Pediatr Infect Dis J. 2002 Jan;21(1):78-80.

Acute retinal necrosis syndrome in a child.

Chen S, Weinberg GA.

Department of Pediatrics, University of Rochester School of Medicine and
Dentistry Rochester, NY, USA.

We recently cared for an 11-year-old child with acute retinal necrosis syndrome, 
an ophthalmologic condition characterized by the triad of anterior uveitis,
occlusive retinal vasculitis and progressive peripheral retinal necrosis. Acute
retinal necrosis syndrome occurs primarily in nonimmunocompromised adults as a
result of reactivated herpes simplex or varicella-zoster virus infection.
Antiviral and antiinflammatory therapy appears to reduce the incidence of
vision-threatening retinal necrosis and involvement of the contralateral eye.

Publication Types: 
    Case Reports

PMID: 11791109 [PubMed - indexed for MEDLINE]

2573: Pain. 2002 Jan;95(1-2):187-9.

Human "autotomy".

Bowsher D.

Pain Research Institute, Clinical Sciences Building, University Hospital Aintree,
Liverpool L9 7AL, UK. pri@liv.ac.uk

We describe two cases of self-injurious behaviour. One was a man with central
post-stroke pain with maximal pain in the tip of the nose, who excavated his ala 
nasae--in which he subsequently continued to experience phantom pain. The second 
case a man who, following ophthalmic herpes zoster and possibly mild postherpetic
neuralgia. He subsequently scratched his anaesthetic forehead down to the bone,
while denying he experienced any pain. We would describe the first case as one of
true autotomy; but the second as destruction of an anaesthetic part of the body. 
The implications for human and animal physiopathology are discussed.

Publication Types: 
    Case Reports

PMID: 11790481 [PubMed - indexed for MEDLINE]

2574: Am J Chin Med. 2001;29(3-4):459-67.

Inhibitory effect of anti-pyretic and anti-inflammatory herbs on herpes simplex
virus replication.

Hsiang CY, Hsieh CL, Wu SL, Lai IL, Ho TY.

Department of Microbiology, China Medical College, Taichung, Taiwan.

The increasing clinical use of acyclovir, ganciclovir, and foscarnet against
herpes simplex virus (HSV), varicella-zoster virus, and cytomegalovirus has been 
associated with the emergence of drug-resistant herpesvirus strains. To develop
anti-HSV compounds from plants, 31 herbs used as antipyretic and
anti-inflammatory agents in Chinese medicine were screened. Five different
preparations (cold aqueous, hot aqueous, ethanolic, acid ethanolic, and
methanolic) from 31 herbs were analyzed by plaque reduction assay, and 7
extracts. which showed significant antiviral activities, were further elucidated 
for their antiviral mechanisms. Our results showed that ethanolic extract of
Rheum officinale and methanolic extract of Paeonia suffruticosa prevented the
process of virus attachment and penetration. Aqueous extract of P. suffruticosa
and ethanolic extract of Melia toosendan inhibited virus attachment to cell
surface. Aqueous extract of Sophora flavescens and methanolic extract of M.
toosendan showed no effect on virus attachment and penetration. These data
indicated that these 4 herbs have a potential value as a source of new powerful
anti-HSV compounds.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11789588 [PubMed - indexed for MEDLINE]

2575: Nervenarzt. 2001 Dec;72(12):955-7.

[Unusual manifestation of zoster sine herpete as unilateral caudal cranial nerve 
syndrome]

[Article in German]

Terborg C, Forster G, Sliwka U.

Neurologische Klinik, Friedrich-Schiller-Universitat Jena, Philosophenweg 3,
07743 Jena. christoph.terborg@med.uni-jena.de

Multiple lower cranial nerve palsies are a rare complication following varicella 
zoster virus (VZV) reactivation, especially if typical herpetic eruptions are
lacking. We report a case of a 45-year-old, immunocompetent male with unilateral 
involvement of the cranial nerves VIII, IX, X, and XI without skin lesions.
Cerebrospinal fluid (CSF) studies revealed mononuclear pleocytosis with
intrathecal antibody synthesis against VZV, while polymerase chain reaction (PCR)
did not detect VZV or HSV (herpes simplex virus). The patient almost completely
recovered after aciclovir administration. VZV reactivation without rash (zoster
sine herpete) may lead to multiple cranial nerve palsies. PCR is a useful tool to
detect VZV-DNA in CSF, but negative results do not exclude a reactivation. In
case of multiple cranial nerve palsies of unknown etiology with mononuclear
pleocytosis in CSF tumors of the skull base, meningitis tuberculosis, and
meningeosis have to be excluded, and antiviral therapy should be discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11789442 [PubMed - indexed for MEDLINE]

2576: Rev Med Virol. 2002 Jan-Feb;12(1):5-11.

Studies on shingles, is the virus ordinary chickenpox virus?

Breuer J.

Publication Types: 
    Biography
    Classical Article
    Historical Article

Personal Name as Subject: 
    Simpson RE

PMID: 11787080 [PubMed - indexed for MEDLINE]

2577: Rev Neurol. 2001 Nov 1-15;33(9):809-11.

[Intrathecal oligoclonal and polyspecific immune response in multiple sclerosis]

[Article in Spanish]

Robinson Agramonte MA, Reiber H, Dorta Contreras AJ, Hernandez Diaz E.

Departamento de Neuroinmunologia; Centro Internacional de Restauracion
Neurologica (CIREN), La Habana, 11300, Cuba. robin@basica.neubas.sld.cu

INTRODUCTION: The intrathecal response of IgG, is the most frequent
neuropathological sign in multiple sclerosis (MS) patients beside the detection
of oligoclonal IgG bands in cerebrospinal fluid. At the same time the observation
of an intrathecal antibody synthesis (antibody index> 1.4) against neurotropic
viruses like measles, rubella, varicella zoster or herpes simple shows a higher
frequency in MS than any other chronic disease (MRZH reaction). We report the
intrathecal, polyspecific and oligoclonal immune response in patients with
definitive MS. PATIENTS AND METHODS: CSF and serum were tested for Albumin, IgG, 
IgM and IgA by standard immunochemical nephelometry assay while virus specific
antibodies in CSF and serum samples were evaluated by ELISA and calculated as
antibody index. RESULTS: Oligoclonal IgG by, isoelectric focusing was detectable 
in all patients. A differential pattern of combined antibody index against
neurotropic virus was observed. The largest frequency of a single species in the 
oligoclonal immune response was for measles antibodies, while the antibody
response was found as a combination with increased rubella antibody index and VZ 
antibody index, respectively. CONCLUSION: Our results although preliminary for
our country, enrich the criteria about that MRZH reaction provide a major
neuroimmunological support to MS diagnosis.

Publication Types: 
    English Abstract

PMID: 11784982 [PubMed - indexed for MEDLINE]

2578: Bone Marrow Transplant. 2001 Dec;28(11):1023-9.

High-dose chemotherapy and CD34-selected peripheral blood progenitor cell
transplantation for patients with breast cancer metastatic to bone and/or bone
marrow.

Klein JL, Hamm C, Dansey RD, Karanes C, Abella E, Cassells L, Peters WP, Baynes
RD.

Barbara Ann Karmanos Cancer Center, Wayne State University School of Medicine,
Division of Hematology and Oncology, Detroit, MI, USA.

Fifty women with breast cancer metastatic to bone or bone marrow involvement on
light microscopy at the time of initial evaluation were treated with high-dose
chemotherapy (HDC) and peripheral blood progenitor cell (PBPC) transplantation
with CD34(+) cell selection using the Isolex 300i system. All patients received
induction chemotherapy. PBPC were mobilized with chemotherapy and granulocyte
colony-stimulating factor. The median CD34(+) progenitor purity was 94.7% (range 
72-98.7%) and recovery 38.4% (range 21-60%). Forty-eight hours after HDC with
cyclophosphamide, cisplatin and carmustine, PBPC were reinfused. Median time to
neutrophil count >0.5 x 10(9)/l was 9 (range 9-12) days and to platelet
transfusion independence 11 (4-30) days. These data demonstrate that selected
CD34(+) PBPCs allow rapid hematologic reconstitution after HDC. During follow-up,
23% of patients developed herpes zoster. Two patients developed cytomegalovirus
infections. Three patients developed fungal infections. The development of these 
infections was not associated with steroid use but appeared more frequently in
patients with diabetes mellitus. Seventy-four per cent of patients received
steroids for pulmonary toxicity. Treatment-related mortality was 4%.
Progression-free survival and overall survival at 35 months was 22.4% and 40.5%, 
with a median of 11.4 months and 15.4 months, respectively.

PMID: 11781611 [PubMed - indexed for MEDLINE]

2579: Tohoku J Exp Med. 2001 Sep;195(1):61-3.

Acute abdominal pain preceding cutaneous manifestations of varicella zoster
infection after allogeneic bone marrow transplantation.

Itoh M, Kawaguchi S, Yago K, Shimada H, Muro H.

Department of Internal Medicine, Shizuoka General Hospital, Japan.
itomitsu-kyt@umin.ac.jp

The current communication describes clinical findings in two recipients of
allogeneic bone marrow transplantation (BMT) with varicella zoster virus
infection who complained of acute severe abdominal pain preceding cutaneous
manifestations. Physical examination, laboratory data and gastroscopic findings
were nonspecific. In these cases, acyclovir was very effective for the symptoms. 
Varicella zoster virus infection should be suspected in BMT recipients who have
rebellant acute abdominal pain but no characteristic skin eruptions.

Publication Types: 
    Case Reports

PMID: 11780725 [PubMed - indexed for MEDLINE]

2580: Clin Experiment Ophthalmol. 2001 Dec;29(6):433-4.

Failure of antiretroviral therapy to control Varicella zoster retinitis.

Ramsay A, Young S, Lightman S.

Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye 
Hospital, London, UK.

The term necrotizing herpetic retinopathies encompasses a spectrum of diseases
which includes cytomegalovirus (CMV) retinitis, acute retinal necrosis (ARN) and 
Varicella zoster retinitis (VZR). Varicella zoster retinitis is a rapidly
progressive, necrotizing condition most commonly reported in patients with AIDS. 
A case of vitreous biopsy-proven VZR is reported in a patient with AIDS that
progressed despite immune recovery on highly active antiretroviral therapy
(HAART) to a viral load < 50 copies/mL and a CD4 count of 230 cells/microL. This 
is in contrast to CMV retinitis in which maintenance therapy appears unnecessary 
once the CD4 count rises and the viral load falls on HAART. Patients with VZR and
AIDS should therefore be monitored for reactivation of retinal disease despite
HAART-induced remission.

Publication Types: 
    Case Reports

PMID: 11778817 [PubMed - indexed for MEDLINE]

2581: Clin Experiment Ophthalmol. 2001 Dec;29(6):429-32.

Multifocal chorioretinal atrophy associated with herpes zoster ophthalmicus.

McKelvie PA, Francis IC, Watson S, Nuovo G.

Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Victoria,
Australia. mckelvpa@svhm.org.au

A 73-year-old woman developed multiple depigmented lesions in the fundus 4-6
months after an episode of acute Herpes zoster ophthalmicus. Post-mortem
examination of the globe 15 years after this acute episode confirmed multiple old
chorioretinal scars probably due to vasculitis of the short posterior ciliary
arteries and branches. Patchy old infarcts were also noted in the iris.

Publication Types: 
    Case Reports

PMID: 11778816 [PubMed - indexed for MEDLINE]

2582: Clin Experiment Ophthalmol. 2001 Dec;29(6):406-10.

Uveitis in Herpes zoster ophthalmicus.

Thean JH, Hall AJ, Stawell RJ.

Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, East
Melbourne, Australia. jthean@hotmail.com

BACKGROUND: Herpes zoster ophthalmicus (HZO) is a common condition occurring
mostly in healthy people. Approximately 50% of HZO patients develop ocular
complications, with iridocyclitis occurring in about 43%. This study aimed to
identify the clinical features of uveitis secondary to HZO. METHOD: A
retrospective case study was performed of consecutive patients with HZO and
secondary uveitis seen in the past 10 years at the Royal Victorian Eye and Ear
hospital as well as those seen in the private clinics of two ocular immunology
consultants. The information collected included the time relationship between
onset of rash and uveitis, duration and treatment of the uveitis, and rate and
nature of ocular complications. RESULTS: Thirty-four patients fulfilled the
enrolment criteria. The age range was from 24 to 83 years with an average age of 
62.5 years. Of these, 28 patients (82%) were immunocompetent and six patients
(18%) had underlying immunosuppression from various causes. Twenty-three patients
had a uniphasic episode of uveitis and 11 patients (32%) had a chronic relapsing 
course of uveitis. The duration of the uveitis was variable, ranging from 1 week 
to 3 years, with 68% of episodes resolving within 2 months. Nineteen patients
(56%) developed secondary glaucoma. Five of these patients (26%) required
trabeculectomies to control their intraocular pressures. Three patients (9%) had 
bilateral ocular involvement and five patients (15%) had a reduction in final
Snellen visual acuity of more than two lines. CONCLUSION: In this study, most
patients were immunocompetent individuals. The course of the uveitis was
generally uniphasic in nature and of a relatively short duration. There was a
high incidence of secondary glaucoma with 15% of all patients requiring surgical 
intervention. The visual loss in the five patients was not directly related to
the uveitis and secondary glaucoma but to other complications associated with
HZO.

PMID: 11778812 [PubMed - indexed for MEDLINE]

2583: J Foot Ankle Surg. 2001 Nov-Dec;40(6):411-3.

Toxic shock syndrome originating from the foot.

Arnold J, Lucarelli M, Cutrona AF, DiDomenico LA, Karlock L.

Forum Health, Department of Podiatric Medicine, Youngstown, OH 44501, USA.

The most familiar etiology of toxic shock syndrome (TSS) is that of menstruation 
and tampon use. Nonmenstrual TSS has been described in all types of wounds
including postsurgical, respiratory infection, mucous membrane disruption, burns,
and vesicular lesions caused by varicella and shingles. A case of TSS occurring
in a diabetic male patient with foot blisters is presented. Early recognition by 
an infectious disease specialist and appropriate medical management led to
complete recovery. There have been no reported cases of Staphylococcus aureus TSS
originating in the foot to date.

Publication Types: 
    Case Reports

PMID: 11777238 [PubMed - indexed for MEDLINE]

2584: Expert Opin Pharmacother. 2002 Jan;3(1):51-8.

Valacyclovir in the treatment of genital herpes and herpes zoster.

Baker DA.

Division of Infectious Diseases, Department of Obstetrics/Gynaecology, State
University of New York at Stony Brook, Stony Brook, New York 11794-8091, USA.

Genital herpes is prevalent and sometimes debilitating. Likewise, herpes zoster
('shingles') can be painful and often disabling. The treatment of these
conditions has been advanced over the past two decades by the introduction of
guanosine nucleoside antivirals such as valacyclovir (Valtrex), Glaxo Wellcome), 
the highly bioavailable prodrug of acyclovir (Zovirax), Glaxo Wellcome). This
review describes the pharmacology, pharmacokinetics, clinical efficacy and
tolerability of valacyclovir and considers its clinical attributes in the context
of those of the antivirals, acyclovir and famciclovir (Famvir), SmithKline
Beecham). The data demonstrate that valacyclovir is more effective than placebo
and as effective as other antivirals in the episodic and suppressive treatment of
recurrent genital herpes. Valacyclovir is the only antiviral shown to be
effective with a short (3-day) course in the episodic treatment of recurrent
genital herpes, as well as with once-daily dosing for daily suppressive therapy. 
In herpes zoster, valacyclovir is as effective as famciclovir and more effective 
than either placebo or acyclovir at facilitating cutaneous healing and healing of
zoster-associated pain and post-herpetic neuralgia. Valacyclovir is well
tolerated, with convenient dosing frequencies for the treatment of genital herpes
or herpes zoster, it also has the option for use as a short course therapy in the
episodic treatment of recurrent genital herpes, all of which are important
benefits in the management of these conditions.

Publication Types: 
    Review

PMID: 11772333 [PubMed - indexed for MEDLINE]

2585: Percept Mot Skills. 2001 Oct;93(2):329-32.

Cell-mediated immune hypersensitivity is stronger in the left side of the body
than the right in healthy young subjects.

Dane S, Erdem T, Gumustekin K.

Department of Physiology, Faculty of Medicine, Ataturk University, Erzurum,
Turkey.

More frequent appearance of herpes zoster infection on the left side of the body 
has been noted. In women, breast cancer occurs more frequently on the left side. 
It has been suggested that the left neocortex is involved in
neuroimmunomodulation via the dopaminergic system. In this study, our purpose was
to investigate the possible difference in cell-mediated hypersensitivity between 
right and left body sides using the tuberculin test with 22 male and 36 female
healthy high school students. In the present study, the cell-mediated
hypersensitivity was higher in the left side of the body than the right. This
difference was slightly more apparent in the girls and may be related to brain
asymmetry in neuroimmunomodulation.

PMID: 11769884 [PubMed - indexed for MEDLINE]

2586: Can Fam Physician. 2001 Nov;47:2299-304.

Varicella zoster virus. Recent advances in management.

Rajan P, Rivers JK.

Division of Dermatology, University of British Columbia, Vancouver Hospital and
Health Sciences Centre.

OBJECTIVE: To provide an update on strategies for managing varicella zoster virus
(VZV) and for preventing and treating established postherpetic neuralgia (PHN).
QUALITY OF EVIDENCE: Treatment guidelines are based on randomized clinical
trials. Recommendations concerning other aspects of VZV management (e.g.,
vaccination) are based mainly on expert opinion. MAIN MESSAGE: Varicella and
herpes zoster caused by VZV can give rise to serious morbidity and mortality and 
should be treated. For preventing chickenpox, safe and effective immunization is 
widely recommended. Treating varicella-exposed seronegative pregnant women
requires special attention because the virus can harm expectant mothers, fetuses,
and newborns. The antiviral drugs, acyclovir, valacyclovir, and famciclovir, have
been approved for treating herpes zoster and have a role in reducing the duration
of PHN. Established PHN can be managed with analgesics, tricyclic
antidepressants, and other agents. CONCLUSION: Vaccination and antiviral and
other systemic agents can substantially reduce the morbidity associated with VZV 
infection.

Publication Types: 
    Review

PMID: 11768928 [PubMed - indexed for MEDLINE]

2587: Geriatrics. 2001 Dec;56(12):18-24.

Herpetic neuralgia. Use of combination therapy for pain relief in acute and
chronic herpes zoster.

Bajwa ZH, Ho CC.

Harvard Medical School, USA.

Herpes zoster (shingles) is a localized infection that begins in the dorsal root 
ganglla of the cranial or spinal nerves and spreads as a rash over the
corresponding dermatome. It usually is caused by reactivation of latent
varicella-zoster virus remaining from childhood chicken pox. Postherpetic
neuralgia (PHN) is a chronic neuropathic pain syndrome that occurs as a
complication of shingles, most commonly in older persons. Acute zoster and PHN
can be severe conditions associated with impaired sleep, decreased appetite,
depression, anxiety disorder, and diminished libido. Management of zoster-related
pain should begin as soon as possible after the onset of symptoms. Combination
therapy--including antiviral, antidepressant, corticosteroid, opioid, and topical
agents--provides the most effective analgesia.

Publication Types: 
    Review

PMID: 11766559 [PubMed - indexed for MEDLINE]

2588: J Eur Acad Dermatol Venereol. 2001 Sep;15(5):473-5.

Granulomatous folliculitis as a manifestation of post-herpetic isotopic response.

Schena D, Barba A, Chieregato C.

Department of Dermatology, Verona University, Italy.

We report a case of postherpetic granulomatous folliculitis in a 52-year-old
female. The several cutaneous granulomatous eruptions following herpes zoster
reported in the literature include annular, sarcoid and tuberculoid granuloma,
granulomatous vasculitis and granulomatous folliculitis. The mechanism of
granuloma formation is probably triggered by a delayed hypersensitivity response 
to the virus.

Publication Types: 
    Case Reports

PMID: 11763396 [PubMed - indexed for MEDLINE]

2589: J Eur Acad Dermatol Venereol. 2001 Sep;15(5):445-7.

Wolf's isotopic response: a case of zosteriform lichen planus on the site of
healed herpes zoster.

Shemer A, Weiss G, Trau H.

Department of Dermatology, Chaim Shea Medical Center, Tel Hashomer, Israel.

Based on histological findings, the patient had lichen planus. The clinical
picture suggests Wolf's isotopic response on the site of healed herpes zoster.
These conditions taken into account lead to the diagnosis of zosteriform lichen
planus. Lichenoid papules in a dermatomal arrangement are extremely rare. The
clinical, dermoscopic and histological features of this case are described.

Publication Types: 
    Case Reports

PMID: 11763387 [PubMed - indexed for MEDLINE]

2590: J Eur Acad Dermatol Venereol. 2001 Sep;15(5):430-2.

Dermatological immune restoration syndrome: does it exist?

Handa S, Bingham JS.

Department of Genitourinary and HIV Medicine, St. Thomas' Hospital, London, UK.

Dermatological conditions are often an early clue to HIV infection and are
common. As the disease progresses patients develop a dominant Th-2 immunological 
response that may facilitate the development of a number of skin conditions. With
antiretroviral therapy the Th-1 response is restored and some skin problems
regress. But, paradoxically, some cutaneous conditions may worsen, such as herpes
zoster, mucocutaneous herpes, eosinophilic folliculitis and mycobacterial
infections. This may be because immune restoration of a host's immunity causes
recognition of silent or latent infection and results in development of the
condition.

Publication Types: 
    Review

PMID: 11763384 [PubMed - indexed for MEDLINE]

2591: Bull Soc Belge Ophtalmol. 2000;(278):27-32.

Diplopia from skew deviation in Ramsey-Hunt syndrome. A case report.

Verhulst E, Van Lammeren M, Dralands L.

Department of Ophthalmology, UZ Leuven Kapucijnenvoer 33, 3000 Leuven Belgium.

OBJECT: Presentation of a 34-year-old pregnant woman with skew deviation due to
peripheral vestibular dysfunction caused by herpes zoster oticus. METHODS: A
multidisciplinary approach (neuroophthalmology, otorhinolaryngology,
neuroradiology) revealed the diagnosis of Ramsey-Hunt syndrome. CASE REPORT: The 
patient presented with painful herpes zoster vesicles of the left ear, associated
with a rotatory vertigo and hearing loss. Otorhinolaryngological examination
showed a unilateral peripheral vestibular loss, a nystagmus towards the
unaffected right side, no facial nerve dysfunction and a left perception hearing 
loss, mainly in the frequencies between 2-6 KHz. The patient was treated with
Zovirax IV. Neuroradiological examination (MRI without contrast) revealed no
abnormalities. Vertical diplopia from skew deviation was noted +/- 10 days after 
onset of herpes zoster oticus. Neuroophthalmological and orthoptic examination
showed a comitant right hypertropia of 6 diopters and a spontaneous nystagmus to 
the right. CONCLUSION: Skew deviation can be caused by a sudden unilateral
cochleo-vestibular loss as described by A.B. Safran. (4,6,7,8).

Publication Types: 
    Case Reports

PMID: 11761557 [PubMed - indexed for MEDLINE]

2592: J Pediatr Ophthalmol Strabismus. 2001 Nov-Dec;38(6):363-6.

Extraocular muscle and facial paresis in herpes zoster ophthalmicus.

Pandey PK, Chaudhuri Z, Sharma P.

Department of Ophthalmology, Guru Nanak Eye Centre, New Delhi, India.

Publication Types: 
    Case Reports

PMID: 11759776 [PubMed - indexed for MEDLINE]

2593: Ann Nucl Med. 2001 Oct;15(5):455-8.

[18F]-FDG uptake in soft tissue dermatome prior to herpes zoster eruption: an
unusual pitfall.

Kerrou K, Montravers F, Grahek D, Younsi N, Perniceni T, Godeberge P, Canuel C,
De Gramont A, Talbot JN.

Service de medecine nucleaire, Hopital Tenon, Paris.
khaldoun.kerrou@egp.ap-hop-paris.fr

Authors report on a case of [18F]-fluorodeoxyglucose ([18F]-FDG) uptake in the
soft tissue of a patient referred for [18F]-FDG coincidence detection emission
tomography (CDET) in a search for recurrence of colorectal cancer. A herpes
zoster eruption occurred in the same site within two days, but was spontaneously 
resolved. To the best of our knowledge this is the first description of a false
positive [18F]-FDG result in relation to a viral infection of soft tissue. It
shows that interpretation of subcutaneous foci has to be cautious in patients
with or without a past history of herpes zoster even in pain-free areas and prior
to skin eruption.

Publication Types: 
    Case Reports

PMID: 11758954 [PubMed - indexed for MEDLINE]

2594: Retina. 2001;21(6):674-7.

Retinitis syphilitica in an HIV-positive patient following acute retinal necrosis
syndrome.

Freigassner PS, Schuhmann G, Ardjomand N, El Shabrawi Y, Haas A.

Department of Ophthalmology, University Eye Clinic of Graz, Austria.
petra.freigassner@kfunigraz.ac.at

Publication Types: 
    Case Reports

PMID: 11756898 [PubMed - indexed for MEDLINE]

2595: Obstet Gynecol. 2001 Dec;98(6):1019-26.

Coxsackie virus infection of the placenta associated with neurodevelopmental
delays in the newborn.

Euscher E, Davis J, Holzman I, Nuovo GJ.

Department of Pathology, Ohio State University Medical Center, Columbus, Ohio
43210, USA.

OBJECTIVE: To determine if viral infection of the placenta was associated with
long-term neurodevelopmental delays in the newborn. METHODS: Placental tissue
from seven newborn infants with severe respiratory failure and subsequent
neurodevelopmental abnormalities as well as ten normal controls and five cases of
known placental infection (cytomegalovirus, herpes simplex virus, and parvovirus)
were tested by in situ hybridization or reverse transcriptase in situ polymerase 
chain reaction (PCR) for adenovirus, coxsackie virus, cytomegalovirus, Epstein
Barr virus, herpes simplex virus, influenza A virus, picornavirus, polyoma virus,
parvovirus, respiratory syncytial virus, rotavirus, and varicella zoster virus.
RESULTS: Coxsackie virus RNA was detected in six of the seven cases, and in none 
of the ten normal controls or five cases with known viral infection. Viral RNA
localized primarily to the Hofbauer cells and trophoblasts of the terminal villi.
Immunohistochemical analysis for the coxsackie virus antigen VP1 yielded
equivalent results. CONCLUSIONS: In utero coxsackie virus of the placenta is
associated with the development of severe respiratory failure and central nervous
system sequelae in the newborn. This underscores the importance of detailed
pathologic and viral examination of the placenta in cases of systemic illness in 
the newborn.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 11755547 [PubMed - indexed for MEDLINE]

2596: Skin Therapy Lett. 2001 Nov;6(12):1-2, 5.

Famiciclovir therapy (famvir) for herpes simplex and herpes zoster infections.

Tyring S.

Departments of Dermatology and Microbiology/Immunology, The University of Texas
Medical Branch at Galveston, Texas, USA.

Genital herpes simplex and herpes zoster infections are common afflictions that
are associated with significant morbidity and a decreased quality of life.
Famciclovir (Famvir, Novartis) is an orally administered prodrug of the antiviral
agent penciclovir. Its unique pharmacokinetic profile makes it an efficacious,
convenient and well-tolerated alternative to the traditionally prescribed
acyclovir. Famciclovir is used for the acute treatment and suppressive therapy of
recurrent genital herpes as well as for herpes zoster and its debilitating
comorbidities. Famiciclovir allows patients to manage or prevent symptoms,
thereby significantly improving their quality of life. Its favorable safety
profile makes it a good treatment choice for the elderly as well as for
immunocompromised patients, including those infected with HIV.

PMID: 11753535 [PubMed - indexed for MEDLINE]

2597: J Virol. 2002 Jan;76(2):673-87.

Regions of the herpes simplex virus scaffolding protein that are important for
intermolecular self-interaction.

Preston VG, McDougall IM.

MRC Virology Unit, Institute of Virology, Glasgow G11 5JR, United Kingdom.
v.preston@vir.gla.ac.uk

The herpes simplex virus type 1 (HSV-1) scaffolding protein encoded by gene
UL26.5 promotes the formation of the icosahedral capsid shell through its
association with the major capsid protein VP5 and through intermolecular
interactions with itself. Inside the capsid shell, the UL26.5 product together
with the maturational protease, a minor protein, form a spherical structure which
is broken down and released from the capsid during packaging of the viral genome.
Selected residues from four internal regions of the HSV-1 scaffolding protein
that have significant conservation of amino acids within the scaffolding proteins
of alphaherpesviruses were mutated, and the properties of the proteins were
examined. Only the HSV-1 scaffolding protein with mutations in the conserved
N-terminal domain showed reduced interaction with the varicella-zoster virus
homologue in a cell-based immunofluorescence assay, providing the first evidence 
that this domain in the HSV-1 protein is likely to be involved in intermolecular 
self-interaction. Scaffolding protein with mutations in this domain or in either 
of two other domains failed to assemble into scaffold-like particles but retained
the ability to self-interact, although the aggregates were significant smaller
than most of the aggregates formed by the wild-type protein. These results
suggest that there are multiple domains involved in the intermolecular
self-association of the HSV-1 scaffolding protein that can act independently of
one another. This conclusion was supported by the observation that none of the
mutant proteins with lesions in an individual domain, including a protein with
mutations in a central region previously implicated in self-interaction (A.
Pelletier, F. Do, J. J. Brisebois, L. Lagace, and M. G. Cordingley, J. Virol.
71:5197-5208, 1997), interfered with capsid assembly in a baculovirus expression 
system. A protein mutated in the central region and another conserved domain,
both of which had been predicted to form coiled coils, was impaired for capsid
formation but still retained the capacity to interact with VP5.

PMID: 11752158 [PubMed - indexed for MEDLINE]

2598: J Clin Epidemiol. 2001 Dec;54 Suppl 1:S22-8.

General medical and psychiatric comorbidity among HIV-infected veterans in the
post-HAART era.

Kilbourne AM, Justice AC, Rabeneck L, Rodriguez-Barradas M, Weissman S; VACS 3
Project Team.

Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System,
University Drive C 11E-124 (130-U), Pittsburgh, PA 15240, USA.

We examined the prevalence of HIV, general medical, and psychiatric comorbidities
by age based on a recent multisite cohort of HIV infected veterans receiving
care: the Veterans with HIV/AIDS 3 Site Study (VACS 3). VACS 3 includes 881 adult
patients with HIV infection enrolled between June 1999 and July 2000. Providers
reported their patients' CDC-defined HIV comorbidities, general medical
comorbidities (based on Duke and Charlson comorbidity scales), and psychiatric
comorbidity. Mean age of participants was 49 years and 54% were African-American.
The most common HIV comorbidities were oral candidiasis (21%), peripheral
neuropathy (16%), and herpes zoster (16%). The most common general medical
comorbidities included chemical hepatitis (53%), hypertension (24%), and
hyperlipidemia (17%). The mean number of HIV and general medical comorbidities
experienced by patients were respectively 1.1 and 1.4 (P < .001). Older (> or =
50 years) HIV-infected patients experienced a greater number of general medical
comorbidities than those < 50 years (respectively 1.7 versus 1.2, P < .001).
There was no significant difference in mean HIV comorbidity number by age. Based 
on patient report, 46% had significant depressive symptoms (> or = 10 on 10-item 
CES-D) and 21% reported at-risk drinking (> or = 8 on AUDIT). Providers reported 
32% of patients had anxiety, 4% mania, 4% schizophrenia, and 11% cognitive
impairment/dementia. General medical and psychiatric comorbidities constituted a 
higher disease burden for HIV-infected veterans than HIV comorbidities. Whether
these comorbidities are due to antiretroviral drug toxicity or are age or
lifestyle-associated conditions, the substantial prevalence of these "non-HIV"
comorbidities suggest an important role for general medical and psychiatric
management of HIV-infected patients.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 11750206 [PubMed - indexed for MEDLINE]

2599: J Clin Virol. 2002 Feb;24(1-2):37-43.

CV-1 and MRC-5 mixed cells for simultaneous detection of herpes simplex viruses
and varicella zoster virus in skin lesions.

Huang YT, Hite S, Duane V, Yan H.

Department of Pathology, University Hospitals of Cleveland, Case Western Reserve 
University, 2085 Adelbert Road, Cleveland, OH 44106, USA. yth@po.cwru.edu

BACKGROUND: Culture for varicella zoster virus (VZV) is relatively insensitive.
Herpes simplex viruses (HSV) culture methods, which rely on primary rabbit kidney
(pRK), mink lung (Mv1Lu) or the ELVIS HSV culture system fail to detect VZV.
Culture of atypical vesicular skin lesions should be able to detect both HSV and 
VZV. OBJECTIVES: In this study, we evaluated the sensitivity of a newly developed
mixture of CV-1/MRC-5 cells for the concurrent detection of both HSV and VZV.
STUDY DESIGN: The CV-1/MRC-5 mixed cells were compared with pRK cells and Mv1Lu
cells for the detection of HSV and to MRC-5 and A-549 cells for the detection of 
VZV. Fresh clinical samples submitted for HSV culture, VZV culture, and/or direct
immunofluorescent assay (DFA) as well as frozen clinical samples previously
positive for VZV were used for these comparisons. RESULTS: This preliminary study
suggest that CV-1/MRC-5 mixed cells are as sensitive as pRK and Mv1Lu cells for
the detection of HSV and appear to be more sensitive than MRC-5 and A-549 cells
for the detection of VZV. Although the sample size is small, pre-CPE staining
with VZV specific monoclonal antibody (Mab) at day 2 post-inoculation may provide
a rapid detection of VZV with these mixed cells, but not with MRC-5 or A549
cells. In addition, culture of VZV in mixed cells from fresh clinical specimens
appears to be as sensitive as antigen detection by DFA. Finally, 1% of specimens 
from skin lesions submitted for HSV culture grew VZV, highlighting the importance
of culturing for both VZV and HSV, particularly in the case of atypical lesions. 
CONCLUSION: CV-1/MRC-5 mixed cells are highly sensitive for the simultaneous
culture of HSV and VZV. The ability to detect either HSV or VZV from skin lesions
is important for patient management.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 11744427 [PubMed - indexed for MEDLINE]

2600: Skin Res Technol. 2001 Nov;7(4):219-22.

Thermal imaging in acute herpes zoster or post-zoster neuralgia.

Ammer K, Schartelmueller T, Melnizky P.

Ludwig Boltzmann Research Institute for Physical Diagnostics, Hanuschkrankenhaus,
Vienna, Austria. kammer1950@aol.com

BACKGROUND/AIMS: Asymmetry of normal skin temperature patterns has been reported 
in patients with herpetic disorders. The aim of the study was to describe the
temperature distribution in patients suffering from acute herpes zoster or
post-herpetic neuralgia. METHODS: Biographic data, including age, gender and time
of onset of the skin lesions, were recorded. The distribution of pain was
investigated by pain mapping, and the intensity of pain and dysesthesia was
quantified by a visual analogue scale. Infrared thermal images of the affected
body regions were performed in all possible views using either an Agema 870 or a 
NEC San-ei Thermotracer. RESULTS: The mean temperature difference between the
affected and the unaffected sides of the body in all patients was 0.52+/-0.30
degrees C. Higher temperatures were detected in early cases with a disease
duration of 1-9 days (mean temperature difference: 0.62+/-0.36 degrees C) than in
patients with pain scores greater than 79 (mean temperature difference:
0.48+/-0.33 degrees C). Only 6 of 57 patients presented with a temperature
difference between the affected side and contralateral side of less than 0.2
degrees C. CONCLUSION: Thermal asymmetry of the skin is a common finding in
patients with acute herpes. However, the thermal patterns seem to correlate
better with the duration of the disease than with the intensity of pain.

PMID: 11737816 [PubMed - indexed for MEDLINE]

2601: Br J Dermatol. 2001 Nov;145(5):799-804.

Experimental studies on the antiviral agent famciclovir in Behcet's disease
symptoms in ICR mice.

Sohn S, Bang D, Lee ES, Kwon HJ, Lee SI, Lee S.

Laboratory of Cell Biology, Ajou University Institute for Medical Sciences, Suwon
442-721, Korea. sohnsh@madang.ajou.ac.kr

BACKGROUND: Chronic oral aphthae, recurrent genital ulcers and uveitis are the
three main manifestations of Behcet's disease (BD). The aetiopathogenesis of BD
is still obscure, but herpes simplex virus (HSV) is one of the possible causal
factors. Various kinds of drugs, including immunosuppressants and aciclovir have 
been used in treatment, but effectiveness is variable. OBJECTIVES: To demonstrate
the efficacy of famciclovir, an antiviral compound that acts against HSV,
varicella-zoster virus and hepatitis B virus, in a murine model of BD. METHODS:
Using the HSV-induced BD mouse model, famciclovir was administered variously
before and after inoculation or from the day of lesion occurrence, with
appropriate controls. Ulceration of the mouth and genital skin and eye
involvement were monitored. In addition, spleen cytokine expression was measured 
by polymerase chain reaction. RESULTS: Pretreatment and concurrent treatment did 
not affect the occurrence of BD, but treatment from the appearance of lesions was
effective in improving BD and preventing recurrence. After famciclovir,
interleukin 2 expression correlated with the recurrence of BD symptoms.
CONCLUSIONS: This model suggests the possible role of immune response to viral
infection in the development and activation of BD. The study provides a rationale
for clinical trials of famciclovir in the human form of BD.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11736905 [PubMed - indexed for MEDLINE]

2602: Pediatr Infect Dis J. 2001 Sep;20(9):915-6.

Comment in:
    Pediatr Infect Dis J. 2002 Feb;21(2):178-9.    Pediatr Infect Dis J. 2003 Mar;22(3):295-6.

Herpes zoster during varicella.

Lau BH, Lin MI, Lin HC.

Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
laukawei@kimo.com.tw

A 4-year-old boy had varicella infection. Two days later vesicular lesions
clustered within the left 10th thoracic dermatome. Varicella-zoster virus IgM
antibody in serum was positive. He was diagnosed with varicella infection
combined with herpes zoster. This is the first case report in the medical
literature.

Publication Types: 
    Case Reports

PMID: 11734778 [PubMed - indexed for MEDLINE]

2603: Pediatr Infect Dis J. 2001 Aug;20(8):775-8.

Seroprevalence of varicella-zoster virus immunoglobulin G antibodies in Swiss
adolescents and risk factor analysis for seronegativity.

Heininger U, Braun-Fahrlander C, Desgrandchamps D, Glaus J, Grize L, Wutzler P,
Schaad UB; SCARPOL Team.

University Children's Hospital, Basel, Switzerland. Ulrich.Heininger@unibas.ch

BACKGROUND: Little is known about the seroprevalence of anti-varicella-zoster
virus (VZV) serum antibodies in adolescents in Switzerland as in most other
European countries. METHODS: Serum specimens from 13- to 15-year-old students
from eight urban and rural areas in Switzerland, obtained as part of an allergy
risk assessment study project (SCARPOL), were available for analysis of IgG
antibodies against VZV by enzyme-linked immunosorbent assay (ELISA) and
confirmation by fluorescent antibody staining of membrane antigen in a subcohort.
Serum specimens and comprehensive sociodemographic data had been collected during
two study periods between 1992 and 1995. RESULTS: Data and serum specimens were
available from 1709 and 1788 subjects, respectively. Seroprevalence of anti-VZV
antibodies as measured by ELISA was 95.5% (95% confidence interval, 94.5 to
96.4). When serum specimens that were indeterminate by ELISA were tested by FAMA,
seroprevalence was 96.5% (95% confidence interval, 95.7 to 97.4). After logistic 
regression analysis, the number of siblings was the only factor that
significantly influenced the presence of VZV antibodies (90.1% in those with no
siblings, >96% with 1 or more siblings), whereas residence (urban vs. rural),
parental education, nationality and gender did not. CONCLUSIONS: Seroprevalence
of anti-VZV serum antibodies is comparatively high among Swiss adolescents.
Individuals who grow up without siblings have a significant risk of evading
natural VZV infection in childhood, and they therefore form a potential target
group for varicella immunization in Switzerland.

PMID: 11734740 [PubMed - indexed for MEDLINE]

2604: Audiol Neurootol. 2001 Sep-Oct;6(5):259-62.

HSV-1 not only in human vestibular ganglia but also in the vestibular labyrinth.

Arbusow V, Theil D, Strupp M, Mascolo A, Brandt T.

Department of Neurology, Klinikum Grosshadern, Ludwig Maximilians University,
Munich, Germany. varbusow@nro.med.uni-muenchen.de

Reactivation of herpes simplex virus type 1 (HSV-1) in the vestibular ganglion
(VG) is the suspected cause of vestibular neuritis (VN). Recent studies reported 
the presence of HSV-1 DNA not only in human VGs but also in vestibular nuclei, a 
finding that indicates the possibility of viral migration to the human vestibular
labyrinth. Distribution of HSV-1 DNA was determined in geniculate ganglia, VGs,
semicircular canals, and macula organs of 21 randomly obtained human temporal
bones by nested PCR. Viral DNA was detected in 48% of the labyrinths, 62% of the 
VGs, and 57% of the geniculate ganglia. The potential significance of this
finding is twofold: (1) Inflammation in VN could also involve the labyrinth and
thereby cause acute unilateral vestibular deafferentation. (2) As benign
paroxysmal positional vertigo often occurs in patients who have had VN, it could 
also be a sequel of viral labyrinthitis. Copyright 2001 S. Karger AG, Basel

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11729328 [PubMed - indexed for MEDLINE]

2605: Rev Neurol. 2001 Sep 16-30;33(6):599-600.

Comment on:
    Rev Neurol. 2001 Jan 1-15;32(1):15-8.

[Brachial plexopathy in varicella of the adults. A case report]

[Article in Spanish]

Martinez-Salio A, Penas M, Blanco A, Miranda P, Porta-Etessam J, Posada I.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 11727250 [PubMed - indexed for MEDLINE]

2606: J Clin Microbiol. 2001 Dec;39(12):4426-32.

Laboratory diagnosis of common herpesvirus infections of the central nervous
system by a multiplex PCR assay.

Markoulatos P, Georgopoulou A, Siafakas N, Plakokefalos E, Tzanakaki G,
Kourea-Kremastinou J.

Department of Virology, Hellenic Pasteur Institute, Athens, Greece.
markoulatos@mail.pasteur.gr

A sensitive multiplex PCR assay for single-tube amplification that detects
simultaneous herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2
(HSV-2), varicella-zoster virus (VZV), human cytomegalovirus (CMV), and
Epstein-Barr virus (EBV) is reported with particular emphasis on how the method
was optimized and carried out and its sensitivity was compared to previously
described assays. The assay has been used on a limited number of clinical samples
and must be thoroughly evaluated in the clinical context. A total of 86
cerebrospinal fluid (CSF) specimens from patients which had the clinical symptoms
of encephalitis, meningitis or meningoencephalitis were included in this study.
The sensitivity of the multiplex PCR was determined to be 0.01 and 0.03 50%
tissue culture infective doses/the reciprocal of the highest dilution positive by
PCR for HSV-1 and HSV-2 respectively, whereas for VZV, CMV and EBV, 14, 18, and
160 ag of genomic DNA were detected corresponding to 48, 66, and 840 genome
copies respectively. Overall, 9 (10.3%) of the CSF samples tested were positive
in the multiplex PCR. HSV-1 was detected in three patients (3.5%) with
encephalitis, VZV was detected in four patients (4.6%) with meningitis, HSV-2 was
detected in one neonate (1.16%), and CMV was also detected in one neonate
(1.16%). None of the samples tested was positive for the EBV genome. None of the 
nine positive CSF samples presented herpesvirus coinfection in the central
nervous system. Failure of DNA extraction or failure to remove any inhibitors of 
DNA amplification from CSF samples was avoided by the inclusion in the present
multiplex PCR assay of alpha-tubulin primers. The present multiplex PCR assay
detects simultaneously five different herpesviruses and sample suitability for
PCR in a single amplification round of 40 cycles with an excellent sensitivity
and can, therefore, provide an early, rapid, reliable noninvasive diagnostic tool
allowing the application of antiviral therapy on the basis of a specific viral
diagnosis. The results of this preliminary study should prompt a more exhaustive 
analysis of the clinical value of the present multiplex PCR assay.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 11724856 [PubMed - indexed for MEDLINE]

2607: Virus Genes. 2001;23(2):145-7.

Presence of VZV and HSV-1 DNA in human nodose and celiac ganglia.

Gilden DH, Gesser R, Smith J, Wellish M, Laguardia JJ, Cohrs RJ, Mahalingam R.

Department of Neurology, University of Colorado Health Sciences Center, School of
Medicine, Denver 80262, USA. don.gilden@uchsc.edu

Polymerase chain reaction (PCR) revealed herpes simplex virus (HSV) and varicella
zoster virus (VZV) DNA in human nodose and celiac ganglia. This is the first
detection of VZV DNA in ganglia of the human autonomic nervous system. The
ability of reactivated VZV to produce serious, sometimes fatal neurological
disease in the absence of rash, raises the possibility that VZV reactivation from
autonomic ganglia might be involved in visceral disease.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11724266 [PubMed - indexed for MEDLINE]

2608: Hematology Am Soc Hematol Educ Program. 2001:392-421.

Preventing opportunistic infections after hematopoietic stem cell
transplantation: the Centers for Disease Control and Prevention, Infectious
Diseases Society of America, and American Society for Blood and Marrow
Transplantation Practice Guidelines and beyond.

Sullivan KM, Dykewicz CA, Longworth DL, Boeckh M, Baden LR, Rubin RH, Sepkowitz
KA; Centers for Disease Control and Prevention; Infectious Diseases Society of
America; American Society for Blood and Marrow Transplantation Practice
Guidelines and beyond.

Division of Medical Oncology, Duke University Medical Center, Durham, NC 27710,
USA.

This review presents evidence-based guidelines for the prevention of infection
after blood and marrow transplantation. Recommendations apply to all
myeloablative transplants regardless of recipient (adult or child), type
(allogeneic or autologous) or source (peripheral blood, marrow or cord blood) of 
transplant. In Section I, Dr. Dykewicz describes the methods used to rate the
strength and quality of published evidence supporting these recommendations and
details the two dozen scholarly societies and federal agencies involved in the
genesis and review of the guidelines. In Section II, Dr. Longworth presents
recommendations for hospital infection control. Hand hygiene, room ventilation,
health care worker and visitor policies are detailed along with guidelines for
control of specific nosocomial and community-acquired pathogens. In Section III, 
Dr. Boeckh details effective practices to prevent viral diseases.
Leukocyte-depleted blood is recommended for cytomegalovirus (CMV) seronegative
allografts, while ganciclovir given as prophylaxis or preemptive therapy based on
pp65 antigenemia or DNA assays is advised for individuals at risk for CMV.
Guidelines for preventing varicella-zoster virus (VZV), herpes simplex virus
(HSV) and community respiratory virus infections are also presented. In Section
IV, Drs. Baden and Rubin review means to prevent invasive fungal infections.
Hospital design and policy can reduce exposure to air contaminated with fungal
spores and fluconazole prophylaxis at 400 mg/day reduces invasive yeast
infection. In Section V, Dr. Sepkowitz details effective clinical practices to
reduce or prevent bacterial or protozoal disease after transplantation. In
Section VI, Dr. Sullivan reviews vaccine-preventable infections and guidelines
for active and passive immunizations for stem cell transplant recipients, family 
members and health care workers.

Publication Types: 
    Guideline
    Review

PMID: 11722995 [PubMed - indexed for MEDLINE]

2609: Acta Otolaryngol. 2001 Oct;121(7):831-5.

Prevalence of herpesviruses in cranial nerve ganglia.

Vrabec JT, Payne DA.

Department of Otolaryngology, University of Texas Medical Branch, Galveston
77555-0521, USA. jvrabec@utmb.edu

A number of cranial nerve disorders are known to result from viral infection or
reactivation, including Bell's palsy, Ramsay Hunt syndrome and herpetic
laryngitis. The consequences of these diseases are well established although the 
patient population at risk is not. Prevalence studies in the general population
are an initial step toward defining individuals at risk. The aim of this study
was to determine the prevalence of herpesvirus DNA in cranial nerve ganglia in a 
random population sample. Qualitative molecular biologic analysis using
polymerase chain reaction assay of the trigeminal, geniculate, vestibular, spiral
and vagal ganglia was used in 18 randomly selected fresh cadaver heads. Herpes
simplex virus (HSV) DNA was detected in 42% of all ganglia surveyed. Varicella
zoster virus (VZV) DNA was detected in 44% of all ganglia. The difference in the 
prevalence rate between viruses was not significant (p = 0.63). At least 1 of the
2 viruses was found in 65% of all ganglia. Both HSV and VZV can commonly be
recovered from cranial nerve ganglia. In order to confirm a viral etiology for
various cranial nerve disorders, demonstration of a significant difference in
prevalence of the viruses in specimens from afflicted individuals will be
necessary.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11718247 [PubMed - indexed for MEDLINE]

2610: Clin Neurol Neurosurg. 2001 Dec;103(4):260-1.

Transverse myelitis caused by Varicella.

Celik Y, Tabak F, Mert A, Celik AD, Aktuglu Y.

Publication Types: 
    Case Reports
    Letter

PMID: 11714576 [PubMed - indexed for MEDLINE]

2611: Eur J Clin Microbiol Infect Dis. 2001 Sep;20(9):670-2.

Usefulness of adding multiplex nested-polymerase chain reaction assay of
cerebrospinal fluid samples to routine diagnostic testing for herpesvirus
encephalitis.

Frias C, Matas L, Ferre X, Millan M, Marti S, Hernandez A, Ausina V.

Department of Microbiology, Hospital Universitari Germans Trias i Pujol,
Carretera del Canyet, Badalona, Spain. cfrias@ns.hugtip.scs.es

The present study was conducted to assess the usefulness of adding the multiplex 
nested-polymerase chain reaction assay of cerebrospinal fluid samples to routine 
diagnostic testing for herpesvirus encephalitis and to monitor the efficacy of
therapy. Cerebrospinal fluid samples from 45 patients with presumed herpesvirus
encephalitis were tested for herpes simplex virus, varicella-zoster virus,
cytomegalovirus, human herpesvirus 6, and Epstein-Barr virus. Ten of the 45
patients were positive for a virus using the polymerase chain reaction assay:
herpes simplex virus (n=5), Epstein-Barr virus (n=3), and herpes simplex virus
plus the Epstein-Barr virus (n=2). Cerebrospinal fluid from two patients who had 
undergone acyclovir therapy gave negative results. Analysis of cerebrospinal
fluid by multiplex polymerase chain reaction can be useful for establishing an
accurate diagnosis and as a marker of the efficacy of therapy.

PMID: 11714053 [PubMed - indexed for MEDLINE]

2612: Rheumatology (Oxford). 2001 Nov;40(11):1285-92.

Reactive haemophagocytic syndrome in children with inflammatory disorders. A
retrospective study of 24 patients.

Stephan JL, Kone-Paut I, Galambrun C, Mouy R, Bader-Meunier B, Prieur AM.

Unite d'Hematologie et d'Oncologie Pediatriques, Hotel Dieu, Clermont-Ferrand,
Service de Pediatrie, Hopital Nord, Marseille, France.

BACKGROUND: The reactive haemophagocytic syndrome (RHS) is a little-known
life-threatening complication of rheumatic diseases in children. It reflects the 
extreme vulnerability of these patients, especially those with systemic-onset
juvenile chronic arthritis (JCA). This immunohaematological process may be
triggered by events such as herpes virus infection and non-steroidal
anti-inflammatory drug therapy. Treatment has not been standardized. METHODS: We 
characterized this unusual disorder and determined its incidence by carrying out 
a retrospective study of patients identified over a 10-yr period in French
paediatric units. RESULTS: Twenty-four cases (nine males, 15 females) were
studied. Eighteen had typical systemic-onset JCA, two had polyarthritis, two had 
lupus and two had unclassifiable disorders. Clinical features at diagnosis
included high spiking fever (24 patients), enlargement of the liver and spleen
(14), haemorrhagic diathesis (six), pulmonary involvement (12) and neurological
abnormalities (coma or seizures) (12). RHS was the first manifestation of
systemic disease in three cases. Admission to intensive care was required in ten 
cases. Hypofibrinogenaemia, elevated liver enzymes and hypertriglyceridaemia were
found consistently. Phagocytic histiocytes were found in 14 of 17 bone marrow
smears. RHS was presumed to have been precipitated by infection in 11 cases (four
Epstein-Barr virus, three varicella-zoster virus, one parvovirus B19, one
Coxsackie virus, one Salmonella, one Pneumocystis carinii) and by the
introduction of medication in three cases (Salazopyrin plus methotrexate;
morniflumate; aspirin). Macrophage activation was indicated by high levels of
monokines in the serum of two patients. Twenty patients had only one episode,
three had an early relapse and one patient had two relapses. The treatment
regimen was tailored to each child as the clinical course was variable. There was
no response to intravenous immunoglobulins, which were used in four cases.
Intravenous steroids at doses ranging from conventional to pulse
methylprednisolone induced remission in 15 of 21 episodes when used alone as the 
first-line treatment. Cyclosporin A was consistently and rapidly effective, both 
when used as second-line therapy in all seven of the episodes in which steroids
failed and in all five patients who received it as their first-line treatment.
This supports a central role of T lymphocytes in the haemophagocytic syndrome.
Two patients died. One patient with lupus died of congestive fulminant heart
failure after 4 days, despite treatment with intravenous steroids and
immunoglobulins, and one patient with systemic-onset JCA died from multiorgan
failure despite aggressive therapy with pulsed steroids and etoposide.
CONCLUSIONS: RHS may be a more common complication of systemic disease in
childhood than previously thought. This life-threatening complication should be
diagnosed promptly, as it calls for the immediate withdrawal of potentially
triggering medications, anti-infective therapy when relevant, and urgent
immunosuppressive treatment, measures that are very often effective. Cyclosporin 
A may be the drug of choice.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11709613 [PubMed - indexed for MEDLINE]

2613: Enferm Infecc Microbiol Clin. 2001 Nov;19(9):443-4.

[Vesicular rash in a healthy five-month-old baby]

[Article in Spanish]

Garcia-Bujalance S, Baquero-Artigao F, Jesus Garcia De Miguel M.

Servicio de Microbiologia y Parasitologia. Hospital La Paz. Madrid.

Publication Types: 
    Case Reports

PMID: 11709124 [PubMed - indexed for MEDLINE]

2614: Int J Clin Pharmacol Res. 2001;21(1):15-9.

Analgesic effects of flecainide on postherpetic neuralgia.

Ichimata M, Ikebe H, Yoshitake S, Hattori S, Iwasaka H, Noguchi T.

Department of Anesthesiology, Oita Medical University, Oita-gun, Japan.

Sodium channel blockers have been reported to be effective in relieving
neuropathic pain. However, although intravenous lidocaine has proved to be
effective, in some patients oral mexiletine fails to produce adequate pain
relief. In this study, we investigated the analgesic effect of flecainide, a
long-lasting antitachyarrhythmic drug, on postherpetic neuralgia. Twenty patients
with postherpetic neuralgia received an intravenous infusion of flecainide and 15
(75%) of those who achieved pain relief subsequently received oral flecainide.
The patients were assessed using a 100 mm visual analog scale 1 month after
treatment. Significant improvement compared with the pretreatment reading was
found. This study suggests that the action of flecainide in blocking the sodium
channel is potent and long-lasting and that, like the intravenous formulation,
the oral formulation has a stable analgesic effect on postherpetic neuralgia.

PMID: 11708571 [PubMed - indexed for MEDLINE]

2615: Ophthalmol Clin North Am. 2001 Sep;14(3):521-31.

Eye manifestations of intrauterine infections.

Mets MB.

Division of Ophthalmology, Children's Memorial Hospital, Chicago, Illinois, USA. 
mbmets@nwu.edu

The eye finding most characteristic of a prenatal, and therefore, congenital
infection is a chorioretinal scar or an active chorioretinitis as can be seen in 
congenital toxoplasmosis, CMV, HSV, lymphocytic choriomeningitis virus, or
varicella zoster infections. Congenital cataracts are suggestive, but less
specific for congenital infection. They may be a relatively isolated finding in
rubella, syphilis, varicella zoster, and Epstein-Barr virus infections. When they
are present in congenital toxoplasmosis, HSV, and CMV, they are associated with
extensive eye involvement. Other manifestations are less common as discussed
above. The mechanism of action of these agents appears to be both a direct toxic 
and a teratogenic effect.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11705152 [PubMed - indexed for MEDLINE]

2616: Bone Marrow Transplant. 2001 Oct;28(7):689-92.

Long-term low-dose acyclovir against varicella-zoster virus reactivation after
allogeneic hematopoietic stem cell transplantation.

Kanda Y, Mineishi S, Saito T, Saito A, Yamada S, Ohnishi M, Chizuka A, Niiya H,
Suenaga K, Nakai K, Takeuchi T, Makimoto A, Tanosaki R, Kami M, Tanaka Y, Fujita 
S, Watanabe T, Kobayashi Y, Tobinai K, Takaue Y.

Stem Cell Transplant Unit, National Cancer Center Hospital, University of Tokyo, 
5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.

To evaluate the efficacy of long-term administration of acyclovir as prophylaxis 
against varicella-zoster virus (VZV) reactivation, we analyzed the medical
records of 86 consecutive adult patients who obtained engraftment after
allogeneic hematopoietic stem cell transplantation from January 1996 to March
2000. We started long-term low-dose (400 mg/day) oral administration of acyclovir
in June 1999, and this was continued until the end of immunosuppressive therapy
after transplantation. There was no breakthrough reactivation of VZV in patients 
receiving acyclovir. Five patients who were receiving cyclosporine or
prednisolone developed VZV reactivation after discontinuing acyclovir. With this 
prophylaxis, the cumulative incidence of VZV reactivation at 1 year after
transplantation decreased from 33% to 10% (P = 0.025). On multivariate analysis, 
the use of long-term acyclovir was identified as a significant independent
parameter for the development of VZV reactivation. These findings suggest the
efficacy of long-term prophylaxis with low-dose acyclovir. Resumption of
acyclovir upon restarting immunosuppressive therapy might be important for the
further prevention of VZV reactivation. The benefit of long-term low-dose
acyclovir should be confirmed prospectively.

Publication Types: 
    Comparative Study
    Evaluation Studies

PMID: 11704792 [PubMed - indexed for MEDLINE]

2617: Int J Dermatol. 2001 Aug;40(8):542-3.

Recurrent herpes zoster.

Bansal R.

Publication Types: 
    Case Reports
    Letter

PMID: 11703533 [PubMed - indexed for MEDLINE]

2618: Int J Dermatol. 2001 Aug;40(8):535-8.

A randomized parallel trial of topical aspirin-moisturizer solution vs. oral
aspirin for acute herpetic neuralgia.

Balakrishnan S, Bhushan K, Bhargava VK, Pandhi P.

Department of Pharmacology and Dermatology, Postgraduate Institute of Medical
Education and Research, Chandigarh-160 012, India.

BACKGROUND: In this study, the efficacy of oral aspirin vs. topical aspirin in
moisturizer (Vaseline Intensive Care Lotion) was studied in an open, randomized, 
parallel trial in patients with acute herpetic neuralgia. METHODS: Thirty
patients were evaluated in the trial, with 15 in each group. The patients were
randomized to receive either oral aspirin, 375-750 mg three times a day, or 75 mg
topical aspirin/mL of moisturizer (5-10 mL, depending on the extent of
involvement), three times a day, for 21 days. Pain was assessed daily by means of
a self-rating visual analog scale and physician assessment. In addition, the skin
and plasma levels of aspirin were measured in both groups. RESULTS: The mean time
to onset of pain relief was 44 min with topical aspirin and 110 min with oral
aspirin. The mean duration of pain relief after a single application of topical
aspirin was 5.4 h, whereas it was 3.5 h with oral aspirin. The mean visual analog
scale scores for pain with oral aspirin decreased from 68.2 +/- 6.1 on day zero
to 43.1 +/- 8.7 on day 21, which was not significant compared with the baseline
score. With topical aspirin, the baseline pain score was 77.5 +/- 3.7 and
decreased to 6.8 +/- 3 on day 21 (P < 0.001 compared to the baseline score and
compared to oral aspirin). The mean plasma and skin levels of aspirin following
oral administration were 16.21 +/- 1.1 microg/mL and 1.97 +/- 0.3 microg/mm2,
respectively. After topical administration, the mean plasma level of aspirin was 
2.29 +/- 0.5 microg/mL (P < 0.01 vs. oral aspirin) and the skin level was 5.96
+/- 0.4 microg/mm2 (P < 0.05 vs. oral aspirin). Treatment tolerance was excellent
in both groups. CONCLUSIONS: This trial has demonstrated that topical aspirin in 
moisturizer is clearly superior to oral aspirin in relieving the pain of acute
herpetic neuralgia, and that the analgesic activity of aspirin is largely due to 
its local effect.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 11703529 [PubMed - indexed for MEDLINE]

2619: Int J Dermatol. 2001 Aug;40(8):521-4.

Molluscum contagiosum in herpes zoster scars.

Nico MM, Bergonse FN, Godoy AM.

Dermatology Department, Hospital das Clinicas, University of Sao Paulo, Sao
Paulo, Brazil.

Publication Types: 
    Case Reports

PMID: 11703525 [PubMed - indexed for MEDLINE]

2620: Br J Ophthalmol. 2001 Nov;85(11):1390-1.

Varicella zoster virus immune recovery stromal keratitis in a patient with AIDS.

Naseri A, Margolis TP.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't
    Review

PMID: 11702739 [PubMed - indexed for MEDLINE]

2621: Dermatology. 2001;203(3):273-5.

Reactive perforating collagenosis after disseminated zoster.

Zanardo L, Stolz W, Landthaler M, Vogt T.

Publication Types: 
    Case Reports
    Letter

PMID: 11701990 [PubMed - indexed for MEDLINE]

2622: J Urol. 2001 Dec;166(6):2048-52.

Impact of febrile infections on the long-term function of kidney allografts.

Witzke O, Schmidt C, Kohnle M, Lutkes P, Philipp T, Heemann U.

Department of Nephrology, Medizinische Klinik, University Hospital Essen, Essen, 
Germany.

PURPOSE: We prospectively determined the impact of febrile infectious disease on 
long-term renal graft function compared with a matched control group. MATERIALS
AND METHODS: Included in our study were 39 patients who presented with episodes
of febrile infection with body temperature greater than 38C on 2 consecutive
occasions, necessitating hospitalization. In addition, 39 controls without
febrile infection requiring hospitalization within 2 months were chosen from the 
complete data pool of all renal transplant recipients followed at our transplant 
clinic using the matched pair technique. Renal function was estimated by serum
creatinine and calculated creatinine clearance. RESULTS: Of the 39 patients with 
infection 15 had urinary tract infection and 24 had other, mostly bacterial
infection, including pneumonia/severe bronchitis in 12, oral/dental infection in 
2, gastroenteritis in 2, shunt sepsis in 1, herpes zoster in 1, cytomegalovirus
in 1 and other in 5. Mean estimated creatinine clearance plus or minus standard
deviation was similar in the infection and control groups at the beginning of the
study (51 +/- 22 and 51 +/- 23 ml. per minute, respectively). During the
infectious episode mean creatinine clearance significantly decreased to 38 +/- 17
ml. per minute in the infection group. After infection resolved creatinine
clearance returned to an almost baseline mean value of 50 +/- 23 ml. per minute. 
However, after 2 years of followup there was a significant difference in mean
creatinine clearance in the infection group versus controls (45 +/- 25 versus 52 
+/- 25 ml. per minute, p = 0.022). CONCLUSIONS: To our knowledge we have shown
for the first time in a prospective controlled study that febrile infectious
episodes correlate with poor long-term renal graft function.

PMID: 11696704 [PubMed - indexed for MEDLINE]

2623: Ther Umsch. 2001 Oct;58(10):614-9.

[Pneumonia in the immune compromised host]

[Article in German]

Fluckiger U, Trampuz A.

Abteilung fur Infektiologie, Universitatskliniken Basel. uflueckiger@uhbs.ch

The term "immunocompromised host" is generally applied to a variety of patients
with different host defense defects. Pulmonary disease in the immunocompromised
host remains a major cause of morbidity and has a high mortality. During the
initial evaluation of the patient, it is helpful to define which of the three
arms of the host defense system is most likely to be affected. Impaired
granulocyte function, as seen after chemotherapy, predisposes to bacterial and
fungal infections. Deficiencies in the humoral immune system predisposes to
infection with encapsulated organisms, such as Streptococcus pneumoniae and
Haemophilus influenzae. Impairment of the cellular immunity is a special problem 
of the transplant patient. Besides bacteria, a number of unusual microorganisms, 
such as viruses (cytomegalovirus, varicella-zoster virus, herpes simplex virus), 
protozoa (Toxoplasma gondii) and fungi (Pneumocystis carinii, Aspergillus,
Cryptococcus neoformans) have to be considered in this group of patients. The
work-up usually requires an invasive technique, such as a bronchoalveolar lavage 
or lung biopsy to establish the diagnosis. The initial therapy of a patient with 
a pulmonary infiltrate often involves an empiric broad-spectrum antibiotic
therapy. Whether an additional treatment against atypical bacterial pathogens,
fungi or viruses should be started, depends on the clinical presentation, the
underlying type and duration of immunosuppression and the radiographic evolution 
of the infiltrate.

Publication Types: 
    English Abstract

PMID: 11695093 [PubMed - indexed for MEDLINE]

2624: Microbiol Immunol. 2001;45(9):635-8.

Herpesvirus DNA in peripheral blood mononuclear cells of some patients with
Meniere's disease.

Takahash K, Aono T, Shichinohe M, Tamura M, Iwata Y, Yamanishi K, Shigeta S.

Department of Microbiology, Fukushima Medical University, Fukushima, Japan.
k-tak@fmu.ac.jp

Herpes simplex virus-1 (HSV) or varicella zoster virus (VZV) DNA was detected by 
nested polymerase chain reaction in peripheral blood mononuclear cells of
patients with Meniere's disease (one of 28 patients for HSV-1, 2 of 28 patients
for VZV) during acute illness (within 5 days after onset). On the other hand,
neither HSV-1 DNA or VZV DNA was detected in PBMCs of 50 age- and sex-matched
healthy individuals and 50 pregnant women. These findings may imply that
reactivation of HSV- 1 or VZV may be associated with the development of some
cases of Meniere's disease.

Publication Types: 
    Comparative Study

PMID: 11694075 [PubMed - indexed for MEDLINE]

2625: Epidemiol Infect. 2001 Oct;127(2):315-25.

Multiple sclerosis and varicella zoster virus infection: a review.

Marrie RA, Wolfson C.

Montreal Neurological Institute, Quebec.

We have evaluated the epidemiological evidence for an aetiological role of
varicella zoster virus (VZV) infection in the development of multiple sclerosis
(MS). A MEDLINE search of the English language literature for 1965-99 identified 
40 studies. These studies were categorized as seroepidemiological (13),
case-control (23), historical cohort (2) or ecological (2). One study used both
case-control and historical cohort methodologies. Studies were then classified
according to methodological rigour, using criteria derived from published
guidelines for the epidemiological study of MS. There was a large variability in 
the quality of evidence. The five studies with the best methodology failed to
show an increased risk of MS associated with varicella or zoster infections. At
the present time there is insufficient evidence to support an important
aetiological role of VZV infection in the development of MS.

Publication Types: 
    Review

PMID: 11693509 [PubMed - indexed for MEDLINE]

2626: Epidemiol Infect. 2001 Oct;127(2):305-14.

Epidemiology of varicella zoster virus infection in Canada and the United
Kingdom.

Brisson M, Edmunds WJ, Law B, Gay NJ, Walld R, Brownell M, Roos L, De Serres G.

PHLS CDSC, and City University, London.

Many countries are currently studying the possibility of mass vaccination against
varicella. The objective of this study was to provide a comprehensive picture of 
the pre-vaccine epidemiology of the varicella zoster virus (VZV) to aid in the
design of immunization programs and to adequately measure the impact of
vaccination. Population-based data including physician visit claims, sentinel
surveillance and hospitalization data from Canada and the United Kingdom were
analysed. The key epidemiological characteristics of varicella and zoster (age
specific consultation rates, seasonality, force of infection, hospitalization
rates and inpatient days) were compared. Results show that the overall
epidemiology of varicella and zoster is remarkably similar between the two
countries. The major difference being that, contrary to Canada, the epidemiology 
of varicella seems to be changing in the United Kingdom with an important
decrease in the average age at infection that coincides with a significant
increase in children attending preschool. Furthermore, differences exist in the
seasonality between the United Kingdom and Canada, which seem to be primarily due
to the school calendar. These results illustrate that school and preschool
contact patterns play an important role in the dynamics of varicella. Finally,
our results provide baseline estimates of varicella and zoster incidence and
morbidity for VZV vaccine effectiveness and cost-effectiveness studies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11693508 [PubMed - indexed for MEDLINE]

2627: Int J Antimicrob Agents. 2001 Oct;18(4):309-28.

Hamao Umezawa Memorial Award Lecture: "An Odyssey in the Viral Chemotherapy
Field".

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven,
Minderbroedersstraat 10, B-3000 Leuven, Belgium.
erik.declercq@rega.kuleuven.ac.be

In the search of effective and selective chemotherapeutic agents for the
treatment of viral infections, my "Odyssey" brought me to explore a variety of
approaches, encompassing interferon and interferon inducers, suramin and other
polyanionic substances, S-adenosylhomocysteine hydrolase inhibitors, inosine
5'-monophosphate dehydrogenase inhibitors, 5-substituted 2'-deoxyuridines such as
(E)-5-(2-bromovinyl)-2'-deoxyuridine, acyclovir (esters) and other acyclic
guanosine analogues, 2',3'-dideoxynucleoside analogues, non-nucleoside reverse
transcriptase inhibitors (NNRTIs), bicyclams, and acyclic nucleoside
phosphonates. This had led to the identification of a number of compounds,
efficacious against such important viral pathogens as human immunodeficiency
virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), herpes simplex
virus (HSV), varicella-zoster virus (VZV), cytomegalovirus (CMV), and other
herpesviruses, pox-, adeno-, polyoma-, and papillomaviruses, and hemorrhagic
fever viruses.

Publication Types: 
    Lectures

PMID: 11691563 [PubMed - indexed for MEDLINE]

2628: Pain. 2001 Nov;94(2):215-24.

Comment in:
    Pain. 2002 Apr;96(3):409-10; author reply 411-2.    Pain. 2002 Apr;96(3):410-1.

Gabapentin in postherpetic neuralgia: a randomised, double blind, placebo
controlled study.

Rice AS, Maton S; Postherpetic Neuralgia Study Group.

Pain Research Group, Department of Anaesthetics, Imperial College School of
Medicine, Chelsea and Westminster Hospital Campus, 369 Fulham Road, London SW10
9NH, UK. a.rice@ic.ac.uk

A multicentre double blind, randomised, placebo controlled 7-week study evaluated
the efficacy and safety of gabapentin 1800 or 2400 mg/day in treating
postherpetic neuralgia. Three hundred and thirty-four men and women aged at least
18 years (mean 73) received gabapentin 1800 or 2400 mg daily or placebo in three 
divided doses with a forced titration schedule. The primary outcome measure was
change in average daily pain diary score (baseline week v final week). Secondary 
outcomes included mean weekly sleep interference score; Short Form-McGill Pain
Questionnaire (SF-MPQ); Clinician and Patient Global Impression of Change
(CGIC/PGIC); Short Form-36 Health Survey (SF-36). From week 1, pain scores showed
a significantly greater improvement with gabapentin: the final difference v
baseline was -34.5% for the 1800 mg dose, -34.4% for the 2400 mg dose compared
with -15.7% for the placebo group. The difference vs. placebo was 18.8% for the
1800 mg dose (95% confidence interval 10.9-26.8%; P<0.01) and 18.7% for the 2400 
mg dose (10.7-26.7%; P<0.01). Sleep interference diaries showed a similar
pattern. There were significant differences in favour of gabapentin for number of
patients reporting >50% reduction in their pain intensity, in the CGIC and PGIC, 
in the sensory and total scores of the SF-MPQ (both doses), in the visual
analogue scale of pain of the SF-MPQ (2400 mg only) and in the vitality, bodily
pain and mental health domains of the SF-36. Overall gabapentin was well
tolerated. The most common adverse events were dizziness and somnolence,
particularly during the titration phase. Thus, this study confirms the role of
gabapentin as an efficacious and well-tolerated treatment for postherpetic
neuralgia.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 11690735 [PubMed - indexed for MEDLINE]

2629: Virology. 2001 Oct 25;289(2):218-23.

Varicella-Zoster virus gene expression in latently infected rat dorsal root
ganglia.

Kennedy PG, Grinfeld E, Bontems S, Sadzot-Delvaux C.

Glasgow University Department of Neurology, Institute of Neurological Sciences,
Southern General Hospital, Glasgow, G51 4TF, Scotland, United Kingdom.
P.G.Kennedy@clinmed.gla.ac.uk

Latent infection of human ganglia with Varicella-Zoster virus (VZV) is
characterized by a highly restricted pattern of viral gene expression. To enhance
understanding of this process we used in situ hybridization (ISH) in a rat model 
of VZV latency to examine expression of RNA corresponding to eight different VZV 
genes in rat dorsal root ganglia (DRG) at various times after footpad inoculation
with wild-type VZV. PCR in situ amplification was also used to determine the cell
specificity of latent VZV DNA. It was found that the pattern of viral gene
expression at 1 week after infection was different from that observed at the
later times of 1 and 18 months after infection. Whereas multiple genes were
expressed at 1 week after infection, gene expression was restricted at the later 
time points when latency had been established. At the later time points after
infection the RNA transcripts expressed most frequently were those for VZV genes 
21, 62, and 63. Gene 63 was expressed more than any other gene studied. While VZV
DNA was detected almost exclusively in 5-10% of neurons, VZV RNA was detected in 
both neurons and nonneuronal cells at an approximate ratio of 3:1. A newly
described monoclonal antibody to VZV gene 63-encoded protein was used to detect
this protein in neuronal nuclei and cytoplasm in almost half of the DRG studied. 
These results demonstrate that (1) this rat model of latency has close
similarities in terms of viral gene expression to human VZV latency which makes
it a useful tool for studying this process and its experimental modulation and
(2) expression of VZV gene 63 appears to be the single most consistent feature of
VZV latency. Copyright 2001 Academic Press.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 11689044 [PubMed - indexed for MEDLINE]

2630: Ann Ital Med Int. 2001 Jan-Mar;16(1):50-3.

Herpes zoster infection and Ogilvie's syndrome in non-Hodgkin's lymphoma with
hypogammaglobulinemia.

Giunta R, Marfella MA, Maffei A, Lucivero G.

VI Division di Medicina Interna ed Immunoallergologia, Dipartimento di
Gerontologia, Geriatria e Malattie del Metabolismo, Seconda Universita degli
Studi di Napoli.

The case of a 43-year-old male with non-Hodgkin's lymphoma (stage IV B), and
hypo-IgG and IgM, who developed acute colonic pseudo-obstruction or Ogilvie's
syndrome during chemotherapy, is presented. The simultaneous occurrence of a
unilateral segmental vesicular rash indicative of herpes zoster infection
suggests an etiopathogenetic relationship between the colonic pseudo-obstruction 
and herpetic involvement of the motor celiac sympathetic ganglia. The rapid
resolution of the abdominal dilation and the functional recovery from the colonic
pseudo-obstruction after anti-viral therapy is also consistent with the
diagnostic hypothesis.

Publication Types: 
    Case Reports

PMID: 11688352 [PubMed - indexed for MEDLINE]

2631: Ugeskr Laeger. 2001 Oct 15;163(42):5835-6.

[Pupillary paresis. A rare complication of Varicella zoster eye infection]

[Article in Danish]

Hallas P.

Kalundborg Sygehus, kirurgisk afdeling. hallas@rocketmail.com

Pupillary paralysis and paresis of the peripheral facial nerve on the left side
was found in a 68-year-old man with concussion and herpes zoster ophthalmicus on 
the left eye. Post mortem examination showed no sign of intracranial hemorrhage. 
The cause of death was pulmonary oedema and aspiration. The neurological signs
were probably caused by herpes zoster affection of the oculomotor and optic
nerves in association with the facial nerve paresis induced by zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11685858 [PubMed - indexed for MEDLINE]

2632: Clin Lab Haematol. 2001 Aug;23(4):253-4.

Inappropriate antidiuretic hormone secretion, abdominal pain and disseminated
varicella-zoster virus infection: an unusual and fatal triad in a patient 13
months post Rituximab and autologous stem cell transplantation.

McIlwaine LM, Fitzsimons EJ, Soutar RL.

Department of Haematology, Western Infirmary, Glasgow, UK.

We report a case of varicella-zoster virus (VZV) infection associated with severe
abdominal pain, inappropriate antidiuretic hormone (ADH) secretion (SIADH) and
death, 13 months post-autologous peripheral blood stem cell transplantation
(PBSCT). This unusual clinical triad has been reported twice in the setting of
allogeneic bone marrow transplantation, however it has not been reported after
autologous transplantation and never so long after transplantation. We speculate 
as to why this occurred, as early recognition might have altered the clinical
outcome.

Publication Types: 
    Case Reports

PMID: 11683787 [PubMed - indexed for MEDLINE]

2633: Auris Nasus Larynx. 2001 May;28 Suppl:S145-7.

Herpes virus reactivation and serum tumor necrosis factor-alpha levels in
patients with acute peripheral facial palsy.

Ohtani F, Furuta Y, Fukuda S, Inuyama Y.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan. fohtani@med.hokudai.ac.jp

Recent studies have shown that tumor necrosis factor-alpha (TNF-alpha) plays an
important regulatory role in several inflammatory and infectious diseases. In the
present study, we evaluated serum TNF-alpha levels of patients with acute
peripheral facial palsy using an ELISA method. We examined sera from each group
(n = 25 per group) of patients with herpes simplex virus type 1 reactivation
(HSV-1). varicella-zoster virus (VZV) reactivation, and with no HSV or VZV
reactivation. We also tested the sera of 25 normal controls. No significant
difference was found between the serum TNF-alpha levels in facial palsy and
controls. No correlation was found between serum TNF-alpha levels in cases with
HSV-1 or VZV reactivation and with no HSV-1 or VZV reactivation. These results
indicate that serum TNF-alpha levels are not affected by HSV-1 or VZV
reactivation in patients with facial palsy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11683335 [PubMed - indexed for MEDLINE]

2634: Auris Nasus Larynx. 2001 May;28 Suppl:S13-7.

Herpes simplex virus type 1 reactivation and antiviral therapy in patients with
acute peripheral facial palsy.

Furuta Y, Ohtani F, Chida E, Mesuda Y, Fukuda S, Inuyama Y.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan. yfuruta@med.hokudai.ac.jp

OBJECTIVE: Recent studies provide compelling data for the hypothesis that herpes 
simplex virus type I (HSV-1) is implicated in the pathogenesis of idiopathic
peripheral facial palsy (Bell's palsy). The present study analyzed the severity
of facial palsy in patients with HSV-1 reactivation and sought to determine the
efficacy of acyclovir-prednisone therapy for these patients. MATERIALS AND
METHODS: In total, 176 patients, clinically diagnosed with Bell's palsy. were
divided into three groups by polymerase chain reaction (PCR) and serological
tests--31 patients with HSV-1 reactivation, 45 patients with VZV reactivation
(zoster sine herpete) and 100 patients without HSV-1 or VZV reactivation (Bell's 
palsy). RESULTS: The difference in the worst grade of facial palsy between
patients with zoster sine herpete and Bell's palsy was significant (P = 0.01 10, 
Mann-Whitney U-test). In contrast, no difference in the severity of palsy was
observed between patients with HSV-1 reactivation and Bell's palsy. Twelve
patients received acyclovir-prednisone treatment within 7 days of onset based on 
positive PCR results and ten of the 12 (83%) recovered completely. In contrast,
14 patients with HSV-1 reactivation received prednisone treatment because their
PCR tests were performed at a later date; ten of these 14 (71%) recovered
completely. The difference in the cure rate between the two treatment groups was 
not significant (P > 0.05, Fisher exact test). CONCLUSIONS: The results indicate 
that the severity of palsy in patients with HSV-1 reactivation is similar to that
in patients with Bell's palsy and suggest that early diagnosis of HSV-1
reactivation by PCR and subsequent acyclovir-prednisone therapy do not improve
recovery from facial palsy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11683332 [PubMed - indexed for MEDLINE]

2635: J Clin Microbiol. 2001 Nov;39(11):4093-6.

Rapid detection of enterovirus RNA in cerebrospinal fluid specimens with a novel 
single-tube real-time reverse transcription-PCR assay.

Verstrepen WA, Kuhn S, Kockx MM, Van De Vyvere ME, Mertens AH.

Center for Molecular Diagnostics, OCMW Hospitals, Antwerp, Belgium.

A single-tube real-time reverse transcription-PCR (RT-PCR) assay for enterovirus 
detection in cerebrospinal fluid (CSF) was developed based on a fluorogenic probe
and primers directed to highly conserved sequences in the 5' untranslated region 
of the enterovirus genome. Quantitative detection of enterovirus genome was
demonstrated in a linear range spanning at least 5 logs. Endpoint titration
experiments revealed that the in-tube detection limit of the assay was 11.8
enterovirus genome equivalents (95% detection rate) corresponding in our current 
extraction protocol to 592 enterovirus genome equivalents per ml of CSF. Twenty
CSF specimens not suspected of viral meningitis were all found to be negative,
and no cross-reactivity with herpes simplex virus type 1 and type 2,
varicella-zoster virus, rhinovirus type 53, and influenza viruses A and B was
observed. Nineteen CSF specimens from 70 patients suspected of viral meningitis
were determined to be positive by PCR (27.1%), whereas only 17 were found to be
positive by viral culture (24.3%). The sensitivity of the assay was 100% and the 
specificity was 96.2% compared to viral culture. Data from the real-time RT-PCR
assay were available within 4 h. Our data suggest that the novel real-time RT-PCR
assay may offer a reliable but significantly faster alternative to viral culture.
Owing to the elimination of postamplification detection steps, its conduct
required considerably less hands-on time and was associated with a substantially 
reduced carryover risk compared to previously described PCR-based enterovirus
detection assays.

Publication Types: 
    Comparative Study
    Evaluation Studies

PMID: 11682535 [PubMed - indexed for MEDLINE]

2636: Ann Emerg Med. 2001 Nov;38(5):592-5.

Documented arterial gas embolism after spinal epidural injection.

MacLean CA, Bachman DT.

Department of Emergency Medicine, Maine Medical Center, Portland, ME 04102, USA. 
maclec@mail.mmc.org

We report the case of a 90-year-old man with syncope, arrhythmia, cardiac
ischemia, and neurologic deficit after undergoing spinal epidural injection for
control of pain related to post-herpetic neuralgia. The diagnosis of arterial gas
embolus was made after air was identified in the left ventricle of the heart on
an abdominal computed tomographic scan. Emergency physicians should consider and 
rapidly diagnose this rare but potentially fatal complication of spinal epidural 
puncture.

Publication Types: 
    Case Reports

PMID: 11679875 [PubMed - indexed for MEDLINE]

2637: J Infect. 2001 Aug;43(2):135-9.

Outcome of varicella pneumonitis in immunocompetent adults requiring treatment in
a high dependency unit.

Jones AM, Thomas N, Wilkins EG.

Department of Infectious Diseases, North Manchester General Hospital, Delaunay's 
Arch, Delaunay's Road, Crumpsall, Manchester, UK. andmarkj@hotmail.com

OBJECTIVES: The incidence of varicella infection is increasing in adults, where
primary pneumonitis is the main complication. Little information exists
concerning treatment of those patients who require admission to a high dependency
unit (HDU) facility. A study was performed to examine the risk factors for
developing varicella pneumonitis (VP), to document disease progression and assess
prognosis for patients with VP requiring HDU admission. METHODS: A 10-year
retrospective casenote review of patients admitted to the Regional Infectious
Diseases Unit HDU. Varicella pneumonitis (VP) was defined as diffuse nodular
shadowing on a chest X-ray (CXR) of a patient with a classical chickenpox rash.
Severe pneumonitis was defined as an hypoxaemia index (pO2 in mmHG/FiO2) of less 
than 150 at any time during hospital stay. All patients were treated with
intravenous acyclovir at a dose of 10 mg/kg. RESULTS: A total of 33 patients were
admitted to the HDU with VP over the study period, 30 were included in the study.
Annual admission rates remained constant. Most patients (76.7%) had at least one 
recognised risk factor for severe VP: smoking 18/30, pregnancy 9/30, chronic lung
disease 7/30. Twelve (40%) patients had severe VP, eight (26.7%) required
assisted ventilation. The presence of greater than one risk factor (p < 0.02) was
associated with progression to severe VP. There was one death: a 63-year-old man 
with a long history of chronic airflow limitation whose treatment had included
domicillary long-term oxygen therapy. Nine (30%) patients developed secondary
bacterial pneumonia; all recovered with appropriate antibiotic treatment. The
period of stay in HDU for the majority of patients was short (mean 4.5 days).
CONCLUSIONS: The prognosis for severe adult VP with current available treatment
is good. The only predictor on admission for severe VP is the presence of more
than one recognised risk factor for developing VP. Copyright 2001 The British
Infection Society.

PMID: 11676521 [PubMed - indexed for MEDLINE]

2638: Arch Ophthalmol. 2001 Oct;119(10):1550-2.

Retinal periphlebitis as zoster sine herpete.

Noda Y, Nakazawa M, Takahashi D, Tsuruya T, Saito M, Sekine M.

Department of Ophthalmology, Hirosaki University School of Medicine, 5 Zaifu-cho,
Hirosaki, 036-8562, Japan. mitsuru@cc.hirosaki-u.ac.jp

Publication Types: 
    Case Reports

PMID: 11594964 [PubMed - indexed for MEDLINE]

2639: J Healthc Inf Manag. 2001 Fall;15(3):223-35.

Next phase of medical management systems: automating administrative transactions 
to integrate payors and providers.

Shingles RB, Shaman HJ, Kongstvedt PR, Hohner JH.

Today, medical management is burdened by the cost and hassle of manual
administrative tasks. Manual intensive processing (that is, phone and fax) of
referral requests and institutional authorization transactions results in
significant unnecessary costs for the providers and payors, delays in approval,
and problems with errors. To address these administrative burdens, the next phase
of online (Internet- and wireless-enabled) medical management applications will
focus on the administrative and transaction side, including self-service referral
and authorization processing between the payor and provider. The advent of the
Health Insurance Portability and Accountability Act (HIPAA) greatly improves the 
ability to gain widespread adoption of these online applications thanks to
mandated standardization of many routine transactions. This article explores this
next phase of online administrative and transaction medical management
applications from the payors' perspective and explores their connectivity with
providers. Payors are striving to meet several objectives as they implement these
online administrative and transaction medical management systems: reducing the
administrative burden and cost, changing traditional medical policies, increasing
provider adoption of connective technologies, addressing HIPAA compliance, and
achieving higher levels of system integration.

PMID: 11642141 [PubMed - indexed for MEDLINE]

2640: Geriatrics. 2001 Oct;56(10):33-8, 41.

Skin and soft tissues. Management of four common infections in the nursing home
patient.

O'Donnell JA, Hofmann MT.

Department of Medicine, Division of Infectious Diseases, MCP Hahnemann School of 
Medicine and University, Medical College of Pennsylvania Hospital, Philadelphia, 
USA.

Common skin and soft tissue infections in nursing home patients include herpes
zoster, cellulitis, pressure ulcer infections, and scables. Treatment of shingles
with an oral antiviral should be started within 24 hours of symptom onset.
Dissemination and bacterial superinfection require antibiotic therapy. Use of
corticosteroids to prevent post-herpetic neuralgia remains controversial.
Cellulitis is most often caused by Staphylococcus aureus and beta-hemolytic
streptococci (groups A and B). Therapy for cellulitis is empiric; gram-negative
bacilli should be covered in diabetic patients. Most pressure ulcers never become
infected; for those that do, empiric therapy should cover S aureus, gram-negative
bacilli, and anaerobes. Topical treatment of scables with 5% permethrin cream or 
1% lindane lotion is recommended.

Publication Types: 
    Review

PMID: 11641861 [PubMed - indexed for MEDLINE]

2641: Nippon Ronen Igakkai Zasshi. 2001 Sep;38(5):678-81.

[A case of malignant lymphoma concomitant with multiple myeloma]

[Article in Japanese]

Iwakiri R, Mikoshiba M, Tsutsumi H, Kumakawa T, Sawabe M, Arai T, Ohta M, Ezaki
Y, Mori M.

Department of Hematology, Tokyo Metropolitan Geriatric Hospital.

A 75-year-old woman was referred to us because of cough, high fever and skin
erythema in April 1999. Malignant lymphoma (diffuse mixed cell type) was
previously diagnosed in 1990 and she achieved complete remission after treatment 
with a series of CHOP regimen treatments. In 1998, multiple myeloma (IgG lambda
type) was diagnosed and she was treated with a combination of melphalan and
prednisolone. On physical examination, superficial lymphadenopathy and skin
erythema were noted. Biclonal gammopathy (IgG kappa/lambda) was shown in serum,
and Bence Jones protein in urine. Computed tomography showed pleural effusion and
swelling of paraaortic lymph nodes. The bone marrow examination showed an
increased number of abnormal plasma cells (19.2%) and no evidence of lymphoma.
Left axillary lymph node biopsy revealed that she had non-Hodgkin's lymphoma
(immunoblastic lymphadenopathy-like T cell lymphoma). She was treated with the
CHOP regimen at reduced doses for both diseases. The lymphoadenopathy reduced
after 6 courses of CHOP and 4 courses of CHOPE (CHOP + VP16), however, she had
bone pain on November 1999 and received treatment with MCNU-VMP (MCNU + VDS +
L-PAM + PSL). Her rib pain improved, but she died of systemic infection of herpes
zoster virus. We report here a rare case of malignant lymphoma concomitant with
multiple myeloma.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11605218 [PubMed - indexed for MEDLINE]

2642: Clin Radiol. 2001 Nov;56(11):926-32.

Facial nerve palsy: evaluation by contrast-enhanced MR imaging.

Kinoshita T, Ishii K, Okitsu T, Okudera T, Ogawa T.

Department of Radiology, Sendai City Hospital, Japan.

AIM: The purpose of this study was to investigate the value of contrast-enhanced 
magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy.
MATERIALS AND METHODS: MR imaging was performed in 147 patients with facial nerve
palsy, using a 1.0 T unit. All of 147 patients were evaluated by
contrast-enhanced MR imaging and the pattern of enhancement was compared with
that in 300 control subjects evaluated for suspected acoustic neurinoma. RESULTS:
The intrameatal and labyrinthine segments of the normal facial nerve did not show
enhancement, whereas enhancement of the distal intrameatal segment and the
labyrinthine segment was respectively found in 67% and 43% of patients with
Bell's palsy. The geniculate ganglion or the tympanic-mastoid segment was
enhanced in 21% of normal controls versus 91% of patients with Bell's palsy.
Abnormal enhancement of the non-paralyzed facial nerve was found in a patient
with bilateral temporal bone fracture. CONCLUSION: Enhancement of the distal
intrameatal and labyrinthine segments is specific for facial nerve palsy.
Contrast-enhanced MR imaging can reveal inflammatory facial nerve lesions and
traumatic nerve injury, including clinically silent damage in trauma. Copyright
2001 The Royal College of Radiologists.

Publication Types: 
    Evaluation Studies

PMID: 11603897 [PubMed - indexed for MEDLINE]

2643: Neurol Sci. 2001 Apr;22(2):209-10.

Low-dose oral methotrexate treatment in chronic progressive multiple sclerosis.

Lugaresi A, Caporale C, Farina D, Marzoli F, Bonanni L, Muraro PA, De Luca G,
Iarlori C, Gambi D.

Department of Oncology and Neuroscience, Gabriele d'Annunzio University, Chieti, 
Italy.

We aimed to further assess the safety and efficacy of low-dose oral methotrexate 
(LDOM) treatment for chronic progressive MS (CPMS). We studied 20 CPMS patients, 
including 16 with secondary progressive MS who had shown disease progression in
the previous year. The mean follow-up was 23 months. The mean EDSS score was
6.3+/-1.1 before treatment and 6.4+/-1.1 after one year of treatment. At one
year, 15 of 20 patients were still being treated, and 10 were stable. Twelve
patients have completed 18 months of treatment, and eight are stable. Two
patients stopped treatment because of side effects, two more because they did not
perceive benefit, and one was lost to follow-up. Six patients had mild, transient
increases in liver enzymes not requiring treatment interruption, and two had
localized herpes zoster. Magnetic resonance imaging (MRI) performed before
treatment and at one year remained unchanged in responders. We confirm that LDOM 
is safe in carefully selected and monitored CPMS patients. MTX is inexpensive
and, given its anti-inflammatory and immunomodulatory properties, may be used as 
add-on therapy in non-responders to interferon beta, although hepatic toxicity
may be a problem in long-term treatment.

Publication Types: 
    Clinical Trial

PMID: 11603629 [PubMed - indexed for MEDLINE]

2644: J Gen Virol. 2001 Nov;82(Pt 11):2761-5.

Characterization of the DNA polymerase gene of varicella-zoster viruses resistant
to acyclovir.

Kamiyama T, Kurokawa M, Shiraki K.

Department of Virology, Toyama Medical and Pharmaceutical University, 2630
Sugitani, Toyama 930-0194, Japan.

The nucleotide changes of the DNA polymerase gene and the susceptibility of
acyclovir (ACV)-resistant varicella-zoster virus (VZV) mutants to anti-herpetic
drugs were determined and compared to those of herpes simplex virus type 1
(HSV-1) mutants. The seven ACV-resistant VZV mutants were classified into three
groups, N(779)S, G(805)C and V(855)M, according to the sequences of their DNA
polymerase genes. The amino acid substitutions N(779)S and G(805)C were identical
in position to the N(815)S and G(814)C mutations in the HSV-1 DNA polymerase
mutants, respectively, and the V(855)M amino acid substitution was similar to the
HSV-1 V(892)M mutation. All three groups of VZV mutants were susceptible to ACV, 
phosphonoacetic acid, vidarabine and aphidicolin, at levels similar to those seen
with the respective HSV-1 mutants, except for subtle differences that were due
possibly to the non-conserved regions in their sequences. Although both the HSV-1
and the VZV DNA polymerase genes show 53% sequence similarity, both viruses
essentially show a similar biochemical behaviour.

PMID: 11602787 [PubMed - indexed for MEDLINE]

2645: Ann N Y Acad Sci. 2001 Sep;941:200-5.

Therapy of T cell lymphomas with pentostatin.

Kurzrock R.

Department of Bioimmunotherapy, University of Texas, M. D. Anderson Cancer
Center, Houston 77030, USA. rkurzroc@mdanderson.org

Pentostatin is a highly lymphocytotoxic agent active in hairy cell leukemia.
Several studies also suggest significant activity in T cell lymphomas manifested 
in the skin. Herein, we will review the studies of pentostatin in these lymphomas
and our most recent trial of this agent in heavily pretreated patients with
cutaneous and peripheral T cell lymphomas. Overall, the data suggest that
pentostatin has significant antitumor activity in these patients, with response
rates ranging from 33% to over 70%. Approximately one-third of the responses are 
complete. The most common side effects include granulocytopenia, nausea, and
renal insufficiency. CD4 suppression occurs and may result in an increased risk
of herpes zoster infection. Although prolonged remissions have been seen, most
responses are short-lived. These observations suggest that further exploration of
this agent, in combination with other drugs active in T cell lymphomas, is
warranted in this group of diseases.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 11594574 [PubMed - indexed for MEDLINE]

2646: Rofo. 2001 Oct;173(10):920-3.

[CT-guided thoracal sympathicolysis for the treatment of peripheral arterial
occlusive disease and chronic thoracal pain syndromes in 6 patients]

[Article in German]

Finkenzeller T, Techert J, Lenhart M, Link J, Feuerbach S.

Abteilung Rontgendiagnostik, Klinikum der Universitat Regensburg, Germany.

CT-guided thoracal sympathicolysis for the treatment of peripheral arterial
occlusive disease and chronic thoracal pain syndromes in 6 patients. PURPOSE:
Retrospective evaluation of the safety and effectivity of CT-guided percutaneous 
thoracal sympathicolysis (CT-TSL) in the treatment of patients with peripheral
arterial occlusive disease (PAOD) of the upper limb and chronic thoracal pain
syndromes. Comparison of our own experience with literature reports. MATERIAL AND
METHODS: Between 6/96 and 12/99, 4 patients with PAOD of the upper limb and two
with chronic thoracal pain syndromes caused by herpes zoster were treated by
unilateral CT-TSL. RESULTS: 18, 21 and 32 months after the intervention 3 out of 
4 patients treated for PAOD reported subjective improvements, and one remained
unchanged. Two patients treated for pain syndromes showed no long-term benefit of
the procedure. There were no serious complications. CONCLUSION: The CT-TSL is an 
alternative method in the treatment of PAOD in patients who are unsuitable for
treatment by revascularization.

Publication Types: 
    English Abstract
    Evaluation Studies

PMID: 11588680 [PubMed - indexed for MEDLINE]

2647: Drugs Aging. 2001;18(8):561-73.

Vanilloid receptor ligands: hopes and realities for the future.

Szallasi A.

Department of Pathology and Immunology, Washington University School of Medicine,
St Louis, Missouri, USA. aszallasi@path.wustl.edu

Neurons possessing C-fibers transmit nociceptive information into the central
nervous system and participate in various reflex responses. These neurons carry
receptors that bind capsaicin, recently identified as the vanilloid VR1 receptor.
Excitation of these cells by capsaicin is followed by a lasting refractory state,
termed desensitisation, in which the neurons fail to respond to a variety of
noxious stimuli. Desensitisation to capsaicin has a clear therapeutic potential
in relieving neuropathic pain and ameliorating urinary bladder overactivity, just
to cite 2 important examples. Vanilloids may also be beneficial in the treatment 
of benign prostate hyperplasia (BPH). Since the majority of elderly patients have
neuropathic pain co-existent with urinary incontinence and/or BPH, a drug that
ameliorates pain and improves urinary symptoms at the same time promises to be of
great clinical value in geriatric medicine. In fact, capsaicin has already been
shown to have a role in the treatment of conditions that can arise in the
elderly, including herpes zoster-related neuropathic pain, diabetic neuropathy,
postmastectomy pain, uraemic itching associated with renal failure, and urinary
incontinence. The potent VR1 agonist resiniferatoxin, now in phase II clinical
trials, appears to be superior to capsaicin in terms of its tolerability profile.
Recent discoveries enhance the therapeutic potential of vanilloids. The
recognition that VR1 also functions as a principal receptor for protons and
eicosanoids implies that VR1 antagonists may be of value in the treatment of
inflammatory hyperalgesia and pain. Animal experimentation has already lent
support to this assumption. The discovery of VR1-expressing cells in the brain as
well as in non-neural tissues such as the kidney and urothelium places VR1 in a
much broader perspective than peripheral pain perception, and is hoped to
identify further, yet unsuspected, indications for vanilloid therapy. The
realisation that VR1 and cannabinoid CB1 receptors have overlapping ligand
recognition properties may also have far-reaching implications for vanilloid
therapy. In fact, arvanil, a combined agonist of VR1 and CB1 receptors, has
already proved to be a powerful analgesic drug in the mouse. From academic
molecular biology laboratories to industrial drug discovery centres to the
clinics, there is a steady flow of new data, forcing us to constantly revise the 
ways we are thinking about vanilloid receptor ligands and their hopes and
realities for the future. This review covers the most promising current trends in
vanilloid research with special emphasis on geriatric medicine.

Publication Types: 
    Review

PMID: 11587243 [PubMed - indexed for MEDLINE]

2648: Expert Opin Pharmacother. 2001 Aug;2(8):1283-7.

Current treatment practice of herpes zoster.

Heald PW.

Yale University School of Medicine, New Haven, Connecticut, USA.
peter.heald@yale.edu

The management of herpes zoster infection has been impacted by the development of
oral and iv. antiviral therapies. There are clinical and historical features that
help optimise the particular therapy course for a given patient. Additionally,
there are common features of management in all patients with herpes zoster. In
this review an understanding of the pathogenesis of herpes zoster is utilised as 
a starting point for the development of a rational approach to therapy. Clinical 
findings that impact decision making are emphasised and the appropriate goals for
therapy are discussed.

Publication Types: 
    Review

PMID: 11584996 [PubMed - indexed for MEDLINE]

2649: Eur Arch Otorhinolaryngol. 2001 Aug;258(6):285-6.

Post-intubation vocal cord paralysis: the viral hypothesis. A case report.

Marie JP, Keghian J, Mendel I, Gueit I, Dehesdin D, Andrieu-Guitrancourt J.

ENT Department, Rouen University Hospital CHU, Rouen, France.

After digestive surgery, a 20-year-old man presented dysphonia and fever.
Indirect laryngoscopy revealed a left vocal cord paralysis with no structural
lesion. IgM and IgG were positive for cytomegalovirus and negative for human
immunodeficiency virus, herpes simplex virus, varicella zoster virus and
Epstein-Barr virus. The patient recovered spontaneously with a normal voice, and 
the mobility of vocal cord recovered within 3 months. The aetiology of
post-intubation vocal cord paralysis (VCP) remains controversial. Vocal cord
paralysis with cytomegalovirus has been reported in two cases associated with
acquired immunodeficiency syndrome. Vocal cord paralysis secondary to viral
disease has also been described in other circumstances. panied by polyneuritis,
especially in immunocompromised patients. We report the case of a patient with
transitory unilateral post-intubation vocal cord paralysis which could have been 
related to a virus infection.

Publication Types: 
    Case Reports

PMID: 11583467 [PubMed - indexed for MEDLINE]

2650: J Neurovirol. 2001 Oct;7(5):400-8.

Infections of the central nervous system of suspected viral origin: a
collaborative study from Finland.

Koskiniemi M, Rantalaiho T, Piiparinen H, von Bonsdorff CH, Farkkila M, Jarvinen 
A, Kinnunen E, Koskiniemi S, Mannonen L, Muttilainen M, Linnavuori K, Porras J,
Puolakkainen M, Raiha K, Salonen EM, Ukkonen P, Vaheri A, Valtonen V; Study
Group.

The Haartman Institute, Department of Virology, University of Helsinki, Finland. 
Marjaleena.Koskiniemi@Helsinki.FI

We studied 3231 patients with acute central nervous system (CNS) symptoms of
suspected viral origin to elucidate the current etiologic spectrum. In 46% of the
cases, a viral finding was observed. Varicella-zoster virus (VZV) was the main
agent associated with encephalitis, as well as meningitis and myelitis. VZV
comprised 29% of all confirmed or probable etiologic agents. Herpes simplex virus
(HSV) and enteroviruses accounted 11% each, and influenza A virus 7%. VZV seems
to have achieved a major role in viral infections of CNS. In encephalitis in our 
population, VZV is clearly more commonly associated with these neurological
diseases than HSV. The increase in VZV findings may in part be a pseudophenomenon
due to improved diagnostic methods, however, a true increase may have occurred
and the pathogenetic mechanisms behind this should be elucidated.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11582512 [PubMed - indexed for MEDLINE]

2651: Cutis. 2001 Sep;68(3):179-82.

Reflex sympathetic dystrophy syndrome following herpes zoster.

Querol I, Cisneros T.

Departments of Dermatology and Rehabilitation, Hospital Reina Sofia de Tudela,
Tudela, Spain. iqueroln@posta.unizar.es

Reflex sympathetic dystrophy syndrome (RSDS), or algodystrophy, is a poorly
understood, painful syndrome that consists of multiple symptoms, including
vasomotor instability, swelling, and chronic pain involving an extremity.
Although RSDS following herpes zoster is classically recognized, only a few
well-documented cases of this complication have been reported to date. We present
the case of a 63-year-old white woman with characteristic signs and symptoms of
RSDS in the left upper limb that appeared 3 weeks after she had a typical herpes 
zona involving the left C5-C6 dermatomes. Early diagnosis and treatment with
physiotherapy, intranasal salmon calcitonin, and oral calcium achieved a
progressive improvement of the disease, which healed without sequelae in a brief 
time.

Publication Types: 
    Case Reports

PMID: 11579780 [PubMed - indexed for MEDLINE]

2652: Klin Padiatr. 2001 Sep;213 Suppl 1:A69-76.

[Antiviral prophylaxis]

[Article in German]

Graubner UB.

Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, Klinikum
der Universitat Munchen-Innenstadt, Abteilung Hamatologie und Onkologie, Germany.

Antiviral prophylaxis in pediatric oncology and pediatric bone marrow
transplantation (BMT)/stem cell transplantation (SCT) focuses herpes viruses:
herpes simplex virus (HSV), varicella zoster virus (VZV) and cytomegalovirus
(CMV) since these viruses cause significant morbidity and mortality due to
primary infection or to reactivation in long term latency. The majority of
studies on antiviral prophylaxis, especially those on CMV-prophylaxis, have been 
conducted in adult patients. Recommendations for antiviral prophylaxis have been 
published recently by the German "Deutsche Gesellschaft fur padiatrische
Infektiologie" and by the following American institutions and societies "Centers 
for Disease Control and Prevention", "Infectious Diseases Society of America",
"American Society of Blood and Marrow Transplantation" who published the
"Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell
Transplant Recipients". Concerning HSV- and VZV-prophylaxis there are almost no
differences between recommendations of the german society and the american
institutions, however recommendations for preventing CMV-disease and
CMV-recurrence do differ considerably. Controversial aspects of antiviral
prophylaxis, e.g. VZV vaccination or CMV prevention, should be studied in
oncology and infectious diseases working groups to define consensus in the near
future.

Publication Types: 
    Comparative Study
    English Abstract
    Review

PMID: 11577365 [PubMed - indexed for MEDLINE]

2653: J Emerg Nurs. 2001 Oct;27(5):519-20.

A woman with unilateral eye pain and malaise.

Molitor L.

Emergancy Department, Shands at AGH, Gainesville, FL, USA. LMolitorge@aol.com

Publication Types: 
    Case Reports

PMID: 11577300 [PubMed - indexed for MEDLINE]

2654: J Clin Pathol. 2001 Oct;54(10):743-7.

Comment in:
    J Clin Pathol. 2002 May;55(5):399; author reply 399.

Vaccination to prevent varicella and shingles.

Breuer J.

Department of Virology, St Bartholomew's and the Royal London School of Medicine 
and Dentistry, Queen Mary and Westfield College, 37 Ashfield Street, London E1
1BB, UK. j.breuer@mds.qmw.ac.uk

Vaccination of healthy children against varicella using the live attenuated Oka
vaccine has been available in Japan and south Korea for several years. In 1996, a
programme of universal vaccination of children to prevent varicella was
introduced in the USA and other countries, including Canada, Germany, and Sweden,
have licensed the vaccine for use in healthy children. This article reviews the
origin of the Oka vaccine and the evidence for vaccine safety and efficacy in
children and adults. Universal vaccination of children and targeted vaccination
of groups at risk of severe varicella are discussed. The possible use of the Oka 
vaccine to prevent zoster is reviewed, and initiatives to develop new varicella
zoster virus vaccines are outlined.

PMID: 11577118 [PubMed - indexed for MEDLINE]

2655: Pain. 2001 Oct;94(1):113-9.

Acute pain in herpes zoster: the famciclovir database project.

Dworkin RH, Nagasako EM, Johnson RW, Griffin DR.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, 601 Elmwood Avenue, Box 604, Rochester, NY 14642, USA.
robert_dworkin@urmc.rochester.edu

The results of a considerable number of recent prospective studies have
demonstrated that greater acute pain severity in herpes zoster patients is
associated with a significantly greater risk of developing postherpetic neuralgia
(PHN). Only a few studies have examined the relationships between acute pain
severity and demographic characteristics and clinical features of patients with
herpes zoster, however, and the results of these studies have been inconsistent. 
To clarify these relationships, data from 1778 herpes zoster patients studied
within 72 h of rash onset in four clinical trials of the antiviral agent
famciclovir were examined. Univariate and multivariate analyses indicated that
greater acute pain severity was significantly associated with greater age, female
sex, greater rash severity, the presence of a prodrome, and primary involvement
of non-trigeminal dermatomes. These results demonstrate that three of the
established risk factors for PHN - older age, greater rash severity, and the
presence of a prodrome - are also associated with more severe acute pain assessed
soon after rash onset in patients with herpes zoster. The results of this study
are consistent with the recommendation that herpes zoster patients who are older,
who have had a prodrome, or who have severe rash or severe acute pain should be
targeted for interventions designed to prevent PHN.

Publication Types: 
    Meta-Analysis
    Research Support, Non-U.S. Gov't

PMID: 11576750 [PubMed - indexed for MEDLINE]

2656: J Am Board Fam Pract. 2001 Sep-Oct;14(5):392-4.

Ramsay Hunt syndrome in a patient with human immunodeficiency virus infection.

Sobn AJ, Tranmer PA.

Department of Family Medicine, University of Illinois at Chicago, 60612, USA.

Publication Types: 
    Case Reports

PMID: 11572547 [PubMed - indexed for MEDLINE]

2657: Hautarzt. 2001 Sep;52(9):817-9.

[Bilateral, asymmetric herpes zoster (herpes zoster duplex asymmetricus)]

[Article in German]

Csontos Z, Sebok B, Karg E, Schneider I.

I. Chirurgische Klinik der Medizinischen Universitat Pecs.

A 73-year-old female patient presented with asymmetric herpes zoster. She was
treated successfully with systemic immunostimulants, vitamin B1 tablets and
topical etheric acetyl-salicylic acid solution. No underlying malignancy,
immunodeficiency or other systemic diseases could be detected.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11572075 [PubMed - indexed for MEDLINE]

2658: Arch Ophthalmol. 2001 Sep;119(9):1315-22.

Validation of a diagnostic multiplex polymerase chain reaction assay for
infectious posterior uveitis.

Dabil H, Boley ML, Schmitz TM, Van Gelder RN.

Department of Ophthalmology and Visual Sciences, Washington University Medical
School, 660 S Euclid Ave, St Louis, MO, USA.

OBJECTIVE: To validate a multiplex polymerase chain reaction (PCR) assay capable 
of simultaneously screening vitreous biopsy specimens for a panel of common
pathogens in posterior uveitis. METHODS: A multiplex PCR assay using novel primer
sets for cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster
virus (VZV), and Toxoplasma gondii was developed. The sensitivity of the assay
was determined for purified pathogen DNA. Twenty-one vitreous specimens from
patients with posterior uveitis were tested by both multiplex and monoplex PCR.
RESULTS: Fewer than 10 genomes of VZV and fewer than 100 genomes of HSV, CMV, and
T gondii could be detected using the new primer sets. When used in multiplex, the
assay lost less than 1 log of sensitivity. Monoplex PCR detected pathogen DNA in 
18 of 21 patient samples; multiplex PCR detected pathogen DNA in 15 of the 18
samples positive by monoplex PCR. None of 10 negative control samples were
positive for pathogen DNA. CONCLUSIONS: Multiplex PCR has adequate sensitivity to
simultaneously screen a substantial differential diagnosis for posterior uveitis 
in a single reaction, without loss of specificity. This assay may reduce the time
and cost involved in PCR-based molecular diagnostics of infectious pathogens.
CLINICAL RELEVANCE: Mutiplex PCR may allow rapid diagnosis of infectious
posterior uveitis.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Validation Studies

PMID: 11545637 [PubMed - indexed for MEDLINE]

2659: Transplantation. 2001 Sep 15;72(5):777-86.

Comment in:
    Transplantation. 2001 Sep 15;72(5):774-5.

Sirolimus allows early cyclosporine withdrawal in renal transplantation resulting
in improved renal function and lower blood pressure.

Johnson RW, Kreis H, Oberbauer R, Brattstrom C, Claesson K, Eris J.

Manchester Royal Infirmary, The Renal Transplant Unit, Oxford Road, Manchester
M13 9WL, UK. rwgj@renal.cmht.nwest.nhs.uk

INTRODUCTION: This study evaluated whether cyclosporine (CsA) could be eliminated
from a sirolimus (Rapamune, rapamycin, SRL)-CsA-steroid (ST) regimen at 3 months.
METHODS: This was an open-label study conducted in Europe, Australia, and Canada.
Upon enrollment, 525 primary (90%) or secondary (10%) renal allograft recipients 
with cadaveric (89%) or living (11%) donors received 2 mg of sirolimus (troughs>5
ng/ml), CsA, and steroids. At 3 months+/-2 weeks, eligible patients were
randomized (1:1) to remain on SRL-CsA-ST or to have CsA withdrawn and therapy
continued with SRL (troughs 20-30 ng/ml)-ST. RESULTS: At 12 months, overall graft
and patient survival were 89.1% and 94.9%, respectively. In the 430 (82%)
randomized patients, there was no difference in graft survival (95.8% vs. 97.2%, 
SRL-CsA-ST vs. SRL-ST) or patient survival (97.2% vs. 98.1%, respectively). The
incidence of biopsy-confirmed primary acute rejection was 13.1% during the
prerandomization period. After randomization, the acute rejection rates were 4.2%
and 9.8% for SRL-CsA-ST and SRL-ST, respectively (P=0.035). Renal function
(calculated glomerular filtration rate, 57 vs. 63 ml/min, P<0.001) and blood
pressure significantly improved when CsA was withdrawn. Hypertension, CsA
nephrotoxicity, hyperuricemia, and Herpes zoster occurred statistically more
frequently in patients remaining on CsA, whereas thrombocytopenia, abnormal liver
function tests, and hypokalemia were reported more often for SRL-ST therapy.
CONCLUSION: Sirolimus, CsA, and steroids for 3 months posttransplant, followed by
elimination of CsA, is a safe and effective alternative to continuous therapy
with sirolimus, CsA, and steroids that can result in better renal function and
lower blood pressure.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 11571437 [PubMed - indexed for MEDLINE]

2660: Int Dent J. 2001 Aug;51(4):273-6.

Post-extraction complications seen at a referral dental clinic in Dar Es Salaam, 
Tanzania.

Simon E, Matee M.

AIM: To investigate the types and magnitude of post extraction complications.
SETTING: A referral hospital in Dar es Salaam, Tanzania. SUBJECTS: All dental
patients who had their teeth extracted at the Muhimbili Medical Centre dental
outpatient clinic during the study period (May September 1999). A total of 3,818 
extractions were performed under local anaesthetic in 3,732 patients. METHOD:
Oral examination of all patients who reported back with post-extraction problems.
RESULTS: The frequency of post extraction complications was low (1.1 per cent),
and was mainly due to; infected sockets (48.7 per cent), followed by bleeding
sockets (41.0 per cent) and retained roots (10.3 per cent). There were eight
'other' complications suffered by 11 patients: necrotising fasciitis (n=l),
herpes zoster (n=l), Ludwig's angina (n=l), infections of the submandibular
(n=l), parapharyngeal (n=2), masticator (n=2) and submasseteric spaces (n =2),
and reaction to local anaesthesia (2ml of 2 per cent lignocaine hydrochloride)
(n=1). CONCLUSION: The results of this study indicate that post-extraction
complications are few, mostly minor, self-limiting and easily treatable. The
study does not support routine antibiotic prophylaxis or special pre-extraction
procedures, even in this patient population with poor oral hygiene and high HIV
seroprevalence.

PMID: 11570541 [PubMed - indexed for MEDLINE]

2661: Curr Opin Investig Drugs. 2001 May;2(5):622-3.

Genvir (Flamel Technologies).

Barnard DL.

Utah State University, Institute for Antiviral Research, Logan 84322-5600, USA.
honery@cc.usu.edu

Flamel Technologies is developing Genvir (formerly known as Viropump), a
twice-daily controlled-release formulation of aciclovir, for potential use in the
treatment of herpes simplex virus and varicella zoster virus infections. Genvir
utilizes Flamel's proprietary Micropump technology, a microparticle-based drug
delivery system designed to extend the time of absorption of drugs in the small
intestine. The drug shows a comparable therapeutic efficacy to valaciclovir and
famciclovir (both GlaxoSmithKline) [313393]. Phase III trials have been completed
[302829]. In August 2000, Flamel filed for regulatory approval for the treatment 
of herpes in France, as a prelude to a pan-European approval [378641] and is
preparing an IND application to begin clinical trials for genital herpes in the
US [245970].

Publication Types: 
    Review

PMID: 11569934 [PubMed - indexed for MEDLINE]

2662: J Clin Virol. 2001 Oct;22(3):279-87.

Immune dysfunction and immune restoration disease in HIV patients given highly
active antiretroviral therapy.

Price P, Mathiot N, Krueger R, Stone S, Keane NM, French MA.

Department of Clinical Immunology and Biochemical Genetics, Royal Perth Hospital,
GPO X2213, Perth, WA 6001, Australia. pprice@cyllene.uwa.edu.au

BACKGROUND: Some immune defects caused by HIV infection resolve following
treatment with highly active antiretroviral therapy (HAART), but residual immune 
dysfunction may cause disease. Problems with the regulation of the restored
immune system in the first six months of treatment can lead to atypical
presentations of mycobacterial, cytomegalovirus (CMV), hepatitis B virus or
hepatitis C virus (HCV) disease. We defined these conditions as immune
restoration diseases (IRD) and showed that they occur in 30-40% of individuals
who begin HAART from low CD4 T cell counts. OBJECTIVES: Analysis of immune
dysregulation in patients who have responded to HAART. STUDY DESIGN: Patients
with successful immune reconstitution following HAART were selected from a
database containing details of all patients managed at Royal Perth Hospital
(Western Australia) on the basis a CD4 T cell count <100/microl before HAART and 
an increase of >4-fold or to >200 CD4 T cells/microl. RESULTS: Patients who had
experienced an IRD demonstrated increased levels of bioavailable IL-6 and
increased expression of CCR5 and CCR3 on monocytes and granulocytes, but numbers 
of gammadeltaT-cells were similar to patients with similar CD4 T cell counts
without an IRD. Carriage of HLA-A2, -B44 was associated with a history of CMV
retinitis and/or encephalomyelitis as an IRD, but not with IRD initiated by
Mycobacterium sp., cutaneous varicella zoster or herpes simplex infections or
HCV. We also identified a patient with Graves' thyrotoxicosis and pronounced
lymphadenopathy after HAART, and demonstrated that thyroid stimulating hormone
receptor antibody production was associated with an increase in serum soluble
CD30, suggesting acquired immune dysregulation. CONCLUSIONS: IRD are associated
with persistent immune activation, where differences in genetic profiles suggest 
that distinct pathological mechanisms are responsible for
retinitis/encephalomyelitis IRD. Further studies are important as dysregulated
T-cell responses may cause disease later in the course of immune reconstitution.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 11564593 [PubMed - indexed for MEDLINE]

2663: Nucleosides Nucleotides Nucleic Acids. 2001 Apr-Jul;20(4-7):271-85.

Acyclic/carbocyclic guanosine analogues as anti-herpesvirus agents.

De Clercq E, Andrei G, Snoeck R, De Bolle L, Naesens L, Degreve B, Balzarini J,
Zhang Y, Schols D, Leyssen P, Ying C, Neyts J.

Rega Institute for Medical Research, K. U. Leuven, B-3000 Leuven, Belgium.

Several guanosine analogues, i.e. acyclovir (and its oral prodrug valaciclovir), 
penciclovir (in its oral prodrug form, famciclovir) and ganciclovir, are widely
used for the treatment of herpesvirus [i.e. herpes simplex virus type 1 (HSV-1), 
and type 2 (HSV-2), varicella-zoster virus (VZV) and/or human cytomegalovirus
(HCMV)] infections. In recent years, several new guanosine analogues have been
developed, including the 3-membered cyclopropylmethyl and -methenyl derivatives
(A-5021 and synguanol) and the 6-membered D- and L-cyclohexenyl derivatives. The 
activity of the acyclic/carbocyclic guanosine analogues has been determined
against a wide spectrum of viruses, including the HSV-1, HSV-2, VZV, HCMV, and
also human herpesviruses type 6 (HHV-6), type 7 (HHV-7) and type 8 (HHV-8), and
hepatitis B virus (HBV). The new guanosine analogues (i.e. A-5021 and D- and
L-cyclohexenyl G) were found to be particularly active against those viruses
(HSV-1, HSV-2, VZV) that encode for a specific thymidine kinase (TK), suggesting 
that their antiviral activity (at least partially) depends on phosphorylation by 
the virus-induced TK. Marked antiviral activity was also noted with A-5021
against HHV-6 and with D- and L-cyclohexenyl G against HCMV and HBV. The
antiviral activity of the acyclic/carbocyclic nucleoside analogues could be
markedly potentiated by mycophenolic acid, a potent inhibitor of inosine
5'-monophosphate (IMP) dehydrogenase. The new carbocyclic guanosine analogues
(i.e. A-5021 and D- and L-cyclohexenyl G) hold great promise, not only as
antiviral agents for the treatment of herpesvirus infections, but also an
antitumor agents for the combined gene therapy/chemotherapy of cancer, provided
that (part of) the tumor cells have been transduced by the viral (HSV-1, VZV) TK 
gene.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11563039 [PubMed - indexed for MEDLINE]

2664: Cancer Chemother Pharmacol. 2001 Jul;47 Suppl:S10-5.

Oral therapy with proteolytic enzymes decreases excessive TGF-beta levels in
human blood.

Desser L, Holomanova D, Zavadova E, Pavelka K, Mohr T, Herbacek I.

Institute of Cancer Research, University of Vienna, Austria. ldesser@hotmail.com

Therapy with oral proteolytic enzymes (OET) with combination drug products
containing papain, bromelain, trypsin, and chymotrypsin has been shown to be
beneficial in clinical settings such as radiotherapy-induced fibrosis, bleomycin 
pneumotoxicity and immunosuppression in cancer, all of which are nowadays known
to be accompanied by excessive transforming growth factor-beta (TGF-beta)
production. It has been demonstrated that proteolytic enzymes reduce TGF-beta
levels in serum by converting the protease inhibitor alpha2 macroglobulin
(alpha2M) from the "slow" form into the "fast" form, whereby the "fast" form
binds and inactivates TGF-beta irreversibly. In this study we have investigated
the effect of OET on the concentration of TGF-beta1 in serum of patients with
rheumatoid arthritis (RA) (n = 38), osteomyelofibrosis (OMF) (n = 7) and herpes
zoster (HZ) (n = 7). Seventy-eight healthy volunteers served as controls.
TGF-beta1 levels in serum were assessed by enzyme-linked immunosorbent assay
(ELISA). We have demonstrated that in healthy volunteers and in patients there
exists a correlation between active and latent TGF-beta1 in serum (r=0.8021;
P<0.0001). Treatment with OET had no significant effect on TGF-beta1
concentration in healthy volunteers or patients with a normal level of TGF-beta1.
In patients with elevated TGF-beta1 concentration (> 50 ng/ml serum), OET reduced
TGF-beta1 in RA (P < 0.005), in OMF (P < 0.05) and in HZ (P < 0.05). Conclusion: 
These results support the concept that OET is beneficial in diseases
characterized in part by TGF-beta1 overproduction.

PMID: 11561866 [PubMed - indexed for MEDLINE]

2665: Eur J Pain. 2001;5(3):333-9.

Opioids in non-cancer pain: a life-time sentence?

Dellemijn PL.

Department of Neurology and Neurophysiology, Saint Joseph Hospital, P.O. Box
7777, 5500 MB Veldhoven, Netherlands. NEI@sjz.nl

There is continuing reluctance to prescribe strong opioids for the management of 
chronic non-cancer pain due to concerns about side-effects, physical tolerance,
withdrawal and addiction. Randomized controlled trials have now provided evidence
for the efficacy of opioids against both nociceptive and neuropathic pain.
However, there is considerable variability in response rates, possibly depending 
on the type of pain, the type of opioid and its route of administration, the time
to follow-up, compliance and the development of tolerance. Five patients were
selected with nociceptive or neuropathic pain in whom other pharmacological or
physical therapies had failed to provide satisfactory pain relief. They received 
transdermal fentanyl (starting dose 25 microg/h) for at least 6 weeks.
Transdermal fentanyl dosage was titrated upwards as required. Transdermal
fentanyl provided adequate pain relief in patients with nociceptive pain
(diabetic ulcer, osteoporotic vertebral fracture, ankylosing spondylitis) or
neuropathic pain with a nociceptive component (radicular pain due to disc
protrusion, herpetic neuralgia). The duration of treatment ranged from 6 weeks to
6 months for four cases. In the case of ankylosing spondylitis, treatment was
carried out for 2 years, stopped and then restarted successfully. There were no
withdrawal effects or addictive behaviour on treatment cessation, regardless of
duration of the treatment. In conclusion, strong opioids may provide prolonged
effective pain relief in selected patients with nociceptive and neuropathic
non-cancer pain. Transdermal fentanyl treatment can often be temporary and can
easily be stopped following adequate pain relief without withdrawal effects or
any evidence of addictive behaviour. Copyright 2001 European Federation of
Chapters of the International Association for the Study of Pain.

Publication Types: 
    Case Reports
    Clinical Trial

PMID: 11558990 [PubMed - indexed for MEDLINE]

2666: Acta Derm Venereol. 2001 Jun-Jul;81(3):212-3.

Zoster in childhood after inapparent varicella.

Lagarde C, Steen AE, Bieber T, Steen KH.

Publication Types: 
    Case Reports
    Letter

PMID: 11558884 [PubMed - indexed for MEDLINE]

2667: Antimicrob Agents Chemother. 2001 Oct;45(10):2771-4.

Acyclovir for treatment of postherpetic neuralgia: efficacy and pharmacokinetics.

Acosta EP, Balfour HH Jr.

Department of Clinical Pharmacology, University of Alabama at Birmingham,
Birmingham, AL 35294-0019, USA. EAcosta@uab.edu

Postherpetic neuralgia is the most common complication of herpes zoster
(shingles) in the immunocompetent host. Its mechanism is incompletely understood,
but one postulate is that continuous replication of varicella-zoster virus (VZV) 
in nerve tissues may be responsible for the pain. If this is so, antiviral
treatment could be advantageous. To test this hypothesis, we performed a
randomized, double-blind, placebo-controlled trial of intravenous acyclovir (10
mg/kg every 8 h [q8h]) for 14 days, followed by oral acyclovir (800 mg q6h) for
42 days in 10 subjects (median age, 71 years) who had experienced at least 6
months of severe pain (median duration of postherpetic neuralgia before
enrollment, 3.2 years). Intensive and sparse pharmacokinetic sampling occurred
during both dosing phases of the study. One- and two-compartment models were
fitted to the oral and intravenous concentration-time data, respectively. The
four men and four women assigned to acyclovir during either or both dosing phases
tolerated it well. Pharmacokinetic results were similar to those previously
reported in younger individuals. The mean oral clearance and elimination
half-life following oral dosing were 1.47 liters/h/kg and 2.78 h, respectively.
Total clearance and terminal half-life following intravenous administration were 
0.16 liters/h/kg and 3.67 h, respectively. Only 1 of 10 participants reported
definite improvement in the severity of postherpetic pain, and treatment had no
effect on titers of humoral antibody to VZV. We concluded that 56 days of
intravenous and oral acyclovir therapy were well tolerated but had little or no
effect on the clinical course of postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11557467 [PubMed - indexed for MEDLINE]

2668: Brain Pathol. 2001 Oct;11(4):465-74.

Human herpesvirus latency.

Cohrs RJ, Gilden DH.

Department of Neurology, University of Colorado, Health Sciences Center, Denver
80262, USA. randall.cohrs@uchsc.edu

Herpesviruses are among the most successful human pathogens. In healthy
individuals, primary infection is most often inapparent. After primary infection,
the virus becomes latent in ganglia or blood mononuclear cells. Three major
subfamilies of herpesviruses have been identified based on similar growth
characteristics, genomic structure, and tissue predilection. Each herpesvirus has
evolved its own unique ecological niche within the host that allows the
maintenance of latency over the life of the individual (e.g. the adaptation to
specific cell types in establishing latent infection and the mechanisms,
including expression of different sets of genes, by which the virus remains
latent). Neurotropic alphaherpesviruses become latent in dorsal root ganglia and 
reactivate to produce epidermal ulceration, either localized (herpes simplex
types 1 and 2) or spread over several dermatomes (varicalla-zoster virus). Human 
cytomegalovirus, the prototype betaherpesvirus, establishes latency in bone
marrow-derived myeloid progenitor cells. Reactivation of latent virus is
especially serious in transplant recipients and AIDS patients. Lymphotropic
gammaherpesviruses (Epstein-Barr virus) reside latent in resting B cells and
reactivate to produce various neurologic complications. This review highlights
the alphaherpesvirus, specifically herpes simplex virus type 1 and
varicella-zoster virus, and describes the characteristics of latent infection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11556692 [PubMed - indexed for MEDLINE]

2669: Brain Pathol. 2001 Oct;11(4):452-64.

Polymerase chain reaction as a diagnostic adjunct in herpesvirus infections of
the nervous system.

Kleinschmidt-DeMasters BK, DeBiasi RL, Tyler KL.

Department of Pathology, University of Colorado Health Sciences Center and The
Denver Veterans Administration Hospital, 80262, USA. BK.DeMasters@UCHSC.edu

Polymerase chain reaction (PCR) is a powerful technique that allows detection of 
minute quantities of DNA or RNA in cerebrospinal fluid (CSF), vesicle and
endoneurial fluids, blood, fresh-frozen, and even formalin-fixed tissues. Various
infectious agents can be detected with high specificity and sensitivity,
including bacteria, parasites, rickettsia and viruses. PCR analysis of CSF has
revolutionized the diagnosis of nervous system viral infections, particularly
those caused by human herpesviruses (HHV), and has now replaced brain biopsy as
the gold standard for diagnosis of herpes simplex virus (HSV) encephalitis. PCR
analysis of both CSF and nervous system tissues has also broadened our
understanding of the spectrum of disease caused by HSV-1 and -2, cytomegalovirus 
(CMV), Epstein-Barr virus (EBV), varicella zoster virus (VZV), and HHV-6.
Nonetheless, positive tissue PCR results must be interpreted cautiously,
especially in cases that lack corroborating clinical and neuropathologic evidence
of infection. Moreover, positive PCR results from tissues do not distinguish
latent from productive (lytic) viral infections. In several neurological
diseases, negative PCR results have provided strong evidence against a role for
herpesviruses as the causative agents. This review focuses on the use of PCR
tests to diagnose HSV and VZV infections of the nervous system.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11556691 [PubMed - indexed for MEDLINE]

2670: Brain Pathol. 2001 Oct;11(4):440-51.

The expanding spectrum of herpesvirus infections of the nervous system.

Kleinschmidt-DeMasters BK, Gilden DH.

Department of Neurology, The University of Colorado Health Sciences Center,
Denver 80262, USA. BK.DeMasters@UCHSC.edu

Herpesviruses cause various acute, subacute, and chronic disorders of the central
(CNS) and peripheral (PNS) nervous systems in adults and children. Both
immunocompetent and immunocompromised individuals may be affected. Zoster
(shingles), a result of reactivation of varicella zoster virus (VZV), is the most
frequent neurologic complication. Other neurological complications include
encephalitis produced by type I herpes simplex virus (HSV-1), and less frequently
HSV-2, as well as by VZV and cytomegalovirus (CMV). Acute meningitis is seen with
VZV and HSV-2, and benign recurrent meningitis with HSV-2. Combinations of
meningitis/ encephalitis and myelitis/radiculitis are associated with Epstein
Barr Virus (EBV); myelitis with VZV, CMV, EBV, and HSV-2; and
ventriculitis/encephalitis with VZV and CMV. Brainstem encephalitis due to HSV
and VZV, and polymyeloradiculitis due to CMV are well documented. HHV-6 produces 
childhood exanthem subitum (roseola) and febrile convulsions. Immunocompetent and
immunocompromised hosts manifest different incidences and patterns of herpesvirus
infections. For example, stroke due to VZV-mediated large vessel disease (herpes 
zoster ophthalmicus) occurs predominantly in immunocompetent hosts, while small
vessel disease (leukoencephalitis) and ventriculitis develop almost exclusively
in immunocompromised patients. EBV-associated primary CNS lymphomas also are
restricted to immunosuppressed individuals. Recent large CSF PCR studies have
shown that VZV, EBV, and CMV more frequently produce meningitis, encephalitis, or
encephalopathy in immunocompetent hosts than was formerly realized. We review
herpesvirus infections of the nervous system and illustrate the expanding
spectrum of disease by including examples of a 75-year-old male on steroid
treatment for chronic lung disease with fatal HSV-2 meningitis and an 81-year-old
male with myasthenia gravis, long-term azathioprine use, and an EBV-associated
primary CNS lymphoma.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11556690 [PubMed - indexed for MEDLINE]

2671: Nippon Rinsho. 2001 Sep;59(9):1738-42.

[Herpes zoster and post-herpetic neuralgia]

[Article in Japanese]

Hashizume K.

Department of Anesthesiology, Nara Medical University.

Pain associated with herpes zoster arise from the virul neuritis of the suffered 
trigeminal or spinal dorsal ganglion. Prolonged neuritis makes an irreversible
nerve injury and continuous pain impulse develops a central sensitization. A
post-herpetic neuralgia is thought to be a neuropathic pain due to the
irreversible nerve injury and sensitization. It is important to treat herpetic
pain completely before the development of the post-herpetic neuralgia, because
there are few effective therapies to cure post-herpetic neuralgia. A sympathetic 
nerve block increases the nerve blood flow supply, and may improve the nerve
injury. It is also known that some sympathetic mechanisms relate to the
development of the sensitization. A sensory nerve block reduces pain impulse to
the dorsal horn, and may interfere the sensitization. A cortico-steroid
administrated with a nerve block can reduce the neuritis, and may improve the
nerve injury.

Publication Types: 
    English Abstract
    Review

PMID: 11554045 [PubMed - indexed for MEDLINE]

2672: Masui. 2001 Aug;50(8):904-7.

[Usefulness of epidural administration of ketamine for relief of postherpetic
neuralgia]

[Article in Japanese]

Mizuno J, Sugimoto S, Ikeda M, Ikeda M, Machida K, Mikawa Y.

Department of Anesthesia, Kochi Prefectural Aki Hospital, Aki 784-0027.

Four patients with postherpetic neuralgia had their pain alleviated by epidural
administration of ketamine. No oral non-steroidal anti-inflammatory drugs and
anti-depressant drugs were effective in all cases. Lidocaine or bupivacaine was
administered epidurally to all four patients. When these patients stated that
they did not feel pain reduced, they received epidural infusion of ketamine at
doses from 5 mg to 20 mg with lidocaine or bupivacaine and their postherpetic
neuralgia was controlled. Therefore with these cases, we suspect that epidural
administration of ketamine, an antagonist for N-methyl-D-aspartic acid receptor, 
could be an effective and useful alternative treatment in a patient with
refractory postherpetic neuralgia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11554028 [PubMed - indexed for MEDLINE]

2673: Prog Drug Res. 2001;Spec No:185-228.

Current and potential therapies for the treatment of herpesvirus infections.

Villarreal EC.

Eli Lilly and Company, Infectious Diseases Research, Lilly Research Laboratories,
Indianapolis, IN 46285, USA. villarreal_elcira_c@lilly.com

Human herpesviruses are found worldwide and are among the most frequent causes of
viral infections in immunocompetent as well as in immunocompromised patients.
During the past decade and a half a better understanding of the replication and
disease causing state of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2),
varicella-zoster virus (VZV), and human cytomegalovirus (HCMV) has been achieved 
due in part to the development of potent antiviral compounds that target these
viruses. While some of these antiviral therapies are considered safe and
efficacious (acyclovir, penciclovir), some have toxicities associated with them
(ganciclovir and foscarnet). In addition, the increased and prolonged use of
these compounds in the clinical setting, especially for the treatment of
immunocompromised patients, has led to the emergence of viral resistance against 
most of these drugs. While resistance is not a serious issue for immunocompetent 
individuals, it is a real concern for immunocompromised patients, especially
those with AIDS and the ones that have undergone organ transplantation. All the
currently approved treatments target the viral DNA polymerase. It is clear that
new drugs that are more efficacious than the present ones, are not toxic, and
target a different viral function would be of great use especially for
immunocompromised patients. Here, we provide an overview of the diseases caused
by the herpesviruses as well as the replication strategy of the better
studiedmembers of this family for which treatments are available. We also discuss
the various drugs that have been approved for the treatment of some herpesviruses
in terms of structure, mechanism of action, and development of resistance.
Finally, we present a discussion of viral targets other than the DNA polymerase, 
for which new antiviral compounds are being considered.

Publication Types: 
    Review

PMID: 11548208 [PubMed - indexed for MEDLINE]

2674: Cutis. 2001 Aug;68(2):120-2.

Concurrent herpes simplex type 1 and varicella-zoster in the V2 dermatome in an
immunocompetent patient.

De Vivo C, Bansal MG, Olarte M, Grossman ME.

Department of Medicine, Columbia University College of Physicians & Surgeons, New
York, New York, USA.

A unique feature of herpesviruses is their ability to establish latent infection 
within the nervous system by colonizing peripheral sensory ganglia, which results
in subsequent episodic outbreaks of infection triggered by precipitating events. 
Despite the latent nature of both herpes simplex virus type 1 (HSV-1) and
varicella-zoster virus (VZV) within these sensory ganglia, simultaneous outbreaks
of these viruses are uncommon. This is generally attributed to the differing
reactivation features of these 2 viruses. Four cases of concurrent HSV-1 and VZV 
infection are described in the literature. We report concurrent infection of
HSV-1 and VZV within the same V2 dermatome in an immunocompetent patient.

Publication Types: 
    Case Reports

PMID: 11534912 [PubMed - indexed for MEDLINE]

2675: J Virol. 2001 Oct;75(19):9483-92.

Varicella-zoster Virus gB and gE coexpression, but not gB or gE alone, leads to
abundant fusion and syncytium formation equivalent to those from gH and gL
coexpression.

Maresova L, Pasieka TJ, Grose C.

Department of Microbiology, University of Iowa, Iowa City, Iowa, USA.

Varicella-zoster virus (VZV) is distinguished from herpes simplex virus type 1
(HSV-1) by the fact that cell-to-cell fusion and syncytium formation require only
gH and gL within a transient-expression system. In the HSV system, four
glycoproteins, namely, gH, gL, gB, and gD, are required to induce a similar
fusogenic event. VZV lacks a gD homologous protein. In this report, the role of
VZV gB as a fusogen was investigated and compared to the gH-gL complex. First of 
all, the VZV gH-gL experiment was repeated under a different set of conditions;
namely, gH and gL were cloned into the same vaccinia virus (VV) genome.
Surprisingly, the new expression system demonstrated that a recombinant VV-gH+gL 
construct was even more fusogenic than seen in the prior experiment with two
individual expression plasmids containing gH and gL (K. M. Duus and C. Grose, J. 
Virol. 70:8961-8971, 1996). Recombinant VV expressing VZV gB by itself, however, 
effected the formation of only small syncytia. When VZV gE and gB genes were
cloned into one recombinant VV genome and another fusion assay was performed,
extensive syncytium formation was observed. The degree of fusion with VZV gE-gB
coexpression was comparable to that observed with VZV gH-gL: in both cases, >80% 
of the cells in a monolayer were fused. Thus, these studies established that VZV 
gE-gB coexpression greatly enhanced the fusogenic properties of gB. Control
experiments documented that the fusion assay required a balance between the
fusogenic potential of the VZV glycoproteins and the fusion-inhibitory effect of 
the VV infection itself.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11533210 [PubMed - indexed for MEDLINE]

2676: J Exp Biol. 2001 Aug;204(Pt 15):2691-8.

Effects of sublethal ammonia exposure on swimming performance in rainbow trout
(Oncorhynchus mykiss).

Shingles A, McKenzie DJ, Taylor EW, Moretti A, Butler PJ, Ceradini S.

School of Biosciences, University of Birmingham, Birmingham, B15 2TT, UK.

Adult trout Oncorhynchus mykiss fitted with a dorsal aortic catheter were exposed
to 288+/-15 micromol l(-1) (mean +/- S.E.M.) total ammonia for 24h in water at a 
pH of 8.39+/-0.02, while swimming at a speed equivalent to 0.75 bodylengths s(-1)
(BLs(-1)) in a Brett-type tunnel respirometer. The fish were then exposed to
stepwise increments in swimming speed (0.25 BLs(-1) every 30 min) until
exhaustion. Measurements of oxygen uptake (M(O2)) and plasma total ammonia levels
and pH were made at each speed. Control trout were treated identically but
without exposure to ammonia. Ammonia exposure caused an increase in plasma total 
ammonia level to 436+/-34 micromol l(-1), compared to 183+/-30 micromol l(-1)in
control animals (N=6). A significant reduction in total plasma ammonia level was 
found in both groups during exercise, despite a large negative concentration
gradient in those exposed to an elevated concentration of ammonia in water, which
may indicate an active excretory process. The overall increase in plasma ammonia 
levels in exposed trout was associated with a significant reduction in critical
swimming speed (U(crit)) to 1.61+/-0.17BL s(-1) from 2.23+/-0.15BL s(-1) in
control animals. Ammonia-exposed trout had a significantly higher maintenance
metabolic rate (MMR) than control fish, when estimated as the y-intercept of the 
relationship between swimming speed and M(O2). Active metabolic rate (AMR,
maximum M(O2) as measured at U(crit)) was significantly lower in ammonia-exposed 
animals, leading to a profound reduction in factorial aerobic scope (AMR/MMR).
Reduced U(crit) was also linked to a reduction in maximum tailbeat frequency.
Calculation of membrane potentials (E(M)) in the white muscle of fish swum to
U(crit) revealed a significant partial depolarisation of white muscle in
ammonia-exposed fish. This may have prevented white muscle recruitment and
contributed to the reduced maximum tailbeat frequency and overall impairment of
swimming performance in the ammonia-exposed fish.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11533119 [PubMed - indexed for MEDLINE]

2677: Am J Ophthalmol. 2001 Sep;132(3):421-3.

Progressive outer retinal necrosis and acute retinal necrosis in fellow eyes of a
patient with acquired immunodeficiency syndrome.

Gariano RF, Berreen JP, Cooney EL.

Department of Ophthalmology and Visual Science, Yale University Eye Center, 330
Cedar Street, New Haven, CT 06520, USA. ray.gariano@yale.edu

PURPOSE: To describe an unusual concurrence of acute retinal necrosis and
progressive outer retinal necrosis in fellow eyes of a patient with acquired
immunodeficiency syndrome (AIDS). METHODS: Interventional case report. In a
37-year-old man with AIDS and herpes zoster keratitis in the right eye,
progressive outer retinal necrosis developed in the right eye and acute retinal
necrosis developed in the left eye. RESULTS: Disparate presentations of retinitis
persisted in each eye, and retinal detachment and vision loss ensued in both eyes
despite antiviral therapy. CONCLUSION: Distinct features of acute retinal
necrosis and progressive outer retinal necrosis do not necessarily reflect
systemic factors, and they may be variant manifestations of the same underlying
infection.

Publication Types: 
    Case Reports

PMID: 11530066 [PubMed - indexed for MEDLINE]

2678: Clin Diagn Lab Immunol. 2001 Sep;8(5):909-12.

Comparison of Chemicon SimulFluor direct fluorescent antibody staining with cell 
culture and shell vial direct immunoperoxidase staining for detection of herpes
simplex virus and with cytospin direct immunofluorescence staining for detection 
of varicella-zoster virus.

Chan EL, Brandt K, Horsman GB.

Virology Section, Clinical Microbiology Department, Provincial Laboratory,
Regina, Saskatchewan S4S 5W6, Canada. echan@health.gov.sk.ca

A new rapid direct immunofluorescence assay, the SimulFluor direct
fluorescent-antibody (DFA) assay, which can simultaneously detect herpes simplex 
virus types 1 and 2 (HSV-1 and -2) and varicella-zoster virus (VZV), was
evaluated in comparison with our current standard procedures of (i) shell vial
direct immunoperoxidase (shell vial IP) staining and cell culture for detection
of HSV and (ii) cytospin DFA staining for VZV detection. A total of 517
vesicular, oral, genital, and skin lesion specimens were tested by all three
procedures. For HSV detection, the SimulFluor DFA assay had an overall
sensitivity, specificity, positive predictive value, and negative predictive
value of 80.0, 98.3, 92.3, and 95.1%, respectively, when compared to culture.
Shell vial IP staining had a sensitivity, specificity, positive predictive value,
and negative predictive value of 87.6, 100, 100, and 96.9%, respectively, when
compared with cell culture. The SimulFluor DFA assay, however, offers same-day,
1.5-hours results versus a 1- to 2-day wait for shell vial IP staining results
and a 1- to 6-day wait for culture results for HSV. For VZV detection SimulFluor 
DFA staining detected 27 positive specimens as compared to 31 by our standard
cytospin DFA technique--a correlation of 87.1%. A positive SimulFluor reaction
for VZV is indicated by yellow-gold fluorescence compared to the bright
apple-green fluorescence observed by cytospin DFA staining. There is no
difference in turnaround time between the two assays. The SimulFluor DFA assay is
a rapid immunofluorescence assay that can detect 80% of the HSV-positive
specimens and 87% of the VZV-positive specimens with a 1.5-h turnaround time.

Publication Types: 
    Comparative Study

PMID: 11527802 [PubMed - indexed for MEDLINE]

2679: Clin Diagn Lab Immunol. 2001 Sep;8(5):871-9.

Development and validation of a gamma interferon ELISPOT assay for quantitation
of cellular immune responses to varicella-zoster virus.

Smith JG, Liu X, Kaufhold RM, Clair J, Caulfield MJ.

Department of Virus and Cell Biology, Merck Research Labs, West Point, PA 19486, 
USA. jeffrey_smith2@merck.com

Cell-mediated immunity appears to be critical for the prevention and control of
varicella-zoster virus (VZV) infection and complications arising from zoster.
Current assays of VZV-specific cell-mediated immunity are cumbersome or lack
sensitivity. We have developed a gamma interferon ELISPOT assay that provides a
direct measure of the number of T cells secreting a cytokine following
stimulation with antigen. This assay is extremely sensitive and specific, with
the ability to detect gamma interferon spot-forming cells (SFC) in the range of
10 to 1,000 SFC per million peripheral blood mononuclear cells (PBMCs). This
assay has been validated by demonstrating the following: (i) the response
detected is mediated almost entirely by CD4+ T cells, (ii) ELISPOT responses from
fresh-frozen PBMCs are equivalent to those from freshly isolated cells, (iii)
frozen PBMCs can be shipped on dry ice for up to 48 h without loss of activity,
(iv) frozen PBMC samples can be stored in liquid nitrogen over long periods (>22 
months) without any significant change in response, and (v) the numbers of
ELISPOTs counted using a computer-based imaging system are equivalent to those
counted by humans but have lower variability. The ability to use frozen cells is 
facilitated by the use of a recombinant nuclease (Benzonase) that can prevent
cell clumping when samples are thawed. Frozen PBMC samples can be cycled through 
multiple changes in storage between liquid nitrogen and dry ice without any
change in response being detected. This facilitates collection of samples at one 
site and testing performed at a remote location. This VZV ELISPOT assay provides 
a new versatile tool for monitoring cellular immune responses either during a
herpes zoster disease outbreak or following vaccination.

Publication Types: 
    Comparative Study
    Validation Studies

PMID: 11527795 [PubMed - indexed for MEDLINE]

2680: Antivir Chem Chemother. 2001 Mar;12(2):77-89.

Furano pyrimidines as novel potent and selective anti-VZV agents.

McGuigan C, Brancale A, Barucki H, Srinivasan S, Jones G, Pathirana R, Carangio
A, Blewett S, Luoni G, Bidet O, Jukes A, Jarvis C, Andrei G, Snoeck R, De Clercq 
E, Balzarini J.

Welsh School of Pharmacy, University of Wales Cardiff, UK. mcguigan@cardiff.ac.uk

Bicyclic furano pyrimidine nucleosides have been found to be highly potent and
selective inhibitors of varicella zoster virus (VZV). They are inactive against
herpes simplex virus and have been known for several decades as (unwanted)
synthetic by-products in the Pd-catalysed coupling of acetylenes to 5-iodo
nucleosides. These fluorescent bicyclic nucleosides are now established as a new 
family of potent antivirals. They are unusual in that they exhibit complete
specificity for VZV and require an alkyl (or alkylaryl) side-chain for biological
activity. The latter requirement confers extremely high lipophilicities on these 
compounds, unknown amongst chemotherapeutic nucleosides, which may be of
considerable importance in formulation, dosing and tissue distribution. The most 
potent compounds reported are p-alkylaryl compounds, with EC50 values below 1 nM 
versus VZV and selectivity index values of around 1,000,000. Here, we review the 
discovery, synthesis, characterization, antiviral profile, SAR, mechanism of
action and development prospects for this new family of antivirals.

Publication Types: 
    Review

PMID: 11527045 [PubMed - indexed for MEDLINE]

2681: Antivir Chem Chemother. 2001 Mar;12(2):119-24.

5'-Nor carbocyclic 5'-deoxy-5'-(isobutylthio)adenosine and a
2',3'-dideoxy-2',3'-didehydro derivative.

Das SR, Schneller SW, Balzarini J, De Clercq E.

Department of Chemistry, Auburn University, Ala., USA.

The inhibition of biochemical processes requiring S-adenosylmethionine as a
co-factor have led to many nucleoside-based medicinal agents. Included in this
group are 5'-deoxy-5'-(isobutylthio)adenosine (SIBA), a nucleoside with
antiparasitic, antiviral and antiproliferative effects, and 5'-noraristeromycin, 
a carbocyclic-derived nucleoside with potent antiviral properties. This report
brings together the structural components of these two compounds by describing
both enantiomers of carbocyclic 5-nor SIBA (3 and 4). Owing to the recent
interest in 2',3'-dideoxy-2',3'-didehydro nucleosides as antiviral agents, this
derivative of 3 (5) is also described. All three compounds were screened against 
a variety of viruses and were found to be inactive at high concentrations or at
limiting concentrations for the screening methods. The viruses subjected to 3-5
were herpes simplex virus types 1 and 2, human cytomegalovirus, vaccinia virus,
vesicular stomatitis virus, respiratory syncytial virus, varicelIa zoster virus, 
coxsackie virus, parainfluenza-3 virus, sindbis virus, punta toro virus,
reovirus-1, human immunodeficiency virus, influenza virus types A and B,
adenovirus type 1 and measles virus. These results suggest that the C-5'
methylene of the C-5' thio-based carbocyclic nucleosides is important for their
antiviral properties.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11527043 [PubMed - indexed for MEDLINE]

2682: J Clin Microbiol. 2001 Sep;39(9):3056-9.

LightCycler multiplex PCR for the laboratory diagnosis of common viral infections
of the central nervous system.

Read SJ, Mitchell JL, Fink CG.

Micropathology Ltd., University of Warwick Science Park, Coventry CV4 7EZ, United
Kingdom. sjread@micropathology.com

A conventional multiplex PCR assay that detects herpes simplex virus type 1
(HSV-1), HSV-2, varicella-zoster virus, and enteroviruses for the diagnosis of
central nervous system infections was modified to be performed using the
LightCycler system. The sensitivity of detection of each of the viruses using the
LightCycler assay was compared to that of the conventional assay using external
quality assessment material. The assays had equivalent sensitivities, but the
LightCycler assay was more rapid, reduced the risk of contamination, and used an 
amplicon detection format that demonstrated greater discrimination than a gel
electrophoresis method.

Publication Types: 
    Evaluation Studies

PMID: 11526128 [PubMed - indexed for MEDLINE]

2683: JAAPA. 2000 Aug;13(8):21-2.

Tingling rash in an older man.

Newman K, Herman L.

New York Institute of Technology PA Program, Old Westbury, NY, USA.

Publication Types: 
    Case Reports

PMID: 11521613 [PubMed - indexed for MEDLINE]

2684: Anal Biochem. 2001 Sep 1;296(1):106-13.

Direct measurement of ferrous ion transport across membranes using a sensitive
fluorometric assay.

Shingles R, North M, McCarty RE.

Department of Biology, Johns Hopkins University, Baltimore, Maryland 21218-2685, 
USA.

The fluorophore, Phen Green SK (PGSK), was assessed for its suitability to be
used in an assay for ferrous ion transport into membrane vesicles. The long
wavelengths of excitation and emission (506 and 520 nm, respectively) enable PGSK
fluorescence to be detected in membranes, such as the chloroplast inner envelope,
that contain high levels of carotenoids which absorb light at lower wavelengths. 
At low concentrations of Fe2+, less than 3 microM, the interaction between PGSK
and Fe2+ appears to result in both static and dynamic quenching of the PGSK
fluorescence. The characteristics of this quenching were used to develop a
calibration curve to determine the concentration of free Fe2+ at these low
concentrations. Pronounced quenching of PGSK fluorescence entrapped within
chloroplast inner envelope membrane vesicles was observed when Fe2+ was added.
The extent of quenching of PGSK fluorescence trapped inside asolectin vesicles on
Fe2+ addition was much less. The kinetics of the quenching of PGSK fluorescence
by Fe2+ in vesicles was quite different from that for PGSK and Fe2+ in solution. 
Using the calibration curve developed for interaction of PGSK and low Fe2+
concentrations the initial rates of iron transport could be determined for the
chloroplast inner envelope membranes. Copyright 2001 Academic Press.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 11520038 [PubMed - indexed for MEDLINE]

2685: Indian J Pediatr. 2001 Jul;68(7):649-54.

Anti-herpes viruses agents.

Abdel-Haq NM, Asmar BI.

Devision of Infectious Diseases, Children's Hospital of Michigan, Wayne State
University, School of Medicine, Detroit, Michigan, USA.

Antiviral agents with demonstrated efficacy are currently available for the
management of infections in children caused by the herpes viruses including
herpes simples type 1 (HSV1) and type 2 (HSV2), varicella-zoster virus (VZV), and
cytomegalovirus (CMV). Recently, progress has been made in the development of
newer agents with enhanced activity against these viruses including resistant
strains. This review focuses on the activity, clinical pharmacology, and clinical
indications of antiviral agents used in the treatment of infections caused by the
different herpes viruses in children.

Publication Types: 
    Review

PMID: 11519289 [PubMed - indexed for MEDLINE]

2686: J Virol Methods. 2001 Jul;96(1):25-31.

Detection of herpes viruses in clinical samples using real-time PCR.

Nicoll S, Brass A, Cubie HA.

Regional Clinical Virology Laboratory, City Hospital, Greenbank Drive, Edinburgh 
EH10 5SB, Scotland, UK.

Herpes viruses including cytomegalovirus, varicella zoster and herpes simplex are
an important cause of morbidity and mortality, especially in immunocompromised
patients. Real-time PCR assays were developed with the aim of introducing a rapid
and sensitive test to replace culture, and as a surveillance system for high-risk
patients. The assays were optimised using cell culture derived material, and the 
sensitivity ascertained using cloned product before applying to extracted and
non-extracted clinical samples. The sensitivity was between 1--100 virus copies
with increased sensitivity to detect less than 10 copies possible when an initial
round of amplification was carried out using external primers. Results were
available within four hours of receipt compared with a median of 4.4 days for
culture and immunofluorescence. Real-time PCR was found to be a sensitive and
rapid method of detecting these viruses and will be a valuable tool for the
surveillance of immunosuppressed patients.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 11516486 [PubMed - indexed for MEDLINE]

2687: Med Hypotheses. 2001 Sep;57(3):310-2.

Does supplemental creatine prevent herpes recurrences?

Ness SR, McCarty MF.

Pantox Laboratories, San Diego, California 92109, USA.

While functioning as a general practitioner at the Camp Pendleton Marine Base,
the first author treated numerous patients with recurrent genital herpes.
Beginning in 1998, a number of these patients failed to return for periodic
acyclovir therapy. Inquiries revealed that these patients had all commenced
supplemental creatine after their last outbreak, and had experienced no further
outbreaks. A literature search uncovered a report that cyclocreatine, a synthetic
compound structurally and functionally homologous to creatine, inhibits the
replication of cytomegalovirus, varicella-zoster, and herpes simplex types 1 and 
2, in low millimolar concentrations; furthermore, dietary cyclocreatine reduces
morbidity and mortality in mice infected with HSV-2. The fact that both creatine 
and cyclocreatine exert neuroprotective and cancer-retardant effects in rodents, 
encourages the speculation that creatine shares the anti-viral activity of
cyclocreatine. Pilot studies to assess the impact of creatine loading on
recurrence of oral and genital herpes appear warranted; the impact of creatine on
shingles occurrence in high-risk patients could also be explored. Although
initially conceived as an aid to athletic performance, creatine loading may prove
to have broad preventive and therapeutic applications.

PMID: 11516222 [PubMed - indexed for MEDLINE]

2688: Mt Sinai J Med. 2001 Sep-Oct;68(4-5):339-41.

Zosteriform Darier's disease versus acantholytic dyskeratotic epidermal nevus.

Goldberg EI, Lefkovits AM, Sapadin AN.

Department of Dermatology, State University at Stony Brook, Stony Brook, NY, USA.

Patients with keratotic lesions distributed in a unilateral, linear, zosteriform 
or localized pattern and revealing histologic features of dyskeratotic
acantholysis have been reported. There is still some controversy regarding the
appropriate nosologic placement of this entity. Some believe it represents a
localized form of Darier s disease, while others argue it is a variant of
epidermal nevus. We report a case of a 42-year-old physician who presented with a
15-year history of an asymptomatic eruption that had been diagnosed as "chronic
zoster." Physical exam revealed hyperkeratotic papules and plaques in a
dermatomal distribution. The controversy regarding the correct nosologic
placement of such a patient is discussed.

Publication Types: 
    Case Reports

PMID: 11514923 [PubMed - indexed for MEDLINE]

2689: Stat Med. 2001 Aug 30;20(16):2429-39.

Comment in:
    Stat Med. 2006 Jan 30;25(2):359-60.

Phase specific analysis of herpes zoster associated pain data: a new statistical 
approach.

Arani RB, Soong SJ, Weiss HL, Wood MJ, Fiddian PA, Gnann JW, Whitley R.

Biostatistics Unit, Comprehensive Cancer Center, University of Alabama at
Birmingham, 35294-3300, USA.

Herpes zoster or shingles is a frequent occurrence in both elderly individuals
and immunocompromised hosts. The pain associated with herpes zoster is the most
debilitating complication of the disease. It can be described as acute pain and
post-herpetic neuralgia or zoster associated pain (ZAP). The latter definition
encompasses pain from the onset of disease through its resolution and provides a 
convenient analytic tool for evaluation of antiviral therapy. A heuristic
examination of ZAP historical data suggests the existence of three phases of pain
resolution: the acute, subacute and chronic phases. The subacute and chronic
phases comprise the post-herpetic neuralgia (PHN) stage. Common analytic methods,
such as a Kaplan-Meier survival function or a Cox's model, have been used to
assess the pain. However, such approaches do not adequately allow for phase
comparison. Notably, in the clinical trial setting the comparison of specific
treatment effects on the latter stages of pain are of the greatest medical
relevance since this is the most debilitating phase of the illness. In order to
incorporate the phase-specific information in the modelling of time to cessation 
of ZAP, we assumed the hazard function was a stepwise constant. Utilizing the
full likelihood function, we obtained the maximum likelihood estimate for the
transition times (that is, change-points), and other parameters of medical
importance. The standard error of the change-point estimates were obtained
through a bootstrapping method. The asymptotic properties of the parameter
estimates are also discussed. Hence, the rates of pain resolution across all
phases can be examined in order to precisely define the existence of multiple
phases. In addition, the covariates effect can be examined across phases and
populations, thereby allowing us to translate potential efficacy of a standard
therapy to different populations. These results can be utilized in the design of 
clinical trials or in targeting the outcome for a specific phase while
controlling for the effect of other variables. Copyright 2001 John Wiley & Sons, 
Ltd.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11512133 [PubMed - indexed for MEDLINE]

2690: J Virol. 2001 Sep;75(18):8854-8.

Varicella-zoster virus ORF47 protein serine kinase: characterization of a cloned,
biologically active phosphotransferase and two viral substrates, ORF62 and ORF63.

Kenyon TK, Lynch J, Hay J, Ruyechan W, Grose C.

Department of Microbiology, University of Iowa, Iowa City, Iowa, USA.

Varicella-zoster virus (VZV) codes for a protein serine kinase called ORF47; the 
herpes simplex virus (HSV) homolog is UL13. No recombinant alphaherpesvirus
serine kinase has been biologically active in vitro. We discovered that
preservation of the intrinsic kinase activity of recombinant VZV ORF47 required
unusually stringent in vitro conditions, including physiological concentrations
of polyamines. In this assay, ORF47 phosphorylated two VZV regulatory proteins:
the ORF62 protein (homolog of HSV ICP4) and the ORF63 protein (homolog of HSV
ICP22). Of interest, ORF47 kinase also coprecipitated ORF63 protein from the
kinase assay supernatant.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11507231 [PubMed - indexed for MEDLINE]

2691: Presse Med. 2001 Jul 7-13;30(23):1151-4.

[Varicella zoster virus infection after bone marrow transplant. Unusual
presentation and importance of prevention]

[Article in French]

Ladriere M, Bibes B, Rabaud C, Delaby P, May T, Canton P.

Service de Maladies infectieuses et tropicales, Centre Hospitalier Universitaire 
de Nancy.

BACKGROUND: Leukemeia and lymphoproliferative disease are associated with a high 
risk of varicela-zoster virus (VZV) infection. Although infrequent, visceral
involvement can be fatal. We report two cases of patients presenting severe VZV
infection after bone marrow transplantation. CASE REPORTS: The first patient was 
a 42-year old man who received an allogeneic bone marrow transplantation for
chronic myelogenous leukemia. A severe graft-versus-host reaction occurred. Three
months after discontinuing VZV prophylaxis, VZV transverse myelitis was
diagnosed, leading to death despite prompt treatment with acyclovir. The second
patient was a 42-year-old woman treated with autologous bone marrow
transplantation for lymphoma. She developed acute viral pancreatitis one month
after discontinuing VZV prophylaxis. Recovery was achieved with intravenous
treatment. DISCUSSION: These two cases illustrate the potential gravity of VZV
infection after bone marrow transplantation. These observations point to the need
for revisiting the duration of VZV prophylaxis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11505833 [PubMed - indexed for MEDLINE]

2692: Hernia. 2001 Jun;5(2):99-100.

Abdominal-wall pseudohernia secondary to herpes zoster.

Zuckerman R, Siegel T.

Department of Surgery, Mary Imogene Bassett Hospital, One Atwell Road,
Cooperstown, NY 13326, USA. rszmd@att.net

We present a case of a 78-year-old woman with abdominal-wall muscle paralysis
following cutaneous herpes zoster in the T12-L1 dermatomes. An EMG confirmed
paralysis, and a CT scan ruled out fascial defect. The paralysis had completely
resolved 1 year later. A review of the literature regarding these unusual
sequelae of herpes zoster is presented.

Publication Types: 
    Case Reports
    Review

PMID: 11505658 [PubMed - indexed for MEDLINE]

2693: Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2000 Mar;14(1):73-6,
101.

[Establishment and application of Z-HL16C cell line]

Zhao S, Liu Z, Xie R.

Phargen Biotech Application Research Institute, Guangdong Shantou S. E. Z,
515041, China.

OBJECTIVE: Human embryonic lung fibroblasts at 8th passage was presented to us by
the Institute of Virology. At its 16th passage,under the culture condition of our
laboratory, the lung fibroblasts changed into epithelial like cells. We attempted
to establish a cell line and applied it for virus isolation. METHODS: The cells
were continuously passaged, cloned, the cell morphology, growth capacity and
chromosome number were determined. RESULTS: The cell size appeared uniform, cell 
boundary was distinct, the cell recovery rate after frozen storing was above 90%.
The cell replicated permanently and now it has been passaged 136 times. The
chromosome number has changed from 46 to 110. We named this cell line the ZHL16C.
It proved to be sensitive to these viruses tested: enteroviruses (Polio, Cox,
Echo), influenza viruses, parainfluenza viruses, adenoviruses, measles virus,
herpes simplex and herpes zoster viruses, cytomegalovirus, rubella virus and
respiratory syncytial virus. When using Z-HL16C cell to isolate virus from 29
adenovirus swab samples collected from 29 soldiers with epidemic high fever in a 
new military, adenovirus type 3,7 coxsackie virus types B1, B5, B5, B5, B5 were
isolated. CONCLUSIONS: The cell line HL16C has been stably established, it has a 
broad spectrum in sensitivity for viruses.

PMID: 11503031 [PubMed - indexed for MEDLINE]

2694: Med Pediatr Oncol. 2001 Aug;37(2):145-7.

Noncutaneous varicella-zoster virus (VZV) infection with fatal liver failure in a
child with acute lymphoblastic leukemia (ALL).

Muller I, Aepinus C, Beck R, Bultmann B, Niethammer D, Klingebiel T.

University Children's Hospital, Department of Hematology and Oncology, Tubingen, 
Germany.

Publication Types: 
    Case Reports

PMID: 11496356 [PubMed - indexed for MEDLINE]

2695: Curr Opin Microbiol. 2001 Aug;4(4):442-9.

Varicella-zoster virus: molecular virology and virus-host interactions.

Arvin AM.

G-312, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA
94305, USA. aarvin@stanford.edu

Cosmid-based mutagenesis and methods to examine varicella-zoster virus (VZV)
tropism for differentiated human cells in vivo provide new information about
molecular mechanisms of VZV infection. How specific VZV gene products contribute 
to viral replication has been further defined, and effects of VZV on expression
of cellular genes have been demonstrated.

Publication Types: 
    Review

PMID: 11495809 [PubMed - indexed for MEDLINE]

2696: J Ir Dent Assoc. 2001;47(2):46-58.

Non-odontogenic toothache.

Murphy E, Merrill RL.

Section of Orofacial Pain and Oral Medicine, UCLA School of Dentistry, Los
Angeles, California, USA.

Publication Types: 
    Review

PMID: 11494946 [PubMed - indexed for MEDLINE]

2697: Can Fam Physician. 2001 Jul;47:1368-70, 1377-9.

Comment in:
    Can Fam Physician. 2001 Oct;47:1961.

Varicella. To be [vaccinated] or not to be: that is the question!

[Article in English, French]

Sullivan-Bentz M.

Publication Types: 
    Editorial

PMID: 11494921 [PubMed - indexed for MEDLINE]

2698: J Infect Dis. 2001 Sep 1;184(5):627-32. Epub 2001 Jul 31.

The influence of placental malaria infection and maternal hypergammaglobulinemia 
on transplacental transfer of antibodies and IgG subclasses in a rural West
African population.

Okoko BJ, Wesumperuma LH, Ota MO, Pinder M, Banya W, Gomez SF, McAdam KP, Hart
AC.

Vaccine Trial Unit, Medical Research Council, Fajara, Banjul, The Gambia, West
Africa. okokobrown@hotmail.com

Two hundred thirteen mother-baby pairs in The Gambia were studied to determine
the influence of placental malaria infection and maternal hypergammaglobulinemia 
on transplacental antibody transfer. Antibody transfer for herpes simplex virus 1
(HSV-1), respiratory syncytial virus (RSV), and varicella-zoster virus (VZV) was 
significantly reduced by placental malaria infection by 69%, 58%, and 55%,
respectively. Maternal hypergammaglobulinemia was associated with a significant
reduction in antibody transfer for HSV-1, RSV, VZV, and pneumococcus by 89%, 90%,
91%, and 88%, respectively. In addition, placental malaria infection was
associated with a significant reduction in transfer of IgG1, IgG2, and IgG4
(P<.01, P=.01, and P=.03, respectively) but not of IgG3 (P=.59). Maternal
hypergammaglobulinemia significantly impaired the transfer of IgG1 and IgG2
(P=.01) but not of IgG3 or IgG4 (P=.62 and P=.59, respectively). Placental
malaria infection and maternal hypergammaglobulinemia were associated with
reduction in the transplacental transfer of these specific antibodies, IgG1, and 
IgG2 in this Gambian population.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11494168 [PubMed - indexed for MEDLINE]

2699: Auris Nasus Larynx. 2001 Aug;28(3):223-6.

Acyclovir improves recovery rate of facial nerve palsy in Ramsay Hunt syndrome.

Kinishi M, Amatsu M, Mohri M, Saito M, Hasegawa T, Hasegawa S.

Department of Otorhinolaryngology, Head and Neck Surgery, Kobe University School 
of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe 650-0017, Japan.
kinishi@med.kobe-u.ac.jp

OBJECTIVE: Although the antiviral agent, acyclovir, is currently employed for the
treatment in Ramsay Hunt syndrome, the benefit of acyclovir on facial nerve is
still unknown and remains controversial. This study was designed to evaluate the 
effect of acyclovir in facial nerve recovery in Ramsay Hunt syndrome. METHODS: To
evaluate drug effect on facial nerve function, evaluation of the facial voluntary
movement and nerve excitability testing were performed. We have used an infusion 
therapy of acyclovir in combination with a high dose of steroid (AS), which was
started within 7 days of onset of facial nerve palsy in 91 patients with Ramsay
Hunt syndrome. The results were compared with those of 47 patients whose therapy 
was steroid alone started within 7 days of onset. RESULTS: Out of 91 patients
treated with AS, nerve exitability was good in 68 (75%), while it was poor in 17 
and absent in six. Of 47 patients treated with steroid alone, nerve exitability
was good in 25 (53%), while it was poor in 11 and absent in 11. There was
statistically significant difference between AS and steroid therapy in the
posttreatment degree of nerve function. Complete recovery to grade I in facial
voluntary movement was attained in 82 of 91 patients (90%) in the AS therapy,
while out of 47 patients treated with steroid alone complete recovery to grade I 
was attained in only 30 (64%). A statistically significant difference in the
recovery rate of facial nerve function was induced between AS and steroid
therapy. CONCLUSION: The AS therapy was proved to keep good degree of nerve
function indicated with nerve excitability testing and improve recovery rate of
facial nerve in Ramsay Hunt syndrome. Based on this study, we now believe that
the AS therapy is an advisable treatment modality to improve the recovery rate of
facial nerve function in Ramsay Hunt syndrome.

Publication Types: 
    Clinical Trial

PMID: 11489365 [PubMed - indexed for MEDLINE]

2700: Klin Monatsbl Augenheilkd. 2001 Jun;218(6):455-8.

[Zinsser-Engman-Cole syndrome (dyskeratosis congenita) with severe sicca
syndrome, panuveitis and corneal perforation--a case report]

[Article in German]

Zagorski Z, Biziorek B, Rakowska E, Jedrzejewski D.

Universitats-Augenklinik, Chmielna 1, 20-075 Lublin, Polen.

BACKGROUND: Zinsser-Engman-Cole syndrome (Z.E.C.) is a very rare type of
ectodermal dysplasia, inherited in X-linked recessive manner and characterised by
poikiloderma, nail dystrophy, lingual leucoplakia, bone marrow hypoplasia,
hyperkeratosis and hyperhidrosis of planta and palms, dental anomalies and
caries, premature grey hair. PATIENT AND METHODS: We report on a 46-year-old man 
who presented with occlusion of lacrimal puncta, trichiasis, severe dry eye,
recurrent corneal ulceration and perforation, uveitis. HLA typing, flow cytometry
of peripheral lymphocytes, bone marrow biopsy, conjunctival biopsy and extensive 
laboratory evaluation towards autoimmune and infectious diseases were performed. 
RESULTS: CD4+ T cells fraction was decreased, CD8+ and CD3+ HLA DR+ elevated. The
patient was HLA-B27 positive. Laboratory studies revealed increased erythrocyte
sedimentation rate and C-reactive protein level, hypochromic and hypoplastic
anaemia, negative serum titers of antibodies to Epstein-Barr virus, HIV, HTLV-I, 
toxoplasma gondii and treponema pallidum, repeated titers to cytomegalovirus,
herpes simplex and herpes zoster viruses--IgM negative, IgG positive. Corneal
perforation was treated with amniotic membrane transplantation and corneal
transplantation. CONCLUSION: The defect in cell-mediated immune mechanisms in
Z.E.C. syndrome explains the corneal perforation, sicca syndrome and uveitis,
first reported in this syndrome.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11488014 [PubMed - indexed for MEDLINE]

2701: Curr Treat Options Neurol. 2001 Sep;3(5):401-411.

Shingles (Herpes Zoster) and Post-herpetic Neuralgia.

Davis LE, King MK.

Departments of Neurology, Neuroscience, and Microbiology, New Mexico VA Health
Care System, 1501 San Pedro Drive, SE, Albuquerque, NM 87108, USA.
LEDavis@UNM.edu

During childhood chickenpox, varicella-zoster virus becomes latent in neurons of 
the dorsal root or trigeminal ganglia. Shingles results years to decades later
from a breakdown of viral latency within a ganglion and subsequent virus spread
to the skin producing a unilateral dermatomal vesicular rash accompanied by
segmental pain. Treatment with famciclovir, valacyclovir, and high dose acyclovir
is beneficial if started within the first 3 days of the rash. All three drugs can
be given orally, are equally effective, shorten the duration of viral shedding
and time to healing of the rash by 1 to 2 days, and lessen the intensity and
duration of the acute neuritic pain. Famciclovir and valacyclovir have more
convenient dosing schedules (three times daily) compared to acyclovir (five times
daily). Mild cases of shingles in younger healthy individuals often do not
require any antiviral treatment. Pain in shingles may have burning, lancinating, 
or allodynic qualities, ranges in intensity from mild to unbearable, and lasts 2 
to 8 weeks. Pain treatment varies on the type and intensity of pain experienced. 
In a few patients, post-herpetic neuralgia develops and the dermatomal pain
persists for months to years. Effective treatment of post-herpetic pain is often 
difficult.

PMID: 11487454 [PubMed - as supplied by publisher]

2702: Jpn J Ophthalmol. 2001 Jul-Aug;45(4):425-8.

Optic neuropathy and central retinal vascular obstruction as initial
manifestations of acute retinal necrosis.

Kang SW, Kim SK.

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University,
Seoul, South Korea.

BACKGROUND: The purpose of this brief communication is to alert ophthalmologists 
that optic neuropathy may herald acute retinal necrosis (ARN). CASE: A previously
healthy 54-year-old man exhibited optic neuropathy as an initial presentation of 
ARN, 8 weeks after varicella-zoster dermatitis. OBSERVATIONS: Central retinal
vascular obstruction developed subsequently in his left eye. Later, the classic
presentation of ARN appeared in his contralateral eye. Systemic acyclovir therapy
stopped the progression of retinitis and resulted in healing of retinal lesions
in his right eye. CONCLUSIONS: This case suggests that optic neuropathy,
especially with preceding herpetic dermatitis, should be suspected as the
prodrome of ARN.

Publication Types: 
    Case Reports

PMID: 11485778 [PubMed - indexed for MEDLINE]

2703: Southeast Asian J Trop Med Public Health. 2001 Mar;32(1):171-6.

Cutaneous manifestations in HIV positive patients.

Supanaranond W, Desakorn V, Sitakalin C, Naing N, Chirachankul P.

Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol
University, Bangkok, Thailand.

Cutaneous manifestations are common clinical findings among HIV positive
patients. The causes may be bacteria, viruses, fungi and other non-infectious
agents. This study was conducted at the Pramongkutklao Hospital skin clinic to
determine the frequency distribution of cutaneous manifestations in HIV positive 
patients. A total of 147 patients with HIV seropositivity were recruited and
divided into a retrospective group and a prospective study group. For the
retrospective study, hospital records of 129 patients who attended from January
1995 to November 1998 were recruited. The prospective study was carried out from 
November 1998 to January 1999 and 18 patients were recruited. Cutaneous finding
among patients in the two studies were evaluated. There were ten common cutaneous
manifestations observed in the retrospective and prospective study including
pruritic papular eruptions (PPE) (51.2%, 50%), oral candidiasis (16.7%, 21.7%),
herpes zoster (10.9%, 5.6%), oral hairy leukoplakia (10%, 5.6%), unclassified
eczema (9%, 11.1%), urticaria (5.6%, 3.1%), seborrheic dermatitis (4.7%, 16.7%), 
folliculitis (4.7%, 5.6%), prurigo simplex (4.7%, 5.6%), and Steven-Johnson
syndrome (3.9%, 0%). However, the distribution of cutaneous manifestations in the
two studies were not significantly different. These findings may be useful as
baseline data for common cutaneous manifestations in HIV positive patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11485081 [PubMed - indexed for MEDLINE]

2704: J Virol. 2001 Sep;75(17):8224-39.

Mutational analysis of the repeated open reading frames, ORFs 63 and 70 and ORFs 
64 and 69, of varicella-zoster virus.

Sommer MH, Zagha E, Serrano OK, Ku CC, Zerboni L, Baiker A, Santos R, Spengler M,
Lynch J, Grose C, Ruyechan W, Hay J, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
94305-5208, USA. marvman@stanford.edu

Varicella-zoster virus (VZV) open reading frame 63 (ORF63), located between
nucleotides 110581 and 111417 in the internal repeat region, encodes a nuclear
phosphoprotein which is homologous to herpes simplex virus type 1 (HSV-1) ICP22
and is duplicated in the terminal repeat region as ORF70 (nucleotides 118480 to
119316). We evaluated the role of ORFs 63 and 70 in VZV replication, using
recombinant VZV cosmids and PCR-based mutagenesis to make single and dual
deletions of these ORFs. VZV was recovered within 8 to 10 days when cosmids with 
single deletions were transfected into melanoma cells along with the three intact
VZV cosmids. In contrast, VZV was not detected in transfections carried out with 
a dual deletion cosmid. Infectious virus was recovered when ORF63 was cloned into
a nonnative AvrII site in this cosmid, confirming that failure to generate virus 
was due to the dual ORF63/70 deletion and that replication required at least one 
gene copy. This requirement may be related to our observation that ORF63
interacts directly with ORF62, the major immediate-early transactivating protein 
of VZV. ORF64 is located within the inverted repeat region between nucleotides
111565 and 112107; it has some homology to the HSV-1 Us10 gene and is duplicated 
as ORF69 (nucleotides 117790 to 118332). ORF64 and ORF69 were deleted
individually or simultaneously using the VZV cosmid system. Single deletions of
ORF64 or ORF69 yielded viral plaques with the same kinetics and morphology as
viruses generated with the parental cosmids. The dual deletion of ORF64 and ORF69
was associated with an abnormal plaque phenotype characterized by very large,
multinucleated syncytia. Finally, all of the deletion mutants that yielded
recombinants retained infectivity for human T cells in vitro and replicated
efficiently in human skin in the SCIDhu mouse model of VZV pathogenesis.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11483768 [PubMed - indexed for MEDLINE]

2705: J Virol Methods. 2001 Sep;97(1-2):77-85.

'RETCIF': a rapid, sensitive method for detection of viruses, applicable for
large numbers of clinical samples.

Alexander R, Lamb D, White D, Wentzel T, Politis S, Rijnsburger J, van Ruyven D, 
Kelly N, Garland SM.

Department of Microbiology & Infectious Diseases, Women's & Children's Health
Care Network, Royal Children's Hospital, Flemington Road, Parkville, 3052, Vic., 
Melbourne, Australia. alexandr@cryptic.rch.unimelb.edu.au

Rapid detection of viruses in clinical samples is important for continuing
appropriate antiviral treatment and discontinuing unnecessary antibacterial
treatment, as well as for excluding viral pathogens. Yet detection of viral
agents may require numerous susceptible cell lines. Even with the shell vial
culture method, it is cumbersome for handling large volumes of specimens. A
procedure has been developed, which is time and cost-saving and uses specific
cell lines in a 96-well microtitre plate and monoclonal antibodies (RETCIF-rapid 
enhanced tissue culture immunofluorescence). Each clinical sample was inoculated 
into 12 different wells with five different cell lines. Enhancement was achieved 
by sonication, centrifugation and hormonal supplementation to the medium used.
Cytomegalovirus (CMV), herpes simplex virus (HSV) and respiratory viruses were
detected by monoclonal antibodies on day 2, whilst varicella zoster virus (VZV)
and enteroviruses were detected on days 5 and 7, respectively. During
July-December 1998, 3298 patient specimens were compared by RETCIF and a modified
shell vial method. Either or both methods isolated 779 viruses (24% positivity
rate), whilst both methods detected 621. Of the 779 viruses, 87% (679) were
isolated by the shell vial method in an average time of 4.9 days. For RETCIF the 
respective rate was 92.5% (721), in an average time of 3.0 days. The RETCIF
method is a time-saving procedure, with higher isolation rates than the shell
vial method.

Publication Types: 
    Comparative Study

PMID: 11483219 [PubMed - indexed for MEDLINE]

2706: Cutis. 2001 Jul;68(1):21-3.

Comment in:
    Cutis. 2003 Jan;71(1):86; author reply 86.

Childhood herpes zoster.

Papadopoulos AJ, Birnkrant AP, Schwartz RA, Janniger CK.

New Jersey Medical School, 185 S Orange Ave, Newark, NJ 07103-2714, USA.

Herpes zoster (HZ) in childhood is rather unusual. This reactivation of
chickenpox, the primary varicella-zoster virus (VZV) infection that lies dormant 
within sensory ganglia, is seen with increased frequency in otherwise healthy
children who acquire chickenpox either in utero or within the first year of life.
Our patient is a good example of this; he was exposed to chickenpox at the age of
3 months (by his 2 siblings) and developed HZ at 6 years of age.

Publication Types: 
    Case Reports

PMID: 11480141 [PubMed - indexed for MEDLINE]

2707: Am J Kidney Dis. 2001 Aug;38(2):256-64.

Treatment of diffuse proliferative lupus glomerulonephritis: a comparison of two 
cyclophosphamide-containing regimens.

Mok CC, Ho CT, Siu YP, Chan KW, Kwan TH, Lau CS, Wong RW, Au TC.

Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong,SAR, China.
ccmok@netvigator.com

Cyclophosphamide (CYC) has proven beneficial in preserving renal function in
patients with lupus with diffuse proliferative glomerulonephritis (DPGN).
However, the optimal route of CYC administration is unknown because direct
comparative studies are unavailable. In this open study, we compared the renal
outcome of two historical cohorts of patients with diffuse proliferative lupus
nephritis (World Health Organization classes IVa and IVb) treated with either
intravenous (IV) pulse CYC (group A; n = 22) or sequential oral CYC followed by
azathioprine (AZA; group B; n = 21) and followed up prospectively. Both groups of
patients had similar clinical, biochemical, and renal parameters at baseline. At 
24 months posttreatment, significant improvements in proteinuria, creatinine
clearance, serum albumin level, and lupus serological results were evident in
both groups. Compared with patients in group A, patients in group B had more
complete or partial remission (90% versus 73%) and less risk for treatment
failure (5% versus 14%), renal flares (5% versus 14%), and doubling of creatinine
levels (5% versus 9%), but the difference was not statistically significant.
However, patients treated with oral immunosuppression had an insignificant
increase in rates of herpes zoster infection (19% versus 9%) and menstrual
disturbance (50% versus 29%). We conclude that sequential oral immunosuppression 
with CYC and AZA tended to have better efficacy than IV pulse CYC in the
treatment of lupus DPGN but was associated with more toxicities. Additional
randomized trials involving a larger cohort of patients with a longer period of
observation are necessary.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 11479150 [PubMed - indexed for MEDLINE]

2708: Dent Update. 2001 May;28(4):181-6, 188.

Viral infections of the oral mucosa and perioral region.

McIntyre GT.

Dundee Dental Hospital and School, Dundee.

Viral infections of the oral mucosa and perioral region are commonly encountered 
in the practice of dentistry. The accurate and timely diagnosis of such
infections, coupled with the institution of appropriate treatment, can often
permit quick resolution of the condition with minimal discomfort and anxiety for 
the patient (and carers) and prevent the spread of infection to others,
especially immunocompromised individuals. This article outlines the clinical
presentation and appropriate management of common viral infections of the oral
mucosa and perioral region.

PMID: 11476033 [PubMed - indexed for MEDLINE]

2709: Ann Hematol. 2001 Jun;80(6):361-4.

Virus-associated hemophagocytic syndrome due to rubella virus and
varicella-zoster virus dual infection in patient with adult idiopathic
thrombocytopenic purpura.

Takeoka Y, Hino M, Oiso N, Nishi S, Koh KR, Yamane T, Ohta K, Nakamae H, Aoyama
Y, Hirose A, Fujino H, Takubo T, Inoue T, Tatsumi N.

Department of Clinical Hematology, Osaka City University Medical School, Japan.

A 26-year-old woman with idiopathic thrombocytopenic purpura (ITP) was admitted
to our hospital because of fever and rash. Blood tests revealed thrombocytopenia,
liver dysfunction, coagulopathy, and hyperferritinemia. Bone marrow examination
revealed many atypical lymphocytes and some histiocytes with hemophagocytosis. On
admission she was diagnosed with rubella virus-associated hemophagocytic syndrome
(VHAS), but on laboratory examination, she was seropositive for varicella-zoster 
virus (VZV)-IgM as well as rubella virus-IgM. She was therefore diagnosed with
dual infection by rubella virus and VZV. Her simultaneous rubella virus and VZV
infection may have been related to the VAHS pathogenesis. She was treated with
prednisolone and gamma globulin therapy and recovered completely.

Publication Types: 
    Case Reports

PMID: 11475151 [PubMed - indexed for MEDLINE]

2710: Ann Dermatol Venereol. 2000 Oct;127(Spec No 1):A129-35.

[Varicella and zona. Epidemiology, physiopathology, diagnosis, clinical course,
treatment]

[Article in French]

[No authors listed]

PMID: 11474510 [PubMed - indexed for MEDLINE]

2711: J Clin Microbiol. 2001 Aug;39(8):2856-9.

Quantitation of varicella-zoster virus DNA in patients with Ramsay Hunt syndrome 
and zoster sine herpete.

Furuta Y, Ohtani F, Sawa H, Fukuda S, Inuyama Y.

Department of Otolaryngology, CREST, JST, Hokkaido University School of Medicine,
Sapporo, Japan. yfuruta@med.hokudai.ac.jp

Varicella-zoster virus (VZV) reactivation causes facial nerve palsy in Ramsay
Hunt syndrome (RHS) and zoster sine herpete (ZSH) with and without zoster rash,
respectively. In the present study, we analyzed the VZV DNA copy number in saliva
samples from 25 patients with RHS and 31 patients with ZSH using a TaqMan PCR
assay to determine differences in the viral load between the two diseases. VZV
copy number in saliva peaked near the day of the appearance of zoster in patients
with RHS. Consequently, VZV DNA was less frequently detected in patients with RHS
who exhibited facial palsy several days after the appearance of zoster. These
findings suggest that the VZV load in saliva samples reflects the kinetics of
viral reactivation in patients with RHS. In addition, VZV DNA was equally
detected in saliva from patients with RHS and ZSH, and there was no significant
difference in the highest viral copy number between patients with RHS and those
with ZSH. The VZV load does not appear to reflect a major difference between RHS 
and ZSH.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11474003 [PubMed - indexed for MEDLINE]

2712: J Int Med Res. 2001 May-Jun;29(3):198-203.

Varicella zoster virus antigens in the epidermis of patients with herpes zoster
before and after treatment with acyclovir: an immunohistochemical study.

Kurokawa I, Yamamoto M, Kurata T.

Department of Dermatology, Hyogo Prefectural Tsukaguchi Hospital, Japan.
ikuro@alles.or.jp

Using a monoclonal antibody to varicella zoster virus (VZV), an
immunohistochemical study was performed before and after treatment with acyclovir
(750 mg/day intravenously for 5 - 7 days) to investigate the distribution of VZV 
antigens in the epidermis of four in-patients with herpes zoster, and to
correlate their presence with clinical manifestations of the disease. Biopsy
specimens were obtained from epidermal lesions on admission to hospital prior to 
acyclovir administration, and again following treatment. In all cases, VZV
antigens were found extensively in the erythematous and vesicular lesions before 
treatment, but they were not detected 5 - 7 days later in the ulcerative, crusted
or pigmented lesions after acyclovir therapy. Further controlled studies will be 
necessary to compare the distribution of epidermal VZV antigens in
acyclovir-treated patients with that in a placebo group to determine whether the 
loss of VZV antigens was due to acyclovir or to a natural decrease over time.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11471857 [PubMed - indexed for MEDLINE]

2713: Mol Biotechnol. 2001 Jun;18(2):155-67.

Evaluating phenotype and genotype of drug-resistant strains in herpesviruses.

Andrei G, Fiten P, De Clercq E, Snoeck R, Opdenakker G.

Rega Institute for Medical Research, Katholieke Univ. Leuven, Leuven, Belgium.
Graciela.Andrei@rega.kuleuven.ac.be

The isolation of drug-resistant strains of herpesviruses, including Herpes
Simplex Virus type I (HSV-1) and type 2 (HSV-2), Varicella-Zoster Virus (VZV),
and cytomegalovirus (CMV), has been reported with increasing frequency in
immunocompromised patients and is a matter of major concern. Determination of
antiviral drug susceptibilities is a prerequisite for the management of
drug-resistant herpesvirus infections. Phenotyping studies should be correlated
with genotyping, i.e., characterization of the mutations in the target genes. The
isolation of drug-resistant virus in the laboratory and the determination of
their phenotype and genotype may be useful to clarify the mechanisms of selective
drug action. We describe here the procedures used for in vitro selection of
drug-resistant herpesvirus mutants and the determination of their patterns of
drug-susceptibility. The subcloning of the HSV-1 DNA polymerase gene is described
as an example of the methodology followed to determine the mutation(s) in the
drug-target viral gene that are associated with the resistant phenotype. To avoid
the introduction of mutations by PCR amplification, all subcloning experiments
were executed directly on viral DNA. Viral DNA was prepared from each
plaque-purified viral strain and a 3.4 kb BamHI fragment containing 87% of the
HSV-1 DNA polymerase gene coding region was purified and further digested with
SacI; the two resulting fragments were subcloned into pU18 and propagated in
Escherichia coli. Plasmid DNA was isolated and the inserts were sequenced using
dideoxynucleotide chain termination method with T7 DNA polymerase and Taq DNA
polymerase in an automated laser fluorescent DNA sequencer. pUC/M13 reverse,
universal primers and oligonucleodite primers based on the wild-type virus
sequence were used. The nucleotide sequences of the DNA polymerase genes of the
different mutants was then compared with the nucleotide sequence of the wild-type
HSV-1 KOS strain.

PMID: 11471457 [PubMed - indexed for MEDLINE]

2714: Trop Med Int Health. 2001 Jul;6(7):529-34.

The influence of prematurity and low birthweight on transplacental antibody
transfer in a rural West African population.

Okoko JB, Wesumperuma HL, Hart CA.

Medical Research Council, Fajara, The Gambia. okokobrown@hotmail.com

OBJECTIVE: To determine the influence of prematurity and low birthweight (LBW) on
transplacental antibody transfer. METHOD: In a physician-blinded, cross-sectional
study of 213 mother--baby pairs in the labour ward of Bansang Hospital, The
Gambia, paired maternal and cord serum samples were tested for specific IgG
antibody titres for measles virus (MeV), herpes simplex virus type 1 (HSV1),
respiratory syncytial virus (RSV), varicella-zoster virus (VZV), tetanus toxoid
(TT) and diphtheria toxoid (DT) antigens using enzyme linked immunosorbent assay 
(ELISA). RESULTS: Prematurity was significantly associated with reduced placental
antibody transfer for MeV, HSV1, TT, DT, RSV and VZV. Maternal antibody transfer 
for MeV, HSV1, TT, DT, RSV and VZV was significantly lower in neonates with LBW
than in babies with adequate birthweight (ABW). CONCLUSION: Materno--foetal
transfer of antibodies is impaired in prematurity and LBW babies in this Gambian 
population. Reduction in antibody transfer may further predispose these already
vulnerable neonates to bacteria and viral infections. Therefore, alternative
vaccination strategies, including earlier vaccination schedules, are needed to
provide better protection to these young infants.

PMID: 11469946 [PubMed - indexed for MEDLINE]

2715: Neurology. 2001 Jul 24;57(2):351-4.

Acute, chronic, and recurrent varicella zoster virus neuropathy without zoster
rash.

Fox RJ, Galetta SL, Mahalingam R, Wellish M, Forghani B, Gilden DH.

Department of Neurology, University of Pennsylvania School of Medicine,
Philadelphia, USA.

The authors report three patients with acute, chronic, and recurrent neuropathy
associated with varicella zoster virus (VZV) infection but without zoster rash.
CSF of all three patients contained VZV immunoglobulin G antibody, but not herpes
simplex virus. In two patients, serum/CSF ratios of VZV immunoglobulin G were
reduced compared to normal ratios for immunoglobulin G and albumin, and one
patient also had VZV immunoglobulin M in CSF. All three patients received
antiviral therapy and improved. The diagnosis of nervous system infection by VZV 
may be confirmed by the presence of antibody to VZV in CSF even without
detectable VZV DNA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11468330 [PubMed - indexed for MEDLINE]

2716: Neurology. 2001 Jul 24;57(2):348-51.

Spectrum of myelopathies in HIV seropositive South African patients.

Bhigjee AI, Madurai S, Bill PL, Patel V, Corr P, Naidoo MN, Gopaul WM, Smith A,
York D.

Department of Neurology, University of Natal, South Africa. Bhigjee@mu.ac.za

The authors determined the cause of myelopathies in 33 HIV seropositive
individuals in KwaZulu/Natal, South Africa. The main associations were with human
T-cell lymphotrophic virus-I, tuberculosis, herpes zoster, and syphilis. A novel 
association with probable bilharziasis was noted. Only one case of vacuolar
myelopathy was identified. Opportunistic infections will probably persist until
routine antiretroviral therapy becomes widely available in South Africa.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11468329 [PubMed - indexed for MEDLINE]

2717: Duodecim. 1998;114(5):475-80.

[Facial neuralgias]

[Article in Finnish]

Murros K.

Keski-Suomen keskussairaala, neurologian yksikko 40620 Jyvaskyla.

Publication Types: 
    Review

PMID: 11466940 [PubMed - indexed for MEDLINE]

2718: Arch Ophthalmol. 2001 Jul;119(7):1044-9.

Evidence for antigen-specific immune deviation in patients with acute retinal
necrosis.

Kezuka T, Sakai J, Usui N, Streilein JW, Usui M.

Department of Ophthalmology, Tokyo Medical University, 6-7-1, Nishishinjuku,
Shinjuku-ku, Tokyo 160-0023, Japan. tkezuka@tokyo-med.ac.jp

BACKGROUND: Because experimental acute retinal necrosis (ARN) induced by herpes
simplex virus in mice develops only if mice fail to acquire virus-specific
delayed hypersensitivity (DH), although they produce antiviral antibodies (ie,
anterior chamber-associated immune deviation), we sought to determine whether a
similar inverse correlation exists for patients with varicella-zoster virus
(VZV)-induced ARN. DESIGN: Patients with acute, VZV-induced ARN and age-matched
control subjects were skin tested with VZV and purified protein derivative
antigens to evaluate DH. Varicella-zoster virus-induced ARN was diagnosed using
polymerase chain reaction and intraocular antibody quotient. Serum samples were
collected and analyzed for anti-VZV and anti-herpes simplex virus antibody
titers. Acute retinal necrosis activity was assessed clinically, and DH skin
tests were repeated 3 months after onset when ocular recovery had taken place.
RESULTS: Whereas controls displayed intense DH when tested with VZV and purified 
protein derivative antigens, a subset of patients with ARN displayed absent
VZV-specific DH (although their purified protein derivative responses were
normal). Patients with the most severe ARN had the lowest DH responses to VZV
antigens. Serum anti-VZV antibody titers were higher in patients with ARN than in
controls, and antiviral titer correlated inversely with the intensity of anti-VZV
DH responses. Varicella-zoster virus-specific DH responses were restored in
patients who recovered from ARN. CONCLUSION: Varicella-zoster virus-ARN develops 
in a setting where DH reactivity to viral antigens is absent, implying that
virus-specific DH might ameliorate the severity of ARN. CLINICAL RELEVANCE:
Linking virus-specific DH to vulnerability to ARN in individuals infected with
VZV might reveal an underappreciated pathogenic mechanism.

PMID: 11448326 [PubMed - indexed for MEDLINE]

2719: Pediatr Infect Dis J. 2001 Jul;20(7):641-5.

Incidence and hospitalization rates of varicella and herpes zoster before
varicella vaccine introduction: a baseline assessment of the shifting
epidemiology of varicella disease.

Coplan P, Black S, Rojas C, Shinefield H, Ray P, Lewis E, Guess H.

Merck Research Laboratories, Blue Bell, PA 19422, USA. paul_coplan@merck.com

BACKGROUND: A 15-year postmarketing evaluation of the impact of varicella vaccine
on the age distribution of varicella disease is being conducted at Kaiser
Permanente Medical Care Program, Northern California (KPMCP). We report on a
baseline assessment of the age-specific incidence and hospitalization rates of
varicella and herpes zoster that was conducted before vaccine introduction.
METHODS: To assess the annual incidence of varicella, a telephone survey was
conducted in a random sample of approximately 8,000 youths 5 to 19 years of age. 
The annual incidence of hospitalizations for varicella and herpes zoster in 1994 
was assessed with the use of the computerized database at KPMCP. RESULTS:
Varicella annual incidence was 10.3% in 5- to 9-year-olds, 1.9% in 10- to
14-year-olds and 1.2% in the 15- to 19-year age groups, respectively.
Hospitalization rates among the entire KPMCP membership were 2.6 and 2.1 per
100,000 person years for varicella and zoster, respectively. Varicella incidence 
in the 15- to 19-year age group was higher among African-Americans than among
Caucasians. CONCLUSIONS: Varicella rates were similar in the 5- to 9- and 10- to 
14-year age groups to rates from other published studies conducted in 1972 to
1978, 1980 to 1988 and 1990 to 1992; however, the rate in 15- to 19-year-olds was
2 to 4 times higher than published rates in the same age category.

PMID: 11465834 [PubMed - indexed for MEDLINE]

2720: Anesthesiology. 2001 Jul;95(1):259-61.

Drug-induced liver disease during continuous epidural block with bupivacaine.

Yokoyama M, Ohashi I, Nakatsuka H, Mizobuchi S, Toda Y, Matsumi M, Morita K,
Hirakawa M.

Department of Anesthesiology and Resuscitology, Okayama University Medical
School, Japan. masayoko@cc.okayama-u.ac.jp

Publication Types: 
    Case Reports

PMID: 11465567 [PubMed - indexed for MEDLINE]

2721: MMW Fortschr Med. 2001 May 31;143(22):50.

[Controlling herpes zoster. End end to bullae]

[Article in German]

[No authors listed]

Publication Types: 
    Comparative Study
    News

PMID: 11460405 [PubMed - indexed for MEDLINE]

2722: J Neurol Neurosurg Psychiatry. 2001 Aug;71(2):149-54.

Ramsay Hunt syndrome.

Sweeney CJ, Gilden DH.

Department of Neurology, Mail Stop B182, University of Colorado Health Sciences
Center, SOM Room 3657, 4200 East 9th Avenue, Denver, Colorado 80262, USA.

The strict definition of the Ramsay Hunt syndrome is peripheral facial nerve
palsy accompanied by an erythematous vesicular rash on the ear (zoster oticus) or
in the mouth. J Ramsay Hunt, who described various clinical presentations of
facial paralysis and rash, also recognised other frequent symptoms and signs such
as tinnitus, hearing loss, nausea, vomiting, vertigo, and nystagmus. He explained
these eighth nerve features by the close proximity of the geniculate ganglion to 
the vestibulocochlear nerve within the bony facial canal. Hunt's analysis of
clinical variations of the syndrome now bearing his name led to his recognition
of the general somatic sensory function of the facial nerve and his defining of
the geniculate zone of the ear. It is now known that varicella zoster virus (VZV)
causes Ramsay Hunt syndrome. Compared with Bell's palsy (facial paralysis without
rash), patients with Ramsay Hunt syndrome often have more severe paralysis at
onset and are less likely to recover completely. Studies suggest that treatment
with prednisone and acyclovir may improve outcome, although a prospective
randomised treatment trial remains to be undertaken. In the only prospective
study of patients with Ramsay Hunt syndrome, 14% developed vesicles after the
onset of facial weakness. Thus, Ramsay Hunt syndrome may initially be
indistinguishable from Bell's palsy. Further, Bell's palsy is significantly
associated with herpes simplex virus (HSV) infection. In the light of the known
safety and effectiveness of antiviral drugs against VZV or HSV, consideration
should be given to early treatment of all patients with Ramsay Hunt syndrome or
Bell's palsy with a 7-10 day course of famciclovir (500 mg, three times daily) or
acyclovir (800 mg, five times daily), as well as oral prednisone (60 mg daily for
3-5 days). Finally, some patients develop peripheral facial paralysis without ear
or mouth rash, associated with either a fourfold rise in antibody to VZV or the
presence of VZV DNA in auricular skin, blood mononuclear cells, middle ear fluid,
or saliva. This indicates that a proportion of patients with "Bell's palsy" have 
Ramsay Hunt syndrome zoster sine herpete. Treatment of these patients with
acyclovir and prednisone within 7 days of onset has been shown to improve the
outcome of recovery from facial palsy.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11459884 [PubMed - indexed for MEDLINE]

2723: Med Clin (Barc). 2001 Jun 23;117(3):81-4.

[Opportunistic episodes in patients infected with the human immunodeficiency
virus during the first 6 months of HAART]

[Article in Spanish]

Gonzalez-Castillo J, Blanco F, Soriano V, Barreiro P, Concepcion Bravo M,
Jimenez-Nacher I, Gonzalez-Lahoz J.

Servicio de Enfermedades Infecciosas, Hospital Carlos III, Instituto de Salud
Carlos III, Madrid. jgdelcastillo@terra.es

BACKGROUND: We aimed at analysing the incidence and characteristics of
opportunistic events (OE) within a few months after starting highly active
antiretroviral therapy (HAART) in HIV infected patients. PATIENTS AND METHOD:
Retrospective study of HIV infected outclinic patients attended in a HIV/AIDS
reference hospital in Madrid, who initiated HAART during the second semester of
1998, with a baseline CD4 cell count 250 x 10(6) cells/l. We recorded the
incidence of OE within 6 months after beginning HAART and analysed virological
and immunological parameters, sociodemographic variables and types of
antiretroviral treatment. RESULTS: The study included 269 patients. Twenty-one
(7.8%) OE were recorded. At the onset of HAART, the mean CD4 cell count in these 
21 patients was 137 (92) x 10(6)/land the median viral load was 24,043 cop/ml. At
the time of OE diagnosis, these parameters were 218 (114) x 10(6)/l (p = 0.012)
and < 500 cop/ml, respectively. OE were distributed as follows: herpes zoster, 9 
cases (43%), Pneumocystis carinii pneumonia, 5 cases (24%), Kaposi sarcoma,3
cases (14%) and tuberculosis, cerebral toxoplasmosis, cytomegalovirus retinitis, 
and non-Hodgkin lymphoma, 1 case each. Overall, 78% of OE occurred within first 4
months after beginning HAART. In addition, an OE was developed by 8% patients
treated with NRTI and PI, 2% treated with NRTI and NNRTI, and 10% treated with
NRTI,NNRTI and PI (p = 0.44). CONCLUSIONS: HIV-infected subjects with low CD4
counts are prone to develop OE within the first few moths after beginning HAART. 
An inflammatory response to latent antigens due to the immune recovery might
explain this fact.

Publication Types: 
    English Abstract

PMID: 11459574 [PubMed - indexed for MEDLINE]

2724: Rev Clin Esp. 2001 May;201(5):281-2.

[Ramsay-Hunt syndrome]

[Article in Spanish]

Plaza Mayor G, Lopez Estebaranz JL, Lopez Lafuente J, de los Santos Granados G.

Unidad de Otorrinolaringologia, Fundacion Hospital Alcorcon, Madrid.

Publication Types: 
    Case Reports

PMID: 11458801 [PubMed - indexed for MEDLINE]

2725: FDA Consum. 2001 May-Jun;35(3):21-5.

Shingles.

Zamula E.

PMID: 11458545 [PubMed - indexed for MEDLINE]

2726: J Gen Virol. 2001 Aug;82(Pt 8):1959-63.

Multimeric humanized varicella-zoster virus antibody fragments to gH neutralize
virus while monomeric fragments do not.

Drew PD, Moss MT, Pasieka TJ, Grose C, Harris WJ, Porter AJ.

University of Aberdeen, Department of Molecular and Cell Biology, Institute of
Medical Sciences, Foresterhill, Aberdeen AB25 2ZD, UK.

Murine monoclonal antibody 206 (MAb mu206) binds to gH, the varicella-zoster
virus (VZV) fusogen, neutralizing the virus in vitro in the absence of complement
and inhibiting cell-to-cell spread and egress of VZV in cultured cells. We have
humanized this antibody to generate MAb hu206 by complementarity determining
region grafting. MAb hu206 retained binding and in vitro neutralizing activity,
as well as cross-reactivity with ten different VZV strains. Single-chain antibody
fragments (scAb) derived from MAb hu206 were produced in Escherichia coli. These 
scAb retained the binding properties of the whole antibody. However, monomeric
scAb exhibited markedly reduced neutralizing activity compared to the bivalent
parental MAb hu206. Shortening the peptide linker joining the V(H) to the
V(kappa) domain from 14 to 5 or even 0 residues encouraged multimerization and
increased neutralizing efficacy. The fact that Fab fragments enzymatically
generated from whole MAb hu206 lost their neutralizing potency lent support to
the proposal that valency is important for VZV neutralization at this epitope.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11458003 [PubMed - indexed for MEDLINE]

2727: J Microbiol Immunol Infect. 2001 Jun;34(2):138-42.

Comparative study of the efficacy and safety of valaciclovir versus acyclovir in 
the treatment of herpes zoster.

Lin WR, Lin HH, Lee SS, Tsai HC, Huang CK, Wann SR, Chen YS, Chiang SC, Yen MY,
Liu YC.

Department of Medicine, Kaohsiung Veterans General Hospital, Taiwan, ROC.

Acyclovir, a specific and selective inhibitor of the replication of Herpesviridae
family, has well-documented efficacy and tolerability in the treatment of herpes 
zoster. Its limited oral bioavailability and short half-life, however,
necessitates frequent dosing. Valaciclovir, the l-valyl ester of acyclovir, could
be rapidly converted to acyclovir after oral administration, resulting in a
three- to five-fold increase in acyclovir bioavailability compared with oral
acyclovir in humans. Valaciclovir allows less frequent dosing and maintains the
safety profiles of the parent drug. During the period from October 1996 through
May 1998, a randomized, prospective study was performed in the Kaohsiung Veterans
General Hospital to compare the safety and efficacy of valaciclovir with
acyclovir in the treatment of herpes zoster in Taiwanese patients. Patients
presenting with herpes zoster within 72 h after the onset of rash were enrolled
and randomized to receive one of the following treatments: 1000 mg valaciclovir
three times daily for 7 days or acyclovir 800 mg five times daily for 7 days.
Patients were followed up for 29 days beginning with the start of therapy. A
total of 57 patients were enrolled and randomized to receive valaciclovir (n =
32) or acyclovir (n = 25). Five patients in the valaciclovir group and three in
the acyclovir group did not complete the study. The intent-to-treat analysis (57 
patients) showed that valaciclovir significantly accelerated the resolution of
herpes zoster-associated pain compared with acyclovir; on day 29, the
valaciclovir group was 23% superior to the acyclovir group. There was no
clinically significant difference in the nature, frequency or severity of adverse
events between these two groups, although one and three adverse events were
reported in the acyclovir and valaciclovir group, respectively. Thus, we conclude
that in the management of herpes zoster, valaciclovir accelerates the resolution 
of pain and offers a simpler dosing, and maintains the favorable safety profile
of acyclovir.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 11456360 [PubMed - indexed for MEDLINE]

2728: Dermatology. 2001;202(4):336-8.

Zosteriform metastatic skin cancer: report of three cases and review of the
literature.

Kikuchi Y, Matsuyama A, Nomura K.

Department of Dermatology, Aomori Prefectural Central Hospital, Aomori, Japan.
kiku1227@cc.hirosaki-ac.jp

BACKGROUND: Metastatic skin cancer is a rare complication of internal
malignancies. Patients who do develop skin metastases seldom present with a
zosteriform distribution. OBJECTIVE: To elucidate the characteristics of
zosteriform metastatic skin cancer, 15 cases from the medical literature and 3
cases seen in our clinic were reviewed clinically and histopathologically.
METHODS: The age and sex of each patient, site of the primary tumor, pathology of
primary and metastatic lesions, location of the skin cancer and presence of pain 
were determined for the 18 cases of zosteriform skin cancer. RESULTS: The most
frequent site of the primary tumor was the breast (4 cases), ovary or lung (3
cases each), prostate, bladder or stomach (2 cases each) and uterus or colon (1
case each). The most common site of the skin metastases was the chest wall (8
cases) and abdominal wall (7 cases). The histology of the primary lesion was
compatible with adenocarcinoma (10 cases), transitional cell carcinoma or serous 
papillary cystadenocarcinoma (2 cases each) and ductal carcinoma (1 case). Eleven
cases developed on the nearest covering skin and/or on the same side as the
primary tumor. Eleven patients complained of pain. Seven cases were treated as
herpes zoster with antiviral agents. CONCLUSION: Approximately 50% of cases of
metastatic skin cancer developed on the nearest skin covering and on the same
side as the primary tumor. This evidence may be useful when trying to pinpoint
the location of the primary tumor. One third of patients with skin metastases
were misdiagnosed and their lesions were treated initially as herpes zoster. When
a band-like eruption is seen in patients with internal malignancies, the
possibility of metastatic skin lesions should be considered. A skin biopsy is
necessary to confirm the diagnosis. Copyright 2001 S. Karger AG, Basel

Publication Types: 
    Case Reports
    Review

PMID: 11455149 [PubMed - indexed for MEDLINE]

2729: Dermatology. 2001;202(4):302-7.

Acute herpes zoster neuralgia: retrospective analysis of clinical aspects and
therapeutic responsiveness.

Haas N, Holle E, Hermes B, Henz BM.

Department of Dermatology and Allergy, Charite, Campus Virchow, Humboldt
University, Berlin, Germany. norb.haas@charite.de

BACKGROUND: Although the efficacy of modern antiviral agents for the treatment of
herpes zoster is unquestioned, their ability to affect the associated pain
remains controversial. OBJECTIVE: We have therefore evaluated the inpatient
hospital records of 550 patients with herpes zoster with regard to pain-related
clinical aspects and therapeutic responsiveness. METHODS: Intensity of pain was
quantified by calculating a daily pain equivalence index (PEI) on the basis of
different classes of pain medication and the number of tablets used in each
category. RESULTS: The mean age of patients was 66.7 years, cranial segments were
predominantly involved (55%), 64% of patients suffered from associated diseases
and 77% experienced herpes-related pain. The PEI was 0.90 in the entire patient
population, with significantly higher values in women and in patients with 3 or
more associated diseases. It was lower in sacral and cranial nerve involvement,
and it decreased rapidly in patients prior to discharge from hospital. Although
there were significant differences in hospital stay between patients who received
aciclovir and those who did not (mean 20.3 vs. 23.8 days), and for high- versus
low-dose oral or intravenous administration, no significant differences were
noted between the two groups for initial PEI values and during the course of
observation, irrespective of the route of administration or the dose of aciclovir
and the individual patient's PEI value. The groups were otherwise closely similar
with regard to basic demographic and clinical data. 23.3% predominantly aged
female patients with more associated diseases than the total patient population
had a persistently elevated PEI and stayed in hospital beyond 21 days (mean 35.1 
days), representing patients who went on to postherpetic neuralgia. CONCLUSION:
These data further delineate clinical aspects of acute herpes zoster neuralgia,
underline the unsolved therapeutic problems associated with this condition
despite otherwise effective antiviral treatment, and characterise a subgroup of
patients at risk to develop postherpetic neuralgia. Copyright 2001 S. Karger AG, 
Basel

PMID: 11455141 [PubMed - indexed for MEDLINE]

2730: J Dermatol. 2001 Apr;28(4):208-16.

The effects of famciclovir and epidural block in the treatment of herpes zoster.

Ahn HJ, Lim HK, Lee YB, Hwang SM, Lee WS, Ahn SK, Choi EH.

Department of Dermatology, Yonsei University Wonju College of Medicine, 162
Ilsan-Dong, Wonju, Kangwon-Do 220-701, Republic of Korea.

In our previous study, we concluded that an epidural blockade combined with
intravenous acyclovir is very effective in treating the acute pain in herpes
zoster and postherpetic neuralgia. We evaluated the efficacy of oral famciclovir 
and epidural blockade on the pain of herpes zoster, compared to acyclovir
administered intravenously and epidural blockade. For this purpose, we examined a
new group treated with famciclovir and epidural blockade to compare with the
group treated with acyclovir and epidural blockade in our previously study. The
changes in the intensity of pain, the number of days required for relief of pain,
and the total duration of pain were checked. We compared the days required for
relief of pain (DRP) and the total duration of pain (TDP) of this group with
those of the previous studied group treated with acyclovir and epidural blockade.
DRP was significantly less, but TDP was similar. DRP and TDP were significantly
lower, if the patients were treated within 7 days of symptom onset. The patients 
had a shorter DRP regardless of pain type than the previously studied group
treated with acycolvir and epidural blockade. For the severe and moderate pain
grades, there was a shorter DRP from 100 to 10. TDP was not significantly
different for the groups regardless of pain type or grade. We believe that
famciclovir and epidural blockade are very effective in treating the pain of
herpes zoster, with a view to shortening the period of acute pain, providing
similar effects on the prevention of postherpetic neuralgia, and being convenient
to administer, compared to intravenous acyclovir and epidural blockade in our
previous study.

Publication Types: 
    Comparative Study

PMID: 11449672 [PubMed - indexed for MEDLINE]

2731: J Dermatol. 2001 Apr;28(4):200-7.

A specific thrombin inhibitor, argatroban, alleviates herpes zoster-associated
pain.

Fujii K, Kanno Y, Konishi K, Ohgou N.

Department of Dermatology, Kobe City General Hospital, Minatojima-Nakamachi, 4-6,
Kobe 650-0046, Japan.

We report the result of a randomized, controlled, open trial of anti-thrombin
therapy for herpes zoster-associated pain. Fifty-five herpes zoster patients
within 8 days after the onset of skin lesion were enrolled in the trial. Patients
were treated with an optimal dose of oral acyclovir (4000 mg/day for 7 days) with
or without intravenous administration of a specific anti-thrombin agent,
argatroban (10 mg/day, three times a week). Administration of argatroban reduced 
pain intensity at the 4th through 21st day after the initiation of treatment as
determined by visual analogue scale (Mann-Whitney U test, p < 0.05). It also
shortened the median time to cessation of analgesic use (14 days vs. 24 days, p =
0.02, logrank test), although it did not significantly reduce the median time to 
cessation of pain (21 days vs. 43 days, p = 0.07, logrank test). None of the
enrolled patients showed evidence of adverse effects including hemorrhagic
diathesis. The results suggested that relatively low doses of argatroban are
effective in reducing herpes zoster-associated pain. Up-regulation of prothrombin
expression by the vascular endothelial and sweat gland epithelial cells in the
active skin lesion and transient elevation of plasma thrombin-antithrombin III
complex levels in a proportion of patients suggest a lesional generation of
thrombin in herpes zoster. This may be relevant to the beneficial effects of the 
anti-thrombin treatment on the resolution of herpes zoster-associated pain.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 11449671 [PubMed - indexed for MEDLINE]

2732: Ocul Immunol Inflamm. 2001 Jun;9(2):125-30.

Central retinal vein occlusion due to herpes zoster as the initial presenting
sign in a patient with acquired immunodeficiency syndrome (AIDS).

Biswas J, Deka S, Padmaja S, Madhavan HN, Kumarasamy N, Solomon S.

Medical and Vision Research Foundation, Chennai, India. mrf@sankaranethralaya.org

Central retinal vein occlusion (CRVO) due to herpes zoster has rarely been
reported. Varicella zoster virus is a common opportunistic infection in patients 
with AIDS. This case report is about a 40-year-old man with herpes zoster
ophthalmicus and central retinal vein occlusion of the right eye who is
HIV-positive. Although the lesion resolved following treatment with intravenous
acyclovir and oral steroid, the patient subsequently developed florid disc
neovascularization and vitreous hemorrhage. The paper highlights CRVO as the
initial presentation in an AIDS patient with herpes zoster ophthalmicus.

Publication Types: 
    Case Reports

PMID: 11449328 [PubMed - indexed for MEDLINE]

2733: Otol Neurotol. 2001 Jul;22(4):549-53.

Herpes virus reactivation and gadolinium-enhanced magnetic resonance imaging in
patients with facial palsy.

Suzuki F, Furuta Y, Ohtani F, Fukuda S, Inuyama Y.

Department of Otolaryngology, Shinnittetsu Muroran General Hospital, Muroran,
Japan.

OBJECTIVE: This study investigated whether magnetic resonance imaging (MRI)
patterns were different between patients with Bell's palsy and those with
herpetic facial palsy in whom varicella-zoster virus (VZV) or herpes simplex
virus type 1 (HSV-1) reactivation had been confirmed by polymerase chain reaction
(PCR) or serologic assay. STUDY DESIGN: A retrospective study of 15 patients with
acute peripheral facial palsy was performed to compare virologic tests and
gadolinium (Gd)-enhanced MRI findings. RESULTS: Ramsay Hunt syndrome was
diagnosed in one patient. By use of virologic tests, zoster sine herpete (VZV
reactivation without zoster) was diagnosed in four patients and HSV-1
reactivation in three. Bell's palsy was diagnosed in the remaining seven
patients. No significant difference in the frequency of Gd-enhanced MRI was
observed between herpetic facial palsy and Bell's palsy. However, in those
patients who underwent MRI on the day viral reactivation was confirmed by PCR, Gd
enhancement of the meatal fundus was observed infrequently. In addition, when MRI
was performed within 10 days of the onset of palsy, Gd enhancement was not
detected at the geniculate ganglion in any patients with herpetic facial palsy.
By contrast, both the meatal fundus and the geniculate ganglion were enhanced in 
all patients with Bell's palsy, regardless of when MRI was performed with respect
to the onset of palsy. CONCLUSION: This study shows a difference in the pattern
of Gd enhancement at the meatal fundus and the geniculate ganglion between
patients with Bell's palsy and those with herpetic facial palsy. The results
suggest that the meatal fundus or the geniculate ganglion may be affected first
by virus reactivation in patients with herpetic facial palsy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11449115 [PubMed - indexed for MEDLINE]

2734: Otol Neurotol. 2001 Jul;22(4):465-70.

Delayed facial palsy after stapedectomy.

Shea JJ Jr, Ge X.

Shea Ear Clinic, Memphis, Tennessee 38119, USA.

OBJECTIVE: To study the incidence, pathogenesis, and prevention of delayed facial
palsy after stapedectomy. STUDY DESIGN: Retrospective case review. SETTING:
Otology/neurotology referral center. PATIENTS: A series of 2152 stapedectomy
procedures in 2106 patients over 12 years. INTERVENTION: Delayed facial palsy
after stapedectomy was studied. MAIN OUTCOME MEASURE: House-Brackmann facial
nerve grading system and serum antibody titer tests for herpes simplex virus type
I and type II, and varicella zoster virus. RESULTS: Delayed facial palsy occurred
in 11 of 2152 procedures. Delayed facial palsy occurred from 5 to 16 days (mean
8) after stapedectomy. Predisposing factors were bony facial canal dehiscence
with bare or bulging facial nerve herniation in 5 patients; chorda tympani nerve 
stretched, manipulated, or cut in 2 patients; granulomatous reaction to Gelfoam
in 1 patient; fever blisters on the upper lip in 1 patient; and sinusitis in 2
patients. Elevated anti-varicella antibody titers were found in all 6 patients
studied. Anti-herpes simplex type I and II antibody titers were elevated in 5 of 
6 patients. Acyclovir was effective in preventing delayed facial palsy in 1
patient who had undergone revision stapedectomy and experienced delayed facial
palsy after previous stapedectomy in the same ear with elevated anti-herpes
antibody titer. CONCLUSIONS: Delayed facial palsy occurred in 0.51% of patients
after stapedectomy. Serologic investigation suggests activation of latent
herpesvirus. Mechanical irritation of the facial or chorda nerve during operation
may trigger the activation. The anti-herpesvirus agent acyclovir may prevent
delayed facial palsy after stapedectomy in patients suspected of having this
complication.

Publication Types: 
    Case Reports

PMID: 11449101 [PubMed - indexed for MEDLINE]

2735: Am J Epidemiol. 2001 Jul 15;154(2):161-5.

Prevalence of antibodies to four herpesviruses among adults with glioma and
controls.

Wrensch M, Weinberg A, Wiencke J, Miike R, Barger G, Kelsey K.

Department of Epidemiology and Biostatistics, School of Medicine, University of
California, San Francisco, CA 94143-1215, USA. wrensch@itsa.ucsf.edu

The authors previously reported statistically significant inverse associations
between adult onset glioma and histories of chickenpox and shingles among 462
cases and 443 controls in the San Francisco Bay Area Adult Glioma Study
(1991--1995) and a suggestive but nonsignificant inverse association with
immunoglobulin G antibodies to varicella-zoster virus in a small subset of these 
cases. This report considers antibodies to four common herpesviruses (varicella
zoster, herpes simplex, cytomegalovirus, and Epstein Barr) among 134 cases and
165 controls that represent all subjects for whom usable blood specimens were
available. The prevalences of immunoglobulin G antibodies to varicella-zoster
virus, herpes simplex virus, cytomegalovirus, and Epstein-Barr virus were 90%,
71%, 57%, and 90%, respectively. After adjustment for age, White versus non-White
ethnicity, and gender, glioblastoma cases were less likely than controls to have 
immunoglobulin G antibodies to varicella-zoster virus (odds ratio = 0.4; 95%
confidence interval: 0.1, 0.9). They were also somewhat less likely to have
antibodies to Epstein-Barr virus but somewhat more likely to have antibodies to
herpes simplex virus and cytomegalovirus. Antibody prevalences to all four
herpesviruses were similar between cases with other glioma histologies and
controls. These results corroborate our previously suggestive findings of an
inverse association of varicella-zoster virus antibodies with adult onset glioma.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11447050 [PubMed - indexed for MEDLINE]

2736: Intern Med. 2001 Jun;40(6):552.

Guillain-Barre syndrome associated with herpes zoster.

Wakasugi K, Imaizumi T, Nishimura Y, Fujimoto H, Ayabe M, Shoji H, Iijima H.

First Department of Internal Medicine, Kurume University.

Publication Types: 
    Case Reports

PMID: 11446688 [PubMed - indexed for MEDLINE]

2737: Lancet. 2001 Jun 30;357(9274):2101-2.

Molecular diagnosis of visceral herpes zoster.

de Jong MD, Weel JF, van Oers MH, Boom R, Wertheim-van Dillen PM.

Patients with disseminated herpes zoster may present with severe abdominal pain
that results from visceral involvement of varicella-zoster-virus infection. In
the absence of cutaneous eruptions of herpes zoster, visceral herpes zoster is
extremely difficult to diagnose. This diagnostic difficulty has the potential to 
cause devastating delays in treatment. We report a case series of four patients
with visceral herpes zoster in whom large concentrations of DNA from varicella
zoster virus were detectable in blood by PCR before signs of infection appeared
on the skin, thus enabling early diagnosis and treatment.

Publication Types: 
    Case Reports
    Letter

PMID: 11445106 [PubMed - indexed for MEDLINE]

2738: Clin J Pain. 2001 Jun;17(2):110-4.

Comment in:
    Clin J Pain. 2001 Dec;17(4):378-9.

Screening of patients with complex regional pain syndrome for antecedent
infections.

van de Vusse AC, Goossens VJ, Kemler MA, Weber WE.

Pain Management and Research Centre, University Hospital Maastricht, The
Netherlands. vandevusse@doctor.com

OBJECTIVE: This study was designed to investigate whether Complex Regional Pain
Syndrome type I (CRPS I) could be linked to any previous infection. PATIENTS:
Fifty-two patients with CRPS I of one extremity were screened for the presence of
antibodies against mostly neurotropic microorganisms. RESULTS: Of these 52
patients, none had antibodies against Treponema pallidum, Borrelia burgdorferi,
or HTLV-1. Only four patients were positive for Campylobacter jejuni. For
cytomegalovirus, Epstein-Barr virus, herpes simplex virus, and Toxoplasma gondii,
seroprevalences were similar to control values. The total seroprevalence of
Parvovirus B 19 in our CRPS population was 77%, which was significantly higher
than in an independent Dutch population group (59%). Seroprevalence in lower
extremity CRPS 1 (94%) was significantly higher than in upper extremity CRPS I
patients (68%). In this study all patients were seropositive for varicella zoster
virus (VZV) antibodies, but a high prevalence of VZV antibodies is similar to its
prevalence in a normal population (>90%). CONCLUSIONS: In this study we found a
significantly higher seroprevalence of Parvovirus B19 in CRPS I and this is most 
striking in lower extremity CRPS I patients. Further serologic research in other 
geographic areas is needed to provide additional information about a potential
role of Parvovirus B 19 or other microorganisms in the etiopathogenesis of CRPS
I.

PMID: 11444711 [PubMed - indexed for MEDLINE]

2739: Am J Trop Med Hyg. 2001 Mar-Apr;64(3-4):131-6.

Effect of climatic factors and population density on varicella zoster virus
epidemiology within a tropical country.

Lolekha S, Tanthiphabha W, Sornchai P, Kosuwan P, Sutra S, Warachit B,
Chup-Upprakarn S, Hutagalung Y, Weil J, Bock HL.

Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand. rasll@mahidol.ac.th

Blood samples were collected from healthy subjects, aged 9 months-29 years in
urban and rural communities from 4 distinct regions in Thailand, to determine the
seroprevalence rate of varicella-zoster virus (VZV) antibody and its relationship
with demographic, climatic, and socioeconomic factors. The overall seroprevalence
rate was 52.8% and increased from 15.5% in the 9-month to 4-year-old group to
75.9% in the 20-29 year-olds. The age-adjusted seroprevalence was significantly
higher in the cooler than in the warmer regions. In the warmer regions only, the 
age-specific seroprevalence was significantly higher in the urban population than
in the rural population. In Thailand, climate is the main determinant of VZV
seroprevalence. The delayed onset of natural immunity is more marked in warmer
climate areas. Population density is a secondary determinant; in the warmer
areas, the pattern of adolescent and adult susceptibility was greater in rural
than in urban areas.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11442207 [PubMed - indexed for MEDLINE]

2740: Ned Tijdschr Tandheelkd. 2001 Jun;108(6):223-8.

[Vesiculobullous lesions of the oral mucosa]

[Article in Dutch]

Spijkervet FK, Vissink A, Raghoebar GM, van der Waal I.

Uit de kliniek voor Mondziekten, Kaakchirurgie en Bijzondere Tandheelkunde van
het Academisch Ziekenhuis Groningen.

In general practice, the dentist can be confronted with a vesiculobullous lesion 
of the oral mucosa. In many cases the lesion can be classified as recurrent
herpes labialis, but many other causes can induce a vesiculobullous lesion of the
oral mucosa and perioral skin as well. This article gives an overview of the
various vesiculous and bullous lesions of the oral mucous membranes. Special
attention is given to the possible causes and their treatment.

Publication Types: 
    English Abstract
    Review

PMID: 11441714 [PubMed - indexed for MEDLINE]

2741: Ir J Med Sci. 2001 Jan-Mar;170(1):69-70.

Coma secondary to aciclovir neurotoxicity.

Loughrey J, Coleman P, Donohue J, Marsh B.

Department of Anaesthesia and Intensive Care Medicine, Master Misercordiae
Hospital, Dublin, Ireland. jloughrey@eircom.net

Publication Types: 
    Case Reports

PMID: 11440418 [PubMed - indexed for MEDLINE]

2742: Infection. 2001 May-Jun;29(3):143-7.

Nosocomial Kikuchi's disease--a search for herpesvirus sequences in lymph node
tissues using PCR.

Martinez-Vazquez C, Potel C, Angulo M, Gonzalez-Carrero J, Alvarez M, Tenorio A, 
Cid D, Oliveira I.

Division of Infectious Diseases, Hospital Xeral de Vigo, Universidad de Santiago,
Spain. carmenpotel@airtel.net

BACKGROUND: Histiocytic necrotizing lymphadenitis, also known as Kikuchi's
disease (KD), is a rare disease. Fever and lymphadenopathies with characteristic 
pathologic features are present. The etiology of this disease remains
undetermined. Since the disorder is self-limiting, different viruses have been
implicated as the causative agent. PATIENTS AND METHODS: Seven cases of KD were
studied. Three patients acquired the disease nosocomially, three had
community-acquired KD and one case was associated with systemic lupus
erythematosus. PCR was performed on DNA extracted from lymph node tissues in
order to detect herpesvirus-specific DNA sequences: herpes simpLex virus type 1
and 2 (HSV1-2), varicella zoster virus (VZV), human cytomegalovirus (HCMV), human
herpesvirus 6 (HHV6), Epstein-Barr virus (EBV) and human herpesvirus 8 (HHV8).
RESULTS: Viral DNA was not detected in any of the lymph node tissues from the
seven cases of KD. CONCLUSION: We conclude that these herpesviruses were not
involved in the etiology of the three cases of nosocomial KD, nor in the other
four cases of KD investigated in this study.

PMID: 11440384 [PubMed - indexed for MEDLINE]

2743: South Med J. 2001 Jun;94(6):655.

Choreiform movements in dialysis patient taking valacyclovir and famciclovir.

Maru MC, Fialkow RZ, Haria DM.

Publication Types: 
    Case Reports
    Letter

PMID: 11440337 [PubMed - indexed for MEDLINE]

2744: Scand J Infect Dis. 2001;33(5):398-9.

Comment on:
    Scand J Infect Dis. 2000;32(3):263-9.

Varicella-zoster virus meningitis and cerebrospinal fluid HIV RNA.

Moling O, Rossi P, Rimenti G, Vedovelli C, Mian P.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 11440237 [PubMed - indexed for MEDLINE]

2745: Am J Ophthalmol. 2001 Jul;132(1):117-20.

Progressive outer retinal necrosis syndrome in a lymphoma patient with good
visual outcome.

Foster RE, Petersen MR, Neuss MN, Osher RH.

Cincinnati Eye Institute, Cincinnati, Ohio 45242, USA. refcei@cintieye.com

PURPOSE: To report an HIV-negative lymphoma patient who developed progressive
outer retinal necrosis syndrome and who had a good visual outcome after treatment
with two-drug antiviral therapy and intravenous immunoglobulin. METHODS: Case
report. RESULTS: A 43-year-old man with small lymphocytic lymphoma was diagnosed 
with progressive outer retinal necrosis in his left eye. Treatment was initiated 
with intravenous foscarnet and ganciclovir as well as intravenous gammaglobulin
at a dose of 0.5 gm/kg per day for 5 days. On the second hospital day he was
started on decadron 4 mg orally four times daily. No further posterior retinitis 
progression was observed despite severe immunosuppression. Visual acuity remained
stable at 20/30 with 10 months' follow-up. CONCLUSIONS: The benefit of using
gammaglobulin in progressive outer retinal necrosis is unknown. Given the rapid
improvement seen in this patient's retinitis, it may be reasonable to consider
the use of gammaglobulin in other cases of infectious retinitis in
immunocompromised patients.

Publication Types: 
    Case Reports

PMID: 11438070 [PubMed - indexed for MEDLINE]

2746: Ann Rheum Dis. 2001 Jul;60(7):719.

A case of shingles mimicking carpal tunnel syndrome.

Wilson H, Hamilton J, Madhok R.

Publication Types: 
    Case Reports
    Letter

PMID: 11436859 [PubMed - indexed for MEDLINE]

2747: J Dermatol. 2001 May;28(5):256-8.

Palpable purpura at the site of previous herpes zoster in association with mixed 
cryoglobulinemia and hepatitis C virus infection.

Cecchi R, Giomi A, Paoli S.

Department of Dermatology, Spedali Riuniti, 51100, Pistoia, Italy.

A 70-year-old woman affected with chronic active hepatitis C and mixed
cryoglobulinemia presented a palpable purpura on her abdominal skin in a
metameric configuration, fourteen months after a herpes zoster in the same site. 
Histopathology showed a small vessel leukocytoclastic vasculitis in the
superficial dermis. Post-zoster eruptions are variable, and their spectrum is
still expanding, although the pathogenesis remains to be elucidated. Perhaps our 
case represents an isomorphic reaction, because this palpable purpura, probably
related to HCV infection, occurred several months after herpes zoster.

Publication Types: 
    Case Reports

PMID: 11436363 [PubMed - indexed for MEDLINE]

2748: Allergol Immunopathol (Madr). 2001 May-Jun;29(3):113-8.

[Common variable immunodeficiency. Review]

[Article in Spanish]

Iglesias Alzueta J, Matamoros Flori N.

Servicio de Inmunologia, Hospital Son Dureta, Palma de Mallorca, Espana.

Common variable immunodeficiency (CVI) is a primary immunodeficiency
characterized by deficient antibody production. The cause of this
immunodeficiency is unknown; several in vitro studies have revealed a significant
number of alterations that could explain the hypogammaglobulinemia present in
this syndrome. Among those described are primary B cell alterations, numerical
and functional T cell abnormalities, and defects in the interaction between
accessory cells. The alteration typical of CVI is the failure of B lymphocytes to
differentiate from antibody-producing cells, resulting in deficient
immunoglobulin secretion. Among the T cell abnormalities described are a
diminished proliferative response to mitogens and antigens, alterations in the
level of production of several cytokines, especially reduction in the production 
of IL-2, diminished antigen-specific T cells and increase basal apoptosis after
stimulation. Antigen presenting cells, monocytes and dendritic cells can also
present alterations and contribute to deficient antigen response. The clinical
manifestations of these patients is variable; most present recurrent bacterial
infections due to encapsulated bacteria, especially sinusitis, otitis,
bronchitis, and pneumonias. A few patients can present mycobacterial or fungal
infection and occasionally Pneumocystis carinii. Viral infection is uncommon in
these patients although some suffer recurrent herpes zoster infection. Clinical
features of septicemia and central nervous system infections are less frequent.
The incidence of digestive tract infections in these patients is high. The most
common cause of diarrhea is Giardia lamblia; Salmonella, Shigella and
Campylobacter are also common pathogens. Autoimmune disease is also more
prevalent in these patients than in the general population. The most frequently
associated diseases are hemolytic anemia, idiopathic thrombocytopenic purpura and
autoimmune neutropenia. Cancer is also frequently associated with CVI, the most
common forms being lymphoproliferative syndromes, especially non-Hodgkin's
lymphoma. Granulomas are a unusual manifestation in some patients with CVI; their
localization varies but the most commonly affected organs are the spleen and
lungs. Some authors have compared these granulomas with those characterizing
sarcoidosis, especially when appearing in the lung. Diagnosis of CVI is usually
by exclusion of other diseases, such as cystic fibrosis, immotile cilia syndrome 
or allergic processes. CVI should be suspected in all patients with recurrent
bacterial infections especially those localized in the respiratory tract. Other
primary immunodeficiencies which present clinical findings similar to CVI and
which should be ruled out are selective IgG subclass deficiency, IgA deficiency
and selective deficiency in the response to polysaccharide antigens with normal
immunoglobulin levels. The serum hypogammaglobulinemia present in all patients
with CVI provides the diagnostic key. The age at which clinical manifestations
appear, the absence of familial antecedents and the presence of circulating B
lymphocytes form the basis of the differential diagnosis between X-linked
agammaglobulinemia and autosomal recessive forms. The treatment of choice of
patients with CVI is treatment with human gamma-globulin. Currently, the most
common route of administration is intravenous; these molecules have a half-life
of approximately 21 days and a high degree of safety concerning the possible
transmission of viral infections. Adverse reactions are generally few and
clinically unimportant. The most frequently used doses oscillate between 200 and 
400 mg/kg body weight every 2-4 weeks. Both the dose and its frequency should be 
personalized for each patient. Early diagnosis of patients with CVI, application 
of treatment with appropriate antibiotics for infections and treatment with
gamma-globulins prevent long-term complications of this disease and dramatically 
improve the quality of life and life expectancy of these patients.

Publication Types: 
    English Abstract
    Review

PMID: 11434884 [PubMed - indexed for MEDLINE]

2749: Rinsho Shinkeigaku. 2001 Jan;41(1):56-9.

[A case with trigeminal herpes zoster manifesting a long lesion of the spinal
trigeminal nucleus and tract on MR T2-weighted image]

[Article in Japanese]

Nagane Y, Utsugisawa K, Yonezawa H, Tohgi H.

Department of Neurology, Iwate Medical University Morioka, Japan.

We reported a 53-year-old man with the right trigeminal herpes zoster with
preceding neuralgia (preherpetic neuralgia) in the right upper cervical nerve
area. He developed dysesthesia and scapular pain in the right second cervical
nerve area. 5 days later, herpes zoster emerged in the area of the right
maxillary division of trigeminal nerve. Furthermore, he developed paralysis on
the right facial muscle on the 12th day after the onset of scapular pain.
Neurological examination revealed decrease in superficial sensation accompanied
by pain and dysesthesia in the areas innervated by the right maxillary division
of trigeminal nerve and the right second cervical nerve, and the right peripheral
facial nerve palsy. Any rash was not observed in the right second cervical nerve 
area throughout the course. The cerebrospinal fluid showed a mild mononuclear
pleocytosis. The antibody titer for varicella zoster virus (VZV) was elevated in 
both cerebrospinal fluid and blood serum. T2-weighted magnetic resonance (MR)
image revealed a continuously long high-signal lesion corresponding to the right 
spinal trigeminal nucleus and tract, extending from the lower pons to the second 
cervical segment of the spinal cord. This lesion could have resulted from a
centripetal migration of VZV from the Gasser ganglion to the spinal trigeminal
nucleus and tract, which was probably related to the preherpetic neuralgia in the
upper cervical nerve area without rash.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11433769 [PubMed - indexed for MEDLINE]

2750: J Cataract Refract Surg. 2001 Jun;27(6):805-10.

Consultation section. Cataract surgery problem.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 11432391 [PubMed - indexed for MEDLINE]

2751: Aust Fam Physician. 2001 May;30(5):417.

Transmission of chickenpox from Varicella zoster vaccination is possible.

To E.

Publication Types: 
    Case Reports
    Letter

PMID: 11432009 [PubMed - indexed for MEDLINE]

2752: Hautarzt. 2001 Jun;52(6):554-73.

[Therapy of varicella zoster and herpes simplex virus-induced diseases. 2:
References for implementing and indications for virustatic therapy]

[Article in German]

Mahler V, Schuler G.

Dermatologische Universitatsklinik, Erlangen.

Publication Types: 
    Review

PMID: 11428090 [PubMed - indexed for MEDLINE]

2753: Hautarzt. 2001 Jun;52(6):492-8.

[Development of the German Scale for Assessing Quality of Life in Skin Diseases]

[Article in German]

Schafer T, Staudt A, Ring J.

MPH, Klinik und Poliklinik fur Dermatologie und Allergologie der Technischen
Universitat Munchen, Biedersteiner Strasse 29. tschafer@lrz.tum.de

BACKGROUND AND OBJECTIVE: A German dermatological quality-of-life (QoL)
instrument was developed on the basis of a representative and standardised
patient population. PATIENTS/METHODS: Qualitative interviews were performed in
633 patients. Based on the answers of 20 patients from each of the 10 most
frequent diagnostic groups, items were identified and a questionnaire developed. 
This was used in 704 patients and eventually the number of items was reduced.
RESULTS: The long version of the instrument has 72 items. The median of the total
score of the questionnaire was 75 and significantly different between diagnostic 
groups (herpes/shingles 110, verruca 26; p < 0.001). Significant differences
occurred also between questionnaire domains with categories "psychological,
physical, and treatment" showing the highest results. In contrast to the total
group, patients with urticaria scored highest in dimensions "social, leisure, and
work" (p < 0.001). By factor analysis the number of items was reduced to 36.
CONCLUSIONS: The DIELH was developed on the basis of a standardised and
representative patient population. The long version proved to have a good
discriminant validity with respect to diagnostic groups and dimensions.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 11428077 [PubMed - indexed for MEDLINE]

2754: Clin Diagn Lab Immunol. 2001 Jul;8(4):850-1.

Spinal cord involvement in uncomplicated herpes zoster.

Steiner I, Steiner-Birmanns B, Levin N, Hershko K, Korn-Lubetzki I, Biran I.

Department of Neurology, Hadassah University Hospital, Jerusalem, Israel.
isteiner@md2.huji.ac.il

We prospectively evaluated herpes zoster patients during the acute phase of the
disease for central nervous system involvement. Of 24 patients with spinal
zoster, 13 (54%) had spinal cord abnormality, which was asymptomatic in 12 of the
13. Age but not lack of acyclovir treatment was associated with such involvement.
In all but 2, neurological involvement resolved within 6 months. Although the
mechanism responsible for the neurological abnormalities is unknown, findings may
support the hypothesis that zoster is associated with spread of viral infection
into the spinal cord and therefore support the possibility that zoster is due to 
active viral replication in the ganglion.

PMID: 11427442 [PubMed - indexed for MEDLINE]

2755: Rev Mal Respir. 2001 Apr;18(2):125-35.

[Respiratory infections during chemotherapy-induced aplasia]

[Article in French]

Aoun M, Klastersky J.

Laboratoire de Microbiologie et Departement des Maladies Infectieuses, Service de
Medecine Interne, Institut Jules Bordet, Rue Heger-Bordet 1, 1000 Bruxelles,
Belgique. nathalie.cardinal@bordet.be

Damage to local and systemic host defenses of the lung makes the
immunocompromised patient vulnerable to inhaled microorganisms. When a pulmonary 
infiltrate occurs, the array of possibilities is very large including
conventional and opportunistic agents. The type of underlying disease and its
associated immunodeficiency allow a high degree of accurate pathogen prediction. 
Neutropenia is associated with Gram-negative bacilli pneumonia. Prolonged
neutropenia increases the risk of invasive aspergillosis and other unusual
mycotic agents. Cellular immunodeficiency is associated with intracellular
microorganisms including Mycobacteria spp., Nocardia spp., Legionella spp.,
Rhodococcus equi, cytomegalovirus, Strongyloides stercoralis, Toxoplasma gondii, 
Histoplasma capsulatum, Coccidioides spp., Cryptococcus neoformans and
Pneumocystis carinii, parasites such as Toxoplasma gondii and Strongyloides
stercoralis, and virus such as cytomegalovirus, Herpes simplex or zoster,
adenovirus, respiratory syncitial virus and measles. Humoral immunodeficiency
predisposes to infection with encapsulated pathogens such as S. pneumoniae and
Haemophilus influenzae. Chest computerized tomography scan and bronchoalveolar
lavage are essential procedures for diagnosis. However, despite continuous
progress in diagnostic methods, the specific etiology remains often unknown.
Successful treatment depends on the type of pathogen, status of host defences and
early adequate choice of antibiotic. Enhancement of host defences with growth
factors and cytokines may decrease the incidence and improve the final outcome of
respiratory infections in the immunocompromised host.

Publication Types: 
    English Abstract
    Review

PMID: 11424709 [PubMed - indexed for MEDLINE]

2756: Masui. 2001 May;50(5):548-51.

[Treatment with stellate ganglion block, continuous epidural block and ulnar
nerve block of a patient with postherpetic neuralgia who developed complex
regional pain syndrome (CRPS)]

[Article in Japanese]

Mizuno J, Sugimoto S, Ikeda M, Kamakura T, Machida K, Kusume S.

Department of Anesthesia, Kochi Prefectural Aki Hospital, Aki 784-0027.

We present a case of a 46-year-old female patient with systemic lupus
erythematosus who developed herpes zoster of the right eighth cervical nerve. Her
whole right forearm, hand and the first through fifth fingers were coated with
some gel and protected against pain. She had been suffering from continuous and
spasmodic burning pain, hyperalgesia, allodynia, drop in skin temperature,
sudmotor disturbance, edema, constructure of the joints, muscle atrophy and bone 
atrophy of her right upper extremity probably due to postherpetic neuralgia (PHN)
associated with complex regional pain syndrome (CRPS). She received right
stellate ganglion block (SGB), continuous cervical epidural block and right ulnar
nerve block. Reduction of pain and edema as well as improvement in mobility of
each joint of her right upper extremity was observed. We suspect that SGB,
continuous cervical epidural block and ulnar nerve block are effective and useful
alternative treatments in a patient with PHN associated with CRPS of the eighth
cervical nerve.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11424478 [PubMed - indexed for MEDLINE]

2757: Pediatr Transplant. 2001 Jun;5(3):153-9.

Varicella-zoster infection in pediatric solid-organ transplant recipients: a
hospital-based study in the prevaricella vaccine era.

Pandya A, Wasfy S, Hebert D, Allen UD.

The Department of Pediatrics, Divisions of Infectious Diseases,The Hospital for
Sick Children, University of Toronto, Toronto, Ontario, Canada.

We reviewed 58 cases of varicella-zoster infection that occurred between 1988 and
1998 in 47 pediatric solid-organ transplant recipients. The median age of
patients at the time of admission with varicella-zoster infection was 8.0 yr
(range 1-17 yr). The median interval between transplantation (Tx) and
varicella-zoster virus (VZV) infection was 1.6 yr (range 0.06-9.3 yr). Varicella 
infection occurred at a rate of one case for every seven transplant recipients.
Among the 58 cases of VZV infection, 53% were varicella while 47% were
herpes-zoster. Varicella infection occurred despite treatment with
varicella-zoster immune globulin (VZIG) in 17 of 31 cases of varicella infection.
However, the disease was generally mild with severe disease occurring in only two
patients. One patient (1.7%) died as a result of bacterial sepsis. There was no
significant relationship between VZV infection and specific immune suppressants. 
Episodes of rejection were more likely to be temporally associated with the
occurence of herpes zoster than with varicella infection (p = 0.02). The data
generated provide useful background information in our population in the
prevaricella vaccine era.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11422816 [PubMed - indexed for MEDLINE]

2758: Int J Dermatol. 2001 Mar;40(3):191-2.

Two cases of reactive perforating collagenosis arising at the site of healed
herpes zoster.

Lee HN, Lee DW, Lee JY, Cho BK.

Department of Dermatology, College of Medicine, The Catholic University of Korea,
Seoul, South Korea.

Publication Types: 
    Case Reports

PMID: 11422523 [PubMed - indexed for MEDLINE]

2759: J Clin Virol. 2001 Aug;22(1):73-89.

Antiviral drugs: current state of the art.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven,
Minderbroedersstraat 10, B-3000, Leuven, Belgium.
erik.declercq@rega.kuleuven.ac.be

The chemotherapy of virus infections has definitely come of age. There are now 15
antiviral agents that have been formally licensed for the treatment of human
immunodeficiency virus infections (zidovudine, didanosine, zalcitabine,
stavudine, lamivudine, abacavir, nevirapine, delavirdine, efavirenz, saquinavir, 
ritonavir, indinavir, nelfinavir, amprenavir, lopinavir) and several others, such
as tenofovir disoproxil, emtricitabine, capravirine, emivirine, T-20
(pentafuside) and AMD3100 (bicyclam) are under clinical development. Lamivudine
has been approved, and several other compounds (such as adefovir dipivoxil,
emtricitabine and entecavir) are under clinical development, for the treatment of
hepatitis B virus infections. Among the anti-herpesvirus agents, aciclovir,
valaciclovir, penciclovir, famciclovir, idoxuridine, trifluridine and brivudin
are used in the treatment of herpes simplex virus and varicella-zoster virus
infections, and ganciclovir, foscarnet, cidofovir, fomivirsen and maribavir (the 
latter in the developmental stage) are used in the treatment of cytomegalovirus
infections. Following amantadine and rimantadine, the neuraminidase inhibitors,
zanamivir and oseltamivir, have now become available for the therapy and
prophylaxis of influenza virus infections, and so is ribavirin for the treatment 
of respiratory syncytial virus infections and the combination of ribavirin with
interferon-alpha for the treatment of hepatitis C virus infections.

PMID: 11418355 [PubMed - indexed for MEDLINE]

2760: Am J Med Sci. 2001 Jun;321(6):372-80.

Zoster in patients infected with HIV: a review.

Vafai A, Berger M.

Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
abv4@cdc.gov

Varicella-zoster virus (VZV), a member of the human herpesvirus family, causes
childhood chickenpox (varicella), becomes latent in sensory ganglia, and
reactivates years later in immunocompromised and elderly persons to produce
shingles (herpes zoster). Early in the AIDS epidemic, zoster was noted in adults 
and children infected with HIV. Severe and debilitating zoster-associated
dermatological, ophthalmic, and neurological complications may occur in patients 
infected with HIV. Antiviral therapy can modify the duration of zoster and
alleviate its attendant complications. Varicella vaccine may boost the immunity
and prevent virus reactivation. VZV immune globulin (VZIG) prevents or modifies
clinical illness in persons who have been exposed to varicella or zoster.

Publication Types: 
    Review

PMID: 11417752 [PubMed - indexed for MEDLINE]

2761: Prog Drug Res. 2001;56:77-120.

Current and potential therapies for the treatment of herpesvirus infections.

Villarreal EC.

Eli Lilly and Company, Infectious Diseases Research, Drop Code 0438, Lilly
Research Laboratories, Indianapolis, IN 46285, USA. villarreal_elcira_c@lilly.com

Human herpesviruses are found worldwide and are among the most frequent causes of
viral infections in immunocompetent as well as in immunocompromised patients.
During the past decade and a half a better understanding of the replication and
disease causing state of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2),
varicella-zoster virus (VZV), and human cytomegalovirus (HCMV) has been achieved 
due in part to the development of potent antiviral compounds that target these
viruses. While some of these antiviral therapies are considered safe and
efficacious (acyclovir, penciclovir), some have toxicities associated with them
(ganciclovir and foscarnet). In addition, the increased and prolonged use of
these compounds in the clinical setting, especially for the treatment of
immunocompromised patients, has led to the emergence of viral resistance against 
most of these drugs. While resistance is not a serious issue for immunocompetent 
individuals, it is a real concern for immunocompromised patients, especially
those with AIDS and the ones that have undergone organ transplantation. All the
currently approved treatments target the viral DNA polymerase. It is clear that
new drugs that are more efficacious than the present ones, are not toxic, and
target a different viral function would be of great use especially for
immunocompromised patients. Here, we provide an overview of the diseases caused
by the herpesviruses as well as the replication strategy of the better studied
members of this family for which treatments are available. We also discuss the
various drugs that have been approved for the treatment of some herpesviruses in 
terms of structure, mechanism of action, and development of resistance. Finally, 
we present a discussion of viral targets other than the DNA polymerase, for which
new antiviral compounds are being considered.

Publication Types: 
    Review

PMID: 11417115 [PubMed - indexed for MEDLINE]

2762: Virology. 2001 Jun 20;285(1):42-9.

VZV gB endocytosis and Golgi localization are mediated by YXXphi motifs in its
cytoplasmic domain.

Heineman TC, Hall SL.

Division of Infectious Diseases and Immunology, St. Louis University School of
Medicine, St. Louis, Missouri 63110-0250, USA. heinemtc@slu.edu

The cytoplasmic domains of many membrane proteins contain sorting signals that
mediate their endocytosis from the plasma membrane. VZV gB contains three
consensus internalization motifs within its cytoplasmic domain: YMTL (aa
818-821), YSRV (aa 857-860), and LL (aa 841-842). To determine whether VZV gB is 
internalized from the plasma membrane, and whether these motifs are required for 
its endocytosis, we compared the internalization of native gB to that of gB
containing mutations in each of the predicted internalization motifs. VZV gB
present on the surface of transfected cells associated with clathrin and was
efficiently internalized to the Golgi apparatus within 60 min at 37 degrees C.
VZV gB containing the mutation Y857 failed to be internalized, while gB-Y818A was
internalized but did not accumulate in the Golgi. These data indicate that the
internalization of VZV gB, and its subsequent localization to the Golgi, is
mediated by two tyrosine-based sequence motifs in its cytoplasmic domain.
Copyright 2001 Academic Press.

PMID: 11414804 [PubMed - indexed for MEDLINE]

2763: Acta Derm Venereol. 2001 Jan-Feb;81(1):59-60.

Famciclovir in treatment of acute herpes zoster: results of two post-marketing
surveillance studies in Germany.

Engst R, Schiewe U, Hobel W, Machka K, Meister W.

Publication Types: 
    Letter

PMID: 11411921 [PubMed - indexed for MEDLINE]

2764: Pain. 2001 Jul;93(1):1-5.

Zoster-associated pain and neural dysfunction.

Rowbotham MC, Petersen KL.

Department of Neurology, University of California, UCSF Pain Clinical Research
Center, 1701 Divisadero Street, Suite 480, San Francisco, CA 94115, USA.
mcrwind@ista.ucsf.edu

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11406332 [PubMed - indexed for MEDLINE]

2765: Arch Dermatol. 2001 Jun;137(6):789-90.

A population-based estimate of the prevalence of postherpetic neuralgia after
herpes zoster.

Bigby M.

Department of Dermatology, Harvard Medical School and Beth Israel Deaconess
Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.

PMID: 11405773 [PubMed - indexed for MEDLINE]

2766: Hautarzt. 2001 May;52(5):464-71; quiz 471.

[Therapy of varicella zoster and herpes simplex virus-induced diseases. 1:
Virustatic agents]

[Article in German]

Mahler V, Schuler G.

Dermatologische Universitatsklinik, Hartmannstrasse 14, 91052 Erlangen.
Vera.Mahler@derma.med.uni-erlangen.de

PMID: 11405170 [PubMed - indexed for MEDLINE]

2767: Brain. 2001 Jul;124(Pt 7):1325-35.

Intrathecal antibody production against Chlamydia pneumoniae in multiple
sclerosis is part of a polyspecific immune response.

Derfuss T, Gurkov R, Then Bergh F, Goebels N, Hartmann M, Barz C, Wilske B,
Autenrieth I, Wick M, Hohlfeld R, Meinl E.

Department of Neuroimmunology, Max-Planck-Institute of Neurobiology, Martinsried,
Germany.

Chronic intrathecal immunoglobulin (Ig) production is a hallmark of multiple
sclerosis characterized by the presence of oligoclonal IgGs and, in addition,
polyspecific recognition of different pathogens such as measles, rubella and
herpes zoster virus. While the antigen specificity of the oligoclonal IgGs in
multiple sclerosis is largely unknown, the oligoclonal IgGs arising during CNS
infectious diseases are reactive against the specific pathogen. Recently, a link 
between Chlamydia pneumoniae and multiple sclerosis has been claimed. To test the
possible role of C. pneumoniae in multiple sclerosis, we analysed (i) whether
there is intrathecal IgG production against C. pneumoniae in multiple sclerosis
and (ii) if the oligoclonal IgGs in the CSF of multiple sclerosis patients
recognize C. pneumoniae. By studying paired serum-CSF samples from 120 subjects
(definite multiple sclerosis, 46; probable multiple sclerosis, 12; other
inflammatory neurological diseases, 35; other neurological diseases, 27) by
enzyme-linked immunosorbent assay, we found that 24% of all patients with
definite multiple sclerosis, but only 5% of patients with other inflammatory or
non-inflammatory diseases, produced IgGs specific for C. pneumoniae intrathecally
(definite multiple sclerosis versus other inflammatory neurological diseases: P =
0.027). The presence of intrathecal IgGs to C. pneumoniae was independent of the 
duration of disease and relatively stable over time. The major CSF oligoclonal
IgG bands from multiple sclerosis patients with an intrathecal Ig production to
C. pneumoniae did not react towards purified elementary bodies and reticulate
bodies of C. pneumoniae on affinity-mediated immunoblot following isoelectric
focusing (IEF-western blots). In contrast, the IgGs in the CSF of control
patients with neuroborreliosis strongly reacted with their specific pathogen,
Borrelia burgdorferi, by IEF-western blot analysis. Concomitant analysis of the
CSF of 23 patients with a nested polymerase chain reaction for C. pneumoniae was 
negative in all cases. Together, our findings strongly suggest that the immune
response to C. pneumoniae is part of a polyspecific intrathecal Ig production, as
is commonly observed with other pathogens. This argues against a specific role
for C. pneumoniae in multiple sclerosis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11408328 [PubMed - indexed for MEDLINE]

2768: Antimicrob Agents Chemother. 2001 Jul;45(7):2044-53.

Effect of famciclovir on herpes simplex virus type 1 corneal disease and
establishment of latency in rabbits.

Loutsch JM, Sainz B Jr, Marquart ME, Zheng X, Kesavan P, Higaki S, Hill JM,
Tal-Singer R.

Department of Ophthalmology, LSU Eye Center, Louisiana State University Health
Sciences Center, New Orleans, Louisiana 70112-2234, USA. jlouts@lsuhsc.edu

Famciclovir (FCV) is efficacious in the treatment of acute herpes zoster and
recurrent genital infections but has not been used to treat ocular herpes simplex
virus (HSV) infections. We evaluated the efficacy of orally administered FCV in
treating HSV-1 epithelial keratitis and determined its effects on the
establishment of latency and subsequent reactivation. Rabbits were inoculated
with HSV-1 strain 17 syn+ and treated twice daily with increasing concentrations 
of FCV (60 to 500 mg/kg of body weight). This resulted in a significant,
dose-dependent improvement in keratitis scores, as well as prolonged survival.
Regardless of the dose of drug used, all groups exhibited the high rates of
spontaneous and induced reactivation characteristic of 17syn+. The efficacy of
250 mg of FCV per kg was also compared to topical treatment with 1%
trifluorothymidine (TFT). Although TFT treatment was more effective at reducing
eye disease, FCV-treated rabbits had a better survival rate. Real-time
quantitative PCR analysis of rabbit trigeminal ganglia (TG) demonstrated that FCV
significantly reduced the HSV-1 copy number compared to that after treatment with
TFT or the placebo but not in a dose-dependent manner. In summary, oral FCV
treatment significantly reduces the severity of corneal lesions, reduces the
number of HSV-1 genomes in the TG, improves survival, and therefore may be
beneficial in reducing the morbidity of HSV keratitis in the clinic.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11408221 [PubMed - indexed for MEDLINE]

2769: Ann Otol Rhinol Laryngol. 2001 Jun;110(6):581-4.

Bell's palsy: electrodiagnostics are not indicative of cerebrospinal fluid
abnormalities.

Birkmann C, Bamborschke S, Halber M, Haupt WF.

Department of Neurology, University of Cologne, Germany.

Electrodiagnostic testing (electromyography, electroneuronography, and blink
reflex) and cerebrospinal fluid (CSF) examination (cell count, immunoglobulins,
and antigen-specific intrathecal immunoglobulin G synthesis against herpes
simplex virus, varicella zoster virus, cytomegalovirus, and Borrelia burgdorferi 
sensu latu) were performed in 56 patients with Bell's palsy. The CSF was normal
in 45 patients and abnormal in 11 patients. Acute borreliosis was the most common
specific pathological CSF finding (4 of 11). Electromyography revealed abolished 
volitional activity in 22% of patients with normal CSF and in 36% with
pathological CSF. Electroneuronographic tests with an amplitude decrease of more 
than 90% on the affected side or abolished responses were found in 20% of
patients with normal CSF and in 18% with pathological CSF. Abolished orbicularis 
oculi reflexes were seen in 67% of patients with normal CSF and in 82% with
pathological CSF Concerning electrodiagnostic testing, no statistically
significant difference between patients with normal and abnormal CSF was found,
so we conclude that electrodiagnostic testing has no indicative value for
abnormal CSF in Bell's palsy.

PMID: 11407851 [PubMed - indexed for MEDLINE]

2770: Ophthalmologe. 2001 May;98(5):456-9.

[Analysis of the aqueous humor in keratoplasty patients with keratitis. Initial
results]

[Article in German]

Liekfeld A, Jaeckel C, Pleyer U, Robert PY, Hartmann C.

Augenklinik, Universitatsklinikum Charite, Campus Virchow-Klinikum,
Humboldt-Universitat, Augustenburger Platz 1, 13353 Berlin.
anja.liekfeld@charite.de

OBJECTIVE: Herpetic keratitis is a common indication for corneal transplantation.
In this patient group especially, there is a relatively high risk of graft
failure, partly because of viral recurrence. It can be difficult to clinically
distinguish stromal herpetic recurrence from early endothelial allograft
rejection. Also a perioperative observation of viral activity seems advisable
because of therapeutic consequences. For these reasons we use aqueous humor
analysis in certain corneal transplant patients to determine intraocular antibody
production. The aim of this study was to evaluate the diagnostic value of such an
analysis of aqueous humor. MATERIAL AND METHODS: A total of 28 samples of aqueous
humor were obtained from 24 eyes and all samples were tested for antibodies
against herpes simplex virus (HSV), most samples (26/28) were tested for
antibodies against varizella zoster virus (VZV) and some samples (6/28) for
antibodies against cytomegalovirus. We used a modified micro-ELISA technique to
detect intraocular IgG production. RESULTS: In 14 samples (50%) we found
antibodies against HSV, in 7 samples (25%) against HSV and VZV, in 1 sample
(3.6%) against VZV and 6 samples (21.4%) were negative for all antibodies tested.
CONCLUSION: The results of aqueous humor analysis led to a specific local or
systemic antiviral therapy perioperatively or in the case of postoperative
recurrence of herpetic keratitis in most patients. Some patients could be spared 
long-term treatment with antiviral agents because of negative results in the
aqueous humor analysis.

Publication Types: 
    English Abstract

PMID: 11402827 [PubMed - indexed for MEDLINE]

2771: MMW Fortschr Med. 2001 May 17;143(20):14.

[Post-zoster neuralgia. Local acetylsalicylic acid stops pain for 5 hours]

[Article in German]

Koch HJ, Raschka C.

Psychiatrische Universitatsklinik RegensburgUniversitatsstrabetae 84 D-93053
Regensburg.

Publication Types: 
    Letter

PMID: 11400601 [PubMed - indexed for MEDLINE]

2772: J Emerg Med. 2001 Jul;21(1):67-8.

Scalp necrosis and visual loss due to giant cell arteritis.

Bhatti MT.

Department of Ophthalmology, University of Florida College of Medicine,
Gainesville, FL 32610-0284, USA.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 11399393 [PubMed - indexed for MEDLINE]

2773: Ann Dermatol Venereol. 2001 Apr;128(4):497-501.

[Herpes zoster: incidence study among "sentinel" general practitioners]

[Article in French]

Czernichow S, Dupuy A, Flahault A, Chosidow O.

Unite d Biostatisique et Informatique Medicale, Hopital Tenon, Paris, France.

INTRODUCTION: Herpes zoster is a frequent disease but its incidence in France is 
unknown. METHODS: We conducted a postal survey among the general practitioners of
the "Sentinel" network. The incidence of acute herpes zoster was extrapolated
from the number of cases diagnosed during the year 1998, by the general
practitioners who answered the questionnaire. The general practitioners were also
surveyed on their prescriptions and attitude. RESULTS: Among the 1,368 "Sentinel"
general practitioners, 744 (54.4 p. 100) participated in the survey. The
incidence in 1998 was 3.2 cases for 1,000 inhabitants (95 p. 100 confidence
interval: 3.0 - 3.4). For acute herpes zoster, 73 p. 100 of the patients have
been given an oral antiviral drug, and 63 p. 100 an antalgic. Among the 605
reported herpes zoster cases, 111 (18.4 p. 100) subsequently had chronic pain.
DISCUSSION: The estimated incidence is comparable to the incidence from others
developed countries. To be interpreted, this estimation has to be discussed
according to the sample of population that was studied and the representativity
of the "Sentinelles" general practitioners who participated the survey.

Publication Types: 
    English Abstract

PMID: 11395646 [PubMed - indexed for MEDLINE]

2774: Microbios. 2001;105(411):111-8.

Detection of herpes simplex and varicella zoster viruses in clinical specimens
using direct immunofluorescence and cell culture assays.

Meqdam MM, Todd D, Al-Abosi M.

Department of Applied Biology, Jordan University of Science and Technology,
Irbid.

Patients (33 in toto) with a clinical diagnosis of herpes infections (simplex,
zoster or chickenpox) were investigated for the presence of herpes simplex virus 
(HSV) and varicella zoster virus (VZV) in skin samples, using direct
immunofluorescence and cell culture assays. Five patients with nonherpetic
vesiculobullous disorders were included as negative controls. Of the 33 patients,
nineteen (57.6%) were positive for HSV or VZV and fourteen (42.4%) were negative.
Five controls were all negative for HSV or VZV. Of the nineteen positive
patients, HSV was isolated from eight (42.1%) patients, by both direct
immunofluorescence and cell culture assays. VZV was isolated from eleven (57.9%) 
patients, eleven (100%) by direct immunofluorescence assay, and six (54.5%) by
cell culture assays. HSV was isolated from one patient clinically diagnosed as
chickenpox (VZV), but otherwise the positive laboratory results were concordant
with the clinical diagnosis. For epidemiological studies, atypical cases and
immunocompromised patients the clinical diagnosis should be confirmed in the
laboratory.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11393748 [PubMed - indexed for MEDLINE]

2775: Bioorg Med Chem Lett. 2001 May 21;11(10):1329-32.

Design, synthesis and enzymatic activity of highly selective human mitochondrial 
thymidine kinase inhibitors.

Manfredini S, Baraldi PG, Durini E, Porcu L, Angusti A, Vertuani S, Solaroli N,
De Clercq E, Karlsson A, Balzarini J.

Dipartimento di Scienze Farmaceutiche, Universita di Ferrara, Italy.
mv9@dns.unfie.it

Highly selective arabinofuranosyl nucleosides, which inhibit the mitochondrial
thymidine kinase (TK-2) without affecting the closely related herpes simplex
virus type 1 thymidine kinase (HSV-1 TK), varicella-zoster virus thymidine kinase
(VZV-TK), cytosolic thymidine kinase (TK-1) or the multifunctional Drosophila
melanogaster deoxyribonucleoside kinase (Dm-dNK), have been obtained. SAR studies
indicate a close relation between the length of the substituent at the 2'
position of the arabinofuranosyl moiety and the inhibitory activity.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11392548 [PubMed - indexed for MEDLINE]

2776: No To Hattatsu. 2001 May;33(3):270-5.

[Interleukin-6 in the cerebrospinal fluid of two patients with herpes zoster
meningitis]

[Article in Japanese]

Ohfu M, Masuzaki M, Inoue S, Inoue T, Yasumoto S, Ogawa A, Tomoda Y, Tsuru N,
Mitsudome A.

Department of Pediatrics, Chikushi Hospital, Fukuoka University, Chikushi,
Fukuoka.

Interleukin-6 (IL-6) levels in the cerebrospinal fluid (CSF) and serum were
measured in two immuno-competent children with herpes zoster meningitis, who had 
vesicles, fever, headache and vomiting before admission. The causative agent was 
identified as varicella zoster virus (VZV) by detecting an increased antibody
index in the serum and specific DNA (by polymerase chain reaction) in the CSF.
Both patients fully recovered after treatment with acyclovir. The CSF IL-6 levels
were high (260.1 pg/ml, 106.1 pg/ml) at the acute stage and thereafter showed a
rapid recovery. The serum IL-6 levels were normal. The increased IL-6 level in
the CSF may reflect intrathecal inflammatory response following invasion of VZV
into the central nervous system.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11391972 [PubMed - indexed for MEDLINE]

2777: Am J Dermatopathol. 2001 Jun;23(3):216-20.

Zosteriform and epidermotropic metastatic primary cutaneous squamous cell
carcinoma.

Kato N, Aoyagi S, Sugawara H, Mayuzumi M.

Department of Dermatology and Clinical Research Institute, National Sapporo
Hospital, Kikusui 4-2, Shiroishi-ku, 003-0804 Sapporo, Japan. kato@sap-cc.go.jp

The first case of primary cutaneous squamous cell carcinoma (SCC) to cause
zosteriform and epidermotropic metastasis to skin is reported. The patient is a
72-year-old Japanese woman. A cutaneous SCC appeared on the lateral side of her
right knee and was removed. After dissection of the right inguinal lymph nodes,
which revealed metastases, and irradiation of the right inguinal region, the
patient presented with slightly pruritic and painful erythematous papules on the 
right hip and small brownish papules and vesicles with crusts on the anterior
side of the right thigh. The eruptions were in a zosteriform distribution along
the right L1 to L3 dermatomes. Histologically neoplastic squamous cell nests were
observed in the epidermis, below the epidermal-dermal junction, and within
lymphatic vessels in the deeper reticular dermis. We postulate that neoplastic
cells with the ability to fuse with adjacent squamous epithelium may have been
carried beneath the basal lamina or to the epidermis via dermal lymphatic
backflow, resulting in epidermotropic metastasis.

Publication Types: 
    Case Reports
    Review

PMID: 11391102 [PubMed - indexed for MEDLINE]

2778: Clin Infect Dis. 2001 Jul 1;33(1):62-9. Epub 2001 Jun 5.

Characteristics of patients with herpes zoster on presentation to practitioners
in France.

Chidiac C, Bruxelle J, Daures JP, Hoang-Xuan T, Morel P, Leplege A, El Hasnaoui
A, de Labareyre C.

Department of Infectious and Tropical Diseases-AIDS Reference Center, University 
Claude Bernard, Lyon, France. christian.chidiac@chu-lyon.fr

There have been many epidemiological studies of chickenpox but only a few of
herpes zoster. We report data from an observational study, conducted in France
during a 1-year period, of 9038 patients who presented with acute herpes zoster
(n = 8103) or postherpetic neuralgia (PHN; n = 935) at the office practices of
4635 general practitioners or dermatologists. The incidence of herpes zoster in
France was found to be similar to that in the literature: from 1.4 to 4.8 cases
per 1000 population per year. The patient profiles and clinical patterns were
delineated, as well as the management decisions made according to the type of
treating physician. The impact of herpes zoster on quality of life was evaluated 
on the basis of the Medical Outcome Study Short Form 36 (MOS SF 36) scale, which 
is widely used for assessing quality of life in the field of health. This study
provides reference data on the substantial deterioration in quality of life
associated with herpes zoster and PHN.

PMID: 11389496 [PubMed - indexed for MEDLINE]

2779: Curr Opin Ophthalmol. 2001 Jun;12(3):191-5.

Viral causes of the acute retinal necrosis syndrome.

Walters G, James TE.

Eye Department, St James's University Hospital, Leeds, UK.

Acute retinal necrosis has been described as a clinical entity for nearly 30
years. Acute retinal necrosis is a potentially visually devastating necrotizing
vaso-occlusive retinitis affecting both healthy and immunocompromised patients.
Acute retinal necrosis is caused by the herpes group of viruses, mainly varicella
zoster, herpes simplex types 1 and 2, and, rarely, cytomegalovirus. Recently,
polymerase chain reaction techniques have enabled detection of very small amounts
of viral DNA from intra-ocular fluid samples. This can help in both the diagnosis
of atypical cases of retinitis and uveitis and directing treatment in cases of
acute retinal necrosis.

Publication Types: 
    Review

PMID: 11389345 [PubMed - indexed for MEDLINE]

2780: J Pediatr Ophthalmol Strabismus. 2001 May-Jun;38(3):174-6.

Herpes zoster ophthalmicus.

Ang LP, Au Eong KG, Ong SG.

Singapore National Eye Centre, Singapore.

Publication Types: 
    Case Reports

PMID: 11386651 [PubMed - indexed for MEDLINE]

2781: Arch Virol Suppl. 2001;(17):1-178.

Immunity and Prevention of Herpes Zoster. Proceedings of an international
conference. Osaka, Japan, March 8-10, 1999.

[No authors listed]

Publication Types: 
    Congresses
    Overall
    Research Support, Non-U.S. Gov't

PMID: 11386248 [PubMed - indexed for MEDLINE]

2782: Ned Tijdschr Tandheelkd. 2001 Feb;108(2):71.

[Shooting pains in the temporal region due to infection with herpes zoster]

[Article in Dutch]

Kaptein ML, Langeveld-Wildschut EG.

Afdeling Dermatologie van het Ziekenhuis Hilversum.

Publication Types: 
    Case Reports

PMID: 11383284 [PubMed - indexed for MEDLINE]

2783: Am J Med. 2001 Jun 1;110(8):662-3.

Comment on:
    Am J Med. 2001 Jun 1;110(8):605-9.

Human immunodeficiency virus-associated immune reconstitution disease.

Jacobson MA.

Publication Types: 
    Comment
    Editorial

PMID: 11382378 [PubMed - indexed for MEDLINE]

2784: Am J Med. 2001 Jun 1;110(8):605-9.

Comment in:
    Am J Med. 2001 Jun 1;110(8):662-3.

Herpes zoster as an immune reconstitution disease after initiation of combination
antiretroviral therapy in patients with human immunodeficiency virus type-1
infection.

Domingo P, Torres OH, Ris J, Vazquez G.

Department of Internal Medicine, Infectious Diseases Unit, Hospital de la Santa
Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.

BACKGROUND: Initiation of combination antiretroviral therapy may be followed by
inflammatory reactions. We studied the epidemiology of herpes zoster infection
among patients with human immunodeficiency virus (HIV) infection who were treated
with combination antiretroviral therapy. SUBJECTS AND METHODS: Of 316 patients
who initiated combination antiretroviral therapy, 24 (8%) were treated for herpes
zoster within 17 weeks of starting therapy. The characteristics of these cases
were compared with those of a control group of 96 HIV-1-infected patients, who
were matched by age, sex, plasma HIV-1 RNA concentration and CD4 cell counts, and
length of follow-up. RESULTS: The incidence of herpes zoster associated with
combination antiretroviral therapy was 9 episodes per 100 patient-years. There
were no significant differences between cases and controls in age, sex, years of 
HIV infection, history of herpes zoster, previous acquired immune deficiency
syndrome, or baseline mean CD4 and CD8 cell counts before beginning combination
antiretroviral therapy. However, patients who developed herpes zoster had a
significantly greater mean (+/- SD) increase in the number of CD8 cells than did 
controls (347 +/- 269 vs. 54 +/- 331 cells/mL, P = 0.0006). In a multivariate
analysis, the only factor that was associated with the development of herpes
zoster was the increase in CD8 cells from before initiation of combination
antiretroviral therapy to 1 month before development of herpes zoster (odds ratio
1.3 per percentage increase; 95% confidence interval: 1.1 to 1.5; P = 0.0002).
CONCLUSION: The initiation of combination antiretroviral therapy in
HIV-1-infected patients was often associated with the development of herpes
zoster, especially in those in whom the number of CD8 cells increased after
therapy.

PMID: 11382367 [PubMed - indexed for MEDLINE]

2785: Hautarzt. 2001 Apr;52(4):359-76.

[Infections with varicella zoster virus]

[Article in German]

Kempf W, Lautenschlager S.

Dermatologische Klinik, Universitatsspital Zurich, Gloriastrasse 31, 8091 Zurich,
Schweiz. wkempf@hotmail.com/kempf@derm.unizh.ch

PMID: 11382132 [PubMed - indexed for MEDLINE]

2786: Hautarzt. 2001 Apr;52(4):335-8.

[Bilateral asymmetric herpes zoster in adolescence]

[Article in German]

Bloss G, Ebisch MA, Kunz M, Gross G.

Klinik und Poliklinik fur Dermatologie und Venerologie der Universitat Rostock,
Augustenstrasse 80, 18055 Rostock.

Zoster is a frequent disease of adulthood with a distinct age-dependent increase 
after 60. In contrast during childhood or adolescence zoster only rarely occurs. 
Certain risk factors such as hematologic malignancies are associated with early
appearance. The typical clinical manifestation is unilateral, equally involving
thoracic dermatomes. A 16-year-old patient presented with zoster in bilateral
asymmetrical distribution, with trigeminal and thoracic dermatomes simultaneously
affected. Despite the clinical findings and the unusual localization, there was
no history, clinical nor laboratory signs of an immune suppression or any other
underlying disease. Careful follow-up examinations are necessary in order to
recognize systemic, especially hematologic, malignancies.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11382126 [PubMed - indexed for MEDLINE]

2787: Br J Haematol. 2001 May;113(2):483-5.

Immune neutropenia associated with anti-human neutrophil antigen-2a (NB1)
antibodies following unrelated donor stem cell transplantation for chronic
myeloid leukaemia: perpetuation by granulocyte colony-stimulating factor.

Pocock CF, Lucas GF, Giles C, Vassiliou G, Cwynarski K, Rezvani K, Apperley JF,
Goldman JM.

The Department of Haematology, Hammersmith Hospital and Imperial College School
of Medicine, London, UK.

A case of immune neutropenia following unrelated stem cell transplantation for
chronic myeloid leukaemia is described. The neutropenia developed following
herpes zoster viral infection and was associated with antibodies to the human
neutrophil antigen (HNA)-2a (formerly known as NB1). The neutropenia was
prolonged, profound and unresponsive to granulocyte colony-stimulating factor
(GCSF). The neutrophil count recovered after GCSF was discontinued. HNA-2a has
been reported to be upregulated following GCSF administration. In the present
case, it appears that the immune neutropenia may have been perpetuated by GCSF
administration.

Publication Types: 
    Case Reports

PMID: 11380420 [PubMed - indexed for MEDLINE]

2788: Gastrointest Endosc. 2001 Jun;53(7):809-10.

Varicella zoster gastritis 3 years after bone marrow transplantation for
treatment of acute leukemia.

Rivera-Vaquerizo PA, Gomez-Garrido J, Vicente-Gutierrez M, Blasco-Colmenarejo M, 
Mayor-Lopez J, Perez-Flores R.

Department of Gastroenterology, Albacete General Hospital, Albacete, Spain.

Publication Types: 
    Case Reports

PMID: 11375599 [PubMed - indexed for MEDLINE]

2789: Am J Gastroenterol. 2001 May;96(5):1627-30.

Demonstration of varicella-zoster virus infection in the muscularis propria and
myenteric plexi of the colon in an HIV-positive patient with herpes zoster and
small bowel pseudo-obstruction (Ogilvie's syndrome).

Pui JC, Furth EE, Minda J, Montone KT.

Department of Pathology, Hospital of the University of Pennsylvania,
Philadelphia, 19104, USA.

Gastrointestinal symptomatology as a complication of herpes zoster (HZ) is
extremely rare, with the majority of reported cases showing only temporal or
radiological evidence of GI tract involvement by varicella zoster virus (VZV)
infection. We present the first case of documented direct VZV infection in the
muscularis propria of the gut presenting as intestinal pseudo-obstruction
(Ogilvie's syndrome). The patient was a 34-yr-old HIV+ man who developed small
bowel pseudo-obstruction in association with disseminated cutaneous HZ. A partial
ileocolectomy specimen demonstrated a focal ulcer in the terminal ileum.
Immunohistochemistry against VZV gpI demonstrated diffuse staining of the
muscularis propria and myenteric plexi throughout the length of the specimen.
Viral particles consistent with Herpesviridae were shown to be present
ultrastructurally. We postulate that the viral infection in the neuronal plexi
and muscularis propria caused muscle injury leading to pseudo-obstruction.

Publication Types: 
    Case Reports

PMID: 11374712 [PubMed - indexed for MEDLINE]

2790: Rev Pneumol Clin. 2001 Feb;57(1 Pt 1):21-6.

[Clinical, radiographic and ultrasonographic aspects of mediastinal nodular
tuberculosis in the era of HIV infection]

[Article in French]

Ouedraogo M, Ouedraogo SM, Zoubga ZA, Birba E, Zigani A, Ouedraogo G, Ki C,
Bambara M, Boncoungou K, Ouedraogo E, Auregan G.

Service de Pneumologie, Centre Hospitalier National Yalgado Ouedraogo (CHNYO).

OBJECTIVE: The purpose of this study was to determine the clinical, radiographic,
and ultrasonographic aspects of mediastinal nodal tuberculosis and ascertain its 
clinical course in the era of HIV infection. PATIENTS AND METHODS: We reviewed
retrospectively 39 patients referred to the Ouedraogo Yalgado National Hospital
Center and the National Anticancer Institute between February 1996 and December
1999 for mediastinal nodal tuberculosis. Endoscopic proof of tuberculosis was
obtained in 30 cases (81.8%). HIV serology was positive in 26 of the 30 patients 
tested (86.6%). RESULTS: Nodal mediastinal tuberculosis accounted for 1.7% of the
cases of tuberculosis recorded over the same period at the Anticancer Institute. 
Mean age of the patients was 32.8 years and the sex ratio was 1.05 in favor of
men. Clinically, a past medical history was found in 18 cases (46%) including a
herpes zoster in 6 (15.4%), cough in 38 (97.5%). Weight loss (95%), fever (100%) 
and peripheral node enlargement (20%) were found frequently, probably related to 
HIV infection more than tuberculosis. Radiographically, standard x-rays evidenced
associated lesions in 22 cases, with 59% having predominant parenchymatous
lesions. Other localizations of tuberculosis were very frequent (42.5%).
DISCUSSION: Bronchial fibroscopy is most contributive to diagnosis of mediastinal
nodal tuberculosis with an 81.8% yield in our series. HIV infection had a
determining effect on the disease course since among the 16 patients who died, 14
were HIV-positive (52%).

Publication Types: 
    Comparative Study
    English Abstract

PMID: 11373600 [PubMed - indexed for MEDLINE]

2791: Arch Pathol Lab Med. 2001 Jun;125(6):785-9.

Induction of human immunodeficiency virus 1 replication by human herpesvirus 8.

Mercader M, Nickoloff BJ, Foreman KE.

Department of Pathology and Skin Cancer Research Laboratories, Cardinal Bernardin
Cancer Center, Loyola University Medical Center, Maywood, IL, USA.

BACKGROUND: Human immunodeficiency virus 1 (HIV-1)-infected individuals are
commonly infected with herpesviruses, including cytomegalovirus, herpes simplex
virus, varicella-zoster virus, and human herpesvirus 8 (HHV-8, also known as
Kaposi sarcoma-associated herpesvirus [KSHV]). Previous studies have demonstrated
that coinfection with herpesviruses can modulate HIV-1 replication. This can
occur either through direct interaction between the 2 viruses or through
secondary effects resulting from the release of cellular factors in response to
infection. OBJECTIVE: To investigate HIV-1 replication in the presence and
absence of HHV-8. DESIGN AND METHODS: HIV-1 replication was analyzed following
culture of HIV-1-infected CD4(+) T cells in the presence of HHV-8 infected B-cell
lines or control, uninfected B-cell lines. To confirm and extend the results of
these in vitro studies, HIV-1-infected T cells were injected into human skin
transplanted onto severe combined immunodeficient mice. The human skin was also
injected with purified HHV-8 or phosphate-buffered saline as a control and HIV
replication measured in biopsy specimens taken 5 to 8 days later. RESULTS AND
CONCLUSIONS: The results demonstrated a significant increase in HIV-1 replication
in the presence of HHV-8 in both the in vitro and in vivo model systems. Although
the mechanism responsible for HHV-8 induction of HIV-1 replication remains to be 
identified, the results indicate that these 2 viruses may interact at the
molecular level in coinfected patients, resulting in increased HIV-1 viral load.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11371231 [PubMed - indexed for MEDLINE]

2792: Arch Pathol Lab Med. 2001 Jun;125(6):770-80.

Varicella-Zoster virus infections of the nervous system: clinical and pathologic 
correlates.

Kleinschmidt-DeMasters BK, Gilden DH.

Department of Pathology, The University of Colorado Health Sciences Center,
Denver, CO 80262, USA. BK.DeMasters@UCHSC.edu

BACKGROUND: Diseases that present with protean manifestations are the diseases
most likely to pose diagnostic challenges for both clinicians and pathologists.
Among the most diverse disorders caused by a single known toxic, metabolic,
neoplastic, or infectious agent are the central and peripheral nervous system
complications of varicella-zoster virus (VZV). METHODS: The pathologic correlates
of the neurologic complications of VZV infection, as well as current methods for 
detecting viral infections, are discussed and presented in pictorial format for
the practicing pathologist. RESULTS: Varicella-zoster virus causes chickenpox
(varicella), usually in childhood; most children manifest only mild neurologic
sequelae. After chickenpox resolves, the virus becomes latent in neurons of
cranial and spinal ganglia of nearly all individuals. In elderly and
immunocompromised individuals, the virus may reactivate to produce shingles
(zoster). After zoster resolves, many elderly patients experience postherpetic
neuralgia. Uncommonly, VZV can spread to large cerebral arteries to cause a
spectrum of large-vessel vascular damage, ranging from vasculopathy to
vasculitis, with stroke. In immunocompromised individuals, especially those with 
cancer or acquired immunodeficiency syndrome, deeper tissue penetration of the
virus may occur (as compared with immunocompetent individuals), with resultant
myelitis, small-vessel vasculopathy, ventriculitis, and meningoencephalitis.
Detection of the virus in neurons, oligodendrocytes, meningeal cells, ependymal
cells, or the blood vessel wall often requires a combination of morphologic,
immunohistochemical, in situ hybridization, and polymerase chain reaction (PCR)
methods. The PCR analysis of cerebrospinal fluid remains the mainstay for
diagnosing the neurologic complications of VZV during life. CONCLUSIONS:
Varicella-zoster virus infects a wide variety of cell types in the central and
peripheral nervous system, explaining the diversity of clinical disorders
associated with the virus.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11371229 [PubMed - indexed for MEDLINE]

2793: J Am Acad Dermatol. 2001 Jun;44(6):932-9.

Skin diseases in children with organ transplants.

Euvrard S, Kanitakis J, Cochat P, Cambazard F, Claudy A.

Dermatology Department, the Pediatric Transplantation Unit, Hopital Edouard
Herriot, Lyon, France.

BACKGROUND: Skin diseases are frequent in organ transplant recipients, but
studies concerning children are sparse. OBJECTIVE: We assessed skin diseases in
children who had received organ transplants. METHODS: A total of 145 children
referred to our dermatologic consultation were studied. RESULTS: Steroid-induced 
striae distensae and acne occurred only in adolescents; severe
cyclosporine-related side effects were more frequent in younger children. The
most common findings were warts (53.8%), tinea versicolor (14.5%), herpes
simplex/zoster (9.6%), molluscum contagiosum (6.9%), and impetigo contagiosum and
folliculitis (6.2%). Other notable disorders included a diffuse hyperpigmentation
with a "dirty" appearance of the skin, pyogenic granulomas, melanocytic nevi
proliferation, and skin tags. Two of 20 further adult patients who received
transplants during childhood had squamous cell carcinomas. CONCLUSION: Children
who have received organ transplants frequently present side effects of
immunosuppressive drugs and infectious diseases. Most disorders are related to
the age of the patients rather than to the length of immunosuppression, whereas
others are favored by the reinforcement of immunosuppression. Skin cancers were
not encountered, but the risk of carcinomas in early adulthood should be
considered.

PMID: 11369903 [PubMed - indexed for MEDLINE]

2794: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1998 Aug;20(4):264-6.

[Clinical trial of recombinant alpha-2a interferon in the treatment of herpes
zoster]

[Article in Chinese]

Liu Y, Wang J, Li S.

PUMC Hospital, CAMS and PUMC, Beijing 100730.

OBJECTIVE: A clinical trial on 74 patients with herpes zoster was conducted to
observe the efficacy and side effects of recombinant alpha-2a interferon.
METHODS: All patients were divided into two groups, including forty-four patients
in interferon-treated group and 30 patients in controlled group. The
interferon-treated group was treated with i.m. recombinant alpha-2a-interferon in
a daily dose of one million unit for 6 days. The controlled group was treated
with vitamin B12 and vitamin B1 in conventional dose for 6 days. RESULTS: The
duration of scarring, pain relieving, cure and course of disease in
interferon-treated group was significantly shorter than that in controlled group 
(P < 0.01). There was no postherpetic neuralgia in interferon-treated group and
there were postherpetic neuralgia in 9 cases of controlled group (P > 0.05). Side
effects were mild in interferon-treated group. CONCLUSIONS: It seems that
recombinant alpha-2a-interferon may be recommended as a good medicine for herpes 
zoster.

Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 11367689 [PubMed - indexed for MEDLINE]

2795: BETA. 1999;12(4):71-4.

Open clinical trials for HIV/AIDS treatments.

Townley D.

Community Consortium of the UCSF AIDS Program, San Francisco General Hospital,
CA.

AIDS: Open clinical trials for HIV/AIDS treatments are described. All listings
are taken from the Trials Search database, the American Foundation for AIDS
Research web site, and the AIDS Clinical Trials Information Service site.
Internet addresses and telephone numbers are included. The criteria and study
design for each trial is described, and telephone numbers for further information
on enrolling in each trial is included.

Publication Types: 
    Newspaper Article

PMID: 11367265 [PubMed - indexed for MEDLINE]

2796: BETA. 1999;12(4):67-70.

HIV skin complications in the age of HAART: an interview with Toby Maurer.

Maurer T.

University of California at San Francisco.

AIDS: Kaposi's sarcoma is one of the symbols of AIDS, but other skin
complications are common in HIV-infected persons: herpes zoster (shingles),
herpes simplex, and molliscum contagiosum. Skin complications are painful and
disfiguring, and can significantly reduce a patient's quality of life. Dr. Toby
Maurer of the University of California at San Franscisco updates readers on
dermatological issues, including skin complications related to the use of
anti-HIV drugs.

Publication Types: 
    Interview
    Newspaper Article

PMID: 11367263 [PubMed - indexed for MEDLINE]

2797: BETA. 1998 Oct:5.

FDA approves fomivirsen, famciclovir, and Thalidomide. Food and Drug
Administration.

Highleyman L.

AIDS: The FDA has recently approved three new drugs. Fomivirsen (Vitravene),
developed by Isis Pharmaceuticals, was approved as a treatment for
cytomegalovirus (CMV) retinitis. The drug prevents CMV replication by binding
with the virus' genetic material. It is the first drug using antisense technology
to win approval and is injected into the eye weekly or every other week.
Famciclovir (Famvir) was approved for the treatment of HIV-related herpes simplex
virus (HSV) infection. It is the first oral anti-HSV drug to be approved for use 
in people with HIV-related herpes. Thalidomide (Synovir), developed by Celgene,
has received limited approval for the treatment of leprosy. It has also been used
successfully in trials involving AIDS-related wasting and recurrent aphthous
ulcers, although it has not been approved for these conditions.

Publication Types: 
    Newspaper Article

PMID: 11365993 [PubMed - indexed for MEDLINE]

2798: Proj Inf Perspect. 1997 Nov;(23):12-4.

PHS guidelines on opportunistic infections. US Public Health Service.

[No authors listed]

AIDS: The U.S. Public Health Service (PHS) issued new guidelines for the
prevention and maintenance of HIV-related opportunistic infections. Guidelines
are presented for the following: Pneumocystis carinii pneumonia, toxoplasmosis,
Mycobacterium avium complex infection, cytomegalovirus infection, herpes simplex,
cryptococcal disease, histoplasmosis, varicella-zoster virus infection,
candidiasis, cryptosporidiosis, and tuberculosis.

Publication Types: 
    Newspaper Article

PMID: 11365371 [PubMed - indexed for MEDLINE]

2799: AIDS Patient Care STDS. 1998 Jan;12(1):61-2.

HIV/AIDS case histories: diagnostic problems. Varicella-zoster encephalitis.

Edgar M, Heier L.

Department of Pathology, Cornell University Medical College, USA.

Publication Types: 
    Case Reports

PMID: 11361888 [PubMed - indexed for MEDLINE]

2800: J Tradit Chin Med. 2001 Mar;21(1):78-80.

Acupuncture treatment of herpes zoster.

Hu J.

Institute of Acupuncture and Moxibustion, China Academy of Traditional Chinese
Medicine, Beijing 100700.

Publication Types: 
    Case Reports

PMID: 11360548 [PubMed - indexed for MEDLINE]

2801: J Tradit Chin Med. 2001 Mar;21(1):34-6.

Clinical observation on therapeutic effect of Ji De Sheng She Yao tablet on 16
cases with AIDS complicated by herpes zoster.

Huang Y, Zhang L, Liu G, Huang W, Jia X, Naomi M.

Xiyuan Hospital, China Academy of Traditional Chinese Medicine, Xiyuan, Haidian
District, Beijing 100091.

PMID: 11360536 [PubMed - indexed for MEDLINE]

2802: Aust Endod J. 2000 Apr;26(1):19-26.

Neuropathic orofacial pain part 1--prevalence and pathophysiology.

Vickers ER, Cousins MJ.

Department of Anaesthesia and Pain Management, University of Sydney, Royal North 
Shore Hospital. rvickers@med.usyd.edu.au

Neuropathic pain is defined as "pain initiated or caused by a primary lesion or
dysfunction in the nervous system". Neuropathic orofacial pain has previously
been known as "atypical odontalgia" (AO) and "phantom tooth pain". The patient
afflicted with neuropathic oral/orofacial pain may present to the dentist with a 
persistent, severe pain, yet there are no clearly identifiable clinical or
radiographic abnormalities. Accordingly, multiple endodontic procedures may be
instigated to remove the likely anatomical source of the pain, yet the pain
persists. There have been few studies and limited patient numbers investigating
the condition. Two retrospective studies revealed the incidence of persistent
pain following endodontic treatment to be 3-6% and 5% of patients; one author
with wide experience in assessing the condition estimated its prevalence at
125,000 individuals in the USA alone. In one study, 50% of neuropathic orofacial 
pain patients reported persistent pain specifically following endodontic
treatment. Patients predisposed to the condition may include those suffering from
recurrent cluster or migraine headaches. Neuropathic pain states include
postherpetic neuralgia (shingles) and phantom limb/stump pain. The aberrant
developmental neurobiology leading to this pain state is complex. Neuropathic
pain serves no protective function, in contrast to physiological pain that warns 
of noxious stimuli likely to result in tissue damage. The relevant clinical
features of neuropathic pain include: (i) precipitating factors such as trauma or
disease (infection), and often a delay in onset after initial injury
(days-months), (ii) typical complaints such as dysaesthesias (abnormal unpleasant
sensations), pain that may include burning, and paroxysmal, lancinating or sharp 
qualities, and pain in an area of sensory deficit, (iii) on physical examination 
there may be hyperalgesia, allodynia and sympathetic hyperfunction, and (iv) the 
pathophysiology includes deafferentation, nerve sprouting, neuroma formation and 
sympathetic efferent activity.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11359293 [PubMed - indexed for MEDLINE]

2803: Laryngoscope. 2001 Apr;111(4 Pt 1):719-23.

Western blot analysis for diagnosis of Lyme disease in acute facial palsy.

Furuta Y, Kawabata H, Ohtani F, Watanabe H.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan. yfuruta@med.hokudai.ac.jp

BACKGROUND: Lyme borreliosis has been implicated in the pathogenesis of acute
peripheral facial palsy (APFP). Few studies, however, have used Western blot
analyses to confirm the serological diagnosis. PURPOSE: To analyze the prevalence
of anti-Borrelia antibodies in patients with APFP compared with healthy control
subjects living in Hokkaido Island, Japan. PATIENTS AND METHODS: In total, 113
patients with APFP were analyzed. They included 32 patients with varicella zoster
virus (VZV) reactivation (Ramsay Hunt syndrome and zoster sine herpete) and 81
patients with Bell's palsy. Fifty-eight healthy control subjects were also
included. IgM and IgG antibodies to Borrelia garinii and afzelii were tested by
Western blot, and diagnoses were made according to the Centers for Disease
Control and Prevention criteria. RESULTS: Five of 81 (6.2%) patients with Bell's 
palsy, 1 of 32 (3.1%) patients with VZV reactivation, and 1 of 58 control
subjects (1.7%) were judged to have both IgM and IgG antibodies to Borrelia. This
difference was not significant (P >.05, chi2 test). Patients with Bell's palsy
who had herpes simplex virus type 1 (HSV-1) reactivation at the onset of palsy
had a higher IgM-immunoreactivity to Borrelia afzelii. CONCLUSIONS: Although it
is one of the endemic areas of Lyme disease in Japan, the prevalence of APFP
caused by Lyme borreliosis is low in Hokkaido Island. In addition,
cross-reactivity to B. afzelii in IgM blots is often observed in patients with
HSV-1 reactivation, suggesting that careful interpretation of Borrelia IgM
immunoblot data are needed for accurate serological diagnosis.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 11359146 [PubMed - indexed for MEDLINE]

2804: Am J Nephrol. 2001 Mar-Apr;21(2):162-4.

Neurotoxicity of valacyclovir in peritoneal dialysis: a pharmacokinetic study.

Izzedine H, Mercadal L, Aymard G, Launay-Vacher V, Martinez V, Issad B, Deray G.

Department of Nephrology, Pitie-Salpetriere Hospital, Paris, France.
hassan.izzedine@psl.ap-hop-paris.fr

Valacyclovir is an effective oral agent for the treatment of herpes virus
infection, however, the pharmacokinetics of the drug are altered in renal
failure. It is increasingly recognized that dose adjustment of oral valacyclovir 
in renal failure is necessary to avoid neurotoxicity. We studied this drug in a
continuous ambulatory peritoneal dialysis (CAPD) and immunocompromised patient.
She developed neurotoxicity with an adjustment dosage of valacyclovir for a
cutaneous zoster infection. The elimination half-time (15 h) was similar to that 
reported for end-stage renal disease patients, while the steady-state volume of
distribution (85 l) and the area under the curve concentration (127 mg/l.h) were 
greater. The mean CAPD dialysance was only 5.27 ml/min with less than 1% of an
administered dose being recovered in the 24-hour dialysate. 48 h after
interrupting treatment, she recovered normal neurological status and 500 mg of
valacyclovir every 2 days was effective and well tolerated. Copyright 2001 S.
Karger AG, Basel

Publication Types: 
    Case Reports

PMID: 11359026 [PubMed - indexed for MEDLINE]

2805: Arthritis Rheum. 2001 May;44(5):1149-54.

Comment in:
    Arthritis Rheum. 2002 Mar;46(3):843-4.

Etanercept combined with conventional treatment in Wegener's granulomatosis: a
six-month open-label trial to evaluate safety.

Stone JH, Uhlfelder ML, Hellmann DB, Crook S, Bedocs NM, Hoffman GS.

Johns Hopkins University, Baltimore, Maryland, USA.

OBJECTIVE: To evaluate the safety of etanercept (Enbrel) in patients receiving
conventional treatment for Wegener's granulomatosis (WG). METHODS: We performed a
6-month open-label trial of etanercept (25 mg subcutaneously twice weekly) which 
was added to standard therapies for WG (glucocorticoids, methotrexate,
cyclophosphamide, azathioprine, cyclosporine) and prescribed according to disease
severity. Evaluations of clinical response were determined by the Birmingham
Vasculitis Activity Score for WG (BVAS/WG) in 20 patients with persistently
active disease or with new flares of previously established WG. Fourteen of the
20 patients (70%) had etanercept added as the only new therapeutic variable.
RESULTS: Injection site reactions (ISRs) were the most common adverse event
related to etanercept (8 episodes in 5 patients [25%]; < 1% of all injections).
All ISRs were mild. Two patients had a combined total of 5 hospitalizations (1
patient had 4), but no hospitalizations were attributable solely to
etanercept-related adverse events. One patient with severe subglottic stenosis
developed pneumococcal tracheobronchitis and subsequently had a localized Herpes 
zoster infection. Nineteen patients (95%) were still taking etanercept at 6
months, the single exception being a patient who developed progression of orbital
(retro-bulbar) disease at 4 months. There were no deaths. The mean BVAS/WG at
entry was 3.6 (range 1-8), which decreased at 6 months to 0.6 (P < 0.001, 95%
confidence interval [95% CI] -4.0 to -2.1). Among the 14 patients in whom
etanercept was the only new treatment variable, the mean daily prednisone dose
decreased from 12.9 mg at entry to 6.4 mg at 6 months. This comparison did not
achieve statistical significance (difference -6.5; P = 0.19, 95% CI -16.6 to
+3.6). Sixteen of the patients (80%) achieved BVAS/WG scores of 0 at some point. 
However, intermittently active disease was observed in 15 patients (75%).
CONCLUSION: In this open-label trial, etanercept used in combination with
standard treatments was well-tolerated in patients with WG. Adverse events were
few. BVAS/WG scores improved at 6 months, but intermittently active WG
(occasionally severe) was common. A randomized, double-masked trial to assess the
efficacy of etanercept in WG has begun.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 11352248 [PubMed - indexed for MEDLINE]

2806: Arthritis Rheum. 2001 May;44(5):1122-6.

Systemic lupus erythematosus in adults is associated with previous Epstein-Barr
virus exposure.

James JA, Neas BR, Moser KL, Hall T, Bruner GR, Sestak AL, Harley JB.

University of Oklahoma Health Sciences Center, Oklahoma City, USA.

OBJECTIVE: The possible molecular mimicry of the Epstein-Barr virus (EBV) peptide
PPPGRRP by the peptide PPPGMRPP from Sm B'/B of the human spliceosome is
consistent with the possibility that EBV infection is related to the origin of
systemic lupus erythematosus (SLE) in some patients. Association of EBV exposure 
with SLE was therefore tested for and subsequently found in children and
adolescents (odds ratio [OR] 49.9, 95% confidence interval [95% CI] 9.3-1,025, P 
< 10(-11)). These results were confirmed at the level of EBV DNA (OR > 10, 95% CI
2.53-infinity, P < 0.002). Much smaller seroconversion rate differences were
found against 4 other herpes viruses. Herein, we extend these studies to adults
and test the hypothesis that EBV infection is associated with adult SLE. METHODS:
We selected 196 antinuclear antibody-positive adult SLE patients (age > or =20
years) and 2 age-, race-, and sex-matched controls per patient. SLE patients and 
matched controls were tested for evidence of previous infection with EBV,
cytomegalovirus (CMV), herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), or
varicella-zoster virus (VZV) by standardized enzyme-linked immunosorbent assays. 
RESULTS: Of the 196 lupus patients tested, all but 1 had been exposed to EBV,
while 22 of the 392 controls did not have antibodies consistent with previous EBV
exposure (OR 9.35, 95% CI 1.45-infinity, P = 0.014). No differences were observed
between SLE patients and controls in the seroconversion rate against CMV, HSV-2, 
or VZV. CONCLUSION: These new data from adults, along with the many suggestive
features of EBV infection, are consistent with the contribution of this infection
to the etiology of SLE.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 11352244 [PubMed - indexed for MEDLINE]

2807: Mayo Clin Health Lett. 2001 May;19(5):4.

Steroid shots may help pain after shingles.

[No authors listed]

Publication Types: 
    News

PMID: 11349633 [PubMed - indexed for MEDLINE]

2808: Leuk Lymphoma. 2000 Oct;39(3-4):421-6.

Varicella zoster meningitis preceeded by thrombophlebitis in a patient with
Hodgkin's disease.

Saif MW, Hamilton JM, Allegra CJ.

Medicine Branch, National Cancer Institute, National Naval Medical Center,
Bethesda, MD 20889, USA. saifw@mail.nih.gov

Varicella zoster (V-Z) infections are common among patients with hematological
malignancies, particularly Hodgkin's disease (HD). The common denominator in both
HD and V-Z infections is immunosuppression. Most of V-Z infections occur in
patients with HD during the remission period, who have mixed cellularity
sub-type, with stage III disease and who have received combined chemo-radiation
therapy. Involvement of the central nervous system usually manifests as
post-herpetic neuralgia or encephalitis. Angiitis has also been found in
association with V-Z infections. The authors describe a case of HD who developed 
V-Z meningitis preceeded by superficial thrombophlebitis of upper extremities
during the period of active chemotherapy.

Publication Types: 
    Case Reports

PMID: 11342324 [PubMed - indexed for MEDLINE]

2809: Indian J Ophthalmol. 2000 Dec;48(4):311-2.

Acute panuveitis with haemorrhagic hypopyon as a presenting feature of acquired
immunodeficiency syndrome (AIDS).

Biswas J, Samanta TK, Madhavan HN, Kumarasamy N, Solomon S.

Medical Research Foundation, Chennai, India. drjb@sankaranethralaya.org

Anterior uveitis is a known clinical entity in herpes zoster ophthalmicus
associated with AIDS. However, reports of acute haemorrhagic hypopyon uveitis in 
such cases are lacking. Herein we describe a young male patient presenting with
acute panuveitis with haemorrhagic hypopyon, who was found HIV positive on
investigation.

Publication Types: 
    Case Reports

PMID: 11340891 [PubMed - indexed for MEDLINE]

2810: Arch Virol Suppl. 2001;(17):91-7.

Mutagenesis of the varicella-zoster virus genome: lessons learned.

Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institutes of Health, Bethesda, Maryland 20892, USA.

The varicella-zoster virus (VZV) genome encodes at least 70 genes. We have
developed a cosmid based system to inactivate individual viral genes or to insert
foreign genes into the genome. We have shown that many VZV genes are not required
for replication of the virus in cell culture. Several of these genes, including
VZV ORF61, ORF47, and ORF10, have unexpected phenotypes in cell culture and
differ from their homologs in the better studied herpes simplex virus (HSV). We
have also used the Oka strain of VZV as a live virus vaccine vector. Guinea pigs 
vaccinated with recombinant VZV expressing HSV-2 glycoprotein D and challenged
with HSV-2 have reduced severity of primary genital herpes and reduced mortality 
compared to animals receiving parental VZV. Recently we have inserted the human
immunodeficiency virus (HIV) and simian immunodeficiency virus (SIV) glycoprotein
160 genes into the Oka strain of VZV and have shown that these proteins are
expressed in recombinant virus-infected cells. Thus, directed mutagenesis of the 
VZV genome is providing new insights into viral pathogenesis and may provide new 
candidate vaccines.

Publication Types: 
    Review

PMID: 11339555 [PubMed - indexed for MEDLINE]

2811: Arch Virol Suppl. 2001;(17):81-9.

The role of varicella zoster virus immediate-early proteins in latency and their 
potential use as components of vaccines.

Sadzot-Delvaux C, Rentier B.

Department of Microbiology, Fundamental Virology, Liege University, Sart
Tilman-Liege, Belgium.

Varicella zoster virus immediate-early (IE) proteins are intracellular regulators
of viral gene expression. Some of them (IE62 and IE63) are found in large amounts
in infected cells but are also components of the virion tegument. Several IE and 
early genes are transcribed during latency, while late genes are not. Recently,
we demonstrated the presence of protein IE 63 in dorsal root ganglia of
persistently infected rats as well as in normal human ganglia; other IE proteins 
have been found since in human ganglia. Cell-mediated immunity (CMI) to IE 62 has
been evidenced. We found both humoral immunity and CMI to IE 63 in immune adults.
In elderly zoster-free individuals, CMI to IE 63 remained high. The differences
in the CMI to IE 63 among young adults, elderly people and immunocompromized
patients have to be analyzed according to their status relative to zoster, to
determine whether the decrease in CMI, particularly to IE proteins, could be
responsible for viral reactivation and for the onset of shingles. Hopefully, the 
waning of the CMI to VZV IE 63 and perhaps to other IE proteins could become a
predictive marker for herpes zoster and reimmunization, not only with the vaccine
strain, but also with purified IE proteins could help prevent zoster at old age.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11339554 [PubMed - indexed for MEDLINE]

2812: Arch Virol Suppl. 2001;(17):49-56.

Comparison of DNA sequence and transactivation activity of open reading frame 62 
of Oka varicella vaccine and its parental viruses.

Gomi Y, Imagawa T, Takahashi M, Yamanishi K.

Kanonji Institute, The Research Foundation for Microbial Diseases of Osaka
University, Kagawa, Japan.

When nucleotide sequences of Oka vaccine and its parental viruses of
varicella-zoster virus (VZV) were compared in 5 open reading frames (ORFs)
including glycoprotein C (gC) and 4 immediate-early genes, mutations were
detected only in gene 62 which is one of the immediate-early genes. Compared with
its parental virus, the vaccine virus contained 15 nucleotide substitutions. With
the differentiation method using the simplified restriction-enzyme fragment
length polymorphism analysis by Nae I and Bss HII, which was established based on
the sequence analysis data in this study, the Oka vaccine virus could be
distinguished from its parental virus. Studies of the regulatory activities of
the ORF62 gene product (IE62) in a transient assay indicate the IE62 of the
parental virus had a stronger transactivational activity than that of the vaccine
virus against immediate-early, early and late gene promoters. These data suggest 
that gene 62 might have an important role for attenuation of VZV. This is the
first report in which many substitutions of nucleotides in gene 62 of Oka vaccine
virus was found, compared with that of Oka parental virus.

Publication Types: 
    Comparative Study

PMID: 11339550 [PubMed - indexed for MEDLINE]

2813: Arch Virol Suppl. 2001;(17):41-8.

Biologic and geographic differences between vaccine and clinical varicella-zoster
virus isolates.

Larussa PS, Gershon AA.

Division of Pediatric Infectious Diseases, College of Physsicians & Surgeons,
Columbia University. New York, New York 10032, USA.

Vaccine and wild-type strains of varicella-zoster virus differ both in their
biologic characteristics and in the clinical manifestations of infection caused
by each strain. The biologic differences described for the vaccine strain
(temperature sensitivity and host cell preference) probably reflect the methods
used to adapt the wild-type strain to the in vitro growth conditions imposed
during the attenuation process in cell culture. In addition, restriction fragment
polymorphisms have been described that reflect geographic strain variations
between the parental virus used to develop the vaccine strain and other wild-type
strains. These polymorphisms have been exploited as tools for the identification 
and differentiation of vaccine and wild-type strains in clinical studies.
Infection with the wild-type strain results in the typical extensive rash of
varicella, frequent transmission to other susceptible contacts, establishment of 
latency, and in some individuals, reactivation with the clinical picture of
zoster. Infection with the vaccine strain results in the development of a
protective immune response, minimal rash in a minority of individuals, rare
transmission to other susceptible contacts, and a greatly reduced risk of zoster.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11339549 [PubMed - indexed for MEDLINE]

2814: Arch Virol Suppl. 2001;(17):27-39.

Varicella-zoster virus with a lost gE epitope: evidence for immunological
pressure by the human antibody response.

Padilla JA, Grose C.

Department of Microbiology & Pediatrics, University of Iowa, Iowa City, USA.

The varicella-zoster virus (VZV) genome contains about 70 open reading frames
(ORF). ORF 68 codes for glycoprotein gE, formerly called gpl, which is the
predominant VZV glycoprotein; gE is a typical type 1 transmembrane protein with
623 amino acids. Recently, a variant virus was discovered which has a mutation in
gE codon 150; this mutation converts an aspartic acid into an asparagine residue.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11339548 [PubMed - indexed for MEDLINE]

2815: Arch Virol Suppl. 2001;(17):173-8.

Varicella-zoster virus immunity and prevention: a conference perspective.

Straus SE.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, National Institutes of Health, Bethesda, Maryland
20892-1882, USA.

This report offers a concise overview of the VZV Conference, highlighting recent 
developments in the field and speculating on areas of greatest opportunity and
need for future work. The goal of eradicating VZV disease will be facilitated by 
a multifaceted research agenda directed at a fuller comprehension of how the
virus replicates, spreads and persists, and how it eludes host immune responses.

Publication Types: 
    Review

PMID: 11339547 [PubMed - indexed for MEDLINE]

2816: Arch Virol Suppl. 2001;(17):17-25.

Investigation of varicella-zoster virus variation by heteroduplex mobility assay.

Barrett-Muir W, Hawrami K, Clarke J, Breuer J.

Department of Medical Microbiology, St Bartholomews and the Royal London
Hospitals Medical Schools, Queen Mary and Westfield College, UK.

Heteroduplex mobility assays of 37 regions were performed on ten UK isolates of
varicella zoster virus, four from cases of zoster, and six from cases of
chickenpox. The variation between isolates was found to be 0.061%, which is at
least five times lower than any other member of the human herpesvirus family.
Fifteen of the 37 regions tested had 29 single nucleotide polymorphisms, and over
half the polymorphisms were located in four gene fragments. Of the 29 SNPs,
eleven were non-synonymous and these were clustered in six genes. Isolates from a
child and her mother to whom she had transmitted the virus, were identical at
every locus tested. All other viruses could be distinguished by a combination of 
SNPs and length polymorphisms of the repeat regions R1, R2 and R5.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11339546 [PubMed - indexed for MEDLINE]

2817: Arch Virol Suppl. 2001;(17):161-72.

Immunization of the elderly to boost immunity against varicella-zoster virus
(VZV) as assessed by VZV skin test reaction.

Takahashi M, Kamiya H, Asano Y, Shiraki K, Baba K, Otsuka T, Hirota T, Yamanishi 
K.

The Research Foundation for Microbial Diseases of Osaka University, Suita, Japan.

The utility of the VZV skin test in detecting individual susceptibility to
varicella and zoster was determined. Its specificity particularly with regard to 
herpes simplex was also established. The VZV skin test was negative or weakly
positive during the early stage of herpes zoster, and strongly positive during
recovery from that disease. A small-scale clinical trial to immunize elderly
individuals has been performed for the purpose of preventing herpes zoster, and, 
perhaps, severe post-herpetic neuralgia as well. Sixty individuals > or = 50
years old were screened for VZV antibodies by IAHA test and were given a VZV skin
test for cell-mediated immunity. All were seropositive, but eight were skin-test 
negative. Thirty-seven individuals including the eight with negative skin tests
were immunized with one dose of varicella vaccine (3.0 x 10(4) PFU/dose). After
5-7 weeks, the skin test reaction showed increased positivity, with a change in
score from (-) to (+, ++) in 7/8 subjects, from (+) to (++, +++) in 3/5 subjects,
and from (++) to (+++) in 6/10 subjects. Enhancement of the VZV antibody titer
(defined as twofold or greater) was observed in all 15 vaccine recipients with a 
prevaccination titer of < or = 1:16, and in 19 of 24 subjects with a
prevaccination titer of > or = 1:32. These results indicate that giving live
varicella vaccine with a high viral titer can induce a good boost immunity
particularly cell-mediated immunity to VZV in the elderly.

Publication Types: 
    Review

PMID: 11339545 [PubMed - indexed for MEDLINE]

2818: Arch Virol Suppl. 2001;(17):151-60.

Use of varicella vaccines to prevent herpes zoster in older individuals.

Levin MJ.

Department of Pediatrics, University of Colorado School of Medicine, Denver
80262, USA.

It is likely that the frequency and severity of herpes zoster in older people is 
the result of an age-related decline in varicella-zoster virus-specific T-cell
mediated immunity. Numerous trials of vaccines to boost these responses have
demonstrated their safety and immunogenicity. Both live attenuated and
inactivated vaccines have been studied. Persistence of booster responses is
dose-related, and the half-life of some boosted measures of T-cell mediated
immunity exceeds 5 years. Although these trials have been hampered by uncertainty
about the critical immune responses to evaluate, the stage is set for a
double-blind, placebo-controlled trial of sufficient size to determine efficacy. 
Such a trial is now underway.

Publication Types: 
    Review

PMID: 11339544 [PubMed - indexed for MEDLINE]

2819: Arch Virol Suppl. 2001;(17):135-42.

Varicella zoster virus in human and rat tissue specimens.

Annunziato PW, Lungu O, Panagiotidis C.

Department of Pediatrics, College of Physicians and Surgeons, Columbia
University, New York, New York, USA.

The limited supple of appropriate tissues for study has been an impediment to
investigations of varicella zoster virus (VZV) latency. Human dorsal root ganglia
(DRG) harboring latent virus are not plentiful and are not amenable to
manipulation for studying the events surrounding the establishment, maintenance, 
and cessation of latency. An alternative to studies in human DRG is the rat model
of latency, which appears to provide a reliable method of investigating VZV
latency. Other alternatives include studies in other human tissues involved in
VZV pathogenesis. In order to improve our understanding of the establishment and 
cessation of latency, we performed comparative immunohistochemical analysis of
chickenpox and zoster skin lesions. This analysis revealed that during primary
infection and reactivation productive VZV infection occurs in a variety of cell
types and that the major VZV DNA binding protein, ORF29p, is present in
peripheral axons early during the course of chickenpox. VZV latency was studied
in the rat model by in situ hybridization and compared with similar studies
performed in human DRG containing latent virus, confirming that VZV DNA persists 
in the same sites in DRG of the two species.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11339542 [PubMed - indexed for MEDLINE]

2820: Arch Virol Suppl. 2001;(17):109-19.

Pathway of viral spread in herpes zoster: detection of the protein encoded by
open reading frame 63 of varicella-zoster virus in biopsy specimens.

Iwasaki T, Muraki R, Kasahara T, Sato Y, Sata T, Kurata T.

Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan.

Reactivation of varicella-zoster virus (VZV) in the dorsal root or trigeminal
ganglia causes herpes zoster. The pathway of viral spread from the ganglia to the
skin and also within the skin is not yet completely understood. Histological
studies have revealed that each skin lesion in herpes zoster progresses
sequentially through the stages of erythema, vesicles, pustules and finally
ulceration. An immunohistochemical study of the early skin lesions of herpes
zoster demonstrated a high incidence of hair follicle involvement and the main
localization of the virus at the isthmus. This evidence suggests that VZV
initially spreads from the ganglia through myelinated nerves, which predominantly
end around the isthmus of hair follicles. To further investigate the viral spread
within the skin, we analyzed the sequential appearance of the immediate early
proteins encoded by ORF 63 of VZV (IE63), using an anti-IE63 antibody raised by
immunization of rabbits with a recombinant protein. This antibody could detect
IE63 in a western blot analysis of infected cells and also in immunohistochemical
analysis of the skin lesions of herpes zoster. IE63 initially appeared in the
nuclei of the follicular epithelial cells and basal or parabasal epidermal cells.
Later, the nuclei and cytoplasm of cells in the epidermis and hair follicles
became positive. IE63 remained in the virus-infected cells even during their
degeneration. When we examined the hair follicles in the early erythematous
lesions, cells positive for IE63 were predominantly distributed around the
isthmus. In addition, some lymphocytes around the blood vessels were also
positive for IE63, but these cells were seldom positive for the structural
antigen. Thus, these observations suggest that VZV arriving through myelinated
nerves infects not only permissive cells, but also non-permissive cells in the
involved skin of herpes zoster.

Publication Types: 
    Review

PMID: 11339540 [PubMed - indexed for MEDLINE]

2821: Arch Virol Suppl. 2001;(17):1-6.

The current status of live attenuated varicella vaccine.

Gershon AA.

Department of Pediatrics, Columbia University College of Physicians & Surgeons,
New York, New York 10032, USA.

This manuscript reviews the means by which live attenuated varicella vaccine
offers protection against varicella and zoster. It is accepted that although
varicella is usually a mild illness, complications leading to morbidity and
mortality are significant and the disease is worth preventing. The vaccine offers
close to 100% protection from severe chickenpox and 90% protection from illness. 
Waning of immunity after vaccination, particularly in children, has not been a
significant problem. Ways in which vaccination may decrease the incidence and
severity of zoster include the following. Vaccine virus may be less likely to
establish latency and to be able to reactivate than wild type virus. In addition,
by selective immunization of certain hosts such as HIV-infected children whose,
immune systems are still relatively intact and individuals with latency due to
wild type virus to boost the cell-mediated immune response to the virus, zoster
may be decreased. Varicella vaccine is predicted to have a major impact on the
epidemiology of varicella and zoster in countries with high vaccine uptake.

Publication Types: 
    Review

PMID: 11339539 [PubMed - indexed for MEDLINE]

2822: Neurologia. 2001 Mar;16(3):112-7.

[Neurologic complications of herpes zoster. A retrospective study in 100
patients]

[Article in Spanish]

Sanchez-Guerra M, Infante J, Pascual J, Berciano J, Polo J.

Servicio de Neurologia. Hospital Universitario Marques de Valdecilla, Santander.

INTRODUCTION AND OBJECTIVES: The neurologic complications associated with herpes 
zoster are infrequent except for postherpetic neuralgia. The aim of this study
was to review the clinical profile and the distribution of these complications in
a retrospective series of patients. PATIENTS AND METHOD: A retrospective analysis
of the last 100 patients admitted with the diagnosis of herpes zoster with
neurologic complications to our center from 1992 to 1999 by the Departments of
Internal Medicine and Neurology was performed. The characteristics of the
complications other than postherpetic neuralgia are reported. RESULTS: Aside from
the 88 patients with postherpetic neuralgia, the 12 remaining patients presented 
other complications: seven different peripheral neuropathies, including three
with Ramsay-Hunt syndrome, two meningitis, one encephalitis and one myelitis. In 
addition, one patient had ophthalmic herpes zoster with cerebral vasculopathy as 
ipsilateral Wallenberg's syndrome. Nine patients (75%) were males, four (25%)
were under the age of 20 years and seven older than 60 years and only three were 
immunodepressed. The CSF was abnormal in six out of the eight patients in whom it
was studied with lymphocytic pleocytosis being shown on analysis without
qualitative or quantitative alteration in intrathecal synthesis of IgG. In the
immunosuppressed patients the serology in the CSF of the varicela zoster virus
was negative. All patients demonstrated regressive evolution following treatment 
with acyclovir. CONCLUSIONS: Neurologic complications other than postherpetic
neuralgia occurred in 12% of the patients of this series, there was male
predominance and peripheral neuropathies were the most frequent complications.
Serology of the varicela zoster virus in immunosuppressed patients may be
negative. In this series the prognosis was mainly satisfactory.

Publication Types: 
    English Abstract

PMID: 11333780 [PubMed - indexed for MEDLINE]

2823: MMW Fortschr Med. 2001 Mar 29;143(13):16-8.

[Neuralgia after herpes zoster. Dealing with the trouble at the (nerve) roots]

[Article in German]

Eiden P.

Publication Types: 
    News

PMID: 11332012 [PubMed - indexed for MEDLINE]

2824: Biosci Biotechnol Biochem. 2001 Mar;65(3):683-5.

Antiviral activity of fattiviracin FV-8 against human immunodeficiency virus type
1 (HIV-1).

Habib ES, Yokomizo K, Nagao K, Harada S, Uyeda M.

Faculty of Pharmaceutical Sciences, Kumamoto University, Japan.

A novel antiviral agent, fattiviracin FV-8, purified from the culture broth of
Streptomyces microflavus strain No. 2445, showed potent antiviral activities
against human immunodeficiency virus type 1 (HIV-1), herpes simplex virus type 1 
(HSV-1), varicella-zoster virus (VZV), and influenza A and B viruses. The action 
mechanism of fattiviracin FV-8 against HIV-1 was examined. As a result, the agent
was thought to act on HIV-1 particles directly without lysis of the particles,
and it affords the inhibition of viral entry into the host cells.

PMID: 11330690 [PubMed - indexed for MEDLINE]

2825: Dermatol Online J. 2001 Feb;7(1):6.

Kissing bugs (Triatoma) and the skin.

Vetter R.

Department of Entomlogy, University of California Riverside, USA.

Kissing bugs (Family Reduviidae) can be the source of nocturnal dermatologic
wounds in the mid to southern latitudes in the United States. The insects are
obligate blood feeders and though the bites may be asymptomatic, a variety of
dermatologic eruptions or death from anaphylaxis can result. The various
dermatologic forms of the bite can be mistaken for herpes zoster, erythema
multiforme and the ubiquitous catch-all diagnoses of "spider-bite."

Publication Types: 
    Review

PMID: 11328627 [PubMed - indexed for MEDLINE]

2826: Arch Dermatol. 2001 Apr;137(4):443-8.

Mucocutaneous presence of cytomegalovirus associated with human immunodeficiency 
virus infection: discussion regarding its pathogenetic role.

Dauden E, Fernandez-Buezo G, Fraga J, Cardenoso L, Garcia-Diez A.

Department of Dermatology, Hospital de la Princesa, Autonoma University of
Madrid, c/Diego de Leon, 62, 28006 Madrid, Spain. edaudent@medynet.com

OBJECTIVES: To investigate the significance of cytomegalovirus (CMV) in
mucocutaneous lesions in patients with human immunodeficiency virus (HIV), and to
elucidate its pathogenetic role in lesions genesis. DESIGN: Retrospective (study 
1) and prospective (studies 2 and 3) surveys. SETTING: Departments of
Dermatology, Pathology, and Microbiology at a university hospital in Madrid,
Spain. PATIENTS: Seventeen HIV-infected patients with CMV presenting any type of 
mucocutaneous lesions (study 1); 27 HIV-positive patients with mucocutaneous
vesicles and/or ulcers of any type and location (study 2); and 12 severely
immunosuppressed HIV-positive volunteers (study 3). INTERVENTIONS: Mucocutaneous 
biopsy specimens from the lesions (studies 1 and 2) and from nonlesional skin
(study 3) were analyzed by light microscopy, immunohistochemical analysis, and
microbiological analysis (standard viral culture and shell-vial technique). MAIN 
OUTCOME MEASURES: Clinical data; histologic, immunohistochemical, and
microbiological findings. RESULTS: (1) Studies 1 and 2: Most of the lesions where
CMV was found were ulcers localized mainly on perianal, genital, and perigenital 
areas, usually as part of polymicrobial infections, particularly herpes simplex
and varicella-zoster virus infections. The finding of CMV was confirmed in all
cases by light microscopy; microbiological analysis was rarely useful. The
finding of mucocutaneous CMV inclusions allowed their early detection in
extracutaneous locations. (2) Study 3: Cytomegalovirus was present on healthy
skin of the perianal area in 3 patients, and on the forearm in 1 patient.
CONCLUSION: Cytomegalovirus does not play any significant pathogenetic role at
least in most of the cutaneous lesions where it is found.

Publication Types: 
    Comparative Study

PMID: 11295924 [PubMed - indexed for MEDLINE]

2827: J Perinatol. 2001 Mar;21(2):141-6.

Congenital varicella-zoster virus infection after maternal subclinical infection:
clinical and neuropathological findings.

Mustonen K, Mustakangas P, Valanne L, Professor MH, Koskiniemi M.

Department of Neuropediatrics, North Karelia Central Hospital, 80210 Joensuu,
Finland.

OBJECTIVE: It is known that varicella-zoster virus (VZV) can cause asymptomatic
infections, but it has not been described that congenital infection can be caused
by maternal subclinical infection. The purpose of this study is to evaluate
clinical and neuropathologic findings of infants with neonatal seizures and
cerebrospinal fluid (CSF) VZV antibodies, but no maternal clinical VZV infection 
during the pregnancy. STUDY DESIGN: Screening of 201 neonates were studied for
congenital viral infections, because of neurologic problems of unknown origin.
Antibodies to 16 different microbes were investigated from the CSF and the serum 
of the neonates, as well as from the first trimester and postpartum serum of
their mothers. Clinical symptoms and signs as well as neuropathology of those
infants with antibodies to VZV in CSF were evaluated in this study. RESULTS: Four
neonates with antibodies to VZV in CSF were identified and CSF findings were
reported earlier. Their mothers had laboratory evidence of infection, based on a 
significant rise in serum VZV antibody level during pregnancy in three mothers,
and a constantly high antibody level to VZV in one mother. All four children had 
seizures and abnormalities in muscular tone during the neonatal period, but no
typical manifestations of a congenital VZV infection. One child died at the age
of 4 months. At autopsy, neuropathologic examination showed foci of astrocytic
hyperplasia and hypertrophy but no specific signs of viral infection. CONCLUSION:
Maternal subclinical VZV infection can cause congenital infection with neurologic
symptoms and signs in the child.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Review

PMID: 11324362 [PubMed - indexed for MEDLINE]

2828: J Calif Dent Assoc. 2000 Dec;28(12):911-21.

Herpesvirus-induced diseases: oral manifestations and current treatment options.

Birek C.

Faculty of Dentistry, University of Manitoba, Canada.

The dentist is often the first health professional to be contracted by patients
who develop acute orofacial symptoms of viral conditions such as shingles
(varicella zoster) or herpetic gingivostomatitis. The diagnosis, treatment, and
management of virally induced oral diseases is a challenge inasmuch as their
presentation is atypical and may be complicated by immunosuppression. However, an
increasing body of knowledge regarding the manifestations of viral infections in 
immunocompromised patients and the advances achieved in antiviral drug therapy
during the past several years should make the task less daunting for the dentist.
In this paper, the natural history, typical and atypical oral manifestations,
diagnosis, current treatment options, and advances in the prevention of common
herpesvirus-induced diseases are reviewed, with particular attention to primary
and recurrent varicella zoster virus and herpes simplex type 1 infections.

Publication Types: 
    Review

PMID: 11323945 [PubMed - indexed for MEDLINE]

2829: Pain. 2001 May;92(1-2):139-45.

Erratum in:
    Pain 2001 Dec;94(3):325.

The density of remaining nerve endings in human skin with and without
postherpetic neuralgia after shingles.

Oaklander AL.

Department of Neurological Surgery, Johns Hopkins Medical Institutions, Boston,
MA, USA. aoaklander@partners.org

The mechanisms of chronic neuropathic pain are not well understood. Postherpetic 
neuralgia (PHN), which occurs in some patients after shingles (herpes zoster),
was used to investigate the neural determinants of chronic pain. Skin biopsies
were obtained from 38 adults with or without PHN at least 3 months after healing 
of shingles on the torso. Vertical sections were immunolabeled against PGP9.5, a 
pan-axonal marker, to measure the density of remaining nerve endings in skin
previously affected by shingles. All axons that end in the epidermis are
nociceptors, neurons that transmit pain messages. The densities ranged between 2 
and 3976 neurites/mm2 skin surface, but the overlap between subjects and without 
PHN was small. Of 19 subjects without PHN, 17 had more than 670 neurites/mm2 skin
surface area (mean +/- SEM = 1569 +/- 230), and 18 of 19 subjects with PHN had
640 or fewer neurites/mm2 (mean +/- SEM = 367 +/- 92). PHN may be a
'phantom-skin' pain associated with loss of nociceptors. This threshold of
approximately 650 neurites/mm2 skin surface was not detected in previous studies 
that used summary statistics. It implies that the absence of pain after shingles 
may require the preservation of a minimum density of primary nociceptive neurons,
and that the density of epidermal innervation may provide an objective correlate 
for the presence or absence of PHN pain.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11323135 [PubMed - indexed for MEDLINE]

2830: An Med Interna. 2000 Nov;17(11):618-9.

[Myelitis after varicella zoster virus (VZV) primi-infection: report of a case]

[Article in Spanish]

Ameneiros Lago E, Cerecedo Perez MJ, de la Fueute R, Macias Arribi M.

Publication Types: 
    Case Reports
    Letter

PMID: 11322043 [PubMed - indexed for MEDLINE]

2831: J Pediatr Gastroenterol Nutr. 2001 Feb;32(2):207-8.

Comment in:
    J Pediatr Gastroenterol Nutr. 2001 Nov;33(5):633.

Systemic absorption with complications during topical tacrolimus treatment for
orofacial Crohn disease.

Russell RK, Richardson N, Wilson DC.

Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Sick 
Children, Edinburgh, Scotland, UK. richardkrussell71@hotmail.com

Publication Types: 
    Case Reports

PMID: 11321395 [PubMed - indexed for MEDLINE]

2832: Ophthalmology. 2001 May;108(5):869-76.

Herpes simplex virus type 2 as a cause of acute retinal necrosis syndrome in
young patients.

Van Gelder RN, Willig JL, Holland GN, Kaplan HJ.

Department of Ophthalmology and Visual Sciences, Washington University Medical
School, St. Louis, Missouri.

PURPOSE: To determine the causative virus in acute retinal necrosis (ARN)
syndrome in a series of patients by calculation of modified Witmer coefficients. 
DESIGN: Noncomparative case series. PARTICIPANTS: Ten patients with ARN syndrome 
from four medical centers. METHODS: Aqueous samples, vitreous samples, or both
were collected prospectively during surgery from patients with a clinical
diagnosis of ARN syndrome. Serologic measures of intraocular and serum antibodies
to potentially causative viruses were measured by enzyme-linked immunosorbent
assay. MAIN OUTCOME MEASURES: Modified Witmer coefficients (immunoglobulin G and 
immunoglobulin A) for herpes simplex virus types 1 (HSV-1) and 2 (HSV-2),
varicella zoster virus (VZV), and cytomegalovirus (CMV), as well as adenovirus
type 2, were calculated from aqueous or vitreous samples, or both. RESULTS:
Intraocular antibody measurements were strongly suggestive of a single diagnosis 
in 9 of 10 patients tested. Modified Witmer coefficients demonstrated intraocular
antibody production to HSV in five patients and antibodies to VZV in four
patients, and the measurement was inconclusive in one patient. No patients were
positive for adenovirus or CMV. Strain-specific antibody titers demonstrated that
all HSV-positive patients were reactive only to HSV-2. Herpes simplex virus type 
2 was found predominantly in younger patients with ARN syndrome (mean age, 21.2
+/- 10 years; range, 17-39 years), whereas VZV was more commonly seen in older
patients (mean age, 40.8 +/- 12.2 years; range, 29-58 years; P = 0.033).
Immunoglobulin A testing confirmed immunoglobulin G testing in all patients
examined. CONCLUSIONS: Although VZV is thought to be the most common cause of ARN
syndrome, HSV-2 is an important cause of ARN syndrome, particularly in younger
patients. Because infection with HSV-2 has important medical ramifications, these
results suggest that determination of a causal agent should be considered in some
cases of ARN syndrome.

PMID: 11320015 [PubMed - indexed for MEDLINE]

2833: Rev Neurol (Paris). 2001 Mar;157(3):321-2.

[Benign acute ataxia in an adult with VZV infection]

[Article in French]

Rousseva D, Blard JM, Pages M.

Service de Neurologie A, CHU Gui de Chauliac, Montpellier Cedex 5, France.

In adults, neurological complications of VZV virus usually occur after herpes
zoster infection in patients with AIDS. We report a case of acute and benign
cerebellar ataxia after chickenpox in a patient without immunodeficiency.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11319497 [PubMed - indexed for MEDLINE]

2834: Arch Ophthalmol. 2001 Apr;119(4):608-10.

Optic chiasm, optic nerve, and retinal involvement secondary to varicella-zoster 
virus.

Greven CM, Singh T, Stanton CA, Martin TJ.

Wake Forest University Eye Center, Medical Center Boulevard, Winston-Salem, NC
27157-1033. cgreven@wfubmc.edu

Immunocompromised patients are known to be at risk for varicella-zoster virus
reactivation, often in atypical manners. We describe a 30-year-old man with
simultaneous involvement of the retina, optic chiasm, and optic nerve with
varicella-zoster virus who had a bitemporal visual field defect.

Publication Types: 
    Case Reports

PMID: 11296030 [PubMed - indexed for MEDLINE]

2835: Clin Infect Dis. 2001 May 15;32(10):1481-6. Epub 2001 Apr 17.

Herpes zoster in older adults.

Schmader K.

Center for the Study of Aging and Human Development and Division of Geriatrics,
Department of Medicine, Duke University Medical Center, Durham, NC, USA.
schma001@mc.duke.edu

Herpes zoster (HZ) strikes millions of older adults annually worldwide and
disables a substantial number of them via postherpetic neuralgia (PHN). Key
age-related clinical, epidemiological, and treatment features of zoster and PHN
are reviewed. HZ is caused by renewed replication and spread of varicella-zoster 
virus (VZV) in sensory ganglia and afferent peripheral nerves in the setting of
age-related, disease-related, and drug-related decline in cellular immunity to
VZV. VZV-induced neuronal destruction and inflammation causes the principal
problems of pain, interference with activities of daily living, and reduced
quality of life in elderly patients. Recently, attempts to reduce or eliminate HZ
pain have been bolstered by the findings of clinical trials that antiviral agents
and corticosteroids are effective treatment for HZ and that tricyclic
antidepressants, topical lidocaine, gabapentin, and opiates are effective
treatment for PHN. Although these advances have helped, PHN remains a difficult
condition to prevent and treat in many elderly patients.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Review

PMID: 11317250 [PubMed - indexed for MEDLINE]

2836: Clin Infect Dis. 2001 May 15;32(10):1414-22. Epub 2001 Apr 18.

A predictive model of varicella-zoster virus infection after autologous
peripheral blood progenitor cell transplantation.

Offidani M, Corvatta L, Olivieri A, Mele A, Brunori M, Montanari M, Rupoli S,
Scalari P, Leoni P.

Department of Hematology, Ancona University School of Medicine, Ancona, Italy.
clinemat@popcsi.unian.it

Varicella-zoster virus (VZV) frequently causes severe infections in patients who 
have undergone bone marrow transplantation. The frequency of, characteristics of,
and risk factors for this infection were studied in 164 patients undergoing
autologous peripheral blood progenitor cell transplantation (PBPCT). Twenty-six
patients (15.8%) developed VZV infection, and the actuarial risk was 10% at 1
year. No patient had visceral dissemination or died because of VZV, although
one-third of the patients developed postherpetic neuralgia. By multivariate
analysis, a CD4(+) lymphocyte count of <200 cells/microL (P<.0001; odds ratio
[OR], 2.0) and a CD8(+) lymphocyte count of <800 cells/microL (P=.0073; OR, 2.0) 
at day 30 after transplantation were factors associated with VZV infection.
Patients with both these adverse factors had an actuarial risk of VZV of 48% at 1
year. Patients with deficiency in both CD4(+) and CD8(+) lymphocytes are at high 
risk of VZV infection. These patients should be considered as candidates for
preventive therapy, but whether for antiviral therapy or vaccination remains to
be investigated.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11317241 [PubMed - indexed for MEDLINE]

2837: Br J Ophthalmol. 2001 May;85(5):576-81.

Famciclovir for ophthalmic zoster: a randomised aciclovir controlled study.

Tyring S, Engst R, Corriveau C, Robillard N, Trottier S, Van Slycken S, Crann RA,
Locke LA, Saltzman R, Palestine AG; Collaborative Famciclovir Ophthalmic Zoster
Research Group.

University of Texas Medical Branch, Galveston, TX, USA.

AIMS: To compare the efficacy and safety of famciclovir with aciclovir for the
treatment of ophthalmic zoster. METHODS: Randomised, double masked, aciclovir
controlled, parallel group in 87 centres worldwide including 454 patients with
ophthalmic zoster of trigeminal nerve (V(1)) comprised the intent to treat
population. Oral famciclovir 500 mg three times daily or oral aciclovir 800 mg
five times daily for 7 days. Assessments included day 0 (screening), days 3 and 7
(during treatment), days 10, 14, 21, 28 and monthly thereafter, up to 6 months
(follow up). Proportion of patients who experienced ocular manifestations, severe
manifestations and non-severe manifestations; loss of visual acuity was the main 
outcome measure. RESULTS: The percentage of patients who experienced one or more 
ocular manifestations was similar for famciclovir (142/245, 58.0%) and aciclovir 
(114/196, 58.2%) recipients, with no significant difference between groups (OR
0.99; 95% CI 0.68, 1.45). The percentage of patients who experienced severe and
non-severe manifestations was similar between groups, with no significant
difference. The prevalence of individual ocular manifestations was comparable
between groups. There was no significant difference between groups for visual
acuity loss. CONCLUSION: Famciclovir 500 mg three times daily was well tolerated 
and demonstrated efficacy similar to aciclovir 800 mg five times daily.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 11316720 [PubMed - indexed for MEDLINE]

2838: Lupus. 2001;10(3):154-61.

Cyclophosphamide for the treatment of systemic lupus erythematosus.

Takada K, Illei GG, Boumpas DT.

Arthritis and Rheumatism Branch, National Institute of Arthritis and
Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda,
Maryland, USA.

Aggressive immunosuppressive therapy with cyclophosphamide has improved the
outcome of major organ disease in lupus patients. Controlled trials have shown
that pulse cyclophosphamide is the treatment of choice for patients with moderate
to severe proliferative nephritis. Long-term follow-up of patients participating 
in these controlled trials suggests that combining pulse cyclophoshamide with
pulse methylprednisolone increases efficacy but not toxicity. Retrospective case 
series have also shown that pulse cyclophosphamide therapy may be effective for
the management of severe or refractory to standard therapy neuropsychiatric,
pulmonary, cardiovascular and hematologic disease. Pulse cyclophosphamide is
associated with an increased risk for herpes zoster infections in the short term 
and with sustained amenorrhea in the long-term. Recent studies have also drawn
attention to the lack of response (or incomplete response) and flare of lupus
after an initial response. In an effort to circumvent these limitations, current 
investigations explore the therapeutic potential of high-dose, immunoablative
cyclophosphamide therapy or low-dose cyclophosphamide in combination with
nucleoside analogs or biologic response modifiers.

Publication Types: 
    Review

PMID: 11315345 [PubMed - indexed for MEDLINE]

2839: J Clin Pediatr Dent. 2001 Winter;25(2):107-12.

Oral manifestations of infections of infections due to varicella zoster virus in 
otherwise healthy children.

Kolokotronis A, Louloudiadis K, Fotiou G, Matiais A.

Department of Oral Medicine and Pathology, Dental School of Aristotle University 
of Thessaloniki, 54006 Thessaloniki, Greece.

Varicella zoster virus (VZV) causes varicella (or chickenpox) and establishes
latency in nerve ganglia after the primary infection. The reactivation of virus
later in life can cause mono- or polyneuropathy. The cranial nerves most commonly
involved are five (herpes zoster or shingles), six, seven eight, nine and ten. In
the present study we describe the oral lesions associated with VZV infections in 
normal children. In a 3 year period we examined 62 children, age 2 to 13 years
old with diagnosed varicella and a 4 year old boy with herpes zoster at the 3rd
branch of the trigeminal nerve. According to the clinical picture of varicella,
the disease was defined as: (1) group A mild cases; (2) group B moderate cases;
(3) group C severe. The manifestations of varicella were: mild varicella 19
children, moderate 26 children and severe 17 children. The results of the present
study indicate that the prevalence of oral manifestations of varicella is related
to the severity of the disease. In 17 severe cases, oral lesions were always
present and the number was between 5 to 30. From 26 moderate cases, oral lesions 
were observed in 23 and the number was between 2 to 10. From 19 mild cases, oral 
lesions were present only in 6 cases and their number was 1 or 2. Often
varicella's oral lesions resemble manifestations of other entities, and this may 
cause differential diagnostics problems.

PMID: 11314207 [PubMed - indexed for MEDLINE]

2840: J Am Acad Dermatol. 2001 May;44(5):785-8.

Prevalence and predictors of skin disease in the Women's Interagency HIV Study
(WIHS).

Mirmirani P, Hessol NA, Maurer TA, Berger TG, Nguyen P, Khalsa A, Gurtman A,
Micci S, Young M, Holman S, Gange SJ, Greenblatt RM.

WIHS Collaborative Study Group, University of California, San Francisco
94143-0316, USA.

OBJECTIVE: We attempted to determine the prevalence and predictors of skin
disease in a cohort of women with and at risk for HIV infection. METHODS: We
analyzed baseline data from a multicenter longitudinal study of HIV infection in 
women. RESULTS: A total of 2018 HIV-infected women and 557 HIV-uninfected women
were included in this analysis. Skin abnormalities were reported more frequently 
among HIV-infected than uninfected women (63% vs 44%, respectively; odds ratio
[OR] 2.10; 95% confidence interval [95% CI], 1.74-2.54). Infected women were also
more likely to have more than 2 skin diagnoses (OR, 3.27; 95% CI, 1.31-8.16).
Folliculitis, seborrheic dermatitis, herpes zoster, and onychomycosis were more
common among HIV-infected women (P < .05). Independent predictors of abnormal
findings on skin examination in the infected women were African American race
(OR, 1.38; 95% CI, 1.07-1.77), injection drug use (OR, 2.74; 95% CI, 2.11-3.57), 
CD4(+) count less than 50 (OR, 1.68; 95% CI, 1.17-2.42), and high viral loads
(100,000-499,999 = OR, 1.77; 95% CI, 1.32-2.37; > 499,999 = OR, 2.15; 95% CI,
1.42-3.27). CONCLUSION: HIV infection was associated with a greater number of
skin abnormalities and with specific dermatologic diagnoses. Skin abnormalities
were also more common among women with CD4(+) cell depletion or higher viral
load.

Publication Types: 
    Multicenter Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 11312425 [PubMed - indexed for MEDLINE]

2841: Vaccine. 2001 Apr 30;19(23-24):3076-90.

The epidemiology of herpes zoster and potential cost-effectiveness of vaccination
in England and Wales.

Edmunds WJ, Brisson M, Rose JD.

Department of Economics, City University, Northampton Square, EC1 0HB, London,
UK. jedmunds@phls.org.uk

The epidemiology of herpes zoster and post-herpetic neuralgia (PHN) was
quantified from a variety of data sources and the potential cost-effectiveness of
vaccination assessed. The annual incidence and severity of zoster increases
sharply with age, as measured by physician consultation and hospitalisation
rates, average length of stay, average proportion of cases developing PHN and the
age-specific case-fatality ratio. Combining these data with information on health
related quality of life results in an estimated loss of 20000 quality adjusted
life years (QALYs) annually in England and Wales from herpes zoster (17400 due to
PHN). The current cost of treating herpes zoster associated disease is estimated 
to be 47.6m pounds annually. Since both the health and economic burden are high, 
vaccination of the elderly is expected to be cost-effective under most scenarios,
the attractiveness of immunisation increasing with age due to the increased
burden of disease in the very elderly.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11312002 [PubMed - indexed for MEDLINE]

2842: Eur Neurol. 2001;45(3):189-90.

Internal ophthalmoplegia as a presenting sign of herpes zoster ophthalmicus.

Assal F, Frank HG, von Gunten S, Chofflon M, Safran AB.

Department of Neurology, University Hospital, Geneva, Switzerland.
fredericassal@hotmail.com

Publication Types: 
    Case Reports

PMID: 11306868 [PubMed - indexed for MEDLINE]

2843: Nucleosides Nucleotides Nucleic Acids. 2001 Jan-Feb;20(1-2):41-58.

Synthesis of
1-(2-deoxy-beta-D-ribofuranosyl)-2,4-difluoro-5-substituted-benzenes: "thymine
replacement" analogs of thymidine for evaluation as anticancer and antiviral
agents.

Wang ZX, Duan W, Wiebe LI, Balzarini J, De Clercq E, Knaus EE.

Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton,
Canada.

A group of unnatural 1-(2-deoxy-beta-D-ribofuranosyl)-2,4-difluorobenzenes having
a variety of C-5 two-carbon substituents [-C...C-X, X = I, Br; -C...CH;
(E)-CH=CH-X, X = I, Br; -CH=CH2; -CH2CH3; -CH(N3) CH2Br], designed as nucleoside 
mimics, were synthesized for evaluation as anticancer and antiviral agents. The
5-substituted (E)-CH=CH-I and -CH2CH3 compounds exhibited negligible cytotoxicity
in a MTT assay (CC50 = 10(-3) to 10(-4)M range), relative to thymidine (CC50 =
10(-3) to 10(-5)M range), against a variety of cancer cell lines. In contrast,
the C-5 substituted -C...C-I and -CH(N3)CH2Br compounds were more cytotoxic (CC50
= 10(-5) to 10(-6)M range). The -C...C-I and -CH2CH3 compounds exhibited similar 
cytotoxicity against non-transfected (KBALB, 143B) and HSV-1 TK+ gene transfected
(KBALB-STK, 143B-LTK) cancer cell lines expressing the herpes simplex virus type 
1 (HSV-1) thymidine kinase gene (TK+). This observation indicates that expression
of the viral TK enzyme did not provide a gene therapeutic effect. The parent
group of 5-substituted compounds, that were evaluated using a wide variety of
antiviral assay systems [HSV-1, HSV-2, varicella-zoster virus (VZV), vaccinia
virus, vesicular stomatitis, cytomegalovirus (CMV), and human immunodeficiency
(HIV-1, HIV-2) viruses], showed that this class of unnatural C-aryl nucleoside
mimics are inactive and/or weakly active antiviral agents.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11303562 [PubMed - indexed for MEDLINE]

2844: Infect Dis Clin North Am. 2001 Mar;15(1):65-81, viii.

Live-attenuated varicella vaccine.

Gershon AA.

Department of Pediatrics, Columbia University College of Physicians & Surgeons,
New York, New York, USA. aag1@columbia.edu

This article reviews the history and development of live attenuated varicella
vaccine from its early days in Japan to its widespread use throughout the world. 
The vaccine has proven extremely safe after immunization of as many as 10 million
healthy children and adults in the United States alone. The vaccine is also
highly immunogenic and offers close to 100% protection from severe chickenpox and
90% protection from illness. It is expected to have a major impact on the
epidemiology of varicella and zoster in countries with high vaccine uptake.

Publication Types: 
    Review

PMID: 11301823 [PubMed - indexed for MEDLINE]

2845: Clin Microbiol Infect. 2001 Feb;7(2):91-3.

Herpes zoster in non-hospitalized children.

Socan M.

Center for Communicable Diseases, Institute of Public Health, Trubarjeva 2, 1000 
Ljubljana, Slovenia. maja.socan@ivz-rs.si

PMID: 11298150 [PubMed - indexed for MEDLINE]

2846: Int J Mol Med. 2001 May;7(5):535-8.

HHV-8 prevalence, immunosuppression and Kaposi's sarcoma in South Italy.

Crispo A, Tamburini M, De Marco MR, Ascierto P, Silvestro P, Ronga D, Tridente V,
Desicato S, Carbone S, Fabbrocini G, Spiteri D, Montella M.

Epidemiology Unit, National Cancer Institute, 80131 Naples, Italy.

The identification of HHV-8 has opened the way for numerous epidemiological
studies aimed at determining both the prevalence of HHV-8 in various sub-groups
of the population (affected or not by KS) and at identifying possible cofactors
necessary for the development of KS. We set up a study to evaluate the prevalence
of HHV-8 in the South of Italy in KS cases, hospital patients and blood donors
and to verify the role of immunosuppression in KS. In KS patients the prevalence 
of lytic and latent antigens were both 91% (29 positive cases). Lytic and latent 
antigens have prevalence rates of 20% and 15% respectively in hospital patients. 
In the donor group the rates were 16% for lytic antigens and 2% for latent
antigens. The most recurrent chronic pathology in KS patients was cardiopathy (5 
cases). The pathological case histories report 4 cases of Herpes Zoster, 6 of
diabetes, one case of hepatitis C who had also had gonorrea. There was also a
case, negative to HHV-8, who had had malaria after residing for three years in
Oristano in Sardinia (a zone with high endemic malaria). Our study confirms that 
in Southern Italy there are relatively high prevalences of HHV-8 both in the
general population and in blood donors and that immunodysregulation may be
involved in the pathogenesis of KS. Other studies are necessary to confirm the
sexual transmission of the HHV-8 virus and to better understand the natural
history of HHV-8 infection.

PMID: 11295117 [PubMed - indexed for MEDLINE]

2847: J Peripher Nerv Syst. 2001 Mar;6(1):21-7.

HIV neuropathy: insights in the pathology of HIV peripheral nerve disease.

Pardo CA, McArthur JC, Griffin JW.

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, 
Maryland, USA. cpardo@jhmi.edu

HIV-associated neuropathies (HIV-N) have become the most frequent neurological
disorder associated with HIV infection. The most common forms of HIV-N are the
distal sensory polyneuropathy (DSP) and antiretroviral toxic neuropathies (ATN), 
disorders characterized mostly by sensory symptoms that include spontaneous or
evoked pain that follow a subacute or chronic course. The main pathological
features that characterize DSP and ATN include "dying back" axonal degeneration
of long axons in distal regions, loss of unmyelinated fibers, and variable degree
of macrophage infiltration in peripheral nerves and dorsal root ganglia. Marked
activation of macrophages as well as the effect of pro-inflammatory cytokines
appear to be the main immunopathogenic factors in DSP. Interference with DNA
synthesis and mitochondrial abnormalities produced by nucleoside antiretrovirals 
have been hypothesized as pathogenic factors involved in ATN. The use of skin
biopsy has become a useful tool in the evaluation of HIV-N. Reduction in fiber
density, increased frequency of fiber varicosities and fiber fragmentation are
prominent features of skin biopsies from patients with HIV-N. Other forms of
HIV-N include acute or chronic inflammatory polyneuropathies, uncommon disorders 
that may ocur during seroconversion or early stages of HIV infection.
Opportunisitic infections, mostly associated with cytomegalovirus or herpes
zoster virus infection occur in late stages of AIDS and produce characteristic
clinical features such as mononeuritis multiple or radiculopathies.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11293804 [PubMed - indexed for MEDLINE]

2848: J Peripher Nerv Syst. 2001 Mar;6(1):2-7.

HIV-associated neuropathies: role of HIV-1, CMV, and other viruses.

Kolson DL, Gonzalez-Scarano F.

Department of Neurology, University of Pennsylvania Medical Center, Philadelphia,
USA. kolsond@mail.med.upenn.edu

The role of the human immunodeficiency virus (HIV) and other viruses in the
development of neuropathies associated with HIV infection is controversial.
Distal symmetric polyneuropathy (DSP), the most common subtype of HIV-associated 
neuropathy, is characterized by an abundance of reactive macrophages within the
peripheral nerve, but HIV replication is limited to a small percentage of the
macrophages. Thus, the pathological destruction may be mediated by
pro-inflammatory signals amplified by activated glial elements within the nerve, 
similar to the proposed mechanism of damage caused by HIV within the central
nervous system. In contrast, in mononeuropathy multiplex (MM) and progressive
polyneuropathy (PP), cytomegalovirus (CMV) replication in the peripheral nerve is
consistently demonstrable, and this replication likely results in direct damage
to the infected cells (neurons and glia). The rarest form of HIV-associated
neuropathy, the diffuse infiltrative lymphocytosis syndrome (DILS), is
characterized by an intense CD8+ T lymphocyte infiltration into the nerve and
abundant HIV infection of macrophages. Finally, while other viruses (varicella
zoster, herpes simplex) are associated with myelitis in HIV-infected individuals,
there is little support for a role for these viruses in HIV-associated
neuropathy.

Publication Types: 
    Review

PMID: 11293803 [PubMed - indexed for MEDLINE]

2849: Rev Neurol. 2001 Jan 1-15;32(1):15-8.

Comment in:
    Rev Neurol. 2001 Sep 16-30;33(6):599-600.

[Segmental motor paralysis caused by the varicella zoster virus. Clinical study
and functional prognosis]

[Article in Spanish]

Cruz-Velarde JA, Munoz-Blanco JL, Traba A, Nevado C, Ezpeleta D.

Servicio de Neurologia, Hospital General Universitario Gregorio Maranon, Madrid, 
Espana.

INTRODUCTION: Segmental motor paralysis of the limbs (SMP) complicates 2-3% of
the cases of cutaneous herpes zoster. Viral invasion and inflammation of the
motor neurons of the anterior horn cells by the varicella-zoster virus (VVZ)
causes clinical weakness at the same time and site as the cutaneous eruption.
OBJECTIVES: To analyze the clinical findings, complementary investigations and
functional prognosis of patients with SMP at brachial plexus and lumbosacral
levels. PATIENTS AND METHODS: We made a retrospective study of 10 patients with
SMP admitted to the Hospital Universitario Gregorio Maranon de Madrid during
1989-1999, aged between 38 and 84 years (6 women, 4 men). Neurological
examination was done, including muscle balance, complementary studies including
microbiology (serum and CSF serology, viral PCR-ADN), neurophysiology using MNR
of the spine and plexuses and functional prognosis on the NDS, NSS and RANKIN
scales. RESULTS: There is a close relationship between dermatome and myotome
involvement (90%). The brachial and lumbosacral plexuses were equally affected
(50%). Plasma and CSF VVZ serology was positive in 50% of the cases, permitting
diagnosis of a patient with no cutaneous lesions (zoster sine herpete).
Denervation of the myotomes involved and the paraspinal muscles was shown on
neurophysiological studies. In most cases there was functional improvement, with 
complete functional recovery in 80% of the cases after 12 months. CONCLUSIONS:
VVZ should be considered amongst the aetiologies of SMP, even in the absence of
cutaneous lesions (zoster sine herpete). The SMP coincides in time and place with
the dermatome lesions. In most patients there is complete functional recovery
within 12 months.

Publication Types: 
    English Abstract

PMID: 11293092 [PubMed - indexed for MEDLINE]

2850: FASEB J. 2001 Apr;15(6):1037-43.

Infection by human varicella-zoster virus confers norepinephrine sensitivity to
sensory neurons from rat dorsal root ganglia.

Kress M, Fickenscher H.

Institut fur Physiologie und Experimentelle Pathophysiologie,
Friedrich-Alexander-Universitat Erlangen-Nurnberg, D-91054 Erlangen, Germany.
kress@physiologie1.uni-erlangen.de

Varicella-zoster virus (VZV) is a widespread human herpes virus causing chicken
pox on primary infection and persisting in sensory neurons. Reactivation causes
shingles, which are characterized by severe pain and often lead to postherpetic
neuralgia. To elucidate the mechanisms of VZV-associated hyperalgesia, we
elaborated an in vitro model for the VZV infection of sensory neurons from rat
dorsal root ganglia. Between 35 and 50% of the neurons showed strong expression
of the immediate-early virus antigens IE62 and IE63 and the late glycoprotein gE.
When the intracellular calcium concentration was monitored microfluorometrically 
for individual cells after infection, the sensitivity to GABA or capsaicin was
similar in controls and in VZV-infected neurons. However, the baseline calcium
concentration was increased. Neurons became de novo sensitive to adrenergic
stimulation after VZV infection. Norepinephrine-responsive neurons were more
frequent and calcium responses to norepinephrine were significantly higher after 
infection with wild-type isolates than with the attenuated vaccine strain OKA.
The adrenergic agonists phenylephrine and isoproterenol had similar efficacy. We 
suggest that the infection with wild-type VZV isolates confers norepinephrine
sensitivity to sensory neurons by using alpha(1)- and/or beta(1)-adrenergic
receptors providing a model for the pathophysiology of the severe pain associated
with the acute reactivation of VZV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11292665 [PubMed - indexed for MEDLINE]

2851: J Assoc Physicians India. 2001 Mar;49:343-8.

Neurological manifestations of HIV disease.

Wadia RS, Pujari SN, Kothari S, Udhar M, Kulkarni S, Bhagat S, Nanivadekar A.

Department of Neurology, Ruby Hall Clinic and Poona Medical Research Foundation, 
Pune.

We report the results of neurological evaluation of 1,527 HIV positive subjects. 
Neurological complications were seen in 457 patients (481 neurological events).
The prevalence was 20.24% of patients attending the out-patient clinic and in
44.57% of in-patients. Involvement of all levels of neuraxes was documented. The 
commonest manifestations were neuropathies, including herpes zoster (28.27%),
meningitis (17.88%) and mass lesions (16%). Cryptococcal meningitis was clearly
commoner than tubercular meningitis (67.44% vs 18.60% of all cases of meningitis,
respectivelv). Amongst mass lesions, 14/24 single lesions and 27/38 multiple
lesions responded to anti-toxoplasma treatment and were diagnosed as CNS
toxoplasmosis. In abscence of biopsy, it would be prudent to initiate empirical
anti-toxoplasma treatment for all HIV patients with mass lesions and assess
clinical and radiological response. To our knowledge this is the largest series
of neurological manifestations of HIV disease documented in Indian literature.

PMID: 11291974 [PubMed - indexed for MEDLINE]

2852: Cancer Invest. 2001;19(1):13-22.

A randomized, double-blind trial of famciclovir versus acyclovir for the
treatment of localized dermatomal herpes zoster in immunocompromised patients.

Tyring S, Belanger R, Bezwoda W, Ljungman P, Boon R, Saltzman RL; Colaborative
Famciclovir Immunocompromised Study Group.

University of Texas Medical Branch, Galveston, TX 77555, USA. styring@utmb.edu

In this randomized, double-blind, multicenter, acyclovir-controlled study, the
efficacy and safety of famciclovir were evaluated for the treatment of herpes
zoster in patients who were immunocompromised following bone marrow or solid
organ transplantation or oncology treatment. A total of 148 patients, 12 years or
older with clinical evidence of localized herpes zoster, received either oral
famciclovir, 500 mg three times daily, or acyclovir, 800 mg five times daily, for
10 days. Famciclovir was equivalent to acyclovir with respect to the numbers of
patients reporting new lesion formation while on therapy (77% vs. 73%,
respectively). There were no significant differences between the groups in the
time to cessation of new lesion formation, full crusting, complete healing of
lesions, or loss of acute phase pain. Treatment with famciclovir was well
tolerated, with a safety profile comparable to that of acyclovir. Thus oral
famciclovir is a convenient, effective, and well-tolerated regimen for
immunocompromised patients with herpes zoster.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 11291551 [PubMed - indexed for MEDLINE]

2853: BMJ. 2001 Apr 7;322(7290):860-1.

Comment on:
    BMJ. 2000 Sep 30;321(7264):794-6.

Postherpetic neuralgia. Treatment with amitriptyline is cheaper than with
aciclovir.

Marshall T.

Publication Types: 
    Comment
    Letter

PMID: 11290647 [PubMed - indexed for MEDLINE]

2854: BMJ. 2001 Apr 7;322(7290):861.

Comment on:
    BMJ. 2000 Sep 30;321(7264):778-9.

Postherpetic neuralgia. Why burden the pain clinic?

Greer R, Severn A.

Publication Types: 
    Comment
    Letter

PMID: 11290645 [PubMed - indexed for MEDLINE]

2855: BMJ. 2001 Apr 7;322(7290):859-60.

Comment on:
    BMJ. 2000 Sep 30;321(7264):794-6.

Postherpetic neuralgia. Findings differ from earlier results.

Bowsher D.

Publication Types: 
    Comment
    Letter

PMID: 11290641 [PubMed - indexed for MEDLINE]

2856: BMJ. 2001 Apr 7;322(7290):860.

Comment on:
    BMJ. 2000 Sep 30;321(7264):794-6.

Postherpetic neuralgia. Pathogenesis of postherpetic neuralgia should be
determined.

Breuer J, Scott F, Leedham-Green M.

Publication Types: 
    Comment
    Letter

PMID: 11290628 [PubMed - indexed for MEDLINE]

2857: Semin Immunol. 2001 Feb;13(1):27-39.

Immune evasion as a pathogenic mechanism of varicella zoster virus.

Abendroth A, Arvin AM.

Centre for Virus Research, Westmead Millenium Institute, NSW, 2145, Australia.

Varicella zoster virus (VZV) is a human herpesvirus that causes varicella
(chickenpox) during primary infection, establishes latency in dorsal root ganglia
and may reactivate years later, producing herpes zoster. VZV must evade antiviral
immunity during three important stages of viral pathogenesis, including the
cell-associated viremia characteristic of primary infection, persistence in
dorsal root ganglia during latency and the initial period of VZV reactivation.
Our observations about the immunomodulatory effects of VZV document its capacity 
to interfere with adaptive immunity mediated by CD4 as well as CD8 T cells,
ensuring the survival of the virus in the human population from generation to
generation. Copyright 2001 Academic Press.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11289797 [PubMed - indexed for MEDLINE]

2858: MMW Fortschr Med. 2001 Mar 1;143(9):33-6.

[Symptomatic therapy of exanthema. Finding the proper externum]

[Article in German]

Mohrenschlager M, Ring J, Kohn FM.

Klinik und Poliklinik fur Dermatologie und Allergologie am Biederstein,
Technische Universitat Munchen.

In the treatment of exanthems, the first step is the elimination of the causal
agent. Of great importance also is the symptomatic treatment of the cutaneous
changes and such associated symptoms as itching and pain. The choice of the
appropriate external medication and its vehicle will depend on the clinical
findings, skin type, and the location of the skin lesions. The most important
therapeutic principles are discussed taking drug-induced exanthema, acute
urticaria and (herpes) zoster as examples.

Publication Types: 
    English Abstract
    Review

PMID: 11288529 [PubMed - indexed for MEDLINE]

2859: J Virol. 2001 May;75(9):4117-28.

Herpes simplex virus type 1 entry is inhibited by the cobalt chelate complex
CTC-96.

Schwartz JA, Lium EK, Silverstein SJ.

Integrated Program in Cellular, Molecular and Biophysical Studies, College of
Physicians and Surgeons, Columbia University, New York, New York 10032, USA.

The CTC series of cobalt chelates display in vitro and in vivo activity against
herpes simplex virus types 1 and 2 (HSV-1 and HSV-2). The experiments described
here identify the stage in the virus life cycle where CTC-96 acts and demonstrate
that the drug inhibits infection of susceptible cells. CTC-96 at 50 microg/ml has
no effect on adsorption of virions to Vero cell monolayers. Penetration assays
reveal that CTC-96 inhibits entry of the virus independent of gC and cellular
entry receptors. This observation was supported by the failure to detect the
accumulation of virus-specified proteins and alpha mRNA transcripts when CTC-96
is present at the onset of infection. Moreover, virion-associated alphaTIF does
not accumulate in the nucleus of cells infected in the presence of CTC-96. CTC-96
targets the initial fusion event between the virus and the cell and also inhibits
cell-to-cell spread and syncytium formation. Furthermore, CTC-96 inhibits plaque 
formation by varicella-zoster virus and vesicular stomatitis virus as efficiently
as by HSV-1. Collectively, these experiments suggest that CTC-96 is a
broad-spectrum inhibitor of infection by enveloped viruses and that it inhibits
HSV-1 infection at the point of membrane fusion independent of the type of virus 
and cellular receptors present.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11287561 [PubMed - indexed for MEDLINE]

2860: Bull World Health Organ. 2001;79(3):208-13.

Comment in:
    Bull World Health Organ. 2001;79(3):181.

HIV/AIDS and blindness.

Kestelyn PG, Cunningham ET Jr.

Department of Ophthalmology, Ghent University Hospital, De Pintelaan 185, B-9000 
Ghent, Belgium. philippe.kestelyn@rug.ac.be

Nearly 34 million people are currently living with HIV/AIDS: ocular complications
are common, affecting 50% to 75% of all such patients at some point during the
course of their illness. Cytomegalovirus retinitis is by far the most frequent
cause of vision loss in patients with AIDS. Although the prevalence of
cytomegalovirus retinitis is decreasing in industrialized countries because of
the widespread availability of highly active antiretroviral therapy, between 10% 
and 20% of HIV-infected patients worldwide can be expected to lose vision in one 
or both eyes as a result of ocular cytomegalovirus infection. Less frequent but
important causes of bilateral vision loss in patients with HIV/AIDS include
varicella zoster virus and herpes simplex virus retinitis, HIV-related ischaemic 
microvasculopathy, ocular syphilis, ocular tuberculosis, cryptococcal meningitis,
and ocular toxic or allergic drug reactions. At present, most patients with
HIV/AIDS in developing countries who lose their vision have a very limited life
expectancy. As antiretroviral therapy makes its way to these countries, however, 
both life expectancy and the prevalence of blindness related to HIV/AIDS can be
expected to increase dramatically.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11285664 [PubMed - indexed for MEDLINE]

2861: Am J Dermatopathol. 2001 Apr;23(2):146-8.

Herpesvirus infection of seborrheic keratoses.

Googe PB, King R.

Knoxville Dermatopathology Laboratory, Knoxville, Tennessee 37319, USA.

We present three examples of patients with seborrheic keratoses complicated by
necrotizing herpesvirus infection. Two patients had localized cutaneous herpetic 
infections, and the third patient had a generalized cutaneous herpesvirus
infection. Two of the lesions were thought to be squamous cell carcinoma. The
third was clinically identified as inflamed seborrheic keratosis. Herpesvirus
infection was not clinically suspected in two of the patients. The histologic
changes were similar in all cases. Epidermal proliferation was accompanied by
hyperkeratosis and pseudo horn cyst formation. Extensive keratinocyte necrosis
was present along with balloon degeneration of keratinocytes, herpetic viral
inclusions, and multinucleated giant cells. Viral lesions of molluscum
contagiosum and human papillomavirus have been observed in benign skin
proliferations. Nevertheless, we were unable to find descriptions of herpesvirus 
involvement in seborrheic keratosis in a Medline search. Necrotic seborrheic
keratoses should be carefully examined for the possibility of herpesvirus
infection, a condition that may be improved by prompt medical intervention as
demonstrated in one of our cases.

Publication Types: 
    Case Reports

PMID: 11285412 [PubMed - indexed for MEDLINE]

2862: Eur J Ophthalmol. 2001 Jan-Mar;11(1):53-6.

Uveitis in HIV-infected patients.

Mwanza JC, Kayembe DL.

Department of Ophthalmology, University Hospital of Kinshasa, Democratic Republic
of Congo. jcmwanza@hotmail.com

PURPOSE: To determine the prevalence of HIV infection and to find out the
possible causes (associated conditions) of uveitis in HIV-infected patients.
METHODS: We retrospectively analyzed the data of 581 patients with uveitis
diagnosed over an 11-year period. All patients received a routine eye examination
and most of them a general examination as well as complementary tests. RESULTS:
The prevalence of HIV infection was 14.3% (89 patients). Anterior uveitis (62%)
was the most frequent form, followed by posterior uveitis (22%), panuveitis (12%)
and intermediate uveitis (4%). Associated conditions or causes were found in 88% 
of these 89 patients, the most frequent being Herpes zoster ophthalmicus (43%),
tuberculosis (16%), CMV infection (12%) and toxoplasmosis (10%). CONCLUSIONS: In 
HIV-infected patients uveitis is frequently associated with opportunistic
infections.

PMID: 11284485 [PubMed - indexed for MEDLINE]

2863: Can Fam Physician. 2001 Mar;47:493, 503-4.

Ophthaproblem. Herpes zoster.

Baxter S, Sharma S.

Department of Ophthalmology, Queen's University, Kingston, Ont.

Publication Types: 
    Case Reports

PMID: 11281080 [PubMed - indexed for MEDLINE]

2864: N Engl J Med. 2001 Mar 29;344(13):1021; author reply 1021-2.

Comment on:
    N Engl J Med. 2000 Nov 23;343(21):1514-9.

Intrathecal methylprednisolone for postherpetic neuralgia.

Srinivasan B.

Publication Types: 
    Comment
    Letter

PMID: 11280324 [PubMed - indexed for MEDLINE]

2865: N Engl J Med. 2001 Mar 29;344(13):1020; author reply 1021-2.

Comment on:
    N Engl J Med. 2000 Nov 23;343(21):1514-9.

Intrathecal methylprednisolone for postherpetic neuralgia.

Niebergall H, Priebe HJ.

Publication Types: 
    Comment
    Letter

PMID: 11280323 [PubMed - indexed for MEDLINE]

2866: N Engl J Med. 2001 Mar 29;344(13):1020; author reply 1021-2.

Comment on:
    N Engl J Med. 2000 Nov 23;343(21):1514-9.

Intrathecal methylprednisolone for postherpetic neuralgia.

Lewis G.

Publication Types: 
    Comment
    Letter

PMID: 11280322 [PubMed - indexed for MEDLINE]

2867: N Engl J Med. 2001 Mar 29;344(13):1020-1; author reply 1021-2.

Comment on:
    N Engl J Med. 2000 Nov 23;343(21):1514-9.

Intrathecal methylprednisolone for postherpetic neuralgia.

Zetlaoui PJ, Cosserat J.

Publication Types: 
    Comment
    Letter

PMID: 11280321 [PubMed - indexed for MEDLINE]

2868: N Engl J Med. 2001 Mar 29;344(13):1019; author reply 1021-2.

Comment on:
    N Engl J Med. 2000 Nov 23;343(21):1514-9.

Intrathecal methylprednisolone for postherpetic neuralgia.

Nelson DA, Landau WM.

Publication Types: 
    Comment
    Letter

PMID: 11280320 [PubMed - indexed for MEDLINE]

2869: N Engl J Med. 2001 Mar 29;344(13):1019-20; author reply 1021-2.

Comment on:
    N Engl J Med. 2000 Mar 2;342(9):635-45.    N Engl J Med. 2000 Nov 23;343(21):1514-9.

Intrathecal methylprednisolone for postherpetic neuralgia.

Lampe JB, Hindinger C, Reichmann H.

Publication Types: 
    Comment
    Letter

PMID: 11280319 [PubMed - indexed for MEDLINE]

2870: J Assoc Physicians India. 2000 Dec;48(12):1222.

Post herpes zoster galactorrhoea.

Samanta BB.

Publication Types: 
    Case Reports
    Letter

PMID: 11280239 [PubMed - indexed for MEDLINE]

2871: Am J Nurs. 2001 Mar;101(3):22-3.

The lidocaine patch.

Pasero C, McCaffery M.

PMID: 11279991 [PubMed - indexed for MEDLINE]

2872: Bone Marrow Transplant. 2001 Feb;27(3):333-6.

Intense immunosuppression followed by purified blood CD34+ cell autografting in a
patient with refractory juvenile rheumatoid arthritis.

Nakagawa R, Kawano Y, Yoshimura E, Suzuya H, Watanabe T, Kanamaru S, Onishi T,
Nakayama H, Nakagawa R, Matsuoka S, Yamashita K, Kuroda Y.

Department of Pediatrics, University of Tokushima School of Medicine, Japan.

A 15-year-old boy with refractory juvenile rheumatoid arthritis (JRA) underwent
intense immunosuppressive therapy followed by purified blood CD34+ cell
autografting. He had been taking prednisolone (PDN) daily or every other day
combined with methotrexate once a week to control the disease for 7 years. He
suffered from psychological complications and a very short stature due to the
adverse effects of these drugs. CD34+ cells were purified in bulk from
G-CSF-mobilized PBSC using an Isolex 300. After the administration of
cyclophosphamide (200 mg/kg) and anti-lymphocyte globulin (45 mg/kg), 3.6 x
10(6)/kg purified CD34+ cells were infused. His post-transplant course was
uneventful except for herpes-zoster infection. He is now more than 1 year post
transplant and has not taken any immunosuppressive medication. His rate of growth
has increased (>10 cm/year) due to the effects of the cessation of PDN and the
administration of recombinant human growth hormone (rGH), in contrast to the gain
of 2 cm in the preceding 3 years with rGH treatment. Although the durability of
this remission is unknown, intense immunosuppressive therapy followed by purified
blood CD34+ cell autografting might be acceptable for adolescent patients with
refractory JRA to achieve a drug-free period for physical and psychological
maturation.

Publication Types: 
    Case Reports

PMID: 11277183 [PubMed - indexed for MEDLINE]

2873: Eur J Dermatol. 2001 Mar-Apr;11(2):108-11.

Detection of cutaneous varicella zoster virus infections by immunofluorescence
versus PCR.

Bezold GD, Lange ME, Gall H, Peter RU.

Department of Dermatology, University of Ulm, Oberer Eselsberg 40, 89081 Ulm,
Germany.

Detection of localized, clinically atypical cutaneous infections with varicella
zoster virus (VZV) has proven difficult, as serum antibody tests sometimes are
not sensitive and specific enough for that purpose. Therefore immunofluorescence 
and an internally controlled PCR for VZV are compared for sensitivity. Detection 
of PCR products was done by ELISA, and if positive, additionally by agarose gel
electrophoresis. Of 60 samples 44 were PCR-positive by ELISA (44 = 100%), of
which 37 (84%) were also positive on the agarose gel. Thirty-four samples (77%)
were positive by immunofluorescence. No sample was positive by immunofluorescence
and negative by PCR. A combination of immunofluorescence and PCR with agarose gel
analysis detected 42 samples out of 44 positive by PCR ELISA (95%). These results
demonstrate that immunofluorescence is a suitable, fast and inexpensive method
for routine diagnostics. Additional sensitivity can be achieved by screening
immunofluorescence-negative samples by PCR, which is extremely sensitive but
time-consuming and labor-intensive.

Publication Types: 
    Evaluation Studies

PMID: 11275804 [PubMed - indexed for MEDLINE]

2874: Hum Pathol. 2001 Mar;32(3):342-5.

Fatal parvovirus myocarditis in a 5-year-old girl.

Murry CE, Jerome KR, Reichenbach DD.

Department of Pathology, University of Washington, Seattle, WA 98195, USA.

Infection with parvovirus B19 is common in children and typically causes mild
illness. We report here the case of a 5-year-old girl who died suddenly, 2 weeks 
after the clinical diagnosis of a parvoviral infection (erythema infectiosum).
Microscopic examination of the heart showed severe myocarditis with extensive
T-cell and macrophage infiltration. Cultures, serology, and molecular analyses of
serum for enteroviridae, adenovirus, influenza, varicella zoster,
cytomegalovirus, and herpes simplex viruses were negative. Quantitative
polymerase chain reaction (PCR) analysis for parvovirus B19 in peripheral blood, 
however, showed active infection (91,000 genomes/mL serum; 2.4
genomes/mononuclear cell). Despite the presence of myocarditis, immunostaining
for parvoviral surface antigens was negative in the heart. Quantitative PCR
analysis of paraffin sections showed that myocardial parvoviral content was
significantly less than that of the normal appearing kidney and within the range 
predicted simply by tissue blood content. Thus, parvovirus B19 infection can be
complicated by fatal myocarditis. Because the virus does not appear to have
infected the heart, per se, we speculate that myocarditis arose from
immunological cross-reaction to epitopes shared between the virus and the
myocardium. HUM PATHOL 32:342-345. Copyright 2001 by W.B. Saunders Company

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 11274646 [PubMed - indexed for MEDLINE]

2875: J Assoc Physicians India. 1998 Apr;46(4):337-40.

Comment in:
    J Assoc Physicians India. 1999 Apr;47(4):460-1.

Herpes zoster and post-herpetic neuralgia--a clinical trial of aspirin in
chloroform for anodyne.

Kochar DK, Agarwal RP, Joshi A, Kumawat BL.

Department of Medicine, Neurology Section, Sardar Patel Medical College,
Bikaner-334 003, India.

Pain associated with Herpes Zoster (HZ) and Post-herpetic Neuralgia (PHN) has
been a challenging task to manage with ease. Topical aspirin dissolved in
chloroform is an effective means of reducing pain due to HZ and PHN in most
patients. The locus of pain origin and analgesia induced by topical aspirin is
supposed to be at cutaneous free nerve ending pain receptors. The present study
was conduced in fifty two patients of HZ and PHN. Pain intensity before and after
the application of drug was measured with help of Sort Form McGill Pain
Questionnaire (SE-MPQ). Most of the patients experienced relief of pain within
1-5 minutes after the aspirin-chloroform application. Maximum relief was achieved
in about 30-40 minutes and persisted for 5-6 hrs. In the beginning 3-4
applications were required but frequency decreased gradually as the pain abated.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 11273312 [PubMed - indexed for MEDLINE]

2876: J Assoc Physicians India. 1998 Apr;46(4):333-4.

Zoster associated pain.

Khadilkar SV.

Publication Types: 
    Editorial

PMID: 11273311 [PubMed - indexed for MEDLINE]

2877: Drugs. 2001;61(2):187-96.

Prophylaxis against herpesvirus infections in transplant recipients.

Ljungman P.

Department of Haematology, Huddinge University Hospital, Karolinska Institutet,
Sweden. Per.Ljungman@medhs.ki.se

Herpesvirus infections are important after stem cell and organ transplant. During
the last decades several antiviral agents have been introduced with efficacy
against herpesviruses. These agents are the nucleoside analogues aciclovir,
valaciclovir, famciclovir, and ganciclovir; the nucleotide analogue cidofovir;
and the pyrophosphate analogue foscarnet. Several studies have been performed
with antiviral agents with the aim to reduce morbidity and mortality associated
with herpesvirus infections in transplant recipients. Aciclovir and valaciclovir 
have been examined in randomised, controlled trials in both solid organ and stem 
cell transplant patients, and were shown to be very effective for the prevention 
of herpes simplex virus (HSV) and varicella-zoster virus infections. In addition,
these drugs were shown to reduce cytomegalovirus (CMV) infection and improve
survival in allogenic stem cell transplant patients and to reduce CMV infection, 
CMV disease (aciclovir and valaciclovir), and acute rejection (valaciclovir) in
renal transplant patients. Ganciclovir is very effective for the prevention of
CMV infection and disease in both stem cell and solid organ transplant
recipients. It can also be used in preemptive strategies in which the aim is to
prevent CMV disease in patients who have ongoing CMV infection documented by
antigenaemia or detection of CMV DNA. The latter strategy has the advantage of
reducing the exposure to the drug and thereby the risk for toxicity. Foscarnet
has also been shown to be effective as preemptive therapy for CMV in allogenic
stem cell transplant patients and as therapy for aciclovir-resistant HSV
infections. Finally cidofovir is an interesting agent with broad spectrum
antiherpesvirus efficacy. However, because of the drug's toxicity profile,
further studies are needed.

Publication Types: 
    Review

PMID: 11270937 [PubMed - indexed for MEDLINE]

2878: Transplant Proc. 2001 Feb-Mar;33(1-2):1816-7.

Major infectious complications after kidney transplantation.

Karakayali H, Emiroglu R, Arslan G, Bilgin N, Haberal M.

Baskent University Faculty of Medicine, Bahcelievler, Ankara, Turkey.

PMID: 11267526 [PubMed - indexed for MEDLINE]

2879: Biochem Pharmacol. 2001 Mar 15;61(6):727-32.

2'-O-Acyl/alkyl-substituted arabinosyl nucleosides as inhibitors of human
mitochondrial thymidine kinase.

Balzarinia J, Degreve B, Zhu C, Durini E, Porcu L, De Clercq E, Karlsson A,
Manfredini S.

Rega Institute for Medical Research, K.U. Leuven, Minderbroedersstraat 10,
B-3000, Leuven, Belgium. jan.balzarini@rega.kuleuven.ac.be

Introduction of a bulky lipophilic acyl entity at the 2'-OH position of both
1-beta-D-arabinofuranosylthymine (araT) and
(E)-5-(2-bromovinyl)-1-beta-D-arabinofuranosyluracil (BVaraU), consistently
resulted in a marked ( approximately 10-fold) increase in the inhibitory activity
of these new arabinosyl nucleoside analogues for the mitochondrial thymidine
kinase (TK-2)-catalysed conversion of 2 microM [methyl-(3)H]dThd to
[methyl-(3)H]dTMP. The most potent derivatives were inhibitory to
[methyl-(3)H]dThd phosphorylation by TK-2 within the lower micromolar
concentration range. Substitution of the arabinosyl nucleoside derivatives with
the acyl groups also dramatically increased the selectivity of these compounds.
The inhibitory activity of araT and BVaraU to dThd phosphorylation by other
related nucleoside kinases, including herpes simplex virus type 1 TK,
varicella-zoster virus TK, and cytosolic TK-1, was completely annihilated upon
2'-O-acyl substitution (IC(50) > or = 1000 microM). Kinetic analysis revealed
purely competitive inhibition of 2'-O-acyl-BVaraU against TK-2-catalysed
thymidine phosphorylation (K(i)/K(m): 2.3). However, 2'-O-acyl-BVaraU was
extremely poorly converted to the corresponding arabinosyl nucleoside
5'-monophosphate by TK-2 as revealed by [gamma-(32)P]phosphate transfer studies
from [gamma-(32)P]ATP. Thus, the 2'-O-acyl derivatives of BVaraU did not behave
as substrates, but rather as potent and highly selective inhibitors of TK-2. This
is the first report on such a highly selective arabinosyl nucleoside inhibitor of
mitochondrial TK-2, and opens perspectives for the rational design of selective
mitochondrial TK-2 inhibitors.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11266658 [PubMed - indexed for MEDLINE]

2880: Postgrad Med. 2001 Mar;109(3):31-2.

Postherpetic pain control with concomitant illness?

Belgrade M.

University of Minnesota Medical School-Minneapolis, USA.

Publication Types: 
    Case Reports

PMID: 11265360 [PubMed - indexed for MEDLINE]

2881: Lin Chuang Er Bi Yan Hou Ke Za Zhi. 1998 Nov;12(11):490-2.

[Diagnosis and treatment of Ramsay Hunt syndrome (a report of 39 cases)]

[Article in Chinese]

Guo Y, Wu W, Xie D.

Department of Otolaryngology, Second Affiliated Hospital, Hunan Medical
University, Changsha 410011.

Thirty-nine cases with Ramsay Hunt syndrome were presented, in which 23 cases
were firmly diagnosed early, and others were misdiagnosed to be Bell's palsy in 9
cases, sudden sensorineural hearing loss in 5, herpes zoster pharyngitis in 1 and
acute suppurative otitis media in 1, respectively. All patients were treated with
prednisone or dexamethasone for 3 weeks. The results of treatment were as
follows: complete recovery in 27 cases, residual facial paralysis in 12 patients,
in which 11 had sensorineural hearing loss. We concluded that: 1. When patients
present idiopathic facial paralysis associated with objective sensorineural
hearing loss, Hunt syndrome should be suspected even in the absence of vesicles. 
2. Treatment with steroid and antiviral agent is needed. There is no significant 
difference in the effects between oral and intravenous steroid therapy. 3. The
poor prognosis may relate with severe facial paralysis accompanying severe
hearing loss. 4. Acoustic stapedius reflex in patients with mild or no hearing
loss is useful for defining the involved sites and evaluating the prognosis.

Publication Types: 
    English Abstract

PMID: 11263220 [PubMed - indexed for MEDLINE]

2882: Ocul Immunol Inflamm. 2000 Dec;8(4):263-73.

Ocular manifestations of infection with the human immunodeficiency virus in an
African pediatric population.

Kestelyn P, Lepage P, Karita E, Van de Perre P.

Department of Ophthalmology, Centre Hospitalier de Kigali, Kigali, Rwanda.
philippe.kestelyn@rug.ac.be

PURPOSE: To describe the ocular manifestations of HIV/AIDS infection in an
African pediatric population. METHODS: From 1984 to 1990, all children with HIV
infection attending the Department of Pediatrics of the 'Centre Hospitalier de
Kigali', Rwanda, were referred to the Department of Ophthalmology for ophthalmic 
examination. RESULTS: A total of 162 HIV-infected children were examined. The
overall rate of ophthalmic involvement was 54%. The most common finding was a
perivasculitis of the peripheral retinal vessels, observed in 38% of the
patients. Cytomegalovirus (CMV) infection of the retina was diagnosed in three
patients. Isolated cotton-wool spots of the retina were not observed. Ophthalmic 
herpes zoster and conjunctival xerosis responding to vitamin A administration
were each seen in two patients. One third of a subset of children tested for
lacrimal function had evidence of decreased tear secretion. CONCLUSION: Our data,
in agreement with other series reported in the literature, indicate that
cotton-wool spots and CMV retinitis, the most common ocular manifestations of
HIV/AIDS in adults, are much less prevalent in children. The high incidence of
perivasculitis in the present series, not observed or only seen in a few cases in
other series, suggests that this ocular sign is more prevalent in African
children. Our working hypothesis is that perivasculitis of the retinal vessels,
lymphoid interstitial pneumonitis, parotitis, and lacrimal gland involvement are 
the expression of a diffuse infiltrative lymphocytosis syndrome, similar to what 
has been described in adults.

Publication Types: 
    Comparative Study

PMID: 11262656 [PubMed - indexed for MEDLINE]

2883: Infection. 2001 Jan-Feb;29(1):37-9.

Varicella zoster virus infection associated with erythema multiforme in children.

Prais D, Grisuru-Soen G, Barzilai A, Amir J.

Dept. of Pediatrics C, Schneider Children's Medical Center of Israel, Petah
Tiqva. daprais@hotmail.com

BACKGROUND: Erythema multiforme (EM) is a vesiculobullous disorder with variable 
manifestations which predominantly affects the skin. It is regarded as a
hypersensitivity disorder which is triggered by multiple factors such as
infection, drugs and food. Varicella zoster virus (VZV) has rarely been reported 
as an etiological agent, despite its high incidence as a pathogen in childhood.
PATIENTS: We describe two children in whom EM preceded VZV infection. In the
first, a 5-year-old boy, EM was followed 3 days later by a classical disseminated
varicella eruption. The diagnosis was reached by clinical, epidemiological and
serological means. The second patient was a 13-year-old boy with EM which was
followed 2 weeks later by Ramsay-Hunt syndrome. The diagnosis was confirmed by
skin biopsy, positive serology and viral culture. CONCLUSION: The association of 
EM and VZV infection is probably more common than reported. In clinical cases of 
EM, VZV should be included in the list of possible causative agents.

Publication Types: 
    Case Reports

PMID: 11261757 [PubMed - indexed for MEDLINE]

2884: Pediatr Transplant. 2001 Feb;5(1):44-50.

Pretransplant varicella vaccination is cost-effective in pediatric renal
transplantation.

Olson AD, Shope TC, Flynn JT.

Division of Pediatric Gastroenterology, C.S. Mott Children's Hospital, University
of Michigan, Ann Arbor, USA. olsona@centocor.com

Because of the severe complications that may result from varicella zoster virus
(VZV) infection following renal transplantation (Tx), transplanted
varicella-susceptible children exposed to varicella are typically given varicella
zoster immunoglobulin (VZIG) as prophylaxis or are admitted and treated with
parenteral acyclovir if VZIG prophylaxis fails. As both VZIG and hospitalization 
are costly, prevention of varicella infection by vaccination could potentially
result in significant cost savings in addition to decreasing morbidity and
mortality. To test this hypothesis, we developed a decision-analysis model to
evaluate the cost-effectiveness of vaccinating patients with chronic renal
failure (CRF) against varicella prior to renal transplant. Under baseline
assumptions, vaccination for varicella pretransplant was a cost-effective
strategy, with a cost of $211 per patient vaccinated compared with $1,828 per
patient not vaccinated. The magnitude of cost savings from vaccination was
sensitive to variations in the cost of varicella vaccine, the percentage of
patients hospitalized for treatment with acyclovir, and the percentage of
patients exposed to varicella infection. One- and two-way sensitivity analyses
confirmed that vaccination was the dominant cost-effective strategy under all
conditions examined. We conclude that vaccination for varicella pretransplant is 
cost-effective for patients with CRF, and that the magnitude of cost savings is
sensitive to the cost of hospitalization, the percentage of patients exposed to
varicella, and the cost of varicella vaccination. Pending results of ongoing
studies of the safety and efficacy of VZV vaccine in children with CRF, we
recommend that VZV vaccine be given to all children with CRF.

Publication Types: 
    Comparative Study

PMID: 11260488 [PubMed - indexed for MEDLINE]

2885: J Pharmacol Exp Ther. 2001 Apr;297(1):1-10.

Erratum in:
    J Pharmacol Exp Ther 2001 Jun;297(3):1227.

2001 ASPET Otto Krayer Award Lecture. Molecular targets for antiviral agents.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven,
Minderbroedersstraat 10, B-3000 Leuven, Belgium.
erik.declercq@rega.kuleuven.ac.be

There are a number of virus-specific processes within the virus replicative cycle
or virus-infected cell that have proven to be attractive targets for
chemotherapeutic intervention, i.e., virus adsorption and entry into the cells,
reverse (RNA --> DNA) transcription, viral DNA polymerization, and cellular
enzymatic reactions that are associated with viral DNA and RNA synthesis and
viral mRNA maturation (i.e., methylation). A variety of chemotherapeutic agents, 
both nucleoside (and nucleotide) and non-nucleoside entities, have been
identified that specifically interact with these viral targets, that selectively 
inhibit virus replication, and that are either used or considered for clinical
use in the treatment of virus infections in humans. Their indications encompass
virtually all major human viral pathogens, including human immunodeficiency virus
(HIV), hepatitis B virus (HBV), herpes simplex virus (HSV), varicella-zoster
virus (VZV), cytomegalovirus (CMV), human papilloma virus (HPV), orthomyxoviruses
(influenza A and B), paramyxoviruses [e.g., respiratory syncytial virus (RSV)]
and hemorrhagic fever viruses (such as Ebola virus).

Publication Types: 
    Lectures

PMID: 11259521 [PubMed - indexed for MEDLINE]

2886: Nervenarzt. 2001 Feb;72(2):69-77.

[Gabapentin therapy for pain]

[Article in German]

Block F.

Neurologische Klinik der RWTH Aachen. fblock@post.klinkum.rwth-aachen.de

Gabapentin, which has been approved for add-on therapy of focal seizures, is
increasingly used for treatment of neuropathic pain. Its analgesic effect is
supposed to be due to reduction of glutamatergic transmission, improvement of
GABAergic transmission and to binding to voltage-dependent calcium channels.
Experimental studies demonstrated an ameliorating effect of gabapentin on
neuropathic pain. Placebo-controlled studies revealed an efficacy of gabapentin
against pain in diabetic neuropathy and postherpetic neuralgia and in prophylaxis
of migraine. Case reports show an analgesic effect of gabapentin in trigeminus
neuralgia and in reflex sympathetic dystrophy. The main adverse events are
dizziness, ataxia and somnolence. Controlled studies, which compare the efficacy 
of gabapentin with that of the respective reference drug, are needed to evaluate 
its importance in treatment of pain.

Publication Types: 
    English Abstract
    Review

PMID: 11256157 [PubMed - indexed for MEDLINE]

2887: J Perinat Neonatal Nurs. 2000 Jun;14(1):17-38; quiz 123-4.

Dermatologic manifestations of infectious diseases in pregnancy.

Mancuso P.

Texas Woman's University, Dallas, Texas, USA.

Several pathogens that have been identified as teratogenic or fetotoxic have
associated dermatologic changes when active infection is present. Viral and
bacterial teratogenic pathogens include herpes simplex virus 1, herpes simplex
virus 2, varicella-zoster virus, cytomegalovirus, human papilloma virus, human
parvovirus B19, rubella, viral hepatitis, syphilis, and gonorrhea. This article
focuses on the characteristic dermatologic manifestation of these diseases in
pregnancy; diagnostic strategies; interpretation of maternal and fetal laboratory
test results; treatment of the pregnant woman, fetus, and newborn; and congenital
outcomes of treated and untreated infection. Emphasis is placed on vaccination
and prevention of transmission of infection to pregnant women.

Publication Types: 
    Review

PMID: 11249292 [PubMed - indexed for MEDLINE]

2888: Antiviral Res. 2001 Feb;49(2):115-20.

Anti-herpesvirus activity of
(1'S,2'R)-9-[[1',2'-bis(hydroxymethyl)-cycloprop-1'-yl]methyl] x guanine (A-5021)
in vitro and in vivo.

Neyts J, Naesens L, Ying C, De Bolle L, De Clercq E.

Rega Institute for Medical Research, K.U.Leuven, Minderbroedersstraat 10, B-3000,
Leuven, Belgium. johan.neyts@rega.kuleuven.ac.jp

The novel nucleoside analog
(1S',2R')-9-[[1',2'-bis(hydroxymethyl)cycloprop-1-yl]methyl]guanine (A-5021) was 
previously shown to be a potent inhibitor of the replication of herpes simplex
virus type 1 and 2 (HSV-1 and HSV-2) and varicella zoster virus (VZV), both in
vitro and in vivo (J. Med. Chem. 41, 1284-1298; Antimicrob. Agents Chemother. 42,
1666-1670). Here we demonstrate that A-5021 is also a potent inhibitor of
Epstein-Barr virus (EBV) and human herpes virus 6 (HHV-6A and HHV-6B), but that
the compound lacks activity against HHV-8. A-5021, in comparison to acyclovir,
was also assessed for protective activity against HSV-1-induced mortality in SCID
mice. The compounds were administered at 50 mg/kg per day by subcutaneous
injection for four consecutive days and treatment was initiated at either 2 h, 1 
or 2 days post infection (p.i.). When administered from day 0 to 4 p.i., A-5021
conferred complete protection against the infection (as assessed at 22 days
p.i.), whereas acyclovir delayed virus induced mortality by only 5 days. When
treatment was begun on day 1 or 2, A-5021 still afforded marked protection
against the infection, whereas acyclovir was virtually devoid of any activity
under these conditions. Our data underline that A-5021 may offer great promise
for the treatment of herpesvirus infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11248363 [PubMed - indexed for MEDLINE]

2889: Am J Med. 2001 Mar;110(4):329-30.

Comment on:
    Am J Med. 1999 Feb;106(2):191-7.

Late infections after blood progenitor cell transplantation in patients with
multiple myeloma.

Steingrimsdottir H, Gruber A, Kalin M, Bjorkholm M.

Publication Types: 
    Comment
    Letter

PMID: 11247597 [PubMed - indexed for MEDLINE]

2890: Masui. 2001 Feb;50(2):160-3.

[Preliminary report: the efficacy of clonidine hydrochloride ointment for
postherpetic neuralgia]

[Article in Japanese]

Meno A, Arita H, Hanaoka K.

Department of Anesthesiology and Pain Relief Center, University of Tokyo
Hospital, Tokyo 113-8655.

The combination of clonidine hydrochloride, alpha 2-agonist, and opioid is useful
for relieving the pain due to surgical procedures or cancer. The routes of
administrations used are intravenous, intramuscular as well as intrathecal,
epidural and transmucosal. However, transdermal clonidine has not been reported. 
We, therefore, investigated the analgesic effect of local administration of
clonidine ointment. Ten patients with postherpetic neuralgia (PHN) were selected 
randomly. They were requested to fill out a questionnaire after applying
clonidine ointment (150 micrograms/ointment 1 g) to the painful area. Items
included in the questionnaire were: effectiveness, visual analog scale (VAS)
before and after the administration of clonidine ointment, onset time, with or
without allodynia and effectiveness to allodynia in the former case, side
effects, and patients' background. Analysis of the answers indicates that
clonidine ointment produced a satisfactory effect in nine patients. Onset time
was within a few minutes in most patients. No patients suffered any side effects.
Specific mechanism of effectiveness or the site affected has not been confirmed
in this study, but considering the quick onset, it is presumed that the site
where the ointment was applied was the very site that was affected. Clonidine
hydrochloride ointment was effective in relieving the symptoms of PHN.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 11244770 [PubMed - indexed for MEDLINE]

2891: Pediatr Dent. 2001 Jan-Feb;23(1):44-50.

Prevalence of orodental findings in HIV-infected Romanian children.

Flaitz C, Wullbrandt B, Sexton J, Bourdon T, Hicks J.

Division of Oral and Maxillofacial Pathology, Departments of Stomatology and
Pediatric Dentistry, University of Texas-Houston Health Science Center, Dental
Branch. cflaitz@mail.db.uth.tmc.edu

BACKGROUND: Romania, the pediatric AIDS capital of the world, has tremendous
unmet dental care needs for children and adolescents with HIV infection. The
purpose of this study was to assess the prevalence of orodental conditions in
symptomatic HIV-positive children from Constanta, Romania. METHODS: The children 
underwent dental examinations and treatment at Constanta Municipal Hospital by a 
volunteer team of dental healthcare professionals from the United States. Oral
lesions and dental caries were recorded during an 8-day period prior to
initiating comprehensive dental care. RESULTS: The study population consisted of 
173 children (88 males; 85 females) with a mean age of 8.8 years (range 6 to 12
years). The primary HIV risk factor was contaminated needle reuse and/or blood
products (88%). The most common oral and perioral lesions included: candidiasis
(29%), ulcers (15%), salivary gland disease (9%), necrotizing ulcerative
gingivitis/periodontitis (5%), linear gingival erythema (4%), labial molluscum
contagiosum (3%), oral warts (2%), hairy leukoplakia (2%), and herpes zoster
(1%). One or more oral/perioral lesions occurred in 55% of the children. Severe
dental caries was noted in the majority of children (dfs/dft 16.9/3.7 and
DMFS/DMFT 8.1/3.1). Over-retention of primary teeth (25%) and delayed eruption
(42%) were common. Postoperative complications included delayed clotting (common)
and thrombocytopenia-induced bleeding disorders (4%). CONCLUSIONS: The oral
healthcare needs of Romanian HIV-infected children are considerable, with the
majority living with persistent, symptomatic oral disease.

PMID: 11242731 [PubMed - indexed for MEDLINE]

2892: Prenat Diagn. 2001 Feb;21(2):121-4.

Fetal varicella-herpes zoster syndrome in early pregnancy: ultrasonographic and
morphological correlation.

Petignat P, Vial Y, Laurini R, Hohlfeld P.

Department of Gynecology and Obstetrics, CHUV, Lausanne, Switzerland.
ppetignat@hotmail.com

We report a case of an intrauterine fetal infection by the varicella-herpes
zoster virus following maternal varicella at 17 weeks' amenorrhea. Prenatal
diagnosis of fetal infection was confirmed by serology and fetal damage by
ultrasonography. Autopsy of the fetus showed multiorgan manifestation with
disseminated foci of necrosis and microcalcifications, encephalitis and
unilateral segmental skin scarring with an underlying hypoplastic fixed lower
limb. The placenta showed a multifocal chronic villitis with multinucleated giant
cells. The lesions included segmental anomalies and multiorgan damage. Copyright 
2001 John Wiley & Sons, Ltd.

Publication Types: 
    Case Reports

PMID: 11241539 [PubMed - indexed for MEDLINE]

2893: J Neurol Sci. 2001 Mar 1;184(2):169-77.

Acute encephalitis from 1967 to 1991.

Rantalaiho T, Farkkila M, Vaheri A, Koskiniemi M.

Department of Virology, Haartman Institute, University of Helsinki, POB 21,
FIN-00014, Helsinki, Finland.

We studied all the adult patients with acute encephalitis, 322 in all, in the
Helsinki area, Finland, during the years 1967--1991. The average incidence was
1.4/100000 adults/year. The proportion of known and suggested etiologies in
5-year periods has risen from 36 (1967--71) to 59% (1987--91). Herpes simplex
virus was identified most often (16%), followed by varicella-zoster (5%), mumps
(4%), and influenza A viruses (4%). In addition, 20 other agents were identified.
The leading cause of encephalitis in patients aged 65 years or more was
varicella-zoster virus. Eighteen patients (5.6%) died. It appears that the
etiology of encephalitis changes with age and with time. It is important to
establish the etiological pattern, as this assists in prompt diagnosis, which is 
a prerequisite for successful therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11239952 [PubMed - indexed for MEDLINE]

2894: Int J STD AIDS. 2001 Feb;12(2):79-83.

Varicella zoster virus-associated neurological disease in HIV-infected patients.

Brown M, Scarborough M, Brink N, Manji H, Miller R.

Department of Sexually Transmitted Diseases, Windeyer Institute of Medical
Sciences, Royal Free and University College Medical School, University College
London, UK.

Varicella zoster virus (VZV) is an uncommon but well recognized cause of
neurological disease in HIV-infected patients. Analysis of cerebrospinal fluid
(CSF) using the polymerase chain reaction (PCR) in HIV-infected patients
presenting with neurological disease has increasingly allowed diagnosis of
VZV-associated pathology. We report clinical, radiological and virological data
from 15 consecutive patients with VZV-associated neurological disease. Clinical
presentation was varied, including meningo-encephalitis in 9 and isolated cranial
nerve palsies in 6. VZV deoxyribonucleic acid (DNA) was detected by PCR in CSF of
11/15; pleocytosis was present in only 6/15, raised protein in 11/15. Magnetic
resonance imaging (MRI) appearances were focal signal abnormalities in 8,
meningeal enhancement in 2 and normal in 2. With specific anti-VZV therapy 10
patients recovered fully. The predictive value of PCR on CSF for diagnosis of
VZV-associated neurological disease should take into account the patient's
clinical presentation, concurrent infections and response to anti-VZV therapy.

PMID: 11236108 [PubMed - indexed for MEDLINE]

2895: J Mol Diagn. 2000 Nov;2(4):191-201.

Predictive value of quantitative PCR-based viral burden analysis for eight human 
herpesviruses in pediatric solid organ transplant patients.

Bai X, Rogers BB, Harkins PC, Sommerauer J, Squires R, Rotondo K, Quan A, Dawson 
DB, Scheuermann RH.

Department of Pathology, University of Texas Southwestern Medical Center, Dallas,
Texas, USA.

Human herpesviruses can cause significant morbidity and mortality in pediatric
solid organ transplant recipients. It was hypothesized that viral burden
quantification by polymerase chain reaction using an internal calibration
standard could aid in distinguishing between viral disease and latency. Here we
report the results of a 2-year prospective study of 27 pediatric solid organ
(liver, kidney, or heart) transplant recipients in which multiple samples were
analyzed for levels of all eight human herpesviruses by internal calibration
standard-polymerase chain reaction. Herpes simplex viruses 1 and 2,
varicella-zoster virus, and Kaposi's sarcoma-associated herpesvirus were not
detected in any of these samples. Human herpesvirus types 6 and 7 were detected
in half of the patients, but were present at low levels, similar to those found
in reference populations. Epstein-Barr virus (EBV) and cytomegalovirus (CMV) were
detected in 89% and 56% of the patients, respectively. Viral burden analysis
suggested distinct patient populations for CMV, with a natural cutoff of 10,000
viral targets/ml blood strongly associated with disease. In some cases, a
dramatic increase in CMV levels preceded clinical evidence of disease by several 
weeks. EBV viral burden was relatively high in the only patient presenting with
an EBV syndrome. However, two other patients without evidence of EBV disease had 
single samples with high EBV burden. Rapid reduction in both EBV and CMV burden
occurred with antiviral treatment. These data suggest that viral burden analysis 
using internal calibration standard-polymerase chain reaction for CMV, and
possibly other herpesviruses, is an effective method for monitoring pediatric
transplant patients for significant herpesvirus infection and response to
therapy.

PMID: 11232109 [PubMed - indexed for MEDLINE]

2896: J Assoc Physicians India. 1998 Sep;46(9):775-8.

Clinical profile of AIDS: a study at a referral hospital.

Sircar AR, Tripathi AK, Choudhary SK, Misra R.

Department of Medicine, King George's Medical College, Lucknow-226 003, India.

The present study describes the clinical and epidemiological features of 74
patients with human immunodeficiency virus (HIV) infection who presented to a
referral hospital. Sixty two patients (83.7%) were diagnosed to have acquired
immune deficiency syndrome (AIDS). Mean age of the patients was 34.9 +/- 12 years
and male to female ratio was 3:1. Majority of patients (80%) were from lower
socio-economic class. Multiple unprotected heterosexual contact with commercial
sex workers in metropolitan cities of India, mainly Mumbai, was major risk factor
in 82.1% male patients while most of the females (66.6%) had acquired infection
from HIV positive husbands. Blood transfusion was the risk factor in 9(12.1%)
patients. Sixty eight patients were infected with HIV 1, one with HIV 2, and five
patients with both HIV 1 and HIV 2. Fever and weight loss were the commonest
presenting symptoms. Tuberculosis, oropharyngeal candidiasis, and interstitial
pneumonitis were present in 54.8%, 40.3% and 20.9% patients, respectively.
Fourteen patients (22.5%) had generalised lymphadenopathy. Herpes zoster,
cryptococcal meningitis, and peripheral neuropathy were infrequent. Response to
standard antifungal and antitubercular treatment was satisfactory. Kaposi's
sarcoma, lymphoma, and CNS toxoplasmosis were not found. The clinical
manifestations of AIDS patients are strikingly different from that in the Western
countries. It, thus, necessitates setting up of different guidelines for the
clinical diagnosis and management of AIDS in India.

PMID: 11229245 [PubMed - indexed for MEDLINE]

2897: J Assoc Physicians India. 2001 Feb;49:286-7.

Herpes zoster-induced myocarditis in a patient with diabetes mellitus.

Kundu AK.

Department of Medicine, NRS Medical College, Calcutta 700 014.

Myocarditis as a complication of herpes zoster is very rare. I present the case
of a middle-aged adult male with diabetes mellitus complicated by myocarditis
following herpes zoster infection, the second reported case in Indian literature 
so far.

Publication Types: 
    Case Reports

PMID: 11225150 [PubMed - indexed for MEDLINE]

2898: Pediatr Infect Dis J. 2001 Feb;20(2):226-8.

Herpes simplex mimicking herpes zoster in a child immunized with varicella
vaccine.

Takayama N, Takayama M, Takita J.

Department of Pediatrics, Tokyo Metropolitan Komagome Hospital, Japan.
takyamnd-k@komagome-hospital.bunkyo.tokyo.jp

A 5-year-old boy had zosteriform vesicular lesions 4 years after immunization
with varicella vaccine. PCR analyses of DNA extracted from the crusts revealed
herpes simplex virus type 1 infection. Virologic examinations should be performed
before the vesicular lesion is attributed to the varicella-zoster virus vaccine
strain.

Publication Types: 
    Case Reports

PMID: 11224851 [PubMed - indexed for MEDLINE]

2899: Pediatr Infect Dis J. 2001 Feb;20(2):216-8.

Viral etiologies of encephalitis in Thai children.

Chokephaibulkit K, Kankirawatana P, Apintanapong S, Pongthapisit V, Yoksan S,
Kositanont U, Puthavathana P.

Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok,
Thailand. sikch@mahidol.ac.th

A prospective study of childhood encephalitis was performed in Bangkok from 1996 
through 1998. The viral agents identifiable in 26 (65%) of 40 children were
dengue virus (8), Japanese encephalitis (6), herpes simplex virus (4), human
herpes virus type 6 (3), mumps (2), enterovirus (1), varicella-zoster virus (VZV)
(1) and rabies (1).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11224846 [PubMed - indexed for MEDLINE]

2900: Gastroenterol Hepatol. 2001 Jan;24(1):47.

Comment on:
    Gastroenterol Hepatol. 2000 Jan;23(1):7-8.

[Fulminant infection caused by varicella herpes zoster in patient with Crohn
disease undergoing treatment with azathioprine]

[Article in Spanish]

Vergara M, Brullet E, Campo R, Calvet X, Blanch L.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 11219139 [PubMed - indexed for MEDLINE]

2901: Rinsho Shinkeigaku. 2000 Aug;40(8):791-6.

[Serological diagnostic trial of the causative virus of Bell's palsy by
anti-herpes virus antibodies in the paired sera]

[Article in Japanese]

Chida K, Takase S.

Department of Clinical Neurology, National Iwate Hospital.

Substantial evidence obtained through polymerase chain reaction techniques
strongly supports that reactivation of latently infected herpes simplex virus
(HSV) in geniculate ganglia is the main cause of Bell's palsy. However, serum
antibody titers to HSV rarely increase in patients with this disease. This
discrepancy may result from the difficulty in detecting a small increase in
antibody titers by conventional serological analysis. To detect such a small
increase in antibody titer, we defined the significant increase in IgG antibody
titers more precisely, and examined the association of HSV or varicella-zoster
virus (VZV) with Bell's palsy. From 40 patients with Bell's palsy, paired sera
were obtained within the 4th disease day and 2 weeks later. IgG antibodies to
HSV, VZV, cytomegalovirus (CMV), or measles virus (MsV) were measured with
solid-phase enzyme immunoassay (EIA). IgM antibodies were measured with captured 
EIA. Each antibody titer was expressed as an EIA-value, which was quantitatively 
measured by using a calibration curve prepared from the samples containing known 
titers to the virus in proportion to the logarithm of its titer. An EIA-value
ratio (EVR) between paired sera and a corrected EVR was calculated according to
the formulae: EVR = [EIA-value in the second serum]/[EIA-value in the first
serum]; corrected EVR = [EVR to HSV, VZV or CMV]/[EVR to MsV]. The association
with a virus was determined to be positive when the corrected EVR of the virus
was beyond the normal range (the logarithmical mean +/- 3 SD of corrected EVRs
among 24 healthy controls) while the corrected EVR of the other viruses were
within it. Using the corrected EVR, 6 patients were positive: 4 for HSV, 2 for
VZV. On the other hand, the conventional serological analysis, which confirms
positivity by a 4-fold increase in IgG antibody titer or a demonstration of IgM
antibody, disclosed only 2 positive patients (1 for HSV, 1 for VZV). EIA is a
very sensitive method of detecting antibodies. Corrected EVRs can exclude a
decrease in antibody titers induced by corticosteroids, which are generally used 
for therapy of Bell's palsy. Moreover, the normal range of corrected EVRs can be 
defined more precisely than in conventional serological analyses. Our results
indicate that some sensitive analysis, such as the corrected EVR method, may make
it possible to serologically detect the causative virus of Bell's palsy.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 11218698 [PubMed - indexed for MEDLINE]

2902: Epidemiol Infect. 2000 Dec;125(3):651-69.

Modelling the impact of immunization on the epidemiology of varicella zoster
virus.

Brisson M, Edmunds WJ, Gay NJ, Law B, De Serres G.

PHLS Communicable Disease Surveillance Centre, London.

The objective of this study was to develop and apply a dynamic mathematical model
of VZV transmission to predict the effect of different vaccination strategies on 
the age-specific incidence and outcome of infection. To do so a deterministic
realistic age-structured model (RAS) was used which takes account of the
increased potential for transmission within school aged groups. Various vaccine
efficacy scenarios, vaccine coverages and vaccination strategies were
investigated and a sensitivity analysis of varicella incidence predictions to
important parameters was performed. The model predicts that the overall (natural 
and breakthrough) incidence and morbidity of varicella would likely be reduced by
mass vaccination of 12-month-old children. Furthermore, adding a catch-up
campaign in the first year for 1-11 year olds seems to be the most effective
strategy to reduce both varicella incidence and morbidity (in the short and long 
term), though with the possible detrimental effect of increasing the incidence of
zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11218215 [PubMed - indexed for MEDLINE]

2903: AIDS. 2001 Jan 26;15(2):223-9.

Herpes zoster and HIV-1 infection in a rural Ugandan cohort.

Morgan D, Mahe C, Malamba S, Okongo M, Mayanja B, Whitworth J.

Medical Research Council Programme on AIDS/Uganda Virus Research Institute,
Entebbe.

OBJECTIVE: To compare the rates and clinical features of herpes zoster in
HIV-positive and HIV-negative individuals in a cohort in rural Uganda; to report 
the incidence of herpes zoster in the HIV-positive group in relation to
seroconversion and CD4 cell counts and to determine whether it is indicative of a
more rapid progression to death. DESIGN: A prospective population-based cohort.
METHODS: The cohort comprised 107 prevalent and 144 incident (with documented
dates of seroconversion) participants with HIV infection and 231 HIV-negative
controls who were reviewed routinely every 3 months. RESULTS: The mean rate of
herpes zoster was 53.6/1000 person-years in HIV-positive and 4.4 in HIV-negative 
participants. The cumulative incidence of a first episode of herpes zoster was
7.6% at 2 years, 12.6% at 4 years and 24.0% at 6 years after seroconversion; the 
incidence rate was 35.6/1000 person-years. There was no evidence of a significant
effect of age, gender, period from seroconversion or CD4 cell count on this
incidence rate. Herpes zoster was an indicator of HIV-1 infection in this
population but not an indicator of more rapid progression to death after
adjusting for CD4 cell count and age. CONCLUSIONS: The rates, including the
cumulative incidence after seroconversion and the clinical presentation of herpes
zoster, were similar to those reported from industrialized countries. Although an
indicator of HIV-1 infection in this population, herpes zoster was unrelated to
CD4 cell count or period from seroconversion and did not lead to a faster disease
progression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11216931 [PubMed - indexed for MEDLINE]

2904: J Clin Pathol. 2001 Feb;54(2):103-6.

Detection of herpesvirus DNA by the polymerase chain reaction (PCR) in vitreous
samples from patients with necrotising retinitis.

Nogueira ML, Siqueira RC, Freitas N, Amorim JB, Bonjardim CA, Ferreira PC,
Orefice F, Kroon EG.

Laboratorio de Virus, Departamento de Microbiologia, Instituto de Ciencias
Biologicas, Universidade Federal de Minas Gerais, Av. Antonio Carlos, 6627,
31270-901, Belo Horizonte, MG, Brazil.

AIMS: Viral uveitis and retinitis, usually caused by herpesviruses, are common in
immunosuppressed patients. The diagnosis of viral anterior uveitis and retinitis 
is usually clinical. The polymerase chain reaction (PCR) has been used for the
diagnosis of some viral infections, especially those caused by herpesviruses.
This paper reports the use of PCR in the diagnosis of viral retinitis in vitreous
samples from Brazilian patients. METHODS: PCR was used for the diagnosis of
necrotising retinitis in vitreous samples from patients from the Hospital Sao
Geraldo, Universidade Federal de Minas Gerais, Brazil. The vitreous samples were 
collected by paracentesis and stored until analysis. Samples were analysed by PCR
using specific primers designed to amplify herpes simplex virus 1 (HSV-1),
varicella zoster virus (VZV), or human cytomegalovirus (HCMV). In a case of
anterior uveitis, PCR was performed with a sample from the anterior chamber.
RESULTS: Herpesvirus DNA was amplified in 11 of 17 samples. HCVM DNA was detected
in nine samples but DNA from HSV-1 and VZV were detected only once each.
CONCLUSION: These results strongly suggest that PCR could be used for a rapid
complementary diagnosis of viral uveitis and retinitis. A prospective study to
evaluate the PCR results, clinical evolution, and treatment is imperative to
corroborate the real value of PCR in diagnosis and how it could help the
clinicians' approach.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 11215276 [PubMed - indexed for MEDLINE]

2905: Masui. 2000 Nov;49(11):1204-9.

[Relief of subacute herpetic pain and postherpetic neuralgia with repeated
application of 10% lidocaine cream]

[Article in Japanese]

Iseki M, Mitsuhata H, Miyazaki T, Toriumi E, Yoshino K.

Department of Anesthesiology, Juntendo University School of Medicine, Tokyo
113-0033.

Analgesic efficacy of repeated application of a lidocaine cream formula was
investigated in herpes zoster patients with subacute pain with no further
improvement after continued treatment since their acute stage (S-HZ group, n =
23), and in patients to whom past treatments had not provided adequate pain
relief (PHN group, n = 28). In both groups, visual analog scale (VAS) values
decreased significantly from their corresponding values before the present
treatment with few cases of side effects and complete disappearances of the pain 
in 21.6% of all the patients. The results indicate that the repeated application 
of the lidocaine cream is a safe and effective treatment method. Significantly
higher effectiveness was achieved in the S-HZ group in terms of the difference in
the VAS values between before and after the treatment, effectiveness in improving
the activities of daily life, and overall efficacy evaluation.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 11215225 [PubMed - indexed for MEDLINE]

2906: Lancet. 2001 Feb 3;357(9253):360-1.

Genetic resistance factor for HIV-1 and immune response to varicella zoster
virus.

Wiencke JK, Kelsey KT, Zuo ZF, Weinberg A, Wrensch MR.

A 32 bp deletion in the chemokine receptor CCR5 gene modulates HIV-1 infection.
However, whether this CCR5 gene variation modifies immunity to common herpesvirus
infections is unknown. We investigated whole blood IgG concentrations of 157
normal adult blood donors. Also we assessed whether the 32 bp deletion of CCR5
(delta32CCR5) was associated with circulating IgG to four herpesviruses:
varicella zoster virus, Epstein-Barr virus, cytomegalovirus, and herpes simplex
virus type 1 and type 2. Individuals who carried delta32CCR5 were 9.2 times more 
likely to be seronegative for varicella zoster virus than non-carriers (95% CI
2.9-29.1), but no differences were seen for the other herpesviruses studied.
Variation in CCR5 may modulate humoral immunity to varicella zoster virus.

Publication Types: 
    Letter
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11211001 [PubMed - indexed for MEDLINE]

2907: Klin Monatsbl Augenheilkd. 2000 Dec;217(6):345-50.

[Acute retinal necrosis syndrome: analysis, therapy and long-term follow up of 14
eyes]

[Article in German]

Muller B, Velhagen KH, Pleyer U.

Augenklinik, Charite Campus Virchow-Klinikum, Humboldt-Universitat zu Berlin,
Augustenburger Platz 1, Berlin.

PURPOSE: Acute retinal necrosis syndrome (ARN) might be complicated by retinal
detachment, vasculopathy and optic neuropathy and has a poor prognosis despite
intensive medical and surgical therapy. PATIENTS AND METHODS: A series of 10
consecutive patients (14 eyes) with ARN were followed for 36 months (average of
20 months +/- 10). We present the results of the clinical evaluation for
diagnostic and therapeutic modalities. RESULTS: Viral etiology was confirmed in 9
of 10 aqueous-humor samples. Intraocular antibody synthesis against
Varicella-Zoster Virus was found in 7, against Herpes-Simplex Virus in 5 and
against Cytomegalovirus in 2 samples. Three eyes had a mild clinical course with 
a visual acuity of 0.6 or better. Vitrectomy and silicone-oil tamponade preserved
visual acuity from 0.3 to 0.1. ARN lead to blindness in 5 eyes due to
vasculopathy, optic neuropathy or retinal detachment. An arterial branch
occlusion was successfully overcome with i.v. heparin treatment in one patient.
CONCLUSION: Aqueous-humor analysis supports clinical diagnosis. Early vitrectomy 
and silicone oil tamponade stabilizes retinal structure and preserves visual
acuity. Occlusive vasculopathy and optic neuropathy are the main causes leading
to blindness.

Publication Types: 
    English Abstract

PMID: 11210708 [PubMed - indexed for MEDLINE]

2908: Rev Belge Med Dent. 2000;55(3):149-238.

[Nosologic descriptions of lesions of the oral mucosa]

[Article in French]

Reychler H, Mahy P, Thone M.

Service de stomatologie et de chirurgie maxillo-faciale Universite Catholique de 
Louvain Cliniques Universitaires Saint-Luc 15 avenue Hippocrate 1200 Bruxelles.

This article describes extensively and systematically oral mucosa diseases.
Macroscopical aspects are particularly described in order to give the dentist all
important elements of differential diagnosis. This nosological description is
based on a clinical approach: white and pigmented lesions are distinguished from 
ulcerated and benign so as malignant tumoral lesions. Specifically on the oral
mucosa located lesions and oral mucosa lesions of systemic diseases are
described.

Publication Types: 
    English Abstract

PMID: 11210657 [PubMed - indexed for MEDLINE]

2909: Rev Neurol. 2000 Dec 16-31;31(12):1252-6.

[Infectious and metabolic nervous system complications of systemic cancer]

[Article in Spanish]

Ortiz N.

Seccion de Neurologia, Hospital Universitari Sant Joan, Reus, Tarragona, Espana. 
nortizc@galenics.com

OBJECTIVE: To review the incidence and causes of the infections and metabolic
diseases of the nervous system in patients with systemic neoplasias. DEVELOPMENT:
Patients with immunodeficiency, particularly those with hematological neoplasias 
and persons treated with immunosuppressive drugs have a considerable tendency to 
infection due to opportunist germs. Infections of the nervous system are
relatively rare (0.02%-1%) and the commonest neoplasms are lymphomas, especially 
those of Hodgkin type and lymphosarcomas. The most frequent infections are caused
by the herpes virus, meningitis due to Listeria monocytogenes and the meningitis 
due to fungi (Aspergillus, Candida and Cryptococcus). Cerebral abscesses,
although rarer, are relatively common and are caused by gram negative bacteria,
fungi and toxoplasmosis. In recent years there has been a notable increase in the
number of patients diagnosed as having progressive multifocal leukoencephalopathy
due to the possibility of carrying out studies to detect the DNA of the JC virus 
by polymerase chain reaction techniques. Empirical treatment of patients with
neurological infections and systemic cancer should be started following the
guidelines for immunodepressed patients. The metabolic complications of these
patients are mainly due to hormone overproduction, hydroelectrolytic changes and 
vitamin deficits, which in general cause alterations of mental function of the
confusion state type. CONCLUSION: In all patients with an infection or metabolic 
complication involving the nervous system, the presence of a systemic neoplasm
makes it necessary to vary both the diagnostic approach and the empirical
therapeutic measures taken.

Publication Types: 
    English Abstract
    Review

PMID: 11205570 [PubMed - indexed for MEDLINE]

2910: Contact Dermatitis. 2001 Feb;44(2):104.

Allergic contact dermatitis from benzocaine ointment during treatment of herpes
zoster.

Roos TC, Merk HF.

Department of Dermatology, University Clinic of the RWTH Achen, Germany.

Publication Types: 
    Case Reports

PMID: 11205383 [PubMed - indexed for MEDLINE]

2911: Cutis. 2001 Jan;67(1):43-6.

Recurrent disseminated herpes zoster and cytomegalic perianal ulcer: a case
report and review of the literature.

Barbarulo AM, Metha N, Bucalo B, Rendon MI.

Cleveland Clinic, Fort Lauderdale, Florida, USA.

We describe a patient with lymphocytic leukemia who developed multiple,
disseminated, vesiculopustular eruptions in combination with perianal ulcer. Four
years earlier, she had a herpes zoster (HZ) infection involving the ophthalmic
division of her left trigeminal nerve with subsequent postherpetic neuralgia that
was treated with steroids. After the studies, we concluded that the patient had a
recurrent disseminated HZ infection and perianal ulcer caused by cytomegalovirus 
(CMV).

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 11204603 [PubMed - indexed for MEDLINE]

2912: J Eur Acad Dermatol Venereol. 2000 Jul;14(4):317-9.

A case of herpes zoster misdiagnosed and treated as unstable angina pectoris.

Ozdemir R, Tuncer C, Guven A, Sezgin AT.

Publication Types: 
    Case Reports
    Letter

PMID: 11204530 [PubMed - indexed for MEDLINE]

2913: Am Fam Physician. 2001 Jan 15;63(2):257-68.

Common infections in older adults.

Mouton CP, Bazaldua OV, Pierce B, Espino DV.

The University of Texas Health Science Center at San Antonio, 78284-7795, USA.
mouton@uthscsa.edu

Infectious diseases account for one third of all deaths in people 65 years and
older. Early detection is more difficult in the elderly because the typical signs
and symptoms, such as fever and leukocytosis, are frequently absent. A change in 
mental status or decline in function may be the only presenting problem in an
older patient with an infection. An estimated 90 percent of deaths resulting from
pneumonia occur in people 65 years and older. Mortality resulting from influenza 
also occurs primarily in the elderly. Urinary tract infections are the most
common cause of bacteremia in older adults. Asymptomatic bacteriuria occurs
frequently in the elderly; however, antibiotic treatment does not appear to be
efficacious. The recent rise of antibiotic-resistant bacteria (e.g.,
methicillin-resistant Staphylococcus aureus and vancomycin-resistant
enterococcus) is a particular problem in the elderly because they are exposed to 
infections at higher rates in hospital and institutional settings. Treatment of
colonization and active infection is problematic; strict adherence to hygiene
practices is necessary to prevent the spread of resistant organisms.

Publication Types: 
    Review

PMID: 11201692 [PubMed - indexed for MEDLINE]

2914: Acta Derm Venereol. 2000 Sep-Oct;80(5):391-2.

Zosteriform metastasis of occult bronchogenic carcinoma.

Bianchi L, Orlandi A, Carboni I, Costanzo A, Chimenti S.

Publication Types: 
    Case Reports
    Letter

PMID: 11200850 [PubMed - indexed for MEDLINE]

2915: J Endod. 2000 Aug;26(8):469-71.

Zebra. XIX. Part 2. Oral herpes zoster.

Rauckhorst AJ, Baumgartner JC.

Department of Endodontology, Oregon Health Sciences University School of
Dentistry, 611 S.W. Campus Drive, Portland, OR 97201, USA.

Publication Types: 
    Case Reports

PMID: 11199782 [PubMed - indexed for MEDLINE]

2916: Health News. 2001 Jan;7(1):6.

New treatment for postherpetic neuralgia.

[No authors listed]

Publication Types: 
    News

PMID: 11198414 [PubMed - indexed for MEDLINE]

2917: MMW Fortschr Med. 2000 Dec 14;142(51-52):24-8.

[Not just tolerating chronic pain. Which analgesics for elderly patients?]

[Article in German]

Nikolaus T.

Bethesda Geriatrische Klinik, Ulm.

Some 25-50% of all elderly persons living at home suffer from chronic pain. Among
nursing home residents, the figures are appreciably higher, ranging between 45%
and 80%. The major causes of pain in old age are degenerative joint disease,
lower back pain, cancer, osteoporosis and herpes zoster, polymyalgia rheumatica, 
and arterial occlusive disease. In many cases, chronic pain goes undiagnosed and 
is not properly treated. When a correct diagnosis is established, however, it is 
almost always possible to achieve adequate pain relief by a combination of
non-drug treatment and analgesics, and thus to improve the patient's quality of
life.

Publication Types: 
    English Abstract
    Review

PMID: 11194269 [PubMed - indexed for MEDLINE]

2918: J Perinatol. 2000 Dec;20(8 Pt 1):548-54.

The congenital varicella syndrome.

Sauerbrei A, Wutzler P.

Institute for Antiviral Chemotherapy, Friedrich-Schiller University Jena, H.
Winzeulaer Strasse 10, D-07745 Jena, Germany.

Maternal varicella during the first two trimesters of pregnancy may cause the
congenital varicella syndrome (CVS). After infection in the first 20 weeks'
gestation, the incidence is estimated to be about 2%. To date, nearly 100 infants
born with signs of CVS have been reported in the literature, more than three
quarters of them during the last two decades. The characteristic symptoms consist
of skin lesions in dermatomal distribution (76%), neurologic defects (60%), eye
diseases (51%), and skeletal anomalies (49%). About 30% of infants born with
these lesions died in the first months of life. The diagnosis of CVS should be
established by the appearance of maternal varicella, the presence of typical
clinical symptoms as well as the laboratory evidence of in utero varicella-zoster
virus (VZV) infection. In the reviewed infants, intrauterine VZV-infection has
been proved in about 60%. Passive immunization may reduce the risk of fetal
infection but there is no evidence to prevent fetal viremia. Up to now, there are
no controlled studies concerning antiviral chemotherapy in preventing CVS.

Publication Types: 
    Review

PMID: 11190597 [PubMed - indexed for MEDLINE]

2919: N Engl J Med. 2001 Jan 4;344(1):65-6.

Comment on:
    N Engl J Med. 2000 Mar 2;342(9):635-45.

Guillain-Barre syndrome after reactivation of varicella-zoster virus.

Roccatagliata L, Uccelli A, Murialdo A.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 11187118 [PubMed - indexed for MEDLINE]

2920: Vestn Otorinolaringol. 2000;(6):35.

[Severe course of herpes zoster oticus]

[Article in Russian]

Zagainova NS, Artem'eva AE.

Publication Types: 
    Case Reports

PMID: 11187076 [PubMed - indexed for MEDLINE]

2921: Pediatr Infect Dis J. 2001 Jan;20(1):40-8.

Correlates of opportunistic infections in children infected with the human
immunodeficiency virus managed before highly active antiretroviral therapy.

Dankner WM, Lindsey JC, Levin MJ; Pediatric AIDS Clinical Trials Group Protocol
Teams 051, 128, 138, 144, 152, 179, 190, 220, 240, 245, 254, 300 and 327.

Department of Pediatrics, University of California, San Diego, USA.
wayne.dankner@parexel.com

BACKGROUND: Opportunistic infections (OIs) are an important cause of morbidity
and mortality in children infected with HIV. However, few data are available
regarding the overall prevalence, incidence and immunologic correlates associated
with these diseases in the pediatric HIV population. The Pediatric AIDS Clinical 
Trials Group (PACTG) has conducted multicenter studies in HIV-infected children
since 1988 and through these studies has collected prospective data on the
immunologic and virologic status of study participants and recorded
complications, including infectious diseases, related to HIV infection and its
treatments. Therefore data were analyzed from across 13 PACTG studies, performed 
before treatment with highly active antiretroviral therapy was given, to
determine the rates of various infectious complications and the immunologic
correlates, specifically CD4 cell counts, associated with these diseases.
RESULTS: OIs were tabulated from 3331 HIV-infected children who participated in
13 clinic trials undertaken before highly effective antiretroviral therapy was
available. Five OIs occurred at event rates of >1.0 per 100 patient years (person
years): serious bacterial infections, 15.1; herpes zoster, 2.9; disseminated
Mycobacterium avium complex (DMAC), 1.8; Pneumocystis carinii pneumonia, 1.3; and
tracheobronchial and esophageal candidiasis, 1.2. Six other OIs evaluated,
cytomegalovirus (CMV) disease, cryptosporidiosis, tuberculosis, systemic fungal
infections, toxoplasmosis and progressive multifocal leukoencephalopathy,
occurred at event rates of <1.0 per 100 person years. Pneumonia (11.1 per 100
person years) and bacteremia (3.3 per 100 person years) were the most common
bacterial infections. An AIDS-defining OI before entry was a risk factor for the 
development of a new OI during a trial. Bacterial infections, herpes zoster and
tuberculosis occurred frequently at all stages of HIV infection; whereas DMAC, P.
carinii pneumonia, CMV and other OIs occurred primarily in children with severe
immunosuppression. CONCLUSIONS: The frequency of OIs in HIV-infected children in 
the pre-highly active antiretroviral therapy era varies with age, pathogen, prior
OI and immunologic status. Analysis of CD4 counts at the time of DMAC, CMV and
PCP provide validation for current prophylaxis guidelines in children > or =2
years old. This information on infectious complications of pediatric HIV will be 
especially valuable for contemporary management of HIV infection that is poorly
responsive to highly active antiretroviral therapy.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11176565 [PubMed - indexed for MEDLINE]

2922: Arq Bras Cardiol. 2000 Dec;75(6):523-30.

Pseudo-myocardial infarction during an episode of herpes zoster.

[Article in English, Portuguese]

Franken RA, Franken M.

Faculdade de Ciencias Medicas, Santa Casa de Sao Paulo, Sao Paulo, SP, Brazil.

The patient arrived at the emergency unit with a history of acute myocardial
infarction, for which she was treated. Without improvement in the pain, the
patient developed heart failure and underwent a hemodynamic study, which showed
normal coronary arteries and extensive ventricular impairment. During evolution, 
the clinical findings improved and herpes zoster appeared on the right shoulder. 
In a few months the clinical findings subsided, and the findings of the
electrocardiogram, chest X-ray, and ventricular function were normal. The patient
is currently asymptomatic.

Publication Types: 
    Case Reports

PMID: 11175476 [PubMed - indexed for MEDLINE]

2923: J Am Acad Dermatol. 2001 Feb;44(2 Suppl):391-4.

Persistent verrucous varicella as the initial manifestation of HIV infection.

Zampogna JC, Flowers FP.

University of Florida, College of Medicine, Gainsville, USA.

Clinical presentations of varicella-zoster virus (VZV) infection may vary widely 
among healthy and immunocompromised patients. In addition, the recurrence of VZV 
infection with cutaneous manifestations in both of these populations is more
common than was once believed. Most cases of verrucous varicella infection have
been reported in patients with documented immunosuppression (most commonly
HIV/AIDS). We present an unusual case of persistent verrucous varicella, which
was the initial manifestation of HIV infection, in a previously "healthy"
3-year-old girl with a strong family history of Wiskott-Aldrich Syndrome. Current
research, therapeutic options, and differential diagnoses with regard to VZV
infection are briefly reviewed.

Publication Types: 
    Case Reports

PMID: 11174425 [PubMed - indexed for MEDLINE]

2924: Mol Diagn. 2000 Dec;5(4):279-84.

Detection of herpes simplex virus and varicella-zoster virus in clinical swabs:
frequent inhibition of PCR as determined by internal controls.

Bezold G, Volkenandt M, Gottlober P, Peter RU.

Department of Dermatology, University of Ulm, Oberer Eselsberg 40, 89081 Ulm,
Germany.

BACKGROUND: PCR-based detection of microorganisms is widely used for diagnostic
purposes. Most routine PCR applications do not control for inhibition of PCR,
thus leading to false-negative results. METHODS AND RESULTS: One hundred eighteen
swab samples obtained from skin and mucosa were investigated for the presence of 
herpes simplex virus (HSV), varicella-zoster virus (VZV), and the control gene
betaglobin by internally controlled PCR with purified and unpurified DNA in
parallel. With unpurified DNA, inhibition of PCR was detected in 23% of
betaglobin PCRs, 25% of VZV PCRs, and 16% of HSV PCRs versus 3% each for purified
DNA. Approximately 20% of the samples with positive results for HSV or VZV had
negative or inhibited results using unpurified DNA. CONCLUSION: These results
indicate that PCR from clinical swab specimens should be performed exclusively
with internal controls because the positive control alone cannot exclude PCR
inhibition in individual samples. Purification of DNA will decrease, but not
exclude, PCR inhibition.

Publication Types: 
    Comparative Study

PMID: 11172491 [PubMed - indexed for MEDLINE]

2925: Clin Transplant. 2001 Feb;15(1):32-8.

Skin infections in renal transplant recipients.

Hogewoning AA, Goettsch W, van Loveren H, de Fijter JW, Vermeer BJ, Bouwes
Bavinck JN.

Department of Dermatology, Leiden University Medical Center, The Netherlands.

BACKGROUND: Skin infection is a frequent complication in renal transplant
recipients. The purpose of the study was to acquire long-term, period-specific
incidence data on the most commonly occurring skin infections in renal transplant
recipients. METHODS: A retrospective analysis was performed using medical records
of 134 patients, covering a period between 10 and 29 yr. Cumulative incidences of
the skin infections were calculated by counting the infections per patient for
different time periods and were expressed as a percentage of the total group of
patients. The incidence of the skin infections was determined for different
post-transplant time periods. RESULTS: A total of 340 skin infections in 105 out 
of 134 patients were recorded. Some infections, such as candidal infection,
herpes simplex infection, and impetigo were most prominent during the first
post-transplant year and did not affect many new patients after the first year.
Other infections, such as dermatomycoses, herpes zoster, and folliculitis were
also affecting a substantial number of new patients after the first
post-transplant year. CONCLUSIONS: This study confirms that skin infections among
renal transplant recipients are very common and that the spectrum of skin
infections differs according to the post-transplant time period.

PMID: 11168313 [PubMed - indexed for MEDLINE]

2926: Acta Ophthalmol Scand. 2000 Dec;78(6):651-5.

Morphology of epithelial keratitis in herpes zoster ophthalmicus. A non-contact
photomicrographic in vivo study in the human cornea.

Tabery HM.

Department of Ophthalmology, Malmo University Hospital, Sweden.

PURPOSE: To investigate the in vivo morphology of epithelial changes in acute
herpes zoster keratitis. METHODS: 10 patients with acute disease. In 7, systemic 
acyclovir treatment was started at presentation, in 2 < or = 24 hours before, 1
was not treated. The corneae were examined with the slit lamp, followed
intermittently for 3-30 days, and photographed at intervals ranging between 1 to 
7 days. RESULTS: All but one patient had epithelial changes at presentation; all 
developed new ones. The smallest discernible entities were abnormal cells of
about 10-15 microm in diameter, singular or grouped. Larger foci measured about
100-200 microm. 2 patients showed pseudodendrites at presentation, and further
3/9 observed > or = 2 weeks developed them. Some lesions showed white surface
plaques. No ulcerations were observed. Healing occurred < or = 10-22 days after
the onset of symptoms. CONCLUSIONS: The study seemed to have followed the natural
course of the disease.The rapidly changing morphology in the absence of
ulcerative features indicated successive damage counteracted by reparative
forces.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11167225 [PubMed - indexed for MEDLINE]

2927: Am J Ophthalmol. 2001 Jan;131(1):25-9.

Longitudinal analysis of varicella-zoster virus DNA on the ocular surface
associated with herpes zoster ophthalmicus.

Zaal MJ, Volker-Dieben HJ, Wienesen M, D'Amaro J, Kijlstra A.

Department of Ophthalmology, University Hospital Vrije Universiteit, Amsterdam,
The Netherlands. mjw.zaal@azu.nl

PURPOSE: Longitudinal analysis of varicella-zoster virus DNA on the ocular
surface of patients with herpes zoster ophthalmicus. METHODS: Clinical specimens 
were obtained from the bulbar conjunctival surface with a cotton-tipped swab at
weekly intervals for 6 consecutive weeks from 21 patients with acute ophthalmic
zoster with a skin rash duration of less than 7 days. All patients received oral 
valacyclovir 1000 mg three times daily for 10 days without additional
corticosteroids. The swabs were analyzed by means of polymerase chain reaction
for the presence of varicella-zoster virus and herpes simplex virus type 1 DNA.
Conjunctival swabs were also obtained from a control group of 20 patients with
cataract. RESULTS: On inclusion, varicella-zoster virus DNA was present on the
ocular surface of 19 of the 21 patients. Six varicella-zoster virus DNA-positive 
patients had no signs of ocular inflammation. All control swabs were negative for
both varicella-zoster virus and herpes simplex virus DNA. The duration of
varicella-zoster virus DNA detection from rash onset varied from 2 to 34 days.
The number of days between the onset of herpes zoster skin rash and the latest
positive varicella-zoster virus DNA test was significantly longer in patients
whose age was equal to or above the median age of 66 years than in the younger
patients (Mann-Whitney test: P =.0004). At 6-week follow-up, all conjunctival
swabs were negative for varicella-zoster virus DNA. However, at that time, the
eyes of seven patients were still inflamed. CONCLUSION: The duration of
varicella-zoster virus DNA shedding in herpes zoster ophthalmicus is highly
variable and age dependent, and is probably related to the host immune response.

PMID: 11162975 [PubMed - indexed for MEDLINE]

2928: Virology. 2001 Feb 1;280(1):62-71.

Varicella-zoster virus (VZV) ORF65 virion protein is dispensable for replication 
in cell culture and is phosphorylated by casein kinase II, but not by the VZV
protein kinases.

Cohen JI, Sato H, Srinivas S, Lekstrom K.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, National Institutes of Health,
Bethesda, Maryland 20892, USA. jcohen@niaid.nih.gov

The unique short region of varicella zoster virus (VZV) encodes four genes. One
of these, ORF65, is predicted to encode an 11-kDa protein. Antibody to ORF65
protein immunoprecipitated a 16-kDa protein from the membrane fraction of
VZV-infected cells. ORF65 protein was shown to be phosphorylated by casein kinase
II. The VZV ORF47 or ORF66 protein kinases were not required for phosphorylation 
of ORF65. VZV with a large deletion in ORF65 was constructed and was shown to be 
dispensable for replication of virus in cell culture. The herpes simplex virus
homolog of VZV ORF65 has been reported to be located in the nucleus of infected
cells and in virions as a tegument protein, whereas the pseudorabies virus
homolog is located in the Golgi apparatus of infected cells and in virions as a
type II membrane protein. The ORF65 protein localized to the Golgi apparatus in
virus-infected cells and was located in virions, most likely as a type II
membrane protein. Thus, VZV ORF65 more closely resembles its pseudorabies virus
homolog in its localization in infected cells and virions.

PMID: 11162819 [PubMed - indexed for MEDLINE]

2929: Virology. 2001 Feb 1;280(1):1-6.

Identification and mapping of single nucleotide polymorphisms in the
varicella-zoster virus genome.

Faga B, Maury W, Bruckner DA, Grose C.

Department of Microbiology, University of Iowa, Iowa City, Iowa 52242, USA.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 11162813 [PubMed - indexed for MEDLINE]

2930: J Virol. 2001 Mar;75(5):2067-75.

Transcriptional analysis of Marek's disease virus glycoprotein D, I, and E genes:
gD expression is undetectable in cell culture.

Tan X, Brunovskis P, Velicer LF.

Department of Microbiology, Michigan State University, East Lansing, Michigan
48824-1101, USA. tanxinyu@udel.edu

The various alphaherpesviruses, including Marek's disease virus (MDV), have both 
common and unique features of gene content and expression. The entire MDV U(s)
region has been sequenced in our laboratory (P. Brunovskis and L. F. Velicar,
Virology 206:324-338, 1995). Genes encoding the MDV glycoprotein D (gD),
glycoprotein I (gI), and glycoprotein E (gE) homologs have been found in this
region, although no gG homolog was found. In this work, transcription of the
tandem MDV gD, gI, and gE genes was studied and found to have both unique
characteristics and also features in common with other alphaherpesviruses. MDV gD
could not be immunoprecipitated from MDV GA-infected duck embryo fibroblast cells
by antisera reactive to its TrpE fusion proteins, while gI and gE could be. When 
the gD gene was subjected to in vitro-coupled transcription-translation, the
precursor polypeptide was produced and could be immunoprecipitated by anti-gD.
Northern blot, reverse transcriptase PCR, and RNase protection analyses have
shown that (i) no mRNA initiating directly from the gD gene could be detected;
(ii) a large but low-abundance 7.5-kb transcript spanning five genes, including
the one encoding gD, was seen on longer exposure; and (iii) transcription of the 
gI and gE genes formed an abundant bicistronic 3.5-kb mRNA, as well as an
abundant 2.0-kb gE-specific mRNA. Therefore, the MDV gD gene expression is
down-regulated at the transcription level in MDV-infected cell culture, which may
be related to the cell-associated nature of MDV in fibroblast cells. Compared to 
the highly gD-dependent herpes simplex virus and the other extreme of the
varicella-zoster virus which lacks the gD gene, MDV is an intermediate type of
alphaherpesvirus.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 11160711 [PubMed - indexed for MEDLINE]

2931: J Antimicrob Chemother. 2001 Feb;47 Suppl T1:1-8.

Herpes zoster--predicting and minimizing the impact of post-herpetic neuralgia.

Johnson R.

Pain Management Clinic, Department of Anaesthesia, Bristol Royal Infirmary,
Marlborough Street, Bristol BS2 8HW, UK. robert.johnson@ubht.swest.nhs.uk

Herpes zoster results from reactivation of latent varicella-zoster virus in the
dorsal root ganglia and is frequently associated with severe pain. Most patients 
suffer acute pain during the rash phase, and in many, prodromal pain or
discomfort also precedes the rash. The pain of herpes zoster gradually resolves
with time, but may persist after the acute disease as post-herpetic neuralgia for
weeks, months or even years. Post-herpetic neuralgia, the most common
complication of herpes zoster, often results in significant morbidity and
healthcare resource usage. Early treatment with oral antivirals has been shown to
accelerate the resolution of postherpetic neuralgia, with therapeutic effects
particularly evident in the over-50 age group, where pain generally persists for 
longer. Progressively increasing life expectancy of the population translates to 
increasing numbers of cases of herpes zoster. The socio-economic gains associated
with active management, including use of oral antivirals where indicated, to
speed resolution of pain and post-herpetic neuralgia, readily justify additional 
cost.

Publication Types: 
    Review

PMID: 11160029 [PubMed - indexed for MEDLINE]

2932: Dermatol Clin. 2001 Jan;19(1):23-34.

Antiviral agents.

Brown TJ, Vander Straten M, Tyring SK.

Department of Microbiology and Immunology, University of Texas Medical Branch,
Galveston, Texas, USA.

The potential severity of many viral infections and the lack of appropriate
treatment for these diseases have been a source of endless frustration and
helplessness for clinicians. The newly developed field of antiviral therapy is
expanding at an astounding rate, with new discoveries each day. Although
physicians are not yet able to cure many of the viral infections, such as HSV,
HIV, and CMV, a means of controlling them is available. It is hoped that the
research and investigations currently under way will lead to a future era of
antiviral drugs that will be able to eradicate these diseases.

Publication Types: 
    Review

PMID: 11155584 [PubMed - indexed for MEDLINE]

2933: Acta Virol. 2000 Jun-Aug;44(3):203-10.

How human immunodeficiency viruses and herpesviruses affect apoptosis.

Krzyzowska M, Schollenberger A, Niemialtowski MG.

Division of Immunology, Department of Microbiology and Immunology, Faculty of
Veterinary Medicine, Warsaw Agricultural University, Grochowska 272, 03-849
Warsaw, Poland.

Eighty to hundred percent of patients positive for human immunodefficiency
viruses 1 or 2 (HIV) may develop opportunistic viral infections. According to the
National Institute of Health data, only in the USA the HIV patients are positive 
also for human cytomegalovirus (HCMV) in 25-40%, varicella-zoster virus (VZV) in 
10%, herpes simplex viruses 1 and 2 (HSV-1 and HSV-2), and Kaposi's
sarcoma-associated herpesvirus (human herpesvirus 8, KSHV, HHV-8) in 20%. HIV and
herpesviruses express numerous different proteins that are able to influence
interactions between the host and virus. One of the most interesting regulatory
phenomenon is apoptosis which could play a significant role during both specific 
and non-specific antiviral response and latency. Apoptosis is an ordered cascade 
of precisely regulated enzymatic reactions which may be modulated or even
controlled by viruses. Dramatic changes which occur during infection and which
are exerted by HIV and certain herpesviruses on the mechanism of apoptosis may
contribute to the pathogenesis of acquired immunodeficiency syndrome (AIDS).

Publication Types: 
    Review

PMID: 11155367 [PubMed - indexed for MEDLINE]

2934: Clin J Pain. 2000 Dec;16(4):345-51.

Risk and prognostic factors of postherpetic neuralgia and focal sensory
denervation: a prospective evaluation in acute herpes zoster ophthalmicus.

Zaal MJ, Volker-Dieben HJ, D'Amaro J.

University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
mjw.zaal@azvu.nl

OBJECTIVES: To determine the general risk and the prognostic factors of
postherpetic neuralgia and focal sensory denervation in ophthalmic zoster
disease. STUDY DESIGN: A prospective clinical study. SETTING: An ophthalmic
practice participating in an eye-care network. PATIENTS: A cohort of 81
immunocompetent adult patients with herpes zoster ophthalmicus and referred by
their general practitioner during the acute phase of the disease. METHODS:
Various acute phase clinical parameters were determined via patient history and
regular ophthalmic examinations. At a 2-month follow-up, the intensity of
postherpetic neuralgia, rated on a 4-point verbal scale, and focal sensory
denervation was determined. Skin tactile sensation within the ophthalmic
dermatomes was tested with use of a cotton-wool tip, and corneal sensitivity was 
measured with use of a Cochet-Bonnet esthesiometer by comparing each eye.
Statistical analysis was performed via chi2 analysis or Fisher exact test to
identify prognostic factors of postherpetic neuralgia and focal sensory
denervation at a 2-month follow-up. RESULTS: At a 2-month follow-up, pain of
varying intensity was reported by 38 participants (47%). Of these patients, 25
patients (31%) rated their pain as mild, 8 patients (10%) rated their pain as
moderate pain, and 5 patients (6%) rated their pain as severe. At that time,
focal loss of normal skin or corneal sensation was detected in 49 patients (60%).
Patient age, acute neuralgia score, manifestation and extent of acute skin rash, 
signs of ocular inflammation, and nontrigeminal cranial nerve involvement were
all associated with prolonged pain and tactile sensory loss. CONCLUSIONS: The
severity of acute skin rash, based on a specific manifestation of cutaneous
herpes zoster eruptions, and the extent of infection to other neural pathways
were clearly associated with postherpetic neuralgia and focal sensory denervation
at a 2-month follow-up. These findings suggest that the inability of the immune
system to control the spread of replicating varicella-zoster virus in the initial
phase of the disease is an important factor in the pathogenesis of chronic
zoster-related neuropathy.

PMID: 11153792 [PubMed - indexed for MEDLINE]

2935: Bone Marrow Transplant. 2000 Dec;26(11):1193-7.

Monitoring four herpesviruses in unrelated cord blood transplantation.

Tanaka N, Kimura H, Hoshino Y, Kato K, Yoshikawa T, Asano Y, Horibe K, Kojima S, 
Morishima T.

Department of Pediatrics, Nagoya University School of Medicine, Japan.

Cord blood transplantation, which has lower risk of graft-versus-host disease
than bone marrow transplantation, might have higher risk of infections. A system 
to quantify four herpesviruses, CMV, human herpesvirus 6 (HHV6), EBV,
varicella-zoster virus using the real-time PCR assay was established and applied 
for prospective viral load monitoring in three recipients undergoing cord blood
transplantation. CMV and HHV6 were detected in peripheral blood from all three
recipients, while EBV was detected in two. Varicella-zoster virus was not
detected at all. At the peak of HHV6 or CMV, each patient showed virus-related
symptoms. During the pre-transplant period, CMV DNA was detected in two
recipients who later developed CMV-related diseases. These observations indicate 
that our system is not only useful for managing herpesviruses infections in
transplant recipients, but also a powerful method for clarifying the
relationships between the viral load and clinical symptoms.

Publication Types: 
    Case Reports
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 11149730 [PubMed - indexed for MEDLINE]

2936: Endocrinol Metab Clin North Am. 2000 Dec;29(4):813-29.

Ophthalmologic emergencies in the patient with diabetes.

Wipf JE, Paauw DS.

Department of Medicine, University of Washington, Seattle, Washington, USA.
jwipf@u.washington.edu

Diabetes is associated with many emergent ophthalmologic conditions. The
management of patients with diabetes requires careful monitoring for visual
symptoms and frequent physical examination for signs of retinopathy. Randomized
studies have documented a significant reduction in the development of new
retinopathy and the progression of existing retinopathy with tight control of
diabetes. Photocoagulation laser therapy is helpful in preserving vision in
severe nonproliferative retinopathy, for proliferative retinopathy, and for
clinically significant macular edema. Vascular events include arterial and venous
occlusions and cranial nerve palsies; important diagnostic clues are visual
symptoms and the findings of ocular and neurologic examinations. Life-threatening
infections associated with diabetes include endophthalmitis and mucormycosis,
which require prompt diagnosis to prevent blindness or systemic infection. Herpes
zoster infection, which is common in older patients and in patients with
immunosuppression, may affect the trigeminal nerve and cause anterior uveitis and
keratitis. Patients with zoster and skin vesicles on the face need emergent
ophthalmologic evaluation and treatment because untreated ocular infection and
inflammation may lead to scarring and synechiae formation in the anterior
chamber, resulting in vision loss.

Publication Types: 
    Review

PMID: 11149164 [PubMed - indexed for MEDLINE]

2937: Dermatology. 2000;201(4):321-5.

Mucocutaneous manifestations in Japanese HIV-positive hemophiliacs.

Shimizu S, Chen KR, Tagami H, Hanabusa H.

Department of Dermatology, Hokkaido University Graduate School of Medicine,
Sapporo, Japan. satoko.shimizu@nifty.ne.jp

BACKGROUND: Although various mucocutaneous manifestations have been reported in
patients infected with HIV by sexual transmission or intravenous drug use, the
prevalence and characteristics of skin disorders in HIV-positive hemophiliacs
coinfected with hepatitis C virus (HCV) have rarely been described. OBJECTIVE:
The purpose of this study was to clarify the characteristics of skin disorders in
HIV-positive hemophiliacs and to identify differences in comparison with other
HIV-positive groups. METHODS: A prospective study of the prevalence of
mucocutaneous manifestations in 110 Japanese hemophiliacs (53 HIV-positive
hemophiliacs including 24 AIDS and 57 HIV-negative hemophiliacs) was performed
from July 1997 to July 1998. RESULT: None of the hemophiliacs developed Kaposi's 
sarcoma or sexually transmitted skin diseases. Eosinophilic folliculitis was
observed in 3 AIDS patients. The incidence of folliculitis, common warts,
seborrheic dermatitis, generalized eczema, oral candidiasis and herpes zoster was
higher in HIV-positive than in HIV-negative hemophiliacs (p < 0.05). Although
anti-HCV antibody was positive in all HIV-positive hemophiliacs, HCV-related
dermatoses such as lichen planus and porphyria cutanea tarda were not observed.
CONCLUSION: Although Kaposi's sarcoma and sexually transmitted skin diseases such
as molluscum contagiosum, condyloma, and scabies are frequently associated with
HIV, they were not found in the HIV-positive hemophiliacs in our study. HIV
infection-related mucocutaneous manifestations are influenced not only by the
presence of HIV but also by other factors such as the mode of transmission and
sexual habit. Copyright 2000 S. Karger AG, Basel

PMID: 11146342 [PubMed - indexed for MEDLINE]

2938: Strahlenther Onkol. 2000 Nov;176(11):513-6.

Herpes zoster in breast cancer patients after radiotherapy.

Dunst J, Steil B, Furch S, Fach A, Bormann G, Marsch W.

Department of Radiotherapy, Martin-Luther University Halle-Wittenberg, Germany.
juergen.dunst@medizin.uni-halle.de

PURPOSE: We have studied the incidence of herpes zoster in patients with adjuvant
radiotherapy for breast cancer with special emphasis on possible correlations
with other prognostic factors or survival. PATIENTS AND METHODS: From 1/1985
through 12/1993, 1,155 breast cancer patients received postoperative radiotherapy
with curative intent in our department. After mastectomy 961 patients were
irradiated and after breast-preserving treatment 194 patients. The age ranged
from 34 to 79 years, the median follow-up was 3.1 years (range: 0.3 to 12.4
years). There were 443 women (38%) pre- and 712 (62%) postmenopausal. 21% had T3-
to T4-tumors, 55% had axillary lymph node involvement, and 65% received
additional systemic hormonal and/or cytotoxic therapy. In case of postmastectomy 
radiotherapy, the lateral chest wall and lymphatics (axilla, parasternal and
supraclavicular nodes) were irradiated with an anterior photon field to 50 Gy
(axilla 44 Gy) and most of the chest wall with an electron field to 44 Gy in 2-Gy
fractions. After breast-preservation, the breast was irradiated via tangential
fields with 6- to 8-MV photons up to 50 Gy plus 8 Gy electron boost to the tumor 
bed. Most of the patients were followed routinely in the department for 2 to 5
years. The frequency of zoster was determined retrospectively by reviewing the
patients' records. RESULTS: A zoster after radiotherapy occurred in 41/1,155
patients (3.7%), mostly within the first 2 years after completion of
radiotherapy. All infections remained localized and there was no evidence for
systemic infections. Type of treatment (mastectomy vs breast-preservation) had no
impact on the frequency of herpes zoster (36/961 patients after mastectomy and
5/194 patients after breast-preservation). There was also no correlation with
other prognostic factors such as age, menopausal status, stage of disease or the 
use of adjuvant chemotherapy, nor was the occurrence of zoster linked to the
degree of acute skin reaction in the radiation field. Moreover, patients with
zoster had the same prognosis as compared to patients without zoster with regard 
to local control and survival. CONCLUSIONS: The observed frequency of zoster
(about 4% of patients after postoperative radiotherapy) in this retrospective
study suggests that the risk of developing zoster in this patient group may be 3-
to 5-fold higher as compared to the incidence in the general population. However,
the occurrence of zoster was not linked to prognosis and treatment response.

PMID: 11143525 [PubMed - indexed for MEDLINE]

2939: J Neurosurg. 2000 Dec;93 Suppl 3:165-8.

Treatment of postherpetic trigeminal neuralgia with the gamma knife.

Urgosik D, Vymazal J, Vladyka V, Liscak R.

Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital,
Prague, Czech Republic. urgo@zero.cz

OBJECT: Postherpetic neuralgia is a syndrome characterized by intractable pain.
Treatment of this pain has not yet been successful. Patients with postherpetic
neuralgia will therefore benefit from any progress in the treatment strategy. The
authors performed gamma knife radiosurgery (GKS) as a noninvasive treatment for
postherpetic trigeminal neuralgia (TN) and evaluated the success rate for pain
relief. METHODS: Between 1995 and February 1999, six men and 10 women were
treated for postherpetic TN; conservative treatment failed in all of them. The
median follow up was 33 months (range 8-34 months). The radiation was focused on 
the root of the trigeminal nerve in the vicinity of the brainstem (maximal dose
70-80 Gy in one fraction, 4-mm collimator). The patients were divided into five
groups according to degree of pain relief after treatment. A successful result
(excellent, very good, and good) was reached in seven (44%) patients and
radiosurgery failed in nine (56%). Pain relief occurred after a median interval
of 1 month (range 10 days-6 months). No radiation-related side effects have been 
observed in these patients. CONCLUSIONS: These results suggest that GKS for
postherpetic TN is a relatively successful and safe method that can be used in
patients even if they are in poor condition. In case this method fails, other
treatment options including other neurosurgical procedures are not excluded.

PMID: 11143238 [PubMed - indexed for MEDLINE]

2940: Schweiz Med Wochenschr. 2000;Suppl 125:89S-91S.

[Advantage of screening for for infection in suddden and progressive hearing
loss]

[Article in French]

Gagnebin J, Maire R.

Service d'ORL et de chirurgie cervico-faciale, CHUV, Lausanne.
Joel.Gagnebin@chuv.hospvd.ch

OBJECTIVE: The aim of this retrospective study was to assess the advantage of
systematic screening for infection in patients presenting with sudden or
progressive sensorineural hearing loss. METHOD: 175 patients were included. 102
patients presented with unilateral sudden sensorineural hearing loss and 73 with 
progressive sensorineural hearing loss. Serologies tested were herpes simplex and
zoster (IgM and IgG titres), Lyme disease (ELISA), syphilis (FTA-abs and MHA-TP) 
and HIV. RESULTS: Screening for infection was negative in 172 patients. 2
patients had positive serology for Lyme disease and one for syphilis. The case of
serological syphilis was finally diagnosed as latent syphilis after ruling out
neurosyphilis. Both cases of suspected Lyme disease were later invalidated by
Western blot and lumbar puncture (2 false positives). CONCLUSION: Screening for
infection was positive only in 1/175 patients (0.6%), rendering diagnosis of
latent syphilis possible. These results suggest that, on grounds of
cost-effectiveness, testing for infection should be limited to and focused on
patients with a positive clinical evaluation.

Publication Types: 
    English Abstract

PMID: 11141952 [PubMed - indexed for MEDLINE]

2941: J Virol. 2001 Jan;75(2):821-33.

Herpes simplex virus gE/gI sorts nascent virions to epithelial cell junctions,
promoting virus spread.

Johnson DC, Webb M, Wisner TW, Brunetti C.

Department of Molecular Microbiology & Immunology, Oregon Health Sciences
University, Portland, Oregon 97201, USA. johnsoda@ohsu.edu

Alphaherpesviruses spread rapidly through dermal tissues and within synaptically 
connected neuronal circuitry. Spread of virus particles in epithelial tissues
involves movement across cell junctions. Herpes simplex virus (HSV),
varicella-zoster virus (VZV), and pseudorabies virus (PRV) all utilize a complex 
of two glycoproteins, gE and gI, to move from cell to cell. HSV gE/gI appears to 
function primarily, if not exclusively, in polarized cells such as epithelial
cells and neurons and not in nonpolarized cells or cells that form less extensive
cell junctions. Here, we show that HSV particles are specifically sorted to cell 
junctions and few virions reach the apical surfaces of polarized epithelial
cells. gE/gI participates in this sorting. Mutant HSV virions lacking gE or just 
the cytoplasmic domain of gE were rarely found at cell junctions; instead, they
were found on apical surfaces and in cell culture fluids and accumulated in the
cytoplasm. A component of the AP-1 clathrin adapter complexes, mu1B, that is
involved in sorting of proteins to basolateral surfaces was involved in targeting
of PRV particles to lateral surfaces. These results are related to recent
observations that (i) HSV gE/gI localizes specifically to the trans-Golgi network
(TGN) during early phases of infection but moves out to cell junctions at
intermediate to late times (T. McMillan and D. C. Johnson, J. Virol., in press)
and (ii) PRV gE/gI participates in envelopment of nucleocapsids into cytoplasmic 
membrane vesicles (A. R. Brack, B. G. Klupp, H. Granzow, R. Tirabassi, L. W.
Enquist, and T. C. Mettenleiter, J. Virol. 74:4004-4016, 2000). Therefore,
interactions between the cytoplasmic domains of gE/gI and the AP-1 cellular
sorting machinery cause glycoprotein accumulation and envelopment into specific
TGN compartments that are sorted to lateral cell surfaces. Delivery of virus
particles to cell junctions would be expected to enhance virus spread and enable 
viruses to avoid host immune defenses.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11134295 [PubMed - indexed for MEDLINE]

2942: Acta Otolaryngol. 2000 Oct;120(7):835-9.

Role of viral and Mycoplasma pneumoniae infection in idiopathic sudden
sensorineural hearing loss.

Garcia Berrocal JRG, Ramirez-Camacho R, Portero F, Vargas JA.

Department of Otorhinolaryngology, Clinica Puerta de Hierro, Universidad Autonoma
de Madrid, Spain.

Sudden deafness constitutes a challenge in terms of the etiopathogenic diagnosis.
The causative origin of sudden deafness usually remains unknown. However,
available evidence suggests that viral and Mycoplasma pneumoniae infection could 
be one factor involved. In order to analyze the incidence of these infectious
agents, a microbiology study was carried out during the acute phase of the
disease, and during convalescence, in 24 patients (17 men and 7 women; mean age
39.7 years; range 17-63 years) with idiopathic sudden hearing loss (SHL)
according to previously published criteria. In the acute phase most of the
patients presented IgG antibodies to Epstein-Barr virus (n = 23), herpes simplex 
virus (n = 24), parainfluenza virus (n = 24), varicella-zoster virus (n = 24) and
cytomegalovirus (n = 20). Results obtained from 3 patients suggested the
existence of a recent infectious process caused by Mycoplasma pneumoniae (IgM+)
in 1 patient, Mycoplasma (IgM+) and influenza A virus (complement fixation titer 
> 1/64) in another and parainfluenza virus seroconversion (a fourfold higher
titer between the acute phase and convalescence) in the third. In conclusion, the
low incidence of documented positive serological tests in our series (12.5%) may 
be due to the presence of pathological situations other than acute infection and 
does not justify routine serological studies in patients with SHL.

PMID: 11132716 [PubMed - indexed for MEDLINE]

2943: J Pain Symptom Manage. 2000 Dec;20(6):449-58.

Antidepressants and anticonvulsants for diabetic neuropathy and postherpetic
neuralgia: a quantitative systematic review.

Collins SL, Moore RA, McQuayHJ, Wiffen P.

Pain Research, Nuffield Department of Anaesthetics, University of Oxford, Oxford 
Radcliffe Hospital, Headington, United Kingdom.

To determine the relative efficacy and adverse effects of antidepressants and
anticonvulsants in the treatment of diabetic neuroapathy and postherpetic
neuralgia, published reports were identified from a variety of electronic
databases, including Medline, EMBASE, the Cochrane Library and the Oxford Pain
Relief Database, and from two previously published reviews. Additional studies
were identified from the reference lists of retrieved reports. The relative
benefit (RB) and number-needed-to-treat (NNT) for one patient to achieve at least
50 % pain relief was calculated from available dichotomous data, as was the
relative risk (RR) and number-needed-to-harm (NH) for minor adverse effects and
drug related study withdrawal. In diabetic neuropathy, 16 reports compared
antidepressants with placebo (491 patient episodes) and three compared
anticonvulsants with placebo (321). The NNT for at least 50 % pain relief with
antidepressants was 3.4 (95 % confidence interval 2.6-4. 7) and with
anticonvulsants 2. 7 (2. 2-3. 8). In postherpetic neuralgia, three reports
compared antidepressants with placebo (145 patient episodes) and one compared
anticonvulsants with placebo (225), giving an NNT with antidepressants of 2.1 (1.
7-3) and with anticonvulsants 3.2 (2.4-5). There was little difference in the
incidence of minor adverse effects with either antidepressants or anticonvulsants
compared with placebo, with 1VH (minor) values of about 3. For drug-related study
withdrawal, antidepressants had an NNH (major) of 17 (11-43) compared with
placebo, whereas with anticonvulsants there was no significant difference from
placebo. Antidepressants and anticonvulsants had the same efficacy and incidence 
of minor adverse effects in these tzoo neuropathic pain conditions. There was no 
evidence that selective serotonin reuptake inhibitors (SSRIs) were better than
older antidepressants, and no evidence that gabapentin was better than older
anticonvulsants. In these trials patients were more likely to stop taking
antidepressants than anticonvulsants because of adverse effects.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11131263 [PubMed - indexed for MEDLINE]

2944: J Med Virol. 2001 Jan;63(1):64-6.

Rapid contamination of the environments with varicella-zoster virus DNA from a
patient with herpes zoster.

Yoshikawa T, Ihira M, Suzuki K, Suga S, Tomitaka A, Ueda H, Asano Y.

Department of Paediatrics, Fujita Health University School of Medicine, Toyoake, 
Japan. tetsushi@med.nagota-u.ac.jp

Patients with zoster are considered to be less contagious than varicella patients
because their infection is localised. It is not known, however, when and for how 
long a spread of varicella-zoster virus (VZV) from a zoster patient begins and
continues and the extent of virus spread from the patient. The polymerase chain
reaction (PCR) was used to detect VZV DNA in samples obtained from the hands and 
throat of a patient with zoster and from her room environments including surfaces
of the back of a chair, the door handle, the table and the air conditioner
filter. VZV DNA was detected on the surfaces of the back of the seat and the
table and in peripheral blood mononuclear cells (PBMCs) and serum on Day 4 of the
illness. VZV DNAemia persisted for 4 days until Day 7 of the illness. It was also
detected in samples collected from throat and the air conditioner filter on Days 
6 and 7 of the illness respectively. All of the surfaces, that were examined in
her home environment, were contaminated with VZV DNA by Day 7 of the illness. The
present study showed rapid and wide spread of VZV DNA in the environment even
from a patient with zoster.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 11130889 [PubMed - indexed for MEDLINE]

2945: J Med Virol. 2001 Jan;63(1):52-6.

Nested multiplex polymerase chain reaction for the diagnosis of cutaneous herpes 
simplex and herpes zoster infections and a comparison with electronmicroscopy.

Jain S, Wyatt D, McCaughey C, O'Neill HJ, Coyle PV.

Regional Virus Laboratory, Royal Victoria Hospital, Belfast, United Kingdom.

Herpes simplex virus (HSV) and varicella zoster virus (VZV) are common causes of 
cutaneous and mucocutaneous vesicular eruptions. Laboratory diagnostic techniques
include Tzanck smears, electronmicroscopy, antigen detection and viral culture.
This paper describes a nested multiplex polymerase chain reaction with respective
sensitivities of 0.0001, 0.01 and 0.1 TCID50 for VZV, HSV-1 and HSV-2. The assay 
was used in (a) a salvage capacity for slides already processed for
electronmicroscopy, and (b) as a front-line assay for prospectively processed
specimens. Sixty-two glass slides with vesicle lymph/scrapings from 58 patients
with suspected cutaneous herpetic lesions were examined. The clinical
presentations were described as atypical/not specified (24), VZV (20) or HSV
(18), and involved eruptions from diverse anatomical sites, including the
genitalia. Of the 62 specimens, 6 and 38 were positive by electronmicroscopy and 
multiplex PCR respectively, giving a comparative sensitivity of 16% for
electronmicroscopy. Nested multiplex PCR identified 15 VZV and 20 HSV-1
infections. Where the clinical details indicated either HSV or VZV (38/62),
nested multiplex PCR was statistically likely to be reactive (26/38 vs. 9/24)
(chi2 P = 0.000004) whereas electronmicroscopy was not (4/38 vs. 2/24) (chi2 P=
0.77). Where the clinical details indicated VZV (20/62) or HSV (18/62), nested
multiplex PCR was statistically more likely to confirm VZV (10/20 vs. 5/42) (chi2
P= 0.001) or HSV (9/18 vs. 11/44) (chi2 P = 0.05) respectively. Two suspected HSV
and 6 suspected VZV infections were shown to be VZV and HSV respectively by
nested multiplex PCR.

Publication Types: 
    Comparative Study

PMID: 11130887 [PubMed - indexed for MEDLINE]

2946: Cancer Gene Ther. 2000 Nov;7(11):1456-68.

The role of cellular- and prodrug-associated factors in the bystander effect
induced by the Varicella zoster and Herpes simplex viral thymidine kinases in
suicide gene therapy.

Grignet-Debrus C, Cool V, Baudson N, Velu T, Calberg-Bacq CM.

Laboratory of Fundamental Virology and Immunology, Institute of Pathology,
University of Liege, Belgium. c.grignet@ulg.ac.be

To investigate the factors influencing the bystander effect--a key element in the
efficacy of suicide gene therapy against cancer--we compared the effect triggered
by four extremely efficient gene/prodrug combinations, i.e., VZVtk/BVDU, the
thymidine kinase of Varicella zoster virus associated with
(E)-5-(2-bromovinyl)-2'-deoxyuridine; VZVtk/BVaraU, the same enzyme associated
with (E)-5-(2-bromovinyl)-1-beta-D-arabinofuranosyluracil; HSVtk/BVDU, the
association of the Herpes simplex virus thymidine kinase with BVDU; and the
classical HSVtk/GCV (ganciclovir) paradigm. The cells used, the human MDA-MB-435 
breast cancer, and the rat 9L glioblastoma lines were equally sensitive in vitro 
to these four associations. In both cell types, the combinations involving
pyrimidine analogues (BVDU, BVaraU) displayed a smaller bystander killing than
the combination involving the purine analogue (GCV). In addition, the bystander
effect induced by all the tk/prodrug systems was reduced in MDA-MB-435 cells in
comparison to 9L cells; albeit, the viral kinases were produced at a higher level
in the breast cancer cells. All systems induced apoptotic death in the two cell
types, but the MDA-MB-435 cells, deprived of connexin 43, were noncommunicating
in striking contrast with the 9L cells. That functional gap junctions have to be 
increased in order to improve the breast cancer cell response to suicide gene
therapy was demonstrated by transducing the Cx43 gene: this modification enhanced
the bystander effect associated in vitro with GCV treatment and, by itself,
decreased the tumorigenicity of the untreated cells. However, the
noncommunicating MDA-MB-435 cells triggered a significant bystander effect both
in vitro and in vivo with the HSVtk/GCV system, showing that communication
through gap junctions is not the only mechanism involved.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11129288 [PubMed - indexed for MEDLINE]

2947: Klin Oczna. 2000;102(3):169-72.

[Evaluation and monitoring of selected inflammation patterns in uveitis using
laser tyndallometry]

[Article in Polish]

Biziorek B, Zarnowski T, Zagorski Z.

Katedry i I Kliniki Okulistyki AM w Lublinie.

AIM: The purpose of the present study was to evaluate the degree of inflammation 
and to monitor the dynamics of the blood-aqueous barrier disruption in selected
cases of uveitis using laser tyndalometry. MATERIAL AND METHOD: Measurements with
the use of laser tyndalometer (Kowa FM-500) were performed in 72 patients (90
eyes) with various types of uveitis. They were divided into four groups: anterior
uveitis (28 eyes), intermediate uveitis (pars planitis) (28 eyes), posterior
uveitis (26 eyes) and panuveitis (8 eyes). Aqueous flare values were expressed as
photon counts per millisecond. RESULTS: Tyndalometric mean values in control eyes
were 4.8 +/- 1.0 ph/msec. Mean initial flare was pronounced in multifocal
choroiditis and panuveitis--196.0 ph/msec, HLA-B27 positive acute anterior
uveitis--145.4 ph/msec, and in acute herpes zoster anterior uveitis--52.4
ph/msec. It was mild to moderate in Fuchs uveitis syndrome--7.8 ph/msec, pars
planitis--15.7 ph/msec, posterior uveitis in toxoplasmosis--6.8 ph/msec and
toxocariasis--17.5 ph/msec. The potential of laser flare-meter for precise
follow-up and adjustment of therapy was demonstrated in selected cases.
CONCLUSIONS: Laser tyndalometry has been proved to be a useful tool for the
objective and quantitative evaluation of anterior chamber flare in uveitis and
for monitoring the effectiveness of the treatment, thus improving therapeutic
efficacy of uveitis.

Publication Types: 
    Case Reports
    English Abstract
    Evaluation Studies

PMID: 11126170 [PubMed - indexed for MEDLINE]

2948: Sante. 2000 Sep-Oct;10(5):311-3.

[Uveitis in patients with HIV infection]

[Article in French]

Mwanza JC, Kayembe DL.

Service d'ophtalmologie, Cliniques universitaires de Kinshasa, Republique
democratique du Congo. jcmwanza@hotmail.com

We carried out a retrospective analysis of 581 patients with uveitis seen over an
11-year period, to determine the prevalence of HIV infection in these patients
and to look for associated diseases and the possible causes of uveitis in
HIV-infected patients. All patients underwent routine eye examination and most
also underwent a general examination and complementary tests. The prevalence of
HIV infection was 14.3% (89 patients). Anterior uveitis (62%) was the most
frequent, followed by posterior uveitis (22%), panuveitis (12%) and intermediate 
uveitis (4%). Associated conditions or causes were identified in 88% of the
HIV-infected patients, with herpes zoster ophthalmicus the most frequent (43 %), 
followed by tuberculosis (16%), CMV infection (12%) and toxoplasmosis (10%).
Thus, uveitis in HIV-infected patients is frequently associated with
opportunistic infections.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 11125336 [PubMed - indexed for MEDLINE]

2949: Antimicrob Agents Chemother. 2001 Jan;45(1):150-7.

Pharmacokinetics of oral acyclovir in neonates and in infants: a population
analysis.

Tod M, Lokiec F, Bidault R, De Bony F, Petitjean O, Aujard Y.

Pharmacie and Centre de Recherche en Pathologie Infectieuse et Tropicale, Hopital
Avicenne, Bobigny 93009, France. michel.tod@avc.ap-hop-paris.fr

Acyclovir is approved for the treatment of herpes simplex virus (HSV) and
varicella-zoster virus (VZV) infections in children by the intravenous and oral
routes. However, its use by the oral route in children younger than 2 years of
age is limited due to a lack of pharmacokinetic data. The objectives of the
present study were to determine the typical pharmacokinetics of an oral
suspension of acyclovir given to children younger than 2 years of age and the
interindividual variabilities in the values of the pharmacokinetic parameters in 
order to support the proposed dosing regimen (24 mg/kg of body weight three times
a day for patients younger than 1 month of age or four times a day otherwise).
Children younger than age 2 years with HSV or VZV infections were enrolled in a
multicenter study. Children were treated for at least 5 days with an acyclovir
oral suspension. Plasma samples were obtained at steady state, before acyclovir
administration, and at 2, 3, 5, and 8 h after acyclovir administration. Acyclovir
concentrations were measured by radioimmunoassay. The data were analyzed by a
population approach. Data for 79 children were considered in the pharmacokinetic 
study (212 samples, 1 to 5 samples per patient). Acyclovir clearance was related 
to the estimated glomerular filtration rate, body surface area, and serum
creatinine level. The volume of distribution was related to body weight. The
elimination half-life decreased sharply during the first month after birth, from 
10 to 15 h to 2.5 h. Bioavailability was 0.12. The interindividual variability
was less pronounced when the parameters were normalized with respect to body
weight. Hence, dosage adjustment by body weight is recommended for this
population. Simulations showed that the length of time that acyclovir remains
above the 50% inhibitory concentration during a 24-h period was more than 12 h
for HSV but not for VZV. The proposed dosing regimen seems adequate for the
treatment of HSV infections, while for the treatment of VZV infections, a twofold
increase in the dose seems necessary for children older than age 3 months.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 11120958 [PubMed - indexed for MEDLINE]

2950: Transplant Proc. 2000 Nov;32(7):1952-3.

Primary varicella virus in adult renal transplant recipients: case reports.

Ishikawa N, Tanabe K, Shimmura H, Tokumoto T, Toma H.

Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.

Publication Types: 
    Case Reports

PMID: 11120016 [PubMed - indexed for MEDLINE]

2951: Strahlenther Onkol. 2000 Nov;176(11):513-6.

Herpes zoster in breast cancer patients after|| radiotherapy.

Dunst J, Steil B, Furch S, Fach A, Bormann G, Marsch W.

Department of Radiotherapy, Martin-Luther University|| Halle-Wittenberg, Germany.
juergen.dunst@medizin.uni-halle.de

PURPOSE: We have studied the incidence of herpes zoster||| in patients with
adjuvant radiotherapy for breast cancer with special emphasis||| on possible
correlations with other prognostic factors or survival. PATIENTS||| AND METHODS: 
From 1/1985 through 12/1993, 1,155 breast cancer patients received|||
postoperative radiotherapy with curative intent in our department. After|||
mastectomy 961 patients were irradiated and after breast-preserving treatment||| 
194 patients. The age ranged from 34 to 79 years, the median follow-up was 3.1|||
years (range: 0.3 to 12.4 years). There were 443 women (38%) pre- and 712
(62%)||| postmenopausal. 21% had T3- to T4-tumors, 55% had axillary lymph node|||
involvement, and 65% received additional systemic hormonal and/or cytotoxic|||
therapy. In case of postmastectomy radiotherapy, the lateral chest wall and|||
lymphatics (axilla, parasternal and supraclavicular nodes) were irradiated
with||| an anterior photon field to 50 Gy (axilla 44 Gy) and most of the chest
wall||| with an electron field to 44 Gy in 2-Gy fractions. After
breast-preservation,||| the breast was irradiated via tangential fields with 6-
to 8-MV photons up to||| 50 Gy plus 8 Gy electron boost to the tumor bed. Most of
the patients were||| followed routinely in the department for 2 to 5 years. The
frequency of zoster||| was determined retrospectively by reviewing the patients' 
records. RESULTS: A||| zoster after radiotherapy occurred in 41/1,155 patients
(3.7%), mostly within||| the first 2 years after completion of radiotherapy. All 
infections remained||| localized and there was no evidence for systemic
infections. Type of treatment||| (mastectomy vs breast-preservation) had no
impact on the frequency of herpes||| zoster (36/961 patients after mastectomy and
5/194 patients after||| breast-preservation). There was also no correlation with 
other prognostic||| factors such as age, menopausal status, stage of disease or
the use of adjuvant||| chemotherapy, nor was the occurrence of zoster linked to
the degree of acute||| skin reaction in the radiation field. Moreover, patients
with zoster had the||| same prognosis as compared to patients without zoster with
regard to local||| control and survival. CONCLUSIONS: The observed frequency of
zoster (about 4%||| of patients after postoperative radiotherapy) in this
retrospective study||| suggests that the risk of developing zoster in this
patient group may be 3- to||| 5-fold higher as compared to the incidence in the
general population. However,||| the occurrence of zoster was not linked to
prognosis and treatment||| response.

PMID: 11116559 [PubMed - as supplied by publisher]

2952: Vaccine. 2000 Nov 22;19(7-8):916-23.

The postmarketing safety profile of varicella vaccine.

Sharrar RG, LaRussa P, Galea SA, Steinberg SP, Sweet AR, Keatley RM, Wells ME,
Stephenson WP, Gershon AA.

Worldwide Product Safety and Epidemiology, Merck Research Laboratories, BLB-30,
PO Box 4, West Point, PA 19486, USA. sharrar@merck.com

The postmarketing safety profile of varicella vaccine was evaluated by analyzing 
selected adverse experience reports temporally associated with the administration
of the vaccine. There were 7963 reports voluntarily submitted to Merck for an
overall reporting rate of 5.0 per 10000 doses of vaccine distributed. A varicella
zoster virus (VZV) identification program detected the presence of the Oka
vaccine strain in three individuals with an immune deficiency - two with
pneumonia and one with hepatitis - and in three instances of secondary
transmission from vaccinees with vesicular lesions to susceptible household
contacts. The Oka vaccine strain was present in 23 patients and wild-type VZV was
present in 15 patients with herpes zoster. Vesicular rashes that occurred within 
2 weeks of vaccination were more likely to contain the presence of wild-type VZV,
while vesicular rashes that occurred more than 2 weeks post-vaccination were more
likely to contain the Oka vaccine strain. Eleven patients were hospitalized with 
complications of breakthrough varicella infection.

PMID: 11115716 [PubMed - indexed for MEDLINE]

2953: Vet Hum Toxicol. 2000 Dec;42(6):370-1.

Accidental ingestion of acyclovir in dogs: 105 reports.

Richardson JA.

ASPCA National Animal Poison Control Center, Urbana, Illinois 61802, USA.

Acyclovir is an antiviral agent that causes termination of viral DNA synthesis by
inhibiting viral reverse transcriptase. Acyclovir is used therapeutically to
treat herpes simplex, cytomegalovirus, Epstein-Barr, and varicella-Zoster.
Although acyclovir is thought to be low in toxicity, it has caused an obstructive
nephropathy from accumulation of crystals in renal tissue. A retrospective review
(January 1995 through March 2000) was conducted of acyclovir toxicoses in dogs
reported to the ASPCA National Animal Poison Control Center. Of 105 ingestions,
10 were considered cases of acyclovir toxicosis. The most common signs seen were 
vomiting, diarrhea, anorexia, and lethargy. Ingested dosages ranged from 40 to
2195 mg/kg bw. Polyuria and polydipsia were reported in I dog. In 6/10 cases,
signs developed within 3 h of ingestion. Treatment included standard
decontamination procedures, (ie induction of emesis, administration of activated 
charcoal), diuresis, and supportive care.

Publication Types: 
    Review

PMID: 11111948 [PubMed - indexed for MEDLINE]

2954: Nursing. 2000 Nov;30(11):98.

Varicella-zoster virus.

Sheff B.

St. Elizabeth's Medical Center, Brighton, Mass., USA.

PMID: 11111670 [PubMed - indexed for MEDLINE]

2955: Ned Tijdschr Geneeskd. 2000 Nov 18;144(47):2257.

[Diagnostic image (12). Ramsay Hunt syndrome]

[Article in Dutch]

van der Meer JW.

Academisch Ziekenhuis, afd. Inwendige Geneeskunde, Nijmegen.

A 17-year-old woman developed a unilateral facial paralysis with vesicles in the 
left ear and in the throat. This combination is known as Ramsay Hunt syndrome.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11109470 [PubMed - indexed for MEDLINE]

2956: Praxis (Bern 1994). 2000 Oct 26;89(43):1759-60.

[Herpes zoster]

[Article in German]

Zimmermann I.

Medizinische Universitats-Poliklinik, Departement Innere Medizin, Kantonsspital
Basel.

Publication Types: 
    Case Reports

PMID: 11103622 [PubMed - indexed for MEDLINE]

2957: Schweiz Med Wochenschr. 2000 Nov 4;130(44):1685-8.

[Reactivation of herpes virus infections by vaccination: evidence or
coincidence?]

[Article in German]

Walter R, Hartmann K, Pool V, Gargiullo P, Kuhn M.

Departement fur Innere Medizin, Universitatsspital Zurich.

Varicella zoster and herpes simplex viruses cause latent infections by persisting
in human cells. Reactivation has been associated with increasing age,
immunosuppression, cancer, stress, fever, exposure to ultraviolet light, and
tissue damage. Based on three cases reported to the Swiss Drug Monitoring Centre 
SANZ, we postulated previously that vaccinations may trigger reactivation of
herpes virus infections due to vaccine-induced immunomodulation. In the meantime,
10 new cases of reactivated herpes virus infections soon after vaccinations have 
been reported. They involved 5 women and 5 men with an age range between 16 and
60. In only one case had a trauma preceded, otherwise healthy subjects with no
known relevant comorbidity were vaccinated. The clustering of reports after
publication points to a previous underreporting of similar cases. This may be
explained by the fact that both vaccinations and reactivations of herpes virus
infections are frequent, and a causal link is not suspected. However, these new
cases do not prove causality, and extensive epidemiological or experimental
studies are needed to elucidate the possible link between vaccination and
reactivation of herpes virus infections.

Publication Types: 
    English Abstract

PMID: 11103441 [PubMed - indexed for MEDLINE]

2958: J Gastroenterol Hepatol. 2000 Oct;15 Suppl:G17-25.

Acute liver failure: established and putative hepatitis viruses and therapeutic
implications.

Williams R, Riordan SM.

Institute of Hepatology, University College London and University College London 
Hospitals, England. roger.williams@ucl.ac.uk

Any virus that can cause an acute hepatitis will, on occasion, give rise to acute
liver failure. Such infections can be separated into those due to the primary
hepatitis viral infections A to E and those where hepatitis occurs as part of a
systemic viral infection, as with infection with, for instance, Epstein-Barr
virus, cytomegalovirus, Varicella zoster virus, adenovirus and Herpes simplex
virus. In general, the frequency with which the different hepatitis viruses are
responsible for acute liver failure is related to their underlying prevalence in 
particular countries. An apparent exception is the striking geographical
variation in the reported prevalence of acute liver failure due to hepatitis C
virus infection, with a much higher proportion of cases generally attributed to
this agent in Japan and Taiwan than in Western countries. Recent work has focused
on the possible importance of mutant hepatitis B viral strains, co- and
super-infection with known hepatitis viruses and certain newly described agents
that may account for otherwise unexplained cases of acute liver failure. Despite 
an improved understanding of the pathogenesis of complicating cerebral oedema and
advances in general supportive care, it is likely that the most severely affected
patients with acute liver failure due to viral causes will survive only with
liver transplantation, at least until approaches for promoting adequate liver
regeneration are successfully developed and implemented.

Publication Types: 
    Review

PMID: 11100988 [PubMed - indexed for MEDLINE]

2959: Nat Med. 2000 Dec;6(12):1299-300.

Comment on:
    Nat Med. 2000 Apr;6(4):451-4.

Varicella vaccine revisited.

LaRussa P, Steinberg SP, Shapiro E, Vazquez M, Gershon AA.

Publication Types: 
    Comment
    Letter

PMID: 11100089 [PubMed - indexed for MEDLINE]

2960: Ophthalmology. 2000 Dec;107(12):2129-30.

Diagnosing and treating herpetic anterior uveitis.

Cunningham ET Jr.

Publication Types: 
    Editorial
    Review

PMID: 11097582 [PubMed - indexed for MEDLINE]

2961: Int J Dermatol. 2000 Oct;39(10):766-8.

Comment in:
    Int J Dermatol. 2003 Aug;42(8):664-6.

Wolf's isotopic response: Trichophyton rubrum folliculitis appearing on a herpes 
zoster scar.

Tuzun Y, Iscimen A, Goksugur N, Demirkesen C, Tuzun B.

Department of Dermatology, Istanbul University Cerrahpasa Medical Faculty,
Turkey. ytuzun@superonline.com

Publication Types: 
    Case Reports

PMID: 11095197 [PubMed - indexed for MEDLINE]

2962: Curr Treat Options Neurol. 2000 Sep;2(5):407-416.

Bell's Palsy and Herpes Zoster Oticus.

Morrow MJ.

Hattiesburg Clinic, 415 South 28th Street, Hattiesburg, MS 39401, USA.

Normal facial movement is required for chewing, swallowing, speaking, and
protecting the eye. Bell's palsy causes most cases of acute, unilateral facial
palsy; infection with herpes simplex virus (HSV) type 1 may be its major cause.
Varicella zoster virus (VZV) reactivation (Ramsay Hunt syndrome) is less common, 
but may appear without skin lesions in a form indistinguishable from Bell's
palsy. Symptoms improve in nearly all patients with Bell's palsy, and most
patients with Ramsay Hunt syndrome, but many are left with functional and
cosmetic deficits. Steroids are frequently used to optimize outcomes in Bell's
palsy, but proof of their effectiveness is marginal. Oral prednisone has been
studied extensively, although some reports have suggested a higher recovery rate 
with intravenous steroids. Given the existing data, we support the use of oral
prednisone in those patients with complete facial palsy, and no contraindications
to their use (Fig. 1). In this author's opinion, the greatly increased cost and
inconvenience of intravenous steroids cannot be justified by the data available. 
Antiviral agents may also be effective in treatment of Bell's palsy; HSV is
susceptible to acyclovir and related agents. There have been few investigations
of acyclovir treatment in Bell's palsy, but one controlled study showed added
benefit when the drug was used with prednisone. The risk and cost of acyclovir is
low enough that we support its use, with oral steroids, in those patients with
complete facial paralysis. Several small studies have implied that oral acyclovir
improves the outcome of facial palsy for patients with Ramsay Hunt syndrome.
Although these studies do not prove efficacy, evidence for the benefits of
antiviral agents in other forms of zoster is strong enough to recommend their use
when the facial nerve is involved. VZV is less sensitive to acyclovir than HSV,
so higher doses are recommended to treat Ramsay Hunt syndrome. Because some
Ramsay Hunt syndrome patients with partial facial palsy do not fully recover, we 
recommend oral antiviral agents in all patients suspected of having zoster. There
is weak evidence to suggest additional benefit of oral steroids in facial zoster,
and their use can be supported in immunocompetent individuals. Facial nerve
decompression surgery for Bell's palsy and herpes zoster oticus has experienced
varying levels of enthusiasm over the years. Recent work implies that early,
extensive decompression of the nerve through a middle fossa craniotomy may
benefit patients at high risk for persistent deficits. However, until this
procedure is subjected to a rigorous, controlled trial comparing it with maximal 
medical therapy, it is difficult to justify the very high costs and risk.

PMID: 11096766 [PubMed - as supplied by publisher]

2963: J Am Coll Cardiol. 2000 Nov 15;36(6):1920-6.

Evaluation of viral infection in the myocardium of patients with idiopathic
dilated cardiomyopathy.

Fujioka S, Kitaura Y, Ukimura A, Deguchi H, Kawamura K, Isomura T, Suma H,
Shimizu A.

Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.

OBJECTIVES: The aim of this study was to evaluate the viral etiology of
idiopathic dilated cardiomyopathy (DCM). BACKGROUND: The demonstration of
enteroviral genome in hearts with DCM has reinforced the importance of
enteroviruses in the pathogenesis of DCM. However, there is uncertainty about the
character and activity of enteroviruses detected in the myocardium. Recently, the
association of hepatitis C virus or adenovirus with DCM has been reported.
METHODS: Myocardial specimens from 26 patients with idiopathic DCM, which were
obtained at partial left ventriculectomy (PLV), were examined virologically.
Strand-specific detection of enteroviral RNA was performed to differentiate
active viral replication from latent persistence. Polymerase chain reaction was
used to detect genomic sequences of hepatitis C virus, adenovirus,
cytomegalovirus, influenza viruses, mumps virus, herpes simplex viruses,
varicella-zoster virus and Epstein-Barr virus. RESULTS: Plus-strand enteroviral
RNA was detected in 9 (35%) of the 26 patients. Minus-strand enteroviral RNA was 
determined in seven (78%) of these nine plus-strand RNA-positive patients.
Sequence analysis revealed that the enteroviruses detected were coxsackie B
viruses, such as coxsackievirus B3 and B4. However, genetic material from other
viruses was not detected. Six (86%) of seven minus-strand enteroviral
RNA-positive patients died of cardiac insufficiency within the first six months
after PLV. CONCLUSIONS: Coxsackie B viruses were seen in hearts with idiopathic
DCM. Active viral RNA replication appeared to be present in a significant
proportion of these cases. Minus-strand coxsackieviral RNA in the myocardium can 
be a marker for poor clinical outcome after PLV. There was no evidence of
persistent infection by other viruses in hearts with DCM.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11092665 [PubMed - indexed for MEDLINE]

2964: Microbios. 2000;103(405):127-32.

Comparison of several ELISA tests for detecting the presence of IgG and IgM
against herpes simplex viruses.

Gutierrez J, Fernandez F, Vergara MJ, Suarez S, Soto MJ, Maroto MC.

Department of Microbiology, School of Medicine, University of Granada, Spain.

Four enzyme-linked immunosorbent assays designated test 1 (ETI-HSVK-G 1/2); test 
2 (ETI-HSVK-M 1/2); test 3 (ETI-HSVK-G 2), and test 4 (BioElisa HSV2 IgG) were
studied to evaluate different stages of herpes simplex virus (HSV) infection.
Samples (50 sera and 14 cerebrospinal fluid) were included in four groups. Group 
1 consisted of samples from patients with primary HSV infections; group 2
comprised samples from patients with recurrent HSV infections; group 3 were
samples nonreactive to HSV; and group 4 were samples from patients with
infections by other herpes viruses (4a, chickenpox; 4b, herpes zoster; and 4c,
infectious mononucleosis by Epstein-Barr virus). The percentages of agreement
between tests 1 and 2 were 100 and 72.1%, respectively. The total diagnostic
values of tests 1 and 2 were: 100 and 50% sensitivity, respectively; and 100 and 
89% specificity, respectively. Few positive results for HSV-2 infection were
found, and so, tests 3 and 4 were not evaluated. The results of tests 3 and 4 for
a chickenpox patient, and a herpes zoster patient were not in agreement.

Publication Types: 
    Comparative Study
    Evaluation Studies

PMID: 11092194 [PubMed - indexed for MEDLINE]

2965: J Virol. 2000 Dec;74(24):11893-8.

Varicella-zoster virus gene expression in latently infected and explanted human
ganglia.

Kennedy PG, Grinfeld E, Bell JE.

Glasgow University Department of Neurology, Southern General Hospital, Glasgow,
United Kingdom. P.G.Kennedy@clinmed.gla.ac.uk

A consistent feature of varicella-zoster virus (VZV) latency is the restricted
pattern of viral gene expression in human ganglionic tissues. To understand
further the significance of this gene restriction, we used in situ hybridization 
(ISH) to detect the frequency of RNA expression for nine VZV genes in trigeminal 
ganglia (TG) from 35 human subjects, including 18 who were human immunodeficiency
virus (HIV) positive. RNA for VZV gene 21 was detected in 7 of 11 normal and 6 of
10 HIV-positive subjects, RNA for gene 29 was detected in 5 of 14 normal and 11
of 11 HIV-positive subjects, RNA for gene 62 was detected in 4 of 10 normal and 6
of 9 HIV-positive subjects, and RNA for gene 63 was detected in 8 of 17 normal
and 12 of 15 HIV-positive subjects. RNA for VZV gene 4 was detected in 2 of 13
normal and 4 of 9 HIV-positive subjects, and RNA for gene 18 was detected in 4 of
15 normal and 5 of 15 HIV-positive subjects. By contrast, RNAs for VZV genes 28, 
40, and 61 were rarely or never detected. In addition, immunocytochemical
analysis detected the presence of VZV gene 63-encoded protein in five normal and 
four HIV-positive subjects. VZV RNA was also analyzed in explanted fresh human TG
and dorsal root ganglia from five normal human subjects over a period of up to 11
days in culture. We found a very different pattern of gene expression in these
explants, with transcripts for VZV genes 18, 28, 29, 40, and 63 all frequently
detected, presumably as a result of viral reactivation. Taken together, these
data provide further support for the notion of significant and restricted viral
gene expression in VZV latency.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11090189 [PubMed - indexed for MEDLINE]

2966: J Virol. 2000 Dec;74(24):11464-71.

Analysis of individual human trigeminal ganglia for latent herpes simplex virus
type 1 and varicella-zoster virus nucleic acids using real-time PCR.

Cohrs RJ, Randall J, Smith J, Gilden DH, Dabrowski C, van Der Keyl H, Tal-Singer 
R.

Departments of Neurology, University of Colorado Health Sciences Center, Denver, 
Colorado 80262, USA.

Herpes simplex virus type 1 (HSV-1) and varicella-zoster virus (VZV) establish
latent infections in the peripheral nervous system following primary infection.
During latency both virus genomes exhibit limited transcription, with the HSV-1
LATs and at least four VZV transcripts consistently detected in latently infected
human ganglia. In this study we used real-time PCR quantitation to determine the 
viral DNA copy number in individual trigeminal ganglia (TG) from 17 subjects. The
number of HSV-1 genomes was not significantly different between the left and
right TG from the same individual and varied per subject from 42.9 to 677.9
copies per 100 ng of DNA. The number of VZV genomes was also not significantly
different between left and right TG from the same individual and varied per
subject from 37.0 to 3,560.5 copies per 100 ng of DNA. HSV-1 LAT transcripts were
consistently detected in ganglia containing latent HSV-1 and varied in relative
expression by >500-fold. Of the three VZV transcripts analyzed, only transcripts 
mapping to gene 63 were consistently detected in latently infected ganglia and
varied in relative expression by >2,000-fold. Thus, it appears that, similar to
LAT transcription in HSV-1 latently infected ganglia, VZV gene 63 transcription
is a hallmark of VZV latency.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 11090142 [PubMed - indexed for MEDLINE]

2967: Med Pregl. 2000 May-Jun;53(5-6):309-12.

[Otogenic herpes zoster--the Ramsay-Hunt syndrome]

[Article in Croatian]

Dankuc D, Milosevic D, Komazec Z.

Klinika za bolesti uva, grla i nosa, Klinicki centar, Novi Sad.

INTRODUCTION: Herpes zoster is a viral disease caused by a specific neurotropic
virus-varicella zoster, similar to varicella virus, but not identical. Herpes
zoster oticus was described by Letulle in 1882 and Korner in 1884, but
particularly studied by Ramsay Hunt who reported it as a herpetic disease of
ganglion geniculi in 1907. Herpes zoster oticus associated with facial nerve
paralysis is most commonly called the Ramsay-Hunt syndrome. MATERIAL AND METHODS:
In this work, cases of herpes zoster oticus associated with facial nerve
paralysis are shown. At the ORL Clinic in Novi Sad, in the period from 1996-1997,
5 cases with Ramsay-Hunt syndrome were treated. The diagnostic procedure involved
analysis of anamnestic data, clinical examination, complete cochleovestibular
investigation with electronystagmography (ENG), topodiagnostic investigation of
facial nerve (Schirmer's test, stapedial reflex, electrogustometry),
electromyographic investigation (EMG), laboratory and virusologic investigations.
According to many statistical data, paralysis of facial nerve due to herpes
zoster is after Bell's paralysis the most common cause of the disease. The
efflorescence of auricula, face and neck, which are typical manifestations of the
disease, may precede facial nerve paralysis for about a week or more, and
therefore may be disregarded and misdiagnosed with Bell's paralysis. The
peripheral paralysis of this nerve in herpes zoster has an unfavorable course.
More than 75% of patients have consequences of paralysis (paresis, hemispasm,
synkinesia etc.). Regarding the unfavorable recovery period in herpes zoster, we 
managed our patients accordingly. CONCLUSION: Herpes zoster oticus is a common
cause of peripheral facial nerve paralysis. The clinical course is not as
favorable as in Bell's paralysis. It may be associated with sensorineural hearing
disorder, vertigo and paralysis of other cranial nerves. The therapeutic
procedures in Ramsay-Hunt syndrome include administration of conservative therapy
and surgical intervention. We performed surgery in 2 and conservative therapy in 
3 patients. Facial nerve decompression is indicated in persistent paralyses, or
in cases without clear clinical signs of recovery after 6 weeks-2 months from the
onset of the disease. The site of decompression is determined by topodiagnostic
investigations.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11089377 [PubMed - indexed for MEDLINE]

2968: N Engl J Med. 2000 Nov 23;343(21):1563-5.

Comment on:
    N Engl J Med. 2000 Nov 23;343(21):1514-9.

A new treatment for postherpetic neuralgia.

Watson CP.

Publication Types: 
    Comment
    Editorial

PMID: 11087888 [PubMed - indexed for MEDLINE]

2969: N Engl J Med. 2000 Nov 23;343(21):1514-9.

Comment in:
    N Engl J Med. 2000 Nov 23;343(21):1563-5.    N Engl J Med. 2001 Mar 29;344(13):1019-20; author reply 1021-2.    N Engl J Med. 2001 Mar 29;344(13):1019; author reply 1021-2.    N Engl J Med. 2001 Mar 29;344(13):1020-1; author reply 1021-2.    N Engl J Med. 2001 Mar 29;344(13):1020; author reply 1021-2.    N Engl J Med. 2001 Mar 29;344(13):1020; author reply 1021-2.    N Engl J Med. 2001 Mar 29;344(13):1021; author reply 1021-2.

Intrathecal methylprednisolone for intractable postherpetic neuralgia.

Kotani N, Kushikata T, Hashimoto H, Kimura F, Muraoka M, Yodono M, Asai M,
Matsuki A.

Department of Anesthesiology, University of Hirosaki School of Medicine, Japan.

BACKGROUND: There is no effective treatment for intractable postherpetic
neuralgia. Because there is evidence that postherpetic neuralgia has an
inflammatory component, we assessed treatment with intrathecally administered
methylprednisolone to reduce pain in patients with this disorder. METHODS: We
enrolled 277 patients who had had intractable postherpetic neuralgia for at least
one year, 270 of whom were followed for two years. The patients were randomly
assigned to receive intrathecal methylprednisolone and lidocaine (3 ml of 3
percent lidocaine with 60 mg of methylprednisolone acetate, 89 patients),
lidocaine alone (3 ml of 3 percent lidocaine, 91 patients), or no treatment (90
patients) once per week for up to four weeks. Each weekly dose was injected into 
the lumbar intrathecal space. Pain was evaluated before randomization, at the end
of the treatment period, and then four weeks, one year, and two years later.
Samples of cerebrospinal fluid were obtained for measurement of interleukin-8
before and at the end of the treatment period. RESULTS: There was minimal change 
in the degree of pain in the lidocaine-only and control groups during and after
the treatment period. In the methylprednisolone-lidocaine group, the intensity
and area of pain decreased, and the use of the nonsteroidal antiinflammatory drug
diclofenac declined by more than 70 percent four weeks after the end of
treatment. No complications related to intrathecal methylprednisolone were
observed. Before treatment, the concentrations of interleukin-8 in the
cerebrospinal fluid were inversely related to the duration of neuralgia in all
the patients (r=-0.49, P<0.001). In the patients who received methylprednisolone,
interleukin-8 concentrations decreased by 50 percent, and this decrease
correlated with the duration of neuralgia and with the extent of global pain
relief (P<0.001 for both comparisons). CONCLUSIONS: The results of this trial
indicate that the intrathecal administration of methylprednisolone is an
effective treatment for postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 11087880 [PubMed - indexed for MEDLINE]

2970: Indian Pediatr. 2000 Nov;37(11):1239-41.

Oral acyclovir in varicella zoster virus infections in children with acute
lymphoblastic leukemia.

Jain Y, Lodha R, Tomar S, Arya LS, Kabra SK.

Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, 
New Delhi 110 029, India.

PMID: 11086306 [PubMed - indexed for MEDLINE]

2971: Neurochirurgie. 2000 Nov;46(5):483-91.

[Treatment of central and neuropathic facial pain by chronic stimulation of the
motor cortex: value of neuronavigation guidance systems for the localization of
the motor cortex]

[Article in French]

Nguyen JP, Lefaucheur JP, Le Guerinel C, Fontaine D, Nakano N, Sakka L, Eizenbaum
JF, Pollin B, Keravel Y.

Departement de Neurosciences, Service des Explorations Fonctionnelles, CHU
Henri-Mondor, 94010 Creteil, France.

Thirty two patients with refractory central and neuropathic pain of peripheral
origin were treated by chronic stimulation of the motor cortex between May 1993
and January 1997. The mean follow-up was 27. 3 months. The first 24 patients were
operated according to the technique described by Tsubokawa. The last 13 cases (8 
new patients and 5 reinterventions) were operated by a technique including
localization by superficial CT reconstruction of the central region and
neuronavigator guidance. The position of the central sulcus was confirmed by the 
use of intraoperative somatosensory evoked potentials. The somatotopic
organisation of the motor cortex was established peroperatively by studying the
motor responses at stimulation of the motor cortex through the dura. Ten of the
13 patients with central pain (77%) and nine of the 12 patients with neuropathic 
facial pain had experienced substantial pain relief (75%). One of the 3 patients 
with post-paraplegia pain was clearly improved. A satisfactory result was
obtained in one patient with pain related to plexus avulsion and in one patient
with pain related to intercostal herpes zoster. None of the patients developed
epileptic seizures. The position of the stimulating poles effective on pain
corresponded to the somatotopic representation of the motor cortex. The
neuronavigator localization and guidance technique proved to be most useful
identifying the appropriate portion of the motor gyrus. It also allowed the
establishment of reliable correlations between electrophysiological-clinical and 
anatomical data which may be used to improve the clinical results and possibly to
extend the indications of this technique.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 11084480 [PubMed - indexed for MEDLINE]

2972: Neurochirurgie. 2000 Nov;46(5):429-46.

[Surgery in the dorsal root entry zone for treatment of chronic pain]

[Article in French]

Mertens P, Sindou M.

Service de Neurochirurgie A, Hopital Neurologique et Neurochirurgical P.
Wertheimer, Universite de Lyon, 59, boulevard Pinel, 69003 Lyon.

Microsurgical drezotomy (MDT) consists of an incision and bipolar coagulations
performed ventro-laterally in the Dorsal Root Entry Zone (DREZ) at the entrance
of the rootlets into the dorso-lateral sulcus. The lesion is directed at 35
ventro-medially, and to 2-3 mm deep according to the pre-operative neurological
status and the desired effects. MDT i) interrupts the small (nociceptive) fibres 
regrouped laterally and the large (myotatic) afferents which runs centrally,
whilst sparing part of the large medial (lemniscal) fibres, ii) destroys the
(excitatory) medial part of the Lissauer's tract, iii) and the cells of the
dorsalmost layers of the dorsal horn, which can be the site of hyperactivity, as 
we were able to record in patients with deafferentation pain. Best indications
are: i) well-localized cancer pain, such as Pancoast syndrome; ii) neuropathic
pain due to: brachial plexus injuries; cauda equina and/or spinal cord lesions
(especially for pain corresponding to segmental lesions); peripheral nerve
injuries, amputation, herpes zoster - especially when the predominant component
of pain is of the paroxysmal type and/or corresponds to provoked
hyperalgesia/allodynia); iii) excess of spasticity, especially when associated
with severe pain.

Publication Types: 
    English Abstract
    Review

PMID: 11084476 [PubMed - indexed for MEDLINE]

2973: Med J Malaysia. 2000 Mar;55(1):14-20.

Outcome of 85 lupus nephritis patients treated with intravenous cyclophosphamide:
a single centre 10 year experience.

Chan AY, Hooi LS.

Department of Medicine and Haemodialysis Unit, Hospital Sultanah Aminah, Johor
Bahru.

Retrospective analysis was done on 85 patients (76 female, 9 male) with lupus
nephritis who started intravenous cyclophosphamide between 1/1/1989 and
31/12/1998. The initial renal biopsy (World Health Organisation) classification
was III (4.7%), IV (89.4%) and V (5.9%). Average serum creatinine at time of
biopsy was 0.12 +/- 0.12 mmol/l. Median duration of nephritis before biopsy was 2
months (range 0-133). Median duration of follow-up from time of biopsy to outcome
(death or end-stage renal failure) was 3.3 years (range 0.3-11.8). Nineteen
patients died. The calculated proportion alive at 5 years was 75% and at 10 years
64%. The calculated proportion alive with renal function was 74% and 54% at 5 and
10 years respectively. Fifty-two patients completed cyclophosphamide therapy at
the end of the study. There were ten episodes of herpes zoster, the most common
infection seen. No malignancy was reported.

Publication Types: 
    Clinical Trial

PMID: 11072485 [PubMed - indexed for MEDLINE]

2974: Br J Dermatol. 2000 Oct;143(4):795-8.

Comment in:
    Br J Dermatol. 2001 May;144(5):1090.

Epidemiological study of human herpesvirus-6 and human herpesvirus-7 in
pityriasis rosea.

Kosuge H, Tanaka-Taya K, Miyoshi H, Amo K, Harada R, Ebihara T, Kawahara Y,
Yamanishi K, Nishikawa T.

Department of Dermatology, Tokyo Electric Power Hospital, 9-2 Shinanomachi,
Shinjuku-ku, Tokyo 160-0016, Japan. haruhiko.kosuge@psl.ap-hop-paris.fr

BACKGROUND: Pityriasis rosea (PR) is a common papulosquamous skin disorder that
is suspected to have an infectious aetiology. OBJECTIVES: We aimed to study the
role of human herpesvirus (HHV)-7 and HHV-6 in the pathogenesis of PR. METHODS:
We performed seroepidemiological studies (indirect immunofluorescence test) and
polymerase chain reaction (PCR) analysis for HHV-6 and HHV-7 in patients with PR.
Seventy-two serum samples and 37 samples of peripheral blood mononuclear cells
(PBMC) from 44 patients with PR were obtained. Twenty-five patients with other
skin disorders such as drug eruption, urticaria or herpes zoster were studied as 
controls in the PCR analysis. RESULTS: HHV-7 DNA was detected in 13 of 30 (43%)
samples of PBMC of the patients with PR and 14 of 25 (56%) samples of PBMC of
controls. HHV-6 DNA was detected in six of 29 (21%) patients with PR and nine of 
23 (39%) controls. Thus there was no difference in the prevalence of HHV-6 or
HHV-7 in PBMC between patients with PR and those with other skin disorders. In
the seroepidemiological study, two cases of at least a fourfold rise in titre and
five cases of a fourfold decrease in titre to HHV-7 antibody, and two cases of a 
fourfold rise in titre and two cases of a fourfold decrease in titre to HHV-6
antibody, were observed in 24 patients with PR. This seroepidemiological study
revealed antibody responses consistent with active infection in several PR
patients, but the greater proportion of the patients had no definite increase in 
the antibody titres. CONCLUSIONS: We conclude that HHV-7 and HHV-6 may play a
part in some patients with PR, but that other causative agents may exist. Further
analyses are needed to determine the causative agents of PR.

Publication Types: 
    Multicenter Study

PMID: 11069458 [PubMed - indexed for MEDLINE]

2975: Pediatr Neurol. 2000 Oct;23(4):345-8.

Acute hemiplegia associated with herpes zoster infection in children: report of
one case.

Hung PY, Lee WT, Shen YZ.

Department of Pediatrics; National Taiwan University Hospital;, Taipei, Taiwan.

Herpes zoster infection has been rarely reported to cause angiitis of the central
nervous system in children. We describe a 4-year, 8-month-old female with acute
hemiplegia and central facial palsy 6 weeks after she had had zoster
ophthalmicus. The findings of magnetic resonance angiography, the clinical
picture, and a preceding history of herpes zoster ophthalmicus suggested zoster
vasculitis. Herpes zoster vasculitis is thus another consideration when examining
a child with acute hemiplegia and a recent herpes zoster infection.

Publication Types: 
    Case Reports
    Review

PMID: 11068169 [PubMed - indexed for MEDLINE]

2976: Pharmacoeconomics. 2000 Aug;18(2):95-104.

Antiviral therapies for herpes zoster infections. Are they economically
justifiable?

Smith KJ, Roberts MS.

Mercy Hospital of Pittsburgh, Pennsylvania, USA. ksmith@mercy.pmhs.org

Antiviral treatment of herpes zoster is controversial because of uncertain
benefits and relatively high costs. Most studies show that antiviral therapy
lessens acute herpes zoster symptoms and postherpetic neuralgia (PHN). Current
clinical recommendations support antiviral treatment of severely symptomatic
herpes zoster in all adults, and mild herpes zoster in those 50 or 60 years of
age or older. However, it is unclear if these recommended strategies are cost
effective. Published studies of herpes zoster costs and the effect of antiviral
therapy on costs and quality of life have significant variation in study design
and results, as well as many shortcomings in the data. Thus, definitive economic 
recommendations cannot be made based on the present data. Another approach, which
we have used, is to develop a 'reference case' analysis using decision-analysis
techniques and the available data to estimate the incremental cost effectiveness 
of antiviral treatment in patients of differing age and herpes zoster severity.
In the baseline analysis, parameter values and assumptions were consistently
slightly biased against antiviral use. Effectiveness was measured in
quality-adjusted life years (QALYs). We assumed that antiviral treatment did not 
change PHN risk, but decreased PHN duration in patients older than 50 years. PHN 
risk increased with age and with acute herpes zoster severity as seen in
published data. Mild acute herpes zoster was assumed to have a utility value of
0.9 and severe acute herpes zoster a value of 0.7 on a scale where 0 = death and 
1 = perfect health. Treating mildly symptomatic acute herpes zoster cost
$US89,200/QALY gained in 40-year-olds, $US47,700/QALY in 60-year-olds and
$US40,700/QALY in 70-year-olds (1995 values). Results were most sensitive to
variation of antiviral costs (baseline $US134), but changes in acute symptom
relief, PHN risk, duration, costs and utility, and antiviral effect on PHN
duration increased costs/QALY above $US50,000 in 60- and 70-year-olds in extremes
of parameter ranges. However, no variation resulted in treatment of mild illness 
in 40-year-olds to fall below $US50,000/QALY gained. Treatment of severe acute
herpes zoster cost $US29,700, $US18,000 and $US16,500/QALY gained in 40-, 60- and
70-year-olds, respectively. Results were sensitive to variation of antiviral
costs (> $US225) and acute symptom relief (< 21%) in 40-year-olds. Based on this 
analysis, antiviral therapy of herpes zoster seems economically justifiable for
mildly symptomatic acute herpes zoster in patients aged 50 years and older, and
for severely symptomatic acute herpes zoster in all adults.

Publication Types: 
    Review

PMID: 11067653 [PubMed - indexed for MEDLINE]

2977: Br J Anaesth. 2000 Oct;85(4):632-4.

Comment in:
    Br J Anaesth. 2001 Jun;86(6):899-900.

Complete recovery of consciousness in a patient with decorticate rigidity
following cardiac arrest after thoracic epidural injection.

Taga K, Tomita M, Watanabe I, Sato K, Awamori K, Fujihara H, Shimoji K.

Department of Anaesthesiology, Niigata University School of Medicine, Japan.

A 46-yr-old man with dysaesthesia (burning sensation) following herpes zoster in 
the left upper chest region was treated with a single thoracic (T2/T3) epidural
injection (1.0% lidocaine 3 ml + 0.125% bupivacaine 3 ml) as an outpatient.
Twenty minutes after the injection, a nurse noticed the patient to be unconscious
with dilated pupils, apnoea and cardiac arrest. Following immediate
cardiopulmonary resuscitation, the patient was treated with an i.v. infusion of
thiamylal sodium 2-4 mg kg-1 h-1 and his lungs were mechanically ventilated. When
the patient developed a characteristic decorticate posture, mild hypothermia
(oesophageal temperature, 33-34 degrees C) was induced. On the 17th day of this
treatment, after rewarming (35.5 degrees C) and discontinuation of the
barbiturate, the patient responded to command. Weaning from the ventilator was
successful on the 18th day. About 4 months after the incident, the patient was
discharged with no apparent mental or motor disturbances. We suggest that mild
hypothermia with barbiturate therapy may have contributed to the successful
outcome in this case.

Publication Types: 
    Case Reports

PMID: 11064628 [PubMed - indexed for MEDLINE]

2978: J Virol Methods. 2000 Nov;90(2):205-12.

Rapid diagnosis and quantification of herpes simplex virus with a green
fluorescent protein reporter system.

Kung SH, Wang YC, Lin CH, Kuo RL, Liu WT.

Faculty of Medical Technology, Institute of Biotechnology in Medicine, National
Yang-Ming University, Shih-Pai, 112, Taipei, Taiwan, ROC.

A genetically modified cell line (Vero-ICP10-EGFP) was constructed for detection 
of herpes simplex virus (HSV) by a simple, rapid and direct method. The cell line
was developed by stable transfection of Vero cell with a plasmid encoding the
green fluorescent protein (GFP) driven by the promoter of the HSV-2 ICP10 gene.
As early as 6 h after infection with HSV, fluorescence-emitting cells can be
observed under a fluorescence microscope. A single infected cell emitting
fluorescence can be observed with soft agar overlay by inverted fluorescence
microscopy. No induction of detectable fluorescence was seen following infections
with human cytomegalovirus (HCMV), varicella zoster virus (VZV), coxsackievirus
A16 and enterovirus 71. Analysis by flow cytometry also demonstrated that
intensity of the triggered fluorescence is proportional to the titer of HSV
inoculated. Taken together, this novel GFP reporter system could become a useful 
means for rapid detection and quantification of HSV in clinical specimens.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11064120 [PubMed - indexed for MEDLINE]

2979: Orthop Nurs. 2000 Jan-Feb;19(1):59-62.

Shingles update: common questions in caring for a patient with shingles.

Madison LK.

Cleveland Clinic Foundation, Ohio, USA.

Varicella zoster virus (VZV) is a herpes virus that can cause two distinct
clinical diseases, chickenpox and shingles. Primary infection of varicella, often
called chickenpox, results in a generalized eruption of a vesicular exanthematous
rash which is usually seen in children and is highly contagious. This virus (VZV)
can then become latent and later reactivate causing herpes zoster, commonly known
as shingles. Shingles is usually a localized phenomenon often seen in adults and 
is usually less contagious. The following is a discussion of infection control
questions most commonly asked regarding the care of a patient with shingles.

Publication Types: 
    Review

PMID: 11062626 [PubMed - indexed for MEDLINE]

2980: Expert Opin Investig Drugs. 2000 Aug;9(8):1743-51.

Novel agents for the therapy of varicella-zoster virus infections.

Snoeck R, Andrei G, De Clercq E.

Rega Institute for Medical Research, K.U.Leuven, Minderbroedersstraat 10, B-3000 
Leuven, Belgium. robert.snoeck@rega.kuleuven.ac.be

Varicella-zoster virus (VZV), a member of the herpesvirus family, is responsible 
for both primary (varicella or chickenpox) as well as recurrent (zoster or
shingles) infections. Acyclovir has been the mainstay for treating VZV infections
in both immunocompetent and immunocompromised patients. Recently, newer anti-VZV 
drugs, i.e., valaciclovir (the oral prodrug form of acyclovir) and famciclovir
(the oral prodrug form of penciclovir) have been developed and have enlarged the 
therapeutic options to treat VZV infections. Both acyclovir and penciclovir are
dependent on the virus-encoded thymidine kinase (TK) for their intracellular
activation. Although emergence of drug-resistant strains does not occur in
immunocompetent patients, several reports have documented the isolation of
drug-resistant VZV strains following long-term acyclovir therapy in
immunocompromised patients. Mutations at the level of the TK are responsible for 
development of resistance to drugs that depend on the viral TK for their
phosphorylation (i.e., acyclovir and penciclovir). Foscarnet, a direct inhibitor 
of the viral DNA polymerase, which does not require activation by the viral TK,
is the drug of choice for the treatment of TK-deficient VZV mutants emerging
under acyclovir therapy. Recently, emergence of foscarnet-resistant strains has
also been reported. Both TK-deficient strains and foscarnet-resistant mutants are
sensitive to the acyclic nucleoside phosphonate cidofovir, CDV, HPMPC,
(S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine. This agent does not depend
on the virus-encoded TK, but on cellular enzymes for its conversion to the
diphosphoryl derivative, which then inhibits the viral DNA polymerase.

Publication Types: 
    Review

PMID: 11060773 [PubMed - indexed for MEDLINE]

2981: Curr Rev Pain. 2000;4(6):429-36.

The cancer patient with chronic pain due to herpes zoster.

Modi S, Pereira J, Mackey JR.

Cross Cancer Institute, 11560 University Avenue, Edmonton, Alberta T6G 1Z2,
Canada. shanumod@cancerboard.ab.ca

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster,
and as such has been an area of extensive medical research for the past three
decades. The patients at highest risk for PHN include those older than 50 years, 
those with severe acute cases of zoster, and those with shingles in a trigeminal 
distribution. As persons with malignancy are at a high risk for developing zoster
itself, PHN is a complication that will be faced by many of these patients and
their caregivers. This article reviews the available treatments and preventative 
measures for this debilitating condition.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 11060588 [PubMed - indexed for MEDLINE]

2982: Biol Reprod. 2000 Nov;63(5):1396-402.

Selection of peptides targeting the human sperm surface using random peptide
phage display identify ligands homologous to ZP3.

Eidne KA, Henery CC, Aitken RJ.

Western Australian Institute for Medical Research & Keogh Institute for Medical
Research, QEII Medical Centre, Nedlands, Perth 6009, Australia.
keidne@waimr.uwa.edu.au

Analysis of the surface architecture of human spermatozoa is a necessary step in 
the development of new approaches to contraception and resolving the causes of
human infertility. In this study we have utilized phage display technology to
identify peptides that bind with high affinity to the surface of human
spermatozoa. Fifteen- and twelve-mer random peptide phage display libraries were 
screened against paraformaldehyde-fixed spermatozoa and a number of sperm-binding
peptides were identified. One peptide, M6, displayed a high level of affinity for
the sperm surface and showed sequence homology with a dominant human ZP3 epitope 
(hZP 25-33). This peptide bound preferentially to the equatorial and post
acrosomal domains of the sperm head and exhibited contraceptive activity by
virtue of its capacity to impair the fusion of acrosome-reacted spermatozoa with 
the vitelline membrane of the oocyte. A similar form of contraceptive activity
was also observed within an unrelated peptide, K6, derived from screening the
12-mer library. These results indicate that phage display technology is a
powerful tool for developing reagents capable of targeting the human sperm
surface, providing insights into the composition of this structure and the
identity of targets susceptible to contraceptive attack and pathological
disruption.

Publication Types: 
    In Vitro

PMID: 11058544 [PubMed - indexed for MEDLINE]

2983: Jpn J Infect Dis. 2000 Aug;53(4):156-61.

Jackfruit lectin: properties of mitogenicity and the inhibition of herpesvirus
infection.

Wetprasit N, Threesangsri W, Klamklai N, Chulavatnatol M.

Department of Biotechnology, Faculty of Science, Ramkhamhaeng University, Bangkok
10240, Thailand. nuanwee@yahoo.com

Jackfruit lectin (JFL) from Artocarpus heterophyllus has been found to exhibit
inhibitory activity in vitro with a cytopathic effect towards herpes simplex
virus type 2 (HSV-2), varicella-zoster virus (VZV), and cytomegalovirus (CMV).
The 50% inhibitory dose values from plaque reduction assay (inactivation) were
2.5, 5, and 10 Eg/ml of JFL for HSV-2, VZV, and CMV, respectively. Lymphocyte
proliferation was significantly increased in the presence of the JFL in the
concentration range of 2.5 to 50 Eg/ml, but was reduced at 500 Eg/ml. It was
found that CD16(+)/CD56(+) cells (natural killer cells) were induced among the
primary lymphocyte subpopulations. The activity of natural killer (NK) cells was 
not affected by JFL in the concentration range of 5 to 500 Eg/ml. These data
suggest that JFL is mitogenic for NK lymphocyte (CD16(+)/CD56(+)) and also active
against HSV-2, VZV, and CMV.

PMID: 11056557 [PubMed - indexed for MEDLINE]

2984: J Med Virol. 2000 Nov;62(3):349-53.

Simultaneous detection of 6 human herpesviruses in cerebrospinal fluid and
aqueous fluid by a single PCR using stair primers.

Bouquillon C, Dewilde A, Andreoletti L, Lambert V, Chieux V, Gerard Y, Lion G,
Bocket L, Wattre P.

Laboratoire de Virologie, CHU de Lille, France.

A Herpes Consensus allows the simultaneous detection of 6 human herpesviruses:
herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), human cytomegalovirus
(HCMV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), and human herpes 
virus 6 (HHV-6). This technique was used first to examine retrospectively 100 DNA
extracts from 95 CSF and 5 aqueous fluids, prepared by treatment by saturated
NaCl followed by ethanol precipitation (n = 63) or by simple boiling (n = 37) and
stored at -80 degrees C, and secondly to test prospectively 38 CSF samples for
which two DNA extracts were prepared with commercially available DNA extraction
kits. In all cases, the results were compared with those of an "in-house" PCR.
Concordant results between both PCR and the Herpes Consensus techniques were
obtained in 61 of 63 DNA extracts prepared by treatment by saturated NaCl (97%)
and in only 31 of 37 boiled samples (84%). Both commercially available methods of
DNA extraction examined appear to be suitable for Herpes Consensus PCR, although 
they cannot remove completely PCR inhibitors that must be sought in case of
negative results. This preliminary study shows that the Herpes Consensus method
should be of value for rapid diagnosis of herpesvirus infections on condition
that it is performed on purified DNA extracts.

Publication Types: 
    Comparative Study

PMID: 11055245 [PubMed - indexed for MEDLINE]

2985: AIDS Patient Care STDS. 2000 Oct;14(10):527-8.

Herpes zoster in an HIV-negative man on ritonavir.

Miller KD, Piscitelli SC, Davey RT Jr.

Publication Types: 
    Case Reports
    Letter

PMID: 11054935 [PubMed - indexed for MEDLINE]

2986: Ophthalmology. 2000 Nov;107(11):2083-90;discussion 2090-1.

Primary graft failure : a clinicopathologic and molecular analysis.

Cockerham GC, Bijwaard K, Sheng ZM, Hidayat AA, Font RL, McLean IW.

Ophthalmology Service, Andrews Air Force Base, Camp Springs, Maryland, USA.

OBJECTIVE: Primary graft failure (PGF) corneal tissues were analyzed for herpes
simplex virus (HSV) and varicella-zoster virus (VZV). DESIGN: Retrospective,
noncomparative case series. MATERIALS: Formalin-fixed, paraffin-embedded tissue
of 21 donor corneas and 14 recipient corneas of PGF cases, as well as 10 control 
corneas. METHODS: Clinical, histologic, immunohistochemical, polymerase chain
reaction (PCR), and, in selected cases, transmission electron microscopic
characteristics were studied. MAIN OUTCOME MEASURES: Evidence of HSV or VZV in
donor tissues. RESULTS: Median patient age was 65 years, and median donor age was
48 years. Donor cornea parameters, including endothelial cell counts,
death-to-preservation time, and time in storage, were generally within accepted
standards. Stromal edema was found in all 21 donor corneas with PGF. Eighteen
donor corneas demonstrated severely reduced or absent endothelium and mild to
moderate lymphocytic infiltration without necrosis. Three donor corneas (14%) had
necrotizing stromal keratitis (NSK) with keratic precipitates. Positive
immunohistochemical staining of keratocytes for HSV was present in two of two
donor corneas with NSK and was negative in 18 other donor corneas. Polymerase
chain reaction analysis revealed the DNA of HSV type 1 (HSV1) in all donor
corneas with NSK and in four donor corneas without NSK (33%). Recipient corneal
tissue was negative for HSV1 DNA in three patients with NSK and positive in two
of the four other PCR-positive patients. Transmission electron microscopy
analysis showed viral particles in two donor corneas with NSK. Polymerase chain
reaction analysis revealed no evidence of HSV type 2 or VZV in any cornea. All
control corneas were negative for viral DNA. Sixteen corneas remained clear and
two had failed after regraft for PGF, with a median follow-up of 3.6 years.
CONCLUSIONS: Herpes simplex virus type 1 DNA was present in 33% of patients of
PGF. Herpetic stromal keratitis was found in some failed corneas; the lack of HSV
in the paired recipient suggests importation within the donor cornea. The overall
prognosis for regrafting after PGF is good.

PMID: 11054337 [PubMed - indexed for MEDLINE]

2987: Rev Neurol. 2000 Sep 16-30;31(6):515-21.

Comment in:
    Rev Neurol. 2001 Apr 1-15;32(7):700.

[Neurological complications of patients with lymphomas]

[Article in Spanish]

Gomez-Viera N, Monteagudo-Torres M, de Castro-Arenas R, Ruiz-Garcia D.

Servicio de Neurologia, Hospital Clinico Quirurgico Hermanos Ameijeiras, San
Lazaro, La Habana, Cuba. vdc@hha.sld.cu

INTRODUCTION: The lymphomas are neoplasias which may affect the nervous system at
any stage of development, and affect the quality of life and survival time of
these patients. OBJECTIVES: To identify the neurological complications of
patients with lymphomas, determine the survival time and the cause of death in
these patients. PATIENTS AND METHODS: We made a prospective study in 270 patients
with the diagnosis of lymphoma who were admitted to the Hospital Clinico Hermanos
Ameijeiras Ciudad de la Habana (Cuba). The complications were classified as
direct or indirect, the average survival time was determined according to the
Kaplan-Meier curve and the cause of death was established with
anatomopathological confirmation. RESULTS: We found 26 patients to have
neurological complications. Of 188 patients with non-Hodgkin lymphomas, 12.2% had
neurological disorders and in these patients leptomeningeal infiltration was the 
main neurological complication. In the 82 patients with Hodgkin's disease, 3.6%
had neurological disorders of which herpes zoster infection was the commonest.
The average survival time following diagnosis and the neurological features was
9.7 months. The neurological complication was the cause of death in 57.1% of
those who died. CONCLUSIONS: The patients with lymphomas had direct and indirect 
complications, with an average survival time of less than one year, and most died
of a nervous system complication.

Publication Types: 
    English Abstract

PMID: 11055052 [PubMed - indexed for MEDLINE]

2988: Br J Haematol. 2000 Sep;110(4):874-5.

Sight-threatening varicella zoster virus infection after fludarabine treatment.

Chee YL, Culligan DJ, Olson JA, Molyneaux P, Kurtz JB, Watson HG.

Department of Haematology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK. 
y.chee@abdn.ac.uk

Varicella zoster virus (VZV) infection involving the posterior segment of the eye
after fludarabine treatment has not previously been described. Two patients, who 
had completed fludarabine treatment 3 and 18 months previously, presented with
visual loss that had been preceded by a recent history of cutaneous zoster. The
use of the polymerase chain reaction (PCR) for VZV DNA from ocular specimens
allowed rapid confirmation of clinical diagnosis and treatment with a good
outcome in one patient. With the increasing use of fludarabine and other purine
analogues, an awareness of such complications is important because of their
potentially sight-threatening consequences.

Publication Types: 
    Case Reports

PMID: 11054072 [PubMed - indexed for MEDLINE]

2989: J Dermatol. 2000 Sep;27(9):621-2.

Lichen simplex chronicus after herpes zoster.

Akyol M, Polat M, Ozcek S, Marufihah M.

Publication Types: 
    Case Reports
    Letter

PMID: 11052242 [PubMed - indexed for MEDLINE]

2990: Semin Neurol. 2000;20(3):277-92.

Viral meningitis.

Rotbart HA.

Department of Pediatrics, University of Colorado Health Sciences Center, Denver
80262, USA.

Enteroviruses account for 85 to 95% of all cases of aseptic meningitis, but the
arboviruses and herpes simplex virus are also important etiologic agents. Mumps, 
lymphocytic choriomeningitis virus, herpes zoster, human herpesvirus type 6, and 
influenza viruses are rare causes of meningitis. The virology, pathogenesis,
epidemiology, clinical manifestations, diagnostic studies, and established and
potential antiviral therapies for viral meningitis are discussed. A differential 
diagnosis of the aseptic meningitis syndrome is provided.

Publication Types: 
    Review

PMID: 11051293 [PubMed - indexed for MEDLINE]

2991: Pain. 2000 Nov;88(2):125-33.

Capsaicin evoked pain and allodynia in post-herpetic neuralgia.

Petersen KL, Fields HL, Brennum J, Sandroni P, Rowbotham MC.

Department of Neurology, UCSF Pain Clinical Research Center, University of
California, San Francisco, 94115, USA. klp@itsa.ucsf.edu

The hypothesis that the pain and allodynia associated with post-herpetic
neuralgia (PHN) is maintained by a combination of input from preserved primary
afferent nociceptors and sensitization of central pain transmitting neurons was
examined in 17 subjects with PHN. Pain, allodynia, thermal sensory function,
cutaneous innervation, and response to controlled application of 0.075% capsaicin
were measured. Compared to mirror-image skin, applying capsaicin on a 9 cm(2)
area of PHN skin significantly increased overall PHN pain and allodynia in 11 of 
17 subjects. These 'capsaicin responders' were characterized by higher average
daily pain, higher allodynia ratings, and relatively preserved sensory function
at baseline compared to the non-responders. In three of the 'capsaicin
responders' the area of allodynia expanded into previously non-allodynic and
non-painful skin that had normal sensory function and cutaneous innervation.
These observations support the hypothesis that allodynia in some PHN patients is 
a form of chronic secondary hyperalgesia maintained by input from intact and
possibly 'irritable' primary afferent nociceptors to a sensitized CNS.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 11050367 [PubMed - indexed for MEDLINE]

2992: Br J Ophthalmol. 2000 Nov;84(11):1238-43.

Detection of herpes simplex virus type 1, 2 and varicella zoster virus DNA in
recipient corneal buttons.

van Gelderen BE, Van der Lelij A, Treffers WF, van der Gaag R.

Department of Ophthalmo- Immunology, The Netherlands Ophthalmic Research
Institute, Amsterdam, Netherlands. B.E.vanGelderen@wanadoo.nl

AIM: To study the value of polymerase chain reaction (PCR) analysis, to detect
viral DNA in recipient corneal buttons taken at the time of penetrating
keratoplasty (PKP) in patients with an initial diagnosis of herpetic stromal
keratitis (HSK). Since HSK has a tendency to recur, an accurate diagnosis of
previous HSK could be the reason to start antiviral treatment immediately,
thereby possibly decreasing the number of graft failures due to recurrent
herpetic keratitis. METHODS: Recipient corneal buttons and aqueous humour (AH)
samples were obtained at the time of PKP from HSK patients (n=31) and from other 
patients (n=78). Eye bank corneas were also used (n=23). Herpes simplex virus
type 1 (HSV-1), type 2 (HSV-2), and varicella zoster virus (VZV) infection were
assessed by PCR and antibody detection. RESULTS: The clinical diagnosis HSK could
be confirmed by PCR for HSV-1 in 10/31 (32%). In these corneal buttons HSV-2 DNA 
was detected in 1/31 (3%) and VZV DNA in 6/31 (19%). Intraocular anti-HSV
antibody production was detected in 9/28 AH samples tested (32%). In the other
patient derived corneas HSV-1 DNA was detected in 13/78 (17%), including eight
failed corneal grafts without clinically obvious herpetic keratitis in the
medical history. In clear eye bank corneas HSV-1 was detected in 1/23 (4%).
CONCLUSIONS: PCR of HSV-1 on corneal buttons can be a useful diagnostic tool in
addition to detection of intraocular anti-HSV antibody production. Furthermore,
the results were suggestive for the involvement of corneal HSV infection during
allograft failure of corneas without previous clinical characteristic signs of
herpetic keratitis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11049947 [PubMed - indexed for MEDLINE]

2993: Bone Marrow Transplant. 2000 Oct;26(7):795-6.

Varicella zoster meningoencephalitis following treatment for dermatomal zoster in
an alloBMT patient.

Tauro S, Toh V, Osman H, Mahendra P.

Bone Marrow Transplant Unit, University Hospital Birmingham NHS Trust,
Birmingham, UK.

Herpes zoster infections are frequently observed after allogeneic bone marrow
transplantation (alloBMT). In the majority of cases, the infection is restricted 
to specific dermatomes and responds to oral acyclovir, without visceral
dissemination. We report the case of a 40-year-old male who developed dermatomal 
herpetic infection 8 months post alloBMT. The herpetic rash responded well to
treatment with high-dose oral acyclovir. However, within a week of cessation of
therapy, the patient re-presented with dermatomal zoster and meningoencephalitis.
Although the cutaneous lesions resolved with intravenous acyclovir, clinical
features of meningoencephalitis persisted, along with evidence of varicella
zoster virus (VZV) DNA in cerebrospinal fluid (CSF). A satisfactory response to
treatment was observed only after the addition of intravenous foscarnet to
acyclovir. Based on our experience with this patient, we suggest that in a subset
of alloBMT recipients, late dermatomal herpes zoster infections may respond only 
partially to treatment with standard oral acyclovir. The use of oral acyclovir
preparations with higher bioavailability (valacyclovir) or intravenous acyclovir 
early on may prevent the considerable morbidity associated with disseminated
zoster infection. Bone Marrow Transplantation (2000) 26, 795-796.

Publication Types: 
    Case Reports

PMID: 11042663 [PubMed - indexed for MEDLINE]

2994: Plast Reconstr Surg. 2000 Oct;106(5):1218-9.

Zoster following immediate transverse rectus abdominis myocutaneous breast
reconstruction.

Skoll PJ, Hudson DA.

Publication Types: 
    Case Reports
    Letter

PMID: 11039401 [PubMed - indexed for MEDLINE]

2995: Arch Med Res. 2000 May-Jun;31(3):263-5.

Motor cortex stimulation in the treatment of central and neuropathic pain.

Nguyen JP, Lefaucher JP, Le Guerinel C, Eizenbaum JF, Nakano N, Carpentier A,
Brugieres P, Pollin B, Rostaing S, Keravel Y.

Departement des Neurosciences, CHU Henri Mondor, Creteil, France.

BACKGROUND: Motor cortex stimulation has been proposed for the treatment of
central pain. METHODS: Thirty-two patients with refractory central and
neuropathic pain of peripheral origin were treated by chronic stimulation of the 
motor cortex between May 1993 and January 1997. The mean follow-up was 27.3
months. The first 24 patients were operated on according to the technique
described by Tsubokawa. The last 13 cases (8 new patients and 5 reinterventions) 
were operated on by a technique including localization by superficial CT
reconstruction of the central region and neuronavigator guidance. The position of
the central sulcus was confirmed by the use of intraoperative somatosensory
evoked potentials. The somatotopic organization of the motor cortex was
established preoperatively by studying the motor responses at stimulation of the 
motor cortex through the dura. RESULTS: Ten of the 13 patients with central pain 
(77%) and 10 of the 12 patients with neuropathic facial pain experienced
substantial pain relief (83.3%). One of the three patients with post-paraplegia
pain was clearly improved. A satisfactory result was obtained in one patient with
pain related to plexus avulsion and in one patient with pain related to
intercostal herpes zoster. None of the patients developed epileptic seizures.
CONCLUSIONS: Our results confirm that chronic stimulation of the motor cortex is 
an effective method in treating certain forms of refractory pain.

Publication Types: 
    Clinical Trial

PMID: 11036176 [PubMed - indexed for MEDLINE]

2996: Cochrane Database Syst Rev. 2000;(4):CD001157.

Update of:
    Cochrane Database Syst Rev. 2000;(2):CD001157.

Cyclophosphamide for treating rheumatoid arthritis.

Suarez-Almazor ME, Belseck E, Shea B, Wells G, Tugwell P.

Health Services Research, Veterans Affairs Medical Center, Mailbox Station 152,
2002 Holcombe Blvd, Houston, Texas, USA, 77024. mes@bcm.tmc.edu

OBJECTIVES: To assess the short-term effects of cyclophosphamide for the
treatment of rheumatoid arthritis. SEARCH STRATEGY: We searched the Cochrane
Musculoskeletal Group's Register, the Cochrane Controlled Trials Register (issue 
3, 2000), Medline and Embase up to and including August 2000. We also carried out
a handsearch of the reference lists of the trials retrieved from the electronic
search. SELECTION CRITERIA: All randomized controlled trials (RCTs) and
controlled clinical trials (CCTs) comparing oral cyclophosphamide against placebo
(or an active drug at a dosage considered to be ineffective) in patients with
rheumatoid arthritis. DATA COLLECTION AND ANALYSIS: Data abstraction was carried 
out independently by two reviewers. The same two reviewers using a validated
checklist (Jadad 1996) assessed the methodological quality of the RCTs and CCTs. 
Rheumatoid arthritis outcome measures were extracted from the publications for
baseline and end-of-study. The pooled analysis was performed using standardized
mean differences (SMDs) for joint counts. Weighted mean differences (WMDs) were
used for erythrocyte sedimentation rate (ESR). Toxicity was evaluated with pooled
odds ratios for withdrawals. A chi-square test was used to assess heterogeneity
among trials. Fixed effects models were used throughout. MAIN RESULTS: A total of
70 patients were included in the pooled analysis of two trials, 31 receiving
cyclophosphamide. A statistically significant benefit was observed for
cyclophosphamide when compared to placebo for tender and swollen joint scores:
SMDs were -0.57 and -0.59 respectively. The difference in ESR also favoured the
active drug but did not reach statistical significance (-12 mm, 95%CI: -26 to
2.5). One trial reported the number of patients developing new or worse erosions:
the OR for cyclophosphamide compared to placebo was 0.17 (95% CI: 0.05 to 0.57). 
Patients receiving placebo were six times more likely to discontinue treatment
because of lack of efficacy than patients receiving cyclophosphamide. Withdrawals
from adverse reactions were higher in the cyclophosphamide group (Odds
ratio=2.9), although this difference was not statistically significant. Side
effects from cyclophosphamide included hemorrhagic cystitis, nausea, vomiting,
leucopenia, thrombocytopenia, alopecia, amenorrhea and herpes zoster infections. 
REVIEWER'S CONCLUSIONS: Cyclophosphamide appears to have a clinically and
statistically significant benefit on the disease activity of patients with RA,
similar to some disease modifying antirheumatic drugs (DMARDs) such as
antimalarials or sulfasalazine, but lower than methotrexate. Toxicity however is 
severe, limiting its use given the low benefit-risk ratio compared to other
antirheumatic agents.

Publication Types: 
    Review

PMID: 11034702 [PubMed - indexed for MEDLINE]

2997: Jpn J Ophthalmol. 2000 Sep-Oct;44(5):561-4.

Acute retinal necrosis following contralateral herpes zoster ophthalmicus.

Nakanishi F, Takahashi H, Ohara K.

Department of Ophthalmology, Nippon Medical School, Tokyo, Japan.

BACKGROUND: A case report of contralateral acute retinal necrosis (ARN) following
herpes zoster ophthalmicus. CASE: A 61-year-old male patient developed
iridocyclitis and well-demarcated creamy-white retinal lesions at the nasal
periphery in the right eye 1 month after herpes zoster ophthalmicus in the left
eye. The patient had undergone surgery for primary lung cancer, and had
subsequent intracranial metastasis of the tumor. OBSERVATIONS: The clinical
diagnosis of ARN was supported by polymerase chain reaction investigation of the 
aqueous humor resulting in positive for varicella-zoster virus. Retinal lesions
disappeared after systemic treatment with acyclovir, corticosteroids, and
acetylsalicylate. No retinal detachment developed. CONCLUSIONS: We propose a
careful ophthalmic follow-up for herpes zoster ophthalmicus patients because of
the possibility of acute retinal necrosis developing in the contralateral eye.

Publication Types: 
    Case Reports

PMID: 11033138 [PubMed - indexed for MEDLINE]

2998: Jpn J Ophthalmol. 2000 Sep-Oct;44(5):550-4.

Optic neuritis in herpes zoster ophthalmicus.

Wang AG, Liu JH, Hsu WM, Lee AF, Yen MY.

Department of Ophthalmology, National Yang-Ming University, Taipei Veterans
General Hospital, Republic of, Taipei, Taiwan, China.

BACKGROUND: Optic neuritis in herpes zoster ophthalmicus (HZO) has been reported 
rarely. We report two cases of HZO optic neuritis with detailed magnetic
resonance imaging study and treatment responses. CASES: One patient presented
with anterior optic nerve involvement, and the second presented with retrobulbar 
optic neuritis. Contrast enhanced T(1)-weighted images were obtained in these 2
patients. Intravenous acyclovir and oral prednisolone were given simultaneously. 
OBSERVATIONS: Magnetic resonance imaging revealed peripheral enhancement of the
optic nerve sheath complex on T(1)-weighted scan. Both patients recovered their
vision within 3 months following the start of treatment. CONCLUSIONS: Magnetic
resonance imaging is helpful for the diagnosis of HZO optic neuritis. Systemic
acyclovir and steroid are effective in the treatment of HZO optic neuritis.

Publication Types: 
    Case Reports

PMID: 11033135 [PubMed - indexed for MEDLINE]

2999: Oncol Rep. 2000 Nov-Dec;7(6):1389-94.

Orofacial viral infections in the immunocompromised host.

Samonis G, Mantadakis E, Maraki S.

Division of Medicine, The University of Crete, 711 10 Heraklion, Crete, Greece.
georgsec@med.uch.gr

Orofacial viral infections are common in immunocompromised patients. Herpes
simplex virus (HSV) infections are the most common. Varicella-Zoster virus (VZV) 
infections are less common, but usually more severe. Epstein-Barr virus (EBV) may
produce ulcers, lymphoproliferative syndromes or oral hairy leukoplakia (HL).
Human herpes virus 6 (HHV 6) may be the etiology of recurrent aphthous
stomatitis, while human herpes virus 7 (HHV 7) has an unclear role. Human herpes 
virus 8 (HHV 8) is the etiologic agent of Kaposi sarcoma. Human papilloma viruses
(HPVs) cause warts, papillomas and epithelial hyperplasia. Molluscum contagiosum 
is caused by a poxvirus. All herpes viruses (HSV, VZV, CMV, EBV, HHV 6, HHV 7,
HHV 8) and many HPVs are associated with neoplasias. Research is ongoing to
clarify the role of other viruses in the development of infections and lesions in
the orofacial area.

Publication Types: 
    Review

PMID: 11032950 [PubMed - indexed for MEDLINE]

3000: J Neurovirol. 2000 Oct;6(5):410-7.

A single tube PCR assay for simultaneous amplification of HSV-1/-2, VZV, CMV,
HHV-6A/-6B, and EBV DNAs in cerebrospinal fluid from patients with virus-related 
neurological diseases.

Yamamoto T, Nakamura Y.

Department of Clinical Pathology, Showa University Fujigaoka Hospital, Yokohama, 
Japan.

Cerebrospinal fluid (CSF) specimens from 27 patients with encephalitis,
meningitis, and other neurological diseases were studied for the presence of
herpes simplex virus types 1 and 2 (HSV-1/-2), varicella-zoster virus (VZV),
cytomegalovirus (CMV), human herpesviruses 6A and 6B (HHV-6A/-6B) and
Epstein-Barr virus (EBV) DNA using the polymerase chain reaction (PCR) method.
The DNAs were amplified using two sets of consensus primer pairs in a single
tube, bringing simultaneous amplification of the herpesviruses. The PCR products 
were analyzed by agarose gel electrophoresis, and Southern blot hybridization
with virus-type specific probes, thus allowing discrimination between the
different types of herpesviruses to be made. Each virus-specific probe was highly
specific for identifying the PCR product. Thirty CSF specimens from 13 patients
with encephalitis and 10 specimens from 10 patients with meningitis,
respectively, were examined using this method. Eight patients with encephalitis
and six with meningitis were positive for different herpesviruses, including
patients with coinfections (HSV-1/-2 and VZV, VZV and CMV). Among four CSF
specimens from four patients with other neurological disorders, dual
amplification of CMV and EBV was present. Since identification of the types of
herpesviruses in this system requires a very small amount of CSF, and is
completed with one PCR, it is useful for routine diagnosis of herpesvirus
infections in diagnostic laboratories. The viruses responsible for central
nervous system infection are easily detected with various coinfection and serial 
patterns of herpesviruses, by this consensus primer-based PCR method. This may
give an insight into the relationship between virus-related neurological diseases
(VRNDS) and herpesvirus infections.

PMID: 11031694 [PubMed - indexed for MEDLINE]

3001: Lik Sprava. 2000 Jul-Aug;(5):106-10.

[The clinical characteristics of progressive focal epilepsy with a herpetic
etiology]

[Article in Russian]

Ponomareva EN, Khmara ME, Nedz'ved' MK, Drakina SA, Kolomiets AG, Protas II.

Cases are described of chronic zoster encephalitis presenting with the leading
progressive focal epilepsy syndrome. The clinical presentation of the trouble can
include both general cerebral signs and those of the focal affection of the
central nervous system only. The progressive course and duration of remission
suggest to us a persisting infection manifesting against the background of immune
deficiency.

Publication Types: 
    Case Reports
    English Abstract

PMID: 11031468 [PubMed - indexed for MEDLINE]

3002: Arch Fam Med. 2000 Sep-Oct;9(9):863-9.

Antiviral therapy for herpes zoster: randomized, controlled clinical trial of
valacyclovir and famciclovir therapy in immunocompetent patients 50 years and
older.

Tyring SK, Beutner KR, Tucker BA, Anderson WC, Crooks RJ.

Department of Dermatology, University of Texas Medical Branch, Galveston, TX
77555, USA.

OBJECTIVE: To compare the efficacy and safety of valacyclovir hydrochloride and
famciclovir for the treatment of herpes zoster. DESIGN: A double-blind,
randomized, controlled, multicenter clinical trial in which patients received 7
days of treatment and were followed up for 24 weeks. SETTINGS: Patients reported 
directly to specialist centers or were referred from primary care centers.
PATIENTS: There were 597 otherwise healthy immunocompetent outpatients, aged 50
years and older, who presented within 72 hours of onset of zoster rash.
INTERVENTIONS: Treatment with valacyclovir hydrochloride (1 g 3 times daily) or
famciclovir (500 mg 3 times daily) for 7 days. MAIN OUTCOME MEASURES: Resolution 
of zoster-associated pain and postherpetic neuralgia, rash healing, and treatment
safety. RESULTS: Intent-to-treat analysis did not detect statistically
significant differences for valacyclovir vs famciclovir on resolution of
zoster-associated pain (hazard ratio, 1. 02; 95% confidence interval, 0.84-1.23; 
P =.84). Furthermore, no differences were evident between treatments on rash
healing rates and on a range of analyses of postherpetic neuralgia. Safety
profiles for valacyclovir and famciclovir were similar, with headache and nausea 
being the more common adverse events. CONCLUSIONS: Valacyclovir treatment is
comparable to famciclovir treatment in speeding the resolution of
zoster-associated pain and postherpetic neuralgia. Current wholesale prices
indicate that valacyclovir is the more cost-effective treatment for herpes zoster
($83.90 vs $140.70 per course).

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 11031393 [PubMed - indexed for MEDLINE]

3003: Southeast Asian J Trop Med Public Health. 2000 Mar;31(1):21-4.

Seroprevalence of hepatitis A virus and varicella zoster antibodies in a Javanese
community (Yogyakarta, Indonesia).

Juffrie M, Graham RR, Tan RI, Widjaja S, Mulyadi S, Weil J, Bock HL.

Department of Pediatrics, Faculty of Medicine, Dr Sardjito Hospital, Gadjah Mada 
University, Yogyakarta, Indonesia.

Hepatitis A virus (HAV) cause an acute inflammation of the liver.
Varicella-zoster virus (VZV) cause chickenpox (varicella) and herpes zoster.
Effective vaccines against hepatitis A and varicella are available for children, 
adolescents and adults. In order to implement an appropriate vaccination policy, 
a baseline to assess the potential benefits and sections of the population who
would benefit most are required. We investigated seroprevalence of hepatitis A
virus and varicella zoster antibodies in a Javanese community. A total of 1,103
subjects were studied. The 600 subjects aged 4 to 9 years were sampled between 23
October and 2 November, 1995. The other subjects were sampled between 12 October 
and 1 November, 1996. The overall prevalence of anti-HAV in cohort was 28.7%.
Anti-HAV seroprevalence rates were below 30% until the age of 15 and below 40%
until the age of 25. The anti-varicella seroprevalence showed only in two thirds 
of seropositive population at the age of 15. The results of the study have
implications for vaccination strategies for both hepatitis A and varicella
zoster.

PMID: 11023059 [PubMed - indexed for MEDLINE]

3004: Mt Sinai J Med. 2000 Sep;67(4):336-8.

Herpes zoster.

Sapadin AN, Rudikoff D.

Publication Types: 
    Case Reports

PMID: 11021787 [PubMed - indexed for MEDLINE]

3005: Health News. 2000 Jan;6(1):6.

Blocking shingles pain.

[No authors listed]

Publication Types: 
    News

PMID: 11019661 [PubMed - indexed for MEDLINE]

3006: Nippon Jibiinkoka Gakkai Kaiho. 2000 Aug;103(8):928-36.

[Detection of varicella-zoster virus DNA in tear fluid and saliva of patients
with Ramsay Hunt syndrome]

[Article in Japanese]

Hiroshige K, Ikeda M, Hondo R.

Department of Otolaryngology, Nihon University School of Medicine, Tokyo.

Ramsay Hunt syndrome develops when the varicella-zoster virus (VZV) is
reactivated. In the present study, we examined the secretion kinetics of VZV DNA 
in the tear fluid, submandibular gland saliva and parotid gland saliva of 15
patients with Ramsay Hunt syndrome. The presence of VZV DNA was detected using
PCR and a microplate hybridization method. Hybridization signals were measured
using the fluorescence density of an enzymatic reaction product using fluoroscan 
and a system involving streptavidin-conjugated beta-galactosidase. The results
were converted into numerical values and used to estimate the number of virus DNA
copies. VZV DNA was detected in the tear fluid, submandibular gland saliva and
parotid gland saliva of the Ramsay Hunt syndrome patients. The rate of VZV DNA
detection in the submandibular gland saliva was 72%, and the detection rate in
the parotid gland saliva was 57%. The detection rate in the tear fluid was 27%,
which is significantly lower than other two detection rates. Regarding the
submandibular gland saliva and the parotid gland saliva, the VZV DNA was detected
in samples collected at a comparatively early stage of onset. In the tear fluid, 
the detection rate increased significantly in samples collected 2 weeks after
onset or later. Thus, differences in the detection rate were observed depending
on the type of secretory gland and the timing of the sample collection. The VZV
DNA in the tear fluid is thought to derive from the ganglion trigeminale. The
increase and decrease in the number of VZV DNA copies detected in samples
collected at different times is considered to substantiate VZV reactivation in
Ramsay Hunt syndrome.

Publication Types: 
    English Abstract

PMID: 11019589 [PubMed - indexed for MEDLINE]

3007: Arq Neuropsiquiatr. 2000 Sep;58(3B):836-42.

Polymerase chain reaction for the laboratory diagnosis of aseptic meningitis and 
encephalitis.

Chesky M, Scalco R, Failace L, Read S, Jobim LF.

Immunology Unit, Hospital de Clinicas de Porto Alegre, Universidade Federal do
Rio Grande do Sul, Brasil.

A protocol for testing cerebrospinal fluid specimens using a range of PCR assays 
for the diagnosis of central nervous system infection was developed and used to
test prospectively 383 specimens. PCR assays were used for the detection of
adenovirus, Borrelia burgdorferi, enteroviruses, Epstein Barr virus,
cytomegalovirus, herpes simplex virus, human herpes virus type 6, JC virus,
Leptospira interrogans, Listeria monocytogenes, lymphocytic choriomeningitis
virus, measles virus, mumps virus, Mycobacterium sp. , Mycoplasma pneumoniae,
Toxoplasma gondii and varicella zoster virus. Of the 383 specimens tested in this
study, 46 (12.0%) were found to be positive. The microorganisms detected were
CMV, enterovirus, Epstein Barr virus, herpes simplex virus, human herpes virus
type 6, JC virus, L. monocytogenes, Mycobacterium genus, Toxoplasma gondii and
varicella zoster virus. The introduction of the PCR protocol described has
improved the diagnosis of a range of central nervous system infections in our
laboratory. We believe however that further evaluation of these assays in
immunocompromised patients is necessary to better determine the predictive value 
of positive PCR results in these patient groups.

PMID: 11018820 [PubMed - indexed for MEDLINE]

3008: Clin J Pain. 2000 Sep;16(3):188-92.

Amitriptyline and fluphenazine in the treatment of postherpetic neuralgia.

Graff-Radford SB, Shaw LR, Naliboff BN.

UCLA Pain Management Center, Los Angeles, California, USA.

BACKGROUND: Postherpetic neuralgia (PHN) is a vexing problem occurring in 10 to
20 percent of people with from herpes zoster (shingles). Anecdotal reports show
that fluphenazine enhances the effects of amitriptyline for the treatment of PHN.
The aim of this study was to determine, in a controlled manner, whether this was 
the case. METHODS: In a double-blind placebo-controlled study, 49 patients with
PHN were randomly assigned to four treatment groups: Group 1, amitriptyline;
Group 2, amitriptyline and fluphenazine; Group 3, fluphenazine; Group 4, a
placebo. An active placebo was used to mimic the anticholinergic side effects of 
dry mouth. The study lasted 8 weeks, with weekly progress evaluations with use of
visual analog scales (VAS), the McGill Pain Questionnaire (MPQ), and a
side-effects scale. RESULTS: A statistically significant decrease was seen in
pain in Groups 1 and 2, and no significant changes were seen in Groups 3 and 4.
There was no significant difference when fluphenazine was added to amitriptyline.
CONCLUSION: These data support the effectiveness of amitriptyline in treatment of
PHN, but do not support the addition of fluphenazine.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 11014390 [PubMed - indexed for MEDLINE]

3009: BMJ. 2000 Sep 30;321(7264):794-6.

Comment in:
    BMJ. 2000 Sep 30;321(7264):778-9.    BMJ. 2001 Apr 7;322(7290):859-60.    BMJ. 2001 Apr 7;322(7290):860.    BMJ. 2001 Apr 7;322(7290):860-1.

Prevalence of postherpetic neuralgia after a first episode of herpes zoster:
prospective study with long term follow up.

Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA.

Arbaer Health Care Centre, IS-110 Reykjavik, Iceland. S.Helgason sh@centrum.is

OBJECTIVE: To estimate the frequency, duration, and clinical importance of
postherpetic neuralgia after a single episode of herpes zoster. DESIGN:
Prospective cohort study with long term follow up. SETTING: Primary health care
in Iceland. PARTICIPANTS: 421 patients with a single episode of herpes zoster.
MAIN OUTCOME MEASURES: Age and sex distribution of patients with herpes zoster,
point prevalence of postherpetic neuralgia, and severity of pain at 1, 3, 6, and 
12 months and up to 7.6 years after the outbreak of zoster. RESULTS: Among
patients younger than 60 years, the risk of postherpetic neuralgia three months
after the start of the zoster rash was 1.8% (95% confidence interval 0.59% to
4.18%) and pain was mild in all cases. In patients 60 years and older, the risk
of postherpetic neuralgia increased but the pain was usually mild or moderate.
After three months severe pain was recorded in two patients older than 60 years
(1.7%, 2.14% to 6.15%). After 12 months no patient reported severe pain and 14
patients (3.3%) had mild or moderate pain. Seven of these became pain free within
two to seven years, and five reported mild pain and one moderate pain after 7.6
years of follow up. Sex was not a predictor of postherpetic neuralgia. Possible
immunomodulating comorbidity (such as malignancy, systemic steroid use, diabetes)
was present in 17 patients. CONCLUSIONS: The probability of longstanding pain of 
clinical importance after herpes zoster is low in an unselected population of
primary care patients essentially untreated with antiviral drugs.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 11009518 [PubMed - indexed for MEDLINE]

3010: BMJ. 2000 Sep 30;321(7264):778-9.

Comment in:
    BMJ. 2001 Apr 7;322(7290):861.

Comment on:
    BMJ. 2000 Sep 30;321(7264):794-6.

The management of post-herpetic neuralgia.

Cunningham AL, Dworkin RH.

Publication Types: 
    Comment
    Editorial

PMID: 11009498 [PubMed - indexed for MEDLINE]

3011: Cornea. 2000 Sep;19(5):673-80.

The evolution of antiviral therapy for external ocular viral infections over
twenty-five years.

Gordon YJ.

Department of Ophthalmology, The University of Pittsburgh School of Medicine,
Pennsylvania 15213, USA.

PURPOSE: To review the past 25 years of the evolution of antiviral therapy for
the treatment of common external ocular viral infections (herpes simplex virus
type 1, varicella-zoster virus, and adenovirus). METHODS: A broad-based
literature review in the fields of virology, antiviral research, and
ophthalmology will be carried out. The pathogenesis of the major external ocular 
viral infections and history of antiviral development will be cited. Important
conceptual breakthroughs as well as historical landmarks will be emphasized.
RESULTS: The successful development of effective antivirals to treat the most
common external ocular viral infections have dramatically reduced morbidity and
sight loss. The immune pathogenesis of herpetic stromal keratitis is better
understood. CONCLUSIONS: Remarkable progress in the development of antiviral
therapy has occurred over the past quarter century. Future needs include improved
antivirals and immunomodulators and vaccines to prevent and treat herpetic ocular
infections and adenovirus keratoconjunctivitis.

Publication Types: 
    Comparative Study
    Historical Article
    Review

PMID: 11009319 [PubMed - indexed for MEDLINE]

3012: Cutis. 2000 Sep;66(3):221-3.

Herpes zoster in the medically healthy child and covert severe child abuse.

Gupta MA, Gupta AK.

Department of Psychiatry, University of Western Ontario, London, Canada.

Herpes zoster is associated with depressed cell-mediated immunity and occurs
rarely in the medically healthy nonimmunocompromised child. We report 4 cases of 
childhood-onset herpes zoster in the absence of a medical disorder. All 4
patients reported experiencing severe, chronic child abuse when the herpes zoster
first appeared. It is possible that the severe chronic psychologic stress
resulting from the abuse depressed the patients' cell-mediated immune status and 
thereby predisposed them to herpes zoster. Our findings suggest that the
clinician's suspicion should be heightened for the possibility of covert child
abuse and secondary stress when managing an otherwise apparently healthy child
with herpes zoster.

Publication Types: 
    Case Reports

PMID: 11006859 [PubMed - indexed for MEDLINE]

3013: J Accid Emerg Med. 2000 Sep;17(5):366.

Towards evidence based emergency medicine: best BETs from the Manchester Royal
Infirmary. Oral acyclovir in acute cutaneous herpes zoster.

Terry P, Buttress S.

Publication Types: 
    Case Reports

PMID: 11005412 [PubMed - indexed for MEDLINE]

3014: Natl Med J India. 2000 Jul-Aug;13(4):183-7.

Relationship between clinical conditions and CD4 counts in HIV-infected persons
in Pune, Maharashtra, India.

Ghate MV, Mehendale SM, Mahajan BA, Yadav R, Brahme RG, Divekar AD, Paranjape RS.

National AIDS Research Institute, Maharashtra, India.

BACKGROUND: A decade after the detection of human immunodeficiency virus (HIV)
infection in India, a steady increase in the number of patients with acquired
immunodeficiency syndrome (AIDS) has been observed. The therapeutic options for
patients with AIDS in developing countries include chemoprophylaxis and
identifying and treating opportunistic infections. CD4 counts help in clinical
monitoring and making decisions about initiating antiretroviral therapy or
chemoprophylaxis. Flowcytometry is expensive and available only at specialized
laboratories. Therefore, the possibility of using clinical indicators to predict 
low CD4 counts and disease progression needs to be explored. METHODS: This
cross-sectional study was conducted among 137 HIV-infected persons investigated
at an HIV reference centre in Pune. The study methods comprised pre-test
counselling, informed consent, blood withdrawal and clinical evaluation. Serum
samples were tested for HIV and CD4 counts were estimated on FACSort. RESULTS:
Study participants commonly reported with oral candidiasis, herpes zoster,
pulmonary tuberculosis, lymphadenopathy, weight loss, rash, diarrhoea and fever. 
CD4 counts were significantly lower among men, symptomatic patients and those
with oral candidiasis, weight loss and multiple clinical conditions. The
sensitivity of most of the clinical conditions was low, the specificity was high 
and the positive predictive value of oral candidiasis and weight loss for low CD4
counts was > 75%. CONCLUSION: The presence of oral candidiasis and weight loss
were highly predictive of low CD4 counts and these can be considered as markers
of HIV disease progression. Absence of clinical conditions was found to be a good
predictor of high CD4 counts. Larger systematic natural history studies may help 
in identifying clinical conditions that could have a prognostic significance
among HIV-infected people.

PMID: 11002684 [PubMed - indexed for MEDLINE]

3015: Med Clin (Barc). 2000 Jul 8;115(6):208-10.

[Dermatologic complications after heart transplantation: incidence and prognosis]

[Article in Spanish]

Freire-Ruano A, Crespo-Leiro MG, Muniz J, Paniagua MJ, Almagro M, Castro-Beiras
A.

Programa de Trasplante Cardiaco, Hospital Juan Canalejo, La Coruna.

BACKGROUND: This study was conducted to analyze the type, incidence, predisposing
factors and prognosis of cutaneous complications (CC) occurring in heart
transplant recipients (HTR). PATIENTS AND METHODS: A retrospective study was
carried out among 192 HTR with a survival > 1 month. The following variables were
recorded: age, sex, place of residence, post-transplant diabetes, glucocorticoid 
dose, prophylaxis with acyclovir/itraconazole and CC. RESULTS: One hundred sixty 
three CC were diagnosed in 93 patients. The major types were infectious
complications (n = 115; 70.5%) and tumors (n = 20; 12.3%). The most common
infections were viral (herpes zoster; n = 22) and fungal (pityriasis versicolor; 
n = 53). Out the 20 tumors, 3 were malignant: 2 squamous cell carcinomas (SCC)
and 1 Kaposi sarcoma. None of the CC caused mortality or prolonged hospital stay.
No relationship was found between CC and the variables studied. CONCLUSIONS: Skin
infections were the most common CC in this cohort of HTR. The incidence of SCC
was very low and its prognosis was good due to early diagnosis and surgical
excision.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 11002458 [PubMed - indexed for MEDLINE]

3016: J Assoc Physicians India. 1999 Feb;47(2):254.

Landry Guillain Barre syndrome--an unusual association with herpes zoster.

Mehndiratta MM, Gupta M.

Publication Types: 
    Case Reports
    Letter

PMID: 10999110 [PubMed - indexed for MEDLINE]

3017: Curr Rev Pain. 2000;4(3):219-26.

Postherpetic neuralgia in the cancer patient.

Lojeski E, Stevens RA.

Department of Anesthesiology, Northwestern University Medical School, 251 East
Huron Street, Chicago, IL 60611, USA. ewloje@yahoo.com

Postherpetic neuralgia (PHN) is the most common and devastating complication of
acute herpes zoster (HZ). HZ occurs more frequently in the patient with human
immunodeficiency virus (HIV) and with certain leukemias and lymphomas. PHN occurs
more frequently in the elderly, in patients with severe pain in the acute stage, 
and in patients with lesions in the ophthalmic branch of the trigeminal nerve.
Pain from PHN is often debilitating and difficult to treat. A wide variety of
therapeutic approaches have been advocated over the years, but most are not very 
effective. Early aggressive treatment of HZ with antiviral drugs may be the most 
important step in prophylaxis against PHN. This article reviews the current
knowledge of the pathogenesis and treatment of PHN.

Publication Types: 
    Review

PMID: 10998737 [PubMed - indexed for MEDLINE]

3018: Curr Rev Pain. 2000;4(1):7-11.

The role of stress in the development of herpes zoster and postherpetic
neuralgia.

Livengood JM.

Vanderbilt University Hospital, Psychological Services, Vanderbilt Pain Control
Center, 1211 21st Avenue South, Nashville, TN 37212, USA.
janice.livengood@mcmail.vanderbilt.edu

Chronic pain is a multidimensional experience produced by multiple influences.
This article examines the intervening role of psychologic and physiologic stress 
in the development and pathogenesis of prolonged herpes zoster and postherpetic
neuralgia.

PMID: 10998709 [PubMed - indexed for MEDLINE]

3019: Immunobiology. 2000 Aug;202(2):204-11.

Successful IL-2 therapy for relapsing herpes zoster infection in a patient with
idiopathic CD4+ T lymphocytopenia.

Warnatz K, Draeger R, Schlesier M, Peter HH.

Department of Internal Medicine, University Hospital Freiburg, Germany.
warnatz@mm61.ukl.uni-freiburg.de

Idiopathic CD4+ T lymphocytopenia (ICL) has been defined by the center of disease
control as a rare cause of immunodeficiency with a variable clinical course and
an unknown aetiology. Here we describe a 65-year old patient with relapsing
generalized herpes zoster infection due to ICL and a severe panlymphocytopenia.
In vitro assays revealed an enhanced activation of CD8+ T cells and an increased 
sensitivity of activated CD4+ T cells for cell death. The clinical outcome was
substantially improved after starting the patient on a subcutaneous therapy with 
IL-2.

Publication Types: 
    Case Reports

PMID: 10993296 [PubMed - indexed for MEDLINE]

3020: Rev Med Liege. 2000 Jun;55(6):564-71.

[Muco-cutaneous manifestations of HIV infections in the tropics]

[Article in French]

Fogouang L, Kola DL, Paquet P, Pierard-Franchimont C, Pierard GE.

Service de Dermatopathologie, Universite de Liege.

AIDS can be revealed by some infectious opportunistic infections and neoplastic
diseases. Herpes simplex and zoster of long duration, profuse mycotic diseases
and Kaposi disease are among those which develop frequently in these patients.
They can even represent the first signs of HIV infection. Their early recognition
is mandatory in the strategy aiming at the limitation of the epidemic. Such a
panel of diseases is completed by some inflammatory dermatoses among which
psoriasis and some drug reactions, whose evolution is affected by the
immunodeficiency.

Publication Types: 
    English Abstract

PMID: 10992789 [PubMed - indexed for MEDLINE]

3021: Acta Virol. 2000 Apr;44(2):61-5.

Comparison of virus isolation and various polymerase chain reaction methods in
the diagnosis of mucocutaneous herpesvirus infection.

Nogueira ML, Amorim JB, Oliveira JG, Bonjardim CA, Ferreira PC, Kroon EG.

Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo
Horizonte, Brazil.

We compared two polymerase chain reaction (PCR) assays (simple and multiplex) and
viral isolation to detect herpes simplex virus 1 (HSV-1) and varicella-zoster
virus (VZV) in 15 clinical specimens from 13 patients with mucocutaneous herpetic
infections. HSV-1 or VZV DNA was detected in 13 specimens by simple PCRs (HSV-1
or VZV PCR) and in 12 specimens by multiplex PCR. On the other hand, viral
isolation was positive for 9 specimens only. The PCR protocols used in this study
are not only more sensitive and faster than the traditional viral isolation and
conventional PCR protocols but also can distinguish rapidly HSV-1 from VZV. We
propose the PCRs described here for rapid and precise identification of
etiological agents of mucocutaneous herpetic infections.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 10989695 [PubMed - indexed for MEDLINE]

3022: Med Lett Drugs Ther. 1999 Dec 3;41(1067):113-20.

Drugs for non-HIV viral infections.

[No authors listed]

Publication Types: 
    Historical Article

PMID: 10984212 [PubMed - indexed for MEDLINE]

3023: J Virol. 2000 Oct;74(19):9054-61.

Novel class of thiourea compounds that inhibit herpes simplex virus type 1 DNA
cleavage and encapsidation: resistance maps to the UL6 gene.

van Zeijl M, Fairhurst J, Jones TR, Vernon SK, Morin J, LaRocque J, Feld B,
O'Hara B, Bloom JD, Johann SV.

Department of Molecular Biology/Virology, Wyeth-Ayerst Research, Pearl River, New
York 10965, USA. vanzeim@war.wyeth.com

In our search for novel inhibitors of herpes simplex virus type 1 (HSV-1), a new 
class of thiourea inhibitors was discovered.
N-(4-[3-(5-Chloro-2,4-dimethoxyphenyl)-thioureido]-phenyl)-acetamide and its
2-fluoro-benzamide derivative inhibited HSV-1 replication. HSV-2, human
cytomegalovirus, and varicella-zoster virus were inhibited to a lesser extent.
The compounds acted late in the replication cycle by impairing both the cleavage 
of concatameric viral DNA into progeny genome length and the packaging of the DNA
into capsids, indicative of a defect in the encapsidation process. To uncover the
molecular target of the inhibition, resistant HSV-1 isolates were generated, and 
the mutation responsible for the resistance was mapped using marker transfer
techniques. Each of three independent isolates had point mutations in the UL6
gene which resulted in independent single-amino-acid changes. One mutation was
located in the N terminus of the protein (E121D), while two were located close
together in the C terminus (A618V and Q621R). Each of these point mutations was
sufficient to confer drug resistance when introduced into wild-type virus. The
UL6 gene is one of the seven HSV-1 genes known to play a role in DNA packaging.
This novel class of inhibitors has provided a new tool for dissection of HSV-1
encapsidation mechanisms and has uncovered a new viable target for the treatment 
of herpesviral diseases.

PMID: 10982350 [PubMed - indexed for MEDLINE]

3024: Acta Anaesthesiol Scand. 2000 Sep;44(8):910-8.

Comment in:
    Acta Anaesthesiol Scand. 2000 Sep;44(8):903-5.

Prevention of post-herpetic neuralgia: acyclovir and prednisolone versus epidural
local anesthetic and methylprednisolone.

Pasqualucci A, Pasqualucci V, Galla F, De Angelis V, Marzocchi V, Colussi R,
Paoletti F, Girardis M, Lugano M, Del Sindaco F.

Department of Anesthesiology and Intensive Care, University of Udine, Italy.
A.Pasqualucci@med.uniud.it

BACKGROUND: Treatment of herpes zoster (HZ) includes the use of acyclovir with or
without steroids. An alternative therapy is the epidural administration of local 
anesthetics with or without steroids. This trial compared the efficacy of these
two treatment regimens in the prevention of post-herpetic neuralgia (PHN).
METHODS: Six hundred adults over 55 years of age with a rash of less than 7 days 
duration, and severe pain due to HZ, were enrolled and randomized to receive
either intravenous acyclovir (10 mg/kg three times daily) for 9 days+prednisolone
(60 mg per day with progressive reduction) for 21 days, or 6-12 ml bupivacaine
(0.25%) every 6-8 or 12 h+methylprednisolone 40 mg every 3-4 days by epidural
catheter during a period ranging from 7 to 21 days. Efficacy was evaluated at 1, 
3, 6 and 12 months. PHN was assessed as pain and/or allodynia, and "abnormal
sensations" (hypoesthesia, burning, itching, etc.). Statistical analysis was
performed based on the intent-to-treat population. RESULTS: In the 485 patients
who completed the study, the incidence of pain after 1 year was 22.2% (51
patients of 230) after acyclovir+steroids, and 1.6% (4 patients of 255) after
epidural analgesia+steroids. The incidence of abnormal sensations was 12.2% (28
patients) after acyclovir+steroids, and 4.3% (11 patients) in group B.
CONCLUSIONS: Epidural administration of local anesthetic and methylprednisolone
is significantly more effective in preventing PHN at 12 months compared to
intravenous acyclovir and prednisolone.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 10981565 [PubMed - indexed for MEDLINE]

3025: Acta Anaesthesiol Scand. 2000 Sep;44(8):903-5.

Comment on:
    Acta Anaesthesiol Scand. 2000 Sep;44(8):910-8.

Prevention of post-herpetic neuralgia: can it be achieved?

Johnson RW.

Publication Types: 
    Comment
    Editorial

PMID: 10981563 [PubMed - indexed for MEDLINE]

3026: Neurology. 2000 Sep 12;55(5):708-10.

Early diagnosis of zoster sine herpete and antiviral therapy for the treatment of
facial palsy.

Furuta Y, Ohtani F, Mesuda Y, Fukuda S, Inuyama Y.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan. yfuruta@med.hokudai.ac.jp

The effect of antiviral agents on recovery from facial palsy in patients with
zoster sine herpete (ZSH; varicella zoster virus reactivation without zoster) has
not been evaluated because ZSH is difficult to diagnose early after onset. In
this study, all 13 patients who received acyclovir-prednisone treatment within 7 
days of onset, as confirmed by a positive PCR result, showed complete recovery.
PCR-based early diagnosis of ZSH and antiviral therapy elicited an excellent
outcome for recovery from facial palsy due to ZSH.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10980741 [PubMed - indexed for MEDLINE]

3027: Ocul Immunol Inflamm. 2000 Jun;8(2):115-8.

Herpes zoster sine herpete presenting with hyphema.

Akpek EK, Gottsch JD.

Cornea and External Diseases Service, The Wilmer Eye Institute, Johns Hopkins
University, School of Medicine, Baltimore, Maryland 21287-9238, USA.

PURPOSE: To report a case of herpes zoster sine herpete presenting with hyphema. 
METHODS: A 69-year-old man was referred for traumatic hyphema and corneal edema
in his left eye after a sandblast exposure three weeks previously. Slit-lamp
examination demonstrated hyphema, anterior chamber inflammation, mid-dilated
pupil, impaired corneal sensation, and high intraocular pressure, without any
facial skin lesions. Iris fluorescein angiography revealed tortuosity and
extensive occlusion of iris vessels. The patient was treated with oral acyclovir 
and intensive topical steroids with a presumed diagnosis of severe herpes zoster 
uveitis. RESULTS: Clinical findings improved dramatically within several days.
Typical sectorial iris atrophy with pupillary sphincter dysfunction and complete 
loss of corneal sensation developed after the resolution of intraocular
inflammation. CONCLUSION: Herpes zoster should be considered in patients with
uveitis and hyphema even in the absence of typical skin rash.

Publication Types: 
    Case Reports

PMID: 10980684 [PubMed - indexed for MEDLINE]

3028: JAMA. 2000 Sep 13;284(10):1271-9.

Erratum in:
    JAMA 2000 Dec 27;284(24):3129.

Postlicensure safety surveillance for varicella vaccine.

Wise RP, Salive ME, Braun MM, Mootrey GT, Seward JF, Rider LG, Krause PR.

Division of Epidemiology, Office of Biostatistics and Epidemiology, Center for
Biologics Evaluation and Research, Food and Drug Administration, 1401 Rockville
Pike, FDA CBER HFM-225, Rockville, MD 20852-1448, USA. rpwise@cber.fda.gov

CONTEXT: Since its licensure in 1995, the extensive use of varicella vaccine and 
close surveillance of the associated anecdotal reports of suspected adverse
effects provide the opportunity to detect potential risks not observed before
licensure because of the relatively small sample size and other limitations of
clinical trials. OBJECTIVES: To detect potential hazards, including rare events, 
associated with varicella vaccine, and to assess case reports for clinical and
epidemiological implications. DESIGN AND SETTING: Postlicensure case-series study
of suspected vaccine adverse events reported to the US Vaccine Adverse Event
Reporting System (VAERS) from March 17, 1995, through July 25, 1998. MAIN OUTCOME
MEASURES: Numbers of reported adverse events, proportions, and reporting rates
(reports per 100,000 doses distributed). RESULTS: VAERS received 6574 case
reports of adverse events in recipients of varicella vaccine, a rate of 67.5
reports per 100,000 doses sold. Approximately 4% of reports described serious
adverse events, including 14 deaths. The most frequently reported adverse events 
were rashes, possible vaccine failures, and injection site reactions.
Misinterpretation of varicella serology after vaccination appeared to account for
17% of reports of possible vaccine failures. Among 251 patients with herpes
zoster, 14 had the vaccine strain of varicella zoster virus (VZV), while 12 had
the wild-type virus. None of 30 anaphylaxis cases was fatal. An immunodeficient
patient with pneumonia had the vaccine strain of VZV in a lung biopsy. Pregnant
women occasionally received varicella vaccine through confusion with varicella
zoster immunoglobulin. Although the role of varicella vaccine remained unproven
in most serious adverse event reports, there were a few positive rechallenge
reports and consistency of many cases with syndromes recognized as complications 
of natural varicella. CONCLUSION: Most of the reported adverse events associated 
with varicella vaccine are minor, and serious risks appear to be rare. We could
not confirm a vaccine etiology for most of the reported serious events; several
will require further study to clarify whether varicella vaccine plays a role.
Education is needed to ensure appropriate use of varicella serologic assays and
to eliminate confusion between varicella vaccine and varicella zoster
immunoglobulin. JAMA. 2000;284:1271-1279

PMID: 10979114 [PubMed - indexed for MEDLINE]

3029: Optometry. 2000 Apr;71(4):249-58.

Contact lens considerations for patients infected with HIV.

Chronister CL.

Pennsylvania College of Optometry, Philadelphia, USA.

BACKGROUND: As an eye care practitioner, one must be aware of the many sequelae
of HIV disease and its impact on contact lens patients. With the progressing
development of anti-HIV medications, patients infected with HIV are living longer
and more productive lives. Thus a greater number of patients infected with HIV
may be candidates for contact lens wear. PURPOSE: The eye care practitioner will 
play an important role in caring for patients infected with HIV who wear contact 
lenses. Theoretically, contact lens wear in patients infected with HIV could
potentially increase their risk of corneal infection particularly from
opportunistic pathogens in immuno-compromised patents. METHODS: This article
reviews the common anterior segment HIV-related complications that can impact on 
the ability to wear contact lenses. These complications include:
keratoconjunctivitis sicca, herpes simplex, herpes zoster, microsporidial
keratoconjunctivitis, molluscum contagiosum, bacterial keratitis, conjunctival
microvasculopathy, and Kaposi's sarcoma. "In-office infection control" concerns
will be reviewed, along with proper care and disinfection of contact lenses for
patients infected with HIV.

Publication Types: 
    Review

PMID: 10974925 [PubMed - indexed for MEDLINE]

3030: Enferm Infecc Microbiol Clin. 2000 May;18(5):223-8.

[Detection of viral genomes of the Herpesviridae family in multiple sclerosis
patients by means of the polymerase chain reaction (PCR)]

[Article in Spanish]

Alvarez R, Cour I, Kanaan A, Benedicto M, Martin-Estefania C, Arroyo R, Varela de
Seijas E, Picazo JJ.

Servicio de Microbiologia, Hospital Universitario San Carlos, Madrid.

BACKGROUND: The multiple sclerosis seems to be the junction between genetics
alteration and an unknown environmental factor, that they would originate an
autoimmune alteration, that they would be the reason of the inflammation and
demyelinization responsible of the disease. Our objective has been the
determination of this possible environmental factor and to reach it, we have
studied the appearance of Herpesviridae family viruses. MATERIALS AND METHODS:
204 blood samples were studied: 102 from relapsing-remitting multiple sclerosis
patients (43 were undergoing beta-interferon treatment), and 102 from blood
donors with the same age and sex than multiple sclerosis patients. From this
samples, we extracted the DNA of peripheral blood mononuclear cells (PBMCs), and 
we analyzed by polymerase chain reaction (PCR) to detect the appearance of herpes
simplex virus, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, human
herpesvirus 6 (HHV-6), human herpesvirus 7 and human herpesvirus 8. RESULTS: a)
we only found significative difference (p = 0.0001) in HHV-6: 21.5% donors
positive samples (22/102), opposite to 49.02% of positivity in mulytiple
sclerosis patients (50/102); b) we didn't found significative differences in none
of other viruses studied, between patients treated with beta-interferon and
non-treated ones. CONCLUSIONS: Our results suggest us that HHV-6 can play an
important role in the multiple sclerosis development. The beta-interferon
treatment doesn't affect to DNA prevalence of none of studied viruses.

Publication Types: 
    English Abstract

PMID: 10974766 [PubMed - indexed for MEDLINE]

3031: J Clin Microbiol. 2000 Sep;38(9):3274-9.

Comprehensive PCR-based assay for detection and species identification of human
herpesviruses.

Johnson G, Nelson S, Petric M, Tellier R.

Department of Paediatric Laboratory Medicine, The Hospital for Sick Children,
Toronto, Ontario, Canada.

The description and evaluation of a PCR-based assay for the detection and species
identification of the eight known human herpesviruses are presented. Two primer
pairs targeting well-conserved regions of the genome allowed the amplification of
the DNAs of all known human herpesviruses at a high level of sensitivity (10 to
100 genome copies for most viruses). Identification of the virus species was
achieved through restriction enzyme digestion with BamHI and BstUI, which yielded
fragment sizes that were characteristic for each herpesvirus. Furthermore, it was
demonstrated that this restriction enzyme panel allowed the discrimination
between human herpesvirus 6 variant A and variant B. This assay format was
validated over the course of 1 year in a clinical virology laboratory setting,
where it was shown that it readily detected human herpesviruses, including
occasional multiple infections, in a variety of clinical samples. The PCR assay
was compared to isolation and electron microscopy for the detection of herpes
simplex (HSV) and varicella-zoster virus (VZV) in clinical samples. All specimens
positive by conventional methods were also positive by PCR. However, in a number 
of clinical specimens in which HSV or VZV could not be detected by conventional
methods, PCR was able to demonstrate the presence of the virus.

Publication Types: 
    Evaluation Studies
    Research Support, Non-U.S. Gov't

PMID: 10970370 [PubMed - indexed for MEDLINE]

3032: J Clin Microbiol. 2000 Sep;38(9):3187-9.

Diagnosis of varicella-zoster virus infections in the clinical laboratory by
LightCycler PCR.

Espy MJ, Teo R, Ross TK, Svien KA, Wold AD, Uhl JR, Smith TF.

Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.

Varicella-zoster virus (VZV) causes vesicular dermal lesions which are clinically
evident as varicella (primary infection) or zoster (reactivated) diseases. The
LightCycler system (Roche Molecular Biochemicals) is a newly developed
commercially available system designed to rapidly perform PCR with real-time
detection of PCR products using a fluorescence resonance energy transfer. We
compared the detection of VZV from dermal specimens by shell vial cell culture
(MRC-5) and by LightCycler PCR. Of 253 specimens, VZV was detected in 23 (9.1%)
by shell vial cell cultures and 44 (17.4%) by LightCycler PCR directed to a
nucleic acid target sequence in gene 28. Twenty-one of 44 (47.7%) specimens were 
exclusively positive by LightCycler PCR; the shell vial cell culture assay was
never positive when DNA amplification was negative (specificity, 100%). VZV DNA
was detected in 39 of 44 (88.6%) specimens positive during cycles 10 through 30
of the LightCycler PCR. These VZV DNA-positive specimens (cycles 10 to 30) and 5 
of 11 other PCR positive specimens (cycles 31 to 36) were confirmed by another
LightCycler PCR directed to another (gene 29) target of the viral genome. For
routine laboratory practice, all specimens yielding amplified DNA to the VZV gene
28 target can be considered positive results. The increased sensitivity (91%) of 
the LightCycler PCR for detection of VZV, rapid turnaround time for reporting
results, virtual elimination of amplicon carryover contamination, and equivalent 
costs compared to shell vial cell culture for detection of VZV indicate the need 
for implementation of this technology for routine laboratory diagnosis of this
viral infection.

Publication Types: 
    Evaluation Studies

PMID: 10970354 [PubMed - indexed for MEDLINE]

3033: J Clin Microbiol. 2000 Sep;38(9):3156-60.

Improved identification and differentiation of varicella-zoster virus (VZV)
wild-type strains and an attenuated varicella vaccine strain using a VZV open
reading frame 62-based PCR.

Loparev VN, Argaw T, Krause PR, Takayama M, Schmid DS.

Division of Viral and Rickettsial Diseases, National Center for Infectious
Diseases, Centers for Disease Control and Prevention, U.S. Department of Health
and Human Services, Atlanta, Georgia 30333, USA.

A new method was developed to identify and differentiate varicella-zoster virus
(VZV) wild-type strains from the attenuated varicella Oka vaccine strain. The PCR
technique was used to amplify a VZV open reading frame (ORF) 62 region. A single 
specific amplicon of 268 bp was obtained from 71 VZV clinical isolates and
several laboratory strains. Subsequent digestion of the VZV ORF 62 amplicons with
SmaI enabled accurate strain differentiation (three SmaI sites were present in
amplicons of vaccine strain VZV, compared with two enzyme cleavage sites for all 
other VZV strains tested). This method accurately differentiated the Oka vaccine 
strain from wild-type VZV strains circulating in countries representing all six
populated continents. Moreover, the assay more reliably distinguished wild-type
Japanese strains from the vaccine strain than did previously described methods.

Publication Types: 
    Evaluation Studies

PMID: 10970349 [PubMed - indexed for MEDLINE]

3034: J Formos Med Assoc. 2000 Aug;99(8):659-62.

Home-based patient-controlled epidural analgesia with bupivacaine for patients
with intractable herpetic neuralgia.

Tsai YC, Wang LK, Chen BS, Chen HP.

Department of Anesthesia, Medical College and Hospital, National Cheng Kung
University, Tainan, Taiwan.

This clinical report is based on retrospective observation of the outcome and
effects of patient-controlled epidural analgesia (PCEA) with bupivacaine infusion
administered at home to five patients with intractable herpetic neuralgia. All
patients had severe pain (9 or 10 visual analogue scale [VAS]points) confined to 
the affected dermatomes, which was refractory to medication. The interval between
zoster onset and PCEA application ranged from 27 to 60 days (mean, 37.2 d). The
average daily amount of bupivacaine used was 36.5 to 91.2 mg (mean +/- standard
deviation, 62.4 +/- 19.7 mg). The duration of PCEA therapy ranged from 10 to 28
days (18.4 +/- 7.6 d). One patient developed drug tolerance. All treatments
resulted in effective and satisfactory pain relief (VAS, 0-3), with increase in
physical activities to normal levels and easing of sleep and appetite impairment.
No deleterious effects were found during PCEA therapy. After discontinuation of
PCEA, two patients did not complain of pain but still had slight paresthesia, one
of them required low-dose antidepressant for 17 days; three patients continued to
have occasional sharp pain (VAS, 2-3) and required low-dose antidepressant and
analgesic as-needed for one to six months. These results suggest that PCEA with
bupivacaine infusion provides effective pain relief in patients with intractable 
herpetic neuralgia and is a feasible and effective home treatment modality with
limited side effects.

PMID: 10969513 [PubMed - indexed for MEDLINE]

3035: Harv Womens Health Watch. 2000 Sep;8(1):5.

Shingles vaccine trial underway.

[No authors listed]

PMID: 10966601 [PubMed - indexed for MEDLINE]

3036: Virology. 2000 Sep 1;274(2):420-8.

Sequence analysis of the leftward end of simian varicella virus (EcoRI-I
fragment) reveals the presence of an 8-bp repeat flanking the unique long segment
and an 881-bp open-reading frame that is absent in the varicella zoster virus
genome.

Mahalingam R, White T, Wellish M, Gilden DH, Soike K, Gray WL.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
Colorado 80262, USA. ravi.mahalingam@UCHSC.edu

Simian varicella virus (SVV) causes varicella (chickenpox) in nonhuman primates, 
becomes latent in cranial and dorsal root ganglia, and reactivates to produce
zoster (shingles). Because the clinical and molecular features of SVV closely
resemble those of varicella zoster virus (VZV) infection of humans, SVV infection
of primates has served as an experimental model of VZV pathogenesis and latency. 
The SVV genome has been completely mapped, but attempts to clone the 3600-bp
EcoRI fragment located at the leftward end of the virus genome have hitherto been
unsuccessful. Herein, we report the cloning and the complete nucleotide sequence 
of this region. Comparison of the SVV and VZV sequences in this region revealed
an 8-bp inverted repeat sequence flanking the unique long segment of the SVV
genome; an 879-bp open-reading frame (ORF) A in SVV that is absent in VZV but has
42% amino acid identity to SVV ORF 4 and 49% to VZV ORF 4; a 342-bp ORF B in SVV 
with 35% amino acid identity to a 387-bp ORF located to the left of ORF 1 on the 
VZV genome; and a 303-bp ORF in SVV with 27% amino acid identity to VZV ORF 1. No
homologue of VZV ORF 2 was detected. Transcripts specific for ORFs A and B were
present in SVV-infected cells in culture and in acutely infected monkey ganglia. 
Overall, there are more than 2000 bp of DNA in the SVV genome that are absent in 
the VZV genome. Copyright 2000 Academic Press.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 10964784 [PubMed - indexed for MEDLINE]

3037: J Urol. 2000 Sep;164(3 Pt 2):1074-5.

Oral cimetidine for the management of genital and perigenital warts in children.

Franco I.

Section of Pediatric Urology, Department of Urology, New York Medical College,
Valhalla, New York, USA.

PURPOSE: It is believed that most warts are self-limiting and generally require
little or no treatment. When numerous or almost complete infestation of the
perineum, genital area and groin is encountered it can be distressing and a
difficult problem to treat in children. Multiple treatments with caustic agents
are sometimes necessary, and treatment of perigenital warts may require use of
anesthesia for multiple procedures. Cimetidine is a histamine receptor antagonist
that has been used mainly to treat peptic ulcer disease. Recently it has been
reported to be useful for the treatment of mucocutaneous candidiasis, herpes
simplex, herpes zoster and verruca because of its immunomodulatory effects.
Several studies have been published indicating its effectiveness in the treatment
of warts. MATERIALS AND METHODS: We treated 4 children with extensive condylomata
acuminata of the genital and perigenital areas with high doses of cimetidine in
an attempt to eradicate the condyloma and avoid recurrence in 2 and as primary
treatment in 2. All patients were treated with 30 to 40 mg./kg. cimetidine daily 
in 3 divided doses during a 3-month period. RESULTS: All patients are free of
condyloma at 24 months following treatment. CONCLUSIONS: Our results show that
cimetidine is useful for primary and adjunctive treatment of condyloma in young
children. It also appears to be effective as first line therapy.

PMID: 10958744 [PubMed - indexed for MEDLINE]

3038: Clin Ter. 2000 May-Jun;151(3):177-8.

[Some light at the end of the tunnel in the prevention and treatment of herpetic 
neuritis]

[Article in Italian]

Navazio F.

Dipartimento di biologia molecolare, Universita della California, Berkeley
94720-3200, USA.

PMID: 10958051 [PubMed - indexed for MEDLINE]

3039: Eur J Pain. 2000;4(2):221.

Re: Headley, PM "NMDA antagonists: unequal to the task or unequal to each
other--or both?".

Eisenberg E, Kleiser A, Dortort A, Haim T, Yarnitsky D.

Publication Types: 
    Letter

PMID: 10957703 [PubMed - indexed for MEDLINE]

3040: Neuroradiology. 2000 Jul;42(7):526-8.

MRI in human immunodeficiency virus-associated cerebral vasculitis.

Berkefeld J, Enzensberger W, Lanfermann H.

Institut fur Neuroradiologie, Klinikum der Johann-Wolfgang-Goethe Universitat,
Frankfurt am Main, Germany. Berkefeld@em.uni-frankfurt.de

Cerebral ischaemia caused by inflammatory vasculopathies has been described as
complication of human immunodeficiency virus (HIV) infection. Imaging studies
have shown ischaemic lesions and changes of the vascular lumen, but did not allow
demonstration of abnormalities within the vessel wall itself. Two HIV-infected
men presented with symptoms of a transient ischaemic attack. Initial MRI of the
first showed no infarct; in the second two small lacunar lesions were detected.
In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed
aneurysmal dilatation, with thickening and contrast enhancement of the wall of
the internal carotid and middle cerebral (MCA) arteries. These findings were
interpreted as indicating cerebral vasculitis. In the first patient the
vasculopathy progressed to carotid artery occlusion, and he developed an infarct 
in the MCA territory, but then remained neurologically stable. In the second
patient varicella zoster virus (VZV) infection was the probable cause of
vasculitis. The clinical deficits and vasculitic MRI changes regressed with
antiviral and immunosuppressive therapy.

Publication Types: 
    Case Reports

PMID: 10952187 [PubMed - indexed for MEDLINE]

3041: Retina. 2000;20(4):389-93.

Absence of herpesvirus DNA by polymerase chain reaction in ocular fluids obtained
from immunocompetent patients.

Pendergast SD, Werner J, Drevon A, Wiedbrauk DL.

Retina Associates of Cleveland, Inc., Beachwood, Ohio, USA.

OBJECTIVE: To assess the prevalence of herpesvirus DNA in ocular fluids obtained 
from healthy patients undergoing vitreoretinal surgery. BACKGROUND: Polymerase
chain reaction (PCR) has been used to detect herpesvirus DNA in patients with
acute retinal necrosis and cytomegalovirus retinitis. Little is known regarding
the prevalence of detectable herpesvirus DNA in ocular fluids collected from
healthy seropositive patients with no clinical evidence of viral retinitis.
METHODS: Seventy-five intraocular specimens (35 aqueous and 40 vitreous samples) 
were collected from 75 patients undergoing scleral buckling or vitrectomy. Using 
a PCR-based assay, the authors tested each specimen for the presence of
herpesvirus genome DNA with primers specific for cytomegalovirus, Epstein-Barr
virus, herpes simplex virus types 1 and 2, and varicella zoster virus. Serologic 
testing for immunoglobulin G (IgG) and IgM levels corresponding to each of the
herpesviruses was also performed. RESULTS: Of the 75 samples tested, none was
found to harbor herpesvirus DNA. The assay did not give false-positive results in
patients with active intraocular inflammation. The sensitivity of the assay was
0.08 infection-forming units for cytomegalovirus, 0.6 tissue culture infectious
doses for herpes simplex virus, 0.5 infected-cell equivalents for Epstein-Barr
virus, and 0.03 focus-forming units for varicella zoster virus. The percentage of
patients with positive herpesvirus serology ranged from 86% to 100% and was
consistent with rates observed in the general population. CONCLUSIONS: The
prevalence of herpesvirus DNA detectable by PCR techniques in ocular fluids
appears to be quite low despite the high proportion of patients who tested
positive for herpesvirus antibodies. Therefore, a positive result obtained in a
patient presenting with vitreoretinal inflammation should be regarded as
significant.

Publication Types: 
    Comparative Study

PMID: 10950418 [PubMed - indexed for MEDLINE]

3042: Mol Med. 2000 Apr;6(4):332-41.

Transfer factors: identification of conserved sequences in transfer factor
molecules.

Kirkpatrick CH.

Department of Medicine, University of Colorado Health Sciences Center, Denver,
USA.

BACKGROUND: Transfer factors are small proteins that "transfer" the ability to
express cell-mediated immunity from immune donors to non-immune recipients. We
developed a process for purifying specific transfer factors to apparent
homogeneity. This allowed us to separate individual transfer factors from
mixtures containing several transfer factors and to demonstrate the
antigen-specificity of transfer factors. Transfer factors have been shown to be
an effective means for correction of deficient cellular immunity in patients with
opportunistic infections, such as candidiasis or recurrent Herpes simplex and to 
provide prophylactic immunity against varicella-zoster in patients with acute
leukemia. MATERIALS AND METHODS: Transfer factors of bovine and murine origin
were purified by affinity chromatography and high performance liquid
chromatography. Cyanogen bromide digests were sequenced. The properties of an
apparently conserved sequence on expression of delayed-type hypersensitivity by
transfer factor recipients were assessed. RESULTS: A novel amino acid sequence,
LLYAQDL/VEDN, was identified in each of seven transfer factor preparations. These
peptides would not transfer expression of delayed-type hypersensitivity to
recipients, which indicates that they are not sufficient for expression of the
specificity or immunological properties of native transfer factors. However,
administration of the peptides to recipients of native transfer factors blocked
expression of delayed-type hypersensitivity by the recipients. The peptides were 
not immunosuppressive. CONCLUSIONS: These findings suggest that the peptides may 
represent the portion of transfer factors that binds to the "target cells" for
transfer factors. Identification of these cells will be helpful in defining the
mechanisms of action of transfer factors.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10949913 [PubMed - indexed for MEDLINE]

3043: Klin Monatsbl Augenheilkd. 2000 Jul;217(1):37-42.

[Polymerase chain reaction (PCR) for microbiological diagnosis in refractory
infectious keratitis: a clinical study in 16 patients]

[Article in German]

Lohmann CP, Winkler von Mohrenfels C, Gabler B, Reischl U, Kochanowski B.

Augenklinik, Universitat Regensburg. chris.lohmann@klinik.uni-regensburg.de

BACKGROUND: The identification of the causative pathogen in infectious keratitis 
is possible in only 60% of the cases. The aim of this study was to show if this
number increases by the use of PCR. PATIENTS AND METHODS: In a series of 16 eyes 
with infectious keratitis corneal specimens were collected for culture and PCR.
Serology (HSV, VZV, and Borrelia) was performed in all eyes, with exception of
the 4 eyes presenting an acute form of keratitis, which obviously was bacterial
origin. RESULTS: In all 4 cases of acute keratitis the causative pathogen
(Pseudomonas aeruginosa) was detected by both culture and PCR. Of the remaining
12 eyes PCR was capable to identify the causative pathogen in 11 eyes. In 3 eyes 
herpes simplex virus was detected, in 3 eyes Moraxella catharalis, in 2 eyes
Borrelia burgdorferii, in 2 eyes varizella zoster virus, and in 1 eye Bartonella 
henselae. Culture was positive in only 2 eyes, infected by Moraxella catharalis. 
CONCLUSIONS: PCR is a useful supplement in the microbiological diagnostic of
infectious keratitis, in particular if only a small amount of pathogens are
available (non-acute form) or if the eye has been treated by antibiotics prior to
the microbiological diagnostic.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract

PMID: 10949815 [PubMed - indexed for MEDLINE]

3044: Clin Exp Rheumatol. 2000 Jul-Aug;18(4):541-2.

Microscopic perineuritis. An unexpected finding of post-herpetic neuralgia in a
temporal artery biopsy.

Hernandez-Rodriguez J, Cid MC, Grau JM.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't

PMID: 10949744 [PubMed - indexed for MEDLINE]

3045: Am J Nurs. 2000 Aug;100(8):25.

The HIV floor. On a student nursing rotation.

Davis M.

Yale University School of Nursing, New Haven, CT, USA.

Publication Types: 
    Case Reports

PMID: 10949566 [PubMed - indexed for MEDLINE]

3046: Acta Neurol Scand. 2000 Aug;102(2):94-8.

Apolipoprotein E (APOE) phenotype and APOE concentrations in multiple sclerosis
and acute herpes zoster.

Pirttila T, Haanpaa M, Mehta PD, Lehtimaki T.

Institute for Basic Research in Developmental Disabilities, Staten Island, NY,
USA. tuula.pirttila@kuh.fi

OBJECTIVES: There are three major isoforms of apolipoprotein E (apoE), namely
apoE2, apoE3, and apoE4, that are products of three alleles
(epsilon2,epsilon3,epsilon4) at a single gene locus on chromosome 19. It is well 
known that the presence of apoE4 increases the risk for the development of
Alzheimer's disease and atherosclerosis. The aim of the study was to examine if
apoE polymorphism or apoE levels contribute to the severity of the disease in
patients with multiple sclerosis or the outcome of nerve damage in patients with 
herpes zoster infection. MATERIAL AND METHODS: We examined apoE phenotype of 105 
MS patients and 41 patients with herpes zoster. We also measured serum and
cerebrospinal fluid (CSF) levels of apoE from 93 patients with definite MS using 
enzyme linked immunosorbent assay. RESULTS: There were no differences in apoE
allele frequencies in MS or herpes zoster patients compared to the allele
frequencies of controls. The levels of serum or CSF apoE did not differ from
those of age-matched controls, nor did they correlate with the disease activity. 
CONCLUSION: We conclude that apoE does not contribute to the activity of MS or
the outcome of herpes zoster.

Publication Types: 
    Comparative Study

PMID: 10949525 [PubMed - indexed for MEDLINE]

3047: Pol Arch Med Wewn. 1999 Oct;102(4):893-7.

[Factors causing renal failure in patients with disseminated lupus erythematosus:
description of three cases]

[Article in Polish]

Wanic-Kossowska M, Koziol L, Bajew L, Roszkowiak B, Czekalski S.

Klinika Nefrologii Akademii Medycznej, K. Marcinkowskiego w Poznaniu.

We describe three cases of patients with systemic lupus erythematosus in which
additional infections: mycotic, bacterial and viral deteriorated renal function
and patients needed the dialysis treatment. The patients with autoimmunologic
disorders are very sensitive for different infections which need rapid diagnosis 
and intensive treatment.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10948714 [PubMed - indexed for MEDLINE]

3048: Clin Transplant. 2000 Aug;14(4 Pt 2):413-20.

Analysis of a single-center experience with mycophenolate mofetil based
immunosuppression in renal transplantation.

Triemer HL, Pearson TC, Odom KL, Larsen CP.

Department of Pharmaceutical Services, Emory University Hospital Atlanta, GA,
USA.

PURPOSE: Acute rejection continues to be a major clinical issue in renal
transplantation. Three large multicenter trials have demonstrated a 50% decline
in biopsy-proven rejection when mycophenolate mofetil (MMF) was given to renal
transplant recipients with corticosteroids and cyclosporine. The purpose of this 
study was to compare the 6-month outcome of renal transplant recipients using MMF
and non-MMF based immunosuppression protocols over a 4-year period at a single
center. METHODS: This retrospective study analyzed three patient groups defined
by their immunosuppression protocol. The first group included patients who
received a quadruple immunosuppression regimen of anti-lymphocyte induction
(ATG), cyclosporine (CYA), azathioprine (AZA), and corticosteroids (CCS), and
were transplanted between October 1993 and May 1995 (AZA group). The second group
included patients who received a triple immunosuppression regimen of CYA, MMF,
and CCS, and were transplanted between June 1995 and May 1996 (MMF group). The
third group included patients who were transplanted between January 1997 and
December 1997, and received an immunosuppression regimen of CYA and MMF with a
reduced CCS dosing schema (reduced steroid group (RST)). Data were collected from
a retrospective review of inpatient and outpatient clinical records. RESULTS: A
total of 325 patients were included in the study (106 AZA, 106 MMF, 113 RST). The
demographic characteristics of the three groups were similar; however, the mean
donor age for the AZA group was 40+/-15.1 years versus 33+/-14.1 years and
34+/-13.1 years for the MMF and RST groups, respectively (p<0.043). The incidence
of acute, biopsy-proven rejection at 6 months was significantly less in the MMF
group when compared with the AZA group [16 (15.1%) versus 35 (33%) patients, p = 
0.002]. However, the incidence of acute, biopsy-proven rejection in the RST group
(35 patients, 31%) was similar to that of the AZA group. Kaplan-Meier estimates
for the cumulative incidence of acute rejection demonstrated a significant
difference between the MMF group and the other two groups (p = 0.0059). The AZA
group had more severe rejection as demonstrated by the more frequent use of
antilymphocyte therapy for rejection treatment (68.4% episodes) compared with the
MMF (38.9%) and RST (47.6%) groups. After 6 months of follow-up, 11 patients had 
lost their grafts (8, AZA; 1, MMF; 2, RST). One patient died in each of the AZA
and RST groups due to hemorrhage and a pulmonary embolus, respectively. Four AZA 
patients were diagnosed with a malignancy (three post-transplant
lymphoproliferative disorder, one squamous skin cell carcinoma) compared with 2
MMF patients (prostate cancer, basal skin cell carcinoma) and no RST patients.
Herpes zoster was the only infection that occurred more frequently in the MMF
group (p = 0.03). No other differences in infection rates were noted among the
three groups. The initial length of hospital stay declined significantly over the
4-year study period [11+/-4.3 d (AZA), 7.0+/-4.0 d (MMF), 6.2+/-3.3 d (RST),
p<0.001]. Total number of hospital days for the first 6 months also followed a
similar declining pattern. Despite using intravenous cyclosporine immediately
post-transplant in the MMF and RST groups, the incidence of delayed graft
function was similar among the three groups. Average serum creatinine at 1 month 
was significantly lower in the MMF group (p = 0.008), but no difference was noted
at 3 and 6 months when compared with the AZA and RST groups. CONCLUSION: This
retrospective analysis indicates that MMF is an effective immunosuppressant.
Decreased length of stay and less steroid resistant rejections with MMF is
favorable for decreased hospital costs. However, the rebound in rejection rate
with the RST group suggests that further study is needed to define the optimal
use of this agent in combination with others to maximize effectiveness and
minimize negative side effects.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10946781 [PubMed - indexed for MEDLINE]

3049: Paediatr Drugs. 2000 Jul-Aug;2(4):291-7.

Varicella zoster infection in HIV-infected children.

Rongkavilit C, Mitchell CD, Nachman S.

Division of Pediatric Infectious Diseases, University of Miami School of
Medicine, Florida, USA.

Publication Types: 
    Case Reports

PMID: 10946417 [PubMed - indexed for MEDLINE]

3050: J Pain Symptom Manage. 2000 Jul;20(1):50-8.

Allodynia and pinprick hypesthesia in acute herpes zoster, and the development of
postherpetic neuralgia.

Haanpaa M, Laippala P, Nurmikko T.

Department of Neurology, University of Tampere, Tampere, Finland.

Sensory loss and allodynia are hallmark signs of postherpetic neuralgia (PHN). We
set out to investigate how frequently these signs are present in patients with
acute herpes zoster (HZ) and what their prognostic value might be. We assessed
pain, mechanical allodynia, and sensitivity to pinprick in 113 immunocompetent
patients with HZ of a median duration of 5 days. Follow-up visits took place at 2
weeks, 6 weeks, 3 months, and 6 months. When first seen, 87 (77%) patients
reported ongoing pain and 48/107 (45%) had allodynia. Twenty-eight (25%) patients
had pain at 3 months (and were considered to have developed PHN), while 14 (12%) 
patients had pain at 6 months. Allodynia tended to subside quickly in most
patients. Reduced sensitivity to pinprick was less common. Mechanical allodynia
and pinprick hypesthesia were strongly associated with the development of PHN.
They merit addition to the list of potential risk factors for PHN although they
cannot be used as a predictive rule for an individual patient. By contrast, lack 
of allodynia in the early stages of HZ predicts good recovery by three months.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 10946169 [PubMed - indexed for MEDLINE]

3051: Med J Malaysia. 2000 Jun;55(2):14-20.

Outcome of 85 lupus nephritis patients treated with intravenous cyclophosphamide:
a single centre 10 year experience.

Chan AY, Hooi LS.

Department of Medicine, Hospital Sultanah Aminah, Johor Bahru.

Retrospective analysis was done on 85 patients (76 female, 9 male) with lupus
nephritis who started intravenous cyclophosphamide between 1/1/1989 and
31/12/1998. The initial renal biopsy (World Health Organisation) classification
was III (4.7%), IV (89.4%), and V (5.9%). Average serum creatinine at time of
biopsy was 0.12 +/- 0.12 mmol/l. Median duration of nephritis before biopsy was 2
months (range 0-133). Median duration of follow-up from time of biopsy to outcome
(death or end-stage renal failure) was 3.3 years (range 0.3-11.8). Nineteen
patients died. The calculated proportion alive at 5 years was 75% and at 10 years
64%. The calculated proportion alive with renal function was 74% and 54% at 5 and
10 years respectively. Fifty-two patients completed cyclophosphamide therapy at
the end of the study. There were ten episodes of herpes zoster, the most common
infection seen. No malignancy was reported.

PMID: 10944896 [PubMed - indexed for MEDLINE]

3052: Dermatol Clin. 2000 Jul;18(3):497-508, x.

Cutaneous (non-HIV) infections.

Callahan EF, Adal KA, Tomecki KJ.

Department of Dermatology, Cleveland Clinic Foundation, Ohio, USA.

Cutaneous infections continue to represent a large proportion of inpatient
dermatology. Though most infectious skin diseases do not warrant hospitalization,
some do and can rapidly become fatal if not treated promptly. A selected group of
infections are reviewed--primary cutaneous infections, exotoxin-mediated
syndromes, and systemic infections--that warrant hospitalization. Dermatologists 
play a critical role in the synthesis of patient history and appreciation of
morphologic skin disease, which, when coupled with appropriate lab tests, may
help to establish a diagnosis allowing for the timely implementation of effective
and targeted therapy.

Publication Types: 
    Case Reports
    Review

PMID: 10943544 [PubMed - indexed for MEDLINE]

3053: Clin Orthop Relat Res. 2000 Aug;(377):112-8.

Zoster paresis of the shoulder. Case report and review of the literature.

Yaszay B, Jablecki CK, Safran MR.

Stanford University School of Medicine, CA, USA.

More than 95% of people in the United States are infected with the varicella
zoster virus at some time in life, and this infection usually is manifested as
chicken pox during childhood. The virus then establishes a latent infection of
sensory ganglia, from which it may reactivate many years later to cause herpes
zoster (shingles), a cutaneous painful rash along a dermatomal distribution. Less
commonly, the varicella zoster virus may result in myotomal motor weakness or
paralysis in addition to a painful dermatomal rash. A case of unilateral left
C5-C6 segmental paresis attributable to herpes zoster in an otherwise healthy
individual and a current review of the literature are presented. A case of zoster
paresis of the shoulder muscles is presented to remind the orthopaedic community 
that this diagnosis may be confused with other diagnoses, including rotator cuff 
tear, and should be considered in the differential diagnosis of shoulder pain and
shoulder girdle muscle weakness.

Publication Types: 
    Case Reports
    Review

PMID: 10943192 [PubMed - indexed for MEDLINE]

3054: Haematologica. 2000 Aug;85(8):894-5.

Fatal visceral varicella-zoster infection following rituximab and chemotherapy
treatment in a patient with follicular lymphoma.

Bermudez A, Marco F, Conde E, Mazo E, Recio M, Zubizarreta A.

Publication Types: 
    Case Reports
    Letter

PMID: 10942955 [PubMed - indexed for MEDLINE]

3055: Ann Neurol. 2000 Aug;48(2):254-6.

Ramsay Hunt syndrome in children.

Hato N, Kisaki H, Honda N, Gyo K, Murakami S, Yanagihara N.

Department of Otolaryngology, Ehime University School of Medicine, Onsengun,
Japan.

In a retrospective study, 52 children were diagnosed with Ramsay Hunt syndrome.
The facial palsy was milder and complete recovery of the function was achieved in
78.6% of patients. Associated cranial neuropathies were less common in children
than in adults. The timing of vesicle appearance tended to be delayed in
children. In preschool children, Ramsay Hunt syndrome was rare, although the
frequency has recently increased. The syndrome is relatively common in older
children. This study suggested that vaccination can prevent or reduce the
occurrence of Ramsay Hunt syndrome.

PMID: 10939578 [PubMed - indexed for MEDLINE]

3056: J Med Virol. 2000 Sep;62(1):46-51.

Low induction of varicella-zoster virus-specific secretory IgA antibody after
vaccination.

Terada K, Niizuma T, Yagi Y, Miyashima H, Kataoka N, Sadahiro T.

Department of Pediatrics, Kawasaki Medical School, Kurashiki, Okayama, Japan.
kihei@med.kawasaki-m.ac.jp

Breakthrough after varicella vaccination occurs in approximately 2. 6%
approximately 18.6% of immunocompetent children, but the reason has not been
demonstrated clearly. As a first defense, specific secretory IgA antibody on the 
mucosa plays an important role in preventing invasion of microorganisms. To
examine induction of varicella-zoster virus (VZV) specific secretory IgA after
natural infection and vaccination and its booster mechanisms, 143 salivary
samples were tested by ELISA. The VZV-secretory IgA values were significantly
higher in the matched children after natural chickenpox than in those after
vaccination, although the total secretory IgA did not differ between them. Two
(7%) of the vaccinees lacked the sIgA antibody. In the elderly and in
immunocompromised children, the VZV-secretory IgA values were no lower than those
in healthy children, and they did not lack VZV-secretory IgA. The doctors and
nurses taking care of patients with chickenpox had higher values than the other
groups as did individuals who had had herpes zoster recently. VZV-secretory IgA
was thought to be stimulated by exogenous and reactivated endogenous VZV to
neutralize VZV with weak activity. These results suggest that low or no induction
of VZV-secretory IgA antibody after vaccination may be one of the possible
explanations for a breakthrough. Copyright 2000 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10935988 [PubMed - indexed for MEDLINE]

3057: J Med Virol. 2000 Sep;62(1):42-5.

Reactivation of varicella-zoster virus in delayed facial palsy after dental
treatment and oro-facial surgery.

Furuta Y, Ohtani F, Fukuda S, Inuyama Y, Nagashima K.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan. yfuruta@med.hokudai.ac.jp

In rare cases, acute peripheral facial palsy occurs several days after dental
treatment and oro-facial surgery. Surgical procedures have been known to trigger 
reactivation of varicella-zoster virus (VZV) and herpes simplex virus type 1
(HSV-1). The present study examined eight patients who exhibited delayed facial
palsy after dental treatment or oro-facial surgery. Ramsay Hunt syndrome was
diagnosed in three patients and varicella-zoster virus (VZV) reactivation without
zoster lesions (zoster sine herpete) was diagnosed in three patients either by
PCR or serological assay. Therefore, VZV reactivation was detected in 75% (6 of
8) of patients who exhibited delayed facial palsy after dental or oro-facial
treatment. The results suggest that VZV reactivation is a major cause of delayed 
facial palsy after dental treatment or oro-facial surgery. Copyright 2000
Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10935987 [PubMed - indexed for MEDLINE]

3058: J Med Virol. 2000 Sep;62(1):37-41.

Rapid strip assay for detection of anti-herpes simplex virus antibodies:
application to prediction of varicella-zoster virus reactivation in patients with
acute peripheral facial palsy.

Ohtani F, Furuta Y, Horal P, Bergstrom T.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan.

Varicella-zoster virus (VZV) reactivation causes acute peripheral facial palsy in
the majority (88%) of patients who lack anti-herpes simplex virus (HSV)
antibodies, suggesting that an absence of anti-HSV antibodies is a reliable
serological marker for the diagnosis of VZV reactivation in patients who are
diagnosed initially as idiopathic peripheral facial palsy (Bell's palsy) [Furuta 
et al., 2000] Clinical Infectious Diseases]. A simple and rapid immunoassay for
detection of anti-HSV antibodies based on HSV type 1 glycoprotein D was developed
by modifying the conventional Western blot technique. The assay was evaluated by 
comparing the results with those of conventional Western blot. In total, 100 sera
obtained from patients with acute peripheral facial palsy were tested and judged 
blindly by two investigators. Twenty-four of 26 HSV-seronegative sera were
obtained from patients with VZV reactivation (Ramsay Hunt syndrome or zoster sine
herpete). The sensitivity of the assay was over 95% and the specificity was 100%.
The two investigators agreed on the diagnosis in 99 of the 100 sera. These
results indicate that the rapid strip assay is applicable to prediction of VZV
reactivation in patients diagnosed clinically with Bell's palsy before zoster
lesions appear or PCR using saliva samples indicates VZV reactivation. Copyright 
2000 Wiley-Liss, Inc.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10935986 [PubMed - indexed for MEDLINE]

3059: Am J Ophthalmol. 2000 Jun;129(6):809-10.

Zoster sine herpete with bilateral ocular involvement.

Nakamura M, Tanabe M, Yamada Y, Azumi A.

Department of Ophthalmology, Kobe University School of Medicine, Kobe, Japan.
mxn15@psu.edu

PURPOSE: To report a case of zoster sine herpete with bilateral ocular
involvement. METHOD: Case report. RESULTS: A 65-year-old man showed bilateral
iridocyclitis with sectoral iris atrophy and elevated intraocular pressure
unresponsive to steroid treatment. No cutaneous eruption was manifest on the
forehead. A target region of varicella-zoster virus DNA sequence was amplified
from the aqueous sample from the left eye by polymerase chain reaction. Bilateral
iridocyclitis resolved promptly after initiation of systemic and topical
acyclovir treatment. Secondary glaucoma was well controlled by bilateral
trabeculectomy. CONCLUSIONS: Zoster sine herpete should be considered and
polymerase chain reaction performed on an aqueous sample to detect
varicella-zoster virus DNA for rapid diagnosis whenever anterior uveitis
accompanies the characteristic iris atrophy, even in the case of bilateral
involvement.

Publication Types: 
    Case Reports

PMID: 10926998 [PubMed - indexed for MEDLINE]

3060: N Engl J Med. 2000 Jul 20;343(3):222-3.

Herpes zoster.

Breton G, Bricaire F, Caumes E.

Publication Types: 
    Letter

PMID: 10928869 [PubMed - indexed for MEDLINE]

3061: N Engl J Med. 2000 Jul 20;343(3):222; author reply 223.

Herpes zoster.

Gershon AA, Perkin RT.

Publication Types: 
    Letter

PMID: 10928868 [PubMed - indexed for MEDLINE]

3062: N Engl J Med. 2000 Jul 20;343(3):221-2; author reply 223.

Herpes zoster.

Dworkin RH, Galer BS, Rowbotham MC.

Publication Types: 
    Letter

PMID: 10928867 [PubMed - indexed for MEDLINE]

3063: N Engl J Med. 2000 Jul 20;343(3):221; author reply 223.

Herpes zoster.

Carver A, Payne R, Foley K.

Publication Types: 
    Letter

PMID: 10928866 [PubMed - indexed for MEDLINE]

3064: Pain. 2000 Aug;87(2):121-9.

The role of sympathetic nerve blocks in herpes zoster and postherpetic neuralgia.

Wu CL, Marsh A, Dworkin RH.

The Johns Hopkins Hospital, Department of Anesthesiology and Critical Care
Medicine, Division of Pain Medicine, 550 N. Broadway, Suite 301, Baltimore, MD
21205, USA. chwu@jhmi.edu

The most common complication of herpes zoster in immunocompetent patients is
postherpetic neuralgia (PHN). Sympathetic blocks have been traditionally used for
patients with herpes zoster and PHN with three different therapeutic goals: pain 
relief during acute herpes zoster, pain relief during PHN, and prevention of PHN 
by treating patients with acute zoster. The role of sympathetic blocks in herpes 
zoster and PHN remains controversial due to methodologic shortcomings in
published studies and the limited current understanding of the role of the
sympathetic nervous system in mediating pain. Current theories of the
pathophysiology of PHN, the role of the sympathetic nervous system in herpes
zoster and PHN, and published studies investigating use of sympathetic nerve
blocks in herpes zoster and PHN are reviewed.

Publication Types: 
    Review

PMID: 10924805 [PubMed - indexed for MEDLINE]

3065: Mayo Clin Proc. 1999 Oct;74(10):983-98.

Varicella zoster viral disease.

Liesegang TJ.

Department of Ophthalmology, Mayo Clinic Jacksonville, FL 32224, USA.

Herpes zoster is cause of considerable morbidity, especially among elderly
patients, with a suggestion of a slight increase in incidence among female
patients. Substantial research on the biology of the varicella zoster virus has
led to advances in our knowledge of the pathophysiology of the disease along with
more successful therapy for the acute episodes of herpes zoster. Ophthalmic
zoster is more common than zoster in other cranial nerves and is associated with 
pronounced suffering. This article reviews the epidemiology, biology, and latency
of herpes zoster, discusses the pathophysiology of the disease, and describes
treatment options with antivirals and corticosteroids. The pathophysiology and
treatment options for postherpetic neuralgia are also addressed. The varicella
vaccine is now available, and initial results suggest that this may lessen the
effect of herpes zoster in the future.

Publication Types: 
    Review

PMID: 10918864 [PubMed - indexed for MEDLINE]

3066: Bone Marrow Transplant. 2000 Jul;26(2):231-3.

Inappropriate antidiuretic hormone secretion, abdominal pain and disseminated
varicella-zoster virus infection: an unusual triad in a patient 6 months post
mini-allogeneic peripheral stem cell transplant for chronic myeloid leukemia.

Szabo F, Horvath N, Seimon S, Hughes T.

Royal Adelaide Hospital, Department of Haematology and Bone Marrow
Transplantation, Australia.

Severe abdominal pain followed by inappropriate antidiuretic hormone secretion
(SIADH) preceding by several days the skin manifestation of varicella-zoster
virus (VZV) infection in an immunocompromised patient is described. This is a
rare presentation of a severe infection described previously only once in a
chronic myeloid leukemia (CML) patient 5 months post allo-BMT during
immunosuppressive treatment with cyclosporin A. This is the first case described 
in the setting of non-myeloablative preparation with fludarabine and melphalan
and followed by donor leukocyte infusion (DLI) 2 and 4 months post allo-BMT. The 
influence of these factors on development of VZV virus infection is discussed. We
also highlight the high incidence and high mortality in VZV infection in
immunocompromised patients as well as the frequent atypical presentation.

Publication Types: 
    Case Reports

PMID: 10918438 [PubMed - indexed for MEDLINE]

3067: Pediatr Infect Dis J. 2000 Jul;19(7):648-53.

Role of varicella-zoster virus in stroke syndromes.

Moriuchi H, Rodriguez W.

Department of Infectious Diseases, Children's National Medical Center,
Washington, DC, USA. hiromori@net.nagasaki-u.ac.jp

Publication Types: 
    Case Reports
    Review

PMID: 10917224 [PubMed - indexed for MEDLINE]

3068: J Clin Microbiol. 2000 Aug;38(8):3061-7.

Diagnostic utility of a multiplex herpesvirus PCR assay performed with
cerebrospinal fluid from human immunodeficiency virus-infected patients with
neurological disorders.

Quereda C, Corral I, Laguna F, Valencia ME, Tenorio A, Echeverria JE, Navas E,
Martin-Davila P, Moreno A, Moreno V, Gonzalez-Lahoz JM, Arribas JR, Guerrero A.

Unidad de Enfermedades Infecciosas, Hospital Ramon y Cajal, 28034-Madrid, Spain. 
cqueredar@hrc.insalud.es

We used a multiplex nested-PCR assay for the simultaneous detection in
cerebrospinal fluid (CSF) of five human herpesviruses (HVs) (cytomegalovirus
[CMV], Epstein-Barr virus [EBV], varicella-zoster virus [VZV], herpes simplex
virus [HSV], and human herpesvirus 6 [HHV-6]) in a clinical evaluation of human
immunodeficiency virus (HIV)-infected patients with neurological disorders. This 
method, which has the advantages of being rapid and economical, would be of
particular interest for the diagnosis of neurological syndromes caused by more
than one HV. We studied 251 CSF samples from 219 patients. HV DNA was
demonstrated in 93 (37%) of the CSF samples (34% of the patients). CMV was the HV
most frequently detected in our patients (25%), while EBV, VZV, HSV, and HHV-6
DNAs were present in significantly fewer cases (7, 4, 3, and 1%, respectively).
When results were compared with the final etiological diagnoses of the patients, 
the multiplex HV PCR showed high specificity for the diagnosis of CMV and VZV
neurological diseases and for cerebral lymphoma (0.95, 0.97, and 0.99,
respectively). The sensitivity of the assay was high for CMV disease (0.87), was 
low for cerebral lymphoma (0.33), and was not evaluable for VZV disease due to
the small number of patients with this diagnosis. Nevertheless, detection of VZV 
DNA had possible diagnostic value in four of the nine cases, and EBV DNA
amplification always predicted the diagnosis of cerebral lymphoma in patients
with cerebral masses. Detection of HSV DNA was frequently associated with CMV
amplification and fatal encephalitis. HHV-6 was not considered to have a
pathogenetic role in the three cases in which it was detected. This multiplex HV 
PCR assay is a specific and clinically useful method for the evaluation of
HIV-infected patients with neurological disorders related to HV.

PMID: 10921978 [PubMed - indexed for MEDLINE]

3069: J Tradit Chin Med. 2000 Mar;20(1):36-7.

Twenty-three cases of postherpetic neuralgia treated by acupuncture.

Wu J, Guo Z.

Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine.

PMID: 10921168 [PubMed - indexed for MEDLINE]

3070: Ophthalmology. 2000 Aug;107(8):1507-11.

Comparison of the efficacy and safety of valaciclovir and acyclovir for the
treatment of herpes zoster ophthalmicus.

Colin J, Prisant O, Cochener B, Lescale O, Rolland B, Hoang-Xuan T.

Department of Ophthalmology, Hospital Morvan, Brest, France.

OBJECTIVE: To compare the efficacy and safety of valaciclovir and acyclovir in
immunocompetent patients with herpes zoster ophthalmicus. DESIGN: A multicenter, 
randomized, double-masked study. PARTICIPANTS: One hundred ten immunocompetent
patients with herpes zoster ophthalmicus diagnosed within 72 hours of skin
eruption were treated; 56 were allocated to the valaciclovir group and 54 to the 
acyclovir group. METHODS: Patients randomized to the valaciclovir group received 
two 500-mg tablets of valaciclovir three times daily and one tablet of placebo
twice daily. Patients in the acyclovir group received one 800-mg tablet of
acyclovir five times daily and one tablet of placebo three times daily for 7
days. MAIN OUTCOME MEASURES: Main outcome measures included the frequency,
severity, and duration of ocular complications, patient reports of
zoster-associated pain, and the outcome of skin lesions. Tolerance was also
assessed on the incidence and types of adverse effects and changes in laboratory 
parameters. The analysis was mainly descriptive and performed on an
intent-to-treat basis. RESULTS: Ocular complications of herpes zoster
ophthalmicus were similar in the valaciclovir and acyclovir treatment groups. The
main complications were conjunctivitis (54% and 52%, respectively), superficial
keratitis (39% and 48%, respectively for punctate keratitis; 11% in each group
for dendritic keratitis), stromal keratitis (13% in each group), and uveitis (13%
and 17%, respectively). The long-term outcomes of these ocular complications were
favorable and similar in both treatment groups. Pain duration and severity and
outcome of skin lesions were similar between groups. Most patients reported
prodromal pain. After 1 month, 25% of patients in the valaciclovir group and 31% 
in the acyclovir group still reported pain. The percentage of patients
experiencing postherpetic neuralgia decreased during follow-up. The tolerance to 
acyclovir and valaciclovir was comparable and considered good. The most frequent 
adverse events were vomiting and edema of the eyelids or face (3%-5%). Three
serious adverse events not linked to the study drugs occurred. CONCLUSIONS:
Valaciclovir is as effective as acyclovir in preventing ocular complications of
herpes zoster ophthalmicus, including conjunctivitis, superficial and stromal
keratitis, and pain. Tolerability of the two drugs is similar, but the dosing
schedule of valaciclovir is simpler.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 10919899 [PubMed - indexed for MEDLINE]

3071: Harefuah. 1999 Feb 15;136(4):278-80, 339.

[Ramsay Hunt syndrome--differential diagnosis, pathogenesis and therapy]

[Article in Hebrew]

Aframian D, Ben-Oliel R, Sharav Y.

Dept. of Oral Diagnosis, Hebrew University-Hadassah School of Dental Medicine,
Jerusalem.

Ramsay Hunt syndrome is caused by infection of the geniculate ganglion of the
seventh cranial nerve by varicella-zoster virus. A case in an 82-year-old woman
is described. She presented with oral lesions, right facial palsy and an eruption
and pain in her right ear. Oral examination revealed small circumscribed erosions
on the right anterior two-thirds of the tongue, with loss of taste. There were
also lesions on her right palate. Early diagnosis and treatment are important as 
immediate treatment is more likely to prevent irreversible complications
affecting the facial and other cranial nerves involved.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10914218 [PubMed - indexed for MEDLINE]

3072: J R Soc Med. 2000 Jun;93(6):334-5.

Comment on:
    J R Soc Med. 2000 Apr;93(4):191-2.

Pain management in herpes zoster ophthalmicus.

Dahlmann A.

Publication Types: 
    Comment
    Letter

PMID: 10911838 [PubMed - indexed for MEDLINE]

3073: Br J Ophthalmol. 2000 Aug;84(8):826-33.

Amniotic membrane transplantation for severe neurotrophic corneal ulcers.

Chen HJ, Pires RT, Tseng SC.

Ocular Surface and Tear Center, Department of Ophthalmology, Bascom Palmer Eye
Institute, Miami, Florida, USA.

AIMS: To evaluate whether amniotic membrane transplantation can be an effective
alternative treatment for neurotrophic corneal ulcers. METHODS: Amniotic membrane
transplantation was performed in 16 eyes of 15 patients with neurotrophic corneal
ulcers and vision equal to or worse than 20/200. The neurotrophic state was
developed following keratoplasty (four eyes), herpes zoster ophthalmicus (four
eyes), diabetes mellitus (four eyes), radiation (two eyes), removal of acoustic
neuroma with neuroparalysis (one eye), and herpes simplex keratitis (one eye).
RESULTS: During a mean follow up period of 18.8 (SD 13.0) months, one to three
layers of amniotic membrane with or without additional membrane as a patch were
used for 17 procedures in 16 eyes for persistent neurotrophic corneal ulcers. All
but four (76.4%) instances of amniotic membrane transplantation achieved rapid
epithelialisation in 16.6 (9.0) days. Of the four eyes showing delayed healing,
three eyes healed by tarsorrhaphy, and the remaining one eye with corneal
perforation required penetrating keratoplasty and tarsorrhaphy. Two eyes gained
vision better than 20/200. The healed corneal surface was accompanied by reduced 
inflammation. CONCLUSION: Amniotic membrane transplantation can be considered an 
effective alternative for treating severe neurotrophic corneal ulcers.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10906085 [PubMed - indexed for MEDLINE]

3074: Antivir Chem Chemother. 2000 May;11(3):191-202.

Synthesis and enantioselectivity of the antiviral effects of
(R,Z)-,(S,Z)-methylenecyclopropane analogues of purine nucleosides and
phosphoralaninate prodrugs: influence of heterocyclic base, type of virus and
host cells.

Qiu YL, Geiser F, Kira T, Gullen E, Cheng YC, Ptak RG, Breitenbach JM, Drach JC, 
Hartline CB, Kern ER, Zemlicka J.

Department of Chemistry, Barbara Ann Karmanos Cancer Institute, Wayne State
University School of Medicine, Detroit, Mich., USA.

A series of R and S enantiomers of 2-aminopurine methylenecyclopropane analogues 
of nucleosides was synthesized. Two diastereoisomeric lipophilic phosphate
prodrugs derived from R and S enantiomers of 2,6-diaminopurine analogue were also
prepared. Enantioselectivity (diastereoselectivity in case of prodrugs) of in
vitro antiviral effects was investigated with human and murine cytomegalovirus
(HCMV and MCMV, respectively), herpes simplex virus types 1 and 2 (HSV-1 and
HSV-2, respectively), human immunodeficiency virus type 1 (HIV-1), hepatitis B
virus (HBV), Epstein-Barr virus (EBV) and varicella zoster virus (VZV). Strong
differences in enantioselectivity were found between the R and S enantiomers of
adenine analogue and enantiomeric 2-aminopurine analogues. Thus, the enantiomers 
of adenine analogue were equipotent against HCMV but not MCMV, where the S
enantiomer is strongly preferred. The same S preference was found throughout the 
2-aminopurine series for both HCMV and MCMV. In contrast, R-synadenol in HIV-1
assays was the best agent, whereas the S enantiomers of moderately effective
2-amino-6-cyclopropylamino and 2-amino-6-methoxypurine analogues were preferred. 
Little enantiomeric preference was found for R and S enantiomers of synadenol and
the corresponding enantiomers of 2,6-diaminopurine analogue against HBV. A mixed 
pattern of enantioselectivity was observed for EBV depending on the type of host 
cells and assay. Against VZV, the R and S enantiomers of adenine analogue were
equipotent or almost equipotent, but throughout the series of 2-aminopurine
analogues a distinct preference for the S enantiomers was found. The
stereoselectivity pattern of both diastereoisomeric prodrugs mostly followed
enantioselectivity of the parent analogues. The varying enantioselectivities in
the series of purine methylenecyclopropane analogues are probably a consequence
of differences in the mechanisms of action in different virus/host cell systems.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10901290 [PubMed - indexed for MEDLINE]

3075: Zh Nevrol Psikhiatr Im S S Korsakova. 2000;100(6):58-9.

[Neuritis of the facial nerve and its connection with herpes viruses]

[Article in Russian]

Dekonenko EP, Leont'eva IIa, Martynenko IN, Mitrofanova IV, Sokolova MV,
Karavanov AS, Prytkova MI, Sokolova MM, Idrisova ZhR.

PMID: 10900691 [PubMed - indexed for MEDLINE]

3076: Ceylon Med J. 1999 Dec;44(4):177-8.

Neonatal herpes zoster infection.

Jayawardene DR.

Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama,
Sri Lanka.

Publication Types: 
    Case Reports

PMID: 10895271 [PubMed - indexed for MEDLINE]

3077: Indian J Ophthalmol. 1999 Dec;47(4):241-6.

Laboratory investigations on viral and Chlamydia trachomatis infections of the
eye: Sankara Nethralaya experiences.

Madhavan HN.

Vision Research Foundation, Sankara Nethralaya, Chennai, India.
MDSAAA35@giasmd01.vsnl.net.in

PURPOSE: To review our experiences on the laboratory investigations of viral and 
chlamydial conjunctivitis, congenital cataract and acute retinal inflammations
seen from 1990 to 1998 at Sankara Nethralaya, Chennai, India. METHODS:
Conjunctival swabs/scrapings from 1061 patients with conjunctivitis were
investigated. Nested polymerase chain reaction (nPCR) and restriction fragment
length polymorphism (RFLP) techniques were applied on 74 conjunctival swabs
during the 1996 outbreak of acute viral conjunctivitis. The occurrence of Rubella
virus in 86 lens aspirates of congenital cataract was investigated. Tests were
performed for the association of Herpes simplex virus (HSV), Varicella zoster
virus (VZV) and Cytomegalovirus (CMV) with acute retinal inflammation in 32
patients. RESULTS: The causative agents of conjunctivitis were Adenovirus in
13.8%, HSV in 2.2% and C. trachomatis in 20.9% of the patients. Epidemics were
due to Adenovirus type 4 in 1991, type 3 in 1992-93 and type 7a in 1996. PCR was 
37.9% more sensitive in detecting Adenovirus than virological methods. RFLP
identified the conjunctivitis epidemic strain of 1996 as Adenovirus 7a. Rubella
virus was isolated from 8.1% of lens aspirates from congenital cataract. Nineteen
of the 32 patients with acute retinitis had confirmed virus infections (VZV: 8;
HSV: 5; and CMV: 6) and the rapid detection of the virus agent helped institute
specific chemotherapy resulting in useful vision in some patients. CONCLUSION:
Laboratory investigations for diagnosis of viral and C. trachomatis ocular
infections were useful in establishing the aetiology and determining the
incidence of causative agents of specific ocular diseases.

Publication Types: 
    Comparative Study

PMID: 10892481 [PubMed - indexed for MEDLINE]

3078: Rev Neurol (Paris). 2000 Jul;156(6-7):658-60.

[Ischemic cerebral vascular accident and zoster infection]

[Article in French]

Rahmeh F, Labouret P, Attout H, Ziegler F.

Service de Neurologie, Centre Hospitalier de Belfort.

Herpes zoster is uncommonly followed by cerebral infarction. The
pathophysiological mechanism remains uncertain. Outcome is favorable after early 
specific treatment. We report the case of a 70-year-old woman who developed right
hemiparesis with aphasia 15 days after thoracic herpes zoster. The herpes zoster 
induced cerebral vasculitis was hypothesized as no other etiology could be
identified after detailed assessment of the cerebral infarction including brain
MRI and cerebrospinal fluid study, and as the clinical course responded to
antiviral therapy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10891802 [PubMed - indexed for MEDLINE]

3079: J Med Chem. 2000 Jun 29;43(13):2538-46.

Structure-activity relationships of (E)-5-(2-bromovinyl)uracil and related
pyrimidine nucleosides as antiviral agents for herpes viruses.

Choi Y, Li L, Grill S, Gullen E, Lee CS, Gumina G, Tsujii E, Cheng YC, Chu CK.

Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, The
University of Georgia, Athens 30602-2352, USA.

A series of (E)-5-(2-bromovinyl)uracil analogues and related nucleosides was
synthesized, and their antiviral activities were evaluated.
(E)-5-(2-Bromovinyl)-2'-deoxy-L-uridine (L-BVDU, 2),
1-(beta-L-arabinofuranosyl)-(E)-5-(2-bromovinyl)uracil (L-BVAU, 4),
(E)-5-(2-bromovinyl)-1-(2-deoxy-2-fluoro-beta-L-ribofuranosyl)uracil (L-FBVRU, 8)
and (E)-5-(2-bromovinyl)-1-(2-deoxy-2-fluoro-beta-L-arabinofuranosyl)urac il
(L-FBVAU, 10) were synthesized via appropriate 5-iodouracil analogues from
L-arabinose. D- and L-Oxathiolane and -dioxolane derivatives 13, 16, 20, 21, and 
29-34 were prepared by glycosylation reaction of the oxathiolane and dioxolane
intermediates with silylated uracil analogues using TMSI as the coupling agent.
The synthesized compounds were evaluated in cell cultures infected with the
following viruses: varicella zoster virus (VZV), Epstein Barr virus (EBV), and
herpes simplex virus types 1 and 2 (HSV-1 and HSV-2). Among the tested compounds,
beta-L-CV-OddU (29), beta-L-BV-OddU (31), and beta-L-IV-OddU (33) exhibited
potent in vitro antiviral activity against VZV with EC(50) values of 0.15, 0. 07,
and 0.035 microM, respectively, and against EBV with EC(50) values of 0.49, 0.59,
and 3.91 microM, respectively.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10891113 [PubMed - indexed for MEDLINE]

3080: Oncology (Williston Park). 2000 Jun;14(6 Suppl 2):41-2.

Infectious complications of pentostatin therapy.

Vose JM, Cabanillas F, O'Brien S, Dang N, Drapkin R, Foss F.

Department of Internal Medicine, University of Nebraska Medical Center, Omaha,
USA.

Managing the infectious complications associated with pentostatin (Nipent), used 
alone or in combination with other agents in patients with low-grade lymphomas,
poses a significant problem for clinicians. Since there is limited experience
with these therapies, definitive treatment recommendations concerning prophylaxis
cannot be made. The panel members discussed the use of valacyclovir (Valtrex) to 
provide prophylaxis for herpes zoster, trimethoprim/sulfamethoxazole for
Pneumocystis, and acyclovir (Zovirax) for varicella zoster. They also considered 
combinations of pentostatin with agents such as interferon, rituximab (Rituxan), 
and chlorambucil (Leukeran) and their effect on the immune system. The biology of
B and T cells was discussed, with an emphasis on clinical application.

PMID: 10887644 [PubMed - indexed for MEDLINE]

3081: Postgrad Med. 2000 Jun;107(7):107-8, 113-4, 117-8.

Acute and chronic herpes zoster. An ancient scourge yields to timely therapy.

Landow K.

University of Southern California School of Medicine, Los Angeles, USA.
drlandow@anv.net

With the US population aging steadily, herpes zoster represents a growing
contributor to diminished quality of life. Dermatologic manifestations appear as 
immunity declines with age but rarely pose a significant threat, except in
instances when ocular structures are involved. Pain is of more concern, because
it usually accompanies and may even precede and persist after acute eruptions. In
most young patients, pain is transient and bearable. Unfortunately, in the
elderly--who are at highest risk for herpes zoster--pain is often more prolonged 
and more intense. In spite of a wide spectrum of interventions, palliative
efforts remain rather ineffectual. At present, intervening as early as possible, 
ideally within 48 to 72 hours of disease onset, offers the greatest chance of
minimizing neurologic sequelae. Inoculation with varicella vaccine in patients
between ages 55 and 65 may prove to boost cell-mediated immunity sufficiently so 
that recrudescence of the varicella virus can be relegated to the annals of
history.

Publication Types: 
    Review

PMID: 10887450 [PubMed - indexed for MEDLINE]

3082: Drugs. 2000 Jun;59(6):1317-40.

Valaciclovir: a review of its use in the management of herpes zoster.

Ormrod D, Goa K.

Adis International Limited, Mairangi Bay, Auckland, New Zealand.
demail@adis.co.nz

Varicella zoster virus (VZV), the pathogen responsible for herpes zoster, belongs
to the herpesvirus family and is sensitive to the antiviral drug aciclovir.
However, the low oral bioavailability of aciclovir has to some extent limited its
efficacy in the treatment of herpes zoster and has prompted the development of
the more readily absorbed oral prodrug valaciclovir. In a large comparative study
valaciclovir, (1000 mg 3 times daily for 7 days) was at least as effective as
aciclovir (800 mg 5 times daily for 7 days) in controlling the symptoms of acute 
herpes zoster. Importantly, valaciclovir alleviated zoster-associated pain and
postherpetic neuralgia significantly faster than aciclovir. A 14-day regimen of
valaciclovir showed no significant advantage over the 7-day regimen. A smaller
trial in Japanese patients focusing primarily on the cutaneous (rash) signs of
herpes zoster confirmed the similar efficacy of valaciclovir and aciclovir in the
7-day regimen. This study did not follow all patients for a formal analysis of
postherpetic neuralgia. Valaciclovir and aciclovir demonstrated similar efficacy 
for the control of cutaneous lesions and ocular complications in patients with
zoster ophthalmicus. Preliminary results of a large controlled trial indicate
that valaciclovir 1000 mg 3 times daily and famciclovir (the prodrug of
penciclovir) 500 mg 3 times daily are of similar efficacy in speeding resolution 
of acute herpes zoster rash and shortening the duration of postherpetic
neuralgia. Starting treatment later than 72 hours after rash onset did not
significantly reduce the beneficial effect of valaciclovir on duration of
zoster-associated pain (a continuum of pain that encompasses both acute pain and 
postherpetic neuralgia) in a large observational study, suggesting that
valaciclovir might be effective when given later than previously thought.
However, valaciclovir should ideally be given as soon as possible after symptoms 
appear. With the recommended regimen for the treatment of herpes zoster (1000 mg 
3 times daily for 7 days) valaciclovir was well tolerated, with nausea and
headache being the most commonly reported adverse events. The adverse events
profile of the agent was similar to that seen with aciclovir or famciclovir.
CONCLUSION: The efficacy of valaciclovir for the treatment of herpes zoster has
been confirmed and extended by follow-up studies in herpes zoster ophthalmicus,
in Japanese patients, and in the wider primary care setting. Valaciclovir is at
least equivalent to, and better in certain parameters than, aciclovir and appears
to have similar efficacy to famciclovir 500 mg 3 times daily. Valaciclovir is a
well tolerated first-line therapy with an established place in the treatment of
immunocompetent patients with herpes zoster.

Publication Types: 
    Review

PMID: 10882165 [PubMed - indexed for MEDLINE]

3083: Pediatr Int. 2000 Jun;42(3):275-9.

Herpes zoster in immunocompetent and immunocompromised Japanese children.

Takayama N, Yamada H, Kaku H, Minamitani M.

Department of Pediatrics, Tokyo Metropolitan Komagome Hospital, Japan.
takyamnd-k@komagome-hospital.bunkyo.tokyo.jp

BACKGROUND: To confirm epidemiological features of herpes zoster among children
with or without immunosuppression, herpes zoster patients who had presented to
this hospital were retrospectively investigated. METHODS: Medical records were
reviewed for the 92 cases of pediatric herpes zoster patients diagnosed during
the period from 1981 to 1998. The age at onset of herpes zoster and of varicella,
the interval between varicella and zoster, the dermatomal distribution of herpes 
zoster and complications were compared between immunocompetent and
immunocompromised children. RESULTS: The mean age at onset of zoster in
immunocompetent children was 8.5 +/- 4.0 years and in immunosuppressed children
was 9.7 +/- 3.8 years. The age at onset of varicella was significantly lower (1.6
+/- 1.8 years) in immunocompetent than in immunosuppressed children (4.6 +/- 2.7 
years). The interval between varicella and zoster was 6.2 +/- 3.2 years in
immunocompetent children. More than 80% of patients with acute leukemia or
malignant lymphoma had herpes zoster within 2 years after diagnosis of
malignancy. Lesions of herpes zoster were most frequently found in the thoracic
nerve regions. Five of 11 zoster patients with cutaneous dissemination, three of 
five zoster patients having aseptic meningitis and three of four patients
complicated facial palsy were children without underlying disease. CONCLUSIONS:
The present study confirmed that varicella in the first year of life was a risk
factor in immunocompetent children, as reported previously. Herpes zoster in
children without immunosuppression was found not to be as mild as generally
accepted.

PMID: 10881585 [PubMed - indexed for MEDLINE]

3084: Scand J Infect Dis. 2000;32(3):263-9.

Comment in:
    Scand J Infect Dis. 2001;33(5):398-9.

Neurological complications of varicella-zoster virus infection in adults with
human immunodeficiency virus infection.

De La Blanchardiere A, Rozenberg F, Caumes E, Picard O, Lionnet F, Livartowski J,
Coste J, Sicard D, Lebon P, Salmon-Ceron D.

Department of Internal Medicine, CHU Cochin-AP.HP, Universite Paris, France.

This multicentre retrospective study describes the clinical features and
prognostic significance of Varicella-zoster virus (VZV)-associated neurological
complications. The study was performed in patients with human immunodeficiency
virus (HIV) infection, hospitalized for VZV neurological complications, confirmed
in every case by positive VZV polymerase chain reaction (PCR) in cerebrospinal
fluid (CSF). Between 1990 and 1995, 34 HIV-infected patients were included in the
study. At diagnosis, 59% had AIDS, with a median CD4 count of 11 x 10(9)/l. A
past history of zoster was noted in 35% of cases. A concomitant herpes zoster
rash and/or acute retinal necrosis were noted in 71% and 12% of patients,
respectively. The predominant neurological manifestations were encephalitis (13),
myelitis (8), radiculitis (7) and meningitis (6). The mean CSF white blood cell
count was 126/mm3 and the mean CSF protein concentration was 2.3 g/l.
Interferon-alpha level was increased in 36% of patients. VZV was isolated from
CSF cultures in 2/6 cases. Magnetic resonance imaging was abnormal, demonstrating
encephalitis lesions. After intravenous antiviral therapy, complete recovery was 
obtained in 18 cases (53%), serious sequelae were observed in 10 cases (29%) and 
6 patients died (18%). Severe symptoms and a low CD4 cell count appeared to be
associated with death or sequelae. In conclusion, VZV should be considered as a
possible cause of encephalitis, myelitis, radiculitis or meningitis in
HIV-infected patients, especially in patients with a history of or concomitant
herpes zoster or acute retinal necrosis. VZV-PCR in the CSF may allow rapid
diagnosis and early specific antiviral treatment.

Publication Types: 
    Multicenter Study

PMID: 10879596 [PubMed - indexed for MEDLINE]

3085: Scand J Infect Dis. 2000;32(3):237-48.

Herpesvirus DNA detection in cerebral spinal fluid: differences in clinical
presentation between alpha-, beta-, and gamma-herpesviruses.

Studahl M, Hagberg L, Rekabdar E, Bergstrom T.

Department of Infectious Diseases, Goteborg University, Sweden.

To evaluate the role of 6 human herpesviruses (cytomegalovirus (CMV),
Epstein-Barr virus (EBV), human herpesvirus-6 (HHV-6), herpes simplex virus (HSV)
types 1 and 2 and varicella zoster virus (VZV)) in infections of the nervous
system, cerebrospinal fluid (CSF) samples from 662 patients with suspected viral 
aetiology to neurological symptoms were investigated for presence of herpesviral 
DNA in a PCR-based study. Of the 69 patients (2 patients had 2 herpesvirus DNA
detected in CSF) who had herpesvirus DNA detected in the CSF, 60 (87%) were
non-immunocompromised (CMV 7; HHV-6 6; EBV 16; HSV-1 18; HSV-2 9 and VZV 6) and 9
(13%) were immunocompromised (CMV 3; HHV-6 0; EBV 5; HSV-1 0; HSV-2 1 and VZV 0).
The study was performed in a retrospective/prospective manner. The HSV-1, HSV-2, 
VZV and CMV DNA-positive patients usually had typical clinical syndromes, such as
encephalitis/myelitis and meningitis, but also other neurological conditions were
associated with findings of these viruses. HHV-6 and EBV DNA were detected in
patients presenting with a variety of neurological symptoms, and in some of the
cases, concurrent with diagnosis of other infections of the central nervous
system. Despite the overall variability of clinical conditions seen, a pattern
associated with each investigated herpesvirus was discernable as regards clinical
presentation.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10879592 [PubMed - indexed for MEDLINE]

3086: Neurol India. 2000 Jun;48(2):189-90.

Herpes zoster cervical myelitis in an immunocompetent subject.

Mehndiratta MM, Bansal J, Gupta M, Puri V.

Publication Types: 
    Case Reports
    Letter

PMID: 10878792 [PubMed - indexed for MEDLINE]

3087: J Clin Microbiol. 2000 Jul;38(7):2568-73.

Quantitation of varicella-zoster virus DNA in whole blood, plasma, and serum by
PCR and electrochemiluminescence.

de Jong MD, Weel JF, Schuurman T, Wertheim-van Dillen PM, Boom R.

Section of Clinical Virology, Department of Medical Microbiology, Academic
Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
M.D.deJong@AMC.UVA.NL

We describe a highly sensitive assay for quantitation of varicella-zoster virus
(VZV) DNA in blood, involving PCR amplification, solution hybridization with
Tris-(2, 2'-bipyridine)-ruthenium(II) chelate-labeled probes, and measurement by 
electrochemiluminescence (ECL). Extraction and amplification efficiencies were
monitored by the inclusion of internal control (IC) DNA, mimicking the VZV
target, in the DNA extraction. Viral DNA load was calculated from the ratio of
VZV and IC ECL signals. The lower limit of sensitivity was 20 VZV DNA copies/ml
of plasma or serum and 80 copies/ml of whole blood. In reconstruction
experiments, expected and calculated VZV DNA loads were in excellent accordance. 
Blood specimens from 42 VZV-infected patients were tested for the presence of VZV
DNA and showed detection rates of 86% in patients with varicella and 81% in
patients with herpes zoster. In specimens obtained during the first week after
onset of the rash, detection rates were 100 and 89%, respectively. Viral DNA was 
detected in all immunocompromised patients with herpes zoster, emphasizing the
risk of disseminated disease in this patient group. VZV DNA load was similar in
patients with varicella and multidermatomal herpes zoster and lower in patients
with unidermatomal zoster. Despite the cell-associated nature of the virus, VZV
DNA was detected in serum and plasma at high copy numbers, and at similar
frequencies compared to whole-blood specimens. Quantitation of VZV DNA in blood
is of potential importance for diagnosis and clinical management of VZV-infected 
patients. Plasma and serum provide convenient matrices for this purpose.

PMID: 10878045 [PubMed - indexed for MEDLINE]

3088: J Eur Acad Dermatol Venereol. 2000 Jan;14(1):59-60.

Typical varicella zoster (ophthalmicus) in an HIV-infected person.

Sehgal VN, Kumart S, Jain S, Bhattacharya SN.

Sehgal Nursing Home, Dermato-Venereology (SKIN/VD) Centre, Delhi, India.
drsehgal@ndf.vsnl.net.in

A typical varicella zoster (ophthalmicus) in an incidentally HIV-infected person 
is reported in a young man. It was characterized by tense, grouped,
vesiculobullous eruptions on a brick-red base. The diagnosis was substantiated by
demonstration of swollen epidermal (balloon) cells with a nucleus/several nuclei 
containing inclusion bodies. Reticular degeneration was apparent.

Publication Types: 
    Case Reports

PMID: 10877254 [PubMed - indexed for MEDLINE]

3089: J Eur Acad Dermatol Venereol. 2000 Jan;14(1):23-33.

Factors influencing pain outcome in herpes zoster: an observational study with
valaciclovir. Valaciclovir International Zoster Assessment Group (VIZA).

Decroix J, Partsch H, Gonzalez R, Mobacken H, Goh CL, Walsh L, Shukla S, Naisbett
B.

Mouscron, Cabinet de Dermatologie, Belgium.

AIM OF THE STUDY: An observational study with valaciclovir was conducted to
assess clinical outcome in herpes zoster, especially pain and associated
neurological signs and symptoms in relation to a series of demographic and
disease characteristics discernible at presentation. The safety and acceptability
of valaciclovir for treatment of zoster was assessed in a wide variety of primary
care and clinic referral settings. METHODS: In total, 1897 immunocompetent adults
with clinically diagnosed, localized acute herpes zoster were enrolled in this
international, open-label study of valaciclovir. All subjects received treatment 
with oral valaciclovir (1000 mg three times daily) for 7 days from entry to the
study and were asked to record the presence of zoster-associated pain and
abnormal sensations throughout treatment and 6 months' follow-up. They were seen 
frequently in clinic to verify subjective assessments and for evaluation of rash 
healing. Safety and tolerability were assessed by adverse event monitoring.
RESULTS: Overall, 1191 subjects (63%) were aged > or = 50 years, and 203 (11%)
had ophthalmic zoster. Cessation of zoster-associated pain was significantly
faster in the younger age group; median times to loss of zoster-associated pain
were 23 days and 9 days in the > or = 50 and < 50 years age groups, respectively.
Similarly, abnormal sensations resolved significantly more rapidly in the younger
subjects; the median duration of abnormal sensations was 31 days in the > or = 50
year olds and 16 days in those aged < 50 years. In cases of ophthalmic zoster,
the rate of pain resolution was not different from those with zoster in other
dermatomes (median duration of pain 18 vs. 16 days). However, abnormal sensations
persisted significantly longer in subjects with ophthalmic zoster than in those
with zoster at other sites (47 vs. 22 days). In addition to advancing age,
subjects suffering moderate to severe prodromal pain or acute pain during the
rash phase were at significantly greater risk of zoster-associated pain and
abnormal sensations persisting for longer. Subjects with concomitant neurological
disorders were also more likely to develop prolonged abnormal sensations.
Valaciclovir treatment was well tolerated, and adverse events were rare and
generally mild. CONCLUSION: This study confirmed the prognostic importance of
advancing age and the intensity of prodromal or acute pain as risk factors for
prolonged zoster-associated pain and persisting abnormal sensations in the
affected dermatome. Ophthalmic zoster and pre-existing neurological disorders are
also identified as highly significant risk factors for prolonged abnormal
sensations in herpes zoster.

Publication Types: 
    Clinical Trial

PMID: 10877249 [PubMed - indexed for MEDLINE]

3090: Acta Derm Venereol. 2000 Mar-Apr;80(2):150.

Cutaneous lesions of multicentric reticulohistiocytosis developing in herpes
zoster lesions.

Verma KK, Mittal R.

Publication Types: 
    Case Reports
    Letter

PMID: 10877143 [PubMed - indexed for MEDLINE]

3091: Infusionsther Transfusionsmed. 2000 May;27(3):138-143.

Transfusion-Associated Infections with Cytomegalovirus and Other Human
Herpesviruses.

Kuhn JE.

Of all human herpesviruses, human cytomegalovirus (HCMV) is the most significant 
cause of transfusion-associated (TA) morbidity and mortality. The problem of TA
HCMV infection differs from that of other transfusion-transmitted infections in
that only certain groups of patients require HCMV-free blood or blood components,
i.e. seronegative pregnant women, premature infants of low birth weight who are
born to seronegative mothers, seronegative recipients of allogeneic bone marrow
transplants from seronegative donors, seronegative AIDS patients, and
seronegative immunosuppressed patients in general. HCMV is strictly
cell-associated, and transmission appears to be due to reactivation of latent
virus in white blood cells. TA HCMV infec-tion in risk groups can be minimized by
selection of HCMV-seronegative donors. Since transmission of HCMV from
seropositive donors by blood components containing fewer than 10 7 leukocytes per
unit is unlikely, leukodepletion of transfusion products by filtration is an
effective alternative to the use of seronegative blood products. Other human
herpesviruses causing TA infections are Epstein-Barr virus (EBV) and the human
herpesviruses 6 and 7 (HHV-6, HHV-7), whereas transmissions of herpes simplex
viruses (HSV-1, HSV-2) and varicella-zoster virus (VZV) by blood transfusion - if
occurring at all - are extremely rare events. Frequency and clinical significance
of TA infections with the human herpesvirus 8 (HHV-8) have not yet been fully
elucidated. Despite the low seroprevalence of HHV-8 in Germany, its oncogenic
potential merits attention, and strategies to prevent transmission and spread of 
HHV-8 by blood and blood products should be discussed. Copyright 2000 S. Karger
GmbH, Freiburg

PMID: 10878482 [PubMed - as supplied by publisher]

3092: Semin Oncol. 2000 Apr;27(2 Suppl 5):64-6.

Pentostatin (Nipent) in T-cell lymphomas.

Kurzrock R.

Department of Bioimmunotherapy, The University of Texas M.D. Anderson Cancer
Center, Houston 77030, USA.

Pentostatin (Nipent; SuperGen, San Ramon, CA), which is highly lymphocytotoxic,
is an active agent in hairy cell leukemia. We therefore initiated a trial of this
agent in T-cell lymphomas. Pentostatin was administered at a dose of 3.75 or 5.0 
mg/m2/d intravenously for 3 days every 3 weeks to heavily pretreated patients
with cutaneous and peripheral T-cell lymphomas. To date, there are 24 evaluable
patients in the trial. Seventeen of these individuals have responded (complete or
partial remission). The most common toxicities included granulocytopenia, nausea,
renal insufficiency, CD4 suppression, and delayed herpes zoster. Pentostatin is
an active agent in this group of diseases and merits further exploration.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10877055 [PubMed - indexed for MEDLINE]

3093: Semin Oncol. 2000 Apr;27(2 Suppl 5):41-3.

A phase I and II study of pentostatin (Nipent) with cyclophosphamide for
previously treated patients with chronic lymphocytic leukemia.

Weiss MA.

Department of Medicine, Memorial Sloan-Kettering Cancer Center, and Cornell
University Medical College, New York, NY 10021, USA.

Purine analogs and alkylating agents are the most active drugs in the treatment
of patients with chronic lymphocytic leukemia (CLL). Although fludarabine is the 
most widely tested purine analog in CLL, myelosuppression has limited its use in 
combination chemotherapy regimens. Because pentostatin (Nipent; SuperGen, San
Ramon, CA), a related purine analog with proven activity in CLL, has less
myelosuppression, we postulated that it would prove advantageous and could be
more readily combined with alkylating agents. We are conducting a phase I/II
trial of combination chemotherapy with pentostatin and cyclophosphamide for
previously treated patients with CLL. Patients need to have Rai high-risk disease
or "active" intermediate-risk disease. The treatment regimen consists of a fixed 
dose of pentostatin (4 mg/m2) combined with an increasing dose of
cyclophosphamide. We plan to treat cohorts of three patients each at
cyclophosphamide dose levels of 600, 900, 1,200, 1,500, and 2,000 mg/m2. Cycles
will be repeated every 21 days. If unacceptable toxicity is encountered at one
dose level, then three additional patients (total of six patients) will be
accrued to that dose level before further dose escalations will be permitted. A
second instance of unacceptable toxicity will close that dose level and identify 
the preceding level as the phase II dose. Additional patients will be accrued to 
the phase II dose level to better assess response. Supportive measures include
the use of granulocyte colony-stimulating factor (5 microg/kg/d) to limit
neutropenia. Sulfamethoxazole/trimethoprim will be given as prophylaxis against
Pneumocystis carinii pneumonia and acyclovir will be administered as prophylaxis 
for herpes zoster. Response will be assessed according to standard criteria, and 
flow cytometry and fluorescent in situ hybridization will be used to assess for
minimal residual disease in patients with trisomy 12.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10877051 [PubMed - indexed for MEDLINE]

3094: Jpn J Infect Dis. 2000 Apr;53(2):47-55.

Development of a live varicella vaccine--past and future.

Takahashi M.

The Research Foundation for Microbial Diseases at Osaka University, Osaka, Japan.
michiaki@biken.osaka-u.ac.jp.

Background of the development of a live varicella vaccine, including studies on
the attenuation of measles and polioviruses, and transformation experiments of
cultured hamster and human cells with conditional lethal mutants of adenovirus
and herpes simplex virus were described. Varicella-zoster virus (Oka strain) was 
passaged in guinea pig cells, and the resulting virus (vaccine virus) was found
to have a higher affinity to guinea pig cells. It was recently proved that
variations of base sequence occurred exclusively in gene 62 (immediate-early
gene) in comparison of vaccine Oka virus and parent Oka virus. This variation is 
presumed to have occurred during passage in guinea pig cells. Live varicella
vaccine (Oka strain) has increasingly been used throughout the world. It was also
found in a preliminary study that giving the vaccine to the elderly enhanced
humoral and cell-mediated immunity, leading to a prevention of post herpetic
neuralgia. A large field trial is now going on in the United States to immunize
the elderly for the purpose of prevention of herpes zoster, particularly post
herpetic neuralgia.

Publication Types: 
    Review

PMID: 10871914 [PubMed - indexed for MEDLINE]

3095: Curr Opin Neurol. 2000 Jun;13(3):311-6.

Myelitis.

Andersen O.

Department of Clinical Neuroscience, Sahlgrenska University Hospital, Goteborg,
Sweden.

Acute transverse myelitis (ATM) with moderate symptomatology and smaller multiple
magnetic resonance imaging lesions is often caused by multiple sclerosis. Severe 
ATM with extensive magnetic resonance imaging lesions with or without associated 
meningitis often has a viral cause, particularly in the younger age groups,
whereas vascular disorders may prevail among older patients. Previously, one had 
to rely on indirect evidence such as viral serology or viral identification in
throat washings to confirm a diagnosis of myelitis. Thus, mycoplasma myelitis may
occur coincident with a mycoplasma pneumonia. Viral myelitis is now often
diagnosed by specific polymerase chain reaction of the cerebrospinal fluid, for
echovirus, Coxsackie virus, mumps virus, herpes simplex virus or varicella-zoster
virus, but an autoimmune component may still be important. An anterior horn
syndrome may be produced by the tick-borne encephalomyelitis virus. Severe ATM
may also be a postinfectious or postvaccinal disorder [i.e. a partial acute
disseminated encephalomyelitis (ADEM)]. Neuromyelitis optica, a combination of
severe myelitis and optic neuritis, is often a manifestation of ADEM or systemic 
lupus erythematosus. Many of these disorders are potentially treatable with
specific antiviral agents or immunosuppression. 'Idiopathic' ATM is probably a
consequence of inadequate examination and follow up. The differential
diagnoses-viral myelitis, multiple sclerosis, ADEM, neuromyelitis optica, spinal 
arteriovenous malformation and arteritis-should be considered and are usually
identified by a rapid diagnostic work-up, leaving few ATM cases undiagnosed.

Publication Types: 
    Review

PMID: 10871257 [PubMed - indexed for MEDLINE]

3096: Biol Blood Marrow Transplant. 2000;6(3):219-30.

Varicella-Zoster virus: pathogenesis, immunity, and clinical management in
hematopoietic cell transplant recipients.

Arvin AM.

Infectious Disease Division, Stanford University School of Medicine, California
94305-5208, USA. arvinam@stanford.edu

New information about the mechanisms of varicella-zoster virus (VZV) pathogenesis
and the host response to the virus has improved our understanding of the threat
that VZV reactivation may pose after hematopoietic cell transplantation (HCT).
Antiviral therapy compensates for some of the deficiencies in VZV immunity in HCT
recipients, and inactivated varicella vaccine may be useful for the early
reconstitution of adaptive immunity to VZV after HCT.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10871147 [PubMed - indexed for MEDLINE]

3097: Clin J Pain. 2000 Jun;16(2 Suppl):S90-100.

Prospects for the prevention of postherpetic neuralgia in herpes zoster patients.

Dworkin RH, Perkins FM, Nagasako EM.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, New York 14642, USA. robert_dworkin@urmc.rochester.edu

OBJECTIVE: Herpes zoster is a common and painful disease that is caused by
reactivation of the varicella-zoster virus. Herpes zoster pain that persists
after healing of the acute infection is termed postherpetic neuralgia (PHN), a
chronic pain syndrome that is often refractory to all treatment. The prevalence
of PHN is expected to increase substantially in the coming decades, because the
incidence of herpes zoster and the risk of PHN will both increase as the
population ages. Although the results of recent studies provide a basis for
improved treatment of patients with PHN, as many as half of all PHN patients do
not obtain relief of their pain. Research on the development of improved
treatments is continuing, but it has not been generally recognized that an
equally important goal should be the design of interventions to prevent PHN. The 
prevention of PHN would lead to major reductions in disability, suffering, and
the use of health care resources. DESIGN: The results of recent studies that have
identified risk factors for the development of PHN and have implicated several
peripheral and central mechanisms in its pathophysiology are reviewed. OUTCOME
MEASURES: These risk factors and mechanisms of PHN provide a basis for
hypothesizing that combining antiviral therapy with analgesic treatment beginning
as soon as possible after the onset of herpes zoster would reduce the risk of PHN
beyond that achieved by antiviral therapy alone. CONCLUSIONS: This treatment
approach would be expected to reduce the risk of PHN in herpes zoster patients by
attenuating acute pain and thereby preventing the initiation of central
mechanisms of chronic pain.

Publication Types: 
    Review

PMID: 10870747 [PubMed - indexed for MEDLINE]

3098: Am J Med. 2000 Apr 15;108(6):520-1.

Zoster gangrenosum: necrotizing fasciitis as a complication of herpes zoster.

Sewell GS, Hsu VP, Jones SR.

Publication Types: 
    Case Reports
    Letter

PMID: 10866590 [PubMed - indexed for MEDLINE]

3099: Ann Periodontol. 1999 Dec;4(1):20-31.

Non-plaque-induced gingival lesions.

Holmstrup P.

University of Copenhagen, School of Dentistry, Denmark.
palle.holmstrup@odont.ku.dk

The origin of gingival inflammation is occasionally different from that of
routine plaque-associated gingivitis, and such non-plaque-associated types of
gingivitis often present characteristic clinical features. Examples of such forms
of gingivitis are specific bacterial, viral, and fungal infections. Specific
bacterial infections of gingiva may be due to Neisseria gonorrhea, Treponema
pallidum, streptococci, and other organisms. The most important viral infections 
of gingiva are herpes simplex virus type 1 and 2 and varicella-zoster virus.
Fungal infections may be caused by several fungi, the most important of these
being Candida species including C. albicans, C. glabrata, C. krusei, C.
tropicalis, C. parapsilosis, and C. guillermondii. Gingival histoplasmosis is a
granulomatous disease caused by the fungus Histoplasma capsulatum and, as for the
other specific infections of gingiva, a confirmed diagnosis may require
histopathologic examination and/or culture. Atypical gingivitis may also occur as
gingival manifestations of dermatological diseases, the most relevant of these
being lichen planus, pemphigoid, pemphigus vulgaris, erythema multiforme, and
lupus erythematosus. Non-plaque induced gingival inflammation can be caused by
allergic reactions to dental restorative materials, toothpastes, mouthwashes, and
foods. In addition, gingival inflammation may result from toxic reactions,
foreign body reactions, or mechanical and thermal trauma.

Publication Types: 
    Consensus Development Conference
    Review

PMID: 10863372 [PubMed - indexed for MEDLINE]

3100: Geriatr Nurs. 2000 May-Jun;21(3):132-5; quiz 136.

Herpes zoster and postherpetic neuralgia in the elderly.

Lee VK, Simpkins L.

University of Virginia Health System, Charlottesville, USA.

This article describes herpes zoster (HZ), its cause, diagnosis, treatment, and
associated complications. Postherpetic neuralgia (PHN), the most common
complication of HZ, is the primary focus of the discussion. PHN is defined
broadly as chronic pain that persists after the characteristic vesicular rash of 
HZ has resolved.

Publication Types: 
    Review

PMID: 10864692 [PubMed - indexed for MEDLINE]

3101: Am J Ind Med. 2000 Jul;38(1):108-11.

A study of post-traumatic shingles as a work related injury.

Foye PM, Stitik TP, Nadler SF, Chen B.

Physical Medicine and Rehabilitation, UMDNJ: New Jersey Medical School, Newark,
New Jersey 07103-2499, USA. foyepm@umdnj.edu

BACKGROUND: After chicken pox, the herpes varicella-zoster (HVZ) virus may remain
dormant in the dorsal root ganglion until later reactivation causes shingles,
characterized by painful dysesthesias and cutaneous vesicular eruptions along a
unilateral dermatome. Shingles as a work-related injury has not been previously
addressed in the medical literature. Case History We present a 50-year old female
hospital employee who, while working, sustained an acute, traumatic
hyperextension injury to her right wrist, hand, and fingers. Although she
initially responded to treatment for flexor tendinitis, she suddenly developed
shingles in the right C5-C6 dermatomes. She was treated with famcyclovir and her 
skin lesions resolved, but post-herpetic neuralgia persisted. CONCLUSIONS: It was
felt that her shingles was causally related to her occupational injury since
trauma (previously reported to precipitate shingles) was her only risk factor and
the timing and location of the lesions corresponded closely to the occupational
injury. In addition to appropriately diagnosing and treating their patients,
workers' compensation physicians often must determine if a particular condition
was caused by the original work-related incident. Clinicians who treat trauma
patients and injured workers should be aware of post-traumatic shingles and
understand the causal relationship of this uncommon but clinically important
phenomenon. Copyright 2000 Wiley-Liss, Inc.

Publication Types: 
    Case Reports

PMID: 10861772 [PubMed - indexed for MEDLINE]

3102: J Am Acad Dermatol. 2000 Jul;43(1 Pt 2):S27-30.

Immunomodulatory therapy in the management of viral infections in patients with
HIV infection.

Conant MA.

University of California Medical Center, San Francisco, CA, USA.

Human immunodeficiency virus (HIV) causes disease by infecting lymphocytes and
progressively destroying critical regulatory and effector cells of the immune
system, leaving patients vulnerable to a number of bacterial, fungal, and viral
infections. Facial herpes (herpes simplex virus-1 [HSV-1]), genital herpes
(HSV-2), herpes zoster (varicella zoster virus), oral hairy leukoplakia
(Epstein-Barr virus), Kaposi's sarcoma (HHV-8), molluscum contagiosum, condyloma 
acuminata (human papillomavirus [HPV-6, HPV-11]), plantar warts (HPV-1), and
facial warts and flat warts (HPV-5) are some of the cutaneous viral diseases most
commonly seen in HIV-infected patients. Two immunomodulatory agents, imiquimod
(Aldara), shown to be safe and effective in the management of genital warts, and 
alitretinoin gel, shown to be safe and effective in the treatment of Kaposi's
sarcoma, may offer a new therapeutic approach to treatment of cutaneous viral
diseases. There is a strong scientific rationale to suggest that imiquimod and
alitretinoin gel may be useful in the treatment of a variety of cutaneous viral
diseases that have been shown to respond to immunomodulatory drugs. This
represents a new approach in the therapeutic treatment paradigm for treatment of 
cutaneous viral diseases at their site of infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10861104 [PubMed - indexed for MEDLINE]

3103: Anasthesiol Intensivmed Notfallmed Schmerzther. 2000 May;35(5):274-84.

[Neuroplasticity and chronic pain]

[Article in German]

Muller H.

Klinik fur Anasthesie, Intensivmedizin und Schmerztherapie Klinikum Kemperhof,
Koblenz.

In the seventies and eighties spinal mechanisms inhibiting pain processing were
discovered in animal studies leading to new therapeutic regimens such the use of 
spinal opioids. During the last decade additional studies revealed an increased
sensibility of the spinal cord upon severe, long lasting pain perception, a
mechanism called wind-up. Hyperalgesia is accompanied by persisting genetic
changes of spinal cord cells, which may contribute to the chronification of pain.
The severity and duration of acute pain apparently contributes to the possibility
of chronic pain development. Although not all the consequences of these findings 
are clear, they may influence our way of performing anaesthesia and treating
postoperative or acute pain situations, e.g. pain during herpes zoster or pain
after trauma and amputation. In general, analgetic measures should be potent
enough to prevent spinal sensiblisation, which can be best achieved with spinal
blockade by local anesthetics. Another way of counteracting pain-induced spinal
plasticity is by blocking or antagonizing its pathways with specific transmitters
or their equivalents. All these spinally mediated regimens should be performed
prior to later predominating mechanisms of supraspinal plasticity involving
psychic changes due to persisting pain, which seem to evolve with delay to spinal
processes.

Publication Types: 
    English Abstract
    Review

PMID: 10858836 [PubMed - indexed for MEDLINE]

3104: Ophthalmology. 2000 Jun;107(6):1164-70.

Anterior uveitis with sectoral iris atrophy in the absence of keratitis: a
distinct clinical entity among herpetic eye diseases.

Van der Lelij A, Ooijman FM, Kijlstra A, Rothova A.

Department of Ophthalmology, University Medical Centre, Utrecht, The Netherlands.

OBJECTIVE: To determine the cause and describe the clinical features of
unilateral anterior uveitis with sectoral atrophy of the iris in the absence of
associated keratitis. DESIGN: Retrospective, observational case series.
PARTICIPANTS: Thirty-one patients with unilateral anterior uveitis with sectoral 
iris atrophy and without (previous) keratitis. METHODS: The patients were
selected from our database of 592 patients with anterior uveitis. MAIN OUTCOME
MEASURES: We reviewed the clinical data on the 31 patients and the results of
diagnostic anterior chamber fluid analysis for 24 of the 31 patients.
Specifically, production of local antibodies against herpes simplex virus (HSV)
and varicella zoster virus (VZV) was determined and the polymerase chain reaction
was performed to demonstrate the DNA of HSV, VZV, and cytomegalovirus (CMV) in
the aqueous samples. RESULTS: Main clinical characteristics of anterior uveitis
with iris atrophy included unilateral involvement with a prolonged course and
recurrent exacerbations in all cases. Elevated intraocular pressure during
intraocular inflammation occurred in 90% of patients (28 of 31). Visual outcome
was favorable because 29 of 31 patients (94%) retained a visual acuity of 20/32
or more. The causal agent was identified as HSV in 83% (20 of 24) and VZV in 13% 
(3 of 24) and was inconclusive in one case. The patients with HSV uveitis were
younger than those with VZV uveitis (mean age at onset 34 and 65 years,
respectively; P = 0.0056). CONCLUSIONS: Unilateral anterior uveitis with sectoral
atrophy of the iris without associated (previous) keratitis is a distinct entity 
among herpetic eye diseases. Recurrent unilateral anterior uveitis with iris
atrophy and/or elevated intraocular pressure has most likely been caused by HSV.

PMID: 10857838 [PubMed - indexed for MEDLINE]

3105: Drugs. 2000 May;59(5):1113-26.

Treatment of postherpetic neuralgia: an update.

Kanazi GE, Johnson RW, Dworkin RH.

University of Rochester School of Medicine and Dentistry, New York 14642, USA.

Postherpetic neuralgia (PHN) is a chronic pain syndrome that is often refractory 
to treatment and can last for years, causing physical and social disability,
psychological distress, and increased use of the healthcare system. In this paper
we provide an update on recent developments in the treatment of PHN. We emphasise
the results of recent studies that provide an evidence-based approach for
treating PHN that was not available until very recently. In randomised,
controlled clinical trials, the topical lidocaine patch, gabapentin, and
controlled release oxycodone have been shown to provide superior pain relief in
patients with PHN when compared with placebo. It has also recently been
demonstrated that the tricyclic antidepressant nortriptyline provides equivalent 
analgesic benefit when compared with amitriptyline, but is better tolerated.
Based on these results, nortriptyline can now be considered the preferred
antidepressant for the treatment of PHN, although desipramine may be used if the 
patient experiences unacceptable sedation from nortriptyline. The topical
lidocaine patch, gabapentin and controlled release oxycodone all appear to be as 
effective as tricyclic antidepressants in the treatment of patients with PHN, and
the results of these recent studies suggest that each of these treatments should 
be considered early in the course of treatment. Additional controlled trials are 
needed to compare the efficacy and tolerability of these 4 treatments- tricyclic 
antidepressants, gabapentin, the topical lidocaine patch and controlled release
opioid analgesics--used singly and in various combinations in the treatment of
patients with PHN.

Publication Types: 
    Review

PMID: 10852643 [PubMed - indexed for MEDLINE]

3106: Am J Ophthalmol. 2000 May;129(5):672-3.

Herpes simplex virus DNA identification from aqueous fluid in Fuchs heterochromic
iridocyclitis.

Barequet IS, Li Q, Wang Y, O'Brien TP, Hooks JJ, Stark WJ.

The Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, 
USA.

PURPOSE: To report the presence of herpes simplex virus DNA in the aqueous humor 
of an eye with Fuchs heterochromic iridocyclitis. METHODS: In an eye with a
clinical diagnosis of Fuchs heterochromic iridocyclitis, samples of aqueous humor
and anterior capsule of the lens were obtained during cataract surgery.
Polymerase chain reaction was performed on the samples to detect the presence of 
viral DNA including herpes simplex virus, varicella-zoster virus, and
cytomegalovirus. Serologic analysis was also performed for antiviral
immunoglobulins. RESULTS: Herpes simplex virus DNA was identified in the aqueous 
humor but not in the anterior capsule. Serum immunoglobulin G was positive for
herpes simplex virus, varicella-zoster virus, and cytomegalovirus. CONCLUSIONS:
The presence of herpes simplex virus DNA in the aqueous humor of an eye with
Fuchs heterochromic iridocyclitis suggests that herpes simplex virus infection
may play a role in the pathogenesis of Fuchs heterochromic iridocyclitis.

Publication Types: 
    Case Reports

PMID: 10844066 [PubMed - indexed for MEDLINE]

3107: Br J Haematol. 2000 May;109(2):328-9.

Paroxysmal cold haemoglobinuria in an adult with chicken pox.

Papalia MA, Schwarer AP.

Clinical Haematology and Bone Marrow Transplant Unit, Alfred Hospital, Melbourne,
Victoria, Australia.

Paroxysmal cold haemoglobinuria (PCH) is an autoimmune disorder characterized by 
intravascular haemolysis causing haemoglobinuria. It is due to a biphasic
haemolysin known as the Donath-Landsteiner antibody, which binds specifically to 
the P antigen of red blood cells at low temperatures, leading to complement
activation and red cell lysis at 37 degrees C. PCH is a rare disease which
predominantly affects the paediatric population, occurring mostly during viral
infections. We report on what is possibly the first case of PCH in an adult to be
precipitated by chicken pox infection.

Publication Types: 
    Case Reports
    Review

PMID: 10848819 [PubMed - indexed for MEDLINE]

3108: J Cutan Pathol. 2000 May;27(5):255-7.

Giant cell lichenoid dermatitis within herpes zoster scars in a bone marrow
recipient.

Cordoba S, Fraga J, Bartolome B, Garcia-Diez A, Fernandez-Herrera J.

Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain.

Cutaneous lesions arising in herpes zoster (HZ) scars are rare. We report a
34-year-old woman with acute lymphoblastic leukemia underwent allogenic bone
marrow transplant (BMT). Ten days after the BMT, she developed clusters of
vesicles over the right neck, scapula, shoulder and chest. She was treated with
intravenous acyclovir and foscarnet. One month after the vesiculous episode of HZ
she showed 5 mm to 2 cm clustered flat violaceous lichenoid papules and confluent
plaques within the HZ scars. Histopathologic examination revealed a inflammatory 
infiltrate present in the papillary dermis with granulomatous aggregated formed
by histiocytes, multinucleated giant cells and lymphocytes. She was treated with 
topic steroids with significant improvement. Pathologic findings are similar to
those of an unusual lichenoid reaction named "giant cell lichenoid dermatitis".
We present the first reported case of giant cell lichenoid dermatitis at the
sites of HZ scars.

Publication Types: 
    Case Reports

PMID: 10847551 [PubMed - indexed for MEDLINE]

3109: Eye. 2000 Apr;14 ( Pt 2):251-2.

Herpes zoster ophthalmicus presenting as contralateral disc swelling.

Mearza AA, Chan JH, Gair E, Jagger J.

Publication Types: 
    Case Reports
    Letter

PMID: 10845031 [PubMed - indexed for MEDLINE]

3110: J R Soc Med. 2000 Apr;93(4):191-2.

Comment in:
    J R Soc Med. 2000 Jun;93(6):334-5.

Ophthalmic zoster sine herpete.

Goon P, Wright M, Fink C.

Department of Diagnostic Virology, St Mary's Hospital, London, UK.

Publication Types: 
    Case Reports

PMID: 10844885 [PubMed - indexed for MEDLINE]

3111: Trop Doct. 2000 Jan;30(1):33-5.

Claw hand as a complication of herpes zoster.

Matondo P, Lungu G, Njobvu P.

Department of Medicine, University Teaching Hospital, Lusaka, Zambia.
pmatondo@zamnet.zm

Publication Types: 
    Case Reports

PMID: 10842523 [PubMed - indexed for MEDLINE]

3112: J Ethnopharmacol. 2000 Jun;70(3):235-73.

Medicinal plants and food medicines in the folk traditions of the upper Lucca
Province, Italy.

Pieroni A.

Dipartimento di Scienza del Suolo e Nutrizione della Pianta, Universita degli
Studi di Firenze, Piazzale delle Cascine, 28, I-50144, Florence, Italy.
uzs51a@uni-bonn.de

An ethnopharmacobotanical survey of the medicinal plants and food medicines of
the northern part of Lucca Province, north-west Tuscany, central Italy, was
carried out. The geographical isolation of this area has permitted the survival
of a rich folk phytotherapy involving medicinal herbs and also vegetable
resources used by locals as food medicine. Among these are the uncommon use of
Ballota nigra leaves as a trophic protective; the use of Lilium candidum bulbs as
an antiviral to treat shingles (Herpes zoster); Parmelia sp. as a cholagogue;
Crocus napolitanus flowers as antiseptic; Prunus laurocerasus drupes as a
hypotensive; and the consumption of chestnut flour polenta cooked with new wine
as bechic. Many wild gathered greens are eaten raw in salads, or in boiled
mixtures, as 'blood cleansing' and 'intestine cleansing' agents. Of particular
interest is the persistence of the archaic use of Bryonia dioica root against
sciatica, and the use of ritual plant therapeuticals as good omens, or against
the 'evil eye.' Over 120 species represent the heritage of the local folk
pharmacopoeia in upper Garfagnana. Anthropological and ethnopharmacological
considerations of the collected data are also discussed.

PMID: 10837988 [PubMed - indexed for MEDLINE]

3113: Br J Ophthalmol. 2000 Jun;84(6):563-71.

Comment in:
    Br J Ophthalmol. 2000 Jun;84(6):560-1.

Human herpesviruses in the cornea.

Kaye SB, Baker K, Bonshek R, Maseruka H, Grinfeld E, Tullo A, Easty DL, Hart CA.

Department of Medical Microbiology, University of Liverpool, UK.

AIMS: To determine the sensitivity and specificity of culture,
immunohistochemistry (IHC), the polymerase chain reaction (PCR), and in situ
hybridisation (ISH) for detecting herpes simplex virus (HSV-1) in the cornea of
patients undergoing penetrating keratoplasty. To compare the incidence of HSV-1
in the cornea with that of varicella zoster virus (VZV), cytomegalovirus (CMV),
and Epstein-Barr virus (EBV). METHODS: The corneas of 110 patients, 52 with a
documented history of herpes keratitis (HSK) and 58 with non-herpetic corneal
disease, were investigated using IHC, PCR, ISH, and culture. RESULTS: HSV-1 DNA
and antigen were detected in 82% and 74% respectively, of corneas of patients
with HSK and in 22% and 15% of corneas of patients with no history of HSK. The
sensitivity of PCR and IHC was 82% and 74% with a specificity of 78% and 85%,
respectively. HSV-1 DNA and antigen were found more frequently and in increased
amounts in corneas of patients with a short interval between their last attack of
HSK and surgery. There was a good correlation between PCR and IHC in 71%. HSV-1
was isolated by culture in 2%. Latency associated transcripts were not detected
using ISH. Evidence of VZV DNA or antigen was found significantly more frequently
in the corneas of patients with a history of HSK (p<0.001). No evidence of EBV or
CMV was found in any cornea. CONCLUSIONS: PCR and IHC are both sensitive for the 
detection of HSV-1 in the cornea. A combination of PCR and IHC increases the
specificity for the diagnosis of HSK to 97%. HSV-1 appears to be slowly removed
from the cornea. VZV and HSV-1 may co-infect the cornea.

Publication Types: 
    Comparative Study
    Multicenter Study

PMID: 10837377 [PubMed - indexed for MEDLINE]

3114: J Infect Dis. 2000 Jun;181(6):1897-905. Epub 2000 Jun 5.

Epidemiology of primary varicella and herpes zoster hospitalizations: the
pre-varicella vaccine era.

Lin F, Hadler JL.

Department of Epidemiology and Public Health, Yale University School of Medicine,
New Haven, Connecticut, USA.

To determine the epidemiology and costs of hospitalization with primary varicella
and herpes zoster in the prevaccine era and the usefulness of hospital discharge 
data to determine the population impact of vaccination on these conditions,
statewide hospital discharge data in Connecticut from 1986 to 1995 were analyzed.
Annual hospitalizations for herpes zoster were 4-fold higher than for primary
varicella (16.1 vs. 4.1/100,000). Overall, 69% and 83%, respectively, had no
underlying immunosuppressive conditions. Regarding primary varicella, 53% of
patients were aged <15 years, there was a marked winter-spring seasonality, and
Hispanics and blacks were 4.1 and 2.6 times more likely than whites to be
hospitalized. Regarding herpes zoster, 66.9% of patients were aged >64 years, and
there was no seasonality. The mean patient charges in 1995 were $12,819 for
primary varicella and $15,583 for herpes zoster. Analysis of population-based
hospital discharge data is a feasible means of monitoring the impact of varicella
immunization on severe morbidity due to primary varicella and herpes zoster.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10837168 [PubMed - indexed for MEDLINE]

3115: Nippon Ganka Gakkai Zasshi. 2000 May;104(5):354-62.

[Expression of the varicella zoster virus thymidine kinase and cytokines in
patients with acute retinal necrosis syndrome]

[Article in Japanese]

Sato M, Abe T, Tamai M.

Department of Ophthalmology, Tohoku University School of Medicine, Sendai, Japan.

PURPOSE: Acute retinal necrosis (ARN) is caused by varicella zoster virus (VZV)
infection. In this study, we investigated the activity of this virus and
expressions of some cytokines. PATIENTS AND METHODS: The expression of VZV
thymidine kinase and some cytokines were investigated by reverse
transcriptase-polymerase chain reaction (RT-PCR) in 9 eyes of 8 patients with
ARN. RESULTS: Thymidine kinase expression was observed in all samples except one.
Several cytokines, such as interferon (IFN) gamma, tumor necrosis factor (TNF)
alpha, interleukin (IL)-1 beta, IL-6, and transforming growth factor (TGF) beta 1
were observed in the samples. Among these cytokines, a statistically significant 
expression of IFN gamma was observed in the samples of ARN, when compared to
those of proliferative vitreoretinopathy (PVR) or other uveitis. The expression
of IFN gamma also decreased during successive follow-ups. CONCLUSION: These
cytokines may play an important role in the immune response in ARN.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10835891 [PubMed - indexed for MEDLINE]

3116: Neurosurgery. 2000 Jun;46(6):1504-8; discussion 1508-10.

Primary angiitis of the central nervous system as a first presentation in
Hodgkin's disease: a case report and review of the literature.

Rosen CL, DePalma L, Morita A.

Department of Neurological Surgery, George Washington University Medical Center, 
Washington, District of Columbia 20037, USA. crosen@gwu.edu

OBJECTIVE AND IMPORTANCE: Granulomatous angiitis of the central nervous system is
a rare cause of neurological deterioration. It is often diagnosed posthumously,
and a high index of suspicion is necessary to make the correct diagnosis on a
timely basis. CLINICAL PRESENTATION: A 27-year-old woman presented to the
emergency room with complaints of worsening headache, nausea, and vomiting for 10
days, which were preceded by swelling of her tongue. At the examination, she had 
mild ocular tenderness, but no cranial nerve abnormalities. Radiographic
examination revealed a right temporal lobe area with edema, and mild contrast
enhancement was noted on computed tomography and magnetic resonance imaging. A
similar but smaller region was present in the left frontal lobe. INTERVENTION:
Stereotactic biopsy of the left temporal lobe revealed granulomatous angiitis.
Further workup revealed Hodgkin's disease in the mediastinum. Dexamethasone as
well as chemotherapy for Hodgkin's disease was initiated. The patient's symptoms 
resolved, and she returned to work with her disease in remission. CONCLUSION:
Previous reports of central nervous system angiitis have shown an association
with Sjogren's syndrome, herpes zoster infection, human immunodeficiency virus,
and Hodgkin's disease. A review of the literature revealed a total of 12 patients
with central nervous system angiitis and Hodgkin's disease. As a group, these
patients had very poor outcomes. However, of six patients who presented with
central nervous system angiitis and concurrent Hodgkin's disease and who
underwent aggressive treatment for both conditions, three had a full recovery,
two had a partial recovery, and one died.

Publication Types: 
    Case Reports

PMID: 10834654 [PubMed - indexed for MEDLINE]

3117: Semin Cutan Med Surg. 2000 Mar;19(1):62-8.

Common and unusual cases seen by an inpatient dermatology consult service.

Jones DA, Johnson RA.

Dermatology Residency Training Program, Harvard Medical School, Boston, MA, USA.

This article describes common consult requests and presents case studies from the
dermatology consult service of an academic hospital.

Publication Types: 
    Case Reports

PMID: 10834605 [PubMed - indexed for MEDLINE]

3118: J Laryngol Otol. 2000 Mar;114(3):212-3.

Herpes zoster oticus following mandibular block.

Maini S, Preece M.

Department of Otolaryngology, Royal Gwent Hospital, Newport, UK.

Although a few cases of facial palsy following mandibular nerve block and dental 
surgery have been described, it would appear that herpes zoster oticus following 
dental surgery has not been documented. It is possible that the latent virus may 
be activated by the mandibular nerve block and dental surgical interventions. Two
cases of herpes zoster oticus, both following inferior alveolar nerve block
anaesthesia for dental treatment are presented.

Publication Types: 
    Case Reports

PMID: 10829113 [PubMed - indexed for MEDLINE]

3119: Acta Virol. 1999 Dec;43(6):337-40.

No acute varicella-zoster virus replication in peripheral blood mononuclear cells
during postherpetic neuralgia.

Schunemann S, Mainka C, Wolff MH.

Institute of Microbiology and Virology, University of Witten/Herdecke, Germany.

Patients suffering from postherpetic neuralgia (PHN) were investigated whether
varicella-zoster virus (VZV) DNA or RNA could be detected in their peripheral
blood mononuclear cells (PBMCs). Altogether 16 samples were tested by standard
polymerase chain reaction (PCR) for open reading frame (ORF) 14 and ORF 29,
standard and nested PCR for ORF 63, and isothermal transcription-based nucleic
acid amplification (NASBA) for ORF 63 and ORF 68. By these methods neither VZV
DNA nor VZV RNA could be detected. The obtained results are in contrast to those 
of other authors (Vafai et al., 1988; Mahalingam et al., 1995) but support the
hypothesis of Bennett (1994) and Kost and Straus (1996) proposing that PHN is not
caused by acute VZV replication but a consequence of neuronal damage accompanying
replication of VZV in ganglia during zoster episodes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10825921 [PubMed - indexed for MEDLINE]

3120: Clin Infect Dis. 1999 Apr;28(4):736-9.

Herpes zoster in the elderly: issues related to geriatrics.

Schmader K.

Department of Medicine, Duke University Medical Center, Durham Veterans Affairs
Medical Center, North Carolina, USA. keschma@acpub.duke.edu

This article reviews specific clinical and research issues of herpes zoster
related to geriatric medicine. Salient epidemiological and clinical issues
include the increasing probability of zoster and postherpetic neuralgia with
aging, age-related decline in immunity to varicella-zoster virus, the functional 
and psychosocial impact of zoster on the quality of life of the elderly, illness 
behavior in elderly patients with zoster, and varicella-zoster virus transmission
and control in the nursing home. The role of antiviral therapy, corticosteroids, 
and analgesics; the measurement and analysis of pain, health-related quality of
life, and functional status; and development of the varicella vaccine in the
management of zoster in the elderly are also emphasized. Fertile research
opportunities exist within these areas for investigators interested in infectious
diseases, geriatrics, and other zoster-related disciplines.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10825029 [PubMed - indexed for MEDLINE]

3121: J Dermatol. 2000 Apr;27(4):252-7.

Herpes zoster infection complicated by motor paralysis.

Akiyama N.

Department of Rehabilitation Medicine, Nippon Medical School, Kanagawa, Japan.

We reviewed a total of 1,432 patients diagnosed with cutaneous herpes zoster at
Hyogo College of Medicine Hospital between 1989 and 1997 for epidemiologic
assessment and outcome in patients with zoster paralysis referred for
rehabilitation. Of the 1,432 herpes zoster patients (624 males and 808 females,
mean age 54.3 years), 12 were referred to our department of rehabilitation
medicine for muscle weakness: one had myelitis, and eleven others had lower motor
neuron damage. Except for one 43-year-old man with myelodysplastic syndrome, all 
the lower motor neuron deficit patients were over 60 years of age. Involved
myotomes were more widespread than involved dermatomes in eight patients.
Electromyography in four patients demonstrated denervation of involved muscles.
Five patients experienced complete or near complete recovery from their muscle
weakness. The muscle weakness related to herpes zoster was occasionally diagnosed
by electromyography as motor neuron damage. Manifestations of motor neuron
complications were not noticed but might in fact be more common than was the
clinical muscle weakness.

PMID: 10824489 [PubMed - indexed for MEDLINE]

3122: Acta Neurol Scand Suppl. 1999;173:25-35; discussion 48-52.

Treatment options in postherpetic neuralgia.

Bonezzi C, Demartini L.

Department of Anesthesia, Fondazione Salvatore Haugeri IRCCS, Pavia, Italy.

Postherpetic neuralgia (PHN) is a separate disease entity that represents a
complication of acute herpes zoster. PHN, involving aberrant somatosensory
processing in the peripheral and/or central nervous system, is considered to be a
chronic neuropathic pain, frequently unresponsive to all treatment modalities.
Despite the clinical trial data demonstrating successful pain relief with several
drug regimens, the pharmacologic management of neuropathic pain is difficult,
particularly in PHN. Response to therapy is generally inhomogeneous. Some
patients experience long-term pain control with either topical or oral
monotherapy with antidepressants, anticonvulsants, or opioids. Other PHN
patients, such as those suffering pain due to central nervous system lesions, are
extraordinarily refractory to all measures. This article will review current
treatments--tricyclic antidepressants, anticonvulsants, local anesthetics,
clonidine, N-methyl-D-aspartate (NMDA)-antagonists, and opioids and focus on
mechanism-based pharmacologic interventions. Pharmacologic approaches can be
classified into three groups: 1) drugs that act topically in the affected skin
area; 2) drugs that act on nerve excitability and conduction in sensory axons;
and 3) drugs that act on neural damage related synaptic changes. This last group 
is the only pain treatment option related to central denervation. To date, the
treatment of PHN has relied on the use of tricyclic antidepressants (TCAs), which
represent the most comprehensively studied medications for this pain syndrome.
Clinical data indicate that TCAs are effective analgesics in approximately 50% of
patients; these drugs have been recommended as first-line agents for all
neuropathic pain syndromes except trigeminal neuralgia, but are frequently
contraindicated or poorly tolerated in elderly patients with PHN. If monotherapy 
fails, a mechanism- and/or symptom-based multidrug regimen can be used. There is 
also consistent support for intravenous and topical lidocaine, intravenous
ketamine, carbamazepine, and opioids. Gabapentin, a new anticonvulsant, can be
considered a first-line oral medication for PHN based on the efficacy and safety 
results of a recently completed double-blind trial. In addition to positive
effects on PHN, sleep, mood, and overall quality of life were significantly
improved.

Publication Types: 
    Review

PMID: 10819089 [PubMed - indexed for MEDLINE]

3123: Int J Dermatol. 2000 Jan;39(1):77-8.

Verrucous varicella zoster virus lesions associated with acquired
immunodeficiency syndrome.

Kimya-Asadi A, Tausk FA, Nousari HC.

Publication Types: 
    Case Reports
    Letter

PMID: 10819618 [PubMed - indexed for MEDLINE]

3124: Br J Dermatol. 2000 Jan;142(1):182-3.

Zosteriform metastasis of colonic carcinoma.

Ahmed I, Holley KJ, Charles-Holmes R.

Publication Types: 
    Case Reports
    Letter

PMID: 10819547 [PubMed - indexed for MEDLINE]

3125: Br J Dermatol. 2000 Jan;142(1):180-2.

Zosteriform relapse of B-cell lymphoma.

Au WY, Chan AC, Kwong YL.

Publication Types: 
    Letter

PMID: 10819546 [PubMed - indexed for MEDLINE]

3126: Antimicrob Agents Chemother. 2000 Jun;44(6):1506-11.

In vitro activities of methylenecyclopropane analogues of nucleosides and their
phosphoralaninate prodrugs against cytomegalovirus and other herpesvirus
infections.

Rybak RJ, Hartline CB, Qiu YL, Zemlicka J, Harden E, Marshall G, Sommadossi JP,
Kern ER.

University of Alabama School of Medicine, Birmingham, Alabama, USA.

Human cytomegalovirus (HCMV) infection does not generally cause problems in the
immunocompetent adult but can result in severe clinical disease in the fetus,
neonate, and immunocompromised host. Ganciclovir (GCV), the agent currently used 
to treat most HCMV infections, has resulted in much therapeutic success; however,
efficacy remains suboptimal. Therefore, there is still a need to develop new
compounds for use against HCMV infections. In the present study, several Z- and
E-series methylenecyclopropane analogues and their phosphoroalaninate prodrugs
were tested initially for activity against HCMV, strain AD169, and murine
cytomegalovirus (MCMV) in vitro. Many were found to exhibit efficacy comparable
to that of GCV against HCMV in plaque assays and were active against MCMV as
well. The compounds were also tested for efficacy against herpes simplex virus
types 1 and 2, varicella-zoster virus, and Epstein-Barr virus, and some had
levels of activity that were comparable to that of acyclovir. In addition, the
compounds synguanol (QYL-438) and 2-amino-6-cyclopropylamino analogue (QYL-769)
were chosen for further evaluation and were found to be effective against
additional laboratory and clinical isolates of HCMV and GCV-resistant isolates.
QYL-438 and QYL-769 were found to be nontoxic in human and mouse fibroblasts and 
were considerably less toxic than GCV in granulocyte macrophage CFUs and
erythroid burst-forming units. These results provide evidence for the high
activity of some of these methylenecyclopropane analogues against various
herpesviruses, particularly HCMV, in tissue culture and suggest that further
evaluation is warranted to determine their potential for use in future clinical
studies.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10817700 [PubMed - indexed for MEDLINE]

3127: Clin Otolaryngol Allied Sci. 2000 Apr;25(2):139-42.

Herpes zoster oticus treated with acyclovir and prednisolone: clinical
manifestations and analysis of prognostic factors.

Ko JY, Sheen TS, Hsu MM.

Department of Otolaryngology, National Taiwan University Hospital, College of
Medicine, National Taiwan University, Taipei, Taiwan. kjycln@ha.mc.ntu.edu.tw

Herpes zoster oticus is a cranial polyneuropathy with facial nerve involvement as
its main feature. The prognosis of the facial palsy is usually poor. Thirty
patients with herpes zoster oticus suffering from facial palsy were admitted for 
parenteral acyclovir and oral prednisolone. Multiple regression analysis of
improvement of facial palsy showed three significant covariates: age, multiple
nerve palsies, and the initial grading of the palsy. The recovery of the facial
palsy treated with acyclovir and prednisolone was good, and possibility of a good
outcome was greater when the initial grade of the palsy was higher. Multiple
nerve palsies and age had negative effects on the improvement.

PMID: 10816219 [PubMed - indexed for MEDLINE]

3128: J Org Chem. 2000 Mar 10;65(5):1280-90.

Spiropentane mimics of nucleosides: analogues of 2'-deoxyadenosine and
2'-deoxyguanosine. Synthesis of all stereoisomers, isomeric assignment, and
biological activity.

Guan HP, Ksebati MB, Cheng YC, Drach JC, Kern ER, Zemlicka J.

Department of Chemistry, Experimental and Clinical Chemotherapy Program, Barbara 
Ann Karmanos Cancer Institute, Wayne State University School of Medicine, 110
East Warren Avenue, Detroit, Michigan 48201-1379, USA.

Synthesis of spirocyclic analogues of 2'-deoxyadenosine and 2'-deoxyguanosine
(12a-15a and 12b-15b) is described. Rhodium-catalyzed reaction of ethyl
diazoacetate with methylenecyclopropane 19, obtained from
2-bromo-2-bromomethylcyclopropane 17 via debromination (16), reduction (18), and 
acetylation (19), gave a mixture of all four isomeric spiropentanes 20a-20d.
Hydrolysis afforded hydroxy carboxylic acids 21a-21d. Acetylation of separated
proximal + medial-syn isomers 21a + 21b and medial anti + distal isomers 21c +
21d furnished acetates 22a + 22b and 22c + 22d. Curtius rearrangement effected by
diphenylphosphoryl azide in tert-butyl alcohol performed separately with mixtures
22a + 22b and 22c + 22d led to BOC-amino spiropentanes 23a + 23b and 23c + 23d.
After deacetylation all isomers 24a-24d were separated and deprotected to give
aminospiropentane hydrochlorides 25a-25d. Free bases were of limited stability.
The heterocyclic moieties were introduced into individual isomers 25a-25d via
6-chloropurine derivatives 26a-26d or 30a-30d. Ammonolysis of 26a-26d furnished
the adenine isomeric series 12a-15a, whereas guanine derivatives 12b-15b were
obtained by hydrolysis of 30a-30d with formic acid. The isomeric assignments
followed from IR spectra of BOC-aminospiropentanes 24a-24d and NMR spectra of
12a-15a including NOE and (H,H) COSY. The proximal and medial-syn isomers 12a and
12b were modest inhibitors of human cytomegalovirus (HCMV) and Epstein-Barr virus
(EBV) in culture, whereas the medial-anti isomer 12c was a substrate for
adenosine deaminase. The distal isomer 15b was an anti-EBV agent. The medial-syn 
phosphoralaninate 34 was an effective inhibitor of HCMV replication in vitro. It 
was also active against herpes simplex virus type 1 (HSV-1), varicella zoster
virus (VZV), human immunodeficiency virus (HIV-1), hepatitis B virus (HBV), and
EBV with a varying degree of cytotoxicity.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10814087 [PubMed - indexed for MEDLINE]

3129: AIDS Patient Care STDS. 1999 Sep;13(9):513-6.

Viral folliculitis.

Weinberg JM, Turiansky GW, James WD.

Department of Dermatology, St. Luke's-Roosevelt Hospital Center, New York, New
York, USA. jwein@bway.net

Viral folliculitis is an infrequently reported entity. We describe two patients
with viral folliculitides, including a case of herpetic sycosis caused by herpes 
simplex (HSV) and a case of herpes zoster (HZ) without blisters. Clinicians
should consider viral etiologies in the differential diagnosis of superficial
infectious folliculitis, especially those cases refractory to antibacterial or
antifungal therapy.

Publication Types: 
    Case Reports

PMID: 10813030 [PubMed - indexed for MEDLINE]

3130: Vaccine. 2000 Jun 15;18(25):2915-20.

Comparison of a live attenuated and an inactivated varicella vaccine to boost the
varicella-specific immune response in seropositive people 55 years of age and
older.

Levine MJ, Ellison MC, Zerbe GO, Barber D, Chan C, Stinson D, Jones M, Hayward
AR.

Department of Pediatrics/Pediatric Infectious Diseases, University of Colorado
School of Medicine, Denver 80262, USA. myron.levin@uchsc.edu

Healthy, varicella-zoster virus (VZV)-seropositive subjects, aged 55-89 years
(mean age 66 years), received either 4000 PFU of live, attenuated VZV vaccine
(n=85) or an equal volume of this vaccine that was heat-inactivated (n=82). Both 
vaccines significantly boosted VZV antibody (enzyme immunoassay) and
gamma-interferon production by peripheral blood mononuclear cells stimulated by
VZV antigen. These responses returned to baseline by 12 months. Circulating
mononuclear cells that proliferated in response to VZV antigen were significantly
more numerous (responder cell frequency assay) after either vaccine, and
persisted with a half-life of 17. 5-21.3 months. There were no differences in
immune response to either vaccine in this older age cohort.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 10812235 [PubMed - indexed for MEDLINE]

3131: Vaccine. 2000 Jun 15;18(25):2775-8.

Analysis of varicella vaccine breakthrough rates: implications for the
effectiveness of immunisation programmes.

Brisson M, Edmunds WJ, Gay NJ, Law B, De Serres G.

PHLS CDSC, Colindale, London, UK. mbrisson@phls.nhs.uk

The objective of this study was to quantify key parameters describing varicella
zoster virus (VZV) vaccine efficacy. To do so a mathematical model was developed 
to represent breakthrough cases as a function of time after vaccination in
vaccine efficacy trials. Efficacy parameter sets were identified by fitting the
predicted annual number of breakthrough infections with that observed in three
clinical trials chosen to represent the plausible range of vaccine efficacy.
Results suggest that varicella vaccination seems to result in a high proportion
of individuals who are initially totally protected (97% for the base-case).
However, individuals lose full protection relatively rapidly (3% per year for the
base-case). Once total protection has waned individuals have a high probability
of developing a breakthrough infection if exposed to varicella (73% of the
probability in unvaccinated susceptibles for the base-case). Results also
highlight that vaccine efficacy parameters should be estimated concurrently to
take into account dependencies between parameters.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 10812218 [PubMed - indexed for MEDLINE]

3132: Hautarzt. 2000 Apr;51(4):256-9.

[Specific skin infiltration of extracutaneous B-cell lymphoma in healing herpes
simplex skin]

[Article in German]

Reimann S, Kutting B, Dercken C, Metze D.

Universitats-Hautklinik der Westfalischen Wilhelms-Universitat, Munster.

Both herpes simplex and herpes zoster are not uncommon in patients affected by
malignant lymphoma or leukemia. Of particular interest, the herpetic lesions may 
be followed by specific cutaneous infiltrates. We report on a patient with a
centrocytic-centroblastic non-Hodgkin lymphoma who showed primary skin
infiltrates within the area affected by herpes simplex. After effective therapy
with aciclovir, papules and plaques developed at the site of the herpetic scars. 
Histologic investigation confirmed dense B-lymphocytic infiltrates with
immunoglobulin light chain restriction and a granulomatous reaction. Although the
chemotherapeutical regiment was modified, the patient died one month later of a
lethal blast crisis. The occurrence of so called isotopic skin reactions and
their prognostic significance is discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10810661 [PubMed - indexed for MEDLINE]

3133: Drugs. 2000 Apr;59(4):839-63.

Valaciclovir: a review of its long term utility in the management of genital
herpes simplex virus and cytomegalovirus infections.

Ormrod D, Scott LJ, Perry CM.

Adis International Limited, Mairangi Bay, Auckland, New Zealand.
demail@adis.co.nz

Valaciclovir is an aciclovir prodrug used to treat infections caused by herpes
simplex virus (HSV) and varicella zoster virus, and for prophylaxis against
cytomegalovirus (CMV). Oral valaciclovir provides significantly better oral
bioavailability than oral aciclovir itself, contributing to the need for less
frequent administration. Several studies have demonstrated the efficacy of long
term (> 90 days) therapy with valaciclovir for the suppression of genital HSV
disease in otherwise healthy individuals with HSV infection. In 1 randomised,
double-blind trial, once daily valaciclovir (1000 mg, 500 mg and 250 mg) produced
statistically significant suppression of disease recurrence, as did twice daily
valaciclovir 250 mg and aciclovir 400 mg. Valaciclovir dosages of > or = 500 mg
daily are recommended for suppression of genital herpes recurrences in
immunocompetent individuals. This disease occurs frequently in patients with
human immunodeficiency virus (HIV) infection and, in a single randomised
double-blind trial, prophylactic valaciclovir (1000 mg once daily or 500 mg twice
daily) and aciclovir (400 mg twice daily) were found to be of similar efficacy in
the suppression of genital herpes. However, a higher than expected dropout rate
indicated that more studies of valaciclovir in patients with HIV are required. In
a randomised trial of patients undergoing renal transplant, valaciclovir 2 g 4
times daily for 90 days significantly reduced the incidence and delayed the onset
of CMV disease: the incidence in valaciclovir-treated patients who were
CMV-seronegative at baseline, and recieived a kidney from a CMV-seropositive
donor, was 3% versus 45% for placebo after 90 days of treatment. Acute graft
rejection was also reduced in the valaciclovir-treated group. A small study in
heart transplant patients compared valaciclovir (2 g 4 times daily) with
aciclovir (200 mg 4 times daily) and found a significant reduction in CMV
antigenaemia favouring valacilovir at the end of the treatment period. Additional
reductions in other indices of CMV in those given valaciclovir compared with
aciclovir were also noted. In a preliminary study of prophylaxis for CMV disease 
in bone marrow transplant recipients valaciclovir (2 g 4 times daily) was
superior to aciclovir (800 mg 4 times daily) in terms of time to CMV viraemia or 
viruria. Although valaciclovir (8 g/day for approximately 30 weeks) reduced the
incidence and time to CMV disease compared with aciclovir (3.2 g/day) in patients
with advanced HIV disease, valaciclovir was associated with more gastrointestinal
complaints and an increased risk of death, leading to premature termination of
the study. As yet, no trials comparing the efficacy of valaciclovir with
famciclovir (the oral prodrug for penciclovir) in the suppression of recurrent
episodes of genital herpes have been published, nor have direct comparisons been 
made, between valaciclovir with ganciclovir in patients with CMV disease.
Valaciclovir is well tolerated at dosages used to suppress recurrent episodes of 
genital herpes (500 to 1000 mg/day) in immunocompetent and HIV seropositive
individuals, with headache being reported most often. However, a potentially
fatal thrombotic microangiopathy (TMA)-like syndrome has been reported in some
immunocompromised patients receiving high-dose prophylactic valaciclovir therapy 
(8 g/day) for CMV disease for prolonged periods, and the risk of this syndrome
appears to be higher in patients with advanced HIV disease. While the clinical
benefits of valaciclovir in some immunocompromised patients may outweigh the risk
of TMA, close monitoring for symptoms of TMA is indicated in all
immunocompromised patients receiving high-dose valaciclovir. Conclusion: Oral
valaciclovir is an effective drug for the suppression of recurrent episodes of
genital herpes in immunocompetent and immunocompromised individuals. (ABSTRACT
TRUNCATED)

Publication Types: 
    Review

PMID: 10804039 [PubMed - indexed for MEDLINE]

3134: Bone Marrow Transplant. 2000 May;25(9):1003-5.

Acute abdomen without cutaneous signs of varicella zoster virus infection as a
late complication of allogeneic bone marrow transplantation: importance of
empiric therapy with acyclovir.

Yagi T, Karasuno T, Hasegawa T, Yasumi M, Kawamoto S, Murakami M, Uosima N,
Nakamura H, Hiraoka A, Masaoka T.

Fifth Department of Internal Medicine, Osaka Medical Center for Cancer and
Cardiovascular Diseases, Osaka, Japan.

Two patients complained of severe abdominal pain as the first sign of varicella
zoster virus infection about 1 year after allogeneic BMT. In case 1, eruptions,
found on the face and chest on admission, became vesicular and dispersed on the
third hospital day. Though acyclovir (ACV) was immediately started, he died on
the fourth day. In case 2, skin rash was never observed during the clinical
course. Laparotomy on the third hospital day revealed many hemorrhagic spots on
the liver surface and mucous membrane of the upper GI tract, indicating
disseminated visceral disease. Empiric therapy with ACV was successful.

Publication Types: 
    Case Reports

PMID: 10800071 [PubMed - indexed for MEDLINE]

3135: Cochrane Database Syst Rev. 2000;(2):CD001157.

Update in:
    Cochrane Database Syst Rev. 2000;(4):CD001157.

Cyclophosphamide for rheumatoid arthritis.

Suarez-Almazor ME, Belseck E, Shea B, Wells G, Tugwell P.

Health Services Research, Veterans Affairs Medical Center, Mailbox Station 152,
2002 Holcombe Blvd, Houston, Texas 77024, USA. mes@bcm.tmc.edu

OBJECTIVES: To estimate the short-term effects of cyclophosphamide for the
treatment of rheumatoid arthritis. SEARCH STRATEGY: We searched the Cochrane
Musculoskeletal Group's Register, the Cochrane Controlled Trials Register,
Medline and Embase up to and including July 1997. We also carried out a
handsearch of the reference lists of the trials retrieved from the electronic
search. SELECTION CRITERIA: All randomized controlled trials (RCTs) and
controlled clinical trials (CCTs) comparing oral cyclophosphamide against placebo
(or an active drug at a dosage considered to be ineffective) in patients with
rheumatoid arthritis. DATA COLLECTION AND ANALYSIS: Data abstraction was carried 
out independently by two reviewers. The same two reviewers using Jadad's scale
(Jadad 1995) assessed the methodological quality of the RCTs and CCTs. Rheumatoid
arthritis outcome measures were extracted from the publications for baseline and 
end-of-study. The pooled analysis was performed using standardized mean
differences (SMDs) for joint counts. Weighted mean differences (WMDs) were used
for erythrocyte sedimentation rate (ESR). Toxicity was evaluated with pooled odds
ratios for withdrawals. A chi-square test was used to assess heterogeneity among 
trials. Fixed effects models were used throughout. MAIN RESULTS: A total of 70
patients were included in the pooled analysis of two trials, 31 receiving
cyclophosphamide. A statistically significant benefit was observed for
cyclophosphamide when compared to placebo for tender and swollen joint scores:
SMDs were -0.57 and -0.59 respectively. The difference in ESR also favoured the
active drug but did not reach statistical significance (-12 mm, 95%CI: -26 to
2.5). One trial reported the number of patients developing new or worse erosions:
the OR for cyclophosphamide compared to placebo was 0.17 (95% CI: 0.05 to 0.57). 
Patients receiving placebo were six times more likely to discontinue treatment
because of lack of efficacy than patients receiving cyclophosphamide. Withdrawals
from adverse reactions were higher in the cyclophosphamide group (Odds
ratio=2.9), although this difference was not statistically significant. Side
effects from cyclophosphamide included hemorrhagic cystitis, nausea, vomiting,
leucopenia, thrombocytopenia, alopecia, amenorrhea and herpes zoster infections. 
REVIEWER'S CONCLUSIONS: Cyclophosphamide appears to have a clinically and
statistically significant benefit on the disease activity of patients with RA,
similar to some disease modifying antirheumatic drugs (DMARDs) such as
antimalarials or sulfasalazine, but lower than methotrexate. Toxicity however is 
severe, limiting its use given the low benefit-risk ratio compared to other
antirheumatic agents.

Publication Types: 
    Review

PMID: 10796419 [PubMed - indexed for MEDLINE]

3136: Graefes Arch Clin Exp Ophthalmol. 2000 Mar;238(3):222-7.

Intraocular antibody production in intraocular inflammation.

Liekfeld A, Schweig F, Jaeckel C, Wernecke KD, Hartmann C, Pleyer U.

Department of Ophthalmology, Charite, Humboldt University, Berlin, Germany.

BACKGROUND: The production of intraocular antibodies is considered a specific
marker for active infectious uveitis. The aim of our study was to evaluate the
diagnostic value of aqueous humor analysis in consecutive patients referred to a 
tertiary clinical center. METHODS: We analyzed 91 paired aqueous humor/serum
samples from 89 patients with intraocular inflammation. In 71 patients aqueous
humor analysis was used as a positive or negative confirmation of the suspected
cause, whereas in 18 patients the clinical diagnosis was completely uncertain. A 
modified micro-ELISA technique was used to detect intraocular IgG production
against Toxoplasma gondii, varicella zoster virus, herpes simplex virus and
cytomegalovirus. Statistical analysis was performed using the "Cohen's kappa"
test. RESULTS: Specific intra-ocular antibody production could be detected in 12 
(66.7%) of 18 patients with uncertain diagnosis. Subsequently initiated therapy
led to clinical improvement in 10 patients, whereas 2 patients remained
unchanged. In 2 (2.8%) of 71 patients aqueous humor analysis led to revision of
the initially suspected etiology and to a change of therapy. Statistical analysis
showed a significant accordance of diagnosis and aqueous humor analysis (P<0.01).
CONCLUSION: In patients with infectious uveitis, analysis of intraocular
synthesis of specific antibodies is a valuable tool to establish the etiology
rapidly and allows initiation of targeted antimicrobial treatment.

PMID: 10796036 [PubMed - indexed for MEDLINE]

3137: J Fr Ophtalmol. 2000 Apr;23(4):391-3.

[Pain and zona ophthalmica]

[Article in French]

Lagoutte F.

Clinique Thiers, 330 bis, avenue Thiers, 33100 Bordeaux, France.

Pain before and during Herpes Zoster is well known. A new antiviral therapy is
suggested. Post-herpetic neuralgia remains more difficult to treat.

Publication Types: 
    English Abstract
    Review

PMID: 10794992 [PubMed - indexed for MEDLINE]

3138: Am Fam Physician. 2000 Apr 15;61(8):2437-44, 2447-8.

Management of herpes zoster (shingles) and postherpetic neuralgia.

Stankus SJ, Dlugopolski M, Packer D.

Eisenhower Army Medical Center, Fort Gordon, Georgia 30905, USA.

Herpes zoster (commonly referred to as "shingles") and postherpetic neuralgia
result from reactivation of the varicella-zoster virus acquired during the
primary varicella infection, or chickenpox. Whereas varicella is generally a
disease of childhood, herpes zoster and post-herpetic neuralgia become more
common with increasing age. Factors that decrease immune function, such as human 
immunodeficiency virus infection, chemotherapy, malignancies and chronic
corticosteroid use, may also increase the risk of developing herpes zoster.
Reactivation of latent varicella-zoster virus from dorsal root ganglia is
responsible for the classic dermatomal rash and pain that occur with herpes
zoster. Burning pain typically precedes the rash by several days and can persist 
for several months after the rash resolves. With postherpetic neuralgia, a
complication of herpes zoster, pain may persist well after resolution of the rash
and can be highly debilitating. Herpes zoster is usually treated with orally
administered acyclovir. Other antiviral medications include famciclovir and
valacyclovir. The antiviral medications are most effective when started within 72
hours after the onset of the rash. The addition of an orally administered
corticosteroid can provide modest benefits in reducing the pain of herpes zoster 
and the incidence of postherpetic neuralgia. Ocular involvement in herpes zoster 
can lead to rare but serious complications and generally merits referral to an
ophthalmologist. Patients with postherpetic neuralgia may require narcotics for
adequate pain control. Tricyclic antidepressants or anticonvulsants, often given 
in low dosages, may help to control neuropathic pain. Capsaicin, lidocaine
patches and nerve blocks can also be used in selected patients.

Publication Types: 
    Review

PMID: 10794584 [PubMed - indexed for MEDLINE]

3139: Indian J Med Res. 2000 Jan;111:14-23.

Profile of neurologic disorders associated with HIV/AIDS from Bangalore, south
India (1989-96).

Satishchandra P, Nalini A, Gourie-Devi M, Khanna N, Santosh V, Ravi V, Desai A,
Chandramuki A, Jayakumar PN, Shankar SK.

Department of Neurology, National Institute of Mental Health & Neuro Sciences,
Bangalore.

One hundred patients (95 males, 5 females, mean age at presentation 31.6 +/- 9.4 
yr) with various neurological disorders associated with HIV infection during
1989-1996 were evaluated at NIMHANS, Bangalore. Eighty patients belonged to group
I associated with opportunistic neuroinfections and 20 to group II--non
infectious neurological disorders. Cryptococcal meningitis either alone (n = 31) 
or associated with tuberculous meningitis (n = 6) was the most common (46.3%)
followed by neurotuberculosis either alone (n = 24) or with cerebral
toxoplasmosis (n = 4) accounting for 35 per cent. Other opportunistic
neuroinfections included cerebral toxoplasmosis, herpes zoster, fulminant
pyogenic meningitis and neurosyphilis. Clinical characteristics, diagnostic
clues, their laboratory and radiological profiles and problems encountered in
diagnosis and management of these opportunistic infections are highlighted. In
group II (19 males and one female; mean age of 32.6 +/- 9.4 yr), two patients had
cortical dementia, three acute brain stem involvement, two epilepsy and one had
features suggestive of progressive multifocal leukoencephalopathy. Two patients
of group I during follow up developed cortical dementia. Six had peripheral
nervous system involvement similar to Guillain-Barre syndrome. Sixty six patients
(63 of group I and 3 of group II) progressed to AIDS, 33 patients from group I
and one patient from group II succumbed to the disease. With the rapid increase
in the incidence of HIV/AIDS and an increase in the neurological manifestations
of HIV/AIDS it is important to recognise the magnitude of the problem for health 
planning in India.

PMID: 10793489 [PubMed - indexed for MEDLINE]

3140: Virology. 2000 May 10;270(2):278-85.

Varicella-zoster virus infection of a human CD4-positive T-cell line.

Zerboni L, Sommer M, Ware CF, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
94305-5208, USA. zerboni@leland.stanford.edu

Varicella-zoster virus (VZV) is a human alpha-herpesvirus that causes varicella
(chickenpox) at primary infection and may reactivate as herpes zoster. VZV is a
T-lymphotropic virus in vivo. To investigate the T-cell tropism of VZV, we
constructed a recombinant virus expressing green fluorescent protein (VZV-GFP)
under the CMV IE promoter. Coculture of VZV-GFP-infected fibroblasts with II-23
cells, a CD4-positive human T-cell hybridoma, resulted in transfer of virus to
II-23 cells. II-23 cells are susceptible to VZV-GFP infection as demonstrated by 
expression of immediate/early (IE62), early (ORF4), and late (gE) genes. Recovery
of infectious virus was limited, with only 1 to 3 in 10(6) cells releasing
infectious virus by plaque assay, indicating that transfer of virus results in a 
limited productive infection. In vitro infection of II-23 cells will be useful
for further analysis of VZV tropism for T-lymphocytes. Copyright 2000 Academic
Press.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10792986 [PubMed - indexed for MEDLINE]

3141: J Clin Microbiol. 2000 May;38(5):1839-44.

Rapid phenotypic characterization method for herpes simplex virus and
Varicella-Zoster virus thymidine kinases to screen for acyclovir-resistant viral 
infection.

Suzutani T, Saijo M, Nagamine M, Ogasawara M, Azuma M.

Department of Microbiology, Asahikawa Medical College, Asahikawa, Japan.
suzutani@asahikawa-med.ac.jp

A rapid phenotypic screening method for herpes simplex virus (HSV) and
varicella-zoster virus (VZV) thymidine kinase (TK) genes was developed for
monitoring acyclovir-resistant viruses. This method determines the biochemical
phenotype of the TK polypeptide, which is synthesized in vitro from viral DNA
using a procedure as follows. The TK gene of each sample virus strain is
amplified and isolated under the control of a T7 promoter by PCR. The PCR
products are transcribed with T7 RNA polymerase and translated in a rabbit
reticulocyte lysate. Using this method, enzymatic characteristics and the size of
the TK polypeptides encoding HSV and VZV DNA were defined in less than 2 days
without virus isolation. The assay should be a powerful tool in monitoring
drug-resistant viruses, especially in cases in which virus isolation is
difficult.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10790110 [PubMed - indexed for MEDLINE]

3142: J Neurol. 2000 Mar;247(3):218-9.

Bickerstaff's brainstem encephalitis associated with shingles.

Tagawa Y, Yuki N.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't

PMID: 10787119 [PubMed - indexed for MEDLINE]

3143: J Neurovirol. 2000 Feb;6(1):46-50.

Etiology of microglial nodules in brains of patients with acquired
immunodeficiency syndrome.

Nebuloni M, Pellegrinelli A, Ferri A, Tosoni A, Bonetto S, Zerbi P, Boldorini R, 
Vago L, Costanzi G.

L. Sacco Institute of Biomedical Sciences, University of Milan, L. Sacco
Hospital, Italy.

Microglial nodules associated with opportunistic and HIV-related lesions are
frequently found in the brains of AIDS patients. However, in many cases, the
causative agent is only presumptively suspected. We reviewed 199 brains of AIDS
patients with micronodular lesions to clarify their etiology by
immunohistochemistry (to Toxoplasma gondii, cytomegalovirus, herpes simplex virus
I/II, varicella zoster virus and HIV-p24 core protein), PCR (for herpetic viruses
and Mycobacterium tuberculosis) and electron microscopy. Productive HIV infection
was observed in 110 cases (55.1%): 30 cases with Toxoplasma gondii encephalitis, 
30 with cytomegalovirus encephalitis, eight with multiple cerebral diseases,
while in the remaining 42 cases HIV was the only pathogenetic agent.
Multinucleated giant cells (hallmark of HIV infection) were found in the MGNs of 
85/110 cases with HIV-related lesions; the remaining 25 cases had only p24
positive cells but no multinucleated giant cells. In these latter cases the
micronodular lesions had been initially attributed to the main opportunistic
agent found in the brain, or defined as subacute encephalitis. Individual
microglial nodules positive for an opportunistic pathogen were generally negative
for HIV antigens. In 13 cases no opportunistic agent or HIV productive infection 
was found. In these cases, PCR and electron microscopy examination for HIV and
other viral infections were negative. Our data suggest that
HIV-immunohistochemistry should be used for the etiological diagnosis of
micronodular lesions in AIDS brains, even in the presence of other pathogens.
After extensive search, the etiology of the microglial nodules remains unknown in
only a small percentage of cases.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10786996 [PubMed - indexed for MEDLINE]

3144: Ann Rheum Dis. 2000 May;59(5):342-6.

Detection of multiple viral DNA species in synovial tissue and fluid of patients 
with early arthritis.

Stahl HD, Hubner B, Seidl B, Liebert UG, van der Heijden IM, Wilbrink B, Kraan
MC, Emmrich F, Tak PP.

Institute of Clinical Immunology and Transfusion Medicine, University of Leipzig,
Leipzig, Germany.

OBJECTIVE: Viruses have a role in the pathogenesis of various forms of arthritis.
This study aimed at determining whether viral DNA can be detected in joint
samples in the early stages of idiopathic arthritides. METHODS: Synovial fluid
(SF) and synovial tissue (ST) samples were obtained from 73 patients, with
undifferentiated arthritis (n=22), rheumatoid arthritis (n=13),
spondyloarthropathy (n=17), crystal arthropathy (n=8), osteoarthritis (n=7),
septic arthritis (n=5), and trauma (n=1). The presence of viral DNA was
investigated by polymerase chain reaction analysis. RESULTS: Cytomegalovirus was 
present in 25 patients, parvovirus B19 in 15 patients, Epstein-Barr virus in 12
patients, and herpes simplex virus in 16 patients (in ST, SF, or both),
respectively. The joint samples were negative for viral DNA from adenovirus and
varicella-zoster virus. In ST, eight patients were double positive for parvovirus
B19 and another viral DNA, with herpes simplex virus being the most prevalent.
Seven patients were double positive for other viruses (cytomegalovirus, herpes
simplex virus, Epstein-Barr virus). In SF, four patients were double or triple
positive for viral DNA. Paired samples were available in 56 patients. In these,
viral DNA was detected in 37 patients in ST, as compared with 19 in SF.
CONCLUSION: These data show that one or more viruses can be detected in the
synovial specimens of patients with early arthritis, irrespective of the clinical
diagnosis. This observation might be explained by migration of inflammatory cells
harbouring viral DNA into the inflamed joints.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10784515 [PubMed - indexed for MEDLINE]

3145: Pediatr Infect Dis J. 2000 Apr;19(4):307-12.

Viral infections in children undergoing hematopoietic stem cell transplant.

Maltezou HC, Kafetzis DA, Abisaid D, Mantzouranis EC, Chan KW, Rolston KV.

Department of Medical Specialties, University of Texas M.D. Anderson Cancer
Center, Houston 77030, USA.

BACKGROUND: Although viral infection is a major clinical problem for
hematopoietic stem cell transplant recipients, there are few large series
reporting on these infections in the pediatric population. We performed a
retrospective analysis of the impact of viral infections in this patient
population in our center, managed by a uniform antiviral prophylaxis protocol.
METHOD: We reviewed the medical records of consecutive children and adolescents
who received hematopoietic stem cell transplantation at the Division of
Pediatrics, The University of Texas M. D. Anderson Cancer Center in Houston, TX, 
from July, 1992 to August, 1996. RESULTS: During the study period there were 70
episodes of viral infections in 96 transplants. The viruses most commonly
encountered were cytomegalovirus (24), varicella-zoster (21) and herpes simplex
(10). Fifty of these episodes resulted in clinically apparent diseases, affecting
39 patients. The Kaplan-Meier estimated probability for the development of viral 
diseases was 62%. Ten percent of these patients died as a direct result of the
infectious process, all within 4 months of transplant. Significant factors for
development of viral disease were the development of acute graft-vs.-host disease
and the duration of preengraftment neutropenia. CONCLUSIONS: Viruses are common
pathogens after hematopoietic stem cell transplantation in the pediatric
population. Despite routine antiviral prophylaxis the morbidity and mortality of 
viral infections remain high. Enhancement of immune recovery after hematopoietic 
stem cell transplantation together with the development of new classes of
antiviral agents may impact the incidence and prognosis of viral infections in
this setting.

PMID: 10783020 [PubMed - indexed for MEDLINE]

3146: Schweiz Med Wochenschr. 2000 Jan 29;130(4):101-12.

Antiviral therapy: current options and challenges.

Reusser P.

Department of Medicine, University Hospital, Basel. pierre.reusser@jura.ch

This article reviews current options and concepts for drug treatment of viral
infections with the exception of human immunodeficiency virus infection. Advances
in antiviral drug development and in rapid diagnostic methods have resulted in
efficient management strategies, particularly for infections due to herpes
simplex virus, varicella-zoster virus, cytomegalovirus, influenza A and B
viruses, and chronic hepatitis B and C. Newer antiviral agents, such as
valaciclovir and famciclovir, have a high oral bioavailability which permits less
frequent intake and avoidance of intravenous therapy in many cases. As an
alternative to subcutaneous interferon-alpha (IFN-alpha) treatment, oral
lamivudine is now approved for therapy of chronic hepatitis B. The addition of
oral ribavirin to IFN-alpha treatment has been shown to be superior to IFN-alpha 
alone for therapy of chronic hepatitis C. By contrast to amantadine,
neuraminidase inhibitors such as zanamivir or oseltamivir (GS4104) have activity 
against both influenza A and B viruses and are well tolerated. First results of
controlled trials with these agents are discussed. The emergence of herpes virus 
resistance to antiviral drugs is of concern, and validation of alternative
treatment for patients with documented resistance is required. Future
investigations may also help to clarify the therapeutic role of novel antiviral
drugs and formulations, such as the oral prodrug of cidofovir, valganciclovir,
compounds 1263W94 and Bay 38-4766, and pleconaril.

Publication Types: 
    Review

PMID: 10780051 [PubMed - indexed for MEDLINE]

3147: Pain. 2000 May;86(1-2):95-101.

Allodynia and hyperalgesia induced by herpes simplex virus type-1 infection in
mice.

Takasaki I, Andoh T, Shiraki K, Kuraishi Y.

Department of Applied Pharmacology, Toyama Medical and Pharmaceutical University,
Japan.

Human subjects infected with herpes or varicella-zoster viruses complain of pain,
such as allodynia, in or near the region with vesicles. However, the mechanisms
of the pain are unclear. We show for the first time that infection with herpes
simplex virus type-1 (HSV-1) induces allodynia and hyperalgesia in mice. When
HSV-1 was inoculated on the hind paw of the mouse, eruption appeared on the back 
on day 5 post-inoculation, and zosteriform skin lesions were developed on the
inoculated side. Allodynia and hyperalgesia became apparent in the hind paw on
the inoculated side on day 5 and persisted until at least day 8. HSV-1 DNA was
detected in the dorsal root ganglia from days 2 to 8 post-inoculation, with a
peak effect on day 5. The application of heat-inactivated HSV-1 induced no
allodynia, hyperalgesia and skin lesion. When started from days 0 or 2, repeated 
treatment with acyclovir, anti-HSV-1 agent, inhibited the appearance of
allodynia, hyperalgesia, eruption and the viral proliferation in the dorsal root 
ganglia. In contrast, when started from days 5 or 6, acyclovir treatment slightly
inhibited the development of skin lesions and the viral proliferation, but not
allodynia and hyperalgesia. These results suggest that the propagation of HSV-1
in the dorsal root ganglia produces allodynia and hyperalgesia as a result of
functional abnormality of the sensory neurons in mice. This may be a useful model
for studying the mechanisms of herpetic pain.

PMID: 10779666 [PubMed - indexed for MEDLINE]

3148: J Assoc Physicians India. 1999 Jul;47(7):745.

Acute cerebellar ataxia following herpes zoster ophthalmicus.

Hiran S, Pipersania R, Khan AH, Sethi SK, Vishwanathan KA.

Dept. of Medicine, JLN Hospital and RC Bhilai.

Publication Types: 
    Case Reports

PMID: 10778605 [PubMed - indexed for MEDLINE]

3149: Eur J Cancer Prev. 2000 Feb;9(1):59-64.

Medical history and risk of Hodgkin's and non-Hodgkin's lymphomas.

Tavani A, La Vecchia C, Franceschi S, Serraino D, Carbone A.

Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.
tavani@irfmn.mnegri.it

The relationship between a history of selected medical conditions and risk of
lymphomas was investigated in a hospital-based case-control study conducted in
Northern Italy on 429 incident, histologically confirmed cases of non-Hodgkin's
lymphoma (NHL), 158 cases of Hodgkin's disease (HD) and 1157 controls admitted to
hospitals for acute conditions. The odds ratios (OR) for NHL were above unity in 
patients with a history of infectious mononucleosis (OR 2.9), herpes zoster (OR
1.8), pyelonephritis (OR 4.9), tuberculosis (OR 1.8), malaria (OR 1.9), any
chronic bacterial diseases (OR 1.7), rheumatoid arthritis (OR 1.7) and psoriasis 
(OR 2.5). With reference to HD, the ORs were 4.0 for infectious mononucleosis,
2.9 for herpes zoster, 3.3 for pyelonephritis, 2.3 for tuberculosis, 1.4 for
chronic bacterial diseases, 2.4 for rheumatoid arthritis, 2.7 for psoriasis and
2.1 for diabetes. The association of NHL and HD with herpes zoster was restricted
to the first ten years since the onset of the disease. The relationships between 
NHL and mononucleosis (OR 12.9), malaria (OR 2.8) and psoriasis (OR 14.0) were
stronger for cases aged > or = 60 years, and that with tuberculosis (OR 3.5) was 
stronger for younger cases. For HD, the positive association was stronger for
cases aged > or = 40 years for herpes zoster (OR 3.8) and diabetes (OR 2.6). An
increased risk of NHL was found in association with poliomyelitis (OR 1.6)
(restricted to cases aged > or = 60 years, OR 4.0) and BCG immunizations (OR
1.6), but not with vaccination against smallpox, tetanus and diphtheria;
increased risks of HD were found in relation to poliomyelitis and BCG
immunization in cases aged > or = 40 years (OR respectively 2.5 and 2.1), or > or
= 50 years (OR 4.3 and 2.2). Thus, our results confirm the association between a 
history of several chronic infectious and inflammatory diseases and the risk of
NHL or HD, and are compatible with a role of chronic immunological alterations in
the aetiology of lymphomas.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10777011 [PubMed - indexed for MEDLINE]

3150: Presse Med. 2000 Mar 25;29(11):584-8.

[Rapid diagnosis of the type of meningitis (bacterial or viral) by the assay of
serum procalcitonin]

[Article in French]

Viallon A, Pouzet V, Zeni F, Tardy B, Guyomarc'h S, Lambert C, Page Y, Bertrand
JC.

Service d'Urgence et Reanimation medicales, Hopital Bellevue, CHU de
Saint-Etienne. alain.viallon@univ-st-etienne.fr

OBJECTIVE: It has been shown that serum procalcitonin (PCT) can be used to
differentiate bacterial from viral meningitis in children in all cases. The aim
of this study was to demonstrate the interest of PCT in the management of
suspected meningitis in adults. PATIENTS AND METHODS: We conducted a prospective 
study including 179 consecutive patients admitted to the emergency department for
suspected meningitis. All samples were taken at patient admission. The
discriminant potential between bacterial and viral meningitis was studied for
cerebrospinal fluid parameters (cytology, protein, glucose, lactate) and serum
parameters (C reactive protein, PCT). RESULTS: Thirty-two patients had bacterial 
meningitis, 90 had viral meningitis and meningitis was ruled out in 57. Among all
studied parameters, the most discriminant for distinguishing between bacterial
and viral meningitis in 100% of the cases proved to be serum procalcitonin with a
threshold value of 0.93 ng/ml. CONCLUSION: Serum procalcitonin is an interesting 
parameter in the emergency department for management of meningitis suspicion in
adults.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 10776411 [PubMed - indexed for MEDLINE]

3151: Nippon Rinsho. 2000 Apr;58(4):951-6.

[Pain treatment of herpes zoster]

[Article in Japanese]

Hirata K, Higa K.

Department of Anesthesiology, School of Medicine, Fukuoka University.

Reactivation of varicella-zoster virus causes herpes zoster, which accompanies
severe pain in most patients. Treatment of pain is mandatory in herpes zoster.
Pain caused by herpes zoster is classified as acute herpetic pain and
postherpetic neuralgia. The mechanisms and treatments for the two pains are
different. Acute herpetic pain is inflammatory and nociceptive one. Treatment for
acute herpetic pain includes antiviral drugs, non-steroidal anti-inflammatory
drugs, opioids, and sympathetic nerve blockade. Postherpetic neuralgia is a
neuropathic pain and requires antidepressants, anticonvulsants, and
anti-arrhythmic drugs to relieve the pain. Topical application of capsaicin and
local anesthetics may benefit some patients with postherpetic neuralgia.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 10774222 [PubMed - indexed for MEDLINE]

3152: Nippon Rinsho. 2000 Apr;58(4):939-43.

[Antiherpetic chemotherapy]

[Article in Japanese]

Shiraki K, Kurokawa M.

Department of Virology, Toyama Medical and Pharmaceutical University.

Acyclovir has changed the concept of anti-herpetic chemotherapy by its mechanism 
of action and clinical efficacy. Idoxyuridine, vidarabine, and acyclovir have
been used for herpes simplex virus and varicella-zoster virus infection for two
decades in Japan. Varaciclovir and famciclovir which are the prodrugs of
acyclovir and penciclovir, respectively, will be added to the choice of
anti-herpetic chemotherapy. This review introduces their mechanism of action and 
their comparative characteristics in chemotherapy, and the new development of
anti-herpetic drugs.

Publication Types: 
    English Abstract
    Review

PMID: 10774220 [PubMed - indexed for MEDLINE]

3153: Nippon Rinsho. 2000 Apr;58(4):928-32.

[Prophylaxis and treatment of alpha herpesvirus infection--vaccine]

[Article in Japanese]

Kimura H.

Department of Pediatrics, Nagoya University School of Medicine.

Vaccines for human alpha herpesviruses were reviewed. To prevent recurrent
genital herpes, inactivated virion vaccines, subunit vaccines, live vectored
vaccines, genetically-attenuated live virus vaccines, and DNA vaccines have been 
developed for herpes simplex virus(HSV). Although clinical studies of these
vaccines were reported, successful results have not been confirmed. Further
improvements in target genes, adjuvants, and vaccine strategies are necessary for
clinically useful HSV vaccines. To prevent varicella, a live attenuated
vaccine(Oka strain) was developed in Japan and is now widely used in the world.

Publication Types: 
    English Abstract
    Review

PMID: 10774218 [PubMed - indexed for MEDLINE]

3154: Nippon Rinsho. 2000 Apr;58(4):922-7.

[Alpha herpesvirus infections in AIDS patients]

[Article in Japanese]

Sata T.

Laboratory of Pathology, AIDS Research Center.

Alpha-herpesvirus infections by herpes simplex virus and varicella-zoster virus
among HIV-infected patients were summarized. These infections were occurred in a 
high frequency and shown to be extensive lesions, prolonged virus excretion from 
the lesions, generalized infection, and uncommon diseases as compared these of
with immunocompetent patients. Acyclovir-resistant viruses appeared. These
evidences supplied the profound understanding of the pathogenesis and new
subjects in the field of herpesvirus infection. Recent introduction of HAART
against HIV and the appropriate use of anti-herpesvirus drugs, however, reduced
the development of severe infection, and provided successful treatment,
respectively.

Publication Types: 
    English Abstract
    Review

PMID: 10774217 [PubMed - indexed for MEDLINE]

3155: Nippon Rinsho. 2000 Apr;58(4):918-21.

[Transplantation associated alpha herpes virus infection]

[Article in Japanese]

Masaoka T.

Osaka Medical Center for Cancer and Cardiovascular Diseases.

Immunosuppression after organ or bone marrow transplantation changes its severity
with the time lapse. After bone marrow transplantation, HSV infection occurs in
early period and VZV infection, in intermediate period. Aciclovir prophylaxis is 
effective for preventing HSV in early period and also for elevating the
compliance of drug intake. It delays onset of VZV infection on the other hand.
VZV infection is usually very severe if it is occurred early, before 100 days
after transplant. There was some case of VZV infection with severe abdominal pain
without any skin involvement. The incidence of VZV infection in bone marrow
recipients was 29%. Even in stable period it caused considerable mental problems 
in some patient.

Publication Types: 
    English Abstract
    Review

PMID: 10774216 [PubMed - indexed for MEDLINE]

3156: Nippon Rinsho. 2000 Apr;58(4):906-11.

[Alpha herpes virus and facial palsy]

[Article in Japanese]

Murakami S, Miyamoto N, Watanabe N, Matsuda F.

Department of Otolaryngology, Nagoya City University Medical School.

Alpha herpes virus is the major causes of peripheral facial palsy such as Bell's 
palsy or Ramsay Hunt syndrome. Ramsay Hunt syndrome is caused by varicella zoster
virus (VZV) infection, and can be diagnosed by facial nerve paralysis associated 
with herpetic eruption on the pinna, and complication of by vestibulo-cochlear
dysfunction. On the other hand, Bell's palsy presents only facial palsy and its
diagnosis is made by the exclusion of known conditions. The causes of Bell's
palsy had been unknown for many years, however, recently it was revealed that
herpes simplex type 1 was the major cause of Bell's palsy by PCR. Because early
treatment with acyclovir and prednisone was proven to be effective, we should
make efforts to diagnose these diseases as early as possible.

Publication Types: 
    English Abstract
    Review

PMID: 10774214 [PubMed - indexed for MEDLINE]

3157: Nippon Rinsho. 2000 Apr;58(4):901-5.

[Ophthalmic area]

[Article in Japanese]

Shimomura Y.

Dept. of Ophthalmology, Kinki University School of Medicine.

Although herpes simplex virus type 1 or herpes zoster virus is generally
considered to cause ocular infection among alpha herpesviruses, herpes simplex
virus type 2(HSV-2) retinitis has been recently reported. Acute retinal
necrosis(ARN) syndrome is associated with herpesviruses, but the mechanisms
remain unclear. The representative ocular infection by alpha herpesviruses is
herpes simplex virus type 1(HSV-1) keratitis. The clinical types, ocular symptoms
and therapy are reviewed in herpetic ocular infections(HSV-1 blephalitis,
conjunctivitis, keratitis, retinitis). In addition, ocular infections caused by
herpes zoster virus are reviewed.

Publication Types: 
    English Abstract
    Review

PMID: 10774213 [PubMed - indexed for MEDLINE]

3158: Nippon Rinsho. 2000 Apr;58(4):895-900.

[Alphaherpesvininae--dermatology]

[Article in Japanese]

Honda M, Niimura M.

Jikei University School of Medicine.

The subfamily alphaherpesuvirinae contains herpes simplex virus(HSV) and
varicella-zoster virus(VZV) in the Dermatology. HSV infectious diseases are
herpetic gingivostomatitis, herpes labialis, facial herpes simplex, Kaposi's
varicelliform eruption, genital herpes, lumbosacral herpes simplex, and herpetic 
whitlow. The primary form of VZV infection is varicella, and the reactivation
form is herpes zoster. These infectious diseases in the dermatological clinics
usually occur in adult. In this paper we mention clinical manifestations and
treatment.

Publication Types: 
    English Abstract
    Review

PMID: 10774212 [PubMed - indexed for MEDLINE]

3159: Nippon Rinsho. 2000 Apr;58(4):890-4.

[Clinical manifestations of the subfamily alpha-herpesvirinae in childhood]

[Article in Japanese]

Suga S, Asano Y.

Department of Pediatrics, Fujita Health University School of Medicine.

Herpes simplex virus(HSV) and varicella-zoster virus(VZV) belonging to the
subfamily of alpha-herpesvirinae have the capacity to establish latent infection 
in neural tissues and to reactivate from these sites. HSV infection is
characterized by a vesicular eruption, fever, and other constitutional symptoms
but frequently inapparent both in primary and recurrent infections. However, the 
infection produces a wide spectrum of illness ranging from the trivial fever
blisters to the most severe fatal sporadic encephalitis and neonatal infection.
In contrast, VZV develops varicella, a common contagious disease of childhood
during primary infection and zoster by reactivation of latent virus acquired
during varicella. In normal children, the systemic symptoms of both diseases are 
mild, whereas serious complications are often observed in children with
deficiencies in cell-mediated immunity. Acyclovir has been the drug of choice for
treatment of severe infection with HSV and VZV for approximately 2 decades. Now, 
two new agents, valacyclovir and famciclovir will supplant acyclovir for certain 
indications.

Publication Types: 
    English Abstract
    Review

PMID: 10774211 [PubMed - indexed for MEDLINE]

3160: Nippon Rinsho. 2000 Apr;58(4):883-9.

[Sexually transmitted diseases of alpha herpes virus in women]

[Article in Japanese]

Kawana T.

Dept. Obstetrics & Gynecology, Teikyo University Mizonokuchi Hospital.

Among two alpha herpes viruses, Herpes Simplex Virus(HSV) and Varicella Zoster
virus(VZV), HSV infects genital sites and is frequently transmitted by sexual
contact while VZV has quite different mode of transmission and rarely infects
genital site except herpes zoster at the vulva. Genital herpes is the second and 
the third leading cause of STDs in women and men respectively. While 90% of male 
genital herpes was caused by HSV-2, 55% of female genital herpes was by HSV-2 and
the remaining 45% by HSV-1. As for primary infection of female genital herpes,
60% was caused by HSV-1 and 40% by HSV-2. On the otherhand about 90% of recurrent
infection was by HSV-2 suggesting that HSV-2 is closely related to latent
infection of the female genital tract.

Publication Types: 
    English Abstract
    Review

PMID: 10774210 [PubMed - indexed for MEDLINE]

3161: Nippon Rinsho. 2000 Apr;58(4):871-6.

[Vertical transmission of alpha herpes virus]

[Article in Japanese]

Kawana T.

Department of Obstetrics and Gynecology, Teikyo University Mizonokuchi Hospital.

Alpha herpes viruses which infect human being are Herpes simplex virus(HSV) and
Varicella zoster virus(VZV). Both are known to infect fetus or neonate when their
mothers are infected by these viruses. However, the pathogenesis of these two is 
quite different; HSV infection is usually limited to local area while VZV infect 
systemically. Intrauterine infection of HSV occurs very rarely whereas that of
VZV at the rate of as much as 2.0% when mothers are infected during 13-20 weeks
of gestation. Half of newborns are infected by HSV when their mothers are
primarily infected around the delivery. About 30% of these infected babies are
mortal. Neonatal varicella, caused by transplacentally transmitted VZV, sometimes
results in serious prognosis especially when maternal varicella has an onset
between 5 days before and 2 days after delivery.

Publication Types: 
    English Abstract
    Review

PMID: 10774208 [PubMed - indexed for MEDLINE]

3162: Nippon Rinsho. 2000 Apr;58(4):851-7.

[Diagnosis--serodiagnosis of alpha herpesviruses]

[Article in Japanese]

Ikoma M, The HT, Welling-Wester S.

Department of Medical Microbiology, Faculty of Medicine, University of Groningen,
The Netherlands.

Herpes simplex virus(HSV) serodiagnosis concerns type-common diagnosis and
type-specific diagnosis. Primary HSV infections can be diagnosed by type-common
serological assays, and in the ideal case, in combination with virus isolation.
HSV type 1 and HSV type 2 are very similar except for glycoprotein G(gG). This
glycoprotein can be used to determine type-specific antibodies especially during 
initial non-primary infections. However, antibody response to gG is late compared
to the response to type-common antibodies. A rapid diagnosis of acute
varicella-zoster virus(VZV) infections are often needed in clinical settings and 
in these situations, diagnosis is performed by methods for rapid viral detection,
and not by serology. Serological tests are usually used to screen for immunity
against VZV.

Publication Types: 
    English Abstract
    Review

PMID: 10774205 [PubMed - indexed for MEDLINE]

3163: Nippon Rinsho. 2000 Apr;58(4):838-43.

[Molecular epidemiology of human alpha-herpesvirus infection]

[Article in Japanese]

Yoshida M.

Department of Dermatology, School of Medicine, Kinki University.

Herpes simplex virus type 1, 2 (HSV-1, 2) and varicella-zoster virus(VZV) are
significant pathogens in humans. These three viruses belong to the
alpha-herpesvirus subfamily. The molecular epidemiological analyses of the
viruses are based on the heterogeneity of each viral genome found in isolates.
HSV-1, 2 strains are classified into genotypes as intratypic variations by gains 
or losses of cleavage sites using restriction endonucleases recognizing 6-base
pairs. On the other hand, VZV strains can rarely be distinguished with respect to
the presence or absence of restriation sites, so that the numbers and/or patterns
of repeating units in the reinteration structures(R1, R2, R5) are also available 
to differentiate VZV isolates. Recently, analysis of viral DNA fragments
amplified by polymerase chain reaction has been applied as an alternative method.
The epidemiological relation of strains has been determined in various clinical
conditions such as the transmission of the viruses by these molecular
epidemiological methods.

Publication Types: 
    English Abstract
    Review

PMID: 10774203 [PubMed - indexed for MEDLINE]

3164: Nippon Rinsho. 2000 Apr;58(4):828-37.

[Seroepidemiology of alphaherpesviruses]

[Article in Japanese]

Hashido M.

National Institute of Infectious Diseases.

The seroepidemiology of herpes simplex virus (HSV) type-1 and -2 was studied in
different Japanese populations, by applying HSV gG1 and gG2 type-specific
antibody assays. HSV-1 infections correlated mostly with age and was widely
prevalent among subjects over 40 years old. HSV-2 prevalence varied greatly among
subgroups defined by sexual activity and were associated with risk behaviors,
from 80% among prostitutes to 7% among pregnant women. Since HSV-1 infection
during childhood has been decreasing, primary genital HSV-1 or HSV-2 infection,
with its higher frequency of clinical manifestations, will become more important.
In contrast, antibody prevalence to varicella-zoster virus has been constantly
high in children, with no tendency to change in seroepidemiology of VZV
infections so far.

Publication Types: 
    English Abstract
    Review

PMID: 10774202 [PubMed - indexed for MEDLINE]

3165: Nippon Rinsho. 2000 Apr;58(4):807-14.

[The mechanisms for latency and reactivation of alpha herpesviridae]

[Article in Japanese]

Yoshikawa T.

Laboratory of Virology, Nagoya University School of Medicine.

Alpha herpesviridae (herpes simplex virus, HSV and varicella zoster virus, VZV)
is a neurotropic phathogen of humans that establishes latent infection in the
sensory ganglia, and periodically reactivates from latently infected neurons.
Most of basic research for analyzing the mechanism of latency and reactivation of
herpes viruses has been carried out in HSV. According to the results from the
molecular analysis in the neurons latently infected with HSV, during latency, the
virus genome is quiescent, except for the transcription of the latency associated
transcripts (LATs). Thus, it has been considered that LATs play an important role
for latency and reactivation of the virus. It has been shown that LATs are
required for efficient reactivation from latency in vivo, and regulate the site
specificity for reactivation of the virus. Recent studies demonstrated that the
quantities of latent virus are correlated with the frequency of reactivation of
the virus. Moreover, it was suggested that the latency-related gene of bovine
herpesvirus 1 could inhibit the apoptosis of the several cells including neuronal
cells.

Publication Types: 
    English Abstract
    Review

PMID: 10774199 [PubMed - indexed for MEDLINE]

3166: Nippon Rinsho. 2000 Apr;58(4):787-93.

[The functions of alpha herpesvirus gene products]

[Article in Japanese]

Daikoku T.

Laboratory of Virology, Nagoya University School of Medicine.

Herpes simplex virus type 1(HSV-1), type 2(HSV-2) and varicella-zoster virus
(VZV) belong to alphaherpesvirus family. These herpesviruses have large DNA
genomes which contain at least 69 genes. These viral genes are divided into two
groups based on whether they are essential or dispensable for virus growth in
cell culture. The essential gene products include transcriptional factor, viral
DNA replication, DNA cleavage/packaging and virion components, while the
dispensable gene products include deoxyribonucleotides metabolism, protein
kinases, tegument proteins. This article briefly reviews the functions of
alphaherpesvirus gene products, particularly roles of viral encoded protein
kinases, tegument proteins and host immune evasion.

Publication Types: 
    English Abstract
    Review

PMID: 10774196 [PubMed - indexed for MEDLINE]

3167: J Dermatol. 2000 Mar;27(3):166-9.

Granuloma annulare in herpes zoster scars.

Ohata C, Shirabe H, Takagi K, Kawatsu T.

Department of Dermatology, Osaka Teishin Hospital, Japan.

A 54-year-old Japanese female developed granuloma annulare twice in herpes zoster
scars. Soon after the second event, she developed ulcerative colitis, which was
well controlled by sulfonamides and corticosteroid suppository. She had no
history of diabetes mellitus. There was no recurrence of granuloma annulare by
June of 1999. Granuloma annulare might have contributed to the complications of
ulcerative colitis, although this had not been noticed before.

Publication Types: 
    Case Reports

PMID: 10774142 [PubMed - indexed for MEDLINE]

3168: Dermatology. 2000;200(2):173-5.

Varicella-zoster virus vasculitis: a case of recurrent varicella without
epidermal involvement.

Uhoda I, Pierard-Franchimont C, Pierard GE.

Department of Dermatology, Regional Medical Center, Huy, Belgium.

New types of diseases due to the varicella-zoster virus (VZV) are increasingly
recognized. A case of cutaneous VZV vasculitis without epidermal involvement is
presented. The patient received chemotherapy for a large B cell lymphoma. He
presented a few painless papules on one hand and in the axilla. A lymphocytic
vasculitis was evidenced. Immunohistochemistry revealed the presence of VZV in
endothelial cells and dermal dendrocytes. Nerves and keratinocytes were free of
the virus infection. Such a presentation probably represents a mild form of
recurrent varicella with prominent but limited vascular involvement. Copyright
2000 S. Karger AG, Basel.

Publication Types: 
    Case Reports

PMID: 10773714 [PubMed - indexed for MEDLINE]

3169: J Assoc Physicians India. 1999 Apr;47(4):460-1.

Comment on:
    J Assoc Physicians India. 1998 Apr;46(4):337-40.

Topical aspirin-chloroform in the treatment of zoster associated pain.

Khilnani G.

Publication Types: 
    Comment
    Letter

PMID: 10778545 [PubMed - indexed for MEDLINE]

3170: Br J Dermatol. 2000 Mar;142(3):588-9.

Seasonal variation in herpes zoster infection.

Gallerani M, Manfredini R.

Publication Types: 
    Letter

PMID: 10777280 [PubMed - indexed for MEDLINE]

3171: Isr Med Assoc J. 2000 Mar;2(3):196-9.

Comment in:
    Isr Med Assoc J. 2000 Mar;2(3):224.

Immunity to varicella zoster virus in young Israeli adults.

Avrahami-Heller Y, Cohen D, Orr N, Slepon R, Ashkenazi I, Danon YL.

Kipper Institute of Immunology, Schneider Children's Medical Center of Israel,
Petah Tiqva, Israel.

BACKGROUND: Chickenpox is a highly contagious childhood infection caused by
varicella zoster virus, a virus of the herpes family. Although a mild and
self-limiting disease in otherwise healthy children, chickenpox can be a
complicated and even life-threatening disease in adults, pregnant women and
immunosuppressed individuals. Among infants whose mothers had varicella during
the first trimester of pregnancy, 2-3% will develop a congenital VZV syndrome
that includes a combination of scarring, limb deformation, central nervous system
impairment and ocular injury. In 1974, a live attenuated virus vaccine against
VZV was developed in Japan and has been thoroughly tested for safety, efficacy
and long-term effects. In March 1995 the vaccine was licensed in the U.S. for use
in healthy children only. OBJECTIVES: To determine the rate of immunity to VZV in
young Israeli adults. METHODS: On the assumption that a randomly picked sample of
18-year-old army recruits in Israel is representative of the general Jewish
population, 900 sera samples were taken for 3 years (1985,1988,1992). The sera
were analyzed for IgG to VZV with a commercial ELISA kit using microwells coated 
with VZV antigens. RESULTS: A total of 98% of the samples tested positive for VZV
antibodies. The difference in serologic values between the recruitment years was 
not statistically significant. CONCLUSION: The majority of the Israeli population
reaches adulthood already immunized against VZV, with immigrants having slightly 
lower immunity rates. Nonetheless, a few dozen cases of chickenpox are diagnosed 
in the IDF annually. These data should be taken into account when a vaccination
program is devised. Should such a program be implemented, it would be interesting
to repeat the serosurvey for comparison. A shift in the peak occurrence age might
necessitate the administration of a booster vaccine at an older age.

PMID: 10774265 [PubMed - indexed for MEDLINE]

3172: Ann Pharmacother. 2000 Apr;34(4):465-70.

Comment in:
    Ann Pharmacother. 2000 Nov;34(11):1348-9.

Carbamazepine--indinavir interaction causes antiretroviral therapy failure.

Hugen PW, Burger DM, Brinkman K, ter Hofstede HJ, Schuurman R, Koopmans PP,
Hekster YA.

Department of Clinical Pharmacy, University Hospital Nijmegen, The Netherlands.
p.hugen@klinfarm.azn.nl

OBJECTIVE: To report a case of antiretroviral therapy failure caused by an
interaction between carbamazepine and indinavir. CASE SUMMARY: A 48-year-old
HIV-positive white man was treated with antiretroviral triple therapy, consisting
of indinavir, zidovudine, and lamivudine. His HIV-RNA (viral load) became
undetectable (<400 copies/mL) less than two months after this therapy was
started; this was confirmed one month later. Shortly after the start of
antiretroviral therapy, the patient developed herpes zoster, which was treated
with famciclovir. Tramadol was initially prescribed for postherpetic neuralgia;
however, this was substituted with carbamazepine due to insufficient analgesic
effect. Indinavir plasma concentrations decreased substantially during
carbamazepine therapy. Carbamazepine was stopped after 2.5 months and, two weeks 
later, the HIV-RNA was detectable (6 x 103 copies/mL). Resistance for lamivudine 
was observed in that blood sample; resistance for zidovudine might have been
present, and resistance to indinavir was not detected. A few months later, a
further increase of the HIV-RNA occurred (300 x 103 copies/mL), after which the
therapy was switched to a new antiretroviral regimen containing nevirapine,
didanosine, and stavudine. DISCUSSION: Physicians may prescribe carbamazepine for
HIV-infected patients to treat seizures or postherpetic neuralgia, which are
complications of opportunistic infections such as herpes zoster or toxoplasmosis.
Carbamazepine is a potent enzyme inducer, predominantly of the CYP3A enzyme
system, while HIV-protease inhibitors such as indinavir are substrates for and
inhibitors of CYP3A. Therefore, an interaction between these drugs could be
expected. A low dose of carbamazepine (200 mg/d) and the usual dose of indinavir 
(800 mg q8h) in our patient resulted in carbamazepine concentrations within the
therapeutic range for epilepsy treatment; indinavir concentrations dropped
substantially. The virologic, resistance, and plasma drug concentration data, as 
well as the chronology of events, are highly indicative of antiretroviral
treatment failure due to the interaction between carbamazepine and indinavir.
CONCLUSIONS: Concomitant use of carbamazepine and indinavir may cause failure of 
antiretroviral therapy due to insufficient indinavir plasma concentrations. Drugs
other than carbamazepine should be considered to prevent this interaction.
Amitriptyline or gabapentin are alternatives for postherpetic neuralgia; valproic
acid or lamotrigine are alternatives for seizures. When alternate drug therapy is
not possible, dosage adjustments, therapeutic drug monitoring, and careful
clinical observation may help reduce adverse clinical consequences.

Publication Types: 
    Case Reports

PMID: 10772431 [PubMed - indexed for MEDLINE]

3173: Int J STD AIDS. 2000 Apr;11(4):254-6.

Herpes zoster and HIV infection in Tanzania.

Naburi AE, Leppard B.

Regional Dermatology Training Centre, Kilimanjaro Christian Medical Centre,
Moshi, Tanzania.

Two hundred consecutive patients with herpes zoster attending the skin clinic at 
the Kilimanjaro Christian Medical Centre (KCMC) were examined and checked for HIV
infection. They ranged in age from 10 months to 86 years with the majority in
their 20s and 30s. The dermatomes involved were thoracic (97), trigeminal (50),
cervical (37), lumbar (19) and sacral (3). Six (3%) had more than one dermatome
involved and 2 (1%) had disseminated disease. Only 2 (1%) had severe ulceration
of the skin and all healed in less than 4 weeks. In children under the age of 10 
years and in adults between the ages of 20 and 49 years virtually 100% were HIV
positive; even in the age group 50-59 more than three-quarters were HIV positive.
We conclude that the presence of herpes zoster at any site is a good indication
that the patient is HIV positive except in the teens and the very elderly.

PMID: 10772090 [PubMed - indexed for MEDLINE]

3174: Antiviral Res. 2000 Mar;45(3):157-67.

Antiviral activity of ganciclovir elaidic acid ester against herpesviruses.

Andrei G, Snoeck R, Neyts J, Sandvold ML, Myhren F, De Clercq E.

Rega Institute for Medical Research, Minderbroedersstraat 10, K.U. Leuven,
B-3000, Leuven, Belgium. graciela.andrei@rega.kuleuven.ac.be

A fatty acid derivative of ganciclovir (GCV), elaidic acid ganciclovir (E-GCV),
has been evaluated for its inhibitory activity against laboratory and clinical
strains of herpes simplex type 1 (HSV-1) and type 2 (HSV-2), varicella-zoster
virus (VZV) and human cytomegalovirus (HCMV) in human embryonic lung fibroblasts.
GCV, cidofovir, acyclovir (ACV), brivudin (BVDU) and foscarnet (PFA) were
included as reference compounds. The viruses studied were wild-type, thymidine
kinase-deficient (TK(-)) and PFA-resistant (PFA(r)) HSV strains. The IC(50)
values obtained for E-GCV were 5- to 30-fold lower than those observed for GCV,
the IC(50) value of E-GCV for HSV-1 strain KOS being 0.07 nM. A similarly
increased activity of E-GCV (as compared to GCV) was noted for TK(-) and PFA(r)
HSV-1 or HSV-2 strains. However, E-GCV did not exhibit superior activity over GCV
to VZV or HCMV in vitro. The antiviral efficacy of E-GCV was also evaluated in
vivo against intracerebral HSV-2 infection in NMRI mice. Animals were treated
intraperitoneally or perorally with E-GCV, GCV or placebo once daily for 10 days,
starting the day of infection. E-GCV compared to GCV at equimolar doses, proved
markedly more efficacious than GCV in terms of reduction of mortality rate and
delay of mean time of death. The elaidic acid ester of GCV should therefore be
considered as a novel approach towards the treatment of HSV infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10771080 [PubMed - indexed for MEDLINE]

3175: Cancer Gene Ther. 2000 Feb;7(2):215-23.

Comparative in vitro and in vivo cytotoxic activity of
(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) and its arabinosyl derivative,
(E)-5-(2-bromovinyl)-1-beta-D-arabinofuranosyluracil (BVaraU), against tumor
cells expressing either the Varicella zoster or the Herpes simplex virus
thymidine kinase.

Grignet-Debrus C, Cool V, Baudson N, Degreve B, Balzarini J, De Leval L, Debrus
S, Velu T, Calberg-Bacq CM.

Laboratory of Fundamental Virology and Immunology, University of Liege,
Sart-Tilman, Belgium. C.Grignet@ulg.ac.be

The inhibitory effects of (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) and its
arabinosyl derivative (E)-5-(2-bromovinyl)-1-beta-D-arabinofuranosyluracil
(BVaraU) on the growth of both MDA-MB-435 human breast carcinoma and 9L rat
gliosarcoma cells expressing the thymidine kinase (tk)-encoding gene of the
Varicella zoster virus (VZV) or the Herpes simplex virus (HSV) were evaluated. In
vitro, BVDU and BVaraU effectively killed both cell types expressing VZVtk, with 
50% inhibitory concentration values ranging from 0.06 to 0.4 microM, whereas
ganciclovir (GCV) lacked activity. On HSVtk+ cells, BVDU had high cytotoxic
activity, with 50% inhibitory concentration values that were similar to those of 
GCV, whereas BVaraU was inactive. In vivo, BVDU applied intraperitoneally caused 
a 50% tumor growth inhibition in nude mice inoculated subcutaneously with VZVtk+ 
as well as HSVtk+ mammary tumor cells. In mice and at variance with the in vitro 
results, BVaraU had very little activity against the VZVtk+ mammary cells; GCV
had the highest activity on the HSVtk+ cells, resulting in a 50% eradication of
the tumors. With the 9L rat gliosarcoma model, the VZVtk/BVDU system completely
failed to inhibit the development of VZVtk+ glioma tumors induced subcutaneously 
in syngeneic rats, although BVDU had a similar 45-minute half-life in both rats
and mice. Factors other than degradation of the prodrug and related to the mode
of action of these analogs are possibly involved in the observed discrepancies
between the in vitro and in vivo results.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 10770629 [PubMed - indexed for MEDLINE]

3176: AIDS. 2000 Mar 10;14(4):383-6.

Discontinuation of secondary prophylaxis for opportunistic infections in
HIV-infected patients receiving highly active antiretroviral therapy.

Soriano V, Dona C, Rodriguez-Rosado R, Barreiro P, Gonzalez-Lahoz J.

Service of Infectious Diseases, Hospital Carlos III, Instituto de Salud Carlos
III, Madrid, Spain.

BACKGROUND: Immune reconstitution following the introduction of highly active
antiretroviral therapies (HAART) has lead to a remarkable reduction in the
incidence of opportunistic infections (OI) in subjects with advanced HIV disease.
Moreover, discontinuation of primary prophylaxis for some OI can be attempted
without risk in patients experiencing a favourable response to treatment.
However, data on the feasibility of discontinuing secondary prophylaxis are much 
more scarce, and restricted mainly to the withdrawal of maintenance treatment for
cytomegalovirus (CMV) retinitis. PATIENTS AND METHODS: Retrospective review of
the clinical outcome at 18 months in HIV-infected patients in whom
discontinuation of secondary prophylaxis, for different OI, was recommended 3
months after the introduction of HAART, if both CD4 counts > 100 x 10(6) CD4
lymphocytes/l and plasma HIV-RNA < 500 copies/ml had been achieved. RESULTS:
Fifty-three subjects were analysed. Secondary chemoprophylaxis was discontinued
for the following OI: Pneumocystis carinii pneumonia (PCP) (n = 29), cerebral
toxoplasmosis (n = 9), disseminated Mycobacterium avium complex infection (n =
7), CMV retinitis (n = 5), recurrent oroesophageal candidiasis (n = 5), Visceral 
leishmaniasis (n = 2), recurrent herpes zoster (n = 2), and chronic mucocutaneous
herpes simplex infection (n = 1). In six individuals, OI prophylaxis was
discontinued for two or more entities. Only two episodes of OI were recorded in
these individuals during 18 months of follow-up. One developed tuberculous
lymphadenitis despite having a good response to treatment, and another suffered a
new episode of PCP after voluntary treatment interruption for 6 weeks.
CONCLUSION: Secondary prophylaxis for OI can be attempted without major risk in
HIV-infected patients experiencing a favourable response to HAART. The benefit of
this intervention should reduce costs, drug side-effects and pharmacologic
interactions, and indirectly will improve patient's quality of life and adherence
to antiretroviral treatment.

PMID: 10770540 [PubMed - indexed for MEDLINE]

3177: Am J Dermatopathol. 2000 Apr;22(2):144-50.

Herpes incognito.

Resnik KS, DiLeonardo M.

Institute for Dermatopathology, Thomas Jefferson University, Philadelphia,
Pennsylvania 19107, USA.

Can a microscopist suspect that telltale histopathologic changes of infection by 
herpesvirus (varicella, zoster, or simplex) are nearby even when no diagnostic
epithelial changes are present in the sections being studied? Punch-biopsy
specimens from three patients are presented; in two of those cases herpesvirus
infection was not even a clinical consideration. The initial histopathologic
sections from these patients did not show changes of herpesvirus infection, but
step sections revealed focal diagnostic changes. Atypical lymphocytes were
present in each of these cases. When atypical lymphocytes are found in concert
with a pattern of an inflammatory-cell infiltrate that does not conform precisely
to any well-defined entity, a microscopist should consider that the findings may 
represent changes near infection by herpesvirus. In addition, we reviewed every
case we diagnosed as herpesvirus infection over an 18-month period and found that
in just over two thirds of those specimens (32 out of 45 cases), atypical
lymphocytes accompanied the characteristic epithelial changes induced by
herpesvirus.

Publication Types: 
    Case Reports

PMID: 10770435 [PubMed - indexed for MEDLINE]

3178: Neurologia. 2000 Feb;15(2):85-6.

Comment on:
    Neurologia. 1998 Jun-Jul;13(6):311-2.    Neurologia. 1999 Mar;14(3):139-40.

[The use of corticosteroids in the treatment of neuropathic pain of acute herpes 
zoster]

[Article in Spanish]

Gonzalez Martinez F.

Publication Types: 
    Comment
    Letter

PMID: 10769538 [PubMed - indexed for MEDLINE]

3179: Ophthalmology. 2000 Apr;107(4):790-4.

Progressive outer retinal necrosis caused by herpes simplex virus type 1 in a
patient with acquired immunodeficiency syndrome.

Kashiwase M, Sata T, Yamauchi Y, Minoda H, Usui N, Iwasaki T, Kurata T, Usui M.

Department of Ophthalmology, Tokyo Medical University, Japan.

OBJECTIVE/BACKGROUND: To identify the etiologic agent of rapidly progressive
outer retinal necrosis (PORN) in a 32-year-old man with acquired immunodeficiency
syndrome (AIDS), who had retinitis developed from cytomegalovirus (CMV). Multiple
yellowish spots appeared in the deep retina without evidence of intraocular
inflammation or retinal vasculitis, diagnosed clinically as PORN. Death occurred 
after failure of multiple organs. DESIGN: Case report. METHODS: Both globes were 
taken at autopsy, fixed in formalin, and examined histopathologically and
immunohistochemically to identify causative agents in the retinal lesions. MAIN
OUTCOME MEASURE: Immunohistochemistry. RESULTS: All layers of the retina were
severely damaged and contained focal calcification. Cytomegalic inclusion bodies 
were found in cells in the damaged retina of the right eye. Immunohistochemical
studies for herpesviruses revealed the presence of CMV antigens in the right
retina at the posterior pole and herpes simplex virus type 1 (HSV-1)-specific
antigen in the periphery of both retinas. No varicella-zoster virus (VZV) antigen
was detected in either retina. CONCLUSIONS: PORN has been described as a variant 
of necrotizing herpetic retinopathy, occurring particularly in patients with
AIDS. Although the etiologic agent has been reported to be VZV, HSV-1 can be an
etiologic agent.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10768344 [PubMed - indexed for MEDLINE]

3180: Eur Neurol. 2000;43(3):182-4.

Cervical myelopathy following lumbar herpes zoster.

Pozzessere G, Petrucci AF, Rossi P, Venuto F, D'Alessio C, Colonnese C, Bianco F.

Istituto di Clinica delle Malattie Nervose e Mentali, Universita degli Studi di
Roma 'La Sapienza', Roma, Italia. pozzessere@uniroma1.it

Publication Types: 
    Case Reports

PMID: 10765061 [PubMed - indexed for MEDLINE]

3181: Pediatr Clin North Am. 2000 Apr;47(2):373-94.

Varicella vaccine.

Chartrand SA.

Department of Pediatrics, Creighton University, Omaha, Nebraska, USA.

Varicella vaccine is safe, effective, and cost-effective in healthy children,
adolescents, and adults. Breakthrough cases of MVLS are significantly milder than
wild-type varicella infection. No severe adverse events have been reported
following vaccination, and the incidence of herpes zoster is less in vaccinees
than in individuals who have had natural varicella infections. To date, there is 
no evidence waning immunity following vaccination. "New and improved" varicella
vaccines that may be more effective than the current vaccine and can be stored at
refrigerator temperatures may soon become available in the United States.

Publication Types: 
    Review

PMID: 10761509 [PubMed - indexed for MEDLINE]

3182: J Pain Symptom Manage. 2000 Mar;19(3):193-9.

A phase II trial of triamcinolone hexacetanide for symptomatic recurrent
malignant ascites.

Mackey JR, Wood L, Nabholtz J, Jensen J, Venner P.

Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.

Ascites is a common complication of advanced cancer and frequently requires
paracentesis to reduce symptoms of pain, anorexia, and dyspnea. For many patients
repeat paracenteses are required at short intervals. We prospectively studied 15 
patients with recurrent ascites of malignancy to determine if intraperitoneal
triamcinolone hexacetonide, a slowly metabolized corticosteroid, produced
objective and symptomatic responses. After biochemical, radiological, and symptom
assessment and the establishment of the interval between paracenteses, patients
underwent large-volume paracentesis followed by intraperitoneal triamcinolone
hexacetonide 10 mg/kg. Patients were followed after treatment for assessment of
symptoms and physical signs of ascites. Repeat paracentesis was performed when
symptomatic ascites recurred. Symptomatic ascites recurred in 13 of 15 patients, 
but the interval between paracenteses was extended from 9.5 +/- 1.6 days to 17.5 
days (P = 0.0086). Symptom questionnaire scores assessing well-being, nausea,
abdominal pain, dyspnea, appetite, appearance, and change in abdominal size on a 
scale from 0 to 6 averaged 3.2 +/- 0.3 at entry and 2.5 +/- 0.2 at the 2-week
assessment (P = 0.026). Self-assessed symptoms, feeling of well-being, abdominal 
distention, and physical appearance improved significantly. The mean serum
cortisol decreased from baseline, suggesting that some systemic corticosteroid
absorption occurred. Thirteen of 15 patients have died, with a median survival of
42 days. Potential adverse effects included 1 episode each of transient abdominal
pain, bacterial peritonitis, and localized herpes zoster infection. In patients
with ascites of malignancy, intraperitoneal triamcinolone hexacetonide appears to
postpone the requirement for repeat paracentesis and improve symptoms of
malignant ascites.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II

PMID: 10760624 [PubMed - indexed for MEDLINE]

3183: J Paediatr Child Health. 2000 Apr;36(2):108-13.

Congenital and neonatal varicella in Australia.

Forrest J, Mego S, Burgess M.

National Centre for Immunisation Research and Surveillance of Vaccine Preventable
Diseases (NCIRS), Royal Alexandra Hospital for Children, Westmead, New South
Wales, Australia. jillf@nch.edu.au

OBJECTIVE: To establish the incidence and severity of congenital and neonatal
varicella in Australia. METHODOLOGY: Demographic and clinical details were
obtained by postal questionnaire regarding cases notified to the Australian
Paediatric Surveillance Unit by over 930 participating clinicians in 1995-97
inclusive. RESULTS: Seven cases of congenital varicella (1: 107 000
pregnancies/year) followed maternal infection at 8-26 weeks: five had defects,
two did not. Four of the seven infants with congenital varicella developed herpes
zoster in the first 15 months of life. Forty-four infants had neonatal varicella 
(1: 17 000 pregnancies/year). CONCLUSION:: There is an ongoing, albeit low,
incidence of congenital and neonatal varicella in Australia.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10760005 [PubMed - indexed for MEDLINE]

3184: Int J Dermatol. 2000 Mar;39(3):192-5.

Dermatologic manifestations among human immunodeficiency virus patients in south 
India.

Kumarasamy N, Solomon S, Madhivanan P, Ravikumar B, Thyagarajan SP, Yesudian P.

YRG Center for AIDS Research and Education, and University of Madras, Madras,
India.

BACKGROUND: Human immunodeficiency virus (HIV) may be associated with a large
number of dermatologic manifestations, which may at times constitute the
presenting symptoms. These skin lesions are well delineated in the Western
literature, but there is a paucity of information from the southern part of the
Indian subcontinent. Objective We evaluated 833 persons with HIV to determine the
types of dermatologic lesions present. RESULTS: The various lesions observed were
oral candidiasis (45.0%), multidermatomal herpes zoster (11.2%), dermatophytosis 
of the skin (8.0%), herpes genitalis (7.7%), papular pruritic dermatitis (7.7%), 
staphylococcal infection of the skin (2.9%), oral hairy leukoplakia (2.3%),
molluscum contagiosum (1.3%), genital warts (1.2%), and scabies (0.5%). Alopecia,
intractable itching, dry skin, Addisonian pigmentation, and Kaposi's sarcoma were
also noted. A correlation between the dermatologic manifestations and CD4 cell
counts was found. CONCLUSION: Although the pattern of cutaneous lesions was
comparable with that from the West, there is a strikingly lower incidence of
Kaposi's sarcoma.

PMID: 10759958 [PubMed - indexed for MEDLINE]

3185: Neurology. 2000 Apr 11;54(7):1453-8.

Cross-reactive antibodies against GM2 and CMV-infected fibroblasts in
Guillain-Barre syndrome.

Ang CW, Jacobs BC, Brandenburg AH, Laman JD, van der Meche FG, Osterhaus AD, van 
Doorn PA.

Departments of Neurology, Erasmus University Rotterdam, The Netherlands.
ANG@neuro.fgg.eur.nl

OBJECTIVE: To investigate whether anti-GM2 antibodies in patients with
Guillain-Barre syndrome (GBS) are induced by molecular mimicry with
cytomegalovirus (CMV). BACKGROUND: Antibodies against ganglioside GM2 are
frequently present in the serum from GBS patients with an antecedent infection
with CMV. METHODS: The authors detected inhibition of anti-GM2 reactivity after
incubation of GM2-reactive serum samples with fibroblasts infected with a
GBS-associated CMV strain. Control sera consisted of GQ1b-reactive samples, and
control antigens included uninfected fibroblasts and fibroblasts that were
infected with other herpes viruses. RESULTS: Serum immunoglobulin M reactivity
with GM2 was decreased in a dose-dependent manner after incubation with
CMV-infected fibroblasts. Incubation of anti-GM2-positive serum samples with
uninfected fibroblasts and fibroblasts infected with varicella zoster virus did
not inhibit anti-GM2 reactivity, whereas this reactivity was slightly decreased
after incubation with herpes simplex virus type 1 in one patient. Antibodies
against ganglioside GQ1b did not react with CMV-infected fibroblasts.
CONCLUSIONS: CMV-infected fibroblasts express gangliosidelike epitopes that
recognize specifically anti-GM2 antibodies. These results support the hypothesis 
that antiganglioside antibodies in CMV-infected GBS patients are induced by
molecular mimicry between GM2 and antigens that are induced by a CMV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10751257 [PubMed - indexed for MEDLINE]

3186: J Obstet Gynecol Neonatal Nurs. 2000 Mar-Apr;29(2):181-90.

Common antiviral agents used in women's and children's care, part 1.

Burpo RH.

Parkland School of Nurse-Midwifery of the Parkland Health and Hospital System in 
Dallas, Texas 75235, USA.

Antiviral medications interfere with one or more of the six parts of the viral
reproductive cycle. The five mechanisms of action of antiviral agents are used to
group pharmaceuticals into categories: uncoating inhibitors, nucleic acid
synthesis inhibitors, nucleoside reverse transcriptase inhibitors, nonnucleoside 
reverse transcriptase inhibitors, and protease inhibitors. The pharmacokinetics
and nursing implications of specific uncoating inhibitors for respiratory viruses
and nucleic acid synthesis inhibitors for respiratory syncytial virus, herpes
simplex, and varicella zoster viruses are described in detail.

Publication Types: 
    Review

PMID: 10750684 [PubMed - indexed for MEDLINE]

3187: J Psychosom Res. 2000 Jan;48(1):51-7.

Psychiatric symptoms and distress differ between patients with postherpetic
neuralgia and peripheral vestibular disease.

Clark MR, Heinberg LJ, Haythornthwaite JA, Quatrano-Piacentini AL, Pappagallo M, 
Raja SN.

Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Medical
Institutions, Baltimore, MD 21287-5371, USA. mrclark@jhmi.edu

OBJECTIVE: No previous studies have investigated the psychiatric characteristics 
of patients with postherpetic neuralgia (PHN). Similarly, no studies have been
performed on patients with different chronic somatic symptoms due to a defined
medical disease to compare the characteristics of psychiatric morbidity
associated with each etiology. METHODS: After completing the subscales of the
Symptom Checklist 90-R, a psychiatrist administered the Diagnostic Interview
Schedule to all subjects. The psychiatric comorbidity in 35 patients with pain
due to PHN was compared with a control group of 34 patients with the nonpainful
aversive symptom of vertigo due to a peripheral vestibular disorder that caused
unilateral hypofunction. RESULTS: PHN patients had significantly more symptoms of
major depression and somatization disorder. No significant differences were found
between groups for psychiatric diagnoses. Patients with PHN reported
significantly less acutely distressing somatic symptoms. CONCLUSION: These
results suggest that the psychiatric symptoms of patients with PHN are distinct
from nonspecific acute distress and may be related to the experience of suffering
from chronic neuropathic pain. Patients with PHN may not meet criteria for a
psychiatric diagnosis, but their psychiatric comorbidity places them at
substantial risk for increased pain, suicidal ideation, sustained disability, and
the numerous complications of excessive medical evaluation and treatment.
Patients with PHN should be evaluated specifically for psychiatric symptoms to
reduce potential negative consequences through appropriate treatment.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 10750630 [PubMed - indexed for MEDLINE]

3188: Lakartidningen. 2000 Mar 8;97(10):1114-20.

[Diagnosis of Ramsey Hunt syndrome is both simple and difficult. The viral attack
is more extensive than expected earlier]

[Article in Swedish]

Hyden D, Roberg M.

Oronkliniken, Universitetssjukhuset, Linkoping. dag.hyden@lio.se

In Ramsay Hunt's syndrome (herpes zoster of the head and neck in combination with
facial palsy), the vesicles often appear on the external ear (herpes zoster
oticus) but they can also be found on the exterior of the neck. Serologically
verified cases without vesicles occur (zoster sine herpeticum). Complications
from the eighth cranial nerve (hearing loss and vertigo) are common. MR and PCR
studies show a more extensive viral attack than was earlier believed to be the
case. Due to the risk of remaining cranial nerve dysfunctions, as exemplified in 
a case report, antiviral treatment is indicated, in severe cases combined with
corticosteroids. The potential value of varicella vaccination to reduce zoster
complications is discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10750383 [PubMed - indexed for MEDLINE]

3189: J Clin Microbiol. 2000 Apr;38(4):1476-81.

Development and clinical evaluation of a recombinant-antigen-based
cytomegalovirus immunoglobulin M automated immunoassay using the Abbott AxSYM
analyzer.

Maine GT, Stricker R, Schuler M, Spesard J, Brojanac S, Iriarte B, Herwig K,
Gramins T, Combs B, Wise J, Simmons H, Gram T, Lonze J, Ruzicki D, Byrne B,
Clifton JD, Chovan LE, Wachta D, Holas C, Wang D, Wilson T, Tomazic-Allen S,
Clements MA, Wright GL Jr, Lazzarotto T, Ripalti A, Landini MP.

Department of Congenital Infectious Disease Diagnostics, Abbott Laboratories,
Abbott Park, IL 60064-6199, USA.

A new microparticle enzyme immunoassay (MEIA), the Cytomegalovirus (CMV)
Immunoglobulin M (IgM) test, was developed on the Abbott AxSYM analyzer. This
test uses recombinant CMV antigens derived from portions of four structural and
nonstructural proteins of CMV: pUL32 (pp150), pUL44 (pp52), pUL83 (pp65), and
pUL80a (pp38). A total of 1, 608 specimens from random volunteer blood donors (n 
= 300), pregnant women (n = 1,118), transplant recipients (n = 6), and patients
with various clinical conditions and disease states (n = 184) were tested during 
development and evaluation of this new assay. In a preliminary clinical
evaluation we tested specimens collected prospectively from pregnant women (n =
799) and selected CMV IgM-positive archived specimens from pregnant women (n =
39). The results from the new CMV IgM immunoassay were compared to the results of
a consensus interpretation of the results obtained with three commercial CMV IgM 
immunoassays. The results for specimens with discordant results were resolved by 
a CMV IgM immunoblot assay. The relative sensitivity, specificity, and agreement 
for the AxSYM CMV IgM assay were 94.29, 96.28, and 96.19%, respectively, and the 
resolved sensitivity, specificity, and agreement were 95.83, 97.47, and 97.37%,
respectively. We also tested serial specimens from women who experienced
seroconversion or a recent CMV infection during gestation (n = 17) and
potentially cross-reactive specimens negative for CMV IgM antibody by the
consensus tests (n = 184). The AxSYM CMV IgM assay was very sensitive for the
detection of CMV IgM during primary CMV infection, as shown by the detection of
CMV IgM at the same time as or just prior to the detection of CMV IgG. Specimens 
from individuals with lupus (n = 16) or parvovirus B19 infection (n = 6) or
specimens containing hyper IgM (n = 9), hyper IgG (n = 8), or rheumatoid factor
(n = 55) did not cross-react with the AxSYM assay. One specimen each from
individuals infected with Epstein-Barr virus (n = 26), measles virus (n = 10),
herpes simplex virus (n = 12), or varicella-zoster virus (n = 13) infection, one 
specimen from an influenza vaccinee (n = 14), and one specimen containing
antinuclear antibody cross-reacted with the assay. The overall rate of
cross-reactivity of the specimens with the assay was 3.3% (6 of 184). The AxSYM
CMV IgM assay is a sensitive and specific assay for the detection of CMV-specific
IgM.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10747129 [PubMed - indexed for MEDLINE]

3190: Cornea. 2000 Mar;19(2):135-9.

Penetrating keratoplasty for varicella-zoster virus keratopathy.

Tanure MA, Cohen EJ, Grewal S, Rapuano CJ, Laibson PR.

Cornea Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia,
Pennsylvania 19107, USA.

PURPOSE: To examine and report the results of penetrating keratoplasty performed 
in patients with varicella-zoster virus keratopathy. METHODS: The authors
retrospectively reviewed the records of 15 patients who had penetrating
keratoplasty for varicella-zoster virus keratopathy from January 1989 through
December 1998 on the Cornea Service at Wills Eye Hospital. RESULTS: Twelve
patients had a preoperative diagnosis of herpes zoster ophthalmicus, and three,
of varicella. Four eyes had lateral tarsorrhaphies performed in conjunction with 
penetrating keratoplasty. Three eyes had endothelial rejection episodes that
responded well to treatment with topical steroids. One eye had a regraft 1 month 
after primary failure, and this second graft also failed because of recurrent
neurotrophic keratopathy. Three eyes that had repeated penetrating keratoplasty
for graft failure had clear grafts at the last examination. At an average
follow-up time of 50 months, 13 (86.7%) grafts remained clear, and the best
corrected visual acuity was 20/100 or better in eight (53.3%) eyes. Five patients
had decreased visual acuity because of retinal diseases. CONCLUSION: Although
varicella-zoster virus keratopathy is an uncommon indication for penetrating
keratoplasty, effective visual rehabilitation can be achieved in these patients. 
Careful postoperative management, frequent lubrication, and lateral
tarsorrhaphies to protect the corneal surface are major factors in the successful
outcome of these cases.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 10746442 [PubMed - indexed for MEDLINE]

3191: Nat Med. 2000 Apr;6(4):451-4.

Comment in:
    Nat Med. 2000 Apr;6(4):381-2.    Nat Med. 2000 Dec;6(12):1298-300.    Nat Med. 2000 Dec;6(12):1299-300.

Varicella vaccination: evidence for frequent reactivation of the vaccine strain
in healthy children.

Krause PR, Klinman DM.

Laboratory of DNA Viruses, Bethesda, Maryland, USA.

Wild-type varicella zoster virus (VZV) causes chickenpox, a common childhood
illness characterized by fever and a vesicular rash and rare serious
complications. Wild-type VZV persists in a latent form in the sensory ganglia,
and can re-activate to cause herpes zoster. More than 10 million American
children have received the live attenuated Oka strain VZV vaccine (OkaVZV) since 
its licensure in 1995. Pre-licensure clinical studies showed that mean serum
anti-VZV levels among vaccinees continued to increase with time after
vaccination. This was attributed to immunologic boosting caused by exposure to
wild-type VZV in the community. Here, we examine the alternative, that
large-scale asymptomatic reactivation of OkaVZV might occur in vaccinees. We
analyzed serum antibody levels and infection rates for 4 years of follow-up in
4,631 children immunized with OkaVZV. Anti-VZV titers decreased over time in
high-responder subjects, but rose in vaccinees with low titers. Among subjects
with low anti-VZV titers, the frequency of clinical infection and immunological
boosting substantially exceeded the 13%-per-year rate of exposure to wild-type
varicella. These findings indicate that OkaVZV persisted in vivo and reactivated 
as serum antibody titers decreased after vaccination. This has salient
consequences for individuals immunized with OkaVZV.

PMID: 10742154 [PubMed - indexed for MEDLINE]

3192: Mil Med. 2000 Mar;165(3):193-4.

Skin disease in military personnel.

Selvaag E.

Oslo Military Clinic, Norway.

Skin disease, disease of the musculoskeletal system, and respiratory infections
are the most frequent reasons for military personnel to seek medical care. The
Oslo Military Clinic serves all of the military personnel in Oslo and the
surrounding region, including officers and civilian employees. From September
1996 to May 1997, 1,360 patients were diagnosed and treated by the author, and
the data are included in the following study. Upper respiratory disease was the
primary reason for seeking medical attention in 26% of the patients, 21% visited 
the clinic because of disease or pain in the musculoskeletal system, and 16%
suffered from a skin disease. Apart from the low number of female patients, the
patient population and the disease spectrum observed in the military clinic are
very similar to those in a general medical practice. Among the 222 patients
suffering from a cutaneous disease, eczema (42 patients), allergy (excluding
dermatitis) (34 patients), acne vulgaris (23 patients), and sexually transmitted 
diseases (28 patients) were the most prevalent processes. Other less prevalent
skin diseases were fungal infections, herpes simplex infection, nevi, common
warts, and superficial bacterial skin infections. Skin diseases seen in one
patient only included erysipelas, herpes zoster, dermatitis herpetiformis, and
Ehlers-Danlos syndrome. Good clinical skills in dermatology are of paramount
importance in military medicine, and if possible, the military should appoint a
dermatologist to its medical team to rapidly diagnose and treat the large number 
of patients with skin disorders.

PMID: 10741081 [PubMed - indexed for MEDLINE]

3193: Cancer. 2000 Apr 1;88(7):1710-4.

Feasibility of oral ciprofloxacin for the outpatient management of febrile
neutropenia in selected children with cancer.

Aquino VM, Herrera L, Sandler ES, Buchanan GR.

Department of Pediatrics, The University of Texas Southwestern Medical Center at 
Dallas, Dallas, Texas 75235-9063, USA.

BACKGROUND: Children with cancer who develop an episode of chemotherapy-induced
febrile neutropenia usually are admitted to the hospital for intravenous empiric 
antibiotic therapy. In the current study, the authors examined the use of
ciprofloxacin as outpatient management in selected patients with fever during an 
episode of neutropenia. METHODS: Febrile neutropenic patients with a diagnosis of
cancer were eligible for outpatient management with oral ciprofloxacin if they
appeared well and demonstrated the following characteristics: age 1-21 years,
malignancy in remission, absolute phagocyte count > 100/mm(3), > 7 days since the
initiation of the last course of chemotherapy, and reliable parents. Eligible
children received a single dose of ceftazidime and were observed for 2-23 hours. 
Patients were discharged receiving oral ciprofloxacin (20/mg/kg/day divided in 2 
doses) until the patient was afebrile for 24 hours, had sterile blood cultures,
and had evidence of bone marrow recovery. Patients were admitted if they appeared
toxic, had positive blood cultures, or were febrile for >/= 5 days. RESULTS:
Forty-five evaluable episodes occurred in 32 children. Forty of the 45 patients
(89%) were treated successfully in the outpatient setting. The 95% lower
confidence bound on the proportion of successful outcomes was 70%. Five children 
required hospitalization: 2 due to noncompliance, 1 to receive intravenous
acyclovir for herpes zoster, and 2 (4%) whose blood cultures were positive for
Streptococcus viridans and S. pneumoniae. All had uncomplicated hospitalizations.
CONCLUSIONS: The current study demonstrates that very carefully selected, low
risk patients with febrile neutropenia may be treated successfully without
hospitalization using oral ciprofloxacin. Additional research is required to
refine further the optimal criteria for the selection of appropriate patients for
outpatient management. Copyright 2000 American Cancer Society.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 10738231 [PubMed - indexed for MEDLINE]

3194: Vaccine. 2000 May 8;18(22):2375-80.

Experience with live attenuated varicella vaccine (Oka strain) in healthy
Japanese subjects; 10-year survey at pediatric clinic.

Ozaki T, Nishimura N, Kajita Y.

Department of Pediatrics, Showa Hospital, Kohnan, Aichi, Japan.

Live attenuated varicella vaccine (Oka strain, Biken Institute, Osaka, Japan) was
administered to 973 healthy individuals over a 10-year period (1987-1997) at the 
pediatric clinic of Showa Hospital in Japan. We evaluated the relevant
serological and clinical data, which were collected by questionnaire.
Seroconversion by the immune adherence hemagglutination method was documented in 
94% (805/860) of the initially seronegative subjects. Of the initially
seropositive subjects, 56% (63/113) showed enhancement of antibody after
vaccination. Reactions to the vaccine were generally insignificant, except for a 
rash at the injection site, seen in the first 3 days post-administration in 17%
(41/241) of the recently vaccinated subjects. In March 1998, we conducted a
survey of 559 of the initially seronegative subjects who had received the vaccine
0.6-10. 8 (mean 5.4) years earlier. Of these subjects, 21% (119/559) contracted
breakthrough varicella. However, their symptoms were milder than those caused by 
natural varicella seen in unvaccinated children. Seroconversion was demonstrated 
in 92% (109/119) of these cases. The incidence of breakthrough disease decreased 
with a rise in postvaccination antibody titer to >==32. Four of the subjects
(0.7% of 559) developed herpes zoster following vaccination, two of whom had
earlier exhibited breakthrough varicella. Lesions in one case of zoster, without 
breakthrough varicella, appeared on the cervical dermatome at the injection site.
The vaccine was safe and effective. However, there was a relatively high
incidence of rash at the injection site with certain lot numbers used in recent
years which warrants investigation.

PMID: 10738094 [PubMed - indexed for MEDLINE]

3195: Nippon Jibiinkoka Gakkai Kaiho. 2000 Feb;103(2):133-8.

[Treatment of Bell's palsy with acyclovir and prednisolone]

[Article in Japanese]

Hato N, Honda N, Gyo K, Aono H, Murakami S, Yanagihara N.

Department of Otolaryngology, Ehime University School of Medicine.

Many current studies have suggested that herpes simplex virus is a probable cause
of Bell's palsy, and that treatment with antiviral agents such as acyclovir might
benefit the patients. In the present study, 69 patients with Bell's palsy were
treated with oral administration of acyclovir (2000 mg/day) and prednisolone
(60-40 mg/day) at Ehime University Hospital between Oct. 1995 and Dec. 1998.
Patients enrolled in this study met the following criteria: 1) severe or complete
paralysis with a score lower than 20 by the 40-point Japanese grading system, and
2) treatment started within 7 days of onset. The overall recovery rate was 95.7% 
(66/69). The rate in patients who started this treatment within 3 days after
disease onset was 100%, and this early treatment was highly efficacious in the
prevention of nerve degeneration and resulted in a significantly better recovery.
By comparison, the recovery rate in patients whose treatment was started 4 days
or more after onset was only 84.2%. All patients who were given a diagnosis of
zoster sine herpete and treated with acyclovir-prednisolone had a good outcome.
These results suggest that early treatment, within 3 days after palsy onset, is
necessary for effective acyclovir-prednisolone therapy of Bell's palsy.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 10737002 [PubMed - indexed for MEDLINE]

3196: J Fam Pract. 2000 Mar;49(3):255-64.

Comment in:
    ACP J Club. 2000 Sep-Oct;133(2):56.

Does treatment of acute herpes zoster prevent or shorten postherpetic neuralgia?

Alper BS, Lewis PR.

Pennsylvania State University/Good Samaritan Hospital Family and Community
Medicine Residency Program, Lebanon, USA. alper@earthlink.net

OBJECTIVE: Our goal was to determine if any treatment of acute herpes zoster
alters the incidence or duration of postherpetic neuralgia (PHN), a common
sequela in elderly patients. SEARCH STRATEGY: We systematically searched MEDLINE 
and The Cochrane Library. We also examined the reference lists of identified
trials and reviews. SELECTION CRITERIA: We included all randomized controlled
trials of treatments of zoster published in English that included assessment of
pain at any time after rash healing. DATA COLLECTION/ANALYSIS: Forty-two trials
met inclusion criteria, and 2 reviewers independently evaluated them for
methodologic quality and the statistical and clinical significance of results.
MAIN RESULTS: Four placebo-controlled trials of oral acyclovir with 692 patients 
provided marginal evidence for reduction in pain incidence at 1 to 3 months
following zoster onset. Famciclovir significantly reduced duration but not
incidence of PHN in one placebo-controlled trial of 419 patients. Valacyclovir
significantly reduced duration but not incidence of PHN in one
acyclovir-controlled trial of 1141 patients. Steroids had no effect on PHN.
Amitriptyline for 90 days reduced pain incidence at 6 months in one
placebo-controlled trial of 80 patients. A single trial of percutaneous
electrical nerve stimulation (PENS) in 50 patients suggested a decrease in pain
incidence at 3 and 6 months compared with famciclovir. CONCLUSIONS: There is
limited evidence that current interventions prevent or shorten PHN. Famciclovir
and valacyclovir have been shown to reduce the duration of PHN in single
published trials. Well-designed and larger trials of amitriptyline and PENS
should be conducted.

Publication Types: 
    Review

PMID: 10735485 [PubMed - indexed for MEDLINE]

3197: Bone Marrow Transplant. 2000 Mar;25(6):657-64.

Varicella-zoster infection after allogeneic bone marrow transplantation:
incidence, risk factors and prevention with low-dose aciclovir and ganciclovir.

Steer CB, Szer J, Sasadeusz J, Matthews JP, Beresford JA, Grigg A.

Bone Marrow Transplant Service, Royal Melbourne Hospital, Melbourne, Australia.

We examined the incidence of herpes varicella-zoster virus (VZV) infection in 151
patients undergoing allogeneic BMT between August 1990 and September 1997 and who
survived at least 3 months. Median follow-up was 17 (range 3.3-80.7) months.
Herpes simplex virus antibody positive (HSV+) patients received aciclovir 1200 mg
p.o. daily or 750 mg i.v. daily, in divided doses from day 0 to engraftment.
Ganciclovir (5 mg/kg i.v. three times per week) was given in CMV+ patients (or if
the donor was CMV+) from engraftment to day 84. Ganciclovir was continued or
recommenced if a dose of greater than 20 mg of prednisone was used for the
treatment of GVHD otherwise aciclovir was recommenced. In HSV+ patients not
receiving ganciclovir, aciclovir 600 mg p.o. daily in divided doses was given
until at least 6 months after BMT. Thirty-two patients developed VZV infection
from 4.1 to 28 months after transplant. The estimated cumulative incidence of VZV
was 13% (95% confidence interval 6-19%) at 12 months, 32% (22-42%) at 24 months
and 38% (27-50%) at 28 months, with no further cases beyond that time. No patient
developed VZV whilst receiving aciclovir or ganciclovir (P < 0.0001). However,
there was a rapid onset of VZV following cessation of antiviral therapy (33%
(20-46%) at 1 year post cessation). The presence of GVHD and the prior duration
of antiviral prophylaxis were significant and independent risk factors for the
development of VZV. Age, underlying disease, conditioning therapy or donor type
were not. We conclude that 3-6 months of low-dose aciclovir and ganciclovir are
effective at delaying the onset of VZV after allogeneic BMT, but may not affect
the overall incidence of infection. Prolonged prophylaxis may be warranted in
patients at high risk of infection, for example those patients with GVHD.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 10734301 [PubMed - indexed for MEDLINE]

3198: Brain. 2000 Apr;123 ( Pt 4):665-76.

Comment in:
    Brain. 2000 Apr;123 ( Pt 4):663-4.

The incidence and lifetime prevalence of neurological disorders in a prospective 
community-based study in the UK.

MacDonald BK, Cockerell OC, Sander JW, Shorvon SD.

Institute of Neurology and National Hospital for Neurology and Neurosurgery,
Queen Square, London WC1N 5BG, UK.

Over an 18-month period, all incident cases of neurological disorders were
ascertained prospectively in an unselected urban population based in 13 general
practices in the London area by a General Practice Linkage Scheme with the
National Hospital for Neurology and Neurosurgery. In three of these practices,
the lifetime prevalence of neurological disorders was also assessed. A population
of 100 230 patients registered with participating general practices was followed 
prospectively for the onset of neurological disorders. Multiple methods of case
finding were used to maintain accuracy. The age- and sex-adjusted incidence rates
of neurological disorders were calculated. The lifetime prevalence of
neurological disorders was surveyed in 27 658 of the patients. The age- and
sex-adjusted incidence rates were calculated for major neurological conditions.
[These are expressed as rates per 100 000 persons per annum, with 95% confidence 
intervals (CI) in parentheses]. The commonest of these were first cerebrovascular
events, 205 (CI: 183, 230); shingles, 140 (CI: 104, 184); diabetic
polyneuropathy, 54 (CI: 33, 83); compressive neuropathies, 49 (CI: 39, 61);
epilepsy, 46 (CI: 36, 60); Parkinson's disease, 19 (CI: 12, 27); peripheral
neuropathies, 15 (CI: 9, 23); CNS infections, 12 (CI: 5, 13); post-herpetic
neuralgia, 11 (CI: 6, 17); and major neurological injuries, 10 (CI: 4, 11).
Lifetime prevalence rates are also reported (expressed as rate per 1000 persons
with 95% CI). The most prevalent conditions were: completed stroke, 9 (CI: 8,
11); transient ischaemic attacks, 5 (CI: 4, 6); active epilepsy, 4 (CI: 4, 5);
congenital neurological deficit, 3 (CI: 3, 4); Parkinson's disease, 2 (CI: 1, 3);
multiple sclerosis, 2 (CI: 2, 3); diabetic polyneuropathy, 2 (CI: 1, 3);
compressive mononeuropathies, 2 (CI: 2, 3); and sub-arachnoid haemorrhage, 1 (CI:
0.8, 2). Overall, the onset of 625 neurological disorders was observed per 100
000 population annually. Six percent of the population had at some time had a
neurological disorder. This is the first study of the incidence and lifetime
prevalence of neurological disorders in recent times; we found that these
disorders give rise to significant morbidity in the community.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10733998 [PubMed - indexed for MEDLINE]

3199: Rev Prat. 1999 Dec 15;49(20):2208-16.

[Varicella-zoster virus]

[Article in French]

Saint-Leger E, Fillet AM.

Service de virologie Groupe hospitalier La Pitie-La Salpetriere, Paris.

Varicella-zoster virus, an ubiquitous human pathogen, causes vesicular rash
during varicella, the primary infection of the host and zoster corresponding to
reactivation. The symptoms could be various, nervous systems and lung being
involved. Usually mild, varicella could be severe in immunocompromised patients, 
during pregnancy for the mother and the foetus, for the newborn and also for
adults. Post herpetic neuralgia in old patient is the main complication of
zoster. Various methods for virological diagnosis (culture, cytology, serology,
PCR) with different sensibilities and specificities depending mainly of sample
type are available. Various antiviral drugs are available, acyclovir being the
reference one.

Publication Types: 
    English Abstract

PMID: 10731804 [PubMed - indexed for MEDLINE]

3200: Drugs. 2000 Feb;59(2):245-9; discussion 250-1.

Lidocaine patch 5%.

Comer AM, Lamb HM.

Adis International Limited, Mairangi Bay, Auckland, New Zealand.
demail@adis.co.nz

Lidocaine patch 5% comprises a soft, stretchy adhesive patch (l0 by 14 cm)
containing 5% lidocaine (700 mg) for the topical treatment of pain associated
with postherpetic neuralgia (PHN). Lidocaine provides analgesic relief by
blocking neuronal sodium channels. In clinical trials (conducted over 12 hours to
24 days) involving patients with allodynia associated with PHN, treatment with
lidocaine patch 5% resulted in a significant reduction in pain intensity and
increased pain relief compared with vehicle patch. Lidocaine patch 5% was
associated with few adverse events, the most frequent being mild skin redness or 
irritation at the application site which occurred with a similar incidence with
lidocaine and vehicle patch.

PMID: 10730547 [PubMed - indexed for MEDLINE]

3201: Can Commun Dis Rep. 1999 Jun 1;25(11):100-4.

Direct costs attributed to chickenpox and herpes zoster in British Columbia--1992
to 1996.

[Article in English, French]

Nowgesic E, Skowronski D, King A, Hockin J.

Laboratory Centre for Disease Control (LCDC), Health Canada, Ottawa, Ont.

PMID: 10726371 [PubMed - indexed for MEDLINE]

3202: Eur J Dermatol. 2000 Apr-May;10(3):226-7.

Psoriasis guttate acuta triggered by varicella zoster virus infection.

Ito T, Furukawa F.

Department of Dermatology, Hamamatsu University School of Medicine, 3600
Handa-cho, Hamamatsu, 431-3192, Japan. itoutai@hama-med.ac.jp

A 23-year-old man had small desquamative erythematous lesions, round or oval in
shape, spread over his entire body, and diagnosed as psoriasis guttate acuta
because of clinical and pathological findings. Three weeks before the lesions had
started, he was diagnosed as having varicella by his family physician. The
psoriatic lesions appeared at the same sites where previously lesions of
varicella had appeared. Therefore, VZV infection was regarded as a trigger in
this case. We speculate that genetic factors and the change of skin condition are
basically involved in the pathogenesis of psoriasis guttate. In addition, one
more factor as a trigger is needed to cause the lesions of psoriasis. VZV
infection might change the skin condition and induce subsequent immunological
disregulation.

Publication Types: 
    Case Reports

PMID: 10725825 [PubMed - indexed for MEDLINE]

3203: J Paediatr Child Health. 2000 Feb;36(1):76-7.

Neonatal chickenpox.

Isaacs D.

Department of Immunology and Infectious Diseases, New Children's Hospital,
Westmead, NSW, Australia. davidi@nch.edu.au

Publication Types: 
    Case Reports

PMID: 10723697 [PubMed - indexed for MEDLINE]

3204: Clin Infect Dis. 2000 Mar;30(3):529-33.

High prevalence of varicella-zoster virus reactivation in herpes simplex
virus-seronegative patients with acute peripheral facial palsy.

Furuta Y, Ohtani F, Kawabata H, Fukuda S, Bergstrom T.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo
060-8638, Japan. yfuruta@med.hokudai.ac.jp

Varicella-zoster virus (VZV) and herpes simplex virus (HSV) are considered to be 
the major causes of acute peripheral facial palsy (APFP). One hundred and
forty-two patients with APFP were analyzed by serological assays and polymerase
chain reaction analysis. Ramsay Hunt syndrome was diagnosed in 21 patients. Of
the remaining 121 patients clinically diagnosed with Bell's palsy, VZV
reactivation without zoster (zoster sine herpete) was detected in 35 patients
(29%). The prevalence of antibodies to HSV among patients with Bell's palsy was
significantly higher than the prevalence among those with VZV reactivation
(Ramsay Hunt syndrome or zoster sine herpete). In contrast, a high incidence
(88%) of VZV reactivation among HSV-seronegative patients with APFP was observed.
Our data indicate that VZV is one of the major etiologic agents of clinically
diagnosed Bell's palsy and that VZV reactivation causes APFP in most patients who
lack antibodies to HSV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10722439 [PubMed - indexed for MEDLINE]

3205: Acta Derm Venereol. 2000 Jan-Feb;80(1):55.

Bullous herpes zoster.

Veraldi S, Carrera C, Gianotti R, Caputo R.

Publication Types: 
    Case Reports
    Letter

PMID: 10721839 [PubMed - indexed for MEDLINE]

3206: Leuk Lymphoma. 2000 Mar;37(1-2):229-32.

Lymphomatous skin infiltration at the site of previous varicella zoster virus
infection in a patient with T cell lymphoma.

Paydas S, Sahin B, Yavuz S, Tuncer I, Gonlusen G.

Department of Oncology, Cukurova University Faculty of Medicine, Balcali, Adana, 
Turkey. sepay@mail.cu.edu.tr

Cutaneous infiltrations in hemopoietic neoplasias are not uncommon. They are
generally localized on the legs, arms, back, anterior chest, scalp and face. In
rare cases specific infiltration of neoplastic cells is localized in the site of 
herpes zoster and herpes simplex scars. In this report a case with T cell
lymphoma in leukemic phase with skin infiltration in the previous Varicella
Zoster Virus (VZV) site of infection is reported and literature is reviewed.

Publication Types: 
    Case Reports

PMID: 10721792 [PubMed - indexed for MEDLINE]

3207: J Infect Dis. 2000 Mar;181(3):859-66.

Frequencies of memory T cells specific for varicella-zoster virus, herpes simplex
virus, and cytomegalovirus by intracellular detection of cytokine expression.

Asanuma H, Sharp M, Maecker HT, Maino VC, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
94305, USA.

Memory T cells specific for varicella-zoster virus (VZV), herpes simplex virus
(HSV), and human cytomegalovirus (HCMV) were compared in immune adults by
intracellular cytokine (ICC) detection. The mean percentages of CD4+ T cells were
0.11% for VZV and 0.22% for HSV by interferon (IFN)-gamma production; the
frequency for HCMV was significantly higher at 1.21%. Percentages of VZV-, HSV-, 
and HCMV-specific CD4+ T cells were similar by use of tumor necrosis factor
(TNF)-alpha. HCMV-stimulated CD8+ T cells produced IFN-gamma (1.11%) and
TNF-alpha (1.71%); VZV- and HSV-specific CD8+ T cells were not detectable. VZV
CD4+ T cell numbers were similar in young adults with natural or vaccine-induced 
immunity. VZV CD4+ T cells were significantly less frequent in older adults.
Secondary varicella immunization did not increase VZV-specific CD4+ T cell
frequencies by ICC assay. Numbers of memory T cells specific for herpesviruses
may vary with sites of viral latency and with host age.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 10720505 [PubMed - indexed for MEDLINE]

3208: Anesthesiology. 2000 Mar;92(3):691-8.

Heterogenous patterns of sensory dysfunction in postherpetic neuralgia suggest
multiple pathophysiologic mechanisms.

Pappagallo M, Oaklander AL, Quatrano-Piacentini AL, Clark MR, Raja SN.

Department of Neurology, Hospital for Joint Diseases, New York, New York, USA.

BACKGROUND: Postherpetic neuralgia (PHN) is considered by some investigators to
be predominantly a deafferentation-type central pain syndrome; others suggest
that activity of remaining peripheral nociceptors plays a critical role. The
authors investigated the sensory dysfunction in subjects with PHN of varying
duration and at different sites to gain further insight into the mechanisms
responsible for the clinical features of neuropathic pain. In addition, the
relationships between ongoing pain and pain evoked by mechanical and thermal
stimuli were compared in patients with trigeminal and truncal PHN, to determine
if the pathophysiologic mechanisms differed among subjects. METHODS: In 63
subjects with PHN, quantitative sensory testing was performed in the region of
maximum allodynia or ongoing pain and the corresponding contralateral site. The
intensity of ongoing pain was recorded. Sensory thresholds for warmth, coolness, 
heat pain, and cold pain were determined. Pain induced by various mechanical
stimuli (dynamic, static, punctate) was rated using a numerical rating scale of
0-10. RESULTS: The mean rating of ongoing PHN pain was 7.3 +/- 2.0 (mean +/- SD).
Allodynia induced by one or more mechanical stimuli was observed in 78% of
subjects. A smaller subset (40%) had hyperalgesia to heat or cold stimuli. In
subjects with duration of PHN of < or = 1 yr duration, but not in those with
duration of > 1 yr, the intensity of ongoing pain correlated with intensity of
allodynia induced by dynamic stimuli. Deficits in thresholds for heat and cold
pain were observed in the affected region of subjects with PHN in the thoracic
dermatomes (P < 0.005), but not in the trigeminal distribution. No relationship
was observed between the thermal deficits and ongoing pain or mechanical
allodynia in the groups of subjects with either trigeminal or thoracic PHN.
CONCLUSION: Despite a common cause, the patterns of sensory abnormalities differ 
between subjects. Particular differences were noted between groups with facial or
truncal PHN and between groups with recent or more chronic PHN. The observations 

suggest that the relative contributions of peripheral and central mechanisms to
the pathophysiology of pain differ among subjects and may vary over the course of
PHN.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 10719948 [PubMed - indexed for MEDLINE]

3209: J Infect. 1999 Nov;39(3):209-12.

Is VZV reactivation a common cause of unexplained unilateral pain? Results of a
prospective study of 57 patients.

McKendrick MW, Care CC, Kudesia G, Bates CJ, Oxley MK, Eley A.

Dept. of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield, 
UK.

OBJECTIVE: Pain is a common reason for patients to present to a doctor. Many
patients with zoster have seen their doctor with pain during the days before the 
rash and zoster sine herpete is well described. If early varicella zoster virus
(VZV) reactivation could be identified confidently, it could provide an
opportunity for early antiviral intervention. This prospective study was
performed to assess how often patients presenting to their general practitioner
with unilateral pain of no obvious clinical cause proved to have evidence of VZV 
reactivation. METHODS: Fifty-seven patients were recruited and followed for 28
days; laboratory testing included VZV polymerase chain reaction (PCR) from
peripheral blood mononuclear cells, VZV IgG, IgA and IgM. The control group
consisted of 81 blood donors. RESULTS: Only two study patients developed the rash
of zoster. There was no significant difference in PCR or serological responses
between the study group and control group. Clinical characteristics did not
enable identification of patients presenting to their doctor with unilateral pain
who had prodromal zoster. CONCLUSION: There was no evidence on clinical or
laboratory tests used in this study to support the view that reactivation of VZV 
is a common cause of unexplained unilateral pain.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10714797 [PubMed - indexed for MEDLINE]

3210: Nippon Ganka Gakkai Zasshi. 2000 Feb;104(2):97-102.

[Uveitis associated with zoster sine herpete. Diagnosis and clinical findings]

[Article in Japanese]

Kashiwase M, Sakai J, Usui M.

Department of Ophthalmology, Tokyo Medical University, Japan.

PURPOSE: Zoster sine herpete (ZSH) causes solely neurologic symptoms without the 
eruption that is evident in herpes zoster ophthalmicus. It is occasionally
complicated by acute granulomatous uveitis. We examined patients suspected of ZSH
for detection of the varicella-zoster virus (VZV) genome, and discussed its
clinical appearance. MATERIALS AND METHODS: Nine patients were presumed to have
ZSH. All manifested acute granulomatous iridocyclitis and high intraocular
pressure without eruption. A polymerase chain reaction (PCR) analysis of the
aqueous humor was performed. RESULTS: Five patients were positive for VZV DNA.
They showed mutton-fat keratic precipitates and high intraocular pressure in the 
early stage. Pigmentation in the anterior chamber angle, pigmented keratic
precipitates, and finally sectoral iris atrophy were observed in the recovery
stage. These clinical findings were common to ZSH. CONCLUSIONS: The ocular
lesions in ZSH were shown to have distinctive characteristics, and PCR is useful 
to determine etiological agents in the early stage of disease.

Publication Types: 
    English Abstract

PMID: 10714158 [PubMed - indexed for MEDLINE]

3211: Arch Neurol. 2000 Mar;57(3):427.

Comment in:
    Arch Neurol. 2000 Nov;57(11):1658-9.

Comment on:
    Arch Neurol. 1999 Jul;56(7):851-6.

Association of varicella-zoster virus with cervical artery dissection in 2 cases.

Constantinescu CS.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 10714677 [PubMed - indexed for MEDLINE]

3212: Biol Blood Marrow Transplant. 2000;6(1):44-9.

Varicella zoster virus infections following allogeneic bone marrow
transplantation: frequency, risk factors, and clinical outcome.

Koc Y, Miller KB, Schenkein DP, Griffith J, Akhtar M, DesJardin J, Snydman DR.

Department of Medicine, New England Medical Center, Boston, Massachusetts, USA.

Reactivation of varicella zoster virus (VZV) is a common event in patients
undergoing allogeneic bone marrow transplantation (BMT) and may lead to
life-threatening complications. We retrospectively analyzed the incidence,
clinical outcome, and risk factors for VZV infections occurring within the first 
5 years of transplantation in 100 consecutive adults undergoing allogeneic BMT
between 1992 and 1997. Forty-one patients (41%) developed VZV reactivation a
median of 227 days (range 45-346 days) post-transplantation. Twelve percent of
VZV reactivation occurred in the first 100 days and 88% within the first 24
months. Among those who survived for 2 or more years after transplantation (n =
47), 59% developed VZV infection. Forty percent of patients with VZV reactivation
required admission with a mean hospital stay of 7.2 days. Two patients developed 
encephalitis, and 1 died despite antiviral therapy. The most frequent
complications were post-herpetic neuralgia and peripheral neuropathy (68%).
Thoracic dermatomal zoster represented 41% of the infections; disseminated
cutaneous involvement was observed in 17% of patients. No clinical or
epidemiologic risk factors were associated with recurrence. Administration of
ganciclovir for prevention of cytomegalovirus infection delayed the onset of VZV 
infection beyond 4 months (P = .06). In a further subset analysis, patients with 
a limited chronic graft-versus-host disease (GVHD) had a lower estimated
incidence of VZV reactivation compared with those with extensive chronic GVHD (P 
= .11). We conclude that complications from reactivation of VZV infection are
common and associated with considerable morbidity and mortality in patients
undergoing allogeneic BMT.

Publication Types: 
    Clinical Trial

PMID: 10707998 [PubMed - indexed for MEDLINE]

3213: Vaccine. 2000 Apr 3;18(19):2049-54.

Humoral immunoresponse to varicella-zoster virus pernasally coadministered with
Escherichia coli enterotoxin in mice.

Tsuji T, Shiraki K, Sato H, Yue-Mea J, Honma Y, Yoshikawa T, Asano Y.

Department of Microbiology, Fujita Health University, School of Medicine,
Toyoake, Aichi, Japan.

It is evaluated whether Escherichia coli enterotoxin is useful for induction of
immunity to varicella-zoster virus (VZV) as a mucosal adjuvant in mice. When a
commercially available live varicella vaccine (Oka strain) and toxin were
administered simultaneously via a nasal route three times at 2 or 6 month
intervals, an antibody neutralizing VZV was detected in half or all of the mice
vaccinated, respectively. The antibody specific to the vaccine strain of VZV
reacted to five proteins, molecular weights of which were 110 K, 100 K, 62 K, 54 
K and 46 K. These proteins were composed of glycosylated products of all kinds of
glycoproteins. These results suggest that although a nasal administration of the 
vaccine without the adjuvant has little immunogenicity in mice, the simultaneous 
administration of the live vaccine and the toxin over a long period induces a
specific humoral immunity to VZV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10706968 [PubMed - indexed for MEDLINE]

3214: Am J Ophthalmol. 2000 Mar;129(3):404-5.

High prevalence of herpes simplex virus type 2 in acute retinal necrosis syndrome
associated with herpes simplex virus in Japan.

Itoh N, Matsumura N, Ogi A, Nishide T, Imai Y, Kanai H, Ohno S.

Department of Ophthalmology, Yokohama City University School of Medicine,
Yokohama, Japan. taro@med.yokohama-cu.ac.jp

PURPOSE: To determine the type of herpes simplex virus in acute retinal necrosis 
syndrome associated with herpes simplex virus. METHODS: Herpes simplex virus type
1, herpes simplex virus type 2, varicella-zoster virus, Epstein-Barr virus, and
cytomegalovirus were examined by polymerase chain reaction in intraocular
specimens from 16 patients with acute retinal necrosis syndrome. Anti-herpes
simplex virus type 1 and anti-herpes simplex virus type 2 type-specific
antibodies in serum from the patients were detected by enzyme immunoassay.
RESULTS: Of 16 patients with acute retinal necrosis syndrome, seven were
polymerase chain reaction positive for herpes simplex virus type 2 and nine were 
positive for varicella-zoster virus. Anti-herpes simplex virus type 2 antibody
was positive and anti-herpes simplex virus type 1 antibody was negative in the
sera of the seven patients with herpes simplex virus type 2 DNA-positive acute
retinal necrosis syndrome. In contrast, anti-herpes simplex virus type 2 antibody
was absent in all nine varicella-zoster virus DNA-positive acute retinal necrosis
syndrome patients. CONCLUSION: Herpes simplex virus type 2 has been demonstrated 
to be the major causative agent in acute retinal necrosis syndrome associated
with herpes simplex virus by molecular biological and serological methods.
Negative preexisting anti-herpes simplex virus type 1 antibody may play an
important role in acute retinal necrosis syndrome associated with herpes simplex 
virus type 2.

PMID: 10704570 [PubMed - indexed for MEDLINE]

3215: Geriatr Nurs. 1999 Sep-Oct;20(5):268-72.

HIV & AIDS in older adults.

Wooten-Bielski K.

University of Pennsylvania's School of Nursing, Philadelphia, USA.

Many Americans mistakenly believe that older adults are not at risk for HIV/AIDS.
Older people do not perceive themselves to be at risk for HIV infection, either. 
In reality, approximately 10% of AIDS cases are among people older than 50. Many 
health care providers lack an awareness of the risk of HIV/AIDS in the elderly
population, and as a result, many older people with these conditions are
misdiagnosed with other ailments. Major manifestations of HIV/AIDS in elderly
adults include Pneumocystis carinii pneumonia, herpes zoster, tuberculosis,
cytomegalovirus, oral thrush, Mycobacterium avium complex, and HIV dementia.
Elderly HIV-positive women have special health concerns, such as cervical cancer.
Nurses and nurse practitioners can heighten their colleagues' awareness of the
existence of HIV/AIDS in the elderly population and educate their older patients 
on HIV/AIDS. Furthermore, information about sexuality and sexual practices of
older adults should be incorporated into all health science curricula. Additional
research is needed to determine the extent of the problem and how health care
providers can best serve their older patients' needs.

Publication Types: 
    Review

PMID: 10703354 [PubMed - indexed for MEDLINE]

3216: Otolaryngol Head Neck Surg. 2000 Mar;122(3):463.

Trigeminal herpes zoster/chocolate-vanilla tongue.

Braverman I, Uri N, Greenberg E.

Department of Otolaryngology-Head and Neck Surgery, Carmel Medical Center, Haifa,
Israel.

Publication Types: 
    Case Reports

PMID: 10699831 [PubMed - indexed for MEDLINE]

3217: J Dermatol Sci. 2000 May;23(1):63-72.

Characterization of acyclovir susceptibility and genetic stability of
varicella-zoster viruses isolated during acyclovir therapy.

Ida M, Kageyama S, Sato H, Kamiyama T, Toyomoto T, Ozaki T, Kajita Y, Morohashi
M, Shiraki K.

Department of Virology, Toyama Medical and Pharmaceutical University, 2630
Sugitani, Toyama, Japan.

We have characterized the susceptibility and genetic stability of
varicella-zoster viruses (VZV) isolated from skin lesions of three patients with 
herpes zoster and six patients with varicella treated with conventional
short-term acyclovir (ACV) administration. The susceptibilities to ACV of the
serial isolates from the patients were examined, and there was no significant
difference in the susceptibility to ACV among the isolates before and during the 
ACV treatment, indicating that conventional short-term ACV treatment did not
generate ACV-resistant VZV infections. Polymerase chain reaction (PCR) analyses
of these as well as seven thymidine kinase-deficient VZV strains derived from in 
vitro ACV treatment were carried out to examine their genomic stability. Five
regions containing tandem direct reiterations (R1-R5) were amplified by PCR and
compared, and the region containing the Pst I-site was also examined. PCR
analyses demonstrated that the R1, R5 and the Pst I-sites were stable and useful 
in epidemiological studies even after ACV treatment. The R2, R3 and R4 sites were
far less stable in these experimental conditions. In this paper we discuss the
results of the PCR analyses with regard to the dynamics of VZV population in
patients with VZV infection treated with conventional short-term ACV
administration.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10699766 [PubMed - indexed for MEDLINE]

3218: N Engl J Med. 2000 Mar 2;342(9):635-45.

Erratum in:
    N Engl J Med 2000 Apr 6;342(14):1063.

Comment in:
    N Engl J Med. 2001 Jan 4;344(1):65-6.    N Engl J Med. 2001 Mar 29;344(13):1019-20; author reply 1021-2.

Neurologic complications of the reactivation of varicella-zoster virus.

Gilden DH, Kleinschmidt-DeMasters BK, LaGuardia JJ, Mahalingam R, Cohrs RJ.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA. don.gilden@uchsc.edu

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10699164 [PubMed - indexed for MEDLINE]

3219: Acta Virol. 1999 Apr-Jun;43(2-3):174-80.

Identification and structural analysis of a MDV gene encoding a protein kinase.

Reddy SM, Sui D, Wu P, Lee L.

Avian Disease and Oncology Laboratory, USDA-ARS, East Lansing, MI 48823, USA.

DNA sequence analysis of the BamHI-C fragment of Marek's Disease Virus (MDV)
reveals the presence of a 513 amino acid open reading frame (ORF). This ORF codes
for a protein with an estimated M(r) of 58,901. Comparison of the amino acid
sequence with those available in the Swiss-Prot database indicates extensive
homology with a protein kinase (PK) of herpes simplex virus (HSV) and
varicella-zoster virus (VZV). In Northern blot hybridization, a transcript of 2.0
kb was detected in MDV (GA strain) infected duck embryo fibroblasts (DEFs). A
portion of the ORF was expressed in Escherichia coli as a trpE-fusion protein and
used to generate antiserum in New Zealand rabbits. This antiserum specifically
detected a protein of 60 kDa in MDV serotype 1, 2 and 3 infected DEFs or chicken 
embryo fibroblasts (CEFs) by Western blot analysis. This ORF codes for a
functional PK.

PMID: 10696441 [PubMed - indexed for MEDLINE]

3220: Eur J Pain. 1999 Dec;3(4):375-386.

Thermal and tactile perception thresholds in acute herpes zoster.

Haanpaa ML, Laippala PA, Nurmikko TJ.

Department of Neurology, Tampere University Hospital, Finland

This study was conducted to determine somatosensory perception thresholds in 97
immunocompetent patients with herpes zoster (HZ), and to evaluate their
associations with the development of post-herpetic neuralgia (PHN). Warm, cold
and heat pain thresholds were tested by Thermotest (SOMEDIC) and tactile
thresholds by Semmes-Weinstein monofilaments. To establish reference values, 103 
healthy subjects underwent somatosensory testing, from which values were
calculated for both genders for four age groups (<60, 60-69, 70-79 and
>/=80years) in five dermatomal levels (VI, C3, T3, T10 and S1). Patients with HZ 
underwent quantitative somatosensory testing within the affected dermatome, its
mirror image dermatome and an adjacent dermatome bilaterally. The follow-up
visits with somatosensory testing took place at 2 weeks, 6 weeks, 3 months and 6 
months. When evaluated as means of the results, warm and cold thresholds were
significantly elevated in the affected dermatome from the initial visit until 3
and 6 months, respectively. By contrast, heat pain thresholds were lowered at the
initial visit but normalized by 2 weeks, and tactile thresholds remained
unchanged. These threshold changes were associated neither with further
development of PHN nor each other. It is concluded that measurement of
somatosensory perception thresholds in early stages of HZ shows evidence of
impaired neural function but is not helpful in predicting which patient will go
on to develop PHN. Copyright 1999 European Federation of Chapters of the
International Association for the Study of Pain.

PMID: 10700365 [PubMed - as supplied by publisher]

3221: Eur J Pain. 1999 Dec;3(4):335-342.

The lifetime occurrence of Herpes zoster and prevalence of post-herpetic
neuralgia: A retrospective survey in an elderly population.

Bowsher D.

Pain Research Institute, Walton Hospital, Liverpool, L9 1AE, UK

One-thousand-and-seventy-one randomly chosen elderly persons (537 women, 534 men;
median age 80) were recruited from the Institute of Human Aging (Dept of
Psychiatry, University of Liverpool). Almost a quarter (23.8%; equal numbers of
both sexes) had had shingles (HZ), at a median age of 60 (for both sexes); 39
subjects (3.6% of all respondents, 15% of those who had had shingles), two thirds
of whom were female, developed post-herpetic neuralgia (PHN), defined as pain
persisting for more than 3 months; they acquired HZ at a median age of 70. In 22 
of them, pain had resolved by the time they were questioned, but in 17 it was
ongoing (from less than 12 to 504 months). Two new independent risk factors for
PHN were identified: (1) female gender; and (2) living alone at the time of HZ
acquisition (p = 0.009). In addition to confirming the well-known factor of: (3) 
age at shingles acquisition (up to the early 90s); and (4) scarring, presumed to 
be a consequence of rash severity, was significantly commoner in subjects whose
HZ was followed by PHN.Extrapolating the prevalence figures to the whole UK
population, of whom 9.28 million were over 64 in 1992, it can be conservatively
estimated that at any one time, some 200 000 people in the UK have PHN. Copyright
1999 European Federation of Chapters of the International Association for the
Study of Pain.

PMID: 10700361 [PubMed - as supplied by publisher]

3222: West J Med. 2000 Jan;172(1):10.

Comment on:
    West J Med. 1999 May;170(5):263.

More on herpes zoster lesions.

Litvinoff J.

Publication Types: 
    Comment
    Letter

PMID: 10695432 [PubMed - indexed for MEDLINE]

3223: Ryumachi. 1999 Dec;39(6):829-35.

[Improvement of the maintenance therapy after methylprednisolone pulse
therapy--effect of prednisolone combined with immunosuppressants]

[Article in Japanese]

Miyamae T, Nakasima S, Imagawa T, Ito S, Katakura S, Tomono N, Mori M, Ibe M,
Mitsuda T, Aihara Y, Yokota S.

Department of Pediatrics, Yokohama City University School of Medicine.

OBJECTIVES: We investigated the effect of the combination therapy of prednisolone
(PSL) and immunosuppressants after methylprednisolone pulse therapy. METHODS: A
protocol of PSL (15-20 mg/day) and mizoribine (150-200 mg/day) after
methylprednisolone (mPSL) pulses was used for 2 years to treat 7 patients (PSL + 
MZB group). Cyclophosphamide (CYC) pulse therapy was added to the combined
therapy in 4 patients with severe lupus nephritis. The total dose of
predinisolone, and side effects were compared with those in 6 patients who were
treated with PSL (30 mg/kg) alone after mPSL pulse therapy (PSL group). RESULTS: 
No relapses occurred in the PSL + MZB group, although all of 6 patients relapsed 
in the PSL Group. The total doses of PSL in the PSL + MZB group was about 70% of 
the PSL Group. There were two patients with Herpes-Zoster infection and one
patient with liver dysfunction as side effects, with no differences in the
frequency of side effects between the was groups. CONCLUSIONS: Combination
maintenance therapy with prednisolone and immunosuppressants after
methylprednisolone pulse therapy was effective in preventing relapse.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract

PMID: 10695406 [PubMed - indexed for MEDLINE]

3224: Rinsho Ketsueki. 2000 Jan;41(1):20-4.

[Varicella-zoster virus infection after hematopoietic stem cell transplantation]

[Article in Japanese]

Akiyama H, Inoue T, Okoshi Y, Mori S, Ohashi K, Maeda Y, Sasaki T, Okuyama Y,
Hiruma K, Sakamaki H.

Hematology Division, Tokyo Metropolitan Komagome Hospital.

Of 264 patients aged 15 years or more who underwent hematopoietic stem cell
transplantation between 1989 and September 1998 at the Tokyo Metropolitan
Komagome Hospital, 47 were infected by the varicella-zoster virus (VZV). In 2
patients, visceral disease preceded cutaneous dissemination. One of these
patients exhibited gastrointestinal symptoms followed by disseminated skin rash 6
days later. In the other patient, epigastralgia developed and was followed by
seizures secondary to meningitis; the appearance of a skin rash 5 days after
these initial symptoms yielded the diagnosis. Early diagnosis and treatment of
VZV infection are important, especially for patients who present with visceral
symptoms suspected to be due to VZV.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10695394 [PubMed - indexed for MEDLINE]

3225: Pediatr Infect Dis J. 2000 Feb;19(2):169-70.

Herpes zoster in healthy children immunized with varicella vaccine.

Takayama N, Takayama M, Takita J.

Department of Pediatrics, Tokyo Metropolitan Komagome Hospital, Japan.
takyamndk@komagome-hospital.bunkyo.tokyo.jp

Publication Types: 
    Case Reports

PMID: 10694011 [PubMed - indexed for MEDLINE]

3226: Int J Dermatol. 2000 Feb;39(2):126-33.

Lichenoid and granulomatous dermatitis.

Magro CM, Crowson AN.

Department of Pathology, Cell Biology, and Anatomy, Medical College of Thomas
Jefferson University, Philadelphia, PA, USA.

BACKGROUND: The prototypic lichenoid eruptions, lichen planus (LP), lichenoid
drug eruptions, secondary syphilis, and collagen vascular disease, are defined
histologically by a band-like lymphocytic infiltrate in close apposition to the
epidermis. We describe a novel form of lichenoid dermatitis with a granulomatous 
component. DESIGN: Skin biopsies from 40 patients demonstrating a band-like
lymphocytic infiltrate with concomitant granulomatous inflammation were
encountered over 4 years. Clinicians were contacted to elucidate underlying
triggers and medical illnesses. RESULTS: A lichenoid dermatitis, a linear
eruption, vasculitis, annular erythema, and erythroderma were among the clinical 
presentations. A drug-based etiology was implicated in 14 cases: the drugs
included antibiotics, lipid-lowering agents, anti-inflammatory drugs,
antihistamines, hydroxychloroquine sulfate, and angiotensin-converting enzyme
inhibitors. Over one-third of patients with drug-related eruptions had other
medical illnesses associated with cutaneous granulomatous inflammation, namely
rheumatoid arthritis (RA), Crohn's disease, hepatitis C, diabetes mellitus, and
thyroiditis. A microbial trigger was implicated in 12 patients in the context of 
infective id reactions to herpes zoster, Epstein-Barr virus (EBV), or
streptococci, or active infections by Mycobacterium tuberculosis, M. leprae,
fungi, and spirochetes. The remainder had hepatobiliary disease and RA without
obvious exogenous triggers, cutaneous T-cell lymphoma (CTCL), and idiopathic
lichenoid eruptions (i.e. LP, lichen nitidus, and lichen striatus). One patient
with LP had underlying multicentric reticulohistiocytosis. The histiocytic
infiltrate assumed one or more of five light microscopic patterns: (i)
superficially disposed loose histiocytic aggregates; (ii) cohesive granulomata
within zones of band-like lymphocytic infiltration with or without deeper dermal 
extension; (iii) a diffuse interstitial pattern; (iv) scattered singly disposed
giant cells; and (v) granulomatous vasculitis. Additional features included
lymphocytic eccrine hidradenitis in those patients with drug reactions,
hepatobiliary disease, and antecedent viral illnesses, tissue eosinophilia and
erythrocyte extravasation in drug hypersensitivity, granulomatous vasculitis in
patients with microbial triggers, drug hypersensitivity or RA, and lymphoid
atypia in lesions of CTCL or drug hypersensitivity. CONCLUSIONS: The cutaneous
lichenoid and granulomatous reaction may reflect hepatobiliary disease,
endocrinopathy, RA, Crohn's disease, infection, or a drug reaction. One-fifth of 
cases represent idiopathic lichenoid disorders. Lymphoproliferative disease or
pseudolymphomatous drug reactions must be considered in those cases showing
lymphoid atypia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10692062 [PubMed - indexed for MEDLINE]

3227: Ophthalmology. 2000 Feb;107(2):397-401.

HSV-1--induced acute retinal necrosis syndrome presenting with severe
inflammatory orbitopathy, proptosis, and optic nerve involvement.

Tornerup NR, Fomsgaard A, Nielsen NV.

The University Eye Clinic at Rigshospitalet, Copenhagen, Denmark.

OBJECTIVE: To present a unique case in which orbital inflammation, proptosis, and
optic neuritis were the initial symptoms of acute retinal necrosis (ARN). The
clinical presentation of ARN, as well as the currently recommended diagnostic
procedures and guidelines for medical treatment of ARN, are summarized. DESIGN:
Interventional case report. TESTING: Polymerase chain reaction (PCR) techniques
were made on the vitreous for cytomegalovirus, Epstein-Barr virus, herpes simplex
virus (HSV), varicella zoster virus, and toxoplasmosis. A full laboratory
evaluation was made together with HLA-typing and serologic tests measuring
convalescent titers for HSV and other micro-organisms. Magnetic resonance imaging
scan, computed tomography (CT) scan, and fluorescein angiographic examination
were performed. The patient was treated with acyclovir and oral prednisone. MAIN 
OUTCOME MEASURES: The patient was evaluated for initial and final visual acuity
and for degree of proptosis, periocular edema, and vitreitis. RESULTS: The first 
symptoms and signs of ARN were eye pain, headache, proptosis, and a swollen optic
nerve on CT scan. Other than increased C-reactive protein, all blood samples were
normal. PCR was positive for HSV-type I in two separate vitreous biopsies. The
patient had the strongly ARN-related specificity HLA-DQ7. CONCLUSIONS: This is
the first report of HSV-induced ARN presenting with inflammatory orbitopathy and 
optic neuritis. Polymerase chain reaction for HSV-1 was positive more than 4
weeks after debut of symptoms, which is a new finding. The combination of severe 
vitreitis and retinal whitening, with or without proptosis, should alert the
clinician to the possibility of herpes infection and treatment with intravenous
acyclovir started promptly.

Publication Types: 
    Case Reports

PMID: 10690844 [PubMed - indexed for MEDLINE]

3228: No To Shinkei. 2000 Jan;52(1):43-7.

[A case of herpes zoster encephalitis with Ramsay-Hunt syndrome, herpes zoster
generalisatus and acute pancreatitis]

[Article in Japanese]

Nakane S, Honda H, Hamasaki S, Shirabe S, Nakamura T.

First Department of Internal Medicine, Nagasaki University School of Medicine,
Japan.

We describe here a 71-year-old man who had herpes zoster encephalitis. He
developed high fever, headache and disturbance of consciousness on 1st, May,
1998. On admission, neurological examination revealed disturbance of
consciousness with restlessness and meningeal signs. Brain MRI (T 1 and T 2
weighted images) demonstrated high signal lesions in the left temporal lobe and
cerebellar vermis. VSV encephalitis was diagnosed based on CSF pleocytosis, high 
serum and CSF titers of VZV antibody and EEG abnormality. During hospitalization,
Ramsay-Hunt syndrome, herpes zoster generalisatus and acute pancreatitis
developed. To our knowledge, the characteristic combination of the clinical signs
in this case is very rare. We discussed the pathogenic mechanisms of these
conditions, and this case was considered to have VZV encephalitis, and to be
associated with right facial nerve palsy and pancreatitis, in spite of the
absence of immunological deficiency.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10689690 [PubMed - indexed for MEDLINE]

3229: Postgrad Med. 2000 Feb;107(2):67-70, 73-4, 77-80.

Viral pneumonias. Infection in the immunocompromised host.

Chien JW, Johnson JL.

Case Western Reserve University School of Medicine, Cleveland, USA.
jasonc@u.washington.edu

Three herpesviruses--herpes simplex, varicella-zoster, and
cytomegalovirus--commonly cause respiratory tract infections in immunocompromised
patients. Adenoviruses and measles virus are also significant causes of
respiratory disease in this population. Diagnosis of herpesvirus infections is
difficult because these viruses can establish latency and are often shed
intermittently in the absence of invasive disease. A positive respiratory tract
culture of herpesviruses alone is not diagnostic of active invasive disease.
Preventive measures should focus on limiting the patient's exposure to active
infection, broad use of available vaccines in children and susceptible adults,
and use of hyperimmune globulin and chemoprophylaxis in high-risk patients.
Adenovirus pneumonia is diagnosed by viral culture and rapid antigen detection
assays, whereas measles pneumonia is often identifiable by the characteristic
rash. Treatment of either adenovirus or measles pneumonia is primarily
supportive.

Publication Types: 
    Review

PMID: 10689409 [PubMed - indexed for MEDLINE]

3230: Vaccine. 2000 Feb 25;18(16):1700-6.

Vaccination of immunocompetent elderly subjects with a live attenuated Oka strain
of varicella zoster virus: a randomized, controlled, dose-response trial.

Trannoy E, Berger R, Hollander G, Bailleux F, Heimendinger P, Vuillier D,
Creusvaux H.

Pasteur Merieux Connaught (PMC), Lyon, France.

After primary infection in childhood, varicella zoster virus (VZV) remains latent
in the dorsal route ganglia. Its reactivation later in life can lead to a zoster 
episode. VZV-specific, T-cell-mediated immunity (VZV-CMI) is likely to be
important in preventing symptomatic reactivation. As CMI declines with age, a
vaccine enhancing VZV-CMI might be effective in decreasing the incidence or
severity of zoster in elderly subjects. A randomized, double blind controlled
trial assessing CMI responses of elderly subjects immunized with a live
attenuated, VZV-Oka vaccine was conducted. Two hundred healthy volunteers (55-75 
years of age) received either a single injection of the VZV vaccine (PMC),
containing 3200 (Oka 3200), 8500 (Oka 8500), or 41,650 (Oka 41650) PFU of live
VZV, or a pneumococcus vaccine control group (Pneumo 23((R)). The immune response
to VZV was assessed by measuring the T-cell response to VZV antigens, i.e.
proliferation (stimulation index, SI), precursor cell frequency (PCF), cytokine
secretion, and antibody titers. Six weeks post-vaccination, VZV-specific SI
(adjusted mean values) was significantly greater (P<0.0001) in the 3 vaccine
groups (with SI=5. 6 for Oka 3200; SI=5.0 for Oka 8500, and SI=7.2 for Oka
41,650) than in the control group (SI=2.9). The increase in PCF was striking,
with 72.4, 91.2 and 85.1 precursors per million cells respectively in these 3
vaccine groups, vs 26.3 in the control group. No significant IL-4 secretion was
observed in any subject, whereas the presence of IFN-gamma secretion was found to
correlate with good responder status. The increase of these CMI parameters did
not depend upon the titer of virus injected. Geometric mean titers of VZV
antibodies increased in all vaccine groups and remained unchanged in the control 
group. Nevertheless, no correlation between the antibody response and the
cell-mediated response was found. Live attenuated VZV vaccine caused a
significant increase in VZV-CMI in a healthy, elderly population. No relationship
between vaccine dose and the intensity of the specific response was found.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 10689152 [PubMed - indexed for MEDLINE]

3231: Am J Ophthalmol. 2000 Feb;129(2):166-72.

Viral causes of the acute retinal necrosis syndrome.

Ganatra JB, Chandler D, Santos C, Kuppermann B, Margolis TP.

Francis I. Proctor Foundation, and the Department of Ophthalmology, University of
California at San Francisco, 94143-0944, USA.

PURPOSE: The primary goal of this study was to determine the viral cause of the
acute retinal necrosis syndrome in 28 patients (30 eyes). A secondary goal was to
investigate possible associations between viral cause and patient age, and viral 
cause and central nervous system disease. METHODS: A retrospective case series in
which we reviewed the laboratory results and clinical histories of 28 patients
(30 eyes) diagnosed with acute retinal necrosis syndrome, from whom vitreous or
aqueous specimens were received, for diagnostic evaluation using previously
described polymerase chain reaction-based assays. RESULTS: Varicella-zoster
virus, herpes simplex virus, and cytomegalovirus (CMV) DNA were detected in
aqueous and/or vitreous specimens from 27 of 28 patients (29 of 30 eyes with a
clinical history of acute retinal necrosis syndrome). No sample was positive for 
DNA from more than one virus. Varicella-zoster virus DNA was detected in 13
patients (15 eyes). Median age was 57 years. Herpes simplex virus type 1 DNA was 
detected in seven patients (seven eyes). Median age was 47 years. Six of these
patients had a history of herpes simplex virus encephalitis. Herpes simplex virus
type 2 DNA was detected in six patients (six eyes). Median age was 20 years.
Three of these patients had a likely history of meningitis. Cytomegalovirus DNA
was detected in one patient who was immunosuppressed iatrogenically. No viral DNA
was detected in one patient from whom a sample was taken after 6 weeks of
acyclovir therapy. CONCLUSIONS: The data suggest that varicella-zoster virus or
herpes simplex virus type 1 cause acute retinal necrosis syndrome in patients
older than 25 years, whereas herpes simplex virus type 2 causes acute retinal
necrosis in patients younger than 25 years. A history of central nervous system
infection in a patient with acute retinal necrosis syndrome suggests that herpes 
simplex virus is likely to be the viral cause.

PMID: 10682968 [PubMed - indexed for MEDLINE]

3232: Antivir Ther. 1998;3(4):229-31.

Opportunistic infections shortly after beginning highly active antiretroviral
therapy.

Rodriguez-Rosado R, Soriano V, Dona C, Gonzalez-Lahoz J.

Service of Infectious Diseases, Hospital Carlos III, Instituto de SaludCarlos
III, Madrid, Spain. rafael.rodriguez@mad.servicom.es

The clinical benefit of highly active antiretroviral therapy (HAART) has been
attributed to its suppression of viral replication and improvement in the CD4
lymphocyte count. However, the development of clinical symptoms secondary to
previously silent opportunistic pathogens shortly after beginning HAART has been 
reported as a distinct clinical syndrome and seems to be associated with
inflammatory phenomena surrounding a rapid restoration of the immune system in
previously immunosuppressed patients. Herein, we report nine (3.6%) episodes of
opportunistic infections (OI) in 247 human immunodeficiency virus (HIV)-infected 
patients undergoing HAART in a reference HIV/AIDS institution located in Madrid, 
Spain. In all instances, OI clustered within the first 3 months after beginning
HAART. Episodes of cerebral toxoplasmosis (three cases), Pneumocystis carinii
pneumonia (two cases), and herpes zoster (two cases) occurred in persons without 
a previous AIDS-defining illness, in addition a relapse of cytomegalovirus
retinitis and a rebound in Kaposi's sarcoma were seen, respectively, in another
two patients. Four of the nine subjects had a CD4 count above 200 cells/mm3
before HAART began. Of these, one developed Pneumocystis pneumonia and one other 
cerebral toxoplasmosis. In conclusion, prophylaxis and close clinical monitoring 
of HIV-infected patients should be considered for the first 3 months after
beginning HAART, even for subjects without severe immunosuppression.

PMID: 10682143 [PubMed - indexed for MEDLINE]

3233: J Virol Methods. 2000 Feb;84(2):169-73.

Serological diagnosis of varicella-zoster virus in sera with antibody-capture
enzyme-linked immunosorbent assay of IgM.

Oladepo DK, Klapper PE, Percival D, Vallely PJ.

Cortecs Diagnostics, Deeside, UK.

Evaluation was made of three enzyme-linked immunosorbent assay (ELISA) formats;
varicella-zoster virus (VZV) indirect ELISA; VZV IgM capture using biotin and VZV
IgM capture using peroxidase, for the detection of VZV-specific IgM antibodies in
human sera. It was observed that there was no significant difference in
sensitivity of detection using the three formats but there were important
practical differences in the number of steps and hence time for assay completion 
between the three assay formats. All assays showed some cross-reactivity with
sera containing anti-HSV1 antibodies.

PMID: 10680966 [PubMed - indexed for MEDLINE]

3234: Ann Pharmacother. 2000 Feb;34(2):228-34.

Immunology of Varicella Immunization in the elderly.

Raeder CK, Hayney MS.

School of Pharmacy, University of Wisconsin-Madison, 53706, USA.

OBJECTIVE: To review the varicella-zoster virus (VZV) and herpes zoster disease
and to summarize published reports on the use of the live-attenuated varicella
zoster vaccine to enhance cell-mediated immunity in elderly individuals. DATA
SOURCE: A MEDLINE search (1966-August 1999) for English-language clinical studies
and review articles pertaining to VZV and the live-attenuated varicella vaccine
was conducted; references obtained from these publications were subsequently
reviewed for additional relevant articles. STUDY SELECTION AND DATA EXTRACTION:
Representative clinical trials were summarized and relevant information was
selected to assist in the understanding of VZV, the subsequent immune response,
and the live-attenuated varicella vaccine. DATA SYNTHESIS: The physiologic,
age-related decline in VZV cell-mediated immunity has been shown to be restored
on administration of live-attenuated varicella vaccine. Various studies report
serum anti-VZV antibody concentrations, and production of interferon-gamma were
increased following vaccination. Concentrations subsequently returned to baseline
one year after vaccination. Increase in responder cell frequency, a measure of
cell-mediated immunity, has been reported to last up to four years after
vaccination, at concentrations similar or superior to those observed following
herpes zoster. CONCLUSIONS: Enhancement of cell-mediated immune response in
elderly individuals through vaccination with live-attenuated varicella vaccine is
a possible measure to protect this population from herpes zoster and to attenuate
its complications. A summary of immunogenicity studies to identify the immune
response to live-attenuated varicella vaccine in the elderly is presented. The
absolute clinical significance, as well as appropriate administration guidelines 
of this prophylactic intervention, will become evident following forthcoming
large, masked, placebo-controlled trials.

Publication Types: 
    Review

PMID: 10676831 [PubMed - indexed for MEDLINE]

3235: Intern Med. 2000 Jan;39(1):80-1.

Bilateral facial palsy following trigeminal zoster with zoster oticus.

Hamano T, Takano A, Miyao S, Teramoto J, Wanibe S.

Publication Types: 
    Case Reports
    Letter

PMID: 10674857 [PubMed - indexed for MEDLINE]

3236: Bone Marrow Transplant. 2000 Jan;25(2):167-72.

Incidence, risk factors and outcome of varicella-zoster virus infection in
children after haematopoietic stem cell transplantation.

Leung TF, Chik KW, Li CK, Lai H, Shing MM, Chan PK, Lee V, Yuen PM.

Division of Haematology and Oncology, Department of Paediatrics, The Chinese
University of Hong Kong, Hong Kong.

We report a retrospective analysis of VZV infection after haematopoietic stem
cell transplantation (HSCT) in children. Thirty-three (30%) of the total 109
children who were transplanted during a 7 year period developed post-transplant
VZV infection. Twenty-four of these 33 (73%) children had VZV infection within 1 
year following HSCT. The cumulative incidences of post-transplant VZV infection
at 1 and 5 years were 26% and 45%, respectively. The positive and negative
predictive values of pretransplant VZV serology in recipients on the development 
of HZ following HSCT were 39% and 88%, respectively. Pretransplant VZV
seropositivity in recipients was the only risk factor for post-transplant herpes 
zoster (HZ) infection on multivariate analysis. All patients responded to
acyclovir. The median duration of VZV infection was 5 days. Three (11%) and one
(3%) children with HZ developed visceral dissemination and post-herpetic
neuralgia, respectively. No mortality was directly attributed to VZV infection.
VZV infection remains a major cause of morbidity in children after HSCT. Further 
studies are warranted to evaluate the potential use of VZV vaccine in these
children. Bone Marrow Transplantation (2000) 25, 167-172.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10673675 [PubMed - indexed for MEDLINE]

3237: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Feb;89(2):193-8.

Examination of the oral mucosa and peripheral blood cells of patients with
recurrent aphthous ulceration for human herpesvirus DNA.

Brice SL, Cook D, Leahy M, Huff JC, Weston WL.

Department of Dermatology, School of Medicine, University of Colorado, Denver, CO
80262, USA.

OBJECTIVE: The purpose of this study was to exam the oral mucosa and peripheral
blood cells of patients with recurrent aph-thous ulceration (RAU) for the
presence of the following human herpesviruses: herpes simplex viruses 1 and 2,
varicella zoster virus, Epstein-Barr virus, cytomegalovirus, human herpesvirus-6,
and human herpesvirus-7. STUDY DESIGN: Fifty-eight subjects with RAU and 10
control subjects were recruited at an academic referral center and enrolled in
this prospective, nonrandomized, case-controlled study. Each of the subjects with
RAU was seen during an acute episode, and swab specimens from lesional
(RAU-acute/lesion) and clinically normal (RAU-acute/normal) oral mucosa were
obtained. Each of 2 subjects with RAU was evaluated during more than one acute
episode. Three subjects with RAU were seen between active episodes, and swab
specimens were taken from clinically normal (RAU-convalescent) oral mucosa. Swab 
specimens from clinically normal (control/normal) oral mucosa were obtained from 
the control subjects. Peripheral blood specimens were obtained from subjects with
RAU and control subjects at the time the swab specimens were performed. Through
use of polymerase chain reaction, all swab and peripheral blood specimens were
examined for the presence of human herpesvirus DNA. Statistical significance was 
determined by means of chi(2) analysis. RESULTS: Herpes simplex virus and human
herpesvirus-6 were found in a higher percentage of mucosal specimens from the
control subjects (herpes simplex virus, 4/10; human herpesvirus-6, 5/9) than from
the subjects with RAU (RAU-acute/lesion: 3/45 herpes simplex virus, 13/53 human
herpesvirus-6; RAU-acute/normal: 7/48 herpes simplex virus, 9/53 human
herpesvirus-6). No difference was demonstrated between RAU-acute/lesion,
RAU-acute/normal, and RAU-convalescent mucosal specimens for any of the human
herpesviruses. Different human herpesviruses were identified from individual
subjects with RAU during subsequent episodes of disease. Epstein-Barr virus
(6/35), human herpesvirus-6 (3/40), and human herpesvirus-7 (7/43) were detected 
in the peripheral blood mononuclear cells during acute RAU but not in
RAU-convalescent or control peripheral blood mononuclear cells. CONCLUSIONS: The 
detection of human herpesvirus DNA from the oral mucosa and peripheral blood
mononuclear cells of patients with RAU appears to represent normal viral shedding
rather than a direct causal mechanism in this disorder.

PMID: 10673655 [PubMed - indexed for MEDLINE]

3238: Kyobu Geka. 2000 Feb;53(2):136-40.

[Ineffective and recurrent cases of thoracoscopic sympathectomy for hyperhidrosis
and intractable pain]

[Article in Japanese]

Hoshina K, Amemiya R, Asato Y, Hishikawa S, Nemoto K, Kiyoshima M, Kohno S, Shida
D, Tanaka R, Suzuki A, Yoshimi F, Koizumi S.

Department of Surgery, Ibaraki Prefectural Central Hospital and Cancer Center,
Japan.

We reported the cases of thoracoscopic sympathectomy, that is, six cases of
hyperhidrosis, three of post herpetic neuralgia, and four of reflex sympathetic
dystrophy, including recurrent or incompletely resected or ineffective ones.
Recently this procedure for hyperhidrosis had been performed frequently because
of its effectiveness, less pain, early discharge and cosmetic aspect. For an
ineffective case of hyperhidrosis abdominal respiration which emphasized the
exhalation and using an upper abdomen decreased the sweating. The balance of
autonomic nerve system, toward parasympathetic dominant, was thought to be
improved by conscious respiration. The decrease of sweating right after the
operation in a case of incomplete resection indicated that intraoperative
maneuver could restrict the sympathetic nerve. This procedure for a pain control 
could be less effective than that for hyperhidrosis, so an adequate preoperative 
informed consent was thought to be necessary.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10667025 [PubMed - indexed for MEDLINE]

3239: J Laryngol Otol. 1999 Oct;113(10):914-5.

Delayed facial palsy after middle-ear surgery due to reactivation of
varicella-zoster virus.

Gyo K, Honda N.

Department of Otolaryngology, Ehime University Hospital, Japan.

Viral reactivation is thought to be an important cause of post-operative facial
palsy of delayed onset. We present an unusual case of Ramsay-Hunt syndrome that
occurred as a consequence of middle-ear surgery by triggering varicella-zoster
virus reactivation. As a pathognomonic auricular eruption was not seen, the
patient was initially misdiagnosed as iatrogenic facial palsy. Clinical features,
diagnosis and management are discussed.

Publication Types: 
    Case Reports

PMID: 10664708 [PubMed - indexed for MEDLINE]

3240: Arch Virol. 2000;145(1):85-97.

Stability of a varicella-zoster virus glycoprotein E epitope.

Vafai A, Forghani B, Kilpatrick D, Ling J, Shankar V.

Biologics Branch, Scientific Resources Program, Centers for Disease Control and
Prevention, Public Health Service, U.S. Department of Health and Human Services, 
Atlanta, Georgia, USA.

The epitope stability of a varicella-zoster virus (VZV) glycoprotein E (gE) was
analyzed with monoclonal antibodies (mAbs) in cells infected with different
passages of various VZV strains and isolates. The gE-specific mAbs recognized
same antigenic sites (epitopes) in VZV isolates with various passage history. All
VZV strains and virus-isolates reacted with an anti-gE monoclonal antibody by
immunoprecipitation, or indirect fluorescent antibody staining test. Sera from
VZV seropositive individuals reacted with a truncated VZV gE glycoprotein,
designated TgpI-511. Also, human mononuclear cells (MNCs) stimulated with
TgpI-511 glycoprotein were shown to produce VZV-specific antibodies in vitro. The
results demonstrated the stability of these gE epitopes tested in this study in
TgpI-511 and among the VZV-isolates obtained from different passages. These
results also suggest that VZV glycoproteins as well as live attenuated or killed 
varicella vaccines containing these epitopes could be used as therapeutic booster
vaccines in adults and the elderly to prevent zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10664408 [PubMed - indexed for MEDLINE]

3241: Hautarzt. 1999 Dec;50(12):873-8.

[Virologic diagnosis of herpes zoster]

[Article in German]

Sauerbrei A, Sommer M, Wutzler P.

Institut fur Antivirale Chemotherapie, Friedrich-Schiller-Universitat Jena.

Diagnosis of herpes zoster needs to be rapid when effective antiviral
chemotherapy is being considered. Patients with atypical clinical features can
often only be diagnosed by virological methods. In the present study, vesicle
specimens of 100 patients with zoster were analysed by detecting viral DNA using 
polymerase chain reaction (PCR). The findings were compared with those obtained
by traditional virological and serological methods. PCR results confirmed the
clinical diagnosis of zoster in 95%. Primers selected from varicella-zoster virus
(VZV) gene 28 proved to be most sensitive. The sensitivity of virus culture was
20% (specificity 100%) and of direct immunofluorescent VZV-specific antigen
staining in vesicle samples 82% (specificity 76%). There was a serological
response to specific IgM and IgA antibodies in 48% within four days after the
onset of rash. These findings suggest that PCR is the method of choice for rapid 
laboratory diagnosis of zoster.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 10663022 [PubMed - indexed for MEDLINE]

3242: Folia Med (Plovdiv). 1999;41(3):40-4.

Mucocutaneous infections in hematological malignancies.

Grudeva-Popova J, Goranov S.

Clinic of Hematology, Higher Medical Institute, Plovdiv, Bulgaria.

INTRODUCTION: Mucocutaneous infections of diverse etiology are frequent
complications in patients with hematological malignancies. OBJECTIVE: To study
the incidence, predisposing factors, microbiology, and primary clinical
manifestations of these complications in oncohematological patients. MATERIAL AND
METHODS: The study included 862 patients (394 females and 468 males) with
hematological malignancies, treated in the Clinic of Hematology of the Higher
Medical Institute, Plovdiv from 1990 to 1998. The patients were divided into
three groups according to the primary disorder: lymphoproliferative disorders
(541 patients), myeloproliferative disorders (296 patients), and bone marrow
insufficiency (25 patients). RESULTS AND DISCUSSION: The mucocutaneous infections
studied included most often abscesses and pyodermias. The predominant isolate was
Staphylococcus aureus. Viral infections were caused mainly by herpes simplex
virus type I and, less frequently, varicella zoster virus with intercostal
localization. Candida species was isolated predominantly in oropharyngeal and
esophageal mycoses. CONCLUSION: Prolonged cytostatic-induced neutropenia and
suppressed cellular immune response are the principal factors for the infectious 
complications in hematological malignancies. The early clinical diagnosis and
prompt etiological treatment of the mucocutaneous infections are crucial for the 
prophylaxis of the systemic infectious complications.

PMID: 10658365 [PubMed - indexed for MEDLINE]

3243: Br J Ophthalmol. 2000 Feb;84(2):193-8.

Variable R1 region in varicella zoster virus in fulminant type of acute retinal
necrosis syndrome.

Abe T, Sato M, Tamai M.

Department of Ophthalmology, Tohoku University School of Medicine, Sendai, Japan.

BACKGROUND/AIMS: Varicella zoster virus (VZV) is a causative agent in acute
retinal necrosis (ARN) syndrome. However, in spite of aggressive antiviral
therapy, clinical characteristics among patients have varied. Different viral
strains were examined to determine their respective role in producing clinical
characteristics. The viral strains were also compared with those of previously
reported ones. METHODS: To differentiate VZV strains R1 and R5, variable regions 
of VZV were amplified by nested polymerase chain reaction (PCR) in 11 eyes of 10 
patients. Sequence analysis was also performed. RESULTS: Four cases had strains
diverted only at the tip of the 3' end of the R1 variable region, similar to that
of the H-N3 strain, which was previously reported. Conversely, other cases were
diverted to other regions. Interestingly, some of the latter cases showed
multiple PCR products in the R1 region that were generated by the truncation of
either the 5' or 3' R1 region. Final visual acuities of these patients were less 
than 0.2. The former cases showed final visual acuities more than 0.4. Only two
variants were from the R5 region. No patient had the same viral strain as the
European Dumas type. CONCLUSION: These results showed that variable VZV strains
participated in ARN. Using PCR of the R1 variable region, it was estimated that
patients with a more fulminant type of ARN may have diverse viruses with
extensive replication in the affected eyes.

PMID: 10655197 [PubMed - indexed for MEDLINE]

3244: Adv Wound Care. 1999 Jun;12(5):254-62.

Identification and treatment of herpes lesions.

Chandrasekar PH.

Department of Medicine, Wayne State University, Detroit, MI, USA.

Infections caused by the herpes family of viruses are on the rise. Mucocutaneous 
herpes infections are caused by herpes simplex viruses 1 and 2 and
varicella-zoster virus. Herpes simplex virus commonly causes oral-labial or
genital infection, and varicella-zoster virus causes chicken pox and shingles.
Clinical features frequently are atypical, particularly in compromised patients. 
Therefore, a high index of suspicion must be maintained for early diagnosis.
Availability of easy-to-perform rapid diagnostic tests and several potent
antiherpetic agents have vastly improved the management of herpes infections.

Publication Types: 
    Case Reports
    Review

PMID: 10655799 [PubMed - indexed for MEDLINE]

3245: Rev Neurol. 1999 Dec 16-31;29(12):1225-35.

[Recent advances in the treatment the nervous system disorders with
interferon-alpha]

[Article in Spanish]

Cabrera-Gomez JA, Lopez-Saura P.

Servicio de Neurologia, Hospital Provincial Dr. Gustavo Aldereguia Lima,
Cienfuegos, Cuba. cabrera@jagua.cfg.sld.cu

INTRODUCTION: The interferons (IFN) have had considerable effect on the course of
relapses and the natural course of the disability of patients with multiple
sclerosis (MS). However, the effects of IFN in other neurological disorders are
little known. OBJECTIVES: To review the literature on the experimental and
clinical applications of the IFN in disorders of the nervous system excluding MS.
DEVELOPMENT: We reviewed studies of the applications of the IFN in viral diseases
(experimental and human rabies, herpes zoster, herpes virus, non-herpetic
meningoencephalitic viruses, HTLV-I myelopathy, arbovirus in animals, subacute
sclerosing panencephalitis (SSPE), progressive multifocal leukoencephalopathy);
supposedly viral diseases (Reye's syndrome), continuous partial epilepsy
(Kojewnikoff's syndrome); prion diseases (Creutzfeldt-Jakob disease);
degenerative-hereditary diseases (amyotrophic lateral sclerosis, Alzheimer's
disease, schizophrenia, Sturge-Weber-Dimitri syndrome); immuno-allergic disorders
(experimental myasthenia gravis, chronic inflammatory demyelinating
polyneuropathy-CIDP-); Landry-Guillain-Barre-Strohl syndrome, polyneuropathy
associated with IgM monoclonal gammapathy; tumour disorders (benign and malignant
primary tumours of the brain, metastatic tumours, meningeal carcinomatosis,
extra-intracranial haemangiomas, meningiomas), and other causes (cuban epidemic
neuropathy, neuro-Beccet). CONCLUSIONS: Disorders of the nervous system in which 
IFN may be used in a clinical trial include: herpes zoster and herpes simplex
infections, HTLV-I myelopathy; subacute sclerosing leukoencephalopathy,
continuous partial epilepsy (Kojewnicoff's syndrome), intra-extracranial
haemangiomas, CIDP, polyneuropathy associated with IgM gamma monoclonal disorder,
malignant primary tumours, recurrent meningiomas, some cerebral metastases,
Behcet's disease and schizophrenia.

Publication Types: 
    English Abstract
    Review

PMID: 10652752 [PubMed - indexed for MEDLINE]

3246: Antiviral Res. 1999 Dec 31;44(3):145-54.

Herpes zoster: focus on treatment in older adults.

Whitley RJ, Gnann JW.

Department of Pediatrics, The University of Alabama at Birmingham, Children's
Hospital, 35233, USA. rwhitley@peds.uab.edu

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10651066 [PubMed - indexed for MEDLINE]

3247: J Med Chem. 2000 Jan 27;43(2):278-82.

Synthesis and antiviral activity of novel anti-VZV 5-substituted uracil
nucleosides with a cyclopropane sugar moiety.

Onishi T, Mukai C, Nakagawa R, Sekiyama T, Aoki M, Suzuki K, Nakazawa H, Ono N,
Ohmura Y, Iwayama S, Okunishi M, Tsuji T.

Pharmaceutical Research Laboratories, Ajinomoto Company, Inc., 1-1 Suzuki-cho,
Kawasaki 210-8681, Japan.

A series of 5-substituted uracil nucleoside derivatives with a 1(1'S,
2'R)-[1',2'-bis(hydroxymethyl)cyclopropyl]methyl group as an acyclosugar moiety
were synthesized and evaluated for their anti-herpetic activities. Among the
compounds synthesized, (E)-5-halovinyluracil derivatives showed superior
anti-varicella zoster virus (VZV) activity over acyclovir (ACV) but were less
potent than ACV against herpes symplex virus type-1 (HSV-1). IC(50) values for
the VZV Kawaguchi strain were 0.027 for Br, 0.070 for Cl, and 0.054 microg/mL for
I derivatives and 3.4 microg/mL for ACV. The most potent compound,
(1'S,2'R)-5-[(E)-2-bromoethenyl]-1-[[1',
2'-bis(hydroxymethyl)cycloprop-1'-yl]methyl]-2,4-(1H, 3H)-pyrimidinedione (3a),
was 40-60-fold more potent than ACV against clinical isolates of VZV. It showed
good oral bioavailability in rats (68.5%) and, unlike
(E)-5-(2-bromovinyl)-1-beta-D-arabinofuranosyluracil (BVaraU), did not result in 
the release of (E)-5-(2-bromovinyl)uracil (BVU), a potent dihydropyrimidine
dehydrogenase inhibitor, in plasma after oral administration.

PMID: 10649983 [PubMed - indexed for MEDLINE]

3248: Semin Pediatr Neurol. 1999 Dec;6(4):278-87.

Human herpesviruses and neurological disorders of childhood.

Bale JF Jr.

Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, 
USA.

The human herpesviruses, a group of DNA viruses that includes herpes simplex
viruses types 1 and 2, varicella zoster virus, cytomegalovirus, Epstein-Barr
virus, and human herpes viruses types 6, 7, and 8, cause substantial neurological
morbidity among infants and children. This review describes the biology of these 
viruses and summarizes the clinical manifestations and therapy of the diseases
that result from childhood infection with these important pathogens.

Publication Types: 
    Review

PMID: 10649836 [PubMed - indexed for MEDLINE]

3249: Mayo Clin Health Lett. 2000 Jan;18(1):4.

New skin patch calms pain following shingles.

[No authors listed]

Publication Types: 
    News

PMID: 10646332 [PubMed - indexed for MEDLINE]

3250: Bratisl Lek Listy. 1999 Sep;100(9):515-8.

[Recurrent eruptions of herpes zoster]

[Article in Czech]

Cerny Z.

Department of Infectious Diseases, Medical Faculty, Masaryk University, Brno,
Czech Republic. zcerny@med.muni.cz

BACKGROUND: Repeated eruptions of herpes zoster are frequently detected in
immunocompromised patients, but rarely may occur also in immunocompetent persons.
While detailed analyses of repeated manifestations of this disease in the
literature are scarce, experience with a small group of affected persons is
presented. AIMS OF THE STUDY: To search for the nature of herpes zoster relapses 
occurrence and to use it in treatment quality improvement. METHODS: Analysis and 
processing of clinical documentation of the first and repeated eruptions of
herpes zoster in 12 patients. Study of sex and age, presence of accompanying
diseases, duration of the interval from the first eruption to the relapse,
localization, complications and relation to antiviral therapy. RESULTS: The
interval between the first and repeated manifestation ranged from 1 week to 30
years. The male to female ratio was 10/2. In 3 patients the disease was
accompanied by malignancy, in 3 by diabetes mellitus and in 1 by proved
immunodeficiency. The most frequent eruption localization was intercostal space. 
In 6 patients the relapse was localized at the same site, in 6 of them at
different. Early relapses in the same localization appeared in immunodeficient
persons and also in persons after the first attack treatment with acyklovir.
Primary manifestation was accompanied by complications in 42%, repeated in 92%.
CONCLUSIONS: Early herpes zoster relapses following shortly after the primary
attack treated with acyklovir should be considered as a manifestation of immunity
disorder requiring immediate treatment with other antiviral drug. Late relapses
can be treated with acyclovir. (Tab. 2, Fig. 2, Ref. 22.)

Publication Types: 
    English Abstract

PMID: 10645043 [PubMed - indexed for MEDLINE]

3251: J Virol. 2000 Feb;74(4):2005-10.

Varicella-zoster virus proteins in skin lesions: implications for a novel role of
ORF29p in chickenpox.

Annunziato PW, Lungu O, Panagiotidis C, Zhang JH, Silvers DN, Gershon AA,
Silverstein SJ.

Departments of Pediatrics, College of Physicians and Surgeons, Columbia
University, New York, New York, USA. paa5@columbia.edu

Skin biopsy samples from varicella-zoster virus (VZV)-infected patients examined 
by immunohistochemistry demonstrated VZV replication in nonepithelial cell types.
ORF29p, a nonstructural nuclear protein, was found in nerves of two of six
patients with chickenpox. In tissue culture, ORF29p was secreted by VZV-infected 
fibroblasts. Extracellular ORF29p can be taken up through endocytosis by human
neurons, implying a novel role for this protein in pathogenesis.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 10644373 [PubMed - indexed for MEDLINE]

3252: J Virol. 2000 Feb;74(4):1900-7.

Modulation of major histocompatibility class II protein expression by
varicella-zoster virus.

Abendroth A, Slobedman B, Lee E, Mellins E, Wallace M, Arvin AM.

Departments of Pediatrics and Microbiology & Immunology, Stanford University
School of Medicine, Stanford, California 94305-5208, USA.

We sought to investigate the effects of varicella-zoster virus (VZV) infection on
gamma interferon (IFN-gamma)-stimulated expression of cell surface major
histocompatibility complex (MHC) class II molecules on human fibroblasts.
IFN-gamma treatment induced cell surface MHC class II expression on 60 to 86% of 
uninfected cells, compared to 20 to 30% of cells which had been infected with VZV
prior to the addition of IFN-gamma. In contrast, cells that were treated with
IFN-gamma before VZV infection had profiles of MHC class II expression similar to
those of uninfected cell populations. Neither IFN-gamma treatment nor VZV
infection affected the expression of transferrin receptor (CD71). In situ and
Northern blot hybridization of MHC II (MHC class II DR-alpha) RNA expression in
response to IFN-gamma stimulation revealed that MHC class II DR-alpha mRNA
accumulated in uninfected cells but not in cells infected with VZV. When skin
biopsies of varicella lesions were analyzed by in situ hybridization, MHC class
II transcripts were detected in areas around lesions but not in cells that were
infected with VZV. VZV infection inhibited the expression of Stat 1alpha and Jak2
proteins but had little effect on Jak1. Analysis of regulatory events in the
IFN-gamma signaling pathway showed that VZV infection inhibited transcription of 
interferon regulatory factor 1 and the MHC class II transactivator. This is the
first report that VZV encodes an immunomodulatory function which directly
interferes with the IFN-gamma signal transduction via the Jak/Stat pathway and
enables the virus to inhibit IFN-gamma induction of cell surface MHC class II
expression. This inhibition of MHC class II expression on VZV-infected cells in
vivo may transiently protect cells from CD4(+) T-cell immune surveillance,
facilitating local virus replication and transmission during the first few days
of cutaneous lesion formation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 10644363 [PubMed - indexed for MEDLINE]

3253: J Virol. 2000 Feb;74(4):1864-70.

Infection of human T lymphocytes with varicella-zoster virus: an analysis with
viral mutants and clinical isolates.

Soong W, Schultz JC, Patera AC, Sommer MH, Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA.

Varicella-zoster virus (VZV) disseminates in the body in peripheral blood
mononuclear cells during chickenpox. Up to 1 in 10,000 mononuclear cells are
infected during the viremic phase of the disease. We developed an in vitro system
to infect human mononuclear cells with VZV by using umbilical cord blood. In this
system, 3 to 4% of T cells were infected with VZV. VZV mutants unable to express 
certain genes, such as open reading frame 47 (ORF47) or ORF66, were impaired for 
growth in T cells, while other mutants showed little difference from parental
virus. VZV unable to express ORF47 was even more impaired for spread from
umbilical cord blood cells to melanoma cells in vitro. Early-passage clinical
isolates of VZV infected T cells at a similar rate to the Oka vaccine strain;
however, the clinical isolates were more efficient in spreading from infected T
cells to melanoma cells. This in vitro system for infecting human T cells with
VZV should be useful for identifying cellular and viral proteins that are
important for virus replication in T cells and for the spread of virus from T
cells to other cells.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 10644359 [PubMed - indexed for MEDLINE]

3254: Dermatology. 1999;199(4):361-4.

Simultaneous reactivation of herpes simplex virus and varicella-zoster virus in a
patient with idiopathic thrombocytopenic purpura.

Nikkels AF, Frere P, Rakic L, Fassotte M, Evrard B, De Mol P, Pierard GE.

Department of Dermatopathology, University Medical Center of Liege, Belgium.
af.nikkels@chu.ulg.ac.be

Simultaneous reactivation of distinct Herpesviridae with development of clinical 
manifestations is exceptional. We report a 48-year-old woman suffering from
idiopathic thrombocytopenic purpura. As the disease remained refractory to
corticosteroids, immunoglobulins and splenectomy, a cure of vinblastine was
administered. An atypical stomatitis developed few days later.
Immunohistochemistry on a Tzanck smear and a biopsy evidenced a Herpes simplex
virus type 1 (HSV-1) infection. The patient presented simultaneously a single
necrotic lesion on the abdomen. Immunohistochemistry on a skin biopsy revealed
the presence of the varicella-zoster virus (VZV) gE, gB and IE63 proteins.
Intravenous aciclovir was initiated. The present case of simultaneous clinical
infections by HSV-I and VZV underlines the importance of complementary viral
identification testing in the event of unusual clinical presentations. Copyright 
2000 S. Karger AG, Basel

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10640851 [PubMed - indexed for MEDLINE]

3255: Dev Ophthalmol. 1999;31:192-209.

Management of ocular manifestations in patients with acquired immunodeficiency
syndrome.

Pivetti-Pezzi P, Accorinti M.

Servizio Speciale di Immunovirologia Oculare, Universita di Roma La Sapienza,
Roma, Italia. uveiti.piv.@iol.it

Publication Types: 
    Review

PMID: 10641209 [PubMed - indexed for MEDLINE]

3256: J Altern Complement Med. 1999 Dec;5(6):553-65.

Comment in:
    J Altern Complement Med. 2000 Feb;6(1):1-2.

Evaluating herbal medicine for the management of Herpes zoster in human
immunodeficiency virus-infected patients in Kampala, Uganda.

Homsy J, Katabira E, Kabatesi D, Mubiru F, Kwamya L, Tusaba C, Kasolo S, Mwebe D,
Ssentamu L, Okello M, King R.

Traditional and Modern Health Practitioners Together Against AIDS (THETA),
Kampala, Uganda.

OBJECTIVE: This study was carried out to evaluate the potential effectiveness of 
herbal treatments used for herpes zoster (HZ) by a great number of people living 
with acquired immunodeficiency syndrome (PLWAs) in Uganda. SETTING: Kampala,
Uganda. Clinics of indigenous traditional healers, at the Department of Medicine 
of Mulago Hospital, Makerere University, and at The AIDS Support Organization
(TASO) Clinic, providing primary care to people living with HIV and AIDS. DESIGN,
PATIENTS, AND PARTICIPANTS: Nonrandomized, nonplacebo controlled, observational
study in two phases. Inclusion criteria included HIV seropositivity and a recent 
HZ attack. In phase 1, 52 patients were enrolled, treated, and followed for up to
3 months at three healers' clinics, and compared to 52 TASO Clinic controls
receiving ambulatory care. Phase 2 was similar in design to phase 1, but lasted
longer (6-month follow-up) and involved 154 hospital outpatients treated with
herbal medicine and 55 TASO controls. In both phases, healer patients were given 
herbal treatment according to healers' prescriptions, while controls received
either symptomatic treatment or acyclovir. RESULTS: Healer patients and controls 
experienced similar rates of resolution of their HZ attacks. Fewer healer
patients than controls experienced superinfection in phase 1 (18% versus 42%, p <
0.02) and fewer healer patients showed keloid formation in either phase. This
difference was not statistically significant. In both phases, zoster-associated
pain resolved substantially faster among healer patients with a higher degree of 
significance in phase 2 where the progression of pain over time could be seen
because of the longer follow-up (phase 1: maximum p value (pmax) < pmax < 0.02 at
1 month, pmax < 0.005 at 2 months, pmax < 0.0001 at 3 months). CONCLUSION: Herbal
treatment is an important local and affordable primary care alternative for the
management of HZ in HIV-infected patients in Uganda and similar settings.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 10630349 [PubMed - indexed for MEDLINE]

3257: Diagn Microbiol Infect Dis. 1999 Nov;35(3):205-8.

Evaluation of light diagnostics SimulFluor HSV/VZV immunofluorescence assay.

Scicchitano LM, Shetterly B, Bourbeau PP.

Division of Laboratory Medicine, Geisinger Medical Center, PennState Geisinger
Medical Laboratories, Danville, PA 17822-0131, USA.

In this study, we evaluated the Light Diagnostics SimulFluor HSV/VZV
Immunofluorescence (SIM) assay. A total of 167 specimens yielded 21 VZV and 55
HSV true positive test results. The sensitivity/specificity of the SIM assay for 
VZV and HSV were, respectively, 100/98 and 62/99. These results were comparable
to the results for the predicate devices used in this study. The SIM assay offers
the potential for the simultaneous, direct detection of HSV and VZV from a single
slide well.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10626130 [PubMed - indexed for MEDLINE]

3258: Rev Prat. 1999 Nov 15;49(18):2035-40.

[Varicella and zona: epidemiology, physiopathology, diagnosis, course, treatment]

[Article in French]

Zeller V, Caumes E, Bricaire F.

Service de maladies infectieuses et tropicales, groupe hospitalier La Pitie-La
Salpetriere, Paris.

Publication Types: 
    Comparative Study
    Review

PMID: 10626492 [PubMed - indexed for MEDLINE]

3259: Rev Prat. 1999 Nov 15;49(18):1989-94.

[Epidemiology of uveitis]

[Article in French]

Guex-Crosier Y.

Hopital ophtalmique Jules-Gonin, Universite de Lausanne, Suisse.

Uveitis are a large group of inflammatory diseases involving the iris, the
ciliary body and the uvea. Multiple causes can be responsible for ocular
inflammation that can result either from infectious or autoimmune disease. The
incidence varies from 14 to 28/100,000 habitants. According to the anatomical
classification, about 30-60% (average 47%) are related to anterior uveitis. 6-30%
average 21%) are posterior uveitis, 7-15% (average 12%) are intermediate uveitis 
and 7-69% (average 20%) are panuveitis. A specific diagnostic can be established 
in more than 70% in most series. The most frequently diagnosed entities are
HLA-B27 related uveitis, acute anterior uveitis in herpes zoster disease,
toxoplasmosis, sarcoidosis and pars planitis.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 10626483 [PubMed - indexed for MEDLINE]

3260: Neurol India. 1999 Dec;47(4):294-9.

Comment in:
    Neurol India. 1999 Dec;47(4):253-4.

Non-compressive myelopathy: clinical and radiological study.

Prabhakar S, Syal P, Singh P, Lal V, Khandelwal N, Das CP.

Departments of Neurology and Radiodiagnosis, Postgraduate Institute of Medical
Education and Research, Chandigarh, 160012, India.

Fifty seven patients (42 males and 15 females) with non-compressive myelopathy
were studied from 1997 to 1999. Acute transverse myelitis (ATM) was the commonest
(31) followed by Vit B12 deficiency myelopathy (8), primary progressive multiple 
sclerosis (5), hereditary spastic paraplegia (3), tropical spastic paraplegia
(2), subacute necrotising myelitis (1), radiation myelitis (1), syphilitic
myelitis (1) and herpes zoster myelitis (1). 4 cases remained unclassified. In
the ATM group, mean age was 30.35 years, antecedent event was observed in 41.9%
case, 25 cases had symmetrical involvement and most of the cases had severe
deficit at onset. CSF study carried out in 23 patients of ATM revealed rise in
proteins (mean 147.95mg%, range 20-1200 mg/dL) and pleocytosis (mean 20.78/cumm, 
range 0-200 mm3). Oligoclonal band (OCB) was present in 28% of cases of ATM. The 
most common abnormality detected was a multisegment hyperintense lesion on T2W
images, that occupied the central area on cross section. In 6 patients
hyperintense signal was eccentric in location. MRI was normal in 4 cases of ATM. 
Thus ATM is the leading cause of non-compressive myelopathy. Clinical features
combined with MRI findings are helpful in defining the cause of ATM.

PMID: 10625902 [PubMed - indexed for MEDLINE]

3261: Time. 1999 Sep 20;154(12):86.

Stealthy virus.

Nash JM.

Publication Types: 
    News

PMID: 10620925 [PubMed - indexed for MEDLINE]

3262: Clin Infect Dis. 2000 Jan;30(1):229-30.

Herpes zoster oticus with pontine lesion: segmental brain-stem encephalitis.

Mizock BA, Bartt R, Agbemazdo B.

Department of Medicine, Cook County Hospital, Chicago, IL 60612, USA.
bmizock@earthlink.net

Publication Types: 
    Case Reports

PMID: 10619773 [PubMed - indexed for MEDLINE]

3263: J Fr Ophtalmol. 1999 Dec;22(10):1042-6.

[Cytomegalovirus retinitis and ocular complications in AIDS patients in Togo]

[Article in French]

Balo KP, Amoussou YP, Bechetoille A, Mihluedo H, Djagnikpo PA, Akpandja SM, Banla
M.

Service d'Ophtalmologie, CHU Tokoin, Lome, Togo. komibalo@syfed.tg.refer.org

BACKGROUND: Cytomegalovirus retinitis seems to be an uncommon complication in
African AIDS patients. This study was conducted in 200 patients in order to
evaluate AIDS eye related complications with specific focus to cytomegalovirus
retinitis. MATERIAL AND METHODS: During a period of 20 months, 200 patients (83
men and 117 women) presenting WHO AIDS case definition diagnosis were enrolled
for a complete ocular examination comprising external, anterior segment and
retinal fundus and fluorescein angiographic examination. RESULTS: For the whole, 
200 patients underwent ocular examinations; of them 121 (60.5%) developed ocular 
complications.The most frequent complications were cotton wool spots (25.5%),
cytomegalovirus (CMV) retinitis (21.5%), retinal hemorrhage (6%), papilloedema
(3%), chorioretinal toxoplasmosis (3%), peripheral retinal vascularitis (2. 5%), 
herpes zoster ophthalmicus (2%). Among those with CMV retinitis, bilateral
lesions were found in 30 cases, and unilateral ones in 13 cases. Poor vision was 
associated with the presence of CMV retinitis in 88% of cases.Death occurred in a
mean range of 22 days after the "presumed" diagnosis of CMV retinitis.
CONCLUSION: Cytomegalovirus retinitis represents the second ocular complication
in AIDS patients in this study. Poor visual outcome was associated in 88% of
cases. These results demonstrate that in some west African countries, CMV
retinitis may be a common complication in AIDS patients.

Publication Types: 
    English Abstract

PMID: 10617841 [PubMed - indexed for MEDLINE]

3264: J Biol Chem. 2000 Jan 7;275(1):487-96.

The TATA motif specifies the differential activation of minimal promoters by
varicella zoster virus immediate-early regulatory protein IE62.

Perera LP.

Metabolism Branch, Division of Clinical Sciences, NCI, National Institutes of
Health, Bethesda, Maryland 20892, USA. lperera@niaid.nih.gov

The immediate-early IE62 protein of varicella zoster virus is an acidic
transcriptional activator capable of up-regulating many viral and cellular
promoters with varying efficiencies. We demonstrate that, in the context of a
minimal promoter, a TATA element is both sufficient and essential for
IE62-mediated transcriptional activation. Differential levels of activation by
IE62 in this context were conferred by a panel of naturally occurring sequence
variations within the TATA motif itself. TATA motif-specific, differential
induction was not obtained when the IE62 acidic activation domain was targeted as
a GAL4 fusion protein to the same panel. The prototype acidic transactivator,
VP16 of herpes simplex virus, failed to discriminate between these different TATA
motifs when they were placed into an appropriate responsive promoter context.
Nonetheless, a chimeric IE62 polypeptide substituted with the VP16 activation
domain retained the ability to differentially modulate minimal promoters with
various TATA motifs. Taken together with its binding to TATA box-binding protein 
(TBP) and transcription factor IIB in vitro, we suggest that IE62 has the unusual
ability to achieve differential levels of transcriptional activation through
different TATA motifs, which may be accomplished either directly or indirectly by
recognizing conformational variations in DNA-bound TBP, TBP-transcription factor 
IIA/B, or TBP-TATA-associated factor complexes.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10617643 [PubMed - indexed for MEDLINE]

3265: Prog Retin Eye Res. 2000 Jan;19(1):69-85.

Treatment of viral diseases of the cornea and external eye.

Kaufman HE.

Department of Ophthalmology, LSU Eye Center, Louisiana State University Medical
Center School of Medicine, New Orleans 70112, USA.

Ocular virus infections remain an important cause of corneal and external
disease. Herpes simplex, the most important, is easily treated when it is
confined to the epithelium. New studies indicate that herpetic stromal disease
and iritis are effectively treated with a combination of corticosteroid and
antiviral without additional risk. Recurrences of ocular herpetic disease can be 
reduced with acyclovir given orally; the benefit seems to be greatest in patients
who have had at least one episode of stromal keratitis. Herpes zoster can be
treated with either acyclovir or famciclovir, but to be effective, treatment must
be initiated within 72 hours of onset. Early treatment reduces the risk of
post-herpetic neuralgia and may reduce the risk of ocular complications.
Adenovirus infection (epidemic keratoconjunctivitis) is often spread by the
ophthalmologist. New medications such as cidofovir appear to be effective against
the adenoviruses in non-human systems and may have some effect in man, although
previously, drugs that appeared to have an effect in vitro have proven to be
ineffective in the clinical setting.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10614681 [PubMed - indexed for MEDLINE]

3266: Rinsho Shinkeigaku. 1999 Sep;39(9):958-60.

[A case of zoster sine herpete with involvement of the unilateral IX, X and XI
cranial and upper cervical nerves]

[Article in Japanese]

Funakawa I, Terao A, Koga M.

Department of Internal Medicine, Kawasaki Medical School, Okayama.

We describe a case of unilateral IX, X and XI cranial and upper cervical nerve
palsies involving zoster sine herpete (ZSH). A 63-year-old man experienced
nausea, loss of appetite and general fatigue. On 4 days of illness, dysphagia,
dysarthria and difficulty in elevation of his right arm appeared. Neurological
examination showed the right curtain sign, a nasal voice and a decreased right
gag reflex. He could hardly elevate his right arm laterally. Needle
electromyography revealed positive sharp waves in his right trapezius muscle.
Although no skin lesion was detected, anti-varicella-zoster virus antibodies were
positive in both serum and cerebrospinal fluid. Acyclovir and a steroid were
ineffective for these symptoms. Although case reports of unilateral IX, X and XI 
cranial nerve palsies with ZSH is very rare, ZSH should be kept in mind in the
differential diagnosis of multiple cranial nerve palsies.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10614162 [PubMed - indexed for MEDLINE]

3267: Ann Dermatol Venereol. 1999 Nov;126(11):870-3.

[Facial herpes zoster]

[Article in French]

Fouchard N, Saiag P.

Hopital Francois Quesnay, 2, boulevard Sully, 78201 Mantes-la-Jolie Cedex.

Publication Types: 
    Review

PMID: 10612873 [PubMed - indexed for MEDLINE]

3268: Altern Med Rev. 1999 Dec;4(6):429-35.

Integrative approach to the treatment of postherpetic neuralgia: a case series.

Hui F, Cheng A, Chiu M, Vayda E.

Objective: To determine if the addition of alternative therapy to conventional
medicine enhances the treatment of pain in postherpetic neuralgia (PHN).
Methodology: A review of literature from 1988-1998 was conducted on the MEDLINE
database, searching for information on the current treatment of PHN. The
literature review found that although many medications have been used to reduce
the pain of PHN, no treatments have been completely successful in decreasing
pain. Data on pain reduction in PHN following treatment with a multifaceted
alternative therapy combined with conventional treatment were compiled from a
group of patients in the principal investigator's family medicine practice.
Results: The alternative therapy employed in this study, combined with selected
medications, showed an average pain reduction of 72.1 percent. There was a
77-percent average pain reduction in patients with herpes zoster (HZ) onset of
more than one year and a 68-percent reduction in patients with HZ onset between
one month and one year. Almost two-thirds of the 56 PHN patients reported pain
reductions of between 75 and 100 percent. Conclusion: These preliminary data
suggest the combination of alternative therapy and selected conventional
medications provides good pain relief for most patients presenting with PHN.
Randomized trials with appropriate control groups are needed to validate the
effectiveness of this therapy in the treatment of PHN.

Publication Types: 
    Review

PMID: 10608916 [PubMed - indexed for MEDLINE]

3269: Pediatr Infect Dis J. 1999 Dec;18(12):1112-3.

Natural varicella-zoster virus reactivation shortly after varicella immunization 
in a child.

Kohl S, Rapp J, La Russa P, Gershon AA, Steinberg SP.

Department of Pediatrics, University of California, San Francisco, USA.

Publication Types: 
    Case Reports

PMID: 10608641 [PubMed - indexed for MEDLINE]

3270: Acta Derm Venereol. 1999 Nov;79(6):495.

Comment on:
    Acta Derm Venereol. 1999 Jan;79(1):95.

Post-herpes zoster scar sarcoidosis.

Barrazza V.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 10598782 [PubMed - indexed for MEDLINE]

3271: J Laryngol Otol. 1999 Jun;113(6):573-7.

Herpes and the head and neck: the difficulties in diagnosis.

Whallett EJ, Pahor AL.

Department of Otolaryngology, City Hospital, Birmingham, UK.

A case of primary herpes of the head and neck is presented. The exact source of
infection and the precise diagnosis proved difficult to establish, but evidence
tended to support a diagnosis of varicella zoster infection as opposed to a
herpes simplex infection, though a dual infection was not ruled out. Herpes
simplex has specific clinical features which usually make its distinction from
varicella zoster clear cut. In this case we relied heavily on laboratory
investigations to improve the accuracy of our diagnosis since the clinical
characteristics were blurred. Unlike varicella zoster there has been little
written about herpes simplex infections specifically affecting the ear, face and 
neck.

Publication Types: 
    Case Reports

PMID: 10605593 [PubMed - indexed for MEDLINE]

3272: J Laryngol Otol. 1999 Jul;113(7):670-1.

An extreme and unusual variant of Ramsay Hunt syndrome.

De S, Pfleiderer AG.

Ear, Nose and Throat Department, Edith Cavell Hospital, Peterborough, UK.

Ramsay Hunt syndrome is characterized by facial nerve paralysis, herpetic
vesicles in or around the ear and pain often associated with vestibulocochlear
nerve involvement. It is thought to be a cranial polyneuropathy caused by the
herpes zoster virus. We present an extreme and unusual variant of this disease
with involvement of VIIth, VIIIth, Xth, XIth and XIIth cranial nerves as well as 
C2-4 sensory dermatomes and profound systemic upset which caused some diagnostic 
uncertainty.

Publication Types: 
    Case Reports

PMID: 10605568 [PubMed - indexed for MEDLINE]

3273: Arch Virol. 1999;144(11):2161-72.

Identification and characterization of the simian varicella virus uracil DNA
glycosylase.

Ashburn CV, Gray WL.

Department of Microbiology and Immunology, University of Arkansas for Medical
Science, Little Rock, Arkansas 72205, USA.

Simian varicella virus (SVV) infection of non-human primates is used as a model
to study the pathogenesis and latency of varicella-zoster virus (VZV), the
etiological agent of chickenpox and shingles. Uracil DNA glycosylase (UDG) is a
DNA repair enzyme responsible for excision of uracil residues misincorporated
into DNA. UDG is conserved throughout the herpesvirus family and may play an
important role in viral pathogenesis. This study identified a 300 amino acid SVV 
UDG that shares 53.9% amino acid identity with the VZV UDG. The SVV UDG is
expressed in infected Vero cells as determined by reverse transcriptase
polymerase chain reaction (RT-PCR) and Northern blot analysis. The SVV UDG is
encoded on a 2.0 kb transcript which also appears to encode the SVV glycoprotein 
L (gL) and the VZV gene 58 homolog. The SVV UDG is enzymatically active as
determined by the ability of a SVV UDG-maltose binding protein fusion construct
to remove [(3)H]-uracil incorporated into DNA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10603170 [PubMed - indexed for MEDLINE]

3274: Cancer Chemother Pharmacol. 1999;44 Suppl:S26-8.

Ifosfamide, carboplatin and etoposide (ICE) in metastatic and refractory breast
cancer.

Chang AY, Hui L, Asbury R, Boros L, Garrow G, Rubins J.

Interlakes Oncology and Hematology, P.C., 211 White Spruce Boulevard, Rochester, 
NY 14623, USA.

Twenty-five patients with metastatic breast cancer were treated with ICE after
failure of previous chemotherapy. Their median age was 50 years (range 36-73).
All but 1 patient had multiple sites of metastases. Nineteen (76%) patients had
undergone two or more chemotherapy regimens for metastatic disease prior to ICE. 
The performance status (PS) of the patients was Eastern Cooperative Oncology
Group (ECOG) 0:6; 1:12; 2:5; 3:2. Ifosfamide 1.25 g/m(2) over 3 h D1-3 along with
mesna, etoposide 80 mg/m(2) D1-3 and carboplatin 300 mg/m(2) D1 were given every 
3 weeks. We observed a partial response in 10 patients (40%, 95% confidence
interval 21-62%). The response duration ranged from 1 to 15 months with a median 
duration of 4.5 months. The survival of all 25 patients ranged from 10 days to 25
months, with a median of 9 months. All 25 patients were evaluable for toxicity.
Thirteen patients (52%) experienced grade 4 hematological toxicity, which
improved after growth factor support. Four patients had leukopenic fever, 1 had
gram-negative sepsis, while 2 had Clostridium difficile enterocolitis and another
had herpes zoster reactivation. Four patients (16%) experienced grade 3-4
gastrointestinal (G-I) toxicity. No hepatic or renal toxicity was observed (1
patient had microscopic hematuria). One patient died of G-I bleed, and another
patient died at home of undetermined cause. We conclude that ICE is an effective 
salvage regimen in metastatic and refractory breast cancer, even in heavily
pretreated patients, and is a tolerable treatment when used with growth factor.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 10602907 [PubMed - indexed for MEDLINE]

3275: Lupus. 1999;8(9):767-9.

Successful treatment of lupus with fludarabine.

Viallard JF, Mercie P, Faure I, Pellegrin JL, Leng B.

Clinique de Medecine Interne, Hopital Haut-Leveque, Pessac, France.
JF.viallard@umr5540.u-bordeaux.fr

We describe a 58-year old patient with chronic lymphocytic leukemia (CLL) who
developed systemic lupus erythematosus (SLE) with severe joint involvement.
Dilated myocardiopathy precluded the use of high corticoid doses and a 15 days of
prednisone (15mg/d) had no effect on the polyarthritis. Therefore, fludarabine
(25mg/m2) was administered for 5 d. One month after the first cycle, fever,
muscle stiffness and polyarthritis resolved. A total of 6 cycles were
administered. The evolution was complicated by herpes zoster infection and left
pneumococcal pneumonia. At this time of writing (July 1999), the patient is
symptom free but is profoundly lymphopenic.

Publication Types: 
    Case Reports

PMID: 10602451 [PubMed - indexed for MEDLINE]

3276: Ophthalmology. 1999 Dec;106(12):2322-4.

Successful treatment of crocodile tears by injection of botulinum toxin into the 
lacrimal gland: a case report.

Riemann R, Pfennigsdorf S, Riemann E, Naumann M.

Department of Otorhinolaryngology/Head and Neck Surgery, University of Wurzburg, 
Germany. randolf@mail.uni-wuerzburg.de

OBJECTIVE: Pathologic lacrimation (crocodile tears) is a rare but stigmatizing
symptom after facial nerve paralysis. The aim of this pilot study was to examine 
whether botulinum toxin injection into the lacrimal gland is effective in
reducing pathologic tear secretion. DESIGN: Case report. INTERVENTION: One
patient who had crocodile tears after a zoster oticus infection received a
botulinum toxin injection (2.5 mouse units) into the lacrimal gland. TESTING:
Before injection, 1 week, 1 month, and 6 months after injection, patient's
lacrimation was assessed by a Schirmer test. RESULTS: The lacrimation of the
injected eye was reduced after 1 week and equal after 1 month when compared to
the healthy side. After 6 months, hyperlacrimation reoccurred. No side effects
were observed. CONCLUSION: Intraglandular injection of botulinum toxin into the
lacrimal gland may serve as a sufficient therapy for crocodile tears.

Publication Types: 
    Case Reports

PMID: 10599665 [PubMed - indexed for MEDLINE]

3277: Contrib Microbiol. 1999;3:173-92.

Experience with live-attenuated varicella-zoster vaccines.

LaRussa P.

Columbia University, College of Physicians and Surgeons, New York, N.Y., USA.
psll@columbia.edu

Publication Types: 
    Review

PMID: 10599530 [PubMed - indexed for MEDLINE]

3278: Contrib Microbiol. 1999;3:158-72.

Approaches to the treatment of varicella-zoster virus infections.

Whitley RJ.

Department of Pediatrics, University of Alabama at Birmingham, USA.
Rwhitley@peds.uab.edu

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10599529 [PubMed - indexed for MEDLINE]

3279: Contrib Microbiol. 1999;3:150-7.

Diagnosis of varicella-zoster virus-associated diseases with special emphasis on 
infections in the immunocompromised host.

Wolff MH, Schunemann S, Rahaus M, Schmidt A.

Institute of Microbiology and Virology, University of Witten/Herdecke, Germany.
mhwolff@uni-wh.de

Publication Types: 
    Review

PMID: 10599528 [PubMed - indexed for MEDLINE]

3280: Contrib Microbiol. 1999;3:141-9.

Infections during pregnancy.

Wutzler P, Sauerbrei A.

Institute for Antiviral Chemotherapy, Friedrich-Schiller University Jena, Erfurt,
Germany.

Publication Types: 
    Review

PMID: 10599527 [PubMed - indexed for MEDLINE]

3281: Contrib Microbiol. 1999;3:128-40.

Postherpetic neuralgia.

Watson CP.

Department of Medicine, University of Toronto, Ont., Canada.

Publication Types: 
    Review

PMID: 10599526 [PubMed - indexed for MEDLINE]

3282: Contrib Microbiol. 1999;3:111-27.

Shingles (zoster).

Lilie HM, Wassilew SW.

Dermatologische Klinik, Klinikum Krefeld, Deutschland. lilie@klinikum-krefeld.de

Publication Types: 
    Review

PMID: 10599525 [PubMed - indexed for MEDLINE]

3283: Contrib Microbiol. 1999;3:86-95.

Viremic stages of different varicella-zoster virus-associated diseases.

Schunemann S, Wolff MH, Rahaus M.

Institute of Microbiology and Virology, University of Witten/Herdecke, Germany.
schueni@uni-wh.de

Publication Types: 
    Review

PMID: 10599523 [PubMed - indexed for MEDLINE]

3284: Contrib Microbiol. 1999;3:76-85.

Epidemiology of varicella infections.

Flisser A, Tapia-Conyer R.

Instituto Nacional de Diagnostico y Referencia Epidemiologicos, SSA, Mexico.
flisser@servidor.unam.mx

Publication Types: 
    Review

PMID: 10599522 [PubMed - indexed for MEDLINE]

3285: Contrib Microbiol. 1999;3:61-75.

Varicella-zoster virus: latency and reactivation.

Lungu O, Annunziato PW.

Department of Microbiology, Columbia University, College of Physicians and
Surgeons, New York, N.Y., USA. o14@columbia.edu

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10599521 [PubMed - indexed for MEDLINE]

3286: Contrib Microbiol. 1999;3:43-60.

Role of glycoproteins in varicella-zoster virus infection.

Gershon MD, Gershon AA.

Department of Anatomy and Cell Biology, Columbia University College of Physicians
and Surgeons, New York, N.Y., USA. aag1@columbia.edu

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10599520 [PubMed - indexed for MEDLINE]

3287: J Virol Methods. 1999 Dec;83(1-2):155-67.

Detection of varicella-zoster virus and herpes simplex virus by the polymerase
chain reaction with degenerate primers.

Jacobs JJ, Folkers E, Vreeswijk J.

Institute for Animal Science and Health (ID-DLO), Lelystad, The Netherlands.

Varicella-zoster virus (VZV) and herpes simplex virus (HSV) are human pathogens
of significance involved in multiple diseases with either typical or atypical
clinical features. In neonates and immunocompromised patients these
alphaherpesviruses may cause life-threatening diseases such as encephalitis.
Detection of VZV by virus culture is difficult. Polymerase chain reaction (PCR)
is quicker and more sensitive and applicable in most clinical microbiological
laboratories. Using degenerate primers, glycoprotein B (gB) DNA was amplified
from all alphaherpesvirus field strains present in clinical samples. The
amplification of gB allowed virus typing of VZV, HSV-1 and HSV-2 using
restriction enzyme digestion of the PCR products. Degenerate primers can replace 
conventional primers in diagnostic PCR without loss of sensitivity and
specificity.

Publication Types: 
    Comparative Study

PMID: 10598093 [PubMed - indexed for MEDLINE]

3288: J Neurol Sci. 1999 Nov 15;170(1):19-23.

Bell's palsy and herpes viruses: to (acyclo)vir or not to (acyclo)vir?

Steiner I, Mattan Y.

Laboratory of Neurovirology, Department of Neurology, Hadassah University
Hospital, P.O. Box 12000, Jerusalem, Israel. isteiner@md2.huji.ac.il

The majority of peripheral seventh cranial nerve palsy cases remain without an
identified etiology and will eventually be diagnosed as idiopathic or Bell's
palsy. Some features of this condition may be characteristic of a viral
infection. Indeed, several herpes viruses have been implicated as potential
causative pathogens. Besides varicella-zoster virus, shown to cause Bell's palsy 
under the Ramsay-Hunt syndrome, recent years have seen an increased interest and 
focus on the possible herpes simplex virus type 1 (HSV-1) etiology in idiopathic 
facial paralysis. We review the clinical, biological and virological basis for
the potential herpetic cause of Bell's palsy and the rational for antiviral
therapy in this condition.

Publication Types: 
    Review

PMID: 10540031 [PubMed - indexed for MEDLINE]

3289: Mayo Clin Proc. 1999 Dec;74(12):1266-83.

Antiviral agents for non-human immunodeficiency virus infections.

Keating MR.

Division of Infectious Diseases and Internal Medicine, Mayo Clinic Rochester,
Minnesota 55905, USA.

Several new agents for treating viral infections have been developed in recent
years. All available agents are virustatic, inhibiting specific steps in the
process of viral replication. No agent is active against nonreplicating or latent
viruses. Acyclovir is useful in the treatment of genital herpes, herpes simplex
encephalitis, mucocutaneous herpetic infection, varicella infection in the
immunosuppressed host, and herpes zoster infection in the normal and the
immunosuppressed host. It can also be used for prevention of herpesvirus
infection in immunocompromised patients. Ganciclovir is indicated for the
treatment of cytomegalovirus retinitis in patients with the acquired
immunodeficiency syndrome and is effective in the treatment and prevention of
cytomegalovirus infection in other immunocompromised patients. Famciclovir and
valacyclovir are effective in the management of herpes simplex and
varicella-zoster infection. Amantadine and rimantadine are useful therapeutically
and prophylactically in the management of influenza A virus infection. Chronic
hepatitis B infection can respond to lamivudine therapy, and the optimal
treatment of hepatitis C is the combination of interferon alfa and ribavirin.
Despite pronounced toxic effects, foscarnet and cidofovir are effective antiviral
agents in specific settings.

Publication Types: 
    Review

PMID: 10593357 [PubMed - indexed for MEDLINE]

3290: Neurobiology (Bp). 1999;7(2):103-8.

Topical acetylsalicylic acid versus lidocaine for postherpetic neuralgia: results
of a double-blind comparative clinical trial.

Tajti J, Szok D, Vecsei L.

Department of Neurology, Albert Szent-Gyorgyi Medical University, Szeged,
Hungary.

A double-blind comparative clinical trial was performed with topical aspirin
versus lidocaine for the treatment of 40 patients with postherpetic neuralgia.
The percentage improvement following topical aspirin application was 72.2 +/-
19.9 S.D., while with lidocaine it was 72.8 +/- 25.3 S.D. These results suggest
that the effect of topical treatment with aspirin is as good as that with
lidocaine, since there was no significant difference (P = 0.778) between the two 
drugs in respect of pain reduction and accordingly the topical application of
acetylsalicylic acid can be equally recommended.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 10591045 [PubMed - indexed for MEDLINE]

3291: Chem Immunol. 1999;73:120-36.

Immunopathogenesis of viral ocular infections.

Hendricks RL.

Department of Ophthalmology, University of Pittsburgh School of Medicine, Eye and
Ear Institute, Pittsburgh, Pa., USA. hendricksrr@msx.upmc.edu

Publication Types: 
    Review

PMID: 10590577 [PubMed - indexed for MEDLINE]

3292: Clin Infect Dis. 1999 Dec;29(6):1524-8.

Spectrum of opportunistic infections and malignancies in patients with human
immunodeficiency virus infection in South Korea.

Oh MD, Park SW, Kim HB, Kim US, Kim NJ, Choi HJ, Shin DH, Lee JS, Choe K.

Department of Internal Medicine, Seoul National University College of Medicine,
Seoul National University Hospital, Seoul, 110-744, South Korea.

To determine the frequency and types of major opportunistic diseases in patients 
with HIV infection in South Korea, we reviewed the medical records of 173
HIV-infected patients. The patients were seen from 1985 to 1998 at a referral
hospital for AIDS in South Korea. Most patients (85%) were male, and 107 (62%)
were infected by heterosexual contacts. CD4+ lymphocyte counts at presentation
were <200/microL in 27% of the patients. Tuberculosis was the most frequent
opportunistic infection (25% of patients), followed by candidiasis (21%), herpes 
zoster (20%), Pneumocystis carinii pneumonia (10%), cytomegalovirus disease
(9.8%). There were no cases of toxoplasmosis. Kaposi's sarcoma developed in 3
patients (1.7%), and non-Hodgkin's lymphoma, in 2 (1.2%). Eleven patients (6.4%) 
developed peripheral neuropathy, and 8 (4.6%) had HIV encephalopathy.
Tuberculosis was the single most important HIV-related infection in South Korean 
patients.

PMID: 10585807 [PubMed - indexed for MEDLINE]

3293: Anesth Analg. 1999 Dec;89(6):1585-6.

Comment on:
    Anesth Analg. 1998 Oct;87(4):911-4.

No alternative to antiviral drugs for acute herpes zoster.

Dworkin RH.

Publication Types: 
    Comment
    Letter

PMID: 10589658 [PubMed - indexed for MEDLINE]

3294: J Pain Symptom Manage. 1999 Nov;18(5):311-3.

Postherpetic neuralgia in a patient with a lesion involving the dorsal horn of
the cervical spinal cord.

Innocenti P, Romaniello A, Zucchi R, Leandri M, Cruccu G.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't

PMID: 10584451 [PubMed - indexed for MEDLINE]

3295: Presse Med. 1999 Oct 30;28(33):1833-8.

[Cutaneous complications after organ transplant]

[Article in French]

Euvrard S, Kanitakis J, Claudy A.

Clinique Dermatologique, Hopital Edouard Herriot, Lyon.

FREQUENT DIVERSE COMPLICATIONS: Skin problems in organ recipients mainly result
from the induced immunosuppression but also from specific adverse effects of
immunosuppressive drugs. The degree of extension and gravity of the clinical
manifestations are often proportional to the intensity and/or duration of the
immunosuppressive therapy. Immunodepression mainly leads to infectious and
neoplastic complications. INFECTIONS: Viral and fungal infections are the most
frequently encountered. Herpes simplex and zoster infections require treatment to
prevent visceral involvement. Human papillomavirus infections occur in 80% of
patients 5 years after transplantation and can lead to malignant transformation. 
Fungal infections include pityriasis versicolor and often extensive
dermatophytosis. CANCER: Increased rate of cancer occurs especially in patients
with viral disease. Skin cancers involving papillomavirus are the most frequent
cancers observed in transplant recipients, occurring in half of the long-term
survivors. Squamous cell carcinoma of exposed areas are the most common; they are
often more aggressive than in non-immunodepressed patients (multiple sites,
recurrence). Exposure to sun is a proven inducer. There is a 500-fold higher risk
of Kaposi disease linked to HHV8 virus. This disease can regress simply after
reducing the immunosuppressive treatment. Other more uncommon tumors such as
lymphomas, melanomas, sarcomas and Merkel cell tumors also appear to occur at an 
increased rate in transplant recipients. PREVENTION: Most malignant skin tumors
are the expression of marked immunodepression and their prognosis is improved
with reduction in immunosuppressive therapy. Prevention requires regular
dermatology work-ups and counseling about strict protection from sun exposure.

Publication Types: 
    English Abstract
    Review

PMID: 10584119 [PubMed - indexed for MEDLINE]

3296: Br J Dermatol. 1999 Sep;141(3):587-9.

Dermatotmal chronic cutaneous graft-versus-host disease at the site of prior
herpes zoster.

Lacour JP, Sirvent N, Monpoux F, Perrin C, Castanet J, Michel G, Boutte P.

Publication Types: 
    Case Reports
    Letter

PMID: 10583085 [PubMed - indexed for MEDLINE]

3297: Ann Intern Med. 1999 Nov 2;131(9):712-3.

Comment on:
    Ann Intern Med. 1995 Jul 15;123(2):89-96.

Famciclovir and postherpetic neuralgia.

Bassett KL, Green CJ, Wright JM.

Publication Types: 
    Comment
    Letter

PMID: 10577337 [PubMed - indexed for MEDLINE]

3298: Postgrad Med. 1999 Nov;106(6):127-32, 135-40.

Following the clues to neuropathic pain. Distribution and other leads reveal the 
cause and the treatment approach.

Belgrade MJ.

Fairview Pain Management Center, Fairview-University Medical Center, Minneapolis,
MN 55454, USA. mbelgra1@fairview.org

Neuropathic pain can seem enigmatic at first because it can last indefinitely and
often a cause is not evident. However, heightened awareness of typical
characteristics, such as the following, makes identification fairly easy: The
presence of certain accompanying conditions (e.g., diabetes, HIV or herpes zoster
infection, multiple sclerosis) Pain described as shooting, stabbing, lancinating,
burning, or searing Pain worse at night Pain following anatomic nerve
distribution Pain in a numb or insensate site The presence of allodynia
Neuropathic pain responds poorly to standard pain therapies and usually requires 
specialized medications (e.g., anticonvulsants, tricyclic antidepressants, opioid
analgesics) for optimal control. Successful pain control is enhanced with use of 
a systematic approach consisting of disease modification, local or regional
measures, and systemic therapy.

Publication Types: 
    Case Reports

PMID: 10576007 [PubMed - indexed for MEDLINE]

3299: J Formos Med Assoc. 1999 Oct;98(10):701-4.

Acute respiratory distress syndrome due to tuberculosis in a child after
allogeneic bone marrow transplantation for acute lymphoblastic leukemia.

Chen CC, Huang LM, Chang YL, King CC, Lin KH.

Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

We report the occurrence of tuberculosis in a 10-year-old Taiwanese boy,
approximately 4 months after he received a matched-related bone marrow
transplantation from his sister for acute T-cell lymphoblastic leukemia. After
transplantation, grade III acute graft-versus-host disease developed and the
patient was treated with prednisolone and cyclosporine. Marrow failure was noted 
on day 77 post-transplantation, however, after an episode of herpes zoster
infection. Interstitial pneumonia, diagnosed on the basis of chest x-ray and
computed tomography findings, occurred on day 120. Histologic examination of an
open-lung biopsy specimen showed caseating granulomas and a few acid-fast
bacilli. The patient died of acute respiratory distress syndrome, despite
immediate implementation of antituberculosis therapy. Sputum cultures grew
Mycobacterium tuberculosis 5 weeks later. This report demonstrates that the
possibility of tuberculosis needs to be considered in immunocompromised patients,
and that appropriate prophylaxis should be instituted in areas where tuberculosis
is endemic.

Publication Types: 
    Case Reports

PMID: 10575842 [PubMed - indexed for MEDLINE]

3300: Pediatr Dermatol. 1999 Sep-Oct;16(5):359-63.

Mucocutaneous manifestations of HIV infection in 91 children born to
HIV-seropositive women.

Wananukul S, Thisyakorn U.

Department of Pediatrics, Chulalongkorn University, Bangkok, Thailand.

We examined 91 children under the age of 13 years with definite HIV infection
born to HIV-seropositive women. The clinical spectrum of HIV infection in
children younger than 13 years who are born to HIV-infected mothers was revised
in 1994 into four clinical categories: category N (not symptomatic), category A
(mildly symptomatic), category B (moderately symptomatic), and category C
(severely symptomatic). Mucocutaneous manifestations were found in 47 (51.6%) of 
these children. The prevalence of mucocutaneous manifestations in categories A,
B, and C were 4%, 62%, and 75%, respectively. The mucocutaneous manifestations in
patients in categories B and C were significantly more common than in those
category A (p < 0.001). The most common finding was oral candidiasis (36.3%).
Drug rash, pruritic papular eruption, herpes zoster, cutaneous candidiasis,
Penicillium marneffei infection, and herpes simplex virus stomatitis were found
in 6.6%, 5.5%, 4. 4%, 3.4%, and 2. 2% of patients, respectively. All three
patients who had disseminated P. marneffei infection were in category C.

PMID: 10571833 [PubMed - indexed for MEDLINE]

3301: Cornea. 1999 Nov;18(6):671-4.

Investigating a viral etiology for keratoconjunctivitis sicca among patients who 
are positive for human immunodeficiency virus.

Lee-Wing MW, Hodge WG, Diaz-Mitoma F.

University of Ottawa Eye Institute, Ontario, Canada.

PURPOSE: Herpesvirus infection of the lacrimal gland was investigated as an
etiologic factor for keratoconjunctivitis sicca in patients who were positive for
human immunodeficiency virus (HIV). METHODS: In this cross-sectional study, we
recorded the Schirmer tests and tear break-up times (TBUTs) among 30 patients who
were positive for HIV. Dry-eye state was defined as a Schirmer test of <10 mm of 
wetting at 5 min or a TBUT of <10 s. The polymerase chain reaction assay (PCR)
for herpes family viruses [Epstein-Barr virus (EBV), cytomegalovirus (CMV),
herpes simplex virus (HSV), and varicella-zoster virus (VZV)] was performed on
the conjunctival and tear specimens of the 30 HIV-positive patients by using
virus-specific single primers. We compared the rates of virus DNA detection among
dry-eye and non-dry-eye patients by calculating the odds ratio of detection for
each virus. RESULTS: The odds ratio of viral DNA detection was adjusted for age, 
gender, race, CD4 count, and duration of HIV positivity. The adjusted odds ratios
of EBV DNA detection among dry-eye to non-dry-eye patients were 1.30 (p = 0.79)
and 0.97 (p = 0.98) by using Schirmer tests and TBUTs, respectively. For CMV, the
adjusted odds ratios among dry-eye to non-dry-eye patients were 1.94 (p = 0.58)
with Schirmer tests and 1.02 (p = 0.99) with TBUTs. HSV and VZV DNA were not
detected in any samples. CONCLUSION: Our study does not support the role of
herpesvirus infection of the lacrimal gland as a causative factor in the
pathogenesis of dry eyes in patients positive for HIV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10571297 [PubMed - indexed for MEDLINE]

3302: J Infect Dis. 1999 Dec;180(6):1784-9.

Zoster incidence in human immunodeficiency virus-infected hemophiliacs and
homosexual men, 1984-1997. District of Columbia Gay Cohort Study. Multicenter
Hemophilia Cohort Study.

Engels EA, Rosenberg PS, Biggar RJ.

Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National
Cancer Institute, Rockville, MD 20822, USA. engelse@exchange.nih.gov

Zoster is an important clinical problem for human immunodeficiency virus type 1
(HIV)-infected patients. Risk factors for zoster and trends in incidence in
HIV-infected hemophiliacs and homosexual men (n=1218) were examined. From 1984 to
1997, 174 zoster cases were identified (average yearly incidence, 2.5%). Prior
zoster episodes were associated with increased risk for a subsequent episode
(relative risk [RR], 4.30; 95% confidence interval [CI], 3.11-5.95). Among
hemophiliacs, children and adolescents had the highest zoster risk, and zoster
risk declined with age (RR, 0.80 per decade; 95% CI, 0.68-0.93). These findings
suggest that HIV-infected persons do not produce or maintain adequate booster
responses after varicella zoster virus exposure. Zoster risk was relatively
constant when CD4 cell counts >200 cells/mm3 but increased steeply below this
level. During the 14 years of follow-up, zoster incidence declined 9% per year.
This trend occurred despite decreasing CD4 cell counts and was unexplained by
zidovudine or acyclovir use.

PMID: 10558932 [PubMed - indexed for MEDLINE]

3303: J Neurovirol. 1999 Oct;5(5):445-8.

The problems of latent varicella zoster virus in human ganglia: precise cell
location and viral content.

Mahalingam R, Kennedy PG, Gilden DH.

Department of Neurology, University of Colorado, Health Sciences Center, Denver
80262, USA.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10568880 [PubMed - indexed for MEDLINE]

3304: Arch Dermatol. 1999 Nov;135(11):1359-64.

The effects of epidural blockade on the acute pain in herpes zoster.

Hwang SM, Kang YC, Lee YB, Yoon KB, Ahn SK, Choi EH.

Department of Dermatology, Yonsei University Wonju College of Medicine, South
Korea.

OBJECTIVE: To evaluate the relief of acute pain and possible preventive effects
on postherpetic neuralgia through the use of an epidural blockade in the acute
stage of herpes zoster. DESIGN: Prospective, nonrandomized, comparative clinical 
trial. SETTING: A dermatologic clinic in a university hospital. PATIENTS:
Sixty-five consecutive patients with pain due to acute herpes zoster were treated
for a 7-day hospitalization period from July 1, 1996, through June 30, 1997.
INTERVENTION: The consecutive patients were divided into 2 groups. Group A
consisted of 30 patients who were seen from July 1, 1996, through December 31,
1996, and who were treated with intravenous acyclovir (5 mg/kg) for 7 days. Group
B consisted of 35 patients who were seen from January 1, 1997, through June 30,
1997, and who were treated with intravenous acyclovir (5 mg/kg) and an epidural
blockade for 7 days. The changes in the intensity of pain and the total duration 
of pain in both groups were assessed for 12 to 18 months. MAIN OUTCOME MEASURES: 
The number of days required for relief of pain and the total duration of pain.
RESULTS: The mean +/- SD number of days required for relief of pain, which was
rated on a scale of 100 (worst pain) to 0 (no pain), was significantly fewer in
group B than in group A: it took 2.6 +/- 1.1 days to go from 100 to 50 on the
relief-of-pain scale in group B, but 3.8 +/- 1.1 days in group A (P = .03), and
12.5 +/- 6.4 days to go from 100 to 10 in group B, but 20.1 +/- 14.6 days in
group A (P = .04). The duration of late residual pain was significantly shorter
in group B (5.9 +/- 5.8 days) than in group A (11.9 +/- 7.5 days) (P = .03). The 
total duration of pain was also significantly shorter in group B (18.5 +/- 9.3
days) than in group A (31.6 +/- 17.6 days) (P = .04). CONCLUSIONS: We believe
that an epidural blockade combined with an antiviral agent is a very effective
treatment modality for the pain of acute herpes zoster, and we recommend its use 
for the prevention of postherpetic neuralgia, with a view to shortening the total
duration of pain, especially late residual pain.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 10566834 [PubMed - indexed for MEDLINE]

3305: Acta Paediatr. 1999 Oct;88(10):1161-2.

An immunocompetent child with herpes zoster following post-exposure prophylaxis
of varicella by oral acyclovir.

Maeda A, Hisakawa H, Wakiguchi H, Kurashige T.

Department of Pediatrics, Kochi Medical School, Nankoku, Japan.
Akihiko.Maeda@mtc.ki.se

Publication Types: 
    Case Reports

PMID: 10565468 [PubMed - indexed for MEDLINE]

3306: Enferm Infecc Microbiol Clin. 1999 Oct;17(8):390-3.

[Acyclovir may modulate clonal expansion of cd8+ lymphocytes induced by the
Cytomegalovirus antigen]

[Article in Spanish]

Gavilan F, Caballero J, Cardenas M, Moreno J, Martinez L, Gallego C,
Sanchez-Guijo P, Torre-Cisneros J.

Seccion de Enfermedades Infecciosas, Hospital Universitario Reina Sofia, Cordoba.

BACKGROUND: Although the potent antiviral effect of acyclovir on the
Herpes-simplex (HSV) and Varicela-zoster (VZV) virus and the scarce effectiveness
versus Cytomegalovirus (CMV) is known, some data suggest that it may have an
immunodulator implicated in the control of these viral disease. The aim of this
study was to characterize this possible effect of acyclovir versus the CMV
antigen. METHODS: We stimulated cultures of mononuclear cells obtained in 7
healthy patients who were seropositive for CMV and HSV with CMV antigen, HSV and 
with phitohemaglutinine (PHA). The proliferation index and culture cell phenotype
were later determined in the absence and presence of acyclovir (2 micrograms/ml).
In another group the proliferation index and cell phenotype following stimulation
with the CMV antigen were studied prior to and after treating the same volunteers
with acyclovir for one week (800 mg/6h). RESULTS: The CMV antigen and HSV induced
T cell proliferation predominantly involving the CD8+ subpopulation leading to an
inversion of the CD4/CD8 quotient. On addition of acyclovir to the cell culture a
moderate reduction was produced in lymphoproliferative response versus the CMV
antigen and HVS, characteristically modulating CD8+ cell proliferation, thereby
leading to reestablishment of the CD4/CD8 quotient. However, the proliferation
induced by PHA was not inhibited. These results were produced on oral
administration of acyclovir. CONCLUSIONS: Acyclovir modulates the
lymphoproliferative response induced by CMV antigen. Based on this observation,
the authors hypothesize that this immunomodulation may be related to its
preventive effect on CMV disease in transplanted patients.

Publication Types: 
    English Abstract

PMID: 10563086 [PubMed - indexed for MEDLINE]

3307: Enferm Infecc Microbiol Clin. 1999 Oct;17(8):382-5.

[Open clinical trial with oral acyclovir for the prophylaxis of disease by
Cytomegalovirus in low risk liver transplant recipients]

[Article in Spanish]

Moreno J, Montero JL, Gavilan F, Costan G, Herrero C, Cardenas M, Sanchez-Guijo
P, Torre-Cisneros J.

Seccion de Enfermedades Infecciosas, Hospital Universitario Reina Sofia, Cordoba.

OBJECTIVE: Checking the first 70 low risk liver transplantation performed in our 
hospital, who did not receive prophylaxis for Cytomegalovirus, we found that the 
incidence of Cytomegalovirus-infection and Cytomegalovirus-disease were 47% and
16% respectively. METHODS: For this reason we started a prospective, open
clinical study, to address the safety of acyclovir prophylaxis in low-risk liver 
transplant patients. Seventy patients did not receive acyclovir. Fifty patients
received oral acyclovir during 3 months (800-3,200 mg/day). RESULTS: The
occurrence of Cytomegalovirus infection was not modified (40%) but
Cytomegalovirus disease decreased dramatically (4%, p < 0.01) during the first
year after transplantation. Acyclovir was well tolerated. The incidence of
leukopenia and renal failure were similar in both groups. Acyclovir did not
improved the global survival of patients. CONCLUSIONS: Thus, oral acyclovir does 
not reduce Cytomegalovirus infection although it is efficient and safe in the
prevention of Cytomegalovirus disease in low-risk liver transplantation, and
prevents Herpes-simplex and Varicela-zoster symptomatic disease in this group of 
patients.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 10563084 [PubMed - indexed for MEDLINE]

3308: J Virol. 1999 Dec;73(12):10514-8.

Quantitation of latent varicella-zoster virus and herpes simplex virus genomes in
human trigeminal ganglia.

Pevenstein SR, Williams RK, McChesney D, Mont EK, Smialek JE, Straus SE.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, National Institutes of Health,
Bethesda, Maryland, USA.

Using real-time fluorescence PCR, we quantitated the numbers of copies of latent 
varicella-zoster virus (VZV) and herpes simplex virus type 1 (HSV-1) and type 2
(HSV-2) genomes in 15 human trigeminal ganglia. Eight (53%) and 1 (7%) of 15
ganglia were PCR positive for HSV-1 or -2 glycoprotein G genes, with means of
2,902 +/- 1,082 (standard error of the mean) or 109 genomes/10(5) cells,
respectively. Eleven of 14 (79%) to 13 of 15 (87%) of the ganglia were PCR
positive for VZV gene 29, 31, or 62. Pooling of the results for the three VZV
genes yielded a mean of 258 +/- 38 genomes/10(5) ganglion cells. These levels of 
latent viral genome loads have implications for virus distribution in and
reactivation from human sensory ganglia.

PMID: 10559370 [PubMed - indexed for MEDLINE]

3309: Prescrire Int. 1999 Jun;8(41):75-6.

Valaciclovir in herpes zoster ophthalmicus: new indication. An empty clinical
assessment file.

[No authors listed]

(1) Valaciclovir, a metabolic precursor of aciclovir, improves the
bioavailability of the active compound. It is licensed for the prevention of
ocular complications of herpes zoster ophthalmicus in immunocompetent subjects.
(2) The clinical file on valaciclovir in this indication is very thin. Only two
(uninterpretable) trials have been done, both versus aciclovir. Note that oral
aciclovir has also been assessed inadequately in this indication. (3) Over 10% of
patients treated with valaciclovir in the two trials had nausea or headache.

PMID: 10558445 [PubMed - indexed for MEDLINE]

3310: New Microbiol. 1999 Oct;22(4):309-14.

Acyclovir treatment prevents varicella-zoster virus replication in PBMC during
viremia.

Wolff MH, Schunemann S.

Institute of Microbiology and Virology, University of Witten/Herdecke, Germany.

The most effective antiviral therapy of varicella and zoster has become
acyclovir. Using polymerase chain reaction specific for VZV ORF 14, ORF 29, ORF
63 as well as nucleic acid sequence-based amplification (ORF 63, ORF 68) we
tested PBMC of patients with VZV-associated diseases for the presence of viral
DNA and RNA, respectively. In PBMC of patients treated with acyclovir neither DNA
nor RNA was detectable already one day after the onset of therapy. In three blood
sample pairs from zoster patients we were able to detect viral nucleic acid
before but not after acyclovir treatment. These results confirm clinical and
epidemiological data. It can be concluded that treatment with acyclovir prevents 
VZV replication in peripheral blood mononuclear cells.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10555200 [PubMed - indexed for MEDLINE]

3311: Aust N Z J Obstet Gynaecol. 1999 Aug;39(3):371.

Herpes zoster during pregnancy near term: to treat or not to treat?

Thami GP, Kanwar AJ.

Department of Dermatology and Venereology, Government Medical College Hospital,
Chandigarh, India.

Publication Types: 
    Case Reports

PMID: 10554957 [PubMed - indexed for MEDLINE]

3312: Hautarzt. 1999 Oct;50(10):706-14.

[Infections with herpes simplex and varicella zoster virus in pregnancy: clinical
manifestations in mother, fetus and newborn--therapeutic options]

[Article in German]

Rappersberger K.

Universitatsklinik fur Dermatologie, Abteilung fur Allgemeine Dermatologie, Wien.

Infections with herpes simplex virus (HSV) type I and type II and
varicella/zoster-virus (VZV) are lifelong. The life cycle of the virus - primary 
infection-latency-endogenous reactivation - determines the clinical features of
the diseases, i. e. primary infection and recurrences. During pregnancy,
infections with HSV and VZV may induce severe maternal illness that occasionally 
runs a lethal course. With viremia placental transmission of the virus may occur 
infecting the fetus and possibly causing spontaneous abortion, stillbirth and
congenital malformations. The occurrence of such malformations is best documented
for the "fetal varicella syndrome". Maternal varicella and genital herpes simplex
within the perinatal period represent a tremendous risk for the newborn to be
infected during delivery; such infection may cause life threatening diseases that
have a lethal outcome in more than 50% of affected children. We describe the life
cycle of HSV/VZV in infected individuals and the peculiar clinical features of
maternal infections during pregnancy. The epidemiological and clinical
characteristics of the infected fetus and newborn are highlighted and
prophylactic and therapeutic possibilities are discussed.

Publication Types: 
    English Abstract
    Review

PMID: 10550356 [PubMed - indexed for MEDLINE]

3313: Adv Exp Med Biol. 1999;458:159-65.

Therapeutic approaches to the management of herpes zoster.

Whitley RJ, Gnann JW Jr.

Department of Pediatrics, Microbiology and Medicine, University of Alabama at
Birmingham 35233-0011, USA.

The past several years have provided exciting advances in the management of
herpes zoster in the normal host. In spite of these advances, a significant
portion of zoster patients still have persistent complications from this disease.
Persistent pain is the most debilitating sequela and it occurs in at least 15% of
individuals over 50 years of age. Future research efforts must embrace
alternative approaches for pain control.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10549388 [PubMed - indexed for MEDLINE]

3314: QJM. 1999 Nov;92(11):659-67.

Out-patient parenteral antimicrobial therapy--a viable option for the management 
of cutaneous leishmaniasis.

Seaton RA, Morrison J, Man I, Watson J, Nathwani D.

Infection and Immunodeficiency Unit, and Department of Dermatology, Tayside
University Hospitals NHS Trust, and Department of Clinical Parasitology, Hospital
for Tropical Diseases, London, UK. aseaton66@aol.com

Cutaneous infection with Leishmania braziliensis complex requires treatment with 
parenteral pentavalent antimonials to prevent development of mucocutaneous
leishmaniasis. Patients with imported disease are usually managed in hospital
because of concerns over drug toxicity. This study describes the clinical
features and outcome of infection treated in the UK in an out-patient setting.
Thirteen marines (aged 19-35 years) who acquired leishmaniasis in Belize were
studied prospectively. Three had at least two lesions (0. 6-3 cm diameter), eight
had regional lymphadenopathy and one had localized painless lymphatic thickening.
Histology for amastigotes and PCR for Leishmania braziliensis complex was
positive in all. Culture was positive in six. Patients received 1.5-2 g (mean 1.7
g) (20 mg/kg) sodium stibogluconate intravenously daily for 20 days. All
developed transient musculoskeletal symptoms and asymptomatic hepatitis. Eleven
developed biochemical pancreatitis, and one thrombocytopenia. Three developed
transient ECG changes and one herpes zoster. There were four device-related
infections, two requiring hospitalization (one required surgical drainage of an
abscess). All lesions re-epithelialized. A total of 250 bed-days were saved over 
a 67-day period. These results indicate that in selected patients, out-patient
therapy for cutaneous leishmaniasis with parenteral high-dose sodium
stibogluconate may be appropriate, provided there is adequate monitoring of
therapy.

PMID: 10542306 [PubMed - indexed for MEDLINE]

3315: Adv Exp Med Biol. 1999;458:167-74.

Management of varicella-zoster virus infections in children.

Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California
94305, USA.

The introduction of varicella vaccine for immunization of healthy children is
expected to have a gradual impact on the incidence of VZV infections in the
population but antiviral therapy remains an important intervention in clinical
practice. The efficacy of aciclovir for treatment of primary and recurrent VZV
infections in children has reduced the morbidity and mortality of these illnesses
in immunocompromised children dramatically. Oral aciclovir is an effective and
useful for the management of varicella in healthy children and adolescents.

Publication Types: 
    Review

PMID: 10549389 [PubMed - indexed for MEDLINE]

3316: Adv Exp Med Biol. 1999;458:149-57.

Valaciclovir update.

Bell AR.

Glaxo Wellcome Research and Development, Greenford, Middlesex, United Kingdom.

Publication Types: 
    Review

PMID: 10549387 [PubMed - indexed for MEDLINE]

3317: Adv Exp Med Biol. 1999;458:135-47.

Famciclovir/penciclovir.

Sacks SL, Wilson B.

Department of Pharmacology and Therapeutics, Faculty of Medicine, University of
British Columbia, Canada.

Publication Types: 
    Review

PMID: 10549386 [PubMed - indexed for MEDLINE]

3318: Rinsho Shinkeigaku. 1999 Jul;39(7):750-6.

[A case of non-herpetic acute encephalitis presenting high intensity lesion at
unilateral temparal cortex on MR FLAIR image]

[Article in Japanese]

Suzuki K, Jimi T, Wakayama Y, Yamamoto T, Nakamura R.

Department of Medicine, Showa University Fujigaoka Hospital.

We reported a case of non-herpetic acute encephalitis with unilateral temporal
cortex lesion revealed by MR imaging and SPECT study. The patient was an eighteen
years old woman who developed tonic-clonic seizure after common cold symptom. She
was healthy before this episode. Neurological abnormality was only a single
convulsion at onset and there was no other abnormal physical and neurological
signs except for low grade fever. Electroencephalogram showed spike and slow wave
complex of 2 Hz focused on a right posteriotemporal point (T 6) and an MR FLAIR
(fluid-attenuated inversion recovery) image revealed a high signal intensity area
at right temporal cortex. There was a decrease of cerebral blood flow in the same
portion on SPECT study. This lesion was obscure on T1 and T2 MR images.
Cerebrospinal fluid showed pleocytosis with normal glucose level and protein
concentration. Bacterial and fungal cultures of CSF were negative and a detection
of tubercule bacillus by PCR hybridization method was also negative. Although CSF
findings suggested viral infection of CNS, virological study could not
demonstrate infections of herpes simplex virus type 1, type 2, varicella-zoster
virus, cytomegalovirus, measles virus, mumps virus, Japanese encephalitis virus, 
and influenza virus type A and B. After infusion of acyclovir and antibiotics,
the patient was discharged from our hospital without sequelae of encephalitis.
EEG was normal at this point and a high intensity area of MR FLAIR image
disappeared two months later. SPECT findings were normalized six months later.
The encephalitis presenting unilateral temporal cortex lesion without the
infection of herpes simplex virus is thought to be very rare. Our case was
distinguished from non-herpetic acute limbic encephalitis by an extent of the
lesion and clinical manifestations. MR FLAIR image was useful for the detection
of the lesion in this case.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10548915 [PubMed - indexed for MEDLINE]

3319: J Clin Virol. 1999 Sep;14(1):31-6.

Laboratory diagnosis of herpes zoster.

Sauerbrei A, Eichhorn U, Schacke M, Wutzler P.

Institute for Antiviral Chemotherapy, Friedrich-Schiller University Jena, Erfurt,
Germany. sauerbre@zmkh.ef.uni-jena.de

Virological diagnosis of zoster should be rapid when effective antiviral
chemotherapy is being considered. In the present study, vesicle specimens of 100 
patients with zoster were analysed by detecting viral DNA using polymerase chain 
reaction (PCR). The findings were compared with those obtained by traditional
virological and serological methods. PCR results confirmed the clinical diagnosis
of zoster in 95%. Primers selected from varicella-zoster virus (VZV) gene 28
proved to be most sensitive. The sensitivity of virus culture was 20%
(specificity 100%), of direct immunofluorescent VZV-specific antigen staining in 
vesicle samples 82% (specificity 76%), and in 48% there was a serological
response to specific IgM and IgA antibodies within 4 days after the onset of
rash. These findings suggest that PCR is the method of choice for rapid
laboratory diagnosis of zoster.

Publication Types: 
    Clinical Trial

PMID: 10548128 [PubMed - indexed for MEDLINE]

3320: Retina. 1999;19(5):468-70.

Progressive outer retinal necrosis in a human immunodeficiency virus-negative
patient.

Doi M, Matsui K, Akamine T, Sasoh M, Uji Y, Taniguchi H.

Department of Ophthalmology, Mie University School of Medicine, Tsu, Japan.

Publication Types: 
    Case Reports

PMID: 10546952 [PubMed - indexed for MEDLINE]

3321: Nippon Rinsho. 1999 Nov;57 Suppl:260-3.

[Varicella-zoster virus]

[Article in Japanese]

Takayama M.

Department of Virology 1, National Institute of Infectious Diseases.

Publication Types: 
    Review

PMID: 10635829 [PubMed - indexed for MEDLINE]

3322: J Am Acad Dermatol. 1999 Nov;41(5 Pt 1):793-6.

Papular-purpuric "gloves and socks" syndrome: polymerase chain reaction
demonstration of parvovirus B19 DNA in cutaneous lesions and sera.

Grilli R, Izquierdo MJ, Farina MC, Kutzner H, Gadea I, Martin L, Requena L.

Department of Dermatology, Fundacion Jimenez-Diaz, Universidad Autonoma, Madrid, 
Spain.

We report a typical case of papular-purpuric "gloves and socks" syndrome (PPGSS) 
in which primary infection by parvovirus B19 was demonstrated by seroconversion
to this virus; parvovirus B19 DNA was also identified by polymerase chain
reaction (PCR) methods in the sera of the patient and in the cutaneous biopsy
specimen, both taken 4 days after the onset of clinical manifestations. To our
knowledge, this is the fourth published case in which parvovirus B19 DNA has been
recovered from the skin by PCR. Serologic studies and PCR investigations in
cutaneous biopsy for other viruses including herpes simplex virus types 1 and 2, 
varicella zoster virus, Epstein-Barr virus, cytomegalovirus, and human
herpesvirus 6, 7, and 8 were negative. Clinically, our case presented some
additional features, which have not been previously described in cases of PPGSS, 
namely dysuria with vulvar edema and erythema, and unilateral petechial rash on
the breast. The histopathologic findings of our case were nonspecific and
consisted of an interface dermatitis with slight vacuolar degeneration at the
dermoepidermal junction and a superficial perivascular inflammatory infiltrate
mostly composed of lymphocytes, with numerous extravasated erythrocytes. We
review the cases of PPGSS published in the literature with respect to the
different viruses that have been proposed as etiologic agents and conclude that
acute infection by parvovirus B19 is the only one that has been adequately
proved.

Publication Types: 
    Case Reports

PMID: 10534650 [PubMed - indexed for MEDLINE]

3323: Epilepsia. 1999;40 Suppl 6:S51-6; discussion S73-4.

Postherpetic neuralgia: role of gabapentin and other treatment modalities.

Beydoun A.

Department of Neurology, University of Michigan Medical School, Ann Arbor 48109, 
USA.

Postherpetic neuralgia (PHN) is a chronic and painful condition that may occur
after a herpes zoster infection. The frequency of PHN after untreated zoster
varies widely. Age is the most important risk factor for development of PHN. The 
condition occurs in an estimated 50% of patients older than 50 years. The pain of
PHN can be severe and debilitating and is frequently associated with allodynia.
Although in most patients pain remits within the first year, it may persist for a
lifetime. Tricyclic antidepressants (TCAs), topical agents, opioids, and
gabapentin, a structural gamma-amino butyric acid (GABA) analogue, are the only
agents that have demonstrated efficacy in randomized clinical trials for
treatment of both the shooting and the burning form of pain associated with PHN. 
TCAs are among the most commonly used classes of agents for treating PHN and are 
effective in a significant proportion of patients. However, various adverse
events can limit treatment. These side effects tend to be more acute in the
elderly, the population most likely to suffer from PHN. Topical agents have led
to mild to moderate improvement in patients with PHN but are usually ineffective 
as monotherapy for this condition. Until recently, carbamazepine was the only
antiepileptic drug evaluated for the treatment of PHN. Over the past few years,
however, gabapentin has received increasing attention as a useful treatment for
neuropathic pain. Gabapentin lacks significant drug-drug interactions and has a
favorable safety profile, which makes it particularly useful for treatment of
PHN.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Review

PMID: 10530683 [PubMed - indexed for MEDLINE]

3324: Clin Infect Dis. 1999 Sep;29(3):684-5.

Management of progressive outer retinal necrosis with cidofovir in a human
immunodeficiency virus-infected patient.

Schliefer K, Gumbel HO, Rockstroh JK, Spengler U.

Department of General Internal Medicine, University of Bonn, Germany.
k.schliefer@uni-bonn.de

Publication Types: 
    Case Reports

PMID: 10530469 [PubMed - indexed for MEDLINE]

3325: J Dermatol Sci. 1999 Nov;21(3):147-56.

Dermatological applications of skin potential level measurements.

Uchida T.

Uchida Dermatological Clinic, Nagaoka City, Niigata, Japan.
u-toshio@po.iijnet.or.jp

Decreasing of the negativity of skin potential level (SPL) on the palmar surface 
of healthy subjects associated with the process of falling asleep, with a return 
to increased negativity on awakening, was reported by Nishimura and Nagumo
(Ergonomics 1985;28(6):905-913). To clarify the dermatological significance of
SPL measurements, the SPL of normal skin at various paired sites in the right
upper limb, right lower limb and trunk in healthy volunteers and also at the
sites of lesions in patients with psoriasis, herpes zoster and nummular eczema
were measured. Fitting curves for the decreasing showed exponential
characteristics on the palm and the heel where many sweat glands are involved.
SPL differences on other sites did not show the exponential decreasing, but kept 
almost constant values. The values are negative on normal skin, but positive on
lesions sites. We also studied the effects of water content in the horny layer on
SPL differences and the biorhythmical changes of SPL differences. We discussed
the reasons why these results were obtained. The present study provides the
promise of an objective, noninvasive and easy method of testing dermatological
conditions.

PMID: 10527375 [PubMed - indexed for MEDLINE]

3326: J Clin Epidemiol. 1999 Nov;52(11):1047-53.

Are health states "timeless"? The case of the standard gamble method.

Bala MV, Wood LL, Zarkin GA, Norton EC, Gafni A, O'Brien BJ.

Centocor, Inc., Malvern, Pennsylvania, USA.

The standard gamble method, as currently recommended for use in health care
program evaluation, provides an individual's preference score or "utility weight"
for living in a given health state for the rest of the individual's life. Many
researchers interpret this value as a time-independent or "timeless" one and
order health states on a scale of zero (death) to one (full health), regardless
of the time spent in the health state. This article examines whether preference
scores for a severe pain health state are "timeless," or in other words whether
the utility independence assumption is satisfied. Our study results suggest that 
for the majority of respondents, the preference scores are not independent of
time.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 10526998 [PubMed - indexed for MEDLINE]

3327: Presse Med. 1999 Sep 25;28(28):1518.

Comment on:
    Presse Med. 1999 Mar 6;28(9):473-5.

[Treatment of herpes zoster infections in patients infected with HIV]

[Article in French]

Breton G, Bricaire F, Caumes E.

Publication Types: 
    Comment
    Letter

PMID: 10526558 [PubMed - indexed for MEDLINE]

3328: Arch Neurol. 1999 Oct;56(10):1292-4.

The pathology of shingles: Head and Campbell's 1900 monograph.

Oaklander AL.

Department of Anesthesiology, Massachusetts General Hospital, Harvard Medical
School, Boston 02114, USA.

Shingles (herpes zoster) and postherpetic neuralgia, a chronic neuropathic pain
syndrome that can persist after the shingles lesions heal, were studied by
eminent neurologists of the 19th century. Autopsy studies were used to establish 
sensory neural pathways in the peripheral and central nervous systems. More
recently, zoster and postherpetic neuralgia have served as models for the study
of the pathogenesis and treatment of neuropathic pain. Postherpetic neuralgia has
the cardinal clinical features of all neuropathic pain syndromes, including
sensory abnormalities, ongoing pain, and allodynia (touch-induced pain). Unlike
most other neuropathic pain syndromes, such as trigeminal neuralgia or nerve root
compressions, shingles has a well-defined pathogenesis and onset, as well as
visible lesions, and is therefore uniquely suitable for study.

Publication Types: 
    Historical Article
    Research Support, Non-U.S. Gov't

PMID: 10520948 [PubMed - indexed for MEDLINE]

3329: Med Pregl. 1999 Mar-May;52(3-5):125-8.

[Reactivation of herpes zoster infection by varicella-zoster virus]

[Article in Croatian]

Cvjetkovic D, Jovanovic J, Hrnjakovic-Cvjetkovic I, Brkic S, Bogdanovic M.

Klinika za infektivne bolesti, Medicinski fakultet, Novi sad.

HISTORY: There has been considerable interest in varicella-zoster virus in the
middle of the twentieth century. Virus isolation in 1958 had made it possible to 
find out the complete DNA sequence of the varicella-zoster virus. Molecular
identify of the causative agents of varicella and shingles had been proved.
ETIOPATHOGENESIS AND HISTOPATHOLOGY: Varicella-zoster virus is a member of the
Herpesviridae family. After primary infection which results in varicella, the
virus becomes latent in the cerebral or posterior root ganglia. Some of these
individuals develop shingles after several decades because of virus reactivation.
It is caused by decline of cellular immune response. Circumstances such as old
age, hard work, using of steroids or malignancies contribute to the appearance of
shingles. Histopathological findings include degenerative changes of epithelial
cells such as ballooning, multinucleated giant cells and eosinophilic
intranuclear inclusions. EPIDEMIOLOGY: Shingles occur sporadically, mainly among 
the elderly who have had varicella. There is no seasonal appearance of shingles. 
Individuals suffering from shingles may be sometimes contagious for susceptible
children because of enormous amount of virus particles in vesicle fluid. CLINICAL
FEATURES: Clinically, shingles is characterized at first by pain or discomfort in
involved dermatome, usually without constitutional symptoms. Local edema and
erythema appear before developing of rash. Maculopapular and vesicular rash
evolves into crusts. The most commonly involved ganglia are: lumbar, thoracic,
sacral posterior root ganglia, then geniculate ganglion of the VIIth cranial
nerve and the trigeminal ganglion. The most common complication, postherpetic
neuralgia, may last for as long as two or three weeks, sometimes even one year or
more. Other complications that may be seen in shingles, but more rarely, are
ocular (keratitis, iridocyclitis, secondary glaucoma, loss of sight),
neurological (various motor neuropathies, encephalitis, Guillain-Barre syndrome),
secondary bacterial infection of vesicles. Immunocompromised patients often
develop more severe disease lasting up to two weeks, skin lesions are more
numerous and often with hemorrhagic base and there is a high possibility for
cutaneous dissemination and visceral involvement including viral pneumonia,
encephalitis and hepatitis. Chronic shingles may also be found in
immunocompromised hosts, particularly in those with a diagnosis of HIV infection.
In patients with HIV infection, shingles is often characterised by radicular pain
and itching several days before appearance of skin lesions. Those patients may
have two or more dermatomes involved and recurrences of shingles cannot be quite 
infrequent in those patients. But visceral involvement is rarer than in other
immunocompromised patients. Shingles may occur in the second half of pregnancy
and usually have a mild course. However, congenital abnormalities has been
described in few cases. DIAGNOSIS: The diagnosis of shingles is usually made by
history and physical examination. Exceptionally, for example in zoster sine
herpete and atypical forms of shingles, virus isolation and serological tests
must be used. DIFFERENTIAL DIAGNOSIS: Some other diseases may cause similar skin 
lesions and rash (varicella, erysipelas, impetigo, enteroviral infections, herpes
simplex infections). These diseases are excluded by using detailed history taking
and physical examination, laboratory findings, virus isolation and commercially
available serological tests. THERAPY: The vast majority of immunocompetent
persons with shingles should be treated only by symptomatic therapy.
Predominantly it is directed toward reduction of fever and avoiding secondary
bacterial skin infection in immunocompetent hosts. Acute neuritis and
post-herpetic neuralgia require administration of various analgesics, even like
amitriptyline hydrochloride and fluphenazine hydrochloride. Acyclovir therapy is 
limited to ophthal

Publication Types: 
    English Abstract
    Review

PMID: 10518396 [PubMed - indexed for MEDLINE]

3330: Antiviral Res. 1999 Sep;43(2):67-78.

Isolation and partial characterization of an antiviral, RC-183, from the edible
mushroom Rozites caperata.

Piraino F, Brandt CR.

Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical 
School, Madison 53706-1532, USA.

A protein of 10,425 Da was purified from the edible mushroom Rozites caperata and
shown to inhibit herpes simplex virus types 1 and 2 replication with an IC50
value of < or = 5 microM. The protein designated RC-183 also significantly
reduced the severity of HSV-1 induced ocular disease in a murine model of
keratitis, indicating in vivo efficacy. HSV mutants lacking ribonucleotide
reductase and thymidine kinase were also inhibited, suggesting the mechanism does
not involve these viral enzymes. Antiviral activity was also seen against
varicella zoster virus, influenza A virus, and respiratory syncytial virus, but
not against adenovirus type VI, coxsackie viruses A9 and B5, or human
immunodeficiency virus. Characterization of RC-183 by mass spectroscopy,
sequencing, and other methods suggests it is composed of a peptide (12 or 13 mer)
coupled to ubiquitin via an isopeptide bond between the c-terminal glycine of
ubiquitin and the epsilon amino group of a lysine residue in the peptide. The
peptide sequence did not match any known sequence. Thus, RC-183 is a novel
antiviral that may have clinical utility or serve as a lead compound for further 
development. Determining the mechanism of action may lead to identification of
novel steps in viral replication.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10517309 [PubMed - indexed for MEDLINE]

3331: Can Commun Dis Rep. 1999 Aug;25 Suppl 6:7-19.

Varicella-zoster virus disease.

[Article in English, French]

[No authors listed]

Publication Types: 
    Review

PMID: 10516794 [PubMed - indexed for MEDLINE]

3332: J Oral Maxillofac Surg. 1999 Oct;57(10):1249-51.

Herpes zoster infection of the maxilla: case report.

Owotade FJ, Ugboko VI, Kolude B.

Department of Oral/Maxillofacial Surgery and Oral Pathology, Obafemi Awolowo
University, Ile-Ife, Nigeria.

Publication Types: 
    Case Reports
    Review

PMID: 10513873 [PubMed - indexed for MEDLINE]

3333: An Med Interna. 1999 Aug;16(8):417-9.

[Lumbosacral polyradiculomyelitis caused by herpes simplex virus (HSV) in a
patient with AIDS]

[Article in Spanish]

Miguelez M, Correa-Nazco VJ, Linares M, Laynez P, Gonzalez M, Martinez A.

Servicio de Medicina Interna, Hospital Nuestra Senora de la Candelaria, Santa
Cruz de Tenerife.

To our knowledge this is the first description of lumbosacral polyradiculopathy
produced by herpes simplex virus (HSV) without coinfection by cytomegalovirus
(CMV) in a patient with HIV infection. The acute lumbosacral polyradiculomyelitis
(ALP) in patients with AIDS is a well defined nosologic entity and classically
associated to CMV infection. However, this pathology can be due to others
etiologies as toxoplasmosis, syphilis, lymphoma, tuberculosis, cryptococcus,
varicella-zoster virus fVZV), Epstein-Barr virus (EBT) and HSV associated CMV.
The case report was documented with findings in cerebrospinal fluid, magnetic
resonance imaging and was confirmed by detection of HSV DNA by polymerase chain
reaction. CMV DNA was not detected and no clinical features of CMV disease was
seen. Therapy with foscarnet was successful. This drug without gancyclovir
associated has rarely been employed in the treatment of ALP. We believe that
foscarnet may be a valuable alternative therapy for cases of ALP of suspected
acyclovir-resistant herpes virus infection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10507169 [PubMed - indexed for MEDLINE]

3334: J Clin Oncol. 1999 Oct;17(10):3117-21.

Pentostatin therapy of T-cell lymphomas with cutaneous manifestations.

Kurzrock R, Pilat S, Duvic M.

Departments of Bioimmunotherapy and Medical Specialties, University of Texas,
M.D. Anderson Cancer Center, Houston, TX, USA.

PURPOSE: To determine the side effects of and response to pentostatin in patients
with T-cell lymphomas with cutaneous manifestations. PATIENTS AND METHODS:
Pentostatin was administered to 28 patients who had relapsed cutaneous T-cell
lymphoma or peripheral T-cell lymphoma with prominent cutaneous disease. The
starting dose was between 3.75 to 5.0 mg/m(2)/d intravenous for 3 days every 3
weeks. RESULTS: Of the 24 patients assessable for response, 17 (71%) achieved a
partial remission (46%) or complete remission (25%). The patients had a median
number of three (range, one to 12) prior therapies. Of the 86 courses of
pentostatin given, 39 were administered at doses of 5.0 mg/m(2)/d and 30 at doses
of 3. 75 mg/m(2)/d. Dose escalation to 6.25 mg/m(2)/d was possible in only five
courses, and toxicity necessitated dose reduction to 2.8 mg/m(2)/d in 12 courses.
The most common side effects were granulocytopenia, nausea, and nonneutropenic
fever. Most patients developed significant lowering of CD4 counts. Herpes zoster 
was seen within 1 year after pentostatin in five patients (19%). CONCLUSION:
Pentostatin is an active agent in heavily pretreated T-cell lymphomas with
cutaneous manifestations.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 10506607 [PubMed - indexed for MEDLINE]

3335: Vaccine. 1999 Oct 1;17 Suppl 2:S1-5.

BERNA: a century of immunobiological innovation.

Cryz SJ.

BERNA, Swiss Serum and Vaccine Institute Berne, Rehhagstrasse 79, CH-3018, Bern, 
Switzerland.

At the time the Swiss Serum and Vaccine Institute Berne (BERNA) was found in
1898, few vaccines or immune globulins were available. This short list included
vaccines against cholera, typhoid fever, plague, smallpox and rabies and equine
anti-tetanus and diphtheria immune globulins. Furthermore, their use was
restricted due to limited production capacity, uncertainty regarding safety and
no public health infrastructure to promote their utilization. Today, safe and
effective vaccines exist for more than 30 infectious diseases while human
hyperimmune globulins exist to treat or prevent rabies, tetanus, respiratory
syncytial virus, cytomegalovirus, hepatitis A, hepatitis B, and herpes virus
(Varicella zoster) infections. Throughout its 100 years of existence, BERNA has
played a key role in the evolution of the field by introducing novel technology
leading to safer, and more efficacious vaccines. It was a pioneer in the
development of freeze dried smallpox vaccine free from bacterial contamination.
The Salmonella typhi Ty21a typhoid fever vaccine strain demonstrated that oral
immunization against enteric bacterial pathogens was not only feasible, but could
be accomplished with a virtual lack of attendant adverse reactions. This finding 
has served as an impetus to develop other live attenuated bacterial strains not
only as vaccines, but also as vectors for vaccine antigens and gene therapy. One 
such example is Vibrio cholerae CVD 103-HgR, the first live vaccine for human use
derived through recombinant DNA technology. Subsequent studies have shown that
these two vaccine strains can be combined without sacrificing safety or
immunogenicity, setting the cornerstone for combined orally administered
vaccines. Recently, a novel vaccine antigen delivery system, termed virosomes,
has been utilized to construct hepatitis A and influenza vaccines. Such vaccines 
elicit fewer local adverse reactions than their classical counterparts and
display enhanced immunogenicity. Virosome-formulated influenza vaccine has also
been shown to be safe and immunogenic, when administered by the intranasal route.

PMID: 10506402 [PubMed - indexed for MEDLINE]

3336: Environ Health Perspect. 1999 Oct;107(10):835-41.

Environmental chemical exposures and risk of herpes zoster.

Arndt V, Vine MF, Weigle K.

Department of Epidemiology, University of Ulm, Ulm, Germany.

This study investigated whether residence in Aberdeen, North Carolina, the
location of the Aberdeen pesticides dumps site (a national priority list
Superfund site containing organochlorine pesticides, volatile organic compounds, 
and metals), is associated with immune suppression as indicated by a higher
incidence of herpes zoster and recent occurrences of other common infectious
diseases. Study participants included 1,642 residents, 18-64 years of age, who
responded to a telephone survey concerning potential occupational and
recreational exposures to pesticides and other chemicals, lifetime history of
herpes zoster (shingles), and the recent occurrence of other common infectious
diseases. Stratified and logistic regression analyses were used to compare the
cumulative incidence of herpes zoster among Aberdeen residents and residents of
nearby communities. There was little evidence of an overall increased risk of
herpes zoster among Aberdeen residents during the period 1951-1994 [relative risk
(RR), 1.3; 95% confidence interval (CI), 0.8-2.1]. However, an elevated risk of
herpes zoster was noted consistently among Aberdeen residents of younger ages as 
compared to residents of the nearby communities. The RR was 2.0 (CI, 1.0-4.0)
among those 18-40 years of age and was not affected by controlling for potential 
confounders. The RR of herpes zoster was also consistently elevated in all age
groups for the period before 1985. No differences were noted between residents of
Aberdeen and those of the nearby communities with respect to the recent
occurrence of other common infectious diseases. These results support the
plausibility of an association between exposure to the Aberdeen pesticides dumps 
site and immune suppression and the potential use of herpes zoster as a marker of
immune suppression in studies of environmental chemical exposures.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10504152 [PubMed - indexed for MEDLINE]

3337: J Med Virol. 1999 Nov;59(3):412-4.

Simultaneous treatment of cytomegalovirus and varicella zoster infections in a
renal transplant recipient with ganciclovir: use of viral load to monitor
response to treatment.

Aitken C, Hawrami K, Miller C, Barrett Muir W, Yaqoob M, Breuer J.

Department of Medical Microbiology and Virology, St. Barts and the Royal London
Hospitals, London, United Kingdom.

Disseminated zoster occurring simultaneously with cytomegalovirus (CMV) disease
in a renal transplant recipient is potentially life threatening. We describe the 
use of intravenous ganciclovir to treat both infections. The efficacy of
treatment was assessed clinically and by the measurement of CMV viral load using 
the hybrid capture (Murex version 2) and varicella zoster (VZV) viral load using 
an in-house assay. Results from this case suggest that clinical resolution in
severe viral infections such as described below may be related to early control
of viraemia.

Publication Types: 
    Case Reports

PMID: 10502276 [PubMed - indexed for MEDLINE]

3338: J Gen Virol. 1999 Sep;80 ( Pt 9):2433-6.

Behavioural changes in the rat following infection with varicella-zoster virus.

Fleetwood-Walker SM, Quinn JP, Wallace C, Blackburn-Munro G, Kelly BG,
Fiskerstrand CE, Nash AA, Dalziel RG.

Department of Veterinary Pathology, Royal (Dick) School of Veterinary Studies,
University of Edinburgh, Summerhall, UK.

Following the establishment of a chronic varicella-zoster virus infection in the 
rat, behavioural allodynia and hyperalgesia were observed in the injected, but
not the contralateral hind limb up to 33 days post-infection. This model may
prove useful in investigating mechanisms involved in the establishment of
post-herpetic neuralgia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10501498 [PubMed - indexed for MEDLINE]

3339: Neurology. 1999 Sep 22;53(5):1128-9.

Stroke after zoster ophthalmicus in a 12-year-old girl with protein C deficiency.

Cadavid D, Pearl PL, Dubovsky EC, Angiolillo A, Vezina LG.

Department of Neurology, Children's National Medical Center, George Washington
University School of Medicine, Washington, DC 20010, USA.

A 12-year-old girl who had zoster ophthalmicus 10 months earlier presented with
hemiparesis and corresponding basal ganglionic infarction related to middle
cerebral artery branch thrombosis ipsilateral to the zoster. Hematologic
evaluation disclosed protein C deficiency. This represents the first
zoster-associated stroke reported in childhood associated with protein C
deficiency, with extension of the latency period between zoster and infarction,
previously reported to be 6 months.

Publication Types: 
    Case Reports

PMID: 10496280 [PubMed - indexed for MEDLINE]

3340: Pediatr Infect Dis J. 1999 Sep;18(9):842-3.

Possible role of varicella vaccine in preventing herpes zoster.

Brunell PA.

National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.

PMID: 10493357 [PubMed - indexed for MEDLINE]

3341: Gene Ther. 1999 Sep;6(9):1638-42.

The equine herpes virus 4 thymidine kinase is a better suicide gene than the
human herpes virus 1 thymidine kinase.

Loubiere L, Tiraby M, Cazaux C, Brisson E, Grisoni M, Zhao-Emonet J, Tiraby G,
Klatzmann D.

Laboratoire de Biologie et Therapeutique des Pathologies Immunitaires, UPMC, CNRS
ESA 7087, CERVI, Hopital de la Pitie, 83, Boulevard de l'Hopital, 75651 Paris
cedex 13, France.

The herpes simplex virus type 1 thymidine kinase suicide gene (HSV1tk) together
with ganciclovir (GCV) have been successfully used for in vivo treatment of
various experimental tumors, and many clinical trials using this system have been
launched. With the aim to improve this therapeutic system, we compared the
potential efficacy of different herpes virus derived thymidine kinases (HSV1,
varicella-zoster virus, equine herpes virus type-4 and Epstein-Barr virus) as
suicide genes in association with the nucleoside analogs acyclovir, ganciclovir
and bromovinyldeoxyur- idine. Using various murine and human cell lines
expressing these viral tk, we show that HSV1- and EHV4tk are the more efficient
suicide genes for the different nucleoside analogs tested. Moreover, EHV4tk
expressing murine and human cells were three- to 12-fold more sensitive to GCV
than HSV1tk expressing cells. This was correlated with the presence of five-fold 
higher amounts of the toxic triphosphated-GCV in EHV4- versus HSV1tk expressing
cells. Altogether, these experiments underline the potential advantages of the
EHV4tk as a suicide gene.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 10490775 [PubMed - indexed for MEDLINE]

3342: Lancet. 1999 Sep 11;354(9182):953-4.

Comment on:
    Lancet. 1999 Jun 5;353(9168):1959-64.

Neuropathic pain.

Marples IL, Murray P.

Publication Types: 
    Comment
    Letter

PMID: 10489984 [PubMed - indexed for MEDLINE]

3343: Mayo Clin Proc. 1999 Sep;74(9):923-6.

37-year-old man with back pain.

Montori VM, Rho JP, Bauer BA.

Mayo Graduate School of Medicine, Mayo Clinic Rochester, Minn 55905, USA.

Publication Types: 
    Case Reports

PMID: 10488797 [PubMed - indexed for MEDLINE]

3344: Cornea. 1999 Sep;18(5):511-31.

Varicella-zoster virus eye disease.

Liesegang TJ.

Mayo Clinic Jacksonville, Florida 32224, USA. tliesegang@mayo.edu

PURPOSE: To review the epidemiology, biology, systemic and ocular features, and
treatment options for varicella zoster disease, including postherpetic neuralgia.
METHODS: Literature search and review of author's experience with patients with
varicella and herpes zoster ophthalmicus. RESULTS: In recent years there has been
an increase in the knowledge about the biology, latency, and epidemiology of the 
varicella-zoster virus. The clinical features are correlated with the pathologic 
changes. The pathophysiologic mechanisms and treatment of postherpetic neuralgia 
are reviewed. Treatment options with antiviral therapy and corticosteroids are
offered. Initial experience with the varicella vaccine is encouraging.
CONCLUSIONS: The laboratory and clinical studies have enhanced our knowledge of
the varicella-zoster virus and increased our ability to treat this infection and 
the aftermath. We are still far short of providing adequate therapy for patients 
who experience the severe forms of the disease.

Publication Types: 
    Review

PMID: 10487424 [PubMed - indexed for MEDLINE]

3345: Lupus. 1999;8(7):545-51.

Treatment of membranous lupus nephritis with nephrotic syndrome by sequential
immunosuppression.

Chan TM, Li FK, Hao WK, Chan KW, Lui SL, Tang S, Lai KN.

Division of Nephrology, Department of Medicine, The University of Hong Kong,
Queen Mary Hospital, Hong Kong, China.

The optimal therapy for pure membranous lupus nephritis (MLN) with nephrotic
syndrome remains controversial. While the risk of progressive renal deterioration
may be small, persistent heavy proteinuria leads to the complications of oedema, 
hypoalbuminaemia, hyperlipidaemia, hypercoagulability, and venous thrombosis. We 
examined prospectively the efficacy and tolerability of a sequential
immunosuppressive regimen in a cohort of 20 patients with nephrotic syndrome due 
to pure MLN (WHO Class Va and Vb). Initial therapy comprised prednisolone (0.8
mg/kg/d p.o.) and cyclophosphamide (2-2. 5 mg/kg/d p.o.). Prednisolone dosage was
gradually tapered to 10 mg/d at 6 months, when cyclophosphamide was replaced by
azathioprine (2 mg/kg/d p.o.) as maintenance therapy. Within 12 months of therapy
11(55%) patients had complete remission (CR), 7(35%) patients achieved partial
remission (PR) (proteinuria reduced from 6.2+/-4.0 to 2.0+/-1.7 g/24 h, P<0.01), 
and 2 patients failed to respond. Improvements in proteinuria and serum albumin
level were observed after 3-6 months of treatment. Non-responders had lower
baseline serum albumin compared to complete responders. Renal function remained
stable during follow-up for 73.5+/-48.9 months. 8 patients had disease relapse at
47+/-15 months. Early complications (</=12 months) included herpes zoster (40%), 
minor respiratory or urinary tract infections (25%), mild leukopenia (15%), and
transient amenorrhea (14.3%). 4 of the 20 patients developed pulmonary
tuberculosis during follow-up, at 35+/-24 months after the diagnosis of MLN. 8
patients had hyperlipidaemia. Haemorrhagic cystitis, permanent amenorrhea,
vascular complications, and mortality were not observed. We conclude that this
sequential immunosuppressive regimen is effective in 90% of patients with MLN and
heavy proteinuria. Prudent consideration of the benefits and potential
side-effects is required to determine the optimal management for individual
patients.

Publication Types: 
    Clinical Trial

PMID: 10483033 [PubMed - indexed for MEDLINE]

3346: J Virol. 1999 Oct;73(10):8571-7.

Prevalence of varicella-zoster virus DNA in dissociated human trigeminal ganglion
neurons and nonneuronal cells.

LaGuardia JJ, Cohrs RJ, Gilden DH.

Departments of Neurology, University of Colorado Health Sciences Center, Denver, 
Colorado 80262, USA.

Previous analyses using in situ hybridization alone or together with PCR have
yielded conflicting results regarding the cell type in which latent
varicella-zoster virus (VZV) resides. We separated human trigeminal ganglia (TG) 
into neuronal and nonneuronal fractions, followed by primary and nested PCR to
quantitate VZV DNA at the single cell level. Both TG from each of eight cadavers 
were dissociated and separated into neuronal and nonneuronal cell suspensions by 
differential filtration. Analysis of the neuron fraction (5,000 neurons per
sample) revealed VZV DNA in 9 of 16 samples, with copy numbers ranging from 1 to 
12, whereas only 2 of 16 nonneuronal cell samples were positive for VZV DNA, with
1 copy each. Further analysis of 10 samples of 100 neurons and the corresponding 
nonneuronal cell fractions from each TG of a single subject revealed VZV DNA in 3
of 10 samples of the left TG (range, 2 to 5 copies) and in 1 of 10 samples of the
right TG (2 copies) but in none of the 20 nonneuronal cell fractions. These data 
indicate that latent VZV DNA is present primarily, if not exclusively, in
neurons, at a frequency of two to five copies per latently infected neuron.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 10482610 [PubMed - indexed for MEDLINE]

3347: Acta Med Port. 1999 Apr-Jun;12(4-6):187-93.

[Trigeminal neuralgia]

[Article in Portuguese]

Brito AJ.

Servico de Estomatologia, Santa Casa da Misericordia de Lisboa.

The lesion of the sensorial nerves of the face is expressed by painful phenomena 
called neuralgias of the brainstem or its branches. These may be idiopathic or
essential and secondary or symptomatic and their clinical evidence and course are
different from the former. Essential neuralgia (E.N.), or tic douloureux, is the 
most frequent facial pain neuralgia. The aim of this paper is to review this
subject with evidence of secondary trigeminal neuralgia from oral causes (dental,
traumatic, post herpes zoster, etc). The author establishes the differential
diagnoses with other etiologies of facial pain and mentions the diagnostic
criteria for trigeminal neuralgia (T.N.), makes the difference between essential 
neuralgia (E.N.) and symptomatic neuralgia (S.N.); describes briefly the
different kinds of the medical and surgical therapy, its management and
complications. The author finishes by asserting that all E.N. must complementary 
means of diagnosis (Base skull, X rays, C.T. scan, M.R.I.). Peripheral surgery
has more relapses and less morbidity than neuro-surgical techniques. Under these 
circumstances latter must considered by the patient's, or his relatives, opinion.

Publication Types: 
    English Abstract
    Review

PMID: 10481321 [PubMed - indexed for MEDLINE]

3348: Antivir Chem Chemother. 1999 Jul;10(4):195-209.

Anti-herpesvirus activities and cytotoxicities of 2-thiopyrimidine nucleoside
analogues in vitro.

Shigeta S, Mori S, Kira T, Takahashi K, Kodama E, Konno K, Nagata T, Kato H,
Wakayama T, Koike N, Saneyoshi M.

Department of Microbiology, School of Medicine, Fukushima Medical University,
Japan. sshigeta@cc.fmu.ac.jp

Twenty 2-thiopyrimidine nucleoside analogues were synthesized and examined for
inhibitory activity against herpes simplex virus (HSV) type 1 and 2,
varicella-zoster virus (VZV), human cytomegalovirus (HCMV) and thymidine
kinase-deficient HSV (HSV-TK-) replication in vitro. 2-thiouracil (thymine)
arabinoside, 2'-deoxy-2-thiouridine (or 2-thiothymidine) and their 5-halogenated 
derivatives showed anti-HSV activity in both RPM18226 (human B-lymphoblastoid
cells) and MRC-5 (human embryo lung cells).
2'-deoxy-5-halogenated-2-thiocytidines were also inhibitory against HSV, whereas 
2-thiocytosine arabinoside and its derivatives were not inhibitory against HSV
replication, except 5-bromo and 5-iodo congeners (TN-31, TN-32). Substitution of 
the halogen atom at the 5-position of the pyrimidine rings to an atom with a
higher molecular weight increased anti-HSV and VZV activities, except for the
anti-HSV activity of 2-thiouracil arabinosides. 2'-deoxy-5-methyl-, and
2'-deoxy-5-iodo-2-thiouridines (TN-17, TN-44) showed the most potent anti-HSV
activity, and 2'-deoxy-5-chloro- and 2'-deoxy-5-bromo-2-thiocytidines were potent
inhibitors of VZV replication. However, none of the compounds inhibited HCMV and 
HSV-TK- replication. TN-31 and TN-32 were shown to inhibited HCMV and HSV-TK- as 
well as HSV and VZV replication. The cytotoxicity of the 2-thio-pyrimidine
nucleoside analogues was less than that of the 2-oxy-congeners of the compounds
(5-iodo-2'-deoxyuridine, 5-iodo-2'-deoxycytidine, thymine arabinoside and
cytosine arabinoside). The selectivity index of 2'-deoxy-5-iodo-2-thiouridine
(TN-44) was higher than that of 5-iodo-deoxyuridine. TN-17 and TN-44 were not
cytotoxic to resting or stimulated human peripheral blood mononuclear cells at
400 microM, although TN-32 was cytotoxic at a concentration of 20 microM.

PMID: 10480738 [PubMed - indexed for MEDLINE]

3349: Transplantation. 1999 Aug 27;68(4):578-81.

Clear benefit of mycophenolate mofetil-based triple therapy in reducing the
incidence of acute rejection after living donor renal transplantations.

Kim YS, Moon JI, Kim SI, Park K.

Department of Surgery, Severance Hospital, Yonsei University College of Medicine,
Seoul, Korea.

BACKGROUND: According to a pooled analysis of three randomized clinical studies
concerning the prevention of acute rejection in cadaveric renal transplantation, 
mycophenolate mofetil (MMF) proved superior to azathioprine or placebo in
conjunction with cyclosporine (CsA) and steroids. MMF-treated patients showed
reduced incidence and severity of acute rejection, similar graft survival, and
better graft function over 12 months. However, the multicenter trials did not
include the Asian recipients of living donor kidneys. METHODS: To assess the
efficacy of MMF as the third component of a triple therapy in addition to
CsA-Neoral and steroids in living donor renal transplantation recipients in
Asians, a total of 100 recipients were randomized to receive CsA-Neoral and
steroids (control group, n=50), or MMF-based triple therapy (1.0 g of MMF twice
daily from postoperative day 2, MMF group, n=50). The dosing plan for Neoral and 
steroids was essentially same between groups. During 12 months of follow-up, we
compared the incidence of acute rejection, adverse events such as infections, and
12-month actual graft and patient survival. RESULTS: The graft and patient
survival at 1 year was excellent in both groups: 96/98% in the control group and 
98/100% in the MMF group, respectively. MMF significantly reduced the proportion 
of patients with at least one episode of acute rejection (34% in the control
group vs. 14% in the MMF group), cumulative incidence of acute rejection episodes
(46% vs. 16%), and requirement of antilymphocyte antibody (21.7% vs. 12.5%). In
the MMF group, viral infection such as herpes zoster or chicken pox was more
prevalent than in the control group. CONCLUSIONS: Like cadaveric renal
transplantation, this open clinical trial showed MMF to be effective in reducing 
the incidence and severity of acute rejection if used in conjunction with Neoral 
and steroids after living donor renal transplantation in Asian ethnicity.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 10480420 [PubMed - indexed for MEDLINE]

3350: Minerva Anestesiol. 1999 Jul-Aug;65(7-8):541-8.

[Herpes Zoster and post-herpetic neuralgia: everything to revise?]

[Article in Italian]

Pasqualucci A.

Cattedra di Anestesiologia e Rianimazione, Universita degli Studi, Udine.

The treatment and prevention of the algic symptomatology of Post-Herpetic
Neuralgia (PHN) are problems still to be solved. In our opinion the reason of
this failure is to be found in an insufficient knowledge of the
pathophysiological phenomena which cause the PHN. In fact, many fundamental
aspects, such as its "temporal" and symptomatological definition and its
pathogenesis are still unsolved. This revision tries to focus the problems and
discrepancies hindering an improvement in PHN treatment and prevention. The
literature reports three different symptomatological levels after herpes zoster
acute phase: patients affected by pain and/or allodynia, patients with "abnormal 
sensations" (anesthesia, paresthesia, dysesthesia, prickling, itching, burning,
etc.,) and patients in "complete recovery". Only two studies have analyzed the
final incidence of these symptomatologies. Therefore, it is absolutely unclear
whether the patients in "abnormal sensations", that is with a symptomatology
which is definitely less weakening than pain, have to be considered in PHN
(patients with pain) or in "complete recovery". On the contrary, from a clinical 
and physiopathological point of view this symptomatological difference may have a
great importance: the symptomatological non-distinction could be the cause of the
disagreement concerning PHN incidence data; this distinction could differentiate 
and compare in a reliable way the effects of the various therapies reported in
the literature. The lack of a symptomatological classification does not
facilitate a verification of the physiopathological hypothesis of PHN onset and
maintenance. The differentiation among pain, "abnormal sensations" and "complete 
recovery" could correlate these three symptomatological conditions to the
anatomopathological and viral data which according to literature characterize the
evolution of Herpes Zoster acute phase in PHN. This would largely help to improve
the therapeutic strategy.

Publication Types: 
    English Abstract
    Review

PMID: 10479841 [PubMed - indexed for MEDLINE]

3351: Ann Trop Med Parasitol. 1999 Mar;93(2):169-77.

The influence of prematurity and low birthweight on transplacental antibody
transfer in Sri Lanka.

Wesumperuma HL, Perera AJ, Pharoah PO, Hart CA.

Department of Medical Microbiology, Faculty of Medicine, University of Liverpool,
U.K.

The influence of gestational age, the neonate's birthweight, and maternal age,
weight, height and parity on transplacental antibody transfer was assessed in 141
mothers from Sri Lanka and their neonates. Paired blood samples were collected
from the mothers and the umbilical cords of the newborns. The sera separated from
these samples were categorized as: preterm but adequate birthweight (< 37 weeks' 
gestation and birthweight > or = 2500 g); term but low birthweight (> or = 37
weeks' gestation and birthweight < 2500 g); or term and adequate birthweight (>
or = 37 weeks' gestation and birthweight > or = 2500 g). Neonatal and maternal
sera were assessed, in ELISA, for specific IgG antibodies against measles virus
(MeV), herpes simplex virus type-1 (HSV1), respiratory syncytial virus (RSV),
varicella-zoster virus (VZV), tetanus toxoid (TT), diphtheria toxoid (DT), and
Streptococcus pneumoniae (Pn) and Haemophilus influenzae type-b (Hib) capsular
antigens. Placental antibody transfer to certain antibody specificities was
significantly lower in preterm neonates than term neonates. Thus the ratios
between geometric mean cord antibody levels and geometric mean maternal antibody 
levels (the antibody-transfer ratios) were lower in preterm sera than term sera, 
for MeV (1.51 v. 2.03; P = 0.03), HSV1 (1.29 v. 1.76; P = 0.04), VZV (0.96 v.
2.50; P = 0.01), TT (1.13 v. 1.33; P = 0.04), DT (1.03 v. 2.39; P = 0.02), Pn
(0.68 v. 0.98; P = 0.01) and Hib (0.58 v. 0.98; P = 0.00). Geometric mean levels 
of antibody to MeV, VZV, TT, DT and Pn were also significantly lower in preterm
neonates than term. Compared with the values for 'adequate-birthweight' sera, low
birthweight was independently associated with significantly lower levels of
antibody transfer, for MeV (with antibody-transfer ratios of 1.51 v. 2.03; P =
0.02), VZV (0.99 v. 2.50; P = 0.03), TT (1.01 v. 1.33; P = 0.04) and DT (1.16 v. 
2.39; P = 0.04) and significantly lower levels of antibodies to MeV, HSV1, VZV,
TT, DT and Pn in the neonates. Maternal age, weight, height and parity had no
independent influence on placental IgG transfer for antibodies to any of the
pathogens investigated. These results demonstrate that prematurity and low
birthweight may influence the level of maternally acquired immunity in Sri Lankan
neonates.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10474642 [PubMed - indexed for MEDLINE]

3352: Neuropsychobiology. 1999;40(2):57-62.

No changes in paired viral antibody titers during the course of acute
schizophrenia.

Fukuda R, Sasaki T, Kunugi H, Nanko S.

Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan.
R.Fukuda@iop.kcl.ac.uk

Although there have been many studies surveying the prevalence of specific viral 
antibodies in a large cohort of patients with schizophrenia, changes in antibody 
levels during the course of acute illness have not been fully investigated. We
conducted a preliminary study investigating levels of antibodies to 5
herpesviruses (herpes simplex virus type 1, cytomegalovirus, Epstein-Barr virus, 
varicella-zoster virus and human herpesvirus type 6) and 6 other viruses
(measles, rubella, mumps, influenza A and B and Japanese encephalitis viruses) in
paired sera of 8 patients with acute onset or exacerbation of schizophrenia.
Assay for specific immunoglobulin M (IgM) antibody was also performed for
herpesviruses and mumps. Neither any relevant change in antibody levels nor
appearance of specific IgM antibody was observed for any of the viruses in any of
the patients investigated. It is unlikely that the active infection or
reactivation of these viruses has direct causal relationship to schizophrenia in 
these patients.

PMID: 10474057 [PubMed - indexed for MEDLINE]

3353: Otolaryngol Head Neck Surg. 1999 Sep;121(3):334-5.

Endoscopy during neurotomy of the nervus intermedius for geniculate neuralgia.

Alcaraz N, King WA, Wackym PA.

Department of Otolaryngology, Mount Sinai School of Medicine, New York,Ny, USA.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10471888 [PubMed - indexed for MEDLINE]

3354: J Virol Methods. 1999 Jul;80(2):213-5.

An analytical method for R5 repeated structure in varicella-zoster virus DNA by
polymerase chain reaction.

Yoshida M, Tamura T.

Department of Dermatology, Kinki University, School of Medicine, Osaka, Japan.

The tandem direct reiteration, R5, in varicella-zoster virus (VZV) genome
consists of 88-bp and 24-bp elements. The R5 structure was examined by the
polymerase chain reaction to differentiate between various strains. A sense
primer was designed at the 88-bp element and an antisense primer at the site
separated from R5, in which we expected to detect multiple bands corresponding to
repeating numbers of 88-bp elements. Thirty-four wild strains and a vaccine
strain were analyzed using this method. The 34 wild strains showed two to four
bands corresponding to numbers of 88-bp elements, in which the strain showing
three bands was found to be predominant. The vaccine strain also revealed three
bands.

PMID: 10471031 [PubMed - indexed for MEDLINE]

3355: Br J Dermatol. 1999 Aug;141(2):367-9.

Reactive perforating collagenosis occurring in a zosteriform distribution.

Nakanishi G, Tsunemitsu R, Akagi O.

Publication Types: 
    Case Reports
    Letter

PMID: 10469476 [PubMed - indexed for MEDLINE]

3356: J Invest Dermatol. 1999 Aug;113(2):221-3.

Comment in:
    J Invest Dermatol. 2000 Jul;115(1):131-2.

Low-intensity laser therapy is an effective treatment for recurrent herpes
simplex infection. Results from a randomized double-blind placebo-controlled
study.

Schindl A, Neumann R.

Department of Dermatology, University of Vienna Medical School, Austria.
Andreas.Schindl@akh-wien.ac.at

Recurrent infection with herpes simplex virus is a common disease. Recently,
alternative therapies have been introduced. Among those, low-intensity laser
therapy mainly used for the acceleration of wound healing and in pain therapy has
previously been shown to be of benefit in herpes zoster infections. In this study
we evaluated the influence of low-intensity laser therapy (wavelength 690 nm,
intensity: 80 mW per cm2, dose: 48 J per cm2) in 50 patients with recurrent
perioral herpes simplex infection (at least once per month for more than 6 mo) in
a randomized, double-blind placebo-controlled trial design. Patients in the laser
group received daily irradiations for 2 wk, whereas patients in the placebo group
were sham-irradiated. After completion of the laser/sham treatment, patients were
asked to return to the Department of Dermatology, University of Vienna Medical
School at the time of recurrence. All except two patients completed the study and
were monitored for 52 wk. The median recurrence-free interval in the
laser-treated group was 37.5 wk (range: 2-52 wk) and in the placebo group 3 wk
(range: 1-20 wk). This difference was found to be statistically significant (p < 
0.0001; Wilcoxon's Rank Sum Test). In conclusion, we demonstrated that a total of
10 irradiations with low-intensity laser therapy significantly lowers the
incidence of local recurrence of herpes simplex infection. Since this athermic
phototherapeutic modality represents a safe, noninvasive treatment, it might be
considered as an alternative to established therapeutic regimens in this
indication.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 10469307 [PubMed - indexed for MEDLINE]

3357: J Eur Acad Dermatol Venereol. 1999 May;12(3):280-2.

Scar sarcoidosis following herpes zoster.

Cecchi R, Giomi A.

Publication Types: 
    Case Reports
    Letter

PMID: 10461661 [PubMed - indexed for MEDLINE]

3358: Clin Exp Dermatol. 1999 Jul;24(4):327-8.

Herpes zoster in Japanese patients with systemic lupus erythematosus.

Ishikawa O, Abe M, Miyachi Y.

Department of Dermatology, Gunma University School of Medicine, Showamachi,
Maebashi, Japan. osamuish@akagi.sb.gunma-u.ac.jp

We examined retrospectively the incidence of herpes zoster among 58 Japanese
patients with systemic lupus erythematosus (SLE), 42 patients with systemic
sclerosis (SSc) and 21 patients with autoimmune bullous diseases (AIBD). The
incidence of herpes zoster was significantly higher in SLE (46.6%) than in SSc
(9.5%) or AIBD (4.7%) (P < 0.001). The rate of positive delayed-type skin test
with varicella zoster virus antigens was significantly lower in SLE than in SSc
[4/16 (25.0%) vs. 11/12 (91.7%), P < 0.001]. In addition, the positive rate of
skin test with purified protein derivatives of tuberculin was also low in SLE
patients (3/16, 18.8%). These results reconfirm the general impairment in
cellular immunity in SLE.

PMID: 10457141 [PubMed - indexed for MEDLINE]

3359: J Med Virol. 1999 Jul;58(3):286-90.

Viral gene expression in rat trigeminal ganglia following neonatal infection with
varicella-zoster virus.

Brunell PA, Ren LC, Cohen JI, Straus SE.

Ahmanson Pediatrics Center, Cedars-Sinai Medical Center, and University of
California School of Medicine, Los Angeles, USA. pbrunell@atlas.niaid.nih.gov

Newborn rats were injected intraperitoneally with uninfected human cells or cell 
infected with 56,000 pfu of varicella-zoster virus (VZV). Five to 6 weeks later, 
trigeminal ganglia were harvested and tested for VZV DNA and RNA by PCR. VZV gene
21 and 40 DNA were detected in most infected animals. Gene 21 RNA also was
detected in ganglia from most infected animals, but not gene 40 RNA, paralleling 
previous observations in latently infected human ganglia. The neonatal rat may
represent a useful new model for the study of VZV latency.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10447425 [PubMed - indexed for MEDLINE]

3360: Reg Anesth Pain Med. 1999 Jul-Aug;24(4):287-93.

Comment in:
    Reg Anesth Pain Med. 1999 Jul-Aug;24(4):283-5.

Comparative therapeutic evaluation of intrathecal versus epidural
methylprednisolone for long-term analgesia in patients with intractable
postherpetic neuralgia.

Kikuchi A, Kotani N, Sato T, Takamura K, Sakai I, Matsuki A.

Department of Anesthesiology, University of Hirosaki School of Medicine, Japan.

BACKGROUND AND OBJECTIVES The goal of this study was to evaluate the analgesic
effects of intrathecal versus epidural methylprednisolone acetate (MPA) in
patients with intractable postherpetic neuralgia (PHN). METHODS: We studied 25
patients with a duration of PHN of more than 1 year. The patients were randomly
allocated to one of two groups: an intrathecal group (n = 13) and an epidural
group (n = 12). Sixty milligrams of MPA was administered either into the
intrathecal or the epidural space four times at 1-week intervals depending on the
treatment group. Continuous and lancinating pain and allodynia were evaluated by 
a physician unaware of group assignment with a 10-cm visual analogue scale before
treatment, at the end of treatment, and 1 and 24 weeks after treatment. In
addition, cerebrospinal fluid (CSF) was obtained for measurement of interleukin
(IL)-1beta, -6, and -8 and tumor necrosis factor-alpha before and 1 week after
treatment. RESULTS: We found marked alleviation of continuous and lancinating
pain and allodynia in the intrathecal group (P < .001). The improvements were
much greater in the intrathecal group than in the epidural group at all time
points after the end of treatment (P < .005). IL-8 in the CSF decreased
significantly in the intrathecal group as compared to the epidural group at the
l-week time point (P < .01), whereas the other cytokines were undetectable.
CONCLUSIONS: Our results suggest the effectiveness of intrathecal as compared to 
epidural MPA for relieving the pain and allodynia associated with PHN. Also, our 
findings, together with the decrease in IL-8, may indicate that intrathecal MPA
improves analgesia by decreasing an ongoing inflammatory reaction in the CSF.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 10445766 [PubMed - indexed for MEDLINE]

3361: Reg Anesth Pain Med. 1999 Jul-Aug;24(4):283-5.

Comment on:
    Reg Anesth Pain Med. 1999 Jul-Aug;24(4):287-93.

Intrathecal steroid injection for postherpetic neuralgia: what are the risks?

Abram SE.

Publication Types: 
    Comment
    Editorial

PMID: 10445765 [PubMed - indexed for MEDLINE]

3362: Hinyokika Kiyo. 1999 Jun;45(6):427-9.

[Renal transplantation for patients with systemic lupus erythematosus: report of 
two cases]

[Article in Japanese]

Miyazato M, Koyama Y, Miyazato T, Kagawa H, Yonou H, Sugaya K, Hatano T, Ogawa Y.

Department of Urology, Faculty of Medicine, University of the Ryukyus.

Renal transplantation for patients with systemic lupus erythematosus (SLE)
remains controversial. We performed living-tissue related renal transplantation
on a 45-year-old woman with SLE and an eight-month history of hemodialysis. We
also did cadaveric renal transplantation on a 41-year-old man with SLE and a
12-year history of hemodialysis. Serological tests including tests for
antinuclear antibodies and complements were negative prior to surgery and
throughout the course in both cases. The latter patients survived herpes-zoster
virus infection in month 6 and bacterial pneumonia in month 9 after
transplantation. Neither patient experienced any rejection or relapse of lupus
nephritis after the procedure, and both maintained good renal allograft
functions. The recurrence of lupus nephritis is reportedly extremely rare, i.e., 
with a possibility rate of less than 1% in transplant patients with burnt-out
SLE. To the best of our knowledge, these cases are the 27th and 28th case reports
of renal transplantation for SLE patients in Japanese literature.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10442287 [PubMed - indexed for MEDLINE]

3363: Zh Nevrol Psikhiatr Im S S Korsakova. 1999;99(6):56-8.

[Postherpetic neuralgia in herpes zoster: its treatment with Zovirax]

[Article in Russian]

Dekonenko EP, Shishov AS, Kupriianova LV, Rudometov IuP, Bagrov FI.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 10441870 [PubMed - indexed for MEDLINE]

3364: J Med Virol. 1999 Sep;59(1):78-83.

Ability of yeast Ty-VLPs (virus-like particles) containing varicella-zoster virus
(VZV)gE and assembly protein fragments to induce in vitro proliferation of human 
lymphocytes from VZV immune patients.

Welsh MD, Harper DR, Garcia-Valcarcel M, Fowler WJ, Aitken C, Jeffries DJ, Layton
GT.

Department of Virology, St. Bartholomew's and the Royal London School of Medicine
and Dentistry, United Kingdom. mwelsh@alpha1.dani.gov.uk

Yeast Ty virus-like particles (VLPs) containing viral protein inserts have
previously been shown to be potent immunogens, inducing both humoral and cell
mediated immunity (CMI). The antigenicity of hybrid VLPs containing fragments of 
the varicella-zoster virus (VZV) gE protein or the assembly protein (AP) was
assessed by lymphocyte proliferation. Peripheral blood mononuclear cells (PBMCs) 
from patients with a recent natural VZV infection were stimulated in vitro with
VZV-VLPs together with control antigens. PBMC samples from both varicella (85%)
and zoster (75%) patients proliferated in responses to at least one of the gE
VZV-VLPs. As reported for the first time, VZV specific lymphocyte responses were 
also identified towards the VZV AP in two varicella and two zoster patient
samples. The results demonstrate specific CMI recognition of the VZV gE fragments
tested and the VZV AP delivered in the form of recombinant Ty-VLPs, and
highlights their potential use as a recombinant antigen delivery system for
vaccination.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 10440812 [PubMed - indexed for MEDLINE]

3365: J Am Optom Assoc. 1999 Jun;70(6):384-90.

Sarcoidosis-related anterior uveitis in a patient with human immunodeficiency
virus.

Lee AK, Chronister CL.

Eye Institute, Pennsylvania College of Optometry, Philadelphia, Pennsylvania,
USA.

BACKGROUND: This is the first ophthalmic report--to our knowledge--of an anterior
uveitis secondary to sarcoidosis in a patient infected with human
immunodeficiency virus (HIV). Other reported causes of uveitis in HIV-infected
patients have included HIV, herpes zoster, tuberculosis, syphilis, toxoplasmosis,
cryptococcus, rifabutin prophylaxis for mycobacterium, and protease inhibitors
such as ritonavir and indinavir. Uveitis secondary to sarcoidosis in the non-HIV 
population is classically seen in young, female, African-American patients. There
are rare reports, found exclusively in the pulmonary literature, of sarcoidosis
in HIV-infected patients. CASE REPORT: A 38-year-old African-American male
infected with HIV was treated for chronic recurrent anterior uveitis secondary to
sarcoidosis. His sarcoidosis was diagnosed 1 month earlier, along with the onset 
of his uveitis. During the previous 6 years he has been treated with anti-HIV
antivirals as well as prophylaxis for opportunistic infections. To date, his
infectious disease specialist continues to treat his HIV and systemic
sarcoidosis. CONCLUSION: Patients with HIV infection in whom sarcoidosis with
secondary uveitis develops are very rare. Management of these patients requires
careful use of topical and oral steroidal anti-inflammatories to control ocular
and systemic sequelae of sarcoidosis. This case initiates some interesting
questions about the immunology of sarcoidosis and its presence in
immunocompromised patients. Use of steroids in an immunocompromised patient is
clinically complex. Further clinical study is needed to elicit the full clinical 
significance of sarcoidosis and HIV infection.

Publication Types: 
    Case Reports

PMID: 10437340 [PubMed - indexed for MEDLINE]

3366: J Tradit Chin Med. 1997 Dec;17(4):282-3.

21 cases of herpes zoster treated by scratching method with three-edged needle.

Yuan F.

Department of Traditional Chinese Medicine, Guangnei Hospital, Beijing.

Publication Types: 
    Case Reports

PMID: 10437213 [PubMed - indexed for MEDLINE]

3367: J Tradit Chin Med. 1997 Dec;17(4):266-71.

Dr. Gao Lishan's experience in treating pain syndromes by acupuncture.

Cao W, Liu X.

Cangzhou Hospital of Traditional Chinese Medicine, Hebei Province.

Publication Types: 
    Case Reports

PMID: 10437208 [PubMed - indexed for MEDLINE]

3368: AIDS Care. 1999 Feb;11(1):87-93.

Prevalence of HIV infection among hospital patients in north west Tanzania.

Kwesigabo G, Killewo JZ, Sandstrom A, Winani S, Mhalu FS, Biberfeld G, Wall S.

Department of Epidemiology and Biostatistics, Muhimbili University College of
Health Sciences, Dar es Salaam, Tanzania. gkwesigabo@muchs.ac.tz

In order to estimate hospital HIV prevalence, the economic impact of AIDS on
health care and to assess the implications of HIV testing on clinical suspicion
of AIDS this hospital based study was done at the government regional hospital of
Kagera, Tanzania. Consecutive admissions were recruited into the study, and those
consenting had a blood specimen taken, one portion of which was used to aid
clinical diagnosis, while the other was tested anonymously for HIV antibodies
using two ELISA systems. A short questionnaire was used to specify demographic
characteristics, hospital ward of admission and diagnosis of each study subject. 
The overall age adjusted HIV-1 prevalence was 32.8% (N = 1422) and there was no
significant difference in the age adjusted sex specific prevalence. The highest
prevalence (53.3%) was found in the 25-34 years age group as well as in the
gynaecological and medical wards (41.2% and 40.4%, respectively). The diagnostic 
category of clinical AIDS had a sensitivity of 11.3% and a specificity of 99.3%, 
indicating that only 11.3% of the HIV seropositives would have been HIV tested on
clinical suspicion of AIDS. Similarly, the HIV-1 antibody sensitivity and
specificity for tuberculosis were 5.9% and 97.9%, respectively. Patients who were
HIV-1 infected were more likely to have a history of previous hospital
admissions, RR = 1.34 (95% CI = 1.16-1.56), and were at an increased risk of
developing tuberculosis, RR = 2.02 (95% CI = 1.50-2.70). The diagnostic
categories with the highest HIV-1 infection prevalence were clinical AIDS
(88.5%), herpes zoster and other HIV-1 skin manifestations combined (85.7%) and
pulmonary tuberculosis (58.3%). In conclusion, the prevalence of HIV-1 infection 
was high among hospitalized patients in Bukoba hospital indicating that the major
cause of illness leading to admission to the hospital may have been underlying
HIV-1 infection. The findings also indicate that in a high HIV-1 prevalence area,
testing for HIV infection on the basis of clinical suspicion of AIDS alone is not
sufficient to provide rational care to the majority of HIV infected patients.

PIP: A study was conducted to assess the prevalence of HIV infection among
patients at Bukoba regional government hospital in the Kagera region of Tanzania,
the economic impact of AIDS upon health care, and the implications of HIV testing
upon clinical suspicion of AIDS. 1471 consecutive admissions were recruited into 
the study, of whom 1422 completed questionnaires and had their blood sera tested 
for HIV antibodies. The overall age-adjusted HIV-1 prevalence among the
hospitalized patients was 32.8%, with no statistically significant difference in 
the age-adjusted, sex-specific HIV-1 prevalence rate. The highest HIV-1
prevalence of 53.3% was found among people aged 25-34 years, as well as in the
gynecological and medical wards (41.2% and 40.4%, respectively). HIV-1-infected
patients were more likely to have a history of previous hospital admissions, and 
were at an increased risk of developing tuberculosis (TB). The diagnostic
categories with the highest HIV-1 infection prevalence were clinical AIDS
(88.5%), herpes zoster and other HIV-1 skin manifestations combined (85.7%), and 
pulmonary TB (58.3%). The prevalence of HIV-1 infection was high among these
patients, indicating that the major cause of illness leading to admission to the 
hospital may have been underlying HIV-1 infection. However, since the diagnostic 
category of clinical AIDS was only 11.3% sensitive, only 11.3% of the
HIV-seropositive cases would have been HIV tested on the clinical suspicion of
AIDS. These findings indicate that in a high HIV-1 prevalence area, testing for
HIV infection on the basis of clinical suspicion of AIDS alone is insufficient to
provide rational care to the majority of HIV-infected patients.

PMID: 10434985 [PubMed - indexed for MEDLINE]

3369: Am J Otol. 1999 Jul;20(4):421-4.

Delayed facial paralysis after stapedotomy using KTP laser.

Ng M, Maceri DR.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University,
Baltimore, Maryland, USA.

OBJECTIVE: Delayed facial paralysis after stapes surgery is uncommon and has been
reported after traditional, nonlaser techniques for stapedotomy. The purpose of
this paper is to inform the reader of the potential risk of delayed facial nerve 
paralysis associated with the use of the potassium titanyl phosphate (KTP) laser 
for stapedotomy. Etiologic mechanisms are discussed. STUDY DESIGN: The study was 
a descriptive study-case report. SETTING: The study was conducted at a
university-based otologic practice. PATIENTS: Two patients with otosclerosis and 
delayed onset facial palsy 5 to 7 days after uncomplicated stapedotomy using the 
KTP laser were included in the study. INTERVENTION: Potassium titanyl phosphate
laser stapedotomy was performed. Patients received treatment of facial palsy with
a tapering course of oral steroids. MAIN OUTCOME MEASURE: House-Brackmann facial 
nerve grade scores were used. RESULTS: Improvement of House-Brackmann facial
nerve scores from Grade VI to Grade I-II in one patient, and improvement from
Grade IV to Grade I-II in the other was seen. CONCLUSION: The probable etiology
of delayed facial palsy is viral neuritis from reactivation of dormant virus
within the facial nerve, initiated by thermal stress of the KTP laser.
Presentation and resolution of the facial palsy is similar to other types of
delayed facial palsy resulting from nonlaser techniques of stapes surgery and
other types of middle ear and neurotologic surgeries previously reported.

Publication Types: 
    Case Reports

PMID: 10431880 [PubMed - indexed for MEDLINE]

3370: J Am Acad Dermatol. 1999 Aug;41(2 Pt 2):309-11.

Shingles developing within recent surgical scars.

Nikkels AF, Pierard GE.

Department of Dermatopatholgy, University Medical Center of Liege, Belgium.

Occurrence of varicella and recurrence of herpes simplex on traumatized sites of 
the skin are well-described events. By contrast, herpes zoster occurring
specifically at the site of previously injured skin has not yet been reported.
Two patients are presented who developed shingles limited to skin on and around
recent surgical scars. Varicella zoster virus was identified using
immunohistochemistry on skin biopsy specimens and Tzanck smears. We suspect that 
the occurrence of herpes zoster involving surgical scars is usually misdiagnosed 
and therefore unrecognized. Whether shingles adjacent to scars represents a
coincidental event or is specifically triggered by local injury is unknown.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10426916 [PubMed - indexed for MEDLINE]

3371: No To Shinkei. 1999 Jun;51(6):529-33.

[A case of delayed cerebral infarction occurring in puerperium preceded by herpes
zoster ophthalmicus in late pregnancy]

[Article in Japanese]

Hoshino S, Hayashi A, Yoshizawa T, Tamaoka A, Shoji S.

Department of Neurology, University of Tsukuba, Japan.

Delayed central neurological symptoms following herpes zoster ophthalmicus (HZO) 
such as "herpes zoster ophthalmicus and delayed contralateral hemiparesis" are
considered to be due to ipsilateral intracranial vasculopathy. We experienced a
rare case with cerebral infarction occurred in puerperium following HZO in late
pregnancy. A healthy 30-year-old woman had left HZO at weeks 35 of gestation. She
was given acyclovir (ACV) for external use and improved with small pigmentation
on the left eye-lid. Seven weeks after the onset of HZO, she suddenly developed
aphasia and right hemiparesis. Cerebral angiogram showed narrowing on M 1 segment
of the ipsilateral middle cerebral artery. The occlusion was seen on peripheral
portion of the angular artery on the same side. In cerebrospinal fluid (CSF),
cell count was slightly elevated, but concentration of protein and sugar were
normal. Varicella-zoster titer was increased in both serum and CSF. She was
treated with intravenous ACV (1500 mg/day) for 10 days. On the next day after the
treatment, the cell count was normalized and on 18th day, varicella-zoster titer 
was decreased in CSF. Higher brain function improved and no relapses occurred.
This is a first case of delayed cerebral infarction occurring in puerperium
preceded by herpes zoster ophthalmicus in late pregnancy, as far as we searched. 
We should treat carefully pregnant or lactating patients with HZO, considering
delayed cerebral infarction.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10423756 [PubMed - indexed for MEDLINE]

3372: Pathol Biol (Paris). 1999 May;47(5):570-2.

[Secondary prophylaxis for herpes zoster wi oral acyclovir in HIV patients]

[Article in French]

Leautez S, Bani-Sadr F, Billaud E, Raffi F.

Service de Medecine Interne B, CHU Hotel-Dieu, Nantes, France.

We studied 39 AIDS patients from 1989 to 1996, with previous history of herpes
zoster. Twelve of them received acyclovir (ACV) secondary prophylaxis. There were
31 males and 8 females, mean age 33.9 years (19-60) during first herpes zoster.
Transmission was sexual in 71.8%. Among these 39 patients, 78 herpes zoster
episodes occurred. Median CD4 lymphocytes was 18/mm3 (0-232) among the 12
patients with ACV prophylaxis. Mean posology of ACV was 2,400 mg (1,600-4,000)
per day, during mean 10 months (median 4 months). ACV prophylaxis was used
because of high frequence of herpes zoster (more than 4) (4 cases), neurologic
complications in 4 cases (1 myelitis, 1 myeloradiculitis, 1 vascularitis and 1
meningo-encephalitis), disseminated herpes zoster in 4 cases and one hyperalgic
zoster. Ten from these 12 patients occurred no zoster recurrence. Among patients 
without prophylaxis, zoster recurrences were more frequent at 12 months (68%
versus 22% among patients with prophylaxis). This prophylaxis seems to be
interesting, particularly in deep immunocompromised patients (CD4 < 50/mm3) with 
serious herpes zoster or frequent recurrences (more than 4). However, since
protease inhibitors treatments, zoster incidence is decreasing in HIV+ patients. 
This prophylaxis will probably be less usefull than before.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    English Abstract

PMID: 10418043 [PubMed - indexed for MEDLINE]

3373: Pathol Biol (Paris). 1999 May;47(5):526-30.

[Prenatal diagnosis of viral infections. A two year study in Strasbourg]

[Article in French]

Labouret N, Cecille A, Wendling MJ, Fritsch S, Gut JP, Stoll-Keller F.

Institut de Virologie de la Faculte de Medecine, Hopitaux Universitaires de
Strasbourg, France.

We report here the results of a 2-year study on the prenatal diagnosis of viral
infections in Strasbourg. This screening was carried out by virus isolation, by
PCR assay, or by detection of IgM fetal antibody for 98 pregnant women at risk of
transmitting one of the viruses that causes fetal disease such as parvovirus B19 
(B19), Herpesviruses [cytomegalovirus (CMV), varicella-zoster virus, herpes
simplex virus] and rubella virus. A viral etiology was proven in 7 out 98 cases: 
PCR applied to B19 DNA detection was positive in 5 amniotic fluids (AF), 2 fetal 
serums and one ascitic liquid. The diagnosis of 2 cases of CMV infection was
obtained by both PCR and virus isolation in AF from twins fetuses. The detection 
of specific IgM in maternal serum or fetal serum is useful to achieve the
diagnosis but serological tests on other samples have no efficiency. No virus was
found in any other specimen, but the genome of Toxoplasma gondii was detected by 
PCR in 1 of 17 AF samples analyzed at the Institut de Parasitologie. These
findings show that PCR assay is a sensitive method for the positive diagnosis of 
intrauterine infection and promises to careful follow-up of the pregnancy.

Publication Types: 
    English Abstract

PMID: 10418033 [PubMed - indexed for MEDLINE]

3374: Bone Marrow Transplant. 1999 Jun;23(12):1317-20.

Herpes zoster ophthalmicus following bone marrow transplantation in children.

Walton RC, Reed KL.

Department of Ophthalmology, University of Tennessee College of Medicine, St Jude
Children's Research Hospital, Memphis 38163, USA.

Varicella zoster virus (VZV) infection is a frequent complication following bone 
marrow transplantation (BMT). Involvement of the ophthalmic division of the
trigeminal nerve, herpes zoster ophthalmicus (HZO), can result in significant and
potentially vision-threatening ocular complications. We report the frequency and 
characteristics of HZO following BMT, including the timing of infection,
treatment, ocular complications, and visual outcome. Between 1983 and 1997, 572
patients underwent BMT and seven children developed HZO at a median of 150 days
following transplantation. All but one of the children had undergone allogeneic
BMT. All of the children were treated with acyclovir after onset of the rash but 
none had received prophylactic therapy. All seven children developed ocular
complications within the first 4 weeks following the onset of the dermatomal rash
but none reported any symptoms during this period. Complications included
keratitis in six, anterior uveitis in three and scleritis in one. Keratitis was
an early complication developing within the first 4 weeks, while anterior uveitis
and scleritis occurred later in the course of the disease. The high frequency of 
ocular complications and lack of symptoms in children with HZO following BMT
suggests that early ophthalmologic evaluation is warranted in this group of
patients. Prompt diagnosis and treatment of ocular complications is essential in 
the prevention of acute and long-term ocular sequelae in these children.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10414922 [PubMed - indexed for MEDLINE]

3375: JAMA. 1999 Jul 14;282(2):134-5.

Comment on:
    JAMA. 1998 Dec 2;280(21):1837-42.

Gabapentin for postherpetic neuralgia.

Colman E, Stadel BV.

Publication Types: 
    Comment
    Letter

PMID: 10411191 [PubMed - indexed for MEDLINE]

3376: J Am Acad Dermatol. 1999 Jul;41(1):119-21.

Acute varicella zoster with postherpetic hyperhidrosis as the initial
presentation of HIV infection.

Chopra KF, Evans T, Severson J, Tyring SK.

Department of Dermatology, College of Physicians and Surgeons of Columbia
University, New York, New York, USA.

A 31-year-old man presented with acute pain in his left arm and hemorrhagic
vesicles that followed his left 8th cervical nerve. A diagnosis of herpes zoster 
was made, and the patient was treated with valacyclovir. He refused testing for
antibodies to HIV because he denied being at risk. Two months later he returned
with postherpetic neuralgia and postherpetic hyperhidrosis in the distribution of
the vesicles, which had since resolved. Serology for HIV at this visit was
positive, and the patient admitted to having sexual relations with prostitutes.
Six months later the patient was being treated with triple antiretroviral
therapy, and all signs and symptoms of postherpetic zoster had resolved. This
case report documents the need for HIV testing in patients with unusual
presentations of herpes zoster even if they initially deny being at risk.

Publication Types: 
    Case Reports

PMID: 10411424 [PubMed - indexed for MEDLINE]

3377: J Am Acad Dermatol. 1999 Jul;41(1):1-14; quiz 15-6.

Varicella zoster virus.

McCrary ML, Severson J, Tyring SK.

Section of Dermatology, Medical College of Georgia, Augusta, USA.

Because of its ability to produce two clinically distinct disease entities
(chickenpox and shingles), varicella zoster virus (VZV) is an unusual etiologic
agent. Although in the past viral exanthems were mostly only of academic interest
to the practitioner, the development of antiviral agents and the newly approved
varicella (OKA) vaccine have increased the clinical significance. Also, with the 
increasing seroprevalence of HIV infection, more patients will be stricken with
zoster (at a younger age) and disseminated varicella. In this review, the
history, incidence, pathogenesis, clinical manifestations, and treatment options 
(of VZV infection and postherpetic neuralgia) will be discussed.

Publication Types: 
    Review

PMID: 10411403 [PubMed - indexed for MEDLINE]

3378: Nippon Ganka Gakkai Zasshi. 1999 Jun;103(6):477-81.

Comment on:
    Nippon Ganka Gakkai Zasshi. 1999 Jun;103(6):413-4.

[Acute retinal necrosis with varicella zoster dermatitis in the fellow eyelid]

[Article in Japanese]

Nakanishi F, Takahashi H, Ibaraki N, Ohara K.

Department of Ophthalmology, Nippon Medical School, Tokyo, Japan.

BACKGROUND: We report a case of acute retinal necrosis with contralateral
varicella zoster dermatitis. CASE: The patient, a 61-year-old man, developed
acute retinal necrosis in the right eye 1 month after varicella zoster dermatitis
in the left eyelid. PROGRESS: Intravenous acyclovir, corticosteroids, and laser
photocoagulation were effective without any surgical treatment. CONCLUSION: We
suggest that ophthalmoscopic examination of both eyes is needed in cases with
varicella zoster dermatitis.

Publication Types: 
    Case Reports
    Comment
    English Abstract

PMID: 10410561 [PubMed - indexed for MEDLINE]

3379: Nippon Ganka Gakkai Zasshi. 1999 Jun;103(6):442-8.

Comment in:
    Nippon Ganka Gakkai Zasshi. 1999 Jun;103(6):413-4.

[Cerebrospinal fluid analysis in Kirisawa-Urayama type uveitis]

[Article in Japanese]

Iizuka Y, Abe T, Sasagawa T, Abe H.

Department of Ophthalmology, Niigata University School of Medicine, Japan.

PURPOSE: We investigated whether viral encephalitis could occur in patients with 
Kirisawa-Urayama type uveitis by analysing the cerebrospinal fluid (CSF).
METHODS: CSF samples were aspirated from nine patients with Kirisawa-Urayama type
uveitis and assayed for local antibody production and the presence of herpesvirus
DNA. RESULTS: Seven cases had mild CSF pleocytosis. In six of seven cases who
underwent CSF antibody analysis, we found intrathecal antibody production against
herpes simplex virus or varicella-zoster virus which were the causative viruses
diagnosed from intraocular fluid in each patients. Polymerase chain reaction
(PCR) assay was used to search for virus DNA in the CSF of six patients, but all 
were negative. CONCLUSIONS: The results of this study suggest that
Kirisawa-Urayama type uveitis is often accompanied with optic nerve involvement
and intrathecal antibody production against causative viruses, but we could not
find any viral encephalitis.

Publication Types: 
    English Abstract

PMID: 10410556 [PubMed - indexed for MEDLINE]

3380: Collegian. 1999 Apr;6(2):38-9.

Varicella zoster virus.

Leaver M.

Publication Types: 
    Review

PMID: 10409973 [PubMed - indexed for MEDLINE]

3381: Neurology. 1999 Jul 13;53(1):242.

Comment on:
    Neurology. 1998 Sep;51(3):914-5.

Varicella zoster virus-associated focal vasculitis without herpes zoster.

Rosenblum WI.

Publication Types: 
    Comment
    Letter

PMID: 10408580 [PubMed - indexed for MEDLINE]

3382: Ophthalmology. 1999 Jul;106(7):1328-33.

Scleritis: a clinicopathologic study of 55 cases.

Riono WP, Hidayat AA, Rao NA.

A.R. Irvine Ocular Pathology Laboratories of the Doheny Eye Institute and the
Department of Ophthalmology, University of Southern California School of
Medicine, Los Angeles 90033, USA.

OBJECTIVE: By a clinicopathologic study, to evaluate the histopathologic features
associated with various causes of scleritis. DESIGN: Retrospective observational 
case series. PARTICIPANTS: Enucleated globes or biopsy specimens obtained from 55
cases of clinically diagnosed necrotizing scleritis. METHODS: On the basis of
their histologic appearance, these cases were divided into four morphologic
groups: (1) zonal necrotizing granulomatous scleral inflammation; (2) nonzonal
diffuse scleral inflammation, with or without granulomatous process; (3)
necrotizing inflammation with microabscesses, with or without evidence of
micro-organisms in the section studied; and (4) sarcoidal granulomatous
inflammation. The clinical charts were reviewed for the presence of any
associated disease. RESULTS: There were 14 (25.4%) cases in the first group; 12
had clinical evidence of systemic autoimmune diseases, including 8 cases of
rheumatoid arthritis and 1 each of polychondritis, Goodpasture syndrome, Wegener 
granulomatosis, and collagen vascular disease; of the remaining 2 cases, 1
patient had a history of herpes zoster ophthalmicus, and the other had no history
of any systemic autoimmune or infectious disease. None of the 19 (34.5%) patients
characteristic of group 2 had any history of systemic autoimmune or infectious
disease. Eleven of the 21 (38.2%) patients in group 3 had infections, including
Pseudomonas spp., gram-positive cocci, Haemophilus spp., Actinomyces spp., and
fungi; in the 10 remaining cases, no micro-organisms could be detected. The one
case in group 4 was diagnosed as sarcoidosis. CONCLUSIONS: On the basis of their 
histologic features, rheumatoid scleritis and related systemic
autoimmune-mediated necrotizing scleral inflammations could be differentiated
from either idiopathic or infectious scleritis; however, the histologic features 
of rheumatoid scleritis were similar to those of necrotizing scleritis associated
with other systemic autoimmune diseases.

PMID: 10406616 [PubMed - indexed for MEDLINE]

3383: Clin Radiol. 1999 Jun;54(6):390-7.

CT and MRI manifestations of central nervous system infection following
allogeneic bone marrow transplantation.

Coley SC, Jager HR, Szydlo RM, Goldman JM.

Department of Imaging, Imperial College School of Medicine, Hammersmith Hospital,
London, UK.

AIM: To determine the frequency, microbiological diversity and radiological
patterns of central nervous system (CNS) infection following allogeneic bone
marrow transplantation (BMT). PATIENTS AND METHODS: Two neuroradiologists
retrospectively reviewed the computed tomography (CT) and magnetic resonance
imaging (MRI) examinations of a large cohort of bone marrow recipients. The
radiological findings were correlated with clinical, microbiological and
pathological data. RESULTS: During an 8-year period 406 patients underwent
allogeneic BMT; a total of 11 infections of the CNS were diagnosed in nine
patients [sino-orbital aspergillosis (3), cerebral aspergillosis (2), pseudomonas
(1), listeria (1), human herpes virus-6 (1), herpes zoster (1), toxoplasmosis (1)
and progressive multifocal leucoencephalopathy (1)]. The radiological
abnormalities could be divided into one or more of the following pathological
entities: (i) focal lesions, (ii) invasive sinusitis, (iii) cerebral infarction, 
(iv) demyelination, (v) encephalitis and (vi) meningitis/hydrocephalus.
CONCLUSIONS: Approximately 2% of bone marrow recipients developed an infection of
the CNS. The spectrum of infection changed over time and was related to
predictable deficits in host immunity. The radiological appearances were diverse 
and corresponded to several different pathological processes.

PMID: 10406341 [PubMed - indexed for MEDLINE]

3384: Mayo Clin Proc. 1999 Jul;74(7):658-60.

Dermatologic manifestations in HIV-infected patients: a primary care perspective.

Samet JH, Muz P, Cabral P, Jhamb K, Suwanchinda A, Freedberg KA.

Section of General Internal Medicine Research Unit, Boston Medical Center, MA
02118, USA.

OBJECTIVE: To document the prevalence of dermatologic manifestations in patients 
infected with the human immunodeficiency virus (HIV) on presentation to primary
medical care. DESIGN: Prospective consecutive case series evaluated between June 
and November 1995. SETTING: The HIV intake clinic at an urban hospital. SUBJECTS 
AND METHODS: Ninety-five individuals initiating HIV-related primary care.
RESULTS: Dermatologic manifestations were found in 82 patients (86%). The most
common conditions were dermatophytosis in 32 patients (34%), oral hairy
leukoplakia in 22 (23%), and folliculitis in 18 (19%). Well-described
HIV-associated dermatologic manifestations such as Kaposi sarcoma, herpes zoster,
and psoriasis were uncommon. CONCLUSIONS: The high prevalence of treatable skin
disorders found in HIV-infected patients underscores the importance of careful
and complete skin examination as a fundamental aspect of the initial clinical
evaluation in this population.

PMID: 10405693 [PubMed - indexed for MEDLINE]

3385: Trop Med Int Health. 1999 May;4(5):349-54.

The burden of mucocutaneous conditions and the association with HIV-1 infection
in a rural community in Uganda.

Mayanja B, Morgan D, Ross A, Whitworth J.

Medical Research Council Programme on AIDS, Uganda Virus Research Institute,
Entebbe, Uganda.

OBJECTIVE: To determine the prevalence of mucocutaneous conditions and their
association with HIV-1 infection in a rural community in Uganda. METHODS: In a
prospective cohort study, participants were recruited from a large population
study and invited to attend a clinic every 3 months for a detailed medical
interview and a thorough physical examination. All findings including
mucocutaneous findings were coded onto a standard questionnaire. RESULTS: By the 
end of 1996, 436 participants had provided 1450 person years of observation
(pyo); 646 pyo in HIV-positives and 804 pyo in HIV-negatives. Overall, 70% of
participants had a skin condition during follow-up, and although skin conditions 
were significantly more common in HIV-positive subjects, the background level in 
HIV-negative subjects was high (77.3% and 63.6%, respectively). Herpes zoster,
thin/sparse hair, maculo-papular rash and prurigo were significantly more common 
in the HIV-positives. Kaposi sarcoma, palmar/plantar rash and herpes zoster had
positive predictive values for HIV infection of over 80%. Oral conditions were
found in over 40% of participants and were significantly more common in
HIV-positive subjects. Oral candidiasis and Kaposi sarcoma were significantly
more frequent among HIV-positives. CONCLUSION: HIV infection increases the
already high burden of mucocutaneous diseases in this rural population. We
identified some conditions that are more common in HIV and others that can be
used as indicators of HIV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10402970 [PubMed - indexed for MEDLINE]

3386: Acta Anaesthesiol Sin. 1998 Dec;36(4):235-9.

Patient-controlled epidural analgesia for postherpetic neuralgia in an
HIV-infected patient as a therapeutic ambulatory modality.

Kang FC, Chang PJ, Chen HP, Tsai YC.

Department of Anesthesiology, National Cheng Kung University, College of
Medicine, Tainan, Taiwan, R.O.C.

A 43-year-old HIV-positive male was referred to our pain clinic one month after
his fourth attack of herpes zoster infection. He complained of intermittent
intolerable sharp and lancinating pain accompanied by numbness over the inner
aspect of the left upper extremity, left anterior chest wall and the back.
Physical examination revealed allodynia over the left T1 and T2 dermatomes
without any obvious skin lesion. The pain was treated with epidural block made
possible by a retention epidural catheter placed via the T2-3 interspace. After
the administration of 8 ml of 1% lidocaine in divided doses, the pain was
completely relieved for 4 h without significant change of blood pressure or heart
rate. A pump (Baxter API) for patient-controlled analgesia (PCA) filled with
0.08% bupivacaine was connected to the epidural catheter on the next day and
programmed at a basal rate of 2 ml/h, PCA dose 2 ml, lockout interval 15 min,
with an one-hour dose limit of 8 ml. He was instructed to report his condition by
telephone every weekday. The pump was refilled with drug and the wound of
catheter entry was checked and managed every 3 or 4 days. The epidural catheter
was replaced every week. During treatment, the pain intensity was controlled in
the range from 10 to 0-2 on the visual analogue scale. He was very satisfied with
the treatment and reported only slight hypoesthesia over the left upper extremity
in the early treatment period. Epidural PCA was discontinued after 28 days. He
did not complain of pain thereafter but reported a slight numb sensation still
over the lesion site for a period of time. In conclusion, postherpetic neuralgia 
in an HIV-infected man was successfully treated with ambulatory therapeutic
modality of epidural PCA for 28 days.

Publication Types: 
    Case Reports

PMID: 10399520 [PubMed - indexed for MEDLINE]

3387: Immunol Rev. 1999 Apr;168:143-56.

Varicella-zoster virus immune evasion.

Abendroth A, Arvin A.

Stanford University School of Medicine, California 94305-5208, USA.

CD4+ and CD8+ T cells play dual roles in varicella-zoster virus (VZV)
pathogenesis. The first role is to deliver the virus to cutaneous sites during
primary VZV infection, permitting replication at these sites and the successful
transmission of the virus to other susceptible individuals. The second
contribution of T cells is to provide the critical antigen-specific adaptive
immunity needed to stop viral replication and maintain VZV latency in sensory
ganglia. The equilibrium between VZV and the host can be predicted to be served
by immune evasion mechanisms in at least two important ways, including the
facilitation of cell-associated viremia during primary VZV infection and silent
persistence in dorsal root ganglia. Interference with antigen presentation by MHC
class I downregulation may be expected to play a role in both circumstances.
Transient interference with MHC class II expression in varicella skin lesions
should facilitate local replication and transmission. In addition, when VZV
reactivates, the capacity of viral gene products to block the upregulation of MHC
class II expression triggered by interferon-gamma should permit a sufficient
period of viral replication to cause the lesions of herpes zoster, despite the
presence of VZV-specific T cells, and to allow transmission of the virus to
susceptible individuals. Although the effort is at an early stage compared to
studies of other viral pathogens, identifying the VZV gene products that exert
these effects and their mechanisms of interference has the potential to reveal
novel aspects of MHC class I and class II antigen processing and presentation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10399071 [PubMed - indexed for MEDLINE]

3388: Rev Med Virol. 1998 Oct;8(4):187-201.

Virus infections of the eye.

Ritterband DC, Friedberg DN.

New York Medical College, New York Eye and Ear Infirmary.

In reviewing the clinical features, diagnostic evaluations and therapies of the
most common ocular viral infections we attempt to whet your appetite for
attacking the numerous challenges in diagnosis and treatment of viral eye
disease. The herpes viruses, HSV, VZV and CMV are the cause of significant ocular
morbidity. HSV most commonly affects the cornea producing keratitis that can be
recurrent and may lead to corneal clouding and neovascularisation. Manifestations
can be purely infectious or immunological and treatment options must be tailored 
to the underlying pathophysiology. Herpes zoster ophthalmicus, caused by VZV
infection of the first branch of the trigeminal nerve, produces a characteristic 
rash and can progress to keratitis and uveitis. HSV and VZV can cause retinitis
in both immunocompetent and immunocompromised individuals. There has been a
significant increase in the incidence of CMV retinitis since the beginning of the
AIDS epidemic. We review the numerous new treatments, diagnostic tests and
treatment strategies which have been developed in response to this potentially
blinding retinal infection. Adenovirus produces an epidemic conjunctivitis and
epidemic keratoconjunctivitis which are severe and extremely contagious
conjunctival infections. HIV, molluscum contagiosum, EBV and rubeola also cause
ocular diseases which are described.Copyright 1998 John Wiley & Sons, Ltd.

PMID: 10398508 [PubMed - as supplied by publisher]

3389: Rev Med Virol. 1997 Sep;7(3):131-143.

The pathology of Herpes Zoster and its bearing on sensory localisation.

Head H, Campbell AW, Kennedy PG.

Department of Neurology, Institute of Neurological Sciences, Southern General
Hospital, Glasgow G51 4TF, UK.

PMID: 10398478 [PubMed - as supplied by publisher]

3390: Rinsho Shinkeigaku. 1999 Apr;39(4):475-7.

[A case of Ramsay Hunt syndrome associated with local meningitis, multiple
cranial neuropathy, and the second cervical nerve involvement]

[Article in Japanese]

Nagano K, Yoshimura K, Yamasaki M.

Department of Neurology, Chikamori Hospital, Kochi, Japan.

A 76-year-old man with herpetic vesicle in the right auricle developed
ipsilateral 5th, 6th, 7th, and 8th cranial nerves involvement and pain in the
dermatome of the second cervical nerve. The CSF study revealed elevated opening
pressure up to 220 mmH2O, and pleocytosis up to 151 cells/mm3. Ninety-nine
percent of the CSF cells were mononuclear cells. CSF protein was 47 mg/dl, and
CSF glucose was 62 mg/dl. On the 24th hospital day the CSF cells decreased to
13/mm3 with 100% mononuclear cells. Titer of varicella-zoster virus (VZV)
antibody was significantly elevated in CSF. Brain MRI and ABR demonstrated no
abnormality. Although disorders of 5th and 6th cranial nerves and second cervical
nerve improved, mild facial nerve palsy lasted and hearing disturbance showed no 
recovery. There are only seven cases of Ramsay Hunt syndrome associated with
external ophthalmoplegia in the literature. However, un like the present case,
none of these cases presented disorders of upper cervical nerves. In this case,
we speculate that spreading of reactivated VZV caused local meningitis and
multiple cranial nerve involvement as well as the second cervical nerve.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 10391978 [PubMed - indexed for MEDLINE]

3391: Otolaryngol Head Neck Surg. 1999 Jul;121(1):130-2.

Viral cochleitis with gadolinium enhancement of the cochlea on magnetic resonance
imaging scan.

Fitzgerald DC, Mark AS.

Department of Otolaryngology Head and Neck Surgery, Washington Hospital Center,
DC 20010, USA.

Publication Types: 
    Case Reports

PMID: 10388895 [PubMed - indexed for MEDLINE]

3392: J Pain Symptom Manage. 1999 Jun;17(6):410-7.

A mixed model for factors predictive of pain in AIDS patients with herpes zoster.

Harrison RA, Soong S, Weiss HL, Gnann JW Jr, Whitley RJ.

Biostatistics Unit, University of Alabama at Birmingham 35294-3300, USA.

A unifying model of herpes zoster pain presents considerable analytical
challenges due to the requirement for prospective data collection and the varying
rates of pain resolution reported by individual patients. Demographic, clinical, 
and quality-of-life measures were collected on 166 human immunodeficiency virus
(HIV)-infected patients enrolled in a randomized, controlled trial of antiviral
therapy of herpes zoster comparing acyclovir with sorivudine. A "mixed model" was
used to assess factors predictive of pain severity, activity impairment, and
sleep interruption. The average rate of change in acute pain was -0.04 unit pain 
per day for the first month. Chronic pain decreased -0.12 per month for months
1-12. Acute pain severity was positively correlated with number of new skin
vesicles, analgesic use, and baseline pain, and negatively related to percentage 
of lesion healing and crusting. Postherpetic neuralgia was correlated with
baseline pain, pain at 1 month, and duration of lesions. Treatment group, gender,
race, and CD4 count were not related to change in pain severity. These analyses
verify the significance of baseline pain as a significant predictor of pain
resolution and average pain severity as a predictor of return to normal daily
activities and sleep. The severity of acute pain at presentation and at 1 month
are significant predictors of chronic pain.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 10388246 [PubMed - indexed for MEDLINE]

3393: Acta Derm Venereol. 1999 May;79(3):191-4.

Suction blister formation in skin after acute and repeated mast cell
degranulation.

Kaminska R, Naukkarinen A, Horsmanheimo M, Harvima IT.

Department of Dermatology, Kuopio University Hospital, Finland.

Mast cells and their proteases are thought to participate in the development of
skin blisters in various pathological conditions. In this study, suction
blistering was used as an experimental model to evaluate the significance of mast
cells in blister formation after pre-treatment of normal skin with intradermal
injections of 100 microg/ml compound 48/80 (a mast cell degranulator) or with
0.1% capsaicin cream. Tryptic and chymotryptic enzyme activities in blister
fluids were measured with sensitive p-nitroanilide substrates. Repeated
injections of compound 48/80 once a day on 3 or 5 consecutive days or capsaicin
applications 3 times a day for 7 or 10 days were used to induce mast cell
degranulation and inflammation in normal skin. Both treatments ultimately led to 
decreased wheal and erythema reactions before suction blistering, but neither
treatment affected the size or formation rate of suction blisters. No suction
blister fluids had detectable levels of chymotryptic activity, but blister fluids
from bullous pemphigoid, herpes zoster and insect bullous eruption, used as the
control, revealed clear chymotryptic activity. In addition, tryptic activity in
suction blister fluids was not significantly altered after compound 48/80 and
capsaicin pre-treatments. However, if the wheal reaction was induced immediately 
before suction blistering, a significantly increased rate in blister formation
together with increased tryptic activity was found, but, unexpectedly, no
chymotryptic activity could be detected in blister fluids. The results show that 
repeated mast cell degranulation in normal skin has no effect on the formation
rate of suction blisters, which developed more rapidly on acutely whealing skin. 
This is probably due to skin oedema rather than mast cell proteases, since no
chymotryptic activity was detected in suction blisters where tryptic activity
exhibited high individual variation.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 10384914 [PubMed - indexed for MEDLINE]

3394: Clin J Pain. 1999 Jun;15(2):78-84.

Comment in:
    Clin J Pain. 1999 Jun;15(2):75-6.

Pain and somatosensory dysfunction in acute herpes zoster.

Haanpaa M, Laippala P, Nurmikko T.

Department of Neurology, Tampere University Hospital, Finland.

OBJECTIVE: To determine the nature of sensory change and its association with
pain and allodynia in acute herpes zoster. DESIGN: Prospective clinical study.
PATIENTS: One hundred thirteen immunocompetent patients with acute herpes zoster.
METHODS: Onset, intensity, and quality of pain and severity of rash were
recorded. Quantitative somatosensory testing for tactile and thermal thresholds, 
qualitative pinprick testing, and testing of dynamic and static allodynia were
performed within the affected dermatome, its mirror-image dermatome, and in an
adjacent dermatome bilaterally. RESULTS: Acute pain was reported as severe in
50%, moderate in 29%, mild in 12%, and absent in 9% of patients. Preherpetic pain
(median = 4 days, range = 1-60 days) was experienced by 71%. Mechanical
allodynia, dynamic, static, or both, was found in 37% of patients and was noted
to extend one or more dermatomes outside the rash in 12%. In the affected
dermatomes, thresholds were elevated for warmth and cold, lowered for heat pain, 
and unchanged for touch when compared with the contralateral side. Logistic
regression analyses showed that compression-evoked allodynia, brush-evoked
allodynia, and the history of preherpetic pain were more frequently encountered
in patients with severe pain. Sensory threshold changes were not associated with 
the severity of pain or rash or with the presence of allodynia. CONCLUSION: Pain,
allodynia, and altered sensation are common features of acute herpes zoster. They
are likely to result primarily from widespread neural inflammation within the
affected afferent system. The sensory changes found in acute herpes zoster are
different from those reported in published studies on postherpetic neuralgia and 
suggest sensitization phenomena and preservation of tactile functions rather than
major neural damage. The exact mechanisms for acute herpes zoster pain, however, 
remain speculative.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10382920 [PubMed - indexed for MEDLINE]

3395: West J Med. 1999 May;170(5):263.

Comment in:
    West J Med. 2000 Jan;172(1):10.

Is herpes zoster unilateral?

Usatine RP, Clemente C.

University of California, Los Angeles, USA. rusatine@ucla.edu

Publication Types: 
    Case Reports

PMID: 10379216 [PubMed - indexed for MEDLINE]

3396: Johns Hopkins Med Lett Health After 50. 1999 Jul;11(5):4-5.

New solutions for persistent nerve pain.

[No authors listed]

Publication Types: 
    Review

PMID: 10377909 [PubMed - indexed for MEDLINE]

3397: Ann Intern Med. 1999 Jun 1;130(11):922-32.

Recent advances in varicella-zoster virus infection.

Cohen JI, Brunell PA, Straus SE, Krause PR.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, National Institutes of Health,
Bethesda, MD 20892-1888, USA.

Varicella-zoster virus has developed a complex strategy that allows it to remain 
latent in the body and avoid destruction by the immune system. Although varicella
and zoster have been recognized since antiquity, several new clinical
syndromes--including chronic chickenpox with persistent verrucous lesions and
disseminated varicella without skin lesions--have been noted in patients with
AIDS. Acyclovir has been the mainstay for treating severe varicella-zoster virus 
infections; however, newer antiviral agents, including valacyclovir and
famciclovir, have expanded therapeutic options for treating adults with herpes
zoster. The recently licensed live attenuated vaccine for varicella-zoster virus 
is effective in preventing chickenpox, and the vaccine's ability to stimulate
immunity in seropositive adults suggests a promising strategy with which to
modify the course of herpes zoster.

Publication Types: 
    Congresses
    Review

PMID: 10375341 [PubMed - indexed for MEDLINE]

3398: MMWR Morb Mortal Wkly Rep. 1999 May 14;48(18):379-81.

Varicella-related deaths--Florida, 1998.

Centers for Disease Control and Prevention (CDC).

During 1998, the Florida Department of Health (FDH) reported to CDC six fatal
cases of varicella (chickenpox). FDH investigated all death certificates for 1998
with any mention of varicella as a contributory or underlying cause. Eight deaths
were identified; two were reclassified as disseminated herpes zoster and six were
related to varicella, for an annual varicella death rate of 0.4 deaths per
million population. Two deaths occurred in children and four in adults; none had 
received varicella vaccine. The infection source was identified for three cases; 
two adults acquired varicella from children in the home, and one child acquired
varicella from a classmate. One infection source was known to be unvaccinated;
the other two were presumed to be unvaccinated. This report summarizes these
varicella deaths and recommends prevention strategies.

Publication Types: 
    Case Reports

PMID: 10369579 [PubMed - indexed for MEDLINE]

3399: Virology. 1999 Jun 5;258(2):451-4.

Latent Varicella-zoster virus in human dorsal root ganglia.

Kennedy PG, Grinfeld E, Gow JW.

Institute of Neurological Sciences, Southern General Hospital NHS Trust, Glasgow,
G51 4TF, Scotland, United Kingdom. P.G.Kennedy@clinmed.gla.ac.uk

To understand further the molecular events underlying the process of
Varicella-zoster virus (VZV) latency in human ganglionic tissues, in situ
hybridisation (ISH) for VZV RNA and DNA, and PCR in situ amplification for VZV
DNA were used in human dorsal root ganglia from 12 individuals (3 normal and 9
who had died with AIDS). The results showed that (a) two separate regions of the 
VZV genome, represented by genes 4 and 40, were detected in neurons in two normal
and three AIDS ganglia, (b) evidence of transcription of VZV genes 4, 21, 29, and
63 was found in normal and AIDS cases, and (c) VZV DNA and RNA for the same gene 
(gene 29) was detected in neurons in serial tissue sections in three cases. Thus 
more than one region of the VZV genome is present in neurons during VZV
ganglionic latency, and the presence of both a VZV gene and its corresponding RNA
transcript can be shown to occur in the same localised region of DRG tissue.
Copyright 1999 Academic Press.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10366583 [PubMed - indexed for MEDLINE]

3400: J Am Acad Dermatol. 1999 Jun;40(6 Pt 1):938-48.

Nongenital dermatologic disease in HIV-infected women.

Barton JC, Buchness MR.

St Vincent's Hospital and Medical Center, Dermatology Section, New York, New
York, USA.

BACKGROUND: Dermatologic disease in HIV-infected women has not been adequately
characterized. OBJECTIVE: The main purposes of this study were to characterize
nongenital dermatologic disease in HIV-infected women and correlate these
diagnoses with CD4 lymphocyte count to compare these findings with those in
published reports of men. METHODS: This study was a retrospective chart review of
female patients with dermatologic diagnoses followed up at an HIV clinic in New
York City, seen by either a dermatologist (49 patients) and/or a primary care
practitioner (114 patients). CD4 lymphocyte count was recorded if available
within 6 months of diagnosis; mean CD4 count was calculated for all disorders
with 5 or more diagnoses. RESULTS: Oropharyngeal candidiasis, drug eruption,
dermatophytosis, rash (not otherwise specified), nongenital herpes simplex,
herpes zoster, and seborrheic dermatitis were the most prevalent diagnoses made
by primary care providers. Itchy red bump disease, acne, atopic dermatitis,
xerosis, seborrheic dermatitis, nongenital warts, and molluscum contagiosum were 
the most prevalent diagnoses made by the dermatologist. Mean CD4 lymphocyte count
was lowest in itchy red bump disease, nongenital warts, nongenital herpes
simplex, xerosis, and drug eruptions. CONCLUSION: There appears to be no
appreciable difference in the spectrum or prevalence of dermatologic disease in
HIV-infected women versus HIV-infected men, except for a lower prevalence of
Kaposi's sarcoma, oral hairy leukoplakia, and possibly onychomycosis in women.
The degree of immunosuppression associated with various dermatoses in
HIV-infected women is similar to that in men, except perhaps for molluscum
contagiosum, which may appear earlier in women.

PMID: 10365925 [PubMed - indexed for MEDLINE]

3401: Enferm Infecc Microbiol Clin. 1999 Apr;17(4):162-5.

[Vaccination of chickenpox in children with acute lymphoblastic leukaemia]

[Article in Spanish]

Navajas A, Astigarraga I, Fernandez-Teijeiro A, Aga M, Redondo ML, Roig A, Corral
J.

Unidad de Oncologia Pediatrica, Hospital de Cruces, Baracaldo, Vizcaya.

Varicella vaccine has shown its efficacy to prevent the disease and complications
in healthy and immunodeficient children. In this article the authors evaluate the
immunologic status of acute lymphoblastic leukaemia at diagnosis and at follow up
and the development of chickenpox and/or herpes zoster. Children with negative
serology and continuous complete remission of acute lymphoblastic leukaemia for
one year were vaccinated. Of 71 children diagnosed of acute lymphoblastic
leukaemia from 1983 to 1996, 25 received the vaccine and seroconversion was
obtained in 76% after one dose and 92% after the second dose. Vaccine tolerance
was adequate. The incidence of herpes zoster infection was decreased in
vaccinated children during chemotherapy compared to the wild-virus infected ones.
Nowadays that vaccine for healthy children is recommended, we consider a priority
to protect from chickenpox the children affected by leukaemia that are in
continuous complete remission of the disease.

Publication Types: 
    English Abstract

PMID: 10365508 [PubMed - indexed for MEDLINE]

3402: Br J Ophthalmol. 1999 Mar;83(3):339-42.

AIDS related eye disease in Burundi, Africa.

Cochereau I, Mlika-Cabanne N, Godinaud P, Niyongabo T, Poste B, Ngayiragije A,
Dazza MC, Aubry P, Larouze B.

IMEA/INSERM U13, Hopital Bichat, Paris, France.

AIMS: To determine the prevalence of ocular manifestations in AIDS patients
hospitalised in Bujumbura, Burundi, according to their CD4+ lymphocyte count,
serological status for CMV and VZV, and general health status. METHODS:
Prospective study of 154 consecutive patients who underwent general and
ophthalmological examinations, including dilated fundus examination. AIDS was
diagnosed on the basis of Bangui criteria and HIV-1 seropositivity. CD4+
lymphocyte counts were determined by the Capcellia method. CMV and VZV antibodies
were detected with ELISA methods. RESULTS: The mean age was 37 (SD 9) years and
65% of the patients were male. Active tuberculosis was the most frequent
underlying disease (61%). Almost all the patients (99%) were seropositive for CMV
and VZV. Among the 115 patients for whom CD4+ lymphocyte counts were available,
86 (75%) had more than 100 cells x 10(6)/l. Ocular involvement comprised 16 cases
of microangiopathy, six of opalescence of the anterior chamber, five of retinal
perivasculitis, two of zoster ophthalmicus, two of viral retinitis, and one of
opalescence of the vitreous. CONCLUSION: In Africa, the prevalence of ocular
involvement in HIV infection is far lower than in Europe and the United States,
possibly because most African patients die before ocular opportunistic infections
occur.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10365044 [PubMed - indexed for MEDLINE]

3403: Fetal Diagn Ther. 1999 May-Jun;14(3):176-80.

Evaluation of fetal echogenic bowel in the second trimester.

Yaron Y, Hassan S, Geva E, Kupferminc MJ, Yavetz H, Evans MI.

Center for Fetal Diagnosis and Therapy, Departments of Obstetrics and Gynecology,
Hutzel Hospital/Wayne State University, Detroit, Mich., USA.

Previous studies cite different possible etiologies for fetal echogenic bowel
(FEB). The purpose of this study was to evaluate the possible etiologies for
second-trimester FEB, and to provide clinical guidelines for evaluation of this
finding. The study included 79 patients diagnosed with FEB in the second
trimester. Fifteen cases (19%) were associated with maternal vaginal bleeding. Of
these, 12 patients underwent amniocentesis, 9 of which had visible blood products
in the amniotic fluid. Seven cases (8.9%) had associated severe malformation.
Seven other cases (8.9%) were noted in multifetal pregnancies. Five fetuses
(6.3%) had evidence of bowel obstruction or perforation not associated with
cystic fibrosis (CF). Chromosomal aberrations were found in 5 fetuses (6.3%).
Intrauterine infection with cytomegalovirus, herpes simplex virus,
varicella-zoster virus, or parvovirus B-19 was documented in 5 patients (6.3%).
Three cases (3.8%) were associated with subsequent unexplained stillbirth. Two
fetuses (2.5%) were found to be affected by CF. Finally, in 30 cases (38%), no
obvious reason for FEB was found. We conclude that the evaluation of
second-trimester FEB should include targeted ultrasound for associated
malformations, infectious studies, DNA analysis for CF mutations, amniocentesis
for chromosomal analysis and evaluation of the amniotic fluid for degraded blood 
products, and an autopsy in cases of stillbirth. Even when no apparent reason is 
found, pregnancies should be considered at high risk for poor outcome.

PMID: 10364670 [PubMed - indexed for MEDLINE]

3404: Blood. 1999 Jun 15;93(12):4125-30.

Cladribine activity in adult langerhans-cell histiocytosis.

Saven A, Burian C.

Division of Hematology/Oncology, Ida M. and Cecil H. Green Cancer Center, Scripps
Clinic, La Jolla, CA, USA. asaven@scrippsclinic.com

Langerhans-cell histiocytosis (LCH) results from the accumulation of tissue
histiocytes derived from the same progenitor cells as monocytes. Because
cladribine is potently toxic to monocytes, we conducted a phase II trial of
cladribine. Cladribine was administered to 13 LCH patients at 0.14 mg/kg per day 
by 2-hour intravenous infusion for 5 consecutive days, every 4 weeks for a
maximum of six courses. Median age was 42 years (range, 19 to 72) and median
pretreatment disease duration was 99 months (range, 6 to 252). One patient was
untreated, one had received prior prednisone only, one prior radiation only, six 
prior radiation and chemotherapy, and four prior surgery, radiation, and
chemotherapy. Seven patients had cutaneous involvement, six multifocal osseous,
six pulmonary, two each with soft tissue and nodal involvement, and four had
diabetes insipidus. Of 13 patients, 12 were evaluable for response and all for
toxicity. After a median of three courses (range, 1 to 6), seven (58%) patients
achieved complete responses (two pathologic and five clinical) and two (17%)
patients achieved partial responses; overall response rate, 75%. Median response 
follow-up duration was 33 months (range, 1 to 65). Seven patients experienced
grade 3 to 4 neutropenia. Only one patient had a documented infection, dermatomal
herpes zoster. At a median follow-up of 42 months (range, 5 to 76), 12 patients
remain alive and one patient has died. Thus, cladribine has major activity in
adult LCH and warrants further investigation in both pediatric and adult LCH as a
single agent and in combination with other drugs.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II
    Research Support, Non-U.S. Gov't

PMID: 10361109 [PubMed - indexed for MEDLINE]

3405: Acta Virol. 1998 Dec;42(6):401-7.

Analysis of nucleotide sequence variations in herpes simplex virus types 1 and 2,
and varicella-zoster virus.

Chiba A, Suzutani T, Saijo M, Koyano S, Azuma M.

Department of Microbiology, Asahikawa Medical College, Japan.

To analyze the difference in the degree of divergence between genes from
identical herpesvirus species, we examined the nucleotide sequence of genes from 
the herpes simplex virus type 1 (HSV-1) strains VR-3 and 17 encoding thymidine
kinase (TK), deoxyribonuclease (DNase), protein kinase (PK; UL13) and
virion-associated host shutoff (vhs) protein (UL41). The frequency of nucleotide 
substitutions per 1 kb in TK gene was 2.5 to 4.3 times higher than those in the
other three genes. To prove that the polymorphism of HSV-1 TK gene is common
characteristic of herpesvirus TK genes, we compared the diversity of TK genes
among eight HSV-1, six herpes simplex virus type 2 (HSV-2) and seven
varicella-zoster virus (VZV) strains. The average frequency of nucleotide
substitutions per 1 kb in the TK gene of HSV-1 strains was 4-fold higher than
that in the TK gene of HSV-2 strains. The VZV TK gene was highly conserved and
only two nucleotide changes were evident in VZV strains. However, the rate of
nonsynonymous substitutions in total nucleotide substitutions was similar among
the TK genes of the three viruses. This result indicated that the mutational
rates differed, but there were no significant differences in selective pressure. 
We conclude that HSV-1 TK gene is highly diverged and analysis of variations in
the gene is a useful approach for understanding the molecular evolution of HSV-1 
in a short period.

PMID: 10358747 [PubMed - indexed for MEDLINE]

3406: Kansenshogaku Zasshi. 1999 Apr;73(4):341-5.

[Non-Hodgkin's lymphoma complicated by recurrent intractable generalized herpes
zoster responsive to long-term acyclovir therapy]

[Article in Japanese]

Endo K, Kobayashi Y, Kawai N, Itoh K, Tominaga K, Kusumoto S, Fukuda M, Murohashi
I, Bessho M, Hirashima K, Yamazaki T, Uno H.

First Department of Internal Medicine, Saitama Medical School.

A 34-year-old male with a history of chickenpox developed primary abdominal
non-Hodgkin's lymphoma (diagnosed in August 1995). Treatment with
cyclophosphamide, doxorubicin, vincristine, and prednisolone achieved a partial
remission. In July 1996, the disease recurred, and the patient received
chemotherapy with carboplatine, etoposide, mitoxantrone, and prednisolone, but no
response was noted. Involvement of the central nervous system and meninges was
diagnosed on September 12, 1997. Blast cells were detected in the peripheral
blood on September 26. Based on these findings, he was diagnosed as having
leukemia. On September 27, painless vesicles developed on the left gluteal
region. On October 13, the patient was hospitalized because the vesicles had
spread over his entire body. Pathologic examination of the roofs of the blisters 
showed masses of inclusion bodies. Based on this, a diagnosis of varicella-zoster
infection was made. Treatment with acyclovir (750 mg/day) for seven days failed
to form crusts. New vesicles developed after the drug was discontinued, but
crusts formed after acyclovir therapy was resumed. He died of interstitial
pneumonia on December 21. Autopsy could not be performed. Histopathologic
examination of pulmonary tissue obtained by necropsy did not reveal the presence 
of inclusion bodies characteristic of herpes simplex or varicella-zoster
infection. Varicella-zoster virus (VZV) antigen was negative by an immunochemical
staining method using monoclonal antibodies against VZV. Continuous long-term
administration of acyclovir has been reported to be effective for non-Hodgkin's
lymphoma complicated by recurrent intractable herpes zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10356892 [PubMed - indexed for MEDLINE]

3407: Int Endod J. 1999 Jan;32(1):61-6.

Herpes zoster of the trigeminal nerve third branch: a case report and review of
the literature.

Tidwell E, Hutson B, Burkhart N, Gutmann JL, Ellis CD.

Department of Restorative Sciences, Texas A & M University System, Baylor College
of Dentistry, Dallas 75246, USA.

LITERATURE REVIEW AND CASE REPORT: A literature review of Herpes zoster of the
trigeminal nerve is presented. Included are differential diagnosis and treatment 
modalities that will enable the dental practitioner to identify and manage this
disease. A case report is provided to amplify this timely information.

Publication Types: 
    Case Reports
    Review

PMID: 10356471 [PubMed - indexed for MEDLINE]

3408: Br J Dermatol. 1999 May;140(5):974-5.

Pitted keratolysis of the palm arising after herpes zoster.

Lee HJ, Roh KY, Ha SJ, Kim JW.

Publication Types: 
    Case Reports
    Letter

PMID: 10354390 [PubMed - indexed for MEDLINE]

3409: Br J Dermatol. 1999 Jun;140(6):1174-5.

Sweet's syndrome with systemic lupus erythematosus and herpes zoster.

Choi JW, Chung KY.

Publication Types: 
    Case Reports
    Letter

PMID: 10354095 [PubMed - indexed for MEDLINE]

3410: J Clin Rheumatol. 1999 Jun;5(3):173-8.

Disseminated herpes zoster and s. Aureus septic arthritis in a rheumatoid
arthritis patient treated with 2-chlorodeoxyadenosine (cladribine) and
methotrexate.

Liang GC, Kumar UM.

Department of Medicine, Division of Rheumatology, Northwestern University Medical
School, Ward 3-315, 303 E. Chicago Ave., Chicago, IL 60611.

A recalcitrant rheumatoid arthritis patient taking low dose weekly methotrexate
was given oral 2-chlorodeoxyadenosine (cladribine) for 8 months in a multicenter 
trial. He developed dual infections over the course of the trial: disseminated
herpes zoster and staphylococcal arthritis of the right elbow. His disseminated
herpes zoster started with severe, unremitting abdominal pain caused by a gastric
ulcer, followed by disseminated cutaneous herpes, hepatitis, pancreatitis,
encephalitis, homonymous hemianopsia, the syndrome of inappropriate secretion of 
antidiuretic hormone (ADH), and malabsorption. Both the herpes zoster and S.
aureus infections required prolonged proper chemotherapies. Serious, complicated 
viral, bacterial, or other unusual infections should be considered in patients
with severe rheumatoid conditions treated with combination immunosuppressive
therapy.

PMID: 19078380 [PubMed - in process]

3411: Rev Cubana Med Trop. 1998;50(3):186-90.

[Herpesvirus detection in immunocompromised patients with meningoencephalitis by 
the polymerase chain reaction technic]

[Article in Spanish]

Kouri V, Suarez C, Resik S, Garcia S.

Instituto de Medicina Tropical Pedro Kouri, Ciudad de La Habana, Cuba.

The multiple polymerase chain reaction technique was used to detect in a single
assay tube the presence of herpes simplex virus (HSV), Cytomegalovirus (CMV).
Epstein Barr virus (EBV), varicella zoster virus (VZV), and/or human herpes
virus-6 (HHV6). 50 cerebrospinal fluids from patients with AIDS and clinically
suspected to have meningoencephalitis due to HSV were received and analyzed at
the laboratories of Sexually Transmitted Diseases of the Virology Department of
the "Pedro Kouri" Tropical Medicine Institute from 1993 to 1996. 4 of them were
positive to HSV, 3 to CMV, 2 to VZV, and 1 to HHV6 for a positivity of 20%. The
results of the PCR were correlated to the clinical findings presented by the
patients at the time of the lumbar puncture. The introduction of this technique
in the laboratory allows to have an easy, fast and useful tool for the diagnosis 
of meningoencephalitis due to herpesvirus.

Publication Types: 
    English Abstract

PMID: 10349441 [PubMed - indexed for MEDLINE]

3412: Rinsho Shinkeigaku. 1998 Dec;38(12):1070-2.

[An adult case of peripheral facial nerve palsy following acute cerebellitis
associated with high antibody titers against varicella-zoster virus]

[Article in Japanese]

Ogata K, Yamada T, Hara H, Taniwaki T, Kira J.

Department of Neurology, Faculty of Medicine, Kyushu University, Fukuoka.

Here we report a case of acute cerebellitis, in which the patient developed right
peripheral facial palsy during the recovery phase of cerebellar ataxia. A
67-year-old man developed truncal and limb ataxia following a fever, general
fatigue and anorexia. He was diagnosed to have acute cerebellitis. While the
ataxia symptoms were improving without any treatment, right peripheral facial
nerve palsy developed and an MRI revealed an enhancement of the right facial
nerve proximal to the geniculate ganglion. After treatment with acyclovir and
corticosteroids, his facial nerve palsy and ataxia both gradually improved. There
has been no previous report of an adult case who developed peripheral facial
nerve palsy during the recovery phase of acute cerebellitis. This case indicates 
that a wide spectrum of neurological complications may develop in association
with a varicella-zoster virus infection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10349352 [PubMed - indexed for MEDLINE]

3413: Can Fam Physician. 1999 May;45:1195-6.

Should we offer famciclovir to patients with new-onset herpes zoster?

Martin F, Evans MF.

Kildonan Medical Centres, Winnipeg, Man.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 10349063 [PubMed - indexed for MEDLINE]

3414: Tohoku J Exp Med. 1998 Nov;186(3):169-79.

Progressive multifocal leukoencephalopathy in a patient with acquired
immunodeficiency syndrome (AIDS) manifesting Gerstmann's syndrome.

Saito H, Sakai H, Fujihara K, Fujihara K, Itoyama Y.

Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.

We reported a case of acquired immunodeficiency syndrome (AIDS) via multiple
blood transfusions, who manifested progressive multifocal leukoencephalopathy
(PML) about 18 months after the development of AIDS. PML initiated with right
hemiparesis, dysphasia, and Gerstmann's syndrome and resulted in death within 2
months after the onset. Neuroimaging examinations revealed white matter lesions
mainly in the left posterior parietal lobe. The cortical gray matter also showed 
abnormal signal intensity. Peripheral CD4+ lymphocyte count was 81/microl.
Routine cerebrospinal fluid (CSF) examinations were negative. CSF antibodies
against herpes simplex virus, varicella-zoster virus, cytomegalovirus,
Epstein-Barr virus as well as serum antibody against toxoplasma gondii were
negative. Though autopsy or biopsy of the brain was not performed, JC virus
genomes were detected in the CSF sample by a polymerase chain reaction, and their
sequencing showed unique alterations of the regulatory regions, characteristic to
PML-type JC virus.

Publication Types: 
    Case Reports

PMID: 10348213 [PubMed - indexed for MEDLINE]

3415: J Chromatogr B Biomed Sci Appl. 1999 Apr 16;726(1-2):261-8.

Determination of (E)-5-(2-bromovinyl)-2'-deoxyuridine in plasma and urine by
capillary electrophoresis.

Olgemoller J, Hempel G, Boos J, Blaschke G.

Institute of Pharmaceutical Chemistry, University of Munster, Germany.

(E)-5-(2-Bromovinyl)-2'-deoxyuridine is an antiviral drug used for treatment of
infections with Herpes simplex virus type 1 as well as Varicella zoster virus.
Two fast methods for the determination of the drug and its metabolite in plasma
and urine by capillary electrophoresis have been developed. The plasma method can
be used for measurement of total as well as unbound drug and metabolite. Plasma
and urine samples are prepared for measuring by liquid/liquid extraction
resulting in a limit of quantification of 40 ng/ml for total and 10 ng/ml for
free BVdU in plasma and 170 ng/ml in urine. Inter- as well as intra-day precision
were found to be better than 10% and both methods have been used for drug
monitoring of patients.

PMID: 10348194 [PubMed - indexed for MEDLINE]

3416: J Ark Med Soc. 1999 May;95(12):528-31.

Multidisciplinary approach for the management of post-herpetic neuralgia in
elderly patients.

Ackerman WE 3rd, Ahmad M.

Department of Anesthesiology, University of Arkansas for Medical Sciences, Little
Rock, USA.

Post-herpetic neuralgia is associated with significant distress and morbidity.
The management of acute neuritis and/or post-herpetic neuralgia can be
particularly difficult. A multidisciplinary approach is required. A team
consisting of the primary care physician, pain specialist, neurologist,
geriatrician, pain psychologist, psychiatrist, and a physiatrist with an
integrated approach will provide the best results. Early interventional therapy
with sympathetic nerve blocks may significantly decrease the need for long-term
opioid therapy, as well as long-term use of anticonvulsants, antidepressants, or 
membrane stabilizers. Early referral to a multidisciplinary pain center may
furthermore decrease the behavioral trauma and family disruption associated with 
this painful condition.

Publication Types: 
    Review

PMID: 10341481 [PubMed - indexed for MEDLINE]

3417: Prescrire Int. 1998 Jun;7(35):81-2.

Famciclovir: new preparation. Slightly helpful in herpes zoster.

[No authors listed]

A comparative placebo-controlled trial involving 419 adults showed that a
one-week course of famciclovir started within 3 days of onset of skin lesions had
no effect on the acute phase of zoster, the time required for scabs to fall, the 
end of skin lesion progression, or pain. In this trial famciclovir failed to
reduce the incidence of post-zoster pain, but it did reduce its median duration
by approximately 2 months. According to a subgroup analysis (not planned for by
the protocol), only patients over 50 benefited from this effect. Three other
trials suggest that the approved dose regimen in France (500 mg 3 times a day)
may not be optimal. The dose recommended in the United Kingdom (750 mg in one
daily intake or 250 mg 3 times a day) seems to be more in line with the clinical 
assessment file. The three available comparative trials show no statistically
significant difference between famciclovir and aciclovir in terms of efficacy or 
tolerability. An indirect comparison suggests that the risk-benefit ratio of
famciclovir and valaciclovir are probably similar. However, the effects of
famciclovir on post-zoster pain were observed in a clinical trial, while those of
aciclovir were found only in meta-analyses.

Publication Types: 
    Comparative Study

PMID: 10342925 [PubMed - indexed for MEDLINE]

3418: J Infect. 1999 Mar;38(2):116-20.

Herpes zoster and its complications in Italy: an observational survey.

di Luzio Paparatti U, Arpinelli F, Visona G.

Glaxo Wellcome S.p.A., Research and Development, Verona, Italy.

OBJECTIVES: To estimate the rate of Herpes zoster and its complications in Italy.
METHODS: this is an observational, retrospective study carried out by
Dermatologists, Geriatric Doctors and General Practitioners. Details on
demography, clinical and therapeutic aspects were reported on record forms. The
rate of Herpes zoster was only calculated for patients aged 15 years or more,
attending General Practitioners because this was the only group where the number 
of patients at risk was known. The hypothesis that the rate of complications
depends on sex, age and number of affected dermatomes was explored through
univariate (Chi-square tests) and multivariate (logistic regression) analysis.
RESULTS: the number of cases of Herpes zoster examined by General Practitioners
was 4.1 persons aged 15 years or more/1000/year. Usually, only one dermatome was 
affected, most frequently the thoracic one. Overall the rate of complications was
26.1% The rate of complications is significantly higher (P = 0.001) in patients
with two or more affected dermatomes, it is positively correlated to age while
difference by sex is not significant (P = 0.297). Practically all patients
received treatment for their disease. CONCLUSIONS: this is the first
epidemiological study on Herpes zoster that has been conducted in Italy. It
indicates that annually there are about 200 000 people aged 15 years and over
suffering from Herpes zoster in Italy, with a considerable number of cases of
post herpetic neuralgia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10342652 [PubMed - indexed for MEDLINE]

3419: Pain. 1999 Apr;80(3):533-8.

Topical lidocaine patch relieves postherpetic neuralgia more effectively than a
vehicle topical patch: results of an enriched enrollment study.

Galer BS, Rowbotham MC, Perander J, Friedman E.

Institute for Education and Research in Pain Medicine and Palliative Care,
Department of Pain Medicine and Palliative Care, Beth Israel Medical Centre, New 
York, NY 10003, USA.

This study compared the efficacy of topical lidocaine patches versus vehicle
(placebo) patches applied directly to the painful skin of subjects with
postherpetic neuralgia (PHN) utilizing an 'enriched enrollment' study design. All
subjects had been successfully treated with topical lidocaine patches on a
regular basis for at least 1 month prior to study enrollment. Subjects were
enrolled in a randomized, two-treatment period, vehicle-controlled, cross-over
study. The primary efficacy variable was 'time to exit'; subjects were allowed to
exit either treatment period if their pain relief score decreased by 2 or more
categories on a 6-item Pain Relief Scale for any 2 consecutive days. The median
time to exit with the lidocaine patch phase was greater than 14 days, whereas the
vehicle patch exit time was 3.8 days (P < 0.001). At study completion, 25/32
(78.1%) of subjects preferred the lidocaine patch treatment phase as compared
with 3/32 (9.4%) the placebo patch phase (P < 0.001). No statistical difference
was noted between the active and placebo treatments with regards to side effects.
Thus, topical lidocaine patch provides significantly more pain relief for PHN
than does a vehicle patch. Topical lidocaine patch is a novel therapy for PHN
that is effective, does not cause systemic side effects, and is simple to use.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 10342414 [PubMed - indexed for MEDLINE]

3420: Ryoikibetsu Shokogun Shirizu. 1999;(25 Pt 3):366-8.

[Aphthous stomatitis]

[Article in Japanese]

Michiwaki Y, Michi K.

First Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa
University.

Publication Types: 
    Review

PMID: 10337828 [PubMed - indexed for MEDLINE]

3421: Ryoikibetsu Shokogun Shirizu. 1999;(25 Pt 3):322-5.

[Viral keratitis]

[Article in Japanese]

Nouchi A, Ishibashi Y.

Department of Ophthalmology, Tokyo Women's Medical College, Daini Hospital.

Publication Types: 
    Review

PMID: 10337815 [PubMed - indexed for MEDLINE]

3422: Pediatr Dermatol. 1999 Mar-Apr;16(2):111-2.

Acute generalized varicella zoster in the setting of preexisting generalized
erythema.

Egan CA, O'Reilly MA, Vanderhooft SL, Rallis TM.

Department of Dermatology, University of Utah School of Medicine, Salt Lake City 
84132, USA.

We report a 5-year-old girl who initially had generalized erythema from scarlet
fever. Four days later she developed sheets of monomorphous vesicles in the areas
of erythema. A Tzanck smear of a vesicle base showed multinucleated giant cells, 
and viral culture grew varicella zoster virus, confirming a clinical diagnosis of
varicella. This case illustrates that, with a background of preexisting erythema,
varicella may present in an atypical manner.

Publication Types: 
    Case Reports

PMID: 10337673 [PubMed - indexed for MEDLINE]

3423: Eur Arch Otorhinolaryngol. 1999;256 Suppl 1:S6-7.

Ramsay-Hunt syndrome in a 4-year-old child.

Kimitsuki T, Komiyama S.

Department of Otorhinolaryngology, Faculty of Medicine, Kyushu University,
Fukuoka, Japan.

The Ramsay-Hunt syndrome mostly affects adults, but a small number of children
with herpes zoster oticus have been reported. We describe a case of Ramsay Hunt
syndrome in a healthy 4-year-old boy. He developed varicella at 7 months of age. 
At the age of 4 years, he complained of pain in his right ear, and herpes zoster 
vesicles were noted on his right pinna. Three days later, he developed right
facial paralysis. He was treated with intravenous acyclovir and
methylprednisolone. One month later, his facial paralysis had fully resolved.

Publication Types: 
    Case Reports

PMID: 10337517 [PubMed - indexed for MEDLINE]

3424: Lancet. 1999 May 15;353(9165):1636-7.

Prevention of postherpetic neuralgia.

Dworkin RH.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, NY 14642, USA.

PMID: 10335778 [PubMed - indexed for MEDLINE]

3425: Antivir Chem Chemother. 1999 Mar;10(2):87-97.

Synthesis and antiviral activity of 6-benzoyl-benzoxazolin-2-one and
6-benzoyl-benzothiazolin-2-one derivatives.

Van derpoorten K, Ucar H, Andrei G, Snoeck R, Balzarini J, De Clercq E, Poupaert 
JH.

Division of Pharmaceutical Chemistry, School of Pharmacy, Universite Catholique
de Louvain, Brussels, Belgium. Vanderpoorten@bani.ucl.ac.be

The synthesis and antiviral activity of an original series of
6-benzoyl-benzoxazolin-2-one and 6-benzoyl-benzothiazolin-2-one derivatives are
described. Several compounds were found to have a selective inhibitory activity
against human cytomegalovirus (HCMV) and varicella-zoster virus (VZV) in vitro,
being inactive against a variety of other DNA and RNA viruses.
6-(3-fluorobenzoyl)benzoxazolin-2-one, 6-(3-fluorobenzoyl)benzothiazolin-2-one,
6-(3-bromobenzoyl)benzothiazolin-2-one, 6-(3-iodobenzoyl)benzothiazolin-2-one,
3-methyl-6-(3-fluorobenzoyl)benzothiazolin-2-one,
3-benzyl-6-benzoyl-benzothiazolin-2-one,
3-benzyl-6-(3-fluorobenzoyl)benzothiazolin-2-one and
3-benzoyl-6-(3-fluorobenzoyl)benzothiazolin-2-one were the most active of the
series against HCMV and VZV with a selectivity index (CC50/IC50) ranging from 10 
to 20. They displayed similar activity against thymidine kinase competent (TK+)
and deficient (TK-) VZV strains, and also proved to be active against clinical
HCMV isolates that were resistant to ganciclovir (GCV). Time-of-addition
experiments revealed a site of interaction with the HCMV replicative cycle that
may be close or similar to that of GCV and cidofovir (HPMPC). The compounds
showed poor, if any, activity against herpes simplex virus type 1 (HSV-1) and
HSV-2, and were not inhibitory against human immunodeficiency virus and other DNA
and RNA viruses. Therefore, these compounds may represent a novel lead for the
development of specific HCMV and VZV drugs.

PMID: 10335403 [PubMed - indexed for MEDLINE]

3426: J Korean Med Sci. 1999 Apr;14(2):227-9.

Disseminated superficial actinic porokeratosis like drug eruption: a case report.

Hwang SM, Choi EH, Ahn SK.

Department of Dermatology Yonsei University, Wonju College of Medicine,
Kangwon-Do, Korea.

We report a 54-year-old male patient who developed an unusual form of generalized
drug eruption. He had pain and breathlessness on the left chest wall. He had
history of taking several drugs at private clinics under a diagnosis of herpes
zoster. Two weeks later he had a generalized skin eruption. Examination showed
multiple variable sized, mild pruritic, erythematous macules and papules on the
face and upper extremities. Skin lesions take the form of a clinically consistent
with disseminated superficial actinic porokeratosis (DSAP). Methylprednisolone 16
mg, astemisole 10 mg, oxatomide 60 mg was prescribed. Topical corticosteroid
cream was applied. Within two months, his eruption had cleared almost completely.
The pathogenetic mechanisms of this case are unclear, but drug and UV light have 
been considered.

Publication Types: 
    Case Reports

PMID: 10331575 [PubMed - indexed for MEDLINE]

3427: J Virol Methods. 1999 Apr;79(1):33-40.

Development of a fluorogenic polymerase chain reaction assay (TaqMan) for the
detection and quantitation of varicella zoster virus.

Hawrami K, Breuer J.

Department of Medical Microbiology, St Bartholomew's and the London School of
Medicine and Dentistry, UK. k.hawrami@mds.qmw.ac.uk

A TaqMan based polymerase chain reaction (PCR) assay was developed for the
detection and quantitation of varicella zoster virus (VZV). This method enables
simple, reproducible, sensitive and specific detection and quantification of VZV.
The TaqMan assay was able to detect four copies of VZV and did not cross-react
with other herpesviruses DNA. The assay has several advantages over conventional 
PCR. First, in the TaqMan assay there is no need for gel electrophoresis and
contact with hazardous chemicals. Second, the method is rapid allowing the
analysis of 92 samples within minutes after completion of PCR. Finally, the
incorporation of a specific probe into the PCR reaction enhances the sensitivity 
and specificity of the method compared with conventional PCR. The TaqMan system
could, therefore, be a useful tool for the epidemiological and diagnostic
investigation of VZV.

PMID: 10328533 [PubMed - indexed for MEDLINE]

3428: J Fr Ophtalmol. 1999 Mar;22(2):268.

[Images. Severe infections]

[Article in French]

[No authors listed]

Publication Types: 
    Case Reports

PMID: 10327361 [PubMed - indexed for MEDLINE]

3429: Intervirology. 1998;41(6):272-7.

Demography, symptomatology, and course of disease in ambulatory zoster patients. 
A physician-based survey in Germany.

Meister W, Neiss A, Gross G, Doerr H, Hobel W, Malin J, von Essen J, Reimann B,
Witke C, Wutzler P.

SmithKline Beecham Pharma GmbH Munich, Munich, Germany.

This survey summarises the observations of physicians who prospectively recorded 
clinically relevant data on their patients with an episode of herpes zoster.
These included demography of patients, signs and symptoms during the prodromal
phase, relevant history, description of disease at the first visit, therapeutic
measures and description of disease, and occurrence of postherpetic neuralgia
(pain 4-5 weeks after crusting) at the second visit. A total of 2,063 patients
were reported to the data management centre. The age distribution resembles that 
reported in the literature including the notable increase in zoster frequency
with advancing age. Almost 20% of the patients, however, were 30 years old or
less, and this contrasts markedly with the published literature. Age modifies the
frequency of the dermatome afflicted: more cranial and less thoracic
manifestations were observed with increasing age. Almost all patients reported
symptoms which may be attributed to a prodromal phase, especially pain in the
affected dermatome (82%). The incidence of postherpetic neuralgia was 28%. A
complicated disease course such as visceral, ocular, or otological involvement,
or progression to additional dermatomes was seen in almost 10% of the patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10325537 [PubMed - indexed for MEDLINE]

3430: J Neurovirol. 1999 Apr;5(2):172-80.

Impact of cerebrospinal fluid PCR on the management of HIV-infected patients with
varicella-zoster virus infection of the central nervous system.

Iten A, Chatelard P, Vuadens P, Miklossy J, Meuli R, Sahli R, Meylan PR.

Division of Infectious Diseases, Centre Hospitalier Universitaire Vaudois,
Lausanne, Switzerland.

Over a 2 year period, we identified five HIV-infected patients who presented with
central nervous system infection caused by varicella-zoster virus, three with
myelitits, and two with meningoencephalitis. All five patients were profoundly
immunocompromised. Clinical presentation of these patients overlapped to a
significant extent with diseases caused by other viruses, e.g. CMV. Indeed, in
one case, a dual infection with CMV was diagnosed, but the respective role of
each virus was ascertained by in situ hybridisation. At the time of CNS
involvement, only one patient had active VZV cutaneous lesions, which were
instrumental in diagnosing her condition. In contrast, PCR for VZV DNA in the CSF
was helpful in making a diagnosis in the four other cases, one of which was
confirmed by a post mortem. Of these five patients, two patients developed VZV
disease while receiving oral acyclovir and had foscarnet treatment initiated when
MRI demonstrated widespread lesions. They did not respond to antiviral therapy.
The three other patients had intravenous acyclovir initiated at a time when no or
limited parenchymal lesions were observed by MRI. Two of these three patients had
VZV infection diagnosed solely on the basis of PCR: all three responded to
treatment. Our data show that reactivation of VZV involving the central nervous
system occurs frequently in the absence of cutaneous lesions. PCR of
cerebrospinal fluid may help in making an early diagnosis which is probably a
prerequisite for successful treatment of VZV infection of the CNS.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10321981 [PubMed - indexed for MEDLINE]

3431: J Am Acad Dermatol. 1999 May;40(5 Pt 2):868-9.

Herpes zoster in seven disparate dermatomes (zoster multiplex): report of a case 
and review of the literature.

Vu AQ, Radonich MA, Heald PW.

Department of Dermatology, Yale University School of Medicine, New Haven,
Connecticut 06520-8059, USA.

Noncontiguous multidermatomal herpes zoster is very rare in both immunocompetent 
and immunocompromised persons. Most of the reported cases have been limited to 2 
noncontiguous dermatomes. This unique presentation has been referred to as zoster
duplex unilateralis or bilateralis, depending on whether one or both halves of
the body are involved. Granulomatous dermatitis at sites of herpes zoster scars, 
a rare isotopic response, has only been reported in persons with contiguous
dermatomes of zoster. We describe an immunocompromised patient who developed
herpes zoster in 7 disparate dermatomes. Three months after resolution of the
zoster, the patient developed a granulomatous dermatitis in a zosteriform
distribution at the sites of previous infection.

Publication Types: 
    Case Reports
    Review

PMID: 10321638 [PubMed - indexed for MEDLINE]

3432: Br J Radiol. 1998 Dec;71(852):1317-9.

CT appearances of hepatic involvement in systemic varicella-zoster.

Ruehm SG, Trojan A, Vogt P, Krause M, Krestin GP.

Department of Radiology, University Hospital Zurich, Switzerland.

In a patient suffering from T-cell non-Hodgkin's lymphoma and systemic
varicella-zoster, contrast enhanced CT showed multiple hypodense nodular lesions 
in the liver which corresponded to areas of focal liver necrosis. This appearance
on CT may be characteristic of varicella-zoster involvement of the liver.

Publication Types: 
    Case Reports

PMID: 10319009 [PubMed - indexed for MEDLINE]

3433: Ter Arkh. 1999;71(3):41-5.

[A case of atypical pneumonia caused by viral-bacterial-fungal association]

[Article in Russian]

Ovcharenko SI, Osadchaia VA, Petrii VV, Nedostup AV.

Publication Types: 
    Case Reports

PMID: 10234764 [PubMed - indexed for MEDLINE]

3434: Neurologia. 1999 Mar;14(3):139-40.

Comment in:
    Neurologia. 2000 Feb;15(2):85-6.

[Varicella zoster virus and prednisone]

[Article in Spanish]

Arjona A.

Publication Types: 
    Case Reports
    Letter

PMID: 10232018 [PubMed - indexed for MEDLINE]

3435: Clin Exp Dermatol. 1998 Sep;23(5):237-8.

Are granulomatous reactions in old zoster lesions due to an immune response to
varicella zoster virus envelope glucoproteins?

Nikkels AF, Pierard GE.

Publication Types: 
    Letter

PMID: 10233614 [PubMed - indexed for MEDLINE]

3436: Br J Haematol. 1999 May;105(2):445-7.

Herpes virus infections occur frequently following treatment with fludarabine:
results of a prospective natural history study.

Byrd JC, McGrail LH, Hospenthal DR, Howard RS, Dow NA, Diehl LF.

Hematology-Oncology Service, Divison of Hematologic Malignancies, Johns Hopkins
Oncology Center, Baltimore, Maryland, USA. john_c.byrd@wramaa.chcs.amedd.army.mil

We performed a prospective infectious natural history study of 21 patients with
low-grade lymphoproliferative disorders receiving fludarabine as initial (n = 5) 
or salvage (n = 16) therapy. 12 (57%) of these patients developed herpes zoster
(n = 9), herpes simplex I (n = 1) or herpes simplex II (n = 2) infections at a
median of 8 (range 1-17) months following initiation of fludarabine, with 75% of 
these having completed therapy. All patients with herpes zoster developed severe 
post-herpetic neuralgia. Factors differentiating patients developing these
infections included older age and low serum IgG or IgA. Based upon these
prospective data, we conclude that herpes virus infections frequently occur
following fludarabine treatment, necessitating aggressive patient education and
new prophylactic strategies.

PMID: 10233419 [PubMed - indexed for MEDLINE]

3437: Arch Pediatr. 1999 Apr;6(4):469-76.

[Management of varicella-zona virus infections. A consensus conference of the
French-speaking Society of Infectious Pathology, Lyon, 25 March 1998]

[Article in French]

[No authors listed]

Conclusions ("short text") of a consensus conference on the management of
chickenpox-zona virus infections (CZVI) are presented. They provide actualized
responses to four questions: 1) who are the persons at risk of severe and/or
complicated CZVI infections? 2) which management for chickenpox? 3) Which
management for zona? 4) How to prevent CZVI and for whom?

Publication Types: 
    Consensus Development Conference
    English Abstract
    Review

PMID: 10230491 [PubMed - indexed for MEDLINE]

3438: Am J Clin Pathol. 1999 May;111(5):655-9.

Quantitation of 8 human herpesviruses in peripheral blood of human
immunodeficiency virus-infected patients and healthy blood donors by polymerase
chain reaction.

Hoang MP, Rogers BB, Dawson DB, Scheuermann RH.

Department of Pathology, University of Texas Southwestern Medical Center, Dallas 
75235-9072, USA.

Human herpesviruses are associated with morbidity and mortality in persons with
compromised immune systems, including patients infected with human
immunodeficiency virus (HIV). To investigate the basis for this association, the 
levels of all 8 human herpesviruses (herpes simplex virus, types 1 and 2,
varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, and human
herpesvirus 6, human herpesvirus 7, and human herpesvirus 8) were measured with
the quantitative polymerase chain reaction (PCR). Viral DNA was measured in the
whole blood of 20 HIV-infected patients and compared with levels in 20 healthy
blood donors. There was no significant difference in the frequency of virus
detection of the 8 human herpesviruses between HIV-infected patients and healthy 
adults. These results indicate that HIV infection is not associated with a
general increase in the circulating levels of human herpesviruses, and suggest
that quantitative PCR analysis is superior to qualitative PCR analysis for
detection of clinically relevant disease in HIV-infected patients.

PMID: 10230356 [PubMed - indexed for MEDLINE]

3439: Cutis. 1999 Apr;63(4):217-8.

Herpes zoster in a 7-month-old infant: a case report and review.

Elmer KB, George RM.

USAF, Yokota Air Force Base, Japan.

Herpes zoster (HZ) is a cutaneous viral infection of the skin that presents in a 
dermatomal distribution. It represents reactivation of herpes varicella zoster
virus that has continued to exist in a latent form in the neurons of the
posterior root ganglia. Although it is rare to see HZ in children, cases have
been reported after exposure to varicella zoster in utero or during the first
months of life. We present a case of HZ in a healthy 7-month-old girl who had had
chickenpox at age 4 months.

Publication Types: 
    Case Reports
    Review

PMID: 10228750 [PubMed - indexed for MEDLINE]

3440: Acta Derm Venereol. 1999 Mar;79(2):168.

Localized chronic urticaria at the site of healed herpes zoster.

Lee HJ, Ahn WK, Chae KS, Ha SJ, Kim JW.

Publication Types: 
    Case Reports
    Letter

PMID: 10228647 [PubMed - indexed for MEDLINE]

3441: Int J Biochem Cell Biol. 1999 Mar-Apr;31(3-4):451-61.

Distinct responses of the herpes simplex virus and varicella zoster virus
immediate early promoters to the cellular transcription factors Brn-3a and
Brn-3b.

Brownlees J, Gough G, Thomas S, Watts P, Cohen J, Coffin R, Latchman DS.

Department of Molecular Pathology, Windeyer Institute of Medical Sciences,
University College London Medical School, UK.

The related viruses herpes simplex virus (HSV) and varicella zoster virus (VZV)
show distinct but related patterns of latent infection and reactivation in human 
sensory ganglia. The cellular POU family transcription factors Brn-3a and Brn-3b 
are expressed in sensory ganglia and bind to the TAATGARAT (R stands for purine) 
regulatory motifs in the immediate-early gene promoters of these viruses. We show
that Brn-3a activates the full length HSV IE1 promoter whereas Brn-3b represses
its activity. In contrast both Brn-3a and Brn-3b activate the full length VZV IE 
promoter. The response of the full length VZV promoter to Brn-3b is not observed 
with a minimal VZV immediate-early promoter lacking any TAATGARAT elements and
cannot be restored by addition of either the upstream TAATGARAT-containing region
of the HSV IE promoter or a VZV TAATGARAT-like element to this minimal promoter. 
The unique effect of Brn-3b on the full length VZV immediate early gene promoter 
may play a key role in the distinct pattern of latent infection and reactivation 
observed with this virus in vivo.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 10224669 [PubMed - indexed for MEDLINE]

3442: J Med Virol. 1999 May;58(1):76-8.

Analysis of strain variation of R1 repeated structure in varicella-zoster virus
DNA by polymerase chain reaction.

Yoshida M, Tamura T, Hiruma M.

Department of Dermatology, Kinki University School of Medicine, Osaka, Japan.

The tandem direct reiteration R1 in the varicella-zoster virus genome consists of
two elements: units composed of 18 bp and those having 15 bp, both of whose
numbers and types of combination patterns vary among strains. The variations of
the R1 structure were examined in order to differentiate between the wild strains
and a varicella vaccine (Oka) strain by the polymerase chain reaction using two
primer sets. The results showed that the 31 wild strains were classified into
nine patterns: the R1 structure consisted of a combination of 5 to 7 18-bp units 
and 8 to 12 15-bp units. The strain with a combination of 6 18-bp units and 10
15-bp units was found to be predominant in Japan, and the same pattern was found 
in the vaccine strain, so that differentiation between the vaccine strain and the
wild strains in Japan merely by analysis of R1 in VZV genome is difficult.

PMID: 10223550 [PubMed - indexed for MEDLINE]

3443: Arch Pediatr. 1998 Feb;5(2):199-203.

[Zona in children]

[Article in French]

Banerjee A.

Service de pediatrie generale, centre hospitalier Rene-Dubos, Pontoise, France.

Herpes zoster is the clinical consequence of a late reactivation of the varicella
zoster virus (VZV). It infects mainly the elderly, but pediatric cases are not
uncommon. It occurs mostly in immunocompromised children, or in infancy after
reactivation of latent VZV infection acquired transplacentally during
intrauterine life. Rarely, herpes zoster occurs in otherwise normal children,
especially following varicella during the first year of life. Clinical
presentation of herpes zoster in children is identical to that of adult, with
usually a benign course. The impairment of cellular and non specific immunity
(Natural Killer cells) appears to have a particular role in the occurrence of
herpes zoster. Treatment of the usual form comprises antiseptic measures and
prevention of pruritus. In immunocompromised children, the infection is generally
severe and disseminated, and can result in high rates of morbidity and mortality,
thus requiring specific intravenous antiviral therapy with antiviral drugs such
as acyclovir without delay. There is no single approach towards VZV infection
prevention in immunocompromised hosts. Vaccination with live attenuated varicella
vaccine, has proved to be efficient and safe in immunocompromised children.

Publication Types: 
    English Abstract
    Review

PMID: 10223145 [PubMed - indexed for MEDLINE]

3444: Arch Pediatr. 1998 Jan;5(1):79-83.

[Chickenpox in pregnancy]

[Article in French]

Berrebi A, Assouline C, Ayoubi JM, Parant O, Icart J.

Departement de gynecologie-obstetrique, CHU La Grave, Toulouse, France.

Chickenpox is rare during pregnancy (1 to 7 per 10,000). The infection can be
severe for the mother and indirectly may affect the fetus. Before 20 weeks of
amenorrhea, the varicella-zoster virus may be responsible for a rare
embryofetopathy (incidence rate: 0.4 to 2%). After the 20th week of amenorrhea,
fetal infection is not symptomatic, but it may lead to neonatal or infantile
herpes zoster infection. During the perinatal period, a primary maternal
infection may be responsible for severe neonatal varicella if delivery occurs
prior to maternal antibody production. Practical guidelines are proposed
according to the date of infection during pregnancy and prenatal diagnosis using 
amniocentesis and/or cordocentesis is discussed.

Publication Types: 
    English Abstract
    Review

PMID: 10223117 [PubMed - indexed for MEDLINE]

3445: Rev Med Liege. 1999 Feb;54(2):71-5.

[Drug clinics. How I treat zona]

[Article in French]

Nikkels AF, Pierard GE.

Service de Dermatopathologie, Universite de Liege.

The treatment of herpes zoster relies on the intravenous or oral administration
of antiviral drugs. Oral aciclovir for shingles is hindered by its low
bioavailability. New antiviral drugs with improved oral bioavailability
(famciclovir and valaciclovir) allow a better efficacy. The opportuneness of
treating herpes zoster is different in the immunocompetent and immunocompromised 
patients, and during childhood and pregnancy.

Publication Types: 
    English Abstract

PMID: 10221057 [PubMed - indexed for MEDLINE]

3446: Klin Monatsbl Augenheilkd. 1999 Mar;214(3):175-7.

[Bilateral neuroretinitis with zoster infection]

[Article in German]

Nicaeus T, Wilhelm H.

Abteilungen I (Allgemeine Augenheilkunde mit Poliklinik), Augenklinik der
Eberhard-Karls-Universitat Tubingen.

BACKGROUND: Infections with varicella zoster virus may involve the optic nerve
and the retina. Different pathomechanisms have been discussed. We present a case 
with an autoimmune inflammatory reaction according to the clinical course.
PATIENT: A 69-year-old female was referred to our clinic because of suspected
bilateral anterior ischemic optic neuropathy. She complained of severe visual
loss the day before admission. Her ophthalmological and general history was
unremarkable apart from treatment with 5 to 7.5 mg prednisolone alternately
because of rheumatoid arthritis. Best corrected visual acuity was 1/15 OD and 0.1
OS. A relative afferent pupillary defect on the right eye was present. Optic disc
oedema with multiple hemorrhages of the retina extending into the peripheral
funds, slightly attenuated retinal arteries and macular oedema were seen
fundoscopically in both eyes. THERAPY AND CLINICAL OUTCOME: After immediate
treatment with steroids (initial dose 250 mg prednisolone per day) visual acuity 
improved. Because of a clinically suspected and serologically proven active
varicella-zoster infection an additional virostatic therapy with valaciclovir was
started and steroids were lowered gradually. Within 2 months, visual acuity
increased to 0.8 OD and 1.0 OS. Oedema of optic discs and macula resolved and
retinal hemorrhages disappeared. CONCLUSION: A severe hemorrhagic neuro-retinitis
involving the optic discs was seen in the course of a varicella-zoster infection,
possibly reactivated by chronic steroid therapy of a rheumatoid arthritis.
Because of the normalization of visual function an ischemic pathogenesis is
unlikely. An autoimmune inflammatory reaction seems to be the predominant
mechanism, supported by the good effect of steroid and valaciclovir therapy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10220730 [PubMed - indexed for MEDLINE]

3447: Masui. 1999 Mar;48(3):292-4.

[Treatment of postherpetic neuralgia by topical application of prostaglandin
E1-vaseline mixture--a single blind controlled clinical trial]

[Article in Japanese]

Tamakawa S, Tsujimoto J, Iharada A, Ogawa H.

Department of Anesthesia, Rumoi Municipal Hospital.

The purpose of this study is to find the most effective concentration of topical 
prostaglandin E1 (PGE1) to treat pain in postherpetic neuralgia (PHN). The
concentrations of PGE1 dissolved in vaseline were 0 microgram.g-1, 2
micrograms.g-1, 4 micrograms.g-1 and 8 micrograms.g-1. Visual analog scale (VAS) 
score was reduced after the ointment application in relation to the concentration
of PGE1 with initial relief at 25 minutes and lasting for 5 hours. Three patients
medicated with PGE1 8 micrograms.g-1 and one patient medicated with 4
micrograms.g-1 complained of topical pain of the skin. Topical PGE1 dissolved in 
vaseline is an effective means of reducing pain due to PHN. Probably 4
micrograms.g-1 of the ointment is most useful to treat PHN.

Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 10214018 [PubMed - indexed for MEDLINE]

3448: Arch Dis Child. 1998 Dec;79(6):470-1.

Varicella: to vaccinate or not to vaccinate?

Gershon A.

Columbia University College of Physicians and Surgeons, New York, USA.

PMID: 10210988 [PubMed - indexed for MEDLINE]

3449: J Neurol Neurosurg Psychiatry. 1999 May;66(5):672-6.

Sympathetic contralateral vestibulopathy after unilateral zoster oticus.

Schulz P, Arbusow V, Strupp M, Dieterich M, Sautier W, Brandt T.

Department of Neurology, Ludwig-Maximilians University Munich, Klinikum
Grobetahadern, Marchioninistr. 23, D-81377 Munich, Germany.
pschulz@nefo.med.uni-muenchen.de

A unique case of initially right sided varicella zoster induced Ramsay-Hunt
syndrome with complete vestibular loss is reported. The patient subsequently
developed deficits of the left vestibule 5 months later. An autoimmune
pathogenesis of the left vestibular failure rather than bilateral varicella
zoster infection was suggested by the following data: (1) no evidence of
vesicular eruptions on the left auricle and the virtual absence of antiviral
antibodies after onset of bilateral vestibulopathy; (2) prompt response of the
left vestibule to immunosuppressive therapy with corticosteroids; and (3)
presence of atypical nervous tissue specific autoantibodies against a 45 kDa
protein.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 10209186 [PubMed - indexed for MEDLINE]

3450: Reg Anesth Pain Med. 1999 Mar-Apr;24(2):170-4.

Acute herpetic neuralgia and postherpetic neuralgia in the head and neck:
response to gabapentin in five cases.

Filadora VA 2nd, Sist TC, Lema MJ.

Department of Anesthesiology and Pain Medicine, Roswell Cancer Institute, School 
of Medicine and Biomedical Sciences, State University of New York at Buffalo,
14263, USA.

BACKGROUND AND OBJECTIVES: The clinical presentations and pharmacologic
management of three patients with acute herpetic neuralgia (AHN) and two patients
with postherpetic neuralgia (PHN), confined to the head and neck region, are
described. METHODS: Two patients had pain in the ophthalmic division of the
trigeminal nerve, two had pain confined to the C2-C4 dermatomes, and one patient 
had C2 pain with radiating and referred pain to the second and third divisions of
the trigeminal nerve. RESULTS: Gabapentin, an anticonvulsant drug, was effective 
in treating these patients, including the two cases of AHN. All patients reported
complete pain relief after titration with gabapentin up to 1,800 mg/d. The
patients noted a dose-dependent decrease in pain almost immediately after
starting gabapentin. Specifically, reduction in the frequency and intensity of
allodynia, burning pain, shooting pain, and throbbing pain were noted. None of
the patients experienced side effects from the drug. CONCLUSIONS: In view of the 
results in these patients, blinded, controlled studies are needed to determine
the efficacy of gabapentin for treating AHN and PHN.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 10204905 [PubMed - indexed for MEDLINE]

3451: J Clin Microbiol. 1999 May;37(5):1352-5.

Laboratory diagnosis of common viral infections of the central nervous system by 
using a single multiplex PCR screening assay.

Read SJ, Kurtz JB.

Micropathology Ltd., University of Warwick Science Park, Coventry CV4 7EZ, United
Kingdom. read@telinco.co.uk

A multiplex PCR assay that detects the four commonest causes of viral meningitis 
and encephalitis in the United Kingdom (herpes simplex virus [HSV] type 1
[HSV-1], HSV type 2 [HSV-2], varicella-zoster virus [VZV], and enteroviruses) was
developed, and its sensitivity was compared with those of similar assays
described previously for this application. Compared to the previous assays, this 
single multiplex PCR assay had higher molecular sensitivities for the detection
for each of the viruses and improved utility for routine use in a diagnostic
laboratory. The assay was used to test a series of 1,683 consecutive
cerebrospinal fluid (CSF) samples between June 1997 and March 1998 inclusively.
Viral nucleic acid was detected in 138 (8.2%) of the CSF samples, including
enteroviruses in 51 samples, HSV-2 in 33 samples, VZV in 28 samples, and HSV-1 in
25 samples. Compared to the accepted relative incidence of viral etiologies,
aseptic meningitis due to HSV-2 infection was high, and in adult female patients 
with symptoms of aseptic meningitis, HSV-2 was the virus most commonly detected
in the CSF.

PMID: 10203485 [PubMed - indexed for MEDLINE]

3452: Laryngoscope. 1999 Apr;109(4):617-20.

Amplification of RNA from archival human temporal bone sections.

Ohtani F, Furuta Y, Iino Y, Inuyama Y, Fukuda S.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan.

BACKGROUND: The amplification of DNA from celloidin-embedded human temporal bone 
sections by polymerase chain reaction (PCR) has been applied to some auditory
diseases, such as herpes zoster oticus and hearing loss caused by the mutations
of mitochondrial DNA. However, few studies have reported detection of RNA from
temporal bone sections. OBJECTIVES: Because RNA analysis from temporal bone
sections may elucidate the development of the diseases in the auditory,
vestibular, and facial nerves, the authors investigated whether RNA in these
sections can be amplified by reverse transcription (RT)-PCR. METHODS: Sections
that were formalin-fixed, decalcified, and embedded between 1972 and 1986 were
used. Nucleic acid was extracted from the celloidin-embedded temporal bone
sections and subjected to RT-PCR. Human alpha-tubulin RNA was reverse transcribed
to cDNA and amplified by nested PCR using two sets of primers that were designed 
to distinguish cDNA from genomic DNA based on the presence of an intron between
the primers. RESULTS: Human alpha-tubulin RNA was detected in 11 of 14 temporal
bone sections (79%) by RT-PCR. RNA was detected in even the oldest sections,
which were processed in 1972. CONCLUSIONS: These results indicate that RNA can be
analyzed from archival celloidin-embedded human temporal bone sections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10201751 [PubMed - indexed for MEDLINE]

3453: Ryoikibetsu Shokogun Shirizu. 1999;(24 Pt 2):133-6.

[Herpes zoster]

[Article in Japanese]

Honda M, Niimura M.

Department of Dermatology, Jikei University School of Medicine.

Publication Types: 
    Review

PMID: 10201158 [PubMed - indexed for MEDLINE]

3454: Ryoikibetsu Shokogun Shirizu. 1999;(24 Pt 2):96-8.

[Varicella pneumonia]

[Article in Japanese]

Higashiyama Y, Kohno S.

Second Department of Internal Medicine, Nagasaki University School of Medicine.

Publication Types: 
    Review

PMID: 10201147 [PubMed - indexed for MEDLINE]

3455: Ryoikibetsu Shokogun Shirizu. 1999;(24 Pt 2):55-6.

[Ramsay Hunt syndrome]

[Article in Japanese]

Araga S.

Division of Neurology, Faculty of Medicine, Tottori University.

Publication Types: 
    Review

PMID: 10201135 [PubMed - indexed for MEDLINE]

3456: Ryoikibetsu Shokogun Shirizu. 1999;(24 Pt 2):49-51.

[Myeloradiculitis]

[Article in Japanese]

Shoji H.

First Department (Neurology) of Internal Medicine, Kurume University School of
Medicine.

Publication Types: 
    Review

PMID: 10201133 [PubMed - indexed for MEDLINE]

3457: Ryoikibetsu Shokogun Shirizu. 1999;(24 Pt 2):46-8.

[Myelitis]

[Article in Japanese]

Shoji H.

First Department (Neurology) of Internal Medicine, Kurume University School of
Medicine.

Publication Types: 
    Case Reports
    Review

PMID: 10201132 [PubMed - indexed for MEDLINE]

3458: Ryoikibetsu Shokogun Shirizu. 1999;(24 Pt 2):22-4.

[Varicella and herpes zoster encephalitis]

[Article in Japanese]

Fujita T, Umebayashi Y, Kikuchi M, Tojima H.

Department of Neurology, Hitachi General Hospital.

Publication Types: 
    Review

PMID: 10201125 [PubMed - indexed for MEDLINE]

3459: J Virol. 1999 May;73(5):4197-207.

Characterization of Varicella-Zoster virus glycoprotein K (open reading frame 5) 
and its role in virus growth.

Mo C, Suen J, Sommer M, Arvin A.

Department of Pediatrics, Stanford University School of Medicine, Stanford,
California 94305, USA. cmo@cmgm.stanford.edu

Varicella-zoster virus (VZV) is an alphaherpesvirus that is the causative agent
of chickenpox and herpes zoster. VZV open reading frame 5 (ORF5) encodes
glycoprotein K (gK), which is conserved among alphaherpesviruses. While VZV gK
has not been characterized, and its role in viral replication is unknown,
homologs of VZV gK in herpes simplex virus type 1 (HSV-1) and pseudorabies virus 
(PRV) have been well studied. To identify the VZV ORF5 gene product, we raised a 
polyclonal antibody against a fusion protein of ORF5 codons 25 to 122 with
glutathione S-transferase and used it to study the protein in infected cells. A
40,000-molecular-weight protein was detected in cell-free virus by Western
blotting. In immunogold electron microscopic studies, VZV gK was in enveloped
virions and was evenly distributed in the cytoplasm in infected cells. To
determine the function of VZV gK in virus growth, a series of gK deletion mutants
were constructed with VZV cosmid DNA derived from the Oka strain. Full and
partial deletions in gK prevented viral replication when the gK mutant cosmids
were transfected into melanoma cells. Insertion of the HSV-1 (KOS) gK gene into
the endogenous VZV gK site did not compensate for the deletion of VZV gK. The
replacement of VZV gK at a nonnative AvrII site in the VZV genome restored the
phenotypic characteristics of intact recombinant Oka (rOka) virus. Moreover, gK
complementing cells transfected with a full gK deletion mutant exhibited viral
plaques indistinguishable from those of rOka. Our results are consistent with the
studies of gK proteins of HSV-1 and PRV showing that gK is indispensable for
viral replication.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 10196316 [PubMed - indexed for MEDLINE]

3460: Drug Ther Bull. 1998 Oct;36(10):77-9.

Update on drugs for herpes zoster and genital herpes.

[No authors listed]

Publication Types: 
    Review

PMID: 10194872 [PubMed - indexed for MEDLINE]

3461: Acta Clin Belg. 1999 Jan-Feb;54(1):17-8.

Valaciclovir-induced hepatitis.

Renkes P, Trechot P, Blain H.

Service des Maladies de l'Appareil Digestif, Hopital Clinique Claude-Bernard,
Metz, France.

Publication Types: 
    Case Reports

PMID: 10192972 [PubMed - indexed for MEDLINE]

3462: Int J Dermatol. 1999 Feb;38(2):119-21.

Cutaneous infections by papillomavirus, herpes zoster and Candida albicans as the
only manifestation of idiopathic CD4+ T lymphocytopenia.

Manchado Lopez P, Ruiz de Morales JM, Ruiz Gonzalez I, Rodriguez Prieto MA.

Dermatology Service and the Immunology Unit, Hospital de Leon, Spain.

BACKGROUND: Selective depletion of CD4+ T lymphocytes is common in both primary
and secondary immunodeficiencies. Idiopathic CD4+ T lymphocytopenia (ICL) cases
are defined as a persistent CD4+ T lymphocyte count of less than 300x10(6)
cells/L and/or less than 20% of the total T-cell count. METHOD: A 40-year-old
woman, with a history of psoriasis and paracetamol allergy, presented with
persistent warts of the hands and condylomas of the ano-genitalia. Histological
and virological analysis was carried out on genital and cutaneous lesions and
peripheral blood. RESULTS: Serology for HIV-1, HIV-2, Epstein-Barr virus and
parvovirus B19 were negative. There was lymphopenia of 10% CD4+ cells, with
normal numbers of total leukocytes; there were no other-abnormal immunological
findings. DNA analysis of cutaneous lesions revealed HPV-49 and HPV-3 in the
hands and HPV-6 in the genital region. CONCLUSIONS: The cause of the ICL in this 
patient is unknown. HPV is not known to be an immunosuppressive agent; it remains
to be determined whether the HPV-associated lesions are the cause or the result
of immunosuppression.

Publication Types: 
    Case Reports

PMID: 10192160 [PubMed - indexed for MEDLINE]

3463: Schizophr Res. 1999 Mar 1;35 Suppl:S67-73.

Prolactin and antipsychotic medications: mechanism of action.

Petty RG.

University of Pennsylvania, Department of Psychiatry, Philadelphia, PA
19104-4283, USA. petty@bblmail.psycha.upenn.edu

Until the introduction of the first atypical antipsychotic, clozapine, in 1975,
hyperprolactinemia was assumed to be an inevitable consequence of treatment with 
any antipsychotic agent. Now we know that atypical antipsychotics such as
clozapine, olanzapine, quetiapine, sertindole, and ziprasidone are not associated
with significant prolactin increase. These new antipsychotics appear to spare
dopamine blockade within the brain's tubero-infundibular tract, a dopamine
pathway that also controls prolactin secretion. Since the release of prolactin is
tonically inhibited by the hypothalamus, with dopamine acting as the prolactin
release-inhibiting factor, any disruption of the connection between the
hypothalamus and the pituitary gland is associated with hyperprolactinemia. Other
factors that can increase prolactin secretion are also reviewed (e.g. estrogens, 
thyroid-releasing factor, vasoactive intestinal peptides, opioids, surgery,
illness such as epilepsy or herpes zoster infection, and psychic or physical
stress). Prolactin levels are at their highest 1-2 hours before waking, and early
waking interrupts its secretion. The major effects of hyperprolactinemia in women
are amenorrhea, cessation of normal cyclic ovarian function, loss of libido,
occasional hirsutism, and increased long-term risk of osteoporosis. The effects
in men are impotence, loss of libido, and hypospermatogenesis. Current data
indicate that conventional antipsychotics, as well as high doses of risperidone
(> 6 mg/day), increase prolactin levels to a range associated with sexual
dysfunction in nonpsychiatric patients. The lack of prolactin elevation reported 
with the atypical antipsychotics is believed to be due to their much greater
specificity, which results in less blockade of dopamine receptors in the
tubero-infundibular pathway.

Publication Types: 
    Review

PMID: 10190227 [PubMed - indexed for MEDLINE]

3464: J Am Acad Dermatol. 1999 Apr;40(4):643-4.

Chemotherapy-induced inflammation in seborrheic keratoses mimicking disseminated 
herpes zoster.

Williams JV, Helm KF, Long D.

Section of Dermatology, The Pennsylvania State University College of Medicine,
The Milton S. Hershey Medical Center, Hershey, USA.

We report a rare instance of chemotherapy-induced seborrheic keratoses of
Leser-Trelat in a patient with acute leukemia. In addition, this is the first
known case to mimic disseminated herpes zoster.

Publication Types: 
    Case Reports

PMID: 10188692 [PubMed - indexed for MEDLINE]

3465: Drugs. 1999 Feb;57(2):187-206.

Current pharmacological approaches to the therapy of varicella zoster virus
infections: a guide to treatment.

Snoeck R, Andrei G, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.
robert.snoeck@rega.kuleuven.ac.be

Varicella zoster virus (VZV), a member of the herpesvirus family, is responsible 
for both primary (varicella, chickenpox) as well as reactivation (zoster,
shingles) infections. In immunocompetent patients, the course of varicella is
generally benign. For varicella zoster, post-herpetic neuralgia is the most
common complication. In immunocompromised patients (particularly those with
AIDS), transplant recipients and cancer patients, VZV infections can be
life-threatening. For these patients and also for immunocompetent patients at
risk such as pregnant women or premature infants, the current treatment of choice
is based on either intravenous or oral aciclovir (acyclovir). The low oral
bioavailability of aciclovir, as well as the emergence of drug-resistant virus
strains, have stimulated efforts towards the development of new compounds for the
treatment of individuals with VZV infections. Among these new compounds,
penciclovir, its oral prodrug form famciclovir and the oral pro-drug form of
aciclovir (valaciclovir), rank among the most promising. As with aciclovir
itself, all of these drugs are dependent on the virus-encoded thymidine kinase
(TK) for their intracellular activation (phosphorylation), and, upon conversion
to their triphosphate form, they act as inhibitors/alternative substrate of the
viral DNA polymerase. Therefore, cross-resistance to these drugs may be expected 
for those virus mutants that are TK-deficient and thus resistant to aciclovir.
Other classes of nucleoside analogues dependent for their phosphorylation on the 
viral TK that have been pursued for the treatment of VZV infections include
sorivudine, brivudine, fialuridine, fiacitabine and netivudine. Among
oxetanocins, which are partially dependent on viral TK, lobucavir is now under
clinical evaluation. Foscarnet, which does not require any previous metabolism to
interact with the viral DNA polymerase, is used in the clinic when TK-deficient
VZV mutants emerge during aciclovir treatment. TK-deficient mutants are also
sensitive to the acyclic nucleoside phosphonates (i.e.
[s]-1-[3-hydroxy-2-phosphonylmethoxypropyl]cytosine; HPMPC); these agents do not 
depend on the virus-encoded TK for their phosphorylation but depend on cellular
enzymes for conversion to their diphosphoryl derivatives which then inhibit viral
DNA synthesis. Vaccination for VZV has now come of age. It is recommended for
healthy children, patients with leukaemia, and patients receiving
immunosuppressive therapy or those with chronic diseases. The protection induced 
by the vaccine seems, to some extent, to include zoster and associated neuralgia.
Passive immuniatin based on specific immunoglobulins does not effectively prevent
VZV infection and is therefore restricted to high risk individuals (i.e.
immunocompromised children and pregnant women).

Publication Types: 
    Review

PMID: 10188760 [PubMed - indexed for MEDLINE]

3466: J Am Acad Dermatol. 1999 Apr;40(4):647.

Zosteriform distribution of acantholytic dyskeratotic epidermal nevus?

Elston DM.

Publication Types: 
    Letter

PMID: 10188696 [PubMed - indexed for MEDLINE]

3467: Bone Marrow Transplant. 1999 Mar;23(5):469-74.

Varicella zoster virus infection associated with high-dose chemotherapy and
autologous stem-cell rescue.

Bilgrami S, Chakraborty NG, Rodriguez-Pinero F, Khan AM, Feingold JM, Bona RD,
Edwards RL, Dorsky D, Clive J, Mukherji B, Tutschka PJ.

Bone Marrow Transplant Program, University of Connecticut Health Center,
Farmington 06030, USA.

A retrospective evaluation of 215 consecutive recipients of high-dose
chemotherapy (HDC) and autologous stem cell rescue (ASCR) was conducted to
ascertain the incidence, temporal course, and outcome of varicella zoster virus
(VZV) infection. Herpes zoster was identified in 40 individuals at a median of 69
days following ASCR. Six of these cases occurred at a median of 33 days prior to 
ASCR but following the initiation of high doses of stem cell mobilization
chemotherapy. Twenty-five percent of patients demonstrated cutaneous or systemic 
dissemination and 32.5% required medical intervention for post-herpetic
neuralgia. All except two individuals received antiviral chemotherapy. One
patient with active VZV infection died of multiorgan failure 39 days after ASCR. 
Multivariate analysis of risk factors disclosed the significance of prophylactic 
acyclovir use in Herpes simplex virus seropositive individuals in reducing the
risk of VZV infection. Moreover, the use of busulfan, thiotepa and carboplatin as
the conditioning chemotherapy regimen was associated with an increased risk of
subsequent VZV infection. The incidence of VZV reactivation after HDC and ASCR is
similar to that observed following bone marrow transplantation but has an earlier
onset. This may be related to an earlier induction of immunosuppression by stem
cell mobilization chemotherapy administered prior to ASCR. We demonstrated a
marked reduction in the proliferative and synthetic capacities of peripheral
blood mononuclear cells obtained prior to and following stem cell mobilizing
chemotherapy. Moreover, greater than 80% of VZV infections occurred within 6
months following ASCR and late cases were seldom observed compared to allogeneic 
and autologous bone marrow transplantation. The role of antiviral
chemoprophylaxis during the period of maximum immunocompromise needs to be
studied further in the HDC-ASCR setting.

PMID: 10100561 [PubMed - indexed for MEDLINE]

3468: Nurse Pract. 1999 Mar;24(3):74-6, 79, 83-4 passim.

Varicella: the vaccine and the public health debate.

Niederhauser VP.

University of Hawaii School of Public Health, USA.

Since the March 1995 Food and Drug Administration approval of the varicella
vaccine for the prevention of varicella and the early 1996 American Academy of
Pediatrics recommendation for universal vaccination for all susceptible children 
age 12 months and older, controversy over the need for a universal vaccination
has existed. This article reviews the pathogenesis and epidemiology of the
varicella zoster virus, the historic development of the vaccine, and the benefits
and barriers to adoption of a universal varicella vaccination schedule. It
concludes with the public health perspective on this controversial vaccine and
future research recommendations.

Publication Types: 
    Review

PMID: 10100242 [PubMed - indexed for MEDLINE]

3469: Internist (Berl). 1999 Feb;40(2):162-7.

[Chronic pain in herpes zoster]

[Article in German]

Mergenthaler HG, Beinert T.

Klinik fur Onkologie des Zentrums fur Innere Medizin, Katharinenhospital,
Stuttgart.

Publication Types: 
    Review

PMID: 10097974 [PubMed - indexed for MEDLINE]

3470: AJNR Am J Neuroradiol. 1999 Feb;20(2):278-80.

Ramsay Hunt syndrome associated with brain stem enhancement.

Sartoretti-Schefer S, Kollias S, Valavanis A.

Institute of Neuroradiology, University Hospital of Zurich, Switzerland.

Postcontrast T1-weighted MR images in a patient with Ramsay Hunt syndrome showed 
an enhancing lesion in the region of the nucleus of the pontine facial nerve and 
abnormal enhancement of the intrameatal, labyrinthine, and tympanic facial nerve 
segments and of the geniculate ganglion, as well as enhancement of the
vestibulocochlear nerve and parts of the membranous labyrinth. This enhancement
most probably resulted from a primary neuritis of the intrameatal nerve trunks of
the seventh and eighth cranial nerves.

Publication Types: 
    Case Reports

PMID: 10094353 [PubMed - indexed for MEDLINE]

3471: Cornea. 1999 Mar;18(2):176-81.

Treatment outcome of Moraxella keratitis: our experience with 18 cases--a
retrospective review.

Garg P, Mathur U, Athmanathan S, Rao GN.

Sight Savers' Corneal Training Centre, L.V. Prasad Eye Institute, Hyderabad,
India. prashant@lvpeye.stph.net

PURPOSE: To analyze the clinical presentation, predisposing risk factors, in
vitro antimicrobial susceptibility, and especially the outcome of therapy of
Moraxella keratitis. METHODS: Retrospective review of 18 culture-proven cases of 
Morarella keratitis. RESULTS: Morarella keratitis was associated with Hansen's
disease, uncontrolled diabetes mellitus, herpes zoster ophthalmicus, and
chickenpox of the recent past and severe protein energy malnutrition. Other
associated ocular conditions included lagophthalmos, blepharitis, steroid
therapy, corneal degeneration, and scleritis. In four patients, no systemic or
ocular predisposing factors could be identified. Three patients presented with an
indolent peripheral, anterior stromal infiltrate while the remaining patients
showed a central or paracentral ulceration with or without hypopyon. Moraxella
species was the only pathogen isolated in 11 cases, whereas mixed infection was
seen in seven cases. All isolates were sensitive to ciprofloxacin. Eight of 18
strains of Moraxella were resistant to cefazolin. All 14 eyes for which the
follow-up data were available responded to medical treatment alone. CONCLUSIONS: 
Although considered to be associated with poor outcome, our experience suggests
that a favorable outcome can be expected in Moraxella keratitis. Cefazolin
resistance (as seen in our series) may pose a problem and, hence, monitoring of
antimicrobial susceptibility would be beneficial. In view of cefazolin
resistance, ciprofloxacin monotherapy appears to be an effective method in the
medical management of these cases.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10090363 [PubMed - indexed for MEDLINE]

3472: Nippon Ganka Gakkai Zasshi. 1999 Feb;103(2):137-43.

[A case of AIDS complicated by progressive outer retinal necrosis]

[Article in Japanese]

Shimakawa M, Sato N.

Department of Ophthalmology, Tokyo Women's Medical University, School of
Medicine, Japan.

BACKGROUND: The retina may be involved in patients with acquired immunodeficiency
syndrome (AIDS). Progressive outer retinal necrosis (PORN) is a liability. CASE: 
A 46-year-old female had repeated exacerbations of pulmonary tuberculosis since
two years before. Herpes zoster developed in her right trigeminal nerve area two 
weeks before, leading to a diagnosis of AIDS. She was referred to us for
ophthalmological evaluation. FINDINGS: Both eyes showed numerous yellowish white 
patches in the deeper retinal layers. The anterior chamber and the vitreous were 
almost intact. Herpes zoster virus was identified in the acqueous by the
polymerase chain reaction (PCR) method. Systemic acyclovir or ganciclovir failed 
to prevent rapid extension of fundus lesions, resulting in whole-layer necrosis
of the retina. Retinal detachment with multiple breaks developed in both eyes
whthin eleven days after the patient was first seen by us. The clinical course
was different from acute retinal necrosis and was characteristic of PORN.
CONCLUSION: This case illustrates that PORN may develop in patients affected by
AIDS.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10089753 [PubMed - indexed for MEDLINE]

3473: An Med Interna. 1999 Jan;16(1):49-50.

[Herpes zoster unleashed by rehabilitative therapy]

[Article in Spanish]

Justo Firvida E, Macena Vilarino S, Lado Lado F, Cadarso Palau A.

Publication Types: 
    Case Reports
    Letter

PMID: 10089655 [PubMed - indexed for MEDLINE]

3474: Acta Derm Venereol. 1999 Jan;79(1):95.

Comment in:
    Acta Derm Venereol. 1999 Nov;79(6):495.

Post-herpes zoster scar sarcoidosis.

Corazza M, Bacilieri S, Strumia R.

Publication Types: 
    Case Reports
    Letter

PMID: 10086879 [PubMed - indexed for MEDLINE]

3475: Acta Derm Venereol. 1999 Jan;79(1):90-1.

Zosteriform cutaneous metastases arising from adenocarcinoma of the colon:
diagnostic smear cytology from cutaneous lesions.

Maeda S, Hara H, Morishima T.

Publication Types: 
    Case Reports
    Letter

PMID: 10086875 [PubMed - indexed for MEDLINE]

3476: Br J Haematol. 1999 Mar;104(3):560-8.

Infections in adults undergoing unrelated donor bone marrow transplantation.

Williamson EC, Millar MR, Steward CG, Cornish JM, Foot AB, Oakhill A, Pamphilon
DH, Reeves B, Caul EO, Warnock DW, Marks DI.

Department of Microbiology, Bristol Royal Infirmary.

This study retrospectively reviews infections over a 7-year period in 60
consecutive adults (median age 25 years) undergoing their first unrelated donor
bone marrow transplant (UD-BMT). T-cell depletion was employed in 93%. More than 
half the patients had one or more severe, potentially life-threatening,
infections. There was a high incidence of invasive fungal infections (Aspergillus
17, Candida four), despite the use of itraconazole or amphotericin prophylaxis.
Ten Aspergillus infections occurred beyond 100 d. Two patients (11%) with
invasive aspergillosis survived. Clustering of infections was noted, with
invasive fungal infections significantly associated with bacteraemias (OR 3.73,
P=0.06) and multiple viral infections (OR 4.25, P=0.05). There were 21 severe
viral infections in 16 patients, with CMV disease occurring in four patients
only; viral pneumonitis was predominantly due to 'community respiratory' viruses.
Most early bacteraemias (68%) were due to Gram-positive organisms. The majority
of episodes of Gram-negative sepsis were caused by non-fastidious
non-fermentative bacteria, such as Pseudomonas spp. and Acinetobacter spp.,
historically regarded as organisms of low pathogenicity. In patients with
successful engraftment and minimal graft-versus-host disease, late infections
suggestive of continued immune dysfunction (shingles, recurrent lower respiratory
infections, Salmonella enteritis and extensive warts) were common.

PMID: 10086795 [PubMed - indexed for MEDLINE]

3477: J Formos Med Assoc. 1999 Feb;98(2):141-4.

Progressive outer retinal necrosis syndrome as an early manifestation of human
immunodeficiency virus infection.

Yang CM, Wang WW, Lin CP.

Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Progressive outer retinal necrosis syndrome is a recently recognized variant of
necrotizing herpetic retinopathy, developing in patients with acquired immune
deficiency syndrome (AIDS) or other conditions causing immune compromise. We
report a case in which the diagnosis of retinal necrosis syndrome was made before
the diagnosis of AIDS was confirmed. A 41-year-old man presented with a 1-month
history of blurred vision in his left eye. Ophthalmologic examination revealed
extensive retinal necrosis with total retinal detachment in his left eye and
multifocal deep retinal lesions scattered in the posterior fundus as well as in
the peripheral retina in his right eye. The serologic test for human
immunodeficiency virus (HIV) was positive. Despite intravenous acyclovir
treatment for 1 week, the lesions in the right eye showed rapid progression. High
doses of intravitreal ganciclovir were then given in addition to intravenous
acyclovir. After combined treatment for 1 month, the lesions became quiescent and
the visual acuity improved to 20/30. Although the patient soon developed
full-blown AIDS, the vision in his right eye remained undisturbed. Physicians
should suspect progressive outer retinal necrosis syndrome in any patient with
rapidly progressive necrotizing retinopathy and test the patient for HIV
infection. Aggressive combined antiviral agent therapy should be considered to
save vision.

Publication Types: 
    Case Reports

PMID: 10083772 [PubMed - indexed for MEDLINE]

3478: Int Ophthalmol Clin. 1998 Fall;38(4):149-60.

Varicella zoster virus ocular disease.

Chern KC, Margolis TP.

Francis I. Proctor Foundation, Department of Ophthalmology, University of
California, San Francisco 94143, USA.

Our understanding of the spectrum of diseases caused by VZV continues to evolve
with new and atypical presentations. Newer diagnostic studies are implicating VZV
as the cause of a host of inflammatory conditions, some of which present sine
herpete. Finally, the continued development of antiviral drugs and vaccines will 
allow safer and more effective treatment of VZV and its complications.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 10081731 [PubMed - indexed for MEDLINE]

3479: J Am Pharm Assoc (Wash). 1999 Mar-Apr;39(2):217-21.

Treatment of postherpetic neuralgia.

Menke JJ, Heins JR.

South Dakota State University, Brookings 57007-0099, USA.
menke.jennifer_@sioux-falls.va.gov

OBJECTIVE: To review treatment options for postherpetic neuralgia (PHN). DATA
SOURCES: Clinical literature selected by the authors accessed via MEDLINE. Search
terms included postherpetic neuralgia, capsaicin, antidepressants,
anticonvulsants, and lidocaine. STUDY SELECTION: Controlled trials relevant to
PHN. DATA SYNTHESIS: Traditional analgesics offer little benefit for the
treatment of PHN. The best results for pain relief have come from capsaicin and
tricyclic antidepressants. Anticonvulsants have also been used, although the
number of studies evaluating this is limited. More invasive therapies, such as
transcutaneous electrical nerve stimulation and nerve blocks, can be considered
if other therapies fail. CONCLUSION: Early diagnosis and treatment of herpes
zoster may offer patients the best chance of preventing the development of PHN.
However, if PHN does develop, the patient should seek treatment early for the
best chance of pain relief.

Publication Types: 
    Case Reports
    Review

PMID: 10079653 [PubMed - indexed for MEDLINE]

3480: J Clin Microbiol. 1999 Apr;37(4):950-3.

Amplification of the six major human herpesviruses from cerebrospinal fluid by a 
single PCR.

Minjolle S, Michelet C, Jusselin I, Joannes M, Cartier F, Colimon R.

Laboratoire de Bacteriologie-Virologie, CHU Pontchaillou, Rennes, France.

We used a novel type of primer system, a system that uses stair primers, in which
the primer sequences are based on consensus sequences in the DNA polymerase gene 
of herpesvirus to detect herpesviruses by PCR. A single PCR in a single tube
detected the six major herpesviruses that infect the central nervous system:
herpes simplex virus type 1 (HSV-1), and type 2 (HSV-2), cytomegalovirus (CMV),
Epstein-Barr virus (EBV), varicella-zoster virus (VZV), and human herpesvirus 6
(HHV-6). We used the technique to analyze 142 cerebrospinal fluid (CSF) samples
that had been stored at -80 degrees C and compared the results with those
obtained previously for the same samples by standard, targeted PCR. Four hundred 
one targeted PCR tests had been run with the 142 samples to detect HSV-1, HSV-2, 
CMV, and VZV; screening for EBV and HHV-6 was not prescribed when the samples
were initially taken. Eighteen CSF samples tested positive by classic targeted
PCR. The herpesvirus consensus PCR detected herpesviruses in 37 samples,
including 3 samples with coinfections and 17 viral isolates which were not
targeted. Two samples identified as infected by the targeted PCR tested negative 
by the consensus PCR, and eight samples that tested positive by the consensus PCR
were negative by the targeted PCR. One hundred three samples scored negative by
both the targeted and the consensus PCRs. This preliminary study demonstrates the
value of testing for six different herpesviruses simultaneously by a sensitive
and straightforward technique rather than screening only for those viruses that
are causing infections as suggested by clinical signs.

Publication Types: 
    Comparative Study

PMID: 10074507 [PubMed - indexed for MEDLINE]

3481: J Clin Virol. 1999 Jan;12(1):53-64.

Prevalence of herpes simplex virus types 1 and 2, cytomegalovirus, and
varicella-zoster virus infections in Eritrea.

Ghebrekidan H, Ruden U, Cox S, Wahren B, Grandien M.

Swedish Institute for Infectious Disease Control, Microbiology and Tumour Biology
Centre, Karolinska Institute, Stockholm.

BACKGROUND: Herpesviruses establish latent infections in their hosts for life.
The scarcity of data that exists in regard to herpesvirus infections in many
African regions, could partly be due to the mild nature of their primary
infections and the lack of means for their proper diagnosis. However, in recent
decades the alarming spread of HIV infection in Africa and associated frequent
reactivation of herpesvirus infections is leaving less room for neglect. This
seroprevalence study is intended to help in the evaluation of the prevalence of
herpesvirus infections in Eritrea. OBJECTIVE: To evaluate the spread of herpes
simplex virus types 1 and 2 (HSV-1 and HSV-2), cytomegalovirus (CMV), and
varicella-zoster virus (VZV) infections. STUDY DESIGN: The study population
groups comprise female sex workers (FSW), former guerrilla fighters, truck
drivers, port workers, a tribe called Rashaida, pregnant women, children under 5 
years of age, and children over 5 years of age. The groups of pregnant women and 
children under and over 5 years of age were included to form a background for the
evaluation of groups considered at risk for sexually transmitted or blood borne
infections. RESULTS: All study groups had a high seroprevalence of HSV-1
infections ( > 80%), except for the children under 5 years of age. The FSW had
the highest prevalence of HSV-2 infections, 80%, followed by guerrilla fighters, 
truck drivers, port workers, pregnant women, children, and the Rashaidas.
Positivity for antibodies against CMV was > 90% in all studied populations. The
prevalence of VZV infections was surprisingly low in the tribe of Rashaida, 44%
compared to more than 90% in the other adult groups tested for VZV (P = 0.0001). 
CONCLUSION: The study shows that the prevalence of HSV-2 in the risk group of FSW
was high, which could partly be explained by their sexual behaviours. HSV-2 was
particularly low in the Rashaida group and, as expected, in the children. The low
prevalence of VZV observed in the Rashaida is of importance since it makes them
vulnerable to infection with varicella during their inevitable integration with
the other tribes in their society.

PMID: 10073414 [PubMed - indexed for MEDLINE]

3482: Jpn J Clin Oncol. 1999 Jan;29(1):49-52.

Spinal epidural abscess associated with epidural catheterization: report of a
case and a review of the literature.

Okano K, Kondo H, Tsuchiya R, Naruke T, Sato M, Yokoyama R.

Department of Surgical Oncology, National Cancer Center Hospital, Tokyo, Japan.
kokano@gan2.ncc.go.jp

We describe a 53-year-old man who developed a catheter-related epidural abscess 8
days after left upper lobectomy for lung cancer. Methicillin-resistant
Staphylococcus aureus (MRSA) was detected in a culture of the epidural pus.
Magnetic resonance imaging was essential for the diagnosis of epidural abscess
and for determining the extent of spread. The patient was treated by laminectomy 
and administration of appropriate antibiotics, with almost complete recovery,
except for urinary retention. A literature search yielded 29 additional cases of 
catheter-related epidural abscess. The median duration of catheterization was 4
days and the median time to onset of the clinical symptoms after catheter
placement was 8 days. Eleven of the 30 patients had some underlying disorders,
including malignancy or herpes zoster, or were receiving steroids. Nine of the 10
patients with thoracic epidural abscess had persistent neurological deficits,
whereas 12 of the 15 patients with lumbar epidural abscess showed a full recovery
after treatment. Surgical decompression was not required in six patients without 
significant neurological deficits, who recovered following antibiotic treatment
(four patients) or percutaneous drainage (two patients). Thoracic catheters are
associated with a disproportionately high incidence of epidural abscess and
persistent neurological sequelae following treatment.

Publication Types: 
    Case Reports
    Review

PMID: 10073152 [PubMed - indexed for MEDLINE]

3483: Pediatr Rev. 1999 Mar;20(3):103, 105-6.

Index of suspicion. Case 3. Diagnosis: HIV infection.

Stille CJ.

Connecticut Children's Medical Center, Hartford, USA.

Publication Types: 
    Case Reports

PMID: 10073075 [PubMed - indexed for MEDLINE]

3484: Can J Neurol Sci. 1999 Feb;26(1):29-32.

Herpes zoster and multiple sclerosis.

Ross RT, Cheang M, Landry G, Klassen L, Doerksen K.

Section of Neurology, University of Manitoba and Health Sciences Centre,
Winnipeg, Canada.

BACKGROUND: Clinical experience suggests that young multiple sclerosis patients
may have herpes zoster (HZ) earlier and more often than the general population.
As there is evidence of a relationship between varicella zoster virus (VZV) and
MS, a study of HZ and MS was undertaken. METHODS: Eight hundred and twenty-nine
patient-members of the Manitoba Chapter of the Canadian Multiple Sclerosis
Society were surveyed by mail. Six hundred and thirty-three (76%) responded.
Questions included: age at diagnosis of MS, history of HZ (yes, no, probably),
number of episodes of HZ and age at each occurrence, date of birth, and sex of
respondent. The controls were consecutive patients with other neurological
diseases (OND) attending local neurological or neurosurgical clinics, plus
practice-based and population-based surveys of herpes zoster without reference to
any other disease. The OND controls were assessed at the time of their outpatient
visits. RESULTS: In the MS group with a positive/probable history of HZ, the
HZ/MS rate was 106/633 (16.8%); in the practice-based survey the rate was
192/3534 (5.4%); and among the patients with OND it was 42/616 (6.8%). The HZ
occurred at an earlier age in the MS group. The majority of male patients had HZ 
prior to the diagnosis of MS. The date of diagnosis is more likely to be a
precise memory as opposed to the onset of symptoms. More than one attack of HZ
was also more common in the MS group. CONCLUSIONS: This survey adds to the
evidence that patients with MS have a unique relationship with the herpes zoster 
virus.

PMID: 10068804 [PubMed - indexed for MEDLINE]

3485: Curr Opin Microbiol. 1998 Oct;1(5):535-46.

New antivirals - mechanism of action and resistance development.

Balzarini J, Naesens L, De Clercq E.

Rega Institute for Medical Research Katholieke Universiteit Leuven
Minderbroedersstraat 10 B-3000 Leuven Belgium. jan.balzarini@rega.
kuleuven.ac.be.

In recent years, several novel treatment modalities emerged for a number of virus
infections, including lamivudine for hepatitis B virus, abacavir, adefovir
dipivoxyl and apropovir disprometil for human immunodeficiency virus, cidofovir
for cytomegalovirus, and famciclovir (the oral prodrug of penciclovir) and
cidofovir for other herpesviruses (i.e. herpes simplex virus and varicella-zoster
virus). For all drugs, resistance eventually develops upon prolonged
administration to the infected individuals, albeit at a varying extent. In
addition, new mutations related to multidrug resistance have recently been
identified.

Publication Types: 
    Review

PMID: 10066527 [PubMed - indexed for MEDLINE]

3486: Ugeskr Laeger. 1999 Feb 8;161(6):794-6.

[Complications in two children with acute lymphatic leukemia caused by
vaccination against varicella zoster virus]

[Article in Danish]

Christensen CL, Poulsen A, Bottiger B, Kirk M, Andersen HK, Schmiegelow K.

H:S Righospitalet, klinisk mikrobiologisk afdeling, Kobenhavn.

Complications in two varicella zoster virus (VZV) vaccinated children with
leukemia in remission are reported. Case I presented with varicella on day 30
after vaccination, with a relapse on day 49 and development of zoster on day 70. 
VZV was detected in vesicles by PCR on days 49 and 70. Case II presented with
varicella on day 32 after vaccination, and VZV was detected in vesicles and nasal
secretion. The manifestations were mild and responded to treatment. PCR methods
were directed toward the R5 and PS regions. The virus from the two children was
unambiguously identified as the Oka vaccine strain. The majority of Danish field 
strains had only one copy of the 112 basepair repeat element in the R5 region,
but two, four and presumably higher copy numbers were also seen. All Danish field
strains had the Pst1 cleavage site in the PS region.

Publication Types: 
    Case Reports
    English Abstract

PMID: 10068350 [PubMed - indexed for MEDLINE]

3487: Ter Arkh. 1998;70(12):63-5.

[Neuralgia and zovirax treatment of patients with herpes zoster]

[Article in Russian]

Dekonenko EP, Shishov AS, Kupriianova LV, Rudometov IuP, Bagrov FI.

AIM: To estimate the occurrence of postherpetic neuralgia (PHN) arising after
acute period of herpes zoster (HZ) and determination of zovirax efficiency in PHN
prevention. MATERIALS AND METHODS: Of a total of 102 patients with HZ aged 17-89 
years, 20 patients aged 26-83 years were given zovirax. RESULTS: Acute pain
syndrome in PHN was observed in more that one-third of HZ patients. Patients over
60 years of age were more predisposed to PHN. Zovirax reduced the duration of
acute rash and its healing, decreased the number of patients with
zoster-associated pain and PHN patients. CONCLUSION: Zovirax is effective and
safe in preventing PHN in HZ patients.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract

PMID: 10067257 [PubMed - indexed for MEDLINE]

3488: Clin Infect Dis. 1999 Feb;28(2):412-3.

Comment on:
    Clin Infect Dis. 1998 Jul;27(1):209-10.

Varicella-Zoster virus infection associated with acute liver failure.

Vartian CV.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 10064269 [PubMed - indexed for MEDLINE]

3489: J Dermatol. 1999 Jan;26(1):1-10.

Follow-up of clinical efficacy of iontophoresis therapy for postherpetic
neuralgia (PHN).

Ozawa A, Haruki Y, Iwashita K, Sasao Y, Miyahara M, Sugai J, Matsuyama T, Iizuka 
M, Kawakubo Y, Nakamori M, Ohkido M.

Department of Dermatology, Tokai University School of Medicine, Kanagawa, Japan.

A great variety of therapies have been attempted for PHN, including
pharmacotherapy and physical therapy. However, there has been no decisive
treatment, and reports of the clinical efficacy of all available therapies have
been rather controversial. Almost all studies conducted so far have looked only
at short-term therapeutic efficacy, and only a few investigators have conducted
long-term observations or studies on long-term outcome. We followed up the
clinical efficacy of iontophoresis therapy using lidocaine and methylprednisolone
in 197 PHN patients. Monitoring conducted for an average of 4 years after
completion of the treatment showed that pain remained unchanged or improved
compared to pain observed upon completion of the treatment in 90.4% of patients. 
Although 42.6% of patients were still continuing some treatment, 90.9% were found
to be able to take care of themselves. Findings obtained were reviewed and
discussed from various viewpoints. Our findings showed that iontophoresis therapy
is not only effective at the end of the treatment, but its efficacy is maintained
over a long period of time, indicating that it is clinically very useful for the 
treatment of PHN.

PMID: 10063205 [PubMed - indexed for MEDLINE]

3490: Ther Drug Monit. 1999 Feb;21(1):129-33.

Determination of acyclovir in plasma by solid-phase extraction and column liquid 
chromatography.

Poirier JM, Radembino N, Jaillon P.

Department of Pharmacology, Saint-Antoine University Hospital, Paris, France.

After oral administration, valacyclovir, the L-valyl ester of acyclovir, converts
to the antiherpes virus drug, acyclovir. The bioavailability of acyclovir after
valacyclovir administration is between 3- to 4.5-fold higher than that achieved
after oral acyclovir administration. Therefore, despite the drug's short terminal
half-life (3 hours), acyclovir plasma concentrations obtained after oral
administration of the prodrug offer a more convenient dosage regimen in patients 
with herpes zoster than that required after acyclovir administration. Acyclovir
is also used for viral infection prophylaxis in patients with hematologic
disorders and in those who have undergone solid organ transplantation. We have
described a simple and selective liquid chromatographic method for the
determination of acyclovir in plasma using a new polymeric reversed-phase sorbent
for solid-phase extraction. A mean acyclovir absolute recovery of 90% was found
after elution of the drug from the cartridge with the mobile phase. This
procedure allowed us to measure 62.5 ng/mL of acyclovir with an acceptable
precision using a plasma volume of 250 microL, and no drug was found to interfere
with the assay. This method is suitable for the therapeutic monitoring of
acyclovir in patients who have been given a wide variety of coadministered drugs.

PMID: 10051066 [PubMed - indexed for MEDLINE]

3491: Antiviral Res. 1999 Jan;40(3):155-66.

Emergence of resistance to acyclovir and penciclovir in varicella-zoster virus
and genetic analysis of acyclovir-resistant variants.

Ida M, Kageyama S, Sato H, Kamiyama T, Yamamura J, Kurokawa M, Morohashi M,
Shiraki K.

Department of Virology, Toyama Medical and Pharmaceutical University, Sugitani,
Japan.

We have characterized the differential actions of acyclovir and penciclovir
against varicella-zoster virus (VZV) in cell culture by comparing the frequency
of appearance of resistant viruses followed by their characterization. Cells were
infected with cell-free virus and the cultures were successively treated with
increasing concentrations of acyclovir or penciclovir. Drug-resistant viruses
were selected in the presence of 6 microg/ml of acyclovir or penciclovir. The
emergence frequency of resistant viruses was significantly higher following
acyclovir exposure than following penciclovir exposure (Fisher's exact test,
P<0.0001), possibly reflecting virus growth differences under these experimental 
conditions. Based on antiviral drug susceptibility and thymidine kinase (TK)
activity assays, 11 acyclovir-resistant variants from seven experiments using
three virus strains (Kawaguchi strain, Oka varicella vaccine strain and a
clinical isolate from a zoster patient) were found to be TK-deficient. Sequence
analysis of TK-deficient variants of the Kawaguchi strain revealed deletions that
caused frameshifts, resulting in premature termination in the TK gene.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10027650 [PubMed - indexed for MEDLINE]

3492: Ann Dermatol Venereol. 1998 Sep;125(9):630-6.

[Management of varicella-zoster virus infections]

[Article in French]

[No authors listed]

Publication Types: 
    Consensus Development Conference
    Review

PMID: 10026092 [PubMed - indexed for MEDLINE]

3493: Arch Neurol. 1999 Feb;56(2):241-3.

Adult-onset MELAS presenting as herpes encephalitis.

Sharfstein SR, Gordon MF, Libman RB, Malkin ES.

Department of Neurology, Long Island Jewish Medical Center, Long Island Campus
for the Albert Einstein College of Medicine, New Hyde Park, NY 11042, USA.

OBJECTIVE: To report an unusual presentation of mitochondrial encephalomyopathy, 
lactic acidosis, and stroke-like episodes (MELAS) manifested in late life with a 
clinical picture of herpes simplex encephalitis. DESIGN: Case report. SETTING:
Clinical neurology department in a tertiary care hospital. CASE DESCRIPTION: A
55-year-old woman developed aphasia and delirium during ophthalmic herpes zoster 
infection treated with oral prednisone and ophthalmic steroids, which was
followed by progressive cognitive decline without acute neurologic events for 5
years. At age 60, the patient presented with new onset of seizures, hemiparesis, 
and hemianopsia. Subsequently she developed cortical blindness, multiple
traumatic soft tissue injuries from falls, acute psychosis, and severe dementia
with periods of agitation. She died in a nursing home in March 1997, 6 years
after initial presentation. RESULTS: Magnetic resonance imaging scan of the brain
showed hyperintensity on T2-weighted images involving temporal, parietal, and
occipital lobes bilaterally as well as mild atrophy of brainstem and cerebellum. 
Single photon emission computed tomographic imaging showed hypoperfusion of
temporal, parietal, and occipital lobes. Results of video electroencephalographic
monitoring showed periodic lateralizing epileptiform discharges in temporal and
occipital areas. The serum lactate level was normal in May 1996 and elevated in
October 1996. The creatine kinase level was elevated with a 100% MM fraction in
August 1991 and normal in March 1996. Results of repeated cerebrospinal fluid
analyses indicated elevated protein levels. Analysis of DNA was diagnostic of
MELAS by mitochondrial DNA point mutation at position 3243. The results of
autopsy showed moderate cerebral, cerebellar, and brainstem atrophy with signs of
infarction in temporal and parietal lobes bilaterally. CONCLUSIONS: The clinical 
presentation as well as age at onset of MELAS are highly variable. Onset of
mitochondrial disorders can be provoked by febrile illness when there is mismatch
between energy requirements and availability. In the differential diagnosis of
herpes encephalitides, MELAS syndrome should be considered.

Publication Types: 
    Case Reports

PMID: 10025431 [PubMed - indexed for MEDLINE]

3494: QJM. 1998 Nov;91(11):788-9.

Self-limiting abdominal wall herniation and constipation following herpes zoster 
infection.

Healy C, McGreal G, Lenehan B, McDermott EW, Murphy JJ.

Publication Types: 
    Case Reports
    Letter

PMID: 10024942 [PubMed - indexed for MEDLINE]

3495: Am J Gastroenterol. 1999 Feb;94(2):424-6.

Shingles during the course of treatment with 6-mercaptopurine for inflammatory
bowel disease.

Korelitz BI, Fuller SR, Warman JI, Goldberg MD.

Department of Medicine, Lenox Hill Hospital, and The NYU School of Medicine, New 
York, New York 10021, USA.

OBJECTIVE: Our aim was to study the frequency, severity, and outcome of patients 
with Crohn's disease and ulcerative colitis treated with 6-mercaptopurine (6MP)
who developed shingles during treatment, and to recommend management. While
varicella can be severe in young people immunocompromised by steroids, the
incidence of herpes zoster in older people with inflammatory bowel disease (IBD) 
and whether its severity is influenced by 6MP and azathioprine are unknown.
METHODS: Data were collected from our IBD Center on 550 patients with IBD to
identify those who developed shingles while on 6MP, its severity, the dose and
duration of 6MP, and the management of the 6MP. RESULTS: Twelve of 550 patients
with IBD treated with 6MP developed shingles. In two with herpes zoster
ophthalmicus the pain was prolonged, and one patient developed encephalitis which
was brief and uncomplicated; in nine patients the course was benign. Acyclovir
should be the treatment of choice even though it was available in only three
cases. CONCLUSIONS: Shingles occurs more often in IBD patients treated with 6MP
than in those who are not, but the course is usually benign and there has been no
mortality. The 6MP should be stopped temporarily until severity is established
but if the underlying disease warrants further treatment the 6MP should be
restarted.

Publication Types: 
    Case Reports

PMID: 10022640 [PubMed - indexed for MEDLINE]

3496: Front Biosci. 1999 Feb 15;4:D200-11.

Latency of varicella zoster virus; a persistently perplexing state.

Kinchington PR.

Departments of Ophthalmology and of Molecular Genetics and Biochemistry, School
of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.

Varicella zoster virus (VZV) is the herpesvirus which causes the childhood
disease varicella, also known as chickenpox, and the adult disease herpes zoster,
also known as shingles. These distinct diseases are separated by a lengthy period
of latency, often lasting decades, in which the virus resides within the ganglia 
of the host. VZV latency and reactivation from it have, for the most part, been
extraordinarily difficult to examine. This is due to the lack of a good animal
model for the VZV latent state, the inability to experimentally reactivate VZV
under any circumstances and the caveats and problems encountered in examining
human ganglionic tissue. However, insights into features of the molecular events 
of VZV latency have been gleaned from its pathogenesis and from recent advances
in molecular probing of human and animal ganglia. Evidence suggests that the
latent VZV genome may express transcripts unlike those of closely related
herpesviruses, and some evidence suggests an unusual site for the establishment
of VZV latency. In this review, the current evidence for events occurring during 
the VZV latent state will be discussed, from a view of its pathogenesis as well
as its molecular biology.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 9989948 [PubMed - indexed for MEDLINE]

3497: Dtsch Med Wochenschr. 1999 Jan 22;124(3):45-8.

[Focal mycobacterial lymphadenitis after starting highly active antiretroviral
therapy]

[Article in German]

Schwietert M, Battegay M.

Medizinische Universitats-Poliklinik, Kantonsspital Basel.

HISTORY AND FINDINGS: A 30-year-old man with a known HIV infection for 7 years
presented for treatment with antiretroviral drugs. He was known to have had
herpes zoster, oral hairy leukoplakia and recurrent Candida stomatitis, but was
otherwise without symptoms. INVESTIGATIONS: The CD4 lymphocyte count was 19
cells/mm3 and there were 41,000 HIV-RNA copies/ml. DIAGNOSIS, TREATMENT AND
COURSE: The HIV infection was in CDC stage B3, indicating the need for combined
antiretroviral treatment. A week after starting stavudine, saquinavir and
ritonavir he had to be admitted because of nausea and vomiting, colicky abdominal
pain, diarrhea, fever up to 39 degrees C and a rise of C-reactive protein to 207 
mg/dl. Bacteriological examination of feces and biopsy of an enlarged
retroperitoneal lymph node revealed atypical mycobacteria. Antituberculosis
treatment was started. The CD4 cell count rose to 56/mm3 and the viral count fell
to 11,000/ml. Each time after initiating a different antiviral regimen the
symptoms recurred. CONCLUSIONS: This case illustrates an atypical manifestation
of on opportunistic infection: during combined antiviral treatment the CD4 cell
count rose and thus precipitated an heretofore subclinical mycobacterial
infection with focal lymphadenitis. If, on starting antiretroviral treatment at a
late HIV stage, new symptoms develop within 1-3 weeks, one should consider
drug-induced side effects or the onset of an opportunistic infection that has
become manifest as the result of an improved immunological state.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 9987485 [PubMed - indexed for MEDLINE]

3498: Ophthalmology. 1999 Feb;106(2):350-4.

The prevalence of herpes family virus DNA in the conjunctiva of patients positive
and negative for human immunodeficiency virus using the polymerase chain
reaction.

Lee-Wing MW, Hodge WG, Diaz-Mitoma F.

University of Ottawa Eye Institute, Ontario, Canada.

OBJECTIVE: To help understand the pathogenesis of herpes family virus ocular
infection among patients positive for HIV, the authors compared the rates of
detection of herpes family virus DNA from the conjunctiva of patients who are
positive and negative for human immunodeficiency virus (HIV) using the polymerase
chain reaction (PCR). DESIGN: Cross-sectional study. PARTICIPANTS: The
conjunctival scrapings of 30 patients positive for HIV and 30 patients negative
for HIV were examined. INTERVENTION: PCR was used to assay for the presence of
herpes simplex virus type 1 (HSV), varicella-zoster virus (VZV), cytomegalovirus 
(CMV), and Epstein-Barr virus (EBV) DNA (n = 240 samples). MAIN OUTCOME MEASURE: 
The rate of detection of virus DNA in the two groups, controlling for age,
gender, and race, was measured. RESULTS: HSV and VZV DNA were not detected in any
of the HIV-positive or HIV-negative samples. CMV DNA was detected in 20% (6 of
30) of patients positive for HIV and was undetected in control subjects negative 
for HIV (P = 0.01). EBV DNA was detected in 40% (12 of 30) of patients positive
for HIV and in 47% (14 of 30) of control subjects negative for HIV (P = 0.58).
CONCLUSIONS: There was no difference in the frequency of detection of HSV, VZV,
or EBV DNA from the conjunctiva of patients positive or negative for HIV. Only
CMV DNA was detected at a significantly higher rate in the conjunctiva of
patients positive for HIV compared with control subjects negative for HIV. These 
different rates of peripheral virus shedding may be one possible explanation for 
the different rates of clinical infection among the herpes family viruses among
patients positive for HIV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9951489 [PubMed - indexed for MEDLINE]

3499: J Oral Pathol Med. 1999 Feb;28(2):49-53.

Oral lesions in children with perinatally acquired human immunodeficiency virus
infection.

Nicolatou O, Theodoridou M, Mostrou G, Velegraki A, Legakis NJ.

Department of Oral Pathology and Surgery, School of Dentistry, University of
Athens, Greece.

Fifteen vertically HIV-infected children aged between 2 and 12 years were
followed up for 1 year, weekly to monthly, to study the incidence of oral
lesions. At the time of first examination, oral candidiasis (OC) was observed in 
nine children. Seven children presented with the erythematous type only and two
with pseudomembranous oral candidiasis. Four cases of cheilitis were seen in
association with the erythematous forms of oral candidiasis. One erythematous
candidiasis progressed to pseudomembranous form. A second case of erythematous
OC, after multiple recurrences in the form of erythematous OC, recurred as
pseudomembranous OC. Another case of erythematous OC and one of pseudomembranous 
OC presented after multiple recurrences as a persistent, adherent
pseudomembranous OC. An orofacial herpes-zoster infection, a hairy leukoplakia
and a necrotic lingual ulcer were observed as second lesions and in association
with oral candidiasis in three children. Erythematous oral candidiasis was the
most frequent oral HIV-related lesion, was observed in different stages of
HIV-infection, and in some cases progressed to pseudomembranous candidiasis. A
different, selectively resistant, Candida clone was isolated in three cases of
recurrent candidiasis.

PMID: 9950249 [PubMed - indexed for MEDLINE]

3500: Health News. 1999 Jan 5;5(1):1-2.

Pain after shingles.

[No authors listed]

Publication Types: 
    Review

PMID: 9932537 [PubMed - indexed for MEDLINE]

3501: Cancer. 1999 Jan 1;85(1):65-71.

Long term outcome of patients with hairy cell leukemia treated with pentostatin.

Ribeiro P, Bouaffia F, Peaud PY, Blanc M, Salles B, Salles G, Coiffier B.

Service d'Hematologie, Centre Hospitalier Lyon-Sud, Pierre-Benite, France.

BACKGROUND: With the introduction of new drugs such as interferon-alpha (IFN) and
purine analogs, the management of hairy cell leukemia (HCL) patients has changed.
However, pentostatin has been found to produce higher complete remission rates
than IFN. The current study was undertaken to investigate response and long term 
follow-up in HCL patients treated with pentostatin. METHODS: Between March 1989
and October 1996, 49 patients with HCL and 1 patient with a HCL variant were
treated with pentostatin. Eighteen patients had received no prior therapy, 31
patients had received prior treatment with IFN, and 1 patient had received prior 
treatment with 2'-chlorodeoxyadenosine (2'CdA) and IFN. All patients except 1
were treated with a dose of 4 mg/m2 every 2 weeks. The median number of cycles
was 12. RESULTS: The overall response rate was 96% (48 of 50 patients); 22
patients (44%) achieved a complete response, 18 patients (36%) achieved a good
partial response (defined as residual bone marrow infiltration < 5%), 8 patients 
(16%) achieved a partial response, and 2 patients died. For a median follow-up of
33 months off therapy, there were 5 recurrences between 12-66 months; 3 of these 
patients were treated further with and responded to 2'CdA and 2 died of disease
progression at 12 and 40 months, respectively. In addition, 3 patients died of
unrelated causes (1 of very early infection, 1 of toxic death and another of
cardiac arrest) comprising an overall death rate of 14% (7 of 50 patients). The
overall survival rate was 86% for a median follow-up of 38 months (range, 8-105
months). Major side effects were febrile episodes, herpes zoster, nausea/emesis, 
and pancytopenia. CONCLUSIONS: This analysis confirms both the high remission
rate and durable responses that may be achieved with pentostatin treatment in HCL
patients. Although pentostatin is active, the risk of cytopenia and
immunosuppression must be evaluated carefully.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 9921975 [PubMed - indexed for MEDLINE]

3502: Neurology. 1999 Jan 1;52(1):193-5.

Herpes varicella zoster encephalitis in immunocompromised patients.

Weaver S, Rosenblum MK, DeAngelis LM.

Department of Neurology, Albany Medical Center, NY, USA.

The authors describe specific MRI features that suggest the diagnosis of
varicella zoster encephalitis. MRI initially revealed discrete, subcortical,
nonenhancing lesions that coalesced and developed enhancement. Gray matter
involvement was seen later. Autopsy revealed spherical lesions of demyelination
and hemorrhagic cavitation confirmed as varicella zoster encephalitis.
Characteristic MR features may suggest the diagnosis of varicella zoster
encephalitis, enabling definitive diagnostic testing and early institution of
antiviral treatment.

PMID: 9921876 [PubMed - indexed for MEDLINE]

3503: Rinsho Byori. 1998 Nov;Suppl 108:65-73.

[Laboratory diagnosis of viral infections. 3. Exanthema and muco- cutaneous
infections]

[Article in Japanese]

Morishima T.

Publication Types: 
    Review

PMID: 9921233 [PubMed - indexed for MEDLINE]

3504: Bull Soc Belge Ophtalmol. 1998;270:95-100.

Chronic uveitis in Kinshasa (D R Congo).

Kaimbo Wa Kimbo D, Bifuko A, Dernouchamps JP, Missotten L.

Department of Ophthalmology, University of Kinshasa, D R Congo.

PURPOSE: To determine frequencies of different types of chronic uveitis and the
possible associated conditions. METHODS: In the retrospective study a review is
made of all 336 consecutive patients with chronic uveitis seen during 1983
through 1993. All patients were evaluated ophthalmologically and most of them
medically. Traumatic uveitis was excluded from this study. RESULTS: There were
171 (51%) males and 165 (49%) females. Of 336 patients with chronic uveitis, 194 
(58%) had anterior uveitis, 76 (23%) had isolated posterior uveitis, 38 (11%) had
panuveitis and 28 (8%) intermediate uveitis. Associated conditions were found in 
151 (46%) of 336 patients. AIDS, Herpes Zoster Ophthalmicus, toxoplasmosis,
tuberculosis, rheumatoid arthritis and onchocerciasis were the most common
associated disease respectively in 12.5%, 6.4%, 6%, 6%, 6% and 4% of cases.
CONCLUSION: The findings of this study were different from those of other studies
published in Europe and the United States.

PMID: 9919786 [PubMed - indexed for MEDLINE]

3505: J Antibiot (Tokyo). 1998 Nov;51(11):1035-9.

Fattiviracin A1, a novel antiviral agent produced by Streptomyces microflavus
strain No. 2445. II. Biological properties.

Yokomizo K, Miyamoto Y, Nagao K, Kumagae E, Habib ES, Suzuki K, Harada S, Uyeda
M.

Faculty of Pharmaceutical Sciences, Kumamoto University, Oe-Honmachi, Japan.

Fattiviracin A1, showed potent antiviral activities against herpes simplex virus 
type 1 (HSV-1), varicella-zoster virus (VZV), influenza A virus and human
immunodeficiency virus type 1 (HIV-1). It showed no cytotoxicity against Vero
cells. Fattiviracin A1 exhibited no significant antibacterial or antifungal
activities. Treatment of HSV-1 with fattiviracin A1 decreased its infectivity to 
Vero cells. The mechanism of its antiviral activity may be due to inactivation of
the viral particles and inhibition of viral entry into host cells.

PMID: 9918397 [PubMed - indexed for MEDLINE]

3506: Am J Otol. 1999 Jan;20(1):26-30.

Delayed facial palsy after tympanomastoid surgery.

Vrabec JT.

Department of Otolaryngology, University of Texas Medical Branch, Galveston
77555-0521, USA.

OBJECTIVES: The purpose of this report is to provide data on the incidence of
delayed facial palsy (DFP) after tympanomastoid surgery, compare incidence among 
various otologic and neurotologic procedures, and discuss the possible etiology. 
STUDY DESIGN: The study design was a retrospective case review. SETTING: The
study was conducted at a tertiary referral center. PATIENTS: The records of 486
patients with normal facial function before tympanomastoid surgery were reviewed.
INTERVENTION: Patients underwent tympanomastoid surgery. OUTCOME MEASURES:
Delayed facial palsy was defined as facial palsy occurring more than 72 hours
after surgery. RESULTS: Seven of 486 (1.4%) patients had DFP after tympanomastoid
surgery. In two patients, the DFP was caused by a postoperative wound infection. 
Facial palsy in the other five patients likely was caused by viral reactivation. 
CONCLUSIONS: Published data for otologic surgery suggest a rising incidence of
DFP with increased manipulation of the sensory branches of the facial nerve.
Viral reactivation is postulated to be an important contributing mechanism in the
development of DFP. A number of viruses could potentially cause this phenomenon, 
but observations in this study implicate the varicella zoster virus. Patients
with a history of viral reactivation may be at greater risk for development of
this complication.

PMID: 9918167 [PubMed - indexed for MEDLINE]

3507: Can Commun Dis Rep. 1998 Dec 15;24(24):193-8.

Erratum in:
    Can Commun Dis Rep 1999 Sep 1;25(17):152.

Varicella-zoster virus disease and epidemiology: seeking better control
strategies--Part 1.

[Article in English, French]

Bentsi-Enchill A.

Division of Immunization, Bureau of Infectious Diseases, LCDC, Ottawa, ON.

PMID: 9916347 [PubMed - indexed for MEDLINE]

3508: ORL J Otorhinolaryngol Relat Spec. 1999 Jan-Feb;61(1):10-5.

Blink reflex excitability recovery curves in patients with dysfunctions after
facial nerve palsy.

Nakamura K, Kashima K, Koike Y.

Department of Otolaryngology, University of Tokushima School of Medicine,
Tokushima, Japan. nakamura@clin.med.tokushima-u.ac.jp

The blink reflex excitability recovery curves were studied in 12 patients with
postparalytic facial dysfunctions (PPFD) and 12 healthy control subjects. The
inhibitory effects of the conditioning stimuli on the ipsilateral R2 and
contralateral R2 responses observed in control subjects were significantly less
in patients with PPFD. The enhanced recovery of the R2 responses was similar on
the affected side and unaffected side in the patients. These results indicate
that patients with PPFD have an increased excitability of central interneurons
which mediate the R2 pathway. It is suggested that not only changes in the
peripheral facial nerve but also changes in the central nervous system may
contribute to the onset of PPFD.

PMID: 9892863 [PubMed - indexed for MEDLINE]

3509: Proc Assoc Am Physicians. 1999 Jan-Feb;111(1):35-44.

A double-blind, placebo-controlled, randomized trial of cladribine in
relapsing-remitting multiple sclerosis.

Romine JS, Sipe JC, Koziol JA, Zyroff J, Beutler E.

Division of Neurology, Scripps Clinic, La Jolla, CA 92037, USA.

We conducted an 18-month, placebo-controlled, double-blind study to evaluate
cladribine in the treatment of 52 patients with relapsing-remitting multiple
sclerosis. Patients received either placebo or cladribine 0.07 mg/kg/day by
subcutaneous injection for 5 consecutive days as six monthly courses for a total 
cumulative dose of 2.1 mg/kg. Analysis of results revealed a statistically
significant favorable effect of cladribine on the joint frequency and severity of
relapses and magnetic resonance imaging (MRI) findings. MRI-enhancing lesions
were completely suppressed in the cladribine patients by the sixth month of
treatment. Mild segmental herpes zoster occurred in two cladribine-treated
patients and one patient receiving placebo. Otherwise, there were no side effects
or adverse events. We conclude that cladribine shows promise as a treatment for
relapsing-remitting multiple sclerosis.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9893155 [PubMed - indexed for MEDLINE]

3510: J Med Virol. 1999 Feb;57(2):145-51.

Viral diagnosis of neurological infection by RT multiplex PCR: a search for
entero- and herpesviruses in a prospective study.

Casas I, Pozo F, Trallero G, Echevarria JM, Tenorio A.

Service of Diagnostic Microbiology, Centro Nacional de Microbiologia, Instituto
de Salud Carlos III, Majadahonda, Madrid, Spain. icasas@isciii.es

The diagnosis of a wide range of different neurological syndromes was established
by a reverse transcription multiplex PCR assay. The presence of enterovirus and
herpesviruses was studied in cerebrospinal fluid samples collected prospectively 
from 200 patients hospitalized with neurological diseases suspected of viral
infection. Positive PCR results for enterovirus and neurotropic herpesvirus
(herpes simplex, HSV, and varicella zoster, VZV) were obtained among the
immunocompetent patients (55/156, 35%) who presented aseptic meningitis or
encephalitis. Among immunocompromised patients the yield of positive PCR results 
was 41% (18/44), predominantly lymphotropic herpesviruses (15/44, 34%).
Cytomegalovirus (CMV) DNA was detected in patients with several clinical
syndromes, including encephalitis, chronic meningitis, retinitis, ventriculitis, 
polyradiculomyelitis, and myeloradiculitis. Epstein-Barr (EBV) and VZV-specific
DNA sequences were detected in patients with either encephalitis, aseptic
meningitis, and chronic meningitis. Dual infections of CMV and HSV or CMV and EBV
were established in two AIDS patients with encephalitis and polyradiculomyelitis,
respectively. The applications of this RT multiplex PCR assay are extensive and
may prove to be particularly valuable for the rapid and sensitive diagnosis of
neurological diseases in both immunocompetent and immunocompromised patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9892399 [PubMed - indexed for MEDLINE]

3511: J Pediatr Gastroenterol Nutr. 1999 Jan;28(1):54-8.

Comment in:
    J Pediatr Gastroenterol Nutr. 1999 Jan;28(1):17-8.

Experiences with 6-mercaptopurine and azathioprine therapy in pediatric patients 
with severe ulcerative colitis.

Kader HA, Mascarenhas MR, Piccoli DA, Stouffer NO, Baldassano RN.

Division of Gastroenterology and Nutrition, The Children's Hospital of
Philadelphia, Pennsylvania 19104, USA.

BACKGROUND: The effectiveness of 6-mercaptopurine combined with azathioprine in
treating severe ulcerative colitis has been shown in several adult studies.
Reported pediatric experiences are rare. The purpose of this study was to
investigate the safety and the potential efficacy of 6-mercaptopurine and
azathioprine in the treatment of active ulcerative colitis in a pediatric
population. METHODS: The medical records of patients with active ulcerative
colitis who were under observation at The Children's Hospital of Philadelphia and
its satellite clinics from January 1984 through December 1997 were
retrospectively reviewed. Patients were included who had received a diagnosis of 
ulcerative colitis, who met no criteria for Crohn's colitis, and who had received
treatment with 6-mercaptopurine and azathioprine. They were then analyzed for the
development of side effects, the indication to use 6-mercaptopurine and
azathioprine, and the ability to discontinue corticosteroid use in those patients
taking 5-acetylsalicylic acid products who were corticosteroid-dependent or whose
disease was refractory to treatment. Excluded from the corticosteroid analyses
were patients who underwent surgery for their disease and patients treated with
5-acetylsalicylic acid only. Statistical analysis was performed by the
Kaplan-Meier survival curve and paired Student's t-test. RESULTS: In a review of 
200 medical records of patients with active ulcerative colitis, 20 patients met
the criteria. The patients' average age at the initiation of treatment with
6-mercaptopurine and azathioprine was 13.8 years. Sixteen patients (80%) were
corticosteroid dependent and 3 (15%) had ulcerative colitis refractory to
corticosteroid treatment. One patient had severe colitis treated with
5-acetylsalicylic acid only. Discontinuation of corticosteroid was accomplished
in 12 (75%) of 16 patients. The median time to discontinuation of corticosteroid 
after initiation of 6-mercaptopurine and azathioprine therapy was 8.4 months.
Eight patients (67%), observed from 3 months to 65 months, have continued without
corticosteroid therapy. Side effects included pancreatitis and shingles that
resulted in discontinuation of 5-acetylsalicylic acid, leukopenia corrected by
withholding 6-mercaptopurine, and self-resolved hepatitis. CONCLUSIONS: The data 
support the safety of 6-mercaptopurine and azathioprine use in the treatment of
pediatric patients with ulcerative colitis; side effects were minimal and
reversible. Eighteen (90%) of 20 patients tolerated the therapy well. The results
also show that 12 (75%) of 16 pediatric patients with ulcerative colitis will
benefit from the use of 6-mercaptopurine and azathioprine after initial
discontinuation of corticosteroid therapy. Although 6-mercaptopurine and
azathioprine may not prevent further relapses, medical management of these flares
may be less intense and may not require long-term corticosteroid use. Prospective
clinical trials in pediatric patients are necessary to delineate further the role
of 6-mercaptopurine and azathioprine in pediatric ulcerative colitis.

PMID: 9890469 [PubMed - indexed for MEDLINE]

3512: Eur Neurol. 1999 Jan;41(1):3-9.

Peripheral facial palsy: etiology, diagnosis and treatment.

Roob G, Fazekas F, Hartung HP.

Department of Neurology, Karl Franzens University, Graz, Austria.

Treatment options for peripheral facial palsy (PFP) are an often discussed
problem in neurologic practice. Following a short description of the complex
anatomy of the seventh cranial nerve we therefore review possible etiologies in
the context of leading clinical signs, with idiopathic PFP or Bell's palsy (BP)
being most frequent. A rather typical clinical course of BP allows to focus
differential diagnostic workup predominantly on the rapid identification of
treatable infections such as with Herpes zoster or Borrelia burgdorferi.
Neuroimaging studies are needed only in case of trauma, with slowly developing
PFP or in the presence of associated signs and symptoms. As BP is characterized
by an overall high rate of spontaneous recovery, major emphasis has to be put on 
avoiding complications by protecting the eye. Meta-analysis of four randomized
controlled studies suggests a marginal benefit of steroids concerning eventual
achievement of complete recovery. Beneficial effects of a combination of
acyclovir and prednisone have also been claimed. While such therapies may be
considered in patients with a presumptive bad prognosis, more general
recommendations on medical treatment of BP will have to await further trials.

Publication Types: 
    Review

PMID: 9885321 [PubMed - indexed for MEDLINE]

3513: J Immunol. 1999 Jan 1;162(1):560-7.

Comparison of primary sensitization of naive human T cells to varicella-zoster
virus peptides by dendritic cells in vitro with responses elicited in vivo by
varicella vaccination.

Jenkins DE, Yasukawa LL, Bergen R, Benike C, Engleman EG, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, CA 94305, USA.

Dendritic cells (DC) are potent APC during primary and secondary immune
responses. The first objective of this study was to determine whether human DC
mediate in vitro sensitization of naive CD4+ T cells to epitopes of the immediate
early 62 (IE62) protein of varicella zoster virus (VZV). The induction of CD4+ T 
cell proliferative responses to eight synthetic peptides representing amino acid 
sequences of the VZV IE62 protein was assessed using T cells and DC from
VZV-susceptible donors. The second objective was to compare in vitro responses of
naive T cells with responses to VZV peptides induced in vivo after immunization
with varicella vaccine. T cell proliferation was induced by three peptides, P1,
P4, and P7, in 71-100% of the donors tested before and after vaccination using DC
as APC. Monocytes were effective APC for VZV peptides only after immunization.
Two peptides, P2 and P8, induced naive T cell proliferation less effectively and 
were also less immunogenic for T cells from vaccinated or naturally immune
donors. T cell recognition of specific peptides was concordant between naive,
DC-mediated responses, and postvaccine responses using monocytes as APC in 69% of
comparisons (p = 0.05; chi2); the predictive value of a positive response to an
IE62 peptide before immunization for T cell sensitization in vivo was 82%. These 
observations indicate that primary T cell responses detected in vitro using DC as
APC may be useful to characterize the potential immunogenicity of viral protein
epitopes in vivo.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9886433 [PubMed - indexed for MEDLINE]

3514: Antivir Chem Chemother. 1998 Jul;9(4):341-52.

(Z)- and (E)-2-(hydroxymethylcyclopropylidene)-methylpurines and pyrimidines as
antiviral agents.

Qiu YL, Ptak RG, Breitenbach JM, Lin JS, Cheng YC, Kern ER, Drach JC, Zemlicka J.

Department of Chemistry, Barbara Ann Karmanos Cancer Institute, Wayne State
University School of Medicine, Detroit, MI 48201-1379, USA.

Several Z- and E-methylenecyclopropane nucleoside analogues were synthesized and 
tested for antiviral activity in vitro against human and murine cytomegalovirus
(HCMV, MCMV), Epstein-Barr virus (EBV), varicella zoster virus (VZV), hepatitis B
virus (HBV), herpes simplex virus types 1 and 2 (HSV-1, HSV-2), human herpesvirus
6 (HHV-6) and human immunodeficiency virus type 1 (HIV-1). The
Z-2-amino-6-cyclopropylaminopurine analogue was the most effective agent against 
HCMV (EC50 or EC90 0.4-2 microM) followed by syncytol and the Z-2,6-diaminopurine
analogues (EC50 or EC90 3.4-29 and 11-24 microM, respectively). The latter
compound was also a strong inhibitor of MCMV (EC50 0.6 microM). Syncytol was the 
most potent against EBV (EC50 < 0.41 and 2.5 microM) followed by the
Z-2,6-diaminopurine (EC50 1.5 and 6.9 microM) and the
Z-2-amino-6-cyclopropyl-aminopurine derivative (EC50 11.8 microM). Syncytol was
also most effective against VZV (EC50 3.6 microM). Activity against HSV-1, HSV-2 
and HHV-6 was generally lower; synthymol had an EC50 of 2 microM against HSV-1
(ELISA) and 1.3 microM against EBV in Daudi cells but was inactive in other
assays. The 2-amino-6-cyclopropylamino analogue displayed EC50 values between 215
and > 74 microM in HSV-1 and HSV-2 assays. 2-Amino-6-cyclopropylaminopurine and
2,6-diaminopurine derivatives were effective against HBV (EC50 2 and 10 microM,
respectively), whereas none of the analogues inhibited HIV-1 at a higher virus
load. Syncytol and the E isomer were equipotent against EBV in Daudi cells but
the E isomer was much less effective in DNA hybridization assays. The
E-2,6-diaminopurine analogue and E isomer of synthymol were devoid of antiviral
activity.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9875413 [PubMed - indexed for MEDLINE]

3515: Antivir Chem Chemother. 1998 May;9(3):233-43.

Synthesis and evaluation of some masked phosphate esters of the anti-herpesvirus 
drug 882C (netivudine) as potential antiviral agents.

McGuigan C, Perry A, Yarnold CJ, Sutton PW, Lowe D, Miller W, Rahim SG, Slater
MJ.

Welsh School of Pharmacy, University of Wales Cardiff, UK.

A number of symmetric and asymmetric 5'-phosphate esters of the potent
anti-varicella-zoster virus (VZV) agent
1-(beta-D-arabinofuranosyl)-5-prop-1-ynyluracil (882C; netivudine) were prepared 
as potential lipophilic, membrane-soluble prodrugs of the bio-active phosphate
forms. The compounds were prepared by the base-catalysed coupling of various
phosphorochloridates with the free nucleoside analogue. Compounds were fully
characterized by a range of spectroscopic and analytical methods and were studied
for their inhibition of several viruses in tissue culture. All of the phosphate
esters were inactive against human cytomegalovirus, herpes simplex virus type 2, 
VZV, human immunodeficiency virus type 1 and influenza A virus (EC50 > 100
microM) except the 5'-(4-nitrophenyl phenyl) phosphate, which inhibited influenza
A virus. The relative rate of esterase-mediated hydrolysis of one of the lead
target structures was measured in order to rationalize the poor antiviral action,
and data were collected on possible metabolites in support of this analysis.
Cell-specific esterases are implicated as key determinants of the antiviral
potency of prodrugs of this type.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9875402 [PubMed - indexed for MEDLINE]

3516: Antivir Chem Chemother. 1998 Sep;9(5):403-11.

Broad-spectrum antiviral activity and mechanism of antiviral action of the
fluoroquinolone derivative K-12.

Witvrouw M, Daelemans D, Pannecouque C, Neyts J, Andrei G, Snoeck R, Vandamme AM,
Balzarini J, Desmyter J, Baba M, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

The fluoroquinolone derivatives have been shown to inhibit human immunodeficiency
virus (HIV) replication at the transcriptional level. We confirmed the anti-HIV
activity of the most potent congener,
8-difluoromethoxy-1-ethyl-6-fluoro-1,4-dihydro-7-[4-(2-
methoxyphenyl)-1-piperazinyl]-4-quinolone-3-carboxylic acid (K-12), in both
acutely and chronically infected cells. K-12 was active against different strains
of HIV-1 (including AZT- and ritonavir-resistant HIV-1 strains), HIV-2 and simian
immunodeficiency virus, in MT-4, CEM, C8166 and peripheral blood mononuclear
cells. In all of these antiviral assay systems, K-12 showed a similar activity
(EC50 0.2-0.6 microM). K-12 inhibited Moloney murine sarcoma virus-induced
transformation of C3H/3T3 cells with an EC50 of 6.9 microM. Also, K-12 proved
inhibitory to herpesvirus saimiri, human cytomegalovirus, varicella-zoster virus 
and herpes simplex virus types 1 and 2 (in order of decreasing sensitivity), but 
was not inhibitory (at subtoxic concentrations) to human herpesvirus type 8 (as
evaluated in BCBL-1 cells), vaccinia virus, Sindbis virus, vesicular stomatitis
virus, respiratory syncytial virus, Coxsackie virus, Punta Toro virus,
parainfluenza virus or reovirus. Time-of-addition experiments and quantitative
transactivation bioassays indicated that K-12 inhibits the Tat-mediated
transactivation process in HIV-infected cells.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9875393 [PubMed - indexed for MEDLINE]

3517: J Infect Dis. 1998 Nov;178 Suppl 1:S1-112.

Proceedings of the 3rd International Conference on the Varicella-Zoster Virus.
Palm Beach Gardens, Florida, USA. 9-11 March 1997.

[No authors listed]

Publication Types: 
    Congresses
    Overall

PMID: 9874603 [PubMed - indexed for MEDLINE]

3518: AJNR Am J Neuroradiol. 1998 Nov-Dec;19(10):1897-9.

Multifocal varicella-zoster virus leukoencephalitis in a patient with AIDS: MR
findings.

Aygun N, Finelli DA, Rodgers MS, Rhodes RH.

Department of Radiology, MetroHealth Medical Center/Case Western Reserve
University School of Medicine, Cleveland, OH 44109, USA.

We describe a patient with AIDS who presented with an acute encephalitis caused
by infection with varicella-zoster virus. The hemorrhagic, necrotizing
encephalitis had an unusual MR appearance, with innumerable discrete, small,
targetlike lesions in the right cerebral hemisphere, which were coalescent in the
posterior temporal, parietal, and occipital regions. Of the several known disease
patterns of varicella-zoster viral infection in the CNS, this histopathologic
pattern of multifocal leukoencephalitis is rare. It is important to recognize, as
effective antiviral drug treatments are available.

Publication Types: 
    Case Reports

PMID: 9874543 [PubMed - indexed for MEDLINE]

3519: Am J Health Syst Pharm. 1998 Dec 15;55(24 Suppl 4):S4-8.

A cost-effectiveness model for analyzing two varicella vaccination strategies.

Gayman J.

Department of Pharmaceutical Services, Palmetto Richland Memorial Hospital,
Columbia, SC 29203, USA. jayne.gayman@rmh.edu

A model for estimating the cost-effectiveness of a program for vaccinating
employees at a health care institution against varicella zoster virus (VZV) was
studied. Three outcomes of varicella vaccination--cost-effectiveness, reduction
in employee infections, and reduction in patient exposures--were stratified to
estimate the incremental costs of vaccinating three employee groups. The groups
consisted of all employees (vaccinate-all group), employees providing direct
patient care (direct care group), and employees working in high-risk patient care
areas (high-risk group). Two strategies for employee vaccination were used:
screen (by antibody titer testing) and then vaccinate, and vaccination alone. A
model was used to estimate the various outcomes of the vaccination program. The
model supported the screen, then vaccinate strategy of vaccinating employees, at 
a cost savings of about $50 per employee. Vaccination of all employees prevented 
35 employee infections and 674 patient exposures for every 10,000 potentially
susceptible employees. The cost of preventing one employee infection was about
$15,000, and the cost of preventing one patient exposure was about $775. An
employee vaccination program is a good investment in preventing patient exposures
to VZV and may be cost-effective compared with only screening employees.

PMID: 9872686 [PubMed - indexed for MEDLINE]

3520: Clin Infect Dis. 1998 Dec;27(6):1525-7.

Acyclovir-resistant herpes zoster in human immunodeficiency virus-infected
patients: results of foscarnet therapy.

Breton G, Fillet AM, Katlama C, Bricaire F, Caumes E.

Department of Infectious and Tropical Diseases, Hopital Pitie Salpetriere, Paris,
France.

We retrospectively studied 18 consecutive cases of acyclovir-resistant zoster.
All the patients had chronic skin lesions that failed to heal despite treatment
with intravenous acyclovir (30 mg/[kg.d]) in 15 cases and oral acyclovir (4 g/d) 
in three cases for > 10 days. The mean CD4+ cell count was 20 x 10(6)/L. The mean
number of previous zoster episodes was 1.53. Fifteen of the 16 patients evaluable
for previous acyclovir treatment had received the drug. Thirteen patients were
treated with intravenous foscarnet (200 mg/[kg.d]) for a mean of 17.8 days.
Complete healing was observed in 10 (77%) of the 13 treated patients. Zoster
relapsed after cessation of foscarnet therapy in five of the 10 responding
patients. The median time to relapse was 110 days. Four patients died of
varicella-zoster virus-associated visceral complications. These results show that
acyclovir-resistant zoster has a poor prognosis but responds well to foscarnet
therapy.

PMID: 9868672 [PubMed - indexed for MEDLINE]

3521: Clin Infect Dis. 1998 Dec;27(6):1514-6.

Comment on:
    Clin Infect Dis. 1998 Dec;27(6):1510-3.

Potent antiretroviral therapy does more than just decrease viral load.

Daar ES.

Publication Types: 
    Comment
    Editorial
    Research Support, Non-U.S. Gov't

PMID: 9868669 [PubMed - indexed for MEDLINE]

3522: Clin Infect Dis. 1998 Dec;27(6):1510-3.

Comment in:
    Clin Infect Dis. 1998 Dec;27(6):1514-6.

High incidence of herpes zoster in patients with AIDS soon after therapy with
protease inhibitors.

Martinez E, Gatell J, Moran Y, Aznar E, Buira E, Guelar A, Mallolas J, Soriano E.

Infectious Diseases Unit, Institut d'Investigacions Biomediques August Pi i
Sunyer, Hospital Clinic, Barcelona, Spain.

A high incidence of herpes zoster was noticed among patients with AIDS, shortly
after addition of a protease inhibitor to their baseline treatment with
nucleoside analogue reverse-transcriptase inhibitors. Within a median follow-up
of 64 weeks (range, 34-103 weeks), 14 patients (7%) had a first episode or a
recurrence of herpes zoster (6.2 episodes per 100 patient-years). No episodes of 
zoster were diagnosed before week 4. Twelve episodes (86%) occurred between weeks
4 and 16. The risk of zoster was independent of age, sex, type of protease
inhibitor, and CD4+ lymphocyte count and viral load at baseline and month 1. A
CD8+ lymphocyte proportion at baseline of > 66% (hazard ratio [HR], 10.6; 95%
confidence interval [CI], 3.4-33.1) and an increase in CD8+ lymphocyte proportion
at month 1 of > 5% (HR, 32; 95% CI, 8.1-126.4) were independently associated with
the risk of herpes zoster. These data might be clinically useful for determining 
transient prophylaxis for those patients at high risk.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9868668 [PubMed - indexed for MEDLINE]

3523: Praxis (Bern 1994). 1998 Nov 19;87(47):1614-8.

[Hypotension in acyclovir therapy]

[Article in German]

Wolters H, Mayer A, Gerhardt U, Hohage H.

Medizinische Poliklinik, Universitat Munster.

A 51 year old man developed Herpes zoster on the right arm (C5/C6) treated
subsequently with aciclovir infusions (500 mg, 3/day). Ten months before hospital
admission he did have a radical resection of a epi-oro-hypopharyngeal carcinoma
(T4/N1/G2, M0; lymphangiosis carcinomatosa) as well as a partial laryngeal
resection for a recurrence 3 months later and removal of a cervical lymph node
metastasis after two further months. During aciclovir treatment the patient
experienced repeated bradycardia with hypotension verifiable with the tilt-table 
test. The bradycardias could not be further characterized by ECC. Neither
sonography nor CT-scans gave an indication for infiltration of the cervical
course of the vagus or glossopharyngeal nerves. Serum catecholamines were,
however, markedly reduced. After cessation of aciclovir the bradycardias and
hypotensive episodes disappeared. A final tilt-table test was unremarkable. A
reversible autonomic neuropathy induced by aciclovir seems a possible
explanation.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9865134 [PubMed - indexed for MEDLINE]

3524: Rev Med Suisse Romande. 1998 Nov;118(11):941-7.

[Diagnosis and treatment of ocular viral infections in AIDS patients]

[Article in French]

Guex-Crosier Y.

Hopital ophtalmique Jules Gonin, Lausanne.

Ocular complication of AIDS are seen in about 75% of patients. Viral infections
are predominant and can involve either external segment in the eye (Herpes type 8
in Kaposi sarcoma, molluscum contagiosum, Herpes simplex and zoster), or the
posterior segment of the eye (CMV retinitis). The introduction of a Highly Active
Antiretroviral Therapy (HAART) which associates two reverse transcriptase
inhibitors and one antiprotease has changed the evolution of AIDS. The decrease
of onset of CMV retinitis in AIDS patient is one of the best exemple. For the
first time it was possible to stop the maintenance therapy against CMV retinitis 
in patients that have a sufficient increase in CD4+ cells and they did not
present any relapse of CMV retinitis. But an increase of ocular inflammation can 
be observed with the onset of HAART such as uveitis or cystoid macular edema.

Publication Types: 
    English Abstract
    Review

PMID: 9865123 [PubMed - indexed for MEDLINE]

3525: Arch Phys Med Rehabil. 1998 Dec;79(12):1560-4.

Neuropathic pain in Charcot-Marie-Tooth disease.

Carter GT, Jensen MP, Galer BS, Kraft GH, Crabtree LD, Beardsley RM, Abresch RT, 
Bird TD.

Department of Rehabilitation Medicine, University of Washington School of
Medicine, Seattle, USA.

OBJECTIVES: To determine the frequency and extent to which subjects with
Charcot-Marie-Tooth (CMT) disease report pain and to compare qualities of pain in
CMT to other painful neuropathic conditions. STUDY DESIGN: Descriptive,
nonexperimental survey, using a previously validated measurement tool, the
Neuropathic Pain Scale (NPS). PARTICIPANTS: Participants were recruited from the 
membership roster of a worldwide CMT support organization. MAIN OUTCOME MEASURES:
NPS pain descriptors reported in CMT were compared with those reported by
subjects with postherpetic neuralgia (PHN), complex regional pain syndrome, type 
1 (CRPS-1), also known as reflex sympathetic dystrophy, diabetic neuropathy (DN),
and peripheral nerve injury (PNI). RESULTS: Of 617 CMT subjects (40% response
rate), 440 (71%) reported pain. with the most severe pain sites noted as low back
(70%), knees (53%), ankles (50%), toes (46%), and feet (44%). Of this group, 171 
(39%) reported interruption of activities of daily living by pain; 168 (38%) used
non-narcotic pain medication and 113 (23%) used narcotics and/or benzodiazepines 
for pain. The use of pain description was similar for CMT, PHN, CRPS-1, DN, and
PNI in terms of intensity and the descriptors hot, dull, and deep. CONCLUSIONS:
Neuropathic pain is a significant problem for many people with CMT. The frequency
and intensity of pain reported in CMT is comparable in many ways to PHN, CRPS-1, 
DN. and PNI. Further studies are needed to examine possible pain generators and
pharmacologic and rehabilitative modalities to treat pain in CMT.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 9862301 [PubMed - indexed for MEDLINE]

3526: Am J Chin Med. 1998;26(3-4):375-81.

Effect of Ganoderma lucidum on postherpetic neuralgia.

Hijikata Y, Yamada S.

Tokyo Hijikata Clinic, Osaka, Japan.

Administration of hot water soluble extracts of Ganoderma lucidum (GI) (36 to 72 
g dry weight/day) decreased pain dramatically in two patients with postherpetic
neuralgia recalcitrant to standard therapy and two other patients with severe
pain due to herpes zoster infection.

Publication Types: 
    Case Reports

PMID: 9862025 [PubMed - indexed for MEDLINE]

3527: Clin Exp Dermatol. 1998 May;23(3):116-8.

Zosteriform cutaneous metastases from squamous cell carcinoma of the stump of an 
amputated arm.

Cuq-Viguier L, Viraben R.

Service de Dermatologie, Hopital La Grave, Toulouse, France.

The clinical appearance of skin metastases varies over a wide morphologic
spectrum, cutaneous metastases mimicking herpes zoster being rare. We now report 
the case of an 83-year-old male with zosteriform cutaneous metastases secondary
to a squamous cell carcinoma (SCC) which developed in the stump of an amputated
arm. The pathogenesis is speculative, but in this case, the zosteriform
distribution might well be explained by perineural lymphatic invasion and spread.

Publication Types: 
    Case Reports

PMID: 9861739 [PubMed - indexed for MEDLINE]

3528: Infection. 1998 Nov-Dec;26(6):359-63.

A prognostic score for postherpetic neuralgia in ambulatory patients.

Meister W, Neiss A, Gross G, Doerr HW, Hobel W, Malin JP, von Essen J, Reimann
BY, Witke C, Wutzler P.

SmithKline Beecham Pharma GmbH, Munchen, Germany.

The main objective was to develop a scoring system for easy use by the physician 
in daily clinical practice in deciding the appropriate treatment for his herpes
zoster patient. Data from 635 patients who did not receive antiviral therapy were
included in this analysis. Of these, 131 developed postherpetic neuralgia (PHN). 
Of the 29 variables tested univariately in this study, 15 showed a significant
correlation with the incidence of PHN, but only six proved to contribute to the
overall predictive power in the multivariate approach. Using two independent
approaches, the model showed a very satisfactory performance in the validation
sample. Patients without acute pain rarely developed PHN. In those with acute
pain, being female, being over 50 years of age, having more than 50 lesions,
having lesions of a hemorrhagic nature, having cranial or sacral localisation of 
the rash or having pain in the prodromal phase proved to be significant,
multivariate factors. An easy-to-use scoring system used in a risk graph is
proposed. These data should be useful in the individual treatment decision as
well as in the design and analysis of therapeutic trials in herpes zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9861560 [PubMed - indexed for MEDLINE]

3529: Nervenarzt. 1998 Nov;69(11):1015-8.

[Delirium during oral therapy of herpes zoster with acyclovir. Case report and
brief review of central nervous system side-effects of acyclovir]

[Article in German]

Braun JS, Apel I, Schaffer S, Schumacher M, Berger M.

Abteilung fur Psychiatrie und Psychotherapie, Albert-Ludwigs-Universitat,
Freiburg.

In differential diagnosis of a delir also adverse effects of medicaments have to 
be taken into account beside other causes. We report a case of an agitated delir 
with nocturnal disturbance of consciousness, confusion, restlessness and
sleeplessness. This delir existed exclusively during the therapy of a cutaneous
herpes zoster with zovirax-pills which can only be explained by a causal
connection--after exclusion of other causes. As a so far undescribed
predisposition for neurotoxicity of oral therapy with acyclovir signs of vascular
encephalopathy were found in the patient's cranial magnetic resonance imaging.
The central nervous side effects of acyclovir were summarized shortly.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9859124 [PubMed - indexed for MEDLINE]

3530: Br J Haematol. 1998 Dec;103(3):690-5.

Comment in:
    Br J Haematol. 1999 Mar;104(4):933-4.

Bolus administration of cladribine in the treatment of Waldenstrom
macroglobulinaemia.

Liu ES, Burian C, Miller WE, Saven A.

Division of Hematology and Oncology, Ida M. and Cecil H. Green Cancer Center,
Scripps Clinic, La Jolla, California 92037, USA.

This phase II clinical trial evaluated bolus cladribine as a single agent in
Waldenstrom macroglobulinaemia (WM). Cladribine was administered to 20 patients
at a dose of 0.12 mg/kg/d by 2 h intravenous infusion for 5 consecutive days at
monthly intervals for three courses. Partially responding patients were continued
on therapy until maximal response and/or prohibitive toxicity, to a maximum of
eight courses. Complete responders were treated with one additional course of
cladribine. After a median of three courses of cladribine, all 20 patients were
evaluable; one achieved a complete response (CR) (5%) and 10 achieved a partial
response (PR) (50%). The median duration of response follow-up was 28 months
(range 1-37 months). Four of 7 (57%) untreated and 7/13 (54%) previously treated 
patients responded. The major toxicity encountered was myelosuppression with 60% 
of patients demonstrating grade 3 or 4 neutropenia. Non-haematological toxicities
included two patients with herpes zoster and two patients with non-melanoma skin 
cancers. At a median follow-up duration of 20 months, 17 patients remain alive
and three have died. We confirm that bolus cladribine is an effective and safe
method of drug delivery in WM patients. Recommendations regarding the equivalence
of the continuous infusion and bolus methods in untreated patients requires
further study. Bolus cladribine is more convenient and less costly than
infusional cladribine since it obviates the need for central catheters and
infusional devices.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II

PMID: 9858218 [PubMed - indexed for MEDLINE]

3531: J Med Chem. 1998 Dec 17;41(26):5257-64.

(R)-(-)- and (S)-(+)-Synadenol: synthesis, absolute configuration, and
enantioselectivity of antiviral effect.

Qiu YL, Hempel A, Camerman N, Camerman A, Geiser F, Ptak RG, Breitenbach JM, Kira
T, Li L, Gullen E, Cheng YC, Drach JC, Zemlicka J.

Department of Chemistry, Experimental and Clinical Chemotherapy Program, Barbara 
Ann Karmanos Cancer Institute, Wayne State University School of Medicine,
Detroit, Michigan 48201-1379, USA.

Synthesis of (R)-(-)- and (S)-(+)-synadenol (1a and 2a, 95-96% ee) is described. 
Racemic synadenol (1a + 2a) was deaminated with adenosine deaminase to give
(R)-(-)-synadenol (1a) and (S)-(+)-hypoxanthine derivative 5. Acetylation of the 
latter compound gave acetate 6. Reaction with N,
N-dimethylchloromethyleneammonium chloride led to 6-chloropurine derivative 7.
Ammonolysis furnished (S)-(+)-synadenol (2a). Absolute configuration of 1a was
established by two methods: (i) synthesis from
(R)-methylenecyclopropanecarboxylic acid (8) and (ii) X-ray diffraction of a
single crystal of (-)-synadenol hydrochloride. Racemic
methylenecyclopropanecarboxylic acid (10) was resolved by a modification of the
described procedure. The R-enantiomer 8 was converted to ethyl ester 13 which was
brominated to give vicinal dibromides 14. Reduction with diisobutylaluminum
hydride then furnished alcohol 15 which was acetylated to the corresponding
acetate 16. Alkylation-elimination procedure of adenine with 16 yielded acetates 
17 and 18. Deprotection with ammonia afforded a mixture of Z- and E-isomers 1a
and 19 of the R-configuration. Comparison with products 1a and 2a by chiral HPLC 
established the R-configuration of (-)-synadenol (1a). These results were
confirmed by X-ray diffraction of a single crystal of (-)-synadenol
hydrochloride. The latter forms a pseudosymmetric dimer with adenine-adenine base
pairing in the lattice with the nucleobase in an anti-like conformation.
Enantiomers 1a and 2a exhibit varied enantioselectivity toward different viruses.
Both enantiomers are equipotent against human cytomegalovirus (HCMV) and
varicella zoster virus (VZV). The S-enantiomer 2a is somewhat more effective than
R-enantiomer 1a in herpes simplex virus 1 and 2 (HSV-1 and HSV-2) assays. By
contrast, enantioselectivity of antiviral effect is reversed in Epstein-Barr
virus (EBV) and human immunodeficiency virus type 1 (HIV-1) assays where the
R-enantiomer 1a is preferred. In these assays, the S-enantiomer 2a is less
effective (EBV) or devoid of activity (HIV-1).

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9857093 [PubMed - indexed for MEDLINE]

3532: Invest Ophthalmol Vis Sci. 1998 Dec;39(13):2659-65.

Comment in:
    Invest Ophthalmol Vis Sci. 1999 Sep;40(10):2462-3.

Analysis of immunoregulatory cytokines in ocular fluid samples from patients with
uveitis.

Ongkosuwito JV, Feron EJ, van Doornik CE, Van der Lelij A, Hoyng CB, La Heij EC, 
Kijlstra A.

Department of Ophthalmology, Academic Medical Centre, University of Amsterdam,
The Netherlands.

PURPOSE: To investigate the T-helper cell cytokine profiles in two well-defined
clinical uveitis entities caused by an infectious mechanism. METHODS: Cytokines
(interleukin [IL]-2, IL-4, IL-6, IL-10, and interferon [IFN]-gamma) were measured
in ocular fluid samples obtained from patients with herpes simplex- or
varicella-zoster virus-induced acute retinal necrosis (ARN; n = 17) and
toxoplasma chorioretinitis (n = 27) using enzyme-linked immunosorbent assay
techniques. The data were compared with data for 51 control samples taken during 
cataract surgery (n = 10), vitrectomy in diabetic retinopathy (n = 10), eye bank 
eyes (n = 10) and with samples from patients with "autoimmune" uveitis (n = 21). 
RESULTS: Interleukin-6 was detected in 44 of 51 control samples and 43 of 44 eyes
of patients with uveitis. The highest levels in the control samples were detected
in 9 of 10 vitreous samples from patients with diabetic retinopathy (mean, 648
pg/ml). In 8 of 10 samples taken from patients during cataract surgery and in 7
of 10 eye bank eyes the amount of IL-6 was significantly lower (mean, 10 pg/ml
and 136 pg/ml, respectively). Interleukin-6 levels in patients with ARN (mean,
1436 pg/ml) were significantly higher than in those with toxoplasma
chorioretinitis (mean, 272 pg/ml). Interleukin-2 was detected in one of the
samples from patients with toxoplasma chorioretinitis (1105 pg/ml) and in three
samples from the control subjects suffering from Fuchs' heterochromic anterior
uveitis (mean, 752 pg/ml). No IL-4 (<2 pg/ml) was detected either in patient or
control samples. Interferon-gamma could be detected in 7 of 17 ARN patients
(range, 277-3483 pg/ml), in 13 of 27 samples from patients with toxoplasma
chorioretinitis (range, 12-250 pg/ml), and in 1 of 21 of the samples from control
subjects with uveitis (31 pg/ml) but was absent in nonuveitic control samples.
Interleukin-10 was detected in 10 of 17 ARN patients (range, 29-3927 pg/ml), in
13 of 27 samples from patients with toxoplasma chorioretinitis (range, 4-67
pg/ml), and in only 3 of 51 control samples (6 pg/ml, 16 pg/ml, and 20 pg/ml).
CONCLUSIONS: Various immunoregulatory cytokines (IL-6, IL-10, and IFN-gamma) were
detected in ocular fluid samples from patients with uveitis. A separate role for 
either a T-helper type 1 or T-helper type 2 response in the pathogenesis of
clinical uveitis could not be proven.

PMID: 9856775 [PubMed - indexed for MEDLINE]

3533: Ned Tijdschr Geneeskd. 1998 Sep 5;142(36):1977-9.

[Chickenpox: varicella pneumonia in adults]

[Article in Dutch]

Aerts JG, Tan KY, Rietveld AP.

Sint Fransiscus Gasthuis, Rotterdam.

Two patients, a man aged 33 years and a woman aged 30, suffered from a varicella 
zoster induced pneumonia. In adults a varicella zoster infection may be
accompanied by a very severe pneumonia. In one patient mechanical ventilation was
necessary. A chest X-ray and blood gas analysis must be made in adults suffering 
from a varicella zoster virus infection who have pulmonary complaints. In case of
abnormalities in one of these two examinations the patient must be observed in a 
clinical setting. The pneumonia can be treated with aciclovir.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9856194 [PubMed - indexed for MEDLINE]

3534: Clin Geriatr Med. 1999 Feb;15(1):103-12, vii.

The painful eye: external and anterior segment causes.

Cutarelli PE, Aronsky MA.

Department of Ophthalmology, University Hospitals of Cleveland and Case Western
Reserve University, Cleveland, Ohio, USA.

When a patient presents to a medical practitioner with a painful eye, the initial
history is extremely valuable in determining the cause of the complaint. The
patient should be questioned specifically about the onset and duration of
symptoms; description of the pain; exacerbating and mitigating factors;
associated pruritus, discharge, or photophobia; and any previous occurrences. It 
is important to inquire about the patient's past medical history, past ocular
history (including surgeries, trauma, contact lens wear, and family history of
glaucoma), systemic and ocular medications, and allergies. A careful examination 
of the patient's skin, face, eyelids, conjunctiva, sclera, cornea, and anterior
chamber should be performed. In this article, the authors describe a variety of
external diseases and anterior segment causes of a painful eye, many of which can
be diagnosed from the initial history. The article works systematically,
beginning externally with the eyelids and conjunctiva and progressing internally 
toward the cornea and anterior chamber.

PMID: 9855661 [PubMed - indexed for MEDLINE]

3535: Ann Biol Clin (Paris). 1998 Nov-Dec;56(6):717-8.

[Value of PCR for the early diagnosis of atypical zoster]

[Article in French]

Bellagra N, Lengrand F, Dewilde A, Catteau B, Hober D, Wattre P.

Laboratoire de virologie, Institut Gernez-Rieux, CHU de Lille.

Publication Types: 
    Case Reports

PMID: 9853031 [PubMed - indexed for MEDLINE]

3536: J Infect Dis. 1998 Nov;178 Suppl 1:S109-12.

Use of a live attenuated varicella vaccine to boost varicella-specific immune
responses in seropositive people 55 years of age and older: duration of booster
effect.

Levin MJ, Barber D, Goldblatt E, Jones M, LaFleur B, Chan C, Stinson D, Zerbe GO,
Hayward AR.

Department of Pediatrics, University of Colorado School of Medicine, Denver
80262, USA.

Varicella-zoster virus (VZV)-specific T cell immunity was measured in 130 persons
> or = 55 years of age 6 years after they received a live attenuated VZV vaccine.
Circulating T cells, which proliferated in vitro in response to VZV antigen, were
enumerated (VZV responder cell frequency assay). Six years after the booster
vaccination, the VZV-responding cell frequency (1/61,000 circulating cells) was
still significantly (P < .05) improved over the baseline measurements (1/70,000) 
and appears to have diminished the expected decline in frequency as these
vaccinees aged (to 1/86,000). Ten herpes-zoster--like clinical events were
recorded. Although the frequency of these events, approximately 1/100
patient-years, is within the expected range of such events for this age cohort,
the number of lesions was small, there was very little pain, and there was no
postherpetic neuralgia. These results support the development of a vaccine to
prevent or attenuate herpes zoster.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't

PMID: 9852987 [PubMed - indexed for MEDLINE]

3537: J Infect Dis. 1998 Nov;178 Suppl 1:S104-8.

Erratum in:
    J Infect Dis 1999 Mar;179(3):753.

Cellular immunity to varicella-zoster virus in patients with major depression.

Irwin M, Costlow C, Williams H, Artin KH, Chan CY, Stinson DL, Levin MJ, Hayward 
AR, Oxman MN.

VA Medical Center, University of California, San Diego, USA. mirwin@ucsd.edu

The incidence of herpes zoster increases markedly with advancing age, and this
appears to be causally related to an age-dependent decline in varicella-zoster
virus (VZV)-specific cellular immunity. Psychologic stress has also been linked
to the occurrence of herpes zoster, but the mechanism involved has not been
investigated. This study examined the relationship between major depression and
VZV-specific cellular immunity by comparing VZV-specific responder cell frequency
(RCF) in adults with major depression (n = 11) to that in age- and sex-matched
nondepressed controls (n = 11) and in a larger group of nondepressed adults who
were > or = 60 years old. VZV-specific RCF in depressed patients was markedly
reduced compared with the RCF in matched controls (t = 2.7, P < .02). In fact,
the levels of VZV-specific RCF in the depressed patients were comparable in
magnitude to the low levels found in adults > or = 60 years of age. These data
indicate that major depression is associated with a marked decline in
VZV-specific cellular immunity.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9852986 [PubMed - indexed for MEDLINE]

3538: J Infect Dis. 1998 Nov;178 Suppl 1:S99-103.

A dose-response study of a live attenuated varicella-zoster virus (Oka strain)
vaccine administered to adults 55 years of age and older.

Berger R, Trannoy E, Hollander G, Bailleux F, Rudin C, Creusvaux H.

University Children's Hospital, Basel, Switzerland.

Decreased cell-mediated immune (CMI) response to varicella-zoster virus (VZV) is 
correlated with an increased risk of reactivation of latent virus from dorsal
root sites, leading to herpes zoster. The cell-mediated and humoral
immunogenicity of three concentrations (3200, 8500, and 41,650 pfu/dose) of a
live attenuated VZV vaccine (Oka strain; VZV/Oka) was compared with a control
pneumococcal polysaccharide vaccine in 200 healthy adults who were > or = 55
years old. Six weeks after vaccination, the VZV-specific CMI response (as
measured by stimulation index values and precursor cell frequencies) was enhanced
in all VZV/Oka vaccine groups compared with the control group (for all VZV/Oka
groups combined vs. controls, tested with VZV crude antigen: stimulation index, P
< .001; precursor cell frequency, P < .001). Geometric mean titers of anti-VZV
antibodies increased in all VZV/Oka vaccine groups but remained unchanged in the 
control vaccine group. No dose effect of VZV/Oka vaccine was observed for CMI or 
humoral responses.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9852985 [PubMed - indexed for MEDLINE]

3539: J Infect Dis. 1998 Nov;178 Suppl 1:S91-4.

Postherpetic neuralgia: the importance of preventing this intractable end-stage
disorder.

Watson CP.

An argument is presented here for postherpetic neuralgia as an intractable
end-stage disorder for many patients. The exciting possibility of prevention of
this disorder by early, aggressive treatment exists; however, the extent to which
therapy can be effective is unknown. Early, aggressive treatment of the pain of
herpes zoster is, nevertheless, urged, and the options for treatment are
discussed. These options include antiviral therapy within the first 72 h, if
possible, from the onset of rash or radicular pain and the use of analgesics,
including opioids (if necessary), nerve blocks, and early antidepressant therapy.
In addition, the extent to which vaccination of older adults will prevent
postherpetic neuralgia is unknown but appears to hold promise.

Publication Types: 
    Review

PMID: 9852983 [PubMed - indexed for MEDLINE]

3540: J Infect Dis. 1998 Nov;178 Suppl 1:S85-90.

Cost effectiveness of newer antiviral agents for herpes zoster: is the evidence
spotty?

Smith KJ, Roberts MS.

Department of Medicine, Mercy Hospital of Pittsburgh, PA 15219, USA.
ksmith@mercy.pmhs.org

Famciclovir and valaciclovir were approved for use in the treatment of herpes
zoster despite controversy over antiviral therapy in zoster due to high costs and
uncertain benefits. To explore these issues, a Markov decision model was
developed, and the incremental cost effectiveness of antiviral treatment for
herpes zoster was estimated using these agents compared with no antiviral
therapy. A third-party payer perspective was taken. Sensitivity analyses were
performed, modeling differences in antiviral efficacy, postherpetic neuralgia
(PHN) risk, and other illness parameters. Treatment of severely symptomatic acute
zoster was found reasonable from a cost-effectiveness standpoint in base-case and
worst-case scenarios. Treatment of mildly symptomatic acute zoster was more
expensive but would likely be considered cost effective in scenarios where PHN
risk was higher, PHN duration longer, or antiviral shortening of PHN greater.
Further research comparing antiviral efficacy in herpes zoster is needed.

PMID: 9852982 [PubMed - indexed for MEDLINE]

3541: J Infect Dis. 1998 Nov;178 Suppl 1:S81-4.

Treatment of acute herpes zoster: effect of early (< 48 h) versus late (48-72 h) 
therapy with acyclovir and valaciclovir on prolonged pain.

Wood MJ, Shukla S, Fiddian AP, Crooks RJ.

Department of Infection, Heartlands Hospital, Birmingham, United Kingdom.
m.j.wood@hbham.ac.uk

The efficacy of early versus late treatment with acyclovir and valaciclovir on
zoster-associated pain was assessed from two databases (1076 patients) that were 
compiled from randomized trials. Early treatment was started < 48 h and late
treatment was started 48-72 h after the onset of cutaneous herpes zoster. Median 
times to complete resolution of zoster-associated pain were 28 and 62 days,
respectively, for patients (> or = 18 years of age) treated with acyclovir and
placebo within 48 h (hazard ratio [HR], 1.68; 95% confidence limit [95% CL],
1.19, 2.38) and 28 and 58 days, respectively, for those treated later (HR, 2.20; 
95% CL, 1.03, 4.71). In the valaciclovir versus acyclovir study (in patients > or
= 50 years of age), the corresponding figures were 44 and 51 days for patients
treated early (HR, 1.28; 95% CL, 1.03, 1.60) and 36 and 48 days for those treated
later (HR, 1.40; 95% CL, 1.04, 1.87). Acyclovir significantly shortened the time 
to complete resolution of zoster-associated pain compared with placebo (and
valaciclovir was superior to acyclovir in this regard) even when therapy was
delayed up to 72 h after rash onset.

Publication Types: 
    Comparative Study

PMID: 9852981 [PubMed - indexed for MEDLINE]

3542: J Infect Dis. 1998 Nov;178 Suppl 1:S76-80.

Postherpetic neuralgia: impact of famciclovir, age, rash severity, and acute pain
in herpes zoster patients.

Dworkin RH, Boon RJ, Griffin DR, Phung D.

Department of Anesthesiology, University of Rochester School of Medicine and
Dentistry, New York 14642, USA. dwrkn@troi.cc.rochester.edu

New and previously reported analyses of the data from a placebo-controlled trial 
of famciclovir are reviewed in light of recently proposed recommendations for the
analysis of pain in herpes zoster trials. The analyses examined the effect of
famciclovir treatment on the duration of postherpetic neuralgia (PHN), which was 
defined as pain persisting after rash healing, pain persisting > 30 days after
study enrollment, or pain persisting > 3 months after study enrollment; the
baseline characteristics of patients in the famciclovir and placebo groups who
developed PHN; the impact of famciclovir treatment on the duration of PHN, while 
controlling for significant covariates; and the prevalence of PHN at monthly
intervals from 30 to 180 days after enrollment. The results of these analyses
indicated that greater age, rash severity, and acute pain severity are risk
factors for prolonged PHN. In addition, they demonstrated that treatment of acute
herpes zoster patients with famciclovir significantly reduces both the duration
and prevalence of PHN.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9852980 [PubMed - indexed for MEDLINE]

3543: J Infect Dis. 1998 Nov;178 Suppl 1:S71-5.

The identification of risk factors associated with persistent pain following
herpes zoster.

Whitley RJ, Shukla S, Crooks RJ.

Department of Pediatrics, Microbiology, and Medicine, University of Alabama at
Birmingham 35233, USA. RWhitley@peds.uab.edu

Demographic and clinical characteristics of patients with herpes zoster at the
time of presentation predict the duration and severity of pain on long-term
follow-up. Analyses by Cox's proportional hazard models of six databases from
controlled trials of antiviral drugs (total subjects = 2367) identified
covariates for zoster-associated pain; all tests for significance were two-sided.
Age strongly influenced pain outcome: patients > or = 50 years old were
significantly more likely to have prolonged zoster-associated pain compared with 
those < 30 years old. Patients with prodromal symptoms or moderate or severe pain
at presentation were also more likely to experience prolonged zoster-associated
pain. Neither time to initiating treatment after rash onset nor sex of patient
influenced pain outcome. Advancing age, prodromal symptoms, and acute pain
severity at presentation predicted those individuals most at risk of prolonged
pain and postherpetic neuralgia. When two or more of these factors were present, 
the risk of persistent pain was increased.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9852979 [PubMed - indexed for MEDLINE]

3544: J Infect Dis. 1998 Nov;178 Suppl 1:S67-70.

Racial and psychosocial risk factors for herpes zoster in the elderly.

Schmader K, George LK, Burchett BM, Pieper CF.

Department of Psychiatry and Sociology, Duke University Medical Center, Durham,
NC 27710, USA.

The effects of black race and psychologic stress on the risk of acquiring herpes 
zoster in late life were examined. Subjects were participants of a stratified
probability sample of community-dwelling persons > or = 65 years old. A
comprehensive health survey was administered in 1986-1987 (P1), 1989-1990 (P2),
and 1992-1994 (P3). Incident cases of zoster between P1 and P2 and P2 and P3
served as the dependent variables. Hypothesis-testing variables included race,
negative life events, and measures of social support. Control variables included 
age, sex, education, cancer, other chronic diseases, hospitalization, activities 
of daily living, self-rated health, depression, and cigarette smoking. From P1 to
P2, 1.4% of black and 3.4% of white subjects developed zoster (P < .001). From P2
to P3, 2.9% of black and 7.5% of white subjects developed zoster (P < .001).
After controlling for variables, black subjects were significantly less likely to
develop zoster than were white subjects (adjusted odds ratio, 0.37; 95%
confidence interval, 0.26, 0.53; P = .0001). Most measures of stress were not
significantly related to zoster; however, study limitations preclude definitive
conclusions.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 9852978 [PubMed - indexed for MEDLINE]

3545: J Infect Dis. 1998 Nov;178 Suppl 1:S64-6.

Polymerase chain reaction and restriction fragment length polymorphism analysis
of varicella-zoster virus isolates from the United States and other parts of the 
world.

LaRussa P, Steinberg S, Arvin A, Dwyer D, Burgess M, Menegus M, Rekrut K,
Yamanishi K, Gershon A.

Columbia University, New York City, New York, USA. psL1@columbia.edu

A polymerase chain reaction (PCR) assay that identifies and differentiates
wild-type (wt) and vaccine strains of varicella-zoster virus (VZV) was used to
determine if VZV strains with restriction fragment length polymorphisms
resembling those of the Japanese Oka vaccine strain were present in the wt pool
outside of Japan. Virus samples (n = 114) from patients with chickenpox and
zoster from various parts of the United States and Australia were analyzed. The
assay correctly identified 113 samples as wt strain. The 1 sample identified as
Oka vaccine strain came from a child with leukemia who developed a
vaccine-associated rash after receiving the live attenuated varicella vaccine. At
this point, there is no evidence that wt strains resembling the vaccine are
circulating outside of Japan. This indicates that this PCR assay can be utilized 
to distinguish rashes due to vaccine and wt VZV.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9852977 [PubMed - indexed for MEDLINE]

3546: J Infect Dis. 1998 Nov;178 Suppl 1:S55-7.

Single amino acid change in DNA polymerase is associated with foscarnet
resistance in a varicella-zoster virus strain recovered from a patient with AIDS.

Visse B, Dumont B, Huraux JM, Fillet AM.

Laboratoire de Virologie, CERVI, Hopital Pitie-Salpetriere, Paris, France.

The genetic characterization of a foscarnet-resistant strain of varicella-zoster 
virus (VZV) that was isolated from a patient with AIDS is reported. Compared with
the sequence of the Dumas reference strain, this strain, which was isolated from 
a patient in whom foscarnet treatment failed, had two point mutations. The
emergence of one of the mutations, which includes a change from a glutamic acid
to a lysine at position 512 in the DNA polymerase, suggests that this mutation is
implicated in the VZV foscarnet resistance. The other mutation, which replaces
serine 863 by a glycine, is also present in 2 susceptible strains--Oka and a
wild-type isolate.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9852975 [PubMed - indexed for MEDLINE]

3547: J Infect Dis. 1998 Nov;178 Suppl 1:S48-51.

Evidence of latent varicella-zoster virus in rat dorsal root ganglia.

Annunziato P, LaRussa P, Lee P, Steinberg S, Lungu O, Gershon AA, Silverstein S.

Department of Pediatrics, Columbia University, College of Physicians and
Surgeons, New York, New York 10032, USA. paa5@columbia.edu

Latent varicella-zoster virus (VZV) was studied in ganglia of rats that had been 
inoculated subcutaneously with either a high-passaged wild-type, a low-passaged
wild-type, or the vaccine strain of virus using in situ hybridization. Nine of 11
rats injected with virus and no control rats developed serum VZV antibodies as
demonstrated by fluorescent antibody membrane antigen. Polymerase chain reaction 
2 weeks following inoculation did not detect viremia in the rats. VZV was
detected by in situ hybridization in ganglia of 10 of the 11 infected rats but
not in ganglia of the control rats. The distribution of VZV DNA is identical to
that seen in humans; satellite cells and neurons contain VZV DNA. Although all
animals received unilateral injections of virus, VZV DNA was in ipsilateral and
contralateral ganglia in 6 animals, suggesting that virus replication and viremia
had occurred.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 9852973 [PubMed - indexed for MEDLINE]

3548: J Infect Dis. 1998 Nov;178 Suppl 1:S43-7.

Varicella-zoster virus IE63, a virion component expressed during latency and
acute infection, elicits humoral and cellular immunity.

Sadzot-Delvaux C, Arvin AM, Rentier B.

Department of Pediatrics, Stanford University School of Medicine, California,
USA. csadzot@ulg.ac.be

Varicella-zoster virus (VZV) latency in human dorsal root ganglia is
characterized by the transcription of large regions of its genome and by the
expression of large amounts of some polypeptides, which are also expressed during
lytic cycles. The immediate early 63 protein (IE63) is a virion component
expressed very early in cutaneous lesions and the first viral protein detected
during latency. Immune response against IE63 has been evaluated among naturally
immune adults with a history of chickenpox: Specific antibodies were detected in 
serum, and most subjects who had a T cell proliferation with unfractionated VZV
antigens had T cell recognition of purified IE63. The cytotoxic T cell (CTL)
response to IE63 was equivalent to CTL recognition of IE62, the major tegument
component of VZV, whose immunogenicity has been previously described. T cell
recognition of IE63 and other VZV proteins is one of the likely mechanisms
involved in controlling VZV reactivation from latency.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9852972 [PubMed - indexed for MEDLINE]

3549: Hosp Med. 1998 Oct;59(10):770-6.

Shingles: a review of diagnosis and management.

Morgan R, King D.

Department of Medicine for the Elderly, Wirral NHS Trust Hospital, Merseyside.

Herpes zoster or shingles results from reactivation of varicella zoster virus
previously dormant in cells of the dorsal root ganglion. The incidence of
shingles increases with age and immunosuppression. Guidelines for managing
shingles are now available and implementation, with the emphasis on early
treatment, may reduce the severity of a shingles attack and reduce the incidence 
of complications.

Publication Types: 
    Review

PMID: 9850292 [PubMed - indexed for MEDLINE]

3550: Eye. 1998;12 ( Pt 4):619-22.

Corneal endothelial specular microscopy following deep lamellar keratoplasty with
lyophilised tissue.

Morris E, Kirwan JF, Sujatha S, Rostron CK.

St George's Hospital, London, UK.

PURPOSE: To assess the corneal endothelial cell density following deep lamellar
keratoplasty (DLK) carried out by air dissection and with the transplantation of 
lyophilised tissue. METHOD: Contact endothelial specular microscopy was carried
out on a series of patients who had undergone DLK with a minimum of 1 year
post-operative follow-up. RESULTS: Twenty eyes of 18 patients were examined at
follow-up times ranging from 1 to 8 years post-operatively (mean 3 years).
Indications for surgery were: keratoconus (n = 12), herpes simplex virus (HSV)
keratitis (n = 1), herpes zoster ophthalmicus (HZO) keratitis (n = 1), lipid
keratopathy (n = 2), lattice dystrophy (n = 1) and corneal scarring (n = 3).
Overall, mean post-operative cell density was 2417 cells/mm2 (range 928-3656
cells/mm2). In eyes with pathological conditions not likely to have affected the 
endothelial cell density, such as keratoconus or lattice degeneration, the mean
cell density was 2837 cells/mm2 (range 1030-3656 cells/mm2). CONCLUSIONS: In
patients undergoing DLK for conditions such as keratoconus the post-operative
cell density was at a normal level in the majority of cases. Cell loss through
this surgical intervention thus appears generally to be small. The prospect for
long-term survival of these grafts is good.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9850251 [PubMed - indexed for MEDLINE]

3551: Neurobiol Dis. 1998 Oct;5(4):209-27.

Postherpetic neuralgia: irritable nociceptors and deafferentation.

Fields HL, Rowbotham M, Baron R.

Department of Neurology, University of California at San Francisco 94143, USA.

Postherpetic neuralgia (PHN) is a common and often devastatingly painful
condition. It is also one of the most extensively investigated of the neuropathic
pains. Patients with PHN have been studied using quantitative testing of primary 
afferent function, skin biopsies, and controlled treatment trials. Together with 
insights drawn from an extensive and growing literature on experimental models of
neuropathic pain these patient studies have provided a preliminary glimpse of the
pain-generating mechanisms in PHN. It is clear that both peripheral and central
pathophysiological mechanisms contribute to PHN pain. Some PHN patients have
abnormal sensitization of unmyelinated cutaneous nociceptors (irritable
nociceptors). Such patients characteristically have minimal sensory loss. Other
patients have pain associated with small fiber deafferentation. In such patients 
pain and temperature sensation are profoundly impaired but light moving
mechanical stimuli can often produce severe pain (allodynia). In these patients, 
allodynia may be due to the formation of new connections between nonnociceptive
large diameter primary afferents and central pain transmission neurons. Other
deafferentation patients have severe spontaneous pain without hyperalgesia or
allodynia and presumably have lost both large and small diameter fibers. In this 
group the pain is likely due to increased spontaneous activity in deafferented
central neurons and/or reorganization of central connections. These three types
of mechanism may coexist in individual patients and each offers the possibility
for developing new therapeutic interventions.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 9848092 [PubMed - indexed for MEDLINE]

3552: J Virol. 1999 Jan;73(1):377-87.

Intracellular traffic of herpes simplex virus glycoprotein gE: characterization
of the sorting signals required for its trans-Golgi network localization.

Alconada A, Bauer U, Sodeik B, Hoflack B.

Institut de Biologie, EP CNRS 525, Institut Pasteur de Lille, 59021 Lille Cedex, 
France.

Herpes simplex virus (HSV) and varicella-zoster virus (VZV) are two pathogenic
human alphaherpesviruses whose intracellular assembly is thought to follow
different pathways. VZV presumably acquires its envelope in the trans-Golgi
network (TGN), and it has recently been shown that its major envelope
glycoprotein, VZV-gE, accumulates in this compartment when expressed alone. In
contrast, the envelopment of HSV has been proposed to occur at the inner nuclear 
membrane, although to which compartment the gE homolog (HSV-gE) is transported is
unknown. For this reason, we have studied the intracellular traffic of HSV-gE and
have found that this glycoprotein accumulates at steady state in the TGN, both
when expressed from cloned cDNA and in HSV-infected cells. In addition, HSV-gE
cycles between the TGN and the cell surface and requires a conserved
tyrosine-containing motif within its cytoplasmic tail for proper trafficking.
These results show that VZV-gE and HSV-gE have similar intracellular trafficking 
pathways, probably reflecting the presence of similar sorting signals in the
cytoplasmic domains of both molecules, and suggest that the respective viruses,
VZV and HSV, could use the same subcellular organelle, the TGN, for their
envelopment.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9847342 [PubMed - indexed for MEDLINE]

3553: Plant Physiol. 1998 Dec;118(4):1447-54.

Direct measurement of calcium transport across chloroplast inner-envelope
vesicles

Roh MH, Shingles R, Cleveland MJ, McCarty RE.

Department of Biology, Johns Hopkins University, Baltimore, Maryland 21218-2685, 
USA.

The initial rate of Ca2+ movement across the inner-envelope membrane of pea
(Pisum sativum L.) chloroplasts was directly measured by stopped-flow
spectrofluorometry using membrane vesicles loaded with the Ca2+-sensitive
fluorophore fura-2. Calibration of fura-2 fluorescence was achieved by combining 
a ratiometric method with Ca2+-selective minielectrodes to determine pCa values. 
The initial rate of Ca2+ influx in predominantly right-side-out inner-envelope
membrane vesicles was greater than that in largely inside-out vesicles. Ca2+
movement was stimulated by an inwardly directed electrochemical proton gradient
across the membrane vesicles, an effect that was diminished by the addition of
valinomycin in the presence of K+. In addition, Ca2+ was shown to move across the
membrane vesicles in the presence of a K+ diffusion potential gradient. The
potential-stimulated rate of Ca2+ transport was slightly inhibited by diltiazem
and greatly inhibited by ruthenium red. Other pharmacological agents such as
LaCl3, verapamil, and nifedipine had little or no effect. These results indicate 
that Ca2+ transport across the chloroplast inner envelope can occur by a
potential-stimulated uniport mechanism.

PMID: 9847120 [PubMed - as supplied by publisher]

3554: J Neuroimmunol. 1998 Nov 2;91(1-2):19-27.

Myelin basic protein reactive Th2 T cells are found in acute disseminated
encephalomyelitis.

Pohl-Koppe A, Burchett SK, Thiele EA, Hafler DA.

Center for Neurologic Diseases, Department of Neurology, Brigham and Womens's
Hospital, Harvard Medical School, Boston, MA 02115-5817, USA.

Acute disseminated encephalomyelitis (ADEM), a postinfectious illness of the
central nervous system (CNS), is thought to be an autoimmune disease. Here, we
characterized the cytokines secreted by myelin-reactive T cells generated from
patients with ADEM. The frequency of MBP-reactive T cell lines was ten-fold
higher in patients with ADEM compared to patients with encephalitis and normal
subjects. Whereas there was no significant IFN-gamma secretion, the predominant
cytokine secreted by MBP-reactive T cell lines was IL-4 in patients with ADEM. In
contrast, IL-4 secretion was only rarely detected in the controls. The presence
of high frequencies of MBP-reactive IL-4 secreting T cells in subjects with ADEM 
during their recovery phase may be similar to myelin reactive IL-4 secreting T
cells observed during the spontaneous recovery of animals with EAE.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9846815 [PubMed - indexed for MEDLINE]

3555: JAMA. 1998 Dec 2;280(21):1863-4.

Comment on:
    JAMA. 1998 Dec 2;280(21):1831-6.    JAMA. 1998 Dec 2;280(21):1837-42.

Symptomatic treatment of painful neuropathy.

Low PA, Dotson RM.

Publication Types: 
    Comment
    Editorial
    Research Support, Non-U.S. Gov't

PMID: 9846782 [PubMed - indexed for MEDLINE]

3556: JAMA. 1998 Dec 2;280(21):1837-42.

Comment in:
    JAMA. 1998 Dec 2;280(21):1863-4.    JAMA. 1999 Jul 14;282(2):134-5.

Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled
trial.

Rowbotham M, Harden N, Stacey B, Bernstein P, Magnus-Miller L.

UCSF Pain Clinical Research Center, University of California, San Francisco
94115, USA.

CONTEXT: Postherpetic neuralgia (PHN) is a syndrome of often intractable
neuropathic pain following herpes zoster (shingles) that eludes effective
treatment in many patients. OBJECTIVE: To determine the efficacy and safety of
the anticonvulsant drug gabapentin in reducing PHN pain. DESIGN: Multicenter,
randomized, double-blind, placebo-controlled, parallel design, 8-week trial
conducted from August 1996 through July 1997. SETTING: Sixteen US outpatient
clinical centers. PARTICIPANTS: A total of 229 subjects were randomized.
INTERVENTION: A 4-week titration period to a maximum dosage of 3600 mg/d of
gabapentin or matching placebo. Treatment was maintained for another 4 weeks at
the maximum tolerated dose. Concomitant tricyclic antidepressants and/or
narcotics were continued if therapy was stabilized prior to study entry and
remained constant throughout the study. MAIN OUTCOME MEASURES: The primary
efficacy measure was change in the average daily pain score based on an 11-point 
Likert scale (0, no pain; 10, worst possible pain) from baseline week to the
final week of therapy. Secondary measures included average daily sleep scores,
Short-Form McGill Pain Questionnaire (SF-MPQ), Subject Global Impression of
Change and investigator-rated Clinical Global Impression of Change, Short Form-36
(SF-36) Quality of Life Questionnaire, and Profile of Mood States (POMS). Safety 
measures included the frequency and severity of adverse events. RESULTS: One
hundred thirteen patients received gabapentin, and 89 (78.8%) completed the
study; 116 received placebo, and 95 (81.9%) completed the study. By
intent-to-treat analysis, subjects receiving gabapentin had a statistically
significant reduction in average daily pain score from 6.3 to 4.2 points compared
with a change from 6.5 to 6.0 points in subjects randomized to receive placebo
(P<.001). Secondary measures of pain as well as changes in pain and sleep
interference showed improvement with gabapentin (P<.001). Many measures within
the SF-36 and POMS also significantly favored gabapentin (P< or =.01).
Somnolence, dizziness, ataxia, peripheral edema, and infection were all more
frequent in the gabapentin group, but withdrawals were comparable in the 2 groups
(15 [13.3%] in the gabapentin group vs 11 [9.5%] in the placebo group).
CONCLUSIONS: Gabapentin is effective in the treatment of pain and sleep
interference associated with PHN. Mood and quality of life also improve with
gabapentin therapy.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9846778 [PubMed - indexed for MEDLINE]

3557: Ugeskr Laeger. 1998 Nov 23;160(48):6993-6.

[Antiviral treatment of Varicella zoster virus infection]

[Article in Danish]

Petersen CS.

Dermato-venerologisk afdeling, H:S Bispebjerg Hospital.

PMID: 9846101 [PubMed - indexed for MEDLINE]

3558: Ugeskr Laeger. 1998 Nov 23;160(48):6943.

[Treatment of chickenpox and shingles]

[Article in Danish]

Gerstoft J.

Publication Types: 
    Editorial

PMID: 9846086 [PubMed - indexed for MEDLINE]

3559: Zh Nevrol Psikhiatr Im S S Korsakova. 1998;98(11):4-8.

[Clinical course and treatment of herpetic trigeminal ganglionic neuropathy]

[Article in Russian]

Grachev IuV, Kukushkin ML, Sudarikov AP, Zhuravlev VF, Gerasimenko MIu.

45 patients were observed in the periods of both acute herpes zoster and
postherpetic neuralgia (PHN). In most of the patients herpetic eruptions were
located in the areas of innervation of the first branch of the trigeminal nerve. 
In acute period of the disease there were used aciclovir, helepin or alpisarinum,
antiherpetic immunoglobulin, deoxyribonuclease, non-narcotic analgetics were
used. Of 28 patients residual PHN was observed in 6 cases, delayed PHN (during 3 
months)--in 2 patients. The PHN development was characteristic for elderly
patients, delayed request for medical care, concomitant diseases, eruptions with 
hemorrhagic component and secondary pyodermia and considerable residual sensory
deficit. In therapy of PHN the most effective drugs were amitriptylin,
non-narcotic analgetics, anticonvulsants as well as acupuncture and
electroacupuncture. Relief of a typical deafferentation of pain syndrome was
achieved by means of ultrasonic destruction of the trigeminal nucleus (one case).
Early therapy of acute herpes zoster does not prevent completely PHN development,
but it decreased considerably probability of its forming as well as the severity 
of its course.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9845932 [PubMed - indexed for MEDLINE]

3560: J Infect Dis. 1999 Jan;179(1):9-15.

Herpes zoster: risk categories for persistent pain.

Whitley RJ, Weiss HL, Soong SJ, Gnann JW.

Department of Pediatrics, University of Alabama at Birmingham, USA.
RWhitley@PEDS.UAB.EDU

Acute neuritis and persistent pain are the most significant clinical
manifestations of herpes zoster and are end points for clinical trials therapy.
In an acyclovir and prednisone study, patients were categorized according to pain
severity and number of lesions at presentation. Risk categories were defined
according to the magnitude of risk ratios (RRs) and a comparison of Kaplan-Meier 
survival estimates. For acute neuritis and zoster-associated pain, RRs defined
rate of resolution. Patients who presented with severe or incapacitating pain and
a large number of lesions were less likely to achieve resolution of both acute
neuritis and zoster-associated pain (RR, 18.0; 95% confidence interval [CI], 6.
6-48.6, and RR, 5.3; 95% CI, 4.2-17.2, respectively). These analyses identify the
subgroups of patients for whom aggressive interventions are most strongly
indicated.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 9841816 [PubMed - indexed for MEDLINE]

3561: Aust N Z J Ophthalmol. 1998 Nov;26(4):327-8.

Failure of sorivudine therapy in progressive outer retinal necrosis caused by
varicella zoster virus.

Rosenthal G, Bartz-Schmidt KU, Walter P, Kirchhof B, Heimann K.

Department of Vitreoretinal Surgery, University of Cologne, Germany.
gidir@ramat-negev.org.il

BACKGROUND: We report on the case of a 23-year-old female who presented with
ocular signs of progressive outer retinal necrosis (PORN) syndrome and who failed
to respond to acyclovir, ganciclovir, foscarnet and oral sorivudine. METHODS: The
patient was treated with the antiviral drugs acyclovir, ganciclovir, foscarnet
and oral sorivudine. RESULTS: The patient failed to respond to a combination of
antiviral drugs. Unfortunately, progression of the retintis occurred, which led
to blindness. CONCLUSION: Despite new drugs, the prognosis of PORN is poor and
recurrence is common.

Publication Types: 
    Case Reports

PMID: 9843261 [PubMed - indexed for MEDLINE]

3562: Rev Stomatol Chir Maxillofac. 1998 Oct;99(3):155-64.

[Zona of the cranial nerves. Current aspects]

[Article in French]

Carreau JP, Gola R, Cheynet F, Guyot L.

Service de Stomatologie, Chirurgie Maxillo-Faciale et Plastique de la face, CHU
Nord, Marseille.

Recurrence of the chickenpox virus, herpes zoster localizes in cranial nerves in 
30% of cases, with a predilection for the ophthalmic nerve. In young patients,
clinicians must search for a herpes zoster-HIV association as well as oculomotor 
proprioception impairment in herpes zoster ophthalmicus. Enhanced MRI allows good
objective view of the facial nerve lesions in herpes zoster facial paralysis.
Finally, the gravity and aftereffects of cephalic herpes zoster can be decreased 
by an appropriate therapeutic approach.

Publication Types: 
    English Abstract
    Review

PMID: 9842661 [PubMed - indexed for MEDLINE]

3563: J Vestib Res. 1998 Nov-Dec;8(6):427-33.

High resolution Gd-DTPA MR imaging of the inner ear in 60 patients with
idiopathic vestibular neuritis: no evidence for contrast enhancement of the
labyrinth or vestibular nerve.

Strupp M, Jager L, Muller-Lisse U, Arbusow V, Reiser M, Brandt T.

Department of Neurology, University of Munich, Germany.

Sixty patients with acute idiopathic vestibular neuritis (confirmed by clinical
examination and caloric irrigation) were evaluated in a prospective study by high
resolution magnetic resonance imaging (hr-MRI) between days 3 and 30 after onset 
of symptoms. We used a 1.5 Tesla imager with an axial and coronal T1-weighted
2D-fast low angle shot-, T2-weighted turbo spin echo-, and an axial T2-weighted
3D-constructive interference in steady-state sequence for MRI. None of the
patients' MRIs exhibited contrast enhancement of the labyrinth, vestibulocochlear
nerve, or vestibular ganglion, even when high doses of gadolinium (0.2 mmol/kg)
were used. In contrast, several previous studies demonstrated contrast
enhancement of the vestibulocochlear nerve/labyrinth in herpes zoster oticus,
labyrinthitis, and Cogan's syndrome or of the facial nerve in Bell's palsy. On
the basis of our MRI findings, we speculate that idiopathic vestibular neuritis
is neither a viral infection directly affecting the nerve (such as herpes zoster)
nor a labyrinthitis. An autoimmunological disease of the labyrinth, which should 
involve only the anterior and horizontal semicircular canals, is also unlikely. A
subacute reactivation of a latent viral infection--as discussed for Bell's
palsy--is compatible with our MRI findings. The observed differences between
contrast enhancement of the facial nerve in Bell's palsy and the
vestibulocochlear nerve in vestibular neuritis may be due to their dissimilar
anatomy: contrary to the vestibular nerve, the facial nerve has very prominent
circumneural arteriovenous structures. Hyperemia within these vascular structures
may cause the contrast enhancement seen in Bell's palsy.

PMID: 9842512 [PubMed - indexed for MEDLINE]

3564: Int J Immunopharmacol. 1998 Oct;20(10):521-35.

Comparative study of transfer factor and acyclovir in the treatment of herpes
zoster.

Estrada-Parra S, Nagaya A, Serrano E, Rodriguez O, Santamaria V, Ondarza R,
Chavez R, Correa B, Monges A, Cabezas R, Calva C, Estrada-Garcia I.

Department of Immunology, National School of Biological Sciences, National
Polytechnic Institute, Prol. Carpio Y Plan de Ayala, Mexico, D.F.
i-estrad@bios.encb.ipn.mx

Reactivation of varicella herpes virus (VHV), latent in individuals who have
previously suffered varicella, gives rise to herpes zoster and in some cases
leads to a sequela of post herpetic neuritis with severe pain which is refractory
to analgesics. Many different antiviral agents have been tried without achieving 
satisfactory results. Of all the antiviral agents employed, acyclovir has been
the most successful in reducing post herpetic pain. However acyclovir has not
been as reliable as interferon alpha (IFN-alpha). We have previously looked into 
the use of transfer factor (TF) as a modulator of the immune system, specifically
with respect to its effectiveness in the treatment of herpes zoster. In this work
findings from a comparative clinical evaluation are presented. A double blind
clinical trial of TF vs acyclovir was carried out in which 28 patients,
presenting acute stage herpes zoster, were randomly assigned to either treatment 
group. Treatment was administered for seven days and the patients were
subsequently submitted to daily clinical observation for an additional 14 days.
An analogue visual scale was implemented in order to record pain and thereby
served as the clinical parameter for scoring results. The group treated with TF
was found to have a more favorable clinical course, P < or = 0.015. Laboratory
tests to assess the immune profile of the patients were performed two days prior 
and 14 days after initial treatment. The results of these tests showed an
increase in IFN-gamma levels, augmentation in the CD4+ cell population but not
the percentage of T rosettes in the TF treated group. These parameters were
however insignificantly modified in patients receiving acyclovir. Although TF
treated patients showed an increase in CD4+ counts these cells remained below the
levels for healthy individuals. The fact that IFN-gamma levels as well as the
counts for CD4+ cells rose in the TF treated group and not in the acyclovir one
is very significant and confirms the immunomodulating properties of TF.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 9839657 [PubMed - indexed for MEDLINE]

3565: Antimicrob Agents Chemother. 1998 Dec;42(12):3285-9.

The antiherpesvirus activity of H2G
[(R)-9-[4-hydroxy-2-(hydroxymethyl)butyl]guanine] is markedly enhanced by the
novel immunosuppressive agent mycophenolate mofetil.

Neyts J, Andrei G, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Leuven,
Belgium. johan.neyts@rega.kuleuven.ac.be

Mycophenolate mofetil (MMF) has been approved as an immunosuppressive agent in
kidney transplant recipients and may thus be used concomitantly with antiherpetic
agents, which are used for the treatment of intercurrent herpesvirus infections. 
We have recently demonstrated that MMF and its parent compound mycophenolic acid 
(MPA), which is a potent inhibitor of IMP dehydrogenase, potentiate the
antiherpesvirus activity of acyclovir, ganciclovir, and penciclovir. We have now 
evaluated the antiviral efficacy of the combination of MPA and the novel
antiherpesvirus agent H2G [(R)-9-[4-hydroxy-2-(hydroxymethyl)butyl]guanine]. When
combined with H2G, MPA (at concentrations ranging from 0.25 to 10 microgram/ml,
which are readily attainable in human plasma) markedly potentiated the antiviral 
efficacy of H2G against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2),
as reflected by a 10- to 150-fold decrease in the 50% effective concentration.
Moreover, the activity of H2G against a thymidine kinase-deficient strain of
HSV-1 (TK- HSV-1) was increased more than 2,500-fold when combined with MPA. MPA 
by itself had little or no effect on the replication of these viruses. Similar
observations were made for varicella-zoster virus. Also, ribavirin (another
inhibitor of IMP dehydrogenase) caused a marked enhancement of the activity of
H2G against HSV-1 (10-fold), HSV-2 (10-fold), and TK- HSV-1 (>185-fold).
Exogenously added guanosine reversed the potentiating effects of MPA on the
antiviral activity of H2G, indicating that this potentiating effect resulted from
a depletion of the endogenous dGTP pools, thus favoring the inhibitory action of 
the H2G triphosphate on the viral DNA polymerase.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9835529 [PubMed - indexed for MEDLINE]

3566: Eur J Pediatr. 1998 Nov;157(11):953-4.

False-positive serological tests for Lyme disease in facial palsy and varicella
zoster meningo-encephalitis.

Woelfle J, Wilske B, Haverkamp F, Bialek R.

Publication Types: 
    Letter

PMID: 9835449 [PubMed - indexed for MEDLINE]

3567: Folia Neuropathol. 1998;36(3):129-44.

Opportunistic infections of the central nervous system in the course of acquired 
immune deficiency syndrome (AIDS). Morphological analysis of 172 cases.

Zelman IB, Mossakowski MJ.

Department of Neuropathology, Polish Academy of Sciences, Warsaw.

A neuropathological analysis of 172 cases of AIDS in adults was carried out, to
determine the occurrence and nature of the opportunistic infections of the
central nervous system (CNS). The material comprised 155 cases of men, and 17
women. Mean age of patients was 38 years. Collection under study originated from 
the period between 1987 and 1997. Opportunistic infections were present in 57.5
percent of cases being in 38.4 percent the only pathological process, whereas in 
19.1 percent they coexisted with HIV-dependent pathology or with neoplastic
growth. Cytomegalovirus infection (22.7%), toxoplasmosis (16.3%), cryptococcosis 
(8.1%) and progressive multifocal leukoencephalopathy (9.3%) were the most common
opportunistic infections of CNS. The remaining viral (herpetic encephalitis,
tick-borne encephalitis and herpes zoster multifocal encephalitis), bacterial
(lues, metastatic encephalitis connected with heart valvular changes) and fungal 
(candidiasis) infections were present only in single cases. It is worth
mentioning 3 cases of brain aspergillosis and 5 cases of leptomeningeal
tuberculosis. Great morphological variability in the most common opportunistic
infections found in our material (cytomegaly, toxoplasmosis, cryptococcosis and
PML) was the most striking phenomenon. Neuropathological abnormalities in cases
of toxoplasmosis and cryptococcosis revealed remarkable dependence on clinical
medication used. Cases of PML were characterized by strong variances of the type 
and intensity of demyelination, ranging from disseminated foci of various size to
diffuse complete myelin loss in the white matter involving uni- or bilaterally
cerebral or cerebellar hemispheres. The coexistence of opportunistic infections
with HIV-dependent cerebral pathology or other types of opportunistic processes
was a very characteristic feature. Concomitance of HIV-dependent pathology with
viral opportunistic processes was common. The frequency of this concomitance and 
more severe HIV-dependent pathology in cases with other viral cerebral infections
may suggest pathogenetic interaction of viral infections. Cerebral tuberculosis
was less frequent as compared with other neuropathological collections,
especially those from the United States. However, it seems worth mentioning that 
3 of 5 cases occurred in the last year of observation.

PMID: 9833390 [PubMed - indexed for MEDLINE]

3568: J Med Virol. 1998 Dec;56(4):359-63.

Detection of varicella-zoster virus DNA in peripheral mononuclear cells from
patients with Ramsay Hunt syndrome or zoster sine herpete.

Terada K, Niizuma T, Kawano S, Kataoka N, Akisada T, Orita Y.

Department of Pediatrics, Kawasaki Medical School, Kurashiki, Okayama, Japan.
kihei@med.kawasaki-m.ac.jp

On the basis of alterations in varicella-zoster virus (VZV) antibody titers, it
appears that Bell's palsy in some patients could be associated with VZV
reactivation, that is, zoster sine herpete. To obtain stronger evidence of this
association, polymerase chain reaction (PCR) was used to detect VZV DNA in
auricular lesions or peripheral blood mononuclear cells (PBMCs) from Bell's palsy
or Ramsay Hunt syndrome patients. VZV DNA was detected in the auricular lesions
of Ramsay Hunt syndrome, in PBMCs from 2 Ramsay Hunt syndrome patients, and in 4 
of 17 samples from 16 Bell's palsy patients. Three of these four positive
patients were thought to have zoster sine herpete because of hearing difficulty, 
vertigo, and pain. VZV IgM antibodies were positive in 1 of the 2 patients with
Ramsay Hunt syndrome, and in 2 of the 17 samples from the Bell's palsy patients. 
VZV IgG antibody titers during the acute phase were significantly higher in the
patients positive for the PCR or VZV IgM antibody than in those negative for
them. These findings provide evidence that Bell's palsy in some patients could be
associated with VZV reactivation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9829642 [PubMed - indexed for MEDLINE]

3569: Neurourol Urodyn. 1998;17(6):613-9.

Urinary retention due to herpes virus infections.

Yamanishi T, Yasuda K, Sakakibara R, Hattori T, Uchiyama T, Minamide M, Ito H.

Department of Urology, Chiba University, School of Medicine, Chiba City, Japan.

Urinary retention is uncommon in patients with herpes zoster and anogenital
herpes simplex. Seven patients (four men, three women) with a mean age of 68.1
years (range, 35-84) with urinary retention due to herpes zoster (n = 6) or
anogenital herpes simplex (n = 1) were studied. Six patients had unilateral skin 
eruption in the saddle area (S2-4 dermatome) and one patient with herpes zoster
had a skin lesion in the L4-5 dermatome. All patients had detrusor areflexia
without bladder sensation, and two of them had inactive external sphincter on
electromyography at presentation. Clean intermittent catheterization was
performed, and voiding function was recovered in 4-6 weeks (average, 5.4) in all 
patients. Urodynamic study was repeated after recovery of micturition in three
patients, and they returned to normal on cystometrography and external sphincter 
electromyography. Acute urinary retention associated with anogenital herpes
infection has been thought to occur when the meninges or sacral spinal ganglia
were involved, and, in conclusion, this condition may be considered to be
reversible.

PMID: 9829425 [PubMed - indexed for MEDLINE]

3570: South Med J. 1998 Nov;91(11):1064-6.

In utero varicella-zoster infections.

Derrick CW Jr, Lord L.

Department of Pediatrics, University of South Carolina School of Medicine,
Columbia 29203, USA.

In utero varicella-zoster infections, though infrequent, may have significant
consequences for the affected infant depending on the gestational timing of the
infection. We present a case of infantile zoster in a 5-month-old boy after
maternal varicella infection. Also, we review the three major disorders resulting
from in utero infection with respect to severity and management.

Publication Types: 
    Case Reports
    Review

PMID: 9824193 [PubMed - indexed for MEDLINE]

3571: Chest. 1998 Nov;114(5):1258-63.

Comment in:
    Chest. 1998 Nov;114(5):1230-1.

The effect of adjunctive corticosteroids for the treatment of Pneumocystis
carinii pneumonia on mortality and subsequent complications.

Gallant JE, Chaisson RE, Moore RD.

Johns Hopkins University School of Medicine, Baltimore, MD 21287-6220, USA.

OBJECTIVE: To assess the long-term safety of adjunctive corticosteroids in the
treatment of Pneumocystis carinii pneumonia (PCP). DESIGN: Analysis of data from 
a large prospective observational database. SETTING: HIV clinic at a large urban 
teaching hospital. PATIENTS: One hundred seventy-four patients who developed PCP 
after being enrolled in the database. RESULTS: Fifty-three patients (30%)
received adjunctive corticosteroids and 121 (70%) did not. Survival did not
differ between groups after adjusting for CD4 count (relative risk for adjunctive
corticosteroids = 0.74, p = 0.13). There were no differences in the incidence of 
cytomegalovirus disease (adjunctive corticosteroids: 18.5 cases per 100
person-years vs no adjunctive corticosteroids: 15.7, p = 0.22), Mycobacterium
avium complex (23.4 vs 27.0, p = 0.73), cryptococcal meningitis (1.8 vs 4.1, p = 
0.58), toxoplasmosis (3.6 vs 11.0, p = 0.28), Kaposi's sarcoma (1.8 vs 2.2, p =
0.92), herpes simplex (27.1 vs 42.7, p = 0.66), herpes zoster (3.8 vs 6.9, p =
0.71), oropharyngeal candidiasis (18.9 vs 10.9, p = 0.09), or non-Hodgkin's
lymphoma (3.5 vs 4.2, p = 0.92). Esophageal candidiasis was more common among
adjunctive corticosteroid recipients (45.1 vs 26.6, p = 0.01). Results were
similar for time to development of opportunistic conditions. CONCLUSIONS:
Adjunctive corticosteroids do not increase mortality or the risk of most common
HIV-associated complications.

PMID: 9823998 [PubMed - indexed for MEDLINE]

3572: Am J Ophthalmol. 1998 Nov;126(5):732-3.

Triple viral retinitis diagnosed by polymerase chain reaction of the vitreous
biopsy in a patient with Richter syndrome.

Levinson RD, Hooks JJ, Wang Y, Chiu MT, Kellaway J, Chan CC.

Eye Associates of New Mexico and Southwest Colorado, Albuquerque 87102, USA.

PURPOSE: To report the evaluation and identification of herpes viruses associated
with retinitis in a patient with Richter syndrome. METHODS: Diagnostic vitrectomy
was performed on a patient with systemic leukemia and retinitis. The vitreous
sample was evaluated by cytology, analysis of cytokines by ELISA, and detection
of virus by polymerase chain reaction. RESULTS: The vitreous biopsy specimen
showed no malignant cells but predominant CD8+ lymphocyte infiltration with
elevated interferon gamma and interleukin-6. DNA amplification and Southern blot 
analysis demonstrated DNA of herpes simplex, varicella-zoster, and
cytomegalovirus. CONCLUSION: Retinitis associated with multiple viruses in the
vitreous biopsy may mimic leukemic infiltration in the eye.

Publication Types: 
    Case Reports

PMID: 9822244 [PubMed - indexed for MEDLINE]

3573: Anesthesiology. 1998 Nov;89(5):1254-6.

The source of epidural infection following epidural analgesia identified by
pulsed-field gel electrophoresis.

Sakuragi T, Yasunaka K, Hirata K, Hori K, Dan K.

Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.
hh034563@msat.fukuoka-u.ac.jp

Publication Types: 
    Case Reports

PMID: 9822017 [PubMed - indexed for MEDLINE]

3574: Lancet. 1998 Nov 7;352(9139):1526.

Evaluation of cyberdocs.

Eysenbach G, Diepgen TL.

Publication Types: 
    Letter

PMID: 9820312 [PubMed - indexed for MEDLINE]

3575: Radiol Med. 1998 Jul-Aug;96(1-2):107-8.

[Magnetic resonance findings in a case of herpes zoster myelitis]

[Article in Italian]

Pierallini A, Piattella MC, Ferone E.

Dipartimento di Scienze Neurologiche, Universita degli Studi La Sapienza, Roma.

Publication Types: 
    Case Reports
    Review

PMID: 9819630 [PubMed - indexed for MEDLINE]

3576: J Infect. 1998 Mar;36(2):209-14.

Acute Herpes zoster in Tayside: demographic and treatment details in
immunocompetent patients 1989-1992.

Torrens J, Nathwani D, MacDonald T, Davey PG.

Infection and Immunodeficiency Unit, Kings Cross Hospital, Dundee Teaching
Hospitals NHS Trust, Dundee, UK.

Medical records of 105 patients admitted to Tayside hospitals with acute Herpes
zoster without underlying immunosuppression were examined retrospectively for the
period 1984-1992. In this elderly population (median age: 79 years) there was a
female preponderance (70.5%), most admissions were for trigeminal zoster (49.5%) 
and length of stay ranged from 1-70 days (median: 11 days), indicating
significant morbidity. There was a wide variation in both pre-admission and
inpatient treatment; 53.3% of patients did not receive any anti-viral therapy
prior to admission, and prescribing patterns for in-patients revealed marked
differences, according to the dermatome affected. Idoxuridine 5% solution was
prescribed by 15.24% of General Practitioners. Given the significant morbidity
and associated costs of Herpes zoster, and that existing anti-viral agents exert 
maximal benefit when administered early in the course of the disease,
recommendations are made with respect to appropriate therapy, and auditing
current management of this serious illness, which is expected to increase in
prevalence as the population ages.

PMID: 9570656 [PubMed - indexed for MEDLINE]

3577: J Infect. 1998 Jan;36(1):53-6.

Prevalence of antibodies against varicella zoster, herpes simplex (types 1 and
2), hepatitis B and hepatitis A viruses among Spanish adolescents.

Gil A, Gonzalez A, Dal-Re R, Ortega P, Dominguez V.

Preventive Medicine and Public Health Department, School of Medicine, Complutense
University, Madrid, Spain.

The aim of this cross-sectional study was to assess the seroprevalence of
antibodies against varicella zoster (VZV), herpes simplex type 1 (HSV-1) and type
2 (HSV-2), hepatitis B (HBV) and hepatitis A (HAV) viruses in adolescents (14-17 
years of age) in Madrid, Spain. At the study visit, demographic data and blood
samples were obtained. The enzyme linked immunosorbent assay (ELISA) method was
used to assess the presence of anti-VZV, anti-HSV-1, anti-HSV-2, anti-HBc and
anti-HAV antibodies. A total of 1191 serum samples were collected. Mean age (SD) 
and male/female ratio of the study population were 15.3 (1.1) years and 0.9,
respectively. Seroprevalences obtained were as follows: anti-VZV (94%),
anti-HSV-1 (46%), anti-HSV-2 (5%), anti-HBc (3%) and anti-HAV (5%). These data
show that Spanish adolescents should be considered a target group for prevention 
programmes against HSV-2, HBV and HAV infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9515669 [PubMed - indexed for MEDLINE]

3578: J Infect. 1998 Jan;36 Suppl 1:1-10.

Molecular biology of varicella-zoster virus. A review prepared for the UK
Advisory Group on Chickenpox.

Harper DR, Gilbert RL, Jeffries DJ.

Department of Virology, St Bartholomew's and the Royal London Hospital School of 
Medicine and Dentistry, London, UK.

Varicella-zoster virus (human herpesvirus 3; VZV) is one of eight herpes viruses 
that routinely infect humans. It is classified as a member of the genus
Varicellovirus, subfamily Alphaherpesvirinae, family Herpesviridae. Of the other 
human herpes viruses it is most closely related to the herpes simplex viruses
(also members of the Alphalerpesvirinae). Like all herpes viruses, the virus has 
a large double-stranded DNA genome within an icosahedral nucleocapsid. This is
surrounded by a proteinaceous tegument and a trilaminar membrane derived from
host-cell membranes into which the viral glycoproteins are inserted. The
structure of the virion is summarized in Fig. 1.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 9514102 [PubMed - indexed for MEDLINE]

3579: Ann Neurol. 1998 Nov;44(5):789-95.

Unilateral postherpetic neuralgia is associated with bilateral sensory neuron
damage.

Oaklander AL, Romans K, Horasek S, Stocks A, Hauer P, Meyer RA.

Department of Neurosurgery, the Johns Hopkins Medical Institutions, Baltimore,
MD, USA.

Shingles can cause chronic neuropathic pain (postherpetic neuralgia) long after
skin lesions heal. To investigate its causes, we quantitated immunolabeled
sensory neurites in skin biopsies from 18 subjects with and 16 subjects without
postherpetic neuralgia after unilateral shingles. Subjects rated the intensity of
their pain. Punch skin biopsies were evaluated from the site of maximum pain or
shingles involvement, the homologous contralateral location, and a site on the
back, distant from shingles involvement. Sections were immunostained with
anti-PGP9.5 antibody, a pan-axonal marker, and the density of epidermal and
dermal neurites determined. The group with postherpetic neuralgia had a mean
density of 339 +/- 97 neurites/mm2 in shingles-affected epidermis compared with a
density of 1,661 +/- 262 neurites/mm2 for subjects without pain. Neurite loss was
more severe in epidermis than dermis. Unexpectedly, the group with pain had also 
lost half of the neurites in contralateral epidermis. Contralateral damage
occurred despite the lack of contralateral shingles eruptions or pain, correlated
with the presence and severity of ongoing pain at the shingles site, and did not 
extend to the distant site. Thus, the pathophysiology of postherpetic neuralgia
pain may involve a new bilateral mechanism.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9818935 [PubMed - indexed for MEDLINE]

3580: Neurology. 1998 Nov;51(5):1405-11.

CSF and MRI findings in patients with acute herpes zoster.

Haanpaa M, Dastidar P, Weinberg A, Levin M, Miettinen A, Lapinlampi A, Laippala
P, Nurmikko T.

Department of Neurology, Tampere University Hospital, Finland.

OBJECTIVE: To explore MRI and CSF findings in patients with herpes zoster (HZ)
and to correlate the findings with clinical manifestations of the disease.
METHODS: Fifty immunocompetent patients (mean age, 59 years; range, 17 to 84
years) with HZ of fewer than 18 days duration participated. None had clinical
signs of meningeal irritation, encephalitis, or myelitis. In 42 patients (84%),
the symptoms constituted pain and rash only. Six patients (12%) had motor
paresis, and three patients (6%) had ocular complications. One to three CSF
samples were obtained from 46 patients (the first sampling taken 1 to 18 days
from onset of rash), and 16 patients (all with either trigeminal or cervical HZ) 
underwent MRI of the brain. The clinical follow-up continued at least 3 months.
RESULTS: CSF was abnormal in 28/46 patients (61%): pleocytosis (range, 5 to 1,440
microL) was detected in 21, elevated protein concentration in 12, varicella
zoster virus (VZV) DNA in 10, and immunoglobulin G antibody to VZV in 10. These
changes were more common in patients with acute complications, although they did 
not predict development of postherpetic neuralgia (PHN). In 9/16 patients (56%), 
MRI lesions attributable to HZ were seen in the brainstem and cervical cord. At 3
months, 5/9 patients (56%) with abnormal MRI had PHN, whereas none of the 7
patients with no HZ-related lesions on MRI had any remaining pain. CONCLUSIONS:
Subclinical extension of viral inflammation into the CNS occurs commonly in HZ.
This finding may have implications for treatment of HZ and prevention of various 
associated complications.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9818869 [PubMed - indexed for MEDLINE]

3581: J Am Dent Assoc. 1998 Nov;129(11):1608-11.

Comment in:
    J Am Dent Assoc. 1999 Feb;130(2):158, 160.

Diseases and disorders that open a seam between the face and the self.

Slavkin HC.

National Institute of Dental and Craniofacial Research, Bethesda, Md. 20892-2290,
USA.

PMID: 9818581 [PubMed - indexed for MEDLINE]

3582: Lupus. 1998;7 Suppl 2:S63-6.

Antibody-mediated thrombosis: relation to the antiphospholipid syndrome.

Vermylen J, Van Geet C, Arnout J.

Center for Molecular and Vascular Biology, University of Leuven, Belgium.

Various forms of antibody-mediated thrombosis are presented and the mechanisms
involved in their pathogenesis are discussed. Antibody-mediated thrombosis
includes heparin-induced thrombocytopenia and thrombosis, autoantibodies to von
Willebrand factor mimicking an antiphospholipid syndrome, thrombosis following
injection of the murine monoclonal antibody OKT3, hyperacute and acute xenograft 
rejection, and varicella-associated antibody against protein S. In several of
these entities the pathogenesis of thrombosis is closely related to development
of cellular procoagulant activity through tight occupancy of Fc receptors, or
through complement activation, or through cell-cell interactions. Integrating the
antiphospholipid syndrome into the more general category of antibody-mediated
thrombosis may provide some hints as to how we could approach the study of those 
intriguing patients who have the clinical features of the antiphospholipid
syndrome but lack those antibodies that currently characterize it.

Publication Types: 
    Comparative Study
    Review

PMID: 9814676 [PubMed - indexed for MEDLINE]

3583: New Microbiol. 1998 Oct;21(4):397-401.

In vitro activity of acetylsalicylic acid on replication of varicella-zoster
virus.

Primache V, Binda S, De Benedittis G, Barbi M.

Institute of Virology, University of Milan, Italy.

Topical application of a mixture of acetylsalicylic acid (ASA) and diethyl ether 
is effective in the treatment of acute herpes zoster and postherpetic neuralgia. 
To study whether the other-than-analgesic effects of that treatment could be due 
to an antiviral activity of ASA the effects of the drug on the replication of
varicella zoster virus (VZV) were assessed by the fluorescent focus assay on MRC5
and Vero cells. ASA caused a marked reduction in the spread of infection in MRC5 
monolayers while in growing Vero cells the effective dose proved toxic. ASA
concentrations (5-10 mM) which were effective in vitro against VZV are higher
than the plasma concentrations attained in the standard treatment of chronic
inflammatory states, but are consistent with the skin concentration attained by
topical application of ASA/diethyl ether mixture. These data support similar
findings relating the antiviral activity of acetylsalicylic acid to influenza
virus, CMV, and HIV.

PMID: 9812322 [PubMed - indexed for MEDLINE]

3584: J Virol. 1998 Dec;72(12):9535-43.

Differential intracellular compartmentalization of herpetic thymidine kinases
(TKs) in TK gene-transfected tumor cells: molecular characterization of the
nuclear localization signal of herpes simplex virus type 1 TK.

Degreve B, Johansson M, De Clercq E, Karlsson A, Balzarini J.

Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research,
B-3000 Leuven, Belgium.

The thymidine kinases (TKs) of herpes simplex virus type 1 (HSV-1), HSV-2, and
varicella-zoster virus (VZV) were expressed in human osteosarcoma cells as fusion
proteins with the green fluorescent protein (GFP), and their intracellular
localizations were determined. The three TK-GFP fusion products were localized in
different subcellular compartments of the transfected tumor cells. HSV-1 TK-GFP
was localized exclusively in the nucleus, HSV-2 TK-GFP was predominantly found in
the cytosol, while VZV TK-GFP was localized in both the nucleus and the cytosol. 
In support of these findings, we identified a nuclear localization signal (NLS)
in the N-terminal arginine-rich region of HSV-1 TK that was absent in HSV-2 and
VZV TK. The first 34 amino acids proved necessary for the specific nuclear
localization of HSV-1 TK and, when added to the VZV TK-GFP gene construct, also
sufficed to specifically target VZV TK-GFP to the nucleus. Further analysis of
this NLS through site-directed mutagenesis revealed that the basic amino
acid-rich nonapeptide 25R-R-T-A-L-R-P-R-R33 is of crucial importance in the
nuclear targeting of HSV-1 TK. In particular, we revealed that the presence of
the arginine residues at positions 25, 26, 30, 32, and 33 is obligatory for
efficient NLS functioning, whereas arginine and histidine residues outside of the
nonapeptide (i.e., residues R18, R20, and H22) did not change the functional
properties of the NLS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9811686 [PubMed - indexed for MEDLINE]

3585: J Pharmacol Exp Ther. 1998 Nov;287(2):791-9.

A possible mechanism of eighteen patient deaths caused by interactions of
sorivudine, a new antiviral drug, with oral 5-fluorouracil prodrugs.

Okuda H, Ogura K, Kato A, Takubo H, Watabe T.

Department of Drug Metabolism and Molecular Toxicology, School of Pharmacy, Tokyo
University of Pharmacy and Life Science, 1432-1 Horinouchi, Hachioji-shi, Tokyo
192-03, Japan.

A toxicokinetic study was performed using rats to investigate the possible
mechanism of 18 acute deaths in Japanese patients with cancer and herpes zoster
by interactions of the new oral antiviral drug, sorivudine (SRV), with one of the
oral 5-fluorouracil (5-FU) prodrugs within 40 days after approval of the use of
SRV. Tegafur, an anticancer 5-FU prodrug suggested to be used by most of the
patients who died, and SRV were orally administered to rats simultaneously once
daily. All of these rats died within 10 days, whereas rats given SRV or tegafur
alone under the same dosage conditions showed no appreciable change over 20 days 
compared with controls. In the rats given both drugs, bone marrow and intestinal 
membrane mucosa were greatly damaged at an early stage of the coadministration,
and before death, the animals showed marked decreases in white blood cell and
platelet counts, diarrhea with bloody flux, and severe anorexia, as was also
manifested by the patients who subsequently died. In the rats given both drugs
for 6 days, extremely enhanced 5-FU levels were observed from the first day of
administration in plasma and in all tissues examined, including bone marrow and
intestines. The extreme enhancement of the tissue 5-FU levels was attributable to
the facile inactivation by (E)-5-(2-bromovinyl)uracil (BVU) of hepatic
dihydropyrimidine dehydrogenase (DPD), a key enzyme regulating the systemic 5-FU 
level in the rat and human. BVU, a major metabolite formed from SRV by gut flora,
was found at considerable levels in the liver of rats orally administered SRV
alone or SRV and tegafur, and there was a marked decrease in hepatic DPD
activity. In the presence of NADPH, DPD purified from rat liver cytosol was
rapidly and irreversibly inactivated by [14C]BVU as a suicide inhibitor with
concomitant incorporation of the radioactivity into the enzyme protein, although 
SRV showed no inhibitory effect on DPD under the same conditions. Human liver DPD
was recently demonstrated by us to be inactivated with BVU in a manner very
similar to rat DPD.

PMID: 9808711 [PubMed - indexed for MEDLINE]

3586: Antiviral Res. 1998 Aug;39(2):129-37.

Anti-herpesvirus activity profile of 4'-thioarabinofuranosyl purine and uracil
nucleosides and activity of 1-beta-D-2'-fluoro-4'-thioarabinofuranosyl guanine
and 2,6-diaminopurine against clinical isolates of human cytomegalovirus.

Machida H, Ashida N, Miura S, Endo M, Yamada K, Kitano K, Yoshimura Y, Sakata S, 
Ijichi O, Eizuru Y.

Biochemicals Division, Yamasa Corporation, Choshi, Japan.

Newly synthesized 4'-thio- and 2'-fluoro-4'-thioarabinofuranosyl purine and
pyrimidine nucleosides were compared with the corresponding 4'-oxo type
arabinosyl nucleosides for anti-herpesvirus and anti-cell proliferative
potencies. 4'-Thioarabinosyl- and 2'-fluoro-4'-thioarabinofuranosyl 5-substituted
uracils had selective antiviral activities, but were not superior to 4'-oxo
nucleosides, except for the activity of 5-ethyl-uracil 4'-thio nucleosides
against herpes simplex virus. Furthermore, 4'-thio substituted derivatives of
sorivudine (BV-araU) and related compounds, and
2'-fluoro-5-methyl-arabinosyluracil exhibited reduced activity against
varicella-zoster virus compared with the parent compounds. The
4'-thioarabinosyluracils, except for 5-methyluracil derivatives, were inactive
against human cytomegalovirus (HCMV). 4'-Thioarabinofuranosyl guanine and
diaminopurine had the most potent anti-HCMV and anti-proliferative activities,
whereas arabinosyl guanine and diaminopurine had only marginal antiviral
activity. 2'-Fluoro-4'-thioarabinofuranosyl derivatives of guanine
(4'-thio-FaraG) and 2,6-diaminopurine (4'-thio-FaraDAP), however, had
particularly high activity against all herpesviruses tested with
anti-proliferative activity equipotent to that of arabinosyl guanine and
diaminopurine. 4'-Thio- and 2'-fluoro-4'-thioarabinofuranosyladenines exhibited
biological activities similar to that of arabinosyladenine. Both 4'-thio-FaraG
and 4'-thio-FaraDAP had a 6-fold lower ED50 than ganciclovir against clinical
isolates of HCMV. A ganciclovir-resistant isolate, obtained from a patient who
had received long-term ganciclovir-treatment, was susceptible to 4'-thio-FaraG
and 4'-thio-FaraDAP.

PMID: 9806489 [PubMed - indexed for MEDLINE]

3587: East Afr Med J. 1998 Jul;75(7):379-81.

Comment in:
    East Afr Med J. 1998 Jul;75(7):377-8.

Significance of herpes zoster in HIV/AIDS in Kweneng district, Botswana.

Edhonu-Elyetu Y.

OBJECTIVE: To determine the relevance of herpes zoster eruption or scar relative 
to other symptoms and signs of HIV/AIDS and to look for a syndromic model that
could be used in the diagnosis of HIV infection. DESIGN: Retrospective
case-control study on data from the results of HIV request forms in the district 
from 1st January 1993 to 31st March 1996. HIV request forms bearing ELISA
positive results represented the cases. SETTING: All the 55 health facilities and
one district hospital in Kweneng district, Botswana. SUBJECTS: Six hundred and
forty one valid request forms across all age groups and both sexes were analysed.
MAIN OUTCOME MEASURES: Proportion of herpes zoster among cases and controls.
Sensitivity and specificity test values for herpes zoster as a screening test.
Logistic regression on 11 symptoms and signs found to have a significant
relationship to ELISA either on the chi 2 test or on tests for the attributes of 
an ideal screening test. RESULTS: Herpes zoster ranked sixth as the most common
sign associated with a positive ELISA result. The difference in the proportion of
herpes zoster among cases and controls was highly significant, (chi 2 = 13.1, OR 
3.75, CI =1.7-9.3. p = 0.0003). The following also had a significant
relationship; chronic diarrhoea, persistent generalised lymphadenopathy (PGL) and
non-healing genital ulcers. In addition, herpes zoster and chronic diarrhoea were
highly specific and had high positive predictive values for a positive HIV ELISA 
positive result in 95.5% cases; chronic diarrhoea, weight loss, herpes zoster,
persistent generalised lymphadenopathy and non-healing genital ulcers.
CONCLUSION: Herpes zoster is an important predictor of HIV/AIDS in Kweng district
(PPV = 90%). Used in the above model, prediction rises up to 95.5%. In the
absence of an HIV ELISA test, this model alone could be sufficient for a clinical
diagnosis of HIV infection, at least in Kweneng. It is also suggested that the
presence or a history of herpes zoster scar or eruption be elevated to the status
of a major sign in the World Health Organization (WHO) clinical definition for
AIDS surveillance.

PMID: 9803626 [PubMed - indexed for MEDLINE]

3588: East Afr Med J. 1998 Jul;75(7):377-8.

Comment on:
    East Afr Med J. 1998 Jul;75(7):379-81.

Herpes zoster in HIV/AIDS--a little recognised opportunistic infection with
important clinical and cost implications.

McLigeyo SO.

Publication Types: 
    Comment
    Editorial
    Review

PMID: 9803625 [PubMed - indexed for MEDLINE]

3589: Pediatr Infect Dis J. 1998 Oct;17(10):931-3.

Varicella and zoster in children with human immunodeficiency virus infection.

Derryck A, LaRussa P, Steinberg S, Capasso M, Pitt J, Gershon AA.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, NY, USA.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9802645 [PubMed - indexed for MEDLINE]

3590: Pediatr Infect Dis J. 1998 Oct;17(10):905-8.

Herpes zoster in children and adolescents.

Petursson G, Helgason S, Gudmundsson S, Sigurdsson JA.

Department of Family Medicine, University of Iceland, Reykjavik.

OBJECTIVES: To follow the clinical course of herpes zoster and to determine the
incidence, frequency of complications and association with malignancy in children
and adolescents. DESIGN: Prospective cohort study in a primary health care
setting in Iceland. The main outcome measures were age and sex distribution of
patients and discomfort or pain 1, 3 and 12 months after the rash and general
health before and 3 to 6 years after the zoster episode. RESULTS: During
observation of the target population for a period of 75750 person years, 121
episodes of acute zoster developed (incidence 1.6/1000/year) in 118 patients. End
points were gained for all 118 patients after 554 person years of follow-up.
Systemic acyclovir was never used. No patient developed postherpetic neuralgia,
moderate or severe pain or any pain lasting longer than 1 month from start of the
rash (95% confidence interval, 0 to 0.03). Potential immunomodulating conditions 
were diagnosed in 3 patients (2.5%) within 3 months of contracting zoster. Only 5
(4%) had a history of severe diseases. CONCLUSIONS: The probability of
postherpetic neuralgia in children and adolescents is extremely low. Zoster is
seldom associated with undiagnosed malignancy in the primary care setting.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9802633 [PubMed - indexed for MEDLINE]

3591: Graefes Arch Clin Exp Ophthalmol. 1998 Oct;236(10):747-52.

Correlation of varicella-zoster virus copies and final visual acuities of acute
retinal necrosis syndrome.

Abe T, Sato M, Tamai M.

Department of Ophthalmology, Tohoku University School of Medicine, Miyagi, Japan.
toshi@oph.med.tohoku.ac.jp

BACKGROUND: Herpes viruses may play an important role in acute retinal necrosis
(ARN) syndrome, and raised antibody titer or virus genome have been detected in
intraocular fluids of patients with ARN. In spite of aggressive anti-viral
therapy, the clinical courses and final visual acuities among these patients have
varied. Our purpose was to estimate the amount of virus and compare it to final
visual acuity in patients with ARN. METHODS: The number of varicella-zoster virus
copies in aqueous and vitreous before and after administration of anti-viral
therapy were estimated by polymerase chain reaction (PCR) and by semi-nested PCR 
in 12 eyes of 11 patients with ARN and were compared with clinical
characteristics. RESULTS: Viral genome DNA was amplified in ocular fluids diluted
between 10(-3) and 10(-6) in patients whose final visual acuities were 0.3 or
less. Conversely, the dilution required was between 10(-1) to 10(-3) in the
patients whose final visual acuities were 0.4 or better. The difference was
statistically significant. Further, patients in the latter group reacted to the
anti-viral drug acyclovir more promptly than did the former patients. CONCLUSION:
Our results showed that final visual acuity may partly depend on the number of
virus copies in ocular fluids. The number of virus copies tended to be higher in 
elderly or immunocompromised patients than in others, and the treatment was less 
efficacious in these patients.

PMID: 9801889 [PubMed - indexed for MEDLINE]

3592: Arch Dermatol. 1998 Oct;134(10):1280-1, 1283-4.

An atypical presentation of a common disease. Herpes zoster without vesicles.

Unger S, Lynfield Y, Alapati U.

Department of Veterans Affairs Medical Center, Brooklyn, NY, USA.

Publication Types: 
    Case Reports

PMID: 9801687 [PubMed - indexed for MEDLINE]

3593: Postgrad Med J. 1998 Jul;74(873):423-5.

Neurological manifestations in a patient with visceral leishmaniasis.

Karak B, Garg RK, Misra S, Sharma AM.

Department of Neurology, Banaras Hindu University, Varanasi, India.

Publication Types: 
    Case Reports

PMID: 9799919 [PubMed - indexed for MEDLINE]

3594: Ann Pharmacother. 1998 Oct;32(10):1099-103.

Oral corticosteroids for pain associated with herpes zoster.

Ernst ME, Santee JA, Klepser TB.

Division of Clinical and Administrative Pharmacy, College of Pharmacy, University
of Iowa, Iowa City, IA 52242, USA. michael-ernst@uiowa.edu

It is apparent from published studies that corticosteroids do not prevent the
development of postherpetic neuralgia. Earlier trials that indicated some benefit
in both acute neuralgia and the prevention of postherpetic neuralgia are of
limited use to clinicians due to problems with uncontrolled study designs, small 
sample sizes, and the absence of statistical analysis of the results. The lack of
a consensus definition of postherpetic neuralgia, the variable agents and dosages
used, and the different pain scales reported are of concern when trying to
interpret the results of these studies for their clinical significance. In more
recent larger and well-designed studies, similar rates of postherpetic neuralgia 
were observed in the corticosteroid and control groups. As a result of these
findings, corticosteroids should not be recommended for the prevention of
postherpetic neuralgia. Despite lack of efficacy in preventing postherpetic
neuralgia, limited studies suggest corticosteroids such as prednisone (40-60 mg/d
tapered over 3 wk) are well tolerated and may confer slightly significant
benefits in reducing the duration of acute neuralgia and improving
quality-of-life measures. However, the clinical significance and application of
these findings remain to be addressed. If corticosteroids are used for acute
neuralgia, clinicians are advised to select their patients carefully. The
patients treated in these studies were generally healthy and free of comorbid
diseases, such as hypertension, diabetes mellitus, and psychiatric disorders,
which can be exacerbated in the presence of corticosteroids. Although
dissemination of herpes zoster has been reported infrequently, it remains a
potential risk with use of corticosteroids. Until the results of these studies
are repeated in more diverse patient populations, corticosteroids appear to have 
a limited role in the management of acute neuralgia associated with herpes
zoster.

Publication Types: 
    Review

PMID: 9793604 [PubMed - indexed for MEDLINE]

3595: Scand J Infect Dis. 1998;30(3):215-20.

Acute viral encephalitis in adults--a prospective study.

Studahl M, Bergstrom T, Hagberg L.

Department of Infectious Diseases, Sahlgrenska University Hospital, Goteborg,
Sweden.

We have prospectively studied 27 adult patients attending the Department of
Infectious Diseases, Goteborg, Sweden, between October 1992 and October 1996 with
a diagnosis of acute viral encephalitis. In addition to cerebrospinal fluid (CSF)
virus isolations and antibody analyses against herpes simplex virus,
cytomegalovirus, varicella zoster virus, Epstein-Barr virus (EBV), enterovirus,
adenovirus, tick-borne encephalitis virus, and mycoplasma, polymerase chain
reaction test (PCR) to 5 viruses from the family of human herpes viridae, and to 
adenovirus as well as to enterovirus were analysed in CSF. 10 patients had herpes
simplex virus type-1 (HSV-1), 1 had varicella zoster virus, 1 had tick-borne
encephalitis, and 2 had Influenza A infections. In 13 patients the aetiology
remained unclear. Eight patients with HSV-1 encephalitis and clinical symptoms
for 2-11 d before admission were PCR-positive, while 2 patients with a < or = 2 d
history of disease were negative for HSV-1 DNA on admission. These 2 patients
became positive for HSV-1 DNA in CSF samples taken 4 d later in 1 case and 7 d
later in the other. In 4 patients with HSV-1 encephalitis, in 1 patient with
Influenza A complicated by encephalitis, and in 1 patient with encephalitis of
unknown origin EBV DNA was found in CSF samples during the study. The clinical
significance of these findings is unclear. The study shows that HSV-1 was the
most common etiological agent in patients with viral encephalitis in the Goteborg
area. In spite of improved diagnostic procedures, a large proportion of patients 
with symptoms and laboratory findings compatible with viral encephalitis still
have an unclear aetiology.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9790126 [PubMed - indexed for MEDLINE]

3596: Med Clin (Barc). 1998 Sep 5;111(6):238-9.

[Meningitis caused by varicella-zoster virus and ophthalmic trigeminal neuralgia 
without skin lesions in an immunocompetent woman]

[Article in Spanish]

Maigues Llacer JM, Pujol Farriols R, Perez Saenz JL, Fernandez Viladrich P.

Publication Types: 
    Case Reports
    Letter

PMID: 9789235 [PubMed - indexed for MEDLINE]

3597: J Am Osteopath Assoc. 1998 Sep;98(9):508-9.

Rare presentation of acute urinary retention secondary to herpes zoster.

Ginsberg PC, Harkaway RC, Elisco AJ 3rd, Rosenthal BD.

Department of Surgery, Albert Einstein Medical Center, Philadelphia, Pa.
19141-3030, USA.

There are many causes of acute urinary retention. Reported here is a case of one 
of the more rare causes: herpes zoster. Fewer than 70 cases have been reported in
the literature since 1890. In the present clinical environment where many
patients are immunocompromised, reports of herpes zoster and its sequelae are no 
longer thought of as anecdotal. The virus may interrupt the detrusor reflex due
to involvement of the sacral dorsal root ganglia. Urinary retention with sensory 
loss of both bladder and rectum as well as flaccid paralysis of the detrusor can 
develop in patients with herpes zoster. Fortunately, the outcome of this process 
is benign and full recovery of the detrusor is likely.

Publication Types: 
    Case Reports

PMID: 9785747 [PubMed - indexed for MEDLINE]

3598: Ryumachi. 1998 Aug;38(4):589-94.

[Influence on patients with Sjogren's syndrome after the Great Hanshin-Awaji
Earthquake]

[Article in Japanese]

Kohriyama K, Kohno A.

Department of Internal Medicine, Kobe West City Hospital.

We investigated the influence of clinical findings on patients with Sjogren's
syndrome after the Great Hanshin-Awaji Earthquake. Fifty eight (90%) of 64
patients were struck severely by the earthquake and 26 patients (42%) were forced
to take refuge in emergency shelters. There was no aggravation of clinical
findings or complications in eight patients inhabiting the area where the damage 
was mild. Dry eyes were deteriorated in 14 patients (22%). Dry mouth was
aggravated in 6 patients (9%). However, the mean values of Schirmer's test and
gum test were not different between pre-earthquake and postearthquake in these
patients. Malaise was worsen in 8 patients (13%). The cause was cease of taking
prednisolone for autoimmune hepatitis in 2 patients or was impossibility of
taking T4 drug for hypothyroidism in 2 patients. Other 4 patients had not taken
any medication. Arthralgia was deteriorated in 4 patients (5%). These findings
indicated that deterioration of sicca symptoms, arthralgia and malaise was caused
predominantly by the worsen living condition including shortage of water and
polluted atmosphere in the affected regions.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9785986 [PubMed - indexed for MEDLINE]

3599: Ocul Immunol Inflamm. 1998 Sep;6(3):185-8.

Recurrent varicella-zoster virus retinitis in a patient treated with systemic
corticosteroids.

Satoh N, Abe T, Nakajima A, Sakuragi S.

Department of Ophthalmology, Akita University School of Medicine, Japan.

A case of recurrent unilateral varicella-zoster virus (VZV) retinitis is
reported. The retinitis was characterized by arteriolitis and retinal necrosis
with secondary chorioretinal atrophy localized in the periphery of the
supratemporal quadrant of the retina. Polymerase chain reaction analysis of
aqueous humor demonstrated VZV DNA in both the initial and recurrent episode. The
Goldmann-Witmer coefficient for VZV IgG was elevated. The initial VZV retinitis
was successfully treated with acyclovir and corticosteroids. Three years later,
high-dose corticosteroids alone were used to treat idiopathic facial nerve palsy.
One month after concluding corticosteroids therapy, the VZV retinitis recurred in
the same eye, suggesting that administration of the high-dose corticosteroids
caused VZV reactivation and induced recurrence of VZV retinitis.

Publication Types: 
    Case Reports

PMID: 9785609 [PubMed - indexed for MEDLINE]

3600: J Med Virol. 1998 Nov;56(3):186-91.

Immunoreactivation of Epstein-Barr virus due to cytomegalovirus primary
infection.

Aalto SM, Linnavuori K, Peltola H, Vuori E, Weissbrich B, Schubert J, Hedman L,
Hedman K.

Department of Virology, Haartman Institute, University of Helsinki, Finland.
sanna.aalto@helsinki.fi

Serological diagnosis of herpes virus infections is hampered by concurrent
expression of IgM for heterologous members of this virus family. To assess the
frequency of such multiple diagnostic findings and to understand their etiology, 
we sought by using IgG, IgM, and IgG avidity test serodiagnoses for Epstein-Barr 
virus (EBV) among immunocompetent or immune-suppressed patients with
well-documented cytomegalovirus (CMV) primary infection. Controls had primary
infection by EBV or had acute septic or severe respiratory infection. Among
EBV-seropositive patients with CMV primary infection, a large proportion (13/56, 
23%) showed antibody profiles of EBV reactivation: seroconversion of VCA IgM
and/or > or = fourfold rise of VCA IgG, together with high or intermediate
avidity of VCA IgG. Most of the CMV patients with EBV serodiagnosis showed also
diagnostic HHV-6 antibody rises. In contrast to the frequently occurring
CMV-induced EBV immunoreactivation, EBV primary infections did not appear to
induce immunoreactivations of CMV (0/22). Only one (2%) CMV patient had a
significant varicella zoster virus (VZV) antibody rise. The studies show that CMV
is a particularly active inducer of some, but not all, members of the herpes
virus family and suggest that the in vivo interplay between CMV and EBV occurs
unidirectionally. The high frequency of heterologous herpes virus
immunoreactivations poses demands on laboratory diagnosis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9783683 [PubMed - indexed for MEDLINE]

3601: J Eur Acad Dermatol Venereol. 1998 Sep;11(2):194-5.

Unusual isotopic responses on healed herpes zoster lesions--report on two cases.

Khanna N, D'Souz P, Singh M.

Publication Types: 
    Case Reports
    Letter

PMID: 9784058 [PubMed - indexed for MEDLINE]

3602: J Eur Acad Dermatol Venereol. 1998 Sep;11(2):147-50.

Bullous erythema multiforme following herpes zoster and varicella-zoster virus
infection.

Weisman K, Petersen CS, Blichmann CW, Nielsen NH, Hultberg BM.

Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen NV, Denmark.

Four cases of herpes zoster-induced bullous erythema multiforme (EM) are
reported. Three patients presented with widespread skin lesions 10 to 14 days
after an episode of thoracic herpes zoster. In these patients a high increase in 
varicella-zoster virus (VZV) antibody titer was detected, indicating secondary
VZV infection. Histologic examinations of skin biopsy from a patient with
widespread lesions (case 4) revealed a mixture of EM, toxic epidermal necrolysis 
and herpetic virus infection. VZV should be included in the list of infectious
agents able to trigger EM and Stevens-Johnson syndrome.

Publication Types: 
    Case Reports

PMID: 9784041 [PubMed - indexed for MEDLINE]

3603: Neurology. 1998 Oct;51(4):1202-5.

Comment in:
    Neurology. 2000 Sep 12;55(5):738.

Rapid diagnosis of varicella zoster virus infection in acute facial palsy.

Murakami S, Honda N, Mizobuchi M, Nakashiro Y, Hato N, Gyo K.

Department of Otolaryngology, Ehime University School of Medicine, Japan.

Patients with zoster sine herpete and Ramsay Hunt syndrome without pathognomonic 
vesicles at the initial visit are often misdiagnosed with Bell's palsy and
treated without antiviral agents. With PCR, we found that varicella zoster virus 
genomes were frequently detectable in auricular skin exudate from patients with
zoster sine herpete or Ramsay Hunt syndrome before the appearance of vesicles.

PMID: 9781562 [PubMed - indexed for MEDLINE]

3604: Neurology. 1998 Oct;51(4):1166-71.

Nortriptyline versus amitriptyline in postherpetic neuralgia: a randomized trial.

Watson CP, Vernich L, Chipman M, Reed K.

Etobicoke General Hospital, Canada.

OBJECTIVE (BACKGROUND): Amitriptyline (AT) is a standard therapy for postherpetic
neuralgia (PHN). Our hypothesis was that nortriptyline (NT), a noradrenergic
metabolite of AT, may be more effective. METHODS: A randomized, double-blind,
crossover trial of AT versus NT was conducted in 33 patients. RESULTS: Thirty-one
patients completed the trial. Twenty-one of 31 (67.7%) had at least a good
response to AT or NT, or both. We found no difference with regard to relief of
steady, brief, or skin pain by visual analog scales for pain and pain relief;
mood; disability; satisfaction; or preference between the two drugs. Intolerable 
side effects were more common with AT. Most patients (26/33) were not depressed, 
and most responding showed no change in rating scales for depression despite the 
occurrence of pain relief. CONCLUSIONS: We concluded that this study provides a
scientific basis for an analgesic action of NT in PHN because pain relief
occurred without an antidepressant effect, and that although there were fewer
side effects with NT, AT and NT appear to have a similar analgesic action for
most individuals.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 9781549 [PubMed - indexed for MEDLINE]

3605: Neurology. 1998 Oct;51(4):1110-5.

The spectrum of antecedent infections in Guillain-Barre syndrome: a case-control 
study.

Jacobs BC, Rothbarth PH, van der Meche FG, Herbrink P, Schmitz PI, de Klerk MA,
van Doorn PA.

Department of Neurology, Erasmus University, Rotterdam, The Netherlands.

OBJECTIVE: To determine which antecedent infections are specifically associated
with the Guillain-Barre syndrome (GBS). BACKGROUND: Infections with many agents
have been reported preceding GBS. Some infections are related to specific
clinical and immunologic subgroups in GBS. Most agents were reported in case
reports and uncontrolled small series of GBS patients only, and their relation to
GBS and its subgroups remains unclear. METHOD: A serologic study for 16
infectious agents in 154 GBS patients and 154 sex- and age-matched controls with 
other neurologic diseases. Acute phase, pretreatment samples were used from
clinically well-defined GBS patients. The seasonal distribution of serum sampling
in the GBS and control group was the same. RESULTS: Multivariate analysis showed 
that in GBS patients, infections with Campylobacter jejuni (32%), cytomegalovirus
(13%), and Epstein-Barr virus (10%) were significantly more frequent than in
controls. Mycoplasma pneumoniae infections occurred more often in GBS patients
(5%) than in controls in univariate analysis. Infections with Haemophilus
influenzae (1%), parainfluenza 1 virus (1%), influenza A virus (1%), influenza B 
virus (1%), adenovirus (1%), herpes simplex virus (1%), and varicella zoster
virus (1%) were also demonstrated in GBS patients, but not more frequently than
in controls. C. jejuni infections were associated with antibodies to the
gangliosides GM1 and GD1b and with a severe pure motor form of GBS.
Cytomegalovirus infections were associated with antibodies to the ganglioside GM2
and with severe motor sensory deficits. Other infections were not related to
specific antiganglioside antibodies and neurologic patterns. CONCLUSIONS: Recent 
infections with C. jejuni, cytomegalovirus, Epstein-Barr virus, and M. pneumoniae
are specifically related to GBS. The variety of infections may contribute to the 
clinical and immunologic heterogeneity of GBS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9781538 [PubMed - indexed for MEDLINE]

3606: Am J Ophthalmol. 1998 Oct;126(4):594-7.

Recurrent nodular scleritis associated with varicella zoster virus.

Livir-Rallatos C, El-Shabrawi Y, Zatirakis P, Pellett PE, Stamey FR, Foster CS.

Uveitis and Immunology Service, Massachusetts Eye and Ear Infirmary, Harvard
Medical School, Boston 02114, USA.

PURPOSE: To describe a case of recurrent nodular scleritis that was apparently
caused by reactivation of a varicella zoster virus infection. METHODS: Case
report. Immunohistochemistry and polymerase chain reaction were used to detect
viral antigen and DNA in the biopsy specimen of inflamed sclera of a patient with
a history of recurrent nodular scleritis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9780109 [PubMed - indexed for MEDLINE]

3607: J Rheumatol. 1998 Oct;25(10):1900-7.

Development, recurrence, and severity of infections in Mexican patients with
rheumatoid arthritis. A nested case-control study.

Hernandez-Cruz B, Cardiel MH, Villa AR, Alcocer-Varela J.

Department of Immunology and Rheumatology, Instituto Nacional de la Nutricion
Salvador Zubiran, Mexico City, Mexico.

OBJECTIVE: To determine factors associated with development, recurrence, and
severity of infections in patients with rheumatoid arthritis (RA). METHODS: A
hospital based nested case-control study in a referral center. The same evaluator
reviewed clinical charts of 195 consecutive patients with RA seen in our clinic
during 1993. Patients who had had at least one infection were classified as
"cases" and the others as "controls." We examined 24 demographic, clinical,
therapeutic, and infection related variables. A severity index was developed
according to scores provided by 12 independent multidisciplinary evaluators.
Recurrent infection was defined as > 2 different infections in the same patient
during followup. Descriptive statistics were employed, with comparison between
cases and controls by univariate analysis and multiple logistic regression.
RESULTS: Two hundred eleven infections were detected in 1274 patient-years
(incidence of 0.17 new infections per patient-year). We studied 174 women and 21 
men, mean 41 years of age, with a mean duration of symptoms of RA of 5 years.
Ninety-five were cases and 100 controls. Cases had longer disease duration before
admission and followup (p < 0.05). Infections most commonly seen were upper
respiratory tract (n = 74), skin (41), urinary tract (27), and herpes zoster
(15). Steroids and/or methotrexate (MTX) were associated in 95% of infections.
Infection was associated with duration of RA before admission and followup,
comorbidity, extraarticular disease, mean cumulative dose of MTX, time taking
steroids, and mean daily dose of D-penicillamine, by univariate analysis.
Severity of infection was related to the same variables and years of formal
education, and recurrence of infection was related to time of followup and mean
dose of MTX and steroids. Multiple logistic regression showed that variables
associated with infection were cumulative MTX dose, time taking steroids, and
mean daily dose of D-penicillamine. CONCLUSION: Infections were frequent in our
RA population. The risk factors associated with infections were the cumulative
dose of MTX, duration taking steroids, and mean daily dose of D-penicillamine.

PMID: 9779842 [PubMed - indexed for MEDLINE]

3608: Vaccine. 1998 Nov;16(18):1768-70.

Postherpetic neuralgia in immunocompetent elderly people.

Schmader K.

Department of Medicine, Duke University Medical Center, Durham, NC, USA.

The most menacing complication of herpes zoster in immunocompetent elderly people
is chronic pain or postherpetic neuralgia (PHN). The cardinal epidemiological
feature of PHN is its striking relationship to aging. Among zoster patients over 
60 years old, estimates of the occurrence of PHN, defined as pain 1 month after
rash onset, vary from 27 to 68%. The pathogenesis of PHN is incompletely
understood but seems to involve varicella-zoster virus (VZV)-induced damage of
peripheral afferent neurons and resultant changes in central afferent neurons and
efferent pain-modulating neurons. PHN improves over time in many elderly
patients, but an unfortunate subset experience of debilitating pain lasts for
years. They experience constant and/or intermittent spontaneous pain and
stimulus-evoked pain such as allodynia or hyperpathia. The outcomes of this pain 
include fatigue, sleep disturbance, anorexia, depression, social withdrawal,
impaired activities of daily living and profound lowering of quality of life. The
management of PHN is hampered by two problems: (1) a uniformly effective
treatment for PHN is not available (although tricyclic antidepressants, local or 
regional anaesthetics, capsaicin, opiates, anticonvulsants and physical therapies
are sometimes useful); and (2) early antiviral therapy of zoster may be
ineffective in preventing PHN, partly related to the fact that days of VZV
replication and neuronal destruction have occurred by the time the patient
reaches the doctor. A potential solution to the problem of PHN is the vaccination
of elderly persons with the varicella vaccine to prevent or attenuate zoster or
PHN.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 9778754 [PubMed - indexed for MEDLINE]

3609: Virology. 1998 Oct 10;250(1):205-9.

Varicella-zoster virus ORF57, unlike its pseudorabies virus UL3.5 homolog, is
dispensable for viral replication in cell culture.

Cox E, Reddy S, Iofin I, Cohen JI.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, Bethesda, Maryland, 20892, USA.

Varicella zoster virus (VZV) encodes five genes that do not have homologs in
herpes simplex virus. One of these genes, VZV ORF57, is predicted to encode a
protein containing 71 amino acids. Antibody to ORF57 protein immunoprecipitated a
6-kDa protein in the cytosol of VZV-infected cells. Although the homolog of VZV
ORF57 in pseudorabies virus, UL3.5, is critical for viral egress and growth in
cell culture, VZV unable to express ORF57 replicated to titers similar to those
seen with parental virus. Thus VZV ORF57 has a different role in viral
replication than its pseudorabies virus homolog.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9770434 [PubMed - indexed for MEDLINE]

3610: Clin Infect Dis. 1998 Sep;27(3):509-12.

Herpes zoster and lymphopenia associated with sodium stibogluconate therapy for
cutaneous leishmaniasis.

Wortmann GW, Aronson NE, Byrd JC, Grever MR, Oster CN.

Infectious Disease Service, Walter Reed Army Medical Center, Washington, D.C.
20307-5001, USA.

A review of 84 patients with cutaneous leishmaniasis treated with sodium
stibogluconate (Pentostam) at our institution revealed that three had developed
herpes zoster during or shortly after receiving therapy. Because zoster has been 
associated with depressed cellular immunity, we prospectively followed serial
lymphocyte subpopulations in eight patients with cutaneous leishmaniasis who
received Pentostam. By day 7 of therapy, the white blood cell count had fallen by
a median of 1.15/mm3, the total lymphocyte count by a median of 804/mm3, and the 
CD4+ lymphocyte count by a median of 306/mm3 (67% of baseline; confidence
interval, 52%-78%). An in vitro cell-viability assay demonstrated that Pentostam 
is not toxic to human mononuclear cells. The administration of Pentostam for the 
treatment of cutaneous leishmaniasis results in lymphopenia that may be related
to the subsequent occurrence of herpes zoster.

Publication Types: 
    Clinical Trial

PMID: 9770149 [PubMed - indexed for MEDLINE]

3611: Cutis. 1998 Sep;62(3):143-6.

Recurrent malignant melanoma presenting with zosteriform metastases.

North S, Mackey JR, Jensen J.

Department of Medicine, University of Alberta, Edmonton, Canada.

A 63-year-old man with recurrent metastatic malignant melanoma presented with a
painful right twelfth thoracic dermatomal eruption initially thought to be herpes
zoster. However, 3 weeks later, the patient clearly had melanoma skin metastases 
confined exclusively to this dermatome. Radiotherapy and opiate analgesics
provided effective pain relief. We propose that in this patient, no herpes zoster
infection occurred, but rather that skin metastases presented in a zosteriform
pattern due to lymphatic spread from a previously excised paravertebral skin
metastasis. This is the second reported case of malignant melanoma presenting as 
zosteriform metastases, and we suggest physicians consider this possibility in
patients with melanoma presenting with dermatomal skin changes.

Publication Types: 
    Case Reports

PMID: 9770130 [PubMed - indexed for MEDLINE]

3612: Anesth Analg. 1998 Oct;87(4):911-4.

Comment in:
    Anesth Analg. 1999 Dec;89(6):1585-6.

Percutaneous electrical nerve stimulation: an alternative to antiviral drugs for 
acute herpes zoster.

Ahmed HE, Craig WF, White PF, Ghoname ES, Hamza MA, Gajraj NM, Taylor SM.

Department of Anesthesiology, Eugene McDermott Center for Pain Management,
University of Texas Southwestern Medical Center at Dallas, 75235-9068, USA.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9768793 [PubMed - indexed for MEDLINE]

3613: Presse Med. 1998 May 16;27(18):844-8.

[Anterior uveitis in HIV-infected patients. 3 cases in patients treated with an
antiprotease]

[Article in French]

Fournier S, Deplus S, Janier M, Poinsignon Y, Decazes JM, Modai J.

Clinique de Maladies Infectieuses et tropicales, Hopital Saint Louis, Paris.

OBJECTIVES: Uveitis is an ocular manifestation rarely observed in HIV-infected
patients. We observed three cases of anterior uveitis without progressive
retinitis in HIV patients receiving antiprotease treatment. CASE REPORT: The
first patient developed a first episode of uveitis during ritonavir therapy. Two 
other episodes occurred with indinavir. The second patient developed uveitis when
treated with indinavir. In the third patient, the first episode developed with
indinavir and a second with a ritonavir-saquinavir combination. Uveitis was
unilateral in 4 episodes. Clinical manifestations were red irritable eyes and, in
2 episodes, reduced visual acuity. The antiprotease was interrupted in 4 of the 6
episodes and clinical course was rapidly favorable. DISCUSSION: Pure anterior
uveitis should suggest drug induction in HIV infected patients; rifabutin is
often the cause. Infectious causes predominate in case of total uveitis
associating choroid and retinal involvement. Cytomegalovirus, herpes zoster,
syphilis, and toxoplasmosis have been incriminated. Antiproteases would appear to
be a new cause of anterior uveitis in HIV-infected patients.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9767867 [PubMed - indexed for MEDLINE]

3614: Presse Med. 1998 Jul 4-11;27(24):1237.

[Management of varicella-zoster virus infections. No systematic vaccination
against varicella in France]

[Article in French]

Lorette G.

PMID: 9767786 [PubMed - indexed for MEDLINE]

3615: Presse Med. 1998 Jul 4-11;27(24):1231-6.

[Management of VZV infections. Short text of the 11th consensus conference on
anti-infectious therapies]

[Article in French]

[No authors listed]

Publication Types: 
    Consensus Development Conference
    Review

PMID: 9767785 [PubMed - indexed for MEDLINE]

3616: Neurol Clin. 1998 Nov;16(4):813-32.

Pain caused by herpes zoster infection.

Cluff RS, Rowbotham MC.

Department of Neurology, Pain Clinical Research Center, University of California,
San Francisco 94115, USA.

Postherpetic neuralgia (PHN) is a neuropathic pain disorder that occurs most
often in the elderly. This painful condition is uniquely suited for clinical
research, resulting in an emerging understanding of the pathophysiology of the
persistent pain. Until recently, only the tricyclic antidepressants proved
effective for PHN. Controlled trials of a wide variety of therapeutic strategies 
are in progress or have been recently completed.

Publication Types: 
    Review

PMID: 9767064 [PubMed - indexed for MEDLINE]

3617: Br J Dermatol. 1998 Aug;139(2):357-8.

Elevated soluble Fas levels in herpes zoster patients.

Kato M, Tamada Y, Kageyama M, Yamashita T, Nitta Y, Ikeya T, Nakashima I.

Publication Types: 
    Letter

PMID: 9767625 [PubMed - indexed for MEDLINE]

3618: Br J Dermatol. 1998 Aug;139(2):295-8.

Acute infiltration by non-Hodgkin's B-cell lymphoma of lesions of disseminated
herpes zoster.

Turner RJ, Sviland L, Lawrence CM.

Department of Dermatology, Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4LP,
U.K. Turnerrich@aol.com

A man with a 15-year history of non-Hodgkin's lymphoma presented with
disseminated herpes zoster which initially responded to aciclovir. This was
shortly followed by an acute exacerbation in the sites previously affected which 
was apparently resistant to antiviral therapy. Biopsy revealed a dense
monomorphic lymphocytic infiltrate below active herpes zoster which had the same 
morphology and immunoreactivity as the underlying lymphoma. His clinical
condition resolved with further chemotherapy for his lymphoma and continued
treatment with aciclovir.

Publication Types: 
    Case Reports

PMID: 9767247 [PubMed - indexed for MEDLINE]

3619: Ann Otolaryngol Chir Cervicofac. 1998 May;115(2):59-72.

[Gadolinium and contrast medium MRI of the acoustic nerve in patients with
meningeal neuritis and acoustico-facial syndrome]

[Article in French]

Dumas G, Charachon R, Perret J, Vasdev A, Boulat E, Boubagra K.

Clinique ORL, CHU, Hopital A. Michallon, Grenoble.

Twelve cases of vestibular neuritis were investigated in gradient echo MRI with
gadolinium. Only 3 severe cases associated with an acoustico facial syndrome (2
cases of herpes zoster oticus and one case after influenzae) demonstrated focal
enhancement within the internal auditory canal on post contrast T1 weighted
images. This enhancement involved at least 2 differents nerves. These 3 severe
cases associating sensory neural hearing loss and facial palsy revealed a
meningeal reaction after cerebrospinal fluid examination. The enhancement lasted 
a long time (up to 10 months) in one case of RAMSAY HUNT syndrome associated with
a chronic lymphocytic leukemia. The MRI was able to confirm the anatomical
reality of the vestibular neuritis and more precisely of the meningoneuritis and 
gave arguments for the theory of the polyneuropathy of Adour. Enhancement at MRI 
seems correlated with the severity of the affection (permanent vestibular
areflexia in 3 cases and permanent hearing loss in 1 case).

Publication Types: 
    English Abstract

PMID: 9765700 [PubMed - indexed for MEDLINE]

3620: Dtsch Med Wochenschr. 1998 Sep 4;123(36):1035-8.

[Meningeal irritation--a complication of herpes zoster]

[Article in German]

Bredlich RO, Alfke K, Brickenstein H, Pillekamp H, Peter RU.

Abteilung Dermatologie, Klinikums der Universitat Ulm.

HISTORY AND CLINICAL FINDINGS: A previously healthy 26-year-old man complained of
gradually increasing headache after an attack of flu. After 4 days an erythema
with papules but no blisters was noted in the area of distribution of the left
10th thoracic nerve. As a child he had varicella (chickenpox) without
complications. INVESTIGATIONS: Lymphocytic pleocytosis and evidence of an
abnormal blood-brain barrier were noted in cerebrospinal fluid (CSF). Serology
for varicella zoster virus revealed an IgG titre of > 7400 IU/l in serum and 21
IU/l in CSF. The corresponding IgM titres were negative. TREATMENT AND COURSE:
The headaches and cutaneous changes regressed under i.v. treatment with
acyclovir, 10 mg/kg body weight, 3 x daily for 10 days. Repeat CSF examination
after 10 days showed merely minimal residual changes of inflammation. CONCLUSION:
This case illustrates the risk of severe neurological complications of herpes
zoster infection. A seemingly minor rash with headache must be correctly
diagnosed and immediate high-dosage acyclovir treatment instituted to prevent
life-threatening and severe complications of herpes zoster meningitis or
encephalitis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9765607 [PubMed - indexed for MEDLINE]

3621: AIDS. 1998 Sep 10;12(13):1719-20.

Herpes zoster infection in HIV-seropositive patients associated with highly
active antiretroviral therapy.

Aldeen T, Hay P, Davidson F, Lau R.

Publication Types: 
    Letter

PMID: 9764795 [PubMed - indexed for MEDLINE]

3622: Br J Dermatol. 1998 Jul;139(1):66-72.

The management of established postherpetic neuralgia: a comparison of the quality
and content of traditional vs. systematic reviews.

Ladhani S, Williams HC.

Department of Biochemistry and Molecular Biology, United Medical and Dental
Schools, Guy's Hospital, London, U.K.

In the face of an exponential increase in published biomedical studies,
dermatologists frequently turn to review articles in order to keep abreast of
important developments in the treatment of skin diseases. Traditional review
articles have recently been criticized on the basis of their incompleteness and
susceptibility to bias. Such biases can be minimized by employing a systematic
approach to gathering, combining and interpreting the evidence of treatment
efficacy. Using eight predetermined quality criteria, we compared the quality of 
10 traditional review with one systematic review of treatments for postherpetic
neuralgia, which were identified from the Medline database for 1992-96. None of
the 10 traditional review articles satisfied all eight criteria: one satisfied
five, two satisfied four and the rest satisfied two or fewer criteria. There was 
a wide variation in the recommendations of the authors for the treatment of
postherpetic neuralgia, often based on anecdotal evidence and clinical
experience. On the other hand, the systematic review fulfilled seven of the eight
quality criteria, failing only to discuss future directives. Furthermore,
treatment recommendations were made solely on the basis of randomized controlled 
trials, which are considered to be the gold standard for measuring the benefits
of any intervention. The variation in quality and treatment recommendations of
traditional reviews is worrying. Systematic reviews should be encouraged in
dermatology because they provide a summary of evidence of the effects of
dermatological treatments, which has been derived using explicit methods widely
accepted within science.

Publication Types: 
    Comparative Study

PMID: 9764150 [PubMed - indexed for MEDLINE]

3623: Br J Dermatol. 1998 Jul;139(1):33-9.

Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 
year study of 1161 patients with human immunodeficiency virus disease
predominantly acquired through intravenous drug abuse.

Munoz-Perez MA, Rodriguez-Pichardo A, Camacho F, Colmenero MA.

Department of Dermatology, Virgen Macarena Hospital, School of Medicine of
Seville, Spain.

Several prospective studies on dermatological findings in human immunodeficiency 
virus (HIV) type 1 infected patients have been published, mostly in populations
in which the predominant risk factor for HIV infection is homosexuality. We
attempted to identify cutaneous diseases associated with HIV-1 infection and to
assess disease progression in a cohort of Spanish patients in whom the
predominant cause of HIV infection was intravenous drug abuse. We prospectively
examined 1161 HIV-1-positive patients for 38 months. Seventy-four per cent of
patients were intravenous drug abusers, whereas heterosexual contact was the only
risk factor in 14% and homosexuality in 9%. Centers for Disease Control stage II 
disease predominated (51%), whereas stage IV disease was less frequent (39%). The
mean CD4 count was 353/mm3. We took patients' past and present medical history
and performed a complete physical examination as well as taking photographs and
carrying out the necessary diagnostic procedures. CD4 counts/mm3 were measured at
each visit. A diagnosis of cutaneous disease was made in 799 patients (69%). Oral
candidiasis and seborrhoeic dermatitis were the most common skin disorders,
followed by xerosis, drug eruptions, dermatophytosis and the papular eruption of 
acquired immunodeficiency syndrome. Condyloma acuminatum, herpes zoster and
herpes simplex were the most frequent viral infections. Conditions that have a
statistically significant association with advanced stage and low CD4 levels
include drug eruptions, xerosis, light reactions, diffuse alopecia, herpes
simplex, oral candidiasis, psoriasis, oral hairy leucoplakia, molluscum
contagiosum, Kaposi's sarcoma, furuncles, candidal intertrigo, folliculitis and
ungual infection, as well as onychomycosis and tinea pedis or manuum. Dermatoses 
commonly associated with homosexuality, such as Kaposi's sarcoma and oral hairy
leucoplakia, were rare in our patients.

PMID: 9764146 [PubMed - indexed for MEDLINE]

3624: Arch Dermatol. 1998 Sep;134(9):1168-9.

Unilateral abdominal distention following herpes zoster outbreak.

Vincent KD, Davis LS.

Publication Types: 
    Case Reports
    Letter

PMID: 9762046 [PubMed - indexed for MEDLINE]

3625: Pharm Biotechnol. 1998;11:313-43.

Famciclovir. Discovery and development of a novel antiherpesvirus agent.

Jarvest RL, Sutton D, Vere Hodge RA.

SmithKline Beecham Pharmaceuticals, Harlow, Essex CM19 5AW, England.

Publication Types: 
    Review

PMID: 9760686 [PubMed - indexed for MEDLINE]

3626: J Fr Ophtalmol. 1998 May;21(5):381-6.

[Optic neuromyelitis and bilateral acute retinal necrosis due to varicella zoster
in a patient with AIDS]

[Article in French]

Merle H, Smadja D, Cordoba A.

Service d'Ophtalmologie, CHU de Fort de France, Hopital Pierre Zobda-Quitman,
Fort-de-France, Martinique.

We report a case of bilateral acute retinal necrosis (ARN) following an acute
optic neuromyelitis (AONM) in an immunodepressed patient (T CD4 lymphocyte count 
under 50/mm3) suffering from acquired immunodeficiency syndrome (AIDS). Despite
the medical treatment the evolution led to blindness by bilateral total retinal
detachment. The neuro-ophthalmological features occurred prior to the retinal
manifestation, and the acute optic neuromyelitis occurred after a spreading
zoster. The varicella-zoster virus (VZV) seemed to be involved because of
recurring cutaneous zoster, spreading of this zoster just before the AONM,
previous reports showing a link between VZV and AONM, and VZV and ARN. However,
our patient had first an AONM responding well to corticosteroid therapy following
one month later by an ARN leading to blindness despite the antiviral treatments
received as soon as possible. There is a chronical viremia+ in immunodepressed
patients with recurring and spreading zoster. The rupture of the
hemato-encephalic barrier observed in AONM could facilitate the invasion of the
eye by the virus, leading to an ARN. This hypothesis could explain the two
complications due to the VZV, the AONM and the ARN, the first one is of
dysimmunitary origin and the second one could probably result of a direct viral
attack of the retina. This should incite to treat as soon as possible each
retrobulbar optic neuritis in patients with AIDS, especially if past history of
zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9759432 [PubMed - indexed for MEDLINE]

3627: J Neurol. 1998 Sep;245(9):598-602.

Diagnostic value of atypical lymphocytes in cerebrospinal fluid from adults with 
enteroviral meningitis.

Sato Y, Ohta Y, Honda Y, Kaji M, Oizumi K.

First Department of Internal Medicine, Kurume University School of Medicine,
Japan. y-sato@ktarn.or.jp

We have noted two morphologically distinct types of atypical lymphocytes (AL) in 
the cerebrospinal fluid (CSF) of adult patients with meningitis: one, which we
designate type-I AL, with multilobulated nuclei resembling those of the abnormal 
cells in adult T-cell leukaemia (ATL); and another, type-II AL, characterized by 
large lymphocytes with basophilic cytoplasm and nuclei containing coarse
chromatin. Type-I AL were detected in 25 of 39 patients (64%) with enteroviral
and in 11 of 109 (11%) with aseptic meningitis presumed to be caused by other
viruses, but not in meningitis resulting from Cryptococcus neofirmans (n = 14),
Mycobacterium tuberculosis (n = 19) or acute bacterial infection (n = 49). Type-I
AL were not seen in herpes zoster (n = 15) aseptic meningeal reactions (n = 15), 
or in leptomeningeal carcinomatosis (n = 14). Type-II AL were often present in
meningitis of various aetiologies and in aseptic meningeal reactions, but not in 
leptomeningeal carcinomatosis. The presence of type-I AL in the CSF was found to 
be indicative of enteroviral meningitis with the highest predictive value (69%), 
while type-II AL had a lower diagnostic positive predictive value in meningitis
of the five aetiologies above. Type-I AL immunostained for CD4, while type-II AL 
were stained for CD8. The presence of type-I AL in CSF strongly suggests
enteroviral meningitis, which warrants careful follow-up without antifungal,
antituberculous or antibacterial agents. However, type-I AL, which are likely to 
be virally transformed lymphocytes, must be distinguished from ATL cells, which
frequently involve the meninges.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 9758298 [PubMed - indexed for MEDLINE]

3628: Ann Biol Clin (Paris). 1998 Mar-Apr;56(2):211-2.

[Varicella-zoster virus meningo-encephalomyelitis without skin eruption]

[Article in French]

Sissoko D, Bellagra N, Dewilde A, Rogelet P, Hober D, Wattre P.

Laboratoire de virologie, Institut Gernez-Rieux, CHU de Lille.

Publication Types: 
    Case Reports

PMID: 9754250 [PubMed - indexed for MEDLINE]

3629: Nihon Kokyuki Gakkai Zasshi. 1998 Jun;36(6):531-4.

[Ramsay Hunt syndrome associated with eosinophilic pneumonia]

[Article in Japanese]

Kodama K.

Department of Internal Medicine, Minamitane Town Hospital, Kagoshima, Japan.

A 66-year-old woman was admitted to the hospital because of dry coughing. Ten
days before admission, the patient had suffered from facial palsy accompanying
otic zoster infection (Ramsay Hunt syndrome). Acyclovir was given, and during the
two weeks after admission, the facial palsy resolved completely. The dry coughing
worsened, and marked eosinophilia developed (1.930/mm3). A chest roentgenogram
and a computed tomogram revealed wandering non-segmental infiltration in the left
lung field. Examination of a specimen obtained by transbronchial lung biopsy
revealed moderate eosinophilic infiltration into thickened alveolar septa and
alveolar spaces. An elevated CD 4/CD 8 ratio (4.12) and a high level of
eosinophilic cationic protein (8.730 micrograms/l) were found in bronchoalveolar 
lavage fluid. Eosinophilic pneumonia was diagnosed. The patients condition
improved without medication within one month after the onset of the dry coughing.
Laboratory results revealed no parasitic or mycotic infection, and both an
acyclovir skin test and a lymphocyte stimulation test were negative, which
suggested that the pneumonia had been induced by an allergic reaction to unknown 
antigens resulting from Th 1/Th 2 imbalance after reactivation of
varicella-zoster virus latent in sensory ganglia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9754004 [PubMed - indexed for MEDLINE]

3630: Transplantation. 1998 Sep 15;66(5):667-70.

Squamous cell carcinomas after allogeneic bone marrow transplantation for
aplastic anemia: further evidence of a multistep process.

Socie G, Scieux C, Gluckman E, Soussi T, Clavel C, Saulnier P, Birembault P, Bosq
J, Morinet F, Janin A.

Service d'Hematologie-Greffe de Moelle, Unite de Recherche sur la Biologie des
Cellules Souches, Hopital Saint-Louis, Paris, France. gsocie@chu.stlouis.fr

BACKGROUND: Secondary solid tumors are rare events occurring in patients who
underwent allogeneic marrow transplantation for aplastic anemia and Fanconi's
anemia. Human herpes virus 8 (HHV8), Epstein-Barr virus (EBV), and human
papillomaviruses (HPV) sequences have been found in squamous cell carcinoma (SCC)
occurring in organ transplant recipients. The tumor suppressor gene p53 has been 
strongly linked to the occurrence of SCC in the nonimmunocompromised population. 
PATIENTS AND METHODS: In eight patients with SCC, we searched for HHV8, EBV,
varicella zoster virus, adenovirus, and HPV sequences from DNA extracted from
selected areas of SCC. We also looked for p53 expression in those specimens as
well as the presence of anti-p53 antibodies in the serum of these patients at the
onset of SCC. RESULTS: In one patient, we found the presence of both HHV8 and EBV
sequences, and in another patient we found HPV16 sequences. All five tumors that 
could be studied disclosed evidence of p53 accumulation, but none of the eight
patients had anti-p53 antibodies in the sera. CONCLUSION: SCC developing in
marrow transplant recipients seems to occur via a multistep process. Genetic
predisposition may be present, as in patients with Fanconi's anemia.
Transplantation-related factors, such as irradiation and chronic
graft-versus-host disease, also have a role. In this article, we add two more
potent risk factors: p53 alteration(s) and in some cases the presence of
oncogenic viruses.

PMID: 9753353 [PubMed - indexed for MEDLINE]

3631: Nurs Times. 1998 Aug 5-11;94(31):52-3.

Postherpetic neuralgia: a care study.

Clarke K.

Acute Pain Services, Wrexham Maelor Hospital.

Publication Types: 
    Case Reports

PMID: 9752207 [PubMed - indexed for MEDLINE]

3632: Proc Natl Acad Sci U S A. 1998 Sep 29;95(20):11969-74.

The ORF47 and ORF66 putative protein kinases of varicella-zoster virus determine 
tropism for human T cells and skin in the SCID-hu mouse.

Moffat JF, Zerboni L, Sommer MH, Heineman TC, Cohen JI, Kaneshima H, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
94305, USA. jmoffat@leland.stanford.edu

The varicella-zoster virus (VZV) genes ORF47 and ORF66 are predicted to encode
serine/threonine protein kinases, which are homologs of herpes simplex virus 1
(HSV-1) UL13, and US3. When mutants were constructed by inserting stop codons
into ORF47 and ORF66, the recombinants ROka47S and ROka66S, as well as intact
ROka replicated in tissue culture. In contrast, inoculation of human thymus/liver
or skin implants in SCID-hu mice showed that ORF47 protein was required for viral
growth in human T cells and skin. Eliminating ORF66 expression inhibited VZV
infectivity for T cells partially but did not impair replication in skin compared
with ROka. Infectivity for T cells and skin was restored when ROka47S virus was
complemented by insertion of ORF47 into a distant, noncoding site. The ORF47 gene
product is the first VZV protein identified as necessary for T cell tropism. It
also is essential for skin infectivity in vivo, as is glycoprotein C. Expression 
of ORF66 did not compensate for the absence of the ORF47 protein. The requirement
for ORF47 expression in T cells and skin indicates that this gene product, which 
is dispensable in vitro, has a critical role within differentiated cells that are
essential targets for VZV pathogenesis in vivo.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9751774 [PubMed - indexed for MEDLINE]

3633: Neurology. 1998 Sep;51(3):914-5.

Comment in:
    Neurology. 1999 Jul 13;53(1):242.

Varicella zoster virus-associated focal vasculitis without herpes zoster:
recovery after treatment with acyclovir.

Nau R, Lantsch M, Stiefel M, Polak T, Reiber H.

Department of Neurology, University of Gottingen, Germany.

Publication Types: 
    Case Reports

PMID: 9748063 [PubMed - indexed for MEDLINE]

3634: Arch Ophthalmol. 1998 Sep;116(9):1249.

Progressive outer retinal necrosis in a patient with rheumatoid arthritis.

Bryan RG, Myers FL.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9747694 [PubMed - indexed for MEDLINE]

3635: Br J Dermatol. 1998 Jun;138(6):1091.

Elevated soluble Fas levels in herpes zoster patients.

Kato M, Tamada Y, Kageyama M, Yamashita T, Nitta Y, Ikeya T, Nakashima I.

Publication Types: 
    Letter

PMID: 9747383 [PubMed - indexed for MEDLINE]

3636: Ann Dermatol Venereol. 1998 Feb;125(2):127-8.

[Acyclovir-resistance zona in a immunocompromised HIV seronegative patient]

[Article in French]

Lesueur A, Fillet AM, Bouscary D, Ginsburg C, Palmer P, Chaine B, Salmon-Ceron D,
Dreyfus F, Huraux JM, Sicard D.

Service de medecine interne 2, Hopital Cochin, Paris.

INTRODUCTION: Resistance to antiviral therapy is getting actually more frequent. 
Immunocompromised host are more concerned with this problem. OBSERVATION: We
present a case of disseminated zoster resisting to acyclovir (ACV) therapy, but
healing with foscarnet in a man treated with chemotherapy for lymphoma and
seronegative for HIV. CI50 of VZV strain was 48 microM for ACV, which was 2.8
times higher than value of the reference OKA strain tested simultaneously, which 
confirmed the resistance for ACV. DISCUSSION: Immunocompromised patients often
present varicella zoster virus (VZV) infection. They usually heal in response to 
ACV therapy, but some HIV infected patients have already presented with resistant
strains of VZV. This case is the first described in a non-HIV infected patient.
Foscarnet therapy resulted twice in complete healing because of its direct
activity on viral DNA polymerase, so it is efficaceous therapy for patients with 
thymidine-kinase-deficient ACV-resistant VZV infection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9747231 [PubMed - indexed for MEDLINE]

3637: Kansenshogaku Zasshi. 1998 Jul;72(7):714-9.

[Possibility of prevention of herpes zoster by use of varicella vaccine]

[Article in Japanese]

Kawano S, Terada K, Yagi Y, Kataoka N.

Department of Pediatrics, Kawasaki Medical School.

It has been considered that a decline in specific cell-mediated immunity (CMI)
for the varicella-zoster virus (VZV) could be responsible for a high incidence of
herpes zoster in the elderly. If the strength of CMI for VZV could be increased
by immunization of the elderly with a varicella vaccine, herpes zoster might be
preventable. We compared the CMI for VZV (using a lymphoproliferative assay and a
varicella skin test) and VZV-IgG antibodies in serum before and after 2-3 months 
of vaccination in 15 subjects more than 40 years old. When the CMI for VZV was
measured by the lymphoproliferative assay, a stimulation index (SI) of more than 
2.0 was estimated to be positive in this study. The SIs (mean +/- SD) before and 
after the vaccination were 2.7 +/- 1.8 and 2.7 +/- 1.9, respectively, and no
significant difference was noted. On the other hand, the diameter of erythema in 
the varicella skin test after the vaccination became larger than that before the 
vaccination in the 10 of 13 subjects. In addition, serum VZV-IgG antibodies
increased after vaccination in 6 of 14 subjects. There were no obvious reasons
for the discrepancy in the results of the lymphoproliferative assay and the
varicella skin test. However, because of the poor response indicated by the
assay, only one vaccination for the elderly might not be enough to increase the
CMI for VZV. The appropriate age for vaccination should also be considered.
Lastly, further investigation of the CMI for VZV before and after vaccination on 
larger scale is required.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 9745221 [PubMed - indexed for MEDLINE]

3638: J Clin Epidemiol. 1998 Aug;51(8):667-76.

Valuing outcomes in health care: a comparison of willingness to pay and
quality-adjusted life-years.

Bala MV, Wood LL, Zarkin GA, Norton EC, Gafni A, O'Brien B.

Research Triangle Institute, Research Triangle Park, North Carolina 27709, USA.

Quality-adjusted life-years (QALYs) and willingness to pay (WTP) are two
preference-based measures of health-related outcomes. In this article, we compare
these two measures in eliciting individuals' preferences for health outcomes
associated with shingles. To collect the necessary preference data, we
administered computer-interactive interviews to a sample of 65- to 70-year-olds. 
We found no significant correlation between QALYs and WTP across individuals. We 
discuss our findings and argue that our results raise questions about whether
QALYs and WTP are equivalent preference-based measures of health outcomes.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9743315 [PubMed - indexed for MEDLINE]

3639: Virology. 1998 Sep 15;249(1):21-31.

Antigenic variation of varicella zoster virus Fc receptor gE: loss of a major B
cell epitope in the ectodomain.

Santos RA, Padilla JA, Hatfield C, Grose C.

Department of Microbiology and the Immunology Program, University of Iowa College
of Medicine, Iowa City, Iowa, 52242, USA.

Varicella zoster virus (VZV) is considered to possess a genetically stable
genome; only one serotype is recognized around the world. The 125-kbp genome
contains approximately 70 open reading frames. One that has received particular
attention is open reading frame 68, which codes for glycoprotein gE, the
predominant 623-residue viral envelope product that harbors both B and T cell
epitopes. This report describes the initial characterization of a
community-acquired VZV isolate that was a distinguishable second serotype (i.e., 
it had lost a major B cell epitope defined on the gE ectodomain by a murine
monoclonal antibody called mAb 3B3). The mAb 3B3 epitope was found not only on
the prototype sequenced Dumas strain from Holland and all previously tested North
American isolates but also on the varicella vaccine Oka strain originally
attenuated in Japan. Sequencing of the mutated gE ectodomain demonstrated that
codon 150 exhibited a single base change that led to an amino acid change
(aspartic acid to asparagine). Observation of the monolayers infected with the
mutant VZV strain also led to the surprising discovery that the topography of
egress was altered. Wild-type VZV emerges along distinctive viral highways,
whereas the mutant strain virions were nearly uniformly distributed over the cell
surface in a pattern more closely resembling egress of herpes simplex virus 1.
The mutant VZV strain was designated VZV-MSP because it was isolated in
Minnesota. Copyright 1998 Academic Press.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9740773 [PubMed - indexed for MEDLINE]

3640: Clin Ther. 1998 Jul-Aug;20(4):661-70.

Advances in the treatment of herpesvirus infection: the role of famciclovir.

Tyring SK.

Department of Microbiology/Immunology, University of Texas Medical Branch,
Galveston 77555, USA.

Shingles (herpes zoster) is the result of reactivation of varicella-zoster virus 
after years of latency. The acute phase is self-limiting but is often associated 
with moderate-to-severe pain; postherpetic neuralgia is the most frequent and
debilitating complication of shingles, occurring in 3.4 per 1000 individuals per 
year. In the case of genital herpes, herpes simplex virus can reactivate to cause
recurrent episodes as often as several times a year, sometimes for the remainder 
of a person's life. Antiviral agents such as famciclovir, valacyclovir, and
acyclovir can be used to shorten the course and decrease the severity of these
diseases and may suppress the virus itself, thereby preventing future outbreaks
of genital herpes. This article presents a brief synopsis of the etiology of
herpes zoster and genital herpes and reviews 12 key studies that demonstrate the 
efficacy of famciclovir in the management of these two conditions.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Review

PMID: 9737826 [PubMed - indexed for MEDLINE]

3641: Neurologia. 1998 Jun-Jul;13(6):311-2.

Comment in:
    Neurologia. 2000 Feb;15(2):85-6.

[Unilateral lumbosacral plexus neuritis after herpes zoster infection. Favorable 
response to prednisone]

[Article in Spanish]

Modrego Pardo PJ, Pueyo MJ, Gracia B, Pina MA.

Publication Types: 
    Case Reports
    Letter

PMID: 9734207 [PubMed - indexed for MEDLINE]

3642: Neurologia. 1998 Jun-Jul;13(6):313-4.

[Abdominal tumor presenting as segmental weakness caused by zoster]

[Article in Spanish]

Boto de los Bueis A, Lopez Dominguez JM, Menendez de Leon C, Pujol de la Llave E.

Publication Types: 
    Case Reports
    Letter

PMID: 9734209 [PubMed - indexed for MEDLINE]

3643: J Virol. 1998 Oct;72(10):8083-8.

Varicella-zoster virus (VZV) ORF32 encodes a phosphoprotein that is
posttranslationally modified by the VZV ORF47 protein kinase.

Reddy SM, Cox E, Iofin I, Soong W, Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA.

Varicella-zoster virus (VZV) encodes five gene products that do not have homologs
in herpes simplex virus. One of these genes, VZV open reading frame 32 (ORF32),
is predicted to encode a protein of 16 kDa. VZV ORF32 protein was shown to be
phosphorylated and located in the cytosol of virus-infected cells. Antibody to
ORF32 protein immunoprecipitated 16- and 18-kDa phosphoproteins from VZV-infected
cells. Since VZV encodes two protein kinases that might phosphorylate ORF32
protein, immunoprecipitations were performed with cells infected with VZV mutants
unable to express either of the viral protein kinases. Cells infected with VZV
unable to express the ORF66 protein kinase contained both the 16- and 18-kDa
ORF32 phosphoproteins; however, cells infected with the VZV ORF47 protein kinase 
mutant showed only the 16-kDa ORF32 phosphoprotein. Treatment of
[35S]methionine-labeled proteins with calf intestine alkaline phosphatase
resulted in a decrease in size of the ORF32 proteins from 16 and 18 kDa to 15 and
17 kDa, respectively. VZV unable to express ORF32 protein replicated in human
melanoma cells to titers similar to those seen with parental virus; however, VZV 
unable to express ORF32 was impaired for replication in U20S osteosarcoma cells. 
Thus, VZV ORF32 protein is posttranslationally modified by the ORF47 protein
kinase. Since the VZV ORF47 protein kinase has recently been shown to be critical
for replication in human fetal skin and lymphocytes, its ability to modify the
ORF32 protein suggests that the latter protein may have a role for VZV
replication in human tissues.

PMID: 9733848 [PubMed - indexed for MEDLINE]

3644: J Rheumatol. 1998 Sep;25(9):1694-704.

High dose versus low dose fludarabine in the treatment of patients with severe
refractory rheumatoid arthritis.

Davis JC Jr, Fessler BJ, Tassiulas IO, McInnes IB, Yarboro CH, Pillemer S, Wilder
R, Fleisher TA, Klippel JH, Boumpas DT.

Clinical Investigation Section, Arthritis and Rheumatism Branch, National
Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes
of Health, Bethesda, Maryland, USA.

OBJECTIVE: Fludarabine, a nucleoside analog that targets both resting and
proliferating lymphocytes, is a promising drug for the treatment of autoimmune
diseases. We conducted a 2 dose, open label clinical trial to evaluate the
toxicity/safety of the fludarabine treatment and its clinical and immunological
effects. METHODS: Twenty-six patients with severe rheumatoid arthritis (RA)
refractory to treatment with at least one slow acting antirheumatic drug were
treated with intravenous fludarabine [20 mg/m2 body surface area (n=12) or 30
mg/m2 body surface area (n=14) per day for 3 consecutive days] given monthly for 
6 months. Second line agents with the exception of glucocorticoids were
discontinued at least 4 weeks before study entry. Measurements included toxicity 
and tolerability monitored at monthly intervals: efficacy, by both a 50%
reduction in tender or swollen joint count and American College of Rheumatology
(ACR) criteria for 20% response; and phenotypic analysis of peripheral blood
mononuclear cells and T cell functional assays. RESULTS: Using intention-to-treat
analysis, 2 of 12 (17%) patients in the low dose and 7 of 14 (50%) in the high
dose groups had 50% or greater reduction in tender and/or swollen joint count
after 6 months of therapy compared to baseline (p=0.09). Two of 12 (17%) in the
low dose group and 5 of 14 (36%) in the high dose group met ACR criteria for 20% 
improvement (p=0.28). No immediate toxicity was observed. Several infections
occurred, including 4 episodes of limited Herpes zoster, which responded to
standard therapy. Significant lymphopenia involving T and B cells was observed in
all patients. Both naive (CD4+CD45RA+) and memory CD4+ T cells (CD4+CD45RO+) were
reduced (naive > memory). No significant regeneration of naive T cells was
observed, which may suggest limited thymic regenerative capacity. Fludarabine
decreased the proliferative response of peripheral blood lymphocytes to mitogens,
as well as the production of T cell (interleukin 2 and interferon-gamma) and
monocyte derived (tumor necrosis factor-alpha and IL-10) cytokines. CONCLUSION:
Fludarabine treatment of patients with severe, refractory RA resulted in
significant lymphopenia, suppression of lymphocyte function, and clinical
improvement in the high dose group. There was no immediate toxicity; however,
several infections occurred. Controlled trials are needed to substantiate the
clinical improvement observed in this open label trial.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase I
    Clinical Trial, Phase II
    Controlled Clinical Trial

PMID: 9733448 [PubMed - indexed for MEDLINE]

3645: Eur Neurol. 1998 Jul;40(1):57-8.

Herpes zoster ophthalmicus and delayed contralateral hemiparesis: a case of
ipsilateral midbrain involvement.

Fukutake T, Hatakeyama H, Shinotoh H, Hattori T.

Department of Neurology, Chiba University School of Medicine, Chiba, Japan.

Publication Types: 
    Case Reports
    Review

PMID: 9729115 [PubMed - indexed for MEDLINE]

3646: Eur J Dermatol. 1998 Sep;8(6):397-402.

Management of infections due to the varicella-zoster virus. 11th consensus
conference on anti-infectious therapy of the French-speaking Society of
Infectious Diseases (SPILF).

Peyramond D, Chidiac C, Lucht F, Perronne C, Saimot AG, Soussy JC, Stahl JP.

Hopital de la Croix-Rousse, Service des Maladies infectieuses et tropicales, 93, 
grande rue de la Croix-Rousse, 69317 Lyon Cedex 04.

Publication Types: 
    Consensus Development Conference
    Review

PMID: 9729449 [PubMed - indexed for MEDLINE]

3647: Vestn Oftalmol. 1998 May-Jun;114(3):38-42.

[Features of the course and treatment of several eye diseases in Eastern Africa]

[Article in Russian]

Korneev IuM, Beliaev VS, Shinaev NN.

Ophthalmologist with a 4-year history (1993-1997) of practice at the Russian Red 
Cross Hospital in Addis Ababa (Ethiopia) shares his experience. More than 30,000 
patients were examined and treated. Interesting cases are described:
cytomegalovirus retinitis in the presence of AIDS, AIDS-associated involvement of
the eyes (uveitis, keratitis, Kaposi's sarcoma), herpes zoster involvement of the
eyes, phlyctenar keratoconjunctivitis, vernal conjunctivitis, trachoma, diseases 
of the eyes concomitant with syphilis, a case with Vogt-Koyanagi-Harada. Clinical
course and therapy of these diseases under local conditions are described.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9720400 [PubMed - indexed for MEDLINE]

3648: Nippon Ganka Gakkai Zasshi. 1998 Jul;102(7):462-6.

[A case of ill-defined vitiliginous lesions in the posterior polar regions of
both eyes]

[Article in Japanese]

Abe S, Nishikatsu H, Yasui T.

Department of Ophthalmology, Iwaki Kyoritsu General Hospital, Japan.

In a 34-year-old man, who was examined for binocular visual disturbance as chief 
complaint at the department of ophthalmology, we found ill-defined vitiliginous
lesions of a size about 1/5 approximately 1/7 the diameter of the papilla in the 
fundal posterior polar regions of both eyes. Fluorescein angiography (FA)
revealed hyperfluorescence of the vitiligo. Blood tests showed increased herpes
simplex and herpes zoster varicellosus antibody titers and positive antinuclear
antibodies (spekled type). Following steroid treatment, the vitiligo remitted,
but reappeared later. Indocyanine green infrared fluorescein angiography (IA)
revealed hyperfluorescence of the vitiligo. Fundus findings suggested multiple
evanescent white dot syndrome (MEWDS), but were judged to be negative because 1. 
the vitiliginous lesions were morphologically different; 2. the onset site of the
vitiligo was more posterior and polar-sided, 3. onset of the vitiligo was
binocular, 4. the vitiligo recurred and 5. late hypofluorescence was not observed
in IA.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9720369 [PubMed - indexed for MEDLINE]

3649: Masui. 1998 Jul;47(7):882-4.

[Lidocaine tape (Penles--a dressing tape based on 60% lidocaine--) reduces the
pain of postherpetic neuralgia]

[Article in Japanese]

Tamakawa S, Ogawa H.

Department of Anesthesia, Rumoi Municipal Hospital.

The treatment of postherpetic neuralgia (PHN) by topical administration of local 
anesthetics has a number of drawbacks. Lidocaine tape (Penles) is a 15 cm2
dressing tape based on 60% lidocaine used to anesthetize skin when an intravenous
catheter is inserted. This study aims to evaluate the analgesic efficacy of
lidocaine tape in patients with PHN by comparing the results with those of
surgical drape (Tegaderm). In a single-blind, two session study, lidocaine tape
or surgical drape was applied to the affected skin of 10 patients. In one
session, lidocaine tape was applied to the painful skin area, and in another,
surgical drape was applied to the same area. Pain score and side effects were
measured over 12 hours. Pain score was reduced at measurements taken starting
from 1 hour after lidocaine tape application (P < 0.05). Lidocaine tape induced
minor side-effects, erythema in a patient and increase in pain in another
patient. In conclusion, lidocaine tape is effective for relief of PHN.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 9720343 [PubMed - indexed for MEDLINE]

3650: Nephrol Dial Transplant. 1998 Aug;13(8):2074-6.

Cyclosporin for the prevention of disease reactivation in relapsing
ANCA-associated vasculitis.

Haubitz M, Koch KM, Brunkhorst R.

Department of Nephrology, Medical School, Hannover, Germany.

BACKGROUND: In patients with ANCA-associated vasculitis the frequent development 
of relapses after successful initial treatment remains a major therapeutic
problem. Thus a long-term prophylactic therapy with low side-effect potential is 
needed. As recent data suggest an involvement of T cells in the pathogenesis of
ANCA-associated vasculitis, the prophylactic value of therapy with low-dose
cyclosporin was investigated in seven patients (three with Wegener's
granulomatosis, four with microscopic polyangiitis, all with renal involvement)
who had developed at least one relapse during cyclophosphamide (CP) treatment or 
in the first 4 months after the end of CP therapy. METHODS: After remission had
been achieved for 6 months using CP and prednisolone, the CP dose was reduced (3 
months 75%, 3 months 50%) and cyclosporin was added concomitantly (dose adjusted 
to whole blood levels 60-90 ng/ml). Cyclosporin therapy was continued for 1 year 
after the end of CP treatment. RESULTS: During a mean follow-up of 24 months no
patient developed a relapse. Two patients developed a herpes zoster infection. No
severe bacterial infection occurred. CONCLUSIONS: These preliminary results
indicate that cyclosporin can be successfully used to sustain remission in
patients with a relapsing course of ANCA-associated vasculitis and renal
involvement.

PMID: 9719168 [PubMed - indexed for MEDLINE]

3651: Dermatology. 1998;197(1):87-8.

Zosteriform lichen planus after herpes zoster.

Braun RP, Barua D, Masouye I.

Publication Types: 
    Case Reports
    Letter

PMID: 9711434 [PubMed - indexed for MEDLINE]

3652: Ann Plast Surg. 1998 Aug;41(2):191-3.

Cutaneous reinnervation of the rectus abdominis musculocutaneous flap after chest
wall reconstruction: development of herpes zoster in the transplanted
musculocutaneous flap.

Tomita K, Inoue K.

Department of Plastic and Reconstructive Surgery, Haibara General Hospital,
Shizuoka, Japan.

We report a patient in whom herpes zoster developed in the transplanted rectus
abdominis musculocutaneous flap 14 months after a chest wall reconstruction for
recurrent breast cancer. Based on the distribution of the varicella zoster virus 
spreading along the sensory nerve fibers, we concluded that the virus spread
along the reinnervated sensory nerves from the dorsal ganglia, through the
intercostal nerves, and into the flap skin. It is suggested that this finding
demonstrates the pathway of reinnervation into the transferred musculocutaneous
flap on the chest wall.

Publication Types: 
    Case Reports

PMID: 9718154 [PubMed - indexed for MEDLINE]

3653: J Neurovirol. 1998 Aug;4(4):457-60.

VZV fulminant necrotizing encephalitis with concomitant EBV-related lymphoma and 
CMV ventriculitis: report of an AIDS case.

Nebuloni M, Vago L, Boldorini R, Bonetto S, Costanzi G.

Pathology Unit, L. Sacco Institute of Medical Science, University of Milan,
Italy.

A case of AIDS with varicella zoster virus fulminant necrotizing encephalitis
associated with cytomegalovirus ependymitis-subependymitis and a periventricular 
Epstein-Barr virus-related lymphoma is described. The patient had no herpes
zoster cutaneous eruptions and died three days after the onset of symptoms.
Varicella zoster virus and cytomegalovirus antigens were found by
immunohistochemistry in the same area around a necrotic periventricular lesion; a
periventricular lymphoma, large B cell type, was also observed. In situ
hybridization with Epstein-Barr virus-encoded- RNAs probe was positive in about
40% of the neoplastic cells. The association of herpes-related lesions in the
same cerebral region should be consistent in AIDS cases with acute neurological
symptoms.

Publication Types: 
    Case Reports

PMID: 9718139 [PubMed - indexed for MEDLINE]

3654: J Neurovirol. 1998 Aug;4(4):438-44.

Infectious simian varicella virus expressing the green fluorescent protein.

Mahalingam R, Wellish M, White T, Soike K, Cohrs R, Kleinschmidt-DeMasters BK,
Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA.

Clinical, pathologic, immunologic and virologic features of simian varicella
virus (SVV) infection in primates closely resemble varicella-zoster virus (VZV)
infection in humans. Such similarities provide a rationale to analyze SVV
infection in primates as a model of varicella pathogenesis and latency. Thus, we 
constructed an SVV-expressing green fluorescent protein (SVV-GFP) by inserting
the GFP gene into the unique short segment of the virus genome by homologous
recombination. Analysis of recombinant viral DNA and the expressed proteins of
plaque-purified SVV-GFP confirmed the location of the GFP insert and that the
recombinant SVV expressed the 27 kDa GFP. Infection of monkey kidney cells in
tissue culture with SVV-GFP revealed bright green fluorescence associated with
the characteristic focal cytopathic effect produced by SVV infection. Microscopic
examination of lung from a 3-month-old African green monkey 10 days after
infection with SVV-GFP revealed bright green fluorescence in areas of acute
necrotizing pneumonitis. SVV-GFP allows ready identification of cells infected
with SVV both in vitro and in vivo, and will be useful for further analysis of
varicella pathogenesis and latency in experimentally infected animals--studies
not possible in humans.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9718136 [PubMed - indexed for MEDLINE]

3655: Lancet. 1998 Aug 15;352(9127):540.

A nurse with a rash on her neck.

Aarset H, Fagerli UM, Opsjon SL, Skarsvag S.

Department of Pathology, University Hospital of Trondheim, Norway.

Publication Types: 
    Case Reports

PMID: 9716059 [PubMed - indexed for MEDLINE]

3656: Arch Ophthalmol. 1998 Aug;116(8):1011-7.

Chronic varicella-zoster virus epithelial keratitis in patients with acquired
immunodeficiency syndrome.

Chern KC, Conrad D, Holland GN, Holsclaw DS, Schwartz LK, Margolis TP.

Francis I. Proctor Foundation, University of California San Francisco Medical
Center, USA.

OBJECTIVE: To characterize further a chronic epithelial keratitis caused by
varicella-zoster virus infection in patients with acquired immunodeficiency
syndrome (AIDS). METHODS: Patients with AIDS and chronic epithelial keratitis
associated with varicella-zoster virus from 3 institutions were identified.
Patient records were reviewed retrospectively for the following data: medical and
demographic characteristics, techniques of diagnosis, physical findings, course, 
response to treatment, and outcome. RESULTS: Sixteen patients were studied. CD4+ 
T-lymphocyte cell counts were available in 11 patients, with a median of 0.034 x 
10(9)/L (range, 0-0.094 x 10(9)/L). Two patients had no history of a zosteriform 
rash. In the remaining patients, the interval between rash and keratitis ranged
from 0 days to 6 years. In all cases, the keratitis was chronic and characterized
by gray, elevated, dendriform epithelial lesions that stained variably with
fluorescein and rose bengal. The peripheral and midperipheral cornea was most
commonly affected, and, in 13 of the 16 patients, the lesions crossed the limbus.
Pain was a prominent feature, occurring in 12 of 16 patients. In 9 of 12 patients
tested, varicella-zoster virus was identified by culture, direct fluorescent
antibody testing, polymerase chain reaction testing, or a combination of these
studies, with direct fluorescent antibody testing (6 of 8 positive results) and
polymerase chain reaction testing (3 of 3 positive results) appearing to be the
most sensitive. Response to antiviral medication was variable. CONCLUSIONS: In
patients with AIDS, varicella-zoster virus may cause a chronic infection of the
corneal epithelium. The keratitis is characterized by dendriform lesions,
prolonged course, and frequently by extreme pain. It can occur without an
associated dermatitis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9715680 [PubMed - indexed for MEDLINE]

3657: South Med J. 1998 Aug;91(8):739-44.

Gabapentin for treatment of pain and tremor: a large case series.

Merren MD.

Neurology Clinic of San Antonio, TX 78229, USA.

BACKGROUND: Several anticonvulsant agents, including carbamazepine, phenytoin,
and valproate, are effective in some patients for the treatment of pain and
tremor. This study reports on a trial of the newly introduced anticonvulsant,
gabapentin, for pain and tremor control. METHODS: A large case series of patients
with centrally mediated pain, peripherally mediated pain, migraine, and tremor
were treated in an open-label study with gabapentin (maximum of 2,700 mg/day).
RESULTS: Thirty-nine patients (65%) had moderate-to-excellent improvement in
symptoms, with the best responses occurring in patients with peripherally
mediated neuropathic pain. The other conditions treated that showed some
improvement were benign essential/familial tremor, restless legs syndrome,
centrally mediated pain, and periodic nighttime leg movements. CONCLUSIONS:
Gabapentin offers an effective, safe alternative therapy or co-therapy for the
listed painful conditions and tremor; it does not affect the metabolism of other 
medications and is well tolerated.

Publication Types: 
    Clinical Trial

PMID: 9715219 [PubMed - indexed for MEDLINE]

3658: Lakartidningen. 1998 Jul 22;95(30-31):3284.

[Are valacyclovir and famcyclovir good enough against PHN?]

[Article in Swedish]

Liedholm H, Linne AB.

Publication Types: 
    Letter

PMID: 9715062 [PubMed - indexed for MEDLINE]

3659: Eur J Clin Microbiol Infect Dis. 1998 Apr;17(4):286-9.

Response to acyclovir in two cases of herpes zoster leukoencephalitis and review 
of the literature.

Otero J, Ribera E, Gavalda J, Rovira A, Ocana I, Pahissa A.

Servei de Malatties Infeccioses, Hospital General Vall d'Hebron, Barcelona,
Spain.

Herpes zoster leukoencephalitis is a rare complication of varicella-zoster virus 
infection. Associated with high mortality, the majority of cases have been
discovered postmortem; today, however, magnetic resonance imaging is being used
successfully as an aid in the diagnosis of this disease. The first two reported
cases of HIV-infected patients with herpes zoster leukoencephalitis who recovered
clinically and showed complete resolution of the magnetic resonance demyelination
images after acyclovir treatment are described. In addition, the cases of herpes 
zoster leukoencephalitis reported in the literature to date are reviewed.

Publication Types: 
    Case Reports
    Review

PMID: 9707315 [PubMed - indexed for MEDLINE]

3660: J Am Geriatr Soc. 1998 Aug;46(8):973-7.

Race and stress in the incidence of herpes zoster in older adults.

Schmader K, George LK, Burchett BM, Hamilton JD, Pieper CF.

Department of Medicine, Duke University Medical Center, and Durham Veterans
Affairs Medical Center, North Carolina 27710, USA.

OBJECTIVES: To examine the effect of black race and acute (negative life events) 
and chronic (lack of social support) psychological stress on the risk of herpes
zoster in late life. DESIGN: A population-based, prospective cohort study.
SETTING: Central North Carolina. PARTICIPANTS: Duke Established Populations for
Epidemiological Studies of the Elderly, a stratified probability sample of
community-dwelling persons more than 65 years of age. MEASUREMENTS: Interviewers 
administered a comprehensive health survey to the participants in 1986-1987 (P1, 
n = 4162), 1989-1990 (P2, n = 3336), and 1992-1994 (P3, n = 2568). Incident cases
of zoster between P1 and P2 and P2 and P3 served as the dependent variable.
Hypothesis-testing variables included race, negative life events, and five
measures of social support. Control variables included age, sex, education,
cancer, chronic diseases, basic ADLs, instrumental ADLs, depression, self-rated
health, hospitalization, and cigarette smoking. Statistical analyses employed
chi-square tests and proportional hazards model. RESULTS: At baseline, the sample
had a mean age of 73.6 years and was 55% black, 45% white, and 65% female. There 
were 65 cases of zoster between P1 and P2 and 102 cases of zoster between P2 and 
P3. From P1 to P2, 1.4% of blacks and 3.4% of whites developed zoster (P < .001).
From P2 to P3, 2.9% of blacks and 7.5% of whites developed zoster (P < .001).
After controlling for the above variables, blacks were significantly less likely 
to develop zoster (adjusted risk ratio = 0.35; 95% confidence interval (CI),
0.24-0.51; P < .001). Negative life events increased the risk of zoster, but the 
result was borderline for statistical significance (adjusted RR = 1.38, 95% CI
0.96-1.97; P = .078). No measures of social support were significantly associated
with zoster. CONCLUSION: Black race decreased the risk of zoster in late life
significantly. Measures of stress were not significantly related to zoster, but
study limitations preclude definitive conclusions. Future research should focus
on these factors in larger samples and different populations.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 9706885 [PubMed - indexed for MEDLINE]

3661: Neuropediatrics. 1998 Jun;29(3):120-3.

Chronic active destructive herpes simplex encephalitis with recovery of viral DNA
12 years after disease onset.

Asenbauer B, McEntagart M, King MD, Gallagher P, Burke M, Farrell MA.

Department of Neurology, Children's Hospital, Dublin, Ireland.

Acute herpes simplex encephalitis (HSE) carries significant morbidity and
mortality even after early treatment with antiviral agents (7). As well as
causing acute neurological disease, Herpes viruses are associated with
relapsing--remitting (Varicella--Zoster, Epstein-Barr) and chronic (Rasmussen
encephalitis) disease processes (1). A two-year-old girl developed acute HSE
which was followed by a 10-year neurologic illness characterised by asymmetric
spastic tetraparesis, pseudobulbar palsy, the opercular syndrome of
Foix-Chavany-Marie (4) and seizures. The neurological signs remained static until
the child died suddenly 12 years after disease onset. Neuropathologic examination
demonstrated active chronic encephalitis. Herpes simplex virus (HSV) DNA was
recovered from formalin-fixed paraffin-embedded brain tissue. This case provides 
additional evidence for the development of chronic neurological disease
attributable to persistence of herpes simplex virus type 1.

Publication Types: 
    Case Reports

PMID: 9706620 [PubMed - indexed for MEDLINE]

3662: J Am Acad Dermatol. 1998 Aug;39(2 Pt 1):207-10.

Herpes zoster in children.

Kakourou T, Theodoridou M, Mostrou G, Syriopoulou V, Papadogeorgaki H,
Constantopoulos A.

First Department of Pediatrics, Athens University, Greece.

BACKGROUND: The clinical studies of series of children with herpes zoster (HZ)
are rather limited. OBJECTIVE: The purpose of this study was to evaluate the
epidemiologic conditions, clinical manifestations, therapy, and outcome of HZ in 
children. METHODS: Twenty-one patients with HZ have been studied. Five patients
who had herpes simplex virus infection were excluded. The laboratory diagnosis
was made by fluorescent techniques. Acyclovir was administered systematically for
2 more days after no new lesions had developed. RESULTS: Thirteen patients (group
A) were immunocompromised; eight patients (group B) were otherwise healthy. Two
patients from group B had intrauterine varicella; the other six patients had had 
varicella under the age of 4 years. Three patients were recently exposed to
varicella. The duration of HZ was significantly longer in group A than in group
B, but the outcome was good in all patients. CONCLUSION: Herpes simplex virus
infection may simulate the pattern of HZ; varicella in early childhood is a risk 
factor for HZ in otherwise healthy children; exposure of a child to varicella may
cause reactivation of latent HZ virus; and acyclovir therapy within 3 days of
exanthem onset prevents significant morbidity and death in immunocompromised
children with HZ.

PMID: 9704830 [PubMed - indexed for MEDLINE]

3663: Dermatol Clin. 1998 Jul;16(3):539-52.

Antiviral treatment of diseases in pediatric dermatology.

Trizna Z, Tyring SK.

Department of Dermatology, University of Texas Medical Branch at Galveston, USA.

Pediatric dermatologic disease that have specific therapies and/or specific
prophylactic measures are reviewed. Herpes simplex virus and varicella-zoster
virus infections, human papillomavirus infections, and molluscum contagiosum
infections are discussed with special emphasis on recent advances of therapy and 
prophylaxis.

Publication Types: 
    Review

PMID: 9704210 [PubMed - indexed for MEDLINE]

3664: J Neurol Neurosurg Psychiatry. 1998 Aug;65(2):208.

Pontine inflammatory lesion due to shingles.

Kidd D, Duncan JS, Thompson EJ.

Department of Clinical Neurology, The National Hospital for Neurology and
Neurosurgery, London, UK.

Publication Types: 
    Case Reports

PMID: 9703172 [PubMed - indexed for MEDLINE]

3665: Int J STD AIDS. 1998 Aug;9(8):476-9.

Herpes zoster ophthalmicus and HIV infection in Nigeria.

Umeh RE.

Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu,
Africa.

Eight patients, 3 men and 5 women, aged between 24 and 40 years who had herpes
zoster ophthalmicus (HZO) were seen in the Eye Department of the University of
Nigeria Teaching Hospital, Enugu between 1994 and 1997. One of the patients was
already on treatment for active pulmonary tuberculosis at the time he was first
seen. All had skin eruptions at different stages of development in the area of
distribution of the first trigeminal nerve on the affected side of the face and
head. Ocular examination revealed impaired vision in the affected eye (between
6/12 and hand movement) in all the patients. All had lid oedema while 5 had
ptosis (3 partial and 2 complete). Various degrees of conjunctival injection were
observed in all patients while 6 of them had corneal anaesthesia and keratitis.
Uveal inflammation, present in all the patients varied from mild iritis in 4
individuals to severe iridocyclitis in the remaining 4. Pupils reacted to light
sluggishly in 2 patients while they were dilated and fixed in 3 others. None had 
any associated abnormalities in the posterior segment. Six of the patients
consented and were screened for human immunodeficiency virus (HIV) infection. Of 
these, 4, including the patient with pulmonary tuberculosis, tested seropositive 
while 2 were seronegative. All 8 were treated with topical acyclovir. This was
combined with oral acyclovir in one of the patients. Follow-up period was between
2 and 52 weeks. During this period skin eruptions and anterior segment signs
improved in 5 patients while remaining stable in 3 others; post-herpetic
neuralgia persisted on the affected side in 4 patients. Patients who were HIV
seropositive did not recover as quickly or to the same extent as the seronegative
ones. It is concluded that HZO infection may indicate underlying HIV infection in
young Africans as has been found in whites.

PIP: Manifestations of herpes zoster ophthalmicus (HZO) infection are well known 
in HIV-seropositive White patients in developed countries, but this association
has not been previously noted in African AIDS patients. This paper analyzes 8
cases (3 men and 5 women) 24-40 years of age who were treated at the Eye
Department of the University of Nigeria Teaching Hospital, Enugu, for HZO in
1994-97. Of the 6 patients who consented to HIV screening, 4 were
HIV-seropositive. One of the HIV-infected patients had been treated for pulmonary
tuberculosis a year prior to the present illness, but the remaining 7 were in
apparent good health. The patients presented with skin eruptions in the area of
distribution of the trigeminal nerve on the affected side of the face and head.
Visual acuity was impaired in all 8 cases. The most common ocular findings were
lid edema, ptosis, conjunctival infection, corneal anesthesia, keratitis, uveal
inflammation, and abnormal pupillary reaction. The severity of presentation was
similar in HIV-positive and HIV-negative patients and all improved during
follow-up; however, clinical improvement was less rapid or pronounced among the
HIV-positive patients. These findings suggest that HZO infection in young
Africans should be regarded as a possible indicator of HIV infection.

PMID: 9702597 [PubMed - indexed for MEDLINE]

3666: J Med Virol. 1998 Sep;56(1):91-8.

Characterization of viremia at different stages of varicella-zoster virus
infection.

Mainka C, Fuss B, Geiger H, Hofelmayr H, Wolff MH.

Institute of Microbiology and Virology, University of Witten/Herdecke, Germany.

Varicella-zoster virus (VZV) viremia at different stages of infection was
characterized. Different approaches were used, polymerase chain reaction (PCR),
isothermal transcription based nucleic acid amplification (NASBA), and
immunofluorescence to describe and quantitate viral infection of peripheral blood
mononuclear cells (PBMC). In patients with acute varicella 200 to 5,000 copies of
the viral genome in every 150,000 PBMC were found with quantitative competitive
PCR (QCPCR). With NASBA, viral transcriptional activity was detected in these
cells. RNA transcribed from the immediate early gene IE 63 as well as from the
late gene 68 were found, indicating a productive infection. Glycoprotein gE
specific immunofluorescence visualized by confocal laser scanning microscopy
revealed that only 1 in 10,000 to 100,000 PBMC was infected. T and B lymphocytes 
as well as monocytes expressed viral protein on their surface. Similar results
were obtained with PBMC from immunocompetent zoster patients. In some cases a
transient viremia was found shortly after the onset of rash, although the viral
load seemed to be lower than in patients with varicella. Examination of blood
samples from 16 persons with postherpetic neuralgia (PHN) signs of viral
replication in PBMC were not detected. In conclusion, the data suggest that VZV
viremia is a frequent event in patients with varicella and zoster, but not in
those with postherpetic neuralgia. Moreover, the results indicated that
subclinical reactivations occur both in immunocompromised and immunocompetent
individuals.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9700639 [PubMed - indexed for MEDLINE]

3667: J Infect Dis. 1998 Aug;178(2):539-43.

Congenital varicella-zoster virus infection and Barrett's esophagus.

Ussery XT, Annunziato P, Gershon AA, Reid BS, Lungu O, Langston C, Silverstein S,
Lee KK, Baker CJ.

Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.

Congenital varicella syndrome is a rare complication of varicella-zoster virus
(VZV) infection during pregnancy. An infant was exposed to VZV at 18.5 weeks of
gestation and had eye and skin abnormalities at birth and persistent feeding
difficulties, prompting esophageal biopsies at 12 days and 20 and 20.5 months of 
age. Esophageal tissues demonstrated specialized intestinal metaplasia (Barrett's
esophagus). VZV DNA (in situ hybridization) and proteins (immunohistochemistry
and polymerase chain reaction) were found in esophageal epithelial cells adjacent
to the Barrett's lesion. Immediate-early 63 protein (IE63) of VZV was
demonstrated in the day 12 specimen, and IE62 and the late VZV glycoprotein E
(gE) were found in the 20-month specimen. Clinical and endoscopic improvement
followed fundoplication and acyclovir therapy, but VZV DNA and IE62 persisted in 
esophageal tissue. These findings associate VZV with specialized intestinal
metaplasia within the esophagus and suggest a novel site for either latent or
active VZV infection.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9697739 [PubMed - indexed for MEDLINE]

3668: J Infect Dis. 1998 Aug;178(2):349-59.

Clinical efficacy of high-dose acyclovir in patients with human immunodeficiency 
virus infection: a meta-analysis of randomized individual patient data.

Ioannidis JP, Collier AC, Cooper DA, Corey L, Fiddian AP, Gazzard BG, Griffiths
PD, Contopoulos-Ioannidis DG, Lau J, Pavia AT, Saag MS, Spruance SL, Youle MS.

HIV Research Branch, National Institute of Allergy and Infectious Diseases,
National Institutes of Health, Bethesda, Maryland 20892, USA. ji24m@nih.gov

A meta-analysis of 8 randomized trials (1792 patients, 2947 patient-years of
follow-up) showed that acyclovir (> or = 3200 mg/day) offered a significant
survival benefit (P = .006 by log-rank test) in human immunodeficiency virus
(HIV) infection. The treatment effect did not vary significantly in patient
subgroups of different CD4 cell counts, hemoglobin levels, age, race, and sex,
and with or without AIDS diagnosis. Acyclovir treatment (hazard ratio, 0.78; 95% 
confidence interval [CI], 0.65-0.93), higher CD4 cell count (P < .001), higher
hemoglobin level (P < .001), and younger age (P < .001) reduced the hazard of
mortality. Acyclovir decreased herpes simplex virus infections (odds ratio [OR], 
0.28; 95% CI, 0.21-0.37) and varicella-zoster virus infections (OR, 0.29; 95% CI,
0.13-0.63) but not cytomegalovirus disease or mortality from lymphoma or Kaposi's
sarcoma. A survival advantage was seen specifically in studies with high
incidence of clinical herpesvirus infections (> or = 25% per year). Given the
wide confidence intervals, the small effect in low-risk patients, and recent
changes in HIV therapeutics, the results should be interpreted cautiously, but
the meta-analysis supports the importance of pathogenetic interactions between
herpesviruses and HIV.

Publication Types: 
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9697714 [PubMed - indexed for MEDLINE]

3669: J Infect Dis. 1998 Aug;178(2):310-7.

Recombinant varicella-zoster virus glycoproteins E and I: immunologic responses
and clearance of virus in a guinea pig model of chronic uveitis.

Kimura H, Wang Y, Pesnicak L, Cohen JI, Hooks JJ, Straus SE, Williams RK.

National Institutes of Health, Medical Virology Section, Laboratory of Clinical
Investigation, National Institute of Allergy and Infectious Diseases, Bethesda,
Maryland, USA.

Guinea pigs immunized with recombinant varicella-zoster virus (VZV) glycoproteins
E (gE) and I (gI) developed antigen-specific antibodies in the sera, vitreous,
and conjunctival washes. Sera from immunized animals neutralized both cell-free
and cell-associated VZV, and peripheral blood lymphocytes proliferated in vitro
in response to recombinant gE and gI and to antigens from VZV-infected cells.
Immunized guinea pigs were inoculated intravitreally with VZV, which induces
chronic uveitis. VZV DNA was more rapidly cleared and infectious VZV was isolated
less frequently from the retinas of animals immunized with gE and gI compared
with that in controls receiving adjuvant alone. Nonetheless, cellular infiltrates
in the vitreous, retina, and choroid were prevalent 21 days after VZV inoculation
in both the adjuvant-alone- and gE-gI-immunized animals. Immunization with VZV gE
and gI induced potent humoral and cellular responses that accelerated the
clearance of VZV DNA and may neutralize virus within the eye.

PMID: 9697709 [PubMed - indexed for MEDLINE]

3670: Br J Haematol. 1998 Jul;102(2):532-4.

Prolonged disease-free survival in relapsed/refractory low-grade lymphoma treated
with fludarabine: a report of four cases.

Sternberg AJ, Matutes E, Killick S, Wotherspoon AC, Catovsky D.

Academic Department of Haematology and Cytogenetics, The Royal Marsden Hospital, 
London.

We report four patients with relapsed or refractory follicular (three) and
lymphoplasmacytic (one) lymphoma who achieved complete remission (CR) with
fludarabine (FDR) lasting from 3.2 to 6 years. One had stage III and three stage 
IV and were resistant to chlorambucil and/or anthracycline. FDR was well
tolerated, the only complication being herpes zoster infection in three patients,
which was controlled with aciclovir. One patient developed a gastric MALT
lymphoma from a different clone than the follicular lymphoma. In conclusion, some
patients with refractory low-grade lymphoma achieve long-term CR with FDR:
therefore this agent may be considered as alternative to stem-cell
transplantation.

Publication Types: 
    Case Reports

PMID: 9695970 [PubMed - indexed for MEDLINE]

3671: No To Hattatsu. 1998 Jul;30(4):334-8.

[A case report of acute encephalitis with neuro-psychiatric side-effects of
acyclovir]

[Article in Japanese]

Nakamoto N, Nakayama T, Kudo S, Tanaka M, Fujita Y, Hattori T, Abe T.

Department of Pediatrics, Teikyo University School of Medicine, Tokyo.

We reported a 5-year-old boy with acute encephalitis due to suspected herpes
simplex infection, who developed confusion, agitation and insomnia during
intravenous administration of acyclovir. He recovered from these
neuro-psychiatric symptoms two days after the cessation of acyclovir. The same
symptoms recurred two days after its re-administration and resolved on the next
day of the second cessation of the drug. Electroencephalogram (EEG) showed
periodic lateralized epileptiform discharges (PLEDs) on hospital day 16, which
disappeared on hospital day 27, suggesting that neurotoxicity of acyclovir may
induce PLEDs. Although acyclovir is useful for the treatment of herpes simplex
and varicella-zoster virus infections, we have to pay attention to its
neurotoxicity.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9695630 [PubMed - indexed for MEDLINE]

3672: Clin Exp Dermatol. 1998 Mar;23(2):87-8.

Necrotizing fasciitis complicating disseminated cutaneous herpes zoster.

Jarrett P, Ha T, Oliver F.

Department of Dermatology, Auckland Hospital, New Zealand.

The association of necrotizing fasciitis, often due to group A streptococcus and 
primary varicella (chicken pox), is unusual but recognized in children. The
association in adults is rare but one report in the literature describes a
previously healthy man with the two disorders. We now describe a case of
disseminated cutaneous herpes zoster complicated by subacute necrotizing
fasciitis in an elderly woman taking low dose methotrexate and prednisone for
rheumatoid arthritis. Staphylococcus aureus was isolated. Localized debridement
and split skin grafting were required.

Publication Types: 
    Case Reports

PMID: 9692314 [PubMed - indexed for MEDLINE]

3673: Ugeskr Laeger. 1998 Jul 20;160(30):4429-30.

[Granuloma annulare after herpes zoster: isotopic response]

[Article in Danish]

Bygum A.

Dermatovenerologisk afdeling I, Odense Universitetshospital.

A 33 year-old woman was seen with a localized zosteriform papular eruption in a
Th7 dermatomal distribution. The patient experienced neuralgic pain. A skin
biopsy demonstrated palisading granulomatous dermatitis and a diagnosis of
granuloma annulare after a subclinical herpes zoster infection was made.
"Isotopic response" describes the occurrence of a new disorder at the site of
another, unrelated, and already healed skin disease.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9691836 [PubMed - indexed for MEDLINE]

3674: Rinsho Byori. 1998 Jun;46(6):529-37.

[17-KS sulfate as a biomarker in psychosocial stress]

[Article in Japanese]

Furuya E, Maezawa M, Nishikaze O.

Sumitomo Metal Bio-Science, Inc., Sagamihara.

We found an association between low levels of 17-Ketosteroid Sulfates (17-KS-S)
in subjects under psychosocial stress. Stress associated with overwork and lack
of sleep resulted in decreased levels of 17-KS-S and an increase in
17-Hydroxycorticosteroids (17-OHCS) levels. Alleviation of stress condition was
associated with a restoration of the ratio of 17-KS-S/17-OHCS resulting from a
slow increase in 17-KS-S and a decrease in 17-OHCS. In subjects with severe
mental stress the ratio of 17-KS-S/17-OHCS showed markedly reduced values with a 
transient marked increase in 17-OHCS. There was a decrease in the levels of
17-KS-S in depressives, which was more pronounced during severe depression. There
was no significant difference in 17-OHCS levels. In a cohort experiencing
bereavement, there was a reduction in the levels of 17-KS-S, which remained low
for about 50 days. With time, the level of 17-KS-S returned to the basal level
established prior to spousal death. In this case, there was no significant change
in the levels of 17-OHCS. Persistent severe stress over several months in a
physician, led to a Herpes Zoster outbreak and Arrhythmia, resulting in hospital 
admission. The levels of 17-KS-S gradually decreased over this time reaching 1/3 
of the normal baseline value, while 17-OHCS levels remained within normal ranges.
These results suggest that measurement of 17-KS-S is indispensable for current
research on psychosocial stress.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9691761 [PubMed - indexed for MEDLINE]

3675: Br J Clin Pharmacol. 1998 Jul;46(1):1-4.

Sorivudine and 5-fluorouracil; a clinically significant drug-drug interaction due
to inhibition of dihydropyrimidine dehydrogenase.

Diasio RB.

Department of Pharmacology and Toxicology, University of Alabama at Birmingham,
35294, USA.

Sorivudine (1-beta-D-arabinofuranosyl-E-5-[2-bromovinyl] uracil; BV-araU;
SQ32,756) is an antimetabolite which is a synthetic analogue of thymidine. This
drug has demonstrated antiviral activity against varicella zoster virus, herpes
simplex type 1 virus, and Epstein-Barr virus. Clinical studies in Japan and
subsequently worldwide showed this drug to be a potent agent for treating
varicella zoster infections. Although in general well tolerated, a fatal drug
interaction with fluoropyrimidine drugs was subsequently observed. While three
deaths resulting from this interaction were recognized to have occurred during
the initial clinical evaluation in Japan, the full impact of the interaction was 
not recognized in Japan until post-marketing when an additional 23 cases of
severe toxicity were reported including 16 patients who subsequently died from
fluoro-pyrimidine toxicity. Worldwide recognition of this potentially fatal
drug-drug interaction led to subsequent disapproval in the US and elsewhere. The 
interaction has been shown to be due to suppression of 5-fluorouracil (5-FU)
catabolism, resulting in higher levels of 5-FU than would normally be observed.
The mechanism of this interaction is mediated through inhibition of the 5-FU
rate-limiting catabolizing enzyme dihydropyrmidine dehydrogenase (DPD) by the
BV-araU metabolite BVU. This drug-drug interaction of sorivudine and 5-FU further
emphasizes the critical importance of DPD on the clinical pharmacology of 5-FU.

PMID: 9690942 [PubMed - indexed for MEDLINE]

3676: Jpn J Ophthalmol. 1998 May-Jun;42(3):208-12.

Detection of varicella-zoster virus genome in the vitreous humor from two
patients with acute retinal necrosis; lacking or having a PstI cleavage site.

Mochizuki K, Matsushita H, Hiramatsu Y, Yanagida K.

Yanagida Eye Clinic, Shizuoka, Japan.

Using polymerase chain reaction, we detected the varicella-zoster virus genome in
the vitreous humor of two patients with clinically diagnosed acute retinal
necrosis. One of the two cases was thought to be caused by infection with a
varicella-zoster virus lacking a PstI cleavage site. We could not find any
clinical differences between the two substrains. The presence of a PstI cleavage 
site on the varicella-zoster virus genome might not be associated with the
occurrence of acute retinal necrosis.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 9690900 [PubMed - indexed for MEDLINE]

3677: Int J Colorectal Dis. 1998;13(3):131-3.

Evaluation of specific herpes DNA viruses in idiopathic megarectum and idiopathic
megacolon.

Gattuso JM, Debinski HS, Kangro HO, Jeffries D, Kamm MA.

St. Mark's Hospital, Harrow, Middlesex, UK.

PURPOSE: The aetiology of idiopathic megarectum and idiopathic megacolon is
unknown. A previous study in patients with chronic idiopathic intestinal
pseudo-obstruction, a condition also associated with a dilated gut, identified
the possible involvement of herpes viruses. This study therefore aimed to
determine whether these viruses may also be implicated in the pathogenesis of
these conditions. METHODS: Resected large bowel from three patients with
idiopathic megarectum and three patients with idiopathic megacolon were studied. 
Histology for viral inclusions and nested polymerase chain reaction (PCR) using
specific primers for cytomegalovirus, Epstein-Barr virus, herpes simplex virus
type 1 and varicella zoster virus was performed. DNA was extracted from
paraffin-embedded blocks by proteinase K and phenol chloroform extraction.
RESULTS: Viral inclusions were not seen. PCR failed to identify DNA of the four
herpes viruses tested. CONCLUSION: Patients with idiopathic megarectum or
idiopathic megacolon may have subtle abnormalities of the enteric innervation,
but these do not appear to be attributable to the neurotropic effects of the
herpes viruses studied.

PMID: 9689563 [PubMed - indexed for MEDLINE]

3678: Acta Derm Venereol. 1998 Jul;78(4):300.

Comment on:
    Acta Derm Venereol. 1997 Nov;77(6):491-2.

"Zosteriform" lichen planus: the bizarre consequences of a misnomer.

Happle R.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 9689303 [PubMed - indexed for MEDLINE]

3679: Antimicrob Agents Chemother. 1998 Aug;42(8):2095-102.

Mode of action of (1'S,2'R)-9-[[1',2'-bis(hydroxymethyl)
cycloprop-1'-yl]methyl]guanine (A-5021) against herpes simplex virus type 1 and
type 2 and varicella-zoster virus.

Ono N, Iwayama S, Suzuki K, Sekiyama T, Nakazawa H, Tsuji T, Okunishi M, Daikoku 
T, Nishiyama Y.

Life Science Laboratories, Ajinomoto Co., Inc., Totsuka-ku, Yokohama 244, Japan.

The mode of action of (1'S,2'R)-9-([1',
2'-bis(hydroxymethyl)cycloprop-1'-yl]methyl)guanine (A-5021) against herpes
simplex virus type 1 (HSV-1), HSV-2, and varicella-zoster virus (VZV) was
studied. A-5021 was monophosphorylated at the 2' site by viral thymidine kinases 
(TKs). The 50% inhibitory values for thymidine phosphorylation of A-5021 by HSV-1
TK and HSV-2 TK were comparable to those for penciclovir (PCV) and lower than
those for acyclovir (ACV). Of these three agents, A-5021 inhibited VZV TK most
efficiently. A-5021 was phosphorylated to a mono-, di-, and triphosphate in MRC-5
cells infected with HSV-1, HSV-2, and VZV. A-5021 triphosphate accumulated more
than ACV triphosphate but less than PCV triphosphate in MRC-5 cells infected with
HSV-1 or VZV, whereas HSV-2-infected MRC-5 cells had comparable levels of A-5021 
and ACV triphosphates. The intracellular half-life of A-5021 triphosphate was
considerably longer than that of ACV triphosphate and shorter than that of PCV
triphosphate. A-5021 triphosphate competitively inhibited HSV DNA polymerases
with respect to dGTP. Inhibition was strongest with ACV triphosphate, followed by
A-5021 triphosphate and then (R,S)-PCV triphosphate. A DNA chain elongation
experiment revealed that A-5021 triphosphate was incorporated into DNA instead of
dGTP and terminated elongation, although limited chain extension was observed.
Thus, the strong antiviral activity of A-5021 appears to depend on a more rapid
and stable accumulation of its triphosphate in infected cells than that of ACV
and on stronger inhibition of viral DNA polymerase by its triphosphate than that 
of PCV.

PMID: 9687413 [PubMed - indexed for MEDLINE]

3680: Acta Paediatr. 1998 Jun;87(6):692-4.

Specific cellular immunity in immunocompetent children with herpes zoster.

Terada K, Tanaka H, Kawano S, Kataoka N.

Department of Paediatrics, Kawasaki Medical School, Okayama, Japan.

We investigated whether specific immunity is low in immunocompetent children with
zoster. Specific cellular immunity was found to be significantly lower in 13
otherwise normal children with zoster than it was in 8 matched controls by a
lymphoproliferative assay. However, there was no significant difference between
them with regard to the antibody response. Therefore, even in the immunocompetent
children, decreased specific cellular immunity may play an important role in the 
mechanism of virus reactivation.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 9686665 [PubMed - indexed for MEDLINE]

3681: Cancer Causes Control. 1998 May;9(3):277-83.

Multiple myeloma and work in agriculture: results of a case-control study in
Forli, Italy.

Nanni O, Falcini F, Buiatti E, Bucchi L, Naldoni M, Serra P, Scarpi E, Saragoni
L, Amadori D.

Istituto Oncologico Romagnolo, Forli, Italy.

OBJECTIVES: To evaluate the relation between the exposure to specific pesticides 
in agricultural work and the risk of multiple myeloma (MM). METHODS: A
case-control study was conducted in the province of Forli, Italy. Forty-six cases
of MM (20 females, 26 males; mean age 64 years, range 40 to 74) identified
through the Romagna Cancer Registry in the years 1987-90, and 230 age- and
gender-matched controls from the general population were interviewed in-person
using a structured questionnaire focused on exposure to pesticides and other
occupational and nonoccupational variables. RESULTS: Among nonoccupational
factors, the education level and the altitude of the place of residence were
related inversely to MM risk. First-degree familiarity for hematolymphopoietic
neoplasias and previous herpes zoster diagnosis were associated positively with
the disease. A nonsignificant increase in MM risk was observed among workers in
agriculture as a whole (odds ratio [OR] = 1.31, 95 percent confidence interval
[CI] = 0.62-2.74). An increased risk was associated specifically with the
cultivation of apples and pears (OR = 1.75, CI = 1.05-2.91). As regards pesticide
exposure, only the chlorinated insecticides were related to an increase in the
risk of MM. CONCLUSIONS: This study suggests that agricultural work and exposure 
to pesticides have a role in the etiology of MM.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9684708 [PubMed - indexed for MEDLINE]

3682: Eur J Clin Pharmacol. 1998 May;54(3):231-5.

Skin and plasma levels of acetylsalicylic acid: a comparison between topical
aspirin/diethyl ether mixture and oral aspirin in acute herpes zoster and
postherpetic neuralgia.

Bareggi SR, Pirola R, De Benedittis G.

Department of Pharmacology, University of Milan, Italy.

OBJECTIVE: The aim of this investigation was to elucidate whether the analgesic
effect was due to the local aspirin or to the systemic drug. This was done by
comparing skin and plasma levels of acetylsalicylic acid (ASA) and salicylic acid
(SA) after topically administered ASA/diethyl ether (ADE) mixture in acute
herpetic neuralgia (AHN) and postherpetic neuralgia (PHN). The analgesia and the 
plasma and skin levels of ASA were also determined after oral administration of
aspirin. METHODS: Nineteen patients, 11 (57.9%) with AHN and 8 (42.1 %) with PHN 
were given, on different days, a single 500-mg oral dose of ASA or a topical dose
(750 mg) of (ADE) daubed onto the painful skin. The analgesic effect was assessed
by means of a visual analogue scale (VAS). Overall pain relief was graded as:
excellent, good, fair, or poor. AHN as well as PHN patients had severe pain at
baseline (6.83 and 5.93). Levels of ASA and SA in plasma and in the stratum
corneum after adhesive tape stripping of the treated area were determined by
HPLC. RESULTS: After ADE application, the analgesic effect was very rapid and VAS
scores were lower than at baseline. Pain significantly decreased by 82.6% after
topical and 15.4% after oral ASA. After ADE, 95% of the patients had excellent or
good pain relief, but after oral administration 79% of the patients had a poor
response. Pain relief was similar in the two subgroups after ADE. Skin
concentrations of ASA, but not of SA, after ADE were about 80- to 100-fold those 
after oral administration. Levels of ASA and SA in plasma after oral
administration were similar to those previously found, but after ADE were
undetectable or very low. Patients with excellent pain relief showed a trend
towards higher ASA skin concentrations. CONCLUSIONS: The analgesic effect can be 
obtained only after topical administration, because by this route the skin levels
of ASA are much higher than after oral administration. The mechanism is
exclusively local; there are no active drugs in plasma after topical
administration.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9681665 [PubMed - indexed for MEDLINE]

3683: Int J Dermatol. 1998 Jul;37(7):544-6.

A retrospective study on the clinical outcome of herpes zoster in patients
treated with acyclovir or valaciclovir vs. patients not treated with antiviral.

Goh CL, Khoo L.

Institute of Dermatology, Singapore, National Skin Centre, Singapore.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 9679698 [PubMed - indexed for MEDLINE]

3684: Turk J Pediatr. 1998 Apr-Jun;40(2):231-5.

Blockade of acute grade IV skin and eye graft-versus-host disease by
anti-interleukin-2 receptor monoclonal antibody in genoidentical bone marrow
transplantation setting.

Ozsahin H, Tuchschmid P, Lauener R, Waldvogel K, Nadal D, Seger RA.

Division of Immunology/Hematology, University Children's Hospital, Zurich,
Switzerland.

A six-year-old boy with homozygous beta-thalassemia in the favorable class 1 risk
group received a bone marrow transplant, from his histocompatible sister. He
developed grade IV skin and eye graft-versus-host disease (GVHD) following
varicella zoster reactivation. Despite the appropriate prophylactic use of
cyclosporin A (CsA), methotrexate (MTX), and prompt treatment with high-dose
steroids, GVHD progressed resulting in total body epidermal necrolysis. Anti-IL-2
receptor monoclonal antibodies (anti-IL-2R moAb) in combination with steroids
were administered to selectively block the activated T cells. After 27 days of
daily administration, followed by 17 doses of alternate-day therapy with
anti-IL-2R moAb, the severe skin and eye GVHD resolved. The patient, at two years
posttransplant, has full engraftment and immune reconstitution without chronic
GVHD (cGVHD). In conclusion, we suggest that in the HLA-genoidentical bone marrow
transplantation setting, very severe and steroid-resistant GVHD can be controlled
through the use of anti-IL-2 receptor antibodies which specifically block the
activated IL-2 receptor expressing T cells.

Publication Types: 
    Case Reports

PMID: 9677728 [PubMed - indexed for MEDLINE]

3685: Klin Monatsbl Augenheilkd. 1998 May;212(5):388-91.

[Clinical evaluation of impression cytology in diagnosis of superficial viral
infections]

[Article in German]

Thiel MA, Bossart W, Bernauer W.

Universitatsaugenklinik Zurich.

BACKGROUND: Impression cytology is a non invasive technique for the diagnosis of 
external eye disease. As infected epithelial cells are losing their adhesion to
neighbouring cells they are an ideal target for impression cytology. Despite its 
diagnostic potential impression cytology has not yet become a routine diagnostic 
tool because of technical inconvenience in use of conventional membranes. The aim
of this study was to evaluate a practicable technique of impression cytology for 
the rapid diagnosis of superficial viral eye disease. MATERIAL AND METHODS: 52
patients with suspected viral conjunctivitis or keratitis underwent impression
cytology with a Biopore membrane device. After air fixation immunologic detection
tests using either peroxidase antiperoxidase or fluorescent techniques were
performed directly on the membrane. RESULTS AND CONCLUSIONS: 21 of 38 patients
with suspected Herpes-simplex-virus (HSV), 3 of 4 patients with suspected
Varicella-Zoster-virus (VZV) and 2 of 10 patients with suspected Adenovirus
infection had a positive result on the impression cytology membrane. These
results were confirmed by virus cultures or polymerase chain reactions (PCR) a
few days later. No patient with a negative impression cytology had a positive
culture result. Using impression cytology and an immunodetection test results
became available within 1 to 4 hours. CONCLUSIONS: Impression cytology combined
with immunologic detection tests is a rapid, sensitive and practicable diagnostic
test for superficial viral eye diseases.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 9677587 [PubMed - indexed for MEDLINE]

3686: Klin Monatsbl Augenheilkd. 1998 May;212(5):353-5.

[Varicella zoster virus and atypical necrotizing retinopathies in HIV and AIDS
patients]

[Article in German]

Pedroli GL, Garweg JG, Imesch P, Bohnke M.

Universitats-Augenklinik, Inselspital, Bern.

BACKGROUND: Necrotizing retinopathies of suspected viral origin, but which do not
meet the criteria for either CMV-retinitis or acute retinal necrosis syndrome,
have been grouped together under the term atypical necrotizing retinopathies.
Nothing is known about their etiology. PATIENTS AND METHODS: Aqueous humor
samples were drawn from two HIV-positive and eight patients with AIDS presenting 
with an atypical necrotizing retinopathy, additionally from six patients with
acute retinal necrosis syndrome and 28 patients with active CMV-retinitis at the 
time of diagnosis as well as from thirty healthy controls at surgery. All samples
underwent DNA extraction and amplification for viral DNA of HSV-1, VZV and CMV.
RESULTS: VZV-DNA was detected in seven of nine aqueous humor samples derived from
patients with atypical necrotizing retinopathies and in four of six samples from 
patients with acute retinal necrosis syndrome, but not in any one from the 28
patients with CMV retinitis. In the latter group, CMV DNA was detectable in 23
samples, in two of these additionally HSV-1 DNA. No viral DNA was amplified from 
any of the samples from healthy controls. CONCLUSIONS: Varicella zoster virus ist
the leading cause of atypical necrotizing retinopathies. This should be
considered in the antiviral chemotherapy. Moreover, we were able to establish the
diagnosis using DNA amplification for the viruses of the herpes family
irrespective of the etiology in 80% of necrotizing retinopathies.

Publication Types: 
    English Abstract

PMID: 9677577 [PubMed - indexed for MEDLINE]

3687: Cent Afr J Med. 1998 Feb;44(2):31-4.

Oral manifestations in 100 Zimbabwean HIV/AIDS patients referred to a specialist 
centre.

Jonsson N, Zimmerman M, Chidzonga MM, Jonsson K.

Department of Dentistry, Karolinska Institutet, Stockholm, Sweden.

OBJECTIVE: To document the prevalence, age, sex ratio and clinical features of
oral lesions associated with HIV/AIDS among patients referred to the two largest 
specialist centres in Zimbabwe. DESIGN: Prospective study. SETTING: University
Hospital. SUBJECTS: 100 consecutive patients with oral manifestations of HIV/AIDS
were interviewed and examined by Dental Surgeons and Physicians. METHODS:
Inspection and palpation of head and neck was done in all cases. Examination of
the oral cavity and oropharynx with torchlight and wooden spatula was performed
and lesions recorded according to WHO recording form for oral lesions possibly
related to HIV infection. RESULTS: The median age was 35 years (range 19 to 66
years). The male to female ratio was 4:1. General symptoms and signs found were: 
weight loss in 52, diarrhoea in 34, lymphadenopathy in 21 and Herpes zoster in 12
patients. Ninety two patients had oral lesions of some sort. These consisted of: 
oral ulcerations in 26, candidiasis in 22, osteomyelitis in three, necrotizing
gingivitis in two and herpetic gingivostomatitis in one patient. Neoplasms
recorded were: Kaposi's sarcoma in 72 patients, squamous cell carcinoma in two
patients. Four other tumours not associated with HIV/AIDS were found. No hairy
leukoplakia was found in this study. CONCLUSIONS: The peak prevalence was in the 
age group 31 to 40 years with a male dominance of 4:1. The most frequent lesion
was Kaposi's sarcoma, M:F ratio 3:1, followed by oral ulcers and candidiasis.

PMID: 9675968 [PubMed - indexed for MEDLINE]

3688: Allergol Immunopathol (Madr). 1998 May-Jun;26(3):144-50.

[Prevention and treatment of opportunistic infections]

[Article in Spanish]

Nevot Falco S, Bartralot Soler J.

Servicio de Pediatria, Seccion de Alergia, Hospital General de Manresa.

An opportunist infection (OI) is understood to be an infection produced by
microorganisms that invade a host with impaired immune capacity, such as children
with HIV infection. The adequate treatment and chemoprophylaxis of these
infections has improved the prognosis of their evolution, although they still
present a high morbidity and mortality when they occur. In this sense, the
introduction of triple therapy (new antiretroviral inhibitors and protease
inhibitors) is likely to produce a prompt decrease in the incidence of OI because
of the regression in the degree of immunosuppression that it induces. The degree 
of immunosuppression is determined by the number of CD4 lymphocytes, the most
reliable marker for assessment. Normal CD4 lymphocytes values are different for
each age group and have important connotations for the prophylactic measures to
be used at each moment depending on the CD4 lymphocyte count. Opportunist
infections influence the quality of life of patients. More than 100
microorganisms, including bacteria, viruses, fungi and protozoa, cause OI. This
paper describes primary and secondary prophylaxis as well as the treatment of the
most frequent opportunist infections (Pneumocystis carinii pneumonia, bacterial
infections, Cryptococcus neoformans, Cytomegalovirus, Herpes simple,
Varicella-zoster virus. Toxoplasmosis, Mycobacterium tuberculosis, M.
avium-intracellulare, M. kansasii).

Publication Types: 
    English Abstract
    Review

PMID: 9675398 [PubMed - indexed for MEDLINE]

3689: J Clin Epidemiol. 1998 Jul;51(7):533-5.

The varicella-zoster virus and multiple sclerosis.

Ross RT.

Department of Medicine, University of Manitoba, and The Health Sciences Centre,
Winnipeg, Canada.

This article is a review of the evidence suggesting a unique relationship between
the varicella-zoster virus (as a possible antigen or antigen mimic) and multiple 
sclerosis (MS). Both MS and varicella have increased prevalences in temperate
zones and both are rare in countries closer to the equator. Migration studies
suggest an infectious agent acquired prior to age 14 plays a role in the risk of 
subsequent MS. Hutterites, who educate their children at home, have less
varicella, MS, and herpes zoster than their neighbors and have the appropriate
reduced varicella-zoster seropositivity matching these clinical observations.
Paradoxically, patients with MS report more herpes zoster, and at an earlier age 
and more often, than a group of non-MS patients.

Publication Types: 
    Review

PMID: 9674659 [PubMed - indexed for MEDLINE]

3690: Dtsch Med Wochenschr. 1998 Jun 19;123(25-26):803-6.

[Periorbital pain syndrome. I. Differential diagnosis]

[Article in German]

Forderreuther S, Straube A.

Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universitat Munchen.
sfoe@nefo.med.uni-muenchen.de

Publication Types: 
    Review

PMID: 9672488 [PubMed - indexed for MEDLINE]

3691: J R Coll Physicians Lond. 1998 May-Jun;32(3):199-202.

Update on herpesvirus infections.

Griffiths P.

Royal Free Hospital School of Medicine, London.

Publication Types: 
    Comparative Study
    Review

PMID: 9670143 [PubMed - indexed for MEDLINE]

3692: Dermatology. 1998;196(4):442-6.

Low-productive alpha-herpesviridae infection in chronic lichenoid dermatoses.

Nikkels AF, Sadzot-Delvaux C, Rentier B, Pierard-Franchimont C, Pierard GE.

Department of Dermatopathology, University of Liege, Belgium.

BACKGROUND: Herpes simplex virus (HSV) and Varicella-zoster virus (VZV) are
responsible for various atypical mucocutaneous manifestations in the
immunosuppressed population. One of the causative pathomechanisms suggests an
altered virus-host cell relationship. OBJECTIVE/METHODS: This report investigates
by histology, immunohistochemistry and in situ hybridization the histological and
virological features of 6 protracted, indolent HSV infections and 2 prolonged
zoster infections. RESULTS: Histopathology revealed a lichenoid dermatitis in all
patients. Specific HSV-1, HSV-2 and VZV in situ hybridization proved the viral
origin of the cutaneous lesions. Immunohistochemical assessment demonstrated the 
intracellular presence of the HSV glycoproteins gB, gC and gD in epidermal
keratinocytes which did not exhibit cytolysis. Similar findings were obtained for
the VZV gE and gB. CONCLUSION: These results suggest that in some instances HSV
and VZV infections may present a protracted disease course associated with a
lichenoid inflammatory pattern and a non-cytolytic virus-host cell relationship.

PMID: 9669126 [PubMed - indexed for MEDLINE]

3693: Br J Dermatol. 1998 May;138(5):921-2.

Lichen simplex chronicus as a complication of herpes zoster.

Gerritsen MJ, Gruintjes FW, Andreissen MA, van der Valk PG, van de Kerkhof PC.

Publication Types: 
    Case Reports
    Letter

PMID: 9666859 [PubMed - indexed for MEDLINE]

3694: Med Clin (Barc). 1998 Jun 13;111(1):19-22.

[Abdominal pain as the initial symptom of visceral varicella zoster infection in 
hematopoietic stem cell transplant recipients]

[Article in Spanish]

Munoz L, Balmana J, Martino R, Sureda A, Rabella N, Brunet S.

Unidad de Hematologia Clinica, Hospital de la Santa Creu i Sant Pau, Barcelona.

Varicella zoster virus (VZV) infections are an important cause of morbidity after
stem cell transplantation (SCT), with no differences in their overall incidence
between allogeneic and autologous transplants. We report four patients who
developed a disseminated VZV infection with visceral involvement after an
allogeneic (n = 3) or autologous (n = 1) SCT. In all 4 cases, the initial symptom
was severe abdominal pain which preceded the appearance of the classical herpetic
vesicular skin lesions from two to four days in three cases, while one never
developed skin lesions. The interval from the transplant to the infection ranged 
from 5 to 13 months, and all three allogeneic SCT received a T-cell depleted
graft, although two suffered from chronic GVHD. All patients had clinical,
radiologic and/or biochemical findings indicative of gastrointestinal or visceral
involvement. An extensive bibliography review of this specific form of
presentation of disseminated VZV infection is presented. The interval from the
abdominal pain to the development of the skin lesions has ranged from one to 10
days, and this has led to a delay in the initiation of specific antiviral therapy
in many cases, including our only fatal case. We conclude that an abdominal pain 
of unknown origin in this particular clinical setting should always be regarded
as a possible prodromal phase of a disseminated VZV infection.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 9666431 [PubMed - indexed for MEDLINE]

3695: Ophthalmology. 1998 Jul;105(7):1323-30.

Detection of varicella zoster virus DNA and viral antigen in human eyes after
herpes zoster ophthalmicus.

Wenkel H, Rummelt V, Fleckenstein B, Naumann GO.

Department of Ophthalmology, University of Erlangen-Nurnberg, Germany.

OBJECTIVE: The purpose of the study was to identify varicella zoster virus (VZV) 
DNA and viral antigen in human eyes at various intervals after clinical onset of 
herpes zoster ophthalmicus (HZO). DESIGN: A retrospective case series.
PARTICIPANTS: There were 9 eyes and 4 corneal buttons surgically obtained from 13
patients with HZO at the University Eye Hospital of Erlangen-Nurnberg between
1984 and 1994. Specimens were examined at different timepoints after clinical
onset of HZO (range, 1 day-19 years; median, 36 months). METHODS: Histopathologic
evaluation was performed on formalin-fixed and paraffin-embedded tissue by
routine histology, immunohistochemistry (5-B-7 murine monoclonal antibody to VZV;
peroxidase-antiperoxidase method), and DNA-in situ hybridization (35S
deoxyadenosine triphosphate-labeled HindIII fragments [A and C] of VZV). RESULTS:
Typical histopathologic changes associated with HZO were identified:
vascularization of the corneal stroma (11 of 13), granulomatous reaction to
Descemet's membrane (8 of 13), fusiform-shaped ciliary scarring (5 of 9), optic
neuritis (4 of 9), and perineuritis (8 of 9) and perivasculitis (8 of 9) of the
long posterior ciliary nerves and arteries. VZV antigen was detected in two
patients with acute infection 1 and 7 days after onset of HZO, respectively.
VZV-DNA was identified in seven patients up to 10 years after onset of HZO in
corneal epithelial cells (2 of 13), corneal stroma (5 of 13), inflammatory
infiltrate of the anterior chamber (1 of 9), episclera (2 of 9), posterior
ciliary nerves (1 of 9) and arteries (5 of 9), optic nerve (5 of 9), and adjacent
leptomeninges (2 of 9). CONCLUSION: Persistence of viral genomes, most likely
accompanied by gene expression or slow viral replication, appears to be
responsible for the often smoldering panophthalmitis and the chronic recurrent
keratouveitis in patients with HZO. Localization of viral DNA in vascular
structures suggests a role for vasculitis in the pathogenesis of some ocular
findings associated with HZO.

Publication Types: 
    Case Reports

PMID: 9663241 [PubMed - indexed for MEDLINE]

3696: Anesth Analg. 1998 Jul;87(1):116-8.

Methicillin-resistant Staphylococcus aureus sepsis resulting from infection in
paravertebral muscle after continuous epidural infusion for pain control in a
patient with herpes zoster.

Iseki M, Okuno S, Tanabe Y, Mitsuhata H, Miyazaki T.

Department of Anesthesiology, Juntendo University School of Medicine, Tokyo,
Japan.

Publication Types: 
    Case Reports

PMID: 9661558 [PubMed - indexed for MEDLINE]

3697: Antimicrob Agents Chemother. 1998 Jul;42(7):1666-70.

Antiherpesvirus activities of
(1'S,2'R)-9-[[1',2'-bis(hydroxymethyl)cycloprop-1'-yl]methyl]guanine (A-5021) in 
cell culture.

Iwayama S, Ono N, Ohmura Y, Suzuki K, Aoki M, Nakazawa H, Oikawa M, Kato T,
Okunishi M, Nishiyama Y, Yamanishi K.

Life Science Laboratories, Ajinomoto Co., Inc., Yokohama, Japan.
II_iwayama@te3.ajinomoto.co.jp

Antiherpetic activity of
(1'S,2'R)-9-([1',2'-bis(hydroxymethyl)cycloprop-1'yl]methyl)guanine (A-5021) was 
compared with those of acyclovir (ACV) and penciclovir (PCV) in cell cultures. In
a plaque reduction assay using a selection of human cells, A-5021 showed the most
potent activity in all cells. Against clinical isolates of herpes simplex virus
type 1 (HSV-1, n = 5) and type 2 (HSV-2, n = 6), mean 50% inhibitory
concentrations (IC50s) for A-5021 were 0.013 and 0.15 microgram/ml, respectively,
in MRC-5 cells. Corresponding IC50s for ACV were 0.22 and 0.30 microgram/ml, and 
those for PCV were 0.84 and 1.5 micrograms/ml, respectively. Against clinical
isolates of varicella-zoster virus (VZV, n = 5), mean IC50s for A-5021, ACV, and 
PCV were 0.77, 5.2, and 14 micrograms/ml, respectively, in human embryonic lung
(HEL) cells. A-5021 showed considerably more prolonged antiviral activity than
ACV when infected cells were treated for a short time. The selectivity index, the
ratio of 50% cytotoxic concentration to IC50, of A-5021 was superior to those of 
ACV and PCV for HSV-1 and almost comparable for HSV-2 and VZV. In a growth
inhibition assay of murine granulocyte-macrophage progenitor cells, A-5021 showed
the least inhibitory effect of the three compounds. These results show that
A-5021 is a potent and selective antiviral agent against HSV-1, HSV-2, and VZV.

PMID: 9661001 [PubMed - indexed for MEDLINE]

3698: Aust N Z J Public Health. 1998 Jun;22(4):413-8.

Erratum in:
    Aust N Z J Public Health 1998 Aug;22(5):630.

Varicella-zoster virus infection in Australia.

Chant KG, Sullivan EA, Burgess MA, Ferson MJ, Forrest JM, Baird LM, Tudehope DI, 
Tilse M.

South Western Sydney Public Health Unit, New South Wales.

OBJECTIVE: To determine the epidemiology of varicella-zoster virus (VZV)
infection in Australia using currently available data sources. DESIGN: Analysis
of national death data (23 years), congenital and neonatal cases (one year) and
attendances at sentinel general practices (two years); hospital admissions in NSW
and SA (six years); serological studies in 1995 involving antenatal clinics in
Sydney and Brisbane and child-care centre staff and refugees in Sydney; and
case-ascertainment in 1995 in South Western Sydney among public hospital staff,
child-care centre staff and the community. RESULTS: In Australia, there have been
an average of 3.5 deaths from chickenpox (mostly children) and 11 from herpes
zoster (mostly older people) each year since 1980. The crude death rate for
chickenpox has declined (p > 0.05). In 1995, there were 14 cases of neonatal and 
two of congenital varicella. Average annual admission rates for NSW and SA showed
1,200 hospital bed-days used for chickenpox, more than 20% with complications,
and more than 7,300 bed days for zoster; annually more than 880 in-patient
admissions were complicated by VZV. Most people encounter the virus in their
first 15 years, but some remain susceptible into their 20s; 25% of cases and 37% 
of hospital admissions for chickenpox occur in people > or = 15 years of age.
CONCLUSION: VZV infection involves people of all ages. It causes substantial
morbidity and mortality, particularly at the extremes of life. The death rate
from chickenpox but not zoster has fallen since the introduction of acyclovir in 
the 1980s. Surveillance of VZV infection must be given priority once vaccines
become available, to monitor changes in morbidity and mortality.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9659764 [PubMed - indexed for MEDLINE]

3699: J Infect Dis. 1998 Jul;178(1):35-8.

Identification of the Oka strain of the live attenuated varicella vaccine from
other clinical isolates by molecular epidemiologic analysis.

Mori C, Takahara R, Toriyama T, Nagai T, Takahashi M, Yamanishi K.

Research Foundation for Microbial Diseases, Osaka University, Kannonji, Japan.

A method was developed to distinguish the Oka vaccine strain of varicella-zoster 
virus (VZV) from other clinical isolates. The molecular characteristics of 52
clinical isolates from varicella or zoster patients with no history of VZV
vaccination and the Oka strain, including vaccine and parental viruses, were
analyzed by PstI cleavage of the PstI site-less (PSL) region. This was followed
by single-strand conformational polymorphism (SSCP) after polymerase chain
reaction amplification of repeating region 2 (R2). Most of the clinical isolates 
tested, especially recent isolates, had a PstI site in the PSL region, but the
Oka strain did not. The SSCP patterns of R2 in Oka strain virus differed from
those of other viruses. These results suggest that analysis of the PstI site
followed by SSCP of R2 will be useful for identifying the Oka vaccine virus in
isolates.

PMID: 9652420 [PubMed - indexed for MEDLINE]

3700: J Infect Dis. 1998 Jul;178(1):27-34.

T cells specific for the triggering virus infiltrate the eye in patients with
herpes simplex virus-mediated acute retinal necrosis.

Verjans GM, Feron EJ, Dings ME, Cornelissen JG, Van der Lelij A, Baarsma GS,
Osterhaus AD.

Rotterdam Eye Hospital, and Institute of Virology, Erasmus University Rotterdam, 
The Netherlands. Verjans@viro.fgg.eur.nl

Acute retinal necrosis (ARN) is a rare, potentially blinding retinal disease
resulting from ocular infections with herpes simplex virus (HSV) or
varicella-zoster virus (VZV). To determine the antigen specificity and functional
characteristics of ocular infiltrating T cells in ARN, T cells were isolated and 
expanded nonspecifically from intraocular fluid (IOF) samples from 2 patients
with HSV-1- and 3 with VZV-mediated ARN. HSV-specific T cell reactivity could be 
detected only in the IOF-derived T cell lines (TCLs) of the 2 patients with
HSV-mediated ARN. These TCLs consisted of both HSV type-common and type-specific 
CD4+ and CD8+ T cell clones (TCCs) with differential T cell receptor usage.
Irrespective of their phenotype, the TCCs were cytolytic and secreted
interferon-gamma, tumor necrosis factor-alpha, interleukin-4, and interleukin-5. 
In both patients, the antigen specificity of a substantial number of
HSV-1-specific TCCs could be mapped to approximately 0.67-0.73 HSV-1 map units.
The data presented suggest the contribution of T cells, specific for the
triggering virus, to the pathogenesis of ARN.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9652419 [PubMed - indexed for MEDLINE]

3701: Johns Hopkins Med Lett Health After 50. 1998 Jul;10(5):3.

Taking the sting out of shingles.

[No authors listed]

PMID: 9650524 [PubMed - indexed for MEDLINE]

3702: Int J Dermatol. 1998 Jun;37(6):476-7.

Zosteriform skin metastases from breast carcinoma in association with herpes
zoster.

Cecchi R, Brunetti L, Bartoli L, Pavesi M, Giomi A.

Publication Types: 
    Case Reports
    Letter

PMID: 9646143 [PubMed - indexed for MEDLINE]

3703: Int J Dermatol. 1998 Jun;37(6):465-8.

Jaipur block in postherpetic neuralgia.

Bhargava R, Bhargava S, Haldia KN, Bhargava P.

Department of Dermatology, SMS Medical College, Jaipur, India.

BACKGROUND: Postherpetic neuralgia, a common sequele to herpes zoster infection, 
is a chronic debilitating problem. The available therapeutic modalities are
usually ineffective. METHODS: A total of 3960 patients (1326 women and 2634 men; 
age group, 21-84 years), with postherpetic neuralgia as the presenting complaint 
and with pain lasting from 2 months to 5 years, were treated with Jaipur block,
consisting of local subcutaneous infiltration of 2% xylocaine, 0.5% bupivacaine, 
and 4 mg/mL dexamethasone solution. Patients were followed up at six-weekly
intervals with subsequent injections given in non-responders. RESULTS:
Twenty-eight per cent of patients obtained complete relief from pain after a
single injection, another 57% after a second injection, and 11% after a third
injection; 4% of patients did not respond to treatment. The non-responders were
either old (over 60 years) or had pain lasting for more than 2 years. The
response to therapy was similar in both sexes. There were 31 left-handed patients
in this study. Pain was less severe in left-handed patients and they obtained
complete relief after a single injection. Side-effects including giddiness and
sweating were seen, occasionally, in a few patients. CONCLUSIONS: Ninety six per 
cent of patients obtained complete relief after the block with a follow-up of up 
to 19 years.

Publication Types: 
    Clinical Trial

PMID: 9646140 [PubMed - indexed for MEDLINE]

3704: Retina. 1998;18(2):164-8.

Findings of retinitis on gadolinium-enhanced turbo fluid-attenuated inversion
recovery images.

Bahn MM, Gordon RE, Wippold FJ 2nd, Grand MG.

Mallinckrodt Institute of Radiology, Washington University Medical Center, St.
Louis, Missouri 63110, USA.

PURPOSE: This study sought to determine the findings of retinal inflammation on
gadolinium-enhanced turbo fluid-attenuated inversion recovery (tFLAIR) images.
METHODS: Five patients with retinal abnormalities (acquired immunodeficiency
syndrome complicated by cytomegalovirus retinitis, two patients; lymphoma
complicated by Herpes zoster retinitis, one patient; and diabetic retinopathy,
two patients) were identified on routine brain magnetic resonance imaging
examinations performed with gadolinium-enhanced tFLAIR; five healthy subjects
were retrospectively reviewed for comparison. Retinal signal features and
thickness were evaluated comparing gadolinium-enhanced tFLAIR with turbo
spin-echo T2-weighted and spin-echo T1-weighted images with and without
gadolinium. RESULTS: Abnormal retinal thickening and hyperintensity were most
conspicuous on gadolinium-enhanced tFLAIR images. Unenhanced T1-weighted images
failed to demonstrate any abnormalities. In the enhanced tFLAIR and T1-weighted
images, retinal thickness greater than 1.2 mm was abnormal. Abnormal retinal
contour and signal was most apparent on the tFLAIR images. CONCLUSIONS: Of the
sequences studied, gadolinium-enhanced tFLAIR images were found to be the best in
identifying incidental retinitis and diabetic retinopathy discovered on routine
brain magnetic resonance imaging examinations.

PMID: 9564699 [PubMed - indexed for MEDLINE]

3705: J Endod. 1998 Feb;24(2):143-4.

Herpes zoster infection as a differential diagnosis of acute pulpitis.

Lopes MA, de Souza Filho FJ, Jorge Junior J, de Almeida OP.

Faculty of Odontology, University of Campinas, Sao Paulo, Brazil.

Many diseases can cause orofacial pain, and the diagnosis must be established
before final treatment. This case report presents a patient with orofacial pain
that was diagnosed as an acute pulpitis. However, there was no evidence of this
problem on examination. After 4 days, the patient showed multiples vesicles on
the face, and a herpes zoster viral infection was diagnosed. The patient was
treated with acyclovir and, after 2 yr, she still complains of facial
sensitivity.

Publication Types: 
    Case Reports

PMID: 9641149 [PubMed - indexed for MEDLINE]

3706: J Dermatol. 1998 May;25(5):347-8.

Recurrent herpes zoster.

Horiuchi Y.

Division of Dermatology, Tsukuba Memorial Hospital, Ibaraki, Japan.

Publication Types: 
    Case Reports

PMID: 9640892 [PubMed - indexed for MEDLINE]

3707: Br J Dermatol. 1998 Apr;138(4):714-5.

Hyperkeratotic varicella zoster virus infection in an HIV-infected patient.
Successful treatment of persistent lesions with cryosurgery.

Schofer H, Baur SI, Gregel C, Wolter M, Milbradt R.

Publication Types: 
    Case Reports
    Letter

PMID: 9640393 [PubMed - indexed for MEDLINE]

3708: Br J Ophthalmol. 1998 Apr;82(4):423-8.

Ocular complications of heart, lung, and liver transplantation.

Ng P, McCluskey P, McCaughan G, Glanville A, MacDonald P, Keogh A.

Department of Ophthalmology, Royal Prince Alfred Hospital, Sydney, Australia.

AIM: To document the nature and frequency of ocular complications in a large
group of patients who underwent heart, lung, or liver transplantation. METHODS: A
retrospective audit of the medical records of all patients undergoing heart,
lung, or combined heart-lung transplantation at St Vincent's Hospital, Sydney, or
liver transplantation at Royal Prince Alfred Hospital Sydney, was performed to
detect patients with symptomatic ocular complications following transplantation. 
19 of 860 patients were identified as having ocular complications. RESULTS:
Ocular complications occurred in 2% of patients with 65% of these being
opportunistic infections. Herpes group viral retinitis (77%) and fungal
chorioretinitis (22%) were seen. Other complications included choroidal
pseudolymphoma, central retinal vein occlusion, herpes zoster ophthalmicus,
herpetic keratitis, dacryocystitis, cyclosporin retinopathy, and rifabutin
associated uveitis. CONCLUSION: Herpes group viral retinitis was the most common 
ocular opportunistic infection and occurred most frequently during the second
year after transplantation. Delayed diagnosis was associated with poor visual
outcome.

PMID: 9640194 [PubMed - indexed for MEDLINE]

3709: Am J Infect Control. 1998 Jun;26(3):369-81; quiz 382-4.

Varicella-zoster virus: infection, control, and prevention.

Stover BH, Bratcher DF.

Kosair Children's Hospital, Clinical Information Management Department, Alliant
Health System, Louisville, Ky., USA.

Varicella-zoster virus is a herpes virus that produces a primary infection,
chickenpox, manifested by a vesicular eruption and is considered one of the
common childhood infectious diseases. After the initial infection the virus
becomes latent, then when activated it is manifested as herpes zoster, commonly
known as shingles. This highly communicable human disease is associated with
serious morbidity and significant mortality, particularly among the
immunocompromised. When introduced in the hospital, significant disruptions occur
and serious sequelae may results. Recently, a live virus varicella vaccine was
approved by the Food and Drug Administration in the United States. Studies have
shown the vaccine to be safe and effective. Widespread use of this vaccine may be
beneficial in reducing the opportunities for varicella-zoster virus introductions
in health care settings.

Publication Types: 
    Review

PMID: 9638300 [PubMed - indexed for MEDLINE]

3710: Ir J Med Sci. 1998 Apr-Jun;167(2):74-8.

Post herpetic neuralgia: a review.

Griffin MJ, Chambers FA, MacSullivan R.

Department of Pain Management and Anaesthesia, Mater Misericordiae Hospital,
Dublin.

Publication Types: 
    Review

PMID: 9638018 [PubMed - indexed for MEDLINE]

3711: Neurology. 1998 Jun;50(6):1922-3.

Possible postherpetic neuralgia first occurring seven years after herpes zoster.

Lampl C, Neuner L, Klingler D.

Department of Neurology, General Hospital Linz, Austria.

Publication Types: 
    Case Reports

PMID: 9633769 [PubMed - indexed for MEDLINE]

3712: Neurology. 1998 Jun;50(6):1837-41.

Efficacy of oxycodone in neuropathic pain: a randomized trial in postherpetic
neuralgia.

Watson CP, Babul N.

Department of Medicine, University of Toronto, Ontario, Canada.

OBJECTIVE: Although opioid analgesics are used in the management of neuropathic
pain syndromes, evidence of their efficacy remains to be established. We
evaluated the clinical efficacy and safety of oxycodone in neuropathic pain using
postherpetic neuralgia as a model. METHODS: Patients with postherpetic neuralgia 
of at least moderate intensity were randomized to controlled-release oxycodone 10
mg or placebo every 12 hours, each for 4 weeks, using a double-blind, crossover
design. The dose was increased weekly up to a possible maximum of 30 mg every 12 
hours. Pain intensity and pain relief were assessed daily, and steady (ongoing)
pain, brief (paroxysmal) pain, skin pain (allodynia), and pain relief were
recorded at weekly visits. Clinical effectiveness, disability, and treatment
preference were also assessed. RESULTS: Fifty patients were enrolled and 38
completed the study (16 men, 22 women, age 70+/-11 years, onset of postherpetic
neuralgia 31+/-29 months, duration of pain 18+/-5 hours per day). The oxycodone
dose during the final week was 45+/-17 mg per day. Compared with placebo,
oxycodone resulted in pain relief (2.9+/-1.2 versus 1.8+/-1.1, p=0.0001) and
reductions in steady pain (34+/-26 versus 55+/-27 mm, p=0.0001), allodynia
(32+/-26 versus 50+/-30 mm, p=0.0004), and paroxysmal spontaneous pain (22+/-24
versus 42+/-32 mm, p=0.0001). Global effectiveness, disability, and masked
patient preference all showed superior scores with oxycodone relative to placebo 
(1.8+/-1.1 versus 0.7+/-1.0, p=0.0001; 0.3+/-0.8 versus 0.7+/-1.0, p=0.041; 67%
versus 11%, p=0.001, respectively). CONCLUSIONS: Controlled-release oxycodone is 
an effective analgesic for the management of steady pain, paroxysmal spontaneous 
pain, and allodynia, which frequently characterize postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9633737 [PubMed - indexed for MEDLINE]

3713: Biochim Biophys Acta. 1998 May 11;1397(3):268-74.

Cell type specific repression of the varicella zoster virus immediate early gene 
62 promoter by the cellular Oct-2 transcription factor.

Patel Y, Gough G, Coffin RS, Thomas S, Cohen JI, Latchman DS.

Department of Molecular Pathology, Windeyer Institute of Medical Sciences,
University College London Medical School, The Windeyer Building, 46 Cleveland
Street, London W1P 6DB, UK.

The cellular transcription factor Oct-2.1 has previously been shown to repress
the transactivation of the varicella zoster virus (VZV) immediate early gene
promoter by viral transactivators but not to inhibit its basal activity. In the
case of the related virus herpes simplex virus (HSV), the effect of Oct-2 on the 
IE promoters has been shown to be cell type specific and to differ between the
different alternatively spliced forms of Oct-2. Here we show that as well as
Oct-2.1, the Oct-2.4 and 2.5 isoforms which are expressed in neuronal cells can
inhibit transactivation of the VZV immediate early promoter regardless of the
cell type used. In contrast, all the isoforms of Oct-2 can inhibit basal activity
of the VZV promoter in neuronal cells but not in other cell types indicating that
this effect is cell type specific. These effects are discussed in terms of the
differential regulation of latent infections with HSV or VZV in dorsal root
ganglia.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9582435 [PubMed - indexed for MEDLINE]

3714: J Antimicrob Chemother. 1998 May;41(5):549-56.

A randomized controlled trial of acyclovir versus netivudine for treatment of
herpes zoster. International Zoster Study Group.

Soltz-Szots J, Tyring S, Andersen PL, Lucht RF, McKendrick MW, Diaz Perez JL,
Shukla S, Fiddian AP.

Department of Dermatology, Hospital Rudolfstiftung and Ludwig Boltzmann Institute
of Research on Infectious Dermato- and Venerological Diseases, Vienna, Austria.

Oral acyclovir has become the standard of care for treatment of acute herpes
zoster. Netivudine is a novel antiviral with greater in-vitro activity against
varicella zoster virus. It was compared with acyclovir in a randomized,
double-blind, controlled trial in immunocompetent adults with herpes zoster.
Patients with rash for less than 72 h were assigned to receive either acyclovir
or netivudine, then assessed regularly for 6 months. No evidence for a dose
response with netivudine was found, so intent-to-treat analyses of all 511
enrolled patients compared acyclovir with netivudine. The time to complete
cessation of pain (P = 0.007) and to cessation of moderate to excruciating pain
(P = 0.005) was accelerated in acyclovir recipients. Rash outcomes and adverse
event profiles were similar for both treatments. This study has confirmed the
efficacy of acyclovir in decreasing the duration and severity of pain following
herpes zoster. Greater in-vitro activity of newer agents may not necessarily
provide greater benefit in humans.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9630408 [PubMed - indexed for MEDLINE]

3715: Eur J Clin Microbiol Infect Dis. 1998 Feb;17(2):120-3.

Diagnosis of herpetic keratoconjunctivitis by nested polymerase chain reaction in
human tear film.

Hidalgo F, Melon S, de Ona M, Do Santos V, Martinez A, Cimadevilla R, Rodriguez
M.

Servicio de Microbiologia 1, Hospital Central de Asturias, Seccion de Virologia, 
Oviedo, Asturias, Spain.

A study was performed to evaluate nested PCR (nPCR) versus viral cultures as
method and tear film versus corneal scrapings as specimen in the diagnosis of
viral keratoconjunctivitis. Tear film specimens were taken from both eyes and
corneal scrapings from the affected eye only in 17 patients with suspected viral 
keratoconjunctivitis. In 15 of the 17 patients the viral agent of the infection
could be detected: 11 patients had herpes simplex virus type 1, two
varicella-zoster virus, one both herpes simplex virus type 1 and varicella-zoster
virus, and one adenovirus. Overall there was no significant difference between
the detection rate for corneal scrapings (85%) and tear film (75%). In both types
of specimens nPCR showed a higher detection rate than viral cultures (corneal
scrapings: 87.5% vs 31.25%; tear film: 75% vs 12.5%; P 0.05). For the diagnosis
of keratoconjunctivitis nPCR is superior to viral culture and tear film is an
adequate sample that is easier to collect, causing the patient less discomfort.

PMID: 9629979 [PubMed - indexed for MEDLINE]

3716: An Esp Pediatr. 1998 Apr;48(4):425-6.

[Ramsay-Hunt syndrome in infancy. Apropos of a case]

[Article in Spanish]

Fleta Zaragozano J, Royo Lopez J, Ruiz Pastora R, Baselga Asensio C, Bueno
Sanchez M.

Departamento de Pediatria, Hospital Clinico Universitario Lozano Blesa,
Universidad de Zaragoza.

Publication Types: 
    Case Reports

PMID: 9629806 [PubMed - indexed for MEDLINE]

3717: Ophthalmology. 1998 Jun;105(6):1120-3.

Comment in:
    Ophthalmology. 1999 Feb;106(2):210-1.

Conjunctival flaps.

Alino AM, Perry HD, Kanellopoulos AJ, Donnenfeld ED, Rahn EK.

Department of Ophthalmology, Nassau County Medical Center, East Meadow, New York,
USA.

PURPOSE: The authors reviewed their experience with total conjunctival flaps
(TCF) and partial conjunctival flaps (PCF) for the past 5 years in 61 patients.
METHODS: Forty-eight patients had TCF and 13 had PCF. Diagnoses for surgery
included severe bullous keratopathy for chronic graft failure (not candidates for
keratoplasty) (19), herpes zoster ophthalmicus (7), chronic ulcerative keratitis 
(14), neurotrophic keratitis (2), and herpes simplex keratitis (9). RESULTS:
There were seven complications. Four flap retractions occurred in the TCF group, 
requiring resuturing in two. Three complications occurred in the PCF group. One
patient had two flap retractions and recurrent ulceration, requiring
tarsorrhaphy. One patient with PCF suffered a perforation after flap retraction, 
necessitating penetrating keratoplasty. CONCLUSION: The authors believe
conjunctival flaps are underused and should be considered seriously for bullous
keratopathy, neurotrophic keratitis, recalcitrant keratitis, and persistent
nonhealing epithelial defects.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9627666 [PubMed - indexed for MEDLINE]

3718: RN. 1998 May;61(5):80.

Managing the aftermath of shingles.

Scholz MJ.

Northwest Neuroscience Institute, USA.

Publication Types: 
    Case Reports

PMID: 9626020 [PubMed - indexed for MEDLINE]

3719: Proc Natl Acad Sci U S A. 1998 Jun 9;95(12):7080-5.

Aberrant intracellular localization of Varicella-Zoster virus regulatory proteins
during latency.

Lungu O, Panagiotidis CA, Annunziato PW, Gershon AA, Silverstein SJ.

Department of Microbiology, Columbia University College of Physicians and
Surgeons, New York, NY 10032, USA.

Varicella-Zoster virus (VZV) is a herpesvirus that becomes latent in sensory
neurons after primary infection (chickenpox) and subsequently may reactivate to
cause zoster. The mechanism by which this virus maintains latency, and the
factors involved, are poorly understood. Here we demonstrate, by
immunohistochemical analysis of ganglia obtained at autopsy from seropositive
patients without clinical symptoms of VZV infection that viral regulatory
proteins are present in latently infected neurons. These proteins, which localize
to the nucleus of cells during lytic infection, predominantly are detected in the
cytoplasm of latently infected neurons. The restriction of regulatory proteins
from the nucleus of latently infected neurons might interrupt the cascade of
virus gene expression that leads to a productive infection. Our findings raise
the possibility that VZV has developed a novel mechanism for maintenance of
latency that contrasts with the transcriptional repression that is associated
with latency of herpes simplex virus, the prototypic alpha herpesvirus.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9618542 [PubMed - indexed for MEDLINE]

3720: J Med Virol. 1998 Jul;55(3):250-4.

Acyclovir-resistant varicella-zoster virus: phenotypic and genetic
characterization.

Fillet AM, Dumont B, Caumes E, Visse B, Agut H, Bricaire F, Huraux JM.

Virology Department, Pitie-Salpetriere Hospital, Paris, France.

A man with acquired immunodeficiency syndrome (AIDS) developed zoster of the
right arm which was resistant clinically to acyclovir. Varicella-zoster virus
(VZV) was cultured from a skin biopsy performed at the beginning of acyclovir
therapy (isolate 1) and after its failure (isolate 2). The emergence of acyclovir
resistance during treatment was investigated by developing a simple and rapid
drug sensitivity assay based on the plaque reduction reference method. This
late-antigen synthesis reduction assay involved serial dilutions of
cell-associated virus. The 50% inhibitory concentration (IC50) of acyclovir was
16 +/- 7.5 microM for the susceptible reference strain OKA, in agreement with
published data. The acyclovir IC50 increased from 6.5 microM for isolate 1 to 100
microM for isolate 2. In comparison with the sequence of isolate 1, isolate 2 had
a single mutation consisting of a C to T change at position 907 of the thymidine 
kinase gene, which changed a glutamine codon into a stop codon at position 303 of
the thymidine kinase protein. These results show the emergence of acyclovir
resistance through a single previously undescribed mutation in the thymidine
kinase gene, and confirm the heterogeneity of mutations inducing acyclovir
resistance.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9624615 [PubMed - indexed for MEDLINE]

3721: J Am Board Fam Pract. 1998 May-Jun;11(3):224-8.

The use of corticosteroids in the management of herpes zoster.

MacFarlane LL, Simmons MM, Hunter MH.

Department of Family Medicine, Medical University of South Carolina, Charleston
29425, USA.

Publication Types: 
    Review

PMID: 9625514 [PubMed - indexed for MEDLINE]

3722: Clin Infect Dis. 1998 Apr;26(4):839, 981.

Photo quiz I. Varicella zoster virus-associated leukocytoclastic vasculitis.

Singh N, Deng JS.

Department of Medicine, Veterans Affairs Medical Center, Pittsburgh,
Pennsylvania, USA.

Publication Types: 
    Case Reports

PMID: 9564458 [PubMed - indexed for MEDLINE]

3723: Clin Infect Dis. 1998 Apr;26(4):806-10.

Effect of prophylaxis on the clinical manifestations of AIDS-related
opportunistic infections.

Sepkowitz KA.

Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New
York 10021, USA.

Administration of targeted prophylaxis for AIDS-related opportunistic infections 
has contributed significantly to the recent decrease in mortality among patients 
with AIDS in the United States. Most reported prophylaxis trials have focused on 
determining (a) the percentage of cases prevented and (b) the effect of
widespread antibiotic use on drug susceptibility. A third phenomenon that is
seldom reported on is the attenuating effect of failed prophylaxis on the
clinical presentation of opportunistic infections (OIs). With the increasingly
widespread use of prophylaxis for OIs, more atypical "breakthrough" cases of
opportunistic infections will be seen. Reports of clinical changes are reviewed
below. Investigators should routinely report the clinical manifestations of
breakthrough cases in all articles pertaining to prophylaxis for opportunistic
infections in patients with AIDS.

Publication Types: 
    Review

PMID: 9564456 [PubMed - indexed for MEDLINE]

3724: Ned Tijdschr Geneeskd. 1998 Mar 21;142(12):654-7.

[Fatal varicella-zoster encephalitis; a rare complication of herpes zoster]

[Article in Dutch]

Westenend PJ, Hoppenbrouwers WJ.

Pathologisch Laboratorium voor Dordrecht en Omstreken.

In a 82-year-old woman varicella zoster encephalitis was diagnosed, a rare
complication of shingles. The case was remarkable for its rapid and fatal course 
in a patient without an underlying disease. At autopsy, the histological picture 
of an acute haemorrhagic encephalitis was seen, also a rare finding.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9623132 [PubMed - indexed for MEDLINE]

3725: Postgrad Med J. 1998 Feb;74(868):101-3.

Characteristics of patients with shingles admitted to a district general
hospital.

Morgan R, King D.

Department of Geriatric Medicine, Arrowe Park Hospital, Wirral, Merseyside, UK.

Little is known about why some patients with shingles are admitted to hospital.
We reviewed 72 case notes from a list of 80 patients admitted to hospital with
shingles over a six-year period. Pain was the main complaint of the patients
admitted, most of whom were elderly and lived alone. The commonest site of
involvement in hospital admissions was the eye (herpes zoster ophthalmicus).
Diagnosis of shingles was made after admission in 12 patients, eight of whom had 
originally been diagnosed as having an acute medical or surgical condition. We
conclude that the prodromal phase of shingles may lead to misdiagnosis.

PMID: 9616491 [PubMed - indexed for MEDLINE]

3726: Reg Anesth Pain Med. 1998 May-Jun;23(3):328.

A herpes zoster outbreak temporarily associated with an epidural steroid
injection.

Szokol JW, Gilbert HC.

Publication Types: 
    Case Reports
    Letter

PMID: 9613553 [PubMed - indexed for MEDLINE]

3727: Reg Anesth Pain Med. 1998 May-Jun;23(3):292-305.

Sympathetic nerve blocks: in search of a role.

Boas RA.

Anesthesia Department, Auckland Hospital, New Zealand.

OBJECTIVE: The role of sympathetic blocks in pain therapy is examined in the
light of changing concepts of pain pathophysiology. A critical review of the
literature also sought to develop an evidence-based analysis of outcome studies
to provide recommendations for appropriate applications of sympathetic blocks,
together with ideas for further clinically based research. METHODS: A focus on
the pathophysiology of neuropathic and inflammatory pain disorders was used to
help redefine what contribution, if any, was provided by the sympathetic system, 
to chronic pain states. Validation of nerve block therapies based on historical
practices and these newer concepts and outcome determinations has then been used 
to present an overview of clinical nerve block therapies as applied to the
sympathetic nervous system. RESULTS: 1. Pain Diagnosis: A reclassification of
reflex sympathetic dystrophy (RSD) to the new taxonomy of complex regional pain
syndromes (CRPS) is supported, with evidence that only a questionable sympathetic
contribution at the dorsal root ganglion level can be ascribed etiologically to
this group of disorders. Sympathetic blocks can establish whether pains may be
nonresponsive or variably responsive to such blocks, but are considered
inappropriate in determining a clinical diagnosis. 2. Neuropathic Pain Therapy:
(a) A critical review of the literature regarding the use of sympathetic blocks
in the treatment of acute herpes zoster pain and in the treatment of postherpetic
neuralgia found little support for the widely held view that sympathetic blocks
reduced either the incidence of long-term reduction of pain in these disorders.
Further attempts to reduce PHN by the combination of blocks with aggressive drug 
therapies during acute herpes infection are suggested. (b) CRPS (RSD) treatments 
are seen as evolutionary at present, with the role of sympathetic blocks being
only part of a balanced pain treatment strategy aimed at getting patients
activated under cover of good analgesia and improved function. These proposals
come as consensus recommendations but are not substantiated by outcome studies.
3. Ischemic Pain: Permanent sympathetic block with neurolytic or
thermocoagulation techniques provides up to 50% long-term improved blood flow and
reduction of pain and ulceration for patients with advanced peripheral vascular
disease. This is particularly appropriate at lumbar levels in which percutaneous 
techniques are safe when conducted with real time imaging control. CONCLUSIONS:
Changes in the understanding of CRPS disorders and the role of the sympathetic
nervous system in neuropathic pain has changed both the diagnostic and management
strategies for these pain states. The sensitivity and specificity of response to 
sympathetic blocks in establishing their value at diagnostic aids will not be
fully established without further clinical study. Further use of intravenous
regional blocks or diagnostic intravenous infusions remains questionable.
Preventive and therapeutic use of sympathetic blocks in herpes zoster pain
remains open to well-controlled study.

Publication Types: 
    Review

PMID: 9613543 [PubMed - indexed for MEDLINE]

3728: J Biol Chem. 1998 May 29;273(22):13430-6.

Intracellular transport of the glycoproteins gE and gI of the varicella-zoster
virus. gE accelerates the maturation of gI and determines its accumulation in the
trans-Golgi network.

Alconada A, Bauer U, Baudoux L, Piette J, Hoflack B.

Institut de Biologie de Lille (IFR3), Institut Pasteur de Lille, 59021 Lille,
France.

The varicella-zoster virus (VZV) is the etiological agent of two different human 
pathologies, chickenpox (varicella) and shingles (zoster). This alphaherpesvirus 
is believed to acquire its lipidic envelope in the trans-Golgi network (TGN).
This is consistent with previous data showing that the most abundant VZV envelope
glycoprotein gE accumulates at steady-state in this organelle when expressed from
cloned cDNA. In the present study, we have investigated the intracellular
trafficking of gI, another VZV envelope glycoprotein. In transfected cells, this 
protein shows a very slow biosynthetic transport to the cell surface where it
accumulates. However, upon co-expression of gE, gI experiences a dramatic
increase in its exit rate from the endoplasmic reticulum, it accumulates in a
sialyltransferase-positive compartment, presumably the TGN, and cycles between
this compartment and the cell surface. This differential behavior results from
the ability of gE and gI to form a complex in the early stages of the
biosynthetic pathway whose intracellular traffic is exclusively determined by the
sorting information in the tail of gE. Thus, gI provides the first example of a
molecule localized to the TGN by means of its association with another TGN
protein. We also show that, during the early stages of VZV infection, both
proteins are also found in the TGN of the host cell. This suggests the existence 
of an intermediate stage during VZV biogenesis in which the envelope
glycoproteins, transiently arrested in the TGN, could promote the envelopment of 
newly synthesized nucleocapsids into this compartment and, therefore, the
assembly of infective viruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9593675 [PubMed - indexed for MEDLINE]

3729: Semin Neurol. 1998;18(2):185-96.

Pearls and pitfalls in the diagnosis and management of central nervous system
infectious diseases.

Roos KL.

Department of Neurology, Indiana University School of Medicine, Indianapolis,
USA.

Laboratory techniques for the diagnosis of central nervous system (CNS)
infections are rapidly improving but at present have limitations that necessitate
our guarded enthusiasm. Enteroviruses are the most common infectious agents of
viral meningitis for which an etiology can be determined, and it is anticipated
that the use of the reverse transcriptase polymerase chain reaction (RT-PCR)
technique should significantly improve the identification of the etiologic agent 
of aseptic meningitis. The combination of the polymerase chain reaction technique
with laboratory methods for the determination of intrathecal antibody production 
to herpes simplex virus and varicella-zoster virus have improved the rapidity
with which these viral infections can be diagnosed. The pearls and pitfalls of
the use of these laboratory techniques in the diagnosis of viral meningitis,
recurrent meningitis, and focal encephalitis are included. Recommendations for
the empiric therapy of bacterial meningitis in children and adults have changed
because of the emergence of penicillin and cephalosporin-resistant pneumococcal
organisms. The currently recommended antibiotics and their dosages are included. 
The evidence for the efficacy of dexamethasone therapy in bacterial meningitis is
provided. Meningitis due to Mycobacterium tuberculosis is increasingly
recognized, and the initiation of empiric antituberculous chemotherapy should not
await the results of CSF cultures. Toxoplasma encephalitis and primary CNS
lymphoma are the most common cause of mass lesions in patients with HIV, and the 
diagnostic techniques to distinguish between these two infections is reviewed. A 
short discussion of the best test for the diagnosis of neurosyphilis is provided.

Publication Types: 
    Review

PMID: 9608616 [PubMed - indexed for MEDLINE]

3730: Acta Virol. 1997 Oct;41(5):277-83.

Amplification and sequencing of varicella-zoster virus (VZV) gene 4: point
mutation in a VZV strain causing chickenpox during pregnancy.

Chow VT, Lim KP.

Department of Microbiology, Faculty of Medicine, National University of
Singapore, Republic of Singapore.

The varicella-zoster virus (VZV) causes chickenpox (varicella) as the primary
disease and shingles (zoster) as a recurrent manifestation of infection, both
being generally benign and self-limiting. While these infections may be severe in
adults and even life-threatening in immunosuppressed individuals, they may be
amenable to effective antiviral drugs or varicella-zoster immune globulin,
provided the treatment is administered early. The prompt diagnosis of VZV
infections may be accelerated by rapid, sensitive and specific molecular
techniques such as amplification by polymerase chain reaction (PCR) compared with
slower and more cumbersome tissue culture and serological procedures. Based on
the VZV gene 4 which encodes a transcriptional activator, primers were designed
for use in PCR to amplify a target fragment of 381 bp. Distinct diagnostic bands 
were observed by agarose gel electrophoresis of PCR products of VZV strains
isolated from 11 varicella and 7 zoster patients in Singapore, as well as of the 
Japanese vaccine Oka strain. The detection sensitivity of this PCR assay was
determined to be 1 pg of purified VZV DNA equivalent to about 7,000 viral DNA
copies. No target bands were amplified from negative control templates from five 
related human herpes-viruses and from human DNA. The specificity of the PCR
products was ensured by direct cycle DNA sequencing, which revealed complete
identity of the 18 VZV isolates with the published European Dumas strain. The
strong sequence conservation of the target fragment renders this PCR assay highly
reliable for detecting the VZV sequence. Only one VZV strain isolated from a
patient with varicella during pregnancy exhibited a GGA to GAA point mutation at 
codon 46 of gene 4, culminating in the non-conservative substitution of Ser with 
Phe. The predicted secondary structure of the mutant polypeptide portrayed a
radical alteration, which may influence its function in transcriptional
activation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9607081 [PubMed - indexed for MEDLINE]

3731: Clin Exp Dermatol. 1997 Nov;22(6):274-6.

Cutaneous granulomatous vasculitis after herpes zoster infection showing
polyarteritis nodosa-like features.

Rodriguez-Pereira C, Suarez-Penaranda JM, del Rio E, Forteza-Vila J.

Department of Pathology, Complejo Hospitalario Universitario de Santiago,
Santiago de Compostela, Spain.

Various cutaneous lesions have been described after herpes zoster infection, such
as lymphomas, pseudolymphoma and granulomatous conditions (granuloma annulare,
tuberculoid granuloma, sarcoidosis). However, granulomatous vasculitis is an
extremely rare sequel. We now describe a case of superficial granulomatous
vasculitis with deep 'polyarteritis nodosa (PAN)-like' arteritis that developed
after herpes zoster infection. Polymerase chain reaction did not detect genome of
the herpes virus. We suggest that this condition could be an immune response to
viral proteins.

Publication Types: 
    Case Reports

PMID: 9604453 [PubMed - indexed for MEDLINE]

3732: Cornea. 1998 May;17(3):278-81.

Etiology of immune stromal (interstitial) keratitis.

Schwartz GS, Harrison AR, Holland EJ.

Department of Ophthalmology, University of Minnesota, Minneapolis, USA.

PURPOSE: We compared the etiologies of immune stromal keratitis (ISK), also known
as interstitial keratitis (IK), in a recent group of patients with active and
inactive ISK. METHODS: We reviewed the charts of 97 patients seen in the cornea
clinic at the University of Minnesota from 1985 through 1994. Fifty-five patients
were classified as having active ISK, defined by stromal inflammation without
ulceration within 1 year of presentation. Forty-two patients were identified as
having inactive ISK, defined by evidence of past stromal inflammation including
stromal scarring, stromal thinning, ghost vessels, and reduplication of
Descemet's membrane without active inflammation for the 1 year before
presentation. We determined the etiology of the ISK by careful review of the
patient's ocular examination, as well as medical and laboratory workup. Patients 
were labeled with the diagnosis of idiopathic ISK if no identifiable etiology was
found. RESULTS: Herpes simplex virus (HSV) accounted for 71.4% of unilateral
active ISK. Idiopathic accounted for 14.3%, and varicella-zoster virus accounted 
for 8.6% in this group. HSV was the etiologic factor of 50.0% of inactive
unilateral cases, whereas 33.3% were idiopathic. Sixty percent of cases of
bilateral, active ISK were from idiopathic causes. Syphilis was the cause of
48.5% of bilateral inactive cases. In this group, 33.3% were from idiopathic
causes. CONCLUSION: Although syphilis has been recognized for many years as the
cause of 90% of cases of ISK, this is no longer true. We demonstrated that active
ISK is most commonly caused by HSV or is idiopathic and that, although syphilis
is the leading cause of inactive, bilateral ISK, it is responsible for only 18.6%
of total cases.

Publication Types: 
    Comparative Study

PMID: 9603383 [PubMed - indexed for MEDLINE]

3733: Acta Derm Venereol. 1998 May;78(3):236-7.

Verrucous-crusted herpes zoster in an immunocompetent patient.

Veraldi S, Gnecchi L, Zorzi F.

Publication Types: 
    Case Reports
    Letter

PMID: 9602245 [PubMed - indexed for MEDLINE]

3734: Acta Derm Venereol. 1998 May;78(3):234-5.

Comment on:
    Acta Derm Venereol. 1997 May;77(3):194-7.

Herpes zoster.

Nikkels AF, Pierard GE.

Publication Types: 
    Comment
    Letter

PMID: 9602243 [PubMed - indexed for MEDLINE]

3735: Rinsho Ketsueki. 1998 Apr;39(4):290-6.

[Acquired pure red cell aplasia associated with relapsed non-Hodgkin's lymphoma: 
a case report-improvement of PRCA after acute hepatitis]

[Article in Japanese]

Kuramoto K, Oda K, Katsutani S, Fujii T, Abe K, Imamura N, Kimura A.

Department of Hematology and Oncology, Hiroshima University.

A 47-year-old male patient was admitted because of anemia. He had been diagnosed 
as non-Hodgkin's lymphoma (Follicular mixed, B cell type, stage ISA) by
splenectomy two years before. Bone marrow examination on admission revealed
lymphoma cell infiltration and marked decrease in erythroid cells. These findings
confirmed relapsed lymphoma with acquired pure red cell aplasia. After several
courses of combination chemotherapy, lymphoma cells disappeared from bone marrow,
but PRCA was not improved. In this case there were two times remission of PRCA.
At first time, acute B type hepatitis occurred during the chemotherapy, anemia
improved transiently. At the second time, mild acute hepatitis associated with
herpes zoster occurred. Twenty days after hepatic injury, PRCA was improved, and 
continued in remission state till present day. To disclose the mechanism of PRCA 
in this case, erythroid colony assay of marrow cells was performed. This showed
the presence of inhibitory factor in patient's serum at PRCA state, that was
considered to be related to the occurrence of PRCA. These findings suggest that
the improvement of PRCA was associated with the changes on immunological
condition after acute hepatitis in this case.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 9597896 [PubMed - indexed for MEDLINE]

3736: Biochemistry. 1998 Apr 28;37(17):5923-9.

Site-directed mutagenesis probing the catalytic role of arginines 165 and 166 of 
human cytomegalovirus protease.

Liang PH, Brun KA, Feild JA, O'Donnell K, Doyle ML, Green SM, Baker AE, Blackburn
MN, Abdel-Meguid SS.

Department of Macromolecular Sciences and Molecular Genetics, SmithKline Beecham 
Pharmaceuticals, King of Prussia, Pennsylvania 19406, USA.

Human cytomegalovirus (CMV) is a member of the Herpesviridae family of viruses
that also includes herpes simplex viruses (HSV-1 and HSV-2), varicella-zoster
virus (VZV), human herpes virus-6, 7, and 8 (HHV-6, HHV-7, and HHV-8), and
Epstein-Barr virus (EBV). Each member of this family encodes a serine protease
that is a potential target for antiviral therapeutic intervention. We recently
reported the crystal structure of CMV proteases [Qiu, X., Culp, J. S., DiLella,
A. G., Hellmig, B., Hoog, S. S., Janson, C. A., Smith, W. W., and Abdel-Meguid,
S. S. (1996) Nature 383, 275-279] and proposed that the highly conserved Arg165
and Arg166 residues are involved in stabilizing the oxyanion intermediate in
human herpes protease catalyzed reactions through the backbone NH and side chain,
respectively. In the current study, site-directed mutagenesis was carried out to 
probe the catalytic function of these two amino acid residues. Substitution of
Arg166 with an alanine has led to ablation of enzymatic activity without
detectable change in CMV protease conformation, supporting suggestions from the
crystal structure that Arg166 side chain plays a major role in catalysis. The
wild-type has a Km = 138 +/- 17 microM and kcat = 19.9 +/- 1.1 min-1, while R166A
has only residual activity, with a kcat = 0.012 +/- 0.001 min-1 and an unaltered 
Km = 145 +/- 18 microM. In the crystal structure, the side chain of Arg166 was
shown previously to hold a water molecule that can act as a hydrogen-bond donor
to the oxyanion and was thus proposed to stabilize the oxyanion intermediate.
However, kinetic characterization of the mutant R165A only reveals a 2.7-fold
lower activity than wild-type, with a Km = 166 +/- 19 microM and a kcat = 7.4 +/-
0.4 min-1. These results confirm that Arg165 side chain is not involved in the
stabilization of the oxyanion. It is likely that Arg165 only utilizes the
backbone NH for catalysis as suggested by the crystal structure.

PMID: 9558326 [PubMed - indexed for MEDLINE]

3737: Antimicrob Agents Chemother. 1998 May;42(5):1139-45.

Sorivudine versus acyclovir for treatment of dermatomal herpes zoster in human
immunodeficiency virus-infected patients: results from a randomized, controlled
clinical trial. Collaborative Antiviral Study Group/AIDS Clinical Trials Group,
Herpes Zoster Study Group.

Gnann JW Jr, Crumpacker CS, Lalezari JP, Smith JA, Tyring SK, Baum KF, Borucki
MJ, Joseph WP, Mertz GJ, Steigbigel RT, Cloud GA, Soong SJ, Sherrill LC,
DeHertogh DA, Whitley RJ.

Division of Infectious Diseases, University of Alabama at Birmingham, 35294-2170,
USA. jgnann@uabid.dom.uab.edu

The present randomized, double-blind, placebo-controlled, multicenter clinical
trial was designed to compare the efficacy and tolerability of sorivudine
[1-beta-D-arabinofuranosyl-E-(2-bromovinyl)uracil] and acyclovir for the
treatment of dermatomal herpes zoster in human immunodeficiency virus
(HIV)-seropositive patients. A total of 170 HIV-seropositive adults presenting
with herpes zoster (confirmed by direct fluorescent-antigen testing and/or viral 
culture) were enrolled and randomized to receive a 10-day course of orally
administered sorivudine (40 mg once daily plus acyclovir placebos) or acyclovir
(800 mg five times daily plus sorivudine placebo). Patients were monitored daily 
to document the events of cutaneous healing, pain, zoster-related complications, 
and drug-related adverse events. Patients were reassessed on days 21 and 28 and
then once monthly for 1 year. The primary efficacy endpoint was time to the
cessation of new vesicle formation. Secondary efficacy endpoints included times
to other events of cutaneous healing, resolution of pain, and frequency of
dissemination and zoster recurrence. In a multivariate analysis, sorivudine was
superior to acyclovir for reducing the times to the cessation of new vesicle
formation (relative risk [RR] = 1.54, 95% confidence interval [CI] = 1.00 to
2.36; P = 0.049) and total lesion crusting (RR = 1.48, 95% CI = 1.07 to 2.04; P =
0.017). In a univariate analysis, there was a trend favoring sorivudine for the
cessation of new vesicle formation (median of 3 versus 4 days; P = 0.07) and a
significant advantage for time to total lesion crusting (median of 7 versus 8
days; P = 0.02). The time to the resolution of zoster-associated pain, the
frequency of dissemination, and the frequency of zoster recurrence were not
different between the two treatment groups. Both drugs were well tolerated.
Sorivudine is an effective drug for the treatment of herpes zoster in
HIV-infected patients and results in accelerated cutaneous healing when compared 
with acyclovir therapy.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9593141 [PubMed - indexed for MEDLINE]

3738: J Acquir Immune Defic Syndr Hum Retrovirol. 1998 May 1;18(1):46-50.

Foscarnet decreases HIV-1 plasma load.

Devianne-Garrigue I, Pellegrin I, Denisi R, Dupon M, Ragnaud JM, Barbeau P,
Breilh D, Leng B, Fleury HJ, Pellegrin JL.

Laboratoire de Virologie, CHU de Bordeaux, France.

OBJECTIVE: To evaluate the effect of foscarnet on HIV-1 replication in vivo.
PATIENTS AND METHODS: Seventeen AIDS patients with cytomegalovirus (CMV), herpes 
simplex virus (HSV), varicella-zoster virus (VZV) infection, Kaposi's sarcoma
(KS), or a combination of these were treated with foscarnet. HIV RNA
quantification (bDNA 2.0, Chiron, Emeryville, CA, U.S.A.), CMV pp65 antigenemia
(Argene Biosoft, Varilhes, France), and CMV viremia were determined before and
during therapy. RESULTS: Four patients had CMV retinitis (1 with KS), 2 patients 
had CMV pneumonia (1 with KS), 1 patient had CMV cholecystitis, 2 patients had
VZV infection (1 with KS), 1 patient had HSV-2 infection, and 7 patients had KS
alone. The decrease in HIV-1 load was -0.73 +/- 0.39 log copies/ml (p = 2.10(-6))
after 3 days of treatment and -1.15 +/- 0.49 log copies/ml (p < 10(-7)) after 10 
days of treatment, compared with day 0. Furthermore, reduction of HIV-1 plasma
load during foscarnet therapy did not depend on the presence or absence of CMV
disease or on a positive pp65 antigenemia at day 0. CONCLUSION: We observed
decreased HIV-1 plasma load in all patients treated with foscarnet, regardless of
presence or absence of clinical or biologic CMV infection. This decrease supports
the proposition that foscarnet anti-HIV-1 activity may be of clinical importance.

PMID: 9593457 [PubMed - indexed for MEDLINE]

3739: Ophthalmology. 1998 May;105(5):895-900.

Ocular opportunistic infection incidences among patients who are HIV positive
compared to patients who are HIV negative.

Hodge WG, Seiff SR, Margolis TP.

Francis I. Proctor Foundation and Department of Ophthalmology, UCSF Medical
Center, San Francisco, California, USA.

OBJECTIVE: The purpose of the study was to examine the incidence of ocular
opportunistic infections among patients who are human immunodeficiency virus
(HIV) positive compared to patients who are HIV negative. DESIGN: The study
design was a retrospective cohort study. PARTICIPANTS: All patients were
recruited from 1984 until 1995 at the San Francisco General Hospital.
INTERVENTION: Incidences for numerous diagnoses were compared among the exposure 
group (HIV positive) and nonexposed control group (HIV negative). MAIN OUTCOME
MEASURES: The diagnoses studied were cytomegalovirus (CMV) retinitis, herpes
zoster ophthalmicus, Pneumocystis carinii choroidopathy, herpes simplex
keratitis, Toxoplasma retinitis, fungal retinitis, ocular syphilis, and ocular
lymphoma. RESULTS: Among the HIV-positive pool, there were 1800 patient visits
with a total of 5200 person-years of follow-up. Among the HIV-negative control
pool, there were 48,200 patient visits with a total of 30,100 person-years of
follow-up. Incidence rates were calculated using the product-limit method, and
risk ratios were calculated using the Cox proportional hazards model. Incidence
rate differences were calculated using the incidence density method. Among the
outcomes studied, only CMV retinitis, herpes zoster ophthalmicus, and, to a
lesser extent, Toxoplasma retinitis showed both an elevated risk ratio and rate
difference among patients who were HIV positive compared to patients who were HIV
negative. Of the other outcomes studied, either the risk ratio, rate difference, 
or both were similar among patients who were HIV positive compared to patients
who were HIV negative. CONCLUSIONS: Not all ocular infections seen in patients
who are HIV positive should be considered opportunistic, because many occur with 
similar incidence among patients who are HIV negative. The biologic reasons for
this will require further study.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9593394 [PubMed - indexed for MEDLINE]

3740: J Am Acad Dermatol. 1998 May;38(5 Pt 1):761-3.

Herpes zoster after varicella immunization.

Liang MG, Heidelberg KA, Jacobson RM, McEvoy MT.

Mayo Clinic and Foundation, Department of Dermatology, Rochester, Minnesota
55905, USA.

Publication Types: 
    Case Reports

PMID: 9591823 [PubMed - indexed for MEDLINE]

3741: Acta Otolaryngol. 1998 Mar;118(2):145-9.

Varicella-zoster virus distribution in Ramsay Hunt syndrome revealed by
polymerase chain reaction.

Murakami S, Nakashiro Y, Mizobuchi M, Hato N, Honda N, Gyo K.

Department of Otolaryngology, Ehime University School of Medicine, Japan.
murakami@m.ehime-u.ac.jp

The pathogenesis of facial nerve paralysis and vestibulo-cochlear dysfunction of 
Ramsay Hunt syndrome remains unclear as varicella-zoster virus (VZV) has not been
demonstrated in the lesions. Using the polymerase chain reaction, we detected VZV
genomes not only in the vesicles on the auricles or oral cavity but also in the
facial nerve sheath, middle ear mucosa and cerebrospinal fluid from patients with
Ramsay Hunt syndrome. The VZV genome was undetectable in the same kinds of
clinical samples obtained from control patients with facial nerve paralysis of
other etiologies. The results indicated that VZV spreads widely in the neural
components, mucocutaneous tissue and cerebrospinal fluid. The present study will 
facilitate better understanding of the pathogenesis of facial nerve paralysis,
vertigo, hearing impairment and other cranial nerve dysfunction of Ramsay Hunt
syndrome.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9583779 [PubMed - indexed for MEDLINE]

3742: Pain. 1998 Apr;75(2-3):257-9.

Use of levodopa to relieve pain from painful symmetrical diabetic polyneuropathy.

Ertas M, Sagduyu A, Arac N, Uludag B, Ertekin C.

Department of Neurology, Ege University Faculty of Medicine, Bornova, Izmir,
Turkey.

Levodopa has been used to treat some painful conditions and found to be effective
in neuropathic pain due to herpes zoster in a double-blind study. From our
anecdotal observations about the efficacy of levodopa on diabetic neuropathic
pain, we designed a double-blind placebo-controlled study to test levodopa in
painful diabetic neuropathy. Twenty-five out-patients with painful symmetrical
diabetic polyneuropathy were admitted to the study. Fourteen patients were given 
100 mg levodopa plus 25 mg benserazide to be taken three times per day for 28
days. Eleven patients were given identical placebo capsules. A blinded
neurologist evaluated the patients clinically and performed Visual Analogue Scale
(VAS) measurement every week from day 0 to day 28. The results seemed promising
and levodopa may be a choice for the control of pain in neuropathy for which we
do not have many alternative treatments.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Randomized Controlled Trial

PMID: 9583761 [PubMed - indexed for MEDLINE]

3743: Genitourin Med. 1997 Dec;73(6):467-70.

Herpes zoster and the stage and prognosis of HIV-1 infection.

McNulty A, Li Y, Radtke U, Kaldor J, Rohrsheim R, Cooper DA, Donovan B.

Taylor Square Private Clinic, Australia.

OBJECTIVES: To examine the incidence of herpes zoster in HIV-1 infection. To
assess the prognostic significance of the occurrence of herpes zoster and
progression to AIDS or death DESIGN AND METHODS: 146 homosexually active men with
known times of HIV-1 seroconversion were identified through the Sydney AIDS
Prospective Study and the clinic records of a private medical practice with large
caseload of HIV infected homosexual men. Medical records were reviewed for a
history of herpes zoster, CD4+ lymphocyte counts, and HIV-1 disease status. Cox's
proportional hazards model was used to determine whether herpes zoster predicted 
progression to AIDS or death. RESULTS: After a mean follow up of 54 months, 30
men (20%) had an episode of herpes zoster and three of these men had one
recurrence. The overall incidence of herpes zoster was 44.4 episodes per 1000
person years (95% CI 30.0-63.5). Herpes zoster was not found to be a marker of
deteriorating immune functions as measured by CD4+ lymphocyte counts. CD4+ counts
did not differ significantly between those with and without zoster at 1 year (551
v 572.10(6)/1, p = 0.79), 2 years (451 v 557, p = 0.11), and 3 years (424 v 481, 
p = 0.50) following HIV-1 seroconversion. There was no statistically significant 
difference in progression to AIDS (RR = 1.89, 95% CI 0.80-4.46, p = 0.15) or
death (RR = 0.90, 95% CI 0.31-2.65, p = 0.85) from HIV-1 sero-conversion in those
who did and those who did not develop herpes zoster. CONCLUSION: The incidence of
herpes zoster was consistent with the findings of other studies. There was no
association between the occurrence of herpes zoster and progression of HIV-1
disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9582462 [PubMed - indexed for MEDLINE]

3744: Genitourin Med. 1997 Dec;73(6):462-6.

Necrotising herpetic retinopathy in patients with advance HIV disease.

Miller RF, Brink NS, Cartledge J, Sharvell Y, Frith P.

Department of Sexually Transmitted Diseases, UCL Medical School, London.

OBJECTIVES: To describe the presenting features, clinical and laboratory
diagnosis, response to treatment, and outcome of necrotising herpetic retinopathy
(NHR) in HIV infected patients. METHODS: Retrospective case records/laboratory
data review of five HIV infected patients presenting to the specialist HIV/AIDS
unit at UCL Hospitals, London from April 1994 to August 1996 with a clinical
diagnosis of NHR. RESULTS: All patients had advanced HIV disease with a median
CD4 count of 20.10(6)/1. Three patients had cutaneous varicella zoster virus
(VZV) infection within the preceding 8 weeks. All had uniocular loss of visual
acuity; one also had headache and another ocular pain. All had typical retinal
appearances. VZV DNA was detected in cerebrospinal fluid of four patients (and in
vitreous fluid of one of the four) and in vitreous fluid of one other. One
patient refused therapy and rapidly became blind. Four patients received
intravenous foscarnet with intravenous aciclovir for 6 weeks: three subsequently 
received oral famciclovir and one oral valaciclovir; two patients also had
intravitreal injections of foscarnet. In none of the four did treatment bring
about improvement in visual acuity, but in all four visual loss from retinitis
was halted. CONCLUSIONS: NHR occurs in HIV infected patients with advanced HIV
disease and is strongly associated with evidence of VZV infection. With
aggressive use of antiviral drugs the outcome is not uniformly poor.

PMID: 9582461 [PubMed - indexed for MEDLINE]

3745: An Esp Pediatr. 1998 Jan;48(1):63-4.

[Herpes zoster during chickenpox]

[Article in Spanish]

Gener Turon C, Luelmo Aguilar J, Jorge Bravo J, Reverte Meca L, Ramirez Rodriguez
J.

Unidad de Dermatologia, Consorci Hospitalari del Parc Tauli, Sabadell, Barcelona.

Publication Types: 
    Case Reports
    Review

PMID: 9542228 [PubMed - indexed for MEDLINE]

3746: Proc Natl Acad Sci U S A. 1998 Apr 14;95(8):4658-62.

Latent varicella-zoster virus is located predominantly in neurons in human
trigeminal ganglia.

Kennedy PG, Grinfeld E, Gow JW.

Glasgow University Department of Neurology, Institute of Neurological Sciences,
Southern General Hospital National Health Service Trust, Glasgow G51 4TF, United 
Kingdom.P.G.Kennedy@clinmed.gla.ac.uk

Varicella-zoster virus (VZV) is a human herpesvirus that causes varicella
(chicken pox) as a primary infection and, after a variable period of latency in
trigeminal and dorsal root ganglia, reactivates to cause herpes zoster
(shingles). Both of these conditions may be followed by a variety of neurological
complications, especially in immunocompromised individuals such as those with
human immunodeficiency virus (HIV) infection. There have been a number of
conflicting reports regarding the cellular location of latent VZV within human
ganglia. To address this controversy we examined fixed wax-embedded trigeminal
ganglia from 30 individuals obtained at autopsy, including 11 with HIV infection,
2 neonates, and 17 immunocompetent individuals, for the presence of latent VZV.
Polymerase chain reaction (PCR), in situ hybridization, and PCR in situ
amplification techniques with oligonucleotide probes and primer sequences to VZV 
genes 18, 21, 29, and 63 were used. VZV DNA in ganglia was detected in 15
individuals by using PCR alone, and in 12 individuals (6 normal non-HIV and 6
positive HIV individuals, but not neonatal ganglia) by using PCR in situ
amplification. When in situ hybridization alone was used, 5 HIV-positive
individuals and only 1 non-HIV individual showed VZV nucleic acid signals in
ganglia. In all of the VZV-positive ganglia examined, VZV nucleic acid was
detected in neuronal nuclei. Only occasional nonneuronal cells contained VZV DNA.
We conclude from these studies that the neuron is the predominant site of latent 
VZV in human trigeminal ganglia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9539794 [PubMed - indexed for MEDLINE]

3747: Rev Neurol. 1997 Dec;25(148):2073-4.

[Meningitis and focal encephalopathy due to varicella zoster virus]

[Article in Spanish]

Nunez MJ, Amigo MC, Amador L, Rodriguez JR, Cebrian E, Garcia JC, Allegue MJ.

Publication Types: 
    Case Reports
    Letter

PMID: 9580298 [PubMed - indexed for MEDLINE]

3748: Ann Trop Paediatr. 1997 Dec;17(4):367-73.

Hodgkin's disease in children in southern Africa: epidemiological
characteristics, morbidity and long-term outcome.

Hesseling PB, Wessels G, Van Jaarsveld D, Van Riet FA.

Department of Paediatrics, Tygerberg Hospital, University of Stellenbosch, South 
Africa.

We reviewed 39 children < 15 years of age treated for Hodgkin's disease (HD) from
1973 to 1996. There were seven black, 12 white and 20 coloured children (of mixed
ethnic origin). The M:F ratio was 2.9:1 and the median ages 147, 124 and 119
months in white, coloured and black children, respectively. Coloured and black
children came mainly from a poor socio-economic background. Cervical
lymphadenopathy was present in 74% and systemic symptoms in 51% of cases. Five
per cent had clinical stage I, 41% stage II, 28% stage III and 26% stage IV
disease. Two children underwent a staging splenectomy. The majority of white
children presented with stages I and II and the majority of black and coloured
children with stages III and IV HD. Nodular sclerosing (59%), mixed cellularity
(40%) and lymphocyte-depleted (43%) were the most common histological subtypes in
white, coloured and black children, respectively. Epidemiologically, white
children fitted the criteria for HD type I and coloured and black children the
criteria for HD type III. Nineteen children were treated with ChlVPP
(chlorambucil, vinblastine, prednisone, procarbazine) and 20 with MOPP (mustine, 
Oncovin, procarbazine, prednisone) and/or ABVD (Adriamycin, bleomycin,
vinblastine, DTIC) with involved field radiotherapy to bulky mediastinal disease.
The projected 10-year survival after ChlVPP or MOPP/ABVD therapy was similar at
52%. In stages I and II, HD projected survival at 5 and 10 years was 85%, and in 
stages III and IV it was 82% at 5 and 48% at 10 years. The relapse rate was 47%
in stage II, 45% in stage III and 44% in stage IV. Tuberculosis was suspected and
treated in five children at the time of, and in seven children (three confirmed) 
subsequent to, the diagnosis of HD. Varicella developed in six and herpes zoster 
in five children. Five treatment-related deaths were due to septicaemia following
splenectomy (two), marrow failure, corpulmonale and secondary leukaemia.

PMID: 9578798 [PubMed - indexed for MEDLINE]

3749: Neurologia. 1998 Feb;13(2):94-7.

[Uncommon neurologic complications related to varicella-zoster virus]

[Article in Spanish]

Martin del Pozo M, Benito-Leon J, Rodriguez J, Molina JA, Diaz-Guzman J, Bermejo 
FP.

Servicio de Neurologia, Hospital Universitario 12 de Octubre, Madrid.

Neurological complications caused by varicella-zoster virus, excluding
post-herpetic neuralgia and aseptic meningitis, are infrequent and varied. Other 
complications, which have been described are peripheral motor neuropathy, cranial
nerve palsies, meningoencephalitis, Guillain-Barre syndrome, myelitis, herpes
zoster ophthalmicus with delayed contralateral hemiparesis and Reye syndrome. We 
present 4 patients with infrequent neurological complications associated with
varicella-zoster virus: 3 cases of meningoencephalitis and one case of myelitis.

Publication Types: 
    Case Reports
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 9578678 [PubMed - indexed for MEDLINE]

3750: Pediatrics. 1998 May;101(5):E13.

Cat scratch disease presenting with peripheral facial nerve paralysis.

Walter RS, Eppes SC.

Division of General Pediatrics Department of Pediatrics Thomas Jefferson
University duPont Hospital for Children, Wilmington, DE 19899, USA.

Acquired peripheral facial nerve paralysis is a relatively common disorder that
affects both children and adults. The most frequent nontrauma-related etiologies 
in otherwise neurologically intact patients are idiopathic (Bell's palsy) and
infectious, which includes otitis media, herpes zoster, Lyme disease, herpes
simplex virus, Epstein-Barr virus, and Mycoplasma pneumoniae. Cat scratch disease
(CSD) is typically a subacute, regional lymphadenitis caused by Bartonella
henselae that is seen in children and young adults. CSD most often has a benign, 
self-limited course. However, 11% of CSD patients may present atypically, most
commonly with Perinaud's oculoglandular syndrome or acute encephalopathy. We
present a child with the first reported case of acute facial nerve paralysis in
serologically proven CSD with typical lymphadenitis.

Publication Types: 
    Case Reports

PMID: 9565446 [PubMed - indexed for MEDLINE]

3751: J Neurol Neurosurg Psychiatry. 1998 Apr;64(4):539-42.

Altered antibody pattern to Epstein-Barr virus but not to other herpesviruses in 
multiple sclerosis: a population based case-control study from western Norway.

Myhr KM, Riise T, Barrett-Connor E, Myrmel H, Vedeler C, Gronning M, Kalvenes MB,
Nyland H.

Department of Neurology, The Gade Institute, University of Bergen, Norway.

OBJECTIVE: The prevalence of anti-EBV antibodies was studied in a group of 144
patients with multiple sclerosis and 170 age, sex, and area matched controls from
the county of Hordaland, western Norway. The prevalence of three other
herpesviruses, herpes simplex virus (HSV), varicella zoster virus (VZV), and
cytomegalovirus (CMV), were also included. METHODS: Antibodies to various virus
antigens were determined by enzyme linked immunosorbent assay (ELISA) and
indirect immunfluorescence (IIF) in serum samples from 144 patients with multiple
sclerosis and 170 controls. RESULTS: All of the 144 patients with multiple
sclerosis had IgG antibodies to EBV compared with 162 of 170 controls (p=0.008). 
The frequency of IgG antibodies to EBV capsid antigen (VCA), nuclear antigen
(EBNA), and early antigen (EA) was significantly higher in patients with multiple
sclerosis compared with the controls (p<0.000001, p=0.01, and p<0.0001
respectively). The presence of antibodies was independent of the initial course
of the disease and the disease activity at the time of blood sampling. The
prevalence of IgG antibodies to HSV, CMV, and VZV did not differ between cases
and controls. CONCLUSION: The results suggest a role for EBV in the aetiology of 
multiple sclerosis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9576551 [PubMed - indexed for MEDLINE]

3752: J Med Chem. 1998 Apr 9;41(8):1284-98.

Synthesis and antiviral activity of novel acyclic nucleosides: discovery of a
cyclopropyl nucleoside with potent inhibitory activity against herpesviruses.

Sekiyama T, Hatsuya S, Tanaka Y, Uchiyama M, Ono N, Iwayama S, Oikawa M, Suzuki
K, Okunishi M, Tsuji T.

Central Research Laboratories, Ajinomoto Company, Inc., 1-1 Suzuki-cho, Kawasaki 
210, Japan.

A series of acyclic nucleosides with two hydroxymethyl groups mimicking the 3'-
and 5'-hydroxyl groups of the 2'-deoxyribose moiety were prepared and evaluated
for their antiherpetic activity. Among those, 9-[[cis-1',
2'-bis(hydroxymethyl)cycloprop-1'-yl]methyl]guanine (3) showed extremely potent
antiviral activity against herpes simplex virus type-1 (HSV-1) with good
selectivity. Both enantiomers of 3 were synthesized starting from chiral
epichlorohydrins, and only one of the enantiomers with 1'S,2'R-configuration (3a)
exhibited strong antiherpetic activity (IC50 of 0.020 microg/mL against HSV-1
Tomioka vs 0.81 microg/mL for acyclovir). Enantiomer 3a was also more inhibitory 
than acyclovir against varicella-zoster virus (VZV) but ineffective against human
immunodeficiency virus (HIV). Compound 3a is phosphorylated by HSV-1 thymidine
kinase (TK) very efficiently. The relationship between conformation and
antiherpetic activity in this series of compounds is discussed.

Publication Types: 
    Comparative Study

PMID: 9548818 [PubMed - indexed for MEDLINE]

3753: Cancer Gene Ther. 1998 Mar-Apr;5(2):83-91.

Phosphorylation and cytotoxicity of therapeutic nucleoside analogues: a
comparison of alpha and gamma herpesvirus thymidine kinase suicide genes.

Cazaux C, Tiraby M, Loubiere L, Haren L, Klatzmann D, Tiraby G.

Laboratoire de Microbiologie et de Genetique, Universite Paul Sabatier, Toulouse,
France.

Thymidine kinase (TK) genes from three alpha-herpesviruses (i.e., human herpes
simplex type 1, varicella-zoster virus, equid herpesvirus 4) and two
y-herpesviruses (i.e., Epstein-Barr virus and Saimiri herpesvirus 2) were cloned 
in expression vectors based on zeocin resistance by complementation of a
TK-defective Escherichia coli strain. In vivo complementation of an appropriate
yeast strain and in vitro enzymatic measurements demonstrated that all viral TKs 
possess a second phosphorylating activity corresponding to the thymidylate kinase
function in contrast to the E coli TK, which is deprived of this activity. When
expressed in an engineered E coli strain rendered resistant to purine and
pyrimidine nucleoside analogs, the viral TKs sensitize host bacteria to
3'-azido-3'-deoxythymidine (AZT), 3'-deoxy-2',3'-didehydrothymidine (D4T),
dideoxyinosine, or fluorodeoxyuridine (5-FUdR). The extent of activation of all
these analogs, in this bacterial assay, was found to be greatly superior for the 
two gamma-virus TKs, compared to the alpha-virus TKs, including the reference
suicide gene, HSV1-TK. TK from the two gamma-Epstein-Barr and Saimiri 2 viruses
were also found to be more efficient in sensitizing murine melanoma B16 tumor
cells to pyrimide nucleoside analogs.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9570299 [PubMed - indexed for MEDLINE]

3754: Pediatr Neurol. 1998 Mar;18(3):256-61.

Acute childhood hemiplegia associated with chickenpox.

Yilmaz K, Caliskan M, Akdeniz C, Aydinli N, Karabocuoglu M, Uzel N.

Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University,
Child Health Institute, Turkey.

Although primary varicella-associated central nervous system complications and
herpes zoster ophthalmicus with delayed hemiplegia are well known, and chickenpox
is a common infection, cerebral vasculopathy associated with chickenpox has only 
been described recently. We report the case of an 18-month-old girl who developed
a right hemiplegia 10 days after the onset of a primary varicella infection. She 
has the shortest latent interval in the literature. Cranial computed tomography
and magnetic resonance imaging suggest an infarction involving the left putamen
and internal capsule. Magnetic resonance angiography is normal. Possible causes
of acute infantile hemiplegia are excluded. Neurologic signs gradually improve
without any specific treatment. A review of the literature is also presented.

Publication Types: 
    Case Reports
    Review

PMID: 9568925 [PubMed - indexed for MEDLINE]

3755: Semin Neurol. 1998;18(1):125-44.

Neuropathies associated with malignancy.

Amato AA, Collins MP.

Department of Medicine/Neurology, University of Texas Health Science Center at
San Antonio 78284, USA.

Patients with malignancy can develop peripheral neuropathies as (1) a direct
effect of the cancer by invasion or compression of nerves, (2) a remote or
paraneoplastic effect, or (3) an iatrogenic effect of treatment. Focal or
multifocal cranial neuropathies, radiculopathies, and plexopathies typically
result from tumor infiltration, herpes zoster infection, or radiation-induced
injury. Sensorimotor polyneuropathies are the most frequently encountered
peripheral nerve syndromes, but motor neuropathies, sensory neuronopathies,
polyradiculoneuropathies, and autonomic neuropathies can also occur. Although
uncommon, paraneoplastic mechanisms should be considered in a patient with
malignancy and an associated peripheral nerve disorder, especially in the setting
of small-cell lung cancer or lymphoproliferative cancer. Toxic neuropathies occur
with exposure to several chemotherapeutic agents, including the vinca alkaloids, 
cisplatin, taxanes, and suramin. These neuropathies are usually dose-related,
sensory-predominant, and at least partially reversible, with an axonopathic or
ganglionopathic mechanism. Suramin is unique in causing subacute, demyelinating
polyradiculoneuropathy.

Publication Types: 
    Review

PMID: 9562674 [PubMed - indexed for MEDLINE]

3756: Lakartidningen. 1998 Mar 25;95(13):1384-5.

[Are famciclovir and valaciclovir truly effective in the treatment of shingles?]

[Article in Swedish]

Liedholm H, Linne AB.

Publication Types: 
    Letter

PMID: 9560964 [PubMed - indexed for MEDLINE]

3757: Masui. 1998 Mar;47(3):346-9.

[Two elderly patients with thoracic herpetic pain and post herpetic neuralgia
treated with continuous thoracic sympathetic ganglion block through a placed
catheter]

[Article in Japanese]

Takeda T, Iida H, Ohta S, Oda A, Abe K, Oohata H, Akamatsu S, Dohi S.

Department of Anesthesiology and Critical Care Medicine, Gifu University School
of Medicine.

Epidural block is very useful in the treatment of herpetic pain and post herpetic
neuralgia. However, in the elderly patients with cardiac disease or diabetes
mellitus, severe cardiovascular changes may occur by epidural block. Epidural
block caused severe hypotension in two elderly patients with herpetic pain and
post herpetic neuralgia who had diabetes mellitus or hypertension. Continuous
thoracic sympathetic ganglion block with local anesthetics through a placed
catheter reduced their pain and caused almost no changes in cardiovascular
system.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9560549 [PubMed - indexed for MEDLINE]

3758: J Bioenerg Biomembr. 1997 Dec;29(6):611-6.

Direct measurement of nitrite transport across erythrocyte membrane vesicles
using the fluorescent probe, 6-methoxy-N-(3-sulfopropyl) quinolinium.

Shingles R, Roh MH, McCarty RE.

Department of Biology, Johns Hopkins University, Baltimore, Maryland 21218-2685, 
USA.

Nitrite was shown to quench the fluorescence of 6-methoxy-N-(3-sulfopropyl)
quinolinium (SPQ) almost twofold more than chloride. SPQ loaded inside vesicles
prepared from asolectin and isolated erythrocyte ghosts allowed for the direct
measurement of nitrite movement across these membranes. Movement of nitrite
across asolectin occurred by diffusion as HNO2 in a pH-dependent manner. By
contrast, erythrocyte ghosts had very low diffusion rates for nitrous acid.
Erythrocyte ghosts preloaded with 50 mM nitrite to quench SPQ fluorescence were
utilized to study heteroexchange with externally added anions. SPQ fluorescence
increases (becomes unquenched) with added bicarbonate and nitrate, indicating
that nitrite is moving out of the preloaded vesicles. The pH optimum for this
exchange was approximately 7.6 and exchange was inhibited by N-ethylmaleimide
(NEM) and dihydro-4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS). These 
data indicate that nitrite moves across erythrocyte plasma membranes as NO2- by a
heteroexchange mechanism with other monovalent anions.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 9559862 [PubMed - indexed for MEDLINE]

3759: Antimicrob Agents Chemother. 1998 Apr;42(4):868-72.

Survey of resistance of herpes simplex virus to acyclovir in northwest England.

Christophers J, Clayton J, Craske J, Ward R, Collins P, Trowbridge M, Darby G.

Manchester Public Health Laboratory, Withington Hospital, United Kingdom.

Acyclovir (ACV) has been used for more than 15 years in the management of herpes 
simplex virus (HSV) and varicella-zoster virus (VZV) disease. The present survey 
was undertaken to assess the level of ACV resistance in the population. More than
2,000 HSV isolates from both immunocompetent and immunocompromised patients in
northwest England were collected over a 2-year period and tested for sensitivity 
to ACV. These studies suggested a prevalence of resistance of approximately 0.1
to 0.6% in immunocompetent individuals, with no apparent difference in prevalence
between treated and untreated groups. In line with previous studies, the
prevalence of resistance in treated immunocompromised individuals was
approximately 6%.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9559798 [PubMed - indexed for MEDLINE]

3760: Geriatrics. 1998 Apr;53(4):93-4, 101-2.

Ramsay Hunt syndrome: a challenging herpes zoster virus infection.

Rahimi AR.

Department of Internal Medicine Education, Medical College of Georgia, Savannah, 
USA.

Publication Types: 
    Case Reports

PMID: 9559030 [PubMed - indexed for MEDLINE]

3761: J Rheumatol. 1998 Apr;25(4):623-8.

Infrequent detection of cytomegalovirus and Epstein-Barr virus DNA in synovial
membrane of patients with rheumatoid arthritis.

Mousavi-Jazi M, Bostrom L, Lovmark C, Linde A, Brytting M, Sundqvist VA.

Department of Virology, Swedish Institute for Infectious Disease Control,
Stockholm.

OBJECTIVE: To study the role of the cytomegalovirus (CMV), Epstein-Barr virus
(EBV), herpes simplex virus types 1 and 2 (HSV-1 and 2), varicella zoster virus
(VZV), and human herpes virus 6 (HHV-6) in the etiology of rheumatoid arthritis
(RA). METHODS: Polymerase chain reaction (PCR) was used to detect DNA of the
different herpes viruses in synovial membranes from 31 patients with chronic RA
and 14 control patients. Specific antibodies were determined by indirect
immunofluorescence and ELISA. RESULTS: Out of 31 patients with RA, CMV DNA was
detected in synovial membranes from 2 patients and EBV DNA was detected in
synovial membranes from 2 other patients. All samples from the patients with RA
were negative for DNA from HSV-1 and 2, VZV, and HHV-6. All samples from the 14
control patients were negative in all PCR assays. No statistically significant
differences in IgG antibodies were found for CMV, HSV-1, VZV, and HHV-6 in
patients with RA compared to controls. Higher titers of IgG antibodies against
EBV viral capsid antigen were found in patients with RA, with a significance of p
< 0.05. CONCLUSION: Both CMV and EBV DNA were detected in synovial membranes from
6% of the patients with RA. We cannot exclude the possibility that these viruses 
were associated with disease development in a minority of patients with RA.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9558160 [PubMed - indexed for MEDLINE]

3762: Reg Anesth Pain Med. 1998 Jan-Feb;23(1):25-9.

High thoracic epidural block relieves acute herpetic pain involving the
trigeminal and cervical regions: comparison with effects of stellate ganglion
block.

Higa K, Hori K, Harasawa I, Hirata K, Dan K.

Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.

BACKGROUND AND OBJECTIVES: Stellate ganglion block can promptly relieve acute
herpetic pain (AHP) involving the trigeminal and cervical regions. However,
repeated blocks are needed to maintain pain relief in most patients with severe
AHP. Because continuous epidural block is easily performed using an indwelling
catheter, we compared the effect of high thoracic epidural block with that of
stellate ganglion block to relieve moderate-to-severe AHP involving these
regions. METHODS: Six patients received stellate ganglion blocks and seven
patients received high thoracic epidural blocks. Six milliliters 1% of
mepivacaine was given to each patient. Acute herpetic pain was evaluated before
and up to 60 minutes after the blocks, using a visual analog scale (VAS) of pain.
RESULTS: There was no significant difference in VAS pain scores before the blocks
between the groups, but there were significant (P < .05) decreases in VAS pain
scores for both groups between 10 and 60 minutes after the blocks. There were no 
significant differences in VAS pain scores between the groups after the blocks.
CONCLUSIONS: High thoracic epidural block was as effective as stellate ganglion
block in relieving moderate-to-severe AHP involving the trigeminal and cervical
regions.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9552775 [PubMed - indexed for MEDLINE]

3763: Hautarzt. 1998 Feb;49(2):135-8.

[Zosteriform lichen aureus]

[Article in German]

Dippel E, Schroder K, Goerdt S.

Hautklinik und Poliklinik, Universitatsklinikum Benjamin Franklin, Freie
Universitat Berlin.

Lichen aureus is a special localized variant of purpura pigmentosa chronica. A
patient presented with an unusual striate and segmental or zosteriform
distribution of lichen aureus involving the left leg and lower abdominal area.
Histology showed the characteristic dense band-like infiltrate consisting mainly 
of small lymphocytes and numerous hemosiderin-containing macrophages. No
underlying infection or medication could be identified as a trigger. The lesions 
did not respond well to topical corticosteroid therapy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9551337 [PubMed - indexed for MEDLINE]

3764: Curr Opin Obstet Gynecol. 1998 Apr;10(2):123-8.

Vertical transmission of viral infections.

Mandelbrot L.

Hopital Cochin, Service de Gynecologie Obstetrique I, Paris, France.
laurent.mandelbrot@cch.ap.hop.paris.fr

A variety of congenital viral infections are responsible for a large proportion
of the mortality and morbidity in infancy and childhood. Vertical transmission
may occur during primary maternal infection or during chronic or recurrent
infection, with different implications for counselling and testing in pregnancy. 
Strategies for the diagnosis and prevention of mother-to-child transmission
differ according to the timing and mechanisms involved. As demonstrated by
hepatitis B research in the past and human immunodeficiency virus today,
multicenter cohort studies and clinical trials are a key to developing effective 
interventions.

Publication Types: 
    Review

PMID: 9551307 [PubMed - indexed for MEDLINE]

3765: Singapore Med J. 1997 Nov;38(11):471-4.

Clinical presentation of herpes zoster in a Singapore hospital.

Oh HM, Ho AY, Chew SK, Monteiro EH.

Communicable Disease Centre, Singapore.

BACKGROUND: There is a direct correlation between increasing age and incidence of
herpes zoster. There is an increased risk of complications in the elderly and the
immunocompromised. OBJECTIVE: To study the clinical epidemiology of hospitalised 
patients with herpes zoster. METHODS: Medical records of all patients
hospitalised with zoster were respectively analysed. RESULTS: Sixty-seven
patients (3% of total admissions) were studied. There were 35 males and 32
females with a mean age of 50.35 +/- 21.71. There was an increased proportion of 
older patients in the study cohort. Nineteen patients (28.4%) were
immunocompromised with malignancy occurring in 9 patients. Thirteen had been on
cytotoxic and/or steroid therapy. The commonest symptoms were rash, pain and
fever. Eighty-five percent of the patients had complications (bacterial
super-infection in (61%), dissemination (31%), ocular involvement (5%) and
post-herpetic neuralgia (13.4%). There was an increasing frequency of duration of
pain with increasing age in the patients with post-herpetic neuralgia.
Forty-three patients were treated with acyclovir. The median time to healing of
lesions was 11 days. The 41 patients with bacterial super-infection received
antibiotics with median time to healing of 12 days. CONCLUSION: Increasing age
and immunocompromised state appear to be risk factors for developing herpes
zoster in hospitalised patients.

PMID: 9550907 [PubMed - indexed for MEDLINE]

3766: Ophthalmic Surg Lasers. 1998 Mar;29(3):198-206.

The progressive outer retinal necrosis syndrome: successful treatment with
combination antiviral therapy.

Ciulla TA, Rutledge BK, Morley MG, Duker JS.

Department of Ophthalmology, Indiana University School of Medicine, Indianapolis,
USA.

BACKGROUND AND OBJECTIVE: To assess a two-drug combination of antiviral therapy
for the progressive outer retinal necrosis syndrome (PORN), given the current
poor outcome with acyclovir alone. PATIENTS AND METHODS: A retrospective review
was performed on six consecutive patients who were diagnosed with PORN and were
treated with various combinations of intravenous or oral plus intravenous
antiviral therapy. The relative efficacies of these modalities were compared.
RESULTS: Six eyes of six patients showed active retinitis at the time of
presentation. Three patients had unilateral retinitis, and the remaining patients
had necrotic, end-stage disease in their fellow eye. All the patients were
treated with combination therapy, consisting of either ganciclovir and acyclovir 
(three patients), foscarnet and ganciclovir (two patients), or foscarnet and
acyclovir (one patient). Standard induction doses were employed. During the
combination therapy, all six eyes showed resolution of the retinitis, manifested 
by complete fading of the original retinal lesions and an absence of new lesion
formation. At the final follow-up, the areas of prior active retinitis had
resolved and remained quiescent. A mild recurrence developed in one eye when
ganciclovir and foscarnet were both tapered to a single daily dose. This
recurrence promptly resolved with reinduction (twice daily) dosing. Two patients 
maintained a visual acuity of 20/50 or better in their involved eye for the
duration of follow-up (38 and 27 weeks, respectively). One patient maintained a
visual acuity of 20/40 for 14 weeks. The remaining three patients had macula-off 
retinal detachments despite resolution of active retinitis. In addition, for the 
duration of follow-up, one of the three patients with unilateral disease had
retinitis in the uninvolved eye; all three uninvolved fellow eyes maintained a
visual acuity of 20/20. One patient had progressive optic atrophy. CONCLUSIONS:
Prolonged combination antiviral therapy for PORN may successfully arrest the
progression of retinitis, maintain remission, and prevent involvement of the
fellow eye. Furthermore, if aggressive therapy is begun early, good vision may be
preserved.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9547773 [PubMed - indexed for MEDLINE]

3767: Ann Neurol. 1998 Apr;43(4):534-6.

Optic neuritis heralding varicella zoster virus retinitis in a patient with
acquired immunodeficiency syndrome.

Meenken C, van den Horn GJ, de Smet MD, van der Meer JT.

Department of Ophthalmology, Academic Medical Center, University of Amsterdam,
The Netherlands.

We report on a 29-year-old severely compromised acquired immunodeficiency
syndrome patient who developed retrobulbar optic neuritis 5 weeks after an
episode of cutaneous herpes zoster infection. During the optic neuritis,
varicella zoster virus could be demonstrated in the cerebrospinal fluid. The
neuritis responded well to treatment with foscarnet, but, 3 weeks into therapy,
varicella zoster retinitis developed. Additional treatment with intravenous
acyclovir stopped progression of the retinitis and resulted in healing of the
retinal lesions. This case suggests that retrobulbar optic neuritis can be
regarded as a prodrome of imminent acute retinal necrosis. Early recognition and 
prompt therapy with combined antivirals may prevent the development of this
devastating ocular complication of varicella zoster infection.

PMID: 9546338 [PubMed - indexed for MEDLINE]

3768: Prof Nurse. 1998 Feb;13(5):310-3.

Post-herpetic neuralgia.

Millerchip S.

Walsgrave NHS Trust, Coventry.

Publication Types: 
    Review

PMID: 9544083 [PubMed - indexed for MEDLINE]

3769: Arch Dis Child Fetal Neonatal Ed. 1998 Jan;78(1):F57-61.

Antibodies to varicella zoster virus in the cerebrospinal fluid of neonates with 
seizures.

Mustonen K, Mustakangas P, Smeds M, Mannonen L, Uotila L, Vaheri A, Koskiniemi M.

Department of Neuropediatrics, North Karelia Central Hospital, Ioensu, Finland.

Four neonates with convulsions had IgG antibodies in their cerebrospinal fluid
(CSF) to varicella zoster virus (VZV). These antibodies were found in the sera of
two of these patients after the age of 6 months. Antibodies to 16 different
microbes were studied from the serum and CSF of 201 neonates with neurological
problems. The presence of DNA specific to HSV-1, HSV-2, and VZV in the CSF was
also investigated using the polymerase chain reaction (PCR). Antibodies to VZV
were detected in the CSF of four neonates. Antibody indices suggested production 
of VZV specific antibodies in the central nervous system. These findings suggest 
that intrathecal production of antibodies to VZV can appear in neonates with
neurological problems, which suggests that intrauterine VZV infection can be
acquired without cutaneous symptoms in the mother.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9536843 [PubMed - indexed for MEDLINE]

3770: Br J Dermatol. 1998 Jan;138(1):161-8.

Cutaneous reactions at sites of herpes zoster scars: an expanded spectrum.

Requena L, Kutzner H, Escalonilla P, Ortiz S, Schaller J, Rohwedder A.

Department of Dermatology, Fundacion Jimenez Diaz, Universidad Autonoma, Madrid, 
Spain.

Several types of cutaneous lesions have previously been described at the sites of
herpes zoster scars. We describe 16 patients with cutaneous lesions which had
developed on herpes zoster scars. Biopsies were taken from these lesions, and a
polymerase chain reaction assay was used to detect the viral genome in
paraffin-embedded specimens. Histopathological findings enabled diagnosis of
nonspecific granulomatous dermatitis in five patients, granulomatous vasculitis
in two patients, lichen sclerosus in two patients, and pseudolymphoma, keloid,
sarcoidal granuloma, granuloma annulare, granulomatous folliculitis, lichen
planus and cutaneous Rosai-Dorfman disease, each in one patient. Varicella-zoster
virus DNA was not identified in any of the patients. Granulomatous folliculitis, 
lichen sclerosus and cutaneous Rosai-Dorfman disease have not previously been
described in herpes zoster scars, but they are three new cutaneous reaction
patterns that may have developed within these scars. Our investigations indicate 
that the cutaneous reactions appearing in herpes zoster scars are not due to the 
persistence of varicella-zoster virus DNA within the lesions.

Publication Types: 
    Case Reports

PMID: 9536241 [PubMed - indexed for MEDLINE]

3771: Mult Scler. 1998 Feb;4(1):22-6.

Intrathecal synthesis of virus-specific oligoclonal IgG, and of free kappa and
free lambda oligoclonal bands in acute monosymptomatic optic neuritis. Comparison
with brain MRI.

Frederiksen JL, Sindic CJ.

Department of Neurology, Glostrup University Hospital, Denmark.

Twenty-seven patients with acute monosymptomatic optic neuritis were randomly
selected from a population-based cohort of patients extensively screened for
known etiologies of ON. Paired serum and CSF obtained median 20 days from onset
were examined for oligoclonal IgG, free kappa and free lambda chains, and
virus-specific oligoclonal IgG antibodies by an affinity-mediated capillary blot 
technique. CSF-restricted oligoclonal IgG bands, free kappa and free lambda chain
bands were observed in 17, 15 and nine patients, respectively. In addition, 16
patients showed a polyspecific intrathecal synthesis of oligoclonal IgG
antibodies against one or more viruses (12 measles, nine varicella zoster, six
rubella, six mumps) compared to all the 18 examined patients with definite
multiple sclerosis (P = 0.0014). The presence of virus-specific oligoclonal IgG
was significantly related to the results of oligoclonal IgG (P = 0.0034), free
kappa chain bands (P = 0.0020), and brain MRI abnormalities (P = 0.0402). At 1
year follow-up five patients had developed clinically definite multiple
sclerosis; all had virus-specific oligoclonal IgG antibodies, oligoclonal IgG and
abnormal MRI at onset.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9532588 [PubMed - indexed for MEDLINE]

3772: Rev Neurol. 1997 Dec;25(148):1922-4.

[Horner's syndrome secondary to ophthalmic herpes zoster]

[Article in Spanish]

Tola-Arribas MA, Zarco-Tejada JM, Marco-Llorente J.

Servicio de Neurologia, Hospital Universitario, Valladolid, Espana.

INTRODUCTION: Ophthalmoparesias is a frequent complication of ophthalmic herpes
zoster. It occurs in 31% of all cases. However, the presence of Horner's syndrome
during viral reactivation is a rarity which has only been previously described on
two occasions, and never associated with cranial nerve involvement. CLINICAL
CASE: We describe a patient with the first case of Horner's syndrome secondary to
ophthalmic herpes zoster, with simultaneous, homolateral lesions of the third and
sixth cranial nerves. Clinical evaluation, the course of the disorder, negative
magnetic resonance studies and tests with cocaine and foledrin eye drops
confirmed the presence of a post-ganglionar sympathetic lesion, probably situated
in the ipsilateral cavernous sinus. CONCLUSIONS: Ophthalmoparesias as a
complication of ophthalmic herpes zoster may have various origins. Diffusion of
viral particles from the Gasserian ganglion and branches of the trigeminal nerve 
to adjacent structures, muscles, nerves and vessels, is the mechanism often
mentioned. Presence of a simultaneous sympathetic lesion is very rare and of
unknown pathology. However, it is probable that the origin of the lesion of the
vegetative fibres is the same as that of the sensory or motor fibres, and
adjacent inflammatory process caused by the virus extending. We analyze the
factors involved in the low incidence of this association.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9528032 [PubMed - indexed for MEDLINE]

3773: Antimicrob Agents Chemother. 1998 Feb;42(2):216-22.

The novel immunosuppressive agent mycophenolate mofetil markedly potentiates the 
antiherpesvirus activities of acyclovir, ganciclovir, and penciclovir in vitro
and in vivo.

Neyts J, Andrei G, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.
Johan.Neyts@rega.kuleuven.ac.be

The immunosuppressive agent mycophenolate mofetil (MMF) has been approved for use
in kidney transplant recipients and may thus be used concomitantly for the
treatment of intercurrent herpesvirus infections with drugs such as acyclovir
(ACV), ganciclovir (GCV), and penciclovir (PCV). We found that MMF and its parent
compound mycophenolic acid (at concentrations that are attainable in plasma)
strongly potentiate the antiherpesvirus (herpes simplex virus [HSV] type 1
[HSV-1], HSV-2, thymidine kinase-deficient [TK-] HSV-1, both wild-type and TK-
varicella-zoster virus, and human cytomegalovirus) activities of ACV, PCV, and
GCV (up to 350-fold increases in their activities). The mechanism of potentiation
was found to reside in the depletion of endogenous dGTP pools, which favored the 
inhibitory effect of the triphosphate of ACV, GCV, or PCV on the viral DNA
polymerase. The combination of topically applied 5% MMF with 0.1% ACV strongly
protected against HSV-1-induced cutaneous lesions in hairless mice, whereas
therapy with either compound used singly had no protective effect. Interestingly,
the combination of topically applied 5% MMF with 5% ACV was also highly effective
in protecting against TK- HSV-2-induced cutaneous lesions (that were refractory
to ACV treatment) in athymic nude mice. Topical therapy with MMF was very well
tolerated, and no signs of irritation were observed. When given perorally at 200 
mg/kg of body weight/day, MMF potentiated to some extent the growth retardation
induced by GCV in young NMRI mice. These observations may have clinical
implications (i) for those transplant recipients who receive both MMF and either 
ACV, GCV, or PCV and (ii) for the treatment of ACV-resistant mucocutaneous HSV
infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9527762 [PubMed - indexed for MEDLINE]

3774: Arch Phys Med Rehabil. 1998 Mar;79(3):336-8.

Myofascial trigger points in intercostal muscles secondary to herpes zoster
infection of the intercostal nerve.

Chen SM, Chen JT, Kuan TS, Hong CZ.

Department of Physical Medicine and Rehabilitation, National Cheng-Kung
University Hospital, Tainan, Taiwan.

Chronic pain in the chest wall is a major complication after herpes zoster
infection of intercostal nerves. It is usually difficult to control pain of such 
origin. Two cases are reported of postherpetic neuralgia after herpes zoster
infection involving the intercostal nerves. Both patients had shooting, burning, 
aching, and localized pain in the muscle supplied by the involved intercostal
nerves 1 to 3 months after onset. Compression palpation of a tender spot in one
of these muscles induced a referred pain that followed the corresponding
interspace, usually in the distal anterior direction. Local twitch responses
could be elicited during injection of 0.5% or 1% lidocaine into one of these
tender spots; the pain in the interspace was consistently eliminated immediately 
after injection. One patient had complete pain relief after three series of
injections. The effect of pain relief for the other patient lasted for 1 to 2
weeks after the initial injection and lasted progressively longer (up to 2
months) after repeated injections. It appears that many of the tender spots
formed in intercostal muscles after herpes zoster are myofascial trigger points
that respond to injection with referred pain, local twitch responses, and
immediate pain relief.

Publication Types: 
    Case Reports

PMID: 9523788 [PubMed - indexed for MEDLINE]

3775: Arch Dermatol. 1998 Mar;134(3):279-81.

Tumescent infiltration of corticosteroids, lidocaine, and epinephrine into
dermatomes of acute herpetic pain or postherpetic neuralgia.

Chiarello SE.

Dermatology and Skin Cancer Center of Southwest Florida, Port Charlotte, USA.

PMID: 9521026 [PubMed - indexed for MEDLINE]

3776: J Med Virol. 1998 Mar;54(3):158-61.

Herpes simplex virus-1 and varicella virus infections in familial dysautonomia
patients.

Maayan C, Nimrod A, Morag A, Becker Y.

Department of Pediatrics, Hadassah University Hospital, Mt. Scopus, Israel.

Familial dystautonomia (FD) patients are deficient in type C fibers, suggesting
that there may be a different pattern of infection and clinical presentation when
infected by Herpes simplex virus type 1 (HSV-1) or Varicella-Zoster virus (VZV). 
These viruses infect and are reactivated in the periphery of the body through
type C sensory nerve fibers. HSV-1 infects epithelial cells, penetrates into type
C fibers, and migrates to the ganglia to generate latent infection. In
reactivation, the viral DNA migrates through type C fibers, infecting the
epidermis at the entry site. VZV infects through the respiratory tract, causing
systemic viral infection and latency in the ganglia, from which it is reactivated
and reaches the skin. The study was carried by clinical questionnaire and by HSV 
and VZV IgG antibodies on fifty-one FD patients and eighty matched controls. The 
questionnaire revealed that no FD patient had a history of clinical HSV-1
infection, compared to 15% in the control group (P < 0.05), while 50% FD patients
had been infected by varicella, compared to 66% in the VZV control group. However
in FD, VZV clinical manifestations were mild in comparison to controls. There was
no difference in infection rates for some other viral diseases. HSV-1 antibodies 
were detected in 24% of the FD patients, compared to 38% in the control group (P 
< 0.1). VZV antibodies were similar in FD and controls (66%, 63%). We concluded
that the rate of HSV infection in FD is low and clinical reactivation is rare.
The rate of varicella infection appears to be the same for patients and controls,
but in FD the clinical presentation is mild. We suggest that these differences
are due to the lack of type C fibers in FD patients.

PMID: 9515762 [PubMed - indexed for MEDLINE]

3777: J Med Virol. 1998 Mar;54(3):155-7.

Investigation of vesicular rashes for HSV and VZV by PCR.

Beards G, Graham C, Pillay D.

Public Health Laboratory, Birmingham Heartlands Hospital, United Kingdom.
106573.3726@compuserve.com

Vesicular fluid from rashes of 132 patients was tested by a multiplex PCR shown
to be specific for herpes simplex virus (HSV) type 1 and 2, and varicella zoster 
virus (VZV) genomic DNA. The results were compared with those obtained by
examination by electron microscopy and virus isolation by cell culture. The PCR
did not differentiate between HSV 1 and 2. By PCR, 64 HSV infections and 53 VZV
infections were identified, with presumed 100% sensitivity and specificity.
Fifteen specimens tested negative by PCR, electron microscopy, and virus
isolation for herpes viruses. The sensitivities of virus isolation and electron
microscopy for detection of herpes simplex virus were 56% and 80%. For varicella 
zoster virus, the sensitivities of virus isolation and electron microscopy were
47% and 60%. These data illustrate the advantage of rapid PCR diagnosis of herpes
simplex virus and varicella zoster virus in vesicle fluids.

Publication Types: 
    Comparative Study

PMID: 9515761 [PubMed - indexed for MEDLINE]

3778: J Am Soc Nephrol. 1998 Mar;9(3):444-50.

A randomized study comparing methylprednisolone plus chlorambucil versus
methylprednisolone plus cyclophosphamide in idiopathic membranous nephropathy.

Ponticelli C, Altieri P, Scolari F, Passerini P, Roccatello D, Cesana B, Melis P,
Valzorio B, Sasdelli M, Pasquali S, Pozzi C, Piccoli G, Lupo A, Segagni S,
Antonucci F, Dugo M, Minari M, Scalia A, Pedrini L, Pisano G, Grassi C, Farina M,
Bellazzi R.

Divisione di Nefrologia e Dialisi, Ospedale Maggiore Policlinico IRCCS, Milano,
Italy.

To assess whether chlorambucil or cyclophosphamide may have a better therapeutic 
index in patients with idiopathic membranous nephropathy, we compared two
regimens based on a 6-mo treatment, alternating every other month
methylprednisolone with chlorambucil or methylprednisolone with cyclophosphamide.
Patients with biopsy-proven membranous nephropathy and with a nephrotic syndrome 
were randomized to be given methylprednisolone (1 g intravenously for 3
consecutive days followed by oral methylprednisolone, 0.4 mg/kg per d for 27 d)
alternated every other month either with chlorambucil (0.2 mg/kg per d for 30 d) 
or cyclophosphamide (2.5 mg/kg per d for 30 d). The whole treatment lasted 6 mo; 
3 mo with corticosteroids and 3 mo with one cytotoxic drug. Among 87 patients
followed for at least 1 yr, 36 of 44 (82%; 95% confidence interval [CI], 67.3 to 
91.8%) assigned to methylprednisolone and chlorambucil entered complete or
partial remission of the nephrotic syndrome, versus 40 of 43 (93%; 95% CI, 80.9
to 98.5%) assigned to methylprednisolone and cyclophosphamide (P = 0.116). Of
patients who attained remission of the nephrotic syndrome, 11 of 36 in the
chlorambucil group (30.5%) and 10 of 40 in the cyclophosphamide group (25%) had a
relapse of the nephrotic syndrome between 6 and 30 mo. The reciprocal of plasma
creatinine improved in the cohort groups followed for 1 yr for both treatment
groups (P < 0.01) and remained unchanged when compared with basal values in the
cohort groups followed for 2 and 3 yr. Six patients in the chlorambucil group and
two in the cyclophosphamide group did not complete the treatment because of side 
effects. Four patients in the chlorambucil group but none in the cyclophosphamide
group suffered from herpes zoster. One patient per group developed cancer. It is 
concluded that in nephrotic patients with idiopathic membranous nephropathy both 
treatments may be effective in favoring remission and in preserving renal
function for at least 3 yr.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9513907 [PubMed - indexed for MEDLINE]

3779: Am J Ophthalmol. 1998 Mar;125(3):285-91.

Herpes zoster ophthalmicus in patients with human immunodeficiency virus
infection.

Margolis TP, Milner MS, Shama A, Hodge W, Seiff S.

Francis I. Proctor Foundation, University of California, San Francisco, Medical
Center 94122-0944, USA. tpms@itsa.ucsf.edu

PURPOSE: To investigate the ocular complications of herpes zoster ophthalmicus in
patients with human immunodeficiency virus (HIV) infection. METHODS: This was a
retrospective cohort study of 48 HIV-infected patients (48 eyes) treated at San
Francisco General Hospital for herpes zoster ophthalmicus from December 1985
through March 1994. RESULTS: All patients were initially treated with either
intravenous or oral acyclovir. The median CD4 lymphocyte count at diagnosis was
48 per mm3 (range, 2 to 490 per mm3). Fifteen patients (31%) had mild or no
ocular involvement. Seventeen patients (35%) had stromal keratitis, mostly mild, 
and two (4)% developed chronic infectious pseudodendritic keratitis. Twenty-four 
study patients (50%) had iritis, but only three (6%) had elevations in
intraocular pressure. Two patients (4%) developed postherpetic neuralgia, and two
others (4%) had zoster-associated central nervous system disease. Only two
patients (4%) developed necrotizing retinitis, both in the form of the
progressive outer retinal necrosis syndrome. CONCLUSIONS: Excluding the patients 
with retinitis and central nervous system disease, the rate of sight-threatening 
complications in our series was lower than expected. Almost one third of study
patients had no ocular complications or only mild surface epithelial disease.
Although the relatively low incidence of sight-threatening disease in our study
population may have been a consequence of aggressive management with acyclovir,
chronic infectious pseudodendritic keratitis, retinitis, and central nervous
system disease, complications of ophthalmic zoster whose pathogenesis is largely 
a consequence of active viral replication, were particularly devastating and
difficult to manage.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9512144 [PubMed - indexed for MEDLINE]

3780: Ophthalmology. 1998 Mar;105(3):467-71.

Varicella zoster virus retrobulbar optic neuritis preceding retinitis in patients
with acquired immune deficiency syndrome.

Lee MS, Cooney EL, Stoessel KM, Gariano RF.

Department of Ophthalmology, Yale University School of Medicine, New Haven,
Connecticut, USA.

OBJECTIVE: This study aimed to describe a recently recognized and rare
presentation of varicella zoster virus (VZV) retrobulbar optic neuritis preceding
retinitis in patients with acquired immune deficiency syndrome and to identify
factors that may relate to improved visual outcome. METHODS: Diagnosis,
treatment, and clinical course are described for three eyes of two patients with 
this viral infection. RESULTS: Patients had decreased vision, headache, and
recent zoster dermatitis. Varicella zoster virus retrobulbar optic neuritis was
diagnosed on the bases of clinical, laboratory, and electrophysiologic
examination results. Profound vision loss and peripheral retinitis ensued despite
intravenous antiviral treatment. Combination intravenous and intravitreous
antiviral injections were administered with dramatic visual recovery.
CONCLUSIONS: Varicella zoster virus retrobulbar optic neuritis should be
considered in immunocompromised patients with visual loss. Early diagnosis and
aggressive combination therapy via systemic and intravitreous routes may enable
return of useful vision.

Publication Types: 
    Case Reports

PMID: 9499777 [PubMed - indexed for MEDLINE]

3781: Ophthalmology. 1998 Mar;105(3):390-1.

Comment on:
    Ophthalmology. 1997 Feb;104(2):279-82.

Repair of retinal detachments due to herpes varicella-zoster virus retinitis.

Ciulla TA, Danis RP.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 9499760 [PubMed - indexed for MEDLINE]

3782: Br J Ophthalmol. 1997 Nov;81(11):984-8.

Comment in:
    Br J Ophthalmol. 1997 Nov;81(11):930.    Br J Ophthalmol. 1998 Sep;82(9):1097.

Improved impression cytology techniques for the immunopathological diagnosis of
superficial viral infections.

Thiel MA, Bossart W, Bernauer W.

Department of Ophthalmology, University of Zurich, Switzerland.

BACKGROUND: For epidemiological and therapeutic reasons early diagnosis of
superficial viral infections is crucial. Conventional microbiological techniques 
are expensive, time consuming, and not sufficiently sensitive. In this study
impression cytology techniques were evaluated to analyse their diagnostic
potential in viral infections of the ocular surface. METHOD: A Biopore membrane
device instead of the original impression cytology technique was used to allow
better quality and handling of the specimens. The impressions were processed,
using monoclonal antibodies and immunoperoxidase or immunofluorescence techniques
to assess the presence of herpes simplex virus, varicella zoster virus, or
adenovirus antigens. Ocular surface specimens from healthy individuals (n = 10)
and from patients with suspected viral surface disease (n = 19) were studied.
Infected and non-infected cell cultures served as controls. RESULTS: This
modified technique of impression cytology allowed the collection of large
conjunctival and corneal epithelial cell layers with excellent morphology.
Immunocytological staining of these samples provided diagnostic results for all
three viruses in patients with viral surface disease. CONCLUSIONS: The use of
Biopore membrane devices for the collection of ocular surface epithelia offers
new diagnostic possibilities for external eye diseases. Immunopathological
methods that are applied directly on these membrane devices can provide
virological results within 1-4 hours. This contributes considerably to the
clinical management of patients with infectious diseases of the ocular surface.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9505824 [PubMed - indexed for MEDLINE]

3783: Acta Derm Venereol. 1998 Jan;78(1):74-5.

Centroblastic-centrocytic lymphoma arising at the site of previous herpes zoster 
eruption.

Drago F, Rampini P, Lugani C, Rebora A.

Publication Types: 
    Case Reports
    Letter

PMID: 9498039 [PubMed - indexed for MEDLINE]

3784: Postgrad Med J. 1997 Oct;73(864):623-9.

The management of postherpetic neuralgia.

Bowsher D.

Pain Research Institute, Walton Hospital, Liverpool, UK.

Postherpetic neuralgia is defined as pain persisting, or recurring, at the site
of shingles at least three months after the onset of the acute rash. Thus
defined, at least half of shingles sufferers over the age of 65 years develop
postherpetic neuralgia. In addition to increasing age, less important risk
factors for postherpetic neuralgia are pain severity of acute shingles and
trigeminal distribution. Postherpetic neuralgia accounts for 11-15% of all
referrals to pain clinics and would, in fact, be far more effectively dealt with 
in primary care. Effective treatment of acute shingles by systemic antivirals at 
the appropriate time may have some effect in reducing the incidence of
postherpetic neuralgia, making it easier to treat with tricyclics and greatly
reducing scarring (25% of all cases affect the face). Pre-emptive treatment with 
low-dose tricyclics (ami- or nor-triptyline 10-25 mg nocte) from the time of
diagnosis of acute shingles reduces the incidence of postherpetic neuralgia by
about 50%. Established postherpetic neuralgia should be vigorously treated with
adrenergically active tricyclics in a dose rising over two or three weeks from
10-25 mg to 50-75 mg. Positive relaxation should also be used. Carbamazepine,
like conventional analgesics, is of little or no value. Failure of tricyclics to 
effect relief within eight weeks calls for specialist treatment. North American
practitioners in particular believe that some opioids (e.g., oxycodone) may be
helpful in otherwise intractable cases.

Publication Types: 
    Review

PMID: 9497970 [PubMed - indexed for MEDLINE]

3785: Nephron. 1998;78(2):228-9.

More about acyclovir neurotoxicity in patients on haemodialysis.

Gomez Campdera FJ, Verde E, Vozmediano MC, Valderrabano F.

Publication Types: 
    Case Reports
    Letter

PMID: 9496746 [PubMed - indexed for MEDLINE]

3786: J R Soc Med. 1997 Dec;90(12):670-4.

Herpes zoster ophthalmicus.

Marsh RJ.

Moorfields Eye Hospital, London, UK.

Publication Types: 
    Review

PMID: 9496292 [PubMed - indexed for MEDLINE]

3787: Rinsho Ketsueki. 1998 Jan;39(1):53-8.

[Acute abdomina pain as a presenting symptom of varicella-zoster virus infection 
in an allogeneic bone marrow transplant]

[Article in Japanese]

Hamanishi T, Nishikawa H, Kobayashi M, Nakao T, Ohagi S, Sasaki H, Matsumoto G,
Sanke T, Nanjo K.

First Department of Medicine, Wakayama University of Medical Science.

A 26-year old man was admitted because of acute abdominal pain. He had received
an allogeneic bone marrow transplant (BMT) for aplastic anemia 6 months before.
All physical, laboratory, roentgenographic, and ultrasonographic studies were
performed but nondiagnostic. On the fourth hospital day the patient developed
visual disturbance and on the following day skin eruption appeared. Laboratory
findings revealed severe liver dysfunction. We diagnosed this case as
varicella-zoster virus (VZV) infection with visceral dissemination. Antiviral
therapy with acyclovir was initiated and abdominal pain markedly reduced and
visual acuity was recovered after 4 days. In case of VZV infection, acute
abdominal pain prior to skin eruptions is rare. However in such cases the
patients are highly fatal due to visceral dissemination. Antiviral therapy begun 
before visceral dissemination of VZV is highly effective in preventing serious
disease, whereas it is less effective after dissemination. We consider that early
diagnosis and treatment of VZV infection is necessary for BMT recipients who are 
undergoing immunosuppressive therapy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9492554 [PubMed - indexed for MEDLINE]

3788: J Dermatol. 1997 Dec;24(12):751-7.

Evaluation of acceleration plethysmograms in dermatology--efficacy of lipo PGE1
preparations against herpes zoster and neuralgia following herpes.

Okuda T, Oh-i T, Koga M.

Department of Dermatology, Tokyo Medical College, Japan.

Reports published in recent years indicate that administration of lipo PGE1 is
effective against herpes zoster and neuralgia following herpes. However, there
are presently no standards to objectively assess efficacy. We therefore looked
into the possibility of achieving this goal by using an acceleration
plethysmograph. The results showed a significant difference in the rate of change
of pulse waves after initiation of drip infusion as compared to before drip
infusion among the effective group, the control group, and the non-effective
group. This method appears to be useful to objectively assess both the analgesic 
effects of lipo PGE1 and the efficacy of drugs in general, based on data
analysis. Our results suggest that investigations using this method may be able
to predict the therapeutic effects of vasodilators and analyze hemodynamic
disorders of the skin.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 9492437 [PubMed - indexed for MEDLINE]

3789: J Am Acad Dermatol. 1998 Feb;38(2 Pt 1):279-80.

Gastrointestinal complications of dermatomal herpes zoster successfully treated
with famciclovir and lactulose.

Hong JJ, Elgart ML.

Department of Dermatology, George Washington University Medical Center,
Washington, DC 20037, USA.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9486692 [PubMed - indexed for MEDLINE]

3790: Lancet. 1998 Feb 7;351(9100):419-20.

Triggering of delayed-onset postherpetic neuralgia.

Schott GD.

Publication Types: 
    Case Reports
    Letter

PMID: 9482304 [PubMed - indexed for MEDLINE]

3791: Mikrobiol Z. 1997 Sep-Oct;59(5):83-100.

[The biological activity of the transfer factor induced by bacterial antigens]

[Article in Ukrainian]

Liubchenko TA, Holeva OH, Kholodna LS, Smirnov VV, Vershyhora AIu.

Today's statement of transfer factor, an immunostimulator derived from leukocytes
which enhances antiinfectious immunity, is observed in the review. Basic
biological, physical and chemical characteristics of the transfer factor, its
possible action mechanisms, and laboratory and clinical methods of use to cure
infectious fungal (Candida, Coccidium), invasive (schistosomiasis, leishmaniasis,
cryptosporidiosis), viral (varicella zoster, ophthalmic herpes, Herpes simplex
types 1 and 2, H. zoster, H. simplex ceratitis, genital herpes, human herpes
virus type 6, postherpetic neuritis, hepatitis B, AIDS), and bacterial infections
(Mycobacterium leprae, M. tuberculosis, M. fortuitum, Salmonella cholerae suis,
S. dublin, S. Virchov, Brucella abortus, Actinobacillus pleuropneumoniae,
bacterial sepsis, Staphylococcus) are described.

Publication Types: 
    English Abstract
    Review

PMID: 9480022 [PubMed - indexed for MEDLINE]

3792: J Am Optom Assoc. 1998 Jan;69(1):49-56.

A case of recurrent, isolated, simultaneous, bilateral herpes simplex lid
infection.

Parisi ML.

Pennsylvania College of Optometry, Philadelphia, USA.

BACKGROUND: Ocular herpes simplex is usually diagnosed by its typical clinical
presentation. It is generally accepted to be a unilateral disease, with lid
eruptions typically occurring in primary ocular herpes simplex, while absent or
mild in recurrent disease. Recurrent ocular herpes simplex is generally thought
to be characterized by corneal involvement. CASE REPORT: A 35-year-old woman had 
a 2-day history of a progressive bilateral, erythematous, vesicular rash of the
upper and lower eyelids and associated preseptal cellulitis. She had a history of
a recurrent, unilateral eyelid rash that was previously diagnosed as herpes
zoster. The eyelid involvement was unusual because it was bilateral, severe,
recurrent, vesicular, and isolated, with no additional ocular manifestations of
herpes simplex. These atypical features are in contrast to the generally accepted
manifestations of recurrent ocular herpes simplex. A cytologic evaluation and a
viral culture confirmed infection by HSV Type 1. CONCLUSION: Lid involvement
occurs in recurrent ocular herpes simplex disease more often than generally
accepted, while simultaneous bilateral disease is uncommon. As in this case, when
atypical presentations occur, critical review of the differential diagnosis and
use of laboratory tests are helpful.

Publication Types: 
    Case Reports
    Review

PMID: 9479936 [PubMed - indexed for MEDLINE]

3793: Ophthalmology. 1998 Feb;105(2):347-52.

Characteristics of uveitis presenting for the first time in the elderly.

Chatzistefanou K, Markomichelakis NN, Christen W, Soheilian M, Foster CS.

Ophthalmology Department, Massachusetts Eye and Ear Infirmary, Harvard Medical
School, Boston 02114-3069, USA.

OBJECTIVE: This study aimed to describe the clinical characteristics of uveitis
presenting de novo in the elderly. DESIGN: The study design was a description of 
a retrospectively identified case series. PARTICIPANTS: A population of 138
patients (209 eyes) with uveitis beginning after age 60 was analyzed. RESULTS:
Uveitis in the elderly accounted for 10.4% of the authors' uveitis population.
The localization of uveitis was anterior in 56.5% of patients, intermediate
uveitis was diagnosed in two patients (1.4%), posterior uveitis was found in
25.4%, while 16.7% of patients presented with panuveitis. Idiopathic uveitis
accounted for the majority of cases (31.2%), whereas herpes zoster ophthalmicus
(11.6%), herpes simplex virus (6.5%), presumed sarcoidosis (5.8%), syphilis
(4.3%) ankylosing spondylitis (4.3%), and birdshot chorioretinopathy (3.6%) were 
the most frequent specific diagnostic entities. Secondary elevation of
intraocular pressure was common (67 eyes, or 32%). The development of macular
edema complicated 28.7% of cases (60 eyes). Two cases of intraocular lymphoma
were identified in 19 diagnostic vitreous biopsy specimens. Fifty-two percent of 
eyes retained visual acuity of 20/40 or more; 32.6% had final visual acuity worse
than 20/100. CONCLUSIONS: Uveitis presenting for the first time in the elderly is
not uncommon. Idiopathic uveitis accounts for the majority of cases, and herpes
zoster ophthalmicus and herpes simplex virus are particularly prevalent.
Intraocular lymphoma does not predominate in this age group. With adequate
control of intraocular inflammation and its sequelae, the visual prognosis in
patients in this age group with uveitis is relatively good.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9479298 [PubMed - indexed for MEDLINE]

3794: Eur Neurol. 1998;39(1):26-31.

Herpes zoster oticus: correlations between clinical and MRI findings.

Berrettini S, Bianchi MC, Segnini G, Sellari-Franceschini S, Bruschini P,
Montanaro D.

Department of Neurosciences, Ear, Nose and Throat Unit, University of Pisa,
Italy.

Many gadolinium-enhanced magnetic resonance imaging (MRI) studies focusing on the
anatomy and pathology of the 7th cranial nerve have already been published.
However, only scattered cases of herpes zoster oticus (HZO) have been described
and only the MRI appearance of the soft temporal bone structures has been
reported. Enhanced MRI was performed in 4 patients with HZO observed at the
Department of Otorhinolaryngology of the University of Pisa. A good correlation
was found between the clinical data and MRI findings in both the acute and
chronic stages of the disease. The 2 cases with complete facial palsy presented
prominent and diffuse enhancement of the 7th and 8th cranial nerves on
postcontrast MRI, while the patient with grade III facial palsy showed more
limited nerve enhancement. The patient with grade II facial palsy presented no
MRI abnormalities. In our series, enhancement limited to the geniculate ganglion 
and to the labyrinthine segment of the facial nerve indicates a good prognosis
while a widespread enhancement correlates with a poor prognosis. In conclusion,
MRI with contrast may be useful during the acute stage of HZO because it can
confirm the diagnosis and can provide prognostic information on the facial
function.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 9476720 [PubMed - indexed for MEDLINE]

3795: Ann Pharmacother. 1998 Jan;32(1):111-3.

Acyclovir- and ganciclovir-induced neurotoxicity.

Ernst ME, Franey RJ.

College of Pharmacy, University of Iowa, Iowa City, USA. michael-ernst@uiowa.edu

With increasing use of acyclovir and ganciclovir, primarily due to the increased 
number of AIDS and transplant patients, further cases of neurologic toxicity will
undoubtedly be encountered. Discontinuation or dosage reduction of acyclovir and 
ganciclovir is necessary to manage neurologic toxicity that is directly
attributed to either agent. Renal dysfunction is a known risk factor for
acyclovir neurotoxicity, and case reports indicate that renal dysfunction may
also be a risk factor for ganciclovir neurotoxicity. Since ganciclovir is
structurally related to acyclovir, clinicians should monitor for signs and
symptoms of neurotoxicity as they would with acyclovir until the risk factors are
more clearly defined. Dosage reduction for both agents and increased monitoring
should occur when renal dysfunction is present, to minimize the risk of
neurotoxicity and other serious adverse effects. Tables 1 and 2 summarize the
recommended dosages of acyclovir and ganciclovir, respectively, in the presence
of renal dysfunction. However, as a few case reports describe, neurotoxicity from
these agents has also occurred in patients with normal renal function. Therefore,
clinicians should always remain vigilant in monitoring for signs of neurotoxicity
when acyclovir or ganciclovir is administered, and have a high index of suspicion
for these agents if neurotoxicity is encountered during therapy.

Publication Types: 
    Review

PMID: 9475829 [PubMed - indexed for MEDLINE]

3796: Am J Nurs. 1998 Feb;98(2):46-7.

Clinical snapshot: herpes zoster.

Bjorgen S.

PMID: 9473984 [PubMed - indexed for MEDLINE]

3797: Am J Nurs. 1998 Feb;98(2):18-20.

Pain from herpes zoster and postherpetic neuralgia.

Pasero CL, Davies PS.

Veterans Administration Medical Center, Seattle, WA, USA.

PMID: 9473979 [PubMed - indexed for MEDLINE]

3798: Pediatr Rev. 1998 Feb;19(2):62-6; quiz 67.

Varicella-zoster.

Fisher RG, Edwards KM.

Duke University School of Medicine, Durham, NC, USA.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9473945 [PubMed - indexed for MEDLINE]

3799: S Afr Med J. 1997 Nov;87(11):1558.

HIV and the doctor's responsibility.

Schramm R.

Publication Types: 
    Case Reports
    Letter

PMID: 9472290 [PubMed - indexed for MEDLINE]

3800: Neurologia. 1997 Nov;12(9):381-3.

[Laboratory diagnosis of subacute and acute encephalitis probably of viral
origin: seven years of experience]

[Article in Spanish]

Echevarria JM, Casas I, de Ory F, Tenorio A, Echevarria C, Lozano A.

Servicio de Microbiologia Diagnostica, Instituto de Salud Carlos III,
Majadahonda, Madrid.

The results obtained in the laboratory diagnosis of 609 cases of acute or
subacute encephalitis, studied during a period of time of even years, is briefly 
presented. Diagnostic methods included virus isolation from stools and
cerebrospinal fluid (CSF); specific serology in serum; detection of intrathecal
production of IgG antibody; and, in the last two years, detection of viral genome
sequences in CSF by the polymerase chain reaction. Significant results were
obtained in 196 cases (32.2%) and the alfa-herpesviruses were responsible for a
major part of them (77.5%). Furthermore, 18 cases were likely to respond to dual 
infection by both herpes simplex and varicella-zoster viruses. Epstein-Barr virus
and Human herpesvirus 6 were found in CSF from three immunocompetent patients.
Besides the current vaccination program, measles virus is still responsible for
an important part (22/196, 11.2%) of cases of viral encephalitis.

Publication Types: 
    English Abstract

PMID: 9471174 [PubMed - indexed for MEDLINE]

3801: BMJ. 1998 Jan 17;316(7126):234.

Comment on:
    BMJ. 1997 Nov 1;315(7116):1163.

Steroids in facial palsy due to herpes zoster. Corticosteroids are accepted
treatment.

Homer JJ, England RJ, Ell SR.

Publication Types: 
    Comment
    Letter

PMID: 9468720 [PubMed - indexed for MEDLINE]

3802: BMJ. 1998 Jan 17;316(7126):233-4.

Comment on:
    BMJ. 1997 Nov 1;315(7116):1163.

Steroids in facial palsy due to herpes zoster. Steroids are indicated if
paralysis is complete and no contraindications exist.

Fielder CP, Raza SA.

Publication Types: 
    Comment
    Letter

PMID: 9468719 [PubMed - indexed for MEDLINE]

3803: J Infect Dis. 1998 Feb;177(2):293-300.

Chronic uveitis in guinea pigs infected with varicella-zoster virus expressing
Escherichia coli beta-galactosidase.

Cohen JI, Wang Y, Nussenblatt R, Straus SE, Hooks JJ.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA.

There is no small animal model that replicates chickenpox and herpes zoster,
which are caused by varicella-zoster virus (VZV). Therefore, to detect VZV in
tissues of infected animals, the Escherichia coli beta-galactosidase gene was
inserted into the viral genome. Intravitreal inoculation of guinea pigs with
virus-infected cells resulted in a chronic uveitis, with mononuclear cells in the
vitreous cavity of the eye of nearly all animals. Staining with X-gal
demonstrated the presence of VZV in the ciliary body or iris of approximately 40%
of the animals and in retinal pigmented epithelial cells in 4 animals. X-gal
staining showed VZV in the eye of 1 animal 140 days after inoculation. These
experiments indicate that VZV expressing beta-galactosidase is useful for
detecting virus in tissues and that VZV can cause a chronic uveitis in which
virus can be detected in some animals for up to 4 months.

PMID: 9466514 [PubMed - indexed for MEDLINE]

3804: Rev Neurol. 1997 Oct;25(146):1575-6.

[Myelitis and optic neuritis caused by varicella]

[Article in Spanish]

Pina MA, Ara JR, Capablo JL, Omenaca M.

Servicio de Neurologia, Hospital Miguel Servet, Zaragoza, Espana.

INTRODUCTION: Varicella mainly affects children between 1 and 14 years old. It is
the initial infection caused by the Varicella-Zoster virus. It is characterized
by a vesicular cutaneous eruption, fever and generally good prognosis. The
neurological complications caused by the Varicella-Zoster virus are infrequent
and include: meningitis, encephalitis, cerebellar ataxia, Reye's syndrome,
myelitis, optic neuritis, mononeuropathy, polyneuropathy, necrosis of the retina 
and cerebral arteritis. CLINICAL CASE: We present the unusual case of a woman
patient aged 18 who presented with myelitis 15 days after having a varicella
rash. Analysis of the cerebrospinal fluid showed intrathecal production of
antibodies against the Varicella-Zoster virus. Fourteen days after resolution of 
the myelitis, she presented with unilateral optic neuritis which remitted without
sequelae, (as did the myelitis). Cerebral and medullary MR showed no alterations.
CONCLUSIONS: The pathogenesis leading to involvement of the nervous system is
still not well defined. Direct invasion by the virus has been postulated,
particularly in Herpes-Zoster (reinfection by Varicella-Zoster), as immunological
phenomena which may be more frequent with Varicella (initial infection by
Varicella-Zoster virus). In our case there were two short episodes of
neurological involvement: optic neuritis and myelitis, with a satisfactory
clinical course after giving corticosteroids. This makes one think of
immunological mechanisms rather than direct invasion of the central nervous
system by the Varicella-Zoster virus.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9462984 [PubMed - indexed for MEDLINE]

3805: Support Care Cancer. 1998 Jan;6(1):57-62.

Ambulatory management of varicella-zoster virus infection in immunocompromised
cancer patients.

Rolston KV, Manzullo E, Elting L, Frisbee-Hume S, Rodriguez S, Rubenstein EB.

Ambulatory and Supporting Care Oncology Research Program (ASCORP), University of 
Texas, M.D. Anderson Cancer, Houston 77030, USA.

Immunocompromised patients with varicella-zoster virus (VZV) infection are at
greater risk for dissemination and the development of complications than
immunocompetent individuals. Consequently, they are generally hospitalized in
strict isolation rooms and treated with parenterally administered acyclovir.
Although effective, this approach is expensive and creates logistic difficulties 
in the hospital. We treated 38 immunosuppressed cancer patients presenting to our
ambulatory treatment center with VZV infections with intravenous acyclovir (500
mg/m2 8-hourly) in an ambulatory/home setting. Patients were monitored for
success or failure of therapy, progression of infection, development of
complications or drug toxicity, and satisfaction/compliance with therapy. Most
patients (33, or 87%) responded to therapy. Among the failures, 2 patients had
progressive VZV infection, 2 were hospitalized due to renal toxicity, and 1
developed a superinfection. All patients eventually responded and there were no
deaths on this study. Two patients relapsed within 1 month of initial response.
Both responded to retreatment with acyclovir, without hospitalization. The median
duration of parenteral therapy with acyclovir was 7.5 days. Seven patients (18%) 
had to be switched to oral acyclovir (800 mg, 5 times a day) before complete
response, owing to problems with venous access. All 7 completed therapy
successfully. Overall, patients expressed a high level of satisfaction with
outpatient therapy, and there were no instances of noncompliance or patient
requests for withdrawal from study. The results of this study indicate that VZV
infections in clinically stable immunosuppressed cancer patients are relatively
benign and do not require hospitalization. Parenterally administered acyclovir in
an ambulatory setting is effective therapy for such infections.

Publication Types: 
    Clinical Trial

PMID: 9458538 [PubMed - indexed for MEDLINE]

3806: Support Care Cancer. 1998 Jan;6(1):39-45.

Current concepts and challenges in the prevention and treatment of viral
infections in immunocompromised cancer patients.

Reusser P.

Department of Medicine, University Hospital, Basel, Switzerland.

Patients with acute leukemia treated with intensive chemotherapy and recipients
of bone marrow or peripheral blood stem cell transplants are at high risk of
serious viral disease. Recent progress in diagnostic methods and in antiviral
drug treatment has permitted the development of efficient management strategies
particularly for infections due to herpes simplex virus, varicella-zoster virus, 
and cytomegalovirus in these patients. By contrast, specific treatment of other
virus infections in immunocompromised cancer patients remains an unresolved
issue. The emergence of herpesvirus resistance to antiviral drugs is a matter of 
concern, and its clinical importance among patients with malignancy needs to be
elucidated. Future investigations may furthermore help to clarify the role of
novel antiviral agents, such as cidofovir, lobucavir, and compound 1263W94, and
of the adoptive immunotherapy with virus-specific CTL clones in severely
immunodeficient cancer patients.

Publication Types: 
    Review

PMID: 9458535 [PubMed - indexed for MEDLINE]

3807: AIDS. 1998 Jan 1;12(1):29-33.

Comment in:
    AIDS. 1999 Sep 10;13(13):1789-90.

Impact of opportunistic disease on survival in patients with HIV infection.

Chaisson RE, Gallant JE, Keruly JC, Moore RD.

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore,
Maryland 21287-6220, USA.

OBJECTIVE: To assess the impact of opportunistic diseases on survival in patients
with HIV disease. METHODS: A cohort of 2081 patients followed for a mean of 30
months was studied. Time-dependent Cox proportional hazards analyses were
performed using incident opportunistic diseases and CD4 cell counts as
independent variables. RESULTS: During follow-up, 730 (35%) patients died. The
occurrence of Pneumocystis carinii pneumonia (PCP), cytomegalovirus (CMV)
disease, Mycobacterium avium complex (MAC) disease, Candida esophagitis, Kaposi's
sarcoma, lymphoma, progressive multifocal leukoencephalopathy (PML), dementia,
wasting, toxoplasmosis, and cryptosporidiosis were all significantly associated
with death, independently of CD4 cell count (all P<0.001 for opportunistic
diseases controlling for CD4 cell count). The magnitude of increased risk was
greatest for lymphoma [relative hazard (RH), 7.2], PML (RH, 3.9), MAC (RH, 3.0)
and CMV (RH, 2.2). Cryptococcosis (RH, 0.94) and herpes zoster (RH, 0.85) were
not associated with death. In a multivariate Cox proportional hazards analysis,
MAC [RH, 2.56; 95% confidence interval (CI), 2.1-3.1], CMV (RH, 1.63; 95% CI,
1.3-2.1), toxoplasmosis (RH, 1.85; 95% CI, 1.3-2.6), PCP (RH, 1.29; 95% CI,
1.1-1.5), and CD4 cell count were significantly associated with death. Patients
who had opportunistic diseases had significantly greatly monthly declines in CD4 
counts (-11 x 10(6)/l per month) than those who did not (-6 x 10(6)/l per month; 
P <0.001). CONCLUSION: Most opportunistic diseases increase the risk of death
independently of CD4 cell count. These data support the hypothesis that
opportunistic diseases enhance HIV pathogenesis and further underscore the
importance of prophylaxis.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9456252 [PubMed - indexed for MEDLINE]

3808: Ocul Immunol Inflamm. 1997 Dec;5(4):259-65.

Necrotizing herpetic retinopathies. A spectrum of herpes virus-induced diseases
determined by the immune state of the host.

Guex-Crosier Y, Rochat C, Herbort CP.

Department of Ophthalmology, Hopital Jules Gonin, University of Lausanne,
Switzerland.

PURPOSE: Necrotizing herpetic retinopathies (NHR), a new spectrum of diseases
induced by viruses of the herpes family (herpes simplex virus, varicella-zoster
virus and cytomegalovirus), includes acute retinal necrosis (ARN) occurring in
apparently immunocompetent patients and progressive outer retinal necrosis (PORN)
described in severely immuno-compromised patients. Signs of impaired cellular
immunity were seen in 16% of ARN patients in a review of 216 reported cases,
indicating that immune dysfunction is not only at the origin of PORN but might
also be at the origin of ARN. The aim of this study was to correlate clinical
findings in NHR patients with their immunologic parameters. METHODS: Charts from 
patients with the diagnosis of ARN or PORN seen from 1990 to 1995 were reviewed. 
Clinical characteristics and disease patterns were correlated with immunological 
parameters taking into account CD4 lymphocyte rate in AIDS patients and
blood-lymphocyte subpopulation determination by flow cytometry, cutaneous delayed
type hypersensitivity testing and lymphocytic proliferation rate to seven
antigens in HIV-negative patients. RESULTS: During the period considered, 11
patients and 7 patients fulfilled the criteria of ARN and PORN respectively.
Immune dysfunctions were identified in most patients. Mild type of ARN and
classical ARN were associated with discrete immune dysfunctions, ARN with
features of PORN was seen in more immunodepressed patients and classical PORN was
always seen in severely immunodepressed HIV patients. CONCLUSION: Our findings
suggest that NHR is a continuous spectrum of diseases induced by herpes viruses, 
whose clinical expression depends on the immune state of the host going from mild
or classical ARN at one end in patients with non-detectable or slight immune
dysfunction to PORN in severely immunodepressed patients at the other end and
with intermediary forms between these extremes.

Publication Types: 
    Case Reports

PMID: 9455742 [PubMed - indexed for MEDLINE]

3809: Clin Infect Dis. 1998 Jan;26(1):241-2.

Comment on:
    Clin Infect Dis. 1997 May;24(5):753-61; quiz 762-3.

Morbidity among adults with varicella-zoster virus infection.

Amstey MS.

Publication Types: 
    Comment
    Letter

PMID: 9455574 [PubMed - indexed for MEDLINE]

3810: Clin Infect Dis. 1998 Jan;26(1):85-90.

Acyclovir use and survival among human immunodeficiency virus-infected patients
with CD4 cell counts of < 500/mm3. The Terry Beirn Community Programs for
Clinical Research on AIDS (CPCRA).

Torres RA, Neaton JD, Wentworth DN, Barr MR, Abrams D, Sherer R, Ward T, Sampson 
J.

AIDS Center, St. Vincent's Hospital and Medical Center of New York, New York
10011, USA.

To examine the relationship between acyclovir use and survival in AIDS, we
performed a retrospective analysis of data collected through an observational
cohort of the 17-site Community Program for Clinical Research on AIDS (CPCRA),
under the sponsorship of the National Institute of Allergy and Infectious
Diseases. Data were analyzed regarding 2,368 patients with CD4+ lymphocyte counts
of < 500/mm3, and 7,836 follow-up visits were conducted from September 1990 to
July 1994. Factors associated with use of acyclovir were studied by stratified
analysis of variance and Mantel-Haenzel chi 2 tests. The association between
acyclovir and survival was studied with use of the proportional hazards
regression model. Individuals reporting acyclovir use were more likely to be
white, male, and homosexual; to have a history of herpes simplex and zoster; and 
to have lower CD4+ T cell counts than those who did not. After adjustments for
differences in baseline factors, acyclovir use was not associated with prolonged 
survival.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9455514 [PubMed - indexed for MEDLINE]

3811: Clin Infect Dis. 1998 Jan;26(1):34-45; discussion 46-7.

Rapidly progressive herpetic retinal necrosis: a blinding disease characteristic 
of advanced AIDS.

Ormerod LD, Larkin JA, Margo CA, Pavan PR, Menosky MM, Haight DO, Nadler JP,
Yangco BG, Friedman SM, Schwartz R, Sinnott JT.

Department of Ophthalmology, University of South Florida College of Medicine,
Tampa, USA.

Eleven patients with rapidly progressive herpetic retinal necrosis (RPHRN)
complicating AIDS were investigated retrospectively to study the disease
spectrum, systemic involvement, and therapy. The mean CD4 cell count was
24/microL. There was a characteristic disease pattern with rapid progression, 82%
bilaterality, relative resistance to intravenous antiviral therapy, and 70%
retinal detachment. Varicella-zoster virus was the probable cause in 10 patients 
(detected by polymerase chain reaction in two eyes investigated), and herpes
simplex virus was the probable cause in one. Cutaneous zoster occurred previously
in 73% but was not concurrent. Seventy-three percent had central nervous system
disease, possibly virus-related. RPHRN may be a local herpetic recrudescence in
an immune-privileged site with transneural spread. Only four of 20 affected eyes 
retained useful vision. Poor ocular bioavailability, retinal ischemia, acquired
drug resistance, and strain pathogenicity may underlie treatment failure.
Acyclovir therapy appears relatively ineffective. Combined intravenous and
intravitreal therapy with foscarnet and ganciclovir may be the best current
management. Research advances are needed urgently.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9455507 [PubMed - indexed for MEDLINE]

3812: Lakartidningen. 1997 Dec 17;94(51-52):4881-4.

[Antiviral therapy in herpes zoster. Famciclovir and valaciclovir are two good
agents against shingles]

[Article in Swedish]

Skoldenberg B.

Infektionskliniken, Danderyds sjukhus.

Publication Types: 
    Review

PMID: 9454005 [PubMed - indexed for MEDLINE]

3813: J Rheumatol. 1997 Dec;24(12):2487-8.

Comment on:
    J Rheumatol. 1997 Mar;24(3):589-91.

Herpes zoster encephalomyelitis in a patient with rheumatoid arthritis treated
with low dose methotrexate.

Golden HE.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 9415667 [PubMed - indexed for MEDLINE]

3814: Pain. 1997 Nov;73(2):231-8.

Afferent large fiber polyneuropathy predicts the development of postherpetic
neuralgia.

Baron R, Haendler G, Schulte H.

Klinik fur Neurologie, Christian-Albrechts-Universitat zu Kiel, Germany.
r.baron@neurologie.uni-kiel.de

Acute zoster infection may be followed by a chronic pain syndrome, i.e.,
postherpetic neuralgia (PHN). Besides older age, the intensity of pain and
neuronal damage within the acutely affected body region are regarded as
predictors or risk factors for PHN. As an alternative approach an underlying
peripheral polyneuropathy may be considered as potential co-factor. Is a
preexisting generalized impairment of certain fiber classes important in
initiating chronic pain states after subsequent localized nerve lesion due to
zoster infection? Neurophysiological tests of different efferent and afferent
small and large fiber systems were performed prospectively at unaffected body
regions in patients with acute herpes zoster. Patients that were still in pain 6 
months later (PHN, n = 17) and pain free patients (non-PHN, n = 17) were compared
regarding the results obtained during the acute phase. Both groups were age
matched. Nociceptive C-fiber function was assessed at the forearm by quantitative
measurement of the axon reflex vasodilatation and flare induced by histamine
iontophoresis. Mechanosensitive A beta-fibers were tested at all extremities by
quantitative vibrametry. Parasympathetic small fiber function was studied by
heart rate variability tests. No clinically manifest polyneuropathy was present. 
However, in PHN risk patients considerably higher vibration detection thresholds 
in hands and feet were detected compared with non-PHN patients. Pathologic test
results of vibration sense at the lower extremity predicted PHN with a
sensitivity of 70%. Nociceptive C-fiber and parasympathetic fiber function
demonstrated no significant differences in both groups. Acute zoster pain was
slightly more intense in the PHN group. We concluded that (i) a mild generalized 
impairment of afferent A beta-fiber function (A beta-polyneuropathy) seems to be 
an important co-factor in the development of PHN and (ii) impairment of vibration
sense, i.e., impairment of afferent A beta-fiber function, may be used as a
predictor of PHN.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 9415510 [PubMed - indexed for MEDLINE]

3815: Virology. 1998 Jan 5;240(1):76-82.

The bovine herpesvirus type 1 UL3.5 open reading frame encodes a virion
structural protein.

Schikora B, Lu Z, Kutish GF, Rock D, Magyar G, Letchworth GJ.

Department of Animal Health and Biomedical Sciences, University of Wisconsin,
Madison 53706, USA.

The bovine herpesvirus type 1 (BHV-1) open reading frame (ORF) UL3.5 is similar
to ORFs found in pseudorabies virus, infectious laryngotracheitis virus, equine
herpesvirus type 1, and varicella zoster virus, but clearly absent from herpes
simplex virus. The published sequence for this ORF predicts a 126-amino-acid
(13.2 kDa) protein product with an isoelectric point of 12.3. We confirmed the
UL3.5 sequence, expressed the ORF as a glutathione-S-transferase fusion protein, 
and made rabbit antibodies against the purified fusion protein. The antiserum
detected a 13-kDa protein in Western blots of MDBK cells infected with BHV-1, but
not with other herpesviruses or uninfected cells. The BHV-1 UL3.5 protein was
characterized as a component of the virion envelope or tegument because it was
expressed as a late protein, it was present in the cytoplasm but not the nucleus 
of infected cells, and it was removed from purified virions by detergent
extraction.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 9448691 [PubMed - indexed for MEDLINE]

3816: Arch Ophthalmol. 1998 Jan;116(1):104-5.

Varicella-zoster virus retinitis presenting as an acute vitreous hemorrhage.

Lewis JM, Puklin JE.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't

PMID: 9445218 [PubMed - indexed for MEDLINE]

3817: J Virol. 1998 Feb;72(2):965-74.

Attenuation of the vaccine Oka strain of varicella-zoster virus and role of
glycoprotein C in alphaherpesvirus virulence demonstrated in the SCID-hu mouse.

Moffat JF, Zerboni L, Kinchington PR, Grose C, Kaneshima H, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California
94305-5208, USA.

The SCID-hu mouse implanted with human fetal tissue is a novel model for
investigating human viral pathogenesis. Infection of human skin implants was used
to investigate the basis for the clinical attenuation of the varicella-zoster
virus (VZV) strain, V-Oka, from which the newly licensed vaccine is made. The
pathogenicity of V-Oka was compared with that of its parent, P-Oka, another
low-passage clinical isolate, strain Schenke (VZV-S), and VZV-Ellen, a standard
laboratory strain. The role of glycoprotein C (gC) in infectivity for human skin 
was assessed by using gC-negative mutants of V-Oka and VZV-Ellen. Whereas all of 
these VZV strains replicated well in tissue culture, only low-passage clinical
isolates were fully virulent in skin, as shown by infectious virus yields and
analysis of implant tissues for VZV DNA and viral protein synthesis. The
infectivity of V-Oka in skin was impaired compared to that of P-Oka, providing
the first evidence of a virologic basis for the clinical attenuation of V-Oka.
The infectivity of V-Oka was further diminished in the absence of gC expression. 
All strains except gC-Ellen retained some capacity to replicate in human skin,
but cell-free virus was recovered only from implants infected with P-Oka or
VZV-S. Although VZV is closely related to herpes simplex virus type 1 (HSV-1)
genetically, experiments in the SCID-hu model revealed differences in tropism for
human cells that correlated with differences in VZV and HSV-1 disease. VZV caused
extensive infection of epidermal and dermal skin cells, while HSV-1 produced
small, superficial lesions restricted to the epidermis. As in VZV, gC expression 
was a determinant for viral replication in skin. VZV infects human CD4+ and CD8+ 
T cells in thymus/liver implants, but HSV-1 was detected only in epithelial
cells, with no evidence of lymphotropism. These SCID-hu mouse experiments show
that the clinical attenuation of the varicella vaccine can be attributed to
decreased replication of V-Oka in skin and that tissue culture passage alone
reduces the ability of VZV to infect human skin in vivo. Furthermore, gC, which
is dispensable for replication in tissue culture, plays a critical role in the
virulence of the human alphaherpesviruses VZV and HSV-1 for human skin.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9444989 [PubMed - indexed for MEDLINE]

3818: Mol Pharmacol. 1998 Jan;53(1):157-65.

Intracellular metabolism of the N7-substituted acyclic nucleoside analog
2-amino-7-(1,3-dihydroxy-2-propoxymethyl)purine, a potent inhibitor of
herpesvirus replication.

Neyts J, Balzarini J, Andrei G, Chaoyong Z, Snoeck R, Zimmermann A, Mertens T,
Karlsson A, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.
johan.neyts@rega.kuleuven.ac.be

We investigated the intracellular metabolism of S2242
(2-amino-7-(1,3-dihydroxy-2-propoxymethyl)purine), the only known antivirally
active acyclic nucleoside analogue with the side chain substituted at the N7
position of the purine ring. Uptake of S2242 by CEM cells increased linearly with
increasing extracellular concentrations of the compound and was blocked by
inhibitors of nucleoside transport. S2242 was phosphorylated in a time- and
concentration-dependent manner to its monophosphates, diphosphates, and
triphosphates. Intracellular half-life of the diphosphates and triphosphates in
CEM cells was approximately 3-6 hr. A strong correlation was found between the
cytostatic action of the compound and its phosphorylation in different cell
lines. In accord with the findings that (1) the cytostatic potential of S2242 is 
reversed by deoxycytidine (dCyd) and (2) the growth of deoxycytidine
kinase-deficient (dCK-) cells is refractory to the inhibitory effect of S2242,
the amount of metabolites formed from S2242 in the dCK- cell line was
approximately one hundredth of that in the wild-type cells. The observation that 
purified dCK phosphorylates S2242 to its monophosphate further corroborates these
results. The activity of S2242 against herpes simplex virus, varicella-zoster
virus, and human herpesvirus type 6 was reversed by 50-100-fold on the addition
of exogenous dCyd. Compound S2242 was not preferentially phosphorylated in herpes
simplex virus 1-, varicella-zoster virus-, or human herpesvirus type 6-infected
cells (Vero, human embryonic lung, and HSB-2 cells, respectively), and
exogenously added dCyd reduced substantially the formation of S2242 metabolites
in these cells. In human cytomegalovirus (HCMV)-infected human embryonic lung
cells, a 5-25-fold increase in S2242 metabolite formation was observed compared
with the noninfected cells, suggesting that an HCMV-encoded or -induced enzyme
causes the specific phosphorylation of S2242. Exogenously added dCyd had little
effect on the activity of S2242 against HCMV and on the phosphorylation of the
compound in HCMV-infected cells. S2242 was not specifically phosphorylated by the
HCMV-encoded UL-97 kinase in cells infected with a vaccinia/UL-97 recombinant.
S2242 was found to be a substrate (K(m) = 90 microM) for purified human
deoxyguanosine kinase; the latter enzyme was stimulated 3-4-fold in HCMV-infected
cells.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9443944 [PubMed - indexed for MEDLINE]

3819: Ophthalmology. 1998 Jan;105(1):37-44; discussion 44-5.

Polymerase chain reaction-based assays of vitreous samples for the diagnosis of
viral retinitis. Use in diagnostic dilemmas.

Knox CM, Chandler D, Short GA, Margolis TP.

Francis I. Proctor Foundation, University of California, San Francisco
94122-0944, USA.

OBJECTIVE: This study aimed to review the authors' results using polymerase chain
reaction (PCR)-based assays for the diagnosis of viral retinitis. DESIGN: The
study design was a retrospective case series. PARTICIPANTS: Thirty-seven patients
(38 eyes) with active retinitis from whom vitreous biopsy specimens were received
in the authors' laboratory for diagnostic evaluation. INTERVENTION: Vitreous
biopsy specimens were evaluated with previously described PCR-based assays for
cytomegalovirus (CMV), varicella zoster virus (VZV), and herpes simplex virus
(HSV) DNA; clinical histories were reviewed. MAIN OUTCOME MEASURES: Laboratory
findings and clinical course were measured. RESULTS: The results of the authors' 
assays were consistent with the long-term clinical course of each patient.
Cytomegalovirus, VZV, or HSV DNA was detected in the vitreous from 24 patients.
Cytomegalovirus DNA was detected in vitreous biopsy specimens from 10 patients
(11 eyes). Nine patients (ten eyes) with acquired immune deficiency syndrome
ultimately were diagnosed with CMV retinitis as they were followed clinically
over time. Varicella zoster virus DNA was detected in vitreous biopsy specimens
from eight patients; seven adult patients were ultimately diagnosed with acute
retinal necrosis or progressive outer retinal necrosis. Herpes simplex virus DNA 
was detected in vitreous biopsy specimens from six patients; five patients had
previous or subsequent herpes encephalitis. No viral DNA was detected in the
vitreous from 13 patients; all were ultimately diagnosed with toxoplasmosis,
syphilis, Behcet disease, fungal endophthalmitis, or idiopathic inflammation.
CONCLUSIONS: These data further support the use of PCR-based assays of vitreous
specimens in the diagnostic evaluation of patients with infectious retinitis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9442777 [PubMed - indexed for MEDLINE]

3820: Z Arztl Fortbild Qualitatssich. 1997 Sep;91(6):533-6.

[Sudden hyponatremia with unconsciousness. Case report and brief overview of the 
syndrome of inadequate antidiuresis (SIAD or Schwartz-Bartter syndrome]

[Article in German]

Reimann D, Gross P.

Klinik fur Innere Medizin, Universitatsklinikum C. G. Carus, Dresden.

A sixty-six year old female was admitted to the hospital with an incomplete
hemiparesis on the left side combined with a short episode of unconsciousness.
According to her husband's account she had a seizure. Relevant laboratory
measurements: plasma sodium concentration 113.9 mmol/l, plasma concentration of
ADH 10.3 pg/ml, urine sodium concentration 44.4 mmol/l. The plasma concentrations
of creatinine and urea were within normal limits. The working hypothesis was SIAD
(syndrome of inappropriate antidiuresis) or Schwartz-Bartter-syndrome. The
patient was treated immediately with water restriction (500-1000 ml/day),
furosemide and i.v. replacement of urinary sodium losses by 3% NaCl. The analysis
of cerebrospinal fluid showed pleocytosis and increased concentrations of
immunoglobulins G and M. Serological diagnosis was positive for antigen of
varicella-zoster virus. These observations were thought to be compatible with a
diagnosis of SIAD in the setting of encephalitis. Under water restriction,
infusion of 3% saline, treatment with loop diuretics and aciclovir (3 x 750 mg
daily) the neurological function returned to normal within 2 days. A standard
oral water load on the 14th hospital days showed a return to a normal water
metabolism.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9441028 [PubMed - indexed for MEDLINE]

3821: Am J Ophthalmol. 1997 Sep;124(3):418-21.

Intravitreal ganciclovir treatment in progressive outer retinal necrosis.

Perez-Blazquez E, Traspas R, Mendez Marin I, Montero M.

Department of Ophthalmology, 12 de Octubre University Hospital, Madrid, Spain.
epblazquez@mx2.Redestb.es

PURPOSE: To report two patients with progressive outer retinal necrosis, which is
presumed to be caused by the varicella-zoster virus in patients with acquired
immunodeficiency syndrome (AIDS). METHOD: Case report. RESULTS: The patients were
treated with intravenous foscarnet, 60 mg per kg of body weight three times per
week, without response. Remission of retinal necrosis occurred with the
commencement of intravitreal ganciclovir treatment, 400 mg two times per week.
Laser photocoagulation was performed in both cases. Neither patient developed
retinal detachment. CONCLUSIONS: Intravitreal ganciclovir treatment combined with
systemic antiviral agent therapy in patients with progressive outer retinal
necrosis may delay progress of the disease. Early photocoagulation may prevent
the development of retinal detachment if retinal necrosis is controlled.

Publication Types: 
    Case Reports

PMID: 9439379 [PubMed - indexed for MEDLINE]

3822: Headache. 1997 Nov-Dec;37(10):663-4.

Herpes zoster ophthalmicus mimicking carotid artery dissection: a case report.

Verghese J, Kachroo A, Sparr SA.

Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461,
USA.

Herpes zoster is a common viral illness presenting with vesicular eruptions which
are usually preceded by pain, erythema, and tenderness in a dermatomal
distribution. The ophthalmic division of the trigeminal nerve is commonly
involved (herpes zoster ophthalmicus). Early diagnosis before eruption of
vesicles can be difficult and symptoms may be confused with other neurologic
disorders. We present a patient with herpes zoster ophthalmicus who presented
with face and neck pain associated with visual symptoms mimicking carotid artery 
dissection. Atypical presentation and benefits of early antiviral treatment are
discussed.

Publication Types: 
    Case Reports

PMID: 9439089 [PubMed - indexed for MEDLINE]

3823: J Med Chem. 1998 Jan 1;41(1):10-23.

(Z)- and (E)-2-((hydroxymethyl)cyclopropylidene)methyladenine and -guanine. New
nucleoside analogues with a broad-spectrum antiviral activity.

Qiu YL, Ksebati MB, Ptak RG, Fan BY, Breitenbach JM, Lin JS, Cheng YC, Kern ER,
Drach JC, Zemlicka J.

Department of Chemistry, Barbara Ann Karmanos Cancer Institute, Wayne State
University School of Medicine, Detroit, Michigan 48201-1379, USA.

New nucleoside analogues 14-17 based on a methylenecyclopropane structure were
synthesized and evaluated for antiviral activity. Reaction of 2,3-dibromopropene 
(19) with adenine (18) led to bromoalkene 20, which was benzoylated to give
N6,N6-dibenzoyl derivative 23. Attempts to convert 20 or 23 to bromocyclopropanes
21 and 22 by reaction with ethyl diazoacetate catalyzed by Rh2(OAc)4 were futile.
By contrast, 2,3-dibromopropene (19) afforded smoothly (E)- and
(Z)-dibromocyclopropane carboxylic esters 24 + 25. Alkylation of adenine (18)
with 24 + 25 gave (E)- and (Z)-bromo derivatives 21 + 22. Base-catalyzed
elimination of HBr resulted in the formation of (Z)- and
(E)-methylenecyclopropanecarboxylic esters 26 + 27. More convenient one-pot
alkylation-elimination of adenine (18) or 2-amino-6-chloropurine (30) with 24 +
25 afforded (Z)- and (E)-methylenecyclopropane derivatives 26 + 27 and 31 + 32.
The Z-isomers were always predominant in these mixtures (Z/E approximately 2/1). 
Reduction of 26 + 27 and 31 + 32 with DIBALH afforded (Z)- and
(E)-methylenecyclopropane alcohols 14 + 16 and 33 + 34. The latter were resolved 
directly by chromatography. Compounds 14 + 16 were converted to
N6-(dimethylamino)methylene derivatives 28 and 29 which were separated and
deprotected to give 14 and 16. Reaction of 33 and 34 with HCO2H led to guanine
analogues 15 and 17. The 1H NMR spectra of the Z-analogues 14 and 15 are
consistent with an anti-like conformation of the nucleobases. By contrast, 1H NMR
and IR spectra of bromo ester 21 are indicative of syn-conformation of adenine.
Several Z-(hydroxymethyl)methylenecyclopropanes exhibited in vitro antiviral
activity in micromolar or submicromolar range against human and murine
cytomegalovirus (HCMV and MCMV), Epstein-Barr virus (EBV), human herpes virus 6
(HHV-6), varicella zoster virus (VZV), and hepatitis B virus (HBV). Analogues 14,
15, and 33 were the most effective agents against HCMV (IC50 1-2.1, 0.04-2.1, and
0.8-5.6 microM), MCMV (IC50 2.1, 0.3, and 0.3 microM) and EBV in H-1 (IC50 0.2,
0.3, and 0.7 microM) and Daudi cells (IC50 3.2, 5.6, and 1.2 microM). Adenine
analogue 14 was active against HBV (IC50 2 microM), VZV (IC50 2.5 microM), and
HHV-6 (IC50 14 microM). Synadenol (14) and the E-isomer (16) were substrates of
moderate efficiency for adenosine deaminase from calf intestine. The E-isomer 16 
was more reactive than Z-isomer 14. The deamination of 14 effectively stopped at 
50% conversion. Synadenol (14) was also deaminated by AMP deaminase from
aspergillus sp.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9438017 [PubMed - indexed for MEDLINE]

3824: J Neuroophthalmol. 1997 Dec;17(4):262-5.

Complete ophthalmoplegia after zoster ophthalmicus.

Chang-Godinich A, Lee AG, Brazis PW, Liesegang TJ, Jones DB.

Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.

Complete ophthalmoplegia following herpes zoster ophthalmicus (HZO) is rare. We
report three cases of HZO-associated complete ophthalmoplegia and review thirteen
additional cases reported in the English language medical literature over the
past 30 years. HZO-associated complete ophthalmoplegia occurs mostly in
individuals over the age of 50 years and usually occurs within one to two weeks
of the development of cutaneous HZO. The prognosis for recovery is good,
with-significant improvement typically seen within 2 months and complete or near 
resolution within 18 months time.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Review

PMID: 9427180 [PubMed - indexed for MEDLINE]

3825: Can Fam Physician. 1997 Dec;43:2123.

Dilemmas in care of the elderly.

Pereles L, Triscott J, Meiring P.

Division of Geriatric Medicine, University of Alberta.

Publication Types: 
    Case Reports

PMID: 9426930 [PubMed - indexed for MEDLINE]

3826: Reg Anesth. 1997 Nov-Dec;22(6):575-8.

The "three-in-one block" for treatment of pain in a patient with acute herpes
zoster infection.

Hadzic A, Vloka JD, Saff GN, Hertz R, Thys DM.

Department of Anesthesiology, St. Luke's-Roosevelt Hospital Center, Columbia
University College of Physicians and Surgeons, New York, New York 10025, USA.

BACKGROUND AND OBJECTIVES: Herpes zoster infection in elderly patients frequently
results in disabling pain, carries a high risk of postherpetic neuralgia (PHN),
and can pose a significant therapeutic challenge. METHODS: We describe a
successful use of the perivascular technique of lumbar plexus blockade
("three-in-one block") for treatment of pain during acute herpes zoster infection
in an 82-year-old severely ill patient in whom other modalities were
contraindicated. RESULTS: Three-in-one block using 40 mL of 0.25% bupivacaine
with 1:300,000 epinephrine resulted in excellent pain relief that lasted for 2
weeks. CONCLUSIONS: The perivascular technique of lumbar plexus blockade may be a
useful alternative to epidural and paravertebral techniques of lumbar blockade in
the occasional patient for whom these other approaches are contraindicated.

Publication Types: 
    Case Reports

PMID: 9425976 [PubMed - indexed for MEDLINE]

3827: J Epidemiol Community Health. 1997 Oct;51(5):494-501.

Physical illness and disability among elderly people in England and Wales: the
Medical Research Council Cognitive Function and Ageing Study. The Analysis Group.

Parker CJ, Morgan K, Dewey ME.

Department of Health Care, Elderly, Medical School, Queen's Medical Centre,
Nottingham.

STUDY OBJECTIVE: This study was conducted as part of the MRC cognitive function
and ageing study. It aimed to estimate the lifetime prevalence of self reported
physical illnesses and other health related events, and the prevalence of
limiting disability in people over 65 in six areas of England and Wales. DESIGN: 
Screening phase of a two stage prevalence study. SETTING: Geographically
delimited areas in four urban and two rural areas including institutions.
PARTICIPANTS: Random population samples of people in their 65th year and above on
the sample definition date, interviewed between 1989 and 1994. In Newcastle,
Nottingham, and Oxford (urban) and in Cambridgeshire and Gwynedd(rural), the
sample was stratified to provide equal numbers in the 65-74 and 75 years and over
age groups. In Liverpool (urban), equal numbers in the five year age groups were 
taken. MAIN RESULTS: Age standardised prevalences were calculated for each
geographical area, sex, and age group (65-74, 75+). Many conditions were more
prevalent in the older age group including stroke, Parkinson's disease,
arthritis, diabetes, and shingles but hypertension was more common in the younger
age group. Conditions that were more prevalent in men included angina, heart
attack, stroke, head injury, and peptic ulcers while hypertension, shingles,
pernicious anaemia, and thyroid disease were more common in women. There was a
complex pattern of area differences for individual conditions. Cambridgeshire had
generally low prevalences for many diseases, including vascular problems, Gwynedd
and Newcastle had less healthy elderly populations, and Nottingham and Newcastle 
had the highest percentages of housebound. CONCLUSIONS: This study provides the
most robust available estimates for life-time prevalence of a variety of health
conditions on a regional and national basis. It shows the greatly increased
prevalence of disability in the very old population, particularly women.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9425458 [PubMed - indexed for MEDLINE]

3828: J Virol. 1998 Jan;72(1):42-7.

Varicella-zoster virus gene 21: transcriptional start site and promoter region.

Cohrs RJ, Barbour M, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA. randall.cohrs@uchsc.edu

Varicella-zoster virus (VZV) causes chicken pox (varicella), becomes latent in
dorsal root ganglia, and reactivates decades later to cause shingles (zoster).
During latency, the entire VZV genome is present in a circular form, from which
genes 21, 29, 62, and 63 are transcribed. Immediate-early (IE) VZV genes 62 and
63 encode regulators of virus gene transcription, and VZV gene 29 encodes a major
DNA-binding protein. However, little is known about the function of VZV gene 21
or the control of its transcription. Using primer extensions, we mapped the start
of VZV gene 21 transcription in VZV-infected cells to a single site located at
-79 nucleotides (nt) with respect to the initiation codon. To identify the VZV
gene 21 promoter, the 284-bp region of VZV DNA separating open reading frames
(ORFs) 20 and 21 was cloned upstream from the chloramphenicol acetyltransferase
gene. In transient-transfection assays, the VZV gene 21 promoter was
transactivated in VZV-infected, but not uninfected, cells. Further, the protein
encoded by ORF 62 (IE62), but not those encoded by VZV ORFs 4, 10, 61, and 63,
transactivates the VZV gene 21 promoter. By use of transient-cotransfection
assays in conjunction with 5' deletions of the VZV gene 21 promoter, a 40-bp
segment was shown to be responsible for the transactivation of the VZV gene 21
promoter by IE62. This region was located at -96 to -56 nt with respect to the 5'
start of gene 21 transcription.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9420198 [PubMed - indexed for MEDLINE]

3829: J Am Acad Dermatol. 1997 Dec;37(6):1022.

Comment on:
    J Am Acad Dermatol. 1997 Jan;36(1):98-9.

Cutaneous localization of B-cell chronic lymphocytic leukemia at the site of
varicella/herpesvirus eruptions.

Cerroni L, Kerl H.

Publication Types: 
    Comment
    Letter

PMID: 9418787 [PubMed - indexed for MEDLINE]

3830: J Med Virol. 1997 Dec;53(4):332-9.

Cloning, expression, and immunogenicity of the assembly protein of
varicella-zoster virus and detection of the products of open reading frame 33.

Garcia-Valcarcel M, Fowler WJ, Harper DR, Jeffries DJ, Layton GT.

British Biotech Pharmaceuticals Ltd, Oxford, England.

Herpesviruses produce assembly proteins (AP) that act as scaffolding proteins for
the assembly of the viral capsids. The products of the assemblin gene, which
encodes both maturational protease and AP, have been established for herpes
simplex virus type 1 (HSV-1) and human cytomegalovirus (CMV). We cloned an
inframe ORF (encoding amino acids 304-605), found within the ORF 33 assemblin
gene of VZV, into a yeast expression vector. The 34-kDa AP was expressed as a
fusion protein with the particle-forming Ty p1 protein, resulting in high-level
production of hybrid AP-virus-like particles (AP-VLPs). When AP-VLPs were
injected into mice and rabbits, antibodies were produced that reacted with, but
that did not neutralise, native VZV. Three of four inbred strains of mice
immunised with AP-VLPs produced a VZV-specific T-cell response. The mouse and
rabbit sera reacted with six bands on native VZV by Western blot analysis. The
dominant bands were found at 34 and 38 kDa. Bands were also seen at 66, 63, 41,
and 31 kDa. The 38-kDa protein may represent the mature AP derived from the
41-kDa precursor AP, itself the release product from the full-length 66-kDa
assemblin. The 34-kDa protein probably represents the product of the inframe
co-translational gene within ORF 33 encoding amino acids 304-605. The genetic
organisation and proteolytic maturation of VZV assemblin are, therefore,
analogous to those of other herpesviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9407380 [PubMed - indexed for MEDLINE]

3831: J Med Virol. 1997 Dec;53(4):324-31.

The detection of intrathecal synthesis of anti-herpes simplex IgG antibodies:
comparison between an antigen-mediated immunoblotting technique and antibody
index calculations. European Union Concerted Action on Virus Meningitis and
Encephalitis.

Monteyne P, Albert F, Weissbrich B, Zardini E, Ciardi M, Cleator GM, Sindic CJ.

Laboratory of Neurochemistry, Catholic University of Louvain, Brussels, Belgium.

The detection of intrathecal antibody synthesis was compared by the calculation
of antibody indices (AI) derived from ELISA techniques with the detection of
virus-specific oligoclonal IgGs by an antigen-mediated capillary blot technique. 
Twenty-seven paired serum and cerebrospinal fluid (CSF) samples were examined
from 15 immunocompetent patients with herpes simplex virus encephalitis (HSE)
diagnosed by PCR on early CSF samples. These techniques were also applied to
paired samples from 20 multiple sclerosis (MS) patients, 10 patients with other
inflammatory neurological diseases and 10 patients with non inflammatory
neurological disorders. There was a good correlation between the results obtained
by AI and those obtained by immunoblotting, especially in HSE (2 discordant
results out of 27). Discrepancies were more frequent (25%) in MS patients where a
"polyspecific" reaction characterized by low affinity antibodies is known to
occur. Some of the discrepancies could, in part, be due to serological
cross-reaction with varicella zoster virus.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9407379 [PubMed - indexed for MEDLINE]

3832: Yakugaku Zasshi. 1997 Nov;117(10-11):910-21.

[Lethal drug interactions of the new antiviral, sorivudine, with anticancer
prodrugs of 5-fluorouracil]

[Article in Japanese]

Watabe T, Okuda H, Ogura K.

School of Pharmacy, Tokyo University of Pharmacy and Life Science, Japan.

In 1993 eighteen Japanese patients with cancer and herpes zoster, a viral
disease, died from interactions of the new oral antiviral drug, sorivudine (SRV: 
1-beta-D-arabinofuranosyl-(E)-5-(2-bromovinyl)uracil), with oral anticancer
prodrugs of 5-fluorouracil (5-FU) within 40 d after SRV was approved by the
Japanese government and began to be used clinically. Before the death, most of
these patients had severe symptoms of toxicity, including diarrhea with bloody
flux and marked decreases in white blood cell and platelet counts. All of these
patients received SRV daily for several days while being administered long-term
anticancer chemotherapy with one of the oral 5-FU prodrugs. There was no acute
toxic symptom in patients who received SRV alone or SRV and the other types of
anticancer drugs. A toxicokinetic study was carried out using rats to investigate
the mechanism of the acute death in the patients caused by drug interactions
between SRV and 5-FU prodrugs. Rats were orally coadministered SRV with tegafur
(FT: 1-(2-tetrahydrofuryl)-5-fluorouracil), a 5-FU prodrug that most of the
patients were considered to receive before the death. All the rats receiving SRV 
and FT once daily showed extremely elevated levels of 5-FU in the plasma and
tissues, including bone marrow and small intestines, and died within 10 d, while 
the animals given the same repeated dose of SRV or FT alone were still alive over
20 d without any appreciable toxic symptom. Before their death, there were a
marked damage of bone marrow, a marked atrophy of intestinal membrane mucosa,
marked decreases in white blood cells and platelets, diarrhea with bloody flux,
and severe anorexia as reported for the patients. Data obtained by in vivo and in
vitro studies indicated that (E)-5-(2-bromovinyl)uracil (BVU), generated from SRV
by the gut flora and absorbed through the intestinal membrane, was reduced in the
presence of NADPH to a reactive form by hepatic dihydropyrimidine dehydrogenase
(DPD), a key enzyme regulating the tissue 5-FU levels from FT, bound covalently
to DPD as a suicide inhibitor, and markedly retarded the catabolism of 5-FU. An
irreversible inactivation by BVU of rat and human DPDs, expressed in E. coli for 
the latter, was observed in the presence of NADPH with their purified
preparations in a manner reciprocal to radiolabelling of the enzyme proteins with
[14C]BVU. SRV showed no inhibitory effect on the rat and human DPDs in the
presence of NADPH.

Publication Types: 
    English Abstract
    Review

PMID: 9414600 [PubMed - indexed for MEDLINE]

3833: Pain. 1997 Oct;73(1):97-9.

Mexiletine-induced severe skin eruption, fever, eosinophilia, atypical
lymphocytosis, and liver dysfunction.

Higa K, Hirata K, Dan K.

Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.
higak@msat.fukuoka-u.ac.jp

A 64-year-old man developed a severe generalized pruritic morbilliform skin
eruption, fever, eosinophilia, atypical lymphocytosis, and liver dysfunction 30
days after ingestion of mexiletine, a sodium channel blocker, prescribed to treat
postherpetic neuralgia. Following intravenous dexamethasone, body temperature
normalized the next day. However, the skin eruption did not disappear completely 
for 4 weeks. The patch test was positive for mexiletine. Clinical features and
the result of patch test indicated that the patient developed hypersensitivity
syndrome, a severe adverse cutaneous drug reaction, caused by mexiletine. We
propose that mexiletine be added to the list of drugs that can cause severe
adverse cutaneous drug reactions and that patients receiving mexiletine be warned
to stop taking the drug immediately if a skin eruption occurs.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9414061 [PubMed - indexed for MEDLINE]

3834: New Microbiol. 1997 Oct;20(4):351-4.

Detection of varicella zoster virus DNA in single trigeminal ganglia by
polymerase chain reaction.

Mainka C, Wolff MH.

Institute of Microbiology and Virology, University Witten/Herdecke, Germany.

Single human trigeminal ganglia were studied for DNA sequences of varicella
zoster virus immediate early gene 63 by PCR. Out of 24 trigeminal ganglia five
were tested positive for VZV DNA by standard PCR (21%), in six more VZV DNA was
detectable using nested PCR (46%).

PMID: 9385606 [PubMed - indexed for MEDLINE]

3835: BMJ. 1997 Nov 1;315(7116):1163.

Comment in:
    BMJ. 1998 Jan 17;316(7126):233-4.    BMJ. 1998 Jan 17;316(7126):234.

Steroids should never be given until possible herpes zoster infection has been
excluded.

Devine JC.

Publication Types: 
    Case Reports
    Letter

PMID: 9374910 [PubMed - indexed for MEDLINE]

3836: Biochemistry. 1997 Nov 18;36(46):14023-9.

Active site cavity of herpesvirus proteases revealed by the crystal structure of 
herpes simplex virus protease/inhibitor complex.

Hoog SS, Smith WW, Qiu X, Janson CA, Hellmig B, McQueney MS, O'Donnell K,
O'Shannessy D, DiLella AG, Debouck C, Abdel-Meguid SS.

Department of Macromolecular Sciences, SmithKline Beecham Pharmaceuticals, King
of Prussia, Pennsylvania 19406, USA.

Human herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are responsible for 
herpes labialis (cold sores) and genital herpes, respectively. They encode a
serine protease that is required for viral replication, and represent a viable
target for therapeutic intervention. Here, we report the crystal structures of
HSV-1 and HSV-2 proteases, the latter in the presence and absence of the
covalently bound transition state analog inhibitor diisopropyl phosphate (DIP).
The HSV-1 and HSV-2 protease structures show a fold that is neither like
chymotrypsin nor like subtilisin, and has been seen only in the recently
determined cytomegalovirus (CMV) and varicella-zoster virus (VZV) protease
structures. HSV-1 and HSV-2 proteases share high sequence homology and have
almost identical three-dimensional structures. However, structural differences
are observed with the less homologous CMV protease, offering a structural basis
for herpes virus protease ligand specificity. The bound inhibitor identifies the 
oxyanion hole of these enzymes and defines the active site cavity.

Publication Types: 
    Comparative Study

PMID: 9369473 [PubMed - indexed for MEDLINE]

3837: Urol Nurs. 1997 Sep;17(3):119-21.

Herpes zoster as a reversible cause of neurogenic bladder.

Wozniak-Petrofsky J.

Publication Types: 
    Case Reports

PMID: 9349049 [PubMed - indexed for MEDLINE]

3838: Nurse Pract. 1997 Nov;22(11):17-20, 23-4, 26-7 passim.

Comment in:
    Nurse Pract. 1998 Apr;23(4):18.

Common adult infectious skin conditions.

Reifsnider E.

University of Texas at Austin, School of Nursing, USA.

Infectious skin conditions of the adult patient that primary care providers may
often encounter in practice include those of viral (herpes simplex, herpes
zoster, verruca and condylomata, molluscum), fungal (candidiasis, dermatophyte
infections) and ectoparasitic (scabies, pediculosis) origin. Correct diagnosis
and treatment of these conditions can provide relief to the patient and prevent
spread to household and sexual contacts. This article discusses the epidemiology,
etiology, history, appearance, diagnosis, and treatment of these commonly
encountered infectious skin conditions. The primary care provider can
differentiate these skin conditions by history, appearance, and laboratory tests,
and should be able to diagnose and provide cost-effective therapy and secondary
prevention for them. The primary care provider should also be able to recognize
those lesions that are harbingers of systemic diseases and appropriately refer
for further management.

Publication Types: 
    Review

PMID: 9403871 [PubMed - indexed for MEDLINE]

3839: J Infect Dis. 1997 Dec;176(6):1496-500.

Varicella-zoster virus infection in children with underlying human
immunodeficiency virus infection.

Gershon AA, Mervish N, LaRussa P, Steinberg S, Lo SH, Hodes D, Fikrig S, Bonagura
V, Bakshi S.

Department of Pediatrics, Columbia University College of Physicians & Surgeons,
and Mt. Sinai Medical Center, New York, New York 10032, USA.

This article describes a prospective longitudinal study of varicella-zoster virus
(VZV) infections in human immunodeficiency virus (HIV)-infected children,
designed to determine their natural history of VZV infection and possible effects
of VZV on the progression of HIV infection. Varicella was usually not a serious
acute problem, and it did not seem to precede clinical deterioration. The rate of
zoster was high: 70% in children with low levels of CD4+ lymphocytes at the time 
of development of varicella. It is predicted that immunization with live
attenuated varicella vaccine is unlikely to be deleterious to HIV-infected
children. Moreover, if they are immunized when they still have relatively normal 
levels of CD4+ lymphocytes, they may have a lower rate of reactivation of VZV
than if they were allowed to develop natural varicella when their CD4+ cell
counts have fallen to low levels as a result of progressive HIV infection.

Publication Types: 
    Multicenter Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 9395360 [PubMed - indexed for MEDLINE]

3840: Acta Derm Venereol. 1997 Nov;77(6):491-2.

Comment in:
    Acta Derm Venereol. 1998 Jul;78(4):300.

Zosteriform lichen planus without evidence of herpes simplex virus or
varicella-zoster virus by polymerase chain reaction. Report of two cases.

Lutz ME, Perniciaro C, Lim KK.

Publication Types: 
    Case Reports
    Letter

PMID: 9394999 [PubMed - indexed for MEDLINE]

3841: Am J Otol. 1997 Nov;18(6):734-7.

Detection of viral DNA in vestibular ganglia tissue from patients with Meniere's 
disease.

Welling DB, Miles BA, Western L, Prior TW.

Department of Otolaryngology, Ohio State University, College of Medicine,
Columbus 43210, USA.

OBJECTIVE: The main goal of this study was to examine the vestibular ganglia from
11 patients with intractable classic Meniere's disease (MD) for the presence or
absence of DNA from three neurotropic viruses (herpes simplex virus,
cytomegalovirus, and varicella zoster virus) using exquisitely sensitive
molecular biologic techniques. STUDY DESIGN: This was a prospective controlled
study with vestibular ganglia from patients with MD and from patients with small 
vestibular schwannomas undergoing resection. Polymerase chain reaction was used
for viral DNA detection from the ganglia along with known positive and negative
polymerase chain reaction control subjects. SETTING: The study was performed in
an academic tertiary referral center. PATIENTS: Patients for inclusion had
medically uncontrolled MD, including documented fluctuating sensorineural hearing
loss, episodic vertigo, and tinnitus who elected to undergo vestibular nerve
section. Control patients were undergoing vestibular schwannoma removal.
INTERVENTIONS: The intervention was vestibular nerve section with removal of
vestibular ganglion. MAIN OUTCOME MEASURES: The presence or absence of viral DNA 
(herpes simplex virus, cytomegalovirus, and varicella zoster virus) in vestibular
ganglion tissues detected by polymerase chain reaction. RESULTS: No viral DNA was
detected in the vestibular ganglia of patients with MD (p = 0.028) nor in the
control group. The likelihood of a type II or beta type error was < 10%.
CONCLUSIONS: In patients with MD requiring surgical intervention, infection with 
herpes simplex virus, cytomegalovirus, or varicella zoster virus of the
vestibular ganglia does not appear to play a major role in the pathoetiology of
the disease.

PMID: 9391669 [PubMed - indexed for MEDLINE]

3842: J Child Neurol. 1997 Oct;12(7):464-6.

Childhood AIDS, varicella zoster, and cerebral vasculopathy.

Frank Y, Lu D, Pavlakis S, Black K, LaRussa P, Hyman RA.

North Shore University Hospital, New York, USA.

Publication Types: 
    Case Reports

PMID: 9373805 [PubMed - indexed for MEDLINE]

3843: J Virol. 1997 Dec;71(12):9118-23.

The pseudorabies virus UL28 protein enters the nucleus after coexpression with
the herpes simplex virus UL15 protein.

Koslowski KM, Shaver PR, Wang XY, Tenney DJ, Pederson NE.

Department of Microbiology and Immunology, East Carolina University School of
Medicine, Greenville, North Carolina 27858-4354, USA.

Herpesvirus DNA is packaged into capsids in the nuclei of infected cells in a
process requiring at least six viral proteins. Of the proteins required for
encapsidation of viral DNA, UL15 and UL28 are the most conserved among herpes
simplex virus type 1 (HSV), varicella-zoster virus, and equine herpesvirus 1. The
subcellular distribution of the pseudorabies virus (PRV) UL28 protein was
examined by in situ immunofluorescence. UL28 was present in the nuclei of
infected cells; however, UL28 was limited to the cytoplasm in the absence of
other viral proteins. When cells expressing variant forms of UL28 were infected
with a PRV UL28-null mutant, UL28 entered the nucleus, provided the
carboxyl-terminal 155 amino acids were present. Additionally, PRV UL28 entered
the nucleus in cells infected with HSV. Two HSV packaging proteins were tested
for the ability to affect the subcellular distribution of UL28. Coexpression of
HSV UL15 enabled PRV UL28 to enter the nucleus in a manner that required the
carboxyl-terminal 155 amino acids of UL28. Coexpression of HSV UL25 did not
affect the distribution of UL28. We propose that an interaction between UL15 and 
UL28 facilitates the transport of a UL15-UL28 complex to the infected-cell
nucleus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9371568 [PubMed - indexed for MEDLINE]

3844: Arch Fam Med. 1997 Nov-Dec;6(6):537-41.

Concerns regarding universal varicella immunization. Time will tell.

MacFarlane LL, Sanders ML, Carek PJ.

Department of Family Medicine, Medical University of South Carolina, Charleston, 
USA. macfarll@musc.edu

The American Academy of Pediatrics, the Advisory Committee on Immunization
Practices, and the American Academy of Family Physicians now recommend universal 
immunization for varicella for all susceptible children and adolescents. Although
the varicella vaccine appears safe and efficacious, it is unknown how universal
immunization will influence the epidemiology of varicella infections. The
duration of immunity, both conferred and passive reinoculation, remains a concern
and must continue to be evaluated in the population of vaccinees. As universal
immunization is implemented, the cost-effectiveness of such a program will need
to be evaluated. Physicians and parents must be educated about the risks and
benefits of vaccination vs natural infection.

Publication Types: 
    Review

PMID: 9371046 [PubMed - indexed for MEDLINE]

3845: Am J Obstet Gynecol. 1997 Oct;177(4):894-8.

Prenatal diagnosis of fetal varicella-zoster virus infection with polymerase
chain reaction of amniotic fluid in 107 cases.

Mouly F, Mirlesse V, Meritet JF, Rozenberg F, Poissonier MH, Lebon P, Daffos F.

Laboratoire de Recherche sur les Infections Virales, Hopital Saint Vincent de
Paul, Universite Rene Descartes, Paris, France.

OBJECTIVE: Varicella, resulting from primary infection by varicella zoster virus,
carries a risk of severe congenital varicella. Prenatal diagnosis is rarely
applied because methods remain to be validated. STUDY DESIGN: From 1989 to 1994, 
107 women contracted clinical varicella before 24 weeks of pregnancy.
Amniocentesis was performed in all cases, with simultaneous fetal blood sampling 
in 82 cases. Virus was detected in amniotic fluid by cell culture inoculation and
polymerase chain reaction. Fetal blood was tested for anti-varicella zoster virus
immunoglobulin M. RESULTS: Of the 107 amniotic fluid samples tested, nine of 107 
(8.4%) were positive by polymerase chain reaction, but only two of these (1.8%)
were positive in cell culture; none of the blood samples from infected fetuses
were positive for specific anti-varicella zoster virus immunoglobulin M. The
outcome of 99 pregnancies was fully documented. CONCLUSION: The risk of
transplacental passage before 24 weeks of pregnancy was 8.4% in our series. The
risk of congenital varicella is 3 in 107 (2.8%) and that of isolated postnatal
varicella zoster infection is 3 in 78 (3.8%). Polymerase chain reaction is more
sensitive than cell culture for the detection of varicella zoster virus in
amniotic fluid.

PMID: 9369842 [PubMed - indexed for MEDLINE]

3846: Indian J Gastroenterol. 1997 Oct;16(4):153-4.

Intestinal lymphangiectasia: presentation in pregnancy and association with
herpes zoster and alopecia.

Ghoshal UC, Gupta R, Aggarwal R, Puri AS, Naik SR.

Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical
Sciences, Lucknow.

We report a woman with intestinal lymphangiectasia whose symptoms were wrongly
attributed to pregnancy; the diagnosis was made in the postpartum period. She
also developed alopecia and herpes zoster.

Publication Types: 
    Case Reports

PMID: 9357190 [PubMed - indexed for MEDLINE]

3847: J Infect. 1997 Sep;35(2):183-5.

Disseminated cutaneous zoster and aseptic meningitis in a previously healthy
patient.

Moriuchi H, Moriuchi M, Sun CC, Trucksis M.

Department of Internal Medicine, University of Maryland School of Medicine,
Baltimore, U.S.A.

A previously healthy, 37-year-old immunocompetent man presented with disseminated
cutaneous zoster and aseptic meningitis. Varicella zoster virus DNA was recovered
from the cerebrospinal fluid (CSF) by the polymerase chain reaction. Cytological 
evaluation of the CSF revealed 'reactive, highly atypical lymphocytosis'. The
patient fully recovered after treatment with aciclovir.

Publication Types: 
    Case Reports

PMID: 9354356 [PubMed - indexed for MEDLINE]

3848: Int J Dermatol. 1997 Sep;36(9):717-8.

Herpes zoster-like Sweet's syndrome in acute myelogenous leukemia.

Chiang CT, Chan HL, Kuo TT, Wang PN.

Publication Types: 
    Case Reports
    Letter

PMID: 9352420 [PubMed - indexed for MEDLINE]

3849: Int J Dermatol. 1997 Sep;36(9):667-72.

A retrospective study of the clinical presentation and outcome of herpes zoster
in a tertiary dermatology outpatient referral clinic.

Goh CL, Khoo L.

Institute of Dermatology, National Skin Center, Singapore.

BACKGROUND: This is a retrospective study of the epidemiology and morbidity of
herpes zoster and the risk factors for herpes zoster morbidity in Singapore.
RESULTS: The mean age of 164 patients with herpes zoster seen at our dermatology 
clinic between January 1994 and December 1995 was 48.8 years, with a sex ratio of
1:1. The common presenting symptoms were pain (90%), feelings of helplessness and
depression (20%), and flu-like symptoms (12%). The commonest prodromes were pain 
(41%), itching (27%), and paresthesia (12%). Prodromal pain was more frequently
experienced by patients aged more than 50 years (42%) than by patients aged less 
than 30 years (25%). The thoracic (45%) and cervical (23%) dermatomes were the
most commonly affected in all age groups. There was no statistically significant 
difference in the frequency of dermatomal distribution among the different age
groups and between the sexes. Pain was experienced by almost all (95%) patients
during the course of their disease. It tended to be more severe in older
patients. Burning (26%), stabbing (15%), and shooting (15%) pain were the most
common types experienced. Post-herpetic neuralgia was significantly more common
in older patients. The prevalence of post-herpetic neuralgia decreased over time 
in all age groups. A higher proportion of older patients (more than 50 years of
age) (20%) suffered from post-herpetic neuralgia compared with younger patients
(less than 30 years of age) (7%) (not significant). Patients in all age groups
considered acute pain (46%) and persistent pain (25%) to be their most unbearable
symptoms during the course of herpes zoster. The most significant problems caused
by herpes zoster pain were insomnia (25%), misery (feeling helpless and
depressed) (20%), limitation of movement (9%), and inability to continue work
(8%). Insomnia was significantly more commonly experienced by patients more than 
50 years of age (36%) than those less than 30 years of age (P = 0.026). Few
patients (9%) consulted their general practitioner (GP) during the prodrome or on
the day of appearance of skin eruptions. Most patients (45%) consulted their GP
within the first 3 days of the onset of skin eruptions; 33% sought treatment more
than 3 days after the appearance of zoster symptoms. Only 30% of patients were
willing to pay more than S$200 for antiviral therapy. Most (43%) were only
prepared to pay for antiviral treatment if it cost less than S$200. The most
important features the patients wished to derive from antiviral therapy were a
shortening of the duration of skin lesions (55%) and a reduction in the severity 
of pain (acute and chronic) (30%). CONCLUSIONS: Our study indicated that older
patients (aged more than 50 years) were at a higher risk of developing
post-herpetic neuralgia. They were also more likely to suffer morbidity, e.g.
insomnia. There is a need to educate patients at risk to identify the prodrome
and skin eruptions of herpes zoster so that early antiviral therapy can be
considered.

PMID: 9352407 [PubMed - indexed for MEDLINE]

3850: J Clin Microbiol. 1997 Nov;35(11):2869-72.

Molecular evidence and clinical significance of herpesvirus coinfection in the
central nervous system.

Tang YW, Espy MJ, Persing DH, Smith TF.

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester,
Minnesota 55905, USA.

A total of 60 cerebrospinal fluid (CSF) specimens from patients manifesting
symptoms resembling viral central nervous system (CNS) disease were examined for 
the presence of herpes simplex virus (HSV), human herpesvirus 6 (HHV-6),
Epstein-Barr virus (EBV), cytomegalovirus, varicella-zoster virus, Borrelia
burgdorferi, and Tropheryma whippelii DNA by PCR. Of 30 specimens which were
selected on the basis of HSV DNA positivity, 2 were concomitantly positive for
HHV-6 DNA and 1 was positive for EBV DNA. In the three specimens positive for
more than one herpesvirus, amplicons generated with virus-specific primer sets
hybridized specifically to the corresponding virus-specific probe. Sequence
analysis of the two amplified DNA fragments demonstrated that they were derived
from distinct herpesviruses. Of 22 patients with clinically diagnosed
encephalitis, 2 of 3 patients coinfected with HSV and HHV-6 died, compared to 1
of 19 (5%) patients infected with only HSV. Of 30 CSF specimens that were
negative for HSV DNA, EBV DNA was detected in one sample. These data indicated
the presence of DNA specific for two distinct herpesviruses in the same CSF
specimen, providing molecular evidence that coinfection with this group of
viruses may occur in the CNS.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9350749 [PubMed - indexed for MEDLINE]

3851: J Clin Microbiol. 1997 Nov;35(11):2807-9.

Molecular epidemiology of varicella-zoster virus in East London, England, between
1971 and 1995.

Hawrami K, Hart IJ, Pereira F, Argent S, Bannister B, Bovill B, Carrington D,
Ogilvie M, Rawstorne S, Tryhorn Y, Breuer J.

Department of Medical Microbiology and Virology, St. Bartholomew's and Royal
Hospital School of Medicine and Dentistry, Queen Mary Westfield College, London, 
United Kingdom.

The molecular epidemiology of varicella-zoster virus in London, England, between 
1971 and 1995 was examined by using two informative polymorphic markers, variable
repeat region R5 and a BglI restriction site in gene 54. Viruses from 105 cases
of chickenpox and 144 of zoster were typed. Two alleles of R5, A and B, were
found at prevalences of 89 and 6%, respectively. No difference in allele
frequency between the zoster and chickenpox cases was found, and no change in the
frequencies of these alleles was observed to occur over time. By contrast, a BglI
restriction site (BglI+) was found with increasing frequency over time among
cases of varicella (P < 0.005) and, to a lesser extent, cases of zoster. The
BglI+ polymorphism was strongly associated (P < 0.0005) with zoster in subjects
who had immigrated to the United Kingdom from countries with low adult immunity
to varicella (LAIV). Sixty-three percent of the subjects with zoster who had
emigrated from countries with LAIV carried the BglI+ virus, in contrast to 10% of
adults who had grown up in countries with high adult immunity to varicella. The
significance of these data, in view of the changing epidemiology of chickenpox,
is discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9350738 [PubMed - indexed for MEDLINE]

3852: J Okla State Med Assoc. 1997 Sep-Oct;90(7):376-82.

AMA Council on Scientific Affairs. Immunization of health care workers with
varicella vaccine.

[No authors listed]

Varicella-zoster virus (VZV) is the etiologic agent of two common diseases:
varicella (chickenpox) and herpes zoster (shingles). Groups such as infants under
one year of age, the immunocompromised, and adults are at increased risk of
developing complications from VZV infection. The transmission of VZV within
health care facilities from contact with infected patients, staff, and visitors
is a potentially serious problem. Nosocomial outbreaks of varicella can result in
significant morbidity and mortality in high-risk patients, particularly in
pediatric wards. VZV transmission to susceptible individuals is difficult to
prevent because exposures may occur before appropriate infection control
procedures can be implemented. In 1995, a varicella vaccine was approved for use 
in the United States. The vaccine has been shown to be fairly effective in
preventing varicella in adults and very effective in preventing severe disease.
While current data indicate that the vaccine is safe and poses minimal risks,
more research is needed to address concerns about the long-term safety, efficacy,
and epidemiological impact of more widespread use of the vaccine. It is important
for health care workers, especially those working with high-risk groups, to know 
their VZV immune status. Unless contraindicated, health care workers who have no 
history of VZV infection and are serologically negative should be considered a
priority for immunization with the varicella vaccine. Administration of the
vaccine to health care workers could reduce nosocomial transmission of VZV.
Furthermore, significant cost and labor savings could be realized by avoiding
expensive and potentially disruptive infection control measures.

PMID: 9379251 [PubMed - indexed for MEDLINE]

3853: J Gen Intern Med. 1997 Oct;12(10):626-8.

Translating statistics for use in the clinic.

Atkins CD.

Publication Types: 
    Case Reports

PMID: 9346459 [PubMed - indexed for MEDLINE]

3854: Clin Orthop Relat Res. 1997 Oct;(343):224-34.

Displacements of the tibial tuberosity. Effects of the surgical parameters.

Benvenuti JF, Rakotomanana L, Leyvraz PF, Pioletti DP, Heegaard JH, Genton MG.

Hopital Orthopedique de la Suisse Romande, Lausanne, Switzerland.

A three-dimensional computer model is used, based on the finite element method,
to investigate the effects of 1-, 1.5-, and 2-cm tibial tubercle elevations and
of 0.5- and 1-cm medial displacements of the tuberosity, performed with different
bone shingles. Patellar kinematics and patellofemoral interface peak pressure,
between 45 degrees and 135 degrees of passive knee flexion, are compared for
these different surgical parameters with those of a normal knee not surgically
treated. The shingle lengths of 3, 5, 7, and 10 cm have little influence on the
results. Augmenting tubercle medializations decrease the lateral peak pressure
but result in an overpressure of the medial facet that is 154% of the normal peak
value. With knee flexion between 45 degrees and 60 degrees, increasing tubercle
elevations decreases later and medial peak pressures. With flexion of more than
60 degrees, increasing elevations decrease the lateral peak pressure, but they
augment and even cause overpressure on the medial facet. An overpressure on the
lateral facet also is seen in midrange knee flexion (75 degrees-90 degrees) for
all tubercle elevation values. Increasing tubercle elevations and medializations 
appear to be the predominant parameters from a biomechanical point of view.

Publication Types: 
    Comparative Study

PMID: 9345228 [PubMed - indexed for MEDLINE]

3855: Plast Reconstr Surg. 1997 Oct;100(5):1357-9.

Herpes zoster after breast augmentation.

Tantille MB, Adams WP, Duffy FJ.

Publication Types: 
    Case Reports
    Letter

PMID: 9326805 [PubMed - indexed for MEDLINE]

3856: Anal Biochem. 1997 Oct 1;252(1):190-7.

Measurement of carbonic anhydrase activity using a sensitive fluorometric assay.

Shingles R, Moroney JV.

Department of Biology, The Johns Hopkins University, Baltimore, Maryland
21218-2685, USA.

The dehydration reaction of bicarbonate was measured using the fluorescent pH
indicator, 8-hydroxypyrene-1,3,6-trisulfonate (pyranine), in combination with
stopped-flow spectrofluorometry. The initial rate of bicarbonate dehydration was 
measured after mixing a pH 6.0 solution with a pH 8.0 solution containing
bicarbonate. Addition of carbonic anhydrase to the pH 6.0 solution enabled the
measurement of the initial rate of activity at physiological temperatures with
resolution times of 2 ms. This assay was used to resolve differences in activity 
and sensitivity to sulfonamides by comparing mammalian carbonic anhydrase
isoforms. The fluorescent technique used in this study is very sensitive,
allowing the determination of initial rates with a protein concentration as
little as 65 ng/ml. Pyranine can also be loaded into membrane vesicles to follow 
carbonic anhydrase activity within vesicles. The change in pH within vesicles is 
dependent on the concentration of externally added bicarbonate and the presence
of carbonic anhydrase on either side of the membrane. Therefore, this assay can
be used to measure carbon dioxide flux across membranes and to assess the
contribution of carbonic anhydrase to this flux.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 9324959 [PubMed - indexed for MEDLINE]

3857: Dent Clin North Am. 1997 Oct;41(4):877-90.

Diagnosis and treatment of common oral lesions found in the elderly.

Fantasia JE.

Department of Dental Medicine, Long Island Jewish Medical Center, New Hyde Park, 
New York 11040, USA.

A wide variety of oral lesions are recognized in the geriatric patient. The most 
common lesions include neoplasia, immunologic based mucosal disease,
hematological disorders, oral manifestation of systemic disease, and conditions
characterized by oral or facial pain. Diagnostic and treatment considerations for
leukoplakia, carcinoma, metastatic disease, candidiasis, herpes zoster,
plasmacytoma, myeloma, lymphoma, several of the more common vesiculoulcerative
mucosal diseases and idiopathic burning mouth syndrome are presented.

Publication Types: 
    Review

PMID: 9344282 [PubMed - indexed for MEDLINE]

3858: Muscle Nerve. 1997 Nov;20(11):1433-8.

Motor involvement in acute herpes zoster.

Haanpaa M, Hakkinen V, Nurmikko T.

Department of Neurology, Tampere University Hospital, Finland.

Motor involvement in acute herpes zoster is considered rare, but its incidence is
unknown. In a sample of 40 patients with acute herpes zoster of varying severity,
an abnormal electromyogram (EMG) (fibrillation, positive waves, high-frequency
discharges) was found in 21 (53%), suggesting extension of inflammation to the
anterior horn and/or anterior motor roots. In the majority of patients these
changes were not confined to the segment invaded by the rash but were widespread,
extending several segments cranially and caudally, and both ipsi- and
contralaterally. In 5 (13%) patients these changes became more extensive on
repeat EMG over a period of months. There was no association between severity of 
rash, pain, postherpetic neuralgia, and EMG changes. We conclude that widespread 
subclinical motor involvement is relatively common in herpes zoster, may last for
months, and is easily detectable by EMG.

PMID: 9342160 [PubMed - indexed for MEDLINE]

3859: Clin Chem. 1997 Oct;43(10):1843-9.

Quantitative polymerase chain reaction for human herpesvirus diagnosis and
measurement of Epstein-Barr virus burden in posttransplant lymphoproliferative
disorder.

Bai X, Hosler G, Rogers BB, Dawson DB, Scheuermann RH.

Department of Pathology, University of Texas Southwestern Medical Center, Dallas 
75235-9072, USA.

Human herpesviruses can cause acute diseases such as chicken pox or
mononucleosis, but also may reactivate during immunosuppression and result in
severe or life-threatening illnesses such as shingles or lymphoproliferative
disorders. We report the development and validation of a quantitative PCR method 
to measure viral burden for all eight human herpesviruses (HSV1, HSV2, VZV, EBV, 
CMV, HHV6, HHV7, and KSHV) in patients' samples. The method uses an internal
standard that is coamplified with the viral target, allowing quantification of
viral genomes in absolute terms (e.g., viral targets/mL of blood) and ruling out 
false-negative results. We demonstrate that transplant patients with
lymphoproliferative disorder carry an EBV viral burden 3 logs higher than
nontransplant patients. EBV titers in transplant patients without a
lymphoproliferative disorder are between these values. This quantitative PCR
method may aid in differentiating clinically significant vs latent viral burden
in immunosuppressed patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9342002 [PubMed - indexed for MEDLINE]

3860: Bone Marrow Transplant. 1997 Sep;20(5):381-3.

Varicella vaccination in children after bone marrow transplantation.

Sauerbrei A, Prager J, Hengst U, Zintl F, Wutzler P.

Institute for Antiviral Chemotherapy of the Friedrich Schiller University, Jena, 
Germany.

Herpes zoster (HZ) is one of the most common complications after bone marrow
transplantation (BMT) in children. Apart from treatment with antiviral drugs,
effective prevention by active immunization with varicella-zoster virus (VZV)
appears to be possible. In this study 15 patients were vaccinated with a live
attenuated VZV vaccine (Varilrix) 12-23 months after BMT. The vaccine was well
tolerated without adverse reactions. Chickenpox or HZ were not observed for up to
2 years after immunization. Eight out of nine seronegative patients seroconverted
and in six virus-specific IgG could still be demonstrated 2 years later. The
incidence of VZV diseases in 133 non-immunized children after BMT was 26.3%.
Infections usually occurred within 18 months after BMT.

PMID: 9339753 [PubMed - indexed for MEDLINE]

3861: Bone Marrow Transplant. 1997 Sep;20(5):369-74.

Allogeneic bone marrow transplantation for relapsed and refractory Hodgkin's
disease and non-Hodgkin's lymphoma.

Dann EJ, Daugherty CK, Larson RA.

Department of Medicine, The University of Chicago, IL 60637-1470, USA.

The relative benefit of allogeneic bone marrow transplantation (alloBMT) vs
autologous BMT (autoBMT) for patients with relapsed or refractory Hodgkin's
disease (HD) or non-Hodgkin's lymphoma (NHL) remains uncertain. Toxicity from
graft-versus-host disease (GVHD) may diminish the potential benefits both of
graft-versus-tumor activity and of receiving uncontaminated donor marrow stem
cells. From 1987 to 1995, 27 adults (ages 18-60 years; median 36) underwent
alloBMT for lymphoma after failure of standard chemotherapy. Twenty-one had NHL
and six had HD (nodular sclerosis). Thirteen patients had primary refractory
disease or chemotherapy-resistant relapses; two of these had relapsed after
autoBMT. Three patients had untested relapses (one of them had relapsed after
autoBMT), and 11 had chemotherapy-sensitive relapses. Twenty-four received
HLA-matched bone marrow from a sibling (one twin); three received haploidentical 
marrow cells. Nine (33%) died from lymphoma. Eleven (41%) died of
treatment-related causes. Opportunistic infections were a substantial problem
leading to eight of these deaths (30%). Six patients (22%) survive free of
lymphoma 17-70 months post-BMT (median, 56 months); four had had sensitive
relapses, one had had a resistant relapse, and one had had nontested relapse.
Three have chronic GVHD (limited in one; extensive in two). One HD patient who
had relapsed after autoBMT remains in remission 19 months after alloBMT. No
therapy-related myelodysplasia has been observed. We conclude that alloBMT has
substantial morbidity in heavily pretreated lymphoma patients due to acute
toxicity, infections and GVHD. However, 22% of our HD/NHL patients have had
long-term disease-free survival.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 9339751 [PubMed - indexed for MEDLINE]

3862: Rev Prat. 1997 Sep 1;47(13):1422-7.

[Febrile eruptions and herpesviruses]

[Article in French]

Bodemer C.

Service de dermatologie Hopital Necker Enfants Malades, Paris.

There are 2 types of febrile skin eruptions due to herpesviruses: rashes (human
herpesvirus 6 and 7. Epstein-Barr virus and cytomegalovirus), and vesicular
eruptions (varicella and herpes zoster, primary and recurrent herpetic
infections). Clinical diagnosis is often easy, based on the features of the
eruption: characteristic sudden exanthem, clinical signs of infectious
mononucleosis, or early vesicular trunk lesions characteristic of varicella or
herpes. However, it must be stressed that exanthematic viroses can be highly
variable. In some cases, and based on the background on which these eruptions
occur, laboratory investigations will be necessary, according to the suspected
virus.

Publication Types: 
    English Abstract

PMID: 9339020 [PubMed - indexed for MEDLINE]

3863: JAMA. 1997 Oct 8;278(14):1148; author reply 1149.

Comment on:
    JAMA. 1997 Jun 18;277(23):1848-50.

Contempo 1997: dermatology.

Marks L, Saltzman R.

Publication Types: 
    Comment
    Letter

PMID: 9326466 [PubMed - indexed for MEDLINE]

3864: Arch Dermatol. 1997 Oct;133(10):1316-7.

Comedones appearing after herpes zoster infection: a report of 7 cases.

del Rio E, Nova A, Allegue F, Fachal C, Veiga HA, Penaranda JM.

Publication Types: 
    Letter

PMID: 9382580 [PubMed - indexed for MEDLINE]

3865: Clin Microbiol Rev. 1997 Oct;10(4):674-93.

In search of a selective antiviral chemotherapy.

De Clercq E.

Rega Institue for Medical Research, Katholieke Universiteit Leuven, Belgium.

This article describes several approaches to a selective therapy of virus
infections: (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU [brivudin]) for the
therapy of herpes simplex virus type 1 and varicella-zoster virus infections:
(S)-9-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC [cidofovir]) for the
therapy of various DNA virus (i.e., herpesvirus, adenovirus, papillomavirus,
polyomavirus, and poxvirus) infections; 9-(2-phosphonylmethoxyethyl)adenine (PMEA
[adefovir]) for the therapy of retrovirus, hepadnavirus, and herpesvirus
infections; (R)-9-(2-phosphonylmethoxypropyl)adenine (PMPA) for the therapy and
prophylaxis of retrovirus and hepadnavirus infections; and nonnucleoside reverse 
transcriptase inhibitors (NNRTIs), such as
tetrahydroimidazo[4,5,1-jk][1,4]-benzodiazepin-2(IH)-one and -thione (TIBO),
1-[(2-hydroxyethoxy)methyl]-6-(phenylthio)thymine (HEPT),
alpha-anilinophenylacetamide (alpha-APA), and
2',5'bis-O-(tert-butyldimethylsilyl)-3'-spiro-5"-(4"-amino-1",2"-oxat hiole-
2",2"-dioxide)pyrimidine (TSAO) derivatives, and thiocarboxanilides for the
treatment of human immunodeficiency virus type 1 (HIV-1) infections. For the
clinical use of NNRTIs, some guidelines have been elaborated, such as starting
treatment with combinations of different compounds at sufficiently high
concentrations to effect a pronounced and sustained suppression of the virus.
Despite the diversity of the compounds described here and the different viruses
at which they are targeted, they have a number of characteristics in common. As
they interact with specific viral proteins, the compounds achieve a selective
inhibition of the replication of the virus, which, in turn, should be able to
develop resistance to the compounds. However, as has been established for the
NNRTIs, the problem of viral resistance may be overcome if the compounds are used
from the start at sufficiently high doses, which could be reduced if different
compounds are combined. For HIV infections, drug treatment regimens should be
aimed at reducing the viral load to such an extent that the risk for progression 
to AIDS will be minimized, if not avoided entirely. This may result in a real
"cure" of the disease but not necessarily of the virus infection, and in this
sense, HIV disease may be reduced to a dormant infection, reminiscent of the
latent herpesvirus infections. Should virus replication resume after a certain
time, the armamentarium of effective anti-HIV and anti-herpesvirus compounds now 
available, if applied at the appropriate dosage regimens, should make the virus
return to its dormant state before it has any chance to damage the host. It is
unlikely that this strategy would eradicate the virus and thus "cure" the viral
infection, but it definitely qualifies as a cure of the disease.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 9336668 [PubMed - indexed for MEDLINE]

3866: Postgrad Med. 1997 Oct;102(4):125-6, 129-35, 139-40.

Preventing and treating major opportunistic infections in AIDS. What's new and
what's still true.

Cavert W.

University of Minnesota Delaware Street (HIV) Clinic, Minneapolis, USA.
winston@lenti.med.umn.edu

New highly active antiretroviral therapies are boosting the blood absolute CD4+
counts of many patients with AIDS and are decreasing the prevalence of
AIDS-related opportunistic infections. Nevertheless, the prevention, diagnosis,
and treatment of opportunistic infections remain important features of management
of HIV infection. In recent years, significant advances have been made in the
prevention and treatment of opportunistic diseases such as Pneumocystis carinii
pneumonia, Cytomegalovirus retinitis, disseminated Mycobacterium
avium-intracellulare infection, and mucosal candidiasis. Tuberculosis,
cryptococcal meningitis, herpes simplex virus infection, shingles, and infectious
enteritis also continue to be troublesome. Kaposi's sarcoma may be the newest
AIDS-related opportunistic infection to be identified. The immune system effects 
of highly active antiretroviral therapy are as yet poorly understood. Therefore, 
an aggressive approach to diagnosis and treatment of opportunistic infections
remains mandatory, and patients receiving antiretroviral therapy should continue 
to adhere to recommendations for prophylaxis against such infections.

Publication Types: 
    Review

PMID: 9336601 [PubMed - indexed for MEDLINE]

3867: J Infect Dis. 1997 Oct;176(4):1080-4.

Polymerase chain reaction detection and clinical significance of varicella-zoster
virus in cerebrospinal fluid from human immunodeficiency virus-infected patients.

Burke DG, Kalayjian RC, Vann VR, Madreperla SA, Shick HE, Leonard DG.

Department of Medicine, University Hospitals of Cleveland, Ohio, USA.

Varicella-zoster virus (VZV) causes ocular and other central nervous system (CNS)
disease in human immunodeficiency virus (HIV)-infected persons. To study the
prevalence of CNS disease due to VZV, cerebrospinal fluid (CSF) specimens from 84
consecutive HIV-infected patients with new neurologic symptoms were tested for
VZV DNA by a polymerase chain reaction (PCR) assay. Six patients were
PCR-positive for VZV in CSF; 3 additional patients were subsequently identified
who were not part of the serial population sample. Among these 9 patients, all
had clinical presentations consistent with ocular and other CNS disease due to
VZV; 4 were without zoster on presentation. Sustained improvement in association 
with antiviral therapy was observed in 3. Therefore, VZV DNA was detected in the 
CSF of 7% of HIV-infected patients presenting with neurologic symptoms; the
diagnosis of VZV-related CNS disease was facilitated by this assay; improvement
in association with antiviral therapy was observed in some patients.

PMID: 9333172 [PubMed - indexed for MEDLINE]

3868: Anesth Analg. 1997 Oct;85(4):870-1.

Stellate ganglion block improved loss of visual acuity caused by retrobulbar
optic neuritis after herpes zoster.

Mori T, Terai T, Hatano M, Oda Y, Asada A, Moriwaki M.

Department of Anesthesiology and Intensive Care Medicine, Osaka City University
Medical School, Japan.

Publication Types: 
    Case Reports

PMID: 9322472 [PubMed - indexed for MEDLINE]

3869: Clin Infect Dis. 1997 Sep;25(3):634-9.

Varicella-zoster virus (VZV) DNA in cerebrospinal fluid of patients infected with
human immunodeficiency virus: VZV disease of the central nervous system or
subclinical reactivation of VZV infection?

Cinque P, Bossolasco S, Vago L, Fornara C, Lipari S, Racca S, Lazzarin A, Linde
A.

Department of Infectious Diseases, San Raffaele Scientific Institute, Luigi Sacco
Hospital, Milan, Italy.

To identify varicella-zoster virus (VZV) infections of the nervous system in
patients infected with human immunodeficiency virus (HIV), polymerase chain
reaction (PCR) analysis of cerebrospinal fluid (CSF) samples from 514 consecutive
HIV-infected patients with neurological disease was performed to detect VZV DNA. 
VZV DNA was detected in CSF of 13 (2.5%) of 514 patients. Four of 13 patients had
VZV encephalitis or meningoencephalomyelitis. These four patients received
intravenous acyclovir therapy; CSF became negative for VZV DNA and clinical
conditions improved for two, whereas CSF remained positive for VZV DNA and
clinical conditions worsened until death for two. In nine of 13 patients, the
neurological symptoms were likely caused by other simultaneous HIV-related
complications in the central nervous system. After intravenous therapy with high 
doses of acyclovir or foscarnet, VZV was cleared from CSF in eight of nine
patients. VZV DNA can be detected in CSF of HIV-infected patients in association 
with either manifestations of neurological VZV disease or subclinical
reactivation of VZV infection. Antiviral treatment may be effective in
suppressing VZV replication in the nervous system.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9314452 [PubMed - indexed for MEDLINE]

3870: J Fam Pract. 1997 Sep;45(3):203-4.

Treatments for postherpetic neuralgia.

Chasuk R.

Baton Rouge General Medical Center, Louisiana, USA. rob_chasuk @generalhealth.org

PMID: 9312562 [PubMed - indexed for MEDLINE]

3871: Ophthalmology. 1997 Sep;104(9):1421-5.

Herpes zoster sine herpete. A potential cause of iridoplegic granulomatous
iridocyclitis.

Schwab IR.

Department of Ophthalmology, University of California, Davis, Medical Center,
Sacramento, USA.

OBJECTIVE: Herpes zoster ophthalmicus (HZO) is a recurrence of varicella zoster
virus involving cranial nerve V-1, but does not always have skin manifestations. 
The objective of this work is to study iridoplegic granulomatous iridocyclitis as
an acute, fulminant iridocyclitis that probably is caused by the recurrence of
varicella zoster virus without skin eruptions. PARTICIPANTS: The author reports
15 cases of iridoplegia granulomatous iridocyclitis with involvement of the
anterior uveal tract without known skin eruptions. RESULTS: All patients have had
a clinical course of iridocyclitis closely resembling those cases of herpes
zoster with skin eruptions. Nine of the 15 are documented to have had a
recurrence of varicella zoster virus with an appropriate rise and fall of
systemic titers. The remaining six patients had clinical findings, including loss
of accommodation, iridoplegia, and sectoral iris atrophy that were more typical
for HZO than other infectious agents. CONCLUSIONS: Iridoplegic granulomatous
iridocyclitis is a newly described, acute, fulminant uveitis probably caused by a
herpes virus and most probably by varicella zoster virus. Herpes zoster sine
herpete (erupticum) should be suspected as a potential diagnosis in patients with
appropriate anterior segment manifestations. Further study is necessary to
discern if any of such cases could be caused by herpes simplex.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9307636 [PubMed - indexed for MEDLINE]

3872: J Neuroophthalmol. 1997 Sep;17(3):199-201.

Ocular findings in Ramsay Hunt syndrome.

Mansour AM, Bailey BJ.

Department of Ophthalmology, University of Texas Medical Branch, Galveston, USA.

Publication Types: 
    Case Reports

PMID: 9304535 [PubMed - indexed for MEDLINE]

3873: J Immunol. 1997 Sep 15;159(6):2802-6.

Recognition of the latency-associated immediate early protein IE63 of
varicella-zoster virus by human memory T lymphocytes.

Sadzot-Delvaux C, Kinchington PR, Debrus S, Rentier B, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, CA 94305, USA.

Varicella-zoster virus (VZV) is a human alpha herpesvirus that establishes
latency in sensory ganglia. Latency is characterized by the abundant expression
of the immediate early protein 63 (IE63), whereas other viral proteins have not
yet been detected during the quiescent phase of VZV infection. The IE63 protein
is a component of the virion and is expressed very early in the infectious cycle.
The IE63 protein is also expressed in skin during episodes of varicella and
herpes zoster. We have evaluated the cell-mediated immune response against IE63
in naturally immune adults with a history of chickenpox, by T lymphoproliferation
and cytotoxicity assays. Among donors who had T cell proliferation to
unfractionated VZV Ags from infected cell extract, 59% had T cell recognition of 
purified IE63. The CTL response to IE63 was equivalent to CTL recognition of
IE62, the major tegument component of VZV whose immunogenicity has been
previously described. IgG Abs against IE63 were detected in serum from healthy
immune adults. These results indicate that IE63 is an important target of
immunity to VZV. T cell recognition of IE63 is likely to be involved in
controlling VZV reactivation from latency.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9300702 [PubMed - indexed for MEDLINE]

3874: J Med Virol. 1997 Sep;53(1):63-8.

Neutralizing antibody responses induced by varicella-zoster virus gE and gB
glycoproteins following infection, reactivation or immunization.

Haumont M, Jurdan M, Kangro H, Jacquet A, Massaer M, Deleersnyder V, Garcia L,
Bosseloir A, Bruck C, Bollen A, Jacobs P.

Applied Genetics, University of Brussels, Nivelles, Belgium.

The purpose of this study was to compare the antibody responses to
varicella-zoster virus (VZV) gE and gB after natural VZV infection and after
vaccination with live attenuated OKA vaccine in order to determine the relative
importance of these proteins as components of a subunit vaccine. Anti-VZV
antibody titers determined by IFA were of the same order of magnitude in sera
from individuals with a history of varicella and in vaccinated children but
higher in individuals given booster vaccination. The titers of anti-gE and
anti-gB antibodies were measured by ELISA using recombinant gE or gB as capture
antigen. From these experiments, it appears that the ratio of anti-gE to anti-gB 
antibody is highly variable from one individual to another but relatively stable 
over a long period of time for a particular individual, even after a zoster
episode. Neutralizing antibodies directed against gE or gB were also measured by 
subtracting the neutralization titers obtained before and after depletion of the 
specific antibodies on immobilized recombinant gE, gB, or both. This showed that,
with respect to neutralization, anti-gE and anti-gB are equally prevalent in
vaccinated children and that anti-gE is generally, but not always, predominant
over anti-gB in VZV-infected individuals. Finally, antibodies to these two
glycoproteins appear to be predominant among the neutralizing antibodies directed
to other VZV antigens.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9298734 [PubMed - indexed for MEDLINE]

3875: J Med Virol. 1997 Sep;53(1):60-2.

Analysis of United Kingdom wild-type strains of varicella-zoster virus:
differentiation from the Oka vaccine strain.

Hawrami K, Breuer J.

Department of Medical Microbiology, St. Bartholomew's, Royal London School of
Medicine and Dentistry, England.

In Japan and the United States, where vaccination against varicella-zoster virus 
(VZV) infection with the live attenuated Oka strain of varicella is routine,
cases of chickenpox or shingles occurring in vaccinees can be caused by either
wild-type or vaccine virus. Differentiating such cases is important
epidemiologically and can be achieved only using molecular typing methods. In the
United Kingdom, the Oka vaccine is being considered for use in groups at risk of 
severe primary varicella, such as seronegative immunocompromised patients and
women who may be considering pregnancy. In addition, seronegative health workers 
who may be occupationally exposed to VZV infection might also be offered
vaccination. We analysed 249 U.K. wild-type VZV strains, 105 from cases of
chickenpox and 144 from shingles cases, to determine whether they could be
distinguished from Oka by the genotyping systems used in Japan and the United
States. Four polymorphic loci were examined, a Pst 1 restriction site in gene 38,
a Bgl 1 restriction site in gene 54, the R5 repeat region, and the R2 repeat
region. The results suggest that U.K. strains of VZV are more similar to U.S.
strains than to Japanese strains. All the U.K. wild-type viruses were positive
for the Pst 1-1 restriction site, unlike Oka, which is negative. However, one of 
thirty strains was indistinguishable from Oka at all other loci.

Publication Types: 
    Comparative Study

PMID: 9298733 [PubMed - indexed for MEDLINE]

3876: Mayo Clin Proc. 1997 Sep;72(9):851-3.

Comment in:
    Mayo Clin Proc. 1998 Apr;73(4):390-1.

Granulomatous vasculitis associated with herpes virus: a persistent, painful,
postherpetic papular eruption.

Snow JL, el-Azhary RA, Gibson LE, Estes SA, Espy MJ, Smith TF.

Department of Dermatology, Mayo Clinic Rochester, Minnesota 55905, USA.

Cutaneous granulomatous vasculitis manifesting as a postherpetic reaction pattern
is uncommon hand has previously been reported as a delayed complication of
varicella-zoster virus infection. We describe three patients who had persistent, 
painful, postherpetic papules in a zosteriform distribution that histologically
demonstrated a small vessel granulomatous vasculitis. Herpes simplex virus DNA
detected by the polymerase chain reaction technique was demonstrated in two
cases.

Publication Types: 
    Case Reports

PMID: 9294533 [PubMed - indexed for MEDLINE]

3877: Laryngoscope. 1997 Sep;107(9):1165-75.

Molecular temporal bone pathology: II. Ramsay Hunt syndrome (herpes zoster
oticus).

Wackym PA.

Department of Otolaryngology, Mount Sinai School of Medicine, New York, New York 
10029-6574, U.S.A.

In 1907 J. Ramsay Hunt suggested that herpes zoster oticus resulted from a
geniculate ganglionitis; however, many contemporary authors believe that this
disorder represents a neuritis or polycranial neuropathy. Herpes varicella-zoster
viral (VZV) DNA was identified, using the polymerase chain reaction, in archival 
celloidin-embedded temporal bone sections from two patients who clinically had
Ramsay Hunt syndrome (herpes zoster oticus). The presence of VZV was confirmed by
sequencing the PCR products. These experiments demonstrated that VZV genomic DNA 
was present in the geniculate ganglion of the side with facial paralysis and
cutaneous recrudescence in both patients and in the clinically unaffected side in
patient 1. In addition, patient 2 had a sudden hearing loss and was found to have
VZV genomic DNA in sections from the affected side containing the spiral
ganglion, Scarpa's ganglion, organ of Corti, and macula of the saccule. No VZV
genomic DNA was identified in temporal bone sections from five patients with
Bell's palsy and ten patients without evidence of otologic disease. In this
study, the histopathology of these two cases yielded complementary information
regarding the role of VZV in herpes zoster oticus. These data suggest that in
patients with Ramsay Hunt syndrome, latent VZV is located in the geniculate
ganglia and may be present in the auditory and vestibular primary afferent
ganglia in some patients.

Publication Types: 
    Biography
    Case Reports
    Historical Article
    Portraits
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

Personal Name as Subject: 
    Hunt JR

PMID: 9292598 [PubMed - indexed for MEDLINE]

3878: J Pain Symptom Manage. 1997 Sep;14(3):134-5.

Abrupt spontaneous remission of postherpetic neuralgia after coma.

Ng KF, Chan WS, Yang JC.

Publication Types: 
    Case Reports
    Letter

PMID: 9291699 [PubMed - indexed for MEDLINE]

3879: J Infect Dis. 1997 Sep;176(3):578-85.

Early reconstitution of immunity and decreased severity of herpes zoster in bone 
marrow transplant recipients immunized with inactivated varicella vaccine.

Redman RL, Nader S, Zerboni L, Liu C, Wong RM, Brown BW, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California
94305, USA.

Varicella-zoster virus (VZV) causes herpes zoster after bone marrow
transplantation (BMT). The immunogenicity of heat-inactivated varicella vaccine
and effects on VZV pathogenesis were evaluated in 75 BMT patients randomized to
receive vaccine or no intervention. Among 14 patients given a single dose at 1
month after transplantation, the mean (+/-SE) stimulation index (SI) was 12.20
+/- 3.13 compared with 4.83 +/- 2.74 (P = .036) in 14 unvaccinated patients, but 
clinical disease was not altered. Among 24 patients vaccinated at 1, 2, and 3
months, mean SI was 8.43 +/- 3.89 versus 2.00 +/- 0.33 (P = .014) in 23
unvaccinated patients at 4 months and 8.56 +/- 2.81 versus 5.30 +/- 2.47 (P =
.043) at 5 months. Disease severity associated with VZV reactivation was
decreased dramatically in vaccinees given three doses; severity scores were 6.4
+/- 1.0 versus 11.8 +/- 1.1 (P = .007). This experience with varicella vaccine in
BMT patients is the first evidence that active immunization can reduce morbidity 
due to herpesvirus reactivation in high-risk populations.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9291302 [PubMed - indexed for MEDLINE]

3880: Am J Otolaryngol. 1997 Sep-Oct;18(5):320-3.

Lyme disease and seventh nerve paralysis in children.

Cook SP, Macartney KK, Rose CD, Hunt PG, Eppes SC, Reilly JS.

Department of Pediatrics, Alfred I. duPont Institute Wilmington, DE 19803, USA.

PURPOSE: This study was undertaken to determine the frequency of Lyme disease
(LD) as a cause of transient facial nerve palsy (FNP) in children. Acute onset
FNP in children has been primarily associated with acute otitis media (AOM).
Recently, LD has emerged in regions where the deer-tick vector is present and has
been associated with multiple cranial neuropathies. PATIENTS AND METHODS: Fifty
children with transient FNP were evaluated and treated at our institution over a 
5.5-year period. RESULTS: The rank of etiologies confirmed LD to now be the most 
common (50%), followed by AOM (12%), varicella (6%), Herpes zoster (4%), and
coxsackievirus (2%). Thirteen children (26%) had idiopathic FNP consistent with
Bell's palsy. CONCLUSION: We conclude that transient FNP in children is most
commonly caused by LD for regions with endemic infections caused by Borrelia
burgdorferi.

Publication Types: 
    Comparative Study

PMID: 9282248 [PubMed - indexed for MEDLINE]

3881: J Virol. 1997 Sep;71(9):7073-9.

Varicella-zoster virus open reading frame 4 encodes an immediate-early protein
with posttranscriptional regulatory properties.

Defechereux P, Debrus S, Baudoux L, Rentier B, Piette J.

Laboratory of Fundamental Virology and Immunology, University of Liege, Belgium.

Varicella-zoster virus (VZV) encodes four putative immediate-early proteins based
on sequence homology with herpes simplex virus type 1: the products of ORF4, -61,
-62, and -63. Until now, only two VZV proteins have been described as being truly
expressed with immediate-early kinetics (IE62 and IE63). The ORF4-encoded protein
can stimulate gene expression either alone or in synergy with the major
regulatory protein IE62. Making use of a sequential combination of transcription 
and protein synthesis inhibitors (actinomycin D and cycloheximide, respectively),
we demonstrated the immediate-early nature of the ORF4 gene product, which can
thus be named IE4. The fact that IE4 is expressed with kinetics similar to that
of IE62 further underlines the possible cooperation between these two VZV
proteins in gene expression. Analysis of the IE4-mediated autologous or
heterologous viral gene expression at the mRNA levels clearly indicated that IE4 
may have several mechanisms of action. Activation of the two VZV genes tested
could occur partly by a posttranscriptional mechanism, since increases in
chloramphenicol acetyltransferase (CAT) mRNA levels do not account for the
stimulation of CAT activity. On the other hand, stimulation of the human
immunodeficiency virus type 1 long terminal repeat- or the cytomegalovirus
promoter-associated CAT activity is correlated with an increase in the
corresponding CAT mRNA.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9261438 [PubMed - indexed for MEDLINE]

3882: N Engl J Med. 1997 Aug 21;337(8):535.

Images in clinical medicine. Positive Tzanck smear.

Cohen LM.

Harvard Medical School, Cambridge, MA 02139, USA.

Publication Types: 
    Case Reports

PMID: 9262497 [PubMed - indexed for MEDLINE]

3883: Zhonghua Xue Ye Xue Za Zhi. 1997 Aug;18(8):395-6.

[Allogeneic bone marrow transplantation for a patient with malignant
histiocytosis]

[Article in Chinese]

Zhai M, Hu L, Chen H.

OBJECTIVE: To observe the efficacy and side effects of allogeneic bone marrow
transplantation (allo-BMT) in the treatment of malignant histiocytosis (MH).
METHODS: After conditioning with chemotherapy and total body irradiation, HLA-A, 
B, DR, DQ compatible allo-BMT was performed in a patient with MH. RESULTS: DNA
fingerprinting showed engraftment on day 22, bone marrow aspiration showed
hypercellularity on day 50, and no abnormal cell was found. The patient developed
acute graft-versus-host disease ( II degrees) on day 40 and herpes zoster 6
months post-transplantation, and the patient has survived disease-freely for 24
months after allo-BMT. CONCLUSION: This is the first report of treatment of MH
with allo-BMT in China, showing that allo-BMT may significantly prolong the
survival of MH.

Publication Types: 
    English Abstract

PMID: 15625841 [PubMed - in process]

3884: Pract Periodontics Aesthet Dent. 1997 Aug;9(6):683-90; quiz 692.

Viral infections of the oral mucosa in children: a clinical review.

Fenton SJ, Unkel JH.

Department of Pediatric Dentistry, University of Tennessee/Memphis 38163, USA.

The oral cavity is a microcosm of the world around us, exposed to a variety of
microorganisms present in the local environment. Some of these microorganisms
establish a permanent presence in the oral tissues, which serve as a suitable
growth medium. These locations include soft and hard tissue, areas of high and
low oxygen content, flowing secretions and dryness, and flat or grooved surfaces.
Most of the normal oral flora does not cause disease; some even provide a
protective benefit. However, occasionally one or more groups become pathologic,
producing a disease that may have serious consequences for the host. Many of the 
pathologic microorganisms are viruses, and children are particularly prone to
such infections, since their immune systems are still in the development stage.
The learning objective of this article is to review the viral infections of the
oral mucosa in children, including varicella, herpes zoster, mononucleosis, and
herpangina.

Publication Types: 
    Review

PMID: 9573839 [PubMed - indexed for MEDLINE]

3885: Rev Med Liege. 1997 Aug;52(8):553-5.

[Drug of the month. Valaciclovir (Zelitrex)]

[Article in French]

Pierard GE, Nikkels AF.

Service de Dermatopathologie, Universite de Liege.

Publication Types: 
    Review

PMID: 9381007 [PubMed - indexed for MEDLINE]

3886: Neuroimaging Clin N Am. 1997 Aug;7(3):513-25.

Central nervous system opportunistic infections.

Wright D, Schneider A, Berger JR.

Department of Neurology, University of Kentucky College of Medicine, Lexington,
USA.

The spectrum of opportunistic infections occurring in association with
human-immunodeficiency virus, type 1, is very broad. These infections develop
most frequently in the setting of advanced immunosuppression. There is no part of
the neuraxis that is immune to these complications and the concurrence of more
than one infectious illness may always be considered. The neuroimaging features, 
when coupled with the clinical and laboratory findings, often suggest the correct
diagnosis and enable the physician to initiate therapy.

Publication Types: 
    Review

PMID: 9376966 [PubMed - indexed for MEDLINE]

3887: Br J Ophthalmol. 1997 Aug;81(8):677-82.

Tenascin-C expression in normal, inflamed, and scarred human corneas.

Maseruka H, Bonshek RE, Tullo AB.

Department of Pathological Sciences, University of Manchester.

AIMS/BACKGROUND: In adult tissues the expression of tenascin-cytotactin (TN-C),
an extracellular matrix glycoprotein, is limited to tumours and regions of
continuous renewal. It is also transiently expressed in cutaneous and corneal
wound healing. There are limited data regarding its expression in inflammation
and scarring of the adult human cornea. In this study, TN-C expression patterns
in normal, inflamed, and scarred human corneas have been examined. METHODS:
Penetrating keratoplasty specimens were selected from cases of herpes simplex
keratitis, herpes zoster ophthalmicus, rheumatoid arthritis ulceration, bacterial
keratitis, rosacea keratitis, interstitial keratitis, and previous surgery so as 
to encompass varying degrees of active and chronic inflammation and scarring.
TN-C in these and in normal corneas was immunodetected using TN2, a monoclonal
antibody to human TN-C. RESULTS: There was no TN2 immunopositivity in normal
corneas except at the corneoscleral interface. In pathological corneas, TN2
immunopositivity was localised in and around regions of active inflammation,
fibrosis, and neovascularisation. TN2 positivity was less in acute inflammation
than in active chronic inflammation. Mature, avascular scar tissue and epithelial
downgrowth were TN2 negative. CONCLUSION: These results indicate that in the
adult human cornea, TN-C expression is induced in regions of inflammation,
fibrosis, and neovascularisation, but that expression is absent in mature,
avascular scar tissue. This suggests a role for this glycoprotein in
inflammation, healing, and extracellular matrix reorganisation of the cornea.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9349157 [PubMed - indexed for MEDLINE]

3888: Arch Phys Med Rehabil. 1997 Aug;78(8):880-2.

Herpes zoster polyradiculopathy.

Braverman DL, Ku A, Nagler W.

Department of Rehabilitation Medicine, The New York Hospital-Cornell Medical
Center, New York, USA.

Herpes zoster infection, resulting from reactivation of the dormant varicella
zoster virus in the dorsal root ganglia, usually causes a painful dermatomal
vesicular rash. Rarely, associated peripheral motor weakness is present, the
mechanism of which is unclear. Three patients are reported who had focal limb
muscle weakness associated with zoster infection. Physical and occupational
therapy played a key role in motor function recovery of the patients, yet
emphasis on the rehabilitation of postherpetic motor weakness is lacking in the
literature. Physiatrists evaluating patients with limb muscle weakness following 
herpes zoster infection should be alert to this condition. The clinical syndrome 
of herpes zoster radiculopathy and the rehabilitation of these patients are
discussed.

Publication Types: 
    Case Reports

PMID: 9344310 [PubMed - indexed for MEDLINE]

3889: Antiviral Res. 1997 Aug;35(3):167-75.

Structure-activity relationship of the affinity of 5-substituted uracil
nucleoside analogues for varicella-zoster virus thymidine kinase and their
activity against varicella-zoster virus.

Ashida N, Watanabe Y, Miura S, Kano F, Sakata S, Yamaguchi T, Suzutani T, Machida
H.

Biochemicals Division, Yamasa Corporation, Choshi, Japan.

We investigated structure-activity relationships of 5-substituted uracil
nucleoside analogues for their selective antiviral activity against
varicella-zoster virus (VZV) and affinity for VZV thymidine kinase (TK).
Anti-proliferative activity of the compounds was measured using human
lymphoblastoid cells. Most 2'-deoxyribofuranosyluracil, arabinofuranosyluracil
(araU) and 2'-deoxy-2'-fluoro-arabinofuranosyluracil derivatives showed selective
anti-VZV activity as well as activity against herpes simplex virus types 1 and 2.
2'-Deoxyuridine derivatives showed higher affinity than the corresponding araU
analogues. A correlation was seen between the 50% effective doses for VZV and the
Ki values for VZV TK, except for 5-ethyl-2'-deoxyuridine and 5-ethyl araU that
showed relatively high affinity for VZV TK without showing any activity against
VZV. 5-Halogenovinyluracil nucleosides showed the highest affinity and the most
potent and selective anti-VZV activity. 2'-Deoxy-2'-fluoro-arabinofuranosyluracil
derivatives exhibited high anti-VZV potency though they showed relatively low
affinity for VZV TK. Some 3'-deoxythymidine analogues having anti-human
immunodeficiency virus activity were inactive against herpesviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9298756 [PubMed - indexed for MEDLINE]

3890: Br J Dermatol. 1997 Aug;137(2):259-61.

Routine detection of herpes simplex virus and varicella zoster virus by
polymerase chain reaction reveals that initial herpes zoster is frequently
misdiagnosed as herpes simplex.

Rubben A, Baron JM, Grussendorf-Conen EI.

Department of Dermatology at the RWTH Aachen, Germany.

The differential diagnosis of herpes simplex and zoster may require virological
confirmation, yet virus typing is not regarded as necessary in routine
dermatological assessment. In an attempt to evaluate the clinical benefits of the
routine detection of herpes simplex virus (HSV) and varicella zoster virus (VZV),
we analysed skin swabs from 110 patients who were diagnosed at the first clinical
visit as having herpes simplex (n = 45) or zoster (n = 65). Viruses were typed
using the polymerase chain reaction (PCR) with the general primer pair GPHV-RU.
PCR analysis showed that at the initial clinical presentation, herpes simplex in 
these patients was not mistaken for zoster but that zoster was incorrectly
diagnosed as herpes simplex in nine cases. Thus these results suggest that
initial zoster often mimics herpes simplex, hence routine PCR diagnosis of HSV
and VZV or alternative rapid diagnostic approaches may be beneficial in these
cases.

PMID: 9292077 [PubMed - indexed for MEDLINE]

3891: Br J Dermatol. 1997 Aug;137(2):255-8.

Herpes zoster in three healthy children immunized with varicella vaccine
(Oka/Biken); the causative virus differed from vaccine strain on PCR analysis of 
the IV variable region (R5) and of a PstI-site region.

Na GY.

Department of Dermatology, Fatima Hospital, Sin-Am Dong, Dong Gu, Taegu, South
Korea.

This study was undertaken to determine whether the causative virus was a
vaccine-derived or wild-type virus when zoster occurred in healthy children
immunized with varicella vaccine (Oka/Biken). The DNAs of clinical isolated
strains and vaccine strain (Oka/Biken) were analyzed by the polymerase chain
reaction with two sets of primers for the variable region IV (R5 tandem direct
reiterations, TDR) and for the region with a PstI site in a middle portion of the
long unique segment of the varicella zoster virus genome. Of six zoster patients 
after vaccination with Biken, three clinical isolates were examined and had two
copies in R5 TDR and were PstI-site positive. Therefore, these strains were
different from the vaccine-type strain (Oka/Biken), which had two copies in R5
TDR and was PstI-site-negative. The mean age of onset of zoster was 4 years. The 
mean age of vaccination was 25 months. The mean interval between vaccination and 
onset of zoster was 22 months. Hence the results indicate that the causative
virus of zoster in healthy children immunized with varicella vaccine (Oka/Biken) 
was wild type and differed from the vaccine strain. Some vaccinees probably do
not have protective immunity for a long time after immunization because the mean 
interval between vaccination and onset of zoster was 22 months.

PMID: 9292076 [PubMed - indexed for MEDLINE]

3892: J Korean Med Sci. 1997 Aug;12(4):360-3.

Recurrent herpes zoster myelitis.

Baik JS, Kim WC, Heo JH, Zheng HY.

Department of Neurology, Yonsei University College of Medicine.

Recurrent zoster myelitis is quite rare. We present a previously healthy
27-year-old woman who developed recurrent attacks of myelopathy shortly after the
characteristic skin rashes of herpes zoster. Magnetic resonance imaging studies
demonstrated each lesion in the spinal cord at the same segments as the skin
lesions. She had two attacks at opposite sites at the same spinal cord level and 
complete recovery after being treated with intravenous acyclovir. We suspect that
direct invasion of varicella zoster virus was the cause of recurrent myelopathy
in our patient.

Publication Types: 
    Case Reports

PMID: 9288637 [PubMed - indexed for MEDLINE]

3893: J Am Optom Assoc. 1997 Aug;68(8):527-38.

Herpes zoster ophthalmicus and the immunocompromised host: a case report and
review.

McPherson RE.

Moore Eye Institute, Brandywine Hospital, Exton, Pennsylvania, USA.

BACKGROUND: Herpes zoster is the secondary form of varicella zoster virus
disease, caused by the reactivation of the dormant virus in the sensory ganglia. 
It manifests as a unilateral cutaneous dermatitis with a prodromal fever and
malaise. Herpes zoster ophthalmicus occurs when the ophthalmic division of the
trigeminal nerve becomes afflicted. CASE REPORTS: This case represents a
middle-aged female with breast carcinoma. Cancer radiotherapy and chemotherapy
created an immunosuppressed state, which allowed the development of herpes zoster
ophthalmicus. Most patients who manifest zoster are immunocompetent. However,
with the increased incidence of immunodeficient states (e.g., chemotherapy, organ
transplantation and acquired immunodeficiency syndrome), clinicians are faced
with a greater number of cases of zoster. In the immunodeficient population,
especially, dissemination of the zoster and potentially damaging complications
can occur. CONCLUSIONS: In the light of these facts, clinicians must be well
versed in all aspects of herpes zoster disease, including the clinical and
laboratory diagnosis, as well as the incidence and presentation of herpes zoster.
Current treatments, such as the use of famciclovir, acyclovir, valcyclovir, and
prednisone, must also be understood.

Publication Types: 
    Case Reports
    Review

PMID: 9279053 [PubMed - indexed for MEDLINE]

3894: J Allergy Clin Immunol. 1997 Aug;100(2):274-82.

Conversion of the CD4+ T cell profile from T(H2)-dominant type to T(H1)-dominant 
type after varicella-zoster virus infection in atopic dermatitis.

Fujimura T, Yamanashi R, Masuzawa M, Fujita Y, Katsuoka K, Nishiyama S, Mitsuyama
M, Nomoto K.

Department of Dermatology, Kitasato University School of Medicine, Kanagawa,
Japan.

Skin lesions of atopic dermatitis were examined for cytokine expression by
reverse transcription-polymerase chain reaction. The profile of mRNA for various 
cytokines revealed that both T(H1) and T(H2) types of CD4+ T cells, probably
including T(H0) type, infiltrate into the skin lesion. We observed that atopic
skin lesions improved after varicella infection. In such lesions, expression of
T(H1) type cytokines predominated. The peripheral blood T cells from atopic
patients exhibited a differentiation into T(H2) type cells upon in vitro
stimulation with mite antigen. In contrast they differentiated into T(H1) type
cells upon stimulation by varicella antigen. Since IL-12 has been reported to
switch the in vitro recall response of allergen-specific T cells of atopic donors
from a T(H2)- to a T(H1)-like phenotype, we examined its local production in
varicella lesions. IL-12 p35 and p40 mRNA were expressed in fresh lesions.
Peripheral blood mononuclear cells from atopic patients expressed p40 mRNA upon
in vitro stimulation with live varicella zoster virus, but they did not show p40 
mRNA without stimulation. This finding suggested that in atopic skin lesions
containing the virus, IL-12 was produced and the cell type was changed to T(H1)
type-predominance. These results suggested that patients with atopic dermatitis
always have highly reactive CD4+ T cells infiltrating into their skin, and that
the switch to T(H1) or T(H2) dominance is related to whether the lesion is
improved or exacerbated.

PMID: 9275152 [PubMed - indexed for MEDLINE]

3895: J Cutan Pathol. 1997 Aug;24(7):425-8.

Herpetic syringitis associated with eccrine squamous syringometaplasia in
HIV-positive patients.

Munoz E, Valks R, Fernandez-Herrera J, Fraga J.

Department of Pathology, Hospital Universitario de la Princesa, Madrid, Spain.

Herpetic syringitis has been described as a rare manifestation of herpes virus
infection in patients with an immunodeficiency, usually secondary to human
immunodeficiency virus (HIV) infection. Eccrine squamous syringometaplasia (ESS) 
is an infrequent alteration of the eccrine duct epithelium reported in
association with several conditions, including chronic ulcers, inflammatory
processes, and patients receiving chemotherapy. The association of herpetic
syringitis with ESS has not been reported before. We identified 3 cases of
herpetic syringitis associated with ESS in patients with the acquired
immunodeficiency syndrome. In 2 of 3 cases the signs of herpetic syringitis were 
limited to the metaplastic duct epithelium, but in 1 case there were also
herpetic alterations without ESS. The histological features of herpetic infection
in HIV-positive patients may be atypical and lack the typical epidermal
alterations, observing only an extensive epidermal necrosis. In those cases, the 
alterations of the eccrine ducts may be a diagnostic clue in the diagnosis of
herpetic infection. ESS of the ductal epithelium is probably secondary to the
herpetic infection, although it might also stimulate the extension of the
herpetic infection. Further studies are needed to elucidate the association of
ESS and herpes virus infection.

Publication Types: 
    Case Reports

PMID: 9274960 [PubMed - indexed for MEDLINE]

3896: Neurology. 1997 Aug;49(2):631-2.

Magnetic resonance imaging in a patient with segmental zoster paresis.

Hanakawa T, Hashimoto S, Kawamura J, Nakamura M, Suenaga T, Matsuo M.

Department of Brain Pathophysiology, Kyoto University Faculty of Medicine, Japan.

Publication Types: 
    Case Reports

PMID: 9270616 [PubMed - indexed for MEDLINE]

3897: Arch Dermatol. 1997 Aug;133(8):983-6.

Comment in:
    Arch Dermatol. 1997 Aug;133(8):1039-41.

Viral folliculitis. Atypical presentations of herpes simplex, herpes zoster, and 
molluscum contagiosum.

Weinberg JM, Mysliwiec A, Turiansky GW, Redfield R, James WD.

Department of Dermatology, University of Pennsylvania School of Medicine,
Philadelphia, USA.

BACKGROUND: Viral folliculitis is an infrequently reported entity. The patients
described herein were seen over a 12-year period of practice in a referral
dermatologic setting. The cases involve a variety of viral infections limited to 
the hair follicle. OBSERVATIONS: We describe 5 patients with a variety of viral
folliculitides: 2 with herpetic sycosis caused by herpes simplex; 1 with herpex
simplex folliculitis (this patient also had human immunodeficiency virus); 1 with
herpes zoster without blisters; and 1 with molluscum contagiosum. CONCLUSIONS:
These 5 cases demonstrate that viral folliculitis has varied causes and
presentations. Clinicians should consider viral agents in the differential
diagnosis of superficial infectious folliculitis, especially in cases that are
refractory to antibacterial or antifungal therapy.

Publication Types: 
    Case Reports

PMID: 9267244 [PubMed - indexed for MEDLINE]

3898: Chest. 1997 Aug;112(2):538-40.

Progressive somnolence leading to coma in a 68-year-old man.

Bradley J, Forero N, Pho H, Escobar B, Kasinath BS, Anzueto A.

Brooke Army Medical Center, San Antonio, Tex., USA.

Publication Types: 
    Case Reports

PMID: 9266897 [PubMed - indexed for MEDLINE]

3899: Med Pregl. 1997 Jul-Aug;50(7-8):305-8.

[Herpes zoster--treatment with acyclovir]

[Article in Croatian]

Jovanovic J, Cvjetkovic D, Pobor M, Brkic S.

Klinika za infektivne i kozno-venericne bolesti, Medicinski fakultet, Novi Sad.

We investigated the effect of acyclovir to the evolution of cutaneous changes and
acute herpetic neuralgia at the time of herpes zoster infection. The examined
group of 47 patients predominantly consisted of women in older ages, with
anamnestic data usually referring to the chronic disease or stress as a provoking
factor. In case of 19 patients the therapy was initiated in the phase of
maculopapular changes, in 24 patients it was in the phase of vesicular changes
and in 4 patients in the phase of encrustation. The evolution of cutaneous
changes was accelerated under the acyclovir therapy regardless of the phase in
which it was initiated. The intensity and duration of acute herpetic neuralgia
directly depended on the time of therapy initiation. The patients who were given 
the therapy in time (not later than 6 days after the disease onset) reported the 
pain of lower intensity which completely ceased at the time of hospital
discharge.

Publication Types: 
    English Abstract

PMID: 9441217 [PubMed - indexed for MEDLINE]

3900: An Med Interna. 1997 Jul;14(7):379.

[Herpetic meningitis and cutaneous herpes zoster]

[Article in Spanish]

Marti J, Martinez C, Anton E.

Publication Types: 
    Case Reports
    Letter

PMID: 9410135 [PubMed - indexed for MEDLINE]

3901: J Altern Complement Med. 1997 Summer;3(2):155-8.

Successful treatment of herpetic infections by autohemotherapy.

Olwin JH, Ratajczak HV, House RV.

Rush Presbyterian St. Luke's Medical Center, Chicago, IL, USA.

Herpes zoster (shingles) affects a significant number of individuals over age 50.
To date, no satisfactory treatment has been available. The clinician author (JHO)
witnessed a dramatic response of a shingles patient to autohemotherapy: the pain 
was completely relieved and lesions gone within 5 days with no recurrence of
either. Treatment of other herpetic patients then began with autohemotherapy.
Twenty-five patients with herpes were given an autologous blood transfer of 10 mL
of blood from the antecubital vein into the gluteal bundle and followed for
clinical signs. A 100% favorable response occurred in 20 patients who received
autohemotherapy within 7 weeks of the onset of clinical signs and 1 other who
received autohemotherapy at a 9-week interval. No untoward signs or symptoms of
the treatment occurred. Autohemotherapy has been demonstrated to be effective in 
elimination of clinical sequelae in these cases of herpes infections and these
results justify further rigorous clinical investigation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9395705 [PubMed - indexed for MEDLINE]

3902: Postgrad Med J. 1997 Jul;73(861):437-8.

A treatable cause of lymphocytic meningo-encephalitis.

Fox K, Wright EP, Ramage JK.

Department of Medicine, Conquest Hospital, St Leonards-on-Sea, East Sussex, UK.

Publication Types: 
    Case Reports

PMID: 9338036 [PubMed - indexed for MEDLINE]

3903: Hautarzt. 1997 Jul;48(7):492-5.

[Atypical zosteriform segmental embolia cutis medicamentosa]

[Article in German]

Kohler LD, Worret WI, Hofmann H.

Dermatologische Klinik und Poliklinik, TU Munchen.

A 35-year-old male suffered from an extremely painful embolia cutis
medicamentosa. The atypical segmental localization first led to the diagnosis of 
herpes zoster and an antiviral therapy. Regarding the unusual course of the
complication following an intramuscular injection in this case, the question for 
the real pathomechanisms still remains.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9333630 [PubMed - indexed for MEDLINE]

3904: J R Soc Med. 1997 Jul;90(7):395-6.

Horner's syndrome due to herpes zoster in the T3-T4 dermatome.

Poole TR, Acheson JF, Smith SE, Steiger MJ.

Western Eye Hospital, London, England.

Publication Types: 
    Case Reports

PMID: 9290422 [PubMed - indexed for MEDLINE]

3905: Rev Infirm. 1997 Jul;(29):67-8.

[Zona and herpes: current viral diseases]

[Article in French]

de Villermay D.

PMID: 9283499 [PubMed - indexed for MEDLINE]

3906: Gut. 1997 Jul;41(1):100-6.

DNA viruses in the pathogenesis of sporadic chronic idiopathic intestinal
pseudo-obstruction.

Debinski HS, Kamm MA, Talbot IC, Khan G, Kangro HO, Jeffries DJ.

St Mark's Hospital, London.

BACKGROUND: Hereditary forms of chronic idiopathic intestinal pseudo-obstruction 
(CIIP) are well described but the aetiology of most cases of sporadic CIIP is
unknown. AIM: To determines whether herpes viruses can persist in the
gastrointestinal tract, thereby implicating them in the pathogenesis of CIIP.
METHODS: Twenty one specimens of small and large intestine from 13 patients with 
CIIP (eight visceral myopathy, three visceral neuropathy, two undifferentiated), 
and 12 patients operated on for colorectal cancer (controls) were examined for
evidence of Herpesvirus DNA (cytomegalovirus, Epstein-Barr virus (EBV), herpes
simplex virus type 1, and varicella zoster virus) by nested polymerase chain
reaction (PCR) and in situ DNA hybridisation (ISH) to localise signal to the
muscularis propria or myenteric plexus. RESULTS: Screening with nested PCR
produced three patients with positive results. One patient with an inflammatory
visceral neuropathy had EBV detected in the small intestine by PCR, and ISH
demonstrated localisation to neurones in the myenteric plexus. A patient with a
visceral myopathy had EBV DNA in both the small and large intestine; and one
patient with a visceral neuropathy had small intestine positive for CMV DNA (both
negative by ISH). No control tissue was positive for any virus. CONCLUSIONS: In
individual patients there appears to be evidence linking a viral aetiology to
sporadic CIIP. The role of neurotropic viruses in acute and chronic motility
disturbances needs further study.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9274480 [PubMed - indexed for MEDLINE]

3907: APMIS. 1997 Jul;105(7):531-6.

Detection of serum interferon-alpha by dissociation-enhanced lanthanide
fluoroimmunoassay. Studies of patients with acute viral and bacterial infections.

Ronnblom LE, Perers A, Vallin HS, Eriksson I, Osterlind A, Cederblad B, Alm G.

Department of Internal Medicine, Central Hospital, Boden, Sweden.

A sensitive dissociation-enhanced lanthanide fluoroimmunoassay (DELFIA) was
evaluated for ability to detect interferon-alpha (IFN-alpha) in serum of patients
with acute infectious disease of less than one week's duration and a fever of >
38 degrees C. None of 36 patients with confirmed or probable bacterial disease
was IFN-alpha positive. In contrast, 13/26 patients with viral infections had
detectable levels of IFN-alpha in serum, all clearly positive (> or = 10 U/ml).
The IFN-alpha positive serum samples were obtained early after onset of clinical 
disease, after a mean of 2.4 days. The IFN-alpha positive samples were obtained
from 10 of the 12 patients with influenza or flu-like infection, and 3 of the 5
patients with varicella or herpes zoster. The IFN-alpha negative patients with
viral disease (n = 9) included five patients with mononucleosis. The DELFIA
should be useful in further studies of the value of IFN-alpha determinations in
the identification of acute viral infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9269299 [PubMed - indexed for MEDLINE]

3908: J Neurol. 1997 Jul;244(7):470-2.

Delayed-onset hemidystonia secondary to herpes zoster ophthalmicus-related
intracerebral arteritis in an adolescent.

Burbaud P, Berge J, Lagueny A, Mensire A, Melon M, Caille JM, Bioulac B.

Publication Types: 
    Case Reports
    Letter

PMID: 9266471 [PubMed - indexed for MEDLINE]

3909: Pediatr Dermatol. 1997 Jul-Aug;14(4):333.

Herpes zoster in a 3-month-old infant.

Handa S.

Publication Types: 
    Case Reports
    Letter

PMID: 9263323 [PubMed - indexed for MEDLINE]

3910: Ir J Med Sci. 1997 Jul-Sep;166(3):141-2.

Disseminated herpes zoster in the elderly.

O'Toole EA, Mooney EE, Walsh JB, Sweeney EC, Barnes L.

Department of Dermatology, St. James's Hospital, Dublin.

We describe three cases of disseminated herpes zoster occurring in the elderly,
and discuss the investigation and diagnosis of this condition. The presentation
may be atypical with excoriated papular lesions. We suggest that disseminated
herpes zoster does occur in the non-immunocompromised elderly patient, and is
sometimes overlooked.

Publication Types: 
    Case Reports

PMID: 9256548 [PubMed - indexed for MEDLINE]

3911: ORL J Otorhinolaryngol Relat Spec. 1997 Jul-Aug;59(4):235-7.

Laryngeal zoster with unilateral laryngeal paralysis.

Nishizaki K, Onoda K, Akagi H, Yuen K, Ogawa T, Masuda Y.

Department of Otolaryngology, Okayama University Medical School, Japan.
nishizak@c.okayama-u.ac.jp

The case of a 60-year-old man with a unilateral laryngeal mucosal lesion and
complete left vocal cord paralysis is reported. The lesion localized to the left 
side of the larynx covered the laryngeal vestibule, arytenoid, false vocal cord
and true vocal cord, but did not extend to the hypopharynx or oropharynx. Enzyme 
immunoassay for varicella-zoster virus (VZV) led to a diagnosis of VZV infection.

Publication Types: 
    Case Reports

PMID: 9253027 [PubMed - indexed for MEDLINE]

3912: Cutis. 1997 Jul;60(1):51-2.

Dermatophytosis in healing herpes zoster lesions.

Ferahbas A, Alpay K, Agaoglu C.

Department of Dermatology, Farabi Hospital, Karadeniz Technical University,
Trabzon, Turkey.

Fungal infection of the face is frequently misdiagnosed, since the typical
ringworm, erythematous, slightly scaling, indistinct borders are only uncommonly 
seen on the face. Herpes zoster is a common infection caused by the
varicella-zoster virus that transmits varicella (chickenpox). Granulomatous
reactions such as granuloma annulare, pseudolymphoma, sarcoidal reaction, and
eruptive keratoacanthoma have been described in herpes zoster scars. We describe 
here the first reported case of dermatophytosis occurring in healing herpes
zoster lesions. This condition has not been previously reported.

Publication Types: 
    Case Reports

PMID: 9252737 [PubMed - indexed for MEDLINE]

3913: Eur J Pediatr. 1997 Jul;156(7):541-5.

Epidemiology of encephalitis in children. A prospective multicentre study.

Koskiniemi M, Korppi M, Mustonen K, Rantala H, Muttilainen M, Herrgard E, Ukkonen
P, Vaheri A.

Department of Virology, Haartman Institute, Helsinki University, Finland.

We found 175 cases with acute encephalitis in a population of 791,712 children
aged 1 month-15 years during a 2-year surveillance period in 1993-1994. The
overall incidence was 10.5/100,000 child-years with the highest figure in
children < 1 year of age, 18.4/100,000 child-years. The microbial diagnosis was
considered proven or suggested in 110 cases (63%); varicella zoster, respiratory 
and enteroviruses comprised 61% of these, and adeno, Epstein Barr-, herpes
simplex and rota viruses comprised 5% each. A clearcut change seems to have
occurred in the aetiology of encephalitis. Mumps, measles, and rubella virus
associated encephalitides have been almost eliminated. Varicella zoster,
respiratory, and enteroviruses have increased in frequency and occur in younger
age groups. New causes were identified, especially Chlamydia pneumoniae and
HHV-6. Our data should assist in making a specific diagnosis and defining
appropriate antimicrobial therapy. CONCLUSIONS: The spectrum of encephalitis in
children has changed due to vaccination programs. The incidence, however, appears
to be about the same due to increasing frequency of other associated old and new 
microbes.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 9243237 [PubMed - indexed for MEDLINE]

3914: Am J Otol. 1997 Jul;18(4):512-7.

Surgical management of geniculate neuralgia.

Lovely TJ, Jannetta PJ.

Department of Neurological Surgery, University of Pittsburgh, School of Medicine,
Pennsylvania, USA.

BACKGROUND: Geniculate ganglion or nervus intermedius neuraigia is an unusual
condition resulting in deep ear pain with or without signs of atypical trigeminal
neuralgia, deep face, or throat pain. This article describes an experience with
14 patients who came to the neurosurgical service at the University of Pittsburgh
Medical Center with a diagnosis of geniculate neuralgia. METHODS: After failing
conservative treatment and after undergoing neurologic, otologic, and dental
evaluations, these 14 patients underwent 20 intracranial procedures consisting of
retromastoid craniectomies with microvascular decompression of cranial nerves V, 
IX, and X with section of the nervus intermedius in most cases. RESULTS: At
operation, vascular compression of the nerves and nervus intermedius was found,
which implicated vascular compression as an etiology of this disorder. Initially,
10 of 14 patients had an excellent outcome (71.5%), 3 experienced partial relief 
(21.5%), and there was 1 failure (7%). Ten patients were available for long-term 
(> 12 months) follow-up. Of these 10, 3 retained the excellent result (30%), 6
experienced partial relief (60%), and there was 1 failure (10%). Complications
included one transient facial paresis, one facial numbness, one paresis of
cranial nerves IX and X, one chemical meningitis, two cerebrospinal fluid leaks, 
and one superficial wound infection. Of those that fell from the excellent to
partial category, this usually involved a return of atypical facial pain, but
otalgia remained resolved. CONCLUSIONS: Overall, good results (with excellent or 
partial relief) were found long term for 90% of patients in this series. The
authors recommend microvascular decompression of cranial nerves V, IX, and X with
nervus intermedius section for the treatment of geniculate neuralgia.

Publication Types: 
    Case Reports

PMID: 9233495 [PubMed - indexed for MEDLINE]

3915: Am J Otol. 1997 Jul;18(4):475-83.

Vestibular nerve pathology in cases of intractable vertigo: an
electronmicroscopic study.

Pulec JL, Patterson MJ.

Pulec Ear Clinic, Los Angeles, CA 90017, USA.

OBJECTIVE: This study aimed to determine the absence or presence and the nature
of pathology of the vestibular nerve in case of intractable vertigo. STUDY
DESIGN: This was a prospective study. SETTING: The study was performed at a
private practice tertiary referral center. PATIENTS: There-were 42 patients with 
intractable vertigo in the study. INTERVENTIONS: All patients received thorough
diagnostic examinations and surgical excision of the vestibular nerves. MAIN
OUTCOME MEASURES: Segments of the superior and inferior vestibular nerves were
surgically removed, preserved in glutaraldehyde, examined by electronmicroscopy, 
and the findings were correlated with the clinical diagnosis. RESULTS: A variety 
of different types of pathologic lesions were identified, including axon and
supporting cell degeneration, herpes zoster virus, other viruses, results of
bacterial infection, and regrowth of nerve after surgical resection. CONCLUSION: 
The vestibular nerves were found to be histologically normal in lesions primarily
involving the end organ such as most early Meniere's disease cases, benign
paroxysmal postural vertigo (BPPV), and mild labyrinthine concussion. Vestibular 
nerve degeneration was seen with advanced Meniere's disease, severe labyrinthine 
concussion, and with vascular loops in the internal auditory canal. Herpes zoster
involves Scarpa ganglion in herpes zoster oticus. Viruses were found in the
nuclei of vestibular nerve cells in a patient with delayed hydrops. Regrowth of
the vestibular nerve after surgical resection was confirmed in three cases.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9233489 [PubMed - indexed for MEDLINE]

3916: J Gen Virol. 1997 Jul;78 ( Pt 7):1633-46.

Efficient herpes simplex virus type 1 (HSV-1) capsid formation directed by the
varicella-zoster virus scaffolding protein requires the carboxy-terminal
sequences from the HSV-1 homologue.

Preston VG, Kennard J, Rixon FJ, Logan AJ, Mansfield RW, McDougall IM.

MRC Virology Unit, Institute of Virology, Glasgow, UK. V.PRESTON@VIR.GLA.AC.UK

The scaffolding protein and associated protease of the human herpesvirus
varicella-zoster virus (VZV), encoded by genes 33.5 and 33 respectively, were
synthesized in insect cells using a baculovirus expression system. The expressed 
33.5 product formed numerous long, flexible, hollow rods, and in this respect
different from the herpes simplex virus type 1 (HSV-1) homologue which forms
large aggregates consisting mainly of fibrous material interspersed with
scaffold-like particles. Removal of 27 amino acids from the carboxy terminus of
the VZV scaffolding protein by the gene 33 protease or expression of the cleaved 
product did not result in any discernible change in the morphology of the
scaffolding protein. Again, this was in marked contrast to the situation in HSV-1
where removal of the 25 carboxy-terminal amino acids from the scaffolding protein
by the associated protease or expression of VP22a results in the formation of
large numbers of scaffold-like particles. Despite these differences, when cells
were multiply infected with baculoviruses expressing the HSV-1 capsid shell
proteins and the VZV scaffolding protein complete capsids were observed,
suggesting that the VZV protein could act as a scaffold for the assembly of the
HSV-1 capsid shell. The efficiency of capsid assembly was increased substantially
by exchanging the 23 carboxy-terminal amino acids of the VZV scaffolding protein 
for the corresponding 22 carboxy-terminal amino acids of the HSV-1 homologue,
supporting previous work which showed that this region was critical for the
formation of intact capsids.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9225040 [PubMed - indexed for MEDLINE]

3917: Postgrad Med. 1997 Jul;102(1):187-90, 192-4.

Varicella-zoster virus infection. The complex prevention-treatment picture.

Brody MB, Moyer D.

Department of Medicine, Temple University School of Medicine, Philadelphia, PA
19140, USA.

The highly prevalent and contagious varicella-zoster virus is usually benign in
healthy persons but may cause substantial morbidity in immunocompromised patients
and some adults. New developments in prevention and treatment, as discussed in
this article, offer attractive options but also present difficult management
decisions for primary care physicians.

Publication Types: 
    Review

PMID: 9224486 [PubMed - indexed for MEDLINE]

3918: J Med Virol. 1997 Jul;52(3):316-9.

Detection of varicella-zoster virus DNA in patients with acute peripheral facial 
palsy by the polymerase chain reaction, and its use for early diagnosis of zoster
sine herpete.

Furuta Y, Fukuda S, Suzuki S, Takasu T, Inuyama Y, Nagashima K.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan.

Varicella-zoster virus (VZV) reactivation without cutaneous vesicles (zoster sine
herpete) has been demonstrated in 8 to 25% of patients with acute peripheral
facial palsy (APFP) by serological methods. To make an early diagnosis of zoster 
sine herpete, VZV DNA in oropharyngeal swabs from patients with APFP was examined
by the polymerase chain reaction (PCR). VZV DNA was detected in oropharyngeal
swabs from 6 of 36 (17%) patients with APFP by PCR. VZV DNA was detected in the
oropharyngeal swabs from the six patients at their initial visit (2 to 4 days
after the onset of APFP), while the anti-VZV IgM and IgG antibody titers were not
increased significantly. In contrast, VZV DNA was undetectable in the
oropharyngeal swabs at the time when the VZV specific antibody response appeared.
These results indicate that detection of VZV DNA in oropharyngeal swabs by PCR is
more useful than currently available serological assays for the early diagnosis
of zoster sine herpete in patients with APFP.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9210042 [PubMed - indexed for MEDLINE]

3919: J Infect Dis. 1997 Jul;176(1):261-4.

Chronic varicella-zoster virus skin lesions in patients with human
immunodeficiency virus are related to decreased expression of gE and gB.

Nikkels AF, Rentier B, Pierard GE.

Department of Dermatopathology, Institute of Pathology, University of Liege,
Belgium.

The pathogenesis of chronic, verrucous varicella-zoster virus (VZV) cutaneous
lesions in human immunodeficiency virus (HIV)-infected persons is unknown. It has
been hypothesized that these lesions are due to an altered pattern of virus gene 
expression. Immediate early and late (L) gene expression in five chronic
verrucous VZV lesions, four full-blown herpes zoster vesicular lesions in
HIV-infected persons, and eight vesicular herpes zoster lesions in
immunocompetent individuals was semiquantitatively assessed immunohistochemically
using specific antibodies to the IE63, gE (L), and gB (L) proteins. All patients 
had evidence of IE63 expression in keratinocytes; however, gE expression was
either weak or absent in keratinocytes of three verrucous lesions, and gB was
either weak or absent in two. These results suggest that chronic VZV skin lesions
are associated with diminished gE and gB expression. It is inferred that the VZV 
behavior in keratinocytes may vary from a latency-like state to a fully
developed, productive infection.

PMID: 9207378 [PubMed - indexed for MEDLINE]

3920: J Infect Dis. 1997 Jul;176(1):103-11.

Evaluation of sorivudine (BV-araU) versus acyclovir in the treatment of acute
localized herpes zoster in human immunodeficiency virus-infected adults. The
Multinational Sorivudine Study Group.

Bodsworth NJ, Boag F, Burdge D, Genereux M, Borleffs JC, Evans BA, Modai J,
Colebunders R, Thomas M, DeHertogh D, Pacelli L, Thomis J.

Sydney Hospital and Taylor Square Private Clinic, Australia.

The clinical efficacy and safety of sorivudine as treatment for acute cutaneous
zoster in human immunodeficiency virus-infected adults was compared with that of 
acyclovir in a double-blinded randomized study. A total of 125 patients with
laboratory-confirmed zoster rash present for < or =72 h were assigned treatment
with either 40 mg of sorivudine once daily or 800 mg of acyclovir five times
daily, both taken orally for 7 days. Patients were assessed daily until all
lesions crusted and then monthly for 6 months for postherpetic neuralgia (PHN)
and for 12 months for recurrent or new episodes of zoster. Sorivudine
significantly shortened the median period of new vesicle formation from 3.0 to
4.0 days (log rank P = .0001). Sorivudine was effective regardless of duration of
rash before treatment. Zoster recurrences and new episodes were experienced by
fewer patients assigned sorivudine (11%) than acyclovir (26%, P = .037). No
differences were seen in incidence, severity, or duration of either acute
neuritis or PHN. Both treatments were well tolerated.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9207355 [PubMed - indexed for MEDLINE]

3921: JAMA. 1997 Jun 18;277(23):1848-50.

Comment in:
    JAMA. 1997 Oct 8;278(14):1148; author reply 1149.    JAMA. 1997 Oct 8;278(14):1148; author reply 1149.

Dermatology.

Dover JS, Arndt KA.

Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass,
USA.

PMID: 9185795 [PubMed - indexed for MEDLINE]

3922: Med Clin (Barc). 1997 Jun 14;109(3):95-7.

[Aphthae]

[Article in Spanish]

Coll J.

Publication Types: 
    Editorial

PMID: 9289522 [PubMed - indexed for MEDLINE]

3923: Arch Intern Med. 1997 Jun 9;157(11):1217-24.

Comment in:
    Arch Intern Med. 1997 Jun 9;157(11):1166-7.

Risk factors for postherpetic neuralgia.

Choo PW, Galil K, Donahue JG, Walker AM, Spiegelman D, Platt R.

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital,
Boston, Mass, USA.

BACKGROUND: The risk factors for postherpetic neuralgia (PHN), the most common
complication of herpes zoster, have not been well established. OBJECTIVE: To
elucidate the risk factors for PHN. METHODS: Automated medical, claims, and
pharmacy records of a health maintenance organization were used to identify cases
of PHN and obtain data on risk factors. A case-base design was used to assess the
impact of various patient, disease, and treatment factors on the prevalence of
PHN 1 and 2 months after developing zoster. RESULTS: There were 821 cases of
herpes zoster that met all eligibility criteria. The prevalence of PHN more than 
30 days after onset of zoster was 8.0% (95% confidence interval [CI], 6.3%-10.1%)
and 4.5% (95% CI, 3.2%-6.2%) after 60 days. Compared with patients younger than
50 years, individuals aged 50 years or older had a 14.7-fold higher prevalence
(95% CI, 6.8-32.0) 30 days and a 27.4-fold higher prevalence (95% CI, 8.8-85.4)
60 days after developing zoster. Prodromal sensory symptoms and certain
conditions associated with compromised immunity were also associated with PHN.
Systemic corticosteroids before zoster and treatment of zoster with acyclovir or 
corticosteroids did not significantly affect the prevalence of PHN. CONCLUSIONS: 
Increased age and prodromal symptoms are associated with higher prevalence of PHN
1 and 2 months after onset of zoster. Overall, systemic acyclovir appears not to 
confer any protection against PHN, although benefit among elderly patients cannot
be excluded.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9183233 [PubMed - indexed for MEDLINE]

3924: Arch Intern Med. 1997 Jun 9;157(11):1209-13.

Comment in:
    Arch Intern Med. 1997 Jun 9;157(11):1166-7.

The sequelae of herpes zoster.

Galil K, Choo PW, Donahue JG, Platt R.

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital,
Boston, Mass, USA.

BACKGROUND: The last 40 years was a period during which the incidence of herpes
zoster appears to have increased substantially. OBJECTIVE: To determine whether
the risk of complications of herpes zoster has changed during the last 40 years. 
METHODS: The automated medical records of a health maintenance organization were 
screened for diagnosis codes suggesting herpes zoster and potentially complicated
cases of zoster. The predictive value of a herpes zoster diagnosis was calculated
from sampling full-text records. Records of all patients with codes suggesting
complications were reviewed in full. RESULTS: Of 859 individuals with herpes
zoster who met the eligibility criteria, 101 were identified who experienced at
least 1 complication, corresponding to a 60-day risk of 12%. Corrected for the
sensitivity of the complication-finding strategy, the risk estimate was 14%. Risk
increased markedly with age, with those older than 64 years having more than 6
times the risk of complications of those younger than 25 years (odds ratio, 8.3; 
95% confidence interval, 2.5-29.3). Trigeminal distribution of rash and the
presence of certain conditions associated with immune compromise appeared to
increase risk. CONCLUSIONS: The apparent increase in the incidence of herpes
zoster was not accompanied by a change in the risk of specific or overall
complications in a population-based sample. Advanced age and other conditions
associated with waning cellular immunity may confer an increased risk of
experiencing a complicated course of herpes zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9183232 [PubMed - indexed for MEDLINE]

3925: Arch Intern Med. 1997 Jun 9;157(11):1166-7.

Comment on:
    Arch Intern Med. 1997 Jun 9;157(11):1209-13.    Arch Intern Med. 1997 Jun 9;157(11):1217-24.

Postherpetic neuralgia. Predicting and preventing risk.

Kost RG, Straus SE.

Publication Types: 
    Comment
    Editorial

PMID: 9183226 [PubMed - indexed for MEDLINE]

3926: Sidahora. 1997 Jun-Jul:29-32.

[Ocular troubles and HIV/AIDS]

[Article in Spanish]

[No authors listed]

AIDS: People living with HIV/AIDS are more prone to ocular conditions due to
their weakened immune systems. The symptoms of HIV-related ocular conditions,
such as cotton wool spots from cytomegalovirus infections, ocular hemorrhage,
Kaposi's sarcoma (KS), keratitis, conjunctivitis, ocular toxoplasmosis, lymphoma,
and herpes Zoster, are presented. References are provided for people with ocular 
problems.

Publication Types: 
    English Abstract
    Newspaper Article

PMID: 11364497 [PubMed - indexed for MEDLINE]

3927: AIDS Patient Care STDS. 1997 Jun;11(3):198.

Famciclovir safe and effective for management of shingles.

[No authors listed]

PMID: 11361804 [PubMed - indexed for MEDLINE]

3928: J Tradit Chin Med. 1997 Jun;17(2):124-6.

Clinical application of contralateral acupuncture technique.

Lu F.

Overseas Education College of Xiamen University.

Publication Types: 
    Case Reports

PMID: 10437182 [PubMed - indexed for MEDLINE]

3929: J Indian Med Assoc. 1997 Jun;95(6):197, 200.

Ramsay Hunt syndrome in a patient of malignant granulosa cell tumour of ovary.

Shivaprakash P, Deo RP, Raghavan A, Radheshyam D.

Department of Oncology, Manipal Hospital, Bangalore.

Publication Types: 
    Case Reports

PMID: 9420406 [PubMed - indexed for MEDLINE]

3930: Acta Med Port. 1997 Jun-Jul;10(6-7):497-501.

[Verrucous herpes zoster in AIDS patients]

[Article in Portuguese]

Agusto V, Franca I, Mansinho K, Araujo C, Borges F, Champalimaud JL,
Poiares-Baptista A, Martins C, Ricardo JL.

Unidade de Doencas Infecciosas e Parasitarias, Hospital Egaz Moniz.

The authors describe a case of disseminated Herpes-Zoster (VZV) in an HIV 1
positive patient with AIDS. Hyperkeratotic characteristics, acyclovir resistance 
and sensitivity to foscarnet of cutaneous lesions are the most important features
of this example. From the casuistics of the department, the authors describe two 
similar cases and review the medical literature with emphasis on etiopathogenic, 
diagnostic and therapeutic factors of lesions caused by DNA Virus in
immunocompromised hosts.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 9341044 [PubMed - indexed for MEDLINE]

3931: Acta Ophthalmol Scand. 1997 Jun;75(3):311-3.

The use of capsaicin in herpes zoster ophthalmicus neuralgia.

Frucht-Pery J, Feldman ST, Brown SI.

Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.

The treatment of neuralgia which occurs during and following herpes zoster
ophthalmicus is often unsatisfactory. Capsaicin
(trans-8-methyl-N-vanillyl-6-nonenamide) is a drug which depletes substance P and
may be effective in inhibiting pain. We utilized topical capsaicin to the
affected dermatome five times daily for 4 weeks in 6 patients with acute and post
herpetic neuralgia. In four cases pain was markedly relieved and narcotic
medications were either discontinued or significantly reduced. In two cases, pain
was not reduced. Four patients had side effects including burning sensation at
the site of the drug administration (4 cases), dermatitis as a result of overuse 
of the drug (2 cases) and hyperesthesia (1 case). Our results suggest that
capsaicin may be a useful therapy for the alleviation of pain in some individuals
with herpes zoster ophthalmicus. However, controlled studies are needed to
establish these results.

Publication Types: 
    Case Reports

PMID: 9253983 [PubMed - indexed for MEDLINE]

3932: Leuk Lymphoma. 1997 Jun;26(1-2):77-82.

Phase I study of fludarabine and paclitaxel for the treatment of low-grade
non-Hodgkin's lymphoma.

Younes A, Rodriguez MA, McLaughlin P, North L, Sarris AH, Pate O, Hagemeister FB,
Romaguera J, Preti A, Bachier C, Cabanillas F.

Section of Lymphoma, The University of Texas M. D. Anderson Cancer Center,
Houston 77030, USA.

We conducted a phase I clinical trial of a new combination of fludarabine and
paclitaxel in which 19 patients with histologically confirmed recurrent low-grade
non-Hodgkin's lymphoma (NHL) were treated at five dose levels. Fludarabine was
administered intravenously by bolus for 5 days and paclitaxel was given by
intravenous (I.V.) continuous infusion for 96 or 72 hours starting day 1. Courses
were repeated every 4 weeks. Patients whose disease responded received a maximum 
of six courses. All 19 patients received at least one course and could be
evaluated for toxic effects, and 18 patients could be evaluated for response. The
maximum tolerated dose (MTD) was 20 mg/m2/day I.V. bolus for 5 days of
fludarabine plus 60 mg/m2/day I.V. of paclitaxel given as a continuous infusion
over 72 hours. The limiting toxic effect was neutropenic fever, which was
observed in five of the seven patients treated at the highest dose level. Grade 3
non-hematologic toxic effects of stomatitis (14%), neuropathy (14%), and
hypotension (14%) were also observed at the highest dose level. No grade 4
non-hematologic toxic effects or treatment-related deaths occurred. One patient
had herpes zoster infection of the skin 1 year after the completion of therapy.
The overall response rate was 50%, with the two patients whose disease completely
responded remaining disease free at 22 and 17 months. Patients with no prior
exposure to either paclitaxel or fludarabine had 62% response rate. We conclude
that the combination of fludarabine and paclitaxel appears to have promising
activity for the treatment of recurrent low-grade NHL.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase I

PMID: 9250790 [PubMed - indexed for MEDLINE]

3933: Int J Dermatol. 1997 Jun;36(6):457-9.

Cost-benefit of oral acyclovir in the treatment of herpes zoster.

Kubeyinje EP.

Skin Clinic, Arar Central Hospital, Saudi Arabia.

BACKGROUND: Oral acyclovir is a costly antiviral agent shown to be effective in
the treatment of herpes zoster. Herpes zoster runs a relatively benign course in 
young, healthy individuals, as compared with elderly and immunologically
compromised patients, in whom complications are common. This study attempts to
assess the cost-benefit of treatment with oral acyclovir in young healthy adults 
with herpes zoster. PATIENTS AND METHODS: The records of 42 healthy young adults 
suffering from herpes zoster and treated with oral acyclovir (800 mg five times
daily for 7 days) were compared with those of 40 healthy young adults with herpes
zoster seen during the same period but treated without oral acyclovir. The
duration of zoster-associated pain and the presence of complications were noted. 
RESULTS: There was no statistically significant difference in the duration of
zoster-associated pain between the two groups of patients (P = 0.11). Other
complications of herpes zoster were few and similar in the two groups.
CONCLUSIONS: At a cost of $250 to $300 for a 7-day course of oral acyclovir, the 
use of this antiviral agent in healthy young individuals with herpes zoster is
not justified, especially in developing countries with limited resources.

Publication Types: 
    Comparative Study

PMID: 9248895 [PubMed - indexed for MEDLINE]

3934: Biologicals. 1997 Jun;25(2):227-30.

Live attenuated varicella vaccine for prevention of herpes zoster.

Gershon A, Silverstein S.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, NY, USA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 9236057 [PubMed - indexed for MEDLINE]

3935: Virchows Arch. 1997 Jun;430(6):510-1.

Comment on:
    Virchows Arch. 1996 Jul;428(4-5):275-80.

Hair follicle involvement in herpes zoster.

Nikkels AF, Pierard GE.

Publication Types: 
    Comment
    Letter

PMID: 9230918 [PubMed - indexed for MEDLINE]

3936: J Neurol Neurosurg Psychiatry. 1997 Jun;62(6):586-9.

Neurotropic viruses and Alzheimer's disease: a search for varicella zoster virus 
DNA by the polymerase chain reaction.

Lin WR, Casas I, Wilcock GK, Itzhaki RF.

Department of Optometry and Vision Sciences, UMIST, Manchester, UK.

BACKGROUND: In studies on the possible role of viruses in the aetiopathogenesis
of Alzheimer's disease, herpes simplex virus type 1 (HSV1) DNA was detected by
the polymerase chain reaction (PCR) in a high proportion of normal elderly people
and of patients with Alzheimer's disease. The combination of HSV1 and a host
factor, the type 4 allele of the gene for apolipoprotein E, is a strong risk
factor for the disease. METHODS: Brain specimens were examined for another herpes
virus, varicella zoster (VZV), which, like HSV1, is neurotropic, has a
predilection for residing latently in the peripheral nervous system, and can
reactivate. RESULTS: Using primers for sequences in the VZV origin of replication
gene or thymidine kinase gene, VZV DNA was not found in any of 24 samples (18
HSV1 positive), from 17 patients with Alzheimer's disease, nor in 20 samples (12 
HSV1 positive from 12 aged normal people. Hybridisation of the PCR products with 
a radiolabelled oligonucleotide probe capable of detecting less than 10 copies of
the target sequence, confirmed the absence of VZV DNA. CONCLUSION: The presence
of one neurotropic virus--HSV1--and the absence of another--VZV--in aged human
brains is consistent with a role for HSV1 in the aetiology of Alzheimer's
disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9219743 [PubMed - indexed for MEDLINE]

3937: J Hosp Infect. 1997 Jun;36(2):133-40.

Control of varicella-zoster infection on renal and other specialist units.

Jones EM, Barnett J, Perry C, Roome AP, Caul EO, Tomson CR, MacGowan AP, Reeves
DS.

Department of Medical Microbiology, Southmead Health Services NHS Trust,
Westbury-on-Trym, Bristol, UK.

The introduction of chickenpox onto our renal unit recently raised several issues
surrounding the management of patient and staff contracts. This paper describes
the action taken and makes various recommendations for future management of
similar cases. Guidelines are proposed for the management of patients and staff
as well as the role of the infection control team in handling a chickenpox
problem. Future developments, including the use of VZ vaccine for patient and
staff, are also discussed.

Publication Types: 
    Case Reports

PMID: 9211160 [PubMed - indexed for MEDLINE]

3938: J Pain Symptom Manage. 1997 Jun;13(6):327-31.

The effects of pre-emptive treatment of postherpetic neuralgia with
amitriptyline: a randomized, double-blind, placebo-controlled trial.

Bowsher D.

Pain Research Institute, Walton Hospital, Liverpool, United Kingdom.

Seventy-two patients older than 60 years of age who received a diagnosis of
herpes zoster (HZ) were entered into a randomized, double-blind,
placebo-controlled trial of daily amitriptyline 25 mg. Treatment with either
amitriptyline or placebo continued for 90 days after diagnosis. Pain prevalence
at 6 months was the primary outcome. Results showed that early treatment with
low-dose amitriptyline reduced pain prevalence by more than one-half (p < 0.05;
odds ratio, 2.9:1) This finding makes a strong case for the pre-emptive
administration of amitriptyline, in combination with an antiviral drug, to
elderly patients with acute herpes zoster.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9204652 [PubMed - indexed for MEDLINE]

3939: Clin Infect Dis. 1997 Jun;24(6):1256-60.

Clinical profile of herpes zoster ophthalmicus in Ethiopians.

Bayu S, Alemayehu W.

Department of Ophthalmology, Faculty of Medicine, Addis Ababa University,
Ethiopia, East Africa.

We conducted a prospective study of 100 consecutive Ethiopian patients with
herpes zoster ophthalmicus (HZO); this study revealed a high incidence of HZO
among the young (mean age, 35 years). Eighty-one (95%) of 85 patients who
underwent serological testing were seropositive for antibodies to human
immunodeficiency virus (HIV). Unlike previous investigators, we found a marked
increase in the incidence and severity of eyelid (25%) and ocular (78%)
complications as well as postherpetic neuralgia (55%). Visual loss occurred in
56% of the cases. Lack of medication, delay in presentation, severity of
HIV-related HZO, and application of herbal medications adversely affected the
outcomes for these patients. We conclude that all patients with HZO, especially
those younger than 45 years of age, should be screened for HIV infection. Because
HZO is a vision-threatening problem, all health care workers should become aware 
of its management.

PMID: 9195095 [PubMed - indexed for MEDLINE]

3940: Clin Infect Dis. 1997 Jun;24(6):1172-7.

Infectious ocular complications in orthotopic liver transplant patients.

Papanicolaou GA, Meyers BR, Fuchs WS, Guillory SL, Mendelson MH, Sheiner P, Emre 
S, Miller C.

Department of Ophthalmology, Mount Sinai Medical Center, New York, New York
10029, USA.

We report the frequency and type of infectious ocular complications following
orthotopic liver transplantation (OLT) and review diagnostic and therapeutic
strategies. During the period September 1988 through November 1994, 684 patients 
underwent OLT at Mount Sinai Hospital (New York). Nine orthotopic liver
transplant patients (1.3%) developed ocular infections: Candida albicans
endophthalmitis (2), Aspergillus fumigatus endophthalmitis (1), cytomegalovirus
retinitis (4), herpes simplex virus keratitis (1), and varicella-zoster virus
panophthalmitis (1). The mean time from OLT to ocular symptoms was 42 days for
patients with fungal infections and 128 days for patients with viral infections. 
Blurred vision was the commonest symptom (five of nine cases). The mean duration 
of follow-up was 2 years (range, 33 days to 5 years). Permanent loss of vision
occurred in three patients, five had improvement in visual acuity, and one died
of disseminated aspergillosis 33 days after OLT. Infectious ocular complications 
following OLT may occur as isolated events or with disseminated disease. Fungal
infections occur earlier (mean, 42 days after OLT) than viral infections (mean, 4
months after OLT). The clinical presentation may be atypical; aggressive
vitreoretinal procedures and serial examinations may be required to establish the
diagnosis. Cytomegalovirus retinitis in orthotopic liver transplant patients may 
not require life-long maintenance therapy with antiviral agents.

PMID: 9195078 [PubMed - indexed for MEDLINE]

3941: Clin Infect Dis. 1997 Jun;24(6):1100-6.

Use of polymerase chain reaction assays of aqueous humor in the differential
diagnosis of retinitis in patients infected with human immunodeficiency virus.

Danise A, Cinque P, Vergani S, Candino M, Racca S, De Bona A, Novati R, Castagna 
A, Lazzarin A.

Department of Infectious Diseases, San Raffaele Scientific Institute, Milan,
Italy.

We performed polymerase chain reaction (PCR) for detection of cytomegalovirus
(CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), and Toxoplasma
gondii DNA in aqueous humor from 15 patients who were infected with human
immunodeficiency virus (HIV) and who had retinitis of unclear origin; these
patients were selected from among 820 patients evaluated by ophthalmoscopic
examination. On the basis of the final response to treatment, CMV, VZV, and T.
gondii retinitis was diagnosed in 5, 2, and 4 of the 15 patients, respectively.
No final etiologic diagnosis was reached for four patients. All 5 patients with
CMV retinitis were CMV DNA-positive. 1 of 2 patients with VZV retinopathy were
VZV DNA-positive, and 3 of 4 patients with T. gondii retinitis were T. gondii
DNA-positive. All PCR assays of aqueous humor from the four patients without
infectious retinitis were negative. PCR assay of aqueous humor is helpful in the 
etiologic diagnosis of retinitis of unclear origin in HIV-infected patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9195064 [PubMed - indexed for MEDLINE]

3942: Infect Control Hosp Epidemiol. 1997 Jun;18(6):405-11.

Varicella vaccination for healthcare workers at a university hospital: an
analysis of costs and benefits.

Tennenberg AM, Brassard JE, Van Lieu J, Drusin LM.

Department of Epidemiology, New York Hospital, New York, USA.

OBJECTIVE: To demonstrate the costs and benefits of vaccinating
varicella-susceptible healthcare workers at a university hospital with live,
attenuated varicella-zoster virus vaccine. DESIGN: Retrospective review of
employee medical records and data on the cost of special paid absence for
susceptible healthcare workers after exposure to varicella or herpes zoster.
SETTING: A 988-bed tertiary-care university hospital. RESULTS: In 1994, 224
hospital employees (3.4%) were susceptible to the varicella-zoster virus. There
were 40 exposures to varicella and herpes zoster in that year, involving 29 of
the susceptible employees. Nine (31%) of the exposed susceptibles became
varicella immune by indirect fluorescent antibody testing subsequent to exposure.
Seventeen (59%) have had multiple varicella exposures and special paid absences
while employed by the hospital. In 1994, wages paid to healthcare workers while
furloughed for the communicable period following varicella exposure totaled
$38,463.93. An additional $24,748.74 was paid to replacement workers during that 
same time. Varicella vaccine to immunize all 224 susceptibles in 1994 would have 
cost $17,920. Absences due to varicella and herpes zoster exposure also result in
disruptions to patient care. CONCLUSIONS: Varicella vaccination for
varicella-susceptible healthcare workers at a university hospital would result in
financial savings and improved patient care. We recommend that other institutions
consider the costs and benefits of adopting a varicella immunization program for 
their susceptible employees.

PMID: 9181396 [PubMed - indexed for MEDLINE]

3943: Am Fam Physician. 1997 May 15;55(7):2501-4.

Comment in:
    Am Fam Physician. 1998 Mar 1;57(5):947.

Famciclovir: a new systemic antiviral agent for herpesvirus infections.

Stott GA.

Department of Family Medicine, York Hospital, Pennsylvania, USA.

Acyclovir was the first antiviral drug approved for the treatment of herpes
zoster. Several new antiviral agents have since been introduced, one of which is 
famciclovir. The pharmacokinetics of famciclovir allow a more convenient dosing
schedule than the schedule used with acyclovir. Famciclovir is metabolized in the
liver, but the P450 cytochrome system is not involved. Both acyclovir and
famciclovir accelerate cutaneous healing, but studies suggest that famciclovir
may reduce the severity of postherpetic neuralgia when compared with placebo.
Famciclovir is currently approved only for use in immunocompetent patients, but
clinical trials involving immunocompromised patients are in progress.

PMID: 9166148 [PubMed - indexed for MEDLINE]

3944: Am J Health Syst Pharm. 1997 May 15;54(10):1180-4.

Economic evaluation of famciclovir in reducing the duration of postherpetic
neuralgia.

Huse DM, Schainbaum S, Kirsch AJ, Tyring S.

Medical Research International, Burlington, MA 01803, USA.

The economic impact of famciclovir therapy for postherpetic neuralgia (PHN) in
patients with acute herpes zoster was studied. A decision-analytic model of the
treatment of herpes zoster and PHN was used to compare the cost of PHN between
patients treated with oral famciclovir 500 mg three times daily for seven days
and patients not receiving any antiviral therapy. The effects of famciclovir on
PHN in the model were based on the results of a randomized, double-blind trial in
419 adult outpatients. The cost of the course of famciclovir therapy (21 tablets)
was estimated as the sum of the drug's wholesale acquisition cost and the
pharmacy dispensing cost. The cost of treating PHN (physician visits,
medications, and miscellaneous nondrug therapy) was estimated by consulting a
panel of physicians. According to the model, the cost of treating PHN was $85
lower per famciclovir recipient ($294 for famciclovir versus $379 for no
antiviral therapy). The net cost of famciclovir therapy was $23 per patient ($108
for acquisition and dispensing minus the $85 savings). Among patients 50 years of
age or older, famciclovir reduced the average cost of PHN by $155 ($414 for
famciclovir versus $569 for no antiviral therapy) and yielded a net savings of $7
per patient. A model for the use of famciclovir to treat acute herpes zoster
showed that the cost of such therapy was largely offset by savings in the cost of
treating this complication.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 9161626 [PubMed - indexed for MEDLINE]

3945: Ann Intern Med. 1997 May 15;126(10):831-2.

Comment on:
    Ann Intern Med. 1996 Sep 1;125(5):376-83.

Acyclovir plus steroids for herpes zoster.

Carson MP.

Publication Types: 
    Comment
    Letter

PMID: 9148669 [PubMed - indexed for MEDLINE]

3946: Ann Intern Med. 1997 May 15;126(10):831; author reply 832.

Comment on:
    Ann Intern Med. 1996 Sep 1;125(5):376-83.

Acyclovir plus steroids for herpes zoster.

Herbert DA.

Publication Types: 
    Comment
    Letter

PMID: 9148668 [PubMed - indexed for MEDLINE]

3947: Ann Intern Med. 1997 May 15;126(10):831; author reply 832.

Comment on:
    Ann Intern Med. 1996 Sep 1;125(5):376-83.

Acyclovir plus steroids for herpes zoster.

Atkins CD.

Publication Types: 
    Comment
    Letter

PMID: 9148667 [PubMed - indexed for MEDLINE]

3948: N Z Med J. 1997 May 9;110(1043):167-9.

Neurotoxicity associated with acyclovir in end stage renal failure.

Kitching AR, Fagg D, Hay NM, Hatfield PJ, Macdonald A.

Department of Medicine, Wellington School of Medicine.

AIMS: To alert practitioners to the danger of acyclovir neurotoxicity occurring
in the presence of renal failure. METHODS: Two case reports of acyclovir
neurotoxicity in the patients on continuous ambulatory peritoneal dialysis.
RESULTS: In one case neurotoxicity resulted from the use of a dosage regimen that
would be appropriate in patients with normal renal function. In the other case,
neurotoxicity occurred even though a reduced dose of acyclovir was given.
Supportive management resulted in a complete recovery. CONCLUSIONS: In patients
with end stage renal failure with varicella zoster infections, when acyclovir is 
prescribed the loading dose should be 400 mg and the maintenance dose should be
200 mg twice daily.

Publication Types: 
    Case Reports
    Review

PMID: 9196501 [PubMed - indexed for MEDLINE]

3949: BioDrugs. 1997 May;7(5):386-93.

Cladribine.

Romine JS, Sipe JC, Koziol JA, Zyroff J, McMillan R, Beutler E.

Division of Neurology, Scripps Clinic and Research Foundation, La Jolla,
California, USA.

Cladribine is a novel drug that selectively depletes lymphocytes and may be able 
to destroy the activated immunocytes that damage the central nervous system in
multiple sclerosis. Our initial controlled studies have shown a beneficial,
although temporary, dose-related effect of cladribine on the course of chronic
progressive multiple sclerosis. Peak improvement in median Scripps Neurological
Rating Scale (SNRS) neurological performance scores, followed by gradual decline,
occurred at month 14 after initiation of treatment with a 2.8 mg/kg total dose
and at month 7 after initiation of treatment with a 1.4 mg/kg total dose. A
marked decrease in the presence of enhanced magnetic resonance imaging lesions
was observed at both dose levels. Adverse effects are also dose-related. Mild
segmental herpes zoster or transient marrow suppression occurred in some patients
treated at the higher total dose, whereas no problems of this kind were observed 
at the lower total dose. It is our hope that studies that are presently under way
will establish cladribine as a practical therapeutic option for patients with all
non-benign forms of multiple sclerosis.

PMID: 18031102 [PubMed - in process]

3950: Clin Exp Dermatol. 1997 May;22(3):148-51.

Transient leukaemia cutis in chronic lymphocytic leukaemia.

Wakelin SH, Young E, Kelly S, Turner M.

Department of Dermatology, Amersham Hospital, Bucks.

Leukaemia cutis arises from cutaneous infiltration by neoplastic leukocytes or
their precursors. Recent evidence suggests that this sign does not necessarily
herald a poor prognosis. We describe a 72-year-old woman with B-cell chronic
lymphatic leukaemia who developed a papular eruption of her breast at the site of
a recent herpetic eruption. Histology and immunostaining showed a dense dermal
B-cell infiltrate in keeping with leukaemia cutis. The papules cleared in 6
months without treatment, leaving atrophic scars. The histological features and
possible aetiological mechanisms of post-herpetic papular eruptions in chronic
lymphatic leukaemia are reviewed.

Publication Types: 
    Case Reports
    Review

PMID: 9425697 [PubMed - indexed for MEDLINE]

3951: Aust N Z J Ophthalmol. 1997 May;25(2):173.

A dental prosthesis to close the palpebral fissure.

Meades K.

Sydney Eye Hospital, NSW, Australia.

Publication Types: 
    Case Reports

PMID: 9267607 [PubMed - indexed for MEDLINE]

3952: HNO. 1997 May;45(5):353-5.

[Guidelines/algorithms of the German Society of Otorhinolaryngology, Head and
Neck Surgery. German Society of Otorhinolaryngology, Head and Neck Surgery]

[Article in German]

Ganzer U.

PMID: 9265016 [PubMed - indexed for MEDLINE]

3953: Br J Gen Pract. 1997 May;47(418):330-1.

Corneal exposure in herpes zoster ophthalmicus.

Potamitis T, O'Sullivan JN, Mohan-Roberts I.

Publication Types: 
    Case Reports
    Letter

PMID: 9219421 [PubMed - indexed for MEDLINE]

3954: J Infect. 1997 May;34(3):261-2.

Bilateral facial palsy secondary to herpes zoster meningoencephalitis in a
HIV-positive woman.

Mahadeen ZI, Brennan RW, Kothari MJ.

Division of Neurology, Pennsylvania State University, College of Medicine,
Hershey 17033, USA.

Bilateral facial paralysis of diverse infectious aetiologies has been reported in
HIV infected patients. We present a patient with bilateral facial palsy most
likely due to herpes zoster meningoencephalitis in a patient with neutropenia and
who subsequently tested HIV-positive.

Publication Types: 
    Case Reports

PMID: 9200035 [PubMed - indexed for MEDLINE]

3955: Acta Neurol Scand. 1997 May;95(5):280-3.

Absence of seven human herpesviruses, including HHV-6, by polymerase chain
reaction in CSF and blood from patients with multiple sclerosis and optic
neuritis.

Martin C, Enbom M, Soderstrom M, Fredrikson S, Dahl H, Lycke J, Bergstrom T,
Linde A.

Department of Neurology, Karolinska Institute, Huddinge University Hospital,
Stockholm, Sweden.

Several members of the herpesvirus family have been implicated in the
pathogenesis of multiple sclerosis (MS). Recently, HHV-6 viral antigen has been
demonstrated in association to MS plaques, as well as DNA from human herpesvirus 
6 (HHV-6) in cerebrospinal fluid from a few MS patients by polymerase chain
reaction (PCR). In the present study, CSF from patients with MS, optic neuritis
and other neurological diseases, as well as consecutive CSF and serum samples
from MS patients included in a clinical trial with acyclovir, were analysed by
nested PCR for the presence of DNA from herpes simplex virus 1 and 2,
Epstein-Barr virus, varicella zoster virus, cytomegalovirus, human herpesvirus 6 
and 7. No virus DNA was found in any CSF (n = 115) or serum (n = 116) sample.
These findings argue against a continuous disseminated herpesvirus infection in
MS, but do not rule out a lesion-associated, low-grade herpesvirus infection
within the MS brain.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9188902 [PubMed - indexed for MEDLINE]

3956: Acta Derm Venereol. 1997 May;77(3):245.

Higher herpes zoster infection frequency in right-handed patients and more
frequent appearance in the left body side of females.

Ertunc V, Dane S, Karakuzu A, Deniz O.

Publication Types: 
    Letter

PMID: 9188890 [PubMed - indexed for MEDLINE]

3957: Acta Derm Venereol. 1997 May;77(3):194-7.

Comment in:
    Acta Derm Venereol. 1998 May;78(3):234-5.

Histopathological findings, viral DNA distribution and lymphocytic
immunophenotypes in vesicular and papular types of herpes zoster.

Yi JY, Kim TY, Shim JH, Cho BK, Kim CW.

Department of Dermatology, Catholic University Medical College, Seoul, Korea.

The characteristics rash of herpes zoster begins as erythematous macules and
papules, progressing to vesicles within 12-24 h. Patients with persistent papules
without vesicular change are occasionally found. Our aim was to elucidate
differences in vesicular and papular types of herpes zoster. Biopsy specimens
from 21 patients were examined by an in situ hybridization method to observe
viral distribution, and lymphocytic immunophenotypes were evaluated
immunohistochemically. There was no differences in cell-mediated immunity or
immunophenotypes in lymphocytic infiltrates between vesicular and papular types
of herpes zoster. DNA of varicella-zoster virus was detected in the epidermis and
hair follicles in the vesicular type but was found in the pilosebaceous unit in
the papular type. This indicates that the appearance of clinical types of herpes 
zoster depends on the infected site of varicella-zoster virus in the tissue.

PMID: 9188869 [PubMed - indexed for MEDLINE]

3958: Clin Exp Rheumatol. 1997 May-Jun;15(3):275-82.

Immunosuppressive therapy in lupus nephritis.

D'Cruz D, Cuadrado MJ, Mujic F, Tungekar MF, Taub N, Lloyd M, Khamashta MA,
Hughes GR.

Lupus Arthritis Research Unit, Rayne Institute, London, U.K.

OBJECTIVE: To evaluate the outcomes and side effects of immunosuppressive therapy
in patients with lupus nephritis. PATIENTS AND METHODS: Thirty-nine patients with
lupus nephritis assessed between 1988 and 1993 with a median follow-up of 46
months (range 12-60 months) were studied. Lupus nephritis was biopsy-proven in 37
patients. Patients received a median of 3 (500 mg) weekly pulses of intravenous
cyclophosphamide followed either by azathioprine (n = 32) or oral
cyclophosphamide (n = 7). All patients received oral prednisolone. The time from 
biopsy to renal insufficiency, defined by doubled serum creatinine and/or end
stage renal failure, was used to assess outcome. RESULTS: There were significant 
improvements in the median changes of all major laboratory parameters. Serum
creatinine levels did not change significantly. The prednisolone dose was
significantly reduced during the follow-up period. Outcome: renal function
remained stable in 26 (67%) and deteriorated despite therapy in 13 (33%)
patients. 6/13 (42%) of these patients had impaired renal function at the time of
biopsy. The adverse effects of intravenous cyclophosphamide seen were Herpes
zoster (1), transient leucopenia (2), rash (1) and fatal septicaemia (1); of
azathioprine urinary infections (3), leucopenia (5), rash (1) and increased liver
enzymes (1); and of oral cyclophosphamide ovarian failure (4), Herpes zoster (3),
haemorrhagic cystitis (1), and fatal septicaemia (1). CONCLUSIONS: Therapy with
weekly low dose intravenous pulse cyclophosphamide to induce remission, followed 
by azathioprine appears to be useful in preserving renal function in patients
with diffuse proliferative lupus nephritis. In comparison to other studies, the
reduced incidence of ovarian failure using this regimen was striking.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9177922 [PubMed - indexed for MEDLINE]

3959: Can J Neurol Sci. 1997 May;24(2):137-9.

Varicella zoster antibodies after herpes zoster, varicella and multiple
sclerosis.

Ross RT, Nicolle LE, Dawood MR, Cheang M, Feschuk C.

Section of Neurology, University of Manitoba, Winnipeg.

BACKGROUND: We previously showed that Manitoba Hutterites seek physician care for
varicella zoster virus infection significantly less than non-Hutterites. The
current study was undertaken to measure varicella zoster virus seroprevalence for
Hutterite and non-Hutterite controls. METHODS: Blood was obtained from 315
Hutterites and 259 similar age and sex controls at the time of blood donations to
The Canadian Red Cross Society. The controls were from the same or a contiguous
postal code area and were collected at the same time as the Hutterite samples.
The immune status of the specimens was determined by the ELISA method (enzyme
linked immunosorbent assay). RESULTS: Twenty-eight per cent of 315 Hutterites had
no immunity and an additional 25% had only marginal immunity. Among the 259
controls, 10% had no immunity and an additional 10% had only marginal immunity (p
< .0001). CONCLUSIONS: Manitoba Hutterites have significantly decreased
seroprevalence to varicella zoster virus infection. This study of serum varicella
zoster virus antibodies verifies a previous population based study that
demonstrated the relative rarity of varicella and herpes zoster among a
particular population group.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 9164691 [PubMed - indexed for MEDLINE]

3960: Clin Pharmacol Ther. 1997 May;61(5):563-73.

The effect of sorivudine on dihydropyrimidine dehydrogenase activity in patients 
with acute herpes zoster.

Yan J, Tyring SK, McCrary MM, Lee PC, Haworth S, Raymond R, Olsen SJ, Diasio RB.

Department of Pharmacology and Toxicology, University of Alabama at Birmingham
35294, USA.

OBJECTIVE: Bromovinyl-uracil (BVU) is the principal metabolite of sorivudine, a
potent anti-zoster nucleoside. BVU binds to, and irreversibly inhibits, the
enzyme dihydropyrimidine dehydrogenase (DPD). The objective of this study was to 
assess the time course of recovery of DPD activity after oral administration of
sorivudine in patients with herpes zoster and to correlate restoration of DPD
activity and levels of uracil with the elimination of sorivudine and its
metabolite BVU from the circulation. METHODS: Sorivudine was given orally as 40
mg once-daily doses for 10 consecutive days to a total of 19 patients with herpes
zoster. Serum sorivudine, BVU, and circulating uracil and DPD activity in
peripheral blood mononuclear cells (PBMCs) were determined before, during, and
after administration of sorivudine. RESULTS: BVU was eliminated from the
circulation within 7 days after the last sorivudine dose. DPD activity in PBMCs, 
which was completely suppressed in 18 of the 19 subjects and markedly suppressed 
in the remaining subject during administration of sorivudine, recovered to
baseline levels within 19 days after the last dose of sorivudine in all subjects 
and within 14 days in all but one of the subjects. The restoration of DPD
activity was temporally associated with elimination of BVU from the circulation. 
The elevated uracil concentrations produced by inhibition of DPD activity fell
rapidly after cessation of sorivudine administration and also were temporally
associated with elimination of BVU from the circulation. The time course of
recovery of DPD activity in three patients with renal impairment was similar to
that of the other subjects. CONCLUSIONS: This study indicates that sorivudine
therapy is associated with a profound depression of DPD activity. Recovery of DPD
activity occurred within 4 weeks of the completion of sorivudine therapy, which
indicates that fluorinated pyrimidines may be safely administered 4 weeks after
completion of sorivudine therapy.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 9164418 [PubMed - indexed for MEDLINE]

3961: Neurology. 1997 May;48(5):1347-51.

Unilateral hyperfusion in brain-perfusion SPECT predicts poor prognosis in acute 
encephalitis.

Launes J, Siren J, Valanne L, Salonen O, Nikkinen P, Seppalainen AM, Liewendahl
K.

Department of Neurology, Helsinki University Central Hospital, Finland.

We studied 88 patients with acute encephalitis using hexamethylpropyleneamine
oxime and single photon emission computed tomography (SPECT). All patients had
been initially treated with intravenous acyclovir. The etiology could be
disclosed in 37 patients (42%), which included 15 patients with herpes simplex
encephalitis, 7 with varicella-zoster encephalitis, and 29 with other
encephalitides (Mycoplasma, adenovirus, influenza, rotavirus, rubella,
Epstein-Barr, arbovirus, syphilis, and tuberculosis). Unilateral hyperperfusion
in SPECT was an independent predictor of poor prognosis, whereas neither clinical
outcome variables, such as seizures, state of consciousness, and focal neurologic
findings, nor CSF or EEG findings were not. Focal unilateral hyperperfusion is an
indicator of severe inflammation of the brain tissue and predicts a poor outcome 
as assessed in terms of activities of daily living after recovery.

PMID: 9153471 [PubMed - indexed for MEDLINE]

3962: Drug Metab Dispos. 1997 May;25(5):270-3.

Corrected and republished from:
    Drug Metab Dispos. 1997 Feb;25(2):270-3.

Lethal drug interactions of sorivudine, a new antiviral drug, with oral
5-fluorouracil prodrugs.

Okuda H, Nishiyama T, Ogura K, Nagayama S, Ikeda K, Yamaguchi S, Nakamura Y,
Kawaguchi Y, Watabe T.

Department of Drug Metabolism and Molecular Toxicology, School of Pharmacy, Tokyo
University of Pharmacy and Life Science, Japan.

Rats were orally co-administered sorivudine (SRV:
1-beta-D-arabinofuranosyl-(E)-5-(2-bromovinyl)uracil), a new oral antiviral drug 
for herpes zoster, with the oral anticancer drug tegafur (FT:
1-(2-tetrahydrofuryl)-5-fluorouracil as a prodrug of 5-fluorouracil (5-FU) once
daily to investigate a toxicokinetic mechanism of 15 Japanese patients' deaths
recently caused within a brief period by the drug interaction of these drugs. All
the rats showed extremely elevated levels of 5-FU in plasma and tissues,
including bone marrow and small intestine, and died within 10 days, whereas the
animals given the same dose of SRV or FT alone were still alive over 20 days
without any appreciable toxic symptom. Before their death, there was marked
damage of bone marrow, marked atrophy of intestinal membrane mucosa, marked
decreases in white blood cells and platelets, diarrhea with bloody flux, and
severe anorexia as reported with the Japanese patients. Data obtained by in vivo 
and in vitro studies strongly suggested that (E)-5-(2-bromovinyl)uracil generated
from SRV by gut flora was reduced in the presense of NADPH to a reactive form by 
hepatic dihydropyrimidine dehydrogenase (DPD), a key enzyme determining the
tissue 5-FU levels, bound covalently to DPD as a suicide inhibitor, and markedly 
retarded the catabolism of 5-FU.

Publication Types: 
    Corrected and Republished Article

PMID: 9152608 [PubMed - indexed for MEDLINE]

3963: Arch Ophthalmol. 1997 May;115(5):664-5.

Comment on:
    Arch Ophthalmol. 1997 May;115(5):590-4.

The use of polymerase chain reaction techniques to detect varicella-zoster virus 
in corneal transplant tissue.

Liesegang TJ.

Publication Types: 
    Comment
    Editorial

PMID: 9152136 [PubMed - indexed for MEDLINE]

3964: Arch Ophthalmol. 1997 May;115(5):590-4.

Comment in:
    Arch Ophthalmol. 1997 May;115(5):664-5.

Detection of varicella-zoster virus DNA in keratectomy specimens by use of the
polymerase chain reaction.

Mietz H, Eis-Hubinger AM, Sundmacher R, Font RL.

Department of Ophthalmology, Baylor College of Medicine, Houston, Tex, USA.
h.mietz@uni-koeln.de

OBJECTIVE: To study the correlation of clinical findings, histopathologic
features, and detection of varicella-zoster virus (VZV) DNA in keratectomy
specimens. MATERIALS AND METHODS: Fourteen corneal buttons from patients with a
confirmed history of herpes zoster ophthalmicus were examined by use of light
microscopy and the polymerase chain reaction. The polymerase chain reaction
techniques included gel electrophoresis and hybridization for the detection of
VZV DNA. RESULTS: Seven (50%) of the 14 specimens were positive for VZV DNA. The 
positive findings in the specimens correlated with the clinical findings of
uveitis (3/3) and the histopathologic features of chronic stromal keratitis
(4/4). Patients with stromal scarring, granulomatous keratitis, and neurotrophic 
ulcers had negative findings. The largest interval between the initial appearance
and detection of viral DNA was 51 years. CONCLUSIONS: The results suggest that
VZV DNA is not detectable in the cornea in every patient and at every stage of
zoster keratitis. This may be due to the low number of VZV particles present in
the cornea or the lack of viral DNA in the keratocytes. It remains unclear
whether the VZV-related keratopathy is caused by an immunologic response to a
viral antigen, the viable virus itself, or both.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9152125 [PubMed - indexed for MEDLINE]

3965: Am J Ophthalmol. 1997 May;123(5):699-702.

Retinal perivasculitis in an immunocompetent patient with systemic herpes simplex
infection.

Chatzoulis DM, Theodosiadis PG, Apostolopoulos MN, Drakoulis N, Markomichelakis
NN.

Department of Ophthalmology, School of Medicine, Athens University, Greece.

PURPOSE: To describe a case of retinal perivasculitis in an immunocompetent
patient with systemic herpes simplex infection. METHODS: Polymerase chain
reaction amplifications were performed for aqueous and blood samples using
primers specific for the following members of the herpesvirus family:
cytomegalovirus, Epstein-Barr virus, herpes simplex virus (types 1 and 2), and
varicella-zoster virus. The patient was placed on intravenous acyclovir and
systemic corticosteroids. RESULTS: A positive polymerase chain reaction signal
was found only for herpes simplex virus type 1. Vision in the left eye improved
from light perception to 20/25, and signs of retinal perivasculitis resolved.
CONCLUSION: The use of molecular diagnostic modalities in clinical practice may
aid in determining infectious etiologies in patients with atypical clinical
manifestations.

Publication Types: 
    Case Reports

PMID: 9152082 [PubMed - indexed for MEDLINE]

3966: J Am Acad Dermatol. 1997 May;36(5 Pt 2):831-3.

Chronic varicella zoster infection mimicking a basal cell carcinoma in an AIDS
patient.

Tsao H, Tahan SR, Johnson RA.

Department of Dermatology, Harvard Medical School, Boston, MA, USA.

Chronic herpesvirus infections are common in patients infected with HIV. Atypical
skin lesions secondary to long-standing varicella-zoster virus (VZV) infection
have been reported. We present a case of an AIDS patient with a chronic VZV
infection that simulated a basal cell carcinoma. Histologic examination and
immunohistochemistry confirmed the presence of the virus in the follicular
epithelium. In the immunocompromised patient, biopsies should be performed on all
suspicious lesions because medically-treatable infections may take on the
appearance of malignancy.

Publication Types: 
    Case Reports

PMID: 9146560 [PubMed - indexed for MEDLINE]

3967: J Am Acad Dermatol. 1997 May;36(5 Pt 1):778-9.

Acquired reactive perforating collagenosis: unilateral umbilicated papules along 
the lesions of herpes zoster.

Bang SW, Kim YK, Whang KU.

Department of Dermatology, College of Medicine, Soon-chunhyang University, Seoul,
South Korea.

Publication Types: 
    Case Reports

PMID: 9146541 [PubMed - indexed for MEDLINE]

3968: Clin Infect Dis. 1997 May;24(5):753-61; quiz 762-3.

Comment in:
    Clin Infect Dis. 1998 Jan;26(1):241-2.

Varicella-zoster virus vaccine.

White CJ.

North American Vaccine, Inc., Beltsville, Maryland 20705, USA.

Publication Types: 
    Review

PMID: 9142766 [PubMed - indexed for MEDLINE]

3969: Neuroimaging Clin N Am. 1997 May;7(2):261-80.

Neuroimaging of AIDS. I. Viral infections.

Lizerbram EK, Hesselink JR.

Division of Magnetic Resonance Imaging, University of California at San Diego
Medical Center, San Diego, California 92103-8756, USA.

Viral infections of the brain and spinal cord cause significant morbidity and
mortality in patients afflicted with AIDS. Debate continues over the specific
mechanisms and pathways of how HIV-1 manifests itself in the brain and spinal
cord. Attempts to predict which seropositive patients develop neurocognitive
deficits caused by HIV-1 and how soon these deficits will occur in the course of 
disease have had limited success. The neuropathologic changes of HIV-1 must be
distinguished from other viral infections, such as cytomegalovirus, JC
papovavirus (progressive multifocal leukoencephalopathy), herpes simplex virus
type 1, and varicella-zoster virus. In addition to cerebral spinal fluid sampling
and serum testing, some specific features are seen with contrast-enhanced CT, MR 
imaging, proton MR spectroscopy, SPECT, and PET.

Publication Types: 
    Review

PMID: 9113690 [PubMed - indexed for MEDLINE]

3970: Arch Intern Med. 1997 Apr 28;157(8):909-12.

The effect of treating herpes zoster with oral acyclovir in preventing
postherpetic neuralgia. A meta-analysis.

Jackson JL, Gibbons R, Meyer G, Inouye L.

Department of Medicine, Madigan Army Medical Center, Tacoma, Wash, USA.

BACKGROUND: Herpes zoster is a common affliction in older patients, with up to
15% experiencing some residual pain in the distribution of the rash several
months after healing. Despite numerous randomized clinical trials, the effect of 
treating herpes zoster with oral acyclovir in preventing postherpetic neuralgia
remains uncertain because of conflicting results. METHODS: Meta-analysis of
published randomized clinical trials on the use of acyclovir to prevent
postherpetic neuralgia using the fixed-effects model of Peto. RESULTS: Thirty
clinical trials of treatment with oral acyclovir in immunocompetent adults were
identified. After excluding studies with duplicate data, suboptimal and topical
dosing, non-placebo-controlled or nonrandomized designs, and those using
intravenous acyclovir, 5 trials were found to be homogeneous and were combined
for analysis. From these trials, the summary odds ratio for the incidence of "any
pain" in the distribution of rash at 6 months in adults treated with acyclovir
was 0.54 (95% confidence interval, 0.36-0.81). CONCLUSION: Treatment of herpes
zoster with 800 mg/d of oral acyclovir within 72 hours of rash onset may reduce
the incidence of residual pain at 6 months by 46% in immunocompetent adults.

Publication Types: 
    Meta-Analysis

PMID: 9129551 [PubMed - indexed for MEDLINE]

3971: J Med Chem. 1997 Apr 25;40(9):1401-6.

Carbocyclic oxetanocins lacking the C-3' methylene.

Wu J, Schneller SW, Seley KL.

Department of Chemistry, University of South Florida, Tampa 33620, USA.

Using the observation that the side effects of aristeromycin (carbocyclic
adenosine) were reduced by removing the methylene at the center in aristeromycin 
where phosphorylation occurs, derivatives of carbocyclic oxetanocin A (4a),
oxetanocin G (4b), and 2-aminooxetanocin A (16) lacking the 3'-methylene have
been prepared in racemic form. The only viruses for which an appreciable
inhibitory effect of the compounds (minimum inhibitory concentration ranging from
1 to 40 microg/mL) was noted were herpes simplex virus type 1 (HSV-1) and
varicella-zoster virus (VZV). However, when directly compared for their antiviral
potency against HSV-1 with their parents oxetanocin A and oxetanocin G, compounds
4a and 4b proved clearly less active.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9135038 [PubMed - indexed for MEDLINE]

3972: Biol Psychiatry. 1997 Apr 15;41(8):883-90.

Cerebrospinal fluid viral antibodies in obsessive-compulsive disorder in an
Indian population.

Khanna S, Ravi V, Shenoy PK, Chandramuki A, Channabasavanna SM.

Department of Psychiatry, National Institute of Mental Health and Neurosciences, 
Bangalore, India.

Immunoglobulin G viral antibodies for herpes simplex virus type 1, varicella
zoster virus, cytomegalovirus, measles, and mumps were studied in 76 subjects
with obsessive-compulsive disorder and compared with a control population. There 
was a significantly higher titer for herpes simplex virus type 1 antibodies.
Sera: cerebrospinal fluid ratios were suggestive of intrathecal synthesis.

Publication Types: 
    Clinical Trial

PMID: 9099415 [PubMed - indexed for MEDLINE]

3973: Dent Update. 1997 Apr;24(3):126-8.

HIV-associated fulminating herpes zoster infection with alveolar necrosis and
tooth exfoliation: a case report.

Chindia ML.

Department of Oral and Maxillofacial Surgery/Oral Pathology and Oral Medicine,
Faculty of Dental Sciences, University of Nairobi, Kenya.

This paper presents a case of HIV-associated fulminating herpes zoster infection 
(HZI) that culminated in right mandibular necrosis and tooth exfoliation. The
occurrence of such infection in immunosuppression and the impending clinical
features are briefly reviewed and discussed.

Publication Types: 
    Case Reports

PMID: 9515379 [PubMed - indexed for MEDLINE]

3974: Rev Clin Esp. 1997 Apr;197(4):297.

[Neurotoxicity of acyclovir]

[Article in Spanish]

Calvo Romero JM, Barquilla Esteban JF, Arrobas Vacas M.

Publication Types: 
    Case Reports
    Letter

PMID: 9197149 [PubMed - indexed for MEDLINE]

3975: Leukemia. 1997 Apr;11 Suppl 2:S29-34.

Present status of purine analogs in the therapy of chronic lymphocytic leukemias.

Bergmann L.

Medical Clinic III, University Hospital, JW Goethe University, Frankfurt,
Germany.

Chronic lymphocytic leukemia (CLL) is considered an incurable disease and
therefore the management is palliative and more disease-related symptoms
directed. Recently, the high activity of nucleoside analogs as fludarabine
(FAMP), 2-chlorodeoxyadenosine (2-CDA) and 2-deoxycoformycin (DCF) in low-grade
NHLs has caused a new reawakening interest in CLL concerning new treatment
strategies, the biology and prognostic factors of this disease. Predominantly
FAMP has widely been studied in CLL with impressive remission rates of 30-70%,
including some complete remission (CR) in refractory or relapsed CLL. In
previously untreated patients, the remission rate is about 80% with a CR rate of 
up to 60%. These results open new treatment strategies, even with a curative
intention such as high-dose chemotherapy combined with autologous stem cell
support or allogeneic stem cell transplantation. The clinical experience with
2-CDA in CLL is limited, but the preliminary results suggest a similar efficacy
as FAMP, whereas DCF seems to be less effective. The major treatment-related
morbidity is due to myelo- and immunosuppression by long-lasting T cell
depletion, which may facilitate a greater susceptibility of infections including 
those with opportunistic organisms as herpes simplex or herpes zoster,
cytomegalovirus, Pneumocystis carinii, mycobacteria, listeriosis, candida and
aspergillus in pretreated patients. However, in previously untreated patients no 
increased incidence of infections has been reported compared with other
schedules. Whether FAMP treated patients have any advantage for overall or
progression-free survival has to be answered by ongoing randomized trials.
Presently, the position of FAMP and 2-CDA as two extremely active single agents
in CLL is that of second-line therapy. Their appropriate indication in the
first-line strategy of CLL has, however, still to be defined by clinical studies 
in progress.

Publication Types: 
    Review

PMID: 9178835 [PubMed - indexed for MEDLINE]

3976: Pain. 1997 Apr;70(2-3):287-9.

Comment on:
    Pain. 1996 Apr;65(1):45-51.

Comments on De Benedittis and Lorenzetti: on topical aspirin/diethyl ether for
postherpetic neuralgia, PAIN, 65 (1996) 45-51.

Bonicalzi V, Canavero S.

Publication Types: 
    Comment
    Letter

PMID: 9150304 [PubMed - indexed for MEDLINE]

3977: Aliment Pharmacol Ther. 1997 Apr;11(2):415-7.

Acyclovir-induced colitis.

Wardle TD, Finnerty JP, Swale V, Beer T.

Department of Medicine, Countess of Chester Hospital, Liverpool, UK.

Three patients developed acute colitis, either de novo, or as an exacerbation of 
pre-existing colitis, following the use of oral acyclovir, prescribed for Herpes 
zoster or Herpes simplex infection. Rechallenge with oral acyclovir was performed
in one patient, and resulted in a recurrence of colitic symptoms. It is
speculated that acyclovir can have a direct irritant effect on large bowel
mucosa.

Publication Types: 
    Case Reports

PMID: 9146784 [PubMed - indexed for MEDLINE]

3978: Clin Infect Dis. 1997 Apr;24(4):603-8.

Varicella-zoster virus is strongly associated with atypical necrotizing herpetic 
retinopathies.

Garweg J, Bohnke M.

Department of Ophthalmology, University of Bern, Inselspital, Switzerland.

Aqueous humor samples from nine patients with atypical necrotizing retinopathies 
of suspected viral origin, six with acute retinal necrosis syndrome (ARN), and 17
with active cytomegalovirus (CMV) retinitis underwent amplification for viral DNA
of herpes simplex virus type 1 (HSV-1), varicella-zoster virus (VZV), and human
CMV. VZV DNA was detected in seven of the nine aqueous humor samples from
patients with atypical necrotizing retinopathies of suspected viral origin and in
four of the six samples from individuals with ARN; of the two other samples from 
patients with ARNS, no viral DNA was found in one, and both CMV DNA and HSV-1
DNA, but not VZV DNA, were detected in one (this patient presented with bilateral
ARNS 2 months after being successfully treated for CMV retinitis). Thus, VZV is
likely to be the main pathogen of atypical necrotizing herpetic retinopathies.
DNA amplification may be used to establish an early, sensitive, and reliable
diagnosis of any form of necrotizing retinopathy in 80% of cases, irrespective of
viral etiology.

PMID: 9145733 [PubMed - indexed for MEDLINE]

3979: Auris Nasus Larynx. 1997 Apr;24(2):199-206.

Angioimmunoblastic lymphadenopathy-like T-cell lymphoma. A case report and
immunologic study.

Kanzaki Y, Eura M, Chikamatsu K, Yoshida M, Masuyama K, Nishimura H, Ishikawa T.

Department of Otolaryngology, Kumamoto University, School of Medicine, Japan.

BACKGROUND: Angioimmunoblastic lymphadenopathy (AILD) is rare in the head and
neck and its definition remains controversial. METHOD: A case of AILD with an
ulcer of the lateral pharyngeal wall was studied for viral infection,
immunohistologic findings and T-cell receptor (TCR) V beta rearrangement.
RESULTS: We observed elevation of antibodies against herpes simplex virus and
herpes zoster virus as well as Epstein-Barr virus considered closely associated
with AILD. The affected neck lymph node showed a preponderance of T-cells,
predominantly CD4+ over CD8+ T-cells and all V beta gene families were expressed 
in the T-cells without enhancement of any particular TCR gene usage. CONCLUSION: 
Viral infection may occur easily in patients with AILD, possibly owing to
immunodeficiency. Assessment of TCR V beta gene usage indicated T-cells to
non-specifically become lymphomatous in AILD-like T-cell lymphoma.

Publication Types: 
    Case Reports

PMID: 9134144 [PubMed - indexed for MEDLINE]

3980: Am J Dermatopathol. 1997 Apr;19(2):133-7.

Histopathology of peripheral nerves in cutaneous herpesvirus infection.

Worrell JT, Cockerell CJ.

Department of Dermatology, University of Texas Southwestern Medical Center,
Dallas, USA.

Cutaneous herpesvirus infection is a common viral disorder manifest by epidermal 
and/or mucosal vesicle formation. Though it is believed that the virus most
likely resides in regional sensory ganglia following primary infection and that
cutaneous involvement represents reactivation of a latent infection, the
histopathology of cutaneous nerves in sites of disease has not been well
characterized. In order to assess and characterize the pathologic changes of
these nerves, we retrospectively examined 54 cases of cutaneous and mucosal
herpesvirus infection as defined by the presence of diagnostic multinucleate
epithelial giant cells that demonstrated viral cytopathic effect. Dermal nerves
were evaluable in 48 of 54 cases. All cases showed perineural inflammation that
consisted of a dense mixed lymphocyte-polymorphonuclear cell infiltrate.
Twenty-six cases exhibited intraneural infiltrations accompanied by Schwann cell 
hypertrophy with nuclear eosinophilia and pyknosis. Frank neuronal necrosis was
present in 21 cases, with viral cytopathic effect evident within neurons of four 
cases. The degree of peri- and intraneural inflammation correlated with the
severity of the inflammatory response within the dermis in most cases; however,
in eight cases there was inflammatory involvement of neurovascular structures
distant from and out of proportion to dermal and epidermal changes.
Immunoperoxidase staining using a polyvalent antibody to human herpesvirus was
performed in two cases and demonstrated viral antigen within nerve twigs. This
pattern of peripheral nerve twig inflammation, along with the occurrence of more 
distant neural involvement, may prove to have diagnostic implications and serve
as a clue in the recognition of cutaneous herpesvirus infection, particularly in 
cases with subtle or absent epidermal alteration. Furthermore, the presence of
inflammation within and around nerves as well as degenerative changes suggest
that nerve twigs are not passive conduits for viral spread but may be directly
involved in infection.

PMID: 9129697 [PubMed - indexed for MEDLINE]

3981: J Neurol. 1997 Apr;244(4):239-45.

Subcortical type cognitive impairment in herpes zoster encephalitis.

Hokkanen L, Launes J, Poutiainen E, Valanne L, Salonen O, Siren J, Iivanainen M.

Department of Neurology, University of Helsinki, Finland.

Nine immunocompetent patients with acute herpes zoster encephalitis (HZE) were
studied with the help of neurological investigations. All patients were treated
with acyclovir. Neuropsychological performance was compared with that of a group 
of 16 healthy controls. Computed tomography of the head showed infarct-like
hypodense lesions in two patients, involving the internal capsule in one case and
the temporoparietal cortex and white matter in another. Hypoperfusion shown by
single photon emission computed tomography, mostly involving the frontal areas
bilaterally, was seen in six of the seven patients examined. Hyperperfusion as
seen in herpes simplex encephalitis was not encountered. One patient remained
mildly demented, but all the other patients recovered relatively well.
Neuropsychological examination after acyclovir treatment showed a decline in
memory and speed of cognitive processes, without circumscribed neuropsychological
deficits. Six of the nine patients showed behavioural disinhibition, and mood
changes were also observed. Memory impairment in HZE was not as global or as
severe as is described after encephalitis due to herpes simplex virus. In HZE
both the brain perfusion pattern and the neuropsychological test profile showed
features compatible with subcortical dysfunction.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9112592 [PubMed - indexed for MEDLINE]

3982: Nippon Rinsho. 1997 Apr;55(4):949-53.

[Virus-related neurological disorders complicating in compromised hosts]

[Article in Japanese]

Kimura S.

Dept. of Infection Control and Prevention, Faculty of Med., Univ. of Tokyo.

Chance of opportunistic infections in hospitals is increasing year by year,
because of the steady increase in the number of compromised hosts. Opportunistic 
infections in the nervous system include fungal, protozoal, bacterial and viral
infections. Cytomegalovirus and herpes virus (HSV1 and HSV2) cause encephalitis, 
myelitis and radiculoneuritis. Varicella-zoster virus (VZV) often causes herpes
zoster, which sometimes disseminates when immunodeficiency is severe. VZV also
causes encephalitis. Progressive multifocal leukoencephalopathy (PML) is caused
by JC virus in severely compromised hosts. HIV encephalopathy or AIDS dementia
complex is one of late stage complications of HIV infection. Prevalence of PML
and HIV encephalopathy among AIDS patients tend to increase as other
opportunistic infections became controllable recently. Primary CNS lymphoma in
immunocompromised hosts is supposed to be caused by EB virus and/or Kaposi's
sarcoma-associated herpes virus (KSHV, HHV8). In this sense, CNS lymphoma and
Kaposi's sarcoma can be defined as virus infection-related condition.

Publication Types: 
    English Abstract
    Review

PMID: 9103900 [PubMed - indexed for MEDLINE]

3983: Nippon Rinsho. 1997 Apr;55(4):855-60.

[Herpes viruses--herpes simplex virus, varicella-zoster virus, EB virus,
cytomegalovirus]

[Article in Japanese]

Fujiki N, Tashiro K.

Department of Neurology, Obihiro Kosei Hospital.

Herpes simplex encephalitis is the commonest viral encephalitis among
individuals, and the mortality has been markedly decreased by the use of
vidarabine and acyclovir. Early diagnoses and immediate treatment are essential
for favorable prognoses. Neuro-imagings, such as MRI and SPECT, and PCR technique
for detection of HSV-DNA in CSF, are useful for early diagnoses, without
requiring brain biopsy. Varicella and herpes zoster viruses are complicated, only
rarely, with neurological manifestations, such as meningoencephalitis, myelitis, 
or peripheral neuropathy. Acyclovir is mostly effective in these cases.
Neurological complications of Epstein-Barr virus infections are variable,
including meningitis, cerebellar ataxia, cranial neuropathy, and Guillain-Barre
syndrome. Their prognoses are generally good. Cytomegalovirus encephalitis is one
of the common complications in AIDS patients. Its clinical diagnosis is difficult
and the prognosis is considered to be poor.

Publication Types: 
    English Abstract
    Review

PMID: 9103883 [PubMed - indexed for MEDLINE]

3984: Nippon Rinsho. 1997 Apr;55(4):833-8.

[Genetic diagnosis of viral diseases in nervous system]

[Article in Japanese]

Nakamura S, Nakayama T.

Third Department of Internal Medicine, Hiroshima University School of Medicine.

The rapid diagnosis of viral infection in nervous system is necessary for the
effective treatment, since they progress so rapidly. The identification of
infected virus can be achieved by amplifying DNA or RNA in virus, using
polymerase chain reaction (PCR). Herpes simplex encephalitis is the most common
and fruitful target for genetic diagnosis. Genetic diagnosis can also detect the 
presence of cytomegalovirus, EB virus, human herpes 6 virus, herpes zoster virus,
HTLV-1 (human T-lymphotrophic virus type 1), measles virus, mumps virus, Japanese
encephalitis virus, rubella virus, HIV (human immunodeficiency virus), and HCV
(hepatitis C virus). However, the presence of the virus does not always mean a
recent infection by the virus, nor a cause of the disease.

Publication Types: 
    English Abstract
    Review

PMID: 9103880 [PubMed - indexed for MEDLINE]

3985: Nippon Rinsho. 1997 Apr;55(4):777-82.

[Neurotropic viruses--classification, structure and characteristics]

[Article in Japanese]

Hotta H.

Department of Microbiology, Kobe University School of Medicine.

Classification, structure and characteristics of neurotropic viruses are briefly 
summarized. Neurotropic viruses causing acute infection include Japanese,
Venezuelan equine, and California encephalitis viruses, polio, coxsackie, echo,
mumps, measles, influenza, and rabies viruses as well as members of the family
Herpesviridae such as herpes simplex, varicella-zoster, cytomegalo and
Epstein-Barr viruses. Those causing latent infection include herpes simplex and
varicella-zoster viruses. Those causing slow virus infection include measles,
rubella and JC viruses, and retroviruses such as human T-lymphotropic virus 1 and
human immunodeficiency virus. Prion, which is not a virus but a host-derived
non-physiological protein, causes transmissible spongiform encephalopathy such as
kuru and Creutzfeldt-Jakob disease that resemble slow virus infection.

Publication Types: 
    English Abstract
    Review

PMID: 9103870 [PubMed - indexed for MEDLINE]

3986: Am J Epidemiol. 1997 Apr 1;145(7):594-7.

Does prior infection with varicella-zoster virus influence risk of adult glioma?

Wrensch M, Weinberg A, Wiencke J, Masters H, Miike R, Barger G, Lee M.

Department of Epidemiology and Biostatistics, School of Medicine, University of
California, San Francisco 94143-0560, USA.

To evaluate a possible association between varicella-zoster virus infection and
glioma, the authors asked adults with glioma (n = 462) whose tumors were
diagnosed between August 1, 1991, and March 31, 1994, and age-, sex-, and
ethnicity-matched controls (n = 443) about their histories of chickenpox or
shingles. Cases were significantly less likely than controls to report a history 
of either chickenpox (odds ratio = 0.4, 95% confidence interval (CI) 0.3-0.6) or 
shingles (odds ratio = 0.5, 95% CI 0.3-0.8). To obtain serologic support for
these findings, the authors conducted double-blind enzyme-linked immunosorbent
assays for immunoglobulin G antibodies to varicella-zoster virus among 167
self-reporting subjects for whom blood samples were available. Cases and controls
reporting no history of chickenpox were equally likely to test positive (73% vs. 
75%), but among those reporting a positive history, cases were less likely than
were controls to test positive (71% vs. 85%). Despite the misclassification, an
odds ratio of 0.6 was obtained using either serologic data (95% CI 0.3-1.3) or
reported history of chickenpox (95% CI 0.3-1.1) in this subgroup of subjects.
This suggests that adults with glioma were less likely than controls either to
have had prior varicella-zoster virus infection or to have an immunoglobulin G
antibody response adequate to indicate positivity. Since either explanation
suggests novel mechanisms for brain tumor pathogenesis, these findings require
corroboration and elaboration.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 9098175 [PubMed - indexed for MEDLINE]

3987: Am J Epidemiol. 1997 Apr 1;145(7):581-93.

Familial and personal medical history of cancer and nervous system conditions
among adults with glioma and controls.

Wrensch M, Lee M, Miike R, Newman B, Barger G, Davis R, Wiencke J, Neuhaus J.

Department of Epidemiology and Biostatistics, School of Medcine, University of
California, San Francisco 94143-0560, USA.

The causes of glioma, the most common type of primary malignant brain tumor, are 
poorly understood. This study compared the personal and first-degree familial
medical histories of 462 adults newly diagnosed with glioma in the San Francisco 
Bay Area between August 1, 1991, and March 31, 1994, with those of 443 controls
who were frequency-matched on age, sex, and ethnicity. Cases and controls had
equivalent personal histories of cancers other than brain cancer and most nervous
system conditions, but they differed significantly regarding histories of
epilepsy, seizures, or convulsions 3 or more years prior to diagnosis (odds ratio
= 3.3, 95% confidence interval (CI) 1.4-7.9), chickenpox (odds ratio = 0.4, 95%
CI 0.3-0.6), and shingles (odds ratio = 0.5, 95% CI 0.3-0.8). Four cases (less
than 1%) and no controls had known genetic disorders (three had neurofibromatosis
and one had tuberous sclerosis). Cases and controls had similar family histories 
of cancer and seizures. However, the odds ratio for a validated family history of
primary brain tumor was 2.3 (95% CI 1.0-5.8). These results suggest that although
family history of any cancer probably is not an important risk factor for adult
glioma, a family history of brain tumors may play a role. Variation in exposure
to or biologic response to common viral infections might play a greater role in
the etiology of adult glioma than family history.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 9098174 [PubMed - indexed for MEDLINE]

3988: Proc Natl Acad Sci U S A. 1997 Apr 1;94(7):2874-9.

Crystal structure of varicella-zoster virus protease.

Qiu X, Janson CA, Culp JS, Richardson SB, Debouck C, Smith WW, Abdel-Meguid SS.

Department of Macromolecular Sciences, SmithKline Beecham Pharmaceuticals, King
of Prussia, PA 19406, USA.

Varicella-zoster virus (VZV), an alpha-herpes virus, is the causative agent of
chickenpox, shingles, and postherpetic neuralgia. The three-dimensional crystal
structure of the serine protease from VZV has been determined at 3.0-A
resolution. The VZV protease is essential for the life cycle of the virus and is 
a potential target for therapeutic intervention. The structure reveals an overall
fold that is similar to that recently reported for the serine protease from
cytomegalovirus (CMV), a herpes virus of the beta subfamily. The VZV protease
structure provides further evidence to support the finding that herpes virus
proteases have a fold and active site distinct from other serine proteases. The
VZV protease catalytic triad consists of a serine and two histidines. The distal 
histidine is proposed to properly orient the proximal histidine. The
identification of an alpha-helical segment in the VZV protease that was mostly
disordered in the CMV protease provides a better definition of the postulated
active site cavity and reveals an elastase-like S' region. Structural differences
between the VZV and CMV proteases also suggest potential differences in their
oligomerization states.

PMID: 9096314 [PubMed - indexed for MEDLINE]

3989: Pediatrics. 1997 Apr;99(4):608-10.

Perianal herpes zoster presenting as suspected child abuse.

Christian CW, Singer ML, Crawford JE, Durbin D.

University of Pennsylvania School of Medicine, Division of General Pediatrics,
Children's Hospital of Philadelphia 19104, USA.

Publication Types: 
    Case Reports

PMID: 9093310 [PubMed - indexed for MEDLINE]

3990: Presse Med. 1997 Mar 8;26(7):344-7.

[Prevention of opportunistic infections in HIV seropositive patients. Prevention 
of viral infections and mycoses]

[Article in French]

Casassus P, Padrazzi B, Lhote F, Jarrousse B.

Service de Medecine interne, Hopital Avicenne, Bobigny.

CYTOMEGALOVIRUS INFECTION: Primary prophylaxis is logical in high-risk subjects
(CD4 < 50) who are asymptomatic; per os ganciclovir is under evaluation.
Systematic secondary prophylaxis relies on intravenous ganciclovir or foscarnet. 
HERPES SIMPLEX AND ZOSTER: Secondary prevention with acyclovir is not recommended
due to the risk of resistance. Herpes zoster retinitis is an absolute indication 
for continuous oral treatment with acyclovir. CRYPTOCOCCUS: Oral fluconazol is
required for secondary prophylaxis. CANDIDIASIS: Due to the risk of resistant
strains, neither primary nor secondary prophylasis is recommended.
HISTIOPLASMOSIS: Risk of recurrence justifies secondary prophylaxis with
itraconazole or fluconazole. COCCIDIODOMYCOSIS: Secondary prophylaxis with
amphotericin B or fluconazole is mandatory. ASPERGILLOSIS: Itraconazole is the
best agent when prophylaxis is needed.

Publication Types: 
    English Abstract
    Review

PMID: 9122149 [PubMed - indexed for MEDLINE]

3991: J Commun Dis. 1997 Mar;29(1):57-61.

Optic neuroretinitis, a rare manifestation of herpes zoster ophthalmicus: a case 
report.

Dhar MY, Goel JL, Sota LD.

Guru Nanak Eye Centre, New Delhi.

Publication Types: 
    Case Reports

PMID: 9282530 [PubMed - indexed for MEDLINE]

3992: Br J Biomed Sci. 1997 Mar;54(1):72-3.

Diagnosing varicella zoster virus infection.

Bryden AS.

Publication Types: 
    Letter

PMID: 9167311 [PubMed - indexed for MEDLINE]

3993: Ceylon Med J. 1997 Mar;42(1):36-7.

Acute colonic pseudo-obstruction associated with varicella zoster infection and
acyclovir therapy.

Herath P, Gunawardana SA.

Sri Jayawardenepura General Hospital, Nugegoda, Sri Lanka.

Publication Types: 
    Case Reports

PMID: 9164030 [PubMed - indexed for MEDLINE]

3994: Pediatr Dermatol. 1997 Mar-Apr;14(2):131-43.

Diagnosis and treatment of pustular disorders in the neonate.

Van Praag MC, Van Rooij RW, Folkers E, Spritzer R, Menke HE, Oranje AP.

Department of Dermatology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.

The diagnosis of a pustular dermatosis occurring during the first months of life 
is usually based on clinical findings. However, some cases may require simple
investigations including microscopic examination of pustular content, cultures,
and skin biopsies. The main benign transient neonatal types of pustulosis include
erythema toxicum neonatorum, infantile acropustulosis, transient neonatal
pustular melanosis, and neonatal acne. The most common causes of infectious
pustular skin lesions include bacterial infections, which may be initially
localized (Staphylococcus aureus) or septicemic (with Listeria monocytogenes as
the leading causitive agent); viral infections (herpes simplex, varicella-zoster,
and cytomegalovirus infections); fungal infections (candidiasis); or parasitic
disorders (scabies). The main objective of this article is to propose a
systematic approach to pustular eruptions in the neonate. The need for
investigating every neonate with pustules for an infectious disease is
emphasized. The Tzanck smear, the Gram's stain, and a potassium hydroxide
preparation are the most important quick diagnostic tests. The Tzanck smear is a 
very easy, rapid, and sensitive test for detection of a herpetic infection
(multinucleated giant cells) as well as noninfectious pustular eruptions
(eosinophils, neutrophils). Therefore the Tzanck smear should be the first test
performed. Moreover, a Gram's stain and potassium hydroxide preparation should be
performed in cases of neonatal pustular disorders to detect bacterial and fungal 
infections. The goal of this diagnostic approach is to spare a healthy neonate
with a benign transient condition an invasive evaluation for sepsis, potentially 
harmful antibiotic therapy, and prolonged hospitalization, with its own inherent 
morbidity.

Publication Types: 
    Review

PMID: 9144701 [PubMed - indexed for MEDLINE]

3995: West J Med. 1997 Mar;166(3):211-5.

Management of herpes simplex and varicella-zoster virus infections.

Erlich KS.

Department of Medicine, University of California, San Francisco, School of
Medicine, USA.

Herpes simplex virus and varicella-zoster virus are common infections and are
seen frequently in clinical practice. Infection with these viruses results in
cutaneous lesions that may be diagnosed clinically, but widely available
laboratory testing is useful for confirmation. Asymptomatic herpes simplex virus 
shedding, or "subclinical reactivation," likely occurs in all persons infected
with herpes simplex virus and results in the transmission of virus despite the
absence of signs or symptoms that suggest active infection. Oral and intravenous 
acyclovir are effective in treating initial and recurrent herpes simplex and
varicella-zoster virus infections. The daily administration of oral acyclovir as 
suppressive therapy is effective in patients with frequently recurring genital
infection with herpes simplex virus by reducing the number of symptomatic
recurrences and the frequency of asymptomatic virus shedding. Two new antiviral
agents, famciclovir and valacyclovir hydrochloride, have been approved for the
short-term treatment of recurrent genital herpes simplex virus and recurrent
zoster in nonimmunocompromised hosts. Famciclovir and valacyclovir demonstrate
superior pharmacokinetics compared with acyclovir and allow for less frequent
daily dosing with higher achievable serum drug concentrations. The attenuated
live varicella virus vaccine is now available in the United States and prevents
primary varicella-zoster virus infection in susceptible children and adults.

Publication Types: 
    Review

PMID: 9143202 [PubMed - indexed for MEDLINE]

3996: J Med Virol. 1997 Mar;51(3):214-6.

Detection of latent varicella-zoster virus infection in human vestibular and
spiral ganglia.

Furuta Y, Takasu T, Suzuki S, Fukuda S, Inuyama Y, Nagashima K.

Department of Otolaryngology, Hokkaido University School of Medicine, Sapporo,
Japan.

Varicella-zoster virus (VZV) becomes latent in the sensory ganglia after primary 
infection and VZV DNA has been found in human trigeminal, thoracic, and
geniculate ganglia. In this study, human vestibular and spiral ganglia, which do 
not received innervation from the skin, were examined for VZV DNA using the
polymerase chain reaction. VZV DNA was detected in 2 of 10 (20%) vestibular
ganglia and in 2 of 10 (20%) spiral ganglia from five adults. VZV DNA was
undetectable in either type of ganglion from a newborn and from two of the five
adults. These two adults were VZV seronegative. The results indicate that VZV
becomes latent in several types of sensory ganglion after primary infection and
suggest the possibility that reactivation of the virus from the vestibular and
spiral ganglia may cause disorders in the labyrinth.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9139086 [PubMed - indexed for MEDLINE]

3997: Br J Ophthalmol. 1997 Mar;81(3):189-94.

Management of varicella zoster virus retinitis in AIDS.

Moorthy RS, Weinberg DV, Teich SA, Berger BB, Minturn JT, Kumar S, Rao NA, Fowell
SM, Loose IA, Jampol LM.

Department of Ophthalomology, Northwestern University Medical School, Chicago, IL
60611, USA.

AIMS/BACKGROUND: Varicella zoster virus retinitis (VZVR) in patients with AIDS,
also called progressive outer retinal necrosis (PORN), is a necrotising viral
retinitis which has resulted in blindness in most patients. The purposes of this 
study were to investigate the clinical course and visual outcome, and to
determine if the choice of a systemic antiviral therapy affected the final visual
outcome in patients with VZVR and AIDS. METHODS: A review of the clinical records
of 20 patients with VZVR from six centres was performed. Analysis of the clinical
characteristics at presentation was performed. Kruskall-Wallis non-parametric one
way analysis of variance (KWAOV) of the final visual acuities of patients treated
with acyclovir, ganciclovir, foscarnet, or a combination of foscarnet and
ganciclovir was carried out. RESULTS: Median follow up was 6 months (range 1.3-26
months). On presentation, 14 of 20 patients (70%) had bilateral disease, and 75% 
(15 of 20 patients) had previous or concurrent extraocular manifestations of VZV 
infection. Median initial and final visual acuities were 20/40 and hand
movements, respectively. Of 39 eyes involved, 19 eyes (49%) were no light
perception at last follow up; 27 eyes (69%) developed rhegmatogenous retinal
detachments. Patients treated with combination ganciclovir and foscarnet therapy 
or ganciclovir alone had significantly better final visual acuity than those
treated with either acyclovir or foscarnet (KWAOV: p = 0.0051). CONCLUSIONS: This
study represents the second largest series, the longest follow up, and the first 
analysis of visual outcomes based on medical therapy for AIDS patients with VZVR.
Aggressive medical treatment with appropriate systemic antivirals may improve
long term visual outcome in patients with VZVR. Acyclovir appears to be
relatively ineffective in treating this disease.

Publication Types: 
    Case Reports
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 9135381 [PubMed - indexed for MEDLINE]

3998: J Clin Epidemiol. 1997 Mar;50(3):337-9.

Common infectious diseases in a population with low multiple sclerosis and
varicella occurrence.

Ross RT, Cheang M.

Section of Neurology, University of Manitoba, Winnipeg, Canada.

A previous study revealed the rarity of varicella zoster virus (VZV) diseases
among 5601 Hutterite Brethren living in a high-risk area for these diseases. The 
current study was established to determine the frequency of other common
infectious diseases. The information was gathered from a population-based study
of a unique group of Manitoba citizens and compared with an equal number of their
age and sex-matched neighbors. The data were contained in the records of the
Manitoba Health Services Commission (MHSC). The MHSC, the sole paying agency for 
medical diseases in Manitoba, contained 94,383,972 records for all of Manitoba
for the years 1985 to 1991 inclusive. From these, the records of a cohort of 5601
Hutterites and an equal number of non-Hutterite age- and sex-matched controls
were examined for the frequency of 14 diseases of interest. To be eligible a
Hutterite subject must have one of the 22 unique family names and live on a
Colony with the precise address. A control must be age (within 10 years) and
sex-matched, live in the same or a contiguous postal code, and use the same
medical practitioners. There were no interventions or identification of any
member of the study. Mumps, acute coryza, and rubella are of the same frequency
among the two groups. Only herpes simplex and cellulitis are more common among
the Hutterites. All of the other nine common infectious diseases are
significantly more common among the controls. The VZV diseases are not
exclusively less common among the Hutterite Brethren. Nine other common
infectious diseases are also less common but the degree of significant difference
does not reach the level of the VZV diseases. The reduction in numbers of these
diseases among the Hutterites is not related to the vaccination habits of the
group and is not due to physical isolation. The Hutterites appear to have a more 
effective immune system relative to their neighbors.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9120534 [PubMed - indexed for MEDLINE]

3999: Br J Dermatol. 1997 Mar;136(3):466-7.

Comment on:
    Br J Dermatol. 1996 Mar;134(3):504-9.    Br J Dermatol. 1996 Mar;134(3):606.

Isotopic response.

Wolf R, Ruocco V, Filioli FG.

Publication Types: 
    Comment
    Letter

PMID: 9115937 [PubMed - indexed for MEDLINE]

4000: Br J Dermatol. 1997 Mar;136(3):465.

Comment on:
    Br J Dermatol. 1996 Mar;134(3):504-9.

Leukaemia cutis at the site of prior herpes zoster.

Bahadoran P, Lacour JP, Ortonne JP.

Publication Types: 
    Comment
    Letter

PMID: 9115935 [PubMed - indexed for MEDLINE]

4001: J Dermatol. 1997 Mar;24(3):205-7.

Mo2+ HLA-DR- monocytosis in varicella zoster virus infection.

Horiuchi Y.

Division of Dermatology, Higashi-Matsuyama Medical Association Hospital, Saitama,
Japan.

Two-color analysis using Mo2+ (CD14) monocytes and HLA-DR class II monoclonal
antibodies confirmed monocytosis in varicella zoster virus (VZV) infection in
eight cases of herpes zoster and two cases of varicella. Only three cases, one
being varicella, showed extensive Mo2+ HLA-DR- monocytosis of more than 12%.
Accordingly, monocytosis in VZV infection may not be specific to the VZV antigen.

PMID: 9114622 [PubMed - indexed for MEDLINE]

4002: Acta Anaesthesiol Scand. 1997 Mar;41(3):422-6.

Comment in:
    Acta Anaesthesiol Scand. 1997 Mar;41(3):329-31.

Four years' treatment with ketamine and a trial of dextromethorphan in a patient 
with severe post-herpetic neuralgia.

Klepstad P, Borchgrevink PC.

Department of Anesthesiology, Regional Hospital, University of Trondheim, Norway.

N-methyl-D-aspartate (NMDA) receptors are involved in the development of
neuropathic pain. Ketamine, a non-competitive NMDA receptor antagonist, has in
several case reports given pain relief but efficacy in dosages tolerated in
long-term ketamine treatment is unknown. Another substance with an antagonist
action at NMDA receptors and which is approved for peroral administration is
dextromethorphan. In a randomized study dextromethorphan was no better than
placebo for neuropathic pain but this does not exclude efficacy in selected
patients. We report a patient with severe post-herpetic pain resistant to
conventional pain treatment which was treated with ketamine for 4 years with good
pain relief. The practical application of long-term treatment in different
administration forms of ketamine is described. The patient also responded with
pain relief in a double-blind trial with oral dextromethorphan.

Publication Types: 
    Case Reports

PMID: 9113190 [PubMed - indexed for MEDLINE]

4003: Clin Neuropathol. 1997 Mar-Apr;16(2):61-4.

Herpes zoster brachial plexus neuritis.

Fabian VA, Wood B, Crowley P, Kakulas BA.

Department of Neuropathology, Royal Perth Hospital, Western Australia.

This is the first report of brachial plexus inflammation associated with clinical
herpes zoster paresis. A 78-year-old female with a 3-week history of herpes
zoster of the C4, C5, and C6 dermatomes developed left upper arm monoplegia. She 
died from an acute myocardial infarction. Post-mortem provided a rare opportunity
to study the neuropathology of herpes zoster motor involvement. Histology of the 
brachial plexus showed extensive lymphocytic infiltration, myelin breakdown, and 
preservation of axons without vasculitis. The cervical spinal cord showed
perivascular lymphocytic cuffing and no anterior horn necrosis. We suggest, the
brachial plexus inflammation was a distal extension of a dorsal ganglionitis.
Brachial plexus neuritis may be a direct cause of reversible upper limb paresis
in herpes zoster. We demonstrate the motor neuropathy is an inflammatory
demyelinative process consistent with the recovery observed in a number of
patients. We postulate post-herpetic neuralgia may be related to an ongoing
inflammatory process.

Publication Types: 
    Case Reports

PMID: 9101105 [PubMed - indexed for MEDLINE]

4004: Nippon Ganka Gakkai Zasshi. 1997 Mar;101(3):243-7.

[A study of 44 patients with Kirisawa type uveitis]

[Article in Japanese]

Ichikawa T, Sakai J, Yamauchi Y, Minoda H, Usui M.

Department of Ophthalmology, Tokyo Medical College, Japan.

We studied 50 eyes of 44 patients with acute retinal necrosis, Kirisawa type
uveitis (KU), in order to examine clinical symptoms, pathogenic viruses, clinical
grading, therapy and prognosis for this disease. Varicella-zoster virus (VZV) was
the pathogenic organism in 37 eyes of 31 patients, while herpes simplex virus
(HSV) was responsible in 13 eyes of 13 patients. There were more elderly patients
in the VZV-KU group than in the HSV-KU group. In addition, mutton fat keratic
precipitates and retinal exudates were more common in VZV-KU than in HSV-KU. We
divided KU eyes into 3 clinical grades: severe, serious, and mild. Using
statistical analysis, we found that the VZV-KU group had a significantly greater 
number of severe and serious cases than the HSV-KU group. Furthermore, some HLA
antigens were found to be statistically more common in the VZV-KU group, although
no associations were found in the HSV-KU group. 32% of VZV-KU and 67% of HSV-KU
eyes had a final visual acuity (fVA) of greater than 0.5. When eyes with an fVA
of greater than 0.1 were compared to eyes with an fVA of less than 0.1, we found 
that combined therapy using acyclovir, interferon beta, and prednisolone was
especially effective for VZV-KU, although no significant difference was found for
HSV-KU. Thus, it is essential to determine the pathogenic virus causing KU, in
order to understand the disease pathogenesis as well as to select appropriate
treatment.

Publication Types: 
    English Abstract

PMID: 9086744 [PubMed - indexed for MEDLINE]

4005: Pharmacotherapy. 1997 Mar-Apr;17(2):333-41.

Comparison of valaciclovir and acyclovir for the treatment of herpes zoster in
immunocompetent patients over 50 years of age: a cost-consequence model.

Grant DM, Mauskopf JA, Bell L, Austin R.

GlaxoWellcome Research and Development, Greenford, United Kingdom.

A method was developed for modeling the costs and consequences of treating
varicella zoster viral infections to clinical data generated in a pivotal phase
III clinical trial of valaciclovir versus acyclovir for the treatment of acute
herpes zoster in immunocompetent patients over 50 years of age. Direct medical
costs and indirect costs (productivity losses) were modeled using unit costs
applicable in the United States. Compared with acyclovir, valaciclovir reduced
average direct medical costs per patient by 17% ($60.01) and indirect costs by an
average of 25% ($46.54). Median duration of pain was reduced by 13 days for
valaciclovir compared with acyclovir in the intent-to-treat population or by 19
days in patients with pain after rash healing. The cost variables described in
the model (drug costs, cost of treating long-term pain, physician visits,
hospitalization, treatment of severe ocular involvement, productivity losses)
were tested by sensitivity analysis. Total costs associated with valaciclovir
treatment remained lower than those with acyclovir over the range of the
analysis.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase III
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 9085325 [PubMed - indexed for MEDLINE]

4006: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Mar;83(3):354-7.

Cranial polyneuropathy--Ramsay Hunt's syndrome: case report and discussion.

Turner JE, Geunes PM, Schuman NJ.

Department of Biologic and Diagnostic Sciences, University of Tennessee College
of Dentistry, Memphis, USA.

Ramsay Hunt's syndrome is an infectious cranial polyneuropathy caused by
varicella zoster, the herpetic virus that also causes chickenpox and shingles.
Its symptoms include facial paralysis, ear pain, and an auricular rash. Oral
lesions are also present in most cases. This syndrome can affect any cranial
nerve and usually affects multiple nerves, causing central, cervical, and
peripheral effects. This article reports the case of a 35-year-old white female
who was treated by the oral surgery service of a large urban hospital, after
first reporting to the emergency clinic. Her reported symptoms of unilateral
left-side facial paralysis, auricular pain, and trigeminal hyperesthesia were
confirmed by clinical examination. An initial short low-dose steroid regimen was 
unsuccessful. A second daily dosage of 50 mg of prednisone was successful in 21
days. No permanent sequelae were evident or reported after treatment.

Publication Types: 
    Case Reports

PMID: 9084199 [PubMed - indexed for MEDLINE]

4007: J Am Pharm Assoc (Wash). 1997 Mar-Apr;NS37(2):157-63.

Pharmacology of new antiherpes agents: famciclovir and valacyclovir.

Stein GE.

Department of Medicine, Michigan State University, Lansing, USA.

Limitations of acyclovir in treating infections caused by herpes simplex virus
include the development of resistant isolates and relatively poor oral
bioavailability. Penciclovir and famciclovir may have added clinical utility in
the treatment of herpes virus infections in humans. Intracellular
pharmacokinetics differ for valacyclovir and famciclovir, but the importance of
these differences is unknown. Animal studies suggest that famciclovir (but not
valacyclovir) can affect subsequent latent infection with HSV-1; the relevance of
these findings to humans requires further investigation. Famciclovir and
valacyclovir appear to decrease time to resolution of pain compared with
acyclovir in patients with herpes zoster infections.

Publication Types: 
    Review

PMID: 9069689 [PubMed - indexed for MEDLINE]

4008: J Rheumatol. 1997 Mar;24(3):589-91.

Comment in:
    J Rheumatol. 1997 Dec;24(12):2487-8.

Herpes zoster encephalomyelitis associated with low dose methotrexate for
rheumatoid arthritis.

Lyon CC, Thompson D.

Wharfedale General Hospital, Otley, UK.

We describe herpes zoster encephalomyelitis occurring 9 days after the onset of
cutaneous zoster in an elderly patient taking low dose weekly methotrexate
without concomitant prednisolone.

Publication Types: 
    Case Reports

PMID: 9058671 [PubMed - indexed for MEDLINE]

4009: Ugeskr Laeger. 1997 Feb 17;159(8):1081-5.

[Varicella zoster virus vaccine--a review]

[Article in Danish]

Petersen CS, Buhl MR, Heilmann CJ.

Dermato-venerologisk afdeling, H:S Bispebjerg Hospital, Kobenhaven.

The available published data on the efficacy and safety of a live attenuated
varicella vaccine is presented. The data indicate that immunosuppressed leukemic 
children at high risk for severe varicella can be vaccinated resulting in
complete or partial immunity in most children. Vaccination of immunosuppressed
children is often associated with fever and rash. There seems to be a decreased
risk of herpes zoster in vaccinated leukemic children when compared with a group 
of naturally infected leukemic children. In order to diminish the risk of
varicella zoster virus (VZV) transmission to these high-risk persons family
members of these, if susceptible to varicella infection, should be immunized.
Although vaccination of healthy children is highly effective and associated with 
a low frequency of adverse events, vaccination in this group may be questioned
due to the benign course of varicella. Due to the more severe VZV-infection seen 
among non-immune healthy adults, it seems reasonable to offer vaccination to this
group. It will, however, require extensive serological testing to identify
seronegative individuals. From a theoretical point of view a booster-vaccination 
to the elderly population, resulting in detectable cell-mediated immunity to VZV,
should reduce the risk of herpes zoster. Large placebo-controlled studies are
needed to confirm if such an immunization can prevent herpes zoster in this age
group.

Publication Types: 
    English Abstract
    Review

PMID: 9072851 [PubMed - indexed for MEDLINE]

4010: Pharmacoeconomics. 1997 Mar;11(3):262-73.

Economic evaluation of antiviral therapy for the treatment of herpes zoster in
immunocompetent adults.

Gruger J, Backhouse ME.

SmithKline Beecham Pharmaceuticals, Munich, Germany. Jens.GRUEGER@sb.com

Shingles (herpes zoster) affects 20% of the population at some stage during their
lives. The economic consequences can be significant. For example, in the UK, the 
costs of post-herpetic neuralgia, a complication that affects between 10 and 14% 
of patients with shingles, have been estimated between 4.8 million and 17.9
million pounds sterling (Pounds). This study is the first formal assessment of
the cost-effectiveness of the 2 most commonly used oral antiviral treatments that
have proven efficacy in patients with shingles: famciclovir and aciclovir
(acyclovir). It shows that the clinical advantages of famciclovir over aciclovir 
are accompanied by potential economic advantages in the form of savings in direct
costs to the UK National Health Service of between 2.04 pounds and 16.85 pounds
per patient treated. Future economic research to validate the benefits of
antiviral treatment should focus on prospective assessments alongside controlled 
trials incorporating resource use analysis, quality-of-life appraisal,
assessments of pain severity, and long term follow-up with continuation
protocols.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial

PMID: 10165315 [PubMed - indexed for MEDLINE]

4011: Expert Opin Investig Drugs. 1997 Feb;6(2):173-89.

Valaciclovir: development, clinical utility and potential.

Patel R.

Department of Genitourinary Medicine, Royal South Hants Hospital,
Southampton,Hampshire, SO9 4PE, UK.

Valaciclovir (Valtrex, Zelitrex), the L-valine ester of aciclovir, increases
aciclovir bioavailability by 3- to 5-fold over that achievable with oral
aciclovir. It addresses many unmet needs of currently available anti-herpesvirus 
therapies. Valaciclovir extends the efficacy of aciclovir in the treatment of
herpes zoster and genital HSV infections, using less frequent dose regimens but
retaining the highly acceptable safety profile established for aciclovir. The
potential for valaciclovir in CMV prophylaxis has now been proven, and further
refining to identify the optimal dose regimen is ongoing. After oral
administration, valaciclovir is rapidly absorbed and extensively converted to
aciclovir and L-valine, the essential amino acid. The mode of action and spectrum
of antiviral activity of valaciclovir are thus identical to aciclovir. The
bioavailability of aciclovir after valaciclovir, characterised from studies in
healthy adult volunteers, is similar in a wide range of patient populations,
including the elderly, those with advanced HIV disease, patients with impaired
liver or renal function, or undergoing bone marrow transplantation. No clinically
significant drug interactions with valaciclovir have so far been identified.
Dosage reductions in clinical use of valaciclovir are only necessary when renal
function is severely impaired. In controlled clinical trials in herpes zoster,
valaciclovir (1000 mg three times daily) is superior to aciclovir in speeding the
resolution of zoster-associated pain and post-herpetic neuralgia. It is as
effective as aciclovir in hastening rash healing. In patients with ophthalmic
zoster, no differences were evident between valaciclovir and aciclovir treatment 
on zoster-associated pain or the occurrence of ocular complications. The safety
profiles of valaciclovir, aciclovir and placebo were not different in this study 
programme. In a series of controlled, randomised trials of valaciclovir,
aciclovir and placebo for the acute treatment of genital HSV infections in
approximately 3000 patients, twice daily valaciclovir was proven as effective as 
the standard 5 times daily aciclovir regimen in resolving the clinical signs and 
symptoms of lesional disease. Early patient-initiated valaciclovir therapy (500
mg twice daily) of recurrent genital herpes episodes was shown significantly to
increase the chance of prevention of vesicular or ulcerative lesions, a valuable 
clinical advantage not prospectively proven for aciclovir. When used for periods 
of up to one year, valaciclovir (500 mg once daily) effectively suppresses
genital herpes recurrences. Long-term studies of valaciclovir for HSV
suppression, evaluating doses of up to 1000 mg daily in approximately 3000
patients, about 25% of whom were HIV seropositive (CD+ > 100 cells/microl),
revealed a highly acceptable clinical tolerability profile for valaciclovir that 
did not differ from aciclovir or placebo. There were no cases resembling
thrombotic microangiopathy in these long-term studies. The aciclovir safety
heritage and pharmacokinetic rationale for the development of valaciclovir have
been realised through the clinical research programmes in the zoster and HSV
indications. Further studies in these and related areas, including CMV
prophylaxis, are in progress and aim to expand further the clinical potential of 
valaciclovir in the future.

PMID: 15989601 [PubMed]

4012: Clin Cancer Res. 1997 Feb;3(2):193-7.

High-dose chemotherapy and autologous stem cell support followed by
posttransplantation doxorubicin as initial therapy for metastatic breast cancer.

deMagalhaes-Silverman M, Bloom E, Lembersky B, Lister J, Pincus S, Rybka W,
Voloshin M, Wilson J, Ball E.

Division of Hematology/Bone Marrow Transplantation, Pittsburgh Cancer Institute, 
University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
silverman@edison.isd.upmc.edu

High-dose chemotherapy is associated with a high complete response rate and
possibly some survival advantage in patients with metastatic breast cancer. We
designed a clinical trial consisting of a two-step high-dose chemotherapy regimen
followed by posttransplantation doxorubicin as the first chemotherapy treatment
for metastatic disease. Twenty-one patients with metastatic breast cancer and no 
previous chemotherapy for metastatic disease were treated with high-dose
cyclophosphamide (Cy; 5000 mg/m2), followed by granulocyte colony-stimulating
factor. Peripheral blood stem cells were collected. Subsequently, patients
received Cy (6000 mg/m2), thiotepa (500 mg/m2), and carboplatin (800 mg/m2)
(CTCb) with hematopoietic rescue. Upon recovery of hematopoietic and
gastrointestinal toxicity, three cycles of doxorubicin (Dox; 60 mg/m2) were
delivered. After Cy, nine patients (45%) developed neutropenic fevers. There were
no episodes of bacteremia. Patients received CTCb 37 days after starting Cy and
had a hospital stay of 19 days. After CTCb, the median number of days to an
absolute neutrophil count >5 x 10(9)/liter was 8, and the median number of days
to a platelet count >20 x 10(9)/liter was 9. Neutropenic fevers occurred in 12
patients. There were no hemorrhagic complications. Fifty-five of the 63 planned
courses of Dox were delivered. The median time from peripheral blood stem cell
infusion to the first Dox cycle was 38 days. The median time to the second Dox
cycle was 28 days, and to the last cycle was 30 days. Three episodes of
neutropenic fevers were observed. Two patients developed herpes zoster. This
regimen is feasible, with acceptable toxicity.

Publication Types: 
    Clinical Trial

PMID: 9815672 [PubMed - indexed for MEDLINE]

4013: Klin Monatsbl Augenheilkd. 1997 Feb;210(2):121-3.

[Corneal lipofuscinosis--clinicopathologic study of 10 patients]

[Article in German]

Braun M, Holbach L, Naumann GO.

Augenklinik mit Poliklinik, Universitat Erlangen-Nurnberg.

BACKGROUND: Lipofuscin pigments are considered indigestible residues of lysosomal
activity associated with aging. We present the clinical and histopathological
features of ten patients with corneal lipofuscinosis. PATIENTS AND METHODS: Ten
patients (five female, five male, mean age 62 years, range 53 to 77 years)
underwent penetrating keratoplasty for vascularized corneal scars. The clinical
diagnoses were herpes simplex keratitis (5), zoster keratitis (1), phlyctenular
keratitis (1), immunologic graft rejection (2) and corneal injury (1). The mean
duration of disease was 6.5 years (range 3 to 11 years). On slit lamp examination
both linear and diffuse deposits of yellow pigment were noted in the corneal
stroma. All corneal buttons were processed for histopathologic and electron
microscopic studies. RESULTS: The areas of yellowish pigmentation in the corneal 
stroma corresponded histopathologically to clusters of macrophages, keratocytes
and occasional giant cells containing PAS-positive granules. The granules
measured 1 to 3 micrometers and were also present extracellularly. Results of
Gram stain were negative, but the material showed vivid autofluorescence.
CONCLUSION: Corneal lipofuscin can be detected at the slit lamp as focal or
diffuse yellowish deposits in both the superficial and deep corneal stroma of
patients with long-standing keratitis. This is in contrast to corneal iron
deposits, which appear as yellowish pigment in the corneal epithelium. The
identification of corneal lipofuscin is possible using histochemical and
autofluorescent studies. Further studies should address whether corneal
lipofuscin predisposes to suture loosening.

Publication Types: 
    English Abstract

PMID: 9229595 [PubMed - indexed for MEDLINE]

4014: Am J Ophthalmol. 1997 Feb;123(2):257-8.

Cytomegalovirus-associated acute retinal necrosis syndrome.

Silverstein BE, Conrad D, Margolis TP, Wong IG.

Francis I. Proctor Foundation, University of California at San Francisco Medical 
Center 94143-0944, USA.

PURPOSE: To describe a case of acute retinal necrosis syndrome in which a
polymerase chain reaction-based assay provided evidence for cytomegalovirus as
the causative agent of the syndrome. METHODS: Polymerase chain reaction-based
assays were used to analyze a vitreous aspirate from a 70-year-old man with acute
retinal necrosis syndrome. The specimen was tested for cytomegalovirus,
varicella-zoster virus, and herpes simplex virus type 1 and type 2. RESULTS: The 
polymerase chain reaction assay for cytomegalovirus was positive, and polymerase 
chain reaction assays for varicella-zoster virus and herpes simplex virus type 1 
and type 2 were negative. CONCLUSION: Cytomegalovirus may be a causative agent of
acute retinal necrosis syndrome.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9186135 [PubMed - indexed for MEDLINE]

4015: Am J Ophthalmol. 1997 Feb;123(2):255-7.

Famciclovir for the treatment of acute retinal necrosis (ARN) syndrome.

Figueroa MS, Garabito I, Gutierrez C, Fortun J.

Department of Ophthalmology, Ramon y Cajal University Hospital, Madrid, Spain.

PURPOSE: To document a case of acute retinal necrosis syndrome in an
immunocompetent patient who was successfully treated with famciclovir after
unsuccessful treatment with acyclovir. METHODS: After diagnosing acute retinal
necrosis syndrome in the patient's left eye, we treated him with 13 mg/kg/24
hours of intravenous acyclovir in three daily doses for 14 days, followed by 800 
mg of acyclovir five times per day orally. New areas of retinitis developed
within the posterior pole despite treatment with the maximum dosage of acyclovir;
thus, we used a new antiviral agent, famciclovir. RESULTS: When we administered
500 mg of famciclovir orally every 8 hours for 3 months, the retinitis regressed 
within 1 month, leaving atrophic granular pigmented scars. CONCLUSION:
Famciclovir can effectively treat acute retinal necrosis syndrome in
immunocompetent patients.

Publication Types: 
    Case Reports

PMID: 9186134 [PubMed - indexed for MEDLINE]

4016: Am J Ophthalmol. 1997 Feb;123(2):254-5.

Disciform keratitis: a case of herpes zoster sine herpete.

Silverstein BE, Chandler D, Neger R, Margolis TP.

Francis I. Proctor Foundation, University of California, San Francisco Medical
Center 94143-0944, USA.

PURPOSE: To describe a case of disciform keratitis in a patient with acquired
immunodeficiency syndrome (AIDS) in which varicella-zoster virus was the
causative agent. METHOD: Case report, Polymerase chain reaction-based assays for 
varicella-zoster virus, cytomegalovirus, and herpes simplex virus were used to
analyze an aqueous aspirate. RESULTS: We examined a 41-year-old man with AIDS but
without a history of varicella-zoster virus dermatitis who had disciform corneal 
edema in his left eye. Varicella-zoster virus was detected by a polymerase chain 
reaction-based assay in the aqueous of the left eye; however, neither
cytomegalovirus nor herpes simplex virus DNA were detected by polymerase chain
reaction-based assays. The corneal edema slowly resolved while the patient was
treated with famciclovir. CONCLUSION: Varicella-zoster virus may cause disciform 
keratitis without a preceding skin eruption.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9186133 [PubMed - indexed for MEDLINE]

4017: Am J Ophthalmol. 1997 Feb;123(2):252-4.

Primary varicella-zoster keratitis: diagnosis by polymerase chain reaction.

Power WJ, Hogan RN, Hu S, Foster CS.

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical
School, Boston 02114, USA.

PURPOSE: To report the value of polymerase chain reaction in the diagnosis of a
worsening corneal ulcer. METHODS: A 6-year-old boy underwent an emergent
penetrating keratoplasty for a corneal ulcer that continued to worsen despite
intensive antibiotic therapy. RESULTS: Examination of the corneal specimen by
polymerase chain reaction was positive for varicella-zoster virus but negative
for herpes simplex. Based on polymerase chain reaction studies, we diagnosed
primary varicella-zoster keratitis with corneal perforation. Electron microscopy 
showed herpetic virus particles in the cornea. CONCLUSIONS: Polymerase chain
reaction analysis of corneal buttons at the time of penetrating keratoplasty may 
benefit patients with undiagnosed recalcitrant corneal ulcers.

Publication Types: 
    Case Reports

PMID: 9186132 [PubMed - indexed for MEDLINE]

4018: Am J Ophthalmol. 1997 Feb;123(2):243-51.

The potential impact of the varicella vaccine and new antivirals on ocular
disease related to varicella-zoster virus.

Pepose JS.

Department of Ophthalmology and Visual Sciences, Washington University School of 
Medicine, St Louis, Missouri 63110, USA. pepose@am.seer.wustl.edu

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 9186131 [PubMed - indexed for MEDLINE]

4019: Am J Ophthalmol. 1997 Feb;123(2):157-64.

A polymerase chain reaction-based assay for diagnosing varicella-zoster virus
retinitis in patients with acquired immunodeficiency syndrome.

Short GA, Margolis TP, Kuppermann BD, Irvine AR, Martin DF, Chandler D.

Francis I. Proctor Foundation, University of California, San Francisco Medical
Center 94143-0944, USA.

PURPOSE: To develop a rapid, sensitive, and specific laboratory assay based on
the polymerase chain reaction for the diagnosis of varicella-zoster virus
retinitis in patients with acquired immunodeficiency syndrome (AIDS). METHODS: We
developed and tested a polymerase chain reaction-based assay for the detection of
varicella-zoster virus DNA in vitreous samples. We attempted to detect
varicella-zoster virus DNA in 14 vitreous samples from patients with AIDS and a
clinical diagnosis of progressive outer retinal necrosis syndrome. For controls, 
we also attempted to detect varicella-zoster virus DNA in vitreous samples from
75 immunocompetent patients with vitreoretinal disease and 88 patients with AIDS 
and vitreoretinal inflammatory disease not related to progressive outer retinal
necrosis syndrome. RESULTS: Varicella-zoster virus DNA was detected in 11 of 14
vitreous samples from AIDS patients with progressive outer retinal necrosis
syndrome. All three samples that scored negative for varicella-zoster virus DNA
came from eyes that had been treated aggressively with antiviral drugs and had
clinically inactive disease at the time of vitreous biopsy. Varicella-zoster
virus DNA was detected in only two of 75 control vitreous samples from
immunocompetent patients with vitreoretinal disease and two of 88 control
vitreous samples from patients with AIDS and vitreoretinal inflammatory disease
not related to progressive outer retinal necrosis syndrome. CONCLUSION: We have
developed a rapid, sensitive, and specific polymerase chain reaction-based
diagnostic assay for varicella-zoster virus DNA that will assist in the diagnosis
of varicella-zoster virus retinitis in patients with AIDS.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9186120 [PubMed - indexed for MEDLINE]

4020: Ther Umsch. 1997 Feb;54(2):79-82.

[The dangerous headache]

[Article in German]

Mumenthaler M.

Some particularities are frequent in headache types due to a potentially
dangerous disease, namely sudden onset, rapid increase of pain intensity, very
localized headache, increasing frequency and intensity of pain, and the
insurgence of neurological or psychopathological signs. The headache types
showing one of these characteristics are discussed in detail.

Publication Types: 
    English Abstract

PMID: 9139409 [PubMed - indexed for MEDLINE]

4021: Pharmacogenetics. 1997 Feb;7(1):35-43.

Intestinal anaerobic bacteria hydrolyse sorivudine, producing the high blood
concentration of 5-(E)-(2-bromovinyl)uracil that increases the level and toxicity
of 5-fluorouracil.

Nakayama H, Kinouchi T, Kataoka K, Akimoto S, Matsuda Y, Ohnishi Y.

Department of Bacteriology, School of Medicine, University of Tokushima, Japan.

Sorivudine, 1-beta-D-arabinofuranosyl-5-(E)-(2-bromovinyl)uracil, is a potent
antiviral agent against varicella-zoster virus and herpes simplex virus type 1.
However, sorivudine should not be used in combination with anticancer drugs such 
as 5-fluorouracil (5-FU) because (E)-5-(2-bromovinyl)uracil (BVU), a metabolite
of sorivudine, inhibits the degradation of 5-FU, resulting in its accumulation in
the blood and marked enhancement of the toxicity of 5-FU. Since phosphorolytic
enzymes generate BVU from sorivudine, we investigated the distribution of the
enzyme activity in rats. High activity was found in the cecal and large
intestinal contents, while very low or no detectable activity in the liver,
kidney, stomach, cecum, large intestine, and the stomach and small intestinal
contents. These results suggest that intestinal microflora play an important role
in BVU production. Therefore, we measured the phosphorylase activity in cell-free
extracts from 23 aerobes, 16 anaerobes and a fungus. Bacteroides species B.
vulgatus, B. thetaiotaomicron, B. fragilis, B. uniformis and B. eggerthii,
dominant members of intestinal microflora, had high activity to convert
sorivudine to BVU. To elucidate the contribution of intestinal microflora to BVU 
production in vivo, we administered sorivudine to rats treated with several
antibiotics and measured the BVU concentration in the serum of rats. When
sorivudine was given to rats treated with ampicillin or a mixture of bacitracin, 
neomycin and streptomycin, which decreased the numbers of viable aerobes and
anaerobes, only a small amount of BVU was found in the serum. BVU concentration
in the serum of rats treated with metronidazole to decrease the number of
intestinal anaerobes was also very low. In contrast, BVU concentration in the
serum of rats treated with kanamycin, which was used to decrease the number of
aerobes selectively, was higher than that of non-treated rats. These results also
suggest that BVU is produced by intestinal anaerobic bacteria especially
Bacteroides species in vivo.

PMID: 9110360 [PubMed - indexed for MEDLINE]

4022: Curr Opin Pediatr. 1997 Feb;9(1):24-30.

Advances in antiviral therapy.

Dwyer DE, Kesson AM.

Centre for Infectious Diseases and Microbiology, University of Sydney, Westmead
Hospital, ICPMR, NSW, Australia.

For many years, acyclovir has been used to treat herpes simplex and varicella
zoster infections in adults and children, although new drugs with improved
bioavailability and dosage regimens (ie, famciclovir, valaciclovir) are replacing
it for the outpatient management of these conditions in adults. Acyclovir remains
the treatment of choice for severe herpes infections in both immunocompetent and 
immunosuppressed patients. Data on the newer antiherpes drugs in children are not
available. Treatment of severe cytomegalovirus infections with ganciclovir and
foscarnet is difficult because of toxicity; whether improved formulations of
these drugs or newer agents prove clinically useful remains to be seen. For the
most part, treatment of other herpesviruses is not indicated. The major advance
in pediatric HIV treatment is the reduction in vertical transmission with
peripartum zidovudine, although the optimal use of antiretrovirals in this
situation remains to be determined. The nucleoside analogues zidovudine,
zalcitabine, didanosine, and stavudine have been assessed in HIV-infected
children; pediatric data about appropriate combinations (eg, with the protease
inhibitors and the nonnucleoside reverse transcriptase inhibitors) and dosage
regimens lag well behind the adult literature. The effectiveness of ribavirin in 
respiratory syncytial virus disease is uncertain. Preliminary data suggest that
interferons may have a role in the management of chronic hepatitis B and C.

Publication Types: 
    Review

PMID: 9088751 [PubMed - indexed for MEDLINE]

4023: Acta Ophthalmol Scand. 1997 Feb;75(1):76-81.

Incidence and prevalence of different uveitis entities in Finland.

Paivonsalo-Hietanen T, Tuominen J, Vaahtoranta-Lehtonen H, Saari KM.

Department of Ophthalmology, University of Turku, Finland.

We studied the case records of 1122 patients with endogenous uveitis including
418 new cases treated at the University Eye Clinic in Turku during the years
1980-1982 and 1988. The mean annual incidence and prevalence rates (per 100,000
population) of idiopathic acute anterior uveitis were 17.1 and 48.5,
respectively, sarcoid anterior uveitis 0.5 and 1.5, Posner-Schlossman syndrome
0.4 and 1.9, herpes zoster uveitis 0.4 and 0.7, idiopathic chronic anterior
uveitis 0.3 and 7.3, herpes simplex keratouveitis 0.3 and 0.5, juvenile
rheumatoid arthritis 0.2 and 2.4, Fuchs' heterochromic iridocyclitis 0.2 and 0.5,
intermediate uveitis 0.3 and 1.4, and of toxoplasmic retinochoroiditis 0.3 and
2.4. The incidence and prevalence rates of acute anterior uveitis associated with
ankylosing spondylitis were 2.0 and 10.3 per 100,000 population, respectively,
and this disease association occurred more often in men than in women (p <
0.001). The mean annual incidence of idiopathic acute anterior uveitis was
significantly lower in the age group 0-19 years than in the other age groups (p <
0.001).

PMID: 9088407 [PubMed - indexed for MEDLINE]

4024: Pain. 1997 Feb;69(3):245-53.

Severity of skin lesions of herpes zoster at the worst phase rather than age and 
involved region most influences the duration of acute herpetic pain.

Higa K, Mori M, Hirata K, Hori K, Manabe H, Dan K.

Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.

Duration of acute herpetic pain (AHP) in 1431 patients for whom treatment was
begun within 14 days after the onset of herpes zoster (HZ) was analyzed with
respect to age, involved region, and severity of skin lesions. All patients were 
treated with repeated sympathetic nerve blocks until their pain was almost nil.
Severity of the skin lesions at the worst phase was defined as mild when they
covered less than one-quarter of the primary dermatome, as severe when they
covered more than three-quarters of the primary dermatome, and moderate if they
were between mild and severe. Without taking into account the severity of skin
lesions, the duration of AHP for those aged 60 years or over and for those with
trigeminal involvement was significantly longer than for patients aged under 40
years (P < 0.01 and P < 0.001) and for patients with thoracic (P < 0.001) and
lumbosacral (P < 0.01) involvement, respectively. However, duration of AHP was
significantly longer with increase in the severity of skin lesions in all age
groups (the mild group versus the moderate group, P < 0.01 and P < 0.001; the
moderate group versus the severe group, P < 0.01 and P < 0.001). The mean
duration of AHP for patients aged 60 years or over with mild skin lesions ranged 
from 17.4 to 22.9 days, while that for patients aged 30-59 years with severe skin
lesions ranged from 37.2 to 50.1 days. In addition, duration of AHP was
significantly longer with increase in the severity of skin lesions in all regions
(the mild group versus the moderate group, P < 0.01 and P < 0.001; the moderate
group versus the severe group, P < 0.05 and P < 0.001). The mean duration of AHP 
for those with trigeminal involvement with mild skin lesions was 19.5 days, while
the range was from 51.3 to 55.0 days for patients with severe skin lesions
involving regions other than the trigeminal area. The frequency of severe skin
lesions was significantly higher (P < 0.001) in patients aged 60 years or over
and in those with trigeminal involvement. Multiple stepwise regression analysis
revealed that the most important factors influencing the duration of AHP were the
severity of skin lesions of HZ at the worst phase (r = 0.412), age (r = 0.277)
and the involved region (r = -0.101). Thus, AHP in the elderly and in cases of
trigeminal involvement is longer because of higher frequencies of severe HZ in
the elderly and in trigeminal involvement rather than "being aged' and
"trigeminal involvement' itself. We propose that one needs to analyze the results
of treatment of AHP with respect to the severity of skin lesions at the worst
phase.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9085298 [PubMed - indexed for MEDLINE]

4025: Drugs Aging. 1997 Feb;10(2):80-94.

Herpes zoster and postherpetic neuralgia. Optimal treatment.

Johnson RW.

Pain Management Clinic, Bristol Royal Infirmary, University of Bristol, England.

Herpes zoster is a common disease primarily affecting the elderly. Although some 
individuals experience no symptoms beyond the duration of the acute infection,
many develop chronic pain [postherpetic neuralgia (PHN)], which is the commonest 
complication of herpes zoster infection and remains notoriously difficult to
treat once established. It may persist until death and has major implications for
quality of life and use of healthcare resources. Predictors for the development
of PHN are present during the acute disease and should indicate the need for the 
use of preventive therapy. At the present time, use of antiviral and certain
tricyclic antidepressant drugs, combined with psychosocial support, seem most
effective, but are far from perfect. Sympathetic nerve blocks reduce acute
herpetic pain but it is uncertain whether they prevent PHN. In the future,
vaccines may have an important place in reducing the incidence of chickenpox in
the population or, through the vaccination of middle-aged individuals, in
boosting immunity to varicella zoster virus, thus preventing or modifying the
replication of the virus from its latent phase that results in herpes zoster.
Developments in the understanding of the pathophysiology of PHN indicate possible
directions for improved drug management of established PHN, although no evidence 
yet exists for efficacy of the drugs concerned. Such agents include new
generation anticonvulsants and N-methyl-D-aspartate antagonists.

Publication Types: 
    Review

PMID: 9061266 [PubMed - indexed for MEDLINE]

4026: Ophthalmology. 1997 Feb;104(2):279-82.

Comment in:
    Ophthalmology. 1998 Mar;105(3):390-1.

Repair of retinal detachments due to herpes varicella-zoster virus retinitis in
patients with acquired immune deficiency syndrome.

Weinberg DV, Lyon AT.

Department of Ophthalmology, Northwestern University Medical School, Chicago,
Illinois, USA.

PURPOSE: The authors characterize surgical techniques and report results for
repair of retinal detachments due to varicella-zoster retinitis in patients with 
acquired immune deficiency syndrome (AIDS). BACKGROUND: Varicella-zoster virus
(VZV) retinitis is a distinctly aggressive infection in patients with AIDS.
Retinal detachments occur in the majority of such patients, and contribute to
their poor visual prognosis. METHODS: A case series of five eyes in four patients
with AIDS and retinal detachments due to VZV retinitis is presented, highlighting
surgical technique and results. Pars plana vitrectomy, silicone oil tamponade,
and endolaser photocoagulation were used in all cases. RESULTS: Apparent
contraction of the necrotic retina was observed, requiring large relaxing
retinectomies to achieve retinal attachment in three of the five eyes. Follow up 
after surgery was 4, 6, 15, 29, and 30 months. Four eyes maintained ambulatory
vision and the retinas remained attached. CONCLUSION: Vitrectomy with silicone
oil tamponade may be used to preserve ambulatory vision in carefully selected
patients with AIDS and retinal detachments due to VZV retinitis. Relaxing
retinectomy is a useful technique to achieve and maintain retinal attachment.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9052632 [PubMed - indexed for MEDLINE]

4027: Semin Oncol. 1997 Feb;24(1):132-40.

Infectious complications of patients undergoing therapy for acute leukemia:
current status and future prospects.

Chanock SJ, Pizzo PA.

Pediatric Branch, National Cancer Institute, Bethesda, MD 20892, USA.

The success of managing the infectious complications of acute leukemia has
permitted oncologists to develop new approaches to induction and high-dose
therapy. The single most important risk factor for infection is the duration of
absolute neutropenia. Historically, most attention was directed towards gram
negative aerobes, especially Pseudomonas aeruginosa, but in recent years gram
positive bacteria, generally considered to be less virulent, have become the most
frequent isolates in most centers. A recent disturbing trend is the isolation of 
vancomycin-resistant enterococci. A recent controversy has been whether to use
empirical vancomycin; the Centers for Disease Control has issued a formal
recommendation discouraging empirical vancomycin in the febrile neutropenic
patient. Empirical monotherapy has replaced combination therapy in many
institutions except where there has been an increase in resistant isolates. In
patients who remain profoundly neutropenic, fungal infections represent a serious
source of secondary infection, especially species of Candida and Aspergillus.
Recently lipid-based formulations of amphotericin B have offered reduced
nephrotoxicity. Less toxic antifungals, the azoles, which include fluconazole and
itraconazole, offer an attractive alternative to amphotericin B. New patterns of 
invasive mycoses have emerged, as for example hepatosplenic candidiasis,
presenting new problems in diagnosis and therapy. The successful management of
virus infections with herpes simplex, cytomegalovirus, varicella zoster, and
Epstein Barr virus is based on early recognition and careful attention to
prevention.

Publication Types: 
    Review

PMID: 9045299 [PubMed - indexed for MEDLINE]

4028: Neurology. 1997 Feb;48(2):407-12.

The neurologic complications of B-cell chronic lymphocytic leukemia.

Bower JH, Hammack JE, McDonnell SK, Tefferi A.

Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.

We performed a retrospective study to characterize the type, frequency, and
timing of neurologic complications in patients with B-cell chronic lymphocytic
leukemia (B-CLL). We reviewed 962 total charts with a median follow-up time of
57.5 months. There were 109 cases (11.3%) of neurologic complications, including 
69 cases (7.2%) of herpes zoster infection, 17 cases (1.8%) of other
opportunistic infection, 14 cases (1.5%) of treatment-related conditions, eight
cases (0.8%) of direct leukemic involvement of neural tissue, and 1 case (0.1%)
of intracranial hemorrhage. No cases of a non-zoster opportunistic infection
presented in early-stage (Rai stage 0-2) B-CLL, and only one case of direct
leukemic involvement of neural structures presented in early-stage B-CLL. Of the 
25 cases of non-zoster or treatment-related complications, only 5 presented
before 6 years from the initial B-CLL diagnosis. Three of these were in
advanced-stage B-CLL, staging could not be determined in one, and one presented
in early-stage B-CLL. We conclude that the overall neurologic complication rate
of B-CLL is low, and that the Rai stage of the disease correlates best with the
risk of developing neurologic complications. The occurrence of a related
non-zoster neurologic complication in a patient with B-CLL stage 0-2 approaches
1:1,000.

PMID: 9040730 [PubMed - indexed for MEDLINE]

4029: Muscle Nerve. 1997 Feb;20(2):229-31.

Painful neuropathy after diffuse herpes zoster.

Mondelli M, Scarpini C, Malandrini A, Romano C.

EMG Service, USL 7, Siena, Italy.

Publication Types: 
    Case Reports

PMID: 9040664 [PubMed - indexed for MEDLINE]

4030: J Am Acad Dermatol. 1997 Feb;36(2 Pt 1):183-5.

PUVA-induced phototoxicity: incidence and causes.

Morison WL, Marwaha S, Beck L.

Department of Dermatology, Johns Hopkins Medical School, Baltimore, MD, USA.

BACKGROUND: Phototoxicity is the most significant short-term adverse effect of
PUVA therapy. OBJECTIVE: We attempted to determine the incidence and possible
causes of phototoxicity of sufficient degree to cause interruption of treatment. 
METHODS: A retrospective study was conducted of 16,506 PUVA treatments given to
414 patients in two treatment centers. RESULTS: Phototoxicity occurred in 10.9%
of patients and was an adverse effect in 0.3% of treatments. Problems with the
treatment protocol were the main cause. CONCLUSION: Phototoxicity is a common
adverse effect, and patients should be warned of this potential occurrence.
Awareness of the causes may help to reduce the incidence of this problem.

PMID: 9039165 [PubMed - indexed for MEDLINE]

4031: Antiviral Res. 1997 Feb;33(3):187-200.

The synthesis and immunogenicity of varicella-zoster virus glycoprotein E and
immediate-early protein (IE62) expressed in recombinant herpes simplex virus-1.

Lowry PW, Koropchak CM, Choi CY, Mocarski ES, Kern ER, Kinchington PR, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, CA 94305-5119, 
USA.

In order to evaluate the conditions for optimal expression and immunogenicity of 
varicella-zoster virus (VZV) proteins in a herpes simplex virus-1 (HSV-1) vector,
we selected the VZV glycoprotein E (gE), encoded by ORF 68 and the VZV product of
ORF 62, an immediate-early major tegument protein (IE62). Three HSV/VZV
recombinants were generated: (1) VZV gE protein coding sequences along with the
promoter region were inserted into the thymidine kinase (TK) gene of HSV-1 strain
KOS; (2) VZV gE expressed from the HSV-1 ICP4 promoter was inserted into the
glycoprotein C (gC) gene of HSV-1 strain F; and (3) VZV IE62 protein coding
sequences under the control of the HSV-1 ICP4 promoter were inserted into the gC 
gene of HSV-1 strain F. Immunoblot analysis and immunoperoxidase staining of
infected cell monolayers demonstrated vector expression of VZV proteins.
Following intracranial inoculation in mice, both VZV gE-HSV (TK) and VZV IE62-HSV
(gC) induced an IgG response against VZV gE or VZV IE62. When tested in
cytotoxicity assays using T-lymphocytes from VZV immune human donors, the range
of precursor frequencies for T-lymphocytes that recognized VZV gE or VZV IE62 was
similar whether these proteins were expressed by HSV-1 or a vaccinia vector.
These experiments demonstrate that HSV-1 is a competent vector for expression of 
these VZV proteins and support the feasibility of engineering a combined vaccine 
for these closely related alpha-herpesviruses.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9037375 [PubMed - indexed for MEDLINE]

4032: Ann Pharmacother. 1997 Feb;31(2):185-91.

Valacyclovir.

Acosta EP, Fletcher CV.

Department of Pharmacy Practice, College of Pharmacy, University of Minnesota
55455, USA.

OBJECTIVE: To discuss the clinical pharmacology, antiviral activity, clinical
efficacy, and other therapeutic issues associated with valacyclovir use for the
treatment of herpesvirus infections. DATA SOURCE: Literature searches using
MEDLINE were prospectively designed to include relevant articles and abstracts
between January 1982 and March 1996. The searches focused on valacyclovir
pharmacology, clinical efficacy, and issues associated with herpesvirus
infections. STUDY SELECTION: Selection of clinical and basic science studies were
limited to those focusing on valacyclovir. All articles with pertinent
information relevant to the scope of this article were reviewed. DATA SYNTHESIS: 
Valacyclovir is an amino acid ester prodrug of acyclovir. It is currently
approved for the treatment of herpes zoster infections in immunocompetent adults 
(1 g p.o. tid for 7 d) and recurrent episodes of genital herpes in
immunocompetent adults (500 mg bid for 5 d). Valacyclovir is rapidly and almost
completely hydrolyzed to acyclovir prior to systemic exposure. The
bioavailability of valacyclovir is 54% compared to approximately 20% for oral
acyclovir. At higher dosages (2 g qid), the plasma AUC of acyclovir following
oral valacyclovir administration approximates that seen after intravenous
administration of 10 mg/kg every 8 hours. Clinical data indicate that
valacyclovir is at least as effective as acyclovir in decreasing the duration of 
pain associated with postherpetic neuralgia, and in reducing time to genital
lesion healing and the length of the episode. CONCLUSIONS: Valacyclovir has
improved bioavailability over acyclovir and is at least as efficacious. The
favorable safety profile of acyclovir and increased systemic exposure make it a
particularly ideal candidate for further studies of herpes group viral infections
in immunocompromised patients.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 9034421 [PubMed - indexed for MEDLINE]

4033: Drug Metab Dispos. 1997 Feb;25(2):270-3.

Corrected and republished in:
    Drug Metab Dispos. 1997 May;25(5):270-3.

Lethal drug interactions of sorivudine, a new antiviral drug, with oral
5-fluorouracil prodrugs.

Okuda H, Nishiyama T, Ogura K, Nagayama S, Ikeda K, Yamaguchi S, Nakamura Y,
Kawaguchi K, Watabe T, Ogura Y.

Department of Drug Metabolism and Molecular Toxicology, School of Pharmacy, Tokyo
University of Pharmacy and Life Science, Japan.

Rats were orally co-administered sorivudine (SRV:
1-beta-D-arabinofuranosyl-(E)-5-(2-bromovinyl)uracil), a new oral antiviral drug 
for herpes zoster, with the oral anticancer drug tegafur (FT:
1-(2-tetrahydrofuryl)-5-fluorouracil) as a prodrug of 5-flourouracil (5-FU) once 
daily to investigate a toxicokinetic mechanism of 15 Japanese patients' deaths
recently caused within a brief period by the drug interaction of these drugs. All
the rats showed extremely elevated levels of 5-FU in plasma and tissues,
including bone marrow and small intestine, and died within 10 days, whereas the
animals given the same dose of SRV or FT alone were still alive over 20 days
without any appreciable toxic symptom. Before their death, there was marked
damage of bone marrow, marked atrophy of intestinal membrane mucosa, marked
decreases in white blood cells and platelets, diarrhea with bloody flux, and
severe anorexia as reported with the Japanese patients. Data obtained by in vivo 
and in vitro studies strongly suggested that (E)-5-(2-bromovinyl)uracil generated
from SRV by gut flora was reduced in the presense of NADPH to a reactive form by 
hepatic dihydropyrimidine dehydrogenase (DPD), a key enzyme determining the
tissue 5-FU levels, bound covalently to DPD as a suicide inhibitor, and markedly 
retarded the catabolism of 5-FU.

Publication Types: 
    Comparative Study

PMID: 9029059 [PubMed - indexed for MEDLINE]

4034: J Neurosurg. 1997 Feb;86(2):197-202.

Chronic electrical stimulation of the gasserian ganglion for the relief of pain
in a series of 34 patients.

Taub E, Munz M, Tasker RR.

Division of Neurosurgery, University of Toronto, Ontario, Canada.

The use of an implanted system for chronic electrical stimulation of the
gasserian ganglion for relief of facial pain was described in 1980 by Meyerson
and Hakansson. Between 1982 and 1995, the senior author (R.R.T.) performed
gasserian ganglion stimulation in 34 patients for the relief of chronic medically
intractable facial pain. The etiology of pain was peripheral damage to the
trigeminal nerve in 22 patients (65%), central (stroke) damage in seven (21%),
postherpetic neuralgia in four (12%), and unclassifiable cause in one (3%). All
patients received a trial of transcutaneous stimulation (Stage 1). Successful
trials in 19 patients (56%) were followed by implantation of a permanent system
(Stage II). Trial and postimplantation stimulation were deemed successful when
there was a reduction of pain by at least 50% whenever the stimulator was on.
Success rates varied from five (71%) of seven patients for central pain to five
(23%) of 22 for peripheral pain and none (0%) of four for postherpetic neuralgia.
The median follow-up duration in successful cases was 22.5 months. Infections
occurred in seven patients, all of whom had undergone Stage II treatment.
Infections were more frequent when the stimulating electrode from Stage I was
left in place for Stage II (six [43%] of 14) than when completely new hardware
was used and prophylactic antibiotic drugs were administered (one [20%] of five).
Other complications included iatrogenic injury to the trigeminal nerve or
ganglion in three cases (9%), transient diplopia in two (6%), increased pain in
two (6%), and various technical problems in 10 (29%). It is concluded that pain
of central origin (stroke) is the type most likely to be relieved by this
procedure. This finding is new, as the few other clinical series reported to date
contain no patients with this type of pain. The risk of infection seems to be
lower when completely new hardware is used for Stage II and prophylactic
antibiotic drugs are administered.

PMID: 9010419 [PubMed - indexed for MEDLINE]

4035: J Clin Microbiol. 1997 Feb;35(2):347-9.

Antigen detection: the method of choice in comparison with virus isolation and
serology for laboratory diagnosis of herpes zoster in human immunodeficiency
virus-infected patients.

Dahl H, Marcoccia J, Linde A.

Department of Virology, Swedish Institute for Infectious Disease Control,
Stockholm, Sweden.

Ninety-two adult human immunodeficiency virus (HIV)-infected patients with
suspected herpes zoster were included in a study. The clinical diagnosis of
herpes zoster was verified by examination of blister cell and fluid material or
serum samples. Antigen detection by a direct immunofluorescence assay with a
fluorescein isothiocyanate-labelled monoclonal antibody, virus isolation, and
serologic methods (in-house varicella-zoster virus [VZV] immunoglobulin G [IgG]
and IgM enzyme-linked immunosorbent assays and the commercial Enzygnost assay)
were compared. The direct immunofluorescence assay was found to be the most
sensitive method, diagnosing 85 of 92 infections (92%), while the sensitivity of 
virus isolation was 65% (60 of 92 patients). Despite the use of two different
serological methods, only 60 of 92 patients (65%) had significant VZV IgG titer
rises, and only 26 of 92 patients (28%) had detectable VZV IgM. The lack of a VZV
IgG antibody titer rise was found to correlate with low CD4 counts in peripheral 
blood and high VZV IgG titers in the acute-phase serum sample. The frequency of
IgM-positive sera was lower than that expected from reports of studies with
patients without AIDS. This may be related to early antiviral treatment or
deficient antibody production due to the HIV-related immunosuppression. There was
no significant difference in CD4 counts between VZV IgM-positive and -negative
patients.

Publication Types: 
    Comparative Study
    Multicenter Study

PMID: 9003593 [PubMed - indexed for MEDLINE]

4036: Dtsch Med Wochenschr. 1997 Jan 31;122(5):132-9.

[Zoster. The manifestation forms in the skin, complications and therapy]

[Article in German]

Gross G.

Klinik fur Dermatologie und Venerologie, Universitat Rostock.

Publication Types: 
    Review

PMID: 9072484 [PubMed - indexed for MEDLINE]

4037: Tidsskr Nor Laegeforen. 1997 Jan 10;117(1):23-6.

[Hodgkin disease treated at the Tromso regional hospital 1985-93. Diagnosis,
treatment, prognosis, quality of life and costs of a decentralized treatment]

[Article in Norwegian]

Norum J, Wist E.

Kreftavdelingen, Regionsykehuset i Tromso.

Between 1985-93, 55 patients were treated for Hodgkin's disease at the University
Hospital of Tromso. The median diagnostic delay was four months and a significant
prolonged delay was connected with the lymphocyte predominance subgroup. The
ChlVPP regimen was shown to be a risk factor for herpes zoster virus infection.
The 5-year overall survival was 90%. The survivors experienced a low frequency of
symptoms and a high level of functioning. The females reported a significant
superior global quality of life and had a lower psychological distress and
fatigue score than the males. The cost of one quality-adjusted life year (QALY)
(production gains included and using a 10% discount rate) was estimated to be
1,651 pounds. This makes Hodgkin's disease one of the most cost-effective
malignancies to treat.

Publication Types: 
    English Abstract

PMID: 9064805 [PubMed - indexed for MEDLINE]

4038: Ugeskr Laeger. 1997 Jan 6;159(2):175-9.

[The long-term prognosis of patients with acute chest pain of various origins]

[Article in Danish]

Launbjerg J, Fruergaard P, Hesse B, Jorgensen F, Elsborg L, Petri A.

Hillerod Sygehus, medicinsk afdeling B.

A total of 204 patients with acute chest pain, but without myocardial infarction 
(non-AMI) were included. In 56 a definite diagnosis was obtained within 24-48
hours of admission. The remaining 148 patients underwent a comprehensive
examination program. Ischaemic heart disease (IHD) was diagnosed in 64 patients, 
81 had gastro-oesophageal disorders, 58 chest wall disorders, nine pericarditis, 
five pulmonary embolism, four pneumonia/pleuritis, three pulmonary cancer, two
dissecting aortic aneurysm, one aortic stenosis and one herpes zoster. During 33 
months of follow-up, 31 of the 64 patients with IHD had a cardiac event (cardiac 
deaths, non-fatal AMI, bypass surgery or PTCA) whereas only three events occurred
among the 140 patients without IHD (p < 0.00001). However, the frequency of
readmissions and of recurrent episodes of chest pain were similar in the three
major diagnostic groups (NS). It is concluded that the high risk subset of a
non-AMI population can be identified by means of non-invasive cardiac
examination. The remainder who have other diagnoses are at low risk. However, the
morbidity is high with frequent readmissions and recurrent episodes of chest
pain, and the need for development of strategies with regard to diagnosis and
treatment of these patients is emphasized.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 9012090 [PubMed - indexed for MEDLINE]

4039: Biomed Pharmacother. 1997;51(10):449-54.

Cerebral infarction associated with vasculitis due to varicella zoster virus in
patients infected with the human immunodeficiency virus.

Picard O, Brunereau L, Pelosse B, Kerob D, Cabane J, Imbert JC.

Service de Medecine Interne, Hopital Saint-Antoine, Paris, France.

Cases of herpes zoster ophtalmicus (HZO) with delayed contralateral hemiparesis
caused by hemispheric stroke secondary to granulomatous angiitis have been
reported and are a well-recognized complication of herpes zoster. Similar cases
have been reported more recently during infection with human immunodeficiency
virus (HIV). We describe two HIV+ patients without any clinical history of zoster
dermatitis who developed a sudden hemiparesis followed 2 weeks later for one by
an acute retinal necrosis. Computerized tomography (CT) scan, magnetic resonance 
imaging (MRI), magnetic resonance angiography (MRA), and digital subtraction
angiography (DSA) were performed and showed a hemispheric stroke with evidence of
a segmental arteritis of the carotid syphon. Varicella zoster virus (VZV) was
found in the cerebro spinal fluid (CSF) in the two patients and after puncture of
the vitreous fluid of the patient with the acute retinal necrosis. These two
cases exemplify the difficulty of diagnosis of stroke in HIV+ patients, which
seems to be more frequent than in similarly aged non-infected patients and
demonstrates that VZV needs to be taken in consideration and identified even
without any past history of zoster dermatitis.

Publication Types: 
    Case Reports

PMID: 9863504 [PubMed - indexed for MEDLINE]

4040: Ann Dermatol Venereol. 1997;124(2):144-50.

[Skin diseases disclosing human immunodeficiency virus infection in Mali]

[Article in French]

Mahe A, Bobin P, Coulibaly S, Tounkara A.

Institut Marchoux, BP 251, Bamako, Republique du Mali.

INTRODUCTION: Several skin diseases are associated with human immunodeficiency
virus (HIV) infection. In Africa, due to the difficult access to medical care and
complementary examinations, certain diseases are of particular importance. In the
present work, we report the skin manifestations observed in a dermatology unit of
a large city in Africa over a 3 year period and which were the revealing signs of
HIV infection. PATIENTS AND METHODS: All adult subjects (>15 years) with a
positive HIV serology (confirmed by Western blot) that had been revealed by a
skin disease seen at the Marchoux Institute at Bamako between June 1991 and
September 1994 were included in the study. RESULTS: Two hundred sixty-three skin 
diseases revealed 233 cases of HIV infection. Diseases observed were: zoster (n =
71), seborrheic dermatitis (n = 43), Kaposi's sarcoma (n = 34), prurigo (n = 31),
sexually transmitted diseases (n = 27), extensive dermatophytosis (n = 12),
psoriasis (n = 12), molluscum contagiosum (n = 8), acquired ichthyosis (n = 3),
cutaneous leishmaniasis (n = 2) and other skin diseases (n = 10). More than one
disease were associated in 28 patients. Certain particular features were noted
(superinfection of zoster, papular margin in dermatophytosis). DISCUSSION: In
Africa, certain skin diseases often reveal HIV infection and some diseases have a
high positive predictive value for HIV infection (zoster, seborrheic dermatitis, 
prurigo, Kaposi's sarcoma, extensive dermatophytotis). For prognosis, frequently 
associated diseases are signs of AIDS (Kaposi's disease, prurigo, molluscum
contagiosum).

Publication Types: 
    English Abstract

PMID: 9740824 [PubMed - indexed for MEDLINE]

4041: Ann Dermatol Venereol. 1997;124(4):366-9.

[Question of the month: should herpes zoster in an immunocompetent subject
(except ocular herpes zoster) be treated by antiviral agents?]

[Article in French]

[No authors listed]

PMID: 9739950 [PubMed - indexed for MEDLINE]

4042: Ann Dermatol Venereol. 1997;124(5):401-3.

[Oculomotor nerve paralysis with complete ptosis in herpes zoster ophthalmicus: 2
cases]

[Article in French]

Schoenlaub P, Grange F, Nasica X, Guillaume JC.

Service de dermatologie, Hopital Pasteur, Colmar.

INTRODUCTION: Only few studies focus on ocular motor paralyses in herpes zoster
ophtalmicus. We report 2 cases of complete ptosis resulting from paralysis of the
superior lid levator, appearing at day 6 and 7 of an ophtalmic herpes zoster
under treatment with acyclovir. CASE REPORTS: Case 1: A 68 year old woman
presented an history of ophtalmic herpes zoster with kerato-conjunctivitis and
uveitis treated with acyclovir. At the third day of the treatment and 7th day of 
the ophtalmic zoster, an incomplete paralysis of the oculomotor nerve appeared
resulting in a complete ptosis. The treatment was carried on until the 21st day
without improvement. Four months later, all symptoms had completely cleared. CASE
2: A 66 year old woman was treated with acyclovir for an ophtalmic herpes zoster 
without ocular involvement. At the 4th day of the treatment and 6th day of the
onset of the ophtalmic zoster, a paralytic ptosis and a acute epithelial
keratitis appeared. Acyclovir treatment was continued for 10 days. The ptosis
resolved gradually during 2 months. DISCUSSION: The manifestation of a complete
ptosis with paralysis of the oculomotor nerve or of one of its branch is rarely
seen in ophtalmic herpes zoster. However minor symptoms are often detected when
patients were carefully examined with regard to external ocular movements. The
physiopathological mechanism are discussed about. The possible action of an early
antiviral treatment on the prevention of these complications is not known. In our
two cases, a paralytic ptosis broke out suddenly, even under treatment with
acyclovir for respectively 3 and 4 days. For future prospective studies about
antiviral drugs for ophtalmic herpes zoster, a systematic evaluation of these
neurological symptoms would be interesting.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9739899 [PubMed - indexed for MEDLINE]

4043: Intervirology. 1997;40(5-6):343-56.

Antiviral therapy of herpes simplex and varicella-zoster virus infections.

Wutzler P.

Institute for Antiviral Chemotherapy, Clinicum of the University of Jena, Erfurt,
Germany.

Antiviral treatment of herpesvirus infections is rapidly changing since the
advent of new drugs with improved oral availability. The efficacy of
valaciclovir, the prodrug of aciclovir, and famciclovir, the prodrug of
penciclovir, in the treatment of herpes genitalis and acute herpes zoster has
been well documented in large clinical trials. Both drugs are effective on
zoster-associated pain. Brivudin and sorivudine which are the most active
compounds against varicella-zoster virus (VZV) in cell culture have also been
successful in the treatment of herpes zoster. Aciclovir is still the standard
therapy of severe herpes simplex virus (HSV) and varicella virus infections. In
patients treated with aciclovir, the mortality of herpes encephalitis has been
reduced to about 25%. The development of resistance against aciclovir and the
other nucleoside analogues has not been a problem to date in the treatment of
immunocompetent individuals. However, in immunocompromised patients,
aciclovir-resistant HSV strains often emerge. In such cases, intravenous
foscarnet is the current treatment of choice.

Publication Types: 
    Review

PMID: 9675639 [PubMed - indexed for MEDLINE]

4044: Intervirology. 1997;40(5-6):295-303.

Acyclic nucleoside phosphonates in the chemotherapy of DNA virus and retrovirus
infections.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

The acyclic nucleoside phosphonates [HPMPC (cidofovir), PMEA (adefovir) and PMPA]
have proved to the effective in vitro (cell culture systems) and in vivo (animal 
models, clinical studies) against a wide variety of DNA virus and retrovirus
infections: i.e., HPMPC against herpesvirus (herpes simplex virus type 1 and 2,
varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, human herpesvirus
types 6, 7, and 18), polyoma-, papilloma-, adeno-, and poxvirus (vaccinia virus, 
molluscum contagiosum virus) infections; PMEA against herpesvirus, hepadnavirus
(human hepatitis B virus) and retrovirus (human immunodeficiency virus type 1 and
2, simian immunodeficiency virus, and feline immunodeficiency virus) infections; 
and PMPA against both hepadna- and retrovirus infections.

Publication Types: 
    Review

PMID: 9675635 [PubMed - indexed for MEDLINE]

4045: Can Fam Physician. 1997 Jan;43:35, 43.

Dermacase. Herpes zoster.

Adams SP.

Dermatology Department, University of Calgary, Alta.

Publication Types: 
    Case Reports

PMID: 9626420 [PubMed - indexed for MEDLINE]

4046: Scand J Infect Dis. 1997;29(6):543-9.

The influence of cytomegalovirus on the natural history of HIV infection:
evidence of rapid course of HIV infection in HIV-positive patients infected with 
cytomegalovirus.

Sinicco A, Raiteri R, Sciandra M, Dassio G, Bechis G, Maiello A.

Department of Medical and Surgical Sciences, University of Turin, Italy.

We studied a cohort of 299 HIV-positive individuals with known date of
seroconversion to evaluate the role of Cytomegalovirus (CMV) in the natural
history of HIV. The study population consisted of 236 initially CMV-positive
patients, 55 CMV-negative subjects and 8 CMV seroconverters. The study endpoints 
were the decline to CD4+ < 200 x 10(6) cells/l, AIDS, and death. The cumulative
risk of CMV disease and the survival after CMV disease were also investigated. At
intake, there was no inter-group difference in sex, age, risk behaviours, history
of hairy leucoplakia or herpes zoster and antiretroviral treatment. During the
follow-up, 108 patients fell below 200 CD4+ x 10(6) cells/l, 72 developed AIDS
and 63 died. Twenty-one subjects had CMV disease. The cumulative incidence of CMV
disease in the cohort was 18.9%, and 23.3% within 8 and 9 years for the initially
CMV-positive patients and 33.3% and 66.7% for the CMV seroconverters (log-rank
test: p = 0.101). The median survival after CMV disease was 153 days (range:
28-855, interquartile range: 261), with a cumulative survival of 45.1%, 16.9% and
4.3% within 6, 12 and 18 months, respectively. On Cox's regression, the acute HIV
seroconversion was an independent predictor of each endpoint, history of hairy
leucoplakia or herpes zoster being associated only with CD4+ cell decline.
Baseline CMV seropositivity was related to short survival (p = 0.037) and 2 x 2
inter-group comparison showed that older individuals with sexually acquired HIV
who seroconverted to CMV had higher rates of progression to the study endpoints. 
Our data suggest that CMV infection influences the natural history of HIV disease
and that CMV disease strongly affects the survival of the HIV-positive patients.

PMID: 9571731 [PubMed - indexed for MEDLINE]

4047: Dermatology. 1997;195(4):311-6.

Intracutaneous histamine injection can detect damage of cutaneous afferent fibres
in postherpetic neuralgia.

Stucker M, Hugler P, von Kobyletzki G, Reuther T, Hoffmann K, Laubenthal H,
Altmeyer P.

Department of Dermatology, Ruhr University, Bochum, Germany.

BACKGROUND: The axon reflex response in diseased skin of patients with
postherpetic neuralgia may be significantly impaired. OBJECTIVE: In the present
study we introduced a simple test for quantifying the decreased axon reflex flare
response in the clinical routine. METHODS: Histamine was intradermally applied to
the diseased dermatome as well as to the corresponding dermatome of the
contralateral side of the body. Ten minutes after application, skin blood flow
and the extension of the hyperaemic response were assessed by means of laser
Doppler scanning. RESULTS: In the skin region affected by the postherpetic
neuralgia, the hyperaemic area was significantly smaller than in the healthy
skin. The mean flux values did not differ significantly between the two sites.
There was no correlation between the hyperaemic response and the intensity of
pain sensation assessed by a clinical visual analogue score. CONCLUSION: The
smaller hyperaemic area in the dermatome with postherpetic neuralgia strongly
indicates a C fibre or C nociceptor damage. We consider histamine injections as a
useful tool in the differential diagnosis of postherpetic neuralgia.

PMID: 9529547 [PubMed - indexed for MEDLINE]

4048: Rev Med Interne. 1997;18(12):991.

[Paralytic sciatica of zoster origin]

[Article in French]

Trivalle C, Benharrats I, Wetterwald E, Beaufils M.

Publication Types: 
    Case Reports
    Letter

PMID: 9500006 [PubMed - indexed for MEDLINE]

4049: Rev Cubana Enferm. 1997 Jan-Jun;13(1):41-6.

[Herpes simplex and varicella zoster in HIV seropositive and AIDS patients
diagnosed at the "Pedro Kouri" Institute of Tropical Medicine. Nurses' role]

[Article in Spanish]

Alfonso Rittoles A, Ricardo Fonseca ME, Feliu Lamarque N, Benitez Mazorra D.

Instituto de Medicina Tropical Pedro Kouri, Ciudad de La Habana, Cuba.

A retrospective and descriptive study composed of HIV and AIDS seropositive
patients was conducted, 90 patients with infections caused by herpes simplex and 
zoster varicella were taken as a sample. Percentage was applied to them. Within
the opportunistic infections, those caused by microorganisms from the Herpes
viridae family, such as herpes simplex virus type I and II, cytomegalovirus,
hoster varicella, and Epstein Barr's virus are very frequent among these
patients. The nursing role in the attention to HIV and AIDS seropositive patients
with infections produced by herpes simplex and zoster varicella was analyzed
during two years. Herpes simplex infection (88.8% of the cases) showed the
highest incidence and its genital localization was the most frequent one. 100% of
the lesions of the skin and of the mucous membranes were cured. The efficiency of
nursing care in these infections was proved and emphasis was made on how
important it is to fulfil the biosafety measures with these patients.

Publication Types: 
    English Abstract

PMID: 9479174 [PubMed - indexed for MEDLINE]

4050: Intervirology. 1997;40(2-3):72-84.

Infections of the nervous system caused by varicella-zoster virus: a review.

Echevarria JM, Casas I, Martinez-Martin P.

National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda,
Spain.

Varicella-zoster virus (VZV) is a cause of neurologic disease among humans. Both 
primary infection and recurrence may lead to neurologic infection and disease.
Neurologic syndromes associated with acute VZV infection are caused by abnormal
immune responses, the most frequent manifestation being cerebellar ataxia. Those 
associated with recurrences are often due to the direct effect of viral
replication in the nervous tissue. VZV reaches the nervous system either through 
the bloodstream or by direct spread from sensory ganglia where it remains latent.
Postherpetic neuralgia, acute encephalitis, aseptic meningitis and myelitis are
the most frequent diseases and have been recorded both in association with herpes
zoster and in the absence of a cutaneous rash. Early diagnosis may be established
by detecting virus-specific DNA sequences in the cerebrospinal fluid (CSF) after 
amplification by the polymerase chain reaction and then confirmed by detection of
intrathecally produced, specific IgG antibody. Virus isolation from CSF and
antibody testing in serum are unsuitable for diagnosis. Early acyclovir therapy
is recommended in immuno-compromised patients and those with serious disease.

Publication Types: 
    Review

PMID: 9450225 [PubMed - indexed for MEDLINE]

4051: Retina. 1997;17(6):560-2.

Successful treatment of progressive outer retinal necrosis using high-dose
intravitreal ganciclovir.

Meffert SA, Kertes PJ, Lim PL, Conway MD, Peyman GA.

LSU Eye Center, Louisiana State University Medical Center School of Medicine, New
Orleans 70112-2234, USA.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9428025 [PubMed - indexed for MEDLINE]

4052: Arch Virol Suppl. 1997;13:201-6.

Transmission, species specificity, and pathogenicity of Aujeszky's disease virus.

Sawitzky D.

Institut fur Klinische und Experimentelle Virologie, Universitatsklinikum
Benjamin Franklin, Freie Universitat Berlin, Federal Republic of Germany.

Aujeszky's disease virus (ADV), also known as pseudorabies virus (PrV), is an
alphaherpesvirus that causes fatal infections in a wide range of animal species. 
The virus shares a variety of biological properties with human pathogenic
herpesviruses like herpes simplex virus or varicella-zoster virus. Although only 
limited data are available, it seems unlikely that PrV causes disease in
immunocompetent humans, but may pose a risk for immunocompromised patients.

Publication Types: 
    Review

PMID: 9413539 [PubMed - indexed for MEDLINE]

4053: Arch Anat Cytol Pathol. 1997;45(2-3):153-8.

[Central nervous system infection due to Herpes simplex virus in AIDS]

[Article in French]

Chretien F, Belec L, Wingerstmann L, de Truchis P, Baudrimont M, Perronne C, Gray
F.

Laboratoire d'Anatomie Pathologique (Neuropathologie) et de Medecine Legale,
Faculte de Medecine Paris-Ouest, Universite Paris V, Hopital Raymond-Poincare,
Garches (France.).

Infections of the central nervous system by Herpes simplex viruses (Herpes
simplex type 1 and Herpes simplex type 2) are uncommon in acquired immune
deficiency syndrome and are often clinically and pathologically atypical. We have
collected 11 cases of herpes simplex encephalomyelitis in AIDS patients reported 
in the literature. Only 3 of these cases presented with a typical, necrotizing,
limbic encephalitis. Other clinicopathological patterns included ventriculitis,
rhombencephalitis and myelitis. Ventriculitis and rhombencephalitis were usually 
due to infection by HSV-1, whereas myelitis was mostly due to HSV-2 infection.
Distinction between the 2 types of virus is often difficult by
immunohistochemistry due to frequent cross reactivity and usually requires tissue
culture, in situ hybridization, or polymerase chain reaction. Association of HSV 
encephalomyelitis with productive infection of the central nervous system by the 
human immunodeficiency virus was only found in one case. In contrast,
co-infection with cytomegalovirus was found in 9 of the 11 cases. One case also
had had varicella zoster virus vasculitis, and another case also had a cerebral
malignant non Hodgkin's lymphoma in which Epstein Barr virus genome was
identified. This supports the view that concomitant herpes-virus infections of
the central nervous system is a characteristic feature of AIDS.

Publication Types: 
    English Abstract
    Review

PMID: 9382607 [PubMed - indexed for MEDLINE]

4054: Arch Anat Cytol Pathol. 1997;45(2-3):142-52.

[Central nervous system infection due to varicella and zoster virus in AIDS]

[Article in French]

Chretien F, Belec L, Lescs MC, Authier FJ, De Truchis P, Scaravilli F, Gray F.

Departement de Pathologie (Neuropathologie), Faculte de Medecine de Creteil,
Universite Paris-Val-de-Marne, Hopital Henri Mondor, France.

We have reviewed 23 cases of varicella-zoster virus infection of the central
nervous system in patients with the acquired immunodeficiency syndrome,
previously reported in the literature, including 11 from our own series. This
allowed us to identify 5 clinico-pathological patterns which could occur
simultaneously. In most cases, viral proteins or viral genome were identified
using immunocytochemistry or in situ hybridization. Multifocal encephalitis
involves predominantly the white matter and is likely to be due to haematogenous 
spread of the infection. Ventriculitis may have variable appearance according to 
the course of the disease. In one incipient case, the ependymal lining appeared
irregular with foci of infected ependymal cells some of which protruded into the 
ventricular lumen; in other instances, there was acute or chronic necrosis of the
ventricular wall with marked vasculitis. Acute haemorrhagic
meningo-myelo-radiculitis with necrotising vasculitis may be associated with
ventriculitis and results from shedding of infected ependymal cells into the
ventricular lumen and secondary seeding of the cerebrospinal fluid. Focal
necrotising encephalitis or myelitis usually follows cutaneous herpes zoster in
the corresponding dermatoma and is considered to result from neural spread from
the diseased trigeminal or dorsal root ganglion. Vasculopathy involving
leptomeningeal arteries and causing cerebral infarcts is associated with
meningitis in most cases. These findings are in keeping with the observation in
other immunocompromised patients, that varicella-zoster virus spread to the
central nervous system may follow different routes. Our study tends to show that 
varicella-zoster virus infection of the central nervous system is more frequent
in the acquired immunodeficiency syndrome than previously suspected and suggests 
this diagnosis must be considered systematically in cases of encephalitis,
ventriculitis, focal myelitis, acute myeloradiculitis and cerebral infarcts in
these patients, since an efficient treatment is available.

Publication Types: 
    English Abstract
    Review

PMID: 9382606 [PubMed - indexed for MEDLINE]

4055: Pharmacol Ther. 1997;75(1):1-19.

Chronic neuropathic pain and its control by drugs.

MacFarlane BV, Wright A, O'Callaghan J, Benson HA.

School of Pharmacy, University of Queensland, Brisbane, Australia.

The medical treatment and some currently known aspects of the aetiology of five
neurogenic pain states are discussed. Neurogenic pain can be described as pain
resulting from noninflammatory dysfunction of the peripheral or central nervous
system without nociceptor stimulation or trauma. The enormity of the field has
limited this review to post-herpetic neuralgia, complex regional pain syndromes, 
phantom pain, trigeminal neuralgia and diabetic neuralgia. Evidence suggests that
many neurogenic pain states are not effectively controlled. This may be due in
part to a lack of understanding of the aetiology of these conditions and to the
lack of high quality studies evaluating existing treatments. A compact review of 
the literature is presented with some treatment options and possible future
directions. Where appropriate surgical management and physical therapy have been 
discussed; however, a thorough appraisal of nondrug treatments was not the main
priority of this review.

Publication Types: 
    Case Reports
    Review

PMID: 9364578 [PubMed - indexed for MEDLINE]

4056: Virus Genes. 1997;15(1):45-52.

Herpesvirus of turkeys homologue of HSV VP16 is structurally related to varicella
zoster virus trans-inducing protein encoded by ORF 10.

Kopacek J, Zelnik V, Brasseur R, Koptidesova D, Rejholcova O, Pastorekova S,
Pastorek J.

Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovak Republic.

Expression of the immediate-early genes of alpha-herpesviruses is stimulated by a
family of trans-inducing factors represented by VP16 of HSV-1 and ORF10 gene
product of VZV. We have identified and determined the nucleotide sequence of the 
UL48 gene encoding the herpesvirus of turkeys (HVT) homologue of HSV VP16. The
gene maps to the BamHI-J fragment and appears to be expressed in a form of
bicistronic transcript together with UL49. The deduced amino acid sequence of the
protein encoded by HVT UL48 gene shows 55% identity with MDV UL48 gene product.
Like the majority of related proteins in other alpha-herpesviruses, the protein
encoded by HVT UL48 gene lacks the acidic C-terminal tail, known to possess the
transactivation capacity of HSV VP16. Hydrophobic cluster analysis has revealed
that its predicted domain composition is closely related to the transactivator
protein encoded by ORF10 of VZV. However, the putative amino-terminal activation 
domain of the HVT homologue of HSV VP16 does not contain a typical horseshoe-like
hydrophobic cluster found in other alpha-herpesvirus homologues, suggesting
either that it acts as a transactivator via a different activation domain or that
its transactivation potential is diminished.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9354269 [PubMed - indexed for MEDLINE]

4057: Clin Exp Dermatol. 1997 Jan;22(1):37-40.

Transient leukaemia cutis in chronic lymphocytic leukaemia.

Wakelin SH, Young E, Kelly S, Turner M.

Department of Dermatology, Amersham Hospital, Bucks, UK.

Leukaemia cutis arises due to cutaneous infiltration of neoplastic leukocytes or 
their precursors. Recent evidence suggests that this sign does not necessarily
herald a poor prognosis. We describe a 72-year-old woman with B-cell chronic
lymphatic leukaemia (CLL) who developed a papular eruption on her breast at the
site of a recent herpetic eruption. Histology and immunostaining showed a dense
dermal B-cell infiltrate in keeping with leukaemia cutis. The papules cleared in 
6 months without treatment, leaving atrophic scars. The histological features and
possible aetiological mechanisms of post-herpetic papular eruptions in CLL are
reviewed.

Publication Types: 
    Case Reports
    Review

PMID: 9330053 [PubMed - indexed for MEDLINE]

4058: Med Trop (Mars). 1997;57(2):207-8.

[Antecubital herpes zoster in AIDS]

[Article in French]

Loembe PM, Assengone-Zeh Y, Okome-Kouakou M, Mbiguino Ndjoyi A, Kouna P, Moubeka 
Mounguengui M, Mwanyombet-Ompounga L.

Publication Types: 
    Case Reports
    Letter

PMID: 9304020 [PubMed - indexed for MEDLINE]

4059: Ethiop Med J. 1997 Jan;35(1):43-51.

Pattern of neuro-ophthalmic disorders in a tertiary eye care centre in Addis
Ababa.

Bayu S, Alemayehu W.

Department of Ophthalmology, Faculty of Medicine, Addis Ababa University.

A neuro-ophthalmic subspeciality clinic was established in Ethiopia for the first
time in September 1993. A total of 700 patients attended this clinic over a
period of two years. Optic nerve lesions (22%), herpes zoster ophthalmicus (18%),
ocular motor palsies (17%), facial palsy (10%) and papilloedema (7%) were the
leading neuro-ophthalmic disorders observed. Myasthenia gravis and muscular
dystrophies were not rare diseases as well. HIV infection manifested in a variety
of neuro-ophthalmic disorders. In a significant number of the patients, precise
diagnoses could not be made due to lack of diagnostic facilities. Most patients
presented in advanced and irreversible state. Increased awareness on the part of 
patients as well as health care providers is thus of paramount importance in
order to avert unnecessary death and blindness, also is underlined the need for
improved diagnostic facilities like magnetic resonance imaging and computerized
tomography.

PMID: 9293146 [PubMed - indexed for MEDLINE]

4060: Med Trop (Mars). 1997;57(1):65-7.

[Recurrent varicella and HIV infection. Apropos of 10 cases seen in Lome]

[Article in French]

Pitche P, Gbadoe AE, Tidjani O, Tchangai-Walla K.

Service de Dermatologie et Venereologie, Centre Hospitalier et Universitaire
Tokoin, Lome, Togo.

Herpes-zoster is commonly observed in immunodepressed patients with HIV infection
in Africa. It is due to reactivation of the varicella-zoster virus. Varicella
which is usually considered as the acute invasive phase of infection can recur in
the same subject during immunodepression, thus constituting recurrent varicella. 
Little information is available concerning recurrent varicella in Africa. The
purpose of the present report is to describe 10 cases observed in 9 adults and 1 
child in Lome, Togo. In 6 cases recurrence of varicella allowed diagnosis of HIV 
infection. Clinical symptoms were severe with widespread lesions and
fever-related changes in general status. Nine of the 10 patients required
hospitalization. In all cases the illness lasted more than 3 weeks. This series
demonstrates that varicella in adults can be the first clinical manifestation of 
HIV infection in tropical areas and that this possibility should be investigated 
especially if varicella is recurrent.

Publication Types: 
    English Abstract

PMID: 9289614 [PubMed - indexed for MEDLINE]

4061: Acta Otolaryngol Suppl. 1997;528:77-9.

3D analysis of nystagmus during peripheral vertiginous attacks.

Ohyama Y, Yagi T, Ushio K, Suzuki K.

Department of Otolaryngology, Nippon Medical School, Tokyo, Japan.

In order to localize the site of lesion of peripheral vertigo, 3D analysis of
nystagmus during peripheral vertiginous attacks was carried out. In comparison
between the three components, the horizontal component had the largest ratio in
each disease. Spontaneous nystagmus was directed toward the affected side in 3
cases and to the opposite side in 15. In patients with Meniere's disease (MD),
all subjects had horizontal and torsional components and had almost the same slow
phase velocity in these two components. In patients with vestibular neuritis (VN)
and Hunt's syndrome (HS), nystagmus was directed toward the opposite side.
Furthermore, in VN, all subjects had an upward component, in addition to
horizontal and torsional components. Inferring the focus from the character of
nystagmus, it is speculated that the pathological changes are located in the
entire inner ear in MD, whereas in VN the lesion is located in the horizontal and
anterior semicircular canal or the superior vestibular nerve.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9288245 [PubMed - indexed for MEDLINE]

4062: Intervirology. 1997;40(1):15-21.

Antiviral efficacies of famciclovir, valaciclovir, and brivudin in disseminated
herpes simplex virus type 1 infection in mice.

Wutzler P, Ulbricht A, Farber I.

Institute for Antiviral Chemotherapy, Friedrich Schiller University of Jena,
Erfurt, Germany.

The animal model of necrotic hepatitis caused by HSV-1 infection in juvenile mice
was used to compare the efficacies of the oral antiherpes agents famciclovir
(FCV), valaciclovir (VACV) and brivudin (BVDU). The experimental infection allows
the measurement of viral replication in the liver by macroscopic lesions and the 
evaluation of mortality from encephalitis. Mice intravenously inoculated with a
highly virulent clinical HSV-1 isolate were orally treated by gavage over a
period of 3 days starting on day 2 post infection. The reference drug acyclovir
(ACV) was administered subcutaneously. Necrotic hepatitis was significantly (p < 
0.01) reduced by treatment with FCV, VACV and ACV at a dose of 50 mg/kg per day
divided into 3 doses. No significant effect was achieved with BVDU at 200 mg/kg
per day. Treatment with FCV at 50 mg/kg per day, ACV at 100 mg/kg per day, and
VACV at 200 mg/kg per day significantly (p < 0.001) decreased mortality in mice. 
BVDU treatment at 200 mg/kg per day did not reduce mortality but significantly
prolonged (p < 0.05) the survival time.

Publication Types: 
    Comparative Study

PMID: 9268766 [PubMed - indexed for MEDLINE]

4063: Ann Med Interne (Paris). 1997;148(3):255-7.

[Prevention of herpes simplex and varicella zoster infections in patients of HIV 
infections]

[Article in French]

Caumes E, Bricaire F.

Service de Maladies Infectieuses et Tropicales, GH Pitie-Salpetriere, Paris.

Reactivation of Herpes simplex virus and varicella zoster virus infections occurs
frequently in patients infected with human immunodeficiency virus (HIV).
Prevention of Herpes simplex recurrences with oral acyclovir (400 mg x 2/day)
should be recommended for patients with more than 6 relapses per year.
Varicella-zoster immunoglobulin is recommended for prophylaxis of varicella in
exposed HIV-infected adults and children who are susceptible. Prevention of
varicella-zoster recurrences with oral acyclovir (800 mg x 5/day) should be
considered for patients with retinopathy.

Publication Types: 
    English Abstract
    Review

PMID: 9255335 [PubMed - indexed for MEDLINE]

4064: Eye. 1997;11 ( Pt 1):33-6.

Management of viral retinitis-associated retinal detachment in AIDS.

Hannouche D, Korobelnik JF, Cochereau I, Hoang-Xuan T.

Department of Opthalmology, Bichat-Claude Bernard Hospital, Paris, France.

We retrospectively reviewed the results of surgery in 27 cases of retinal
detachment related to viral necrotising retinitis in acquired immune deficiency
syndrome (AIDS). Vitrectomy and silicone oil tamponade were performed in all
cases. Scleral buckling was applied to 9 eyes. Silicone oil was left in the eye
in all cases. Mean follow-up period was 13 weeks. Post-operative flattening of
the retina at the posterior pole was achieved in 89% of the eyes. Anatomical
results were not related to the intraoperative use of an encircling procedure.
Visual acuity improved by 2 Snellen lines or more in 40% of cases and 67% of the 
eyes retained a post-operative ambulatory vision. Phacosclerosis and optic
atrophy developed in 29% and 22% of cases, respectively. Vitrectomy and silicone 
oil tamponade without scleral buckling are effective in the management of
retinitis-associated retinal detachments. This procedure is short and can be
performed under local anaesthesia.

PMID: 9246273 [PubMed - indexed for MEDLINE]

4065: Drugs. 1997;53 Suppl 2:34-9.

[Treatment of post-herpes zoster pain with tramadol. Results of an open pilot
study versus clomipramine with or without levomepromazine]

[Article in French]

Gobel H, Stadler T.

Service de Neurologie, Hopital Universitaire, Kiel, Allemagne.

To date, no universally applicable recommendations are available for the
treatment of patients with postherpetic neuralgia. A mixture of clinical
anecdotes, experimental findings and observations from clinical trials form the
basis of the medical arsenal for this condition. Tricyclic antidepressants are
commonly used, and clinical experience and several investigations have documented
their effectiveness. Today, single entity antidepressants, which can be combined 
with neuroleptics to increase analgesia, are generally recommended for the
treatment of postherpetic neuralgia. Some authors also recommend the additional
administration of an opioid if analgesia is inadequate. Just over a decade ago,
opioids were considered ineffective for the treatment of neuropathic pain;
however, more recent investigations relating to the use of opioids, primarily in 
the treatment of nontumour-related chronic pain, have led to a revision of their 
use in neuropathic pain. Nevertheless, the use of opioid therapy for neurogenic
pain remains controversial. Tramadol is a synthetic, centrally acting analgesic
with both opioid and nonopioid analgesic activity. The nonopioid component is
related to the inhibition of noradrenaline (norepinephrine) reuptake and
stimulation of serotonin (5-hydroxytryptamine; 5-HT) release at the spinal level.
In this regard, there are parallels with antidepressants, which are believed to
potentiate the effect of biogenic amines in endogenous pain-relieving systems.
There is evidence that, in tramadol, both mechanisms act synergistically with
respect to analgesia. The aim of this pilot study was to investigate, for the
first time, the analgesic efficacy and tolerability of tramadol, compared with
the antidepressant clomipramine, in the treatment of postherpetic neuralgia. If
necessary, clomipramine was used in combination with the neuroleptic
levomepromazine. The study allowed individualised dosages at predetermined
intervals up to a maximum daily dose of tramadol 600mg and clomipramine 100mg, or
clomipramine 100mg with or without levomepromazine 100mg. 21 (60%) of 35
randomised patients (> or = 65 years) received the study medication over the
6-week period [tramadol n = 10; clomipramine with or without levomepromazine) n =
11]. After 3 weeks' treatment the dosage in both groups remained almost constant 
for the rest of the 6-week treatment phase (mean daily dose: tramadol 250 to
290mg; clomipramine 59.1 to 63.6mg). Only 3 patients required the combination of 
clomipramine and levomepromazine. At the outset, both groups recorded an average 
pain level of 'moderate' to 'very severe'. In correlation with increasing the
study medication, this had decreased to 'slight' by the end of the treatment,
when 9 of 10 patients in the tramadol group and of 6 of 11 patients in the
clomipramine group retrospectively rated their analgesia as excellent, good or
satisfactory. The psychological/physical condition of the patients did not change
significantly during tramadol treatment. Sensitivity and depression parameters
decreased in the clomipramine group. The incidence of adverse events for all
patients was similar in both groups (tramadol 76.5%; clomipramine with or without
levomepromazine 83.3%). In conclusion, tramadol would appear to be an interesting
therapeutic alternative for pain relief in postherpetic neuralgia, particularly
in patients who are not depressed. In clinical practice, tramadol and
clomipramine can best be used differentially. For example, tramadol could be the 
drug of first choice in patients with obvious cardiovascular disease (not an
uncommon problem in the > or = 65 year age group) in whom antidepressants are
contraindicated, and similarly in patients in whom an antidepressant effect is
not required. (ABSTRACT TRUNCATED)

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract
    Randomized Controlled Trial

PMID: 9190323 [PubMed - indexed for MEDLINE]

4066: Dermatology. 1997;194(3):306.

Interferon alpha gel for herpes zoster.

Miyoshi H, Hirotsuji N, Kino T, Katsu K.

Publication Types: 
    Letter

PMID: 9187858 [PubMed - indexed for MEDLINE]

4067: Dermatology. 1997;194(3):276-7.

Congenitally acquired herpes zoster infection in a newborn.

Mogami S, Muto M, Mogami K, Asagami C.

Department of Dermatology, Yamaguchi University, Japan.
mogami-ygc@umin.u-tokyo.ac.jp.

We report a case of congenitally acquired herpes zoster infection in a newborn
whose mother suffered from varicella in her eighth month of pregnancy. The
newborn had vesicles with limited distribution on the left C7 region. Herpes
zoster infection was clinically suspected and confirmed by the Tzanck test and a 
high titer of anti-varicella-zoster-virus immunoglobulin M (x1,280).

Publication Types: 
    Case Reports

PMID: 9187848 [PubMed - indexed for MEDLINE]

4068: Arch Virol. 1997;142(1):89-102.

Sequence analysis of the bovine herpesvirus type 1 genes homologous to the DNA
polymerase (UL30), the major DNA-binding protein (UL29) and ICP18.5 assembly
protein (UL28) genes of herpes simplex virus.

Meyer G, Vlcek C, Paces V, O'Hara MK, Pastoret PP, Thiry E, Schwyzer M.

Department of Virology, Faculty of Veterinary Medicine, University of Liege,
Belgium.

The nucleotide sequence of a 10.5 kb region (map position 0.332 to 0.410) of
bovine herpesvirus type 1 (BHV-1) was determined. This region contained three
open reading frames (ORFs) homologous to herpes simplex virus DNA polymerase
catalytic subunit (DNApol, UL30), major DNA-binding protein (MDBP, UL29) and
ICP18.5 assembly protein (ICP18.5, UL28). The BHV-1 DNApol. MDBP and ICP18.5 ORFs
were 1246, 1203 and 826 amino acids long with a calculated molecular mass of
134.2 kDa, 124.4 kDa and 86.9 kDa, respectively. They showed a high homology with
alphaherpesvirus homologs despite large differences in the G + C content of the
UL30-UL28 segment ranging from 44.4% for varicella zoster virus to 71.5% for
BHV-1. Particularly well conserved among Alphaherpesvirinae are the putative
functional domains of the DNApol and MDBP proteins which are discussed.
Phylogenetic analysis revealed that BHV-1 clustered in the Varicellovirus genus
with the animal D-type viruses. In this group, the BHV-1 position was shown to
vary according to the investigated genes. Indeed, pseudorabies virus clustered
with BHV-1 in the DNApol tree but with equine herpesvirus 1 in the ICP18.5 tree.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9155875 [PubMed - indexed for MEDLINE]

4069: Kurume Med J. 1997;44(1):61-6.

A case of zoster in the 2nd and 3rd branches of the trigeminal nerve associated
with simultaneous herpes labialis infection--a case report.

Terasaki S, Kameyama T, Yamamoto S.

Department of Oral Surgery, Kurume University School of Medicine, Japan.

A patient with herpes zoster infection affecting the second and third branches of
the trigeminal nerve is reported. This case demonstrates the occurrence of a
simultaneous VZV and HSV infection. Isolation of these viruses from exudates of
the blisters was required to prove coexistence of the two viruses within the same
blister. Relevant literature is discussed.

Publication Types: 
    Case Reports

PMID: 9154763 [PubMed - indexed for MEDLINE]

4070: Arch Virol. 1997;142(2):349-62.

Characterization of neutralizing domains on varicella-zoster virus glycoprotein E
defined by monoclonal antibodies.

Wu L, Forghani B.

Division of Communicable Disease Control, California State Department of Health
Services, Berkeley 94704, U.S.A.

The genome of varicella-zoster virus (VZV), encodes at least six glycoproteins
and they elicit the formation of complement-independent, complement-dependent,
and non-neutralizing antibody responses. We have used our library of MAbs to VZV 
glycoprotein E (gE) to determine the neutralizing epitopes of gE, and shown that 
gE has 3 distinct neutralizing domains. In this report we have used the
baculovirus expression system to identify the antigenic domains of gE. We have
generated 3 recombinant baculoviruses, expressing the full-length gE and two
overlapping truncated forms (the amino-terminal and the carboxy-terminal) of gE. 
By immuno-fluorescence and immunoblotting we have explored the physical
interactions of Mabs to gE on these constructs. Our panel of MAbs revealed 3
district antigenic domains on gE. All MAbs reacted with the full-length gE; MAbs 
with high titered complement-dependent neutralizing activities reacted with the
N-terminal truncated gE; MAbs with low titered or non-neutralizing activities
reacted with the C-terminal truncated gE; MAbs with complement-enhanced
neutralizing activities reacted with both truncated constructs. However, although
the antibody binding in immunofluorescence and immunoblotting was carried out
under denatured conditions, whereas the neutralization is under non-denatured
conditions, still the antigenic mapping was similar in both conditions.

PMID: 9125048 [PubMed - indexed for MEDLINE]

4071: Acta Otorhinolaryngol Belg. 1997;51(1):49-50.

A nasal septum perforation caused by a Varicella zoster infection in an AIDS
patient.

Colebunders R, De Roo A, Benimadho S, Mestdagh F, Van Damme P.

Institute of Tropical Medicine, University Hospital, University of Antwerp,
Wilrijk, Belgium.

A nasal septum perforation caused by a Varicella Zoster Infection in an AIDS
patient. A patient with an acquired immune deficiency syndrome is described who
developed a nasal septum perforation. This perforation was probably caused by
frequently scratching chronic zoster lesions inside the nose.

Publication Types: 
    Case Reports

PMID: 9105484 [PubMed - indexed for MEDLINE]

4072: Cancer Invest. 1997;15(2):165-76.

Comment in:
    Cancer Invest. 1997;15(2):163-4.

Postherpetic neuralgia: a review.

Hanania MM, Brietstein D.

Department of Anesthesiology, Long Island Jewish Medical Center, Albert Einstein 
College of Medicine, New Hyde Park, New York, USA.

Publication Types: 
    Review

PMID: 9095213 [PubMed - indexed for MEDLINE]

4073: Cancer Invest. 1997;15(2):163-4.

Comment on:
    Cancer Invest. 1997;15(2):165-76.

Introduction--postherpetic neuralgia: a treatment dilemma.

Elliott KJ.

Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New
York, USA.

Publication Types: 
    Comment

PMID: 9095212 [PubMed - indexed for MEDLINE]

4074: Presse Med. 1997 Jan;26 Suppl 1:10-2.

[Herpes simplex virus and varicella-zoster virus infections in HIV-infected
patients]

[Article in French]

Leport C, Brun-Vezinet F.

Service des-Maladies infectieuses et tropieales Centre Hospitalier Bichat-Claude 
Bernard, Paris.

Publication Types: 
    Review

PMID: 9082434 [PubMed - indexed for MEDLINE]

4075: Pain. 1997 Jan;69(1-2):55-63.

Effect of adrenergic receptor activation on post-herpetic neuralgia pain and
sensory disturbances.

Choi B, Rowbotham MC.

Department of Neurology, UCSF Pain Clinical Research Center 94115, USA.

Patients with acute herpes zoster, and to a lesser extent post-herpetic neuralgia
(PHN), have been reported to respond to local anesthetic blockade of the
sympathetic nervous system. In animal models of nerve injury, local injection of 
adrenergic agonists after nerve injury, but not before, excites nociceptors. In
some patients with chronic neuropathic pain, local application of norepinephrine 
evokes pain. In 15 subjects with PHN, the role of adrenergic receptors in PHN
pain was assessed in a two-session double blind study comparing the response to
cutaneous infiltration of epinephrine or phenylephrine (30 micrograms in 3 ml)
with the response to normal saline in both the painfully affected skin and
mirror-image normal skin. Two adjacent sites were studied on each side of the
body, one site for injection and the other for measuring sensory effects of the
injection. In the morning part of each session, mirror-image normal skin was
injected. In the afternoon portion of each session, skin in the most painful area
affected by PHN was injected. Injection of saline or the adrenergic agonist in
normal skin produced mild and transient pain without development of allodynia and
without affecting overall PHN pain intensity. In PHN skin, injection of saline
and the adrenergic agonist produced an equivalent degree of transient pain that
was slightly greater than injection into mirror-image normal skin. After
injection of the adrenergic agonist into PHN skin, both overall PHN pain and
allodynia severity were significantly greater than after saline injection,
peaking at 10-15 min post-injection. Even when PHN has been present for years,
adrenergic receptor stimulation in PHN skin increases pain, most likely through
direct activation of C-nociceptors in the painful skin. Increased allodynia is
most likely mediated centrally and driven by the increase in C-nociceptor input.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 9060013 [PubMed - indexed for MEDLINE]

4076: Clin Dermatol. 1997 Jan-Feb;15(1):93-111.

Human immunodeficiency virus in women: mucocutaneous manifestations.

Wright SW, Johnson RA.

Division of Dermatology, Harvard Medical School, Deaconess Hospital, Boston, MA
02215, USA.

Publication Types: 
    Review

PMID: 9034659 [PubMed - indexed for MEDLINE]

4077: Antiviral Res. 1997 Jan;33(2):73-85.

Assessment of pain in herpes zoster: lessons learned from antiviral trials.

Dworkin RH, Carrington D, Cunningham A, Kost RG, Levin MJ, McKendrick MW, Oxman
MN, Rentier B, Schmader KE, Tappeiner G, Wassilew SW, Whitley RJ.

Columbia-Presbyterian Medical Center, New York, NY, USA.

Pain typically accompanies acute herpes zoster and, in a proportion of patients, 
it persists well beyond rash healing. Pain must therefore be analyzed in trials
of antiviral agents in herpes zoster, but different methods have been used to
analyze pain in recent published trials. These reports are reviewed and their
methodological strengths and weaknesses examined. Based on this review,
recommendations for the design and analysis of future trials of antiviral agents 
in herpes zoster are proposed. The principal recommendation is that antiviral
efficacy should be evaluated both by distinguishing post-herpetic neuralgia from 
acute pain and by considering pain as a continuum. The primary endpoint should
address both the prevalence and duration of post-herpetic neuralgia and should be
examined in those patients who have post-herpetic neuralgia. Adopting the
proposed recommendations in design and analysis of future trials should
facilitate comparison across trials of the efficacy of antiviral agents in the
treatment of herpes zoster.

Publication Types: 
    Review

PMID: 9021049 [PubMed - indexed for MEDLINE]

4078: Clin Neuropathol. 1997 Jan-Feb;16(1):1-12.

Neocortical temporal lobe sclerosis masquerading as Alzheimer dementia: does
herpes virus encephalopathy protect against Alzheimer's disease?

Ball MJ, Kaye JA, Steiner I.

Department of Pathology, Oregon Health Sciences University, Portland 97201-3098, 
USA.

Semi-quantitative neuropathological analysis and morphometric evaluations of the 
brains of 5 elderly people (63-85 years old) dying following a 5-27-year history 
of dementia reveal that, despite exhaustive survey of all major brain regions, 4 
of these cases show virtually no histopathological lesions of Alzheimer's
disease. Instead their CNS manifests a severe, bilateral, neuronal depletion, and
astrogliosis afflicting the lateral temporal neocortex, highly compatible with a 
previous herpetic viral encephalitis. In the fifth case unilateral neocortical
temporal lobe sclerosis is accompanied by Alzheimer's disease, but with much more
dense Alzheimer lesions throughout the contralateral cerebral hemisphere. Three
of these 5 individuals had a history either of herpes zoster of the skin or of a 
single episode of viral meningoencephalitis, roughly concomitant with the onset
of memory loss. This clinical and pathological evidence that a remote herpes
virus encephalopathy (when bilateral) "protects" that brain against Alzheimer's
disease strengthens our growing suspicion that incomplete replication cycles of
herpes simplex or zoster virus, following repeated reactivation within neurons of
the trigeminal ganglia, may link these viruses to the pathogenetic cascade
underlying dementia of the Alzheimer type.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9020387 [PubMed - indexed for MEDLINE]

4079: J Virol Methods. 1997 Jan;63(1-2):71-9.

Luminometric microplate hybridization for detection of varicella-zoster virus PCR
product from cerebrospinal fluid.

Koskiniemi M, Mannonen L, Kallio A, Vaheri A.

Haartman Institute, Department of Virology, University of Helsinki, Finland.
marjaleena.Koskiniemi@helsinki.fi

We modified and optimized a new microplate hybridization assay to detect the
varciella-zoster virus (VZV) PCR product, and studied cerebrospinal fluid (CSF)
samples of 287 patients with meningitis, encephalitis or other neurological
diseases or symptoms. Specific antibodies to VZV and reference antigens were
determined by enzyme immunoassay from serum and CSF, they were then compared with
clinical findings and with the results obtained by VZV-PCR using different
detection methods for VZV-specific amplified DNA. VZV DNA was found in the CSF of
25 patients using the microplate hybridization assay and chemiluminescence
detection for amplified DNA. All 25 CSF samples were also positive in Southern
blotting. Among the patients, 10 had chickenpox, 4 had shingles, and 11 had no
rash at all. The detection rate of VZV-specific DNA by microplate hybridization
was 30% higher than that obtained by conventional agarose gel electrophoresis. In
most patients the diagnosis was confirmed by demonstrating specific intrathecal
antibody production to VZV but not to other viruses. These results indicate the
presence of VZV in the central nervous system (CNS) in many patients with
chickenpox or shingles, and even in patients without a rash. The microplate
hybridization assay based on chemiluminescence detection improves considerably
the detection rate of the VZV-PCR product compared to agarose gel electrophoresis
and will add to the list of recognized VZV infections in the CNS. It is
especially useful in cases where there is no cutaneous manifestation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9015277 [PubMed - indexed for MEDLINE]

4080: Drugs. 1997 Jan;53(1):40-73.

Drug treatment of HIV-related opportunistic infections.

Klepser ME, Klepser TB.

Division of Clinical and Administrative Pharmacy, College of Pharmacy, University
of Iowa, Iowa City 52242-1112, USA. michael_klepser@uiowa.edu

The AIDS epidemic has led to the emergence of several disease entities which in
the pre-AIDS era were rare or seemingly innocuous. Experience of treating these
diseases varies. In some instances, such as Pneumocystis carinii pneumonia, there
is an abundance of published literature to direct our course of action. However, 
for many of these newly recognised diseases our treatment experience is limited. 
Furthermore, in many instances, well controlled trials evaluating treatment
modalities in the AIDS population are lacking. We have identified 13 disease
entities (P. carinii pneumonia, toxoplasmosis, cryptococcosis, histoplasmosis,
Mycobacterium tuberculosis, Mycobacterium avium complex, cytomegalovirus,
coccidioidomycosis, isosporiasis, candidosis, Kaposi's sarcoma, herpes simplex
virus, and varicella zoster virus) and have reviewed the current literature with 
regard to their treatment.

Publication Types: 
    Review

PMID: 9010648 [PubMed - indexed for MEDLINE]

4081: J Gen Virol. 1997 Jan;78 ( Pt 1):179-88.

Replacement of the herpes simplex virus type 1 Vmw175 DNA binding domain with its
varicella-zoster virus counterpart results in a protein with novel regulatory
properties that can support virus growth.

Tyler JK, Orr A, Everett RD.

MRC Virology Unit, Glasgow, UK.

The alphaherpesviruses encode major immediate early transactivator proteins that 
are essential for the expression of later classes of viral genes. We have
previously shown that the extensive sequence similarity between the herpes
simplex virus type 1 (HSV-1) and varicella-zoster virus (VZV) members of the
family (proteins Vmw175 and VZV140k) extends to function, since a virus which
expresses VZV140k in place of Vmw175 is able to grow, albeit at reduced
efficiency. We have also shown that the DNA binding characteristics of the
isolated DNA binding domains of Vmw175 and VZV140k are related but distinct. In
order to assess whether the different DNA binding properties of the two proteins 
are responsible for the differences in their individual transcriptional
regulatory functions, we constructed a plasmid and an HSV-1 virus in which the
VZV140k DNA binding domain coding sequences replace those of Vmw175. The
characteristics of the resultant hybrid protein in transfection assays and during
virus infection suggest that the nature of the DNA binding domain plays a
significant role in the transactivation and repression properties of the Vmw1 75 
family of proteins.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9010302 [PubMed - indexed for MEDLINE]

4082: J Neurol. 1997 Jan;244(1):35-9.

A comparison of brain biopsy and CSF-PCR in the diagnosis of CNS lesions in AIDS 
patients.

d'Arminio Monforte A, Cinque P, Vago L, Rocca A, Castagna A, Gervasoni C, Terreni
MR, Novati R, Gori A, Lazzarin A, Moroni M.

Infectious Diseases Clinic, L Sacco Hospital, Milan, Italy.

Twenty patients with AIDS who had intracranial lesions underwent both brain
biopsy and cerebrospinal fluid (CSF) examination to compare histological
diagnosis with the polymerase chain reaction (CSF-PCR) for the identification of 
infectious agents. CSF-PCR was performed for herpes simplex virus, varicella
zoster virus, cytomegalovirus (CMV), JC virus (JCV), Epstein-Barr virus (EBV),
Toxoplasma gondii and Mycobacterium tuberculosis. A definitive diagnosis was
obtained by brain biopsy in 14 patients (2 with astrocytoma, 12 with brain
infection). CSF-PCR was positive for EBV DNA in 3 of 3 cases of primary cerebral 
lymphoma, positive for JCV DNA in 6 of 7 biopsy-proven (and one autopsy-proven)
cases of progressive multifocal leukoencephalopathy (PML). CSF-PCR was positive
for CMV DNA in one biopsy-proven and one autopsy-proven case of CMV encephalitis 
(the former also had PML) and positive for M. tuberculosis DNA in one case of
tuberculous encephalitis. None of the five toxoplasmic encephalitis cases (one
definite, four presumptive) were T. gondii DNA positive. There was close
correlation between histology and CSF-PCR for CMV encephalitis, PML and PCL.
Antitoxoplasma therapy affected the sensitivity of both histological and CSF-PCR 
methods.

Publication Types: 
    Comparative Study

PMID: 9007743 [PubMed - indexed for MEDLINE]

4083: J Clin Oncol. 1997 Jan;15(1):37-43.

Major activity of cladribine in patients with de novo B-cell prolymphocytic
leukemia.

Saven A, Lee T, Schlutz M, Jacobs A, Ellison D, Longmire R, Piro L.

Department of Pathology, Ida M. and Cecil H. Green Cancer Center, Scripps Clinic 
and Research Foundation, La Jolla, CA 92037, USA.

PURPOSE: De novo B-cell prolymphocytic leukemia (B-PLL) is a distinct
clinicopathologic entity usually characterized by marked lymphocytosis, massive
splenomegaly, an aggressive course, and refractoriness to therapy. Cladribine
(2-chlorodeoxyadenosine [2-CdA]; Ortho Biotech, Raritan, NJ) is a newer purine
analog with potent activity against indolent lymphoproliferative disorders.
PATIENTS AND METHODS: We treated eight patients with cladribine 0.1 mg/kg/d for 7
days by continuous infusion or 0.14 mg/kg/d over 2 hours for 5 days, every 28 to 
35 days, for a median of three courses (range, two to five). There were five men 
and three women, with a median age of 62 years and a median pretreatment duration
of 6 months; four patients were previously untreated. RESULTS: All eight patients
were assessable: five achieved a complete response with a median response
duration of 14 months (range, 1+ to 55+), and three achieved a partial response
with a median duration of 3 months (range, 1 to 3). Of four patients who achieved
a complete response and in whom a peripheral-blood immunophenotypic analysis was 
performed, two had no circulating B-PLL cells and one had no residual disease on 
Southern blot analysis. Myelosuppression and infection were the major toxicities:
three patients developed grade 3 or 4 myelosuppression, four had bacterial
infections, and two had herpes zoster infections. CONCLUSION: In this small study
of patients with de novo B-PLL, cladribine was an active agent that induced a
high overall and complete response rate. These results require confirmation in
larger numbers of B-PLL patients.

PMID: 8996122 [PubMed - indexed for MEDLINE]

4084: Clin Microbiol Rev. 1997 Jan;10(1):86-124.

Infections in solid-organ transplant recipients.

Patel R, Paya CV.

Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester,
Minnesota 55905, USA.

Solid-organ transplantation is a therapeutic option for many human diseases.
Infections are a major complication of solid-organ transplantation. All
candidates should undergo a thorough infectious-disease screening prior to
transplantation. There are three time frames, influenced by surgical factors, the
level of immunosuppression, and environmental exposures, during which infections 
of specific types most frequently occur posttransplantation. Most infections
during the first month are related to surgical complications. Opportunistic
infections typically occur from the second to the sixth month. During the late
posttransplant period (beyond 6 months), transplantation recipients suffer from
the same infections seen in the general community. Opportunistic bacterial
infections seen in transplant recipients include those caused by Legionella spp.,
Nocardia spp., Salmonella spp., and Listeria monocytogenes. Cytomegalovirus is
the most common cause of viral infections. Herpes simplex virus, varicella-zoster
virus, Epstein-Barr virus and others are also significant pathogens. Fungal
infections, caused by both yeasts and mycelial fungi, are associated with the
highest mortality rates. Mycobacterial, pneumocystis, and parasitic diseases may 
also occur.

Publication Types: 
    Review

PMID: 8993860 [PubMed - indexed for MEDLINE]

4085: Pediatrics. 1997 Jan;99(1):35-9.

Varicella and zoster in children after kidney transplantation: long-term results 
of vaccination.

Broyer M, Tete MJ, Guest G, Gagnadoux MF, Rouzioux C.

Department of Pediatric Nephrology, Hopital Necker-Enfants Malades, Paris,
France.

OBJECTIVE: To determine the long-term prevalence of varicella infection and
herpes zoster after kidney transplantation and to assess the effectiveness of
varicella immunization with the Oka attenuated strain. METHODS: This study
involved 704 children and adolescents who received a kidney graft in our
institution from 1973 to 1994 and had routinely been given varicella vaccine
beginning in 1980 in preparation for transplantation. RESULTS: After vaccination 
62% of these patients still had varicella/zoster (VZ) antibodies at 1 year and
42% after 10 years. After transplantation the incidence of varicella was
significantly lower, 26/212 (12%), in patients who received immunization than in 
those who did not and had no history of varicella, 22/49 (45%). The disease was
also significantly less severe in the vaccinated patients (three deaths among
naive patients vs none among vacciness). In the vaccinees, varicella infection
was observed only in those who did not develop or lost VZ antibodies; in
addition, 21 patients of this subgroup had an asymptomatic seroconversion. Four
of the 415 patients with a history of varicella had another episode of benign
varicella after grafting. Herpes zoster was observed in 76 of the 704 patients
included in the study. The prevalence differed according to VZ status at the time
of grafting: 13% in patients with a history of varicella, 7% in the vacciness,
and 38% in the naive patients at grafting who developed varicella. Three
rejection episodes occurred in association with a varicella episode and four with
a zoster episode, but graft function was only transiently impaired, and as a
whole varicella or zoster did not significantly affect graft function or
survival. CONCLUSION: Naive VZ patients with a kidney graft are at risk to
develop severe varicella and this may be effectively prevented by available
immunization.

PMID: 8989334 [PubMed - indexed for MEDLINE]

4086: J Virol. 1997 Jan;71(1):25-33.

From essential to beneficial: glycoprotein D loses importance for replication of 
bovine herpesvirus 1 in cell culture.

Schroder C, Linde G, Fehler F, Keil GM.

Institute of Molecular and Cellular Virology, Federal Research Centre for Virus
Diseases of Animals, Insel Riems, Germany.

Glycoprotein D (gD) of bovine herpesvirus 1 (BHV-1) has been shown to be an
essential component of virions involved in virus entry. gD expression in infected
cells is also required for direct cell-to-cell spread. Therefore, BHV-1 gD
functions are identical in these aspects to those of herpes simplex virus 1
(HSV-1) gD. In contrast, the gD homolog of pseudorabies virus (PrV), although
essential for penetration, is not necessary for direct cell-to-cell spread.
Cocultivation of cells infected with phenotypically gD-complemented gD- mutant
BHV-1/80-221 with noncomplementing cells resulted in the isolation of the
cell-to-cell-spreading gD-negative mutant ctcs+BHV-1/80-221, which was present in
the gD-null BIV-1 stocks. ctcs+BHV-1/80-221 could be propagated only by mixing
infected with uninfected cells, and virions released into the culture medium were
noninfectious. Marker rescue experiments revealed that a single point mutation in
the first position of codon 450 of the glycoprotein H open reading frame,
resulting in a glycine-to-tryptophan exchange, enabled complementation of the gD 
function for cell-to-cell spread. After about 40 continuous passages of
ctcs+BHV-1/80-221-infected cells with noninfected cells, the plaque morphology in
the cultures started to change from roundish to comet shaped. Cells from such
plaques produced infectious gD- virus, named gD-infBHV-1, which entered cells
much more slowly than wild-type BHV-1. In contrast, integration of the gD gene
into the genomes of gD-infBHV-1 and ctcs+BHV-1/80-221 resulted in recombinants
with accelerated penetration in comparison to wild-type virions. In summary, our 
results demonstrate that under selective conditions, the function of BHV-1 gD for
direct cell-to-cell spread and entry into cells can be compensated for by
mutations in other viral (glyco)proteins, leading to the hypothesis that gD is
involved in formation of penetration-mediating complexes in the viral envelope of
which gH is a component. Together with results for PrV, varicella-zoster virus,
which lacks a gD homolog, and Marek's disease virus, whose gD homolog is not
essential for infectivity, our data may open new insights into the evolution of
alphaherpesviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8985319 [PubMed - indexed for MEDLINE]

4087: J Virol. 1997 Jan;71(1):17-24.

Adaptability in herpesviruses: glycoprotein D-independent infectivity of
pseudorabies virus.

Schmidt J, Klupp BG, Karger A, Mettenleiter TC.

Institute of Molecular and Cellular Virology, Federal Research Centre for Virus
Diseases of Animals, Insel Riems, Germany.

Initial contact between herpesviruses and host cells is mediated by virion
envelope glycoproteins which bind to cellular receptors. In several
alphaherpesviruses, the nonessential glycoprotein gC has been found to interact
with cell surface proteoglycans, whereas the essential glycoprotein gD is
involved in stable secondary attachment. In addition, gD is necessary for
penetration, which involves fusion between virion envelope and cellular
cytoplasmic membrane. As opposed to other alphaherpesvirus gD homologs,
pseudorabies virus (PrV) gD is not required for direct viral cell-to-cell spread.
Therefore, gD- PrV can be passaged in noncomplementing cells by cocultivating
infected and noninfected cells. Whereas infectivity was found to be strictly cell
associated in early passages, repeated passaging resulted in the appearance of
infectivity in the supernatant, finally reaching titers as high as 10(7) PFU/ml
(PrV gD- Pass). Filtration experiments indicated that this infectivity was not
due to the presence of infected cells, and the absence of gD was verified by
Southern and Western blotting and by virus neutralization. Infection of bovine
kidney cells constitutively expressing PrV gD interfered with the infectivity of 
wild-type PrV but did not inhibit that of PrV gD- Pass. Similar results were
obtained after passaging of a second PrV mutant, PrV-376, which in addition to gD
also lacks gG, gI, and gE. Penetration assays demonstrated that PrV gD- Pass
entered cells much more slowly than wild-type PrV. In summary, our data
demonstrate the existence of a gD-independent mode of initiation of infection in 
PrV and indicate that the essential function(s) that gD performs in wild-type PrV
infection can be compensated for after passaging. Therefore, regarding the
requirement for gD, PrV seems to be intermediate between herpes simplex virus
type 1, in which gD is necessary for penetration and cell-to-cell spread, and
varicella-zoster virus (VZV), which lacks a gD gene. Our data show that the
relevance of an essential protein can change under selective pressure and thus
demonstrate a way in which VZV could have evolved from a PrV-like ancestor.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8985318 [PubMed - indexed for MEDLINE]

4088: J Clin Microbiol. 1997 Jan;35(1):71-8.

Detection of adeno-associated virus type 2 sequences in the human genital tract.

Friedman-Einat M, Grossman Z, Mileguir F, Smetana Z, Ashkenazi M, Barkai G,
Varsano N, Glick E, Mendelson E.

Institute of Hematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.

Adeno-associated virus (AAV) is a defective parvovirus with unknown
pathogenicity. It requires helper functions for its normal replication in human
tissue and therefore is not readily isolated from clinical specimens. We have
used the PCR method to examine the following clinical samples for the presence of
AAV sequences: (i) 15 nasopharyngeal aspirates from symptomatic patients, (ii) 7 
swab or fluid specimens from vesicles of patients suspected of having
varicella-zoster virus infections, (iii) 21 human papilloma virus-positive
genital biopsy specimens, (iv) 61 genital swab specimens from women suspected of 
having herpes simplex virus (HSV) infection examined either directly or following
propagation in tissue culture, (v) 62 samples of first-trimester aborted
material, including 38 samples from spontaneous abortions and 24 samples from
induced abortions, (vi) 11 samples of chorionic villi taken from women undergoing
genetic prenatal diagnosis, and (vii) three lots of cultured human embryonic
cells. AAV sequences were detected only in samples taken from the genital tracts 
of women suspected of having HSV infection and not in any of the other types of
samples. Samples from 11 patients were positive for AAV: for 4 patients the
original swab sample was positive, for 4 patients the cultured swab sample was
positive, and for 3 patients both the original swab samples and the cultures were
positive. Five of the 11 patients were infected with HSV. Our study demonstrates 
the presence of AAV in the female genital tract. However, in contrast to a
previous report (E. Tobiasch, M. Rabreau, K. Geletneky, S. Larue-Charlus, F.
Severin, N. Becker, and J. R. Schlehofer, J. Med. Virol. 44:215-222, 1994), we
did not find solid evidence of its replication in maternal or embryonal tissues
from the first trimester of pregnancy. The questions of a potential pathogenic
etiology of AAV and the interaction with HSV remain open.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 8968883 [PubMed - indexed for MEDLINE]

4089: Wien Klin Wochenschr. 1996 Dec 27;108(24):795-801.

[Early postoperative infections after liver transplantation--pathogen spectrum
and risk factors]

[Article in German]

Gotzinger P, Sautner T, Wamser P, Gebhard B, Barlan M, Steininger R, Fugger R,
Muhlbacher F.

Abteilung fur Transplantationschirurgie, Universitatsklinik fur Chirurgie, AKH
Wien.

Infections occurring during the early postoperative phase after liver
transplantation result in a significant rise in morbidity and mortality. The
records of 279 orthoptic transplantations performed in 248 patients were analyzed
retrospectively. 55.6% of all patients suffered from one or more episodes of
bacterial and/or fungal infection during their postoperative hospitalisation. The
median onset of bacterial/fungal infection was on day 7 after transplantation.
Enterococci (42 episodes), Pseudomonas aeruginosa (38 episodes), staphylococci
(37 episodes), Escherichia coli (17 episodes) and Candida albicans (11 episodes) 
were the most frequently detected organisms. 74 (29.8%) patients developed viral 
infections. 20 patients (8.1%) showed infection with cytomegalovirus (CMV), 32
patients (12.9%) with herpes simplex virus (HSV) and 6 patients (2.4%) with
varicella zoster virus (VZV). 14 patients (5.6%) developed infection with both
CMV and VZV. Triple infection with CMV, HSV and VZV occurred in one patient.
Statistical analysis of potential risk factors showed a significant influence of 
blood volume replacement (p < 0.001) and occurrence of at least one rejection
period (p < 0.02) for major bacterial/fungal infection and immunosuppression (p <
0.001), cold ischemic time (p < 0.04), occurrence of at least one rejection
period (p < 0.005) and blood volume replacement (p < 0.04) for viral infection.

Publication Types: 
    English Abstract

PMID: 9092210 [PubMed - indexed for MEDLINE]

4090: Commun Dis Rep CDR Wkly. 1996 Dec 13;6(50):433.

Shortage of varicella zoster immunoglobulin prompts restriction on use.

[No authors listed]

PMID: 8996931 [PubMed - indexed for MEDLINE]

4091: N Engl J Med. 1996 Dec 5;335(23):1769; author reply 1769.

Comment on:
    N Engl J Med. 1996 Jul 4;335(1):32-42.

Treatment of postherpetic neuralgia.

Rosler A, Schnorpfeil F, Fritz C.

Publication Types: 
    Comment
    Letter

PMID: 8965886 [PubMed - indexed for MEDLINE]

4092: N Engl J Med. 1996 Dec 5;335(23):1768-9; author reply 1769.

Comment on:
    N Engl J Med. 1996 Jul 4;335(1):32-42.

Treatment of postherpetic neuralgia.

Zenz T, Zenz M, Tryba M.

Publication Types: 
    Comment
    Letter

PMID: 8965885 [PubMed - indexed for MEDLINE]

4093: Asian Pac J Allergy Immunol. 1996 Dec;14(2):129-31.

Prevalence of anti-varicella zoster IgG antibody in undergraduate students.

Bhattarakosol P, Chantarabul S, Pittayathikhun K, Mung-mee V, Punnarugsa V.

Department of Microbiology, Faculty of Medicine, Chulalongkorn University,
Bangkok, Thailand.

Sera from 74 healthy Thai undergraduate students, mean age 21 + 1.7 years, were
tested for the presence of IgG antibody against varicella zoster virus (anti-VZV 
IgG) by ELISA. Fifty-five of 74 (74.3%) individuals possessed anti-VZV IgG
antibody. The presence of anti-VZV IgG was associated with a past history of
varicella (p < 0.005, X2 = 33.4989). No sexual preponderance was observed. We
therefore found that 1 of 4 Thai young adults was susceptible to VZV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9177828 [PubMed - indexed for MEDLINE]

4094: Br J Radiol. 1996 Dec;69(828):1187-90.

Case report: varicella-zoster virus myelitis--serial MR findings.

Hirai T, Korogi Y, Hamatake S, Ikushima I, Shigematsu Y, Takahashi M, Ando Y,
Arima T, Ando M.

Department of Radiology, Kumamoto University School of Medicine, Japan.

The authors describe a 32-year-old male in whom herpes zoster of the left upper
extremity was complicated by the development of cervical myelitis. Contrast
enhancement and abnormal signal intensity on T1 and T2 weighted images was seen
at C1-C6 levels in the spinal cord and medulla. There was also slight enlargement
of the cord at these levels. On serial MR imaging the degree of enhancement
changed from marked to none with corresponding clinical improvement.

Publication Types: 
    Case Reports

PMID: 9135480 [PubMed - indexed for MEDLINE]

4095: Soins Gerontol. 1996 Dec;(5):38-9.

[Herpes in the elderly]

[Article in French]

Portet L.

Service de Geriatrie, hopital Emile Roux, Eaubonne.

PMID: 9077297 [PubMed - indexed for MEDLINE]

4096: Rev Neurol. 1996 Dec;24(136):1532-5.

[Myelitis associated with varicella-zoster virus in the absence of cutaneous
zoster]

[Article in Spanish]

Caminero AB, Pareja JA, Echevarria JM, de Ory F.

Unidad de Neurologia, Hospital Ntra. Sra. de Sonsoles, Avila, Espana.

INTRODUCTION: The spectrum of neurological complications associated with the
infection by varicella-zoster virus (VVZ) is very broad. The diagnosis, usually
based on clinical findings and their temporal relationship with cutaneous herpes 
zoster should be confirmed by serological and/or virological techniques. However,
there are an increasing number of cases compatible with this diagnosis in the
absence of a skin rash. CLINICAL CASE: We describe the case of a previously
healthy woman of 27 who developed a neurological condition of subacute-chronic
course, not preceded by a skin rash and compatible with the diagnosis of
myelitis. She had had varicella at the age of 13. The MR of the medulla showed
two hyperintense lesions in potentiated sequences in T2 at the level of the
cervical medulla (segments C3-C4 and C6). Studies made to rule out other causes
of myelopathy were normal or negative. After the first lumbar puncture there was 
an increase in the number of cells seen (up to 50/mm3) mainly mononuclear with
oligoclonal bands, raised tibling index, antibodies (ab) IgG to VVZ and the
indexes showing specificity to these abs and their intrathecal production were
positive. Treatment with acyclovir produced no change in either her clinical
condition or in the cerebrospinal fluid findings. CONCLUSION: One should consider
the possibility of the association with VVZ in patients of any age, whether
immunodeficient or not, who present any neurological syndrome for which no other 
aetiology has been found, whether or not it is preceded by a typical skin rash.
The improvement of serological and virological methods permits precise diagnosis 
of the disorder.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9064169 [PubMed - indexed for MEDLINE]

4097: Anaesthesia. 1996 Dec;51(12):1190.

Comment on:
    Anaesthesia. 1996 Jul;51(7):647-51.

Epidural morphine and postherpetic neuralgia.

Mayne CC, Hudspith MJ, Munglani R.

Publication Types: 
    Comment
    Letter

PMID: 9038480 [PubMed - indexed for MEDLINE]

4098: J Toxicol Sci. 1996 Dec;21(5):299-300.

Strategic proposals for predicting drug-drug interactions during new drug
development: based on sixteen deaths caused by interactions of the new antiviral 
sorivudine with 5-fluorouracil prodrugs.

Watabe T.

Department of Drug Metabolism and Molecular Toxicology, School of Pharmacy, Tokyo
University of Pharmacy and Life Science, Japan.

PMID: 9035040 [PubMed - indexed for MEDLINE]

4099: West Indian Med J. 1996 Dec;45(4):127-8.

Ramsay Hunt syndrome complicated by contralateral cerebral infarction.

Barrow KO, Richards JS.

Department of Medicine, University of the West Indies, Jamaica.

Varicella-zoster virus has been associated with a variety of neurological
manifestations. We describe a patient with the Ramsay Hunt Syndrome who developed
a contralateral cerebral infarction.

Publication Types: 
    Case Reports

PMID: 9033235 [PubMed - indexed for MEDLINE]

4100: Postgrad Med J. 1996 Dec;72(854):725-30.

Comment in:
    Postgrad Med J. 1997 Jul;73(861):448.

Ophthalmic complications of HIV/AIDS.

Ah-Fat FG, Batterbury M.

St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.

As a result of improved treatment and patient survival, ophthalmic complications 
are now being seen with increasing frequency in AIDS, occurring in up to 75% of
patients during the course of the disease. The eye may be involved by an
AIDS-related microvasculopathy, which gives rise to cotton wool spots, and by
opportunistic infections caused by a wide range of organisms, including
cytomegalovirus, herpes simplex virus, varicella zoster, Toxoplasma gondii,
Mycobacterium avium-intracellulare, Treponema pallidum, Pneumocystis carinii and 
various fungal agents. Opportunistic infections may be the presenting sign of
disseminated infection. The eye may also be involved by neoplasms such as
Kaposi's sarcoma and lymphoma, and by intracranial disease. Ocular involvement
may lead to blindness if untreated and prompt ophthalmological referral is
essential. This article reviews the range of ocular diseases seen in HIV and
AIDS, current therapeutic options and outcome.

Publication Types: 
    Review

PMID: 9015465 [PubMed - indexed for MEDLINE]

4101: J Pathol. 1996 Dec;180(4):434-40.

Alterations in mast cell proteinases and protease inhibitors in the progress of
cutaneous herpes zoster infection.

Kaminska R, Harvima IT, Naukkarinen A, Nilsson G, Horsmanheimo M.

Department of Dermatology, Kuopio University Hospital, Finland.

The possible involvement of mast cell proteases in the cutaneous inflammation of 
herpes zoster was studied histochemically in ten patients. Mast cell tryptase and
chymase bioactivities were demonstrated enzyme-histochemically. The localization 
of protease inhibitors as well as tryptase and chymase proteins in mast cells was
established using a sequential double-staining method which first demonstrated
bioactive tryptase or chymase, followed by immunohistochemical identification of 
these antigens. Biopsies were taken from involved vesicular and erythematous
skin, as well as from normal healthy-looking skin. Tryptase-bioactive mast cells 
were significantly lower in number in the upper, but not in the deeper dermis of 
vesicular skin (68 +/- 37 cells/mm2, mean +/- SD) when compared with either
healthy-looking (97 +/- 38) or erythematous skin (105 +/- 36) (t-test, P <
0.005). In contrast, chymase-bioactive mast cells were significantly reduced in
number both in erythematous skin (44 +/- 20, P < 0.02) and even more so in
vesicular skin (26 +/- 20, P < 0.0005) when compared with healthy-looking skin
(64 +/- 27). The percentage of alpha 1-antitrypsin -immunoreactive and alpha
1-antichymotrypsin-immunoreactive mast cells in the upper dermis increased
steadily from the values in healthy-looking skin (37.9 +/- 18.8 and 82.5 +/- 21.6
per cent) to those in erythematous (64.4 +/- 16.4 and 93.5 +/- 7.9 per cent) and 
vesicular skin (75.2 +/- 10.2 and 96.4 +/- 4 per cent). A novel finding was that 
cells showing tryptase immunoreactivity but no enzyme activity were found in two 
out of nine erythematous skin specimens and in four out of seven vesicular
specimens. In healthy-looking skin, all cells with chymase immunoreactivity also 
displayed chymase bioactivity, but only 53.2 +/- 24.25 per cent of these mast
cells in erythematous lesions and 44.4 +/- 15.9 per cent in vesicular lesions
showed chymase bioactivity, suggesting inactivation of chymase by protease
inhibitors. These results show prominent alterations in mast cell proteinases and
protease inhibitors, indicating that these enzymes participate in the cutaneous
inflammation due to herpes zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9014866 [PubMed - indexed for MEDLINE]

4102: Aust Fam Physician. 1996 Dec;25(12):1878.

Infectious diseases case study. Could this be viral?

Golledge CL.

Clinical Microbiology and Infectious Diseases, Western Australian Centre for
Pathology and Medical Research.

Publication Types: 
    Case Reports

PMID: 9009009 [PubMed - indexed for MEDLINE]

4103: J Virol Methods. 1996 Dec;62(2):169-78.

Isolation of viruses from clinical specimens in microtitre plates with cells
inoculated in suspension.

O'Neill HJ, Russell JD, Wyatt DE, McCaughey C, Coyle PV.

Regional Virus Laboratory, Royal Hospitals Trust, Belfast, UK.

Virus isolation is essential for the provision of a full diagnostic virology
service. Present methods are time consuming, expensive and relatively inflexible 
for routine use. Our objective was to audit our existing virus isolation system
and to develop a sensitive, flexible virus isolation system which could be
adapted for use in a busy routine laboratory which is required to provide a
service for a wide range of clinical situations. We carried out a pilot study
which compared conventional roller tube monolayer cultures to a microplate system
using cells inoculated in suspension and showed that the microplate method using 
extra cell lines could provide a more sensitive system for virus isolation. This 
system was adapted for routine use using six cell lines inoculated in suspension 
and the results are presented for 2610 specimens for virus isolation and 972 for 
Clostridium difficile toxin (CDT) detection. There were 516 viruses isolated and 
229 specimens positive for CDT using this system. Polioviruses (92), echoviruses 
(35), coxsackieviruses (15) and untyped enteroviruses (13) were isolated in RMK, 
E6-vero and RD cells. Adenoviruses (137) were isolated in HEp2 and E6-vero cells.
Herpes simplex virus (HSV) was isolated from 149 specimens in E6-vero, FCL and
HFF9 cells. Myxoviruses (38) and paramyxoviruses were isolated in RMK cells. HEp2
was the only cell line necessary to isolate the 33 respiratory syncytial viruses 
(RSV). Cytomegaloviruses (CMV) (2) and varicella zoster (1) virus (VZV) were
isolated only in the human fibroblast cell line HFF9. Rubella virus was isolated 
from a baby with congenital rubella in RMK, E6-vero and additionally in BGM
cells. In conclusion, the use of cells inoculated in suspension in microtitre
plates for virus isolation was sensitive and convenient. It allowed the use of
six cell lines for routine virus isolation without using additional laboratory
staff time. It improved turnaround times. It was also safer microbiologically
than conventional isolation in tube monolayers. The precise identification of
virus isolates was simplified.

PMID: 9002075 [PubMed - indexed for MEDLINE]

4104: J Cutan Pathol. 1996 Dec;23(6):576-81.

Dermatomal lichenoid chronic graft-vs-host disease following varicella-zoster
infection despite absence of viral genome.

Baselga E, Drolet BA, Segura AD, Leonardi CL, Esterly NB.

Department of Dermatology, Medical College of Wisconsin, Milwaukee, USA.

Localized cutaneous graft-versus-host disease (GVHD) following a dermatomal
distribution or in a pattern of Blaschko's lines. Some authors have postulated
that dermatomal GVHD is triggered by a varicella-zoster virus infection, although
in reported cases, there was no history of a preceding herpes zoster. We describe
a case of GVHD localized to the exact dermatome of a culture-proven
varicella-zoster virus infection. PCR analysis failed to detect persistence of
viral genome in the affected skin.

PMID: 9001991 [PubMed - indexed for MEDLINE]

4105: S Afr Med J. 1996 Dec;86(12):1562-3.

Herpes zoster--results from a questionnaire-based surveillance of patients and
their general practitioners.

Schoub BD, Sacho H.

Publication Types: 
    Letter

PMID: 8998234 [PubMed - indexed for MEDLINE]

4106: Nippon Jibiinkoka Gakkai Kaiho. 1996 Dec;99(12):1772-9.

[Clinical features and prognosis of facial palsy and hearing loss in patients
with Ramsay Hunt syndrome]

[Article in Japanese]

Murakami S, Hato N, Horiuchi J, Miyamoto Y, Aono H, Honda N, Yanagihara N.

Department of Otolaryngology, Ehime University School of Medicine.

Clinical studies were performed on 325 patients with Ramsay Hunt syndrome who
were treated in the Facial Nerve Clinic at Ehime University Hospital between 1976
and 1995. The clinical manifestations of Ramsay Hunt syndrome were various. Three
major symptoms, auricular vesicles, facial paralysis and vestibulo-cochlear
dysfunction, were found in 57.6% of the patients although these symptoms did not 
always appear simultaneously. Auricular vesicles appeared before (19.3%), during 
(46.5%), or after (34.2%) the onset of facial paralysis. Hearing loss was
observed subjectively in only 20% but objectively in 48.2% of the patients.
Hearing loss appeared before (34.3%), during (34.3%), or after (31.3%) the onset 
of facial paralysis. Complete recovery from facial paralysis was achieved in
52.4% of the patients. Good recovery of the facial nerve function was achieved in
patients who had zoster vesicles or vestibulo-cochlear dysfunction preceding the 
development of facial paralysis. Complete recovery of hearing was also achieved
in 45.4% of the patients, and the recovery was better in patients having light
hearing loss, less than 35dB. The patients younger than 16 years old showed
better recovery from both facial paralysis and hearing loss than the patients
older than 60 years. Glossopharyngeal nerve or vagal nerve paralysis concomitant 
with facial paralysis was found in 8 (2.5%) patients. The outcome of
glossopharyngeal nerve paralysis was good but that of the vagal nerve was poor.

Publication Types: 
    English Abstract

PMID: 8997096 [PubMed - indexed for MEDLINE]

4107: Chem Pharm Bull (Tokyo). 1996 Dec;44(12):2331-4.

Synthesis and antiviral activity of 6-chloropurine arabinoside and its
2'-deoxy-2'-fluoro derivative.

Maruyama T, Sato Y, Oto Y, Takahashi Y, Snoeck R, Andrei G, Witvrouw M, De Clercq
E.

Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Japan.

6-Chloropurine arabinoside (3a) was obtained by treatment of the 2'-O-acetylated 
congener (2) with ammonia in methanol. The 3',5'-di-O-tritylated riboside (6) was
allowed to react with diethylaminosulfur trifluoride (DAST) in the presence of
pyridine to give the 2'-deoxy-2'-fluoroarabinoside (7), from which
6-chloro-9-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)purine (3b) was obtained.
The antiviral effects of 3a and 3b were assayed against several DNA and RNA
viruses. Only 3a displayed potent activity against varicella-zoster virus (VZV). 
This antiviral activity was dependent on phosphorylation by the VZV-induced
thymidine kinase (TK). Compound 3a showed moderate activity against other DNA
viruses, herpes simplex type 1 (HSV-1) and type 2 (HSV-2), and vaccinia virus.
They were equally active against TK- and TK+ strains of HSV-1, which suggests
that the HSV-1-encoded TK does not play a role in the anti-HSV-1 activity. No
activity was noted with any of the compounds against various RNA viruses,
including human immunodeficiency virus, at subtoxic concentrations.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8996865 [PubMed - indexed for MEDLINE]

4108: Br J Cancer. 1996 Dec;74(12):2013-7.

High-dose chemotherapy supported by peripheral blood progenitor cells in poor
prognosis metastatic breast cancer--phase I/II study. Edinburgh Breast Group.

Cameron DA, Craig J, Gabra H, Lee L, MacKay J, Parker AC, Leonard RC, Anderson E,
Anderson T, Chetty U, Dixon M, Hawkins A, Jack W, Kunkler I, Leonard R, Matheson 
L, Miller W.

Western General Hospital, Edinburgh, UK.

Current treatments for metastatic breast cancer are not associated with
significant survival benefits despite response rates of over 50%. High-dose
therapy with autologous bone marrow transplantation (ABMT) has been investigated,
particularly in North America, and prolonged survival in up to 25% of women has
been reported, but with a significant treatment-related mortality. However, in
patients with haematological malignancies undergoing autologous transplantation, 
haematopoietic reconstruction is significantly quicker and mortality lower than
with ABMT, when peripheral blood progenitor cells (PBPCs) are used. In 32 women
with metastatic breast cancer, we investigated the feasibility of PBPC
mobilisation with high-dose cyclophosphamide and granulocyte colony-stimulating
factor (G-CSF) after 12 weeks' infusional induction chemotherapy and the
subsequent efficacy of the haematopoietic reconstitution after conditioning with 
melphalan and either etoposide or thiotepa. PBPC mobilisation was successful in
28/32 (88%) patients, and there was a rapid post-transplantation haematopoietic
recovery: median time to neutrophils > 0.5 x 10(9) l-1 was 14 days and to
platelets > 20 x 10(9) l-1 was 10 days. There was no procedure-related mortality,
and the major morbidity was mucositis (WHO grade 3-4) in 18/32 patients (56%). In
a patient group of which the majority had very poor prognostic features, the
median survival from start of induction chemotherapy was 15 months. Thus, PBPC
mobilisation and support of high-dose chemotherapy is feasible after infusional
induction chemotherapy for patients with metastatic breast cancer, although the
optimum drug combination has not yet been determined.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase I
    Clinical Trial, Phase II

PMID: 8980406 [PubMed - indexed for MEDLINE]

4109: Br J Dermatol. 1996 Dec;135(6):1005-6.

Comment on:
    Br J Dermatol. 1996 Jan;134(1):164-6.

Leishmania infection occurring in herpes zoster lesions in an HIV positive
patient.

Del Giudice P.

Publication Types: 
    Comment
    Letter

PMID: 8977732 [PubMed - indexed for MEDLINE]

4110: J Virol. 1996 Dec;70(12):8710-8.

Expression and function of the equine herpesvirus 1 virion-associated host
shutoff homolog.

Feng X, Thompson YG, Lewis JB, Caughman GB.

Department of Oral Biology/Microbiology, Medical College of Georgia, Augusta
30912-1126, USA.

The ability of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2, respectively)
to repress host cell protein synthesis early in infection has been studied
extensively and found to involve the activities of the UL41 gene product, the
virion-associated host shutoff (vhs) protein. To date, UL41 homologs have been
identified in the genomes of three other alphaherpesviruses: equine herpesvirus 1
(EHV-1), varicella-zoster virus, and pseudorabies virus, but very little is known
about the putative products of these homologous genes. Our earlier observations
that no rapid early host protein shutoff occurred in EHV-1-infected cells led us 
to test EHV-1 vhs activity more thoroughly and to examine the expression and
function of the EHV-1 UL41 homolog, ORF19. In the present study, the effects of
EHV-1 and HSV-1 infections on cellular protein synthesis and mRNA degradation
were compared at various multiplicities of infection in several cell types under 
an actinomycin D block. No virion-associated inhibition of cellular protein
synthesis or vhs-induced cellular mRNA degradation was detected in cells infected
with any of three EHV-1 strains (Ab4, KyA, and KyD) at multiplicities of
infection at which HSV-1 strain F exhibited maximal vhs activity. However,
further analyses revealed that (i) the EHV-1 vhs homolog gene, ORF19, was
transcribed and translated into a 58-kDa protein in infected cells; (ii) the
ORF19 protein was packaged into viral particles in amounts detectable in Western 
blots (immunoblots) with monoclonal antibodies; (iii) in cotransfection vhs
activity assays, transiently-expressed ORF19 protein had intrinsic vhs activity
comparable to that of wild-type HSV-1 vhs; and (iv) this intrinsic vhs activity
was ablated by in vitro site-directed mutations in which either the functionally 
inactive HSV-1 vhs1 UL41 mutation (Thr at position 214 replaced by Ile
[Thr-214-->Ile]) was recreated within ORF19 or two conserved residues within the 
putative poly(A) binding region of the ORF19 sequence were altered (Tyr-190,
192-->Phe). From these results we conclude that EHV-1's low vhs activity in
infected cells is not a reflection of the ORF19 protein's intrinsic vhs activity 
but may be due instead to the amount of ORF19 protein associated with viral
particles or to modulation of ORF19 protein's intrinsic activity by another viral
component(s).

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8970998 [PubMed - indexed for MEDLINE]

4111: J Fam Pract. 1996 Dec;43(6):539-40.

Acyclovir or prednisone for treating herpes zoster.

Becker LA, Horst PS.

SUNY Health Science Center at Syracuse, New York, USA.

Publication Types: 
    Comparative Study

PMID: 8969699 [PubMed - indexed for MEDLINE]

4112: South Med J. 1996 Dec;89(12):1224.

Is the syndrome of inappropriate secretion of antidiuretic hormone responsible
for hyponatremia in a patient with herpes varicella zoster virus?

Calenda E, Muraine M, Dessole E.

Publication Types: 
    Case Reports
    Letter

PMID: 8969365 [PubMed - indexed for MEDLINE]

4113: Transplant Proc. 1996 Dec;28(6):3296-7.

Varicella zoster in a transplant program: experience with 15 cases and 70
contacts.

Zayas E, Gonzalez Caraballo Z, Morales Otero L, Santiago Delpin EA.

Department of Surgery, University of Puerto Rico Medical School, San Juan, Puerto
Rico 00936-5067.

PMID: 8962279 [PubMed - indexed for MEDLINE]

4114: Neurology. 1996 Dec;47(6):1441-6.

Comment in:
    Neurology. 1998 Jul;51(1):324-5.    Neurology. 1998 Jul;51(1):324; author reply 324-5.

Varicella zoster virus, a cause of waxing and waning vasculitis: the New England 
Journal of Medicine case 5-1995 revisited.

Gilden DH, Kleinschmidt-DeMasters BK, Wellish M, Hedley-Whyte ET, Rentier B,
Mahalingam R.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA.

A 73-year-old man developed an ill-defined fatal vasculitis involving the central
nervous system. The case report was published as a clinicopathologic exercise in 
February 1995 in The New England Journal of Medicine. We restudied the pathologic
material and found both varicella zoster virus (VZV) DNA and VZV-specific
antigen, but not herpes simplex virus (HSV) or cytomegalovirus (CMV) DNA or HSV- 
or CMV-specific antigen, in three of the five cerebral arteries examined. The
inflammatory response, disruption of the internal elastic lamina, and detection
of viral antigen were patchy from one artery to another, as well as within a
given artery. A search for VZV should be conducted in cases of vasculitis when
both the central and peripheral nervous systems are involved, when focal
narrowing is present in large arteries, when brain imaging reveals infarction in 
gray and white matter, both deep and superficial, and when white matter is
disproportionally involved. Zosteriform rash is not required for diagnosis.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 8960724 [PubMed - indexed for MEDLINE]

4115: Acad Emerg Med. 1996 Dec;3(12):1144-5, 1153-5.

Facial weakness and rash. Ramsay Hunt syndrome (herpes zoster cephalicus, herpes 
zoster oticus, herpes zoster auricularis).

Birinyi F.

Department of Emergency Medicine, Ohio State University, Columbus, USA.
esi@netset.com

Publication Types: 
    Case Reports
    Review

PMID: 8959171 [PubMed - indexed for MEDLINE]

4116: Ophthalmic Epidemiol. 1996 Dec;3(3):151-8.

A uveitis register at the Leicester Royal Infirmary.

Thean LH, Thompson J, Rosenthal AR.

Department of Ophthalmology, Leicester Royal Infirmary, U.K.

In the study of uveitis, epidemiology is frequently neglected. Our uveitis
register consisted of data collected on all uveitis patients except minor, easily
resolved, anterior uveitis cases at the Leicester Royal Infirmary. The diagnoses 
of these patients were classified by the aetiological method. A total of 712
patients was entered into the register over a period of 10 years starting from
January 1985. In the study, 73.0% of the cases fit into named clinical syndromes 
while 27.0% of the cases were diagnosed as idiopathic but uncategorised. The
commonest definable cause of anterior uveitis was HLA-B27-related acute anterior 
uveitis, comprising 15.2% of all uveitis cases. Intermediate uveitis accounted
for 7.9% of all cases while the commonest definable cause of posterior uveitis
was toxoplasmosis, forming 4.6% of all uveitis cases. The aim of the study was to
present data relating to diagnostic categories from a primary and secondary
uveitis clinic, and to explore the usefulness of such a uveitis register within
an ophthalmic department.

PMID: 8956319 [PubMed - indexed for MEDLINE]

4117: Arch Ophthalmol. 1996 Dec;114(12):1481-5.

Erratum in:
    Arch Ophthalmol 2000 Apr;118(4):543. Arrevalo JF [corrected to Arevalo JF].

Optic neuropathy preceding acute retinal necrosis in acquired immunodeficiency
syndrome.

Friedlander SM, Rahhal FM, Ericson L, Arevalo JF, Hughes JD, Levi L, Wiley CA,
Graham EM, Freeman WR.

Department of Pathology, University of California, San Diego, La Jolla, USA.

OBJECTIVE: To describe the clinical course of varicella-zoster optic neuropathy
preceding acute retinal necrosis in patients with acquired immunodeficiency
syndrome. DESIGN: Case series. SETTING: Two tertiary care centers in San Diego,
Calif, and London, England. PATIENTS: Three human immunodeficiency virus-positive
men with previous cutaneous zoster infection, optic neuropathy, and necrotizing
retinitis. RESULTS: All patients had an episode of zoster dermatitis treated with
acyclovir. Visual loss consistent with an optic neuropathy ensued, followed by
typical herpetic retinitis. The cause of visual loss was not suspected to be
varicella-zoster until after the retinitis occurred. Despite aggressive medical
treatment, 4 of 6 eyes progressed to retinal detachment. CONCLUSIONS:
Varicella-zoster may cause an optic neuropathy in patients with acquired
immunodeficiency syndrome, especially in those with previous shingles. A high
index of suspicion is necessary to establish the diagnosis and begin early
antizoster treatment.

Publication Types: 
    Case Reports

PMID: 8953979 [PubMed - indexed for MEDLINE]

4118: J Clin Microbiol. 1996 Dec;34(12):2869-74.

Application of long PCR method of identification of variations in nucleotide
sequences among varicella-zoster virus isolates.

Takayama M, Takayama N, Inoue N, Kameoka Y.

Department of Virology I, National Institute of Health, Tokyo, Japan.

Restriction fragment length polymorphism (RFLP) analysis of whole viral DNA of
varicella-zoster virus (VZV) requires the time-consuming and laborious
preparation of a large amount of purified viral DNA. RFLP analysis of small DNA
fragments amplified by PCR was developed as an alternative method. However, its
use has been limited because of the small number of variations in VZV. To
overcome these drawbacks and to identify variations in VZV, we developed an RFLP 
analysis method combined with the long PCR method which has recently been
developed for the amplification of DNA fragments between 5 and 35 kb in length.
We amplified three DNA regions ranging from 6.8 to 11.4 kb and demonstrated that 
RFLP analyses of these regions allowed for the classification of 40 VZV isolates 
in Japan into 17 groups. One-fourth of the isolates contained a nucleotide
difference of C versus T, which abolished the StyI site at position 76530; this
alteration was linked to the reported PstI site polymorphism at position 69349
(nucleotide positions are based on those of strain Dumas). Nucleotide sequence
variation in the examined regions among VZV isolates in Japan was estimated at
roughly less than 0.05%, confirming the previously proposed idea that VZV is
genetically stable and not highly diversified. Our method will be useful for
studies of the molecular epidemiology of VZV.

PMID: 8940414 [PubMed - indexed for MEDLINE]

4119: Hepatology. 1996 Dec;24(6):1361-5.

Prevalence of herpesviridae and hepatitis B virus DNA in the liver of patients
with non-A, non-B fulminant hepatic failure.

Mason A, Sallie R, Perrillo R, Rayner A, Xu L, Dohner DE, Dehner M, Naoumov N,
Gelb L, Saha B, O'Grady J, Williams R.

Section of Gastroenterology and Hepatology, Alton Ochsner Medical Institutions,
New Orleans, LA 70121, USA.

Members of the herpes virus family and hepatitis B virus (HBV) have been
implicated as etiologic agents in non-A, non-B (NANB) fulminant hepatic failure
(FHF), but the frequency of infection with these agents has not been established 
using appropriate controls. To examine this issue, we studied 50 NANB FHF
patients and 104 liver transplant recipients from North America and Europe.
Hepatic DNA was analyzed by polymerase chain reaction (PCR) for evidence of
Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus I (HSV I)
and II (HSV II), varicella-zoster virus (VZV), and human herpes virus-6 (HHV-6)
nucleic acid sequences. The prevalence of HBV was assessed in North American
subjects only. HSV I, HSV II, VZV, and HHV-6 viral sequences were not observed in
any samples. Three of 50 FHF (6%) and 14 of 104 control patients (13%) were
positive for CMV DNA. Two of 50 FHF (4%) and 10 of 104 control patients (10%) had
EBV DNA, and HBV DNA was observed in 3 of 10 North American FHF patients (30%)
and 3 of 59 controls (5%) without serum markers for HBV infection. The finding of
HBV DNA in the liver of seronegative controls from North America but not Europe
suggests that occult hepatitis B sequences in patients with NANB FHF may simply
reflect geographic differences. The majority of cryptogenic FHF cases cannot be
attributed to infection with herpes viruses or HBV.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8938162 [PubMed - indexed for MEDLINE]

4120: N Engl J Med. 1996 Nov 21;335(21):1587-95.

Case records of the Massachusetts General Hospital. Weekly clinicopathological
exercises. Case 36-1996. A 37-year-old man with AIDS, neurologic deterioration,
and multiple hemorrhagic cerebral lesions.

[No authors listed]

Publication Types: 
    Case Reports
    Clinical Conference

PMID: 8900094 [PubMed - indexed for MEDLINE]

4121: EMBO J. 1996 Nov 15;15(22):6096-110.

A tyrosine-based motif and a casein kinase II phosphorylation site regulate the
intracellular trafficking of the varicella-zoster virus glycoprotein I, a protein
localized in the trans-Golgi network.

Alconada A, Bauer U, Hoflack B.

European Molecular Biology Laboratory, Cell Biology Programme, Heidelberg,
Germany.

We have studied the intracellular trafficking of the envelope glycoprotein I
(gpI) of the varicella-zoster virus, a human herpes virus whose assembly is
believed to occur in the trans-Golgi network (TGN) and/or in endocytic
compartments. When expressed in HeLa cells in the absence of additional virally
encoded factors, this type-I membrane protein localizes to the TGN and cycles
between this compartment and the cell surface. The expression of gpI promotes the
recruitment of the AP-1 Golgi-specific assembly proteins onto TGN membranes,
strongly suggesting that gpI, like the mannose 6-phosphate receptors, can leave
the TGN in clathrin-coated vesicles for subsequent transport to endosomes. Its
return from the cell surface to the TGN also occurs through endosomes. The
transfer of the gpI cytoplasmic domain onto a reporter molecule shows that this
domain is sufficient to confer TGN localization. Mutational analysis of this
domain indicates that proper subcellular localization and cycling of gpI depend
on two different determinants, a tyrosine-containing tetrapeptide related to
endocytosis sorting signals and a cluster of acidic amino acids containing casein
kinase II phosphorylatable residues. Thus, the VZV gpI and the mannose
6-phosphate receptors, albeit localized in different intracellular compartments
at steady-state, follow similar trafficking pathways and share similar sorting
mechanisms.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8947032 [PubMed - indexed for MEDLINE]

4122: N Engl J Med. 1996 Nov 14;335(20):1514-21.

Case records of the Massachusetts General Hospital. Weekly clinicopathological
exercises. Case 35-1996. A 57-year-old woman with fever, sweats, neuropathy, and 
multiple pulmonary nodules.

[No authors listed]

Publication Types: 
    Case Reports
    Clinical Conference

PMID: 8890104 [PubMed - indexed for MEDLINE]

4123: Plant Physiol. 1996 Nov;112(3):1375-1381.

Nitrite Transport in Chloroplast Inner Envelope Vesicles (I. Direct Measurement
of Proton-Linked Transport).

Shingles R, Roh MH, McCarty RE.

Department of Biology, Johns Hopkins University, Baltimore, Maryland 21218-2685.

Chloroplast inner envelope membrane vesicles that are loaded with the
pH-sensitive fluorophore, pyranine, show rapid internal acidification when
nitrite is added. Acidification is dependent upon [delta]pH, with the inside of
vesicles being alkaline with respect to the outside. The rate of vesicle
acidification was directly proportional to the concentration of nitrite that was 
added and the imposed pH difference across the membrane. In contrast, added
nitrate had no effect on vesicle acidification. Nitrite also caused acidification
of asolectin vesicles. The extent of vesicle acidification is dependent on the
internal volume of vesicles. Inner envelope and asolectin vesicles that were
prepared by extrusion were approximately the same size, allowing them to be
compared when the final extent of acidification, measured after the pH gradient
had collapsed, was similar. The rate of nitrite-dependent acidification was
similar in these two preparations at any single nitrite concentration. These
results indicate that nitrite movement occurs by rapid diffusion across membranes
as nitrous acid, and this movement is dependent on a proton gradient across the
lipid bilayer. Under conditions approximating those in vivo, the rate of
diffusion of nitrous acid far exceeds that of nitrite reduction within
chloroplasts.

PMID: 12226452 [PubMed - as supplied by publisher]

4124: Clin Diagn Virol. 1996 Nov;7(2):69-76.

In situ hybridization detection of varicella zoster virus in paraffin-embedded
skin biopsy samples.

Annunziato P, Lungu O, Gershon A, Silvers DN, LaRussa P, Silverstein SJ.

Department of Pediatrics, Columbia University, College of Physicians and
Surgeons, New York, NY 10032, USA.

BACKGROUND: When virologic and molecular diagnostic techniques are unavailable,
the diagnosis of varicella zoster virus (VZV) infection depends on clinical
criteria and histologic evaluation of skin biopsy specimens or Tzank
preparations. These methods can misdiagnose chickenpox and zoster, particularly
when the clinical manifestations are atypical. OBJECTIVE: To improve diagnosis in
these settings, we developed an in situ hybridization technique for the detection
of VZV utilizing a fluorescein-labeled oligonucleotide probe visualized with
anti-fluorescein alkaline phosphatase-conjugated antibody. STUDY DESIGN: We
retrospectively examined 26 paraffin-embedded skin biopsy specimens with
histologic features consistent with VZV or herpes simplex virus (HSV) infection
and 11 control cases by in situ hybridization. In situ hybridization for VZV and 
HSV-1 was compared with polymerase chain reaction (PCR) for VZV and HSV-1 and
clinical and histologic examination. RESULTS: Thirteen of the 26 study cases and 
two of the 11 control cases were positive for VZV by in situ hybridization. When 
compared with PCR, in situ hybridization was 92% sensitive and 88% specific. When
compared with clinical diagnosis, in situ hybridization was 86% sensitive and 87%
specific. All cases of chickenpox had VZV-positive inflammatory cells in the
dermis but this finding was less frequent among the cases of zoster. CONCLUSIONS:
This in situ hybridization technique is a sensitive and specific method for the
diagnosis of VZV in skin lesions that is applicable to most histopathology
laboratory settings. In addition, in situ hybridization reveals individual
infected cells and may provide insight into the pathogenesis of VZV skin
infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9137862 [PubMed - indexed for MEDLINE]

4125: Drugs. 1996 Nov;52(5):754-72.

Valaciclovir. A review of its antiviral activity, pharmacokinetic properties and 
therapeutic efficacy in herpesvirus infections.

Perry CM, Faulds D.

Adis International Limited, Auckland, New Zealand.

Valaciclovir, the L-valyl ester of aciclovir (acyclovir), is an oral prodrug that
undergoes rapid and extensive first-pass metabolism to yield aciclovir and the
essential amino acid L-valine. Aciclovir, the active antiviral component of
valaciclovir, shows good in vitro activity against the herpesviruses herpes
simplex virus (HSV)-1, HSV-2 and varicella zoster virus. The bioavailability of
aciclovir from oral valaciclovir is considerably greater than that achieved after
oral aciclovir administration. Thus, valaciclovir delivers therapeutic aciclovir 
concentrations when administered in a less frequent oral dosage regimen than is
required for aciclovir. Valaciclovir is an effective treatment for herpes zoster 
in immunocompetent adults. In a large comparative study that included patients > 
or = 50 years of age, valaciclovir (1000mg 3 times daily for 7 or 14 days) and
oral aciclovir (800mg 5 times daily) were equally effective in achieving
resolution of cutaneous zoster lesions. Importantly, valaciclovir was
significantly more effective than aciclovir in reducing the duration of
zoster-associated pain. Preliminary results of several studies indicate that
valaciclovir (500 to 1000mg twice daily for 5 to 10 days) is as effective as
aciclovir (200mg 5 times a day for 5 to 10 days) in the treatment of genital
herpes. In patients with first or recurrent episodes of genital herpes,
valaciclovir reduced the duration of viral shedding, hastened lesion healing and 
decreased lesion-associated pain. Valaciclovir was also effective in suppressing 
recurrent episodes of genital herpes and significantly prolonged the time to a
recurrent episode of infection compared with placebo. Valaciclovir is a well
tolerated drug; in herpes zoster and HSV studies its tolerability profile was
similar to that of aciclovir or placebo. Valaciclovir represents and advance in
antiherpes drug therapy and is a useful treatment option for patients with herpes
zoster or genital herpes. It is at least as effective as aciclovir and is
administered in a more convenient oral dosage regimen. Thus, valaciclovir may
ultimately succeed aciclovir as a first-line treatment for genital herpes or
herpes zoster.

Publication Types: 
    Review

PMID: 9118821 [PubMed - indexed for MEDLINE]

4126: Rev Alerg Mex. 1996 Nov-Dec;43(6):148-51.

[Interferon alpha 2b in pain caused by herpes zoster. Preliminary report]

[Article in Spanish]

Montero Mora P, Colin D, Gonzalez Espinosa A, Almeida Arvizu V.

Departamento de alergia e inmunologia clinica, Hospital de Especialidades del
Centro Medico Nacional Siglo XXI, Mexico D.F.

We studied forty patients with Zoster Herpes, twenty two of them, with this acute
disease, eighteen with postherpetic neuralgia, to those that were considered
chronic. The evaluation of the effect of INF alpha 2b, in the secondary pain of
Zoster Herpes acute disease, in the patients with chronic severe secondary
neuralgia they shared; the evolution with the treatment for half for visual pain 
analog scale in both groups the patients with acute pain, entered for visual pain
analog scale between 10 and two points, with medium of 8.2 SD 2.1. They did not
find any significance difference with this values p < 0.6. Most of the patients
with acute pain was of 6 a 0 points with the medium a 0.27 y SD: 1,2 in the
chronics went from. 6 to 0 points with a medium of 1.27 (SD:2.4), with a
significative difference for t Student for comparation the initial scale in final
in both groups of (p < 0.0001). The comparation of the best days, the disease
bettered in acute quicker than the chronics with significance difference: (p <
0.001).

Publication Types: 
    English Abstract

PMID: 9053126 [PubMed - indexed for MEDLINE]

4127: Radiologe. 1996 Nov;36(11):897-913.

[Inflammatory diseases of the spinal cord and spinal nerve roots in the MRI]

[Article in German]

Sartoretti-Schefer S, Wichmann W, Valavanis A.

Institut fur Neuroradiologie, Universitatsspital Zurich.

PURPOSE: To evaluate characteristic and reliable MRI patterns of different
inflammatory lesions of the spinal cord and the nerve roots in immunologically
compromised and immunologically competent patients in order to be able to
establish a correct diagnosis based on MRI findings. MATERIAL AND METHODS: The
MRI examinations of 52 patients (27 men, 25 women, mean age 38.5 years, range
14-75 years) with proven inflammatory lesions (39 patients) or
tumorous/postactinic lesions of the spinal cord (6 patients) and vascular
malformations of the spinal cord (7 patients) were retrospectively analyzed. All 
examinations were performed on a 1.5 T MR unit, using bi- or triplanar T1-w pre- 
and postcontrast as well as T2-w SE sequences. Additionally, a review of the
common medical literature concerning inflammatory lesions of the spinal cord was 
included. RESULTS: Clinical and radiological examinations allow a subdivision of 
inflammations of the spinal cord and the nerve roots into (meningoradiculo)
myelitis and meningoradiculo (myelitis) in immunologically suppressed or
competent patients. The MRI patterns of these two inflammatory subtypes vary:
meningoradiculitis presents with an enhancement of the nerve roots and the
leptomeninges; myelitis itself is characterized by single or multiple, diffuse or
multifocal, with or without nodular, patchy or diffusely enhancing intramedullary
lesions, with or without thickening of the cord and leptomeningeal inflammation. 
This differentiation helps to determine the underlying etiology in some of the
patients. The immunologically suppressed patient suffers from viral infections
(especially herpes simplex, varicella-zoster virus, cytomegalovirus), bacterinal 
infections (tuberculosis), but rarely from parasitic infections. The
immunologically competent patient suffers from bacterial (borreliosis), but
rarely viral infections, sarcoidosis and demyelinating diseases. Idiopathic
myelitis is also common. CONCLUSIONS: Secondary ischemic and demyelinating
processes result in a complex morphology of inflammatory lesions on MRI, and
therefore the whole spectrum of demyelinating, ischemic and inflammatory lesions 
has to be included in the differential diagnosis. Even tumors may imitate
inflammatory myelitis and radiculitis. Most commonly, meningoradiculitis can be
separated from myelitis. A reliable diagnosis of a specific inflammatory lesion
is difficult and is mostly achieved in patients with multiple sclerosis and in
patients with HIV-associated cytomegalovirus infection.

Publication Types: 
    English Abstract
    Review

PMID: 9036432 [PubMed - indexed for MEDLINE]

4128: Radiologe. 1996 Nov;36(11):890-6.

[Inflammatory facial paralysis in MRI. An overview]

[Article in German]

Sartoretti-Schefer S, Wichmann W, Valavanis A.

Institut fur Neuroradiologie, Universitatsspital Zurich.

In inflammatory peripheral facial nerve palsy pathologically intense, linear and 
smooth enhancement of the distal intrameatal nerve segment can always be observed
on T1-w- SE- MR sequences. The other nerve segments often present with a
pathological enhancement as well. On T2-w- SE sequences, a thickening of the
distal intrameatal nerve segment can be observed. The pathological enhancement
persists over weeks and months; even in patients with complete clinical recovery,
a persistent enhancement of the distal intrameatal nerve segment can be
demonstrated. No correlation can be established between the intensity of the
enhancement, the clinical condition and the electrophysiological data on
electroneurography. The persistent enhancement of the different nerve segments is
due to a long-lasting breakdown of the blood-peripheral nerve-barrier related to 
the process of degeneration and regeneration of the facial nerve in inflammatory 
palsy.

Publication Types: 
    English Abstract
    Review

PMID: 9036431 [PubMed - indexed for MEDLINE]

4129: Internist (Berl). 1996 Nov;37(11):1168-9.

[Possible involvement of the autonomic nervous system in herpes zoster]

[Article in German]

Prange H.

Neurologische Universitatsklinik, Gottingen.

PMID: 9036114 [PubMed - indexed for MEDLINE]

4130: Vet Microbiol. 1996 Nov;53(1-2):55-66.

Lessons to be learned from varicella-zoster virus.

Rentier B, Piette J, Baudoux L, Debrus S, Defechereux P, Merville MP,
Sadzot-Delvaux C, Schoonbroodt S.

Department of Microbiology, University of Liege, Belgium. brentier@ulg.ac.be

Varicella-zoster virus (VZV) is an alphaherpesvirus responsible for two human
diseases: chicken pox and shingles. The virus has a respiratory port of entry.
After two successive viremias, it reaches the skin where it causes typical
lesions. There, it penetrates the peripheral nervous system and it remains latent
in dorsal root ganglia. It is still debatable whether VZV persists in neurons or 
in satellite cells. During latency, VZV expresses a limited set of transcripts of
its immediate early (IE) and early (E) genes but no protein has been detected.
Mechanisms of reactivation from ganglia have not been identified. However,
dysfunction of the cellular immune system appears to be involved in this process.
The cell-associated nature of VZV has made it difficult to identify a temporal
order of gene expression, but there appears to be a cascade mechanism as for
HSV-1. The lack of high titre cell-free virions or recombination mutants has
hindered so far the understanding of VZV gene functions. Five genes, ORFs 4, 10, 
61, 62, and 63 that encode regulatory proteins could be involved in VZV latency. 
ORF4p activates gene promoters with basal activities. ORF10p seems to activate
the ORF 62 promoter. ORF61p has trans-activating and trans-repressing activities.
The major IE protein ORF62p, a virion component, has DNA-binding and regulatory
functions, transactivates many VZV promoters and even regulates its own
expression. ORF63p is a nuclear IE protein of yet unclear regulatory functions,
abundantly expressed very early in infection. We have established an animal model
of VZV latency in the rat nervous system, enabling us to study the expression of 
viral mRNA and protein expression during latency, and yielding results similar to
those found in humans. This model is beginning to shed light on the molecular
events in VZV persistent infection and on the regulatory mechanisms that maintain
the virus in a latent stage in nerve cells.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 9010998 [PubMed - indexed for MEDLINE]

4131: Br J Ophthalmol. 1996 Nov;80(11):982-5.

Association of progressive outer retinal necrosis and varicella zoster
encephalitis in a patient with AIDS.

van den Horn GJ, Meenken C, Troost D.

Department of Ophthalmology, Academic Medical Center, University of Amsterdam,
The Netherlands.

BACKGROUND: A patient with AIDS who developed the clinical picture of bilateral
progressive outer retinal necrosis (PORN) in combination with varicella zoster
encephalitis is described. The picture developed more than 2 years after an
episode of ophthalmic zoster infection, and following intermittent exposure to
oral acyclovir because of recurrent episodes of cutaneous herpes simplex
infection. METHODS: Aqueous humour, obtained by paracentesis of the anterior
chamber, was analysed using immunofluorescence and polymerase chain reaction
(PCR). Postmortem analysis of eye and brain tissue was performed by using
conventional techniques and in situ hybridisation. RESULTS: While conventional
techniques all failed to detect a causative agent, analysis of the aqueous humour
using PCR, and histological examination of necropsy specimens from eyes and brain
using in situ hybridisation were conclusive for the diagnosis varicella zoster
virus (VZV) infection. CONCLUSION: This case documents the presumed association
of PORN and VZV encephalitis in a severely immunocompromised AIDS patient.

Publication Types: 
    Case Reports

PMID: 8976726 [PubMed - indexed for MEDLINE]

4132: Br J Ophthalmol. 1996 Nov;80(11):956-61.

Aetiology of uveitis in Sierra Leone, west Africa.

Ronday MJ, Stilma JS, Barbe RF, McElroy WJ, Luyendijk L, Kolk AH, Bakker M,
Kijlstra A, Rothova A.

Netherlands Opthalmic Research Institute, Amsterdam, The Netherlands.

BACKGROUND: In 1992, non-onchocercal uveitis caused 9% of blindness, 8% of visual
impairment, and 11% of uniocular blindness among patients visiting an eye
hospital in Sierra Leone, west Africa. The aim of this study was to determine the
aetiology of uveitis in this population. METHODS: General and ophthalmic
examination complemented by serum and aqueous humour analyses for various
infectious agents was performed for 93 uveitis patients and compared with serum
(n = 100) and aqueous humour (n = 9) analysis of endemic controls. RESULTS: At
the initial examination, 45 patients (48%) proved to be severely visually
handicapped. After clinical and laboratory analyses, an aetiological diagnosis
was established for 49 patients (52%). Toxoplasma gondii was the most important
cause of uveitis (40/93; 43%). Anti-toxoplasma IgM antibodies were detected in
serum samples of seven of 93 patients (8%) compared with one of 100 controls (1%,
p < 0.05). At least six patients (15%) with ocular toxoplasmosis had acquired the
disease postnatally. Antibodies against Treponema pallidum were detected in 18 of
92 patients (20%) and in 21 controls (21%). Other causes of uveitis were
varicella zoster virus (one patient), herpes simplex virus (two patients), and
HLA-B27 positive acute anterior uveitis with ankylosing spondylitis (one
patient), while one patient had presumed HTLV-I uveitis. CONCLUSIONS: In a
hospital population in Sierra Leone, west Africa, uveitis was associated with
severe visual handicap and infectious diseases. Toxoplasmosis proved to be the
most important cause of the uveitis. Although the distribution of congenital
versus acquired toxoplasmosis in this population could not be determined, the
results indicate an important role of postnatally acquired disease. The results
further suggested minor roles for HIV, tuberculosis, toxocariasis, and
sarcoidosis as causes of uveitis in this population.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8976721 [PubMed - indexed for MEDLINE]

4133: J Pain Symptom Manage. 1996 Nov;12(5):290-9.

Postherpetic neuralgia and its treatment: a retrospective survey of 191 patients.

Bowsher D.

Pain Research Institute, Walton Hospital, Liverpool, United Kingdom.

One hundred and ninety-one patients with postherpetic neuralgia (PHN) in whom
treatment was begun 3 or more months after acute herpes zoster (HZ) were
retrospectively considered. Relieved (> or = 75% fall in visual analogue score
for worst pain within last 24 hr) and unrelieved groups were subdivided into
those who had and those who had not received antiviral treatment for their acute 
shingles. More than 90% of all patients experienced allodynia with a clinically
evident sensory deficit for temperature and/or pinprick sensation. The
probability of relief is worst in patients with PHN of the isolated ophthalmic
nerve and of the brachial plexus, and best when involving the jaw, neck, and
trunk. The presence (90%) or absence of allodynia has no predictive significance;
but the small number of patients without allodynia or sensory deficit (all of
whom had had antiviral treatment for their acute shingles) all improved. The
probability of pain relief was found to correlate very strongly with the brevity 
of the interval between rash onset and commencement of treatment with an
adrenergically active antidepressant. Further, time to relief in patients treated
with an antidepressant starting at the same interval after HZ is significantly
shorter in patients who received acyclovir for their original HZ. With the
possible exception of dextroamphetamine added to the antidepressant, other
treatments (particularly analgesics, anticonvulsants, and sympathetic blockade)
were found to be without value in most cases. Thirty percent of patients who
recover from PHN and have had their original shingles treated with acyclovir
subsequently suffer from severe itching. It is recommended that elderly patients 
be given low-dose antidepressant on diagnosis of shingles, and asked to report
back in 6 weeks. If they are pain-free at this interval, low-dose antidepressant 
should be continued for another month or so and then stopped. If, however, pain
is present at 6 weeks, the dose of antidepressant should be increased and the
patient reviewed every 2 months.

PMID: 8942124 [PubMed - indexed for MEDLINE]

4134: Orthopedics. 1996 Nov;19(11):976-7.

Herpes zoster related lumbar radiculopathy.

Shapiro M.

Tahoe Spine Center, Incline Village, Nev, USA.

Publication Types: 
    Case Reports

PMID: 8936535 [PubMed - indexed for MEDLINE]

4135: AIDS. 1996 Nov;10(13):1604-6.

AIDS-related varicella zoster meningoencephalitis and radicular pain without
cutaneous eruption.

Debat Zoguereh D, Saadoun R, Zandotti C, Cawston P, Moreau J.

Publication Types: 
    Case Reports
    Letter

PMID: 8931804 [PubMed - indexed for MEDLINE]

4136: J Med Virol. 1996 Nov;50(3):244-8.

Effect of acyclovir and prednisolone on the serological response in herpes
zoster.

Bates CJ, Kudesia G, McKendrick MW.

Sheffield Public Health Laboratory, England.

The serological response of patients with acute herpes zoster was studied to
determine whether a diagnosis could be made on a single serum sample, and whether
this response was modified by treatment with antiviral and/or steroid therapy.
The patients received one of four regimes of acyclovir and prednisolone,
Varicella zoster virus (VZV) IgG, IgM, and IgA responses were measured by
commercial and in-house enzyme immunoassays (EIA) using serum samples taken at
days 0, 7, and 21 after entry into the study. Samples were also tested for IgM to
Epstein-Barr virus (EBV) viral capsid antigen (VCA), and cytomegalovirus (CMV)
IgM and for herpes simplex virus (HSV) antibodies by the complement fixation test
(CFT). Analysis was carried out on data from 71 patients. VZV IgM was detected in
72%, VZV IgA in 78%, and either VZV IgM or IgA in 88% of patients tested, at some
time during the 3-week study period. The optimal time to detect either class of
antibody was approximately 1 week after the onset of the vesicular rash, when 85%
of patients had one or both classes of acute phase antibody in their serum. There
was no evidence of cross reaction with EBV, CMV, or HSV antibodies. Neither
treatment with prednisolone nor the length of therapy with acyclovir affected
significantly the VZV IgM or IgA responses. Therefore it is possible to make a
serological diagnosis of herpes zoster on a single sample, optimally 1 week after
the onset of the rash, in patients treated with acyclovir alone or with acyclovir
and steroids.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8923289 [PubMed - indexed for MEDLINE]

4137: Clin Infect Dis. 1996 Nov;23(5):990-5.

Herpes zoster and progression to AIDS in a cohort of individuals who
seroconverted to human immunodeficiency virus. Italian HIV Seroconversion Study.

Alliegro MB, Dorrucci M, Pezzotti P, Rezza G, Sinicco A, Barbanera M, Castelli F,
Tarantini G, Petrucci A.

Centro Operativo AIDS, Istituto Superiore di Sanita, Rome, Italy.

A prospective study of 1,198 individuals who seroconverted to human
immunodeficiency virus (HIV) was conducted to estimate the incidence and
determinants of herpes zoster and to determine whether herpes zoster can
accelerate the progression to AIDS. Herpes zoster was diagnosed for 48
individuals (4%). After adjusting for the CD4 cell count, individuals acquiring
HIV infection through sexual contact were more likely to have herpes zoster than 
were injection drug users (relative hazard, 1.50). The crude relative hazard of
AIDS for individuals who had herpes zoster compared with those without herpes
zoster was 2.44; the adjusted relative hazard was 1.08. After adjusting for the
CD4 cell count, fever was the only specific characteristic of herpes zoster that 
was significantly associated with a more rapid progression to AIDS (relative
hazard, 6.52). Data suggest that herpes zoster occurs more frequently in
individuals acquiring HIV infection through sexual transmission. There was no
evidence that herpes zoster per se is an independent cofactor of progression of
HIV disease, although febrile episodes of herpes zoster may predict a faster
progression to AIDS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8922791 [PubMed - indexed for MEDLINE]

4138: Pancreas. 1996 Nov;13(4):356-71.

Infectious causes of acute pancreatitis.

Parenti DM, Steinberg W, Kang P.

Division of Infectious Diseases, George Washington University Medical Center,
Washington, DC 20037, USA.

A wide variety of infectious agents has been associated with acute pancreatitis. 
Strict diagnostic criteria were developed to assess with relationship between
individual microorganisms and acute pancreatitis. Pathologic or radiologic
evidence of pancreatitis associated with well-documented infection was noted with
viruses (mumps, coxsackie, hepatitis B, cytomegalovirus, varicella-zoster virus, 
herpes simplex virus), bacteria (Mycoplasma, Legionella, Leptospira, Salmonella),
fungi (Aspergillus), and parasites (Toxoplasma, Cryptosporidium, Ascaris). Clues 
to the infectious nature of pancreatitis lay in the characteristic signs and
symptoms associated with the particular infectious agent. How often these agents 
are responsible for idiopathic pancreatitis is unclear.

Publication Types: 
    Review

PMID: 8899796 [PubMed - indexed for MEDLINE]

4139: Cornea. 1996 Nov;15(6):633-4.

Presumed bilateral herpes zoster ophthalmicus in an AIDS patient: a case report.

Yau TH, Butrus SI.

Department of Ophthalmology, Washington Hospital Center, DC, USA.

A 31-year-old man with the acquired immunodeficiency syndrome presented with
herpes zoster ophthalmicus on the right. Five days after he began treatment for
the zoster pseudodendrites and skin lesions, he developed superficial punctate
keratitis, uveitis, and crusting skin lesions in the left eye. After treatment,
the ocular lesions resolved in both eyes without incident. The bilateral
manifestation of herpes zoster ophthalmicus is a result of the increased severity
associated with immunosuppression caused by the human immunodeficiency virus.

Publication Types: 
    Case Reports

PMID: 8899277 [PubMed - indexed for MEDLINE]

4140: J Virol. 1996 Nov;70(11):7878-84.

Synthesis, processing, and oligomerization of bovine herpesvirus 1 gE and gI
membrane proteins.

Whitbeck JC, Knapp AC, Enquist LW, Lawrence WC, Bello LJ.

Department of Pathobiology, School of Veterinary Medicine, University of
Pennsylvania, Philadelphia 19104-6049, USA.

This study reports the identification and initial characterization of the
precursors, modified forms, and oligomers of bovine herpesvirus 1 (BHV-1) gI and 
gE proteins with polyvalent rabbit serum specific for gI or gE. Our experiments
used the Colorado strain of BHV-1 and mutant viruses with insertions of the
Escherichia coli lacZ gene into the predicted gE and gI reading frames. We also
translated the gE and gI open reading frames in vitro and expressed them in
uninfected cells using eukaryotic expression vectors. Precursor-product
relationships were established by pulse-chase analysis and endoglycosidase H and 
glycopeptidase F digestions. Like the homologous glycoproteins of herpes simplex 
virus type 1, pseudorabies virus, and varicella-zoster virus, BHV-1 gI and gE are
modified by N-linked glycosylation and associate with each other soon after
synthesis, forming a noncovalent complex in infected and transfected cells. An
analysis of mutant and wild-type-virus-infected cells and transfected COS cells
expressing gE or gI alone suggested that gE-gI complex formation is necessary for
efficient processing of the gE precursor to its mature form. One new finding was 
that unlike the other alphaherpesvirus gI homologs, a fraction of pulse-labeled
gI synthesized in BHV-1-infected cells apparently is cleaved into two relatively 
stable fragments 2 to 4 h after the pulse. Finally, we incubated BHV-1-infected
cell extracts with nonimmune mouse, rabbit, horse, pig, and calf sera and found
no evidence that gE or gI functioned as Fc receptors as reported for the herpes
simplex virus type 1 and varicella-zoster virus homologs.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 8892910 [PubMed - indexed for MEDLINE]

4141: Ugeskr Laeger. 1996 Oct 28;158(44):6282-4.

[Painful skin eruptions precedes prolonged pain in herpes zoster. Four cases from
general practice and a review]

[Article in Danish]

Kardel T.

Four cases of herpes zoster with prolonged severe pain illustrate the dilemma
that specific antiviral therapy cannot be instituted at onset of symptoms in the 
cases that would most benefit from such therapy: In all four cases the
characteristic skin eruption was preceded by severe, but unspecific, pain for
several days.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8966814 [PubMed - indexed for MEDLINE]

4142: Rev Prat. 1996 Oct 15;46(16):2009-14.

[Varicella and herpes zoster. Epidemiology, physiopathology, diagnosis,
development, treatment]

[Article in French]

Perronne C.

Service des maladies infectieuses et tropicales, hopital Raymond-Poincare,
Garches.

PMID: 8978209 [PubMed - indexed for MEDLINE]

4143: Hosp Pract (Minneap). 1996 Oct 15;31(10):42.

Comment on:
    Hosp Pract (Minneap). 1996 Jul 15;31(7):137-44.

Expanding zoster's differential diagnosis.

Kahn CB.

Publication Types: 
    Comment
    Letter

PMID: 8859205 [PubMed - indexed for MEDLINE]

4144: Arch Pathol Lab Med. 1996 Oct;120(10):956-8.

Verrucous herpes virus infection in human immunodeficiency virus patients.

Fagan WA, Collins PC, Pulitzer DR.

Division of Dermatology, The University of Texas Health Science Center at San
Antonio, USA.

OBJECTIVE: Two cases of varicella-zoster virus infection that were clinically and
pathologically verrucous are reported. Although this phenomenon has previously
been described in the dermatology literature, it has not, to our knowledge, been 
described in the pathology literature. It is important that pathologists are
aware of these uncommon but histologically distinctive lesions. DATA SOURCES: The
patients were seen and treated at the Departments of Dermatology of the
University of Texas Health Science Center at San Antonio and Brackenridge
Hospital in Austin, Tex. All information was derived from the medical records and
from the attending physicians. CONCLUSIONS: Verrucous lesions of herpes
(varicella) zoster virus infection are rare, but they do occur in patients with
the acquired immunodeficiency syndrome. Clinically, the lesions studied resembled
ordinary papillomavirus-induced verrucae. Histologically, there was verrucoid
epidermal hyperplasia and, unlike ordinary lesions of herpes (varicella) zoster, 
very little inflammation of the dermis. Diagnostic multinucleated keratinocytes
with herpesvirus cytopathic changes were present within the stratum corneum.

Publication Types: 
    Case Reports

PMID: 12046608 [PubMed - indexed for MEDLINE]

4145: Rev Neurol (Paris). 1996 Oct;152(10):587-601.

[Central nervous system infections in patients with malignant diseases]

[Article in French]

Carpentier AF, Bernard L, Poisson M, Delattre JY.

Hopital de la Salpetriere, Service de Neurologie du Pr Brunet, Paris.

Infections of the nervous system remain a significant source of morbidity and
mortality in patients with cancer. This paper reviews the main pathogens and
emphasizes some of the principles of diagnosis and management of nervous system
infections in cancer patients. Due to immunosuppression, diagnosis is more
difficult in this group, secondary to the multitude of potential pathogens, and
often by their atypical presentations. Fever or headache are often the only
symptoms. Clinical history and general examination should guide appropriate
studies such as neuroimaging. CSF analysis, cultures, and brain biopsy.
Diagnostic evaluation should be pursued rapidly and aggressively since specific
treatments can often reduce morbidity and mortality. Bacterial infections are
generally due to break-down of the natural barriers and neutropenia. In
neutropenia, Pseudomonas aeruginosa, and Enterobacteriae are the most frequent
etiology. If all causes of immunodepression are included, Listeria monocytogenes 
meningitis is the main bacterial infection encountered. Fungal infections have
emerged as a major cause of death among cancer patients. The prognosis of
cryptococcosis and histoplasmosis meningitis are markedly improved with new
antifungal therapy. Aspergillosis and Mucormycosis, which may cause cerebral
abcesses and secondary vascular complications, are almost always fatal. The
incidence of meningo-cerebral Candidiasis is often underestimated. Similar to
Histoplasmosis, it is frequently disseminated. Viral infections are mainly seen
in patients with T-lymphocyte defects. Herpes-simplex virus and Varicella-Zoster 
virus encephalitis should quicky lead to intravenous treatment with Acyclovir. As
in AIDS patients, cerebral toxoplasmosis is the most frequent parasitic infection
and appropriate therapy greatly reduces morbidity. It should be emphasized that
multitude pathogens are often seen in cancer patients. Despite development of new
therapeutic agents, central nervous system infections should still be considered 
life-threatening. Therefore, antibacterial, antifungal, and antiviral prophylaxis
should be the rule for all cancer patients.

Publication Types: 
    English Abstract
    Review

PMID: 9033951 [PubMed - indexed for MEDLINE]

4146: J Laryngol Otol. 1996 Oct;110(10):918-21.

Impaired specific cellular immunity to the varicella-zoster virus in patients
with herpes zoster oticus.

Ikeda M, Hiroshige K, Abiko Y, Onoda K.

Department of Otolaryngology, Nihon University School of Medicine, Tokyo, Japan.

The possible involvement of depression on cellular immunity in reactivation of
varicella-zoster virus (VZV) in herpes zoster oticus was investigated. The
subjects comprised 59 cases of herpes zoster oticus, 33 cases of herpes zoster
sine herpete (ZSH) with facial paralysis, and 205 cases of Bell's palsy. The
transformation rate of lymphocytes to phytohaemagglutinin in herpes zoster oticus
tended to be lower than that in Bell's palsy. In skin tests with purified protein
derivatives of tuberculin, the positivity rate in herpes zoster oticus was
significantly lower than that in Bell's palsy (p < 0.015). In skin tests using
VZV antigen the positivity rate in herpes zoster oticus and ZSH were
significantly lower than that of Bell's palsy (p < 0.001 and p < 0.015,
respectively). Thus, it was noted that cellular immunity, especially specific
cellular immunity against VZV, was significantly depressed in herpes zoster
oticus and ZSH. We consider that depression of specific cellular immunity plays
an important role in triggering reactivation of VZV and onset of these diseases.

PMID: 8977852 [PubMed - indexed for MEDLINE]

4147: Emerg Infect Dis. 1996 Oct-Dec;2(4):361-2.

Epidemic zoster and AIDS.

Morens DM, Agarwal AK, Sarkar S, Panda S, Detels R.

Publication Types: 
    Letter

PMID: 8969257 [PubMed - indexed for MEDLINE]

4148: Pain. 1996 Oct;67(2-3):241-51.

Pain and its persistence in herpes zoster.

Dworkin RH, Portenoy RK.

Department of Anesthesiology, Columbia University College of Physicians and
Surgeons, New York, NY 10032, USA.

The nature and duration of pain associated with herpes zoster is highly variable.
This review of research on pain in acute herpes zoster and postherpetic neuralgia
(PHN) explores those observations relevant to the definition and pathogenesis of 
PHN and the design of treatment trials. A model for the pathogenesis of PHN is
presented, which gains support from studies of risk factors. Several directions
for future research are identified.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8951917 [PubMed - indexed for MEDLINE]

4149: Acta Ophthalmol Scand. 1996 Oct;74(5):506-8.

Progressive outer retinal necrosis in an immunocompetent patient.

Carrillo-Pacheco S, Vazquez-Marouschek MC, Lopez-Checa F, Sanchez-Roman J.

Department of Ophthalmology, Hospital Universitario Virgen del Rocio, Seville,
Spain.

Progressive outer retinal necrosis syndrome is a variant of necrotizing herpetic 
retinopathy, a group of retinal infections caused by the herpes viruses. It has
been described only in immunosuppressed patients. We present a healthy
immunocompetent 16-year-old male who suffered a bilateral progressive outer
retinal necrosis. Varicella-zoster virus infection was confirmed on the basis of 
serologic study. Treatment with intravenous acyclovir and oral prednisone was
successful.

Publication Types: 
    Case Reports

PMID: 8950404 [PubMed - indexed for MEDLINE]

4150: Infect Control Hosp Epidemiol. 1996 Oct;17(10):694-705.

Prevention and control of varicella-zoster infections in healthcare facilities.

Weber DJ, Rutala WA, Hamilton H.

Division of Infectious Disease, University of North Carolina School of Medicine, 
USA.

Varicella-zoster virus (VZV) is the causative agent of two diseases: varicella
(chickenpox) and zoster (shingles). Although varicella generally is a mild
disease in children, serious morbidity and mortality are common if infection
occurs in neonates, pregnant women, adults, or immunocompromised patients. For
this reason, the Centers for Disease Control and Prevention recommends that all
the hospitals institute control measures. Healthcare workers should be screened
for VZV immunity and, if susceptible, should receive the recently licensed
Oka/Merck vaccine (unless contraindicated). This article reviews nosocomial
outbreaks associated with VZV and provides detailed algorithms for preexposure
immunization and postexposure management of healthcare workers exposed to VZV.

Publication Types: 
    Review

PMID: 8899447 [PubMed - indexed for MEDLINE]

4151: Clin Microbiol Rev. 1996 Oct;9(4):448-68.

Pediatric human immunodeficiency virus infection.

Domachowske JB.

Pediatric Infectious Disease, State University of New York Health Science Center,
Syracuse 13210, USA. jdomach@helix.nih.gov

In the past decade, an increase in pediatric human immunodeficiency virus (HIV)
infection has had a substantial impact on childhood morbidity and mortality
worldwide. The vertical transmission of HIV from mother to infant accounts for
the vast majority of these cases. Identification of HIV-infected pregnant women
needs to be impoved so that appropriate therapy can be initiated for both mothers
and infants. While recent data demonstrate a dramatic decrease in HIV
transmission from a subset of women treated with zidovudine during pregnancy,
further efforts at reducing transmission are desperately needed. This review
focuses on vertically transmitted HIV infection in children, its epidemiology,
diagnostic criteria, natural history, and clinical manifestations including
infectious and noninfectious complications. An overview of the complex medical
management of these children ensues, including the use of antiretroviral therapy.
Opportunistic infection prophylaxis is reviewed, along with the important role of
other supportive therapies.

Publication Types: 
    Review

PMID: 8894346 [PubMed - indexed for MEDLINE]

4152: Int J Dermatol. 1996 Oct;35(10):749-50.

Treatment of herpes zoster with interferon alpha-2A.

Naoum C, Perissios A, Varnavas V, Lagos D.

Department of Dermatology, General Hospital of Athens, "Evagelismos," Greece.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 8891834 [PubMed - indexed for MEDLINE]

4153: Am J Ophthalmol. 1996 Oct;122(4):586-8.

Varicella-zoster virus retrobulbar optic neuritis in a patient with human
immunodeficiency virus.

Shayegani A, Odel JG, Kazim M, Hall LS, Bamford N, Schubert H.

Department of Ophthalmology, Edward S. Harkness Eye Institute, USA.

PURPOSE: To determine the cause of bilateral retrobulbar optic neuritis followed 
by progressive outer retinal necrosis in a patient with human immunodeficiency
virus (HIV). METHODS: Extensive ophthalmologic, neurologic, infectious disease,
rheumatologic, and radiologic examinations were performed. RESULTS: Cerebrospinal
fluid samples taken after the onset of bilateral retrobulbar optic neuritis and
before the development of clinical progressive outer retinal necrosis disclosed
varicella-zoster virus from polymerase chain reaction and viral culture.
CONCLUSION: Ophthalmologists and neurologists should consider varicella-zoster
virus optic neuritis as a potential precursor of progressive outer retinal
necrosis and as a cause of retrobulbar optic neuritis in patients infected with
HIV.

Publication Types: 
    Case Reports

PMID: 8862063 [PubMed - indexed for MEDLINE]

4154: Am J Emerg Med. 1996 Oct;14(6):588-601.

Dermatologic problems encountered in the emergency department.

Ferrera PC, Dupree ML, Verdile VP.

Department of Emergency Medicine, Albany Medical College, USA.

Publication Types: 
    Review

PMID: 8857814 [PubMed - indexed for MEDLINE]

4155: Neurology. 1996 Oct;47(4):929-31.

Zoster myelitis: improvement with antiviral therapy in two cases.

de Silva SM, Mark AS, Gilden DH, Mahalingam R, Balish M, Sandbrink F, Houff S.

Department of Neurology, Veterans Affairs Medical Center, Washington, DC 20422,
USA.

This report describes two patients with acquired immunodeficiency syndrome (AIDS)
and herpes zoster myelopathy. Patient one had a T-8 myelitis that preceded the
onset of T-8-distribution zoster and was followed by cervical myelopathy.
Antibody to varicella zoster virus (VZV) was present in the CSF. He never
received steroids or other immunosuppressive drugs, and his condition improved
dramatically after treatment with intravenous acyclovir. The second patient had a
rapidly progressive myelitis with paralysis of both legs. Detection of VZV DNA
and antibody to VZV in his CSF led to successful treatment with famciclovir
despite discontinuation of dexamethasone and earlier treatment failure with
acyclovir. These cases support the idea that VZV myelopathy in the
immunosuppressed host is caused by virus invasion. CSF analysis for antiviral
antibody and for VZV DNA by polymerase chain reaction are helpful in establishing
the diagnosis. Aggressive antiviral therapy is advised.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 8857721 [PubMed - indexed for MEDLINE]

4156: Ann Intern Med. 1996 Oct 1;125(7):549-57.

Comment in:
    Ann Intern Med. 2002 Sep 17;137(6):545-6; author reply 545-6.

Methylprednisolone and cyclophosphamide, alone or in combination, in patients
with lupus nephritis. A randomized, controlled trial.

Gourley MF, Austin HA 3rd, Scott D, Yarboro CH, Vaughan EM, Muir J, Boumpas DT,
Klippel JH, Balow JE, Steinberg AD.

National Institutes of Health, Bethesda, Maryland, USA.

BACKGROUND: Uncertainty exists about the efficacy and toxicity of bolus therapy
with methylprednisolone or of the combination of methylprednisolone and
cyclophosphamide in the treatment of lupus nephritis. OBJECTIVE: To determine 1) 
whether intensive bolus therapy with methylprednisolone is an adequate substitute
for bolus therapy with cyclophosphamide and 2) whether the combination of
methylprednisolone and cyclophosphamide is superior to bolus therapy with
methylprednisolone or cyclophosphamide alone. DESIGN: Randomized, controlled
trial with at least 5 years of follow-up. SETTING: Government referral-based
research hospital. PATIENTS: 82 patients with lupus nephritis who had 10 or more 
erythrocytes per high-power field, cellular casts, proteinuria (> 1 g of protein 
per day), and a renal biopsy specimen that showed proliferative nephritis.
INTERVENTIONS: Bolus therapy with methylprednisolone (1 g/m2 body surface area), 
given monthly for at least 1 year; bolus therapy with cyclophosphamide (0.5 to
1.0 g/m2 body surface area), given monthly for 6 months and then quarterly; or
bolus therapy with both methylprednisolone and cyclophosphamide. MEASUREMENTS: 1)
Renal remission (defined as < 10 dysmorphic erythrocytes per high-power field,
the absence of cellular casts, and excretion of < 1 g of protein per day without 
doubling of the serum creatinine level), 2) prevention of doubling of the serum
creatinine level, and 3) prevention of renal failure requiring dialysis. RESULTS:
Renal remission occurred in 17 of 20 patients in the combination therapy group
(85%), 13 of 21 patients in the cyclophosphamide group (62%), and 7 of 24
patients in the methylprednisolone group (29%) (P < 0.001). Twenty-eight patients
(43%) did not achieve renal remission. By life-table analysis, the likelihood of 
remission during the study period was greater in the combination therapy group
than in the methylprednisolone group (P = 0.028). Combination therapy and
cyclophosphamide therapy were not statistically different. Adverse events were
amenorrhea (seen in 41% of the cyclophosphamide group, 43% of the combination
therapy group, and 7.4% of the methylprednisolone group), cervical dysplasia
(seen in 11% of the cyclophosphamide group. 7.1% of the combination therapy
group, and 0% of the methylprednisolone group), avascular necrosis (seen in 11%
of the cyclophosphamide group, 18% of the combination therapy group, and 22% of
the methylprednisolone group), herpes zoster (seen in 15% of the cyclophosphamide
group, 21% of the combination therapy group, and 3.7% of the methylprednisolone
group) and at least one infection (seen in 26% of the cyclophosphamide group. 32%
of the combination therapy group, and 7.4% of the methylprednisolone group).
CONCLUSIONS: Monthly bolus therapy with methylprednisolone was less effective
than monthly bolus therapy with cyclophosphamide. A trend toward greater efficacy
with combination therapy was seen.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 8815753 [PubMed - indexed for MEDLINE]

4157: Nature. 1996 Sep 19;383(6597):275-9.

Unique fold and active site in cytomegalovirus protease.

Qiu X, Culp JS, DiLella AG, Hellmig B, Hoog SS, Janson CA, Smith WW, Abdel-Meguid
SS.

Department of Macromolecular Sciences, SmithKline Beecham Pharmaceuticals, King
of Prussia, Pennsylvania 19406, USA.

Human herpesviruses are responsible for a variety of diseases. They are divided
into three subfamilies: alpha includes herpes simplex viruses (HSV-1 and HSV-2)
and varicella-zoster virus (VZV); beta includes cytomegalovirus (CMV) and human
herpesvirus-6 (HHV-6); and gamma includes Epstein-Barr virus (EBV). Each virus
encodes a serine protease that is essential for its replication and is a
potential target for therapeutic intervention. Human CMV is a ubiquitous
opportunistic pathogen that can result in life-threatening infections in
congenitally infected infants, immunocompromised individuals and immunosuppressed
cancer or transplant patients. Here we report the crystal structure of human CMV 
protease at 2.5 angstroms resolution. The structure reveals a fold that has not
been reported for any other serine protease, and an active site consisting of a
novel catalytic triad in which the third member is a histidine instead of an
aspartic acid, or possibly a catalytic tetrad consisting of a serine, two
histidines and an aspartic acid. An unusual dimer interface that is important to 
the protease activity has also been identified.

PMID: 8805707 [PubMed - indexed for MEDLINE]

4158: P N G Med J. 1996 Sep;39(3):196-9.

Ocular manifestations of AIDS.

Verma N, Kearney J.

Port Moresby General Hospital, Papua New Guinea.

The acquired immune deficiency syndrome (AIDS) is a lethal multisystem disease.
Its ocular manifestations have received relatively little attention in the
literature. Between 73% and 100% of AIDS patients develop ocular lesions. The
commonest lesions seen are retinal--either infectious or noninfectious
retinopathy. Involvement of the conjunctiva with Kaposi's sarcoma, infected tears
and infected cornea as well as the vitreous are less common. Infections with
cytomegalovirus and varicella zoster virus are common causes of visual loss and
can be treated with antiviral agents such as ganciclovir and foscarnet. This
greatly increases the quality of life in these patients by preventing visual
loss.

PIP: Ocular manifestations of AIDS, which occur in 73-100% of AIDS patients, are 
important to diagnose given their treatability. The most common AIDS-related
ocular lesions are cotton wool spots and noninfectious retinopathies,
cytomegalovirus retinitis, and conjunctival Kaposi's sarcoma. Less common are
herpes zoster ophthalmicus, retinal toxoplasmosis, choroidal Pneumocystis carinii
infection, herpes simplex and herpes zoster retinitis, and cryptococcal
choroiditis. Administration of antiretroviral agents such as ganciclovir and
foscarnet can prevent blindness, but their serious toxicity and the lack of oral 
preparations remain problematic.

Publication Types: 
    Review

PMID: 9795562 [PubMed - indexed for MEDLINE]

4159: P N G Med J. 1996 Sep;39(3):174-80.

HIV infection and AIDS.

Lloyd A.

Prince Henry Hospital, Sydney, Australia.

Many of the clinical features of HIV/AIDS can be ascribed to the profound immune 
deficiency which develops in infected patients. The destruction of the immune
system by the virus results in opportunistic infection, as well as an increased
risk of autoimmune disease and malignancy. In addition, disease manifestations
related to the virus itself may occur. For example, during the primary illness
which occurs within weeks after first exposure to HIV, clinical symptoms occur in
at least 50% of cases, typically as a mononucleosis syndrome. HIV-related
complications are rarely encountered in patients with preserved immunity (i.e.
CD4 T-cell counts greater than 500 cells/mm3). Recurrent mucocutaneous herpes
simplex (HSV), herpes zoster (VZV), oral candidiasis and oral hairy leukoplakia
occur with increasing frequency as the CD4 count drops below this level. Immune
thrombocytopenia (ITP) occurs in association with HIV and often presents early in
the clinical course. The risk of developing opportunistic infections and
malignancies typical of AIDS increases progressively as CD4 counts fall below 200
cells/mm3. The clinical manifestations of infections associated with AIDS tend to
fall into well-recognized patterns of presentation, including pneumonia,
dysphagia/odynophagia, diarrhoea, neurological symptoms, fever, wasting, anaemia 
and visual loss. The commonest pathogens include Candida albicans, Pneumocystis
carinii, Mycobacterium tuberculosis, Toxoplasma gondii, Cryptococcus neoformans, 
Mycobacterium avium intracellulare and cytomegalovirus. Malignant disease in
patients with HIV infection also occurs in a characteristic pattern. Only two
tumours are prevalent: Kaposi's sarcoma, a multifocal tumour of vascular
endothelium which typically involves skin and mucosal surfaces; and non-Hodgkin's
lymphoma, which is typically high grade in phenotype, often arising within the
central nervous system. The principles of therapy include reduction of HIV
replication by antiretroviral agents, prophylaxis against the common
opportunistic infections and treatment followed by subsequent lifelong
maintenance therapy for infections when they do occur.

PIP: This article presents basic information on the clinical features of HIV
infection, most of which are related to the profound immune deficiency associated
with HIV/AIDS. Primary HIV infection is associated with clinical symptoms,
primarily a mononucleosis syndrome, in about 50% of cases. In the ensuing 10
years, more than 50% of HIV-infected individuals develop the opportunistic
infections (OIs) indicative of the onset of AIDS. Common presentations of AIDS
include pneumonia, dysphagia, diarrhea, neurologic symptoms, fever, wasting,
anemia, and vision loss. Monitoring of peripheral blood CD4 T-lymphocytes
provides a measure of the current risk of OIs and a guide for antiretroviral
therapy. Protease inhibitors, used in combination with other antiretrovirals,
allow long-term control of HIV disease, but the substantial cost of these drugs
has prohibited their widespread use in developing countries. Treatment of
HIV-related infections must be followed by a maintenance regimen intended to
prevent relapse.

Publication Types: 
    Review

PMID: 9795558 [PubMed - indexed for MEDLINE]

4160: J Tradit Chin Med. 1996 Sep;16(3):214-7.

Acupuncture treatment of dermopathies and pediatric diseases.

Sun Y, Wang D.

Beijing College of Acupuncture and Traumatology.

PMID: 9389123 [PubMed - indexed for MEDLINE]

4161: J Ophthalmic Nurs Technol. 1996 Sep-Oct;15(5):205-12.

Ocular manifestations of AIDS.

Vrabec TR.

Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

1. Cytomegalovirus retinitis is the leading cause of AIDS-related blindness. 2.
Patients with reduced CD4 counts are at risk of developing cytomegalovirus
retinitis and should be informed of symptoms (floaters, scotoma) and should have 
periodic dilated retina examinations. 3. AIDS patients who develop herpes zoster 
should be monitored for progressive outer retinal necrosis.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 9120867 [PubMed - indexed for MEDLINE]

4162: Acta Anaesthesiol Sin. 1996 Sep;34(3):151-5.

Erratum in:
    Acta Anaesthesiol Sin 1996 Dec;34(4):252.

Epidural coadministration of ketamine, morphine and bupivacaine attenuates
post-herpetic neuralgia--a case report.

Wong CS, Shen TT, Liaw WJ, Cherng CH, Ho ST.

Department of Anesthesiology, National Defense Medical Center, Taipei, Taiwan,
R.O.C.

The N-methyl-D-aspartate (NMDA) receptor system plays an important role in
nociceptive signal modulation in the central nerve system. There is considerable 
evidence that NMDA receptor antagonists can abolish hypersensitivity of
nociceptors in animal models. In this case report, we described a patient who
suffered post-herpetic neuralgia with severe pain, allodynia, and hyperesthesia
over right side T2 to T8 dermatomes. Treatment with conventional doses of
non-steroid anti-inflammatory drug (NSAID), antidepressant, anticonvulsant and
benzodiazepine failed to provide satisfactory pain relief. With the patient's
consent, we administered subanalgesic doses of ketamine (10 mg), morphine (1 mg),
and 6 ml bupivacaine (0.1%) through the thoracic epidural route. After the
treatment, hyperalgesia and allodynia improved dramatically, and the receptive
field also reduced. After four weeks' treatment, satisfactory pain relief was
achieved with conventional analgesics treatment. The combination of relatively
low doses of morphine, ketamine and bupivacaine epidurally provides effective
pain relief in this case. The result strongly suggests a synergy from this
combination that warrants a formal study of the dose-response relationship
involved in this treatment and the mechanism by which this effect is achieved.
This regimen provides a promising treatment for the neuropathic pain with limited
side effects.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9084539 [PubMed - indexed for MEDLINE]

4163: Aviat Space Environ Med. 1996 Sep;67(9):899-900.

You're the flight surgeon: severe headache.

Geyer DE.

Publication Types: 
    Case Reports

PMID: 9045600 [PubMed - indexed for MEDLINE]

4164: Practitioner. 1996 Sep;240(1566):552.

Shingles.

Wyndham M.

British Society for the Study of Infection.

Publication Types: 
    Review

PMID: 8984465 [PubMed - indexed for MEDLINE]

4165: Br J Dermatol. 1996 Sep;135(3):502-3.

Cytological diagnosis of zosteriform skin metastases in undiagnosed breast
carcinoma.

Heckmann M, Volkenandt M, Lengyel ER, Schirren CG, Gizycki-Nienhaus BV.

Publication Types: 
    Case Reports
    Letter

PMID: 8949466 [PubMed - indexed for MEDLINE]

4166: J Dermatol. 1996 Sep;23(9):631-4.

A case of herpes zoster associated with colitis.

Okimura H, Muto M, Ichimiya M, Mogami S, Takahata H, Asagami C.

Department of Dermatology, Yamaguchi University School of Medicine, Ube, Japan.

A 58-year-old Japanese woman who had herpes zoster in association with colitis
was successfully treated with intravenously administrated acyclovir. Vesicular
lesions with red haloes ranged from the left side of her buttock to the left
extremity, corresponding to the L4 to S2 dermatomes. Her colitis was considered
to have been induced by varicella-zoster virus, based on the facts that the
clinical courses were correlated and that the innervation of the affected site of
the colon corresponded to an infected dermatome (S2).

Publication Types: 
    Case Reports
    Review

PMID: 8916665 [PubMed - indexed for MEDLINE]

4167: Electromyogr Clin Neurophysiol. 1996 Sep;36(6):369-75.

Segmental zoster paresis of limbs.

Merchut MP, Gruener G.

Department of Neurology, Loyola University Medical Center, Maywood, IL 60153 USA.

Segmental zoster paresis (SZP) is the focal, asymmetrical neurogenic weakness
which may occur in a limb affected by cutaneous zoster. We have summarized the
features of this syndrome, based on a retrospective review of 8 personal and 96
published cases. Limb SZP becomes apparent in at least 3-5% of patients with
cutaneous zoster, who are usually over the age of sixty and weak proximally
(C5,6,7 or L2,3,4 innervated muscles). Functional motor recovery occurs in about 
75% of cases, generally by 1-2 years. Limb weakness is probably due to a lesion
of the ventral nerve root, in close proximity to the initiating dorsal
ganglionitis. The electrodiagnostic findings, scarce in the literature, typically
consist of absent compound sensory nerve action potentials in the involved limb, 
with less frequent reduction or loss of compound muscle action potentials.
Fibrillations and positive sharp waves become detectable within 1-4 months in
limb and related paraspinal muscles, decreasing or disappearing later. In
addition to this radiculopathy, peripheral nerves may also occasionally become
involved, manifest as mononeuropathies of the median, ulnar, long thoracic,
recurrent laryngeal, and phrenic nerves. The zoster infection or consequent
inflammatory response appears able to affect motor axons distally as well as
proximally.

Publication Types: 
    Case Reports
    Review

PMID: 8891477 [PubMed - indexed for MEDLINE]

4168: J Med Virol. 1996 Sep;50(1):82-92.

Detection of both herpes simplex and varicella-zoster viruses in cerebrospinal
fluid from patients with encephalitis.

Casas I, Tenorio A, de Ory F, Lozano A, Echevarria JM.

Department of Diagnosis, Instituto de Salud Carlos III, Majadahonda, Madrid,
Spain.

Cerebrospinal fluid (CSF) samples from 46 patients with encephalitis were studied
for the presence of herpes simplex virus (HSV) types 1 and 2 and/or varicella
zoster virus (VZV)-specific DNA sequences by the polymerase chain reaction (PCR) 
assay. Patients were studied because of detection of intrathecal production of
IgG antibody to HSV alone (10 patients, Group A) or to both HSV and VZV (11
patients, Group B) or because of the presence of specific anti-HSV IgG in CSF
without evidence of intrathecal antibody production (25 patients, Group C). CSF
samples taken between days 1 and 10 from onset of encephalitis were available
from all patients, and follow-up samples (taken after 10 days from onset) were
obtained from some of them. Positive PCR results were obtained in a total of 13
patients. Four patients (three from Group A and one from Group B) gave
amplification of HSV type 1 DNA alone, two patients (both from Group B) showed
amplification of VZV DNA alone, and seven patients (all from Group B) gave dual
amplification of both HSV type 1 and VZV DNA sequences in CSF. All CSF samples
from patients in Group C were negative by PCR. Ten patients with CSF samples
positive by PCR lacked a prior history of herpetic cutaneous lesions. In seven
patients, serum antibody tests (specific IgM detection and specific IgG avidity
assays) identified both primary and recurrent infections. The results suggest
that the dual presence of IgG antibody to both HSV and VZV in CSF from patients
with encephalitis may reflect in some cases a dual infection of the central
nervous system caused by both agents.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8890045 [PubMed - indexed for MEDLINE]

4169: Cutis. 1996 Sep;58(3):231-4.

Connatal herpes zoster.

Querol I, Bueno M, Cebrian A, Gonzalez-Echeverria FJ.

Department of Dermatology, Hospital Reina Sofia de Tudela, Spain.

We describe a case of connatal herpes zoster present in a newborn girl whose
mother had been exposed to varicella infection during the seventh month of
pregnancy. A few minutes after delivery, the newborn was examined for an
erythematous maculopapular rash with clear grouped vesicles involving the right
L2-L4 dermatome. She was given varicella zoster immunoglobulin and oral and
topical acyclovir, and all the skin lesions were completely healed eight days
later. This report emphasizes one aspect of the relationship between maternal
exposure to varicella zoster virus infection and the occurrence of connatal
shingles, the benign course of the disease in this case, and the favorable
response to acyclovir therapy in neonates.

Publication Types: 
    Case Reports

PMID: 8886539 [PubMed - indexed for MEDLINE]

4170: AIDS. 1996 Sep;10(11):1300-1.

Comment on:
    AIDS. 1996 Jan;10(1):55-60.

Famciclovir in AIDS-related acute retinal necrosis.

Klein JL, Sandy C, Migdal CS, Main J.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 8883599 [PubMed - indexed for MEDLINE]

4171: Graefes Arch Clin Exp Ophthalmol. 1996 Sep;234(9):547-52.

Immunological profiles in patients with acute retinal necrosis.

Rochat C, Polla BS, Herbort CP.

Department of Ophthalmology, Hopital Jules Gonin, University of Lausanne,
Switzerland.

PURPOSE: Acute retinal necrosis (ARN) is a newly recognized disease caused by
human commensal viruses of the herpes family (herpes simplex virus,
varicella-zoster virus and cytomegalovirus) occurring in apparently
immunocompetent patients. As at least three viruses can cause ARN, the
modification in the host-virus interaction at the origin of the disease most
probably comes from the host. A review of 216 reported cases of ARN showed that
there were signs of impaired cellular immunity in 16% of these cases. The purpose
of this study was to investigate immune parameters in ARN. METHODS: In nine
HIV-negative ARN patients who were not under steroid or immunosuppressive
therapy, the following prospective immunological investigations were performed:
(1) skin testing for delayed-type hypersensitivity to seven common antigens
(Candida, diphtheria, purified protein derivative tuberculin Proteus,
Streptococcus, tetanus, Trichophyton); (2) lymphocytic proliferative responses in
vitro to these antigens and to three mitogens; (3) determination of blood
lymphocyte sub-populations by flow cytometry. RESULTS: Cutaneous anergy was found
in five of seven tested cases. The lymphocyte proliferative index was less than
20% of the index of a control group for all antigens in three of nine cases, and 
for three or more antigens in eight of nine cases. In eight of nine cases there
was a relative increase of B-lymphocytes, and in seven of nine cases
B-lymphocytes were also increased in absolute numbers. In all nine cases one or
more of these parameters were abnormal. CONCLUSION: Our findings suggest that ARN
may develop in association with an imbalance of the immune system characterized
by an impaired cellular response and/or a maintained or increased humoral
response.

PMID: 8880152 [PubMed - indexed for MEDLINE]

4172: Ann Pharmacother. 1996 Sep;30(9):978-85.

Famciclovir for treatment of herpesvirus infections.

Luber AD, Flaherty JF Jr.

School of Pharmacy, University of California, San Francisco 94143, USA.

OBJECTIVE: To discuss the antiviral activity, pharmacokinetics, clinical
efficacy, and adverse effect profile of famciclovir, the oral prodrug of
penciclovir (PCV), and to compare these features of famciclovir with those of
acyclovir in the treatment of herpesvirus infections. DATA SOURCES: Literature
was identified by MEDLINE search, and abstracts from recent meetings were
included where relevant. Data provided by the manufacturer were also used. STUDY 
SELECTION: Data regarding antiviral activity were included if accepted and widely
used methods were followed. Clinical trials in which a comparison with acyclovir 
or placebo was performed were given the highest priority. DATA SYNTHESIS: In
comparison with acyclovir, PCV has similar antiviral activity although its mode
of action is not identical. When administered orally, faMciclovir, the oral
prodrug of PCV, is better absorbed than acyclovir, yielding an absolute
bioavailability of PCV of 77%. The predominant route of PCV elimination is via
the kidneys, with a half-life of approximately 2.5 hours. In trials comparing
famciclovir with acyclovir for the treatment of herpes zoster in immunocompetent 
individuals, comparable results were obtained. Famciclovir is also effective as
therapy for recurrent episodes of genital herpes and may prove useful for chronic
suppressive therapy. The most common adverse effects of famciclovir are headache 
and gastrointestinal upset. The dosage of famciclovir for herpes zoster in
immunocompetent individuals is 500 mg po tid for 7 days; for recurrent genital
herpes a dosage of 125 mg po bid for 5 days is recommended. Dosage adjustments
are necessary in patients with renal dysfunction. CONCLUSIONS: Given its
comparable efficacy, similar adverse effect profile, and less frequent dosing
schedule than acyclovir, famciclovir represents a viable alternative for
treatment of herpes zoster and for episodic therapy of recurrent genital herpes
in immunocompetent adults. Specific recommendations for other uses of famciclovir
await the publication of recent clinical trial results.

Publication Types: 
    Review

PMID: 8876860 [PubMed - indexed for MEDLINE]

4173: Ann Pharmacother. 1996 Sep;30(9):967-71.

Comment in:
    Ann Pharmacother. 1996 Sep;30(9):964-6.

The past as prelude to the future: history, status, and future of antiviral
drugs.

Whitley RJ.

University of Alabama at Birmingham 35233, USA.

OBJECTIVE: To review the first generation of antiviral agents (e.g., idoxuridine,
amantadine, vidarabine) that paralleled discovery of antineoplastic agents. DATA 
SOURCES: A MEDLINE search (1962 to 1996) of the English-language literature
pertaining to antiviral agents was performed. DATA EXTRACTION: All articles were 
considered for this review. Pertinent references on antiviral therapy, as judged 
by the author, were selected. DATA SYNTHESIS: Acyclovir, the first
second-generation antiviral agent, has a known selective mechanism of action and 
provides the model for development of future antiviral therapies. Despite the
safety and clinical value of acyclovir, therapy does not prevent establishment of
latency or decrease frequency of occurrences, resistance has been documented, and
outcome is frequently poor. With the emergence of the HIV/AIDS epidemic, several 
antiretroviral agents have been developed and approved. However, none of the four
available nucleoside analogs provides a cure. CONCLUSIONS: Viral resistance has
emerged as an important component of antiviral therapy. Improved therapies for
cytomegalovirus are needed. Several new therapies for herpes zoster, including
prodrugs, are licensed or in Phase III clinical trials. Future directions include
the use of molecular biologic techniques to identify enzymes unique to viral
replication and to accelerate diagnosis of viral diseases.

Publication Types: 
    Historical Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8876858 [PubMed - indexed for MEDLINE]

4174: Int J Dermatol. 1996 Sep;35(9):665-6.

Herpes zoster: treatment with Clinacanthus nutans cream.

Charuwichitratana S, Wongrattanapasson N, Timpatanapong P, Bunjob M.

Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 8876301 [PubMed - indexed for MEDLINE]

4175: AIDS. 1996 Sep;10(10):1174-5.

Ocular and neurological complications of varicella zoster virus infection in a
patient with AIDS.

Meenken C, van den Horn GJ, Danner SA.

Publication Types: 
    Letter

PMID: 8874639 [PubMed - indexed for MEDLINE]

4176: AIDS. 1996 Sep;10(10):1091-9.

Serological and polymerase chain reaction-based analysis of aqueous humour
samples in patients with AIDS and necrotizing retinitis.

Verbraak FD, Galema M, van den Horn GH, Bruinenberg M, Luyendijk L, Danner SA,
Kijlstra A.

Department of Ophthalmology, Academic Medical Centre, University of Amsterdam,
The Netherlands.

OBJECTIVE: To evaluate the measurement of intraocular antibody production and
detection of DNA by the polymerase chain reaction (PCR) for diagnosis of the
causative microorganism in patients with AIDS and necrotizing retinitis. METHODS:
Paired serum and aqueous humour samples obtained from 28 patients with AIDS and
necrotizing retinitis, seen between January 1987 and March 1992, were analysed
for intraocular antibody production against cytomegalovirus (CMV), varicella
zoster virus, herpes simplex virus, Epstein-Barr virus, and Toxoplasma gondii.
Specific antibody titres in the inflamed eye and in the circulation were related 
to total immunoglobulin G content in the aqueous humour and serum. In addition,
PCR analysis was performed in 15 samples. Results were compared to the final
diagnosis, which was based on the subsequent clinical course. Results were also
related to parameters describing the immune state of the patients: CD4 count,
time between diagnosis of an AIDS-defining illness and retinitis, and time of
survival following the diagnosis of retinitis. RESULTS: In 11 (39%) out of 28
patients we found local intraocular antibody production which correlated with the
final diagnosis (one out of two cases with acute retinal necrosis, three out of
five cases with toxoplasma retinitis, and eight out of 21 patients with CMV
retinitis). In all 13 patients with CMV retinitis PCR analysis detected CMV DNA. 
In one patient with the clinical diagnosis of Toxoplasma retinitis, Toxoplasma
DNA could be determined, whereas in the same sample CMV DNA was also found. In
yet another patient with Toxoplasma retinitis only CMV DNA could be detected. A
relationship between results of local antibody determination with either CD4
counts, or the time interval between AIDS-defining illness and retinitis, or
survival time after diagnosis of retinitis could not be established. CD4 counts
were higher than 50 x 10(6)/l in eight out of 19 patients with CMV retinitis. No 
complications of paracentesis were seen. CONCLUSIONS: Detection of intraocular
antibody production and PCR analysis are quick and safe procedures and helpful
tools for diagnosis of the involved pathogen in AIDS patients with a necrotizing 
retinitis. Negative results of local antibody production, even in the presence of
detectable viral DNA, could not be related to the parameters of a more
deteriorated immune status of these patients.

Publication Types: 
    Comparative Study

PMID: 8874625 [PubMed - indexed for MEDLINE]

4177: Cornea. 1996 Sep;15(5):446-50.

Herpes zoster peripheral ulcerative keratitis in patients with the acquired
immunodeficiency syndrome.

Neves RA, Rodriguez A, Power WJ, Muccioli C, Lane L, Belfort R Jr, Foster CS.

Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical
School, Boston, Massachusetts, USA.

The purpose of this study was to describe the clinical characteristics and course
of peripheral ulcerative keratitis (PUK) secondary to herpes varicella-zoster
virus in patients with the acquired immunodeficiency syndrome (AIDS). Three AIDS 
patients with ocular herpes zoster infection (mean age at onset, 33.0 years;
range, 30-42) developed PUK. The three patients had skin involvement, and two of 
them had bilateral keratouveitis. All were treated with high-dose oral acyclovir 
(4 g/day) with or without topical antiviral therapy. Two of the patients
responded well to oral acyclovir, but one of them stopped the treatment, and
bilateral progressive outer retinal necrosis and lethal encephalitis developed.
The third patient had a recurrent episode of inflammation with PUK, extensive
stromal scarring, and deep neovascularization. AIDS patients with herpes
varicella-zoster virus infection may have severe and protracted corneal
manifestations, including PUK. The correct diagnosis and aggressive early
long-term systemic antiviral treatment must be instituted to control
inflammation, ulcer progression, and complications.

Publication Types: 
    Case Reports

PMID: 8862919 [PubMed - indexed for MEDLINE]

4178: Infect Dis Clin North Am. 1996 Sep;10(3):677-88.

New varicella vaccines.

Ellis RW.

Merck Research Laboratories, West Point, Pennsylvania, USA.

The live attenuated varicella vaccine, which is available for the prevention of
chickenpox, was produced by a classic technology that also has been used for
polio, measles, mumps, and rubella vaccines. There are many newer technologies
that have been applied to the research and development of other vaccines. Each of
these other approaches offers potential advantages and disadvantages relative to 
the current varicella vaccine.

Publication Types: 
    Review

PMID: 8856359 [PubMed - indexed for MEDLINE]

4179: Infect Dis Clin North Am. 1996 Sep;10(3):657-75.

The varicella vaccine. Prevention of herpes zoster.

Levin MJ, Hayward AR.

Department of Pediatrics, Children's Hospital, Denver, Colorado, USA.

The live attenuated varicella vaccine offers some hope that the frequency or
severity of herpes zoster might be reduced. Universal immunization with this
vaccine should result in less latent varicella-zoster virus in dorsal root and
cranial nerve ganglia than that which occurs following varicella. Moreover, the
vaccine virus is not well adapted for growth in human cells at normal body
temperature. Thus, reduced virus for reactivation, and less robust replication,
may lessen the problem of herpes zoster in vaccinees. For those individuals who
have already had varicella, the risk of herpes zoster is closely related to the
loss of varicella-zoster virus cell-mediated immune responses, which decline with
aging (or immune suppression). In aging individuals these immune responses can be
enhanced by booster immunization with the varicella vaccine, suggesting that a
vaccine to prevent herpes zoster is feasible.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8856358 [PubMed - indexed for MEDLINE]

4180: Infect Dis Clin North Am. 1996 Sep;10(3):631-55.

Epidemiologic effects of varicella vaccination.

Halloran ME.

Department of Biostatistics, Rollins School of Public Health, Emory University,
Atlanta, Georgia, USA.

For a plausible range of values for the different efficacy characteristics of the
live varicella (Oka) vaccine at different levels of coverage, modeling results
suggest that routine immunization of preschool children would greatly reduce the 
number of primary varicella cases, whereas the shift in age distribution of cases
would not result in increased overall morbidity as measured by number of
hospitalizations. Although information about some of the vaccine assumptions is
scanty, the combinations of assumptions leading to an increase in morbidity seem 
unlikely. A catch-up program in older children who have not yet had chickenpox
will be important. The number and age distribution of the cases in vaccinees are 
sensitive to assumptions about the vaccine, especially the degree and
distribution of partial protection against infection, relative residual
infectiousness, and waning of immunity. Responsiveness to boosting by wild-type
VZV infection was especially important in reducing the number of older cases. The
advantage conferred by responsiveness to boosting depends on the level of
transmission. The direct and indirect effects of vaccines and vaccination
programs interact. Understanding how a vaccine works at the individual level is
important for the vaccinated individual, but it also influences the overall
public health benefits of an immunization programs. Lieu et al based a
cost-effectiveness analysis of varicella vaccines on this model of varicella
dynamics and assumptions about how the vaccines work. Models cannot replace
biologic understanding. The purpose of such models is not to predict the number
of cases of varicella, but to examine some possible consequences of introducing a
vaccine into the routine immunization schedule of preschool children in the
United States, effects of different vaccination strategies, and the benefits of a
temporary catch-up program for older children. Modeling exercises of this sort
force us to formalize our thinking, for instance about the vaccine mechanisms,
and to admit our uncertainties, such as about the vaccine efficacy assumptions.
Such models also show where more data need to be collected, for example, on
boosting and waning of immunity and relative residual infectiousness.
Improvements in the design of vaccine efficacy studies are necessary to provide
the input to these models for looking at the long-term effects of vaccination
programs. Frailty models can be used to analyze the data in the presence of
heterogeneities in susceptibility. Waning can also be estimated using appropriate
methods. Relative infectiousness of vaccinees with breakthrough cases can be
measured by comparing the relative secondary attack rates when the index infected
person is vaccinated and when the index infected person is unvaccinated. More
studies are needed to understand how to evaluate responsiveness to boosting.
Vaccine efficacy studies in the field should be designed to obtain better
estimates of residual susceptibility, residual infectiousness, duration of
protection, and the effects of boosting by reinfection with wild-type VZV.

Publication Types: 
    Review

PMID: 8856357 [PubMed - indexed for MEDLINE]

4181: Infect Dis Clin North Am. 1996 Sep;10(3):617-29.

Modified varicella-like syndrome.

Clements DA.

Division of General Pediatrics, Duke University Medical Center, Durham, North
Carolina, USA.

After incidental exposure to natural varicella, up to 18% of vaccinees reported a
breakthrough infection known as modified varicella-like syndrome (MVLS) over up
to 10 years of postvaccination follow-up, compared with natural varicella
occurring in similarly aged unvaccinated children at the rate of 9% per year.
Children with MVLS are frequently asymptomatic, and their disease is
characterized by having fewer lesions, less fever, and lasting fewer days than
natural varicella. When a case of MVLS occurs there are few secondary cases,
suggesting that it is infrequently transmitted. Sequelae such as secondary
bacterial infection, cerebellar ataxia, encephalitis, and pneumonia occur
infrequently.

Publication Types: 
    Review

PMID: 8856356 [PubMed - indexed for MEDLINE]

4182: Infect Dis Clin North Am. 1996 Sep;10(3):609-15.

Clinical trials of varicella vaccine in healthy adolescents and adults.

Arbeter AM.

Department of Pediatric and Adolescent Medicine, Albert Einstein Medical Center, 
Philadelphia, Pennsylvania, USA.

Adolescents and adults have an increased risk of severe and, rarely, fatal
varicella. Increased risk of exposure of susceptible teens and adults occurs
because of the more common use of day care and nursery programs, and more common 
exposure of health care workers to herpes zoster. The exposure of susceptible
parents to their own children represents an important hazard. Live attenuated
varicella vaccine requires two doses to be adequately immunogenic in adults.
Safety and clinical tolerability have been well documented, and persistent
antibody protection from infection and virtual absence of early herpes zoster
infections are inferred from encouraging preliminary data.

Publication Types: 
    Review

PMID: 8856355 [PubMed - indexed for MEDLINE]

4183: Infect Dis Clin North Am. 1996 Sep;10(3):595-608.

Clinical trials of varicella vaccine in healthy children.

White CJ.

The Oka varicella vaccine has been tested in clinical trials worldwide in
thousands of children. Following licensure in Japan, Korea, Germany, and the
United States, the vaccine has been used in several millions of children. The
vaccine has been generally well-tolerated with the most common complaints being
pain and redness at the injection site and a mild rash following vaccination. The
incidence of herpes zoster has not increased in vaccinees and may have decreased.
Efficacy rates vary between 65% and 100% depending on the intensity of exposure
to natural varicella and the potency of the vaccine. In those few vaccinees who
develop MVLS, the rash is generally milder than seen following natural infection 
(median < 50 versus 300 lesions, respectively, as well as a lower incidence of
fever). There has been no evidence to date to indicate waning immunity
postvaccination. Studies are in progress in the United States to evaluate whether
this will occur and the effect of booster doses of vaccine. It is expected that
in countries where there is widespread use of the vaccine in healthy children,
disease rates will fall dramatically as will the morbidity and mortality
associated with natural varicella in this population.

Publication Types: 
    Review

PMID: 8856354 [PubMed - indexed for MEDLINE]

4184: Infect Dis Clin North Am. 1996 Sep;10(3):583-94.

The varicella vaccine. Clinical trials in immunocompromised individuals.

Gershon AA, LaRussa P, Steinberg S.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, New York, USA.

A review of the use of live attenuated varicella vaccine in immunocompromised
children, particularly those with underlying leukemia in remission, is presented.
Data concerning safety, immunogenicity, and efficacy of this vaccine in high-risk
children are reviewed. The unique contributions toward our understanding of
varicella vaccine, including spread of vaccine-type virus, incidence of zoster,
and immune correlates provided by studies of immunocompromised patients are
discussed. The importance of protecting high-risk children against severe
varicella by the use of varicella vaccine is apparent.

Publication Types: 
    Review

PMID: 8856353 [PubMed - indexed for MEDLINE]

4185: Infect Dis Clin North Am. 1996 Sep;10(3):571-81.

The epidemiology of varicella-zoster virus infections.

Wharton M.

Child Vaccine Preventable Diseases Branch, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA.

Historically, varicella has been a disease predominantly affecting preschool and 
school-aged children in the United States. The live attenuated varicella vaccine 
was licensed in this country in 1995 and has been recommended for routine use in 
immunization of children 12 to 18 months of age. As an increasing proportion of
the children in the United States are protected from varicella by vaccination,
changes in the current epidemiology of the disease are anticipated. This article 
reviews the current epidemiology of VZV infection and outlines issues related to 
possible changes in varicella epidemiology that may follow widespread use of the 
live varicella (Oka) vaccine.

Publication Types: 
    Review

PMID: 8856352 [PubMed - indexed for MEDLINE]

4186: Infect Dis Clin North Am. 1996 Sep;10(3):469-88.

The varicella vaccine. Vaccine development.

Takahashi M.

Research Institute for Microbial Diseases, Osaka University, Japan.

In this article, rationales and method of development of attenuated live
varicella (Oka) vaccine are described, with biologic and biophysical
characteristics of the vaccine virus. The results of early clinical trials in
Japan are also described, along with the results of detection of viremia in
vaccinees and a follow-up of incidence of zoster in acute leukemic children,
which indicate possible immunopathogenesis of varicella and zoster.

PMID: 8856348 [PubMed - indexed for MEDLINE]

4187: Infect Dis Clin North Am. 1996 Sep;10(3):457-68.

Varicella-zoster virus. The virus.

Cohen JI.

National Institutes of Health, Bethesda, Maryland, USA.

Varicella-zoster virus (VZV) causes chickenpox and herpes zoster. After acute
infection the virus becomes latent in dorsal root and trigeminal ganglia for the 
lifetime of the individual. The viral genome encodes about 70 proteins, at least 
three of which are thought to be expressed during latency in humans. VZV grows in
cell culture, but is very cell-associated; it is relatively difficult to obtain
high titers of cell-free virus.

Publication Types: 
    Review

PMID: 8856347 [PubMed - indexed for MEDLINE]

4188: Hum Pathol. 1996 Sep;27(9):927-38.

The patterns of varicella zoster virus encephalitis.

Kleinschmidt-DeMasters BK, Amlie-Lefond C, Gilden DH.

Department of Pathology, University of Colorado Health Sciences Center, Denver
80262, USA.

Varicella zoster virus (VZV) encephalitis has become increasingly prevalent in
the era of acquired immunodeficiency syndrome (AIDS), and a widening spectrum of 
pathological lesions has defined the disease in these and other severely
immunosuppressed patients. VZV produces three distinct morphological patterns of 
brain damage. VZV can cause bland or hemorrhagic infarctions secondary to a large
or medium vessel vasculopathy. Deep white matter, ovoid mixed necrotic, and
demyelinative lesions occur as a consequence of small vessel vasculopathy, with
demyelination dependent on the degree of additional oligodendrocyte infection.
Distinctive Cowdry A intra-nuclear viral inclusions are rare in either large or
small blood vessels or near infarctions, but are commonly found in glial cells at
the edge of the smaller ovoid, demyelinative lesions. Ependymal and
periventricular necrosis occurs as a result of vasculopathy of subependymal
vessels and secondary infection of ependymal and other glial cells in the
periventricular region. To clarify these patterns of VZV encephalitis and shed
light on their pathogenesis, the authors have examined all cases of VZV
encephalitis seen at our institution since 1984. Additionally, the authors review
the extensive literature in an attempt to classify the patterns of VZV
encephalitis into (1) large/ medium vessel vasculopathy with bland or hemorrhagic
infarctions, (2) small vessel vasculopathy with mixed ischemic/demyelinative
lesions, and (3) ventriculitis/periventriculitis. Although one of these three
patterns often predominates clinically and radiographically, careful histological
examination at autopsy shows mixed features in many cases.

Publication Types: 
    Case Reports

PMID: 8816888 [PubMed - indexed for MEDLINE]

4189: J Pain Symptom Manage. 1996 Sep;12(3):149.

Postherpetic neuralgia: treatment reminder.

Hargus EP, Clark J, Gadbaw J, Paige D.

Publication Types: 
    Case Reports
    Letter

PMID: 8803377 [PubMed - indexed for MEDLINE]

4190: Ann Intern Med. 1996 Sep 1;125(5):376-83.

Comment in:
    Ann Intern Med. 1997 May 15;126(10):831-2.    Ann Intern Med. 1997 May 15;126(10):831; author reply 832.    Ann Intern Med. 1997 May 15;126(10):831; author reply 832.

Acyclovir with and without prednisone for the treatment of herpes zoster. A
randomized, placebo-controlled trial. The National Institute of Allergy and
Infectious Diseases Collaborative Antiviral Study Group.

Whitley RJ, Weiss H, Gnann JW Jr, Tyring S, Mertz GJ, Pappas PG, Schleupner CJ,
Hayden F, Wolf J, Soong SJ.

Department of Pediatrics, University of Alabama at Birmingham, Children's
Hospital 35233, USA.

OBJECTIVE: To determine the effect of acyclovir and prednisone treatment of
herpes zoster on chronic pain and quality-of-life outcomes. DESIGN: Randomized,
double-blind, placebo-controlled study with a 2 x 2 factorial design. SETTING: 15
university hospitals or affilliated clinics. PATIENTS: 208 immunocompetent
patients older than 50 years of age who had localized herpes zoster that
developed less than 72 hours before study enrollment. INTERVENTION: Acyclovir or 
a matched placebo was administered orally, 800 mg five times daily, for 21 days. 
Prednisone or a matched placebo was administered orally at 60 mg/d for the first 
7 days, 30 mg/d for days 8 to 14, and 15 mg/d for days 15 to 21. The four
treatments regimens given were acyclovir plus prednisone; acyclovir plus
prednisone placebo; prednisone plus acyclovir placebo; and placebos for both
acyclovir and prednisone. MEASUREMENTS: Patients were monitored daily for the
first 28 days for lesion healing, resolution of pain, return to usual activity,
and return to uninterrupted sleep. Monitoring was then done monthly for 6 months.
Patients documented analgesic requirements each day, and adverse events and
laboratory abnormalities were recorded at each clinical visit. An
intention-to-treat analysis was used. RESULTS: Patients were randomly allocated
to receive one of the four regimens. Demographic characteristics were similar for
each group. Time to total crusting and healing was accelerated for patients
receiving acyclovir plus prednisone compared with patients receiving two
placebos; the risk ratios were 2.27 (95% Cl, 1.46 to 3.55) for total crusting and
2.07 (Cl, 1.26 to 3.38) for healing. Similarly, compared with the placebo group, 
patients receiving acyclovir plus prednisone had accelerated time to cessation of
acute neuritis (risk ratio, 3.02 [Cl, 1.42 to 6.41]), time to return to
uninterrupted sleep (risk ratio, 2.12 [Cl, 1.25 to 3.58]); time to return to
usual daily activity (risk ratio, 3.22 [Cl, 1.92 to 5.40]); and time to cessation
of analgesic therapy (risk ratio, 3.15 [Cl, 1.69 to 5.89]). In the acyclovir plus
prednisone group, resolution of pain during the 6 months after disease onset did 
not statistically differ from that in the other groups. No important clinical or 
laboratory adverse events occurred in any group. CONCLUSIONS: In relatively
healthy persons older than 50 years of age who have localized herpes zoster,
combined acyclovir and prednisone therapy can improve quality of life.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8702088 [PubMed - indexed for MEDLINE]

4191: J Med Chem. 1996 Aug 16;39(17):3307-18.

Synthesis and antiviral activity evaluation of some new aminoadamantane
derivatives. 2.

Kolocouris N, Kolocouris A, Foscolos GB, Fytas G, Neyts J, Padalko E, Balzarini
J, Snoeck R, Andrei G, De Clercq E.

Department of Pharmacy, University of Athens, Panepistimioupoli-Zografou, Greece.

The synthesis of some new aminoadamantane derivatives is described. The new
compounds were evaluated against a wide range of viruses [influenza A H1N1,
influenza A H2N2, influenza A H3N2, influenza B, parainfluenza 3, herpes simplex 
virus type 1 (HSV-1) and type 2 (HSV-2), thymidine kinase-deficient (TK-) HSV-1, 
vaccinia, vesicular stomatitis, polio 1, Coxsackie B4, Sindbis, Semliki forest,
Reo 1, varicella-zoster virus (VZV), TK- VZV, human cytomegalovirus (HCMV), and
human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2)]. Some of them
proved markedly active against the influenza A H2N2 (compounds 4a,b, 5a, 6a, and 
7a), H3N2 (compounds 5a, 6a, and 7a), and H1N1 (compounds 4b,c and 6d). Since
compounds 5a, 6a, and 7a, amantadine, and rimantadine showed the same comparative
pattern of potency against influenza strains H2N2, H3N2, and B, it may postulated
that they act according to a similar mechanism, with regard to their "amine"
effect, on the M2 ion channel of influenza A (H1N1, H2N2, or H3N2). In general,
no significant activity was noted with any of the new compounds against any of
the other viruses tested, making their activity against influenza virus more
specific and striking. Borderline activity was noted with some of the compounds
(4b,c, 5a-c, and 8a) against HIV-1.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8765514 [PubMed - indexed for MEDLINE]

4192: J Med Chem. 1996 Aug 16;39(17):3263-8.

Synthesis of 2'-aminomethyl derivatives of N-(2-(phosphonomethoxy)ethyl)
nucleotide analogues as potential antiviral agents.

Dvorakova H, Masojidkova M, Holy A, Balzarini J, Andrei G, Snoeck R, De Clercq E.

Institute of Organic Chemistry and Biochemistry, Academy of Sciences of the Czech
Republic, Praha, Czech Republic.

A series of purine and pyrimidine N-(2-(phosphonomethoxy)ethyl) derivatives
bearing aminomethyl, (dimethylamino)methyl, morpholinomethyl, and
(trimethylammonio)methyl groups at the 2'-position were synthesized. The
compounds were prepared by alkylation of the heterocyclic bases with
appropriately substituted (aminoalkyl)oxiranes followed by condensation of the
resulting intermediates with dialkyl ((p-tolylsulfonyl)oxy)methanephosphonate and
subsequent treatment of the obtained diester with bromotrimethylsilane.
9-(3-Amino-2-(phosphonomethoxy)propyl)adenine (2a) proved active against
varicella zoster virus (VZV), cytomegalovirus (CMV), and Moloney murine sarcoma
virus (MSV) in the concentration range of 7-35 micrograms/mL. None of the other
aminoalkyl derivatives demonstrated significant antiviral activity against herpes
simplex virus type 1 and 2 (HSV-1 and HSV-2), VZV, (CMV), vaccinia virus (VV),
MSV, and human immunodeficiency virus type 1 and 2 (HIV-1 and HIV-2).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8765509 [PubMed - indexed for MEDLINE]

4193: Cent Afr J Med. 1996 Aug;42(8):233-5.

Maternal human immunodeficiency virus infection and pregnancy outcome.

Sukwa TY, Bakketeig L, Kanyama I, Samdal HH.

Tropical Disease Research Centre, Ndola, Zambia.

OBJECTIVE: A longitudinal study to determine the natural history of HIV-1
infection in pregnancy, infancy and early childhood was carried out in Ndola,
Zambia. DESIGN: Prospective study. SETTING: Kabushi and Chifubu clinics.
SUBJECTS: A total of 965 women attending antenatal care were screened for
anti-HIV antibodies using the Welcozyme test. All reactive sera were confirmed by
Western Blot. One hundred and fifty seropositive pregnant women (cases) with
their age and parity matched pregnant control (seronegative) were recruited into 
the study. They were followed up through delivery. MAIN OUTCOME MEASURE: personal
characteristics, socio-economic and other risk factors. RESULTS: The prevalence
of anti HIV-1 antibodies among the 965 women was 15.5pc. Results of baseline data
between the two groups of women indicate significant differences (p < 0.05) in
the following variables; marital status, outcome of last pregnancy, whether last 
child is still alive, history of herpes zoster, lymphadenopathy, dermatitis, oral
thrush and mean haemoglobin level. There were no differences in the incidence of 
abortions, stillbirths and neonatal deaths. However, the mean birth weight of
babies born out of seropositive women was significantly lower than babies of
seronegative women. CONCLUSION: It is concluded that HIV-1 infection in pregnancy
is associated with low birth weight.

PIP: Data on 130 HIV-1 infected pregnant women were compared with data on 150
HIV-1 negative pregnant women to determine the effect of HIV-1 infection on
pregnancy outcomes. All the women were recruited while seeking prenatal services 
at Chifubu and Kabushi clinics in Ndola, Zambia, during 1991-1993. None of the
HIV-1 infected women had AIDS. The HIV- 1 prevalence rate for the recruited
pregnant women was 15.5%. The socioeconomic characteristics of the women in both 
suburbs were similar. Yet, pregnant women at Chifubu were more likely to be HIV-1
positive than those at Kabushi (p 0.001). The proximity to the border with Zaire 
and the higher inward and outward migration rates in Chifubu may contribute to
the higher HIV-1 prevalence rate in Chifubu. HIV-1 infected women were more
likely than controls to have a history of Herpes zoster, cervical
lymphadenopathy, axillary lymphadenopathy, skin rash, and oral thrush (p 0.05).
They were less likely than controls to be married, to have the outcome of their
last birth be a live birth, and to have their last child still be alive (p =
0.01). HIV-1 pregnant women had a lower hemoglobin level and smaller newborns
than controls (10.3 vs. 10.9 g % and 2.76 vs. 3.03 kg, respectively; p 0.03).
When the researchers controlled for gestation, there was no difference in mean
birth weights between the groups. Both groups had similar perinatal mortality
outcomes (1 stillbirth each and 2 neonatal deaths each). The most significant
finding is that HIV-1 infection in pregnancy contributes to low birth weight.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8990567 [PubMed - indexed for MEDLINE]

4194: Hautarzt. 1996 Aug;47(8):604-9.

[Epidemiology of varicella zoster infection. Results of a prospective study in
the Ansbach area]

[Article in German]

Paul E, Thiel T.

Hautklinik, Klinikum Nurnberg Nord, Universitat Erlangen-Nurnberg.

In the country city of Ansbach, Germany all cases of varicellazoster virus
infection seen by dermatologists, pediatricians and general practitioners were
registered over a period of 16 months, from February 1992 until May 1993. 152
patients were clinically diagnosed with herpes zoster and 437 patients with
chickenpox. The population-based incidence of zoster infections was 22.6 per
10,000 inhabitants per year, while the incidence of chickenpox was 42.4. There
was a slight predominance of male patients with zoster. There was also a marked
influence of age and sex, on the localization of the involved nerve segments.
Zoster was seen in patients of all ages but there was a clear predominance in
older patients. The peak of the disease occurred in the eighth decade. In
patients with chickenpox, the sex ratio was equal. The disease typically occurs
in children and we observed a predominance of the cases in the first decade.
Spread over the year, zoster was seen equally during all seasons. Chickenpox,
however, showed epidemiological peaks of frequency. It is possible that the
epidemic spread of the disease and the end of the peak are influenced by special 
metereological conditions.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 8964702 [PubMed - indexed for MEDLINE]

4195: Immunol Rev. 1996 Aug;152:157-73.

Human herpes viruses latent infection in the nervous system.

Steiner I.

Department of Neurology, Hadassah University Hospital, Jerusalem, Israel.

The neurotropic herpes viruses, HSV-1, HSV-2 and VZV, colonize and establish
latent infection in human peripheral sensory ganglia. Recurrent diseases due to
reactivation of these viral pathogens can take place despite an effective immune 
response. Molecular, cellular, physiological and immune mechanisms work in
concert to enable the establishment of latency, the maintenance of the latent
state for the entire life of the host, and the reactivation infection. Although
all three viruses belong to the same family and establish latent infection in the
same tissue, the clinical pattern of their reactivation is quite different. This 
review covers current knowledge of the basis of these infections, and offers a
theory explaining the basis of HSV-1 latent infection and the differences of the 
disorders caused by HSV-1 and VZV reactivation in humans.

Publication Types: 
    Review

PMID: 8930672 [PubMed - indexed for MEDLINE]

4196: Aust N Z J Ophthalmol. 1996 Aug;24(3):287-8.

CT appearance of a functioning Jones tube after dacryocystorhinostomy and bypass 
tube surgery.

Francis IC, Egan CA, Wilcsek GA.

Dalcross Hospital, Killara, New South Wales.

Publication Types: 
    Case Reports

PMID: 8913135 [PubMed - indexed for MEDLINE]

4197: J Med Virol. 1996 Aug;49(4):279-82.

Erratum in:
    J Med Virol 1997 Feb;51(2):137.

Evaluation of a new general primer pair for rapid detection and differentiation
of HSV-1, HSV-2, and VZV by polymerase chain reaction.

Baron JM, Rubben A, Grussendorf-Conen EI.

Department of Dermatology, RWTH-Aachen, Germany.

The polymerase chain reaction (PCR) enables rapid and sensitive detection of VZV 
and HSV DNA and its efficiency depends mainly on the choice of the primers.
Primers should hybridize to conserved DNA sequences within the viral genomes in
order to avoid unreliable amplification due to DNA sequence variation between
different strains. The aim of the study was to design and to evaluate a general
primer pair which permits fast and reliable detection of HSV and VZV. The genes
UL 15 of HSV and UL 42 of VZV share the highest degree of homology within the two
genomes. We designed a primer pair (GPHV-RU) which hybridizes to these genes. The
genetic variability of amplified sequences from clinical specimens was analyzed
by restriction enzyme cleavage analysis and by temperature gradient SSCP analysis
(TG-SSCP). PCR with GPHV-RU amplified viral sequences from all analyzed specimens
(25 x VZV, 10 x HSV-1, 5 x HSV-2) obtained from patients with clinical evidence
of HSV or VZV infection. Restriction enzyme cleavage analysis with Hpa II further
permitted reliable distinction between VZV, HSV-1, and HSV-2. Analysis of the
heterogeneity of the amplified sequences by restriction enzyme cleavage and by
TG-SSCP demonstrated no variability between the analyzed clinical specimens of VZ
and of HSV-2 and only one differing TG-SSCP-pattern within the HSV-1 isolates.
The results suggest that detection of HSV and VZV using the new primer pair
GPHV-RU should give reliable results as the amplified sequences show little
genetic variability within clinical isolates of HSV-1/2 and VZV.

PMID: 8877759 [PubMed - indexed for MEDLINE]

4198: J Neurol. 1996 Aug;243(8):618-9.

Dual detection of antibody to both herpes simplex and varicella-zoster viruses in
cerebrospinal fluid: cross reactivity or dual infection?

Echevarria JM, Casas I, Tenorio A, Martinez-Martin P.

Publication Types: 
    Letter

PMID: 8865033 [PubMed - indexed for MEDLINE]

4199: J Hosp Infect. 1996 Aug;33(4):235-48.

Herpesvirus resistance to antiviral drugs: a review of the mechanisms, clinical
importance and therapeutic options.

Reusser P.

Department of Medicine, University Hospital, Basel, Switzerland.

During the past decade, potent agents against herpes simplex virus (HSV) types 1 
and 2, varicella zoster virus (VZV), and cytomegalovirus (CMV) have become
available. The increasing clinical use of acyclovir, ganciclovir, and foscarnet
has been associated with the emergence of drug-resistant herpesvirus strains.
Resistance to acyclovir or ganciclovir most frequently results from deficient
intracellular phosphorylation of these agents which is required for drug
activation. Resistance to foscarnet is due to viral DNA polymerase mutants that
permit viral replication despite the presence of the drug. In immunocompetent
patients, herpesvirus resistance is rare and generally does not correlate with
clinical outcome. In contrast, in immunocompromised hosts, resistance of HSV,
VZV, and CMV is increasingly detected, and may be associated with disease
refractory to antiviral therapy. Foscarnet treatment has been used with some
clinical benefit in patients with acyclovir-resistant HSV or VZV, or
ganciclovir-resistant CMV. For therapy of resistant mucocutaneous HSV disease,
topical trifluorothymidine, and topical or intravenous cidofovir (HPMPC) have
yielded encouraging results that warrant further investigation. Improved methods 
for detection of herpesvirus resistance, and validation of alternative therapy
for patients with documented resistance are required to reduce the clinical
impact of drug-resistant herpesviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8864937 [PubMed - indexed for MEDLINE]

4200: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996 Aug;82(2):166-72.

Cause of oral ulcers in HIV-infected patients: a study of 19 cases.

Piluso S, Ficarra G, Lucatorto FM, Orsi A, Dionisio D, Stendardi L, Eversole LR.

Institute of Stomatology, University of Florence.

OBJECTIVES: To study the cause and clinical aspects of oral ulcers in
HIV-infected patients. STUDY DESIGN: Forty-one consecutive HIV-positive patients 
with long-standing oral ulcers were examined; 19 were evaluated by biopsy. From
these 19 cases, viral, bacterial, and fungal cultures and biopsies were taken in 
each patient. When indicated, special microbial stains were undertaken to
identify bacteria or fungi. Ten cases without granulomatous bacterial fungal or
lymphomatous features were available for in situ hybridization to detect viral
DNA of herpes simplex virus 1 and 2, cytomegalovirus, varicella-zoster virus, and
Epstein-Barr virus. RESULTS: Most of the oral ulcers occurred in patients with
severe immunodepression. Median CD4 T-lymphocyte count was 60 cell/mm3 (range, 3 
to 335). It was ascertained that nine (47%) patients had nonspecific
aphthous-like ulcers, and ulcers caused by herpes group viruses were identified
in six (31.5%) patients. One (5%) person was diagnosed with non-Hodgkin's
lymphoma; and in one (5%) patient, multiple ulcers were an expression of lues
maligna. Two ulcers (10.5%) in the palate harbored mycotic granulomatous foci
(cryptococcosis, histoplasmosis). In this population, almost all of these ulcers 
were found to be large, persistent, and painful. CONCLUSIONS: Nontumefactive oral
ulcers in HIV-positive patients may be a source of diagnostic difficulties
because of the diverse array of underlying pathologic entities and multiplicity
of etiologic agents. Biopsy should always be performed on long-standing ulcers
because either infection or a neoplastic process may be extant. In the absence of
infection or neoplasm, such lesions are then designated as ulcers not otherwise
specified.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 8863306 [PubMed - indexed for MEDLINE]

4201: J Dermatol. 1996 Aug;23(8):556-8.

Milia arising in herpes zoster scars.

Lee WS, Kim SJ, Ahn SK, Lee SH.

Department of Dermatology, Yonsei University Wonju, College of Medicine, Korea.

Milia caused by proliferative tendencies of the epithelium after injury may occur
in areas of bullous eruption (10). Even though the possibility of milia arising
in herpes zoster scar is real, it has not been reported previously. We describe a
case of milia arising in herpes zoster scars as an another example of milia
occurring in traumatized skin.

Publication Types: 
    Case Reports
    Review

PMID: 8854589 [PubMed - indexed for MEDLINE]

4202: Int J Dermatol. 1996 Aug;35(8):603-4.

Guillain-Barre syndrome associated with varicella-zoster infection.

da Rosa-Santos OL, Moreira AM, Golfetto CA, Maceira JP, Ramos-e-Silva M.

Publication Types: 
    Case Reports
    Letter

PMID: 8854170 [PubMed - indexed for MEDLINE]

4203: AIDS. 1996 Aug;10(9):951-8.

Polymerase chain reaction on cerebrospinal fluid for diagnosis of
virus-associated opportunistic diseases of the central nervous system in
HIV-infected patients.

Cinque P, Vago L, Dahl H, Brytting M, Terreni MR, Fornara C, Racca S, Castagna A,
Monforte AD, Wahren B, Lazzarin A, Linde A.

Department of Infectious Diseases, University of Milan, Italy.

OBJECTIVE: To assess the diagnostic reliability of polymerase chain reaction
(PCR) on cerebrospinal fluid (CSF) for virus-associated opportunistic diseases of
the central nervous system (CNS) in HIV-infected patients. DESIGN: CSF samples
from 500 patients with HIV infection and CNS symptoms were examined by PCR. In
219 patients the PCR results were compared with CNS histological findings.
METHODS: Nested PCR for detection of herpes simplex virus (HSV) type 1 or 2,
varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV),
human herpesvirus 6 (HHV-6), and JC virus (JCV) DNA. Histopathological
examination of CNS tissue obtained at autopsy or on brain biopsy. RESULTS: DNA of
one or more viruses was found in CSF in 181 out of 500 patients (36%; HSV-1 2%,
HSV-2 1%, VZV 3%, CMV 16%, EBV 12%, HHV-6 2%, and JCV 9%). Among the 219 patients
with histological CNS examination, HSV-1 or 2 was detected in CSF in all six
patients (100%) with HSV infection of the CNS, CMV in 37 out of 45 (82%) with CMV
infection of the CNS, EBV in 35 out of 36 (97%) with primary CNS lymphoma, JCV in
28 out of 39 (72%) with progressive multifocal leukoencephalopathy. Furthermore, 
HSV-1 was found in one, VZV in four, CMV in three, EBV in three, HHV-6 in seven, 
and JCV in one patient without histological evidence of the corresponding CNS
disease. CONCLUSIONS: CSF PCR has great relevance for diagnosis of virus-related 
opportunistic CNS diseases in HIV-infected patients as demonstrated by its high
sensitivity, specificity, and the frequency of positive findings.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8853727 [PubMed - indexed for MEDLINE]

4204: Nervenarzt. 1996 Aug;67(8):639-49.

[Infectious diseases as a cause and risk factor for cerebrovascular ischemia]

[Article in German]

Grau AJ, Buggle F, Hacke W.

Neurologische Universitatsklinik, Heidelberg.

Cerebrovascular ischemia can be caused by infectious diseases which involve
cerebral arteries or the heart, including infectious endocarditis, bacterial and 
fungal meningitis, neurosyphilis, neuroborreliosis, herpes zoster, the acquired
immunodeficiency syndrome, cat scratch disease and other rare infectious
diseases. Presently, there is increasing evidence that infection in general and
mainly respiratory infection is a risk factor for ischemic stroke. Case reports
and smaller case series reported an association of cerebrovascular ischemia and
recent infection in children and younger adults. Two case control studies from
Helsinki (54 patients under the age of 50) and from Heidelberg (197 patients aged
80 or less) identified recent infection as an important risk factor for ischemic 
stroke. Febrile, bacterial and respiratory infections were most important in this
respect. In the study from Heidelberg, the neurological deficit was more severe
and cardioembolism was more frequent in infection-associated stroke than in
stroke without preceding infection. This review summarizes the association of
infectious diseases and cerebrovascular ischemia and discusses potential
pathogenetic mechanisms linking both diseases.

Publication Types: 
    English Abstract
    Review

PMID: 8805109 [PubMed - indexed for MEDLINE]

4205: Nervenarzt. 1996 Aug;67(8):623-9.

[Herpes zoster: follow-up, complications and therapy]

[Article in German]

Straube A, Padovan CS.

Neurologische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universitat,
Munchen.

In clinical practice herpes zoster infections are common. The cause is the
reactivation of the herpes varicella virus that persists in the sensory ganglia
after an earlier primary infection with shingles. There are several neurological 
complications such as meningitis, ventriculitis, encephalitis, myelitis, cerebral
angiitis, myositis, paresis of motor nerves, acute polyneuritis, and most
commonly post-zoster neuralgia. A proposed reason for these complications is the 
direct infiltration of the virus or a hematogenous infection. Some of the
complications can be treated symptomatically such as post-zoster neuralgia and
the occurrence of certain complications that can be prevented by the right choice
of acute therapy.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8805107 [PubMed - indexed for MEDLINE]

4206: J Neurovirol. 1996 Aug;2(4):249-58.

Detection of herpesviridae in postmortem multiple sclerosis brain tissue and
controls by polymerase chain reaction.

Sanders VJ, Felisan S, Waddell A, Tourtellotte WW.

Department of Neurology, UCLA School of Medicine 90095, USA.

OBJECTIVE: To test for the presence of herpesviruses in postmortem brain samples 
from multiple sclerosis patients and controls using polymerase chain reaction.
BACKGROUND: Herpes simplex virus, varicella-zoster virus, Epstein-Barr virus,
cytomegalovirus, and human herpesvirus-6 are common viruses capable of
persistence and latency. All have been detected in the CNS. METHODS: Active and
inactive plaque tissue, unaffected white matter (WM) and gray matter (GM) from MS
cases, and WM and GM controls (Alzheimer's disease, Parkinson's disease and
non-neurological disease) were screened for the herpesvirus by PCR. RESULTS: (1) 
37% of the MS cases were positive for herpes simplex virus (HSV). Twenty-eight
percent of controls cases were positive for HSV. Forty-one percent of active
plaques were positive for HSV in contrast to only 20% of inactive plaques
(Sanders et al, 1996). (2) 57% of the MS cases and 43% of the control cases were 
positive for HHV-6. Thirty-two percent of the active plaques contained HHV-6
compared to 17% of inactive plaques. (3) 43% of the MS cases and 32% of the
control cases were positive for VZV. Fourteen percent of the active plaques and
10% of the inactive plaques were positive for VZV. (4) 27% of MS cases and 38% of
control cases were positive for EBV. Five percent of the active plaques were
positive for EBV and 10% of the inactive plaques were positive. (5) 16% of the MS
cases and 22% of the controls were positive for CMV. Nine percent of the active
plaques and 10% of the inactive plaques were positive. We also compared MS WM and
GM with controls and found no significant difference. CONCLUSIONS: HSV, HHV-6,
and VZV were present in a greater frequency of MS cases compared to controls;
however, no statistical differences were noted. The presence of herpesvirus in
all tissue makes an etiologic association to MS uncertain. Cellular localization 
of virus and its relationship to pathology and latency may reveal an association.

PMID: 8799216 [PubMed - indexed for MEDLINE]

4207: Epidemiol Infect. 1996 Aug;117(1):165-71.

An analysis of infection control of varicella-zoster virus infections in
Addenbrooke's Hospital Cambridge over a 5-year period, 1987-92.

Wreghitt TG, Whipp J, Redpath C, Hollingworth W.

Clinical Microbiology & Public Health Laboratory, Addenbrooke's Hospital,
Cambridge, UK.

This prospective study analyses infections with varicella-zoster virus (VZV) in
Addenbrooke's Hospital, Cambridge during 1987-92 and examines the spread of
infection. In total, 93 patients and staff experienced VZV infection. Twenty-one 
patients had varicella and 49 experienced zoster. None of 101 patients and 1 of
625 staff members in contact with varicella cases acquired infection. By
contrast, 2 of 227 patients, and 5 of 1039 staff in contact with zoster cases
acquired varicella. One out of 28 (3.6%) VZV antibody-negative patients and staff
in contact with varicella acquired infection, compared with 5 out of 29 (17.2%)
VZV antibody-negative patients and staff in contact with zoster. Thus, zoster was
found to be a more frequent cause of nosocomial infection than varicella.
Fourteen members of staff had VZV infection during the study period. One of 99
patients and none of 389 staff members in contact with these cases developed
varicella. The cost of dealing with infection control for VZV infections in our
hospital is estimated to be Pounds 714 per patient case and a total of Pounds
13,204 per year.

PMID: 8760965 [PubMed - indexed for MEDLINE]

4208: Neurology. 1996 Aug;47(2):569-70.

Varicella-zoster virus DNA in CSF and arteries in delayed contralateral
hemiplegia: evidence for viral invasion of cerebral arteries.

Melanson M, Chalk C, Georgevich L, Fett K, Lapierre Y, Duong H, Richardson J,
Marineau C, Rouleau GA.

McGill University, Montreal, Quebec, Canada.

A 78-year-old woman presented with a right basal ganglia infarct 6 weeks after a 
left herpes zoster ophthalmicus. MR angiography showed focal segmental stenosis
of the proximal segments of the anterior, middle, and posterior cerebral
arteries. Varicella DNA was detected in the CSF by polymerase chain reaction
(PCR). Treated with dexamethasone and acyclovir without improvement, she died 1
month later. There was focal endarteritis in the left anterior, middle, and
posterior cerebral arteries at autopsy. Varicella DNA was detected by PCR of
extracts from these vessels but not from the arteries on the right side. This
study provides further evidence that the vasculopathy after herpes zoster
ophthalmicus results from direct viral invasion of the vessel wall.

Publication Types: 
    Case Reports

PMID: 8757040 [PubMed - indexed for MEDLINE]

4209: Arch Dermatol. 1996 Aug;132(8):963, 966.

Vesicular eruption on the scalp. Varicella-zoster virus with Torulopsis glabrata 
colonization.

Meffert JJ, Rush WL, Kennard CD.

Wilford Hall Air Force Medical Center, Lackland Air Force Base, Tex, USA.

Publication Types: 
    Case Reports

PMID: 8712849 [PubMed - indexed for MEDLINE]

4210: Am J Surg Pathol. 1996 Aug;20(8):1000-10.

Specific cutaneous infiltrates of B-cell chronic lymphocytic leukemia: a
clinicopathologic and prognostic study of 42 patients.

Cerroni L, Zenahlik P, Hofler G, Kaddu S, Smolle J, Kerl H.

Department of Dermatology, University of Graz, Austria.

The clinical and histopathologic features of specific skin infiltrates in
patients with B-cell chronic lymphocytic leukemia (B-CLL) have rarely been
reported in detail. In this study we analyzed the clinical, histopathologic,
immunophenotypic, and molecular features of 84 skin lesions from 42 patients (M:F
= 1.3:1; mean age, 66.0 years; range, 42-83 years) with specific cutaneous
manifestations of B-CLL. The duration of B-CLL before skin manifestations varied 
from 0 to 142 months (mean, 39 months). In seven patients (16.7%), skin lesions
represented the first sign of disease. Clinical presentations included localized 
or generalized erythematous papules, plaques, nodules, and large tumors.
Ulceration was uncommon. In six patients lesions were confined at the sites of
scars from previous herpes zoster (four patients) or herpes simplex (two
patients) eruptions. Histologically, three main patterns were recognized: (a)
patchy perivascular and periadnexal, (b) nodular-diffuse, and (c) band-like.
Cytomorphologically, small monomorphous lymphocytes predominated. Proliferation
centers were observed in only four specimens. In two patients presenting with
tumors, a high content of large cells with feature of centroblasts and
immunoblasts was found (Richter's syndrome). Immunohistologic analyses were
performed on paraffin-embedded specimens in 40 biopsies from 20 patients and on
cryostat sections in 17 biopsies from 11 patients. Neoplastic B lymphocytes in
all cases showed an aberrant phenotype (paraffin sections: CD20+/CD5+/CD43+;
cryostat sections: CD19+/CD5+; immunoglobulin light-chain restriction).
Proliferation markers (Ki67, PCNA, MIB1) stained 5 to 80% of cells (mean, 25%;
median, 20%). Polymerase chain reaction performed in nine cases on
paraffin-embedded tissues using consensus primers for immunoglobulin heavy-chain 
genes showed a monoclonal population of B lymphocytes in all cases. Several
discrete bands in addition to the prominent ones were noted in five cases,
indicating the additional presence of B lymphocytes whose immunoglobulin genes
were not monoclonally but oligoclonally rearranged. Follow-up data could be
obtained from 31 patients. The two patients with Richter's syndrome died after 5 
and 8 months, respectively. The 5-year survival of patients with small-cell
cutaneous B-CLL was 66.6%. Our study indicates that cutaneous specific
manifestations of B-CLL present with characteristic histologic, immunophenotypic,
and molecular patterns. Prognosis in these patients is probably not affected by
skin involvement.

PMID: 8712287 [PubMed - indexed for MEDLINE]

4211: Surg Endosc. 1996 Aug;10(8):848-9.

Herpes zoster mistaken for biliary colic and treated by laparoscopic
cholecystectomy: a cautionary case report.

Hassan I, Donohue JH.

Department of Surgery, Mayo Clinic and Mayo Foundation, 200 First Street, SW,
Rochester, MN 55905, USA.

Herpes zoster must be included in the differential diagnosis of acute right upper
quadrant pain. The presence of a dermatomal vesicular rash should be considered a
contraindication to surgical intervention.

Publication Types: 
    Case Reports

PMID: 8694952 [PubMed - indexed for MEDLINE]

4212: Hosp Pract (Minneap). 1996 Jul 15;31(7):137-44.

Comment in:
    Hosp Pract (Minneap). 1996 Oct 15;31(10):42.

Early treatment of herpes zoster.

Tyring SK.

Department of Dermatology, University of Texas Medical Branch at Galveston, USA.

Although varicella virus vaccine may eventually decrease the incidence of herpes 
zoster, the disease will continue to plague patients and physicians for at least 
the next several decades. Recognition of shingles early in its vesicular stage is
important, since that is when antiviral treatment is effective. Moreover, a
variety of agents are now available for symptomatic relief of postherpetic
neuralgia.

Publication Types: 
    Case Reports
    Review

PMID: 8682880 [PubMed - indexed for MEDLINE]

4213: MMWR Recomm Rep. 1996 Jul 12;45(RR-11):1-36.

Prevention of varicella: Recommendations of the Advisory Committee on
Immunization Practices (ACIP). Centers for Disease Control and Prevention.

[No authors listed]

These recommendations represent the first statement by the Advisory Committee on 
Immunization Practices (ACIP) on the use of live, attenuated varicella virus
vaccine--VARIVAX--manufactured by Merck and Company, Inc. and licensed in March
1995 for use in healthy persons > or = 12 months of age. In addition to
presenting information regarding vaccine, this statement updates previous
recommendations concerning the use of varicella zoster immune globulin (VZIG) as 
prophylaxis against varicella (MMWR 1984; 33:84-90, 95-100).

Publication Types: 
    Guideline
    Practice Guideline

PMID: 8668119 [PubMed - indexed for MEDLINE]

4214: Proc Natl Acad Sci U S A. 1996 Jul 9;93(14):7231-5.

Mass vaccination to control chickenpox: the influence of zoster.

Ferguson NM, Anderson RM, Garnett GP.

Wellcome Centre for the Epidemiology of Infectious Disease, Department of
Zoology, Oxford University, United Kingdom.

The impact of transmission events from patients with shingles (zoster) on the
epidemiology of varicella is examined before and after the introduction of mass
immunization by using a stochastic mathematical model of transmission dynamics.
Reactivation of the virus is shown to damp stochastic fluctuations and move the
dynamics toward simple annual oscillations. The force of infection due to zoster 
cases is estimated by comparison of simulated and observed incidence time series.
The presence of infectious zoster cases reduces the tendency for mass
immunization to increase varicella incidence at older ages when disease severity 
is typically greater.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8692974 [PubMed - indexed for MEDLINE]

4215: Curr Opin Ophthalmol. 1996 Aug;7(4):65-70.

Infectious diseases of the conjunctiva and cornea.

van Bijsterveld OP, Jager GV.

Oogcentrum Houten, The Netherlands.

The modern local antibiotics, such as the aminoglycosides and quinolones, are
very successful in treating infectious conjunctivitis and keratitis. More notably
in some Third World countries, however, suppurative keratitis is found in more
than half of the infectious disease cases caused by Fusarium species. Here, of
course, treatment should be antifungal. The emergence of some problematic
microorganisms is related to contact lens wear. Pseudomonas, for example, have
the ability to adhere to contact lenses and thus form microcolonies, which are
protected by biofilm that predisposes to infection. Acanthamoeba infections of
the cornea are a direct consequence of inappropriate or inadequate disinfection
of contact lens systems. Occasionally the diagnosis of herpes simplex
manifestations of the outer eye can be very difficult. Even more confusing is the
delayed appearance of zoster manifestations, such as pseudodendrites,
particularly in cases of zoster sine herpete eruptione. The polymerase chain
reaction is of particular value in demonstrating the presence of varicella zoster
DNA. Although infectious disease of the outer eye remains common, the incidence
and complications have increased because of frequent use of antimicrobial agents.
In the under-developed areas of the world, however, infections are still very
common, are frequently caused by fungi, and are the cause of serious ocular
complications. In the Western World infectious eye disease does not seem to be a 
major diagnostic or therapeutic point at present. Some organisms that have been
in the environment all along, however, have emerged in the past half century as a
major problem. Thus, in the past years a number of new techniques in diagnosis as
well as new insights in pathophysiology and new developments in treatment have
emerged that are of interest.

Publication Types: 
    Review

PMID: 10163642 [PubMed - indexed for MEDLINE]

4216: N Engl J Med. 1996 Jul 4;335(1):32-42.

Comment in:
    N Engl J Med. 1996 Dec 5;335(23):1768-9; author reply 1769.    N Engl J Med. 1996 Dec 5;335(23):1769; author reply 1769.

Postherpetic neuralgia--pathogenesis, treatment, and prevention.

Kost RG, Straus SE.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, MD 20892, USA.

Publication Types: 
    Review

PMID: 8637540 [PubMed - indexed for MEDLINE]

4217: Int J Antimicrob Agents. 1996 Jul;7(2):119-34.

Famciclovir, from the bench to the patient - a comprehensive review of
preclinical data.

Bacon TH.

SimithKline Beecham Pharmaceuticals, New Frontiers Science Park (South), Third
Avenue, Harlow, Essex CM19 5AW, UK.

Famciclovir is converted rapidly and efficiently after oral administration to the
selective antiviral compound, penciclovir. In cell culture, penciclovir is a
potent inhibitor of herpes simplex virus (HSV) types 1 and 2, varicella-zoster
virus (VZV), Epstein-Barr virus (EBV) and hepatitis B virus (HBV).
Phosphorylation of penciclovir and aciclovir in uninfected cells is limited, and 
penciclovir, like aciclovir, has minimal effect on replicating cells in culture
as expected for a selective antiviral agent. Mode of action studies with VZV and 
HSV have shown that the phosphorylation of penciclovir in infected cells is far
more efficient than for aciclovir. This compensates for differences observed
between penciclovir triphosphate and aciclovir triphosphate in the inhibition of 
HSV and VZV DNA polymerases. Because HBV is not known to encode a thymidine
kinase, a different rationale for the selective inhibition of this virus by
penciclovir is required. Recent data indicate that the DNA polymerase of HBV is
far more sensitive to inhibition by penciclovir triphosphate than cellular DNA
polymerases, suggesting that for this virus, selectivity operates at the DNA
polymerase. Penciclovir triphosphate is more stable within infected cells than
aciclovir triphosphate, and consequently penciclovir has more prolonged antiviral
activity than aciclovir. Similarly, famciclovir is more effective than aciclovir 
or valaciclovir in suppressing HSV replication when given at a lower dosing
frequency in certain animal models. These preclinical properties have helped to
provide the foundation for the famciclovir clinical programme.

PMID: 18611746 [PubMed - in process]

4218: Australas Chiropr Osteopathy. 1996 Jul;5(2):45-6.

Sometimes they may be zebras: herpes zoster of the L2 spinal nerve. A case
report.

Reggars JW, French SD.

This case report describes a relatively uncommon presentation of herpes zoster
affecting the cutaneous distribution of the L2 spinal nerve. The coexistence of a
previous history of leg pain, cortical thickening of the femoral shaft on plain
film x-ray examination, and the absence, at the time of examination, of the tell 
tale rash of herpes zoster provided the clinician with a diagnostic challenge.
Furthermore, this case stresses the importance of a thorough neurological and
orthopaedic examination as well as careful visual inspection of the painful
region.

PMID: 17987138 [PubMed]

4219: Liver Transpl Surg. 1996 Jul;2(4):253-62.

Famciclovir treatment of hepatitis B virus recurrence after liver
transplantation: a pilot study.

Kruger M, Tillmann HL, Trautwein C, Bode U, Oldhafer K, Maschek H, Boker KH,
Broelsch CE, Pichlmayr R, Manns MP.

Department of Gastroenterology and Hepatology, Medizinische Hochschule Hannover, 
Germany.

Despite hepatitis B immunoprophylaxis hepatitis B virus (HBV) recurrence is a
frequent and often fatal complication after orthotopic liver transplantation
(OLT). The purine nucleoside analogues penciclovir and its oral form famciclovir 
(FCV) proved to be well tolerated and effective against herpes simplex and zoster
virus infections. In addition, an effective reduction of duck and human HBV
replication was observed. Therefore, we conducted an uncontrolled pilot study of 
famciclovir in patients with HBV recurrence after OLT. Twelve patients have
received famciclovir for at least 3 months in an open compassionate-use protocol.
FCV was administered orally 500 mg three times a day for all patients (except one
patient who was started on 750 mg three times a day for the first 2 weeks).
Immediately after starting famciclovir, serum HBV DNA levels declined in 9 of 12 
patients (75%) with a mean reduction from baseline levels of 80% after 3 months, 
90% after 6 months, and > 95% after 12 months of treatment. With continued
treatment, 5 of these 9 patients became negative by conventional hybridization
assay, and in one of these HBV DNA became undetectable by polymerase chain
reaction (PCR) 28 weeks after the start of treatment. Three patients showed no
(sustained) reduction in HBV DNA after at least 3 months of treatment; therefore,
FCV was stopped. Latest serum alanine aminotransferase (ALT) levels decreased in 
6 of 12 patients (50%) with a median decrease of 80% (range, 40%-95%) in
comparison to pretreatment ALT values. ALT levels normalized in 4 patients (33%).
One patient died due to sepsis and peritonitis in week 13 of treatment. This
event was not related to FCV. No clinically significant side effects were noticed
in any patient. The oral nucleoside analog famciclovir reduces HBV replication
and transaminase levels in patients with HBV recurrence after liver
transplantation. Because long-term FCV treatment is well tolerated, famciclovir
appears to be a promising antiviral strategy in the treatment of HBV in
immunocompromised patients.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 9346658 [PubMed - indexed for MEDLINE]

4220: Electromyogr Clin Neurophysiol. 1996 Jul-Aug;36(5):305-10.

Clinical usefulness of electrically elicited pain-related evoked potentials.

Nakashima K, Yokoyama Y, Shimoyama R, Shimoda M, Wang Y, Sakuma K, Kusumi M,
Takahashi K.

Division of Neurology, Faculty of Medicine, Tottori University, Yanago, Japan.

In 14 patients with sensory disturbance, the clinical usefulness of electrical
pain-related evoked potentials (EPREPs) were studied. In four patients with deep 
sensation disturbance, conventional somatosensory evoked potentials (SEPs) were
abnormal. However, EPREPs were abnormal only in one of the patients. In nine
patients with pain-temperature sensation disturbance, SEPs were normal except for
only one patient and EPREPs were abnormal in seven of the nine patients. In a
patient with herpes zoster myelitis, EPREPs elicited by electrical stimulation
below the disturbed spinal level were delayed. After symptomatic improvement,
EPREPs recovered. EPREPs are useful in the clinical field.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8877323 [PubMed - indexed for MEDLINE]

4221: Am J Otol. 1996 Jul;17(4):625-9.

Delayed facial palsy after acoustic neuroma resection: the role of viral
reactivation.

Gianoli GJ, Kartush JM.

Department of Otolaryngology-Head and Neck Surgery, Tulane University Medical
Center, New Orleans, Louisiana 70112, USA.

Delayed facial palsy after acoustic neuroma resection may occur in up to 15% of
cases. Prognosis is generally good if the palsy does not progress to total
paralysis. However, a delayed palsy with subsequent total paralysis has a more
variable final outcome, which ranges from normal function to permanent total
paralysis. This delayed paralysis has been attributed to edema from surgical
manipulation of the facial nerve. Steroids and intraoperative decompression of
the meatal foramen have been used with some success, but some cases remain
refractory to these measures. Herpes simplex virus and varicella-zoster virus are
ubiquitous in the population and remain in a latent state in neural ganglia.
These viruses are reactivated during times of stress. Trigeminal nerve surgery
(partial sensory rhizotomy and microvascular decompression) stimulates
reactivation of herpes simplex with manifestations in the sensory distribution of
the trigeminal nerve in 38-94% of procedures. Prevention of this reactivation has
been demonstrated in placebo-controlled trials by using prophylactic acyclovir.
We present a patient who underwent translabyrinthine resection of an
intracanalicular acoustic neuroma and in whom developed otalgia, vesicles on the 
ear canal and the ipsilateral buccal mucosa, and progressive facial palsy the
week after surgery. Serologic evaluation confirmed the diagnosis of herpes zoster
oticus. Reactivation of latent virus apparently occurred as a result of surgical 
manipulation of the facial nerve. This parallels viral reactivation seen in
trigeminal nerve surgery. We propose a new theory for an additional cause of
delayed facial palsy after acoustic neuroma resection-reactivation of latent
herpesvirus resulting from surgical trauma. Acyclovir should be evaluated in
clinical trials for a prophylactic role in patients undergoing acoustic neuroma
resection or a therapeutic role in patients in whom a delayed postoperative
facial palsy develops.

Publication Types: 
    Case Reports

PMID: 8841711 [PubMed - indexed for MEDLINE]

4222: Clin Pharmacokinet. 1996 Jul;31(1):1-8.

The clinical pharmacokinetics of famciclovir.

Gill KS, Wood MJ.

Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital,
Bordesley Green East, England.

Famciclovir is an oral prodrug of the antiherpesvirus nucleoside analogue,
penciclovir. Following oral administration famciclovir undergoes extensive first 
pass metabolism to penciclovir and essentially no parent compound is recovered
from plasma or urine. Penciclovir plasma concentrations reach a maximum less than
1 hour after famciclovir administration in fasting individuals, but are delayed
if famciclovir is taken within 2 hours of a meal. The bioavailability of
penciclovir, measured by urinary recovery, is approximately 60% and is not
affected by food. Over the likely therapeutic dose range of famciclovir 125 mg to
750 mg, the pharmacokinetics of penciclovir are linear. The volume of
distribution of penciclovir after intravenous administration is more than 1 L/kg,
indicating extensive distribution into the tissue. Penciclovir is predominantly
eliminated unchanged by the kidney, partly by active tubular excretion and has a 
terminal phase elimination half-life (t1/2 beta) of between 2 and 2.5 hours and a
renal clearance (CLR) of between 25 and 30 L/h in individuals with normal renal
function. In those with severe renal impairment the CLR falls markedly and the
t1/2 beta increases to over 18 hours. Haemodialysis appears to be effective in
clearing penciclovir from plasma. Elderly individuals tolerate famciclovir well, 
despite slower elimination secondary to age-related lower renal clearance.
Uncomplicated herpes zoster does not affect the pharmacokinetic profile of
penciclovir. In the limited studies undertaken so far, no significant drug
interactions have been demonstrated.

Publication Types: 
    Comparative Study
    Review

PMID: 8827396 [PubMed - indexed for MEDLINE]

4223: Ir Med J. 1996 Jul-Aug;89(4):132-4.

Treatment of herpes simplex & varicella zoster infection.

Barrg C, Sheehan G.

Publication Types: 
    Editorial
    Review

PMID: 8824033 [PubMed - indexed for MEDLINE]

4224: Pediatr Infect Dis J. 1996 Jul;15(7):643-4.

Acute glomerulonephritis with zoster.

Rossetti A, Tonz M, Bianchetti MG.

Publication Types: 
    Case Reports
    Letter
    Review

PMID: 8823871 [PubMed - indexed for MEDLINE]

4225: Graefes Arch Clin Exp Ophthalmol. 1996 Jul;234(7):419-24.

A comparative study of the polymerase chain reaction and local antibody
production in acute retinal necrosis syndrome and cytomegalovirus retinitis.

Abe T, Tsuchida K, Tamai M.

Department of Ophthalmology, Tohoku University School of Medicine, Miyagi, Japan.

BACKGROUND: It has been thought that herpes viruses may play an important role in
acute retinal necrosis syndrome (herpes simplex and varicella-zoster viruses) as 
well as in cytomegalovirus retinitis and it would be useful to know the
specificity of the methods for detecting the viruses. METHODS: Amplification of
the herpetic viral genome DNA by polymerase chain reaction (PCR) in aqueous and
vitreous humor was compared with Goldmann-Witmer coefficients against herpetic
antigens in five patients with acute retinal necrosis syndrome and in two
patients with cytomegalovirus retinitis, using vitreous samples to determine the 
specificity of these diagnostic methods. RESULTS: The varicella-zoster virus
genome DNA was amplified by PCR in four of the five patients with acute retinal
necrosis syndrome, and cytomegalovirus genome DNA was enhanced in both patients
with cytomegalovirus retinitis. Four patients who exhibited the varicella-zoster 
viral genome showed marked increase of the Goldmann-Witmer coefficient against
varicella-zoster virus. Conversely, the two patients with cytomegalovirus
retinitis showed no remarkable changes among the antigens. CONCLUSION: Our
results showed that the amplification of the viral genome DNA in the samples by
PCR is specific in both diseases, and that the increased level of local antibody 
production also is specific in varicella-zoster retinitis. In cytomegalovirus
retinitis, however, antibody production against cytomegalovirus does not show
increase of the Goldmann-Witmer coefficient.

Publication Types: 
    Comparative Study

PMID: 8817284 [PubMed - indexed for MEDLINE]

4226: Clin Infect Dis. 1996 Jul;23(1):201-2.

Prednisone therapy is not associated with increased risk of herpetic infections
in patients infected with human immunodeficiency virus.

Keiser P, Jockus J, Horton H, Smith JW.

University of Texas Southwestern Medical Center, Dallas, USA.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 8816167 [PubMed - indexed for MEDLINE]

4227: Eur Heart J. 1996 Jul;17(7):1028-34.

The diagnoses of patients admitted with acute chest pain but without myocardial
infarction.

Fruergaard P, Launbjerg J, Hesse B, Jorgensen F, Petri A, Eiken P, Aggestrup S,
Elsborg L, Mellemgaard K.

Department of Medicine B, Hillerod Sygehus, Denmark.

OBJECTIVE: The purpose of this study was to describe the frequencies of various
diagnoses in patients admitted with acute chest pain, but without acute
myocardial infarction, and to evaluate a non-invasive screening programme for
these patients. PATIENTS: A total of 204 consecutive non-acute myocardial
infarction patients were included. Fifty-six had a definite diagnosis within 48
h, whereas 148 patients underwent an examination programme including pulmonary
scintigraphy, echocardiography, exercise electrocardiography, myocardial
scintigraphy, Holter monitoring, hyperventilation test,
oesophago-gastro-duodenoscopy, 3 h monitoring of oesophageal pH, oesophageal
manometry, Bernstein test, physical examination of the chest wall and thoracic
spine, bronchial histamine provocation test and ultrasonic examination of the
abdomen. RESULTS: According to predefined criteria, 186 patients (91%) had at
least one diagnosis, 144 had one, whereas 39 had two, and three patients had
three diagnoses. In 18 patients no diagnosis was obtained. The diagnoses belonged
mainly to three groups: (1) ischaemic heart disease (n = 64); (2)
gastro-oesophageal diseases (n = 85); (3) chest-wall syndromes (n = 58). Less
frequent diagnoses included pulmonary embolism, pleuritis/pneumonia, lung cancer,
aortic stenosis, aortic aneurysm and herpes zoster. CONCLUSIONS: The high risk
subset of a non-acute myocardial infarction population can be identified by means
of a clinical evaluation and non-invasive cardiac examinations. Among the
remainder, pulmonary embolism, gastro-oesophageal diseases and chest-wall
syndromes should be paid special attention. A careful physical examination of the
chest wall and upper endoscopy seems to be the most cost-beneficial examination
to employ in this subset.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8809520 [PubMed - indexed for MEDLINE]

4228: Clin Microbiol Rev. 1996 Jul;9(3):361-81.

Varicella-zoster virus.

Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California
94305-5119, USA. MN.AMA@FORSYTHE.STANFORD.EDU

Varicella-zoster virus (VZV) is a ubiquitous human alphaherpesvirus that causes
varicella (chicken pox) and herpes zoster (shingles). Varicella is a common
childhood illness, characterized by fever, viremia, and scattered vesicular
lesions of the skin. As is characteristic of the alphaherpesviruses, VZV
establishes latency in cells of the dorsal root ganglia. Herpes zoster, caused by
VZV reactivation, is a localized, painful, vesicular rash involving one or
adjacent dermatomes. The incidence of herpes zoster increases with age or
immunosuppression. The VZV virion consists of a nucleocapsid surrounding a core
that contains the linear, double-stranded DNA genome; a protein tegument
separates the capsid from the lipid envelope, which incorporates the major viral 
glycoproteins. VZV is found in a worldwide geographic distribution but is more
prevalent in temperate climates. Primary VZV infection elicits immunoglobulin G
(IgG), IgM, and IgA antibodies, which bind to many classes of viral proteins.
Virus-specific cellular immunity is critical for controlling viral replication in
healthy and immunocompromised patients with primary or recurrent VZV infections. 
Rapid laboratory confirmation of the diagnosis of varicella or herpes zoster,
which can be accomplished by detecting viral proteins or DNA, is important to
determine the need for antiviral therapy. Acyclovir is licensed for treatment of 
varicella and herpes zoster, and acyclovir, valacyclovir, and famciclovir are
approved for herpes zoster. Passive antibody prophylaxis with varicella-zoster
immune globulin is indicated for susceptible high-risk patients exposed to
varicella. A live attenuated varicella vaccine (Oka/Merck strain) is now
recommended for routine childhood immunization.

Publication Types: 
    Review

PMID: 8809466 [PubMed - indexed for MEDLINE]

4229: Drugs. 1996 Jul;52(1):17-32.

New antiherpesvirus agents. Their targets and therapeutic potential.

Alrabiah FA, Sacks SL.

Department of Medicine, University of British Columbia, Vancouver, Canada.

Of the large number of agents under development for the treatment of herpes virus
infections [herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), varicella
zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV)], only ten
have apparently reached clinical development. Aciclovir was approved for the
treatment of HSV infections over 10 years ago, and it remains an important and
reliable antiviral agent. Recent approvals in some countries of valaciclovir for 
VZV infection and famciclovir for both HSV and VZV infections demonstrate the
rapidity of change in this field. Intravenous ganciclovir and foscarnet are
approved for the treatment of CMV infection in the immunocompromised patient.
Five of the antiherpetic drugs under current clinical development are nucleoside 
analogues or their prodrugs; another is a phosphorylated nucleoside (nucleotide).
Four of the nucleoside agents-penciclovir, famciclovir, valaciclovir and
lobucavir-are being developed for the management of HSV and VZV infections.
Valaciclovir is also being developed for the prevention of CMV infections and
famciclovir and lobucavir for the treatment of hepatitis B virus infection. Oral 
ganciclovir, lobucavir, ISIS 2922 and cidofovir are being developed for the
suppression of CMV infections in immunocompromised patients. Sorivudine has been 
studied in VZV infections. n-Docosanol is under development for HSV infections,
and cidofovir is being developed for both HSV and CMV infections, as well as for 
treatment of other viral diseases. Traditionally, the adverse effects associated 
with anti-CMV compounds have been more difficult to manage and are acceptable
clinically only because of the severity of the underlying infection and lack of
safer therapeutic alternatives. In general, toxicity issues continue to be
problematic in the anti-CMV arena, although newer agents have improved the
situation to some extent. In contrast, the safety of anti-HSV compounds has
traditionally been excellent, establishing a safety standard that must be met by 
newer agents entering the field.

Publication Types: 
    Review

PMID: 8799682 [PubMed - indexed for MEDLINE]

4230: Hawaii Med J. 1996 Jul;55(7):118-21.

Herpes zoster at school-age: a case presentation and discussion of the unique
aspects within the pediatric population.

Piette ML.

John A. Burns School of Medicine, University of Hawaii, Honolulu, USA.

This paper is a case presentation and discussion of a 12-year-old boy previously 
in excellent health who presents with dematomal herpes zoster. Although not
unheard of, the occurrence of herpes zoster in the pediatric population is
infrequent. This case provides the opportunity to address many of the aspects of 
herpes zoster that are unique to the pediatric population including epidemiology,
pathophysiology, management and course, and the potential impact of the live
attenuated varicella vaccine, recently approved for the prevention of the primary
varicella infection, chickenpox.

Publication Types: 
    Case Reports
    Review

PMID: 8771986 [PubMed - indexed for MEDLINE]

4231: Virchows Arch. 1996 Jul;428(4-5):275-80.

Comment in:
    Virchows Arch. 1997 Jun;430(6):510-1.

Hair follicle involvement in herpes zoster: pathway of viral spread from ganglia 
to skin.

Muraki R, Iwasaki T, Sata T, Sato Y, Kurata T.

Department of Dermatology, Kasumigaura National Hospital, Ibaraki, Japan.

Herpes zoster is caused by reactivation of varicella-zoster virus (VZV)
persisting in dorsal root or trigeminal ganglia. To clarify the pathway of viral 
spread from the ganglia to skin, 16 biopsy specimens of early skin lesions of
herpes zoster obtained from the face and trunk of 13 patients were studied
histologically and immunohistochemically using monoclonal antibodies to the
structural proteins of VZV. VZV-infected cells were detected in the hair
follicles in 10 of the 16 specimens and in the epidermis in 2 specimens. Infected
cells were localized in the isthmus of every involved follicle (12/12),
frequently in the stem (8/10) and infundibulum (6/10), and never in the bulb. The
high frequency of follicular involvement in herpes zoster suggests that VZV
spreads to the area of skin innervated by myelinated nerves, which end around the
isthmus of hair follicles and sebaceous glands.

PMID: 8764937 [PubMed - indexed for MEDLINE]

4232: Ear Nose Throat J. 1996 Jul;75(7):410-5.

Total facial nerve decompression: technique to avoid complications.

Pulec JL.

Pulec Ear Clinic, Los Angeles, California 90017, USA.

Exposure of the facial nerve from the brainstem to the parotid can be
accomplished without injury to the nerve, tympanic membrane, external auditory
canal, ossicular chain, inner ear or structures within the cerebello-pontine
angle. The procedure has reliably provided good results for patients who have had
the proper indications with facial paralysis from Bell's palsy, herpes zoster
oticus, infection, hemi-facial spasm, temporal bone fracture and tumors. The
current technique for exposure through the mastoid, middle cranial fossa and
retrolabyrinthine combined approaches are described. This technique, properly
performed, is a valuable treatment for facial nerve lesions.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8764701 [PubMed - indexed for MEDLINE]

4233: Anaesthesia. 1996 Jul;51(7):647-51.

Comment in:
    Anaesthesia. 1996 Dec;51(12):1190.

Epidural morphine for postherpetic neuralgia.

Watt JW, Wiles JR, Bowsher DR.

Pain Relief Foundation, Liverpool.

Eleven patients with established postherpetic neuralgia, unresponsive to
antidepressant therapy, entered this single-blind, placebo-controlled study to
assess the effectiveness of epidural morphine in the control of the pain of
postherpetic neuralgia. Two patients obtained a reduction in pain of greater than
50% following morphine 0.5 mg. The duration of this pain relief was 36 h in one
patient and 72 h in the other. Repeated doses, however, were ineffective in one
patient and resulted in intolerable side effects in the other. The other six
patients who received morphine developed opioid-related side effects without pain
relief. Three patients did not receive morphine as they gained significant,
long-lasting pain relief from placebo. Two retained that benefit for more than 6 
months. Epidural morphine is more likely to produce side effects than pain relief
when administered to patients with postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 8758156 [PubMed - indexed for MEDLINE]

4234: J Gen Virol. 1996 Jul;77 ( Pt 7):1505-13.

Intracellular distribution of the ORF4 gene product of varicella-zoster virus is 
influenced by the IE62 protein.

Defechereux P, Debrus S, Baudoux L, Schoonbroodt S, Merville MP, Rentier B,
Piette J.

Laboratory of Fundamental Virology, Department of Microbiology, Institute of
Pathology B23, University of Liege, Belgium.

Varicella-zoster virus (VZV) open reading frame 4-encoded protein (IE4) possesses
transactivating properties for VZV genes as well as for genes of heterologous
viruses. The major regulatory immediate-early protein of VZV (IE62) is a
transactivator of VZV gene expression. In transfection assays, IE4 has been shown
to enhance activation induced by IE62. To investigate the functional interactions
underlying this observation, indirect immunofluorescence studies were undertaken 
to determine whether IE62 could influence IE4 intracellular localization in
transfected cells. In single transfections, IE4 was predominantly found in
cytoplasm. In cotransfection with IE62, the IE4 localization pattern was altered,
with nuclear staining predominating over cytoplasmic staining. This effect was
specific to the IE62 protein since the gene products of ORF63 and ORF61, which
are also regulatory proteins, did not influence IE4 distribution. The use of IE62
mutants indicated that IE62 influence is independent of its transactivation
function and that the integrity of regions 3 and 4 is required. IE62 remained
nuclear whether IE4 was present or not. These observations underline differences 
in the regulation of gene expression between VZV proteins and their herpes
simplex virus type 1 homologues. In infected cells, IE4 was only sometimes found 
to colocalize with IE62 in nuclei. This observation suggests that when all VZV
proteins are present, complex interactions probably occur which could diminish
the influence of IE62.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8757993 [PubMed - indexed for MEDLINE]

4235: J Am Acad Dermatol. 1996 Jul;35(1):21-6.

Cytomegalovirus DNA identified in skin biopsy specimens of patients with
vitiligo.

Grimes PE, Sevall JS, Vojdani A.

Vitiligo and Pigmentation Center of Southern California, Los Angeles 90004, USA.

BACKGROUND: Viral infections have been implicated in the pathogenesis of a
variety of autoimmune diseases. OBJECTIVE: This investigation was undertaken to
determine the presence or absence of viral genomes in the depigmented and
uninvolved skin of patients with vitiligo. METHODS: A polymerase chain reaction
assay was used to detect viral genomes in paraffin-embedded skin biopsy
specimens. Twenty-nine patients with vitiligo and 22 control subjects were
included. Biopsy specimens were screened in a blinded fashion for a panel of DNA 
and RNA viruses including herpes simplex, varicella-zoster, cytomegalovirus
(CMV), Epstein-Barr, HIV, and human T-cell lymphotropic virus. RESULTS: CMV DNA
was identified in 38% of the patients studied. Twenty-one percent had
indeterminate results. Results in all control subjects were negative. Polymerase 
chain reaction screening for identification of other viral genomes was negative. 
Although not statistically significant, data trends suggested a correlation
between the presence of CMV DNA in biopsy specimens and active vitiligo of
relatively brief duration. In addition, CMV-positive patients had a statistically
significant increased frequency of other concurrent autoimmune diseases.
CONCLUSION: CMV DNA in the depigmented and uninvolved skin of some patients with 
vitiligo and its absence in control subjects suggest that vitiligo may indeed be 
triggered by a viral infection in select patients.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8682958 [PubMed - indexed for MEDLINE]

4236: J Infect Dis. 1996 Jul;174(1):239-41.

Comment on:
    J Infect Dis. 1995 Mar;171(3):701-4.

Racial differences in herpes zoster and age at onset of varicella.

Dworkin RH.

Publication Types: 
    Comment
    Letter

PMID: 8656005 [PubMed - indexed for MEDLINE]

4237: Am J Health Syst Pharm. 1996 Jun 15;53(12):1454, 1456.

Confusion and bradykinesia associated with famciclovir therapy for herpes zoster.

Gales BJ, Gales MA.

Publication Types: 
    Case Reports
    Letter

PMID: 8781691 [PubMed - indexed for MEDLINE]

4238: Blood. 1996 Jun 15;87(12):5341-54.

Human herpesvirus 6: infection and disease following autologous and allogeneic
bone marrow transplantation.

Kadakia MP, Rybka WB, Stewart JA, Patton JL, Stamey FR, Elsawy M, Pellett PE,
Armstrong JA.

Department of Infectious Diseases and Microbiology, Graduate School of Public
Health, University of Pittsburgh, PA 15261, USA.

Human herpesvirus 6 activity (HHV-6) was studied in 15 allogeneic and 11
autologous marrow transplantation patients. After transplantation, HHV-6 was
isolated from the peripheral blood mononuclear cells of 12 of 26 patients (6
allogeneic and 6 autologous). All isolates were variant B. Eleven of 26 and 12 of
19 patients showed salivary shedding of HHV-6 DNA before and after
transplantation, respectively. The antibody titer increased in 7 of 26 patients. 
Thus, 23 of 26 patients showed evidence of active HHV-6 infection either by virus
isolation, salivary shedding, or increases in antibody titers. The fraction of
saliva specimens positive in 19 patients was negatively associated with their
antibody titers (P= .005). The proportion of cultures positive increased after
transplantation (P = .007). Sinusitis was associated with HHV-6 isolation in
autologous recipients (P= .002). In allogeneic patients, active human
cytomegalovirus infection was associated with HHV-6 isolation (P = .04). No
association was observed between HHV-6 infection and GVHD, pneumonia, delay in
engraftment, or marrow suppression. Of the 120 clinical events analyzed in 26
patients, HHV-6 was defined as a probable cause of 16 events in 9 patients based 
on the propinquity of HHV-6 activity and the clinical event plus the absence of
other identified causes of the event.

Publication Types: 
    Comparative Study

PMID: 8652850 [PubMed - indexed for MEDLINE]

4239: J Clin Rheumatol. 1996 Jun;2(3):167-9.

Sacral herpes-zoster infection presenting as sciatic pain.

Ablin J, Symon Z, Mevorach D.

Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem,
Israel.

Acute herpes-zoster infection is a painful dermatomal lesion that can be
manifested by a wide array of neurologic symptoms. We present a 55-year-old
female with non-Hodgkin's lymphoma, who developed a left sciatic pain involving
the S roots. Two weeks later, the patient developed fever and vesicular rash over
the left gluteal area. Herpes-zoster infection was diagnosed and confirmed by the
presence of immunoglobulin M (IgM) antibodies against varicella-zoster. The pain 
and rash resolved, after treatment with acyclovir. In the appropriate clinical
setting, sacral herpes-zoster infection ought to be considered in the
differential diagnosis of new-onset sciatic pain.

PMID: 19078055 [PubMed - in process]

4240: J Assoc Physicians India. 1996 Jun;44(6):427-8.

Myocarditis in herpes zoster.

Chauhan R, Singh RP, Hooda AK, Vadhera V, Singh VP, Mabena DM.

Botswana Defence Force.

Publication Types: 
    Case Reports

PMID: 9282569 [PubMed - indexed for MEDLINE]

4241: Pol Tyg Lek. 1996 Jun;51(23-26):338-9.

[Efficacy of cimetidine in treatment of Herpes zoster in the first 5 days from
the moment of disease manifestation]

[Article in Polish]

Kapinska-Mrowiecka M, Turowski G.

221 patients with Herpes zoster have undergone the treatment. They were given
cimetidine in the daily dose 3 x 200 mg and 1 x 400 mg to night. It was proved
that the efficacy of the Herpes zoster treatment by cimetidine is inversely
proportional to the time of the disease duration. The authors suggest to use
cimetidine in the treatment of Herpes zoster virus infections even during the
prodromal period.

Publication Types: 
    English Abstract

PMID: 9273526 [PubMed - indexed for MEDLINE]

4242: Pol Tyg Lek. 1996 Jun;51(23-26):321-3.

[Herpes zoster--clinical aspects]

[Article in Polish]

Wnuk A, Pynka M, Boron-Kaczmarska A.

Katedry i Kliniki Chorob Zakaznych Pomorskiej AM w Szczecinie.

Clinical course of herpes zoster was assessed in 119 immuno-competent and in 28
immuno-compromised hosts. Complications of herpes zoster were observed in one
third cases. However, the frequency of post-herpetic neuralgia was lower than
that seen by other authors. Despite severe underlying diseases in compromised
hosts, good outcome of herpes zoster was obtained. It may be related to the use
of aciclovir in all these cases. Early and rational treatment with aciclovir is
important for decreasing of the frequency of severe complications of herpes
zoster.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 9273519 [PubMed - indexed for MEDLINE]

4243: Neurobiol Dis. 1996;3(3):205-14.

Cutaneous innervation density in the allodynic form of postherpetic neuralgia.

Rowbotham MC, Yosipovitch G, Connolly MK, Finlay D, Forde G, Fields HL.

Department of Neurology, University of California, School of Medicine, San
Francisco 94143-1635, USA.

The relationship between deafferentation, sensory function, and pain was explored
in 18 subjects with chronic postherpetic neuralgia (PHN). Subjective thresholds
for warmth, cooling, and heat pain were measured quantitatively in painful skin
areas and compared with normal contralateral skin. The severity of allodynia was 
graded in the affected area. Two 3-mm punch biopsies were taken from the most
painful skin area and one from unaffected contralateral mirror-image skin.
Immunofluorescence with the axonal marker PGP 9.5 revealed a reduction in density
of innervation of the epidermis, the dermal-epidermal junction, and the eccrine
sweat glands in PHN skin. In painful PHN skin, the reduction in innervation
density was positively correlated with the magnitude of the thermal sensory
deficits. However, loss of cutaneous innervation was inversely correlated with
allodynia, indicating that surviving cutaneous primary afferent nociceptors that 
are spontaneously active and/or sensitized contribute to PHN pain and allodynia.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8980021 [PubMed - indexed for MEDLINE]

4244: Semin Dermatol. 1996 Jun;15(2 Suppl 1):27-31.

Efficacy of famciclovir in the treatment of herpes zoster.

Tyring SK.

University of Texas Medical Branch, Galveston 77555, USA.

Although vidarabine was the first systemic antiviral drug for the treatment of
acute herpes zoster, the agent now used most frequently is acyclovir, a far safer
drug that became available a decade ago. However, even with widespread use of
acyclovir, postherpetic neuralgia (PHN) remains a principal cause of
postinfectious morbidity. Newer antiviral agents, such as famciclovir and
valacyclovir, have recently been introduced for the treatment of uncomplicated
herpes zoster. In a double-blind, randomized study, 500 mg of famciclovir three
times daily for 7 days was compared with placebo; in a second study, 500 mg of
famciclovir three times daily for 7 days was compared with 800 mg of acyclovir
five times daily for 7 days. Famciclovir significantly reduced duration of viral 
shedding (P = 0.0001) and accelerated lesion resolution compared with placebo.
Famciclovir was comparable to acyclovir for these acute parameters. Most
importantly, famciclovir recipients lost PHN two times faster than those
receiving placebo (P = 0.02 all patients; P = 0.004 patients > or = 50 years)
resulting in a reduction in the median duration of PHN (56 days all patients; 100
days patients > or = 50 years). This reduction translated to a 3.5-month
reduction in the median duration of PHN for patients 50 years or older, those at 
greatest risk for developing the most common complication of herpes zoster.
Famciclovir 500 mg administered three times a day for 7 days is an effective and 
well-tolerated treatment for acute herpes zoster, and is the only oral antiviral 
agent proven to reduce the duration of PHN when administered during acute zoster 
infection.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Review

PMID: 8840413 [PubMed - indexed for MEDLINE]

4245: Semin Dermatol. 1996 Jun;15(2 Suppl 1):14-26.

The pharmacological profile of famciclovir.

Crumpacker C.

Division of Infectious Diseases, Beth Israel Hospital, Boston, MA 02215, USA.

Famciclovir is the well-absorbed oral form of penciclovir, a potent and selective
antiviral agent, with activity against members of the herpesvirus family,
including varicella-zoster virus (VZV), and herpes simplex virus-1 (HSV-1) and
HSV-2. Famciclovir is rapidly absorbed and converted to penciclovir. Penciclovir 
has excellent bioavailability (77%) after oral administration of 500 mg of
famciclovir. Similar to acyclovir, famciclovir is converted by phosphorylation to
its active metabolite, penciclovir-triphosphate. Penciclovir-triphosphate has a
prolonged in vitro intracellular half-life of 10 to 20 hours in HSV-1-and
HSV-2-infected cells, respectively, and 9 to 14 hours in VZV-infected cells. In
contrast, the in vitro intracellular half-life of acyclovir is substantially
shorter at 0.7 and 1 hours in HSV-1- and HSV-2-infected cells, respectively, and 
0.8 hours in VZV-infected cells. Famciclovir is eliminated primarily via the
kidneys. Dosage adjustment is not required for famciclovir in elderly patients
with normal or mildly impaired renal function, and the extent of penciclovir
availability is not affected by food. The excellent bioavailability ensures that 
adequate drug reaches virus-infected cells, and the prolonged intracellular
half-life of the active form of famciclovir results in persistent antiviral
activity.

Publication Types: 
    Review

PMID: 8840412 [PubMed - indexed for MEDLINE]

4246: Semin Dermatol. 1996 Jun;15(2 Suppl 1):8-13.

Epidemiology and management of postherpetic neuralgia.

Gershon AA.

Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA.

Herpes zoster occurs rarely in immunocompetent children and infrequently in
immunocompetent young adults. However, its incidence increases with age,
particularly after age 50. Reactivation of varicella-zoster virus (VZV) is
characterized by a rash and is generally accompanied by considerable pain,
dysesthesias, and skin hypersensitivity. Chronic pain that is sometimes
experienced after the rash has healed is referred to as postherpetic neuralgia
(PHN), the most common complication of herpes zoster. Postherpetic neuralgia is
often severe and, unfortunately, refractory to most forms of treatment. The
incidence of PHN also increases dramatically with increased age. More than 50% of
zoster patients over 60 years old will develop PHN, which may persist for months 
and even years. Thus, established PHN is difficult to manage, often causing
serious morbidity, depression, and high costs in terms of consumption of
healthcare resources. Currently, early antiviral treatment with famciclovir has
shown promise of reducing the duration of PHN.

Publication Types: 
    Review

PMID: 8840411 [PubMed - indexed for MEDLINE]

4247: Semin Dermatol. 1996 Jun;15(2 Suppl 1):4-7.

Varicella-zoster virus: overview and clinical manifestations.

Arvin AM.

Stanford University School of Medicine, CA 94305, USA.

Varicella-zoster virus (VZV) is a human pathogen that has probably infected
humans since prehistoric times. Varicella-zoster virus causes chickenpox in
childhood (varicella), and establishes latency in sensory ganglia after the
primary infection. Varicella-zoster virus may reemerge later in life, taking
advantage of the decline in immune function that occurs with aging.
Varicella-zoster virus reactivation causes herpes zoster, commonly known as
shingles. The incidence of herpes zoster increases with advancing age. Severe
pain is the major cause of acute and chronic morbidity in patients with herpes
zoster. Fortunately, the acute phase is self-limiting and transient. However,
chronic and often debilitating pain may persist after the lesions have healed and
is referred to as postherpetic neuralgia (PHN), the most common complication of
herpes zoster. Similar to acute herpes zoster, the incidence of PHN increases
dramatically with age.

Publication Types: 
    Review

PMID: 8840410 [PubMed - indexed for MEDLINE]

4248: Semin Dermatol. 1996 Jun;15(2 Suppl 1):1-3.

Advances in the management of herpesvirus infections. Introduction.

Whitley RJ.

University of Alabama at Birmingham, USA.

Publication Types: 
    Review

PMID: 8840409 [PubMed - indexed for MEDLINE]

4249: Acta Neurol Scand. 1996 Jun;93(6):470-2.

A case of varicella-zoster myelopathy.

Aizawa H, Suzutani T, Yahara O, Gotoh R, Morita K, Minami H, Sasaki N, Tobise K.

Department of Internal Medicine, National Hospital Nayoro, Japan.

INTRODUCTION: Early diagnosis of neurological complications of varicella-zoster
virus (VZV) is important because of its treatability. We performed polymerase
chain reaction (PCR) to detect VZV-DNA from the cerebrospinal fluid (CSF) of a
patient with myelopathy. PATIENT & METHODS: A 69-year-old man developed sensory
disturbances in the lower extremities and bladder-bowel disturbances, followed by
cutaneous zoster on his left arm. Polymerase chain reaction was applied to
identify the viral DNA in CSF. RESULTS: The increased antibody index of VZV and
herpes simplex virus (HSV) in the CSF suggested intrathecal synthesis of IgG
antibodies to these viruses. VZV-DNA was detected in the CSF by nested PCR, but
neither HSV-1 nor HSV-2 DNA was detected in CSF. He was successfully treated with
acyclovir and prednisolone. CONCLUSION: PCR may be a useful tool for the
diagnosis of VZV myelopathy.

Publication Types: 
    Case Reports

PMID: 8836311 [PubMed - indexed for MEDLINE]

4250: Intern Med. 1996 Jun;35(6):478-81.

Syndrome of inappropriate secretion of antidiuretic hormone in elderly patients
with rheumatoid arthritis associated with infections: report of two cases.

Furuta E, Yasuda M, Yoshioka K, Isayama T, Nobunaga M.

Department of Physical Therapy and Rheumatology, Beppu National Hospital.

Two rheumatoid arthritis (RA) patients with the syndrome of inappropriate
secretion of antidiuretic hormone (SIADH) during the course of infection are
herein reported. One patient developed SIADH during the course of a localized
cutaneous herpes zoster infection while the other developed SIADH in conjunction 
with Staphylococcus simulans septicemia. We consider that the development of
SIADH was strongly associated with superimposed infections in the underlying RA. 
This is the first report discussing the association of SIADH and infections in RA
patients in which SIADH is diagnosed by measurement of plasma ADH.

Publication Types: 
    Case Reports

PMID: 8835600 [PubMed - indexed for MEDLINE]

4251: J Paediatr Child Health. 1996 Jun;32(3):211-7.

Acyclovir for the prevention and treatment of varicella zoster in children,
adolescents and pregnancy.

Kesson AM, Grimwood K, Burgess MA, Ferson MJ, Gilbert GL, Hogg G, Isaacs D,
Kakakios A, McIntyre P.

Australasian Society for infectious Diseases, Sydney, New South Wales, Australia.

Varicella causes a mild, self-limiting childhood disease that may reactivate
years later as shingles. In immunocompromised patients with altered cell mediated
immunity, and rarely in healthy individuals, varicella results in a
life-threatening infection. The antiviral drug, acyclovir, substantially reduces 
the mortality and risk of severe disease in these groups of patients. Early
commencement of acyclovir is recommended for children with both varicella and
altered cell mediated immunity, newborns during the first 2 weeks of life,
preterm infants in the neonatal nursery, and severe varicella or shingles
(including ocular zoster) in any patient, as well as during pregnancy. Acyclovir 
may be considered in children with serious cardiopulmonary disease or chronic
skin disorders where varicella may exacerbate the underlying disease or increase 
the risk of secondary bacterial sepsis. Acyclovir, however, is not recommended
for healthy individuals without severe disease, as a prophylactic agent against
varicella, for asthmatics receiving aerosolized or low-dose oral steroids and/or 
as treatment of the post-varicella syndromes. When acyclovir is prescribed it
should be given intravenously to those with severe disease, those at risk of
dissemination and in children younger than 2 years of age.

Publication Types: 
    Review

PMID: 8827537 [PubMed - indexed for MEDLINE]

4252: Am J Infect Control. 1996 Jun;24(3):201-2.

Comment in:
    Am J Infect Control. 1997 Jun;25(3):287-8.

The 1996 CDC and HICPAC isolation guideline: a pediatric perspective.

Stover BH.

Kosair Children's Hospital, Louisville, KY 40204, USA.

PMID: 8806998 [PubMed - indexed for MEDLINE]

4253: Cutis. 1996 Jun;57(6):421-4.

Ramsay Hunt syndrome presenting as a cranial polyneuropathy.

Asnis DS, Micic L, Giaccio D.

Department of Internal Medicine, Flushing Hospital Medical Center, New York
11355, USA.

Ramsay Hunt syndrome is herpes zoster of the facial nerve, frequently associated 
with VIII cranial nerve involvement, but on rare occasions V, VI, IX, and X
cranial nerves are affected as well. We present a case of a Ramsay Hunt syndrome 
with involvement of V, VII, and VIII cranial nerves.

Publication Types: 
    Case Reports

PMID: 8804844 [PubMed - indexed for MEDLINE]

4254: J Neurovirol. 1996 Jun;2(3):175-90.

Clinical implications of nucleic acid amplification methods for the diagnosis of 
viral infections of the nervous system.

Weber T, Frye S, Bodemer M, Otto M, Luke W.

Department of Neurology, Georg-August-University, Gottingen, Germany.

Amplification of viral nucleic acids from the cerebrospinal fluid (CSF) has
considerably improved the diagnosis of several acute, subacute and chronic viral 
infections of the nervous system. In herpes simplex virus (HSV) encephalitis
(HSE) the polymerase chain reaction (PCR) has become the method of choice for the
rapid, non invasive diagnosis. Other herpes virus associated diseases which can
now be reliably diagnosed are encephalitis, ventriculoencephalitis,
polymyeloradiculitis, myelitis and an inflammatory polyradiculoneuropathy caused 
by cytomegalovirus (CMV), HSV, varicella-zoster virus (VZV) or Epstein-Barr virus
(EBV), EBV associated primary B-cell-lymphoma of the brain, acute aseptic
meningitis in young adults allied with VZV, and meningoencephalitis with
recurrent seizures due to human herpes virus type 6 (HHV-6). In AIDS patients,
PCR has helped to differentiate lesions either due to the human immunodeficiency 
virus (HIV) itself or to opportunistic infections such as progressive multifocal 
leukoencephalopathy (PML) caused by JC virus (JCV) or CMV related complications. 
HIV can be detected early in the course of infection in the CSF and the amount of
proviral DNA in CSF cells seems to be correlated with the severity and/or
progression of neurological signs and symptoms. Acute epidemic aseptic meningitis
caused by enterovirus infections can now be reliably diagnosed and typed by
reverse transcriptase PCR (RT-PCR). Meningitis cases caused by vaccination with
the Jeryl Lynn and Urabe vaccine strain of mumps virus have been identified using
RT-PCR and sequencing of the amplified products (amplicon).

Publication Types: 
    Review

PMID: 8799210 [PubMed - indexed for MEDLINE]

4255: Clin Infect Dis. 1996 Jun;22(6):1128-9.

Comment on:
    Clin Infect Dis. 1995 Aug;21(2):370-5.

Ramsay Hunt syndrome in a patient infected with human immunodeficiency virus.

Johnson KB, Blazes DL, Keith M, Decker CF, Ohl CA.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 8783739 [PubMed - indexed for MEDLINE]

4256: Ryumachi. 1996 Jun;36(3):514-21.

[Untoward effects of low dose methotrexate therapy in rheumatoid arthritis]

[Article in Japanese]

Kawabe Y, Eguchi K, Tsuboi M, Kita M, Tsukada T, Takashima H, Mizokami A,
Kawakami A, Matsuoka N, Migita K, Nagataki S.

First Department of Internal Medicine, Nagasaki University School of Medicine.

Sixty patients with rheumatoid arthritis who were administered weekly low dose
methotrexate (MTX) were retrospectively analyzed for their untoward effects of
MTX by interviewing to the patients and by the medical records. Cough and sputa
were the most frequent symptoms (23.3%) and gastrointestinal symptoms were the
next (20%). Five of 60 patients (8.2%) showed liver function test abnormalities, 
and four (6.7%) exhibited transient exacerbation of arthralgia for several hours 
to a few days after MTX administration. Three patients (5%) suffered from
interstitial pneumonitis. Hair loss was seen in 3 patients (5%), and headache,
leucocytepenia, fever, skin eruption, abnormal taste, hemorrhagic cystitis, and
flashing were experienced in a patient, respectively. Three (5%) suffered from
fungal infection, and herpes zoster, sepsis, and osteomyelitis were experienced
in each one patient, respectively. MTX was withdrawn in three patients (5%)
because of cough and sputa the drug was withdrawn in other three patients because
of the interstitial pneumonia, and was drawn in another three patients because of
transient exacerbation of arthralgia. The drug was withdrawn in each one patient,
because of nausea and vomiting, skin eruption, osteomyelitis, and sepsis,
respectively. Overall, MTX were withdrawn in 21 patients (35%), and, of those, 13
patients (21.7%) because of untoward effects and 8 patients (13.3%) because of
the lack of efficacy.

Publication Types: 
    English Abstract

PMID: 8779788 [PubMed - indexed for MEDLINE]

4257: Enferm Infecc Microbiol Clin. 1996 Jun-Jul;14(6):396-7.

Comment on:
    Enferm Infecc Microbiol Clin. 1995 Jan;13(1):6-11.

[Meningoencephalitis and pancreatitis caused by the varicella virus, herpes
zoster]

[Article in Spanish]

Pascual-Velasco F.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 8756222 [PubMed - indexed for MEDLINE]

4258: Otolaryngol Clin North Am. 1996 Jun;29(3):445-54.

Update on facial nerve disorders.

Bauer CA, Coker NJ.

Department of Otorhinolaryngology and Communicative Sciences, Baylor College of
Medicine, Houston, Texas, USA.

Many issues involving the diagnosis and treatment of facial nerve disorders
continue to engender controversy and debate. This article examines the theory
that Bell's palsy is a herpes simplex neuritis and proposes facial nerve
decompression for recurrent palsies. The contemporary management of herpes zoster
oticus, temporal bone fractures, otogenic facial paralysis, and hemifacial spasm 
is reviewed.

Publication Types: 
    Review

PMID: 8743343 [PubMed - indexed for MEDLINE]

4259: Drugs Aging. 1996 Jun;8(6):459-76.

Amitriptyline. A review of its pharmacological properties and therapeutic use in 
chronic pain states.

Bryson HM, Wilde MI.

Adis International Ltd, Auckland, New Zealand.

Amitriptyline is a tricyclic antidepressant agent which also has analgesic
properties. Whether its analgesic effects are linked to its mood-altering
activity or attributable to a discrete pharmacological action (or a combination
of both) is unknown. Clinical trials demonstrate that oral amitriptyline achieves
at least a good or moderate response in up to two-thirds of patients with
post-herpetic neuralgia and three-quarters of patients with painful diabetic
neuropathy, neurogenic pain syndromes that are often unresponsive to narcotic
analgesics. Amitriptyline has also demonstrated efficacy in heterogeneous groups 
of patients with chronic non-malignant pain. Other possible areas of use for
amitriptyline are in patients with fibromyalgia or as an adjuvant for
uncontrolled cancer pain, although evidence for the latter application is
limited. Adverse events resulting from the antimuscarinic activity of
amitriptyline (primarily dry mouth and sedation) are commonly reported, even at
the low dosages used for the control of pain. Low starting doses and careful
dosage titration may help to minimise these effects. Orthostatic hypotension and 
tachycardia, sometimes associated with tricyclic antidepressant agents, may also 
pose a problem in the elderly. In summary, amitriptyline has a valuable place in 
the treatment of chronic pain conditions that affect the elderly provided that
the drug is used judiciously to minimise adverse effects. Importantly,
amitriptyline remains the best studied of the antidepressant agents in
post-herpetic neuralgia and diabetic neuropathy and is an important and effective
treatment option in these syndromes.

Publication Types: 
    Review

PMID: 8736630 [PubMed - indexed for MEDLINE]

4260: Transplant Proc. 1996 Jun;28(3):1511-2.

Varicella-zoster infection in cyclosporine A-treated renal transplant patients.

Lo CY, Cheng IK.

Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.

Publication Types: 
    Comparative Study

PMID: 8658764 [PubMed - indexed for MEDLINE]

4261: J Virol. 1996 Jun;70(6):3938-46.

Properties of the protein encoded by the UL32 open reading frame of herpes
simplex virus 1.

Chang YE, Poon AP, Roizman B.

The Marjorie B. Kovler Viral Oncology Laboratories, The University of Chicago,
Illinois 60637, USA.

The functions previously assigned to the essential herpes simplex virus 1 UL32
protein were in cleavage and/or packaging of viral DNA and in maturation and/or
translocation of viral glycoproteins to the plasma membrane. The amino acid
sequence predicts N-linked glycosylation sites and sequences conserved in
aspartyl proteases and in zinc-binding proteins. We report the following. (i) The
596-amino-acid UL32 protein accumulated predominantly in the cytoplasm of
infected cells but was not metabolically labeled with glucosamine and did not
band with membranes containing a known glycoprotein in flotation sucrose density 
gradients. The UL32 protein does not, therefore, have the properties of an
intrinsic membrane protein. (ii) Experiments designed to demonstrate aspartyl
protease activity in a phage display system failed to reveal proteolytic
activity. Moreover, substitution of Asp-110 with Gly in the sequence Asp-Thr-Gly,
the hallmark of aspartyl proteases, had no effect on viral replication in Vero
and SK-N-SH cell lines or in human foreskin fibroblasts. Therefore, if the UL32
protein functions as a protease, this function is not required in cells in
culture. (iii) Both the native UL32 protein and a histidine-tagged UL32 protein
made in recombinant baculovirus-infected insect cells bound zinc. The consensus
sequence is conserved in the UL32 homologs from varicella-zoster virus and equine
herpesvirus 1. UL32 protein is therefore a cysteine-rich, zinc-binding essential 
cytoplasmic protein whose function is not yet clear.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8648731 [PubMed - indexed for MEDLINE]

4262: J Virol. 1996 Jun;70(6):3517-27.

Identification and characterization of the pseudorabies virus UL3.5 protein,
which is involved in virus egress.

Fuchs W, Klupp BG, Granzow H, Rziha HJ, Mettenleiter TC.

Institute of Molecular and Cellular Virology, Friedrich-Loeffler-Institutes,
Federal Research Centre for Virus Diseases of Animals, Insel Riems, Germany.

Alphaherpesvirus genomes exhibit a generally collinear gene arrangement, and most
of their genes are conserved among the different members of the subfamily. Among 
the exceptions is the UL3.5 gene of pseudorabies virus (PrV) for which positional
homologs have been detected in the genomes of varicella-zoster virus, equine
herpesvirus 1, and bovine herpesvirus 1 but not in the genomes of herpes simplex 
virus types 1 and 2. To identify and characterize the predicted 224 amino acid
UL3.5 protein of PrV, a rabbit antiserum was prepared against a UL3.5 fusion
protein expressed in Escherichia coli. In Western blot (immunoblot) analyses the 
antiserum detected a 30-kDa protein in the cytoplasm of PrV infected cells which 
was absent from purified virions. For functional analysis, UL3.5-expressing cell 
lines were established and virus mutants were isolated after the rescue of
defective, glycoprotein B-negative PrV by insertion of the complementing
glycoprotein B-encoding gene of bovine herpesvirus 1 at two sites within the
UL3.5 locus. A PrV mutant carrying the insertion at codon 159 and expressing a
truncated UL3.5 protein was still capable of efficient productive replication in 
noncomplementing cells. In contrast, a PrV mutant carrying the insertion at codon
10 of the UL3.5 gene did not express detectable UL3.5 protein and exhibited a
dramatic growth deficiency on non-complementing cells with regard to plaque
formation and one-step replication. Electron microscopical studies showed an
accumulation of unenveloped capsids in the vicinity of the Golgi apparatus. This 
defect could be compensated by propagation on complementing UL3.5-expressing cell
lines. Our results thus demonstrate that the PrV UL3.5 gene encodes a
nonstructural protein which plays an important role in virus replication,
presumably during virus egress. The functionally relevant domains appear to be
located within the N-terminal part of the UL3.5 protein which also comprises the 
region exhibiting the highest level of homology between the predicted UL3.5
homologous proteins of other alphaherpesviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8648685 [PubMed - indexed for MEDLINE]

4263: J Am Acad Dermatol. 1996 Jun;34(6):1084-6.

Predictive value of seborrheic dermatitis and other common dermatoses for HIV
infection in Bamako, Mali.

Mahe A, Simon F, Coulibaly S, Tounkara A, Bobin P.

Institut Marchoux, Bamako, Mali.

PMID: 8647980 [PubMed - indexed for MEDLINE]

4264: J Am Acad Dermatol. 1996 Jun;34(6):1005-7.

Cimetidine therapy for warts: a placebo-controlled, double-blind study.

Yilmaz E, Alpsoy E, Basaran E.

Department of Dermatology, Akdeniz University Medical Faculty, Antalya, Turkey.

BACKGROUND: Cimetidine, an H2-receptor antagonist, has been used successfully to 
treat patients with mucocutaneous candidiasis, common variable immunodeficiency, 
herpes simplex, and herpes zoster because of its immunomodulatory effects.
Recently, some trials have suggested that cimetidine may also be useful for the
treatment of warts. OBJECTIVE: The aim of the present study was to determine
whether cimetidine is effective in the treatment of warts. METHODS: Seventy
patients with multiple warts were included in a placebo-controlled, double-blind 
study. Patients were randomly allocated to treatment groups equally. The groups
received cimetidine, 25 to 40 mg/kg daily, or placebo for 3 months. Patients were
examined at monthly intervals. RESULTS: At the end of the therapy, 28
cimetidine-treated and 26 placebo-treated patients were examined to determine the
efficacy of treatment. Cure rates obtained were 32% (9 of 28) in the
cimetidine-treated group and 30.7% (8 of 26) in the placebo-treated group. No
significant difference was found between cimetidine and placebo in effectiveness 
(p = 0.85). CONCLUSION: Our results show that cimetidine is no more effective
than placebo in the treatment of patients with common warts.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 8647965 [PubMed - indexed for MEDLINE]

4265: Electroencephalogr Clin Neurophysiol. 1996 Jun;101(3):185-91.

Electrophysiological findings in peripheral fibres of subjects with and without
post-herpetic neuralgia.

Mondelli M, Romano C, Della Porta P, Rossi A.

Institute of Neurological Sciences, University of Siena, Italy.

The peripheral nervous system was studied using classical electrophysiological
methods in 23 subjects with post-herpetic neuralgia (PHN), and compared with the 
same parameters in 64 herpes zoster (HZ) patients without PHN. The findings
indicated sensory axonopathy, the severity of which varied in different patients.
Ten percent of all cases showed segmental paresis corresponding to dermatomes
affected by HZ. In another 17% of patients axonal motor damage was only
detectable by EMG as denervation. No statistically significant difference was
found between the two groups in the mean percentage differences of the
electrophysiological data for peripheral sensory fibres with respect to mean
control values, or between sides affected by HZ and healthy sides. Hence HZ is
associated with sensory axonopathy, the severity of which is similar, on the
whole, in the groups with and without PHN and stable in time. This suggests that 
damage to peripheral large-diameter sensory fibres is not the cause of PHN.

Publication Types: 
    Comparative Study

PMID: 8647028 [PubMed - indexed for MEDLINE]

4266: Am J Ophthalmol. 1996 Jun;121(6):650-8.

Serologic and polymerase chain reaction analysis of intraocular fluids in the
diagnosis of infectious uveitis.

de Boer JH, Verhagen C, Bruinenberg M, Rothova A, de Jong PT, Baarsma GS, Van der
Lelij A, Ooyman FM, Bollemeijer JG, Derhaag PJ, Kijlstra A.

The Netherlands Ophthalmic Research Institute, Amsterdam, The Netherlands.

PURPOSE: Infectious uveitis entities are usually rapidly progressive blinding
diseases that can be prevented by prompt administration of specific antimicrobial
therapy. With the aim of improving early diagnosis in patients with infectious
uveitis, intraocular fluid samples from patients with sight-threatening posterior
uveitis were investigated to determine the causative agent. METHODS: Thirty-eight
patients with acquired immunodeficiency syndrome (AIDS) and retinitis, eight
immunosuppressed patients with retinitis, 16 immunocompetent patients with acute 
retinal necrosis, and 22 immunocompetent patients with toxoplasmic
retinochoroiditis were analyzed by polymerase chain reaction for the presence of 
herpesviruses and Toxoplasma gondii DNA and for local antibody production against
these microorganisms. RESULTS: In patients with AIDS and retinitis, polymerase
chain reaction was positive for cytomegalovirus DNA in 21 (91%) of the 23 ocular 
fluid samples obtained during active cytomegalovirus retinitis, whereas local
antibody production analysis was negative in all cases. In acute retinal
necrosis, varicella-zoster virus or herpes simplex virus could be established as 
the inciting agent in 81% of the cases, using the combination of both techniques.
Polymerase chain reaction was positive in all samples obtained within two weeks
after the onset of disease. Toxoplasma gondii DNA was detected in 4 of 13 samples
(31%) from immuno-competent patients with active toxoplasmic retinochoroiditis;
in each case, local antibody production was also detected. In contrast, no local 
antibody production was observed in two of three samples from transplant
recipients that were positive for T. gondii DNA. All the control samples tested
were negative for the above-mentioned tests. CONCLUSIONS: In patients with AIDS, 
polymerase chain reaction analysis is preferable above local antibody production 
in detecting the inciting agent of retinitis. In other cases, the combination of 
both techniques can make a valuable contribution to the diagnosis.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8644808 [PubMed - indexed for MEDLINE]

4267: Muscle Nerve. 1996 Jun;19(6):784-6.

Segmental zoster paresis: an electrophysiological study.

Sachs GM.

Department of Clinical Neurosciences, Brown University School of Medicine,
Providence, Rhode Island 02903, USA.

Publication Types: 
    Case Reports

PMID: 8609933 [PubMed - indexed for MEDLINE]

4268: Muscle Nerve. 1996 Jun;19(6):696-700.

Neuromuscular complications associated with liver transplantation.

Wijdicks EF, Litchy WJ, Wiesner RH, Krom RA.

Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
55905, USA.

We studied neuromuscular complications in a cohort of 520 patients with liver
transplantation. Perioperative mononeuropathy developed in 9 patients. The
peroneal nerve, radial nerve, and cutaneous branch of the femoral nerve were
affected in 2 patients each. Two patients had herpes zoster-associated
radiculopathy, and 1 patient had Horner's syndrome. Recovery was good in most
patients. In 7 patients, severe quadriplegia complicated the perioperative
course. In 5 patients, electrophysiologic studies suggested acute necrotic
myopathy, and muscle biopsy specimens showed evidence of rhabdomyolysis in 1
patient. Outcome in survivors was good, all recovering completely. We conclude
that neuromuscular complications in liver transplantation are uncommon (less than
1%) and do not significantly contribute to morbidity. Mononeuropathies may have
iatrogenic perioperative causes, and rhabdomyolysis may be an important cause of 
generalized muscle weakness after liver transplantation.

PMID: 8609918 [PubMed - indexed for MEDLINE]

4269: N Z Med J. 1996 May 24;109(1022):196.

Immunocompromised patients, herpes zoster and acyclovir.

Elder M, Thomas MG, Ellis-Pegler RB.

Publication Types: 
    Letter

PMID: 8657394 [PubMed - indexed for MEDLINE]

4270: Nucleic Acids Res. 1996 May 15;24(10):1809-15.

The viral thymidine kinase gene as a tool for the study of mutagenesis in
Trypanosoma brucei.

Valdes J, Taylor MC, Cross MA, Ligtenberg MJ, Rudenko G, Borst P.

Division of Molecular Biology, The Netherlands Cancer Institute, Plesmanlaan,
Amsterdam.

We have tested the use of thymidine kinase as a negative selection system for
Trypanosoma brucei. To this end we have targeted a construct containing a Herpes 
simplex virus thymidine kinase (TK) gene into the ribosomal DNA array of
procyclic T. brucei. This resulted in TK activity 30-50-fold above background and
in susceptibility to the nucleoside analogues ganciclovir, ethyl-deoxyuridine and
1-[2-deoxy,2-fluoro-8-D-arabinofuranosyl]-5-iodouracil, all of which have no
effect on wild-type trypanosomes. TK+ trypanosomes, however, reverted to a
ganciclovir resistant phenotype at a rate of 10(-6) per cell-generation. A
similar reversion rate was observed using the Varicella-zoster virus TK gene.
Loss of TK activity was not due to detectable DNA rearrangements or a decrease in
TK mRNA. Sequence analysis of the revertant genes demonstrated, however, the
occurrence of point mutations and frameshifts. One revertant line had a mutation 
in the thymidine binding site leading to the substitution of a conserved arginine
by a glycine. Other mutations included single base insertion, single base
deletion and the introduction of a premature termination codon by point mutation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8657559 [PubMed - indexed for MEDLINE]

4271: Dtsch Med Wochenschr. 1996 May 10;121(19):635-8.

[Zoster and the nervous system]

[Article in German]

Malin JP.

Neurologische Klinik, Ruhr-Universitat Bochum.

Publication Types: 
    Review

PMID: 8631229 [PubMed - indexed for MEDLINE]

4272: Clin Diagn Virol. 1996 May;5(2-3):121-9.

Laboratory diagnosis of intrauterine and perinatal virus infections.

Best JM.

United Medical and Dental Schools of Guy's and St Thomas's Hospitals, St Thomas's
Campus, London SE1 7EH, UK.

BACKGROUND: Intrauterine infection with rubella, cytomegalovirus (CMV), varicella
zoster virus (VZV), parvovirus B19 and human immunodeficiency virus type 1
(HIV-1) may occur following maternal infection. Diagnosis of congenital infection
in the neonate is dependent on the appropriate laboratory techniques being used. 
Prenatal diagnosis of intrauterine infection may also be indicated. Herpes
simplex virus (HSV), HIV-1, VZV, enteroviruses, hepatitis B (HBV) and hepatitis C
viruses (HCV), human T-cell lymphotropic viruses (HTLV-1 and 2) and genital
papillomaviruses (PVs) may be acquired at delivery. Neonatal HSV, VZV and
enterovirus infections may be severe or even fatal. Perinatally acquired HBV,
HCV, HIV-1 and HTLVs are associated with persistent infection and chronic disease
in later life. However, if the mother is identified as a carrier in the antenatal
period, mother-infant transmission of HBV may be prevented by active/passive
immunisation of the neonate, HIV-1 by caesarian section or antiviral therapy, and
of HTLV-1 by avoiding breast feeding. OBJECTIVES AND STUDY DESIGN: To review the 
techniques available for the diagnosis of intrauterine infections, neonatal
infections with HSV, HIV-1, VZV and enteroviruses, maternal infection with HBV,
HCV and HIV-1 and prenatal diagnosis of intrauterine rubella, CMV and B19.
RESULTS: Congenital rubella may be diagnosed by detection of specific IgM, but
virus detection is the technique of choice for congenital cytomegalovirus.
Congenital VZV may be diagnosed by serological techniques in up to 71% of cases. 
Detection of virus in vesicle scrapings or swabs from the oropharynx is the
technique of choice for neonatal HSV, while enterovirus infections are best
diagnosed by detection of viral RNA. A clinical diagnosis of congenital VZV is
often possible. HIV-1 may be diagnosed within 3 months of birth by testing serial
blood samples with a combination of techniques. Maternal infection with HBV, HCV,
HIV and HTLV1/11 may be diagnosed by serological techniques and genital PVs by
detection of viral DNA. Chorionic villus samples, amniotic fluid and fetal blood 
may be obtained for prenatal diagnosis of infection. Although detection of virus 
in amniotic fluid is the technique of choice for prenatal diagnosis of CMV,
insufficient data is currently available to determine whether it may be used for 
intrauterine rubella. The most reliable technique for diagnosis of fetal B19
infection is detection of viral DNA in fetal blood. CONCLUSIONS: Close liaison
between clinicians and microbiologists/virologists is required in order that
appropriate specimens are collected from infant and/or mother and appropriate
tests conducted. The use of TORCH screening should be discouraged.

PMID: 15566870 [PubMed]

4273: Lik Sprava. 1996 May-Jun;(5-6):134-6.

[Amizon in the treatment of nervous system involvement in herpes zoster]

[Article in Russian]

Rudenko AE, Trinus FP, Korzhenevskii LV, Bukhtiarova TA, Koval' AZ, Malyi VD,
Novikova OV, Tkachenko EV.

The authors submit results of treatment of patients having suffered from
postherpetic pain syndrome (herpetic ganglionitis of the cervical, thoracic,
lumbosacral localization, postherpetic intercostal neuralgia, ganglionitis of the
trigeminal nerve). In viral diseases, amizone has marked analgetic,
antiinflammatory, and immunomodulating effects. The drug is well tolerated by
patients, is not associated with side effects under prescribed doses (0.25-0.75
as one dose on a three- or four-times daily schedule during the course of
treatment lasting three or four weeks). The drug preparation in question is less 
effective in the treatment of chronic recurring post-therapeutic intercostal
neuralgias, radiculalgia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9377379 [PubMed - indexed for MEDLINE]

4274: Aust Fam Physician. 1996 May;25(5):798.

Spinal nerves are most commonly involved in herpes zoster.

Monz W.

Publication Types: 
    Letter

PMID: 8935557 [PubMed - indexed for MEDLINE]

4275: Mol Chem Neuropathol. 1996 May-Aug;28(1-3):135-41.

Neurotropic viruses and Alzheimer disease. Interaction of herpes simplex type 1
virus and apolipoprotein E in the etiology of the disease.

Lin WR, Shang D, Itzhaki RF.

Department of Optometry and Vision Sciences, UMIST., Manchester, UK.

Infectious agents have been proposed as possible etiological factors in sporadic 
cases of Alzheimer disease (AD), herpes simplex type 1 virus (HSV1) being a
likely candidate. We have detected laten HSV1 in brain from AD patients and from 
aged normal individuals, using polymerase chain reaction (PCR), in the regions
most affected in the disease. In contrast, we have not detected another
neurotropic herpes virus, varicella zoster (VZV), in any brains. We have
postulated that HSV1 reactivates periodically, and that a host or viral
characteristic determines the degree of damage caused by the resulting acute
infection-with much greater damage in the case of AD patients. We have therefore 
examined a host factor-the apolipoprotein E (apoE) genotype, since the E4 allele 
is a known risk factor in the disease. We have found that the risk of developing 
AD is much greater in those who are HSV1-positive in brain and who possess an
apoE4 allele than for those with only one of these factors.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8871952 [PubMed - indexed for MEDLINE]

4276: Masui. 1996 May;45(5):629-33.

[Analgesic effect of dextromethorphan for postherpetic neuralgia]

[Article in Japanese]

Suzuki T, Kato J, Saeki S, Ogawa S, Suzuki H.

Department of Anesthesiology, Surugadai Nihon University Hospital, Tokyo.

We investigated the analgesic effect of dextromethorphan (DM), a non-selective
NMDA receptor antagonist, in 25 patients with postherpetic neuralgia (PHN). We
administered DM 45mg.day-1 orally for 14 days and then 90mg.day-1 for next 14
days. Decrease in pain intensity and alleviation of allodynia were observed in 9 
patients (36%). Side effects with no severe cases occurred in 8 patients (32%)
and these were mainly digestive symptoms. We concluded that DM might be useful to
treat PHN with allodynia probably due to central sensitization.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 8847791 [PubMed - indexed for MEDLINE]

4277: J Antimicrob Chemother. 1996 May;37 Suppl B:97-112.

Antivirals in the context of HIV disease.

Wood MJ.

Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital,
UK.

Antiviral drugs, other than those with anti-retroviral activity, are used in
persons with human immunodeficiency virus (HIV) infection for two purposes:
treatment or prevention of viral infections that cause disease in persons with
immunodeficiency, and to suppress viruses that might act as co-factors and
promote replication of HIV itself. Human herpesviruses are the major targets of
therapy in both settings. The herpesviruses, particularly cytomegalovirus (CMV), 
herpes simplex virus (HSV) and varicella-zoster virus (VZV) act as opportunistic 
pathogens as cell-mediated immunity declines, and there is theorectical,
in-vitro, and in-vivo evidence that one or more herpesviruses can accelerate the 
progression of HIV disease. Therapy and prophylaxis with antiherpes compounds
such as acyclovir, ganciclovir and foscarnet are well established in HIV
infection, and this article will review their present use and recent improvements
in formulations and drug delivery.

Publication Types: 
    Review

PMID: 8818833 [PubMed - indexed for MEDLINE]

4278: Clin Exp Rheumatol. 1996 May-Jun;14(3):295-9.

Pulse cyclophosphamide in the treatment of neuropsychiatric systemic lupus
erythematosus.

Ramos PC, Mendez MJ, Ames PR, Khamashta MA, Hughes GR.

Lupus Arthritis Research Unit, Rayne Institute, St. Thomas' Hospital, London,
U.K.

OBJECTIVE: The effect of pulse cyclophosphamide treatment was retrospectively
assessed in 25 systemic lupus erythematosus (SLE) patients with central nervous
system involvement. All patients who tested positive for anti-phospholipid
antibodies and/or lupus anticoagulant were excluded. RESULTS: Low-dose
intravenous cyclophosphamide pulses (500 mg) were administered weekly in all
patients. Twenty-four out of 25 patients attained a good response (after a mean
of 11 days). Cyclophosphamide was well tolerated in all patients with only minor 
side effects. None of the patients experienced ovarian failure, cystitis or
herpes zoster. CONCLUSIONS: Weekly low-dose cyclophosphamide pulses appear to be 
safe and effective for the management of neuropsychiatric manifestations in SLE
patients without antiphospholipid antibodies.

Publication Types: 
    Clinical Trial

PMID: 8809444 [PubMed - indexed for MEDLINE]

4279: Pediatr Dermatol. 1996 May-Jun;13(3):226-9.

Herpes zoster in childhood: case report and review of the literature.

Smith CG, Glaser DA.

Division of Dermatology, Saint Louis University School of Medicine, Missouri
63104, USA.

Herpes zoster in childhood is uncommon even in the setting of known risk factors 
such as primary varicella zoster infection before 12 months of age and
immunocompromised states. We report a 7-year-old, otherwise healthy girl with
shingles, and review the risk factors, prognosis, and treatment of pediatric
zoster.

Publication Types: 
    Case Reports

PMID: 8806124 [PubMed - indexed for MEDLINE]

4280: In Vivo. 1996 May-Jun;10(3):313-8.

Potential in vitro activity of Kutapressin against Epstein-Barr virus.

Rosenfeld E, Salimi B, O'Gorman MR, Lawyer C, Katz BZ.

Department of Pediatrics, Northwestern University Medical School, Children's
Memorial Hospital, Chicago, IL 60614, USA.

BACKGROUND: Kutapressin (KU), a porcine liver extract with
bradykinin-potentiating effects but no vitamin B 12 activity, has been used in
the treatment of Herpes zoster. We examined a phenol-free preparation of this
drug for in vitro activity against Epstein-Barr Virus (EBV). MATERIALS AND
METHODS: Immortalization-inhibition assays were used to assess EBV infectivity.
Mitogen stimulation and cell viability assays were used to assess kutapression
toxicity. Lytic replication assays and flow cytometry were used to assess the
mechanism of drug activity. RESULTS: Seventy-five hundred mcg/ml of KU blocked
the infection of 2 x 10(5) human umbilical cord mononuclear cells when added
together with two strains of EBV (B95-8 and FF41). Doses as low as 250 mcg/ml
were occasionally effective as well. Unlike acyclovir, KU does not inhibit viral 
DNA polymerase nor does it appear to compete with EBV as it binds to its receptor
on the B-cell surface. CONCLUSIONS: The mechanism whereby KU may inhibit EBV
immortalization remains to be determined. KU, a drug which is safe in humans,
deserves further study as an agent with potential to block EBV-induced
immortalization of B-lymphocytes.

PMID: 8797033 [PubMed - indexed for MEDLINE]

4281: J Infect. 1996 May;32(3):227-30.

Adult primary IgA nephropathy and common viral infections.

Hung KY, Chen WY, Yen TS, Yang CS, Ferng SH, Kao CL.

Department of Internal Medicine, National Taiwan University Hospital, Taipei,
R.O.C.

Serum samples obtained from 69 histopathologically proven IgA nephropathy (IgAN) 
patients and 563 healthy controls were examined to evaluate the association
between IgAN and common viral infections. Antibody titres to cytomegalovirus
(CMV), herpes simplex virus (HSV), Vericella-Zoster virus (VZV), Influenza A
(Inf. A) and Influenza B (Inf. B) viruses were determined, using a complement
fixation test. The viral antibody titres were considered to be positive with
dilutions of 1:8 or greater except for Epstein-Barr virus (EBV), studied using
immunofluorescence, which was considered to be positive with dilutions of 1:10 or
greater. The positive rate of Inf. B antibody in IgAN patients was significantly 
lower than that in controls. The frequency of positive CMV antibody titres was
higher than for controls, but with only borderline statistical significance (P = 
0.059). The frequency of positive CMV and Inf. B titres was compared by age in
IgAN patients and controls. but showed no statistically significant difference.
Comparisons of percentage distributions at each antibody dilution level to the
common virus of IgAN patients and controls, but showed no statistically
significant difference. Comparisons of percentage distributions at each antibody 
dilution level to the common virus of IgAN patients and controls were made;
however, none showed a statistically significant difference. In conclusion, no
absolutely higher frequency of positive antibody titres for common viruses was
demonstrated in IgAN patients in this study.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8793713 [PubMed - indexed for MEDLINE]

4282: Cent Afr J Med. 1996 May;42(5):141-4.

Retrospective study on the criteria for diagnosis of HIV infection in adults in
Zimbabwe.

Chibatamoto PP, Chandiwana SK, Sabeta CT, Gomo E.

Blair Research Laboratory, Harare, Zimbabwe.

OBJECTIVE: To review the criteria for diagnosis of HIV infection in adults in
order to improve upon the Zimbabwe Adult AIDS case definition. DESIGN: A
descriptive study which involved the analysis of "Request fo r HIV Antibody Test"
forms which had been submitted by clinicians to Masvingo Public Health
Laboratory, between June 1990 and December 1992. SETTING: Masvingo Public Health 
Laboratory, Zimbabwe. SUBJECTS: 627 adult patients. MAIN OUTCOME MEASURES: HIV
seroprevalence; specific, sensitivity and positive predictive values of the Adult
AIDS case definition. RESULTS: The HIV seroprevalence in 627 adult patients whose
forms had been submitted to Masvingo Public Health Laboratory was 79pc. The
criterion for the diagnosis of HIV infection had a very high specificity value of
93pc but low sensitivity of 53pc. The positive predictive value of the case
definition was very high (97pc). The positive predictive values of individual
symptoms were calculated and only weight loss and persistent generalized
lymphodenopathy had high values of 99pc and 72pc respectively. CONCLUSIONS: This 
study has shown that the criterion used in the diagnosis of HIV infection in
Zimbabwe is highly specific but relatively insensitive at identifying
seropositive patients. This shows the ability of clinicians to identify HIV
positive patients irrespective of the stage of the disease (i.e. HIV related
symptoms, AIDS related complex or full blown AIDS). There is also a need for
constant monitoring of the clinical manifestations of AIDS patients to keep
abreast with newer disease manifestations.

PIP: In Zimbabwe, researchers analyzed data on blood samples collected from 627
adult patients at least 14 years old at all hospitals in the 7 districts of
Masvingo Province during June 1990-December 1992 to reexamine the criteria for
diagnosis of HIV infection in hopes of improving the Zimbabwe Adult AIDS case
definition. This case definition is: an illness characterized by at least 2 major
signs and 1 minor sign provided serologic tests for HIV are positive (major
signs: weight loss 10% of body weight, chronic diarrhea for 1 month, and fever
for 1 month; minor signs: cough 1 month, general pruritic dermatitis, recurrent
Herpes zoster, oropharyngeal candidates, chronic progressive and disseminated
Herpes simplex infection, and generalized lymphadenopathy). 79.1% tested positive
for HIV infection. 271 of all adult patients had signs and symptoms that met the 
criterion for diagnosis of HIV infection. 97.1% of them actually had HIV
infection. The specificity for this criterion was 93.9%, but its sensitivity was 
53%, suggesting a high ability of clinicians to identify HIV positive patients
but low ability to correctly exclude HIV infection. The positive predictive value
was higher than that in Uganda (97% vs. 74%). The symptom with the highest
positive predictive value and the highest sensitivity value was weight loss
greater than 10% of body weight (98.9% vs. 2-71.9% and 74.6% vs. 1.5-57.4%,
respectively). Candidiasis and chronic diarrhea had the highest specificity
values (86.3% and 85.4%, respectively, vs. 26.4-80.9%). In conclusion, the
criterion for diagnosis of HIV infection in Zimbabwe is very specific but rather 
insensitive at identifying HIV positive patients.

PMID: 8771933 [PubMed - indexed for MEDLINE]

4283: An Med Interna. 1996 May;13(5):243-4.

[The clinico-microbiological diagnosis of encephalitis due to herpes zoster in an
elderly patient: apropos a case]

[Article in Spanish]

Munoz Garcia MD, Guerrero Diaz MT, Diaz Guzman J, Torres Gonzalez M.

Servicio de Geriatria, Hospital Universitario de Getafe, Madrid.

Varicella-zoster infection consists of well-recognized cutaneous manifestations. 
However, in several cases it is complicated with central nervous system
disorders. We present a 79-year-old diabetic woman with zoster ophthalmicus, who 
developed an acute confusional syndrome. EEG, cranial computed tomographic,
biochemical and haematologic and liquoral studies were performed. An increased in
the CSF-IgG index was founded, and it was related with Varicella-Zoster Herpes
antibodies. She was treated with intravenous acyclovir, and her encephalopathy
was resolved.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8767873 [PubMed - indexed for MEDLINE]

4284: J Radiol. 1996 May;77(5):367-71.

[Cerebral arteritis in AIDS. Demonstration with MRA in 2 patients]

[Article in French]

Brunereau L, Picard O, Levy C, Marsot-Dupuch K, Tubiana JM.

Service de Radiologie, Hopital Saint-Antoine, Paris.

Two cases of cerebral arteritis related to varicella-zoster virus in seropositive
patients are presented. Diagnosis of arteritis was made by conventional
angiography. However, 3D Time of Flight MR Angiography demonstrated an excellent 
sensitivity in detection of cerebral arterial stenosis located at the skull base.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8762936 [PubMed - indexed for MEDLINE]

4285: Nihon Kyobu Shikkan Gakkai Zasshi. 1996 May;34(5):610-5.

[Pneumonia caused by varicella-zoster virus in a patient with rheumatoid
arthritis]

[Article in Japanese]

Nakamura M, Kanazawa M, Yamaguchi K, Akizuki M, Satoh S, Inada S.

Department of Medicine, School of Medicine, Keio University, Tokyo, Japan.

A 56-year-old woman suffering from rheumatoid arthritis, was admitted to our
hospital for evaluation of fever and dyspnea. A month before admission, she had
been given a diagnosis of herpes zoster and was treated with an antiviral agent. 
However, a perineal eruption persisted. A chest X-ray film and a chest CT scan
showed many diffuse nodular shadows in both lung fields. With conservative
treatment, the shadows regressed along with the skin eruption and other symptoms.
Pneumonia caused by varicella-zoster virus was diagnosed from the clinical
course, chest roentgenographic and CT scan findings, and serological data. The
risk of mortality in varicella-zoster pneumonia is high in adults, especially in 
immunosuppressed patients. Early diagnosis and effective treatment are,
therefore, essential in the management of this disease. Though varicella-zoster
pneumonia is rare, chest roentgenographic and CT scan findings are characteristic
and suggestive. This case may serve as a reminder of the features of
varicella-zoster pneumonia: many nodular shadows on the chest X-ray film and CT
scan.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8753124 [PubMed - indexed for MEDLINE]

4286: Pediatr Hematol Oncol. 1996 May-Jun;13(3):231-8.

Varicella zoster infections in children with acute lymphoblastic leukemia.

Poulsen A, Schmiegelow K, Yssing M.

Section of Pediatric Hematology and Oncology, Juliane Marie Centre, University
Hospital, Copenhagen, Denmark.

During the period July 1986 through December 1991, 67 children were treated for
non-B-cell acute lymphoblastic leukemia at The Juliane Marie Centre, GGK, The
University Hospital Rigshospitalet, Copenhagen. Twenty-five children were
susceptible to varicella zoster (VZ) virus at diagnosis. For these patients the
cumulated risk of VZ exposure was 90% after 32 months. Five patients developed
varicella (two of whom had pneumonitis) during the period of antileukemic
treatment. Two of these had received prophylactic treatment with acyclovir. The 2
year cumulated risk of having chickenpox or herpes zoster in children with
previous VZ infection was 24% and 34%, respectively. VZ vaccination ought to be
considered for this group of children in order to diminish transmission and
morbidity.

PMID: 8735338 [PubMed - indexed for MEDLINE]

4287: Bone Marrow Transplant. 1996 May;17(5):813-7.

European survey of herpesvirus resistance to antiviral drugs in bone marrow
transplant recipients. Infectious Diseases Working Party of the European Group
for Blood and Marrow Transplantation (EBMT).

Reusser P, Cordonnier C, Einsele H, Engelhard D, Link D, Locasciulli A, Ljungman 
P.

Department of Medicine, University Hospital, Basel, Switzerland.

A survey of herpesvirus resistance to antiviral drugs was conducted by mailing a 
questionnaire to the centers of the European Group for Blood and Marrow
Transplantation (EBMT). Results from 68 centers were reported. The number of
centers with proven or suspected resistance of herpes simplex virus (HSV) was 17 
(25%), of varicella-zoster virus (VZV) was three (4%), and of cytomegalovirus
(CMV) was 19 (28%). Acyclovir-resistant HSV strains were recovered from 10
patients with HSV disease. Replacement of acyclovir by foscarnet in seven of
these patients resulted in improved or healed HSV disease in five (17%).
Acyclovir-resistant VZV was isolated from one patient with zoster which improved 
after a change to vidarabine therapy. CMV resistance to ganciclovir was proven in
only two patients but was suspected in 23. Ganciclovir was replaced by foscarnet 
in 15 of these 25 patients which resulted in better virological and/or clinical
outcome in 13 (87%). These results suggest that herpesvirus resistance is an
emerging problem in marrow transplant recipients, and that foscarnet treatment
may prove to be a valuable alternative when the presence of acyclovir- or
ganciclovir-resistant herpesvirus disease is documented in these patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8733703 [PubMed - indexed for MEDLINE]

4288: Pharmacotherapy. 1996 May-Jun;16(3):466-8.

Does acyclovir increase serum lithium levels?

Sylvester RK, Leitch J, Granum C.

MeritCare Hospital, North Dakota State University, Fargo 58105, USA.

A 42-year-old woman was admitted to the hospital to receive intravenous acyclovir
for a herpes zoster infection. At the time she was taking lithium carbonate 450
mg twice/day. Six days after starting acyclovir she exhibited signs of lithium
toxicity. When measured, the serum lithium level had increased 4-fold during
acyclovir therapy. Both agents are excreted by the kidneys, raising the
possibility that acyclovir at high serum concentrations may interfere with the
renal excretion of lithium. A MEDLINE search did not identify any citation
describing the possibility of an interaction between the drugs. This case
suggests that acyclovir when given intravenously in doses of 10 mg/kg may result 
in increased serum lithium concentrations. Until additional data are available,
if intravenous acyclovir is administered concurrently with lithium, we recommend 
closely monitoring patients for signs of lithium toxicity and measuring serum
lithium levels every second or third day.

Publication Types: 
    Case Reports

PMID: 8726608 [PubMed - indexed for MEDLINE]

4289: Pediatr Infect Dis J. 1996 May;15(5):471-2.

Herpes zoster ophthalmicus with delayed contralateral hemiplegia.

Francois P, Bost C, Pavese P, Bost M.

Department of Pediatrics, Centre Hospitalier Universitaire de Grenoble, Grenoble,
France.

Publication Types: 
    Case Reports

PMID: 8724079 [PubMed - indexed for MEDLINE]

4290: Pediatr Infect Dis J. 1996 May;15(5):461-2.

Varicella disease and transmission in pediatric house officers.

Oshiro AC, Begue RE, Steele RW.

Department of Pediatrics, Louisiana State University School of Medicine and
Children's Hospital, New Orleans 70118, USA.

PMID: 8724072 [PubMed - indexed for MEDLINE]

4291: Clin Infect Dis. 1996 May;22(5):886.

Comment on:
    Clin Infect Dis. 1995 Sep;21(3):479-86; quiz 487-8.

Use of famciclovir and valaciclovir in the treatment of viral keratitis.

Gatchel S.

Publication Types: 
    Comment
    Letter

PMID: 8722973 [PubMed - indexed for MEDLINE]

4292: Psychiatr Prax. 1996 May;23(3):146.

[Sexual side-effects of clomipramine--a psychopharmacologic personal experience]

[Article in German]

Haberfellner EM.

Facharzt fur Psychiatre und Neurologie, Linz.

PMID: 8711010 [PubMed - indexed for MEDLINE]

4293: Br J Ophthalmol. 1996 May;80(5):465-8.

Detecting herpesvirus DNA in uveitis using the polymerase chain reaction.

Yamamoto S, Pavan-Langston D, Kinoshita S, Nishida K, Shimomura Y, Tano Y.

Department of Ophthalmology, Harvard Medical School, Boston, USA.

BACKGROUND: Herpesviruses are involved in the pathogenesis of many ocular
diseases including keratitis, iridocyclitis, and acute retinal necrosis syndrome.
The rapid and accurate diagnosis of herpetic infections has become increasingly
important with the rising incidence of immunosuppressive diseases. The purpose of
this study was to evaluate the use of the polymerase chain reaction (PCR) to
detect herpesvirus DNA in uveitis patients. METHODS: Aqueous samples were
aspirated from 11 patients with active uveitis of suspected viral origin. Using
PCR, masked samples were assayed for herpes simplex virus (HSV), varicella zoster
virus (VZV), and cytomegalovirus (CMV) to assist in supporting the clinical
diagnosis of viral aetiology. Masked controls included 10 aqueous humour
specimens from normal patients undergoing cataract surgery and specimens from
seven patients diagnosed with active non-viral uveitis--Behcet's disease,
sarcoidosis, Fuchs' heterochromic iridocyclitis, or Harada's disease. RESULTS:
Ten of 11 cases clinically diagnosed as being of possible viral aetiology yielded
aqueous PCR positive for a herpesvirus. Eight patients were PCR positive for
amplified HSV DNA, of whom two had acute retinal necrosis, one had corneal
endotheliitis, and five had recurrent iridocyclitis. VZV DNA was detected in one 
case of iridocyclitis, and CMV DNA in one case of chorioretinitis. Successful
therapy was based on the PCR results. Ten normal aqueous specimens and the seven 
uveitis samples from cases not suspected of a viral aetiology were PCR negative
for HSV, VZV, and CMV. CONCLUSION: These results demonstrate that detecting
herpesvirus DNA in the aqueous humour is useful to support a clinical diagnosis
of viral uveitis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8695570 [PubMed - indexed for MEDLINE]

4294: Isr J Med Sci. 1996 May;32(5):331-4.

Cases 1A and 1B. 1995 intravenous lidocaine infusion for chronic pain therapy.

Avidan A, Devor M.

Department of Anesthesiology and CCM, Hadassah University Hospital, Ein Kerem,
Jerusalem.

Publication Types: 
    Case Reports
    Clinical Conference

PMID: 8641876 [PubMed - indexed for MEDLINE]

4295: Br J Haematol. 1996 May;93(2):386-8.

Donor leucocyte transfusions for relapse in myelodyplastic syndrome after
allogeneic bone marrow transplantation.

Okumura H, Takamatsu H, Yoshida T.

Department of Internal Medicine, Toyama Prefectural Central Hospital, Japan.

A 31-year-old man with refractory anaemia of excess blasts, which had karyotypic 
abnormalities, received an allogeneic bone marrow transplant (BMT). At time of
relapse, 3 months after BMT, he was treated with donor leucocyte transfusion
(DLT). Grade III acute GVHD (graft-versus-host disease) occurred 35 d after DLT
which was fully reversed with cyclosporin and prednisolone. His condition was
complicated by a herpes zoster infection. 2 months after DLT, neutrophil and
platelet count were increased and karyotypic abnormalities disappeared. This
observation demonstrates that DLT is an effective treatment for relapse of
myelodysplastic syndrome (MDS) after BMT.

Publication Types: 
    Case Reports

PMID: 8639432 [PubMed - indexed for MEDLINE]

4296: Am J Hematol. 1996 May;52(1):58-9.

Paraneoplastic pemphigus in a patient with non-Hodgkin's lymphoma.

Plumb R, Doolittle GC.

Division of Clinical Oncology, University of Kansas Medical Center, Kansas City
66160-7353, USA.

Paraneoplastic pemphigus (PNP) is an autoimmune disorder occurring in the setting
of an underlying neoplasm in which patients have polymorphous skin and mucous
membrane lesions. We describe a patient with non-Hodgkin's lymphoma who developed
bullous, ulcerating lesions in an area being treated with radiation therapy. The 
diagnosis of PNP was confirmed by indirect immunofluorescence of the patient's
serum on rat bladder. The disorder was refractory to therapy, and ultimately the 
patient expired.

Publication Types: 
    Case Reports

PMID: 8638613 [PubMed - indexed for MEDLINE]

4297: J Infect Dis. 1996 May;173(5):1077-84.

Placental transfer and maternally acquired neonatal IgG immunity in human
immunodeficiency virus infection.

de Moraes-Pinto MI, Almeida AC, Kenj G, Filgueiras TE, Tobias W, Santos AM,
Carneiro-Sampaio MM, Farhat CK, Milligan PJ, Johnson PM, Hart CA.

Department of Pediatrics, Escola Paulista de Medicina, Sao Paulo, Brazil.

Transplacental transfer of specific IgG antibodies was studied in 46 pairs of
human immunodeficiency virus type 1 (HIV-1)-seropositive women and their neonates
and in 53 pairs of healthy HIV-seronegative mothers and their newborns. Neonatal 
and maternal sera were assessed by nephelometry for total levels of serum IgG and
by ELISA for IgG antibodies to herpes simplex virus (HSV), varicella-zoster virus
(VZV), measles virus, tetanus toxoid, streptolysin O, and Streptococcus
pneumoniae capsular antigens. Placental transfer of IgG antibodies to VZV,
tetanus toxoid, measles, streptolysin O, and S. pneumoniae was decreased by
maternal HIV infection. Maternal levels of total IgG had an independent effect on
transfer of antibodies to HSV, VZV, measles, and S. pneumoniae. Neonatal antibody
levels to tetanus toxoid, measles, and S. pneumoniae were significantly lower in 
the HIV group. Both maternal hypergammaglobulinemia and maternal HIV infection
may contribute to these low antibody levels at birth and thus lead to early
infection in this high-risk population.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8627057 [PubMed - indexed for MEDLINE]

4298: Lancet. 1996 Apr 27;347(9009):1195.

Garlic burns mimicking herpes zoster.

Farrell AM, Staughton RC.

Publication Types: 
    Case Reports
    Letter

PMID: 8609803 [PubMed - indexed for MEDLINE]

4299: Cas Lek Cesk. 1996 Apr 17;135(8):244-8.

[Changes in the incidence and clinical manifestations of herpes zoster]

[Article in Czech]

Cerny Z.

Infekcni klinika LF MU, Brno.

BACKGROUND: Shingles is the manifestation of activated latent disease caused by
the varicella-herpes zoster virus. The prerequisite of its activation is a
reduction of the immunity of the organism: the incidence (with some reservations)
of herpes zoster in the population can be therefore considered an indicator of
the general immune state. The objective of the submitted paper was to assess
whether and to what extent the frequency of herpes zoster increased (whether the 
number of patients hospitalized at the Clinic for Infectious Diseases increased
in 1974-1994, and if so, by how much). METHODS AND RESULTS: By comparing clinical
manifestations of herpes zoster in a group of 348 patients hospitalized in
1992-1994 with results of a similar investigation made in the same department in 
a group of 308 patients hospitalized in 1979-1983 the following was revealed: the
annual numbers of treated patients with herpes zoster doubled during the last 15 
years. Almost 70% of the affected patients were then and now above 60 years of
age, among the patients women predominated markedly (chi 2 = 69.540), the number 
of malignancies increased greatly (chi 2 = 4.435), there was also a significant
increase of ischaemic heart disease, hypertension (chi 2 = 39.741) etc. As to the
ratio of different sites of the shingles, no significant changes were observed,
while there was a significant increase of manifestations of dermal generalization
(chi 2 = 36.377) and a significant increase of peripheral pareses (chi 2 =
5.615). The author explains the fact that the period of hospitalization was not
longer and that there was even a significant decrease in the number of
postherpetic neuralgias persisting for more than a month, by the early onset of
treatment with acyclovir administered by the i.v. route. CONCLUSIONS: The annual 
numbers of patients hospitalized on account of herpes zoster doubled during the
past 15 years, the number of malignancies increased as well as the number of
cardiovascular diseases, and the frequency of skin generalizations and peripheral
pareses increased. Treatment with acyclovir had a favourable effect on the period
of hospitalization.

Publication Types: 
    English Abstract

PMID: 8689663 [PubMed - indexed for MEDLINE]

4300: Ann Intern Med. 1996 Apr 15;124(8):775.

Effects of famiciclovir in acute herpes zoster.

Tirelli U.

Publication Types: 
    Letter

PMID: 8633841 [PubMed - indexed for MEDLINE]

4301: J Virol Methods. 1996 Apr 5;57(2):169-74.

Typing of varicella zoster virus by amplification of DNA polymorphisms.

Hawrami K, Harper D, Breuer J.

Department of Medical Microbiology, London Hospital Medical College, UK.

The polymerase chain reaction was used to amplify five variable regions of
varicella zoster virus DNA from 20 samples of vesicle fluid. Two of the regions, 
R1 and R5, were found to be polymorphic, with the former having three alleles (A,
B and C) and the latter, two (A and B). The R1 and R5 polymorphisms were stable
up to passage five in tissue culture. The sensitivity of the PCR (down to six
copies) enabled detection of virus from vesicle fluid dried on glass slides and
overall the method was five times more sensitive than conventional tissue
culture. The method described is simple, sensitive and informative and provides a
means by which questions about the epidemiology and clinical biology of VZV
infection may begin to be addressed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8801228 [PubMed - indexed for MEDLINE]

4302: Enferm Infecc Microbiol Clin. 1996 Apr;14(4):277-8.

[Diagnosis of infections caused by varicella zoster virus]

[Article in Spanish]

Barraquer P, Rabella N, Labeaga R, Mercader M, Prats G.

Publication Types: 
    Letter

PMID: 9044653 [PubMed - indexed for MEDLINE]

4303: Arq Bras Cardiol. 1996 Apr;66(4):199-203.

[Infections caused by virus in 100 patients submitted to heart transplantation]

[Article in Portuguese]

Uip DE, Amato Neto V, Varejao Strabelli TM, Alcides Bocchi E.

Divisao de Molestias Infecciosas e Parasitarias e Instituto do Coracao do
Hospital das Clinicas--FMUSP, Sao Paulo, SP.

PURPOSE: To analyse prevalence, clinical features and organ involvement in viral 
infections occuring after heart transplantation. METHODS: One hundred consecutive
heart transplantation patients were studied. The follow-up was three to 90 (mean 
23.32 +/- 25.97) months. Viral infections were diagnosed using the Center for
Disease Control criteria. RESULTS: Viral infections were responsible for 51
infections, 19.6% of all infections in this patient population. Herpesvirus
infection was the most common etiology: 32 (59.25%) of all viral infections were 
caused by reactivation of or reinfection by cytomegalovirus. Of those infections 
27 (84.37%) occurred in the first three weeks following surgery. Only 4 (12.50%) 
of those showed clinical signs of cytomegalovirus disease. Other herpesvirus
causing infections were herpes simplex and varicella-zoster virus. CONCLUSION:
Infections are common after heart transplantation and viral infections of
herpesviridae family are important causes of those infections; usually as
reactivation in an immune suppressed patient. The most important viral infections
were caused by reactivation of or reinfection by cytomegalovirus.

Publication Types: 
    English Abstract

PMID: 8935684 [PubMed - indexed for MEDLINE]

4304: Antimicrob Agents Chemother. 1996 Apr;40(4):920-3.

Analysis of phosphorylation pathways of antiherpesvirus nucleosides by
varicella-zoster virus-specific enzymes.

Koyano S, Suzutani T, Yoshida I, Azuma M.

Department of Microbiology, Asahikawa Medical College, Japan.

The inhibitory activities of acyclovir (ACV),
1-beta-D-arabinofuranosyl-E-5-(2-bromovinyl)uracil (BV-araU), ganciclovir (GCV), 
9-(2-deoxy-2-hydroxymethyl-beta-D-erythro-oxetanosyl)guanine (OXT-G), and
(+)-9-[(1R,2R,3S)-2,3-bis(hydroxymethyl)Cyclobutyl]guanine (cOXT-G) on the
replication of wild-type and thymidine kinase (TK)-negative strains of herpes
simplex virus types 1 and 2 and varicella-zoster virus (VZV) and the wild-type
strain of human cytomegalovirus were tested to clarity whether the
phosphorylation of these compounds is catalyzed by viral TK or other enzymes. ACV
and BV-araU had little effect on the replication of TK-negative virus strains. On
the other hand, GCV, OXT-G, and cOXT-G inhibited the replication of TK-negative
VZV at concentrations 10 times higher than those at which they inhibited
wild-type VZV, indicating that a kinase other than TK phosphorylates GCV and
OXT-G in VZV-infected cells. GCV phosphorylation activity was not detected in
VZV-infected cell lysates; therefore, this activity was evaluated in COS 1 cells 
expressing viral TK and viral protein kinase (PK). The COS 1 cells expressing VZV
TK were shown to be susceptible to all compounds tested. In contrast, VZV
Pk-expressing COS 1 cells were susceptible to only GCV, OXT-G, and cOXT-G. These 
results suggest that VZV PK phosphorylates some nucleoside analogs, for example, 
GCV, OXT-G, and cOXT-G. This phosphorylation pathway may be important in the
anti-VZV activities of some nucleoside analogs.

Publication Types: 
    Comparative Study

PMID: 8849252 [PubMed - indexed for MEDLINE]

4305: Pain. 1996 Apr;65(1):45-51.

Comment in:
    Pain. 1997 Apr;70(2-3):287-9.

Topical aspirin/diethyl ether mixture versus indomethacin and diclofenac/diethyl 
ether mixtures for acute herpetic neuralgia and postherpetic neuralgia: a
double-blind crossover placebo-controlled study.

De Benedittis G, Lorenzetti A.

Pain Research and Treatment Unit, University of Milan, Italy.

The efficacy of topical aspirin/diethyl ether (ADE) mixture in the treatment of
acute herpetic neuralgia and postherpetic neuralgia, suggested in a previous
open-label study (De Benedittis et al. 1992), has been evaluated in a
double-blind crossover placebo-controlled study as compared with two other NSAID 
(indomethacin and diclofenac) drug/ether mixtures. The study included 37 patients
(15 with acute herpetic neuralgia (AHN) and 22 with postherpetic neuralgia
(PHN)). Comparative treatment results showed that only aspirin (but not
indomethacin and diclofenac) was significantly superior to placebo, as compared
with baseline and duration of pain relief (P < 0.05 and P < 0.01, respectively), 
in both AHN and PHN groups. Good-to-excellent results were achieved by 87% of AHN
patients and by 82% of PHN patients treated with the ADE mixture, with no
significant differences between the two groups. On the whole, patients with
trigeminal involvement, less severe pain and with dysaesthetic quality of pain
yielded best results.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 8826489 [PubMed - indexed for MEDLINE]

4306: Pain. 1996 Apr;65(1):39-44.

Lidocaine patch: double-blind controlled study of a new treatment method for
post-herpetic neuralgia.

Rowbotham MC, Davies PS, Verkempinck C, Galer BS.

Department of Neurology, UCSF Pain Clinical Research Center, University of
California 94115, USA.

Post-herpetic neuralgia (PHN) is a common and often intractable neuropathic pain 
syndrome predominantly affecting the elderly. Topical local anesthetics have
shown promise in both uncontrolled and controlled studies. Thirty-five subjects
with established PHN affecting the torso or extremities completed a four-session,
random order, double-blind, vehicle-controlled study of the analgesic effects of 
topically applied 5% lidocaine in the form of a non-woven polyethylene adhesive
patch. All subjects had allodynia on examination. Up to 3 patches, covering a
maximum of 420 cm2, were applied to cover the area of greatest pain as fully as
possible. Lidocaine containing patches were applied in two of the four 12-h-long 
sessions, in one session vehicle patches were applied, and one session was a
no-treatment observation session. Lidocaine containing patches significantly
reduced pain intensity at all time points 30 min to 12 h compared to no-treatment
observation, and at all time points 4--12 h compared to vehicle patches.
Lidocaine patches were superior to both no-treatment observation and vehicle
patches in averaged category pain relief scores. The highest blood lidocaine
level measured was 0.1 micrograms/ml, indicating minimal systemic absorption of
lidocaine. Patch application was without systemic side effect and well tolerated 
when applied on allodynic skin for 12 h. This study demonstrates that topical 5% 
lidocaine in patch form is easy to use and relieves post-herpetic neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 8826488 [PubMed - indexed for MEDLINE]

4307: Rinsho Shinkeigaku. 1996 Apr;36(4):590-3.

[A patient with thyroid carcinoma who developed consciousness disturbance during 
acyclovir administration for herpes zoster]

[Article in Japanese]

Matsumoto R, Yoshida T, Tabata K, Nakagawa S, Yanagisawa N.

Department of Neurology, Saku Central Hospital.

A 69-year-old man developed confusion and disorientation, following intravenous
administration of acyclovir for herpes zoster at the right C5 area. His
consciousness was disturbed four days after the beginning of acyclovir therapy
(daily dose: 500 mg, every 12 h), and the symptoms resolved two days after
cessation of acyclovir. Neuroradiological examination revealed no intracranial
abnormality, and the routine CSF examination was within the normal range of
values except for a mild elevation of IgG (7.4 mg/dl). An electroencephalogram
showed diffuse slow activities without paroxysmal waves on admission, but the
findings of electroencephalograms were gradually normalized in parallel with the 
recovery of consciousness. Fever, signs of meningeal irritation, involuntary
movement or renal dysfunction were not observed during the course of illness.
Although the serum concentration of acyclovir was not elevated, we considered the
adverse effects of acyclovir had resulted in his consciousness disturbance.
Acyclovir is greatly useful for herpes simplex and varicella-zoster virus
infections, and its complications are extremely rare. However, several reports
described various neuropsychiatric side effects in patients receiving acyclovir. 
Most of such cases had an association with severe renal failure or malignant
tumor; actually, an intense malignancy surveillance over our case revealed
thyrogenic papillary adenocarcinoma without metastasis. The excretion of
acyclovir is mainly through the kidney, so that the neurotoxicity of acyclovir in
cases with renal insufficiency stems from its excessive accumulation in the body.
In malignancy complicated patients, on the other hand, some authors surmised
about the influences from the co-use of other neurotoxic drugs or radiation
therapy, but reasons for such conditions remain obscure. The neuropsychiatric
manifestation caused by acyclovir is an entity distinguishable from viral
encephalitis, and a careful surveillance for malignancy is required in such
cases.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8810856 [PubMed - indexed for MEDLINE]

4308: Ann Oncol. 1996 Apr;7(4):373-9.

Long-term survival following cladribine (2-chlorodeoxyadenosine) therapy in
previously treated patients with chronic lymphocytic leukemia.

Juliusson G, Liliemark J.

Department of Medicine, Huddinge Hospital, Sweden.

PURPOSE: To assess long-term survival following cladribine salvage treatment for 
previously treated patients with chronic lymphocytic leukemia. PATIENTS AND
METHODS: Fifty-two patients aged 39-84 years with previously treated CLL received
cladribine 0.12 mg/kg/day in 2-hour infusions for 5 days in monthly courses.
Two-thirds were refractory to previous therapy, and 8 had prior fludarabine.
RESULTS: Sixteen (31%) patients achieved complete response (CR) and 14 (27%)
partial remission (PR) according to consensus criteria. Response correlated with 
clinical stage, number of previous treatment regimes, blood lymphocyte count, and
lymphocyte halflife following the first cladribine course. Toxicity included
pneumonia (n = 9), herpes zoster (n = 7), and septicemia (n = 2). Four patients
in CR underwent high-dose chemotherapy with autologous blood stem cell support,
and 2 remain in CR 48 and 60 months from start of cladribine, and 2 had relapse
at 42 and 48 months, respectively. Median progression-free survival (Kaplan-Meier
analysis) for CR patients was 23 months from start of cladribine treatment, and
for PR patients 16 months. The projected overall survival was 80% at 3 years for 
CR patients, and the median survival 28 months for PR patients and 4 months for
non-responding patients. CONCLUSIONS: Our previous finding of durable CRs from
cladribine in advanced CLL is thus confirmed in a larger patient material, and
follow-up indicate that long-term survival may be achieved.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8805929 [PubMed - indexed for MEDLINE]

4309: J Neurovirol. 1996 Apr;2(2):136-8.

Another case of virologically confirmed zoster sine herpete, with
electrophysiologic correlation.

Amlie-Lefond C, Mackin GA, Ferguson M, Wright RR, Mahalingam R, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80662, USA.

A third virologically-confirmed case of thoracic-distribution zoster sine herpete
is reported. Electromyography (EMG) of paraspinal muscles demonstrated frequent
fibrillation potentials restricted to chronically painful thoracic root segments.
Treatment with intravenous acyclovir and oral famciclovir were ineffective. These
findings suggest the usefulness of EMG of muscles corresponding to painful
dermatomes, combined with virologic studies, to support the diagnosis of zoster
sine herpete.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 8799205 [PubMed - indexed for MEDLINE]

4310: Eur J Clin Microbiol Infect Dis. 1996 Apr;15(4):273-5.

Advances and controversies in the antiviral therapy of herpes zoster.

Cunningham AL, Dwyer DE.

Publication Types: 
    Editorial

PMID: 8781875 [PubMed - indexed for MEDLINE]

4311: Neurology. 1996 Apr;46(4):1175-6.

Gabapentin as a novel treatment for postherpetic neuralgia.

Segal AZ, Rordorf G.

Department of Neurology, Massachusetts General Hospital, Boston 02114, USA.

Publication Types: 
    Case Reports

PMID: 8780121 [PubMed - indexed for MEDLINE]

4312: Acta Ophthalmol Scand. 1996 Apr;74(2):194-6.

Retrobulbar neuritis in a patient with acquired immune deficiency syndrome.

Cacciatori M, Ling CS, Dhillon B.

Department of Ophthalmology, Princess Alexandra Eye Pavilion, Edinburgh,
Scotland.

Publication Types: 
    Case Reports

PMID: 8739690 [PubMed - indexed for MEDLINE]

4313: Braz J Med Biol Res. 1996 Apr;29(4):485-7.

In vitro induced antibody production for the diagnosis of herpes simplex virus
infection in immunosuppressed patients.

Bellei NC, Granato CF, Tomiyama H.

Disciplina de Doencas Infecciosas e Parasitarias, Universidade Federal de Sao
Paulo, Brasil.

We developed and evaluated a specific test for herpes simplex virus (HSV)
infection based on the secretion of HSV-specific antibodies by lymphocytes
stimulated in vitro with HSV-1 antigens. The in vitro induced antibody production
(IVIAP) test was used for the diagnosis of HSV infection in 43 seropositive
selected subjects: 9 healthy subjects (controls), 30 symptomatic patients (26 of 
them immunocompromised and 4 immunocompetent) and 4 patients with varicella
zoster infection. Anti-HSV antibodies were detected by an immune assay using an
anti-human IgG peroxidase conjugate. The test showed a sensitivity of 93% (15/16)
and specificity of 92% (1/13) which were confirmed by positive culture or
clinical and laboratory follow-up. One AIDS patient had a false-negative result
and one false-positive result (1/9) was obtained among the healthy subjects. All 
patients infected with varicella zoster virus were negative to the IVIAP test.
The test is rapid, inexpensive, easy to interpret and can be used for the
diagnosis of HSV infections, especially in immunocompromised patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8736112 [PubMed - indexed for MEDLINE]

4314: Mol Biotechnol. 1996 Apr;5(2):125-37.

Acyclic nucleosides as antiviral compounds.

Freeman S, Gardiner JM.

Department of Pharmacy, University of Manchester, UK.

Acyclovir is an effective drug for the treatment of HSV and VZV infections, which
after phosphorylation to the triphosphate, inhibits viral DNA polymerase.
Acyclovir has low oral bioavailability, therefore prodrugs have been developed,
and the L-valyl ester, valaciclovir, recently has been licensed for the treatment
of shingles. Ganciclovir is used against CMV, and famciclovir, a lipophilic
prodrug of penciclovir, is marketed for shingles. The acyclic nucleoside
phosphonates are active against thymidine kinase-resistant viral strains.
Promising analogs are PMEA (in clinical trial for the treatment of AIDS) and
(S)-HPMPC (good in vivo activity against HSV, VZV, CMV, and EBV).
Oligonucleotides incorporating acyclic nucleosides at the 3'-and 5'-ends, or
constituted of amino acyclic nucleosides, are resistant to cleavage by nucleases 
and may be useful in antisense and/or antigene therapy. HEPT is active against
HIV-1: It binds in a hydrophic pocket on reverse transcriptase, rather than in
the polymerase active site. Some acyclic nucleosides are potent inhibitors of
purine and pyrimidine nucleoside phosphorylase. These compounds may have a
therapeutic niche in combination therapy with antiviral and anticancer
nucleosides, and in the treatment of diseases involving the T-cell.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8734425 [PubMed - indexed for MEDLINE]

4315: Br J Dermatol. 1996 Apr;134(4):788-90.

Colonic pseudo-obstruction: a complication of herpes zoster.

Jucgla A, Badell A, Ballesta C, Arbizu T.

Department of Dermatology, Cuitat Sanitaria i Universitaria de Bellvitge, Spain.

Herpes zoster has been associated rarely with somatic and visceral motor
complications, including segmental motor paralysis, neurogenic bladder
dysfunction and, unusually, colonic pseudo-obstruction. We report a patient who
developed acute pseudo-obstruction of the colon which followed the appearance of 
dermatomal herpes zoster.

Publication Types: 
    Case Reports

PMID: 8733394 [PubMed - indexed for MEDLINE]

4316: J Rheumatol. 1996 Apr;23(4):763-5.

Resolution of the neutropenia of Felty's syndrome by longterm administration of
recombinant granulocyte colony stimulating factor.

Krishnaswamy G, Odem C, Chi DS, Kalbfleisch J, Baker N, Smith JK.

Department of Medicine, East Tennessee State University, James H. Quillen College
of Medicine, Johnson City 37614-0622, USA.

Felty's syndrome is characterized by neutropenia, splenomegaly, and recurrent
infection in patients with rheumatoid arthritis. We used recombinant granulocyte 
colony stimulating factor (rGCSF) in a patient with Felty's syndrome and
recurrent sepsis. rGCSF induced a statistically significant increase in the
patient's absolute neutrophil and total white blood cell counts. During 14 months
of followup taking rGCSF, disseminated varicella zoster was the only infectious
complication. Except mild thrombocytopenia and a transient flare of arthritis, no
serious adverse effects occurred. rGCSF may be a safe and effective therapy for
Felty's syndrome in selected patients.

Publication Types: 
    Case Reports
    Review

PMID: 8730142 [PubMed - indexed for MEDLINE]

4317: Optom Vis Sci. 1996 Apr;73(4):225-30.

Review of external ocular disease associated with aids and HIV infection.

Chronister CL.

Eye Institute of the Pennsylvania College of Optometry, Philadelphia, USA.

External ocular disease associated with human immunodeficiency virus (HIV)
infection can often be overlooked by the eye care practitioner. Different types
of external ocular disease can be an indication of the patient's overall immune
status as well as the stage of HIV infection. The external ocular sequelae of HIV
infection can be of visual consequence for the patient. Eye care practitioners
need to become familiar with these conditions. The diagnosis and management of
the following ocular conditions associated with HIV infection are reviewed:
conjunctival microvascular disease, dry eye, allergic conjunctivitis,
microsporidial keratoconjunctivitis, herpes zoster ophthalmicus, herpes simplex
keratitis, molluscum contagiosum, fungal keratitis, bacterial
keratoconjunctivitis, and Kaposi's sarcoma (KS).

Publication Types: 
    Review

PMID: 8728488 [PubMed - indexed for MEDLINE]

4318: AIDS. 1996 Apr;10(4):393-9.

Complications of varicella zoster virus reactivation in HIV-infected homosexual
men.

Veenstra J, van Praag RM, Krol A, Wertheim van Dillen PM, Weigel HM, Schellekens 
PT, Lange JM, Coutinho RA, van der Meer JT.

Department of Public Health and Environment, University of Amsterdam, The
Netherlands.

OBJECT: To study the complication rate of varicella zoster virus (VZV)
reactivation and the relationship between complications, presentation and
localization of zoster and immune function in HIV disease. DESIGN AND METHODS: A 
total of 142 episodes of VZV reactivation in 113 out of 544 HIV-1-infected
participants in the Amsterdam Cohort Study of homosexual men were studied.
Persistent hyperkeratotic or necrotic skin lesions, post-herpetic neuralgia,
other neurological events, ocular events and pneumonitis occurring within 6
months of the onset of the last episode of VZV reactivation were defined as
complications, provided that other possible diagnoses were excluded and the event
had been previously described in the literature as related to VZV reactivation.
RESULTS: Twenty-four complications occurred in 15 (11%) of these 142 episodes.
Complications occurred exclusively in the 40 episodes with either multidermatomal
or disseminated presentation, or a trigeminal localization, or both. In the group
of episodes of unidermatomal zoster at a non-trigeminal localization no
complications occurred. Twenty-one episodes of herpes zoster were localized in
the trigeminal area. Localization was not significantly associated with the level
of immune function. Compared to unidermatomal presentation (n = 120),
multidermatomal (n = 15) and disseminated presentation (n = 7) occurred at lower 
median CD4+ cell counts (330, 240 and 50 x 10(6)/l, respectively; P = 0.003) and 
significantly lower levels of CD3 monoclonal antibodies or
phytohaemagglutinin-induced T-cell reactivity in vitro. Complications were
related to CD4+ cell counts, but in the cases of disseminated, multidermatomal or
trigeminal zoster a CD4+ cell measurement provided no additional information on
the risk of complications. CONCLUSION: In HIV-infected individuals the extent of 
the clinical presentation and the occurrence of complications of VZV reactivation
are related to the degree of immunodeficiency. In episodes of VZV reactivation
with either multidermatomal or disseminated presentation or a trigeminal
localization, or both the complication rate was high. CD4+ cell counts provided
no additional information on the complication risk. Oral acyclovir appears to be 
sufficient as therapy for unidermatomal zoster at a non-trigeminal localization.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8728043 [PubMed - indexed for MEDLINE]

4319: Trop Doct. 1996 Apr;26(2):72-6.

AIDS in Africa: what drugs do the carers want or need?

Lamont AC, Greiff M, Rosenberg DS, Wiggin TR.

Inter Care, Leicester, UK.

Our objectives were: (1) to discover requirements for treatment of patients with 
AIDS (PWAs) for health-care workers in eight English-speaking African countries; 
(2) to establish policies for supply of drugs, and develop a method for
determining the contents of parcels (PWA-BOXes) for the relief of PWAs.
Fifty-seven questionnaires were sent to non-government medical units treating
PWAs, supplied by the charity Inter Care. Of these 37 units replied, two had no
known PWAs, three were swamped by refugees; therefore, the total number analysed 
was 32. Only 24 units had access to HIV testing and the mean number of PWAs per
unit was 58. The reported complications of AIDS were: diarrhoea 28 units;
tuberculosis 27 units; pneumonia 28 units; sexually transmitted diseases 26;
candidiasis 28 units; and herpes zoster 20. Lists of drug requirements were
received. We present a protocol for calculation of contents of PWA-BOXes in the
hope that this will provide guidelines for other workers in this field.

PIP: Inter Care, a UK charitable organization, provides essential drugs to 120
medical units in Africa. To upgrade support to units caring for substantial
numbers of acquired immunodeficiency syndrome (AIDS) patients, Inter Care sent a 
questionnaire to 57 of its small rural hospitals and health and maternity units. 
Of the 37 units that returned the questionnaire, 24 reported access to human
immunodeficiency virus (HIV) laboratory tests while another seven relied on
clinical diagnostic methods. The number of AIDS patients treated per month ranged
from 0 to 200 (mean, 50). Diseases and conditions most commonly associated with
AIDS included diarrhea, pneumonia, candidiasis, tuberculosis, and sexually
transmitted diseases. The most commonly used drugs were metronidazole,
micronazole oral gel, and oxytetracycline. On the basis of these findings, Inter 
Care was able to modify the contents of AIDS boxes provided to its affiliates. An
assumption was made that a patient with AIDS spends only two weeks in the
hospital before death given the rapid progression of the disease in Africa. The
drugs supplied vary according to specific requests and the type of facility, but 
seek to treat the AIDS-related conditions identified in the survey with the least
expensive drug available. Also provided, depending on need, are HIV test kits and
educational posters.

Publication Types: 
    Multicenter Study

PMID: 8685971 [PubMed - indexed for MEDLINE]

4320: Nephrol Dial Transplant. 1996 Apr;11(4):752.

Acyclovir-associated encephalopathy in haemodialysis.

Peces R, de la Torre M, Alcazar R.

Publication Types: 
    Case Reports
    Letter

PMID: 8671884 [PubMed - indexed for MEDLINE]

4321: J Clin Oncol. 1996 Apr;14(4):1262-8.

Fludarabine, mitoxantrone, and dexamethasone: an effective new regimen for
indolent lymphoma.

McLaughlin P, Hagemeister FB, Romaguera JE, Sarris AH, Pate O, Younes A, Swan F, 
Keating M, Cabanillas F.

Department of Hematology, The University of Texas M.D. Anderson Cancer Center,
Houston, TX, USA.

PURPOSE: Although most patients with indolent lymphomas respond to initial
therapy, virtually all experience relapse. Secondary therapy is often beneficial,
but responses are rarely, if ever, durable. We conducted this phase II trail to
evaluate the therapeutic efficacy and toxicity of fludarabine, mitoxantrone, and 
dexamethasone (FND) in patients with relapsed indolent lymphoma. PATIENTS AND
METHODS: Fifty-one patients with recurrent or refractory indolent lymphoma were
treated with a regimen of fludarabine 25 mg/m2/d intravenously (IV) on days 1 to 
3, mitoxantrone 10 mg/m2 IV on day 1, and dexamethasone 20 mg/d IV or orally on
days 1 to 5. Treatment was repeated at 4-week intervals for a maximum of eight
courses. Late in the course of this trial, trimethoprim-sulfamethoxazole
(TMP-SMX) was incorporated for Pneumocystis carinii (PCP) prophylaxis. RESULTS:
Responses were complete (CR) in 24 patients (47%) and partial (PR) in 24 (47%).
The median failure-free survival time was 21 months for CR patients and 9 months 
for PR patients. Notable activity of FND was seen even in the elderly, in those
with high serum lactate dehydrogenase (LDH) or beta2-microglobulin levels, and in
those with multiple prior treatment regimens. The predominant toxic effects were 
myelosuppression and infections; other toxic effects were modest. Infections
occurred in 12% of courses. Almost half of the infections were proven or
suspected opportunistic infections, including six cases of dermatomal herpes
zoster and two cases of proven PCP pneumonia. CONCLUSION: The FND combination is 
highly active in patients with recurrent or relapsed indolent lymphoma and
results in a high percentage of CRs. Because of the risk of opportunistic
infections, we currently recommend prophylaxis with TMP-SMX and advise deletion
of corticosteroids for patients who develop opportunistic infections.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II

PMID: 8648382 [PubMed - indexed for MEDLINE]

4322: J Clin Oncol. 1996 Apr;14(4):1071-6.

Comment in:
    J Clin Oncol. 1997 Jun;15(6):2476.

Severe lymphocytopenia and interstitial pneumonia in patients treated with
paclitaxel and simultaneous radiotherapy for non-small-cell lung cancer.

Reckzeh B, Merte H, Pfluger KH, Pfab R, Wolf M, Havemann K.

Department of Internal Medicine, Division of Hematology/Oncology,
Phillips-Universitat, Marburg, Germany.

PURPOSE: In a phase II trial with paclitaxel and simultaneous radiotherapy in
non-small-cell lung cancer (NSCLC) patients, an unexpected high incidence of
interstitial pneumonias was observed. The type of immunodeficiency associated
with this treatment approach is characterized. PATIENTS AND METHODS: Fifteen
patients with inoperable stage IIIA/B NSCLC were treated with paclitaxel as a
3-hour infusion on day 1 in weeks 1 to 3 and 6 to 8 at dose levels between 50
mg/m2 and 86 mg/m2 and with simultaneous radiotherapy in daily doses of 2 Gy, 5
days per week, in weeks 1 to 3 and 6 to 8 up to a total dose of 56 Gy.
Hematologic parameters and lymphocyte subsets were monitored. RESULTS: Fourteen
patients are assessable for response. The overall response rate was 78%, with
four major responses, six partial remissions, and four minor responses. The major
toxic effect observed was a moderate to severe protracted lymphocytopenia (380
+/- 310/microL) in all patients. Seven patients developed moderate to severe
interstitial pneumonia; one had an additional herpes zoster infection, while an
eighth patient had a cytomegalovirus infection. During treatment, all lymphocyte 
subsets were reduced, as follows (n = 9, mean +/- SD): CD4+ T cells (100 +/-
90/microL), CD8+ T cells (130 +/- 160/microL), natural killer (NK) cells (70 +/- 
80/microL), and B cells (20 +/- 10/microL). Thus, the most pronounced toxicity
was seen in CD4+ T and B cells. There was no recovery of lymphocyte subsets
during a 3-month follow-up period. CONCLUSION: Paclitaxel with simultaneous
radiation induces lymphocytopenia and promotes opportunistic infections.
Long-term antibiotic and antimycotic prophylaxis is recommended. Whether the
lymphocytopenia is an additive effect of paclitaxel and radiation or whether it
can be induced by low-dose weekly paclitaxel alone remains to be determined.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II

PMID: 8648359 [PubMed - indexed for MEDLINE]

4323: Dent Clin North Am. 1996 Apr;40(2):359-68.

Herpesvirus infections.

Greenberg MS.

Department of Oral Medicine, University of Pennsylvania School of Dental
Medicine, Philadelphia, USA.

There are presently seven known herpes viruses that infect humans. Those viruses 
are important in the fields of oral medicine and dentistry because they cause
oral lesions, infect saliva, and cause serious and potentially life-threatening
infections in patients whose immune systems are compromised by cancer
chemotherapy, immunosuppressive drugs, or HIV infection. This article reviews the
basic virology and clinical manifestations of the herpes viruses while
highlighting the clinical aspects of herpes-related diseases important to
dentistry.

Publication Types: 
    Review

PMID: 8641526 [PubMed - indexed for MEDLINE]

4324: J Fam Pract. 1996 Apr;42(4):350.

Famciclovir for the treatment of herpes zoster.

Gordon A.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial

PMID: 8627199 [PubMed - indexed for MEDLINE]

4325: Laryngoscope. 1996 Apr;106(4):438-42.

Quantitative assessment of the variation within grades of facial paralysis.

Neely JG, Joaquin AH, Kohn LA, Cheung JY.

Department of Otolaryngology-Head and Neck Surgery. Washington University School 
of Medicine, St. Louis, MO 63110, USA.

A completely objective, unambiguous outcome measure of facial function is now
available. A new automated computer-assisted clinimetric system combines the
crucial detection capabilities of the human observer and the unique capacity of
the computer to quantify the image light reflectance difference observed during
facial expression. The new system was applied to 27 patients with a variety of
diseases affecting the facial nerve. All subjects could be individually and
objectively ranked, and disease-specific profiles could be constructed. These
tasks are not possible with the House-Brackmann scale, because of the wide
variation within grades and the ambiguity between grades. With the automated
objective, unambiguous outcome measure, it may be possible to define individual
case progression, recovery, and outcome over the course of disease.

Publication Types: 
    Comparative Study

PMID: 8614218 [PubMed - indexed for MEDLINE]

4326: Ann Intern Med. 1996 Apr 1;124(7):633-42.

Natural history of opportunistic disease in an HIV-infected urban clinical
cohort.

Moore RD, Chaisson RE.

Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

OBJECTIVE: To determine the effect of contemporary clinical care on the natural
history of opportunistic disease in an urban population infected with human
immunodeficiency virus (HIV). SETTING: Urban university HIV clinic. DESIGN:
Retrospective and prospective observational study. PATIENTS: 1246 HIV-infected
patients with CD4+ counts of 300 cells/mm3 or less. MEASUREMENTS: Incidence rates
and Kaplan-Meier estimates of the probability of developing opportunistic disease
with time, distribution of the CD4+ counts at which opportunistic disease
develops, survival after the development of opportunistic disease, and the
association between preventive drug therapies and the occurrence of opportunistic
infection. RESULTS: The most common opportunistic disease was Candida
esophagitis, which had an incidence of 13.3 events per 100 person-years and a
3-year Kaplan-Meier probability of 0.30. Pneumocystis carinii pneumonia,
Mycobacterium avium complex bacteremia, cytomegalovirus, and the acquired
immunodeficiency syndrome dementia complex occurred at rates of 5 to 9 events per
100 person-years and 3-year Kaplan-Meier probabilities of 0.15 to 0.22.
Toxoplasmosis, cryptococcal meningitis, herpes zoster, the wasting syndrome, and 
Kaposi sarcoma occurred at rates of about 2 to 4 events per 100 person-years and 
with 3-year Kaplan-Meier probabilities of 0.05 to 0.10. Non-Hodgkin lymphoma, M. 
tuberculosis infection, progressive multifocal leukoencephalopathy, and
cryptosporidiosis were the least common disorders, with an incidence of about 1
to 2 events per 100 person-years and a 3-year Kaplan-Meier probability less than 
0.05. Only the incidences of cryptococcal meningitis, secondary P. carinii
pneumonia, and herpes zoster decreased (P < 0.05) between 1989-1992 and
1993-1995. Fluconazole use was associated with a decreased relative rate of 0.49 
(P = 0.06) for cryptococcal meningitis and a decreased relative rate of 0.61 (P =
0.005) for esophageal candidiasis. Rifabutin use was associated with a decreased 
relative rate of 0.37 (P = 0.002) for M. avium complex bacteremia, and
trimethoprim-sulfamethoxazole use was associated with decreased relative rates of
0.33 (P = 0.02) for secondary P. carinii pneumonia and 0.55 (P = 0.08) for
primary P. carinii pneumonia. Candidiasis, herpes zoster, and M. tuberculosis
infection first occurred at a median CD4+ count greater than 100 cells/mm3, but
all other opportunistic diseases first occurred at a median CD4+ count less than 
50 cells/mm3. Median survival after diagnosis varied from 35 days for
non-Hodgkin's lymphoma to 680 days for herpes zoster. CONCLUSIONS: In the
patients studied, the incidences of secondary P. carinii pneumonia, cryptococcal 
meningitis, and herpes zoster have declined in the past 5 years. The incidences
of primary P. carinii pneumonia and Kaposi sarcoma appear to be declining
compared with historical estimates. However, although these and other
opportunistic diseases continue to be relatively frequent complications of HIV
infection, they are first occurring at more advanced immunosuppression than in
the past. Continued efforts are needed to develop effective strategies for
preventing opportunistic disease in very advanced HIV infection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8607591 [PubMed - indexed for MEDLINE]

4327: Dtsch Med Wochenschr. 1996 Mar 15;121(11):331-5.

[Varicella-zoster-virus myelitis without herpes. An important differential
diagnosis of the radicular syndrome]

[Article in German]

Jacobs A, Bamborschke S, Szelies B, Lanfermann H, Schroder R, Heiss WD.

Klinik und Poliklinik fur Neurologie und Psychiatrie der Universitat, Koln.

HISTORY AND CLINICAL FINDINGS: A 43-year-old woman was admitted with a 14-day
history of general malaise, subfebrile temperature, radicular dysaesthesias in
the "riding breeches" area, severe pain in the lumbar region and progressive
disorders of bladder and rectal emptying. Physical examination showed a
conus-cauda syndrome. Differential diagnosis was between myelitis (inflammatory
or infectious), space-occupying intraspinal mass or vascular lesion.
INVESTIGATIONS: Cerebrospinal fluid contained 1700/3 cells and there was
intrathecal antibody synthesis against varicella zoster virus (VZV) and positive 
VZV-DNA analysis in the polymerase chain reaction. Magnetic resonance imaging of 
the lumbar spine revealed an inflamed enlarged conal and epiconal area with small
haemorrhagic spots. There was no evidence of an underlying immune-modulated
disease. TREATMENT AND COURSE: With the diagnosis of varicella zoster myelitis
with cutaneous changes having been established the clinical signs and symptoms
regressed almost completely with aciclovir administration (10mg/kg intravenously 
for 14 days). CONCLUSION: VZV without cutaneous involvement should be considered 
in the differential diagnosis of the radicular pain syndrome. When clinical signs
of beginning myelitis or encephalitis are present, immediate investigations and
therapy are necessary.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8681722 [PubMed - indexed for MEDLINE]

4328: Rev Med Virol. 1996 Mar;6(1):17-23.

Pathophysiology of Pain with Reference to Herpes Zoster.

Johnson RW.

Pain Management Clinic, Bristol Royal Infirmary, Bristol, UK.

PMID: 10398443 [PubMed - as supplied by publisher]

4329: J Assoc Physicians India. 1996 Mar;44(3):220-1.

Zoster myelitis and its response to Acyclovir.

Sharma R, Vijayvergiya R, Baid CS, Maheshwari VD, Sunderam SM.

Department of Medicine, SMS Hospital, Jaipur.

Publication Types: 
    Case Reports

PMID: 9251328 [PubMed - indexed for MEDLINE]

4330: J Antimicrob Chemother. 1996 Mar;37(3):583-97.

Multiple dose netivudine, a potent anti-varicella zoster virus agent, in healthy 
elderly volunteers and patients with shingles.

Peck RW, Crome P, Wood MJ, McKendrick MW, Bannister B, Mandal BK, Crooks RJ.

Wellcome Research Laboratories, Beckenham, Kent, UK.

Netivudine is a nucleoside analogue with potent anti-varicella zoster virus
activity. We now report two open studies of the pharmacokinetics and tolerability
of netivudine in doses of 50, 100 and 200 mg twice daily. In one study, healthy
volunteers received an initial, single dose followed, a week later, by repeat
dosing for 9 1/2 days; in the other, patients with shingles were treated for 8
days and data were also recorded for rash resolution and pain duration and
intensity. Netivudine was well tolerated in both studies. Plasma concentrations
were similar in patients and healthy volunteers and increased in proportion to
dose. Steady state concentrations were 15-25% lower than expected from single
dose data, probably because of slightly decreased netivudine absorption after
food. Elimination half-life was l4-20 h. Plasma concentrations of
5-propynyluracil (5-PU), the main metabolite of netivudine, did not increase in
proportion to the netivudine dose and tended to be higher in patients than
volunteers. 5-PU concentrations remained elevated for up to 72 h after the last
netivudine dose, suggesting continued but slow release from unabsorbed netivudine
in the gut lumen. New lesion formation ceased and vesicles crusted most quickly
in the 200 mg group; zoster-associated pain intensity, was reduced in a
dose-related manner.

Publication Types: 
    Clinical Trial

PMID: 9182115 [PubMed - indexed for MEDLINE]

4331: J Antimicrob Chemother. 1996 Mar;37(3):403-21.

Antiviral resistance: mechanisms, clinical significance, and future implications.

Kimberlin DW, Whitley RJ.

Department of Pediatrics, The University of Alabama at Birmingham, 35233, USA.

The increased awareness of antiviral resistance over the past decade has
paralleled the development of new antiviral agents. While such resistant viral
isolates are of clinical significance primarily in immunocompromised individuals,
the development and transmission of such mutants have been reported in
immunocompetent persons as well. As antiviral agents are increasingly utilised by
the clinician, the incidence of such occurrences is likely to increase. Issues
relating to mechanisms of antiviral resistance, clinical manifestations and
significance of resistance, and implications for future antiviral development and
utilisation are reviewed in this article. Viruses that are discussed include
herpes simplex virus, varicella-zoster virus, cytomegalovirus, influenza A virus,
and human immunodeficiency virus.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 9182098 [PubMed - indexed for MEDLINE]

4332: Cornea. 1996 Mar;15(2):135-8.

Aqueous tear production in patients with neurotrophic keratitis.

Heigle TJ, Pflugfelder SC.

Department of Ophthalmology, University of Miami School of Medicine, Florida,
USA.

The purpose of this study was to determine whether corneal epithelial defects and
epitheliopathy in patients with unilateral dysfunction of the ophthalmic division
of the trigeminal nerve (neurotrophic keratitis) is associated with reduced
aqueous tear production. Sensation of the skin, cornea, and nasal mucosa, aqueous
tear production by Schirmer 1 testing, nasal-lacrimal reflex, and exposure zone
rose bengal staining were evaluated in the affected and fellow eyes of subjects
with neurotrophic keratitis (n = 5), eyes of subjects who had recent herpes
zoster ophthalmicus (HZO) and who did not develop neurotrophic keratitis (n = 4),
and normal controls (n = 10). Sensation in the brow and upper lid skin and nasal 
mucosa was absent on the affected side of patients with neurotrophic keratitis,
but was intact in all other groups. Corneal sensation and Schirmer 1 test values 
were significantly reduced (p < or = 0.05) in eyes with neurotrophic keratitis
compared with the other groups. The nasal-lacrimal reflex was absent on the
involved side of subjects with neurotrophic keratitis but was intact in subjects 
with HZO without keratopathy, and in normal controls (p < 0.008). Rose bengal
keratitis staining scores were significantly increased in eyes with neurotrophic 
keratitis compared with the other groups (p < 0.05). We conclude that
neurotrophic keratitis is associated with reduced cutaneous, nasal mucosal, and
corneal sensation on the affected side, as well as marked reduction in aqueous
tear production with loss of the nasal-lacrimal reflex. It is possible that the
corneal epithelial pathology in neurotrophic keratitis is due in part to aqueous 
tear deficiency.

PMID: 8925660 [PubMed - indexed for MEDLINE]

4333: J Clin Microbiol. 1996 Mar;34(3):675-9.

Evaluation of a commercial enzyme-linked immunosorbent assay for detection of
serum immunoglobulin G response to human herpesvirus 6.

Sloots TP, Kapeleris JP, Mackay IM, Batham M, Devine PL.

Clinical Virology Research Unit, Sir Albert Sakzewski Virus Research Centre,
Royal Children's Hospital, Brisbane, Australia.

A rapid (60-min) commercially available enzyme-linked immunosorbent assay (ELISA)
for the detection of immunoglobulin G (IgG) class antibodies to human herpesvirus
6 (HHV-6) was evaluated. The specificity of the ELISA for HHV-6 was confirmed by 
absorption studies, with the reactivities of HHV-6-positive sera being unaffected
by other herpesviruses (cytomegalovirus, herpes simplex virus, and
varicella-zoster virus) or the HSB2 cell line used to culture HHV-6. HHV-6 IgG
antibody levels in a panel of 502 serum samples were determined by ELISA and an
indirect immunofluorescence assay (IFA). Results obtained by the two methods were
in close agreement, suggesting that the ELISA provides a suitable test method for
the determination of HHV-6 IgG antibodies in a routine clinical laboratory. Both 
tests were positive in 398 cases (79%), and both were negative in 71 cases (14%),
with a different result obtained by IFA and ELISA in only 33 cases (7%).
Furthermore, absorption of sera with HHV-6 prior to assay revealed that the
majority of these results were false positive (n = 8) or false negative (n = 23) 
in the IFA (true positives or negatives in the ELISA). Subsequently, the ELISA
showed a sensitivity of 99.76% and a specificity of 98.75%. HHV-6-specific IgG
levels were also determined in paired serum samples collected from 49 donors--14 
with exanthem subitum (ES), 15 with ES which was complicated with central nervous
system involvement, and 20 undergoing bone marrow transplantation--in whom HHV-6 
infection had been demonstrated by virus isolation and/or PCR. All patients with 
ES or central nervous system complications showed an increase in HHV-6-specific
IgG, indicating that this ELISA may be a useful aid in the diagnosis of these
conditions. Furthermore, 14 of 20 patients undergoing bone marrow transplantation
showed an increase in HHV-6-specific IgG levels, possibly reflecting a
reactivation of HHV-6 in these patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8904436 [PubMed - indexed for MEDLINE]

4334: Aust Fam Physician. 1996 Mar;25(3):299-307.

Management issues in herpes zoster.

Dwyer DE.

Centre for Infectious Diseases and Microbiology, Westmead Hospital, New South
Wales.

Herpes zoster is a common clinical illness, with acute and chronic pain a major
feature. Antiviral agents started within 72 hours of the onset of the rash are
effective in the acute illness and in post herpetic neuralgia or zoster
associated pain. Newer agents offer advantages in efficacy and dosage
convenience.

Publication Types: 
    Review

PMID: 8867180 [PubMed - indexed for MEDLINE]

4335: J Rheumatol. 1996 Mar;23(3):548-50.

Herpes zoster myelitis occurring during treatment for systemic lupus
erythematosus.

Ebo DG, DeClerck LS, Stevens WJ, Ieven M, Ursi D, Van Goethem JW, Couttenye MM.

Department of Immunology, Allergology, and Rheumatology, University of Antwerp,
Belgium.

A woman with systemic lupus erythematosus (SLE) presented with a zoster eruption.
Transverse myelitis developed at the site of the dermatomal distribution of the
rash. SLE and varicella zoster virus (VZV) can both cause myelitis, and are
difficult to differentiate. The topographic association between the cutaneous and
the neurological involvement suggesting VZV myelitis was confirmed by polymerase 
chain reaction (PCR) for VZV in the cerebrospinal fluid. This case illustrates
the potential role of the selective amplification of VZV DNA in cerebrospinal
fluid to diagnose central neurological complications associated with VZV. The
value of magnetic resonance imaging of the spinal cord in the evaluation of
patients with myelitis is emphasized.

Publication Types: 
    Case Reports

PMID: 8833001 [PubMed - indexed for MEDLINE]

4336: Indian J Ophthalmol. 1996 Mar;44(1):40-2.

Bilateral and multifocal generalized eruptions in herpes zoster ophthalmicus:
case report.

Nath R.

Department of Ophthalmology, King George's Medical College, Lucknow.

Publication Types: 
    Case Reports

PMID: 8828306 [PubMed - indexed for MEDLINE]

4337: J Pediatr. 1996 Mar;128(3):353-6.

Herpes zoster infection after bone marrow transplantation in children.

Kawasaki H, Takayama J, Ohira M.

Department of Pediatrics, Kansai Medical University, Osaka, Japan.

OBJECTIVE: To determine the frequency of, risk factors for, and clinical course
of herpes zoster (HZ) after bone marrow transplantation (BMT) in children. STUDY 
DESIGN: A total of 107 children with hematologic malignancy or solid tumor who
underwent allogeneic or autologous BMT were studied retrospectively. RESULTS: Of 
the 107 patients, HZ developed in 35 (33%) after BMT; 31 (89%) of these 35
patients had localized HZ. The median onset of infection was day 96 after BMT,
and 89% of cases of HZ occurred before day 365 after BMT. HZ developed in 26
(58%) of 45 patients (13/21 (62%) allogeneic and 13/24 (54%) autologous patients)
with hematologic malignancy; most of these patients had undergone total body
irradiation. Of 33 patients with solid tumor, HZ developed in 9 (27%). All
patients with HZ were treated with acyclovir, and no patients died of
complications directly resulting from HZ. CONCLUSION: Herpes zoster occurred
earlier after BMT than in adults, and it occurred frequently in children who had 
hematologic malignancy and/or had undergone total body irradiation. Prompt
antiviral therapy reduced the mortality rate and significant morbidity associated
with HZ.

Publication Types: 
    Comparative Study

PMID: 8774503 [PubMed - indexed for MEDLINE]

4338: Transpl Immunol. 1996 Mar;4(1):19-22.

Antiepithelial cell antibodies do not impair paediatric renal allograft survival 
but appear to be associated with acute viral infections.

Spencer SE, McCarthy N, Hannigan B, Gill D, Taylor MR, Murphy D, Walshe JJ.

Beaumont Hospital, Dublin, Ireland.

There is a reported association between antiepithelial cell (AEC) antibodies and 
increased renal allograft loss in paediatric recipients. Our unit experienced a
dramatic fall in 1-year graft survival so we undertook a study to determine if
AEC antibodies could account for such losses. We also studied healthy children
and adults as well as a group of individuals with serologically proven viral
infection in an attempt to determine the prevalence and possible aetiology of
these antibodies. Sera were screened for AEC antibodies in a microcytotoxicity
test using a lung epithelial cell line (A549) as target. The prevalence of these 
antibodies in our paediatric recipients was similar to that reported elsewhere
but we found no correlation between the presence of AEC antibody and allograft
loss. Within the control populations, we found the antibody was more prevalent in
children than in adults (p < 0.0001). We also found a strong age banding pattern,
with antibody being present in 50% of children under 10 years and declining with 
increasing age, so that by the age of 16 years the seroprevalence was similar to 
that found in our adults. However, AEC antibody had a significantly higher
prevalence in individuals with active viral infection than in our healthy control
groups (p = 0.00003). A positive association was noted between rubella and
respiratory syncytial virus and AEC antibody presence and a negative association 
with varicella zoster. We conclude that AEC antibodies do not correlate with
increased paediatric renal allograft loss but appear to be linked to certain
viral infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8762004 [PubMed - indexed for MEDLINE]

4339: Clin Exp Dermatol. 1996 Mar;21(2):174-5.

Varicella zoster virus infection complicating bullous pemphigoid.

Cliff S, Ostlere LS, Harland CC.

Publication Types: 
    Case Reports
    Letter

PMID: 8759218 [PubMed - indexed for MEDLINE]

4340: Acta Derm Venereol. 1996 Mar;76(2):159-60.

Herpes zoster-associated trigeminal neurotrophic ulcer.

Nielsen NH, Petersen CS.

Publication Types: 
    Case Reports
    Letter
    Review

PMID: 8740279 [PubMed - indexed for MEDLINE]

4341: Antiviral Res. 1996 Mar;29(2-3):141-51.

Famciclovir: review of clinical efficacy and safety.

Cirelli R, Herne K, McCrary M, Lee P, Tyring SK.

Department of Microbiology/Immunology, University of Texas Medical Branch,
Galveston 77555, USA.

Famciclovir is the well-absorbed oral form of penciclovir, an antiviral agent
with potent activity against varicella-zoster virus (VZV) and herpes simplex
virus (HSV-1) and 2 (HSV-2). After oral administration, famciclovir is rapidly
converted to penciclovir with a bioavailability of 77%. penciclovir is
efficiently phosphorylated to the active metabolite, penciclovir-triphosphate,
and has a prolonged intracellular half-life of approximately 9-10 h in
VZV-infected cells, and 10 and 20 h in cells infected with HSV-1 and HSV-2,
respectively. Two multicenter clinical trials have shown that famciclovir given
during the acute zoster phase accelerated healing of cutaneous lesions. More
importantly, in a placebo-controlled study, famciclovir reduced the duration of
postherpetic neuralgia (PHN), particularly in elderly patients. Famciclovir has
also been proven effective in treating recurrent genital herpes, as demonstrated 
by a reduction in times to cessation of viral shedding, complete healing, and
loss of all symptoms. One study showed that suppressive therapy with famciclovir 
was effective in reducing genital herpes episodes in patients with frequent
recurrences. A promising new area of investigation for famciclovir is controlling
virus replication in patients with chronic hepatitis B virus (HBV) or HBV
reinfections after liver transplant. Results from a double-blind,
placebo-controlled, pilot study and several case reports have shown that
famciclovir, alone or in combination with other agents, decreased HBV-DNA levels 
and was tolerated with long-term treatment. Available clinical data indicate that
famciclovir is an effective agent for treating herpes and holds significant
promise for the treatment of chronic HBV infection HBV reinfection after liver
transplantation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8739594 [PubMed - indexed for MEDLINE]

4342: Br J Dermatol. 1996 Mar;134(3):606.

Comment in:
    Br J Dermatol. 1997 Mar;136(3):466-7.

Nodular solar degeneration following herpes zoster.

Yamamoto T, Yokoyama A.

Publication Types: 
    Case Reports
    Letter

PMID: 8731699 [PubMed - indexed for MEDLINE]

4343: Br J Dermatol. 1996 Mar;134(3):504-9.

Comment in:
    Br J Dermatol. 1997 Mar;136(3):465.    Br J Dermatol. 1997 Mar;136(3):465-6.    Br J Dermatol. 1997 Mar;136(3):466-7.

Cutaneous reactions following herpes zoster infections: report of three cases and
a review of the literature.

Gibney MD, Nahass GT, Leonardi CL.

Division of Dermatology, St Louis University Health Sciences Center, Missouri
63104, USA.

Three patients, one healthy and two immunocompromised, developed cutaneous
reactions that histologically mimicked granuloma annulare at sites of resolved
varicella-zoster virus (VZV) reactivation infections. Variable latency periods
between the infection and the granulomatous reaction were noted. As in other case
reports, the presence of VZV DNA in these lesions was inconsistently demonstrated
by the polymerase chain reaction (PCR) and appears more common in early, as
opposed to late, post-zoster granulomas. In addition to various granulomatous
reactions, vasculitic and neoplastic eruptions following resolved VZV infections 
have been described and are reviewed here. Therapeutically, topical,
intralesional and systemic corticosteroids, as well as acyclovir, have been tried
with inconsistent results. Although the pathogenesis remains unclear, the
presence of VZV DNA in early lesions that histologically do not display viral
cytopathic changes, suggests the virus induces an atypical delayed
hypersensitivity reaction not affected by antiviral therapy.

Publication Types: 
    Case Reports
    Review

PMID: 8731677 [PubMed - indexed for MEDLINE]

4344: Compr Ther. 1996 Mar;22(3):183-6.

Clinical management of herpes zoster in the elderly patient.

Beutner KR.

Department of Dermatology, University of California, San Francisco 94589-2500,
USA.

Publication Types: 
    Review

PMID: 8706390 [PubMed - indexed for MEDLINE]

4345: J Clin Pathol. 1996 Mar;49(3):243-8.

Distribution of varicella zoster virus and herpes simplex virus in disseminated
fatal infections.

Nikkels AF, Delvenne P, Sadzot-Delvaux C, Debrus S, Piette J, Rentier B, Lipcsei 
G, Quatresooz P, Pierard GE.

Department of Dermatopathology, CHU Sart Tilman, Belgium.

AIMS: To study the cutaneous and visceral distribution of herpes simplex virus
(HSV) and varicella zoster virus (VZV) in fatal infections. METHODS: Standard
histology, immunohistochemistry (monoclonal antibodies VL8 and VL2 and polyclonal
antibody IE63 directed against VZV; monoclonal antibodies IBD4 and HH2 and
polyclonal antibodies directed against HSVI and HSVII) and in situ hybridisation 
(anti-HSV and anti-VZV probes) were applied to formalin fixed, paraffin wax
sections. RESULTS: On histological examination, Herpesviridae infection was
evident in various organs including the lungs, liver and skin. In addition,
immunohistochemistry and in situ hybridisation revealed the presence of HSV and
VZV antigens and nucleic acids in several cell types and tissues showing no
cytopathological alterations suggestive of Herpesviridae infection. The organs
with histological evidence of infection also contained VZV or HSV antigens and
their genes. CONCLUSIONS: These findings suggest that organ failure in
disseminated VZV and HSV infections is primarily caused by HSV or VZV induced
cell damage and lysis. They also indicate that immunohistochemistry and in situ
hybridisation can provide an accurate, type-specific diagnosis on formalin fixed,
paraffin wax embedded tissue even when classic histological and cytological
characteristics are lacking.

Publication Types: 
    Case Reports

PMID: 8675738 [PubMed - indexed for MEDLINE]

4346: Br J Haematol. 1996 Mar;92(4):947-9.

Human herpesvirus-6-associated exanthema in a patient with acute lymphocytic
leukaemia.

Fujita H, Maruta A, Tomita N, Taguchi J, Sakai R, Shimizu A, Harada M, Ogawa K,
Kodama F, Okubo T.

Department of Haematology / Chemotherapy, Clinical Research Institute, Kanagawa
Cancer Centre, Yokohama, Japan.

Summary: We report the first case of human herpesvirus-6 (HHV-6) associated
exanthema in a patient with acute lymphocytic leukaemia (ALL). We analysed DNA
extracted from an exanthematous lesion using the polymerase chain reaction (PCR).
DNA was positive for HHV-6 but negative for herpes simplex virus, varicella
zoster virus, and cytomegalovirus. Immunohistochemical staining of the skin with 
monoclonal antibody against (HHV-6 confirmed the infection. The possibility of
HHV-6 infection should be considered when an atypical skin rash is seen in
patients with ALL.

Publication Types: 
    Case Reports

PMID: 8616091 [PubMed - indexed for MEDLINE]

4347: Tidsskr Nor Laegeforen. 1996 Feb 28;116(6):721-5.

[Virological diagnostics in acute encephalitis. Experience with nucleic acid
detection and ratio examination during the period 1991-94]

[Article in Norwegian]

Bruu AL.

Avdeling for virologi, Statens institutt for folkehelse, Torshov, Oslo.

In every single case of acute encephalitis it is important to confirm the
clinical diagnosis by means of virological investigations. Previously,
examination by brain biopsy was regarded as the gold standard for detecting the
presence of virus or virus antigen in suspected cases of encephalitis caused by
herpes simplex virus, but the extraction of the sample material requires
experience, and is not without risk. In recent years, detection of herpes simplex
DNA using the polymerase chain reaction is recommended as the method of choice
during the acute state of the illness, followed by ratio determination, e.g. the 
relation between IgG antibodies in serum and cerebrospinal fluid during the
reconvalescence period. Between 1991 and 1994, the clinical diagnosis of acute
encephalitis was confirmed by laboratory investigations in 42 cases in our
laboratory. Detection of viral DNA and subsequent ratio determination showed the 
encephalitis to have been caused by herpes simplex virus in 21 cases, and by
varicella zoster virus in eight cases. Nucleic acid was detected in 21 cases, and
16 patients showed pathological ratio values. These results show that the
polymerase chain reaction is a valuable diagnostic tool during the first two
weeks of the illness, whereas ratio determination is a better way of
investigating samples taken after this period.

Publication Types: 
    English Abstract

PMID: 8644072 [PubMed - indexed for MEDLINE]

4348: Schweiz Med Wochenschr. 1996 Feb 17;126(7):264-76.

[Prenatal and perinatal infections--problems for the practicing pediatrician:
group B streptococci, varicella, toxoplasmosis]

[Article in German]

Kind C, Duc G.

Neonatologic Frauenklinik, Kantonsspital St. Gallen.

A practical approach is reported for the care of the neonate born to a mother
infected/colonized during pregnancy by group B streptococcus, varicella-zoster
virus or Toxoplasma gondii. Starting from clinical situations, an attempt is made
to work out evidence based recommendations using an overview of the current
literature. GROUP B STREPTOCOCCI: Relevant factors for the treatment of infants
born to colonized mothers are clinical symptoms, gestational age, additional risk
factors (such as premature rupture of membranes or maternal fever) and
intrapartum antibiotics. Postnatal antibiotic prophylaxis and laboratory screens 
failed the test of controlled trials. Transfer to a neonatology unit is
recommended for symptomatic term and all preterm infants. Asymptomatic term
infants should be carefully monitored during the first 48 hours for signs of
respiratory, circulatory or thermoregulatory compromise. VARICELLA: In the case
of maternal varicella near term, delaying delivery for one week will lower the
risk of severe neonatal varicella. The postnatal administration of
varicella-zoster-immunoglobulin to the neonate is supported by some (if limited) 
evidence from the literature in the case of maternal eruption between 7 days
before and 2 days after delivery. In newborns of mothers with eruption appearing 
later immunoglobulin is often recommended, though no supporting clinical evidence
is available. There are no data to justify the use of immunoglobulin after
exposure during pregnancy in order to prevent pneumonia in the pregnant patient, 
but there are preliminary indications that its application could lower the risk
of congenital varicella syndrome (2% between 13 and 20 weeks). The use of
immunoglobulin in very low birth weight infants after nosocomial exposure is
generally recommended but efficacy data are lacking. TOXOPLASMOSIS: The practical
approach depends on clinical findings in the newborn and laboratory results
during pregnancy and after birth. Examination of the newborn should include
fundoscopy, cranial sonography and, in cases of documented infection, lumbar
puncture. Serology from cord blood comprises assays for IgG, IgM and if possible 
IgA/IgE. If available, demonstration of the parasite by culture or PCR can be
helpful. All infants with documented congenital toxoplasmosis should be treated
for a minimum of 12 months. In the case of suspected toxoplasmosis the child
should be treated as long as the suspicion persists. The prognosis after
consequential therapy is less bleak than previously reported for untreated
children even in seriously symptomatic patients.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8720324 [PubMed - indexed for MEDLINE]

4349: Gene. 1996 Feb 12;168(2):189-93.

Sequence and expression of a bovine herpesvirus-1 gene homologous to the
glycoprotein K-encoding gene of herpes simplex virus-1.

Khadr A, Tikoo SK, Babiuk LA, van Drunen Littel-van den Hurk S.

Veterinary Infectious Disease Organization, University of Saskatchewan,
Saskatoon, Canada.

In the bovine herpes virus-1 (BHV-1) genome, a gene equivalent to the
glycoprotein k (gK)-encoding gene of other herpesviruses was identified and
sequenced. The primary translation product is predicted to comprise 338 amino
acids (aa) and to exhibit a molecular mass of 37.5 kDa. It possesses
characteristics typical for membrane glycoproteins including a potential
cleavable signal sequence, three transmembrane domains and two potential N-linked
glycosylation sites. Comparison to the gK proteins of the other herpesviruses
revealed aa sequence homologies of 46, 44, 53, 43, and 46% with the gK
counterparts of herpes simplex viruses-1 and 2 (HSV-1 and 2), equine
herpesvirus-1 (EHV-1), Marek's disease virus (MDV) and varicella zoster virus
(VZV), respectively. A 30-kDa primary translation product was identified
following in vitro translation of in vitro transcribed mRNA. When canine
microsomal membranes were added to the translation reaction, a 38-kDa
glycosylated protein was detected. Treatment with endoglycosidase F or H (endo or
H) removed the glycosyl groups and reduced the apparent molecular mass of the
38-kDa glycoprotein.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8654942 [PubMed - indexed for MEDLINE]

4350: J Med Chem. 1996 Feb 2;39(3):789-95.

Synthesis and anti-herpes virus activity of 2'-deoxy-4'-thiopyrimidine
nucleosides.

Rahim SG, Trivedi N, Bogunovic-Batchelor MV, Hardy GW, Mills G, Selway JW,
Snowden W, Littler E, Coe PL, Basnak I, Whale RF, Walker RT.

Wellcome Research Laboratories, Beckenham, Kent, U.K.

A series of 5-substituted 2'-deoxy-4'-thiopyrimidine nucleosides was synthesized 
and evaluated as potential antiviral agents. A number of analogues such as
2'-deoxy-5-propyl-4'-thiouridine (3ii), 2'-deoxy-5-isopropyl-4'-thiouridine
(3iii), 5-cyclopropyl-2'-deoxy-4'-thiouridine (3iv),
2'-deoxy-4'-thio-5-vinyluridine (3viii), and
5-(2-chloroethyl)-2'-deoxy-4'-thiouridine (3xx) were found to be highly active
against herpes simplex virus type-1 (HSV-1) and varicella zoster virus (VZV) in
vitro with no significant cytotoxicity. The compound with the broadest spectrum
of activity was 2'-deoxy-5-ethyl-4'-thiouridine (3i) which showed significant
activity against HSV-1, HSV-2, and VZV.

PMID: 8576922 [PubMed - indexed for MEDLINE]

4351: J Rheumatol. 1996 Feb;23(2):273-8.

Comment in:
    J Rheumatol. 1996 Feb;23(2):212-3.

Outpatient monthly oral bolus cyclophosphamide therapy in systemic lupus
erythematosus.

Dawisha SM, Yarboro CH, Vaughan EM, Austin HA 3rd, Balow JE, Klippel JH.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS),
National Institutes of Health, Bethesda, MD, USA.

OBJECTIVE: An open label study to determine the feasibility and acute toxicity of
a 6 month course of outpatient intermittent bolus high dose oral cyclophosphamide
in patients with active systemic lupus erythematosus (SLE). METHODS: Oral
cyclophosphamide in a single dose of 0.5 to 1.0 g/m2 was given monthly for 6
consecutive months. Disease activity was monitored by quantitative assessments of
urine sediment, 24h urine protein excretion, and the Systemic Lupus Activity
Measure (SLAM). RESULTS: Twelve patients (11 with glomerulonephritis and one with
thrombocytopenia) were studied. Improvements in SLAM scores, proteinuria, and
urinary cellular casts were observed in the majority of the 9 patients with
nephritis who completed the study. Adverse effects included mild nausea in most
patients and intercurrent infections in 2 patients (herpes zoster, cellulitis,
urinary tract infection). Three patients failed to complete the 6 month course of
therapy because of treatment failure in the patient with thrombocytopenia,
pregnancy, and severe vomiting, respectively. CONCLUSION: High dose pulse oral
cyclophosphamide is an acceptable alternative for the aggressive outpatient
management of selected patients with lupus nephritis.

Publication Types: 
    Clinical Trial

PMID: 8882031 [PubMed - indexed for MEDLINE]

4352: Arch Pharm (Weinheim). 1996 Feb;329(2):66-72.

Synthesis and antiviral activity of 5-substituted
(2'S)-2'-deoxy-2'-C-methylcytidines and -uridines.

Awano H, Shuto S, Miyashita T, Ashida N, Machida H, Kira T, Shigeta S, Matsuda A.

Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan.

Synthesis of several 5-substituted (2'S)-2'-deoxy-2'-C-methylcytidines (8) and
-uridines (6, 11) has been accomplished using radical deoxygenation of the
2'-tert-alcohols via their methyl oxalyl esters as a key reaction. Anti-herpes
simplex virus type-1 and -2, and anti-varicella-zoster virus activities of the
newly synthesized nucleosides were evaluated. Among them, the 5-iodouracil
derivative 6e showed the most potent activity against herpes simplex virus
type-1, with an EC50 of 0.14 micrograms/mL without showing cytotoxicity up to 100
micrograms/mL, but had a weak activity against herpes simplex virus type-2 and no
activity against varicella-zoster virus up to 50 micrograms/mL in vitro. Although
the 5-fluorocytosine derivative 8b had a potent anti-herpes simplex virus type-1 
activity (EC50 = 0.22 micrograms/mL), it was rather cytotoxic to the CCRF-HSB-2
human T-cell line (IC50 > or = 1.0 microgram/mL).

PMID: 8851469 [PubMed - indexed for MEDLINE]

4353: Drugs Aging. 1996 Feb;8(2):97-112.

Antiviral therapy of acute herpes zoster in older patients.

Herne K, Cirelli R, Lee P, Tyring SK.

Department of Microbiology/Immunology, University of Texas Medical Branch,
Galveston 77555, USA.

Although herpes zoster (shingles) can occur in anyone with a history of
chickenpox, it is more prevalent and usually more severe in older patients (i.e. 
persons over 50 years of age). While the cutaneous manifestations of shingles
usually resolve in approximately 4 weeks, the pain can persist for several
months, or even years in the untreated patient. This pain following healing of
the skin, termed post-herpetic neuralgia (PHN), can be very severe. Three well
tolerated and effective antiviral drugs are available for the therapy of acute
herpes zoster. The nucleoside analogues, aciclovir, famciclovir and valaciclovir,
appear to shorten the duration of PHN to a similar degree, but none affects the
incidence of PHN. Aciclovir is taken 5 times daily for 7 days, while famciclovir 
is taken 3 times daily for 7 days. Valaciclovir, the L-valyl ester of aciclovir, 
when taken orally, produces plasma levels of aciclovir equivalent to those seen
following intravenous administration of aciclovir. Valaciclovir has not only been
proved to be more efficient than aciclovir (i.e. 3 times daily administration)
but also more effective than aciclovir in shortening the duration of PHN. Current
studies are determining the relative efficacy of valaciclovir versus famciclovir.
Presently, a fourth drug, sorivudine, is being compared with aciclovir for the
therapy of acute herpes zoster in older patients, but data from these trials are 
not yet available. Corticosteroids have been used to treat herpes zoster for much
longer than the antiviral drugs, but the effect of corticosteroids on PHN does
not appear to be consistent. Corticosteroids plus aciclovir did not provide an
added benefit over aciclovir alone in one study but this combination did appear
to improve the quality of life of older patients in another investigation. The
recent availability of the varicella zoster vaccine may cause shingles to be an
uncommon and/or mild disease by the mid twenty-first century. Meanwhile, the
search continues for more effective and efficient therapies for acute herpes
zoster with the primary goal in older patients to affect the most important
sequela of zoster in this population, PHN.

Publication Types: 
    Review

PMID: 8845591 [PubMed - indexed for MEDLINE]

4354: Clin Infect Dis. 1996 Feb;22(2):341-7.

Oral acyclovir therapy accelerates pain resolution in patients with herpes
zoster: a meta-analysis of placebo-controlled trials.

Wood MJ, Kay R, Dworkin RH, Soong SJ, Whitley RJ.

Department of Infection & Tropical Medicine, Birmingham Heartlands Hospital,
United Kingdom.

Meta-analysis of four double-blind, randomized, placebo-controlled trials of oral
acyclovir (800 mg five times daily) for the treatment of herpes zoster was
conducted to provide definitive assessments of the effect of acyclovir on the
resolution of zoster-associated pain. The studies involved a total of 691
patients, and the analysis was performed on an intent-to-treat basis. A range of 
milestones of pain cessation were evaluated by means of Cox regression models
with adjustment for relevant prognostic factors. The proportion of patients with 
postherpetic neuralgia at 3 and 6 months was also determined. Advancing age and
more severe pain at presentation were associated with more prolonged pain.
Acyclovir was clearly shown to accelerate pain resolution by all of the measures 
employed. Benefit was especially evident in patients 50 years of age or older.
Fewer acyclovir recipients had postherpetic neuralgia at 3 or 6 months. Overall, 
the reductions of pain duration and prevalence were approximately twofold.

Publication Types: 
    Meta-Analysis

PMID: 8838194 [PubMed - indexed for MEDLINE]

4355: Eur Respir J. 1996 Feb;9(2):284-7.

Characteristics of sputum smear-positive tuberculosis patients with and without
HIV infection in a hospital in Zimbabwe.

Schoch OD, Rieder HL.

Driefontein Tuberculosis Sanatorium, Mvuma, Zimbabwe.

Human immunodeficiency virus (HIV) infection has a large impact on tuberculosis
in Africa. In this study, the prevalence of HIV infection in a population of
hospitalized tuberculosis patients in Zimbabwe was determined and demographic
characteristics, clinical signs and symptoms, as well as radiographic appearance 
were compared in tuberculosis patients with and without HIV infection. During a 5
month observation period, information on tuberculosis patients referred to
Driefontein Tuberculosis Sanatorium, Mvuma, Zimbabwe was collected, computerized 
and analysed with commercially available software. Of 467 patients admitted, 255 
were sputum smear positive for acid-fast bacilli. Of 196 patients with complete
information, 127 (65%) were HIV-seropositive. When compared to the 69
HIV-seronegative patients, HIV-infected patients were not different in age,
gender, the period of delay between the onset of symptoms and diagnosis,
radiographic appearance, history of previous antituberculosis treatment and
symptoms and signs reported, with the exception of herpes zoster and other
sexually-transmitted disease. The prevalence of HIV infection in our population
of tuberculosis patients was large. However, since demographic and clinical
characteristics are remarkably similar in tuberculosis patients with and without 
HIV infection, case-finding activities need not be altered in the wake of the HIV
epidemic.

PIP: During April-September 1992, demographic, clinical, and bacteriological
information was collected on all 467 tuberculosis (TB) patients aged 15 years and
older admitted to the Driefontein Tuberculosis Sanatorium serving people from the
Midlands and Masvingo provinces in Zimbabwe. 255 people had at least one sputum
smear positive for acid-fast bacilli. Researchers retained 196 of these for
analysis and compared demographic characteristics, clinical signs and symptoms,
and radiographic appearance in TB patients with and without HIV infection. 127
(65%) people tested positive for HIV. HIV-infected TB patients were not
significantly different compared to HIV-negative TB patients in age, gender, the 
period of delay between the onset of symptoms and diagnosis (about 2 months for
both groups), radiographic appearance, history of previous anti-TB treatment, and
symptoms and signs reported. They were more likely than HIV-negative TB patients 
to have a history of sexually transmitted diseases (adjusted odds ratio = 3.4; p 
= 0.01) and herpes zoster infection (9 vs. 0 patients). These findings suggest
that health workers need not change case finding activities in the wake of the
HIV epidemic. In conclusion, the most cost-effective intervention continues to be
identification and curative treatment of sputum smear-positive TB patients
irrespective of their HIV status.

PMID: 8777965 [PubMed - indexed for MEDLINE]

4356: East Afr Med J. 1996 Feb;73(2):88-90.

Serological investigation of HIV-1 variant subtype strains in transmission in
Nairobi.

Songok EM, Tukei PM, Mulaa FJ.

Virus Research Centre, Kenya Medical Research Institute, Nairobi, Kenya.

In a bid to determine the HIV-1 subtype variants in transmission in Nairobi and
its possible association with clinical status, we screened 207 confirmed HIV-1
positive patients visiting HIV/AIDS laboratory at the Virus Research Centre in
Nairobi between January and March 1994. We used a selfmade ELISA obtained from an
established panel of HIV-1 V3 loop peptides (ANRS, France) and derived from seven
isolates: MN, HXB2, SC, Z6, Z2, ELI and CDC4. Test samples were obtained from 95 
blood donors and medical examination attendees, 57 patients with chronic
diarrhoea, 31 confirmed pulmonary tuberculosis, 16 with pneumonia and 12 herpes
zoster. Out of the total, 21.5% had antibodies against the MN strain, 19.1% had
against the Z2 strain while reaction against the HXB2 strain was observed in
17.2%. SC, CDC4, Z6 and ELI had prevalences of 11.5%, 6.2%, 5.3% and 3.8%
respectively. Fifteen per cent of the tested sera showed no reaction to any of
the used peptides. Strong and significant associations were observed between the 
total number of strains a sample react to and the clinical state. We infer that
both the North American consensus strains (MN and HXB2) and the African isolates 
(Z2 and Z6) are predominant in Nairobi. The correlation between antibody
reactivity and clinical state is an interesting observation that necessitates an 
expanded study and, the use of strain specific peptides maybe a sensitive and
easier method for use for molecular epidemiological purposes.

PIP: During January-March 1994, in Nairobi, Kenya, the sera of pre-university
students, suspected AIDS/advanced HIV-infection cases, and blood donors were
screened for HIV-1 antibodies at the Virus Research Centre. All confirmed HIV-1
positive samples were categorized according to the patient's clinical status. A
self-made ELISA was obtained from an established panel of HIV-1 V3 loop peptides 
and derived from seven isolates (MN and HXB2 [North American strains], SC, CDC4, 
Z2 and Z6 [African strains], and ELI). The sera of the 22 confirmed HIV-1
negative students were used as negative controls. There were 207 confirmed HIV-1 
cases (95 blood donors and 112 suspected AIDS/advanced HIV-infection cases). 64
(31%) and 112 (54%) samples reacted to at least 3 strains and no more than 2
strains, respectively. The remaining 31 (15%) samples did not react to any of the
7 peptide strains. Samples with CD4 cell counts greater than 500 x 1 million
reacted significantly to more peptide strains than those with CD4 counts below
200 x 1 million (88% vs. 7%). Reactivity to specific strains were 21.5% for MN,
19.1% for Z2, 17.2% for HXB2, 11.5% for SC, 6.2% for CDC 4, 5.5% for Z6, and 3.8%
for ELI. Anti-HXB2 antibodies were more common in blood donors than suspected
AIDS/advanced HIV-infection cases (22% vs. 13%). AIDS/advanced HIV-infection
cases were more likely to have no antibodies than blood donors (21% vs. 7%). A
significant association existed between the number of peptide strains a patient
could react to and the clinical state (p 0.01). Specifically, 77% of samples with
no V3 antibodies to the seven strains had AIDS or advanced HIV infection while
55% of those which had cross reactivity with three or more strains were
asymptomatic. Further research is needed to better understand this correlation.
These findings suggest that use of strain specific peptides may be a sensitive
and easier method for use for molecular epidemiological purposes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8756045 [PubMed - indexed for MEDLINE]

4357: Rinsho Shinkeigaku. 1996 Feb;36(2):345-7.

[A case of diaphragmatic paralysis following herpes zoster]

[Article in Japanese]

Fujimoto S, Matsuno O, Matsumoto T, Kumamoto T, Tsuda T.

Third Department of Internal Medicine, Oita Medical University.

We report a case of diaphragmatic paralysis after herpes zoster. A 82-year-old
woman developed shortness of breath on effort after about two months of a typical
herpes zoster eruptions affecting the C4 and C5 dermatomic areas on the right
side. A chest x-ray showed an elevated right diaphragm. The diaphragmatic evoked 
potential by stimulation of the right phrenic nerve at the posterior border of
the sternocleidomastoid muscle was not elicited. Chest CT and cervical MRI were
normal. The viral antibody titers of herpes zoster were elevated in the serum.
Cervical herpes zoster should be considered as a possible cause of
hemidiaphragmatic paralysis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8752692 [PubMed - indexed for MEDLINE]

4358: J Neurol. 1996 Feb;243(2):191-5.

Acute infectious disorders of the spinal cord and its roots with gadolinium-DTPA 
enhancement in magnetic resonance imaging.

Engelter S, Lyrer P, Radu EW, Steck AJ.

Department of Neurology, University Hospital, Basle, Switzerland.

We studied three patients with myelomeningoradiculitis caused by Borrelia
burgdorferi, herpes zoster virus or cytomegalovirus infection. All patients
underwent MRI of the spinal cord with gadolinium-DTPA and showed enhancing
lesions of the spinal cord or nerve roots that correlated with clinical signs.
Gadolinium-DTPA enhancement may visualize lesions that suggest an inflammation
associated with blood-brain-barrier alteration and indicate the diagnosis before 
serological results are available.

Publication Types: 
    Case Reports

PMID: 8750559 [PubMed - indexed for MEDLINE]

4359: Fam Pract. 1996 Feb;13(1):84-91.

Treatments for postherpetic neuralgia--a systematic review of randomized
controlled trials.

Volmink J, Lancaster T, Gray S, Silagy C.

Department of Public Health and Primary Care, University of Oxford, Radcliffe
Infirmary, UK.

BACKGROUND. A number of different therapies have been used for postherpetic
neuralgia. We decided to conduct a systematic review of existing randomized
controlled trials. OBJECTIVE. To determine the efficacy of available therapies
for relieving the pain of established postherpetic neuralgia. METHODS. We
performed a systematic review, including meta-analysis, of existing randomized
controlled trials. Eleven published trials and one unpublished trial were
identified which met the inclusion criteria and were included in the current
review. RESULTS. Pooled analysis of the effect of tricyclic antidepressants
demonstrate statistically significant pain relief (OR 0.15, CI 0.08-0.27).
Pooling of the results of the three trials comparing the effects of capsaicin and
placebo could not be done due to heterogeneity. This heterogeneity was mainly
attributable to an unpublished trial which differed in terms of the dose and
duration of treatment. When this study was omitted, no heterogeneity was found
and the pooled analysis revealed a statistically significant benefit (OR 0.29,
95% CI 0.16-0.54). However, problems with blinding in patients using capsaicin
may have accounted for the positive effect. One small study of vincristine
iontophoresis compared to placebo also yielded a favourable result (OR 0.05, 95% 
CI 0.01-0.26). Other treatment evaluated include lorazepam, acyclovir, topical
benzydamine, and acupuncture. We found no evidence that these are effective in
relieving pain associated with postherpetic neuralgia. CONCLUSION. Based on
evidence from randomized trials, tricyclic anti-depressants appear to be the only
agents of proven benefit for established postherpetic neuralgia.

Publication Types: 
    Comparative Study
    Meta-Analysis
    Research Support, Non-U.S. Gov't

PMID: 8671108 [PubMed - indexed for MEDLINE]

4360: J Tenn Med Assoc. 1996 Feb;89(2):47-8.

The great imposter.

Hanumanthu S.

Vanderbilt University Medical Center, Nashville, USA.

Publication Types: 
    Case Reports

PMID: 8649028 [PubMed - indexed for MEDLINE]

4361: Geriatrics. 1996 Feb;51(2):56.

Painful rash on the right cheek.

Levine N.

University of Arizona Health Sciences Center, Tucson, USA.

Publication Types: 
    Case Reports

PMID: 8631532 [PubMed - indexed for MEDLINE]

4362: Arch Otolaryngol Head Neck Surg. 1996 Feb;122(2):195, 197-8.

Pathologic quiz case 2. Bilateral herpes zoster oticus.

Lee D, Belmont M, Lucente FE.

Publication Types: 
    Case Reports

PMID: 8630216 [PubMed - indexed for MEDLINE]

4363: Am Fam Physician. 1996 Feb 1;53(2):565-74.

Management of ocular emergencies and urgent eye problems.

Garcia GE.

Massachusetts Eye & Ear Infirmary, Boston, USA.

Evaluation of the patient with an acute eye problem begins with documentation of 
the level of vision in each eye, except in the case of a splash injury. In such
cases, immediate copious irrigation is of critical importance. Subconjunctival
hemorrhage is common and, typically, completely benign. Herpes simplex infection 
is painful and can lead to extensive damage. Herpes zoster infection is usually
accompanied by skin lesions and can be effectively treated with oral acyclovir or
famcyclovir. In patients with Bell's palsy, the eye must be carefully protected
to prevent secondary injury. Corneal abrasions heal rapidly when antibiotics and 
patch protection are provided. Acute infections of the eyelids and conjunctivae
usually respond well to topical antibiotics and warm compresses. Traumatic
injuries require careful evaluation and, frequently, referral to an
ophthalmologist.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8629538 [PubMed - indexed for MEDLINE]

4364: J Infect Dis. 1996 Feb;173(2):450-3.

The protective effect of immunologic boosting against zoster: an analysis in
leukemic children who were vaccinated against chickenpox.

Gershon AA, LaRussa P, Steinberg S, Mervish N, Lo SH, Meier P.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, New York 10032, USA.

Whether reexposure of varicella-immune persons to varicella-zoster virus would
protect against or predispose to development of zoster was analyzed. The rate of 
zoster in 511 leukemic recipients of varicella vaccine who had 1 or > 1 dose of
varicella vaccine and in those who did or did not have a household exposure to
varicella was determined. A Kaplan-Meier life-table analysis revealed that the
incidence of zoster was lower in those given > 1 dose of vaccine (P < .05). A Cox
proportional hazards analysis showed that both household exposure to varicella
and receipt of > 1 dose of vaccine were highly protective (P < .01) against
zoster. Thus, the risk of zoster is decreased by reexposure to varicella-zoster
virus, either by vaccination or by close exposure to varicella.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8568309 [PubMed - indexed for MEDLINE]

4365: J Virol. 1996 Feb;70(2):1091-9.

Identification and characterization of the bovine herpesvirus 1 UL7 gene and gene
product which are not essential for virus replication in cell culture.

Schmitt J, Keil GM.

Institute of Molecular and Cellular Virology, Friedrich-Loeffler-Institutes,
Insel Riems, Germany.

The UL7 gene of bovine herpesvirus 1 (BHV-1) strain Schonboken was found at a
position and in a context predicted from the gene order in the prototype
alphaherpesvirus herpes simplex virus type 1. The gene and flanking regions were 
sequenced, the UL7 RNA and protein were characterized, and 98.3% of the UL7 open 
reading frame was deleted from the viral genome without destroying productive
virus replication. Concomitant deletion of nine 3' codons from the BHV-1 UL6 ORF 
and 77 amino acids from the carboxy terminus of the predicted BHV-1 UL8 protein
demonstrated that these domains are also not essential for function of the
respective proteins. The UL7 open reading frame encodes a protein of 300 amino
acids with a calculated molecular mass of 32 kDa. Comparison with UL7 homologs of
other alphaherpesviruses revealed a high degree of homology, the most prominent
being to the predicted UL7 polypeptide of varicella-zoster virus, with 43.3%
identical amino acids. A monospecific anti-UL7 serum identified the 33-kDa
(apparent-molecular-mass) UL7 polypeptide which is translated from an
early-expressed 1.7-kb RNA. The UL7 protein was localized in the cytoplasm of
infected cells and could not be detected in purified virions. In summary, we
describe the first identification of an alphaherpesviral UL7-encoded polypeptide 
and demonstrate that the UL7 protein is not essential for replication of BHV-1 in
cell culture.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8551568 [PubMed - indexed for MEDLINE]

4366: J Med Chem. 1996 Jan 19;39(2):538-42.

Synthesis and antiviral activity of 2'-deoxy-4'-thio purine nucleosides.

Van Draanen NA, Freeman GA, Short SA, Harvey R, Jansen R, Szczech G, Koszalka GW.

Division of Experimental Therapy, Burroughs Wellcome Company, Research Triangle
Park, North Carolina 27709, USA.

A series of 2'-deoxy-4'-thioribo purine nucleosides was prepared by
trans-N-deoxyribosylase-catalyzed reaction of 2'-deoxy-4'-thiouridine with a
variety of purine bases. This synthetic procedure is an improvement over methods 
previously used to prepare purine 4'-thio nucleosides. The compounds were tested 
against hepatitis B virus (HBV), human cytomegalovirus (HCMV), herpes simplex
virus (HSV-1 and HSV-2), varicella zoster virus (VZV), and human immunodeficiency
virus (HIV-1). Cytotoxicity was determined in a number of cell lines. Several
compounds were extremely potent against HBV and HCMV and had moderate to severe
cytotoxicity in vitro. The lead compound from the series,
2-amino-6-(cyclopropylamino)purine 2'-deoxy-4'-thioriboside, was the most potent 
and selective agent against HCMV and HBV replication in vitro; however, this
analogue was nephrotoxic when tested in vivo.

PMID: 8558524 [PubMed - indexed for MEDLINE]

4367: Med Lett Drugs Ther. 1996 Jan 5;38(965):3-4.

Valacyclovir.

[No authors listed]

Publication Types: 
    Clinical Trial
    Multicenter Study

PMID: 8551979 [PubMed - indexed for MEDLINE]

4368: Yao Xue Xue Bao. 1996;31(11):837-43.

[Synthesis of adenine derivatives and their activities against herpes virus in
vitro]

[Article in Chinese]

Zhong M, Liu ZP, Xu LJ, Wang ZY, Wang GT.

Faculty of Pharmacy, Shandong Medical University, Jinan.

A series of 9-(N4-substituted acetaldehyde thiosemicarbazone) adenines were
synthesized and evaluated for antiherpes virus activity. Compounds 4a-l were
prepared by condensation of 9-(acetaldehyde) adenine(6) and the corresponding
N4-substituted thiosemicarbazides (10). The antiviral effects of all compounds
4a-l were tested in vitro in primary rabbit kidney cell cultures infected with
herpes simplex virus type 1 (HSV-1) and varicella-herpes zoster virus (VZV), and 
in primary human embryo cell cultures infected with herpes simplex virus type 2
(HSV-2). The results showed that the minimum inhibitory concentrations (MIC) of
4e and 4f for HSV-1 and VZV were 20, 40, 20 and 20 micrograms.ml-1, respectively,
and other compounds were 200 micrograms.ml-1. For HSV-2, the MIC of all tested
compounds were 300 micrograms.ml-1. We also evaluated the antiherpetic effect of 
4e (and 4f) by combination with acyclovir (ACV) in the ratio of 1:1 in vitro. The
MIC of the combined compounds were 2 micrograms.ml-1 for 4e and 6 micrograms.ml-1
for 4f, while their minimum cytotoxicities (MCC) in the cell were markedly
reduced compared with the individual compounds.

Publication Types: 
    English Abstract

PMID: 9863254 [PubMed - indexed for MEDLINE]

4369: Arch Virol. 1996;141(12):2465-9.

B-cell epitopes of varicella-zoster virus glycoprotein II.

Kjartansdottir A, Lycke E, Norrby SR.

Department of Infectious Diseases, Lund University, Sweden.

B-cell epitopes of varicella-zoster virus glycoprotein II were mapped by means of
solid phase ELISA, synthetic oligopeptides (constructed according to the
Davison-Scott sequencing of the varicella-zoster virus genome) and sera from
varicellae and herpes zoster patients. The individual pattern of antibody peptide
binding varied considerably but at least 9 more reactive sites seemed
discernible. A 31-mer-peptide corresponding to a hydrophilic segment of the
glycoprotein (aa 417-447) was constructed. This peptide reacted with 2 out of 4
varicellae and 5 out of 9 zoster sera, respectively.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 9526550 [PubMed - indexed for MEDLINE]

4370: Rom J Virol. 1996 Jan-Dec;47(1-4):75-80.

Immunomodulating and antiviral therapy in herpes zoster.

Topciu V, Mihailescu R.

University of Medicine and Pharmacy, Timisoara.

Two groups of patients with herpes zoster were followed up. The first group was
subjected, beside a symptomatic therapy, to an immunological and antiviral
treatment. The control group was treated only symptomatically. The immunological 
preparations used were: the immunostimulant SRE (Corynebacterium parvum), which
stimulated the lymphocytes and macrophages, Moroxidin (Virustat-Paris) and
Antiherpin (interferon inductor), which acted by blocking the virus replication. 
The preparations were indigenous and atoxic. A significant difference between the
courses of disease in the two groups was observed, namely, the severity and
duration of subjective and objective symptoms were more than double and followed 
by persistent neurological sequelae in the control group in comparison with the
patients of the experimental group.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 9495784 [PubMed - indexed for MEDLINE]

4371: Bull Soc Belge Ophtalmol. 1996;262:107-13.

Bromovinyldeoxyurdine treatment of outer retinal necrosis due to varicella-zoster
virus: a case-report.

Dullaert H, Maudgal PC, Leys A, Dralands L, Clercq E.

Department of Ophthalmology, U.Z. Leuven.

In December 1995, a 70-years old male was referred to us because of rapid visual 
loss in the right eye, one month after a central retinal artery occlusion in the 
left eye. This renal transplant patient, with limited renal function, was on
immunosuppressive therapy. The diagnosis of bilateral progressive outer retinal
necrosis (PORN) due to varicella-zoster virus (VZV) was confirmed by polymerase
chain reaction (PCR) detection of VZV DNA in the aqueous fluid. As retinitis
progressed despite of intravenous acyclovir administration, the antiviral therapy
was switched to oral bromovinyldeoxyuridine (BVDU). This case-report demonstrates
that oral BVDU can be a good alternative to acyclovir for the treatment of VZV
retinal infections.

Publication Types: 
    Case Reports

PMID: 9339038 [PubMed - indexed for MEDLINE]

4372: Bol Chil Parasitol. 1996 Jan-Jun;51(1-2):20-7.

[Diagnosis in 1348 patients which consulted for a probable spider bite or insect 
sting]

[Article in Spanish]

Schenone H.

Departamento de Parasitologia, Facultad de Medicina, Universidad de Chile,
Santiago, Chile.

Accumulate experience, from 1955 to 1995, in an outpatient university
parasitology clinic in Santiago, with 1,384 patients referred from diverse public
and private medical institutions because of a probable spider bite or insect
stings, is presented. It is noteworthy that only 618 (44.7%) of consultations
corresponded to clinical conditions originated by arthropods, whereas from the
remaining 766, 612 (44.2%) were due to a bacterial, viral or parasitic etiology
and 154 (11.1%) were caused by physical or chemical agents. Frequency of
diagnosis was: loxoscelism 16.6%, spider bites (excluded Loxosceles laeta) 1.3%, 
scorpion sting 0.9%, tick stings 2.2%, insect bites 23.7%, impetigo 6.6%,
folliculitis 11.3%, boil 22.7%, erysipelas 0.1%, pustula maligna 0.3%, herpes
simplex 2.5, palpebral herpes zoster 0.3%, acute Chagas' disease 0.4%,
angioneurotic edema 0.1%, ecchymosis 3.0, contact dermitis 7.8% and chemical
dermitis 0.2%. These frequencies do not indicate the real occurrence of the
diagnosed nosologies, but what happened in a specialized outpatient clinic
dealing cheaply with parasitic diseases and arthropod envenomations. Description 
of relevant clinical features and epidemiological considerations of pathology
observed, conjointly with differential diagnosis are presented.

Publication Types: 
    English Abstract

PMID: 9196950 [PubMed - indexed for MEDLINE]

4373: Scand J Infect Dis Suppl. 1996;100:51-4.

Antiviral drugs in development for herpes zoster.

Fiddian AP.

International Medical Affairs Division, Glaxo Wellcome plc, Stockley Park,
Middlesex, UK.

Until recently aciclovir has been the only licensed drug for the treatment of
herpes zoster. A number of new drugs have emerged over the past few years which
offered the potential for improved efficacy or ease of administration. With the
completion of the first efficacy trials for each of these agents it has become
apparent that, whilst less frequent dosing can he accomplished, it is not easy to
significantly improve on the efficacy of aciclovir. Increasing age, the presence 
of prodromal pain and more severe pain at presentation have, however, been found 
to predispose to a longer duration of pain. Taking cessation of pain as the
single most important parameter, at least for the older immunocompetent
population as a whole, only valaciclovir has, to date, been shown to be superior 
to standard therapy with aciclovir. This review utilises primarily
intent-to-treat data to illustrate the relative efficacy of the different
therapies.

Publication Types: 
    Review

PMID: 9163026 [PubMed - indexed for MEDLINE]

4374: Scand J Infect Dis Suppl. 1996;100:46-50.

Latency and reactivation of varicella zoster virus infections.

Dueland AN.

Department of Neurology, Ulleval Hospital, Oslo, Norway.

Varicella zoster virus (VZV) is the causative agent of chickenpox (varicella) and
shingles (zoster). The study of latency and reactivation has been hampered by the
fact that the virus is strictly human and grows to low titres in tissue culture. 
Molecular biology techniques have opened a new era of VZV research. The site of
VZV latency was determined to be sensory ganglia by Southern blotting and later
by PCR technology. It was also demonstrated that the entire virus genome is
present in the latently infected ganglia and that VZV is latent in multiple
ganglia along the entire human neuraxis. Since the amount of latent VZV per cell 
is very low, the question of which cell type is involved in VZV latency could not
be conclusively settled by the use of traditional in situ hybridization studies. 
However, we have now demonstrated the presence of latent VZV DNA in neurons only,
by using a more sensitive method which employs a combination of in situ PCR and
in situ hybridization. The transcriptional activity of VZV during latency is
still not completely clear. Ganglia are small and the total amount of latent VZV 
is low, therefore conventional methods to detect latent VZV have proved limited. 
Nevertheless, the detection of a latent transcript from the SalI C region of the 
virus was demonstrated by Southern hybridization of cDNA synthesized from RNA
isolated from latently-infected ganglia. Further studies have localized this
transcript to the open reading frame of VZV gene 21. The study of VZV latency and
reactivation has, until now, been dependent on the investigation of post mortem
human tissue. However, simian varicella virus seems to be the simian counterpart 
to human VZV. The 2 viruses exhibit DNA homology as well as similarities in
clinical, virological, and immunological features. Further studies of VZV
infections may open new and possibly unpredictable opportunities in varicella
virus research.

Publication Types: 
    Review

PMID: 9163025 [PubMed - indexed for MEDLINE]

4375: Scand J Infect Dis Suppl. 1996;100:41-5.

Polymerase chain reaction for diagnosis of varicella zoster virus central nervous
system infections without skin manifestations.

Bergstrom T.

Department of Clinical Virology, Goteborg University, Goteborg, Sweden.

Varicella zoster virus (VZV) can cause disease in the central nervous system
(CNS) during both primary infection and reactivation. Rapid and adequate
diagnosis of VZV have previously been hampered by the shortcomings of standard
virological methods, such as isolation and serology. Earlier reported cases of
CNS manifestations of VZV infection have, therefore, mostly been noted in
connection with, or shortly after, onset of vesicular rash. Several studies have 
recently been described of cases of VZV-induced CNS disease occurring as the only
sign of viral reactivation, with the diagnosis aided by polymerase chain reaction
(PCR) amplification and other methods of genome detection. A prospective study
was performed using PCR on cerebrospinal fluid (CSF) and brain samples received
for routine diagnosis of possible VZV infection during a 2-year period. Samples
from 8 (7 from CSF, 1 from brain) of the 260 patients investigated (3.1%) were
found to be positive for VZV-DNA. All 8 had a presumed reactivated VZV infection 
according to serological and clinical analysis. Their CNS manifestations ranged
from meningitis to severe encephalitis, and only in 3 of these patients was a
vesicular rash present. Thus, VZV-DNA detection in the CSF was an unexpected
finding for the clinician and, in 2 cases, antiviral treatment with aciclovir was
initiated only because of the PCR evidence of CNS infection. VZV should be
considered as a possible causative agent of infection in patients with CNS
disease of suspected viral origin, even in the absence of skin manifestations.
Rapid diagnosis by PCR amplification of VZV-DNA from CSF might allow for early
and adequate antiviral treatment.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 9163024 [PubMed - indexed for MEDLINE]

4376: Scand J Infect Dis Suppl. 1996;100:35-40.

Neurological complications in herpes zoster.

Flamholc L.

Department of Infectious Diseases, Malmo University Hospital, University of Lund,
Malmo, Sweden.

This paper discusses the complications associated with herpes zoster, with
emphasis on its neurological manifestations. These complications, which are
particularly prevalent in elderly and immunodeficient patients, include focal
muscle paralysis, contralateral hemiplegia, myelitis, cranial nerve palsies and
meningoencephalitis. A causative relationship with herpes zoster in many of these
syndromes is probably more common than previously suspected due to difficulties
in diagnosis and lack of awareness among clinicians. Zoster sine herpete--
reactivation of varicella zoster virus without rash--is associated with a
spectrum of neurological disease and, for obvious reasons, is particularly
difficult to diagnose. The polymerase chain reaction could be a valuable tool in 
overcoming these diagnostic problems, especially in patients without
characteristic eruptions, allowing the early initiation of effective antiviral
therapy.

Publication Types: 
    Review

PMID: 9163023 [PubMed - indexed for MEDLINE]

4377: Scand J Infect Dis Suppl. 1996;100:33-4.

The Swedish telephone herpes helpline.

Hallen A, Strand A, Juserius H.

Dept. of Dermatology & Venereology, Akademiska Sjukhuset, University Hospital,
Uppsala, Sweden.

To increase the accessibility of qualified and anonymous advice on herpes
infections in Sweden, a telephone counselling service was initiated in November
1994. The nucleus of the service is an answering machine that works around the
clock. A caller can choose one of 3 different messages dealing with labial or
genital herpes infection or herpes zoster--each message is approximately 3 min
long. Those wanting written information can register and have material sent to
them. For 2 h daily, 4 days a week, calls pass directly to the staff of the
sexually transmitted diseases clinic of the University Hospital in Uppsala,
Sweden--the caller pays only a single telephone unit charge. The personal calls
deal with all aspects of herpes infections. During the first 3 months of the
counselling service more than 4,500 calls were received.

PMID: 9163022 [PubMed - indexed for MEDLINE]

4378: J Fr Ophtalmol. 1996;19(11):712-5.

[Multifocal choroiditis associated with herpes zoster ophthalmicus. Apropos of a 
case]

[Article in French]

Chiquet C, Germain P, Burillon C, Coudry-Vergne D, Perez M, Paupert-Ravault M,
Denis P.

Service d'Ophtalmologie, Lyon.

We describe a patient with multifocal choroidal lesions affecting the
midperipheral fundus, with an atrophic and scattered punched-out pale aspect.
Lesions were discovered seven months after an ipsilateral herpes zoster
ophthalmicus. Fluorescein angiography findings exhibited a delay of choroidal
injection and late moderate staining during the venous phase. The etiological
arguments refer to a previous herpes zoster infection. The pathogeny would
involve an occlusion of posterior ciliary arteries, lesions of posterior ciliary 
nerves and/or direct cytopathogenic involvement of chorioretina by neurotropic
virus from ciliary ganglion.

Publication Types: 
    Comparative Study
    English Abstract
    Review

PMID: 9033894 [PubMed - indexed for MEDLINE]

4379: Ann Dermatol Venereol. 1996;123(8):471-3.

[Cutaneous localizations of chronic lymphoid leukemia in a zona area]

[Article in French]

Bahadoran P, Lacour JP, Del Giudice P, Perrin C, Dubois D, Samak R, Ortonne JP.

Service de Dermatologie, Hopital Archet, Nice.

INTRODUCTION: Leukemia cutis is a rare event in B-cell chronic lymphocytic
leukemia. CASE REPORT: A patient with B-cell chronic lymphocytic leukemia
developed leukemia cutis at the site of prior cervical (C2-C3) herpes zoster.
DISCUSSION: Leukemia cutis on prior site of herpes zoster is exceptional. It
should be differentiated from non specific skin reactions secondary to herpes
zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 9033718 [PubMed - indexed for MEDLINE]

4380: Retina. 1996;16(6):530-4.

The Agar sandwich technique for retinal biopsy processing.

Banker AS, Gonzalez C, Wiley CA, Bergeron-Lynn G, Freeman WR.

Department of Ophthalmology, Shiley Eye Center, University of California, San
Diego, USA.

BACKGROUND: The authors developed an agar sandwich technique for retinal biopsy
processing. This tissue agar embedding technique allows for a rapid and reliable 
method to handle and transport retinal biopsies from the operative field to the
histology laboratory. METHODS: Biopsies from rabbit retinas infected with herpes 
simplex virus, epiretinal membranes from patients with macular pucker, and
retinas from patients with acute retinal necrosis were studied. Each retinal
biopsy was fixed, mounted on an agar disc, and covered with liquid agar. Light
microscopy, electron microscopy, immunocytochemistry, and polymerase chain
reaction were employed on the agar-embedded tissue. RESULTS: The tissues remained
mounted in the agar sandwich and maintained their orientation throughout the
processing. The morphologic integrity, histologic characteristics, antigenic
properties, and DNA quality all were preserved using the agar sandwich technique.
CONCLUSION: The agar sandwich technique is an efficient and simple technique for 
handling small biopsy specimens that require various analyses.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 9002138 [PubMed - indexed for MEDLINE]

4381: Retina. 1996;16(6):479-87.

Successful treatment of progressive outer retinal necrosis syndrome.

Spaide RF, Martin DF, Teich SA, Katz A, Toth I.

Department of Ophthalmology, St. Vincent's Hospital and Medical Center of New
York, New York, USA.

PURPOSE: Progressive outer retinal necrosis is a destructive retinopathy found in
patients with acquired immune deficiency syndrome. Treatment of this disorder has
been unsuccessful in reported patient series, with the patients experiencing
profound bilateral loss of vision. METHODS: We treated six patients with
combination antiviral therapy, usually with intravenous foscarnet and either
ganciclovir or acyclovir. RESULTS: These six patients retained a visual acuity of
20/100 or better in at least one eye for the remainder of their lives (a period >
4 months for each patient). Retinal detachments developed in four patients, for
which vitrectomy and silicone oil tamponade were required. CONCLUSIONS: A
combination of intravenous antiviral therapy and aggressive vitrectomy techniques
to repair any associated detachments may allow the preservation of useful visual 
acuity in patients with progressive outer retinal necrosis. This is the first
reported series of successful long-term treatment of patients with this disorder.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 9002130 [PubMed - indexed for MEDLINE]

4382: Biotherapy. 1996;9(1-3):73-5.

Effect of anti-herpes specific transfer factor.

Byston J, Cech K, Pekarek J, Jilkova J.

Dept. of Allergology and Clinical Immunology, Faculty Hospital, Olomouc, Czech
Republic.

Using a blood cell separator, lymphocytes were collected from otherwise healthy
convalescents suffering from herpetic infections. A specific anti-herpes
dialysate (AH-DLE) was prepared from the lymphocytes, using standard procedures. 
Patients with recurrent herpetic infections were treated with a single dose of
the dialysate, at the initial signs of herpetic infection (group A), with two
doses (group B) or with three doses (group C). A total number of 37 patients (29 
women, 8 men, age range 15-73 years) were treated. No improvement was observed in
7 patients (18.9%), whilst 7 patients did not manifest any exacerbation of their 
herpetic infection in the course of the one-year follow-up. The remaining 62.2%
of the patients showed a marked improvement: decrease of the frequency and/or
duration or relapses. Before AH-DLE administration, the mean number of herpes
relapses in this group of patients was 12 p.a.. After therapy, the number of
relapses decreased to 3.5 p.a.. No statistically significant difference was
observed between groups A and B. The least favourable results were registered in 
group C. However, this group included 6 female patients extremely resistant to
the previously therapeutic attempts, including inosiplex, non-specific DLE or
acyclovir. Thus, even in this group, the therapy was successful in 50% of the
patients.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 8993761 [PubMed - indexed for MEDLINE]

4383: Int Ophthalmol Clin. 1996 Summer;36(3):17-28.

Herpesvirus infections of the anterior segment.

Chang EJ, Dreyer EB.

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical
School, Boston 02114, USA.

Publication Types: 
    Review

PMID: 8989597 [PubMed - indexed for MEDLINE]

4384: Rev Clin Esp. 1996 Jan;196(1):53-4.

[Lymphocytic meningitis, vesicles in the auricular concha, and facial paresis]

[Article in Spanish]

Otero Anton E, Gonzalez Quintela A, Alende Sixto MR, Torre Carballada JA, Martin 
Martin C, Barrio Gomez E.

Servicio de Medicina Interna, Complejo Hospitalario Universitario de Santiago de 
Compostela.

Publication Types: 
    Case Reports

PMID: 8948845 [PubMed - indexed for MEDLINE]

4385: Respiration. 1996;63(6):403-6.

Hemidiaphragmatic paralysis caused by cervical herpes zoster.

Soler JJ, Perpina M, Alfaro A.

Hospital Universitario La Fe, Servicio de Neumologia, Valencia, Spain.

Although herpes zoster virus usually affects sensory nerves, it can also damage
motoneurons. Injury to the phrenic nerve has been described previously, but only 
anecdotally. We report on a case of left hemidiaphragmatic paralysis with severe 
axonal degeneration secondary to cervical herpes zoster, and describe its
clinical, radiological, pulmonary function and electromyographic evolution during
an 18-month follow-up.

Publication Types: 
    Case Reports

PMID: 8933664 [PubMed - indexed for MEDLINE]

4386: AIDS. 1996 Jan;10(1):55-60.

Comment in:
    AIDS. 1996 Sep;10(11):1300-1.

Acute retinal necrosis in the course of AIDS: study of 26 cases.

Batisse D, Eliaszewicz M, Zazoun L, Baudrimont M, Pialoux G, Dupont B.

Infectious Disease Department, Pasteur Institute Hospital, Paris, France.

OBJECTIVE: To report 26 cases of acute retinal necrosis (ARN) in HIV-infected
patients, to compare these data with the literature and to discuss the clinical
spectrum of ARN during HIV infection. DESIGN AND SETTING: Twenty-six HIV-infected
patients with ARN, collected from five ophthalmology departments in Paris
(France) between 1985 and 1993, were analysed retrospectively. PATIENTS:
Twenty-eight patients were enrolled; two were lost of follow-up. Diagnosis of ARN
was established on the following criteria: (1) inflammation of the anterior
segment and the characteristic triad, and (2) peripheral circular necrosis with
centripetal progression toward the posterior pole associated with occlusive
periarteritis and inflammation of the vitreous. RESULTS: ARN is a late event in
the course of immunosuppression (CD4+ lymphocyte count < 100 x 10(6)/l). The most
frequent presenting syndrome is a decrease of visual acuity, but signs related to
a retrobulbar optic neuritis may also be present. In 60-90% of cases, vesicular
viral eruption, usually shingles, precedes the onset of ARN by several days.
Occasionally, neurological impairment is also present. Progression to blindness
occurs in 76-85% of cases, bilaterally in 59%, and is usually induced by retinal 
detachment. This study and literature data suggest that varicella zoster virus
(VZV) is directly implicated in the onset of ARN. At present, the most efficient 
therapeutic schedule is unknown. CONCLUSION: ARN is a rare and serious disease in
AIDS patients. It is often associated with VZV infection. There is no preventive 
or curative efficient treatment. ARN might be considered as another opportunistic
infection because of its rapid clinical evolution and severe prognosis.

Publication Types: 
    Case Reports

PMID: 8924252 [PubMed - indexed for MEDLINE]

4387: Retina. 1996;16(5):399-404.

Multiple recurrent branch retinal artery occlusions associated with varicella
zoster virus.

Zamora RL, del Priore LV, Storch GA, Gelb LD, Sharp J.

Department of Ophthalmology and Visual Sciences, Washington University School of 
Medicine, St. Louis, MO 63110, USA.

PURPOSE: The authors describe an immunocompetent patient who developed multiple
recurrent branch retinal artery occlusions (BRAOs) associated with the varicella 
zoster virus (VZV). METHODS: A 69-year-old woman with mild bilateral vitritis
developed superior and inferior BRAOs in her right eye with decreased visual
acuity to 20/40, and a peripheral BRAO inferotemporally in her left eye. One
month later, the inferotemporal BRAO progressed proximally in her left eye with a
decrease of visual acuity to 20/40. After an extensive negative systemic
evaluation, she underwent a diagnostic pars plana vitrectomy of her right eye.
RESULTS: Vitreous fluid was positive for VZV DNA by polymerase chain reaction
(PCR). The patient was treated with intravenous acyclovir and systemic oral
steroids. After remaining disease free for 3 months, the patient had two
recurrences: 1) a mild vitritis and 2) development of a new superior temporal
artery occlusion in the left eye. Both recurrences were treated with oral
acyclovir and systemic steroids. The patient remained recurrence free for 12
months on a maintenance dose of oral acyclovir, and for 4 additional months
without acyclovir. CONCLUSIONS: Varicella zoster virus can be associated with the
syndrome of multiple recurrent BRAOs. The diagnosis of VZV-associated BRAO can be
established by PCR of intraocular fluid.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8912966 [PubMed - indexed for MEDLINE]

4388: Retina. 1996;16(5):393-8.

Fluorescein angiography in the progressive outer retinal necrosis syndrome.

Walton RC, Byrnes GA, Chan CC, Nussenblatt RB.

Laboratory of Immunology, National Eye Institute, National Institutes of Health, 
Bethesda, Maryland, USA.

PURPOSE: Progressive outer retinal necrosis syndrome is a devastating retinopathy
seen primarily in patients with acquired immune deficiency syndrome. To provide
additional details of the pathogenesis of this disease, the authors describe the 
evolution of clinical and fluorescein angiographic changes during the course of
progressive outer retinal necrosis syndrome. METHODS: The authors performed
serial clinical examinations, fundus photography, and fluorescein angiography in 
a patient with acquired immune deficiency syndrome with progressive outer retinal
necrosis syndrome. Clinical and fluorescein angiographic findings were correlated
to provide detailed sequential analysis of the pathologic changes occurring
during the course of this disorder. RESULTS: The angiographic changes seen during
the various stages of the disease consisted of zonal microvascular alterations,
retinal pigment epithelium (RPE) destruction, and choroidal leakage. Retinal
damage was correlated closely with regions of choroidal leakage and was
clinically evident as outer retinal whitening. Disease reactivation occurred as a
prominent brush-fire border of intense leakage involving the retina, RPE, and
choroid. Extensive damage to the retinal vasculature and RPE was noted in the
wake of clinical infection. CONCLUSIONS: The angiographic findings in our patient
demonstrate that the progressive outer retinal necrosis syndrome is a
retinochoroiditis that involves the full thickness of retina as well as the RPE
and choroid. The inflammatory changes seen throughout the course of this disease 
correlate with the histopathologic patterns reported to date.

Publication Types: 
    Case Reports

PMID: 8912965 [PubMed - indexed for MEDLINE]

4389: Annu Rev Microbiol. 1996;50:59-100.

Live attenuated varicella vaccine.

Arvin AM, Gershon AA.

Department of Pediatrics and Microbiology/Immunology, Stanford University Medical
Center, California 94305, USA.

Varicella-zoster virus (VZV) is a ubiquitous human pathogen that causes
varicella, commonly called chicken pox; establishes latency; and reactivates as
herpes zoster, referred to as shingles. A live attenuated varicella vaccine,
derived from the Oka strain of VZV has clinical efficacy for the prevention of
varicella. The vaccine induces persistent immunity to VZV in healthy children and
adults. Immunization against VZV also has the potential to lower the risk of
reactivation of latent virus. The varicella vaccine may eventually reduce or
eliminate herpes zoster, which is a serious problem for elderly and
immunocompromised individuals.

Publication Types: 
    Review

PMID: 8905076 [PubMed - indexed for MEDLINE]

4390: Proc West Pharmacol Soc. 1996;39:47-8.

Postherpetic neuralgia: response to topical clonidine.

Abadir AR, Kraynack BJ, Mayda J 2nd, Gintautas J.

Brookdale University Hospital and Medical Center, Brooklyn, NY 11212, USA.

Publication Types: 
    Clinical Trial

PMID: 8895966 [PubMed - indexed for MEDLINE]

4391: Masui. 1996 Jan;45(1):115-8.

[Lumbar and thoracic epidural anesthesia in children's hospitals in Japan]

[Article in Japanese]

Kitahara Y, Maruyama H, Fukatsu O.

Department of Anesthesia, Tokyo Metropolitan Hachioji Children's Hospital.

A retrospective study of the lumbar and thoracic epidural anesthesia
(catheterization) in infants and children younger than 12 years was undertaken in
children's hospitals in Japan. Seventeen institutions replied to our
questionnaire and 10 institutions experienced these procedures in the year
preceding September 1994. The total number of the lumbar and thoracic epidural
anesthesia performed was 324, with average of 32.4 +/- 31.1, and maximum of 113
and the minimum of 2. The number of thoracic epidural anesthesia performed was 56
a much smaller figure than that of lumbar anesthesia. Infants younger than 12
months were 23 in both groups. No major complications occurred except a case of
infection at the insertion site. The patient had herpes zoster. On the other
hand, several institutions cast doubt on the necessity of epidural anesthesia in 
infants and children. The long-term influence on the developing nervous system
should be investigated.

Publication Types: 
    English Abstract

PMID: 8865737 [PubMed - indexed for MEDLINE]

4392: Eur Neurol. 1996;36(5):288-92.

Effects of acyclovir on sensory axonal neuropathy, segmental motor paresis and
postherpetic neuralgia in herpes zoster patients.

Mondelli M, Romano C, Passero S, Porta PD, Rossi A.

Institute of Neurological Sciences, University of Siena, Italy.

The effect of oral treatment with acyclovir (ACV) on sensory axonal neuropathy,
segmental motor paresis and postherpetic neuralgia (PHN) was studied in 105
patients with herpes zoster. Forty-seven patients were treated with ACV at a dose
of 4 g/day in 5 doses for at least a week; the others did not undergo any kind of
treatment. Electrodiagnostic examination of the nerves and muscles corresponding 
to the dermatomeric lesions was performed, including sensory and motor nerve
conduction studies, blink reflex and electromyography (EMG). The patients treated
with ACV showed a significant reduction in the number of cases in which there was
electrophysiological evidence of axonal damage in afferent fibres of nerves
arising from roots corresponding to affected dermatomes. The treated group also
showed a smaller incidence of segmental motor neuritis, clinically evident or
only detectable by EMG as denervation. However, there was no significant
difference between groups as far as the incidence of PHN was concerned. Oral
treatment with ACV therefore reduces peripheral sensory axonopathy due to
ganglion damage and prevents the possibility of spread to anterior roots and
spinal motoneurones. In this way it reduces the incidence of segmental motor
neuritis, but does not reduce the incidence of PHN.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 8864710 [PubMed - indexed for MEDLINE]

4393: Scand J Infect Dis Suppl. 1996;100:55-8.

How to measure and reduce the burden of zoster-associated pain.

Wood MJ.

Department of Infection & Tropical Medicine, Birmingham Heartlands Hospital,
Birmingham, UK.

Several parameters of shingles' pain can be measured and each provides meaningful
information. Generally, the more comprehensive the assessment the better, but
there are significant difficulties in measuring the duration of post-herpetic
neuralgia (PHN). Patients with herpes zoster usually feel pain as a continuum
and, although acute pain and PHN have different qualities and pathophysiologies, 
we lack the sophistication to determine when PHN commences. Use of an arbitrarily
defined starting point is meaningless for the patient and may introduce
statistical bias (particularly if acute pain and PHN are divided by the point of 
rash healing). Thus, measurement of the pain as a continuum ('zoster-associated
pain') is advocated. We also need to decide what degree of pain intensity is
meaningful and whether complete cessation of pain or loss of pain (or only
'moderate/severe' pain) for a finite period is a better assessment. This approach
to pain measurement was recently adopted in a meta-analysis of the
placebo-controlled trials of oral aciclovir in herpes zoster. When 'time to
complete cessation of all pain' was assessed, the hazard ratio was 2.13 in favour
of aciclovir, with a 95% confidence interval (CI) of 1.42 to 3.19. For 'time to
complete cessation of moderate/severe pain' the hazard ratio was 1.46 (95% CI;
1.11, 1.93); for 'time to first pain-free period' it was 1.31 (95% CI; 1.08,
1.60). These results indicate that aciclovir significantly speeds pain resolution
in shingles.

Publication Types: 
    Review

PMID: 8860354 [PubMed - indexed for MEDLINE]

4394: Dev Biol Stand. 1996;87:167-71.

A varicella vaccine stable at 5 degrees C.

Fanget B, Francon A.

Pasteur Merieux serums & vaccins, Marcy l'Etoile, France.

Varicella-Zoster virus (VZV), which causes Chicken Pox and Zoster, belongs to the
Herpes viridae family [1, 2]. The virus is strongly cell dependent and its in
vitro stability is very low. Following Takahashi's work, we have developed and
prepared a vaccine with the OKA strain virus in the Japanese stabilizer. To
improve the stability of the virus in a freeze-dried form, we have finalized a
new formulation of stabilizer, called V 15-1. This stabilizer is a protein-free
solution with defined contents of amino acids, salts and sugars. Comparative
stability studies between the Japanese stabilizer and V 15-1 have been performed 
at different temperatures. We have demonstrated good stability for two years at +
5 degrees C and at + 25 degrees C and + 37 degrees C for the vaccine in
freeze-dried form. We have also found a good stability of this vaccine at + 5
degrees C and + 25 degrees C after reconstitution. The use of V 15-1 thus allows 
us to prepare a Varicella vaccine with the OKA strain (> 2000 PFU per dose) which
has good stability at 5 degrees C. A Varicella vaccine using a live attenuated
virus strain OKA was developed in 1974 by Takahashi in Japan [3, 4]. The virus
was isolated from vesicular fluid collected from a child with chicken pox. After 
propagation in human embryonic lung cells (HEC), guinea pigs embryonic cells
(GPE) and human diploid cells (WI 38), the virus was attenuated. All the licensed
vaccines are prepared with the OKA strain [5].

Publication Types: 
    Comparative Study

PMID: 8854014 [PubMed - indexed for MEDLINE]

4395: Clin Infect Dis. 1996 Jan;22(1):187-8.

Neuropsychiatric toxicity in a patient undergoing hemodialysis and receiving
treatment with oral acyclovir.

Collins A, Krieff D, Smith C, Singer C.

Division of Infectious Diseases, Long Island Jewish Medical Center, New York,
USA.

Publication Types: 
    Case Reports

PMID: 8825003 [PubMed - indexed for MEDLINE]

4396: Clin Infect Dis. 1996 Jan;22(1):138-40.

Myelitis due to varicella-zoster virus in two patients with AIDS: successful
treatment with acyclovir.

Lionnet F, Pulik M, Genet P, Petitdidier C, Davous P, Lebon P, Rozenberg F.

Department of Hematology, Hopital d'Argenteuil, France.

Only a few cases of varicella-zoster virus (VZV) myelitis have been described,
and nearly all have been diagnosed post-mortem. There have been no reports in the
literature of successful treatment of VZV myelitis with antiviral medications. We
report on two patients with AIDS who had acute severe myelitis accompanied by
herpes zoster. The presence of VZV DNA in cerebrospinal fluid (CSF) was
documented by the polymerase chain reaction (PCR) technique. Early treatment with
acyclovir was followed by a slow but complete recovery after a phase of initial
aggravation. After a follow-up of > 1 year, the two patients remained
asymptomatic. We conclude that (1) VZV should be considered a curable cause of
myelitis in patients with AIDS, (2) PCR assay of CSF will assist in early
diagnosis, and (3) early treatment with acyclovir should aid in recovery.

Publication Types: 
    Case Reports

PMID: 8824980 [PubMed - indexed for MEDLINE]

4397: Adv Virus Res. 1996;46:263-309.

Varicella-zoster virus: aspects of pathogenesis and host response to natural
infection and varicella vaccine.

Arvin AM, Moffat JF, Redman R.

Stanford University School of Medicine, California 94305, USA.

Events in the pathogenesis of infection and the host response to VZV are very
closely linked. Our experiments demonstrate that CD4- and CD8+ T-lymphocyte
populations that are targets of cell-associated VZV viremia also mediate
protection against severe infection. Diminished cell-mediated immunity
predisposes the host to progressive primary or recurrent VZV disease because
infected lymphocytes persist in the circulation and carry the virus to major
organs, causing pneumonitis, hepatitis, or other life-threatening complications. 
The live attenuated varicella vaccine induces cell-mediated immunity and protects
against or significantly reduces the morbidity associated with primary VZV
infections. The universal administration of varicella vaccine is likely to
generate new insights about host-virus interactions, particularly in relation to 
how VZV immunity is maintained, that will be relevant to the design of vaccines
for other human herpesviruses.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8824702 [PubMed - indexed for MEDLINE]

4398: Prenat Diagn. 1996 Jan;16(1):71-4.

Prenatal diagnosis of congenital varicella infection.

Kustermann A, Zoppini C, Tassis B, Della Morte M, Colucci G, Nicolini U.

First Department of Obstetrics and Gynaecology, University of Milano, Italy.

Fourteen fetuses at risk of Varicella-Zoster virus (VZV) infection underwent
prenatal diagnosis at 10-24 weeks' gestation by a combination of chorionic villus
sampling, amniocentesis, and fetal blood sampling. Polymerase chain reaction
(PCR) was done on fetal and placental tissues, using primers which define a 221
bp region of the gene coding for the 44 kD protein of VZV. Positive cases were
further analysed by dot blot hybridization, using radiolabelled DNA probes
corresponding to the Hind III fragment VZV genome. The rate of placental/fetal
infection was 36 per cent (5/14 fetuses: 2/11 in the first and 3/3 in the second 
trimester). At post-mortem examination, two aborted fetuses had hydrocephaly and 
VZV DNA was found in most of the examined tissues. The nine women who tested
negative at prenatal investigation delivered healthy neonates whose VZV-specific 
IgM antibody titres were negative and none of them developed herpes zoster
infection. In view of the high frequency of fetal VZV infection and the reported 
low rate of malformations, the role of invasive prenatal diagnosis in women who
acquire the infection in the first half of gestation is mainly that of
reassurance when the test is negative.

PMID: 8821856 [PubMed - indexed for MEDLINE]

4399: Adv Exp Med Biol. 1996;394:59-66.

Treatment of acyclovir-resistant herpes simplex and varicella zoster virus
infections.

Safrin S.

Herpes Virus Research Laboratory, San Francisco General Hospital, California,
USA.

Publication Types: 
    Review

PMID: 8815710 [PubMed - indexed for MEDLINE]

4400: Adv Exp Med Biol. 1996;394:41-4.

Sorivudine: a potent inhibitor of varicella zoster virus replication.

Whitley RJ.

University of Alabama, Birmingham, USA.

Sorivudine provides a unique nucleoside analog with significantly enhanced both
in vitro as in vitro activity toward VZV and enhanced oral bioavailability, as
compared with existing antivirals. Early indications from controlled studies,
while not peer reviewed, indicate that sorivudine therapy is superior to
acyclovir for the treatment of localized zoster in individuals with HIV infection
and chicken pox in adults. These studies await peer evaluation. One might
question, as these data unfold, the relative clinical value of antivirals with
such enhanced in vitro activity and oral bioavailability as compared to standard 
compounds. Should these drugs induce accelerated healing, but not as dramatically
as would have been anticipated from the in vitro data, new approaches to the
management of herpes zoster will need to be developed if further improvement is
desired. Despite this provision, sorivudine therapy does appear to result in
significantly accelerated healing of cutaneous zoster as compared to acyclovir,
and sorivudine can be administered once daily in a dose that is one-hundredth
that of acyclovir, and less than one tenth of the doses of valacuyclovir or
famciclovir. These findings in and of themselves should allow for licensure of
the compound in developed societies.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8815706 [PubMed - indexed for MEDLINE]

4401: Adv Exp Med Biol. 1996;394:33-9.

Valacyclovir HCl (Valtrex): an acyclovir prodrug with improved pharmacokinetics
and better efficacy for treatment of zoster.

Smiley ML, Murray A, de Miranda P.

Glaxo Wellcome Inc., Research Triangle Park, North Carolina, USA.

Publication Types: 
    Review

PMID: 8815698 [PubMed - indexed for MEDLINE]

4402: Adv Exp Med Biol. 1996;394:17-31.

Famciclovir: efficacy in zoster and issues in the assessment of pain.

Boon RJ, Griffin DR.

SmithKline Beecham Pharmaceuticals, Reigate, Surrey, United Kingdom.

Publication Types: 
    Review

PMID: 8815684 [PubMed - indexed for MEDLINE]

4403: Adv Exp Med Biol. 1996;394:1-10.

Management of genital herpes.

Mertz GJ.

University of New Mexico School of Medicine, Albuquerque, USA.

Oral acyclovir is the therapy of choice for treatment of first-episode genital
herpes, for suppression of frequently recurrent genital herpes, and, in selected 
patients, for episodic treatment of recurrent genital herpes. Topical acyclovir
therapy is relatively or totally ineffective and is therefore discouraged.
Indications for intravenous acyclovir therapy of mucocutaneous HSV infections
include patients hospitalized with severe first-episode genital herpes and
immunocompromised patients who have severe infections or who cannot swallow the
oral preparation. The most promising investigational drugs are the oral prodrugs 
valaciclovir and famciclovir. Famciclovir is licensed in the U.S. for treatment
of zoster but not for treatment of mucocutaneous genital herpes. When used for
episodic therapy of recurrent genital herpes, both famciclovir and valaciclovir
effectively reduce the duration of viral shedding, lesion healing times, and the 
duration of symptoms. Suppressive therapy with famciclovir has also been shown to
be effective in reducing the frequency of episodes in women with frequently
recurring genital herpes. Although these drugs can be given less frequently than 
oral acyclovir, there is yet no clear indication that they are more effective or 
better tolerated than oral acyclovir.

Publication Types: 
    Review

PMID: 8815676 [PubMed - indexed for MEDLINE]

4404: Auris Nasus Larynx. 1996;23:63-8.

Immunological and virological study of sudden deafness.

Yoshida Y, Yamauchi S, Shinkawa A, Horiuchi M, Sakai M.

Department of Otolaryngology, Hadano Red Cross Hospital, Japan.

Thirty-three patients with sudden deafness and 11 controls were selected from the
patients admitted to the Department of Otolaryngology, Tokai University Hospital 
from November 1990 to October 1991. Viral titers were measured for mumps,
adenovirus, rubella, measles, herpes simplex virus (HSV), varicella zoster virus 
(VZV), rhinosyncytial virus, cytomegalo-virus (CMV), and mycoplasma pneumoniae in
33 sudden deafness patients and 11 controls at a 2-week interval. In 20 of 33
sudden deafness patients and 5 of 11 controls, autoantibodies of rheumatoid
factor (RF), anti-mitochondrial antibody (AMA), anti-nuclear antibody (ANA),
anti-parietal cell antibody (APA), anti-smooth muscle antibody (ASA), and
anti-type II collagen antibody were studied. Viral titer study did not reveal any
significant change either in the patients or in the controls, whereas
autoantibody study revealed a relatively high incidence for ASA in the patients
as compared with the controls. The relatively high incidence for ASA suggests
that immune-mediated processes may be involved in the etiology of sudden
deafness.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 8809325 [PubMed - indexed for MEDLINE]

4405: Rev Med Interne. 1996;17(2):169-70.

[Varicella zoster virus retinitis in AIDS]

[Article in French]

Herrmann B, Rabaud C, Maalouf T, Angioi-Duprez C, May T, Canton P.

Service d'ophtalmologie, CHU de Nancy, hopitaux de Brabois, Vandoeuvre-les-Nancy,
France.

Publication Types: 
    Case Reports

PMID: 8787091 [PubMed - indexed for MEDLINE]

4406: Am J Med Qual. 1996 Spring;11(1):33-42.

Variations in practice patterns: antiviral drug use in hospitalized patients with
herpes infections.

DesHarnais S, Simpson KN, Paul JE.

Department of Health Policy and Administration, School of Public Health,
University of North Carolina, Chapel Hill 27599-7400, USA.

This study describes patterns of antiviral drug use for patients hospitalized
with chickenpox, herpes simplex, and herpes zoster infections, and also for a
subgroup of herpes patients with severe infections (systemic infections, eye
infections, encephalitis, hemorrhagic pneumonitis, and other severe conditions). 
Our findings demonstrate that there is great deal of variation in the use of
antiviral drugs for these herpes patients, and that much of this variation is
apparently unrelated to medical indications for antiviral drug use. Instead,
patterns of use are associated with patient characteristics (age, race) and with 
hospital characteristics (location, teaching status, number of beds). Because
these drugs are effective when used properly, treatment guidelines and protocols 
may be needed so that improved drug use will produce better patient outcomes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8763219 [PubMed - indexed for MEDLINE]

4407: Zh Nevrol Psikhiatr Im S S Korsakova. 1996;96(2):26-9.

[The Guillain-Barre syndrome in herpes zoster patients]

[Article in Russian]

Shishov AS, Virych IE, Bagrov FI, Latysheva IT.

A rare case of Guillain-Barre syndrome associated with herpes zoster developed on
the 7th day of eruption in the right dermatoma DII-III in a man of 51 years old. 
The peculiarities of the symptoms, current status, liquor changes have been
analysed basing on the data from foreign literature on 24 cases of Guillain-Barre
syndrome (polyradiculoneuritis) associated with herpes zoster.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8754335 [PubMed - indexed for MEDLINE]

4408: Br J Dermatol. 1996 Jan;134(1):164-6.

Comment in:
    Br J Dermatol. 1996 Dec;135(6):1005-6.

Leishmania infection occurring in herpes zoster lesions in an HIV-positive
patient.

Barrio J, Lecona M, Cosin J, Olalquiaga FJ, Hernanz JM, Soto J.

Dermatology and Pathology Services, Gregario Maranon General Hospital, Madrid,
Spain.

We report the first case of co-infection with herpes zoster and leishmania in the
same lesion, on the face of a 29-year-old female, who was an intravenous drug
user and who was HIV positive. The infection was initially resistant to acyclovir
and itraconazole, and the patient died due to severe internal complications, not 
attributed to visceral leishmaniasis. The prevalence of leishmania infection in
the Mediterranean countries is increasing among the HIV-positive population
because of the existence of human carriers. Paradoxically, most of these patients
show mild forms of visceral leishmaniasis.

Publication Types: 
    Case Reports

PMID: 8745907 [PubMed - indexed for MEDLINE]

4409: Curr Probl Dermatol. 1996;24:209-18.

Aciclovir and its l-valyl ester, valaciclovir.

Smiley ML, Murray A.

Department of Infectious Diseases, Burroughs Wellcome Co., Research Triangle
Park, N.C., USA.

Publication Types: 
    Review

PMID: 8743272 [PubMed - indexed for MEDLINE]

4410: Horm Res. 1996;45(1-2):46-9.

Aging and immune function: a possible role for growth hormone.

Gelato MC.

Division of Endocrinology, State University of New York, Stony Brook, USA.

Elderly individuals have four to five times the case rate of cancer, tuberculosis
and herpes zoster and six to seven times the fatality rate from pneumonia
compared to young adults. This may be causally related to two changes that occur 
with aging, i.e. decreased growth hormone (GH)/insulin-like growth factor-1
(IGF-1) production and decreased immune function. Data from our laboratory as
well as others have shown that, based on either GH secretory dynamics or IGF-1
levels, approximately 40% of adults aged 60 and older are GH deficient. In the
same population of subjects, immune function decreases such that there is a
decline in cell-mediated and humoral immune responsiveness. Some of these immune 
deficits have been shown to be reversed in humans and primates by GH and/or IGF-1
treatment. This paper will review some of these data.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8742118 [PubMed - indexed for MEDLINE]

4411: Acta Neurochir (Wien). 1996;138(4):364-9.

Results of DREZ coagulations for pain related to plexus lesions, spinal cord
injuries and postherpetic neuralgia.

Rath SA, Braun V, Soliman N, Antoniadis G, Richter HP.

Department of Neurosurgery, University of Ulm, Gunzburg, Federal Republic of
Germany.

The results of 58 dorsal root entry zone (DREZ) thermocoagulation procedures in
51 patients are reported. The postoperative analgesic effect was judged by the
patients as being good (more than 75% pain reduction), fair (25-75% pain
reduction) or poor (less than 25% pain reduction). Of the 14 patients who
underwent surgery for pain due to cervical root avulsion, 10 (77%) had
permanently good (8) or fair (2) pain relief after a mean follow up period of 76 
months, another 2 (15%) experienced recurrence to the preoperative level
(initially 1 good, 1 fair) after more than 2 and 4 years, respectively. Twenty
two paraplegics were operated upon, 3 of whom twice, for intractable pain. After 
a mean observation time of 54 months, continuing pain relief was reported by 12
(55%) patients (11 good, 1 fair), and one (initially fair) had recurrent pain
after 8 months. All 3 (early) re-operations remain successful for an average
period of 75 months. Poor results were seen especially in cases of associated
spinal cord cysts (5 out of 7), despite combined drainage, and in patients with
diffuse pain distribution (5 out of 6). Continuous marked improvement for longer 
periods (mean follow up: 52 months) after DREZ lesions was reported only by 2 out
of 10 patients with postherpetic neuralgia (12 procedures) and by 1 out of 5 with
painful states due to radiation-induced brachial plexopathy (2), previous surgery
(2) and malignant tumour infiltration of the brachial plexus (1). Three patients 
died postoperatively due to acute cardiac failure (2) and pulmonary embolism (1).
Major complications, especially permanent gait disturbances were observed in 6
patients (12%) following primary procedures and in 2 out of 7 patients after
re-operations, most of them suffering from postherpetic neuralgia. Minor
neurological deficits were noted in 9 cases (18%). DREZ lesions revealed to be an
effective procedure in patients with pain related to root avulsion and
paraplegia. In contrast, it seems to be less successful for painful states due to
other plexus lesions or postherpetic neuralgia.

PMID: 8738385 [PubMed - indexed for MEDLINE]

4412: Antiviral Res. 1996 Jan;29(1):67-8.

Unique clinical trial design: combination acyclovir plus prednisone therapy of
localized zoster in the normal host.

Whitley RJ, Gnann JW Jr, Weiss HL, Soong SJ.

University of Alabama at Birmingham 35294-2710, USA.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8721549 [PubMed - indexed for MEDLINE]

4413: Acta Derm Venereol. 1996 Jan;76(1):45-7.

Pruritus circumscriptus sine materia: a sequel of postzosteric neuralgia.
Evaluation by quantitative psychophysical examination and laser-evoked
potentials.

Darsow U, Lorenz J, Bromm B, Ring J.

Department of Dermatology, University Hospital Eppendorf, University of Hamburg, 
Germany.

A case of circumscribed pruritus existing since 1 year on clinically uninvolved
skin is reported, in which careful history revealed a 5-year previous episode of 
herpes zoster in the same dermatome. Impairment of cutaneous sensitivity was
evaluated by use of a quantitative psychophysical examination and laser-evoked
cortical potentials (LEP).

Publication Types: 
    Case Reports

PMID: 8721492 [PubMed - indexed for MEDLINE]

4414: J Dermatol. 1996 Jan;23(1):22-32.

Immunohistochemical study of cellular events in lesional skin during common virus
infections.

Tsukahara T, Horiuchi Y.

Department of Dermatology, Kitasato University School of Medicine, Sagamihara,
Japan.

Determination was made of epidermal Langerhans cell (LC) distribution and
infiltrating cellular events in lesional skin during varicella zoster virus (VZV)
infection, and the results were compared with those for herpes simplex (HS),
measles, and rubella by immunohistochemical staining with cell surface markers.
CD1a positive epidermal LCs increased in number, particularly in measles and
rubella. The number of LCs was within the normal range or slightly increased in
the epidermis of VZV infection. In herpes zoster (HZ) and varicella, HLA-DR
positive epidermal cells were present in the basal part of the epidermis. In
measles, HLA-DR positive cells aggregated in papular lesions. In measles and
rubella, the number of HLA-DQ positive epidermal cells appeared to increase. In
HS cases, CD11b (OKM1) positivity of the upper epidermal keratinocytes was quite 
pronounced, but not in the basal layer. CD8 positive suppressor/cytotoxic cells
extensively infiltrated the dermis of HZ and varicella. Dermal infiltrates were
identified as CD8 positive cell dominant in measles, HZ, and varicella. These
results provide a partial explanation as to why cellular events in skin lesions
act immunosuppressively.

Publication Types: 
    Comparative Study

PMID: 8720254 [PubMed - indexed for MEDLINE]

4415: Verh K Acad Geneeskd Belg. 1996;58(1):19-47; discussion 47-9.

Therapeutic potential of Cidofovir (HPMPC, Vistide) for the treatment of DNA
virus (i.e. herpes-, papova-, pox- and adenovirus) infections.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit, Leuven.

(S)-1-(3-Hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC, Cidofovir, Vistide)
is an acyclic nucleoside phosphonate with broad-spectrum activity against a wide 
variety of DNA viruses including herpesviruses [Herpes simplex virus type 1
(HSV-1) and type 2 (HSV-2), varicella-zoster virus (VZV), cytomegalovirus (CMV), 
Epstein-Barr virus (EBV), human herpesvirus type 6 (HHV-6) and equine and bovine 
herpesviruses], papovaviruses [human polyoma virus and human papilloma virus
(HPV)], adeno-, irido-, hepadna-, and poxviruses. HPMPC has proved effective
against these viruses in different cell culture systems and/or animal models. The
mechanism of action of HPMPC is based upon the interaction of its active
intracellular metabolite, the diphosphorylated HPMPC derivative HPMPCpp, with the
viral DNA polymerase. HPMPCpp has been shown to block CMV DNA synthesis by DNA
chain termination following incorporation of two consecutive HPMPC molecules at
the 3'-end of the DNA chain. HPMPC confers a prolonged antiviral action, which
lasts for several days or weeks, thus allowing infrequent dosing (i.e. every week
or every two weeks). This prolonged antiviral action is probably due to the very 
long intracellular half-life of the HPMPC metabolites, particularly the
HPMPCp-choline adduct. In clinical studies, HPMPC has proved efficacious in the
treatment of CMV retinitis, following both intravenous injection (3 or 5 mg/kg,
every other week) and intravitreal injection (single dose of 20 micrograms per
eye). Initial clinical trials also point to the efficacy of both systemic
(intravenous) and topical HPMPC (1% ointment) in the treatment of
acyclovir-resistant HSV infections, and of topical HPMPC (ointment or injection) 
in the treatment of pharyngeal, laryngeal and anogenital HPV infections. HPMPC is
now being pursued in the topical and/or systemic (intravenous) treatment of
various infections due to CMV, HSV, VZV, EBV, HPV, polyoma-, adeno- and
poxviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8701600 [PubMed - indexed for MEDLINE]

4416: Am J Otol. 1996 Jan;17(1):154-61.

Correlation of MRI, clinical, and electroneuronographic findings in acute facial 
nerve palsy.

Brandle P, Satoretti-Schefer S, Bohmer A, Wichmann W, Fisch U.

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of 
Zurich, Switzerland.

Intratemporal enhancement of (Gd-DTPA) was investigated by an
interleaved-overlapping magnetic resonance imaging (MRI) technique in 35 cases of
acute facial palsy. In a reference group (normal facial function), enhancement
was localized from the ganglion geniculi to the stylomastoid foramen. In cases of
acute palsy, the facial nerve enhanced in the meatal fundus independent of
etiology (idiopathic, herpetic, or traumatic). In 70% of those with Ramsay-Hunt
syndrome, the vestibular and cochlear nerves, the labyrinth, and the sheets of
the internal and external auditory canal additionally enhanced. No correlation
was found between intensity, extension, and duration of the enhancement and the
clinical, intraoperative, or electroneuronographic degree of the facial palsy.
The pathogenesis of the Gd-DTPA enhancement of the facial nerve appears to be
closely connected with the vascular supply of the fallopian canal and the
permeability of the neural sheets.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 8694122 [PubMed - indexed for MEDLINE]

4417: J Virol Methods. 1996 Jan;56(1):3-11.

Comparison of a DNA probe assay with the plaque reduction assay for measuring the
sensitivity of herpes simplex virus and varicella-zoster virus to penciclovir and
acyclovir.

Standring-Cox R, Bacon TH, Howard BA.

SmithKline Beecham Pharmaceuticals, Betchworth Surrey, UK.

A DNA probe assay was compared with the plaque reduction assay to determine the
sensitivity of clinical isolates of herpes simplex virus (HSV) and
varicella-zoster virus (VZV) to penciclovir and acyclovir in MRC-5 cells. In both
assays, penciclovir and acyclovir shared comparable activity against cell-free
virus (CFV) preparations of VZV and herpes simplex virus type 1 (HSV-1) isolates,
whilst acyclovir was significantly more active than penciclovir against herpes
simplex virus type 2 (HSV-2) isolates in both the DNA probe assay (P < or = 0.01)
and the plaque reduction assay (P < or = 0.01). However, the 50% effective
concentrations (EC50s) were generally lower in the DNA probe assay and the
correlation between the plaque reduction and DNA probe assays was poor for either
compound. Six acyclovir-resistant strains of HSV-1 derived in cell culture were
also tested for susceptibility to penciclovir and acyclovir, in the DNA probe and
plaque reduction assays. The relative susceptibilities of these strains were
comparable, for example, one ACV-resistant strain was susceptible to penciclovir 
in both assays. Further comparisons of the assay methods were made using
cell-associated VZV (CAV). As with CFV the EC50s were significantly lower in the 
DNA probe assay than the plaque reduction assay for penciclovir (P < or = 0.01)
and acyclovir (P < or = 0.01). In the DNA probe assay there was no significant
difference in the EC50s for either penciclovir or acyclovir when comparing CAV
with CFV. However, in the plaque reduction assay the EC50s for CAV were
significantly higher than those for CFV for both penciclovir (P < or = 0.01) and 
acyclovir (P < or = 0.01). Overall the DNA probe assay is objective, does not
require prior titration of isolates and provides opportunities for automation. It
is more suitable for sensitivity testing of large numbers of clinical isolates
than the well-established plaque reduction assay.

Publication Types: 
    Comparative Study

PMID: 8690764 [PubMed - indexed for MEDLINE]

4418: Ther Umsch. 1996 Jan;53(1):49-57.

[Why are AIDS patients frequently visually impaired?]

[Article in German]

Fabricius EM.

Patients with HIV infection and, above all, patients with full-blown AIDS can get
a variety of ocular diseases as well as some cerebral maladies which have an
influence on ocular functions. First there are hematogenous opportunistic
infections of the retina or the choroid. The cytomegalovirus [CMV] retinitis was 
found in nearly 20% of all AIDS patients. Without treatment this disease destroys
the retina completely, and the involved eye becomes blind. This can be prevented 
by modern therapeutic strategies in most of the cases. Other infections affecting
the retina are toxoplasmosis, systemic varizella zoster or herpes simplex virus
infections, syphilis or, seldom, fungal or bacterial pathogens. The choroid
mainly can be infested by mycobacteria, cryptococci and pneumocystis carinii.
Early detection and treatment of all inflammations are necessary. The anterior
eye can be affected by a sicca syndrome and various superficial infections but
also noninfectious inflammation. The anterior uvea can be involved in various
opportunistic infections of the posterior eye segment. An HIV-associated isolated
anterior uveitis has been described in earlier stages of the HIV infection.
Treatment of mycobacterial infections with rifabutin can cause an anterior
uveitis as well. 1 to 2% of HIV-infected persons suffer from a zoster
ophthalmicus with more severe keratitis than it occurs in immunocompetent
persons. Last but not least, there are various cerebral affections which can
cause visual disturbances. So the optic nerve can be involved in various forms of
retinitic or meningoencephalitic processes, of ischemic mechanisms or elevated
intracranial pressure. Neuroophthalmological symptoms also include homonymous
hemianopsia caused by foci of cerebral toxoplasmosis, progressive multifocal
leucencephalopathy or primary intracerebral malignant lymphoma situated in the
central neuron of the afferent visual pathway. A variety of oculomotor
abnormalities can be caused by a great variety of cerebral disease. Moreover,
there are signs of neuroretinal dysfunction in computed perimetry and in color
vision or contrast sensitivity testing. Some sight threatening diseases initially
can be symptomless for the patient, though they should be treated immediately in 
order to keep the remaining visual damage small. Thus, regular ophthalmological
investigations are necessary in patients with an advanced stage of the
immunodeficiency, regardless whether they have ocular complaints or not.
Moreover, the patients have to be advised to attend an ophthalmologist
immediately, when they notice any kind of visual disturbances or ocular symptoms.

Publication Types: 
    English Abstract
    Review

PMID: 8650623 [PubMed - indexed for MEDLINE]

4419: Med Pregl. 1996;49(1-2):57-8.

[Case report of a female patient with post-infection depression]

[Article in Croatian]

Soldatovic-Stajic B, Drezgic-Vukic S.

Medicinski fakultet, Novi Sad.

In this article the authors present a case of a secondary depression in woman, 75
years old, without previous psychiatric anamnesis or heredity. She had
post-herpetic intercostal neuralgia and developed symptoms of depression. This
case is an example which points to necessity of cooperation of other medical
branches with psychiatry.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8643074 [PubMed - indexed for MEDLINE]

4420: Eur J Clin Microbiol Infect Dis. 1996 Jan;15(1):1-3.

Can herpes zoster be prevented?

Levin MJ.

Publication Types: 
    Editorial

PMID: 8641298 [PubMed - indexed for MEDLINE]

4421: J Formos Med Assoc. 1996 Jan;95(1):51-5.

Transfusion-acquired AIDS in Taiwan.

Yao C, Wang WW, Chung YM, Su YL, Liu CY, Chen YM.

Institute of Public Health, National Yang-Ming University, Taipei, Taiwan, ROC.

Human immunodeficiency virus type 1 (HIV-1) can be transmitted through blood
transfusion. The first transfusion-acquired immunodeficiency syndrome (AIDS)
patient in Taiwan was a 46-year-old woman who received two units of whole blood
during a hysterectomy at a provincial hospital in 1985. In 1991, she experienced 
a herpes zoster infection. In March 1993, she had extensive herpetic
gingivostomatitis and another herpes zoster attack, and was treated at the same
hospital. Two months later, she had oral candidiasis and was treated at a medical
center. She was not tested for HIV-1 infection until she developed Pneumocystis
carinii pneumonia in June 1993. In February 1994, and developed cytomegalovirus
retinitis and died 6 months later. Donor blood given to the patients during the
hysterectomy was HIV-1 positive. The donor's HIV infection was discovered in 1991
and he died of AIDS in 1993. As blood centers in Taiwan did not start screening
for HIV-1 until January 1988, it is urgently recommended that any individual who 
received a blood transfusion between 1984 and 1987 in Taiwan and who currently
experiences repeated episodes of opportunistic infections have an HIV-1 blood
test. The receipt of a blood transfusion between 1984 and 1987 should be listed
by the Department of Health as an indication for HIV-1 screening.

PIP: In June 1993, in Taiwan, a woman admitted to a local hospital with cough,
fever, chills, and difficult breathing who tested positive for HIV-1 infection
was transferred to Taipei Veterans General Hospital. In January 1985, at a
provincial hospital, then 46 years old, she underwent an anterior total
hysterectomy and bilateral salpingo-oophorectomy during which she received two
units of whole blood. One of the blood donors was an AIDS patient who had been
treated at the same hospital in 1991 and who had died in 1993. In the interim
between hospitalizations, she had two episodes of herpes zoster infection,
including oral ulcers diagnosed as herpetic gingivostomatitis, and an episode of 
oral candidiasis. Physicians at the Taipei Veterans General Hospital diagnosed
oral candidiasis, herpes simplex type 1 virus infection forming ulcers on her
lips, and Pneumocystis carinii pneumonia in June 1993. Her CD4 count was 0 and
her CD8 count was 20%. Treatment consisted of intravenous (IV)
trimethoprim/sulfamethoxazole (TMP/SMX) and oral zidovudine, fluconazole, and
acyclovir. She continued this medication after discharge in August 1993. She was 
readmitted to Taipei Veterans General Hospital in February 1994 for blurred
vision. She was diagnosed with cytomegalovirus retinitis. Her CD4 count was up to
1% and her CD8 count was down to 8%. The candidiasis infection had extended from 
her oral cavity to the esophageal mucosa. She was put on IV ganciclovir, TMP/SMX,
and fluconazole. She was discharged 3 weeks after admission. Her condition
deteriorated thereafter, resulting in her death in August 1994. Up until this
study, this HIV/AIDS case was listed with 79 other HIV/AIDS patients as unknown
cause. During the 8 years between HIV exposure and her diagnosis of AIDS, she had
unprotected sexual intercourse with her husband. Neither the husband nor any of
her four children have AIDS. Screening for HIV-1 in Taiwan began in January 1988.
The authors urgently recommend that anyone who received a blood transfusion
between 1984 and 1987 in Taiwan and who currently suffers repeated episodes of
opportunistic infections undergo an HIV-1 blood test.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8640096 [PubMed - indexed for MEDLINE]

4422: Cardiology. 1996 Jan-Feb;87(1):60-6.

Long-term risk of death, cardiac events and recurrent chest pain in patients with
acute chest pain of different origin.

Launbjerg J, Fruergaard P, Hesse B, Jorgensen F, Elsborg L, Petri A.

Medical Department B, Hillerod Hospital, Copenhagen, Denmark.

The purpose of the study was to describe the prognosis of patients with acute
chest pain of different origin, but without myocardial infarction (non-AMI). A
total of 204 patients were included. In 56, a definite diagnosis was obtained
within 24-48 H of admission. The remaining 148 patients underwent the following
examinations: exercise test, myocardial scintigraphy, echocardiography, Holter
monitoring, hyperventilation test, oesophago-gastro-duodenoscopy, oesophageal
manometry, oesophageal pH monitoring, Bernstein test, physical chest wall
examination, bronchial histamine test, chest X-ray and ultrasonic upper abdominal
examination. Ischaemic heart disease (IHD) was diagnosed in 64 patients, 81 had
gastro-oesophageal disorders, 58 chest wall disorders, 9 pericarditis, 5
pulmonary embolism, 4 pneumonia/pleuritis, 3 pulmonary cancer, 2 dissecting
aortic aneurysm, 1 aortic stenosis and 1 herpes zoster. During follow-up of 33
months, 31 of the 64 patients with IHD had a cardiac event (cardiac deaths,
non-fatal AMI, bypass surgery or PTCA), whereas only 3 event occurred among the
140 patients without IHD (p < 0.00001). However, the frequency of readmissions
and of recurrent episodes of chest pain were similar in the 3 major diagnostic
groups (NS). To conclude, the high-risk subset of a non-AMI population can be
identified by means of non-invasive cardiac examination. The remainder who have
other diagnoses are at low risk. However, the morbidity is high with frequent
readmissions and recurrent episodes of chest pain and the need for development of
strategies with regard to diagnosis and treatment of these patients are
emphasized.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8631047 [PubMed - indexed for MEDLINE]

4423: Arch Virol. 1996;141(1):43-55.

Identification and analysis of the simian varicella virus thymidine kinase gene.

Pumphrey CY, Gray WL.

Department of Microbiology and Immunology, University of Arkansas for Medical
Sciences, Little Rock, USA.

The thymidine kinase (TK) of herpesviruses, in contrast to cellular TKs,
phosphorylates a variety of substrates including antiherpetic nucleoside
analogues. This study reports the identification and DNA sequence of the simian
varicella virus (SVV) TK gene. A 32P-labeled varicella zoster virus (VZV) TK DNA 
probe hybridized to the HindIII B subclone of the SVV BamHI B restriction
endonuclease (RE) fragment, indicating the presence of a SVV DNA sequence
homologous to the VZV TK gene. DNA sequence analysis of the SVV HindIII B
subclone revealed a 1014 base pair (bp) open reading frame (ORF) encoding a 337
amino acid polypeptide homologous to herpesvirus TKs. The predicted SVV and VZV
TK polypeptides share 51.3% identity, and alignment of the putative protein
sequence of several TK homologues suggests the position of a conserved nucleotide
binding site and a nucleoside (substrate) binding site in the SVV TK.
Identification of the 5' end of the SVV TK transcript by primer extension
analysis allowed a comparison of the SVV and VZV TK promoter regions indicating
extensive conservation of the DNA sequence and transcription factor binding
sites. Plaque reduction assays demonstrate that the SVV TK is active based on the
susceptibility of SVV to acyclovir treatment and that SVV is less sensitive to
acyclovir than VZV and herpes simplex virus (HSV-1) in infected Vero cells.
Identification of the SVV TK ORF will facilitate studies that examine the role of
viral TKs in pathogenesis and antiviral sensitivity and provides a potential
insertion site for the expression of foreign genes.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8629950 [PubMed - indexed for MEDLINE]

4424: Arch Fam Med. 1996 Jan;5(1):42-6.

Shingles in one family practice.

Richards P.

One hundred twenty-four patients presented with herpes zoster in a small-town,
solo practice between 1983 and 1992. This article reviews the clinical features
and natural history of herpes zoster, followed by a description of the cases seen
in the study practice. This common disease, easily diagnosed and treated by the
family physician, usually responds well to treatment with acyclovir.

Publication Types: 
    Review

PMID: 8542053 [PubMed - indexed for MEDLINE]

4425: J Am Geriatr Soc. 1996 Jan;44(1):74-82.

Approach to fever and infection in the nursing home.

Yoshikawa TT, Norman DC.

Department of Internal Medicine (MP-11), Charles R. Drew University of Medicine
and Science, King-Drew Medical Center, Los Angeles, California 90059, USA.

OBJECTIVE: To summarize current information on the scope, epidemiology, clinical 
manifestations, diagnostic approach, and general management of infectious
diseases in nursing home residents, as well as the specific treatment of common
infections occurring in the nursing home setting. DESIGN: Survey and literature
review of the diagnostic and therapeutic problems of nursing home residents with 
infections. CONCLUSIONS: Older persons residing in nursing homes as well as other
types of long-term care facilities are at increased risk for infections.
Moreover, infection is the most frequent reason for patients to be transferred
from nursing homes to an acute-care facility. The most common infections that are
acquired in nursing homes are urinary tract infection (cystitis pyelonephritis), 
respiratory infections (pneumonia, bronchitis), and skin/soft tissue infections
(infected pressure ulcers, cellulitis). Most serious infections in this setting
are caused by bacteria; however, influenza and other respiratory viruses as well 
as herpes zoster may cause significant morbidity in older nursing home residents.
Mycobacterium tuberculosis infects nursing home residents at a higher rate than
it infects older community dwellers. Infections in older nursing home residents
may manifest clinically, with atypical symptoms and signs, including the absence 
of fever. Rapid diagnostic evaluation and early therapeutic intervention are
essential for minimizing the high mortality and morbidity associated with
infections in this older population; most nursing home residents with serious
infections should be considered for hospitalization.

Publication Types: 
    Review

PMID: 8537596 [PubMed - indexed for MEDLINE]

4426: Ann Intern Med. 1996 Jan 1;124(1 Pt 1):27-30.

Comment in:
    Ann Intern Med. 1996 Jan 1;124(1 Pt 1):63-5.    Ann Intern Med. 1996 Oct 15;125(8):698-9.

Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial
fluid and muscle.

Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N.

Ehime University School of Medicine, Japan.

OBJECTIVE: To determine whether herpes simplex virus type 1 (HSV-1) causes Bell
palsy. DESIGN: Prospective study. SETTING: University inpatient service.
PATIENTS: 14 patients with Bell palsy, 9 patients with the Ramsay-Hunt syndrome, 
and 12 other controls. MEASUREMENTS: Viral genomes of HSV-1, varicella-zoster
virus, and Epstein-Barr virus were analyzed in clinical samples of facial nerve
endoneurial fluid and posterior auricular muscle using polymerase chain reaction 
(PCR) followed by hybridization with Southern blot analysis. RESULTS: Herpes
simplex virus type 1 genomes were detected in 11 of 14 patients (79%) with Bell
palsy but not in patients with the Ramsay-Hunt syndrome or in other controls. The
nucleotide sequences of the PCR fragments were identical to those of the HSV-1
genome. CONCLUSIONS: Herpes simplex virus type 1 is the major etiologic agent in 
Bell palsy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7503474 [PubMed - indexed for MEDLINE]

4427: Virology. 1995 Dec 20;214(2):531-40.

Identification of immunodominant regions and linear B cell epitopes of the gE
envelope protein of varicella-zoster virus.

Fowler WJ, Garcia-Valcarcel M, Hill-Perkins MS, Murphy G, Harper DR, Jeffries DJ,
Burns NR, Adams SE, Kingsman AJ, Layton GT.

British Biotech Pharmaceuticals Ltd., Oxford, United Kingdom.

The envelope proteins of varicella-zoster virus (VZV) are highly immunogenic and 
one of the most abundant is glycoprotein E (gE). However, its immunodominant
regions and epitopes have not been identified. In this study, using human sera
from individuals with recent varicella or zoster infections, we have localized
antigenic sequences of gE using recombinant hybrid Ty-virus-like particles (VLPs)
carrying overlapping fragments of the gE protein. gE(1-134)-VLPs (particles
carrying amino acids 1-134 of gE) and, to a lesser extent, gE(101-161)-VLPs were 
found to be the most antigenic when tested by Western blotting and ELISA. Other
fragments of gE (spanning residues 161-623) showed weak or no antigenicity.
Pepscan analysis of human sera on overlapping synthetic peptides representing
residues 1-135 of gE revealed that the most antigenic region was between residues
50 and 135. Three immunodominant sequences (residues 86-105, 116-135, and, to a
lesser extent, 56-75) were detected using sera from both varicella and zoster
patients. All sera from varicella, but not zoster, patients reacted strongly with
an epitope in peptide 66-85. Other epitopes were recognized weakly by some
varicella or zoster sera. More sera need to be tested to assess the potential
disease specificity of these epitopes. The neutralizing monoclonal antibody (MAb)
IF-B9 reacted with residues 71-90; however, another neutralizing MAb, SG1A, which
bound to both gE(1-134)-VLPs and gE(101-161)-VLPs did not bind to any peptide.
The identification of immunodominant sequences of gE will help toward the
development of a subunit VZV vaccine.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8553555 [PubMed - indexed for MEDLINE]

4428: BETA. 1995 Dec:33-7.

Herpesviruses.

Bowers M.

San Francisco AIDS Foundation, San Francisco, CA.

AIDS: The signs, symptoms, diagnoses, and treatment of human herpesviruses are
discussed, including advances and refinements in treatment options. Various
treatment drugs, such as Zovirax, Famvir, Cidofovir, Foscarnet, Valtrex, and
Virend, are examined. Genital herpes vaccines and possible alternative therapies 
are reviewed. In particular, varicella zoster virus, the virus that produces
chicken pox and shingles, is examined, including its signs, symptoms, and
intervention strategies using famciclovir and sorivudine. Final comments discuss 
the Epstein-Barr virus, the cause of mononucleosis, the newly discovered human
herpesviruses, and the future prospects for identifying and appropriately
treating herpesviruses.

Publication Types: 
    Newspaper Article

PMID: 11363008 [PubMed - indexed for MEDLINE]

4429: Southeast Asian J Trop Med Public Health. 1995 Dec;26(4):677-83.

Genome differences among varicella-zoster viruses isolated in Thailand.

Thawaranantha D, Balachandra K, Jongtrakulsiri S, Yamkunthong W, Chimabutra K,
Bhumiswasdi J.

Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand.

The DNAs of 17 isolates of varicella-zoster virus (VZV) obtained from 17 Thai
individuals with normal varicella or zoster infections (no underlying diseases)
were compared by restriction endonuclease analysis using BglI, PstI, EcoRI, SmaI 
and BamHI. The DNA of the Japanese strain, Kawaguchi, was also conducted as a
reference DNA. All of virus isolates were confirmed for existence of VZV and
VZV-DNA by immunofluorescent test and DNA-hybridization, respectively. Almost all
of the Thai epidemiologically unrelated isolates and the Kawaguchi strain could
be individually differentiated using BglI, PstI, and EcoRI. The other two
isolates were identical in restriction profiles even after five endonuclease
digestions which SmaI and BamHI were the two more enzymes used, therefore, they
could be discriminated totally into 16 strains from overall 17 isolates. These
findings demonstrate the strain variation of wild-type varicella-zoster viruses
isolated in Thailand.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 9139375 [PubMed - indexed for MEDLINE]

4430: Neurology. 1995 Dec;45(12):2293.

Polyneuritis cranialis due to varicella-zoster virus in the absence of rash.

Osaki Y, Matsubayashi K, Okumiya K, Wada T, Doi Y.

Department of Medicine and Geriatrics, Kochi Medical School, Nankoku, Japan.

Publication Types: 
    Case Reports

PMID: 8848213 [PubMed - indexed for MEDLINE]

4431: Neurology. 1995 Dec;45(12):2246-50.

Recurrent brainstem encephalitis associated with herpes simplex virus type 1 DNA 
in cerebrospinal fluid.

Tyler KL, Tedder DG, Yamamoto LJ, Klapper JA, Ashley R, Lichtenstein KA, Levin
MJ.

Department of Neurology, University of Colorado Health Sciences Center, Denver,
USA.

A 47-year-old man had recurrent signs and symptoms of brainstem encephalitis over
a 4-year period. Although CSF viral cultures were repeatedly negative, herpes
simplex virus type 1 (HSV-1) DNA was detected in CSF by polymerase chain reaction
(PCR). HSV-1-specific antibodies were absent at the time of the first positive
PCR test, but CSF seroconversion to high HSV-1-specific antibody titer
subsequently occurred. CSF antibody to cytomegalovirus (CMV) and varicella-zoster
virus (VZV) was not detectable, nor could CMV, VZV, or Epstein-Barr virus nucleic
acid be detected by CSF by PCR. This is the first report of the use of CSF PCR
for the rapid antemortem diagnosis of herpetic brainstem encephalitis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8848201 [PubMed - indexed for MEDLINE]

4432: Virus Res. 1995 Dec;39(2-3):181-93.

The inverted repeat regions of the simian varicella virus and varicella-zoster
virus genomes have a similar genetic organization.

Gray WL, Gusick NJ, Ek-Kommonen C, Kempson SE, Fletcher TM 3rd.

Department of Microbiology and Immunology, University of Arkansas for Medical
Sciences, Little Rock 72205, USA. wgray@biomed.uams.edu

Simian varicella virus (SVV) causes a varicella-like disease in nonhuman
primates. The DNA sequence and genetic organization of the inverted repeat region
(RS) of the SVV genome was determined. The SVV RS is 7559 bp in size with 56%
guanine+cytosine (G+C) content and includes 3 open reading frames (ORFs). The SVV
RS1 ORF encodes a 1279 amino acid (aa) protein with 58 and 39% identity to the
varicella-zoster virus (VZV) gene 62 and herpes simplex virus type 1 (HSV-1) ICP4
homologs, respectively. The predicted 261 aa SVV RS2 polypeptide possesses 52%
identity with the VZV gene 63 homolog and 23% identity with the HSV-1 ICP22. The 
SVV RS3 encodes a 187 aa polypeptide with 56% and 28% identity to the VZV gene 64
and the HSV-1 US10 homologs, respectively, and includes an atypical zinc finger
motif. A G+C-rich 16 base-pair (bp) sequence which is repeated 7 times and a
putative SVV origin of replication were identified between the RS1 and RS2 ORFs. 
Comparison with the VZV RS indicates the SVV and VZV RS regions are similar in
size and genetic organization.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8837883 [PubMed - indexed for MEDLINE]

4433: J Antimicrob Chemother. 1995 Dec;36(6):1089-1101.

How should zoster trials be conducted?

Wood MJ, Balfour H, Beutner K, Bruxelle J, Fiddian P, Johnson R, Kay R, Cubed S, 
Portnoy J, Rentier B, et al.

Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital,
UK.

In 1994, an international group of interested clinicians and biostatisticians met
to discuss the design of clinical trials in herpes zoster. They agreed that
trials in herpes zoster should have prospectively agreed definitions of all
outcome measures and plans for data analysis. In immunocompetent individuals, in 
whom pain is the major outcome measure, trials should only include patients over 
the age of 50 years, and for those recruited within 72 h of rash onset, should be
designed to demonstrate superiority of any new therapy over existing antivirals. 
The primary endpoint should be time to cessation of pain for at least 4 weeks
and, for the purposes of statistical analysis of its duration, the pain
associated with herpes zoster ought to be considered as a continuum. All other
variables, including the incidence of post-herpetic neuralgia and effects upon
quality of life should be considered as secondary end-points. Evaluation of
treatment effects on primary endpoints should be based upon an intent-to-treat
(ITT) analysis and subgroup analysis should be used only to support the findings 
of the ITT analysis. These elements of good study design should be borne in mind 
in the evaluation of current and future trails of antiviral drugs in herpes
zoster.

Publication Types: 
    Review

PMID: 8821612 [PubMed - indexed for MEDLINE]

4434: J Comput Aided Mol Des. 1995 Dec;9(6):473-8.

A pseudoreceptor modelling study of the varicella-zoster virus and human
thymidine kinase binding sites.

Greenidge PA, Merz A, Folkers G.

Department of Pharmacy, ETH Zurich, Switzerland.

A representative range of pyrimidine nucleoside analogues that are known to
inhibit herpes simplex virus (HSV) replication have been used to construct
receptor binding site models for the varicella-zoster virus (VZV) thymidine
kinase (TK) and human TK1. Given a set of interacting ligands, superimposed in
such a manner as to define a pharmacophore, the pseudoreceptor modelling
technique Yak provides a means of building binding site models of macromolecules 
for which no three-dimensional experimental structures are available. Once the
models have been evaluated by their ability to reproduce experimental binding
data [Vedani et al., J. Am. Chem. Soc., 117 (1995) 4987], they can be used for
predictive purposes. Calculated and experimental values of relative binding
affinity are compared. Our models suggest that the substitution of one residue
may be sufficient to determine ligand subtype affinity.

PMID: 8789189 [PubMed - indexed for MEDLINE]

4435: Acta Med Okayama. 1995 Dec;49(6):309-12.

Effects of varicella zoster virus or herpes simplex virus type I infection in
vitro on response of human peripheral blood mononuclear cells to
phytohemagglutinin.

Horiuchi Y, Okuno T, Yamanishi K.

Department of Dermatology, Kitasato University School of Medicine, Japan.

Examination was made of the in vitro response of human peripheral blood
mononuclear cells (PBNMCs) to phytohemagglutinin (PHA) following treatment with
varicella zoster virus (VZV) or herpes simplex virus type 1 (HSV 1). Cell
proliferation was determined by colorimetric assay using
3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide. The response to
PHA was depressed in all cases by virus infection of PBMNCs prior to PHA
treatment. When the infection with the viruses was after PHA treatment, PHA
response differed. For VZV infection, the response increased in four out of six
samples, but was reduced in the other two. The response to PHA was depressed in
all six samples by HSV 1 infection.

Publication Types: 
    Review

PMID: 8770240 [PubMed - indexed for MEDLINE]

4436: Clin Infect Dis. 1995 Dec;21(6):1466-8.

Immunodeficiency and elevated CD4 T lymphocyte counts in two patients coinfected 
with human immunodeficiency virus and human lymphotropic virus type I.

Fantry L, De Jonge E, Auwaerter PG, Lederman HM.

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore,
Maryland 21287-3923, USA.

We describe two patients who were coinfected with human immunodeficiency virus
(HIV) and human T-cell lymphotropic virus (HTLV) type I. They had clinical
evidence of immunodeficiency (anergy, oral candidiasis, and disseminated herpes
zoster) despite having elevated CD4 T lymphocyte counts (range, 2,450-5,292/mm3).
We conclude that CD4 lymphocyte counts may not be reliable markers of immunologic
competence in patients coinfected with HIV and HTLV-I.

Publication Types: 
    Case Reports

PMID: 8749634 [PubMed - indexed for MEDLINE]

4437: Arq Neuropsiquiatr. 1995 Dec;53(4):760-5.

The value of CSF analysis for the differential diagnosis of HTLV-I associated
myelopathy and multiple sclerosis.

Puccioni-Sohler M, Kitze B, Felgenhauer K, Graef IT, Lange P, Novis S, Reiber H, 
Vaz B.

Klinik und Poliklinik fur Neurologie, Georg-August-Universitat Gottingen,
Germany.

Cerebrospinal fluid (CSF) and serum of 17 patients with HAM/TSP (HTLV-I
associated myelopathy/tropical spastic paraparesis), six with multiple sclerosis 
and six with idiopathic epilepsy (non inflammatory control) from Brazil were
analysed for the presence of intrathecal synthesis of virus-specific antibodies
against measles, rubella, varicella zoster virus and herpes simplex virus by
enzyme-linked immunosorbent assay (ELISA). All HAM/TSP and multiple sclerosis
cases had an intrathecal immune response (oligoclonal IgG). In HAM/TSP, only 1/17
case showed a polyspecific intrathecal immune response against measles and
rubella virus. In multiple sclerosis, specific antibodies against measles and
rubella (MRZ response) were observed in all patients but not in the control with 
idiopathic epilepsy. The diagnostic and theoretical relevance of mono- and
polyspecific immune responses is discussed for these chronic neurological
diseases.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8729769 [PubMed - indexed for MEDLINE]

4438: Antiviral Res. 1995 Dec;28(4):281-90.

Valacyclovir: a review of its antiviral activity, pharmacokinetic properties, and
clinical efficacy.

Beutner KR.

Department of Dermatology, University of California at San Francisco, USA.

Oral administration of the prodrug valacyclovir results in enhanced
bioavailability and significantly greater plasma concentrations of acyclovir than
can be achieved with oral doses of acyclovir itself. The results of clinical
trials with valacyclovir have demonstrated significant benefits in the resolution
of pain associated with herpes zoster infection. Efficacy parameters were similar
for valacyclovir and acyclovir in the treatment of herpes simplex; however the
results were achieved with lower and less-frequent doses of valacyclovir. The
cost of a course of therapy with valacyclovir is expected to be similar to that
of other antivirals. The potential clinical benefits of valacyclovir will likely 
be apparent in the case of acyclovir-resistant herpesvirus infections, where
high-dose intravenous treatment with acyclovir has been necessary. Most of these 
resistant viruses have been encountered in immunocompromised patients, and the
resistance has been attributed to inadequate exposure to the drug. Because
optimal levels of acyclovir are achieved with a simpler dosing regimen of
valacyclovir, compliance may be improved in many patients, thus reducing the
incidence of resistant virus.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8669888 [PubMed - indexed for MEDLINE]

4439: J Dermatol. 1995 Dec;22(12):939-42.

Sebaceous adenomas, squamous cell carcinoma and skin infections in a patient with
carcinoma of the colon, rectum and bladder.

Abraham Z, Gluck Z, Lahat N, Kinarty A.

Department of Dermatology, Reish Policlinic, Haifa, Israel.

Sebaceous adenomas and squamous cell carcinoma developed in a male patient in
addition to viral, mycotic and bacterial infections, several years after the
removal of three malignant tumors from his lower gastrointestinal and urinary
tract. Skin tests with trichophytin, candidin, and mixed bacteria were negative. 
Various aspects regarding cutaneous changes associated with colorectal and
bladder carcinomas are discussed.

Publication Types: 
    Case Reports

PMID: 8648002 [PubMed - indexed for MEDLINE]

4440: J Med Virol. 1995 Dec;47(4):342-7.

Immunohistochemical identification of varicella-zoster virus gene 63-encoded
protein (IE63) and late (gE) protein on smears and cutaneous biopsies:
implications for diagnostic use.

Nikkels AF, Debrus S, Sadzot-Delvaux C, Piette J, Rentier B, Pierard GE.

Department of Dermatopathology, CHU Sart Tilman, Liege, Belgium.

Early and specific recognition of varicella zoster virus (VZV) infection is of
vital concern in immunocompromised patients. The aim of this study was to compare
the diagnostic accuracy of histochemical and immunohistochemical identification
of the VZV ORF63 encoded protein (IE63) and of the VZV late protein gE on smears 
and formalin-fixed paraffin-embedded skin sections taken from lesions clinically 
diagnosed as varicella (n = 15) and herpes zoster (n = 51). Microscopic
examinations of Tzanck smears and skin sections yielded a diagnostic accuracy of 
Herpesviridae infections in 66.7% (10/15) and 92.3% (12/13) of varicella, and
74.4% (29/39) and 87.8% (43/49) of herpes zoster, respectively.
Immunohistochemistry applied to varicella provided a type-specific virus
diagnostic accuracy of 86.7% (13/15; IE63) and 100% (15/15; gE) on smears, and of
92.3% for both VZV proteins on skin sections. In herpes zoster, the diagnostic
accuracy of immunohistochemistry reached 92.3% (36/39; IE63) and 94.9% (37/39;
gE) on smears, and 91.7% (44/48; IE63) and 91.8% (45/49; gE) on skin sections.
These findings indicate that the immunohistochemical detection of IE63 and gE on 
both smears and skin sections yields a higher specificity and sensitivity than
standard microscopic assessments.

PMID: 8636701 [PubMed - indexed for MEDLINE]

4441: Masui. 1995 Dec;44(12):1680-4.

[A case of RSD with complete disappearance of symptoms following intravenous
ketamine infusion combined with stellate ganglion block and continuous epidural
block]

[Article in Japanese]

Kishimoto N, Kato J, Suzuki T, Arakawa H, Ogawa S, Suzuki H.

Department of Anesthesiology and Resuscitology, Kochi Medical School, Nankoku.

A 74 year-old woman with a 6-month history of RSD following herpes zoster on her 
right arm was treated with stellate ganglion blocks (SGB), continuous epidural
block (CEB) and continuous intravenous infusion of ketamine known as one of the
NMDA receptor blockers. Of the symptoms of RSD, burning pain and
hyperperspiration but allodynia disappeared after the treatment with SGB 8 times 
and CEB for 4 days. Allodynia disappeared completely after ketamine treatment,
where ketamine was infused once using a subanesthetic dose for 2 hours. It is
considered that ketamine is one of the useful drugs for the treatment of
neuropathic pain with allodynia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8583666 [PubMed - indexed for MEDLINE]

4442: Br J Dermatol. 1995 Dec;133(6):978-82.

Necrotizing herpes zoster mimicking relapse of vasculitis in angioimmunoblastic
lymphadenopathy with dysproteinaemia.

Boni R, Dummer R, Dommann-Scherrer C, Dommann S, Zimmermann DR, Joller-Jemelka H,
Burg G.

Department of Dermatology, University Hospital of Zurich, Switzerland.

An 81-year-old man presented with a generalized maculopapular rash,
lymphadenopathy, conjunctivitis and arthritis. Vasculitis was confirmed by skin
biopsy and by direct immunofluorescence, which showed perivascular C3 and
granular IgM accumulation. Histology of an inguinal lymph node was diagnostic for
angioimmunoblastic lymphadenopathy with dysproteinaemia (AILD), and this was
confirmed by the finding of hypergammaglobulinaemia and elevated IgE levels.
Immunohistology on a lymph node biopsy showed a T-helper cell (CD4) infiltrate
expressing the interleukin (IL)-2 receptor alpha and beta chains. While receiving
prednisone 100 mg/day, the patient developed new lesions, mimicking a relapse of 
vasculitis, which were subsequently shown to be necrotizing herpes zoster. Serum 
IL-2 and IL-6 levels were elevated. To our knowledge, this is the first report of
simultaneous elevation of IL-2 and IL-6 in AILD: IL-2 may be involved in
proliferation of the malignant cell clone, and IL-6 in the pathogenesis of both
the vasculitis (via endothelial cell activation) and the hypergammaglobulinaemia.

Publication Types: 
    Case Reports
    Review

PMID: 8547055 [PubMed - indexed for MEDLINE]

4443: Neurology. 1995 Dec;45(12 Suppl 8):S78-9.

Prospective epidemiologic study of painful and neurologic sequelae induced by
herpes zoster in patients treated early with oral acyclovir.

Bruxelle J.

Department of Anesthesiology, Hospital Cochin-Tarnier, Paris, France.

Three hundred and one patients with acute herpes zoster treated early with oral
acyclovir were enrolled in an open, prospective study designed to evaluate
painful and neurologic disorders over a 6-month period. Age, initial pain
severity, and occurrence of a neurologic deficit influenced the incidence of
postherpetic neuralgia. No relationship was found between initial rash severity
and either pain incidence or neurologic deficit.

PMID: 8545032 [PubMed - indexed for MEDLINE]

4444: Neurology. 1995 Dec;45(12 Suppl 8):S76-7.

Efficacy of famciclovir in the treatment of herpes zoster: reduction of pain
associated with zoster.

Boon RJ, Griffin DR.

SmithKline Beecham Pharmaceuticals plc, Harlow, Essex, UK.

Publication Types: 
    Review

PMID: 8545031 [PubMed - indexed for MEDLINE]

4445: Neurology. 1995 Dec;45(12 Suppl 8):S73-5.

Sorivudine: a promising drug for the treatment of varicella-zoster virus
infection.

Whitley RJ.

Department of Pediatrics, University of Alabama at Birmingham 35233, USA.

Sorivudine provides a unique nucleoside analog with significantly enhanced both
in vitro and in vitro activity and enhanced oral bioavailability. Early
indications from controlled studies indicate that sorivudine therapy is superior 
to acyclovir for the treatment of localized zoster in individuals with HIV
infection and adults with chicken pox. However, these studies await peer
evaluation. Importantly, recent experience in Japan indicates administration of
sorivudine with 5-fluorouracil (5-FU) is contraindicated. Sorivudine inhibits
dihydropyrimidine dehydrogenase, which is required for the metabolism of 5-FU. As
a consequence, toxic levels of 5-FU accumulate in the plasma and have led to the 
deaths of nearly 30 patients in Japan. One might question, as these data unfold, 
the relative value of drugs with such enhanced in vitro activity and oral
bioavailability as compared with standard therapeutic agents. Should accelerated 
healing occur, but not as dramatically as would have been anticipated from the in
vitro data, unique approaches to the management of herpes zoster will need to be 
developed if further improvement is desired. Regardless, sorivudine appears
superior to acyclovir for acceleration of cutaneous healing and, importantly, can
be administered once daily in significantly smaller concentrations. These
findings in and of themselves should allow for licensure of the compound in other
developed societies.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8545030 [PubMed - indexed for MEDLINE]

4446: Neurology. 1995 Dec;45(12 Suppl 8):S70-2.

The future of predictors, prevention, and therapy in postherpetic neuralgia.

Johnson RW.

Pain Management Clinic, Bristol Royal Infirmary, England.

Pain is the most common complication of herpes zoster, but much confusion and
dissent exist regarding terminology. Established (chronic) herpetic pain is
remarkably resistant to treatment, but its prevention is partly achievable.
Prodromal and acute herpetic pain are predictors for chronic pain. If research
programs and clinical management are to progress optimally, researchers and
clinicians must agree on appropriate use of such terms as "zoster-associated
pain" and "postherpetic neuralgia."

PMID: 8545029 [PubMed - indexed for MEDLINE]

4447: Neurology. 1995 Dec;45(12 Suppl 8):S63-5.

Mechanical allodynia in postherpetic neuralgia: evidence for central mechanisms
depending on nociceptive C-fiber degeneration.

Baron R, Saguer M.

Klinik fur Neurologie, Christian-Albrechts-Universitat Kiel, Germany.

In 12 zoster patients who had developed postherpetic neuralgia with dynamic
mechanical allodynia and in six zoster patients who had recovered without pain,
the functional role of nociceptive C-fibers in allodynia was assessed by
quantifying axon reflex reactions induced by histamine iontophoresis within
allodynic regions and in their contralateral sites. In patients with postherpetic
neuralgia, histamine responses were reduced or abolished within allodynic areas, 
indicating degeneration of nociceptive C-fibers. In patients who recovered
without pain, histamine responses were bilaterally identical, indicating complete
regeneration of nociceptive C-fibers. These results demonstrate that sensitized
nociceptive C-fibers are not involved in signaling and maintenance of allodynia. 
Alteration in CNS processing may reorganize synaptic ties between central
pain-signaling pathways and mechanoreceptive A beta-fibers depending on afferent 
C-fiber degeneration rather than ongoing C-fiber input.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8545026 [PubMed - indexed for MEDLINE]

4448: Neurology. 1995 Dec;45(12 Suppl 8):S61-2.

How should we measure pain in herpes zoster?

Wood MJ.

Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital,
UK.

Pain occurs during the acute phase of herpes zoster and as postherpetic neuralgia
(PHN) for months or years after the acute illness has healed. The acute pain
results from viral replication leading to the death of neurons together with
cutaneous inflammation. However, the exact mechanism of PHN is still conjectural.
Historically, PHN has been defined as any pain that follows disappearance of the 
rash of herpes zoster, but a number of other definitions (eg, pain present for
more than 1 or 2 months after rash onset) have also been used. Since pain is
purely subjective and is usually felt as a continuum, any definition is entirely 
arbitrary and sheds no light upon the pathophysiology of the prolonged pain. An
arbitrary division of pain poses problems for the measurement of the effect of
acute therapy upon the duration of PHN. Use of a definition of PHN that involves 
the time of rash healing also leads to considerable difficulties in the
assessment of therapies that affect the duration of the rash. The median times
for resolution of both acute pain and PHN are likely to be biased in favor of
therapy that heals the rash more rapidly, even if the continuum of pain is not
affected. For these reasons, the term "zoster-associated pain," encompassing both
the acute and chronic pain associated with herpes zoster, has evolved as a more
meaningful way of measuring pain both for the individual patient and also for the
comparison of two potential therapies.

Publication Types: 
    Review

PMID: 8545025 [PubMed - indexed for MEDLINE]

4449: Neurology. 1995 Dec;45(12 Suppl 8):S58-60.

The treatment of postherpetic neuralgia.

Watson CP.

Department of Medicine, University of Toronto, ON, Canada.

Postherpetic neuralgia, when defined as neuropathic pain persisting 1 month or
longer after herpes zoster infection, affects about 10% of all patients who have 
contracted the disease. The incidence of postherpetic neuralgia increases with
age; at age 60, about 50% of herpes zoster patients will suffer significant pain,
and this proportion grows with subsequent decades. If therapy is carefully chosen
and monitored, it is possible to give satisfactory relief, taking pain from
severe to mild, to between 60 and 70% of patients. This article will review
current treatment and focus on antidepressant drugs, treatments that are
contentious and of current interest such as topical agents, and the use of
opioids for this type of chronic neuropathic pain.

Publication Types: 
    Review

PMID: 8545024 [PubMed - indexed for MEDLINE]

4450: Neurology. 1995 Dec;45(12 Suppl 8):S56-7.

Pathophysiology of postherpetic neuralgia: towards a rational treatment.

Bowsher D.

Pain Research Institute, Walton Hospital, Liverpool, UK.

Publication Types: 
    Review

PMID: 8545023 [PubMed - indexed for MEDLINE]

4451: Neurology. 1995 Dec;45(12 Suppl 8):S54-5.

Clinical features and pathophysiologic mechanisms of postherpetic neuralgia.

Nurmikko T.

Department of Neurology, Tampere University Hospital, Finland.

Postherpetic neuralgia is an unfortunate aftermath of shingles, and is most
likely to develop, and most persistent, in elderly patients. Pain, allodynia, and
sensory loss in the affected dermatome are the cardinal manifestations of the
disorder. The pathophysiology of postherpetic neuralgia is not well known, but
recent observations suggest multiple changes in the afferent pathways at both
peripheral and central nervous system levels.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8545022 [PubMed - indexed for MEDLINE]

4452: Neurology. 1995 Dec;45(12 Suppl 8):S52-3.

Herpes zoster and quality of life: a self-limited disease with severe impact.

Lydick E, Epstein RS, Himmelberger D, White CJ.

Merck Research Laboratories, West Point, PA 19486-0004, USA.

PMID: 8545021 [PubMed - indexed for MEDLINE]

4453: Neurology. 1995 Dec;45(12 Suppl 8):S50-1.

Herpes zoster ophthalmicus.

Pavan-Langston D.

Harvard Medical School/Massachusetts Eye and Ear Infirmary, Cambridge 02114, USA.

Publication Types: 
    Review

PMID: 8545020 [PubMed - indexed for MEDLINE]

4454: Neurology. 1995 Dec;45(12 Suppl 8):S47-9.

Localization of varicella-zoster virus nucleic acids and proteins in human skin.

Nikkels AF, Debrus S, Sadzot-Delvaux C, Piette J, Rentier B, Pierard GE.

Department of Dermatopathology, University of Liege, Belgium.

The pathogenic mechanisms involved in varicella-zoster virus (VZV) infections
remain elusive. The pattern of cutaneous distribution of the IE63 protein and of 
the gpI (gE) and gpII glycoproteins with their corresponding genome sequences
during VZV infections was studied by immunohistochemistry and in situ
hybridization. Skin biopsy specimens were obtained from immunocompetent and
immunocompromised patients with varicella, herpes zoster, or atypical VZV
lesions. The first evidence for VZV infection consisted of the presence of IE63
in keratinocytes. In the vesicles and pustules, the viral transcripts gpI, gpII, 
and IE63 and the corresponding nucleic acids for gpI and gpII were identified in 
keratinocytes, sebocytes, Langerhans cells, dermal dendrocytes,
monocytes/macrophages, and endothelial cells. The gpI and gpII glycorpoteins were
essentially located on the cellular membranes while IE63 expression was generally
restricted to the nuclei. In three biopsies of early herpes zoster, viral
proteins were disclosed in dermal nerves and in perineurial type I dendrocytes.
This was never encountered in varicella. Vasculitic changes and endothelial cell 
involvement were more prominent in varicella than in herpes zoster. It is
concluded that the secondary viremia in varicella that affects the dermal
endothelial cells is followed by a cell-to-cell spread to keratinocytes. In
herpes zoster, the viral progression through cutaneous nerves primarily extends
to the pilosebaceous units with a secondary involvement of epidermal
keratinocytes, followed by a further spread to dermal cells.

PMID: 8545019 [PubMed - indexed for MEDLINE]

4455: Neurology. 1995 Dec;45(12 Suppl 8):S41-6.

Immunization to reduce the frequency and severity of herpes zoster and its
complications.

Oxman MN.

Department of Medicine, University of California, San Diego, USA.

Herpes zoster (HZ) is a localized disease that results from reactivation of an
endogenous varicella-zoster virus (VZV) infection that has persisted in latent
form within sensory ganglia following an earlier attack of varicella. The
incidence and the severity of HZ and its complications increase with advancing
age, and this is temporally associated with an age-related decline in
cell-mediated immunity (CMI) to VZV. Information on the cellular site and
mechanism of VZV latency and on the events that follow reactivation appears to
explain many of the clinical features of HZ and to provide a pathophysiologic
basis for the presumption that immunity to VZV plays a critical role in limiting 
the frequency and consequences of VZV reactivation. The close temporal
correlation between the decline in VZV-specific CMI and the increased frequency
and severity of HZ and its complications in older individuals suggests that HZ
may actually develop because VZV-specific CMI falls below some critical
threshold. The development of a live attenuated varicella vaccine provides a
means of stimulating VZV-specific CMI and thus of determining its role in the
pathogenesis of HZ. Levin and his colleagues have demonstrated that waning
VZV-specific CMI in elderly persons can be stimulated by varicella vaccine to
levels typical of those observed in younger persons, in whom the incidence and
severity of HZ are much reduced. Thus the stage is set for a large
placebo-controlled clinical trial that will test directly the hypothesis that
restoration of waning CMI to VZV will reduce the frequency and severity of HZ and
its complications in the elderly.

PMID: 8545018 [PubMed - indexed for MEDLINE]

4456: Neurology. 1995 Dec;45(12 Suppl 8):S33-5.

Transcriptional mapping of varicella-zoster virus regulatory proteins.

Kinchington PR, Vergnes JP, Turse SE.

Department of Ophthalmology and Molecular Genetics, University of Pittsburgh, PA 
15213, USA.

Varicella-zoster virus (VZV) expresses four proteins that influence viral
transcriptional events and that also are homologous to herpes simplex virus type 
1 (HSV-1) immediate-early proteins. However, their transcription and the
mechanisms by which it is regulated are not yet resolved. To identify the
promoter regions, a precise knowledge of the initiation and termination of the
encoded RNAs is first required. In this report, we summarize the complete and
precise mapping of the RNA transcripts of two of these genes--those from open
reading frames 4 and 63. In addition, several elements of their promoter
regulatory regions have been identified and predicted. Structural and functional 
studies of the regulatory sequences suggest that these two VZV genes may be
regulated in a fashion different from that of their HSV-1 counterparts.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8545015 [PubMed - indexed for MEDLINE]

4457: Neurology. 1995 Dec;45(12 Suppl 8):S23-7.

Varicella-zoster virus gene regulation.

Piette J, Defechereux P, Baudoux L, Debrus S, Merville MP, Rentier B.

Department of Microbiology, University of Liege, Belgium.

The varicella-zoster virus genome contains 71 open reading frames (ORFs), five of
which (ORF62, ORF4, ORF63, ORF61, and ORF10) encode regulatory proteins. ORF62
codes for the major immediate early protein of the virus exhibiting DNA-binding
and regulatory functions. This protein, localized in the cell nucleus, is a
functional homologue to ICP4 of herpes simplex virus type 1 (HSV-1). It
trans-activates several varicella-zoster virus promoters of the various gene
classes and autoregulates its own expression. ORF4 protein activates gene
promoters provided they have basal activities, but it is not a functional
homologue of HSV-1 ICP27. Gene regulation activity appears to be linked to its
cysteine-rich C-terminal region. ORF63 codes for an immediate early protein
mainly located in the cell nucleus. The regulatory functions it performs are
still unclear. ORF61 protein is the functional homologue of HSV-1 ICP0. Its
N-terminal region exhibits a RING domain responsible for trans-activating and
trans-repressing activities. ORF10 protein exhibits similarities with HSV-1 VP16 
and activates the ORF62 promoter.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8545012 [PubMed - indexed for MEDLINE]

4458: Neurology. 1995 Dec;45(12 Suppl 8):S21-8.

Varicella-zoster virus ocular infection in the rabbit: a model of human zoster
ophthalmicus.

Dunkel EC, Geary PA, Pavan-Langston D, Piatak M, Zhu Q.

Schepens Eye Research Institute, Harvard Medical School, Boston, MA, USA.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8545011 [PubMed - indexed for MEDLINE]

4459: Neurology. 1995 Dec;45(12 Suppl 8):S18-20.

Varicella-zoster virus latency in the adult rat is a useful model for human
latent infection.

Sadzot-Delvaux C, Debrus S, Nikkels A, Piette J, Rentier B.

Department of Microbiology, University of Liege, Belgium.

A model of latent infection by varicella-zoster virus (VZV) was obtained in the
adult rat. Inoculation of VZV-infected cells in the skin led to infection of the 
peripheral nervous system. Latency was characterized by a long-lasting presence
of the viral genome, of selected viral gene transcripts, and of at least one
viral protein in the dorsal root ganglia. Reactivation has not been obtained in
vivo, but has occurred ex vivo after repeated stresses. Many similarities with
VZV latency in humans were found, making this model useful for vaccine and
antiviral studies.

PMID: 8545010 [PubMed - indexed for MEDLINE]

4460: Neurology. 1995 Dec;45(12 Suppl 8):S1-79.

Updated proceedings of the 2nd International Conference on the Varicella-Zoster
Virus. Paris, France, July 7-8, 1994.

[No authors listed]

Publication Types: 
    Congresses
    Overall
    Research Support, Non-U.S. Gov't

PMID: 8545006 [PubMed - indexed for MEDLINE]

4461: J Virol. 1995 Dec;69(12):8109-13.

Immunization with recombinant varicella-zoster virus expressing herpes simplex
virus type 2 glycoprotein D reduces the severity of genital herpes in guinea
pigs.

Heineman TC, Connelly BL, Bourne N, Stanberry LR, Cohen J.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892, USA.

Varicella-zoster virus (VZV) is an attractive candidate for a live-virus vector
for the delivery of foreign antigens. The Oka vaccine strain of VZV is safe and
effective in humans, and recombinant Oka VZV (ROka) can be generated by
transfecting cells with a set of overlapping cosmid DNAs. By this method, the
herpes simplex virus type 2 (HSV-2) glycoprotein D (gD2) gene was inserted into
an intergenic site in the unique short region of the Oka VZV genome. Expression
of gD2 in cells infected with the recombinant Oka strain VZV (ROka-gD2) was
confirmed by antibody staining of fixed cells and by immunoblot analysis. Immune 
electron microscopy demonstrated the presence of gD2 in the envelope of ROka-gD2 
virions. The ability of ROka-gD2 to protect guinea pigs against HSV-2 challenge
was assessed by inoculating animals with three doses of uninfected human
fibroblasts, fibroblasts infected with ROka VZV, or fibroblasts infected with
ROka-gD2. Neutralizing antibodies specific for HSV-2 developed in animals
immunized with ROka-gD2. Forty days after the third inoculation, animals were
challenged intravaginally with HSV-2. Inoculation of guinea pigs with ROka-gD2
significantly reduced the severity of primary HSV-2 infection (P < 0.001). These 
experiments demonstrate that the Oka strain of VZV can be used as a live virus
vector to protect animals from disease with a heterologous virus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 7494331 [PubMed - indexed for MEDLINE]

4462: Proc Natl Acad Sci U S A. 1995 Nov 21;92(24):10980-4.

Reactivated and latent varicella-zoster virus in human dorsal root ganglia.

Lungu O, Annunziato PW, Gershon A, Staugaitis SM, Josefson D, LaRussa P,
Silverstein SJ.

Department of Microbiology, Columbia University, College of Physicians and
Surgeons, New York, NY 10032, USA.

Ganglia obtained at autopsy were examined by in situ hybridization from one
patient with zoster (also called herpes zoster or shingles), two varicella-zoster
virus (VZV)-seropositive patients with clinical evidence of zoster, one
VZV-seronegative child, and one fetus. Ganglia positive for VZV had a
hybridization signal in both neuronal and nonneuronal satellite cells. Ganglia
obtained from the fetus and from the seronegative infant were consistently
negative for VZV. Two striking observations were evident regarding the presence
of VZV DNA in ganglia obtained from the individual with zoster at the time of
death. First, ganglia innervating the sites of reactivation and ganglia
innervating adjacent sites yielded strongly positive signals in neurons and
satellite cells, whereas ganglia from distant sites were rarely positive. Second,
VZV DNA was found in both the nuclei and the cytoplasm of neurons innervating
areas of zoster. However, in neurons innervating zoster-free areas, VZV DNA was
found only in the nucleus of neurons and their supporting satellite cells.
Immunohistochemistry with a fluorescent monoclonal antibody to the VZV
glycoprotein gpI, a late virus protein, revealed a positive signal in the
cytoplasm of ganglia with clinical evidence of reactivation. These results
illustrate that both neuronal and satellite cells become latently infected
following primary VZV infection. The presence of VZV DNA and gpI in the cytoplasm
of neurons demonstrates productive infection following reactivation at the site
of latency.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7479921 [PubMed - indexed for MEDLINE]

4463: Aten Primaria. 1995 Nov 15;16(8):508-10.

[Herpes zoster in primary care]

[Article in Spanish]

Sanz Gallego PJ, Perez Sanchez FC, Salgado Palacio MD, Lopez Vazquez A.

Publication Types: 
    Letter

PMID: 8527636 [PubMed - indexed for MEDLINE]

4464: Sante. 1995 Nov-Dec;5(6):349-52.

[Prevalence of skin manifestations in AIDS patients in the Lome-Tokoin University
Hospital (Togo)]

[Article in French]

Pitche P, Tchangai-Walla K, Napo-Koura G, Mijiyawa M, Agbere A, Tatagan A.

Hopitaux, praticien hospitalier, Service de dermatovenereologie, CHU-Tokoin,
Lome, Togo.

A prospective study was conducted for 13 months to determine the prevalence of
skin disease in AIDS patients in the Lome teaching hospital. 99 of the 120 AIDS
patients (75 males, 49 females) examined during this period had skin diseases
(82.5% of the cases). This prevalence was 59.99% during 1 to 3 months of AIDS
evolution, 81.77% during 4 to 6 months, and 100% after 6 months. The principal
skin diseases were: pruritic papular eruption (33.33%), oral candidiasis (25%),
herpes zoster (16.16%), hair dystrophies (13.13%), xeroderma (14.60%), furuncle
(10%), seborrheic dermatitis (6.66%), Kaposi's sarcoma (5%) and recurrent
folliculitis (4.16%). Thus, the skin diseases were common in AIDS patients in
Lome, Togo, and tended to be more frequent as immunodeficiency progressed.
Dermatological examination remains important in the detection of HIV infection
and AIDS.

Publication Types: 
    English Abstract

PMID: 8784537 [PubMed - indexed for MEDLINE]

4465: J Investig Allergol Clin Immunol. 1995 Nov-Dec;5(6):350-3.

Impaired response to HBcAg in a hepatitis B virus carrier.

Motoyoshi F, Kondo N, Terasawa S, Orii T.

Department of Pediatrics, Gifu University School of Medicine, Japan.

Hepatitis B virus (HBV) carriers usually produce antibody to HB core antigen
(anti-HBc). We present the case of an HBV carrier who has lacked anti-HBc for a
2-year observation period. Antibody titers against several common viruses (herpes
simplex virus-1, varizella-zoster virus and Epstein-Barr virus) were detected in 
his serum. His lymphocytes proliferated in vitro in response to
phytohemagglutinin and concanavalin A. In contrast to other naturally immune or
chronic HBV carriers, anti-HBc was not produced by his peripheral mononuclear
cells (PBMC) in culture supernatant of pokeweed mitogen-induced anti-HBc
production system. These results suggested that he was in a state of impaired
specific antibody response to HB core antigen (HBcAg).

Publication Types: 
    Case Reports

PMID: 8653225 [PubMed - indexed for MEDLINE]

4466: Clin Infect Dis. 1995 Nov;21(5):1348-9.

Foscarnet-resistant multidermatomal zoster in a patient with AIDS.

Fillet AM, Visse B, Caumes E, Dumont B, Gentilini M, Huraux JM.

Department of Infectious and Tropical Diseases, Pitie-Salpetriere Hospital,
Paris, France.

Publication Types: 
    Case Reports

PMID: 8589182 [PubMed - indexed for MEDLINE]

4467: Pediatr Infect Dis J. 1995 Nov;14(11):935-40.

Disseminated Penicillium marneffei infection in human immunodeficiency
virus-infected children.

Sirisanthana V, Sirisanthana T.

Faculty of Medicine, Chiang Mai University, Thailand.

Disseminated infection with the fungus Penicillium marneffei is one of the most
common opportunistic infections in human immunodeficiency virus (HIV) disease in 
northern Thailand. We report the clinical, laboratory and therapeutic features of
21 human immunodeficiency virus-infected children with disseminated P. marneffei 
who were prospectively followed. Significant clinical and laboratory features
included generalized lymphadenopathy (90%), hepatomegaly (90%), body temperature 
> 38.5 degrees C (81%), papular skin lesions with central umbilication (67%),
splenomegaly (67%), failure to thrive (52%), severe anemia (hemoglobin < 60
g/liter) (43%) and thrombocytopenia (platelet count < 0.5 x 10(11)/liter) (21%). 
The response rate in patients who were treated with appropriate antifungal
therapy (amphotericin B, fluconazole or ketoconazole) was 82%. No relapse was
observed in patients given ketoconazole prophylactically. Skin lesions, usually
papules with central necrotic umbilication, provide the most significant clue to 
the diagnosis. Early diagnosis based on finding P. marneffei in the skin smear or
lymph node provides the basis for prompt administration of antifungal therapy and
improved outcome.

PIP: This report describes the epidemiology of Penicillium marneffei infections
among HIV infected children who were seen at Chiang Mai University Hospital,
Thailand, between April 1989 and January 1995. HIV infections among children 18
months old and older were determined by both enzyme-linked immunosorbent assay
and particle agglutination tests. Confirmation of HIV infection was made among
younger children by signs and symptoms and repeated reactive serum tests.
Diagnosis of P. marneffei infection was determined by isolation of the organism
from clinical blood or tissue specimens. Antifungal agents were administered and 
improvement was recorded. There were 23 cases of P. marneffei among the 362
children diagnosed with HIV infection during the study period. One case was a
non-HIV infected girl and another was a thalassemic patient who had received an
HIV infected blood transfusion. The remaining 21 children acquired the infection 
perinatally. All mothers of the 21 children had acquired the HIV infection as
prostitutes or from husbands who used prostitutes. All 21 children had clinical
cases of HIV infection at the onset of the P. marneffei infection. The median
time of presentation was 32 months. Fever was a primary symptom. 67% had skin
lesions and most lesions were on the face and extremities. Other laboratory
findings are reported. 9 of the 21 children had other HIV-related opportunistic
infections diagnosed at the same time as the diagnosis of P. marneffei. There
were 4 cases of Salmonella bacteremia, 2 cases of cryptosporidiosis, 1 case of
Pseudomonas aeruginosa bacteremia, 1 case of Pneumocystis carinii and
cytomegalovirus pneumonia, and 1 case of nontyphoid Salmonella bacteremia and
herpes zoster. All 7 culture-proved patients who did not receive antifungal
therapy died. 9 culture-proved and 3 other cases responded to antifungal
treatment. Findings suggest that P. marneffei infection should be included as
another AIDS-defining illness. The case fatality rate of patients with P.
marneffei infection was very high, mostly due to late diagnosis.

PMID: 8584358 [PubMed - indexed for MEDLINE]

4468: J Neurol Sci. 1995 Nov;133(1-2):194-6.

Myasthenia gravis, acute transverse myelitis, and HTLV-I.

Ijichi T, Adachi Y, Nishio A, Kanaitsuka T, Ohtomo T, Nakamura M.

Department of Internal Medicine, Shakaihoken Kobe Central Hospital, Japan.

We present the unusual case of a 49-year-old female carrier of HTLV-I with
myasthenia gravis who presented with acute transverse myelitis. Laboratory data
suggested a recent infection with varicella zoster virus and demyelination by an 
autoimmune process in the central nervous system. Adult T-cell leukemia-like
cells were observed in the cerebrospinal fluid. T-cell-mediated immune responses 
modulated by HTLV-I infection may be involved in the pathogenesis of myasthenia
gravis and acute transverse myelitis in this case.

Publication Types: 
    Case Reports

PMID: 8583226 [PubMed - indexed for MEDLINE]

4469: J Med Assoc Thai. 1995 Nov;78(11):624-7.

Treatment of herpes zoster with Clinacanthus nutans (bi phaya yaw) extract.

Sangkitporn S, Chaiwat S, Balachandra K, Na-Ayudhaya TD, Bunjob M, Jayavasu C.

Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand.

A randomized, placebo-controlled trial of the efficacy of topical formulation of 
Clinacanthus nutans (Bi Phaya Yaw) extract was carried out in 51 patients with
varicella-zoster virus infection. The study medication was applied five times
daily for 7-14 days until the lesions were healed. The number of patients with
lesion crusting within 3 days and with lesion healing within 7 days and 10 days
were significantly greater in the C. nutans extract-treated group than the
placebo group (p < 0.01). Pain scores were reduced more rapidly in the C. nutans 
extract-treated group than in the placebo group. There were no side effects of
the study medication.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 8576675 [PubMed - indexed for MEDLINE]

4470: J Dermatol. 1995 Nov;22(11):865-75.

Iontophoresis for enhancing penetration of dermatologic and antiviral drugs.

Gangarosa LP Sr, Ozawa A, Ohkido M, Shimomura Y, Hill JM.

Department of Oral Biology-Pharmacology, School of Dentistry, Medical College of 
Georgia, Augusta 30912-1128, USA.

Iontophoresis is the process of introducing ionic drugs into the body for
therapeutic purposes. Although iontophoresis has the potential for systemic
therapy, it has mainly been used for local therapy at body surfaces. Many ionic
drugs are available including lidocaine, epinephrine, methylprednisolone
succinate, dexamethasone phosphate, several antivirals, various antibiotics, and 
other specific drugs. The use of an indicated ionic drug by iontophoresis offers 
a broad potential for promoting the development of more effective therapies in
dermatology. Iontophoresis of ionized drugs provided a 20-60 fold increase in
penetration over topical application. Iontophoresis for dermatological use
requires that: a) a charged drug be placed at an electrode having a polarity the 
same charge as the drug, b) the condition or disease under treatment be at or
near the body surface, and c) a modern, sophisticated source of direct current,
with appropriate accessories, be used. The current source must have features that
make it not only effective, but also safe for application to the patient. Modern 
systems for application of drugs by iontophoresis have features that make the
process simple and efficient for use in practice. Iontophoresis has a long
history of use, having been suggested for various therapies for many years in
medicine, physical therapy and dentistry. Pilocarpine iontophoresis is a
preferred method for cystic fibrosis detection. Also, lidocaine iontophoresis has
been advocated to anesthetize the tympanic membrane before myringotomy.
Anesthesia of the skin to a depth of 1.0 cm or more has been reported in
double-blind studies of human volunteers. Local anesthesia by iontophoresis was
reported to be effective for: 1) cutaneous cutdowns in patients requiring kidney 
dialysis, 2) delicate eyelid surgery, as the sole anesthetic, 3) preinjection
topical anesthesia, and 4) shave biopsies of skin lesions. The use of
iontophoresis for treating difficult cases of hyperhydrosis is quite popular
among dermatologists. The present report emphasizes uses of iontophoresis in
dermatology and is divided into discussion of studies using iontophoresis for
postherpetic neuralgia, local anesthesia, antiviral therapy, and for
corticosteroid therapy of nonspecific inflammatory lesions. Over 1250 patients
have been treated for postherpetic neuralgia by corticosteroid iontophoresis at 6
medical centers with 60-80% of patients showing a major therapeutic response with
return to a tolerable pain level. Double-blind studies of varicella zoster
(active and postherpetic) and herpes simplex have proven that iontophoresis is a 
valuable modality for treating viral diseases of the skin. Many other uses for
iontophoresis have been proposed in the literature that involve several hundred
research papers, several textbooks and many book chapters. Review of the
literature supports the concept that iontophoresis provides an optimal method for
drug application in therapy of surface tissues.

Publication Types: 
    Review

PMID: 8557860 [PubMed - indexed for MEDLINE]

4471: J Am Acad Dermatol. 1995 Nov;33(5 Pt 1):724-8.

Rapid detection and distinction of cutaneous herpesvirus infections by direct
immunofluorescence.

Zirn JR, Tompkins SD, Huie C, Shea CR.

Department of Dermatology, New York Hospital-Cornell Medical Center, USA.

BACKGROUND: Optimal management of cutaneous herpes simplex virus (HSV) and
varicellazoster virus (VZV) infections requires rapid, accurate distinction
between these pathogens. OBJECTIVE: In a mixed-case series of suspected cutaneous
herpesvirus infections, we compared the diagnostic utility of viral culture and
direct immunofluorescence (DIF) using a panel of fluoresceinated monoclonal
antibodies against HSV and VZV. METHODS: Epifluorescence microscopy of smears and
viral culture were performed in parallel on 58 lesions. RESULTS: DIF and culture 
were equally sensitive (88%) in HSV infections, whereas DIF was four times as
sensitive as culture (100% vs 18%) in VZV. DIF either refuted an incorrect
clinical diagnosis or permitted definitive laboratory diagnosis of a clinically
indeterminate lesion in 7 (12%) of 58 lesions tested. CONCLUSION: DIF is a rapid,
simple, sensitive, specific, cost-effective, and clinically useful technique for 
detecting and distinguishing cutaneous HSV and VZV infections.

Publication Types: 
    Comparative Study

PMID: 7593769 [PubMed - indexed for MEDLINE]

4472: J Clin Epidemiol. 1995 Nov;48(11):1319-24.

Varicella zoster virus and multiple sclerosis in a Hutterite population.

Ross RT, Nicolle LE, Cheang M.

Section of Neurology, University of Manitoba, Winnipeg, Canada.

There are similarities between multiple sclerosis and varicella. They are common 
in the same parts of the world and both are scarce in other areas. Immigration
studies suggest the environmental cause of multiple sclerosis (MS) must be
contracted prior to age 15 years and will usually remain dormant for years. At
age 10 years varicella has occurred in greater than 95% of children living in the
high-risk areas for both of these diseases. The varicella zoster virus (VZV)
could be etiologically important in multiple sclerosis. The known host
containment of the virus for decades with recrudescence and the variable
cell-mediated immunity of the host, which can wax and wane without clinical
manifestations, all lend themselves to the natural history of multiple sclerosis.
A population-based study of the medical records of 5601 Hutterite Brethren was
performed to determine the occurrence of multiple sclerosis, varicella, and
herpes zoster. Compared to their matched non-Hutterite neighbors who acted as
controls, these events were significantly less common among the Hutterites.
Included in the study was an assessment of other common neurological diseases and
"autoimmune" diseases among the Hutterites and the controls. There is evidence of
a relationship between MS and VZV that may not be coincidental.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7490594 [PubMed - indexed for MEDLINE]

4473: Arch Ophthalmol. 1995 Nov;113(11):1381-5.

Delayed herpes zoster pseudodendrites. Polymerase chain reaction detection of
viral DNA and a role for antiviral therapy.

Pavan-Langston D, Yamamoto S, Dunkel EC.

Department of Ophthalmology, Harvard Medical School, Boston, Mass, USA.

BACKGROUND: The late-onset pseudodendrites, delayed corneal mucous plaques, of
herpes zoster ophthalmicus are reported to be of mechanical or immune origin and 
to be worsened by antiviral therapy. OBJECTIVE: To study pseudodendrites to
ascertain a viral presence in the lesions and their response to antiviral
therapy. DESIGN: Prospective clinical study. SETTING: Outpatient and inpatient
hospital-based corneal specialty referral practice; molecular virology
laboratory. PATIENTS: Six patients, aged 33 to 89 years, four with delayed herpes
zoster ophthalmicus pseudodendrites and two with herpes zoster ophthalmicus
neurotrophic ulceration. One patient was immunosuppressed. MAIN OUTCOME MEASURES:
Findings from clinical evaluation; polymerase chain reaction assays of lesions
and tear film of six patients; polymerase chain reaction and light and electron
microscopy of the corneal button from one patient; and the clinical response of
four patients to various antiviral drugs. RESULTS: In contrast to reports in the 
current literature, delayed pseudodendrites may also be infectious, as they are
positive for zoster DNA by polymerase chain reaction and appear responsive to
certain antiviral therapy. The corneal button from an immunosuppressed patient
had mature and immature viral particles in the basal cells within 2 weeks of
transplantation. CONCLUSIONS: To our knowledge, this is the first report of viral
DNA in delayed zoster pseudodendrites. Recurrent viral infection may play a role 
in this form of zoster keratopathy and warrant antiviral therapy.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7487598 [PubMed - indexed for MEDLINE]

4474: Arch Ophthalmol. 1995 Nov;113(11):1358-9.

Detecting varicella-zoster virus DNA in iridocyclitis using polymerase chain
reaction: a case of zoster sine herpete.

Yamamoto S, Tada R, Shimomura Y, Pavan-Langston D, Dunkel EC, Tano Y.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7487588 [PubMed - indexed for MEDLINE]

4475: South Med J. 1995 Nov;88(11):1089-92.

Herpes zoster and internal malignancy.

Smith JB, Fenske NA.

Division of Dermatology and Cutaneous Surgery, University of South Florida, Tampa
33612, USA.

Herpes zoster (HZ) often occurs concomitantly with various internal malignancies,
most commonly hematologic in origin. Authors in the past proposed that HZ was a
marker for internal malignancy, since it is often found in association with a
malignancy. A critical review of the literature revealed that when HZ and
malignancy occur in the same individual, rarely does HZ precede the malignancy,
but usually follows it. Many studies have evaluated HZ in cancer patients, but
only three studies have evaluated the occurrence of malignancy after the
diagnosis of HZ, and all found no increased incidence of internal malignancy in
patients with HZ. Since HZ is a poor marker for internal malignancy, extensive
workups to find occult malignancy are not indicated. In rare cases, however, HZ
precedes a malignancy. We therefore recommend a baseline history and physical
examination, with further directed workup only if there are abnormal findings.

Publication Types: 
    Review

PMID: 7481976 [PubMed - indexed for MEDLINE]

4476: J Virol. 1995 Nov;69(11):7367-70.

The varicella-zoster virus (VZV) open reading frame 47 (ORF47) protein kinase is 
dispensable for viral replication and is not required for phosphorylation of
ORF63 protein, the VZV homolog of herpes simplex virus ICP22.

Heineman TC, Cohen JI.

Medical Virology Section, Laboratory of Clinical Investigation, National
Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA.

To investigate the role of varicella-zoster virus (VZV) open reading frame 47
(ORF47) protein kinase during infection, a VZV mutant was generated in which two 
contiguous stop codons were introduced into ORF47, thus eliminating expression of
the ORF47 kinase. ORF47 kinase was not essential for the growth of VZV in
cultured cells, and the growth rate of the VZV mutant lacking ORF47 protein was
indistinguishable from that of parental VZV. Nuclear extracts from cells infected
with parental VZV contained several phosphorylated proteins which were not
detected in extracts from cells infected with the ORF47 mutant. The herpes
simplex virus type 1 (HSV-1) UL13 protein (the homolog of VZV ORF47 protein) is
responsible for the posttranslational processing associated with phosphorylation 
of HSV-1 ICP22 (the homolog of VZV ORF63 protein). Immunoprecipitation of
32P-labeled proteins from cells infected with parental virus and those infected
with ORF47 mutant virus yielded similar amounts of the VZV phosphoproteins
encoded by ORF4, ORF62, ORF63, and ORF68 (VZV gE), and the electrophoretic
migration of these proteins was not affected by the lack of ORF47 kinase.
Therefore, while the VZV ORF47 protein is capable of phosphorylating several
cellular or viral proteins, it is not required for phosphorylation of the ORF63
protein in virus-infected cells.

PMID: 7474171 [PubMed - indexed for MEDLINE]

4477: J Virol. 1995 Nov;69(11):6779-86.

Role of the virion host shutoff (vhs) of herpes simplex virus type 1 in latency
and pathogenesis.

Strelow LI, Leib DA.

Department of Ophthalmology and Visual Sciences, Washington University School of 
Medicine, St. Louis, Missouri 63110, USA.

The herpes simplex virus type 1 (HSV-1) UL41 gene product, virion host shutoff
(vhs), has homologs among five alphaherpesviruses (HSV-1, HSV-2, pseudorabies
virus, varicella-zoster virus, and equine herpesvirus 1), suggesting a role for
this protein in neurotropism. A mutant virus, termed UL41NHB, which carries a
nonsense linker in the UL41 open reading frame at amino acid position 238 was
generated. UL41NHB and a marker-rescued virus, UL41NHB-R, were characterized in
vitro and tested for their ability to replicate in vitro and in vivo and to
establish and reactivate from latency in a mouse eye model. As demonstrated by
Western blotting (immunoblotting) and Northern (RNA) blotting procedures, UL41NHB
encodes an appropriately truncated vhs protein and, as expected for a vhs null
mutant, fails to induce the degradation of cellular glyceraldehyde-3-phosphate
dehydrogenase mRNA. The growth of UL41NHB was not significantly altered in
one-step growth curves in Vero or mouse C3H/10T1/2 cells but was impaired in
corneas, in trigeminal ganglia, and in brains of mice compared with the growth of
KOS and UL41NHB-R. As a measure of establishment of latency, quantitative DNA PCR
showed that the amount of viral DNA within trigeminal ganglia latently infected
with UL41NHB was reduced by approximately 30-fold compared with that in
KOS-infected ganglia and by 50-fold compared with that in UL41NHB-R-infected
ganglia. Explant cocultivation studies revealed a low reactivation frequency for 
UL41NHB (1 of 28 ganglia, or 4%) compared with that for KOS (56 of 76, or 74%) or
UL41NHB-R (13 of 20 or 65%). Taken together, these results demonstrate that vhs
represents a determinant of viral pathogenesis.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7474089 [PubMed - indexed for MEDLINE]

4478: N Z Med J. 1995 Oct 27;108(1010):432-3.

Herpes zoster during pregnancy: a case report.

Janes R.

Publication Types: 
    Case Reports

PMID: 7478348 [PubMed - indexed for MEDLINE]

4479: Virology. 1995 Oct 20;213(1):28-37.

Identification and transcriptional analysis of a 3'-coterminal gene cluster
containing UL1, UL2, UL3, and UL3.5 open reading frames of bovine herpesvirus-1.

Khattar SK, van Drunen Littel-van den Hurk S, Babiuk LA, Tikoo SK.

Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon,
Canada.

We have identified and sequenced 3113 nucleotides located at the right end of the
HindIII L fragment of the bovine herpesvirus-1 genome from map units 0.712 to
0.734. Analysis of the sequence identified four open reading frames (ORFs) which 
are designated UL1, UL2, UL3, and UL3.5 based on their homology with proteins of 
herpes simplex virus-1 (HSV-1), pseudorabies virus (PRV), equine herpesvirus-1,
and varicella-zoster virus. The UL1 ORF of 158 amino acids exhibits limited
homology with UL1 (glycoprotein gL) of HSV-1 (27%) and PRV (21%). The UL2 ORF of 
204 amino acids shows significant homology to UL2 (uracil-DNA glycosylase) of
HSV-1 (68%) and PRV (75%). The UL3 ORF of 204 amino acids shows significant
homology to UL3 (nuclear phosphoprotein) of HSV-1 (62%) and PRV (53%). The UL3.5 
ORF of 126 amino acids shows limited homology to the UL3.5 ORF of PRV (31%). The 
homolog of this gene is absent in HSV-1. Nucleotide sequence analyses also
revealed potential TATA boxes located upstream of each ORF. However, only one
polyadenylation signal was detected downstream of the UL3.5 ORF. Northern (RNA)
blot analyses revealed four transcripts of 2.4, 1.9, 1.3, and 0.7 kb, which are
transcribed in the same direction and are 3'-coterminal transcripts. These mRNAs 
appear to yield proteins encoded by UL1 (2.4 kb), UL2 (1.9 kb), UL3 (1.3 kb), and
UL3.5 (0.7 kb) ORFs.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7483276 [PubMed - indexed for MEDLINE]

4480: Med Lett Drugs Ther. 1995 Oct 13;37(959):87-94.

Drugs for AIDS and associated infections.

[No authors listed]

PMID: 7565297 [PubMed - indexed for MEDLINE]

4481: FEBS Lett. 1995 Oct 2;373(1):41-4.

The cytostatic activity of 5-(1-azidovinyl)-2'-deoxyuridine (AzVDU) against
herpes simplex virus thymidine kinase gene-transfected FM3A cells is due to
inhibition of thymidylate synthase and enhanced by UV light (lambda = 254 nm)
exposure.

Balzarini J, Andrei G, Kumar R, Knaus EE, Wiebe LI, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

5-(1-Azidovinyl)-2'-deoxyuridine (AzVDU) and a series of
5-[1-azido-2-halogenoethyl]-derivatives of beta-D-arabinofuranosyluracil (AU)
proved markedly inhibitory to the replication of herpes simplex virus type 1
(HSV-1) and varicella zoster virus (VZV), but not thymidine kinase (TK)-deficient
HSV-1 and VZV strains. None of the compounds were cytostatic. However, AzVDU, but
not the 5-[1-azido-2-halogenoethyl]-AU derivatives became highly cytostatic
against HSV-1 and HSV-2 TK gene-transfected FM3A tumor cells. The molecular
target for the cytostatic effect of AzVDU proved to be thymidylate synthase.
Short exposure of AzVDU-treated FM3A TK-/HSV-1 TK+ cells to irradiation at lambda
= 254 nm enhanced the cytostatic activity of AzVDU by 5-fold.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7589430 [PubMed - indexed for MEDLINE]

4482: AIDS Clin Care. 1995 Oct;7(10):83-4.

HIV and family living. Preventing the spread of HIV and other diseases.

Sax P, Weinberger H.

Brigham and Women's Hospital, Boston, MA.

AIDS: HIV is spread through direct contact with body fluids, such as blood,
semen, vaginal fluids, and breast milk. HIV is not spread through everyday
contact. People with HIV are not dangerous to the people they live with at home
or in the community and with whom they have ordinary, non-sexual contact. Certain
precautions should be taken, however, to minimize risk. First, personal items
such as razors, toothbrushes or earrings, should not be shared. Latex gloves
should be worn by uninfected family members when they may come into contact with 
bodily fluids, and the family members should always wash their hands with soap
and water after touching blood and other fluids, even if gloves have been worn.
The person with HIV can be protected by minimizing exposure to food-borne
illnesses carried by raw or undercooked meat, eggs or unpasteurized milk;
limiting contact with people who have colds, the flu or diarrhea; and avoiding
contact with cages or litter boxes of pets. To help clarify sanitary measures,
some frequently asked questions are answered. These questions address the safety 
of sharing food with HIV-infected people; chickenpox infection and emergence of
shingles; prevention of CMV infection; toxoplasmosis and cats; spread of M. avium
complex (MAC); and the safety of contact between HIV-infected people and infants.

Publication Types: 
    Newspaper Article

PMID: 11362833 [PubMed - indexed for MEDLINE]

4483: Clin Infect Dis. 1995 Oct;21(4):989-90.

Herpes zoster in patients with human immunodeficiency virus infection--an
ever-expanding spectrum of disease.

Whitley RJ, Gnann JW Jr.

Publication Types: 
    Editorial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8645853 [PubMed - indexed for MEDLINE]

4484: Clin Infect Dis. 1995 Oct;21(4):986-8.

Chronic varicella-zoster virus myelitis without cutaneous eruption in a patient
with AIDS: report of a fatal case.

Manian FA, Kindred M, Fulling KH.

Division of Infectious Diseases, St. John's Mercy Medical Center, St. Louis,
Missouri 63141, USA.

We describe a fatal case of varicella-zoster virus myelitis that was preceded by 
neurological symptoms for 10 months in a patient with human immunodeficiency
virus infection and an extremely low CD4 cell count (20/microL). The patient was 
also receiving chronic acylovir therapy for suppression of herpes complex.
Despite chronic unilateral periauricular and facial pain, which was later
accompanied by upper- and lower-extremity weakness, a cutaneous eruption never
developed. It is hypothesized that a blunted inflammatory response in the spinal 
cord--possibly related to a very low CD4 cell count--and long-term acylovir
administration might have contributed to the atypical manifestation might have
contributed to the atypical manifestation of varicella-zoster virus-related
neurological disease in this immunocompromised patient.

Publication Types: 
    Case Reports

PMID: 8645852 [PubMed - indexed for MEDLINE]

4485: Clin Infect Dis. 1995 Oct;21(4):1035-7.

Herpes zoster as the initial presentation of human immunodeficiency virus type 1 
infection in Kenya.

Tyndall MW, Nasio J, Agoki E, Malisa W, Ronald AR, Ndinya-Achola JO, Plummer FA.

World Health Organization Collaborating Centre for Research and Training in
Sexually Transmitted Diseases, Nairobi, Kenya.

We conducted a prospective observational study to determine the clinical
features, the degree of immunosuppression, and the prevalence of human
immunodeficiency virus type 1 (HIV-1) infection associated with herpes zoster in 
Kenya. The study included 196 HIV-1 positive individuals and 34 HIV-1 negative
individuals between the ages of 16 and 50 years who presented to a referral
clinic in Nairobi. Comparison of the clinical characteristics in the two groups
found that the duration of illness in the HIV-1-positive group was longer (32 vs.
22 days; P < .001) and that the HIV-1-positive group was more likely to have
generalized lymphadenopathy (74% vs. 3%; OR: 12.2; 95% CI: 1.6, 91.7), severe
pain (69% vs. 39%; OR: 3.6; 95% CI; 1.7, 7.6), bacterial superinfection (15% vs. 
6%; OR: 5.7; 95% CI: 1.3, 25.0), and more than one affected dermatome (38% vs.
18%; OR: 2.8; 95% CI: 1.1, 8.0). Dermatomal distribution of the lesions was
similar in the two groups, except for cranial lesions, which occurred exclusively
in the HIV-1-positive group. The mean CD4 T lymphocyte count at presentation was 
333/mm(3) in the HIV-1-positive group and 777/mm(3) in the HIV-1-negative group
(P < .001). Herpes zoster is often recognized as the initial HIV-1-related
illness in Kenya despite the fact that patients have moderate to severe
depression of CD4 cell counts at presentation. Although the clinical features of 
herpes zoster may be more severe in HIV-1-positive individuals, recovery is
generally complete and uncomplicated.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8645797 [PubMed - indexed for MEDLINE]

4486: J Mol Med. 1995 Oct;73(10):525-8.

Molecular evidence for the existence of disseminated zoster as a distinct entity 
in an immunosuppressed renal transplant patient.

Schlupen EM, Korting HC, Nachbar F, Volkenandt M.

Department of Dermatology, Ludwig-Maximilina University, Munchen, Germany.

Immunosuppressed renal transplant recipient are at substantially increased risk
for the development of varicella zoster virus infections. They are also more
prone than immunocompetent patients to develop atypical zoster and to experience 
a protracted course, and among them there is a higher frequency of generalized
infections with possible fatal outcome. While establishing the diagnosis is
essential to provide adequate therapy, conventional laboratory methods frequently
fail to confirm the suspected infection. We report on a 47-year-old renal
transplant recipient who developed multiple necrotic cutaneous ulcers under
immunosuppressive treatment. While electron-microscopic analysis (negative
staining) revealed no viral structures, varicella zoster virus specific DNA was
detected by polymerase chain reaction in material obtained by a swab from these
ulcers. Atypical herpetic infection should also be considered as a cause of
disseminated ulcerative or necrotic skin lesions in immunosuppressed patients.
Assays based on polymerase chain reaction are useful for the rapid confirmation
or rejection of the suspected diagnosis of atypical herpetic infection.

Publication Types: 
    Case Reports

PMID: 8581515 [PubMed - indexed for MEDLINE]

4487: Pain. 1995 Oct;63(1):93-101.

Capsaicin-induced flare and vasodilatation in patients with post-herpetic
neuralgia.

Morris GC, Gibson SJ, Helme RD.

Prince Philip Hospital, Llanelli, Wales, UK.

The aim of the present study was to investigate the role of primary afferent
fibres with polymodal nociceptors in the various pain symptoms and signs
associated with post-herpetic neuralgia (PHN). Forty-four patients with PHN
affecting thoracic dermatomes were examined clinically for evidence of sensory
disturbance to touch and pinprick and compared to 14 normal subjects and 9
subjects with evidence of past herpes zoster infection but no pain. The patients 
were then divided into 3 groups on the basis of their clinical symptoms and
signs-those with steady burning discomfort only (n = 12), those with burning
discomfort, allodynia and hyperalgesia to pinprick (n = 17), and those with
burning discomfort, allodynia and hypalgesia to pinprick (n = 15). Indirect
measurement of primary afferent fibre function was performed by measuring the
neurogenic axon reflex flare to topical capsaicin using Doppler flowmetry in the 
5 clinical groups. The 2 groups with allodynia had significantly decreased
neurogenic flare responses compared to PHN subjects without allodynia and the 2
control groups. These results suggest that allodynia in patients with
post-herpetic neuralgia may be a consequence of disrupted function of primary
afferent fibres.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8577495 [PubMed - indexed for MEDLINE]

4488: Med Hypotheses. 1995 Oct;45(4):389-91.

Obtaining automated diagnostic information and pain relief.

Collins HW.

The silent confluent flow of a conglomerate of sensory related signals is
automatically delegated to the total specific distribution of a single spinal
nerve. This silent confluent flow may be accessed, evaluated, and modified by
using intradermal saline infiltration to stimulate the sensory receptors located 
in the skin overlying its nerve root. An unmistakable augmented burst of
infiltration pain immediately followed by profound long lasting pain relief
identifies a spinal nerve monitoring peripheral pathology. The identification of 
a monitoring spinal nerve tentatively confirms the presence of pathology confined
to the specific peripheral distribution of that specific spinal nerve. The
practically unknown visceral distribution proves to be specific and visceral
pathology echoes through its collated spinal nerve without patent variation.
Practically cost free and without side effects or contraindications dermatomal
infiltration opens a whole new chapter in the field of diagnosis as it may be
used to determine the presence of pathology, to locate that pathology to the
specific distribution of a specific spinal nerve or nerves, and to produce
unequalled pain relief.

Publication Types: 
    Case Reports

PMID: 8577304 [PubMed - indexed for MEDLINE]

4489: J Paediatr Child Health. 1995 Oct;31(5):483.

Intra-uterine varicella or herpes zoster and childhood deafness.

Mutton PE.

Publication Types: 
    Case Reports
    Letter

PMID: 8554875 [PubMed - indexed for MEDLINE]

4490: Drugs Aging. 1995 Oct;7(4):317-28.

Topical capsaicin. A review of its pharmacological properties and therapeutic
potential in post-herpetic neuralgia, diabetic neuropathy and osteoarthritis.

Rains C, Bryson HM.

Adis International Ltd. Auckland, New Zealand.

Capsaicin, the active principle of hot chili pepper, is thought to selectively
stimulate unmyelinated C fibre afferent neurons and cause the release of
substance P. Prolonged application of capsaicin reversibly depletes stores of
substance P, and possibly other neurotransmitters, from sensory nerve endings.
This reduces or abolishes the transmission of painful stimuli from the peripheral
nerve fibres to the higher centres. In clinical studies of patients with
post-hepatic neuralgia, diabetic neuropathy or osteoarthritis, adjunctive therapy
with topical capsaicin achieved better relief than its vehicle in most studies.
In a single trial, topical capsaicin in demonstrated similar efficacy to oral
amitriptyline in patients with diabetic neuropathy. Topical capsaicin is not
associated with any severe systemic adverse effects. However, stinging and
burning, particularly during the first week of therapy, is reported by many
patients. Topical capsaicin merits consideration as adjuvant therapy in
conditions such as post-herpetic neuralgia, diabetic neuropathy and
osteoarthritis, where the pain can be chronic and difficult to treat.

Publication Types: 
    Comparative Study
    Review

PMID: 8535059 [PubMed - indexed for MEDLINE]

4491: Acta Paediatr Jpn. 1995 Oct;37(5):648-50.

Herpes zoster in a normal child after varicella vaccination.

Matsubara K, Nigami H, Harigaya H, Baba K.

Department of Pediatrics, Nishi-Kobe Medical Center, Japan.

A healthy 5 year old girl developed herpes zoster in the dermatome supplied by
the ophthalmic branch of the fifth cranial nerve 40 months after varicella
vaccination. She was admitted to our hospital because of high fever and painful
vesicular lesions over the left side of her forehead. She was treated
successfully with systemic and topical acyclovir without developing herpetic
keratoconjunctivitis. Our acute and convalescent phase evaluations showed that
non-specific cellular and humoral immunity was normal. This is the fourth case of
herpes zoster developing in an immunocompetent child following vaccination.
Unlike the previously reported cases, our patient required hospitalization mainly
to prevent ocular involvement. The issue concerning whether the universal
introduction of varicella vaccination of normal children will reduce the
incidence of the subsequent occurrence of herpes zoster must await further
studies involving longer follow-up periods.

Publication Types: 
    Case Reports

PMID: 8533598 [PubMed - indexed for MEDLINE]

4492: Fortschr Neurol Psychiatr. 1995 Oct;63(10):383-7.

[Granulomatous vasculitis of the CNS as a complication of herpes zoster
ophthalmicus]

[Article in German]

Terborg C, Busse O.

Neurologische Klinik des Klinikums Minden.

A 61-year old man with a history of arterial hypertension suffered a left HZO,
and was treated with acyclovir. Three weeks later he suddenly developed moderate 
left hemiparesis particularly of the leg, severe paresis of the right leg,
aphasia and somnolence. Treated with IV acyclovir and high-dose corticosteroids
deterioration of the right hemiparesis was apparent. Serological and CSF-studies 
showed acute varicella-zoster virus infection with intrathecal antibody synthesis
(antibody specificity index 2.7). On the third day CT scan revealed infarctions
in the territory of both anterior cerebral arteries, at the fifth day
additionally left striatocapsular infarction. Selective carotid arteriogram
showed bilateral occlusions of anterior cerebral arteries in their proximal
segment. With a mean delay of seven weeks granulomatous vasculitis is a rare
complication of HZO, leading commonly to ischemic infarctions in the region of
the middle cerebral artery. Trigeminovascular connections are the probable
pathway of virus-transmission from the trigeminal nerve to ipsilateral branches
of the circle of Willis. Because of the presumed pathogenesis immediate therapy
with high-dose corticosteroids and acyclovir is justified.

Publication Types: 
    English Abstract

PMID: 8529986 [PubMed - indexed for MEDLINE]

4493: An Med Interna. 1995 Oct;12(10):501-2.

Comment in:
    An Med Interna. 1996 Sep;13(9):459-60.

[Acyclovir nephrotoxicity]

[Article in Spanish]

Briso-Montiano JM, Hernandez E, Escudero E, Mendiluce A, Sanchez L, Miyar V.

Servicio de Nefrologia, Hospital Clinico-Universitario, Valladolid.

We are presenting the case of a seventy-six year old male infected with Herpes
zoster of the trigeminal nerve. He had no previous nephropathology, but developed
acute renal failure following the administration of an intravenous bolus of
Acyclovir. The existing literature was reviewed. Possible pathogenic mechanisms
are discussed, and precautions against nephrotoxicity are emphasized.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8519942 [PubMed - indexed for MEDLINE]

4494: AIDS. 1995 Oct;9(10):1153-8.

Herpes zoster, immunological deterioration and disease progression in HIV-1
infection.

Veenstra J, Krol A, van Praag RM, Frissen PH, Schellekens PT, Lange JM, Coutinho 
RA, van der Meer JT.

Department of Public Health and Environment, University of Amsterdam, The
Netherlands.

OBJECTIVE: To study the incidence of herpes zoster, the relationship between
herpes zoster and immunological markers, and the prognostic value of herpes
zoster for progression of HIV disease. DESIGN AND METHODS: A total of 966
homosexual participants in The Amsterdam Cohort Study were studied. Herpes zoster
was defined by its characteristic clinical presentation. Incidence was calculated
using Poisson regression, cumulative incidence by the Kaplan-Meier product-limit 
method and the prognostic value was evaluated using Cox proportional hazards
model. RESULTS: The incidence of first episodes of herpes zoster was 3.31 per
1000 person-years (PY) in HIV-seronegatives and 51.51 per 1000 PY in
HIV-1-seropositive individuals. Recurrences only occurred in HIV-1-positive
patients (25.6%). Cumulative incidences of first episodes increased linearly with
the duration of follow-up. In HIV-1-seropositives the incidence was 31.2 per 1000
PY at CD4+ cells > or = 500 x 10(6)/l, 47.2 per 1000 PY [relative risk (RR),
1.51; 95% confidence interval (CI), 0.78-2.94] at CD4+ cells 200-499 x 10(6)/l
and 97.5 per 1000 PY (RR, 3.13; 95% CI, 1.54-6.32) at CD4+ cells < 200 x 10(6)/l.
Besides CD4+ cell counts, CD3 monoclonal antibodies and
phytohaemagglutinin-induced T-cell reactivity were independent predictors for
herpes zoster. The hazard ratio for AIDS after herpes zoster was 1.6 (95% CI,
1.1-2.4) and for death 1.7 (95% CI, 1.1-2.5), but these were not independent from
CD4+ cell counts. CONCLUSION: In HIV-1 infection the incidence of herpes zoster
increases with the decrease of CD4+ cell counts and T-cell reactivity, but herpes
zoster is not an independent predictor for disease progression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8519451 [PubMed - indexed for MEDLINE]

4495: J Infect Dis. 1995 Oct;172(4):1087-90.

Detection of herpesvirus DNA by nested polymerase chain reaction in cerebrospinal
fluid of human immunodeficiency virus-infected persons with neurologic disease: a
prospective evaluation.

Fox JD, Brink NS, Zuckerman MA, Neild P, Gazzard BG, Tedder RS, Miller RF.

Department of Medical Microbiology, University College London Medical School and 
Hospitals, United Kingdom.

A nested polymerase chain reaction-based method was used prospectively to detect 
herpesvirus DNA in cerebrospinal fluid (CSF) from 111 patients with AIDS, 39 of
whom had a suspected diagnosis of cytomegalovirus (CMV)-associated neurologic
disease (patients with encephalopathy, polyradiculopathy, or peripheral
neuropathy) and 72 who had alternative diagnoses. CSF from 24 (62%) of the
patients with suspected CMV-associated disease had detectable CMV DNA compared
with only 8 (11%) of the patients with other diagnoses. Varicella-zoster virus
DNA was detected in CSF from 3 patients (2 with myelitis and 1 with
encephalitis), all of whom had recent cutaneous zoster. No CSF specimen contained
detectable herpes simplex virus type 1 DNA, and none of the patients with
myelitis had detectable herpes simplex virus type 2 DNA in CSF. This study
demonstrates a significant association between detectable CMV DNA in CSF and
suspected CMV-associated neurologic disease in patients with AIDS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7561185 [PubMed - indexed for MEDLINE]

4496: J Laryngol Otol. 1995 Oct;109(10):1013-5.

Ramsay Hunt syndrome mimicking acoustic neuroma on MRI.

Goldsmith P, Zammit-Maempel I, Meikle D.

Nuffield Department of Medicine, John Radcliffe Hospital, Oxford.

Publication Types: 
    Case Reports

PMID: 7499937 [PubMed - indexed for MEDLINE]

4497: Transplant Proc. 1995 Oct;27(5 Suppl 1):10-2.

Antiviral antibodies in transplantation.

Snydman DR.

Department of Medicine, New England Medical Center, Boston, Massachusetts 02111, 
USA.

Antiviral antibodies clearly play a role in organ transplantation. The only
antibody with a licensed indication for this population is CMVIG; however, the
use of HBIG has become the standard of care for those patients at risk for HBV
recurrence, and the use of VZIG would appear to be indicated for exposures to
varicella-zoster in patients lacking immunity. Future studies defining the role
of antiviral antibodies for therapy are necessary, and the role of antibody to
prevent the EBV PTLD remains to be explored.

Publication Types: 
    Review

PMID: 7482809 [PubMed - indexed for MEDLINE]

4498: Lancet. 1995 Sep 30;346(8979):914-5.

Are varicella zoster and herpes simplex sentinel lesions for cytomegalovirus in
renal transplant recipients?

Lippmann BJ, Brennan DC, Wong J, Lowell JA, Singer GG, Howard TK.

Publication Types: 
    Letter

PMID: 7564715 [PubMed - indexed for MEDLINE]

4499: J Med Chem. 1995 Sep 29;38(20):4106-14.

Synthesis and antiproliferative and antiviral activity of
2'-deoxy-2'-fluoroarabinofuranosyl analogs of the nucleoside antibiotics
toyocamycin and sangivamycin.

Krawczyk SH, Nassiri MR, Kucera LS, Kern ER, Ptak RG, Wotring LL, Drach JC,
Townsend LB.

Department of Medicinal Chemistry, College of Pharmacy, University of Michigan,
Ann Arbor 48109-1065, USA.

The glycosylation of 3,4-dicyano-2-[(ethoxymethylene)amino]pyrrole (7) with
2-deoxy-2-fluoro-alpha-D-erythro-pentofuranosyl bromide (2) furnished an anomeric
mixture of nucleosides (8a,b). This mixture was separated, and the individual
anomers were treated with methanolic ammonia to effect a concomitant deblocking
and ring closure. This furnished both anomers of
2'-deoxy-2'-fluoro-ara-toyocamycin (9a,b). The cyano moiety of 9b was converted
to the carboxamide moiety to furnish 2'-deoxy-2'-fluoro-ara-sangivamycin (10) and
to the thiocarboxamide moiety to furnish 2'-deoxy-2'-fluoro-ara-thiosangivamycin 
(11). The target compounds 10 and 11 showed similar antiproliferative activity
against L1210 cells in vitro, with IC50's of 3 and 5 microM. Antiviral evaluation
revealed a somewhat different pattern of activity. All analogs, both alpha and
beta anomers, were active against human cytomegalovirus (HCMV), albeit the beta
anomers were most active. The beta anomers also were active against herpes
simplex virus type 1 (HSV-1) and human immunodeficiency virus (HIV). Compound 10 
was most active in the series, ca. 10-fold more potent than 11; IC50's for 10
ranged from 4 to 25 nM for HCMV, HIV, and varicella zoster virus (VZV) and from
30 to 500 nM for HSV-1. Even though compound 10 was cytotoxic, which will
probably preclude its use as an antiviral drug (IC50's = 0.2-5.5 microM), the
difference between cytotoxicity and activity against HCMV, HIV, and VZV was
sufficient to indicate specific activity against a viral target.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7562946 [PubMed - indexed for MEDLINE]

4500: Proc Natl Acad Sci U S A. 1995 Sep 26;92(20):9333-7.

Hydrophobic cluster analysis predicts an amino-terminal domain of
varicella-zoster virus open reading frame 10 required for transcriptional
activation.

Moriuchi H, Moriuchi M, Pichyangkura R, Triezenberg SJ, Straus SE, Cohen JI.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, MD 20892, USA.

Varicella-zoster virus open reading frame 10 (ORF10) protein, the homolog of the 
herpes simplex virus protein VP16, can transactivate immediate-early promoters
from both viruses. A protein sequence comparison procedure termed hydrophobic
cluster analysis was used to identify a motif centered at Phe-28, near the amino 
terminus of ORF10, that strongly resembles the sequence of the activating domain 
surrounding Phe-442 of VP16. With a series of GAL4-ORF10 fusion proteins, we
mapped the ORF10 transcriptional-activation domain to the amino-terminal region
(aa 5-79). Extensive mutagenesis of Phe-28 in GAL4-ORF10 fusion proteins
demonstrated the importance of an aromatic or bulky hydrophobic amino acid at
this position, as shown previously for Phe-442 of VP16. Transactivation by the
native ORF10 protein was abolished when Phe-28 was replaced by Ala. Similar
amino-terminal domains were identified in the VP16 homologs of other
alphaherpesviruses. Hydrophobic cluster analysis correctly predicted activation
domains of ORF10 and VP16 that share critical characteristics of a distinctive
subclass of acidic activation domains.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7568128 [PubMed - indexed for MEDLINE]

4501: Acta Otolaryngol. 1995 Sep;115(5):577-84.

Gd-DPTA enhanced MRI in Bell's palsy and herpes zoster oticus: an overview and
implications for future studies.

Jonsson L, Tien R, Engstrom M, Thuomas KA.

Department of Oto-Rhino-Laryngology, Uppsala University, Akademiska sjukhuset,
Sweden.

Magnetic resonance imaging (MRI) is a new and important tool for use in
diagnosing and investigating diseases affecting the facial nerve. In recent
gadolinium-DTPA enhanced MRI (Gd-MRI) studies it has unequivocally been
demonstrated that ipsilateral facial nerve contrast enhancement, predominantly in
the meatal portion, is present in both Bell's palsy and herpes zoster oticus. In 
this overview, the results of MRI studies performed on patients with acute
peripheral facial palsy, especially Bell's palsy and herpes zoster oticus, are
discussed. The Gd-MRI pattern in Bell's palsy is very similar to that seen in
herpes zoster oticus, and the findings reported so far support the theory that an
inflammation may be the cause of the nerve injury in both cases. So far, however,
Gd-MRI has not been helpful in evaluating the severity and/or prognosis of the
facial palsy. Further studies employing improved techniques, including
three-dimensional fast (or turbo) spin echo (3DFSE) MRI with heavily T2-weighted 
sections and high resolution three-dimensional Fourier transform (3DFT) MRI, need
to be conducted in order to determine whether it is possible to follow the course
of the disease and whether MRI and/or Gd-MRI are useful prognostic tools in the
early stages of palsy.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8928627 [PubMed - indexed for MEDLINE]

4502: Pharmacotherapy. 1995 Sep-Oct;15(5 Pt 2):49S-58S.

Cost-consequence models for varicella-zoster virus infections.

Paul JE, Mauskopf JA, Bell L.

Care Management Division, Glaxo Wellcome USA Inc., Research Triangle Park, North 
Carolina 27709, USA.

Three cost-consequence models were developed for treatment of infections due to
varicella-zoster virus (VZV) with acyclovir in immunocompetent patients--adult-
and childhood-onset chickenpox, and herpes zoster (shingles) in adults. For
chickenpox, separate models allow examination of differences in severity and
impact of the disease for children and adults, as well as in the management of
civilians and adults in military service. Each model includes direct medical
costs, indirect costs and health-related productivity loss, symptom and quality
of life impact, and model assumptions and conclusions. Alternatives of treatment 
and no treatment are addressed. Quality of life impact is conceptualized in terms
of a quality-adjusted life-days decrement due to VZV symptoms of importance to
the patient, such as pain, rash, and itching. As experience and data become
available, alternative agents such as valacyclovir and famciclovir for the
treatment of patients with herpes zoster should be included in the modeling
process.

Publication Types: 
    Comparative Study

PMID: 8577631 [PubMed - indexed for MEDLINE]

4503: Pharmacotherapy. 1995 Sep-Oct;15(5 Pt 2):43S-48S.

Management of herpesvirus infections in the healthy host.

Dudley MN.

Antiinfective Pharmacology Research Unit, University of Rhode Island College of
Pharmacy, Roger Williams Medical Center, Providence 02908-4734, USA.

Human herpesvirus infections continue to be a concern in immunocompetent as well 
as immunocompromised hosts. They are often life threatening in the
immunocompromised patient. In the healthy immunocompetent person the infections
tend to be self-limited, although they can directly or indirectly cause periods
of severe discomfort and disability, and their treatment can affect productivity,
as shown by cost-outcome models. Treatment of primary or secondary episodes in
the immunocompetent host is therefore directed toward more rapid resolution of
initial and recurrent episodes, thereby limiting the impact of the infections.

Publication Types: 
    Comparative Study
    Review

PMID: 8577630 [PubMed - indexed for MEDLINE]

4504: Rhinology. 1995 Sep;33(3):180-2.

Hutchinson's sign and its importance in rhinology.

Tomkinson A, Roblin DG, Brown MJ.

Department of Otolaryngology, Royal Gwent Hospital, Newport, United Kingdom.

Herpes zoster ophthalmicus usually has a typical appearance. However, if the
disease is limited to the nasociliary branch of the trigeminal nerve, the ocular 
appearance may be confusing. Hutchinson in 1865 first noted that involvement of
the external nasal branch of the fifth cranial nerve was associated with an
increased incidence of ocular zoster. A case of herpes zoster ophthalmicus is
presented that clinically resembled an ocular complication of sinus disease. The 
presence of a localized vesicular rash at the nasal tip assisted in an early
diagnosis. Although this sign is known amongst ophthalmologists, its importance
in rhinology is stressed. An anatomical explanation of Hutchinson's sign is given
and the treatment of herpes zoster ophthalmicus is briefly discussed.

Publication Types: 
    Case Reports

PMID: 8560175 [PubMed - indexed for MEDLINE]

4505: Rev Neurol. 1995 Sep-Oct;23(123):1063-6.

[CNS vasculitis after ophthalmic herpes zoster infection]

[Article in Spanish]

Munoz A, Vinuela F, Mesa A, Fernandez JM, Garcia Moreno JM, Izquierdo G.

Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla.

We present a case of cerebral vasculitis secondary to infection with Varicella
Zoster Virus which appeared in a 27 year old patient after a latency period of
eight weeks. We emphasize the usefulness of angioresonance as a fitting means of 
evolutive follow up without the need to carry out control cerebral angiography.
We likewise point out the usefulness of acyclovir as the sole treatment necessary
in non-complicated cases.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8556594 [PubMed - indexed for MEDLINE]

4506: Burns. 1995 Sep;21(6):477.

Ophthalmic zoster as a reason for admission into a regional burns unit.

Greenwood JE, Davenport PJ.

Publication Types: 
    Case Reports
    Letter

PMID: 8554696 [PubMed - indexed for MEDLINE]

4507: Br J Dermatol. 1995 Sep;133(3):472-4.

Mucocutaneous histoplasmosis in AIDS.

Souza Filho FJ, Lopes M, Almeida OP, Scully C.

Department of Oral Pathology, University of Campinas, Picacicaba-SP, Brazil.

A 36-year-old man, who was an intravenous drug abuser, developed thoracic herpes 
zoster, paronychia, oral candidosis, necrotizing gingivitis and bilateral parotid
salivary gland swelling. Granulomatous oral lesions and ulceration on the nose
were shown to be due to disseminated histoplasmosis.

Publication Types: 
    Case Reports
    Review

PMID: 8547008 [PubMed - indexed for MEDLINE]

4508: Clin J Pain. 1995 Sep;11(3):220-8.

Continuous epidural infusion of local anesthetics and shorter duration of acute
zoster-associated pain.

Manabe H, Dan K, Higa K.

Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.

OBJECTIVE: The purpose of this study was to investigate the effects of continuous
epidural blockade on acute zoster-associated pain, compared with intermittent
epidural blocks. DESIGN: The design was a retrospective, nonrandomized study.
SETTING: The study was conducted at a university hospital in Japan from 1982
through 1992. PATIENTS: A total of 178 otherwise healthy patients hospitalized
with moderate or severe herpes zoster lesions. INTERVENTIONS: Group A (n = 66)
had intermittent epidural blocks using 1% mepivacaine, 4-6 ml, three to six time 
daily; group B (n = 43) were given intermittent epidural blocks and parenteral
acyclovir (500 mg/day) or vidarabine (600 mg/day) for 5 days; group C (n = 69)
were administered a continuous epidural 0.5% bupivacaine infusion (0.3-1.0 ml/h) 
for approximately 2 weeks and antiviral agents followed by intermittent blocks.
MAIN OUTCOME MEASURES: The number of treatment days was used as the outcome
measure. RESULTS: The length of treatment was significantly shorter in group C
than in groups A or B. For moderate lesions the means (days) were 36.2 [95%
confidence interval (CI), 31.4-41.7), 45.6 (95% CI, 34.0-61.4), and 26.8 (95% CI,
22.3-32.3) for groups A, B, and C, respectively (p < 0.01). For severe lesions
they were 73.3 (95% CI, 55.1-97.7), 81.7 (95% CI, 59.1-113.0), and 44.9 (95% CI, 
35.2-57.3) for groups A, B, and C, respectively (p < 0.01). CONCLUSIONS:
Continuous epidural blockade for patients with acute zoster can shorten the
duration of treatment and may reduce the incidence of postherpetic neuralgia.

PMID: 8535042 [PubMed - indexed for MEDLINE]

4509: J Rheumatol. 1995 Sep;22(9):1636-45.

Comment in:
    J Rheumatol. 1995 Sep;22(9):1611-7.

Combination drug therapy of seropositive rheumatoid arthritis.

McCarty DJ, Harman JG, Grassanovich JL, Qian C, Klein JP.

Department of Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.

OBJECTIVE. To determine the longterm morbidity and mortality in a cohort of 169
patients with seropositive rheumatoid arthritis (RA) treated by a single
rheumatologist with remittive agents used in combination. The effectiveness of a 
regimen combining pulse oral methotrexate, azathioprine and an antimalarial drug 
(MAH) was examined in detail. METHODS. All outpatient visits by patients followed
for at least one year and up to 18 years (mean 7 years) were abstracted.
Remittive antirheumatic drugs were used in combination to achieve progressive
improvement. Univariate and multivariate analyses of the differences between
first and last visit results in 9 process or outcome variables were calculated
for the entire cohort, for those patients receiving or not receiving MAH at last 
visit, and for those patients taking methotrexate but not in combination with
both azathioprine and an antimalarial. The numbers of patients in remission
(Lansbury articular index zero), and near remission (articular index < 6) were
determined for each of these groups. A survival curve was calculated. RESULTS.
The entire patient cohort showed improvement in every variable except hemoglobin 
at the time of the last visit (p < 0.0004). On multivariate analysis MAH patients
were improved only in American Rheumatism Association functional class compared
to the other groups (p < 0.0001). Remission and near remission rates overall were
43 and 61%; for MAH patients 45 and 69% (p = n.s.). Survival was no different
from that of the general population. Herpes zoster (17 patients) and second
attacks of varicella (2 patients) were the most striking side effects. Prednisone
use was reduced from 34 to 19% of patients and the mean daily dose was lowered
from 9.3 to 5.9 mg. CONCLUSION. Combination therapy with multiple antirheumatic
agents successfully controlled joint inflammation in 167 of 169 patients with
seropositive RA; complete remission was achieved in 43% of patients. Survival of 
this patient cohort did not differ from that of the general population.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8523336 [PubMed - indexed for MEDLINE]

4510: Anesth Analg. 1995 Sep;81(3):646-8.

A case of herpes zoster myelitis occurring during epidural analgesia.

Oda Y, Terai T, Yukioka H, Fujimori M.

Department of Anesthesiology and Intensive Care Medicine, Osaka City University
Medical School, Japan.

Publication Types: 
    Case Reports

PMID: 7653839 [PubMed - indexed for MEDLINE]

4511: Laryngorhinootologie. 1995 Sep;74(9):553-4.

[Detection of serum IgA antibodies to varicella zoster virus (VZV)--differential 
etiology of peripheral facial paralysis. A case report]

[Article in German]

May G, May W.

Institut fur Virusdiagnostik am Hyg.-bakt. Landesuntersuchungsamt, Westfalen,
Munster.

During the early manifestation of peripheral facial paralysis, VZV specific IgA
antibodies were detected in the serum in a single case. In similar cases, this
serological parameter should be tested for causal diagnosis in connection with
early Aciclovir therapy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7495437 [PubMed - indexed for MEDLINE]

4512: Aust Fam Physician. 1995 Sep;24(9):1747; quiz 1747-8.

Shingles in a 63 year old woman.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 7487662 [PubMed - indexed for MEDLINE]

4513: J Neuroradiol. 1995 Sep;22(3):184-92.

[CMV and VZV encephalitis in AIDS]

[Article in French]

Hassine D, Gray F, Chekroun R, De Truchis P, Schouman-Claeys E, Vallee C.

Service de Radiologie, Hopital Raymond Poincare, Garches.

MATERIAL AND METHODS: Eighty patients were followed up prospectively.
Histological correlation was obtained in 25 cases. All MRI examinations were
performed on at 0.5 Tesla in T1-weighted sequences with and without gadolinium
injection, and in axial or frontal T2-weighted spin echo sequences. Histological 
confirmation was obtained 30 days on average after the last MRI examination.
Immunohistochemical stainings were performed in search of CMV, VZV, toxoplasma,
HIV antigen and lymphoma. RESULTS: CMV meningoencephalitis was found in 6 cases. 
In 3 of these it was manifested by atrophy, either isolated or associated with
high signal intensity punctiform areas. Histology detected cortical or
subcortical microglial nodules. In 2 cases MRI displayed abnormalities of
subependymal nodular signals without enhancement, associated with punctiform
abnormalities of subcortical signals. Histology showed subependymal foci of
necrosis and abnormalities of white matter. In one case, MRI showed a
ventriculitis confirmed by histology. VZV meningoencephalitis was diagnosed in 2 
cases. MRI displayed abnormal basal ganglia related to meningitis (n = 1). All
abnormalities were confirmed at histology. CONCLUSION: Some images
(ventriculitis, infarction in basal ganglia, abnormal subependymal signal) would 
suggest VZV and CMV encephalitis. Other images (abnormalities of punctiform
signals or atrophy) are not specific.

Publication Types: 
    English Abstract

PMID: 7472535 [PubMed - indexed for MEDLINE]

4514: J Neuroradiol. 1995 Sep;22(3):180-3.

[Pathologic anatomy of cytomegalovirus encephalomyelitis and varicella-zona virus
encephalomyelitis]

[Article in French]

Henin D, Gervaz E, Seilhean D.

Service d'Anatomie et de Cytologie Pathologiques, Hopital Beaujon, Clichy.

Cytomegalovirus (CMV) infection of the nervous system is frequent in acquired
immunodeficiency syndrome (AIDS) and can be responsible for encephalitis,
encephalomyelitis, meningoradiculitis or polyradiculo-neuropathy. Encephalitis is
characterized at microscopy by its periventricular and cerebellar location, and
by the presence of cytomegalic cells, containing intranuclear and/or
intracytoplasmic inclusions, microglial nodules and necrotic foci. The virus can 
infect almost all types of cells. Coexistence of CMV and HIV has been observed in
giant cells of macrophagic origin. It has been suggested that the two viruses
could act in synergy. The nervous system is seldom infected by the
varicella-zoster virus (VZV) in AIDS. The infection can be responsible for
multifocal leukoencephalitis, ventriculitis, vascular lesions associated or not
with cerebral infarction, or with meningomyeloradiculitis. In almost all cell
types Cowdry's type A intranuclear inclusions have been found. The virus can be
demonstrated by immunohistochemistry or in situ hybridization. VZV antigens have 
been reported in the walls of vessels damaged by a non inflammatory obliterating 
vasculopathy or by a granulomatous angiitis. Coexistence of VZV and HIV has been 
observed in giant cells of macrophagic origin, and synergy between those two
viruses has been suspected.

Publication Types: 
    English Abstract
    Review

PMID: 7472534 [PubMed - indexed for MEDLINE]

4515: Dtsch Med Wochenschr. 1995 Aug 18;120(33):1133-8.

[Herpes zoster: a herpes non-simplex disease]

[Article in German]

Wutzler P, Doerr HW.

Institut fur Antivirale Chemotherapie der Universitat Jena.

Publication Types: 
    Comparative Study
    Review

PMID: 7656839 [PubMed - indexed for MEDLINE]

4516: N Engl J Med. 1995 Aug 17;333(7):408-13.

Erratum in:
    N Engl J Med 1995 Nov 16;333(20):1367.

Comment in:
    N Engl J Med. 1995 Aug 17;333(7):450-1.    N Engl J Med. 1995 Dec 28;333(26):1783.

A controlled trial of zidovudine in primary human immunodeficiency virus
infection.

Kinloch-De Loes S, Hirschel BJ, Hoen B, Cooper DA, Tindall B, Carr A, Saurat JH, 
Clumeck N, Lazzarin A, Mathiesen L, et al.

Central Laboratory of Virology, Geneva University Hospital, Switzerland.

BACKGROUND. It is possible that antiretroviral treatment given early during
primary infection with the human immunodeficiency virus (HIV) may reduce acute
symptoms, help preserve immune function, and improve the long-term prognosis.
METHODS. To assess the effect of early antiviral treatment, we conducted a
multicenter, double-blind, placebo-controlled trial in which 77 patients with
primary HIV infection were randomly assigned to receive either zidovudine (250 mg
twice daily; n = 39) or placebo (n = 38) for six months. RESULTS. The mean time
from the onset of symptoms until enrollment in the study was 25.1 days. Among the
43 patients who were still symptomatic at the time of enrollment, there was no
appreciable difference in the mean (+/- SE) duration of the retroviral syndrome
between the zidovudine group (15.0 +/- 4.1 days) and the placebo group (15.8 +/- 
3.6 days). During a mean follow-up period of 15 months, minor opportunistic
infections developed in eight patients: oral candidiasis in four, herpes zoster
in two, and oral hairy leukoplakia in two. Disease progression was significantly 
less frequent in the zidovudine group (one opportunistic infection) than in the
placebo group (seven opportunistic infections; P = 0.009 by the log-rank test).
After adjustment for the base-line CD4 cell count, the patients treated with
zidovudine had an average gain of 8.9 CD4 cells per cubic millimeter per month
(95 percent confidence interval, -1.4 to 19.1) during the first six months of the
study, whereas those receiving placebo had an average loss of 12.0 CD4 cells per 
cubic millimeter per month (95 percent confidence interval, 5.2 to 18.7), for a
between-group difference of 20.9 CD4 cells per cubic millimeter per month (95
percent confidence interval, 8.5 to 33.2; P = 0.001). CONCLUSIONS. Antiretroviral
therapy administered during primary HIV infection may improve the subsequent
clinical course and increase the CD4 cell count.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 7616989 [PubMed - indexed for MEDLINE]

4517: Ned Tijdschr Geneeskd. 1995 Aug 12;139(32):1657.

[Acetylsalicylic acid in acute and postherpetic neuralgia should no be dissolved 
in chloroform]

[Article in Dutch]

van Horssen N.

Laboratorium der Nederlandse Apothekers, Den Haag.

PMID: 7566222 [PubMed - indexed for MEDLINE]

4518: Arch Intern Med. 1995 Aug 7-21;155(15):1605-9.

The incidence of herpes zoster.

Donahue JG, Choo PW, Manson JE, Platt R.

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital,
Boston, Mass., USA.

BACKGROUND: There are few population-based studies of the natural history and
epidemiology of herpes zoster. Although a relatively common cause of morbidity,
especially among the elderly, contemporary estimates of herpes zoster incidence
are lacking. Herein we describe a population-based investigation of incident and 
recurrent herpes zoster from 1990 through 1992 in a health maintenance
organization. METHODS: The health maintenance organization's automated medical
records contain clinical and administrative information about care rendered to
patients in ambulatory settings, emergency departments, and hospitals. Cases of
herpes zoster were ascertained by screening the medical record for coded
diagnoses. The predictive value of a herpes zoster diagnosis code was determined 
by review of a sample of patient records. Records from all patients with
potential recurrences were also reviewed. RESULTS: The overall incidence, based
on 1075 cases in 500,408 person-years, was 215 per 100,000 person-years (95%
confidence interval, 192 to 240 per 100,000) and did not vary by gender. Although
the rate increased sharply with age, approximately 5% of the cases occurred among
children younger than 15 years. Infection with human immunodeficiency virus was
documented in 5% of the persons with incident herpes zoster and cancer in 6%.
Four persons had confirmed recurrences of herpes zoster (744 per 100,000
person-years; 95% confidence interval, 203 to 1907); three of these persons were 
infected with the human immunodeficiency virus. CONCLUSIONS: The recorded
incidence of herpes zoster was 64% higher than that reported 30 years ago; the
age-standardized rate was more than twofold higher. Immunosuppressive conditions 
had little impact on overall incidence, although they were strongly associated
with early recurrences.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7618983 [PubMed - indexed for MEDLINE]

4519: Dtsch Med Wochenschr. 1995 Aug 4;120(31-32):1102.

[Therapy of peripheral facial nerve paralysis and hearing loss]

[Article in German]

Huttenbrink KB.

Klinik und Poliklinik fur Hals-Nasen-Ohrenheilkunde der Technischenn Universitat,
Dresden

Publication Types: 
    Comparative Study

PMID: 7543839 [PubMed - indexed for MEDLINE]

4520: Clin Diagn Virol. 1995 Aug;4(2):105-12.

Detection of varicella-zoster virus (VZV) DNA in throat swabs and peripheral
blood mononuclear cells of immunocompromised patients with herpes zoster by
polymerase chain reaction.

Ito M, Nishihara H, Mizutani K, Kitamura K, Ihara T, Kamiya H, Sakurai M.

Department of Pediatrics, Mie University School of Medicine, 2-174 Edobashi, Tsu,
Mie Japan.

BACKGROUND: Varicella-zoster virus (VZV) is rarely isolated from throat swabs and
peripheral blood leukocytes from patients with herpes zoster by conventional
virus isolation methods. The polymerase chain reaction (PCR) is a highly
sensitive method to detect VZV genomes. It has been reported that VZV DNA was
detected in the cerebrospinal fluid (Puchhammerstockl et al., 1991) and
peripheral blood mononuclear cells (PBMC) of patients with VZV-associated
neurological symptoms (Gilden et al., 1992) by PCR. OBJECTIVES: We used the
nested double PCR to detect VZV DNA in patients with herpes zoster. STUDY DESIGN:
Sixteen patients with herpes zoster, ten immunocompromised and six
immunocompetent patients, were studied. Throat swabs and PBMC were collected
weekly and examined for VZV DNA by the nested double PCR. RESULTS: VZV DNA was
detected in 60% (6/10) of throat swabs and in 60% (6/10) of PBMC of
immunocompromised patients, and in 16.7% (1/6) of throat swabs and in 33% (2/6)
of PBMC of immunocompetent patients within two weeks after the onset of skin
rash. VZV DNA was detected in throat swabs or PBMC of two patients 5 and 7 days
after cessation of acyclovir. CONCLUSION: VZV DNA was detected in throat swabs
and PBMC-associated viremia exist in patients with herpes zoster. It is suggested
that VZV spread from sensory ganglia to the skin or pharyngeal area along the
nerve fiber or hematogenously and local cutaneous replication of VZV can lead to 
viremia with subsequent hematogenous dissemination in patients with herpes
zoster.

PMID: 15566832 [PubMed]

4521: AIDS Alert. 1995 Aug;10(8):97-100.

Clinicians not providing necessary pain relief for AIDS patients.

[No authors listed]

AIDS: At a recent seminar on pain management in Atlanta, researchers reported
that health care providers do poorly when it comes to recognizing and managing
the pain suffered by patients with AIDS. This lack of adequate attention is
reflected in the lack of relevant studies about pain management in the medical
literature. As with cancer, AIDS pain increases with disease progression.
However, patients with AIDS tend to be more depressed than cancer patients, and
have a higher rate of suicidal thoughts. Experts at the seminar discussed the
obstacles involved in treating pain in AIDS patients who have a history of
substance abuse. According to one study, pain medication addiction is rare in
patients. Providers must distinguish between tolerance and physical dependence.
Guidelines for managing pain in substance abusers include respecting the
patient's reports of pain, and setting clear goals and conditions for opioid
therapy. Using a team approach that recognizes pharmacological and
non-pharmacological interventions, and that pays attention to psychosocial issues
will also lead to greater success in treating patients with pain. The most common
painful illnesses are HIV-related headaches, herpes simplex, peripheral
neuropathy, back pain, herpes zoster, and throat pain.

Publication Types: 
    Newspaper Article

PMID: 11362681 [PubMed - indexed for MEDLINE]

4522: An Med Interna. 1995 Aug;12(8):410-1.

[Polyradiculitis and cutaneous herpes zoster]

[Article in Spanish]

Sanchez Ayuso FJ, Sicilia Enriquez de Salamanca JJ.

Publication Types: 
    Case Reports
    Letter

PMID: 8924538 [PubMed - indexed for MEDLINE]

4523: Clin Infect Dis. 1995 Aug;21(2):370-5.

Comment in:
    Clin Infect Dis. 1996 Jun;22(6):1128-9.

Clinical spectrum of herpes zoster in adults infected with human immunodeficiency
virus.

Glesby MJ, Moore RD, Chaisson RE.

Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, 
Maryland 21205, USA.

To determine the incidence and clinical manifestations of herpes zoster in a
hospital-based clinic for adults infected with human immunodeficiency virus
(HIV), we reviewed the records of all patients for whom zoster was diagnosed at
or after their first clinic visit. Fifty-two episodes of zoster occurred in 45
patients during 1,614 person-years of follow-up (incidence, 3.2 episodes per 100 
person-years). The following major complications of zoster occurred in 12
patients (27%): ocular complications (5), neurological complications (4), and
chronic atypical skin lesions (5). Six patients each had postherpetic neuralgia
and bacterial superinfection, which were the common minor complications of
zoster. Multivariate analysis revealed that only a low CD4 cell count (< or =
200/mm3) was predictive of a major complication of zoster (OR, 13.2; 95% CI,
1.52-114; P = .019). Thus, complications of herpes zoster are common in patients 
with HIV infection, especially those with advanced immunosuppression.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8562746 [PubMed - indexed for MEDLINE]

4524: Clin Infect Dis. 1995 Aug;21 Suppl 1:S114-20.

Herpesvirus infections in persons infected with human immunodeficiency virus.

Stewart JA, Reef SE, Pellett PE, Corey L, Whitley RJ.

Division of Viral and Rickettsial Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia 30333, USA.

Herpesviruses are among the most common causes of infections of humans. Viruses
in this family share the unique biological property of being able to establish
latency and to recur. Furthermore, chronic excretion of virus is not uncommon. In
the immunocompromised host, including persons with human immunodeficiency virus
(HIV) infection, herpesvirus disease can be particularly severe, resulting in
chronic, persistent, active infection and, in some cases, life-threatening
disease. The most pathogenic of the herpesviruses in patients with AIDS include
herpes simplex viruses, human cytomegalovirus, and varicella-zoster virus.
Disease caused by Epstein-Barr virus, particularly opportunistic malignancies,
has been recognized. A new herpesvirus that is associated with Kaposi's sarcoma
was recently described. On the other hand, disease caused by human herpesviruses 
6 and 7 in persons infected with HIV remains to be unequivocally recognized.
Prevention of exposure to herpesviruses, disease, and recurrence requires
different measures than those for some of the other opportunistic infections in
HIV-infected patients; this is because herpesvirus disease develops in most of
these individuals as a result of reactivation rather than primary infection.
Thus, approaches to the prevention and control of herpesvirus infections must be 
individualized according to both the type of virus as well as the type of
infection (i.e., primary or recurrent). We discuss recommended measures for the
prevention and control of these infections.

Publication Types: 
    Review

PMID: 8547499 [PubMed - indexed for MEDLINE]

4525: Drugs. 1995 Aug;50(2):396-415.

Famciclovir. A review of its pharmacological properties and therapeutic efficacy 
in herpesvirus infections.

Perry CM, Wagstaff AJ.

Adis International Limited, Auckland, New Zealand.

Famciclovir, a synthetic acyclic guanine derivative, is a prodrug which, after
oral administration, is rapidly metabolised to the highly bioavailable antiviral 
compound penciclovir. Penciclovir is active in vitro against the herpesviruses
herpes simplex virus (HSV)-1, HSV-2 and varicella zoster virus (VZV). Famciclovir
is an effective treatment of immunocompetent patients with acute herpes zoster
(shingles) caused by VZV. Comparative studies have demonstrated that famciclovir 
has therapeutic efficacy similar to that of oral aciclovir (acyclovir) in
attenuating the acute signs and symptoms of infection (including pain during the 
acute phase of infection). In a placebo-controlled study, famciclovir
significantly reduced the duration of postherpetic neuralgia; this effect was
more pronounced (almost a 3-fold reduction) in patients aged > or = 50 years. In 
immunocompetent patients with recurrent genital herpes infection, suppressive
treatment with oral famciclovir effectively prolonged the time to recurrence of
symptomatic episodes of infection compared with placebo. In addition, famciclovir
significantly reduced the duration of viral shedding, accelerated healing of
genital herpes lesions and reduced the duration of symptoms. Famciclovir is
reported to be the first antiviral agent to significantly reduce symptoms
associated with multiple genital herpes lesions. Famciclovir is a well-tolerated 
drug with a tolerability profile similar to that of placebo and aciclovir. Thus, 
famciclovir is now established as an effective treatment of immunocompetent
patients with herpes zoster or genital herpes infection, particularly as
famciclovir is administered in a convenient dosage regimen that may improve
compliance compared with aciclovir.

Publication Types: 
    Comparative Study
    Review

PMID: 8521764 [PubMed - indexed for MEDLINE]

4526: Arch Ophthalmol. 1995 Aug;113(8):972-3.

Bilateral optic neuritis following herpes zoster ophthalmicus.

Deane JS, Bibby K.

Publication Types: 
    Case Reports
    Letter

PMID: 7639667 [PubMed - indexed for MEDLINE]

4527: Am J Ophthalmol. 1995 Aug;120(2):252-3.

Aqueous and vitreous humor samples for the diagnosis of cytomegalovirus
retinitis.

Mitchell SM, Fox JD.

Moorfields Eye Hospital, London, United Kingdom.

PURPOSE/METHODS: Techniques for detection of viral DNA based on the polymerase
chain reaction are increasingly being applied to ocular fluids; however, the
clinical significance of such findings can sometimes be unclear. Two patients had
the acquired immunodeficiency syndrome (AIDS) in whom different herpesviruses
were detected in aqueous and vitreous fluids from the involved eye.
RESULTS/CONCLUSIONS: In both patients dual viral infections were present and the 
application of polymerase chain reaction-based methods to ocular fluids made a
useful contribution to the treatment of the patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7639312 [PubMed - indexed for MEDLINE]

4528: J Gen Virol. 1995 Aug;76 ( Pt 8):1927-35.

Construction of a herpes simplex virus/varicella-zoster virus (HSV/VZV) thymidine
kinase recombinant with the pathogenic potential of HSV and a drug sensitivity
profile resembling that of VZV.

Bevilacqua F, Davis-Poynter N, Worrallo J, Gower D, Collins P, Darby G.

Deaprtment of Molecular Biology, Wellcome Research Laboratories, Beckenham, Kent,
UK.

A recombinant of herpes simplex virus (HSV) was constructed in which the HSV
thymidine kinase (TK) gene was deleted and the varicella-zoster virus (VZV) TK
gene was introduced into the US5 region under the control of the human
cytomegalovirus IE promoter. Infection with the recombinant (R18) led to the
induction of TK although the kinetics of synthesis resembled those of a 'late'
gene product. The recombinant was virulent in the zosteriform mouse model with
the pattern of pathogenesis similar to that of wild-type HSV-1. The sensitivity
of the recombinant to several nucleoside analogues was assessed and in most cases
(BVaraU, ACV and GCV) it resembled VZV rather than HSV. The enhanced sensitivity 
of the recombinant to BVaraU compared with wild-type HSV resulted in a far
greater response to treatment with BVaraU as assessed in the mouse model.

PMID: 7636473 [PubMed - indexed for MEDLINE]

4529: Am J Respir Crit Care Med. 1995 Aug;152(2):738-45.

Pulmonary function tests in HIV-infected patients without AIDS. Pulmonary
Complications of HIV Infection Study Group.

Rosen MJ, Lou Y, Kvale PA, Rao AV, Jordan MC, Miller A, Glassroth J, Reichman LB,
Wallace JM, Hopewell PC.

Department of Medicine, Beth Israel Medical Center, New York, New York 10003,
USA.

To determine the prevalence, incidence, and types of lung diseases that occur in 
association with HIV infection, 1,353 subjects, including HIV-seropositive
homosexual men, injection drug users, female sexual partners of HIV-positive men,
and HIV-seronegative control subjects from the first two transmission categories 
were evaluated prospectively in a multicenter study. Patients with AIDS at the
time of initial evaluation were excluded. One thousand two-hundred ninety-four
subjects who had no AIDS-defining diagnosis within 3 mo of enrollment had
measurements of FVC, FEV1 and DLCO at the time of enrollment. As a group, all
subjects had mean values of FVC and FEV1 close to 100% predicted. Those with CD4 
counts below 200/mm3 had slightly reduced DLCO compared with the others. Subjects
with a history of HIV-associated symptoms (thrush, weight loss, herpes zoster)
also had a reduced DLCO compared with those without symptoms. Injection drug
users had reduced FVC, FEV1 and DLCO compared with homosexual men and female
sexual partners of HIV-infected men, with DLCO more substantially reduced. Part
of the reduction in DLCO in drug users was attributable to factors other than HIV
infection, especially cigarette smoking and race. Using predicted values that
take cigarette smoking into account, the prevalence of abnormality in DLCO was
higher among injection drug users (33.3%) than among homosexual men (11.2%) and
female sexual partners (12.7%). These results show that advanced HIV infection,
characterized by CD4 count < 200/mm3 or HIV-associated symptoms, and factors
unrelated to HIV infection, including race, cigarette smoking, and injection drug
use, are all associated with reductions in DLCO measurements.

Publication Types: 
    Comparative Study
    Multicenter Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 7633736 [PubMed - indexed for MEDLINE]

4530: J Neurol Neurosurg Psychiatry. 1995 Aug;59(2):198-9.

Herpes zoster meningoencephalitis without rash: varicella zoster virus DNA in
CSF.

Powell KF, Wilson HG, Croxson MO, Marshall MR, Wong EH, Anderson NE, Thomas MG.

Publication Types: 
    Case Reports
    Letter

PMID: 7629547 [PubMed - indexed for MEDLINE]

4531: J Virol. 1995 Aug;69(8):4693-701.

Proteins and cis-acting elements associated with transactivation of the
varicella-zoster virus (VZV) immediate-early gene 62 promoter by VZV open reading
frame 10 protein.

Moriuchi H, Moriuchi M, Cohen JI.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, Bethesda, Maryland 20892, USA.

Varicella-zoster virus (VZV) open reading frame 10 (ORF10) protein, the homolog
of herpes simplex virus type 1 (HSV-1) VP16, is a virion-associated
transactivator of the VZV immediate-early (IE) gene 62 (IE62) promoter. VP16
forms a complex with cellular factors (Oct1 and host cell factor [HCF]) and
TAATGARAT elements (found in all HSV-1 IE promoter/enhancer sequences) to mediate
stimulation of IE transcription. The VZV IE62 promoter also contains three
TAATGARAT-like elements. Mutagenesis studies of the VZV IE62 promoter indicated
that TAATGARAT-like elements contribute to transactivation of the VZV IE62
promoter by ORF10 protein. Other cis-acting elements such as GA-rich and cyclic
AMP-responsive elements were also needed for full transactivation by ORF10
protein. In mobility shift assays, ORF10 protein formed a complex with either of 
two TAATGARAT-like elements that lack an overlapping octamer-binding motif
(octa-/TAATGARAT) but not with a TAATGARAT element with an overlapping
octamer-binding motif (octa+/TAATGARAT). In contrast, VP16 formed a high-affinity
ternary complex with an octa+/TAATGARAT element and a low-affinity complex with
octa-/TAATGARAT elements. Addition of antibodies to ORF10 protein, Oct1, or HCF
disrupted the complexes, demonstrating that ORF10 protein interacts with Oct1 and
HCF. These results suggest that transactivation of the VZV IE62 gene by ORF10
protein and HSV IE genes by VP16 require similar cellular proteins but distinct
cis-acting elements.

PMID: 7609034 [PubMed - indexed for MEDLINE]

4532: J Neurol Sci. 1995 Aug;131(2):190-9.

Avidity distribution of antibodies against peripheral nerve myelin in patients
with polyneuropathy associated with IgM monoclonal gammopathy and in healthy
controls.

Vrethem M, Ekerfelt C, Ernerudh J.

Department of Neurology, University Hospital, Linkoping, Sweden.

To elucidate the role and nature of antibodies against peripheral nerve myelin
(PNM) we studied their avidity distribution. Twelve patients with demyelinating
polyneuropathy associated with IgM monoclonal gammopathy were compared with 12
healthy blood donors previously found to have anti-PNM antibodies of IgM isotype.
For comparison, the avidity distribution of IgM antibodies against the varicella 
zoster antigen in 10 patients with herpes zoster infection was also studied.
Microtitre plates containing antibody bound to antigen were exposed to increasing
concentrations of sodium thiocyanate (NaSCN) followed by an ELISA assay. NaSCN
changes the ion strength and the pH, and thereby the critical conditions for
antibody-antigen binding. Resistance to NaSCN was used as a measure of antibody
avidity. Anti-PNM antibodies from patients with monoclonal gammopathy were of
predominantly low avidity whereas antibodies from blood donors were of
predominantly high avidity. Avidity index, representing the molar concentration
of NaSCN required to reduce the initial absorbance values by 50%, was on average 
11.7 times higher in blood donors (range 0.24-2.65, mean = 0.82) than in patients
with monoclonal gammopathy (range 0.04-0.10, mean = 0.07) (p = 0.002). On the
other hand, patients with monoclonal gammopathy had on average a 100-fold higher 
relative concentration of antibodies against PNM compared to blood donors (range 
4.1-392.6 AU, mean 85.0 AU, and range 0.2-1.7 AU, mean 0.85 AU, respectively) (p 
= 0.002). Antibodies against the varicella zoster antigen from patients with
herpes zoster showed a high avidity index (range 0.25-2.6, mean = 1.24). Using
Western blot, several 14-30 kDa proteins in PNM were found to be the target
antigen for IgM anti-PNM antibodies in both patients with monoclonal gammopathy
and polyneuropathy, and in blood donors.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7595646 [PubMed - indexed for MEDLINE]

4533: Kansenshogaku Zasshi. 1995 Aug;69(8):908-12.

[Incidence of herpes zoster in pediatricians and history of reexposure to
varicella-zoster virus in patients with herpes zoster]

[Article in Japanese]

Terada K, Hiraga Y, Kawano S, Kataoka N.

Department of Pediatrics, Kawasaki Medical School.

We found that pediatricians have enhanced specific cellular immunity to
varicella-zoster virus (VZV) compared with the general population, which may be
due to reexposure to VZV from children with chickenpox. There have been some
reported that the varicella vaccine enhance the specific cellular immunity. To
estimate the efficacy of varicella vaccine for protection against herpes zoster
in the elderly, we investigated the incidence of herpes zoster in 500
pediatricians and family practitioners with their fifties and sixties, and
history of reexposure to VZV in 61 patients with herpes zoster by questionnaires 
retrospectively. Thirty-four of 352 pediatricians had a past history of herpes
zoster. The incidence per 100,000 person-years of herpes zoster was 65.2 in those
in their fifties and 158.2 in those in their sixties, which are 1/2 to 1/8 of
other reports regarding the general population. Among 61 immunocompetent patients
with herpes zoster, only 4 patients (6.6%) had the chance for reexpose to VZV
before their herpes zoster. Only 7 (17.5%) of the 40 patients older than 50 years
of age lived with their children less than 14 years of age. Twenty-three (57.5%) 
of them lived without their children and grandchildren. They are thought to be
less chance to reexpose to VZV through children. We may think that the booster
effect by reexposure to VZV plays an important role to prevent herpes zoster.
Therefore, we can speculate that the varicella vaccine may protect against herpes
zoster in the elderly by the enhanced specific cellular immunity due to the
booster effect.

Publication Types: 
    English Abstract

PMID: 7594784 [PubMed - indexed for MEDLINE]

4534: Arch Dis Child. 1995 Aug;73(2):162-3.

Reactivation of chickenpox contracted in infancy.

Terada K, Kawano S, Hiraga Y, Morita T.

Department of Paediatrics, Kawasaki Medical School, Okayama, Japan.

Varicella zoster virus DNA in mononuclear cells was studied by the polymerase
chain reaction to obtain virological evidence of reactivation in the children who
had contracted chickenpox in infancy. The results appear to explain why
chickenpox in infancy is a risk factor for herpes zoster in immunocompetent
children.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7574864 [PubMed - indexed for MEDLINE]

4535: Rev Clin Esp. 1995 Aug;195(8):530-3.

[Herpes-zoster virus infection in patients with systemic lupus erythematosus]

[Article in Spanish]

Moga I, Formiga F, Canet R, Pac M, Mitjavila F, Pujol R.

Servicio de Medicina Interna, Hospital de Bellvitge-Princeps d'Espanya, CSU de
Bellvitge.

The prevalence of infection with VZV in 145 patients with SLE was investigated,
with a mean follow-up of 7.6 years; its relationship with different variables,
particularly with therapy of the underlying disease, was analyzed. Twenty
episodes of VZV infection in 19 patients were diagnosed (13.1%). In no case was
the therapeutic regime changed nor was worsening of SLE observed. There was
neither dissemination of herpes nor superinfection. An increase in the number of 
VZV infections was observed in patients with SLE under corticosteroid therapy (p 
= 0.04) and particularly when drug administration was on a daily basis (p =
0.00006). Cytotoxic agents also favored the infection (p = 0.0014). VZV infection
is of a benign nature in SLE and its emergence is favored by immunosuppressive
agents. The risk is lower if corticosteroid administration is on alternate days. 
There is no need to decrease therapy for SLE.

Publication Types: 
    English Abstract

PMID: 7569198 [PubMed - indexed for MEDLINE]

4536: J Laryngol Otol. 1995 Aug;109(8):777-80.

Early diagnosis and treatment of Ramsay Hunt syndrome: the role of magnetic
resonance imaging.

Kuo MJ, Drago PC, Proops DW, Chavda SV.

Department of Otolaryngology and Radiology, Queen Elizabeth Hospital, Birmingham,
UK.

We present the case of a 47-year-old woman with left otalgia, rotatory vertigo,
sensorineural hearing loss and acute facial nerve palsy. An enhanced magnetic
resonance imaging (MRI) scan showed discrete enhancement of the facial and
vestibulocochlear nerves in the left internal auditory canal as well as of the
labyrinth. This appearance was compatible with that in Ramsay Hunt syndrome and
acyclovir was started prior to the appearance of any vesicular eruption. The
diagnosis was subsequently confirmed serologically. She regained full facial
function but the sensorineural hearing loss persisted. The literature pertaining 
to the role of the MRI in acute facial palsies is reviewed.

Publication Types: 
    Case Reports
    Review

PMID: 7561508 [PubMed - indexed for MEDLINE]

4537: J Dermatol. 1995 Aug;22(8):625-6.

Mild reduction of generalized rash in guinea pigs experimentally infected with
varicella zoster virus or herpes simplex virus type 1.

Horiuchi Y, Okuno T, Yamanishi K.

Publication Types: 
    Letter

PMID: 7560465 [PubMed - indexed for MEDLINE]

4538: Antimicrob Agents Chemother. 1995 Aug;39(8):1802-8.

Mode of action of (R)-9-[4-hydroxy-2-(hydroxymethyl)butyl]guanine against
herpesviruses.

Lowe DM, Alderton WK, Ellis MR, Parmar V, Miller WH, Roberts GB, Fyfe JA,
Gaillard R, Ertl P, Snowden W, et al.

Wellcome Research Laboratories, Beckenham, Kent, United Kingdom.

The activity, metabolism, and mode of action of
(R)-9-[4-hydroxy-2-(hydroxymethyl)butyl]guanine (H2G) against herpes simplex
virus type 1 (HSV-1) and type 2 (HSV-2) and varicella-zoster virus (VZV) were
studied. Compared to acyclovir (ACV), H2G has superior activity against VZV (50% 
inhibitory concentration of 2.3 microM) and Epstein-Barr virus (50% inhibitory
concentration of 0.9 microM), comparable activity against HSV-1, and weaker
activity against HSV-2. The antiviral effect on HSV-1 showed persistence after
removal of compound. H2G was metabolized to its mono-, di- and triphosphate
derivatives in virus-infected cells, with H2G-triphosphate being the predominant 
product. Only small amounts of H2G-triphosphate were detected in uninfected cells
(1 to 10 pmol/10(6) cells), whereas the level in HSV-1-infected cells reached
1,900 pmol/10(6) cells. H2G was a substrate for all three viral thymidine kinases
and could also be phosphorylated by mitochondrial deoxyguanosine kinase. The
intracellular half-life of H2G-triphosphate varied in uninfected (2.5 h) and
infected (HSV-1, 14 h; VZV, 3.7 h) cells but was always longer than the half-life
of ACV-triphosphate (1 to 2 h). H2G-triphosphate inhibited HSV-1, HSV-2, and VZV 
DNA polymerases competitively with dGTP (Ki of 2.8, 2.2, and 0.3 microM,
respectively) but could not replace dGTP as a substrate in a polymerase assay.
H2G was not an obligate chain terminator but would only support limited DNA chain
extension. Only very small amounts of radioactivity, which were too low to be
identified by high-performance liquid chromatography analysis of the digested
DNA, could be detected in purified DNA from uninfected cells incubated with
[3H]H2G. Thus, H2G acts as an anti-herpesvirus agent, particularly potent against
VZV, by formation of high concentrations of relatively stable H2G-triphosphate,
which is a potent inhibitor of the viral DNA polymerases.

PMID: 7486922 [PubMed - indexed for MEDLINE]

4539: Anal Biochem. 1995 Jul 20;229(1):92-8.

Production of membrane vesicles by extrusion: size distribution, enzyme activity,
and orientation of plasma membrane and chloroplast inner-envelope membrane
vesicles.

Shingles R, McCarty RE.

Department of Biology, Johns Hopkins University, Baltimore, Maryland 21218-2685, 
USA.

A comparison of plasma membrane vesicles prepared by a freeze/thaw method was
made with vesicles prepared by extrusion through a 100-nm polycarbonate filter.
Based on ATPase measurements in the presence or absence of detergent, plasma
membrane vesicles were approximately 30% right-side-out in freeze/thaw vesicles, 
whereas vesicles produced by extrusion were approximately 80% right-side-out.
Chloroplast inner-envelope membrane vesicles were loaded with a
membrane-impermeant, pH-sensitive fluorophore, pyranine, by either freeze/thaw or
extrusion techniques. ATP-linked proton transport activity was considerably lower
in vesicles prepared by extrusion compared to vesicles prepared by freeze/thaw.
However, total ATPase activity measured as ADP release from ATP was equivalent in
both preparations of vesicles. These results suggest that the inner-envelope
vesicles produced by extrusion were predominantly oriented right-side-out.
Inner-envelope vesicles were loaded internally with phosphate to study
proton-linked transport of 3-phosphoglycerate. Vesicle acidification by
3-phosphoglycerate addition was similar in both freeze/thaw and extruded vesicle 
preparations, indicating that metabolite transport by the phosphate translocator 
is both functional and bidirectional. These results indicate that extrusion can
be used as a method to produce proteoliposomes which are competent for transport 
studies.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 8533901 [PubMed - indexed for MEDLINE]

4540: Ann Intern Med. 1995 Jul 15;123(2):89-96.

Comment in:
    ACP J Club. 1995 Nov-Dec;123(3):67.    Ann Intern Med. 1999 Nov 2;131(9):712-3.

Famciclovir for the treatment of acute herpes zoster: effects on acute disease
and postherpetic neuralgia. A randomized, double-blind, placebo-controlled trial.
Collaborative Famciclovir Herpes Zoster Study Group.

Tyring S, Barbarash RA, Nahlik JE, Cunningham A, Marley J, Heng M, Jones T, Rea
T, Boon R, Saltzman R.

University of Texas Medical Branch, Galveston, USA.

OBJECTIVE: To document the effects of treatment with famciclovir on the acute
signs and symptoms of herpes zoster and postherpetic neuralgia. DESIGN: A
randomized, double-blind, placebo-controlled, multicenter trial. SETTING: 36
centers in the United States, Canada, and Australia. PATIENTS: 419
immunocompetent adults with uncomplicated herpes zoster. INTERVENTION: Patients
were assigned within 72 hours of rash onset to famciclovir, 500 mg; famciclovir, 
750 mg; or placebo, three times daily for 7 days. MEASUREMENTS: Lesions were
assessed daily for as long as 14 days until full crusting occurred and then
weekly until the lesions healed. Viral cultures were obtained daily while
vesicles were present. Pain was assessed at each of the visits at which lesions
were examined and then monthly for 5 months after the lesions healed. Safety was 
assessed throughout the study. RESULTS: Famciclovir was well tolerated, with a
safety profile similar to that of placebo. Famciclovir accelerated lesion healing
and reduced the duration of viral shedding. Most importantly, famciclovir
recipients had faster resolution of postherpetic neuralgia (approximately twofold
faster) than placebo recipients; differences between the placebo group and both
the 500-mg famciclovir group (hazard ratio, 1.7 [95% CI, 1.1 to 2.7]) and the
750-mg famciclovir group (hazard ratio, 1.9 [CI, 1.2 to 2.9]) were statistically 
significant (P = 0.02 and 0.01, respectively). The median duration of
postherpetic neuralgia was reduced by approximately 2 months. CONCLUSIONS: Oral
famciclovir, 500 mg or 750 mg three times daily for 7 days, is an effective and
well-tolerated therapy for herpes zoster that decreases the duration of the
disease's most debilitating complication, postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7778840 [PubMed - indexed for MEDLINE]

4541: Int J Antimicrob Agents. 1995 Jul;5(4):209-17.

Pharmacology and clinical use of foscarnet.

Gerard L, Salmon-Ceron D.

Department of Infectious and Tropical Diseases, Bichat-Claude Bernard Hospital,
Paris, France.

Foscarnet, licenced by Astra pharmaceutical products, is a pyrophosphate analogue
that selectively inhibits replication of viruses in infected cells. It inhibits
in vitro the replication of all herpes viruses, including human cytomegalovirus
(HCMV) at concentrations of 100 to 300 mumol/l and has a dose-related inhibitory 
effect on HIV-1 virus, influenza virus and hepatitis B virus. It does not require
intra-cellular phosphorylation for antiviral activity. Oral bioavailability of
foscarnet is low (12-22%), and foscarnet must be administered intravenously. It
is mainly eliminated unchanged by the kidneys. Mean half-life in plasma ranges
from 3.4 to 5 h. For acute therapy, the currently recommended regimen is 60 mg/kg
t.i.d. or 90-100 mg/kg b.i.d. In AIDS patients, foscarnet is an effective
treatment of HCMV retinitis. Healing or stabilisation of lesions is obtained in
85-95% of patients after 2 weeks or 3 weeks therapy. For HCMV gastrointestinal
disease, complete or partial response rates of 57-95% have been reported with
foscarnet. The optimal maintenance dosage of foscarnet necessary in CMV
infections in AIDS patients remains to be clearly established. Data from small
samples size studies have shown that foscarnet decreased significantly
circulating levels of HIV antigen in AIDS patients with HCMV disease. Foscarnet
is an effective treatment for acyclovir-resistant herpes simplex virus and for
acyclovir-resistant varicella-zoster virus (40 mg/kg every 8 h). In patients with
immunosuppression not HIV-related HCMV infections, particularly interstitial
pneumonia in transplant recipients, experience with foscarnet is limited. The
major adverse effect of foscarnet is reversible renal dysfunction, due to acute
tubular toxicity. In may be partially prevented by hyperhydratation during the
treatment. Fluctuations in serum calcium and phosphore levels, with both increase
and decrease are also frequent adverse reactions. Most clinical symptoms are
related to decrease in ionized calcium levels. Hyperphosphatemia, a clinically
benign phenomenom, reflects the incorporation of foscarnet in bone. Penile
ulcerations have been described and may result from mococutaneous direct toxicity
of foscarnet eliminated in urine. Although relapses frequently occur after a few 
months of maintenance therapy, foscarnet that shows a marked activity against
HCMV in vitro, has allowed important progress in therapy of HCMV infections in
AIDS patients.

PMID: 18611671 [PubMed - in process]

4542: Parkinsonism Relat Disord. 1995 Jul;1(1):13-9.

Movement disorders in AIDS: Infective, neoplastic and iatrogenic causes.

Manji H, Sweeney B, Connolly S, Hughes A, Miller RF, Harrison MJ.

Department of Neurological Studies, University College and Middlesex Hospital
Medical School, London, UK.

We present seven cases of movement disorders encountered in patients with AIDS at
a national referral centre over a 4 year period. These include cases of chorea
athetosis due to cerebral toxoplasmosis, progressive multifocal
leucoencephalopathy, cerebral infarction due to Herpes zoster infection and
hypoglycaemia secondary to pentamidine therapy, wing beating tremor as a result
of primary cerebral lymphoma, and two cases of drug induced akinetic rigid
syndrome.

PMID: 18590997 [PubMed - in process]

4543: Clin Diagn Virol. 1995 Jul;4(1):61-5.

Detection of varicella-zoster virus DNA in maternal breast milk from a mother
with herpes zoster.

Yoshida M, Tezuka T, Hiruma M.

Department of Dermatology, Kinki University School of Medicine, Ohnohigashi
377-2, Osakasayama, Osaka 589, Japan.

BACKGROUNDS: We previously reported that varicella-zoster virus (VZV) DNA was
detected by polymerase chain reaction (PCR) from maternal breast milk of a
post-partum mother with chickenpox. OBJECTIVES: We tried to decide the route of
VZV contamination to maternal milk. CASE REPORT: A 22-year-old woman developed
herpes zoster on her right Th3-4 dermatome. RESULTS AND CONCLUSIONS: VZV DNA was 
detected by PCR from peripheral blood and the maternal milk of the right breast, 
but not from the maternal milk of the left breast. These results suggest that VZV
in maternal milk may not derive from VZV-infected mononuclear cells in peripheral
blood, but from the VZV-infected epitheliums of the lacteal gland.

PMID: 15566828 [PubMed]

4544: Clin Diagn Virol. 1995 Jul;4(1):1-13.

Human herpesvirus-7 (HHV-7): current status.

Ablashi DV, Berneman ZN, Kramarsky B, Whitman J Jr, Asano Y, Pearson GR.

Advanced Biotechnologies Inc., Columbia, MD 21046, USA.

BACKGROUND: Human herpesvirus-7 (HHV-7) is a newly discovered virus and very
little is known about its prevalence, biologic, immunologic and molecular biology
aspect. Besides the HHV-7 etiologic role in a few cases of exanthem subitum, its 
association with other diseases has not been reported. OBJECTIVES: To review what
is currently known about HHV-7. RESULTS: HHV-7 was first isolated in 1990 from
purified T-cells from a healthy individual. Following this report, an independent
isolation of HHV-7 was reported from the mononuclear cells (PBMC) of a chronic
fatigue syndrome patient. HHV-7 is closely related to human herpesvirus-6 (HHV-6)
and human cytomegalovirus (HCMV), but is distinct from Epstein-Barr virus (EBV), 
herpes simplex virus and varicella zoster virus. Using polyvalent and monoclonal 
antibodies, several HHV-7 viral proteins were identified, ranging from 136 to 30 
kDa. HHV-7 infection occurs later than HHV-6, which appears in early childhood.
HHV-7 is ubiquitous, and its prevalence rate is >85% in the US population,
although its rates of prevalence in Japan is lower than in the USA and Europe.
HHV-7 is frequently isolated from saliva; however, HHV-7 has been consistently
isolated from PBMC from young children as well. Several cases of exanthem subitum
have been linked to primary infection of HHV-7, suggesting that it may also cause
exanthem subitum. Primary infection with HHV-7 was also reported from a patient
with features of hepatitis and exanthem subitum. This virus was also isolated
from tissues from a case of hepatosplenomegaly and pancytopenia lacking either
EBV or HCMV. Thus far, no other disease associated with HHV-7 has been reported. 
Only one continuous T-cell line (SupT1) can support the replication of HHV-7, but
the virus yield is extremely low. CONCLUSIONS: It has been about 4 years since
this member of the human herpesvirus family was reported. In the coming years,
more data will be available on the epidemiology, biology, immunology, molecular
biology, and pathogenesis of HHV-7. The finding of reciprocal interference
between HHV-7 and HIV-1, suggesting competition at the receptor level is
important, needs further work and here HHV-7 may play a role as a negative
cofactor in the natural history of HIV infection. Because of HHV-7 interaction
with HIV-1, the possibility of its vertical transmission needs to be
investigated. This review on HHV-7 is intended to provide current information on 
HHV-7.

PMID: 15566823 [PubMed]

4545: Zh Mikrobiol Epidemiol Immunobiol. 1995 Jul-Aug;(4):72-5.

[The clinical efficacy in using leukinferon in adults with diseases caused by the
varicella-zoster virus]

[Article in Russian]

Kuznetsov VP, Nikolaeva IN, Barer GM, Beliaev DL, Sundukov AV, Babaiants AA,
Iushchuk ND.

To achieve more effective treatment of varicella (chickenpox) and herpes zoster
in adults, a wide-spectrum immunocorrective agent containing, together with
alpha-interferon, a number of other cytokines of the first phase of immune
response was used. In patients with the different severity of disease leukinferon
induced a rapid decrease in the severity of the disease, arrested the development
of new elements on the skin and the buccal mucosa, and reduced the duration of
the fever period. When used in such forms as intramuscular injections in
combination with the irrigation of the buccal mucosa and ointment, leukinferon
proved to be a highly effective preparation for the treatment of diseases caused 
by varicella-zoster virus.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract

PMID: 9381878 [PubMed - indexed for MEDLINE]

4546: Ann Acad Med Singapore. 1995 Jul;24(4):528-33.

Prevalence of skin disease in patients infected with human immunodeficiency virus
in Bangkok, Thailand.

Sivayathorn A, Srihra B, Leesanguankul W.

Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol
University, Bangkok, Thailand.

A detailed study of the skin lesions of 248 patients infected with the human
immunodeficiency virus (HIV) in Bangkok, Thailand, is reported. The study
population consisted of 140 patients with asymptomatic disease (stage I), 27
patients with symptomatic disease (stage II), and 81 patients with advanced stage
of the disease (stage III). Ninety-five percent of all patients were observed to 
have one or more skin disorders. Conditions with prevalence higher than 5%
included oral candidiasis (34.3%), pruritic papular eruption (32.7%), seborrhoeic
dermatitis (21.0%), herpes zoster (16.1%), oral hairy leucoplakia (14.9%), herpes
simplex (10.9%), onychomycosis (9.3%), cutaneous ringworm (7.7%), psoriasis
(6.5%), and folliculitis (5.6%). Patients in the stage II and III subgroups were 
found to have a significantly more number of skin disorders than patients in
stage I. The prevalence pattern of skin disorders in this study are generally
similar to previous studies in the literature. Three notable differences,
however, emerge from this study: (1) the high prevalence of pruritic papular
eruption in all subgroups, (2) the high prevalence of Penicillium maneffei
infection in patients with advanced disease, and (3) the absence of Kaposi's
sarcoma in the study population. Knowledge about the cutaneous disease pattern in
the locals will be more clinically relevant for proper care of the patients.

PIP: During July 1993-June 1994 in Bangkok, Thailand, dermatologists examined the
skin of 248 HIV-infected patients attending the outpatient clinic or admitted to 
the medical wards of Siriraj Hospital and performed a CD4+ T-lymphocyte count to 
determine the prevalence of skin disorders in HIV-infected people and to
categorize them into clinical stages. 86% of the patients were male. 140 people
were in the asymptomatic group, 27 in the symptomatic group, and 81 in the
advanced group (CD4+ 50 cells/sq m). 95% of all HIV-infected patients had at
least 1 skin disorder, especially oral candidiasis (34.3%) and pruritic papular
eruption (PPE) (32.7%). Other skin disorders included seborrhoeic dermatitis
(21%), herpes zoster (16.1%), oral hairy leukoplakia (14.9%), herpes simplex
(10.9%), onychomycosis (9.3%), cutaneous ringworm (7.7%), psoriasis (6.5%), and
folliculitis (5.6%). No one had Kaposi's sarcoma. 3.2% of all HIV-infected
patients had Penicillium maneffei infection, which was limited to only AIDS
patients. 9.9% of AIDS patients had Penicilliosis maneffei. Prior to the AIDS
epidemic, this infection was unknown to most physicians. AIDS patients were more 
likely to have at least 3 skin disorders. AIDS patients were more likely to have 
severe skin lesions than asymptomatic and symptomatic patients (14.8% vs. 9.4%
and 7.5%, respectively). Asymptomatic patients had higher prevalence of the
frequently seen skin disorders, except cutaneous ringworm, than general patients 
attending the outpatient clinics (e.g., 3-fold increase for psoriasis, about
25-increase for candidiasis). PPE and oral hairy leukoplakia were unique to HIV
infection. This population tended to share a similar pattern of skin
manifestations of HIV disease. It is unusual that this population has a high
prevalence of PPE and P. maneffei infection and no Kaposi's sarcoma.

PMID: 8849182 [PubMed - indexed for MEDLINE]

4547: Rinsho Shinkeigaku. 1995 Jul;35(7):814-6.

[A case of multiple cranial neuropathy due to varicella-zoster virus infection:
detection of involvement of cranial ganglia with MRI]

[Article in Japanese]

Kikuchi H, Yoshimura T, Hara H, Mihara F, Kobayashi T.

Department of Neurology, Kyushu University, Fukuoka, Japan.

We describe here a 50-year-old patient who had multiple cranial nerve palsies
(lt.VIII,IX,X,XI and rt.VII, IX,X) with varicella-zoster virus (VZV). He
developed hoarseness, dysphagia on 30th, November, 1994. On the 8th day after the
onset, he suffered from left tinnitus and left facial nerve palsy. Neurological
examination on the 10th day revealed left peripheral facial nerve palsy, lt.
vocal cord palsy, mild dysphagia and loss of bilateral taste. He did not show
signs of meningeal irritation. On the 11th day, he felt vertigo and had
horizontal nystagmus on the right lateral gaze. The cerebrospinal fluid findings 
revealed increased protein content but not pleocytosis. The antibody titer for
varicella zoster virus elevated both in cerebrospinal fluid and in serum. Cranial
magnetic resonance imaging (MRI) revealed gadlinium enhancement on the left
geniculate ganglion and left superior or inferior ganglion of IX and X nerves,
indicating that multiple cranial nerve palsies associated with VZV infection
originate in the cranial ganglia. Focal brainstem encephalitis does not seem to
be the main cause of multiple cranial neuropathy in this case.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8777811 [PubMed - indexed for MEDLINE]

4548: Cancer. 1995 Jul 1;76(1):26-31.

Specific cutaneous infiltrates of B-cell chronic lymphocytic leukemia arising at 
the site of herpes zoster and herpes simplex scars.

Cerroni L, Zenahlik P, Kerl H.

Department of Dermatology, University of Graz, Austria.

BACKGROUND. Cutaneous lymphoid infiltrates at sites of herpes zoster scars in
patients with B-cell chronic lymphocytic leukemia (B-CLL) often are diagnosed as 
benign lymphoid hyperplasia ("pseudolymphomas"). The histologic and
immunophenotypic features of these lesions are not well characterized. Appearance
of skin lesions in B-CLL patients is considered a poor prognostic sign. METHOD.
Eight punch biopsies from five patients (three males, two females; mean age, 66.7
years) affected by B-CLL and presenting with lesions at sites of previous herpes 
simplex (upper lip, one patient) or herpes zoster (trunk, four patients;
forehead, one patient) infections were included in the study. Histologic
examination was performed on routine sections stained with hematoxylin and eosin 
and Giemsa. Immunohistologic stainings were performed with a standard three-step 
immunoperoxidase technique on formalin fixed, paraffin embedded tissue sections. 
RESULTS. Specific cutaneous infiltrates of B-CLL were diagnosed
histopathologically and immunophenotypically in eight biopsies from all five
patients. Clinically, patients presented with erythematous papules or plaques
confined to the area of previous herpes virus eruptions. Histopathologic features
in most cases were characterized by a variably dense perivascular and periadnexal
infiltrate of small hyperchromatic lymphocytes throughout the entire dermis,
reaching the subcutaneous fat. In one case, a dense, diffuse infiltrate involving
the entire dermis was observed. A granulomatous reaction with presence of
epithelioid and multinucleated giant cells was a prominent feature in four
biopsies from three patients. Light areas containing large lymphoid cells with
features of prolymphocytes and paraimmunoblasts (so-called "proliferation
centers") could be observed only in the case characterized by a diffuse
infiltrate. Immunohistology revealed an aberrant CD20+/CD43+ phenotype of
neoplastic B cells, which is not found in normal B lymphocytes (CD20+/CD43-).
Reactive T lymphocytes were present in all lesions and had a normal
CD20-/CD43+/CD45Ro+ phenotype. At the time of this writing, four patients were
alive without signs of skin disease after a mean follow-up of 58.5 months, and
one patient died of B-CLL 24 months after the cutaneous eruption. CONCLUSIONS.
Specific cutaneous infiltrates of B-CLL are not uncommon at sites of herpes virus
scars. The diagnosis can be confirmed by histopathologic and immunophenotypic
criteria. The prognosis is better than previously reported.

PMID: 8630873 [PubMed - indexed for MEDLINE]

4549: Alaska Med. 1995 Jul-Sep;37(3):118-9.

Painless herpes zoster.

Rodriguez MA.

Publication Types: 
    Case Reports
    Letter

PMID: 8546259 [PubMed - indexed for MEDLINE]

4550: J Antimicrob Chemother. 1995 Jul;36(1):271-3.

A pharmacokinetic and safety evaluation of a 28 day course of oral acyclovir in
elderly patients with herpes zoster.

Moss PJ, Wood MJ, Crooks RJ, Gallagher J, McKendrick MW.

Publication Types: 
    Clinical Trial
    Letter

PMID: 8537281 [PubMed - indexed for MEDLINE]

4551: J Infect. 1995 Jul;31(1):82.

New nucleoside analogues--time for caution?

Nathwani D.

Publication Types: 
    Letter

PMID: 8522846 [PubMed - indexed for MEDLINE]

4552: J Infect. 1995 Jul;31(1):49-50.

HIV-2 strikes injecting drug users (IDUs) in India.

Singh NB, Panda S, Naik TN, Agarwal A, Singh HL, Singh YI, Deb BC.

Microbiology Dept., Regional Medical College, Imphal, Manipur, India.

Manipur, a north-eastern state of India bordering Myanmar, observed introduction 
of HIV-1 among fairly large number of IDUs in October 1989, followed by rapid
spread within the next 6 months. HIV-2 in injectors was not present until
recently, though it was detected from other parts of India in 1991. This
communication reports for the first time presence of HIV-2 among young injectors 
of Manipur. All the HIV-2 infected IDUs were also found to be infected with
HIV-1. HIV-2 has affected a large number of people in Africa through heterosexual
transmission. It remains to be seen whether HIV-2 spreads rapidly also among the 
drug-injecting population of Manipur. Observation of the disease progression
among HIV-2 infected IDUs will also be of interest.

PIP: HIV-1 was first detected in India in 1986. HIV-2 was first detected in the
country in 1991 when paid blood donors and STD clinic attenders in north India
tested seropositive for the virus. HIV-2 was later detected in Bombay and Goa.
HIV-2 was also introduced in Madras and followed by an exponential increase in
1992 where heterosexual transmission was found to be responsible for the spread
of the virus. 433 blood samples were collected and screened during the second
quarter of 1994 from blood donors, injecting drug users (IDUs), and clinically
suspected HIV disease cases admitted to the Regional Medical College (RMC)
Hospital or treated at the outpatient department. 60.5% of IDUs tested positive
for HIV-1, 6.6% were infected with both HIV-1 and HIV-2, and none were found to
be infected exclusively with HIV-2. HIV-infected IDUs were aged 15-35 years and
exclusively male. Most clinically suspected cases were young males attending the 
various departments of RMC with a history of long continued diarrhea, herpes
zoster, extreme weight loss, miliary pulmonary tuberculosis, extrapulmonary
tuberculosis, or pericardial effusion. Their histories suggested that many were
IDUs, while a few only gave histories of unprotected sex with commercial sex
workers. The report of a possible link between IDUs of Manipur and Madras
suggests that HIV-2 may have come from Madras. The study of dual infection with
both HIV-1 and HIV-2 among the IDUs may help in understanding the factors
responsible for the efficient transmission of the two viruses. An extensive
literature search found that HIV-2 among IDUs has previously been reported only
from Spain approximately two years earlier.

Publication Types: 
    Comparative Study

PMID: 8522832 [PubMed - indexed for MEDLINE]

4553: J Virol. 1995 Jul;69(7):4515-8.

Varicella-zoster virus gene 51 complements a herpes simplex virus type 1 UL9 null
mutant.

Chen D, Stabell EC, Olivo PD.

Department of Medicine, Washington University School of Medicine, St. Louis,
Missouri 63110, USA.

Varicella-zoster virus (VZV) gene 51 encodes a protein which is homologous to
UL9, the origin of DNA replication-binding protein of herpes simplex virus type
1. No genetic information is available on VZV gene 51, but its product has been
shown to bind to virtually the same recognition sequence as does UL9 (D. Chen and
P. D. Olivo, J. Virol. 68:3841-3849, 1994; N. D. Stow, H. M. Weir, and E. C.
Stow, Virology 177:570-577, 1990). We report here that gene 51 can complement a
UL9 null mutant (hr94) (A. K. Malik, R. Martinez, L. Muncy, E. P. Carmichael, and
S. K. Weller, Virology 190:702-715, 1992), but at a level which is only 20% of
that of UL9. Quantitation of viral DNA synthesis suggests that this phenotype is 
due to a defect in viral DNA synthesis. Regardless, the ability of VZV gene 51 to
complement UL9 suggests that alphaherpesviruses have a highly conserved mechanism
of initiation of viral DNA synthesis.

PMID: 7769714 [PubMed - indexed for MEDLINE]

4554: Hautarzt. 1995 Jul;46(7):508-10.

[Meeting report of the 2nd International Conference on Varicella Zoster VIrus,
7-8 July 1994 in Paris]

[Article in German]

Lilie HM, Wassilew SW.

Dermatologische Klinik (Direktor: Prof. Dr. S. W. Wassilew), Stadtische
Krankenanstalten, Krefeld.

Publication Types: 
    Congresses

PMID: 7672996 [PubMed - indexed for MEDLINE]

4555: Leukemia. 1995 Jul;9(7):1130-5.

2-Chlorodeoxyadenosine (CdA) for patients with previously untreated chronic
lymphocytic leukemia (CLL).

Delannoy A, Martiat P, Gala JL, Deneys V, Ferrant A, Bosly A, Schieff JM, Michaux
JL.

l'Universite Catholique de Louvain, Cliniques Saint-Luc, Hematology Department,
Brussels, Belgium.

The encouraging therapeutic results attained with the purine analogue CdA in
patients with previously treated CLL prompted us to assess its potential in
untreated CLL patients. Nineteen patients, 13 males and six females, median age
65 years (range 27-75), with previously untreated CLL were given monthly courses 
of CdA, 0.12 mg/kg/day as 2-h i.v. infusions for 5 days, until maximum response
or excessive toxicity. Five patients with Binet's stage A, 10 with stage B and
four with stage C CLL entered the study. After a median of five courses of CdA
(range 1-9) nine complete responses (CR = 47%, CI: 24-69%), five partial
responses (PR = 26%, CI: 7-46%) and five failures (= 26%, CI: 7-46%) were
recorded. In five complete responders and in one partial responder
cytofluorometric analysis of blood and/or bone marrow failed to demonstrate a
residual clonal B cell population. A search for residual disease by PCR
technology and by immunostaining of bone marrow biopsies however disclosed
residual leukemic cells in these six cases. Adverse reactions included fever of
unknown origin (n = 3), pneumonia (n = 2), herpes simplex infection, herpes
zoster, an anal abscess, a cutaneous rash, autoimmune hemolysis and mental
disturbance (one patient each). In this small cohort, neither age, stage, blood
counts, cytogenetics or pattern of bone marrow infiltration at inclusion were
predictive for response. From these preliminary data, we conclude that CdA has
remarkable short-term efficacy in patients with previously untreated CLL.
However, toxicity is not negligible and long-term benefit from therapy with CdA
still has to be established.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 7630184 [PubMed - indexed for MEDLINE]

4556: J Neuroimaging. 1995 Jul;5(3):192-3.

Cervical (C2) herpes zoster infection followed by pontine infarction.

Patrick JT, Russell E, Meyer J, Biller J, Saver JL.

Division of Neuroimaging Research, Dent Neurologic Institute, Buffalo, NY 14209, 
USA.

This article reports a man who had herpes varicella zoster cervicalis with
delayed stroke in the posterior circulation. Empiric treatment was acyclovir,
methylprednisolone, and aspirin. Pontine infarction involving migration of the
virus via cervicovascular innervation from C2 dorsal root ganglia to the
vertebrobasilar circulation with attendant angiitis/angiopathy and thrombosis is 
proposed.

Publication Types: 
    Case Reports

PMID: 7626829 [PubMed - indexed for MEDLINE]

4557: J Comput Assist Tomogr. 1995 Jul-Aug;19(4):624-7.

Herpes zoster vasculitis: demonstration by MR angiography.

Sarazin L, Duong H, Bourgouin PM, Melanson M, Chalk C, Richardson J, Vezina JL.

Department of Radiology, Montreal General Hospital, McGill University, Quebec,
Canada.

A patient presented with multiple cerebral infarcts in various vascular
territories after having been treated for herpes zoster ophthalmicus. Magnetic
resonance angiography demonstrated multiple focal stenoses involving the proximal
intracranial vessels which corresponded to endarteritis at autopsy.

Publication Types: 
    Case Reports

PMID: 7622697 [PubMed - indexed for MEDLINE]

4558: Neurology. 1995 Jul;45(7):1422-3.

Comment on:
    Neurology. 1994 Jul;44(7):1221-6.

CNS vasculitis.

Mackey A, Simard D.

Publication Types: 
    Comment
    Letter

PMID: 7617211 [PubMed - indexed for MEDLINE]

4559: J Am Acad Dermatol. 1995 Jul;33(1):126-9.

Concurrent herpes simplex and varicella-zoster infection in an immunocompromised 
patient.

Gibney MD, Leonardi CL, Glaser DA.

Division of Dermatology, Saint Louis University Health Sciences Center, St.
Louis, MO, USA.

Publication Types: 
    Case Reports
    Review

PMID: 7601930 [PubMed - indexed for MEDLINE]

4560: J Rheumatol. 1995 Jul;22(7):1254-8.

Herpes zoster in systemic lupus erythematosus.

Manzi S, Kuller LH, Kutzer J, Pazin GJ, Sinacore J, Medsger TA Jr, Ramsey-Goldman
R.

Department of Medicine, Graduate School of Public Health, Pittsburgh, PA, USA.

OBJECTIVE. To define the clinical spectrum and disease sequelae of herpes zoster 
and to determine the risk factors associated with the development of herpes
zoster in patients with systemic lupus erythematosus (SLE). METHODS.
Retrospective matched case control study in a consecutive series of patients with
SLE first evaluated between 1979 and 1989. Patients were classified as cases if
their first episode of zoster occurred after lupus diagnosis. Lupus patients who 
never had zoster were eligible as controls and were matched 2:1 to cases for age,
race, sex, and survival status. Clinical features of the cases from the time of
lupus diagnosis to the time of zoster were compared to their respective controls 
over similar time periods. RESULTS. Forty eight (15%) of 321 patients were
classified as cases. Cases were more likely to have received cyclophosphamide (p 
= 0.03), and azathioprine (p = 0.006). More cases had lupus nephritis (p = 0.02),
and a concurrent or previous malignancy (p = 0.01) than their controls. Seven
cases had cutaneous dissemination. Seven patients had postherpetic neuralgia > 2 
months and in only 2 patients symptoms persisted for > 12 months' duration. Only 
3 of 36 patients had immunosuppressive medication discontinued at the time of
diagnosis of zoster, and 10 cases received acyclovir for the zoster infection.
There were no permanent neurologic deficits or death. CONCLUSION.
Immunosuppressive therapy, specifically cyclophosphamide and azathioprine, lupus 
nephritis, and a concurrent or previous malignancy may be risk factors for the
development of herpes zoster infections in patients with SLE. Our study suggests 
that although herpes zoster occurs frequently in patients with SLE, it has a
relatively benign course. Discontinuing needed immunosuppressive therapy in
patients with SLE may be unnecessary in the setting of a zoster infection. With
the current emphasis on reduction in medical costs, both by limiting inpatient
admissions and eliminating unneeded medications, it is necessary to identify
which patients require more intensive therapy with antiviral medications and/or
hospitalization and which are likely to have a benign, self-limited course
without intervention.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7562754 [PubMed - indexed for MEDLINE]

4561: J Med Virol. 1995 Jul;46(3):252-7.

Oral brivudin vs. intravenous acyclovir in the treatment of herpes zoster in
immunocompromised patients: a randomized double-blind trial.

Wutzler P, De Clercq E, Wutke K, Farber I.

Institute for Antiviral Chemotherapy, Friedrich-Schiller University of Jena,
Germany.

The efficacy of oral brivudin vs. intravenous acyclovir was compared in a
randomized multicentered study under double-blind conditions using the
double-dummy technique. Forty-eight patients with a herpes zoster rash less than 
72 hours in duration were entered in the study. Brivudin was given as one 125-mg 
tablet every 6 hours. Acyclovir was infused over 1 hour at a dose of 10 mg/kg
every 8 hours. Treatment was continued for 5 days. There was no significant
difference between the treatment groups when analyzed in terms of new lesion
formation, increase in the area of rash within the primary dermatome, cutaneous
dissemination, and affection of mucous membranes or visceral organs. Both
treatment regimes were also equally effective in the time to full crusting of
lesions. Oral brivudin and intravenous acyclovir were well tolerated by most
patients. There was no need to interrupt the treatment in any case. As effective 
as intravenous acyclovir in the treatment of herpes zoster, oral brivudin offers 
the potential for outpatient treatment of herpes zoster in immunocompromised
patients.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 7561799 [PubMed - indexed for MEDLINE]

4562: Clin Microbiol Rev. 1995 Jul;8(3):440-50.

Cutaneous manifestations of opportunistic infections in patients infected with
human immunodeficiency virus.

Tappero JW, Perkins BA, Wenger JD, Berger TG.

Childhood and Respiratory Diseases Branch, Centers for Disease Control and
Prevention, Atlanta, Georgia 30333, USA.

Bacillary angiomatosis (BA) presents most commonly as a cutaneous disease and is 
caused by two organisms. Bartonella (Rochalimaea) henselae and Bartonella
(Rochalimaea) quintana. Biopsy confirmation of cutaneous BA is essential because 
lesions can mimic nodular Kaposi's sarcoma in appearance. Although the vast
majority of human immunodeficiency virus (HIV)-infected patients with BA have CD4
lymphocyte counts of less than 100 cells per mm3, the disease responds well to
antimicrobial therapy. Staphylococcus aureus is the most common bacterial skin
pathogen affecting HIV-infected patients. The prevalence of skin disease due to
S. aureus may be explained by high nasal carriage rates for the organism ( > or =
50%) and altered immune function in conjunction with an impaired cutaneous
barrier. Herpes simplex virus causes mucocutaneous disease early in the course
HIV infection and ulcerative lesions at any site in advanced HIV infection.
Herpes zoster is common early in the course of HIV infection; recurrent and
disseminated herpes zoster infections are characteristic of patients with
advanced HIV disease. Acyclovir resistance is usually seen in patients with
large, untreated, ulcerative lesions of herpes simplex virus and in patients with
chronic, verrucous lesions of varicella-zoster virus. Cutaneous cryptococcosis,
histoplasmosis, and coccidiomycosis are markers of disseminated disease and
require biopsy confirmation. Scabies is easily diagnosed but may be atypical in
presentation and difficult to eradicate in advanced HIV disease.

Publication Types: 
    Review

PMID: 7553576 [PubMed - indexed for MEDLINE]

4563: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995 Jul;80(1):92-5.

Herpes zoster infection presenting as an acute pulpitis.

Sigurdsson A, Jacoway JR.

Department of Endodontics, School of Dentistry, University of North Carolina at
Chapel Hill, USA.

A major reason for referral to an endodontic practice is management of pain. Most
cases are diagnosed as being of pulpal or periapical origin. However, some turn
out quite differently than their initial appearance. This case report presents a 
patient referred to the endodontic clinic because of symptoms mimicking an
irreversible pulpitis. On examination no obvious cause of the symptoms could be
found. The patient was treated conservatively after which a herpes zoster viral
infection was diagnosed. This case stresses the importance of a thorough
investigation of all signs and symptoms and the delay of definitive treatment
until a diagnosis is made.

Publication Types: 
    Case Reports

PMID: 7552870 [PubMed - indexed for MEDLINE]

4564: Arch Dermatol. 1995 Jul;131(7):805-8.

Analysis of the polymerase chain reaction in the detection of herpesvirus DNA
from fixed and stained tissue sections.

Nahass GT, Penneys NS, Leonardi CL.

Division of Dermatology, St Louis (Mo) University School of Medicine, USA.

BACKGROUND AND DESIGN: The polymerase chain reaction (PCR) is a molecular
diagnostic technique that has been applied to many infectious processes. Stained 
and unstained Tzanck smears, vesicle fluid swabs, and crusts have all been used
as the source for template DNA for the PCR to document evidence of herpes simplex
virus and varicella-zoster virus infection. Thirty-five cases with histologic
evidence of acute herpesvirus infection were retrieved from archival tissue
blocks that were up to 5 years old. Paraffin and hematoxylin-eosin-stained tissue
sections obtained from routinely prepared glass slides from these cases were then
examined for herpesvirus DNA using the PCR. RESULTS: The PCR-detected herpesvirus
DNA from 34 (97.1%) of 35 paraffin tissue samples. Herpes simplex virus and
varicella-zoster virus DNA were detected in eight and 26 of these cases,
respectively. For hematoxylin-eosin-stained tissue samples, PCR detected
herpesvirus DNA sequences in 16 (45.7%) of 35 cases. Herpesvirus DNA was isolated
from paraffin tissue sections and recently prepared hematoxylin-eosin-stained
tissue samples obtained from archival tissue blocks that were up to 5 and 2 years
old, respectively. CONCLUSIONS: The PCR can detect herpesvirus DNA in extremely
high yield from unstained paraffin-embedded tissue samples with histologic
evidence of acute herpesvirus infection that are up to 5 years old. Herpesvirus
DNA can also be identified in approximately 50% of these cases from
hematoxylin-eosin-stained tissue sections obtained from routinely prepared glass 
slides.

PMID: 7541979 [PubMed - indexed for MEDLINE]

4565: Antimicrob Agents Chemother. 1995 Jul;39(7):1546-53.

Valaciclovir compared with acyclovir for improved therapy for herpes zoster in
immunocompetent adults.

Beutner KR, Friedman DJ, Forszpaniak C, Andersen PL, Wood MJ.

Department of Dermatology, University of California at San Francisco, Vallejo
94589, USA.

Acyclovir treatment of acute herpes zoster speeds rash healing and decreases pain
and ocular complications. The limited oral bioavailability of acyclovir
necessitates frequent dosing. Valaciclovir, the l-valyl ester of acyclovir, is
rapidly and almost completely converted to acyclovir in vivo and gives three- to 
fivefold increases in acyclovir bioavailability. In a randomized, double-blind,
multicenter study, the safety and efficacy of oral valaciclovir given at a dosage
of 1,000 mg three times daily for 7 or 14 days and oral acyclovir given at a
dosage of 800 mg five times daily for 7 days were compared in immunocompetent
adults aged > or = 50 years with herpes zoster. Patients were evaluated for 6
months. The intent-to-treat analysis (1,141 patients) showed that valaciclovir
for 7 or 14 days significantly accelerated the resolution of herpes
zoster-associated pain (P = 0.001 and P = 0.03, respectively) compared with
acyclovir; median pain durations were 38 and 44 days, respectively, versus 51
days for acyclovir. Treatment with valaciclovir also significantly reduced the
duration of postherpetic neuralgia and decreased the proportion of patients with 
pain persisting for 6 months (19.3 versus 25.7%). However, there were no
differences between treatments in pain intensity or quality-of-life measures.
Cutaneous manifestations resolved at similar rates in all groups. Adverse events 
were similar in nature and prevalence among groups, and no clinically important
changes occurred in hematology or clinical chemistry parameters. Thus, in the
management of immunocompetent patients > or = 50 years of age with localized
herpes zoster, valaciclovir given at 1,000 mg three times daily for 7 days
accelerates the resolution of pain and offers simpler dosing, while it maintains 
the favorable safety profile of acyclovir.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 7492102 [PubMed - indexed for MEDLINE]

4566: Med Lett Drugs Ther. 1995 Jun 23;37(951):55-7.

Varicella vaccine.

[No authors listed]

PMID: 7783692 [PubMed - indexed for MEDLINE]

4567: N Engl J Med. 1995 Jun 22;332(25):1684.

Images in clinical medicine. Herpes zoster.

Kulkarni AG, Brid NS.

Krishna Hospital and Medical Research Centre, Karad, Maharashtra, India.

Publication Types: 
    Case Reports

PMID: 7760869 [PubMed - indexed for MEDLINE]

4568: Virology. 1995 Jun 20;210(1):100-8.

Nucleotide sequence analysis of a 30-kb region of the bovine herpesvirus 1 genome
which exhibits a colinear gene arrangement with the UL21 to UL4 genes of herpes
simplex virus.

Vlcek C, Benes V, Lu Z, Kutish GF, Paces V, Rock D, Letchworth GJ, Schwyzer M.

Institute of Molecular Genetics, Czech Academy of Sciences, Prague.

We report the nucleotide sequence of the 19-kb HindIII fragment B of bovine
herpesvirus 1 (BHV-1) DNA and adjacent parts of the HindIII A and L fragments,
which together span a still completely uncharted 30-kb region located between the
glycoprotein H gene and the right end of the unique long segment. The analysis
revealed 17 complete open reading frames (ORFs) and 2 ORFs that were interrupted 
by potential splice donor and acceptor sites. All of these ORFs exhibited strong 
amino acid sequence homology to the gene products of other alphaherpesviruses.
The BHV-1 ORFs were arranged colinearly with the prototype sequence of herpes
simplex virus 1 in the range of the UL21 to UL4 genes. Colinearity was also
observed with the genes of betaherpesviruses and gamma herpesviruses, although
not all ORFs exhibited clear sequence homology. The possible functions of the
proteins encoded within the sequenced region are assessed and features found are 
discussed. Unexpected findings include the following: high amino acid sequence
conservation among alphaherpesviruses despite large differences in G + C content,
ranging from 45% for varicella zoster virus to 72% for BHV-1; high similarity
with other UL20 proteins at the predicted structural level in spite of relatively
low amino acid homology; and a 2-kb open reading frame overlapping UL19 in the
opposite sense and exhibiting high amino acid similarity to the same area of
pseudorabies virus.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 7793062 [PubMed - indexed for MEDLINE]

4569: Br J Hosp Med. 1995 Jun 21-Jul 11;54(1):49-50.

Herpes zoster ophthalmicus masquerading as giant cell arteritis.

Chittenden HB, Clearkin LG, Sidky K.

Department of Ophthalmology at Frimley Park Hospital, Surrey.

Publication Types: 
    Case Reports

PMID: 7551476 [PubMed - indexed for MEDLINE]

4570: Indian J Ophthalmol. 1995 Jun;43(2):78-9.

Optic neuropathy secondary to herpes zoster ophthalmicus.

Menon V, Kumar G, Tandon R.

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of
Medical Sciences, New Delhi.

Publication Types: 
    Case Reports

PMID: 8818317 [PubMed - indexed for MEDLINE]

4571: Afr J Med Med Sci. 1995 Jun;24(2):173-8.

Clinical features of HIV seropositive Zambian subjects.

Siziya S, Mwendapole R, Fleming AF.

Biostatistics Unit, Tropical Diseases Research Centre, Ndola, Zambia.

Data was collected from 1595 anti-HIV positive patients out of which 90% of the
patients were from the Copperbelt province, and the rest from five out of the
eight other provinces of Zambia. One-hundred and one positive HIV patients were
less than 2 years of age, 69 were aged 2 to 14 years and 1418 were aged above 15 
years. The male to female ratio was about 1:1 at all ages, except that there was 
an excess of males below 5 years. Of the four most frequent symptoms or signs,
loss of weight or malnutrition was regarded in about 50% of seropositive patients
at all ages; generalized lymphadenopathy was seen in at least 35% of all age
groups and most frequently at 2-14 (60%); chronic watery diarrhoea was most
common at less than 2 years (44%) and least common in older children (17%);
chronic chest infections had highest frequency in children 2-14 years (59%) and
lowest in adults (32%). Intensive education of children before they are sexually 
active is the best hope for controlling the epidemic.

PIP: During December 1985 to November 1986, in Zambia, clinicians provided
information on 1595 HIV-positive patients to assess the age and sex distribution 
and clinical features of HIV-positive patients. 92.2% of the HIV-positive
patients were from the Copper Province, especially the towns of Ndola (44.9%) and
Kitwe (28.9%). 101 HIV-positive patients were under 2 years old, 69 were aged
2-14 years, and 1418 were 15 years old or older. The most common clinical
features of HIV infection in all age groups were weight loss/malnutrition (about 
50%) and generalized lymphadenopathy (35.1%). They were malnutrition (56.5%),
chronic chest infection (48.2%), chronic diarrhea (43.5%), and generalized
lymphadenopathy (43.5%) for children aged under 2; generalized lymphadenopathy
(60.3%), chronic chest infection (58.6%), weight loss/malnutrition (55.2%), and
chronic diarrhea (17.2%) for children aged 2-14; and weight loss (49.3%),
generalized lymphadenopathy (33.4%), chronic chest infection (32.3%), chronic
diarrhea (29.6%), herpes zoster (14.7%), and sexually transmitted diseases
(10.6%) for people aged 15 and older. Generalized lymphadenopathy was
significantly more common in the 2-14 year old group than the older age group
(60.3% vs. 33.4%; p 0.05). People aged 15 and over were significantly less likely
to have chronic chest infection than the other age groups (32.3% vs. 48.2-58.6%; 
p 0.05). The male/female ratio was 1:0.93 in the 15 and older age group. Solid
education of school-aged children before they become sexually active provides the
best hope for controlling the HIV/AIDS epidemic in Zambia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8669398 [PubMed - indexed for MEDLINE]

4572: Am J Ophthalmol. 1995 Jun;119(6):796-8.

Possible role of herpes simplex virus in the origin of Posner-Schlossman
syndrome.

Yamamoto S, Pavan-Langston D, Tada R, Yamamoto R, Kinoshita S, Nishida K,
Shimomura Y, Tano Y.

Department of Virology, Schepens Eye Research Institute, Boston, MA 02114, USA.

PURPOSE/METHODS: We conducted this study to determine if the herpesviruses are
possible etiologic agents in Posner-Schlossman syndrome. We aspirated aqueous
humor samples from patients during acute attacks of the syndrome. Ten normal
aqueous humor specimens from patients undergoing cataract surgery were used as
controls. DNA was extracted and subjected to polymerase chain reaction
amplification and Southern blot hybridization. RESULTS/CONCLUSION: All three
specimens were positive for amplified genomic fragments of herpes simplex virus
and negative for varicella-zoster virus and cytomegalovirus. Ten normal aqueous
specimens were negative for all three. Herpes simplex virus may play a role in
the origin of Posner-Schlossman syndrome.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 7785697 [PubMed - indexed for MEDLINE]

4573: Ann Neurol. 1995 Jun;37(6):784-90.

The vasculopathy of varicella-zoster virus encephalitis.

Amlie-Lefond C, Kleinschmidt-DeMasters BK, Mahalingam R, Davis LE, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262, USA.

Varicella-zoster virus (VZV) encephalitis has become more prevalent in the era of
acquired immunodeficiency syndrome and other immunosuppressive diseases and poses
diagnostic and therapeutic challenges for clinicians, radiologists, and
pathologists. Six cases studied at our institutions shed light on the patterns
and pathogenesis of the disease. VZV encephalitis is predominantly a
vasculopathy, involving small and large vessels, that generates seizures, mental 
changes, and focal deficits. Brain imaging reveals large and small ischemic or
hemorrhagic infarcts, often both, of cortex and subcortical gray and white
matter. Deep-seated white matter lesions often predominate and are ischemic
and/or demyelinative, depending on the size of blood vessels involved and the
amount of additional demyelination caused by infection of oligodendrocytes. The
demyelinative lesions are smaller and less coalescent than those seen in
progressive multifocal leukoencephalopathy.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 7778852 [PubMed - indexed for MEDLINE]

4574: J Virol Methods. 1995 Jun;53(2-3):176-87.

Combined use of complement and anti-immunoglobulin in an enhanced neutralization 
assay for antibodies to varicella-zoster virus.

Krah DL, Provost PJ, Ellis RW.

Department of Virus and Cell Biology, Merck Research Laboratories, West Point, PA
19486, USA.

An enhanced neutralization assay was developed to permit the sensitive, specific,
and reproducible measurement of antibodies to varicella-zoster virus (VZV).
Optimal neutralization was achieved using a combination of guinea pig complement 
(C') and rabbit anti-human IgG. This provided 625-, 160- and 13- to 64-fold
increases in dilution endpoints of human post-zoster serum, varicella-zoster
immune globulin and representative sera from recipients of live attenuated
varicella vaccine, respectively, above those measured in the absence of C' and
anti-IgG. The specificity of the assay was shown by the absorption of serum
neutralization capacity with VZV-specific antigen and the lack of concordance
between antibody titers to VZV with those to either herpes simplex virus type-2
or cytomegalovirus. The antibody status of recipients of live attenuated
varicella vaccine was established from the amount of neutralizing activity
produced at a single optimal serum dilution.

PMID: 7673386 [PubMed - indexed for MEDLINE]

4575: Pediatr Dermatol. 1995 Jun;12(2):138-44.

Localized linear bullous eruption of systemic lupus erythematosus in a child.

Roholt NS, Lapiere JC, Wang JI, Bernstein LJ, Woodley DT, Eramo LR.

Department of Dermatology, Northwestern University Medical School, Children's
Memorial Hospital, Chicago, Illinois 60611, USA.

A 9-year-old girl newly diagnosed with systemic lupus erythematosus (SLE)
developed a localized linear papulovesicular eruption over the right dorsal hand 
and ulnar forearm. The skin findings were clinically suggestive of herpes zoster,
lichen striatus, or lichen planus-lupus erythematosus overlap. However,
histologic, immunofluorescent, immunoelectron microscopic, and immunoblot studies
revealed findings compatible with bullous SLE. Our patient is noteworthy because 
she is the first one reported with bullous SLE presenting in a localized linear
pattern. She is also the second-youngest reported patient with bullous SLE.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 7659640 [PubMed - indexed for MEDLINE]

4576: Int J Dermatol. 1995 Jun;34(6):403-7.

Malignant syphilis (lues maligna) and concurrent infection with HIV.

Don PC, Rubinstein R, Christie S.

Department of Dermatology, New York Medical College-Metropolitan Hospital Center,
NY 10029, USA.

BACKGROUND. During the past 2 1/2 years we observed six patients who had a
reactive serology for syphilis, of which four developed widespread
noduloulcerative and two vesiculonecrotic lesions. The purpose was to report the 
occurrence of lues maligna, a rare form of secondary syphilis, in five patients
infected with the human immunodeficiency virus (HIV) and in one patient with risk
factors for infection. METHODS. Tzanck preparations, viral cultures, and skin
biopsies were performed to evaluate the etiology of the lesions. RESULTS.
Syphilis serology titers ranged from 1:32 to 1:128 and in one instance was as low
as 1:8. Such titers can also be found in patients with the latent form of
syphilis. Therefore, confirmation of the clinical diagnosis of lues maligna was
dependent on skin biopsies that were compatible with secondary syphilis and
negative viral studies that excluded varicella, disseminated varicella-zoster or 
herpes simplex. Lues maligna takes an aggressive course in HIV-infected patients 
since four of the patients required hospitalization and the two patients who
refused to complete treatment, subsequently developed more severe skin and
constitutional symptoms. CONCLUSIONS. HIV-infected patients are at risk for
developing lues maligna. Despite its malignant presentation, lues maligna lesions
respond rapidly to treatment with penicillin. Secondary syphilis should be added 
to the list of diseases known to be more aggressive in HIV-infected patients.

Publication Types: 
    Case Reports

PMID: 7657439 [PubMed - indexed for MEDLINE]

4577: Acta Paediatr Jpn. 1995 Jun;37(3):302-7.

Herpes zoster in children with bone marrow transplantation: Report from a single 
institution.

Nakayama H, Okamura J, Ohga S, Miyazaki C, Matsuzaki A, Ikuno Y, Ueda K, Tasaka
H.

Section of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.

Herpes zoster (HZ) has been often observed after bone marrow transplantation
(BMT) in childhood. The occurrence of HZ was reviewed in children who received
BMT. The clinical features of HZ were reviewed in 44 children who underwent BMT
at Kyushu Cancer Center. Among the 35 recipients with a history of varicella
before BMT, several factors associated with BMT and the lymphocyte subsets were
compared between the patients who developed HZ (HZ+ group) and those who did not 
(HZ- group). Twenty-two recipients (50%) developed HZ; in two-thirds of these
cases (15/22: 68%), HZ occurred between 80 and 120 days after BMT (median 101
days). The recipients treated with busulfan had a higher occurrence of HZ than
those treated without it. The patients with Grade II-IV acute graft-versus-host
disease (GVHD) developed HZ more frequently. In the HZ+ group, the absolute
number of lymphocytes, CD3+, CD4+ or CD8+ cells at 3 months was significantly
lower than that observed at 12 months after BMT and the CD4/CD8 ratio was
significantly lower at 1 month than after 3 months of BMT. In conclusion,
recipients were susceptible to HZ at around 100 days after BMT. The development
of HZ may be associated with unbalanced T lymphocytes at that time.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7645377 [PubMed - indexed for MEDLINE]

4578: Masui. 1995 Jun;44(6):841-4.

[A case of using continuous double-tapped epidural analgesia for herpes zoster
duplex]

[Article in Japanese]

Wajima Z, Ishikawa G, Kaneko K, Inoue T, Ogawa R.

Department of Anesthesia, Kitamurayama Kohritsu Hospital, Yamagata.

A 66-year-old woman developed herpes zoster duplex, which is a rare disease. She 
had severe pain at the right upper back area and left lower abdominal area. The
authors used double-tapped continuous epidural analgesia for this patient. The
catheters for the epidural block were placed at the 8th thoracic vertebral level 
and 2nd lumbar vertebral level. After the start of continuous epidural block, she
suffered from nausea, vomited, and felt dizzy. It was evident that these symptoms
were caused by local anesthetic toxicity. We emphasize that we must pay attention
to the patient who undergoes continuous double-tapped epidural analgesia for pain
relief so as not to elicit local anesthetic toxicity.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 7637162 [PubMed - indexed for MEDLINE]

4579: J Med Virol. 1995 Jun;46(2):91-6.

Distribution of varicella-zoster virus gpI and gpII and corresponding genome
sequences in the skin.

Nikkels AF, Delvenne P, Debrus S, Sadzot-Delvaux C, Piette J, Rentier B, Pierard 
GE.

Department of Dermatopathology, Chu du Sart Tilman, Liege, Belgium.

In the course of varicella-zoster virus (VZV) infection, some viral capsid
antigens are found in the epidermis and dermis. The aim of this study was to
investigate the localisation of two major VZV glycoproteins (gpI and gpII) and of
their respective genes in the skin. The distribution of VZV gpI and II in 27
formalin fixed paraffin embedded skin biopsies from herpes zoster eruptions were 
compared by immunohistochemistry. Double immunostaining was carried our to
identify infected cells. The presence of viral nucleic acids coding for gpI and
gpII was examined by in situ hybridisation. The distribution of gpI and gpII and 
their corresponding genome sequences was similar in the epidermis. gpI and gpII
were also detected in dermal FXIIIa positive dendrocytes, in Mac 387 and CD68
positive macrophages, and in perineural and endothelial cells. However, the
corresponding viral nucleic acids were rarely and barely detected in these cells 
of the dermis. It is concluded that VZV infection of epithelial cells follows a
different course than in dermal cells.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7636508 [PubMed - indexed for MEDLINE]

4580: J Med Virol. 1995 Jun;46(2):144-7.

Varicella-zoster virus assembly protein p32/p36 is present in DNA-containing as
well as immature capsids.

Harper DR, Sanders EA, Ashcroft MA.

Department of Virology, Medical College of St. Bartholomew's Hospital, London,
United Kingdom.

Varicella-zoster virus (VZV) produces a group of nucleocapsid proteins (the
p32/p36 nucleoprotein complex) which are the VZV analogues of the herpes simplex 
virus type 1 (HSV-1) and cytomegalovirus (CMV) assembly proteins. There are
multiple components in the VZV p32/p36 complex, with major proteins of 32 and 36 
kDa and minor proteins of 34 and 38 kDa. In HSV-1 the assembly proteins have been
shown to be present in immature (B) capsids, but are removed prior to the
formation of mature (C) capsids containing the viral DNA genome. Our work has
shown that VZV produces capsids corresponding to the B and C forms. However, in
contrast to HSV-1, VZV also produces "B/C" capsids that appear to contain both
the assembly proteins and the viral DNA genome. Possible mechanisms for this are 
discussed. In addition, it was shown that VZV capsids appear to lack the 36 and
38 kDa proteins, and based on this observation we suggest that these may
represent unprocessed forms of the assembly protein. In both HSV and CMV, a much 
larger, cross-reactive protein has been identified as the full-length product of 
the gene coding for the assembly protein. The homologous VZV gene (ORF 33)
theoretically has the capacity to produce a 66 kDa protein. However, no such
protein is readily apparent in VZV-infected cells. The presence of an
immunoreactive 64 kDa protein was demonstrated in purified VZV capsids which may 
represent the full-length ORF 33 protein.

PMID: 7636502 [PubMed - indexed for MEDLINE]

4581: Occup Environ Med. 1995 Jun;52(6):374-9.

Chronic lymphocytic leukaemias and non-Hodgkin's lymphomas by histological type
in farming-animal breeding workers: a population case-control study based on job 
titles.

Amadori D, Nanni O, Falcini F, Saragoni A, Tison V, Callea A, Scarpi E, Ricci M, 
Riva N, Buiatti E.

Divisione di Oncologia Medica (Medical Oncology Unit), Forli, Italy.

OBJECTIVES--A population based case-control study was conducted in a highly
agricultural area in the north east of Italy to evaluate the association between 
farming and animal breeding and the risk of developing non-Hodgkin's lymphoma
(NHL) and chronic lymphocytic leukaemia (CLL). METHODS--Occupational histories
and other data were collected by personal interview on 164 NHLs, 23 CLLs,
diagnosed in 1988-90, and on 977 controls. This paper only reports the results of
the analysis relative to the coding of job titles through the modified
International Labour Office (ILO) classification. Estimates of odds ratios (ORs) 
for occupational variables were calculated, after adjustment for sex, age,
altitude of municipality, first degree familiarity, and previous Herpes zoster
infection. RESULTS--From the analysis of the most frequent occupational
categories, no occupation showed a significantly high risk. When the two job
titles farmers only and farmer-breeders who are also involved in animal breeding 
are classified within the extremely varied occupation of agriculture or
animal-breeding or fishing, a high risk for NHLs and CLLs is seen in the
farmer-breeders (OR 1.79, 95% CI 1.22 - 2.63). Analyses according to histological
type show that the risks are concentrated in CLLs and in low grade NHLs. No
effect or trend by period at work or duration of employment in farming and animal
breeding was found. CONCLUSION--Subjects working in agriculture associated with
animal breeding are at high risk of NHL/CLLs, particularly CLLs and low grade
NHLs. This finding could be related to the use of chemicals in agriculture or to 
exposure to animal transmitted diseases or specific chemicals used in animal
breeding.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7627313 [PubMed - indexed for MEDLINE]

4582: Br J Ophthalmol. 1995 Jun;79(6):575-80.

Retinal detachment and herpesvirus retinitis in patients with AIDS.

Dowler JG, Towler HM, Mitchell SM, Cooling RJ, Lightman SL.

Moorfields Eye Hospital, London.

BACKGROUND--The prolongation of survival of patients with herpesvirus retinitis
and AIDS has been associated with a rise in the incidence of retinal detachment. 
In such cases, however, retinal reattachment may be difficult to achieve, and
postoperative visual acuity may be poor despite anatomically successful surgery. 
METHODS--In order to examine factors affecting the visual outcome of surgery, a
retrospective review of 29 patients with retinal detachment, herpesvirus
retinitis, and AIDS was performed. Retinal reattachment surgery (32 procedures)
or prophylactic laser demarcation (five procedures) was performed in 28 eyes of
23 patients. RESULTS--The macula was attached in 23/28 (82%) eyes at the last
outpatient visit. Best postoperative visual acuity (median 6/18, range 6/6-hand
movements) was significantly greater than final postoperative acuity (median
counting fingers, range 6/6-no perception of light) (Wilcoxon sign rank test, p =
0.003), and was retained for a median of 3 months (1-91 weeks) after surgery.
Poor visual outcome as evidenced by submedian final visual acuity was invariably 
associated with persistence of macular detachment, and significantly associated
with the occurrence of optic atrophy (odds ratio = 5, p = 0.02).
CONCLUSION--Retinal reattachment surgery appears justified in patients with
herpesvirus retinitis and AIDS, but postoperative visual deterioration may occur 
in association with optic atrophy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7626574 [PubMed - indexed for MEDLINE]

4583: Aust Fam Physician. 1995 Jun;24(6):1167-8.

Cold sores and shingles.

Holley WC.

Publication Types: 
    Letter

PMID: 7625954 [PubMed - indexed for MEDLINE]

4584: J R Coll Surg Edinb. 1995 Jun;40(3):197.

Unusual cause for acute retention of urine.

Dauleh MI, Byrne DJ.

Department of Urology, Dundee Royal Infirmary, UK.

Acute retention of urine occurs uncommonly in women. One of the more common
causes has been labelled psychogenic. Postoperative urinary retention is seen
infrequently, particularly after pelvic and anal surgery. Rare causes include
complete procidentia, vesical herpes zoster, bladder stone and bladder tumours
with or without clot retention.

Publication Types: 
    Case Reports

PMID: 7616477 [PubMed - indexed for MEDLINE]

4585: No To Shinkei. 1995 Jun;47(6):595-9.

[Granulomatous angiitis of the central nervous system complicated by the syndrome
of inappropriate antidiuretic hormone]

[Article in Japanese]

Shiozi Y, Takeshima M, Itoshima T, Nose S, Hamaya K.

Department of Internal Medicine, Okayama Saiseikai General Hospital, Japan.

We report an autopsy case of granulomatous angiitis of the central nervous system
(GANS) complicated by the syndrome of inappropriate antidiuretic hormone (SIADH).
A 88-year old female was admitted because of progressive mental deterioration,
fever, and vomiting. A computed tomogram disclosed bilateral periventricular
lucency, and a low-density area in the right occipital lobe. Laboratory studies
during her hospital stay, revealed hyponatremia, hypoalbuminemia, and increased
antidiuretic hormone. Treatment with antibiotics, hypertonic saline solution, and
steroids, and water restriction was ineffective, and the patient died six weeks
after admission. Autopsy examination of the brain revealed slightly turbid
meninges with multiple small infarctions in the corona raiata of both cerebral
hemispheres. Microscopic study disclosed granulomatous inflammation with many
giant cells in the walls of small and medium sized vessels, and the adventitia
and media were more involved than the intima. Their lumens were narrowed, and
many thrombi were observed. Extensive non-granulomatous inflammatory change was
found mainly in the subarachnoid space. All of these findings were similar to the
GANS firstly reported by Cravioto et al, in 1959. Since the blood vessels in the 
central nervous system play an important part in any inflammatory conditions and 
the blood vessels may be involved by bacterial, fungal, parasitic or viral
meningitis, various microorganisms have been suspected as the cause of GANS,
including mycoplasma, herpes zoster, herpes simplex viruses, cytomegalovirus, and
human T-lymphotropic virus type III (HTLV-III). Some reported cases have been
associated with Hodgkin's disease and cerebral amyloid angiopathy. We could not
identify any cause in our case.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Case Reports
    English Abstract

PMID: 7605690 [PubMed - indexed for MEDLINE]

4586: Clin Ter. 1995 Jun-Jul;146(6-7):393-448.

[Update on the use of interferons in clinical practice]

[Article in Italian]

Lauta VM.

Dipartimento di Scienze Biomediche ed Oncologia Umana, Universita degli Studi di 
Bari.

Discovered by Isaac and Lindemann as a substance able to induce a biological
interference among viruses and host cells, interferon appeared to include three
main antigenic classes: alpha, beta and gamma. There is a large variety of
actions exhibited by different types of interferon and among them it is possible 
to distinguish an antiviral, antineoplastic, immunomodulatory or hormonal
activity. Many years ago, the antiviral action seemed to be relative to some
cellular membrane disorders, but later other mechanisms were stressed. Among
them, it is worth describing the transcription and transduction of antiviral
proteins like the oligoadenilsinthetase and proteinphosphokinase, able to cause
the viral RNA breackage. The antineoplastic action is exerted by direct and
indirect mechanisms. Direct mechanisms include an antiproliferative activity and 
the induction to cellular differentiation whereas the indirect ones involve the
enhancement on tumor cell surfaces of some tumor associated antigens included in 
the I class of MHC system. The immunomodulatory action is exerted by the
stimulation of macrophages, T cells and Killer cells cytotoxic activity. The list
of viral diseases sensitive to interferon treatment includes condiloma acuminata,
herpes zoster, chronic B and C hepatitis and Kaposi sarcoma AIDS-related. High
proportions of overall response rate were observed among interferon treated
patients with condiloma acuminata (80-100%). The use of interferon in the
treatment of herpes zoster achieved good results regarding a shorter duration of 
the time spent to induce the chest pains and cutaneous symptoms disappearance
when compared with that relative to other antiviral drugs. Results obtained in
the treatment of chronic B and C hepatitis regard the disappearance of viral
replication serological markers and the improvement of histological and enzymatic
pattern. The effectiveness of interferon in the therapy of Kaposi sarcoma is
demonstrated by the reduction of cutaneous symptoms and recurrent infectious
diseases incidence. The use of interferon in treatment of solid tumors seems to
play secondary role and, at any rate, to be adjuvant to chemotherapy. The
administration of beta interferon as therapy of breast cancer seems to increase
the estrogens and progesterone concentration in the neoplastic tissue and so it
aims to improve the sensitivity to the tamoxifen treatment. The addition of
interferon alpha both to 5-FU and cis-platinum seems to improve the proportion of
overall response rate respectively in the treatment of colon cancer and head and 
neck cancer.(ABSTRACT TRUNCATED AT 400 WORDS)

Publication Types: 
    English Abstract
    Review

PMID: 7586995 [PubMed - indexed for MEDLINE]

4587: Vet Hum Toxicol. 1995 Jun;37(3):233-4.

Hemodialysis removal of acyclovir.

Leikin JB, Shicker L, Orlowski J, Blair AT, McAllister K.

Emergency Services, Rush Poison Control Center, Rush Presbyterian St Luke's
Medical Center, Chicago, Illinois 60612, USA.

A 59-y-old with a history of chronic renal failure on hemodialysis was diagnosed 
with herpes zoster and begun on 800 mg acyclovir 5 times daily. Two days later
the patient developed visual hallucinations, ataxia, confusion and memory loss
along with focal myoclonus, nausea and vomiting. No fever, elevated WBC count or 
significant electrolyte imbalance was found. CT scan of the brain was
unremarkable. The patient was then dialyzed for presumed acyclovir toxicity. Her 
acyclovir level was later found to have been 3.4 micrograms/ml (normal peak range
0.4-2 micrograms/ml) prior to dialysis. After 3 h of hemodialysis, her
post-dialysis acyclovir level was 1.9 micrograms/ml. After a second course of
hemodialysis the next day the patient's mental status improved, and she was
discharged 5 d later. Due to its low volume of distribution (0.6 L/kg), low
protein binding (about 15%) and water solubility, acyclovir is an example of the 
ideal drug that can be removed by hemodialysis. About 45% of the total body
amount can be extracted through a 3-h course of hemodialysis with resultant
improvement in symptoms.

Publication Types: 
    Case Reports

PMID: 7571352 [PubMed - indexed for MEDLINE]

4588: J Neurol. 1995 Jun;242(6):390-7.

Intrathecal production of specific IgA antibodies in CNS infections.

Roberg M, Forsberg P, Tegnell A, Ekerfeldt K.

Department of Infectious Diseases, Faculty of Health Sciences, University
Hospital, Linkoping University, Sweden.

Cerebrospinal fluid (CSF) and serum from subjects with herpes simplex
encephalitis, herpes zoster, mumps meningitis and neuroborreliosis were analysed 
for the presence of immunoglobulin A (IgA) and G (IgG) antibodies to the
corresponding four antigens. Specific intrathecal IgA antibody synthesis as
manifested by an elevated index was a frequent finding. Higher IgA index values
than the corresponding IgG was seen in one third of the samples from subjects
with herpes simplex encephalitis and herpes zoster. Correlation between specific 
IgG and IgA index was most pronounced for varicella-zoster virus (r = 0.66, P <
0.001). In subjects with mumps meningitis a strong intrathecal IgA and IgG
antibody response to Borrelia burgdorferi was demonstrated. Specific herpes
simplex and varicella-zoster virus IgA was not found to contain secretory
component, thus contradicting an active secretion into the CNS compartment. In
conclusion, our data indicate that specific IgA is intrathecally produced in
herpes simplex encephalitis, herpes zoster and mumps meningitis but is a rare
finding in neuroborreliosis.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7561968 [PubMed - indexed for MEDLINE]

4589: Cephalalgia. 1995 Jun;15(3):241-2.

Syncope and seizure-like activity secondary to acute herpes zoster infection of
the trigeminal nerve.

Bonamico L, Celnik P.

A Thomson Neurological Center, Hospital Frances, Buenos Aires, Argentina.

Syncope may occur with glossopharyngeal neuralgia. We describe a patient with
acute herpetic infection of the first branch of the trigeminal nerve associated
with episodes of shooting pain, cardiac arrest and tonic-clonic movements.
Resemblances with the so-called "cardiovascular" form of glossopharyngeal
neuralgia, as well as putative mechanisms of the syncope, are discussed.

Publication Types: 
    Case Reports

PMID: 7553816 [PubMed - indexed for MEDLINE]

4590: Bratisl Lek Listy. 1995 Jun;96(6):338-9.

[Grawitz tumor in a female patient with minor manifestations of herpes zoster
detected by an active dermatologic examination]

[Article in Slovak]

Kolibasova K, Baumgartner J, Stojkovic J, Ondrias F.

Kozna klinika Institutu pre dalsie vzdelavanie zdravotnickych pracovnikov v
Bratislave, Slovakia.

Publication Types: 
    Case Reports

PMID: 7552413 [PubMed - indexed for MEDLINE]

4591: Curr Opin Neurol. 1995 Jun;8(3):170-4.

Acute viral infections.

Jackson AC.

Department of Medicine, Queen's University, Kingston, Ontario, Canada.

There have been important recent advances in the diagnosis of acute viral
infections of the nervous system. Polymerase chain reaction amplification of
nucleic acids in cerebrospinal fluid and tissues is a rapid and accurate tool in 
the diagnostic evaluation of patients with suspected infections. It has proved to
be highly valuable in the noninvasive diagnosis of herpes simplex virus
encephalitis and also in establishing the role of herpes simplex virus infection 
in Mollaret's meningitis. Improved diagnosis of herpesvirus infections should
lead to more appropriate antiviral therapy and better outcomes.

Publication Types: 
    Review

PMID: 7551114 [PubMed - indexed for MEDLINE]

4592: J Formos Med Assoc. 1995 Jun;94(6):313-7.

Varicella zoster virus infection after allogeneic or autologous hemopoietic stem 
cell transplantation.

Tzeng CH, Liu JH, Fan S, Wang SY, Wang SR, Chen KY, Hsieh RK, Yung CH, Chen PM.

Department of Medicine, Veterans General Hospital-Taipei, Taiwan ROC.

A retrospective study was carried out in 161 patients who underwent allogeneic or
autologous hemopoietic stem cell transplants. The aim was to determine the
frequency, outcome and risk-factors associated with varicella zoster virus (VZV) 
infection. Post-transplant VZV infection occurred in 29 patients. The median
onset of infection was 6.5 months post-transplant, with 82% of cases occurring
within the first year. Localized herpes zoster was seen in 27 patients, one
patient had varicella, and one patient had simultaneous presentation of both
herpes zoster and varicella. No cutaneous or visceral dissemination was noted in 
the series. Each patient was treated with intravenous acyclovir. Mild
complications with postherpetic neuralgia were reported by three patients. There 
were no deaths from VZV infection. Two risk factors noted to be associated with
VZV infection were the presence of graft-versus-host disease in allogeneic
transplants and leukemia as the underlying disease in autologous transplants. The
overall incidence of post-transplant VZV infection in the present series was
relatively low compared with that of other reports involving either allogeneic or
autologous bone marrow transplantation.

PMID: 7549549 [PubMed - indexed for MEDLINE]

4593: Dtsch Med Wochenschr. 1995 May 12;120(19):700.

[Zoster neuralgia]

[Article in German]

Terborg C, Busse O.

Neurologische Klinik, Klinikum Minden.

PMID: 7768166 [PubMed - indexed for MEDLINE]

4594: Virology. 1995 May 10;209(1):29-51.

The DNA sequence of human herpesvirus-6: structure, coding content, and genome
evolution.

Gompels UA, Nicholas J, Lawrence G, Jones M, Thomson BJ, Martin ME, Efstathiou S,
Craxton M, Macaulay HA.

Department of Clinical Sciences, London School of Hygiene and Tropical Medicine, 
University of London, United Kingdom.

The complete DNA sequence was determined for strain U1102 of human herpesvirus-6,
a CD4+ T-lymphotropic virus with disease associations in immunodeficient settings
and a possible complicating factor in AIDS. The genome is 159,321 bp in size, has
a base composition of 43% G + C, and contains 119 open reading frames. The
overall structure is 143 kb bounded by 8 kb of direct repeats, DRL (left) and DRR
(right), containing 0.35 kb of terminal and junctional arrays of human
telomere-like simple repeats. Since eight open reading frames are duplicated in
the repeats, six span repetitive elements and three are spliced, the genome is
considered to contain 102 separate genes likely to encode protein. The genes are 
arranged colinearly with those in the genome of the previously sequenced
betaherpesvirus, human cytomegalovirus, and has a distinct arrangement of
conserved genes relative to the sequenced gammaherpesviruses, herpesvirus saimiri
and Epstein-Barr virus, and the alphaherpesviruses, equine herpesvirus-1,
varicella-zoster virus, and herpes simplex virus. Comparisons of predicted amino 
acid sequences allowed the functions of many human herpesvirus-6 encoded proteins
to be assigned and showed the closest relationship in overall number and
similarity to human cytomegalovirus products, with approximately 67% homologous
proteins as compared to the 21% identified in all herpesviruses. The features of 
the conserved genes and their relative order suggested a general scheme for
divergence among these herpesvirus lineages. In addition to the "core" conserved 
genes, the genome contains four distinct gene families which may be involved in
immune evasion and persistence in immune cells: two have similarity to the
"chemokine" chemotactic/proinflammatory family of cytokines, one to their peptide
G-protein-coupled receptors, and a fourth to the immunoglobulin superfamily.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 7747482 [PubMed - indexed for MEDLINE]

4595: Virology. 1995 May 10;209(1):281-3.

Pseudorabies virus EPO is functionally homologous to varicella-zoster virus ORF61
protein and herpes simplex virus type 1 ICPO.

Moriuchi H, Moriuchi M, Dean H, Cheung AK, Cohen JI.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892, USA.

Pseudorabies virus (PRV) early protein O (EPO) is the homolog of varicella-zoster
virus (VZV) open reading frame 61 (ORF61) protein and herpes simplex virus type 1
(HSV-1) ICPO. A PRV EPO deletion mutant grows poorly in cell culture, suggesting 
that EPO plays a critical role in the viral replicative cycle. In this study, we 
have shown that the growth defect of an EPO deletion mutant was complemented in
Vero cells expressing VZV ORF61 protein or HSV-1 ICPO. In transient expression
assays PRV EPO, like VZV ORF61 protein and HSV-1 ICPO, transactivates a variety
of promoters from PRV, VZV, HSV, and unrelated viruses. These data indicate that 
PRV EPO is functionally homologous to VZV ORF61 protein and HSV-1 ICPO.

PMID: 7747481 [PubMed - indexed for MEDLINE]

4596: Clin Diagn Virol. 1995 May;3(4):323-32.

Application of fluoroimmunoassay to the identification of low avidity specific
IgG against pathogenic human viruses and Toxoplasma gondii.

de Ory F, Casas I, Domingo CJ, Echevarria J.

Departamento de Diagnostico, Centro Nacional de Microbiologia, Virologia e
Inmunologia Sanitarias, Instituto de Salud Carlos III, Majadahonda, 28220 Madrid,
Spain.

BACKGROUND: Serological diagnosis of primary viral infections is usually made by 
detection of specific IgM. In some cases, false positive results (mainly due to
crossreactions between closely related viruses) can be obtained. Moreover, some
primary infections occur without specific IgM response. Thus, alternative
serological approaches are required for diagnosis. Detection of low avidity,
specific IgG has been applied as a useful serological marker for diagnosing
infections caused by several viruses and Toxoplasma gondii. OBJECTIVE: The
standardization and application of specific IgG avidity assays using a
semiautomated solid phase immunoassay (fluoroimmunoassay (FIA)) on the basis of
the urea elution principle, for the characterization of low avidity specific IgG 
against rubella virus, herpes simplex virus (HSV), varicella-zoster virus (VZV), 
cytomegalovirus (CMV) and T. gondii. STUDY DESIGN: The method consists of two
simultaneous determinations, one as recommended by the manufacturer and the other
including a washing step with 8 M urea after the antigen-antibody reaction. A
reduction in titer higher than, or equal to, 50% was considered indicative for
presence of low avidity specific IgG. RESULTS: When applied to the diagnosis of
infections, this method showed sensitivity ranging from 81% to 100%, and absolute
specificity. The detection of low avidity specific IgG allowed the
differentiation between primary and recurrent infections caused by VZV.
Furthermore, it helped in the identification of CMV as the etiological agent of
congenital infection in the absence of specific IgM response, as well as in the
elucidation of crossreactivity between antigenically related viruses, i.e., VZV
and HSV, and Epstein-Barr virus and CMV. CONCLUSION: FIA can be used for the
characterization of the avidity of specific IgG antibody as a diagnostic test in 
clinical laboratories.

PMID: 15566813 [PubMed]

4597: Nippon Sanka Fujinka Gakkai Zasshi. 1995 May;47(5):503-6.

[A case of pregnancy complicated with virus-associated hemophagocytic syndrome]

[Article in Japanese]

Yamanaka S, Katsube Y, Honda H, Kasaoka N, Toyota N.

Department of Obstetrics and Gynecology, Kure Kyosai Hospital, Hiroshima.

Publication Types: 
    Case Reports

PMID: 7775820 [PubMed - indexed for MEDLINE]

4598: J Am Acad Dermatol. 1995 May;32(5 Pt 2):908-11.

Atypical varicella-zoster virus infection in an immunocompromised patient: result
of a virus-induced vasculitis.

Erhard H, Runger TM, Kreienkamp M, Muller J, Muller-Hermelink HK, Brocker EB.

Department of Dermatology, University of Wurzburg, Germany.

We describe a patient with cutaneous T-cell lymphoma in whom persistent,
painless, ecthymatous nodules developed as a result of a varicella-zoster virus
infection. The localized infection occurred without a vesicular stage.
Ultrastructural studies revealed a lack of epidermal involvement and massive
varicella-zoster virus replication within endothelial cells, leading to an
obliterative vasculitis. This suggests direct infection of dermal vessels from
adjacent nerves, bypassing the epidermis, which is usually infected first in the 
classic infectious pathway during varicella-zoster virus reactivation from
sensory nerves.

Publication Types: 
    Case Reports

PMID: 7722056 [PubMed - indexed for MEDLINE]

4599: J Am Acad Dermatol. 1995 May;32(5 Pt 2):854-7.

Zosteriform metastases in melanoma.

Itin PH, Lautenschlager S, Buechner SA.

Department of Dermatology, University of Basel, Switzerland.

Zosteriform metastasis is a rare form of tumor spread to the skin that most often
arises from an internal carcinoma or a hematologic malignancy. We describe a
29-year-old woman with malignant melanoma of the back in whom zosteriform
metastases developed along the fifth thoracic dermatome.

Publication Types: 
    Case Reports

PMID: 7722043 [PubMed - indexed for MEDLINE]

4600: J Am Acad Dermatol. 1995 May;32(5 Pt 1):730-3.

Detection of herpes simplex and varicella-zoster infection from cutaneous lesions
in different clinical stages with the polymerase chain reaction.

Nahass GT, Mandel MJ, Cook S, Fan W, Leonardi CL.

Department of Internal Medicine, Saint Louis University Health Sciences Center,
MO 63104, USA.

BACKGROUND: The polymerase chain reaction (PCR) can be used to diagnose a variety
of infectious processes. OBJECTIVE: We sought to determine whether Tzanck smear
debris, vesicle fluid swabs, crusts, or fixed tissue specimens are the best
source for template herpes simplex virus (HSV) or varicella-zoster virus (VZV)
DNA for the PCR. METHODS: Patients with both clinical and histologic evidence of 
HSV (n = 6) or VZV (n = 16) infection were examined. Stained Tzanck smears,
vesicle fluid swabs, dried crusts, and skin biopsy specimens were obtained at the
same time from each patient. DNA was extracted from the different clinical
specimens and then examined for HSV or VZV DNA with PCR. Fifteen control subjects
did not have clinical or histologic evidence of herpesvirus infection. RESULTS:
In cases of suspected VZV infection, PCR detected VZV DNA sequences from all 15
Tzanck smears, all 15 vesicle swabs, one of one crust, and 14 of 16 fixed tissue 
specimens. HSV DNA sequences were detected from all six Tzanck smears, all four
vesicle fluid swabs, two of two crusts, and five of six fixed tissue specimens.
CONCLUSION: PCR can detect VZV and HSV DNA sequences from a variety of sources
including formalin-fixed tissue specimens. Although viral DNA was detected
slightly more frequently from Tzanck smear debris, crusts, and vesicle fluid
swabs compared with fixed tissue specimens, each was an excellent source of
target DNA for the PCR to confirm the diagnosis of herpesvirus infection.

PMID: 7722016 [PubMed - indexed for MEDLINE]

4601: J Virol. 1995 May;69(5):3240-5.

Varicella-zoster virus gene 63 encodes an immediate-early protein that is
abundantly expressed during latency.

Debrus S, Sadzot-Delvaux C, Nikkels AF, Piette J, Rentier B.

Laboratory of Fundamental Virology, Institute of Pathology, University of Liege, 
Belgium.

Varicella-zoster virus (VZV) gene 63 encodes a protein with a predicted molecular
mass of 30.5 kDa which has amino acid similarities with the immediate-early (IE) 
protein 22 (ICP-22) of herpes simplex virus type 1. In order to study the
expression of this protein during lytic and latent infection, gene 63 was cloned 
in frame and downstream from the glutathione-S-transferase gene, expressed as a
fusion protein, and purified. In VZV-infected Vero cells, antibodies directed
against this protein detect two polypeptides of 45 and 38 kDa which are localized
both in the cytoplasm and in the nucleus. Using a sequential combination of
transcription and protein synthesis inhibitors (actinomycin D and cycloheximide, 
respectively), we demonstrated the immediate-early nature of this protein, which 
can thus be named IE63. Using a rat model of VZV latency, we showed that IE63 is 
heavily expressed, essentially in neurons, during latency. IE63 can also be
detected in the skin of patients showing early herpes zoster symptoms.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7707559 [PubMed - indexed for MEDLINE]

4602: J Virol. 1995 May;69(5):2786-93.

Regulatory function of the equine herpesvirus 1 ICP27 gene product.

Zhao Y, Holden VR, Smith RH, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932, USA.

The UL3 protein of equine herpesvirus 1 (EHV-1) KyA strain is a homolog of the
ICP27 alpha regulatory protein of herpes simplex virus type 1 (HSV-1) and the ORF
4 protein of varicella-zoster virus. To characterize the regulatory function of
the UL3 gene product, a UL3 gene expression vector (pSVUL3) and a vector
expressing a truncated version of the UL3 gene (pSVUL3P) were generated. These
effector plasmids, in combination with an EHV-1 immediate-early (IE) gene
expression vector (pSVIE) and chimeric EHV-1 promoter-chloramphenicol
acetyltransferase (CAT) reporter constructs, were used in transient transfection 
assays. These assays demonstrated that the EHV-1 UL3 gene product is a regulatory
protein that can independently trans activate the EHV-1 IE promoter; however,
this effect can be inhibited by the repressive function of the IE gene product on
the IE promoter (R. H. Smith, G. B. Caughman, and D. J. O'Callaghan, J. Virol.
66:936-945, 1992). In the presence of the IE gene product, the UL3 gene product
significantly augments gene expression directed by the promoters of three EHV-1
early genes (thymidine kinase; IR4, which is the homolog of HSV-1 ICP22; and UL3 
[ICP27]) and the promoter of the EHV-1 late gene IR5, which is the homolog of
HSV-1 US10. Sequences located at nucleotides -123 to +20 of the UL3 promoter
harbor a TATA box, SP1 binding site, CAAT box, and octamer binding site and, when
linked to the CAT reporter gene, are trans activated to maximal levels by the
pSVIE construct in transient expression assays. Results from CAT assays also
suggest that the first 11 amino acids of the UL3 protein are not essential for
the regulatory function of the UL3 gene product.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 7707500 [PubMed - indexed for MEDLINE]

4603: J Infect. 1995 May;30(3):193-200.

Guidelines for the management of shingles. report of a working group of the
British Society for the Study of Infection (BSSI).

[No authors listed]

Publication Types: 
    Guideline
    Practice Guideline
    Research Support, Non-U.S. Gov't

PMID: 7673741 [PubMed - indexed for MEDLINE]

4604: Bone Marrow Transplant. 1995 May;15(5):805-7.

Visceral varicella zoster infection after bone marrow transplantation without
skin involvement and the use of PCR for diagnosis.

Rogers SY, Irving W, Harris A, Russell NH.

University Department of Haematology, City Hospital, Nottingham, UK.

A 41-year-old patient with acute myeloid leukemia was transplanted from an
HLA-identical but ABO-incompatible sibling. The post-transplant course was
complicated by pure erythrocyte aplasia and mild chronic graft-versus-host
disease. Eleven months after transplant while on steroid therapy she developed
abdominal pain rapidly followed by fatal fulminant hepatic failure. Varicella
zoster virus (VZV) was detected using the polymerase chain reaction from blood
and liver obtained at necropsy even though no skin manifestations of VZV were
present. This case confirms previous reports of visceral VZV infection in the
absence of skin lesions thus emphasising the importance of suspecting the
presence of VZV in this clinical setting and outlines the possible value of PCR
in the rapid diagnosis of infection.

Publication Types: 
    Case Reports

PMID: 7670413 [PubMed - indexed for MEDLINE]

4605: Optom Vis Sci. 1995 May;72(5):312-9.

Non-CMV infectious chorioretinopathies in AIDS.

Litwak AB.

VA Medical Centers, Baltimore/Fort Howard, Maryland, USA.

Cytomegalovirus (CMV) retinitis is the most common posterior segment
opportunistic infection and the leading cause of blindness in acquired
immunodeficiency syndrome (AIDS) patients. CMV is not the sole agent that can
infect the fundus of an immunocompromised patient. Disseminated herpes zoster
(HZ), herpes simplex, toxoplasmosis, and Candidiasis are possible. Syphilis,
Pneumocystis carinii, cryptococcosis, tuberculosis, and a host of other viruses, 
protozoa, bacteria, or neoplasms may invade the retina or choroid. The eye care
practitioner must not only differentiate noninfectious retinopathy (AIDS
retinopathy) from CMV retinitis, but also distinguish CMV retinitis from other
posterior segment infections because the treatment modalities are different. This
paper will review the clinical features of non-CMV infectious retinopathies and
choroidopathies that occur in AIDS patients.

Publication Types: 
    Review

PMID: 7667008 [PubMed - indexed for MEDLINE]

4606: Virus Res. 1995 May;36(2-3):269-78.

Identification and characterization of a Marek's disease virus gene encoding DNA 
polymerase.

Sui D, Wu P, Kung HJ, Lee LF.

USDA-Agricultural Research Service, Avian Disease and Oncology Laboratory, East
Lansing, MI 48823, USA.

DNA sequence analysis revealed a gene encoding the Marek's disease virus (MDV)
DNA polymerase (pol) within the BamHI-E fragment of the long unique region of the
virus genome. Identification is based on an extensive amino acid homology between
the MDV open reading frame and the DNA pol (UL30) of the herpes simplex virus. We
describe here a 3540-base-pair fragment of the MDV DNA encoding 1180 amino acids 
with a M(r) of 133,920 daltons as the viral DNA pol gene, with the analysis of
transcription and translation. In Northern blot hybridization, a transcript of
4.0 kb was detected in GA-MDV-infected duck embryo fibroblast (DEF) cells. An
antiserum was generated in rabbit using TryE-pol fusion protein expressed in E.
coli. This antiserum specifically immunoprecipitated a protein of 135 kD from
lysates of MDV-GA-infected DEF cells. MDV DNA pol showed extensive homology to
five distantly related herpesviruses: equine herpesvirus (EHV), varicella-zoster 
virus (VZV), herpes simplex virus type 1 (HSV-1), Epstein-Barr virus (EBV), and
human cytomegalovirus (HCMV). Comparison of amino acid sequences among the
herpesviruses highlights nine highly conserved regions. Three of the conserved
regions are in the N-terminus in the 3'-5' exonuclease domains and the remaining 
six are in the C-terminus in the catalytic domains. The predicted structural
characters are in good agreement with the published data on a number of human
herpesvirus DNA pol. The identification of MDV DNA pol gene may lead to a better 
understanding of MDV replication.

Publication Types: 
    Comparative Study

PMID: 7653104 [PubMed - indexed for MEDLINE]

4607: Pediatr Infect Dis J. 1995 May;14(5):445-9.

Present and future challenges of immunizations on the health of our patients.

Gershon AA.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, NY, USA.

A recent analysis demonstrated a change in incidence approaching 100% for
diseases against which we routinely immunize in the United States. At present,
measles, mumps, rubella, invasive Haemophilus disease, poliomyelitis, diphtheria 
and tetanus are well-controlled but not eliminated. Diseases that now pose
special problems include pertussis, hepatitis A and B and varicella. The
incidence of pertussis surged in 1994, possibly in part because of waning
immunity in the immunized population. Acellular pertussis vaccines are available 
for booster doses in children but are not now recommended for adults. Licensure
of acellular pertussis vaccines for primary immunization of infants is eagerly
awaited. Recombinant hepatitis B vaccine has been licensed for more than 10 years
but there has been little change in disease incidence in the United States.
Routine immunization of infants is now recommended but concerns exist about cost 
and persistence of immunity into adolescence. Inactivated hepatitis A vaccines
appear to be highly effective in preventing clinical hepatitis and controlling
epidemics. Potential target populations include military personnel, day-care
attendees and travelers. Hepatitis A vaccine may be recommended for all children 
after approval by the United States Food and Drug Administration and if a
combination vaccine becomes available. A live, attenuated varicella vaccine
developed in 1974 and unlicensed in the United States is safe and highly
effective in preventing varicella in healthy and immunocompromised populations.
It also appears to reduce subsequent development of herpes zoster. Vaccines
against pneumococci (conjugate vaccine), respiratory syncytial virus, rotavirus, 
tuberculosis and human immunodeficiency virus are needed. Research and technology
to develop these vaccines must be developed, and efficient delivery mechanisms
must be created and implemented.

Publication Types: 
    Review

PMID: 7638035 [PubMed - indexed for MEDLINE]

4608: Pediatr Infect Dis J. 1995 May;14(5):395-7.

Two cases of disseminated cutaneous herpes zoster in infants after intrauterine
exposure to varicella-zoster virus.

Chiang CP, Chiu CH, Huang YC, Lin TY.

Department of Pediatrics, Chang Gung Children's Hospital, Kweishan, Taoyuan,
Taiwan.

Publication Types: 
    Case Reports

PMID: 7638019 [PubMed - indexed for MEDLINE]

4609: J Virol Methods. 1995 May;53(1):37-45.

Differential in situ hybridization for herpes simplex virus typing in routine
skin biopsies.

Botma HJ, Dekker H, van Amstel P, Cairo I, van den Berg FM.

Department of Pathology-H2, University of Amsterdam, The Netherlands.

A herpes simplex virus (HSV) type 2 specific recombinant plasmid probe designated
pH2S3 was constructed from non-HSV-1 crossreactive regions of the HSV-2 genome.
DNA in situ hybridization on in vitro reconstructed tissue samples of sheep
collagen matrix impregnated with herpes virus-infected human cells was used to
demonstrate absence of crossreactivity of the pH2S3 probe with HSV-1 and
varicella zoster virus under stringent posthybridization washing conditions. It
was demonstrated that DNA in situ hybridization with pH2S3 allows specific
detection of HSV-2 in routine formalin-fixed, paraffin-embedded patient material.

PMID: 7635926 [PubMed - indexed for MEDLINE]

4610: J Virol Methods. 1995 May;53(1):25-36.

New method for the extraction of viral RNA and DNA from cerebrospinal fluid for
use in the polymerase chain reaction assay.

Casas I, Powell L, Klapper PE, Cleator GM.

Department of Pathological Sciences, Medical School, University of Manchester,
UK.

A new, rapid, and simple method for the isolation of either RNA or DNA from
cerebrospinal fluid samples for subsequent amplification by specific polymerase
chain reaction (PCR) assays is described. The technique involves a single
extraction with a guanidinium thiocyanate acid (GuSCN) buffer, and does not
require the use of organic solvents. Applied to the recovery of enteroviral RNA, 
herpes simplex virus (HSV) and Varicella-zoster virus (VZV) DNAs the method has
proved to be of equivalent or better efficiency than established methods of
nucleic acid separation but is less laborious and time consuming. The simplicity 
of the procedure permits the processing of large numbers of samples and the use
of a single preparative method for either RNA or DNA PCR makes it an attractive
method for the routine laboratory.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7635925 [PubMed - indexed for MEDLINE]

4611: Clin Infect Dis. 1995 May;20(5):1378-80.

Brain stem encephalitis due to varicella-zoster virus in a patient with AIDS.

Moulignier A, Pialoux G, Dega H, Dupont B, Huerre M, Baudrimont M.

Service de Neurologie, Hopital Tenon, Paris, France.

We describe a patient infected with human immunodeficiency virus (HIV) who had
localized brain stem encephalitis due to varicella-zoster virus (VZV) and no
cutaneous eruption. Diagnosis of the infection was based on the presence of
Cowdry type A intranuclear inclusions in neurons, astrocytes, and
oligodendrocytes positive for VZV (as shown by immunochemical staining). Although
this infection is rare, we demonstrate the need for clinicians to include VZV
infection in the differential diagnosis of rapidly progressive multiple cranial
nerve palsies in HIV-infected patients, particularly because specific treatment
for VZV infection is effective and relatively safe.

Publication Types: 
    Case Reports

PMID: 7620026 [PubMed - indexed for MEDLINE]

4612: Int J Dermatol. 1995 May;34(5):341-8.

Comment in:
    Clin Exp Dermatol. 2003 Sep;28(5):555-6.    Int J Dermatol. 2003 Aug;42(8):664-6.

Isotopic response.

Wolf R, Brenner S, Ruocco V, Filioli FG.

Department of Dermatology, Tel-Aviv Sourasky Medical Center, Ichilov Hospital,
Israel.

BACKGROUND--The occurrence of a new skin disorder exactly at the site of another 
one, already healed and unrelated, was first described in 1955. In 1985, Wolf et 
al. recognized that we are dealing with a dermatologic phenomenon and established
a precise definition for this phenomenon. Fifty-eight cases corresponding to the 
definition of this phenomenon have been reported until now. METHODS--The new
phenomenon, for which the term "isotopic response" has been suggested, has been
defined. Cases corresponding to the definition have been analyzed with special
emphasis on the diseases involved, the time intervals, and the locations of the
diseases. Eight new cases are described. RESULTS--A total of 58 cases of isotopic
response have been described. The first disease in most of the patients was
herpes zoster; in three cases it was herpes simplex, in two varicella, and in
one, thrombophlebitis. The second disease, which appeared exactly at the site of 
the first, already healed disease, was in most reported cases a carcinoma (26
cases, in particular 15 cases of breast carcinoma, 5 basal cell carcinomas (BCC),
4 squamous cell carcinomas (SCC), 2 basosquamous carcinomas), or granuloma
annulare (16 cases). Additional diseases were Kaposi's sarcoma (2 cases),
pseudolymphoma (2 cases), sarcoid (2 cases), tinea (2 cases), tuberculoid and
vasculitis granuloma (1 case), angiosarcoma, metastasis, Bowen's disease,
lymphoma, leukemia cutis, and acne (1 case each). The diseases did not show any
predilection for a particular location. The interval between the first and second
disease was extremely variable (ranging from days to years) and showed no
particular features. In the eight additional cases described in the present
report, the first disease was herpes simplex (6 cases) or herpes zoster (2
cases). The second disease was viral warts (3 cases) or squamous cell carcinoma
(2 cases). Additional diseases were furunculosis, contact dermatitis, and
molluscum contagiosum (1 case each). CONCLUSIONS--The new term, "isotopic
response," describes the occurrence of a new skin disorder at the site of
another, unrelated, and already healed skin disease. It is suggested that the
term "isotopic response" be included in the lexicon (glossary) of dermatology.
Introducing the new term and classifying all the cases under a single key word,
will make it possible to locate and collect them easily and to search for the
mechanism underlying this phenomenon.

Publication Types: 
    Case Reports
    Review

PMID: 7607796 [PubMed - indexed for MEDLINE]

4613: Br J Theatre Nurs. 1995 May;5(2):29.

Cytomegalovirus retinitis.

[No authors listed]

Cytomegalovirus (CMV) is a member of the herpes virus family, which also includes
herpes simplex virus types 1 and 2, varicella-zoster virus, and Epstein-Barr
virus. CMV is a common viral infection that, in the absence of HIV or other
immunocompromising conditions, remains latent and is not associated with serious 
illness. In immunocompromised people, however, CMV may be a major cause of
disease because the suppressed immune system may permit reactivation of the
virus. More than ninety percent of people with acquired immunodeficiency syndrome
(AIDS) show evidence of prior CMV infection and may continue to harbour inactive 
or latent virus.

PMID: 7599417 [PubMed - indexed for MEDLINE]

4614: Reg Anesth. 1995 May-Jun;20(3):255-6.

Interpleural block for acute combined cervical and thoracic herpes zoster.

Thwaites BK, Powell DR.

Publication Types: 
    Case Reports
    Letter

PMID: 7547670 [PubMed - indexed for MEDLINE]

4615: Reg Anesth. 1995 May-Jun;20(3):227-33.

Does sympathetic ganglionic block prevent postherpetic neuralgia? Literature
review.

Ali NM.

Department of Anesthesiology, University of New Mexico School of Medicine,
Albuquerque 87131, USA.

BACKGROUND AND OBJECTIVES. To examine specifically the role of sympathetic block 
in the prevention of postherpetic neuralgia by its application in the treatment
of acute herpes zoster. METHODS. Data sources included a Medline search and
cross-referencing of articles and text books. A total of 84 references were
reviewed. Peer-reviewed articles were selected according to their relevance to
the subject and originality. The data were critically analyzed by the author with
the specific intention of avoiding bias. RESULTS. The opinion of the medical
community is divided on the role of sympathetic block in preventing postherpetic 
neuralgia because of the lack of controlled trials and the conflicting
retrospective reports as to its effectiveness. While many reports promote the
early use of sympathetic blocks during acute herpes zoster to prevent
postherpetic neuralgia, others deny their value. CONCLUSIONS. Considering the
degree of uncertainty, and the seriousness of postherpetic neuralgia, sympathetic
block in addition to treatment with acyclovir should be considered early during
acute herpes zoster. Large controlled trials are needed to provide the necessary 
scientific evidence.

Publication Types: 
    Review

PMID: 7547660 [PubMed - indexed for MEDLINE]

4616: BMJ. 1995 Apr 15;310(6985):1005.

Comment on:
    BMJ. 1994 Oct 29;309(6962):1124.

Acyclovir and post-herpetic neuralgia. Two other participating study centres
report different results.

McKendrick MW, Wood MJ.

Publication Types: 
    Clinical Trial
    Comment
    Controlled Clinical Trial
    Letter

PMID: 7728001 [PubMed - indexed for MEDLINE]

4617: BMJ. 1995 Apr 15;310(6985):1005.

Comment on:
    BMJ. 1994 Oct 29;309(6962):1124.

Acyclovir and post-herpetic neuralgia. The balance of available evidence supports
its use.

Harding SP.

Publication Types: 
    Comment
    Letter

PMID: 7728000 [PubMed - indexed for MEDLINE]

4618: Virology. 1995 Apr 1;208(1):376-82.

The acidic amino-terminal region of varicella-zoster virus open reading frame 4
protein is required for transactivation and can functionally replace the
corresponding region of herpes simplex virus ICP27.

Moriuchi M, Moriuchi H, Debrus S, Piette J, Cohen JI.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, Bethesda, Maryland 20892, USA.

Both varicella-zoster virus open reading frame 4 (ORF4) protein and its herpes
simplex virus type 1 homolog ICP27 have highly acidic amino-terminal regions and 
cysteine-rich carboxy-terminal regions. To investigate the functional domains of 
these proteins, mutants were constructed and their transregulatory functions were
tested in transient expression assays using two reporter plasmids, pTK-CAT-SV40A 
and pTK-CAT-synA, containing the same promoter sequences but different mRNA
processing signals. ORF4 transactivates both pTK-CAT-SV40A and pTK-CAT-synA,
while ICP27 transrepresses pTK-CAT-SV40A and transactivates pTK-CAT-synA.
Deletion of the ORF4 amino-terminal region abolished most of the transactivating 
activity for pTK-CAT-synA but retained most of the transactivating activity for
pTK-CAT-SV40A. Construction of chimeric ORF4-ICP27 molecules indicated that the
ORF4 amino-terminal region was able to replace the corresponding region of ICP27 
which is required for both transrepression of pTK-CAT-SV40A and transactivation
of pTK-CAT-synA. Similarly, the ICP27 amino-terminal region was able to partially
replace the corresponding region of ORF4 which is required for transactivation of
pTK-CAT-synA Thus, while ORF4 and ICP27 have different properties in transient
expression assays, the amino-terminal regions of ORF4 and ICP27 are functionally 
homologous to each other and are important in regulating gene expression.

PMID: 11831723 [PubMed - indexed for MEDLINE]

4619: Am J Dermatopathol. 1995 Apr;17(2):163-8.

Subtle clues to the diagnosis of the herpesvirus by light microscopy. Herpetic
syringitis.

Sangueza OP, Gordon MD, White CR Jr.

Department of Pathology, Oregon Health Sciences University, Portland 97201,
U.S.A.

Among the numerous infections to which AIDS patients are susceptible, those
caused by herpesvirus (simplex and varicella/zoster) are among the most common.
Because herpetic infections may be the first manifestations of AIDS and often are
associated with poor prognosis, rapid and accurate diagnosis of them is
imperative. Herpesvirus infection may be diagnosed histopathologically by the
presence of ballooned, acantholytic, and multinucleated keratinocytes;
intranuclear eosinophilic viral inclusions; steel gray color of affected
keratinocytic cytoplasm and nuclei, chromatin margination, and necrotic
acantholytic keratinocytes in older lesions. These changes are often limited to
the epidermis, but there may frequently be involvement of epithelia of follicles 
(herpetic folliculitis) and sebaceous glands as well. Similar changes, although
seldom noted, may be present in eccrine ducts and glands (herpetic syringitis).
Recognition of subtle histologic clues concerning the secretory and ductal
components of sweat glands in an unusual case of herpes infection facilitated
rapid diagnosis in an AIDS patient, allowing appropriate treatment.

Publication Types: 
    Case Reports

PMID: 8600782 [PubMed - indexed for MEDLINE]

4620: Arch Esp Urol. 1995 Apr;48(3):302-4.

[Herpes and acute urinary retention]

[Article in Spanish]

Portillo Martin JA, Martin Garcia B, Rodriguez Hernandez R, Correas Gomez M,
Gutierrez Banos JL, Monje Mirallas JM, Roca Edreira YA.

Servicio de Urologia, Hospital Universitario de Valdecilla, Santander, Espana.

OBJECTIVE: The possible relationship between herpes zoster and acute urinary
retention was investigated. METHODS: Two cases of acute urinary retention
secondary to herpes zoster are described. The pathophysiological mechanisms that 
influence this condition are analyzed. RESULTS: Herpes zoster appears to play an 
important role in the development of micturition disorders. CONCLUSIONS: Acute
urinary retention can result from herpes zoster infection, although it usually
resolves spontaneously.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 7755437 [PubMed - indexed for MEDLINE]

4621: Ther Umsch. 1995 Apr;52(4):275-81.

[Skin changes in HIV infections]

[Article in German]

Lautenschlager S, Eichmann A.

Dermatologisches Ambulatorium des Stadtspitals Triemli, Zurich.

The spectrum of dermatologic findings related to human immunodeficiency virus
includes a variety of cutaneous and mucocutaneous disorders. The most frequent
diagnoses are oral candidiasis, seborrheic dermatitis, pyodermas and Kaposi's
sarcoma. Distinctive skin lesions occur at various stages of HIV infection.
Especially herpes zoster, seborrheic dermatitis and oral candidiasis may act as
indicators, and their recognition is of particular importance for the early
diagnosis of HIV infection and for the prevention of further opportunistic
infections. In addition, some dermatologic findings as mollusca contagiosa and
Kaposi's sarcoma occur mostly as late manifestations and may constitute a
cutaneous correlate of advanced cellular immune deficiency.

Publication Types: 
    English Abstract
    Review

PMID: 7754472 [PubMed - indexed for MEDLINE]

4622: Rev Med Suisse Romande. 1995 Apr;115(4):303-5.

[Clinical problem: painful abdomen]

[Article in French]

Loizeau E.

Clinique de Genolier.

Publication Types: 
    Case Reports

PMID: 7740254 [PubMed - indexed for MEDLINE]

4623: Med Care. 1995 Apr;33(4 Suppl):AS195-202.

Estimating the value of a generic quality-of-life measure.

Mauskopf JA, Austin R, Dix LP, Berzon RA.

Burroughs Wellcome Company, Research Triangle Park, NC 27709, USA.

In this paper, data from a clinical trial of a new antiviral agent for treating
patients with zoster are used to answer the following question: Does the
Nottingham Health Profile (NHP) add to the information obtained from the clinical
measures? Three ways in which the NHP could add information are measured. First, 
Cox's regression analysis is used to determine whether health-related
quality-of-life scores obtained at diagnosis give information about disease
prognosis. Second, changes in mean NHP scores in different dimensions are
computed after pain resolution to determine whether NHP scores provide more
sensitive indicators of disease resolution. Third, linear regression is used to
determine whether the impacts of disease on quality of life are measured
adequately by the clinical parameters. These analyses show that use of the
physical mobility and energy dimensions of the NHP increases understanding of
disease prognosis; demonstrates the continuing impact of zoster on patients'
sleep patterns and energy levels, disease symptoms not included as clinical
measures, that persist after the cessation of zoster-associated pain; and gives a
measure of the impact of zoster on the patient, which includes unmeasured and
measured levels of severity.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 7723447 [PubMed - indexed for MEDLINE]

4624: BMJ. 1995 Apr 1;310(6983):873.

Comment on:
    BMJ. 1995 Jan 7;310(6971):2-3.

Immunisation against chickenpox. Good argument exists for universal vaccination.

Skinner GR, Davies J.

Publication Types: 
    Comment
    Letter

PMID: 7711648 [PubMed - indexed for MEDLINE]

4625: Am J Ophthalmol. 1995 Apr;119(4):516-7.

Treatment of progressive outer retinal necrosis with sorivudine.

Pinnolis MK, Foxworthy D, Kemp B.

Visual Services Department, Massachusetts Eye and Ear Infirmary, Boston 02114,
USA.

PURPOSE/METHODS: We examined a patient with progressive outer retinal necrosis,
which is presumably caused by the varicella-zoster virus in patients with the
acquired immunodeficiency syndrome. RESULTS/CONCLUSIONS: The patient was
successfully treated with a combination of intravitreal ganciclovir and oral
sorivudine. Treatment for progressive outer retinal necrosis has been
disappointing; both acyclovir and ganciclovir have had only limited success.
Sorivudine, a new antiviral medication with activity against varicella-zoster
virus, may represent an effective alternative treatment for retinal necrosis.

Publication Types: 
    Case Reports

PMID: 7709980 [PubMed - indexed for MEDLINE]

4626: Eur J Clin Microbiol Infect Dis. 1995 Apr;14(4):318-29.

Comparative activity of selected antiviral compounds against clinical isolates of
varicella-zoster virus.

Andrei G, Snoeck R, Reymen D, Liesnard C, Goubau P, Desmyter J, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

Sixteen freshly isolated varicella-zoster virus (VZV) strains were evaluated in
vitro, in parallel with two reference strains expressing a functional thymidine
kinase (TK+) (Oka and YS) and two thymidine kinase-deficient mutants (TK-) (07-1 
and YS-R), for their susceptibility to a broad range of antiviral compounds. The 
following compounds were included: acyclovir (ACV), brivudine (BVDU), sorivudine 
(BVaraU), other BVDU congeners such as BTDU, CTDU, CVDC and CVDU, ganciclovir
(GCV), FIAC, araT, araA, araC, foscarnet (PFA), phosphonoacetic acid (PAA), the
acyclic nucleoside phosphonates HPMPC, cHPMPC, HPMPA, cHPMPA, HPMPc3A, PMEA and
PMEDAP, the N7-isomeric acyclic nucleoside analogue N7AP, penciclovir (PCV),
compounds 882C87 and H2G and two oxetanocin derivatives OXT-A and OXT-G. Fourteen
of the 16 clinical isolates displayed the following order of decreasing
selectivity against VZV: BVaraU > BVDU > CVDU approximately CVDC > H2G > N7AP
approximately CTDU approximately BTDU approximately OXT-G approximately 882C87 > 
ACV > FIAC approximately araT > HPMPC approximately cHPMPC approximately HPMPA
approximately HPMPc3A approximately cHPMPA > PCV approximately GCV approximately 
OXT-A > PMEDAP approximately PMEA > PFA approximately PAA approximately araA >
araC. Two VZV strains (isolated from the cerebrospinal fluid of an AIDS patient) 
that were shown to have a truncated TK were clearly resistant to all the
compounds that need the viral TK for their phosphorylation, while sensitivity to 
the acyclic nucleoside phosphonates, PFA, PAA, OXT-A and araA, remained
unchanged. A slight (5- and 10-fold) increase was noted in the 50% inhibitory
concentration of N7AP and OXT-G, respectively, for the TK- VZV strains as
compared to the TK+ VZV strains. Ganciclovir and FIAC also showed a marked
decrease in their activity against these two strains, but this was not as
pronounced as for the other viral TK-dependent drugs. From our results, it
appears that although acyclic nucleoside phosphonates may not have as favourable 
a therapeutic index as drugs requiring the viral TK, they should be considered
for the treatment of TK- VZV life-threatening infections that are resistant to
the viral TK-dependent drugs.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7649195 [PubMed - indexed for MEDLINE]

4627: Semin Thorac Cardiovasc Surg. 1995 Apr;7(2):88-94.

Viral pulmonary infections in thoracic and cardiovascular surgery.

Avery RK, Longworth DL.

Department of Infectious Diseases, Cleveland Clinic Foundation, 1 Clinic Center, 
OH 44195, USA.

Viral respiratory infections are uncommon causes of pulmonary infiltrates in
immunocompetent patients who undergo cardiothoracic surgery. In winter months,
however, influenza can be acquired in the community preoperatively or in the
hospital setting. The recognition of influenza cases is essential to prevent
nosocomial transmission. Respiratory syncytial virus is also an important
pulmonary pathogen in pediatric patients who undergo cardiothoracic surgery and
may produce serious disease in children with underlying pulmonary or congenital
heart disease. Viral infections of the respiratory tract are important causes of 
morbidity and mortality in heart and lung transplant recipients, especially
cytomegalovirus (CMV). Other herpes viruses such as varicella zoster virus and
herpes simplex virus may also occasionally involve the lung. Epstein-Barr virus
has been incriminated in the pathogenesis of post-transplant lymphoproliferative 
disease, an uncommon but severe complication of transplantation. Except for
Epstein-Barr virus, effective therapy exists for CMV and the other herpes
viruses. Prophylaxis with ganciclovir is effective in preventing serious CMV
infections in seropositive heart transplant recipients. However, better
strategies are needed to prevent primary CMV infection in these patients.

Publication Types: 
    Review

PMID: 7612760 [PubMed - indexed for MEDLINE]

4628: J Dermatol. 1995 Apr;22(4):262-6.

Primary Sjogren's syndrome and psoriasis vulgaris in a case of OKT4 epitope
deficiency.

Tanaka H, Mizutani H, Okada H, Shimizu M.

Department of Dermatology, Mie University Faculty of Medicine, Tsu, Japan.

We report a 29-year-old female OKT4 epitope deficiency patient with primary
Sjogren's syndrome and psoriasis vulgaris. Immunological investigations during
the prolonged clinical course of her herpes zoster revealed that she has OKT4
epitope deficiency and primary Sjogren's syndrome. She had been treated for
psoriasis vulgaris for 17 years without systemic immunosuppressive therapy. Flow 
cytometric study revealed that her OKT4 deficiency is heterogeneous and excluded 
interference with the OKT4 epitope by anti OKT4 autoantibodies. The rare
coexistence of primary Sjogren's syndrome and psoriasis implicates an immune
disturbance due to an unusual phenotype of CD4.

Publication Types: 
    Case Reports

PMID: 7541811 [PubMed - indexed for MEDLINE]

4629: Praxis (Bern 1994). 1995 Mar 21;84(12):353-4.

[A case from practice (320). 1. Drug-induced fever. 2. HIV infection C3. multiple
Kaposi sarcomas of the skin. Status after cerebral toxoplasmosis, PCP, herpes
zoster. status after syphilis and gonorrhea]

[Article in German]

Nuesch R.

Departement fur Innere Medizin, Kantonsspital, Basel.

Publication Types: 
    Case Reports

PMID: 7701175 [PubMed - indexed for MEDLINE]

4630: Masui. 1995 Mar 3;44(3):428-33.

[The effect of iontophoresis with several Ca channel blockers for PHN patients]

[Article in Japanese]

Ikebe H, Miyagawa A, Mizutani A, Miyamoto M, Taniguchi K, Honda N.

Department of Anesthesiology, Oita Medical University.

We performed iontophoresis with Ca channel blockers for healthy adult volunteers.
In this clinical study, we used iontophoresis with Ca channel blockers. Ten out
patients with PHN treated at our pain clinic were treated with iontophoresis.
They were randomly assigned to one of the following four treatments: (1) 5 ml of 
4% lidocaine HCl, (2) 2 mg of nicardipine HCl + 5 ml of distilled water, (3) 2 mg
of verapamil HCl + 5 ml of distilled water, and (4) 2 mg of diltiazem HCl + 5 ml 
distilled water. Iontophoresis was performed using the above four drugs on the
positive pole. Using a VAS, each patient was evaluated concerning the analgesic
effect. The pain before treatment (10 points) was used as the base line. Compared
with the scores before treatment, VAS scores decreased significantly after
iontophoresis in all four groups. In the lidocaine group, a significant decrease 
in VAS scores occurred immediately after iontophoresis and lasted up to 24 hours,
reaching the nadir at 2 hours. In the nicardipine group, the decrease occurred
immediately after iontophoresis and lasted up to one day, reaching the nadir at
four hours. In the verapamil group, the decrease started 1 hour after
iontophoresis and lasted up to 48 hours, reaching the nadir at 8 hours. In
diltiazem group, the decrease started 1 hour after iontophoresis and lasted up to
48 hours, reaching the nadir at 4 hours. Iontophoresis with Ca channel blockers
produced a prolonged analgesic effect in PHN patients. Previously we had observed
the same effect in adult volunteers. Therefore, we believe that this therapy will
be clinically useful.

Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 7745800 [PubMed - indexed for MEDLINE]

4631: Semin Ophthalmol. 1995 Mar;10(1):28-41.

Diagnosis and management of viral retinitis in the acute retinal necrosis
syndrome.

Morse LS, Mizoguchi M.

University of California, Davis Department of Ophthalmology, Sacramento 95816,
USA.

Publication Types: 
    Review

PMID: 10155697 [PubMed - indexed for MEDLINE]

4632: J Neurovirol. 1995 Mar;1(1):130-3.

Persistence of varicella-zoster virus DNA in elderly patients with postherpetic
neuralgia.

Mahalingam R, Wellish M, Brucklier J, Gilden DH.

Department of Neurology, University of Golorado Health Sciences Center, Denver
80262, USA.

The most common complication of zoster in the elderly is postherpetic neuralgia, 
operationally defined as pain persisting longer than 1-2 months after rash. The
cause of postherpetic neuralgia is unknown. Using polymerase chain reaction, we
detected varicella zoster virus DNA in blood mononuclear cells from 11 of 51
postherpetic neuralgia patients, but not in any of 19 zoster patients without
postherpetic neuralgia, or in any of 11 elderly individuals without a history of 
zoster. Blood mononuclear cells from nine of 27 serially-bled postherpetic
neuralgia patients were positive for varicella zoster virus DNA; six were
positive once, and three patients were positive more than once. Our results
indicated that postherpetic neuralgia may be related to persistence of varicella 
zoster virus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 9222350 [PubMed - indexed for MEDLINE]

4633: J Neuropathol Exp Neurol. 1995 Mar;54(2):268-75.

Multicystic encephalopathy: review of eight cases with etiologic considerations.

Weidenheim KM, Bodhireddy SR, Nuovo GJ, Nelson SJ, Dickson DW.

Department of Pathology (Neuropathology), Albert Einstein College of Medicine,
Bronx, New York 10461.

Multicystic encephalomalacia (MCE) is a rare lesion that arises during the
perinatal period. Although hypoxic-ischemic insults may be responsible for this
lesion, recent evidence suggests that herpesviruses may represent another
etiologic agent. To elucidate the pathogenesis of MCE, eight cases collected over
a 34-year period were evaluated for destructive lesions in gray and white matter.
Immunocytochemical methods, in situ hybridization and polymerase chain reaction
(PCR) methodology were employed to search for herpes simplex viruses types 1 and 
2 (HSV1 and HSV2), cytomegalovirus (CMV), varicella zoster virus (VZV),
Epstein-Barr virus (EBV) and JC variant of papovavirus (JCV). Review of the
clinical histories revealed that there had been a complicated labor and delivery 
in 6/7 cases. Neuropathological lesions consisted of extensive tissue
destruction, neuronal loss and gliosis in hemispheric white matter, cerebral
cortex, basal ganglia, thalamus, cerebellum and brainstem tegmentum. Only one
case showed evidence of latent HSV infection by PCR. CMV, VZV, JCV and EBV were
not detected. Arteriopathy was noted in one case. The widespread nature of the
lesions and their association with perinatal ischemia suggest that severe hypoxia
may be the more common etiology of MCE. Term infants appear especially
susceptible to this type of cerebral damage.

PMID: 7876894 [PubMed - indexed for MEDLINE]

4634: J Infect Dis. 1995 Mar;171(3):701-4.

Comment in:
    J Infect Dis. 1996 Jul;174(1):239-41.

Racial differences in the occurrence of herpes zoster.

Schmader K, George LK, Burchett BM, Pieper CF, Hamilton JD.

Department of Medicine, Duke University Medical Center, Durham, North Carolina
27710.

The purpose of this study was to determine if there are racial differences in the
occurrence of herpes zoster (shingles). The study population was the Duke
Established Populations for Epidemiologic Studies of the Elderly, a probability
sample of community-dwelling persons > 64 years old in North Carolina.
Interviewers administered a comprehensive health survey to the participants that 
included questions about lifetime occurrence of shingles. Of the 3206 subjects,
316 (9.9%) had had zoster: 81 (4.5%) of 1754 blacks and 235 (16.1%) of 1452
whites had had shingles (P < .0001). After controlling for age, cancer, and
demographic factors, blacks remained one-fourth as likely as whites (adjusted
odds ratio 0.25, 95% confidence interval 0.18-0.35; P = .0001) to have
experienced zoster. In summary, blacks had a significantly lower risk of
developing herpes zoster than whites, a new finding in herpes zoster
epidemiology.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 7876622 [PubMed - indexed for MEDLINE]

4635: Ceylon Med J. 1995 Mar;40(1):14-8.

Raised serum IgE levels in chronic inflammatory lung diseases.

Ray D, Saha K, Date A, Jairaj PS.

Department of Chest Diseases, Christian Medical College, Vellore, India.

OBJECTIVE: To study the serum IgE response in nonallergic subjects with chronic
inflammatory lung diseases. SETTING: Christian Medical College Hospital, Vellore.
SUBJECTS: Twenty six patients with bronchiectasis, five with pulmonary mycosis
referred from all over India and 30 healthy subjects. MAIN OUTCOME MEASURES:
Serum IgE value (determined by radioimmuno assay) above the upper limit of normal
control range (136 to 948 iu/ml) was considered as raised level. RESULTS: Of the 
26 patients with bronchiectasis 13 had pyogenic infections, six had pulmonary
tuberculosis; in six patients sputum culture was sterile while another patient
had herpes zoster. Five cases of mycosis included one each of actinomycosis,
aspergillosis, blastomycosis, cryptococcosis and nocardiasis. The serum IgE
levels were raised in 20 (65%) of the 31 patients. CONCLUSION: Associated
bacterial, fungal and parasitic infections were probably responsible for inducing
an hyper-IgE response in these non-allergic subjects.

PMID: 7781087 [PubMed - indexed for MEDLINE]

4636: J Clin Gastroenterol. 1995 Mar;20(2):157-9.

Ogilvie's syndrome from disseminated varicella-zoster infection and infarcted
celiac ganglia.

Nomdedeu JF, Nomdedeu J, Martino R, Bordes R, Portorreal R, Sureda A,
Domingo-Albos A, Rutllant M, Soler J.

Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

We report a patient who had refractory Hodgkin's disease and who received an
autologous bone marrow transplantation and 8 months later developed abdominal
pain associated with acute colonic dilation. The course of the patient was
rapidly fatal due to a lobar pneumonia. Autopsy revealed signs of disseminated
herpesvirus infection with marked hemorrhagic infarction of celiac sympathetic
ganglia. This finding supports the hypothesis that denervation caused by virus
reactivation and secondary hemorrhage is a main mechanism of acute colonic
pseudoobstruction.

Publication Types: 
    Case Reports

PMID: 7769201 [PubMed - indexed for MEDLINE]

4637: Clin Infect Dis. 1995 Mar;20(3):514-20.

Infectious complications following pancreatic transplantation: incidence,
microbiological and clinical characteristics, and outcome.

Lumbreras C, Fernandez I, Velosa J, Munn S, Sterioff S, Paya CV.

Division of Infectious Diseases and Internal Medicine, Mayo Clinic and
Foundation, Rochester, Minnesota 55905.

The infectious complications following pancreatic transplantation in 34
consecutive recipients were analyzed during a mean follow-up of 39 months.
Twenty-seven recipients (79%) developed a mean of 2.1 serious infectious
complications. Three of the six deaths (overall mortality, 18%) were infection
related. Thirty-three percent of severe infectious episodes were caused by
bacteria (72% by gram-positive cocci) and 26% by fungi (87% by Candida species); 
severe cytomegalovirus (CMV) infection accounted for 33% of infectious
complications. CMV disease and organ involvement occurred most frequently in the 
donor-seropositive/recipient-seronegative group (36%), followed by the
donor-seronegative/recipient-seropositive group (25%). In four patients (12%)
Epstein-Barr virus (EBV)-related posttransplantation lymphoproliferative disease 
(PTLD) developed, directly resulting in two deaths. PTLD developed in two of the 
three EBV-seronegative and two of the 31 EBV-seropositive recipients. Infections 
due to herpes simplex and zoster viruses and Pneumocystis carinii (2, 3, and 1,
respectively) developed in 6 patients. The use of OKT3 for rejection therapy was 
associated with symptomatic CMV disease and EBV-related PTLD. In summary, severe 
infectious complications are the main cause of morbidity and death among patients
who undergo pancreas transplantation. Aggressive antimicrobial prophylactic
regimens are required to decrease the effects of such complications.

PMID: 7756469 [PubMed - indexed for MEDLINE]

4638: J Adv Nurs. 1995 Mar;21(3):427-33.

Patients' experiences of herpes zoster and postherpetic neuralgia.

Engberg IB, Grondahl GB, Thibom K.

Department of Research, Bords University College of Health and Caring Sciences,
Sweden.

The purpose of the study was to investigate retrospectively whether patients (n =
73) who had suffered another disease and/or experienced psychosocial stress at
the time of the onset of herpes zoster had experienced a more severe clinical
course of herpes zoster, and were more subject to the development of postherpetic
neuralgia than other patients (n = 45) with herpes zoster. The interview
questionnaire included questions about changes in the patients' daily lives due
to neuralgia, and their current living circumstances. Significantly more of the
patients who had had another disease and/or psychosocial stress at the time of
the onset of herpes zoster reported severe pain during the acute phase of herpes 
zoster. They also reported pain to a greater extent at the time of the interview 
and mentioned that their lives had changed owing to postherpetic neuralgia. More 
of these patients reported that their habits and activities had been negatively
affected and they also experienced their current situation as unsatisfactory.
These results must, however, be interpreted with caution as the patients'
recollection of other diseases and/or psychosocial stress and the patients'
current mood due to postherpetic neuralgia at the time of the interview may have 
influenced the memory and the answers.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7745194 [PubMed - indexed for MEDLINE]

4639: Br J Radiol. 1995 Mar;68(807):334-5.

Prolonged contrast enhancement of the inner ear on MRI in Ramsay Hunt syndrome.

Zammit-Maempel I, Campbell RS.

Publication Types: 
    Case Reports
    Letter

PMID: 7735780 [PubMed - indexed for MEDLINE]

4640: Enferm Infecc Microbiol Clin. 1995 Mar;13(3):193-4.

[Varicella zoster pneumonia. Treatment with orally administered acyclovir]

[Article in Spanish]

Gil Sanz ME, Arribas Blanco JM, Lopez Romero A, Gonzalez-Baylin ML.

Publication Types: 
    Case Reports
    Letter

PMID: 7734507 [PubMed - indexed for MEDLINE]

4641: Nippon Ganka Gakkai Zasshi. 1995 Mar;99(3):289-95.

[A statistical study of ocular complications of herpes zoster ophthalmicus and
its prolongation factors]

[Article in Japanese]

Amaki S, Suzuki S, Shinbo R, Ando R, Oguchi Y, Shimizu H, Nishikawa T.

Department of Ophthalmology; School of Medicine, Keio University, Tokyo, Japan.

A statistical study was carried out on 218 patients (107 male and 111 female)
with herpes zoster ophthalmicus (HZO) who visited our clinic from April 1985 to
March 1992. The incidence of ocular complications (OCs) and the rate of prolonged
OCs (over 6 months) were also studied with the factors that were considered to
have affected them. There were 114 patients who showed OCs out of 218 HZO
patients (52.3%). The incidence of OCs was higher among the patients with nose
eruption than among those without (p < 0.001), and lower among the patients with 
acyclovir treatment in advance than among those without (p < 0.001). The rate of 
prolonged OCs was higher among the patients over 50 years old than among those
under 50 years old (p < 0.05), higher among the patients with nose eruption than 
among those without (p < 0.05), and lower among the patients with acyclovir
treatment in advance than among those without (p < 0.01). Those with nose
eruption had a high rate of prolonged iritis. Severe visual acuity loss remained 
in 3 cases (2.6%): 2 cases of corneal opacity in the center and 1 case of
neurouveitis. Two patients suffered from high intraocular pressure complicated
with prolonged iritis.

Publication Types: 
    English Abstract

PMID: 7732919 [PubMed - indexed for MEDLINE]

4642: Fortschr Med. 1995 Feb 10;113(4):43-8.

[Enzyme therapy--an alternative in treatment of herpes zoster. A controlled study
of 192 patients]

[Article in German]

Billigmann P.

PROBLEM: Herpes Zoster requires an effective, inexpensive form of treatment not
only because it impairs quality of life, but also on account of its relatively
high incidence and the resulting costs incurred. Given the present situation in
the health care sector, the high costs of treatment with the standard drug,
acyclovir, often mean that herpes zoster patients do not receive medicinal
therapy. AIM: The aim of the present study was to establish whether the positive 
results of a prior investigation involving treatment with an enzyme combination
preparation could be confirmed. METHOD: Over a period of 14 days, two groups of
96 patients each were given acyclovir or an enzyme combination preparation.
During the course of the study, the intensity (score) of segmental pain and
various skin lesions were investigated. RESULTS: In terms of the first end point,
"segmental pain", the test groups showed no significant difference either on day 
7 or on day 14. Although the second end point "segmental reddening" did reveal a 
significant difference (p = 0.015) in favor of the acyclovir group on day 14, no 
significant difference was found for any of the other examination endpoints. Nor 
did any of the other skin lesions evaluated differ significantly by the end of
the study. CONCLUSIONS: Overall, the enzyme combination preparation showed
identical efficacy with acyclovir. The results of the prior study were thus
confirmed. Further investigations on the immunomodulatory potency, dosage and
effects on postherpetic herpes neuralgia are, however, still required.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract
    Multicenter Study
    Randomized Controlled Trial

PMID: 7713467 [PubMed - indexed for MEDLINE]

4643: Adolesc Med. 1995 Feb;6(1):55-64.

Varicella-Zoster Virus Infections in Adolescents.

Schutze GE, Jacobs RF.

Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202-3591,
USA.

Adolescents are susceptible to both chickenpox and shingles, and they become more
ill and more likely to be hospitalized than younger patients infected with
varicella. Issues such as diagnosis, therapy, infection control, and prevention
are reviewed as they relate to both varicella and zoster.

PMID: 10358301 [PubMed - as supplied by publisher]

4644: J Ky Med Assoc. 1995 Feb;93(2):56-8.

An alternate method for intercostal blockade for the management of post herpetic 
neuralgia.

Ackerman WE 3rd, Kennedy LD.

Publication Types: 
    Case Reports

PMID: 7884295 [PubMed - indexed for MEDLINE]

4645: No Shinkei Geka. 1995 Feb;23(2):125-30.

[Treatment of intractable postherpetic neuralgia and blepharospasm: intraneural
injection of adriamycin]

[Article in Japanese]

Saiki M, Kondo A, Kinuta Y, Iwasaki K, Kobata H, Hasegawa K, Chin M, Nakano I,
Yamamoto T.

Department of Neurosurgery, Kitano Medical Research Institute and Hospital.

Adriamycin, an anthracycline antineoplastic agent, can swiftly be transported to 
the sensory or somatic motor neurons by way of axoplasmic transport when injected
into the subepineurium of the trigeminal nerve or sciatic nerve in experimental
animals, and is consequently able to induce degeneration of the neurons without
any systemic side effects. Intraneural injection of this agent was carried out
for the treatment of a total of 22 patients presenting with intractable neural
dysfunction (12 with neuralgia, including 7 with post-herpetic neuralgia and 10
with facial dystonia). The nerve which innervated the affected site was exposed
under local anesthesia and approximately 10-60 microliters of 1-20% adriamycin
was injected into the subepineurium. Results of the treatment after average
follow-up periods of 21.5 months were as follows: Out of 12 patients with
neuralgia, good results were obtained in 2 cases (16.7%), fair results in 6 cases
(50.0%) (overall effective rate 67.7%). There were no changes in symptoms in 4
cases (33.3%). Out of 10 patients with facial dystonia, good results were
obtained in 2 cases (20.0%), fair in 2 cases (20.0%) (overall effective rate
40.0%), and no changes in symptoms in 6 cases (60.0%). No major complications
were encountered during these procedures and, once symptoms had disappeared after
the treatment, no recurrence of symptoms was experienced. This method clearly
differs from other various kinds of simple peripheral neurotomy, since
transection of the peripheral nerve does not cause any, destructive changes in
the sensory ganglion or motor nucleus and, hence, symptoms may recur.(ABSTRACT
TRUNCATED AT 250 WORDS)

Publication Types: 
    Case Reports
    English Abstract

PMID: 7877732 [PubMed - indexed for MEDLINE]

4646: Virology. 1995 Feb 1;206(2):835-42.

Varicella-zoster virus open reading frame 1 encodes a membrane protein that is
dispensable for growth of VZV in vitro.

Cohen JI, Seidel KE.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
National Institutes of Health, Bethesda, Maryland 20892.

Varicella-zoster virus (VZV) encodes 69 unique open reading frames, 5 of which do
not have herpes simplex virus type 1 (HSV-1) homologs. One of the 5, ORF1, is
predicted to encode a protein of 108 amino acids. We identified a 470-base RNA
corresponding to ORF1. To determine whether ORF1 encodes a protein, an
11-amino-acid epitope was inserted in frame after the ninth codon of the ORF1
open reading frame. A recombinant virus carrying this epitope expressed a protein
that was immunoprecipitated with monoclonal antibody to the epitope. The ORF1
protein was detected in the membrane of infected cells. The size of ORF1 protein 
expressed in VZV-infected cells was slightly larger than the size expressed by
translation in vitro, suggesting that the protein may undergo post-translational 
modification in infected cells. Insertion of stop codons immediately before the
epitope in the ORF1 gene resulted in a recombinant virus that did not express
ORF1 protein and that was not growth impaired in cell culture. Thus, ORF1 encodes
a protein that localizes to the membrane of VZV-infected cells and that is
dispensable for virus growth in vitro.

Publication Types: 
    Comparative Study

PMID: 7856096 [PubMed - indexed for MEDLINE]

4647: Lakartidningen. 1995 Feb 1;92(5):427-32.

[Gene amplification in viral CNS infections. Rapid diagnostic identification of
herpesviruses]

[Article in Swedish]

Bergstrom T, Olofsson S, Studahl M, Kyllerman M, Darin N, Martinell J, Ricksten
A.

Virologiska laboratoriet, Sahlgrenska sjukhuset, Goteborg.

DNA amplification with the polymerase chain reaction (PCR) technique was used as 
a diagnostic test on cerebrospinal fluid samples in cases where herpesvirus
infection of the central nervous system (CNS) was suspected. During the period,
1992-93, 47 (8.9%) of 528 patients tested were positive for one or another of the
following herpesviruses: herpes simplex virus type 1 (n = 16) or type 2 (n = 9), 
cytomegalovirus (n = 16), varicella-zoster virus (n = 4), or Epstein-Barr virus
(n = 2). The study showed PCR to be a rapid and useful diagnostic method in
clinical routine, enabling early antiviral intervention in several cases with an 
atypical clinical picture. Moreover, cytomegalovirus was found to be an important
CNS pathogen in addition to herpes simplex virus, especially during childhood.

Publication Types: 
    English Abstract

PMID: 7853921 [PubMed - indexed for MEDLINE]

4648: Ann Neurol. 1995 Feb;37(2):246-53.

Topical lidocaine gel relieves postherpetic neuralgia.

Rowbotham MC, Davies PS, Fields HL.

Department of Neurology, University of California-San Francisco 94143.

Postherpetic neuralgia (PHN) following herpes zoster is a common and disabling
neuropathic pain syndrome. In a double-blind, three-session study, 5% lidocaine
gel or vehicle was applied simultaneously to both the area of pain and to the
contralateral mirror-image unaffected skin. In the local session, lidocaine gel
was applied to the painful skin area. In the remote session, lidocaine gel was
applied to mirror-image skin. In the placebo session, vehicle was applied
bilaterally. For cranial PHN, gel was applied without occlusion for 8 hours. For 
limb or torso PHN, gel was applied under occlusion for 24 hours. The 16 subjects 
with cranial PHN reported pain relief significantly favoring local drug
application at 30 minutes, 2, 4, and 8 hours. The 23 subjects with torso or limb 
PHN reported significantly lower pain intensity with local drug application at 8 
hours and both pain relief and reduced pain intensity at 24 hours. Remote
lidocaine application to mirror-image skin was no different from placebo. No
systemic adverse effects were reported and blood levels did not exceed 0.6
microgram/ml. Topical application of 5% lidocaine gel relieves PHN pain by a
direct drug action on painful skin.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7847866 [PubMed - indexed for MEDLINE]

4649: J Am Acad Dermatol. 1995 Feb;32(2 Pt 2):357-61.

Zosteriform zygomycosis.

Woods SG, Elewski BE.

Department of Dermatology, University Hospitals of Cleveland, Case Western
Reserve University, Ohio 44106.

We describe a patient with zygomycosis that resembled herpes zoster infection.
The diagnosis was readily made with a potassium hydroxide preparation that
revealed sparsely to non-septate hyphae. The patient responded to combination
antifungal therapy with amphotericin B and fluconazole. The clinical response
correlated with antifungal susceptibility test results.

Publication Types: 
    Case Reports

PMID: 7829740 [PubMed - indexed for MEDLINE]

4650: Virus Res. 1995 Feb;35(2):193-204.

Nucleotide sequence of infectious laryngotracheitis virus (gallid herpesvirus 1) 
ICP4 gene.

Johnson MA, Tyack SG, Prideaux C, Kongsuwan K, Sheppard M.

CSIRO Division of Animal Health, Animal Health Research Laboratory, Victoria,
Australia.

The infectious laryngotracheitis virus (ILTV) gene encoding a homologue to the
ICP4 protein of herpes simplex virus (HSV) has been mapped to the inverted repeat
region. The complete nucleotide sequence of ILTV ICP4 has been determined. The
ILTV ORF encoding ICP4 is 4386 nucleotides long, calculated from the first of
four ATG codons, and has an overall G+C content of 59%. The ILTV ICP4 contains
two domains of high homology which have been reported in other studies to be
conserved in the ICP4 homologues of alphaherpesviruses, and to be functionally
important. Several regulatory features were identified including a serine-rich
domain in region one. A more extensive serine-rich domain was located in region
five which is also found in varicella-zoster virus (VZV) and bovine herpesvirus
1. A 5.4 kb immediate early transcript was identified in infected primary kidney 
cells.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7762292 [PubMed - indexed for MEDLINE]

4651: Ear Nose Throat J. 1995 Feb;74(2):128.

Comment on:
    Ear Nose Throat J. 1994 Nov;73(11):850-2.

75-year-old patient who has Ramsey Hunt syndrome.

Fitzgerald DC.

Publication Types: 
    Comment
    Letter

PMID: 7755786 [PubMed - indexed for MEDLINE]

4652: Ann Rheum Dis. 1995 Feb;54(2):155.

Comment on:
    Ann Rheum Dis. 1994 Apr;53(4):224-8.

Severe, disseminated, life threatening herpes zoster infection in a patient with 
rheumatoid arthritis treated with methotrexate.

Ching DW.

Department of Medicine, Timaru Hospital, New Zealand.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 7755781 [PubMed - indexed for MEDLINE]

4653: Zhonghua Yi Xue Za Zhi (Taipei). 1995 Feb;55(2):127-36.

Profile of opportunistic infections among HIV-1 infected people in Hong Kong.

Wong KH, Lee SS, Lo YC, Li PC, Ho HF, Sitt WH, Lam TW, Lai KY.

Department of Health, Queen Elizabeth Hospital, Hong Kong.

BACKGROUND. To determine the spectrum of opportunistic infections in patients
with human immunodeficiency virus (HIV-1) infection in Hong Kong. METHODS. A
retrospective study of 214 HIV-1-infected patients, seen between December 1984
and December 1993 in a specialist clinic for HIV/AIDS. RESULTS. A majority (94%) 
of the patients in the cohort were male; 84% had acquired HIV via sexual
contacts. Two-thirds were ethnic Chinese. Ninety-two (43%) had developed AIDS,
and 54(25%) had presented with other non AIDS-defining opportunistic infections
during the study period. The primary AIDS defining illnesses of 80 patients were 
infections: Pneumocystis carinii pneumonia (50%), extrapulmonary tuberculosis
(10%) and cytomegalovirus (CMV) disease (8%). Opportunistic infections among
Chinese and non-Chinese were similar in spectrum, though higher frequencies of
infection with CMV, Mycobacterium avium intracellulare and tuberculosis were seen
among Chinese, whereas the opposite was true for Pneumocystis carinii pneumonia, 
toxoplasmosis and cryptosporidiosis. Disseminated Penicillium marneffei infection
was another significant disease for HIV-positive patients. Common non
AIDS-defining opportunistic infections included herpes zoster, oral candidiasis, 
herpes simplex infection and genital/anal wart. The median CD4 count at HIV
diagnosis for AIDS patients was much lower than non-AIDS patients (147 vs
546/ul). Survival of deceased AIDS patients was poor, with a median of only five 
months. Survival has however, apparently, improved over the recent years.
CONCLUSIONS. In Hong Kong, Pneumocystis carinii pneumonia remained the most
common primary AIDS event, while Penicillium marneffei was emerging as another
significant cause of major infection. Herpes zoster and oral candidiasis were the
two most frequently encountered minor opportunistic infections.

PMID: 7750052 [PubMed - indexed for MEDLINE]

4654: Br J Clin Pharmacol. 1995 Feb;39(2):143-9.

The bioavailability and disposition of
1-(beta-D-arabinofuranosyl)-5-(1-propynyl)uracil (882C87), a potent, new
anti-varicella zoster virus agent.

Peck RW, Wootton R, Lee DR, Jackson SH, Posner J.

Department of Clinical Pharmacology, Wellcome Foundation Ltd., Beckenham, Kent.

1. The bioavailability and disposition of 882C87, an anti-varicella zoster virus 
(VZV) agent, have been investigated in healthy young and elderly volunteers. 2.
The mean bioavailability of a 200 mg tablet was 21.1% in the young (range
13.3-33.0%, n = 10) and 24.6% in the elderly (range 14.4-38.4%, n = 8), which is 
sufficient to achieve plasma concentrations well above the IC50 for anti-VZV
activity. 3. Plasma concentrations of 882C87 after 50 mg i.v. were higher in the 
elderly than in the young, associated with a significantly longer half-life (13.7
vs 11.8 h) and decreased renal clearance (0.11 vs 0.14 ml min-1 kg-1) and total
clearance (0.15 vs 0.17 ml min-1 kg-1). 4. After intravenous administration, the 
main route of elimination of 882C87 was renal with 81.6% recovered unchanged in
urine in the young and 71.2% in the elderly. The pyrimidine base,
5-propynyluracil (5-PU) was unquantifiable in plasma and only present in trace
amounts in urine. 5. After oral administration to four healthy volunteers, only
17% of a dose of [14C]-882C87 was recovered unchanged in urine and 58% as 5-PU,
with total recovery in urine accounting for 86% of the dose. There was a lag of
4-12 h before the appearance of 5-PU in plasma, peak concentrations were
one-third to a half those of 882C87. The data suggest that 5-PU is formed from
unabsorbed 882C87 in the gut lumen and then absorbed and excreted in urine. 6.
882C87 is a potential once daily treatment for shingles.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 7742152 [PubMed - indexed for MEDLINE]

4655: Qual Life Res. 1995 Feb;4(1):41-5.

Area under the curve: a metric for patient subjective responses in episodic
diseases.

Lydick E, Epstein RS, Himmelberger D, White CJ.

Department of Epidemiology, Merck Research Laboratories, West Point, PA 19486,
USA.

Herpes zoster manifests as a characteristic painful rash that resolves within 2
months of initial presentation in 90% of patients. As pain is a hallmark of the
disease, the severity of an episode can be described by the magnitude and
duration of pain. The Brief Pain Inventory (BPI) was used to follow the daily and
weekly amount of pain reported by 50 patients with herpes zoster. Results
demonstrate that the BPI is a reproducible, responsive and valid measure of pain 
due to herpes zoster. From the individual responses on the BPI, the area under
the curve (AUC) for each patient was derived from the pain reported on sequential
administrations of the BPI. This metric was simple to calculate, easy to explain 
and captured two dimensions of this episodic disease (magnitude and duration of
pain) in a single continuous measure. AUC could prove useful in the application
of patient response data to intervention trials in diseases that are of an
episodic nature.

PMID: 7711690 [PubMed - indexed for MEDLINE]

4656: Enferm Infecc Microbiol Clin. 1995 Feb;13(2):130-1.

[Acute retinal necrosis caused by varicella zoster virus]

[Article in Spanish]

Sotorra O, Villalonga P, Ribera E, Mateo C, Castro M, Juste C.

Publication Types: 
    Case Reports
    Letter

PMID: 7711128 [PubMed - indexed for MEDLINE]

4657: Enferm Infecc Microbiol Clin. 1995 Feb;13(2):128-9.

[Disseminated herpes zoster with pneumonitis in an HIV-positive patient]

[Article in Spanish]

Geijo P, Santiago M, Ruiz D, de Benito L.

Publication Types: 
    Case Reports
    Letter

PMID: 7711126 [PubMed - indexed for MEDLINE]

4658: Acta Ophthalmol Scand. 1995 Feb;73(1):83-5.

Presumed ophthalmic herpes zoster after contralateral cataract extraction.

Walland MJ.

Moorfields Eye Hospital, London, England.

Herpes zoster ophthalmicus (HZO) may occur spontaneously, but can be precipitated
by stress, trauma, debility or systemic illness. A case is here reported of
Herpes zoster involving the contralateral eye, associated with a midline skin
rash, following cataract extraction under local anaesthesia.

Publication Types: 
    Case Reports

PMID: 7627766 [PubMed - indexed for MEDLINE]

4659: Rev Med Chil. 1995 Feb;123(2):225-8.

[Hepatitis C virus viremia and Herpes zoster virus infection in a patient in
hemodialysis treated with erythropoietin]

[Article in Spanish]

Duclos J.

Departamento de Nefrologia, Hospital Naval, Vina del Mar, Chile.

Hepatitis C virus infection in chronic hemodialysis patients is associated with
several unresolved problems. We report a 85 years old female patient in chronic
hemodialysis and treated with erythropoietin, that during the course of an Herpes
zoster, presented severe malaise, weight loss and muscle weakness. Two weeks
later, a slight rise in serum transaminases was detected. The patient had
negative antibodies for HIV and hepatitis C virus and negative hepatitis B
surface antigen. A PCR test was positive for serum hepatitis C virus RNA. The
patient's condition deteriorated and she died 7 days after admission.
Erythropoietin administration, whose immunosuppressive effect has been reported
previously, could have influenced the dismal outcome of this patient.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7569463 [PubMed - indexed for MEDLINE]

4660: Virology. 1995 Jan 10;206(1):655-60.

The varicella-zoster virus origin-binding protein can substitute for the herpes
simplex virus origin-binding protein in a transient origin-dependent DNA
replication assay in insect cells.

Webster CB, Chen D, Horgan M, Olivo PD.

Department of Medicine, Washington University School of Medicine, St. Louis,
Missouri 63110.

We isolated two recombinant baculoviruses each of which expresses a
varicella-zoster virus (VZV) homolog of one of the seven herpes simplex virus
type 1 (HSV-1) genes required for DNA replication. We performed transient
origin-dependent DNA replication assays in insect cells in which we substituted a
baculovirus which expresses a VZV protein for a baculovirus which expresses its
HSV homolog. VZV gene 51 protein was found to be able to support origin-dependent
DNA synthesis when it was substituted for UL9, the HSV-1 origin-binding protein
(OBP). This occurred whether an HSV-1 or a VZV origin-containing plasmid was used
in the assay. These results suggest that VZV gene 51 protein is able to interact 
with the HSV replication machinery, and in light of the extensive structural
divergence of these proteins, it suggests that initiation of VZV and HSV-1 DNA
synthesis may involve a limited number of interactions between the OBP and other 
replication factors. Substitution of infected-cell protein 8 (ICP8), the major
single-stranded DNA-binding protein of HSV-1, with VZV gene 29 protein, however, 
did not result in amplification of plasmids containing either an HSV-1 or a VZV
origin. In the absence of ICP8, addition of both VZV gene 51 protein and gene 29 
protein was also negative for origin-dependent replication whether or not UL9 was
present. Although demonstration that our baculovirus-expressed VZV gene 29
protein is functional for DNA replication will await development of a VZV
replication system, our results suggest that VZV gene 29 protein is unable to
interact functionally with one or more of the HSV replication proteins. This
approach should contribute to efforts to define the interactions among the
alphaherpesvirus DNA replication proteins.

PMID: 7831822 [PubMed - indexed for MEDLINE]

4661: Wiad Lek. 1995 Jan-Jun;48(1-12):234-41.

[Central nervous system infections in patients with AIDS]

[Article in Polish]

Niwicka-Michalowska A.

Katedry i Kliniki Chorob Zakaznych Ak. Med., Lodzi.

Central Nervous System (CNS) is very common site of the opportunistic infections 
in patients with AIDS. Patients, who died because of AIDS have described
pathology of CNS in 80% in autopsy series. Toxoplasmic encephalitis (TE) is the
most common infection in the course of AIDS, and it touches 25-50% of the
HIV-infected people. The treatment of TE is very difficult, but relapses are very
often and primary and secondary prophylaxis of TE is necessary. Fungal infections
(particularly cryptococcal meningitis) are very unpopular in immunocompetent
patients; in HIV-infected people Cryptococcus neoformans is the cause of the 30% 
of encephalitis. Viral and bacterial encephalitis, they are not very common in
AIDS patients.

Publication Types: 
    English Abstract
    Review

PMID: 9638248 [PubMed - indexed for MEDLINE]

4662: Acta Neurochir (Wien). 1995;137(1-2):1-5.

Microsurgical DREZotomy (MDT) for pain, spasticity, and hyperactive bladder: a
20-year experience.

Sindou M.

Department of Neurosurgery, Neurological Hospital P. Wertheimer, University of
Lyon, France.

Since 1972, micro-DREZ-tomy has been performed in 367 patients: with cancer pain 
in 81, neurogenic pain in 139, hyperspasticity in 135, and hyperactive neurogenic
bladder in 12. MDT consists of an incision and bipolar coagulations performed
ventro-laterally in the Dorsal Root Entry Zone (DREZ) at the entrance of the
rootlets into the dorso-lateral sulcus. The lesion is directed at 45 degrees
ventro-medially, and 2-3 mm deep according to the pre-operative neurological
status and the desired effects. MDT 1 degree interrupts the small (nociceptive)
fibres regrouped laterally and the large (myotatic) afferents which runs
centrally, whilst sparing part of the large medial (lemniscal) fibres. 2 degrees 
destroys the (excitatory) medial part of the Lissauer's tract, 3 degrees and the 
cells of the dorsalmost layers of the dorsal horn, which can be the site of
hyperactivity, as we were able to record in patients with deafferentation pain.
Best indications are: 1) well localized cancer pain, such as Pan-coast syndrome; 
2) neuropathic pain due to: brachial plexus injuries, cauda equina and/or spinal 
cord lesions especially for pain corresponding to segmental lesions, peripheral
nerve injuries-amputation-herpes zoster-(especially when the predominant
component of pain is of the paroxysmal type and/or corresponds to provoked
hyperalgesia/allodynia); 3) excess of spasticity and 4) neurogenic hyperactive
bladder.

PMID: 8748859 [PubMed - indexed for MEDLINE]

4663: Cancer Treat Res. 1995;79:149-71.

Herpesvirus infections in immunocompromised patients.

Snoeck R, De Clercq E.

Rega Institute for Medical Research, Leuven, Belgium.

Publication Types: 
    Review

PMID: 8746653 [PubMed - indexed for MEDLINE]

4664: Trans Am Ophthalmol Soc. 1995;93:623-83.

Ocular manifestations of HIV infection.

Jabs DA.

Department of Ophthalmology, Johns Hopkins University School of Medicine, USA.

OBJECTIVE: To evaluate the frequency of ocular complications and the clinical
outcomes of these complications in patients with various stages of HIV infection.
METHODS: Retrospective review of all HIV-infected patients seen in an AIDS
ophthalmology clinic from November 1983 through December 31, 1992. RESULTS:
Eleven-hundred sixty-three patients were seen for ophthalmologic evaluation. Of
these, 781 had the acquired immune deficiency syndrome (AIDS), 226 had
symptomatic HIV infection (AIDs-related complex [ARC]), and 156 had asymptomatic 
HIV infection. Non-infectious HIV retinopathy was the most common ocular
complication, affecting 50% of the patients with AIDS, 34% of the patients with
ARC, and 3% of the patients with asymptomatic HIV infection. Cytomegalovirus
(CMV) retinitis was the most common opportunistic ocular infection, affecting 37%
of the patients with AIDS. Other opportunistic ocular infections, including
ocular toxoplasmosis, varicella zoster virus retinitis, and Pneumocystis
choroidopathy were all much less common, each occurring in < or = 1% of the
patients with AIDS. Treatment of CMV retinitis with either foscarnet or
ganciclovir was successful in initially controlling the retinitis. However,
relapse represented a significant problem and required frequent re-inductions. As
a consequence of the retinal damage associated with relapse, loss of visual
acuity occurred. The median time to a visual acuity of 20/200 or worse for all
eyes with CMV retinitis was 13.4 months, and the median time to a visual acuity
of 20/200 or worse in the better eye was 21.1 months. At last follow-up, 75% of
the patients had a final visual acuity of 20/40 or better in at least one eye.
Retinal detachments were a frequent ophthalmologic complication of CMV retinitis 
with a cumulative probability of a retinal detachment in at least one eye of 57% 
at 12 months after the diagnosis of CMV retinitis. Herpes zoster ophthalmicus
developed in 3% of the overall series and was seen in all stages of HIV
infection. Fifty-six percent of the cases of ocular toxoplasmosis had
simultaneous toxoplasmic cerebritis. Ocular toxoplasmosis responded to standard
anti-microbial therapy. Varicella zoster virus retinitis, when manifested by the 
acute retinal necrosis (ARN) syndrome, responded to intravenous acyclovir
therapy. Conversely, in a limited number of patients with the progressive outer
retinal necrosis syndrome, the disease responded poorly to intravenous acyclovir 
therapy, but appeared to respond to combination foscarnet and acyclovir therapy. 
Neuro-ophthalmic lesions were present in 6% of the patients with AIDS. The most
common cause of a neuro-ophthalmic lesion was cryptococcal meningitis, and 25% of
the patients with cryptococcal meningitis developed a neuro-ophthalmic
complication. CONCLUSIONS: Ocular manifestations are common in patients with
AIDS. CMV retinitis represented a major vision-threatening problem in these
patients. While available therapy was successful in initially controlling the
retinitis, the phenomenon of relapse resulted in some degree of long-term visual 
loss. Preservation of the patient's visual acuity in at least one eye was
generally successful. Other opportunistic ocular infections were substantially
less common than CMV retinitis but require aggressive therapy.

PMID: 8719695 [PubMed - indexed for MEDLINE]

4665: Scand J Infect Dis. 1995;27(6):623-5.

Chronic ulcerating acyclovir-resistant varicella zoster lesions in an AIDS
patient.

Bernhard P, Obel N.

Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.

We describe a 28-year-old HIV-infected woman with AIDS, defined by cerebral
toxoplasmosis and a CD4-count of less than 10 x 10(6) cells/I, who, after several
eruptions of genital herpes and typical dermatomal herpes zoster, all
successfully treated with acyclovir, developed chronic cutaneous ulcerating
lesions on a finger and on the tibia. The lesions were found to contain varicella
zoster virus antigen but repeated treatment courses with acyclovir were
unsuccessful. After a course of intravenous foscarnet the lesions resolved. They 
recurred after discontinuation of foscarnet but finally responded to a second
course of treatment.

Publication Types: 
    Case Reports

PMID: 8685644 [PubMed - indexed for MEDLINE]

4666: Kurume Med J. 1995;42(4):299-305.

Effect of a helium-neon laser on cutaneous inflammation.

Sakihama H.

Department of Dermatology, Kurume University School of Medicine, Japan.

A Helium-Neon (He-Ne) laser with a wavelength of 632.8 nm is known to have
photobiological effects and is widely used for reducing the pain of herpes zoster
and accelerating wound healing, however the cellular mechanism and effect of the 
He-Ne laser are poorly understood. The present study was designed to examine the 
influence of He-Ne laser irradiation on irritant and allergic contact dermatitis 
of the mouse ear and on histamine release from rat peritoneal mast cells.
Irradiation was applied with a He-Ne laser (12.2 J/cm2) at 1 h, 10 min, 5 min and
0 min before, and 5 min, 6 hs and 24 hs after a challenge of an irritated contact
dermatitis (ICD) or allergic contact dermatitis (ACD) was made on the right ears 
of ICR-mice. Twenty-four hours after the challenge, the swelling of the ear was
measured with a dial thickness gauge, and the anti-inflammatory effect of He-Ne
laser irradiation was expressed as an ear thickness ratio (ETR). Although the
laser did not decelerate the ETR from ICD, the allergic response was decelerated.
Irradiation at 5 min after the challenge of contact dermatitis increased the
thickness ratio. Next, the influence of the He-Ne laser on histamine release from
Wistar-rat peritoneal mast cells was observed. The spontaneous histamine release 
was inhibited by laser irradiation, while substance P and compound 48/80-induced 
histamine release were not inhibited. From these results, it can be suggested
that He-Ne laser irradiation has an anti-inflammatory effect on cutaneous
inflammation.

PMID: 8667602 [PubMed - indexed for MEDLINE]

4667: Med Pregl. 1995;48(1-2):44-7.

[Clinical and epidemiologic aspects of paraneoplastic dermatoses in hospitalized 
patients treated at the Clinic for Dermatologic and Venereal Diseases in Novi Sad
over a 10-year period (1980-1990)]

[Article in Croatian]

Stojanovic S, Poljacki M, Dimoski A, Tasic S.

Klinika za infektivne i dermatoveneroloske bolesti, Medicinski fakultet Novi Sad.

Authors report results of a retrospective investigation on frequency of
paraneoplastic dermatoses, their clinical characteristics, time of onset and
course regarding 10 - year material on hospitalized patients at the Clinic for
Infectious and Dermatovenerous Diseases in Novi Sad. Out of 9086 hospitalized
patients in 14 patients (0.16%) paraneoplastic dermatisis was diagnosed. Out of
14 patients in 5 patients (35.71%) Herpes zoster was diagnosed; in 4 patients
(28.57%) bullous dermatosis; in 2 patients (14.29%) paraneoplastic acrokeratosis;
in 1 patient (7.14%) exudative multiform erythema in 1 patient (7.14%) erythema
figuratum and in one more patient necrotic Herpes labialis was diagnosed.
Concerning malignant neoplasms of internal organs together with paraneoplastic
dermatosis in most cases (4 - 28.57%) chronic lymphocyte leucosis was found, and 
in remaining 10 (71.43%) carcinomas were diagnosed at different internal organs. 
In 7 cases (50%) malignancy proceeded paraneoplastic dermatosis, in 4 cases
(28.57%) the malignancy was diagnosed at the same time as paraneoplastic
dermatosis and in 3 cases (28.43%) malignancy was established after the onset of 
paraneoplastic dermatosis. Authors point to the fact that usual skin changes,
characteristic for the dermatologic diseases mentioned, in cases when they are
associated with visceral malignomas, are characterized by a more serious clinical
picture, a longer course of the disease and resistance concerning usual therapy.

Publication Types: 
    English Abstract

PMID: 8657057 [PubMed - indexed for MEDLINE]

4668: Nephron. 1995;71(4):485-6.

Tubulointerstitial nephritis with uveitis syndrome following varicella zoster
reactivation.

Ljutic D, Glavina M.

Publication Types: 
    Case Reports
    Letter

PMID: 8587642 [PubMed - indexed for MEDLINE]

4669: Acta Haematol Pol. 1995;26(4):393-402.

[Natural cytotoxicity of peripheral blood mononuclear cells in Herpes simplex and
Varicella-zoster virus infections]

[Article in Polish]

Leszczyszyn-Pynka M.

Katedra i Klinika Chorob Zakaznych Pomorskiej Akademii Medycznej w Szczecinie.

Natural cytotoxicity of peripheral blood was assessed in adults with recurrent
Herpes labialis and in patients with Herpes zoster. CD16+ cells count,
lymphocytes forming conjugates with K 562 cells count and NK activity in
chromium-release assay were measured. Decreased CD16+ cells count and depressed
NK activity were found during latency of HSV infection. During reactivation of
the infection lymphocytes forming conjugates count was increased. Functional
activation of natural killing was noted in patients with herpes zoster in the
acute phase of the disease. However, no differences between results of all NK
tests after herpes zoster versus control group were found.

Publication Types: 
    English Abstract

PMID: 8571741 [PubMed - indexed for MEDLINE]

4670: Ophthalmologica. 1995;209(5):267-9.

Effects of calcium antagonists in the treatment of ophthalmic postherpetic
neuralgia.

Fama F, Santamaria S, Castagna I, Genovese FR, Ferreri G.

Institute of Ophthalmology, University of Messina, Italy.

Postherpetic neuralgia is one of the most common, but also one of the most
difficult conditions to treat. This condition mainly involves trigeminal,
intercostal and sciatic nerves and the brachial plexus area. It mostly appears in
patients older than 60 years. Although pain is a transient condition, the pain of
postherpeutic neuralgia may become intractable, disabling an may decrease the
quality of the patient's life. We studied 30 patients affected by ophthalmic
postherpetic neuralgia, appearing, some months after fronto-orbital cutaneous
eruption. All patients received nicardipine retard, decreasing gradually, 40
mg/day for 2 weeks. The monitoring of pain was performed using the visual
analogue score of Scott-Huskissonn. The results show an improvement in 'pain
relief'.

PMID: 8570150 [PubMed - indexed for MEDLINE]

4671: Nephron. 1995;71(3):321-7.

Sequential therapy for diffuse proliferative and membranous lupus nephritis:
cyclophosphamide and prednisolone followed by azathioprine and prednisolone.

Chan TM, Li FK, Wong RW, Wong KL, Chan KW, Cheng IK.

Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.

A retrospective single-center cohort study was conducted on 35 patients with
diffuse proliferative (WHO type IV) and/or membranous (type V) lupus nephritis
(22 with type IV, 6 with type V, and 7 with type IV plus V) who had been treated 
with a sequential regimen comprising prednisolone and cyclophosphamide during
active disease, followed by low-dose prednisolone and azathioprine maintenance.
The follow-up period was 33.2 +/- 4.5 months. At presentation, 32 (91.4%)
patients were nephrotic, and an abnormal serum creatinine level was noted in 14
(48.3%) patients with type IV changes. Cyclophosphamide was given for 26.8 +/-
2.8 weeks. 33 (94.3%) patients achieved complete or partial renal remissions:
77.3 and 22.7% of the type IV patients, 16.7 and 66.6% of the type V patients,
and 14.3 and 71.4% of the type IV plus V patients, respectively (p < 0.0001 for
type IV versus type V and for type IV versus type IV plus V). The duration of
therapy before renal remissions and normalization of C3 were attained was similar
among the three groups of patients. Disease relapse occurred in 4 (18.2%) of 22
IV patients and in 1 of the 5 type V patients in remission. Mortality was not
observed, and none of the patients had an increase in serum creatinine level to
double the baseline value. Adverse effects related to therapy included: hair loss
(42.9%), transient amenorrhea (53.6%), leukopenia (11.4%), febrile episodes
(14.3%), and herpes zoster(28.6%). We conclude that sequential use of
prednisolone and cyclophosphamide followed by low-dose prednisolone and
azathioprine can achieve favorable therapeutic results in the majority of
patients with diffuse proliferative and/or membranous lupus nephritis, without
excessive toxicities.

Publication Types: 
    Comparative Study

PMID: 8569982 [PubMed - indexed for MEDLINE]

4672: J Fr Ophtalmol. 1995;18(10):625-33.

[Bilateral acute retinal necrosis in a patient with acquired immunodeficiency
syndrome]

[Article in French]

Menerath JM, Gerard M, Laurichesse H, Goldschmidt P, Peigue-Lafeuille H,
Rozenberg F, Beytout J.

Service d'Ophtalmologie, Hopital Gabriel Montpied, CHU, BP 69, Clermont-Ferrand.

A case of bilateral progressive outer retinal necrosis occurred after herpes
zoster ophthalmicus in a patient with acquired immunodeficiency syndrome. This
case does not correspond to the classical picture of progressive outer retinal
necrosis. The disease led to blindness despite intravenous therapy with acyclovir
and foscarnet. PCR could not identify any virus in the aqueous humour, but VZV is
evidenced in cerebrospinal fluid. Acute retinal necrosis is now clearly defined
by the American Uveitis Society, which should allow to determine its incidence
and risk factors. Herpes zoster usually precedes the acute outer retinal
necrosis. The infectious theory (VZV, HSV, CMV) widely prevails over the immune
theory. We prefer the virus genome identification in the aqueous humor or in the 
vitreous by PCR to confirm diagnosis rather than the specific antibody titration.
Therapy consists in acyclovir, foscarnet and ganciclovir. But whatever the
treatment, the visual prognosis is poor.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8568169 [PubMed - indexed for MEDLINE]

4673: Virus Genes. 1995;10(3):217-26.

HSV-1 brain infection by the olfactory nerve route and virus latency and
reactivation may cause learning and behavioral deficiencies and violence in
children and adults: a point of view.

Becker Y.

Department of Molecular Virology, Faculty of Medicine, Hebrew University of
Jerusalem, Israel.

Two recent studies provided new evidence on the latency of HSV-1 DNA in 15.5% of 
olfactory bulbs and in 72.5% of trigeminal nerves from human corpses at forensic 
postmortems (1) and in 35% of 40 autopsied human brains (2). In the latter
brains, latent HSV-1 DNA was found in the olfactory bulbs, amygdala, hippocampus,
brain stem, and trigeminal ganglia. Although in these studies it is not known by 
which route HSV-1 entered the olfactory bulbs and brain, experimental studies in 
mice (3) revealed that injection of HSV-1 into the olfactory bulbs leads to virus
migration into the brain amygdala and hippocampus via the olfactory nerve and
locus coeruleus. If the olfactory ciliary nerve epithelium is the port of entry
of HSV-1 into the olfactory bulbs and brain in humans as well, protection of the 
nose against HSV-1 infection may be needed to prevent virus latency in neurons in
the amygdala and hippocampus (3). Infection of humans by HSV-1 was estimated to
increase from 18.2% in the 0-20 year population group to 100% in persons older
than 60 years (1), indicating that worldwide human populations at all ages are at
risk of brain infection by the olfactory nerve route. In addition, both primary
infection and reactivation of latent DNA in the brain may lead to damage of
neurons in the brain involved in memory, learning, and behavior, as observed in
infected, acyclovir-treated mice (3). The current introduction of a live
apathogenic varicella-zoster virus (VZV) vaccine to immunize children against
chickenpox (4) may suggest that the time is ripe for immunization of children and
adults against HSV-1 infections, especially infections by the olfactory nerve
route, to prevent potential brain damage.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8560783 [PubMed - indexed for MEDLINE]

4674: Nephrol Dial Transplant. 1995;10(9):1775-7.

Acyclovir-associated encephalopathy, lack of relationship between acyclovir
levels and symptoms.

de Knegt RJ, van der Pijl H, van Es LA.

Department of Internal Medicine, University Hospital Leiden, The Netherlands.

Publication Types: 
    Case Reports

PMID: 8559507 [PubMed - indexed for MEDLINE]

4675: Ophthalmic Res. 1995;27(5):310-6.

Detection of varicella-zoster virus genome having a PstI site in the ocular
sample from a patient with acute retinal necrosis.

Kumano Y, Manabe J, Hamamoto M, Kawano Y, Minagawa H, Fukumaki Y, Inomata H.

Department of Ophthalmology, Faculty of Medicine, Kyushu University, Fukuoka,
Japan.

We detected the virus genome in ocular samples from a 65-year-old woman with
clinically diagnosed acute retinal necrosis using DNA amplification. She
exhibited occlusive retinal vasculitis, confluent necrotizing retinitis, mainly
peripheral, and iridocyclitis. For DNA amplification, we used recently published 
primers specific for varicella-zoster virus (VZV) and herpes simplex virus. Using
VZV primers, we detected the VZV genome in the aqueous humor, but not in the
vitreous, by amplifying a DNA fragment 642 base pairs in length. HSV DNA was not 
detected. After detecting the VZV genome, PstI restriction endonuclease was used 
because an epidemiological study found that about 25% of the VZV strains in Japan
carry a mutation lacking a PstI recognition site. The VZV genome from the patient
had a PstI cleavage pattern, while the positive control had a VZV genome that
carried a PstI-site-less mutation. We considered our patient with acute retinal
necrosis to be infected with VZV having a PstI site.

Publication Types: 
    Case Reports

PMID: 8552371 [PubMed - indexed for MEDLINE]

4676: J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jan 1;8(1):23-9.

Neurologic manifestations of AIDS: a comparative study of two populations from
Mexico and the United States.

Trujillo JR, Garcia-Ramos G, Novak IS, Rivera VM, Huerta E, Essex M.

Department of Cancer Biology, Harvard School of Public Health, Boston,
Massachusetts 02115, USA.

Neurologic complications associated with human immunodeficiency virus type 1
(HIV-1) infection vary geographically. To understand the pattern of
HIV-associated neurologic complications in Mexico, 120 AIDS patients from Mexico 
City, Mexico, and 500 AIDS patients from Houston, Texas, were studied
cross-sectionally and retrospectively. Neurologic, laboratory, imaging, and
pathologic examinations identified 40 Mexican patients and 130 U.S. patients with
neurologic complications. Whereas AIDS dementia complex was the most common
neurologic manifestation in both groups, intracranial tuberculoma was present
only in the Mexican population (10%). Primary brain lymphoma was more prevalent
in the U.S. population (8.4%). The different findings in the Mexican population
likely reflect afflictions common to developing countries--a high prevalence of
tuberculosis and a high mortality rate. These conditions preclude complications
such as lymphoma, which develop later in the natural course of HIV infection.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8548343 [PubMed - indexed for MEDLINE]

4677: Cancer Biother. 1995 Fall;10(3):181-94.

Haplotype donor-generated graft-versus-leukemia responses: serendipity revisited.

Wimer BM.

JBMW Immunotherapeutics, Albuquerque NM 87123, USA.

This re-evaluation of a pilot study conducted nearly three decades ago
(1965-1970), in which serendipity played a central role in favorable responses of
hematologic malignancies to the administration of adoptive lymphocytes from both 
parents, has been motivated by clearer understanding. Temporary remissions
marking LAK cell-driven graft-versus-leukemia (GvL) responses were observed in
four of seven acute leukemia patients associated with unique self-limited
graft-versus-host (GvH) reactions that were NK cell and cytokine related.
Retinopathy not previously reported in a GvH setting was a consistent
manifestation in these patients. Cure was achieved in an eighth patient with
acute lymphoblastic leukemia after she had been given effective chemotherapy, an 
active role for the adoptive therapy indicated by the occurrence of a week of
fever suggesting an abortive GvH reaction. Two of five patients with Hodgkin's
disease also experienced favorable responses to parental leukocyte therapy, one
exhibiting GvH manifestations almost identical to those seen in the acute
leukemia patients when given the adoptive therapy successfully to spur recovery
from severe herpes zoster that had interrupted curative radiation therapy. The
GvH in the other patient was a more typical one, the key effect being an increase
in circulating lymphocytes that may have contributed indirectly to cure with
subsequent therapy. These and other attempts to apply GvL responses
therapeutically, including those currently in favor, exemplify the shortcomings
of partial mitogenic responses to alloactivation, which are dependent on
engraftment, limited in scope, excessively toxic, and difficult to control.
Treatment with mitogens such as PHA would be a superior alternative because of
the abilities of these agents to regulate immune responses by simple modulations 
of dosage, scheduling, and modes of application.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 8547957 [PubMed - indexed for MEDLINE]

4678: Eye. 1995;9 ( Pt 5):594-8.

Herpes zoster chorioretinopathy.

Roberts TV, Francis IC, Kappagoda MB, Dick AD.

Westmead Hospital, Sydney, Australia.

Chorioretinitis and subsequent choroidal and retinal pigment epithelial atrophy
following herpes zoster ophthalmicus (HZO) have rarely been reported. We report
two patients, who several months following attacks of acute HZO, developed
posterior fundus features of yellow, non-pigmented, punched-out areas of retinal 
pigment epithelial and choroidal pigment atrophy, which we have termed herpes
zoster chorioretinopathy. An occlusive vasculitic process is proposed as the
pathogenesis for this chorioretinopathy, and may be similar to that seen in the
delayed cerebral vasculitis following HZO. A previous history of HZO should be
sought in patients with a unilateral, multifocal, non-pigmented
chorioretinopathy, as this may represent a characteristic delayed feature.

Publication Types: 
    Case Reports

PMID: 8543079 [PubMed - indexed for MEDLINE]

4679: Ann Dermatol Venereol. 1995;122(6-7):436-8.

[Post-Herpes Zoster calcinosis]

[Article in French]

Puskas M, Schneider I, Dull G, Zombai E.

Clinique Dermatologique, Faculte de Medecine de Pecs Hopital Departemental de
Nagykanizsa (Hongrie).

INTRODUCTION. Cutaneous calcinosis, without any disturbance of phosphocalcic
metabolism, secondary to circumscribed previous skin lesions are quite common.
Those secondary to viral skin lesions are rare and worth of publication. CASE
REPORT. A 73-year old female patient disclosed progressive calcinosis in the scar
of a cervico-thoracic herpes zoster which occurred 20 years ago. DISCUSSION. The 
occurrence of a secondary calcinosis in an old scar is common and non specific:
the eliciting role of a previous herpes virus infection (VZV) may be discussed in
the reported case and in few other cases reported in the literature (HSV, CMV)

Publication Types: 
    Case Reports
    English Abstract

PMID: 8526428 [PubMed - indexed for MEDLINE]

4680: Ann Med Interne (Paris). 1995;146(5):292-4.

[Varicella-zoster virus pancreatitis in hematologic diseases]

[Article in French]

Pulik M, Teillet F, Teillet-Thiebaud F, Lionnet F, Genet P, Petitdidier C.

Service d'Hematologie, Hopital Victor-Dupouy, Argenteuil

We report four cases of varicella-zoster pancreatitis in immunocompromised hosts.
All 4 patients presented a severe immunodeficiency because of chronic
lymphoproliferative disorders (mainly lymphoma and Hodgkin disease) and long-term
immunosuppressive therapy. Varicella zoster pancreatitis is a very unusual
presentation of varicella-zoster infection. Few cases of pancreatitis occurring
after bone marrow transplantation have been reported. All 4 patients presented
with acute epigastric pain associated with transient elevation of serum amylase. 
The vesicular rash followed the presenting symptoms of severe abdominal pain by 8
days. This clinical presentation, occurring in immunocompromised patients,
defines a set of symptoms which should lead the physician to suspect
varicella-zoster pancreatitis, even in the initial absence of the characteristic 
skin vesicular eruption. Early institution of antiviral therapy seems mandatory.

Publication Types: 
    English Abstract
    Review

PMID: 8526311 [PubMed - indexed for MEDLINE]

4681: Rev Med Interne. 1995;16(10):792-3.

[Herpes zoster ophthalmicus and oculomotor involvement]

[Article in French]

Granel F, Maignan M, Canton P.

Publication Types: 
    Case Reports
    Letter

PMID: 8525163 [PubMed - indexed for MEDLINE]

4682: Nurse Pract. 1995 Jan;20(1):80.

Famciclovir approved for shingles.

[No authors listed]

Publication Types: 
    News

PMID: 7898796 [PubMed - indexed for MEDLINE]

4683: Nippon Jibiinkoka Gakkai Kaiho. 1995 Jan;98(1):112-8.

[Evaluation of the plasma endothelin levels in facial nerve paralysis]

[Article in Japanese]

Iijima M, Ikeda M.

Department of Otolaryngology, Nihon University School of Medicine, Tokyo.

The etiology of so-called Bell's palsy is still unknown. Based on the hypothesis 
that endothelin, with its potent vasoconstricting action, is in some way involved
in the etiological mechanism of facial nerve paralysis, we measured the blood
endothelin levels of 62 patients with Bell's palsy in the acute stage (within one
week following onset). The measurements were extended to include 10 patients with
Ramsay Hunt syndrome and 14 patients with zoster sine herpete. To determine
endothelin content, blood samples were drawn into blood collecting tubes,
containing EDTA-2Na+aprotinin at any time desired during the day. The samples
were immediately chilled and centrifuged to separate the plasma portion, and 2ml 
of this plasma sample was preserved by freezing. ET-1 was extracted using
silica-ODS and analyzed by RIA using anti-ET 1 antibody. An age-matched
comparison between the Bell's palsy patients and 36 normal individuals using the 
Mann-Whitney U test showed a significant difference (p < 0.01). The patients with
Ramsay Hunt syndrome and zoster sine herpete also tended to have elevated
endothelin levels. This finding suggests that disorders of the microcirculatory
system in which endothelin is in some way involved may play a role in the
pathogenesis of facial nerve paralysis.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 7897568 [PubMed - indexed for MEDLINE]

4684: Enferm Infecc Microbiol Clin. 1995 Jan;13(1):6-11.

Comment in:
    Enferm Infecc Microbiol Clin. 1996 Jun-Jul;14(6):396-7.

[Neurologic manifestations of varicella herpes zoster infection]

[Article in Spanish]

de Otero J, Surinach JM, Ribera E, Alegre J, Juste C, Rio J.

Unidad de Enfermedades Infecciosas, Hospital General Universitari de la Vall
d'Hebron, Universidad Autonoma, Barcelona.

BACKGROUND: The aim of the present study was to analyze the clinical
characteristics and fluid alterations in neurologic infection by varicella herpes
zoster virus in hospitalized patients. METHODS: A retrospective study of the
cases with neurologic involvement by the varicella herpes zoster virus in
patients admitted in the authors' hospital from March 1991 to March 1993 was
carried out. RESULTS: Our of the 14 patients studied with neurologic involvement 
by the varicella herpes zoster virus, 10 were males (71%) with a mean age of 38
years (range: 13-83 years). Only 4 patients (28%) presented a base disease
(diabetes mellitus in 2 cases and HIV infection in another 2). In 10 cases (71%) 
the appearance of cutaneous lesions was prior to neurologic manifestations
(between 1 and 30 days before neurologic clinical manifestations). All the
patients presented hyperthermia at some time. The most common symptoms were:
headache, vomiting, confusion and/or neck stiffness, with meningitis,
encephalitis and neurologic foci and mixed pictures. In 4 cases (28%) the
cephalorhachidian fluid did not present analytical changes suggestive of viral
meningitis. All the patients underwent i.v. acyclovir treatment at a dosis of
10-15 mg/kg/8 h with good evolution, with no deaths being observed. In 3 out of
the 6 cases presenting neurologic foci the evolution was slow with sequelae
following treatment completion. CONCLUSIONS: Neurologic involvement by the
varicella herpes zoster virus does not clinically defer from other neutrotropic
virus. Fluid alterations were compatible with benign lymphocytary meningitis
although some cases of encephalitis showed normal LCR. Taking into account that
none of the patients herein reported died and considering the mortality
associated with meningitis or encephalitis by varicella herpes zoster referred in
the literature in untreated patients, the authors believe that the use of
acyclovir is obligatory in these cases.

Publication Types: 
    English Abstract

PMID: 7893793 [PubMed - indexed for MEDLINE]

4685: Transpl Int. 1995;8(1):58-60.

Herpes zoster-associated idiopathic thrombocytopenic purpura in a liver
transplant recipient: a case report and overview.

Singh N, Gayowski T, Yu VL.

Department of Veterans Affairs Medical Center, Pittsburgh, PA 15240.

Idiopathic (autoimmune) thrombocytopenic purpura has been previously reported as 
a rare complication in children and in a few adults following chickenpox. We
report a case of varicella zoster virus-associated idiopathic thrombocytopenic
purpura in an adult liver transplant recipient following dermatomal zoster.
Idiopathic thrombocytopenic purpura developed 3 days after the onset of herpes
zoster in our patient, with a nadir platelet count of 3000/mm3. The patient was
treated with intravenous gamma globulin with recovery of thrombocytopenia after 3
weeks. Transplant clinicians need to be aware that this serious and potentially
life-threatening complication may occur with herpes zoster in transplant
recipients.

Publication Types: 
    Case Reports

PMID: 7888054 [PubMed - indexed for MEDLINE]

4686: Br J Obstet Gynaecol. 1995 Jan;102(1):79.

Comment on:
    Br J Obstet Gynaecol. 1994 May;101(5):418-21.

Fetal immunological and haematological changes in intrauterine infection.

Michie CA, Harvey D.

Publication Types: 
    Comment
    Letter

PMID: 7833325 [PubMed - indexed for MEDLINE]

4687: Arch Dermatol. 1995 Jan;131(1):24-6.

The treatment of acyclovir-resistant herpes zoster with trifluorothymidine and
interferon alfa.

Rossi S, Whitfeld M, Berger TG.

University of British Columbia, Vancouver.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 7826092 [PubMed - indexed for MEDLINE]

4688: J Histochem Cytochem. 1995 Jan;43(1):47-52.

Expression of MxA protein in inflammatory dermatoses.

Fah J, Pavlovic J, Burg G.

Department of Dermatology, University of Zurich, Switzerland.

The human MxA protein can be detected in the cytoplasm of IFN-alpha/beta-treated 
cells, whereas other cytokines, including IFN-gamma, are poor inducers. Because
IFN-alpha/beta is predominantly synthesized in response to viral infections, MxA 
protein should be detectable in virally infected tissue. Biopsy specimens (n =
64) of 12 different dermatoses were therefore screened with an MxA-specific
monoclonal antibody on formalin-fixed, paraffin-embedded and microwave-treated
tissue sections. As expected, high amounts of MxA protein were found in acute
viral skin lesions (chickenpox, Herpes zoster, and Herpes labialis). In addition,
MxA protein was also detected in some inflammatory skin lesions of unknown
etiology (lupus erythematosus, lichen planus, Schoenlein-Hennoch's anaphylactoid 
purpura and psoriasis). MxA protein was not found in non-viral infections
(bacterial, mycotic, and parasitic) and was also not detectable in various other 
dermatoses (eczema, scleroderma, urticaria, granulomatous and bullous disorders).
MxA staining proved a reliable, sensitive histochemical viral marker for
infectious dermatoses. The positive results in non-infectious inflammatory
dermatoses might implicate viral involvement or activation of the IFN system by
thus far unknown mechanisms.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7822763 [PubMed - indexed for MEDLINE]

4689: J Am Acad Dermatol. 1995 Jan;32(1):127-8.

Zosteriform cutaneous T-cell lymphoma.

Ricci RM, Latham PL, Soong V, Mullins D.

Maxwell Air Force Base, Birmingham, Alabama.

Publication Types: 
    Case Reports

PMID: 7822504 [PubMed - indexed for MEDLINE]

4690: Invest Ophthalmol Vis Sci. 1995 Jan;36(1):41-51.

Ocular inoculation of monkeys with simian varicella virus: clinical and
histopathologic observations.

Metcalf JF, Christianson MD, Brady AG.

Department of Ophthalmology, College of Medicine, University of South Alabama,
Mobile 36688.

PURPOSE. To explore the possibility that inoculation of the eyes of African green
monkeys with simian varicella virus (SVV) induces the symptoms of herpes zoster
ophthalmicus (HZO), as seen in humans, and to develop a realistic and
reproducible animal model of herpes zoster ophthalmicus for experimental studies.
METHODS. In the first experiment, the right eyes of three African green monkeys
were inoculated by intrastromal and subconjunctival injections with a suspension 
of SVV-infected Vero cells. In the second experiment, three additional monkeys
were pretreated with intramuscular injections of methylprednisolone (41 mg/kg)
for 7 days before ocular inoculation with SVV and for 3 weeks at 14 mg/kg after
virus inoculation. The eyes were examined by slit-lamp biomicroscopy. Histologic,
immunohistochemical, and electron microscopic studies were performed. RESULTS. In
the first experiment, all three animals developed high titers of anti-SVV
antibodies (IgG). Diffuse stromal opacity, with keratitic precipitates, stromal
edema, and mild vascularization of the cornea, appeared 12 to 14 days after
inoculation. The onset of ocular disease was correlated with the rise in serum
antibody levels. There was no clinical evidence of a systemic viral infection
resulting from the corneal inoculations in these monkeys. In the second
experiment, all three animals treated with methylprednisolone developed severe
ocular pathology within 1 week of inoculation. The clinical appearance of the
diseased eyes strongly indicated that local viral infection had occurred.
Dendritiform keratitis, corneal erosion, and stromal necrosis with
vascularization of the cornea was seen in all the eyes. The disease resolved
within 4 to 5 weeks of inoculation, leaving opaque, vascularized corneas.
Histologic studies showed that inflammatory cells and viral antigens were
widespread throughout the diseased corneas. A high titer of anti-SVV antibody
(IgG) was detected in the immunosuppressed monkeys, but no evidence of systemic
viral infection was observed. CONCLUSIONS. The authors propose that inoculation
of the eyes of methylprednisolone-treated African green monkeys with simian
varicella virus provides an appropriate animal model for studies of the virology 
and immunopathology of ocular varicella virus infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7822158 [PubMed - indexed for MEDLINE]

4691: Am Fam Physician. 1995 Jan;51(1):57.

Topical chloroform and postherpetic neuralgia.

Kaye R.

Publication Types: 
    Letter

PMID: 7810481 [PubMed - indexed for MEDLINE]

4692: Ann Emerg Med. 1995 Jan;25(1):111-4.

Varicella: pediatric genital/rectal vesicular lesions of unclear origin.

Simon HK, Steele DW.

Department of Pediatrics, Brown University, Providence, Rhode Island.

Three children who presented with localized vesicular rash in the diaper area
were found to have primary varicella-zoster infections. Primary varicella can
closely mimic genital herpes simplex virus (HSV 1 or 2), which may be an
indicator of sexual abuse. To avoid unfounded investigation for sexual abuse,
primary varicella-zoster infection must be included in the differential
diagnosis. Direct fluorescent antibody testing is a sensitive and specific
diagnostic test that can be used to distinguish HSV 1 or 2 from varicella-zoster.

Publication Types: 
    Case Reports

PMID: 7802360 [PubMed - indexed for MEDLINE]

4693: Arch Virol. 1995;140(4):623-34.

ICP27 immediate early gene, glycoprotein K (gK) and DNA helicase homologues of
infectious laryngotracheitis virus (gallid herpesvirus 1) SA-2 strain.

Johnson MA, Prideaux CT, Kongsuwan K, Tyack SG, Sheppard M.

CSIRO Division of Animal Health, Animal Health Research Laboratory, Parkville,
Victoria, Australia.

A 4.8 kilobase segment located at the left-terminal in the unique long (UL)
region of infectious laryngotracheitis virus (ILTV) SA-2 strain contained three
open reading frames (ORFs). The first of 421 amino acids (aa) was located at map 
units 0.065 to 0.07, and its predicted 48 kiloDaltons (kDa) protein product has
significant homology to the immediate early regulatory protein ICP27 (UL54) of
herpes simplex virus type-1 (HSV-1), to varicella-zoster virus (VZV) ORF4 and to 
equine herpesvirus 1 (EHV-1) ORF5. The zinc finger conserved in the C-terminal of
the proteins from HSV-1, VZV and EHV-1, is poorly conserved in ILTV homologue.
The second ORF of 336 aa, located at map units 0.075 to 0.08, has a predicted
molecular weight (MW) of 38 kDa with significant homology to glycoprotein K (gK) 
of HSV-1 (UL53), ORF5 of VZV and ORF6 of EHV-1. ILTV gK has features
characteristic of a membrane-bound glycoprotein. The 3' region of a third ORF was
located at map units 0.08 to 0.095. Translation of the sequence revealed
significant homology to the 3'-region of the DNA helicase-primase complex protein
(UL52) of HSV-1, ORF6 of VZV and ORF 7 of EHV-1. Northern blot analyses were used
to characterize the ILTV ICP27, gK and DNA helicase mRNAs. The data revealed that
ILTV ICP27 is an immediate early gene that encodes a 1.6 kb mRNA, ILTV gK encodes
a late transcript of 1.8 kb, while ILTV DNA helicase encodes a late transcript of
3.7 kb.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7794109 [PubMed - indexed for MEDLINE]

4694: Br J Gen Pract. 1995 Jan;45(390):39-45.

Primary care management of acute herpes zoster: systematic review of evidence
from randomized controlled trials.

Lancaster T, Silagy C, Gray S.

University Department of Public Health and Primary Care, Radcliffe Infirmary,
Oxford.

Although a number of randomized controlled trials of treatment for herpes zoster 
have been performed, there is no consensus on how it should be managed in general
practice. A systematic review of existing trials, including meta-analysis, was
performed to determine the efficacy of available therapies in reducing the
incidence of postherpetic neuralgia. The treatments studied included antiviral
agents, corticosteroids and other drugs which had been studied in randomized
trials. Trials were included if the subjects were immunocompetent adults and the 
intervention was feasible in general practice. The main outcome measure was
prevalence of pain at one, three and six months after onset of the acute herpetic
rash. Data for each time point were not available for all trials. The quality of 
studies was also assessed. Pooled analyses of trials with acyclovir failed to
detect a significant reduction of pain in the treatment group at one or six
months, but found a 35% reduction at three months. Confidence limits were wide,
and a modest benefit of treatment cannot be ruled out at one and six months.
Pooled analyses were not possible for other treatments, either because too few
trials had been performed, or because completed trials demonstrated significant
heterogeneity. Many clinical trials in this area have been too small to give
reliable results. Variations in the definition and reporting of postherpetic
neuralgia create difficulties in combining data from different studies. Firm
recommendations for clinical practice are not possible because existing evidence 
neither confirms nor refutes the hypothesis that treatment during the acute phase
of herpes zoster reduces pain later.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 7779475 [PubMed - indexed for MEDLINE]

4695: Nephron. 1995;69(4):428-32.

Avoiding acyclovir neurotoxicity in patients with chronic renal failure
undergoing haemodialysis.

Almond MK, Fan S, Dhillon S, Pollock AM, Raftery MJ.

Department of Nephrology, Royal London Hospital, London, UK.

Acute neurotoxicity following the administration of the recommended oral dose of 
acyclovir (800 mg twice daily) to dialysis-dependent patients is increasingly
recognised. This suggests that the recommended dose is too high. Little is known 
of the pharmacokinetics of oral acyclovir in dialysis patients. We studied 7
patients with oliguric end stage renal failure receiving haemodialysis. Following
haemodialysis, each patient received a single 800-mg tablet of acyclovir. Plasma 
acyclovir levels were monitored over the next 48 h as well as before and after
the next routine dialysis. Peak plasma levels were achieved at 3 h (12.54 +/-
1.76 microM, range 8.5-17.5 microM) with the half-life calculated to be 20.2 +/- 
4.6 h. Mean plasma level of 6.29 +/- 0.94 microM were within the quoted range to 
inhibit herpes zoster virus (4-8 microM) at 18 h. Haemodialysis (4-5 h)
eliminated 51 +/- 11.5% of the acyclovir which remained at 48 h. Computer
modelling of various dose modifications suggests that a loading dose of 400 mg
and a maintenance dose of 200 mg twice daily is sufficient to maintain a mean
plasma acyclovir level of 6.4 +/- 0.8 microM. A further loading dose (400 mg)
after dialysis would raise the residual acyclovir concentration by 6.1 +/- 1.0
microM. Such a dose modification should prevent neurotoxicity, whilst the rapid
elimination of acyclovir by a single haemodialysis treatment provides both a
diagnostic and therapeutic tool when toxicity is suspected.

PMID: 7777108 [PubMed - indexed for MEDLINE]

4696: Retina. 1995;15(1):14-20.

Progressive outer retinal necrosis secondary to varicella zoster virus in
acquired immune deficiency syndrome.

Greven CM, Ford J, Stanton C, Shogreen M, Feldman S, Pegram S, Slusher MM.

Department of Ophthalmology, Wake Forest University Eye Center, Winston-Salem,
North Carolina, USA.

BACKGROUND: A syndrome consisting of rapidly progressive outer retinitis in
patients with suppressed immune systems has been described. The etiologic agent
appears to be a member of the herpes virus family. METHODS: A 41-year-old man
with acquired immune deficiency syndrome (AIDS) developed bilateral outer
retinitis and choroiditis, which progressed despite antiviral treatment. A
transscleral eye wall biopsy specimen and whole globe were submitted for
microbiologic and histologic study. RESULTS: Polymerase chain reaction of a
transscleral eye wall biopsy specimen and of the enucleated specimen determined
the etiologic agent to be varicella zoster virus (VZV). Histologic studies
demonstrated intranuclear inclusions consistent with viral particles in choroidal
cells. CONCLUSION: Our study revealed intranuclear inclusions in choroidal cells,
a previously undocumented finding in progressive outer retinal necrosis.
Polymerase chain reaction was very useful in identifying the causative agent.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 7754241 [PubMed - indexed for MEDLINE]

4697: J Infect. 1995 Jan;30(1):29-36.

Is Bell's palsy a reactivation of varicella zoster virus?

Morgan M, Moffat M, Ritchie L, Collacott I, Brown T.

Department of Medical Microbiology, Aberdeen Royal Hospitals Trust (University of
Aberdeen), Foresterhill, U.K.

Despite various pointers to an infectious aetiology, the cause of Bell's palsy
remains obscure. We examined paired sera from 62 patients with facial palsy and
50 age and sex matched contemporaneous controls. Significantly more patients than
controls had IgM antibodies by ELISA to varicella zoster virus (56.5% vs. 20%, P 
= 0.0001) and herpes simplex virus (41.9% vs. 18%, P = 0.006). Additionally,
significantly more patients than controls were positive for CF antibody to
varicella zoster virus (14.5% vs. 0%, P = 0.004) but not to herpes simplex or
cytomegalovirus. Significantly more controls than patients (54% vs. 25.8%, P =
0.002) had no evidence of antigenic stimulation by any of the herpesvirus group. 
No significant difference between patients and controls in seropositivity by IgM 
ELISA to cytomegalovirus. Epstein-Barr virus and IFA for human herpes virus 6 was
found. Furthermore, there was no significant difference between the two groups as
to evidence of recent infection by the following agents: rubella virus and
Borrelia burgdorferi by IgM ELISA, influenza A. influenza B, adenovirus,
respiratory syncytial virus, mumps and measles. Mycoplasma pneumoniae, Coxiella
burnetii and chlamydia spp. by complement fixation test. The first reported case 
of clinically and serologically proven Mycoplasma pneumoniae pneumonia associated
with Bell's palsy is described. The rate of complete recovery at 6-8 weeks after 
onset was not significantly different in patients who were given steroids
compared to those who were not. Ear related symptoms were the most common,
occurring in 12 of 65 cases, but only three (4.6%) had clinical shingles
(vesicles in ear).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7751662 [PubMed - indexed for MEDLINE]

4698: Trans R Soc Trop Med Hyg. 1995 Jan-Feb;89(1):37-40.

Tuberculin sensitivity and HIV-1 status of patients attending a sexually
transmitted diseases clinic in Lusaka, Zambia: a cross-sectional study.

Duncan LE, Elliott AM, Hayes RJ, Hira SK, Tembo G, Mumba GT, Ebrahim SH, Quigley 
M, Pobee JO, McAdam KP.

School of Medicine, University of Zambia, Lusaka.

A cross-sectional study to estimate the prevalence of latent tuberculosis (TB) in
a group of Zambians at high risk of human immunodeficiency virus type 1 (HIV-1)
infection and to examine the effect of HIV-1 infection on the tuberculin response
was conducted in the University Teaching Hospital in Lusaka, Zambia during July
to September 1990. Patients were selected from those presenting to the
out-patient clinic for first referral with either sexually transmitted or skin
disease. 268 adults were included in the study; 158 (59%; 95% confidence interval
[CI] = 53-65%) were HIV-1 antibody positive. Of 82 HIV-1 negative participants
who returned for Mantoux skin test reading, 51 (62%; 95% CI = 57-67%) had a
positive test reaction (diameter > or = 10 mm) after receiving 2 units of RT-23
tuberculin. Of 106 HIV-1 positive participants who returned, only 32 (30%; 95% CI
= 26-34%) had a diameter > or = 10 mm. Nine (28%) of the HIV-1 positive and
Mantoux positive participants had large reactions > or = 30 mm, compared to 4
(8%) of the HIV-1 negative, Mantoux positive participants (P = 0.03). Results in 
the HIV-1 negative group indicated a prevalence of latent TB of 62% in this
population. HIV-1 infection was associated with a much higher frequency of
negative response to tuberculin and with a few large skin test responses. Thus,
in populations where HIV seropositivity is high, Mantoux skin tests cannot be
used to assess those with latent TB who might benefit from chemoprophylaxis.

PIP: A cross-sectional study of the Mantoux response and HIV-1 status of a sample
of patients with sexually transmitted diseases and skin diseases in Lusaka,
Zambia, sought to estimate the prevalence of latent tuberculous infection. The
sample was selected from patients attending the sexually transmitted
diseases/dermatology section at the University Teaching Hospital, Lusaka, Zambia,
between July and September 1990. A questionnaire regarding socioeconomic factors,
history of TB, contact with TB, location and documentation of bacillus
Calmette-Guerin (BCG) scar(s) and history of BCG vaccination was completed, and a
physical examination for acquired immune deficiency syndrome (AIDS) was carried
out. The Mantoux result was recorded as the average diameter of induration,
measured in 2 perpendicular directions by the pen and palpation method. A total
of 158 patients (59%) were HIV-1 positive. Of the 66 women who took part, 46
(70%) were HIV-1 positive; of the 201 men, 112 (56%) were HIV-1 positive (p =
0.06). 232 patients had sexually transmitted diseases, the commonest being
genital ulceration; 123/231 (53%) were HIV-1 positive. The remaining 36 patients 
had skin diseases, the commonest being herpes zoster; 32/36 (89%) were HIV-1
positive. Of the 267 patients remaining in the study, 193 (72%) returned to have 
their Mantoux test read, 188 within 48-72 h. 106 (67%) HIV-1 positive patients
and 82 (75%) HIV-1 negative patients returned. Of the 82 HIV-1 negative patients,
51 (62%) had a Mantoux reaction or= 10 mm; 55 (67%) had a reaction or= 5 mm. Of
the 106 HIV-1 positive patients, only 32 (30%) had a Mantoux reaction or= 10 mm; 
35 (33%) had a response or= 5 mm. Comparing HIV-1 negative and HIV-1 positive
participants gave a significant odds ratio of 3.85 for a Mantoux response or= 10 
mm. Among the individuals with a Mantoux reaction or= 10 mm, 9/32 (28%) of HIV-1 
positive participants had a megareaction or= 30 mm, while megareactions occurred 
in 4/51 (8%) of HIV-1 negative participants (odds ratio 4.6).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7747304 [PubMed - indexed for MEDLINE]

4699: J Mal Vasc. 1995;20(1):1-7.

[Vasculitis of viral origin. Pathogenesis and therapeutic implications]

[Article in French]

Genereau T, Tri N'Guyen Q, Lortholary O, Cohen P, Guillevin L.

Service de Medecine Interne, Hopital Avicenne, Bobigny.

Some viruses are unquestionably the cause of vasculitis, by different mechanisms:
circulating immune complexes, cryoglobulinemia and/or direct infection of the
blood vessel. The main viruses responsible for vasculitis are hepatitis B & C
viruses, cytomegalovirus, parvovirus B19 and human immunodeficiency virus. Viral 
vasculitis are clinically protean, most of the time similar to idiopathic
vasculitis. The manifestations due to the virus itself are sometimes hidden and
vasculitis may reveal the viral infection. In some cases of viral vasculitis,
particularly in hepatitis virus-induced vasculitis, antiviral therapy may help in
controlling the disease. A viral etiology must be considered during atypical
vasculitis.

Publication Types: 
    English Abstract
    Review

PMID: 7745353 [PubMed - indexed for MEDLINE]

4700: Clin Infect Dis. 1995 Jan;20(1):206-8.

Myelitis due to varicella-zoster virus in an immunocompromised patient without a 
cutaneous rash.

Meylan PR, Miklossy J, Iten A, Petignat C, Meuli R, Zufferey J, Sahli R.

Publication Types: 
    Case Reports
    Letter

PMID: 7727664 [PubMed - indexed for MEDLINE]

4701: Adv Pediatr Infect Dis. 1995;10:93-124.

Varicella-zoster virus: prospects for control.

Gershon AA.

Department of Pediatrics, Columbia University College of Physicians & Surgeons,
New York, New York, USA.

There have been a number of new developments in the field of VZV concerning
pathogenesis, diagnosis, prevention, and treatment. These include improved
understanding of how latent infection develops and is maintained, the development
and, we hope, licensure of live attenuated varicella vaccine for routine use in
children and in adults who have not had varicella, an increased availability of
antiviral therapy for healthy and immunocompromised patients, and the development
of newer diagnostic techniques, including PCR to diagnose illnesses caused by VZV
and LA for rapid, sensitive, and accurate determination of immune status to VZV. 
Even as vaccine use becomes more and more widespread, we will continue to need
effective antiviral therapy for VZV for use in immunocompromised persons and in
those in whom zoster develops. Eventually it may be possible to develop either a 
vaccine or an antiviral drug that prevents the development of latent VZV
infection. Until that time, however, VZV will remain with us, and we will
continue to need an effective antiviral armamentarium, including diagnostic
techniques, passive immunization, antiviral therapy, and vaccine.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 7718215 [PubMed - indexed for MEDLINE]

4702: Oncol Nurs Forum. 1995 Jan-Feb;22(1):121-6.

A teaching booklet for patients receiving mantle field irradiation.

Gomez EG.

Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New
York, NY.

PURPOSE/OBJECTIVES: To design a booklet for use in educating patients with
Hodgkin's disease about mantle field irradiation. DATA SOURCES: Published
articles, book chapters, and clinical experience. DATA SYNTHESIS: Information
about the actual mantle field irradiation treatment and its acute side effects,
self-care measures, and late effects are included in the booklet, along with a
self quiz. CONCLUSIONS: Feedback from patients and staff is positive. Early
detection of and intervention for herpes zoster infection has improved.
IMPLICATIONS FOR NURSING PRACTICE: The booklet can be used in conjunction with
other teaching tools for radiation therapy and skin care and as a written
reference for patients and staff.

PMID: 7708511 [PubMed - indexed for MEDLINE]

4703: J Clin Microbiol. 1995 Jan;33(1):41-4.

Comparison of three methods for extraction of viral nucleic acids from blood
cultures.

Espy MJ, Patel R, Paya CV, Smith TF.

Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota 55905.

Reliable nucleic acid extraction techniques for blood specimens are required for 
the sensitive detection of viral DNA. Standardized procedures for processing
blood specimens for the molecular detection of herpesviruses (cytomegalovirus
[CMV], herpes simplex virus, varicella-zoster virus, and Epstein-Barr virus
[EBV]) have not been established. Three methods were used to extract DNA from
blood specimens from healthy donors and asymptomatic immunocompromised patients: 
(i) IsoQuick treatment of whole blood, (ii) extraction of the peripheral blood
leukocytes by lysis (lysis buffer and proteinase K), and (iii) extraction of
peripheral blood leukocytes with phenol-chloroform (sodium docecyl sulfate
solution and proteinase K). All blood specimens from 25 healthy blood donors were
negative for CMV, herpes simplex virus and varicella-zoster virus nucleic acid
sequences, regardless of the extraction method, while three samples (12%)
extracted by the lysis technique were positive for EBV DNA. Of 25 blood samples
from asymptomatic immunocompromised patients, CMV and EBV each were detected in
nine specimens by lysis extraction, four each by IsoQuick and four (CMV) and six 
(EBV) by the phenol-chloroform method. Our results indicate that the lysis method
is optimal for the detection of CMV and EBV DNA sequences by PCR from the
leukocytic fraction of blood specimens. DNA of these viruses is frequently
present in blood specimens from asymptomatic immunocompromised patients and
occasionally from healthy donors.

Publication Types: 
    Comparative Study

PMID: 7699063 [PubMed - indexed for MEDLINE]

4704: Neurochirurgie. 1995;41(2):73-86; discussion 87-8.

[Chronic spinal cord stimulation in the treatment of neurogenic pain. Cooperative
and retrospective study on 20 years of follow-up]

[Article in French]

Lazorthes Y, Siegfried J, Verdie JC, Casaux J.

Service de Neurochirurgie, CHU Rangueil, Faculte de Medecine Rangueil, Toulouse.

The aim of this investigation is to evaluate the long-term spinal cord
stimulation (SCS) efficacy and safety, with a 20-years study concerning 692
patients (series I: 279, series II: 413). The series concern 304 arachno-epidural
fibrosis, 152 peripheral nerve lesions, 25 amputations pain, 17 plexus brachial
lesions, 101 spinal cord lesions, 22 cancer pain, and 71 vascular pain. A
multidisciplinary chronic pain evaluation must exclude contra-indications
(nociceptive pain, serious drug habituations, psychological problems, unresolved 
issues or secondary pain). Percutaneous epidural SCS is a screening method if the
trial is sufficiently prolonged (3 to 14 days) and if the pain topography is
overlapped by induced paresthesias. The immediate global results of the 2 series 
are similar: respectively 86% and 85% of success one month after implantation.
With the same longterm follow-up (mean: 10 yrs, range: 2-20), and the same
evaluation criteria, the percentage of long-term global success rate is 54% in
series I, and 52% in series II. In the most recent period (1984-1990) concerning 
301 patients, the success rate are respectively 68% and 60%. Analysing the
results etiologically confirms the therapeutic value of SCS for neurogenic pain
secondary to partial deafferentation. For upper limb pain, ipsilateral radicular 
stimulation is preferable. When the nerve lesion extends to the pre-ganglionic
portion (brachial plexus avulsion, herpes zoster) or in cases of pain of spinal
or cerebral origin, thalamic stimulation must be considered, after failure of
SCS.

Publication Types: 
    Clinical Trial
    English Abstract
    Multicenter Study
    Review

PMID: 7630466 [PubMed - indexed for MEDLINE]

4705: ORL Head Neck Nurs. 1995 Winter;13(1):10.

What are the primary nursing diagnoses to be considered when planning care for
the patient with Ramsay Hunt syndrome?

McCall M.

PMID: 7627869 [PubMed - indexed for MEDLINE]

4706: An Otorrinolaringol Ibero Am. 1995;22(4):339-48.

[Epidemic outbreak of herpes zoster oticus (Ramsay-Hunt syndrome)]

[Article in Spanish]

Mochon A, Esteban F, Solano J, Gonzalez-Moles MA, Mendoza J, Dominguez C.

Servicio de Otorrinolaringologia del Hospital Virgen de las Nieve de Granada.

In this paper are reported 5 cases of herpes zoster oticus diagnosed in our
surroundings, all of them presented independently, in a two weeks term.
Discussion of the disease's etiopathogeny besides the possibility of its
spreading as outbreaks.

Publication Types: 
    English Abstract

PMID: 7573854 [PubMed - indexed for MEDLINE]

4707: Retina. 1995;15(3):233-40.

Interpretation of intraocular and serum antibody levels in necrotizing retinitis.

Davis JL, Feuer W, Culbertson WW, Pflugfelder SC.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami
School of Medicine, Florida, USA.

BACKGROUND: Intraocular antibodies have been measured as a diagnostic aid in
necrotizing retinitis but interpretation of results may be difficult. METHODS:
Vitreous or aqueous and serum immunoglobulin G antibodies to toxoplasmosis,
cytomegalovirus, herpes simplex virus I and II, and varicella zoster virus were
subjected to enzyme-linked immunosorbent assay in 27 patients with necrotizing
retinitis and 15 control patients. A quotient was derived quantitating the amount
of excess antibody in the eye compared to serum. Different interpretative rules
were analyzed to determine which yielded the highest sensitivity and specificity.
RESULTS: The highest intraocular antibody relative to serum among the 4
antibodies correctly predicted the final clinical diagnosis in 21 of 27 patients,
for a sensitivity of 78% and a specificity of 90%. Interpretive rules that relied
on a high numeric value of the antibody quotient or did not consider the relative
ranking of the four antibody quotients were less sensitive and specific because
multiple antibodies were detected in most eyes. The technique was safe and rapid.
CONCLUSION: Interpretation of antibody titers in intraocular fluids is
facilitated by testing several relevant antibodies and comparing the results. The
technique may be helpful to diagnose necrotizing retinitis and to ascertain viral
cause in acute retinal necrosis.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7569351 [PubMed - indexed for MEDLINE]

4708: Eye. 1995;9 ( Pt 3):390-2.

Comment on:
    Eye. 1994;8 ( Pt 1):70-4.

Oral acyclovir in herpes zoster ophthalmicus.

Harding SP.

Publication Types: 
    Comment
    Letter

PMID: 7556765 [PubMed - indexed for MEDLINE]

4709: Eye. 1995;9 ( Pt 3):271-6.

Progressive outer retinal necrosis (PORN) in AIDS patients: a different
appearance of varicella-zoster retinitis.

Pavesio CE, Mitchell SM, Barton K, Schwartz SD, Towler HM, Lightman S.

Uveitis and Acquired Immunodeficiency Syndrome Clinics, Moorfields Eye Hospital, 
London, UK.

Retinal infections caused by the varicella-zoster virus (VZV) have been reported 
in immunocompetent and immunocompromised individuals. Two cases of a VZV-related 
retinitis are described with the characteristic features of the recently
described progressive outer retinal necrosis (PORN) syndrome. Both patients
suffered from the acquired immunodeficiency syndrome (AIDS) with greatly reduced 
peripheral blood CD4+ T lymphocyte counts, and presented with macular retinitis
without vitritis. The disease was bilateral in one case and unilateral in the
other. The clinical course was rapidly progressive with widespread retinal
involvement and the development of rhegmatogenous retinal detachment with
complete loss of vision in the affected eyes despite intensive intravenous
antiviral therapy. VZV DNA was identified in vitreous biopsies, by molecular
techniques based on the polymerase chain reaction (PCR), in both patients. At
present, the use of very high-dose intravenous acyclovir may be the best
therapeutic option in these patients for whom the visual prognosis is poor.
Intravitreal antiviral drugs could also contribute to the management of these
cases.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 7556731 [PubMed - indexed for MEDLINE]

4710: Microbiol Immunol. 1995;39(2):129-33.

Increased expression of adhesion molecules (CD54, CD29 and CD44) on fibroblasts
infected with cytomegalovirus.

Ito M, Watanabe M, Ihara T, Kamiya H, Sakurai M.

Department of Pediatrics, Mie University School of Medicine, Japan.

The expression of ICAM-1 (CD54), beta 1 integrin (CD29), and CD44 on
cytomegalovirus (CMV)-infected human embryonic fibroblasts (HEF) was analyzed by 
flow cytometry. The expression of these adhesion molecules increased
significantly on CMV-infected HEF, on days 2 and 5 after inoculation, compared to
uninfected HEF. However, the expression of these adhesion molecules decreased on 
herpes simplex virus (HSV)-1 and varicella-zoster virus (VZV)-infected HEF.
Increased expression was not observed on HEF treated either with inactivated CMV 
or with supernatant fluid of CMV-infected cells. The addition of anti-cytokine
(TNF-alpha, IL-1 beta, or IFN-gamma) antibodies had no effect on the increase of 
these adhesion molecules. This suggests that the increase in CD54, CD29, and CD44
on CMV-infected cells requires active virus replication and was not mediated by a
soluble factor released from CMV-infected cells. Changes in adhesion molecules on
CMV-infected fibroblasts may contribute to inflammation induced by CMV infection.

PMID: 7540252 [PubMed - indexed for MEDLINE]

4711: Arch Virol. 1995;140(11):2055-66.

Detection of latent varicella zoster virus DNA and human gene sequences in human 
trigeminal ganglia by in situ amplification combined with in situ hybridization.

Dueland AN, Ranneberg-Nilsen T, Degre M.

Institute of Bacteriology, National Hospital, University of Oslo, Norway.

Varicella zoster virus (VZV) establishes latency in sensory ganglia following
primary infection (chickenpox) and may reactivate decades later to produce zoster
(shingles). The presence of VZV DNA in latently infected ganglia has been
demonstrated by Southern blot hybridization as well as by polymerase chain
reaction of DNA extracted from latently infected ganglia. Conflicting results
have been obtained by in situ hybridization studies to determine the cell type in
the ganglia harboring the latent VZV. To address this controversy we have
utilized a more sensitive method than the previous studies. We have applied the
technique of polymerase chain reaction to sections of ganglia from latently
infected individuals and combined this with in situ hybridization to detect the
amplified product. Primers specific for VZV were used to amplify VZV DNA in
latently infected human trigeminal ganglia and demonstrated the presence of VZV
DNA in neurons only. Sections from human kidney and ganglia from neonates as well
as monkey ganglia served as controls and did not show amplification of VZV
sequences. Amplification using primers for human genes, alpha tubulin and the
oncogene Bcl-2, demonstrated the presence of these sequences in nearly all cells 
in the human tissues while only weak signals were seen in the monkey tissue. This
is the first report where in situ amplification has been utilized to detect
latent VZV in human ganglia.

PMID: 7503701 [PubMed - indexed for MEDLINE]

4712: Bull Soc Belge Ophtalmol. 1995;255:115-22.

[Aids and chorioretinal opportunistic infections]

[Article in French]

De Munck J, Lefevre A, Vandercam B, Delaere B, Zech F, Snyers B.

Service d'Ophtalmologie, Cliniques Universitaires Saint-Luc, UCL, Bruxelles.

Retrospective study of 19 cases of opportunistic infections of the chorioretina
in patients with the Acquired Immunodeficiency Syndrome. We observed 14 cases of 
CMV retinitis, 2 cases of toxoplasmic chorioretinitis, 1 case of cryptococcal
choroiditis and 2 cases of herpes zoster retinitis. Review of the clinical,
angiographical and histopathological aspects of these infections. Review of the
vital and visual prognosis after treatment.

Publication Types: 
    English Abstract

PMID: 7496567 [PubMed - indexed for MEDLINE]

4713: Rev Med Panama. 1995 Jan-May;20(1-2):54-7.

[Herpes zoster in infants]

[Article in Spanish]

Rivas de La Lastra E, Lasso Bonilla MA.

CHMAAM, Caja de Seguro Social de Panama.

The authors present the clinical history of four children under two years of age 
who were hospitalized in the Arnulfo Arias Madrid Medical Complex with the
diagnosis of herpes zoster. The mothers of these children had varicella when in
the third, sixth, eight and fifth month of pregnancy respectively and the
children were 3, 24, 14 and 8 months old when they had herpes zoster. The first
child (whose mother had varicella when she was three months pregnant) was born
underweight, dysphagic and premature. The fourth (whose mother had varicella in
the 5th. month of gestation) was only underweight. The other two (mothers had
varicella in the 6th and 8th month of pregnancy, respectively) were born without 
apparent abnormality. The authors, based on their findings, believe that there is
risk for the child to have a congenital malformation when the mother develops
varicella in the first months of pregnancy.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 7480905 [PubMed - indexed for MEDLINE]

4714: Br J Hosp Med. 1994 Dec 14-1995 Jan 17;52(11):565-7, 570.

Postherpetic neuralgia: current concepts and management.

Lee JJ, Gauci CA.

Pain Relief Clinic, Whipps Cross Hospital, London.

Postherpetic neuralgia (PHN) is the most feared complication of herpes zoster and
remains one of the most common and intractable chronic pain disorders. Recent
evidence has shed some light on the possible mechanisms of pain, and on the
prophylactic and treatment approaches to PHN. This article reviews the current
concepts and management of PHN.

Publication Types: 
    Review

PMID: 7719579 [PubMed - indexed for MEDLINE]

4715: Eur Arch Otorhinolaryngol. 1994 Dec:S530-1.

Therapeutic policy for Bell's palsy and Hunt syndrome.

Kinishi M, Hosomi H, Amatsu M.

Department of Otolaryngology, Kobe University School of Medicine, Japan.

PMID: 10774441 [PubMed - indexed for MEDLINE]

4716: Eur Arch Otorhinolaryngol. 1994 Dec:S493-4.

Herpes zoster of the geniculate ganglion: therapeutic concepts.

Darrouzet V, Gharbi F, de Bonfils C, Rognon C, Bebear JP.

ENT Department, Pellegrin Hospital, Bordeaux, France.

PMID: 10774432 [PubMed - indexed for MEDLINE]

4717: Eur Arch Otorhinolaryngol. 1994 Dec:S491-2.

Recent treatment of Ramsay Hunt syndrome.

Inamura H, Aoyagi M, Tojima H, Maeyama H, Koike Y.

Department of Otolaryngology, Yamagata University School of Medicine, Japan.

PMID: 10774431 [PubMed - indexed for MEDLINE]

4718: Eur Arch Otorhinolaryngol. 1994 Dec:S432-3.

Detection of varicella zoster virus DNA by polymerase chain reaction in clinical 
samples from patients with Hunt's syndrome.

Kawasaki Y, Aruga H, Ogino S, Hashimoto K, Yamanishi K, Matsunaga T.

Department of Otolaryngology, Osaka University Medical School, Japan.

PMID: 10774415 [PubMed - indexed for MEDLINE]

4719: Arch Ophthalmol. 1994 Dec;112(12):1601-9.

Comment in:
    Arch Ophthalmol. 1995 Oct;113(10):1226-8.

Detection of herpes simplex viral DNA in the iridocorneal endothelial syndrome.

Alvarado JA, Underwood JL, Green WR, Wu S, Murphy CG, Hwang DG, Moore TE, O'Day
D.

Department of Ophthalmology, University of California, San Francisco.

OBJECTIVE: To test the hypothesis that the iridocorneal endothelial (ICE)
syndrome has a viral origin by comparing the incidence of viral DNA in corneal
specimens from patients with the ICE syndrome and from controls. DESIGN:
Thirty-one corneas obtained from 25 patients with the ICE syndrome and six with
chronic herpetic keratitis (n = 31) were compared with 30 control specimens
obtained from 15 healthy donors and from 15 patients with other, nonviral chronic
corneal diseases. METHODS: Primer pairs and polymerase chain reaction methods
were used to identify and amplify either a segment of the DNA polymerase gene in 
the case of the herpes simplex and zoster viruses or a region of the nuclear
antigen gene for the Epstein-Barr virus. The oligonucleotide amplified by
polymerase chain reaction was fully characterized with the use of restriction
enzyme, hybridization, and sequence analyses to determine that it contained the
expected base pair sequence. RESULTS: Sixteen of 25 ICE syndrome specimens and
four of six herpetic keratitis specimens were positive for herpes simplex virus
(HSV) DNA. All nine ICE syndrome specimens tested were negative for the presence 
of DNA from the herpes zoster or the Epstein-Barr viruses. Controls were
uniformly negative for HSV DNA whether they were obtained from ostensibly normal 
corneas (n = 15) or from corneas with intestinal keratitis, aphakic bullous
keratopathy, or keratoconus (n = 15). Tissue samples cut from positive ICE
syndrome specimens yielded negative results when retested after the endothelial
layer was removed. These findings indicate that localization of HSV DNA is within
the endothelium, the tissue primarily involved in the pathogenesis of the ICE
syndrome. CONCLUSIONS: Polymerase chain reaction evidence shows that HSV DNA is
present in a substantial percentage of ICE syndrome corneal specimens and that
HSV-DNA is absent in normal corneas and in corneas from patients with three other
chronic corneal diseases. These results provide direct evidence to support our
hypothesis that the ICE syndrome has a viral origin. We discussed clinical
implications, including possible therapeutic interventions.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7993217 [PubMed - indexed for MEDLINE]

4720: Arch Ophthalmol. 1994 Dec;112(12):1515-6.

Differentiating zosteriform herpes simplex from ophthalmic zoster.

Yamamoto S, Shimomura Y, Kinoshita S, Tano Y.

Publication Types: 
    Case Reports
    Letter

PMID: 7993204 [PubMed - indexed for MEDLINE]

4721: Surgery. 1994 Dec;116(6):1024-30.

Comparative analysis of complications from I-131 radioablation for
well-differentiated thyroid cancer.

DiRusso G, Kern KA.

Department of Surgery, Hartford Hospital, Conn.

BACKGROUND. The decision to extend thyroidectomy to the opposite lobe during
resection of well-differentiated thyroid cancer should include an analysis of
complications of I-131 radioablation directly related to the thyroid remnant. If 
significant, then contralateral resection would be indicated. To clarify this
issue we studied the incidence of complications of I-131 radioablation in 63
cases of well-differentiated thyroid cancer. METHODS. Retrospective reviews of
operative notes, pathology reports, office records, and physician interviews were
made. We analyzed operations, complications, and radiation dosing. RESULTS.
Procedures included unilateral thyroidectomy, 10 (15.9%); subtotal thyroidectomy,
seven (11.1%); near-total thyroidectomy, 25 (39.7%); and total thyroidectomy, 21 
(33.3%). The average ablative dose was 101 mCi (range, 30 to 208 mCi). Nineteen
percent (12 of 63) of patients had complications including radiation thyroiditis 
(eight), chronic sialoadenitis (one), odynophagia (one), facial edema (one), and 
shingles (one). Near-total or total thyroidectomy resulted in significantly fewer
complications compared with lesser resections (8.7% versus 47.1%, p < 0.005).
CONCLUSIONS. The incidence of complications of I-131 radioablation after
thyroidectomy for well-differentiated thyroid cancer is related to the extent of 
thyroidectomy performed. We recommend contralateral thyroid resection (resulting 
in a near-total or total thyroidectomy) in patients likely to receive
postoperative I-131 radioablation.

Publication Types: 
    Comparative Study

PMID: 7985082 [PubMed - indexed for MEDLINE]

4722: South Med J. 1994 Dec;87(12):1227-31.

Acyclovir neurotoxicity: clinical experience and review of the literature.

Adair JC, Gold M, Bond RE.

Department of Neurology, Shands Hospital, University of Florida, Gainesville
32610.

Acyclovir produces neurologic symptoms that resemble extension of viral infection
into the central nervous system. We discuss our observations in the cases of two 
patients with acyclovir neurotoxicity and review the findings of all previous
reports in the English language literature. Systemic disease, most commonly renal
dysfunction, preceded all 30 reported cases of acyclovir neurotoxicity. The most 
common symptoms were mental status disorder and involuntary movements.
Measurement of serum acyclovir levels substantiated the diagnosis in only a
subset of patients. Although all patients recovered, hemodialysis hastened the
rate of recovery.

Publication Types: 
    Case Reports
    Review

PMID: 7973922 [PubMed - indexed for MEDLINE]

4723: J Virol. 1994 Dec;68(12):7850-8.

Varicella-zoster virus (VZV) open reading frame 10 protein, the homolog of the
essential herpes simplex virus protein VP16, is dispensable for VZV replication
in vitro.

Cohen JI, Seidel K.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

Varicella-zoster virus (VZV) open reading frame 10 (ORF10) protein in the homolog
of the herpes simplex virus type 1 (HSV-1) protein VP16. VZV ORF10 transactivates
the VZV IE62 gene and is a tegument protein present in the virion. HSV-1 VP16, a 
potent transactivator of HSV-1 immediate-early genes and tegument protein, is
essential for HSV-1 replication in vitro. To determine whether VZV ORF10 is
required for viral replication in vitro, we constructed two VZV mutants which
were unable to express ORF10. One mutant had a stop codon after the 61st codon of
the ORF10 gene, and the other mutant was deleted for all but the last five codons
of the gene. Both VZV mutants grew in cell culture to titers similar to that of
the parental virus. To determine whether HSV-1 VP16 alters the growth of VZV, we 
constructed a VZV mutant in which VP16 was inserted in place of ORF10. Using
immune electron microscopy, we found that HSV-1 VP16 was present in the tegument 
of the recombinant VZV virions. The VZV VP16 substitution mutant produced smaller
plaques and grew to a lower titer than parental virus. Thus, VZV ORF10 is not
required for growth of the virus in vitro, and substitution of HSV-1 VP16 for VZV
ORF10 impairs the growth of VZV.

Publication Types: 
    Comparative Study

PMID: 7966575 [PubMed - indexed for MEDLINE]

4724: J Virol. 1994 Dec;68(12):7757-65.

Identification and expression of a murine cytomegalovirus early gene coding for
an Fc receptor.

Thale R, Lucin P, Schneider K, Eggers M, Koszinowski UH.

Department of Virology, University of Heidelberg, Germany.

Several herpesviruses, including cytomegalovirus, induce receptors for the Fc
domain of murine immunoglobulin G (IgG) molecules. Viral genes coding for these
receptors have been characterized only for alphaherpesviruses. In this report, we
describe a new approach that led to the identification of an Fc receptor (FcR) of
murine cytomegalovirus (MCMV). The Fc fragment of IgG precipitated glycoproteins 
(gp) of 86 to 88 and 105 kDa from MCMV-infected cells. Deglycosylation by
endoglycosidase F resulted in a protein with a molecular mass of 64 kDa.
Injection of complete MCMV DNA or of DNA fragments, and the subsequent testing of
cytoplasmic binding of IgG by immunofluorescence microscopy, was used to search
for the coding region in the MCMV genome. The gene was located in the HindIII J
fragment, map units 0.838 to 0.846, where an open reading frame of 1,707
nucleotides predicts a gp of 569 amino acids with a calculated molecular mass of 
65 kDa. The sequence of this gp is related to those of the gE proteins of herpes 
simplex virus type 1 and varicella-zoster virus. The defined length of the mRNA, 
1,838 nucleotides, was in agreement with that of a 1.9-kb RNA expressed
throughout the replication cycle, starting at the early stages of infection.
Expression of the gene fcr1 by recombinant vaccinia virus resulted in the
synthesis of gp86/88 and gp105, each with FcR properties, and the correct
identification of the gene encoding the FcR was confirmed by the DNA injection
method.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7966565 [PubMed - indexed for MEDLINE]

4725: Am J Respir Crit Care Med. 1994 Dec;150(6 Pt 1):1697-701.

Prevalence of occupational asthma among workers exposed to eastern white cedar.

Malo JL, Cartier A, L'Archeveque J, Trudeau C, Courteau JP, Bherer L.

Department of Chest Medicine, Hopital du Sacre-Coeur, Montreal, Quebec, Canada.

We assessed the prevalence of occupational asthma among current (n = 29/31, 94%) 
and former (n = 13/49, 27%) employees of a sawmill in which eastern white cedar
has been made into shingles during the past 3 yr. All participants answered a
respiratory questionnaire, and all except one underwent spirometry and
methacholine inhalation tests. All those with bronchial hyperresponsiveness (PC20
methacholine < or = 19 mg/ml) were invited to undergo specific inhalation
challenges. Mean duration of exposure was 13 mo (19 workers > 12 mo).
Twenty-eight workers (65%) reported a history compatible with asthma, and 25
(58%) had symptoms that were suggestive of occupational asthma. Only two subjects
had significant airway obstruction (FEV1 < 80% pred) (mean value = 98% pred).
Eighteen subjects (42%) had a PC20 < or = 16 mg/ml. Specific inhalation tests
with plicatic acid and/or western red cedar (which contains twice as much
plicatic acid as eastern white cedar), were done on 12 subjects who had a PC20 < 
or = 16 mg/ml when they were assessed. Three subjects were considered to have
positive tests (one had an isolated immediate reaction, one had a late reaction, 
and one had significant changes in PC20 each time he was exposed but no changes
in FEV1). Environmental monitoring showed concentrations of total dusts above 2
mg/m3 in half of the samples. The prevalence of occupational asthma in this
workplace was three of 42 participants (7%) or at least three of 80 (3.8%) of all
current or ex-workers. This is comparable to the prevalence of occupational
asthma in subjects exposed to western red cedar.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7952635 [PubMed - indexed for MEDLINE]

4726: Postgrad Med J. 1994 Dec;70(830):940.

Herpes zoster encephalitis in the elderly.

Gillanders I, MacKay J, Campbell F, MacLennan WJ.

Publication Types: 
    Case Reports
    Letter

PMID: 7870650 [PubMed - indexed for MEDLINE]

4727: Qual Life Res. 1994 Dec;3(6):431-5.

The Nottingham Health Profile as a measure of quality of life in zoster patients:
convergent and discriminant validity.

Mauskopf J, Austin R, Dix L, Berzon R.

Economics Research Department, Burroughs Wellcome Co., Research Triangle Park, NC
27709.

The main symptoms of zoster, a disease caused by the reactivation of the
varicella zoster virus (that causes chicken-pox) are: rash, associated with pain,
burning, or itching, and pain that outlasts the rash sometimes by months or
years. The uncomfortable and long-lasting symptoms of herpes zoster are likely to
compromise the patient's quality of life. However, the impact of zoster on
health-related quality of life has not previously been measured directly. Recent 
papers have demonstrated the ability of generic measures to discriminate among
patients with different clinical symptoms. In this paper, we demonstrate the
convergent validity for zoster of a generic measure, the Nottingham Health
Profile (NHP), by measuring its correlation with rash progression, pain levels,
and pain medications. The discriminant validity of the NHP was demonstrated by
its ability to distinguish between different levels of pain severity. The NHP
dimensions most highly correlated with the pain measures, were pain (0.42-0.50), 
energy (0.34-0.38) and sleep (0.32-0.38). The NHP scores in all six dimensions
show large differences at different levels of pain severity that are
statistically significant. These results demonstrate the NHP's validity as a
measure of health-related quality of life in zoster patients.

PMID: 7866361 [PubMed - indexed for MEDLINE]

4728: Am J Dermatopathol. 1994 Dec;16(6):588-92.

Viral glycoproteins in herpesviridae granulomas.

Nikkels AF, Debrus S, Delvenne P, Sadzot-Delvaux C, Piette J, Rentier B, Pierard 
GE.

Department of Dermatopathology, University of Liege, Belgium.

Granulomatous reactions after varicella zoster virus (VZV) and herpes simplex
virus (HSV) infections are rare, and their pathogenesis remains unclear. We
studied by immunohistochemistry and in situ hybridization early granulomatous
reactions after VZV and HSV infections. In the five cases studied, the VZV
glycoproteins gp I and gp II were present in cells abutted to altered vessels,
but the corresponding genome sequences were disclosed in similar locations in
only one of these cases. In an immunocompromised patient with diffuse HSV
eruption, HSV I antigens were present in cells of the reticular dermis, while
viral nucleic acids were not evident. Immunophenotyping of the granulomas showed 
strong Mac 387 and CD68 positive labelings of macrophages/monocytes, without any 
involvement of Factor XIIIa-positive cells. These findings suggest that the major
viral envelope glycoproteins, rather than complete viral particles could trigger 
granuloma formation following HSV and VZV skin infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7864296 [PubMed - indexed for MEDLINE]

4729: Rev Clin Esp. 1994 Dec;194(12):1062-3.

[Pontine infarction and cervical herpes zoster]

[Article in Spanish]

Sempere AP, Fernandez A, Calabuig MJ, Duarte J.

Publication Types: 
    Case Reports
    Letter

PMID: 7863060 [PubMed - indexed for MEDLINE]

4730: Drugs Aging. 1994 Dec;5(6):411-8.

Post-herpetic neuralgia in older patients. Incidence and optimal treatment.

Bowsher D.

Pain Research Institute, Walton Hospital, Liverpool, England.

Post-herpetic neuralgia (PHN) is a disease caused by having had herpes zoster; it
is not a continuation of shingles. Up to 50% of elderly patients who have had
shingles may develop PHN. PHN is defined as pain recurring or continuing at the
site of shingles, 1 or more months after the onset of the rash. Because many
cases resolve spontaneously in the early stages, no claims of 'pharmacological
cure' can be entertained before 3 months post-rash. In fact, some authorities
will not accept claims made before 6 months. Antivirals administered systemically
within the appropriate time-window greatly relieve the pain of acute shingles,
and to a large extent prevent scarring. There is no evidence that they prevent
the subsequent development of PHN. However, patients with PHN whose acute
shingles were treated with aciclovir obtain pain relief with antidepressants in
half the time required by those patients who did not receive aciclovir for their 
acute shingles. If patients with acute shingles are given low dose amitriptyline 
from the onset, only half as many are in pain at 6 months as a group not so
treated, irrespective of the antiviral treatments given. The most effective
treatment of established PHN to date consists of adrenergically active
antidepressants. There is a strict correlation with the brevity of the interval
between acute shingles and initiation of such treatment. 75% of patients starting
treatment with antidepressants within 3 to 6 months after shingles obtain pain
relief, whereas if antidepressants are not started for 2 years, only 25% obtain
pain relief.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Review

PMID: 7858367 [PubMed - indexed for MEDLINE]

4731: J Gerontol Nurs. 1994 Dec;20(12):42-6.

Herpes zoster and the aging.

McMahon MA.

Publication Types: 
    Case Reports

PMID: 7852712 [PubMed - indexed for MEDLINE]

4732: Yan Ke Xue Bao. 1994 Dec;10(4):248-50.

[Herpes zoster keratoendotheliitis]

[Article in Chinese]

Huang Y, Cheng B, Guan Z.

Department of Ophthalmology, Zhongshan People's Hospital, Guangdong, China.

Herpes zoster keratoendotheliitis is related to autoimmunity or herpes zoster
virus infection. It is characterised by K.P. and interstitial edema. The disease 
responds well to the administration of steroids and a good result is often
achieved.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 7774702 [PubMed - indexed for MEDLINE]

4733: Med Hypotheses. 1994 Dec;43(6):361-71.

CD4 similarity to proteins of infectious agents in AIDS and their role in
autoimmunity.

Root-Bernstein RS, Dewitt SH.

Department of Physiology, Michigan State University, East Lansing 48824, USA.

Lymphocytotoxic autoimmunity (LA) is ubiquitous in AIDS. Its causes are unknown. 
We report that significant amino acid sequence similarities exist between the
proteins of infectious organisms associated with AIDS and the CD4 protein of
T-helper lymphocytes. These included: HIV, cytomegalovirus (CMV), Epstein-Barr
virus (EBV), herpes simplex viruses (HSV), Varicella Zoster virus (VZV),
Escherichia coli, Mycobacteria, Mycoplasmas, Plasmodium, and Staphylococcus. It
has been reported previously that HIV proteins have significant similarities with
human class II MHC (HLA class II) proteins. Since CD4 and HLA class II proteins
are chemically complementary, pairs of homologous antigens will also be
complementary. It follows that concurrent infections with CD4 and HLA class
II-homologous antigens will result in idiotype-antiidiotype antibody pairs that
cannot distinguish 'self' from 'nonself', that acts as lymphocytotoxins, and form
circulating immune complexes. Thus, combined HIV-CMV, HIV-EBV, HIV-HBV,
HIV-mycoplasma, or other appropriate infectious pairs may suffice to trigger LA
in AIDS.

Publication Types: 
    Comparative Study

PMID: 7739408 [PubMed - indexed for MEDLINE]

4734: Arch Dis Child. 1994 Dec;71(6):529-31.

A survey of recommendations given to patients going home after bone marrow
transplant.

Brandt L, Broadbent V.

Paediatric Oncology Unit, Addenbrooke's Hospital, Cambridge.

A postal questionnaire was sent to 11 UK Children's Cancer Study Group bone
marrow transplant centres asking them for details of their instructions to
patients on discharge after either allogeneic or auto transplant; nine centres
responded. There was no recommendation on which they all agreed. Though all
centres gave prophylactic septrin, the times of starting and stopping treatment
varied considerably. Three centres recommended lifelong penicillin after total
body irradiation, one treated for two years and five gave no such prophylaxis.
Four of nine centres gave routine acyclovir for herpes simplex prophylaxis. Most 
centres suggested prophylaxis against varicella after contact exposure for one
year. However, three gave zoster immune globulin alone, one gave this together
with acyclovir, and five gave acyclovir alone. No two centres recommended the
same dose of acyclovir. Vaccinations were allowed from 6-18 months after
transplant. One centre required documentation of recovery of immune function
first. Four centres recommended a child stay off school for six months; others
had 'common sense' approaches. Only one centre did not allow family holidays for 
the first six months but many imposed restrictions on these holidays. Dietary
restrictions varied greatly between centres. It is concluded that there is a need
for unified and scientifically justified guidelines after transplant for
paediatric bone marrow transplant patients.

PMID: 7726614 [PubMed - indexed for MEDLINE]

4735: Antimicrob Agents Chemother. 1994 Dec;38(12):2710-6.

The N-7-substituted acyclic nucleoside analog
2-amino-7-[(1,3-dihydroxy-2-propoxy)methyl]purine is a potent and selective
inhibitor of herpesvirus replication.

Neyts J, Andrei G, Snoeck R, Jahne G, Winkler I, Helsberg M, Balzarini J, De
Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

2-Amino-7-[(1,3-dihydroxy-2-propoxy)methyl]purine (compound S2242) represents the
first antivirally active nucleoside analog with the side chain attached to the
N-7 position of the purine ring. Compound S2242 strongly inhibits the in vitro
replication of both herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) (50%
effective concentration [EC50], 0.1 to 0.2 microgram/ml), varicella-zoster virus 
(EC50, 0.01 to 0.02 microgram/ml) and thymidine kinase (TK)-deficient strains of 
HSV (EC50, 0.4 microgram/ml) and varicella-zoster virus (EC50, 0.2 to 0.5
microgram/ml). Potent activity was also observed against murine cytomegalovirus
(EC50, 1 microgram/ml), human cytomegalovirus (HCMV) (EC50, 0.04 to 0.1
microgram/ml), and human herpesvirus 6 (EC50, 0.0005 microgram/ml). Compound
S2242 (i) was not cytotoxic to confluent Vero, HeLa, or human fibroblast cells at
concentrations of > 100 micrograms/ml, (ii) proved somewhat more cytostatic to
Vero, HEL, HeLa, and C127I cells than ganciclovir, and (iii) was markedly more
cytostatic than ganciclovir to the growth of the human lymphocytic cell lines
HSB-2 and CEM degrees. In contrast to ganciclovir, (i) compound S2242 proved not 
to be cytocidal to murine mammary carcinoma (FM3A) cells transfected with the
HSV-1 or HSV-2 TK gene, (ii) exogenously added thymidine had only a limited
effect on its anti-HSV-1 activity, and (iii) the compound was not phosphorylated 
by HSV-1-encoded TK derived from HSV-1 TK-transfected FM3A cells, indicating that
the compound is not activated by a virally encoded TK. Compound S2242 inhibited
(i) the expression of late HCHV antigens at an EC50 of 0.07 microgram/ml (0.6
microgram/ml for ganciclovir) and (ii) HCMV DNA synthesis at an EC50 of 0.1
microgram/ml (0.32 microgram/ml for ganciclovir), i.e., values that are close to 
the EC50S for inhibition of HCMV-induced cytopathogenicity. Neither ganciclovir
nor S2242 had any effect on the expression of immediate-early HCMV antigens,
which occurs before viral DNA synthesis. In time-of-addition experiments, S2242
behaved like ganciclovir and acyclovir; i.e., the addition of the drugs could be 
delayed until the onset of viral DNA synthesis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7695251 [PubMed - indexed for MEDLINE]

4736: S Afr Med J. 1994 Dec;84(12):873.

Recurrent herpes zoster and high-dose inhaled steroids for asthma.

Bruning AH, Samie MH.

Publication Types: 
    Case Reports
    Letter

PMID: 7570247 [PubMed - indexed for MEDLINE]

4737: Lakartidningen. 1994 Nov 23;91(47):4348.

[Bandage for relief in Herpes zoster]

[Article in Swedish]

Bolander L.

Publication Types: 
    Letter

PMID: 7808136 [PubMed - indexed for MEDLINE]

4738: Gene. 1994 Nov 18;149(2):203-9.

Mapping, cloning and sequencing of a glycoprotein-encoding gene from bovine
herpesvirus type 1 homologous to the gE gene from HSV-1.

Rebordosa X, Pinol J, Perez-Pons JA, Lloberas J, Naval J, Querol E.

Institut de Biologia Fonamental, Universitat Autonoma de Barcelona, Bellaterra,
Spain.

In order to map and identify the glycoprotein-encoding gene from bovine
herpesvirus type 1 (BHV-1), homologous to the gE glycoprotein from herpes simplex
virus type 1 (HSV-1), a region of the unique short sequence from the BHV-1 genome
has been sequenced. The sequenced region contains an ORF coding for a polypeptide
of 575 amino acids (aa). The aa sequence presents substantial similarity to that 
of the glycoprotein gE from HSV-1 and to homologous proteins of related viruses
such as pseudorabies virus, equine herpesvirus type 1 and varicella zoster virus.
The aa sequence presents additional characteristics compatible with the structure
of a viral glycoprotein: signal peptide, putative glycosylation sites and a long 
C-terminal transmembrane alpha-helix.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7958994 [PubMed - indexed for MEDLINE]

4739: Am J Ophthalmol. 1994 Nov 15;118(5):589-600.

Clinical and histopathologic study of varicella zoster virus retinitis in
patients with the acquired immunodeficiency syndrome.

Kuppermann BD, Quiceno JI, Wiley C, Hesselink J, Hamilton R, Keefe K, Garcia R,
Freeman WR.

Department of Ophthalmology, University of California, San Diego, La Jolla
92093-0946.

Varicella zoster virus retinitis in patients with the acquired immunodeficiency
syndrome is known to be a devastating disease. We studied a series of six
consecutive patients that sheds new light on the clinical manifestations and
treatment options of this disorder. All patients had episodes of cutaneous
zoster, long-term exposure to oral acyclovir, and CD4+ T lymphocyte counts less
than 50 cells/mm3. Two of the six patients had simultaneous radiographically
demonstrable and histologically proven varicella zoster virus encephalitis; this 
is an important association. Histologic examination of autopsy specimens
disclosed that the retinal infection by varicella zoster virus involves the
retinal pigment epithelium more heavily than the inner retina, which is
consistent with the characteristic clinical impression of an outer retinal
necrosis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7977572 [PubMed - indexed for MEDLINE]

4740: Virology. 1994 Nov 15;205(1):352-9.

Transcriptional analysis of two simian varicella virus glycoprotein genes which
are homologous to varicella-zoster virus gpI (gE) and gpIV (gI).

Fletcher TM 3rd, Gray WL.

Department of Microbiology and Immunology, University of Arkansas for Medical
Sciences, Little Rock 72205.

Simian varicella virus (SVV) causes a natural, varicella-like disease in nonhuman
primates. The unique short region of the SVV genome contains four open reading
frames (ORFs), two of which encode glycoproteins that exhibit extensive homology 
with varicella-zoster virus (VZV) gpIV (gI) and gpI (gE). Northern hybridization,
primer extension, and RNase protection analyses were employed to define precisely
the transcripts mapping to the SVV gpIV and gpI genes. A total of five
transcripts composing two coterminal families of RNAs were mapped to the SVV gpIV
and gpI ORF region. Based on transcriptional mapping and previous DNA sequence
analysis, two transcripts 1.3 and 2.2 kb in size were assigned to the SVV gpIV
and gpI genes, respectively. The transcriptional patterns described in this study
for the SVV gpIV and gpI ORFs are analogous to those previously reported for the 
homologous glycoproteins genes encoding the herpes simplex virus type 1 Us7 (gI) 
and Us8 (gE) and VZV gpIV and gpI genes. In addition, the transcriptional start
site for the VZV gpI RNA was determined. DNA alignments of the promoter regions
for the SVV and VZV gpIV and gpI genes revealed a number of cis-acting elements
which are conserved between the two viruses. The characterization of SVV
glycoprotein genes will facilitate future studies to define their role in SVV
pathogenesis and immunity and assist in the construction of recombinant vaccines 
which could be evaluated in the simian varicella model.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7975231 [PubMed - indexed for MEDLINE]

4741: Virology. 1994 Nov 15;205(1):238-46.

The RING finger domain of the varicella-zoster virus open reading frame 61
protein is required for its transregulatory functions.

Moriuchi H, Moriuchi M, Cohen JI.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
NIH, Bethesda, Maryland 20892.

Varicella-zoster virus (VZV) open reading frame 61 (ORF61) protein transactivates
expression of VZV promoters. VZV ORF61 is functionally homologous to herpes
simplex virus type 1 (HSV-1)-infected cell protein 0 (ICP0); however, amino acid 
sequence homology of these two proteins is limited to the RING finger domains, a 
recently identified sequence motif composed of cysteine and histidine residues,
located in their amino-terminal regions. A carboxy-terminal truncation mutant of 
ICP0 (which retains the RING finger domain) was previously shown to act as a
potent transrepressor and as a dominant-negative mutant in the presence of
full-length ICP0. We have shown that the corresponding region of ORF61 has
similar properties. Amino-terminal truncation mutants of VZV ORF61 and HSV-1
ICP0, which lack the RING finger domain, cannot transactivate VZV promoters;
however, fusion of the amino portion of one protein to the carboxy portion of the
other restored the transactivating activity of the full-length proteins. To
further study the role of the ORF61 RING finger domain, cysteine or histidine
residues of this domain were individually replaced with serine or aspargine,
respectively. Each of these amino acid substitution mutants in the RING finger
abolished the transactivating activity of the full-length ORF61 protein. Each of 
the substitutions also reduced the transrepressing and dominant-negative
properties of a carboxy-terminal truncation mutant of ORF61. These results
indicate that the RING finger domain is required for the transregulatory
functions of ORF61.

PMID: 7975220 [PubMed - indexed for MEDLINE]

4742: Curr Opin Ophthalmol. 1994 Dec;5(6):84-90.

Ocular manifestations of systemic infection.

Abramson J, Kushnick HJ, Mayers M.

Montefiore Medical Center, Bronx, New York, USA.

Increased research and awareness of various systemic infections places a greater 
emphasis on the ophthalmologist's knowledge of ocular manifestations of these
diseases. New advances in the diagnosis and treatment, as well as studies of the 
pathogenesis and histological features of different infectious processes are
continually being reported. Recent publications focusing on ophthalmic findings
of infectious diseases are reviewed. This article discusses new reports on herpes
simplex, herpes zoster, Lyme disease, malaria, onchocerciasis, cysticercosis, and
toxocariasis.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 10150833 [PubMed - indexed for MEDLINE]

4743: Dtsch Med Wochenschr. 1994 Nov 4;119(44):1526-7.

[The efficacy of acyclovir and glucocorticoids in the treatment of herpes zoster 
and postzoster neuralgias]

[Article in German]

Bruch D, Ruzicka T.

Hautklinik der Universitat, Dusseldorf.

PMID: 7956784 [PubMed - indexed for MEDLINE]

4744: J Gen Virol. 1994 Nov;75 ( Pt 11):3219-27.

DNA sequence and transcriptional analysis of the simian varicella virus
glycoprotein B gene.

Pumphrey CY, Gray WL.

Department of Microbiology and Immunology, University of Arkansas for Medical
Sciences, Little Rock 72205.

The varicella-zoster virus (VZV) glycoprotein B (gB) is a major viral antigen
which elicits immunity and neutralizing antibodies. In this study, the genomic
map position and DNA sequence of a simian varicella virus (SVV) homologue of the 
VZV gB gene was identified and the transcript analysed. A 32P-labelled VZV gB DNA
probe hybridized to a subclone of the SVV BamHI B restriction endonuclease
fragment indicating the fine map position of SVV DNA sequences homologous to the 
VZV gB gene. The SVV gB DNA sequence was determined and analysis revealed a 2751 
base pair open reading frame (ORF) with 71.1% identity to the VZV gB gene and
53.8% identity to the herpes simplex type 1 gB gene. The SVV gB ORF encodes a 916
amino acid polypeptide with a predicted molecular mass of 104K. The deduced SVV
and VZV gB polypeptides share 78.9% amino acid identity and predicted N-linked
glycosylation sites, cleavage sites and transmembrane regions. 32P-labelled SVV
gB DNA and RNA probes hybridized to a 3.5 kilobase SVV polyadenylated transcript.
Primer extension experiments identified transcript start sites for the SVV and
VZV gB genes and permitted a comparison of the sequences upstream of the SVV and 
VZV gB ORFs. The SVV and VZV gB promoter elements are similar in content and
align closely. The VZV gB transcript start site suggests a gB polypeptide
initiation site which is inconsistent with the previously reported ATG start
codon.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7964632 [PubMed - indexed for MEDLINE]

4745: J Gen Virol. 1994 Nov;75 ( Pt 11):3087-93.

Absence of varicella-zoster virus (VZV) glycoprotein V does not alter growth of
VZV in vitro or sensitivity to heparin.

Cohen JI, Seidel KE.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892.

Varicella-zoster virus (VZV) encodes at least five glycoproteins, gpI to gpV. VZV
gpV, M(r) 100K to 110K, is the product of VZV open reading frame (ORF) 14. VZV
gpV is homologous to herpes simplex virus gC and pseudorabies virus gIII. To
determine whether gpV is required for viral replication, we inserted a stop codon
after the fifteenth codon of the ORF14 gene in a cosmid containing the gene.
Transfection of human melanoma cells with the cosmid containing the mutant ORF14 
gene and three other cosmids resulted in the production of infectious VZV.
Immunoprecipitation indicated that the mutant virus did not express gpV. VZV that
did not express gpV grew at the same rate as parental virus and was inhibited by 
heparin to a similar extent. The pattern of inhibition by heparin of the gpV
mutant was similar to that reported for a herpes simplex virus mutant that does
not contain gC, but different from that described for a pseudorabies virus mutant
devoid of gIII. These results indicate that VZV gpV is not required for viral
replication in vitro.

PMID: 7964618 [PubMed - indexed for MEDLINE]

4746: Am J Gastroenterol. 1994 Nov;89(11):2092-3.

Colonic pseudo-obstruction: a complication of herpes zoster.

Oldfield EC 3rd.

Division of Infectious Diseases, Eastern Virginia Medical School, Norfolk.

PMID: 7942751 [PubMed - indexed for MEDLINE]

4747: J Am Acad Dermatol. 1994 Nov;31(5 Pt 1):746-54.

Erratum in:
    J Am Acad Dermatol 1995 Aug;33(2 Pt 1):206.    J Am Acad Dermatol 1995 Jun;32(6):976.

Cutaneous findings in HIV-1-positive patients: a 42-month prospective study.
Military Medical Consortium for the Advancement of Retroviral Research (MMCARR).

Smith KJ, Skelton HG, Yeager J, Ledsky R, McCarthy W, Baxter D, Turiansky GW,
Wagner KF, Turianski G.

Walter Reed Army Institute of Research, Bethesda, Maryland.

BACKGROUND: Cutaneous disease is common in patients infected with HIV-1.
OBJECTIVE: The aim of our study was to identify cutaneous markers associated with
HIV-1 infection and disease progression as measured by Walter Reed (WR) stage.
METHODS: For 42 months we have observed 912 HIV-1-positive patients in all WR
stages. All patients had an extensive past and present medical history taken as
well as a complete physical examination, periodic visits, and appropriate
diagnostic procedures. RESULTS: Increasing dryness of the skin and seborrheic
dermatitis are early findings in a large percentage of patients in WR stage 1;
the occurrence and severity of both conditions increase with disease progression.
Tinea infections, condylomata acuminata, and verrucae are seen early, but with
disease progression, although there is no clear increase in occurrence, these
infections become more diffuse and resistant to treatment. Flares in acne
vulgaris and folliculitis show a peak occurrence in early and mid-stage disease
with a decreased occurrence in late-stage disease. Herpes simplex infections,
oral candidiasis, molluscum contagiosum, Staphylococcus aureus infections, and
oral hairy leukoplakia show a marked increase in occurrence with advanced
disease. Conditions that have a statistically significant association with
disease progression as measured by a change in a stage include drug eruptions,
seborrheic dermatitis, oral candidiasis, oral hairy leukoplakia, molluscum
contagiosum, herpes zoster, and hyperpigmentation (nail, oral, skin). CONCLUSION:
The most frequent and persistent cutaneous disorders were asteatosis (with or
without asteatotic eczema) and seborrheic dermatitis. Conditions that were
associated with a change in WR stage include drug eruptions, seborrheic
dermatitis, oral candidiasis, oral hairy leukoplakia, molluscum contagiosum,
herpes zoster, and hyperpigmentation. In addition to Kaposi's sarcoma, patients
with HIV-1 disease have an increased potential for the development of both
cutaneous epithelial and probably melanocytic malignancies. Epithelial tumors
were seen in patients in all stages of disease.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 7929920 [PubMed - indexed for MEDLINE]

4748: Clin Infect Dis. 1994 Nov;19(5):975.

Comment on:
    Clin Infect Dis. 1993 Sep;17(3):431-6.

Multidermatomal herpes zoster in an AIDS patient.

Edelstein H.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 7893895 [PubMed - indexed for MEDLINE]

4749: Vaccine. 1994 Nov;12(15):1485.

Diagnosis of varicella-zoster and evaluation of varicella vaccine by passive
haemagglutination by non-invasive procedures.

Arya SC.

Publication Types: 
    Letter

PMID: 7887029 [PubMed - indexed for MEDLINE]

4750: Am J Otolaryngol. 1994 Nov-Dec;15(6):387-408.

Acute facial paralysis: evaluation and early management.

Selesnick SH, Patwardhan A.

Department of Otolaryngology, New York Hospital-Cornell University Medical
College, New York 10021.

Publication Types: 
    Review

PMID: 7872475 [PubMed - indexed for MEDLINE]

4751: Aust Fam Physician. 1994 Nov;23(11):2157-61, 2164-6.

Treatment of herpes simplex and varicella zoster infections.

Kainer M, Mills J.

Fairfield Infectious Diseases Hospital, Victoria.

The introduction of antiviral agents such as acyclovir has had a remarkable
impact on management of patients with viral infections. In this article the
authors outline the management of herpes simplex and varicella zoster infections,
giving specific guidelines for treatment with acyclovir.

Publication Types: 
    Case Reports

PMID: 7864771 [PubMed - indexed for MEDLINE]

4752: Support Care Cancer. 1994 Nov;2(6):355-68.

Viral infections in severely immunocompromised cancer patients.

Devine SM, Wingard JR.

Bone Marrow Transplant Program, Emory University School of Medicine, Emory South 
Clinic, Atlanta, GA 30322.

Immunocompromised cancer patients are susceptible to infection by many viral
pathogens. The most serious morbidity results from active infection by members of
the herpes virus family. Reactivation of latent virus occurs as a sequela of
cytotoxic therapy and deficiency of cell-mediated immunity, especially cytotoxic 
responses, the major host protective defense. Herpes simplex virus and varicella 
zoster virus infections are problematic in patients with all types of cancer;
cytomegalovirus infections cause life-threatening morbidity in bone marrow
transplant patients. Several antiviral agents are highly active against these
pathogens and different strategies of using them have resulted in reduced
morbidity and mortality. Ultimately, the resolution of these infections is
dependent on the control of the malignancy and the ability of the patient to
mount an adequate immune response.

Publication Types: 
    Review

PMID: 7858927 [PubMed - indexed for MEDLINE]

4753: J Med Virol. 1994 Nov;44(3):258-62.

Activation of a varicella-zoster virus-specific IgA response during acute
Epstein-Barr virus infection.

Karner W, Bauer G.

Abteilung Virologie, Universitat Freiburg, Germany.

The influence of an acute Epstein-Barr virus (EBV) infection on the serological
parameters of persistent varicella-zoster virus (VZV) and herpes simplex virus
(HSV) was studied. Sera from 161 patients with infectious mononucleosis caused by
EBV and 178 age-matched controls were tested for HSV- and VZV-specific IgA. 98.7 
percent of VZV-IgG-positive controls were negative for VZV-IgA, pointing to the
stringent control of latent VZV in healthy individuals. During acute EBV
infection, 33.8% of VZV-IgG-positive infectious mononucleosis patients produced
VZV-specific IgA. This result may be explained either by reactivation of VZV due 
to transient suppression of cellular immune functions during acute EBV infection 
or by polyclonal stimulation caused by EBV. Due to the high incidence of HSV-IgA 
in healthy HSV-IgG-positive individuals, only a marginal effect of acute EBV
infection on the appearance of HSV-specific IgA was found.

PMID: 7852970 [PubMed - indexed for MEDLINE]

4754: Natl Med J India. 1994 Nov-Dec;7(6):267-9.

Clinical features of HIV infection in drug users of Manipur.

Panda S, Kamei G, Pamei M, Sarkar S, Sarkar K, Singh ND, Deb BC.

Indian Council of Medical Research Unit for Research on AIDS, North Eastern
States of India, Salt Lake City, Calcutta, West Bengal.

BACKGROUND. The human immunodeficiency virus was first detected in young
intravenous drug users in Manipur in 1989 and it quickly reached a high
prevalence in this group. Diagnostic facilities are scarce and it is thus
important to suspect the presence of the infection by its clinical features.
METHODS. We did a cross-sectional survey for 13 months among residents of
different detoxification centres of Imphal, Manipur, to study the sensitivity,
specificity and positive predictive values of different signs and symptoms
occurring at the early phase of the infection. RESULTS. Most of the young
injectors in this survey were found to be in the early phases (stage I 43%; stage
II 32%; stage III 15% and stage IV 9.9%) of the World Health Organization
clinical staging of human immunodeficiency virus infection and disease. Herpes
zoster, oral candidiasis, pruritic papular eruptions, jaundice and
lymphadenopathy had positive predictive values of 100%, 100%, 93%, 93% and 88%
respectively. Cryptosporidial diarrhoea and tuberculosis (pulmonary and
extrapulmonary) were also encountered. CONCLUSION. Intravenous drug users in
Manipur who have human immunodeficiency virus infection suffer from different
opportunistic infections which give rise to clinical features that are easily
recognizable. It is important to be aware of these in areas which lack diagnostic
facilities for confirming the infection.

PIP: A cross-sectional study conducted among intravenous drug users in India's
Manipur State suggests that certain clinical signs and symptoms can be used to
detect human immunodeficiency virus (HIV) in areas with scarce diagnostic
resources. From May 1992 to April 1993, 154 intravenous drug users recruited from
drug detoxification centers in the capital city of Imphal were monitored for
clinical manifestations of disease. 131 subjects were HIV-positive, but examining
clinicians were not given data on HIV status. All subjects had started injecting 
within the last seven years, so the majority were in the early phases of HIV. The
distribution, by clinical stage, was as follows: I, 43%, II, 32%, III, 15%, and
IV, 9.9%). Clinical features most frequently encountered included herpes zoster
(27 men), oral thrush (7), pruritic papular eruptions (15), lymphadenopathy (33),
and jaundice (14). The positive predictive values of these signs were 100%, 100%,
93%, 88%, and 93%, respectively. Similar studies in other areas are urged to
provide information on the sensitivity and specificity of major signs for
defining clinical cases of HIV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7841877 [PubMed - indexed for MEDLINE]

4755: J Clin Pathol. 1994 Nov;47(11):1054-6.

Varicella zoster gastritis in a bone marrow transplant recipient.

McCluggage WG, Fox JD, Baillie KE, Coyle PV, Jones FG, O'Hara MD.

Department of Pathology, Royal Group of Hospitals, Belfast.

A case is reported of a patient who had previously undergone autologous bone
marrow transplantation for recurrent Hodgkin's disease. The patient developed a
generalised vesicular skin eruption. The clinical diagnosis was of disseminated
shingles. Herpes viral particles were identified within the vesicular fluid by
electron microscopy and using a specific monoclonal antibody to varicella zoster 
virus (VZV), positive immunofluorescence was detected in scrapings from the base 
of a vesicle. Gastroscopy and biopsy were performed because of severe abdominal
pain and vomiting. The histological features were of non-specific active
inflammation. Despite the histological absence of viral inclusions electron
microscopy of the gastric biopsy revealed the presence of intranuclear herpes
viral particles with a diameter of 90-100 nm. VZV specific DNA was detected by
the polymerase chain reaction in the gastric biopsy extract. The patient was
treated with acyclovir and made a full recovery.

Publication Types: 
    Case Reports

PMID: 7829687 [PubMed - indexed for MEDLINE]

4756: Ear Nose Throat J. 1994 Nov;73(11):850-2.

Comment in:
    Ear Nose Throat J. 1995 Feb;74(2):128.

Cephalic zoster with laryngeal paralysis.

Rothschild MA, Drake W 3rd, Scherl M.

Department of Otolaryngology, Mount Sinai School of Medicine, New York, New York.

Herpes zoster reactivaction in the head and neck region is often associated with 
multiple cranial neuropathies, the most common one being facial paralysis.
Laryngeal paralysis has also been occasionally reported with zoster infection. We
present two such cases, and discuss the relevant literature on the
pathophysiology, evaluation and management of this disease. Recent advances in
antiviral therapy have allowed for specific medical treatment, thus making it all
the more imperative to suspect zoster, even in clinically atypical cases. We
suggest aggressive treatment with intravenous acyclovir for cephalic zoster
complicated by vocal cord paralysis.

Publication Types: 
    Case Reports
    Review

PMID: 7828480 [PubMed - indexed for MEDLINE]

4757: Nippon Ganka Gakkai Zasshi. 1994 Nov;98(11):1141-6.

[Rapidly progressive outer retinal necrosis in a patient with acquired
immunodeficiency syndrome]

[Article in Japanese]

Oshitari K, Arimoto H, Suzuki S, Oguchi Y.

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

We report a case of rapidly progressive varicella zoster virus retinitis, which
is distinct from acute retinal necrosis syndrome. The patient was a 52-year-old
male and suffered acquired immunodeficiency syndrome. Two months after the
varicella zoster dermatitis in the distribution of the first division of the left
trigeminal nerve, pseudodendritic keratitis and iridocyclitis were observed in
the left eye. After 5 weeks, multifocal and patchy white exudates were observed
in the peripheral deeper layer of the retina in the left eye, but retinal
vasculitis in the exudative lesions was slight. Despite systemic administration
of acyclovir, white exudates progressed confluently from the periphery to the
post pole of the retina and reached the macula in 10 weeks. Eight weeks after the
observation of lesions in the left eye, we found the same lesions in the right
eye. After the white exudative lesions disappeared, the retina became atrophic
and the retinal vessels were narrowed, but no retinal detachment was observed.
Recently, Foster and associates described the rapidly progressive outer retinal
necrosis as a new entity of varicella zoster virus retinitis in AIDS patients. We
think our case was very similar to the rapidly progressive outer retinal
necrosis. This case shows that we must carefully follow up the rapidly
progressive outer retinal necrosis in the AIDS patients with a varicella zoster
dermatitis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7825511 [PubMed - indexed for MEDLINE]

4758: Gesundheitswesen. 1994 Nov;56(11):599-601.

[The epidemiologic significance of varicella]

[Article in German]

Hofmann F, Sydow B, Michaelis M.

Arbeitsmedizin, Personalarztliche Untersuchungsstelle, Univ.-Klinikum Freiburg.

A total of 552 persons working in the university hospital of Freiburg, Germany
(nurses, pediatric nurses, administration--and technical personnel) was screened 
for antibodies to varicella zoster virus. Prevalence of antibodies to VZV among
men was higher than among women. While the degree of immunity of nurses and
administration/technical personnel was comparable, pediatric nurses had a
significantly higher seroprevalence (< 20 years 89.3%, -30 years 95.7%, > 30
years 98.6%). Therefore, pediatric nurses should be screened and susceptible
persons should be vaccinated.

Publication Types: 
    English Abstract

PMID: 7819671 [PubMed - indexed for MEDLINE]

4759: Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Nov;32(11):1073-7.

[A case of limited Wegener's granulomatosis with hemophilia A, complicated by
empyema, bronchopleural fistula and herpes zoster during therapy]

[Article in Japanese]

Tao Y, Hayashi T, Nagatomo H, Yoshii C, Nikaido Y, Nagata N, Kido M.

Division of Respiratory Diseases, University of Occupational and Environmental
Health, Japan.

A 36-year-old man with hemophilia A was admitted to hospital because of otalgia, 
hearing loss, nasal obstruction, nonproductive cough, and high fever. His
laboratory data showed high-grade acute inflammatory reactions. His chest X-ray
and CT films showed multiple cavitary masses in the right lower lung field.
Bronchoscopy performed at our institution revealed bronchial nodules in the
intermediate truncus, and BAL revealed increases in the neutrophils and an IgG
index (BAL IgG/albumin divided by serum IgG/albumin). Biopsy specimens obtained
from nasal mucosa showed epithelioid granulomas with Langerhans' giant cells and 
necrotizing vasculitis. Antineutrophil cytoplasmic antibodies were also positive,
but no evidence of glomerulonephritis was observed. The diagnosis of limited
Wegener's granulomatosis was thus made. He was treated with standard therapy
(daily cyclophosphamide and glucocorticoids), but within 1 month he had
complications of empyema with herpes zoster, and bronchopleural fistula. The
complications resolved with appropriate treatment.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7815760 [PubMed - indexed for MEDLINE]

4760: Ophthalmology. 1994 Nov;101(11):1801-4.

Herpes zoster ophthalmicus in Malawi.

Lewallen S.

International Eye Foundation, Blantyre, Malawi, Africa.

OBJECTIVE: The objective was to describe the complications and outcomes of herpes
zoster ophthalmicus in a population of young Africans with a high seroprevalence 
of human immunodeficiency virus type 1 in which treatment often is delayed and in
which antiviral drugs are not available. METHODS: Twenty-seven patients with
herpes zoster ophthalmicus presenting consecutively to a large urban hospital
were examined and followed. Treatment was limited to that which was locally
available. RESULTS: Visual outcomes were poor. Sixty-six percent of eyes had
final visual acuity less than 20/60. Forty percent had light perception or no
light perception visual acuity. Severe keratouveitis and corneal perforation were
common and responsible for most poor visual outcomes. CONCLUSION: Young Africans 
with herpes zoster ophthalmicus are at a high risk for significant visual loss.

Publication Types: 
    Comparative Study

PMID: 7800359 [PubMed - indexed for MEDLINE]

4761: J Clin Epidemiol. 1994 Nov;47(11):1271-6.

The accuracy of self-report of herpes zoster.

Schmader K, George LK, Newton R, Hamilton JD.

Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.

The accuracy of self-report of herpes zoster was investigated in the Duke
Established Populations for Epidemiological Studies of the Elderly, a
longitudinal study of 4162 community-dwelling elderly persons residing in North
Carolina, 1986-1993. The authors compared self-reports of zoster with physician
diagnosis of zoster and with a zoster verification questionnaire (ZVQ). Compared 
to physician diagnosis, 3.2% (95% confidence interval 0-61%) of self-reports of
zoster (n = 31) were false-positive and no denials of zoster (n = 63) were
false-negative. The agreement of self-reports to physician diagnosis was 98.9%,
the sensitivity and negative predictive value were 100%, the specificity was
98.4% and the positive predictive value was 96.7%. The ZVQ comparisons were
similarly high. These data suggest that the frequency of false-positive and
false-negative reports of zoster is low in this elderly population. Zoster
self-reports appear to be accurate and suitable for epidemiological
investigations.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 7722563 [PubMed - indexed for MEDLINE]

4762: Ann Acad Med Singapore. 1994 Nov;23(6 Suppl):139-44.

Management of postherpetic neuralgia.

Lefkowitz M, Marini RA.

Pain Management Service, Long Island College Hospital, Brooklyn 11201, USA.

Postherpetic neuralgia is a perplexing disorder in which pain develops as a
result of herpes zoster. It is a common cause of neuropathic pain and may render 
its effects especially on the elderly and immunocompromised. Once established,
postherpetic neuralgia is resistant to most treatment modalities and can lead to 
much despair. Many therapeutic approaches have been attempted through the years, 
most with varying results. This review describes clinical manifestations
including allodynia, hyperaesthesia and anaesthesia. It also reviews
pharmacologic and non-pharmacologic treatment modalities including a review of
anaesthetic nerve blocks, neurostimulation, acupuncture and surgical techniques.

Publication Types: 
    Review

PMID: 7710224 [PubMed - indexed for MEDLINE]

4763: Haematologica. 1994 Nov-Dec;79(6):513-8.

Cyclophosphamide (3.6 g/m2) therapy with G-CSF support for resistant myeloma.

Palumbo A, Boccadoro M, Bruno B, Triolo S, Pileri A.

Dipartimento di Medicina ed Oncologia Sperimentale, Universita di Torino,
Ospedale Molinette, Italy.

BACKGROUND. In myeloma patients resistance to both melphalan- and
doxorubicin-containing regimens has been related to very short survival
(approximately 6 months). The development of effective regimens combined with a
low toxicity rate is mandatory in this patient subgroup. METHODS. Fourteen
resistant myeloma patients were treated with cyclophosphamide (a total of 3.6
g/m2 was delivered in 2 doses on days 1 and 3) and prednisone (2 mg/kg, days 1-4)
every month for 4 cycles. G-CSF support was administered to reduce
myelosuppression. RESULTS. This combination was well tolerated. Granulocyte
levels fell below 0.1 x 10(9)/L in all patients after a median of 9 days (range
8-11), followed by recovery to 0.5 x 10(9)/L after a median of 12 days from the
start of treatment (range 10-13 days). Platelets never fell below 50 x 10(9)/L.
All patients were treated on an outpatient basis and only 2 required
hospitalization for major complications (pneumonia and heart failure). Response
to cyclophosphamide was observed in 6/14 patients: 2 achieved complete remission,
4 showed a 50% or greater reduction of the M-component. Five patients are still
in remission after 2, 6, 7, 9 and 10 months; 1 relapsed after 10 months. All
patients except one are alive 4-16 months from the start of treatment.
CONCLUSIONS. This schedule may represent a new approach for resistant myeloma,
and its very low toxicity allows it to be delivered on an outpatient basis.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 7534745 [PubMed - indexed for MEDLINE]

4764: BMJ. 1994 Oct 29;309(6962):1124.

Comment in:
    BMJ. 1995 Apr 15;310(6985):1005.    BMJ. 1995 Apr 15;310(6985):1005.

Acyclovir and post-herpetic neuralgia and ocular involvement.

McGill JI, White JE.

Southampton University Hospitals.

PMID: 7987104 [PubMed - indexed for MEDLINE]

4765: Med Lett Drugs Ther. 1994 Oct 28;36(934):97-8.

Famciclovir for herpes zoster.

[No authors listed]

PMID: 7935158 [PubMed - indexed for MEDLINE]

4766: Rev Prat. 1994 Oct 15;44(16):2133-6.

[Acyclovir and infections caused by varicella-zoster viruses]

[Article in French]

Vilde JL, Longuet P.

Service des maladies infectieuses et tropicales, hopital Bichat--Claude-Bernard, 
Paris.

PMID: 7984909 [PubMed - indexed for MEDLINE]

4767: Biol Psychiatry. 1994 Oct 15;36(8):517-21.

Viral antibodies in recent onset, nonorganic psychoses: correspondence with
symptomatic severity.

Srikanth S, Ravi V, Poornima KS, Shetty KT, Gangadhar BN, Janakiramaiah N.

Department of Psychiatry, National Institute of Mental Health and Neurosciences, 
Bangalore, India.

A parallel of generalized viral infection with psychiatric symptoms has been
reported in nonorganic psychotic disorders. The patients concerned had been ill
for long periods and some of them had been readmitted. In order to determine the 
presence of viral infection at the very onset of the psychosis, antibodies in
blood and cerebrospinal fluid (CSF) to six viruses [cytomegalovirus (CMV), herpes
simplex (HSV) Type 1, mumps, measles, varicella zoster virus (VZV), and Japanese 
encephalitis virus (JEV)] were assayed in 35 psychotic patients [14
schizophrenics; 13 manic patients; and 8 patients with psychosis not otherwise
specified (NOS)] within 1 month of onset of illness. Ten (28.6%) patients had a
diagnostic (fourfold) change in the antibody titer in the paired serum and/or CSF
samples (drawn at 2-week intervals) and another 10 had high titers (above 2 SDs
from the mean in 35 control subjects). The striking temporal correlation with the
initial severity and resolution of psychopathology by 2 weeks on the Brief
Psychiatric Rating Scale (BPRS) suggests a causally significant, currently active
viral infection in these 20 cases.

PMID: 7827214 [PubMed - indexed for MEDLINE]

4768: Plant Physiol. 1994 Oct;106(2):731-737.

Direct Measurement of ATP-Dependent Proton Concentration Changes and
Characterization of a K+-Stimulated ATPase in Pea Chloroplast Inner Envelope
Vesicles.

Shingles R, McCarty RE.

Department of Biology, The Johns Hopkins University, Baltimore, Maryland
21218-2685.

Inner envelope membrane vesicles prepared from pea (Pisum sativum L. var Laxton's
Progress No. 9) chloroplasts have K+-stimulated ATPase activity with a pH optimum
of 8.4. ATP addition to inner envelope vesicles loaded with pyranine caused a
decrease in pyranine fluorescence that was consistent with internal
acidification. The transmembrane pH change induced by the addition of 5 mM ATP
was about 0.4 unit. Measurement of phosphate released by ATP hydrolysis
paralleled the pH change, indicating that intravesicular acidification was linked
to ATPase activity. Vanadate, molybdate, N-ethylmaleimide, and dithiothreitol
inhibited ATP-dependent vesicle acidification completely, whereas ATPase activity
was only partially inhibited. These data indicate that pea chloroplast inner
envelope vesicles contain a proton translocating ATPase and that the
pyranine-loading method can be utilized to study directly ATP-dependent H+
transport across these membranes.

PMID: 12232365 [PubMed - as supplied by publisher]

4769: Brain. 1994 Oct;117 ( Pt 5):987-99.

Varicella-zoster virus infection of the central nervous system in the acquired
immune deficiency syndrome.

Gray F, Belec L, Lescs MC, Chretien F, Ciardi A, Hassine D, Flament-Saillour M,
de Truchis P, Clair B, Scaravilli F.

Departement de Pathologie (Neuropathologie), Hopital Henri Mondor, Faculte de
Medecine de Creteil, Universite Paris-Val de Marne, France.

Productive varicella-zoster virus (VZV) infection of the central nervous system
(CNS) was demonstrated in 11 acquired immune deficiency syndrome (AIDS) patients 
using immunocytochemistry and in situ hybridization. A characteristic zoster skin
eruption was seen in only four cases. From our own series and 11 other cases in
the literature, we identified five clinico-pathological patterns of VZV infection
of the CNS in AIDS patients which could occur simultaneously. (i) Multifocal
encephalitis predominantly involving the white matter, likely to be due to
haematogenous spread of the infection was found in four cases. (ii) Ventriculitis
was found in three cases. In two cases there was complete acute or chronic
necrosis of the ventricular wall with marked vasculitis; in the third, the
ependymal lining appeared irregular with foci of VZV-infected ependymal cells,
some of which protruded into the ventricular lumen. (iii) Acute haemorrhagic
meningo-myeloradiculitis with necrotizing vasculitis was observed in two cases.
In one, this was associated with ventriculitis and was possibly due to shedding
of infected ependymal cells into the ventricular lumen and secondary seeding of
the CSF. (iv) Focal necrotizing myelitis was seen in one case. It followed
cutaneous herpes zoster and was considered to result from neural spread from the 
diseased dorsal root ganglion similar to cases previously described of
encephalitis limited to the visual system following VZV ophthalmicus, or bulbar
encephalitis following a trigeminal zoster. (v) Vasculopathy involving
leptomeningeal arteries and causing cerebral infarcts was seen in four cases, it 
was associated with meningitis in most cases. These findings are in keeping with 
the observation in non-AIDS patients that VZV spread to the CNS may follow
different routes. Our study tends to show that VZV infection of the CNS occurs
more frequently in AIDS than previously suspected and suggests that it must be
considered as a diagnosis in cases of encephalitis, ventriculitis, focal
myelitis, acute myeloradiculitis and cerebral infarcts in these patients.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Review

PMID: 7953606 [PubMed - indexed for MEDLINE]

4770: Am J Epidemiol. 1994 Oct 1;140(7):632-42.

Shingles, allergies, family medical history, oral contraceptives, and other
potential risk factors for systemic lupus erythematosus.

Strom BL, Reidenberg MM, West S, Snyder ES, Freundlich B, Stolley PD.

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
School of Medicine, Philadelphia 19104-6095.

The authors undertook a case-control study to explore the many factors that have 
been postulated to be related to the etiology of systemic lupus erythematosus. A 
total of 195 cases of systemic lupus diagnosed in the Philadelphia, Pennsylvania,
metropolitan area between 1985 and 1987 were compared with 143 controls, friends 
of the cases matched to them according to age (+/- 5 years) and sex. Through
personal interviews and chart reviews, data were collected on demographic
factors, personal and familial medical history, reproductive history, medication 
history, and environmental exposures. Associations were found between systemic
lupus erythematosus and having a family history of autoimmune disease (age-,
sex-, and race-adjusted odds ratio (OR) = 2.3, 95% confidence interval (CI)
1.2-4.6), a history of shingles (adjusted OR = 6.4, 95% CI 1.4-28.0), a history
of hives (adjusted OR = 1.8, 95% CI 1.1-3.0), and a history of medication
allergies (adjusted OR = 2.6, 95% CI 1.5-4.5). No association was present between
systemic lupus erythematosus and either any use or recent use of oral
contraceptives (e.g., OR = 0.6 (95% CI 0.2-1.4) for use in the 3 years prior to
diagnosis), family history of multiple other diseases, or a history of numerous
other infections or various other types of allergies. Thus, these data indicate
that systemic lupus erythematosus is associated with a family history of
autoimmune diseases, a history of shingles, and a history of allergies. In
contrast, if the development of systemic lupus is affected by use of oral
contraceptives, this effect must be extremely modest. These findings may help
clarify the possible pathogenesis of systemic lupus erythematosus, and they
provide clues as to when the presence of systemic lupus should be suspected.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 7942763 [PubMed - indexed for MEDLINE]

4771: Neurology. 1994 Oct;44(10):1818-23.

Varicella-zoster virus myelitis: an expanding spectrum.

Gilden DH, Beinlich BR, Rubinstien EM, Stommel E, Swenson R, Rubinstein D,
Mahalingam R.

Department of Neurology, University of Colorado School of Medicine, Denver.

We report four cases of varicella-zoster virus (VZV)-associated myelopathy in
adults. Myelopathy was remitting-exacerbating in two remarkable instances, once
acute and once chronic. VZV myelopathy was diagnosed based on the close temporal 
relationship between rash and onset of myelopathy, and for the first time, by
polymerase chain reaction, which revealed VZV DNA in the cerebral spinal fluid of
three patients with pleocytosis weeks to months later. Magnetic resonance imaging
was abnormal in three of four patients. Although all four patients were treated
at some time with intravenous acyclovir, concomitant treatment with steroids and 
the presence of acquired immunodeficiency syndrome in one patient prevented
conclusions about a favorable response to therapy. Myelopathy after VZV infection
may be remitting-exacerbating in addition to acute or chronic. Detection of VZV
DNA in cerebral spinal fluid months after rash was useful for diagnosis and
suggests a role for virus in the pathogenesis of myelopathy.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 7936229 [PubMed - indexed for MEDLINE]

4772: J Clin Oncol. 1994 Oct;12(10):2051-9.

Phase II trial of fludarabine phosphate and interferon alfa-2a in advanced
mycosis fungoides/Sezary syndrome.

Foss FM, Ihde DC, Linnoila IR, Fischmann AB, Schechter GP, Cotelingam JD,
Steinberg SM, Ghosh BC, Stocker JL, Bastian A, et al.

National Cancer Institute, National Institutes of Health, Bethesda, MD.

PURPOSE: This phase II study was undertaken to assess the efficacy and toxicity
of the addition of continuous low-dose interferon alfa-2a (IFN) to fludarabine in
patients with advanced or refractory mycosis fungoides (MF) or the Sezary
syndrome (SS). PATIENTS AND METHODS: Thirty-five patients were treated with
fludarabine 25 mg/m2 intravenously (IV) on days 1 to 5 every 28 days along with
IFN 5 x 10(6) U/m2 subcutaneously three times per week continuously for up to
eight cycles. IFN doses were escalated to 7.5 x 10(6)/m2 at day 29 if
constitutional toxicities were less than grade 3. Twenty-one patients had not
responded to prior chemotherapy or total-skin electron-beam irradiation (TSEB),
and 10 of these had received prior deoxycoformycin (pentostatin; DCF) and
intermittent high-dose IFN; seven had received only topical therapies, and seven 
were untreated. RESULTS: Four patients achieved a complete response (CR) and 14
achieved a partial response (PR) for an overall response rate of 51% (95%
confidence interval, 35% to 70%). Four of 11 patients with visceral involvement
responded. The median progression-free survival duration of the patients who
responded was 5.9 months, and three of the complete responders are in
unmaintained response after 18 to 35 months. Grade 3 or 4 hematologic toxicity
occurred in 21 patients, including two who developed persistent bone marrow
aplasia. Eighteen patients developed infections during therapy, including five
with herpes zoster, one with Pneumocystis carinii, one with extrapulmonary
tuberculosis, and two with disseminated toxoplasmosis. CONCLUSION: The
combination of fludarabine with continuous low-dose IFN is an active regimen in
patients with advanced MF/SS, including patients with visceral involvement and
patients who progressed after prior therapy with DCF and IFN. This regimen has
induced unmaintained remissions in a small subset of patients.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II

PMID: 7931473 [PubMed - indexed for MEDLINE]

4773: Am J Hosp Pharm. 1994 Oct 1;51(19):2326.

Famciclovir released for shingles treatment.

[No authors listed]

Publication Types: 
    Comparative Study
    News

PMID: 7847396 [PubMed - indexed for MEDLINE]

4774: Antimicrob Agents Chemother. 1994 Oct;38(10):2454-7.

Safety of famciclovir in patients with herpes zoster and genital herpes.

Saltzman R, Jurewicz R, Boon R.

SmithKline Beecham Pharmaceuticals, Philadelphia, Pennsylvania.

Safety reporting from individual ongoing and completed clinical studies has
demonstrated that famciclovir, the well-absorbed oral form of the antiherpesvirus
agent penciclovir, has been well tolerated by more than 3,000 individuals
worldwide. An integrated safety evaluation has been performed and includes over
1,600 patients from 11 completed, randomized, double-blind clinical trials and 2 
open trials. The famciclovir population consisted of 816 herpes zoster patients
(four trials), 409 patients with acute genital herpesvirus infections (seven
trials), and 382 patients from two genital herpes suppression studies. Overall,
the famciclovir-treated patient population was 57.7% female and ranged in age
from 15 to 102 years (mean, 42.6 years), with 31.2% aged 50 years or more and
15.7% aged 65 years or more. The mean duration of exposure to famciclovir was
28.8 days (5.8 days excluding suppression studies). The total daily doses ranged 
from 125 mg to 2.25 g. The most common adverse experiences reported as related to
study medication (famciclovir and placebo) were headache, nausea, and diarrhea.
The frequencies of adverse experiences and laboratory abnormalities (hematology, 
clinical chemistry, and urinalysis parameters) were similar in both famciclovir
and placebo recipients. Thus, safety data from the analysis of 13 completed
clinical studies demonstrate that famciclovir is tolerated well by patients with 
either herpes zoster or genital and has a safety profile comparable to that of
placebo.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 7840587 [PubMed - indexed for MEDLINE]

4775: Anaesthesist. 1994 Oct;43(10):682.

[Therapy of post-zoster neuralgia]

[Article in German]

Hugler P, Laubenthal H.

Publication Types: 
    Letter

PMID: 7818052 [PubMed - indexed for MEDLINE]

4776: Clin Nucl Med. 1994 Oct;19(10):877-9.

Incidental finding of herpes zoster infection by Tc-99m HMPAO.

Hirano T, Otake H, Kanuma M, Mogi Y, Tatezawa T, Endo K.

Department of Nuclear Medicine, Gunma University, School of Medicine, Japan.

Tc-99m HMPAO brain SPECT study incidentally demonstrated a large area of
increased accumulation in the soft tissue of the face and fronto-parietal region 
of the head, corresponding to the distribution of the ophthalmic and maxillary
branches of the trigeminal nerve, which had been infected by herpes zoster.

Publication Types: 
    Case Reports

PMID: 7805321 [PubMed - indexed for MEDLINE]

4777: Br J Ophthalmol. 1994 Oct;78(10):757-9.

Retinal findings in Malawian patients with AIDS.

Lewallen S, Kumwenda J, Maher D, Harries AD.

International Eye Foundation, Blantyre, Malawi.

The purpose of this study was to determine the prevalence of retinal disease in a
group of patients with AIDS in Malawi. Indirect ophthalmoscopy was performed on
99 patients with AIDS who were admitted consecutively to a medical ward at a
central hospital. Necrotising retinitis was present in one eye of one patient
examined. Non-infectious retinopathy was present in 13%. Retinitis is less common
in AIDS patients from Africa compared with those from developed countries; it is 
believed that most patients die before acquiring it. Non-infectious retinopathy
may also be less common.

PIP: Retinal diseases and destructive eye pathology have been recognized in
patients with HIV infections and acquired immunodeficiency syndrome (AIDS).
Opportunistic viral agents such as herpes simplex virus, cytomegalovirus, and
varicella zoster virus have also been described in severe cases of retinitis.
Most of these studies have been carried out in developed countries. This article 
reports the findings of a Malawian study in which 99 AIDS patients (63 men and 36
women) were examined for retinal pathology. A diagnosis of AIDS required a
positive enzyme-linked immunosorbent assay (ELISA). 58 patients (58.6%) had
pulmonary tuberculosis (TB) and 10 others (10.1%) had extrapulmonary TB. Indirect
ophthalmoscopy was performed on all patients. 73 patients (73.7%) had normal eye 
examinations; 1 patient (1.0%) was found to have necrotizing retinitis; only 13
patients (13.1%) showed noninfectious retinopathy. These studies suggest that
retinitis is less common in sub-Saharan Africa than in developed countries.
Tuberculosis was the most common opportunistic infection found in this study.

PMID: 7803351 [PubMed - indexed for MEDLINE]

4778: Drugs. 1994 Oct;48(4):528-48.

Recognition and treatment of shingles.

Nikkels AF, Pierard GE.

Department of Dermatopathology, University of Liege, Belgium.

Varicella zoster virus (VZV) is responsible for a primary infection (varicella)
followed by a latency, eventually resulting in herpes zoster (shingles). The
replication cycle of VZV is normally interrupted after varicella. Consequently,
VZV remains dormant in the organism. Reactivation occurs after viraemia, and the 
development of tissue alterations (skin and viscera) depends on the immunological
status of the patient. Diagnosis of herpes zoster relies on clinical recognition 
and cytological and histological evaluations combined with immunohistochemistry
and molecular biology techniques. Treatment of herpes zoster primarily relies
upon antiviral drugs and incidentally on immunomodulating agents, specific
immunoglobulins, antimicrobial agents, antiviral enzymes and corticosteroids.
Drugs with a clinically relevant activity against varicella zoster virus
infections include aciclovir, adenosine monophosphate, bromodeoxyuridine,
desciclovir, fiacitabine, idoxuridine, interferon-alpha and vidarabine. Among
them, aciclovir appears to be a first-line agent. Its efficacy has been well
established by many clinical studies. Promising drugs for the future include
famciclovir, penciclovir, valaciclovir and other molecules currently under
investigation. Recent and promising improvements in antiviral drug development
may increase patient compliance, cost-benefit ratios and therapeutic efficacy.

Publication Types: 
    Review

PMID: 7528128 [PubMed - indexed for MEDLINE]

4779: Arch Intern Med. 1994 Sep 26;154(18):2109.

(Mis)treatment of acute herpes zoster.

Tyring SK.

Publication Types: 
    Letter

PMID: 8092916 [PubMed - indexed for MEDLINE]

4780: Tidsskr Nor Laegeforen. 1994 Sep 10;114(21):2486-8.

[Varicella zoster complications]

[Article in Norwegian]

Chelsom J, Langeland N.

Medisinsk avdeling, Haukeland Sykehus.

Varicella zoster virus is known to cause varicella in children and to reactivate 
years later as shingles. Both the primary disease and the reactivation can cause 
complications, both in the form of serious affection of organs by the virus
itself, and through secondary bacterial infections owing to temporary immune
deficiency. Relatively frequent complications include secondary bacterial skin
infections, pneumonitis, complications affecting the central nervous system, and 
hepatitis. We describe a few typical cases seen recently in our department, and
review important points connected to treatment and prophylaxis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7940450 [PubMed - indexed for MEDLINE]

4781: Tidsskr Nor Laegeforen. 1994 Sep 10;114(21):2484-6.

[Varicella zoster infections and neurologic complications]

[Article in Norwegian]

Vatne A, Vedeler C, Tysnes OB, Myrmel H.

Nevrologisk Avdeling, Haukeland Sykehus, Bergen.

We describe three patients who suffered from neurological complications to
varicella-zoster virus infections. One had polyradiculoneuritis, another
myelitis, and a third suffered from focal encephalitis. These patients were all
treated with acyclovir, and showed good recovery within a few days. The diagnosis
must be based on clinical characteristics, together with virological and
immunological tests. The indications for antiviral treatment are discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7940449 [PubMed - indexed for MEDLINE]

4782: Nature. 1994 Sep 8;371(6493):89-90.

Blaming somebody else.

[No authors listed]

Publication Types: 
    Editorial

PMID: 8072549 [PubMed - indexed for MEDLINE]

4783: Science. 1994 Sep 2;265(5177):1383-5.

Vaccines for varicella-zoster virus and cytomegalovirus: recent progress.

Plotkin SA.

Pasteur-Merieux-Connaught, Marnes-la-Coquette, France.

Publication Types: 
    Review

PMID: 8073277 [PubMed - indexed for MEDLINE]

4784: Semin Pediatr Neurol. 1994 Sep;1(1):43-9.

Congenital infections caused by varicella zoster virus and herpes simplex virus.

Grose C.

Department of Pediatrics, University of Iowa College of Medicine, Iowa City, USA.

Congenital infections are caused by both varicella-zoster virus (VZV) and herpes 
simplex virus type 2 (HSV-2). The VZV fetopathy and the HSV fetopathy exhibit
several similarities. Both affect the skin, eyes and brain, often with
devastating consequences. Congenital VZV infection also may damage portions of
the cervical or lumbosacral plexi, an insult that leads to denervation and
maldevelopment of an extremity. As is evident from the pathology, most of the
fetal sequelae caused by intrauterine infection with VZV and HSV-2 are caused by 
the pronounced neurotropism of both alpha-herpes viruses.

Publication Types: 
    Review

PMID: 9422218 [PubMed - indexed for MEDLINE]

4785: Am J Otol. 1994 Sep;15(5):639-43.

Detection of viral DNA in endolymphatic sac tissue from Meniere's disease
patients.

Welling DB, Daniels RL, Brainard J, Western LM, Prior TW.

Department of Otolaryngology, Ohio State University, College of Medicine,
Columbus 43210, USA.

Neurotropic viruses have been postulated to play a role in the development of
Meniere's disease (MD). The purpose of this study was to evaluate the
endolymphatic sacs of patients undergoing surgery for MD in a single-blind study 
for evidence of herpes simplex virus (HSV), varicella zoster (VZ), or
cytomegalovirus (CMV) DNA. Polymerase chain reaction (PCR) was used as the method
of detection because of its sensitivity, specificity, and applicability to fresh,
as well as fixed tissues. Twenty-two patients with MD and 11 control patients
with vestibular schwannomas had a portion of the endolymphatic sac removed at the
time of surgery. The specimens were then evaluated for herpes simplex type and 2,
varicella zoster, and cytomegalovirus DNA. Herpes simplex virus DNA was detected 
in 2 of the 22 extracts from the endolymphatic sacs obtained from patients with
MD. There was no evidence of a positive signal obtained with any of the other
viral DNA probes when PCR was performed on the control tissue extracts or the
other MD tissue extracts. These results do not demonstrate a significant
difference and do not statistically support the postulate that ongoing viral
infection in the endolymphatic sac is a frequent factor in the development of
Meniere's disease.

PMID: 8572065 [PubMed - indexed for MEDLINE]

4786: Ophthalmology. 1994 Sep;101(9):1488-502.

Comment in:
    Ophthalmology. 1995 Dec;102(12):1737-9.

The progressive outer retinal necrosis syndrome. A variant of necrotizing
herpetic retinopathy in patients with AIDS.

Engstrom RE Jr, Holland GN, Margolis TP, Muccioli C, Lindley JI, Belfort R Jr,
Holland SP, Johnston WH, Wolitz RA, Kreiger AE.

UCLA Ocular Inflammatory Disease Center.

BACKGROUND: The progressive outer retinal necrosis syndrome is a recently
recognized variant of necrotizing herpetic retinopathy. This report characterizes
more fully its clinical features and course. METHODS: Using standardized clinical
criteria, patients with progressive outer retinal necrosis syndrome from four
institutions were identified. Patient records were reviewed retrospectively for
the following data: medical and demographic characteristics, presenting symptoms,
physical findings, course, responses to treatment, and outcomes. RESULTS:
Thirty-eight patients (65 involved eyes) were studied. All had acquired immune
deficiency syndrome. A known history of cutaneous zoster was documented in 22
(67%) of 33 patients. Median CD4 lymphocyte count was 21/mm3 (range, 0-130/mm3). 
Median follow-up was 12 weeks. The most common presenting symptom was unilateral 
decreased vision (35 of 65 eyes, 54%); median visual acuity at presentation was
20/30 (range, 20/20 to no light perception [NLP]). Anterior chamber and vitreous 
inflammatory reactions were absent or minimal in all patients. Typical retinal
lesions were multifocal, deep opacities scattered throughout the periphery,
although macular lesions also were present in 21 eyes (32%) at diagnosis. Lesions
progressed rapidly to confluence. Initial intravenous antiviral therapy appeared 
to reduce disease activity in 17 (53%) of 32 eyes, but treatment did not alter
final visual outcome. Visual acuity was NLP in 42 (67%) of 63 eyes within 4 weeks
after diagnosis. Retinal detachment occurred in 43 (70%) of 61 eyes, including 13
(93%) of 14 eyes that received prophylactic laser retinopexy. CONCLUSION: The
progressive outer retinal necrosis syndrome is characterized by features that
distinguish it from cytomegalovirus retinopathy, acute retinal necrosis syndrome,
and other necrotizing herpetic retinopathies. Visual prognosis is poor with
current therapies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8090452 [PubMed - indexed for MEDLINE]

4787: Arch Dermatol. 1994 Sep;130(9):1207-8.

Comment on:
    Arch Dermatol. 1994 Jan;130(1):70-2.

Lichenoid chronic graft-vs-host disease.

Reisfeld PL.

Publication Types: 
    Comment
    Letter

PMID: 8085882 [PubMed - indexed for MEDLINE]

4788: Arch Dermatol. 1994 Sep;130(9):1193, 1196.

Asymptomatic vesicles in a patient with the acquired immunodeficiency syndrome.
Disseminated varicella-zoster virus (VZV) infection.

Blankenship W, Herchline T, Hockley A.

Keesler Air Force Base, Miss.

Publication Types: 
    Case Reports

PMID: 8085878 [PubMed - indexed for MEDLINE]

4789: J Infect Dis. 1994 Sep;170(3):522-6.

Immune responses of elderly persons 4 years after receiving a live attenuated
varicella vaccine.

Levin MJ, Murray M, Zerbe GO, White CJ, Hayward AR.

Department of Pediatrics, University of Colorado School of Medicine, Denver
80262.

Annually, for 4 years after a live attenuated varicella-zoster virus (VZV)
vaccine was administered to 202 elderly (55 to > 87 years old) VZV-immune
persons, the immune response of vaccinees was evaluated. Anti-VZV antibody levels
were enhanced by vaccination for just 1 year. However, VZV-specific proliferating
T cells in peripheral blood were increased in frequency from 1 in 68,000 to 1 in 
40,000 at 1 year; VZV-responding T cells were still 1 in 51,000 4 years after
vaccination. The calculated half-life of this enhanced immunity was 54 months.
Age had little effect on response to the vaccine, but larger doses were
associated with longer duration of enhanced immunity. Immunity in approximately
10%-15% of vaccinees, independent of dose, failed to increase with the vaccine.
This might complicate the use of this vaccine for prevention or attenuation of
herpes zoster in the elderly.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8077709 [PubMed - indexed for MEDLINE]

4790: No To Shinkei. 1994 Sep;46(9):849-54.

[Sequential change of cerebral angiography in a case of cerebral angiitis
following herpes zoster ophthalmicus]

[Article in Japanese]

Tomiyama N, Mukawa J, Yamashiro K, Kinjo T, Momoji J, Arakaki H, Nagataki S.

Department of Neurosurgery, University of Ryukyus School of Medicine, Okinawa,
Japan.

Delayed neurological symptoms and signs following herpes zoster ophthalmicus
(HZO) such as "Delayed contralateral hemiplegia with HZO" are supposed to be due 
to ipsilateral intracranial angiitis and ischemic disorder. We experienced a rare
case with ipsilateral cerebral hemorrhage following HZO. Under the diagnosis of
cerebral angiitis associated with HZO, we treated her conservatively and observed
sequential change of angiography for four months. A 54-year-old female, who had
been treated for systemic lupus erythematosus (SLE), developed HZO on left
ophthalmic nerve area. Seven weeks after the onset of HZO, she complained of
headache, mild right hemiparesis, and disturbance of consciousness. Computed
tomography revealed subcortical hemorrhage at the left temporo-occipital lobe.
Cerebral angiography showed vascular irregularities such as segmental narrowing
and sausage-like dilation on proximal portion of the ipsilateral anterior, middle
and posterior cerebral arteries. Same findings were seen on peripheral portions
of the posterior cerebral artery on the same side. Moreover sequential angiograms
showed appearance of an aneurysm in the left middle cerebral artery (M2 potion). 
Under the diagnosis of cerebral angiitis associated with HZO, she was treated
with antiviral agents, antiplatelet drugs, steroid and stellate ganglion block.
Those irregularities were found to diminish on the sequential angiograms, and the
aneurysm disappeared four month later.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7999442 [PubMed - indexed for MEDLINE]

4791: Hautarzt. 1994 Sep;45(9):623-9.

[HIV-associated dermatoses and their prevalence in 456 HIV-infected patients.
Relation to immune status and its importance as a diagnostic marker]

[Article in German]

Garbe C, Husak R, Orfanos CE.

Universitats-Hautklinik und Poliklinik, Klinikum Steglitz, Freien Universitat
Berlin.

Some 456 patients with HIV-associated skin disorders were documented in the HIV
follow-up clinics at the Department of Dermatology, University Medical Center
Steglitz, Berlin, during the years 1982-1992. Males comprised 91% of the
patients. The most important risk groups for HIV infection were homosexual and
bisexual men (77.9%) and individuals with intravenous drug abuse (12.7%). The
most frequent dermatological diagnoses were oral candidosis (44.5%), seborrhoeic 
dermatitis (38.6%), folliculitis (32.9%) and Kaposi's sarcoma (23.5%).
Altogether, 138 of the patients died during the time of observation. The most
frequent cause of death was disseminated Kaposi's sarcoma (26.8%). A significant 
proportion of the patients developed skin diseases before significant reduction
of the circulating CD4+ lymphocytes. In a still satisfactory immune situation,
predominantly infections of the skin with dermatophytes (tinea), human papilloma 
viruses (warts) and bacteria (pyodermas) were observed. A considerable number of 
the HIV patients who developed zoster were also still in a favourable immune
status; another 50% of these cases, however, developed the disease with reduced
CD4+ lymphocyte count (< 300/microliters). Skin manifestations that tended to
occur later in the course of HIV infection were oral candidosis, oral hairy
leukoplakia, herpes genitoanalis, mollusca contagiosa and Kaposi's sarcoma, in
spite of their early appearance in some cases. In the large majority of these
patients the immunological parameters were already clearly reduced. Fungal,
bacterial and viral infections of the skin, especially with extended skin
involvement, may manifest themselves during the early phases of HIV infection.
The number and severity of the skin manifestations increase with progressing
immunosuppression, and treatment is often a difficult challenge for the
dermatologist.

Publication Types: 
    English Abstract

PMID: 7960770 [PubMed - indexed for MEDLINE]

4792: J R Soc Med. 1994 Sep;87(9):526-30.

Effects of lymphoma on the peripheral nervous system.

Hughes RA, Britton T, Richards M.

Department of Neurology, UMDS, Guy's Hospital, London, UK.

Peripheral nervous system abnormalities occur in 5% of patients with lymphoma and
have a wide differential diagnosis. Herpes zoster is the commonest cause. Vinca
alkaloids are the only drugs used in lymphoma which commonly cause neuropathy.
Compression or infiltration of nerve roots by lymphoma is a rare presenting
feature but becomes more common with advanced disease. Radiation plexopathy does 
not usually develop until at least 6 months after irradiation and can be
difficult to distinguish from neoplastic infiltration. Either multifocal
infiltration of nerves or lymphoma-associated vasculitis may present as a
peripheral neuropathy. The incidence of Guillain-Barre (GBS) syndrome, and
possibly chronic idiopathic demyelinating polyradiculoneuropathy, appears to be
increased in association with lymphoma, especially Hodgkin's disease. Subacute
sensory neuronopathy and subacute lower motor neuronopathy have both been
reported as paraneoplastic syndromes associated with Hodgkin's disease. Treatment
of the underlying lymphoma is only rarely followed by recovery of the associated 
neuropathy.

Publication Types: 
    Review

PMID: 7932460 [PubMed - indexed for MEDLINE]

4793: J Acquir Immune Defic Syndr. 1994 Sep;7(9):972-7.

Progression to AIDS or death following diagnosis with a class IV non-AIDS
disease: utilization of a surveillance database.

Maden C, Hopkins SG, Lafferty WE.

Seattle-King County Department of Public Health, Washington 98104.

Time to progression to an AIDS-defining disease or death was analyzed for
residents of King County, Washington State, with selected class IV non-AIDS
diagnoses. Relative to people with constitutional symptoms, the risk of
progression to an AIDS-defining diagnosis was 1.4 [95% confidence interval (CI), 
0.8-2.2), 1.6 (95% CI, 1.0-2.5), and 2.1 (95% CI, 1.3-3.5) times greater for
people with a diagnosis of oral hairy leukoplakia, oral candidiasis, and multiple
diseases, respectively. Relative to subjects with CD4 counts of > or = 200, the
risk of progression to AIDS was greater for subjects with CD4 counts < 200;
relative risks ranged from 2.3 (95% CI, 0.8-6.6) for subjects with constitutional
symptoms and CD4 counts < 200 to 6.7 (95% CI, 3.3-13.6) for subjects diagnosed
with oral hairy leukoplakia and CD4 counts > 200. However, the statistical test
for interaction between CD4 count and diagnostic group was not significant (p =
0.62). Our findings are in general agreement with results from previous cohort
studies and suggest the utility of surveillance databases for natural history
studies of the course of HIV illness.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 7914234 [PubMed - indexed for MEDLINE]

4794: Clin J Pain. 1994 Sep;10(3):240-2.

Successful treatment of postherpetic neuralgia with oral ketamine.

Hoffmann V, Coppejans H, Vercauteren M, Adriaensen H.

Department of Anesthesia, University Hospital of Antwerpen, Edegem, Belgium.

OBJECTIVE: To demonstrate the possibilities of the use of oral ketamine in the
treatment of postherpetic neuralgia. SETTING: A pain clinic in a university
hospital. PATIENT: A patient with postherpetic neuralgia of the ophthalmic nerve.
INTERVENTION: Subcutaneous and later oral ketamine after classical treatment had 
failed. RESULTS: A complete recovery was accomplished without any sign of side
effects. CONCLUSIONS: Oral ketamine may provide an alternative in the treatment
of postherpetic neuralgia. The possible mechanism of action by its
N-methyl-D-aspartate (NMDA) blocking properties is discussed.

Publication Types: 
    Case Reports

PMID: 7833583 [PubMed - indexed for MEDLINE]

4795: J Antimicrob Chemother. 1994 Sep;34(3):307-11.

Successors to acyclovir.

Easterbrook P, Wood MJ.

Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital,
UK.

Publication Types: 
    Review

PMID: 7829405 [PubMed - indexed for MEDLINE]

4796: Rinsho Shinkeigaku. 1994 Sep;34(9):928-9.

[A case of isolated vagus nerve palsy with herpes zoster]

[Article in Japanese]

Ohashi T, Fujimoto M, Shimizu H, Atsumi T.

Department of Neurology, Seirei Hamamatsu General Hospital.

A case of isolated vagus nerve palsy with herpes zoster was reported. A
31-year-old woman was admitted to our hospital with six days' history of
difficulty of swallowing of fluid and hoarseness with a painful vesicle on the
right ear. Neurological examination revealed poor elevation of soft palate on the
right side, but the pharyngeal reflex was preserved. Herpetic vesicles were
present on the right concha, within posterior wall of the external auditory
meatus. No facial palsy, loss of hearing and mucosal lesions in the mouth or
pharynx were present. This is the first case of isolated vagus nerve palsy due to
varicella-zoster infection, showing the distribution of the auricular branch of
the vagus (Arnold's nerve) in the ear.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7820972 [PubMed - indexed for MEDLINE]

4797: Infect Dis Clin North Am. 1994 Sep;8(3):637-54.

Dermatologic manifestations of infectious diseases in cardiac transplant
patients.

Gentry LO, Zeluff B, Kielhofner MA.

Baylor College of Medicine, Houston, Texas.

Infection remains a significant cause of morbidity and mortality in cardiac
transplant patients. Skin infections are not uncommon in these patients. Although
usually caused by secondary dissemination after initial infection of another
organ system, some skin infections may be primary infections, such as bacterial
infections caused by the use of intravenous catheters or fungal infections in
severely immunosuppressed patients. Nevertheless, the presence of skin lesions in
a transplant patient may indicate infection in a primary site or another
deep-seated focus of infection.

Publication Types: 
    Review

PMID: 7814838 [PubMed - indexed for MEDLINE]

4798: Semin Neurol. 1994 Sep;14(3):247-54.

Postherpetic neuralgia.

Rowbotham MC.

Department of Neurology, University of California, San Francisco 94143.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 7701125 [PubMed - indexed for MEDLINE]

4799: J Invest Dermatol. 1994 Sep;103(3):330-4.

Expression of Fas antigen on keratinocytes in vivo and induction of apoptosis in 
cultured keratinocytes.

Sayama K, Yonehara S, Watanabe Y, Miki Y.

Department of Dermatology, Ehime University School of Medicine, Japan.

Fas antigen, which belongs to a nerve growth factor/tumor necrosis factor
receptor superfamily, is a membrane protein that induces apoptosis. In humans,
distribution of Fas antigen has been reported on cell lines and lymphocytes.
Immunohistochemical studies revealed Fas antigen on the keratinocytes of lesional
epidermis in lichenoid drug eruption, erythema multiforme, contact dermatitis,
bullous pemphigoid, pemphigus vulgaris, and herpes zoster; it is co-expressed
with intercellular adhesion molecule-1. Cultured keratinocytes expressing Fas
antigen increased from 8.4% to 34.6% after stimulation with interferon gamma for 
24 h. Treatment of interferon-gamma-stimulated keratinocytes with anti-Fas for 48
h resulted in DNA fragmentation and death of 32% of cells, suggesting that Fas
antigen may mediate apoptosis. The expression of Fas antigen on keratinocytes in 
lesional skin suggests that death via Fas antigen may play an important role in
the pathogenesis of keratinocyte cytotoxicity.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7521376 [PubMed - indexed for MEDLINE]

4800: N Engl J Med. 1994 Aug 18;331(7):481-2.

Comment on:
    N Engl J Med. 1994 Mar 31;330(13):906.

Trifluridine for herpes zoster.

Harris DJ Jr.

Publication Types: 
    Comment
    Letter

PMID: 8035857 [PubMed - indexed for MEDLINE]

4801: N Engl J Med. 1994 Aug 18;331(7):481.

Comment on:
    N Engl J Med. 1994 Mar 31;330(13):896-900.

Acyclovir for herpes zoster.

Tangeman JC, Kuzminski AM, Svahn DS.

Publication Types: 
    Comment
    Letter

PMID: 8035856 [PubMed - indexed for MEDLINE]

4802: N Engl J Med. 1994 Aug 18;331(7):481.

Comment on:
    N Engl J Med. 1994 Mar 31;330(13):896-900.

Acyclovir for herpes zoster.

van den Broek PJ, Stuyt PM, van der Meer JW.

Publication Types: 
    Comment
    Letter

PMID: 8035855 [PubMed - indexed for MEDLINE]

4803: Am J Ophthalmol. 1994 Aug 15;118(2):205-11.

Acute retinal necrosis caused by reactivation of herpes simplex virus type 2.

Thompson WS, Culbertson WW, Smiddy WE, Robertson JE, Rosenbaum JT.

Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.

Acute retinal necrosis is a severe form of necrotizing retinitis. Acute retinal
necrosis has been demonstrated to be caused by varicella-zoster virus and herpes 
simplex virus type 1. We treated three patients with acute retinal necrosis
apparently caused by recrudescence of latent herpes simplex virus type 2. Primary
viral infection was probably congenital, with documented perinatal herpes simplex
virus type 2 infection in two patients. Bilateral chorioretinal scars were
present in two patients, neither of whom had a history of ocular herpetic
infection, suggesting that earlier subclinical chorioretinitis had occurred. In
each case, periocular trauma preceded the development of retinitis by two to
three weeks. These cases are evidently caused by trauma-induced reactivation of
latent virus rather than the onset of a primary infection.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8053466 [PubMed - indexed for MEDLINE]

4804: Int J Antimicrob Agents. 1994 Aug;4(3):211-26.

Chemotherapy of varicella zoster virus infections.

Snoeck R, Andrei G, De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven,
Minderbroedersstraat 10, B-3000 Leuven, Belgium.

Varicella zoster virus (VZV), a member of the herpesvirus family, is responsible 
for a primary infection (varicella, chickenpox) as well as a recurrent disease
(zoster, shingles). The course of varicella is generally benign in
immunocompetent patients. For zoster, post-herpetic neuralgia is the most common 
complication. In immunocompromised patients, particularly patients suffering from
the acquired immune deficiency syndrome (AIDS), transplant recipients and cancer 
patients, VZV infections can be life-threatening. For these patients and also for
immunocompetent patients at risk, such as pregnant women or premature infants,
the current treatment of choice is based on acyclovir (ACV) by either intravenous
or oral route. The low oral bioavailability of ACV, as well as the emergence of
drug-resistant virus strains, have stimulated efforts towards the development of 
new compounds for the treatment of VZV infections. Among these new compounds,
penciclovir (PCV) and its oral prodrug form, famciclovir (FCV), 882C87, BVDU,
BVaraU and the oral prodrug form of acyclovir (valacyclovir) rank among the most 
promising. Like ACV itself, all these drugs are dependent on the virus-encoded
thymidine kinase (TK) for their intracellular activation (phosphorylation), and, 
therefore, cross-resistance to these drugs may be expected for those virus
mutants that are TK-deficient and thus resistant to ACV. However, such TK(-) VZV 
mutants are still sensitive to the acyclic nucleoside phosphonates (i.e. HPMPC), 
which for their phosphorylation do not depend on the virus-encoded TK. The
molecular targets within the viral replicative cycle, with which these different 
compounds interact, are discussed, as are the in vitro activity and in vivo
efficacy of the most promising compounds. Other aspects, such as vaccination and 
passive immunization, are briefly mentioned.

PMID: 18611613 [PubMed - in process]

4805: Br J Radiol. 1994 Aug;67(800):819-21.

Case report: prolonged contrast enhancement of the inner ear on magnetic
resonance imaging in Ramsay Hunt syndrome.

Downie AC, Howlett DC, Koefman RJ, Banerjee AK, Tonge KA.

Department of Radiology, St Thomas' Hospital, London, UK.

There have been recent reports of enhancement of the inner ear in acute
labyrinthitis on gadolinium enhanced magnetic resonance imaging (MRI). However,
none has described persistence of enhancement beyond 6 weeks. We report a case of
Ramsay Hunt syndrome with labyrinthitis, sensorineural hearing loss and facial
nerve palsy in which marked enhancement of the inner ear structures was observed 
on MRI 6 months after the onset of symptoms. Enhancement on delayed or repeated
imaging after a period of months does not exclude labyrinthitis from the
differential diagnosis of the small intracanalicular acoustic neuroma, and care
should be taken not to confuse them.

Publication Types: 
    Case Reports

PMID: 8087491 [PubMed - indexed for MEDLINE]

4806: Am J Med. 1994 Aug;97(2):145-51.

Effect of corticosteroid therapy on human immunodeficiency virus-associated
nephropathy.

Smith MC, Pawar R, Carey JT, Graham RC Jr, Jacobs GH, Menon A, Salata RA, Seliga 
R, Kalayjian RC.

Department of Medicine, Case Western Reserve University School of Medicine,
Cleveland, Ohio.

PURPOSE: Human immunodeficiency virus-associated nephropathy (HIV-AN) occurs
predominantly in blacks and is characterized histologically by focal segmental
glomerulosclerosis or mesangial proliferation and a lymphohistiocytic
tubulointerstitial infiltrate. Patients manifest heavy proteinuria and, once
azotemia occurs, progress rapidly to end-stage renal disease within 2 to 6
months. No treatment has been shown to be useful for HIV-AN. The purpose of this 
study was to determine the effect of corticosteroid agents on the progression of 
HIV-AN. PATIENTS AND METHODS: Four consecutive HIV-infected adults with fewer
than 200 CD4 cells/microL, moderate to severe renal insufficiency, proteinuria
greater than 2 g per 24 hours, and HIV-AN demonstrated by renal biopsy were
treated with 60 mg of prednisone daily for 2 to 6 weeks. Patients were followed
with respect to serum creatinine level, 24-hour protein excretion, adverse drug
reactions, and the occurrence of opportunistic infections. RESULTS: CD4 counts
ranged from 30 to 80 cells/microL before therapy with steroids. The mean (+/- SD)
pretreatment serum creatine concentration was 9.1 +/- 5.7 mg/dL and decreased to 
3.3 +/- 1.8 mg/dL (P < 0.05) after 2 to 6 weeks of corticosteroid therapy.
Twenty-four hour protein excretion did not change (5.2 +/- 2.4 g pretreatment
versus 4.6 +/- 4.1 g posttreatment). One patient was able to discontinue dialysis
after 10 days. Two patients developed Mycobacterium avium-complex infections and 
steroid-associated psychosis. One of these patients developed a recurrence of
genital herpes, and the other developed dermatomal zoster. None of the four
required dialysis during a 1.5- to 5.5-month period of follow-up after cessation 
of steroid treatment. CONCLUSION: In selected patients with HIV-AN, short-term
treatment with corticosteroid agents improves renal function and prevents the
development of end-stage renal disease during a 1.5- to 5.5-month period of
observation, but may be associated with an increased risk of opportunistic
infection.

Publication Types: 
    Case Reports
    Review

PMID: 8059780 [PubMed - indexed for MEDLINE]

4807: J Am Acad Dermatol. 1994 Aug;31(2 Pt 1):284-6.

Zosteriform inflammatory metastatic carcinoma from transitional cell carcinoma of
the renal pelvis.

Ando K, Goto Y, Kato K, Murase T, Matsumoto Y, Ohashi M.

Department of Dermatology, Nagoya First Red Cross Hospital, Japan.

Publication Types: 
    Case Reports

PMID: 8040420 [PubMed - indexed for MEDLINE]

4808: Neuroradiology. 1994 Aug;36(6):462-8.

3D-FT MRI of the facial nerve.

Girard N, Raybaud C, Poncet M.

Hopital Nord, Marseille, France.

Contrast-enhanced 3D-FT MRI of the intrapetrous facial nerve was obtained in 38
patients with facial nerve disease, using a 1.0 T magnet and fast gradient-echo
acquisition sequences. Contiguous millimetric sections were obtained, which could
be reformatted in any desired plane. Acutely ill patients, were examined within
the first 2 months, included: 24 with Bell's palsy and 6 with other acute
disorders (Herpes zoster, trauma, neuroma, meningeal metastasis, middle ear
granuloma). Six patients investigated more than a year after the onset of
symptoms included 3 with congenital cholesteatoma, 2 with neuromas and one with a
chronic Bell's palsy. The lesion was found incidentally in two cases (a suspected
neurofibroma and a presumed drop metastasis from an astrocytoma). Patients with
tumours had nodular, focally-enhancing lesions, except for the leptomeningeal
metastasis in which the enhancement was linear. Linear, diffuse contrast
enhancement of the facial nerve was found in trauma, and in the patient with a
middle ear granuloma. Of the 24 patients with an acute Bell's palsy 15 exhibited 
linear contrast enhancement of the facial nerve. Three of these were lost to
follow-up, but correlation of clinical outcome and contrast enhancement showed
that only 4 of the 11 patients who made a complete recovery and all 10 patients
with incomplete recovery demonstrated enhancement. Possible explanations for
these findings are suggested by pathological data from the literature. 3D-FT
imaging of the facial nerve thus yields direct information about the of the nerve
condition and defines the morphological abnormalities. It can also demonstrate
contrast enhancement which seems to have some prognostic value in acute
idiopathic Bell's palsy.

PMID: 7991093 [PubMed - indexed for MEDLINE]

4809: AIDS. 1994 Aug;8(8):1115-7.

Successful treatment of varicella zoster virus meningoencephalitis in patients
with AIDS: report of four cases and review.

Poscher ME.

Department of Medicine, University of California/Mount Zion Medical Center, San
Francisco.

OBJECTIVE: Neurologic complications are common in patients with AIDS. Herpes
zoster is a common early manifestation of HIV infection, but there have been few 
reports of encephalitic complications and nearly all have been postmortem. We
report four cases of varicella zoster virus (VZV) meningoencephalitis diagnosed
and treated antemortem, and briefly review the relevant literature. SETTING:
Mount Zion Medical Center, San Francisco, California, USA. PATIENTS: Four
HIV-positive male patients with antibodies to VZV in their cerebrospinal fluid.
INTERVENTION: Treatment with intravenous acyclovir (three cases) and intravenous 
ganciclovir (one case), which resulted in resolution of all symptoms except
blindness in one patient. CONCLUSION: Antibodies to VZV in the cerebrospinal
fluid of HIV-positive individuals may allow early diagnosis and lifesaving
treatment of VZV meningoencephalitis.

Publication Types: 
    Case Reports

PMID: 7986408 [PubMed - indexed for MEDLINE]

4810: Ryumachi. 1994 Aug;34(4):733-43.

[Methylprednisolone pulse therapy for SLE patients with CNS disorder]

[Article in Japanese]

Ichikawa Y, Hashimoto H, Kashiwazaki S, Kondo H, Akizuki M, Tokanou Y.

Institute of Medical Science, Saint Marianna University School of Medicine,
Kanagawa.

A clinical trial was conducted in 22 SLE patients with central nervous system
(CNS) disorder in which the efficacy of pulse methylprednisolone suleptanate at
the dose of 400 mg or 800 mg (as methylprednisolone) was assessed. The symptoms
of CNS disorder disappeared within 40 days after pulse therapy in all of the 16
patients with organic brain syndrome (OBS). No improvement in the symptoms took
place in any but one of the five patients who had cerebrovascular disorder. One
SLE patient with depression showed improvement 55 days after pulse therapy. In
the patients with OBS who had not received pulse therapy until 28 days or more
after onset of CNS disorder, the symptoms disappeared in 20 days or more in both 
400 mg and 800 mg dose groups. On the other hand, five of the six patients given 
the dose of 800 mg within 10 days of occurrence of the disease experienced a
complete relief of the symptoms in 10 days after pulse therapy. However, at least
13 days were required for complete relief in all the four patients of the 400 mg 
group. The adverse reactions reported consisted of hyperlipemia, diabetes
mellitus, and infections such as thrush or herpes zoster. The above results
suggest that methylprednisolone pulse therapy is useful in the treatment of CNS
disorder associated with SLE, particularly in patients with OBS who are given the
dose of 800 mg early after onset of the disease.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    English Abstract
    Multicenter Study

PMID: 7974024 [PubMed - indexed for MEDLINE]

4811: Klin Monatsbl Augenheilkd. 1994 Aug;205(2):103-8.

[Varicella zoster virus infections of the retina in patients with and without
immune suppression]

[Article in German]

Helbig H, Bornfeld N, Bechrakis NE, Kellner U, Foerster MH.

Universitats-Augenklinik, Klinikum Steglitz, Freie Universitat Berlin.

BACKGROUND. Infections of the retina with the varicella-zoster virus can lead to 
severe visual impairment. Patients with immunodeficiency are particularly
predisposed to viral infections, and the alterations of the immune system may
lead to a modified clinical picture. PATIENTS. Two cases of infections of the
retina with the varicella-zoster virus in an immunocompromised and an
immunocompetent patient are presented. The first otherwise healthy patient showed
the typical clinical picture of the "acute retinal necrosis syndrome" with
orbital pain and decrease of vision. He had inflammatory infiltration of the
vitreous and the anterior chamber, retinal vasculitis, optic disc edema and
whitening of the peripheral retina with full thickness retinal necrosis. The
second patient with AIDS presented with a history of sudden painless loss of
vision in one eye. He had a swollen optic disc, inflammatory infiltrates in the
choroid and virtually no cellular infiltration of the vitreous or the anterior
chamber. The diagnosis of varicella-zoster virus infection of the retina was
confirmed in both patients by polymerase chain-reaction of aqueous and vitreous
humor, by determination of intraocular antibody titers and immunohistochemistry
on retinal biopsy material, respectively. In both patients no inflammation in the
fellow eye developed under therapy with aciclovir. The first patient regained
full vision after vitrectomy with membrane dissection. CONCLUSIONS.
Varicella-zoster virus infections of the retina can present with different
clinical pictures in immunocompromised and immunocompetent patients. Early
diagnosis and adequate medical and surgical therapy can significantly improve
visual prognosis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7967403 [PubMed - indexed for MEDLINE]

4812: J Med Virol. 1994 Aug;43(4):336-40.

Vitreous fluid sampling and viral genome detection for the diagnosis of viral
retinitis in patients with AIDS.

Mitchell SM, Fox JD, Tedder RS, Gazzard BG, Lightman S.

Department of Clinical Science, Moorfields Eye Hospital, London, England.

Cytomegalovirus (CMV) causes severe necrotizing retinitis in patients with the
acquired immune deficiency syndrome (AIDS) and other herpesviruses have been
implicated in the acute retinal necrosis syndrome (ARN), seen in both the
immunocompetent and the immunosuppressed. At present the diagnosis of viral
retinitis relies solely on clinical appearances. In order to assess whether the
detection of herpesvirus-specific DNA in cell-free vitreous biopsy samples could 
be useful in the early diagnosis of viral retinitis, vitreous fluid samples were 
taken from 100 patients. Fifty patients had AIDS as defined by the Centers for
Disease Control, (MMWR 36 (suppl 1S):1S-15S, 1987) and retinal disease. The
remainder were not known to be HIV infected and had no clinical evidence of
retinal infection. Each sample was tested for the presence of CMV, herpes simplex
virus 1 (HSV-1), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), and
human herpesvirus 6 (HHV6), by amplification of viral DNA using a sensitive and
specific nested polymerase chain reaction (PCR). The presence of detectable CMV
or VZV DNA was clearly associated with clinical disease whereas the presence of
HSV-1, EBV, and HHV6 sequences were not. Clinical discrimination between CMV- and
VZV-associated retinitis was greatly enhanced when the PCR results were taken
into consideration.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7964643 [PubMed - indexed for MEDLINE]

4813: J Med Virol. 1994 Aug;43(4):331-5.

Detection of varicella-zoster virus-specific DNA sequences in cerebrospinal fluid
from patients with acute aseptic meningitis and no cutaneous lesions.

Echevarria JM, Casas I, Tenorio A, de Ory F, Martinez-Martin P.

Servicio de Microbiologia Diagnostica, Instituto de Salud Carlos III,
Majadahonda, Madrid, Spain.

Acute aseptic meningitis (AAM) is considered as an uncommon manifestation of
varicella-zoster virus (VZV) recrudescence and is usually regarded as a
complication of the cutaneous infection in patients with impaired cellular
immunity. Indirect evidence suggests, however, that VZV-associated AAM may also
respond to direct spread of the virus to the leptomeninges from the cells
supporting the latency. The polymerase chain reaction (PCR) was used to amplify
VZV-specific DNA sequences in serial cerebrospinal fluid (CSF) samples from 21
patients with AAM, who presented laboratory evidence of intrathecal production of
VZV-specific antibody on follow-up. Eleven of these patients never showed
cutaneous zosteriform lesions. VZV-DNA sequences were detected in the CSF from
all patients with cutaneous zoster, as well as from six patients (55%) lacking
skin lesions. Viral DNA sequences were present in six cases before the rise in
specific antibody was seen in CSF, disappearing during follow-up in the seven
positive cases. These results support the proposed involvement of VZV in the
etiology of AAM seen among normal young adults and strongly suggest that the
virus can reach directly and infect the CNS from the latently infected spinal
ganglia.

PMID: 7964642 [PubMed - indexed for MEDLINE]

4814: J Dermatol. 1994 Aug;21(8):560-70.

Scanning and transmission electron microscopic studies of lesional epidermis in
herpes zoster.

Tanaka K, Tsuda S, Sasai Y.

Department of Dermatology, Kurume University School of Medicine, Japan.

The epidermal skin lesions of herpes zoster were studied by scanning (SEM) and
transmission electron microscopy (TEM). When erythematous lesions were observed
by TEM, many of the infected keratinocytes showed evidence of cell degeneration, 
being characterized by swollen nuclei, disappearance of desmosomes, and widening 
of intercellular spaces. Macrophages and/or lymphocytes migrated through the
intercellular spaces between degenerated keratinocytes. In the vesicular lesions,
SEM and TEM showed some infiltrating neutrophils, directly adhering to the
virus-infected keratinocytes, with swollen nuclei and irregularly clumped
chromatin. In some specimens, balloon-degenerated keratinocytes were observed in 
the cavity. In the pustular stage, ruptured keratinocytes and numerous
neutrophils were observed in the reticular-degenerated epidermal tissue. These
results suggest that, in herpes zoster, the epidermal damage may be due, at least
in part, to cell-mediated host immunity as well as to the cytopathic effect of
varicella-zoster virus.

PMID: 7962953 [PubMed - indexed for MEDLINE]

4815: Acta Paediatr Jpn. 1994 Aug;36(4):341-6.

Effect of varicella zoster virus antigen-antibody complexes on hydrogen peroxide 
generation by human polymorphonuclear leukocytes.

Fujiwara T, Ihara T, Yamawaki K, Ito M, Kamiya H, Sakurai M.

Department of Pediatrics, Mie University, Japan.

Hydrogen peroxide (H2O2) generation by human polymorphonuclear leukocytes (PMN)
incubated with varicella zoster virus (VZV) antigen was studied by
cytofluorography. Hydrogen peroxide generation was detected in the presence of
VZV-seropositive sera. When seropositive sera were heat-inactivated, H2O2
generation was reduced. When PMN were pre-incubated with Leu-11b, a monoclonal
antibody to the Fc receptor on PMN, H2O2 generation was also reduced. These
results suggest that VZV antigen-antibody-complement complexes induce H2O2
generation by PMN after these complexes attach to Fc receptors on PMN.

Publication Types: 
    In Vitro

PMID: 7941996 [PubMed - indexed for MEDLINE]

4816: Ther Umsch. 1994 Aug;51(8):538-44.

[Clinical aspects and therapy of Herpes simplex and Varicella-Zoster virus
infections in practice]

[Article in German]

Nadal D, Vogt M.

Abteilung Immunologie/Hamatologie, Universitats-Kinderklinik Zurich.

Primary infections with herpes simplex virus are usually localized, whereas those
with varicella-zoster virus always disseminate. Both viruses persist within the
host and may cause recurrent infections. Newborns and immunocompromised
individuals have a risk for severe disease. Acyclovir is the drug of choice for
complications or in immunodeficiency.

Publication Types: 
    English Abstract

PMID: 7940410 [PubMed - indexed for MEDLINE]

4817: Graefes Arch Clin Exp Ophthalmol. 1994 Aug;232(8):503-8.

Retinal toxicity and ocular kinetics of
1-beta-D-arabinofuranosyl-E-5-(2-bromovinyl)uracil in rabbits.

Mochizuki K, Torisaki M, Yamashita Y, Komatsu M, Tanahashi T, Ijichi K, Machida
H.

Department of Ophthalmology, Kanazawa University School of Medicine, Ishikawa,
Japan.

The intraocular penetration of 1-beta-D-arabinofuranosyl-E-5-(2-bromovinyl)uracil
(BV-araU), a new antiviral drug, after oral administration, the effects of
non-toxic intravitreal doses of BV-araU, and the intraocular kinetics of BV-araU 
after intraocular injection were studied in rabbits. The intravitreal penetration
of BV-araU after oral administration was very poor: 0.11 +/- 0.13 micrograms/ml
and 0.20 +/- 0.02 microgram/ml respectively in albino and pigmented rabbits 2 h
after 30 mg/kg. An intravitreal injection of 200 micrograms BV-araU caused
transient electroretinographic (ERG) changes, whereas a 100-micrograms injection 
and intravitreal irrigation with 20 micrograms/ml BV-araU caused no ERG and
histologic changes over the 4-week follow-up period. The half-life of the
intravitreal concentration of BV-araU after an intravitreal injection was short
(2.4 h). The results suggest that an intravitreal injection of 100 micrograms
BV-araU or an intravitreal irrigating solution containing 20 micrograms/ml
BV-araU is non-toxic to the retina and may be used for treatment of retinitis
caused by varicella-zoster virus or herpes simplex virus type 1.

PMID: 7926887 [PubMed - indexed for MEDLINE]

4818: Am J Clin Oncol. 1994 Aug;17(4):353-9.

Systemic hyperthermia in the treatment of HIV-related disseminated Kaposi's
sarcoma. Long-term follow-up of patients treated with low-flow extracorporeal
perfusion hyperthermia.

Alonso K, Pontiggia P, Sabato A, Calvi G, Curto FC, de Bartolomei E, Nardi C,
Cereda P.

Laboratory Atlanta, Riverdale, Georgia.

Treatment of HIV and related malignancies with pharmacologic and biologic agents 
has not appreciably modified the course of disease. Immunologic impairment
remains the critical factor in response. We report the long-term results of a
single session of low-flow (0.3 L/min) extracorporeal perfusion hyperthermia on
29 men and 2 women with disseminated Kaposi's sarcoma and profound immunologic
impairment. Any antiretroviral drug employed by the patient was stopped 72 hours 
prior to treatment and withheld during the period of follow-up. Core temperature 
was raised to 42 degrees C and held for 1 hour with extracorporeal perfusion and 
ex vivo blood heating to 49 degrees C as the means of temperature control. Of 31 
patients, 2 died of complications secondary to treatment (cardiac arrhythmia; CNS
bleed). There were two cases of intravascular coagulopathy. Pressure point skin
damage may occur despite adequate cushioning. At 30 days posttreatment complete
or partial regressions were seen in 20/29 of those treated, with regressions
persisting in 14/29 of those treated by 120 days posttreatment. At 360 days, 4/29
maintain tumor regressions with 1 in complete remission (at 26 months). The
patient in complete remission remains culture-negative and PCR-negative for HIV. 
CD4+ counts rose from around 250 to, and remain around, 800 in this man. Selected
healed lesions were biopsied to demonstrate tumor absence. Patients were selected
for treatment if pretreatment testing of the tumor showed regression in vitro
with heat exposure. Analysis of the early and midterm failures showed little
sustained rise of the CD4+ cells if presenting total CD4+ counts were below 50
and had been at such low levels for extended periods, although other surrogate
markers of HIV activity declined (semiquantitative PCR) during this period and is
felt to support the hypothesis of apoptosis proposed in this illness. Analysis of
the tumors of the few men not responding demonstrated elevated levels of IL-6 as 
compared to responders (12 vs < 1 pg/ml). At 120 days 29/31 patients remained
alive (expected, 20). At 360 days, 21/31 remained alive (expected, 11). In no
patient was HIV activity stimulated with heat exposure. CMV retinitis did clear
in some patients treated (both techniques), but treatment alone did not prevent
later development of retinopathy. EBV parameters were markedly altered in the
short term with heat exposure in some patients. Few patients showed herpes
simplex activation. Varicella-zoster virus remitted in some patients. There is
utility in the use of systemic hyperthermia to control HIV and related
malignancy.(ABSTRACT TRUNCATED AT 400 WORDS)

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase I
    Research Support, Non-U.S. Gov't

PMID: 7914057 [PubMed - indexed for MEDLINE]

4819: Pharmacol Ther. 1994 Aug;63(2):199-207.

Metabolic suicide genes in gene therapy.

Mullen CA.

Division of Cancer Biology, National Cancer Institute, National Institutes of
Health, Bethesda, MD 20892.

This article reviews uses of metabolic suicide genes in gene therapy. Suicide
genes encode novel nonmammalian enzymes that can convert a relatively nontoxic
prodrug into a highly toxic agent. Cells genetically transduced to express such
genes essentially commit metabolic suicide in the presence of the appropriate
prodrug. Three metabolic suicide genes are described: herpes simplex thymidine
kinase, Escherichia coli cytosine deaminase and varicella zoster thymidine
kinase. Transfer and expression of these genes into mammalian cells is described.
Preclinical models of suicide gene therapy of cancer and human immunodeficiency
virus are discussed, and several clinical trials employing suicide genes are
described.

Publication Types: 
    Review

PMID: 7809180 [PubMed - indexed for MEDLINE]

4820: Neuropathol Appl Neurobiol. 1994 Aug;20(4):368-74.

A molecular and cellular model to explain the differences in reactivation from
latency by herpes simplex and varicella-zoster viruses.

Kennedy PG, Steiner I.

Glasgow University Department of Neurology, Southern General Hospital, UK.

There are marked similarities in the biological properties of the human
neurotropic herpesviruses herpes simplex virus type 1 (HSV-1) and
varicella-zoster virus (VZV), including their ability to establish lifelong
latent infections in human peripheral sensory ganglia (PSG). Despite this, their 
patterns of reactivation are quite different: HSV-1 reactivations occur many
times during a lifetime, they are localized to the cutaneous distribution of a
single sensory nerve, they are not associated with sensory symptomatology and
their frequency decreases with age. VZV recurrence on the other hand is usually a
single event which tends to appear with advancing age, its cutaneous eruption
involves an entire dermatome and is usually extremely painful. To help explain
these differences, we have formulated a model based on current knowledge of the
molecular and cellular basis of latent infection in the nervous system. We
suggest that the amount of latent viral DNA and RNA in the latently infected
tissue (higher with HSV-1), the cellular location of latent virus (neuronal in
HSV-1, probably non-neuronal in VZV), the presence or absence of viral
replication in the PSG during reactivation together with the host immune
response, are all key determinants of the clinical expression of viral
reactivation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7808587 [PubMed - indexed for MEDLINE]

4821: Semin Oncol Nurs. 1994 Aug;10(3):198-207.

Critical care issues in the patient with hematologic malignancy.

Lawrence J.

Autologous Bone Marrow Transplant Unit, Duke University Medical Center, Durham,
NC.

Patients with lymphomas, multiple myeloma, and leukemia are often at risk for
life-threatening complications. Complications include viral infections (eg,
herpes zoster, herpes simplex, cytomegalovirus) and hemolytic anemia, which are
related to the hematologic origin of the malignancy. Life-threatening disorders
related to amount of tumor burden are leukostasis and hyperviscosity.
Complications related to therapy include pulmonary capillary leak syndrome and
tumor lysis syndrome. Good assessment skills assist in early identification of
individuals at risk and initiation of preventive measures.

Publication Types: 
    Review

PMID: 7800974 [PubMed - indexed for MEDLINE]

4822: Pharmacoeconomics. 1994 Aug;6(2):142-8.

The cost of treatment for post-herpetic neuralgia in the UK.

Davies L, Cossins L, Bowsher D, Drummond M.

Centre for Health Economics, University of York, England.

Post-herpetic neuralgia (PHN) following acute shingles caused by the herpes
simplex virus is a painful and often disabling condition. Treatment of the
condition can involve a range of drug therapies. In addition, patients with
continuing pain may make several visits to general practitioners and hospital
outpatient departments. The costs of treatment for these patients may be
substantial. The main objective of this study was to estimate the costs and
consequences to the UK National Health Service (NHS) of the treatment of PHN
following shingles, and the effect of the condition on patients' lives in terms
of pain and time off usual activities such as work. The lifetime direct treatment
costs of a cohort of people from onset of PHN to resolution of the disease or
death were calculated. These costs were estimated from data on the type and
quantity of health resources used, and the unit costs or prices of those
resources. This study has shown that PHN can be a costly consequence of acute
shingles. For patients attending a tertiary referral centre the lifetime cost was
770 British pounds sterling. For a 1-year incidence cohort of people with
shingles in the UK, the lifetime costs of treating PHN are between 4.8 million
British pounds sterling (incidence of 21 000 people) and 17.9 million British
pounds sterling (incidence of 78 200 people). Efforts are needed to reduce the
incidence or severity of PHN.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 10147439 [PubMed - indexed for MEDLINE]

4823: JAMA. 1994 Jul 6;272(1):47-52.

Effect of hypnotic suggestion on the delayed-type hypersensitivity response.

Locke SE, Ransil BJ, Zachariae R, Molay F, Tollins K, Covino NA, Danforth D.

Department of Psychiatry, Beth Israel Hospital, Boston, MA 02215.

OBJECTIVE--To determine whether individuals selected for good general health,
high hypnotizability, and the ability to alter skin temperature under hypnotic
suggestion can influence the delayed-type hypersensitivity (DTH) response to
varicella-zoster (VZ) antigen under hypnotic suggestion. DESIGN--A blinded
clinical trial using a repeated measures design with subjects serving as their
own controls. Subjects were randomly assigned to undergo a predetermined sequence
of four different experimental conditions, occurring at weekly intervals, with
each condition including VZ skin testing: (1) hypnosis with suggestions to
enhance the DTH response to VZ antigen; (2) hypnosis with suggestions to suppress
the DTH response; (3) hypnosis with suggestions for relaxation only; and (4) skin
testing without hypnosis. SETTING--A National Institutes of Health-supported
clinical research center in a teaching hospital. SUBJECTS--A stratified sample of
24 ambulatory, healthy, highly hypnotizable, volunteer college students selected 
for their above-average ability to alter skin temperature after hypnotic
suggestions and their positive baseline responses to VZ antigen. There were 11
males and 13 females with a mean +/- SD age of 22 +/- 6 years. The mean +/- SD
hypnotizability score (Harvard Group Scale of Hypnotic Susceptibility) was 11 +/-
1. INTERVENTIONS--Intradermal skin testing with VZ antigen (Mantoux method) and
hypnotic suggestion. MAIN OUTCOME MEASURES--Areas of induration of the DTH
response measured at 24 and 48 hours after injection of antigen. RESULTS--The
area of the DTH response was not affected by the experimental interventions. The 
area of erythema was likewise unaffected. CONCLUSIONS--Our subjects were unable
to alter their DTH responses using hypnotic suggestion.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8007079 [PubMed - indexed for MEDLINE]

4824: J Virol. 1994 Jul;68(7):4204-11.

Unusual phosphorylation sequence in the gpIV (gI) component of the
varicella-zoster virus gpI-gpIV glycoprotein complex (VZV gE-gI complex).

Yao Z, Grose C.

Department of Microbiology, University of Iowa College of Medicine, Iowa City
52242.

Varicella-zoster virus (VZV) glycoprotein gpIV, to be renamed VZV gI, forms a
heterodimer with glycoprotein gpI (gE) which functions as an Fc receptor in
virus-infected cells. Like VZV gpI (gE), this viral glycoprotein is
phosphorylated in cell culture during biosynthesis. In this report, we
investigated the nature and specificity of the phosphorylation event involving
VZV gpIV (gI). Phosphoamino acid analysis indicated that gpIV (gI) was modified
mainly on serine residues. To identify the precise location of the
phosphorylation site on the 64-kDa protein, a step-by-step mutagenesis procedures
was followed. Initially a tailless mutant was generated, and this truncated
product was no longer phosphorylated. Thereafter, point mutations were made
within the cytoplasmic tail of gpIV (gI) at potential phosphorylation sites. The 
phosphorylation site was localized to the following sequence: Ser-Pro-Pro (amino 
acids 343 to 345). Examination of the point mutants established that serine 343
in the cytoplasmic tail was the major phosphoacceptor. In addition, we found that
the prolines located immediately to the C terminus of serine 343 were an integral
part of the kinase recognition sequence. This site was located immediately N
terminal to a predicted beta-turn secondary structure. By comparison with known
substrate consensus sequences for various protein kinases, these data suggested
that the phosphorylation of VZV gpIV (gI) was catalyzed by a proline-directed
protein kinase. Computer homology analysis of other alphaherpesviruses
demonstrated that a similar potential phosphorylation site was highly conserved
in the cytoplasmic tails of herpes simplex virus type 1 gI, equine herpesvirus
type 1 gI, and pseudorabies virus gp63.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8207795 [PubMed - indexed for MEDLINE]

4825: Eur J Haematol. 1994 Jul;53(1):51-3.

The Ch1VPP regimen, a risk factor for herpes zoster virus infection in patients
treated for Hodgkin's disease.

Norum J, Bremnes RM, Wist E.

Publication Types: 
    Letter

PMID: 8062898 [PubMed - indexed for MEDLINE]

4826: Aust Fam Physician. 1994 Jul;23(7):1355-6.

The mark of Zorro.

Colquhoun JP.

Publication Types: 
    Case Reports

PMID: 8060283 [PubMed - indexed for MEDLINE]

4827: Ophthalmology. 1994 Jul;101(7):1236-43.

Paraneoplastic retinopathy associated with antiretinal bipolar cell antibodies in
cutaneous malignant melanoma.

Weinstein JM, Kelman SE, Bresnick GH, Kornguth SE.

Department of Ophthalmology, University of Wisconsin, Madison.

PURPOSE: It has been shown previously that the sera, from patients with visual
paraneoplastic syndrome associated with lung cancer, contain immunoglobulins that
are reactive with the tumor and with photoreceptor and large retinal ganglion
cells. The purpose of this study is to determine the retinal cell population that
reacts with immunoglobulins in the sera of patients with melanoma-associated
retinopathy. METHODS: Clinical and electrophysiologic studies were used to
determine the locus responsible for the visual defect in each patient. Sera from 
two patients with melanoma-associated retinopathy, from a patient with herpes
zoster, and from a patient who had a colon tumor were obtained. The sera were
incubated with sections of retina obtained from a healthy 3-year-old child who
had died of asphyxiation. The tissue sections subsequently were incubated with
biotin-labeled anti-human immunoglobulin G, and then with streptavidin-labeled
peroxidase. Finally, the tissue sections were developed to show peroxidase
activity in the targeted retinal cells. RESULTS: Clinical and electrophysiologic 
studies were consistent with a defect in intra-retinal transmission distal to the
photoreceptors. The immunoglobulins from the patients with the
melanoma-associated retinopathy reacted selectively with the bipolar cells of the
retina; approximately 30% of the bipolar cells were immunoreactive. The sera from
the other two patients were not reactive with any of the retinal cells examined. 
CONCLUSIONS: The sera of patients with the paraneoplastic syndrome,
melanoma-associated retinopathy, contain high titer immunoglobulins that are
reactive only with a subset of the bipolar retinal cells. The clinical,
electrophysiologic, and immunologic studies are all consistent with an
intra-retinal transmission defect at the level of the bipolar cells.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8035987 [PubMed - indexed for MEDLINE]

4828: South Med J. 1994 Jul;87(7):758-61.

Linear and dermatomal cutaneous graft-versus-host disease.

Cohen PR, Hymes SR.

Department of Dermatology, University of Texas Medical School, Houston 77030.

A 17-year-old girl had linear and dermatomal lichenoid chronic graft-versus-host 
disease (GVHD) 18 months after receiving an allogeneic bone marrow
transplantation for aplastic anemia. The cutaneous GVHD lesions appeared on
previously normal skin.

Publication Types: 
    Case Reports

PMID: 8023213 [PubMed - indexed for MEDLINE]

4829: Chest. 1994 Jul;106(1 Suppl):22S-27S.

Varicella-zoster virus pneumonitis.

Feldman S.

Department of Pediatrics, University of Mississippi Medical Center, Jackson.

Publication Types: 
    Review

PMID: 8020329 [PubMed - indexed for MEDLINE]

4830: Chest. 1994 Jul;106(1 Suppl):15S-21S; discussion 34S-35S.

Herpesvirus infections in burn patients.

Hayden FG, Himel HN, Heggers JP.

Department of Internal Medicine, University of Virginia School of Medicine,
Charlottesville.

Publication Types: 
    Review

PMID: 8020328 [PubMed - indexed for MEDLINE]

4831: Am Fam Physician. 1994 Jul;50(1):78-84.

Clinical virology in children.

Ryan ME, Leichter J.

Geisinger Clinic, Danville, Pennsylvania.

Virology has become an increasingly important field of medicine in the past
decade. Many infectious diseases that were once of unknown etiology can now be
linked to the specific viral pathogen. New methods for diagnosing and treating
viral diseases are being developed. In addition, antiviral therapy or prophylaxis
is available for many of these viral illnesses. This article reviews the basic
medical aspects of some viral infections. Human parvovirus B19 causes erythema
infectiosum, with the classic "slapped-cheek" rash. Human herpesvirus type 6 is
thought to be the cause of roseola infantum, characterized by the familiar
macular/maculopapular rash on the trunk and arms. Varicella-zoster virus
infection results in chickenpox, which in the future may be prevented by a
vaccine. Herpes simplex virus-1 causes up to 90 percent of oral and labial herpes
infections. Congenital cytomegalovirus infection results in birth defects.
Epstein-Barr virus is the primary cause of mononucleosis. Human papillomavirus
causes laryngeal and genital warts. Respiratory syncytial virus is the major
cause of lower respiratory tract disease in children. Rotavirus is the common
agent in childhood diarrhea.

Publication Types: 
    Review

PMID: 8017260 [PubMed - indexed for MEDLINE]

4832: J Infect Dis. 1994 Jul;170(1):68-75.

Phenotypic and genotypic characterization of acyclovir-resistant varicella-zoster
viruses isolated from persons with AIDS.

Boivin G, Edelman CK, Pedneault L, Talarico CL, Biron KK, Balfour HH Jr.

Dept. of Laboratory Medicine and Pathology, Minneapolis, MN 55455-0392.

Phenotypic and genotypic analyses were done on 17 varicella-zoster virus (VZV)
isolates recovered from 10 persons with AIDS (mean CD4 cell count, 16.4/mm3) who 
had chronic VZV lesions. Eleven acyclovir-resistant isolates were recovered from 
10 patients after a mean of 20.1 weeks of therapy. Six susceptible isolates were 
recovered before acyclovir treatment (n = 1), early during therapy (n = 4; mean
time, 4.2 weeks), or after discontinuation of acyclovir (n = 1).
Acyclovir-resistant VZV isolates were deficient in thymidine kinase (TK) or
induced a TK with altered substrate specificity; all isolates were susceptible to
foscarnet. Ten of 11 acyclovir-resistant mutants contained tk gene mutations,
including single nucleotide substitutions in highly conserved binding sites (n = 
2) as well as nucleotide deletions (n = 4) and insertions (n = 4). These findings
suggest that multiple, nonuniform mutations within the tk gene are associated
with acyclovir-resistant VZV phenotypes.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8014522 [PubMed - indexed for MEDLINE]

4833: Eur J Obstet Gynecol Reprod Biol. 1994 Jul;56(1):67-8.

Varicella zoster virus infection during pregnancy: the limits of prenatal
diagnosis.

Lecuru F, Taurelle R, Bernard JP, Parrat S, Lafay-pillet MC, Rozenberg F, Lebon
P, Dommergues M.

Service de Gynecologie Obstetrique, Hopital Boucicaut, Paris, France.

In a mother with clinical evidence of chicken-pox at 12.5 weeks, fetal herpes
varicella zoster infection was revealed by transient fetal ascites with liver
calcifications at 27 weeks routine ultrasound. At 27 and 35 weeks fetal blood
sampling and amniocentesis failed to demonstrate fetal viral infection. However, 
the diagnosis was confirmed postnatally based on thoracic herpes zoster at 8
months in an otherwise healthy infant. Polymerase chain reaction (PCR) on stored 
amniotic cells performed retrospectively was positive for varicella zoster virus 
(HVZV). This observation suggests that (1) in contrast to PCR, conventional fetal
biology lacks sensitivity for prenatal diagnosis of HVZV infection, (2) the
association of fetal sonographic abnormalities and positive amniotic PCR can be
associated with a favorable pediatric outcome. Therefore, prenatal diagnosis of
HVZV infection should be considered with the greatest caution.

PMID: 7982520 [PubMed - indexed for MEDLINE]

4834: Rinsho Shinkeigaku. 1994 Jul;34(7):720-3.

[A case of herpes zoster meningoencephalitis followed by involvement of cranial
nerves IX, X, XI]

[Article in Japanese]

Kondo M, Hokezu Y, Nagai M, Mori T, Nagamatsu K.

Department of Neurology, Oita Prefectural Hospital.

The patient is a 64-year-old woman with herpes zoster meningo-encephalitis
followed by involvement of cranial nerves IX, X, XI. On admission, she had severe
neck pain on the left side and mild nuchal rigidity. Three days later, herpetic
vesicles on the left side of her neck (C2, C3, area). Herpes zoster
meningoencephalitis was diagnosed based on CSF pleocytosis, high serum and CSF
titers of herpes zoster antibody, and EEG abnormality. During hospitalization,
paralysis of the left vocal cord, rightward deviation of the uvula, and gradual
paralysis of the left sternocleidomastoideus and trapezius muscles developed. On 
cranial magnetic resonance imaging (MRI), T2-weighted image clearly revealed a
high-signal lesion in left dorsal part of the medulla oblongata. This area
appeared to correspond to the nucleus ambiguous and vagal nucleus. In this case, 
we believe that the inflammation originated in the C2, C3 posterior ganglion
cells, extended to the IX, X, XI cranial nerves and to the part of the medulla
oblongata. It is likely that the number of patients in whom a lesion of the
cranial nucleus is revealed by MRI will increase in the future.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 7955732 [PubMed - indexed for MEDLINE]

4835: Clin Exp Dermatol. 1994 Jul;19(4):327-9.

Chronic verrucous varicella-zoster infection in a patient with AIDS.

Vaughan Jones SA, McGibbon DH, Bradbeer CS.

St John's Institute of Dermatology, St Thomas' Hospital, London, UK.

The expression of herpes varicella zoster virus in patients already infected with
the human immunodeficiency virus (HIV) provides the perfect illustration of an
opportunist microbe at work. There is an increased incidence of herpes zoster
which may be more severe, recurrent or disseminated. Likewise, varicella may be
more severe and recurrent. In both patterns of infection atypical lesions in the 
form of persistent ulcerative or verrucous lesions have been seen. An
HIV-positive patient is described who developed verrucous lesions de novo, 4
months after her child had varicella.

Publication Types: 
    Case Reports

PMID: 7955476 [PubMed - indexed for MEDLINE]

4836: Arzneimittelforschung. 1994 Jul;44(7):866-71.

Management of viral infections with thymopentin.

Sundal E, Bertelletti D.

Recurrent herpes simplex-, herpes zoster- and human papilloma virus infections
are sometimes difficult to control by traditional antiviral therapy. Although
detectable immune disturbances are not regularly associated with the clinical
presentation, a compromised cellular immunity has been found to play an important
role in the pathogenesis of those diseases. Thymopentin (Arg-Lys-Asp-Val-Tyr) is 
a synthetic pentapeptide corresponding to the active structure of the natural 49 
amino acids containing thymic hormone thymopoietin, which has shown impressive
immunoregulatory activity in many animal model systems and human in-vitro tests. 
Cumulative clinical experience with this drug has suggested that it would be of
particular value in certain recurrent viral diseases. This report summarizes some
of the individual studies performed so far, and discusses the mechanisms of
action within the context of relevant published articles in this field. Contrary 
to antiviral drugs, thymopentin's effect appears to be long-lasting also after
discontinuation of treatment. The drug seems to be extremely safe and no serious 
adverse reactions have been reported to date.

Publication Types: 
    Review

PMID: 7945525 [PubMed - indexed for MEDLINE]

4837: Wiad Lek. 1994 Jul;47(13-14):527-32.

[Capsaicin in pain therapy]

[Article in Polish]

Sokolowski P.

Katedry i Kliniki Neurologii Ak. Med. w Lodzi.

In the paper the possibilities of therapeutic use of capsaicin are presented.
This drug seems to be very effective in neuralgia after zoster, and less
effective in painful diabetic neuropathy. Attempts are also undertaken at its use
in cluster headache, trigeminal neuralgia and arthralgia. Confirmation of the
effectiveness of the discussed drug in these pain syndromes requires further
studies.

Publication Types: 
    English Abstract
    Review

PMID: 7716941 [PubMed - indexed for MEDLINE]

4838: Schweiz Med Wochenschr. 1994 Jun 25;124(25):1109-16.

[Encephalitis in adults]

[Article in German]

Ruef C.

Abteilung Infektionskrankheiten und Spitalhygiene, Universitatsspital Zurich.

Encephalitis is the result of focal or global inflammation of the brain caused by
invasion of the brain parenchyma by viruses, bacteria, parasites or fungi. In
addition, postinfectious encephalitis may result from immunological processes as 
a consequence of preceding viral infections such as measles. For most forms of
viral encephalitis no specific therapy is available. Herpes simplex encephalitis 
may be diagnosed using modern laboratory techniques for detection of viral DNA
without the need for brain biopsy. Herpes simplex encephalitis responds well to
treatment with acyclovir, as does encephalitis caused by varicella-zoster virus, 
which typically occurs following cutaneous herpes zoster involving dermatomal
distributions of the trigeminal nerve. In immunocompromised hosts many etiologies
of encephalitis need to be considered. It is important to arrive at a precise
diagnosis in order to choose appropriate therapeutic agents directed toward
treatable pathogens such as Toxoplasma gondii and cytomegalovirus.

Publication Types: 
    English Abstract
    Review

PMID: 8029684 [PubMed - indexed for MEDLINE]

4839: Lancet. 1994 Jun 25;343(8913):1648.

Proposed classification of herpes zoster pain.

Dworkin RH, Portenoy RK.

Publication Types: 
    Letter
    Research Support, U.S. Gov't, P.H.S.

PMID: 7911959 [PubMed - indexed for MEDLINE]

4840: JAMA. 1994 Jun 22-29;271(24):1948-52.

Viral imitations of host defense proteins. Flattery that turns to battery.

Murphy PM.

Laboratory of Host Defenses, National Institute of Allergy and Infectious
Diseases, National Institutes of Health, Bethesda, Md 20892.

Publication Types: 
    Case Reports
    Clinical Conference
    Review

PMID: 8201740 [PubMed - indexed for MEDLINE]

4841: Lancet. 1994 Jun 18;343(8912):1548-51.

Comment in:
    Lancet. 1994 Oct 1;344(8927):950-1.

Consequences of varicella and herpes zoster in pregnancy: prospective study of
1739 cases.

Enders G, Miller E, Cradock-Watson J, Bolley I, Ridehalgh M.

Institut fur Virologie, Infektiologie und Epidemiologie, Stuttgart, Germany.

In a joint prospective study in Germany and the United Kingdom between 1980 and
1993, 1373 women who had varicella and 366 who had herpes zoster during the first
36 weeks of gestation were followed up. 9 cases of congenital varicella syndrome 
were identified, all occurring after maternal varicella during the first 20 weeks
of gestation. The highest risk (2.0%) was observed between 13-20 weeks gestation,
with 7 affected infants identified among 351 pregnancies (95% CI of risk
0.8-4.1%). Only 2 cases of congenital varicella syndrome were identified among
472 pregnancies in which maternal varicella occurred before 13 weeks (observed
risk 0.4%, 95% CI 0.05-1.5%). Herpes zoster in infancy was reported in 10
children whose mothers had had varicella in pregnancy. No infants with clinical
evidence of intrauterine infection were born to the 366 women with herpes zoster 
in pregnancy (upper 95% confidence limit of estimated risk 1.0%).
Varicella-zoster-specific IgM antibody was found at birth in 4 of 16 (25%)
infants with clinical manifestations of intrauterine infection and persistent
specific IgG antibody in 5 of 7 infants tested. The corresponding rates in
asymptomatic infants whose mothers had varicella were 12% (76/615) and 7%
(22/335) respectively. No serological evidence of intrauterine infection was
found in infants who mothers had herpes zoster in pregnancy. In 97 pregnant
women, varicella occurred after post-exposure prophylaxis with
anti-varicella-zoster immunoglobulin. No cases of congenital varicella syndrome
or zoster in infancy occurred in this group. Our estimates provide a sound basis 
for counselling women with varicella in pregnancy. Although the risk of
congenital varicella syndrome is small, the outcome for the affected infant is so
serious that a reliable method of prenatal diagnosis would be valuable. In the
long term, prevention of maternal varicella would be an option if a safe and
effective vaccine were to become routinely available.

PMID: 7802767 [PubMed - indexed for MEDLINE]

4842: Gene. 1994 Jun 10;143(2):217-22.

Sequences of the ribonucleotide reductase-encoding genes of equine herpesvirus 4.

Riggio MP, Onions DE.

Department of Veterinary Pathology, University of Glasgow Veterinary School, UK.

The equine herpesvirus 4 (EHV-4) genes encoding the two subunits of the enzyme
ribonucleotide reductase (RR) were cloned and their nucleotide (nt) sequences
determined. The large subunit (RR1) is predicted to comprise 789 amino acids
(aa), which compares with lengths of 790, 775 and 1137 aa for the RR1 proteins
encoded by equine herpesvirus 1 (EHV-1) gene 21, varicella zoster virus (VZV)
gene 19 and herpes simplex virus type 1 (HSV-1) UL39, respectively. In common
with VZV RR1, the EHV-4 RR1 protein lacks the N-terminal domain of HSV-1 RR1
which possesses protein kinase activity. EHV-4 RR1 demonstrates identities of 88,
52 and 29% with the RR1 proteins of EHV-1, VZV and HSV-1, respectively. The small
subunit (RR2) is predicted to be 320 aa in length, which compares with lengths of
321, 306 and 340 aa for the RR2 proteins encoded by EHV-1 gene 20, VZV gene 18
and HSV-1 UL40, respectively. The EHV-4 RR2 protein exhibits identities of 90, 60
and 55% with the RR2 proteins of EHV-1, VZV and HSV-1, respectively.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8206376 [PubMed - indexed for MEDLINE]

4843: J Virol. 1994 Jun;68(6):3841-9.

Expression of the varicella-zoster virus origin-binding protein and analysis of
its site-specific DNA-binding properties.

Chen D, Olivo PD.

Department of Medicine, Washington University School of Medicine, St. Louis,
Missouri 63110.

The varicella-zoster virus (VZV) genome contains homologs to each of the seven
herpes simplex virus (HSV) genes that are required for viral DNA synthesis. VZV
gene 51 is homologous to HSV UL9, which encodes an origin of DNA replication
binding protein (OBP). It was previously shown, by using a protein A fusion
protein, that the product of gene 51 is a site-specific DNA-binding protein which
binds to sequences within the VZV origin (Stow et al., Virology 177:570-577,
1990). In this report, gene 51 was expressed in an in vitro translation system.
Rabbit antiserum raised against the carboxyl-terminal 20 amino acids was used to 
confirm expression of the full-length gene 51 protein, and site-specific
DNA-binding activity was demonstrated in a gel retardation assay. The
origin-binding domain was located within a 263-amino-acid region of the carboxyl 
terminus by using a series of deletion mutants. The affinity of binding of the
VZV OBP to the three binding sites in the VZV origin was found to be similar. In 
addition, as with UL9, a CGC triplet within a 10-bp consensus sequence is
critical to the interaction between the OBP and the origin. The HSV and VZV OBPs,
therefore, appear to have virtually identical recognition sequences despite only 
33% identity and 44% similarity in the primary structure of their site-specific
DNA-binding domains.

PMID: 8189521 [PubMed - indexed for MEDLINE]

4844: J Virol. 1994 Jun;68(6):3693-701.

Helicase-primase complex of herpes simplex virus type 1: a mutation in the UL52
subunit abolishes primase activity.

Klinedinst DK, Challberg MD.

Laboratory of Viral Diseases, National Institute of Allergy and Infectious
Diseases, Bethesda, Maryland 20892.

The UL52 gene product of herpes simplex virus type 1 (HSV-1) comprises one
subunit of a 3-protein helicase-primase complex that is essential for replication
of viral DNA. The functions of the individual subunits of the complex are not
known with certainty, although it is clear that the UL8 subunit is not required
for either helicase or primase activity. Examination of the predicted amino acid 
sequence of the UL5 gene reveals the existence of conserved helicase motifs; it
seems likely, therefore, that UL5 is responsible for the helicase activity of the
complex. We have undertaken mutational analysis of UL52 in an attempt to
understand the functional contribution of this protein to the helicase-primase
complex. Amino acid substitution mutations were introduced into five regions of
the UL52 gene that are highly conserved among HSV-1 and the related herpesviruses
equine herpesvirus 1, human cytomegalovirus, Epstein-Barr virus, and
varicella-zoster virus. Of seven mutants analyzed by an in vivo replication
assay, three mutants, in three different conserved regions of the protein, failed
to support DNA replication. Within one of the conserved regions is a 6-amino-acid
motif (IL)(VIM)(LF)DhD (where h is a hydrophobic residue), which is also
conserved in mouse, yeast, and T7 primases. Mutagenesis of the first aspartate
residue of the motif, located at position 628 of the UL52 protein, abolished the 
ability of the complex to support replication of an origin-containing plasmid in 
vivo and to synthesize oligoribonucleotide primers in vitro. The ATPase and
helicase activities were unaffected, as was the ability of the mutant enzyme to
support displacement synthesis on a preformed fork substrate. These results
provide experimental support for the idea that UL52 is responsible for the
primase activity of the HSV helicase-primase complex.

PMID: 8189507 [PubMed - indexed for MEDLINE]

4845: J Virol. 1994 Jun;68(6):3674-81.

Cloning and expression of an equine herpesvirus 1 origin-binding protein.

Martin DW, Deb S.

Department of Microbiology, University of Texas Health Science Center at San
Antonio 78284.

Equine herpesvirus 1 (EHV-1) is an important pathogen of horses and is closely
related to several important human pathogens, herpes simplex virus types 1 and 2 
(HSV-1 and HSV-2) and varicella-zoster virus. The EHV-1 genome contains open
reading frames similar in sequence to the HSV-1 replication genes. PCR was used
to clone EHV-1 gene 53, which is similar in sequence to the HSV-1 UL9 gene. The
gene 53 product has regions of striking similarity to the HSV-1 UL9 and VZV gene 
51 products. In vitro transcription and translation of this gene generated a
protein of 87 kDa as measured by sodium dodecyl sulfate-polyacrylamide gel
electrophoresis. Further characterization of this protein was accomplished
through the use of gel shift analysis. The in vitro-synthesized protein bound
sequence specifically to EHV-1 OriS as well as HSV-1 OriS. A site was used in gel
shift analysis to show that the EHV-1 origin-binding protein bound to the same
consensus site as the HSV-1 origin-binding protein, 5'-CGTTCGCACTT-3'. Using a
nuclear extract of EHV-1-infected RK13 cells, we have identified an activity that
interacts similarly with this consensus site. In gel shift assays, the retarded
band arising from the nuclear extract migrated similarly to the retarded band
arising from in vitro-translated EHV-1 gene 53. An N-terminal deletion of EHV-1
gene 53 was also created, expressed in vitro, and used in gel shift assays to
localize the DNA-binding domain. Results of these experiments indicated that
amino acids 1 to 499 were dispensable for binding and that the C-terminal
fragment (amino acids 500 to 888) recognized the same consensus site as did the
wild-type protein. Thus, the product of EHV-1 gene 53 is an origin-binding
protein with a high degree of similarity to the HSV-1 and varicella-zoster virus 
origin-binding proteins and possibly serves as the initiator of DNA replication
in EHV-1.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 8189505 [PubMed - indexed for MEDLINE]

4846: J Virol. 1994 Jun;68(6):3593-603.

Identification of an immediate-early gene in the Marek's disease virus long
internal repeat region which encodes a unique 14-kilodalton polypeptide.

Hong Y, Coussens PM.

Department of Animal Science, Michigan State University, East Lansing 48824.

Marek's disease virus (MDV) is an oncogenic avian herpesvirus whose genomic
structure is similar to those of herpes simplex virus and varicella-zoster virus.
Repeat regions of the MDV genome have been intensively investigated because of a 
potential relationship to MDV oncogenicity and abundant expression of
immediate-early transcripts. In this study, a 1.6-kb immediate-early transcript
was localized to the BamHI-I2 region by Northern (RNA) hybridization analysis.
With cDNA cloning and sequencing, two cDNAs of 1.4 kb (C1) and 1.35 kb (C2) were 
identified. Both cDNAs are derived from spliced mRNAs spanning the BamHI-H and
-I2 fragments. C1 and C2 use the same splice acceptors and 3' ends, but they
differ at their 5' ends and utilize different splice donors. The upstream
promoter-enhancer region of C1 cDNA has been defined as a bidirectional
regulatory region shared by the MDV pp38 gene. Sequencing analysis shows two
small open reading frames (ORFs) within each cDNA (ORF1a and ORF2 in C1, ORF1b
and ORF2 in C2). Potential ORFs of the sequence have no significant homology with
any known protein in the Swiss-Protein data base. DNA fragments encoding ORF1a
and ORF1b were cloned into pGEX-3X vectors to produce glutathione S-transferase
fusion proteins and induce antisera. In Western blot (immunoblot) analysis of
MDV-infected-cell lysates, a 14-kDa polypeptide was identified by antisera
against both ORF1a and ORF1b. This 14-kDa protein is expressed in cells which are
lytically infected with MDV strains GA, Md11 passage 14 (oncogenic), and Md11
passage 83 (attenuated), as well as in the latently MDV-infected and transformed 
MSB-1 cell line.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 8189498 [PubMed - indexed for MEDLINE]

4847: J Virol. 1994 Jun;68(6):3570-81.

Transcriptional mapping of the varicella-zoster virus regulatory genes encoding
open reading frames 4 and 63.

Kinchington PR, Vergnes JP, Defechereux P, Piette J, Turse SE.

Department of Ophthalmology, University of Pittsburgh, Pennsylvania 15213.

Four of the 68 varicella-zoster virus (VZV) unique open reading frames (ORFs),
i.e., ORFs 4, 61, 62, and 63, encode proteins that influence viral transcription 
and are considered to be positional homologs of herpes simplex virus type 1
(HSV-1) immediate-early (IE) proteins. In order to identify the elements that
regulate transcription of VZV ORFs 4 and 63, the encoded mRNAs were mapped in
detail. For ORF 4, a major 1.8-kb and a minor 3.0-kb polyadenylated [poly(A)+]
RNA were identified, whereas ORF 63-specific probes recognized 1.3- and 1.9-kb
poly(A)+ RNAs. Probes specific for sequences adjacent to the ORFs and mapping of 
the RNA 3' ends indicated that the ORF 4 RNAs were 3' coterminal, whereas the
RNAs for ORF 63 represented two different termination sites. S1 nuclease mapping 
and primer extension analyses indicated a single transcription initiation site
for ORF 4 at 38 bp upstream of the ORF start codon. For ORF 63, multiple
transcriptional start sites at 87 to 95, 151 to 153, and (tentatively) 238 to 243
bp upstream of the ORF start codon were identified. TATA box motifs at good
positional locations were found upstream of all mapped transcription initiation
sites. However, no sequences resembling the TAATGARAT motif, which confers IE
regulation upon HSV-1 IE genes, were found. The finding of the absence of this
motif was supported through analyses of the regulatory sequences of ORFs 4 and 63
in transient transfection assays alongside those of ORFs 61 and 62. Sequences
representing the promoters for ORFs 4, 61, and 63 were all stimulated by VZV
infection but failed to be stimulated by coexpression with the HSV-1
transactivator Vmw65. In contrast, the promoter for ORF 62, which contains
TAATGARAT motifs, was activated by VZV infection and coexpression with Vmw65.
These results extend the transcriptional knowledge for VZV and suggest that ORFs 
4 and 63 contain regulatory signals different from those of the ORF 62 and HSV-1 
IE genes.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8189496 [PubMed - indexed for MEDLINE]

4848: Minerva Med. 1994 Jun;85(6):333-7.

[Herpes zoster and post-herpetic neuralgia. Comparison between elderly patients
and young adults treated with acyclovir]

[Article in Italian]

Bilora F, Genovese R, Presotto F, Saccaro G, Vettore G, San Lorenzo I, Dazzi A.

Dipartimento di Emergenza, Complesso Ospedale-Universita degli Studi di Padova.

Herpes zoster (HZ) is a common skin disease due to a virus identical to that
responsible for chickenpox. In a variable number of cases neuritic pain persist
after cutaneous healing. Aim of this investigation was to analyze zoster clinical
evolution in 102 immunocompetent patients, subdivided by age (< 60 years and > or
= 60 years) and sex, after treatment with acyclovir (4 g/die x 10 days). Signs
and symptoms of the disease were evaluated, with particular attention to pain and
the duration of post-herpetic neuralgia. Vescicular eruption was most frequently 
found in the thoraco-abdominal region and in the trigeminal one, with no
significant differences among the subgroups. Two thirds of the subjects
complained of pain and it was prevalent in female sex (84% of cases vs 53%, p <
0.01) but not in any age-class. After 1 months from the episode (and its
pharmacological treatment), post-herpetic neuralgia was still present in about
20% of the patients, above all in those > or = 60 years; this last difference
reached statistical significance after 6 months (9.7% vs 1.4% for subjects > or =
60 years and < 60 years respectively, p < 0.05). No patient showed any adverse
pharmacological effect after treatment. We conclude that acyclovir is well
accepted both in young and elderly immune-competent subjects suffering from HZ,
but it necessitates further efficacy investigations in sight of its broader
utilization.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 8084437 [PubMed - indexed for MEDLINE]

4849: J Clin Microbiol. 1994 Jun;32(6):1610-3.

Comparison of techniques and evaluation of three commercial monoclonal antibodies
for laboratory diagnosis of varicella-zoster virus in mucocutaneous specimens.

Perez JL, Garcia A, Niubo J, Salva J, Podzamczer D, Martin R.

Service of Microbiology, Hospital Princeps d'Espanya, Ciutat Sanitaria i
Universitaria de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.

A comparison of direct antigen detection in cell scrapings with culture
techniques (tube culture and shell vial method) for diagnosis of varicella-zoster
virus (VZV) mucocutaneous infections was done in parallel in two groups of
specimens. A total of 100 specimens were from patients with clinical diagnosis of
VZV infection (group 1), and 69 were from patients with no suspicion of VZV
infection (group 2) but mainly with herpes simplex virus infections. In addition,
three commercially available monoclonal antibodies (Whittaker, Biosoft Clone
2013, and Ortho 3B3) directed against VZV antigens were evaluated in parallel in 
the last 87 group 1 specimens. Overall, 80% of the group 1 specimens were
confirmed positive by direct detection, in comparison with 56% positive by tube
culture and/or shell vial. None of the group 2 specimens were positive for VZV by
any of the methods, and none of the monoclonal antibodies assayed reacted with
any herpes simplex virus stock strains. Antiviral therapy and the length of
evolution time of lesions affected negatively the performance of all laboratory
methods, but to a lesser extent in direct detection techniques than in culture
techniques. The Whittaker and Biosoft reagents (indirect immunofluorescence
assay) showed statistically significant differences in sensitivity with respect
to the Ortho antibody (P = 0.002 and P = 0.039, respectively; two-tailed binomial
test). Direct antigen detection is a rapid, easy-to-perform, sensitive, and
specific technique and appears to be the method of choice for laboratory
confirmation of VZV mucocutaneous infections.

Publication Types: 
    Comparative Study

PMID: 8077417 [PubMed - indexed for MEDLINE]

4850: Nippon Jibiinkoka Gakkai Kaiho. 1994 Jun;97(6):1019-27.

[Detection of varicella-zoster virus DNA by polymerase chain reaction in patients
with Hunt syndrome and clinical progression]

[Article in Japanese]

Bessho K, Ogino S.

Department of Otolaryngology, Osaka University, School of Medicine.

Varicella-zoster virus (VZV) is known to be associated with Hunt syndrome. In
this study, the detection of VZV-DNA in peripheral blood, throat swabs, urine and
crusts was performed, in 6 cases of Hunt syndrome, by the polymerase chain
reaction (PCR) method. For DNA-extraction, glass-powder was used. As a primer, an
oligonucleotide, which specifically amplifies 1201-1424 in the Sst-Ig region, was
used. Amplification was performed by repeating 30 cycles of the following
procedures: denaturing at 94 degrees C, annealing at 60 degrees C, and extension 
at 72 degrees C. In one case, VZV-DNA was detected in all samples, in another
case it was detected in a throat swab, urine and crust, and in another case in
peripheral blood, urine and crust. The other 3 cases showed VZV-DNA only in
crusts. These results indicate that viremia might occur in Hunt syndrome, and
that those patients in whom VZV-DNA was detected in peripheral blood and urine
showed a tendency for slow recovery. The present results indicate that this
method provides a valuable tool for the early diagnosis of Hunt syndrome and
zoster sine herpes and that it is useful for predicting the progression of Hunt
syndrome.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8051589 [PubMed - indexed for MEDLINE]

4851: Nippon Rinsho. 1994 Jun;52(6):1508-15.

[Clinical statistics of sarcoidosis in Japan]

[Article in Japanese]

Tachibana T.

Osaka Prefectural Hospital, Department of Internal Medicine.

In addition to 8th national survey on sarcoidosis in 1991, several other Japanese
surveys on clinical features of sarcoidosis was performed and summarized by
Tachibana and others. Selected data from these surveys are described in this
paper Elderly female patients and detection by symptoms were predominant in 8th
national survey, in contrary to the previous data of predominance of younger
patients and detection by mass examination. 80 familial occurrence of sarcoidosis
was collected in Japan. Brother-sister set was predominant, including two
identical twins. Whereas age at detection of cardiac and various other
extrathoracic lesions listed in 3 tables was mainly older than 40 years old, it
was younger in the CNS involvement especially diabetes insipidus. As various
extrathoracic lesions appeared even in stage 1 and also newly appeared during
clinical course, careful follow up of the disease is necessary. Major
complications of sarcoidosis were malignancy, tuberculosis, mycosis, herpes
zoster and other infections and collagen diseases. Pulmonary mycosis was major
complication of stage 3 sarcoidosis. Sarcoid reaction was found both in regional 
lymph nodes and primary malignant tumors, including lung and gastric cancer and
others. Worsening of sarcoidosis after labor was found in relatively high
frequency in stage 2 and 3, but also in stage 1.

Publication Types: 
    English Abstract
    Review

PMID: 8046832 [PubMed - indexed for MEDLINE]

4852: Nippon Sanka Fujinka Gakkai Zasshi. 1994 Jun;46(6):539-42.

[A case report of aplasia cutis congenita]

[Article in Japanese]

Ikeda Y, Masuzaki H, Yamabe T, Maekawa H, Murakami M, Koide E, Nakashita Y,
Yamamoto K.

Department of Obstetrics and Gynecology, Nagasaki University School of Medicine.

Publication Types: 
    Case Reports

PMID: 8040628 [PubMed - indexed for MEDLINE]

4853: Ophthalmology. 1994 Jun;101(6):979-89.

Human excimer laser keratectomy. Clinical and histopathologic correlations.

Binder PS, Anderson JA, Rock ME, Vrabec MP.

National Vision Research Institute, San Diego, CA 92121.

PURPOSE: To understand the healing capabilities of the diseased human cornea
after excimer laser photoablation by morphologic analysis of laser-treated
corneas. METHODS: Twelve corneal specimens were obtained 5 to 16 months after
lamellar or full-thickness keratoplasty following phototherapeutic keratectomy
for undercorrected myopic epikeratoplasty (2 eyes), corneal leukomas (2 eyes),
herpes zoster corneal scarring (1 eye), band keratopathy (2 eyes), adenoviral
subepithelial opacity (1 eye), keratoconus (1 eye), herpes simplex corneal
scarring (2 eyes), granular corneal dystrophy (1 eye), and recurrent lattice
dystrophy (1 eye). The morphology of the corneas was examined by light and
electron microscopy. RESULTS: Epithelial hyperplasia, abnormal epithelial
attachment, and disorganized stromal matrices were observed. Evidence of residual
disease frequently observed in these specimens indicated that the pathology
either was not excised at the time of laser keratectomy or was recurrent.
CONCLUSIONS: The response of the diseased cornea to excimer laser treatment has
similar characteristics to the responses previously observed in animal studies.
Incomplete ablation of diseased tissue and/or recurrence of the initial disease
was the major reason for failure of the treatment. Possible causes for the
inability to remove diseased tissues and superficial scars with the excimer laser
include (1) insufficiently achieved ablation depth and/or diameter and (2)
decreased laser ablation rates of scarred cornea.

Publication Types: 
    Case Reports

PMID: 8008363 [PubMed - indexed for MEDLINE]

4854: Insight. 1994 Jun;19(2):14-6.

Recognition of herpes zoster ophthalmicus.

Krimmer JE.

Herpes zoster ophthalmicus is a form of herpes zoster. Approximately 10 to 25
percent of zoster cases are ophthalmicus. The process is caused by reactivation
of latent varicella virus affecting the fifth cranial nerve. Recognition of signs
and symptoms leading to early diagnosis and treatment with acyclovir may alter
the course and diminish damage to ocular structures.

PMID: 8006487 [PubMed - indexed for MEDLINE]

4855: Mol Cell Probes. 1994 Jun;8(3):193-8.

One-step determination of herpes simplex virus types I and II by polymerase chain
reaction.

Shimizu C, Shimizu H, Mitsuda T, Tsukuda M, Ichikawa S, Yokota S.

Department of Pediatrics, Yokohama City University School of Medicine, Kanagawa, 
Japan.

A rapid and sensitive one-step polymerase chain reaction (PCR) assay was
developed for use in identifying type I and type II herpes simplex virus (HSV).
Although the nucleotide sequences of the two HSV subtypes are quite similar,
common and type-specific sequences 20 nucleotides in length could be deduced in
the thymidine kinase gene. Oligonucleotide primers targeted to the type-specific 
regions generated products of different sizes that served to distinguish two HSV 
types. Type-specific PCR amplification products were verified by restriction
enzyme digestion. Specificity of the HSV PCR was established by the lack of
amplification of other herpes-group viruses including cytomegalovirus,
Epstein-Barr virus, and varicella zoster virus. Extraction of DNA from clinical
materials (throat swabs, vesicular swabs, cerebrospinal fluid and eye discharge) 
yielded an amplification product of the predicted size for each HSV type. Thus,
this PCR system provides a rapid, sensitive and specific assay that can
supplement the currently available modalities for detecting and typing HSV.

PMID: 7969191 [PubMed - indexed for MEDLINE]

4856: J Cutan Pathol. 1994 Jun;21(3):239-46.

Electron microscopic examination of cutaneous lesions by the quick re-embedding
method from paraffin-embedded blocks.

Ogiyama Y, Ohashi M.

Department of Dermatology, Nagoya University School of Medicine, Japan.

We attempted to evaluate whether Widehn's quick re-embedding method from paraffin
blocks is useful for dermatopathological diagnosis. Regarding fine preservation
of nuclei, tono-fibrils and desmosomes of keratinocytes in normal skin, we could 
recognize no difference between the quick re-embedding method and traditional
re-embedding methods. However, preservation of mitochondria and Birbeck granules 
in Langerhans cells was poor regardless of the method used. Furthermore, we
studied the ultrastructural features of some viral skin diseases including
molluscum contagiosum, herpes simplex, varicella-zoster and verruca vulgaris, and
some skin tumors, including angioleiomyoma, angiosarcoma, Merkel cell carcinoma
and amelanotic melanoma using the quick re-embedding method. We determined that
all viral structures were sufficiently preserved by the quick method to observe
the virions and development of the virus. Myofilaments and dense bodies of
angioleiomyoma, Weibel-Palade bodies of angiosarcoma, neurosecretory granules of 
Merkel cell carcinoma and melanosomes of amelanotic melanoma were recognized by
the quick method. From these results, we concluded that the quick re-embedding
method is useful for the diagnosis of skin diseases, especially viral skin
diseases and some skin tumors.

PMID: 7962826 [PubMed - indexed for MEDLINE]

4857: Am J Dermatopathol. 1994 Jun;16(3):268-74.

Clinical application of polymerase chain reaction amplification to diagnosis of
herpes virus infection.

Thomas CA, Smith SE, Morgan TM, White WL, Feldman SR.

Department of Dermatology, Bowman Gray School of Medicine, Wake Forest
University, Winston-Salem, North Carolina.

Amplification of viral DNA offers a potentially sensitive and specific method for
identifying herpes viruses in pathologic specimens. The purpose of this study is 
to assess the value of polymerase chain reaction amplification of DNA as a
diagnostic test for herpes virus in pathologic specimens. The purpose of this
study is to assess for herpes virus infections. We examined 79 paraffin-embedded 
tissue samples from 43 patients and 55 viral culture samples from 45 patients.
Herpes virus DNA in the specimens was amplified by polymerase chain reaction.
Using paraffin-embedded tissue on which a diagnosis of herpes virus was made by
morphologic criteria, 11 of 19 patients had herpes virus DNA identified by PCR;
herpes virus DNA was not identified in any of 35 negative control specimens.
Herpes virus DNA was also identified by polymerase chain reaction in all of the
positive herpes virus culture specimens. Of 29 culture negative specimens, herpes
virus DNA was identified in six. We conclude that polymerase chain reaction is
useful to establish or confirm the presence of a herpes virus infection in
paraffin-embedded tissue samples and that it is more sensitive than viral
culture.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7943633 [PubMed - indexed for MEDLINE]

4858: J Antimicrob Chemother. 1994 Jun;33(6):1245-9.

Trough plasma acyclovir concentrations and safety of oral acyclovir, 800 mg five 
times daily for 7 days in elderly patients with herpes zoster.

Wood MJ, McKendrick MW, Freris MW, Jeal SC, Jones DA, Gilbert AM.

Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital,
UK.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 7928819 [PubMed - indexed for MEDLINE]

4859: Indian J Ophthalmol. 1994 Jun;42(2):51-63.

Acquired immunodeficiency syndrome and its ocular complications.

Rao NA.

Doheny Eye Institute, Los Angeles, California 90033.

Human immunodeficiency virus infection is the first major pandemic of the 20th
century. At present, almost 10 million people are known to be infected with this 
virus, and it is estimated that by the year 2000, approximately 40 million people
will be infected. Transmission of this deadly infection is predominantly by
sexual contact. Individuals infected with this virus pass through several
predictable stages with progressive decrease in circulating CD4+ T cells. During 
the advanced stage, these patients develop various opportunistic infections or
malignancies, or both. It is this advanced stage that was first recognized as
AIDS, which has a 100% mortality rate. The opportunistic organisms that can
involve the eye in patients with AIDS include cytomegalovirus, herpes zoster,
Toxoplasma gondii, Mycobacterium tuberculosis, Cryptococcus neoformans,
Mycobacterium avium-intracellulare, Pneumocystis carinii, Histoplasma capsulatum,
Candida, and others. Intraocular lesions from these agents often represent
disseminated infections. Visual morbidity occurs secondary to retinitis due to
cytomegalovirus, herpes zoster, or Toxoplasma gondii. Anti-viral agents such as
ganciclovir or foscarnet are effective against cytomegalovirus infection. The
role of the ophthalmologist in the diagnosis and management of AIDS is becoming
increasingly important. Not only does the eye reflect systemic disease, but
ocular involvement may often precede systemic manifestations. In the AIDS
patient, the ophthalmologist thus has an opportunity to make not only a
slight-saving, but also life-saving diagnosis of disseminated opportunistic
infections.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 7927632 [PubMed - indexed for MEDLINE]

4860: Asian Pac J Allergy Immunol. 1994 Jun;12(1):51-8.

IN vitro cell-mediated immune reactions in herpes zoster patients treated with
cimetidine.

Komlos L, Notmann J, Arieli J, Hart J, Levinsky H, Halbrecht I, Sendovsky U.

B Gattegno Research Institute for Human Reproduction and Fetal Development,
Hasharon Hospital, Golda Medical Center, Petah-Tiqva, Israel.

In a double-blind placebo-control study the immunomodulating effect of cimetidine
treatment for one week and placebo was investigated for cell-mediated immune
reactions of 22 patients with herpes zoster (HZ). The mitogen induced leukocyte
migration inhibition test (LMIT) and the in vitro proliferation of the patients' 
lymphocytes to exogenous IL-2 were used. Before any treatment, the mitogen
induced leukocyte migration inhibition capacity (LMIC) of HZ patients was found
to be significantly reduced (p < 0.02) as compared to healthy blood bank donors
(controls). After one week, within the same treatment, the LMIC was significantly
improved (p < 0.01). The patients' lymphoproliferative response to IL-2, before
any treatment, was not significantly different from that of controls (p < 0.05). 
However, significantly higher values (p < 0.001) were found in patients tested 7 
days after the disease onset as compared to those tested after 12 days. One-week 
cimetidine treatment significantly improved (p < 0.05) the lymphoproliferative
response to IL-2 of initially low responders and had no effect on higher
responder patients. In contrast to this, after one week of placebo treatment, a
significant decrease in the patients' lymphoproliferative response to IL-2 could 
be observed as compared to patients' initial responses (p < 0.05) or to those of 
controls (p < 0.05). Although the number of cases is very small. The data suggest
that after cimetidine treatment, as compared to placebo, healing from skin rash
and pain was achieved in a significantly shorter time (p < 0.01).

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 7872992 [PubMed - indexed for MEDLINE]

4861: Southeast Asian J Trop Med Public Health. 1994 Jun;25(2):252-7.

Effects of human alpha, beta and gamma interferons on varicella zoster virus in
vitro.

Balachandra K, Thawaranantha D, Ayuthaya PI, Bhumisawasdi J, Shiraki K, Yamanishi
K.

Health Sciences Research Institute, Department of Medical Sciences, Nonthaburi,
Thailand.

The antiviral effects of interferon (IFN) on varicella zoster virus (VZV) and
herpes simplex virus (HSV) in vitro were examined. The values for the 50%
inhibitory dose (ID50) of IFN-alpha, beta and gamma determined by plaque
reduction assay, were 0.813, 0.650 and 13.750 IU/ml, respectively, against VZV
and 18.00, 10.38 and 115.0 IU/ml, respectively, against HSV. Thus IFN-alpha and
beta were more effective than IFN-gamma against both VZV and HSV and VZV was more
sensitive than HSV to the IFNs. Five mutants of VZV which were resistant to
acyclovir (ACV), phosphonoacetic acid (PAA) or bromodeoxyuridine (BUDR) were also
sensitive to IFN beta, their average ID50 being 1.31 IU/ml. Analysis of
virus-specific proteins by the immunofluorescent technique with various antisera 
showed that IFN had a significant effect before early protein synthesis.

PMID: 7855636 [PubMed - indexed for MEDLINE]

4862: APMIS. 1994 Jun;102(6):401-6.

Detection of the BC 24 transforming fragment of the herpes simplex virus type 2
(HSV-2) DNA in cervical carcinoma tissue by polymerase chain reaction (PCR).

Yamakawa Y, Forslund O, Chua KL, Dillner L, Boon ME, Hansson BG.

Department of Medical Microbiology, University of Lund, Malmo General Hospital,
Sweden.

The polymerase chain reaction (PCR) was used to investigate samples from
Indonesian and Swedish patients with cervical intraepithelial neoplasia grade III
(CIN III), squamous cell carcinoma or adenocarcinoma of the cervix for the
presence of a transforming fragment (BC 24) of herpes simplex virus type 2
(HSV-2) DNA. The PCR test for HSV-2 DNA was more sensitive than the infectivity
endpoint titer in a cell culture system and no cross reactivity was found with
either varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, human
papillomavirus 16 or 18, or human genomic DNA. Using this PCR test, 2 out of 5
cases with CIN III, 10 of 71 squamous cell carcinomas, and 3 of 11
adenocarcinomas of the uterine cervix were found to contain DNA sequences
homologous to the BC 24 fragment of the HSV-2 genome. Only two of the samples
containing this transforming region of the HSV-2 DNA were positive in a PCR assay
for the HSV-2 DNA polymerase gene. The great majority of the HSV-2 BC 24 DNA
positive (12 of 15) came from the Indonesian group of patients. All 15 CIN III or
cancer samples positive for the HSV-2 BC 24 fragment were also positive for
papillomavirus DNA. In line with observations made by others, our data support
the hypothesis that HSV infection could represent one of several possible
oncogenic cofactors leading to cervical carcinoma. The HSV cofactor might be more
important in the Indonesian than in the Swedish population.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7794306 [PubMed - indexed for MEDLINE]

4863: Lancet. 1994 May 28;343(8909):1363.

Comment on:
    Lancet. 1994 Apr 16;343(8903):928-9.

Varicella-zoster vaccination for health care workers.

Simini B.

Publication Types: 
    Comment
    Letter

PMID: 7910352 [PubMed - indexed for MEDLINE]

4864: Dtsch Med Wochenschr. 1994 May 6;119(18):679.

[Acyclovir treatment]

[Article in German]

Maass G.

Deutsche Vereinigung zur Bekampfung der Viruskrankheiten e.V., Munster.

PMID: 8187617 [PubMed - indexed for MEDLINE]

4865: Nippon Ganka Gakkai Zasshi. 1994 May;98(5):443-8.

[Detection of herpesvirus DNA in intraocular tissues]

[Article in Japanese]

Usui N.

Department of Ophthalmology, Tokyo Medical College, Japan.

To elucidate the pathogenic mechanism of end-ophthalmitis due to viruses of the
herpes family, one approach is to utilize the polymerase chain reaction (PCR)
method for detection of the viral DNA. Using PCR, we examined 15 human eyes for
the presence and distribution of DNA of the herpes simplex virus (HSV),
varicella-zoster virus (VZV), Epstein-Barr virus (EBV), human cytomegalovirus
(HCMV), and human herpesvirus-6 (HHV-6). HSV DNA was found in the retinal pigment
epithelium (RPE) of 3 eyes, VZV DNA was found in the RPE of 2 eyes and the retina
of 1 eye, EBV DNA was found in the iris and ciliary body of 2 eyes, the retina of
4 eyes, the RPE of 2 eyes, and the choroid of 1 eye, and HCMV DNA was found in
the retina and choroid of 1 eye. These results indicate the possibility that
herpes family viruses have an affinity for intraocular tissues, particularly the 
retina and the RPE.

Publication Types: 
    English Abstract

PMID: 8197913 [PubMed - indexed for MEDLINE]

4866: Arch Dermatol. 1994 May;130(5):661-3.

Comment in:
    Arch Dermatol. 1995 Feb;131(2):226.

Postzoster cutaneous pseudolymphoma.

Roo E, Villegas C, Lopez-Bran E, Jimenez E, Valle P, Sanchez-Yus E.

Publication Types: 
    Case Reports
    Letter

PMID: 8179351 [PubMed - indexed for MEDLINE]

4867: Arch Dermatol. 1994 May;130(5):618-23.

Photosensitivity as the presenting illness in four patients with human
immunodeficiency viral infection.

Pappert A, Grossman M, DeLeo V.

Environmental Dermatology Unit, Columbia-Presbyterian Medical Center, New York,
NY.

BACKGROUND: A multitude of skin lesions have been reported in individuals with
human immunodeficiency virus (HIV) infection. Some of them, eg, severe seborrheic
dermatitis and herpes zoster infections, may predate the onset of the diagnostic 
criteria for the acquired immunodeficiency syndrome and may actually raise the
suspicion of HIV infection in healthy-appearing individuals. We have recently
evaluated four individuals who presented with a severe idiopathic
photosensitivity of eczematous morphologic features who eventuated in a diagnosis
of HIV seropositivity. Four individuals who presented with an eczematous eruption
of sun-exposed skin were referred to the Environmental Dermatology Unit of
Columbia-Presbyterian Medical Center (New York, NY) for evaluation of possible
photosensitive disease. They were examined and underwent photobiological testing 
(minimal erythema dose testing and photopatch testing) to confirm and classify
their suspected photosensitivity. OBSERVATIONS: All four patients fulfilled the
criteria for chronic actinic dermatitis, a rare idiopathic photosensitivity
characterized by debilitating, unremitting dermatitis with eczematous or
lymphomalike histologic features and reproduction of lesions by small quantities 
of mid-wave UV-B radiation (290 to 320 nm). All four individuals were HIV
seropositive and CD4 counts were markedly suppressed in all four. The
photosensitivity predated the finding of seropositivity and the diagnosis of
acquired immunodeficiency syndrome in all four patients. CONCLUSION: The
presentation of healthy-appearing individuals with photodistributed dermatitis of
unknown cause should alert the physician to the possibility of HIV infection.

Publication Types: 
    Case Reports

PMID: 8179344 [PubMed - indexed for MEDLINE]

4868: Ann Neurol. 1994 May;35(5):530-3.

Zoster sine herpete, a clinical variant.

Gilden DH, Wright RR, Schneck SA, Gwaltney JM Jr, Mahalingam R.

University of Colorado School of Medicine, Department of Neurology, Denver 80262.

Two otherwise healthy immunocompetent men, ages 62 and 66 years, experienced
years of radicular pain without zoster rash. An extensive search for systemic
disease and malignancy was negative. Varicella-zoster virus DNA, but not herpes
simplex virus DNA, was found in the cerebrospinal fluid of the first patient 5
months after the onset of pain, and in the second patient 8 months after the
onset of pain. Prolonged radicular pain without zoster rash combined with the
presence of varicella-zoster virus in the cerebrospinal fluid indicates that both
men had zoster sine herpete, and strongly supports this syndrome as a clinical
variant.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8179298 [PubMed - indexed for MEDLINE]

4869: J Am Acad Dermatol. 1994 May;30(5 Pt 1):757-67.

Treatment of the cutaneous pain of acute herpes zoster with 9% lidocaine (base)
in petrolatum/paraffin ointment.

Riopelle J, Lopez-Anaya A, Cork RC, Heitler D, Eyrich J, Dunston A, Riopelle AJ, 
Johnson W, Ragan A, Naraghi M.

Department of Anesthesiology, Louisiana State University Medical Center, New
Orleans.

BACKGROUND: Treatment of the pain of acute herpes zoster by local anesthetic
injections has drawbacks. Topical percutaneous local anesthesia (TPLA) may offer 
another strategy of providing regional analgesia in affected patients. OBJECTIVE:
We evaluate the analgesic efficacy and safety of 9% (wt/vol) lidocaine (base) in 
petrolatum/paraffin ointment in patients with acute herpes zoster. METHODS:
Ointment was applied to the affected skin of 22 patients. Pain, tenderness,
sensitivity to pinprick and cold, and blood lidocaine concentration were measured
repeatedly during a 20-hour interval and intermittently thereafter. RESULTS: Mean
pain, tenderness, and cutaneous sensation scores were reduced at measurements
taken from 4 to 20 hours after ointment application (p < 0.05), but not every
patient obtained relief. No patient had local skin irritation or systemic toxic
effects related to the local anesthetic. CONCLUSIONS: TPLA is a promising therapy
for control of cutaneous pain of acute herpes zoster. Controlled studies should
be performed to prove efficacy, determine optimal TPLA formulation, and define
dosage limits.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8176016 [PubMed - indexed for MEDLINE]

4870: Arch Otolaryngol Head Neck Surg. 1994 May;120(5):560-4.

Magnetic resonance imaging-enhancing lesions of the labyrinth and facial nerve.
Clinical correlation.

Wilson DF, Talbot JM, Hodgson RS.

Portland (Ore) Ear Medical Group.

OBJECTIVE: Gadolinium-enhanced magnetic resonance imaging (MRI) is useful in
assessing inflammatory and neoplastic lesions of the labyrinth and facial nerve. 
The following cases demonstrate the ability of MRI to differentiate neoplastic
from inflammatory lesions within the labyrinth. PATIENTS OR OTHER PARTICIPANTS:
Nine patients were selected with enhancing lesions of the labyrinth and the
facial nerve identified on MRI. INTERVENTION: Acyclovir and prednisone were
prescribed for herpes zoster oticus; surgical removal of neoplastic lesions was
performed. MAIN OUTCOME MEASURE: The hypothesis was developed in the course of
clinical practice. No planned outcome was emphasized, as this article is based on
the differential diagnoses of the cases reported. RESULTS: Gadolinium-enhanced
MRI is useful in differentiating neoplastic from inflammatory lesions within the 
labyrinth. Axial and coronal 3-mm sections with gadolinium enhancement were
necessary for identifying these lesions and particularly for recognizing the
sharp enhancement of the neoplastic margin in contrast to the dull cloudy margins
of an inflammatory lesion. CONCLUSIONS: The MRI differentiation of these lesions 
is helpful in providing appropriate medical and surgical management of neoplastic
and inflammatory lesions of the labyrinth.

Publication Types: 
    Case Reports

PMID: 8172709 [PubMed - indexed for MEDLINE]

4871: J Virol. 1994 May;68(5):3317-23.

Deletion of the varicella-zoster virus large subunit of ribonucleotide reductase 
impairs growth of virus in vitro.

Heineman TC, Cohen JI.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

Cells infected with varicella-zoster virus (VZV) express a viral ribonucleotide
reductase which is distinct from that present in uninfected cells. VZV open
reading frames 18 and 19 (ORF18 and ORF19) are homologous to the herpes simplex
virus type 1 genes encoding the small and large subunits of ribonucleotide
reductase, respectively. We generated recombinant VZV by transfecting cultured
cells with four overlapping cosmid DNAs. To construct a virus lacking
ribonucleotide reductase, we deleted 97% of VZV ORF19 from one of the cosmids.
Transfection of this cosmid with the other parental cosmids yielded a VZV mutant 
with a 2.3-kbp deletion confirmed by Southern blot analysis. Virus-specific
ribonucleotide reductase activity was not detected in cells infected with VZV
lacking ORF19. Infection of melanoma cells with ORF19-deleted VZV resulted in
plaques smaller than those produced by infection with the parental VZV. The
mutant virus also exhibited a growth rate slightly slower than that of the
parental virus. Chemical inhibition of the VZV ribonucleotide reductase has been 
shown to potentiate the anti-VZV activity of acyclovir. Similarly, the
concentration of acyclovir required to inhibit plaque formation by 50% was
threefold lower for the VZV ribonucleotide reductase deletion mutants than for
parental virus. We conclude that the VZV ribonucleotide reductase large subunit
is not essential for virus infection in vitro; however, deletion of the gene
impairs the growth of VZV in cell culture and renders the virus more susceptible 
to inhibition by acyclovir.

PMID: 8151792 [PubMed - indexed for MEDLINE]

4872: J Virol. 1994 May;68(5):3267-82.

Identification of a dimerization domain in the C-terminal segment of the IE110
transactivator protein from herpes simplex virus.

Ciufo DM, Mullen MA, Hayward GS.

Department of Pharmacology and Molecular Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland 21205.

The 775-amino-acid IE110 (or ICP0) phosphoprotein of herpes simplex virus (HSV)
functions as an accessory transcription factor during the lytic cycle and plays a
critical role in reactivation from latent infection. By immunofluorescence
analysis, IE110 localizes in a novel pattern consisting of several dozen
spherical punctate granules in the nuclei of DNA-transfected cells. We
constructed a hybrid version of IE110 that contained an epitope-tagged domain
from the N terminus of the HSV IE175 protein and lacked the IE110 N-terminal
domain that confers punctate characteristics. This hybrid IE175(N)/IE110(C)
protein gave an irregular nuclear diffuse pattern on its own but was
redistributed very efficiently into spherical punctate granules after
cotransfection with the wild-type HSV-1 IE110 protein. Similar colocalization
interactions occurred with internally deleted forms of IE110 that lacked the zinc
finger region or large segments from the center of the protein, including both
cytoplasmic and elongated punctate forms, but C-terminal truncated versions of
IE110 did not interact. In all such interactions, the punctate phenotype was
dominant. Evidence that C-terminal segments of IE110 could also form stable
mixed-subunit oligomers in vitro was obtained by coimmunoprecipitation of in
vitro-translated IE110 polypeptides with different-size hemagglutinin
epitope-tagged forms of the protein. This occurred only when the two forms were
cotranslated, not when they were simply mixed together. An in vitro-synthesized
IE110 C-terminal polypeptide also gave immunoprecipitable homodimers and
heterodimers when two different-size forms were cross-linked with glutaraldehyde 
and reacted specifically with a bacterial glutathione S-transferase/IE110
C-terminal protein in far-Western blotting experiments. The use of various
N-terminal and C-terminal truncated forms of IE110 in the in vivo assays revealed
that the outer boundaries of the interaction domain mapped between codons 617 and
711, although inclusion of adjacent codons on either side increased the
efficiency severalfold in some assays. We conclude that the C-terminal region of 
IE110 contains a high-affinity self-interaction domain that leads to stable dimer
and higher-order complex formation both in DNA-transfected cells and in in vitro 
assays. This segment of IE110 is highly conserved between HSV-1 and HSV-2 and
appears to have the potential to play an important role in the interaction with
the IE175 protein, as well as in correct intracellular localization, but it is
not present in the equivalent proteins from varicella-zoster virus, pseudorabies 
virus, or equine abortion virus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8151788 [PubMed - indexed for MEDLINE]

4873: J Virol. 1994 May;68(5):3154-62.

Identification and zinc dependence of the bovine herpesvirus 1 transactivator
protein BICP0.

Fraefel C, Zeng J, Choffat Y, Engels M, Schwyzer M, Ackermann M.

Institute of Virology, Faculty of Veterinary Medicine, University of Zurich,
Switzerland.

Bovine herpesvirus 1 (BHV-1) specifies and unspliced early 2.6-kb RNA (ER2.6)
which is 3' coterminal with exon 2 of the 2.9-kb immediate-early (IE) RNA. The
two transcripts have a common open reading frame (676 codons). The predicted
protein, designated BHV-1 infected cell protein 0 (BICP0), contains a zinc finger
domain with homology to ICP0 of herpes simplex virus type 1 and protein 61 of
varicella-zoster virus, and depending on the promoter, it acts as a strong
activator or as a repressor in transient expression assays. In situ
immunoadsorbent assays using antisera against synthetic oligopeptides
demonstrated that BICP0 accumulates in nuclei of BHV-1-infected cells, as
expected for an IE gene product involved in gene regulation. Western blots
(immunoblots) revealed a BHV-1-specific 97-kDa protein which was detectable
during the IE phase and also at later periods of infection, indicating that the
kinetics of BICP0 synthesis is consistent with the switch from IER2.9 to ER2.6.
To confirm that ER2.6 encoded the 97-kDa BICP0 protein, a DNA fragment containing
BICP0-coding sequences was inserted into the Autographa californica baculovirus
genome. A recombinant protein, identified by its reactivity with antipeptide
sera, exhibited the same electrophoretic mobility as BICP0 specified by BHV-1. We
microinjected Xenopus oocytes with a BICP0 effector plasmid and a
promoter-chloramphenicol acetyltransferase plasmid. BICP0-induced stimulation of 
this promoter was strongly reduced when intracellular zinc was chelated by
thionein, indicating that the effect of BICP0 is zinc dependent.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8151780 [PubMed - indexed for MEDLINE]

4874: J Med Virol. 1994 May;43(1):91-6.

Seroprevalence of antibodies to human herpesviruses in England and Hong Kong.

Kangro HO, Osman HK, Lau YL, Heath RB, Yeung CY, Ng MH.

Department of Virology, St. Bartholomew's Hospital Medical College, West
Smithfield, London, England.

The age-related prevalence of antibodies to herpesviruses was compared in England
and Hong Kong. Altogether 327 sera from England and 266 sera from Hong Kong were 
tested for antibodies to herpes simplex virus (HSV), varicella-zoster virus
(VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpesvirus 6
(HHV-6). Herpesvirus infections were common in both countries but generally were 
acquired earlier and were more prevalent in Hong Kong. Over 90% of children in
Hong Kong were infected with VZV, EBV, and HHV-6 by 8 years of age. HSV and CMV
were the least prevalent childhood infections in both countries, although, 30-40%
of babies in Hong Kong became infected during the first year of life. CMV
infections were rare throughout childhood in the English cohort. Overcrowding and
early attendance at kindergarten may aid more efficient and earlier transmission 
of herpesvirus in Hong Kong. The high prevalence of CMV in particular may have
implications for the management of young pregnant women and organ transplant
recipients in Hong Kong.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8083655 [PubMed - indexed for MEDLINE]

4875: Clin Infect Dis. 1994 May;18(5):810-2.

Development of myelopathy before herpes zoster rash in a patient with AIDS.

Gomez-Tortosa E, Gadea I, Gegundez MI, Esteban A, Rabano J, Fernandez-Guerrero
ML, Soriano F.

Department of Neurology, Fundacion Jimenez Diaz, Madrid, Spain.

We describe the case of a patient with AIDS who developed progressive myelopathy 
due to varicella-zoster virus 2 months before the appearance of skin lesions
typical of herpes zoster. Varicella-zoster virus was isolated from his CSF.
Therapy with acyclovir failed to control his neurological complications despite
its in vitro efficacy against the isolates.

Publication Types: 
    Case Reports

PMID: 8075278 [PubMed - indexed for MEDLINE]

4876: Ann Pharmacother. 1994 May;28(5):585-7.

Acyclovir excretion in human breast milk.

Taddio A, Klein J, Koren G.

Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children,
Toronto, Ontario.

OBJECTIVE: To measure acyclovir concentrations in the breast milk of a lactating 
woman using the drug for herpes zoster while nursing her 7-month-old infant.
METHODS: The maternal dosage of acyclovir was 800 mg five times daily for seven
days. Three random breast milk samples collected on the fifth and sixth days of
therapy were analyzed for acyclovir concentrations with radioimmunoassay (RIA).
RESULTS: Acyclovir concentrations in breast milk ranged from 18.5 mumol (4.16
micrograms/mL) to 25.8 mumol (5.81 micrograms/mL). An estimate of the infant's
dosage ingested through nursing was 0.73 mg/kg/d, or approximately 1 percent of
the maternal dose in milligrams/kilograms/day. The baby was nursed without any
signs of adverse effects. CONCLUSIONS: Acyclovir was measured in clinically
insignificant concentrations in the milk of a woman receiving large dosages for
herpes zoster. Breast feeding continued without adverse effects to the nursing
infant.

Publication Types: 
    Case Reports

PMID: 8068994 [PubMed - indexed for MEDLINE]

4877: J Am Board Fam Pract. 1994 May-Jun;7(3):245-7.

Fatal Pasteurella septicemia associated with herpes zoster lesions.

Carr RJ, Gonzalez G, Lin T.

Department of Family Medicine, Georgetown University School of Medicine,
Washington, DC 20017.

Publication Types: 
    Case Reports

PMID: 8059630 [PubMed - indexed for MEDLINE]

4878: Klin Monatsbl Augenheilkd. 1994 May;204(5):440-9.

[Acute retinal necrosis syndrome. Lausanne cases, review of the literature and
new physiopathogenetic hypothesis]

[Article in French]

Rochat C, Herbort CP.

Hopital Jules Gonin, Service d'ophtalmologie, Universite de Lausanne.

PURPOSE: The purpose of this study was to analyse our ARN-patients, perform an
extensive review of the literature, suggest a physiopathogenic hypothesis for the
disease that should influence the therapeutical approach of these cases. PATIENTS
AND METHODS: From 1985 to 1993, 15 HIV-negative cases of ARN were seen in our
clinic. Eleven cases were analysed prospectively: the herpetic agent involved in 
each case was searched for by the determination of intraocular specific antibody 
production and a complete immunological work-up was performed. RESULTS: Our
collective included 4 cases of bilateral ARN (BARN). In 9 cases the clinical
presentation was that of a typical ARN, in 3 cases ARN was of the "mild-type" and
in 3 cases lesions were multifocal involving initially the posterior pole
resembling the clinical picture of PORN (progressive outer retinal necrosis). The
viral agent was varicella-zoster virus in 7 cases, herpes simplex virus in 3
cases, cytomegalovirus in 1 case and was not determined in 4 cases. In the 216
published cases a state of immunodepression was found in 15.7%. In our group with
systematic immunological work-up this rate was 46%. CONCLUSION: This is in
support of the thesis that an immune dysfunction is probably at the origin of
ARN. We therefore suggest to avoid to add systemic steroids to the specific
antiviral therapy but to treat inflammation by periocular steroids.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8051895 [PubMed - indexed for MEDLINE]

4879: J Can Dent Assoc. 1994 May;60(5):450-3.

Herpes zoster of the trigeminal nerve: the dentist's role in diagnosis and
management.

Millar EP, Troulis MJ.

Royal Victoria Hospital, Montreal, Quebec.

Herpes zoster is caused when the varicella/zoster virus that has remained latent 
since an earlier varicella infection is reactivated. During the prodromal stage, 
the only presenting symptom may be odontalgia, which may prove to be a diagnostic
challenge for the dentist. He or she may carry out emergency treatment that might
be irreversible or inappropriate, as well as delay appropriate treatment. With an
ever-increasing number of elderly and immunocompromised patients attending the
dentist, the dental profession can expect to encounter an increased number of
herpes zoster patients. The practising dentist must be familiar with the
presenting signs and symptoms of patients experiencing the prodromal
manifestations of herpes zoster of the trigeminal nerve.

Publication Types: 
    Case Reports

PMID: 8004523 [PubMed - indexed for MEDLINE]

4880: J Can Dent Assoc. 1994 May;60(5):439-40.

Dr. Helene Shingles: a life dedicated to geriatric dentistry.

Crawford PR.

Publication Types: 
    Biography
    Historical Article
    Portraits

Personal Name as Subject: 
    Shingles H

PMID: 8004521 [PubMed - indexed for MEDLINE]

4881: Med Microbiol Immunol. 1994 May;183(2):105-17.

Characterization and immunogenicity of a candidate subunit vaccine against
varicella-zoster virus.

Davies J, Hallworth JA, McLeish P, Randall S, Martin BA, Buchan A, Skinner GR.

Vaccine Research Foundation, Lapworth, Warwickshire, UK.

This study describes the properties of an inactivated subunit antigen preparation
from varicella-zoster virus (VZV)-infected MRC-5 cells by treatment with
detergent and formaldehyde, ultracentrifugation over sucrose and acetone
precipitation. The method preserved the antigenicity of VZV proteins and several 
VZV-specific glycoproteins, while virus DNA was less than 20 pg/250 micrograms
protein--a putative vaccine dose. The vaccine was immunogenic in rabbits and
stimulated antibodies to the major capsid protein as well as to glycoproteins; an
immunoprecipitin was shared with a known immune human serum. The preparation
contained no infectious VZV with no evidence of side effects in a rabbit or in
five human vaccinees during a follow-up period of 6-10 years.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 7935160 [PubMed - indexed for MEDLINE]

4882: Infection. 1994 May-Jun;22(3):216-8.

Severe pneumonia in pregnancy three months after resolution of cutaneous zoster.

Moling O, Mayr O, Gottardi H, Mian P, Zanon P, Oberkofler F, Gramegna M, Colucci 
G.

Sektion fur Infektionskrankheiten, Medizinische Abt. I, Allgemeines
Regionalkrankenhaus Bozen, Italy.

A 22 weeks pregnant women was affected by a life-threatening pneumonia and a
paresis of the proximal muscles with cerebrospinal fluid pleocytosis. Her past
medical history had been unremarkable except for recurrent episodes of
paraumbilical herpes zoster. The clinical findings suggested a dissemination of
varicella-zoster virus without skin lesions. Acyclovir was added to the therapy, 
and the clinical picture began to improve. Varicella-zoster virus DNA was
detected in placental tissue by DNA-hybridisation analysis.

Publication Types: 
    Case Reports

PMID: 7927822 [PubMed - indexed for MEDLINE]

4883: Clin Neurol Neurosurg. 1994 May;96(2):156-60.

Vasculitic, hypoxic-ischemic leukoencephalopathy.

Heye N, Terstegge K, Gosztonyi G.

Institute of Neuropathology and Radiological Clinic, Freie Universitat Berlin,
Germany.

The case of a 67-year-old woman with terminal renal insufficiency, who developed 
extensive encephalopathy with predominant involvement of the white matter is
reported. The encephalopathy was the consequence of preexisting hypertensive
alterations, acidosis, hypoxia, ischemia, bacteremia and varicella-zoster
meningoencephalitis. The vasculitic alterations associated with
meningoencephalitis had a major influence on the development and the extent of
the leukoencephalopathy.

Publication Types: 
    Case Reports

PMID: 7924081 [PubMed - indexed for MEDLINE]

4884: Fortschr Med. 1994 Apr 30;112(12):172-3.

[Current developments in antiviral chemotherapy. 3: Vidarabine, ganciclovir]

[Article in German]

Stamminger T, Fleckenstein B.

Institut fur Klinische und Molekulare Virologie, Universitat Erlangen-Nurnberg.

PMID: 8200604 [PubMed - indexed for MEDLINE]

4885: Fortschr Med. 1994 Apr 20;112(11):159-60.

[Current developments in antiviral chemotherapy. 2: Acyclovir]

[Article in German]

Stamminger T, Fleckenstein B.

Institut fur Klinische und Molekulare Virologie, Universitat Erlangen Nurnberg.

PMID: 8200599 [PubMed - indexed for MEDLINE]

4886: Am J Ophthalmol. 1994 Apr 15;117(4):536-8.

Varicella-zoster virus retinitis as the initial manifestation of the acquired
immunodeficiency syndrome.

Friedman SM, Margo CE, Connelly BL.

Publication Types: 
    Case Reports
    Letter

PMID: 8154542 [PubMed - indexed for MEDLINE]

4887: Am J Ophthalmol. 1994 Apr 15;117(4):480-7.

Vaccinia keratouveitis manifesting as a masquerade syndrome.

Lee SF, Buller R, Chansue E, Hanika WC, Brunt EM, Aquino T, Storch GA, Pepose JS.

Department of Ophthalmology and Visual Sciences, Washington University School of 
Medicine, St. Louis, Missouri 63110.

A patient who used contact lenses and had a history of blunt trauma developed
vaccinia keratouveitis after accidental ocular autoinoculation from a recent
vaccination site. Corneal and conjunctival cultures were taken for bacteria,
fungi, Acanthamoeba, and viruses. Viral-like cytopathic effects became evident in
tissue culture within three days. Immunofluorescence studies were negative for
varicella-zoster virus, herpes simplex virus, adenovirus, measles, mumps,
parainfluenza, and influenza. Pox viral particles were identified in the infected
tissue cultures by electron microscopy. The Hind III restriction endonuclease
profile of the viral DNA isolate was similar to the Lister strain of vaccinia
virus. Ocular vaccinia may manifest as a masquerade syndrome and may mimic signs 
of herpes simplex virus, varicella-zoster virus, and Acanthamoeba infection.
Although vaccination with vaccinia is currently limited to a few populations
throughout the world, vaccinia must still be considered in the differential
diagnosis of infectious keratouveitis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8154530 [PubMed - indexed for MEDLINE]

4888: Zhonghua Hu Li Za Zhi. 1994 Apr 5;29(4):212-3.

[Analysis and comparison of different methods in topical treatment of herpes
zoster]

[Article in Chinese]

Xu WP, Zheng W.

Publication Types: 
    Comparative Study

PMID: 7788775 [PubMed - indexed for MEDLINE]

4889: Cah O M. 1994 Apr-Jun;47(186):225-44.

[The impact of population growth on Tamba Kosi, a Himalayan valley in Nepal]

[Article in French]

Verliat S.

PIP: Two several-month-long stays in the isolated Tamba Kosi valley in Nepal in
1983 and 1986 allowed an assessment of the importance of changes in rural
societies. In about 50 years, the oldest inhabitants of some villages have seen
the number of houses quadruple. In the absence of reliable statistical data, the 
inhabitants say that the Tamba Kosi valley population has doubled in the last 25 
years. This population growth exacerbates the multiethnic fight for good land
(i.e., ground of modest slope, hot, and humid). Many people have emigrated, which
has somewhat eased problems relative to population growth. Soil degradation,
which is becoming more and more acute, drives the inhabitants to cut down trees
and clear the land for cultivation of new plots. These new plots are running up
against steep slopes and high altitude. Most families have barely two hectares,
which must suffice to feed 5-6 people on average. This fuels intensification of
agricultural production, resulting in low efficacy. Livestock mutilate forests
with their hooves and teeth. The marked increase in the variety of livestock
accelerates this destruction. Three types of building materials are used in this 
high valley: thatch, shingles (fir tree), and bamboo matting. The disappearance
of wild grasses used to make thatch roofs and people moving to higher and higher 
altitudes resulted in use of shingles to make roofs. Buildings made of shingles, 
which demanded changes in construction techniques, changed the conception of
homes. They became the preferred building type, which increased the demand for
fir trees and deforestation. This lead to a demand for roofing material made of
bamboo matting and another change in construction techniques. The retreat of the 
forest and disappearance of the most wanted plant species are the most
spectacular impacts of population growth. This environmental degradation
exacerbates erosion at all bioclimatic altitudes.

Publication Types: 
    English Abstract

PMID: 12319796 [PubMed - indexed for MEDLINE]

4890: Ann Rheum Dis. 1994 Apr;53(4):224-8.

Comment in:
    Ann Rheum Dis. 1995 Feb;54(2):155.

Infection rate and use of antibiotics in patients with rheumatoid arthritis
treated with methotrexate.

van der Veen MJ, van der Heide A, Kruize AA, Bijlsma JW.

Department of Rheumatology, University Hospital Utrecht, The Netherlands.

OBJECTIVE--To investigate prospectively the frequency and type of infections and 
the use of antibiotics among patients with rheumatoid arthritis (RA) on
methotrexate (MTX) and patients with RA without MTX. METHODS--Every three months 
for one year 77 patients on MTX and 151 patients without MTX were asked about
infections and the use of antibiotics by means of a standardised questionnaire.
Medication was checked with the pharmacist. RESULTS--In the MTX group there were 
significantly more infections and more antibiotic therapy. The relative risks for
patients on MTX of infection or antibiotics use were 1.52 (95% Confidence
Interval (CI) 1.04-2.22) and 1.49 (95% CI 1.04-2.13), respectively. The relative 
risk of MTX for respiratory tract infections was 1.43 (95% CI 0.96-2.14) and for 
skin infections 2.19 (95% CI 1.45-3.31). The increased risks could only partly be
explained by differences in disease severity and were not related to either
duration of MTX therapy or use of prednisone. Three patients in the MTX group had
herpes zoster versus one in the control group. CONCLUSIONS--Treatment with MTX
increases the rate of infection and thus the use of antibiotics but does not lead
to serious complications necessitating discontinuation of the drug.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8203949 [PubMed - indexed for MEDLINE]

4891: Union Med Can. 1994 Apr;123(4):221-4.

[What use is made of acyclovir in immunocompetent patients?]

[Article in French]

Pineau MC.

l'Hopital Royal-Victoria.

PMID: 8203043 [PubMed - indexed for MEDLINE]

4892: Internist (Berl). 1994 Apr;35(4):392-4.

[Recurrent burning pain, erythema, cutaneous edema and hyperthermia of both lower
legs after herpes zoster thoracalis]

[Article in German]

Jabs HU, Druke P.

Innere Abteilung, St. Vincenz Hospital Coesfeld.

Publication Types: 
    Case Reports

PMID: 8200764 [PubMed - indexed for MEDLINE]

4893: Harefuah. 1994 Apr 1;126(7):380-3, 426.

[Herpes zoster treated with acyclovir]

[Article in Hebrew]

Grempel H, Rozenman D, Zuckerman F.

Dermatology Dept., Central Emek Hospital, Afula.

During the past 5 years, 99 patients with herpes zoster were hospitalized and
followed. Age, sex, localization of rash, complications, duration of
hospitalization and treatment were analyzed. Most patients were in their 6th and 
7th decades. Cranial nerve involvement was frequent (35%). A generalized rash was
more common in those with immunodeficiency. Acyclovir (Zovirax) inhibited to some
extent the spreading of the rash and reduced the frequency of herpetic neuralgia.
Our findings are in accord with those in the literature.

Publication Types: 
    English Abstract

PMID: 8200584 [PubMed - indexed for MEDLINE]

4894: Neurology. 1994 Apr;44(4):773-4.

Absence of auricular lesions in Ramsay Hunt syndrome.

Shapiro BE, Slattery M, Pessin MS.

Department of Neurology, Tufts University School of Medicine, New England Medical
Center, Boston, MA.

Publication Types: 
    Case Reports

PMID: 8164846 [PubMed - indexed for MEDLINE]

4895: Ophthalmology. 1994 Apr;101(4):728-35.

Evaluation of laser flare-cell photometry in the appraisal and management of
intraocular inflammation in uveitis.

Guex-Crosier Y, Pittet N, Herbort CP.

Department of Ophthalmology, Hopital Jules Gonin, University of Lausanne,
Switzerland.

BACKGROUND: Laser flare-cell photometry enables objective and quantitative
measurement of anterior chamber inflammation. Systematic data currently are used 
mainly for clinical research; few are yet available in uveitis. The authors
prospectively studied the amount, duration, and pattern of inflammation for
well-defined uveitic conditions and evaluated the potential usefulness of laser
flare-cell photometry in uveitis. METHODS: Mean initial flare was calculated in
HLA-B27-positive acute anterior uveitis, acute herpes zoster uveitis, acute
retinal necrosis (ARN), Fuchs heterochromic cyclitis, intermediate uveitis (pars 
planitis-type), posterior sarcoidosis, posterior pole toxoplasmosis, and birdshot
chorioretinopathy. Evolution of aqueous flare and cells was analyzed for acute
anterior uveitis, ARN, and pars planitis treated for cystoid macular edema (CME),
all of which received a standardized therapy. RESULTS: Blood-aqueous barrier
disruption was very pronounced in acute anterior uveitis (170.2 +/- 33
photons/msecond), ARN (177.4 +/- 88 photons/msecond), moderate in posterior
sarcoidosis (38.1 +/- 11 photons/msecond), acute zoster uveitis (25.8 +/- 6.1
photons/msecond), and pars planitis (19.1 +/- 2.9 photons/msecond) but only
minimal in Fuchs heterochromic cyclitis (10.2 +/- 3.5 photons/msecond),
toxoplasmosis (9.0 +/- 1.2 photons/msecond) and birdshot chorioretinopathy (5.7
+/- 1.1 photons/msecond). For acute anterior uveitis, ARN, and pars planitis with
CME, the inflammatory patterns were determined. The potential of laser flare-cell
photometry for precise follow-up and adjustment of therapy was illustrated in
cases of anterior and posterior uveitis. CONCLUSION: The authors' findings show
that laser flare-cell photometry allows quantitative assessment of inflammation
in uveitis and contributes to improved management of patients with uveitis.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 8152769 [PubMed - indexed for MEDLINE]

4896: J Virol. 1994 Apr;68(4):2468-77.

Varicella-zoster virus open reading frame 4 encodes a transcriptional activator
that is functionally distinct from that of herpes simplex virus homology ICP27.

Perera LP, Kaushal S, Kinchington PR, Mosca JD, Hayward GS, Straus SE.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

Varicella-zoster virus is the etiological agent of chickenpox and zoster in
humans and belongs to the Alphaherpesvirinae subfamily within the family
Herpesviridae. Much of the current understanding of gene regulation in
alphaherpesviruses has been derived from studies of the prototype herpes simplex 
virus (HSV). In HSV, two virus-encoded, trans-regulatory proteins, ICP4 and
ICP27, are essential for the replicative cycle of the virus. ICP4 is important in
modulating HSV genes of all three kinetic classes, whereas the trans-regulatory
effects of ICP27 are primarily associated with the expression of late genes.
Recent evidence indicates that the trans-regulatory effects of ICP27 involve
posttranscriptional processing of target gene transcripts (R. M. Sandri-Golding
and G. E. Mendoza, Genes Dev. 6:848-863, 1992). The ICP27 homolog in
varicella-zoster virus is a 452-amino-acid polypeptide encoded by the open
reading frame 4 (ORF4) gene. Contrary to what is found with ICP27, we show that
the ORF4 polypeptide is a transcriptional activator of diverse target promoters
and has a critical requirement for the presence of upstream elements within these
promoters to mediate its transcriptional effects. Evidence is also presented to
implicate a critical role for the cysteine-rich, C-terminal region of the ORF4
polypeptide in its trans-regulatory functions. Specifically, by
oligonucleotide-directed site-specific mutagenesis, we demonstrate that of 10
cysteine residues in the ORF4 polypeptide, only C-421 and C-426 are essential for
transactivator function and suggest that these cysteine residues may participate 
in critical protein-protein interactions rather than protein-nucleic acid
interactions to mediate ORF4 inducibility.

Publication Types: 
    Comparative Study

PMID: 8139031 [PubMed - indexed for MEDLINE]

4897: Virology. 1994 Apr;200(1):297-300.

Varicella-zoster virus (VZV) virion-associated transactivator open reading frame 
62 protein enhances the infectivity of VZV DNA.

Moriuchi M, Moriuchi H, Straus SE, Cohen JI.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, Bethesda, Maryland 20892.

Varicella-zoster virus (VZV) open reading frame (ORF) 62 protein (the homolog of 
herpes simplex virus type 1 (HSV-1) ICP4) and ORF10 protein (the homolog of HSV-1
VP16) are virion-associated transactivators. To investigate whether these
proteins function during the initial stages of VZV infection, human melanoma
cells were cotransfected with purified VZV DNA, devoid of any structural
proteins, along with a plasmid expressing VZV ORF62 or ORF10 under the control of
the human cytomegalovirus major immediate-early promoter. Expression of ORF62
enhanced the infectivity of VZV DNA up to 70-fold. In contrast, expression of
ORF10 enhanced the infectivity of VZV DNA only threefold. These results show that
high-level expression of ORF62 protein increases the probability that transfected
VZV DNA will result in productive infection, suggesting that this
virion-associated transactivator (ORF62) has a critical role in initiating
infection.

Publication Types: 
    Comparative Study

PMID: 8128631 [PubMed - indexed for MEDLINE]

4898: J Med Virol. 1994 Apr;42(4):338-47.

Meningoradiculoneuritis due to acyclovir-resistant varicella zoster virus in an
acquired immune deficiency syndrome patient.

Snoeck R, Gerard M, Sadzot-Delvaux C, Andrei G, Balzarini J, Reymen D, Ahadi N,
De Bruyn JM, Piette J, Rentier B, et al.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

Varicella zoster virus (VZV) is recognized as one of the major viral pathogens
reactivated in patients with the acquired immune deficiency syndrome (AIDS). We
report the case of meningoradiculoneuritis in an AIDS patient,associated with the
isolation in the cerebrospinal fluid (CSF) of a thymidine kinase (TK)-deficient, 
acyclovir (ACV)-resistant strain of VZV. Although the virus was sensitive in
vitro to phosphonoformate (PFA), the patient did not improve during PFA therapy
and finally died. Several VZV strains isolated from this patient (including two
isolates from the patient's CSF) were analyzed for their TK activity and
subsequently the viral TK gene was sequenced showing a major deletion leading to 
a truncated protein. Their susceptibility to several antiviral agents including
ACV, PFA, (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU),
9-beta-D-arabinofuranosyladenine (vidarabine),
(S)-1-(3-hydroxy-2-phosphonylmethoxypropyl) cytosine (HPMPC), and
(S)-9-(3-hydroxy-2-phosphonyl-methoxypropyl)adenine (HPMPA) was evaluated. All
the virus strains isolated from this patient remained sensitive to HPMPA and
HPMPC, pointing to the potential usefulness of these acyclic nucleoside
phosphonates for the treatment of ACV-resistant VZV infections in
immunocompromised patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8046424 [PubMed - indexed for MEDLINE]

4899: An Med Interna. 1994 Apr;11(4):203.

[Vesiculo-papular lesions and peripheral facial paralysis. Ramsay-Hunt syndrome]

[Article in Spanish]

Lanzas G, Ruiz de Ocenda M, Pardo I, Abu-Shams J, Tiberio G.

Publication Types: 
    Case Reports
    Letter

PMID: 8043745 [PubMed - indexed for MEDLINE]

4900: Antiviral Res. 1994 Apr;23(3-4):203-18.

Cyclocreatine (1-carboxymethyl-2-iminoimidazolidine) inhibits the replication of 
human herpes viruses.

Lillie JW, Smee DF, Huffman JH, Hansen LJ, Sidwell RW, Kaddurah-Daouk R.

AMIRA, Inc., Cambridge, MA 02142.

The creatine kinase/creatine phosphate (CK/CrP) system plays an important role in
cellular energy homeostasis. CK isoenzymes, which reversibly generate ATP from
CrP, are compartmentalized at cellular sites where energy is produced or
utilized. It has been noted that the expression of CK is induced in cells
infected by several DNA viruses, implicating a role for cellular energy
modulation as an important step for efficient viral replication. A CK substrate
analog, 1-carboxymethyl-2-iminoimidazolidine (cyclocreatine; CCr), was tested in 
vitro for antiviral activity against a variety of herpes viruses and RNA viruses.
Several members of the human herpes virus family were found to be sensitive to
CCr, including herpes simplex types 1 and 2 (HSV-1 and HSV-2). varicella-zoster
virus, and cytomegalovirus. When administered to mice infected vaginally with
HSV-2, CCr significantly reduced mortality, reduced vaginal lesion scores, and
lowered the titers of recoverable virus. This treatment combined with acyclovir
appeared to enhance the antiviral effects of acyclovir. In a second model, mice
infected intraperitoneally with HSV-2 and treated with CCr showed a significant
increase in survival compared to placebo. We conclude that CCr is the first
example of a new class of antiviral compounds that target the CK/CrP system.

PMID: 8042860 [PubMed - indexed for MEDLINE]

4901: Ann Pharmacother. 1994 Apr;28(4):460-3.

Acute renal failure and neurotoxicity following oral acyclovir.

Johnson GL, Limon L, Trikha G, Wall H.

Department of Pharmacy Services, Medical College of Virginia Hospitals, Richmond.

OBJECTIVE: To report a case of acute renal failure and neurotoxicity following
administration of oral acyclovir. DATA SOURCES: Medical record of the patient,
case reports identified by MEDLINE. DATA EXTRACTION: Data were abstracted from
relevant published data by Johnson and reviewed by the remaining authors. CASE
SUMMARY: A 69-year-old woman was diagnosed with herpes zoster and oral acyclovir 
was prescribed by her local physician. After approximately two days the patient
was taken to the emergency department of a local hospital with signs of acute
confusion and acute renal failure. Medications included oxycodone/acetaminophen, 
alprazolam, prazepam, and digoxin. Pertinent laboratory abnormalities included
serum digoxin 4.1 mumol/L, white blood cell count 17.6 x 10(9)/L, blood urea
nitrogen (BUN) 24 mmol/L of urea, and serum creatinine 305 mumol/L (patient
baseline is 11 mmol/L of urea and 91.5 serum creatinine mumol/L, respectively).
Because of increasing lethargy and a focal seizure, she was transferred to our
institution. Despite an extensive workup, no organic cause of her altered mental 
status and acute renal failure was identified. Four days after discontinuation of
the acyclovir, without specific intervention, the patient's mental status
improved and her BUN and serum creatinine concentrations had decreased to 21
mmol/L of urea and 190.6 mumol/L, respectively. On day 5, the patient was alert
and oriented to name, place, year, and month. On day 9, her renal function and
mental status had returned to baseline and she was discharged. CONCLUSIONS: Acute
renal failure and neurotoxicity are usually associated with intravenous
acyclovir. The temporal relationship between the initiation of oral acyclovir
therapy and the onset of adverse events, supported by published data of a few
similar cases, strongly implicate oral acyclovir as the cause of this patient's
acute renal failure and neurotoxicity. This case suggests that elderly patients
with mild increased serum creatinine concentrations may be at increased risk and 
should be monitored closely for signs and symptoms of acute renal failure and
neurotoxicity.

Publication Types: 
    Case Reports

PMID: 8038467 [PubMed - indexed for MEDLINE]

4902: Anesthesiology. 1994 Apr;80(4):950-2.

Comment in:
    Anesthesiology. 1994 Sep;81(3):785.

Repeated stellate ganglion blockade using a catheter for pediatric herpes zoster 
ophthalmicus.

Elias M, Chakerian MU.

Department of Anesthesiology, University of California, San Diego Medical Center 
92103-8812.

Publication Types: 
    Case Reports

PMID: 8024151 [PubMed - indexed for MEDLINE]

4903: Klin Monatsbl Augenheilkd. 1994 Apr;204(4):235-40.

[Bilateral acute retinal artery necrosis--healing of the second affected eye]

[Article in German]

Kalman A, Vogt M, Bernasconi E, Gloor B.

Augenklinik, Universitatsspitales Zurich.

BACKGROUND: The acute retinal necrosis syndrome (ARN) is caused by the Varicella 
zoster virus or the Herpes simplex virus. However the dosage and duration of the 
antiviral therapy for prevention of an infection in the second eye or treatment
of an infection on an affected fellow eye is still not known. We discuss the
timing of a possible steroid treatment and demonstrate in a case report how an
acute retinal necrosis syndrome in a fellow eye was successfully treated.
PATIENT: First eye: A 27-year-old not immunocompromised patient (HIV-negative)
showed 2 months after a febrile state an acute iritis in the right eye. 14 days
later an acute retinal necrosis syndrome was observed. The patient received
Acyclovir 3 x 750 mg i.v. for 6 days, and afterwards 5 x 200 mg orally for 5
days. The patient developed an inoperable retinal detachment despite therapy.
Second eye: Eight days later the fellow eye developed a localized retinal
necrosis. Varicella zoster DNA was found in the aqueous humor using the
polymerase chain reaction (PCR). The antiviral therapy with Acyclovir was
increased from 1.1 g q 12 h (2 x 15 mg/kg/d) to 1.0 g q 8 h (3 x 12.5 mg/kg/d).
After 4 weeks the i.v. therapy was followed by an oral therapy of 5 x 800 mg for 
12 weeks. This dosage was reduced to 5 x 400 mg for another 12 weeks. The oral
therapy with corticosteroids started on the 11th day with 100 mg Prednisone, in
slowly reducing dosage during 18 weeks. The fellow eye recovered fully with a
visual acuity of 20/20 after 6 months. CONCLUSION: The disease started in the
fellow eye with an acute iritis and a secondary glaucoma. These symptoms can be a
characteristic prodroma of an acute retinal necrosis syndrome caused by a
varicella zoster- or Herpes simplex virus infection, which was not recognized
first. Whether a long-term therapy (as described above) is necessary or not is
unclear on the basis of a single case report, but we currently recommend the
high-dose treatment regimen until further data emerge.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8022154 [PubMed - indexed for MEDLINE]

4904: Int J Dermatol. 1994 Apr;33(4):268-9.

Granulomatous vasculitis in herpes zoster scars.

Baalbaki SA, Malak JA, al-Khars MA, Natarajan S.

Dermatology Service, Saudi Aramco-Dhahran Health Center, Saudi Aramco Medical
Services Organization, Dhahran, Saudi Arabia.

Publication Types: 
    Case Reports

PMID: 8021084 [PubMed - indexed for MEDLINE]

4905: Int J Dermatol. 1994 Apr;33(4):227-32.

Pathophysiology and clinical manifestations of varicella zoster virus infections.

Rockley PF, Tyring SK.

Department of Dermatology, University of Texas Medical Branch, Galveston
77555-0783.

Publication Types: 
    Review

PMID: 8021075 [PubMed - indexed for MEDLINE]

4906: J Pediatr Surg. 1994 Apr;29(4):514-7.

Infectious complications in living related liver transplantation.

Uemoto S, Tanaka K, Fujita S, Sano K, Shirahase I, Kato H, Yamamoto E, Inomata Y,
Ozawa K.

Second Department of Surgery, Faculty of Medicine, Kyoto University, Japan.

During the last 31 months, 50 children between 3 months and 15 years of age have 
undergone living related liver transplantation (LRLT) for end-stage liver
diseases (39 biliary atresia, 2 Budd-Chiari syndrome, 2 progressive intrahepatic 
cholestasis, 3 liver cirrhosis, 1 Wilson disease, 1 protoporphyria, 1
tyrosinemia, and 1 fulminant hepatitis). Combined FK-506 and low-dose steroids
were routinely used for immunosuppression. There were seven deaths, two of which 
were related to infection (Candida pneumonia and Epstein-Barr virus
[EBV]-associated lymphoproliferative syndrome [LPS]). Five patients had a
bacterial infection, all of which were associated with surgical complications.
Three patients had Candida infection, all of which were malnourished, had biliary
atresia, and had been managed with prolonged antibiotics against obstinate
ascending cholangitis. There were 14 symptomatic viral infections (1 herpes
simplex virus, 1 herpes zoster virus, 5 cytomegalovirus [CMV], 6 EBV, and 1
EBV-associated LPS). Three of the five CMV infections appeared in patients whose 
graft was ABO-incompatible, who were managed with prophylactic OKT-3. Most of the
viral infections (except 1 EBV-associated LPS) were minor and were treated
successfully. The low incidence and successful treatment of CMV infection are
related to the high compatibility and low incidence of allograft rejection in
LRLT. Bacterial and fungal infections can be decreased by greater refinement of
surgical technique and more aggressive preoperative management. Treatment of EBV 
infection is still an unsolved problem.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8014805 [PubMed - indexed for MEDLINE]

4907: Transfus Med Rev. 1994 Apr;8(2):96-116.

The risk of varicella-zoster infections in different patient populations: a
critical review.

Rusthoven JJ.

Department of Medical Oncology, Ontario Cancer Treatment and Research Foundation,
Hamilton Regional Cancer Centre, Canada.

Publication Types: 
    Review

PMID: 8003859 [PubMed - indexed for MEDLINE]

4908: N Engl J Med. 1994 Mar 31;330(13):932-4.

Comment on:
    N Engl J Med. 1994 Mar 31;330(13):896-900.

Herpes zoster with postherpetic neuralgia--persisting pain and frustration.

Gilden DH.

Publication Types: 
    Comment
    Editorial

PMID: 8114868 [PubMed - indexed for MEDLINE]

4909: N Engl J Med. 1994 Mar 31;330(13):906.

Comment in:
    N Engl J Med. 1994 Aug 18;331(7):481-2.

Images in clinical medicine. Herpes zoster.

Rosencrance G.

West Virginia University Health Sciences Center, Charleston 25304.

Publication Types: 
    Case Reports

PMID: 8114862 [PubMed - indexed for MEDLINE]

4910: N Engl J Med. 1994 Mar 31;330(13):896-900.

Comment in:
    N Engl J Med. 1994 Aug 18;331(7):481.    N Engl J Med. 1994 Aug 18;331(7):481.    N Engl J Med. 1994 Mar 31;330(13):932-4.

A randomized trial of acyclovir for 7 days or 21 days with and without
prednisolone for treatment of acute herpes zoster.

Wood MJ, Johnson RW, McKendrick MW, Taylor J, Mandal BK, Crooks J.

Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital,
United Kingdom.

BACKGROUND. Acyclovir given for 7 to 10 days is of proved benefit in acute herpes
zoster, but studies of its effectiveness in preventing postherpetic neuralgia
have had conflicting results. The role of corticosteroids in the treatment of
herpes zoster is also controversial. METHODS. We conducted a double-blind,
controlled trial in patients with acute herpes zoster to determine whether either
21 days of acyclovir therapy or the addition of prednisolone offered any
improvement over 7 days of acyclovir therapy. Patients with a rash of less than
72 hours' duration were assigned to receive acyclovir (800 mg orally, five times 
daily) for 7 days with either prednisolone or placebo, or acyclovir for 21 days
with either prednisolone or placebo. Prednisolone therapy was initiated at a dose
of 40 mg per day and tapered over a three-week period. Patients were assessed
frequently through day 28 and then monthly through month 6 to assess postherpetic
neuralgia. RESULTS. Of 400 patients recruited, 349 completed the study. No
significant differences were detected between the four groups in the progression 
of the rash (P > 0.1). With steroid therapy, a significantly higher proportion of
the rash area had healed on days 7 and 14 (P = 0.02). Pain reduction was greater 
during the acute phase of disease in patients treated with steroids or 21 days of
acyclovir (P < 0.01 and P = 0.02, respectively, on day 7; P < 0.01 for steroid
therapy on day 14). However, on follow-up there were no significant differences
between any of the groups in the time to a first or a complete cessation of pain.
The steroid recipients reported more adverse events. CONCLUSIONS. In acute herpes
zoster, treatment with acyclovir for 21 days or the addition of prednisolone to
acyclovir therapy confers only slight benefits over standard 7-day treatment with
acyclovir. Neither additional treatment reduces the frequency of postherpetic
neuralgia.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 8114860 [PubMed - indexed for MEDLINE]

4911: Nucleic Acids Res. 1994 Mar 11;22(5):711-21.

The DNA binding domains of the varicella-zoster virus gene 62 and herpes simplex 
virus type 1 ICP4 transactivator proteins heterodimerize and bind to DNA.

Tyler JK, Everett RD.

MRC Virology Unit, Glasgow, UK.

The product of varicella-zoster virus gene 62 (VZV 140k) is the functional
counterpart of the major transcriptional regulatory protein of herpes simplex
virus type 1 (HSV-1), ICP4. We have found that the purified bacterially expressed
DNA binding domain of VZV 140k (residues 417-647) is a stable dimer in solution. 
As demonstrated by the appearance of a novel protein--DNA complex of intermediate
mobility in gel retardation assays, following in vitro co-translation of a pair
of differently sized VZV 140k DNA binding domain peptides, the 140k DNA binding
domain peptide binds to DNA as a dimer. In addition, the DNA binding domain
peptide of HSV-1 ICP4 readily heterodimerizes with the VZV 140k peptide on
co-translation, indicating that HSV-1 ICP4 and VZV 140k possess very similar
dimerization interfaces. It appears that only one fully wild type subunit of the 
dimer is sufficient to mediate sequence specific DNA recognition in certain
circumstances. Co-immunoprecipitation analysis of mutant DNA binding domain
peptides, co-translated with an epitope-tagged ICP4 DNA binding domain, shows
that the sequence requirements for dimerization are lower than those necessary
for DNA binding.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8139909 [PubMed - indexed for MEDLINE]

4912: Med J Aust. 1994 Mar 7;160(5):247-50.

Australia's first case of AIDS? Pneumocystis carinii pneumonia and HIV in 1981.

Gerrard JG, McGahan SL, Milliken JS, Mathys JM, Wills EJ.

Royal Prince Alfred Hospital, Camperdown, NSW.

OBJECTIVE: To present the earliest Australian case of the acquired
immunodeficiency syndrome (AIDS) reported to date. CLINICAL FEATURES: A
72-year-old man developed a prolonged illness, beginning in February 1981,
characterised by anorexia, malaise, weight loss and an episode of herpes zoster. 
In July he noted the insidious onset of dyspnoea with a productive cough. He was 
admitted to hospital in August, where Pneumocystis carinii pneumonia was
diagnosed from a transbronchial lung biopsy. Splenomegaly and generalised
lymphadenopathy were noted but a scalene lymph node biopsy examined at that time 
failed to establish an underlying diagnosis. The patient was single and lived
alone in an inner suburb of Sydney. He had never left Australia and had never
received a blood transfusion. His sexual history is not recorded, nor is there
any documented history of intravenous drug use. OUTCOME: The patient died in
September 1981. Recent re-examination of the preserved lymph node specimen by
means of an in-situ hybridisation method detected human immunodeficiency virus
(HIV). Preserved prostatic tissue from a resection performed in January 1980 on
the same patient was also found to be HIV positive. CONCLUSION: AIDS existed in
Australia as early as July 1981, around the time of the publication of the first 
American case reports. Whether this represents an isolated case in a man who
progressed rapidly because of his relatively advanced age, or whether HIV was
present earlier in Australia than previously thought, remains unanswered.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 8107624 [PubMed - indexed for MEDLINE]

4913: Schmerz. 1994 Mar;8(1):24-36.

[Pain therapy in herpes zoster and post-zoster neuralgia.]

[Article in German]

Zenz T, Zenz M, Tryba M.

Universitatsklinik fur Anasthesiologie, Intensiv- und Schmerztherapie,
BG-Kliniken Bergmannsheil, Gilsingstra?e 14, D-44789, Bochum.

Herpes zoster neuralgia and post-zoster neuralgia (PZN) are common disabling pain
syndromes. While pain from acute herpes zoster is self-limited in most cases, as 
pain may disappear without treatment, post-zoster neuralgia is difficult to
manage. Pathological findings in acute herpes zoster include infiltration of
ganglia, demyelinization and loss of axons; yet the pathogenesis of pain remains 
largely unknown. In postzoster (often incorrectly called post-herpetic)
neuralgia, peripheral and central origins are mentioned for the development of
pain: selective loss of myelin-sheathed nerve fibres, sensitization of peripheral
nociceptors, cross-talk between afferents and sympathetic efferents,
deafferentation with somatotopic remodeling, virus-induced spontaneous activity, 
and nociceptive nervi nervorum. Pain shows no sex-specific differences, but there
is a clear predominance in elderly patients over 60 years of age. In these
patients aggressive therapy should be instituted. Numerous pharmacological,
anesthetic and surgical approaches have been proposed for the treatment of pain
in herpes zoster. Most approaches have been studied in uncontrolled settings.
Treatment is most effective when installed early in the course of the disease.
For acute zoster pain, treatment with acyclovir, glucocorticosteroids and
sympathetic blocks reveal the best results. PZN of less than 3 months' duration
should be treated with sympathetic blocks. Long-standing PZN resolves in
two-thirds of the cases when treated with tricyclic antidepressants. TENS may be 
tried concomitantly. Topical ASA and capsaicin show promising effects and should 
be the object of further investigation. The same is true for specific zoster
hyperimmunoglobulins and non-specific immunoglobulins; however, there are no
definite results. In the future, controlled, double-blind studies on the effect
of therapeutic measures in preventing postzosteric neuralgia need to be
conducted. So far, the positive effect of sympathetic blocks in preventing the
late pain complications of herpes zoster can only be suggested and recommended
based on subjective experience.

PMID: 18415452 [PubMed - as supplied by publisher]

4914: Bone Marrow Transplant. 1994 Mar;13(3):277-83.

Varicella zoster infection after bone marrow transplantation: incidence, risk
factors and complications.

Han CS, Miller W, Haake R, Weisdorf D.

Department of Medicine, University of Minnesota, Minneapolis.

The cellular immunoincompetence which follows bone marrow transplantation (BMT)
allows both primary and reactivation infection with herpes viruses. We report the
overall incidence and timing of varicella zoster virus (VZV) infections after
BMT, including the clinical course, complications and associated clinical risk
features. Of 1186 patients undergoing BMT through 1989, 216 patients developed
VZV infection between 4 days and 10.8 years after BMT; 86% of them within the
first 18 months. Of all patients transplanted, 15 +/- 3% by 6 months and 52 +/-
14% by 5 years had developed VZV infection. Dermatomal zoster represented 62% of 
the infections, while 32% had complicated VZV infection--CNS, disseminated or
visceral zoster. All serious infections occurred within 7 months of BMT but only 
two patients died, both from VZV pneumonitis. Allogeneic and autologous
recipients had a similar incidence of VZV infection. VZV seropositive patients
had more frequent, earlier and often more complicated or disseminated infections.
Age > or = 10 years and radiation in the pre-transplant conditioning were
significantly and independently associated with higher rates of VZV infection
within a multivariate regression model. Using this model, we could define
clinical risk groups with distinctly different hazards of VZV infection: age > 10
years, radiation pre-BMT and VZV seropositive patients had a 44% incidence by 3
years versus age < 10 years, no radiation and VZV seronegative had a 0% incidence
by 3 years. Acyclovir assigned for prophylaxis of CMV or HSV infection had no
effect on the timing or incidence of VZV infection.(ABSTRACT TRUNCATED AT 250
WORDS)

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8199570 [PubMed - indexed for MEDLINE]

4915: AJNR Am J Neuroradiol. 1994 Mar;15(3):479-85.

Idiopathic, herpetic, and HIV-associated facial nerve palsies: abnormal MR
enhancement patterns.

Sartoretti-Schefer S, Wichmann W, Valavanis A.

Department of Neuroradiology, University Hospital of Zurich, Switzerland.

PURPOSE: To determine specific criteria that can be used to define normal versus 
abnormal MR contrast enhancement of the facial nerve. METHODS: Twenty-three
patients with acute unilateral inflammatory peripheral facial nerve palsy were
examined on a 1.5-T MR using multiplanar T1-weighted spin-echo sequences before
and after injection of gadopentetate dimeglumine. These MR patterns were compared
with those of healthy control subjects. RESULTS: The normal facial nerve usually 
showed a mild to moderate enhancement of the geniculate ganglion and the
tympanic-mastoid segment. The intracanalicular-labyrinthine segment did not
enhance. All patients showed abnormal enhancement of the distal intracanalicular 
and the labyrinthine segment. An intense enhancement could be observed in the
geniculate ganglion and the proximal tympanic segment, especially in herpetic
palsy. Associated enhancement of the vestibulocochlear nerve was seen in herpetic
and idiopathic palsy. Enhancement of the inner ear structures was detected only
in herpetic palsy. CONCLUSIONS: Abnormal contrast enhancement of the distal
intracanalicular and the labyrinthine facial nerve segment is observed in all
patients and is the only diagnostically reliable MR feature proving an
inflammatory facial nerve lesion. The intense enhancement of the geniculate
ganglion and the proximal tympanic segment is possibly correlated with the
reactivation of the latent infection in the sensory ganglion. The abnormal
enhancement results from breakdown of the blood-peripheral nerve barrier and/or
from venous congestion in the venous plexuses of the epi- and perineurium.

PMID: 8197944 [PubMed - indexed for MEDLINE]

4916: Electromyogr Clin Neurophysiol. 1994 Mar;34(2):125-8.

An electromyographic evaluation of motor complications in thoracic herpes zoster.

Cioni R, Giannini F, Passero S, Paradiso C, Rossi S, Fimiani M, Battistini N.

Institute for Nervous and Mental Diseases, University of Siena, Italy.

Motor complications in thoracic herpes zoster were evaluated in 52 patients by
electromyographic examination of the paraspinal muscles. At the initial EMG
examination, abnormal findings were observed in 18 patients (35%). In 8 patients 
the myomers involved coincided in location with affected dermatomes, while in 10 
patients, in addition to the involvement of myomers corresponding to affected
dermatomes, there also appeared an involvement of one or more contiguous myomers 
not corresponding to affected dermatomes. Our study demonstrated that motor
involvement in thoracic HZ is much more common than previously suggested and its 
incidence (35%) appears to be greater than that reported in both cervical and
lumbosacral HZ.

PMID: 8187679 [PubMed - indexed for MEDLINE]

4917: Masui. 1994 Mar;43(3):405-8.

[Unknown fever and abnormal liver functions after repeated epidural blocks with
lidocaine for management of herpes zoster pain]

[Article in Japanese]

Uematsu H, Hiei K, Kawasaki H.

Department of Anesthesiology, Ibi General Hospital, Gifu.

We present a case of unknown fever and abnormal liver functions which developed
during the course of pain management for herpes zoster with repeated epidural
blocks with 0.5% lidocaine 10 ml. The patient was a 67 year old woman. At her
first admission to dermatology, there were no abnormal findings in her blood
examinations. She complained of severe pain from herpes zoster. She was admitted 
to the pain clinic. She received thoracic epidural blocks with 0.5% lidocaine 10 
ml repeatedly three or four times a week. Two weeks later, she developed general 
fatigue, appetite loss, nausea and a high fever. Blood examinations revealed the 
elevation of glutamic oxalacetic transaminase (GOT), glutamic pyruvic
transaminase (GPT), alkaline phosphatase (ALP), and gamma glutamyltrans peptidase
(gamma-GTP), C reactive protein (CRP), and blood sedimentation rate (BSR). Many
examinations including abdominal and thoracic computer tomography and abdominal
echograph could not reveal the cause of high fever and abnormal blood
examinations. We continued the thoracic epidural block for her herpes zoster
pain. GOT, GPT, ALP, and gamma-GTP gradually went down to normal values in next
two weeks, though fever still persisted. At this time, lymphocyte cell simulation
test with 0.5 % lidocaine was positive and eosinophylic cell had increased to 5%.
After ceasing the epidural block, fever resolved and blood examinations returned 
to normal values. These findings suggest strongly that 0.5% lidocaine induced
fever and hepatitis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8182888 [PubMed - indexed for MEDLINE]

4918: J Infect Dis. 1994 Mar;169(3):650-2.

Varicella-zoster virus (VZV) reactivation is related to the low response of
VZV-specific immunity after chickenpox in infancy.

Terada K, Kawano S, Yoshihiro K, Morita T.

Department of Pediatrics, Kawasaki Medical School, Kurashiki, Japan.

To clarify the cause of herpes zoster in immunocompetent children, specific
humoral and cellular immunity was determined using an ELISA and a
lymphoproliferative assay, respectively, in infants < 1 year of age and children 
> or = 1 year of age who had chickenpox. Thirteen (59.1%) of 22 infants, 17
(81.0%) of 21 children > or = 1 year of age (P < .02), and 13 (86.7%) of 15
children > or = 2 years of age (P < .001) had positive varicella-zoster virus
(VZV)-specific cellular immunity. VZV-specific antibodies in infants were
significantly lower than those in children > or = 1 year old (P < .01) and > or =
2 years old (P < .001). The possibility of subclinical reactivation was
demonstrated by an increase in the specific cellular or humoral immunity (or
both) in all of 6 infants who had negative specific cellular immunity. The low
response of specific immunity and the immunologic evidence of reactivation in
infants after chickenpox provide a possible explanation for the finding that
chickenpox in infancy is a risk factor for herpes zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8158043 [PubMed - indexed for MEDLINE]

4919: Arch Ophthalmol. 1994 Mar;112(3):372-9.

The eye in bone marrow transplantation. VI. Retinal complications.

Coskuncan NM, Jabs DA, Dunn JP, Haller JA, Green WR, Vogelsang GB, Santos GW.

Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine,
Baltimore, MD.

OBJECTIVE: To evaluate the posterior segment ocular complications of patients
undergoing bone marrow transplantation (BMT). DESIGN: Retrospective analysis.
SETTING: Academic ophthalmology department at a tertiary care hospital with a BMT
unit. PATIENTS: Patients undergoing BMT were seen by an ophthalmologist for
clinical care and enrolled in a long-term follow-up study, during which they were
seen 6 and 12 months after the transplantation and annually thereafter. RESULTS: 
Of 397 patients undergoing BMT, 51 (12.8%) developed posterior segment
complications. Fourteen patients (3.5%) developed hemorrhagic complications with 
either intraretinal and/or vitreous hemorrhages and 17 patients (4.3%) developed 
cotton-wool spots in the fundus of both eyes. Eleven patients (2.8%) had
bilateral optic disc edema, with eight cases attributed to the toxic effects of
cyclosporine and three to other causes. Two patients (0.5%) developed serious
retinal detachments. Eight patients (2.0%) developed infectious retinitis and/or 
endophthalmitis. Fungal infections with Candida or Aspergillus usually occurred
within 120 days after BMT, while viral infections with herpes zoster or
cytomegalovirus and parasitic infections with Toxoplasma occurred later.
Intraocular lymphoma occurred in one patient (0.2%). CONCLUSION: Severe,
potentially vision-threatening, posterior segment complications following BMT
occur due to a variety of causes.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8129664 [PubMed - indexed for MEDLINE]

4920: J Virol. 1994 Mar;68(3):1987-92.

Varicella-zoster virus open reading frame 4 protein is functionally distinct from
and does not complement its herpes simplex virus type 1 homolog, ICP27.

Moriuchi H, Moriuchi M, Smith HA, Cohen JI.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
National Institutes of Health, Bethesda, MD 20892.

Varicella-zoster virus (VZV) open reading frame 4 (ORF4) encodes a putative
immediate-early protein which is homologous to herpes simplex virus type 1
(HSV-1) ICP27 on the basis of gene location and similarity in amino acid
sequence. In transient expression assays, however, ORF4 and ICP27 exhibit
different properties. ICP27 alone has little activity on target plasmids, but it 
acts as a transactivator or a transrepressor in the presence of other HSV-1
transactivators. In contrast, ORF4 directly transactivates plasmids containing
homologous or heterologous promoters and has no apparent transrepressing
activity. To further illuminate the functional similarities and differences
between ORF4 and ICP27, Vero cell lines which express ORF4 under the inducible
metallothionein promoter were constructed. Cell lines expressing functionally
active ORF4 protein upregulated the expression of transfected VZV target plasmids
but were unable to efficiently complement HSV-1 ICP27 mutants. These results
indicate that, despite structural similarities, VZV ORF4 and HSV-1 ICP27 behave
differently in transient expression assays and may play different roles in virus 
replication.

Publication Types: 
    Comparative Study

PMID: 8107260 [PubMed - indexed for MEDLINE]

4921: J Virol. 1994 Mar;68(3):1886-902.

Molecular evolution of herpesviruses: genomic and protein sequence comparisons.

Karlin S, Mocarski ES, Schachtel GA.

Department of Mathematics, Stanford University, California 94305.

Phylogenetic reconstruction of herpesvirus evolution is generally founded on
amino acid sequence comparisons of specific proteins. These are relevant to the
evolution of the specific gene (or set of genes), but the resulting phylogeny may
vary depending on the particular sequence chosen for analysis (or comparison). In
the first part of this report, we compare 13 herpesvirus genomes by using a new
multidimensional methodology based on distance measures and partial orderings of 
dinucleotide relative abundances. The sequences were analyzed with respect to (i)
genomic compositional extremes; (ii) total distances within and between genomes; 
(iii) partial orderings among genomes relative to a set of sequence standards;
(iv) concordance correlations of genome distances; and (v) consistency with the
alpha-, beta-, gammaherpesvirus classification. Distance assessments within
individual herpesvirus genomes show each to be quite homogeneous relative to the 
comparisons between genomes. The gammaherpesviruses, Epstein-Barr virus (EBV),
herpesvirus saimiri, and bovine herpesvirus 4 are both diverse and separate from 
other herpesvirus classes, whereas alpha- and betaherpesviruses overlap. The
analysis revealed that the most central genome (closest to a consensus
herpesvirus genome and most individual herpesvirus sequences of different
classes) is that of human herpesvirus 6, suggesting that this genome is closest
to a progenitor herpesvirus. The shorter DNA distances among alphaherpesviruses
supports the hypothesis that the alpha class is of relatively recent ancestry. In
our collection, equine herpesvirus 1 (EHV1) stands out as the most central
alphaherpesvirus, suggesting it may approximate an ancestral alphaherpesvirus.
Among all herpesviruses, the EBV genome is closest to human sequences. In the DNA
partial orderings, the chicken sequence collection is invariably as close as or
closer to all herpesvirus sequences than the human sequence collection is, which 
may imply that the chicken (or other avian species) is a more natural or more
ancient host of herpesviruses. In the second part of this report, evolutionary
relationships among the 13 herpesvirus genomes are evaluated on the basis of
recent methods of amino acid alignment applied to four essential protein
sequences. In this analysis, the alignment of the two betaherpesviruses (human
cytomegalovirus versus human herpesvirus 6) showed lower scores compared with
alignments within alphaherpesviruses (i.e., among EHV1, herpes simplex virus type
1, varicella-zoster virus, pseudorabies virus type 1 and Marek's disease virus)
and within gammaherpesviruses (EBV versus herpesvirus saimiri).(ABSTRACT
TRUNCATED AT 400 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 8107249 [PubMed - indexed for MEDLINE]

4922: J Virol. 1994 Mar;68(3):1350-9.

Phosphorylation of varicella-zoster virus open reading frame (ORF) 62 regulatory 
product by viral ORF 47-associated protein kinase.

Ng TI, Keenan L, Kinchington PR, Grose C.

Department of Microbiology, University of Iowa, Iowa City 52242.

Varicella-zoster virus (VZV) encodes within its unique long region a gene product
with protein kinase motifs. In a previous study, we demonstrated that
immunoprecipitated VZV open reading frame (ORF) 47 protein was associated with a 
functional protein kinase activity, on the basis of its ability to both
autophosphorylate and phosphorylate artificial substrates. To further define
potential substrates of ORF 47-associated protein kinase, we analyzed individual 
viral phosphoproteins to determine whether any were modified by the viral protein
kinase. These candidates included gene products of VZV ORFs 4, 61, 62, and 63,
which are homologs of herpes simplex virus type 1 (HSV-1) immediate-early
proteins. Each of the above VZV proteins was coimmunoprecipitated with ORF 47
kinase, and the immune complex was incubated in a protein kinase assay. Under
these conditions, only the VZV immediate-early ORF 62 protein was phosphorylated 
by ORF 47-associated protein kinase. The specificity of this phosphorylation
event was analyzed by a competition assay in which a recombinant ORF 47 protein
lacking enzymatic activity was able to reduce the amount of phosphorylation of
ORF 62 protein by VZV ORF 47-associated kinase. To provide an additional
evaluation of specificity, the experiment was repeated with [32P]GTP instead of
[32P]ATP, because the VZV ORF 47 kinase has the distinctive property of using GTP
as a phosphate donor. Again the ORF 62 substrate was phosphorylated. In summary, 
the VZV ORF 47-associated protein kinase (the HSV-1 UL13 homolog) catalyzed the
in vitro phosphorylation of the VZV ORF 62 protein, the homolog of the HSV-1 ICP4
regulatory protein.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8107200 [PubMed - indexed for MEDLINE]

4923: J Acquir Immune Defic Syndr. 1994 Mar;7(3):254-60.

Management of acyclovir-resistant herpes simplex and varicella-zoster virus
infections.

Balfour HH Jr, Benson C, Braun J, Cassens B, Erice A, Friedman-Kien A, Klein T,
Polsky B, Safrin S.

Department of Laboratory Medicine & Pathology, University of Minnesota Health
Sciences Center, Minneapolis.

Persons with AIDS who have CD4+ counts < or = 100 and transplant patients,
especially bone marrow allograft recipients, may experience clinically
significant infections with acyclovir-resistant herpes simplex virus (HSV) or
varicella-zoster virus (VZV). Patients who have received prior repeated acyclovir
treatment appear to be at the highest risk of harboring acyclovir-resistant
strains. Algorithms for the management of these infections were developed at a
recent roundtable symposium. The consensus of the panelists was that treatment
with foscarnet should be initiated within 7-10 days in patients suspected to have
acyclovir-resistant HSV or VZV infections. Foscarnet therapy should be continued 
for at least 10 days or until lesions are completely healed.

Publication Types: 
    Case Reports
    Consensus Development Conference
    Research Support, Non-U.S. Gov't
    Review

PMID: 8106965 [PubMed - indexed for MEDLINE]

4924: Trop Med Parasitol. 1994 Mar;45(1):36-8.

Recognition of AIDS by health personnel in rural south-Rwanda.

Harms G, Kleinfeldt V, Bugingo G, Butera JB, Kirsch T, Bienzle U.

Landesinstitut fur Tropenmedizin Berlin, Germany.

The ability of rural health personnel to recognise AIDS related symptoms and
signs according to the WHO clinical case definition (CCD) and its modified
Rwandan version was tested in 4141 clinically suspected cases in South-Rwanda.
The sensitivities of these CCDs for AIDS in adults were 33% (36%), the
specificities 78% (76%), and the positive predictive values (ppv) 46%. For AIDS
in children the sensitivities of the CCDs were 13% (16%), the specificities 94%
(90%), and the ppv 44% (38%). While the specificities did not differ from those
found in studies conducted by trained physicians, the low sensitivities and
predictive values demand improvement of the training of the health personnel to
diagnose AIDS related symptoms and signs, especially where laboratory tests are
not available.

PIP: In order to test the ability of health care workers in rural Rwanda to
recognize the signs and symptoms of AIDS according to the World Health
Organization clinical case definition (CCD) and to the slightly modified Rwandan 
version, serum samples and completed questionnaires were collected from all 4141 
clinically-suspected cases of AIDS from 62 rural health centers and hospitals in 
Butare province during 1991. Of the 3669 patients older than 12 years, 964 met
the CCD for adults, and 444 were seropositive. 1040 met the modified Rwandan
version of the CCD, and 482 were seropositive. Of the 472 children, 35 met the
CCD for children, with 16 seropositive. 53 met the Rwandan CCD, and 20 of these
were seropositive. Sensitivities of the CCD and the Rwandan CCD, respectively,
were 33 and 36% in adults and 13 and 16% in children. The respective
specificities were 78 and 76% in adults and 94 and 90% in children. The positive 
predictive values were, therefore, 46% in adults and 44 and 38%, respectively, in
children. These low sensitivity and positive predictive values will result in
many cases of AIDS going undiagnosed. Whereas no single symptom had a sensitivity
and specificity high enough to be used for diagnoses, an episode of herpes zoster
is highly indicative of AIDS. Since this diagnosis is unequivocal, this strong
association may prove useful in the diagnosis of AIDS. Because laboratory tests
will remain unavailable in certain settings, health personnel must receive proper
training to improve their ability to diagnose AIDS following the clinical case
definition.

PMID: 8066379 [PubMed - indexed for MEDLINE]

4925: Haematologica. 1994 Mar-Apr;79(2):148-53.

Oral lesions among HIV-infected hemophiliacs. A study of 54 patients.

Ficarra G, Chiodo M, Morfini M, Longo G, Orsi A, Piluso S, Rafanelli D.

Institute of Odontology and Stomatology, University of Florence, Italy.

BACKGROUND. HIV-infected individuals develop a large variety of oral
manifestations. This study was designed to assess the prevalence and types of
oral lesions among HIV-positive hemophiliacs. MATERIALS AND METHODS. A study
population of 54 hemophiliacs was evaluated from February, 1987 to March, 1992 in
order to analyze types, prevalence and relationships to clinical stages of
HIV-related oral lesions. Thirty-six (67%) of the group of patients were HIV
seropositive. The remaining 18 tested negative to HIV during the observation
period. RESULTS. The majority of patients suffered from hemophilia A. One patient
was also bisexual and two were also intravenous drug abusers. Analysis of patient
stage revealed that half had a CD4+ T-lymphocyte count over 0.5 x 10(9)/L cells, 
10 between 0.2 and 0.499 x 10(9)/L and 8 showed a count lower than 200 x 10(9)/L.
Oral lesions were recorded in 18 (50%) HIV-seropositive hemophiliacs. No oral
lesions were observed among the HIV-seronegative hemophiliacs. Advanced stage of 
immunosuppression and presence of oral lesions were significantly associated (p =
0.040). Candidiasis was the most common disturbance, followed by hairy
leukoplakia. Oral herpes simplex infection, necrotizing gingivitis and facial
herpes zoster were found in a small number of patients. Those with oral lesions
showed a lower median CD4+ T lymphocyte count (0.209 x 10(9)/L cells; range 0.008
to 0.615) when compared to the ones without oral lesions (median CD4+ count was
0.539 x 10(9)/L cells; range 0.042 to 1.180; p = 0.002). CONCLUSIONS.
HIV-seropositive hemophiliacs may develop oral lesions during the course of their
disease. Candidiasis and hairy leukoplakia are among the most common
manifestations. A careful oral examination should be included in the clinical
evaluation of all HIV-infected hemophiliacs.

PMID: 8063262 [PubMed - indexed for MEDLINE]

4926: Med J Malaysia. 1994 Mar;49(1):29-35.

Varicella in children with haematological malignancy--outcome of treatment and
prevention.

Ho CM, Khuzaiah R, Yasmin AM.

Department of Paediatrics, Hospital Besar, Kuala Lumpur.

Primary varicella-zoster virus infection in children with haematological
malignancy is a life threatening disease. In one year, there were 10 cases of
varicella and 2 cases of zoster among these children as well as 5 mothers who
were accompanying their children who developed varicella in the oncology ward.
Two children died of fulminating disease despite aggressive antiviral and
supportive treatment. Acyclovir can be used in treatment and prophylaxis in
exposed susceptible children. Varicella -zoster immune globulin is not available 
in this country. Vaccination with live virus has been shown to be protective in
immunocompromised children and needs consideration.

PMID: 8057987 [PubMed - indexed for MEDLINE]

4927: J Infect. 1994 Mar;28(2):167-73.

Epidemic of herpes zoster following HIV epidemic in Manipur, India.

Panda S, Sarkar S, Mandal BK, Singh TB, Singh KL, Mitra DK, Sarkar K, Tripathy
SP, Deb BC.

ICMR Unit for Research on AIDS in north eastern states of India, Calcutta.

Since 1989, injecting drug use (IDU) related HIV infection has affected thousands
of young adults in Manipur, a north eastern state of India bordering Myanmar
following a similar kind of epidemic in adjoining countries like Thailand and
Myanmar. During a clinical surveillance of a group of HIV positive IDUs for a
natural history study at Manipur, herpes zoster (HZ) emerged as the most specific
early HIV related illness (positive predictive value of 100%) in patients
belonging to the age group of 12-45 years. Data collected from the dermatology
departments of the two main hospitals of the state revealed that there had been
an epidemic of HZ since 1990 (rate of 1990 being 11.3/1000 compared to 6.5/1000
in 1989, P value < 0.0001) among males of 12-45 years. The epidemic of HZ has
been attributed to the preceding epidemic of IDU related HIV in the same age and 
gender group occurring 1 year earlier. HZ should be recognised as a marker
condition similar to tuberculosis indicating the necessity of screening for HIV
in regions where the dual problem of IDU and HIV exist in young adults.

Publication Types: 
    Comparative Study

PMID: 8034996 [PubMed - indexed for MEDLINE]

4928: J Neuroophthalmol. 1994 Mar;14(1):12-4.

Multifocal choroidal lesions. A rare complication of herpes zoster ophthalmicus.

McElvanney AM, Murray PI.

Birmingham and Midland Eye Hospital, United Kingdom.

We document the case of a 76-year-old woman who developed mutifocal choroidal
lesions as an unusual complication of herpes zoster ophthalmicus.

Publication Types: 
    Case Reports

PMID: 8032472 [PubMed - indexed for MEDLINE]

4929: Natl Med J India. 1994 Mar-Apr;7(2):63-4.

Herpes zoster in an HIV-positive 14-month-old baby.

Panda S, Nabachandra T, Sarkar S, Chakraborty S, Naik TN, Deb BC.

Indian Council of Medical Research Unit, Manipur.

BACKGROUND. In Manipur, a state in northeast India bordering Myanmar, within one 
year of reports of a high human immunodeficiency virus (HIV) seroprevalence among
young injecting drug users, there has been a rapid spread of HIV infection in the
general population. METHODS. Since 1990 our unit, together with the Medical
Directorate, Government of Manipur, has studied different aspects of this
epidemic, especially the natural history of HIV in this setting. RESULTS. Here we
report the first case of herpes zoster in a 14-month-old HIV-positive baby
(diagnosed by the polymerase chain reaction). The case was referred to our clinic
by one of our patients residing in the same locality as the child and presently
working as a counsellor in a drug detoxification-cum-rehabilitation centre at
Imphal, Manipur. Dual infection of HIV and herpes zoster was also found in
several other members of the same family. CONCLUSION. This report of perinatally 
acquired HIV infection in an environment of injecting drug users in India might
help in understanding the course of paediatric HIV infection here.

Publication Types: 
    Case Reports

PMID: 8019397 [PubMed - indexed for MEDLINE]

4930: Ryoikibetsu Shokogun Shirizu. 1994;(4):712-4.

[Ramsay Hunt syndrome; a special feature of acute respiratory failure]

[Article in Japanese]

Komori T.

Department of Neurology, Tokyo Metropolitan Neurological Hospital.

Publication Types: 
    Review

PMID: 8007285 [PubMed - indexed for MEDLINE]

4931: FEMS Immunol Med Microbiol. 1994 Mar;8(3):219-24.

Viral antibodies in infectious mononucleosis.

Haukenes G, Viggen B, Boye B, Kalvenes MB, Flo R, Kalland KH.

Department of Microbiology and Immunology, Gade Institute, Bergen, Norway.

Patients with Epstein-Barr virus (EBV) infectious mononucleosis (IM) usually
develop heterophilic antibodies and some autoantibodies. Antibodies to rubella,
measles, adeno-, entero-, herpes simplex, cytomegalo- and varicella-zoster
viruses were titrated in sera from IM patients and matched healthy controls using
the complement fixation test (CFT) and the haemagglutination inhibition test.
Except for herpes simplex virus and cytomegalovirus, the IM sera had
significantly higher arithmetical and geometrical mean antibody titres and showed
in most cases higher antibody prevalences in the CFT. The titre rise was most
pronounced for rubella and measles antibodies, between 2- and 3-fold. There were 
no cases of very high titres occasionally seen in IM. The IM sera had higher
total IgG serum levels than the controls, 17.27 g/l and 11.8 g/l, respectively (P
< 0.001). The present data show that in addition to previously reported high
levels of some autoantibodies and of heterophilic antibodies, there is a more
general increase in IgG antibodies to commonly occurring viruses. This increase
is most likely due to the polyclonal activation of B-lymphocytes following the
binding of EBV to the complement receptor CR2 (CD21). When due consideration is
given to the possible occasional occurrence of a false positive rubella IgM test,
the raised antibody-titres will most likely not interfere with routine
diagnostics.

Publication Types: 
    Comparative Study

PMID: 8004058 [PubMed - indexed for MEDLINE]

4932: Nippon Rai Gakkai Zasshi. 1994 Mar;63(1):3-11.

Antibody to 65-kD stress protein (HSP65) of Mycobacterium leprae in various
inflammatory skin diseases. A preliminary report.

Izaki S, Goto Y, Kitamura K, Nomaguchi H.

Department of Dermatology, Saitama Medical Center, Saitama Medical School,
Kawagoe, Japan.

Cells from prokaryotes and eukaryotes exposed to environmental changes produce a 
series of highly homologous proteins called stress proteins, or heat shock
proteins (HSPs). Recent investigators suggested that the reaction to the shared
antigenic epitope between HSPs may link infections with induction of autoimmune
processes. In the present study, antibody level to HSP with 65 kDa (HSP65) of
Mycobacterium leprae was investigated with enzyme-linked immunosorbent assay
(ELISA) in various skin diseases. Comparing to normal group (n = 9) including
patients with nevus cell nevus showing 0.097 +/- 0.039 (mean +/- SD) in
anti-HSP65 IgG level (OD492), 20 patients with palmoplantar pustulosis (PPP) and 
22 with psoriasis demonstrated elevated (0.170 +/- 0.079, 0.111 +/- 0.053,
respectively) level. Among them patients judged as focal infection-related PPP or
psoriasis showed significantly higher level of anti-HSP65 (p < 0.01) than those
without focal infection. Anaphylactoid purpura (0.125 +/- 0.085, n = 5), Behcet
disease (0.178 +/- 0.045), atopic dermatitis (0.218 +/- 0.096, n = 13), urticaria
(0.185 +/- 0.079, n = 30), and herpes zoster (0.193 +/- 0.092, n = 13) showed
likewise elevated anti-HSP65 antibody. Similar tendency was found in anti-HSP65
IgM level but not in anti-HSP65 IgA. Western blotting confirmed specific
immunoreaction bands to HSP65 in blood samples with high titer. Immunomodulation 
by stress proteins of bacterial or host cells is assumed in pathophysiology of
inflammatory skin disorders, especially in relation to focal bacterial infection 
as observed in cases with PPP and psoriasis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7928800 [PubMed - indexed for MEDLINE]

4933: Acta Med Port. 1994 Mar;7(3):141-8.

[Mucocutaneous pathology in HIV infection]

[Article in Portuguese]

Lamarao P, Eliseu T, Castro H, Maltez F, Machado J, Morgado A, Proenca R.

Servico I de Medicina, Hospital de Curry Cabral, Lisboa.

Several infectious, neoplastic or inflammatory skin diseases, may be early
manifestations of HIV infection. We reviewed the clinical data of 226 HIV
seropositive male patients with cutaneous disease, from a total of 337 inpatients
at the Infectious Diseases Unit--Department of Medicine 1--Curry Cabral Hospital,
from 1985 to 1991. Some considerations are made about the most common
dermatological disorders: oral candidiasis, seborrheic dermatitis, Kaposi's
sarcoma, herpes simplex infection, drug-related skin disorders, herpes zoster and
dermatophytosis. The high prevalence of cutaneous manifestations in HIV
infection, the uncommon clinical findings and their occasional therapeutic
problems, makes an early diagnosis essential.

Publication Types: 
    English Abstract

PMID: 7911640 [PubMed - indexed for MEDLINE]

4934: P N G Med J. 1994 Mar;37(1):29-39.

Surgery, surgical pathology and HIV infection: lessons learned in Zambia.

Watters DA.

Department of Clinical Sciences, University of Papua New Guinea, Boroko, NCD.

HIV (human immunodeficiency virus) infection is prevalent in many areas of
sub-Saharan Africa. Seropositivity rates reach 10-15% in urban adults, 21% in
critically ill adults and 30% in surgical inpatients aged 21-40 years. AIDS
(acquired immune deficiency syndrome) is a multisystem disease which presents to 
the surgeon with a wide range of pathologies including Kaposi's sarcoma,
lymphadenopathy and sepsis. The more common sites for sepsis are the female
genital tract, anorectum, pleural cavity, soft tissues (necrotizing fasciitis)
and bone and joints. To prevent iatrogenic HIV infection more use should be made 
of autologous blood. Occupational exposure to HIV infection can be minimized by
double-gloving, protecting the eyes when operating and ensuring that theatre
gowns are waterproof. The risk of HIV infection from a needlestick injury is
0.4%. Although contact with blood during a surgical procedure is common, the risk
is lower than for a hollow needlestick injury.

PIP: In Zambia, 10-15% of urban adults are reported HIV positive, as are over 80%
of prostitutes. The HIV seroprevalence rate in a Lusaka hospital's intensive care
unit was 21% (27% for surgical and 18% for trauma admissions). HIV-infected
patients could be clinically recognized by risk factors or symptoms and signs:
weight loss, chronic cough, chronic diarrhea, sepsis, septic arthritis, subacute 
hematogenous osteomyelitis, a history of sexually transmitted diseases (STDs),
death of a spouse or of a child under age 2, recent pregnancy unable to go to
term, poor quality or thin hair, appearance of aging beyond years, mental
slowness, persistent or unexplained fever, lymphadenopathy, aggressive atypical
Kaposi's sarcoma, oral thrush, hairy leukoplakia of the tongue, shingles scars,
and scars of maculopapular dermatitis. Common sites for HIV-related sepsis are
the female genital tract, anorectum, pleural cavity, soft tissues (e.g.,
necrotizing fascitis), and bone and joints. Autologous blood transfusion and use 
of donor blood screened for HIV antibodies, preferably limited to emergencies,
would reduce the likelihood of iatrogenic HIV transmission. Surgeons should wear 
two pairs of gloves, a waterproof gown, and goggles to protect themselves from
HIV transmission. If they have skin rashes, cuts, or abrasions on the hands or
arms, they should not perform operations. Proper cleaning and disinfection of
endoscopes are required. The risk of infection from a needle stick is small (
0.4%).

Publication Types: 
    Case Reports

PMID: 7863725 [PubMed - indexed for MEDLINE]

4935: Ger J Ophthalmol. 1994 Mar;3(2):116-9.

Dys- and paraproteinaemias in patients suffering from ophthalmic herpes zoster.

Pinter E, Pek L.

Central Laboratory and Ophthalmology Department of Szent Laszlo Korhaz, Budapest,
Hungary.

Humoral immune parameters were measured in 93 patients suffering from ophthalmic 
herpes zoster. The control group consisted of 31 other ophthalmic patients. In
all cases, electrophoresis, immunoglobulins, acutephase proteins, immune
complexes, antinuclear antibody and complement components were determined as
well. In patients suffering from ophthalmic herpes zoster the main immunological 
deviations among the humoral parameters were found in the non-specific immune
response. These alterations were comparable with the extent and severity of the
pathological processes. Para-proteins were detected in 12% of the patients. In
contrast they were not present in the control group.

PMID: 7514916 [PubMed - indexed for MEDLINE]

4936: Virology. 1994 Mar;199(2):458-62.

Neutralization epitope of the varicella-zoster virus gH:gL glycoprotein complex.

Forghani B, Ni L, Grose C.

Viral and Rickettsial Disease Laboratory, California Department of Health
Services, Berkeley.

Varicella-zoster virus (VZV) glycoprotein gpIII is the homolog of herpes simplex 
virus gH. Through the use of panels of monoclonal antibodies, VZV gpIII is known 
to possess a complement-independent neutralization epitope which is
conformational in nature. Monoclonal antibody to this same epitope, when added
postinfection, inhibits both syncytia formation and egress of virus. The nature
of the neutralization epitope was investigated to determine whether its formation
was dependent on gpIII alone or required a second VZV glycoprotein. To this end, 
VZV ORF 37 (gH) and VZV ORF 60 (gL homolog) were cloned into a vaccinia
virus-pTM1 expression system. Analyses of the transfected products demonstrated
that gpIII alone was not fully glycosylated nor was it transported to the cell
surface. When both ORF 37 and ORF 60 were cotransfected, the gpIII product was
transported to the cell surface, where it formed a neutralization epitope
recognized by a previously characterized monoclonal antibody reagent. In summary,
the VZV homologs of the herpes simplex virus gH:gL complex included a M(r)
118,000 product (gpIII or gH) and a M(r) 20,000 product (ORF 60 or gL).

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 7510086 [PubMed - indexed for MEDLINE]

4937: Transplantation. 1994 Feb 27;57(4):506-12.

Viral prophylaxis in combined pancreas-kidney transplant recipients.

Stratta RJ, Taylor RJ, Bynon JS, Lowell JA, Cattral MS, Frisbie K, Miller S,
Radio SJ, Brennan DC.

Department of Surgery, University of Nebraska Medical Center, Omaha 68198-3280.

The purpose of this study was to analyze different regimens of viral prophylaxis 
after combined pancreas-kidney transplantation (PKT). Over a 4-year period, we
performed 82 PKTs with quadruple immunosuppression with OKT3 induction. Four
regimens of prophylaxis were studied. The first 30 patients received standard
intravenous immunoglobulin (IVIG; 0.5 g/kg) for 6 doses and oral acyclovir for 3 
months. The next 34 recipients received intravenous ganciclovir (2.5 mg/kg) twice
daily for 2 weeks followed by oral acyclovir for 3 months. In the third group,
patients were randomized to 5 doses over 2 months of either standard IVIG (n = 9)
or CMV hyperimmune globulin (Cytogam; n = 9; 100-150 mg/kg) plus 2 weeks of i.v. 
ganciclovir followed by 3 months of oral acyclovir. The 4 groups were similar
with respect to clinical, demographic, and immunologic variables, including donor
and recipient CMV serologic status and blood transfusions. All patients were
monitored for viral infections in the first 6 months after PKT. The regimens of
prophylaxis resulted in (1) no major non-CMV (including no EBV) viral infections;
(2) 3 cases of minor non-CMV viral infections (shingles); and (3) no differences 
in the incidence, timing, or severity of symptomatic CMV infections in the 4
groups. No death or graft loss was due to viral infection. Prophylaxis is
effective in reducing the incidence of non-CMV viral infections and may reduce
the severity of symptomatic CMV infection. However, we could not show any added
benefit of either Cytogam or standard IVIG when used in combination with other
antiviral agents. For economic as well as efficacy reasons, we recommended that
IVIG preparations not be used routinely with antilymphocyte therapy but only in
high-risk situations such as primary CMV exposure.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 8116033 [PubMed - indexed for MEDLINE]

4938: Am J Ophthalmol. 1994 Feb 15;117(2):201-10.

Detection of intraocular antibody production to herpesviruses in acute retinal
necrosis syndrome.

de Boer JH, Luyendijk L, Rothova A, Baarsma GS, de Jong PT, Bollemeijer JG,
Rademakers AJ, Van der Lelij A, Zaal MJ, Kijlstra A.

The Netherlands Ophthalmic Research Institute, Amsterdam.

In order to improve the determination of the causative agent in acute retinal
necrosis syndrome, we evaluated the detection of intraocular antibody production 
to herpesviruses in 28 patients with this disease. Intraocular antibody
production was determined by calculation of the Goldmann-Witmer coefficient
whereby specific antibody titers in the inflamed eye and circulation are related 
to the total IgG content in ocular fluid and serum. Specific antibody titers to
herpesviruses and Toxoplasma were determined by the indirect immunofluorescence
technique. Thirty-five patients with ocular toxoplasmosis, cataract, or
proliferative vitreoretinal disorders were tested as controls. By this technique,
intraocular antibody production to varicella zoster virus or herpes simplex virus
could be established in 16 (57%) of the patients with the typical clinical
features of acute retinal necrosis, compared to none of the controls. Of the 33
affected eyes, 21 (64%) had a visual outcome of less than 20/200. We concluded
that detection of intraocular antibody production to herpesviruses may be a
useful diagnostic tool in establishing the causative agents in acute retinal
necrosis.

PMID: 8116748 [PubMed - indexed for MEDLINE]

4939: Am J Ophthalmol. 1994 Feb 15;117(2):160-3.

Detection of herpes simplex virus DNA in human tear film by the polymerase chain 
reaction.

Yamamoto S, Shimomura Y, Kinoshita S, Nishida K, Yamamoto R, Tano Y.

Department of Ophthalmology, Osaka University Medical School, Japan.

We investigated the use of the polymerase chain reaction for detecting genomes of
herpes simplex virus, varicella-zoster virus, and cytomegalovirus from tear film 
of patients with clinically diagnosed herpes simplex virus keratitis. Using the
polymerase chain reaction with a herpes simplex virus detection sensitivity
adjusted to 1.0 plaque-forming units/ml, we detected herpes simplex virus genomic
sequences in 12 of 12 epithelial keratitis specimens, two of six stromal
keratitis specimens, but in none of 20 normal specimens. Neither varicella-zoster
virus nor cytomegalovirus genomic sequences were detected in any sample. These
results suggest that polymerase chain reaction quickly performed with reduced
sensitivity is useful as a diagnostic tool for confirming clinical observations.

PMID: 8116743 [PubMed - indexed for MEDLINE]

4940: Med Clin (Barc). 1994 Feb 12;102(5):161-4.

[Incidence and etiology of viremia in 2,619 patients]

[Article in Spanish]

Caballero Requero E, Martinez Cuevas O, Cortes Borra A, Fernandez Perez F,
Capdevila JA, Calico I.

Servicio de Microbiologia y Parasitologia, Hospital General Universitario Vall
d'Hebron, Barcelona.

BACKGROUND: Virus investigation, specially cytomegalovirus (CMV), in blood has
increased such that the capacity of hospitalary laboratories is threatened with
collapse. The causal agents of viremia are analyzed being correlated with the
clinical symptoms and underlying disease to establish the selection criteria of
patients for virologic study. METHODS: Two thousand six hundred nineteen patients
suspected of having viral infection, fundamentally by CMV were studied over 6
years by 4,394 blood samples. Of these patients 1,646 were immunosuppressed, 824 
were considered immunocompetent and this data was unknown in 149 patients. The
leukocytes were separated using standardized techniques being seeded in cell
cultures (human embryo lung fibroblasts). RESULTS: Three hundred forty-seven
specimens corresponding to 242 patients were positive with isolation of the
following pathogens: 327 strains of CMV, 4 enterovirus, 2 adenovirus, 1 herpes
simplex virus, 1 varicella-zoster, another 5 unidentified cytopathic agents, 6
strains of toxoplasma and 1 Cryptococcus. With regard to the base disease, 302
positive samples to CMV pertained to 204 immunosuppressed patients: 103 (13.6%
positives among the cases studied) AIDS or AIDS-related complex, 54 (21.3%)
kidney transplant patients, 31 (24.8%) liver transplant patients, 2 (1.5%) lung
transplant patients, and 2 (1.5%) bone marrow transplant patients. A non CMV
microorganism was isolated in 13 samples from 12 immunosuppressed patients. Only 
24 (2.5% of those studied) immunocompetent or with unknown immunity status had
viremia by CMV, being detected in 25 samples. Non CMV cytopathic agents were
isolated in another 7 samples from 6 patients. CONCLUSIONS: Analysis of blood
cultures allows the isolation of cytomegalovirus and occasionally other
unsuspected agents such as toxoplasma. This investigation is indicated in
immunosuppressed patients but not in immunocompetent patients who present a
febrile syndrome with no clinical suspicion of cytomegalovirus infection.

Publication Types: 
    English Abstract

PMID: 8127163 [PubMed - indexed for MEDLINE]

4941: J Fam Pract. 1994 Feb;38(2):186-91.

Comment in:
    J Fam Pract. 1994 Feb;38(2):121-3.

Uses and safety of acyclovir in pregnancy.

Spangler JG, Kirk JK, Knudson MP.

Department of Family and Community Medicine, Bowman Gray School of Medicine of
Wake Forest University, Winston-Salem, NC 27157-1084.

Acyclovir, an antiviral nucleoside analogue, is a widely used agent highly
specific for herpes simplex and varicella-zoster viruses. Unintended exposure to 
acyclovir early in pregnancy, which is not uncommon, may cause excessive maternal
and physician anxiety. This drug has not been studied prospectively in large
numbers of pregnant women and lacks the Food and Drug Administration's approval
for gestational use unless benefits clearly outweigh potential fetal harm.
However, data published since acyclovir became available do not indicate
increased adverse effects related to its use in pregnancy, especially if
prescribed in selected situations, such as disseminated primary herpes simplex
infections or maternal varicella pneumonia. This article reports the impact of
inadvertent acyclovir exposure on a woman during the first trimester of pregnancy
and reviews the literature on acyclovir's pharmacology, safety profile, and
potential uses during pregnancy.

Publication Types: 
    Case Reports
    Review

PMID: 8308511 [PubMed - indexed for MEDLINE]

4942: Laryngoscope. 1994 Feb;104(2):127-34.

Cloning and sequencing of genomic DNA extracted from archival human temporal bone
sections.

Kerner MM, Wackym PA, Popper P, Tabor DE, Grody WW.

Laboratory of Molecular Biology, UCLA School of Medicine 90024-1794.

Cloning techniques allow the engineering and production of highly purified DNA.
Further advances in molecular biology have provided the means to identify DNA
sequences in a rapid fashion. Sequencing methods can identify mutations,
deletions, polymorphisms, or confirm a known genetic sequence. The use of these
techniques in clinical medicine has made it possible to accurately diagnose
infectious diseases and determine the molecular etiology of many genetic
disorders and malignancies. In this study, DNA extracted from archival,
celloidin-embedded temporal bone sections has been cloned and sequenced using
these techniques. We amplified, cloned, and sequenced varicella-zoster viral DNA 
extracted from archival temporal bone sections from patients who had herpes
zoster oticus. The application of cloning and sequencing techniques to DNA
extracted from archival temporal bones provides the methodology to study temporal
bone pathology at the molecular level.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8302113 [PubMed - indexed for MEDLINE]

4943: Phys Ther. 1994 Feb;74(2):129-42.

Physical therapy management of peripheral vestibular dysfunction: two clinical
case reports.

Gill-Body KM, Krebs DE, Parker SW, Riley PO.

Physical Therapy Services, Massachusetts General Hospital, Boston 02114.

We describe the treatment of two patients with peripheral vestibular dysfunction 
using a novel, staged exercise program. Response to treatment was documented. The
first patient, a 62-year-old woman with unilateral vestibular dysfunction (UVD)
and a 6-month history of disequilibrium following herpes zoster oticus resulting 
in damage to the right inner ear, was treated with an 8-week course of vestibular
physical therapy. During the 8 weeks, the patient attended weekly physical
therapy sessions and was trained to perform vestibular adaptation exercises on a 
daily basis at home. The second patient, a 53-year-old woman with progressive
disequilibrium secondary to profound bilateral vestibular hypofunction (BVH), was
treated with a 16-week course of vestibular physical therapy. During the first 8 
weeks, the patient attended weekly physical therapy sessions and was trained to
perform vestibular adaptation and substitution exercises on a daily basis at
home. During the second 8 weeks, the patient continued performing vestibular
physical therapy exercises at home independently. Vestibular function (sinusoidal
vertical axis rotation testing), postural control (clinical tests and
posturography), stability during the performance of selected activities of daily 
living (ADLs), and self-perception of symptoms and handicap were measured prior
to and at the conclusion of treatment for both patients and at the midpoint of
treatment for the patient with BVH. After 8 weeks of treatment, both patients
reported improvements in self-perception of symptoms and handicap and
demonstrated objective improvements in clinical balance tests, posturography, and
several kinematic indicators of stability during the performance of selected
ADLs. Further improvements were noted in the patient with BVH after 16 weeks of
treatment. Improvements in postural control were noted after 8 weeks of treatment
for the patient with UVD and after 16 weeks for the patient with BVH. Vestibular 
function improved during the course of treatment for the patient with UVD only.
These case reports describe two different individualized treatment programs and
document self-reported and laboratory-measured functional improvements in two
patients with vestibular deficients--one with unilateral damage and one with
bilateral damage.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 8290618 [PubMed - indexed for MEDLINE]

4944: J Am Acad Dermatol. 1994 Feb;30(2 Pt 1):250-60.

Polymerase chain reaction: basic concepts and clinical applications in
dermatology.

Lo AC, Feldman SR.

Department of Dermatology, Bowman Gray School of Medicine of Wake Forest
University, Winston-Salem, NC 27157-1071.

The polymerase chain reaction (PCR) has been extensively used in basic science
research, and the clinical potential of PCR is only now beginning to be realized.
The PCR is based on the fundamental DNA replication process that occurs in every 
living cell. PCR is essentially an in vitro adaptation of the in vivo DNA copying
process. Because PCR is so efficient at amplifying even picogram quantities of
DNA, contamination with even trace amounts of nucleic acids can lead to the
generation of unwanted DNA sequences and false-positive test results. Despite
this, there has been rapid growth in the use of PCR in biomedical research and
clinical diagnostics. PCR is the most sensitive test for herpes simplex virus,
varicella-zoster virus, and human papillomavirus infections. Other diagnostic
uses, including tests for genetic diseases, cancers, and other infectious
diseases, are evolving.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8288785 [PubMed - indexed for MEDLINE]

4945: J Chir (Paris). 1994 Feb;131(2):96-8.

[Acute pancreatitis caused by varicella-zoster virus after liver transplantation]

[Article in French]

Coelho JC, Wiederkehr JC, Campos AC, Zeni Neto C, Oliva V.

Services de Chirurgie, l'Hopital des Cliniques de l'Universite Federale du
Parana, Curitiba, Bresil.

Twenty-six days after liver transplantation for primary biliary cirrhosis, a 52
year-old patient was rehospitalized for viral infection. The clinical features
were fatigue, anorexia and vomiting. On physical examination, vesicular skin
lesions involving the left 8 th intercostal space were suggestive of
herpes-zoster infection. The following day the patient was extremely tired and
dyspnoeic. The abdomen was distended with moderate abdominal epigastric pain. The
clinical picture worsened rapidly and the patient died a few hours later. Autopsy
revealed acute haemorrhagic necrosis of the pancreas due to herpes-zoster virus.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8207103 [PubMed - indexed for MEDLINE]

4946: Med Microbiol Immunol. 1994 Feb;183(1):1-11.

Reactivity of varicella-zoster virus subunit antigens in enzyme-linked
immunosorbent assay to sera from varicella, zoster, and herpes simplex virus
infections.

Takayama M.

Department of Virology I, National Institute of Health, Tokyo, Japan.

Serological responses to varicella-zoster virus (VZV) subunit antigens, such as
capsid, envelope, and soluble (S) antigens, in patients with VZV and herpes
simplex virus (HSV) infections were studied by comparing with responses to virion
(V) antigens using an enzyme-linked immunosorbent assay (ELISA). S antigen,
prepared by concentrating supernatant of VZV or HSV type 1 (HSV-1)-infected cell 
culture fluid, reacted strongly to sera from patients with secondary infection
but reacted poorly to those from patients with a primary infection of VZV or HSV.
Antibody titers to VZV-S antigen persisted for a long period in patients with VZV
infections. Patients infected with VZV showed antibody increase to HSV-1, when
tested by complement fixation or complement-enhanced neutralization test, in
cases with a history of prior HSV infection. However, such a cross-reaction was
only observed to a minor extent in ELISA test using S antigen. S antigen reaction
was stronger in secondary infections in tests with various subunit antigens.
Almost no cross-reactivity was observed in an immunoblotting test with S antigen.
Differentiation between infections with either varicella or zoster or HSV can be 
made by comparison of antibody responses to V and S antigens.

PMID: 8202026 [PubMed - indexed for MEDLINE]

4947: Contact Dermatitis. 1994 Feb;30(2):119-20.

Allergic contact dermatitis from propylene glycol in Zovirax cream.

Kim YJ, Kim JH.

Department of Dermatology, Hanyang University Hospital, Seoul, Korea.

Publication Types: 
    Case Reports

PMID: 8187495 [PubMed - indexed for MEDLINE]

4948: Ann Pharmacother. 1994 Feb;28(2):208-9.

Oral acyclovir in immunocompetent patients with varicella.

Croze SM, Stoukides CA.

University Hospital, Boston, Massachusetts.

Publication Types: 
    Review

PMID: 8173138 [PubMed - indexed for MEDLINE]

4949: Acta Paediatr Jpn. 1994 Feb;36(1):53-6.

Cytotoxicity against varicella zoster virus infected targets in children with
acute leukemia.

Ihara T, Oitani K, Torigoe S, Kitamura K, Ito M, Kamiya H, Sakurai M.

Department of Pediatrics, Mie National Hospital, Japan.

To eliminate the role of natural killer (NK), antibody-dependent cell-mediated
cytotoxicity (ADCC), and polymorphonuclear leukocyte (PMN)-mediated cytotoxicity 
in Varicella zoster virus (VZV) infections, peripheral blood mononuclear cell
(PBMC)-mediated NK and ADCC, and phorbol myristate acetate-stimulated
PMN-mediated cytotoxicity against VZV-infected targets were studied in children
with leukemia. Natural killer and PMN-mediated cytotoxic activity was depressed
for 6 months after complete remission and ADCC activity was depressed for 1 year 
after complete remission. The magnitude of three cytotoxic mechanisms in leukemic
children gradually increased while they continued in complete remission. These
results suggested that decreased cytotoxic activities of PBMC and PMN might
contribute to serious VZV infections and susceptibility to herpes zoster in
leukemic children.

PMID: 8165909 [PubMed - indexed for MEDLINE]

4950: Antiviral Res. 1994 Feb;23(2):93-105.

Efficacy of A-73209, a potent orally active agent against VZV and HSV infections.

Alder J, Mitten M, Norbeck D, Marsh K, Kern ER, Clement J.

Abbott Laboratories, Department 47T, Abbott Park, IL 60064-3500.

A-73209 is a novel oxetanocin derivative with potent in vitro and in vivo
activity against VZV, HSV-1, and HSV-2. A-73209 was two logs more potent than
acyclovir against five thymidine kinase positive (TK+) strains of VZV in vitro
(mean EC50 0.01 vs. 1.22 micrograms/ml). The activity of A-73209 was one log more
potent than acyclovir against TK+ HSV-1 strains in vitro (EC50 = 0.03 vs. 0.32
micrograms/ml). A-73209 yielded a mean EC50 of 2.2 micrograms/ml compared to a
mean EC50 of 0.37 micrograms/ml for acyclovir against a panel of TK+ HSV-2
strains in vitro. The in vitro activity of A-73209 against thymidine kinase
negative or deficient strains of VZV, HSV-1 and HSV-2 was much lower than for the
corresponding TK+ strains. A-73209 produced efficacy superior to acyclovir
against lethal systemic or intracerebral HSV-1 infections in mice. The greater
efficacy of A-73209 relative to acyclovir was especially apparent with oral
dosing. Against HSV-2 infections in mice, the efficacy of A-73209 ranged from
equal to 1.7 times less active relative to acyclovir with oral dosing. A-73209
was orally bioavailable in mice, with maximal serum concentrations well in excess
of in vitro inhibitory concentrations. A-73209 appears to be a potent and
selective agent against varicella-zoster virus and herpes simplex virus
infections.

Publication Types: 
    Comparative Study

PMID: 8147583 [PubMed - indexed for MEDLINE]

4951: Anal Chem. 1994 Feb 1;66(3):341-4.

A novel immunosensor for herpes viruses.

Konig B, Gratzel M.

Institut de Chimie Physique II, Ecole Polytechnique Federale de Lausanne,
Switzerland.

We have developed a reusable piezoelectric immunosensor for the detection of the 
following human herpes viruses: herpes simplex viruses types 1 and 2,
varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus. Synthetic
peptides, representing different surface antigens of the five viruses, were used 
to generate virus-specific monoclonal antibodies. Apply an antibody layer via
protein A immobilization onto a 10-MHz AT-cut crystal resulted in 5 x 10(4)-1 x
10(9) viruses on the electrode surface in a linear frequency change and a
long-term stability of 8 weeks when the modified crystal was stored dry over
silica gel blue at room temperature. Under these conditions, the coated crystal
can be used 18 times without detectable loss of activity.

PMID: 8135375 [PubMed - indexed for MEDLINE]

4952: Arch Dis Child. 1994 Feb;70(2):133-5.

Acyclovir resistant varicella zoster and HIV infection.

Lyall EG, Ogilvie MM, Smith NM, Burns S.

Department of Haematology, Royal Hospital for Sick Children, Edinburgh.

A child infected with HIV who developed chronic varicella zoster virus infection 
resistant to acyclovir is presented. The clinical course of the infection,
treatment, virological investigations, and relationship of the infection to the
child's immunodeficient state are discussed.

Publication Types: 
    Case Reports

PMID: 8129436 [PubMed - indexed for MEDLINE]

4953: Ophthalmology. 1994 Feb;101(2):270-9.

Triple retinal infection with human immunodeficiency virus type 1,
cytomegalovirus, and herpes simplex virus type 1. Light and electron microscopy, 
immunohistochemistry, and in situ hybridization.

Rummelt V, Rummelt C, Jahn G, Wenkel H, Sinzger C, Mayer UM, Naumann GO.

Department of Ophthalmology, University of Erlangen-Nurnberg, Germany.

PURPOSE: This report describes the histopathologic and virologic findings of the 
retina from a 55-year-old bisexual patient with the acquired immune deficiency
syndrome (AIDS), who had concurrent human immunodeficiency virus type 1 (HIV-1), 
cytomegalovirus (CMV), and herpes simplex virus type 1 (HSV-1) retinitis, and was
treated with ganciclovir. METHODS: The eyes were obtained at autopsy and
processed for light microscopy and transmission electron microscopy.
Immunohistochemical stains for HSV-1, CMV, HIV-1, varicella zoster virus, and
glial fibrillary acidic protein were carried out using the
peroxidase-antiperoxidase and streptavidin-biotin-alkaline phosphatase
techniques. For in situ hybridization, a radiolabeled CMV DNA probe (Eco-RI-Y
fragment of strain AD 169) was used. RESULTS: Results of histopathologic
examination showed a full-thickness necrotizing retinitis with cytomegalic and
herpes viral intranuclear inclusions in cells of the neurosensory retina, retinal
vascular endothelium, and the retinal pigment epithelium. Some areas of the
retina were replaced by glial tissue. The choroid contained only a few chronic
inflammatory cells. Immunoperoxidase studies disclosed CMV antigens diffusely
distributed throughout all layers of the retina and the retinal pigment
epithelium. Herpes simplex virus type 1 antigens were present in retinal cells
and the retinal vascular endothelium. Human immunodeficiency virus type 1
antigens were found in mononuclear cells in all layers of the sensory retina.
Dual infections with HIV-1 and CMV of individual multinucleated giant cells of
glial origin were demonstrated immunohistochemically. Transmission electron
microscopy showed herpes viral particles in the vascular endothelium of the
retinal vessels and the choriocapillaris. Human immunodeficiency virus particles 
were identified in the endothelium of the choriocapillaris. CONCLUSIONS: The
possibility of multiple viral infections of the retina, mimicking classic CMV
retinitis, should be considered in the clinical and histologic differential
diagnosis of necrotizing retinitis in patients with AIDS.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8115149 [PubMed - indexed for MEDLINE]

4954: J Indian Med Assoc. 1994 Feb;92(2):64-6.

Acyclovir in paediatrics.

Sharma A.

Department of Paediatrics, Medical College, Rohtak.

Publication Types: 
    Review

PMID: 8071563 [PubMed - indexed for MEDLINE]

4955: Aust N Z J Ophthalmol. 1994 Feb;22(1):77-80.

Herpes zoster ophthalmicus and the orbital apex syndrome.

Bourke RD, Pyle J.

Royal Brisbane Hospital, Herston, Queensland.

Herpes zoster ophthalmicus (HZO) commonly causes isolated ophthalmoplegic
syndromes. Visual loss caused by optic neuritis secondary to HZO can be
reversible or irreversible. HZO rarely presents as an orbital apex syndrome, when
an association with meningo-encephalitis has been reported. We report a case of
orbital apex syndrome secondary to HZO treated with systemic steroids and
acyclovir. Our patient suffered no systemic complications and displayed a rapid
resolution of optic neuropathy. We discuss this case in the light of previous
reports and explore the possible pathogenic mechanisms involved.

Publication Types: 
    Case Reports

PMID: 8037920 [PubMed - indexed for MEDLINE]

4956: Can Fam Physician. 1994 Feb;40:321-6, 329-32.

Pharmacologic management of herpes zoster and postherpetic neuralgia.

Mamdani FS.

Department of Pharmacy, Vancouver General Hospital.

Herpes zoster is an infection caused by reactivation of dormant varicella-zoster 
virus. The acute course of herpes zoster is generally benign; however, some
patients will experience postherpetic neuralgia characterized by severe,
relentless, and at times disabling pain that is often refractory to treatment.
While herpes zoster responds to acyclovir, cost-benefit considerations limit the 
drug's usefulness to only a select group. Postherpetic neuralgia requires a
holistic approach, including pharmacologic therapy using several different
classes of drugs.

Publication Types: 
    Review

PMID: 7907508 [PubMed - indexed for MEDLINE]

4957: Schweiz Med Wochenschr. 1994 Jan 29;124(4):152-8.

Erratum in:
    Schweiz Med Wochenschr 1994 Feb 26;124(8):346.

[Resistance to virostatic agents in Herpes viruses: mechanism, incidence and
clinical significance]

[Article in German]

Reusser P.

Departement fur Innere Medizin, Kantonsspital Basel.

Following the introduction of potent antiviral agents against herpes simplex
virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV) into
clinical use, the isolation of resistant virus strains has been reported with
increasing frequency. The first part of this overview focuses on the mechanisms
of action of acyclovir, ganciclovir, and forcarnet, and on the mechanisms of
viral resistance. In the second part, the incidence and clinical importance of
resistant herpes viruses are discussed. Among immunocompetent patients, herpes
virus resistance is a rare event even in the case of long-term treatment with
acyclovir for suppression of genital herpes. By contrast, among immunocompromised
hosts, the isolation of resistant herpes virus strains from patients with disease
unresponsive to antiviral drugs is not infrequent. The incidence of
acyclovir-resistant HSV isolates in two large studies was 5%, and that of
ganciclovir-resistant CMV strains was reported to be about 7%. At present, data
on infections due to resistant VZV strains are scarce. Results from case reports 
and small series suggest some clinical benefit from the use of foscarnet when
acyclovir-resistant HSV or VZV is present, or when CMV disease is caused by
ganciclovir-resistant strains. Broader use of susceptibility testing to antiviral
drugs and the development of new antiherpetic agents are required to improve the 
diagnosis and treatment of disease due to resistant herpes viruses.

Publication Types: 
    English Abstract

PMID: 8128197 [PubMed - indexed for MEDLINE]

4958: Med J Aust. 1994 Jan 17;160(2):93-4.

Comment on:
    Med J Aust. 1993 Oct 4;159(7):439-40.

Varicella-zoster vaccine.

Haski AL.

Publication Types: 
    Comment
    Letter

PMID: 7508543 [PubMed - indexed for MEDLINE]

4959: Neurosci Lett. 1994 Jan 3;165(1-2):97-100.

Axon-reflex reactions in affected and homologous contralateral skin after
unilateral peripheral injury of thoracic segmental nerves in humans.

Baron R, Saguer M.

Klinik fur Neurologie, Christian-Albrechts-Universitat Kiel, Germany.

Transection and regeneration of a rat peripheral nerve on one side reduces the
ability of the contralateral nerve to evoke plasma extravasation after antidromic
excitation of afferent C-fibers induced by electrical nerve stimulation (afferent
axon reflex). An unknown transneuronal signalling substance was postulated. In
humans, axon-reflex vasodilatation was studied using cutaneous iontophoresis of
histamine for C-fiber stimulation and laser Doppler flowmetry for measuring
vasodilatation. As a model of peripheral nerve lesion with regeneration, patients
with severe unilateral zoster neuropathy of thoracic segmental nerves were
examined. Axon-reflex reactions were considerably impaired within the affected
dermatome compared with the unaffected side and compared with controls. In
contrast, no significant differences could be found between the unaffected
corresponding sites of patients and similar dermatomes of healthy controls,
indicating that this type of nerve injury does not influence the ability of the
contralateral nerve to evoke axon-reflex vasodilatation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8015746 [PubMed - indexed for MEDLINE]

4960: Int J Antimicrob Agents. 1994;4(4):241-6.

Famciclovir, a new oral antiherpes drug: results of the first controlled clinical
study demonstrating its efficacy and safety in the treatment of uncomplicated
herpes zoster in immunocompetent patients.

Degreef H; Famciclovir Herpes Zoster Clinical Study Group.

U.Z. St Rafael, Kapucijnenvoer 35, 3000 Leuven, Belgium.

This multicentre, double-blind, double-dummy, randomised study was undertaken to 
compare the efficacy and tolerability of famciclovir administered at 250 mg, 500 
mg and 750 mg three times daily with acyclovir 800 mg five times daily for the
treatment of acute uncomplicated herpes zoster in immunocompetent adults. A total
of 545 patients participated in this trial. Treatment was initiated within 72 h
of the onset of the zoster rash and was continued for seven days. When treatment 
was initiated within 72 h, famciclovir was found to be as effective as acyclovir 
at all dose levels for cutaneous lesion healing as demonstrated by the median
times to full crusting, cessation of new lesion formation, loss of vesicles and
loss of crusts; time to loss of acute pain was comparable in patients receiving
famciclovir and acyclovir. Time to resolution of zoster-associated pain, however,
occured at a significantly faster rate in patients treated with famciclovir
within 48 h of rash onset compared with acyclovir treatment. Famciclovir was well
tolerated with a safety profile comparable to that of acyclovir. Gastrointestinal
disturbances and headache were the most common adverse experiences in all
treatment groups. In conclusion, famciclovir, administered less frequently and at
lower unit doses than acyclovir, is an effective treatment for patients with
uncomplicated herpes zoster.

PMID: 18611615 [PubMed - in process]

4961: Srp Arh Celok Lek. 1994;122 Suppl 1:124-6.

[Diagnostic problems of Stevens-Johnson syndrome. A case report]

[Article in Serbian]

Djordjevic N, Sarovic N, Pasic S, Dujic A.

Stivens-Johnson Syndrome is a rare, severe, bullose form of erythema multiforme
of unknown etiology. The role of immunological factors in its pathogenesis
elucidates. A patients (Sh.V.), nine years of age, was admitted for reccurent
streptococcal infections with skin and mucose membrane lesions. In June 1990
streptococcal pharyngitis, fever (38.8-39,9 degrees C) were registered.
Penicillin was given. Next day bullous lesions on lips, left ear, trunk and lower
extremities and vesiculose lesions with a wide, erythematose base ("iris") and
then conjuctivitis were registered. Laboratory tests: SR70.; Leu - 11,0;
anti-herpes Ab IgG 1/64, IgM 1/8. Stevens-Johnson was diagnosed. There was a
recidivation two years after - oral lesions followed by necrosis and bleeding,
after half a year a second recidivation with spreading of bullous and vesiculous 
lesions to penis gland with prepuce of the penis. Last recidivation in February
1993. Anamnesis: Viral meningitis in 1988. mother suffers from herpes labialis.
Peripheral blood immunophenotiping lymphocite extremly indicated decreasing
values of B Ly, NK and IL-2R+ cells. Bacteriological tests showed an increase of 
anti-Chlamidia Ab titer (IgG 1/128, IgA and IgM +). In virological testing there 
was no increase of titer of Abs against viral antigens (Herpes simplex virus,
Varicella-Zoster virus, Citomegalovirus, Adenovirus). We conclude that
Stevens-Johnson Sy to be diagnosed by characteristic clinical features, aspecialy
by frequent reccurences. Immunological testing during the last recidivation
showed that parameters of humoral immune reactivity were within normal ranges
while revealed defects of cellular immune reactivity cannot elucidate the
ethiopathogenesis of this disease.

Publication Types: 
    Case Reports
    English Abstract

PMID: 18173215 [PubMed - indexed for MEDLINE]

4962: Beitr Infusionsther Transfusionsmed. 1994;32:197-9.

[Increase of post-infection cold agglutinins after infection with Mycoplasma
pneumoniae, varicella-zoster and rubella virus]

[Article in German]

Leo A, Enders G, Roelcke D.

Institut fur Immunologie, Heidelberg.

Cold agglutinins (CA) are observed during acute infections as transiently
occurring postinfection autoantibodies directed against erythrocyte antigens.
Distinct infectious agents induce CA of distinct specificity. A common
association is the infection with Mycoplasma pneumoniae and the production of CA 
with anti-I specificity. In infections with varicella-zoster virus (VZV) and
rubella virus (RV) a few cases of CA appearance are reported, all of them showing
specificity for the Pr antigens. We examined the frequency of CA with the anti-Pr
specificity in patients suffering from acute infections with VZV and RV (table
1). The known association of anti-I in about 70% of the cases with acute
Mycoplasma pneumoniae infection is confirmed by our results. The occurrence of CA
in infections with VZV and RV is a rare event. Based on published data, the
specificity of these CA apparently is anti-Pr. Three of 5 anti-Pr examples were
found in newborns with rubella embryopathy. Possibly, anti-Pr can be observed
more frequently in these patients compared to adults.

Publication Types: 
    English Abstract

PMID: 9480085 [PubMed - indexed for MEDLINE]

4963: Folia Med (Plovdiv). 1994;36(4):45-9.

Herpes zoster in infants.

Dobrev H.

Department of Dermatology, University of Medicine, Plovdiv, Bulgaria.

The author reported four cases of herpes zoster in infants without history of
chickenpox but with positive history of maternal varicella either in the early
life or during pregnancy. One of the infants had been in a close contact with his
father who had varicella. Herpes zoster in infancy develops secondary to an
asymptomatic foetal varicella zoster virus infection or to an unrecognized
subclinical varicella in infants born to varicella zoster virus immune mothers.

PMID: 8698285 [PubMed - indexed for MEDLINE]

4964: Arch Dermatol. 1994 Jan;130(1):70-2.

Comment in:
    Arch Dermatol. 1994 Sep;130(9):1206-8.    Arch Dermatol. 1994 Sep;130(9):1207-8.

Lichenoid chronic graft-vs-host disease occurring in a dermatomal distribution.

Freemer CS, Farmer ER, Corio RL, Altomonte VL, Wagner JE, Vogelsang GB, Santos
GW.

Department of Dermatology, Johns Hopkins University School of Medicine,
Baltimore, Md.

BACKGROUND: Chronic graft-vs-host disease (GVHD) is a late complication of
allogeneic bone marrow transplantation and is associated with high morbidity and 
mortality. While the pathogenesis of chronic GVHD is not fully understood,
several observations and studies suggest that viral infections may play a role.
We describe two patients who developed linear lichenoid chronic GVHD. The
dermatomal distribution of their lesions suggests an association with herpes
zoster virus infection. OBSERVATIONS: Two allogeneic bone marrow transplantation 
patients developed violaceous papules in a dermatomal distribution. Histologic
examination of these lesions revealed dyskeratosis, vacuolar changes in the basal
layer, and a mild perivascular and interstitial infiltrate, diagnostic of
lichenoid chronic GVHD. CONCLUSIONS: The linear distribution of our patients'
lichenoid chronic GVHD is unique and may represent an association with herpes
zoster virus infection, providing further support for a role for viral infections
in the pathogenesis of chronic GVHD.

Publication Types: 
    Case Reports

PMID: 8285743 [PubMed - indexed for MEDLINE]

4965: J Infect Dis. 1994 Jan;169(1):91-4.

Detection of varicella-zoster virus DNA in air samples from hospital rooms.

Sawyer MH, Chamberlin CJ, Wu YN, Aintablian N, Wallace MR.

Department of Pediatrics, University of California, San Diego, La Jolla
92093-0672.

Varicella-zoster virus (VZV) is a highly contagious infectious agent that causes 
outbreaks in institutional settings. Transmission of VZV is felt to occur
following direct contact with an infected individual and by aerosol spread. To
document the aerosolization of VZV, a polymerase chain reaction (PCR) assay was
used to detect VZV DNA in air samples obtained from hospital rooms of patients
with active VZV infection. VZV DNA was detected in 64 (82%) of 78 air samples
from rooms housing patients with active varicella and 9(70%) of 13 samples from
rooms of patients with herpes zoster. VZV was detected 1.2-5.5 m from patients'
beds and for 1-6 days following onset of rash. On some occasions, VZV DNA could
be detected outside the hospital isolation rooms housing patients. This PCR-based
method allows the detection and semiquantitation of VZV aerosolization and can be
a useful tool for monitoring efforts to control VZV aerosols in the environment.

PMID: 8277202 [PubMed - indexed for MEDLINE]

4966: Virology. 1994 Jan;198(1):71-80.

Analysis of the DNA-binding domain of the HSV-1 origin-binding protein.

Martin DW, Munoz RM, Oliver D, Subler MA, Deb S.

Department of Microbiology, University of Texas Health Science Center at San
Antonio 78284-7758.

In order to understand DNA-protein interactions at the origin of DNA replication 
in herpes simplex virus type 1 (HSV-1), we have undertaken an analysis of the
DNA-binding domain of the origin-binding protein (OBP) and its mechanism of
binding to the Oris sequence of HSV-1. Mutant DNA-binding domains were
constructed, expressed in vitro, and used to test for binding by gel shift
analysis. A C-terminal deletion mutant was functional in binding, thereby
redefining the C-terminal boundary of the DNA-binding domain at amino acid 822.
Fifteen insertion mutants were also constructed across the DNA-binding domain.
Several of these mutants were unable to bind DNA. Interestingly, 4 mutants that
destroy DNA binding fall within a region that has a particularly high degree of
sequence similarity to the varicella zoster virus gene 51 product. A second
objective was to define how the DNA-binding domain interacts with the origin.
Results of gel shift analysis using contranslated proteins of different sizes
suggest that the DNA-binding domain can interact with a single binding site as a 
monomer. Binding to the wild-type Oris template indicated that the binding
domains can interact with both binding sites I and II independent of any
cooperative effect mediated by the amino-termini. This suggests that the basic
unit of recognition involved in OBP/Oris interactions may contain a single
DNA-binding domain of OBP in association with a single binding site.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 8259684 [PubMed - indexed for MEDLINE]

4967: Virology. 1994 Jan;198(1):385-9.

Equid herpesviruses 1 and 4 encode functional homologs of the herpes simplex
virus type 1 virion transactivator protein, VP16.

Purewal AS, Allsopp R, Riggio M, Telford EA, Azam S, Davison AJ, Edington N.

Department of Pathology and Infectious Diseases, Royal Veterinary College,
London, United Kingdom.

The herpes simplex virus type 1 (HSV-1) tegument protein VP16 is a potent
transcriptional inducer of immediate-early gene expression, comprising an
N-terminal domain involved in binding DNA linked to an acidic transactivating
C-terminal domain. The gene encoding the counterpart of this protein in equid
herpesvirus 4 (EHV-4) was sequenced. Comparisons with VP16 and the homologous
proteins of equine herpesvirus 1 (EHV-1) and varicella-zoster virus (VZV) showed 
that a region in the N-terminal domain involved in formation of a complex with
cellular proteins is partially conserved in all four proteins. In contrast, the
C-terminal regions of the EHV proteins, like that of VZV, are not particularly
acidic and are not significantly conserved with respect to the C-terminal region 
of VP16. Nevertheless, transient expression experiments indicated that the EHV-1 
and EHV-4 proteins are able to transactivate HSV-1 and EHV-1 immediate-early
promoters in a dose-dependent manner, which suggests that this activity is not
dependent on an acidic C-terminal domain.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8259676 [PubMed - indexed for MEDLINE]

4968: J Indian Med Assoc. 1994 Jan;92(1):17-9.

AIDS and the gateway of the body.

Bandyopadhyay P, Bhowal RN, Sikdar SN, Roy AK, Roy JG, Bandyopadhyay D, Pal NC,
Chatterjee BD.

Department of Dental Surgery, Medical College, Calcutta.

PIP: In the early phases of HIV infection, the oral cavity may develop
erythematous and pseudomembranous candidiasis, oral hairy leukoplakia (OHL),
necrotizing ulcerative periodontal disease, Kaposi's sarcoma, and infections with
Herpes simplex viruses, cytomegalovirus, Epstein-Barr virus, and Varicella zoster
virus. The leading oral infections are candidiasis and OHL. The most common oral 
form of candidiasis is pseudomembranous, which appears white and milky and can be
easily removed from the mucosal surface. After removal, this surface will bleed
and be raw. OHL forms a white, corrugated (hairy) 1 m to 2 cm patch, generally on
the lateral borders of the tongue. OHL rarely occurs in persons not infected with
HIV. HIV-positive people often experience considerable periodontal destruction,
causing much pain. They may also have atypical gingivitis. Painful, indolent oral
ulcers are often on the tongue, lip, gingiva, and esophagus. Almost everyone with
advanced HIV infection is seropositive for cytomegalovirus. Molluscum contagiosum
lesions in HIV-infected persons are larger and more numerous than those in
children. Various cutaneous or noncutaneous noninfective conditions (e.g.,
psoriasis and vasculitis) are also more common in HIV-infected persons. Possible 
agents to control candidiasis are fluconazole and chlorhexidine oral rinse.
Topical or systemic corticosteroids may control aphthous-like ulcers. The drug
acyclovir may control herpes virus and other viral infections. If acyclovir is
ineffective, desciclovir, ganciclovir, or foscarnet are possible alternatives.
Papilloma virus lesions can be treated with cryosurgery, laser therapy, or
surgical excision. Radiotherapy, chemotherapy, and interferon are treatments for 
Kaposi's sarcoma. Aspirin and other nonsteroidal anti-inflammatory drugs may be
contraindicated in patients with thrombocytopenia or who are on corticosteroid
therapy.

PMID: 8207272 [PubMed - indexed for MEDLINE]

4969: Virchows Arch. 1994;424(4):437-40.

Analysis of herpesvirus genomes in Kikuchi's disease.

Sumiyoshi Y, Kikuchi M, Minematu T, Ohshima K, Takeshita M, Minamishima Y.

First Department of Pathology, School of Medicine, Fukuoka University, Japan.

We examined the cervical lymph nodes of 30 patients with Kikuchi's disease and 15
patients with non-specific lymphadenitis, using Southern blot analysis and
polymerase chain reaction (PCR) to identify human herpesviruses such as
Epstein-Barr virus (EBV), cytomegalovirus, herpes simplex virus, and
varicella-zoster virus. By Southern blot analysis, no virus DNA was recognized,
but 16 of the 30 nodes from patients with Kikuchi's disease and 8 of the 15 nodes
from patients with non-specific lymphadenitis showed amplified EBV DNA by PCR.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8205356 [PubMed - indexed for MEDLINE]

4970: Acta Otolaryngol Suppl. 1994;511:170-4.

Gd-DTPA enhanced MRI in Ramsay Hunt syndrome.

Tada Y, Aoyagi M, Tojima H, Inamura H, Saito O, Maeyama H, Kohsyu H, Koike Y.

Department of Otolaryngology, Yamagata University School of Medicine, Japan.

Ten patients with Ramsay Hunt syndrome underwent magnetic resonance (MR) scans.
In many examinations, abnormal enhancement of the 7th nerve in the internal
acoustic meatal segment through the mastoid segment was observed. Out of seven
patients with cochlear and/or vestibular symptoms, only one showed abnormal
enhancement of the 8th nerve, in addition to the 7th. The other 6 patients showed
the same findings as in Bell's palsy, showing no enhancement of the 8th nerve.
This suggests that clinical symptoms have no relation to the results of MRI.
Enhanced MRI is the most sensitive means of making differential diagnoses between
Hunt's syndrome and tumors, but it is impossible to detect all lesion sites
corresponding to the symptoms in Hunt's syndrome.

Publication Types: 
    Case Reports

PMID: 8203224 [PubMed - indexed for MEDLINE]

4971: Acta Otolaryngol Suppl. 1994;511:161-4.

Electrophysiological study on the pathology of synkinesis after facial nerve
paralysis.

Maeyama H, Aoyagi M, Tojima H, Inamura H, Kohsyu H, Koike Y.

Department of Otolaryngology, Yamagata University School of Medicine, Japan.

By conducting electrophysiological tests on patients with facial nerve paralysis,
the characteristics of synkinesis and the mechanisms of its manifestations were
examined. The subjects were 114 patients of facial nerve paralysis on whom
electroneurography (ENoG) and the blink reflex were conducted. As a result, it
was indicated that synkinesis could be determined by the blink reflex, and that
the frequency of synkinesis manifestation increased with severity of paralysis.
From examination during the latent period, early component (SI) recognized in the
cases of synkinesis was found to be the waveform which passed the fibers with a
slow conducting speed. It was not related to the degree of degeneration of nerves
for either the severe or light degeneration of nerves. From the above result it
was concluded that synkinesis is generated as a misdirection of reproduced
nerves.

PMID: 8203222 [PubMed - indexed for MEDLINE]

4972: Acta Otolaryngol Suppl. 1994;511:156-60.

Recording of single fiber electromyography in patients with peripheral facial
palsy.

Takeda K, Tojima H, Aoyagi M, Koike Y.

Department of Otolaryngology, Yamagata University School of Medicine, Japan.

We determined muscle fiber density with single fiber electromyography (SFEMG) to 
discuss the condition of re-innervation after the recovery of facial movement in 
cases of peripheral facial palsy. Muscle fiber density was then compared with
electroneurography (ENoG) which is thought to correlate with the severity of
facial neuropathy in the early stage after the onset. The degree of neuropathy
and subsequent recovery of innervation was also discussed. The subjects were 36
patients with peripheral facial palsy (30 patients with Bell's palsy and 6 with
Hunt's syndrome), treated at our hospital, in whom ENoG could be recorded within 
2 weeks after the onset. Muscle fiber density was determined after the recovery
of facial movement. As a control, muscle fiber density was determined in 11
normal adults, and muscles on the healthy side in 23 patients with Bell's palsy. 
Muscle fiber density was 1.44 +/- 0.15 (mean +/- S.D.) in normal adults and 1.51 
+/- 0.18 on the healthy side in patients, showing no significant difference. Data
on the affected side were divided into 4 groups according to the minimum ENoG
level within 2 weeks after onset and were compared with the normal group. In all 
cases with an ENoG level of 40% or more, muscle fiber densities were normal, and 
no significant differences were noted between the affected side and the healthy
side. In cases with an ENoG level of less than 40%, muscle fiber density
increased significantly with increasing severity of denervation. These findings
suggest that collateral sprouting is absent in cases of peripheral facial palsy
who show an ENoG level of 40% or more, or no wallerian degeneration.

PMID: 8203221 [PubMed - indexed for MEDLINE]

4973: J Clin Lab Anal. 1994;8(2):105-15.

A rapid simple in situ hybridization method for herpes simplex virus employing a 
synthetic biotin-labeled oligonucleotide probe: a comparison with
immunohistochemical methods for HSV detection.

Wang JY, Montone KT.

Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia
19104.

We examined 28 paraffin-embedded tissue specimens with histologic evidence of
herpes virus infection by in situ hybridization (ISH) utilizing manual capillary 
action technology (MicroProbe Staining System) and a 21 base synthetic
multibiotinylated oligonucleotide probe from the HSV glycoprotein C region. The
results were compared to a rapid simple immunohistochemical (IHC) protocol for
detection of HSV proteins. HSV was detected by ISH and IHC in all but one
specimen which was shown to be positive for varicella zoster virus by direct
fluorescent antibody studies. Hybridization signal was confined to the nucleus in
all cases. Staining was identified in cells with early as well as late cytopathic
effect. IHC produced intense nuclear and/or cytoplasmic signal in infected cells 
and stained in areas of necrosis which were otherwise spared by ISH. HSV was
detected by IHC and/or ISH in 3/5 specimens with histology suggestive of, but not
diagnostic for, HSV infection. Both techniques were sensitive and specific for
HSV, resulted in rapid detection of the pathogen in routinely processed tissues, 
and may be useful in cases where the histologic impression is equivocal for HSV
infection. ISH for HSV may be preferred because it can identify early HSV
infection, which in turn can be treated with antiviral agents.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8189321 [PubMed - indexed for MEDLINE]

4974: Ann Neurol. 1994;35 Suppl:S69-72.

New antivirals with activity against varicella-zoster virus.

Gnann JW Jr.

University of Alabama at Birmingham 35294.

Herpes zoster is a serious medical problem, not only because of the discomfort
associated with the acute rash, but also because of the potential for
post-herpetic neuralgia. Acyclovir is currently the antiviral drug of choice for 
the treatment of herpes zoster. Efforts are underway to develop new drugs that
have improved activity against varicella-zoster virus as well as more favorable
pharmacokinetic properties. The goal of these efforts is to develop an orally
administered antiviral drug that will accelerate the events of cutaneous healing 
as well as reduce the frequency and severity of post-herpetic neuralgia.
Investigational drugs currently under evaluation include valaciclovir and
famciclovir, the prodrugs of acyclovir and penciclovir, respectively. Two new
uracil derivatives, sorivudine and BW882C87, with increased anti-varicella-zoster
virus activity in vitro are also being studied.

Publication Types: 
    Review

PMID: 8185303 [PubMed - indexed for MEDLINE]

4975: Ann Neurol. 1994;35 Suppl:S62-4.

Otological complications of herpes zoster.

Adour KK.

Department of Head and Neck Surgery, Kaiser Permanente Medical Center, Oakland,
CA 94611.

Otological complications of varicella-zoster virus (Ramsay Hunt syndrome) include
facial paralysis, tinnitus, hearing loss, hyperacusis (dysacousis), vertigo,
dysgeusia, and decreased tearing. Cranial nerves V, IX, and X are often affected.
Gadolinium-enhanced magnetic resonance imaging demonstrates enhancement of the
geniculate ganglion and facial nerve. These manifestations are identical to
Bell's palsy but are more severe and carry a graver prognosis. Eight percent of
Bell's palsy patients eventually are diagnosed as "zoster sine herpete." A new
case of Ramsay Hunt syndrome will occur every 52 minutes, compared to every 10
minutes for a new case of Bell's palsy.

Publication Types: 
    Review

PMID: 8185302 [PubMed - indexed for MEDLINE]

4976: Ann Neurol. 1994;35 Suppl:S57-61.

Other neurological complications of herpes zoster and their management.

Elliott KJ.

Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY
10021.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8185301 [PubMed - indexed for MEDLINE]

4977: Ann Neurol. 1994;35 Suppl:S54-6.

Chronic opioid therapy as alternative treatment for post-herpetic neuralgia.

Pappagallo M, Campbell JN.

Dept of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD 21287.

Neurosurgical procedures such as the dorsal root entry zone operation,
ganglionectomy, and spinal-cord stimulation have been offered to patients with
intractable post-herpetic neuralgia (PHN). Poor efficacy or high morbidity have
limited the overall usefulness of these procedures. We recently conducted a
preliminary open-label study with long-acting oral opioids. The mean pretreatment
pain score, on a scale of 0 to 10 (0 = no pain) was 9.0 +/- 0.3 (mean +/- SEM, N 
= 20). At two months of treatment the average pain score was 4.0 +/- 0.4 (p <
0.001, paired t test), and at six months the average pain score was 3.8 +/- 0.2
(p < 0.001, N = 16). These observations warrant a controlled opioid trial for
patients affected by PHN.

Publication Types: 
    Case Reports

PMID: 8185300 [PubMed - indexed for MEDLINE]

4978: Ann Neurol. 1994;35 Suppl:S50-3.

Treatment of post-herpetic neuralgia: antidepressants.

Max MB.

Clinical Trials Unit, National Institute of Dental Research, National Institutes 
of Health, Bethesda, MD 20892.

Five controlled clinical trials and extensive clinical experience have shown that
amitriptyline and several other antidepressants reduce the severity of
post-herpetic neuralgia. Studies in post-herpetic neuralgia and in painful
diabetic neuropathy suggest that blockade of norepinephrine reuptake is the most 
important action accounting for pain relief; selective agents such as desipramine
may be useful in patients unable to tolerate amitriptyline side effects. The
selective serotonin reuptake inhibitors, zimelidine and paroxetine, have shown
little effectiveness in neuropathic pain, but small studies in diabetic
neuropathy have shown that paroxetine and citalopram have modest effects. Studies
of the latter agents in post-herpetic neuralgia, concentration-response studies
of amitriptyline, and studies of drug combinations including antidepressants may 
lead to improved treatment.

Publication Types: 
    Review

PMID: 8185299 [PubMed - indexed for MEDLINE]

4979: Ann Neurol. 1994;35 Suppl:S46-9.

Managing post-herpetic neuralgia with opioids and local anesthetics.

Rowbotham MC.

Department of Neurology, University of California, San Francisco, School of
Medicine 94143-0114.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8185298 [PubMed - indexed for MEDLINE]

4980: Ann Neurol. 1994;35 Suppl:S42-5.

Pain modulation and the action of analgesic medications.

Fields H.

University of California, Department of Neurology and Physiology, San Francisco
94143-0114.

A general approach to improving the treatment of patients with post-herpetic
neuralgia is outlined. Pain-generating processes initiated by injury to
peripheral nerve and new treatments that target these processes are discussed.
Another described approach is to use knowledge of central nervous system
pain-modulating networks to improve the effectiveness of centrally acting
analgesics such as opioids and tricyclic antidepressants.

Publication Types: 
    Review

PMID: 8185297 [PubMed - indexed for MEDLINE]

4981: Ann Neurol. 1994;35 Suppl:S4-8.

Overview: the biology of varicella-zoster virus infection.

Straus SE.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, National Institutes of Health, Bethesda, MD 20892.

Varicella-zoster virus infection is manifested initially as chickenpox. The virus
persists for life in sensory nerve ganglia, from which it reactivates in many
people to cause zoster. Among the many recognized complications of these
infections, post-zoster neuralgia is the most frequently debilitating. The
molecular events of virus replication, latency, and reactivation, and the
pathogenesis of post-zoster neuralgia, are incompletely understood and
inadequately addressed by current therapeutic strategies.

Publication Types: 
    Review

PMID: 8185296 [PubMed - indexed for MEDLINE]

4982: Ann Neurol. 1994;35 Suppl:S38-41.

Hypotheses on the pathogenesis of herpes zoster-associated pain.

Bennett GJ.

Neurobiology and Anesthesiology Branch, National Institute of Dental Research,
National Institutes of Health, Bethesda, MD 20892.

Publication Types: 
    Review

PMID: 8185295 [PubMed - indexed for MEDLINE]

4983: Ann Neurol. 1994;35 Suppl:S35-7.

Immune senescence.

Weksler ME.

Department of Medicine, Cornell University Medical College, New York, NY
10021-4896.

The immune system changes dramatically with age. There is a decline in the
production of naive lymphocytes by the central lymphoid organs, the thymus and
bone marrow. This leads to a reduced diversity and altered repertoire of antigen 
specificities recognized by the immune system. Thus, with age there is a
progressive decline in the capacity of the immune system to react with foreign
antigens associated with an increased reactivity with autoantigens. As T cells
specific for certain microbial antigens decline with age, their capacity to
prevent reactivation of certain chronic infections such as herpes zoster
diminishes. This results in the increased reactivation of herpes zoster in
persons over 45 years old.

Publication Types: 
    Review

PMID: 8185294 [PubMed - indexed for MEDLINE]

4984: Ophthalmologica. 1994;208(2):61-4.

Bilateral retrobulbar neuritis following unilateral herpes zoster ophthalmicus.

Gunduz K, Ozdemir O.

Eye Clinic, Faculty of Medicine, University of Ankara, Turkey.

A 48-year-old male diagnosed with right-onset herpes zoster ophthalmicus
developed visual acuity loss in the left eye during the following 3 weeks.
Visually evoked cortical potential recordings revealed a marked increase in P100 
latency and a marked decrease in its amplitude in both eyes. Pattern
electroretinography suggested diffuse pathology with reduced positive and
negative components. A possible transsynaptic or intraneural spread of the
varicella-zoster virus in the optic nerve might be responsible for this
unexplained contralateral loss of visual acuity.

Publication Types: 
    Case Reports

PMID: 8183526 [PubMed - indexed for MEDLINE]

4985: J Rheumatol. 1994 Jan;21(1):84-6.

Herpes zoster infections in systemic lupus erythematosus: risk factors and
outcome.

Kahl LE.

Department of Internal Medicine, Washington University School of Medicine, St.
Louis, MO.

OBJECTIVE. To determine factors that influence the frequency and outcome of
herpes zoster infection in patients with systemic lupus erythematosus (SLE).
METHODS. In this case-central retrospective study, patients with a history of
zoster infection were identified from our computerized database of 348 patients
with SLE. Medical records were reviewed to establish activity of SLE at the time 
of zoster, as well as complications of the zoster infection. RESULTS. Fifty-five 
episodes of zoster occurred among 47 (13.5%) patients, at a rate of 16
episodes/1000 patient-years of followup. Dissemination occurred in 6 episodes
(11%), and was more frequent during immunosuppressive therapy [odds ratio (OR) = 
4.0]. Bacterial superinfection occurred in 5 (9%), resulting in one death from
sepsis, and was increased among patients receiving prednisone > or = 60 mg daily 
(OR = 4.1). Compared to those without zoster, patients with zoster were
significantly more likely to have previously had serious disease manifestations
including nephritis, thrombocytopenia or hemolytic anemia, and to have received
treatment with cyclophosphamide (all p < or = 0.05). However, 65% of zoster
episodes occurred during mild or inactive SLE, when the majority of patients were
receiving less than 20 mg prednisone daily and no immunosuppressive therapy.
CONCLUSION. Herpes zoster infections occur at increased frequency among patients 
with SLE compared to the general population, and carry significant morbidity.
Patients who have had severe manifestations of lupus are at greatest risk of
zoster, though not necessarily at the time of disease flare or immunosuppressive 
therapy. If disease activity allows, a reduction in prednisone dosage may reduce 
the risk of bacterial superinfection during zoster episodes.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8151595 [PubMed - indexed for MEDLINE]

4986: J Photochem Photobiol B. 1994 Jan;22(1):37-43.

Photodynamic inactivation of herpes viruses with phthalocyanine derivatives.

Smetana Z, Mendelson E, Manor J, van Lier JE, Ben-Hur E, Salzberg S, Malik Z.

Central Virology Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel.

The antiviral photosensitization capacity of 11 different phthalocyanine (Pc)
derivatives was examined using herpes simplex virus-1, herpes simplex virus-2 and
varicella zoster virus in the search for the most potent sensitizers for viral
decontamination of blood. The kinetics of viral photoinactivation were resolved
during the stages of viral adsorption and penetration into the host cells. The
capacity of Pc in the photodynamic inactivation of viruses was compared with that
of merocyanine 540 (MC540), another widely studied photosensitizer. Sensitivity
to photoinactivation decreased progressively with time after addition of viruses 
to their host cells. The viruses were most sensitive to photodynamic inactivation
up to 30 min from the initiation of adsorption. Cell-associated viruses, 45-60
min after the onset of adsorption, are highly resistant to photodynamic treatment
by most photosensitizers, with the exception of amphiphilic Pc derivatives. Thus 
the mixed sulfonated Pc-naphthalocyanine derivatives AlNSB3P and AlN2SB2P
demonstrated a remarkable decontamination activity even 60 min after the onset of
adsorption. Ultrastructural examination of these photosensitized viruses
demonstrated damage to the viral envelope which prevented viral adsorption and/or
penetration. The non-enveloped adenovirus was found to be resistant to all the
dyes tested.

PMID: 8151454 [PubMed - indexed for MEDLINE]

4987: J Child Neurol. 1994 Jan;9(1):56-8.

Disseminated multifocal herpes zoster leukoencephalitis and subcortical
hemorrhage in an immunosuppressed child.

Herrold JM, Hahn JS.

Department of Neurology, Stanford University, Palo Alto, CA.

We describe a rare case of multifocal varicella-zoster leukoencephalitis in an
immunosuppressed adolescent boy who developed a herpetiform rash on his groin and
subsequently presented with a subacute encephalopathy, aphasia, and hemiparesis. 
Magnetic resonance imaging scan of the brain revealed multifocal bi-hemispheric
target-like lesions predominantly in the white matter. A magnetic resonance
imaging scan 2 weeks later showed a subcortical hemorrhage in the left insular
region. He received long-term high-dose intravenous acyclovir and had significant
improvement in his neurologic status.

Publication Types: 
    Case Reports

PMID: 8151085 [PubMed - indexed for MEDLINE]

4988: Ophthalmologica. 1994;208(1):41-3.

Detection of varicella-zoster virus DNA in conjunctivas of patients with herpes
zoster.

Tamura T, Yoshida M, Tezuka T.

Department of Dermatology, School of Medicine, Kinki University, Osaka, Japan.

Detection of varicella-zoster virus (VZV) DNA was carried out in the conjunctivas
of 18 patients with herpes zoster by polymerase chain reaction. The rate of VZV
DNA detection in conjunctivas was 3/4 in herpes zoster ophthalmicus associated
with eruption on the dorsum nasi, 2/5 in herpes zoster ophthalmicus without
eruption on the dorsum nasi, 1/2 in herpes zoster with eruption on the cheek and 
lower jaw, 1/2 in generalized herpes zoster and 0/5 in herpes zoster associated
with eruption on the trunk or extremities, respectively. The reason for the
detection of VZV DNA in conjunctivas is discussed.

PMID: 8145984 [PubMed - indexed for MEDLINE]

4989: Dermatol Clin. 1994 Jan;12(1):51-68.

Tests for detecting herpes simplex virus and varicella-zoster virus infections.

Cohen PR.

Department of Dermatology, University of Texas-Houston Medical School.

Several laboratory diagnostic methods are available for the diagnosis,
differentiation, and subtyping of HSV and VZV infections. In the office or at the
bedside of a hospitalized patient, a positive Tzanck smear preparation is an
inexpensive, rapid, and morphologic technique for confirming a suspected
diagnosis of a herpesvirus infection. An expedient, slightly more expensive,
reliable technique for establishing a HSV infection, yet not able to
differentiate the subtype of that infection, is a recently marketed monoclonal
antibody-based filtration type enzyme immunoassay (Kodak SureCell Herpes Test
Kit). Serologic tests traditionally do not have a major role in the diagnosis of 
HSV infection; yet, new type-specific methods using Western blot assays may be
useful for confirming the presence of unrecognized, subclinical HSV2 infections
that are presently being underdiagnosed by current procedures. The gold standard 
for establishing the diagnosis of HSV infection has been the viral tissue
culture. The fluorescent antibody to membrane antigen test and viral tissue
culture have been the principal methods for diagnosing VZV infection.
Immunomorphologic techniques have been useful adjuvant methods for both the
diagnosis and the differentiation of HSV and VZV infections. Molecular virology
techniques (particularly those using PCR) are likely to become the diagnostic
methods of choice for both HSV infection and VZV infection once these tests
become commercially available.

Publication Types: 
    Review

PMID: 8143385 [PubMed - indexed for MEDLINE]

4990: Dermatology. 1994;188(2):108-12.

Spectrum of dermatological lesions in renal allograft recipients in a tropical
environment.

Chugh KS, Sharma SC, Singh V, Sakhuja V, Jha V, Gupta KL.

Department of Nephrology, Postgraduate Institute of Medical Education and
Research, Chandigarh, India.

A total of 157 renal allograft recipients were followed for over 1-23 months for 
the development of dermatological lesions. The non-infective lesions related to
immunosuppressive drugs included cushingoid features in 133 (84.7%), xerosis in
120 (76.4%), striae in 69 (43.9%), hypertrichosis in 65 (21.6%), facial erythema 
in 42 (26.7%) and friable skin in 34 (21.4%) patients. Of the infective lesions, 
cutaneous mycoses were the most frequent (82.6%) and included tinea corporis and 
cruris in 82 (52.2%), tinea versicolor in 21 (13.3%), candidiasis in 7 (4%),
onychomycosis in 4 (2%) and cryptococcosis in 2 (1.2%) patients. Viral infections
included those due to herpes zoster in 17 (10.8%), herpes simplex in 5 (3.1%) and
viral warts in 13 (8.2%) patients. Cutaneous malignancy was seen in 1 patient
only.

PMID: 8136535 [PubMed - indexed for MEDLINE]

4991: Infect Control Hosp Epidemiol. 1994 Jan;15(1):61-2.

Valaciclovir more effective than acyclovir in reducing pain from shingles.

[No authors listed]

Publication Types: 
    News

PMID: 8133011 [PubMed - indexed for MEDLINE]

4992: Anaesthesist. 1994 Jan;43(1):53-4.

Comment on:
    Anaesthesist. 1992 Dec;41(12):772-8.

[Comments on the paper by P. Hugler et al. The therapy of postherpetic zoster
neuralgia]

[Article in German]

Maier C, Baron R, Hertel D, Hildebrandt J, Simgen WL, Sprotte G, Werkmeister J,
Wulf H, Zech D.

Publication Types: 
    Comment

PMID: 8122726 [PubMed - indexed for MEDLINE]

4993: Clin Microbiol Rev. 1994 Jan;7(1):1-13.

"The end of innocence" revisited: resistance of herpesviruses to antiviral drugs.

Field AK, Biron KK.

Hybridon, Inc., Worcester, Massachusetts 01605.

In the past 4 years, interest in drug-resistant herpesviruses has evolved from
the realm of academic laboratory studies to that of great clinical importance.
Recurrent and persistent infections due to the herpes simplex viruses,
varicella-zoster virus, and human cytomegalovirus have been an unwelcome
consequence of immunosuppression in graft recipients, cancer patients, and those 
suffering from AIDS. Treatment of these infections with the available antiviral
drugs, such as acyclovir, ganciclovir, and foscarnet, has resulted in both
clinical benefit and the emergence of drug-resistant variants. In addition, the
role of Epstein-Barr virus is being clarified for an array of disease syndromes, 
and therapeutic approaches are beginning to emerge. In the present review, the
emergence and clinical importance of drug resistance among the herpesviruses have
been explored. Furthermore, particular attention has been focused on our
understanding of the mechanisms of drug resistance and how that understanding
will guide us in the development of more effective antiviral drugs and drug
usage.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8118786 [PubMed - indexed for MEDLINE]

4994: Nippon Jinzo Gakkai Shi. 1994 Jan;36(1):44-50.

Nephrotic syndrome in the elderly--clinicopathological study.

Ozono Y, Harada T, Yamaguchi K, Taura K, Hara K, Taguchi T.

2nd Department of Internal Medicine of Nagasaki University, Japan.

Clinical and pathological findings and the effects of therapy were investigated
in 90 cases of nephrotic syndrome (NS) in elderly patients aged over 60 years.
Membranous nephropathy was the most frequent type of primary NS. Amyloidosis and 
malignancy were common causes of secondary NS. Damage to the interstitium in the 
kidney, such as focal mononuclear cell infiltration, fibrosis and thickening of
the small arterial wall in membranous cases, was often observed. Stage I and II
based on electron-microscopy, were mainly observed in the patients, with
membranous nephropathy. Prednisolone and immunosuppressive agent were most
effective in these patients with membranous nephropathy. Prednisolone alone was
the most effective on minimal change NS in the elderly. In the course of therapy,
side effects such as pneumonia, sepsis due to fungus infections, such as
aspergillus and candida, and infection, such as cytomegalovirus and herpes
zoster, were more frequently observed, especially in the cases of MPGN, DPGN with
moderate to severe mesangial proliferation, with a decline in renal function (Ccr
< 50 L/day) and secondary NS. In secondary NS, the prognosis of amyloidosis was
very poor and the findings pointed to a relationship between malignancy and
nephrotic syndrome.

PMID: 8107308 [PubMed - indexed for MEDLINE]

4995: Ann Med Interne (Paris). 1994;145(3):194-6.

[Herpes zoster meningoradiculitis in AIDS]

[Article in French]

Debourdeau P, Blum L, Cabane J, Picard O, Imbert JC.

Publication Types: 
    Case Reports
    Letter

PMID: 8092636 [PubMed - indexed for MEDLINE]

4996: Acta Otolaryngol Suppl. 1994;514:132-4.

Detection of human alpha-herpesvirus DNA using consensus primers and specific
probes.

Aono T, Murakami S, Yanagihara N, Yamanishi K.

Department of Virology, Osaka University, Japan.

A simple and rapid diagnostic assay system was developed for detecting and
identifying human alpha-herpesviruses, such as herpes simplex virus types 1 and 2
and varicella-zoster virus, by polymerase chain reaction. This system was based
on an amplification step, using primers that bind the DNA polymerase consensus
sequence of alpha-human herpesviruses, and a detection step, using
non-radioactive virus-specific probes. This method could be used to amplify any
human alpha-herpesviruses, and each virus-specific probe was highly specific for 
identification of the amplified product. This system is readily applicable for
implementation in the clinical laboratory.

PMID: 8073876 [PubMed - indexed for MEDLINE]

4997: Acta Clin Belg. 1994;49(2):104-7.

Atypical varicella zoster infection in persons with HIV infection.

Colebunders R, Van Damme L, Van den Abbeele K, Fleerackers Y, Van den Enden E,
Dockx P.

Instituut voor Tropische Geneeskunde, Antwerpen, Belgie.

Four patients with HIV infection and severe immunodeficiency are described who
developed atypical varicella zoster lesions. Three of the patients presented with
chronic varicella zoster lesions. In two of them such lesions were
hyperkeratotic. All three patients had been treated initially with subtherapeutic
doses of acyclovir. In one of the patients the lesions were clinically resistant 
to high dose acyclovir treatment and disappeared only when renal insufficiency
developed during foscarnet-famcyclovir treatment. One patient developed a
disseminated varicella zoster infection.

Publication Types: 
    Case Reports

PMID: 8067171 [PubMed - indexed for MEDLINE]

4998: J Int Med Res. 1994;22 Suppl 1:33A-42A.

Acyclovir--and beyond.

Darby G.

Wellcome Research Laboratories, Wellcome Foundation Ltd., Beckenham, Kent, UK.

Over the past 15 years, acyclovir has become established as standard therapy for 
the management of herpes simplex virus infections, but there are areas where
improvements might be made. Acyclovir has a relatively low oral bioavailability. 
As a result, valaciclovir, the L-valine ester of acyclovir, is being developed.
This new drug produces enhanced plasma levels of acyclovir following oral dosing,
which will not only allow more convenient dosing for the treatment of herpes
simplex virus and varicella zoster virus (VZV) infections, but also mean that
valaciclovir has the potential for superior clinical efficacy over acyclovir.
This may broaden the potential utility of the drug to include human
cytomegalovirus prophylaxis. Other new drugs in the antiherpes area include
penciclovir and its pro-drug famciclovir, which have antiviral characteristics
similar to acyclovir but no clinical benefit over and above that seen with
acyclovir has been demonstrated. The synthesis of new specific antiherpes
compounds has led to the discovery of a novel nucleoside analogue, 882C87, which 
has significantly greater activity against VZV than acyclovir. The compound also 
has a longer plasma half-life than acyclovir which may permit less frequent
dosing.

Publication Types: 
    Review

PMID: 8063023 [PubMed - indexed for MEDLINE]

4999: J Int Med Res. 1994;22 Suppl 1:3A-12A; discussion 12A-13A.

Clinical aspects of chickenpox and herpes zoster.

Balfour HH Jr.

Department of Laboratory Medicine and Pathology, University of Minnesota Health
Sciences Center, Minneapolis.

Chickenpox in immunocompromised individuals is potentially fatal and should be
treated with intravenous acyclovir as soon as it is recognized. Data from four
double-blind, placebo-controlled trials in the USA provide a sound scientific
basis for using acyclovir to treat chickenpox in immunocompetent individuals.
Three studies in children and a fourth study in US naval recruits showed
statistically significant reductions in the duration of fever, constitutional
illness, and time to cutaneous healing, when treatment was initiated within 24 h 
of rash onset. Although chickenpox is generally mild in children the severity of 
the disease increases with age and secondary cases in the family tend to be more 
ill than the primary case. It is recommended that secondary and tertiary cases in
a family, and adolescents and adults with chickenpox be treated with acyclovir.
In immunocompromised hosts, intravenous acyclovir halts the progression of herpes
zoster and is recommended as therapy during new lesion formation. Herpes zoster
in otherwise normal hosts is rarely accompanied by visceral dissemination, but
carries an increasing risk of post-herpetic neuralgia with increasing age.
Published clinical trials have shown a reduction in the duration and severity of 
acute pain during herpes zoster for patients treated with acyclovir, but results 
for chronic pain are conflicting with some, but not all, studies showing a
beneficial effect.

Publication Types: 
    Review

PMID: 8063022 [PubMed - indexed for MEDLINE]

5000: Rev Assoc Med Bras. 1994 Jan-Mar;40(1):71.

[Psychiatric disorders related to acyclovir use in a patient with renal
insufficiency]

[Article in Portuguese]

Nishioka Sde A, Manfrim RF.

Publication Types: 
    Case Reports
    Letter

PMID: 8061702 [PubMed - indexed for MEDLINE]

5001: J Cancer Res Clin Oncol. 1994;120(9):545-9.

Inhibition of fluorouracil catabolism in cancer patients by the antiviral agent
(E)-5-(2-bromovinyl)-2'-deoxyuridine.

Keizer HJ, De Bruijn EA, Tjaden UR, De Clercq E.

University Hospital Leiden, Department of Clinical Oncology, The Netherlands.

The thymidine analogue (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVdUrd), which is an
antiviral agent effective against herpes simplex virus type 1 and varicella
zoster virus, has also proved to be a potent inhibitor of dihydrouracil
dehydrogenase, the major degrading enzyme of the anticancer drug fluorouracil
(FUra). To evaluate the effect of BVdUrd on the pharmacokinetics of FUra in
cancer patients, BVdUrd was administered orally at a daily dose of 250 mg (five
patients) or 3 x 250 mg (five patients). FUra was infused at doses of 110-400 mg 
over 10 min. Blood and urine samples were collected regularly during a period of 
up to 50 h. BVdUrd was rapidly absorbed, peak plasma levels of 0.6-7.1
micrograms/ml being achieved after 1-2 h. Following a rapid decline, plasma
BVdUrd levels remained higher than 10 ng/ml for up to 2 days after BVdUrd
administration. The total body clearance of FUra was approximately 61/h and t1/2 
markedly increased to 4-7 h. The mean urinary excretion of FUra was 50%. No
differences in FUra kinetics were observed between patients receiving one or
three oral doses of BVdUrd. We conclude that the concomitant use and subsequent
interaction of FUra and the antiviral agent BVdUrd resulted in an impressive
inhibition of FUra breakdown and marked increase of renal clearance. The findings
indicate that the simultaneous use of FUra and drugs resembling this antiviral
agent in patients may result in unexpected toxicity. Further experience with
BVdUrd and new analogues might enable the development of new FUra treatment
schedules and treatment designs e.g. combinations with leucovorin.

PMID: 8045919 [PubMed - indexed for MEDLINE]

5002: Eye. 1994;8 ( Pt 1):70-4.

Comment in:
    Eye. 1995;9 ( Pt 3):390-2.

Influence of oral acyclovir on ocular complications of herpes zoster
ophthalmicus.

Aylward GW, Claoue CM, Marsh RJ, Yasseem N.

Bascom Palmer Eye Institute, Miami, FL 33101.

The role of oral acyclovir (ACV) in the management of immunocompetent patients
with herpes zoster ophthalmicus remains controversial. We have performed a
retrospective, comparative, case-control study of cases seen in the Zoster Clinic
at Moorfields Eye Hospital over the last 5 years. A standard proforma was used
during this period to collect data on the rash, ocular involvement and treatment.
There were 419 immunocompetent patients of whom 77 were treated with oral ACV
prior to attending the clinic. We compared these with paired controls matched for
age, sex and severity of rash. No difference in the rate of ocular complications 
between treated and untreated patients could be detected. This suggests that oral
ACV as currently prescribed has little or no preventive effect on the ocular
complications of ophthalmic zoster.

Publication Types: 
    Comparative Study

PMID: 8013722 [PubMed - indexed for MEDLINE]

5003: Adv Pediatr. 1994;41:453-70.

Premature exfoliation of teeth in childhood and adolescence.

Hartsfield JK Jr.

Department of Oral-Facial Development, Indiana University School of Dentistry,
Indianapolis.

Although the premature loss of primary teeth in conjunction with early eruption
may be of no clinical significance, the loss of primary or permanent teeth in the
absence of trauma should not be overlooked by the clinician. Premature loss of
teeth associated with systemic disease usually results from some change in the
immune system or connective tissue. This chapter presented some conditions
associated with loosening and/or premature loss of teeth that may be encountered 
in children and adolescents. The most common of these conditions appear to be
hypophosphatasia and early-onset periodontitis. Other less common conditions were
described to aid in forming a differential diagnosis. Other diseases that may
manifest with severe oral infection, such as Wiskott-Aldrich syndrome, diabetes
mellitus, or herpes zoster, could result in early tooth loss.

Publication Types: 
    Review

PMID: 7992695 [PubMed - indexed for MEDLINE]

5004: Klin Med (Mosk). 1994;72(3):66-8.

[Clinical classification of herpes zoster]

[Article in Russian]

Shishov AS.

Publication Types: 
    Review

PMID: 7990365 [PubMed - indexed for MEDLINE]

5005: Viral Immunol. 1994;7(1):31-6.

Immune response to secondary immunization with live or inactivated VZV vaccine in
elderly adults.

Hayward AR, Buda K, Levin MJ.

Department of Pediatrics, University of Colorado School of Medicine, Denver.

Healthy varicella zoster virus (VZV) immune subjects > 55 years old, were
immunized with 4,000 PFU of Oka strain VZV live vaccine or a similar amount of
heat-inactivated vaccine. A subset of each group was also immunized with tetanus 
toxoid (TT) 3 months before receiving the VZV vaccine. The live and inactivated
VZV vaccine groups had similar ages, sex distribution, and previous immunity to
VZV. The live and inactivated VZV vaccines elicited similar increases in the
frequency in blood of VZV-specific T cells, in vitro interferon-gamma production,
and serum antibody levels both 3 and 12 months after immunization. Individuals
with the highest responder cell frequency (RCF) at entry had the highest
postimmunization RCF following either vaccine. There was no correlation at entry 
between the RCF to TT or RCF to VZV. There was a weak (P = 0.05) correlation in
the incremental response to TT and VZV among individuals who responded to both
vaccines. Entry variables that did not correlate with the response included
percent of T cells or the CD45R0 (memory) T cell subset in blood, serum antibody 
levels, or amount of interferon-gamma production. The results indicate that the
inactivated vaccine is safe for VZV-immune subjects and boosts their antibody and
T-cell responses as effectively as the live vaccine for at least 1 year following
immunization.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7986334 [PubMed - indexed for MEDLINE]

5006: Vox Sang. 1994;67(1):85.

Cold agglutinin syndrome and liver transplantation.

Nydegger U, Hardegger T, Tobler A, Rieder H, Cerniak A, Lammle B.

Publication Types: 
    Case Reports
    Letter

PMID: 7975463 [PubMed - indexed for MEDLINE]

5007: Dermatology. 1994;189(3):312.

Herpes zoster and Ogilvie's syndrome.

Alpay K, Yandt M.

Publication Types: 
    Case Reports
    Letter

PMID: 7949493 [PubMed - indexed for MEDLINE]

5008: Scand J Infect Dis. 1994;26(3):239-47.

Cytomegalovirus infection rate among heart transplant patients in relation to
anti-thymocyte immunoglobulin induction therapy. Copenhagen Heart Transplant
Group.

Krogsgaard K, Boesgaard S, Aldershvile J, Arendrup H, Mortensen SA, Petterson G.

Department of Infectious Diseases M, Rigshospitalet, University of Copenhagen,
Denmark.

During a 2-year period, 49 patients underwent heart transplantation at
Rigshospitalet, Copenhagen. Nine (18%) were females and the mean age for all
patients was 44 years (range 14-56 years). Immunosuppressive therapy included
cyclosporin, azathioprine and steroids in all patients. 43 patients received in
addition short-term (approx. 4 days) induction treatment with antithymocyte
immunoglobulin (ATG). 17 patients received ATG Fresenius, 2.5 mg/kg/day or ATGAM,
12.5 mg/kg/day, whereas the remaining 26 patients received ATG Merieux, 2.5
mg/kg/day. Prophylactic antimicrobial chemotherapy included ceftriaxone,
acyclovir (1 g daily), nystatin, and pyrimethamine in toxoplasmosis mismatch
patients. Serological assays for cytomegalovirus (CMV), Epstein-Barr virus,
varicella-zoster virus, herpes simplex virus, legionella and toxoplasmosis as
well as CMV and bacterial culturing were carried out before transplantation, at
regular intervals and when clinically indicated. Five patients developed
septicaemia. Nine had pulmonary bacterial infections, including 2 cases of
legionella pneumonia. Two had Clostridium difficile diarrhoea. Three patients had
Pneumocystis carinii pneumonitis. 24 patients (49%) had evidence of CMV
infection/reactivation. Seven out of 10 CMV mismatch (pos donor/neg recipient)
patients and 3 out of 12 CMV match (pos donor/pos recipient) patients developed
clinical CMV disease. The rate of CMV infection/reactivation was significantly
higher among patients who had CMV-positive donors (p < 0.01) and among patients
receiving ATG Merieux induction treatment (p < 0.0001). Logistic regression
analysis showed that both positive CMV donor status and ATG Merieux induction
treatment were significant independent predictors of CMV infection. Six patients 
(12%) died. Two out of 4 infection related deaths could be ascribed to CMV
disease.

PMID: 7939422 [PubMed - indexed for MEDLINE]

5009: J Formos Med Assoc. 1994 Jan;93(1):75-7.

Herpes zoster in infancy after intrauterine exposure to varicella zoster virus:
report of two cases.

Huang JL, Sun PC, Hung IJ.

Department of Pediatrics, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.

Herpes zoster occurs very rarely in infancy. We report two infants who developed 
zoster-like lesions at three and seven months of age. They had no history of
chickenpox after birth. Both mothers acquired varicella infection during their
sixth month of pregnancy. The crops of vesicular rashes appeared in right L1-3
dermatomes in one patient and left V3, C2 dermatomes in the other. Laboratory
findings demonstrated a four-fold rise in varicella zoster virus (VZV) IgG
antibody in one patient and positive VZV IgM antibody in the other. Both infants 
received acyclovir treatment and the skin lesions healed rapidly without sequela.
In infancy, herpes zoster may be the primary clinical manifestation of
reactivation of latent VZV infection acquired transplacentally during
intrauterine life.

Publication Types: 
    Case Reports

PMID: 7915587 [PubMed - indexed for MEDLINE]

5010: Ann Neurol. 1994;35 Suppl:S1-72.

Varicella-Zoster Virus Infection: New Insights into Pathogenesis and
Post-Herpetic Neuralgia. Workshop proceedings. Bethesda, Maryland, May 13-14,
1993.

[No authors listed]

Publication Types: 
    Congresses
    Overall
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7910447 [PubMed - indexed for MEDLINE]

5011: Curr Med Res Opin. 1994;13(4):207-13.

Herpes zoster: a comparative study of general practitioner and patient
experience.

Henry T.

Spectrum Research Limited, Cheltenham, England.

A study was carried out to compare attitudes, perceptions and experiences of
general practitioners and patients who had treated/suffered from herpes zoster,
or shingles, in the recent past. Randomized samples of 224 general practitioners 
and 236 patients were drawn from different locations in Italy, Germany and the
United Kingdom, and interviews were undertaken as semi-structured face-to-face
discussions with the subjects. Most of the discussion questions were the same for
both samples but specifically targeted either towards the professional or the
patient group. Analysis of the findings showed that although there was a high
level of correlation between the two groups on opinions and attitudes on a number
of issues, there were significant, important differences on others. For example, 
prodromal symptoms acknowledged by patients were not always recognized by general
practitioners and there appeared to be an inability of some to diagnose early
enough to take advantage of appropriate anti-viral therapy whilst they
acknowledged the need to do so. This in turn led to a number of patients either
not receiving specific therapy or having inadequate therapy. Similarly, whilst
general practitioners mainly reflected the current medical view that shingles is 
a benign and self-limiting condition, patients tended to consider shingles and
post-herpetic neuralgia as a painful and serious condition that adversely
affected their quality of life and to a greater extent than appreciated by many
doctors. The findings of the survey indicate that there is need for improved
understanding of the disease and its effects by both doctors and
patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 7882700 [PubMed - indexed for MEDLINE]

5012: Eye. 1994;8 ( Pt 6):688-91.

Comparison of topical and oral acyclovir in early herpes zoster ophthalmicus.

Neoh C, Harding SP, Saunders D, Wallis S, Tullo AB, Nylander A, Nelson ME.

St Paul's Eye Unit, Royal Liverpool University Hospital, UK.

Poor systemic absorption has limited the efficacy of early oral acyclovir in
herpes zoster ophthalmicus (HZO). Aqueous humour levels are substantially higher 
if the drug is administered topically to the eye. A multicentre open randomised
study was performed to compare the ocular prophylactic effects of topical and
oral acyclovir. Fifty-seven patients with HZO within 72 hours of the onset of
rash received either topical acyclovir ointment or 800 mg oral acyclovir, both 5 
times daily for 7 days, and were followed for 12 months. Patients receiving
ointment were significantly more likely to have ocular complications (p < 0.02)
and anterior uveitis was significantly more frequent (p < 0.01) and severe (p <
0.01). Corneal hypoaesthesia was significantly more frequently (p < 0.05) and
severe (p < 0.02) at 1 month. From 2 weeks patients receiving ointment were more 
likely to have pain and at all times their pain was more severe, but these
differences were not statistically significant. In spite of its apparently better
penetration topical acyclovir appears to have no prophylactic value in the
management of early HZO.

Publication Types: 
    Clinical Trial
    Comparative Study
    Multicenter Study
    Randomized Controlled Trial

PMID: 7867830 [PubMed - indexed for MEDLINE]

5013: Eye. 1994;8 ( Pt 6):684-7.

Detection of varicella-zoster virus DNA in ocular samples from patients with
uveitis but no cutaneous eruption.

Stavrou P, Mitchell SM, Fox JD, Hope-Ross MW, Murray PI.

Birmingham & Midland Eye Hospital, UK.

Herpes zoster ophthalmicus is a well-recognised cause of intraocular
inflammation, which may become recurrent or chronic after the acute phase has
elapsed. Although it commonly presents with the typical rash, cases of ocular
zoster with no cutaneous eruption have been well documented. We present two
patients with unilateral anterior uveitis complicated by cataract, in whom
molecular techniques based on the polymerase chain reaction detected
varicella-zoster virus DNA in intraocular material obtained during cataract
surgery. Neither patient gave a history of cutaneous eruption.

Publication Types: 
    Case Reports

PMID: 7867829 [PubMed - indexed for MEDLINE]

5014: Int Ophthalmol. 1994;18(3):163-5.

The progressive outer retinal necrosis syndrome.

Holland GN.

UCLA School of Medicine, Jules Stein Eye Institute 90024-7003.

The progressive outer retinal necrosis (PORN) syndrome is a recently described
clinical variant of necrotizing herpetic retinopathy in patients with the
acquired immunodeficiency syndrome (AIDS). It is caused by varicellazoster virus 
infection of the retina. Its course and clinical features distinguish it from the
acute retinal necrosis syndrome and CMV retinopathy. Early disease is
characterized by multifocal deep retinal opacification. Lesions rapidly coalesce 
and progress to total retinal necrosis over a short period of time. Despite
aggressive therapy with intravenous antivirial drugs, prognosis is poor; disease 
progression and/or recurrence is common, and the majority of patients develop no 
light perception vision. Total retinal detachments are common. Prophylaxis
against retinal detachment using laser retinopexy has not been useful in most
cases. PORN syndrome is an uncommon, but devastating complication of AIDS.

Publication Types: 
    Review

PMID: 7852023 [PubMed - indexed for MEDLINE]

5015: Eye. 1994;8 ( Pt 5):577-9.

Orbital disease in herpes zoster ophthalmicus.

Vardy SJ, Rose GE.

Orbital and Adnexal Service, Moorfields Eye Hospital, London, UK.

Three cases of orbital inflammatory disease caused by herpes zoster are
described. This extremely rare complication occurred between 5 days and 14 days
following the skin eruption and slowly resolved with or without treatment. Biopsy
of a chronic inflammatory lesion on the cheek of one patient demonstrated a
sterile vasculitis and granulomatous liponecrosis, a process which may underlie
the orbital disease in these patients.

Publication Types: 
    Case Reports

PMID: 7835456 [PubMed - indexed for MEDLINE]

5016: Nephron. 1994;68(2):262-4.

Syndrome of inappropriate antidiuretic hormone secretion and herpes zoster
infection: 1. Report of this association in a patient suffering from AIDS.

Arzuaga JA, Estirado E, Roman F, Perez-Maestu R, Masa C, de Letona JM.

Servicio de Medicina Interna II, Clinica Puerta de Hierro, Universidad Autonoma
de Madrid, Espana.

The syndrome of inappropriate secretion of antidiuretic hormone is a common
consequence of neurologic and pulmonary infections as well as drug intake and
many other clinical situations. Its association with herpes varicella-zoster
virus infections is scarcely reported in the literature. It generally appears in 
immunosuppressed patients suffering from serious underlying diseases. There are
also a few cases of syndrome of inappropriate secretion of antidiuretic hormone
related to vidarabine use. We report the case of a man infected by human
immunodeficiency virus who developed a disseminated herpes varicella-zoster virus
infection and symptoms due to hyponatremia caused by antidiuretic hormone excess.
The patient was cured with saline hypertonic infusion, water restriction, and
intravenous administration of acyclovir. To the best of our knowledge, this is
the first case of this association in a human immunodeficiency virus infected
patient. We propose the use of acyclovir instead of vidarabine in the management 
of these situations.

Publication Types: 
    Case Reports

PMID: 7830868 [PubMed - indexed for MEDLINE]

5017: Leuk Lymphoma. 1994;14 Suppl 1:115-9.

Deoxycoformycin induces long-lasting remissions in hairy cell leukemia: clinical 
and biological results of two different regimens.

Annino L, Ferrari A, Giona F, Cimino G, Crescenzi S, Cava MC, Pacchiarotti A,
Mandelli F.

Dept. of Human Biopathology, University La Sapienza, Rome, Italy.

The use of alpha interferon (alpha IFN) and, more recently, of the purine
analogues deoxycoformycin (dCF) and 2-chlorodeoxyadenosine (2-CdA) has
dramatically improved the prognosis of patients affected by hairy cell leukemia
(HCL). DCF has been shown to induce an higher and more durable response rate than
IFN, with only moderate myelosuppression and relatively few side effects. In this
paper, we report our experience with dCF in a series of 38 HCL patients who had
progression of their disease after IFN therapy. Serum interleukin-1 beta (IL-1
beta), soluble interleukin-2 receptors (sIl-2R) and Tumor Necrosis Factor alpha
(TNF alpha) levels were also evaluated before, both during and after treatment in
order to monitor clinical response. Two schedules of treatment were employed: 23 
patients were treated with the EORTC protocol and the following 15 with the NCI
regimen. The overall response rate was 94.7%; no significant differences in
response rates were observed between the two schedules. In respect to toxicity,
we recorded nausea and in two cases a cutaneous rash. Four patients experienced
localized herpes zoster and one had a fungal pneumonia. Median overall survival
after therapy is 38.5 months, 55 percent of patients enrolled in the EORTC
schedule and 77% of those who received the NCI program are currently in CCR at 3 
years. Serum IL-1 beta and sIL-2R levels significantly decreased after treatment,
while no significant changes in serum TNF alpha levels were observed. In our
study, dCF was confirmed as an effective agent in HCL, inducing an high response 
rate with only moderate side effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Clinical Trial

PMID: 7820042 [PubMed - indexed for MEDLINE]

5018: Bone Marrow Transplant. 1994;14 Suppl 4:S19-28.

The lung as a critical organ in marrow transplantation.

Quabeck K.

Department of Bone Marrow Transplantation, University of Essen School of
Medicine, Germany.

Respiratory failure is the main cause of death in patients undergoing bone marrow
transplantation (BMT). In this paper, clinical and research aspects as well as
diagnostic, prophylactic and therapeutic strategies concerning the various forms 
of pulmonary and bronchial complications, which may evolve after BMT, are
discussed. Both cytomegalovirus (CMV)-induced interstitial pneumonia (PM) and the
idiopathic pneumonia syndrome rarely occur in the cytopenic phase post-BMT.
Haematological reconstitution with donor type cells seems to be a prerequisite to
the development of these complications, suggesting a key role of immunological
reactions. While CMV pneumonia can be effectively treated or prevented by
ganciclovir, the idiopathic syndrome is usually fatal. Due to improved
prophylaxis and therapy, lethal interstitial PM due to Pneumocystis carinii,
herpes simplex, varizella zoster or Toxoplasma gondii as well as lethal PM caused
by bacteria or Candida species are comparatively rare events. Aspergillus
species, on the other hand, have emerged as frequent causative pathogens in
lethal PM during the past years. Prolonged granulocytopenia and prolonged
medication with corticosteroids are major risk factors of pulmonary
aspergillosis, which is usually fatal; effective prophylaxis may be achieved by
sterile air supply during the hospital stay and by inhalation of amphotericin B
thereafter. Pulmonary haemorrhage, as diagnosed by bronchoalveolar lavage (BAL), 
may develop due to the toxicity of the conditioning regimen, or may be secondary 
to infectious PM of various kind. Congestive heart failure or the application of 
cytokines might give rise to the development of pulmonary oedema. Patients with
hepatic veno-occlusive disease have a high risk of subsequent pulmonary
complications, possibly on the basis of toxic lung injury. Venous thromboembolism
or air embolism may occur; they are usually venous catheter-associated. Pleural
effusions may develop secondary to infection, congestive heart failure,
veno-occlusive disease, pulmonary embolism or malignancy. Patients with
bronchiolitis obliterans, which leads to progressive respiratory failure, present
with an obstructive pattern in lung function tests and hyperinflated lungs on
chest radiographs.(ABSTRACT TRUNCATED AT 400 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 7728120 [PubMed - indexed for MEDLINE]

5019: J Fr Ophtalmol. 1994;17(12):784-8.

[Neurological complications of zona. Apropos of a case]

[Article in French]

Mariotti JM, Fanton Y, Jomaa A.

Service d'Ophtalmologie, C.H.G. Ajaccio, Corse.

A 70 year old woman had left sixth nerve palsy, following an ophthalmic zona.
Later she had controlateral hemiplegia with expression aphasia. Corticosteroid
therapy improved the situation. The pathogenesis of this complication is
discussed in this article. Ischaemic vasculitis is now a well known complication 
of herpes zoster which has already appeared in the literature. The case presented
was related to ischaemia of the anterior artery of the troncus infero-lateral of 
Heubner's artery confirmed by further exploration.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 7722241 [PubMed - indexed for MEDLINE]

5020: Int Ophthalmol. 1994-1995;18(6):361-2.

Wegener's granulomatosis, pituitary adenoma and BARN.

Murray PI.

Academic Unit of Ophthalmology, Birmingham and Midland Eye Hospital, UK.

A 53-year-old man with Wegener's granulomatosis and a co-existing pituitary
adenoma developed bilateral acute retinal necrosis (BARN), probably secondary to 
varicella-zoster virus (VZV) infection as IgM antibodies were detected in the
serum. Intravenous acyclovir and ganciclovir limited the spread of necrosis, but 
to prevent recurrence he was maintained on oral acyclovir. A left cataract
developed 17 months later which was extracted and replaced with a heparin surface
modified intraocular lens. Intraocular specimens removed at the time of surgery
were analysed by the polymerase chain reaction (PCR) using primers specific for a
number of the herpes group of viruses, but no herpesviral DNA could be detected.

Publication Types: 
    Case Reports

PMID: 7642338 [PubMed - indexed for MEDLINE]

5021: Int Ophthalmol. 1994-1995;18(5):293-8.

Epidemiological characteristics of uveitis in Switzerland.

Tran VT, Auer C, Guex-Crosier Y, Pittet N, Herbort CP.

Department of Ophthalmology, Hopital Jules Gonin, University of Lausanne,
Switzerland.

Since January 1990, data from uveitis patients have been systematically stored in
a computer data bank. During the period from January 1990 to March 1993, 435 new 
patients (185 female and 250 male, mean age 43 years; range 6-92) were seen at
the Uveitis Clinic of the Hopital Jules Gonin. These 435 patients (630 eyes) were
subdivided into anterior uveitis (268 patients--62%), intermediate uveitis (47
patients--11%), posterior uveitis (89 patients--20%) and panuveitis (31
patients--7%). The incidence of uveitis for the referral area considered was
calculated to be 17 per 100,000 inhabitants per year. A specific diagnosis was
found in 312 cases (72%). The most frequently diagnosed entities were
HLA-B27-associated acute anterior uveitis (67 cases--15.4%), uveitis associated
with acute herpes zoster ophthalmicus (40 cases--9.2%), toxoplasmosis (39
cases--9%), typical pars planitis (29 cases--6.7%), sarcoidosis (29 cases--6.7%),
Fuchs' heterochromic cyclitis (27 cases--6.2%), herpetic anterior uveitis (21
cases--4.8%) and acute retinal necrosis (11 cases--2.5%). Incidence and
distribution of most disease entities correspond to those of other European
series.

PMID: 7607811 [PubMed - indexed for MEDLINE]

5022: Duodecim. 1994;110(19):1789-91.

[Vitamin B 12 in zoster neuralgia]

[Article in Finnish]

Kaipainen WJ.

Publication Types: 
    Case Reports

PMID: 7555774 [PubMed - indexed for MEDLINE]

5023: Biotherapy. 1994;8(1):63-8.

Transfer factor prevents relapses in herpes keratitis patients: a pilot study.

Pizza G, Meduri R, De Vinci C, Scorolli L, Viza D.

Immunodiagnosis and Immunotherapy Unit, S. Orsola-Malpighi Hospital, Bologna,
Italy.

Transfer Factor is a dialysable moiety obtained from immune lymphocytes. It has
been successfully used for the treatment of several viral infections including
labial and genital herpes. In the present study, thirty-three patients with low
immune response to HSV antigens and suffering from herpes ocular infections were 
orally treated with HSV-specific transfer factor (TF). Their relapse index was
reduced from 20.1 before treatment to 0.51 after TF administration, with only
6/33 patients relapsing. Although this is not a placebo-controlled-randomized
study, the results suggest that TF specific for HSV antigens may be efficacious
for preventing relapses of ocular herpes infections as has been the case with
genital and labial localisations.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 7547082 [PubMed - indexed for MEDLINE]

5024: Methods Mol Biol. 1994;33:243-56.

Detection of virus nucleic acids by radioactive and nonisotopic in situ
hybridization.

Gowans EJ, Blight K, Arthur J, Higgins GD.

Division of Medical Virology, Institute of Medical and Veterinary Science,
Adelaide, Australia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7534581 [PubMed - indexed for MEDLINE]

5025: Dermatology. 1994;188(4):305-9.

Comment in:
    Dermatology. 1994;188(4):249-50.

Localization of perforin in viral vesicles and erythema multiforme.

Sayama K, Watanabe Y, Tohyama M, Miki Y.

Department of Dermatology, Ehime University School of Medicine, Japan.

BACKGROUND: Perforin (Pf), a pore-forming protein, is a cytolytic protein of
killer cells. Its deposition in lesioned skin has not been studied. OBJECTIVE:
The purpose of this study is to show Pf deposition in the lesioned skin and Pf
expression in the dermal infiltrates of various inflammatory skin diseases.
METHODS: Frozen specimens obtained from 29 patients with 5 different diseases
were immunohistochemically stained. RESULTS: Granular deposition of Pf was found 
in the lesioned skin in 2 out of 5 cases of viral vesicles and in 3 out of 7
cases of erythema multiforme. In the cases with Pf deposition, the percentages of
Pf+ cells in the dermis were higher than in those without deposition. CONCLUSION:
Pf released from natural killer cells or cytotoxic T lymphocytes may play a role 
in tissue damage.

PMID: 7514909 [PubMed - indexed for MEDLINE]

5026: Ann Neurol. 1994;35 Suppl:S65-8.

Current experience with antiviral therapy for acute herpes zoster.

Wood MJ.

Birmingham Heartlands Hospital, United Kingdom.

Inhibition of varicella-zoster virus replication during acute herpes zoster
would, theoretically, accelerate cutaneous healing and reduce the pain, both
acute and chronic, associated with shingles. Early antiviral drugs were of
limited efficacy, excessively toxic, or needed to be given parenterally, and were
unsuitable for use in immunocompetent individuals. Acyclovir was a significant
advance and remains the antiviral drug of choice for herpes zoster. There is
ample evidence for its efficacy in acute illness, but its ability to influence
post-herpetic neuralgia is controversial. This review also discusses the role of 
adjunctive therapy with steroids in acute shingles.

Publication Types: 
    Review

PMID: 7514385 [PubMed - indexed for MEDLINE]

5027: Mov Disord. 1994 Jan;9(1):13-21.

The syndrome of painful legs and moving toes.

Dressler D, Thompson PD, Gledhill RF, Marsden CD.

MRC Human Movement and Balance Unit, Institute of Neurology, London, England.

The clinical presentation, symptoms, and signs in 20 new patients with the
painful legs and moving toes syndrome are presented. Painful legs and moving toes
may develop in the setting of spinal cord and cauda equina trauma, lumbar root
lesions, injuries to bony or soft tissues of the feet, and peripheral neuropathy.
In 4 of the 20 cases in the present study, no definite cause was found. Pain
preceded the onset of toe movements in 18 cases, but in 2 the reverse sequence
occurred. The pain had many of the characteristics of causalgia, but none of the 
patients exhibited the full picture of reflex sympathetic dystrophy, and
peripheral trauma was the trigger in only 5 cases. Several patients reported that
the occurrence of toe movements was closely related to the pain, although
abolition of pain with lumbar sympathetic blocks was not necessarily associated
with disappearance of the movements. Several features suggest a central origin
for the movements. Symptoms may begin on one side and become bilateral; movements
may be momentarily suppressed by voluntary action or exacerbated by changing
posture; and electromyography reveals complex patterns of rhythmic activity with 
normal recruitment of motor units involving several myotomes. Three other
patients with similar moving toes but no pain are also described. The occurrence 
of similar movements in the absence of pain raises the possibility that these
cases represent examples at one end of a spectrum of disorders, with pain alone
(causalgia) at the other end and the syndrome of painful legs and moving toes in 
between.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Case Reports

PMID: 7511213 [PubMed - indexed for MEDLINE]

5028: Drugs. 1994 Jan;47(1):153-205.

Aciclovir. A reappraisal of its antiviral activity, pharmacokinetic properties
and therapeutic efficacy.

Wagstaff AJ, Faulds D, Goa KL.

Adis International Limited, Auckland, New Zealand.

Aciclovir (acyclovir) is a nucleoside analogue with antiviral activity in vitro
against the herpes simplex viruses (HSV), varicella zoster virus (VZV),
Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpesvirus 6 (HHV-6). 
Topical, oral or intravenous aciclovir is well established in the treatment of
ophthalmic, mucocutaneous and other HSV infections, with intravenous aciclovir
the accepted treatment of choice in herpes simplex encephalitis. The efficacy of 
aciclovir is increased with early (preferably during the prodromal period)
initiation of treatment but, despite significant clinical benefit, viral latency 
is not eradicated, and pretreatment frequencies of recurrence usually continue
after episodic acute treatment is completed. Intravenous administration has also 
shown benefit in the treatment of severe complications of HSV infection in
pregnancy, and neonatal HSV infections. Recurrence of HSV has been completely
prevented or significantly reduced during suppressive therapy with oral aciclovir
in immunocompetent patients. Use of oral aciclovir is effective but controversial
in the treatment of otherwise healthy individuals with varicella (chickenpox),
and in some countries it has been recommended for use only in cases which may be 
potentially severe. The development of rash and pain associated with herpes
zoster (shingles) is attenuated with oral or intravenous aciclovir therapy,
ocular involvement is prevented, and post-herpetic neuralgia appears to be
decreased. Similarly, in a few patients with zoster ophthalmicus, oral aciclovir 
has reduced the frequency and severity of long term ocular complications and
post-herpetic neuralgia, and herpes zoster oticus is improved with intravenous
aciclovir. Oral aciclovir has prevented recurrence of HSV genital or orofacial
infections during suppressive therapy in > 70% of immunocompetent patients in
most clinical trials. Suppression of latent HSV, VZV and CMV infections has been 
achieved in many immunocompromised patients receiving the oral or intravenous
formulations. Aciclovir also appears to offer partial protection from invasive
CMV disease in CMV-seropositive bone marrow transplant recipients. The few
comparative trials published have shown aciclovir to be at least as effective as 
other investigated antivirals in the treatment of HSV infections in
immunocompetent patients, and more effective than inosine pranobex in the
prophylaxis of genital herpes. Similarly, in isolated clinical trials, oral
aciclovir appears as effective as topical idoxuridine and oral brivudine in some 
parameters in immunocompetent patients with VZV infections, and the intravenous
formulation appears at least as effective as oral brivudine and intravenous
vidarabine in treating these infections in immunocompromised patients.(ABSTRACT
TRUNCATED AT 400 WORDS)

Publication Types: 
    Review

PMID: 7510619 [PubMed - indexed for MEDLINE]

5029: Dig Dis Sci. 1994 Jan;39(1):15-8.

Decreased incidence of viral infections in liver transplant recipients. Possible 
effects of FK506?

Singh N, Mieles L, Yu VL, Starzl TE.

Department of Medicine, VA Medical Center, Pittsburgh, Pennsylvania 15240.

Cytomegalovirus (CMV) is a major infectious complication of organ transplantation
and its incidence is influenced by the type and intensity of immunosuppressive
therapy employed. Using a new immunosuppressive agent FK506, CMV infection was
observed in 30% and CMV disease in 15% of the 26 liver transplant recipients.
Delayed onset of CMV disease was noted; the mean time to the occurrence of CMV
disease being 137 days posttransplantation. No graft loss or mortality could be
attributed to CMV infection. Mucocutaneous herpes simplex virus (HSV) infections 
were encountered in 19% of the patients, while no disease could be attributed to 
varicella zoster virus or Epstein-Barr virus (EBV). The contribution of FK506 to 
a decrease in viral morbidity and associated mortality bears further
investigation.

PMID: 7506641 [PubMed - indexed for MEDLINE]

5030: Arch Immunol Ther Exp (Warsz). 1994;42(2):83-8.

Molecular mimicry between Fc receptors and viral antigens.

Oleszak EL.

Department of Pathology, University of Texas Health Science Center, Medical
School, Houston 77030, USA.

Molecular mimicry has been characterized as the presence of common epitopes,
either linear or conformational, shared by host and microbial determinants. Such 
cross-reactivity may lead to an autoimmune disease. On the other hand molecular
mimicry between certain viral proteins and host determinant may protect invading 
virus to be eliminated by immune system and may promote persistence. In this
mini-review I discuss the molecular mimicry of S peplomer protein of mouse
hepatitis virus, strain JHM (MHV-JHM) to the host Fc gamma receptor (Fc gamma R).
MHV-JHM induces in rodents acute encephalomyelitis and surviving animals develop 
demyelinating disease with concomitant persistent infection. We have demonstrated
that rabbit IgG, but not is F(ab')2 fragments, monoclonal rat and mouse IgG and
the rat 2.4G2 anti-Fc gamma R mab immunoprecipitated natural and recombinant S
peplomer protein of several strains of MHV. Furthermore, MHV-JHM infected cells
formed rosettes with anti-sheep red blood cell (SRBC) - antibody coated SRBC. The
2.4G2 anti-Fc gamma R mab are able to neutralize several strains of MHV,
presumably by binding to S peplomer protein. Therefore, the Fc binding site of S 
is present on the surface of MHV-infected cells. This molecular mimicry between S
peplomer protein of MHV-JHM and Fc gamma R has been extended to other members of 
Coronaviridae, namely bovine coronavirus and transmissible gastroenteritis virus 
but not to infectious bronchitis virus. The molecular mimicry of viral antigens
to Fc receptors has been described also for members of Herpesviridae, namely
Herpes simplex, cytomegalovirus and Varicella zoster.(ABSTRACT TRUNCATED AT 250
WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 7503651 [PubMed - indexed for MEDLINE]

5031: J Mol Biol. 1993 Dec 20;234(4):1038-47.

A novel arrangement of zinc-binding residues and secondary structure in the C3HC4
motif of an alpha herpes virus protein family.

Everett RD, Barlow P, Milner A, Luisi B, Orr A, Hope G, Lyon D.

MRC Virology Unit, Institute of Virology, Glasgow, Scotland, U.K.

A highly conserved, cysteine-rich region plays a crucial role in the function of 
a family of regulatory proteins encoded by alpha herpes viruses. The so-called
C3HC4 motif spans approximately 60 residues and has been predicted to bind zinc. 
This motif occurs in a number of other viral and cellular proteins, many of which
appear to be involved in some aspect of the regulation of gene expression. We
have cloned and expressed in bacteria a portion of immediate-early protein Vmw110
of herpes simplex virus type 1 that encompasses the C3HC4 motif, and the
equivalent regions from the homologous proteins of varicella zoster virus and
equine herpes virus type 1 (EHV-1). All three polypeptides were purified and
found to bind zinc stably. None of the three interacted significantly with either
DNA or RNA under our assay conditions. The EHV-1 domain yielded interpretable
proton nuclear magnetic resonance spectra. Assignment of resonances and analysis 
of nuclear Overhauser effects revealed its secondary structure. Starting from the
N terminus, this consists of an ordered but irregular loop, the first two strands
of a triple-stranded antiparallel beta-sheet, two turns of an alpha-helix, a
second irregular loop, and the third strand of the beta-sheet. It appears that,
taking the cysteine and histidine residues in turn, cysteine residues I, II, IV
and V co-ordinate one zinc atom while the histidine residue and cysteine residues
III, VI and VII co-ordinate a second zinc atom. This arrangement of secondary
structure differs from that found in other characterized zinc-containing
proteins.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8263911 [PubMed - indexed for MEDLINE]

5032: Lancet. 1993 Dec 18-25;342(8886-8887):1555.

Varicella-zoster DNA in temporal bones of patients with Ramsay Hunt syndrome.

Wackym PA, Popper P, Kerner MM, Grody WW.

Publication Types: 
    Letter

PMID: 7902926 [PubMed - indexed for MEDLINE]

5033: J Neuroradiol. 1993 Dec;20(4):226-38.

MRI exploration of the intrapetrous facial nerve.

[Article in English, French]

Girard N, Poncet M, Chays A, Florence A, Gignac D, Magnan J, Raybaud C.

Service de Radiologie, Hopital Nord, Marseille.

We report our experience of intrapetrous facial nerve evaluation in 33 patients
examined by three-dimensional MRI (3D-FT) with intravenous gadolinium injection. 
The examinations were performed by a 1 Tesla magnet, using Flash and Turbo-Flash 
sequences which enabled us to obtain contiguous millimetric sections and to make 
reconstructions in all planes. Among these 33 patients, 31 had facial palsy and 2
a facial nerve lesion without clinical signs and discovered by chance. Facial
palsy had started rather abruptly in 26 cases. It was either idiopathic (n = 20) 
or caused by herpes zoster (n = 1), injuries (n = 2), metastasis (n = 1) and
tumour (n = 1); it was concomitant with a granuloma in 1 case. Five patients seen
or explored late had congenital cholesteatoma (n = 2), facial nerve neurinoma (n 
= 2) or persistent idiopathic facial palsy (n = 1). There was no contrast
enhancement in "chronic" non tumoral facial palsy. All tumours (neurinoma,
neurofibroma, metastasis) were contrast-enhanced, as were the 2 cases of
traumatic palsy and the case with granuloma of the labyrinth. In acute idiopathic
facial palsy (n = 20), contrast enhancement was demonstrated in 11 patients;
among these, recovery was complete at 2 months in 1 case and incomplete in 9
cases; 1 patient was lost sight of. In the 9 patients without contrast
enhancement, recovery was complete in 7; 2 patients were lost sight of. This
study shows that minute lesions of the facial nerve can be detected with
millimetric MRI T1-weighted sequences and contrast enhancement. It also suggests 
that contrast enhancement has some prognostic value in patients with acute
idiopathic facial palsy.

PMID: 8308541 [PubMed - indexed for MEDLINE]

5034: J Clin Microbiol. 1993 Dec;31(12):3260-3.

Simultaneous detection of and differentiation between herpes simplex and
varicella-zoster viruses with two fluorescent probes in the same test system.

Brumback BG, Farthing PG, Castellino SN.

Virology Department, American Medical Laboratories, Inc., Chantilly, Virginia
22021.

Specimens from skin lesions were examined simultaneously for herpes simplex virus
(HSV) and varicella-zoster virus (VZV) by direct specimen testing and shell vial 
culture in single-test systems. For direct testing, cells in a single specimen
well were stained with a combination direct-indirect immunofluorescence stain by 
using two fluorescent tags. A total of 203 fresh specimens were tested in
parallel. Of these, 100 specimens contained too few cells for the direct VZV
comparison and 91 contained too few cells for the HSV comparison. After these
specimens were eliminated, the sensitivities and specificities, respectively, of 
the dual direct test were 86.1 and 97.3% for HSV compared with single culture and
92.2 and 100% for VZV compared with single direct testing. Shell vial monolayers 
in the combined cultures were stained for both viruses by the same method. A
total of 305 fresh specimens were cultured in parallel by dual- and
single-culture methods. The sensitivities and specificities, respectively, of the
combined culture compared with separate cultures were 100 and 98.4% for HSV and
87.9 and 99.2% for VZV. The combined methods gave a performance comparable to
those of single tests, required less specimen volume, and were less costly to
perform.

Publication Types: 
    Comparative Study

PMID: 8308120 [PubMed - indexed for MEDLINE]

5035: Spine. 1993 Dec;18(16):2523-4.

Herpes zoster radiculopathy.

Helfgott SM, Picard DA, Cook JS.

Center for Spine Disorders, Brigham and Women's Hospital, Boston, Massachusetts.

Herpes zoster-related radiculopathy usually can be easily diagnosed in the
presence of cutaneous lesions. Before development of the skin rash, the diagnosis
may be in doubt, particularly if motor symptoms and signs are a major clinical
feature. We report a patient with herpes zoster-related radiculopathy whose
clinical features mimicked other spinal disorders.

Publication Types: 
    Case Reports

PMID: 8303458 [PubMed - indexed for MEDLINE]

5036: Brain. 1993 Dec;116 ( Pt 6):1477-96.

Postherpetic neuralgia. Are C-nociceptors involved in signalling and maintenance 
of tactile allodynia?

Baron R, Saguer M.

Klinik fur Neurologie, Christian-Albrechts-Universitat Kiel, Germany.

Under normal conditions acute stimulation and sensitization of polymodal
nociceptive C-fibres cause pain and, due to afferent axon reflex activation, a
local skin vasodilatation, flare reaction and skin temperature increase. Two
questions arise: (i) Do sensitized C-nociceptors signal allodynia in chronic
postherpetic neuralgia? (ii) If not, does ongoing peripheral nociceptive C-fibre 
input maintain a central process that accounts for allodynia? Ten patients with
postherpetic neuralgia and tactile allodynia and 10 control subjects were studied
using a laser Doppler perfusion monitor. Peripheral nociceptive C-fibre function 
was assessed by quantitative measurement of the axon reflex vasodilatation and
flare reaction induced by histamine iontophoresis and compared with non-neural
vasodilatation induced by local skin heating. Resting skin temperature, skin
resistance and resting skin blood flow were the same in the allodynic area and
the contralateral homologous skin area. The histamine responses (vasodilatation
and flare) were significantly reduced or nearly abolished in the allodynic area
compared with the contralateral side, whereas the temperature-dependent
vasodilatation in patients and the histamine responses in healthy controls showed
no side differences. C-fibre mediated pain and itch sensations were also
decreased in the allodynic area. These findings indicate a considerable
impairment of cutaneous nociceptive C-fibre function in the allodynic area.
Allodynic stimuli of 20 s did not cause any local blood flow change. Impairment
of C-fibre function was positively correlated with intensity of neuropathic pain.
We conclude that sensitized nociceptive C-fibres are not involved in signalling
allodynia. Changes in CNS processing may occur after zoster infection that
strengthen the synaptic ties between central pain signalling pathways and
low-threshold mechanoreceptors with A beta-fibres. This altered central
processing is not maintained by ongoing cutaneous nociceptive C-fibre input, at
least in some patients with postherpetic neuralgia. On the contrary, an
anatomical synaptic reorganization depending on afferent C-fibre degeneration
seems to be more likely, particularly in advanced stages of postherpetic
neuralgia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8293282 [PubMed - indexed for MEDLINE]

5037: Clin Pharmacol Ther. 1993 Dec;54(6):595-605.

Pharmacokinetics of the acyclovir pro-drug valaciclovir after escalating single- 
and multiple-dose administration to normal volunteers.

Weller S, Blum MR, Doucette M, Burnette T, Cederberg DM, de Miranda P, Smiley ML.

Division of Pharmacokinetics and Drug Metabolism, Burroughs Wellcome Co.,
Research Triangle Park, NC 27709.

The pharmacokinetics and safety of the L-valyl ester pro-drug of acyclovir,
valaciclovir (256U87), were investigated in two phase I, placebo-controlled
trials in normal volunteers. These included a single-dose study with doses from
100 to 1000 mg (single cohort) and a multiple-dose investigation with doses from 
250 to 2000 mg (five separate cohorts). In each cohort, eight subjects received
valaciclovir and four subjects received placebo. Pharmacokinetic findings for
valaciclovir and acyclovir were consistent in the two studies. Valaciclovir was
rapidly and extensively converted to acyclovir, resulting in significantly
greater acyclovir bioavailability (approximately threefold to fivefold) compared 
with that historically observed with high-dose (800 mg) oral acyclovir. At the
higher valaciclovir doses, acyclovir maximum concentration and daily area under
the concentration-time curve approximated those obtained with intravenous
acyclovir. The favorable safety profile and enhanced acyclovir bioavailability
from valaciclovir administration has prompted additional clinical evaluations for
zoster and herpes simplex virus treatment, as well as cytomegalovirus suppression
in immunocompromised patients.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase I
    Randomized Controlled Trial

PMID: 8275615 [PubMed - indexed for MEDLINE]

5038: Am J Gastroenterol. 1993 Dec;88(12):2110-1.

Acyclovir-associated colitis.

Moshkowitz M, Konikoff FM, Arber N, Baratz M, Gilat T.

Department of Gastroenterology, Ichilov Hospital, Tel-Aviv Medical Center,
Israel.

Publication Types: 
    Case Reports

PMID: 8249983 [PubMed - indexed for MEDLINE]

5039: Am Fam Physician. 1993 Dec;48(8):1384, 1388.

Comment on:
    Am Fam Physician. 1993 May 1;47(6):1445-50.

Oral corticosteroids and postherpetic neuralgia.

Woolner E.

Publication Types: 
    Comment
    Letter

PMID: 8249767 [PubMed - indexed for MEDLINE]

5040: J Am Acad Dermatol. 1993 Dec;29(6):970-3.

Herpes zoster: daily marking of new vesicles in therapeutic studies. A clinical
method for objective assessment of the end of the eruptive phase.

Runne U, Ochsendorf FR.

Department of Dermatology, J.W. Goethe University, Frankfurt/Main, Germany.

BACKGROUND: The efficacy of a therapeutic agent must be evaluated by objective
criteria. However, in herpes zoster (HZ) studies there has been no generally
accepted objective clinical criterion. OBJECTIVE: Our purpose was to establish a 
clinical method for determining objectively the point in time at which the
eruptive phase of HZ is completed (no new vesicle formation). This point is said 
to be a clinical criterion for the end of viral replication in the skin and thus 
for measuring the efficacy of a virustatic agent. METHODS: Newly formed vesicles 
were marked with differently colored permanent marker pens each day. This method 
was evaluated by comparing the results of acyclovir therapy in two groups of
patients with HZ. (Group A, no underlying malignancy; n = 9. Group B, underlying 
malignancy; 64% of these patients were undergoing cytostatic polychemotherapy or 
had immunodeficiency; n = 22). RESULTS: In both groups, acyclovir stopped the
eruption of new vesicles within 1.8 and 2.8 days, respectively (not statistically
significant). Group B showed a tendency toward more protracted hematogenous
dissemination and a longer duration of therapy. The total duration of the
eruptive phase depended solely on the length of the interval between the onset of
the HZ and the beginning of therapy. CONCLUSION: The method of marking new
vesicles is independent of laboratory facilities, simple, and cost effective; in 
addition, this method is suitable for statistical evaluation. It is thus superior
to other clinical methods for objective assessment of the progression of HZ.

Publication Types: 
    Comparative Study

PMID: 8245263 [PubMed - indexed for MEDLINE]

5041: J Clin Neuroophthalmol. 1993 Dec;13(4):250-3.

Herpes zoster ophthalmicus as a cause of Horner syndrome.

Smith EF, Santamarina L, Wolintz AH.

Department of Ophthalmology, State University of New York, Health Science Center 
at Brooklyn.

Herpes zoster ophthalmicus is a disease in which the varicella-zoster virus
replicates and produces inflammation in the skin of the face supplied by the
sensory branches of the ophthalmic division of the trigeminal nerve. It can also 
cause a conjunctivitis, keratitis, uveitis, extraocular muscle paralysis, and
acute retinal necrosis. We found only a single report of this disease as a cause 
of Horner syndrome. Here we report a case of herpes zoster ophthalmicus that
progressed to a sixth nerve palsy and, subsequently, a Horner syndrome. We
discuss how the anatomic relationship of the fifth, sixth, and sympathetic nerves
in the cavernous sinus provides a route whereby the varicella-zoster virus may
produce a Horner syndrome. To our knowledge this is the first fully documented
case of Horner syndrome caused by herpes zoster ophthalmicus.

Publication Types: 
    Case Reports

PMID: 8113436 [PubMed - indexed for MEDLINE]

5042: Gynecol Oncol. 1993 Dec;51(3):307-10.

Invasive vulvar tumors in young women--a disease of the immunosuppressed?

Carter J, Carlson J, Fowler J, Hartenbach E, Adcock L, Carson L, Twiggs LB.

Women's Cancer Center, Department of Obstetrics and Gynecology, Minneapolis,
Minnesota 55455.

Twenty-seven patients under the age of 40 years were treated for invasive vulvar 
cancer at the Women's Cancer Center, University of Minnesota. Seventeen patients 
had Stage I, five patients had Stage II, two patients had Stage III, and two
patients had Stage IV disease. Twenty patients (80%) gave a history of smoking.
Associated medical and immunosuppressive conditions present in these patients
included vulval HPV (N = 3), diabetes mellitus (N = 3), pregnancy (N = 2),
autoimmune connective tissue disease (N = 2), renal transplant (N = 2), previous 
chemotherapy for invasive malignancies at other sites (N = 1), chronic hepatitis 
(N = 1), schizophrenia (N = 1), and one patient on Imuran for herpes zoster and
multiple sclerosis. Two of the nonsmokers were in this group of immunosuppressed 
patients. Three patients have died of intercurrent disease while another is
currently alive with invasive disease. All others are alive without evidence of
disease. The mean duration of follow-up is 45.2 months (range, 1-158 months).
Invasive vulvar tumors are uncommon in young women. Smoking and a history of an
immunosuppressive medical illness is common in this patient population.

PMID: 8112637 [PubMed - indexed for MEDLINE]

5043: Rev Clin Esp. 1993 Dec;193(9):480-2.

[Neurological disease due to the varicella-zoster virus without a skin lesion]

[Article in Spanish]

Monzon Monguilod MJ, Ayuso Blanco T, Velilla Marco I, Gracia Naya M, Lopez Gaston
JI, Calderon CR.

Servicio de Neurologia, Hospital Miguel Servet, Zaragoza.

We studied three cases of inflammatory neurological disease and serological
evidence of varicella-zoster viral (VZV) infection without cutaneous
manifestation. They corresponded to a case of cranial multi-neuritis, a case of
aseptic meningitis, and another case of meningoencephalitis. Despite the
infrequency of any such association, the spectrum of the neurological diseases
associated with VZV without skin lesions is quite wide. We are motivated to
present our experience by the belief that it is important to think about this
possible etiology based on inflammatory areas at different levels of the Nervous 
System in patients who are still immunocompetent.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8108579 [PubMed - indexed for MEDLINE]

5044: Pediatrics. 1993 Dec;92(6):838-42.

Varicella-zoster virus infection in Romanian children infected with the human
immunodeficiency virus.

Leibovitz E, Cooper D, Giurgiutiu D, Coman G, Straus I, Orlow SJ, Lawrence R.

Department of Pediatrics, New York University School of Medicine, NY.

OBJECTIVE. Varicella-zoster virus (VZV) infections can cause severe disease in
immunocompromised individuals. To evaluate the spectrum of VZV infections in
human immunodeficiency virus (HIV)-infected children, we retrospectively analyzed
all the cases of VZV infection in a cohort of children cared for at a hospital
for infectious diseases in Bucharest, Romania. METHODS. The records of 391
HIV-infected children admitted to the acquired immunodeficiency syndrome pavilion
of Colentina Hospital during the period January 1, 1991, through March 31, 1992, 
were reviewed for evidence of VZV infection. The diagnosis of varicella or zoster
was made clinically and information was collected concerning course of the
illness, number of skin lesions, and clinical evidence of complications.
Lymphocyte subpopulation typing, as an estimate of immune function, was performed
by either a standard fluorescent activated flow cytometric method or by
immunofluorescent technique. RESULTS. Thirty-eight cases of varicella (9.7%) and 
seven cases of zoster (1.8%) were adequately documented among the 391 records
reviewed. The duration of varicella was prolonged; in 57% of the children it was 
greater than 10 days. Forty percent of children with varicella developed a
complication, including superinfection of the skin, pneumonia, or
thrombocytopenia. None of the children developed clinical hepatitis or
encephalitis. Two children (5%) died during varicella, both of respiratory
failure. None of the 7 children with zoster had chronic, recurrent, or
disseminated lesions. Lymphocyte subset analysis was available for 22 of 38
children with varicella and 3 of 7 children with zoster. Fifteen of the 22
children had normal, age-adjusted, absolute CD4 counts within 3 months of the
diagnosis of varicella. All 3 children with zoster who had lymphocyte subset
analysis had low CD4 counts and absolute numbers. None of the 45 children
received antiretroviral therapy and only 1 child with varicella and 1 with zoster
received acyclovir. CONCLUSIONS. The spectrum of VZV infection in this
hospitalized group of HIV-infected children was broad. The majority (57%)
experienced a prolonged course of disease and a higher rate of complications than
normal children hospitalized with varicella.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7901834 [PubMed - indexed for MEDLINE]

5045: APMIS. 1993 Dec;101(12):946-52.

Serum antibodies to viral pathogens and Toxoplasma gondii in HIV-infected
individuals.

Flo RW, Nilsen A, Voltersvik P, Haukenes G.

Medical Department B, Haukeland Hospital, University of Bergen, Norway.

Sera from 38 HIV-infected individuals were examined longitudinally for antibodies
to viruses that may increase morbidity in HIV infection, as well as commensal
viruses and Toxoplasma gondii. HTLV infection was seen in Norway for the first
time as four patients had antibodies to HTLV-II and one had antibodies to HTLV-I.
Antibodies to hepatitis B virus (HBV) were found in 47.2%, while 21.6% of the
patients had antibodies to hepatitis C virus (HCV). There was no evidence of
acquisition of HBV or HVC during the mean observation period of 2 years. A titre 
increase in CMV antibody with time was observed for 7 out of 21 patients and a
decrease for 2 patients. For Epstein-Barr virus, herpes simplex,
varicella-zoster, rubella and measles viruses, human polyomavirus BK as well as
for Toxoplasma gondii, antibody prevalences and titres were within the range seen
in normal populations. Also, no longitudinal changes were observed in titres of
these antibodies, indicating that humoral immunity remained intact during the
study period. The high prevalences of HTLV-I/II, HBV and HCV antibodies in
HIV-infected patients reflect common modes of virus transmission, and the
fluctuations in CMV antibody titre are indicative of reactivations. Such
coinfections may influence disease progression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7509159 [PubMed - indexed for MEDLINE]

5046: J Am Acad Dermatol. 1993 Nov;29(5 Pt 2):859-62.

Granuloma annulare perforans in herpes zoster scars.

Krahl D, Hartschuh W, Tilgen W.

Universitats-Hautklinik, Ruprecht-Karls-University, Heidelberg, Germany.

Granuloma annulare perforans limited to a thoracic dermatome that was previously 
involved by herpes zoster occurred in a 51-year-old woman who also had Lennert's 
lymphoma. Of the various local granulomatous infiltrates described after herpes
zoster, granuloma annulare perforans is unique, although ordinary granuloma
annulare has been described in a few patients. A high incidence of specific and
nonspecific reaction patterns in herpes zoster scars has been described in
patients with malignant lymphoma. In contrast to previous patients, all of whom
had chronic lymphatic leukemia, our patient had Lennert's lymphoma.

Publication Types: 
    Case Reports

PMID: 8408827 [PubMed - indexed for MEDLINE]

5047: Elder Care. 1993 Nov-Dec;5(6):33.

Surviving shingles.

Hutt A.

Publication Types: 
    Case Reports

PMID: 8298601 [PubMed - indexed for MEDLINE]

5048: Am J Perinatol. 1993 Nov;10(6):463-4.

Disseminated herpes zoster in a pregnant woman positive for human
immunodeficiency virus.

Petrozza JC, Monga M, Oshiro BT, Graham JM, Blanco JD.

Department of Obstetrics, Gynecology and Reproductive Sciences, Lyndon B. Johnson
General Hospital, University of Texas Health Science Center, Houston 77026.

We report a case of disseminated herpes zoster in a pregnant patient positive for
the human immunodeficiency virus (HIV). Disseminated zoster was the first
manifestation of HIV infection in this patient. In HIV-positive patients, zoster 
may be complicated by cutaneous dissemination, visceral involvement, and death.
Intravenous acyclovir may prevent serious sequelae in both mother and fetus.

Publication Types: 
    Case Reports

PMID: 8267815 [PubMed - indexed for MEDLINE]

5049: Pediatr Infect Dis J. 1993 Nov;12(11):960-1.

Characteristics of herpes zoster in otherwise normal children.

Terada K, Kawano S, Yoshihiro K, Miyashima H, Morita T.

Department of Pediatrics, Kawasaki Medical School, Okayama, Japan.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8265292 [PubMed - indexed for MEDLINE]

5050: Pediatr Infect Dis J. 1993 Nov;12(11):903-8.

Etiology of acute encephalitis in childhood in Slovenia.

Cizman M, Jazbec J.

University Medical Centre, Department of Infectious Diseases, Ljubljana,
Slovenia.

The etiology of acute encephalitis was evaluated in a retrospective study of 170 
children (98 boys and 72 girls) ages 1 month to 15 years, who were hospitalized
during a 13-year period from 1979 to 1991. The etiology was confirmed or
considered very probable in 68% of cases. The identified etiologic agents
included Central European tick-borne encephalitis virus (28.8%), varicella-zoster
virus (17.0%), herpes simplex (10.0%), rubella (2.9%), mumps (2.3%), measles
virus, Chlamydia psittaci (1.1%) and some other agents found in individual cases.
The etiology remained unknown in 54 children (31.7%). Forty-two patients had
encephalitis with focal neurologic signs. The most common confirmed or
presumptive infective agent in those cases was herpes simplex virus (40.4%),
followed by rubella (7.1%), Central European tick-borne encephalitis virus (4.7%)
and some other agents identified in individual cases. The etiology remained
unknown in 15 (36%) children with focal encephalitis.

PMID: 8265278 [PubMed - indexed for MEDLINE]

5051: Am J Emerg Med. 1993 Nov;11(6):633-8.

Hemorrhagic varicella: a case report and review of the complications of varicella
in children.

Miller HC, Stephan M.

Division of Emergency Medicine, Children's Hospital Medical Center, Cincinnati,
OH 45229.

The case of a previously healthy child who developed progressive systemic
varicella with purpura is reported. The clinical course of this patient is
outlined, and the range of potential complications of chickenpox in children is
reviewed. Familiarity with the usual uncomplicated natural history of primary
varicella infection should alert the clinician to signs and symptoms that signal 
significant systemic involvement.

Publication Types: 
    Case Reports
    Review

PMID: 8240570 [PubMed - indexed for MEDLINE]

5052: J Intern Med. 1993 Nov;234(5):507-11.

Distinguishing acyclovir neurotoxicity from encephalomyelitis.

Rashiq S, Briewa L, Mooney M, Giancarlo T, Khatib R, Wilson FM.

Department of Medicine, St John Hospital and Medical Center, Detroit, Michigan.

OBJECTIVES. To define the clinical characteristics of acyclovir neurotoxicity and
to outline how to distinguish it from viral encephalitis. DESIGN. Case series of 
acyclovir neurotoxicity. SETTING. All cases reported in Index Medicus or in
bibliographic reviews of acyclovir neurotoxicity plus two representative studies 
of Varicella zoster and Herpes simplex virus encephalitis. SUBJECTS. Thirty-five 
patients who developed neuropsychiatric symptoms during acyclovir therapy.
INTERVENTIONS. Analysis of the patients' demographics, risk factors, acyclovir
dosages and duration, clinical and laboratory findings and outcome. MAIN OUTCOME 
MEASURES. All clinical and laboratory findings that were statistically
significantly different from viral encephalitis. RESULTS. The median age was 53.3
years. The most common predisposing factors were the use of other potentially
neurotoxic medications (17 cases) and acute or chronic renal failure (15 cases). 
Acyclovir levels were frequently found above the therapeutic range. The
characteristic manifestations were confusion (15 cases), hallucination or
delirium (9 cases), agitation (8 cases) and lethargy (10 cases). Few patients had
associated tremors (11 cases). Fever, headache, seizures and focal neurologic
findings were distinctly rare. Cerebrospinal fluid and computed tomography were
normal except in patients with other central nervous system disorders. Symptoms
appeared within 2 days of therapy in the majority and resolved completely within 
several days of discontinuing acyclovir. CONCLUSIONS. Acyclovir neurotoxicity is 
a self-limiting, dose-dependent phenomenon which is more common in the elderly,
in patients with renal failure or in association with other neurotoxic
medications. It is distinguished from viral encephalitis by its sudden onset,
absence of fever or headache, lack of focal neurologic findings and normal
cerebrospinal fluid.

Publication Types: 
    Case Reports
    Review

PMID: 8228796 [PubMed - indexed for MEDLINE]

5053: J Infect Dis. 1993 Nov;168(5):1264-8.

Herpes zoster in patients with advanced human immunodeficiency virus infection
treated with zidovudine. Zidovudine Epidemiology Study Group.

Glesby MJ, Moore RD, Chaisson RE.

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore,
MD 21205.

To determine the prevalence, incidence, and effects on disease progression and
survival of herpes zoster in patients with advanced human immunodeficiency virus 
(HIV) disease, data from a multicenter observational cohort study of 1044
patients with AIDS or AIDS-related complex (ARC) and CD4 cell count < or = 0.25 x
10(9)/L treated with zidovudine were analyzed. Of 163 patients (16%) with a
history of herpes zoster at enrollment, 22 (13%) had a recurrence during the
2-year follow-up. For those without prior herpes zoster, the probability of its
development was 6.3% at 1 and 8.8% at 2 years. Progression to AIDS was not
associated with herpes zoster. By proportional hazards analysis, an initial
occurrence of herpes zoster was associated with prolonged survival independent of
baseline CD4 cell count and disease stage; however, recurrence tended to be
associated with death. Thus, herpes zoster is relatively common in advanced HIV
infection and its initial occurrence late in disease may indicate improved
prognosis.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 8228361 [PubMed - indexed for MEDLINE]

5054: Virology. 1993 Nov;197(1):45-52.

DNA sequence of a simian varicella virus gene that encodes a homologue of
varicella zoster virus IE62 and herpes simplex virus ICP4.

Clarke P, Brunschwig A, Gilden DH.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

Clinical and biological studies indicate that simian varicella virus (SVV)
infection of primates is the counterpart of human varicella zoster virus (VZV)
infection. We have identified an SVV open reading frame (ORF) that is homologous 
to the VZV protein IE62 and herpes simplex virus (HSV) ICP4. Like the genes
encoding the VZV and HSV proteins, the SVV gene is located in the repeat region
of the virus genome. Its expression in SVV-infected cells yields a 4.2-kb
transcript. DNA sequencing of the SVV gene reveals a coding region 3834
nucleotides in length and a G+C content of 60.3%. Like ICP4 homologues in other
herpesviruses, the SVV protein has five regions, two of which (regions 2 and 4)
are highly conserved. The SVV protein also contains a run of serine residues in
its amino terminus that is characteristic of herpesvirus ICP4 homologues. The SVV
protein shows an overall homology of 24% to HSV ICP4 and 53% to VZV IE62.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8212583 [PubMed - indexed for MEDLINE]

5055: Virology. 1993 Nov;197(1):159-65.

Tyrosine sulfation of varicella-zoster virus envelope glycoprotein gpl.

Edson CM.

Department of Pathology, Tufts University School of Medicine, Boston,
Massachusetts 02111.

Sulfation is a common post-translational modification of secreted and membrane
proteins, with the sulfate attached to tyrosine residues or to glycan
side-chains. I have shown that varicella-zoster virus (VZV) envelope
glycoproteins gpI, gpII, and gpIII can be labeled with [35S]sulfate. The
predominant VZV glycoprotein, gpI, was shown to be sulfated on asparagine-linked 
glycans and on tyrosine. This is the first report of tyrosine sulfation of a
viral envelope glycoprotein. Examination of the predicted amino acid sequences of
gpI from the Dumas and CP-5262 VZV strains revealed the presence of a single
consensus sequence for tyrosine sulfation of tyr88:IWPRNDYDGFLEN. Consensus
sequences are also present in the homologues of gpI in herpes simplex type 1,
herpes simplex type 2, and pseudorabies virus, suggesting that tyrosine sulfation
may be a general post-translational modification of the neurotropic
alphaherpesviruses.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 8212550 [PubMed - indexed for MEDLINE]

5056: Clin Infect Dis. 1993 Nov;17(5):943-4.

Comment on:
    Clin Infect Dis. 1993 Feb;16(2):208-12.

Necrotizing retinitis and cerebral vasculitis due to varicella-zoster virus in
patients infected with the human immunodeficiency virus.

Rousseau F, Perronne C, Raguin G, Thouvenot D, Vidal A, Leport C, Vilde JL.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 8135942 [PubMed - indexed for MEDLINE]

5057: Leuk Lymphoma. 1993 Nov;11(5-6):447-52.

Patient education for self-referral and on-demand treatment for herpes zoster in 
lymphoma patients.

Maung ZT, Taylor PR, Robinson P, Moore J, Lucraft HH, Evans RG, Proctor SJ.

Department of Haematology, Royal Victoria Infimary, Newcastle upon Tyne, UK.

The aim of this study is to evaluate the benefit of educating lymphoma patients
in early self-diagnosis of zoster and subsequent self-referral for prompt
treatment. Each of 337 patients attending an out-patient lymphoma clinic was
given an explanatory leaflet and photograph about shingles when they first
presented with lymphoma. One to two years following the completion of therapy for
lymphoma an assessment was made on these patients using a combination of
questionnaire survey and retrospective analysis of case notes. Fifty-six (16.6%) 
of the study population developed zoster following the diagnosis of lymphoma; 29 
had had zoster prior to the diagnosis (8.6%). There was an increased incidence of
herpes zoster in patients with Hodgkin's disease as compared to those with
non-Hodgkin's lymphoma (P < 0.01). Patients who remembered having received the
shingles education leaflets were more likely to make self-referral to hospital
for prompt treatment (P < 0.001). Long-term complications, eg post-herpetic
neuralgia, were less prevalent in patients presenting to hospital for prompt
on-demand therapy, compared to those treated in the community. Education of
lymphoma patients regarding awareness of early features of zoster is beneficial
in preventing complications, but the shingles information episode needs
subsequent reinforcement for maximum benefit.

PMID: 8124217 [PubMed - indexed for MEDLINE]

5058: Eur J Clin Microbiol Infect Dis. 1993 Nov;12(11):875-9.

Evaluation of a monoclonal antibody for detection of varicella-zoster virus
infections using a shell vial technique.

Perez JL, Niubo J, Mariscal D, Tubau F, Salva J, Martin R.

Servicio de Microbiologia, Hospital Princeps d'Espanya, Ciutat Sanitaria i
Universitaria de Bellvitge, Barcelona, Spain.

Standard cell culture and a shell vial technique using a monoclonal antibody were
compared for the detection of varicella-zoster virus in 167 mucocutaneous
specimens. Of 75 specimens from patients clinically diagnosed with varicella or
zoster, a total of 40 (53.3%) were positive by either method (4 positive only by 
conventional culture and 4 only by shell vial). No false-positive results were
obtained with shell vials stained after 48 h of incubation. This technique is
rapid, 100% specific, and should be a good alternative to cell culture. Both
techniques are equally influenced by antiviral treatment or by the time of
evolution of disease.

Publication Types: 
    Comparative Study

PMID: 8112364 [PubMed - indexed for MEDLINE]

5059: Semin Pediatr Surg. 1993 Nov;2(4):218-34.

Infectious disease considerations in pediatric organ transplantation.

Deen JL, Blumberg DA.

Department of Pediatrics, UCLA School of Medicine 90024.

Infections are a major cause of morbidity and mortality after organ
transplantation in children. Immunosuppression, surgery, and invasive devices all
predispose to infection. A comprehensive pretransplantation evaluation can
minimize risks and help anticipate special problems. Appropriate anti-microbial
coverage during the perioperative period decreases the risk of infection.
Bacteria and fungi are the major causes of infections occurring in the first
month after transplantation. The site of infection during this period varies by
organ transplanted: liver recipients often have intraabdominal infections, kidney
recipients are predisposed to urinary tract infections and perinephric abscesses,
and heart recipients often have respiratory tract or sternal wound infections.
Viruses play a major role in infections occurring more than 1 month after
transplantation, with cytomegalovirus the most significant agent. Other viruses
of concern include herpes simplex virus, varicella-zoster virus, several common
respiratory viruses, and Epstein-Barr virus with associated lymphoproliferative
disorders. Tuberculosis, toxoplasmosis, and Pneumocystis pneumonia also occur
later. Appropriate immunization and antimicrobial prophylaxis can help prevent
infectious complications after transplantation.

Publication Types: 
    Review

PMID: 8062043 [PubMed - indexed for MEDLINE]

5060: Intern Med. 1993 Nov;32(11):854-6.

Disseminated herpes zoster with multifocal neurologic involvement in an HTLV-1
carrier.

Fujii N, Itoh Y, Tomoda H.

Department of Neurology, Iizuka Hospital, Fukuoka.

A 56-year-old previously healthy man suffered from an attack of disseminated
herpes zoster, followed by multifocal neurologic involvement. The patient was a
human T-cell lymphotropic virus type 1 (HTLV-1) carrier. HTLV-1 infection, even
though normally asymptomatic, has been suggested to be one of the risk factors
for severe herpes virus infection and its associated neurologic disorders.

Publication Types: 
    Case Reports

PMID: 8012086 [PubMed - indexed for MEDLINE]

5061: Med Clin (Barc). 1993 Oct 16;101(12):477.

[Herpes zoster during foscarnet treatment in an AIDS patient]

[Article in Spanish]

Ricart Olmos C, Lopez Aldeguer J, Marino Blanes Julia F, Sinelni E.

Publication Types: 
    Case Reports
    Letter

PMID: 8231374 [PubMed - indexed for MEDLINE]

5062: Presse Med. 1993 Oct 2;22(29):1352-6.

[Generalized BCG infection after intravesical instillations of Calmette-Guerin
bacillus]

[Article in French]

de Saint Martin L, Boiron C, Poveda JD, Herreman G.

Service de Medecine interne, Hopital Saint Joseph, Paris.

BCG has been disappointing as immunotherapy of numerous cancers, but it has been 
clinically successful in the intravesical treatment of bladder carcinomas sparing
the muscle coat; it has indeed become the reference treatment for this type of
cancer. However, complications are repeatedly reported, including generalized
BCGitis. We report such a case with positive BCG culture. From the cases already 
published there emerges a homogeneous and often subacute clinical presentation
suggestive of an ordinary pathogen. Bacteriology is not very helpful, even when
recent techniques are used, and therefore the diagnosis rests on the context and,
when samples are taken, on suggestive histological findings. To discuss the
physiopathology of BCGitis--generalized immune reaction or multifocal BCG
proliferation--is not useless since treatment depends on it. It is probable that 
these 2 mechanisms working together can be incriminated justifying the
prescription of both antibiotics and corticosteroids. When this is done, the
prognosis seems to be favourable in most patients. Yet a strict respect of
contra-indications and a very careful subsequent radiotherapy should reduce the
risks.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8248067 [PubMed - indexed for MEDLINE]

5063: Ned Tijdschr Tandheelkd. 1993 Oct;100(10):463.

[Misleading pain complaints due to herpes zoster]

[Article in Dutch]

Meijndert L, Rittersma J.

Publication Types: 
    Case Reports

PMID: 11822148 [PubMed - indexed for MEDLINE]

5064: J Am Acad Dermatol. 1993 Oct;29(4):563-8.

An evaluation of oral ulcers in patients with AIDS and AIDS-related complex.

Liang GS, Daikos GL, Serfling U, Zhu WY, Pecoraro M, Leonardi CL, Fischl MA,
Penneys NS.

Department of Dermatology and Cutaneous Surgery, University of Miami School of
Medicine, Florida.

BACKGROUND: Patients with HIV infection can have recurrent and persistent oral
ulcers, not attributable to known infectious agents. OBJECTIVE: Our aim was to
evaluate prospectively oral ulcers in patients with HIV infection to determine
whether an etiologic agent could be identified. METHODS: Sixteen patients with
HIV infection who had oral ulcers not attributable to known causes had culture of
the base and a biopsy specimen taken from the ulcer. Cultures were obtained for
herpes simplex and varicella-zoster viruses, mycobacteria, and fungi. By
polymerase chain reaction (PCR) analysis with primer/probe sets for herpes
simplex viruses 1 and 2, varicella-zoster virus, cytomegalovirus, human
papillomavirus, and Mycobacterium tuberculosis, each biopsy specimen was analyzed
for the presence of DNA from these organisms. Specimens were also evaluated
histologically. RESULTS: Histoplasmosis was detected histologically in one biopsy
specimen, candidiasis in a second, and herpetic changes in a third. Viral
cultures were positive for herpes simplex virus 1 in four cases and herpes
simplex virus 2 in one case. PCR analysis detected DNA for herpes simplex virus 1
in one case and herpes simplex virus 2 in another; DNA from other pathogens was
not identified. In the remaining eight patients, hematoxylin-and-eosin staining
revealed eosinophilic ulcers in five cases and nonspecific changes in three
cases. CONCLUSION: The etiologic agent of recurrent or persistent oral ulcers in 
patients with AIDS and AIDS-related complex was not identified in 50% of
patients. PCR analysis was not useful. Herpes simplex virus or other pathogens
were not detected in ulcers containing numerous eosinophils.

PMID: 8408791 [PubMed - indexed for MEDLINE]

5065: Gastroenterology. 1993 Oct;105(4):1254-5.

Varicella virus in achalasia.

Schulze-Delrieu K.

PMID: 8405874 [PubMed - indexed for MEDLINE]

5066: J Oral Pathol Med. 1993 Oct;22(9):391-401.

Acyclovir: is it an effective virostatic agent for orofacial infections?

Lavelle CL.

University of Manitoba, Department of Oral Biology, Winnipeg, Canada.

Oral and intravenous acyclovir formulations provide effective virostasis against 
many herpes viruses infections, especially severe herpes simplex or
varicella-zoster infections in ambulatory and immunocompromised patients. The
therapeutic virostatic efficacy of topical acyclovir formulations requires
further development, however, especially for orolabial herpetic infections.

Publication Types: 
    Review

PMID: 8301603 [PubMed - indexed for MEDLINE]

5067: Kidney Int Suppl. 1993 Oct;43:S87-90.

Immunizations for pediatric transplant patients.

Gershon AA.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, New York.

Infection remains a major cause of morbidity and mortality in transplant
patients. Many infections, however, can be successfully prevented by
immunization. This presentation reviews the problems associated with, and the
questions that arise concerning the use of routine pediatric vaccines, such as
diphtheria-pertussis-tetanus (DPT) and measles-mumps-rubella (MMR). It also
reviews the use of special vaccines such as hepatitis B, pneumococcal, and
influenza vaccines in transplant patients. Data concerning the use of two
experimental, live-attenuated virus vaccines, against cytomegalovirus (CMV) and
varicella, are discussed. The live-attenuated varicella vaccine can be predicted 
to decrease the morbidity and mortality of varicella-zoster virus infection in
transplant patients. It has already been given successfully to immunocompromised 
children and is highly effective in the prevention of varicella.

Publication Types: 
    Review

PMID: 8246377 [PubMed - indexed for MEDLINE]

5068: Fukuoka Igaku Zasshi. 1993 Oct;84(10):436-9.

Acyclovir-resistant herpes zoster encephalitis successfully treated with
vidarabine: a case report.

Washio M, Hamada T, Goda H, Yoshimitsu T, Kajioka T, Koga H, Shogakiuchi Y,
Fujishima M, Okayama M.

Imazu Red Cross Hospital, Fukuoka.

A 78-year-old man developed herpes zoster virus (HZV) encephalitis. Initially,
treatment with aciclovir (750 mg per day) improved CSF cell count and protein
level. During the treatment, however, encephalitis in the patient deteriorated in
spite of the treatment with aciclovir, suggesting that HZV in the patient had
become resistant to aciclovir. Subsequent treatment with vidarabine (600 mg per
day, for 15 days) resulted in dramatic improvement in CSF pleocytosis. About two 
months after the discontinuation of vidarabine, the CSF cell count was normal.
The patient became alert gradually, but his amnestic syndrome remained unchanged.
Vidarabine may be recommended in the treatment of HZV encephalitis when aciclovir
is not effective.

Publication Types: 
    Case Reports

PMID: 8225157 [PubMed - indexed for MEDLINE]

5069: Arch Neurol. 1993 Oct;50(10):1046-53.

Topical aspirin in chloroform and the relief of pain due to herpes zoster and
postherpetic neuralgia.

King RB.

Department of Neurosurgery, State University of New York Health Science Center,
Syracuse, NY 13210.

OBJECTIVE--To determine pain patterns and relationships in patients with herpes
zoster and postherpetic neuralgia before and after topical application of aspirin
dissolved in chloroform applied to the painful skin surface. DESIGN--A
consecutive series of 42 patients examined and treated in a uniform manner and
followed up until their pain subsided or this management mode failed. SETTING--An
ambulatory referral private practice. PATIENTS--All patients had pain due to
herpes zoster or postherpetic neuralgia and were referred for management of
severe pain. None refused. INTERVENTION--Topical application of crushed aspirin
tablets dissolved in chloroform. OUTCOME MEASURES--Short-Form McGill Pain
Questionnaire. RESULTS--All patients reported substantially decreased pain
promptly after treatment, with maximum relief at 20 to 30 minutes and lasting 2
to 4 hours. Patients gradually decreased the use of aspirin in chloroform as pain
abated. CONCLUSIONS--Topical aspirin dissolved in chloroform is an effective
means of reducing pain due to herpes zoster and postherpetic neuralgia in most
patients. The locus of pain origin and analgesia induced by topical aspirin is
most likely at cutaneous free-nerve ending pain receptors. The mechanism
responsible for the analgesic properties of aspirin is probably not the same as
that responsible for its anti-inflammatory properties.

PMID: 8215962 [PubMed - indexed for MEDLINE]

5070: Semin Oncol. 1993 Oct;20(5 Suppl 6):80-7.

Infections in allogeneic bone marrow transplant recipients.

Wingard JR.

Department of Medicine, Emory University School of Medicine, Atlanta, GA.

Remarkable strides have been made in the management of infectious complications
after bone marrow transplantation. Improved understanding of patterns of
infection, the introduction of new antimicrobials, the advent of cytokines to
enhance immune recovery, the development of better strategies to control
graft-versus-host disease, and the availability of more accurate and rapid
diagnostic assays have all contributed to reducing the morbidity and mortality
from infection after allogeneic marrow transplantation.

Publication Types: 
    Review

PMID: 8211220 [PubMed - indexed for MEDLINE]

5071: J Med Assoc Thai. 1993 Oct;76(10):542-8.

Infection in systemic lupus erythematosus.

Janwityanuchit S, Totemchokchyakarn K, Krachangwongchai K, Vatanasuk M.

Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand.

A review of 1,069 total admissions of 537 systemic lupus erythematosus (SLE)
patients during a 10-yr period at Ramathibodi Hospital showed that 220 episodes
which occurred in 137 patients (25.5%) were motivated by infection. Skin was the 
most common site (23%) with Herpes zoster being the most common organism (15.5%) 
found in our lupus patients. However, if we considered only major infections,
pulmonary tuberculosis, salmonella septicemia and urinary tract infection by E.
coli would be the most frequent complications respectively. In the absence of
immunosuppressive therapy, infections coincided with the initial manifestation of
SLE in 25 patients and were associated with exacerbation of the disease in 20
patients. Mean SLEDAI score in these patients was 8.8, suggesting that active
lupus link together with infection. Steroid therapy influenced the rate of
opportunistic infections (p = 0.006). Infections were determined to be the cause 
of death in 23 of 77 patients (29.9%). Opportunistic pathogens played an equal
role as other common bacterial organisms in these fatal cases. SLE patients who
died from infections were treated with cyclophosphamide in higher proportion than
those with no infectious complication (p = 0.025). Our study demonstrated the
rate, nature and predisposing factors of infection in SLE which may lead to
better anticipation and diminution of morbidity and mortality related to
infection in hospitalized patients with SLE.

PMID: 7964223 [PubMed - indexed for MEDLINE]

5072: Roum Arch Microbiol Immunol. 1993 Oct-Dec;52(4):293-303.

Role of complement inhibition in topical therapy of muco-cutaneous herpes simplex
virus infections.

Gancevici GG.

Cantacuzino Institute, Bucharest, Romania.

A complement-inhibiting formulation with anti-inflammatory activity due to
suppression of both the classical and alternative pathways of complement
activation is presented for local treatment of muco-cutaneous lesions produced by
Herpes simplex virus, types 1 and 2. The drug contains glutaraldehyde, a strong
inhibitor of the complement system, dimethylsulphoxyde, used as a vector
modifying the barrier properties of the skin and 1,2-propylene glycol, a
delipidating agent which increases the adhesiveness of the watery solutions to
the skin surface. It proved to be devoid of adverse effects for normal skin of
animal and humans, and produced rapid disappearance of herpetic neuralgia and
accelerates the remission of local symptoms. The mechanism of action seems to be 
associated with the inhibition of local anaphylatoxin release (C3a and C5a) which
are responsible for the acute evolution of the lesions produced by viruses of the
Zoster-Varicella group and with a quick lethal effect on the parasitized cells
which are selectively eliminated without affecting the adjoining normal cells of 
the host.

PMID: 7827366 [PubMed - indexed for MEDLINE]

5073: Fortschr Med. 1993 Sep 30;111(27):423-5.

[Oral combination therapy of zoster neuralgia. Pain reduction by 1-adamantanamine
sulfate and carbamazepine per os]

[Article in German]

Kunzelmann V.

Dermatologische Klinik und Poliklinik, Univ.-Klinikums Charite, Berlin.

In four patients hospitalized with severe neuralgic complaints in conjunction
with a Zoster infection, the pain-relieving effect of oral 1-adamantanamine
sulfate used in combination with carbamazepine was studied. From the results
obtained, the oral administration of 1-adamantanamine sulfate also appears to
have a reliable analgesic effect, so that ambulatory treatment is readily
possible.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8225147 [PubMed - indexed for MEDLINE]

5074: Am J Ophthalmol. 1993 Sep 15;116(3):297-301.

Association of herpes zoster ophthalmicus with acquired immunodeficiency syndrome
and acute retinal necrosis.

Sellitti TP, Huang AJ, Schiffman J, Davis JL.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, FL
33101.

We conducted a review to investigate the prevalence of human immunodeficiency
virus (HIV), or acquired immunodeficiency syndrome (AIDS), in patients with
herpes zoster ophthalmicus, as well as the incidence of acute retinal necrosis
after herpes zoster ophthalmicus. All charts of patients seen at our institution 
between 1987 and 1992 with a primary diagnosis of herpes zoster ophthalmicus were
reviewed. Of 112 patients with herpes zoster ophthalmicus, 29 (26%) had HIV or
AIDS. All these patients were younger than 50 years at the time of diagnosis.
Five of 29 (17%) immunocompromised patients had acute retinal necrosis after
herpes zoster ophthalmicus. No acute retinal necrosis was identified in the
nonimmunocompromised patients after herpes zoster ophthalmicus. We recommend that
all patients younger than 50 years who have herpes zoster ophthalmicus at initial
examination be tested for HIV. Additionally, HIV-infected patients should be
monitored closely after herpes zoster ophthalmicus for development of acute
retinal necrosis. Long-term oral prophylactic as well as initial high-dose
intravenous acyclovir may be appropriate in HIV-infected individuals with herpes 
zoster.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8357053 [PubMed - indexed for MEDLINE]

5075: Presse Med. 1993 Sep 11;22(26):1226-31.

[Diagnosis of diffuse encephalopathies in adults with HIV infection. I]

[Article in French]

Gray F, Belec L, Geny C, Schouman-Claeys E.

Laboratoire d'Anatomie pathologique (Neuropathologie), Hopital Raymond Poincare
et Faculte de Medecine Paris-Ouest, Garches.

The diagnostic approach of focal central nervous system lesions in AIDS patients 
is now well established. In contrast, it is extremely difficult to determine the 
cause of diffuse encephalopathies, occurring frequently at the terminal stage of 
AIDS. Imaging is usually non specific and laboratory investigations are seldom
contributive. In most cases, the aetiological diagnosis is provided by post
mortem examination. In this first part of the study the authors deal with viral
encephalitides which represent a classical and frequent cause of diffuse
encephalopathy in AIDS. HIV encephalitis usually causes a progressive brain
disease resulting in severe dementia; imaging may show diffuse
leucoencephalopathy and/or cortico-subcortical atrophy. CMV encephalitis is often
asymptomatic, discovered at autopsy; however, this diagnosis should be considered
in patients with an encephalopathy of rapid onset, discrete signs of meningitis, 
symptoms of myelo-radiculitis, or a systemic CMV infection. Varicella-zoster
virus encephalitis is not uncommon and may occur in the absence of characteristic
rash. Infections by herpes simplex and measles viruses are exceptional.

Publication Types: 
    English Abstract

PMID: 8248044 [PubMed - indexed for MEDLINE]

5076: Br J Hosp Med. 1993 Sep 15-Oct 5;50(6):301-8.

Herpesvirus infections in childhood: 2.

Nathwani D, Wood MJ.

Infection and Immunodeficiency Service, King's Cross Hospital, Dundee.

Infections due to herpesviruses have received increasing attention over the past 
decade, culminating in the isolation in 1986 of human herpesvirus-6. This is the 
second of two articles in which we examine the clinical spectrum of acquired
herpesvirus infections in children and review developments in our understanding
of the molecular biology, pathogenesis, treatment and prevention of these
infections.

Publication Types: 
    Review

PMID: 8242213 [PubMed - indexed for MEDLINE]

5077: Schmerz. 1993 Sep;7(3):182-4.

[Ten years of therapy resistant intercostal neuralgia-suspected postherpetic
neuralgia following herpes zoster sine herpete.]

[Article in German]

Zwolfer W, Hartmann T, Spacek A, Grubhofer G, Porges P.

Akupunkturambulanz der Klinik fur Anasthesie und Allgemeine Intensivmedizin der
Universitat Wien, Spitalgasse 23, A-1090, Wien.

We report the case of a 65 year old man who has been suffering from segmental
back pain for 10 years. The diagnosis postherpetic neuralgia following herpes
zoster sine herpete was fixed 9 years after the beginning of pain. All treatments
prior to ours were ineffective. Acupuncture and the use of homeopathic drugs led 
to success at last.

Publication Types: 
    English Abstract

PMID: 18415405 [PubMed - in process]

5078: J Neurol Neurosurg Psychiatry. 1993 Sep;56(9):1001-3.

Focal weakness following herpes zoster.

Cockerell OC, Ormerod IE.

Department of Neurology, St Thomas' Hospital, London, UK.

Three patients presented with focal weakness of an arm which followed segmental
herpes zoster affecting the same limb. Neurophysiological investigations suggest 
that the site of the lesion lay at the root, plexus, or peripheral nerve level.
This reflects the various ways in which the virus may affect the peripheral
nervous system.

Publication Types: 
    Case Reports

PMID: 8410022 [PubMed - indexed for MEDLINE]

5079: Elder Care. 1993 Sep-Oct;5(5):41-4; quiz 45-6.

Herpes zoster (shingles).

Garrett G.

PMID: 8401445 [PubMed - indexed for MEDLINE]

5080: J Gen Virol. 1993 Sep;74 ( Pt 9):1837-45.

Nucleotide and predicted amino acid sequences of Marek's disease virus homologues
of herpes simplex virus major tegument proteins.

Yanagida N, Yoshida S, Nazerian K, Lee LF.

United States Department of Agriculture--Agricultural Research Service, Avian
Disease and Oncology Laboratory, East Lansing, Michigan 48823.

The DNA sequence of an 8.4 kbp BamHI-EcoRI fragment of Marek's disease virus
(MDV) strain GA was determined. Three of the predicted polypeptides are
homologous to UL47, UL48 and UL49 encoding the major tegument proteins of herpes 
simplex virus type 1 (HSV-1), and four are homologous to HSV-1 UL45, UL46, UL49.5
and UL50. These seven genes are found in the long unique region of the MDV genome
and are collinear with homologues in HSV-1 and varicella-zoster virus (VZV).
Northern blot analysis revealed different transcriptional patterns from those of 
HSV-1 and VZV. MDV homologues of UL49.5, UL49 and UL47 lack a poly(A) signal
immediately downstream of their coding regions. Amino acid conservation between
MDV and HSV-1, and between MDV and VZV is as high as that between HSV-1 and VZV. 
The MDV homologue of UL48 shows 60% similarity to its HSV-1 counterpart. Amino
acid sequence comparison reveals that the MDV homologue of UL48 lacks an acidic
carboxyl terminus. This homologue, like the VZV homologue of UL48, may be
involved in the trans-activation of immediate early genes and may function as an 
important component of the structural proteins.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8397281 [PubMed - indexed for MEDLINE]

5081: J Pediatr. 1993 Sep;123(3):418-22.

Unsuspected varicella-zoster virus encephalitis in a child with acquired
immunodeficiency syndrome.

Silliman CC, Tedder D, Ogle JW, Simon J, Kleinschmidt-DeMasters BK, Manco-Johnson
M, Levin MJ.

Department of Pediatrics, University of Colorado School of Medicine, Denver.

We report a case of progressive encephalitis caused by varicella-zoster virus
(VZV) in an adolescent with hemophilia and acquired immunodeficiency syndrome but
without cutaneous signs of VZV infection. Magnetic resonance imaging of the brain
demonstrated an abnormally increased periventricular signal in T2-weighted
images. Infection with VZV was proved by in situ hybridization and
immunofluorescence staining of brain tissue, which showed histologic evidence of 
herpesvirus infection. Encephalitis caused by infection with VZV is a potentially
treatable complication of acquired immunodeficiency syndrome and requires a high 
index of suspicion for diagnosis.

Publication Types: 
    Case Reports

PMID: 8394901 [PubMed - indexed for MEDLINE]

5082: Arch Neurol. 1993 Sep;50(9):925-30.

Idiopathic granulomatous angiitis of the central nervous system. Diagnostic
challenges.

Vollmer TL, Guarnaccia J, Harrington W, Pacia SV, Petroff OA.

Department of Neurology, Yale University School of Medicine, New Haven, Conn
06510-3289.

OBJECTIVE--Granulomatous angiitis of the central nervous system (CNS) is a rare
cause of vasculitis involving the brain and spinal cord and is included in lists 
of disorders causing strokes. To determine the frequency of strokes (eg, sudden
onset of focal symptoms) as a presenting complication and to determine the
sensitivity of angiography and other technologies in detecting vasculitis in
histologically proved cases of idiopathic granulomatous angiitis of the CNS
(IGANS), we reviewed the published literature. DATA SOURCES--A biopsy-proved case
of IGANS in a patient presenting without strokes and with a normal angiogram is
reported. Additional cases of pathologically proved IGANS where results of
angiography or other neuroimaging procedures were available were found by search 
of MEDLINE and bibliographies of pertinent articles and books. DATA
EXTRACTION--We compared our case with 39 reported cases of histologically proved 
granulomatous angiitis of the CNS not associated with Hodgkin's disease, herpes
zoster, sarcoidosis, or other proximate cause. We included only those cases that 
had been evaluated with angiography or other neuroimaging techniques before death
or biopsy. DATA SYNTHESIS--Analysis of these cases shows that strokes as
presenting complications are rare in IGANS. Most patients present with a diffuse 
encephalopathy and, when focal symptoms develop, they tend to develop gradually. 
Including our case, 56% of 41 angiograms performed in 31 reported patients with
histologically proved IGANS were abnormal, but only 27% were diagnostic for
vasculitis. CONCLUSIONS--We conclude that stroke is uncommon as a presenting
complaint in IGANS and angiography is insensitive as a screening test for these
patients.

Publication Types: 
    Case Reports
    Comparative Study
    Review

PMID: 8363446 [PubMed - indexed for MEDLINE]

5083: Reg Anesth. 1993 Sep-Oct;18(5):277-82.

Relationship between time of treatment of acute herpes zoster with sympathetic
blockade and prevention of post-herpetic neuralgia: clinical support for a new
theory of the mechanism by which sympathetic blockade provides therapeutic
benefit.

Winnie AP, Hartwell PW.

Department of Anesthesiology & Critical Care, Cook County Hospital, Chicago, IL
60612.

BACKGROUND AND OBJECTIVES. Since Rosenak's original report more than 50 years ago
as to the efficacy of sympathetic blocks in terminating acute herpes zoster, many
investigators have reported that a more important benefit of this form of therapy
is the prevention of post-herpetic neuralgia. However, most of these reports have
indicated that sympathetic blocks are effective in preventing post-herpetic
neuralgia only if applied soon after the onset of the acute phase of the disease;
in fact, if applied too late, this form of therapy failed to prevent the
development of post-herpetic neuralgia. The present study was carried out to
determine more precisely the relationship between the time of treatment of acute 
herpes zoster and the prevention of post-herpetic neuralgia and to attempt to
correlate this time with the authors' previously published theory on the
mechanism by which sympathetic blocks provide the therapeutic benefit. METHODS.
The present study was a retrospective review of 122 patients treated at variable 
intervals after the onset of acute herpes zoster. Data tabulated included the
duration of symptoms at the time of treatment, the number of sympathetic blocks
required to provide relief, and the efficacy of the sympathetic blockade in
terminating the acute phase of herpes zoster and then preventing the development 
of post-herpetic neuralgia. RESULT. According to the data obtained in this
retrospective study, sympathetic blocks terminated the pain of acute herpes
zoster and prevented or relieved post-herpetic neuralgia in more than 80% of
patients treated within 2 months of the onset of the acute phase of the disease, 
after which time the success rate decreased drastically. CONCLUSION. Sympathetic 
blockade applied within the first 2 months after the onset of acute herpes zoster
terminated the acute phase of the disease, probably by restoring intraneural
blood flow, thus preventing the death of the large fibers and avoiding the
development of post-herpetic neuralgia. If sympathetic blocks were to be carried 
out after 2 months, the damage to the large fibers would be irreversible, and
this therapeutic modality would not be able to prevent the development of
post-herpetic neuralgia.

PMID: 8268115 [PubMed - indexed for MEDLINE]

5084: Reg Anesth. 1993 Sep-Oct;18(5):271-3.

The sympathetic nervous system in post-herpetic neuralgia.

Hogan QH.

Publication Types: 
    Comparative Study
    Editorial

PMID: 8268114 [PubMed - indexed for MEDLINE]

5085: Masui. 1993 Sep;42(9):1343-6.

[Herpes zoster and malignancy]

[Article in Japanese]

Zaha M, Hayashi I, Odashiro M, Mizoguchi H, Fujiwara M, Kato H, Kawamura J.

Department of Anesthesia, Hokkaido Kinikyou Chuo Hospital, Sapporo.

A retrospective survey was conducted regarding the relationship between
hospitalized patients with herpes zoster and malignancy based on clinical
records. A total of 220 patient were hospitalized for treatment of herpes zoster 
during the past 15 years, and 23 of them had involvement with malignant tumors.
Malignancy was found during hospitalization in 4 cases (1.8%). This was
significantly higher than 0.27, the predicted number of malignancy cases. Three
of the 4 cases were gastric cancer. The discovery rate of gastric cancer through 
screening at admittance was 2.4%, which was higher than 0.14%, the discovery rate
in gastric cancer checkups in Hokkaido. Examination for malignant tumors should
be required for all patients with herpes zoster who need to be hospitalized.

Publication Types: 
    English Abstract

PMID: 8230723 [PubMed - indexed for MEDLINE]

5086: HNO. 1993 Sep;41(9):449-52.

[Treatment of zoster oticus with acyclovir. Report from general practice and a
small hospital department]

[Article in German]

Haass HG.

HNO-Abteilung, Diakonissenkrankenhauses Mannheim.

Findings in patients having zoster oticus infection are reported following
treatment in an oto-rhino-laryngological practice connected to a small hospital
department. Treatment involved intravenous administration of acyclovir and-in
most cases-additional infusions of dextran, cortisone and naftidrofuryl, as
adapted from a drug regimen proposed by Stennert. Although treatment was not
effective in all cases, several very good results and some partial results were
found that justified continued use of this combination therapy.

Publication Types: 
    English Abstract

PMID: 8226133 [PubMed - indexed for MEDLINE]

5087: Graefes Arch Clin Exp Ophthalmol. 1993 Sep;231(9):508-13.

An improved technique for the diagnosis of viral retinitis from samples of
aqueous humor and vitreous.

Garweg J, Fenner T, Bohnke M, Schmitz H.

Department of Ophthalmology, University of Bern, Inselspital, Switzerland.

We applied the technique of DNA amplification with the polymerase chain reaction 
to nine aqueous humor and five vitreous samples from HIV-1-infected patients with
clinically diagnosed cytomegalovirus retinitis. For the amplification, recently
published primers specific for herpes simplex virus (HSV), varicella zoster virus
(VZV) and cytomegalovirus (CMV-1) were used. Additionally, a newly developed
primer pair specific for the main immediately early gene of CMV (CMV-2) was
selected and compared with the published one. All primers were tested on
noninfected and HSV-, VZV- and CMV-infected human fibroblast cell culture
supernatant, thereby excluding cross-reactivity of the chosen primers. In none of
13 aqueous humor and six vitreous samples of healthy controls was any viral DNA
amplified. Using the CMV-1 primers, we detected CMV DNA in five of nine aqueous
humor and three of five vitreous samples amplifying a DNA fragment 435 base pairs
in length. With the CMV-2 primers, we detected a CMV DNA fragment with a length
of 110 base pairs in eight of nine aqueous humor and in four of five vitreous
samples. Additionally, CMV DNA was found in three of nine urine and two of nine
saliva specimens. Both CMV and HSV DNA were amplified in one aqueous sample.
Varicella DNA was not detected in any of the specimens. Thus, the polymerase
chain reaction is more sensitive than other comparable diagnostic tests and may
provide an alternative to conventional virus isolation and in situ hybridization 
techniques for the laboratory diagnosis of viral ocular disease.

PMID: 8224954 [PubMed - indexed for MEDLINE]

5088: Clin Infect Dis. 1993 Sep;17(3):431-6.

Comment in:
    Clin Infect Dis. 1994 Nov;19(5):975.

Gastrointestinal visceral motor complications of dermatomal herpes zoster: report
of two cases and review.

Tribble DR, Church P, Frame JN.

Infectious Diseases Division, Naval Medical Research Unit No. 3, Cairo, Egypt.

Motor complications are uncommon manifestations of herpes zoster. This report
describes two cases of gastrointestinal visceral motor manifestations associated 
with dermatomal herpes zoster and reviews the English-language literature since
1900. The 17 cases reviewed were divided clinically into two groups: colonic
pseudo-obstruction and localized colonic spasm. Characteristics of the patients, 
radiographic study results, endoscopic findings, proposed pathogenesis, and
management options are discussed. It is important to recognize this manifestation
in order to institute proper management and avoid unnecessary surgery, given the 
complete resolution with conservative management in most cases.

Publication Types: 
    Case Reports
    Review

PMID: 8218686 [PubMed - indexed for MEDLINE]

5089: Arthritis Rheum. 1993 Sep;36(9):1329.

Isolation of varicella zoster virus from the synovial fluid of a patient with
herpes zoster arthritis.

Amoura I, Fillet AM, Huraux JM, Bourgeois P.

Pitie-Salpetriere Hospital, Paris, France.

Publication Types: 
    Case Reports

PMID: 8216427 [PubMed - indexed for MEDLINE]

5090: J Gen Virol. 1993 Sep;74 ( Pt 9):1955-8.

An epitope within the DNA-binding domain of the herpes simplex virus immediate
early protein Vmw175 is conserved in the varicella-zoster virus gene 62 protein.

Everett R, Cross A, Tyler J, Orr A.

MRC Virology Unit, Glasgow, U.K.

We have isolated a panel of monoclonal antibodies that recognize the DNA-binding 
domain of the herpes simplex virus type 1 (HSV-1) immediate early polypeptide
Vmw175. The mice used for the fusions had been immunized with the isolated Vmw175
DNA-binding domain. This had been purified from bacteria that carried a phage T7 
expression plasmid with the DNA-binding domain coding region. The epitopes
recognized by the monoclonal antibodies were mapped by using a family of
truncated versions of the DNA-binding domain, which had also been expressed in
the bacterial expression system. The monoclonal antibodies divided into at least 
four different groups according to this mapping. Several of the monoclonal
antibodies recognized Vmw175 expressed in infected BHK cells by HSV-1 strain 17
in Western blots. One of them also recognized the corresponding protein of
varicella-zoster virus gene 62. This is further illustration of the relatedness
of the two polypeptides.

Publication Types: 
    Comparative Study

PMID: 7690843 [PubMed - indexed for MEDLINE]

5091: Orv Hetil. 1993 Aug 29;134(35):1927-30.

[Ophthalmoplegia in herpes zoster: clinical review based on two case reports]

[Article in Hungarian]

Pal E, Szekeres V, Vecsei L.

Pecsi Orvostudomanyi Egyetem Neurologiai Klinika.

The authors describe two cases of ophthalmic herpes zoster complicated with
ophthalmoplegia. This rare complication developed in the 2nd week after beginning
of the disease and it is only slightly influenced by antiviral therapy, but
improvement was observed after the administration of corticosteroids. A short
overview summarizes the diagnostic possibilities, the therapy and the
complication of the disease.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8361748 [PubMed - indexed for MEDLINE]

5092: JAMA. 1993 Aug 11;270(6):710.

Comment on:
    JAMA. 1993 Apr 14;269(14):1836-9.

Acute herpes zoster: sympathetic nerve block unsupported by prospective trial.

McGuinness JP.

Publication Types: 
    Comment
    Letter

PMID: 8336372 [PubMed - indexed for MEDLINE]

5093: Zhonghua Yi Xue Za Zhi (Taipei). 1993 Aug;52(2):71-6.

Five-year experience of human immunodeficiency virus type 1 national screening
program implemented at Veterans General Hospital-Taipei.

Cheng DL, Liu YC, Liu WT, Liu CY, Yen MY, Wang JH, Wang WW, Lin HH, Chen YS, Wang
JH.

Department of Medicine, Veterans General Hospital-Kaohsiung & Taipei, Taiwan,
R.O.C.

From July 1986 through June 1990, 33,199 sera from various risk groups were
collected in Veterans General Hospital-Taipei for detection of antibody against
human immunodeficiency virus, type 1 (HIV-1). Sixty-five samples were proved
positive by Western blot analysis. Among individual high risk groups,
hemophiliacs had the highest positive rate of 20/60 (29.41%), followed by
homosexual/bisexual males (41/1,264, 3.24%). The overall positive rate was
65/33,199 (0.19%). Ten cases were recognized as acquired immunodeficiency
syndrome (AIDS), 1 case had AIDS-related complex (ARC) and 4 case had other
apparently symptomatic infections. Among these 15 cases, 7 expired, 1 lost of
follow-up and 7 surviving cases are being treated with zidovudine (AZT). Most of 
symptomatic HIV-1 antibody positive cases had abnormal T4/T8 ratio of 0.39 +/-
0.54 as compared with the asymptomatic HIV-1 carriers at a ratio of 0.81 +/-
0.69. The opportunistic infections included Pneumocystis carinii pneumonia (PCP) 
in 6 case, disseminated cytomegalovirus infection in 6 cases, herpes zoster virus
infection in 3 case, candidiasis in 4 cases, syphilis in 3 cases, pulmonary
tuberculosis in 2 cases, and others with cryptococcosis, salmonellosis,
Mycobacterium avium-intracellulare infection, gonorrhea, Staphylococcus aureus
endocarditis and bacterial sepsis, etc. The natural history of HIV-1 infection to
AIDS involved acute and persistent multiple infections. Although prevalence of
HIV-1 infection was low in Taiwan, nationwide surveillance of HIV-1 infection in 
various risk groups is still needed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8402370 [PubMed - indexed for MEDLINE]

5094: Bone Marrow Transplant. 1993 Aug;12(2):167-8.

HIV infection after autologous bone marrow transplantation despite HIV-antibody
and HIV-antigen screening.

Jootar S, Angchaisuksiri P, Chiewsilp P, Sathapatayavongs B, Chuncharunee S,
Tanprasert S.

Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol
University, Bangkok, Thailand.

We report a 41-year-old woman who underwent ABMT for non-Hodgkin's lymphoma
during her third CR. Her post-transplant course was complicated by interstitial
pneumonitis, hemorrhagic cystitis, cytopenia and episodes of infection from
herpes zoster virus and Staphylococcus aureus. She required prolonged blood
product support and was later found to be seropositive for anti-HIV on day +191
despite HIV-antibody and HIV-antigen screening of blood donors.

Publication Types: 
    Case Reports

PMID: 8401366 [PubMed - indexed for MEDLINE]

5095: AAOHN J. 1993 Aug;41(8):369-73.

Varicella zoster virus in the health care setting: risk and management.

Lund J.

1. Varicella zoster poses a threat to clients and staff in health care settings
because of its ease of transmission and incidence of complications in those over 
age 20, neonates, and the immunocompromised. 2. Risk surveillance of personnel
via a comprehensive screening program will establish the pool of seronegative (or
"at risk") health care workers. 3. Clear policies on restricting client admission
or visitors, and work restrictions for health care workers related to varicella
will aid in preventing outbreaks in the health care setting. 4. Prompt follow up 
of exposures is best accomplished using an established protocol for loss control.

PMID: 8397553 [PubMed - indexed for MEDLINE]

5096: Hum Pathol. 1993 Aug;24(8):871-9.

Herpesviruses in chronic encephalitis associated with intractable childhood
epilepsy.

Vinters HV, Wang R, Wiley CA.

Department of Pathology and Laboratory Medicine, UCLA Medical Center 90024-1732.

Herpesviruses (especially cytomegalovirus [CMV] and Epstein-Barr virus [EBV])
have been implicated in the pathogenesis of chronic (Rasmussen) encephalitis
associated with epilepsy. To assess the presence of herpesvirus genes in brain
tissue from epileptic children with chronic (usually Rasmussen type)
encephalitis, DNA was extracted from surgically resected brain tissue and studied
by the polymerase chain reaction using primers specific for CMV, varicella zoster
virus, herpes simplex virus, EBV, and human herpesvirus 6 genes. By this
technique evidence for the presence of low levels of CMV and EBV genes was
detected in most brain specimens from encephalitis patients and in several brain 
specimens from patients without encephalitis (eg, cortical dysplasia, gliosis, or
encephalomalacia) who also had intractable epilepsy. Occasionally, both EBV and
CMV genes were found in the same brain. Signal strength for both CMV and EBV was 
much lower in epileptic brains than in the brains of acquired immunodeficiency
syndrome patients with CMV encephalitis or brain lymphoma. We found evidence for 
infection of the brain by human herpesvirus 6 in only one patient with
encephalitis. Polymerase chain reaction technology applied to resected brain
tissue from epileptic patients may provide evidence for or against viral-mediated
pathogenesis of Rasmussen encephalitis or other types of encephalitis. The small 
amounts of EBV and CMV genes found suggest that herpesvirus infection of the
brain does not directly cause Rasmussen encephalitis.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8397159 [PubMed - indexed for MEDLINE]

5097: Virology. 1993 Aug;195(2):793-7.

Functional interaction of varicella zoster virus gene 62 protein with the DNA
sequence bound by herpes simplex virus ICP4 protein.

Betz JL, Wydoski SG.

Department of Microbiology and Immunology, University of Colorado School of
Medicine, Denver 80262.

Varicella zoster virus gene 62 protein [defined as the product of open reading
frame (ORF)62], like its herpes simplex virus type-1 homolog ICP4 (alpha 4,
Vmw175), trans-activates gene expression from the early HSV-1 glycoprotein D
promoter. In transient co-transfection assays, trans-activation of gD gene
expression by the VZV protein was increased by the presence of cloned alpha 4
binding sites in the promoter. Bacterial extracts containing the 230-amino acid
domain of VZV ORF62 homologous to the DNA binding domain of ICP4 (region 2)
formed specific complexes with the alpha 4BS DNA sequence. These results indicate
that VZV ORF62 protein, like ICP4, binds DNA in a sequence-specific fashion, and 
the binding may contribute to its mechanism of activation of gene expression.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8393246 [PubMed - indexed for MEDLINE]

5098: J Virol. 1993 Aug;67(8):4464-73.

Identification of the phosphorylation sequence in the cytoplasmic tail of the
varicella-zoster virus Fc receptor glycoprotein gpI.

Yao Z, Jackson W, Grose C.

Department of Microbiology, University of Iowa College of Medicine, Iowa City
52242-1083.

Varicella-zoster virus (VZV) glycoprotein gpI, the homolog of herpes simplex
virus gE, functions as a receptor for the Fc portion of immunoglobulin G. Like
other cell surface receptors, this viral receptor is highly phosphorylated in
cell culture. To identify the precise location of the cellular kinase-mediated
phosphorylation, we generated a tailless deletion mutant and several point
mutants which had altered serine and threonine residues within the cytoplasmic
domain of gpI. The mutated and wild-type genes of gpI were transfected and
expressed within a vaccinia virus-T7 polymerase transfection system in order to
determine what effect these mutations had on the phosphorylation state of the
protein in vivo and in vitro. Truncation of the cytoplasmic domain of gpI
diminished the phosphorylation of gpI in vivo. Examination of the point mutants
established that the major phosphorylation sequence of gpI was located between
amino acids 593 and 598, a site which included four phosphorylatable serine and
threonine residues. Phosphorylation analyses of the mutant and wild-type
glycoproteins confirmed that gpI was a substrate for casein kinase II, with
threonines 596 and 598 being critical residues. Although the mutant glycoproteins
were phosphorylated by casein kinase I, protease V8 partial digestion profiles
suggested that casein kinase II exerted the major effect. Thus, these mutagenesis
studies demonstrated that the gpI cytoplasmic sequence Ser-Glu-Ser-Thr-Asp-Thr
was phosphorylated in mammalian cells in the absence of any other herpesvirus
products. Since the region defined by transfection was consistent with results
obtained with in vitro phosphorylation by casein kinase II, we propose that VZV
gpI is a physiologic substrate for casein kinase II. Immunofluorescence and
pulse-chase experiments demonstrated that the mutant glycoproteins were processed
and transported to the outer cell membrane.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 8392591 [PubMed - indexed for MEDLINE]

5099: Nippon Jibiinkoka Gakkai Kaiho. 1993 Aug;96(8):1329-39.

[MRI enhancement of the facial nerve with Gd-DTPA--second report--investigation
of enhanced nerve portions in patients with facial palsy]

[Article in Japanese]

Yanagida M.

Department of Otorhinolaryngology, Kansai Medical University, Osaka.

We performed enhanced MRI using Gd-DTPA in 84 patients with facial palsy. After
assessing enhancement of the normal facial nerve, we examined enhancement in
patients with Bell's palsy and Ramsay Hunt syndrome. The following results were
obtained. 1. In 95% of patients with Bell's palsy, enhancement was obtained in
the distal IAC and labyrinthine portions. In 72%, enhancement was significant
from the distal IAC portion through the vertical portion. In some of the patients
who underwent enhanced MRI twice, increased signal intensity was observed in
distal portions such as the vertical portion. 2. In many cases with Ramsay Hunt
syndrome, enhancement was seen extensively in the IAC portion through the
vertical portion. In the subjects with internal auditory symptoms such as vertigo
and tinnitus, enhancement of the IAC portion was seen not only in the facial
nerve but also in the vestibular and the cochlear nerves. These results suggest
that the vascular permeability of lesions in Bell's palsy may be increased from
the distal IAC portion to the vertical portion. Judging from the present findings
with Ramsay Hunt syndrome, symptoms related to the enhanced portions suggest that
accompanying internal auditory symptoms occur due to inflammation of the IAC
portions of cochlear and vestibular nerves.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8377065 [PubMed - indexed for MEDLINE]

5100: Masui. 1993 Aug;42(8):1171-6.

[Transdermal application of 10% lidocaine-gel for management of pain associated
with herpes zoster]

[Article in Japanese]

Shimoda O, Kano T, Takaki M, Tashima T, Tashiro M, Ikuta Y, Morioka T, Nakano M, 
Mishima M.

Department of Anesthesiology, Kumamoto Rosai Hospital, Yatsushiro.

We have developed transdermally applicable 10% lidocaine aqueous gel containing
an absorption promoter and applied it for 15 patients suffering from severe pain 
in acute or subacute phase of herpes zoster. The patients, consisting of 7 males 
and 8 females with a mean age 58.5 +/- 13.0 (SD) yrs, had skin eruptions of
herpes zoster for the past 2 months. Lidocaine-gel was applied locally to the
diseased skin with or without an occlusive dressing. In 14 of the 15 patients
(93%), a remarkable reduction of pain (below 10% of pretreatment level) was
obtained after 9.9 +/- 5.6 (SD) times of lidocaine-gel treatments. There was no
adverse systemic reactions or local skin damages. None of them developed
post-herpetic neuralgia. The lidocaine-gel treatment appears to be very useful
for reduction of pain associated with acute or subacute phase of herpes zoster.

Publication Types: 
    English Abstract

PMID: 8366557 [PubMed - indexed for MEDLINE]

5101: Aging (Milano). 1993 Aug;5(4):325-32.

FRAR course on laboratory approaches to aging. "Orphan" phenotypes in
gerontological research.

Martin GM.

Department of Pathology, University of Washington, Seattle 98195.

It is argued that, in addition to investigations of life span parameters, a large
number of biomedically important phenotypes can be profitably studied from a
gerontological perspective. These would include "private" patterns of aging,
especially in our own species, which exhibits extraordinary genetic
heterogeneity. These, as well as a number of relatively common age-associated
phenotypes, have been comparatively neglected by the gerontological community,
and therefore warrant the designation as "orphan" phenotypes. From a tabulation
of examples from each of the major body systems, five are elaborated upon:
"hyperhippocampals," defined as individuals with intrinsically enhanced
functional reserve in relevant neural circuitry; patients with a heterogeneous
set of pathologies collectively referred to as "normal pressure hydrocephalus";
patients with late life activation of herpes zoster; individuals with unusually
early onset of loss of olfactory function; and geriatric subjects with unusual
sensitivity to "jet lag."

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 8297936 [PubMed - indexed for MEDLINE]

5102: J Med Virol. 1993 Aug;40(4):339-42.

Comparative analysis of the restriction endonuclease profiles of the Dumas and
Singapore strains of varicella-zoster virus.

Chow VT, Wan SS, Doraisingham S, Ling AE.

Department of Microbiology, Faculty of Medicine, National University of
Singapore.

The incidence of varicella in Singapore has been increasing since 1984. In 1991, 
17,930 cases were reported in a population of about 3 million. A serological
survey completed in 1990 demonstrated that only 43% of the cohort had antibodies 
to varicella-zoster virus (VZV), indicating inadequate herd immunity. To exclude 
novel VZV strains, representative VZV isolates from 9 chicken pox and 4 zoster
patients were characterised by restriction endonuclease analysis. DNAs were
extracted from viral isolates propagated in MRC5 human embryo lung cells and were
digested separately with BglII, EcoRI, PstI, SalI, and XbaI enzymes. The cleavage
profiles of these VZV strains derived from both chicken pox and zoster lesions
revealed no distinct differences. This observation implies that the current
upsurge of chicken pox most likely stems from closely related VZV genotypes
infecting a susceptible population with insufficient herd immunity. Comparison of
the restriction fragments of the Singapore and the Dumas strains revealed
polymorphisms of the SalI-D, SalI-E, and XbaI-I fragment lengths, which
correlated with variable regions I, II, and III of the VZV genome, thereby
representing geographically distinct genotypic variants of VZV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8228928 [PubMed - indexed for MEDLINE]

5103: J Med Virol. 1993 Aug;40(4):278-84.

Epstein-Barr virus genomic sequences and specific antibodies in cerebrospinal
fluid in children with neurologic complications of acute and reactivated EBV
infections.

Imai S, Usui N, Sugiura M, Osato T, Sato T, Tsutsumi H, Tachi N, Nakata S,
Yamanaka T, Chiba S, et al.

Department of Virology, Hokkaido University School of Medicine, Sappord, Japan.

Four children with infectious mononucleosis (IM) and one with reactivated
Epstein-Barr virus (EBV) infection had concomitant central nervous system
disorders. Cerebrospinal fluid (CSF) samples from all five patients contained EBV
genomic sequences and EBV-specific antibodies in the neurologic stage, but not
during convalescence. Cerebrospinal fluid from two non-neurologic IM patients had
neither EBV DNA nor EBV antibodies. The EBV-positive CSF of the five with
neurological disorders were aseptic in culture and all negative for other human
herpesvirus DNAs and antibodies: herpes simplex virus types 1 and 2,
cytomegalovirus, varicella-zoster virus, and human herpesvirus 6. Epstein-Barr
virus DNA and EBV antibodies were not detected in the CSF of 17 EBV-seropositive 
patients with mumps meningitis, rubella encephalitis, unknown febrile convulsion,
or partial epilepsy. It is suggested that EBV plays a causal role in neurologic
manifestations in patients with acute and reactivated EBV infections, through
direct viral invasion and immunopathological reactions.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8228918 [PubMed - indexed for MEDLINE]

5104: J La State Med Soc. 1993 Aug;145(8):333-5.

Herpes zoster oticus: diagnosis and management.

Muecke M, Amedee RG.

Tulane University Medical Center, Dept of Otolaryngology, Head & Neck Surgery,
New Orleans.

Herpes zoster oticus (Ramsay Hunt syndrome) is recognized as a polycranial
neuritis caused by the DNA virus Herpes zoster and characterized by damage to
sensory and motor nerves, including the audio-vestibular apparatus. Common
presenting symptoms include cutaneous auricular vesicles, severe otalgia,
inflammation of the pinna, and occasionally unilateral sudden facial paralysis.
This article reviews the medical management of this disease, including the
efficacy of antibiotics, corticosteroids, and acyclovir, along with the role of
surgical decompression of the facial nerve.

Publication Types: 
    Review

PMID: 8228542 [PubMed - indexed for MEDLINE]

5105: J Cutan Pathol. 1993 Aug;20(4):317-9.

Antibody deposits in Tzanck smears in pemphigus vulgaris.

Verma KK, Khaitan BK, Singh MK.

Department of Dermatology, All India Institute of Medical Sciences, New Delhi.

Forty-three patients, including 24 males and 19 females between 5 and 62 years of
age, having pemphigus vulgaris (27), pemphigus foliaceus (1), bullous pemphigoid 
(3), chronic benign bullous dermatosis of childhood (2) and herpes zoster (10)
were included in this study. Tzanck smears were prepared from the floor of the
blisters in these patients by deroofing the bullae, and the slides were stored
without fixation at room temperature for 1 to 10 days. Immunofluorescence
staining was done with FITC-conjugated anti-human IgG. Twenty-one cases having
pemphigus vulgaris and 1 case having pemphigus foliaceus showed bright green
fluorescence on the membrane of acantholytic cells. No epithelial cells were seen
in smears from bullous pemphigoid and chronic benign bullous dermatosis of
childhood, whereas epithelial cells were seen in 10 cases of herpes zoster. These
stained negative with anti-IgG. Storage of the prepared smears for 1-10 days did 
not seem to affect the results of immunofluorescence. Tzanck smears can be used
as an easy substitute for skin/mucosal biopsy for the direct immunofluorescence
test.

PMID: 8227607 [PubMed - indexed for MEDLINE]

5106: Ann Med. 1993 Aug;25(4):329-33.

Herpes virus infections in immunocompromised patients: problems and therapeutic
interventions.

Ljungman P.

Huddinge University, Sweden.

Herpes virus infections are responsible for morbidity and mortality among
immunosuppressed patients. During the last decade substantial advances have been 
achieved through improvement of diagnostic techniques, development of effective
antiviral agents and the use of different strategies for prophylaxis and
treatment. Cytomegalovirus infection and disease can today be prevented and
treated effectively; however, antiviral resistance is beginning to emerge as a
potential major clinical problem. Similarly, infections with herpes simplex virus
and varicella-zoster virus can be effectively treated, but antiviral resistance
has also emerged for these viruses. Two new herpes viruses, human herpes viruses 
6 and 7, have been discovered, and it is possible that these viruses can also
cause significant problems in immunosuppressed individuals. New antiviral agents 
will be needed during the next decade to allow further advances in the treatment 
of herpes virus infections.

Publication Types: 
    Review

PMID: 8217097 [PubMed - indexed for MEDLINE]

5107: Am J Dermatopathol. 1993 Aug;15(4):320-5.

Ultrastructural findings in mucocutaneous infections of patients seropositive to 
HIV.

Cavicchini S, Brezzi A, Alessi E.

First Clinic of Dermatology, Milan, Italy.

Tissue samples from 19 HIV-seropositive immunocompromised patients suffering from
oral hairy leukoplakia, chronic vesicular or ulcerative herpes simplex, chronic
nonmetameric herpes zoster, secondary syphilis, condylomata acuminata, molluscum 
contagiosum, or disseminated cutaneous mycobacteriosis were examined
ultrastructurally in order to better define the fine structure of the causative
organisms in parasitic conditions and to clarify the host-parasite relationships.
Taking into account the few data in the literature regarding the same disorders
in immunocompetent subjects, no striking differences in the morphology of the
infectious agents or in the types of parasitism were found. Nevertheless,
isolated herpesvirus and papillomavirus virions were found outside the infected
cells, and this observation, if confirmed in a larger series of cases, could
suggest a persistent infectivity of the lesions in immunocompromised patients.
Moreover, electron microscopy proved to be useful for diagnostic purposes; in one
case of disseminated cutaneous mycobacteriosis, repeated cultures failed to grow 
the organism.

PMID: 8214389 [PubMed - indexed for MEDLINE]

5108: Genitourin Med. 1993 Aug;69(4):273-5.

Detection of varicella-zoster virus DNA using the polymerase chain reaction in an
immunocompromised patient with transverse myelitis secondary to herpes zoster.

Grant AD, Fox JD, Brink NS, Miller RF.

Department of Medicine, University College and Middlesex School of Medicine,
London, UK.

A case of herpes zoster transverse myelitis is described in which the clinical
diagnosis was confirmed by demonstrating the presence of varicella-zoster virus
(VZV) DNA in the cerebrospinal fluid (CSF) by amplification using the polymerase 
chain reaction. This case illustrates the potential role of the selective
amplification of VZV DNA from CSF in contributing to the diagnosis of
neurological complications associated with VZV infection.

Publication Types: 
    Case Reports

PMID: 7721287 [PubMed - indexed for MEDLINE]

5109: N Engl J Med. 1993 Jul 29;329(5):297-303.

Comment in:
    ACP J Club. 1994 Jan-Feb;120 Suppl 1:11.    N Engl J Med. 1993 Dec 16;329(25):1895; author reply 1895-6.    N Engl J Med. 1993 Dec 16;329(25):1895; author reply 1895-6.    N Engl J Med. 1993 Dec 16;329(25):1895; author reply 1895-6.    N Engl J Med. 1993 Jul 29;329(5):351-2.    N Engl J Med. 1994 Jun 16;330(24):1758-9.

Zidovudine in persons with asymptomatic HIV infection and CD4+ cell counts
greater than 400 per cubic millimeter. The European-Australian Collaborative
Group.

Cooper DA, Gatell JM, Kroon S, Clumeck N, Millard J, Goebel FD, Bruun JN, Stingl 
G, Melville RL, Gonzalez-Lahoz J, et al.

National Centre in HIV Epidemiology and Clinical Research, St. Vincent's
Hospital, University of New South Wales, Sydney, Australia.

BACKGROUND. Zidovudine therapy is of benefit in the treatment of symptomatic and 
asymptomatic human immunodeficiency virus (HIV) infection in persons with CD4+
cell counts of less than 500 per cubic millimeter. The efficacy, safety, and
duration of benefit of zidovudine in those with 500 or more CD4+ cells per cubic 
millimeter are uncertain. METHODS. In a double-blind, placebo-controlled trial,
993 patients with asymptomatic HIV infection and CD4+ cell counts above 400 per
cubic millimeter were randomly assigned to receive zidovudine (500 mg twice
daily) or placebo for three years. The primary end point was progression of
disease, as defined by the development of Centers for Disease Control and
Prevention (CDC) group IV disease (including recurrent oral candidiasis, hairy
leukoplakia, or progressive diarrhea) or two CD4+ cell counts below 350 per cubic
millimeter. This outcome measure was changed from the original end point of the
acquired immunodeficiency syndrome (AIDS) or advanced AIDS-related complex to
reflect changes in recommendations for management. The study was terminated after
the first interim analysis. RESULTS. Disease progression was significantly less
frequent in the zidovudine group (relative risk, 0.56; 95 percent confidence
interval, 0.43 to 0.75; P < 0.001 by the log-rank test). The probability of
disease progression at two years was 0.19 with zidovudine, as compared with 0.34 
with placebo (95 percent confidence interval for the difference, -0.21 to -0.08).
Progression to CDC group IV disease was reduced by half in the zidovudine
recipients (relative risk, 0.49; P = 0.049) and decline in CD4+ cell counts to
below 350 per cubic millimeter was reduced by 40 percent (relative risk, 0.60; P 
< 0.001). The inclusion of early HIV disease events (oral candidiasis, oral hairy
leukoplakia, and herpes zoster) as end points confirmed the effects of zidovudine
on the progression of clinical disease (relative risk, 0.55; 95 percent
confidence interval, 0.37 to 0.84; P = 0.004). The median duration of treatment
was 94 weeks. Severe hematologic or clinical side effects were rare. CONCLUSIONS.
Treatment with zidovudine benefits HIV-infected persons with CD4+ cell counts
above 400 per cubic millimeter. Despite the use of doses larger than those now
generally prescribed, zidovudine was well tolerated for up to three years by most
of our patients.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 8100611 [PubMed - indexed for MEDLINE]

5110: Ned Tijdschr Geneeskd. 1993 Jul 24;137(30):1509-12.

[Blepharospasm; results of treatment with botulin]

[Article in Dutch]

Aramideh M, Devriese PP, Ongerboer de Visser BW, Brans JW, Speelman JD.

Onderzoeksschool Neurowetenschappen, Academisch Medisch Centrum, Amsterdam.

OBJECTIVE. Discussion of clinical symptoms and differential diagnosis of
blepharospasm and treatment with botulinum A toxin. Blepharospasm is an
involuntary spasmodic contraction of the eyelids. Within a few years 35%-70% of
the patients becomes severely disabled. DESIGN. Prospective, open study. SETTING.
Academical Medical Centre, Amsterdam. METHOD. In the period 1985-1992 we have
seen 85 patients with blepharospasm. Of these 69 were treated with botulinum
toxin, a total of 436 treatments, with a mean dose of 25 IU for each eye.
RESULTS. The cause of blepharospasm was unknown in 71 patients. Secondary
blepharospasm occurred in: peripheral facial palsy (one patient), herpes zoster
infection of the trigeminal nerve (2), brain infarct (1), use of neuroleptics
(2), progressive supranuclear palsy (2), Shy-Drager syndrome (1), kernicterus
(1), and morbus Sjogren (4). There were 18 patients with autoimmune diseases. 77 
(91%) patients had a (very) severe form of blepharospasm. Electromyographic
registration revealed a dysfunction of M. levator palpebrae in 7 patients. More
than 70% of the patients were free of symptoms for a mean period of two months
after each treatment. Local side effects were seen in 61 (14%) of the 436
treatments: ptosis, haematoma, dry eyes, and diplopia. CONCLUSION. Blepharospasm 
is a disabling disease and occurs sometimes in association with other
neurological and ophthalmological diseases. Botulinum A toxin is a safe and
effective therapy. Electrophysiological investigation is important in the
differential diagnosis; it is unnecessary to do CT or MRI routinely.

Publication Types: 
    English Abstract

PMID: 8366939 [PubMed - indexed for MEDLINE]

5111: Lancet. 1993 Jul 17;342(8864):143-6.

Comment in:
    Lancet. 1993 Oct 23;342(8878):1053.    Lancet. 1993 Sep 11;342(8872):676.    Lancet. 1993 Sep 11;342(8872):676.

Spectrum of immunodeficiency in HIV-1-infected patients with pulmonary
tuberculosis in Zaire.

Mukadi Y, Perriens JH, St Louis ME, Brown C, Prignot J, Willame JC, Pouthier F,
Kaboto M, Ryder RW, Portaels F, et al.

Projet SIDA, Kinshasa, Zaire.

Tuberculosis (TB) is the most common opportunistic infection in African patients 
who die from AIDS, yet the stage of immunodeficiency at which TB develops is
uncertain. We studied the immune status of HIV-infected outpatients with
pulmonary TB in relation to their clinical presentation in a cross-sectional
study of 216 HIV-seropositive and 146 HIV-seronegative ambulatory incident cases 
of smear-positive and culture-positive pulmonary TB in Kinshasa, Zaire.
HIV-seropositive and seronegative patients had median CD4 lymphocyte counts of
316.5/microL and 830.5/microL, respectively. Of the HIV-seropositive patients,
32.9% had less than 200 CD4 lymphocytes/microL, 37% between 200 and 499, and
30.1% 500 or more. Clinical AIDS, as defined by the WHO clinical case-definition 
or a modified version, was of similar limited use as a predictor of
immunodeficiency. Among HIV-seropositive patients, oral candidosis, lymphopenia, 
a negative tuberculin purified protein derivative test, and cutaneous anergy were
strongly associated with CD4 counts of less than 200/microL, and seemed to be
better markers of immune dysfunction. We conclude that pulmonary TB develops
across a broad spectrum of HIV-induced immunodeficiency and that a diagnosis of
pulmonary TB is of limited use as a marker of stage of HIV disease in African
HIV-infected outpatients.

PIP: Between March 1989 and September 1991, physicians compared CD4 lymphocyte
counts of 216 HIV-seropositive patients whose sputum smears tested positive for
pulmonary tuberculosis (TB) with those of 146 HIV- negative patients who also
tested positive for TB at a TB screening center in Kinshasa, Zaire. The
researchers wanted to investigate the immune status of HIV-infected outpatients
with pulmonary TB in relation to clinical criteria. HIV seropositive patients had
much lower CD4 lymphocyte counts than did HIV seronegative patients (total CD4
count, 316.5/mcl vs. 830.5/mcl; CD4 count, 13% vs. 36%; p .001). 90.4% of
HIV-positive patients had CD4 counts 800 compared with 48% of HIV- negative
patients. 32.9% of HIV-positive patients had CD4 counts 200 while just 1.4% of
HIV-negative patients did. As CD4 counts fell, weight loss, diarrhea during the
previous month, past or present herpes zoster, and oral candidosis occurred more 
frequently (p = .004 for oral candidosis and p = .02 for the rest). Negative
purified protein derivative RT23 (PPD) tests and cutaneous anergy occurred more
often as immunodeficiency rose (p .001). Increased immunosuppression was also
characterized by no detectable cavitation on chest radiography, anemia, and low
total lymphocyte counts (p = .02 for absence of cavitation and p .001 for the
others). These results suggested that pulmonary TB occurred along the continuum
of immunodeficiency as defined by CD4 counts. Thus, it is not likely to be a
marker of the severity of HIV infection. Instead weight loss, diarrhea during the
previous month, past or present herpes zoster, oral candidosis, negative PPD test
and cutaneous anergy, absence of detectable cavitation on chest radiography,
anemia, and low total lymphocyte appeared to be better markers of the severity of
HIV-related immunodeficiency.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8101257 [PubMed - indexed for MEDLINE]

5112: Am J Ophthalmol. 1993 Jul 15;116(1):42-50.

Recurrence of presumed varicella-zoster virus retinopathy in patients with
acquired immunodeficiency syndrome.

Johnston WH, Holland GN, Engstrom RE Jr, Rimmer S.

University of California, Los Angeles.

Five patients with acquired immunodeficiency syndrome (AIDS) and presumed
varicella-zoster virus retinopathy had recurrence of retinopathy after
stabilization with initial intravenous antiviral therapy. Recurrences were
recognized as increased retinal opacification at the borders of preexisting
lesions or as new lesions. In four of the five patients, recurrences were
temporally associated with a reduction in the amount of antiviral medication
being received. Changes included switch from intravenous to oral acyclovir (two
patients), taper of oral acyclovir (one patient), and discontinuation of
medications (one patient). In four patients disease was initially unilateral; in 
three of these four, disease subsequently developed in the previously unaffected 
fellow eye at the time of recurrence. The median time from stabilization of
disease to recurrence was 51 days (range, 14 to 90 days). In contrast to the
management of varicella-zoster virus retinopathy in immunocompetent patients and 
varicella-zoster virus lesions of the skin, varicella-zoster virus retinopathy in
patients with AIDS appears to require chronic suppressive antiviral therapy to
prevent recurrences. In this respect it is similar to other opportunistic retinal
infections in patients with AIDS. The best drugs and optimal treatment regimens
for maintenance antiviral therapy remain unknown.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8328542 [PubMed - indexed for MEDLINE]

5113: N Z Med J. 1993 Jul 14;106(959):296.

Comment on:
    N Z Med J. 1993 Jun 9;106(957):233-4.

Post herpetic neuralgia.

Jones D.

Publication Types: 
    Comment
    Letter

PMID: 8321460 [PubMed - indexed for MEDLINE]

5114: J Med Chem. 1993 Jul 9;36(14):2033-40.

Synthesis and antiherpes virus activity of 1,5-anhydrohexitol nucleosides.

Verheggen I, Van Aerschot A, Toppet S, Snoeck R, Janssen G, Balzarini J, De
Clercq E, Herdewijn P.

Laboratory of Pharmaceutical Chemistry, Rega Institute for Medical Research,
Katholieke Universiteit Leuven, Belgium.

The synthesis of 1,5-anhydrohexitol nucleosides is described. These nucleoside
analogues were obtained by alkylation of the heterocyclic bases with the tosylate
10 or by alkylation of the bases with the alcohol 12 under Mitsunobu conditions. 
The compounds were evaluated for antiviral and cytostatic activity. Highly
selective activity against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2)
was noted for 1,5-anhydro-2,3-dideoxy-2-(5-iodouracil-1-yl)-D-arabino-hexitol 4b 
at a concentration of 0.07 microgram/mL. This activity must be dependent on a
specific phosphorylation by the virus-encoded thymidine kinase (TK), since
compound 4b was inactive against TK-deficient mutants of HSV-1. The corresponding
cytosine 4c and guanine 4e analogues showed activity against HSV-1, HSV-2, and
other herpes viruses (i.e. cytomegalovirus, varicella-zoster virus) at
concentrations well below the cytotoxicity threshold (2 and 20 micrograms/mL,
respectively). At these concentrations, compounds 4c and 4e proved also
inhibitory to the growth of human T-cells (i.e. MT-4, CEM, MOLT-4).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8393114 [PubMed - indexed for MEDLINE]

5115: J Infect Dis. 1993 Jul;168(1):245.

Comment on:
    J Infect Dis. 1992 Nov;166(5):1153-6.

Herpes zoster and human immunodeficiency virus infection: a cohort study of 101
coinfected patients. Groupe d'Epidemiologie clinique du SIDA en aquitaine.

Rogues AM, Dupon M, Ladner J, Ragnaud JM, Pellegrin JL, Dabis F.

Publication Types: 
    Comment
    Letter

PMID: 8515121 [PubMed - indexed for MEDLINE]

5116: J Pharm Belg. 1993 Jul-Aug;48(4):270-4.

[From herpes to zona]

[Article in French]

Poot F.

Service de Dermatologie, Cliniques St-Luc U.C.L.

Publication Types: 
    Review

PMID: 8410632 [PubMed - indexed for MEDLINE]

5117: J Antimicrob Chemother. 1993 Jul;32 Suppl A:121-32.

Antivirals for the treatment of herpesvirus infections.

De Clercq E.

Rega Institute for Medical Research, K.U. Leuven, Belgium.

Agents available to treat herpesvirus infections include idoxuridine,
trifluridine, vidarabine and acyclovir for the topical treatment of herpetic eye 
infections; vidarabine and acyclovir for the systemic (intravenous) treatment of 
herpes encephalitis; acyclovir for the topical and systemic (oral) treatment of
genital herpes; acyclovir for the systemic (intravenous, oral) treatment of HSV
or varicella-zoster (VZV) infections in immunosuppressed patients; brivudin for
the systemic (oral) treatment of HSV-1 or VZV infections in immunosuppressed
patients; and ganciclovir and foscarnet for the systemic (intravenous) treatment 
of cytomegalovirus (CMV) retinitis in AIDS patients. Brivudin is also effective
in the treatment of herpetic eye infections that no longer respond to
idoxuridine, trifluridine, vidarabine or acyclovir; and foscarnet is effective in
the treatment of infections with acyclovir-resistant, thymidine kinase-deficient 
(TK-) HSV or VZV mutants. Other antiviral agents considered for use in
herpesvirus infections include brovavir, penciclovir (and its prodrug
famciclovir), desciclovir (a prodrug of acyclovir),
bishydroxymethylcyclobutylguanine (BHCG) and, in particular,
1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC). The latter is more
active than either acyclovir or ganciclovir in the chemotherapy and prophylaxis
of various HSV-1, HSV-2, TK- HSV, VZV or CMV infections in animal models.

Publication Types: 
    Review

PMID: 8407694 [PubMed - indexed for MEDLINE]

5118: J Oral Pathol Med. 1993 Jul;22(6):268-73.

Oral infections due to cytomegalovirus in immunocompromised patients.

Schubert MM, Epstein JB, Lloid ME, Cooney E.

Oral Medicine Service, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.

Herpes group virus infections in the immunocompromised host are associated with
significant morbidity and mortality. Herpes simplex virus (HSV) and to a lesser
extent varicella zoster virus (VZV) have long been recognized as causes of oral
and peri-oral lesions in subjects undergoing bone marrow transplantation and in
individuals infected with the Human Immunodeficiency Virus (HIV). A role for
Cytomegalovirus (CMV) in such lesions is less clear and not well documented. This
report describes two bone marrow transplant recipients and one individual
infected with HIV in whom CMV was implicated as the cause of oral lesions.
Diagnostic and management issues as well as clinical implications are discussed.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 8394928 [PubMed - indexed for MEDLINE]

5119: J Med Virol. 1993 Jul;40(3):241-3.

Infection of human fetal dorsal root neurons with wild type varicella virus and
the Oka strain varicella vaccine.

Somekh E, Levin MJ.

Pediatric Infectious Diseases, University of Colorado School of Medicine, Denver 
80262.

The relative ability of a varicella-zoster virus (VZV) clinical isolate and a
live attenuated VZV vaccine strain (Oka) to infect human neurons was determined
in vitro. VZV infection of neurons prepared in culture from dorsal root ganglia
of fetuses was assessed using an infectious center assay. Cultures were infected 
with 50-5,000 pfu of either VZV and assayed at either 24 or 48 hours post-VZV
infection. Cultures infected with the clinical VZV isolate had seven-fold more
infected neurons than cultures infected with the vaccine strain VZV.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8394874 [PubMed - indexed for MEDLINE]

5120: Virology. 1993 Jul;195(1):42-50.

Identification and deletion mutagenesis of the bovine herpesvirus 1 dUTPase gene 
and a gene homologous to herpes simplex virus UL49.5.

Liang X, Tang M, Manns B, Babiuk LA, Zamb TJ.

Veterinary Infectious Disease Organization, University of Saskatchewan,
Saskatoon, Canada.

The gene encoding bovine herpesvirus 1 (BHV 1) deoxyuridine triphosphatase
(dUTPase) was isolated by a PCR procedure using degenerate oligonucleotide
primers whose sequences were based upon conserved motifs commonly present in
dUTPase genes. This gene was found to reside between 0.059 and 0.066 map units in
the BHV 1 Cooper strain. DNA sequence analysis of this region revealed an open
reading frame of 975 base pairs capable of encoding 325 amino acids. The deduced 
amino acid sequence of the open reading frame exhibits significant homology with 
dUTPases of other herpesviruses (including human herpes simplex virus,
varicella-zoster virus, and Epstein-Barr virus), and it contains five conserved
amino acid motifs characteristics of all dUTPases identified to date. A mutant
virus carrying a partial deletion of the putative dUTPase gene was made and was
found to lack virus-encoded dUTPase activity. This further confirmed that we have
identified the BHV 1 dUTPase gene. In addition, a further analysis of the genomic
fragment which contains the dUTPase coding sequence revealed an additional
288-base-pair open reading frame which appears to be colinear with the HSV 1
UL49.5 gene. The deduced amino acid sequence of this open reading frame is
significantly homologous to the HSV 1 UL49.5 gene product, and as with UL49.5, it
contains a potential signal sequence and transmembrane domain characteristic of
membrane-associated proteins. These results suggest that this open reading frame 
represents the BHV 1 homolog of the HSV 1 UL49.5 gene. Since our dUTPase negative
mutant was fully viable and since the mutant was constructed such that the UL49.5
gene was also deleted, both the dUTPase and the UL49.5 gene homolog are not
required for virus growth in cell culture.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8391186 [PubMed - indexed for MEDLINE]

5121: AJR Am J Roentgenol. 1993 Jul;161(1):167-76.

Herpesvirus infections of the CNS: MR findings.

Tien RD, Felsberg GJ, Osumi AK.

Department of Radiology (Neuroradiology Section), Duke University Medical Center,
Durham, NC 27710.

Herpesvirus infections of the CNS are prevalent in all segments of the
population, and are an important health care issue. The family of herpesviruses
consists of a large group of double-stranded DNA viruses that includes herpes
simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2),
cytomegalovirus, Epstein-Barr virus, varicella-zoster virus, B virus, herpesvirus
6, and herpesvirus 7. In addition to producing infection when the host initially 
acquires the virus, an important property shared by these viruses is the ability 
to produce latent infection and to be reactivated.

Publication Types: 
    Review

PMID: 8390790 [PubMed - indexed for MEDLINE]

5122: J Virol. 1993 Jul;67(7):4379-85.

Characterization of the regulatory functions of varicella-zoster virus open
reading frame 4 gene product.

Defechereux P, Melen L, Baudoux L, Merville-Louis MP, Rentier B, Piette J.

Department of Microbiology, University of Liege, Belgium.

Varicella-zoster virus (VZV) open reading frame 4 (ORF4) encodes a protein with a
predicted molecular weight of 51,540 presenting amino acid sequence homology with
the immediate-early regulatory protein ICP27 of herpes simplex virus type 1. To
investigate the regulatory properties of the ORF4 gene product, we performed a
series of transient expression assays in Vero cells, using a plasmid expressing
ORF4 as effector and several VZV genes and heterologous genes as targets. The VZV
target plasmids contained promoter/regulatory regions from genes belonging to the
three putative VZV kinetic classes fused to the chloramphenicol acetyltransferase
(CAT) gene. The heterologous target plasmids consisted of promoter/regulatory
regions of human cytomegalovirus, Rous sarcoma virus, and human immunodeficiency 
virus type 1 fused to the reporter gene. These experiments demonstrated that the 
ORF4 gene product activated expression of ORF62 in a dose-dependent fashion but
had no effect on the expression of the three other putative immediate-early genes
(ORF4, ORF61, and ORF63). When various amounts of ORF4 were transfected in the
presence of early gene promoters, dose-dependent transactivation was evidenced
with the thymidine kinase gene (ORF36) and the major DNA-binding protein gene
(ORF29) promoters; interestingly, little activity was detected with the promoter 
of the DNA polymerase gene (ORF28). No activation of late gene expression,
represented by the glycoprotein I and glycoprotein II genes, was seen even over a
wide range of concentrations of input ORF4 plasmid. Expression of pCMVCAT,
pRSVCAT, and pHIVCAT was also stimulated by the ORF4 gene product. CAT mRNA
analysis showed that activation of VZV target promoters occurs at the
transcriptional and/or posttranscriptional level.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8389935 [PubMed - indexed for MEDLINE]

5123: J Virol. 1993 Jul;67(7):4290-5.

Varicella-zoster virus (VZV) open reading frame 61 protein transactivates VZV
gene promoters and enhances the infectivity of VZV DNA.

Moriuchi H, Moriuchi M, Straus SE, Cohen JI.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

The varicella-zoster virus (VZV) open reading frame 61 (ORF61) protein is the
homolog of herpes simplex virus type 1 (HSV-1) ICP0. Both genes are located in
similar parts of the genome, their predicted products share a cysteine-rich
motif, and cell lines expressing VZV ORF61 are able to complement an HSV-1 ICP0
deletion mutant (H. Moriuchi, M. Moriuchi, H. A. Smith, S. E. Straus, and J. I.
Cohen, J. Virol. 66:7303-7308, 1992). In transient expression assays, HSV-1 ICP0 
is a transactivator alone and transactivates in synergy with another viral
transactivator, ICP4. However, VZV ORF61 represses the activation by VZV-encoded 
proteins ORF62 (the homolog of ICP4) and ORF4. To further characterize the
function of VZV ORF61 and its role(s) in regulation of viral gene expression, we 
performed transient expression assays using target promoters from VZV, HSV-1, and
unrelated viruses. In the absence of other viral activators, VZV ORF61
transactivated most promoters tested. In addition, a cell line stably expressing 
VZV ORF61 complemented the HSV-1 mutant in 1814, which lacks the transactivating 
function of VP16. The cell line expressing VZV ORF61 enhanced the infectivity of 
HSV-1 virion DNA. Moreover, transient expression of VZV ORF61 also enhanced the
infectivity of VZV DNA. These results indicate that VZV ORF61 can stimulate
expression of HSV-1 and VZV genes at an early stage in the viral replicative
cycle and that ORF61 has an important role in VZV gene regulation.

Publication Types: 
    In Vitro

PMID: 8389928 [PubMed - indexed for MEDLINE]

5124: J Virol. 1993 Jul;67(7):4246-51.

The transcriptional activation domain of varicella-zoster virus open reading
frame 62 protein is not conserved with its herpes simplex virus homolog.

Cohen JI, Heffel D, Seidel K.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

Varicella-zoster virus (VZV) open reading frame 62 (ORF62) encodes an
immediate-early protein that transactivates expression of VZV, herpes simplex
virus (HSV), and cellular genes in transient expression assays. VZV ORF62 is
homologous to HSV ICP4 and pseudorabies virus immediate-early (IE180) proteins.
All three viral proteins have conserved DNA binding domains that recognize
similar sites in their corresponding promoters. Here, we show that the
transcriptional activation domain of ORF62 is located near the amino terminus of 
the protein and is not conserved with the activation domain of ICP4. A
161-amino-acid activation domain of ORF62 activates transcription to a level
comparable to that of the potent HSV VP16 activation domain; much of the activity
is contained in the first 90 amino acids of ORF62. Deletion of the activation
domain from full-length ORF62 markedly reduced transactivating activity. These
experiments indicate that while VZV ORF62 and HSV ICP4 have conserved amino acid 
sequences, including their DNA binding domains, the transcriptional activation
domains are poorly conserved.

Publication Types: 
    Comparative Study

PMID: 8389926 [PubMed - indexed for MEDLINE]

5125: J Virol. 1993 Jul;67(7):4122-32.

Characterization of the myristylated polypeptide encoded by the UL1 gene that is 
conserved in the genome of defective interfering particles of equine herpesvirus 
1.

Harty RN, Caughman GB, Holden VR, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932.

Equine herpesvirus 1 (EHV-1, Kentucky A strain) preparations enriched for
defective interfering particles (DIPs) can readily establish persistent
infection. The UL1 gene, which is conserved in the genome of DIPs that mediate
persistent infection, maps between nucleotides 1418 and 2192 (258 amino acids)
from the L (long) terminus. UL1 has no homology with any known gene encoded by
herpes simplex virus type 1 but has limited homology to open reading frame 2 of
varicella-zoster virus and the "circ" gene of bovine herpesvirus type 1. Previous
work showed that the EHV-1 UL1 gene belongs to the early kinetic class and is
transcribed as a 1.2-kb polyadenylated mRNA (R. N. Harty, R. R. Yalamanchili, and
D. J. O'Callaghan, Virology 183:830-833, 1991). In this report, the UL1 protein
was identified and characterized as a 33-kDa polypeptide in EHV-1-infected cells 
by using rabbit polyclonal antiserum raised against a TrpE-UL1 fusion protein
(amino acids 7 to 258 of UL1) synthesized in Escherichia coli. Results from
Western blot (immunoblot), immunoprecipitation, indirect immunofluorescence, and 
biochemical analyses indicated that the UL1 polypeptide (i) is more abundant in
cells infected with DIP-enriched virus than in cells infected with standard
EHV-1, (ii) is synthesized as early as 3 h postinfection (p.i.) in infection with
standard virus or in infection with DIP-enriched virus preparations and increases
in abundance up to 12 h p.i., (iii) appears to be associated with the rough
endoplasmic reticulum-Golgi apparatus early in infection (3 to 4 h p.i.), while a
diffuse cytoplasmic pattern of fluorescence is observed late in infection (7 to 8
h p.i.), (iv) is modified by myristic acid as it contains a consensus N-terminal 
myristylation site and is readily labeled with [3H]myristic acid, and (v) is
associated with mature EHV-1 virions.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 8389920 [PubMed - indexed for MEDLINE]

5126: Acta Pharm Hung. 1993 Jul;63(4):204-14.

[Incorporation of the antiherpetic 5-isopropyl-2'-deoxyuridine into a synthetic
DNA and the consequence of incorporation on structure and functions of the DNA]

[Article in Hungarian]

Sagi J, Szabolcs A, Szemzo A, Michaela V, Jaroslav K, Jitka S, Alena S, Otvos L.

MTA Kozponti Kemiai Kutato Intezete, Budapest.

5-Isopropyl-2'-deoxyuridine is the active ingredient of Hevizos ointment, a
commercially available drug in Hungary, applied on the local treatment of patient
with herpes labialis, zoster and progenitalis. The 5'-triphosphate derivative of 
the compound was incorporated by a DNA polymerase enzyme into a synthetic DNA of 
poly(dA-dT) type in order to study possible alterations in the structure and
bioorganic functions of the DNA, in comparison with unmodified poly(dA-dT).
Alterations observed by spectroscopic, electron microscopic and biochemical
methods refer to the formation of stable hairpins protruding from the DNA duplex,
which may be responsible for the impairment of the integrity of the DNA
structure. This, in turn, may negatively influence normal biochemical functions
of a DNA.

Publication Types: 
    English Abstract

PMID: 8379336 [PubMed - indexed for MEDLINE]

5127: Acta Pharm Hung. 1993 Jul;63(4):181-7.

[Clinical experience with Hevizos ointment]

[Article in Hungarian]

Makleit L.

Biogal Gyogyszergyar Rt., Debrecen.

After a brief summary of the effects of Hevizos ointment, major clinical studies 
conducted in Hungary are described. In a double-blind comparative clinical study 
involving the dermatological departments of three medical universities, Hevizos
has been found more effective than Virungent ointment in herpes simplex labials
and herpes zoster. In herpes genitalis the two products were of identical
efficacy. Both Hevizos and Virungent proved to be more effective than placebo in 
all three indications. By the evidence of an open clinical trial Hevizos is not
superseded by Zovirax ointment: confirmation of these findings in a double-blind 
study is underway.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract
    Multicenter Study

PMID: 8379333 [PubMed - indexed for MEDLINE]

5128: Pain. 1993 Jul;54(1):15-9.

Painful symptoms reported by ambulatory HIV-infected men in a longitudinal study.

Singer EJ, Zorilla C, Fahy-Chandon B, Chi S, Syndulko K, Tourtellotte WW.

West Los Angeles VAMC, Department of Neurology, CA 90073.

We studied the painful symptoms associated with human immunodeficiency virus
(HIV) infection and its treatment in a group of men enrolled in a prospective
longitudinal study of HIV effects on the nervous system. The most common painful 
illnesses reported were HIV-related headaches, herpes simplex, painful peripheral
neuropathy, back pain, herpes zoster, 3'-azido-3'-deoxythymidine (AZT)-induced
headaches, throat pain, and arthralgia. Painful illnesses were reported at all
stages of systemic disease but were more common in the later stages of disease
and in subjects who progressed to a more advanced stage during the study period. 
There was an association between the frequency of multiple pains, increased
disability on the Karnofsky scale, and higher depression scores, as measured by
the Brief Symptom Inventory (BSI). We conclude that painful symptoms are
important even in relatively healthy and independent HIV-infected men.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 8378098 [PubMed - indexed for MEDLINE]

5129: Rev Med Liege. 1993 Jul 1;48(7):401-5.

[Diagnosis of skin infections caused by simplex-type herpes virus and by
varicella zona]

[Article in French]

Nikkels AF, Hermanns-Le T, Nikkels-Tassoudji N, Pierard GE.

Service de Dermatopathologie, CHU du Sart Tilman.

Publication Types: 
    Review

PMID: 8367639 [PubMed - indexed for MEDLINE]

5130: Mayo Clin Proc. 1993 Jul;68(7):652-5.

Herpes zoster-associated meningoencephalitis in patients with systemic cancer.

Hughes BA, Kimmel DW, Aksamit AJ.

Department of Neurology, Mayo Clinic Rochester, MN 55905.

We reviewed the experience at the Mayo Clinic with neurologic complications
related to herpes zoster in patients with systemic cancer. Aside from pain, the
most common neurologic complication was zoster-associated meningoencephalitis,
which occurred in 9 of 1,125 patients. In these nine patients, the most common
underlying malignant lesions were chronic lymphocytic leukemia and lymphoma. All 
patients in whom meningoencephalitis developed had trigeminal zoster or
disseminated zoster. The primary neurologic symptoms were headache, confusion,
and somnolence. Nuchal rigidity and fever were uncommon. The response to
treatment with acyclovir was generally favorable.

PMID: 8350638 [PubMed - indexed for MEDLINE]

5131: Br J Ophthalmol. 1993 Jul;77(7):459-61.

A case of presumed congenital herpes zoster ophthalmicus.

Singh J, Gibson JM.

Department of Ophthalmology, East Birmingham Hospital.

Publication Types: 
    Case Reports

PMID: 8343481 [PubMed - indexed for MEDLINE]

5132: Gan To Kagaku Ryoho. 1993 Jul;20(9):1195-201.

[A study of toxicities and complications observed in alternating
non-cross-resistant chemotherapy (CAMBO-VIP) for non-Hodgkin's lymphoma]

[Article in Japanese]

Maruyama F, Ezaki K, Okamoto M, Miyazaki H, Wakita M, Nomura T, Tsuzuki M, Kojima
H, Sobue R, Matsui T, et al.

Dept. of Internal Medicine, Fujita Health University School of Medicine.

Thirty-nine patients with non-Hodgkin's lymphoma were treated with weekly
alternating non-cross-resistant chemotherapy (CAMBO-VIP). We obtained a high
response rate, and prolonged disease-free survival with side effects and
complications of various severity were observed. Three patients were withdrawn
from the study due to aggravation of liver cirrhosis, cerebral infarction, and
poor tolerance. Thirty-six patients completed this 12-week intensive
chemotherapy. The median treatment delay in all patients was 3 days (-4 to 29
days), and a delay of over 15 days was seen in 5 patients. The nadir of the
neutrophil count was 0 to 2,100/microliters (median 140/microliters), and 15
patients were below 100/microliters. Two patients had pneumonia and 4 had herpes 
zoster infection. The platelet count nadir was 20,000 to 240,000/microliters
(median 90,000/microliters). Ten patients were below 50,000/microliters, but none
required platelet transfusion. Red cell transfusion was given in 6 patients.
Elevation of transaminases was seen in 25 patients, but it was not serious except
for a patient with liver cirrhosis. The elevation of serum LDH level and decrease
of serum haptoglobin level seen shortly after completion of treatment seemed due 
to the increased blood cell destruction. Stomatitis was observed in 32 patients, 
17 of whom showed more than grade 3 toxicity. Blister formation on palms and/or
soles was noted in 6 patients. There was no treatment-related death observed.

Publication Types: 
    English Abstract

PMID: 8333748 [PubMed - indexed for MEDLINE]

5133: Intern Med. 1993 Jul;32(7):530-2.

Headache and painful lymphadenopathy in extracranial or systemic infection:
etiology of new daily persistent headaches.

Santoni JR, Santoni-Williams CJ.

Department of Neurology, Universidad Autonoma de Santo Domingo, Dominican Rep.

From 108 cases of new daily persistent headaches, clinical or laboratory evidence
was found suggesting extracranial or systemic infections in: 28 cases (25.9%) of 
gastrointestinal mainly Salmonella, 28 (25.9%) urinary Coli, 16 (14.8%)
Streptococcal, 4 (3.7%) each of Epstein Barr virus or Toxoplasma, and 1 (0.9%)
each of Herpes Zoster or pneumonia. A group of 26 (24.1%) showed high Proteus OX 
titer or clinical adenoviral involvement. All had normal neurological
examinations plus selective negative neuroimaging or spinal taps. The mean
headache duration was 13.8 days, and mean age 28.8 years. Prominent symptoms were
fever in 37 (34.2%) cases, nausea/vomiting in 30 (27%) and vertigo in 17 (15.7%).
Diarrhea, dysuria, and abdominal discomfort were rare. Headache was a solitary
symptom in 36 (33.3%). The predominant sign was painful cervical lymphadenopathy 
in 61 (56.5%). These cases represent 1.2% of our 9060 neurology patients.

PMID: 8286828 [PubMed - indexed for MEDLINE]

5134: Med J Aust. 1993 Jun 21;158(12):830-4.

Infections in the elderly.

Henschke PJ.

Aged and Extended Care Department, Repatriation General Hospital, Daw Park, SA.

Weakness, falls, incontinence or altered mental states may signal infection in
the elderly, while fever may be absent. Bacteria are the most likely cause, and
the most common sites are the respiratory system, the urinary tract and the soft 
tissues. Joint infections and meningitis must be remembered, as must bacterial
endocarditis. Herpes zoster may be ameliorated by early treatment with acyclovir.
Annual influenza vaccination is recommended, and amantadine may protect against
influenza A (not B) during outbreaks. A single pneumococcal vaccination is
recommended for those with chronic cardiopulmonary disease or alcoholism or for
those who are immunosuppressed. All major hospitals and large nursing homes have 
committees which can give advice on infection control.

Publication Types: 
    Review

PMID: 8326895 [PubMed - indexed for MEDLINE]

5135: N Z Med J. 1993 Jun 9;106(957):233-4.

Comment in:
    N Z Med J. 1993 Jul 14;106(959):296.

Treatment of postherpetic neuralgia with topical piroxicam gel.

Nicholls DS.

Publication Types: 
    Case Reports
    Letter

PMID: 8305013 [PubMed - indexed for MEDLINE]

5136: Am J Phys Med Rehabil. 1993 Jun;72(3):144-50.

Intercostal somatosensory-evoked potentials. A new technique.

Dreyfuss P, Dumitru D, Prewitt-Buchanan L.

University of Texas Health Science Center, Department of Rehabilitation Medicine,
San Antonio.

Presently, there are few electrodiagnostic medicine techniques to evaluate
lesions affecting the thoracic nerve roots or spinal cord. A new
electrophysiologic technique to assess these structures, intercostal
somatosensory-evoked potentials (SEPs), is described. Thirty neurologically
normal subjects were used in this investigation to generate intercostal SEPs.
Bilateral intercostal SEPs were easily elicited after stimulation of the third
intercostal nerves just lateral to the sternum anteriorly. Intercostal SEPs were 
also easily elicited from the fifth, seventh and ninth intercostal nerves along
the anterior axillary line bilaterally. Intercostal SEPs are not only easily and 
painlessly obtained, but are specific for individual spinal levels. This SEP
method will provide the clinician with another neural stimulation procedure to
assist in the diagnosis of both central and peripheral thoracic neural
compromise.

Publication Types: 
    Case Reports

PMID: 8512676 [PubMed - indexed for MEDLINE]

5137: Arch Ophthalmol. 1993 Jun;111(6):824-6.

Erratum in:
    Arch Ophthalmol 1993 Oct;111(10):1358.

Long-term effects of mitomycin on filtering blebs. Lack of fibrovascular
proliferative response following severe inflammation.

Yaldo MK, Stamper RL.

Department of Ophthalmology, California Pacific Medical Center, San Francisco
94115.

BACKGROUND AND OBJECTIVE--The use of antimetabolites, such as fluorouracil and
mitomycin, enhances the success rate of filtering surgery, especially in eyes at 
high risk for failure, and increases the likelihood of a thin, avascular
filtering bleb. In addition, mitomycin may cause long-term inhibition of the
fibroblast's ability to proliferate in the conjunctiva and Tenon's capsule.
Preoperative and postoperative inflammation frequently contributes to scarring of
filtering blebs. The purpose of this study is to evaluate the effect of
intraoperative mitomycin use on the survival of filtering blebs after severe
inflammation. DESIGN--We retrospectively studied three eyes that had undergone
trabeculectomy with intraoperative mitomycin. Two eyes had concomitant
intraocular lens implantation. All three eyes had blebs that functioned well
postoperatively. PATIENTS--These eyes sustained episodes of intense inflammation 
in the form of herpes zoster ophthalmicus, endophthalmitis, or purulent infection
of the bleb postoperatively. RESULTS--Following treatment of the inflammation, no
change in the appearance or function of the bleb could be detected.
CONCLUSION--Either the indirect effect of mitomycin in producing a thin,
avascular bleb or a long-term effect of mitomycin on the ability of conjunctival 
and Tenon's capsule fibroblasts to proliferate may have contributed to bleb
survival.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8512484 [PubMed - indexed for MEDLINE]

5138: Geriatrics. 1993 Jun;48(6):61-4, 69-70.

HIV infection in older patients: when to suspect the unexpected.

Wallace JI, Paauw DS, Spach DH.

Division of Gerontology and Geriatric Medicine, University of Washington,
Seattle.

The number of AIDS patients over age 60 has risen steadily in the past decade.
The number of transfusion-acquired AIDS cases probably has peaked--or will soon
peak. Homosexual (or bisexual) behavior remains the predominant risk factor for
AIDS until the seventh decade. Disease progression appears to be more rapid in
the elderly, although the observed shorter survival time may result from a delay 
in diagnosis. Symptoms of HIV infection are often nonspecific, such as fatigue,
anorexia, weight loss, and decreased physical and cognitive function. The five
most common opportunistic infections in older HIV-infected patients are
Pneumocystis carinii pneumonia, tuberculosis, Mycobacterium avium complex, herpes
zoster, and cytomegalovirus. A number of features of HIV-related dementia may
help to distinguish it from Alzheimer's disease.

Publication Types: 
    Review

PMID: 8500775 [PubMed - indexed for MEDLINE]

5139: Klin Monatsbl Augenheilkd. 1993 Jun;202(6):491-9.

[Ophthalmologic findings in graft versus host disease (GvHD)]

[Article in German]

Kasmann B, Ruprecht KW.

Augenklinik und Poliklinik, Universitat des Saarlandes.

BACKGROUND: Since the era of bone marrow transplantation, the picture of acute
and/or chronic transplant reaction of the host cells against grafted bone marrow 
has become more frequent. The so-called adaptive immune therapy bases on the fact
that patients who present with a low grade of GvHD less often suffer from a
relapse of the malignant leukaemic disease. Therefore, new therapeutic regimen
are now performed which keep the patient on a low level of GvHD to prevent a
recurrence of leukaemia. Here a close cooperation of oncologists and
ophthalmologists becomes more and more important to estimate the stage of GvHD.
PATIENTS: Demonstrating two case reports, we report on the ophthalmological
symptoms of acute and chronic GvHD. Both patients presented with acute ocular
GvHD as well as with signs of chronic ocular GvHD. Concerning the
ophthalmological symptoms, in acute or chronic GvHD the conjunctival involvement 
is most important. There is a lymphocytic infiltration of the conjunctiva and of 
the lacrimal glands which leads to an extreme sicca-syndrome. The acute GvHD of
the conjunctiva can be classified into 4 stages: injection/exudation and
chemosis/formation of pseudomembranes/defects of the corneal epithelium. These
stages correlate directly to the prognosis of the survival time of the patient. A
pathognomonic sign for the chronic GvHD of the conjunctiva are the fibrous-scarry
Arlt-lines of the tarsal conjunctiva. CONCLUSIONS: All patients who underwent a
bone marrow transplantation for leukaemia need to be followed up closely to
estimate the level of GvHD they are in. This applies especially to those patients
who are treated according to the regimen of adaptive immune therapy. A close
cooperation of oncologists and ophthalmologists during adaptive immune therapy is
mandatory, as the ophthalmologist can provide important information to help to
grade the level of GvHD, judging by the morphological picture at the slit lamp.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8397319 [PubMed - indexed for MEDLINE]

5140: Ann Ophthalmol. 1993 Jun;25(6):208-15.

Herpes zoster ophthalmicus: the virus strikes back.

Karlin JD.

Department of Ophthalmology, UCLA School of Medicine.

The objective of this article is (1) to review the range of anterior segment
ocular disease caused by varicella-zoster virus (VZV), (2) to discuss the
pathophysiology of the mechanisms involved in the ensuing tissue damage, and (3) 
to bring the reader up to date on the current management and therapy of herpes
zoster ophthalmicus (HZO). The design of this article is a review of the
literature with special emphasis on the ocular manifestations of HZO. The
conclusions reached by this review include that HZO is a common form of the
recurrent form of HZ infection caused by VZV. Although HZO is generally benign in
most nonimmunocompromised patients, the incidence of ocular complications is
high. Immunocompromised hosts manifest HZ (and HZO) in much higher frequencies
and develop more severe sequelas, which may lead to loss of vision, dissemination
of the virus, or death. An increased incidence of acquired and iatrogenic
immunodeficiency states has given rise to a greater occurrence of recurrent VZV
infection. Thus, there is a greater need for earlier diagnosis and appropriate
management of the protean manifestations of this potentially disastrous disease.

Publication Types: 
    Review

PMID: 8393312 [PubMed - indexed for MEDLINE]

5141: Clin Exp Immunol. 1993 Jun;92(3):425-31.

Correlative studies of rheumatoid factors and anti-viral antibodies in patients
with rheumatoid arthritis.

Ferraro AS, Newkirk MM.

Department of Medicine, Montreal General Hospital Research Institute, McGill
University, Quebec, Canada.

An analysis of the relationship between the immune response to ubiquitous herpes 
family viruses, namely Epstein-Barr virus (EBV), cytomegalovirus (CMV), and
varicella-zoster virus (VZV) and the presence of rheumatoid factors (RF), which
are autoantibodies characteristic of patients with rheumatoid arthritis (RA), was
conducted. Antibody profiles (RF, anti-viral antibodies) were monitored in the
serum of the RA patients, and in normal individuals. No patient was found to have
circulating RF in the absence of anti-viral antibodies. When the patients and
normal controls were subdivided according to the presence of serum RF, it was
found that when RF were present, the frequency of anti-CMV antibodies, but not
anti-EBV or anti-VZV antibodies, was significantly higher (P = 0.02) when
compared with RF-negative individuals. The titres of anti-CMV but not anti-VZV
antibodies were found to increase in the RA patients with disease duration. To
see if these viruses could stimulate RF production in vitro, peripheral blood
mononuclear cells (PBMC) isolated from the patients and normal controls were
stimulated with viral antigens. PBMC from normal controls, but not from RA
patients, appeared to be responsive to viral antigen stimulation and produced RF.
These data suggest that the immune response to CMV, to a greater extent than to
EBV or VZV, correlates with the presence of RF.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8390334 [PubMed - indexed for MEDLINE]

5142: J Gen Virol. 1993 Jun;74 ( Pt 6):1011-6.

Kinetic studies of the predicted substrate-binding site of varicella-zoster virus
thymidine kinase.

Suzutani T, Davies LC, Honess RW.

Division of Virology, National Institute for Medical Research, Mill Hill, London,
U.K.

To investigate the mechanism of kinetic action and substrate recognition of
varicella-zoster virus (VZV) thymidine kinase (TK), we designed and isolated a
site-directed mutant VZV TK which has double amino acid substitutions,
136threonine to leucine and 137isoleucine to leucine (SDM TK). This mutant was
designed to alter the substrate-binding site of the VZV TK to duplicate that of
the herpes simplex virus type 2 enzyme. Kinetic studies of the activity of
wild-type TK indicated that the binding order of ATP and thymidine is random and 
that wild-type VZV TK possessed high thymidylate kinase (TM-K) activity. The
sensitivity of VZV TK to bisubstrate analogues, dinucleotides of adenosine and
thymidine, showed that the optimum distance between the ATP- and
substrate-binding sites is two phosphoryl groups greater than with the natural
substrate for TK activity. SDM TK lost deoxycytidine kinase activity and had
reduced TK and TM-K activities. Inhibition studies on both WT and SDM TK by
5-halogenovinyluridine analogues and their 5' monophosphate derivatives revealed 
that amino acids at positions 136 and 137 are involved in substrate binding,
probably through a role in the formation of the binding pocket for bulky
substrates.

PMID: 8389797 [PubMed - indexed for MEDLINE]

5143: Clin J Pain. 1993 Jun;9(2):135-7.

Combined stellate ganglion and sphenopalatine ganglion block in acute herpes
infection.

Prasanna A, Murthy PS.

Department of Anaesthesia, Pain Relief and Palliative Care Medicine, Kasturba
Medical College Hospital, Manipal, India.

Publication Types: 
    Case Reports

PMID: 8358137 [PubMed - indexed for MEDLINE]

5144: Infect Dis Clin North Am. 1993 Jun;7(2):183-201.

New developments in the diagnosis of viral diseases.

Smith TF, Wold AD, Espy MJ, Marshall WF.

Division of Clinical Microbiology, Mayo Clinic and Foundation, Rochester,
Minnesota.

Major technical advances have occurred, especially in the last 5 years, in the
laboratory diagnosis of viral infections. Immunologic detection of immediate
early antigens in specimens such as bronchoalveolar lavage fluid and blood
inoculated into shell vial cell cultures, particularly for herpesvirus
(cytomegalovirus, herpes simplex virus, varicella-zoster virus), has provided
results 16 to 48 hours after inoculation rather than the several days required
for recognition of cytopathic effects in conventional tube cell cultures.
Similarly, cytomegalovirus viremia can be detected directly by immunostaining of 
peripheral blood leukocytes with commercially available reagents the same day the
specimen is submitted to the laboratory. Single-test membrane immunoassays have
provided rapid (15 minutes) detection of viral antigens (respiratory syncytial
virus, rotavirus, influenza virus type A). In the near future, diagnostic
virology laboratories will be expected to monitor viral strains for
susceptibility to the growing list of antiviral drugs. Amplification of nucleic
acid sequences of viruses from cerebrospinal fluid or tissue, which generally
does not yield isolates by conventional diagnostic techniques, has added a new
dimension to the laboratory diagnosis of viral infection.

Publication Types: 
    Case Reports
    Review

PMID: 8345165 [PubMed - indexed for MEDLINE]

5145: J R Soc Med. 1993 Jun;86(6):360.

Acute proximal myopathy due to herpes zoster.

Joseph TP, Chand RP, Tariq SM, Johnston WJ, Muirhead D, Buhl L.

Department of Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of
Oman.

Publication Types: 
    Case Reports

PMID: 8315636 [PubMed - indexed for MEDLINE]

5146: Cent Afr J Med. 1993 Jun;39(6):110-2.

Salmonella and shigella bacteraemia in Zimbabwe.

Pithie AD, Malin AS, Robertson VJ.

Department of Medicine, University of Zimbabwe, Avondale, Harare.

In patients with HIV infection, non-typhoidal salmonellae are a recognised cause 
of bacteraemia. This association was initially demonstrated in the United States,
but has more recently been found in Kenyan patients. This prompted us to review
the cases of patients with enterobacteriaceae bacteraemia admitted to
Parirenyatwa Hospital, Harare. Non-typhoidal salmonella bacteraemia as compared
with typhoid fever was significantly more common in HIV infected patients than in
non-HIV infected patients (p < 0.01). It was also a cause of bacteraemia in
patients with other immuno-suppressive conditions and in some patients without
identifiable risk factors.

PIP: The case notes of patients with blood cultures positive for
enterobacteriaceae were examined retrospectively over a 6-month period in
Parirenyatwa Hospital, Harare, Zimbabwe. Speciation was possible for Salmonella
typhi and shigellae only. Nontyphoidal salmonellae were serotyped. Salmonella or 
shigella bacteremia was identified in 51 patients. There were 14 isolates of S.
typhi, 32 isolates of nontyphoidal salmonellae, and 5 isolates of shigellae
species. The case notes of 38 patients could be identified for review, and of
these HIV serology was available for 15 seropositive and 15 seronegative
patients. The male to female ratio was approximately 3:1 for both groups and the 
mean age was 29.7 +or- 21. Nontyphoidal bacteremias as compared with typhoid
fever were strongly associated with HIV seropositivity [p 0.01]. 3 out of 8
HIV-negative patients with nontyphoidal bacteremia had another underlying
immunosuppressive disease [2 had myeloma and 1 patient had cirrhosis with
complicating hepatoma]. 2 patients with nontyphoidal bacteremia whose HIV status 
was unknown also had another immunosuppressing disease [acute myeloid leukemia
and idiopathic pancytopenia]. 13 out of 15 HIV-positive patients showed other
signs of HIV infection [oral candida, herpes zoster, persistent generalized
lymphadenopathy]. 3 out of 11 patients [27%] with typhoid died, while 11 out of
27 patients [40.7%] with nontyphi bacteremia died. Most strains of S. typhimurium
were included in serogroup B, which accounted for 37% of nontyphoidal isolates.
Earlier studies identified invasive salmonellosis in patients with other AIDS
defining diseases. In Nairobi clinical features of HIV infection were found in
64% of bacteremic HIV-positive patients, but only 28% of patients fulfilled the
CDC clinical case definition for AIDS. A more recent study from Nairobi
demonstrated that S. typhimurium bacteremia is a common cause of intercurrent
infection in HIV-positive tuberculous patients.

PMID: 8131197 [PubMed - indexed for MEDLINE]

5147: Lancet. 1993 May 22;341(8856):1342.

Failure of foscarnet in disseminated herpes zoster.

Bendel AE, Gross TG, Woods WG, Edelman CK, Balfour HH Jr.

Publication Types: 
    Case Reports
    Letter

PMID: 8098465 [PubMed - indexed for MEDLINE]

5148: J Med Chem. 1993 May 14;36(10):1343-55.

Novel acyclonucleotides: synthesis and antiviral activity of alkenylphosphonic
acid derivatives of purines and a pyrimidine.

Harnden MR, Parkin A, Parratt MJ, Perkins RM.

SmithKline Beecham Pharmaceuticals, Epsom, Surrey, U.K.

A series of phosphonoalkenyl and (phosphonoalkenyl)oxy derivatives of purines and
a pyrimidine were synthesized. These compounds are the first reported
acyclonucleotides which incorporate the alpha,beta-unsaturated phosphonic acid
moiety as the phosphate mimic and include compounds in which the acyclic
substituent is attached to N-9 of a purine or N-1 of a pyrimidine by either a
nitrogen-carbon or a nitrogen-oxygen bond. The phosphonoalkenyl-substituted
compounds 7a-c, 8a-c, 9, 10, and 12 were prepared either by Mitsunobu coupling of
alcohols with purine or pyrimidine derivatives or by alternative alkylations of
the heterocyclic bases. The (phosphonoalkenyl) oxy derivatives 7d-g, 8d-g, and 11
were synthesized by coupling of alcohols with 9-hydroxypurines or a
1-hydroxypyrimidine under Mitsunobu conditions. The novel acyclonucleotides were 
tested for activity against herpes simplex types 1 and 2 (HSV-1 and HSV-2),
varicella zoster virus (VZV), cytomegalovirus (CMV), visna virus, and human
immunodeficiency virus type 1 (HIV-1). Guanine derivatives were moderately to
extremely cytotoxic, but the adenines were less toxic to cells. At the
concentrations tested, (Z)-isomers in the unbranched series had no activity
against herpes viruses or HIV-1. (E)-9-[(4-Phosphonobut-3-enyl) oxy]adenine (7d) 
displayed selective activity against HIV-1,
(E)-2,6-diamino-9-(4-phosphonobut-3-enyl) purine (9) showed selective
antiretrovirus activity, and
(E)-9-[2-(hydroxymethyl)-4-phosphonobut-3-enyl]adenine (7c) showed selective
antiherpesvirus (VZV and CMV) activity.

PMID: 8496903 [PubMed - indexed for MEDLINE]

5149: J Am Acad Dermatol. 1993 May;28(5 Pt 1):738-44.

Reduced lymphocyte subpopulations in patients with advanced or disseminated
melanoma.

Cartei G, Sala PG, Sanzari M, Ceschia V, Clocchiatti L, Sibau A, Dona S,
Giovannoni M, Vigevani E.

Division of Medical Oncology and Cancer Center, Udine General Hospital, Italy.

BACKGROUND: Studies have revealed many features of lymphocyte behavior in
patients with malignant melanoma, but there are conflicting results. OBJECTIVE:
The aim of this study was to measure with easily reproducible assays the
circulating lymphocytes and other immunologic aspects in 33 patients with
advanced or disseminated malignant melanoma (MM). METHODS: The following
variables were measured: circulating monocytes; total lymphocytes; B (CD19) and
T-cell subpopulations; CD3, CD4, and CD8, natural killer cells (anti-Leu-7+ or
CD57 and anti-Leu-11+ or CD16) (cytofluorimetry); plasma levels of IgG, IgA, IgM,
and IgE; complement fractions 3, 4, and 1Q; antibodies against foreign
microorganisms (AaM) (adeno, herpes simplex, herpes zoster, measles, parotitis,
cytomegalo, Epstein-Barr, and rubella viruses) and Toxoplasma; and cutaneous
delayed hypersensitivity (CDH) to recall antigens (tetanus, diphtheria,
Streptococcus, tuberculin, Proteus, Trichophyton, and Candida). We also studied
96 healthy persons, matched for age and geographic location, who were tested on
the same days as the patients. RESULTS: In MM the number of total lymphocytes and
subsets CD19, CD3, CD4, and CD8 was decreased from 25% to 40% (p < 0.001). The
CD4/CD8 ratio increased (22%, p < 0.005) because of the relatively greater
decrease of CD8. The CD57 and CD16 cells (expression of natural killer
lymphocytes) were consistently reduced (30%; p < 0.002 to p < 0.003). C3 serum
level was increased (30%; p < 0.001). Immunoglobulins, CDH, AaM, and all other
tests were the same in the two groups. CONCLUSION: The single most important
result seems to be a reduction of CD57 and CD16 cells in patients with advanced
MM.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8496418 [PubMed - indexed for MEDLINE]

5150: J Comput Assist Tomogr. 1993 May-Jun;17(3):495-7.

Ramsay-Hunt syndrome and high-resolution 3DFT MRI.

Rovira Canellas A, Sanchez Torres C, Grive Isern E, Capellades Font J, Castella
Fierro E, Gili Planas J.

Centre de Ressonancia Magnetica, Hospital Universitari Vall d'Hebron, Barcelona, 
Spain.

A case of Ramsay-Hunt syndrome has been studied with pre- and postcontrast MR
imaging, using a three-dimensional Fourier transform fast imaging with steady
precession sequence with axially oriented sections and coronal reformatted
images. A clear demonstration of the abnormal enhancement of the labyrinth and of
the intratemporal cranial nerves was obtained. This demonstration assisted us in 
establishing the diagnosis of Ramsay-Hunt syndrome.

Publication Types: 
    Case Reports

PMID: 8491921 [PubMed - indexed for MEDLINE]

5151: Am Fam Physician. 1993 May 1;47(6):1445-50.

Comment in:
    Am Fam Physician. 1993 Dec;48(8):1384, 1388.    Am Fam Physician. 1994 Apr;49(5):1080, 1083.

Common dermatoses in the elderly.

Beacham BE.

University of Maryland School of Medicine, Baltimore.

Common dermatoses in the elderly include xerosis, pruritus, contact dermatitis,
acne rosacea, stasis dermatitis, bullous pemphigoid and herpes zoster. Physicians
must be able to recognize these pathologic changes superimposed on the intrinsic 
and extrinsic effects of aging. Diagnosis is dependent on clinical appearance and
supportive laboratory studies. Management is based on correct diagnosis.

Publication Types: 
    Review

PMID: 8480566 [PubMed - indexed for MEDLINE]

5152: Eur J Obstet Gynecol Reprod Biol. 1993 May;49(3):201-4.

Postpartum hemolytic uremic syndrome following placental abruption.

Pajor A, Hintalan A, Bakos L, Lintner F.

2nd Department of Obstetrics and Gynecology, Semmelweis Medical University,
Budapest, Hungary.

Hemolytic uremic syndrome associated with pregnancy is a rare condition. Authors 
report a patient treated with corticosteroids for bronchial asthma who was
afflicted by placental abruption at 24 weeks' gestation. The abruption was
preceded by developing herpes zoster and by deteriorating respiratory symptoms.
The induced labor was followed by anuria, acute renal failure, microangiopathic
hemolytic anemia, thrombocytopenia then fever and hypertension. The patient was
treated early with plasma infusion, transfusion and hemodialysis. She recovered
completely after 7 weeks. This case seems to be unique inasmuch as the hemolytic 
uremic syndrome was preceded by prodromal illness during pregnancy and was
associated with placental abruption.

Publication Types: 
    Case Reports

PMID: 8405636 [PubMed - indexed for MEDLINE]

5153: Am J Otolaryngol. 1993 May-Jun;14(3):179-86.

Acute "idiopathic" peripheral facial palsy: clinical, serological, and
cerebrospinal fluid findings and effects of corticosteroids.

Hyden D, Roberg M, Forsberg P, Fridell E, Fryden A, Linde A, Odkvist L.

Department of Oto-Rhino-Laryngology, Linkoping University, Stockholm, Sweden.

INTRODUCTION: The causes for peripheral facial palsy remain obscure in many
patients. Evidence exists suggesting viruses, especially those belonging to the
herpesvirus group, may be causative. This study was developed to evaluate this
theory. METHODS: One hundred forty-seven patients with acute peripheral facial
palsy of primarily unknown origin were studied. All were examined within 1 week
of onset. Subsequent follow-up was undertaken until the palsy had recovered or
become static. Paried cerebral spinal fluid and serum samples were obtained for
serological evaluation to detect herpes simplex, varicella zoster,
cytomegalovirus, measles, mumps, rubella, tick-borne encephalitis, adenovirus,
Epstein-Barr virus, and human immunodeficiency virus, as well as the antibodies
to Borrelia burgdorferi. RESULTS: Elevated antibiotic titers to Borrelia
burgdorferi were observed in 11% of patients, whereas 9% of patients demonstrated
elevated viral titers. Antibody pattern consistent with Epstein-Barr virus
reactivation was present in 13%. A total of 67% were classified as idiopathic.
CONCLUSION: Patients with reactivated Epstein-Barr virus were characterized by
having a higher incidence of auricular pain and displayed diabetes mellitus in a 
higher frequency than in other groups. In the Borrelia group, neck/back pain was 
more common. Healing was less favorable in the Borrelia group despite an equal
rate of palsy at onset and adequate antibiotic treatment. Corticosteroid
treatment used in 44% of the patients did not significantly improve the
functional outcome.

PMID: 8393307 [PubMed - indexed for MEDLINE]

5154: Pediatr Infect Dis J. 1993 May;12(5):402-6.

Multifocal leukoencephalitis caused by varicella-zoster virus in a child with
leukemia: successful treatment with acyclovir.

Carmack MA, Twiss J, Enzmann DR, Amylon MD, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, CA 94305-5119.

Publication Types: 
    Case Reports

PMID: 8392165 [PubMed - indexed for MEDLINE]

5155: J Neurol Sci. 1993 May;116(1):6-11.

Age distribution of latent herpes simplex virus 1 and varicella-zoster virus
genome in human nervous tissue.

Liedtke W, Opalka B, Zimmermann CW, Lignitz E.

Department of Neurology, University of Essen, Faculty of Medicine, Germany.

Latency in nervous tissue caused by herpes simplex virus 1 (HSV-1) and by
varicella-zoster virus (VZV) is an intriguing feature of herpes-virus'
neurotropism. HSV-1 and VZV latency are the causes of ophthalmic zoster and
recurrent HSV infections in the distributions of the trigeminal branches. HSV-1
neuronal latency may play a role in the etiopathogenesis of HSV encephalitis. We 
attempted to determine the prevalence and age distribution of VZV and HSV
latency. We applied nested polymerase chain reaction (PCR) assays to detect HSV-1
and VZV genome in trigeminal ganglia and olfactory bulbs which were obtained from
109 human corpses at forensic postmortems. HSV-1 latency was found in 72.5% of
trigeminal ganglia and in 15.5% of olfactory bulbs. VZV latency was 63.3% in
trigeminal ganglia and 1% in olfactory bulbs. Simultaneous latency of VZV and HSV
genome occurs in 48.8% of trigeminal ganglia. The age-group specific prevalence
of HSV neuronal latency increases from 18.2% in 0-20 years to reach finally 100% 
in persons older than 60 years. Age specific prevalences of VZV peaked for a
first time with 82% between 21-30 years, fell to 50% for 40-50 years, and rose to
89% for 71-80 years. If the latent trigeminal ganglion HSV-1 genome were the
source of endogenously acquired encephalitis, the peak incidence of HSV
encephalitis in older subjects correlates with our findings. Increased VZV
latency prevalence in nervous tissue of younger people without subsequent disease
indicates sufficient immune surveillance.

PMID: 8389816 [PubMed - indexed for MEDLINE]

5156: J Virol. 1993 May;67(5):2739-46.

Varicella-zoster virus open reading frame 10 protein, the herpes simplex virus
VP16 homolog, transactivates herpesvirus immediate-early gene promoters.

Moriuchi H, Moriuchi M, Straus SE, Cohen JI.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

The varicella-zoster virus (VZV) open reading frame 10 (ORF10) protein is the
homolog of the herpes simplex virus type 1 (HSV-1) protein VP16. These are two
virion tegument proteins that have extensive amino acid sequence identity in
their amino-terminal and middle domains. ORF10, however, lacks the acidic carboxy
terminus which is critical for transactivation by VP16. Earlier studies showed
that VZV ORF10 does not form a tertiary complex with the TAATGARAT regulatory
element (where R is a purine) with which HSV-1 VP16 interacts, suggesting that
ORF10 may not have transactivating ability. Using transient-expression assays, we
show that VZV ORF10 is able to transactivate VZV immediate-early (IE) gene
(ORF62) and HSV-1 IE gene (ICP4 and ICP0) promoters. Furthermore, cell lines
stably expressing ORF10 complement the HSV-1 mutant in1814, which lacks the
transactivating function of VP16, and enhance the de novo synthesis of infectious
virus following transfection of HSV-1 virion DNA. These results indicate that
ORF10, like its HSV-1 homolog VP16, is a transactivating protein despite the
absence of sequences similar to the VP16 carboxy-terminal domain. The
transactivating function of the VZV ORF10 tegument protein may be critical for
efficient initiation of viral infection.

Publication Types: 
    Comparative Study

PMID: 8386275 [PubMed - indexed for MEDLINE]

5157: Klin Monatsbl Augenheilkd. 1993 May;202(5):352-5.

[Ocular manifestations of rheumatic diseases. Cooperation between
internist/ophthalmologist]

[Article in German]

Tyndall A, Steiger U.

Rheumatologische Universitatsklinik, Felix Platter-Spital, Basel.

A red or painful eye may be the clue to a systemic condition, many of which are
of a rheumatological or immunological nature. Conjunctivitis may occur in
Sjogren's Syndrome, Reiter's Syndrome (and other sero negative
spondyloarthropathies) and with infections such as chlamydia and viruses. 70% of 
cases of episcleritis are idiopathic, the other 30% being associated with
rheumatoid arthritis or other connective tissue diseases or herpes zoster
infection. Scleritis may be seen with connective tissue diseases or auto immune
conditions (rheumatoid arthritis, Wegener granulomatosis, polyarteritis nodosa,
relapsing polychondritis, SLE), infections (herpes, tuberculosis, syphilis,
aspergillosis) or metabolic (gout, porphyria, cystinosis). Retinal vasculitis is 
seen in SLE, Behcet's Disease, sarcoidosis, polyarteritis nodosa, Whipple's
disease and Crohn's disease among others. However, uveitis presents perhaps the
greatest diagnostic challenge and interface between ophthalmology and
rheumatology. Some syndromes are purely ophthalmological (eg: Fuch's
heterochromic cyclitis) but others may lead to the diagnosis of a rheumatic
disorder (eg: recurrent unilateral acute anterior uveitis and ankylosing
spondylitis). Systemic syndromes most likely to be associated with uveitis are
Reiter's disease, ankylosing spondylitis, sarcoidosis, juvenile arthritis,
interstitial nephritis, inflammatory bowel disease, syphilis. The patterns are
different, eg: acute painful unilateral anterior uveitis with ankylosing
spondylitis and chronic asymptomatic bilateral uveitis in juvenile arthritis (ANA
positive, pauci-articular) or bilateral symptomatic uveitis in sarcoidosis. An
illustrative case will be presented and an algorithm for the evaluation of
uveitis discussed.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8377390 [PubMed - indexed for MEDLINE]

5158: Clin Ther. 1993 May-Jun;15(3):510-26.

A randomized vehicle-controlled trial of topical capsaicin in the treatment of
postherpetic neuralgia.

Watson CP, Tyler KL, Bickers DR, Millikan LE, Smith S, Coleman E.

Department of Neurology, University of Toronto, Ontario, Canada.

A large double-blind, vehicle-controlled study of 143 patients with chronic
postherpetic neuralgia (PHN) was performed to evaluate the degree of efficacy of 
topically applied capsaicin 0.075% cream. In addition, the safety and efficacy of
long-term application of topical capsaicin in PHN was assessed by following
patients in an open-label study for up to 2 years. In the double-blind phase, 143
patients with PHN of 6 months' duration or longer were enrolled. Since
epidemiologic studies of patients who receive no treatment have shown that only
10% to 25% of those with PHN after 1 month will still have pain at 1 year, two
separate efficacy analyses were performed: one with all evaluable patients (n =
131) and the other with 93 patients whose PHN lasted for longer than 12 months
prior to study startup. All efficacy variables, including the physician's global 
evaluation of reduction in PHN pain, changes in pain severity on the categoric
scale, visual analogue scale for pain severity, visual analogue scale for pain
relief, and functional capacity scale, showed significant improvement at nearly
all time points throughout the study for both patient groups, based on duration
of PHN pain. In contrast, the group receiving vehicle cream remained essentially 
unchanged. Data from the long-term, open-label phase (up to 2 years, n = 77),
which immediately followed the 6-week blinded phase, showed that the clinical
benefit in patients treated for a short (6-week) period with topical capsaicin
could be maintained or amplified in most patients (86%) during prolonged therapy.
There were no serious adverse effects observed or reported throughout the trial; 
in fact, the only side effect associated with capsaicin treatment was the burning
or stinging at local sites of application (in 9% of patients) during exposures of
up to 2 years (long-term phase). On the basis of these data, we conclude that
capsaicin 0.075% cream is a safe and effective treatment for the pain of
postherpetic neuralgia and should be considered for initial management of
patients with this condition.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8364943 [PubMed - indexed for MEDLINE]

5159: Hinyokika Kiyo. 1993 May;39(5):459-61.

[Severe central nervous system symptoms following oral administration of
acyclovir in a patient with chronic renal failure: a case report]

[Article in Japanese]

Niibori D, Fujisawa M, Matsuzaki M.

Department of Urology, Fukagawa Municipal General Hospital.

A case of renal failure in a patient with severe central nervous system symptoms 
during oral acyclovir medication is reported. A 68-year-old man maintained on
hemodialysis was given oral acyclovir 4,000 mg daily in divided doses because of 
herpes zoster affecting the left C3/5 dermatomes. He had vomiting and confusion
36 hours after administration. He had no focal neurological signs. The symptoms
resolved 4 days after cessation of acyclovir administration and blood
purification every day. Because of its high therapeutic index the use of
acyclovir is associated with few side effects. In patients with renal failure the
half-life of acyclovir is prolonged, this report indicates the importance of
adhering to the dosage reductions in patients with renal failure.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8322628 [PubMed - indexed for MEDLINE]

5160: Ann Acad Med Singapore. 1993 May;22(3 Suppl):441-2.

Low energy laser therapy for treatment of post-herpetic neuralgia.

Yaksich I, Tan LC, Previn V.

Neurosurgical Unit, Allamanda Private Hospital, Southport, Queensland, Australia.

Post-herpetic neuralgia is a significant and severe disability that afflicts some
patients following the acute manifestation of the disease despite what may be
considered adequate pharmacological treatment at the time of onset of the
vesicular rash. Surgery in general has little to offer in this condition although
dorsal route entry zone lesions may be appropriate in some situations. Low dose
laser therapy has been of value in a small series, to date, of cases that the
treatment has been used on. This has been both in the early phase soon after the 
vesicles have cleared and often late, many years after the onset of the pain.
Reported is a good improvement rate in approximately 60% of cases. The treatment 
is non-invasive and consideration of initial laser therapy is advocated.

PMID: 8215196 [PubMed - indexed for MEDLINE]

5161: Proc Natl Acad Sci U S A. 1993 May 1;90(9):4141-5.

Erratum in:
    Proc Natl Acad Sci U S A 1994 Feb 1;91(3):1193.

Human monoclonal antibodies against a plethora of viral pathogens from single
combinatorial libraries.

Williamson RA, Burioni R, Sanna PP, Partridge LJ, Barbas CF 3rd, Burton DR.

Department of Immunology, Scripps Research Institute, La Jolla, CA 92037.

Conventional antibody generation usually requires active immunization with
antigen immediately prior to the preparation procedure. Combinatorial antibody
library technology offers the possibility of cloning a range of antibody
specificities at a single point in time and then accessing these specificities at
will. Here we show that human monoclonal antibody Fab fragments against a
plethora of infectious agents can be readily derived from a single library.
Further examination of a number of libraries shows that whenever antibody against
a pathogen can be detected in the serum of the donor, then specific antibodies
can be derived from the corresponding library. We describe the generation of
human Fab fragments against herpes simplex virus types 1 and 2, human
cytomegalovirus, varicella zoster virus, rubella, human immunodeficiency virus
type 1, and respiratory syncytial virus. The antibodies are shown to be highly
specific and a number are effective in neutralizing virus in vitro.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7683424 [PubMed - indexed for MEDLINE]

5162: J Med Chem. 1993 Apr 30;36(9):1221-9.

Synthesis and antiviral activity of novel isonucleoside analogs.

Tino JA, Clark JM, Field AK, Jacobs GA, Lis KA, Michalik TL, McGeever-Rubin B,
Slusarchyk WA, Spergel SH, Sundeen JE, et al.

Bristol-Myers Squibb Pharmaceutical Research Institute, Princeton, New Jersey
08543-4000.

A series of branched-chain sugar isonucleosides was synthesized and evaluated for
antiviral activity against herpesviruses. The preparation of homochiral [3S-(3
alpha, 4 beta, 5 alpha)]-2-amino-1,
9-dihydro-9-[tetrahydro-4,5-bis(hydroxymethyl)-3-furanyl]-6H-purin-6-one (7,
BMS-181,164) and related compounds was stereospecifically achieved starting from 
1,2-isopropylidene-D-xylofuranose (10). An efficient two-step reduction of the
anomeric center of bis-acetate 18 involved formation of the chloride intermediate
19, followed by diisobutylaluminum hydride reduction. Tosylation of the resulting
alcohol 20 provided the key intermediate 21, which was coupled with a variety of 
nucleobase anions. Several members of this new class of compounds possess
activity against herpes simplex virus types 1 and 2 (HSV-1 and -2),
varicella-zoster virus (VZV), and human cytomegalovirus (HCMV). Compound 7
exhibits potent and selective activity against thymidine kinase encoding
herpesviruses, in particular, HSV-1 and HSV-2. Evaluation of compound 7 for
inhibition of WI-38 cell growth indicated an ID50 of > 700 microM. Although the
antiherpetic activity in vitro of 7 is less than that of acyclovir (1), compound 
7 displays superior efficacy in mouse model infections. The (bromovinyl)uridine
analog 8 (BMS-181,165) also exhibits selective activity against HSV-1 and VZV,
with no cytostatic effect on WI-38 cell growth at > 800 microM. Compound 8 is
active against simian varicella virus and is efficacious in the corresponding
monkey model.

PMID: 8387600 [PubMed - indexed for MEDLINE]

5163: Rev Prat. 1993 Apr 15;43(8):1023-7.

[Chickenpox and herpes zoster. Epidemiology, physiopathology, diagnosis,
development, treatment]

[Article in French]

Raffi F.

Maladies infectieuses et tropicales, service de medecine interne, Hotel-Dieu,
Nantes.

PMID: 8341968 [PubMed - indexed for MEDLINE]

5164: JAMA. 1993 Apr 14;269(14):1836-9.

Comment in:
    JAMA. 1993 Aug 11;270(6):710.

Shingles. Sorrows, salves, and solutions.

Straus SE.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, National Institutes of Health, Bethesda, Md. 20892.

Publication Types: 
    Case Reports
    Clinical Conference

PMID: 8459517 [PubMed - indexed for MEDLINE]

5165: J Natl Cancer Inst. 1993 Apr 7;85(7):559-66.

Intensive combined modality therapy for limited-stage small-cell lung cancer.

Elias AD, Ayash L, Frei E 3rd, Skarin AT, Hunt M, Wheeler C, Schwartz G, Mazanet 
R, Tepler I, Eder JP, et al.

Department of Medicine, Dana-Farber Cancer Institute, Boston, MA 02115.

BACKGROUND: Conventional-dose chemotherapy for small-cell lung cancer has
resulted in high response rates but rarely in a cure. The addition of thoracic
radiotherapy (chemoradiotherapy) has improved survival for patients having
limited disease, resulting in a median survival of 14-18 months. Previous trials 
evaluating high-dose chemotherapy and autologous bone marrow transplantation have
demonstrated enhanced complete response rates without documenting overall
survival benefit. PURPOSE: The purpose of this phase II trial was to determine
the disease-free and overall survival, toxic effects, and relapse patterns in
patients with limited small-cell lung cancer who were in partial or complete
response to first-line conventional-dose chemotherapy and then received intensive
systemic combined modality therapy. METHODS: Adults with stage III small-cell
lung cancer who had achieved at least a partial response to conventional-dose
induction chemotherapy were treated with high-dose cyclophosphamide, cisplatin,
and carmustine combined with autologous bone marrow transplantation. Cumulative
doses of the three drugs were 5625, 165, and 480 mg/m2, respectively. After
recovery, patients received thoracic radiotherapy (50-60 Gy in 25-30 fractions
over 5-6 weeks) and cranial radiotherapy (30 Gy in 15 fractions during 3 weeks). 
RESULTS: Of 19 patients in the study, six had achieved complete response, eight
had a greater than 90% reduction in tumor size, and five had a 50%-90% reduction 
in tumor size. After high-dose therapy, 15 of the 19 were in complete response.
Overall, median time to treatment failure after high-dose therapy was 12 months. 
Overall survival was 73% (95% confidence interval [CI] = 42%-89%) at 1 year and
53% (95% CI = 22%-77%) at 2 years. Of the 14 patients in or near complete
response before high-dose therapy, 10 remain disease free with no further
chemotherapy a median of 15 (4-69+) months after therapy. Actuarial 2-year
disease-free survival is 57% (95% CI = 20%-82%). One patient died of Candida
sepsis. Morbidity was low, and most patients returned to full-time work. With the
exception of herpes zoster, there were no complications more than 3 months after 
high-dose therapy. CONCLUSIONS: The majority of the patients in this study are
experiencing prolonged and unmaintained disease-free survival. Our findings
suggest that patients in or near complete response before high-dose therapy have 
the most favorable prognosis. IMPLICATIONS: A randomized comparison between this 
approach and conventional-dose therapy is planned to define the utility of dose
intensification with autologous bone marrow transplantation in the treatment of
patients with limited-stage small-cell lung cancer who are in or near complete
response.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8384264 [PubMed - indexed for MEDLINE]

5166: Dtsch Med Wochenschr. 1993 Apr 2;118(13):481.

[Thrombocytopenia following Varicella zoster infection]

[Article in German]

Schneider W.

Medizinische Klinik und Poliklinik A der Universitat, Dusseldorf.

Publication Types: 
    Case Reports

PMID: 8467749 [PubMed - indexed for MEDLINE]

5167: Clin Infect Dis. 1993 Apr;16(4):497-9.

Fatal noncutaneous visceral infection with varicella-zoster virus in a patient
with lymphoma after autologous bone marrow transplantation.

Stemmer SM, Kinsman K, Tellschow S, Jones RB.

Bone Marrow Transplant Program, University of Colorado Health Sciences Center,
Denver 80262.

After undergoing high-dose chemotherapy and autologous bone marrow
transplantation, a patient developed fatal disseminated infection due to
varicella-zoster virus (VZV) with no coincident skin lesions. This article
describes this unusual case and briefly reviews the English-language literature
on the abdominal presentation of VZV infection as well as that on VZV infection
after bone marrow transplantation. In the severely immunocompromised host,
visceral infection with VZV may uncommonly occur in the absence of skin lesions. 
The possibility of such infection should be considered when immunocompromised
patients develop unusual symptoms or other evidence of visceral disease (e.g.,
cholecystitis).

Publication Types: 
    Case Reports

PMID: 8513054 [PubMed - indexed for MEDLINE]

5168: Dermatol Nurs. 1993 Apr;5(2):122-3.

What's your assessment? Herpes zoster.

Bielan B.

Publication Types: 
    Case Reports

PMID: 8507535 [PubMed - indexed for MEDLINE]

5169: J R Soc Med. 1993 Apr;86(4):212-6.

The genetic mosaic.

Findlay G.

University of Pretoria, South Africa.

Blaschko's lines are the acknowledged markers which represent the patterns of
systematized naevi. Their interpretation has remained mysterious, because certain
special features which they exhibit are impossible to reconcile with any known
anatomical system in the human body. It is proposed that by changing one's views 
on the nature and growth of the dermatome, the patterns of zoster, and the
behaviour of tissue mosaicism, the major difficulties hitherto experienced will
be overcome.

PMID: 8505730 [PubMed - indexed for MEDLINE]

5170: Acta Paediatr Jpn. 1993 Apr;35(2):141-3.

A case of congenital herpes zoster.

Kusuhara K, Miyazaki C, Ise K, Hidaka Y, Tokugawa K, Ueda K.

Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

A 5 day old girl was transferred to the pediatric ward of Kyushu University
Hospital because of papules noted since birth. The papules were distributed on
her skin corresponding to the dermatomes innervated by the left Th1-Th3 and the
left L1-L3. Varicella-zoster virus antigens were detected in scrapings of incised
papules. The diagnosis of herpes zoster was made and acyclovir (ACV) was
administered. She responded to ACV well, but she experienced a recurrence twice
after discontinuation of ACV. This is the first report of 'congenital herpes
zoster', which supports the hypothesis that varicella embryopathy is the sequelae
of herpes zoster in utero.

Publication Types: 
    Case Reports
    Review

PMID: 8503271 [PubMed - indexed for MEDLINE]

5171: J Infect Dis. 1993 Apr;167(4):882-9.

Tumor necrosis factor-alpha (TNF alpha) in cerebrospinal fluid from patients with
meningitis of different etiologies: high levels of TNF alpha indicate bacterial
meningitis.

Glimaker M, Kragsbjerg P, Forsgren M, Olcen P.

Department of Infectious Diseases, Orebro Medical Center Hospital, Sweden.

The levels of tumor necrosis factor (TNF)-alpha in cerebrospinal fluid (CSF) were
analyzed in 139 patients with meningitis and in 20 control subjects. Elevated
concentrations were observed in 42 (82%) of 51 patients with purulent bacterial
meningitis (18/24 Haemophilus influenzae, 13/14 Streptococcus pneumoniae, 7/7
Neisseria meningitidis, and 4/6 with other purulent bacterial etiology). In
contrast, elevated levels were found in only 5 of 78 individuals with
nonbacterial meningitis (2/8 with herpes simplex type 2, 3/3 with
varicella-zoster virus). Thus, the positive and negative predictive values were
0.89 for indicating a purulent bacterial meningitis. Raised CSF TNF alpha levels 
were observed in 7 of 8 patients with purulent bacterial meningitis in whom the
routinely used parameters did not unequivocally indicate the diagnosis.
Moderately increased levels were seen in 5 of 6 patients with Mycobacterium
tuberculosis meningitis and in 1 of 4 cases of Borrelia burgdorferi. Thus, the
present study indicates that concentrations of TNF alpha in CSF usually can
discriminate between purulent bacterial and nonbacterial meningitis. These
findings may contribute diagnostic guidance with routinely used CSF parameters.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8450254 [PubMed - indexed for MEDLINE]

5172: Med Trop (Mars). 1993 Apr-Jun;53(2):225-39.

[Principal clinical manifestations during the course of disease caused by the
human immunodeficiency virus (HIV) in Pointe-Noire (Republic of Congo). (307
cases hospitalized during 2 years at the medical service of the Regional Hospital
of the Army)]

[Article in French]

Cheval P, Kinzonzi P, Allaert-Cheval C.

Service de Medecine, Hopital Regional des Armees, Pointe-Noire, Republique
Populaire du Congo.

At the sight of the hospitalization of 307 patients, attacked by AIDS, inside the
department of Medicine of the Military Hospital in Pointe-Noire (Congo) between
1990-1992, the authors try to point out the principal epidemiological
characteristics of their patients; give a semeiological and clinical descriptions
of the key symptoms encountered; try to draw a scale depending on the apparition 
and frequency of the opportunistic infections. The great number of some diseases 
(tuberculosis, cryptococcal meningitidis, herpes zoster, diarrhea, neurologic
complications ...) the more or less absence of others (pneumocystis carinii
pneumonia) grant to Central Africa AIDS an undeniable originality compared to
those of Europe and America. This analysis shows that a certain number of clinic 
signs in tropical area must attract the attention of the physician (facial palsy,
herpes zoster, dementia, focal brain disorders), and so, to include the detection
of AIDS, in the etiology of these affections.

Publication Types: 
    English Abstract

PMID: 8412594 [PubMed - indexed for MEDLINE]

5173: Antimicrob Agents Chemother. 1993 Apr;37(4):642-5.

Comparative activity of penciclovir and acyclovir in mice infected
intraperitoneally with herpes simplex virus type 1 SC16.

Sutton D, Boyd MR.

SmithKline Beecham Pharmaceuticals, Epsom, Surrey, United Kingdom.

Penciclovir [PCV; 9-(4-hydroxy-3-hydroxymethylbut-1-yl)guanine; BRL 39123] is a
potent and selective inhibitor of herpes simplex virus and varicella-zoster virus
in human cell culture. We have compared the activities of PCV and acyclovir (ACV)
in DBA/2 mice infected intraperitoneally with herpes simplex virus type 1 SC16 by
measuring the amount of virus in peritoneal washings. In untreated mice after an 
eclipse phase, virus titers are maximum at 48 h after infection and decline
thereafter. PCV and ACV reduced virus replication to a similar extent when given 
ad libitum in drinking water, even though ACV had better oral bioavailability and
greater potency in murine cells. Thus, PCV was more active than had been
predicted. In dose-response experiments, PCV given as a single subcutaneous dose 
24 h after infection was active at a 10-fold-lower dose than ACV (P < 0.01). A
single subcutaneous dose of PCV at 5 h after infection prevented virus
replication for 3 days and was more effective than three doses of ACV given 1, 5,
and 20 h after infection (P < 0.05). The superior activity of PCV following
discrete dosing is not due to pharmacokinetic differences but is probably a
reflection of the known stability of the intracellular triphosphate. In this
model, the maintenance of high concentrations in blood is less important for PCV 
than for ACV and may lead to less-frequent doses in clinical use.

Publication Types: 
    Comparative Study

PMID: 8388195 [PubMed - indexed for MEDLINE]

5174: Ophthalmology. 1993 Apr;100(4):530-3.

A comparison of enzyme immunoassay and polymerase chain reaction with the
clinical examination for diagnosing ocular herpetic disease.

Kowalski RP, Gordon YJ, Romanowski EG, Araullo-Cruz T, Kinchington PR.

Charles T. Campbell Laboratory, Eye and Ear Institute of Pittsburgh, PA 15213.

PURPOSE: The results of two laboratory diagnostic herpes simplex virus (HSV)
tests, an enzyme immunoassay (improved Herpchek [iHC]) and the polymerase chain
reaction (PCR), were compared with the clinical examination in the diagnosis of
HSV. We determined when diagnostic laboratory tests provided the initial
diagnosis of HSV ocular disease and when they were only confirmatory. METHODS:
The sensitivity and specificity of iHC and PCR were determined using 22 HSV
culture-positive clinical samples, 10 adenovirus culture-positive clinical
samples, 5 samples from normal conjunctivas, 4 bacterial samples, and 1 sample
containing Varicella zoster virus. The medical history of the 22 patients with
positive HSV cultures were reviewed to determine the initial diagnosis by
clinical examination and the initial therapy. RESULTS: For typical presentations 
of ocular HSV disease, the clinical examination is as accurate as iHC (P = 0.99) 
and PCR (P = 0.24). However, for atypical presentations of ocular HSV disease,
iHC (P = 0.000005) or PCR (P = 0.00006) were more accurate in detecting HSV
infection than the clinical examination. CONCLUSION: Laboratory diagnosis of HSV 
from ocular samples was most useful to the clinician in atypical presentations of
herpetic ocular disease.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8386821 [PubMed - indexed for MEDLINE]

5175: Virology. 1993 Apr;193(2):762-73.

DNA sequence and genetic organization of the unique short (US) region of the
simian varicella virus genome.

Fletcher TM 3rd, Gray WL.

Department of Microbiology and Immunology, University of Arkansas for Medical
Sciences, Little Rock 72205.

Simian varicella virus (SVV) infection of nonhuman primates is a model for the
study of human varicella zoster virus (VZV) infections. The DNA sequence of the
entire SVV unique short (US) region and adjacent flanking sequences of the
inverted repeats were determined. The US region is 4904 bp in size and has a
60.9% A + T base composition. Four potential open reading frames (ORFs),
designated SVUS 1, SVUS 2, SVUS 3, and SVUS 4, were identified and found to be
remarkably similar in size, genetic content, and transcriptional orientation to
their respective VZV US counterparts; ORF 65, ORF 66 (US PK), ORF 67 (gpIV), and 
ORF 68 (gpI). The SVUS 1 ORF encodes a putative 9 kDa homolog of the herpes
simplex virus type-1 (HSV-1) US9 tegument phosphoprotein. The SVUS 2 ORF encodes 
a predicted 345 amino acid polypeptide that contains a number of sequence domains
conserved in cellular and viral serine/threonine (S/T) protein kinases and
exhibits extensive homology with previously reported alphaherpesviral US S/T PKs,
including VZV ORF 66, HSV-1 US3, pseudorabies virus (PRV) PK, and equine
herpesvirus (EHV-1) ORF 69. The SVUS 3 and SVUS 4 ORFs exhibit features
characteristic of membrane glycoproteins: an amino terminal signal sequence,
potential N-linked glycosylation sites, and a large hydrophobic transmembrane
domain. The predicted 353 amino acid protein encoded by SVUS 3 ORF is homologous 
to the VZV gpIV (ORF 67), HSV-1 gI (US7), PRV gp63, and EHV-1 gI (ORF 73) gene
products. The SVUS 4 ORF encodes a putative 604 amino acid polypeptide which
exhibits extensive homology with VZV gpI and more limited homology with HSV-1 gE 
(US8), PRV gpI, and EHV gE (ORF 74). This report describes the initial
characterization of individual SVV genes and further defines the evolutionary
relationships between SVV, VZV, and other alphaherpesviruses.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8384754 [PubMed - indexed for MEDLINE]

5176: Virology. 1993 Apr;193(2):1028-32.

The pseudorabies virus host-shutoff homolog gene: nucleotide sequence and
comparison with alphaherpesvirus protein counterparts.

Berthomme H, Jacquemont B, Epstein A.

Centre de Genetique Moleculaire et Cellulaire, UMR 106,-C.N.R.S., Universite
Claude Bernard Lyon I, France.

The virion host shutoff function (VHS) of many herpesviruses is required for
inhibition of cellular gene expression in infected cells. This function
corresponds to the UL41 open reading frame of herpes simplex virus type 1 (HSV-1)
and homolog sequences have been found in other alphaherpesvirus, like HSV-2,
Varicella-Zoster virus (VZV) and equine herpesvirus type 1 (EHV-1). In this work,
we have cloned and sequenced a pseudorabies virus (PRV) gene which is homologous 
to the VHS genes of the other alphaherpesvirus. Sequence comparison between all
deduced amino acid sequences indicates the presence of several conserved domains,
separated by regions containing gaps or low conserved sequences.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8384744 [PubMed - indexed for MEDLINE]

5177: J Virol. 1993 Apr;67(4):2381-4.

Quantitation of latent varicella-zoster virus DNA in human trigeminal ganglia by 
polymerase chain reaction.

Mahalingam R, Wellish M, Lederer D, Forghani B, Cohrs R, Gilden D.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

Competitive polymerase chain reaction was used to quantitate latent
varicella-zoster virus (VZV) DNA in human trigeminal ganglia. Ganglionic DNA from
five subjects was amplified with oligonucleotide primers specific for VZV gene
28. Two of the samples were also analyzed with primers specific for VZV gene 62. 
Our results indicated that there are 6 to 31 copies of the VZV genome in every
100,000 ganglionic cells.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8383249 [PubMed - indexed for MEDLINE]

5178: J Virol. 1993 Apr;67(4):2255-65.

Transcriptional and translational analyses of the UL2 gene of equine herpesvirus 
1: a homolog of UL55 of herpes simplex virus type 1 that is maintained in the
genome of defective interfering particles.

Harty RN, Holden VR, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932.

Defective interfering particles (DIPs) of equine herpesvirus 1 (EHV-1; Kentucky A
strain) mediate persistent infection. DNA sequences at the L terminus, which
contain the UL2 gene (homolog of UL55 of herpes simplex virus type 1 and open
reading frame 3 of varicella-zoster virus) of standard EHV-1, have been shown to 
be highly conserved in all clones of the EHV-1 DIP genome. The UL2 mRNA was
characterized by S1 nuclease analyses, which mapped the 5' and 3' termini of the 
0.9-kb early UL2 mRNA to approximately 26 and 16 nucleotides downstream of a
TTTAAA box and polyadenylation signal, respectively. The UL2 open reading frame, 
present within both the EHV-1 standard and DIP genomes, was inserted into the
transcription expression vector pGEM-3Z to yield constructs pGEML2 and pDIL2,
respectively. After in vitro transcription and translation, both constructs
yielded a comigrating 23-kDa protein, as determined by sodium dodecyl
sulfate-polyacrylamide gel electrophoresis. Polyclonal antiserum was raised
against the UL2 protein by injecting rabbits with a TrpE/UL2 fusion protein
expressed from plasmid pATH23L2 in Escherichia coli. The UL2-specific antiserum
reacted in Western immunoblot and immunoprecipitation analyses with a 23-kDa
polypeptide synthesized in cells infected with standard EHV-1 or DIP-enriched
virus. These data also indicated that the UL2 polypeptide was more abundant in
DIP-infected cells than in standard EHV-1-infected cells. Results from time
course and pulse-chase analyses suggested that the UL2 polypeptide has a rapid
turnover rate in DIP-infected cells.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 8383240 [PubMed - indexed for MEDLINE]

5179: Acta Derm Venereol. 1993 Apr;73(2):123-5.

Atypical varicella-zoster infection in AIDS.

Lokke Jensen B, Weismann K, Mathiesen L, Klem Thomsen H.

Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen, Denmark.

A case of atypical varicella zoster in a 33-year-old AIDS patient is reported.
The patient had had two attacks of herpes zoster within a year and was given
high-dose acyclovir several times. Thereafter he developed small keratotic
pellucid papules on fingers, wrists and face, which were found to contain
varicella-zoster antigen by the ELISA test. Skin biopsy showed acanthosis and
lack of vesication, as is usually seen in herpes infections. The atypical
varicella-like lesions persisted despite repeated doses of acyclovir but cleared 
temporarily when the patient was given foscarnet. We believe that the prolonged
therapy may have allowed selection of acyclovir-resistant varicella-zoster
strains, resulting in the atypical clinical course.

Publication Types: 
    Case Reports

PMID: 8103257 [PubMed - indexed for MEDLINE]

5180: Arch Dis Child. 1993 Apr;68(4):521-4.

HIV infection in haemophilia--a European cohort.

Aronstam A, Congard B, Evans DI, Gazengel CF, Herberg U, Hill FG, Jones PM, Ljung
R, Mauser-Bunschoten EP, Scheibel E, et al.

Basingstoke District Hospital, UK.

Ten haemophilia centres in northern Europe have pooled data on 202 haemophilic
children who were infected with HIV between 1979 and 1986. All cases were under
16 years of age on 1 July 1985. The age at infection ranged from 1-15 years.
Thirty seven cases (18%) had progressed to AIDS by 1 July 1991 and 15 of these
have died. Persistent generalised lymphadenopathy has been noted in 102 patients 
of whom 18 (17%) have developed AIDS. Twenty three of the remaining patients
(23%) have not. CD4+ T cell counts have fallen steadily. Of 36 patients who have 
had shingles since seroconversion, 19 (53%) had counts below 0.2 x 10(9)/l.
Thirty five out of 145 patients without shingles (24%) had similar values. The
mean IgA concentration in patients with CD4+ T cell counts above 0.5 x 10(9)/l
was 2.38 g/l, between 0.2 and 0.5 was 3.07 g/l, and in those with CD4+ T cell
counts below 0.2 x 10(9)/l the mean IgA concentration was 4.58 g/l. Treatment
patterns have altered between 1989 and 1991, with increased use of zidovudine in 
patients without AIDS and a marked increase in primary prophylaxis against
pneumocystis pneumonia. This has been associated with a decline in the incidence 
of pneumocystis as an indicator disease in new AIDS cases from 56% in 1989 to 20%
in 1991. These observations indicate that persistent generalised lymphadenopathy 
does not worsen the outlook, but shingles does. Rising IgA concentrations are
markers for disease progression. Modern prophylactic regimens are delaying the
onset of indicator disease, but CD4 values continue to fall steadily.

PMID: 8099271 [PubMed - indexed for MEDLINE]

5181: AIDS Action. 1993 Mar-May;(20):6-8.

Diagnosing symptomatic HIV infection and AIDS in adults.

[No authors listed]

PIP: The US Centers for Disease Control in 1982 listed conditions and infections 
then associated with AIDS. That case definition, used as a model for many
countries, was designed primarily for epidemiologic surveillance and now includes
more than 20 conditions. The definition, however, requires diagnostic and
laboratory technologies which are not always available in developing countries.
The World Health Organization (WHO) therefore published the Bangui definition in 
1985 which uses clinical criteria alone. Many developing countries have adapted
this definition to the types of pathogens they encounter domestically. According 
to the AIDS clinical definition, the presence of generalized Kaposi sarcoma or
cryptococcal meningitis is sufficient for the diagnosis of AIDS. AIDS is also
diagnosed if at least two major signs and one minor sign are present in the
absence of known causes of immunosuppression such as malnutrition. Major signs
are fever for more than one month, loss of more than 10% of body weight, and
diarrhea for more than one month. Minor signs include cough for more than one
month, generalized pruritic dermatitis, recurrent herpes zoster or shingles,
oropharyngeal candidiasis or thrush, chronic or aggressive ulcerative herpes
simplex, and persistent generalized lymphadenopathy. WHO has also developed
criteria for diagnosing symptomatic HIV infection as an aid to individual case
management. These criteria, however, are not intended to replace the Bangui AIDS 
case definitions developed for epidemiological purposes. The diagnosis of
symptomatic HIV infection is made through physical examination and the taking of 
a very detailed case history. In so doing, there may be cardinal, characteristic,
and/or associated findings. Cardinal findings of HIV infection are Kaposi
sarcoma, oesophageal candidiasis, cytomegalovirus retinitis, Pneumocystis carinii
pneumonia, and Toxoplasma encephalitis. Characteristic findings include oral
thrush in a patient not taking antibiotics; hairy leukoplakia; cryptococcal
meningitis; miliary, extrapulmonary,, or non-cavity pulmonary tuberculosis;
current or past herpes zoster or shingles; severe prurigo; Kaposi sarcoma of a
less than generalized or rapidly progressive nature; and high-grade B-cell
extranodal lymphoma. Finally, associated findings in the absence of any other
obvious cause of immunosuppression are recent and/or explained weight loss of
more than 10% of body weight; fever for more than one month; diarrhea for more
than one month; ulcers for more than one month; cough for more than one month;
neurological complaints or findings, peripheral neuropathy, dementia, and
progressively worsening headache; generalized lymphadenopathy; previously unseen 
drug reactions; and severe or recurrent skin infections. A person has symptomatic
HIV infection if there are one or more cardinal findings, two or more
characteristics findings, one characteristic finding and two or more associated
findings, three or more associated findings together with any risk factors, or
two associated findings together with a positive HIV test result. Malawi, Zambia,
Thailand, and the English-speaking Caribbean are adapting these criteria for
national use.

PMID: 12288934 [PubMed - indexed for MEDLINE]

5182: Oftalmologia. 1993 Mar-May;37(2):124-9.

[Ocular complications in zona ophthalmica]

[Article in Romanian]

Cernea P, Mocanu C, Tenea C.

Clinica Oftalmologica Craiova.

81 cases of herpes zoster ophthalmicus with ocular affection, hospitalized in the
clinic of ophthalmology between 1980-1991, are presented. The most frequent
ocular complications were dendritic keratitis and punctate epithelial keratitis
in 12 cases, neurotrophic keratitis in 7 cases, keratoendothelitis in 22 cases,
iritis and iridocyclitis in 26 cases posterior uveitis in 3 cases. Seldom
complications, presented each with a single case, were secondary glaucoma,
optical postnevritical atrophy, oculomotor nerves palsy. The lesions were equally
distributed between the two eyes. The associations of these complications
determined visual acuity diminishing below 1/10 in 27 cases. In spite of
association of classical treatment with recent antiviral medication and due to
serious ocular complications which appear at most of 50% of the patients with
herpes zoster ophthalmicus, the functional prognosis remains reserved.

Publication Types: 
    English Abstract

PMID: 8507622 [PubMed - indexed for MEDLINE]

5183: Changgeng Yi Xue Za Zhi. 1993 Mar;16(1):75-80.

[Oral complications following a herpes zoster infection of trigeminal nerve]

[Article in Chinese]

Lin JR, Huang CC.

Department of Dentistry, Chang Gung Memorial Hospital, Taiwan, R.O.C.

A case of herpes zoster involving the ophthalmic and maxillary divisions of the
trigeminal nerve is reported. It presented as a oral herpes zoster infection with
prodromal odontalgia and progressed to spontaneous exfoliation and devitalization
of teeth and osteonecrosis of the maxilla. The literature is reviewed and the
pathophysiology of tooth exfoliation, tooth devitalization and osteonecrosis by
V-Z viruses are discussed in addition to the management of herpes zoster and
post-zoster complications.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8490779 [PubMed - indexed for MEDLINE]

5184: Clin Exp Dermatol. 1993 Mar;18(2):196.

The treatment of herpes zoster with flamazine--a double-blind placebo-controlled 
trial.

Mallett RB, Staughton RC.

Publication Types: 
    Clinical Trial
    Letter
    Randomized Controlled Trial

PMID: 8482003 [PubMed - indexed for MEDLINE]

5185: Rev Clin Esp. 1993 Mar;192(4):203-4.

[Herpes zoster involving multiple cranial nerves]

[Article in Spanish]

de la Fuente Aguado J, Bordon JM, Prieto Lopez I, Sopena Perez-Arguelles B.

Publication Types: 
    Case Reports
    Letter

PMID: 8480073 [PubMed - indexed for MEDLINE]

5186: Hautarzt. 1993 Mar;44(3):143-7.

[Dexamethasone-cyclophosphamide pulse therapy in bullous autoimmune dermatoses]

[Article in German]

Appelhans M, Bonsmann G, Orge C, Brocker EB.

Universitats-Hautklinik Munster.

The problem in the treatment of bullous autoimmune dermatoses with long-term
corticosteroids is that the high doses cause side-effects. An alternative form of
therapy with high-dose dexamethasone-cyclophosphamide pulses was used to treat 20
patients between 33 and 86 years: 7 patients had bullous pemphigoid, 6 pemphigus 
vulgaris, 5 pemphigus foliaceus, and 2 cicatricial pemphigoid. On each of days
1-3 100 mg dexamethasone was administered i.v. and on day 1, 500 mg
cyclophosphamide i.v. In the therapy interval between the pulses 50 mg
cyclophosphamide per day. Initially the pulses were repeated every 2 weeks and
later at 10-week intervals. After 6 months of this regimen 13 patients were
symptom-free, 4 had improved, and 3 showed no change. The efficacy of treatment
was equal in newly diagnosed and previously treated cases. (Side-effects were
leucopenia (n = 3), myalgia and arthralgia (n = 2), taste disturbance (n = 2),
diffuse hair loss (n = 2), thrombophlebitis (n = 1), herpes zoster (n = 1) and a 
delayed-type hypersensitivity reaction to mesna. Owing to the rather short
follow-up, no conclusions on long-term side-effects of this therapy are possible.
However, dexamethasone-cyclophosphamide pulse therapy appears so far to be a good
alternative to the standard continuous corticosteroid treatment.

Publication Types: 
    English Abstract

PMID: 8463094 [PubMed - indexed for MEDLINE]

5187: No To Hattatsu. 1993 Mar;25(2):128-34.

[Neurological complications of varicella-zoster virus (VZV) infection]

[Article in Japanese]

Shiihara H.

Department of Pediatrics, Koshigaya Hospital, Dokkyo University School of
Medicine, Saitama.

Sixty cases with varicella-associated neurological disorders from Japanese
literature during recent 11 years were analyzed and compared with previous
reports. Chief diseases were encephalitis (encephalopathy) (23.3%), cerebellar
ataxia (21.7%), meningitis (18.3%), cerebral infarction (13.3%) and facial palsy 
(8.3%). Cerebellar ataxia, meningitis and cerebral infarction were found in young
children under 9 years, and other disorders were seen also in older children and 
adults. Some cases had neurological symptoms before the appearance of skin rash. 
The number of cells in cerebrospinal fluid was increased in meningitis,
encephalitis and myelitis. Though neurological complications due to varicella
were rare, prognosis was not necessarily good, including several cases with death
or severe sequelae. In our 4 cases of herpes zoster meningitis, marked
intrathecal VZV-specific antibody production was found and they showed high
antibody index. Oligoclonal band was found in one case. The pathogenesis of
neurological complications of VZV infection was considered to be caused by direct
viral invasion in herpes zoster and at least in some cases of varicella. Therapy 
with antiviral agents is necessary and vaccination is recommended for prevention.

Publication Types: 
    English Abstract

PMID: 8461162 [PubMed - indexed for MEDLINE]

5188: Am Rev Respir Dis. 1993 Mar;147(3):658-63.

Pulmonary complications of human immunodeficiency virus infection in Bujumbura,
Burundi.

Kamanfu G, Mlika-Cabanne N, Girard PM, Nimubona S, Mpfizi B, Cishako A, Roux P,
Coulaud JP, Larouze B, Aubry P, et al.

Department of Medicine, University of Bujumbura School of Medicine, Burundi.

To determine the types of pulmonary disease associated with human
immunodeficiency virus (HIV) infection, we conducted a prospective study of 302
consecutive patients admitted for acute respiratory disease to a university
hospital in Bujumbura, Burundi. Diagnoses were made according to well-defined
criteria. Of the total, 222 patients (73.5%) were HIV seropositive, with women
younger than men. Features suggestive of underlying HIV infection were the
clinical findings of oral thrush, peripheral lymphadenopathy, or herpes zoster
and the radiographic abnormalities of hilar-mediastinal adenopathy or a
reticulonodular infiltrate. Tuberculosis and community-acquired pneumonia
occurred with approximately equal frequency in the HIV-seropositive and
seronegative groups. Pneumocystis carinii pneumonia was diagnosed in 11 patients,
all seropositive. Gram-negative bacteremia, especially Salmonella typhimurium,
occurred in 23 seropositive patients (10.4%). A total of 24 seropositive patients
died during the initial hospitalization, and 11 others required readmission; no
seronegative patients died or were rehospitalized. We conclude that HIV infection
is a major risk factor for the development of acute respiratory diseases in
adults of sufficient severity to require hospitalization in Bujumbura. In this
Central African country, where exposure to virulent bacterial pathogens is
ubiquitous, tuberculosis, pneumonia, and salmonellosis occur with much greater
frequency than classic AIDS-defining opportunistic infections or malignancies.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8442602 [PubMed - indexed for MEDLINE]

5189: J Infect Dis. 1993 Mar;167(3):547-52.

Comment in:
    J Infect Dis. 1993 Dec;168(6):1596.

Esophageal disease in AIDS is associated with pathologic processes rather than
mucosal human immunodeficiency virus type 1.

Smith PD, Eisner MS, Manischewitz JF, Gill VJ, Masur H, Fox CF.

Laboratory of Immunology, National Institute of Dental Research, National
Institutes of Health, Bethesda, Maryland.

Twenty-five patients with AIDS and esophageal symptoms were evaluated for the
presence of esophageal disease and human immunodeficiency virus type 1 (HIV-1) in
the esophageal mucosa. A single infectious process caused by Candida albicans,
cytomegalovirus, herpes simplex virus, varicella-zoster virus, or Mycobacterium
avium-intracellulare complex or a single noninfectious process caused by Kaposi's
sarcoma or reflux esophagitis was identified in 20 patients. Two processes were
identified in 5 patients. HIV-1 mRNA was detected by in situ hybridization in
mononuclear cells in esophageal lamina propria in 36% of patients. The presence
of HIV-1 in the esophageal mucosa was not associated with a specific esophageal
symptom, mucosal inflammation or ulceration, Kaposi's sarcoma, specific
opportunistic infection, or response of the infection(s) to therapy. Esophageal
disease in patients with AIDS appears to be associated with specific pathologic
processes rather than the presence of HIV-1 in esophageal mucosa.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 8440925 [PubMed - indexed for MEDLINE]

5190: Cornea. 1993 Mar;12(2):131-7.

Detection of varicella zoster virus DNA and viral antigen in human cornea after
herpes zoster ophthalmicus.

Wenkel H, Rummelt C, Rummelt V, Jahn G, Fleckenstein B, Naumann GO.

Department of Ophthalmology, University of Erlangen-Nurnberg, Germany.

This article describes the histopathology, immunohistochemistry, and varicella
zoster virus DNA in situ hybridization of 14 corneal buttons obtained from 14
patients (average age 69.0 years) after perforating keratoplasty (four patients) 
or surgical enucleation (10 patients) at different times after the clinical onset
of herpes zoster ophthalmicus (average 58.7 months). The main histopathologic
features were intense stromal vascular scarring (12 patients) and granulomatous
reaction to Descemet's membrane (nine patients). Using the
peroxidase-antiperoxidase method, varicella zoster virus (VZV) antigen could be
detected by immunohistochemistry in two patients within epithelial cells of the
cornea and in the limbal episclera during the active phase of herpes zoster
ophthalmicus. For in situ hybridization we used the 35S-labeled HindIII A and C
fragment of VZV and identified viral DNA in five corneal buttons obtained 1 day
to 8 years after the clinical onset of infection. Viral DNA was mainly found in
mononuclear cells with eosinophilic intracytoplasmic inclusions within vascular
stromal scars, in keratocytes, and in epithelial cells of the cornea. Our results
show that VZV DNA is detectable in human cornea even 8 years after the clinical
onset of herpes zoster ophthalmicus and may indicate VZV persistence in a latent 
form in corneal tissue or reactivation of the virus from an endogenous or
exogenous source causing a severe and often recurrent keratitis in the progress
of herpes zoster ophthalmicus.

PMID: 8388787 [PubMed - indexed for MEDLINE]

5191: Pediatr Neurol. 1993 Mar-Apr;9(2):134-6.

Reye syndrome associated with subclinical varicella zoster virus and influenza A 
infection.

Hukin J, Junker AK, Thomas EE, Farrell K.

Department of Pediatrics, University of British Columbia, Vancouver, Canada.

An association is reported between Reye syndrome and varicella zoster virus (VZV)
infection in a 10-year-old boy who had serologic evidence of coinfection with VZV
and influenza A H3N2, and exposure to salicylates. He developed VZV reinfection
without skin lesions after family exposure and influenza A was
community-acquired. Recent chickenpox contact should initiate VZV serologic
studies in Reye syndrome patients, regardless of the chickenpox history or
evidence of infection with other viruses.

Publication Types: 
    Case Reports

PMID: 8388687 [PubMed - indexed for MEDLINE]

5192: Acta Paediatr. 1993 Mar;82(3):284-90.

Immunological factors in milk from Brazilian mothers delivering small-for-date
term neonates.

Grumach AS, Carmona RC, Lazarotti D, Ribeiro MA, Rozentraub RB, Racz ML, Weinberg
A, Carneiro-Sampaio MM.

Department of Paediatrics, University of Sao Paulo, Brazil.

Breast milk samples from three groups of Brazilian women were evaluated: G1,
mothers delivering term babies of low birth weight (n = 16); G2, mothers
delivering preterm babies of appropriate birth weight (n = 20); G3, mothers
delivering term babies of appropriate birth weight (n = 30). Milk samples were
obtained at 48 h and on the 7th, 15th, 30th and 60th days after delivery and they
were analyzed for lysozyme and total IgA levels and for the presence of specific 
antibodies against Poliovirus types I, II, III, Rotavirus, Herpes simplex virus, 
Varicella zoster and Cytomegalovirus. The groups were not statistically different
in relation to mother's age, parity, type of delivery or socio-economic levels.
IgA levels were higher in both low-birth-weight groups (G1 & G2) compared to the 
control group (G3) throughout the study period. Lysozyme levels decreased up to
the 15th day, increasing thereafter up to the 60th day in all groups. Specific
antibodies were detected throughout the study period, with no differences among
groups. We conclude that breast milk composition of mothers delivering
low-birth-weight babies (G1 & G2) was similar despite the different gestational
ages.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8388277 [PubMed - indexed for MEDLINE]

5193: Surv Ophthalmol. 1993 Mar-Apr;37(5):313-52.

Systemic viral infections and their retinal and choroidal manifestations.

Yoser SL, Forster DJ, Rao NA.

Doheny Eye Institute, University of Southern California School of Medicine, Los
Angeles.

Viruses are one of the most common causes of infections involving the posterior
segment of the eye. Such infections can occur either on a congenital or an
acquired basis, and may affect primarily the retina or the choroid. Congenital
cytomegalovirus (CMV) and rubella infections may result in retinitis. CMV
retinitis is also the most common cause of acquired viral retinitis, primarily
because of the acquired immunodeficiency syndrome (AIDS). Other types of viral
retinitis, such as those caused by herpes simplex or herpes zoster, can occur in 
immunocompromised or immunocompetent individuals. Retinitis or choroiditis caused
by viruses such as measles, influenza, Epstein-Barr virus, and Rift Valley fever 
virus, typically occurs subsequent to an acute viral systemic illness. The
systemic and ocular manifestations, as well as the histopathology, laboratory
tests, differential diagnoses, and treatment regimens for each of the individual 
viruses are discussed in detail.

Publication Types: 
    Review

PMID: 8387231 [PubMed - indexed for MEDLINE]

5194: Chem Pharm Bull (Tokyo). 1993 Mar;41(3):516-21.

Synthesis and antiviral activity of carbocyclic oxetanocin analogues (C-OXT-A,
C-OXT-G) and related compounds. II.

Maruyama T, Hanai Y, Sato Y, Snoeck R, Andrei G, Hosoya M, Balzarini J, De Clercq
E.

Department of Pharmaceutical Sciences, Tokushima Bunri University, Japan.

9-(cis-3-Hydroxymethyl-2-methylenecyclobutyl)guanine (3b) and
9-(3-methylene-trans-2-hydroxymethylcyclobutyl)guanine (4b) were prepared from
N2-isobutyryl-9-[trans-trans-2,3-bis(hydroxymethyl)cyclobutyl]guanine (2f) or
2,3-bis(hydroxymethyl)-1-cyclobutanol (7b). Carbocyclic oxetanocin analogues (A, 
1d; G, 2d) and related compounds including 4b were assayed against a broad
variety of viruses. It appeared that the activity of 2d against herpes simplex
virus (HSV) and varicella-zoster virus (VZV) at least partially depends on
phosphorylation by the virus-induced thymidine kinase (TK). Although 1d and 2d
are inhibitory to the replication of human immunodeficiency virus (HIV), they are
quite toxic to proliferating human T-lymphocytes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8386594 [PubMed - indexed for MEDLINE]

5195: Gut. 1993 Mar;34(3):299-302.

Varicella-zoster virus DNA in the oesophageal myenteric plexus in achalasia.

Robertson CS, Martin BA, Atkinson M.

Department of Surgery, University of Nottingham.

In a search for past or present infection with herpes viruses, serum antibody
titres to herpes simplex type 1 virus, cytomegalovirus, and varicella-zoster
virus were measured by complement fixation test in 58 patients with achalasia.
Serum was also taken from 40 age and sex matched patients without oesophageal
symptoms who formed a control group. All titres were low, and those for herpes
simplex type 1 virus and cytomegalovirus did not differ in the achalasia patients
and the controls. However, the incidence of varicella-zoster virus antibodies was
significantly greater in the achalasia than in the control group (p < 0.05).
Using oesophageal tissue containing myenteric plexus removed at the time of
cardiomyotomy in nine patients with achalasia, in situ DNA hybridisation showed
evidence of varicella-zoster virus in three, but all were negative for the other 
two viruses. No positive results were obtained for herpes simplex type 1 virus,
cytomegalovirus, or varicella-zoster virus in oesophageal tissue from 20 patients
undergoing oesophageal resection for diseases other than achalasia. The incidence
of positivity for varicella-zoster virus was significantly increased in the
achalasia group compared with the controls (p < 0.02). The findings indicate that
varicella-zoster virus DNA may persist in the oesophageal myenteric plexus in
some patients with achalasia and raise the possibility that this virus is of
aetiological importance in achalasia.

PMID: 8386130 [PubMed - indexed for MEDLINE]

5196: J Med Virol. 1993 Mar;39(3):242-5.

Depressed immune functions in the early phase of varicella-zoster virus
reactivation.

Saibara T, Maeda T, Onishi S, Yamamoto Y.

First Department of Medicine, Kochi Medical School, Nankoku, Japan.

Varicella-zoster virus (VZV) infections are among the most common viral diseases 
characterized by recurrent episodes alternating with asymptomatic periods. VZV
reactivation is believed to be induced by the impairment of the host's
cell-mediated immune system; however, the precise mechanisms involved in the
latency period and reactivation of herpes viruses in the infected host are not
yet fully elucidated. We assessed the immune functions in noncompromised patients
with typical herpes zoster to investigate the immunological status during the
process of reactivation of VZV. The results indicated depressed immune functions 
in the early stage of VZV reactivation with gradual improvement during the
recovery phase. These findings are in accord with the clinical course of herpes
zoster and suggest a possible therapeutic trial.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8385706 [PubMed - indexed for MEDLINE]

5197: Antimicrob Agents Chemother. 1993 Mar;37(3):602-4.

2-Acetylpyridine 5-[(dimethylamino)thiocarbonyl]-thiocarbonohydrazone (1110U81)
potently inhibits human cytomegalovirus replication and potentiates the antiviral
effects of ganciclovir.

Hamzeh FM, Spector T, Lietman PS.

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore,
Maryland 21205.

We studied the effects of 2-acetylpyridine
5-[(dimethylamino)thiocarbonyl]-thiocarbonohydrazone (1110U81 or A1110U), a
potent inhibitor of the ribonucleotide reductases encoded by herpes simplex virus
types 1 and 2 and by varicella-zoster virus, against human cytomegalovirus (HCMV)
replication in infected MRC-5 cells. We show that 1110U81 is a potent inhibitor
of HCMV DNA replication (50% inhibitory concentration [IC50], 3.6 microM; IC90,
5.6 microM) and also potentiates the effects of ganciclovir (GCV) against HCMV.
The IC90 of GCV is reduced from 65 microM when GCV alone is given to 2.8 microM
when GCV is combined with 1110U81 at a molar ratio of 1:1.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8384821 [PubMed - indexed for MEDLINE]

5198: J Comput Assist Tomogr. 1993 Mar-Apr;17(2):313-6.

MRI in varicella-zoster virus leukoencephalitis in the immunocompromised host.

Lentz D, Jordan JE, Pike GB, Enzmann DR.

Department of Radiology, Stanford University School of Medicine, CA 94305-5105.

Immunocompromised patients are at increased risk for CNS and disseminated
varicella zoster virus (VZV) infection. In this report we present the MR findings
in a leukemic patient with active, biopsy-proven VZV leukoencephalitis. The
characteristic MR features of this infection were clustered subcortical
plaque-like lesions demonstrating rapid demyelination. Active lesions enhanced
with intravenous contrast medium administration. Edema and hemorrhage were not
prominent early findings but developed as the infection evolved. These findings
were strikingly similar to those reported in prior autopsy studies of
immunocompromised patients with VZV leukoencephalitis.

Publication Types: 
    Case Reports

PMID: 8384224 [PubMed - indexed for MEDLINE]

5199: Tunis Med. 1993 Mar;71(3):119-22.

[Cutaneous manifestations of AIDS]

[Article in French]

Marrakchi H, Mokhtar I, Zarrouk H, Daghfous M, Kamoun MR.

Service de Dermatologie, Hopital Charles Nicolle, Tunis.

PIP: HIV destroys the immune system, causing group of clinical signs which are
referred to as AIDS. Some of these signs are cutaneous in nature. An acute rash
on the trunk is associated with HIV seroconversion. It usually disappears in 8
days but can last for several hours or 30 days. Infectious manifestations of HIV 
infection are common. Candidiasis represents 90% of mycoses. It usually manifests
on the tongue but can also occur on oral or genital mucosa. Antifungal medication
usually treats it effectively. Yeastlike fungi cause seborrheic dermatitis, which
is characterized by profuse inflammatory lesions resembling psoriasis. Topical
and general antifungal medication do not effectively treat it. Dermacorticoids
are more likely to be successful. Dermaphyte infections also occur HIV-infected
persons. Organisms responsible for cutaneous profound mycoses, which tend to be
rare but fatal, include Cryptococcus neoformans, Histoplasma capsulatum,
sporotrichoses, scopulariopsis, and Pneumocystis carinii. Amphotericin B is the
treatment of choice for manifestation of the first 2 organisms. Cutaneous viral
infections in HIV-infected persons are caused by herpes simplex virus, herpes
zoster, cytomegalovirus, Epstein Barr virus, Pox virus, and human papilloma
virus. A patient who has had chronic cutaneous or mucosal herpes simplex
infection for more than 1 month should be suspected of having HIV infection.
Actclovir can treat herpes simplex infection, herpes zoster infection, and
Epstein Barr virus (to make lesions disappear). Cytomegalovirus lesions are not
specific. Cytomegalovirus infection is generally fatal. Cutaneous bacteria
infections include banal infections (e.g., acne and folliculitis), syphilitic
chancre lesions, and granulomatous tuberculosis. Protozoans and arthropods also
cause cutaneous conditions in HIV-infected patients. Cutaneous neoplasms include 
Kaposi's sarcoma and other tumors (e.g., lymphomas). Other dermatoses are rare
but may include psoriasis and toxidermia.

Publication Types: 
    Review

PMID: 8351723 [PubMed - indexed for MEDLINE]

5200: Rev Invest Clin. 1993 Mar-Apr;45(2):133-8.

Transfusion associated AIDS in Mexico. Clinical spectrum, conditional latency
distribution, and survival.

Volkow P, Ponce de Leon S, Calva J, Ruiz-Palacios G, Mohar A.

Department of Infectious Diseases, Instituto Nacional de Cancerologia, Mexico,
D.F.

There is very little information on the clinical spectrum and the incubation
period among AIDS patients in Latin America. This study reports the clinical
spectrum, survival, and the incubation period for a group of Mexican patients
infected with HIV-1 as a result of contaminated blood transfusion. We analyzed
data from 39 patients of whom date of transfusion and diagnosis were known. The
clinical spectrum of the disease was compared with a group of AIDS Mexican
patients infected by sexual route. The prevalence distribution of opportunistic
infections was similar in both groups. However, there was a significant
difference in the distribution of opportunistic malignancies, i.e., Kaposi's
sarcoma was observed only in the homosexual group. AIDS developed within 48
months after infection (3% within 12 months after transfusion, 50% within 29
months, 75% within 36 months, and the remaining within four years). The mean
survival was of nine months after AIDS is made, the survival in this group of
AIDS Mexican patients was similar to that observed in other HIV-1 exposed risk
groups in Mexico. These findings suggest that the route of exposure to HIV-1 may 
have prognostic implications in the natural history of this infection in the
Mexican population.

PIP: Transfusions-associated AIDS represents 14.7% of total AIDS cases reported
to the National Council of AIDS in Mexico. The incidence of HIV infection via
this route and the resulting related prevalence of AIDS patients have rapidly
increased since 1987 as a result of the high seroprevalence of HIV-1 infection
among the pool of paid blood donors; 7.2% of 9100 donors screened between June
and November 1986 were HIV-seropositive. This paper presents the clinical
spectrum, survival, and incubation period for 39 Mexican patients with AIDS
infected with HIV-1 from contaminated blood transfusions. The authors compare
these data with corresponding information on a group of 107 homosexual Mexican
AIDS patients at the National Institute of Nutrition infected with HIV through
sexual intercourse. The former group was comprised of 13 men and 26 women of mean
age 38.8 years over the range 2-76 years from 3 hospitals in Mexico City. The
Kaplan-Meier method was used to determine mean survival. The prevalence
distribution of opportunistic infections was similar between groups. The
distribution of opportunistic malignancies was, however, significantly different 
between groups, with Kaposi's sarcoma being present among only the homosexuals
(47%). Herpes zoster was present among 21% of those infected via transfusion, but
in only 7% of the homosexuals. AIDS developed within 48 months after infection in
the transfusion-infected individuals and they survived for a mean period of 9
months after being diagnosed with AIDS. This average survival period is similar
to that observed in other HIV-1 exposed risk groups in Mexico. These findings
suggest that the route of exposure to HIV-1 may have prognostic implications in
the natural history of infection in the Mexican population.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8337540 [PubMed - indexed for MEDLINE]

5201: Chin Med Sci J. 1993 Mar;8(1):38-40.

Treatment of herpes zoster: recombinant alpha-2a-interferon versus acyclovir and 
vitamin therapy. Clinical Study Group on Interferon.

Yu B.

PUMC Hospital, CAMS, Beijing.

The efficacy of r-interferon alpha 2a (IFM) versus acyclovir (ACV) and vitamin
therapy in the treatment of herpes zoster is reported. A total of 305 patients
were randomly divided into 3 groups. One million units of IFN were administered
i.n. once a day for 6 days in 223 cases, oral ACV 200 mg five times daily for 7
days in 34 cases, and vitamin B12, B1 and B2 therapy at conventional doses for
7-14 days in 48 cases. The results showed that both IFN and ACV could reduce pain
in patients with herpes zoster and cut the total duration of symptoms, in
comparison with vitamin therapy (P < 0.01). In the IFN group, 45 patients (20.2%)
experienced side effects, including mild fever in 35 cases (15.7%) and a slightly
depressed leukocyte count or increased serum ALT level (3 cases each). In the ACV
group, one complained of discomfort in the gastroenteric tract, and another
patient reported lumbodynia.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 8274720 [PubMed - indexed for MEDLINE]

5202: J Assoc Physicians India. 1993 Mar;41(3):178.

Unilateral ataxia following herpes zoster of spinal C4 segment.

Keswani P, Gupta R, Singh KP, Juneja P, Chablani P.

Department of Medicine, Monilek Hospital & Research Centre, Jawahar Nagar,
Jaipur.

Focal lesions of central nervous system are extremely rare following cutaneous
herpes zoster. A 55 year old male developed cerebellar speech, right sided ataxia
and intention tremor, three weeks after herpes zoster of right spinal C4 segment.
Clinical examination and investigations confirmed a focal vascular lesion in the 
midbrain suggestive of granulomatous angiitis which can cause focal neurological 
defect after herpes zoster.

Publication Types: 
    Case Reports

PMID: 8226607 [PubMed - indexed for MEDLINE]

5203: Ugeskr Laeger. 1993 Feb 22;155(8):536-40.

[Neurological complications of herpes zoster in the central nervous system]

[Article in Danish]

Andersen B.

Neuromedicinsk afdeling, Kobenhavns Amts Sygehus i Glostrup.

The Varicella zoster virus may affect the central nervous system (CNS) as a
complication of herpes zoster (HZ). A series of neurological syndromes are
described and, on the basis of a review of the literature and two illustrative
case histories, the symptomatology, pathogenesis, therapeutic possibilities and
the diagnostic difficulties in HZ-associated cerebral vasculitis and
HZ-associated encephalitis are reviewed. Progressive multifocal encephalopathy in
immune-insufficient individuals is briefly mentioned. The diagnosis is most
frequently established on the basis of the clinical picture when the
characteristic symptoms develop in connection with cutaneous HZ. A long latent
period may result in defective recognition of the connection. Immuno-suppression 
and dissemination are critical determinants for the course of the condition but, 
in immune-competent individuals, the morbidity and mortality are low. Treatment
with acyclovir is employed to an increasing extent with good results but the
conditions are rare and clinically controlled investigations are not available.
It is important that the possibility of HZ-associated CNS-disease is borne in
mind, in view of the therapeutic possibilities. The pathogeneses of these
complications is little understood but there is increasing evidence that a direct
viral invasion is the mechanism responsible. A post-infectious immune-mediate
mechanism is also another popular opinion.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8451785 [PubMed - indexed for MEDLINE]

5204: Ugeskr Laeger. 1993 Feb 22;155(8):528-32.

[Human herpesvirus infections. A clinical review]

[Article in Danish]

Peterslund NA.

Medicinsk haematologisk afdeling, Arhus Amtssygehus.

Publication Types: 
    Review

PMID: 8383894 [PubMed - indexed for MEDLINE]

5205: Am J Epidemiol. 1993 Feb 15;137(4):439-46.

Clinical factors associated with weight loss related to infection with human
immunodeficiency virus type 1 in the Multicenter AIDS Cohort Study.

Graham NM, Munoz A, Bacellar H, Kingsley LA, Visscher BR, Phair JP.

Department of Epidemiology, Johns Hopkins University School of Hygiene and Public
Health, Baltimore, MD.

The relation between a number of potential risk factors and change in body mass
index per semester was examined in a community-based cohort of 1,809 homosexual
and bisexual men seropositive for human immunodeficiency virus type 1 (HIV-1).
The men were followed semiannually for up to 6.5 years between 1984 and 1990. A
total of 9,735 person-semesters of observations were available for analysis. A
Markov-type autoregressive model, adjusting for previous body mass index, was
used to predict the change in body mass index over each person-semester. Overall,
the cohort was gaining weight. An asymptomatic participant 1.8 m in height whose 
CD4+ cell count was > 750/microliters gained a mean of 0.5 kg each
person-semester. In bivariate autoregressive models, diarrhea, fever, oral
thrush, acquired immunodeficiency syndrome (AIDS), and CD4+ lymphocyte counts of 
< 100 and 100-199 cells/microliters were all associated with a significant
decrease in body mass index. A significant inverse association was also found
between change in body mass index and lymphadenopathy and herpes zoster, but when
the intercept coefficient was added, no overall decrease in body mass index was
seen in these models. In a final multivariate model, diarrhea was less strongly
associated with a change in body mass index (p = 0.057), although AIDS (p =
0.009), fever (p = 0.006), thrush (p = 0.002), and a CD4+ lymphocyte count of <
100 cells/microliters (p < 0.001) all remained independently associated with a
decrease in body mass index. Lymphadenopathy and a CD4+ lymphocyte count of
100-199 cells/microliters were also significant covariates in the final model,
but neither of the beta coefficients exceeded that of the intercept, indicating
that they were not independently associated with a decrease in body mass index.
These findings suggest that the importance of diarrhea as a cause of HIV-related 
weight loss may have been over-estimated in previous clinic-based studies. AIDS
and nonspecific markers of progression (fever, thrush, and a CD4+ count of < 100 
cells/microliters) were the best predictors of weight loss during a semester.

Publication Types: 
    Multicenter Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 8096357 [PubMed - indexed for MEDLINE]

5206: Lancet. 1993 Feb 13;341(8842):447.

Zoster after shiatsu massage.

Mumm AH, Morens DM, Elm JL, Diwan AR.

Publication Types: 
    Case Reports
    Letter

PMID: 8094222 [PubMed - indexed for MEDLINE]

5207: Nucleic Acids Res. 1993 Feb 11;21(3):513-22.

The DNA binding domain of the varicella-zoster virus gene 62 protein interacts
with multiple sequences which are similar to the binding site of the related
protein of herpes simplex virus type 1.

Tyler JK, Everett RD.

MRC Virology Unit, Glasgow, UK.

Varicella-zoster virus gene 62 encodes a protein with predicted Mr of 140,000D
(VZV 140k) that shares extensive predicted amino acid sequence homology with the 
major immediate early (IE) transcriptional regulator protein of herpes simplex
virus type 1 (HSV-1) Vmw175. The integrity of highly conserved region 2 is
essential for the DNA binding and transcriptional regulatory functions of Vmw175.
Similarly, an insertion mutation in region 2 (codons 468-641) of 140k eliminates 
the transcriptional repression and activation functions of this protein. We have 
expressed a fragment of 140k which encompasses region 2 as a non-fusion
polypeptide in bacteria. This 140k DNA binding domain peptide (codons 417-646)
binds to numerous DNA sequences throughout the VZV gene 62 promoter region. It
induces multiple regions of protection from DNase I digestion, flanked by sites
of DNase I hypersensitivity. Several of the sites recognized can be considered to
be divergent forms of the consensus sequence which is recognized by Vmw175.
However, by use of a panel of mutagenized probe fragments, we found that the 140k
DNA binding domain was less sequence-specific than Vmw175 in its interactions
with DNA. Consistent with this, the homologous Vmw175 DNA binding domain, and
also intact Vmw175, recognize the gene 62 binding sites much less efficiently
than the 140k DNA binding domain. Also in contrast to the situation with Vmw175, 
the 140k DNA binding domain failed to induce DNA bending when occupying the
binding sites in its own promoter. Deletion analysis has mapped the minimal DNA
binding domain of the VZV 140k protein, as measured in gel retardation analysis, 
to lie within residues 472 to 633. The differences in binding characteristics of 
the DNA binding domains of the homologous VZV 140k and HSV-1 Vmw175 IE proteins
may account for the subtle differences in their regulatory activities in
transfection assays and during virus growth in tissue culture.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8382799 [PubMed - indexed for MEDLINE]

5208: J Indian Med Assoc. 1993 Feb;91(2):46-7.

Postherpetic neuralgia and its managements.

Rudra A, Mitra A, Pan AK, Roy M.

Department of Anaesthesiology, NRS Medical College, Calcutta.

Publication Types: 
    Review

PMID: 8501317 [PubMed - indexed for MEDLINE]

5209: Pediatr Emerg Care. 1993 Feb;9(1):33-5.

Pediatric herpes zoster with mild cutaneous dissemination.

Courter BJ.

Department of Emergency Medicine, Greenville Hospital System, South Carolina.

The textbook division of herpes zoster into segmental or disseminated is too
simple and limited. Like all diseases, herpes zoster presents as a spectrum of
disease. Mild cutaneous dissemination represents a "transition zone" in this
spectrum and appears to be a benign clinical variant. This case of pediatric
herpes zoster with mild cutaneous dissemination did not need aggressive inpatient
treatment with IV agents; appropriate treatment included close follow-up.
Optional treatment with high-dose oral acyclovir was also instituted.

Publication Types: 
    Case Reports

PMID: 8488143 [PubMed - indexed for MEDLINE]

5210: Klin Monatsbl Augenheilkd. 1993 Feb;202(2):102-9.

[Tarsoconjunctival advancement--a surgical procedure in cicatricial entropion
with marginal tarsus deformation]

[Article in German]

Kuckelkorn R, Becker J, Reim M.

Augenklinik der Medizinischen Fakultat, Rheinisch-Westfalischen Technischen
Hochschule RWTH.

BACKGROUND: After severe chemical and thermal burns, and in chronic inflammatory 
conditions of the conjunctiva frequently scarring of the tarsal plate with
distortion of the eyelid margin and keratinization of the tarsal conjunctiva
could be found. This condition is accompanied with chronic inflammation and
malposition of the eyelids resulting in entropion and trichiasis. PATIENTS AND
METHODS: A surgical procedure is introduced separating the scarred and shortened 
tarsal plate from the cutis-muscle sheet. After excision of tarsal scar tissue
and of the marginal metaplastic tarsus a new eyelid margin is formed by
tarso-conjunctival advancement, correcting trichiasis and cicatricial entropion. 
During the time from August 1984 to December 1991 this surgical procedure was
conducted on 16 patients, correcting 18 upper and 4 lower eyelids. 11 patients
suffered from severe chemical and thermal burns, 2 patients from
Stevens-Johnson-syndrome, 2 patients from ocular pemphigoid and 1 patient from
herpes zoster infection. RESULTS: All patients were examined at least once in the
first 6 postoperative months, 11 patients are still under continuing outpatient
review. The mean follow-up time is 27 months, the minimum follow-up period is 7
months. In 7 patients the surgical procedure prepared conditions for a successful
keratoplasty and in 5 other cases the keratopathy healed. In 4 cases a recurrence
of the entropion occurred (18% recurrence rate). CONCLUSIONS: The presented
surgical procedure is a promising alternative to more complicated procedures for 
correcting cicatricial entropion with keratinization of the marginal tarsus.

Publication Types: 
    Case Reports
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 8487462 [PubMed - indexed for MEDLINE]

5211: Anaesthesist. 1993 Feb;42(2):119-28.

[The stellate ganglion blockade]

[Article in German]

Hempel V.

Klinik fur Anaesthesiologie, Krankenanstalten Konstanz.

Stellate ganglion block is a selective sympathetic blockade affecting one side of
the head and neck, and the upper extremity and upper part of the thorax on the
same side. It is an important method of treating impaired vascular circulation,
sympathetic reflex dystrophy, causalgia and herpes zoster in the area other
indications, e.g. acute hearing loss and retinal arterial spasms, are still
disputed. The anatomy of the cervical sympathetic chain, the technique used to
achieve the block (paratracheal access) and tests of the effectiveness of
stellate ganglion blockade are described. The side-effects and complications of
the method and other means of sympathetic blockade are discussed. Patients need
to be informed of the possible complications and the alternatives available
before being asked to give informed consent.

Publication Types: 
    English Abstract
    Review

PMID: 8470786 [PubMed - indexed for MEDLINE]

5212: Med J Aust. 1993 Feb 1;158(3):186-7.

Unusual features of herpes simplex or zoster infection that suggest HIV
infection.

Crowe SM.

Macfarlane Burnet Centre for Medical Research, Fairfield Hospital, Vic.

Patients with herpes simplex or zoster infections are common in most medical
practices. These infections are also very important in HIV medicine, often
presenting in an otherwise well person. Knowledge of the effects of immune
deficiency on herpes simplex and zoster infection assists in determining when to 
consider HIV.

Publication Types: 
    Case Reports

PMID: 8450787 [PubMed - indexed for MEDLINE]

5213: Aust Fam Physician. 1993 Feb;22(2):195.

A case of unilateral painful eye.

Thomas P.

Emergency Department, Princess Alexandra Hospital, Queensland.

A 24 year old man presented with a painful eye that had been treated empirically 
with steroid drops. The case is presented to illustrate that before prescribing
steroid eye drops, a definitive diagnosis must be reached and this often requires
the services of an ophthalmologist.

Publication Types: 
    Case Reports

PMID: 8447789 [PubMed - indexed for MEDLINE]

5214: J Am Acad Dermatol. 1993 Feb;28(2 Pt 2):306-8.

Chronic hyperkeratotic herpes zoster and human immunodeficiency virus infection.

Grossman MC, Grossman ME.

Department of Dermatology, College of Physicians and Surgeons, New York, NY
10032.

A patient with human immunodeficiency virus infection had hyperkeratotic papules 
in the T 11 and T 12 dermatomes in which she previously had papulovesicular
herpes zoster. Findings of a biopsy specimen and viral culture of these papules
subsequently revealed varicella-zoster that eventually responded to prolonged
high-dose acyclovir therapy and debridement. A review of reported cases of
hyperkeratotic varicella-zoster infections is presented, in addition to our
recommendations for the treatment of varicella-zoster infection in patients who
have acquired immunodeficiency syndrome.

Publication Types: 
    Case Reports
    Review

PMID: 8436645 [PubMed - indexed for MEDLINE]

5215: Arch Ophthalmol. 1993 Feb;111(2):167-8.

Detection of varicella-zoster virus DNA in disciform keratitis using polymerase
chain reaction.

Yu DD, Lemp MA, Mathers WD, Espy M, White T.

Publication Types: 
    Case Reports
    Letter

PMID: 8431148 [PubMed - indexed for MEDLINE]

5216: Am J Med. 1993 Feb;94(2):212-5.

Acyclovir-induced neurotoxicity: concentration-side effect relationship in
acyclovir overdose.

Haefeli WE, Schoenenberger RA, Weiss P, Ritz RF.

Department of Internal Medicine, University Hospital (Kantonsspital), Basel,
Switzerland.

PURPOSE: To investigate the concentration-side effect relationship in a patient
with severe acyclovir-induced neurotoxicity and to summarize the information
available in the literature about central nervous system side effects due to
acyclovir. METHODS: Repeated blood samples were drawn in a patient with severe
acyclovir overdose who developed coma and nonoliguric renal failure. The
acyclovir levels measured by radioimmunoassay were related to the level of
consciousness. RESULTS: We measured the highest acyclovir serum levels reported
so far (229.9 mumol/L = 51.8 mg/L). Impairment of consciousness developed with a 
remarkable temporal delay of 24 to 48 hours after occurrence of peak serum
concentrations and resolved with a comparable delay after reaching the
therapeutic range (anticlockwise hysteresis). Six days after discontinuation of
the drug, central nervous system symptoms had resolved, and, 4 days later, renal 
function returned to pretreatment values. CONCLUSIONS: The observation that
neurotoxicity developed with a delay of 24 to 48 hours after acyclovir peak serum
concentrations could explain the wide range of acyclovir levels reported in
similar cases. Single drug level measurements may therefore be of little
diagnostic value. Since toxicity develops with a remarkable delay, early removal 
of the drug (by hemodialysis) could possibly prevent central nervous toxicity.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Review

PMID: 8430717 [PubMed - indexed for MEDLINE]

5217: Blood. 1993 Feb 1;81(3):828-34.

Human immunodeficiency virus-related conditions in children and adults with
hemophilia: rates, relationship to CD4 counts, and predictive value.

Eyster ME, Rabkin CS, Hilgartner MW, Aledort LM, Ragni MV, Sprandio J, White GC, 
Eichinger S, de Moerloose P, Andes WA, et al.

Department of Medicine, Pennsylvania State University School of Medicine,
Hershey.

To further elucidate the natural history of human immunodeficiency virus (HIV)
infection, we studied intermediate HIV-related conditions occurring before
acquired immunodeficiency syndrome (AIDS) in a prospectively observed multicenter
cohort of 738 HIV-infected persons with hemophilia. We analyzed the frequency in 
adults and children of common HIV-related conditions and the relative risk of
AIDS after occurrence of these conditions, controlling for age at seroconversion 
and the percentage of CD4+ lymphocytes. Thrombocytopenia was the most frequently 
observed condition with cumulative incidences of 43% +/- 7% in adults and 27% +/-
6% in children and adolescents by 10 years after seroconversion. Oral
candidiasis, fever, weight loss, and non-AIDS pneumonia were two to four times
more common in adults than children, whereas herpes zoster risk was similar in
the two age groups. HIV-related conditions were infrequent during the first 4
years of infection, particularly in children. With the exception of
thrombocytopenia, mean CD4 counts were less than 350 cells/microL at the onset of
the conditions. The relative hazard of AIDS after oral candidiasis was 18 in
children and 3.8 in adults. Relative hazard in adults was also increased after
persistent fever (10), weight loss (3.2), and non-AIDS pneumonia (2.2). Herpes
zoster and thrombocytopenia were not significantly associated with AIDS in either
age group. We conclude that intermediate HIV-related conditions occur more
frequently in adults than in children with hemophilia. Persistent fever is the
strongest predictor of AIDS in adults, whereas oral candidiasis is the strongest 
predictor in children. These findings should facilitate the design and conduct of
clinical trials as well as the management of HIV-infected children and adults.

Publication Types: 
    Multicenter Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8427974 [PubMed - indexed for MEDLINE]

5218: J Cutan Pathol. 1993 Feb;20(1):28-33.

Varicella-zoster virus DNA in granulomatous skin lesions following herpes zoster.
A study by the polymerase chain reaction.

Serfling U, Penneys NS, Zhu WY, Sisto M, Leonardi C.

Granulomatous reactions at sites of previous cutaneous herpes zoster lesions
occur, but their etiology is not known. Three tissue specimens from 5 cases
identified clinically and histologically as post-zosteric granulomatous reactions
were studied for the presence of varicella-zoster virus (VZV) deoxyribonucleic
acid (DNA) by the polymerase chain reaction using specific primers for VZV. VZV
DNA was detected in 1 of 3 cases where the granulomatous reaction occurred
immediately in the wake of resolving vesicular herpes zoster lesions. Finding
viral DNA in earlier reactions probably represents residue from the active
herpetic process. VZV DNA was not identified in granulomatous reactions arising
between 1 month and up to 4 years after resolved herpes zoster. The negative
result in these cases supports the hypothesis that there is no association
between persistence of VZV DNA and granuloma formation. How long VZV DNA is
detectable at sites of resolved herpes zoster lesions could be the subject of
further studies.

Publication Types: 
    Case Reports

PMID: 8385680 [PubMed - indexed for MEDLINE]

5219: Zhonghua Yi Xue Za Zhi (Taipei). 1993 Feb;51(2):116-22.

Acute retinal necrosis syndrome.

Chung YM, Liu JH, Yeh TS.

Department of Ophthalmology, National Yang-Ming Medical College, Taipei, Taiwan, 
Republic of China.

Acute retinal necrosis syndrome (ARN) is a rare and potentially visually
devastating syndrome that occurs in otherwise healthy patients. We present ten
cases seen at the Veterans General Hospital-Taipei from 1985 to 1990. All
patients were male. The onset occurred at the age of 19 to 71 years (43.7 in
average). All except one case were unilaterally involved. Among the 11 diseased
eyes, 4 eyes of 3 cases recovered a fair vision and the rest 7 eyes nearly lost
vision. There was nearly total blindness in the earlier cases. Retinal detachment
occurred in 7 cases (70%). Intraocular antibody production by determining the
Goldmann-Witmer coefficient was calculated in 9 cases. It was found significant
elevation of varicella zoster virus in 8 cases and of herpes simplex virus in 1. 
Although all patients appeared healthy with nothing particular in the past
history, a decreased reaction to delayed type hypersensitivity as performed with 
skin anergy panel test was found in 4 of 5 performed patients.

Publication Types: 
    Case Reports

PMID: 8385549 [PubMed - indexed for MEDLINE]

5220: Geburtshilfe Frauenheilkd. 1993 Feb;53(2):105-7.

[Diaplacental transmission of varicella zoster virus antibodies after chickenpox 
at the time of birth]

[Article in German]

Eis-Hubinger AM, Quade A, Lutzke G, Schneweis KE, Niesen M, Diedrich K.

Zentrum fur Hygiene und Medizinische Mikrobiologie, Universitat Bonn.

A pregnant woman with post-term birth developed a varicella rash on the day, when
birth was to be initiated. The date was then postponed, until varicella zoster
virus (VZV) IgG-antibodies could be proved in the mother, so as to allow the
child to achieve an adequate diaplacental passive immunisation. Cesarean section 
was performed on the 7th day after the rash, but a comparison of the child's
blood (from the umbilical cord) with the mother's blood showed, that the VZV
antibodies developed by the mother during this time were only present in a
tenfold reduced amount in the child. Antibodies to herpes simplex virus, already 
present in the mother's blood before the VZV infection, also increased because of
the close relationship of the virus to VZV. Similar to the VZV antibodies, these 
antibodies did not increase in the baby as in the mother. Our results show that
maternal antibodies are not transferred rapidly to the baby, and therefore it
seems reasonable, that in the case of chickenpox at the time of delivery, the
birth should be delayed, not only until seroconversion in the mother's blood, but
- if possible - a few days longer.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8385048 [PubMed - indexed for MEDLINE]

5221: Clin Infect Dis. 1993 Feb;16(2):208-12.

Comment in:
    Clin Infect Dis. 1993 Nov;17(5):943-4.

Varicella-zoster virus retinitis in a patient with AIDS-related complex: case
report and brief review of the acute retinal necrosis syndrome.

Hellinger WC, Bolling JP, Smith TF, Campbell RJ.

Section of Infectious Diseases, Mayo Clinic Jacksonville, Florida 32224.

Retinitis reminiscent of the acute retinal necrosis syndrome was recognized in a 
patient with AIDS-related complex after he had experienced several episodes of a 
sacral, dermatomic zosteriform eruption. Varicella-zoster virus (VZV) was
subsequently recovered from cell culture of retinal tissue. The literature on VZV
retinitis, including that on acute retinal necrosis, is reviewed. Dissemination
of VZV infection in AIDS is also reviewed. Features that differentiate the
findings and course of VZV retinitis in patients with AIDS from those in
otherwise healthy adults are noted and related to potentially different
pathogenic mechanisms. This unusual and recently recognized complication of
herpesvirus infection may be promoted by AIDS-related immunosuppression. Acute
retinal necrosis and other more-recently described forms of VZV retinitis, which 
have primarily been subjects of the ophthalmologic literature, merit the
attention of clinicians and investigators of infectious diseases.

Publication Types: 
    Case Reports
    Review

PMID: 8382963 [PubMed - indexed for MEDLINE]

5222: Oral Surg Oral Med Oral Pathol. 1993 Feb;75(2):173-5.

Zoster sine herpete of the trigeminal nerve.

Barrett AP, Katelaris CH, Morris JG, Schifter M.

Westmead Hospital Dental Clinical School, New South Wales, Australia.

Zoster sine herpete infection that involves the trigeminal nerve is rarely
reported. The present case details a case of varicella zoster virus infection of 
the mandibular division of the left trigeminal nerve without evidence of a
vesicular eruption. The diagnosis was established on clinical findings and was
supported by the demonstration of an IgG antibody titer of > 1:640 during the
acute phase of the disease.

Publication Types: 
    Case Reports

PMID: 8381216 [PubMed - indexed for MEDLINE]

5223: J Assoc Physicians India. 1993 Feb;41(2):113-4.

Ramsay Hunt syndrome with aseptic meningitis.

Bhattacharyya PC, Kakati S.

Assam Medical College, Dibrugarh.

A case of Ramsay Hunt Syndrome with characteristic vesicles on the lateral aspect
of the left pinna, evidence of infranuclear palsy of the left 7th cranial nerve, 
associated with same sided loss of taste sensation in the presulcal area of the
tongue and perceptive deafness without vestibular disturbances is reported here. 
The patient had evidence of aseptic meningitis.

Publication Types: 
    Case Reports

PMID: 8335601 [PubMed - indexed for MEDLINE]

5224: Lik Sprava. 1993 Feb-Mar;(2-3):128-31.

[Herpes zoster in hematology patients]

[Article in Ukrainian]

Turkot LA, Donets' IA, Kmita VV.

A clinical course of herpes zoster in hematological patients (chronic
lympholeukosis, lymphogranulomatosis, acute leucosis, myeloma disease, chronic
agranulocytosis) is presented. These patients exhibited a more severe course of
herpes zoster that is caused by immunodeficiency state. It is judicious to treat 
the patients with reaferon.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 8191711 [PubMed - indexed for MEDLINE]

5225: J Hosp Infect. 1993 Feb;23(2):161-2.

Comment on:
    J Hosp Infect. 1992 Feb;20(2):125-6.

Susceptibility of hospital staff to varicella-zoster virus infection in Hong
Kong.

Bassett DC, Ho AK, Cheng AF.

Publication Types: 
    Comment
    Letter

PMID: 8097220 [PubMed - indexed for MEDLINE]

5226: Dtsch Med Wochenschr. 1993 Jan 12;118(1-2):30-7.

[Skin and mucosal infections caused by viruses of the herpesvirus group in HIV
infections]

[Article in German]

Plettenberg A, Stoehr A, Meigel W.

Interdisziplinare HIV-Ambulanz des Allgemeinen Krankenhauses St. Georg, Hamburg.

Publication Types: 
    Review

PMID: 8380556 [PubMed - indexed for MEDLINE]

5227: Rom J Virol. 1993 Jan-Jun;44(1-2):91-5.

[Beneficial effects of immunostimulant and antiviral therapy of ophthalmic herpes
zoster]

[Article in French]

Topciu V, Chercota G, Mihailescu R, Nadolnic A.

Universite de Medecine et Pharmacie, Timisoara, Roumanie.

A group of 16 patients with ophthalmic zona zoster received antiviral and
immunostimulative treatment with Romanian specific products. Results were
spectacular. The problem of the identity of the varicella and zoster viruses is
discussed.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    English Abstract

PMID: 9702254 [PubMed - indexed for MEDLINE]

5228: Rom J Virol. 1993 Jan-Jun;44(1-2):17-20.

[Moroxidine, an antiviral agent used for the treatment of shingles (herpes
zoster)]

[Article in French]

Athanasiu P, Petrescu A, Vulcan V.

Institut de Virologie Stefan S. Nicolau, Bucarest, Roumanie.

Treatment with moroxidine, Romanian preparation with virustatic effects, was
applied in 350 patients with different localisation herpes zoster lesions.
Treatment had good effects, especially when it was applied early.

Publication Types: 
    English Abstract

PMID: 9702246 [PubMed - indexed for MEDLINE]

5229: Neuroradiology. 1993;35(4):269.

Gadolinium-enhanced MRI in a patient with AIDS and the Ramsay-Hunt syndrome.

Li J, Xiong L, Jinkins JR.

Neuroradiology Section, University of Texas Health Science Center, San Antonio
78284-7800.

Publication Types: 
    Case Reports

PMID: 8492890 [PubMed - indexed for MEDLINE]

5230: Acta Otolaryngol Suppl. 1993;504:125-9.

A case of Bickerstaff's encephalitis. With special reference to neurotological
findings.

Omura A, Watanabe Y, Kobayashi H, Shojaku H, Mizukoshi K.

Department of Otorhinolaryngology, Faculty of Medicine, Toyama Medical and
Pharmaceutical University, Japan.

The case of a 60-year old male with prodromal common cold symptoms and
progression of brain stem involvement with no cardiac or respiratory
complications is described. This conformed to the criteria of Bickerstaff's
encephalitis. Neurotological examinations, including the OKN test, the caloric
test, and the GBST were performed from onset to recovery of the disease. The
results of these tests closely reflected the central nervous system disorders
each time, but there was a discrepancy in the results of the two test batteries
of equilibrium function, the caloric test and the GBST. The caloric test showed
bilateral canal paresis while the GBST showed normal responses. These results
suggested that the involved area of the vestibular nucleus was localized to the
superior portions. Form our clinical observations, we can conclude that
neurotological examinations provide more vital information for localized
diagnosis and follow-up of the brain stem lesion in Bickerstaff's encephalitis.

Publication Types: 
    Case Reports

PMID: 8470517 [PubMed - indexed for MEDLINE]

5231: Eur Neurol. 1993;33(2):156-8.

Guillain-Barre syndrome after herpes zoster infection: a report of 2 cases.

Ormerod IE, Cockerell OC.

Department of Neurology, St Thomas' Hospital, London, UK.

We report 2 patients with Guillain-Barre syndrome following infection with the
varicella-zoster virus. Evidence from neurophysiological studies is provided and 
the literature is reviewed on the association between these conditions.

Publication Types: 
    Case Reports
    Review

PMID: 8467824 [PubMed - indexed for MEDLINE]

5232: Dysphagia. 1993;8(2):79-82.

The gastroenterologist's approach to dysphagia.

Lorenz R, Jorysz G, Tornieporth N, Classen M.

Department of Internal Medicine II, Technical University of Munich, Germany.

In the gastroenterological diagnostic armamentarium, dysphagia is considered as
an important symptom for diseases of the esophagus. Concerning the history of
illness, symptoms such as retrosternal pain and heartburn are often associated
with gastroesophageal reflux disease. Morphological changes of the mucosa can be 
diagnosed by flexible endoscopy and radiographic examinations. Investigation with
24-h pH monitoring, manometry, and pharmacological tests is necessary for the
diagnosis of functional disorders. Additionally, dysphagia can be associated with
multiple internal diseases, including muscular diseases such as dermatomyositis, 
progressive systemic sclerosis, as well as lupus erythematosus. Difficulties in
swallowing associated with hypo- and hyperthyroidism can also be interpreted as
muscular lesions. Metabolic disorders such as alcoholism, and diabetes mellitus
can be the cause of dysphagia. Increasing importance in the differential
diagnosis of dysphagia is attached to infections of the upper GI tract.
Especially in immunocompromised patients, infections of Candida albicans,
mycobacterias, herpes, varicella zoster, and cytomegaloviruses can produce
dysphagia and odynophagia. The differential diagnosis of the "angina-like chest
pain" has to differentiate between cardiac disease and a noncardiac genesis.
Therefore, besides the cardiac diagnostic investigation, endoscopy, radiography, 
and manometry are often indicated.

Publication Types: 
    Review

PMID: 8467728 [PubMed - indexed for MEDLINE]

5233: Union Med Can. 1993 Jan-Feb;122(1):31-6.

[The emergence of viruses resistant to antiviral agents: a new challenge]

[Article in French]

Boivin G.

Division of clinical microbiology, University of Minnesota Medical School.

Recent use of antiviral drugs and the increase in the number of viral infections 
in immunocompromised hosts have led to the development of viral resistance. In
this paper, the author reviews the antiviral drugs on the market, the antiviral
susceptibility tests and presents a review of the literature concerning
infections with resistant viruses. Acyclovir-resistant herpes simplex and
varicella-zoster virus, ganciclovir-resistant cytomegalovirus and
zidovudine-resistant human immunodeficiency virus will be discussed.

Publication Types: 
    English Abstract
    Review

PMID: 8465473 [PubMed - indexed for MEDLINE]

5234: J Infect. 1993 Jan;26(1):87-8.

Aseptic arthritis associated with herpes zoster.

Aarons EJ, Beeching NJ.

Regional Infectious Disease Unit, Fazakerley Hospital, Liverpool, U.K.

Arthritis associated with herpes zoster is rarely reported. We describe the
clinical features of an immunocompromised 54-year-old woman who developed sterile
arthritis of a knee in association with acute ipsilateral zoster of the L1/L2
dermatomes.

Publication Types: 
    Case Reports

PMID: 8454892 [PubMed - indexed for MEDLINE]

5235: Ostomy Wound Manage. 1993 Jan-Feb;39(1):44-5, 48, 50-1.

Case study: a hydrogel for infected herpes zoster lesions.

Harvey MJ.

Publication Types: 
    Case Reports

PMID: 8452622 [PubMed - indexed for MEDLINE]

5236: Acta Otolaryngol Suppl. 1993;500:58-61.

Enhanced MRI in patients with Ramsay-Hunt's syndrome.

Yanagida M, Ushiro K, Yamashita T, Kumazawa T, Katoh T.

Department of Otolaryngology, Kansai Medical University, Osaka, Japan.

Enhanced MRI was performed in 14 patients with Ramsay-Hunt's syndrome to
investigate the pathogenesis of this syndrome. All MRI studies were performed on 
a 0.5T superconductivity MRI system using a head coil with Gd-DTPA. Enhancement
was observed in the areas of the distal internal auditory canal and labyrinthine 
segment in many patients, and was especially prominent in patients suffering from
vertigo, tinnitus, and hearing loss. In some patients it involved not only the
facial nerve of the internal auditory canal but also the cochlear nerve and
vestibular nerves. Since histological changes of the facial nerve in patients
with Ramsay-Hunt's syndrome are assumed to occur in the distal internal auditory 
canal and labyrinthine segment, which is more proximal than the geniculate
ganglion, and the possibility is suggested that inflammation may spread to the
vestibular and cochlear nerve via the internal auditory canal.

Publication Types: 
    Case Reports

PMID: 8452022 [PubMed - indexed for MEDLINE]

5237: Clin Infect Dis. 1993 Jan;16(1):190-1.

Acute abdominal pain as a presenting symptom of varicella-zoster virus infection 
in recipients of bone marrow transplants.

Verdonck LF, Cornelissen JJ, Dekker AW, Rozenberg-Arska M.

Publication Types: 
    Case Reports
    Letter

PMID: 8448313 [PubMed - indexed for MEDLINE]

5238: Clin Exp Dermatol. 1993 Jan;18(1):92-3.

An unusual distribution of an acneiform rash due to herpes zoster infection.

Stubbings JM, Goodfield MJ.

Department of Dermatology, General Infirmary, Leeds, UK.

Acne can affect unusual sites and occur at unusual ages with little involvement
of the commonly affected sites. Discrete areas can be affected by acne which has 
been reported to occur in a naevoid form. We report a patient who developed an
acneiform rash in the site of a previous herpes zoster infection.

Publication Types: 
    Case Reports

PMID: 8440068 [PubMed - indexed for MEDLINE]

5239: Ann Ophthalmol. 1993 Jan;25(1):20-3.

Superior altitudinal hemianopia and herpes zoster.

Miyashita K, Kigasawa K, Mashima Y, Fujino T.

Department of Opthalmology, School of Medicine, Tokai University, Kanagawa,
Japan.

A healthy 41-year-old women had acute retrobulbar optic neuritis with superior
altitudinal hemianopia four weeks after cutaneous herpes zoster. Her visual
acuity decreased to 0.04 OD, and mild iritis was noticed. However,
ophthalmoscopic examination and fluorescein angiography disclosed no remarkable
change. She had a low amplitude during flash visual-evoked potential testing with
almost normal latency time in the acute stage. Corticosteroid therapy was
administered, and her visual acuity and visual-field defect rapidly improved.
Complete recovery, including the pattern-reversal visual-evoked potential
results, was obtained.

Publication Types: 
    Case Reports

PMID: 8427486 [PubMed - indexed for MEDLINE]

5240: Ann Ophthalmol. 1993 Jan;25(1):14-5.

Posttraumatic herpes zoster ophthalmicus as a presenting sign of human
immunodeficiency virus infection.

Netland PA, Zierhut M, Raizman MB.

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston.

We present the case of a 38-year-old man who developed herpes zoster ophthalmicus
after orbital blunt trauma. Additional evaluation revealed human immunodeficiency
virus type 1 (HIV-1) infection. This case shows that varicella-zoster may be
activated by local trauma and that herpes zoster ophthalmicus in young patients
may indicate underlying HIV-1 infection.

Publication Types: 
    Case Reports

PMID: 8427484 [PubMed - indexed for MEDLINE]

5241: AJNR Am J Neuroradiol. 1993 Jan-Feb;14(1):203-4.

MR of the spinal cord in a patient with herpes zoster.

Esposito MB, Arrington JA, Murtaugh FR, Coleman JM, Sergay SM.

Department of Radiology, University of South Florida College of Medicine, Tampa
33612.

Increased signal intensity on initial magnetic resonance images of the spinal
cord in a patient with herpes zoster demonstrated that this virus caused
inflammation of the cervical spinal cord. This pathology corresponded well with
neurologic deficits seen clinically, but the extent of the neurologic deficits
ultimately could not be determined by magnetic resonance of the spinal cord alone
because the nerve roots were also affected.

Publication Types: 
    Case Reports

PMID: 8427090 [PubMed - indexed for MEDLINE]

5242: AJNR Am J Neuroradiol. 1993 Jan-Feb;14(1):185-90.

Herpes zoster ophthalmicus with orbital pseudotumor syndrome complicated by optic
nerve infarction and cerebral granulomatous angiitis: MR-pathologic correlation.

Lexa FJ, Galetta SL, Yousem DM, Farber M, Oberholtzer JC, Atlas SW.

Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia
19104.

The authors describe a 41-year-old woman with herpes zoster ophthalmicus and
extensive intracranial and orbital involvement as documented by MR and
pathologically. MR showed all of the lesions that led to the ophthalmoplegia and 
pseudotumor syndrome, the periaxial infarct of the distal optic nerve, pontine
infarcts, and granulomatous angiitis of the meningeal vessels. MR is useful in
both detection and monitoring of the disease.

Publication Types: 
    Case Reports

PMID: 8427086 [PubMed - indexed for MEDLINE]

5243: Int J Dermatol. 1993 Jan;32(1):24-6.

Urinary retention associated with herpes zoster infection.

Cohen LM, Fowler JF, Owen LG, Callen JP.

Department of Medicine, University of Louisville School of Medicine, Kentucky.

BACKGROUND. Herpes zoster infection particularly involving the sacral dermatomes 
has been associated with bladder and bowel dysfunction, most commonly urinary
retention. CASE REPORTS. We report two patients who developed acute urinary
retention, one of whom also had constipation, within days of herpes zoster skin
lesions of the S2-S4 dermatomes. CONCLUSIONS. Herpes zoster is a reversible cause
of neurogenic bladder and bowel dysfunction and should be considered in a patient
that presents with acute urinary retention and/or constipation. Sensory
abnormalities and flaccid detrusor paralysis are most likely involved in the
pathogenesis.

Publication Types: 
    Case Reports

PMID: 8425796 [PubMed - indexed for MEDLINE]

5244: Transplantation. 1993 Jan;55(1):95-103.

Comment in:
    Transplantation. 1993 Sep;56(3):766.

The effect of cyclosporine on the progression of human immunodeficiency virus
type 1 infection transmitted by transplantation--data on four cases and review of
the literature.

Schwarz A, Offermann G, Keller F, Bennhold I, L'age-Stehr J, Krause PH, Mihatsch 
MJ.

Department of Nephrology, Free University, Berlin, Germany.

Two women and two men were infected with the human immunodeficiency virus type 1 
(HIV-1) transmitted by renal transplantation from i.v. drug-addicted donors in
1984. The four recipients were treated with cyclosporine and methylprednisolone
(one patient only for three months because of early graft failure). Two patients 
died 66 and 74 months after transplantation, one of endocarditis and one of
cerebral hemorrhage. Despite several infections including urinary tract infection
(n = 8), peritonitis (n = 1), shunt infection (n = 1), bronchitis (n = 1),
salmonellosis (n = 1), herpes stomatitis (n = 2), herpes zoster (n = 1), and
cytomegalovirus (n = 1), and despite treatment of several rejection episodes (n =
8), none of them had or has infections typical of the acquired immunodeficiency
syndrome (AIDS). However, two patients developed cervical lymphadenopathy and one
autoimmune thrombocytopenia 15-20 months after HIV-1 infection. Their T helper
cell counts (355/microliters to 75/microliters) and helper/suppressor T cell
ratios (1.0-0.2) are distinctly lowered. One patient has membranous
glomerulopathy with virus-like particles within and on the outside of the
basement membrane and tubuloreticular inclusions in glomerular endothelial cells.
We evaluated the case reports of 53 patients with HIV-infection caused by an
infected transplant or by blood transfusions during or shortly after
transplantation. The cumulative incidence of AIDS was significantly lower in 40
transplant patients with an immunosuppressive regimen including cyclosporine than
in 13 transplant patients receiving immunosuppressive treatment without
cyclosporine (5-year cumulative risk of AIDS: 31% versus 90%, P = 0.001).

Publication Types: 
    Review

PMID: 8420072 [PubMed - indexed for MEDLINE]

5245: Am J Med Sci. 1993 Jan;305(1):36-9.

Case report: acyclovir neurotoxicity and nephrotoxicity--the role for
hemodialysis.

Krieble BF, Rudy DW, Glick MR, Clayman MD.

Wishard Memorial Hospital, Indiana University School of Medicine, Indianapolis.

Severe neurotoxicity and acute renal failure developed in a patient with newly
diagnosed AIDS while receiving high-dosage intravenous acyclovir for disseminated
herpes zoster. Hemodialysis resulted in a rapid resolution of neurologic symptoms
and was associated with a reduction in plasma acyclovir concentration. Acute
hemodialysis therapy should be considered in cases of serious neurotoxicity
secondary to acyclovir, especially when accompanied by renal failure.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 8416680 [PubMed - indexed for MEDLINE]

5246: Microbiol Immunol. 1993;37(5):365-8.

Passive hemagglutination assays for the detection of antibodies to herpes
viruses.

Kino Y, Minamishima Y.

Chemo-Sero-Therapeutic Research Institute, Kumamoto, Japan.

A simple and effective method for the detection of antibodies to herpes simplex
virus (HSV), human cytomegalovirus (HCMV) and varicella-zoster virus (VZV), has
been established using the passive hemagglutination assay (PHA) in combination
with viral specific glycoproteins. The results obtained with the PHA were
compared with those from neutralization (NT) and complement fixation (CF) tests. 
The PHA test for each of the herpes viruses appears to compare favorably with the
other assays tested. The specificity and sensitivity of HSV PHA to NT were 100%, 
whereas the specificity and sensitivity of HSV CF test to NT were 98% and 100%,
respectively. For HCMV, the specificity and sensitivity of PHA to NT and PHA to
CF were 100%. Similarly, the specificity and sensitivity of VZV PHA to NT were
100%. Because of the low sensitivity of the VZV CF, the sensitivity of CF to NT
was 83%. Furthermore, the range of antibody titers and their absolute levels
obtained in the PHAs were significantly greater than those in the NT and CF
tests.

Publication Types: 
    Comparative Study

PMID: 8394981 [PubMed - indexed for MEDLINE]

5247: Arch Virol. 1993;132(1-2):183-91.

Identification and nucleotide sequence of a gene in feline herpesvirus type 1
homologous to the herpes simplex virus gene encoding the glycoprotein H.

Maeda K, Kawaguchi Y, Kamiya N, Ono M, Tohya Y, Kai C, Mikami T.

Department of Veterinary Microbiology, Faculty of Agriculture, University of
Tokyo, Bunkyo-ku, Japan.

A gene encoding the glycoprotein H (gH) homologue of feline herpesvirus type 1
was identified and sequenced. It was located immediately downstream of the
thymidine kinase gene within an EcoRI 6.6 kbp fragment. In addition, a partial
UL21 homologous gene was located downstream of the gH homologous gene. The
primary translation product of the gH homologous gene is predicted to consist of 
821 amino acids with a molecular weight of 92.5 kDa. It possesses several
characteristics typical of transmembrane glycoproteins, including a N-terminal
hydrophobic signal sequence, C-terminal transmembrane domain, and putative
N-linked glycosylation sites. Analysis of this protein revealed amino acid
sequence homologies of 33.1% with equine herpesvirus type 1 (EHV-1) gH, 32.6%
with EHV-4 gH, 29.1% with varicella-zoster virus gIII, 28.5% with pseudorabies
virus gH, and 25.1% with herpes simplex virus type 1 gH. By Northern blot
analysis, one of the transcripts specific for the gH homologous gene might be a
mRNA of approximately 3.0 kb.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8394688 [PubMed - indexed for MEDLINE]

5248: Int Ophthalmol Clin. 1993 Winter;33(1):81-93.

The biology of herpes simplex and varicella zoster virus infections.

Liesegang TJ.

Department of Ophthalmology, Mayo Clinic Jacksonville, FL 32224.

Publication Types: 
    Review

PMID: 8394293 [PubMed - indexed for MEDLINE]

5249: Arch Virol. 1993;131(1-2):89-9.

Polymerase chain reaction for detection of herpesvirus simiae (B virus) in
clinical specimens.

Slomka MJ, Brown DW, Clewley JP, Bennett AM, Harrington L, Kelly DC.

Virus Reference Division, Central Public Health Laboratory, London, U.K.

A polymerase chain reaction (PCR) was designed which is specific to Macaca
fascicularis (cynomolgus monkey) isolates of B virus. The PCR primers produced
the expected 188 basepair product from the Cyno 2 strain and seven other
cynomolgus monkey isolates of B virus. Oligomer hybridization with a 31-mer
oligonucleotide was used to confirm the origin of this product. The PCR failed to
amplify DNA of Epstein-Barr virus, cytomegalovirus, varicella-zoster virus, and
other alphaherpesviruses (herpes simplex virus types 1 and 2, four SA 8 isolates 
and three rhesus isolates of B virus). PCR testing of swabs obtained from four
orally-infected cynomolgus monkeys confirmed the presence of B virus DNA in
samples previously shown to be positive by culture. In addition, PCR detected B
virus in several swabs from infected monkeys that were culture negative. Total
DNA extracts from the trigeminal and sacral ganglia of these animals were tested 
by nested PCR and B virus DNA was detected in the trigeminal ganglia of 3 of the 
4 orally-infected cynomolgus monkeys. Nested PCR did not detect B virus DNA in
total DNA extracts obtained from the brains of the four monkeys.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8392323 [PubMed - indexed for MEDLINE]

5250: Acta Otolaryngol Suppl. 1993;503:74-8.

Serum viral antibody titer in vestibular neuronitis.

Shimizu T, Sekitani T, Hirata T, Hara H.

Department of Otolaryngology, Yamaguchi University School of Medicine, Ube,
Japan.

Fifty-seven cases of vestibular neuronitis were evaluated for viral infection by 
means of serum antibody titer. The viruses tested were herpes simplex virus,
varicella-zoster virus, cytomegalovirus, EB virus, adenovirus, influenza virus A,
influenza virus B, parainfluenza virus 3, mumps virus, rubella virus and measles 
virus. Paired sera were examined in 49 cases among 57 cases, 26 cases showed
significant change (four-fold or greater change) in viral antibody titer. Only
one case (53-year old female) showed high HSV 1 IgM antibody level by ELISA
method, so the vestibular neuronitis in this case was assumed to have a close
relation to viral infection.

PMID: 8385868 [PubMed - indexed for MEDLINE]

5251: Virchows Arch A Pathol Anat Histopathol. 1993;422(2):121-6.

Comparative immunohistochemical study of herpes simplex and varicella-zoster
infections.

Nikkels AF, Debrus S, Sadzot-Delvaux C, Piette J, Delvenne P, Rentier B, Pierard 
GE.

Department of Dermatopathology, University of Liege, Belgium.

Herpes simplex (HSV) and varicella-zoster (VZV) skin infections share so many
histological similarities that distinguishing between them may prove to be
impossible. We developed and characterized a new monoclonal antibody, VL8, IgG
kappa isotype, directed to the VZV envelope glycoprotein gpI.
Immunohistochemistry with VL8 appeared highly sensitive and specific on
formalin-fixed paraffin-embedded biopsies and a clear-cut distinction between HSV
and VZV infections was possible. The pattern of VL8 immunolabelling in VZV
infections was strikingly different from that found in HSV infections studied
with polyclonal antibodies to HSV I and II. Double immunolabelling revealed the
VL8 positivity of sebaceous cells, endothelial cells, Mac 387- and CD68-positive 
monocyte-macrophages, and factor XIIIa-positive perivascular, perineural and
interstitial dendrocytes. Intracytoplasmic VL8 labelling of endothelial cells and
perivascular dendrocytes was found at the site of leukocytoclastic vasculitis.

Publication Types: 
    Comparative Study

PMID: 8385379 [PubMed - indexed for MEDLINE]

5252: J Infect Dis. 1993 Jan;167(1):78-83.

Investigation of the pathogenesis of varicella-zoster virus infection in guinea
pigs by using polymerase chain reaction.

Lowry PW, Sabella C, Koropchak CM, Watson BN, Thackray HM, Abbruzzi GM, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California
94305.

The polymerase chain reaction method (PCR) was used to investigate events in the 
pathogenesis of varicella-zoster virus (VZV) infection in strain 2, Hartley, and 
euthymic hairless guinea pigs. VZV was detected in peripheral blood mononuclear
cells (PBMC) obtained 2-5 days after infection in 8 (50%) of 16 strain 2, 4 (40%)
of 10 hairless, and 10 (34%) of 29 Hartley guinea pigs. The frequency of
VZV-infected PBMC was estimated to be at least 1/200,000, which is comparable to 
that observed in human infection. When VZV PCR was used to test ganglia from
hairless guinea pigs, samples from 6 of 8 animals were positive. Of 45
VZV-infected guinea pigs that were tested for cellular immunity by VZV T
lymphocyte proliferation assay, 44 developed a stimulation index > 2.0. Control
animals had no detectable virus by PCR and did not develop cellular immunity to
VZV. These experiments showed that viremia was detectable by PCR during primary
VZV infection of guinea pigs in about half of the animals regardless of the
strain of guinea pig. Acquisition of cellular immunity provided a consistent
marker of infection in all guinea pig strains. PCR was also useful for
demonstrating VZV in guinea pig ganglia tissue, with VZV gene sequences being
detectable for at least 80 days after infection. With the combination of PCR and 
immunologic assays, various guinea pig strains should be useful for studies of
VZV pathogenesis and for the evaluation of antiviral agents and vaccine
strategies.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8380293 [PubMed - indexed for MEDLINE]

5253: J Virol. 1993 Jan;67(1):305-14.

Varicella-zoster virus glycoprotein gpI/gpIV receptor: expression, complex
formation, and antigenicity within the vaccinia virus-T7 RNA polymerase
transfection system.

Yao Z, Jackson W, Forghani B, Grose C.

Department of Microbiology, University of Iowa College of Medicine, University
Hospital, Iowa City 52242-1083.

The unique short region of the varicella-zoster virus (VZV) genome contains two
open reading frames which encode glycoproteins designated gpI and gpIV (herpes
simplex virus homologs gE and gI, respectively). Like its herpesviral counterpart
gE, the VZV gpI gene product functions as a cell surface receptor (V. Litwin, W. 
Jackson, and C. Grose, J. Virol. 66:3643-3651, 1992). To evaluate the
biosynthesis of the two VZV glycoproteins and further explore their relationship 
to one another, the two glycoprotein genes were individually cloned into a pTM1
vector under control of the T7 promoter. Transfection of the cloned gpI or gpIV
construct into HeLa cells previously infected with vaccinia recombinant virus
expressing bacteriophage T7 polymerase resulted in a much higher level expression
of each VZV glycoprotein than previously achieved. Synthesis of both gpI and gpIV
included intermediary partially glycosylated forms and mature N- and O-linked
final product. Transfections in the presence of 32Pi demonstrated that the mature
forms of both gpI and gpIV were phosphorylated, while similar experiments with
[35S]sulfate showed that only the mature gpI was sulfated. When gpI and gpIV were
coexpressed in the same cell, the two glycoproteins were complexed to each other,
as both proteins could be immunoprecipitated by antibodies against either gpI or 
gpIV. Coprecipitation did not occur as a result of a shared epitope, because gpI 
expressed alone was not precipitated by antibody to gpIV, and gpIV expressed
alone was not precipitated by antibody to gpI. Pulse-chase analysis demonstrated 
that the gpI-gpIV association occurred early in processing; furthermore, this
complex formation interfered with posttranslational modifications and thereby
reduced the M(r)s of the mature forms of both gpI and gpIV. Similarly, the
molecular masses of the cotransfected gene products corresponded with those of
the infected cell glycoproteins, a result which suggested that authentic gpI and 
gpIV were ordinarily found within a complex. Thus, the adjacent open reading
frames 67 and 68 code for two glycoproteins which in turn form a distinctive
sulfated and phosphorylated cell surface complex with receptor properties.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 8380078 [PubMed - indexed for MEDLINE]

5254: Eur Urol. 1993;24(2):244-7.

Urological manifestations of herpes zoster.

Broseta E, Osca JM, Morera J, Martinez-Agullo E, Jimenez-Cruz JF.

Department of Urology, La Fe Hospital, Valencia, Spain.

Herpes zoster is an infection caused by the varicella virus. Inflammatory
reaction can involve the spinal cord and anterior horn cells causing varied
neurological disorders including urological alterations. We reviewed 57 patients 
who suffered herpes zoster between 1984 and 1991. 15 of them (26%) showed
urological manifestations: 2 cases acute urinary retention, 3 patients urinary
incontinence and 10 cases had a cystitis-like syndrome. The clinical findings and
diagnostic procedures are studied. The possible etiological mechanisms are
discussed. The literature is reviewed.

PMID: 8375446 [PubMed - indexed for MEDLINE]

5255: J Clin Lab Anal. 1993;7(4):203-8.

Application of checkerboard immunoblotting (CBIB) to the detection of anti-viral 
IgG in human serum.

Craig WY, Poulin SE, Dorsett PH, Ledue TB, Ritchie RF.

Foundation for Blood Research, Scarborough, ME 04070-0190.

In the present study, we have begun to investigate the possibility of using
checkerboard immunoblotting (CBIB) as a semi-quantitative screening tool for
detecting human serum IgG against specific viral antigens. The viral antigens
studied were Epstein-Barr, herpes simplex I and II, cytomegalovirus, varicella
zoster, rubella, rubeola, and mumps. Western immunoblotting experiments using
these partially purified preparations demonstrated that there were apparently no 
interactions between IgG from non-immune sera and the respective viral antigen
preparations. The CBIB assay was evaluated using sera of known positive or
negative immune status for the viral antigens. There was excellent agreement
between the results of CBIB and the results of alternative methods for evaluating
immune status: all discrepancies (1/18 sera for mumps, 3/18 sera for rubeola, and
1/28 sera for rubella) involved sera with borderline results, either by CBIB or
by the alternative method. Therefore, although further work is required to define
the method in terms of sensitivity and clinical specificity, and to refine
positive/negative cutpoint criteria for certain antigen components, our
preliminary experience suggests that CBIB has considerable potential in the
efficient and inexpensive screening of sera for the presence of IgG against a
panel of viral antigens, so as to identify subjects at risk for infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8360795 [PubMed - indexed for MEDLINE]

5256: Bull Soc Pathol Exot. 1993;86(2):87-9.

[Herpes Zoster, predictive element of human immunodeficiency virus infection
(HIV). Epidemio-clinical study in Cotonou (Benin)]

[Article in French]

Yedomon HG, Doango-Padonou F, Adjibi A, Latoundji S, Zohoun I.

Service de Dermatologie-Venerologie, CNHU Cotonou, Benin.

An epidemio-clinical study of Herpes Zoster in 39 healthy patients of Benin has
permitted to the authors to evaluate the positive predictive value of Herpes
Zoster for HIV infection on West Africa; and to compare it with results of
central Africa. The mean age of patients is 34.74 years. The positive predictive 
value of Herpes Zoster for HIV infection is 41.02%. It is increased by the
cranial site of Herpes Zoster.

Publication Types: 
    English Abstract

PMID: 8353480 [PubMed - indexed for MEDLINE]

5257: Int Ophthalmol Clin. 1993 Winter;33(1):129-43.

Acute retinal necrosis and similar retinitis syndromes.

Culbertson WW, Atherton SS.

Bascom Palmer Eye Institute, Miami, FL 33101.

Publication Types: 
    Comparative Study
    Review

PMID: 8349421 [PubMed - indexed for MEDLINE]

5258: Schweiz Monatsschr Zahnmed. 1993;103(6):742-51.

[Acute ulcerous-mucocutaneous skin and mucosal changes. The clinical picture,
diagnosis and differential diagnosis]

[Article in French, German]

Gottsauner AJ, Hardt N.

Kantonsspital Luzern, Klinik fur Mund-Kiefer-Gesichts-Chirurgie.

Publication Types: 
    Review

PMID: 8322059 [PubMed - indexed for MEDLINE]

5259: Acta Neuropathol. 1993;86(6):659-65.

Acute varicella-zoster virus ventriculitis and meningo-myelo-radiculitis in
acquired immunodeficiency syndrome.

Chretien F, Gray F, Lescs MC, Geny C, Dubreuil-Lemaire ML, Ricolfi F, Baudrimont 
M, Levy Y, Sobel A, Vinters HV.

Department de Pathologie (Neuropathologie), Hopital Henri Mondor, Faculte de
Medecine de Creteil, Universite Paris XII, France.

A 30-year-old AIDS patient with no history of cutaneous eruption, presented with 
rapidly progressive flaccid paraplegia, hypoesthesia, urinary retention, moderate
psychomotor slowing and fever (39.8 degrees C), leading to death within 1 week.
CD4 count was 290/mm3. Cerebrospinal fluid contained 210 white blood cells and
238 mg/100 ml protein. Neuropathology revealed HIV encephalitis and diffuse
ventriculitis with Cowdry type A inclusions in the ependymal cells. Extensive
necrotic and hemorrhagic changes with marked recrotizing vasculitis involved the 
entire spinal cord and spinal roots. Immunocytochemistry revealed numerous
inclusion bodies positive for varicella-zoster virus (VZV) and negative for
cytomegalovirus (CMV) and herpes simplex virus type 1 and 2, in ependymal cells, 
subpial glial cells, endothelial cells and Schwann cells. Electron microscopy
confirmed herpes virus-like particles. In situ hybridization confirmed VZV genome
in leptomeninges, brain, spinal cord and spinal roots. Comparable
neuropathological findings and numerous VZV inclusion bodies were also found in
the brain, spinal cord, and spinal roots of a 40-year-old AIDS patient who died
from a fulminant ascending myeloradiculopathy previously reported as "necrotizing
vasculitis of the nervous system". Direct infection of the brain by VZV, in AIDS 
patients, has been shown to cause leukoencephalitis and cerebral non-inflammatory
vasculopathies. Our observations demonstrate that, in AIDS patients, VZV
infection of the central nervous system may also be responsible for
meningo-myelo-radiculitis possibly secondary to ventriculitis as in CMV
infection. The role of VZV in the pathogenesis of some AIDS-related vasculitides 
seems also very likely.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8310822 [PubMed - indexed for MEDLINE]

5260: Ann Dermatol Venereol. 1993;120(8):563-70.

[Capsaicin in dermatology]

[Article in French]

Paul C, Chosidow O, Frances C.

Unite de Dermatologie, Groupe Hospitalier Pitie Salpetriere, Paris.

Publication Types: 
    Review

PMID: 8304717 [PubMed - indexed for MEDLINE]

5261: Acta Otolaryngol Suppl. 1993;508:11-8.

Analysis of viral infection in patients with IgA nephropathy.

Kunimoto M, Hayashi Y, Kuki K, Mune M, Yamada Y, Tamura S, Takano I, Fujiwara K, 
Akagi Y, Samukawa T, et al.

Department of Otorhinolaryngology, Wakayama Medical College, Japan.

We investigated viral infections in the tonsils, pharynx and renal tissues of
patients with IgA nephropathy using cell culture, polymerase chain reaction (PCR)
and immuno-fluorescent techniques, and measured antibody titers against numerous 
types of viruses. Neutralization tests found no significant inhibition of growth 
of adenovirus-1, 2, 3, 4, 5, 6, 7, 11 or 19, Coxsackie virus-A7, A9, A16, B1, B2,
B3, B4, B5 or B6, or RS virus. Swabs of the oral cavity of patients with IgA
nephropathy were cultured with Hel cells, MDCK cells, FL cells, BHK-21 cells and 
RD-18S cells. No cytopathic effect was detected in any of these cell cultures. We
failed to detect the presence of herpes simplex virus-1 and -2, varicella-zoster 
virus, cytomegalovirus and Epstein-Barr virus (EBV)-1 and -2 in tonsils, renal
tissues and mouthwashings from patients with IgA nephropathy. On the other hand, 
EBV alone was detected with the PCR technique, in mouthwashings from 6 out of 14 
patients with IgA nephropathy (42%). Immunohistological and serological analyses 
were done to examine the relationship between EBV and IgA nephropathy. No
evidence was obtained that EBV-infected B lymphocytes were producing IgA. It
seems unlikely that the viral infections examined in this study play a
significant role in the pathogenesis of IgA nephropathy.

PMID: 8285037 [PubMed - indexed for MEDLINE]

5262: Wien Klin Wochenschr. 1993;105(21):611-3.

[Infective pathogens as a possible etiology of idiopathic peripheral facial
paralysis]

[Article in German]

Imarhiagbe D, Prodinger WM, Schmutzhard E.

Universitatsklinik fur Neurologie, Innsbruck.

A prospective clinical study was carried out from 1988 until 1990 on 38
consecutive patients with Bell's palsy at the Neurological Department of
Innsbruck University Hospital. The age range was between 16 and 88 years, the
female:male ratio was 18:20. Serological methods were employed to study the
impact of infectious agents on the aetiology of this disease. 11 out of 38 cases 
(= 29%) were probably infectious in origin, whereby 6 cases were due to Borrelia 
burgdorferi, 4 to Varicella zoster virus (VZV) and 1 to Herpes simplex virus
(HSV), as determined by elevation of antibody titre or presence of specific IgM. 
Patients with a significant serological finding were treated with ceftriaxon or
tetracycline for borreliosis or with acyclovir for VZV or HSV infection.
Altogether, in 36 of the 38 cases a full recovery was seen at the last follow-up 
investigation.

Publication Types: 
    English Abstract

PMID: 8273359 [PubMed - indexed for MEDLINE]

5263: Rev Neurol (Paris). 1993;149(5):353-4.

[Jugular foramen syndrome caused by herpes zoster]

[Article in French]

Kahane P, De Saint Victor JF, Besson G, Hommel M, Perret J.

Departement des Neurosciences Cliniques et Biologiques, Centre Hospitalier
Regional et Universitaire de Grenoble.

Multiple cranial nerve palsies frequently occur in patients with cephalic zoster.
Nevertheless, to our knowledge, involvement of the glossopharyngeal (IXth), vagus
(Xth) and accessory (XIth) nerves has not yet been reported. We report a case of 
jugular foramen syndrome with palatolaryngeal herpetic eruption, aseptic
meningitis and a high level of serum antibody to varicella-zoster virus.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8272734 [PubMed - indexed for MEDLINE]

5264: Recent Results Cancer Res. 1993;132:175-84.

Varicella zoster infections in bone marrow transplants.

Feldman S.

UMC Children's Hospital, University of Mississippi Medical Center, Jackson 39216.

Publication Types: 
    Review

PMID: 8265859 [PubMed - indexed for MEDLINE]

5265: Vaccine. 1993;11(11):1151-3.

Diagnosis of zoster and evaluation of varicella vaccine with a passive
haemagglutination assay.

Kino Y, Minamishima Y.

Chemo-Sero-Therapeutic Research Institute, Kumamoto, Japan.

A passive haemagglutination (PHA) assay for the detection of varicella-zoster
virus (VZV) antibody was prepared with purified viral glycoproteins. Serum
samples from vaccinees with live attenuated varicella vaccine, and of zoster
patients, were measured for antibody titres against VZV with PHA, complement
fixation (CF) and immune adherence haemagglutination (IAHA) assays, and the
results compared. Antibody development could be detected as early as 3 weeks
after vaccination, by both PHA and IAHA tests, but not with the CF test.
Significant rises in VZV antibody in zoster patients were detected by both PHA
and CF tests several days after onset. No cross-reaction was observed using HSV
PHA among the vaccinees and the zoster patients. The VZV PHA assay could be used 
as a monitor of vaccination and a tool for differential diagnosis.

Publication Types: 
    Comparative Study

PMID: 8249435 [PubMed - indexed for MEDLINE]

5266: Scand J Infect Dis. 1993;25(4):521-4.

Natural killer cell activity in herpes zoster in children without underlying
disease.

Terada K, Kawano S, Yoshihiro K, Morita T.

Department of Pediatrics, Kawasaki Medical School, Okayama, Japan.

We determined natural killer cell (NKC) activity in 10 otherwise normal children 
with herpes zoster. NKC activity values in children with vs. without
varicella-zoster virus specific IgM antibodies and in controls were 28.3 +/-
8.6%, 11.9 +/- 3.6% and 20.2 +/- 3.8% (mean +/- SD), respectively. There were
significant differences between the children with and without IgM antibodies
during the acute phase (p < 0.005) and between children without IgM antibodies
and controls (p = 0.005). NKC values in children with mild vs. moderate morbidity
were 11.7 +/- 4.1% and 25.7 +/- 9.9%, respectively (p < 0.05). The morbidity was 
moderate in all children with IgM antibodies, but in only 2 of the 5 children
without IgM antibodies. Children who contracted varicella when a few months old
had the highest IgM antibody titers and the highest value of NKC activity. NKC
activity was related both to the presence of IgM antibodies and to the morbidity 
of herpes zoster.

PMID: 8248754 [PubMed - indexed for MEDLINE]

5267: J Med Virol. 1993;Suppl 1:97-101.

Management of ophthalmic zoster.

Harding SP.

St. Paul's Eye Unit, Royal Liverpool University Hospital, UK.

The natural history of herpes zoster ophthalmicus and aspects of its treatment
and prevention are presented. Intraocular complications occur in 50 percent of
cases. Anterior uveitis and the various varieties of keratitis are commonest,
affecting 92% and 52% of patients with ocular involvement, respectively.
Sight-threatening complications include neuropathic keratitis, perforation,
secondary glaucoma, posterior scleritis/orbital apex syndrome, optic neuritis,
and acute retinal necrosis. Twenty-eight percent of initially involved eyes
develop long-term ocular disease (6 months), with chronic uveitis, keratitis, and
neuropathic ulceration being the commonest. Acute pain occurs in 93% of patients 
and is still present in 31% at 6 months. Of patients aged 60 and over pain
persists in 30% for 6 months or longer, and this rises to 71% in those aged 80
and over. Current evidence favours the use of topical acyclovir alone for
treatment of established ocular complications, with topical steroids being
withheld in all but the most severe cases. Stellate ganglion block has proved
useful in the treatment of established acute pain. Amitryptiline, and to a lesser
extent sodium valproate, are useful in established chronic pain. Evidence of the 
efficacy of early oral acyclovir on ocular complications is conflicting, with two
studies reporting significant improvement in differing disease parameters. A
similar situation exists for pain, with published studies showing differing
effects on pain at varying times after the onset of disease. The use of systemic 
steroids to prevent pain is not supported by currently available evidence, but
its therapeutic relationship with acyclovir requires further evaluation.(ABSTRACT
TRUNCATED AT 250 WORDS)

Publication Types: 
    Review

PMID: 8245902 [PubMed - indexed for MEDLINE]

5268: J Med Virol. 1993;Suppl 1:93-6.

Effect of oral acyclovir on pain resolution in herpes zoster: a reanalysis.

Huff JC, Drucker JL, Clemmer A, Laskin OL, Connor JD, Bryson YJ, Balfour HH Jr.

University of Colorado Health Sciences Center, Denver.

The most frequent complication of herpes zoster is postherpetic neuralgia,
usually defined as chronic pain in the area of the exanthem that persists for at 
least a month after the skin lesions have healed. Several clinical studies of
acyclovir showed a reduction in severity and duration of acute pain, but provided
no definitive data for chronic pain. In order to determine if acyclovir therapy
could reduce chronic pain, we reanalyzed data from the largest U.S.
placebo-controlled treatment trial of 187 immunocompetent persons with herpes
zoster. By considering pain as a continuum, we found that the median duration of 
pain in acyclovir recipients was 20 days vs. 62 days for their placebo
counterparts (P = 0.02). Thus, acyclovir has been shown to reduce chronic
zoster-associated pain. We also noted that the absence of pain at the onset of
cutaneous herpes zoster did not preclude its later development.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 8245901 [PubMed - indexed for MEDLINE]

5269: J Med Virol. 1993;Suppl 1:90-2.

Treatment of varicella in the immunocompetent adult.

Wallace MR, Bowler WA, Oldfield EC 3rd.

Department of Internal Medicine (Infectious Disease Division), Naval Hospital,
San Diego, California 92134-5000.

Varicella in the immunocompetent adult is an infrequent but potentially serious
infection. Previous studies in immunocompetent hosts and normal adults have
demonstrated the value of intravenous acyclovir in the treatment of
varicella-zoster virus infections. Oral acyclovir has also shown efficacy in both
normal adults with zoster (shingles) and immunocompetent children with varicella.
A recently completed double-blind placebo-controlled study of oral acyclovir in
immunocompetent adults with uncomplicated varicella also demonstrated efficacy.
Therapy within the first day reduced the time to 100% crusting of skin lesions
from 7.4 to 5.6 days, and reduced the duration of fever by one-half day. Symptoms
were also diminished. These benefits were observed only when therapy was
initiated within 24 hours of the appearance of the rash. Adults with complicated 
varicella (usually symptomatic varicella pneumonia) should receive intravenous
acyclovir. Several new agents for varicella-zoster therapy are being evaluated;
brovavir is a new agent currently being compared to placebo in the treatment of
adult varicella.

Publication Types: 
    Review

PMID: 8245900 [PubMed - indexed for MEDLINE]

5270: J Med Virol. 1993;Suppl 1:82-4.

Varicella-zoster virus infection in immunocompromised patients.

Masaoka T, Hiraoka A, Teshima H, Tominaga N.

Department of 5th Internal Medicine, Centre for Adult Diseases, Osaka, Japan.

The prophylactic effect of acyclovir (ACV) on varicella-zoster virus (VZV)
infection in leukaemia patients who have undergone bone marrow transplantation
(BMT) was reviewed. The benefits of the use of the laminar air flow (LAF) room in
the prevention of nosocomial VZV infections in the haematological ward are also
discussed. Since 1986 ACV has been administered to BMT patients to prevent herpes
simplex virus (HSV) infections. Of 98 patients with leukaemia who underwent BMT, 
73 received ACV (200 mg five times daily) and 25 were not given ACV. In the
untreated group, 9 patients (36.0%) developed VZV infection by day 67 (median)
and 3 patients died due to disseminated VZV infection. In the ACV-treated group, 
18 patients (24.6%) developed VZV infection by day 150 (median) and there were no
deaths. From July to December 1989, nine cases of VZV infections (eight patients 
and one nurse) were reported in the haematological ward of the hospital. All
cases originated in the conventionally ventilated areas of the ward while no VZV 
infections were reported in the 14 patients who occupied the LAF rooms during the
same period.

PMID: 8245898 [PubMed - indexed for MEDLINE]

5271: J Med Virol. 1993;Suppl 1:74-81.

Current management of varicella zoster virus infections.

Balfour HH Jr.

Department of Laboratory Medicine, University of Minnesota Health Sciences
Center, Minneapolis 55455-0392.

A series of randomized, placebo-controlled, double-blind clinical trials
conducted from 1980 to the present provide the basis for appropriate management
of varicella-zoster virus (VZV) infections. Placebo recipients in these studies
have also provided valuable natural history data on the clinical course of VZV
infections. The protocols in toto have shown acyclovir (ACV) to be safe and
effective for treatment of nearly all forms of acute VZV infection. A number of
issues still need to be addressed, including appropriate dosage, importance of
early initiation of therapy, cost-benefit ratio, and viral resistance.
Considering the data in aggregate, the author recommends ACV treatment for all
acute VZV infections in immunocompromised hosts; for acute herpes zoster
infections in all adults; and for varicella in otherwise healthy adults and
adolescents, and children who contract it from a sibling.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 8245897 [PubMed - indexed for MEDLINE]

5272: J Med Virol. 1993;Suppl 1:158-64.

Impact of herpesvirus infections in the future.

Levin MJ.

University of Colorado Health Sciences Center, School of Medicine, Denver.

Numerous diverse, often opposing, trends will determine the frequency (and
severity) of herpesvirus infections in the future. A major factor is the growing 
population of iatrogenically immunocompromised patients, accruing especially from
large increases in organ and autologous bone marrow transplantation. Of even
greater importance is the immense number of human immunodeficiency virus
(HIV)-infected patients for whom herpesviruses may: (1) have been a cofactor in
acquisition of HIV infection; (2) contribute to in vivo activation of HIV; (3)
cause severe infections. Another factor influencing severe herpesvirus infections
is the aging of populations in developed countries; this will be associated with 
a greater prevalence, and more morbid manifestations, of herpes zoster.
Sociologic changes will also be important. The consequences of these, such as
attempts to influence sexual practices, will be difficult to predict. Other
changes, such as more frequent use of early child care facilities, will
predictably lead to early acquisition of most herpesviruses, thereby decreasing
the incidence of severe disease in adulthood. Factors that will reduce the
incidence and/or severity of herpesvirus infections include vaccines (varicella, 
herpes simplex, cytomegalovirus); prophylactic strategies for immunocompromised
hosts (passive immunization, antiviral drugs, blood product selection); more
rapid and sensitive diagnostic methods; and suppressive or early antiviral
therapy for common infections, such as genital herpes simplex and
varicella.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Review

PMID: 8245885 [PubMed - indexed for MEDLINE]

5273: J Med Virol. 1993;Suppl 1:154-7.

Preliminary pharmacokinetics and safety of 882C87 in patients with herpes zoster.

Wood MJ, McKendrick MW, Bannister B, Mandal BK, Peck RW, Crooks RJ.

East Birmingham NHS Trust, UK.

882C87 [1-(beta-D-arabinofuranosyl)-5-propynyluracil] is a nucleoside analogue
with potent and specific antiviral activity against varicella-zoster virus (VZV).
The IC50 of 882C87 against VZV ranges from 0.6 to 3.8 microM. Potentially
therapeutic plasma concentrations are readily achieved in humans; the
pharmacokinetics have been previously evaluated in healthy young and elderly (>
65 years) volunteers following single oral doses of 50-400 mg. Thirty
immunocompetent patients with localised herpes zoster were treated with 882C87.
Groups of patients received 50 mg, 100 mg, or 200 mg tablets of 882C87 every 12
hours for 7 or 7.5 days (14 or 15 doses). Six patients in each group were over 60
years of age. Blood samples for determination of 882C87 concentrations were taken
at entry, steady state, and during the elimination phase following the last dose.
After the final doses of the 50 mg 100 mg, and 200 mg dosage regimens, the Cmax
of 882C87 in patients over 60 years old was 7.7 +/- 3.1 microM, 12.6 +/- 3.5
microM, and 24.8 +/- 14.0 microM, respectively, and the AUCs 0-12 were 78.4 +/-
31.8 microM.hr, 137.5 +/- 22.8 microM.hr, and 272.5 +/- 170.5 microM.hr,
respectively. Preliminary estimates of the elimination half-life ranged from 15.1
to 20.0 hr. These preliminary pharmacokinetic data confirmed good dose
proportionality for AUC and Cmax with values between those predicted from single 
dose data in the young and those in elderly volunteers. The plasma concentration 
profiles at these doses were in excess of IC50 values and support the use of
once- or twice-daily regimens in future studies of 882C87 in herpes zoster.

Publication Types: 
    Multicenter Study

PMID: 8245884 [PubMed - indexed for MEDLINE]

5274: J Med Virol. 1993;Suppl 1:139-45.

Review of research leading to new anti-herpesvirus agents in clinical
development: valaciclovir hydrochloride (256U, the L-valyl ester of acyclovir)
and 882C, a specific agent for varicella zoster virus.

Purifoy DJ, Beauchamp LM, de Miranda P, Ertl P, Lacey S, Roberts G, Rahim SG,
Darby G, Krenitsky TA, Powell KL.

Wellcome Research Laboratories, Beckenham, Kent, England.

Research leading to the new anti-herpesvirus compounds discussed here has come
from three approaches. The first approach was directed towards improving the
bioavailability of acyclovir by examining the potential of a variety of prodrugs,
leading to the new compound valaciclovir hydrochloride. The second approach was
to examine a large number of 5-substituted pyrimidines for activity against those
viruses which were not as potently inhibited by acyclovir as are herpes simplex
viruses, i.e., varicella zoster virus (VZV) and human cytomegalovirus (HCMV).
This research led to the new chemical entity 882C for VZV. A third approach has
been to examine drug combinations with acyclovir. This research led to the
compound 348U, an inhibitor of herpes simplex virus ribonucleotide reductase
which acts synergistically in combination with acyclovir. This manuscript will
focus on the first two approaches leading to new compounds valaciclovir
hydrochloride and 882C since Dr. Safrin details such background for
348U/acyclovir. Attempts to improve the bioavailability of acyclovir began a
decade ago. Early prodrugs were compounds with alterations in the 6-substituent
of the purine ring of acyclovir. The 6-amino congener required the cellular
enzyme adenosine deaminase for conversion to acyclovir and the 6-deoxycongener
was dependent on cellular xanthine oxidase for conversion. Neither of these
prodrugs had a chronic toxicity profile in laboratory animals as good as
acyclovir. Efforts were directed towards simpler esters and 18 amino acid esters 
were made. The pharmacokinetic profile of each prodrug was determined in rats by 
measuring the recovery of acyclovir in urine after oral dosing.(ABSTRACT
TRUNCATED AT 250 WORDS)

Publication Types: 
    Review

PMID: 8245881 [PubMed - indexed for MEDLINE]

5275: J Med Virol. 1993;Suppl 1:102-5.

A retrospective and an observational study with acyclovir.

Malin JP.

Neurologische Klinik und Poliklinik, Ruhr-Universitat Bochum, Germany.

Retrospective analysis: This open controlled non-randomized study was carried out
to investigate the influence of intravenous acyclovir (ACV) on the incidence of
post-herpetic neuralgia (PHN). Twelve women and 11 men (mean age 52 years, range 
19-89) received ACV 5 mg/kg every 8 hours) for 10 days (I). Twenty-seven
untreated patients (mean age 62 years, range 20-89) were taken as a control group
(II). Six to 24 months after the onset of herpes zoster (shingles) the patients
were reexamined. The analysis revealed a significantly lower incidence of both
general pain and severe pain (P < 0.05, chi 2 = 5.55 and 4.39) for (I) compared
to (II). For 21 patients who were treated for a period of 10 days, the
significance level was 1% (chi 2 = 7.82 and 8.62). Observational study: Fifteen
thousand eight hundred and thirty-one non-hospitalized patients with shingles
(mean age 55.2 years) received oral ACV (800 mg five times daily) for 7 days. At 
the onset of therapy, 15,420 patients (97.6%) reported pain (severe 42.6%,
moderate 43.1%, mild 14.3%). The pain during treatment was documented by the
patients (n = 5,728) in a diary and transferred to a scoring system (0 = none, 1 
= mild, 2 = moderate, 3 = severe). From day 1 to day 7 there was a decrease in
the pain score level from 2.3 to 0.9. Three months after the onset of herpes
zoster, 2,519 of 14,858 patients (16.95%) reported pain; 311 patients (2.1%)
complained of continuous pain, typical for PHN.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Clinical Trial

PMID: 8245873 [PubMed - indexed for MEDLINE]

5276: Arch Virol. 1993;133(1-2):171-8.

DNA sequence of a gene cluster in the equine herpesvirus-4 genome which contains 
a newly identified herpesvirus gene encoding a membrane protein.

Riggio MP, Onions DE.

Department of Veterinary Pathology, University of Glasgow Veterinary School, U.K.

Complete DNA sequences for the equine herpesvirus-4 (EHV-4) genes analogous to
equine herpesvirus-1 (EHV-1) genes 8, 9, 10, and 11, varicella zoster virus (VZV)
genes 7, 8, 9 A, and 9, and herpes simplex virus type 1 (HSV-1) genes UL51, UL50,
UL49A, and UL49 are presented. The EHV-4 gene corresponding to EHV-1 gene 10/VZV 
gene 9A/HSV-1 UL49A is of particular interest in that it is a newly identified
herpesvirus gene whose product demonstrates features characteristic of
membrane-inserted proteins. Furthermore, this gene has counterparts in all
herpesvirus genomes sequenced to date.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 8240007 [PubMed - indexed for MEDLINE]

5277: Arch Immunol Ther Exp (Warsz). 1993;41(2):137-40.

Vratizolin in treatment of mouth and ear herpetic infections: comparison with
conventional therapy.

Rostkowska B, Pospiech L, Jankowska M.

Department of Clinic of Otolaryngology, Medical Academy, Wroclaw.

Vratizolin is a new non-steroidal anti-inflammatory drug registered for use on
humans in Poland. Published and unpublished data on Vratizolin showed that it has
anti-inflammatory, antiviral, antibacterial, antimycotic, analgesic and
immunomodulating activities. The purpose of these randomized, parallel-group
studies was to compare Vratizolin with other standard drugs, used for the
treatment of mouth and ear infections. The study involved 193 patients with
recurrent Herpes simplex, Herpes zoster oticus, Stomatitis herpetica and
infections of the external ear canal. Vratizolin was used topically, as 3%
hydrophilic cream or ointment, four times daily. Standard treatment included zinc
ointment, Aphtin (boric acid plus glycerin), Oxycort and Dicortinef. In almost
all of the treated patients the efficacy of Vratizolin treatment was superior to 
the drugs mentioned above. It was assessed by measuring disappearance of both
objective (edema, erythema, crusting) and subjective symptoms (pain, burning and 
itching).

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 8239918 [PubMed - indexed for MEDLINE]

5278: Ann Otolaryngol Chir Cervicofac. 1993;110(3):170-2.

[Oral manifestations of zona. Apropos of a case]

[Article in French]

Eury J, Gilain L, Peynegre R.

Service d'ORL et de chirurgie cervico-faciale, Hopital intercommunal de Creteil.

Oral manifestations of herpes zoster are very less common than cutaneous. Only a 
few cases of oral herpes zoster in children had been already described. Authors
report a case of maxillary superior nerve's herpes zoster. Oral lesions are
encountered in case of viral disease of the second and third branch of trigeminal
nerve (VII, VIII). Dental pain is usually the first sign and can induce
misdiagnosis. The diagnosis is based on the specific ulcerative lesions, strictly
unilateral, developed in the field of sensitive innervation of the maxillary
nerves. The use of antiviral drugs seems to be actually the best treatment.

Publication Types: 
    Case Reports
    English Abstract

PMID: 8239338 [PubMed - indexed for MEDLINE]

5279: Retina. 1993;13(3):214-21.

An animal model of focal, subacute, viral retinitis.

Freeman WR, Schneiderman TE, Wiley CA, Listhaus AD, Svendsen P, Munguia D,
Bergeron-Lynn G.

Department of Ophthalmology, University of California, San Diego 92093.

To study local intravitreal therapies for retinitis due to herpes viruses, an
animal model of focal, subacute, relatively nonlethal herpes family retinitis is 
needed. Herpes simplex virus type 1 (HSV-1) was injected into the subretinal
space of 33 Dutch pigmented rabbit eyes. The animals were observed for up to 42
days after the inoculation. All inoculated eyes developed a focal, enlarging area
of retinitis in a predictable manner, showing focal enlarging areas of retinal
opacification and necrosis with variable retinal hemorrhage. In the inoculated
eyes, retinal detachment developed in all animals within 21 days; 33% of the
animals developed focal retinitis in the uninoculated eye. Histologic examination
showed encephalitis to be present in 11 (73%) of the 15 animals studied after 1
week. This model may be used to evaluate the therapeutic efficacy of new
antiviral agents and modalities in the treatment of herpes family viral
retinitis. The model is most similar to herpes simplex or zoster retinitis in
humans, but also shares some similarities (and differences) with cytomegalovirus 
(CMV) retinitis in humans.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 8235102 [PubMed - indexed for MEDLINE]

5280: Eye. 1993;7 ( Pt 3):350-70.

Ophthalmic herpes zoster.

Marsh RJ, Cooper M.

Department of Clinical Ophthalmology, Moorfields Eye Hospital, London, UK.

A current review of ophthalmic zoster is presented including its virology,
immunology, epidemiology and pathogenesis. We give our findings in 1356 patients 
referred to the Zoster Clinic at Moorfields Eye Hospital, London. The treatment
of the disease and its ocular complications is discussed.

Publication Types: 
    Review

PMID: 8224290 [PubMed - indexed for MEDLINE]

5281: Ann Otolaryngol Chir Cervicofac. 1993;110(6):337-40.

[Herpes of the larynx. Apropos of 3 cases]

[Article in French]

Mesolella M, Testa B, Mesolella C, Giuliano A, Testa G.

Medico interno Clinica ORL, Universita degli Studi di Napoli 2, Italy.

Herpes laryngis is a rare inflammatory disease, caused by herpes simplex (HSV) or
herpes zoster virus (HZV). Three cases of acute viral laryngitis are described.
The first case of laryngitis is caused by HZV, with involvement of VII., VIII.,
IX. and X. cranial nerves. In the second and third cases, caused by HSV, only the
laryngeal mucosa is involved. Laryngeal symptoms, diagnostic criteria and
therapeutic results are described.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 8210094 [PubMed - indexed for MEDLINE]

5282: Pneumonol Alergol Pol. 1993;61(11-12):610-6.

[Pulmonary infections in patients with lung cancer during antineoplastic therapy]

[Article in Polish]

Slupek A, Podsiadlo B, Augustynowicz-Kopec E.

III Kliniki Gruzlicy i Chorob Pluc, Warszawie.

162 pulmonary infection episodes were observed in 94 patients with lung cancer
undergoing antineoplastic therapy. 80 (40%) episodes occurred during leukopenia. 
Elevation of leucocyte count was seen in 12 episodes only. Elevated body
temperature was the only sign in 20 episodes, of which in 7 cases microorganisms 
were cultured from the blood. Purulent pulmonary infections were observed in 71
episodes, in 66 the causative agent was identified. Purulent urinary tract
infections were observed in 29 episodes, of which in 28 the microorganisms were
identified. A coexistent pulmonary and urinary tract infection was seen in 13
cases, of which in all the causative agent was identified. Purulent infections of
the nasopharyngeal mucosal membranes were observed in 16 cases, while herpes
zoster in 13. The most often isolated organism in these cases were: Gram negative
rods (E. coli, Klebsiella sp., Proteus sp., Hemophilus influenzae); less commonly
Gram positive bacteria were isolated, mainly Staphylococcus aureus. Candida sp.
was the most common fungus that was isolated from these patients. In four cases
Candida was isolated from blood.

Publication Types: 
    English Abstract

PMID: 8148761 [PubMed - indexed for MEDLINE]

5283: Leuk Lymphoma. 1993;11 Suppl 2:115-25.

Viral infections in leukemia and bone marrow transplant patients.

Wingard JR.

Bone Marrow Transplant Program, Emory University School of Medicine, Atlanta,
Georgia 30322.

Infections by herpesviruses are common phenomena in patients being treated for
acute leukemia and those undergoing bone marrow transplantation. Reactivation of 
endogenous latent virus caused by the immunosuppressive and cytotoxic effects of 
cytoreductive therapies is a common mechanism of infection. With cytomegalovirus 
(CMV), acquisition of exogenous virus by transfusion of blood products containing
virus and from the bone marrow graft in the case of bone marrow transplantation
can occur. Serious morbidity can result and occasional mortality. CMV infections 
in allogeneic BMT recipients have high case fatality rates. Treatment and
preventive strategies for herpes simplex virus (HSV), CMV, and varicella zoster
virus (VZV) have been developed to reduce morbidity. Acyclovir, either given
prophylactically or as treatment of active infection, has been highly successful 
in reducing illness from HSV and VZV infection. For CMV, provision of
CMV-seronegative blood products is the mainstay of prevention of morbidity in
seronegative patients and is especially important in the care of patients
undergoing allogeneic BMT. Ganciclovir given either prophylactically or as early 
therapy for patients detected to be shedding CMV appears to be a promising
strategy. Bolstering host immunity through augmentation of anti-CMV cytotoxic
T-cell responses appears to be an exciting candidate therapy under development.

Publication Types: 
    Review

PMID: 8124223 [PubMed - indexed for MEDLINE]

5284: Leuk Lymphoma. 1993;10 Suppl:139-45.

Nucleoside analogs in treatment of chronic lymphocytic leukemia.

Keating MJ, O'Brien S, Kantarjian H, Robertson LB, Koller C, Beran M, Estey E.

Department of Hematology, University of Texas M.D. Anderson Medical Center,
Houston 77030.

The nucleoside analogs fludarabine monophosphate, 2-chlorodeoxyadenosine, and
2-deoxycoformycin (pentostatin) all have activity in chronic lymphocytic
leukemia. The most widely studied drug is fludarabine which is able to obtain
complete or partial responses in more than 50% of previously treated patients.
The response rate is 44% for 2-CDA and approximately 25% for pentostatin.
Fludarabine has also been used to treat patients as initial therapy, and has
resulted in overall response rate of 79% with 75% of the patients achieving
complete remission. The NCI and International Working Group for CLL criteria for 
complete remission allow for persistent nodules or lymphoid infiltrates in the
bone marrow biopsy. Studies have now demonstrated persistent lymphoid aggregates 
are associated with a shorter time to progression for responders but no survival 
disadvantage. There is a strong association of documented refractoriness to
alkylating agents with probability of response to fludarabine and also survival. 
The major morbidity associated with the use of these drugs are infections, which,
in some circumstances, are associated with neutropenia but in other circumstances
are probably related to the hypogammaglobulinemia and T-cell immunodeficiency
which are part of the disease. The T-cell immunodeficiency is aggravated by the
nucleoside analogs. Even after discontinuation of therapy the immunodeficiency as
measured by CD4 cell number is sustained for 12 to 24 months. Opportunistic
organisms such as herpes simplex, herpes zoster, Listeria monocytogenes, and
pneumocystis carinii are being noted in patients treated with these agents. The
potency of these drugs and low incidence of toxicities to other organs suggests
that they will be effectively combined with other agents.(ABSTRACT TRUNCATED AT
250 WORDS)

Publication Types: 
    Review

PMID: 8097653 [PubMed - indexed for MEDLINE]

5285: Australas J Dermatol. 1993;34(3):113-4.

Cerebral infarction following thoracic herpes zoster.

Kumar A, Mollison L.

Department of Medicine, Alice Springs Hospital, N.T., Australia.

OBJECTIVE: To present a case of cerebral infarction following thoracic herpes
zoster presenting as Gerstmann's syndrome. CLINICAL FEATURES: A 61 year old male 
developed herpes zoster of T 1-2 dermatomes. Four months later he developed a
confusional state together with expressive aphasia, dyscalculia, dysgraphia and
finger agnosia with no long tract signs. CT scan of head showed recent infarction
of this left parietal lobe. He received a five day course of acyclovir 800 mg
four times daily and showed slow but steady improvement. CONCLUSION: Herpes
zoster is uncommonly followed by cerebral infarction. Acyclovir may have a role
in therapy of this complication.

Publication Types: 
    Case Reports

PMID: 8080412 [PubMed - indexed for MEDLINE]

5286: Scand J Infect Dis. 1993;25(6):775-8.

Proliferative response to varicella-zoster virus is inverse related to
development of high levels of varicella-zoster virus specific IgG antibodies.

Terada K, Kawano S, Yoshihiro K, Morita T.

Department of Pediatrics, Kawasaki Medical School, Okayama, Japan.

We examined specific humoral and cellular immunity from varicella-zoster virus
(VZV) in 10 pediatricians, 8 healthy immune adults, 2 non-immune adults, and 15
patients with acute lymphocytic leukemia (ALL) in order to investigate the
mechanism of resistance to VZV and the booster effect of frequent re-exposure.
The responder cell frequency (RCF) against VZV antigen was determined by
lymphoproliferative response with limiting dilution. Four of the 10 children with
ALL and receiving maintenance therapy did not have VZV-specific cellular immunity
according to our positive criteria (Stimulation Index > 2.0 and RCF > 1:150,000),
but 3 of these 4 patients had VZV-specific IgG antibody. In both healthy adults
and ALL patients re-exposure to VZV or reactivation of the virus enhanced
VZV-specific immunity. Individuals with very high RCF values (> 1:10,000) had the
lowest IgG antibody titers.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 8052820 [PubMed - indexed for MEDLINE]

5287: Rev Roum Virol. 1993 Jan-Jun;44(1-2):91-5.

[The beneficial effects of immunostimulating and antiviral therapy on ophthalmic 
zona]

[Article in French]

Topciu V, Chercota G, Mihailescu R, Nadolnic A.

Universite de Medecine et Pharmacie, Timisoara, Roumanie.

A group of 16 patients with ophthalmic zona zoster received antiviral and
immunostimulating treatment with Romanian specific products. Results were
spectacular. The problem of the identity of the varicella and zoster viruses is
discussed.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 8043484 [PubMed - indexed for MEDLINE]

5288: Rev Roum Virol. 1993 Jan-Jun;44(1-2):17-20.

[Moroxidine, an antiviral used for the treatment of zona (herpes zoster)]

[Article in French]

Athanasiu P, Petrescu A, Vulcan V.

Institut de Virologie Stefan S. Nicolau, Bucarest, Roumanie.

Treatment with moroxidine, Romanian preparation with virustatic effects, was
applied in 350 patients with different localisation herpes zoster lesions.
Treatment had good effects, especially when it was applied early.

Publication Types: 
    English Abstract

PMID: 8043474 [PubMed - indexed for MEDLINE]

5289: Adv Exp Med Biol. 1993;335:235-40.

Epidemiology and infectious complications of human immunodeficiency virus
antibody positive patients.

Yangco BG, Kenyon VS.

St. Joseph's Hospital Infectious Disease Research Institute Tampa, FL 33677-4227.

From July 1, 1991 to March 31, 1992, 156 patients (pts) with positive antibody
titers to the human immunodeficiency virus (HIV) were seen in our clinic. A
retrospective review of the epidemiology and infectious complications of these
patients is presented. There were 129 males and 27 females (4.8:1, ratio). Only
10/156 (12.8%) were non-whites (13 blacks and 7 hispanics). The majority, 126
(80.7%), were 25 to 44 years old. The most common risk factor was homosexuality
or bisexuality 100 (64.1%), followed by heterosexual acquisition 25 (16%),
intravenous drug abuse 23 (13.7%), unknown 6 (3.8%) and transfusion-related 3
(1.9%). Sixty-five pts had no infections. In the remaining 91 pts, the infections
noted were: candidiasis (54 pts); Pneumocystis carinii pneumonia (25 pts); Herpes
simplex (13 pts); cytomegalovirus (CMV) retinitis (11 pts) and CMV esophagitis (1
pt), central nervous system toxoplasmosis (8); Herpes zoster (6 pts);
cryptococcal meningitis (5 pts); Mycobacterium avium complex bacteremia (4 pts); 
Molluscum contagiosum, hepatitis-B, staphylococcal infection, perirectal abscess 
and oral hairy leukoplakia (2 pts each); syphilis, cryptosporidiosis,
nocardiosis, histoplasmosis and laryngeal papillomatosis (1 pt each). Infections 
were multiple in 57/91 (62%) pts and tend to occur more often when the helper
cells are < 200 47/57 (82%) pts. Appropriate antimicrobials for prophylaxis and
maintenance therapy appeared to decrease the occurrence or relapse of infections 
such as pneumocystosis, candidiasis, cryptococcosis, tuberculosis and
toxoplasmosis.

PMID: 7901972 [PubMed - indexed for MEDLINE]

5290: Dakar Med. 1993;38(1):97-100.

[Ocular manifestations of AIDS in Dakar]

[Article in French]

Ndoye NB, Sow PS, Ba EA, Ndiaye MR, Wade A, Coll-Seck AM.

Clinique Ophtalmologique CHU Le Dantec, Dakar.

In this prospective study undertaken between november 1989 and december 1991, the
authors report their observations of ocular lesions seen in a cohort of 67 AIDS
patients hospitalised in the Infectious Diseases department CHU Fann Dakar.
Ocular lesions were discovered in 52.23%. These lesions were observed in both
HIV-1 and HIV-2 positive patients, however they were much more common in the
former group (77.14%). Retinal pathology was by far the most frequently observed 
(63%) and yet classic retinis was not discovered in our series. We feel that the 
ophtalmologist should play a key role in the routine care of AIDS patients
especially in surveillance of retinal changes.

PIP: During November 1989 to December 1991 in Senegal, physicians regularly
followed 67 HIV infected patients aged 20-76 (46 men and 21 women) who had been
admitted to Fann University Hospital in Dakar. The HIV infection had progressed
to AIDS in all but one case. 52.33% had ocular lesions, of which the most
frequent were cotton-like nodules (14.2%), retinal bleeding and Roth's spots
(8.5%), and ophthalmic herpes zoster (8.5%). Most lesions (63%) were located in
the retina. Yet, there were no cases of classic retinitis. Among 21 AIDS patients
with a known lymphocyte count, 62.5% of those with a CD4 count of less than 200
had a normal ophthalmological examination. Patients with CD4 counts between 0 and
200 had macular edema, hyalitis, cotton-like nodules, retinal uveitis, and
microangiopathy, while those with higher CD4 counts had none of these ocular
lesions. Patients with CD4 counts greater than 400 had conjunctivitis (one case, 
Kaposi sarcoma-related conjunctivitis), ophthalmic herpes zoster, and ocular
dryness. The only ocular lesion in patients with CD4 counts between 200 and 400
was ophthalmic herpes zoster. 77.14% of HIV infected patients with ocular lesions
were infected with HIV-1. The three ophthalmic herpes zoster cases were less than
30 and homosexual. During the two years of follow-up, only one case died. Based
on these findings, the authors suggest that ophthalmologists should
systematically be involved in the routine care of AIDS patients, particularly by 
screening for changes in the retina.

Publication Types: 
    English Abstract

PMID: 7882859 [PubMed - indexed for MEDLINE]

5291: N Engl J Med. 1992 Dec 10;327(24):1697-703.

Erratum in:
    N Engl J Med 1993 Mar 4;328(9):671.

Clinical manifestations and predictors of disease progression in drug users with 
human immunodeficiency virus infection.

Selwyn PA, Alcabes P, Hartel D, Buono D, Schoenbaum EE, Klein RS, Davenny K,
Friedland GH.

Department of Epidemiology and Social Medicine, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, N.Y.

BACKGROUND AND METHODS. To examine the clinical course of human immunodeficiency 
virus (HIV) infection in injection-drug users, we conducted a prospective study
of a cohort of patients in a methadone-treatment program in New York City from
July 1985 through December 1990. The patients underwent standardized evaluations 
at base line and semiannually thereafter and received on-site primary medical
care. Rates of progression to the acquired immunodeficiency syndrome (AIDS) and
major outcomes before the development of AIDS were examined by univariate
analyses; the risk of AIDS was also assessed by product-limit survival analysis
and proportional-hazards regression. RESULTS. Of 318 HIV-seropositive patients
who did not yet have AIDS (171 men and 147 women), 90 were black, 179 were
Hispanic, and 49 were white; the median age was 33 years. Over a median of 3.0
years of follow-up, 55 (17 percent) received a diagnosis of AIDS (incidence per
100 person-years, 5.8). Major outcomes before the development of AIDS included
oral candidiasis (incidence per 100 person-years, 11.2), pyogenic bacterial
infections including pneumonia and sepsis (8.0), pulmonary tuberculosis (1.2),
multiple constitutional symptoms (13.6), and herpes zoster (1.3). There were 41
deaths from AIDS, and 13 seropositive patients without AIDS (4.1 percent) died of
bacterial infections, as compared with only 1 of 411 seronegative patients
studied (P < 0.001). The incidence of AIDS was 62 percent lower among those who
took zidovudine than among those who did not (P = 0.02). In the multivariate
analysis, progression to AIDS was best predicted by low numbers and percentages
of CD4+ lymphocytes, nonuse of zidovudine, and the presence of oral candidiasis, 
bacterial infections, or tuberculosis. There was no consistent relation between
progression to disease and the continued use of injection drugs. CONCLUSIONS.
HIV-infected injection-drug users have progression to AIDS at rates comparable to
those of other HIV-infected groups, but they have substantial pre-AIDS morbidity 
and mortality, particularly from bacterial infections, which also appear to
predict disease progression.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1359411 [PubMed - indexed for MEDLINE]

5292: Pediatr Dermatol. 1992 Dec;9(4):326-8.

Cutaneous manifestations of pediatric HIV infection.

Prose NS.

Duke University Medical Center, Durham, North Carolina.

Children who are infected with human immunodeficiency virus may develop a wide
variety of mucocutaneous manifestations, such as skin infections, tumors, and
inflammatory skin disorders. The most significant infectious diseases are
candidiasis, dermatophytosis, herpes simplex, herpes zoster, and pyoderma.
Inflammatory disorders include seborrheic dermatitis, vasculitis, and pyoderma
gangrenosum. Kaposi sarcoma is extremely rare in children with the acquired
immunodeficiency syndrome.

Publication Types: 
    Review

PMID: 1492046 [PubMed - indexed for MEDLINE]

5293: An Med Interna. 1992 Dec;9(12):624-5.

Comment on:
    An Med Interna. 1992 Mar;9(3):155-6.

[Transient intestinal and bladder atonies in a geriatric patient with
disseminated herpes zoster]

[Article in Spanish]

Revenga F, Ruiz R, Vanaclocha F.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 1486175 [PubMed - indexed for MEDLINE]

5294: Semin Neurol. 1992 Dec;12(4):322-8.

Herpes zoster.

Hirschmann JV.

Seattle VA Medical Center, University of Washington School of Medicine 98108.

Publication Types: 
    Review

PMID: 1485041 [PubMed - indexed for MEDLINE]

5295: J Emerg Nurs. 1992 Dec;18(6):547-8.

A 72-year-old woman with severe lower back pain and malaise.

Childs SA.

Publication Types: 
    Case Reports

PMID: 1469824 [PubMed - indexed for MEDLINE]

5296: Anesthesiology. 1992 Dec;77(6):1223-5.

Segmental reflex sympathetic dystrophy involving the thumb: a rare complication
of a varicella zoster infection.

Chester MH.

Department of Family and Community Medicine, University of California, School of 
Medicine, San Francisco.

Publication Types: 
    Case Reports

PMID: 1466473 [PubMed - indexed for MEDLINE]

5297: Am J Kidney Dis. 1992 Dec;20(6):647-9.

Neurotoxicity of acyclovir in patients with end-stage renal failure treated with 
continuous ambulatory peritoneal dialysis.

Davenport A, Goel S, Mackenzie JC.

Department of Renal Medicine, Southmead Hospital, Westbury-on-Trym, Bristol,
England.

We report two cases of herpes-zoster in which the administration of acyclovir to 
patients with end-stage renal failure treated by continuous ambulatory peritoneal
dialysis (CAPD) resulted in acyclovir neurotoxicity, even though the doses
administered were within those recommended by the manufacturer's data sheet for
patients with renal failure. Acyclovir removal was negligible with peritoneal
dialysis and one patient died. The other patient was successfully treated with
hemodialysis, which effectively reduced plasma concentrations, resulting in an
improvement in conscious state. Acyclovir neurotoxicity should be considered in
patients with renal failure who have been treated for viral infections, in whom
the conscious state has deteriorated despite normal brain computed tomography
(CT) scan and lumbar puncture investigations. Hemodialysis is the preferred
treatment for the rapid removal of acyclovir.

Publication Types: 
    Case Reports

PMID: 1462997 [PubMed - indexed for MEDLINE]

5298: J Acquir Immune Defic Syndr. 1992 Dec;5(12):1212-23.

A simplified surveillance case definition of AIDS derived from empirical clinical
data. The Clinical AIDS Study Group, and the Working Group on AIDS case
definition.

Weniger BG, Quinhoes EP, Sereno AB, de Perez MA, Krebs JW, Ismael C, Sion FS,
Ramos-Filho CF, de Sa CA, Byers RH, et al.

Centers for Disease Control, Public Health Service, U.S. Department of Health and
Human Services, Atlanta, Georgia.

A clinical AIDS case definition is needed for surveillance in countries where the
CDC case definition is not practical. To derive such a definition, we compared
110 HIV-seropositive and 135 randomly selected HIV-seronegative adult
medical-ward inpatients in Brazil. Multivariate analysis of clinical signs and
symptoms and simple diagnoses resulted in a discriminant function with
sensitivity of 89% and specificity of 96% in predicting for AIDS. These data were
the empirical basis for a clinical definition of AIDS in adults drafted in a
Caracas, Venezuela, workshop sponsored by the Pan American Health Organization.
The revised "Caracas" definition presented here requires a positive HIV serology,
the absence of cancer or other cause of immunosuppression, plus > or = 10
cumulative points, as follows: Kaposi's sarcoma (10 points);
extrapulmonary/noncavitary pulmonary tuberculosis (10); oral candidiasis or hairy
leukoplakia (5); cavitary pulmonary/unspecified tuberculosis (5); herpes zoster <
60 years of age (5); CNS dysfunction (5); diarrhea > or = 1 month (2); fever > or
= 1 month (2); cachexia or > 10% weight loss (2); asthenia > or = 1 month (2);
persistent dermatitis (2); anemia, lymphopenia, or thrombocytopenia (2);
persistent cough or any pneumonia except TB (2); and lymphadenopathy > or = 1 cm 
at > or = 2 noninguinal sites for > or = 1 month (2). This definition has a
sensitivity of 95% and a specificity of 100% (91% without HIV serology) when
applied to the Brazilian patients in this study. The Caracas definition has been 
adopted by Brazil, Honduras, and Surinam, and is in validation elsewhere. The use
of a reasonably sensitive and specific case definition commensurate with
available diagnostic resources should facilitate AIDS surveillance in developing 
countries.

Publication Types: 
    Comparative Study

PMID: 1453332 [PubMed - indexed for MEDLINE]

5299: J Clin Oncol. 1992 Dec;10(12):1907-13.

Phase II study of pentostatin and intermittent high-dose recombinant interferon
alfa-2a in advanced mycosis fungoides/Sezary syndrome.

Foss FM, Ihde DC, Breneman DL, Phelps RM, Fischmann AB, Schechter GP, Linnoila I,
Breneman JC, Cotelingam JD, Ghosh BC, et al.

National Cancer Institute, National Institutes of Health, Bethesda, MD.

PURPOSE: This phase II study was undertaken to assess the efficacy and toxicity
of alternating administration of pentostatin (deoxycoformycin [DCF]) and
interferon alfa-2a (IFN) in patients with advanced or refractory mycosis
fungoides (MF) or the Sezary syndrome (SS). PATIENTS AND METHODS: Forty-one
patients underwent therapy with alternating cycles of DCF 4 mg/m2 intravenously
(IV) days 1 through 3 and IFN 10 million U/m2 intramuscularly (IM) day 22, and 50
million U/m2 intramuscularly (IM) days 23 through 26. Twenty-nine patients had
not responded to prior chemotherapy or total-skin electron-beam irradiation
(TSEB), six had not responded to topical therapies, and six had no previous
treatment. RESULTS: Two patients achieved a complete response (CR) and 15
achieved a partial response (PR), for an overall response rate of 41% (95%
confidence interval, 26% to 58%). No responses were observed in the seven
patients with visceral involvement. The median progression-free survival of
patients who responded was 13.1 months. IFN-related constitutional symptoms were 
reported in 39% of patients; severe toxicities included cardiomyopathy in one
patient, acute and chronic pulmonary dysfunction in four, and reversible mental
status changes in two. Seven patients developed herpes zoster during therapy and 
six had staphylococcal bacteremia. CONCLUSION: These results suggest that the
combination of DCF and IFN is an active regimen in MF patients without visceral
involvement.

Publication Types: 
    Clinical Trial
    Clinical Trial, Phase II

PMID: 1453206 [PubMed - indexed for MEDLINE]

5300: J Virol. 1992 Dec;66(12):7303-8.

Erratum in:
    J Virol 1995 Apr;69(4):2723.

Varicella-zoster virus open reading frame 61 protein is functionally homologous
to herpes simplex virus type 1 ICP0.

Moriuchi H, Moriuchi M, Smith HA, Straus SE, Cohen JI.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

The varicella-zoster virus (VZV) open reading frame 61 (ORF61) protein is thought
to be the homolog of herpes simplex virus type 1 (HSV-1) ICP0, based on gene
location and limited amino acid homology. However, HSV-1 ICP0 trans activates
HSV-1 genes, while VZV ORF61 protein trans represses the function of VZV trans
activators on VZV promoters in transient expression assays. To investigate the
functional relatedness of HSV-1 ICP0 and VZV ORF61 protein, we established Vero
and MeWo cell lines which stably express VZV ORF61 under the control of a
metallothionein promoter and performed complementation studies with an HSV-1 ICP0
deletion mutant (7134). Mutant 7134 is impaired for plaque formation and
replication at a low multiplicity of infection in cell culture, but these defects
were complemented by up to 200-fold in Vero cell lines expressing VZV ORF61.
Likewise, the efficiency of plaque formation was improved by up to 100-fold in
MeWo cell lines expressing VZV ORF61. A cell line expressing another VZV
immediate-early gene product (ORF62) was unable to complement mutant 7134. HSV-1 
mutants which are deleted for other HSV-1 immediate-early gene products (ICP4,
ICP27) were unable to grow in VZV ORF61-expressing cell lines. These results
indicate that, despite marked differences in their sequences and in effects on
their cognate promoters in transient expression assays, VZV ORF61 protein is the 
functional homolog of HSV-1 ICP0.

Publication Types: 
    Comparative Study

PMID: 1366099 [PubMed - indexed for MEDLINE]

5301: Bone Marrow Transplant. 1992 Dec;10(6):495-8.

Long-term acyclovir prophylaxis for prevention of varicella zoster virus
infection after autologous blood stem cell transplantation in patients with acute
leukemia.

Sempere A, Sanz GF, Senent L, de la Rubia J, Jarque I, Lopez F, Arilla MJ, Guinot
M, Martin G, Martinez J, et al.

Department of Hematology, La Fe University Hospital, Valencia, Spain.

Twenty-one adult patients with acute leukemia who underwent autologous blood stem
cell transplantation (ABSCT) and who received acyclovir during the first 6 months
after transplant to prevent varicella zoster virus (VZV) infection were studied
retrospectively to determine the incidence and outcome of VZV infection after
ABSCT. The cumulative risk of VZV infection was 32% by 1 year after transplant.
No patient developed VZV while on prophylactic acyclovir but five (24%) had
localized herpes zoster within 1 month of acyclovir withdrawal. There were no
deaths related to VZV infection and only one patient had disseminated disease and
post-herpetic neuralgia. These preliminary results suggest that the incidence and
outcome of VZV infection after ABSCT largely parallel those reported in marrow
transplant patients and that long-term acyclovir prophylaxis delays but does not 
prevent VZV infection. Prophylaxis of VZV infection after ABSCT requires new
therapeutic approaches.

PMID: 1362686 [PubMed - indexed for MEDLINE]

5302: J Am Acad Dermatol. 1992 Dec;27(6 Pt 1):943-50.

Erratum in:
    J Am Acad Dermatol 1993 Mar;28(3):411.

Verrucous lesions secondary to DNA viruses in patients infected with the human
immunodeficiency virus in association with increased factor XIIIa-positive dermal
dendritic cells. The Military Medical Consortium of Applied Retroviral Research
Washington, D.C.

Smith KJ, Skelton HG 3rd, Frissman DM, Angritt P.

Walter Reed Army Institute of Research.

BACKGROUND: Hyperkeratotic lesions caused by varicella-zoster, herpes simplex, or
cytomegalovirus occur in patients infected with human immunodeficiency virus type
1 (HIV-1). We have also observed this type of lesion with molluscum contagiosum. 
OBJECTIVES: These cases were studied to determine whether there are any
pathologic changes unique to these lesions. METHODS: The cases were studied by
routine microscopic examination and immunohistochemistry. RESULTS: Each case
showed changes diagnostic of the viral infection, which was confirmed by
immunohistochemical stains for herpes simplex and cytomegalovirus. In the dermis 
there were fewer inflammatory cells than expected, but there was an increase in
factor XIIIa-positive dendritic cells. CONCLUSION: Varicella-zoster, herpes
simplex virus, cytomegalovirus, and molluscum contagiosum can cause verrucous
lesions in HIV-1-infected patients. These lesions may be related to an increase
in factor XIIIa-positive dendritic cells.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 1362209 [PubMed - indexed for MEDLINE]

5303: Am Fam Physician. 1992 Dec;46(6):1772-81.

Comment in:
    Am Fam Physician. 1993 Jul;48(1):39-40.

Update on drug therapy for HIV and related infections in adults.

Montauk SL, Mandell K.

University of Cincinnati Medical Center, Ohio.

Antiretroviral therapy with zidovudine is indicated in patients with CD4 cell
counts below 500 per mm3 (500 x 10(6) per L). Patients intolerant of zidovudine
and those with advanced human immunodeficiency virus infection may benefit from
newer antiretroviral agents, such as didanosine (ddl) or zalcitabine (ddC).
Prophylactic therapy for Pneumocystis carinii pneumonia is indicated in patients 
with CD4 cell counts below 200 per mm3 (200 x 10(6) per L), in patients with CD4 
cell counts less than 20 percent of the total lymphocytes and in patients with a 
prior history of P. carinii infection. In addition, prophylaxis is often
initiated if thrush is present, even when CD4 cell counts are above 200.
Trimethoprim-sulfamethoxazole is the drug of choice for Pneumocystis prophylaxis;
aerosolized pentamidine is reserved for patients unable to tolerate
trimethoprim-sulfamethoxazole. Oral candidiasis is treated with nystatin
suspension, clotrimazole troches, ketoconazole or fluconazole, with fluconazole
used for resistant or more invasive infection. Finally, acyclovir is used to
treat herpes zoster or herpes simplex virus infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 1360766 [PubMed - indexed for MEDLINE]

5304: Occas Pap R Coll Gen Pract. 1992 Dec;(58):56-61.

Red or uncomfortable eye.

Davey C, Hurwitz B.

1. A red, uncomfortable eye may be accompanied by other symptoms such as blurred,
decreased, or double vision, haloes, photophobia, pain or discharge. 2. A careful
history and brief systematic examination will sort out most problems. 3. Examine 
eyelids, the conjunctivae and corneas. Checking visual acuity is often important.
4. The most common underlying causes can usually be managed within general
practice, though a few patients will require urgent eye assessment, or routine
referral to ophthalmic outpatients. 5. The following are typical eye problems
which require urgent referral: History of pain as opposed to discomfort, Trauma
including foreign bodies, chemicals and suspected penetrating injury, Unexplained
drop in visual acuity of two lines or more in a painful eye. Specific conditions:
preseptal cellulitis, herpes simplex ulcer, scleritis, orbital cellulitis, herpes
zoster, bacterial corneal ulcer, dacryocystitis. 6. The following are typical
problems which may require routine referral: Persistence of the problem not
relieved by simple measures, Recurrent disorders of uncertain diagnosis, Eyelid
swelling such as chalazion, cysts, basal cell carcinoma, Gradual loss of vision, 
for example cataract, macular degeneration.

PMID: 1345157 [PubMed - indexed for MEDLINE]

5305: Cent Afr J Med. 1992 Dec;38(12):466-7.

Herpes zoster treated by acupuncture.

Coghlan CJ.

Seventh Avenue, Surgical Unit, Mutare.

The treatment of Herpes zoster by acupuncture is described. These were four
patients with acute zoster and four with post-herpetic neuralgia. In a majority
of the cases electro-acupuncture was found to be effective, and this treatment
should be instigated as early as possible. Since the treatment of Herpes zoster
by drugs is not routinely successful and can prove expensive, acupuncture, whose 
side effects are minimal, merits a trial.

Publication Types: 
    Case Reports

PMID: 1340799 [PubMed - indexed for MEDLINE]

5306: Pediatr Res. 1992 Dec;32(6):699-703.

Latency in vitro of varicella-zoster virus in cells derived from human fetal
dorsal root ganglia.

Somekh E, Tedder DG, Vafai A, Assouline JG, Straus SE, Wilcox CL, Levin MJ.

Department of Pediatrics, University of Colorado School of Medicine, Denver
80262.

A potential in vitro model of varicella-zoster virus (VZV) latency was developed.
Dissociated human dorsal root ganglion cultures were infected with VZV and
maintained for 1 wk in the presence of bromovinyl arabinosyl uracil, a potent
inhibitor of VZV. Seven to 21 d after removing the inhibitor (> or = 14 d after
infection), the cells were trypsinized, passed to monolayers of human embryonic
lung fibroblasts, and observed for VZV reactivation as indicated by typical
cytopathic effects and the appearance of VZV antigens. VZV reactivated from 56%
of the cultures containing both neurons and satellite cells but not from cultures
specifically enriched for either neurons, satellite cells, or ganglion-derived
fibroblasts. The failure to isolate VZV from cell suspensions that were sonicated
before cocultivation with fibroblasts indicated that infectious VZV was not
present before reactivation. Moreover, immunohistochemical and
immunoprecipitation studies revealed no VZV-specific antigens in any cultures
before the reactivation stimulus. VZV antigens were detected after trypsinization
and cocultivation. These findings suggest that cultures containing both neurons
and satellite cells provide a model system for VZV persistence that possesses
many properties of a latent infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1337586 [PubMed - indexed for MEDLINE]

5307: Anaesthesist. 1992 Dec;41(12):772-8.

Comment in:
    Anaesthesist. 1994 Jan;43(1):53-4.

[Therapy of post-herpetic neuralgia. Pain therapy using an anti-varicella zoster 
immunoglobulin]

[Article in German]

Hugler P, Heimann R, Laubenthal H.

Klinik fur Anaesthesiologie, St. Josef Hospital Bochum.

After remission of the dermatological symptoms of herpes zoster infection,
post-zoster neuralgia (PZN) can persist or recur for months and years. Most
frequently, satisfactory therapy of PZN is not possible. During recent years the 
persistence of viruses on the surface of neuronal cells has been discussed as the
possible reason for chronic pain. Virostatic therapy as well as polyvalent
7s-IgG-immunoglobulins exerted a minimal effect on the pain level. In an open
trial we therefore used a specific anti-varicella zoster immunoglobulin (VZI) for
treatment of PZN. METHODS. In our study ten patients (six female, four male; age 
55-87 years) with latencies between the acute infection and onset of
immunoglobulin therapy between 10 months and 3 years were included. PZN was
located according to the dermatomes involved: one trigeminal nerve, one cervical,
four thoracic and four lumbal segments. All patients had received more than two
different drugs or had had therapeutic procedures without success. On the visual 
analogue scale (VAS: 0-100%) all patients rated their subjective pain with at
least 49%. Before starting the study the preexisting specific drug therapy was
discontinued in all patients. VZI infusion was given i.v. at a dose of 2 ml/kg
body weight within 120 min. All patients had to rate their pain at the VAS every 
10 min during the 120 min infusion time, at day 1, 2, 7, 14, 30 and than every
month after therapy with VZI. RESULTS. Even during the infusion all ten patients 
reported a sharp decrease in pain of at least 47% (average 87%) on the VAS.
Fourteen days later the remaining pain level averaged 6% VAS. Only the first of
the 10 patients reported twice a recurring increase of pain. He therefore
received the standard dosage of VZI again at day 2 and day 214, respectively.
Thereafter until day 566 the pain level of this patient was lower than 10% VAS.
The maximum surveillance interval has so far been 600 days. No side-effects due
to the infusion of VZI have been encountered. CONCLUSIONS. Treating pain in
persistent PZN is extremely difficult and mostly results in a small diminution of
the pain level. Persistence of viruses on the neuronal cell surface and resulting
reduction of "luxury functions" of those cells may explain algogenesis by PZN and
resistance to therapeutic efforts. We used VZI for the first time for therapy of 
PZN and observed a striking analgesic effect in all patients for the entire
surveillance time.

Publication Types: 
    English Abstract

PMID: 1336934 [PubMed - indexed for MEDLINE]

5308: Antimicrob Agents Chemother. 1992 Dec;36(12):2747-57.

Mode of antiviral action of penciclovir in MRC-5 cells infected with herpes
simplex virus type 1 (HSV-1), HSV-2, and varicella-zoster virus.

Earnshaw DL, Bacon TH, Darlison SJ, Edmonds K, Perkins RM, Vere Hodge RA.

SmithKline Beecham Pharmaceuticals, Epsom, Surrey, England.

The metabolism and mode of action of penciclovir
[9-(4-hydroxy-3-hydroxymethylbut-1-yl)guanine; BRL 39123] were studied and
compared with those of acyclovir. In uninfected MRC-5 cells, low concentrations
of the triphosphates of penciclovir and acyclovir were occasionally just
detectable, the limit of detection being about 1 pmol/10(6) cells. In contrast,
in cells infected with either herpes simplex virus type 2 (HSV-2) or
varicella-zoster virus (VZV), penciclovir was phosphorylated quickly to give high
concentrations of the triphosphate ester. Following the removal of penciclovir
from the culture medium, penciclovir-triphosphate remained trapped within the
cells for a long time (half-lives, 20 and 7 h in HSV-2- and VZV-infected cells,
respectively). In HSV-2-infected cells, acyclovir was phosphorylated to a lesser 
extent and the half-life of the triphosphate ester was only 1 h. We were unable
to detect any phosphates of acyclovir in VZV-infected cells.
(S)-Penciclovir-triphosphate inhibited HSV-1 and HSV-2 DNA polymerase
competitively with dGTP, the Ki values being 8.5 and 5.8 microM, respectively,
whereas for acyclovir-triphosphate, the Ki value was 0.07 microM for the two
enzymes. Both compounds had relatively low levels of activity against the
cellular DNA polymerase alpha, with Ki values of 175 and 3.8 microM,
respectively. (S)-Penciclovir-triphosphate did inhibit DNA synthesis by HSV-2 DNA
polymerase with a defined template-primer, although it was not an obligate chain 
terminator like acyclovir-triphosphate. These results provide a biochemical
rationale for the highly selective and effective inhibition of HSV-2 and VZV DNA 
synthesis by penciclovir and for the greater activity of penciclovir than that of
acyclovir when HSV-2-infected cells were treated for a short time.

Publication Types: 
    Comparative Study

PMID: 1336346 [PubMed - indexed for MEDLINE]

5309: Hautarzt. 1992 Dec;43(12):767-71.

[Detection of varicella zoster virus infections using polymerase chain reaction]

[Article in German]

Eis-Hubinger AM, Kaiser R, Kleim JP, Dlugosch D, Estor A, Kleemann E, Lange CE,
Schneweis KE.

Institut fur Medizinische Mikrobiologie und Immunologie Rheinischen
Friedrich-Wilhelms-Universitat Bonn.

The polymerase chain reaction (PCR) was used to detect varicella zoster virus
(VZV) DNA in vesicle samples from patients with varicella and zoster. Primers and
the oligonucleotide probe were chosen from the region of the immediate early gene
63. Procedures for preparing the DNA from the specimens were omitted, and the
amplified DNA was directly detected in ethidium bromide-stained polyacrylamide or
agarose gels, thus providing a rapid and less laborious assay. A total of 66
vesicle specimens including 3 crusts (collected on days 1-14 after the onset of
exanthem) were tested by the simplified VZV-PCR, and 64 (97%) were positive. When
the direct visualization of the amplified DNA was confirmed by DNA hybridization,
a non-radioactive hybridization assay involving a digoxigenin-labelled
oligonucleotide probe and detection by chemiluminescence proved as adequate as a 
radioactive hybridization assay. Thus, the VZV PCR described appears to be a
useful diagnostic test for detecting and identifying varicella zoster virus.

Publication Types: 
    English Abstract

PMID: 1335444 [PubMed - indexed for MEDLINE]

5310: Infect Dis Clin North Am. 1992 Dec;6(4):831-49.

Viral keratitis.

Mader TH, Stulting RD.

Department of Ophthalmology, Madigan Army Medical Center, Tacoma, Washington.

Viruses that affect the cornea produce changes that range from benign,
self-limited conjunctivitis to sight-threatening scarring and vascularization of 
the cornea. In this article, the forms of viral keratitis most commonly
encountered by the clinician are reviewed. The epidemiology, clinical
presentation, and treatment of infection by Herpes simplex virus, varicella
zoster virus, and the adenoviruses are discussed. Also included are other viral
infections of the cornea.

Publication Types: 
    Review

PMID: 1334105 [PubMed - indexed for MEDLINE]

5311: Rev Prat. 1992 Dec 1;42(19):2495-7.

[Herpes zoster. Epidemiology, physiopathology, diagnosis, development, treatment]

[Article in French]

Guillet PG, Plantin P.

Service de dermatologie-allergologie, CHRU de Brest, hopital Augustin Morvan.

PMID: 1296327 [PubMed - indexed for MEDLINE]

5312: Am J Ophthalmol. 1992 Nov 15;114(5):603-9.

Polymerase chain reaction for the detection of the varicella-zoster genome in
ocular samples from patients with acute retinal necrosis.

Nishi M, Hanashiro R, Mori S, Masuda K, Mochizuki M, Hondo R.

Department of Ophthalmology, Escola Paulista de Medicina, Sao Paulo, Brazil.

We used the polymerase chain reaction to detect the virus genome in ocular
samples from patients with clinically diagnosed acute retinal necrosis. Four
samples from four patients with acute retinal necrosis, and five samples from
three patients with other ocular diseases (sarcoidosis, rhegmatogenous retinal
detachment, and epiretinal membrane of unknown origin) were evaluated. The
samples consisted of aqueous humor, vitreous, or subretinal fluid. Primers were
specific for varicella-zoster virus, herpes simplex virus, or cytomegalovirus.
The varicella-zoster virus genome was detected in three of the four samples from 
patients with acute retinal necrosis. Among these three positive samples, two had
PstI-site-less point mutation, strains that have been described only in Japan and
of low prevalence. Samples from patients with diagnoses other than acute retinal 
necrosis yielded negative results when varicella-zoster virus primer was used. No
sample was positive for herpes simplex virus or cytomegalovirus primers.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1332482 [PubMed - indexed for MEDLINE]

5313: JAMA. 1992 Nov 11;268(18):2541-4.

Comparison of Tzanck smear, viral culture, and DNA diagnostic methods in
detection of herpes simplex and varicella-zoster infection.

Nahass GT, Goldstein BA, Zhu WY, Serfling U, Penneys NS, Leonardi CL.

Department of Internal Medicine, St Louis University School of Medicine, MO
63104.

OBJECTIVE--To compare Tzanck smears, viral cultures, and DNA diagnostic methods
using the polymerase chain reaction (PCR) in detection of herpes simplex virus
(HSV) or varicella-zoster virus (VZV) infection in clinically suspected cases.
DESIGN--A 12-month trial comparing PCR with viral cultures and Tzanck smears in
patients with clinically suspected HSV or VZV infection. SETTING--Both ambulatory
and hospitalized patients were recruited from a tertiary referral center and the 
Miami (Fla) Veterans Affairs Medical Center. PATIENTS--Convenience samples of
patients clinically suspected to have HSV (n = 48) or VZV (n = 35). To be
included in the final analysis patients needed to have a positive Tzanck smear,
viral culture, or PCR result. Patients who were clinically suspected to have HSV 
but had VZV by viral culture or PCR were analyzed in the VZV group. Similarly,
patients who were clinically suspected to have VZV, but had HSV by viral culture 
or PCR were analyzed in the HSV group. Seventy-seven patients were available for 
final analysis: HSV (n = 30), VZV (n = 32), and 15 control cases who did not have
evidence of viral infection. RESULTS--For HSV, PCR detected HSV DNA sequences in 
73% of stained smears and 83% of unstained smears. For VZV infection, VZV DNA
sequences were detected in 88% of stained smears and 97% of unstained smears.
Viral DNA sequences were not detected in the 15 control cases. Viral cultures
were positive in 83% and 44% of HSV and VZV cases, respectively. The Tzanck smear
was positive in 60% and 75% of HSV and VZV cases, respectively. CONCLUSIONS--PCR 
is a reliable method for detecting HSV and VZV DNA sequences from single stained 
and unstained Tzanck smears. It is clearly superior to viral culture in
identifying VZV infection and is equivalent to conventional culture techniques in
identifying cases of HSV.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 1328700 [PubMed - indexed for MEDLINE]

5314: Med Clin (Barc). 1992 Nov 7;99(15):596-7.

[Acute meningitis caused by reactivation of the varicella-zoster virus without
cutaneous lesions. Contribution to the serologic diagnosis]

[Article in Spanish]

Guerrero M, Gutierrez J, Maroto MC, Gonzalez Maldonado R.

Publication Types: 
    Case Reports
    Letter

PMID: 1334174 [PubMed - indexed for MEDLINE]

5315: Q J Med. 1992 Nov-Dec;85(307-308):855-60.

Use of prednisolone in the treatment of HIV-positive tuberculosis patients.

Elliott AM, Halwiindi B, Bagshawe A, Hayes RJ, Luo N, Pobee JO, McAdam KP.

Department of Clinical Sciences, London School of Hygiene and Tropical Medicine.

Corticosteroids are beneficial in the treatment of some forms of tuberculosis,
but their role in TB affecting HIV-positive patients is not clear. During a
cohort study of tuberculosis patients in Lusaka, Zambia, prednisolone was
prescribed for specific indications. Six of 47 (13 per cent) of patients who
received prednisolone early in treatment developed herpes zoster, compared with 2
of 118 (2 per cent) of those who did not. Three patients who received
prednisolone developed Kaposi's sarcoma, compared with none who did not. At 2
months patients who had received prednisolone showed a greater improvement in
generalized lymphadenopathy and cough. Controlled studies of the risks and
benefits of administration of corticosteroids to HIV-positive TB patients are
urgently needed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1484947 [PubMed - indexed for MEDLINE]

5316: Br J Ophthalmol. 1992 Nov;76(11):646-50.

Comment in:
    Br J Ophthalmol. 1993 Aug;77(8):538.

Deep lamellar keratoplasty on air with lyophilised tissue.

Chau GK, Dilly SA, Sheard CE, Rostron CK.

St George's Hospital & Medical School, London.

Deep lamellar keratoplasty on air involves injecting air into the corneal stroma 
to expand it to several times its normal thickness. This method is designed to
facilitate dissection of the deep stroma and reduce the risk of perforation of
Descemet's membrane when carrying out deep lamellar keratoplasty. We have
modified the technique by using prelathed freeze-dried donor tissue and report
our results in a series of patients with corneal stromal scarring owing to a
variety of corneal problems, namely, keratoconus, pterygium, and herpes zoster
ophthalmicus. All patients achieved best corrected postoperative visual acuity of
6/12 or better without problems associated with graft failure or rejection.
Histopathological examination of corneal tissue following air injection showed
surgical emphysema within the cornea and separation of deep stromal fibres from
the underlying Descemet's membrane.

PMID: 1477037 [PubMed - indexed for MEDLINE]

5317: Br J Gen Pract. 1992 Nov;42(364):493-4.

Comment on:
    Br J Gen Pract. 1992 Jun;42(359):244-6.

Acute herpes zoster, postherpetic neuralgia, acyclovir and amitriptyline.

Avery AJ, Reeves J.

Publication Types: 
    Comment
    Letter

PMID: 1472405 [PubMed - indexed for MEDLINE]

5318: Acta Psychiatr Scand. 1992 Nov;86(5):418-20.

Search for evidence of herpes simplex virus, type 1, or varicella-zoster virus
infection in postmortem brain tissue from schizophrenic patients.

Alexander RC, Cabirac G, Lowenkopf T, Casanova M, Kleinman J, Wyatt RJ, Kirch DG.

Department of Psychiatry and Human Behavior, Jefferson Medical College, Thomas
Jefferson University, Philadelphia, PA 19107.

The highly sensitive polymerase chain reaction (PCR) was used to search for
herpes simplex virus type 1 (HSV-I) or varicella-zoster virus (VZV) in the DNA
extracted from postmortem temporal cortex samples of 8 schizophrenic subjects, 8 
nonschizophrenic suicide victims and 8 normal controls. HSV-I or VZV-specific DNA
amplification was not detected in any of the samples studied.

Publication Types: 
    Comparative Study

PMID: 1336636 [PubMed - indexed for MEDLINE]

5319: Clin Geriatr Med. 1992 Nov;8(4):735-43.

Viral infections.

Cesario TC, Yousefi S.

University of California School of Medicine, Irvine.

Viral infections may cause serious morbidity as well as death in elderly
patients. Of the RNA viruses, influenza virus is the most important pathogen; the
majority of influenza-related deaths occur in older patients. Respiratory
syncytial virus appears to be gaining increasing importance in elderly persons.
Herpes zoster or shingles is caused by the DNA virus, varicella-zoster virus, and
its major morbidity in older patients is postherpetic neuralgia.

Publication Types: 
    Review

PMID: 1330279 [PubMed - indexed for MEDLINE]

5320: Virology. 1992 Nov;191(1):346-54.

The varicella-zoster virus immediate early protein, IE62, can positively regulate
its cognate promoter.

Perera LP, Mosca JD, Sadeghi-Zadeh M, Ruyechan WT, Hay J.

Department of Microbiology, Uniformed Services University of the Health Sciences,
Bethesda, Maryland 20814-4799.

Varicella-Zoster virus (VZV) is a neurotropic alphaherpes virus closely related
to herpes simplex virus (HSV). However, unlike its close relative HSV, VZV lacks 
a functional alpha-TIF (alpha-gene transinducing factor) that activates the
transcription of immediate early genes during the initial events of the virus
life cycle. Hence, in the absence of a functional alpha-TIF, the mechanism
triggering the expression of immediate early genes in VZV at present remains
unclear. Accumulating evidence indicates that the gene product of the putative
immediate early gene ORF62 (IE62) plays a pivotal role in activating VZV genes of
all three putative kinetic classes, namely immediate early (alpha), early (beta),
and late (gamma) classes of VZV genes. In the present study, we show that IE62
can positively autoregulate its cognate promoter using a transient transfection
assay, both in lymphocytes and in neural cells. In the same system, we can also
demonstrate activation of the VZV IE62 promoter by HSV ICP4. By deletion analysis
and oligonucleotide-directed site-specific mutagenesis we have localized specific
regions in the IE62 promoter/upstream sequences that mediate inducibility by IE62
and HSV ICP4, and provide evidence that this promoter activation by these two
proteins may be through different mechanisms. These data, taken together with the
recent demonstration of the presence of IE62 in the VZ virion tegument
(Kinchington, P.R., Hoagland, J.K., Arvin, A.M., Ruyechan, W.T., and Hay, J.
1992. J. Virol. 66, 359-366) provides a possible mechanism by which the
triggering of VZV gene expression occurs in the absence of a functional alpha-TIF
protein.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1329324 [PubMed - indexed for MEDLINE]

5321: J Infect Dis. 1992 Nov;166(5):1157-9.

Detection of varicella-zoster virus DNA in human geniculate ganglia by polymerase
chain reaction.

Furuta Y, Takasu T, Fukuda S, Sato-Matsumura KC, Inuyama Y, Hondo R, Nagashima K.

Department of Pathology, Hokkadio University, School of Medicine, Sapporo, Japan.

Latent varicella-zoster virus (VZV) has been demonstrated in the human trigeminal
and thoracic ganglia by means of nucleic acid hybridization. However, the human
geniculate ganglia in VZV latency have not been examined. Tissue DNA extracted
from the trigeminal and geniculate ganglia of a newborn and 7 adults was examined
by polymerase chain reaction with a pair of VZV-specific primers. None had
symptoms of recent infection with VZV (chickenpox or shingles). VZV DNA was
detected in 11 (79%) of 14 trigeminal ganglia and in 9 (69%) of 13 geniculate
ganglia of the adults. VZV DNA was not detected in either type of ganglion from
the newborn or from 1 adult who was seronegative for VZV antibodies. These
findings indicate that VZV becomes latent in human geniculate ganglia after
primary infection and suggest the possibility that reactivation of the virus from
the geniculate ganglia may cause Ramsay Hunt syndrome.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1328403 [PubMed - indexed for MEDLINE]

5322: J Infect Dis. 1992 Nov;166(5):1153-6.

Comment in:
    J Infect Dis. 1993 Jul;168(1):245.

Herpes zoster and human immunodeficiency virus infection.

Buchbinder SP, Katz MH, Hessol NA, Liu JY, O'Malley PM, Underwood R, Holmberg SD.

AIDS Office, San Francisco Department of Public Health, California.

The interaction of herpes zoster and the human immunodeficiency virus (HIV) was
evaluated in a cohort study of 287 homosexual men with well-defined dates of HIV 
seroconversion and 499 HIV-seronegative homosexual men. The incidence of herpes
zoster was significantly higher among HIV-seropositive men (29.4 cases/1000
person-years) than among HIV-seronegative men (2.0 cases/1000 person-years); the 
overall age-adjusted relative risk (RR) was 16.9 (95% confidence interval [CI],
8.7-32.6). When compared with that of age-matched population controls from 1945
to 1959, the incidence of zoster was significantly higher among seropositive men 
(RR, 26.7; 95% CI, 19.3-37.1) and slightly higher among seronegative men (RR,
1.85; 95% CI, 1.0-3.3); the latter may reflect increasing background rates over
several decades. The risk of herpes zoster was not associated with duration of
HIV infection and was not predictive of faster progression to AIDS.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1308664 [PubMed - indexed for MEDLINE]

5323: Cancer Epidemiol Biomarkers Prev. 1992 Nov-Dec;1(7):533-6.

Medical history and the risk of non-Hodgkin's lymphomas.

La Vecchia C, Negri E, Franceschi S.

Istituto di Ricerche Farmacologiche, Mario Negri, Milan, Italy.

The relationship between selected aspects of medical history and the risk of
non-Hodgkin's lymphomas (NHLs) was investigated using data from a hospital-based 
case-control study conducted in northern Italy on 177 cases of NHL and 561
controls in hospital for acute conditions, other than nonneoplastic or
immunological. Among six viral diseases considered, only herpes zoster (shingles)
had a relative risk (RR) significantly above unity [RR = 2.7; 95% confidence
intervals (CI), 1.5 to 4.7]. The association, however, was restricted to subjects
whose diagnosis of herpes zoster dated back to less than 10 years, suggesting
that this slow-acting virus could be reactivated by the early development of NHL.
Six of eight bacterial diseases considered showed RR above unity, and the
estimate was significant for scarlet fever (RR = 1.9; 95% CI, 1.1 to 3.5) and
pyelonephritis (RR = 5.3; 95% CI, 1.8 to 16.2). These associations were not
restricted to the few years before lymphoma diagnosis. When various classes of
infectious or inflammatory diseases were grouped together, no association was
evident for viral infections (RR = 0.8; 95% CI, 0.6 to 1.2), acute bacterial
diseases (RR = 1.0; 95% CI, 0.7 to 1.5), or allergic conditions (RR = 1.0; 95%
CI, 0.6 to 2.1). The risk estimates were nonsignificantly above unity for chronic
bacterial diseases (RR = 1.2; 95% CI, 0.7 to 1.2) and autoimmune conditions (RR =
1.4; 95% CI, 0.9 to 2.2), and significantly elevated for chronic inflammatory
disease (RR = 1.9; 95% CI, 1.2 to 3.0).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 1302565 [PubMed - indexed for MEDLINE]

5324: J Med Virol. 1992 Nov;38(3):183-90.

Detection of herpesvirus DNA in the large intestine of patients with ulcerative
colitis and Crohn's disease using the nested polymerase chain reaction.

Wakefield AJ, Fox JD, Sawyerr AM, Taylor JE, Sweenie CH, Smith M, Emery VC,
Hudson M, Tedder RS, Pounder RE.

Inflammatory Bowel Disease Study Group, University College and Middlesex School
of Medicine, United Kingdom.

The prevalence of herpesvirus DNA was examined in inflammatory bowel disease
tissue. DNA was extracted from resection and biopsy specimens of the large
intestine from patients with ulcerative colitis (n = 21), patients with Crohn's
disease (n = 29), and patients with noninflammatory bowel disease (controls) (n =
21). The nested polymerase chain reaction was used to detect viral DNA using
primer pairs specific for either cytomegalovirus (CMV), herpes simplex virus 1
(HSV1), human herpesvirus 6 (HHV6), varicella zoster virus (VZV), or Epstein Barr
virus (EBV). HSV1 and VZV DNA were not detected in any of tissue samples. There
was a high prevalence of CMV (81%), HHV6 (76%), and EBV (76%) DNA in ulcerative
colitis tissue compared to Crohn's disease tissues (CMV 66%, HHV6 45%, EBV 55%). 
Control tissue had a relatively low frequency of CMV (29%) and EBV (19%) DNA but 
a prevalence of HHV6 DNA similar to that of ulcerative colitis (86%). However,
the simultaneous presence of HHV6 and CMV and/or EBV DNA in ulcerative colitis
tissue (76%) was much greater than in either Crohn's disease tissues (38%) or
control tissue (29%) (P < 0.05). There was a low prevalence of CMV, HHV6, and EBV
DNA in peripheral blood mononuclear cells from all patient groups. CMV and EBV
are capable of reactivating HHV6: the high prevalence of coexistent HHV6
infection with either or both of these two viruses in ulcerative colitis tissue
suggests that they may play a synergistic role in the pathogenesis of this
disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1287131 [PubMed - indexed for MEDLINE]

5325: J Gen Virol. 1992 Nov;73 ( Pt 11):2969-73.

Human sera from varicella-zoster virus (VZV) infections cross-react with human T 
cell leukaemia virus type 1 (HTLV-1): common epitopes in VZV gene 22 protein and 
HTLV-1 p19 gag protein.

Sato A, Isaka Y, Morita F, Ishii A, Goto Y, Imai J, Igarashi H, Yoshie O, Hinuma 
Y.

Shionogi Institute for Medical Science, Osaka, Japan.

Twenty-nine of 100 sera from patients recently infected with varicella-zoster
virus (VZV) were found to cross-react with human T cell leukaemia virus type 1
(HTLV-1) antigen in the particle agglutination (PA) assay using HTLV-1
antigen-coated gelatin particles. Anti-VZV IgM antibodies were shown to be
responsible for this cross-reactivity. Western blot analysis revealed that
PA-positive anti-VZV sera reacted with the HTLV-1 gag p19 protein in
HTLV-1-infected cells and recombinant p19 protein produced in Escherichia coli.
By using a truncated p19, the cross-reactive region was located to the C-terminal
17 amino acids of p19. One oligopeptide derived from the C terminus, PQIPPPYVEPT 
(amino acids 115 to 125), was capable of inhibiting PA, suggesting that this
peptide carries the cross-reactive epitope. A homologous sequence was found in
the VZV gene 22 protein by database analysis, and the oligopeptide TNIPPPLALLR
(amino acids 1330 to 1340) had the ability to inhibit PA. These findings suggest 
that some IgM antibodies against the VZV gene 22 protein produced in the early
phase of VZV infection are cross-reactive with the HTLV-1 gag p19 protein because
they recognize an antigenic determinant containing an IPPP tetrapeptide.

Publication Types: 
    Comparative Study

PMID: 1279104 [PubMed - indexed for MEDLINE]

5326: Virology. 1992 Oct;190(2):597-605.

Molecular analysis of simian varicella virus DNA.

Clarke P, Rabkin SD, Inman MV, Mahalingam R, Cohrs R, Wellish M, Gilden DH.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

Clinical and pathological studies indicate that simian varicella virus (SVV)
infection in primates is the counterpart of human varicella zoster virus (VZV)
infection. The SVV and VZV genomes are also similar in size and structure. To
extend studies of SVV DNA, we analyzed virus DNA from African green monkey kidney
cells infected with the Delta-herpes-virus strain of SVV. The infectivity of SVV 
DNA was 88 PFU/micrograms. The buoyant density of SVV DNA, determined by
isopycnic banding in CsCl gradients, was 1.700 +/- 0.002 g/ml, corresponding to a
G + C molar ratio of 40.8%. The size of SVV DNA, estimated by analysis of
restriction endonuclease digestion products and pulsed-field gel electrophoresis 
was 125.1 and 124.9 kbp, respectively. Electron microscopy of SVV DNA revealed a 
long region of 110.0 kbp, a unique short (Us) region of 5.1 kbp, and inverted
repeat regions of 7.5 kbp flanking the Us. An EcoRI map of SVV DNA revealed two
fragments not previously reported; our complete Pstl map also shows some
differences. Mapping of SVV DNA with an additional restriction enzyme,
measurement of full-length SVV DNA molecules, and the first use of pulsed-field
electrophoresis to size SVV DNA, confirm and extend Gray's recent finding that
SVV DNA has the same size and molecular configuration as VZV. We also show for
the first time that the density of SVV DNA is similar to that of VZV DNA and that
SVV DNA is infectious.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1519354 [PubMed - indexed for MEDLINE]

5327: Rev Fr Gynecol Obstet. 1992 Oct;87(10):490-2.

[Chickenpox and pregnancy]

[Article in French]

Vincent Y, Bernard JP, Laroussinie MP, Lafay Pillet MC, Taurelle R.

Service de Gynecologie-Obstetrique, Hopital Boucicaut, Paris.

The authors report a case of chickenpox exposure during the first three months of
pregnancy. Ultrasonographic monitoring of the fetus revealed signs of fetal
infection starting from 32 weeks of amenorrhea (hepatomegaly, ascites, pleural
effusion) but clinical examination of the child at birth showed nothing abnormal.
The diagnosis was confirmed by the development of herpes zoster in the child
after birth. The difficulty of determining a fetal prognosis during pregnancy is 
emphasised.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1470822 [PubMed - indexed for MEDLINE]

5328: Pain. 1992 Oct;51(1):111-8.

T-lymphocyte subsets in otherwise healthy patients with herpes zoster and
relationships to the duration of acute herpetic pain.

Higa K, Noda B, Manabe H, Sato S, Dan K.

Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.

T-lymphocyte subsets (CD3, CD4, and CD8 lymphocytes) in peripheral blood,
parameters of cell-mediated immunity, were serially measured in 62 otherwise
healthy Japanese patients with herpes zoster (HZ), and the findings were compared
with those of 20 age-matched healthy controls who had had varicella but not HZ.
Our objective was to elucidate whether there were changes in cell-mediated
immunity, even in immunocompetent patients with HZ, and to investigate
relationships between these variables and the duration of acute herpetic pain
(AHP). All the patients underwent repeated sympathetic nerve blocks until pain
was relieved. As compared with controls, there were slight increases in the
percentages of CD4 lymphocytes (helper/inducer) and highly significant increases 
in the percentages of CD8 lymphocytes (suppressor/cytotoxic), resulting in marked
decreases in CD4/CD8 ratios in the acute phase of HZ. The percentages of CD3
lymphocytes (pan-T lymphocytes) did not differ significantly. The duration of AHP
was analyzed in 49 patients in whom T-lymphocyte subsets were measured more than 
twice. There was a weak but statistically significant positive linear correlation
between age and the duration of AHP (r = 0.43, P < 0.01). There were
statistically highly significant positive linear correlations between the number 
of days on which percentages of CD3 (r = 0.72, P < 10(-8)) and CD4 lymphocytes (r
= 0.60, P < 10(-5)), and CD4/CD8 ratios (r = 0.62, P < 10(-5)) reached the
maximum values after the onset of HZ and the duration of AHP. These correlation
coefficients were higher than that between age and the duration of AHP.(ABSTRACT 
TRUNCATED AT 250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1454393 [PubMed - indexed for MEDLINE]

5329: Br J Ophthalmol. 1992 Oct;76(10):639.

Comment on:
    Br J Ophthalmol. 1991 Sep;75(9):542-6.

Acyclovir in herpes zoster ophthalmicus.

Herbort CP.

Publication Types: 
    Comment
    Letter

PMID: 1420049 [PubMed - indexed for MEDLINE]

5330: Transplant Proc. 1992 Oct;24(5):1926.

Safe use of acyclovir (Zovirax) in renal transplant patients on cyclosporine A
therapy: case reports.

Hayes K, Shakuntala V, Pingle A, Dhawan IK, Masri MA.

Faculty of Medicine and Health Sciences, Jazera Central Hospital, Abu Dhabi,
United Arab Emirates.

Publication Types: 
    Case Reports

PMID: 1412913 [PubMed - indexed for MEDLINE]

5331: Int J Dermatol. 1992 Oct;31(10):745-6.

Granuloma annulare arising after herpes zoster.

Hayakawa K, Mizukawa Y, Shiohara T, Nagashima M.

Publication Types: 
    Case Reports
    Letter

PMID: 1399211 [PubMed - indexed for MEDLINE]

5332: Dermatol Clin. 1992 Oct;10(4):741-61.

Ocular and periocular infections.

Holzberg M, Stulting RD, Drake LA.

Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.

The eye is an important site for infectious disease because an incorrect
diagnosis can cause loss of vision or loss of life. An approach to accurate
diagnosis, intervention, and therapy is outlined.

Publication Types: 
    Review

PMID: 1395156 [PubMed - indexed for MEDLINE]

5333: Kansenshogaku Zasshi. 1992 Oct;66(10):1373-7.

[Clinical varicella-zoster virus reinfection observed in two advanced-age
persons]

[Article in Japanese]

Takayama N, Takayama M, Negishi M.

Tokyo Metropolitan Komagome Hospital, Japan.

We observed two mild varicella cases of an advanced-age man and woman, although
varicella in the adult generally presents a more severe course than in the child.
The cases had been exposed to his great-grandchild and her grandchild with
varicella in their home. They did not experience neuralgia as is typical from
herpes zoster. Serological examinations revealed that they had high
IgG-antibodies (Ab) against varicella-zoster virus (VZV), but low anti-VZV
IgM-Ab. They were also found to have a high level of Ab against VZV soluble
antigens (Ag) which are generally low in primary VZV infection. Immunoblotting
analysis of anti-VZV IgG-Abs using sera from case 1 or 2 showed that their
reaction patterns resembled those of sera children who contracted mild varicella 
after immunization with varicella vaccine and a herpes zoster-patient rather than
those of sera from an immunocompetent adult with varicella. These results of
serological examinations and their clinical course indicated that the cases had
contracted varicella in the past and were again exposed to VZV resulting in
clinically overt but mild varicella.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1338086 [PubMed - indexed for MEDLINE]

5334: Mol Cell Probes. 1992 Oct;6(5):367-73.

A prospective study of the polymerase chain reaction for detection of herpes
simplex virus in cerebrospinal fluid submitted to the clinical virology
laboratory.

Aslanzadeh J, Osmon DR, Wilhelm MP, Espy MJ, Smith TF.

Department of Laboratory Medicine, Mayo Clinic, Rochester, MN 55905.

Polymerase chain reaction (PCR) was prospectively performed with cerebrospinal
fluid (CSF) from 51 patients whose CSF was available for analysis and was
submitted for viral culture and/or herpes simplex virus (HSV) serology and 20
patients whose CSF was submitted exclusively to the Clinical Biochemistry
Laboratory. Primers were used that flanked a 92 bp segment of the HSV DNA
polymerase gene (35 cycles). Amplified products were electrophoresed on agarose
gel, blotted onto nylon membrane, and probed with a 32P-labelled sequence
internal to the primers. For nested PCR, 1 microliter of PCR product was
amplified for an additional 35 cycles before electrophoresis and Southern blot
analysis. Review of the clinical records revealed that 15 patients had central
nervous system (CNS) infections. Specific HSV DNA sequences were detected in CSF 
specimens of three of the individuals [PCR(2), nested PCR(1)]. Two of these
patients had disseminated HSV infection including encephalitis and one patient
had aseptic meningitis. The diagnoses of the 12 patients with CNS infection who
did not have HSV DNA detected in CSF included encephalitis [varicella-zoster
virus (1), cytomegalovirus (1), Mycoplasma pneumoniae (1)], meningitis [Neisseria
meningitidis (1), Coccidioides immitis (1), Enterovirus (1), aseptic meningitis
(1)], varicella-zoster radiculitis (2), human immunodeficiency virus dementia
(2), and transverse myelitis due to Epstein-Barr virus (1). Importantly, HSV DNA 
was also not detected in the CSF of the 36 patients who did not have CNS
infection and 20 samples submitted exclusively to the Clinical Biochemistry
Laboratory. Our findings demonstrate the utility of PCR as a rapid, non-invasive 
method for the routine laboratory diagnosis of CNS infection due to HSV.

PMID: 1335547 [PubMed - indexed for MEDLINE]

5335: East Afr Med J. 1992 Oct;69(10):550-3.

World Health Organization clinical case definition for AIDS in Africa: an
analysis of evaluations.

Keou FX, Belec L, Esunge PM, Cancre N, Gresenguet G.

Department of Medical Microbiology, Broussais University Hospital, Paris, France.

In 1985 at a World Health Organization (WHO) workshop on AIDS in Bangui, Central 
African Republic, a clinical case definition of Acquired Immune Deficiency
Syndrome (AIDS) was developed for developing countries, such as sub-Saharan
Africa, where sophisticated diagnostic equipment is not widely available. A
particular cachectic syndrome, the "slim disease", which is highly suggestive of 
AIDS in Africa, constitutes the substratum for the clinical definition for AIDS. 
The WHO/Bangui definition in adults has a sensitivity of 60%, a specificity of
90%, and a high predictive value especially in endemic areas. The WHO/Bangui
clinical case definition for paediatric AIDS is less easy to use in practice. Its
low sensitivity (about 35%) is in relation to its incapacity to diagnose many of 
the frequently observed secondary infection for paediatric AIDS according to the 
CDC criteria. The WHO/Bangui clinical definition for AIDS seems to be convenient 
for epidemiological surveillance of the HIV epidemic in Africa. Nevertheless, the
low sensitivity and the low specificity result in the failure to detect some
cases of full blown AIDS.

PIP: In 1985, at a WHO workshop on AIDS in Bangui, Central African Republic, a
clinical case definition of AIDS was developed for developing countries. This 1st
definition contained 4 major criteria (chronic asthenia, major weight loss,
chronic fever, and chronic diarrhea) and 6 minor criteria (chronic cough,
persistent lymphadenopathy, herpes zoster, recurrent herpetic infection, pruritic
dermatitis, and oropharyngeal candidiasis). Kaposi's sarcoma and cryptococcal
meningitis were sufficient by themselves for the diagnosis of AIDS. In children, 
the temporary definition of AIDS consisted of 3 major clinical criteria (weight
loss and/or abnormally slow growth, chronic diarrhea lasting more than 1 month,
and fever lasting more than 1 month), and 6 secondary clinical criteria
(generalized lymphadenopathy, oropharyngeal candidiasis, repeated common
infections such as otitis and pharyngitis, persistent cough, generalized pruritic
dermatitis, and confirmed maternal HIV infection). The revised Bangui definition 
was evaluated in 174 adult patients hospitalized at the Mama Yemo Hospital of
Kinshasa, Zaire. 46% of 174 patients met the criteria of the WHO/Bangui
definition. Overall, the sensitivity of the definition for HIV-1 infection was
59%, the specificity was 90%, and the positive predictive value (PPV) was 74%.
However, the clinical case definition of African AIDS lacks specificity when it
is applied to patients suffering from cachectic syndromes. The Bangui definition 
was also evaluated at the pediatric ward of Mama Yemo Hospital with 159
hospitalized children whose mean age was 33 months. 21 (13%) were infected by
HIV-1. The sensitivity of the definition was 35%, its specificity was 86%, and
its PPV was 26%. Although the specificity was relatively high, the low values of 
sensitivity and PPV underline the weakness of the Bangui clinical case definition
for diagnosing pediatric AIDS cases.

PMID: 1335410 [PubMed - indexed for MEDLINE]

5336: Minerva Pediatr. 1992 Oct;44(10 Suppl 1):147-54.

[Perinatal viral infections of the central nervous system]

[Article in Italian]

Midulla M, Bavastrelli M.

Istituto di Clinica Pediatrica, Universita degli Studi La Sapienza, Roma.

Publication Types: 
    Review

PMID: 1335110 [PubMed - indexed for MEDLINE]

5337: West J Med. 1992 Oct;157(4):448-9.

Medical treatment of retinal infections in patients with AIDS.

Holland GN.

The Council on Scientific Affairs of the California Medical Association presents 
the following inventory of items of progress in ophthalmology. Each item, in the 
judgment of a panel of knowledgeable physicians, has recently become reasonably
firmly established, both as to scientific fact and important clinical
significance. The items are presented in simple epitome, and an authoritative
reference, both to the item itself and to the subject as a whole, is generally
given for those who may be unfamiliar with a particular item. The purpose is to
assist busy practitioners, students, researchers, and scholars to stay abreast of
these items of progress in ophthalmology that have recently achieved a
substantial degree of authoritative acceptance, whether in their own field of
special interest or another.The items of progress listed below were selected by
the Advisory Panel to the Section on Ophthalmology of the California Medical
Association, and the summaries were prepared under its direction.

PMID: 1334299 [PubMed - indexed for MEDLINE]

5338: Neuropathol Appl Neurobiol. 1992 Oct;18(5):502-14.

Varicella-zoster virus encephalitis in acquired immunodeficiency syndrome: report
of four cases.

Gray F, Mohr M, Rozenberg F, Belec L, Lescs MC, Dournon E, Sinclair E, Scaravilli
F.

Departement de Pathologie Cellulaire et Tissulaire, Faculte de Medecine de
Creteil, Universite Paris-Val de Marne France.

Four patients with acquired immunodeficiency syndrome, a 27-year-old female
intravenous drug abuser and three males (two drug addicts aged 27 and 33 years
and a 40-year-old homosexual) presented with a rapidly progressive
encephalopathy. Two had generalized varicella-zoster virus skin infection, one
had had a regressive thoracic zoster rash 7 months previously and one had no
history of cutaneous eruption. Neuropathological examination revealed, in each
case, multifocal necrotic changes with numerous, intranuclear Cowdry type A
inclusion bodies in glial cells, endothelial cells, macrophages and neurons,
within and around the lesions. These inclusion bodies were stained positively for
varicella-zoster virus by immunocytochemistry and contained herpes virus
nucleocapsids by electron microscopy. Molecular biology using the
polymerase-chain-reaction method demonstrated viral genome. In one case,
zoster-induced non-inflammatory vasculopathy involved medium sized leptomeningeal
vessels and was associated with circumscribed areas of cortico-subcortical
infarction. In another case, varicella-zoster virus encephalitis was associated
with human immunodeficiency virus encephalitis and a secondary cerebral lymphoma.
Multinucleated giant cells expressing human immunodeficiency virus proteins in
their cytoplasm, were found in the lymphomatous deposits and in the
varicella-zoster virus necrotic lesions. In these latter lesions, Cowdry type A
inclusion bodies could be seen in the nuclei of some multinucleated giant cells
confirming previous observations of MGCs co-infected by HIV and CMV, and
supporting the hypothesis that DNA viruses interact with HIV, thus increasing its
effect.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 1333572 [PubMed - indexed for MEDLINE]

5339: Virology. 1992 Oct;190(2):654-65.

Genetic relationships between bovine herpesvirus 4 and the gammaherpesviruses
Epstein-Barr virus and herpesvirus saimiri.

Bublot M, Lomonte P, Lequarre AS, Albrecht JC, Nicholas J, Fleckenstein B,
Pastoret PP, Thiry E.

Virology Department, Faculty of Veterinary Medicine, University of Liege,
Belgium.

The overall arrangement of genes in the unique central part of the bovine
herpesvirus type 4 (BHV-4) genome has been deduced by analysis of short DNA
sequences. Twenty-three genes conserved in at least one of the completely
sequenced herpesviruses have been identified and localized. All of these genes
encoded amino acid sequences with higher similarity to proteins of the
gammaherpesviruses Epstein-Barr virus (EBV) and herpesvirus saimiri (HVS) than to
the homologous products of the alphaherpesviruses varicella-zoster virus and
herpes simplex virus type 1 or the betaherpesvirus human cytomegalovirus. The
genome organization of BHV-4 had also an overall colinearity with that of the
gammaherpesviruses EBV and HVS. Furthermore, the BHV-4 genes content and
arrangement were more similar to those of HVS than to those of EBV, suggesting
that BHV-4 and HVS are evolutionarily more closely related to each other than
either are to EBV. BHV-4 DNA sequences were generally deficient in CpG
dinucleotide. This CpG deficiency is characteristic of gammaherpesvirus genomes
and suggests that the BHV-4 latent genome is extensively methylated. Despite
several biological features similar to those of betaherpesviruses, BHV-4 displays
the molecular characteristics of the representative members of the
gammaherpesvirinae subfamily.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 1325698 [PubMed - indexed for MEDLINE]

5340: J Assoc Physicians India. 1992 Oct;40(10):706.

Comment on:
    J Assoc Physicians India. 1992 Mar;40(3):210-1.

Viral encephalitis--overdiagnosed, undertreated.

Bhatia RS.

Publication Types: 
    Comment
    Letter

PMID: 1307373 [PubMed - indexed for MEDLINE]

5341: N Engl J Med. 1992 Sep 10;327(11):782-9.

Erratum in:
    N Engl J Med 1993 Mar 4;328(9):671.    N Engl J Med 1997 Dec 4;337(23):1703.

Acyclovir: a decade later.

Whitley RJ, Gnann JW Jr.

Department of Pediatrics, University of Alabama, Birmingham.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1288525 [PubMed - indexed for MEDLINE]

5342: Cancer Causes Control. 1992 Sep;3(5):449-56.

Leukemia, lymphoma, and multiple myeloma following selected medical conditions.

Doody MM, Linet MS, Glass AG, Friedman GD, Pottern LM, Boice JD Jr, Fraumeni JF
Jr.

Epidemiology and Biostatistics Program, National Cancer Institute, Bethesda, MD
20892.

The role of selected prior medical conditions in the etiology of hematopoietic
malignancies was examined in a case-control study of members of two regional
branches of the Kaiser Permanente Medical Care Program (USA). Past history of
chronic infectious, autoimmune, allergic, and musculoskeletal disorders was
abstracted from medical records for leukemia (n = 299), non-Hodgkin's lymphoma
(NHL, n = 100), and multiple myeloma (n = 175) cases and matched controls (n =
787). Little difference was found between cases and controls for most of the
chronic conditions evaluated, including sinusitis, carbuncles, urinary tract
infections, pelvic infections, herpes zoster, asthma, rheumatoid arthritis,
psoriasis, bursitis, and gout. Only three statistically significant elevated
risks were found, i.e., with combined disc disease myeloma among patients with
prior eczema and disk and other musculoskeletal conditions, and NHL following
tuberculosis. Only two of these associations showed consistent patterns by sex
and geographic region (myeloma with eczema and with musculoskeletal conditions). 
While prior history of eczema and musculoskeletal conditions may slightly
increase risk of myeloma, this study provided little if any support for an
association of chronic infectious, autoimmune, allergic, and musculoskeletal
conditions with subsequent occurrence of the leukemias or NHL. Additionally,
these data did not support a role for chronic antigenic stimulation, as defined
in previous epidemiologic studies, in the etiology of hematopoietic malignancies.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1525326 [PubMed - indexed for MEDLINE]

5343: Arch Dermatol. 1992 Sep;128(9):1278-9.

The clinical spectrum from classic varicella zoster to zoster sine herpete: the
missing link.

Nahass GT, Penneys NS, Leonardi CL.

Publication Types: 
    Case Reports
    Letter

PMID: 1519950 [PubMed - indexed for MEDLINE]

5344: Southeast Asian J Trop Med Public Health. 1992 Sep;23(3):541-2.

Herpes zoster myelitis treated with acyclovir.

Chotmongkol V, Phankingthongkum R.

Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand.

Publication Types: 
    Case Reports

PMID: 1488716 [PubMed - indexed for MEDLINE]

5345: Clin Ter. 1992 Sep;141(9 Pt 2):11-6.

[Immunoglobulins in the treatment of herpes zoster]

[Article in Italian]

Agostini G, Agostini S.

Instituto di Clinica Dermatologica, Universita degli Studi di Pisa.

We have treated 20 patients with Herpes Zoster with "hyperimmune anti-Zoster
immunoglobulins" (Uman-VZIG) by intralesional administration, 20 patients with
Uman-VZIG by intramuscular administration and 23 patients with acyclovir by
intravenous administration. The results of treatment in both groups of patients
treated with Uman-VZIG were clinically satisfactory with disappearance of fever, 
local pain and amelioration of cutaneous lesions after two days from the start of
treatment and with a mean duration of disease of five days. In patients treated
with acyclovir, signs and symptomatology of disease ameliorated slowly and we
have observed a longer mean duration of disease (about 8 days). We concluded that
Uman-VZIG, both by intralesional and intramuscular administration, is effective
and safe in Herpes Zoster treatment.

Publication Types: 
    English Abstract

PMID: 1468193 [PubMed - indexed for MEDLINE]

5346: Int J Dermatol. 1992 Sep;31(9):672.

Comment on:
    Int J Dermatol. 1992 Jan;31(1):55-7.

Granuloma annulare following herpes zoster.

Wright AL.

Publication Types: 
    Comment
    Letter

PMID: 1459773 [PubMed - indexed for MEDLINE]

5347: Br J Gen Pract. 1992 Sep;42(362):398.

Comment on:
    Br J Gen Pract. 1992 Jun;42(359):244-6.

Acute herpes zoster, postherpetic neuralgia, acyclovir and amitriptyline.

Herxheimer A.

Publication Types: 
    Comment
    Letter

PMID: 1457182 [PubMed - indexed for MEDLINE]

5348: Surv Ophthalmol. 1992 Sep-Oct;37(2):151-2; author reply 152-3.

Comment on:
    Surv Ophthalmol. 1992 May-Jun;36(6):395-410.

Readers comment on "Herpes zoster ophthalmicus".

Juzych MS, McHenry J, Spoor TC.

Publication Types: 
    Comment
    Letter

PMID: 1455301 [PubMed - indexed for MEDLINE]

5349: Surv Ophthalmol. 1992 Sep-Oct;37(2):151; author reply 152-3.

Comment on:
    Surv Ophthalmol. 1992 May-Jun;36(6):395-410.

Readers comment on "Herpes zoster ophthalmicus".

Harper DG.

Publication Types: 
    Comment
    Letter

PMID: 1455300 [PubMed - indexed for MEDLINE]

5350: Surv Ophthalmol. 1992 Sep-Oct;37(2):150; author reply 152-3.

Comment on:
    Surv Ophthalmol. 1992 May-Jun;36(6):395-410.

Readers comment on "Herpes zoster ophthalmicus".

Seiff SR, Margolis T.

Publication Types: 
    Comment
    Letter

PMID: 1455299 [PubMed - indexed for MEDLINE]

5351: J Laryngol Otol. 1992 Sep;106(9):839-40.

Isolated bilateral paralysis of the soft palate in an adult.

Izzat M, Sharma PD.

A case of bilateral paralysis of the soft palate occurring in a 42-year-old
patient is presented. Idiopathic paralysis of the soft palate as an isolated
clinical entity was first described by Edin et al. 1976. Since then 22 similar
cases have been reported, all in children and all unilateral. A search of the
English language literature has not revealed a case of bilateral palatal palsy in
an adult.

Publication Types: 
    Case Reports

PMID: 1431530 [PubMed - indexed for MEDLINE]

5352: AJNR Am J Neuroradiol. 1992 Sep-Oct;13(5):1404-6.

Herpes zoster myelitis: MR appearance.

Friedman DP.

Department of Radiology, Jefferson Medical College, Philadelphia, PA.

The author describes a 71-year-old woman in whom cutaneous cervical herpes zoster
was complicated by the development of cervical myelitis. T2-weighted MR showed
two focal areas of hyperintensity in the cervical cord and suggested a slight
enlargement at C2-C3 and C7.

Publication Types: 
    Case Reports

PMID: 1414833 [PubMed - indexed for MEDLINE]

5353: Pediatr Nurs. 1992 Sep-Oct;18(5):499-503.

Acyclovir in the treatment of chickenpox.

Farrington E.

Although chickenpox is a highly contagious disease affecting 90% of susceptible
persons exposed, its morbidity and mortality in healthy patients is minimal.
Treatment of chickenpox with oral acyclovir appears to decrease the number of pox
lesions and shorten the duration of new lesion formation. Most importantly,
children treated with acyclovir begin to feel better soon and had fewer systemic 
signs and symptoms of chickenpox (fever, fatigue, loss of appetite). However, the
greatest mortality from chickenpox is seen in the immunocompromised patient, or
in elderly patients with zoster (shingles) due to reactivation of latent
varicella infection. Therefore, prevention of varicella is necessary to decrease 
mortality from the varicella-zoster virus. It is hopeful that the varicella
vaccine will be licensed in the U.S. for routine immunization of healthy children
within the next year. While its general use will not eliminate either chickenpox 
or zoster, there will be a considerable decrease in the morbidity and mortality
caused by this agent as a result of routine immunization.

PMID: 1408423 [PubMed - indexed for MEDLINE]

5354: J Am Acad Dermatol. 1992 Sep;27(3):403-5.

The Tzanck smear: can dermatologists accurately interpret it?

Grossman MC, Silvers DN.

Department of Dermatology, College of Physicians and Surgeons, Columbia
University, New York, NY 10032.

BACKGROUND: The Tzanck preparation is a standard technique for the rapid
diagnosis of herpes simplex and varicella-zoster virus infections. OBJECTIVE:
This study was designed to determine the ability of practicing dermatologists to 
interpret Tzanck preparations accurately. METHODS: Dermatologists at different
levels of training interpreted a series of Tzanck preparations under test
conditions. RESULTS: Second- and third-year residents had a pooled average for
correct responses of 91%; dermatologists in practice less than 10 years, 84%;
dermatologists in practice more than 10 years, 67%. CONCLUSION: Dermatologists
are able to use the Tzanck preparation effectively for diagnosing herpetic
infections. Second- and third-year residents who are most likely to be diagnosing
blistering eruptions in immunosuppressed or otherwise critically ill patients are
especially accurate interpreters.

PMID: 1401275 [PubMed - indexed for MEDLINE]

5355: Hautarzt. 1992 Sep;43(9):576-9.

[Erosive pustular dermatosis of the scalp after zoster ophthalmicus and trauma]

[Article in German]

Wollenberg A, Heckmann M, Braun-Falco O.

Dermatologische Klinik und Poliklinik, Ludwig-Maximilians-Universitat Munchen.

Erosive pustular dermatosis of the scalp (EPDS), first described in 1979, is a
rare, chronic, pustular condition with scarring alopecia, and nonspecific
histological findings. While the initial responded to steroids is good, it can be
treated successfully by oral administration of zinc sulphate. Local trauma has
recently been suggested to play a role in the pathogenesis of EPDS. The
differential diagnosis of EPDS includes folliculitis decalvans, sterile
eosinophilic pustulosis Ofuji, pustular psoriasis vulgaris, trichophytosis,
Perifolliculitis capitis abscedens et suffodiens, pemphigus vulgaris and
cicatricial pemphigoid. We present the cases of a 74-year-old woman suffering
from EPDS following herpes zoster ophthalmicus and of a 54-year-old man in whom
EPDS followed a head injury.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1399604 [PubMed - indexed for MEDLINE]

5356: Ir Med J. 1992 Sep;85(3):115-6.

Herpes zoster oticus-diagnosis and treatment.

O'Driscoll KJ, McShane DP.

Royal Victoria Eye and Ear Hospital, Dublin.

Four cases of Herpes Zoster Oticus (HZO) with facial paralysis are presented. HZO
is a Herpes Zoster viral infection of the Geniculate Ganglion of the facial
nerve. It presents classically with severe otalgia, a vesicular rash in the
Concha or on the Pinna of the affected ear in association with a lower motor
neurone lesion of the homolateral facial nerve. There also may be labyrinthine
symptoms, sensineural hearing loss and vesicular eruptions in the regions
supplied by the vagus and glossopharyngeal nerves viz, hypopharynx and oropharynx
as these nerves communicate with the facial nerve. Treatment consists of
Acyclovir. One reference in the past refers to a clustering of the condition and 
its predisposition for females. Interestingly all cases presented were referred
with incorrect diagnoses.

Publication Types: 
    Case Reports

PMID: 1399478 [PubMed - indexed for MEDLINE]

5357: Br J Psychiatry. 1992 Sep;161:411-2.

Delusional infestation associated with post-herpetic neuralgia and EEG
abnormalities.

Harper R, Moss G.

University Department of Psychiatry, Leicester Royal Infirmary.

An 80-year-old widow with delusional infestation in association with
post-herpetic neuralgia and EEG abnormalities in the left anterior parietal lobe 
responded to combined pimozide and carbamazepine. Aetiological factors are
reviewed in relation to the literature.

Publication Types: 
    Case Reports

PMID: 1393315 [PubMed - indexed for MEDLINE]

5358: Semin Dermatol. 1992 Sep;11(3):256-60.

Rational use of acyclovir in the treatment of mucocutaneous herpes simplex virus 
and varicella zoster virus infections.

Beutner KR.

Department of Dermatology, University of California San Francisco, Vallejo 94589.

The herpes family of viruses establishes latent infection in neurons and produces
a spectrum of acute and recurrent clinical disease. Therapies to terminate the
neurolatency or to enhance host responses are not yet available. Current therapy 
consists of antiviral drugs, which interfere with viral replication, can
favorably alter the signs and symptoms of symptomatic disease, and act as
prophylaxis against recurrent disease. Because the severity of acute and
recurrent herpes group infection varies greatly between individuals, proper
selection of patients to be treated with antiviral therapy is important. In
general in immunocompetent patients, antiviral therapy has the greatest potential
benefit for patients early in the course of primary or initial disease, or for
patients with frequent and/or severe recurrent disease. Patients late in acute
disease or with infrequent and/or mild recurrent disease are very unlikely to
benefit from antiviral therapy. With immunocompromised patients, antiviral
therapy is of the greatest potential value. By careful selection of patients, the
clinician can maximize the benefits of antiviral therapy for patients with
cutaneous herpes group viral infections.

PMID: 1390038 [PubMed - indexed for MEDLINE]

5359: Semin Dermatol. 1992 Sep;11(3):218-25.

Treatment of postherpetic neuralgia.

Rowbotham MC.

Department of Neurology, University of California, San Francisco 94143.

Postherpetic neuralgia (PHN) is the most common and feared complication of herpes
zoster. The more severe and painful the initial zoster outbreak, the more likely 
that PHN will develop, with elderly patients being at greatest risk. There are no
proven treatments that have a large impact in reducing the risk of PHN. Tricyclic
antidepressants are the mainstay of treatment for established PHN, aided by
transcutaneous electrical nerve stimulation, physical therapy techniques, and
cautious use of other medications. Topical agents, such as capsaicin, aspirin,
and lidocaine, may soon become one of the mainstays of therapy for PHN.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1390037 [PubMed - indexed for MEDLINE]

5360: Semin Dermatol. 1992 Sep;11(3):211-7.

Natural history of varicella zoster virus.

Tyring SK.

Department of Microbiology, University of Texas Medical Branch, Galveston 77550.

The varicella zoster virus (VZV) is a herpesvirus responsible for two distinct
clinical disorders, primary varicella (chickenpox) and zoster (shingles). Primary
varicella is a common childhood disease in Western countries, which presents as
pruritic macules, papules, vesicles, pustules, and crusts, usually on the back,
chest, face, and abdomen. In immunocompetent children, chickenpox is generally a 
mild disease with little morbidity and rare mortality. Primary varicella is
associated with more morbidity in adults. Following resolution of primary
varicella, VZV persists in a latent form in dorsal ganglion cells for what is
usually an extended period of time. For reasons that are still poorly understood,
VZV can later start replicating in the ganglion, producing severe neuralgia and
spread of the virus down the sensory nerve. Vesicles then appear on the skin in
the distribution of this nerve, producing the characteristic dermatomal rash of
shingles. The vesicles progress to pustules, then to crusts that eventually are
lost. Scarring and changes in pigmentation can result, but the most frequent
sequela of zoster is postherpetic neuralgia, which is usually most severe in the 
elderly. Primary varicella or herpes zoster in immunocompromised patients can
sometimes involve internal organs (eg, lungs, liver, brain) resulting in high
rates of morbidity and mortality. Congenital VZV infection is uncommon but can
result in severe congenital malformations. A Tzanck smear can be useful to
demonstrate a herpesvirus infection, but confirmation of VZV as the cause of the 
infection requires at least one of the following tests: culture, serology, direct
immunofluorescence staining, or molecular techniques.

Publication Types: 
    Review

PMID: 1390036 [PubMed - indexed for MEDLINE]

5361: Rev Med Interne. 1992 Sep-Oct;13(5):387-91.

[Benefits of corticosteroids in the treatment of Horton's disease and rhizomelic 
pseudopolyarthritis: advantages and inconveniences. A meta-analysis]

[Article in French]

Genereau T, Cabane J.

Service de Medecine Interne, Hopital Saint-Antoine, Paris.

Although corticosteroid treatment is clearly beneficial to patients with temporal
arteritis, its exact risk/benefit ratio in these old and side effects-prone
patients is unknown. We have thus surveyed that available French and English
literature, in order to pool the published series and to evaluate the iatrogenic 
potential of corticosteroids in this situation. We selected 11 series, yielding a
total of 1008 patients. A treatment failure resulted in the death of the patient 
in five cases. Twenty-seven patients became blind, but only 2 under treatment.
The side-effects involved 29% of the patients and are responsible of 29 deaths
(2.9%): osteoporosis was the main problem, followed by femoral head necrosis and 
muscle wasting. Gastroduodenal ulcers were uncommon and generally benign; sigmoid
colon diverticulitis was infrequent but dangerous; some infectious complications 
were noted (herpes zoster, tuberculosis, etc...); high blood pressure and
diabetes were common problems. Psychiatric side-effects were rare. Thus, the
unwanted effects of corticosteroids in the treatment of temporal arteritis are
relatively infrequent and generally not severe, except osteoporosis. They should 
be systematically prevented by appropriate diet and treatments (e.g., calcium,
potassium, and vitamin D supplements).

Publication Types: 
    English Abstract
    Meta-Analysis

PMID: 1344839 [PubMed - indexed for MEDLINE]

5362: Am J Otolaryngol. 1992 Sep-Oct;13(5):295-300.

Meniere's disease and antibody reactivity to herpes simplex virus type 1
polypeptides.

Bergstrom T, Edstrom S, Tjellstrom A, Vahlne A.

Department of Clinical Virology, University of Goteborg, Sahlgrens Hospital,
Sweden.

PURPOSE: It has been reported that the inner ear is capable of responding to
antigen challenge. In this study, we have investigated the antibody reactivity to
herpes simplex virus 1 (HSV-1) proteins in sera from patients with Meniere's
disease. PATIENTS AND MATERIALS: Serum from 21 patients scheduled to undergo
endolymphatic sac decompression for Meniere's disease was obtained. The sera from
21 age- and sex-matched individuals without a history of ear disease served as
the control. An enzyme-linked immunosorbent assay (ELISA) was used to detect
antibodies to HSV-1, HSV-2 cytomegalovirus (CMV), varicella-zoster virus (VZV),
and measles virus. Immunoblotting was used to confirm and further evaluate the
HSV-1 antibody response. RESULTS: All but one patient had antibodies to HSV-1.
ELISA mean log titers were significantly lower in the patient group to CMV and
VZV when compared with controls. A pattern of generally higher antibody
reactivity in patients with Meniere's disease was demonstrated to the individual 
SDS-PAGE HSV-1 polypeptides as judged by immunoblotting. CONCLUSION: The HSV-1
antibody response found in patients with Meniere's disease may indicate viral
reactivation and denotes the importance of further studies on the role of
infectious agents in this disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1337422 [PubMed - indexed for MEDLINE]

5363: Surv Ophthalmol. 1992 Sep-Oct;37(2):150-1; author reply 152-3.

Comment on:
    Surv Ophthalmol. 1992 May-Jun;36(6):395-410.

Readers comment on "Herpes zoster ophthalmicus".

Herbort CP.

Publication Types: 
    Comment
    Letter

PMID: 1333645 [PubMed - indexed for MEDLINE]

5364: Cornea. 1992 Sep;11(5):471-4.

Delayed onset of varicella keratitis.

de Freitas D, Sato EH, Kelly LD, Pavan-Langston D.

Department of Ophthalmology, Harvard Medical School, Boston, MA.

Although varicella is one of the most common infectious diseases in the United
States, systemic and ocular complications are rare. We report a patient who
developed disciform edema followed by microdendritic keratitis 1 and 2 months,
respectively, after resolution of the acute phase of varicella. Cultures were
negative, but serologic analysis found positive antibodies against varicella
zoster virus and negative antibodies against herpes simplex virus. Based on this 
case and on a review of the literature, we believe that this delayed onset of
keratitis represents a distinct category of varicella corneal complications.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1330439 [PubMed - indexed for MEDLINE]

5365: Virus Res. 1992 Sep 1;25(1-2):105-16.

Identification and expression of the UL1 gene product of equine herpesvirus 1.

Harty RN, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932.

Sequences encoding the UL1 gene of equine herpesvirus type 1 (EHV-1) are
conserved in the genome of EHV-1 defective interfering particles (DIPs) that
mediate oncogenic transformation and persistent infection. The UL1 protein was
identified by in vitro transcription/translation and hybrid-arrest translation
analyses which employed a UL1/pGEM-3Z construct designated pGEML1. SDS-PAGE
analyses of in vitro translation products synthesized from UL1-specific RNA
revealed that the UL1 ORF encodes a 30 kDa protein which corresponds in size to
the 258 amino acid protein predicted by DNA sequence analyses. This result was
confirmed by arresting translation of the in vitro transcribed UL1 RNA with an
oligodeoxynucleotide complementary to UL1 coding sequences. The UL1 protein is a 
homolog of the predicted protein encoded by the ORF2 gene of varicella-zoster
virus, but UL1 has no homolog in herpes simplex virus type 1. The UL1 protein
contains a region conforming to a 'PEST' (Proline, Glutamic acid, Serine, and
Threonine) sequence, which is commonly found in proteins with half-lives of less 
than two hours.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1329372 [PubMed - indexed for MEDLINE]

5366: Rev Med Liege. 1992 Sep;47(9):447-55.

[Varicella and pregnancy]

[Article in French]

Paquet P, Pierard GE.

CHU Sart Tilman, Service de Dermatopathologie, Universite de Liege.

Publication Types: 
    Review

PMID: 1329173 [PubMed - indexed for MEDLINE]

5367: Ophthalmology. 1992 Sep;99(9):1408-13.

Comparison of immunocytology to tissue culture for diagnosis of presumed
herpesvirus dendritic epithelial keratitis.

Simon MW, Miller D, Pflugfelder SC, Murchison JF, Huang AJ, Atherton SS.

Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL 33136.

OBJECTIVE: The objective of this study is to prospectively compare the
sensitivity and specificity of immunodetection of herpes simplex virus (HSV) in
impression cytology specimens obtained directly from presumed herpesvirus
dendritic epithelial keratitis with virus isolation by tissue culture of cells
scraped from the same lesion. METHODS: Corneal impression cytology and tissue
culture were performed on 29 consecutive patients presenting with presumed
herpesvirus dendritic epithelial keratitis during a 6-month period. Impression
cytology of dendritic epithelial keratitis lesions with Millipore Biopore
membranes were evaluated for the presence of antigens specific to HSV type I
(HSV-1), HSV-2, and varicella-zoster virus (VZV) using monoclonal antibodies
specific to these herpesviruses and immunofluorescent staining techniques.
RESULTS: Tissue culture was positive for HSV-1 in 52% (13 of 25) of dendritic
epithelial keratitis patients without skin lesions, and was negative for VZV in 4
patients with dendritic epithelial keratitis and skin lesions in the distribution
of the first division of the trigeminal nerve. The remaining 12 tissue cultures
showed no cytopathic effect. Compared with tissue culture, impression cytology
was 100% sensitive (13 of 13) and 92% specific (11 of 12) for the diagnosis of
HSV-1 dendritic epithelial keratitis (Kappa coefficient of agreement 0.92).
Although our sample size for VZV dendritic epithelial keratitis was small, the
impression cytology findings correlated with our clinical diagnosis more often
than tissue culture (2 of 4 versus 0 of 4). CONCLUSION: Impression cytology
allows simultaneous debridement of dendritic epithelial keratitis and, when
combined with immunocytologic staining procedures, provides a simpler, more
rapid, and less expensive alternative to tissue culture for the diagnosis of
dendritic epithelial keratitis caused by HSV or VZV.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 1328982 [PubMed - indexed for MEDLINE]

5368: J Clin Microbiol. 1992 Sep;30(9):2487-91.

Immunoelectron microscopy for rapid diagnosis of varicella-zoster virus in a
complicated case of human T-cell lymphotropic virus type 1 infection.

Folkers E, Vreeswijk J, Wagenaar F, Kapsenberg JG, Hulsebosch HJ, Oranje AP.

Department of Dermatology, Hospital de Heel, Zaandam, The Netherlands.

Rapid techniques for the detection of herpes simplex virus (HSV) and
varicella-zoster virus (VZV) are needed for optimal therapeutic management. VZV
infection poses a serious threat, especially to seriously ill patients, for
instance, immunocompromised patients. We report a case of human T-cell
lymphotropic virus type 1-positive leukemia complicated by atypical
multidermatomal herpes zoster. Viral culture and standard serological tests
failed to prove VZV infection. Herpesvirus infection was confirmed by
cytodiagnosis (Tzanck test). The final diagnosis of VZV was made by
immunoelectron microscopy (IEM), which can differentiate between HSV and VZV.
Immunoglobulin M antibodies in serum directed against VZV were detected by IEM
but not by immunofluorescence. Because IEM was able to identify virus and analyze
sera in only 2 h, it is considered a valuable additional tool for the rapid
diagnosis of HSV and VZV infections.

Publication Types: 
    Case Reports

PMID: 1328289 [PubMed - indexed for MEDLINE]

5369: Virology. 1992 Sep;190(1):307-15.

The equine herpesvirus type 1 (EHV-1) homolog of herpes simplex virus type 1 US9 
and the nature of a major deletion within the unique short segment of the EHV-1
KyA strain genome.

Flowers CC, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130.

The DNA sequence of the short (S) genomic component of the equine herpesvirus
type 1 (EHV-1)KyA strain has been determined recently in our laboratory. Analysis
of a 1353-bp BamHI/PvuII clone mapping at the unique short/terminal inverted
repeat (Us/TR) junction revealed 507 bp of Us and 846 bp of TR sequences as well 
as an open reading frame (ORF) that is contained entirely within the Us. This ORF
encodes a potential polypeptide of 219 amino acids that shows significant
homology to the US9 proteins of herpes simplex virus type 1 (HSV-1), EHV-4,
pseudorabies virus (PRV), and varicella zoster virus (VZV). The US9 polypeptides 
of the two equine herpesviruses exhibit 50% identity but are twice as large as
their counterparts in HSV-1, PRV, and VZV. All five US9 proteins are enriched for
serine and threonine residues and share a conserved domain of highly basic
residues followed by a region of nonpolar amino acids. DNA sequence and Southern 
blot hybridization analyses revealed that the Us of EHV-1 KyA differs from the Us
of EHV-1 KyD and AB1 in that the ORFs encoding glycoproteins I and E and a unique
10-kDa polypeptide are deleted from the KyA genome. These data demonstrate that
the predicted 10-kDa protein unique to EHV-1 is nonessential for replication in
vitro and that EHV-1 glycoproteins I and E, like their equivalents in HSV-1 and
PRV, are also nonessential. These findings and those reported previously by this 
laboratory and others reveal that the Us segment of EHV-1 comprises nine ORFs,
two of which, US4 and 10-kDa ORF, are unique to EHV-1. The gene order of the Us
is US2, protein kinase, gG, US4, gD, gI, gE, 10 kDa, and US9.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1326805 [PubMed - indexed for MEDLINE]

5370: J Virol. 1992 Sep;66(9):5363-72.

Identification and transcriptional analyses of the UL3 and UL4 genes of equine
herpesvirus 1, homologs of the ICP27 and glycoprotein K genes of herpes simplex
virus.

Zhao Y, Holden VR, Harty RN, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932.

The DNA sequence of 3,240 nucleotides of the XbaI G fragment located in the
unique long (UL) region of the equine herpesvirus 1 genome revealed two major
open reading frames (ORFs) designated UL3 and UL4. The UL3 ORF of 470 amino acids
(aa) maps at nucleotides (nt) 4450 to 3038 from the long terminus, and its
predicted 51.4-kDa protein product exhibits significant homology to the ICP27
alpha regulatory protein of herpes simplex virus type 1 (HSV-1; 32% identity) and
to the ORF4 protein of varicella-zoster virus (13% identity). Interestingly, a
zinc finger motif is conserved in the C-terminal domains of both ICP27 of HSV-1
(aa 483 to 508) and UL3 of equine herpesvirus 1 (aa 441 to 466). The UL4 ORF of
343 aa maps at nt 5618 to 4587 and could encode a protein of 38.1 kDa which
exhibits significant homology to the UL53 protein (cell fusion protein or
glycoprotein K) of HSV-1 (26% identity) and to the ORF5 protein of
varicella-zoster virus (33% identity). Analyses of the UL4 amino acid sequence
revealed domains characteristic of a membrane-bound glycoprotein and included
potential signature sequences for (i) a signal sequence, (ii) two N-linked
glycosylation sites, and (iii) four transmembrane domains. Nucleotide sequence
analyses also revealed potential TATA boxes located upstream of the UL3 and UL4
ORFs. However, only a single polyadenylation signal (nt 2988 to 2983) was
detected downstream of the UL3 ORF. Northern (RNA) blot hybridization and S1
nuclease analyses were used to map and characterize the UL3 and UL4 mRNAs.
Metabolic inhibitors were used to identify the kinetic class of these two genes. 
The data revealed that UL3 is an early gene that encodes a 1.6-kb mRNA, while UL4
is a late gene encoding a 3.8-kb mRNA that overlaps the UL3 transcript. Both
transcripts were shown by S1 nuclease analyses to initiate 24 to 26 nt downstream
of their respective TATA boxes and to have a common transcription termination
signal as a pair of 3'-coterminal mRNAs.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1323700 [PubMed - indexed for MEDLINE]

5371: J Virol. 1992 Sep;66(9):5298-304.

Erratum in:
    J Virol 1995 Apr;69(4):2723.

Regulation of varicella-zoster virus gene expression in human T lymphocytes.

Perera LP, Mosca JD, Ruyechan WT, Hay J.

Department of Microbiology, Uniformed Services University of the Health Sciences,
Bethesda, Maryland 20814-4799.

Varicella-zoster virus (VZV), a neurotropic alphaherpesvirus, is the etiologic
agent of chicken pox and shingles (zoster) in humans. Using an in vitro transient
expression assay, we have evaluated the ability of the putative immediate early
VZV genes, ORF4, ORF61, and ORF62 (the analogs of the herpes simplex virus alpha 
27, alpha 0, and alpha 4 genes, respectively), to modulate the expression of VZV 
genes of different putative kinetic classes in a human T lymphocyte cell line.
These cells are of the type in which VZV can be readily detected in the viremic
phase of human infection. We present evidence to indicate that, in this system,
the gene product of ORF62 (IE62) is a major regulatory protein in VZV and is
capable of activating VZV genes of all putative kinetic classes. In addition, we 
demonstrate that the gene product of ORF4 and, unlike the apparent situation in
Vero cells, the gene product of ORF61 may play an accessory regulatory role in
synergizing the activation of VZV genes induced by the gene product of ORF62 in
human T lymphocytes.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1323696 [PubMed - indexed for MEDLINE]

5372: Pediatr Clin North Am. 1992 Aug;39(4):669-90.

Congenital infections and the nervous system.

Bale JF Jr, Murph JR.

Department of Pediatrics, University of Iowa College of Medicine, Iowa City.

Despite vaccines, new antimicrobials, and improved hygienic practices, congenital
infections remain an important cause of death and long-term neurologic morbidity 
among infants world-wide. Important agents include Toxoplasma gondii,
cytomegalovirus, Treponema pallidum, herpes simplex virus types 1 and 2, and
rubella virus. In addition, several other agents, such as the varicella zoster
virus, human parvovirus B19, and Borrelia burgdorferi, can potentially infect the
fetus and cause adverse fetal outcomes. This article provides an overview of
these infectious disorders and outlines current strategies for acute treatment
and long-term management.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1321971 [PubMed - indexed for MEDLINE]

5373: Schweiz Med Wochenschr. 1992 Aug 4;122(31-32):1178-84.

[Neurogenic pain syndrome]

[Article in German]

Sturzenegger M.

Neurologische Universitatsklinik, Inselspital Bern.

Several pathophysiologic mechanisms are known which induce neuropathic pain in
presence of peripheral nerve damage. They help to explain the clinical features
of neuropathic pain syndromes and why causal and symptomatic treatments can be
effective. However, careful analysis of every pain syndrome is necessary in order
to select the type of pain management required.

Publication Types: 
    English Abstract
    Review

PMID: 1496346 [PubMed - indexed for MEDLINE]

5374: J Infect Dis. 1992 Aug;166 Suppl 1:S42-7.

Comment in:
    J Infect Dis. 1993 Jan;167(1):254.

Varicella in pregnancy, the fetus, and the newborn: problems in management.

Brunell PA.

Ahmanson Pediatric Center, Cedars Sinai Medical Center, Los Angeles, California
90048.

As many as 9000 pregnancies annually may be complicated by varicella, which
creates management problems for the woman and her fetus or newborn. Estimates on 
risk to the fetus and to neonates vary widely, making counseling difficult.
Likewise, the efficacy of passive immunization of pregnant women or their exposed
newborns is not precisely known. In addition to these problems in clinical
management, questions remain about the developmental immunology of
varicella-zoster virus infection. For example, why do infants exposed in utero to
the virus get zoster at an early age and why does passive immunization of
newborns appear to be less effective than immunization of older individuals?

Publication Types: 
    Review

PMID: 1624811 [PubMed - indexed for MEDLINE]

5375: Curr Opin Neurol Neurosurg. 1992 Aug;5(4):549-53.

Myelitis and toxic, inflammatory and infectious disorders.

Cumming WJ.

Department of Neurology, University Hospital of South Manchester, UK.

Developments in our understanding of the anatomical-clinical and pathological
correlates of spinal cord disorders have greatly enhanced our understanding of
the clinical presentation. The impact of viral disease on the spinal cord is
reviewed. The value of magnetic resonance (MR) scanning of the brain and spinal
cord in the evaluation, both in the short and long term, of patients with
myelopathy is underlined.

Publication Types: 
    Review

PMID: 1515693 [PubMed - indexed for MEDLINE]

5376: S Afr Med J. 1992 Aug;82(2):95-7.

AIDS--the Baragwanath experience. Part III. HIV infection in adults at
Baragwanath Hospital.

Karstaedt AS.

Department of Medicine, Baragwanath Hospital, Johannesburg.

By December 1990, 181 HIV-positive black adults had been seen in the medical
wards and HIV clinic at Baragwanath Hospital. Fifty per cent were in the late
stage of HIV infection; 34% of those so diagnosed in 1990 have died. Equal
numbers of both sexes have been seen. Their ages have ranged from 16 years to 66 
years, with peak frequencies in women aged 20-29 years and in men aged 30-39
years. Tuberculosis was the commonest complicating infection, followed by acute
pneumonia. Pneumocystis carinii pneumonia was rare. Herpes zoster was the first
sign of HIV infection in 13% of clinic patients. 'Slim disease' occurred in only 
11% of patients, a much lower figure than in other parts of Africa.

PMID: 1509338 [PubMed - indexed for MEDLINE]

5377: Clin Geriatr Med. 1992 Aug;8(3):461-82.

Epidemiology of nondental oral disease in the elderly.

Beck JD, Watkins C.

Department of Dental Ecology, School of Dentistry, University of North Carolina, 
Chapel Hill.

This article presents the descriptive epidemiology, risk factors, and clinical
highlights of the oral mucosal lesions that are most common or of greatest
concern among the elderly. Leukoplakia, oral cancer, candidiasis, lichen planus, 
and RAU have not been studied extensively among the elderly. Recent efforts to
standardize definitions and research methods should greatly enhance future
information. The paucity of research on oral lesions such as herpes zoster,
epulis, and oral medication reactions is surprising, given that these are common 
problems among the elderly.

Publication Types: 
    Review

PMID: 1504939 [PubMed - indexed for MEDLINE]

5378: Am J Med. 1992 Aug;93(2):131-4.

A pilot study of oral corticosteroid therapy for idiopathic esophageal
ulcerations associated with human immunodeficiency virus infection.

Wilcox CM, Schwartz DA.

Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
30303.

PURPOSE: To evaluate the efficacy and safety of oral prednisone therapy for
idiopathic esophageal ulcerations (IEU) associated with human immunodeficiency
virus (HIV) infection. PATIENTS AND METHODS: Over a 14-month period, all
HIV-infected patients with IEU as defined by clinical, endoscopic, and pathologic
criteria were prospectively identified. Prednisone was initiated at a dose of 40 
mg/d orally, tapering 10 mg/wk, for a total of 1 month of therapy. Patients were 
closely followed to determine the response to therapy as well as the occurrence
of any side effects related to prednisone. All patients were requested to undergo
endoscopy within 1 week of the completion of therapy. RESULTS: Of 14 patients
identified with IEU, 12 consented to prednisone therapy. The mean duration of
esophageal symptoms was 2.9 weeks, and odynophagia was the most common presenting
symptom. Ten of 12 patients had the acquired immunodeficiency syndrome. Eleven of
the 12 patients (92%) had a complete symptomatic response, usually within the
first week of therapy. In some patients, the response was dramatic such that oral
intake could be rapidly resumed and discharge from the hospital possible. Two
patients completed 2 and 3 weeks of therapy, respectively, prior to death, both
with a complete symptomatic response. Endoscopic re-examination in seven patients
demonstrated complete ulcer healing in all six symptomatic responders, but a
persistent ulceration in the one nonresponder. The oral corticosteroid regimen
was well tolerated. Mild asymptomatic Candida esophagitis was identified in three
of seven patients undergoing follow-up endoscopy. One patient developed
self-limited herpes zoster during therapy. No systemic opportunistic infections
were documented during or within 1 month of the completion of therapy.
CONCLUSIONS: Oral corticosteroid therapy appears to be a highly efficacious and
safe therapy for HIV-associated IEU. Further controlled studies will be necessary
to conclusively establish efficacy, as well as determine the optimal dose and
duration of therapy.

PMID: 1497008 [PubMed - indexed for MEDLINE]

5379: Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Aug;30(8):1569-73.

[Case of adult primary varicella pneumonia]

[Article in Japanese]

Uemura A, Okano A, Iwata M, Satou A.

Division of Internal Medicine, Kakegawa General Hospital, Shizuoka Pref., Japan.

We report a case of adult primary varicella pneumonia. A 34-year-old man was
admitted to our hospital with fever, dry cough and eruptions. He had no history
of chicken pox and his sons had contracted varicella 2 weeks before the onset of 
his symptoms. Chest X-ray showed diffuse nodular shadows in both lungs. The
diagnosis of primary varicella pneumonia was made based on family history,
typical eruptions and high titer of antibody against Varicella zoster virus. An
electron micrograph indicated this case to be primary varicella pneumonia with
fibrosis and edema of interstitial spaces and the presence of virus-like
particles in cells. The patient was treated with antibiotics, an antiviral agent 
and immunoglobulin. The clinical symptoms and diffuse nodular shadows resolved
with this treatment.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1434232 [PubMed - indexed for MEDLINE]

5380: Masui. 1992 Aug;41(8):1322-6.

[Herpes zoster of the right cervical region associated with right facial nerve
palsy and hoarseness]

[Article in Japanese]

Dehara K, Takeda S, Nakamizo N, Morimoto F, Ikeda T, Tomaru T.

Department of Anesthesiology, Showa University Fujigaoka Hospital, Yokohama.

A 69-year-old man was suffering from herpes zoster on his 2nd and 3rd right
cervical spinal segments and 3rd branch of the trigeminal nerve. He came to our
hospital on his 10th illness day and was treated with continuous cervical
epidural block, intravenous infusion of acyclovir for five days, and oral
paramethasone and Vitamin B12. Oh his 18th illness day, right facial nerve palsy 
and hoarseness became clear. His cerebrospinal fluid showed no abnormality except
cell count 23 x 3 mm-2. No clear paralysis of vocal cords was detected on
laryngoscopy. He was also treated with right stellate ganglion block starting on 
his 21st illness day. His pain and facial nerve palsy recovered completely by his
68th illness day, but hoarseness continued about two months. The hoarseness might
be a result of spread of the disease 1) by cerebrospinal fluid, 2) by contact
with the 3rd cervical nerve and vagal nerve via accessory nerve, and 3) direct
effect on the vocal cords and the muscles controlling them. Herpes zoster on the 
head and neck region shows various complications and we should follow its course 
cautiously.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1433860 [PubMed - indexed for MEDLINE]

5381: J Infect Dis. 1992 Aug;166 Suppl 1:S51-7.

Therapeutic approaches to varicella-zoster virus infections.

Whitley RJ.

Department of Pediatrics, University of Alabama, Birmingham.

Varicella-zoster virus (VZV) infections, the cause of chickenpox and shingles,
are usually benign but are associated with morbidity and mortality, especially in
immunocompromised hosts. Significant advances have been achieved in the treatment
of VZV infections. In immunocompromised patients, both vidarabine and acyclovir
have proved useful for the therapy of chickenpox and herpes zoster. Acyclovir,
administered intravenously, is the treatment of choice for these infections. Both
chickenpox and herpes zoster in the normal host are amenable to therapy with
orally administered acyclovir. For older individuals with herpes zoster,
acceleration of cutaneous healing can be accomplished at dosages of 800 mg five
times a day for 10 days. Acyclovir therapy of chickenpox is recommended for
adolescents and young adults with infection. In the future, improved therapies
for VZV infections may include such newer antiviral drugs as bromovinyl
arabinosyl uracil and acyclovir prodrugs.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1378081 [PubMed - indexed for MEDLINE]

5382: Acta Derm Venereol. 1992 Aug;72(4):314.

A high incidence of venereal diseases and a rapid increase of herpes zoster in
Africa.

Lomholt G.

Publication Types: 
    Letter

PMID: 1357902 [PubMed - indexed for MEDLINE]

5383: J Infect Dis. 1992 Aug;166 Suppl 1:S1-68.

The 1st International Conference on the Varicella-Zoster Virus. Harriman, New
York, 29-31 October 1991.

[No authors listed]

Publication Types: 
    Congresses
    Overall
    Research Support, Non-U.S. Gov't

PMID: 1352533 [PubMed - indexed for MEDLINE]

5384: J Virol Methods. 1992 Aug;38(2):195-204.

Isolation of a cell line for rapid and sensitive histochemical assay for the
detection of herpes simplex virus.

Stabell EC, Olivo PD.

Department of Medicine, Washington University School of Medicine, St. Louis, MO
63110.

A cell line which can be used in a simple, sensitive, and rapid histochemical
assay was isolated for detection of herpes simplex virus (HSV). The cell line was
derived by selection of G418 resistant colonies following co-transfection of baby
hamster kidney cells with a plasmid which contains a G418 antibiotic resistance
marker and a plasmid which contains the Escherichia coli LacZ gene placed behind 
an inducible HSV promoter. The promoter is from HSV-1UL39 which encodes ICP6, the
large subunit of ribonucleotide reductase (RR1). This promoter has a number of
features which make it ideal for the detection of HSV. First, there is no
constitutive expression from this promoter in uninfected cells. Second,
activation of the promoter appears to be specific for HSV. Third, expression from
this promoter occurs within hours after infection. Fourth, this promoter is
strongly transactivated by the virion associated trans-activator protein VP16. As
early as six hours after infection HSV-infected cells can be detected by
histochemical staining for beta-galactosidase activity. Infected cells stain
intensely blue whereas uninfected cells show no staining, and a single infected
cell can easily be recognized in a microscopic field of uninfected cells. Both
HSV-1 and HSV-2 are detected with this cell line, but after infection with human 
cytomegalovirus (HCMV), varicella zoster virus (VZV), adenovirus, and sindbis
virus no blue cells were detected. Quantitation of HSV-1 stocks on this cell line
by counting blue cell forming units (BFU) reveals that the number of BFU/ml
closely approximates the number of plaque forming units (PFU)/ml as determined by
plaque assays on the parent cell line. This cell line should provide a useful
adjunct in the diagnostic virology laboratory for the rapid detection of HSV in
clinical specimens.

PMID: 1325470 [PubMed - indexed for MEDLINE]

5385: J Gen Virol. 1992 Aug;73 ( Pt 8):2167-71.

A novel herpes simplex virus gene (UL49A) encodes a putative membrane protein
with counterparts in other herpesviruses.

Barnett BC, Dolan A, Telford EA, Davison AJ, McGeoch DJ.

Institute of Virology, University of Glasgow, U.K.

Comparative analysis of DNA sequences located between the coding regions of genes
UL49 and UL50 of herpes simplex virus types 1 and 2 (HSV-1 and -2) has revealed a
small open reading frame (ORF) of 91 and 87 codons respectively with the
characteristics of a genuine protein-coding region. The predicted protein
products are clearly related and exhibit features of membrane-inserted proteins, 
with potential N-proximal signal peptides and C-proximal membrane anchor regions.
Counterparts are present in the other sequenced alphaherpesviruses, namely
varicella-zoster virus (a previously undescribed gene, 9A) and equine herpesvirus
type 1 (gene 10), in the betaherpesvirus human cytomegalovirus (gene UL73) and in
the gammaherpesvirus Epstein-Barr virus (gene BLRF1). Therefore, we consider that
this ORF represents an additional HSV gene (UL49A) with counterparts in all
sequenced alpha-, beta- and gammaherpesviruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1322965 [PubMed - indexed for MEDLINE]

5386: J Infect Dis. 1992 Aug;166(2):253-9.

Immune response of elderly individuals to a live attenuated varicella vaccine.

Levin MJ, Murray M, Rotbart HA, Zerbe GO, White CJ, Hayward AR.

Department of Pediatrics, University of Colorado School of Medicine, Denver
80262.

The Oka strain live attenuated varicella-zoster virus (VZV) vaccine was
administered subcutaneously to 202 VZV-immune individuals who were 55 to greater 
than 87 years old. The dose administered varied from 1100 to 12,000 pfu. One
cohort received 3000 pfu with a 3000 pfu booster 3 months later. The vaccine was 
well tolerated. VZV-specific immunologic responses were evaluated over a 24-month
period. The mean anti-VZV antibody level was significantly increased for 12
months after vaccination. Interferon-gamma production in vitro by peripheral
blood mononuclear cells (PBMC) of vaccinees was also increased for 6 months after
vaccination. Most significantly, VZV-specific proliferating T cells in PBMC of
vaccinees were increased in frequency from 1 in 68,000 to 1 in 40,000. This
vaccine-enhanced frequency of VZV-responding T cells is similar to the frequency 
observed in 35- to 40-year-old adults. Dose and age of the vaccinees did not
significantly influence the magnitude of the mean cell-mediated immune response. 
The data indicate that VZV immunity in the elderly can be boosted by active
immunization. If the increased incidence of herpes zoster that accompanies aging 
results from the natural waning of immunity, active immunization may prevent or
attenuate zoster in the elderly.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1321859 [PubMed - indexed for MEDLINE]

5387: J Infect Dis. 1992 Aug;166 Suppl 1:S63-8.

Varicella vaccine: the American experience.

Gershon AA, LaRussa P, Hardy I, Steinberg S, Silverstein S.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, NY 10032.

Live attenuated varicella vaccine is safe and effective in preventing chickenpox.
The best immune responses occur in healthy children. Leukemic children have a 50%
incidence of mild-to-moderate adverse effects but have a high degree of
protection once immune reactions to varicella-zoster virus (VZV) have developed. 
Adult vaccinees have a lower degree of protection (70%) than children. Vaccinees 
who develop breakthrough varicella usually have a modified infection. Another
significant advantage of vaccination is that in leukemic children it leads to a
lower incidence of zoster than after natural chickenpox. It is possible to
differentiate between vaccine-type and wild-type VZV using a combination of
polymerase chain reaction and restriction endonuclease digestion. A new assay for
antibodies to VZV measured by latex agglutination reveals that 8-10 years after
vaccination antibodies are detectable in greater than 90% of leukemic children
who have not had breakthrough varicella.

Publication Types: 
    Review

PMID: 1320652 [PubMed - indexed for MEDLINE]

5388: J Infect Dis. 1992 Aug;166 Suppl 1:S58-62.

Immunization of the elderly and patients with collagen vascular diseases with
live varicella vaccine and use of varicella skin antigen.

Takahashi M, Iketani T, Sasada K, Hara J, Kamiya H, Asano Y, Baba K, Shiraki K.

Research Institute for Microbial Diseases, Osaka University, Japan.

Elderly subjects and patients with collagen vascular diseases were immunized with
a live varicella vaccine to assess the vaccine's potential for preventing herpes 
zoster. An improved varicella-zoster virus (VZV) skin test antigen was then used 
to assess cell-mediated immunity to VZV. The antigen was prepared from culture
fluid of VZV-infected cells and had far less protein content than crude antigen
prepared by sonication of infected cells. In 11 of 12 patients with ophthalmic
zoster and 17 of 21 with dermal zoster, the skin reaction was negative at the
beginning of the disease but became positive later. After two doses of VZV
vaccine, 8 of 12 elderly subjects (greater than 60 years old) and 4 of 6 patients
with collagen vascular diseases, who were VZV-skin test negative but purified
protein derivative tuberculin test-positive, became VZV skin test-positive.

PMID: 1320651 [PubMed - indexed for MEDLINE]

5389: J Infect Dis. 1992 Aug;166 Suppl 1:S35-41.

Cell-mediated immunity to varicella-zoster virus.

Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California.

Natural varicella-zoster virus (VZV) infection and immunization with live
attenuated varicella vaccine elicits T lymphocytes that recognize VZV
glycoproteins, gpI-V, and the immediate early/tegument protein, the product of
gene 62 (IE62). Proliferation or cytotoxicity assays, done under limiting
dilution conditions to estimate responder cell frequencies, indicate no
preferential recognition of VZV proteins by human T cells. Analysis of the
primary cytotoxic T lymphocyte (CTL) response after vaccination demonstrates that
both gpI and IE62 are targets of the early response. CD4(+)- and CD8(+)-mediated 
CTL recognition of these viral proteins can be detected with natural and
vaccine-induced immunity. Responder cell frequencies for protein-specific T cell 
proliferation and CTL function are generally comparable in subjects with natural 
and vaccine-acquired immunity to VZV. Exogenous reexposure to VZV results in
enhanced T cell proliferation and may be an important mechanism for maintaining
virus-specific cellular immunity. Providing exogenous reexposure by giving
varicella vaccine to individuals who have preexisting natural immunity markedly
increases the responder cell frequencies of T cells that proliferate in response 
to VZV antigen and the numbers of circulating CTL that recognize VZV proteins.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1320649 [PubMed - indexed for MEDLINE]

5390: J Infect Dis. 1992 Aug;166 Suppl 1:S30-4.

Varicella-zoster virus reactivation without rash.

Gilden DH, Dueland AN, Devlin ME, Mahalingam R, Cohrs R.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

Reactivation of varicella-zoster virus (VZV) leads to localized zoster
(shingles), a syndrome characterized by pain and a vesicular rash. Rarely,
patients experience radicular pain without zosteriform rash, cases that have been
regarded as zoster sine herpete (zoster without rash). Virologic evidence for
zoster sine herpete is sparse. However, VZV can produce other neurologic and
visceral diseases in the absence of rash or radicular pain. The clinical and
virologic features of zoster sine herpete and other disorders produced by VZV
without rash are reviewed. Evidence is also presented for the detection of VZV
DNA in human blood mononuclear cells of elderly individuals in the absence of
skin lesions or other VZV-associated neurologic or systemic disease.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1320648 [PubMed - indexed for MEDLINE]

5391: J Infect Dis. 1992 Aug;166 Suppl 1:S24-9.

Restricted transcription of varicella-zoster virus in latently infected human
trigeminal and thoracic ganglia.

Cohrs R, Mahalingam R, Dueland AN, Wolf W, Wellish M, Gilden DH.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

Normal human trigeminal and thoracic ganglia latently infected with
varicella-zoster virus (VZV) were identified by polymerase chain reaction (PCR). 
Total RNA was extracted from these ganglia and treated with DNase until
ganglionic RNA was free of VZV DNA as determined by PCR. Radiolabeled cDNA
synthesized by priming with random oligonucleotides was hybridized to Southern
blots containing recombinant clones that spanned greater than 95% of the VZV
genome. The single region of the VZV genome detected was the 12.5-kb SalI C
fragment located in the unique long segment of the viral genome. Two additional
regions of the VZV genome, EcoRI G and SalI B, were detected in RNA from adult
dorsal root ganglia and infant nervous system tissue.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1320647 [PubMed - indexed for MEDLINE]

5392: J Infect Dis. 1992 Aug;166 Suppl 1:S13-23.

Comparative biology of latent varicella-zoster virus and herpes simplex virus
infections.

Meier JL, Straus SE.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
National Institutes of Health, Bethesda, Maryland 20892.

The clinicoepidemiologic features of varicella-zoster virus and herpes simplex
virus latency are clearly distinctive. These differences indicate that each virus
has evolved a unique strategy to ensure the establishment and maintenance of
latency and to reactive therefrom. Indeed, current data reveal divergent
pathogenetic and molecular biologic properties that may account for the
clinicoepidemiologic characteristics that distinguish recurrent infections with
these herpesviruses.

Publication Types: 
    Comparative Study
    Review

PMID: 1320646 [PubMed - indexed for MEDLINE]

5393: J Infect Dis. 1992 Aug;166 Suppl 1:S1-6.

Varicella and herpes zoster: a perspective and overview.

Weller TH.

Department of Tropical Public Health, Harvard School of Public Health, Boston,
Massachusetts.

The events leading to the isolation of varicella-zoster virus (VZV) are described
beginning with the pioneering contributions of Ernest Tyzzer and Ernest
Goodpasture and the early epidemiologic observations that indicated a
relationship between varicella and zoster. Isolation, propagation, and
immunologic proof of the coidentity of the viruses from the two clinical entities
evolved from the introduction of human cell culture systems, a development that
revolutionized virus research. Now the social significance of VZV is increasing. 
This reflects an aging population, increasing use of immunosuppressive
therapeutic procedures, and the advent of a biologic immunosuppressive agent, the
virus that causes AIDS. Currently there are unsolved problems: For unknown
reasons varicella is often an adult disease in the tropics, and cell cultures
fail to demonstrate VZV in throat washings from cases. These peculiarities
warrant elucidation.

Publication Types: 
    Historical Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1320645 [PubMed - indexed for MEDLINE]

5394: BMJ. 1992 Jul 25;305(6847):260.

A tale of one city.

De Wind CM.

PIP: A report from Kampala, Uganda, compares the situation in 1991 to the state
of chaos 10 years earlier when the regime of Idi Amin had been overthrown by
Milton Obote's soldiers with the help of Tanzanian troops. Soldiers went on
looting sprees, and 1 victim of their marauding became a 12-year old boy who got 
shot for refusing to part with his bike. In contrast, in 1991 things were much
more peaceful; however, the AIDS epidemic was the new threat. The government
radio transmits hourly warnings on HIV. Since President Museveni came to power,
economy and security have improved radically. Shops and markets are open until
late at night; public transport is reliable, and small scale industry flourished.
There would be optimism about the future, if AIDS was not here. There is no doubt
that the economy will soon be affected. According to the Kampala blood bank, 40% 
of the healthy population is already seropositive. In the hospitals the majority 
of admissions suffer from AIDS with diarrhea and an itching dermatitis; there is 
more cancer of the cervix and lymphoma; appendicitis is on the increase; and
tuberculous lymph nodes are now quite common. Many of these patients have
clinical AIDS. The government is frank about the situation and is active in
preventive measures and education. Private charities and foreign aid
organizations contribute. But the epidemic is so overwhelming, that some Western 
organizations might soon lose interest owning to meager returns on their efforts.
A 6-year-old boy has grossly swollen lymph nodes around his neck, both parotids
are painfully swollen, pus pours from the ears. A nonspecific cough and mild
diarrhea are also present with an itching and sore herpes zoster on his left
chest. the mother is frightened of losing him, and demurs at the hint of AIDS,
since for her, AIDS means sexual promiscuity.

PMID: 1392851 [PubMed - indexed for MEDLINE]

5395: Med J Aust. 1992 Jul 20;157(2):80-2.

Antiviral agents: problems and promises.

Smith DW.

State Health Labortory Services, Queen Elizabeth II Medical Centre, Nedlands, WA.

Publication Types: 
    Review

PMID: 1378525 [PubMed - indexed for MEDLINE]

5396: Am J Ophthalmol. 1992 Jul 15;114(1):55-62.

Six cases of scleritis associated with systemic infection.

Hemady R, Sainz de la Maza M, Raizman MB, Foster CS.

Immunology Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 
Boston.

Isolated scleritis (without keratitis) associated with infections is uncommon,
and correct diagnosis and appropriate therapy for it are often delayed. Six
patients with infection-associated scleritis were seen at our institution between
May 1983 and May 1990 (these patients represented 4.6% of all patients with
scleritis [six of 130 patients] in that period). Three of these cases were
associated with systemic infections. One was associated with syphilis, one was
associated with tuberculosis, and one was associated with toxocariasis. Three
cases resulted from local infections. One was associated with infection with
Proteus mirabilis, one was associated with infection with herpes zoster virus,
and one was associated with infection with Aspergillus. The Aspergillus infection
developed after trauma and the P. mirabilis-induced infection developed after
strabismus surgical procedures. Four of the six cases were initially misdiagnosed
and inappropriately managed. Correct diagnosis was made seven days to four years 
after onset of symptoms. Review of systems, scleral biopsy, culture, and
laboratory investigation were used to make the diagnosis. Differential diagnosis 
of scleritis must include infective agents.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 1621786 [PubMed - indexed for MEDLINE]

5397: Curr Opin Ophthalmol. 1992 Aug;3(4):527-33.

Management of uveitis.

Bierly JR, Nozik RA.

The Francis I. Proctor Foundation, University of California at San Francisco.

The management of uveitis continues to rely on the relatively nonspecific use of 
topical, periocular, and systemic steroids. A notable exception is infectious
causes of uveitis, which often require specific antimicrobial agents. This is
particularly true in immunosuppressed patients in whom infectious diseases such
as toxoplasmosis and herpes zoster may have atypical and fulminant clinical
courses necessitating early therapeutic intervention. Analysis of local antibody 
production in the aqueous or vitreous humor may aid in the diagnosis. Severe
forms of endogenous uveitis such as Behcet's disease have often required the use 
of nonspecific cytotoxic agents such as chlorambucil or cyclophosphamide. Agents 
such as cyclosporine and FK-506 are newer immunosuppressives that may have less
severe long-term systemic side effects. Chorioretinal biopsy offers an additional
tool for the specific etiologic diagnosis of uveitis. The role of posterior
chamber lens implantation in patients with a history of uveitis continues to
evolve.

Publication Types: 
    Review

PMID: 10147736 [PubMed - indexed for MEDLINE]

5398: Afr Health. 1992 Jul;14(5):10-1.

Some clinical aspects of HIV infection in Africa.

Harries A.

PIP: An update on clinical aspects of HIV in africa highlights new proposed
clinical definitions of adult AIDS and of tuberculosis in HIV+ adults, and
staging of adult HIV infection. The 1986 WHO clinical definition of AIDS has been
widely used in Africa, but now research suggests that this definition has several
limitations: the definition will pick up several unrelated diseases such as
diabetes mellitus and renal failure. It does not ascertain cases of AIDS marked
by nonopportunistic infections. Most persons with pulmonary tuberculosis may be
wrongly diagnosed with AIDS by this definition. The study showed that the WHO
clinical definition has good specificity and positive predictive value for HIV+
people, but its positive predictive value fell to 30% in identifying people with 
AIDS in Africa. New definitions should take into account any serious morbidity,
tuberculosis, neurological disease, both endemic localized Kaposi's, and
aggressive typical Kaposi's sarcoma, and HIV serological testing. Tuberculosis is
a problem because few HIV+ people suspected of having pulmonary TB
(sputum-negative TB) actually have it based on bronchoscopy, while HIV+ persons
with TB experience high mortality, often from pyogenic bacteremia. HIV+ persons
with TB suffer high rates of relapse, possibly related to insufficient drug
treatment or reinfection. 1 study showed that 6 months of isoniazid significantly
improved incidence of TB over 30 months of follow-up. Staging of AIDS in Africa
based on degree of immunosuppression was proposed as: 1) clinically inapparent
HIV infection marked by pulmonary TB, soft tissue infections, and community
acquired pneumonia; 2) lymphadenopathy, oral thrush, widespread pruritic
maculopapular rash, herpes zoster, enteric illness, dysentery, and Kaposi's
sarcoma; and 3) HIV wasting syndrome, chronic pulmonary disease, meningitis, and 
fever of unknown origin.

PMID: 12317768 [PubMed - indexed for MEDLINE]

5399: J Pain Symptom Manage. 1992 Jul;7(5):320-3.

Postherpes simplex type 1 neuralgia simulating postherpetic neuralgia.

Gonzales GR.

Patients with prodromal neuralgia associated with recurrent herpes simplex type 1
(HST1) infection and chronic facial pain following years of relapsing HST1 have
been described. Chronic neuralgia following a single clinical HST1 infection and 
simulating postherpetic neuralgia has not been previously reported. Such a case
is described: A 49-yr-old woman with a 2-mo history of oral-facial dyskinesia
developed burning pain and hypersensitivity of the left side of the tongue, lower
gum, and inner cheek, followed 1 day later by a vesicular rash in the same
painful distribution. Viral cultures of the lesions identified HST1 but not
herpes zoster. Cerebrospinal fluid analyses during the vesicular lesion stage and
1 mo later were normal with no viral growth. Oral and facial lesions resolved
after 10 days; acyclovir was given for 3 wk. Brain and brainstem magnetic
resonance imaging (MRI), electroencephalogram, and brainstem evoked potential
studies were normal. Hyperesthesias, allodynia, and burning pain persisted
despite nonsteroidal antiinflammatory agents, codeine and hydrocodone. Oral
opioids were administered until sedation occurred, with no relief of pain. The
burning pain and hyperesthesia resolved after the 16th day of amitriptyline use, 
75 mg/day. A trial off amitriptyline 6 mo later resulted in recurrence of pain,
and amitriptyline was restarted with good pain control. Post-HST1 neuralgia may
simulate postherpetic neuralgia clinically, and painful symptoms may respond to
amitriptyline.

Publication Types: 
    Case Reports

PMID: 1624816 [PubMed - indexed for MEDLINE]

5400: Behav Res Ther. 1992 Jul;30(4):359-65.

An application of the fear avoidance model to three chronic pain problems.

Rose MJ, Klenerman L, Atchison L, Slade PD.

Department of Clinical Psychology, University of Liverpool, England.

The Fear Avoidance Model of Exaggerated Pain Perception was developed in an
attempt to explain how, and why, some individuals develop a more substantial
psychological overlay to their low back pain problem than do others. The present 
paper describes a study in which three chronic pain groups, consisting of
Post-Herpetic neuralgia patients, Reflex Sympathetic Dystrophy patients and
chronic low back pain patients were compared with three pain-free comparison
groups using the Fear Avoidance Model of Exaggerated Pain Perception. The results
show statistically significant differences between the chronic groups and the
recovered comparison groups. These results demonstrate the usefulness of the Fear
Avoidance Model as an explanation of psychological overlay in chronic pain
conditions regardless of pathology.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1535497 [PubMed - indexed for MEDLINE]

5401: Infection. 1992 Jul-Aug;20(4):207-12.

Acyclovir monotherapy versus acyclovir plus beta-interferon in focal viral
encephalitis in children.

Wintergerst U, Belohradsky BH.

Universitats-Kinderklinik, Ludwig-Maximilians-Universitat, Munchen, Germany.

Severe focal viral encephalitis is most commonly caused by herpes simplex virus
(HSV), but other viruses may act as etiologic agents as well. Acyclovir (ACV) is 
the standard therapy for HSV encephalitis, but the mortality of 28% and defect
healing rate of about 35% are still unsatisfactory. Furthermore, ACV has
virtually no effect on other pathogens of viral encephalitis, except for
varicella-zoster virus (VZV). It is well known that beta-interferon (beta-IFN)
has a broad antiviral spectrum, and it has been demonstrated in vitro that
beta-IFN in combination with acyclovir has synergistic inhibitory effects on HSV.
To investigate if the combination of ACV with and without beta-IFN might also be 
of significance for the treatment of severe viral encephalitis, we performed a
retrospective study. A case record form was sent to all 278 West German
children's hospitals. The response rate was 78%. A total of 301 patients were
reported, of whom 214 received specific antiviral therapy with either ACV alone
(n = 179) or ACV plus beta-IFN (n = 35). No overall differences between ACV
monotherapy and the combination therapy were observed. However, in a subgroup of 
41 patients (ACV n = 30, ACV plus beta-IFN n = 11) who had low-density areas of
the temporal lobes on cranial computed tomography scans, compatible with severe
focal encephalitis, sequelae due to defect formation and mortality were
significantly (p = 0.014) reduced in patients who had received combination
therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 1521886 [PubMed - indexed for MEDLINE]

5402: Ophthalmology. 1992 Jul;99(7):1062-70; discussion 1070-1.

Oral acyclovir for herpes zoster ophthalmicus.

Hoang-Xuan T, Buchi ER, Herbort CP, Denis J, Frot P, Thenault S, Pouliquen Y.

Hopital Hotel-Dieu, Paris, France.

BACKGROUND: Reports on the natural history of herpes zoster ophthalmicus stress
its high morbidity related to vicious scars on eyelids, ocular complications, and
post-herpetic neuralgia. Early treatment with oral acyclovir is effective, but
the optimal duration of treatment has not been defined. METHODS: The authors
performed a bicentric, prospective, randomized, double-masked study of 86
patients with acute herpes zoster ophthalmicus, within 72 hours of skin eruption,
who received oral acyclovir (800 mg 5 times daily), either for 7 days (plus 7
days oral placebo) or for 14 days. All patients concomitantly received ophthalmic
3% acyclovir ointment; follow-up was at least 6 months. RESULTS: Statistical
analyses of subjective symptoms, skin lesions, and ocular complications showed no
significant differences between the groups, suggesting that a 7-day course of
treatment was sufficient. Drug tolerance was good. Pooled data from both groups
corroborated earlier reports that prompt treatment with oral acyclovir reduces
the severity of the skin eruption, the incidence and severity of late ocular
manifestations, and the intensity of postherpetic neuralgia. At 6 months, late
ocular inflammatory complications were seen in 29.1% of our 86 patients, versus
50% to 71% of untreated patients described by others. Only 13% of our patients
experienced post-herpetic neuralgia, which in no case required the use of
analgesics. CONCLUSION: The authors believe it is not useful to prolong treatment
with 800 mg of oral acyclovir 5 times daily for more than 7 days in herpes zoster
ophthalmicus. This study confirms the efficacy of oral acyclovir not only against
skin lesions and ocular complications, but also against postherpetic neuralgia in
herpes zoster ophthalmicus.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 1495785 [PubMed - indexed for MEDLINE]

5403: J Assoc Physicians India. 1992 Jul;40(7):496-7.

Herpes zoster opthalmicus with complete external ophthalmoplegia.

Garg RK, Kar AM, Jain AK.

Publication Types: 
    Case Reports
    Letter

PMID: 1484059 [PubMed - indexed for MEDLINE]

5404: Nippon Rinsho. 1992 Jul;50 Suppl:166-9.

[The detection of VZV DNA by in situ hybridization using biotin-labeled DNA
probe]

[Article in Japanese]

Kazuyama Y.

Research and Development Center of Hygienic Science, Kitasato University.

Publication Types: 
    Review

PMID: 1328708 [PubMed - indexed for MEDLINE]

5405: Nippon Rinsho. 1992 Jul;50 Suppl:160-5.

[Application of PCR to DNA diagnosis and molecular epidemiology of
varicella-zoster virus infection]

[Article in Japanese]

Hondo R, Ito S.

Publication Types: 
    Review

PMID: 1328707 [PubMed - indexed for MEDLINE]

5406: Nippon Rinsho. 1992 Jul;50 Suppl:104-10.

[Titration of viral genome in clinical specimens by polymerase chain reaction and
microplate hybridization]

[Article in Japanese]

Hondo R, Inouye S, Ito S.

Publication Types: 
    Review

PMID: 1328703 [PubMed - indexed for MEDLINE]

5407: Ann Pharmacother. 1992 Jul-Aug;26(7-8):955-62.

Treatment of herpesvirus infections in HIV-infected individuals.

Fletcher CV.

Department of Pharmacy Practice, College of Pharmacy, University of Minnesota,
Minneapolis 55455.

OBJECTIVE: To discuss strategies available for the treatment of herpesvirus
infections in individuals infected with HIV. DATA SOURCES: Information was
obtained from controlled and uncontrolled clinical trials, abstracts, conference 
proceedings, and review articles. STUDY SELECTION: Emphasis was placed on
controlled investigations in subjects infected with HIV. DATA EXTRACTION: Data
from human studies were extracted by the author and evaluated according to the
patient population studied, sample size, dosage regimen, and therapeutic
response. DATA SYNTHESIS: Herpes group viruses are common opportunistic pathogens
in HIV-infected individuals. Zoster, caused by varicella-zoster virus (VZV), is
an early indication of the loss of cell-mediated immunity and HIV disease
progression. Anorectal mucocutaneous disease is the most common manifestation
caused by herpes simplex virus (HSV). Acyclovir is the drug of choice for
treatment of both VZV and HSV infections. Cytomegalovirus (CMV) is the most
common life-threatening viral infection in patients with AIDS; retinitis is the
most frequent clinical manifestation. The response rate of CMV retinitis to
initial treatment with either ganciclovir or foscarnet is equivalent,
approximately 60-90 percent. Recent data suggest that the survival benefit may be
greater with foscarnet. CONCLUSIONS: Advances in the development and application 
of antiviral drugs for herpes group viruses have made treatment and, in some
cases, prevention of infections possible. Future efforts, aimed at earlier
intervention and suppression of latent virus, may offer additional improvement in
quality of life for the HIV-infected individual.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1324033 [PubMed - indexed for MEDLINE]

5408: J Gen Virol. 1992 Jul;73 ( Pt 7):1849-54.

Identification of the glycoprotein H gene of murine cytomegalovirus.

Xu J, Dallas PB, Lyons PA, Shellam GR, Scalzo AA.

Department of Microbiology, University of Western Australia, Queen Elizabeth II
Medical Centre, Nedlands.

Partial sequencing of the HindIII C fragment of murine cytomegalovirus (MCMV)
revealed an open reading frame of 2172 nucleotides in length encoding a 724 amino
acid protein with a predicted Mr of 80.4K. Analysis of the predicted amino acid
sequence revealed homology with glycoprotein H (gH) from a number of other
herpesviruses. MCMV gH showed strongest amino acid identity with human (H) CMV
and human herpesvirus 6 gH, and less identity with the gH protein sequences of
Epstein-Barr virus, varicella-zoster virus and herpes simplex virus type 1. The
greatest identity between MCMV and HCMV gH occurs in the C-terminal region. The
MCMV gH is characterized by having a 14 amino acid signal sequence, a 23 amino
acid transmembrane region, a seven amino acid positively charged cytoplasmic
anchor sequence and eight putative N-linked glycosylation sites. Comparison of
MCMV gH with that of HCMV indicates that there are 12 conserved cysteine residues
and three conserved potential N-linked glycosylation sites.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1321219 [PubMed - indexed for MEDLINE]

5409: J Gen Virol. 1992 Jul;73 ( Pt 7):1661-71.

Identification of homologues to the human cytomegalovirus US22 gene family in
human herpesvirus 6.

Efstathiou S, Lawrence GL, Brown CM, Barrell BG.

Department of Pathology, University of Cambridge, U.K.

The sequence of 10079 bp corresponding to the overlapping SalI H and SmaI G
restriction fragments of the genome of human herpesvirus 6 (HHV-6) strain U1102
was determined. The sequence contains six complete open reading frames (ORFs) and
two incomplete ORFs located at the 5' and 3' ends of the SalI H and SmaI G
fragments respectively. Seven of these ORFs have recognizable homologues only in 
the beta-herpesvirus human cytomegalovirus (HCMV), no obvious counterparts being 
detectable in the genomes of the human alpha-herpesviruses, varicella-zoster
virus and herpes simplex virus type 1 or the gamma-herpesvirus Epstein-Barr
virus. The DNA sequenced is located proximal to the left repeat of the HHV-6
genome outside the well recognized region encompassing conserved herpesvirus gene
blocks. A close colinear relationship is evident between the HHV-6 ORFs
identified in this study and their counterparts in HCMV, ORFs UL23, UL24 and UL27
to UL31. Four of the HHV-6 ORFs, SHL1, SHL2, SFL1 and SSL2, are related to
members of the HCMV US22 family of proteins, which are themselves tandemly
arranged and located predominantly within the unique short and the left end of
the unique long region of the prototype HCMV strain AD169 genome. Two adjacent
HHV-6 ORFs, SSL1 and SHL3, are related to HCMV UL27. The identification of this
gene set in addition to the HHV-6 ORFs with amino acid sequence similarity to the
HCMV US22 family indicates a particularly close relationship between these two
human herpesviruses, and suggests that the clustering of these related tandemly
arranged genes may be a general feature of beta-herpesvirus-type genomes.

PMID: 1321206 [PubMed - indexed for MEDLINE]

5410: J Urol. 1992 Jul;148(1):192-4.

Human papillomavirus and herpes virus DNA are not detected in benign and
malignant prostatic tissue using the polymerase chain reaction.

Serfling U, Ciancio G, Zhu WY, Leonardi C, Penneys NS.

Veterans Affairs Medical Center, Department of Dermatology, Miami, Florida.

Fresh prostatic tissue removed at the time of surgery was assayed for the
presence of human papillomavirus (HPV) types 6, 11, 16, 18 and 33 and herpes and 
varicella-zoster viruses (HV) using DNA amplification followed by specific
hybridization. Thirty samples representing both benign and malignant prostatic
disease were assayed. Although appropriate amplimers were present for beta
globulin gene indicating successful extraction of DNA, no HPV or HV amplimers
could be obtained with appropriate primers. We conclude that HPV and HV are not
routinely found in human prostate.

PMID: 1319507 [PubMed - indexed for MEDLINE]

5411: Virology. 1992 Jul;189(1):304-16.

The DNA sequence of equine herpesvirus-1.

Telford EA, Watson MS, McBride K, Davison AJ.

Institute of Virology, University of Glasgow, United Kingdom.

The complete DNA sequence was determined of a pathogenic British isolate of
equine herpesvirus-1, a respiratory virus which can cause abortion and
neurological disease. The genome is 150,223 bp in size, has a base composition of
56.7% G + C, and contains 80 open reading frames likely to encode protein. Since 
four open reading frames are duplicated in the major inverted repeat, two are
probably expressed as a spliced mRNA, and one may contain an internal
transcriptional promoter, the genome is considered to contain 76 distinct genes. 
The genes are arranged collinearly with those in the genomes of the two
previously sequenced alphaherpesviruses, varicella-zoster virus, and herpes
simplex virus type-1, and comparisons of predicted amino acid sequences allowed
the functions of many equine herpesvirus 1 proteins to be assigned.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1318606 [PubMed - indexed for MEDLINE]

5412: Pediatrics. 1992 Jul;90(1 Pt 2):144-8.

Varicella vaccine: still at the crossroads.

Gershon AA.

Department of Pediatrics, Columbia University, College of Physicians and
Surgeons, New York, NY 10032.

Publication Types: 
    Review

PMID: 1318541 [PubMed - indexed for MEDLINE]

5413: Med Lett Drugs Ther. 1992 Jun 26;34(873):62-3.

Capsaicin--a topical analgesic.

[No authors listed]

PMID: 1608346 [PubMed - indexed for MEDLINE]

5414: Lancet. 1992 Jun 13;339(8807):1449-50.

Comment in:
    Lancet. 1992 Sep 12;340(8820):669.

Cerebrovascular complications of primary herpes varicella-zoster infection.

[No authors listed]

Publication Types: 
    Editorial

PMID: 1351133 [PubMed - indexed for MEDLINE]

5415: J Med Chem. 1992 Jun 12;35(12):2191-5.

(+-)-carbocyclic 5'-nor-2'-deoxyguanosine and related purine derivatives:
synthesis and antiviral properties.

Patil SD, Koga M, Schneller SW, Snoeck R, De Clercq E.

Department of Chemistry, University of South Florida, Tampa 33620-5250.

Beginning with 3-cyclopenten-1-ylamine hydrochloride, the 5'-nor derivatives of
carbocyclic 2'-deoxyguanosine (2), 2'-deoxyadenosine (3), and 2,6-diaminopurine
2'-deoxyribofuranoside (4) have been prepared. These compounds were evaluated for
antiviral potential versus herpes simplex virus, varicella-zoster virus,
cytomegalovirus, vaccinia virus, vesicular stomatitis virus, and human
immunodeficiency virus and found to lack activity. Also, compounds 2-4 were
virtually nontoxic toward the host (human diploid fibroblast ESM and HEL) cells. 
These biological properties may be due to the inability of 2-4 to be
phosphorylated to the requisite nucleotide level that is likely to be necessary
for biological activity by correlation to carbocyclic 2'-deoxyguanosine (1),
which possesses significant antiviral properties as a result of conversion to its
5'-triphosphate derivative.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1319491 [PubMed - indexed for MEDLINE]

5416: Schmerz. 1992 Jun;6(2):146-9.

[Anticonvulsant agents in neuralgic pain.]

[Article in German]

Jurna I, Zenz M.

Institut fur Pharmakologie und Toxikologie der Universitat des Saarlandes,
W-6650, Homburg/Saar, Bundesrepublik Deutschland.

The anticonvulsants, carbamazepine, clonazepam, phenytoin, and valproic acid are 
capable of depressing attacks of shooting pain in neuralgia. Shooting pain is
perceived in trigeminal, intercostal, and other neuralgias, as a consequence of
infectious diseases such as herpes zoster, and in the course of polyneuropathies 
of various causes. It is due to injury of nociceptive afferents, which generate
bursts of activity in response to appropriate environmental changes. The
anticonvulsant agents have no analgesic property per se, so that background pain 
remains unchanged. The depression of shooting pain results from the
anticonvulsant action of the compounds. Both carbamazepine and phenytoin block
synaptic transmission of neuronal hyperactivity by a direct depressant action
that includes reduction of sodium conductance and by activation of inhibitory
control. Clonazepam and valproic acid act by enhancing GABA-mediated inhibition
of synaptic transmission. Carbamazepine is by far the most widely used compound; 
phenytoin, clonazepam, and valproic acid are not so popular because of their side
effects.

Publication Types: 
    English Abstract

PMID: 18415623 [PubMed - in process]

5417: Schmerz. 1992 Jun;6(2):99-104.

[Prevalence and characteristics of neuropathic pain in malignant disease.]

[Article in German]

Grond S, Zech D, Meuser T, Radbruch L, Kasper M, Lehmann KA.

Institut fur Anasthesiologie und Operative Intensivmedizin, Universitat zu Koln, 
Joseph-Stelzmann-Stra?e 9, W-5000, Koln 41, Bundesrepublik Deutschland.

Neuropathic pain is one of the problem areas in the management of cancer pain. In
a retrospective study, prevalence and characteristics of neuropathic pain in 1318
cancer patients attending a pain clinic were examined. Of the patients, 135
suffered from neuropathic, 285 from neuropathic and nociceptive, 890 from
nociceptive and 8 from unknown pain conditions. Among the patients with
neuropathic pain 62% rated the pain intensity as very sincere; this was so in 48%
of those with nociceptive pain. Neuropathic pain was caused by direct tumour
involvement (nerve compression or infiltration) in 71%, by oncological treatment 
(surgery, chemotherapy, radiation) in 15%, by debilitating disease (e.g. herpes
zoster) in 6% and by factors unrelated to cancer or its treatment in 8% of the
patients. Of 110 clinically analysed neuropathic pain conditions, 44% were
neuralgic, 31% radicular, 13% sympathically maintained, and 10% caused by
deafferentiation, while in 3% the nature was unknown. To evaluate the efficacy of
cancer pain treatment, nocicepetive pain has to be differentiated from
neuropathic pain. In addition to this, neuropathic pain has to be divided into
subgroups.

PMID: 18415614 [PubMed - as supplied by publisher]

5418: Clin Infect Dis. 1992 Jun;14(6):1270-1.

Herpes zoster-induced acute hyperparathyroid crisis.

Martinez E, Domingo P.

Publication Types: 
    Case Reports
    Letter

PMID: 1623092 [PubMed - indexed for MEDLINE]

5419: Rev Clin Esp. 1992 Jun;191(2):109-10.

[Acute aseptic meningitis caused by herpes zoster]

[Article in Spanish]

Pacios Martinez EC, Fernandez Capitan MC, Pantoja Zarza L, Sanchez Munoz Torrero 
J, Rubio Batlles M.

Publication Types: 
    Case Reports
    Letter

PMID: 1502381 [PubMed - indexed for MEDLINE]

5420: Recenti Prog Med. 1992 Jun;83(6):350-3.

Erratum in:
    Recenti Prog Med 1992 Nov;83(11):664.

[Presence and significance of anticardiolipin antibodies in infectious diseases]

[Article in Italian]

Barrile A, Quattrocchi P, Bonanno D, Crisafi A, Staiti A, Magaraci G, Romano S,
Sturniolo G, Ricciardi R, Ferlazzo B, et al.

Istituto di Patologia medica e Medicina mediterranea, Universita, Messina.

IgG and IgM anti-cardiolipin antibodies were measured, by an ELISA technique, in 
the sera of patients with B hepatitis (28), infectious mononucleosis (10),
chicken pox (12), HIV infection (20), acquired toxoplasmosis (41) and other
infectious diseases [HBsAg+ chronic hepatitis (5), brucellosis (6), herpes zoster
(4), boutonneuse fever (3), viral pneumonitis (4), rheumatic fever (2)].
Increased levels of anti-cardiolipin antibodies (aCL), at least in one
immunoglobulin class, were detected in 37 out of 135 patients [27.4%; range: 7.3%
(in the patients with toxoplasmosis) -80% (in the patients with HIV infection)]. 
Low or medium titer aCL were present in 28 patients, high titer in 9 (6 with HIV 
infection, 2 with chicken pox and I with lymphoadenopathic toxoplasmosis). None
of the manifestations associated with aCL was present in the aCL-positive
patients. Finally, positivity for aCL didn't seem to modify the clinical picture 
and the prognosis of the infectious disease.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract

PMID: 1496184 [PubMed - indexed for MEDLINE]

5421: Oral Surg Oral Med Oral Pathol. 1992 Jun;73(6):664-6.

Maxillary osteomyelitis and spontaneous tooth exfoliation after herpes zoster.

Mintz SM, Anavi Y.

Detroit Receiving Hospital, Mich.

Reports of spontaneous tooth exfoliation and osteonecrosis trigeminal herpes
zoster are extremely rare and have been sporadic. This article reports a
pertinent case of a 50-year-old man who exhibited prodromal odontalgia before the
appearance of vesicular mucocutaneous lesions, together with severe destruction
of the maxillary bone and exfoliation of multiple teeth. This patient was
successfully treated using a unique closed nasal-vestibular drainage system for
the ultimate control of maxillary bone viability. A review and analysis of the
clinical aspects and the pathogenesis of herpes zoster and bone necrosis are
discussed.

Publication Types: 
    Case Reports
    Review

PMID: 1437032 [PubMed - indexed for MEDLINE]

5422: Br J Gen Pract. 1992 Jun;42(359):244-6.

Comment in:
    Br J Gen Pract. 1992 Nov;42(364):493-4.    Br J Gen Pract. 1992 Sep;42(362):398.

Acute herpes zoster and postherpetic neuralgia: effects of acyclovir and outcome 
of treatment with amitriptyline.

Bowsher D.

Pain Research Institute, Liverpool.

This retrospective study was designed to assess the effects of acyclovir
treatment of acute herpes zoster on subsequent postherpetic neuralgia, and to
examine the effects of amitriptyline in the treatment of postherpetic neuralgia. 
Eighty seven patients with postherpetic neuralgia of three or more months'
duration were studied: 24 of them had had their herpes zoster treated with oral
acyclovir. At first presentation, only 25% of the 24 patients who had had their
herpes zoster treated with acyclovir selected the word group containing burning
on the McGill pain questionnaire compared with 76% of the 63 patients who had not
received acyclovir. A higher proportion of patients who had had acyclovir than
had not selected the word group which contains the word aching (63% versus 49%). 
Acyclovir thus appears to change the nature of postherpetic neuralgia.
Postherpetic neuralgia was treated with amitriptyline, alone or in combination
with distigmine and/or sodium valproate. There was a strong correlation between
pain relief and the interval between the occurrence of herpes zoster and the
initiation of treatment with amitriptyline--early treatment is almost twice as
likely to be successful as late. Since conventional analgesics and sympatholytic 
drugs are of no benefit in the treatment of established postherpetic neuralgia,
the sequelae of herpes zoster must, therefore, be recognized and treated with
amitriptyline as soon as possible.

PMID: 1419247 [PubMed - indexed for MEDLINE]

5423: Semin Respir Infect. 1992 Jun;7(2):122-31.

Viral pneumonia in the immunocompromised adult with neoplastic disease: the role 
of common community respiratory viruses.

Whimbey E, Bodey GP.

Section of Infectious Diseases, University of Texas, M.D. Anderson Cancer Center,
Houston 77030.

Until recently, the viruses most often identified in lower respiratory tract
infections among immunocompromised adults with neoplastic disease have been the
herpesviruses (cytomegalovirus, herpes simplex virus, varicella-zoster virus,
human herpesvirus-6) and adenovirus. These viral pneumonias occur with greater
frequency and/or severity among these adults than among immunocompetent adults.
During the last decade, mounting evidence has suggested that the RNA viruses that
commonly cause lower respiratory tract disease in the general population, namely 
influenza virus, respiratory syncytial virus, and parainfluenza virus, are also
an important cause of serious community-acquired and nosocomial lower respiratory
tract disease among immunocompromised adults. Because these infections are
associated with considerable morbidity and mortality and are potentially
preventable and treatable, it is important that they be recognized and treated
promptly. Various therapies have been tried with some reported success, including
amantadine (specifically for influenza A), ribavirin, and intravenous
immunoglobulin. The optimal therapy or combination of therapies for these
infections among immunocompromised adults remains to be defined in controlled
trials.

Publication Types: 
    Review

PMID: 1332171 [PubMed - indexed for MEDLINE]

5424: Kinderarztl Prax. 1992 Jun;60(4-5):119-23.

[Infections after bone marrow transplantation in childhood]

[Article in German]

Ludwig S, Ludwig U, Farber I, Wutzler P, Straube E, Koch H, Hermann J, Fuchs D,
Zintl F.

Universitats-Kinderklinik Jussuf Ibrahim, Jena.

In 66 children having undergone bone marrow transplantation (BMT) the occurrence 
of infections was studied retrospectively. Bacterial infections were mostly found
in the early period after transplantation before marrow engraftment. The analysis
of positive blood cultures showed a dominance of gram-positive bacteria,
especially of coagulase-negative staphylococci. Cytomegalovirus (CMV) infections 
were most important, because of its high rate and the risk of CMV associated
interstitial pneumonia (IP), two patients suffered from. Infections from herpes
simplex virus (HSV), varizella zoster virus (VZV) and Epstein Barr virus (EBV)
had no influence on prognosis. In fungal infections the systemic aspergillosis
was the most important complication. To increase the effectiveness and safety of 
therapy the serum levels of antibiotics and antifungal drugs should be
determined.

Publication Types: 
    English Abstract

PMID: 1323001 [PubMed - indexed for MEDLINE]

5425: Ann Hematol. 1992 Jun;64 Suppl:A152-7.

Prevention of viral infections after bone marrow transplantation.

Schuler U, Ehninger G.

Medizinische Klinik, Universitat Tubingen, Federal Republic of Germany.

After bone marrow transplantation, a number of viral infections contribute to the
morbidity and mortality of the procedure. Established preventive measures to
avoid primary infection and reactivation of herpes-and cytomegaloviruses are
outlined. Possible future strategies against these viruses (e. g., monoclonal
antibodies, transfer of T-lymphocytes) and the possible role of improved
diagnostic tools are briefly discussed.

Publication Types: 
    Review

PMID: 1322188 [PubMed - indexed for MEDLINE]

5426: Ann Hematol. 1992 Jun;64 Suppl:A143-7.

Correlation of pretransplant viral serology and complications of bone marrow
transplantation.

Ringden O.

Department of Clinical Immunology, Karolinska Institute, Huddinge Hospital,
Stockholm, Sweden.

Latent herpes viruses such as herpes simplex virus, cytomegalovirus (CMV), and
varicella zoster virus are often reactivated after bone marrow transplantation,
giving rise to infections. In contrast, Epstein-Barr virus infections rarely
occur. Significant mortality is induced especially by pneumonitis, most often
caused by CMV. Immunosuppression and pancytopenia caused by CMV increase the risk
of bacterial infections and invasive fungal infections. Herpes viruses may
increase the risk of acute and chronic graft-versus-host disease (GVHD). Thus,
immunity to several herpes viruses was associated with an increased risk of acute
GVHD. Seropositivity for CMV in recipient and donor increased the risk of chronic
GVHD. Herpes viruses were also associated with a decreased risk of leukemic
relapse. CMV infection, asymptomatic CMV infection, and seropositivity for
several herpes viruses were associated with a reduced incidence of relapse in
different reports. In spite of this possible antileukemic effect, leukemia-free
survival was unaffected by herpes virus immunity in recipients or donors.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 1322186 [PubMed - indexed for MEDLINE]

5427: Epidemiol Infect. 1992 Jun;108(3):513-28.

The epidemiology of varicella-zoster virus infections: the influence of varicella
on the prevalence of herpes zoster.

Garnett GP, Grenfell BT.

Department of Animal and Plant Sciences, Sheffield University.

This paper uses mathematical models and data analysis to examine the
epidemiological implications of possible immunologically mediated links between
patterns of varicella and herpes-zoster incidence in human communities. A review 
of previously published reports does not clarify whether or not there is a
relationship between the incidence of varicella and the incidence of zoster.
However, new analysis of data collected by the Royal College of General
Practitioners provides indirect evidence for the hypothesis that a high intensity
of varicella transmission suppresses viral reactivation. The significance of this
finding for proposed varicella vaccination campaigns is explored by a review of
published data on the use of the vaccine. No significant difference is shown to
exist between the risk of zoster caused by the vaccine and the wild virus. A
mathematical model is then developed to take into consideration the influence of 
the prevalence of varicella on viral reactivation and the impact of vaccination
with attenuated virus, which may be able to recrudesce. Under some conditions,
mass application of such vaccines may have the impact of increasing zoster
incidence. The results presented here indicate that, before starting any
vaccination programme against varicella, its consequences need to be assessed in 
much more depth.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1318219 [PubMed - indexed for MEDLINE]

5428: Epidemiol Infect. 1992 Jun;108(3):495-511.

The epidemiology of varicella-zoster virus infections: a mathematical model.

Garnett GP, Grenfell BT.

Department of Animal and Plant Sciences, Sheffield University.

Herpes-zoster is caused by the reactivation of varicella-zoster virus (VZV). In
this paper different hypotheses of how this re-emergence of virus comes about are
reviewed and discussed. From these hypotheses, and epidemiological data
describing the initial transmission of the virus, a mathematical model of primary
disease (varicella) and reactivated disease (zoster) in developed countries is
derived. The steady-state age distributions of zoster cases predicted by this
model are compared with the observed distribution, derived from a review and
analysis of published epidemiological data. The model allows differentiation
between published hypotheses in which age of host may or may not influence the
probability of viral reactivation. The results indicate that the probability of
reactivation must increase with age to allow the observed pattern of zoster
cases. The basic mathematical model presented provides a conceptual framework,
which may be extended to assess possible control programmes.

PMID: 1318218 [PubMed - indexed for MEDLINE]

5429: Virology. 1992 Jun;188(2):704-13.

Identification and characterization of an equine herpesvirus 1 late gene encoding
a potential zinc finger.

Holden VR, Yalamanchili RR, Harty RN, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932.

In this report, we present the DNA sequence and transcriptional characterization 
of a gene (IR5) that maps within each of the inverted repeat (IR) segments of the
equine herpesvirus type 1 (EHV-1) genome. The IR5 open reading frame (ORF) is
located within both IR sequences (nucleotides 9932-10,642 of the IR). DNA
sequence analyses of the IR5 gene region revealed an ORF of 236 amino acids
(24,793 Da) that showed significant homology to ORF64 of varicella-zoster virus
and ORF3 of EHV-4 both of which map within the inverted repeats and to the US10
ORF of herpes simplex virus type 1 (HSV-1) which maps within the unique short
segment. Additional analyses of the nucleotide sequence failed to reveal any
overlapping ORFs that would correspond to US11 or US12 of HSV-1. Interestingly,
the IR5 ORF of EHV-1 possesses a sequence of 13 amino acids (CAYWCCLGHAFAC) that 
is a perfect match to the consensus zinc finger motif
(C-X2-4-C-X2-15-C/H-X2-4-C/H). Putative cis-acting elements flanking the IR5 ORF 
include a TATA box (nucleotides 9864-9870), a CAAT box (nucleotides 9709-9714),
and a polyadenylation signal (nucleotides 10,645-10,650). Northern blot and S1
nuclease analyses identified a single 0.9-kb mRNA species that first appears at 2
hr postinfection, and whose synthesis is reduced in the presence of
phosphonoacetic acid, an inhibitor of EHV-1 DNA synthesis. Thus, the IR5 gene of 
EHV-1 exhibits characteristics representative of a late gene of the gamma-1
class. The characterization of the IR5 gene at the DNA and RNA levels will
facilitate ongoing studies to identify and characterize the IR5 polypeptide.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1316680 [PubMed - indexed for MEDLINE]

5430: J Virol. 1992 Jun;66(6):3899-903.

Characterization of regulatory functions of the varicella-zoster virus gene
63-encoded protein.

Jackers P, Defechereux P, Baudoux L, Lambert C, Massaer M, Merville-Louis MP,
Rentier B, Piette J.

Laboratory of Fundamental Virology, University of Liege, Belgium.

Varicella-zoster virus (VZV) gene 63 encodes a protein (IE63) with a predicted
molecular mass of 30.5 kDa which has amino acid similarities to the
immediate-early (IE) protein 22 (ICP22) of herpes simplex virus type 1. ICP22 is 
a polypeptide synthesized in herpes simplex virus type 1-infected cells, and as
is the case for its VZV counterpart, its regulatory functions are unknown. On the
basis of the VZV DNA sequence, it has been shown that IE63 exhibits hydrophilic
and acidic properties, suggesting that this protein could play a regulatory role 
during the infectious cycle. We report in this article cotransfection experiments
which demonstrate that the VZV gene 63 protein strongly represses, in a
dose-dependent manner, the expression of VZV gene 62. On the other hand,
transient expression of the VZV gene 63 protein can promote activation of the
thymidine kinase gene but cannot affect the expression of the genes encoding
glycoproteins I and II. The results of transient expression experiments strongly 
suggest that the VZV gene 63 protein could play a pivotal role in the repression 
of IE gene expression as well as in the activation of early gene expression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1316489 [PubMed - indexed for MEDLINE]

5431: J Virol. 1992 Jun;66(6):3690-8.

Transcription from varicella-zoster virus gene 67 (glycoprotein IV).

Ling P, Kinchington PR, Sadeghi-Zadeh M, Ruyechan WT, Hay J.

Department of Microbiology, School of Medicine, Uniformed Services University of 
the Health Sciences, Bethesda, Maryland 20814-4799.

Three transcripts map to the varicella-zoster virus (VZV) open reading frame
(ORF) 67, which encodes glycoprotein IV (gpIV). All of these transcripts are
polyadenylated and are transcribed from left to right towards the genomic
terminal short repeats. Previous Northern (RNA) blot analyses suggested that the 
most abundant of these transcripts (1.65 kb) might code for gpIV. We performed S1
nuclease protection and primer extension assays and determined that the 5'
terminus of the 1.65-kb transcript maps 91 bp upstream from the gpIV initiation
codon. An AT-rich region (ATAAA), -28 bp from the cap site, is a potential TATA
box, and at -71 bp there is a consensus CCAAT box motif. The 3' end of the
1.65-kb transcript is 20 bp downstream of two overlapping polyadenylation
signals, AATAAA and ATTAAA, and just downstream of the 3' terminus is a GU-rich
sequence. These results are reminiscent of data from our analysis of the VZV gpV 
gene, confirming that VZV appears able to use unusual TATA box motifs. Many
canonical TATA sequences are present upstream from these VZV transcriptional
start sites but, apparently, are not used. We tested sequences upstream from the 
gpIV cap site for promoter activity in transient expression experiments by
cloning a DNA fragment (+63 to -343 bp) into pCAT3M, which contains a
chloramphenicol acetyltransferase reporter gene. This clone showed little
constitutive promoter activity but was activated more than 200-fold by infection 
with VZV and 5-fold with herpes simplex virus. The two known VZV transactivating 
genes (those for ORF 4 and ORF 62) were tested for their abilities to activate
expression from the gpIV promoter by using their cognate promoters. The ORF 4
gene was minimally active, whereas the ORF 62 gene gave twofold induction; both
genes, acting together, gave fivefold induction. However, replacement of the IE62
promoter with the immediate-early cytomegalovirus promoter in the ORF 62
construct gave over 40-fold induction of chloramphenicol acetyltransferase
activity under the gpIV promoter in the same assay.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1316476 [PubMed - indexed for MEDLINE]

5432: J Virol. 1992 Jun;66(6):3643-51.

Receptor properties of two varicella-zoster virus glycoproteins, gpI and gpIV,
homologous to herpes simplex virus gE and gI.

Litwin V, Jackson W, Grose C.

Department of Microbiology, University of Iowa College of Medicine, Iowa City
52242.

The varicella-zoster virus (VZV) genome contains 70 reading frames (ORF), 5 of
which encode the glycoproteins gpI, gpII, gpIII, gpIV, and gpV. ORF 67 and 68 lie
adjacent to each other in the unique short region of the VZV genome and code for 
gpIV and gpI, respectively. These two genes, which are contained within the
HindIII C fragment of the VZV genome, were subcloned in the correct orientation
downstream from the promoter regions of the eukaryotic expression vectors pCMV5
and pBJ. After transfection, 5 to 20% of the Cos cells bound antibody specific
for the given glycoprotein. In this study, it was shown that only the cells
transfected with the gpI construct bound to the Fc fragment of human
immunoglobulin G. Neither the transfected gpIV gene product nor the vector only
bound to the Fc fragment. Thus, VZV gpI is confirmed to be the VZV-encoded
Fc-binding glycoprotein. Like the wild-type form of gpI expressed in VZV-infected
cells, gpI precipitated from transfected cells contained both N-linked and
O-linked glycans and was heavily sialated. In addition, the transfected gpI gene 
product was phosphorylated both in cell culture and in protein kinase assays by
mammalian casein kinases I and II. Extensive computer-assisted analyses of the
VZV gpI sequence, as well as those of alphaherpesviral homolog glycoproteins,
disclosed properties similar to those of other cell surface receptors; these
included (i) exocytoplasmic regions rich in cysteine residues, (ii)
membrane-proximal regions with potential O-linked glycosylation sites, and (iii) 
cytoplasmic domains with consensus phosphorylation sites.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1316474 [PubMed - indexed for MEDLINE]

5433: J Med Chem. 1992 May 15;35(10):1799-806.

Synthesis and antiviral activity of 1-cyclobutyl-5-(2-bromovinyl)uracil
nucleoside analogues and related compounds.

Slusarchyk WA, Bisacchi GS, Field AK, Hockstein DR, Jacobs GA, McGeever-Rubin B, 
Tino JA, Tuomari AV, Yamanaka GA, Young MG, et al.

Bristol-Myers Squibb Pharmaceutical Research Institute, Princeton, New Jersey
08543-4000.

A series of racemic (1 alpha (E), 2 beta, 3
alpha)-1-[2,3-bis(hydroxymethyl)cyclobutyl]-5-(2-halovinyl)uracils was
synthesized and evaluated in cell culture. The bromovinyl, iodovinyl, and
chlorovinyl analogues, 13, 15, and 16, respectively, are all potent inhibitors of
varicella zoster virus (VZV), but are less inhibitory to the replication of human
cytomegalovirus (HCMV) and herpes simplex viruses 1 and 2 (HSV-1, HSV-2). The
excellent anti-VZV activities of 13, 15, and 16 coupled with their virtual
inability to inhibit WI-38 cell growth indicate high in vitro therapeutic
indices. VZV thymidine kinase readily converts these compounds to their
respective monophosphates but not to their corresponding diphosphates. Compound
13a, the (1'R) enantiomer of the bromovinyl analogue 13, was also synthesized,
and its potency is comparable to that of the racemate. A lower homologue 14, (1
alpha (E),2 beta, 3 alpha)-1-[2-hydroxy-3-(hydroxymethyl)cyclobutyl]-5-
(2-bromovinyl)uracil, was found to be inactive against VZV, HCMV, HSV-1, and
HSV-2.

PMID: 1316966 [PubMed - indexed for MEDLINE]

5434: Am J Otolaryngol. 1992 May-Jun;13(3):145-55.

Infections of the external ear.

Hirsch BE.

Department of Otolaryngology, University of Pittsburgh School of Medicine,
Montefiore University Hospital, PA.

Publication Types: 
    Review

PMID: 1626615 [PubMed - indexed for MEDLINE]

5435: Can J Psychiatry. 1992 May;37(4):271-3.

Comment in:
    Can J Psychiatry. 1993 Nov;38(9):631.

Encephalitis associated with herpes zoster: a case report and review.

McKenna KF, Warneke LB.

Alberta Heritage Foundation for Medical Research; Edmonton.

This paper describes the case of a patient with a history of affective disorder
who developed encephalitis associated with herpes zoster which presented as a
delirium with prominent manic symptoms. Published reports of encephalitis
following herpes zoster infections are reviewed. The diagnosis of herpes
zoster-associated encephalitis should be suspected in individuals with changes in
his or her mental state, an abnormal electroencephalogram and an abnormal
cerebrospinal fluid examination which closely follow a cutaneous herpes zoster
lesion.

Publication Types: 
    Case Reports

PMID: 1611590 [PubMed - indexed for MEDLINE]

5436: J Ophthalmic Nurs Technol. 1992 May-Jun;11(3):103-8.

Acute retinal necrosis syndrome.

Spires R.

1. Acute retinal necrosis (ARN) represents a specific pattern of clinical
presentations for certain herpes virus infections in the posterior segment of the
eye. These include varicella zoster virus and herpes simplex virus. 2. Patients
with ARN usually complain of mild to moderate ocular or periorbital pain, foreign
body sensation, and a red eye. Visual symptoms usually include hazy vision,
floaters, and, rarely, decreased peripheral vision. 3. Medical treatment of
choice is intravenous acyclovir. Surgical treatment of choice is pars plana
vitrectomy. If retinal detachment is present, vitrectomy with endolaser, internal
drainage of subretinal fluid, air-fluid exchange, and long-acting gas tamponade
are recommended.

Publication Types: 
    Case Reports

PMID: 1597865 [PubMed - indexed for MEDLINE]

5437: Surv Ophthalmol. 1992 May-Jun;36(6):395-410.

Comment in:
    Surv Ophthalmol. 1992 Sep-Oct;37(2):150-1; author reply 152-3.    Surv Ophthalmol. 1992 Sep-Oct;37(2):150; author reply 152-3.    Surv Ophthalmol. 1992 Sep-Oct;37(2):151-2; author reply 152-3.    Surv Ophthalmol. 1992 Sep-Oct;37(2):151; author reply 152-3.

Herpes zoster ophthalmicus.

Karbassi M, Raizman MB, Schuman JS.

New England Deaconess Hospital, Department of Surgery, Boston, Massachusetts.

Herpes zoster ophthalmicus occurs worldwide, usually in healthy adults, but,
increasingly in patients who are immunocompromised. After primary varicella
infection (chickenpox), the virus lies dormant in the sensory ganglion until it
becomes reactivated as zoster. Involvement of the ophthalmic branch of the
trigeminal nerve is characterized early by corneal dysesthesia and dendritiform
keratopathy, and these are self-limited. However, smoldering disease may cause
pathological changes in the ocular structures through direct invasion of virus,
secondary inflammation, and alterations of autoimmune mechanisms. Antiviral
agents have demonstrated some success in resolving early signs and symptoms, but 
their role in preventing and treating late complications remains to be fully
studied. Until a definitive antiviral agent is established, the benefits of
steroid use in certain acute inflammatory processes outweight its risk of
reducing host immunity. Corneal complications of herpes zoster ophthalmicus
sometimes require surgical intervention.

Publication Types: 
    Review

PMID: 1589855 [PubMed - indexed for MEDLINE]

5438: Neurology. 1992 May;42(5):1122-3.

Segmental motor involvement in herpes zoster: an EMG study.

Greenberg MK, McVey AL, Hayes T.

Department of Neurology, Wilford Hall USAF Medical Center, Lackland AFB, TX
78236.

PMID: 1579243 [PubMed - indexed for MEDLINE]

5439: J Neurosurg. 1992 May;76(5):888.

Comment on:
    J Neurosurg. 1991 Oct;75(4):505-11.

Geniculate neuralgia.

Young RF.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 1520357 [PubMed - indexed for MEDLINE]

5440: Ear Nose Throat J. 1992 May;71(5):207-8.

Acyclovir for the treatment of idiopathic vocal fold paralysis.

Benninger MS.

Publication Types: 
    Case Reports
    Letter

PMID: 1505368 [PubMed - indexed for MEDLINE]

5441: Rinsho Shinkeigaku. 1992 May;32(5):524-6.

[A case of multiple cranial nerve palsy with severe dysphagia due to herpes
zoster infection]

[Article in Japanese]

Maeda A, Shiojiri T, Tsuchiya K, Watabiki S.

Department of Neurology, Musashino Red Cross Hospital.

A case of multiple cranial nerve palsy by herpes zoster was reported. A
79-year-old man showed fever, sore throat, and dysphagia. No vesicle was noted at
ear and pharynx. The patient developed, later, left peripheral facial nerve
palsy. The cerebrospinal fluid revealed pleocytosis with increased protein. The
viral antibody titer of herpes zoster was significantly elevated both in
cerebrospinal fluid and in serum. The left facial palsy was slightly improved.
But his dysphagia didn't improve during at least 10 months after the onset. Among
the cranial nerves, trigeminal and facial nerves are the most commonly affected
by herpes zoster. But there are a few cases of the 9th and 10th cranial nerve
involvement in the literature. However, dysphagia has rarely been reported in
these previous cases, only four cases developed severe dysphagia like the present
patient. All of these cases including our case were over sixty years old, while
cases with slight dysphagia were under sixty years old. No other differentiating 
factor is noted between these two groups with regard to sites of vesicles,
findings of cerebrospinal fluid and mode of therapy.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 1458731 [PubMed - indexed for MEDLINE]

5442: Klin Oczna. 1992 May-Jun;94(5-6):135-6.

[Oral acyclovir treatment of viral eye infections]

[Article in Polish]

Moszczynska-Kowalska A, Kecik T, Drobecka-Brydak E, Stanislawska A.

Kliniki Okulistycznej AM, Warszawie.

Forty four patients with virus conjunctivitis, keratitis, uveitis and retinitis
were treated by acyclovir in tablets--5 times a day 400 mg.; the results were
satisfactory. The drug was well tolerated and it could be used also in patients
who showed hypersensitivity for acyclovir after ++intra-conjunctival application 
in the form of ointment.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1453671 [PubMed - indexed for MEDLINE]

5443: J Formos Med Assoc. 1992 May;91(5):508-12.

Dorsal root entry zone lesions in the treatment of pain following brachial plexus
avulsion and herpes zoster.

Chen HJ.

Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.

Fifteen patients with brachial plexus avulsion injury and four patients with
postherpetic pain submitted to dorsal root entry zone surgery. Nashold's method
was used in all cases. The initial results in the group with brachial plexus
avulsion injury were satisfactory. Twelve patients experienced pain relief. Only 
one patient had a poor result. Ten patients (66%) continued to have good pain
relief in the follow-up period of 15-48 months. Three patients with postherpetic 
pain had good pain relief in the initial stage after surgery. Two of these four
cases were found to have a recurrence of some pain, which could be relieved more 
or less by oral analgesics. No mortality or major complications were found in
this series, although eight patients complained postoperatively of mild sensory
weakness which disappeared within two weeks.

Publication Types: 
    Case Reports

PMID: 1358329 [PubMed - indexed for MEDLINE]

5444: Acta Neurol Scand. 1992 May;85(5):372-5.

Recurrent herpes zoster myelitis treated with human interferon alpha: a case
report.

Nakano T, Awaki E, Araga S, Takai H, Inoue K, Takahashi K.

Division of Neurology, Tottori University, Yonago, Japan.

Recurrent herpes zoster myelitis is very rare. However, a case was recently
observed in our hospital. A 43-year-old woman developed myelitis 2 weeks after
development of shingles. Her condition was improved by methylprednisolone. Seven 
months later, she developed myelitis after development of shingles again.
Antibody against varicella-zoster (VZV), increased in the serum, but was negative
in the cerebrospinal fluid. Methylprednisolone was not sufficiently effective
against this attack. The refractory sensory disturbance was improved by human
interferon alpha (IFN-alpha). Natural killer cell activity, the helper
T-cell/suppressor T-cell ratio and the kappa/lambda ratio of B-cells increased
with clinical improvement. In this case, delayed-type hypersensitivity after VZV 
infection played a role in the occurrence of myelopathy and clinical improvement 
resulted from the immunosuppressive effects of IFN-alpha.

Publication Types: 
    Case Reports

PMID: 1320320 [PubMed - indexed for MEDLINE]

5445: Ophthalmology. 1992 May;99(5):781-99.

Biology and molecular aspects of herpes simplex and varicella-zoster virus
infections.

Liesegang TJ.

Mayo Clinic Jacksonville, FL 32224.

The herpes simplex and varicella-zoster viruses are members of the subfamily
alpha herpesviruses with specific properties of the virion and with the capacity 
to establish latent infections in humans. The genome of each of these viruses has
been determined with an estimate of the number of genes and proteins encoded. The
biology and molecular events of the herpes simplex virus productive and latent
infection have been detailed with the use of both in vitro and in vivo model
systems. The neuron is the site of latency in the ganglia with a limited
transcription of genes expressed during the latent period. The specific molecular
regulation of latency and reactivation are not well established. There are
co-cultivation, electron microscopy, and biochemical studies that support the
concept of corneal latency, although this has not been proven conclusively.
Details about the varicella-zoster virus biology and molecular events are not as 
well advanced since animal models have been lacking. The biology of the
productive infection (varicella) is different from herpes simplex virus infection
since the portal of entry is the respiratory system. Data support the concept of 
the maintenance of latency within satellite cells in the ganglia rather than
within neurons. There are multiple genes expressed during this latency. These
features may explain the different clinical presentations and course of
reactivation (zoster) compared with herpes simplex virus reactivation.

Publication Types: 
    Review

PMID: 1317538 [PubMed - indexed for MEDLINE]

5446: Virology. 1992 May;188(1):193-7.

Prevalence and distribution of latent simian varicella virus DNA in monkey
ganglia.

Mahalingam R, Clarke P, Wellish M, Dueland AN, Soike KF, Gilden DH, Cohrs R.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

We used polymerase chain reaction to analyze the prevalence and distribution of
latent simian varicella virus (SVV) in ganglionic and nonganglionic tissues from 
nine African green monkeys experimentally infected with SVV. Primers specific for
three different regions of the SVV genome were used for amplification. SVV DNA
sequences were detected in trigeminal ganglia from seven of nine monkeys and in
thoracic ganglia from seven of nine monkeys. Analysis of DNA from nonneuronal
tissues of three monkeys and from adrenal glands of nine monkeys revealed the
presence of SVV-specific sequences in the adrenal gland of one monkey. The
results indicate that, like human varicella, SVV becomes latent primarily in
ganglia at multiple levels of the neuraxis, and more than one region of the SVV
genome is present in latently infected ganglia. SVV latency in primates may be a 
useful model for varicella latency in humans.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1314451 [PubMed - indexed for MEDLINE]

5447: J Virol. 1992 May;66(5):2763-72.

Immediate-early RNA 2.9 and early RNA 2.6 of bovine herpesvirus 1 are 3'
coterminal and encode a putative zinc finger transactivator protein.

Wirth UV, Fraefel C, Vogt B, Vlcek C, Paces V, Schwyzer M.

Institute of Virology, Faculty of Veterinary Medicine, University of Zurich,
Switzerland.

Bovine herpesvirus 1 (BHV-1) contains three major immediate-early (IE) genes
involved in regulation of the productive cycle of replication. Two spliced IE
RNAs, IER4.2 (4.2 kb) and IER2.9 (2.9 kb), are under the control of a single
promoter; IER1.7 (1.7 kb) is transcribed from a different promoter in the
opposite direction. Examining the kinetics of transcription, we found that the
IER4.2/2.9 promoter was turned off at the end of the IE period. An alternative
promoter became active, directing synthesis of an unspliced early RNA, ER2.6 (2.6
kb), which was colinear with the second exon of IER2.9 except for its 5' end in
the intron about 10 bases upstream of the splice site. Sequence analysis revealed
a single open reading frame common to IER2.9 and ER2.6 with a coding potential of
676 amino acids. The putative protein, named p135, contained a cysteine-rich zinc
finger domain near the N terminus with homology to ICP0 of herpes simplex virus
type 1, to protein 61 of varicella-zoster virus, to early protein 0 of
pseudorabies virus, and to other viral and cellular proteins. The remaining parts
of p135 exhibited only limited homology, mainly with pseudorabies virus protein
0, but the entire sequence was highly conserved between two strains of BHV-1 (K22
and Jura). The latency-related antisense transcript covered a large portion of
ER2.6 excluding the zinc finger coding region. In transient expression assays,
p135 activated a variety of promoters, including that for ER2.6, but repressed
the IER1.7 promoter. Thus, p135 combines functional characteristics of ICP0, a
strong transactivator, and of protein 61, a repressor. BHV-1 seems to have
evolved a subtle mechanism to ensure the continued synthesis of p135 while
turning off IER4.2, which encodes p180, the herpes simplex virus type 1 ICP4
homolog.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1313901 [PubMed - indexed for MEDLINE]

5448: J Virol. 1992 May;66(5):2631-8.

Expression of the Marek's disease virus (MDV) homolog of glycoprotein B of herpes
simplex virus by a recombinant baculovirus and its identification as the B
antigen (gp100, gp60, gp49) of MDV.

Niikura M, Matsuura Y, Endoh D, Onuma M, Mikami T.

Department of Veterinary Microbiology, Faculty of Agriculture, University of
Tokyo, Japan.

A gene encoding a homolog of glycoprotein B of herpes simplex virus (gB homolog) 
has been identified on the Marek's disease virus (MDV) genome (L. J. N. Ross, M. 
Sanderson, S. D. Scott, M. M. Binns, T. Doel, and B. Milne, J. Gen. Virol.
70:1789-1804, 1989); however, the molecular and immunological characteristics of 
the gene product(s) are still not clear. In the present study, the gB homolog of 
MDV was expressed in insect cells by a recombinant baculovirus, and it was
characterized to determine its molecular and antigenic properties. The expressed 
recombinant protein had three molecular sizes (88 to 110, 58, and 49 kDa) and was
recognized by antisera from chickens inoculated with each of the three serotypes 
of MDV. By immunofluorescence analysis, it was shown that the protein was
expressed in the cytoplasm and on the surface of the recombinant
baculovirus-infected cells. The gB homolog of MDV was processed similarly to
pseudorabies virus and varicella-zoster virus with respect to cleavage and the
intramolecular disulfide bond between the cleaved products. Interestingly, the
expressed protein reacted with monoclonal antibody M51, specific to the B antigen
(gp100, gp60, gp49) of MDV, although the locations of the gene encoding the B
antigen and of the gene encoding the gB homolog were reported to be different.
Moreover, competitive experiments revealed that anti-gB homolog serum and
monoclonal antibody M51 recognized the same molecules. From these results, the gB
homolog and the B antigen of MDV seem to be the same glycoprotein.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1313890 [PubMed - indexed for MEDLINE]

5449: Schweiz Med Wochenschr. 1992 Apr 18;122(16):569-75.

[Antiviral drug therapy of infections caused by Herpes simplex and Varicella
Zoster viruses]

[Article in German]

Vogt M, Huss R, Wunderli W.

Departement fur Innere Medizin, Universitatsspital Zurich.

Herpes simplex virus type 1 and 2 may cause painful mucocutaneous lesions in both
immunosuppressed and immunocompetent patients. Indications for the use of
acyclovir (ACV) are reviewed. In the second part the management of infections
caused by varicella-zoster virus are discussed. Primary varicella (chickenpox) in
immunosuppressed children should be treated with i.v. ACV without delay. In
healthy patients varicella pneumonia needs to be treated with ACV. Healthy
patients with herpes zoster are not usually candidates for antiviral therapy. The
only exception is herpes zoster ophthalmicus. In patients with severe
immunosuppression, such as transplant recipients, ACV therapy is recommended in
order to reduce the rate of dissemination. First reports and our own observations
on the development of ACV-resistant HSV and VZV isolates stress the importance of
discriminating use of ACV and other antiviral compounds in immunosuppressed
patients.

Publication Types: 
    English Abstract
    Review

PMID: 1579862 [PubMed - indexed for MEDLINE]

5450: N Z Med J. 1992 Apr 8;105(931):135.

Herpes zoster.

King AS.

Publication Types: 
    Letter

PMID: 1560929 [PubMed - indexed for MEDLINE]

5451: Ann Oncol. 1992 Apr;3 Suppl 2:S85-8.

Risk factors for adult soft tissue sarcoma in northern Italy.

Franceschi S, Serraino D.

Epidemiology Unit, Aviano Cancer Centre, Italy.

The role of several potential risk factors in the etiology of soft-tissue sarcoma
(STS) was examined in a hospital-based case-control study, conducted in the
Friuli-Venezia Giulia region, northeast Italy, between 1985 and 1991. A total of 
93 STS cases (53 males and 40 females, median age: 52 years) and of 721 controls 
(371 males and 350 females, median age: 54 years) were interviewed. Significant
increased risks were associated with a history of herpes zoster infection (odds
ratio (OR): 2.3, 95% confidence interval (CI): 1.1-4.9), chicken-pox (OR: 2.1,
95% CI: 1.2-4.1) and mumps (OR: 2.0, 95% CI: 1.1-3.8). None of the other medical 
conditions investigated - socio-economic and anthropometric indicators, tobacco
smoking, consumption of alcoholic beverages, coffee and tea - seemed to affect
STS risk. No risk elevation was found in subjects employed in agriculture (OR -
for greater than 10 years employment = 0.8, 95% CI: 0.4-1.5), nor in those who
reported exposure to pesticides or herbicides (OR = 0.4, 95% CI: 0.1-1.2).
Workers who reported exposure to chemical agents or to benzene or other solvents 
for more than 10 years had, respectively, a 1.8-fold (95% CI: 0.7-4.4) and a
2.2-fold (95% CI: 0.9-5.5) higher risk of developing STS.

PMID: 1622876 [PubMed - indexed for MEDLINE]

5452: Rev Clin Esp. 1992 Apr;190(7):375-6.

[Lethal meningitis caused by varicella-zoster virus in a patient with AIDS]

[Article in Spanish]

Soriano V, Bru F, Gonzalez-Lahoz J.

Publication Types: 
    Case Reports
    Letter

PMID: 1620928 [PubMed - indexed for MEDLINE]

5453: Trop Doct. 1992 Apr;22(2):68-70.

Herpes zoster as an indicator of HIV infection in Africa.

Dehne KL, Dhlakama DG, Richter C, Mawadza M, McClean D, Huss R.

Tropical Health Unit, Academic Unit of Public Health Medicine, Leeds.

In areas where resources for health information are limited, the incidence of
herpes zoster can usefully be monitored as an indicator of HIV infection. A
sudden parallel rise of the number of symptomatic HIV cases and herpes zoster
cases was observed in a northern district of Zimbabwe. Herpes zoster was made
locally reportable. Three years later the incidence of herpes zoster and HIV in
the hospital and of herpes zoster in the surrounding rural health centres was
analysed. The herpes zoster attack rate and the HIV seropositivity rate of herpes
zoster patients resembled those elsewhere in Africa. The distribution of cases of
zoster was comparable with that of HIV infection.

PIP: In 1987, Karoi district in northern Zimbabwe made herpes zoster a reportable
disease because of an unusual increase in the number of cases in the district.
Health workers at the hospital had seen an increase in the number of patients
with HIV associated symptoms between June 1986 and March 1989. Herpes zoster
cases rose from 0 to 100 between 1986 and 1987. HIV cases increased from 10 to
300 between 1986 and 1987. By 1988, these numbers increased to 500 and 450,
respectively. 89% of herpes zoster cases at the hospital in 1988-89 were HIV
positive. About 66% of these HIV positive cases had no sign or symptom of HIV
infection other than herpes zoster. The percentage of confirmed HIV cases with a 
current or previous history of herpes zoster was 15% in 1987, 32% in 1988, and
17% in 1989. The decrease after 1988 was due to hospital staff telling health
centers' staff that they no longer needed to refer all herpes zoster cases to the
hospital since almost all young herpes zoster cases were HIV positive. Based on a
herpes zoster attack rate of 15%, a positive predictive value of 90%, and the
cumulative herpes zoster incidence for 1986-89 of 250/1200 inhabitants, the
researchers calculated that there were about 1500 HIV positive cases or 12.5% of 
the total population living in the area. This would bring the number of HIV
positive cases in the district to 3600 or 4 times the number who came to the
hospital with HIV associated symptoms and were indeed HIV positive. Health
workers can monitor expansion of the HIV epidemic in northern Zimbabwe based on
the number of herpes zoster cases.

Publication Types: 
    Comparative Study

PMID: 1604717 [PubMed - indexed for MEDLINE]

5454: Br J Haematol. 1992 Apr;80(4):466-71.

Sequential administration of recombinant interferon alpha and deoxycoformycin in 
the treatment of hairy cell leukaemia.

Habermann TM, Andersen JW, Cassileth PA, Bennett JM, Oken MM.

Mayo Clinic, Rochester, MN 55905.

Both recombinant interferon alpha and deoxycoformycin (dCF) are effective in the 
treatment of hairy cell leukaemia. In an attempt to reduce the complications from
dCF therapy, a pilot study of the Eastern Cooperative Oncology Group (ECOG) first
treated patients with interferon to improve peripheral blood cell counts before
dCF treatment began. Thirty-four patients were treated for 3 months with
recombinant interferon alpha-2a (rIFN alpha-2a), 3 x 10(6) IU subcutaneously
three times a week for 3 months, and then by dCF, 4 mg/m2 intravenously every 2
weeks for a maximum of 12 months. The overall response rate was 94% (32/34); 76% 
of patients (26/34) had complete response (CR) (90% confidence interval, 62-88%) 
and 18% (6/34) partial response. One patient was found to have a Mycobacterium
avium infection while receiving rIFN alpha-2a. Without specific antimycobacterial
therapy and with continued administration of rIFN alpha-2a and dCF, the infection
resolved and he achieved CR. Three patients had culture-negative febrile episodes
during the dCF phase of treatment. Non-disseminated herpes zoster developed in
four patients, but three of the episodes occurred only after treatment was
discontinued. Sequential administration of rIFN alpha-2a and dCF resulted in
fewer infections (P = 0.027) than in ECOG's previous study of dCF used alone. Two
patients died, one of combined hairy cell leukaemia and non-Hodgkin's lymphoma of
intermediate histologic type 17 months after entry into the study and the other
of cardiac arrest 20 months after entry. Thirty-two patients were alive with a
median follow-up of 21 months (range 13-31 months). This combination produces
durable CRs with a low incidence of infection.

Publication Types: 
    Clinical Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 1581231 [PubMed - indexed for MEDLINE]

5455: Pediatrics. 1992 Apr;89(4 Pt 1):685-6.

A varicella-induced pupil abnormality.

Caputo AR, Mickey KJ, Guo S.

Publication Types: 
    Letter

PMID: 1557256 [PubMed - indexed for MEDLINE]

5456: Rinsho Shinkeigaku. 1992 Apr;32(4):451-3.

[Varicella-zoster virus-associated spinal myoclonus without skin lesions]

[Article in Japanese]

Ogata A, Honma S, Tashiro K.

Department of Neurology, Hokkaido University School of Medicine.

A 50-year-old woman was admitted to our hospital because of abnormal involuntary 
movement of upper abdomen. Three months before admission, she had suffered from
left lateral chest pain without skin lesions for one week. The neurological
examination on admission revealed myoclonus of upper abdomen, and hyperalgesia
and thermohyperesthesia from T4 to T9. There was no weakness, the tendon reflexes
were symmetrical and the plantar responses were flexor. The surface EMG disclosed
the symmetrical, synchronous contractions of m. rectus abdominis and m. obliques 
externus abdominis. This spinal myoclonus reduced during sleep. The EEG, CT and
MRI showed no abnormalities. Serum varicella-zoster virus (VZV) titers increased 
significantly on follow-up examinations. Clonazepam, 1.5 mg daily was effective
in this patient. The myoclonus spontaneously disappeared without clonazepam in
six weeks after onset, and at the same time the sensory disturbance also
improved. From the neurological findings and clinical course, we consider this
spinal myoclonus was probably elicited by involvement of the inhibitory
interneurons of the dorsal horns, due to immune response to latent VZV infection 
but not to direct neuronal destruction by VZV. Spinal myoclonus should be
recognized as the spectrum of neurological disease associated with VZV even in
the absence of skin lesions.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 1395336 [PubMed - indexed for MEDLINE]

5457: Cent Afr J Med. 1992 Apr;38(4):139-43.

Pattern of HIV-infection in Hurungwe district, Mashonaland West, Zimbabwe.

Denhe K, Dhlakama D, Richter C, Mawadza M, McClean D, Huss R.

Academic Unit of Public Health Medicine, University of Leeds, UK.

After the first case of HIV-infection had been diagnosed in 1986 in a Northern
district of Zimbabwe, a local hospital based surveillance system, was introduced.
In order to monitor the spread of the epidemic in the district, residence, age,
sex and clinical presentation of all newly diagnosed HIV-patients were recorded. 
After three years, the data were compiled and analysed with the following
results. Altogether 887 symptomatic HIV-patients (0.5 pc of the district
population) were diagnosed. The most common HIV-associated signs and symptoms
were PGL (47 pc), chest infection (29 pc), herpes zoster (24 pc) and chronic STDs
(15 pc). The female-to-male ratio in adults was 1.4. The average age on diagnosis
in women was 26.0 +/- 6.7 years and in men 30.7 +/- 8.6 years. The three years'
cumulative incidence of HIV-cases was 27.2/1,000 in the urban area and 3/1,000 in
the rural areas of the district.

PIP: Data on 887 AIDS cases in Zimbabwe were collected at the District Hospital
in Hurungwe, Zimbabwe, from 1986-89 before the official notification system
included this disease. The number of cases increased from 19 in 1986 to 290 in
1987, 433 in 1988, and 145 in the first 3 months of 1989. The female male ratio
in adults were 1.4. There were 102 children under 5 with AIDS and the 5 children 
aged 5-15, who were all female. The presenting signs and symptoms were most often
persistent generalized lymphadenopathy, chest infection, herpes zoster, chronic
STDs, and chronic diarrhea with weight loss. There were 44 cases of HIV-positive 
pulmonary tuberculosis; 8 patients being treated for tuberculosis developed
Stevens-Johnson syndrome. Of patients, overall, with herpes zoster, 89% were
HIV-positive, of those with oral thrush, 83% were HIV-positive, of those with
generalized lymphadenopathy, 76% were HIV-positive, and of those with weight loss
and chronic diarrhea, 70% were HIV-positive. The Hurungwe District lies along the
road from harare to Lusaka, Zambia, where long-distant truck drivers frequently
interact with the locally mobile population. The authors suggest that herpes
zoster, with its ease of diagnosis, be used as a tool to follow the spread of
HIV.

PMID: 1394393 [PubMed - indexed for MEDLINE]

5458: Br J Ophthalmol. 1992 Apr;76(4):244-5.

Ophthalmic zoster.

Marsh RJ.

Publication Types: 
    Review

PMID: 1390496 [PubMed - indexed for MEDLINE]

5459: Baillieres Clin Neurol. 1992 Apr;1(1):103-54.

Central nervous system opportunistic infections in HIV disease: clinical aspects.

Guiloff RJ, Tan SV.

Westminster Hospital, London, UK.

Nervous system opportunistic infections are seen in about one fifth of AIDS cases
and account for over 40% of the patients with neurological manifestations.
Serious infections are seen in severely immunosuppressed patients, usually with
CD4 counts of 200 ml-1 or less. The commonest is CMV, which can produce acute
encephalitis, sometimes with focal hemisphere or brain-stem signs, dementia,
retinitis, optic neuritis and an ascending radiculomyeloencephalitis.
Cryptococcal meningitis is the most frequent fungal disease; a high degree of
clinical suspicion is required in patients with fever, malaise, headache or
seizures. Only CSF cultures are always positive; both serum and CSF cryptococcal 
antigen tests are highly sensitive and specific. Treatment with amphotericin B
and flucytosine is successful in at least 70% of first episodes but side-effects 
are common. Without maintenance therapy 50% of patients relapse; fluconazole is
recommended. Cerebral toxoplasmosis can present with focal cerebral or spinal
cord signs but also as a diffuse encephalopathy; negative T. gondii serology is
exceptional but positive serum titres are usually unhelpful. Treatment with
sulfadiazine, pyrimethamine and folinic acid achieves good results in 90% of the 
first episodes, but side-effects are common. Appearances on CT scan or MRI may
take several weeks to improve. The value of an empirical approach to treatment is
well-established; an initial cerebral biopsy is difficult to justify. Without
maintenance therapy a relapse rate of 50% can be expected; therapy with
sulfadiazine and pyrimethamine may also prevent pneumocystosis. HIV disease
appears to increase the likelihood of neurosyphilis, and the risk of relapse
after conventional penicillin doses, in patients with syphilis; at least 3-4
weeks of appropriate therapy are recommended. A number of other diseases caused
by viruses, fungi, bacteria and parasites are less common; these include
progressive multifocal leukoencephalopathy, herpes simplex and zoster infections 
and tuberculosis.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 1344647 [PubMed - indexed for MEDLINE]

5460: J Gen Virol. 1992 Apr;73 ( Pt 4):811-9.

Immunity in strain 2 guinea-pigs inoculated with vaccinia virus recombinants
expressing varicella-zoster virus glycoproteins I, IV, V or the protein product
of the immediate early gene 62.

Lowry PW, Solem S, Watson BN, Koropchak CM, Thackray HM, Kinchington PR, Ruyechan
WT, Ling P, Hay J, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California
94305.

The immunogenicity of specific varicella-zoster virus (VZV) proteins, with
emphasis upon cell-mediated immune responses, was evaluated by immunizing strain 
2 guinea-pigs with vaccinia virus recombinants that express gpI (vac-gpI), gpIV
(vac-gpIV) and gpV (vac-gpV) or the IE-62 protein (vac-IE-62). Vac-gpI elicited
the highest initial mean T cell proliferation response [stimulation index (S.I.) 
3.8 +/- 0.9 S.E.M.] whereas inoculation with vac-gpV produced the lowest primary 
T cell response (S.I. 2.5 +/- 1.1 S.E.M.). T cell proliferation was detected for 
a shorter period after immunization with vac-gpV compared to vac-gpI, vac-gpIV or
vac-IE-62. A comparison of the immunogenicity of vac-gpI and vac-IE-62 with the
same proteins prepared by immunoaffinity purification showed that immunization
with these proteins in either form elicited virus-specific IgG antibodies and T
cell recognition. The presence or absence of IgG antibodies to the IE-62 protein 
was used to assess protection against challenge with guinea-pig cell-adapted
infectious VZV in animals that had been inoculated with vac-gpI, vac-gpIV or
vac-gpV. Immunization with vac-gpI and vac-gpIV restricted VZV replication but
all animals given vac-gpV developed antibodies to IE-62 after challenge with
infectious VZV. Priming of the T lymphocyte response was observed in all animals 
immunized with VZV-vaccinia virus recombinants after subsequent exposure to
infectious VZV. These experiments with VZV vac-gpI, vac-gpIV and vac-gpV in
guinea-pigs suggest variability in the capacity of herpesviral glycoproteins to
elicit cell-mediated immunity in vivo. Induction of virus-specific immunity using
IE-62 means that this major tegument protein of VZV could be a useful component
for vaccine development.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1321876 [PubMed - indexed for MEDLINE]

5461: Brain. 1992 Apr;115 ( Pt 2):383-98.

Presence, distribution and spread of productive varicella zoster virus infection 
in nervous tissues.

Schmidbauer M, Budka H, Pilz P, Kurata T, Hondo R.

Neurological Institute, University of Vienna, Austria.

Nervous tissue lesions were retrospectively studied for detection of productive
varicella zoster virus (VZV) infection in 33 autopsied cases, including 19 herpes
zoster (HZ) (10 trigeminal, nine spinal) and 14 cases of nodular brainstem
encephalitis without HZ. Immunocytochemistry for VZV antigens and in situ
hybridization with a biotinylated VZV DNA probe were used on formol-fixed
paraffin sections. Peripheral and central nervous system, skin and striated
muscle were investigated in serial sections; available tissue blocks, however,
varied between cases. Varicella zoster virus production (both antigen and DNA) in
nervous tissue was found in HZ cases but only of short survival after a rash of
up to 7 wks (eight out of 12 patients). Varicella zoster virus was visualized in 
nerve cells, glial cells, Schwann cells and blood vessels. In the central nervous
system (CNS), VZV was detected in trigeminal nuclei (one out of 10 brains) or
disseminated nodular brainstem lesions (one out of 10 brains), in subependymal
microvessels (one out of 10 brains) or vasculitic arteries (two out of 19 brains 
or spinal cords). In the peripheral nervous system (PNS), VZV (DNA and antigen)
was found in neurons and satellite cells of sensory ganglia (four out of seven
cases with sampling of ganglia), and in damaged nerve fibres including a muscle
nerve in one case; myositis with VZV in affected muscle fibres was found in the
latter case. In nodular brainstem encephalitis, one case contained VZV within
nodular lesions. We conclude that (i) VZV neural spread is suggested by
detectable virus in ganglia, nerve fibres and CNS target nuclei; (ii)
haematogenous spread of VZV is suggested by detection of virus in CNS
microvessels and in disseminated brainstem encephalitis; (iii) VZV myositis may
occur in zosteric myotomes; and (iv) VZV is a possible agent in nodular brainstem
encephalitis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 1318768 [PubMed - indexed for MEDLINE]

5462: Rinsho Ketsueki. 1992 Apr;33(4):483-7.

[Disseminated varicella-zoster virus infection without vesicles in a patient with
malignant lymphoma]

[Article in Japanese]

Matsui T, Maruyama F, Miyazaki H, Nomura T, Ezaki K, Hirano M, Mizoguchi Y.

Department of Medicine, Fujita Health University School of Medicine.

A 76-year-old man was diagnosed as having malignant lymphoma (non-Hodgkin's
lymphoma, diffuse medium cell-sized, B cell type). He was treated with CHOP
therapy but with no response. In the terminal stage, he had continuous high
temperature despite the administration of anti-bacterial and anti-fungal agents. 
Paralytic ileus, liver and pancreas dysfunction, and gastrointestinal bleeding
developed. No skin eruptions occurred throughout the clinical course. He died on 
day 36 of treatment. Postmortem examination revealed foci of hemorrhagic necrosis
containing many multinuclear giant-cells some of which with intranuclear
inclusion bodies (Cowdry type A), in the liver, pancreas, gastrointestinal tract,
bone marrow and other organs. Electron microscopy showed viral particles in the
cytoplasm but not the nuclei of infected cells which were covered with a capsule,
which was characteristic of varicella-zoster virus infection. Cells of the above 
organs were positive for immunohistochemical staining using antivaricella-zoster 
antibodies. The multiorgan failure seen in the terminal stage was considered to
be due to disseminated varicella-zoster infection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1318430 [PubMed - indexed for MEDLINE]

5463: Ann Neurol. 1992 Apr;31(4):444-8.

Localization of herpes simplex virus and varicella zoster virus DNA in human
ganglia.

Mahalingam R, Wellish MC, Dueland AN, Cohrs RJ, Gilden DH.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262.

Human dorsal root ganglia from 14 randomly autopsied adults and 1 infant (all
seropositive for both herpes simplex virus [HSV] and varicella zoster virus
[VZV]) were examined for latent HSV-1 and VZV DNA by polymerase chain reaction.
Thoracic ganglionic DNA from all subjects and trigeminal ganglionic DNA from 11
adults were analyzed. HSV-1 DNA was detected in trigeminal ganglia from 8 of 11
(73%) adults and in thoracic ganglia from 2 of 14 (14%) adults. VZV DNA was
detected in trigeminal ganglia from 10 of 11 (91%) adults and in thoracic ganglia
from 12 of 14 (86%) adults. None of the DNA samples were positive with primers
specific for HSV-2. These findings indicate the presence of latent HSV-1 and VZV 
DNA in trigeminal ganglia and latent VZV DNA in thoracic ganglia of most
seropositive adults. Furthermore, although HSV-1 latency most commonly develops
in trigeminal ganglia, we also show for the first time the presence of HSV-1
latency in thoracic ganglia. Finally, both viruses can become latent in the same 
trigeminal ganglion.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1316733 [PubMed - indexed for MEDLINE]

5464: Med Clin (Barc). 1992 Mar 28;98(12):476-7.

[Diaphragmatic paralysis and respiratory insufficiency due to cervical herpes
zoster]

[Article in Spanish]

Gonzalez-Moreno M, Llibre JM, Roset J, Gutierrez U.

Publication Types: 
    Case Reports
    Letter

PMID: 1573919 [PubMed - indexed for MEDLINE]

5465: Proc Natl Acad Sci U S A. 1992 Mar 15;89(6):2076-80.

Differentiation of multiple domains in the herpes simplex virus 1 protease
encoded by the UL26 gene.

Liu F, Roizman B.

Marjorie B. Kovler Viral Oncology Laboratories, University of Chicago, IL 60637.

Previous studies have shown that the herpes simplex virus 1 gene UL26 encodes a
635-amino acid protease that cleaves approximately 20 amino acids from the
carboxyl terminus of itself and of a 329-amino acid product of the UL26.5 gene.
The results of studies with a variety of protease inhibitors showed that the UL26
protease was inhibited by serine protease inhibitors but not by inhibitors of
cysteine protease, aspartic acid protease, or metalloprotease. Mutations
resulting in amino acid substitutions, deletions, or insertion of stop codons in 
the gene or of 20-amino acid stretches into the protease have delineated the
dispensable domains I and IV at the amino and carboxyl domains of the gene
product. The essential carboxyl-proximal domain (III) can be separated from the
essential amino-proximal domain (II) by at least 20 amino acids. The
amino-proximal domain is the most conserved region among varicella-zoster virus
and human cytomegalovirus homologues of UL26. Of the conserved aspartic acid,
histidine, or serine amino acids in this domain, only histidine-61 and -148 could
not be replaced without impairment of the proteolytic activity.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1312713 [PubMed - indexed for MEDLINE]

5466: Am J Ophthalmol. 1992 Mar 15;113(3):248-56.

Herpesvirus antibody levels in the etiologic diagnosis of the acute retinal
necrosis syndrome.

Pepose JS, Flowers B, Stewart JA, Grose C, Levy DS, Culbertson WW, Kreiger AE.

Department of Ophthalmology, Washington University School of Medicine, St. Louis,
Missouri 63110.

Quantitative antibody levels to three herpesviruses in acute and chronic sera
from six patients with clinical signs of the acute retinal necrosis syndrome were
consistent with a specific etiologic diagnosis only in the two cases associated
with cutaneous herpes zoster. Available data on acute and convalescent antibody
titers to herpes group viruses from these six patients in addition to data from
27 acute retinal necrosis cases from the literature disclosed that only 13 of the
33 patients (39%) had a diagnostic increase or decrease in herpes group viral
antibody levels on serial sampling. Three patients had nondiagnostic changes in
viral antibody levels despite positive vitreous cultures for herpesviruses. In
contrast, a review of 25 cases from the literature with paired antiviral serum
and intraocular fluid antibody levels suggested a more promising approach to the 
etiologic diagnosis of the acute retinal necrosis syndrome. By calculating the
ratio of antiviral antibodies in intraocular fluid and serum, an etiologic
diagnosis could be made in 12 of 14 (86%) of subacute and convalescent samples.
The sensitivity of this method decreased to 72% (13 of 18) when fluids were
obtained earlier in the course of the disease.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1311902 [PubMed - indexed for MEDLINE]

5467: J Infect Dis. 1992 Mar;165(3):450-5.

Disseminated herpes zoster in the immunocompromised host: a comparative trial of 
acyclovir and vidarabine. The NIAID Collaborative Antiviral Study Group.

Whitley RJ, Gnann JW Jr, Hinthorn D, Liu C, Pollard RB, Hayden F, Mertz GJ, Oxman
M, Soong SJ.

Department of Pediatrics, University of Alabama, Birmingham.

Seventy-three immunocompromised patients with disseminated herpes zoster were
evaluated in a double-blind controlled trial of acyclovir (n = 37) versus
vidarabine (n = 36) therapy. Acyclovir was administered at 30 mg/kg/day at 8-h
intervals and vidarabine was given as a continuous 12-h infusion at 10 mg/kg/day 
for 7 days (longer if resolution of cutaneous or visceral disease was
incomplete). No demographic differences existed between treatment groups. No
deaths attributable to varicella-zoster virus infection occurred within 1 month
of treatment. Neither rates of cutaneous healing, resolution of acute neuritis,
and frequency of postherpetic neuralgia nor adverse clinical and laboratory
events differed between treatment groups. Acyclovir recipients were discharged
from the hospital more promptly than vidarabine recipients (P = .04, log rank
test). These data indicate that disseminated herpes zoster is amenable to therapy
with either acyclovir or vidarabine; resultant mortality is low.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1538151 [PubMed - indexed for MEDLINE]

5468: JAMA. 1992 Mar 11;267(10):1354-8.

Infections complicating mycosis fungoides and Sezary syndrome.

Axelrod PI, Lorber B, Vonderheid EC.

Department of Medicine, Temple University School of Medicine, Philadelphia, PA.

OBJECTIVE--To determine, in patients with mycosis fungoides and Sezary syndrome, 
the incidence of infections, the importance of nosocomial infections, and the
epidemiologic factors associated with cutaneous and visceral infections. DESIGN
AND SETTING--Retrospective inception cohort study at a university medical center 
referral clinic. PATIENTS--Three hundred fifty-six patients with mycosis
fungoides or Sezary syndrome. MAIN OUTCOME MEASURES--Incidence rates for specific
infections, and multivariate risk ratios for demographic and clinical factors
associated with infection. RESULTS--Cutaneous bacterial infection was most common
(17.0 infections per 100 patient-years), followed by cutaneous herpes simplex
virus and herpes zoster virus infection (3.8 infections per 100 patient-years),
bacteremia (2.1 infections per 100 patient-years), bacterial pneumonia (1.7
infections per 100 patient-years), and urinary tract infection (1.4 infections
per 100 patient-years). Twenty-seven percent of herpesvirus infections
disseminated on the skin but none disseminated to internal organs. Pneumonia or
bacteremia was present in 88% of patients who died of infection. Only three
patients had invasive fungal or protozoal infection. Nosocomial infections
accounted for 19% of cutaneous bacterial infections, 59% of bacteremias, 62% of
pneumonias, and 88% of infections leading to death. By logistic and Cox
regression, the presence of extracutaneous involvement with lymphoma was the most
important independent risk factor for recurrent bacterial skin infection (risk
ratio [RR], 12; 95% confidence interval [CI], 1.2 to 120), disseminated
herpesvirus infection (RR, 28; 95% CI, 2.7 to 290), bloodstream infection (RR,
5.5; 95% CI, 1.7 to 18), and death from infection (RR, 15; 95% CI, 3.6 to 64).
CONCLUSIONS--Community-acquired bacterial skin infections are a common cause of
morbidity in patients with mycosis fungoides and Sezary syndrome but are usually 
treated without hospital admission. Bacteremia and pneumonia, which are usually
nosocomial, are the major infectious causes of death. Advanced disease stage,
independent of corticosteroids and other therapies, is the most important risk
factor for both cutaneous and systemic infections.

PMID: 1740857 [PubMed - indexed for MEDLINE]

5469: Med Clin (Barc). 1992 Mar 7;98(9):339-41.

[Acute pancreatitis associated with varicella-zoster virus infection in a patient
with acquired immunodeficiency syndrome]

[Article in Spanish]

Fernandez de la Puebla Gimenez RA, Lechuga Varona T, Kindelan Jaquotot JM, Jurado
Jimenez R, Delgado Blanco M, de Non-Louis y Persson E.

Unidad de Enfermedades Infecciosas, Hospital Regional Universitario Reina, Sofia,
Cordoba.

A patient with the acquired immunodeficiency syndrome (AIDS) who developed acute 
pancreatitis (AP) during the course of a disseminated herpes zoster is presented.
Diagnosis was based on the simultaneity of abdominal pain with hyperamylasemia,
the dissemination of the cutaneous lesions and the positive varicella-zoster
virus serology at titres 1/640. Response to acyclovir treatment was spectacular. 
To our knowledge this is the second case of AP produced by the varicella-zoster
virus and the first described in the course of disseminated herpes zoster. We
believe that the varicella-zoster virus should be included within the causes of
AP in patients with the human immunodeficiency virus.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 1583963 [PubMed - indexed for MEDLINE]

5470: J Assoc Physicians India. 1992 Mar;40(3):201-3.

Herpes zoster associated encephalitis.

Raju D, Mathew T, Kathirvel H, Vijayalekshmy N, Abhayambika K.

Department of Medicine, Medical College Trivandrum.

Herpes zoster associated encephalitis is a very rare complication of herpes
zoster. We are reporting a young healthy man who developed this complication
along with the usual cutaneous presentation of herpes zoster. He was successfully
treated with acyclovir.

Publication Types: 
    Case Reports

PMID: 1634491 [PubMed - indexed for MEDLINE]

5471: Rinsho Shinkeigaku. 1992 Mar;32(3):314-6.

[A case of herpes zoster associated with multiple cranial nerve involvement]

[Article in Japanese]

Kobayashi Y, Riku S, Ieda T, Aoki S.

Department of Neurology, Shakaihoken Chukyo Hospital.

A 74-year-old man who had suffered from right herpes zoster ophthalmicus
developed ipsilateral multiple cranial nerve involvement two weeks later. He
showed right visual disturbance, total ophthalmoplegia and peripheral facial
palsy. Pleocytosis and increased protein were found in CSF. Titer of VZV antibody
increased in serum and CSF. CT and MRI demonstrated no abnormal findings in the
brain stem. Within a month, peripheral facial palsy improved. Severe
extra-ophthalmoplegia began to improve after three months, and moderately
recovered. After two and a half year, visual disturbance and mydriasis showed no 
improvement. In this case, we speculate that localized leptomeningitis caused
multiple cranial nerve involvement.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1628455 [PubMed - indexed for MEDLINE]

5472: Acta Otorrinolaringol Esp. 1992 Mar-Apr;43(2):117-20.

[The incorporation of acyclovir into the treatment of peripheral paralysis. A
study of 45 cases]

[Article in Spanish]

Ramos Macias A, de Miguel Martinez I, Martin Sanchez AM, Gomez Gonzalez JL,
Martin Galan A.

Servicio de ORL, Hospital Clinico Universitario de Salamanca.

The relation between use of acyclovir and facial nerve palsy prognosis was
studied. In a randomised study, steroids or steroids + acyclovir (oral doses for 
Bell's palsy, and intravenous doses for Ramsay Hunt's syndrome) were given to 45 
patients with facial palsy. There was a significant reduction of sequelae in
patients treated with acyclovir in the group of Ramsay Hunt's syndrome (n = 15)
(p less than 0.05). There were no significant differences in the group of Bell's 
palsy (n = 30) (p greater than 0.05), treated with acyclovir compared with
steroids.

Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 1605959 [PubMed - indexed for MEDLINE]

5473: J Tradit Chin Med. 1992 Mar;12(1):71.

34 cases of herpes zoster treated by moxibustion at dazhui (du 14).

Li H.

Section of Acupuncture, Zhaotong District Hospital, Yunnan Province.

Publication Types: 
    Case Reports

PMID: 1598005 [PubMed - indexed for MEDLINE]

5474: Pain. 1992 Mar;48(3):383-90.

Erratum in:
    Pain 1992 Aug;50(2):245.

A new topical treatment for acute herpetic neuralgia and post-herpetic neuralgia:
the aspirin/diethyl ether mixture. An open-label study plus a double-blind
controlled clinical trial.

De Benedittis G, Besana F, Lorenzetti A.

Pain Research and Treatment Unit, University of Milan, Italy.

Topical aspirin/diethyl ether (ADE) mixture was used to treat 45 consecutive
patients with acute herpetic neuralgia (AHN) (n = 28) and with post-herpetic
neuralgia (PHN) (n = 17) in an open-label study. Good-to-excellent results were
achieved by 93% of AHN patients and by 65% of PHN patients. Earlier treatment
yielded better results for the AHN but not the PHN group. The topical treatment
seemed to accelerate the healing of acute herpetic skin lesions and possibly
modulate the severity of the herpetic infection. Furthermore, a striking
reduction in the percentage of AHN patients developing PHN was observed in the
treated group, as compared with the disease natural history reported in the
literature (4 vs. 50-70%). Treatment tolerance was excellent with no adverse
effect observed. In addition to the open trial, a pilot double-blind crossover
placebo-controlled study (n = 11) compared the analgesic efficacy of ADE with two
other NSAID (indomethacin and diclofenac) drug/ether mixtures. Aspirin (but not
indomethacin and diclofenac) was significantly superior to placebo as regards
pain relief (P less than 0.05).

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 1594261 [PubMed - indexed for MEDLINE]

5475: Reg Anesth. 1992 Mar-Apr;17(2):107-9.

Intrapulmonary placement of a pleural catheter.

Lefever EB, Rosenthal RM, Ramamurthy S.

Audie Murphy Veterans Administration Hospital, San Antonio, Texas.

OBJECTIVE AND CONCLUSION. A case of intrapulmonary placement of a pleural
catheter is described that was likely due to the presence of focal pleural
thickening at the site of catheter insertion.

Publication Types: 
    Case Reports

PMID: 1581248 [PubMed - indexed for MEDLINE]

5476: J Clin Epidemiol. 1992 Mar;45(3):245-53.

Using serial observations to identify predictors of progression to AIDS in the
Toronto Sexual Contact Study.

Coates RA, Farewell VT, Raboud J, Read SE, Klein M, MacFadden DK, Calzavara LM,
Johnson JK, Fanning MM, Shepherd FA.

Department of Preventive Medicine and Biostatistics, Faculty of Medicine,
University of Toronto, Ontario, Canada.

The Toronto Sexual Contact Study comprises a cohort of 249 male sexual contacts
of men with HIV disease which has been followed every 3 months for almost 5
years. On enrollment 143 were seropositive and 16 seroconverted during the
follow-up period. By 31 December 1989, 41 of the 159 seropositive cohort members 
had developed AIDS. Using Cox relative risk regression models, we investigated
the association of a number of laboratory and clinical variables and progression 
to AIDS. Fixed covariate models examined laboratory variables from the enrollment
visit of cohort members, with time calculated from this date. In models assessing
time dependent covariates, time was calculated from the estimated date of HIV
infection. In the univariate models of either fixed or time dependent covariates,
many variables were significantly associated with risk of progression to AIDS (T4
cell count, T4/T8 ratio, blastogenic responses to phytohemagglutinin,
concanavalin A, and pokeweed mitogen, serum IgA, appearance of p24 antigen, and
the development of oral hairy leukoplakia, thrush, or herpes zoster). Appearance 
of persistent generalized lymphadenopathy was not associated with increased risk 
of progression. In the multivariate model which evaluated fixed laboratory
covariates, T4/T8 ratio, IgA level, and PHA response at enrollment were
significantly associated with elevated risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1569421 [PubMed - indexed for MEDLINE]

5477: An Med Interna. 1992 Mar;9(3):155-6.

Comment in:
    An Med Interna. 1992 Dec;9(12):624-5.

[Neurological complications caused by varicella zoster in geriatric patients]

[Article in Spanish]

Castrillo Viguera C, Ramos Rincon JM, Lopez de Andres M, Sanchez Portocarrero J.

Publication Types: 
    Case Reports
    Letter

PMID: 1567957 [PubMed - indexed for MEDLINE]

5478: J Reprod Med. 1992 Mar;37(3):280-2.

Early-second-trimester use of acyclovir in treating herpes zoster in a bone
marrow transplant patient. A case report.

Horowitz GM, Hankins GD.

Department of Obstetrics and Gynecology, Wilford Hall United States Air Force
Medical Center, Lackland Air Force Base, Texas 78236-5300.

Bone marrow transplantation from a human leukocyte antigen (HLA)-identical
sibling for treatment of severe aplastic anemia among women of reproductive age
is becoming more common. Successful pregnancy has been reported to occur in
several such patients. A woman delivered a healthy, term, female infant 18 months
after a transplant from her HLA-identical sister. Her pregnancy was complicated
by disseminated herpes zoster, treated with intravenous acyclovir at 14 weeks'
gestation, before the diagnosis of pregnancy. While there have been several case 
reports involving the use of acyclovir in the third trimester, primarily in the
treatment of varicella infections, there have been no previous reports of such an
early utilization of this antiviral drug.

Publication Types: 
    Case Reports

PMID: 1564715 [PubMed - indexed for MEDLINE]

5479: J Pharmacol Exp Ther. 1992 Mar;260(3):974-8.

Increased urinary morphine, codeine and tetrahydropapaveroline in parkinsonian
patient undergoing L-3,4-dihydroxyphenylalanine therapy: a possible biosynthetic 
pathway of morphine from L-3,4-dihydroxyphenylalanine in humans.

Matsubara K, Fukushima S, Akane A, Kobayashi S, Shiono H.

Department of Legal Medicine, Shimane Medical University, Izumo, Japan.

We have identified morphine and codeine in human urine by means of gas
chromatography/mass spectrometry. Gas chromatography/mass spectrometry was also
used to quantitate the two alkaloids and tetrahydropapaveroline (THP) in urine of
both normal subjects and parkinsonian subjects receiving L-dopa therapy. The
morphine, codeine and THP levels in healthy nondrinker controls were 2.93 +/-
0.23, 2.01 +/- 0.53 and 6.70 +/- 1.13 pmol/ml (mean +/- S.E.M.), respectively. In
contrast, the urinary levels of codeine and THP in L-dopa-treated parkinsonian
patients were significantly elevated to 62.20 +/- 17.54 and 31.04 +/- 15.69
pmol/ml, respectively. Some of the parkinsonian patients showed high urinary
morphine levels. Morphine excretion was also enhanced in patients complaining of 
severe pain due to herpes zoster (24.60 +/- 9.51 pmol/ml) but not in patients
with severe pain due to cerebral embolus. These alkaloid levels in the urine of
abstinent alcoholics were very low. There were significant correlations among
these three alkaloid levels in the urine. The results indicate that morphine and 
codeine are synthesized in the body from L-dopa and/or dopamine, via the
THP-related pathway.

PMID: 1545408 [PubMed - indexed for MEDLINE]

5480: J Clin Neuroophthalmol. 1992 Mar;12(1):37-40.

Herpes zoster ophthalmicus. Anterior ischemic optic neuropathy and acyclovir.

Borruat FX, Herbort CP.

Hopital Ophthalmique Jules Gonin, University Eye Clinic of Lausanne, Switzerland.

A healthy 56-year-old man developed left-sided herpes zoster ophthalmicus,
accompanied initially by ipsilateral anterior uveitis and increased intraocular
pressure. Although he was treated in the subacute phase (5 days after skin
eruption) with adequate oral doses of acyclovir for 10 days, the condition was
later complicated by a left sectorial anterior ischemic optic neuropathy. The
pathogenesis of this rare complication is discussed in this article.

Publication Types: 
    Case Reports

PMID: 1532599 [PubMed - indexed for MEDLINE]

5481: Bone Marrow Transplant. 1992 Mar;9(3):217.

Comment on:
    Bone Marrow Transplant. 1991 Jun;7(6):489-91.

Abdominal presentation of varicella zoster infection after bone marrow
transplantation.

Perez-Oteyza J, Pascual C, Garcia-Larana J, Odriozola J, Rocamora A, Navarro JL.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 1511259 [PubMed - indexed for MEDLINE]

5482: J Gen Virol. 1992 Mar;73 ( Pt 3):521-30.

Characterization of the varicella-zoster virus gene 61 protein.

Stevenson D, Colman KL, Davison AJ.

MRC Virology Unit, University of Glasgow, U.K.

The protein predicted to be encoded by varicella-zoster virus (VZV) gene 61
exhibits limited amino acid sequence similarity to the herpes simplex virus type 
1 nuclear phosphoprotein Vmw110, which functions as a transcriptional activator. 
The gene 61 protein was expressed in its entirety, or as an amino- or
carboxy-terminal fragment in Escherichia coli and vaccinia virus recombinants,
and monospecific rabbit antisera were raised against an E. coli fusion between
beta-galactosidase and the majority of the gene 61 protein. Use of the antisera
showed that the gene 61 protein is present in VZV-infected cell nuclei as a
heterogeneous phospho-protein of Mr62K to 65K. Phosphorylation occurs in the
amino- and, to a lesser extent, carboxy-terminal portions of the protein. The
carboxy-terminal region directs transport of the protein to the nucleus, whereas 
the amino-terminal region, which contains a potential zinc-binding domain, is
responsible for a punctate distribution. Preliminary mapping data indicated that 
gene 61 is transcribed as a 1.8 kb mRNA which initiates about 65 bp upstream from
the translation initiation codon, at a position located appropriately with
respect to potential regulatory elements.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 1312115 [PubMed - indexed for MEDLINE]

5483: Med Clin (Barc). 1992 Feb 22;98(7):245-9.

[A topical solution of 40% idoxuridine in dimethyl sulfoxide compared to oral
acyclovir in the treatment of herpes zoster. A double-blind multicenter clinical 
trial]

[Article in Spanish]

Aliaga A, Armijo M, Camacho F, Castro A, Cruces M, Diaz JL, Fernandez JM,
Iglesias L, Ledo A, Mascaro JM, et al.

Hospital General Universitario, Valencia.

BACKGROUND: Both topical 40% idoxuridine in dimethylsulfoxide (IDU) and oral
acyclovir (ACV) are useful in herpes zoster (HZ). This is the first clinical
trial which compares the efficacy of both drugs in the course of the disease and 
in the prevention of post-herpetic neuralgia (PHN). METHODS: Patients of both
sexes older than 18 years, with a HZ of less than 4 days were selected. Patients 
with otic or ophthalmic zoster, serious concomitant illness or pregnant or
breast-feeding women were excluded. Following a double dummy design, the patients
received at random topical IDU and oral placebo, or oral ACV and topical placebo.
Topical treatment was applied during 4 days and oral treatment during 7 days. The
evolution of the disease (number of individual lesions, evolution of symptoms,
use of analgesic drugs and eventual appearance of complications) was controlled
on days 0, 2, 4, 6, 8, and weekly until its resolution. RESULTS: The group of
patients treated with IDU (85) showed a better evolution of the disease than
those treated with ACV (86) in some of the parameters controlled: day of first
and all vesicles drying (p less than 0.05), last day of moderate-intense pain (p 
less than 0.05), hyperaesthesia (p less than 0.05) and itching (p less than 0.05)
and last day of analgesic use (p less than 0.01). The appearance of new vesicles 
during treatment was lower in the IDU treated group (p less than 0.01). A
tendency favouring IDU can be observed in the appearance of PHN. CONCLUSIONS: In 
our study topical 40% idoxuridine in DMSO was better than oral acyclovir in 7 of 
the 14 clinical parameters studied.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract
    Multicenter Study
    Randomized Controlled Trial

PMID: 1560699 [PubMed - indexed for MEDLINE]

5484: Ann Intern Med. 1992 Feb 15;116(4):320-8.

Predictors of mortality among HIV-infected women in Kigali, Rwanda.

Lindan CP, Allen S, Serufilira A, Lifson AR, Van de Perre P, Chen-Rundle A,
Batungwanayo J, Nsengumuremyi F, Bogaerts J, Hulley S.

Center for AIDS Prevention Studies, University of California at San Francisco.

OBJECTIVE: To better characterize the natural history of disease due to human
immunodeficiency virus (HIV) infection in African women. DESIGN: Prospective
cohort study over a 2-year follow-up period. PARTICIPANTS: A total of 460
HIV-seropositive women and a comparison cohort of HIV-seronegative women
recruited from prenatal and pediatric clinics in Kigali, Rwanda in 1988.
MEASUREMENTS: Clinical signs and symptoms of HIV disease, AIDS, and mortality.
MAIN RESULTS: Follow-up data at 2 years were available for 93% of women who were 
still alive. At enrollment, many seropositive women reported symptoms listed in
the World Health Organization (WHO) clinical case definition of AIDS, but these
were nonspecific and often improved over time. The 2-year mortality among
HIV-infected women by Kaplan-Meier survival analysis was 7% (95% CI, 5% to 10%)
overall, and 21% (CI, 8% to 34%) for the 40 women who fulfilled the WHO case
definition of AIDS at entry. In comparison, the 2-year mortality in women not
infected with HIV was only 0.3% (CI, 0% to 7%). Independent baseline predictors
of mortality in seropositive women by Cox proportional hazards modeling were, in 
order of descending risk factor prevalence: a body mass index of 21 kg/m2 or less
(relative hazard, 2.3; CI, 1.1 to 4.8), low income (relative hazard, 2.3; CI, 1.1
to 4.5), an erythrocyte sedimentation rate exceeding 60 mm/h (relative hazard,
4.9; CI, 2.2 to 10.9), chronic diarrhea (relative hazard, 2.6; CI, 1.1 to 5.7), a
history of herpes zoster (relative hazard 5.3; CI, 2.5 to 11.4), and oral candida
(relative hazard, 7.3; CI, 1.6 to 33.3). Human immunodeficiency virus disease was
the cause of death in 38 of the 39 HIV-positive women who died, but only 25 met
the WHO definition of AIDS before death. CONCLUSIONS: Human immunodeficiency
virus disease now accounts for 90% of all deaths among child-bearing urban
Rwandan women. Many symptomatic seropositive patients may show some clinical
improvement and should not be denied routine medical care. Easily diagnosed signs
and symptoms and inexpensive laboratory tests can be used in Africa to identify
those patients with a particularly good or bad prognosis.

PIP: In 1988, researchers recruited 18-35 year old women from pediatric and
prenatal care clinics at the Centre Hospitalier de Kigali in Rwanda to observe
HIV disease progression. They compared probability of survival of the 460
HIV-positive women with that of the 998 HIV-negative women. They used simple
clinical and laboratory variables as predictors of mortality from AIDS. The
researchers did not use the WHO clinical case definition of AIDS as the outcome
measure since 40 and 30 women from each group, respectively, met the criteria for
AIDS at entry. Only 66% (25) of the HIV=infected women who died met the criteria 
for AIDS during the study. After 2 years, mortality among HIV-infected women
stood at 7% (39) which was more than 20 times higher than that among women not
HIV infected (0.3%; p .001). Mortality was 21% for those who met the WHO criteria
for AIDS. The wasting syndrome was the cause of the death in 51% of HIV-infected 
death cases. The baseline predictors of mortality in HIV-infected women in
descending order of prevalence of predictor included an at most body mass index
of 21 kg.sq. (48%; relative hazard [RH] 2.3), low income (46%; RH=2.6), mm/hour
erythrocyte sedimentation rate (39%; rh = 4.9), chronic diarrhea (10%; RH = 2.6),
a history of herpes zoster (9%; RH 5.3), and oral candidiasis (1%; RH 7.3). The
erythrocyte sedimentation rate was a better predictor than lymphocyte counts (p
.001) and p .11, respectively). Of the 40 HIV-infected women who met the criteria
for AIDS, the health of 32 women improved so the physicians no longer considered 
them to have AIDS. Thus health workers should treat symptomatic HIV-positive
cases. AIDS was responsible for 90% of all deaths among reproductive age women
living in Kigali. Health workers in Africa can use the simpler erythrocyte
sedimentation rate instead of the more costly CD4 counts as a predictor of
progression to AIDS.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1733389 [PubMed - indexed for MEDLINE]

5485: Am J Med. 1992 Feb 14;92(2A):1S-2S.

Clinical implications of herpesvirus infections in patients with AIDS.
Introduction.

Masur H.

National Institutes of Health, Bethesda, Maryland 20892.

PMID: 1310568 [PubMed - indexed for MEDLINE]

5486: Am J Dermatopathol. 1992 Feb;14(1):1-7.

Chronic verrucous varicella-zoster virus infection in patients with the acquired 
immunodeficiency syndrome (AIDS). Histologic and molecular biologic findings.

LeBoit PE, Limova M, Yen TS, Palefsky JM, White CR Jr, Berger TG.

Department of Pathology, School of Medicine, University of California, San
Francisco 94143-0506.

Verrucous skin lesions have been attributed to various herpes viruses in
immunosuppressed patients, including those with human immunodeficiency virus
infection (HIV). We examined such lesions from six HIV-infected patients to
determine the range of microscopic findings present and to establish which
herpesviruses were present. Verrucous epidermal hyperplasia, pseudocarcinomatous 
hyperplasia, and massive hyperkeratosis correlate with the warty clinical
appearance of the lesions. Herpetic cytopathic changes, including multinucleated 
epidermal giant cells, steel-gray nuclei, necrotic acantholytic keratinocytes,
and Cowdry type A nuclear inclusions were seen most prominently in the dells
between papillations and in adnexal epithelium. In two cases, increased numbers
of spindled cells were seen in the dermis. Immunoperoxidase staining with
anti-type IV collagen antibodies demonstrated that these findings were not those 
of Kaposi's sarcoma, but represent a fibrotic reaction to the infection. Viral
cultures of four of the cases demonstrated the presence of varicella-zoster
virus, whose presence was detected by the polymerase chain reaction in
paraffin-embedded lesional tissue from all six cases. Polymerase chain reaction
did not show the presence of cytomegalovirus, herpes simplex, Epstein-Barr, or
human papillomavirus. We conclude that these unusual verrucous lesions are a
chronic manifestation of herpes zoster infection and that the reported presence
of other agents in such lesions is probably coincidental.

PMID: 1324620 [PubMed - indexed for MEDLINE]

5487: Ugeskr Laeger. 1992 Feb 10;154(7):425-6.

[Herpes zoster complicated by myelitis]

[Article in Danish]

Christensen B.

Neurologisk Afdeling, Holstebro Centralsygehus.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1536056 [PubMed - indexed for MEDLINE]

5488: Harefuah. 1992 Feb 2;122(3):182-5.

[Postherpetic neuralgia--therapeutic approaches]

[Article in Hebrew]

Niv D, Wolman I, Geller E.

Publication Types: 
    Review

PMID: 1563673 [PubMed - indexed for MEDLINE]

5489: Hum Pathol. 1992 Feb;23(2):164-71.

Primary (granulomatous) angiitis of the central nervous system: a
clinicopathologic analysis of 15 new cases and a review of the literature.

Lie JT.

Division of Pathology, Mayo Clinic, Rochester, MN 55905.

The clinical and pathologic features of 15 new cases of the uncommon primary or
granulomatous angiitis of the central nervous system (PACNS) are described. To
date, only 108 such cases have been reported in the English literature.
Clinically, most PACNS patients have been young or middle-aged (mean age, 45
years; range, 3 to 96 years), with men outnumbering women slightly by a ratio of 
4 to 3. The most frequent presenting complaints are headache, weakness, and
confusion; less common complaints are aphasia, dysphasia, nausea or vomiting,
loss of memory, and seizure disorder. There is usually no evidence of a systemic 
disease; the erythrocyte sedimentation rate is almost invariably normal, and
there are no diagnostic laboratory tests. The cerebral angiogram usually shows
multifocal, segmental stenosis or irregularity of small and medium-sized
leptomeningeal and intracranial blood vessels, often with a beading or aneurysmal
appearance, and alterations in blood flow in the affected regions. Anatomically, 
the angiitis is focal and segmental in distribution. An isolated negative biopsy,
therefore, does not rule out the disease. Histologically, PACNS may be
granulomatous, necrotizing, or lymphocytic in character, and mixed morphologic
types often occur. Large- and small-vessel thrombosis is common. Acute lesions
frequently coexist with healing or healed lesions. Involvement of extracranial
blood vessels occurs only rarely. Past or current herpes zoster infection and
Hodgkin's lymphoma are the most noteworthy clinical associations of PACNS, but
whether they are causally related remains uncertain.

Publication Types: 
    Review

PMID: 1740300 [PubMed - indexed for MEDLINE]

5490: Ann Otol Rhinol Laryngol. 1992 Feb;101(2 Pt 1):161-2.

Herpes zoster oticus: treatment with acyclovir.

Uri N, Greenberg E, Meyer W, Kitzes-Cohen R.

Department of Otolaryngology, Lady Davis Carmel Hospital, Haifa, Israel.

Herpes zoster oticus produces facial paralysis with a low recovery rate.
Acyclovir, a specific virostatic drug, was given intravenously in five herpes
zoster oticus patients, and in three of them was followed by oral therapy. In
follow-ups of 1 to 24 months, one patient had grade I recovery, three patients
grade II, and one grade III. These good results encourage the use of acyclovir in
herpes zoster oticus patients.

PMID: 1739262 [PubMed - indexed for MEDLINE]

5491: Cancer. 1992 Feb 1;69(3):784-9.

Long-term sequelae of autologous bone marrow or peripheral stem cell
transplantation for lymphoid malignancies.

Vose JM, Kennedy BC, Bierman PJ, Kessinger A, Armitage JO.

University of Nebraska Medical Center, Department of Internal Medicine, Omaha
68198-3330.

The study was made to evaluate the long-term physical and psychosocial changes
after high-dose therapy and autologous bone marrow or peripheral stem
transplantation for recurrent lymphoid malignancies. Patients who had undergone
high dose therapy and autologous bone marrow or peripheral stem cell
transplantation for recurrent lymphoid malignancies at least 1 year previously
were contacted by phone interview regarding their status after the transplant.
The patients' comments were confirmed by checking medical records when possible. 
Fifty patients who had undergone transplantation at the University of Nebraska
Medical Center at least 1 year before the interview were available for interview 
and willing to answer questions. After transplant, many patients noticed
temporary changes in their appearance, which usually returned to normal within 1 
year. Few patients reported remarkable cardiovascular, gastrointestinal, or
pulmonary changes after transplantation. However, up to one-third of the patients
reported changes in sexual function or desire. The most common infectious problem
after transplant was Herpes zoster, which occurred in 25% of the patients.
Overall, the patients had a positive outlook after high-dose therapy and
transplantation, with most being able to return to work and enjoy a normal life
style. Ninety-six percent of the patients stated that they would be willing to
undergo high-dose therapy and transplantation again under the same circumstances.

PMID: 1730128 [PubMed - indexed for MEDLINE]

5492: J Dermatol. 1992 Feb;19(2):94-8.

Significance of monocytosis in varicella and herpes zoster.

Tsukahara T, Yaguchi A, Horiuchi Y.

Division of Dermatology, Kashima Rosai Hospital, Ibaraki, Japan.

Percent ratios and absolute numbers of peripheral blood monocytes in patients
with varicella and herpes zoster were determined and compared with those in
patients with herpes simplex virus infection, measles and rubella. Monocytosis
during the acute stage (p less than 0.01) was statistically significant in
varicella and generalized and localized herpes zoster, compared with the levels
in herpes simplex virus infection, measles and rubella. Absolute monocyte counts 
in varicella and HZ were significantly increased (p less than 0.02) beyond those 
of measles and rubella. The high % ratios of monocytes in varicella and herpes
zoster during the acute stage decreased to normal ranges with cure.

Publication Types: 
    Comparative Study

PMID: 1619111 [PubMed - indexed for MEDLINE]

5493: Ann Ophthalmol. 1992 Feb;24(2):50-3.

Optic neuropathy and central retinal artery occlusion in a patient with herpes
zoster ophthalmicus.

Atmaca LS, Ozmert E.

Department of Retinal Diseases, Ankara University, Turkey.

We present the case of a patient with herpes zoster ophthalmicus and optic
neuropathy followed by central retinal artery occlusion. In those with herpes
zoster ophthalmicus, in addition to the known usual complications, the
possibility of this rare complication also should be considered, and the patient 
should be followed closely for a prolonged time.

Publication Types: 
    Case Reports

PMID: 1562124 [PubMed - indexed for MEDLINE]

5494: N C Med J. 1992 Feb;53(2):71-3.

Prodrome of disseminated varicella zoster in an immunocompromised adult.

Beaty O 3rd, Engel J, Jones B, Raab M.

Department of Internal Medicine, East Carolina University School of Medicine,
Greenville 27858-4354.

Publication Types: 
    Case Reports

PMID: 1557136 [PubMed - indexed for MEDLINE]

5495: J Abnorm Psychol. 1992 Feb;101(1):200-5.

A high-risk method for studying psychosocial antecedents of chronic pain: the
prospective investigation of herpes zoster.

Dworkin RH, Hartstein G, Rosner HL, Walther RR, Sweeney EW, Brand L.

College of Physicians and Surgeons, Columbia University.

Although patients with chronic pain are often psychologically distressed, it has 
been difficult to determine whether this distress is an antecedent of chronic
pain or whether it is caused by the experience of living with chronic pain. The
aim of this investigation was to develop a method that would allow individuals
who are at risk for the development of chronic pain to be studied before their
pain has become chronic. Patients with acute herpes zoster were assessed with
demographic, medical, pain, and psychosocial measures. Pain was assessed in
follow-up interviews at 6 weeks and 3, 5, 8, and 12 months after these initial
assessments. There were no significant differences between patients who developed
short-term herpes zoster pain and patients who did not develop short-term pain
for any of the measures at the initial assessment, except for one measure of pain
intensity. Patients who developed chronic herpes zoster pain, however, had
significantly greater pain intensity, higher state and trait anxiety, greater
depression, lower life satisfaction, and greater disease conviction at the
initial assessment than patients who did not develop chronic pain. In
discriminant analyses, disease conviction, pain intensity, and state anxiety each
made a unique contribution to discriminating patients who did and who did not
develop chronic pain. This study demonstrates the feasibility of investigating
psychosocial antecedents of the development of chronic pain by prospectively
examining the longitudinal course of herpes zoster.

PMID: 1537967 [PubMed - indexed for MEDLINE]

5496: J Dermatol Surg Oncol. 1992 Feb;18(2):97-100.

Zosteriform and epidermotropic metastasis. Report of two cases.

Manteaux A, Cohen PR, Rapini RP.

Department of Dermatology, University of Texas Medical School, Houston 77030.

We report two cases of zosteriform metastasis to the skin. One patient had
epidermotropic papulovesicular metastases from a presumed cutaneous adnexal
neoplasm. The second patient had painful zoster-like papulovesicles from
metastatic breast cancer. Previously reported dermatomal or zosteriform
metastases are reviewed.

Publication Types: 
    Case Reports

PMID: 1537956 [PubMed - indexed for MEDLINE]

5497: Riv Eur Sci Med Farmacol. 1992 Feb;14(1):45-7.

["Chronic paroxysmal hemicrania" following ophthalmic herpes zoster]

[Article in Italian]

Giacovazzo M, Di Sabato F, Gallo MF, Granata M, Martelletti P.

Istituto di Clinica Medica VI, Universita La Sapienza, Roma.

The authors report the first observation of a 73-year-old woman affected from CPH
(Chronic Paroxysmal Hemicrania) which following an ophthalmic herpes-zoster
infection. The improvement with a 5-HT 1-like agonist receptors (Sumatriptan) and
with Timostimulin is discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1529145 [PubMed - indexed for MEDLINE]

5498: Cent Afr J Med. 1992 Feb;38(2):86-8.

Human immunodeficiency virus and Guillain 'Barre' syndrome in intensive care unit
patients.

Chinyanga HM, Danha RF.

Department of Anaesthetics, University of Zimbabwe Medical School, Avondale,
Harare.

Among 155 medical admissions to the intensive care unit during the period 1989 to
1990, 16 patients had Guillain-'Barre' Syndrome (GBS), five of whom were HIV
positive. Out of the five cases, three had manifested herpes zoster and one had
TB. The impact of HIV infection o GBS is discussed.

PMID: 1505017 [PubMed - indexed for MEDLINE]

5499: Tuber Lung Dis. 1992 Feb;73(1):45-51.

Cross-sectional survey of HIV infection among patients with tuberculosis in
Nairobi, Kenya.

Nunn P, Gicheha C, Hayes R, Gathua S, Brindle R, Kibuga D, Mutie T, Kamunyi R,
Omwega M, Were J, et al.

Kenya Medical Research Institute, Nairobi.

Evidence from many countries suggests an association of human immunodeficiency
virus (HIV) infection and tuberculosis of major public health significance. In
order to begin assessing the impact of HIV on tuberculosis in Kenya, we have
determined the HIV-1 seroprevalence among tuberculosis patients and compared the 
clinical characteristics of tuberculosis in HIV-positive and HIV-negative
patients in two cross-sectional studies at the Infectious Disease Hospital (IDH) 
and the Ngaira Avenue Chest Clinic (NACC), Nairobi, Kenya. The diagnosis in 92%
of all patients with pulmonary tuberculosis was confirmed by culture. The
remainder were diagnosed on histological, clinical or radiological grounds. HIV
seroprevalence among tuberculosis patients at IDH was 26.5% (52/196) compared to 
9.2% (18/195) at NACC (P less than 0.001). There was no association between
numbers of streptomycin injections in the previous 5 years and HIV infection.
Positive sputum smear rates in HIV-positive patients were slightly lower than in 
HIV-negative patients at both study sites (71% vs 83% at IDH and 73% vs 82% at
NACC) but the difference was not significant. Only Mycobacterium tuberculosis was
isolated. Miliary disease was not associated with HIV infection. Persistent
diarrhoea, oral candidiasis, generalized itchy rash, herpes zoster and
generalized lymphadenopathy were all associated with HIV infection, but 46% (95% 
CI:38-54%) of all HIV-positive patients had none of the clinical features listed 
in the WHO Clinical Criteria for the Diagnosis of AIDS, apart from fever, cough
and weight loss. Stevens-Johnson Syndrome was reported in 7/52 (13%) patients
with HIV infection, and in 4/144 (3%) patients without (RR 4.85, 95% CI:
1.45-15.88).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 1381970 [PubMed - indexed for MEDLINE]

5500: Bone Marrow Transplant. 1992 Feb;9(2):129-37.

Engraftment of leukocyte subsets following autologous bone marrow transplantation
in acute myeloid leukemia using anti-myeloid (CD14 and CD15) monoclonal
antibody-purged bone marrow.

Ericson SG, Colby E, Welch L, Ball ED.

Department of Medicine, Dartmouth Medical School, Hanover.

The cell surface phenotype of leukocyte subsets during reconstitution following
autologous bone marrow transplantation (ABMT) using bone marrow purged with
anti-myeloid monoclonal antibodies (MoAbs) and complement (C') was evaluated in
20 patients with acute myeloid leukemia (AML). Repopulation of B and T
lymphocytes, natural killer (NK) cells, and myeloid cells was assessed by
phenotypic analysis using two-color cytofluorography of peripheral blood
mononuclear cells (PBMNC) at several time points up to 2 years
post-transplantation. In spite of removal of the majority of monomyeloid cells of
the autograft by purging with anti-CD14 and anti-CD 15, engraftment occurred
rapidly. The myeloid cells appeared normal by surface phenotype. An early rise in
NK cells, characterized by expression of CD57 and CD 16, was seen. The CD4:CD8
ratio remained low throughout the study period, primarily due to a persistently
low CD4 level. ABMT using bone marrow purged with the anti-myeloid MoAbs PM-81
and AML-2-23 and C' resulted in prompt engraftment of neutrophils. Although there
was a prolonged time for recovery of lymphocyte subsets, this did not result in
an increased risk of early infectious complications. Late infectious
complications post-transplantation were limited to herpes zoster infection in one
patient 18 months post-transplantation, and bacterial meningitis in that same
patient 2 months later. This study demonstrates that ABMT in patients with AML
using bone marrow purged with the anti-myeloid MoAbs PM81 (anti-CD15) and
AML-2-23 (anti-CD14) and C' results in rapid hematologic engraftment and delayed 
phenotypic immunologic reconstitution without significant acute or chronic
clinical toxicities.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1373982 [PubMed - indexed for MEDLINE]

5501: J Virol. 1992 Feb;66(2):664-73.

ICP22 homolog of equine herpesvirus 1: expression from early and late promoters.

Holden VR, Yalamanchili RR, Harty RN, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932.

The complete nucleotide sequence of the short region, made up of a unique segment
(Us; 6.5 kb) bracketed by a pair of inverted repeat sequences (IR; 12.8 kb each),
of the equine herpesvirus 1 (EHV-1) genome has been determined recently in our
laboratory. Analysis of the IR segment revealed a major open reading frame (ORF) 
designated IR4. The IR4 ORF exhibits significant homology to the immediate-early 
gene US1 (ICP22) of herpes simplex virus type 1 and to the ICP22 homologs of
varicella-zoster virus (ORF63), pseudorabies virus (RSp40), and equine
herpesvirus 4 (ORF4). The IR4 ORF is located entirely within each of the inverted
repeat sequences (nucleotides [nt] 7918 to 9327) and has the potential to encode 
a polypeptide of 469 amino acids (49,890 Da). Within the IR4 ORF are two
reiterated sequences: a 7-nt sequence tandemly repeated 17 times and a 25-nt
sequence tandemly repeated 13 times. Nucleotide sequence analyses of IR4 also
revealed several potential cis-regulatory sequences, two TATA sequences separated
by 287 nt, an in-frame translation initiation codon following each TATA sequence,
and a single polyadenylation site. To address the nature of the mRNA species
encoded by IR4, we used Northern (RNA) blot and S1 nuclease analyses. RNA mapping
data revealed that IR4 has two promoters that are regulated differentially during
a lytic infection. A 1.4-kb mRNA appears initially at 2 h postinfection and is an
early transcript since its synthesis is not affected by the presence of
phosphonoacetic acid, an inhibitor of EHV-1 DNA replication. In contrast, a
1.7-kb mRNA appears at later times postinfection and is designated as a gamma-1
transcript, since its synthesis is significantly reduced by phosphonoacetic acid.
These IR4-specific mRNAs are 3' coterminal, have unique 5' termini, and would
code for in-frame, overlapping, carboxy-coterminal proteins of 293 and 469 amino 
acids, respectively. Interestingly, the site of homologous recombination to
generate the genome of EHV-1 defective interfering particles that initiate
persistent infection occurs between nt 3244 and 3251 of UL3 (ICP27 homolog) and
nt 9027 and 9034 of IR4 (ICP22 homolog). Thus, this recombination event would
generate a unique ORF that would encode a potential protein whose amino end was
derived from the N-terminal 193 amino acids of the ICP22 homolog and whose
carboxyl end was derived from the C-terminal 68 amino acids of the ICP27 homolog.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1370553 [PubMed - indexed for MEDLINE]

5502: J Hosp Infect. 1992 Feb;20(2):125-6.

Comment in:
    J Hosp Infect. 1993 Feb;23(2):161-2.

Transmission of chickenpox to two intensive care unit nurses from a liver
transplant patient with zoster.

Wreghitt TG, Whipp PJ, Bagnall J.

Publication Types: 
    Letter

PMID: 1348758 [PubMed - indexed for MEDLINE]

5503: Mayo Clin Proc. 1992 Feb;67(2):160-78.

Antiviral agents.

Keating MR.

Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester, MN
55905.

In recent years, the antiviral armamentarium has expanded considerably. Currently
available agents are virustatic, inhibiting specific steps in the process of
viral replication. No agent is active against nonreplicating or latent viruses.
Acyclovir is useful in the treatment of genital herpes, herpes simplex
encephalitis, mucocutaneous herpetic infection, varicella infection in the
immunosuppressed host, and herpes zoster infection in the normal and the
immunosuppressed host. It can also be used for prevention of herpesvirus
infection in immunocompromised patients. Ganciclovir is indicated for the
treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency
syndrome (AIDS) and is effective in the management of organ-specific
cytomegalovirus infection in other immunocompromised patients. Chronic hepatitis 
C and condyloma acuminatum due to human papillomavirus respond to therapy with
interferon alfa-2b. Patients with human immunodeficiency virus infection and CD4 
lymphocyte counts of less than 500 cells/mm3 should be treated with zidovudine.
Amantadine is useful in a therapeutic and prophylactic role in the management of 
influenza A virus infection. With the expanded use of and indications for
antiviral therapy, clinically significant resistance to these agents has been
encountered with increasing frequency.

Publication Types: 
    Congresses
    Review

PMID: 1347578 [PubMed - indexed for MEDLINE]

5504: Cesk Farm. 1992 Feb;41(1):1-4.

[Effectiveness of phosphonoformic acid in herpes infections]

[Article in Czech]

Smejkal F, Otova B, Zikan V, Roubinek F.

Vyzkumny ustav pro farmacii a biochemii, Praha.

The antiviral efficacy of phosphonoformic acid (PFA) was examined on tissue
cultures of the human embryonal lungs against the viruses herpes simplex type 1
and 2, herpes zoster, and the human cytomegalovirus using the method of the
inhibition of the cytopathic effect and against herpes simplex type 1 and 2 on
the tissue cultures of Vero cells using the methods of the inhibition of plaque
formation. PFA was demonstrated to inhibit the reproduction of the viruses under 
study in both tests on tissue cultures. In persistence studies, the
cytomegalovirus was not isolated back from the cells of the human embryonal
lungs, which gave evidence of its greater sensitivity to PFA. In in vivo
experiments, PFA in the form of a 3% ointment suppressed herpetic dermatitis on
the guinea-pig skin, when treatment started 6, 24 and 48 hours after infection.
In a preliminary experiment on rabbit corneas, an ointment with 3% PFA inhibited 
herpetic keratoconjunctivitis in time intervals of 1 and 3 hours after infection.

Publication Types: 
    English Abstract

PMID: 1316808 [PubMed - indexed for MEDLINE]

5505: J Neurol. 1992 Feb;239(2):69-70.

Detection of varicella-zoster virus DNA by polymerase chain reaction in
cerebrospinal fluid of patients with herpes zoster meningitis.

Shoji H, Honda Y, Murai I, Sato Y, Oizumi K, Hondo R.

First Department of Internal Medicine, Kurume University School of Medicine,
Japan.

In three of five patients with herpes zoster meningitis, varicella-zoster virus
(VZV) DNA was detected by the polymerase chain reaction (PCR) in the initial
samples of cerebrospinal fluid. DNA fragments of group A or B, following
classification of VZV strains by the size of the variable region IV of VZV
genome, were found at the 7th, 10th and 24th illness day in the three positive
cases: one of these cases did not have skin lesions. These results suggest that
the detection of VZV DNA by PCR is useful for the diagnosis of herpes zoster
meningitis, as well as for its molecular epidemiology.

PMID: 1313077 [PubMed - indexed for MEDLINE]

5506: Oral Surg Oral Med Oral Pathol. 1992 Feb;73(2):215-25.

Management of oral health in persons with HIV infection.

Scully C, McCarthy G.

University Department of Oral Medicine, Surgery and Pathology, Bristol Dental
Hospital and School, England.

Prevention and treatment of oral disease is required to maintain quality of life 
and to improve prognosis of patients infected with the human immunodeficiency
virus (HIV). Management requires a team approach, and close collaboration with
the appropriate responsible physicians and other health care workers is
necessary. Oral infection is frequent and usually opportunistic, and management
is based on certain principles. Infections may disseminate and can be persistent 
and severe; multiple concurrent or consecutive infections with different
microorganisms are frequent; fungal, viral, and parasitic infections are rarely
curable; and long-term antimicrobial therapy may be required. This article
reviews the management of oral candidiasis, hairy leukoplakia, and infections
with herpes simplex virus, varicella-zoster virus, and cytomegalovirus. The
management of Kaposi's sarcoma, lymphomas, aphthous ulceration, gangrenous
stomatitis, bleeding, xerostomia, and adverse drug reactions is also described.
Treatment should avoid further immunosuppression and inducement of xerostomia or 
caries, and should be designed to avoid adverse drug reactions and possible drug 
interactions.

Publication Types: 
    Review

PMID: 1312692 [PubMed - indexed for MEDLINE]

5507: Oral Surg Oral Med Oral Pathol. 1992 Feb;73(2):155-63.

Viral infections of the head and neck among HIV-seropositive patients.

Eversole LR.

Section of Oral Diagnosis, Oral Medicine and Oral Pathology, School of Dentistry,
UCLA Health Sciences Center 90024.

Many viruses cause opportunistic infections in HIV-positive patients. Those that 
cause oral lesions include herpes simplex, varicella zoster, Epstein-Barr virus, 
cytomegalovirus, and papillomavirus. Importantly, many of the herpes-group
viruses are able to augment immunosuppression and some actually transactivate HIV
replication-inducing genetic sequences. This article reviews the role of viral
agents in the activation of HIV replication and details the features of the
reported oral lesions that represent viral opportunistic infections.

Publication Types: 
    Review

PMID: 1312690 [PubMed - indexed for MEDLINE]

5508: Epidemiol Infect. 1992 Feb;108(1):165-74.

Antibody-capture enzyme-linked immunosorbent assays that use enzyme-labelled
antigen for detection of virus-specific immunoglobulin M, A and G in patients
with varicella or herpes zoster.

van Loon AM, van der Logt JT, Heessen FW, Heeren MC, Zoll J.

Department of Medical Microbiology, University of Nijmegen, The Netherlands.

Antibody-capture enzyme-linked immunosorbent assays (AC-ELISA) which use
enzyme-labelled antigen were developed for detection of varicella-zoster
virus-(VZV) specific IgM, IgA and IgG antibody in patients with varicella or
herpes zoster and in sera from healthy individuals. All 18 patients with
varicella developed a VZV-IgM and a VZV-IgG response, 17 also a VZV-IgA response.
In contrast, all 19 patients with herpes zoster were shown to be positive for
VZV-IgA whereas only 13 of these reacted positively for VZV-IgM. A VZV-IgM
response was detected in only two sera from 100 healthy individuals and an IgA
response in only one. The presence of virus-specific IgA and IgG in the
cerebrospinal fluid as determined by AC-ELISA was a useful indicator of VZV
infection of the central nervous system. By AC-ELISA, VZV-IgG was detected
predominantly in sera from patients with acute or recent VZV infection. Only 14
sera from 100 healthy individuals were positive for VZV-IgG by AC-ELISA, whereas 
all were positive by an indirect ELISA. These results indicate that AC-ELISA's
may be useful assays for determination for acute or recurrent VZV infection, but 
are not suitable for determination of past infection with this virus.

PMID: 1312479 [PubMed - indexed for MEDLINE]

5509: Pediatrics. 1992 Feb;89(2):353-4.

Comment on:
    Pediatrics. 1991 May;87(5):604-10.

Varicella vaccine reflux.

Mangano MF.

Publication Types: 
    Comment
    Letter

PMID: 1310355 [PubMed - indexed for MEDLINE]

5510: J Med Chem. 1992 Jan 24;35(2):346-50.

Structure-function studies of peptides inhibiting the ribonucleotide reductase
activity of herpes simplex virus type I.

Gaudreau P, Brazeau P, Richer M, Cormier J, Langlois D, Langelier Y.

Neuroendocrinology Laboratory, Notre-Dame Hospital Research Center, Montreal,
Canada.

Ac-Tyr298-Ala299-Gly300-Thr301-Val302-I le303-Asn304-Asp305-Leu306-OH (Ac-VZV
R2-(298-306)) represents the acetylated form of the C-terminus of
varicella-zoster virus (VZV) ribonucleotide reductase subunit 2 (R2). This
peptide possesses a high degree of homology with the C-terminus nonapeptide of
the herpes simplex virus (HSV) type I and II ribonucleotide reductase R2 protein 
and is 15 times more potent than the latter in its in vitro inhibition of HSV-1
reductase activity. Accordingly, a new series of analogues based on this
structure was studied in vitro. The replacement of Asp305 by Asn, Glu, Gln, Ser, 
or Cys; of Asn304 by Gln or Ser; of Ile303 and Val302 by D-Val; and of Tyr298 by 
Cha induced an important loss of inhibitory potency. The substitution of Asn304
by Asp; of Thr301 by Cys, Ser, or Val; of Gly300 by Ala or Val; of Ala299 by Val;
or of Tyr298 by homoPhe, 4'-fluoro-Phe, 4'-chloro-Phe, 3'-iodo-Tyr, Me-Tyr, or
For-Trp led to a moderate decrease of the Ac-VZV R2-(298-306) potency. The
replacement of Val302 by Ile; Ala299 by Cys, Ser, or Thr; or the insertion of a
six- or eight-carbon chain between Tyr298 and the NH2 terminus either preserved
or slightly increased the inhibitory potency of Ac-VZV R2-(298-306). Finally, the
substitution of Tyr298 by Trp or the addition of 4'-nitro-Phe at the amino
terminus resulted in a 3-fold increase of potency. Altogether, these results
stress the importance of the structural integrity of the minimum active core
302-306 in preserving the inhibitory potency and suggest that further studies on 
monosubstitutions could be directed at the portion 298-301 of the peptide.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1310120 [PubMed - indexed for MEDLINE]

5511: Presse Med. 1992 Jan 4-11;21(1):27-30.

[CD8 hyperlymphocytosis in HIV infection. 63 cases. GECSA (Groupe d'Epidemiologie
Clinique du SIDA en Aquitaine)]

[Article in French]

Constans J, Ladner J, Dabis F, Brossard G, Commenges D, Leng B, Conri C.

Service de Medecine interne, Hopital Saint-Andre, CHRU de Bordeaux.

A group of 63 patients infected by HIV and presenting with CD8 hyperlymphocytosis
(CD8+) has been studied. CD8 hyperlymphocytosis was defined by the presence,
during at least three months, of at least 1,500 CD8 circulating lymphocytes. The 
CD8+ patients (n = 63) were identified and followed within the cohort (1,444
patients) of the "Groupe d'Epidemiologie Clinique du SIDA en Aquitaine " (GECSA).
CD8+ patients were compared with a control group of 126 HIV infected patients
without CD8 hyperlymphocytosis recruited within the GECSA cohort and followed in 
the same manner during two years. The occurrence of opportunistic infections was 
less frequent in CD8+ patients. The proportion of patients with a CD4 lymphocyte 
count below 200/mm3 was lower in the CD8+ group than in the CD8- group at
inclusion and at the last check-up (P less than 0.01). A tendency for longer
survival and delayed onset of AIDS was noted in CD8+ patients. Such a difference 
in prognosis might be due to a peculiar cytotoxic response against HIV among CD8+
patients. Further follow-up of a larger group of patients is needed to confirm
this hypothesis.

Publication Types: 
    Comparative Study
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 1531260 [PubMed - indexed for MEDLINE]

5512: Pain. 1992 Jan;48(1):29-36.

Amitriptyline versus maprotiline in postherpetic neuralgia: a randomized,
double-blind, crossover trial.

Watson CP, Chipman M, Reed K, Evans RJ, Birkett N.

Irene Eleanor Smythe Pain Clinic, University of Toronto, Ont., Canada.

Amitriptyline (AT) relieves some patients with postherpetic neuralgia (PHN). Many
patients suffer side effects and better therapies are necessary. The aim of this 
study was to evaluate the efficacy of maprotiline (MT) (noradrenergic) compared
to AT (mixed noradrenergic and serotonergic) in this disorder. Thirty-five
patients entered a randomized, double-blind, crossover trial of these two agents.
We found that MT relieved PHN in many patients but was not as effective as AT.
Side effects were troublesome with both agents. Relief of steady pain, brief pain
and pain on tactile stimulation occurred. Four groups of responses were
identified. Some patients reported relief with both agents, some with neither
agent and others with only one of the drugs. Most patients were not depressed and
analgesia was observed to occur without change in depression ratings in most
patients who responded. This result provides evidence that in some patients AT
may act via a selective noradrenergic mechanism in relieving PHN and that
individuals may differ in the balance and type of neurotransmitters inhibiting
pain. Selective noradrenergic agents may be effective if AT fails.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 1738571 [PubMed - indexed for MEDLINE]

5513: Int J Dermatol. 1992 Jan;31(1):55-7.

Comment in:
    Int J Dermatol. 1992 Sep;31(9):672.

Granuloma annulare and disseminated herpes zoster.

Zanolli MD, Powell BL, McCalmont T, White WL, Jorizzo JL.

Department of Dermatology, Wake Forest University, Bowman Gray School of
Medicine, Winston-Salem, North Carolina 27103.

A 71-year-old man was admitted to the Wake Forest University/Baptist Hospital
Medical Center on February 1, 1989, with pharyngitis and a cutaneous eruption
that began that day. The past history was significant for a diagnosis of chronic 
lymphocytic leukemia (CLL) made in 1984, and for longstanding hypertension,
severe coronary artery disease, and prostatic hypertrophy. The patient had
required no therapy for his CLL until August, 1988, when he developed hemolytic
anemia and was treated with oral chlorambucil, 4 mg/day, and a tapering course of
prednisone. By December, 1988, the prednisone therapy had been discontinued, but 
the patient required hospital admission for pneumococcal pneumonia, which
responded well to intravenous antibiotic therapy. One day prior to the current
admission the patient complained of persistent fevers, sore throat, productive
cough, and headache. He noted a new cutaneous eruption on the day of admission in
February, 1989. The past history was positive for occasional herpes stomatitis.
The patient did not know if he had previously been infected with varicella. Skin 
examination revealed multiple (greater than 20), single, and grouped vesicles in 
a generalized distribution involving the bilateral trunk, head, neck, arms, and
legs. The heaviest involvement was on the right posterior auricular area and on
the neck. A Tzanck preparation obtained from an early lesion was positive for
multinucleated giant cells. Viral culture was negative at 24 hours and at 1 week.
A skin biopsy of an early vesicular lesion was performed and revealed
intraepidermal vesicles with acantholysis and giant cells.(ABSTRACT TRUNCATED AT 
250 WORDS)

Publication Types: 
    Case Reports

PMID: 1737692 [PubMed - indexed for MEDLINE]

5514: Cutis. 1992 Jan;49(1):27-31.

Chronic varicella zoster in a child infected with human immunodeficiency virus:
case report and review of the literature.

Leibovitz E, Kaul A, Rigaud M, Bebenroth D, Krasinski K, Borkowsky W.

Department of Pediatrics, New York University Medical Center, Bellevue Hospital, 
New York.

Chronic zoster represents an infrequent presentation of varicella zoster virus
infection. It is observed with increased frequency in patients infected with
human immunodeficiency virus, especially when their lymphocyte counts are
depressed. We report a child infected with human immunodeficiency virus who
showed a long-standing cutaneous zoster lesion and was treated for a prolonged
period of time with acyclovir. The occurrence of resistance to acyclovir by
varicella zoster virus was suspected based on the clinical picture. The clinical 
and laboratory features of this case and a review of the literature are
presented.

Publication Types: 
    Case Reports
    Review

PMID: 1733656 [PubMed - indexed for MEDLINE]

5515: J Assoc Physicians India. 1992 Jan;40(1):45-6.

Herpes zoster oticus associated with facial, auditory and trigeminal involvement.

Garg RK, Agrawal A, Nag D, Jha S.

Department of Neurology, KG'S Medical College, Lucknow.

We report a case of herpes zoster oticus with involvement of the mandibular
division of the trigeminal nerve and loss of taste sensation in the anterior two 
third of the tongue. Infranuclear facial palsy and sensorineural deafness were
also present.

Publication Types: 
    Case Reports

PMID: 1634465 [PubMed - indexed for MEDLINE]

5516: Respiration. 1992;59(2):94-6.

Herpes zoster in patients with sarcoidosis.

Miyagawa Y, Miyazaki M, Inutsuka S, Hayashi S, Yagawa K, Ikeda T.

Research Institute for Diseases of the Chest, Faculty of Medicine, Kyushu
University, Fukuoka, Japan.

108 patients with sarcoidosis were retrospectively studied for the development of
herpes zoster. Five of these patients (4.6%), 2 of whom were in their twenties,
developed herpes zoster. Only 1 patient had been treated with an oral steroid.
All 5 had extrathoracic lesions. Zoster tended to occur during the inactive stage
of sarcoidosis and did not exacerbate the activity of the sarcoidosis. The
clinical course of their zoster infection was typically benign. There have been
few reports of herpes zoster in patients with sarcoidosis. Further studies are
required to determine whether sarcoidosis predisposes to herpes zoster infection.

PMID: 1620988 [PubMed - indexed for MEDLINE]

5517: Clin Infect Dis. 1992 Jan;14(1):46-8.

Chronic maxillary sinusitis associated with the mushroom Schizophyllum commune in
a patient with AIDS.

Rosenthal J, Katz R, DuBois DB, Morrissey A, Machicao A.

Division of Infectious Diseases, Case Western Reserve University, Cleveland,
Ohio.

Invasive infection with fungi of the Basidiomycota (rusts, smuts, toadstools,
mushrooms, and puffballs) is extremely rare. We report such an infection in a
patient with human immunodeficiency virus disease who presented with chronic
maxillary sinusitis associated with the mushroom Schizophyllum commune. The
organism was isolated from the surgical drainage material, and septate hyphae
were seen invading the maxillary submucosa. The limited literature on this
subject is reviewed.

Publication Types: 
    Case Reports

PMID: 1571461 [PubMed - indexed for MEDLINE]

5518: Cornea. 1992 Jan;11(1):44-6.

The use of conjunctival flaps in the treatment of herpes keratouveitis.

Brown DD, McCulley JP, Bowman RW, Halsted MA.

Department of Ophthalmology, University of Texas Southwestern Medical Center,
Dallas.

Conjunctival flaps have been used in the treatment of corneal diseases since the 
1800s, although in recent years their use has decreased. In selected cases,
however, the placement of a conjunctival flap still may be the treatment of
choice. We report our experience with the use of conjunctival flaps in patients
with herpes keratouveitis who had persistent corneal epithelial defects.
Preoperatively, all patients had chronic or recurrent epithelial defects and
intraocular inflammation with or without recurrent live viral infection requiring
frequent medicine application and office visits. Postoperatively, all patients
had an intact, healthy ocular surface and a noninflamed eye requiring few to no
medications and infrequent office visits. No patient has had recurrent live viral
activity.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1559346 [PubMed - indexed for MEDLINE]

5519: Ophthal Plast Reconstr Surg. 1992;8(1):50-5.

Argon laser treatment for trichiasis.

Huneke JW.

Medical Eye Services, Ada, OK 74820.

The goal of trichiasis treatment is to eliminate misdirected cilia that irritate 
the eyeball. Established methods for removal of the eyelashes include epilation, 
electrolysis, and cryotherapy. Cryotherapy is currently the most effective method
in widespread use, but has as potential posttreatment complications "visual loss,
lid notching, corneal ulcer, acceleration of symblepharon formation, xerosis,
cellulitis, activation of herpes zoster, skin depigmentation, and severe soft
tissue reaction." (Wood JR, Anderson RL. Complications of cryosurgery. Arch
Ophthalmol 1981;99:460-3.) The use of an argon laser allows more precise
placement and control of the treatment, with better overall results. We reviewed 
the clinical course of 77 patients with a diagnosis of trichiasis, and 1 with
distichiasis. We have found treatment of trichiasis with an argon laser with the 
patient under local anesthesia to be an effective office procedure.

PMID: 1554654 [PubMed - indexed for MEDLINE]

5520: Minerva Pediatr. 1992 Jan-Feb;44(1-2):55-6.

[Visceral leishmaniasis complicated by herpes zoster. An unusual case in the
pediatric age]

[Article in Italian]

Di Martino L, Nocerino A, Pettoello M, Toscano P, Franzese A, Di Maio S.

Dipartimento di Pediatria, Universita Federico II di Napoli.

The Authors describe a case report of a girl of 7 years affected by visceral
leishmaniasis (VL) complicated by herpes zoster (Hz). Hz infection is unusual in 
paediatric age, but it may complicate immunodeficiency states. VL causes, as well
known, T cell immunity depression: Hz infection could be facilitated by this
situation.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1552880 [PubMed - indexed for MEDLINE]

5521: J R Soc Med. 1992 Jan;85(1):60.

Comment on:
    J R Soc Med. 1991 Jan;84(1):1-2.

Myocarditis--a controversial disease.

Appleby M, Kon P, Davidson C.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 1548669 [PubMed - indexed for MEDLINE]

5522: Masui. 1992 Jan;41(1):106-10.

[Thoracic and lumbar sympathetic ganglion block for post herpetic neuralgia]

[Article in Japanese]

Kageshima K, Wakasugi B, Shiotani M, Ooseto K, Yuda Y, Karasawa H, Ohno K.

Department of Anesthesiology, Jikei University School of Medicine, Tokyo.

Of 2,667 patients with herpes zoster who visited our hospital between January
1972 and March 1989, 136 patients whose treatments were started after more than 6
months following the onset were subjects of the present study. Thus we performed 
a retrospective study of the therapeutic effects of sympathetic ganglion block
(using alcohol) on postherpetic neuralgia left untreated for more than 6 months
after the onset. After more than 1 year following the onset, the disease was
nearly or completely cured in 9 of 37 patients (24%) treated with sympathetic
ganglion block with alcohol and in 6 of 34 (17.6%) without the treatment. Thus
the patients who underwent sympathetic ganglion block with alcohol tended to show
better results. The above findings suggest that, in patients with postherpetic
neuralgia in whom the initiation of treatment was delayed, treatment mainly
consisting of thoracic or lumbar sympathetic ganglion block using alcohol in
combination with antidepressants and antianxiety drugs can greatly improve
patients' activities of daily life and that, at present, this method is most
effective in relieving postherpetic neuralgia.

Publication Types: 
    English Abstract

PMID: 1545488 [PubMed - indexed for MEDLINE]

5523: Nippon Jibiinkoka Gakkai Kaiho. 1992 Jan;95(1):65-70.

[Conservative treatment of Hunt syndrome]

[Article in Japanese]

Kinishi M, Hosomi H, Amatsu M, Tani M, Koike K.

Department of Otolaryngology, Kobe University School of Medicine.

Based on the pathophysiology of Bell's palsy that edema as well as ischemia lead 
to both compression and hypoxia, Stennert employed high doses of cortisone and
dextran and reported a high recovery rate. In the past 5 years, we have been
treating patients with Bell's palsy and Hunt syndrome with a high dose of
steroids or low-molecular dextran (SD therapy). SD therapy was administrated in
71 cases of Hunt syndrome, and the results were compared with those of a group of
36 patients who had been treated with orally administrated low-dose steroids. All
patients with incomplete palsies recovered completely, regardless of the mode of 
treatment. In cases of complete palsy, 62% of patients recovered completely when 
treated with SD therapy. In contrast, 29% of the patients treated with orally
administrated steroids recovered completely. These results indicate that for
patients with complete palsy SD therapy is more effective than oral steroid
therapy, while patients with incomplete palsy recover completely with oral
steroids. On the basis of this study, oral steroids are best used in cases of
incomplete palsy unless complete palsy develops. In these latter cases, we now
believe that SD therapy should be started immediately.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 1545312 [PubMed - indexed for MEDLINE]

5524: J Nurse Midwifery. 1992 Jan-Feb;37(1):17-24.

Management of varicella-zoster virus infection during pregnancy and the
peripartum.

Russell LK.

Midwifery Service, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire.

This paper reviews the important concepts about varicella-zoster virus (VZV)
infection, varicella (chickenpox), and herpes zoster (shingles, zoster) during
pregnancy and the peripartum period. The majority of the U.S. population has had 
chickenpox during childhood, leaving only about 10% of adults over the age of 15 
susceptible to the virus. However, nonimmune adults, including pregnant women,
are at greater risk for complications and mortality when they contract varicella.
The virus is also teratogenic. The implication of VZV infection during pregnancy 
and the perinatal period are presented. Risks such as varicella pneumonia and
congenital defects can be serious even though the incidence during pregnancy is
low, one to five per 10,000 pregnancies. Management and treatment plans are
presented. Counseling and education aimed at prevention or modification of the
infection in the mother and baby is outlined.

Publication Types: 
    Review

PMID: 1538264 [PubMed - indexed for MEDLINE]

5525: Eur Neurol. 1992;32(5):264-6.

Segmental myoclonus preceding herpes zoster radiculitis.

Koppel BS, Daras M.

Department of Neurology, New York Medical College, Valhalla.

Segmental myoclonus arising in the spinal cord occurs with several viral
infections, including herpes zoster radiculitis. Usually, abnormal movements
follow the rash and require drug treatment to suppress. We report a patient with 
AIDS in whom arm and shoulder myoclonus preceded herpes zoster involving the same
segments contralaterally on two occasions. Myoclonus remitted promptly with
antiviral treatment. Unlike in other immunosuppressed patients, encephalitis did 
not occur after the second episode.

Publication Types: 
    Case Reports

PMID: 1521547 [PubMed - indexed for MEDLINE]

5526: Scand J Immunol Suppl. 1992;11:67-8.

Herpes zoster ophthalmicus: an early pointer to HIV-1 positivity in young African
patients.

Palexas GN, Welsh NH.

Department of Ophthalmology, University of the Witwatersrand, Johannesburg, South
Africa.

We studied prospectively 30 patients, seen over 10 months, who had herpes zoster 
ophthalmicus (HZO) and who were classified by age, sex, ophthalmological
observations and HIV-1 status. Of patients who presented with HZO, 40% were HIV
positive, and the majority were less than 40 years of age. The clinical
manifestation of HZO has a high positive predictive value for HIV positivity in
young patients with this viral infection.

PMID: 1514054 [PubMed - indexed for MEDLINE]

5527: Dermatology. 1992;184(4):314-6.

Systemic corticosteroids do not prevent postherpetic neuralgia.

Calza AM, Schmied E, Harms M.

Clinique de Dermatologie, Hopital Cantonal Universitaire, Geneve, Suisse.

We review the use of corticosteroids in preventing postherpetic neuralgia (PHN)
in a retrospective study over 5 years and 10 months. Out of 113 patients
evaluable, 46 (40%) had PHN. 21 of these 46 patients (38%) had received
prednisone (p = 0.49; n.s.). Duration and intensity of PHN were not different in 
the prednisone-treated group. This long-term study does not support the use of
prednisone for preventing PHN.

PMID: 1498407 [PubMed - indexed for MEDLINE]

5528: Trop Doct. 1992;22 Suppl 1:35-41;60.

Cutaneous findings associated with HIV disease including AIDS: experience from
Sub Saharan Africa.

Pallangyo KJ.

Department of Medicine, Faculty of Medicine, Muhimbili Medical Centre, Dar es
Salaam, Tanzania.

Cutaneous manifestations are common in patients with HIV infection and tend to be
more frequent as immunodeficiency progresses. In the initial stage of HIV
infection a transient maculopapular-rash may appear. During the otherwise
asymptomatic phase that follows, patients may develop seborrhoeic dermatitis,
persistent genital ulcer disease, pruritic papular eruption and/or a variety of
scaling dermatoses. The most frequent skin tumour associated with HIV disease is 
Kaposi's sarcoma. Skin manifestations of adverse reactions to a variety of drugs 
occur more frequently in patients with HIV disease than in immunocompetent
patients. In general most skin diseases that occur in association with HIV
disease respond well to standard treatment regimens. However relapses, and/or
recurrences are frequent in this group of patients.

PIP: Cutaneous manifestations are common in patients infected with HIV and tend
to be more frequent as immunodeficiency progresses. It remains, however, unclear 
which or how many with HIV-1 infection will develop skin disease. This paper
presents and describes the commonly reported skin diseases occurring in people
with HIV-1 infection. Observed infections include herpes zoster, herpes simplex, 
chancroid, syphilis, condylomata acuminata, oral hairy leukoplakia, molluscum
contagiosum, candidiasis, bacterial infections, dermatophytosis, and scabies.
Noninfective conditions such as pruritic papular eruption, seborrhoeic
dermatitis, psoriasis, and others may also present. Regarding disease etiology, a
transient maculopapular rash may present in the initial stage of HIV infection.
Seborrhoeic dermatitis, persistent genital ulcer disease, pruritic papular
eruption, and/or a variety of scaling dermatoses may then be observed during the 
otherwise asymptomatic phase. Kaposi's sarcoma is the most frequent skin tumor
associated with HIV disease. It is also observed that skin manifestations of
adverse reactions to drugs occur more frequently in patients with HIV disease
than in immunocompetent patients. In closing, most skin diseases associated with 
HIV disease respond well to standard treatment regimens. Relapses and/or
recurrences are, however, frequent among these patients.

Publication Types: 
    Review

PMID: 1492376 [PubMed - indexed for MEDLINE]

5529: Acta Oncol. 1992;31(6):681-3.

Simultaneous disseminated herpes zoster and bacterial infection in cancer
patients.

Maiche AG, Kajanti MJ, Pyrhonen S.

Department of Radiotherapy and Oncology, Helsinki University Central Hospital,
Finland.

PMID: 1466899 [PubMed - indexed for MEDLINE]

5530: Nephron. 1992;62(3):280-3.

Comment in:
    Nephron. 1994;66(3):362-3.

Neurotoxicity associated with oral acyclovir in patients undergoing dialysis.

MacDiarmaid-Gordon AR, O'Connor M, Beaman M, Ackrill P.

Department of Nephrology, University Hospital of South Manchester, UK.

Neurotoxicity associated with intravenous acyclovir therapy is well documented.
We report 4 cases of acyclovir-induced neurotoxicity in dialysis patients
receiving oral therapy at a reduced dose.

Publication Types: 
    Case Reports

PMID: 1436338 [PubMed - indexed for MEDLINE]

5531: J Urol (Paris). 1992;98(2):105-7.

[Complete urinary retention secondary to lumbosacral zona]

[Article in French]

Punga A, Zemrag J, Galas JM, Hubert J, Six A, Guillemin P.

Service d'Urologie, CHRU Nancy, Vandoeuvre-les-Nancy.

A case of complete urinary retention related to a HZV neurogenic bladder is
reported. Different findings of the disease are discussed, e.g., urodynamics and 
physiopathology.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1431183 [PubMed - indexed for MEDLINE]

5532: Clin Neurol Neurosurg. 1992;94(3):253-5.

Iatrogenic acute spinal epidural abscess with septic meningitis: MR findings.

Shintani S, Tanaka H, Irifune A, Mitoh Y, Udono H, Kaneda A, Shiigai T.

Department of Neurology, Toride Kyodo General Hospital, Ibaraki, Japan.

A contaminated catheter used in epidural anesthesia in a 71-year-old female
produced acute epidural abscess and septic meningitis. Methicillin-resistant
Staphylococcus aureus (MRSA) was detected in a culture of the epidural pus. Both 
T1- and T2-weighted MR images showed low intensity mass lesion compressing the
thecal sac behind the vertebral body L3. The low intensity lesion was probably
pus with gas component. In these low intensity lesions in MR findings with gas
component, MR was superior to myelography because it visualized both the degree
of compression to the thecal sac and extension of the lesion in all directions.

Publication Types: 
    Case Reports

PMID: 1382912 [PubMed - indexed for MEDLINE]

5533: Br J Ophthalmol. 1992 Jan;76(1):43-4.

Dual appearance of fluorescein staining in vivo of diseased human corneal
epithelium. A non-contact photomicrographic study.

Tabery HM.

University of Lund, Department of Ophthalmology, Malmo, Sweden.

Adherence of fluorescein sodium dye to diseased epithelial cells, a hitherto
unreported phenomenon, was captured in photomicrographs in severe herpes zoster
and keratoconjunctivitis sicca keratopathies. It is notable that this phenomenon 
differs completely from the well known fluorescent property of the dye
penetrating into defective corneal epithelium, and that the staining pattern
shown by adherent fluorescein correlates well with the staining pattern shown by 
rose bengal dye.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1371224 [PubMed - indexed for MEDLINE]

5534: Duodecim. 1992;108(19):1689-92.

[Sore throat and vertigo in herpes zoster oticus]

[Article in Finnish]

Kuttila S, Suonpaa J.

TYKS:n korva-, nena-ja kurkkutautien klinikka, Turku.

Publication Types: 
    Case Reports

PMID: 1366197 [PubMed - indexed for MEDLINE]

5535: Rev Cubana Med Trop. 1992;44(1):47-9.

[Infections and other opportunistic processes in a group of Cuban stage-IV HIV
patients]

[Article in Spanish]

Menendez Capote R, Millan Marcelo JC.

Instituto de Medicina Tropical Pedro Kouri.

Forty Cuban patients affected by the human immunodeficiency virus (HIV),
belonging to Group IV, assisted during a year at the Pedro Kouri Tropical
Medicine Institute, are reported. Pneumocystis carinii, cryptosporidiosis,
mucocutaneous herpes simplex, oral candidiasis and multidermatoma herpes zoster
were the most commonly found infections. Other non-opportunistic diseases such as
dermatitis seborrhoeica and onychomycosis were also present.

Publication Types: 
    English Abstract

PMID: 1344688 [PubMed - indexed for MEDLINE]

5536: Zhen Ci Yan Jiu. 1992;17(4):257-9.

[Recent progress in the treatment of zoster by moxibustion]

[Article in Chinese]

Hui K.

Publication Types: 
    Review

PMID: 1340421 [PubMed - indexed for MEDLINE]

5537: Immunol Res. 1992;11(3-4):226-38.

Herpesviral Fc receptors and their relationship to the human Fc receptors.

Litwin V, Grose C.

Department of Microbiology, University of Iowa College of Medicine, Iowa City.

Nearly two decades ago, it was observed that cells infected with herpes simplex
virus (HSV) acquired an IgG Fc binding activity. The properties of the viral Fc
receptor (FcR) have now been characterized by several laboratories. The Fc
binding activity appears on the surface of the infected cell prior to formation
of progeny virions. The FcR induced by HSV has been identified as the HSV
glycoprotein, gE. When HSV gE forms a complex with a second HSV glycoprotein, gI,
the receptor binds IgG with higher affinity. Varicella-zoster virus (VZV), which 
is closely related to HSV, has also been shown to induce an FcR. Like the HSV
FcR, the FcR specified by VZV possesses characteristics common to viral
glycoproteins. VZV encodes two glycoproteins, gpI and gpIV, which are the
homologs of HSV gE and gI. The VZV glycoproteins have many properties common to
cell surface receptors, including O-linked glycans and phosphorylation sites.
However, extensive computer-assisted analyses of the amino acid sequences of VZV 
gpI and gpIV did not uncover regions of homology to the human cellular Fc
receptors for IgG.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1337547 [PubMed - indexed for MEDLINE]

5538: Microbiol Immunol. 1992;36(11):1217-21.

Detection of herpes simplex and varicella-zoster virus DNA by field-inversion gel
electrophoresis from clinical materials.

Arao Y, Yoshida M, Sata T, Nakatsukasa A, Miyoshi K, Yamada M, Uno F, Kurata T,
Nii S.

Department of Pathology, National Institute of Health, Tokyo, Japan.

A simple method using field-inversion gel electrophoresis (FIGE) was applied to
detect herpes simplex virus (HSV) and varicella-zoster virus (VZV) genomes in
clinical specimens. The whole genomes of these viruses could be detected in small
vesicle tissues by the FIGE method regardless of their clinical stages of skin
lesions. And the sensitivity of the FIGE method was equivalent to that of an
immunofluorescent (IF) method. These data indicated usefulness of the FIGE method
to detect the whole genomes of HSV and VZV in clinical specimens.

PMID: 1337135 [PubMed - indexed for MEDLINE]

5539: Ger J Ophthalmol. 1992;1(6):388-93.

Diagnosis and management of the acute retinal necrosis syndrome.

Gerling J, Neumann-Haefelin D, Seuffert HM, Schrader W, Hansen LL.

Universitats-Augenklinik, Freiburg, Federal Republic of Germany.

The acute retinal necrosis (ARN) syndrome is an increasingly occurring entity
characterized by the triad of acute confluent peripheral retinitis with
papillitis and anterior-chamber uveitis. We present case reports on four patients
(age, 12-65 years) with an ARN syndrome caused by herpes simplex or varicella
zoster virus and discuss diagnostic and therapeutic modalities. Immediate
antiviral therapy in three patients exhibiting the typical clinical features
reduced the intraocular inflammation. However, due to proliferative
vitreoretinopathy with peripheral retinal necrosis, vitrectomy with encircling
band and silicone oil instillation was necessary in all patients. The suspected
diagnosis of an ARN syndrome induced by herpes simplex virus (HSV) was confirmed 
in one case during the early stage of the disease by the detection of increased
levels of HSV-IgA in the vitreous and in another case by the measurement of
increased titers of HSV-IgG in the vitreous. For the first time, we found
intraocular HSV DNA sequences using the polymerase chain reaction (PCR) in one of
these patients. In a fourth patient intraocular varicella zoster virus (VZV)
infection was confirmed by the detection of elevated VZV-IgA levels and by
positive PCR in the intraocular fluids. Two patients who were diagnosed and
treated early retained a visual acuity of 0.4 and 0.5, respectively, whereas in
the other two patients, whose diagnosis and therapy were delayed (> 6 weeks),
visual acuity was reduced to light perception. We conclude that use of the PCR in
the intraocular fluids together with detection of autochthonous antibodies in the
vitreous seem to be the most important diagnostic laboratory tools.(ABSTRACT
TRUNCATED AT 250 WORDS)

Publication Types: 
    Case Reports

PMID: 1337004 [PubMed - indexed for MEDLINE]

5540: DNA Seq. 1992;3(3):143-52.

The IR3 gene of equine herpesvirus type 1: a unique gene regulated by sequences
within the intron of the immediate-early gene.

Holden VR, Harty RN, Yalamanchili RR, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932.

The complete nucleotide sequence of the inverted repeat component (IR; 12,776 bp 
each) of the genome of equine herpesvirus type 1 (EHV-1) has been determined.
Transcription analyses have revealed that the EHV-1 IR sequence encodes at least 
6 genes. In this report, we present the DNA sequence and transcriptional
characterization of a gene (IR3) that maps entirely within the IR sequences. The 
IR3 open reading frame (ORF) is located between nucleotides (nt) 6123-6411 of the
IR sequence and possesses an ORF of 95 amino acids. Interestingly, this ORF does 
not show homology to any known herpesvirus gene, suggesting that the IR3 gene is 
unique to EHV-1. Moreover, the location of the IR3 gene between the
immediate-early (IR1) gene and the origin of replication is unique in comparison 
to the IR gene arrangement of other alphaherpesviruses such as herpes simplex
virus type 1 and varicella zoster virus. Putative cis-acting elements flanking
the IR3 ORF include a TATA box (nt 5648-5652), a GC box (nt 5600-5605), and three
polyadenylation signals (nt 6533-6538, 6648-6653, and 6663-6668). Northern blot
analyses identified a 1.0 kb mRNA that exhibits characteristics of a late gene of
the gamma-1 class. Northern blot, S1 nuclease, and primer extension analyses
revealed that transcription of IR3 initiates within the intron of the
immediate-early gene (IR1) on the opposite stand of the genome. Thus, the 5' end 
of IR3 transcript is antisense to the 5' end of the IR1 mRNA and promoter, and
IR3 transcription may regulate the expression of IR1 during late times of
infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1335300 [PubMed - indexed for MEDLINE]

5541: Vaccine. 1992;10(14):1007-14.

Current status and prospects of live varicella vaccine.

Takahashi M.

Research Institute for Microbial Diseases, Osaka University, Japan.

Since its development in 1974 the Oka strain live attenuated varicella vaccine
has been tested in healthy and immunocompromised adults and children. Its safety 
and efficacy have been established and it is now licensed for general use in
Japan and Korea, and for immunocompromised patients in several other countries.
Possibilities for the future include its use to prevent zoster in the elderly,
its incorporation in a multivalent vaccine and its use as a vehicle to express
foreign genes in recombinant vaccines.

Publication Types: 
    Review

PMID: 1335196 [PubMed - indexed for MEDLINE]

5542: DNA Seq. 1992;3(1):25-39.

Infectivity determinants encoded in a conserved gene block of human
herpesvirus-6.

Gompels UA, Carss AL, Sun N, Arrand JR.

Dept. of Medicine, Addenbrooke's Hospital Level 5, Cambridge, UK.

The nucleotide sequence was determined for a 9.3 kb BamHI DNA fragment derived
from a cosmid clone (Lorist 6) library of the 160 kb human herpesvirus-6 (HHV-6) 
strain U1102 genome. Analysis of the sequence showed two different sources for
the DNA; 8.0 kb was derived from HHV-6, while 1.3 kb was derived from the right
repeat of transposon Tn10, the insertion sequence (IS) element IS10R. The IS
element sequence is shown to be derived from the host bacteria of the plasmid.
The HHV-6 sequence represents a highly conserved part of the genome encoding 15% 
of the genes conserved among the other human herpesviruses in only 5% of the
genome. Six genes were identified, five encoding products with amino acid
sequence similarity to homologues in herpes simplex virus (HSV), Varicella Zoster
Virus (VZV), human cytomegalovirus (CMV) and Epstein-Barr Virus (EBV). All had
closest amino acid similarity to CMV proteins. Three clustered structural genes, 
included glycoprotein H, a major conserved determinant of infectivity, were
jointed to a putative dUTPase homologue in an arrangement distinct to CMV and
HHV-6. In the other herpes viruses these genes are separated by over 50 kb. The
gene at this point of genetic rearrangement had no sequence similarity to
proteins of other herpesviruses. However, there is a protein at this locus in CMV
with similar composition and character. Both appear to be highly glycosylated,
secreted glycoproteins with repetitive elements similar to those of human mucins.
Comparison of sequence available in the HHV-6 GS strain also shows this to be a
variable region (5% nucleotide differences) in an overall conserved DNA sequence 
(0.5%).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1333836 [PubMed - indexed for MEDLINE]

5543: Pediatrie. 1992;47(6):481-6.

[Acquired peripheral facial palsy in children. Current data illustrated by 66
recent personal cases]

[Article in French]

Truy E, Granade G, Bensoussan J, Kauffman I, Langue J, Morgon A.

Service d'otorhinolaryngologie, hopital Edouard-Herriot, Lyon, France.

The authors observed 66 cases of peripheral facial palsy (PFP) in children during
a 5-year period (1986-1990). Bell's palsy (idiopathic facial paralysis) occurred 
in 26 children (39.3%), 1 month to 14.5 years old, with a complete recovery in
95% of the cases; a surgical decompression was carried out in 2 cases. The PFP
was related to otitis in 16 cases (24.2%): acute otitis media (6), mastitis (4), 
serous otitis (5), cholesteatoma (1); the treatment was medical and surgical in
all cases with complete recovery in 15 cases. In 15 cases the PFP was secondary
to trauma (13) or surgery (2); complete spontaneous recovery occurred in 11
cases, and partial recovery following surgical treatment in 2 cases. A viral
origin was retained in 6 cases: herpes zoster (3), mumps (1), echovirus (1),
herpes (1); the recovery was complete in 4 cases, partial in 2 cases. In 3 cases 
the PFP was related to a rare cause: lymphoma, metabolic acidosis,
Melkerson-Rosenthal syndrome. Bell's palsy remains the main cause of PFP in
childhood; other etiologies can be ruled out by the case history, a careful
physical examination, and a limited number of laboratory and/or X-ray studies;
medical treatment, in particular prednisone, does not seem to have an effect upon
the rate of recovery which is spontaneously high; similarly there is no evidence 
that surgical decompression really modifies the rate of recovery so that the
authors suggest that it should be reserved to the complete forms with no clinical
and electrical evidence of recovery after 3 weeks.

Publication Types: 
    English Abstract

PMID: 1331969 [PubMed - indexed for MEDLINE]

5544: Zh Nevropatol Psikhiatr Im S S Korsakova. 1992;92(2):47-9.

[Virolex in the treatment of herpetic diseases of the nervous system]

[Article in Russian]

Umanskii KG, Dekonenko EP, Shishov AS, Kupriianova LV, Rudometov IuP.

The authors relate the results of the use of virolex (acyclovir), a new
etiotropic agent, for the treatment of some herpetic lesions of the nervous
system. The use of the drug for the treatment of herpetic encephalitis, one of
the gravest forms of encephalitides, exerts a beneficial effect. In the course of
the treatment, it is of paramount importance to adhere to the established time of
therapy, since the disease may recur. The treatment with virolex of different
forms of herpes zoster in children and adults brings about positive results as
well.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1326174 [PubMed - indexed for MEDLINE]

5545: Acta Otolaryngol Suppl. 1992;492:103-6.

Peripheral facial palsy caused by Borrelia burgdorferi and viruses in
south-western Finland.

Puhakka HJ, Laurikainen E, Viljanen M, Meurman O, Valkama H.

Department of Otolaryngology, University of Turku, Finland.

In a prospective study from 1983 through 1984, 77 patients (31 men and 46 women
with a mean age of 47 +/- 20 years) with peripheral facial palsy of primarily
unknown etiology were investigated. Only 2 patients with acute otitis media
received antibiotics. Serology of the patients was investigated on days 1 and 14.
IgG and IgM antibodies against herpes simplex, varicella-zoster and
cytomegalovirus were determined by enzyme immunoassay, and against Epstein-Barr
virus by immunofluorescence. In a retrospective analysis, IgM, IgA and IgG
antibodies against Borrelia burgdorferi were determined by enzyme immunoassay.
Borreliosis was diagnosed in 5 patients and varicella-zoster infection in 7.
There was no statistically significant difference in recovery time between the
different groups. Follow-up time for the patients with borreliosis was over 5
years. Neither meningeal symptoms nor polyneuropathy was observed in the patients
with borreliosis even in the absence of antibiotic therapy.

PMID: 1321549 [PubMed - indexed for MEDLINE]

5546: Clin Investig. 1992 Jan;70(1):28-37.

The diagnostic significance of antibody specificity indices in multiple sclerosis
and herpes virus induced diseases of the nervous system.

Felgenhauer K, Reiber H.

Klinik und Poliklinik fur Neurologie, Georg-August-Universitat, Gottingen.

The antibody specificity index (ASI) indicates the cerebrospinal fluid
(CSF)/serum difference of antibody amounts per weight unit IgG (normal less than 
1.5). It has proven to be the most sensitive inflammation parameter in CSF
analysis so far, more sensitive than the Western blot, the "oligoclonal"
response, and the empirical differentiation of CSF immunoglobulins. By this
diagnostic criterion, several benign viral meningitis cases were found to be
caused by the varicella/zoster virus. The diagnostic relevance of local zoster
antibody synthesis was greatest in ganglionitis cases, e.g., in zoster oticus
sine herpete (facial paresis) and acute radicular syndromes of the elderly. The
diagnostic significance of the local immune response against measles, rubella,
and zoster antigens (MRZ response) was ascertained further. Together with
oligoclonal gamma-globulin fractionation, there is now only 1 out of 100 multiple
sclerosis (MS) patients left who has been found to have a normal CSF.

PMID: 1318123 [PubMed - indexed for MEDLINE]

5547: Prog Med Virol. 1992;39:19-75.

Herpes zoster: pathogenesis and latency.

Gilden DH, Mahalingam R, Dueland AN, Cohrs R.

Department of Neurology, University of Colorado School of Medicine, Denver.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1317598 [PubMed - indexed for MEDLINE]

5548: Clin Infect Dis. 1992 Jan;14(1):263-71.

Comment in:
    Clin Infect Dis. 1993 Jan;16(1):181.

Facial palsy and infection: the unfolding story.

Morgan M, Nathwani D.

Department of Microbiology, Aberdeen Royal Infirmary, Scotland.

While it is now universally accepted that Ramsay Hunt syndrome is caused by
varicella-zoster virus, Bell's palsy continues to be labeled "idiopathic." We
review the literature associating Bell's palsy with various infectious agents as 
well as with Kawasaki disease, a condition in which an infectious etiology is
suspected. Good evidence--mostly serological--exists for an etiologic role for
the herpes group of viruses, mumps virus, and rubella virus. In addition, recent 
evidence has focused on Bell's palsy in human immunodeficiency virus infection
and Lyme borreliosis. In view of the multiplicity of implicated agents, it is
likely that the immunologic response associated with infection triggers a cranial
or generalized polyneuropathy culminating in facial nerve compression,
degeneration, and paralysis. The mounting interest in Bell's palsy, coupled with 
the increasing availability of more sensitive and specific tests, is likely to
augment the available evidence for an infectious etiology and to clarify the role
of other, previously unsuspected infectious agents.

Publication Types: 
    Review

PMID: 1315161 [PubMed - indexed for MEDLINE]

5549: Arch Virol. 1992;123(3-4):267-77.

Monoclonal antibodies for the identification of herpesvirus simiae (B virus).

Cropper LM, Lees DN, Patt R, Sharp IR, Brown D.

Virus Reference Laboratory, Central Public Health Laboratory, London, U.K.

To differentiate between B virus and HSV isolates from monkeys and man monoclonal
antibodies (mabs) were produced to herpesvirus simiae (B virus) and herpes
simplex type 1 and 2 (HSV-1 and HSV-2). Mabs were tested by indirect
immunofluorescence (IFAT) for reactivity against herpesviruses from Asiatic
monkeys (B virus), African monkeys (SA 8 virus), and man (HSV-1, HSV-2,
varicella-zoster virus, cytomegalovirus, and Epstein-Barr virus). Mabs could be
divided into groups A-E displaying specific reactivity for B virus (A);
reactivity with both B virus and SA 8 but not HSV (B); reactivity with B virus,
SA 8 virus and HSV strains (C); specific reactivity with HSV-1 (D); and specific 
reactivity with HSV-2 (E). Two of the B virus specific mabs were able to
differentiate between cynomolgus and rhesus strains of B virus. None of the mabs 
reacted with human varicella-zoster virus, cytomegalovirus, or Epstein-Barr
virus. A panel of mabs for the unequivocal identification of B virus isolates
from monkey or man is proposed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1314049 [PubMed - indexed for MEDLINE]

5550: Pediatr Hematol Oncol. 1992 Jan-Mar;9(1):29-34.

Varicella vaccine in children with acute lymphoblastic leukemia and non-Hodgkin
lymphoma.

Yeung CY, Liang DC.

Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, Republic of
China.

To determine the safety and efficacy of varicella vaccine, 17 children with acute
lymphoblastic leukemia (ALL) and 2 children with non-Hodgkin lymphoma (NHL)
receiving chemotherapy in remission were immunized with live attenuated varicella
vaccine (Oka strain). Rash occurred in 7 children 7-53 days (median 24 days)
after vaccination. There were 10-80 (median 20) erythematous vesicles and
low-grade fever. All children required no specific treatment. There was no spread
of varicella to their susceptible siblings. The control group comprised 92 ALL
and 25 NHL patients receiving chemotherapy in remission who were nonvaccinated
and susceptible to varicella. Over a risk duration of 80 person-years, one child 
of the vaccinated group developed varicella of mild degree, whereas in a risk
duration of 120 person-years, 14 of the control group developed varicella. One
patient died, though prompt antiviral therapy, especially acyclovir, was given to
all of them. Herpes zoster of mild degree was observed in one child of the
vaccinated group 65 days after vaccination. Two children of the control group
developed disseminated herpes zoster. With acyclovir therapy, there was no
mortality. The incidence of varicella in the vaccinated group was less than that 
of the control group. The difference is statistically significant (p = .0222),
and the side effects of the vaccine were acceptable. Thus we conclude that the
vaccine can be safely used in children with ALL or NHL under chemotherapy and can
effectively protect such children from varicella.

PMID: 1313688 [PubMed - indexed for MEDLINE]

5551: Arch Virol. 1992;123(1-2):13-27.

Localization of herpes simplex virus type 1 in sebaceous glands of mice.

Moriyama K, Imayama S, Mohri S, Kurata T, Mori R.

Department of Virology, School of Medicine, Kyushu University, Fukuoka, Japan.

The distribution of HSV-1 during the development of zosteriform skin lesions in
SCID mice was analyzed by immunofluorescence and electron microscopy. The virus
initially appeared within certain keratinocytes, sometimes surrounded by
keratinocytes whose surfaces were also positive for the antigens, in the lower
epidermal layers including the hair follicles, and then extended upward to the
entire epidermis and downward to the sebaceous glands 1-2 days later, when no
macroscopic skin lesion was seen. The affected epidermal cells subsequently
degenerated and lost their viral antigens within a day, when the zosteriform
lesion then became evident. This was followed by a degeneration of the dermis.
The sebaceous glands eventually degenerated in 10 days, but some glands in the
necrotic skin areas preferentially retained HSV-1. The horizontal spread of the
virus in the epidermis beyond the first invaded dermatome occurred much later. In
mice passively immunized with specific immune serum, viral antigens were observed
even 20 days after the infection in sebaceous glands in necrotized areas.
Therefore, HSV-1 appears to spread first via the extracellular fluid among the
keratinocytes after being shed from nerve endings, and then produces a successive
degeneration of the affected keratinocytes which may prevent any further
extension of horizontal viral spread. The pilosebaceous apparatus is possibly
acting as a site not only for the replication of HSV-1 with a delayed cytopathic 
effect, but also as an area that is temporarily sheltered from host defense
mechanisms.

PMID: 1312819 [PubMed - indexed for MEDLINE]

5552: Virchows Arch A Pathol Anat Histopathol. 1992;420(1):71-6.

Immunohistochemical study of skin lesions in herpes zoster.

Muraki R, Baba T, Iwasaki T, Sata T, Kurata T.

Department of Dermatology, University of Tsukuba, Ibaraki, Japan.

Thirty-seven biopsy skin tissues of herpes zoster taken from 27 patients were
analysed immunohistochemically using two monoclonal antibodies detecting either
nucleocapsid or glycoproteins of varicella-zoster virus (VZV) on paraffin
sections of formalin fixed tissues. Skin lesions of herpes zoster were divided
clinically into four stages: erythematous, vesicular, pustular and ulcerative. In
the erythematous stage, VZV antigens, if detected, were found only within
ballooning cells in the lower epidermis or follicular epithelium. In the
vesicular stage, antigens were detected in the cells around and within the
intraepidermal vesicles and in histiocytes or fibrocytes of the dermis in all
cases and in the endothelial or perineural cells in 10 of 14 cases. In the
pustular stage, the antigens were observed in degenerated or necrotic
keratinocytes and multinucleated giant cells within pustules and some necrotic
cells in the dermis. In the ulcerative stage, the viral antigens were detected
only at the ulcer margin and around the hair shaft in 2 of 7 cases. These results
suggest that VZV initially involves the epidermis in the erythematous stage,
subsequently invades the dermis in the vesicular stage, and disappears in the
early ulcerative stage.

PMID: 1311486 [PubMed - indexed for MEDLINE]

5553: Br J Dermatol. 1992 Jan;126(1):19-23.

Detection of HSV-specific DNA in biopsy tissue of patients with erythema
multiforme by polymerase chain reaction.

Aslanzadeh J, Helm KF, Espy MJ, Muller SA, Smith TF.

Department of Laboratory Medicine, Mayo Clinic, Rochester, MN 55905.

Formalin-fixed paraffin-embedded skin biopsies of lesions of erythema multiforme 
(EM) from 32 patients and 13 controls were examined for the presence of herpes
simplex virus (HSV) by polymerase chain reaction (PCR) and for histological
findings by direct immunofluorescence and staining with haematoxylin and eosin.
HSV-specific DNA was detected in 23 (72%) patients. A history of recurrent skin
rash was present in 59% of the PCR-positive cases, while 55% had had suspected
HSV infections. Only two PCR-positive specimens were found in patients without a 
history of recurrent rash and/or previous oral lesions. One biopsy was positive
for HSV by conventional cell cultures. There was no significant difference in
histology between HSV-related and HSV-negative cases of EM. In the 13 control
specimens [bullous pemphigoid (3), dermatitis herpetiformis (2), lichen planus
(1), aphthous ulcer (1), fixed-drug eruption (1), varicella-zoster (1),
hypereosinophilic syndrome (1), photocontact dermatitis (1), contact dermatitis
(1), and cellulitis (1)], no HSV-DNA was detected.

PMID: 1311188 [PubMed - indexed for MEDLINE]

5554: Heart Lung. 1992 Jan;21(1):85-91.

Varicella zoster and herpes simplex virus infections.

Gurevich I.

Infection Control Section, Winthrop-University Hospital, Mineola, NY 11501.

There are six herpes viruses, three of which, the varicella-zoster virus and the 
herpes simplex viruses types 1 and 2, are of particular concern to patients and
staff in critical care units. These viruses, especially in their reactivated
states, may present atypically in critically ill and immune-suppressed patients, 
and, by the time the diagnosis is made, exposures of other patients and
clinicians may have occurred. Pregnancy and immunosuppressed states can result in
severe, even life-threatening varicella-zoster virus infections in susceptible
adults. Similarly, nosocomial herpes simplex virus infections can have serious
consequences for exposed patients and staff. An additional problem after herpes
simplex virus infection is the potential of lifelong and possibly frequent
recurrences. In this article, the manifestations, modes of transmission, and
treatment will be discussed. Special emphasis will be placed on describing the
types of patients who are at high risk of presenting with varicella-zoster virus 
or herpes simplex virus infection so that physicians and nurses can use
appropriate preventive measures to avert nosocomial infections in patients and
staff.

Publication Types: 
    Review

PMID: 1310493 [PubMed - indexed for MEDLINE]

5555: J Infect Dis. 1992 Jan;165(1):119-26.

Subclinical varicella-zoster virus viremia, herpes zoster, and T lymphocyte
immunity to varicella-zoster viral antigens after bone marrow transplantation.

Wilson A, Sharp M, Koropchak CM, Ting SF, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, CA 94305.

Bone marrow transplant (BMT) recipients were evaluated for subclinical
varicella-zoster virus (VZV) viremia and symptoms of herpes zoster after
transplantation. Viremia was demonstrated by testing peripheral blood mononuclear
cells using polymerase chain reaction and was documented in 19% of 37 patients.
When reactivation was defined as herpes zoster and/or subclinical VZV viremia,
41% of VZV-seropositive BMT recipients experienced VZV reactivation. None of 12
patients tested before VZV reactivation had T lymphocyte proliferation to VZV
antigen (mean stimulation index, 1.0 +/- 0.42 [SD] at less than 100 days; 12.0
+/- 6.03 at greater than 100 days [P = .003]). Among patients tested at greater
than 100 days, 5 (63%) of 8 with detectable T cell proliferation had subclinical 
or clinical VZV reactivation compared with none of 6 who lacked VZV T cell
responses. Recovery of VZV-specific cytotoxic T lymphocyte function was observed 
in 50% of BMT patients, but BMT recipients had significantly fewer circulating
cytotoxic T lymphocytes that recognized VZV immediate early protein (P = .03) or 
glycoprotein I (P = .004) than did healthy VZV immune subjects. In vivo
reexposure to VZV antigens due to subclinical VZV viremia or symptomatic VZV
reactivation may explain the recovery of virus-specific T cell immunity after
BMT.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1309369 [PubMed - indexed for MEDLINE]

5556: J Virol. 1992 Jan;66(1):562-6.

The unique sequence of the herpes simplex virus 1 L component contains an
additional translated open reading frame designated UL49.5.

Barker DE, Roizman B.

Marjorie B. Kovler Viral Oncology Laboratories, University of Chicago, Illinois
60637.

We present evidence for the existence of an additional herpes simplex virus 1
gene designated UL49.5. The sequence, located between genes UL49 and UL50,
predicts a hydrophobic protein with 91 amino acids. Attempts to delete UL49.5
were not successful. To demonstrate that UL49.5 is expressed, we made two
recombinant viruses. First, we inserted in frame an oligonucleotide encoding a
15-amino-acid epitope known to react with a monoclonal antibody. This gene,
consisting of the authentic promoter and chimeric coding domain, was inserted
into the thymidine kinase gene of wild-type virus and in infected cells expressed
a protein which reacted with the monoclonal antibody. The second recombinant
virus contained a 5' UL49.5-thymidine kinase fusion gene. The protein expressed
by this virus confirmed that the first methionine codon of UL49.5 served as the
initiating codon. The predicted amino acid sequence of UL49.5 is consistent with 
the known properties of NC-7, a small capsid protein whose gene has not been
previously mapped. A homolog of UL49.5 is present in the genome of
varicella-zoster virus, located between homologs of UL49 and UL50.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1309263 [PubMed - indexed for MEDLINE]

5557: J Virol. 1992 Jan;66(1):359-66.

The varicella-zoster virus immediate-early protein IE62 is a major component of
virus particles.

Kinchington PR, Hougland JK, Arvin AM, Ruyechan WT, Hay J.

Department of Biochemistry, Uniformed Services University of the Health Sciences,
Bethesda, Maryland 20814-0499.

Varicella-zoster virus (VZV) open reading frame (ORF) 62 potentially encodes a
protein with considerable amino acid homology to the herpes simplex virus (HSV)
immediate-early regulatory polypeptide ICP4 (or IE3). To identify and
characterize its protein product(s) (IE62), we used a rabbit antiserum prepared
against a synthetic peptide corresponding to the C-terminal 13 amino acids of the
predicted protein. This antiserum reacted with phosphorylated polypeptides of 175
to 180 kDa that were made in VZV-infected cells and in cells infected with a
vaccinia virus recombinant expressing IE62, but not in control-infected cells,
confirming its specificity and reactivity to the IE62 protein. The antiserum
recognized a 175-kDa polypeptide in purified virions that comigrated with a major
structural protein. Comparison of this reactivity with that of an antipeptide
antiserum directed against the VZV ORF 10 product (homologous to the HSV major
structural protein VP16) indicates similar levels of ORF 62 and ORF 10
polypeptides in VZV virions. In contrast, antipeptide antiserum directed against 
the VZV ORF 29 product, the homolog of the HSV major DNA-binding protein, failed 
to recognize any protein in our virion preparations. Treatment of virions with
detergents that disrupt the virion envelope did not dissociate IE62 from the
nucleocapsid-tegument structure of the virion. Differential sensitivity of VZV
virion IE62 to trypsin digestion in the presence or absence of Triton X-100
indicates that IE62 is protected from trypsin degradation by the virus envelope; 
since it is not a nucleocapsid protein, we conclude that it is part of the
tegument. Finally, we show that the virion 175-kDa protein either can
autophosphorylate or is a major substrate in vitro for virion-associated protein 
kinase activity.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1309252 [PubMed - indexed for MEDLINE]

5558: Zhonghua Er Bi Yan Hou Ke Za Zhi. 1992;27(6):342-4, 382.

[Transtemporal supralabyrinthine approach]

[Article in Chinese]

Zhao JC.

Tianjin Medical College Hospital.

Transtemporal supralabyrinthine approach is a modified middle cranial fossa
approach. It offers all the advantages of a middle cranial fossa procedure and
avoids its disadvantages, mainly the extensive temporal lobe retraction and
frightening complications. The principle of the approach is to gain sufficient
access toward the internal auditory canal by removing bone from the roof of the
petrous pyramid rather than by elevating the middle fossa dura away from it.
Fifteen patients underwent this approach for decompression of paralysed facial
nerve resulted from temporal bone fracture, Bell's palsy and herpes zoster
oticus; for removal of facial neuromas and primary cholesteatomas in temporal
bone and for sectioning of great superficial petrous nerve. Preliminary study
showed good results.

Publication Types: 
    English Abstract

PMID: 1303667 [PubMed - indexed for MEDLINE]

5559: Rev Neurol (Paris). 1992;148(11):663-71.

[Cerebrovascular complications of cancers]

[Article in French]

Dubas F, Serre I.

Service de Neurologie A, CHU Angers.

About 15% of patients with cancer have cerebrovascular lesions, resulting from 4 
kinds of disorders sometimes intermingled in advanced disseminated cancer:
coagulation disorders, direct effects of the tumor, infections and therapeutic
measures. Infarction, hardly less frequent than hemorrhage, mostly complicates
lymphoma and carcinoma. Hypercoagulation states, such as chronic disseminated
intravascular coagulation, nonbacterial thrombotic endocarditis, and
nonmetastatic cerebral venous thrombosis account for about 50% of cases. Tumor
emboli, as seen in intravascular malignant lymphomatosis, arteritis related to
aspergillus, granulomatous angiitis with or without herpes zoster and
radiation-induced atherosclerosis are rarer. Cerebral hemorrhages, excluding
bleeding from the metastases of choriocarcinoma and melanoma are mainly
associated with leukemia by acute disseminated intravascular coagulation as in
promyelocytic leukemia, by leukostasis or by pancytopenia. Both infarction and
hemorrhage rarely reveal the neoplasia. Lesions are often small and disseminated,
and therefore produce a picture of diffuse acute or subacute encephalopathy
rather than acute focal deficits. Finally, there may be no relationship between
the cerebrovascular event and the neoplasia, and atherosclerosis or traumatic
subdural hematoma may well be the causal factor.

Publication Types: 
    English Abstract
    Review

PMID: 1303555 [PubMed - indexed for MEDLINE]

5560: Przegl Epidemiol. 1992;46(3):237-44.

[Ophthalmic zoster in clinical material from the clinic of infectious diseases
PAM in Szczecin during 1985-1989]

[Article in Polish]

Niscigorska J, Mozolewska K.

Klinika Chorob Zakaznych PAM, Szczecinie.

Clinical course, early and late complications as well as treatment of ophthalmic 
zoster in 70 hospitalized patients are presented. Authors pay the attention to
early treatment (general and topical) with Zovirax in prevention of ocular
complications.

Publication Types: 
    English Abstract

PMID: 1284257 [PubMed - indexed for MEDLINE]

5561: Am J Ophthalmol. 1991 Dec 15;112(6):735-6.

Magnetic resonance imaging in a patient with herpes zoster keratouveitis and
contralateral acute retinal necrosis.

Farrell TA, Wolf MD, Folk JC, Pulido JS, Yuh WT.

Publication Types: 
    Case Reports
    Letter

PMID: 1957917 [PubMed - indexed for MEDLINE]

5562: Lancet. 1991 Dec 14;338(8781):1527.

Comment on:
    Lancet. 1991 Nov 16;338(8777):1244-5.

Ophthalmic zoster.

Marsh RJ.

Publication Types: 
    Comment
    Letter

PMID: 1683948 [PubMed - indexed for MEDLINE]

5563: Med Clin (Barc). 1991 Dec 7;97(20):789-90.

[Treatment of herpes zoster and post-herpetic neuralgia]

[Article in Spanish]

Aguilar Sanchez JL.

Servicio de Anestesiologia, Hospital Germans Trias i Pujol, Badalona, Barcelona.

Publication Types: 
    Review

PMID: 1795575 [PubMed - indexed for MEDLINE]

5564: JAMA. 1991 Dec 4;266(21):3019-22.

Ocular manifestations of AIDS.

de Smet MD, Nussenbatt RB.

Laboratory of Immunology, National Eye Institute, Bethesda, Md 20892.

Publication Types: 
    Case Reports
    Clinical Conference

PMID: 1668177 [PubMed - indexed for MEDLINE]

5565: AIDS. 1991 Dec;5(12):1419-24.

Virological markers in the cerebrospinal fluid from HIV-1-infected individuals.

Buffet R, Agut H, Chieze F, Katlama C, Bolgert F, Devillechabrolle A, Diquet B,
Schuller E, Pierrot-Deseilligny C, Gentilini M, et al.

Laboratoire de Bacteriologie-Virologie, Hopital de la Pitie-Salpetriere, Paris,
France.

We analysed 127 specimens of cerebrospinal fluid (CSF) from 118 HIV-1-infected
individuals at different stages of infection. Intrathecal antibody synthesis was 
evident in 23 samples tested and was more frequently directed against HIV than
against rubella virus, herpes simplex virus, varicella zoster virus or
cytomegalovirus. HIV was isolated from only 14% of the 127 CSF specimens, but
from 82% of CSF-paired blood samples. HIV antigen was detected in 12% of CSF
specimens and 44% of paired plasma samples. Twenty specimens analysed using the
polymerase chain reaction (PCR) detected proviral DNA in 75% of CSF specimens.
The low rate of virus recovery from CSF was caused by neither the freezing of
specimens prior to culture nor therapy. In contrast, virus isolation from CSF was
significantly associated with CSF cell count. Virus isolation and antigen
detection in CSF were not correlated with either the Centers for Disease Control 
disease stage or the peripheral CD4+ lymphocyte count, whereas viraemia was
significantly associated with a low CD4+ lymphocyte count. Moreover, virus
isolation and antigen detection in CSF were not associated with symptoms of
subacute HIV encephalitis, suggesting that these markers are not of potential
value in the diagnosis of HIV-specific neurologic complications. The value of PCR
in this field merits further investigation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1814327 [PubMed - indexed for MEDLINE]

5566: Antimicrob Agents Chemother. 1991 Dec;35(12):2463-6.

Inactivation of enveloped viruses by anthraquinones extracted from plants.

Sydiskis RJ, Owen DG, Lohr JL, Rosler KH, Blomster RN.

Department of Microbiology, University of Maryland, Baltimore 21201.

To determine the extent of antiviral activity present in a number of plant
extracts, hot glycerin extracts were prepared from Rheum officinale, Aloe
barbadensis, Rhamnus frangula, Rhamnus purshianus, and Cassia angustifolia and
their virucidal effects were tested against herpes simplex virus type 1. All the 
plant extracts inactivated the virus. The active components in these plants were 
separated by thin-layer chromatography and identified as anthraquinones. A
purified sample of aloe emodin was prepared from aloin, and its effects on the
infectivity of herpes simplex virus type 1 and type 2, varicella-zoster virus,
pseudorabies virus, influenza virus, adenovirus, and rhinovirus were tested by
mixing virus with dilutions of aloe emodin for 15 min at 37 degrees C,
immediately diluting the sample, and assaying the amount of infectious virus
remaining in the sample. The results showed that aloe emodin inactivated all of
the viruses tested except adenovirus and rhinovirus. Electron microscopic
examination of anthraquinone-treated herpes simplex virus demonstrated that the
envelopes were partially disrupted. These results show that anthraquinones
extracted from a variety of plants are directly virucidal to enveloped viruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1810179 [PubMed - indexed for MEDLINE]

5567: Clin J Pain. 1991 Dec;7(4):323-9.

Measurement of tissue impedance in dorsal root entry zone surgery for pain after 
brachial plexus avulsion and herpes zoster.

Chen HJ.

Department of Surgery, Chang Gung Medical School, Taiwan, R.O.C.

Fifteen patients with brachial plexus avulsion and five patients with
postherpetic pain underwent dorsal root entry zone surgery with intraoperative
impedance monitoring. The usual range of initial impedance values recorded in the
superficial layers of the normal cord is from 1,000 to 1,500 omega. The
recordings usually decrease to less than 1,000 omega in the segments of root
avulsion injuries. Some variation in recordings occurs owing to atrophy and
scarring of the damaged cord. In postherpetic neuralgia, measurements of
impedance are abnormally low in the involved area, in which the roots appear
macroscopically abnormal. In this study, tissue impedance was correlated with
gross pathologic changes in the spinal cord.

Publication Types: 
    Case Reports

PMID: 1809446 [PubMed - indexed for MEDLINE]

5568: J Neurol Sci. 1991 Dec;106(2):153-7.

Lhermitte's sign in a patient with herpes zoster.

Vollmer TL, Brass LM, Waxman SG.

Department of Neurology, Yale University School of Medicine, New Haven, CT 06510.

A 34-year-old, previously healthy man developed herpes zoster (shingles)
involving the C4 dermatome. This was accompanied by Lhermitte's sign, i.e. an
electric shock-like sensation radiating from the neck to the sacrum, elicited by 
flexion of the neck. Lhermitte's sign resolved in this patient after several
days, and probably reflected acute inflammation together with changes in sensory 
axon excitability. This positive manifestation of dorsal column dysfunction can
be present in the absence of fixed neurological deficits, and can reflect dorsal 
column dysfunction caused by a wide spectrum (demyelinating, traumatic,
compressive, toxic/deficiency, infectious and inflammatory) of etiologies.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 1802963 [PubMed - indexed for MEDLINE]

5569: East Afr Med J. 1991 Dec;68(12):948-51.

HIV and acute peripheral facial nerve palsy.

Amayo EO, Kwasa TO.

Department of Medicine, College of Health Sciences, University of Nairobi.

Between April and December 1989, 32 consecutive patients referred to the
neurology clinic with acute peripheral facial paralysis were studied. Patients
with traumatic facial palsy, parotid gland disease, otitis media and meningitis
were excluded. Each of the patients selected had HIV test done by ELISA and the
positive ones confirmed by Western blot. 8 (25%) of the patients tested positive 
for HIV antibodies. Their mean age was 34 +/- 13 years with an age range of 15-53
years. 4 (50%) of the 8 seropositive patients had generalized lymphadenopathy,
one herpes zoster, one generalized pruritic rash, two of the patients were
asymptomatic. The seroprevalence of HIV antibodies in patients with acute
peripheral facial paralysis is much lower than that reported in other African
countries.

PIP: Between April-December 1989, physicians at the neurology clinic of the
Kenyatta National Hospital in Nairobi, Kenya recruited 32 patients who exhibited 
facial nerve palsy of lower motor neuron type and who did not have any trauma,
inflammation of the middle ear, surgery, or disease of the parotid gland. 8 (25%)
of the patients were HIV seropositive. Researchers did not retest any of the
seronegative patients for HIV. 6 of the HIV seropositive cases had symptoms of
early HIV infection: 4 generalized lymphadenopathy, 1 herpes zoster, and 1
generalized pruritic rash. The 2 other HIV seropositive patients did not have any
symptoms other than facial paralysis. Several other studies have demonstrated an 
association between HIV infection and acute peripheral facial paralysis,
especially in asymptomatic or AIDS related complex patients. In a study in
Bangui, Central African Republic, HIV seroprevalence among patients with acute
peripheral facial paralysis was 69%. The researchers could not identify the
reason for the difference between the HIV seroprevalences of the 2 studies.
Nevertheless physicians should expect to treat more cases of acute peripheral
facial paralysis as the prevalence of HIV increases.

PMID: 1800092 [PubMed - indexed for MEDLINE]

5570: Voen Med Zh. 1991 Dec;(12):26-7.

[A rare etiological variant of a disorder in cerebral circulation]

[Article in Russian]

Morozov NS, Mikhailenko AA, Kiselev VF, Grabchuk MA, Ovchinnikova SP.

Publication Types: 
    Case Reports

PMID: 1799064 [PubMed - indexed for MEDLINE]

5571: J Tradit Chin Med. 1991 Dec;11(4):302-3.

What are the common acupuncture methods for treating herpes zoster?

Hu J.

PMID: 1795549 [PubMed - indexed for MEDLINE]

5572: J Neurol. 1991 Dec;238(8):452-6.

Topical 0.025% capsaicin in chronic post-herpetic neuralgia: efficacy, predictors
of response and long-term course.

Peikert A, Hentrich M, Ochs G.

Neurologische Klinik und Poliklinik, Technischen Universitat, Munchen, Federal
Republic of Germany.

In order to evaluate the efficacy, time-course of action and predictors of
response to topical capsaicin, 39 patients with chronic post-herpetic neuralgia
(PHN), median duration 24 months, were treated with 0.025% capsaicin cream for 8 
weeks. During therapy the patients rated their pain on a visual analogue scale
(VAS) and a verbal outcome scale. A follow-up investigation was performed 10-12
months after study onset on the patients who had improved. Nineteen patients
(48.7%) substantially improved after the 8-week trial; 5 (12.8%) discontinued
therapy due to side-effects such as intolerable capsaicin-induced burning
sensations (4) or mastitis (1); 15 (38.5%) reported no benefit. The decrease in
VAS ratings was significant after 2 weeks of continuous application. Of the
responders 72.2% were still improved at the follow-up; only one-third of them had
continued application irregularly. Treatment effect was not dependent on
patient's age, duration or localization of PHN (trigeminal involvement was
excluded), sensory disturbance or pain character. Treatment response was not
correlated with the incidence, time-course or severity of capsaicin-induced
burning. If confirmed in controlled trials, the long-term results of this open,
non-randomized study might indicate that the analgesic effect of capsaicin in PHN
is mediated by both interference with neuropeptide metabolism and morphological
changes (perhaps degeneration) of nociceptive afferents.

Publication Types: 
    Clinical Trial

PMID: 1779253 [PubMed - indexed for MEDLINE]

5573: Zahnarztl Mitt. 1991 Dec 1;81(23):2396-400.

[Virus statics in dental practice]

[Article in German]

Knolle G.

Publication Types: 
    Review

PMID: 1667884 [PubMed - indexed for MEDLINE]

5574: J Mol Evol. 1991 Dec;33(6):483-94.

Evidence for selective evolution in codon usage in conserved amino acid segments 
of human alphaherpesvirus proteins.

Schachtel GA, Bucher P, Mocarski ES, Blaisdell BE, Karlin S.

Department of Mathematics, Stanford University, CA 94305.

The genomes of human viruses herpes simplex 1 (HSV1) and varicella zoster (VZV), 
although similar in biology, largely concordant in gene order, and identical in
many amino acid segments, differ widely in their genomic G + C (abbreviated S)
content, which is high in HSV1 (68%) and low in VZV (46%). This paper analyzes
several striking codon usage contrasts. The S difference in coding regions is
dramatically large in codon site 3, S3, about 42%. The large difference in S3 is 
maintained at the same level in a subset of closely similar genes and even in
corresponding identical amino acid blocks. A similar difference in S levels in
silent site 1 (S1) is found in leucine and arginine. The difference in S3 levels 
occurs in every gene and in every multicodon amino acid form. The S difference
also exists in amino acid usage, with HSV1 using significantly more codon types
SSN, while VZV uses more codon types WWN (where W stands for A or T). The
nonoverlapping and narrow histograms of S3 gene frequencies in both viruses
suggest that the difference has arisen and been maintained by a process of
selective rather than nonselective effects. This is in sharp contrast to the
relatively large variance seen for highly similar genes in the human versus yeast
analysis. Interpretations and hypotheses to explain the HSV1 vs VZV codon usage
disparity relate to virus-host interactions, to the role of viral genes in DNA
metabolism, to availability of molecular resources (molecular Gause exclusion
principle), and to differences in genomic structure.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1663999 [PubMed - indexed for MEDLINE]

5575: Antiviral Res. 1991 Dec;16(4):327-39.

In vitro antiviral activity of polyoxotungstate (PM-19) and other
polyoxometalates against herpes simplex virus.

Fukuma M, Seto Y, Yamase T.

Division of Chemotherapy, School of Medicine, Keio University, Tokyo, Japan.

Polyoxotungstates with Keggin-type structure were found to demonstrate marked
antiherpetic activity. K7[TiW10PO40].6H2O (PM-19) caused a decrease in plaque
formation by several strains of herpes simplex virus (HSV) type 1, including
acyclovir-resistant (thymidine kinase-negative) strains, at concentrations which 
were not toxic to the host cells. The 50% plaque-inhibiting concentration (EC50) 
for the different strains was between 20 and 50 micrograms/ml. Single-cycle HSV
growth was also inhibited by PM-19. PM-19 inhibited viral DNA synthesis in
HSV-infected cells at a concentration of 5 micrograms/ml but did not exhibit a
virucidal effect, and pretreatment of the host cells with PM-19 did not provide
resistance to herpes infection. Yet, virus adsorption to the cells was markedly
affected at PM-19 concentrations higher than 25 micrograms/ml. PM-19 was also
effective against human cytomegalovirus, but not against adenoviruses and
varicella-zoster virus, although it did delay the development of the cytopathic
effect of these viruses.

PMID: 1663733 [PubMed - indexed for MEDLINE]

5576: Am J Obstet Gynecol. 1991 Dec;165(6 Pt 1):1727-30.

Comment in:
    Am J Obstet Gynecol. 1992 Nov;167(5):1480-1.

In utero diagnosis of congenital varicella zoster virus infection by chorionic
villus sampling and polymerase chain reaction.

Isada NB, Paar DP, Johnson MP, Evans MI, Holzgreve W, Qureshi F, Straus SE.

Department of Obstetrics and Gynecology, Hutzel Hospital/Wayne State University, 
Detroit, MI 47201.

Varicella zoster virus infection acquired in pregnancy is reported to cause fetal
damage in 5% to 10% of cases. We used polymerase chain reaction to attempt
molecular diagnosis of fetoplacental varicella zoster virus infection in two
patients. Tissue obtained by chorionic villus sampling in the second trimester
was analyzed by polymerase chain reaction with a varicella zoster virus-specific 
primer, ORF-63, and was found to be positive in both patients. Viral cultures
were negative. One patient elected pregnancy termination at 23 weeks. Southern
blot hybridization of neonatal brain tissue for varicella zoster virus was
negative. The second patient carried the pregnancy to term and was delivered of a
normal infant. Varicella zoster virus immunoglobulin M and viral cultures were
negative. The presence of viral deoxyribonucleic acid sequences in placental
tissue does not correlate with fetal disease.

Publication Types: 
    Case Reports

PMID: 1661069 [PubMed - indexed for MEDLINE]

5577: N Engl J Med. 1991 Nov 28;325(22):1577-9.

Comment in:
    N Engl J Med. 1992 Apr 30;326(18):1224; author reply 1225-6.

Comment on:
    N Engl J Med. 1991 Nov 28;325(22):1539-44.    N Engl J Med. 1991 Nov 28;325(22):1545-50.

Chickenpox--examining our options.

Brunell PA.

Publication Types: 
    Clinical Trial
    Comment
    Editorial

PMID: 1658651 [PubMed - indexed for MEDLINE]

5578: N Engl J Med. 1991 Nov 28;325(22):1545-50.

Comment in:
    N Engl J Med. 1991 Nov 28;325(22):1577-9.

The incidence of zoster after immunization with live attenuated varicella
vaccine. A study in children with leukemia. Varicella Vaccine Collaborative Study
Group.

Hardy I, Gershon AA, Steinberg SP, LaRussa P.

Department of Pediatrics, Columbia University College of Physicians and Surgeons,
New York, NY 10032.

BACKGROUND. The Oka strain of live attenuated varicella vaccine is immunogenic
and highly protective, but there has been concern about the risk of zoster after 
immunization. METHODS. We examined the incidence of zoster, risk factors for it, 
and measures of immune response in children with leukemia who received the
vaccine and in appropriate controls. RESULTS. After a mean follow-up of 4.1
years, zoster was documented in 13 of the 548 vaccinated children with leukemia
(2.4 percent). In a subgroup of 96 vaccinated children matched prospectively with
96 children with leukemia who had had natural varicella infections, there were 4 
cases of zoster among the vaccinated children and 15 among the controls, for
crude incidence rates of 0.80 and 2.46 cases per 100 person-years, respectively
(P = 0.01). Of the total of 13 vaccinated children who had zoster, 11 had a skin 
rash due to varicella-zoster virus, either from the vaccine itself or from
breakthrough varicella after household exposure in the period between
immunization and the documentation of zoster. In the 268 children who had any
type of rash caused by varicella-zoster virus after vaccination, as compared with
those who did not have a rash, the relative risk of subsequent zoster was 5.75.
For the 21 vaccinated children who received bone marrow transplants, as compared 
with those who did not, the relative risk of zoster was 7.5. Cell-mediated
immunity as assessed by lymphocyte stimulation was lower in 4 children in whom
zoster later developed than in 29 controls who had been vaccinated but who did
not have zoster (mean stimulation index, 5.1 vs. 23.8; P = 0.0001). CONCLUSIONS. 
In children with leukemia who receive the live attenuated varicella vaccine, the 
subsequent incidence of zoster is lower than in children who have natural
varicella infections.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1658650 [PubMed - indexed for MEDLINE]

5579: Lancet. 1991 Nov 16;338(8777):1244-5.

Comment in:
    Lancet. 1991 Dec 14;338(8781):1527.

Treatment of ocular herpes zoster.

[No authors listed]

Publication Types: 
    Editorial

PMID: 1682651 [PubMed - indexed for MEDLINE]

5580: Presse Med. 1991 Nov 16;20(38):1904-5.

[Phrenic nerve paralysis caused by zona]

[Article in French]

Morcamp D, Sibille C.

Publication Types: 
    Case Reports
    Letter

PMID: 1661421 [PubMed - indexed for MEDLINE]

5581: Ophthalmology. 1991 Nov;98(11):1641-5; discussion 145-6.

Chickenpox-associated acute retinal necrosis syndrome.

Culbertson WW, Brod RD, Flynn HW Jr, Taylor BC, Brod BA, Lightman DA, Gordon G.

Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami
School of Medicine, FL 33136.

Acute retinal necrosis (ARN) syndrome usually occurs as the result of secondary
reactivation of latent, previously acquired, varicella-zoster or herpes simplex
virus. The authors report four patients who developed a mild form of ARN within 1
month (5 to 28 days) after the onset of chickenpox. In contrast to typical cases 
of ARN, these cases were less severe, with retinitis limited to two quadrants or 
less (three patients), no retinal detachment (four patients), minimal vitreitis
(four patients), and no loss of visual acuity (four patients). Thus, ARN may
occur during the course of primary varicella-zoster infection.

Publication Types: 
    Case Reports

PMID: 1666176 [PubMed - indexed for MEDLINE]

5582: J ET Nurs. 1991 Nov-Dec;18(6):198-200.

Herpes zoster: implications for ET nurses.

Brown CS, Doubleman J.

Publication Types: 
    Case Reports

PMID: 1954299 [PubMed - indexed for MEDLINE]

5583: Neurology. 1991 Nov;41(11):1846.

Thalamic infarction following lingual herpes zoster.

Geny C, Yulis J, Azoulay A, Brugieres P, Saint-Val C, Degos JD.

Department of Neurosciences, Hopital Henri Mondor, Creteil, France.

Publication Types: 
    Case Reports

PMID: 1944922 [PubMed - indexed for MEDLINE]

5584: Lupus. 1991 Nov;1(1):31-5.

Short course of weekly low-dose intravenous pulse cyclophosphamide in the
treatment of lupus nephritis: a preliminary study.

Houssiau FA, D'Cruz DP, Haga HJ, Hughes GR.

Lupus Arthritis Research Unit, Rayne Institute, St Thomas' Hospital, London, UK.

We review our experience with low-dose intravenous pulse cyclophosphamide as
treatment of biopsy-proven lupus nephritis. Seventeen patients were treated with 
2-4 (mostly 3) weekly low-dose intravenous pulses of cyclophosphamide (500 mg)
and moderate doses of prednisolone (0.5 mg/kg/day), followed by an oral
immunosuppressive drug (either azathioprine or cyclophosphamide). As compared
with the classical monthly high-dose cyclophosphamide regimen, this weekly
low-dose regimen induced neutropenia in one patient only. The incidence of herpes
zoster was very low (6%). At the end of the follow-up period (15 +/- 8 months),
two patients required chronic ambulatory peritoneal dialysis. The 14 patients
that could be evaluated improved their mean serum albumin from 30 +/- 7 to 37.5
+/- 7 g/l (mean +/- SD; P < 0.01) and their mean serum creatinine fell from 125
+/- 119 to 101 +/- 66 mumol/l (not significant). Mean DNA binding dropped from 71
+/- 29 to 26 +/- 27% (P < 0.001) and mean complement fraction C4 levels increased
from 14 +/- 8 to 28 +/- 18 mg/dl (P < 0.05). The mean daily prednisolone dose was
dramatically reduced from 26 +/- 8 to 10 +/- 4 mg (P < 0.001). Although this
preliminary and retrospective study clearly needs validation with a larger cohort
followed for a longer period, it seems that a treatment combining moderate doses 
of steroids and 3-4 weekly low-dose intravenous pulses of cyclophosphamide,
followed by oral immunosuppression, is well tolerated and beneficial--at least in
the short term--for most patients with severe lupus nephritis.

PMID: 1845361 [PubMed - indexed for MEDLINE]

5585: Infection. 1991 Nov-Dec;19(6):401-5.

Antiviral therapy of varicella-zoster virus infection in immunocompromised
children--a prospective randomized study of aciclovir versus brivudin.

Heidl M, Scholz H, Dorffel W, Hermann J.

Institut fur Infektionskrankheiten im Kindesalter, Jena, Germany.

Both aciclovir and brivudin are effective in the treatment of immunocompromised
children with varicella-zoster virus infection. To determine which drug is
preferable, a prospective randomized trial aciclovir vs. brivudin was conducted. 
Forty-three immunocompromised children were randomly assigned to receive
aciclovir intravenously at a dose of 1,500 mg/m2/d and brivudin orally at a dose 
of 15 mg/kg/d, respectively. Twenty-two patients were treated with aciclovir and 
21 with brivudin. In all children the general status improved within two days.
The eruption of new lesions stopped within one to five days, fever stopped within
one to nine days, complete remission occurred within five to six days after
introduction of the virustatic therapy. There was no difference in therapeutic
efficacy between aciclovir and brivudin. Two children in each group did not
respond to the medication. No myelo-, hepato- and nephrotoxic side effects due to
aciclovir or brivudin were observed. All obviously immunocompromised children
with varicella or zoster may be treated with aciclovir or brivudin.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 1816110 [PubMed - indexed for MEDLINE]

5586: Rinsho Shinkeigaku. 1991 Nov;31(11):1245-7.

[Monoparesis due to the brachial plexus neuritis by herpes zoster virus--report
of a case]

[Article in Japanese]

Ohtake T, Komori T, Hirose K, Tanabe H.

Department of Neurology, Tokyo Metropolitan Neurological Hospital.

A 73-year-old woman suffering from the acute onset monoparesis of her right arm
which followed the skin eruption with mild sensory disturbance of right C4-6
level, was reported. Electrophysiological examinations revealed the brachial
plexus neuritis and axonal degeneration of the proximal portion, with the
evidence of herpes zoster infection. Her paresis of the right arm gradually
improved without any medication during her hospital course. It was concluded that
herpes zoster should be considered to be one of the causes of acute onset
brachial plexopathy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1813197 [PubMed - indexed for MEDLINE]

5587: J Parodontol. 1991 Nov;10(4):359-69.

Aggressive periodontal destruction and herpes zoster in a suspected AIDS patient.

[Article in English, French]

Moskow BS, Hernandez G.

Center for Clinical Research in Dentistry, School of Dental and Oral Surgery,
Columbia University, New York, N.Y.

An unusual case of spontaneous and rapidly destructive lesions involving the
periodontal structures is described in a 54 year old, bi-sexual patients
suspected of having AIDS. Concomitant with the periodontal breakdown, the patient
developed a severe case of Herpes Zoster involving the area of the face
innervated by the 5th cranial nerve. The dermal lesions involved the face, nose, 
eyes and scalp. Similar lesions were noted on the gingival and palatal mucosa on 
the same side of the jaw as the skin lesions. The differences between this type
of periodontal destruction and more conventional forms of periodontitis are
discussed.

Publication Types: 
    Case Reports

PMID: 1811045 [PubMed - indexed for MEDLINE]

5588: Physiol Behav. 1991 Nov;50(5):1027-31.

A taste illusion: taste sensation localized by touch.

Todrank J, Bartoshuk LM.

Psychology Department, University of Pennsylvania, Philadelphia 19104.

Taste sensations appear to come from all over the inner surface of the mouth, yet
the taste receptors are restricted to relatively small particular areas of the
oral surface. In addition, even if a relatively large (e.g., one half) proportion
of the taste field is damaged, subjective taste experience may be unaffected. The
touch system contributes to this constancy because taste sensations appear to be 
localized by touch. If a taste solution is painted from the side of the tongue
(an area of low receptor density) past the tip (an area of high receptor density)
and on to the second side, the taste sensation begins weak, gets stronger at the 
tip, and retains much of its intensity. The strong taste from the tip follows the
tactile path of the stimulus sweep. This illusion occurs for all four stimuli
tested: sucrose, sodium chloride, citric acid, and quinine hydrochloride.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1805264 [PubMed - indexed for MEDLINE]

5589: J Am Acad Dermatol. 1991 Nov;25(5 Pt 1):852-4.

Phaeohyphomycosis caused by Exserohilum rostratum mimicking hemorrhagic herpes
zoster.

Tieman JM, Furner BB.

Division of Dermatology, University of Texas Health Science Center, San Antonio
78284-7876.

Publication Types: 
    Case Reports

PMID: 1802911 [PubMed - indexed for MEDLINE]

5590: Nippon Ronen Igakkai Zasshi. 1991 Nov;28(6):837-8.

[Herpes zoster associated encephalitis with rapid response to a combination
therapy with acyclovir, prednisolone and human gamma-globulin]

[Article in Japanese]

Toyoda H, Tomeoku M, Fujioka H, Hamada M, Kanamaru M.

Publication Types: 
    Case Reports

PMID: 1795448 [PubMed - indexed for MEDLINE]

5591: Nippon Ronen Igakkai Zasshi. 1991 Nov;28(6):817-22.

[An elderly case of systemic lupus erythematosus associated with herpes zoster,
anemia, and hemiparesis]

[Article in Japanese]

Hashizume K, Sato M, Saeki S, Takamoto S, Mino Y, Onishi T.

Department of Internal Medicine, Hanwa-Senboku Hospital.

An elderly case of systemic lupus erythematosus (SLE) with suspected hemolytic
anemia was experienced. A 70 year-old female was admitted to our hospital on
December 31 with complaints of herpetic eruption. She complained of arthralgia
since 3 month prior to her admission. The positive findings on examination were
skin eruption in the left chest, a systolic heart murmur and a palpable elastic
hard liver. Laboratory data showed raised erythrocyte sedimentation rate of 149
mm per hour, decreased Hb (10.1 g/dl), decreased hematocrit (30.0%), increased
reticulocytes (33%1000), decreased thrombocytes (73,000/mm3), increased
gamma-globulin (33%) and positive rheumatoid factor. During admission, she
developed anemia. A stool test for occult blood was negative. The haptoglobin was
38.8 mg/dl and bone marrow aspiration showed increased erythropoiesis, suggesting
features of immune hemolytic anemia, except she was negative on Coomb'test. Eye
fundi were similar to case of typical bleeding observed in SLE. Concerning
immunological findings, the antinuclear factor was x 1280 and the anti-dsDNA
antibody was x 80, on which a diagnosis of SLE was based. She experienced
numbness of the left arm and developed left hemiparesis 2 days later. Therapy
with 15 mg/day prednisone obtained a good response and anemia, abnormal
immunological findings and hemiparesis disappeared.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1795445 [PubMed - indexed for MEDLINE]

5592: Rev Med Interne. 1991 Nov-Dec;12(6):419-23.

[Human immunodeficiency virus infection in patients over 60 years of age. A
cohort study of 31 patients followed-up at the Regional University Hospital
Center of Bordeaux]

[Article in French]

Dupon M, Bismuth MJ, Parneix P, Morlat P, Malou M.

Centre Hospitalier Regional et Universitaire, Bordeaux.

Thirty-one patients aged 60 years or more and infected with the human
immunodeficiency virus type 1 (HIV-1) were followed up retrospectively and
prospectively at the Regional University Hospital of Bordeaux. These patients
represented 2.3 percent of all HIV infected patients followed up by the AIDS
Clinical Epidemiology Group of Aquitaine. The male-to-female sex ratio was 1.4/1.
Contamination resulted from blood transfusion in 58 percent of the cases. In 45.2
percent of these patients the belated diagnosis was revealed by a pathology
pointing to AIDS. The most frequent clinical signs were candidiasis, herpes
zoster or neurological manifestations which created a difficult differential
diagnosis problem with senile dementia. The prognosis of the HIV infection was
severe, with a 39.7 percent probability of survival at 18 months (confidence
limits 95 percent: 18.6%, 60.8%). This prognosis could be improved by an earlier 
diagnosis and by a treatment suitable for elderly people.

Publication Types: 
    English Abstract

PMID: 1792431 [PubMed - indexed for MEDLINE]

5593: Kansenshogaku Zasshi. 1991 Nov;65(11):1389-93.

[Herpes zoster in connective tissue diseases: II. Rheumatoid arthritis and mixed 
connective tissue disease in comparison with systemic lupus erythematosus]

[Article in Japanese]

Yamauchi Y, Nagasawa K, Tada Y, Tsukamoto H, Yoshizawa S, Mayumi T, Niho Y,
Kusaba T.

First Department of Internal Medicine, Faculty of Medicine, Kyushu University.

We investigated the incidence of herpes zoster (HZ) and the immunological state
to HZ in patients with rheumatoid arthritis (RA) and mixed connective tissue
disease (MCTD) in comparison with systemic lupus erythematosus (SLE). HZ occurred
in 6 (25%) out of 24 patients with RA and 4 (22%) out of 18 patients with MCTD.
One patient had had HZ before the diagnosis of RA. On the other hand, all 4
patients with MCTD had had HZ before the diagnosis of MCTD. The patients with RA 
and MCTD showed normal or higher antibody titers to varicella zoster virus (VZV) 
than normal subjects as assayed by both complement fixation technique and
neutralization test. However, the antibody levels were not very high compared to 
those in patients with SLE. On the other hand, only 7 (50%) of 14 patients with
RA and 4 (40%) of 10 patients with MCTD showed positive skin reactions to VZV
antigen, whereas all 15 normal subjects had positive reactions. Thus, cellular
immunity to VZV was thought to be impaired in these diseases. In the patients who
were receiving less than 10 mg/day of prednisolone, 7 (64%) of 11 had positive
skin reactions in RA patients and 3 (60%) out of 5 patients with MCTD, whereas
none (0%) out of 3 patients with RA and 1 (20%) out of 5 patients with MCTD who
were receiving 10 mg/day or more prednisolone showed positive skin reactions.
These results suggest that the high incidence of HZ in patients with RA and MCTD 
is probably due to an impaired cellular immunity as in the case of SLE.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 1791339 [PubMed - indexed for MEDLINE]

5594: Vestn Otorinolaringol. 1991 Nov-Dec;(6):33-5.

[Herpes zoster oticus]

[Article in Russian]

Nikitin KA.

In 1985-89, 8 patients with Herpes zoster oticus were examined in the ENT
department of the First Leningrad Medical Institute named after I.P. Pavlov. All 
the patients were treated, taking into consideration the severity of injury of
cerebrocranial nerves. It is emphasized that the pathology may have many clinical
forms and that it deserves special attention in AIDS diagnosis.

Publication Types: 
    English Abstract

PMID: 1788891 [PubMed - indexed for MEDLINE]

5595: Khirurgiia (Mosk). 1991 Nov;(11):118-22.

[Erroneous laparotomy in emergency surgery]

[Article in Russian]

Magdiev TSh, Kuznetsov VD, Shipilov VA, Severinko NV.

The authors studied the data concerning 101 patients who had undergone erroneous 
laparotomy for suspected acute surgical disease; these accounted for 0.4% of all 
the patients who were operated on for emergency indications in the same period.
Eleven patients died. The operation was undertaken for an erroneous diagnosis of 
acute appendicitis (32 patients), acute cholecystitis (18), perforating gastric
ulcer (15), peritonitis of unknown etiology (14), acute intestinal obstruction
(5), strangulated hernia (3), destructive pancreatitis (3), tumor of the large
intestine complicated by obstruction (3), abdominal abscess (2), thrombosis of
the mesenteric vessels (1), ovarian apoplexy (1), closed abdominal trauma with
injury to the viscera (4 patients). Diseases simulating the clinical picture of
"acute abdomen" but not requiring an emergency operation were as follows: female 
reproductive (20 patients), pancreatic (11), renal diseases (11), hepatitis,
cirrhosis of the liver (10), cardiovascular (9), pulmonary diseases (5),
mesoadenitis (5), Crohn's disease (3), chronic colitis (3), carcinomatosis of the
peritoneum (3), herpes zoster (3), and other diseases and injuries (20 patients).
The main causes of the diagnostic and tactical errors were objective difficulties
in the differential diagnosis due to similar symptomatology, as well as errors in
the examination of the patient and haste in making a decision to make an
operation.

Publication Types: 
    English Abstract

PMID: 1779533 [PubMed - indexed for MEDLINE]

5596: Rinsho Ketsueki. 1991 Nov;32(11):1481-5.

[Primary myelofibrosis transforming into multiple subcutaneous monoblastoma--a
case report]

[Article in Japanese]

Hamamoto K, Taniguchi H, Ohga S, Nagano T, Kishimoto Y, Kitajima H, Fujimoto M,
Kimura T, Fujitake H, Yasunaga K.

First Department of Internal Medicine, Kansai Medical University.

A 83-year-old man was diagnosed with primary myelofibrosis based on the presence 
of leukoerythroblastosis, splenomegaly, chromosome 46 XY, a dry tap bone marrow
aspiration and fibrosis on bone marrow biopsy, when he was admitted for herpes
zoster in June 1987. He was admitted for a second time with multiple subcutaneous
tumors over his entire body in July, 1989. He had mild splenomegaly, but no
hepatomegaly nor lymphadenopathy. Laboratory tests were as follows: RBC 214 x
10(4)/microliters, Hb 5.1 g/dl, Ht 17.7%, WBC 3,200/microliters with
leukoerythroblastosis, platelets 11.6 x 10(4)/microliters, s-lysozyme 251
micrograms/ml, u-lysozyme 770 micrograms/ml, NAP ratio 98%, score 278. Bone
marrow aspiration resulted in a dry tap. Bone marrow biopsy showed marked
fibrosis. Histologic examination of subcutaneous tumor biopsy specimens revealed 
a diffuse infiltration of monocytes with flexuous nuclei. These cells were
positive for alpha-naphtyl butyrate esterase stain, and negative for peroxidase, 
alpha-naphtol ASD chloroacetate esterase stain and platelet glycoprotein IIb/IIIa
stain (APAAP). Ultrastructurally, these cells were mostly monocytes and
promonocytes, while phenotypically, CD11b, CD13, CD14, CD33 and HLA-DR were
positive. These date indicated that the subcutaneous tumors originated from
monocytes.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1758057 [PubMed - indexed for MEDLINE]

5597: Virology. 1991 Nov;185(1):56-66.

Nucleotide sequence and transcriptional mapping of the major capsid protein gene 
of pseudorabies virus.

Yamada S, Imada T, Watanabe W, Honda Y, Nakajima-Iijima S, Shimizu Y, Sekikawa K.

National Institute of Animal Health, Ibaraki, Japan.

The gene encoding the 142-kDa major capsid protein (MCP142) of pseudorabies virus
(PrV) was isolated and sequenced. Nucleotide sequence analysis revealed that the 
MCP142 gene has a single open reading frame of 3993 nucleotides (nt) encoding
1330 amino acids. The 4400-nt major RNA from the MCP142 gene was detected in
PrV-infected cells. The 5' end of the transcript was located 60 nt upstream of
the initiation codon. The 3' end of the transcript was located 18 nt downstream
of a putative poly(A) signal sequence TATAAA and 133 nt downstream of the
termination codon. In comparing amino acid sequence homology between MCP142 of
PrV and other available herpesviruses MCP was shown to have 58% homology with
herpes simplex virus type 1 and varicella-zoster virus, 27% with Epstein-Barr
virus, and 24% with human herpesvirus 6 and human cytomegalovirus. It has greater
homology with those of the alpha-herpesviruses than with those of the
beta-herpesviruses and the gamma-herpesviruses.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 1718089 [PubMed - indexed for MEDLINE]

5598: Med Hypotheses. 1991 Nov;36(3):206-10.

Are recurrent oral aphthous ulcers of viral etiology?

Pedersen A.

Dental Department, University Hospital-Rigshospitalet, Copenhagen, Denmark.

The etiology of recurrent oral aphthous ulcers (RAU) remains unsolved. The
present article relates previous immunopathologic findings in RAU to a possible
viral etiopathogenesis with special reference to the herpes virus family. It is
concluded that RAU might be of viral etiology, and it is furthermore speculated
that the aphthous ulcers may be the clinical manifestation of 'latent'
varicella-zoster virus reactivation (reinfection).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1664908 [PubMed - indexed for MEDLINE]

5599: Rev Infect Dis. 1991 Nov-Dec;13 Suppl 11:S960-3.

Glycoproteins of varicella-zoster virus and their herpes simplex virus homologs.

Grose C.

Department of Pediatrics, University of Iowa College of Medicine, Iowa City.

This report describes the glycoproteins of varicella-zoster virus (VZV) and their
role as immunogens and discusses the relevance of studies of VZV to the selection
of a glycoprotein subunit herpes simplex virus (HSV) vaccine. HSV types 1 and 2
and VZV are alpha-herpesviruses, which are characterized by common biologic
features such as a relatively short replication cycle and a latent state, often
in neurologic tissues. The three viruses also conserve several glycoprotein
genes, including gB, gC, gE, gH, and gI. The known properties of the VZV
glycoproteins closely resemble those of their homologous HSV counterparts and may
provide further insight into biologic functions of the immunogens. In particular,
VZV glycoproteins gpII and gpIII closely resemble their HSV homologs gB and gH in
that all four harbor complement-independent neutralization epitopes.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1664135 [PubMed - indexed for MEDLINE]

5600: N Engl J Med. 1991 Oct 17;325(16):1178-9.

Acute renal failure and coma after a high dose of oral acyclovir.

Eck P, Silver SM, Clark EC.

Publication Types: 
    Case Reports
    Letter

PMID: 1891032 [PubMed - indexed for MEDLINE]

5601: Ann Rheum Dis. 1991 Oct;50(10):706-9.

Serum soluble interleukin 2 receptor in systemic lupus erythematosus: effects of 
disease activity and infection.

Wong KL, Wong RP.

Department of Medicine, Queen Mary Hospital, University of Hong Kong.

Serum soluble interleukin 2 receptor (sIL2R) was measured in patients with active
and inactive systemic lupus erythematosus (SLE). The concentration of sIL2R was
higher in inactive SLE than in normal controls and was significantly increased in
active compared with inactive SLE. When patients with active SLE were followed up
serially it was found that the sIL2R concentration fell when the disease became
inactive. There was no statistically significant association between sIL2R and
the grades of disease activity, however. In patients with either active or
inactive SLE and infection the sIL2R concentration was much higher than in those 
without infection. Chronic infection (tuberculosis or candida) was associated
with a much higher concentration of sIL2R than pyogenic or herpes zoster
infection. The sIL2R concentration helps to distinguish infection in patients
with SLE.

PMID: 1958094 [PubMed - indexed for MEDLINE]

5602: Neurology. 1991 Oct;41(10):1685-6.

A case of C2 herpes zoster with delayed bilateral pontine infarction.

Ross MH, Abend WK, Schwartz RB, Samuels MA.

Division of Neurology, Brigham and Women's Hospital, Boston, MA 02115.

Publication Types: 
    Case Reports

PMID: 1922821 [PubMed - indexed for MEDLINE]

5603: Geriatrics. 1991 Oct;46(10):64-6, 69-71.

Ophthalmic herpes zoster: diagnosis and antiviral therapy.

Liesegang TJ.

Mayo Medical School, Mayo Clinic Jacksonville, Jacksonville, FL.

Elderly patients, whether of normal or depressed immune status, are at increased 
risk of herpes zoster infection. Ocular complications occur in 50% of patients
with zoster that reactivates in the ophthalmic division of the trigeminal
ganglion. Early intervention with high-dose oral acyclovir has been effective in 
preventing many of these complications, while reducing the duration of the acute 
infection. Postherpetic neuralgia remains a difficult therapeutic problem, and
options are offered.

Publication Types: 
    Review

PMID: 1916303 [PubMed - indexed for MEDLINE]

5604: Acta Neurol Scand. 1991 Oct;84(4):344-7.

Abdominal muscle paralysis associated with herpes zoster.

Gottschau P, Trojaborg W.

Medical Department, Roskilde County Hospital, Koge, Denmark.

We describe a 77-year-old women with cutaneous herpes zoster in the area of the
right T9-T11 dermatomes complicated by abdominal muscle paralysis. Four months
after onset of paralysis, stimulation of appropriate intercostal nerves failed to
evoke responses from the corresponding segments of the rectus abdominis muscle.
Three months later EMG of these muscle segments revealed profuse denervation
activity and spontaneous long-lasting burst of high frequency discharges.
Magnetic stimulation applied transcranially and peripherally at T10 evoked
responses from the left, but not from the right paralytic rectus abdominis
muscle. Electric stimulation of right T10 elicited a markedly delayed, prolonged 
and polyphasic response in the transverse abdominis muscle and EMG revealed
polyphasia and increased motor unit potential duration in muscle segments
underlying herpes zoster eruption. One and a half years after onset, the
paralysis of the rectus abdominis muscle was still present. A survey of the
literature concerning this rare type of zoster paralysis is presented.

Publication Types: 
    Case Reports

PMID: 1837649 [PubMed - indexed for MEDLINE]

5605: Q J Med. 1991 Oct;81(294):857-70.

Neurological manifestations of systemic lupus erythematosus: a prospective study.

Wong KL, Woo EK, Yu YL, Wong RW.

University Department of Medicine, Queen Mary Hospital, Hong Kong.

A prospective study of the neurological manifestations in all patients with
systemic lupus erythematous (SLE) was conducted between February 1985 to January 
1989. Excluding herpes zoster infection of peripheral or cranial nerves,
post-herpetic neuralgia and migraine, 36 neurological episodes occurred in 33
patients. The presenting symptoms were mental confusion (10), psychosis (five),
seizures (six), focal neurological deficit (three), coma (two), headache (five), 
blurring of vision (three), neuropathy (one) and myelopathy (one). Of these
manifestations, only eight episodes were due to primary involvement by SLE:
psychosis (two), seizure (two), multiple cerebral infarcts (one), papillitis
(one), neuropathy (one) and myelopathy (one). Infection was the most common
secondary cause of neurological episodes: all 10 episodes of mental confusion
(fungal seven, pyogenic two, tuberculous one, nocardial one); two of six seizures
(tuberculous one, pyogenic one); all five headaches (tuberculous meningitis
three, cryptococcal meningitis two). The other secondary causes included steroid 
psychosis (two), hypertensive encephalopathy with seizure (one) and hypertensive 
retinopathy (one). Three of five cases of focal neurological deficit were due to 
macrovascular disease rather than to vasculitic infarction. We concluded that
cerebral psychosis was a relatively rare presentation in our patients with SLE.
In patients who presented with a neurological problem, especially mental
confusion, efforts should be made to ascertain the underlying cause, especially
if this may be an infection.

PMID: 1801058 [PubMed - indexed for MEDLINE]

5606: J Dermatol. 1991 Oct;18(10):613-5.

Trigeminal trophic syndrome--a report of three patients.

Tada J, Ueda M, Abe Y, Fujiwara H, Arakawa K, Arata J.

Department of Dermatology, Okayama University Medical School, Japan.

Three Japanese patients with trigeminal trophic syndrome, a rare dermatosis in
Japan, were reported. Cutaneous lesions were a long-standing ulcer and
destruction of the right ala nasi in case 1, a persistent deep ulceration on the 
forehead after a small trauma in case 2, and development of small, discrete
ulcers on the right forehead during the treatment of a postherpetic neuralgia in 
case 3. A protective device was very effective in one patient.

PMID: 1791243 [PubMed - indexed for MEDLINE]

5607: Bone Marrow Transplant. 1991 Oct;8(4):245-51.

Influence of total body irradiation on infections after autologous bone marrow
transplantation.

Callum JL, Brandwein JM, Sutcliffe SB, Scott JG, Keating A.

University of Toronto Autologous Bone Marrow Transplant Program, Toronto
Hospital, Canada.

Infectious complications were analysed in 50 consecutive autologous bone marrow
transplant (ABMT) patients treated with high dose etoposide and melphalan, 30 of 
whom also received total body irradiation (TBI). Fever developed in 44 patients
and bacteremia was documented in 13 (26%). Patients given TBI had increased
susceptibility to bacteremia; 11 of 30 patients who received TBI had positive
blood cultures, in contrast to two of the 20 who did not (p = 0.035). In
addition, patients who received TBI had significantly more severe diarrhea (p =
0.037) when compared with those who received chemotherapy alone. Thirty-five
patients treated with trimethoprim-sulfamethoxazole prophylaxis had a
signficantly lower incidence of gram-negative bacteremia (p = 0.024). However,
when those patients who received trimethoprim-sulfamethoxazole until neutrophil
recovery were analysed alone, those who were also given TBI still had
significantly more bacteremia (p = 0.047). Forty-seven patients with follow-up of
more than 12 months are available for analysis of varicella zoster (VZV)
infections. Of the 29 patients who received TBI, 11 (38%) developed VZV
infections, in contrast to one of 18 patients (6%) treated with chemotherapy
alone (p = 0.013). These results suggest that addition of TBI to the intensive
therapy regimen for ABMT is associated with significantly more bacteremia and
late VZV infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1756321 [PubMed - indexed for MEDLINE]

5608: Jpn J Clin Oncol. 1991 Oct;21(5):372-6.

Severe herpes simplex virus hepatitis following autologous bone marrow
transplantation: successful treatment with high dose intravenous acyclovir.

Hayashi M, Takeyama K, Takayama J, Ohira M, Tobinai K, Shimoyama M.

Hematology-Oncology and Medical Oncology Division, National Cancer Center
Hospital, Tokyo.

A 17-year-old male patient with T-cell type lymphoblastic lymphoma in complete
remission underwent high dose chemotherapy (busulfan 16 mg/kg and
cyclophosphamide 120 mg/kg) followed by autologous bone marrow transplantation
(ABMT). The patient had been taking oral acyclovir (200 mg x 5) daily from seven 
days prior to the ABMT (day -7). On day +24, he complained of epigastralgia and
general malaise, and the next day his GOT and GPT rose to 570 U/l and 397 U/l,
respectively. Although he had no mucocutaneous lesions, hepatitis caused by a
herpes virus was suspected, and high dose intravenous acyclovir (10 mg/kg x
3/day) was immediately started. His GOT, GPT and total bilirubin reached peaks of
2,870 U/l on day +26, 1,830 U/l on day +27 and 10.3 mg/dl on day +39,
respectively, and rapidly improved thereafter. Serological analyses on IgG
antibody titers to herpes simplex virus type 1 using an enzyme-linked
immunosorbent assay revealed specific increases (454-fold before transplantation 
to 3,830-fold on day +46). Antiviral antibody titers to cytomegalovirus,
varicella-zoster virus and Epstein-Barr virus showed no significant changes. The 
serologic markers of hepatitis B virus, hepatitis A virus and hepatitis C virus
were all negative. The results indicate the patient's severe icteric hepatitis to
have been caused by a reactivation of herpes simplex virus type 1 due to
immunosuppression after high dose chemotherapy with ABMT. It is suggested that
prompt commencement of high dose intravenous acyclovir is required to treat
severe herpes simplex virus hepatitis affecting immunocompromised patients.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 1753418 [PubMed - indexed for MEDLINE]

5609: Clin Dermatol. 1991 Oct-Dec;9(4):497-503.

Capsaicin and substance P.

Bernstein JE.

GenDerm Corporation, Lincolnshire, IL 60069.

Publication Types: 
    Review

PMID: 1726584 [PubMed - indexed for MEDLINE]

5610: DICP. 1991 Oct;25(10):1077-9.

Topical aspirin for postherpetic neuralgia.

Brady SI, Middleton RK.

School of Pharmacy, University of California, San Francisco 94143.

Publication Types: 
    Comparative Study
    Review

PMID: 1725080 [PubMed - indexed for MEDLINE]

5611: Anaesthesist. 1991 Oct;40(10):523-9.

[The treatment of zoster neuralgia]

[Article in German]

Wulf H, Maier C, Schele HA.

Klinik fur Anaesthesiologie und operative Intensivmedizin, Kiel.

Neuralgic pain during or following herpes zoster infection is a common problem in
pain therapy. The current management of neuralgias due to zoster is discussed
with reference to patients in a chronic pain clinic within an anesthesiology
department. The courses of 80 patients followed up for at least 3 months from the
pain clinic at the University Hospital in Kiel were analyzed. The mean age was 69
years. The predominant locations for zoster lesions were the thoracic segments
(65%) and the first branch of the trigeminal nerve (19%). Diabetes mellitus was
present in 20% of the patients and malignant disease in 18%. In 2 patients
recurrent postherpetic neuralgia was the first symptom of HIV infection. Despite 
pretreatment, the mean initial pain score was 8 on an analog scale (range 0-10). 
Acute herpes zoster pain during the infection was treated with virustatic agents,
corticosteroids and sympathetic blocks. Postherpetic neuralgias required a more
sophisticated approach, depending on the stage of the disease and the type of
pain involved: sympathetic blockade with local anesthetic agents or injections of
very low dose opioids to sympathetic ganglia, transcutaneous electrical nerve
stimulation, and antidepressants or anticonvulsants. The success of the therapy
is correlated with the duration of pain. If the history of zoster pain was less
than 1 month, the majority of patients showed good or excellent results. On the
other hand, only one-third of patients with a history longer than 6 months had
adequate pain relief. Therefore, early and appropriate treatment is desirable for
patients suffering from zoster neuralgias.

Publication Types: 
    English Abstract

PMID: 1684093 [PubMed - indexed for MEDLINE]

5612: Enferm Infecc Microbiol Clin. 1991 Oct;9(8):514.

[Aseptic meningitis caused by varicella-zoster virus. Isolation of the virus from
CSF]

[Article in Spanish]

Falco V, Alegre J, Garcia A, Fernandez de Sevilla T.

Publication Types: 
    Case Reports
    Letter

PMID: 1666842 [PubMed - indexed for MEDLINE]

5613: Antiviral Res. 1991 Oct;16(3):227-32.

Suppression of ocular herpes recurrences by a thymidine kinase inhibitor in
squirrel monkeys.

Kaufman HE, Varnell ED, Cheng YC, Bobek M, Thompson HW, Dutschman GE.

Lions Eye Research Laboratories, Louisiana State University Medical Center,
School of Medicine, New Orleans.

5'-Ethynylthymidine, an inhibitor of viral thymidine kinase (TK), was given
intraperitoneally to squirrel monkeys previously infected by the ocular route
with Rodanus strain herpes simplex virus. Spontaneous ocular recurrences were
reduced during therapy, compared to saline-treated controls. This is the first in
vivo demonstration that a viral TK inhibitor can reduce recurrences of HSV-1.
Similar benefit would be expected for HSV-2 and perhaps VZV (varicella zoster
virus).

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1666825 [PubMed - indexed for MEDLINE]

5614: J Med Virol. 1991 Oct;35(2):136-41.

Diagnosis of acute and latent varicella-zoster virus infections using the
polymerase chain reaction.

Dlugosch D, Eis-Hubinger AM, Kleim JP, Kaiser R, Bierhoff E, Schneweis KE.

Institute of Medical Microbiology and Immunology, University of Bonn, Germany.

A simplified assay for the diagnosis of varicella-zoster virus (VZV) infections
based on the polymerase chain reaction (PCR) is described. Omitting the
procedures for extraction and purification of DNA, the crude vesicle fluid
materials were used for PCR. Moreover, hybridization was not necessary for
detection of the amplification products because they were already visible after
ethidium bromide staining of the electrophoresis gel. Results could therefore be 
obtained within one day. In comparison to virus isolation, PCR proved much more
rapid, highly sensitive, and specific. DNA extraction and a double PCR assay with
nested primers were necessary for detection of latent VZV infections in
trigeminal and thoracic ganglia. The data suggest that the procedures described
are universally applicable to several types of specimens dependent on the
calculated amount of target DNA.

Publication Types: 
    Comparative Study

PMID: 1662705 [PubMed - indexed for MEDLINE]

5615: Mol Gen Mikrobiol Virusol. 1991 Oct;(10):13-6.

[Detection of herpes simplex virus by DNA-DNA hybridization method]

[Article in Russian]

Diorditsa SV, Zaitsev IZ, Mal'tseva NN, Ebralidze LK.

Eight recombinant clones were obtained by insertion of BamHI fragments of herpes 
simplex type I viral DNA into a vector plasmid pUC19o. Of the obtained clones 5
were found to hybridize with herpes simplex type I and 2 viral DNA while 3 clones
revealed a positive reaction with the Vero cells DNA. A constructed DNA-probe
possessing the highest level of activity was selected for further studies. The
probe is a BamHI fragment of herpes simplex type I viral DNA labelled with 32P
dTTP. Probe sensitivity in blot hybridization is 10 pg for identification of type
I viral DNA and 50 pg for type 2 viral DNA. The DNAs of cytomegalovirus and
herpes zoster virus do not show positive signals with the probe. The increased
sensitivity of the used dot hybridization as compared with biological or IEA
antigen identification of the virus was confirmed with the clinical material from
59 patients with the different clinical manifestations of the herpes viral
infection.

Publication Types: 
    English Abstract

PMID: 1661848 [PubMed - indexed for MEDLINE]

5616: J Virol Methods. 1991 Oct;34(3):273-89.

Improved detection of HSV by electron microscopy in clinical specimens using
ultracentrifugation and colloidal gold immunoelectron microscopy: comparison with
viral culture and cytodiagnosis.

Folkers E, Vreeswijk J, Oranje AP, Wagenaar F, Duivenvoorden JN.

Department of Dermatology and Venereology, Hospital De Heel, Zaandam, The
Netherlands.

Three tests were compared to diagnose herpes virus infection: electron microscopy
(EM), viral culture (VC) and cytodiagnosis (Tzanck smear). The study comprised 67
patients with skin or mucous membrane lesions suggestive of herpes simplex virus 
(HSV) infection. The sensitivity of EM increased 25% after virus concentration by
ultracentrifugation. Herpes virus infection was confirmed in 55 of the 67 cases
by EM or VC or both. EM detected 53 herpes virus-positive lesion samples of which
14 were not detected by VC; only two lesion samples that were herpes
virus-positive in VC were not detected by EM. The sensitivities of EM, VC, and
Tzanck smear for the group of 55 herpes virus-positive cases were 96%, 75% and
76%, respectively. The specificity of the Tzanck smear was 83% (prevalence 82%). 
Colloidal gold immuno-EM was used to rapidly type HSV-1, HSV-2 and varicella
zoster virus (VZV) present in skin and mucous membrane lesions in less than 4 h. 
Immuno-EM was able to detect antiviral antibodies on viral envelopes and viral
cores in lesion samples with negative VC. Antiviral antibodies do not interfere
with typing of herpes viruses by immuno-EM. It is suggested that formation of
viral immune complexes and inactivation of virus particles by antibodies may have
caused a negative VC. Improved EM is discussed for its applicability to special
cases that cannot rely on VC and cytodiagnosis or when rapid diagnosis is
required.

Publication Types: 
    Comparative Study

PMID: 1660490 [PubMed - indexed for MEDLINE]

5617: J Virol. 1991 Oct;65(10):5597-604.

Identification of the human herpesvirus 6 glycoprotein H and putative large
tegument protein genes.

Josephs SF, Ablashi DV, Salahuddin SZ, Jagodzinski LL, Wong-Staal F, Gallo RC.

Laboratory of Tumor Cell Biology, National Cancer Institute, Bethesda, Maryland
20892.

Determination of the nucleotide sequences of two molecular clones of human
herpesvirus 6 (HHV-6) (strain GS) and comparison with those of human
cytomegalovirus (HCMV) has allowed the identification of the genes for the
glycoprotein H (gH) and the putative large tegument protein of HHV-6. Two
molecular clones of fragments of HHV-6, the BamHI-G fragment (7,981 bp) of the
clone termed pZVB43 and a HindIII fragment (8,717 bp) of the clone termed pZVH14,
represent approximately 10% of the HHV-6 genome (16,689). An open reading frame
within the BamHI-G fragment was designated the gH gene of HHV-6 because of the
extensive sequence similarity of its predicted product (79,549 Da) to the HCMV gH
gene product. The predicted product (239,589 Da) of an open reading frame within 
clone pZVH14 showed homology to the predicted product of the proposed gene of
HCMV representing the large tegument protein. Computer analyses indicated a
closer relationship of the predicted peptides of these HHV-6 genes to those of
HCMV than to those of the other human herpesviruses Epstein-Barr virus, herpes
simplex virus type 1, and varicella-zoster virus. The gH gene was more conserved 
among the human herpesvirus group, while significant sequence similarity of the
tegument gene could be found only with that of HCMV. The data reported here with 
one conserved gene (gH) and a more divergent gene (tegument) support previous
reports that HHV-6 and HCMV are more closely related to each other than to the
other well-characterized human herpesviruses.

Publication Types: 
    Comparative Study

PMID: 1654455 [PubMed - indexed for MEDLINE]

5618: J Virol. 1991 Oct;65(10):5289-96.

Erratum in:
    J Virol 1995 Apr;69(4):2723.

Characterization of a potent varicella-zoster virus-encoded trans-repressor.

Nagpal S, Ostrove JM.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

Using a transient expression assay in Vero cells, we have shown that the protein 
product from gene 61 of varicella-zoster virus (VZV) can repress the function of 
the VZV encoded trans-activators on putative viral immediate-early, early, and
late gene promoters. The repression is exerted at the transcriptional level and
requires functional gene 61 protein. This trans-repressor is the herpes simplex
type 1 ICP0 (a trans-activator) homolog, as defined by gene location, the sharing
of a cysteine-rich putative zinc-binding finger in the amino-terminal region, and
limited amino acid homology. Open reading frame 61 (ORF61)-mediated
trans-repression appears to be specific for VZV-encoded trans-activators in that 
it has no effect on simian virus 40 and Rous sarcoma virus promoters. Moreover,
it does not inhibit trans-activation of the human T-lymphotropic virus type I and
human immunodeficiency virus long terminal repeats by tax and tat genes,
respectively. We constructed plasmids with mutations in ORF61 and tested them for
their ability to inhibit trans-activator (VZV genes 4 and 62)-mediated activation
of the viral thymidine kinase promoter-chloramphenicol acetyltransferase
construct. Mutants containing interruptions in ORF61 lost their trans-repressing 
ability, as demonstrated at both the protein and steady-state RNA levels. These
results suggest that the ORF61 protein product can mediate down-regulation of VZV
gene expression.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1654442 [PubMed - indexed for MEDLINE]

5619: J Virol. 1991 Oct;65(10):5260-71.

Cloning of the latency gene and the early protein 0 gene of pseudorabies virus.

Cheung AK.

Virology Swine Research Unit, U.S. Department of Agriculture, Ames, Iowa 50010.

A collection of overlapping cDNA clones encoding the latency transcript of
pseudorabies virus and the DNA nucleotide sequence of the latency gene has been
obtained. The transcript is spliced with 4.6 kb of intervening sequences. This
mRNA, designated the large latency transcript, is 8.5 kb. It is polyadenylated
and contains a large open reading frame capable of coding for a 200-kDa
polypeptide. The direction of transcription is antiparallel to that of the
immediate-early gene IE180 and a newly identified early gene, EP0. The latency
transcript overlaps the entire IE180 gene and most of the EP0 gene. The EP0 mRNA 
is 1.75 kb and polyadenylated. The deduced amino acid sequence revealed the
presence of cysteine-rich zinc finger domain similar to that of the
immediate-early gene ICP0 of herpes simplex virus type 1 and the gene 61
polypeptide of varicella-zoster virus. On the basis of the biological functions, 
conserved protein domains, and unique spatial arrangements of the homologous
polypeptides (IE180 versus ICP4 and EP0 versus ICP0) between pseudorabies virus
and herpes simplex virus type 1, it is predicted that a homologous protein domain
is also encoded by the 8.5-kb large latency transcripts of these two viruses.

Publication Types: 
    Comparative Study

PMID: 1654441 [PubMed - indexed for MEDLINE]

5620: Virology. 1991 Oct;184(2):625-35.

A detailed analysis of transcripts mapping to varicella zoster virus gene 14
(glycoprotein V).

Ling P, Kinchington PR, Ruyechan WT, Hay J.

Department of Microbiology, Uniformed Services University of the Health Sciences,
Bethesda, Maryland 20814-4799.

We have characterized in detail those transcripts mapping to the varicella zoster
virus (VZV) glycoprotein V (gpV) open reading frame (ORF). The analyses revealed 
that a major 1.95-kb and a minor 2.5-kb transcript map to these sequences for VZV
strain Scott, with 1.8- and 2.3-kb transcripts in a vaccine Oka strain,
consistent with intragenic repeat (R2) copy number differences. The transcripts
for each strain are 5' coterminal, are polyadenylated, and do not seem to be
spliced. Upstream of the cap site there are few obvious regulatory consensus
sequences, but there is a potential CCAAT box at -59 bp and an unusual sequence
at -25 to -33, ATTTAAATT, which may serve as the TATA box for this gene. The 3'
termini map 10 to 20 bases downstream from potential polyadenylation signals:
ATAAA for the 1.95-kb transcript and ACGTAAA for the 2.5-kb transcript. This
transcript pattern is quite different from that observed for the gpV homologue in
herpes simplex virus (HSV-1), glycoprotein C (gC). Strain Scott synthesizes about
20-fold more gpV-specific transcripts than a strain of the Oka vaccine virus,
reflecting the amounts of gpV polypeptide accumulating in both strains; this
implies that the defect in Oka gpV polypeptide production is at the level of
transcription.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1653492 [PubMed - indexed for MEDLINE]

5621: Tidsskr Nor Laegeforen. 1991 Sep 20;111(22):2751-3.

[Treatment of herpesvirus infections]

[Article in Norwegian]

Moeland A, Bruun JN.

Publication Types: 
    Review

PMID: 1658973 [PubMed - indexed for MEDLINE]

5622: Am J Ophthalmol. 1991 Sep 15;112(3):326-30.

The effect of corneal hypesthesia on the duration of proparacaine anesthetic
eyedrops.

Weiss JS, Goren MB.

Division of Ophthalmology, University of Massachusetts Medical Center, Worcester 
01655.

The duration of action of proparacaine is known in the normal cornea but not in
the hypesthetic cornea. To determine this, we examined both eyes in seven
patients with documented unilateral corneal hypesthesia associated with inactive 
herpetic disease. Cochet-Bonnet measurements were made in both eyes before and at
two- to five-minute intervals after the instillation of one drop of 0.5%
proparacaine until baseline corneal sensitivity levels were again achieved. Mean 
recovery time was 34.86 minutes in eyes with normal corneal sensitivity, compared
to 45.43 minutes in hypesthetic corneas. In all patients, the recovery time was
remarkably longer in the hypesthetic eye than it was in the normal fellow eye.
These data demonstrate the need to wait up to one hour after the instillation of 
proparacaine in eyes suspected of having corneal hypesthesia if corneal
sensitivity is to be determined accurately. Additionally, the duration of action 
of topically instilled anesthetic may be a useful method of discovering subtle
differences in corneal sensitivity.

PMID: 1882944 [PubMed - indexed for MEDLINE]

5623: N Engl J Med. 1991 Sep 12;325(11):749-55.

Comment in:
    N Engl J Med. 1992 Feb 27;326(9):640-1; author reply 642.    N Engl J Med. 1992 Feb 27;326(9):641; author reply 642.    N Engl J Med. 1992 Feb 27;326(9):641; author reply 642.

Intrathecal immune response in patients with the post-polio syndrome.

Sharief MK, Hentges R, Ciardi M.

Department of Clinical Neurochemistry, National Hospital for Neurology and
Neurosurgery, London, United Kingdom.

BACKGROUND. The syndrome of progressive muscular atrophy decades after acute
paralytic poliomyelitis (post-polio syndrome) is not well understood. The theory 
that physiologic changes and aging cause the new weakness does not explain the
immunologic abnormalities reported in some patients. An alternative explanation
is persistent or recurrent poliovirus infection. METHODS. We assessed the
intrathecal antibody response to poliovirus and intrathecal production of
interleukin-2 and soluble interleukin-2 receptors in 36 patients with the
post-polio syndrome and 67 controls (including 13 who had had poliomyelitis but
had no new symptoms and 18 with amyotrophic lateral sclerosis). Intrathecal
antibody responses to measles, mumps, herpes simplex, and varicella zoster
viruses were also determined. RESULTS. Oligoclonal IgM bands specific to
poliovirus were detected in the cerebrospinal fluid of 21 of the 36 patients with
the post-polio syndrome (58 percent) but in none of the control group (P less
than 0.0001). In quantitative studies there was evidence of increased intrathecal
synthesis of IgM antibodies to poliovirus only among the patients with the
post-polio syndrome; there was no increased synthesis of IgM to measles, mumps,
herpes simplex, or varicella zoster viruses. The patients with post-polio
syndrome had significantly higher mean (+/- SD) (cerebrospinal fluid levels of
interleukin-2 and soluble interleukin-2 receptors than the controls (8.1 +/- 5.3 
vs. 1.4 +/- 0.8 U per milliliter and 159.6 +/- 102.9 vs. 10.7 +/- 6.2 U per
milliliter, respectively). The intrathecal synthesis of IgM antibodies to
poliovirus correlated with the cerebrospinal fluid concentrations of
interleukin-2 (P less than 0.0005) and soluble interleukin-2 receptors (P less
than 0.001). CONCLUSIONS. An intrathecal immune response against poliovirus is
present in many patients with the post-polio syndrome. In some of these patients 
the recrudescence of muscle weakness may be caused by persistent or recurrent
infection of neural cells with the poliovirus.

Publication Types: 
    Case Reports

PMID: 1651456 [PubMed - indexed for MEDLINE]

5624: Pediatr Dermatol. 1991 Sep;8(3):236-42, 246-7.

Oral acyclovir therapy for varicella and zoster infections in pediatric and
pregnant patients: a brief review.

Rothe MJ, Feder HM Jr, Grant-Kels JM.

Department of Medicine, University of Connecticut Health Center, Farmington
06030.

Oral acyclovir recently was approved for the treatment of herpes zoster and has
been shown to be effective in the treatment of varicella. Studies of the use of
high-dose oral acyclovir in the management of varicella-zoster infections in
immunocompetent pediatric patients are reviewed. Guidelines are provided for the 
drug's use in immunocompetent children and adolescents, pregnant patients, and
pediatric atopic patients receiving systemic steroids.

Publication Types: 
    Review

PMID: 1745635 [PubMed - indexed for MEDLINE]

5625: Med J Aust. 1991 Sep 2;155(5):344-6.

Contralateral hemiplegia following thoracic herpes zoster.

Rawlinson WD, Cunningham AL.

Department of Infectious Diseases and Microbiology, Westmead Hospital, NSW.

OBJECTIVE: To suggest interim therapeutic guidelines for stroke following truncal
herpes zoster on the basis of the first reported Australian case, in a patient
who showed good clinical response related temporally to antiviral therapy.
CLINICAL FEATURES: A 70-year-old patient with no known underlying immune disorder
presented with left-sided hemiplegia one week after right-sided truncal herpes
zoster. In all probability the neurological deficit was due to large artery
vasculopathy with thrombosis. INTERVENTION AND OUTCOME: Clinical improvement (not
to pre-morbid levels) was noted soon after commencement of antiviral therapy with
acyclovir. CONCLUSION: Stroke following herpes zoster may be a treatable
condition. In view of the previously described occurrence of viral antigen within
the walls of intracerebral vessels, the occasional progression of the syndrome
over months, the generally low toxicity of acyclovir and the clinical response of
the few patients treated with antiviral agents to date, early antiviral therapy
in patients presenting with delayed contralateral hemiplegia associated with
herpes zoster is recommended as prudent.

Publication Types: 
    Case Reports

PMID: 1895982 [PubMed - indexed for MEDLINE]

5626: Aten Primaria. 1991 Sep;8(8):654; author reply 654-5.

Comment on:
    Aten Primaria. 1990 Nov;7(10):681-2.

[Peripheral facial paralysis and the herpes chickenpox-zoster virus]

[Article in Spanish]

Ponce de Leon M.

Publication Types: 
    Comment
    Letter

PMID: 16986251 [PubMed - indexed for MEDLINE]

5627: Arch Neurol. 1991 Sep;48(9):900.

Comment on:
    Arch Neurol. 1990 Sep;47(9):1033-5.

Delayed varicella vasculopathy.

Liu GT.

Publication Types: 
    Comment
    Letter

PMID: 1953409 [PubMed - indexed for MEDLINE]

5628: Clin Nephrol. 1991 Sep;36(3):155-6.

Acute renal failure induced by oral acyclovir.

Hernandez E, Praga M, Moreno F, Montoyo C.

Publication Types: 
    Case Reports
    Letter

PMID: 1934676 [PubMed - indexed for MEDLINE]

5629: Br J Ophthalmol. 1991 Sep;75(9):542-6.

Comment in:
    Br J Ophthalmol. 1992 Oct;76(10):639.

Double-masked trial of topical acyclovir and steroids in the treatment of herpes 
zoster ocular inflammation.

Marsh RJ, Cooper M.

Department of Clinical Ophthalmology, Moorfields Eye Hospital, London.

Ninety seven new patients with ophthalmic zoster were randomly allocated to three
topical treatment groups: acyclovir (ACV) ointment and placebo drops (AP),
placebo ointment with steroid drops (PS), and acyclovir ointment with steroid
drops (AS). The dosage administered was determined by the score of the ocular
inflammation. Follow-up was for at least one year. The results showed that
topical ACV alone is insufficient for severe ocular inflammation but is not
inclined to lead to recurrences in milder cases. Topical steroid alone is
effective but tends to necessitate prolonged treatment. Combined steroid and ACV 
is questionably better than steroid alone and causes marginally fewer rebound
inflammations.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 1911657 [PubMed - indexed for MEDLINE]

5630: Vrach Delo. 1991 Sep;(9):92-5.

[The clinical and treatment characteristics of patients with herpes zoster in
different locations]

[Article in Russian]

Vinichuk SM, Unich PP, Ivanenko ZI, Barabanchik VG.

An analysis is presented of the clinical course and results of treatment of 102
patients with herpes zoster. The spinal ganglia of the thoracic region and
trigeminal nerve ganglia were most frequently involved. The disease was
manifested not only in local disorders but also in generalized systemic
vegetative-trophic and vascular disorders. The authors report a high therapeutic 
efficiency of complex treatment of patients with herpes zoster using antiviral,
antiherpetic and detoxification agents, immunostimulators, vegetotropic drugs,
physiotherapy and ointment applications.

Publication Types: 
    English Abstract

PMID: 1759444 [PubMed - indexed for MEDLINE]

5631: J Infect. 1991 Sep;23(2):169-74.

Herpes zoster associated encephalitis in dialysis patients.

Cheung WC, Yuen KY, Chang CM, Cheng KP.

University Medical Unit, University of Hong Kong, Queen Mary Hospital, Pokfulam.

Two patients on dialysis because of chronic renal failure who developed herpes
zoster associated encephalitis are reported. Both developed overt encephalopathy 
despite treatment with oral acyclovir for the preceding herpes zoster eruption.
The encephalopathy responded rapidly to intravenous acyclovir.

Publication Types: 
    Case Reports

PMID: 1753116 [PubMed - indexed for MEDLINE]

5632: HNO. 1991 Sep;39(9):362-6.

[Idiopathic facial paralysis and magnetic resonance tomography (MRT)]

[Article in German]

Doringer E, Albegger K, Sinzinger G, Schmoller HJ.

Zentrales Rontgeninstitut, Landeskrankenanstalten Salzburg.

We investigated 15 patients with unilateral facial paralysis using
gadolinium(Gd)-DTPA (diethylenetriamine pentaacetic acid) enhanced (magnetic
resonance imaging (MRI). Eleven were idiopathic and 1 each was due to basal skill
trauma, Lyme's disease, Foville's syndrome and herpes zoster oticus. Ten of 11
Bell's palsies showed a significant enhancement of the facial nerve on the
paralysed side. In all cases enhancement was shown in the labyrinthine segment,
in 9 in the meatal segment, in 8 in the mastoid segment and in 7 in the tympanic 
segment also. Follow-up Gd-enhanced MRI investigation was performed 3-11 months
later in 8 patients. In 1 case with incomplete return of function after 3 months 
MRI enhancement was decreased. We could not find any correlation between the
intensity of the Gd enhancement and the course, severity or outcome of Bell's
palsy, or stapedius reflex audiometry. The mechanisms and aetiology of the Gd
enhancement in Bell's palsy seem to be non-specific phenomena which are also
found in post-traumatic facial lesions, for instance. Nevertheless, the ability
to image the facial nerve in Bell's palsy provides a new means of examination in 
this disorder. In our opinion Gd-enhanced MRI is recommended in cases of
recurrent or "atypical" Bell's palsy and in cases with total loss of electrical
excitability, to exclude tumours. It is further suggested that MRI may provide
valuable information concerning areas which may require surgical exploration or
decompression.

Publication Types: 
    English Abstract

PMID: 1748580 [PubMed - indexed for MEDLINE]

5633: Southeast Asian J Trop Med Public Health. 1991 Sep;22(3):323-5.

Seroepidemiological study of herpes viruses in Nepal.

Kubo T, Rai SK, Nakanishi M, Yamano T.

JICA Faculty, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

The antibody positive rates among Nepalese, in a community, to herpes simplex
virus (HSV), varicella-zoster virus (VZV) and cytomegalovirus (CMV) were studied.
Immune adherence hemagglutination test (for VZV) and complement fixation test
(for HSV and CMV) were used to measure the antibodies. An 80% positive rate of
anti-HSV antibodies was found in early childhood (1-4 years) that further
increased with age (96.1% positive in greater than 15 years age). Only 25% of
children 1-4 years old showed antibodies to VZV but the number of positives
increased rapidly with age (82.9% in greater than 15 years age). Antibody against
CMV was positive in all the subjects studied.

PMID: 1667956 [PubMed - indexed for MEDLINE]

5634: J Am Acad Dermatol. 1991 Sep;25(3):500-6.

Concurrent epidermal involvement of cytomegalovirus and herpes simplex virus in
two HIV-infected patients. Military Medical Consortium for Applied Retroviral
Research (MMCARR).

Smith KJ, Skelton HG 3rd, James WD, Angritt P.

Armed Forces Institute of Pathology, Department of Dermatopathology, Washington, 
DC 20306.

Although cytomegalovirus has previously been reported in cutaneous lesions of
patients infected with the human immunodeficiency virus, these reports are not
common despite the prevalence of this infection and the significant pathologic
characteristics that it induces in HIV disease. Rare reports of possible
epidermal involvement by cytomegalovirus have never been fully documented and
have been believed by some to represent epidermal involvement by varicella-zoster
and/or herpes simplex infections, with dermal involvement of cytomegalovirus. We 
present two cases of concurrent epidermal involvement by cytomegalovirus and
herpes simplex virus documented by immunohistochemical studies and DNA
hybridization studies and correlate this with the distinctive morphologic
features seen in these two viral infections on routine staining.

Publication Types: 
    Case Reports

PMID: 1655836 [PubMed - indexed for MEDLINE]

5635: Schweiz Med Wochenschr. 1991 Aug 24;121(34):1194-204.

[Ambulatory therapy and prevention of the most frequent HIV-associated
opportunistic infections]

[Article in German]

Malinverni R, Blatter M.

Medizinische Universitatspoliklinik, Inselspital Bern.

Earlier diagnosis and improved therapies for the opportunistic infections have
led to improved quality of life as well as survival time of patients with
advanced HIV-related immunodeficiency. Most of the therapies can be administered 
on an outpatient basis. Outpatient treatment further contributes to improving the
quality of life of the patients. Presentation, clinical aspects, treatment and
prophylaxis of the five most frequent opportunistic infections in HIV-infected
patients with advanced immunodeficiency in our outpatient clinic (oral and
esophageal candidiasis, pneumocystis carinii pneumonia, herpes zoster, herpes
simplex virus infection and cerebral toxoplasmosis) are discussed with respect to
the practical implications.

Publication Types: 
    English Abstract
    Review

PMID: 1925448 [PubMed - indexed for MEDLINE]

5636: Am J Ophthalmol. 1991 Aug 15;112(2):206-7.

Human immunodeficiency virus, herpes zoster, and the retina.

Nussenblatt RB, Palestine AG.

Publication Types: 
    Editorial

PMID: 1867307 [PubMed - indexed for MEDLINE]

5637: Am J Ophthalmol. 1991 Aug 15;112(2):151-8.

Clinical patterns and associated conditions in chronic uveitis.

Weiner A, BenEzra D.

Department of Ophthalmology, Hadassah Medical Center, Hebrew University Medical
School, Jerusalem, Israel.

We determined the relative frequencies of the different types of chronic uveitis,
and the possible associated conditions, among 400 consecutive patients with
chronic uveitis examined during the years 1982 through 1988. Of the 400 patients,
183 (45.75%) had anterior uveitis, 98 (24.5%) ahd panuveitis, 61 (15.3%) had
intermediate uveitis, and 58 (14.5%) had isolated posterior uveitis. Only four of
the 98 patients with panuveitis (4.1%) were considered idiopathic after a
comprehensive examination, whereas 94 of the 183 patients with anterior uveitis
(51.4%) were similarly classified. We found an associated condition in 242 of the
400 patients of the study group (60.5%). Of these 242 patients, 61 had Behcet's
disease, which constituted the most frequently encountered associated condition
in this study. Of the 61 patients with Behcet's disease, 58 had panuveitis and
constituted 59.2% of the panuveitis group. Of the 61 patients with intermediate
uveitis, 17 (27.9%) had a concurrent disease. An associated condition was found
in 95% and 96.2% of patients with unilateral and bilateral panuveitis,
respectively, but in none of the patients with unilateral intermediate uveitis.
Environmental, cultural, or genetic factors may be accountable for the
differences discovered between our findings and those of previously published
studies from the United States and England with respect to relative frequencies
of some of the associated diseases in patients with chronic uveitis.

PMID: 1867298 [PubMed - indexed for MEDLINE]

5638: Am J Ophthalmol. 1991 Aug 15;112(2):147-50.

Analysis of local antibody production in the vitreous humor of patients with
severe uveitis.

Baarsma GS, Luyendijk L, Kijlstra A, de Vries J, Peperkamp E, Mertens DA, van
Meurs JC.

Eye Hospital, Rotterdam, The Netherlands.

We analyzed the local antibody production in vitreous humor samples collected
during vitrectomy in patients with severe vision-threatening uveitis. In 24
patients, paired serum and undiluted vitreous humor samples were collected and
tested for antibodies against Toxoplasma gondii, herpes simplex virus,
varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, and Toxocara canis. 
Total IgG and the Goldmann-Witmer coefficient were determined. The initial
diagnosis of ocular toxoplasmosis could be confirmed in six of the seven
patients. The seventh patient showed a local antibody production against herpes
simplex virus. One of the three patients with chronic panuveitis at initial
diagnosis showed a local antibody production against T. gondii. These last two
findings resulted in a change in medical treatment. Analysis of local antibody
production in vitreous humor samples is a valuable diagnostic tool.

PMID: 1651055 [PubMed - indexed for MEDLINE]

5639: Am J Ophthalmol. 1991 Aug 15;112(2):119-31.

Varicella-zoster virus retinitis in patients with the acquired immunodeficiency
syndrome.

Margolis TP, Lowder CY, Holland GN, Spaide RF, Logan AG, Weissman SS, Irvine AR, 
Josephberg R, Meisler DM, O'Donnell JJ.

University of California Los Angeles Ocular Inflammatory Disease Center.

We examined five patients infected with the human immunodeficiency virus who
developed a rapidly progressive necrotizing retinitis characterized by early
patchy choroidal and deep retinal lesions and late diffuse thickening of the
retina. In all but one case, the retinitis began in the posterior pole with
little or no clinical evidence of vasculitis. All five patients had relentless
progression of disease and were left with atrophic and necrotic retinae, pale
optic-nerve heads, and narrowed vasculature. None of the patients developed
aqueous or vitreal inflammation or retinal detachment. Clinical and laboratory
evidence suggested that varicella-zoster virus was the causal agent in all five
cases. First, the onset of retinitis in four cases either succeeded or was
coincident with an eruption of dermatomal zoster. Second, varicella-zoster virus 
was cultured from the two chorioretinal specimens and varicella-zoster virus
antigen was detected in the vitreal aspirate from one case. Third, by means of
immunocytochemistry, varicella-zoster virus antigen was found in the outer
retinae of both enucleation specimens. Fourth, viral capsids with the size and
shape of herpesviridae were found in the outer retinae of both enucleation
specimens. The clinical features observed in this study are distinct from those
described for the acute retinal necrosis syndrome and appear to constitute a new 
and highly characteristic pattern of varicella-zoster virus-induced disease.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1651054 [PubMed - indexed for MEDLINE]

5640: Med J Aust. 1991 Aug 5;155(3):206-7.

Comment on:
    Med J Aust. 1991 Jun 3;154(11):781.

EMLA Cream and herpetic neuralgia.

Collins PD.

Publication Types: 
    Comment
    Letter

PMID: 1875823 [PubMed - indexed for MEDLINE]

5641: Acta Neurol Scand. 1991 Aug;84(2):146-52.

Pain and allodynia in postherpetic neuralgia: role of somatic and sympathetic
nervous systems.

Nurmikko T, Wells C, Bowsher D.

Department of Neurology, University Central Hospital, Tampere, Finland.

The immediate effects of selective sympathetic and somatic blockades on pain and 
tactile allodynia in 12 patients with long-standing ophthalmic or high cervical
postherpetic neuralgia were compared. For the duration of the somatic blockade,
pain was completely abolished in 11 patients and allodynia in 8 patients. In
contrast, during the sympathetic blockade only one patient reported total pain
relief and three a marginal attenuation of pain while eight remained unchanged;
and no patient reported clear alleviation of allodynia. After successful somatic 
blockade, pain and allodynia reappeared with tactile sensation while thermal
sensation was still absent. Pain and allodynia appear to be related to sensory
impulses travelling along the large rather than the small diameter fibres; and
the sympathetic system may only have a limited role.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1950450 [PubMed - indexed for MEDLINE]

5642: J Rheumatol. 1991 Aug;18(8):1254-6.

Pneumocystis carinii pneumonia associated with methotrexate therapy in rheumatoid
arthritis.

Flood DA, Chan CK, Pruzanski W.

Department of Medicine, Wellesley and Princess Margaret Hospitals, University of 
Toronto, ON, Canada.

Opportunistic infections occur in patients with rheumatic diseases treated with
low dose methotrexate (MTX) with or without other immunosuppressants. Our case
report illustrates a fatal case of Pneumocystis carinii pneumonia in a patient
with rheumatoid arthritis treated with low dose MTX and glucocorticoid. A review 
of the literature reveals other opportunistic infections such as Cryptococcus,
Nocardia, and herpes zoster presenting in such patients. These occurrences
suggest that MTX should be used cautiously in patients with rheumatic disease
receiving concomitant medical therapy.

Publication Types: 
    Case Reports
    Review

PMID: 1941836 [PubMed - indexed for MEDLINE]

5643: J Rheumatol. 1991 Aug;18(8):1172-5.

Complications of immunosuppression associated with weekly low dose methotrexate.

Shiroky JB, Frost A, Skelton JD, Haegert DG, Newkirk MM, Neville C.

Department of Pathology, Montreal General Hospital, McGill University, Canada.

Complications of immunosuppression are thought to be rare with the use of low
dose pulse methotrexate (MTX) for nonneoplastic conditions. We describe 4
complications of immunosuppression observed in a group of 41 patients who had
received MTX for at least 6 months, during a 2-year period. We report the first
case of a reversible lymphoproliferative disorder similar to that reported with
immunosuppressive therapy associated with organ transplantation. Two cases of
disseminated herpes zoster and 1 case with Pneumocystis carinii pneumonia are
described. As the indications for the use of low dose MTX broaden and older
patients with other comorbid diseases are included, our experience suggests that 
complications of immunosuppression with prolonged use of MTX may be seen more
commonly.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 1941818 [PubMed - indexed for MEDLINE]

5644: Masui. 1991 Aug;40(8):1256-60.

[Iontophoretic administration of indomethacin in the treatment of postherpetic
neuralgia]

[Article in Japanese]

Morimoto M, Hakuto T, Morimoto E, Kato H, Iwasaku K, Kurioka M, Hyodo M.

Department of Anesthesiology, Osaka Medical College.

Iontophoretic administration of indomethacin (IND) was applied to investigate its
effect in 21 cases of postherpetic neuralgia (PHN), which showed no response to
other treatment such as nerve blocks. Iontophoretic therapy of IND was applied
for 20 minutes once a week up to 5 time (series 1). When pain relief was
unsatisfactory in series 1, the same treatment was given once again (series 2).
Long term follow-up results were obtained 3 months after the final treatment in
series 1 or 2. We used visual analog scale (VAS) to measure their pain intensity.
VAS was reduced clearly at the end of the treatment in each series. The average
improvement rate of the VAS in each series was as follows; series 1:60.3 +/-
8.2%, series 2:73.7 +/- 7.0%, long term follow-up results: 73.7 +/- 7.0% (mean
+/- S.E.) We concluded from the present results that iontophoretic administration
of IND was one of the effective and useful treatments for PHN.

Publication Types: 
    English Abstract

PMID: 1920805 [PubMed - indexed for MEDLINE]

5645: Pediatr Infect Dis J. 1991 Aug;10(8):569-75.

Recurrent varicella-zoster virus infections in apparently immunocompetent
children.

Junker AK, Angus E, Thomas EE.

Department of Pediatrics, University of British Columbia, Vancouver, Canada.

Fourteen generally healthy children (5 females, 9 males, ages 18 months to 13
years) who have developed 2 to 5 attacks of chickenpox are described. Herpes
zoster also occurred in 2 of 14 children. No case of chickenpox was severe or
associated with complications. General studies of immunoglobulins, specific
antibodies to immunization agents, complement and lymphocyte subpopulation number
and function indicated that 1 of 14 had low serum IgA and 3 of 14 lacked antibody
to 1 (n = 2) or 2 (n = 1) immunization agents. Varicella-zoster virus
(VZV)-specific immune studies showed that the children developed VZV-antibody
titers by enzyme-linked immunosorbent assay of 1:640 to 1:10 240. By immunoblot
assay all appeared to develop a normal spectrum of antibodies to individual VZV
proteins. All but one developed VZV cellular immune responses with stimulation
indices ranging from 3.6 to 174. Sequential follow-up of 8 patients revealed 1
who became seronegative and 2 who lost VZV cell-mediated immune responses.
Chickenpox may recur more frequently than is generally recognized. General and
VZV-specific immune investigations are unlikely to indicate a reason.

Publication Types: 
    Case Reports

PMID: 1891288 [PubMed - indexed for MEDLINE]

5646: J R Soc Med. 1991 Aug;84(8):501-2.

Contralateral hemiplegia complicating herpes zoster ophthalmicus.

McNeil JD, Horowitz M.

Department of Medicine, Royal Adelaide Hospital, South Australia.

Publication Types: 
    Case Reports

PMID: 1886125 [PubMed - indexed for MEDLINE]

5647: Br J Ophthalmol. 1991 Aug;75(8):510.

Bilateral simultaneous spontaneous acute angle closure glaucoma in a herpes
zoster patient.

al Halel A, Hirsh A, Melamed S, Blumenthal M.

Publication Types: 
    Case Reports
    Letter

PMID: 1873277 [PubMed - indexed for MEDLINE]

5648: Am J Med. 1991 Aug;91(2):201-2.

Excessive salivation as an anginal equivalent: a sequela to Ramsay Hunt syndrome.

Cozzi PJ, Talano JV.

Publication Types: 
    Case Reports
    Letter

PMID: 1867247 [PubMed - indexed for MEDLINE]

5649: Neurology. 1991 Aug;41(8):1215-8.

Preherpetic neuralgia.

Gilden DH, Dueland AN, Cohrs R, Martin JR, Kleinschmidt-DeMasters BK, Mahalingam 
R.

Department of Neurology, University of Colorado School of Medicine, Denver.

We have encountered six zoster patients whose pain preceded rash by 7 to more
than 100 days. Pain was severe, burning, and radicular, and located both in
dermatomes different from, as well as in, the area of eventual rash. Two patients
ultimately developed disseminated zoster with neurologic complications, one of
zoster paresis, and the other, a fatal zoster encephalitis; both had been taking 
long-term, low-dose steroids. A third case of preherpetic neuralgia developed in 
a patient with prior metastatic carcinoma, and another case in a patient with an 
earlier episode of brachial neuritis. The final two cases of preherpetic
neuralgia developed in individuals with no underlying disease. An extended period
of pain before the onset of zoster rash has gone largely unrecognized.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1866008 [PubMed - indexed for MEDLINE]

5650: Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Aug;29(8):1037-41.

[A case of Ramsey Hunt syndrome with multiple cranial nerve paralysis and acute
respiratory failure]

[Article in Japanese]

Sato K, Nakamura S, Koseki T, Yamauchi F, Baba M, Mikami M, Kobayashi R, Fujikawa
T, Nagaoka S.

Department of Pneumology, Tokyo Metropolitan Hiroo General Hospital, Japan.

The authors report a 56-year-old woman with Ramsey Hunt syndrome with multiple
cranial nerve paralysis and acute respiratory failure. Five days before
admission, she experienced right otalgia and right facial pain and consulted an
otolaryngologist of our hospital, who diagnosed the illness as acute parotitis
and laryngopharyngitis. One day before admission, she experienced mild dyspnea
and general fatigue and came to our hospital emergency room. A chest X-ray film
revealed no abnormalities but some blisters were observed around her right ear.
The next day, her dyspnea became more severe and she was admitted. A chest X-ray 
film on admission revealed right lower lobe consolidation, and neurological
examination disclosed multiple cranial nerve paralysis, i.e., paralysis of the
right fifth, seventh, eighth, ninth, tenth, eleventh, twelfth and left tenth
cranial nerve. The serum titer of anti-herpes zoster antibody was elevated to
1,024, and the patient was diagnosed as having Ramsey Hunt syndrome with multiple
cranial nerve paralysis. Arterial blood gas analysis revealed hypoxemia with
hypercapnea, which was considered to be due to aspiration pneumonia and central
airway obstruction caused by vocal cord paralysis. Mechanical ventilation was
soon instituted and several antibiotics and acyclovir were administered
intravenously, with marked effects. Three months after admission, the patient was
discharged with no sequelae except mild hoarseness. Patients with herpes zoster
oticus, facial nerve paralysis and auditory symptoms are diagnosed as having
Ramsey Hunt syndrome. This case was complicated by lower cranial nerve paralysis 
and acute respiratory failure, which is very rare.(ABSTRACT TRUNCATED AT 250
WORDS)

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 1753519 [PubMed - indexed for MEDLINE]

5651: Pain. 1991 Aug;46(2):195-9.

The prognosis with postherpetic neuralgia.

Watson CP, Watt VR, Chipman M, Birkett N, Evans RJ.

Irene Eleanor Smythe Pain Clinic, Department of Anaesthesia, University of
Toronto, Ont., Canada.

One hundred and fifty-six patients with moderate to severe postherpetic neuralgia
(PHN) were followed for up to 11 years. Nearly half of all patients were doing
well at the final assessment (median 2 years) and more than half of these were on
no therapy at this time. The most commonly used agents associated with a good
outcome were antidepressants, topical capsaicin and analgesics of various kinds. 
Longer duration PHN appeared to have a worse prognosis. More of these patients
were noted to be using some form of treatment at follow up. A group of patients
seemed to follow a progressive course and were refractory to all treatments used 
in this study.

PMID: 1749643 [PubMed - indexed for MEDLINE]

5652: Curr Opin Dent. 1991 Aug;1(4):384-97.

Oral manifestations of viral infections in immunocompromised patients.

Schubert MM.

Department of Oral Medicine, School of Dentistry, University of Washington,
Seattle.

Viral infections are a significant cause of morbidity and mortality in
immunosuppressed patients. It is clear that diseases or medical treatments that
have cytostatic or cytotoxic effects on lymphocytes and disrupt cytokine
production or activity increase the risk of viral infections. While the rate of
viral infection varies with the nature and degree of immunosuppression, it is
clear that reactivation of latent virus is the most important determinant of the 
types of viral infections most frequently noted in immunosuppressed patients
result from the reactivation of latent virus. Herpesviruses account for the
majority of oral viral infections. Herpes simplex virus, varicella-zoster virus, 
and Epstein-Barr virus infections nearly always result from reactivation of
latent virus, while cytomegalovirus infections, besides presenting as reactivated
disease, are almost as likely to present as a primary infection in susceptible
hosts. Other viral pathogens potentially of concern in immunocompromised patients
are enteric viruses (adenoviruses and coxsackieviruses), human papillomaviruses, 
and possibly the recently identified human herpesvirus type 6. Ninety-eight
percent of herpes simplex virus lesions are caused by reactivated disease and
tend to be characterized by large, very painful ulcerative lesions throughout the
mouth. Varicella-zoster virus is also rarely seen as primary infection, and the
herpes zoster lesions involving cranial nerves can cause significant morbidity,
including postherpetic neuralgia, corneal scarring, cranial nerve palsies, and
deafness. Distinct oral ulcerative lesions caused by Epstein-Barr virus and
cytomegalovirus have only recently been described in detail and are usually
associated with disseminated disease. Oral human papillomavirus lesions are noted
as warts and condylomas. The contribution of enteric viruses and human
herpesvirus type 6 to oral disease in immunosuppressed patients is yet to be
determined.

Publication Types: 
    Review

PMID: 1666308 [PubMed - indexed for MEDLINE]

5653: Am J Vet Res. 1991 Aug;52(8):1252-7.

Location of open reading frames coding for equine herpesvirus type-1
glycoproteins with homology to gE and gI of herpes simplex virus.

Elton DM, Bonass WA, Killington RA, Meredith DM, Halliburton IW.

Department of Microbiology, University of Leeds, UK.

The DNA fragments representing the entire short unique region and part of the
repeat sequences of the equine herpesvirus type-1 genome were cloned into plasmid
vectors. The approximate positions of the junctions between the short unique
region and the inverted repeats were then located by restriction endonuclease
mapping. Two open reading frames coding for potential glycoproteins have been
identified within the short unique region, using DNA sequence analysis. The
predicted amino acid sequences of these open reading frames had extensive
homology to the herpes simplex virus glycoproteins gE and gI and the related
glycoproteins of pseudorabies virus and varicella-zoster virus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1656822 [PubMed - indexed for MEDLINE]

5654: Ophthalmology. 1991 Aug;98(8):1216-29.

Diagnosis and therapy of herpes zoster ophthalmicus.

Liesegang TJ.

Division of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224.

Studies in the basic and clinical sciences have yielded new information about the
biology, infection, latency, and recurrence of the varicella-zoster virus.
Contrast is made with the herpes simplex virus. The host-viral relationship is an
extremely dynamic one with clinical disease being determined primarily by the
host cellular immune system. The complications of herpes zoster ophthalmicus are 
related to multiple mechanisms including viral growth, vascular and neural
damage, and the host-immune response to infection. There are several laboratory
tests available for confirming the diagnosis or determining the immune status.
Systemic acyclovir administered early in the course alleviates many of the
symptoms of herpes zoster ophthalmicus. Acute and postherpetic neuralgia remain
significant and enigmatic problems; an update of therapeutic options is offered. 
The role of corticosteroids in herpes zoster ophthalmicus is scrutinized along
with the potential and uncertainties of a varicella-zoster virus vaccine.

Publication Types: 
    Review

PMID: 1656354 [PubMed - indexed for MEDLINE]

5655: J Med Chem. 1991 Aug;34(8):2383-9.

5-(5-Bromothien-2-yl)-2'-deoxyuridine and 5-(5-chlorothien-2-yl)-2'-deoxyuridine 
are equipotent to (E)-5-(2-bromovinyl)-2'-deoxyuridine in the inhibition of
herpes simplex virus type I replication.

Wigerinck P, Pannecouque C, Snoeck R, Claes P, De Clercq E, Herdewijn P.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

2'-Deoxyuridines with a five-membered heterocyclic substituent in the 5-position 
were synthesized by palladium-catalyzed coupling reactions of
5-iodo-2'-deoxyuridine with the activated heteroaromatics. Further modification
of the compound with the 5-thien-2-yl substituent gave
5-(5-bromothien-2-yl)-2'-deoxyuridine and
5-(5-chlorothienyl-2-yl)-2'-deoxyuridine. Both compounds show potent and
selective activity against herpes simplex virus type 1 and varicella-zoster
virus.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 1652017 [PubMed - indexed for MEDLINE]

5656: J Med Chem. 1991 Aug;34(8):2380-3.

Synthesis and antiviral activity of 3-substituted derivatives of
3,9-dihydro-9-oxo-5H-imidazo[1,2-a]purines, tricyclic analogues of acyclovir and 
ganciclovir.

Boryski J, Golankiewicz B, De Clercq E.

Institute of Bioorganic Chemistry, Polish Academy of Sciences, Poznan.

9-[(2-Hydroxyethoxy)methyl]guanine (acyclovir, 1a) and
9-[(1,3-dihydroxy-2-propoxy)methyl]guanine (DHPG, ganciclovir, 1b) were
transformed to their respective tricyclic derivatives, 3-substituted
3,9-dihydro-9-oxo-5H-imidazo[1,2-a]purines 2b, 3a, and 3b. The
6-methyl-substituted compound 2b was obtained following reaction of 1b with
bromoacetone. A two-step approach via 1-(2,2-diethoxyethyl) intermediates 4a,b
was the most effective for the preparation of the derivatives unsubstituted in
the appended ring (3a,b). The novel acyclonucleosides, in particular ganciclovir 
derivative 2b, proved markedly active against herpes simplex virus type 1 and 2, 
varicella-zoster virus, and cytomegalovirus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1652016 [PubMed - indexed for MEDLINE]

5657: Lakartidningen. 1991 Jul 24;88(30-31):2504-5.

[Why increase the indications for Zovirax?]

[Article in Swedish]

Pers M.

PMID: 1865714 [PubMed - indexed for MEDLINE]

5658: Am J Ophthalmol. 1991 Jul 15;112(1):23-30.

Detection of antibodies against Borrelia burgdorferi in patients with uveitis.

Isogai E, Isogai H, Kotake S, Yoshikawa K, Ichiishi A, Kosaka S, Sato N, Hayashi 
S, Oguma K, Ohno S.

Department of Hygiene, Higashi Nippon Gakuen University, Hokkaido, Japan.

We determined the antibody response against Borrelia burgdorferi strains isolated
from Japanese Ixodes ovatus and Ixodes persulcatus ticks by enzyme-linked
immunosorbent assay and indirect immunofluorescence assay of serum specimens from
127 patients with uveitis. We examined samples of serum from Japanese patients
with unclassified uveitis, iridocyclitis caused by herpes zoster virus, Behcet's 
disease, Vogt-Koyanagi-Harada syndrome, sarcoidosis, or other conditions
(sympathetic ophthalmia, Posner-Schlossman syndrome and acute anterior uveitis
with ankylosing spondylitis). Serum from healthy individuals and patients with
Lyme disease served as negative and positive control samples, respectively.
Significantly higher antibody titers were demonstrated in patients with uveitis
than in control subjects. Of 29 patients with unclassified uveitis, nine (31) had
significantly increased antibody titers against B. burgdorferi strain H014 by
ELISA testing. Five patients also showed higher IgG and IgM responses than in
three control subjects with Lyme disease. All positive controls showed joint
problems characteristic of rheumatoid arthritis. One of three patients had
uveitis. The patients were diagnosed as having Lyme disease on the basis of their
history and serologic tests. A positive antibody response was recognized in
several patients with Behcet's disease, Vogt-Koyanagi-Harada syndrome,
sarcoidosis, and other conditions (acute anterior uveitis with ankylosing
spondylitis), but not in control subjects.

PMID: 1882917 [PubMed - indexed for MEDLINE]

5659: Am J Ophthalmol. 1991 Jul 15;112(1):76-82.

Intrathecal antibody production against viruses of the herpesvirus family in
acute retinal necrosis syndrome.

el Azazi M, Samuelsson A, Linde A, Forsgren M.

Department of Ophthalmology, Huddinge University Hospital, Sweden.

Viruses of the herpesvirus family cause acute retinal necrosis syndrome, a
devastating necrotic retinitis in immunocompetent individuals. Direct proof of
the viral origin of this disease may be obtained by demonstration of the virus,
viral antigens, or viral DNA in biopsy specimens of retinas. In search of
alternative diagnostic methods, we analyzed cerebrospinal fluid and serum with
enzyme-linked immunosorbent assays for virus-specific antibody activity.
Intrathecally produced viral antibodies were found in three consecutive patients 
with acute retinal necrosis syndrome: herpes simplex type 2 in a 30-year-old
woman with a history of suspected neonatal herpes encephalitis, herpes simplex
type 1 in a 35-year-old man, and varicella-zoster virus activity in a 62-year-old
woman. None of the patients had clinical signs indicating an acute disorder in
the central nervous system. This serologic approach seems to be of value for the 
diagnosis of an associated intracerebral viral infection in cases of acute
retinal necrosis syndrome.

Publication Types: 
    Case Reports

PMID: 1652896 [PubMed - indexed for MEDLINE]

5660: S Afr Med J. 1991 Jul 6;80(1):17-20.

HIV-1 infection among heterosexual attenders at a sexually transmitted diseases
clinic in Durban.

O'Farrell N, Windsor I, Becker P.

STD Department, King Edward VIII Hospital, Durban.

In a study of 2,682 selected attenders at a sexually transmitted diseases (STD)
clinic for blacks in Durban, antibodies to human immunodeficiency virus type 1
(HIV-1) were detected in 63 (2.4%)--30 of 937 women (3.2%) and 33 of 1,745 men
(1.9%). Women aged 15-19 years (P = 0.002) were at greater risk of HIV-1
infection than women of other age groups. Among men, HIV-1 seropositivity was
associated with genital ulcer disease (GUD) (P = 0.007) and donovanosis
(granuloma inguinale) (P = 0.02). Among seropositive men with donovanosis the
probability of HIV-1 infection increased as the duration of lesions increased.
When HIV-1 seropositive women were compared with a subgroup of 73 seronegative
women with GUD, inflammatory cytological changes were associated with antibodies 
to HIV-1 (P = 0.02). Among women overall, HIV-1 seropositivity was associated
with previous syphilis (P = 0.03). In men herpes zoster (P = 0.04) and in women
lymphadenopathy (P = 0.002) accounted for HIV-1 seropositivity in patients with
medical complaints. HIV-1 seropositivity in men with gonorrhoea and genital warts
was less than in men without gonorrhoea (P = 0.001) and genital warts (P = 0.03).
These results support the causal hypothesis of HIV transmission whereby mucosal
discontinuity acts as a portal of entry for the virus. GUD and cervical
inflammation secondary to STDs in seronegative subjects may facilitate HIV
transmission. The relative risk of various STDs are probably dependent upon the
duration of epithelial damage and exposure to HIV-1.

PMID: 2063236 [PubMed - indexed for MEDLINE]

5661: J Pediatr. 1991 Jul;119(1 ( Pt 1)):129-35.

Comment in:
    J Pediatr. 1992 Apr;120(4 Pt 1):665.

Acyclovir therapy in neonates.

Englund JA, Fletcher CV, Balfour HH Jr.

Department of Pediatrics, University of Minnesota Hospital, Minneapolis.

STUDY OBJECTIVE: To determine the pharmacokinetic parameters of acyclovir
disposition in neonates with renal dysfunction. DESIGN: Prospective sequential
open enrollment of neonates with presumed herpes group virus infections. SETTING:
Neonatal intensive care units in the greater Minneapolis-St. Paul metropolitan
area. PATIENTS: Sixteen neonates with gestational ages between 27 and 40 weeks
(median 38 weeks) were given acyclovir between days 1 and 56 of life to treat
presumed herpes virus infections. Six infants were critically ill with
multisystem disease, five infants had hepatic failure and underwent blood
exchange transfusion, and five infants had renal failure. A mean of four (range 1
to 19) serum acyclovir concentrations per patient were measured by
radioimmunoassay. Pharmacokinetic parameters were calculated from acyclovir
concentrations in 46 samples from 16 patients. MEASUREMENTS AND MAIN RESULTS: The
pharmacokinetic disposition of acyclovir was described as a two-compartment
model. Although the ranges for acyclovir clearance and terminal elimination (t
1/2 beta) were wide, a statistically significant relationship was demonstrated
between clearance and beta versus serum creatinine concentration. The average t
1/2 beta for infants with serum creatinine level less than 1 mg/dl (88 mumol/L)
was 5.0 hours, and 15.6 hours for those with serum creatinine level greater than 
1 mg/dl. CONCLUSIONS: Neonates with hepatic or renal dysfunction or young
premature infants accumulate acyclovir when dosed without adjustment for organ
dysfunction. Measurement of serum creatinine or creatinine clearance can be
useful in the dosing of acyclovir in neonates.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2066845 [PubMed - indexed for MEDLINE]

5662: Arch Intern Med. 1991 Jul;151(7):1295-303.

Comment in:
    Arch Intern Med. 1992 Aug;152(8):1726.    Arch Intern Med. 1992 Sep;152(9):1924.

Human immunodeficiency virus infection and the skin.

Cockerell CJ.

Department of Pathology, University of Texas Southwestern Medical Center, Dallas 
75235-9072.

The skin is commonly affected in the course of human immunodeficiency virus (HIV)
infection. In many cases, skin findings may be the earliest sign of HIV disease
or acquired immunodeficiency syndrome. When cutaneous diseases occur in unusual
settings, such as zoster in a young individual, are increased in severity or fail
to respond to routine therapy, the possibility of underlying immunodeficiency
should be suspected. Skin diseases in HIV-infected hosts include primary
infections, such as those caused by herpes simplex virus and molluscum
contagiosum, as well as secondary involvement of systemic diseases, such as
cryptococcosis and histoplasmosis. Noninfectious inflammatory processes, such as 
seborrheic dermatitis and psoriasis, as well as neoplasms, such as Kaposi's
sarcoma and basal cell carcinoma, may all be seen in these patients. We review a 
number of these diseases and discuss their treatment. Clinicians must be aware of
the cutaneous manifestations of HIV infection so that the disease will be
recognized at an earlier point in time and therapy with zidovudine and
prophylactic antibiotics will be instituted where appropriate.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 2064480 [PubMed - indexed for MEDLINE]

5663: Am J Dis Child. 1991 Jul;145(7):722-3.

Herpes zoster oticus.

Rathore MH, Friedman AD, Barton LL, Dunkle LM.

Publication Types: 
    Case Reports
    Letter

PMID: 2058599 [PubMed - indexed for MEDLINE]

5664: Minerva Anestesiol. 1991 Jul-Aug;57(7-8):433-6.

[The rationale for the use of peridural local anesthetics in the therapy of
herpes zoster]

[Article in Italian]

Pasqualucci V, Del Sindaco F, Cirulli P.

Istituto di Anestesiologia e Rianimazione, Universita degli Studi di Perugia.

Publication Types: 
    Review

PMID: 1944968 [PubMed - indexed for MEDLINE]

5665: Clin Chem. 1991 Jul;37(7):1153-60.

Quantification of virus-specific antibodies in cerebrospinal fluid and serum:
sensitive and specific detection of antibody synthesis in brain.

Reiber H, Lange P.

Neurochemisches Labor der Neurologischen Klinik, Universitat Gottingen, F.R.G.

Specific antibody synthesis in brain could be detected with maximal sensitivity
by combining an advanced enzyme immunoassay with a sophisticated evaluation
method that involves calculating the ratio between the cerebrospinal fluid
(CSF)/serum quotients for specific antibodies (Qspec) and total IgG (QIgG). This 
Antibody Index (AI = Qspec/QIgG) discriminates between a blood-derived and a
pathological, brain-derived specific antibody fraction in CSF and takes into
account individual changes in blood/CSF barrier function. For local synthesis of 
polyclonal IgG in the central nervous system (QIgG greater than QLim), we propose
the correction AI = Qspec/QLim (QLim represents that IgG fraction in CSF
originating only from blood, calculated from the individual albumin quotient of a
single patient). The normal reference range for the AI was between 0.7 and 1.3 (n
= 250 control patients for each antibody species). Values of AI greater than or
equal to 1.5 indicated a local specific antibody synthesis in the central nervous
system. Sensitivity and precision were greatest if we analyzed the virus-specific
antibodies in CSF and serum simultaneously with an enzyme immunoassay in
continuous concentrations (arbitrary units) instead of titer steps. We have
applied the method successfully to antibodies to measles, rubella, herpes
simplex, varicella-zoster, human immunodeficiency virus (HIV), and
cytomegalovirus, and to anti-Toxoplasma or -Borrelia antibodies. Clinical
relevance is demonstrated for an acute zoster virus infection (monospecific
response), chronic diseases such as HIV encephalitis with acute opportunistic
Toxoplasma infection, and multiple sclerosis (secondary polyspecific response).

PMID: 1855284 [PubMed - indexed for MEDLINE]

5666: Nippon Jinzo Gakkai Shi. 1991 Jul;33(7):665-71.

[Intravenous cyclophosphamide therapy in patients with steroid-resistant lupus
nephritis]

[Article in Japanese]

Matsumoto H, Shibasaki T, Ohno I, Kodama K, Kanai T, Mutsuda H, Nakano H,
Ishimoto F, Sakai O.

Second Department of Internal Medicine, Jikei University School of Medicine.

We evaluated short term clinical effects of intravenous cyclophosphamide (iv CyP)
therapy performed by every three month in 7 patients with steroid-resistant lupus
nephritis. Significant improvements were observed in daily urinary protein
excretion (3.1 to 0.83 g/day), creatinine clearance (65.4 to 95.3 ml/min), CH 50 
levels (20.8 to 37.4 U/ml), and anti-DNA antibody titer (26.6 to 7.0 U/ml). In
addition, the mean daily dose of prednisolone (PSL) could be markedly reduced
from 38.6 mg to 13.9 mg at the final observation. Two patients suffered from
Herpes Zoster infection at a few months after ivCyP therapy, however this
incidence were not considered as critical side effect which reached to the
discontinuation of this therapy. We concluded that ivCyP therapy by every three
months were safety and achieved beneficial clinical effects on steroid-resistant 
lupus nephritis as far as short observation. On the contrary, the long term
effect of this mode of therapy is to be defined.

Publication Types: 
    English Abstract

PMID: 1749117 [PubMed - indexed for MEDLINE]

5667: Neurology. 1991 Jul;41(7):1024-8.

Both intravenous lidocaine and morphine reduce the pain of postherpetic
neuralgia.

Rowbotham MC, Reisner-Keller LA, Fields HL.

Department of Neurology, University of California, San Francisco 94143.

We studied the analgesic efficacy of an intravenous infusion of lidocaine and
morphine in 19 adults with well-established postherpetic neuralgia in a
three-session, randomized, double-blind, placebo-controlled trial. Compared with 
saline placebo, both lidocaine and morphine reduced pain intensity. Reductions in
pain did not correlate with side effects produced by the infusions. For morphine,
there was a significant correlation between reductions in pain intensity and
blood level achieved. In the majority of subjects who reported definite pain
relief, allodynia also disappeared. The results show that neuropathic pain can
respond to opioids and to systemically administered local anesthetic drugs.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1712433 [PubMed - indexed for MEDLINE]

5668: Am Fam Physician. 1991 Jul;44(1):203-10.

Treatment of herpes zoster and postherpetic neuralgia.

Carmichael JK.

University of Arizona College of Medicine, Tucson.

Herpes zoster results from reactivation of latent varicella-zoster virus. It is
most common in elderly patients and immunosuppressed patients, especially those
with human immunodeficiency virus (HIV) infection. Zoster is often the earliest
indicator of HIV infection. The acute course of herpes zoster is generally
benign, but systemic complications may be fatal. Postherpetic neuralgia is the
major chronic complication and is a difficult management problem. High-dose
acyclovir (800 mg orally five times daily) has recently been approved for
treatment of herpes zoster and, if started early, decreases the duration and
severity of symptoms. In the prevention of postherpetic neuralgia, acyclovir does
not appear to be effective, and the efficacy of steroids is questionable. The
best therapy currently available for postherpetic neuralgia is amitriptyline,
topical capsaicin and transcutaneous electrical stimulation.

Publication Types: 
    Review

PMID: 1676237 [PubMed - indexed for MEDLINE]

5669: Kansenshogaku Zasshi. 1991 Jul;65(7):851-6.

[Herpes zoster in connective tissue diseases: I. Association with systemic lupus 
erythematosus and its immunological abnormalities]

[Article in Japanese]

Yamauchi Y, Nagasawa K, Tada Y, Tsukamoto H, Yoshizawa S, Mayumi T, Niho Y,
Kusaba T.

First Department of Internal Medicine, Faculty of Medicine, Kyushu University.

We determined the incidence of herpes zoster (HZ) in 119 patients with systemic
lupus erythematosus (SLE). HZ occurred in 56 patients (47%), and 9 patients had
had HZ even before SLE developed. After diagnosis of SLE, an incidence of zoster 
was high, 5.45 cases per 100 person-years. It was found that the susceptibility
to HZ was not related to the presence of renal disorder or maximum dose of
corticosteroids. The patients with SLE who had had HZ showed significantly higher
antibody titers than those without a history of HZ and normal subjects as assayed
by both complement fixation technique and neutralization test. On the other had, 
only 17 of 55 patients (31%) with SLE showed positive skin reactions to varicella
zoster virus (VZV) antigen, whereas all 15 normal subjects had positive
reactions. In the patients who were receiving less than 10 mg/day of
prednisolone, 11 of 17 (65%) had positive skin reactions to VZV antigen, whereas 
only 4 of 31 (13%) patients who were receiving 10 mg/day or more prednisolone
showed positive reactions. It was of interest that in 7 patients with SLE who had
not received corticosteroids, only 2 (29%) patients showed positive skin
reactions to VZV antigen. These results suggest that high incidence of HZ in
patients with SLE is probably due to an impaired cellular immunity because of
both underlying disease and corticosteroid treatment.

Publication Types: 
    English Abstract

PMID: 1655920 [PubMed - indexed for MEDLINE]

5670: J Clin Microbiol. 1991 Jul;29(7):1513-6.

Detection of varicella-zoster virus DNA by polymerase chain reaction in the
cerebrospinal fluid of patients suffering from neurological complications
associated with chicken pox or herpes zoster.

Puchhammer-Stockl E, Popow-Kraupp T, Heinz FX, Mandl CW, Kunz C.

Institute of Virology, University of Vienna, Austria.

The polymerase chain reaction (PCR) was used to detect varicella-zoster virus
(VZV) DNA in the cerebrospinal fluid of patients with VZV infection associated
with neurological symptoms. Positive results were obtained in three of five
children with post-chicken pox cerebellitis and in seven of seven herpes zoster
patients with neurological symptoms. The PCR thus provides a useful tool for the 
early diagnosis of VZV-associated neurological disease.

PMID: 1653267 [PubMed - indexed for MEDLINE]

5671: Scand J Immunol. 1991 Jul;34(1):45-52.

Strong donor mononuclear cell reactivity for herpes simplex virus (HSV) antigen
in HSV immune donors combined with recipient seropositivity for HSV is associated
with acute graft-versus-host disease.

Bostrom L, Ringden O, Forsgren M.

Department of Clinical Immunology, Karolinska Institute, Huddinge Hospital,
Stockholm, Sweden.

Prior to bone marrow transplantation (BMT) titres of IgG antibodies for
cytomegalovirus (CMV), herpes simplex virus (HSV) and varicella zoster virus
(VZV) were analysed in 51 donors and recipients of allogeneic bone marrow. Donor 
mononuclear cells from peripheral blood and bone marrow cells were stimulated
with antigen prepared from CMV, HSV and VZV. High IgG titres for HSV in the
recipient were associated with grade II-III acute graft-versus-host disease
(GVHD) (P = 0.05). Furthermore, the combination of positive IgG titre for HSV
antibodies in the recipient, and strong donor blood mononuclear cell reactivity
to HSV antigen in HSV immune donors, significantly increased the incidence of
grade II-III acute GVHD (P = 0.04). The data suggest that HSV immune donor
mononuclear cells may initiate a GVH reaction.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1648786 [PubMed - indexed for MEDLINE]

5672: Arch Dermatol. 1991 Jul;127(7):1069-71.

Acyclovir-resistant varicella zoster responsive to foscarnet.

Smith KJ, Kahlter DC, Davis C, James WD, Skelton HG, Angritt P.

Publication Types: 
    Case Reports
    Letter

PMID: 1648341 [PubMed - indexed for MEDLINE]

5673: Ann Intern Med. 1991 Jul 1;115(1):19-21.

Foscarnet therapy in five patients with AIDS and acyclovir-resistant
varicella-zoster virus infection.

Safrin S, Berger TG, Gilson I, Wolfe PR, Wofsy CB, Mills J, Biron KK.

University of California, San Francisco.

OBJECTIVE: To determine whether foscarnet has potential efficacy in the treatment
of acyclovir-resistant mucocutaneous varicella-zoster infection in patients with 
the acquired immunodeficiency syndrome (AIDS). DESIGN: Open-label study. SETTING:
Three university medical centers. PATIENTS: Five patients with AIDS who were
infected with thymidine-kinase-deficient or -altered strains of varicella-zoster 
virus. INTERVENTION: Foscarnet, 40 mg/kg body weight every 8 hours in 1-hour
infusions for 10 or more days. MAIN RESULTS: Four patients had healing in
response to foscarnet therapy, and each of four tested patients became culture
negative for virus during foscarnet therapy. Results of fluorescent antigen
testing remained positive during therapy in two patients; one of these patients
had concomitant clinical failure but the other patient healed fully. One patient 
had complete healing despite the emergence of resistance to foscarnet in serial
specimens obtained during foscarnet therapy. CONCLUSION: Foscarnet is a
potentially effective and tolerable antiviral agent for patients with
acyclovir-resistant, varicella-zoster virus infection; however, the optimal
dosage and duration of therapy require further study, as does the relation
between clinical findings and in-vitro susceptibility results.

PMID: 1646585 [PubMed - indexed for MEDLINE]

5674: Tumori. 1991 Jun 30;77(3):268-70.

Skin metastasis of ovarian cancer: report of three cases.

Merimsky O, Chaitchik S, Inbar M.

Department of Oncology, Ichilov Hospital, Tel-Aviv Sourasky Medical Center,
Israel.

Three cases of skin metastases in patients with ovarian cancer are reported. The 
late onset of skin metastases in the course of the disease represents an advanced
stage accompanied by intraperitoneal spread and has a poor prognosis. Diagnosis
and differentiation from herpes zoster and other skin tumors were based on
histologic examination. Palliation of symptoms and partial local response were
achieved by electron beam irradiation.

Publication Types: 
    Case Reports

PMID: 1862558 [PubMed - indexed for MEDLINE]

5675: Lakartidningen. 1991 Jun 26;88(26-27):2381-2.

[Zoster should be treated with peroral acyclovir]

[Article in Swedish]

Molin L.

Hudkliniken, regionsjukhuset, Orebro.

Publication Types: 
    Review

PMID: 1857160 [PubMed - indexed for MEDLINE]

5676: Biochem Pharmacol. 1991 Jun 21;42(1):91-6.

Herpes and human ribonucleotide reductases. Inhibition by 2-acetylpyridine
5-[(2-chloroanilino)-thiocarbonyl]-thiocarbonohydrazone (348U87).

Spector T, Harrington JA, Porter DJ.

Wellcome Research Laboratories, Research Triangle Park, NC 27709.

The mode of inactivation of herpes simplex virus type 1 and human ribonucleotide 
reductases by 2-acetylpyridine
5-[(2-chloroanilino)-thiocarbonyl]-thiocarbonohydrazone++ + (348U87) was
determined and compared to that described previously [Porter et al. Biochem
Pharmacol 39: 639-646, 1990] for 2-acetylpyridine
5-[(dimethylamino)thiocarbonyl]-thiocarbonohydrazone (A1110U). 348U87 inactivated
herpes ribonucleotide reductase faster than did A1110U. Moreover, iron-complexed 
348U87 was a considerably more potent inactivator than iron-complexed A1110U. It 
appeared to efficiently form an initial complex with the viral enzyme prior to
rapid enzyme inactivation. The combination of 348U87 and iron-complexed 348U87
inactivated with a rate constant that was slightly greater than the sum of their 
individual rate constants of inactivation. The corresponding combination of
A1110U species inactivated with a rate constant that was much greater than the
sum of the individual rate constants of inactivation. Herpes ribonucleotide
reductase that had been inactivated by either species of 348U87 was reactivated
by diluting the enzyme and inactivators into assay medium containing excess iron.
348U87 was also an effective inactivator of herpes simplex virus type 2 and
varicella zoster virus ribonucleotide reductases. The iron-complexed forms of
348U87 and A1110U exhibited very different modes of inactivation of human
ribonucleotide reductase. Iron-complexed 348U87 was a tight-binding inactivator, 
whereas iron-complexed A1110U was only a weak, non-inactivating, inhibitor.
Furthermore, the inactivation by iron-complexed 348U87 was not stimulated by
either 348U87 or A1110U, whereas the weak inhibition by iron-complexed A1110U was
converted to rapid inactivation by A1110U. Excess iron prevented the inactivation
by iron-complexed 348U87. Uncomplexed 348U87 was similar to uncomplexed A1110U in
that it was not an inhibitor of the human enzyme.

Publication Types: 
    Comparative Study

PMID: 1648925 [PubMed - indexed for MEDLINE]

5677: Med J Aust. 1991 Jun 3;154(11):781.

Comment in:
    Med J Aust. 1991 Aug 5;155(3):206-7.

EMLA cream and herpetic neuralgia.

Wheeler JG.

Publication Types: 
    Letter

PMID: 2046584 [PubMed - indexed for MEDLINE]

5678: Hum Immunol. 1991 Jun;31(2):94-9.

Viral antibody titers, immunogenetic markers, and their interrelations in
multiple sclerosis patients and controls.

Alperovitch A, Berr C, Cambon-Thomsen A, Puel J, Dugoujon JM, Ruidavets JB,
Clanet M.

INSERM U.169, Villejuif, France.

Our purpose was to investigate possible interrelations between antibody titers
against seven viruses (measles, rubella, herpes simplex, mumps, varicella-zoster,
coronavirus, cytomegalovirus), HLA-class II antigens, and immunoglobulin Gm
allotypes in multiple sclerosis (MS). We studied 57 MS patients and 59 controls
with similar age and sex distributions. In MS patients, we found the classical
increased frequency of HLA-DR2, HLA-DQw1 and also an excess of Gm (3; +/- 23;
5*). Mumps antibody levels were higher in MS patients than in controls; elevation
was not significant for measles antibodies. Analysis suggests that an association
between HLA-DQw1 and antibody titers against various viruses exists in controls
but is absent in MS patients. In particular, we found that mumps antibody titers 
were higher in DQw1-positive than in DQw1-negative controls, while there was no
significant difference among MS cases. Accordingly, we found that the overall
difference between patients and controls was due to the fact that DQw1-positive
patients had higher titers than controls, while DQw1-negative cases had similar
titers as controls. These findings suggest that biological and molecular
characteristics of DQw1 might differ in MS patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2066275 [PubMed - indexed for MEDLINE]

5679: J Med Chem. 1991 Jun;34(6):1767-72.

Synthesis and antiviral activity of 5-heteroaryl-substituted 2'-deoxyuridines.

Wigerinck P, Snoeck R, Claes P, De Clercq E, Herdewijn P.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

The synthesis of 5-heteroaryl-substituted 2'-deoxyuridines is described. The
heteroaromatics were obtained from three different 5-substituted
2'-deoxyuridines. Cycloaddition reaction of nitrile oxides on the 5-ethynyl
derivative 1 gave the isoxazoles 4a-e. The thiazole derivatives 14a-c were
obtained from the 5-thiocarboxamide 11, while 5-pyrrol-1-yl-2'-deoxyuridine (17) 
could be synthesized directly from 5-amino-2'-deoxyuridine. The compounds were
evaluated for antiviral activity. Selective activity against herpes simplex virus
type 1 (HSV-1) and varicella zoster virus (VZV) was noted for
5-(3-bromoisoxazol-5-yl)-2'-deoxyuridine (4c). The compound was inactive against 
herpes simplex virus type 2, cytomegalovirus, and thymidine kinase (TK)-deficient
mutants of HSV-1 and VZV, which indicates that, most likely, its antiviral
activity depends on phosphorylation by the virus-specified TK.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2061920 [PubMed - indexed for MEDLINE]

5680: Enferm Infecc Microbiol Clin. 1991 Jun-Jul;9(6):385.

[Diaphragmatic paralysis in cervical herpes zoster]

[Article in Spanish]

Agusti A, Cortes P, Bisbe J.

Publication Types: 
    Case Reports
    Letter
    Review

PMID: 1932254 [PubMed - indexed for MEDLINE]

5681: Neurologia. 1991 Jun-Jul;6(6):228-9.

[Cranial multineuritis caused by the varicella-zoster virus without cutaneous
lesion]

[Article in Spanish]

Castro-Salomo A, Royo I, Tintore M, Montalban J, Codina A.

Publication Types: 
    Case Reports
    Letter

PMID: 1931104 [PubMed - indexed for MEDLINE]

5682: Klin Monatsbl Augenheilkd. 1991 Jun;199(1):40-4.

[Secondary angle-block glaucoma in posterior scleritis]

[Article in German]

Mangouritsas G, Ulbig M.

Universitats-Augenklinik Wurzburg.

Posterior scleritis is an often misdiagnosed disease of the eye. Mainly it
appears in elderly women and tends to be recurrent. Symptoms leading to diagnosis
are swelling of the eye lids, a red eye, disturbances of the motility and
protrusio bulbi. In rare cases you find exudative choroidal or retinal
detachment, edema of the macula, or the optic nerve head, and secondary angle
closure glaucoma. Often posterior scleritis is associated with general illness as
herpes zoster, mixed connective tissue diseases, or Boeck's disease. Differential
diagnosis are choroidal tumors as for example, melanoma, hemangioma, and
metastases. The typical uveal effusion can also be caused by an arterio-venous
fistula, panretinal photocoagulation, buckling procedure for retinal detachment, 
and by intraocular surgery in general. Especially cyclitis anularis
pseudotumorosa has to be considered and shut out. Most important diagnostical
means are ultrasound, and CT-scan. The underlying case describes an 81 years old 
woman that presented with acute angle closure glaucoma, and exudative choroidal
detachment of the right eye. The ultrasound and CT-scan investigations confirmed 
the diagnosis of scleritis posterior. The acute angle closure glaucoma, and the
choroidal detachment regressed immediately under the treatment with steroids
given locally and systemically. There was no impact of miotics and peripheral
iridectomy which both could not avoid recurrence of angle closure glaucoma.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1895739 [PubMed - indexed for MEDLINE]

5683: Int J Dermatol. 1991 Jun;30(6):432-4.

Cutaneous malignancies mimicking herpes zoster.

Williams LR, Levine LJ, Kauh YC.

Department of Dermatology, Jefferson Medical College, Thomas Jefferson
University, Philadelphia, Pennsylvania 19107.

Cutaneous metastases occur in 2.5% to 5% of patients with malignant disease. The 
relative frequency of the primary site roughly parallels the frequency of the
various malignancies in each sex. We present two cases of cutaneous malignancy
occurring in a dermatomal distribution and masquerading as herpes zoster. The
differential diagnosis of zosteriform eruptions is reviewed and the possible
pathogenesis of metastatic disease in this cutaneous distribution is discussed.
Skin biopsy is recommended in these cases to determine the etiology of the
eruption.

Publication Types: 
    Case Reports

PMID: 1894409 [PubMed - indexed for MEDLINE]

5684: Bone Marrow Transplant. 1991 Jun;7(6):435-7.

Early herpes zoster infection in adult patients with Hodgkin's disease undergoing
autologous bone marrow transplant.

Christiansen NP, Haake RJ, Hurd DD.

Department of Medicine, University of Minnesota Health Sciences Center,
Minneapolis.

The incidence of varicella-zoster-virus infection/reactivation in adult patients 
with Hodgkin's disease undergoing autologous bone marrow transplantation (BMT) at
the University of Minnesota Hospital and Clinic was determined. Seven of 28
evaluable patients (25%) developed varicella-zoster infections in the first 150
days post-transplant. Two additional patients developed zoster after day 150 for 
a total incidence of 32%. We evaluated analysed risk factors to determine if
there were any characteristics that could identify patients at risk for zoster
early (less than 150 days) in their post-transplant course. Sex, age, prior
radiation, and lack of immunity as determined by viral antibody titers were not
associated with an increased incidence. Ten of the 28 patients had a history of
zoster at some time after the diagnosis of Hodgkin's disease. Six of these 10
patients (60%) again developed zoster post-transplant. This compared to only one 
episode of varicella-zoster post-transplant among the 18 patients without a
history of zoster following the diagnosis of Hodgkin's disease (p less than 0.01,
Fisher's exact). We conclude that a prior history of zoster any time after
diagnosis of Hodgkin's disease is strongly associated with developing zoster in
the first 150 days after autologous BMT.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1873590 [PubMed - indexed for MEDLINE]

5685: Bone Marrow Transplant. 1991 Jun;7(6):489-91.

Comment in:
    Bone Marrow Transplant. 1992 Mar;9(3):217.

Abdominal presentation of varicella-zoster infection in recipients of allogeneic 
bone marrow transplantation.

Schiller GJ, Nimer SD, Gajewski JL, Golde DW.

Department of Medicine, UCLA School of Medicine 90024-1678.

We report here three recipients of allogeneic bone marrow transplantation in whom
visceral varicella-zoster virus infection preceded cutaneous dissemination
producing life-threatening complications including hepatitis, pancreatitis and
haemorrhage.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 1843181 [PubMed - indexed for MEDLINE]

5686: Klin Med (Mosk). 1991 Jun;69(6):69-72.

[Acyclovir in the treatment of severe generalized forms of herpes zoster]

[Article in Russian]

Shishov AS, Leshchinskaia EV, Martynenko IN.

Aciclovir administration in 8 herpes zoster patients aged 14-74 to manage
resistant generalized herpetic eruption, serous meningitis, meningoencephalitis
resulted in a pronounced response in 5 of them. Aciclovir has the advantage of
its effectiveness in spite of late treatment (on herpes zoster day 6-22). This is
particularly important for those forms of the disease which manifest severe
symptoms during the second phase, i.e. disseminated eruption, involvement of
brain matter, etc. Two lethal outcomes due to pulmonary artery embolism were
unrelated to the drug administration.

Publication Types: 
    Case Reports
    Clinical Trial
    English Abstract

PMID: 1774918 [PubMed - indexed for MEDLINE]

5687: J Hosp Infect. 1991 Jun;18 Suppl A:317-29.

Natural history and treatment of varicella-zoster in high-risk populations.

Gnann JW, Whitley RJ.

Department of Medicine, University of Alabama, Birmingham.

Rigorous clinical trials have established that both acyclovir and vidarabine
favourably alter the clinical course of herpes zoster and chicken-pox in
immunocompromised patients. In one comparative study, acyclovir was shown to be
superior to vidarabine for zoster in bone marrow transplant recipients. These
data, plus the fact that acyclovir is easier to administer than vidarabine, and
perhaps less toxic, have made intravenous acyclovir the recognized drug of choice
for treatment of herpes zoster in immunocompromised patients. Acyclovir sodium
sterile powder received Federal Drug Administration (FDA) approval for this
indication in 1990 in the United States. Since complications of zoster occur in
only a minority of immunocompromised patients, most physicians would prefer to
initiate therapy with an orally-administered drug and avoid the cost and
inconvenience of hospitalization. Future studies will compare the efficacy and
safety of orally administered bromovinyl arabinosyl uracil and acyclovir in
treatment of varicella-zoster virus infections.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1679798 [PubMed - indexed for MEDLINE]

5688: Microb Pathog. 1991 Jun;10(6):451-8.

Chemotaxis of polymorphonuclear leukocytes to varicella-zoster virus antigens.

Ihara T, Yasuda N, Kamiya H, Torigoe S, Sakurai M.

Department of Pediatrics, Mie National Hospital, Japan.

Chemotaxis of polymorphonuclear leukocytes (PMNs) to various varicella-zoster
virus (VZV) antigens was studied using a membrane filter method. Chemotactic
activity of PMNs was detected in the presence of sonicated VZV antigen and
soluble VZV skin test antigen. This activity was reduced when sonicated VZV
antigen was treated with human seropositive serum or murine monoclonal antibodies
which reacted with glycoprotein (GP) I or GP II of VZV. However, chemotaxis of
PMNs was not reduced when sonicated VZV antigen was treated with human
seronegative serum or a murine monoclonal antibody which reacted with GP IV.
These results suggest that GP I and GP II act as chemoattractants to PMNs, and
this mechanism might contribute to the resolution of the skin lesions of
varicella and herpes zoster.

Publication Types: 
    In Vitro

PMID: 1665536 [PubMed - indexed for MEDLINE]

5689: Clin Chest Med. 1991 Jun;12(2):223-35.

Viral pneumonitis.

Ruben FL, Nguyen ML.

University of Pittsburgh School of Medicine, Pennsylvania.

Viral pneumonitis can affect all age groups and normal as well as compromised
hosts. This article discusses salient features of pneumonitis caused by
respiratory syncytial virus, adenoviruses, varicella-zoster virus, herpes simplex
virus, influenza A and B viruses, and cytomegalovirus. The clinical picture,
diagnosis, treatment and prevention for each agent are discussed.

Publication Types: 
    Review

PMID: 1649731 [PubMed - indexed for MEDLINE]

5690: Pediatr Infect Dis J. 1991 Jun;10(6):476.

Comment on:
    Pediatr Infect Dis J. 1990 Dec;9(12):865-9.

Volume of varicella-zoster immune globulin.

Marchant CD, Leszczynski J.

Publication Types: 
    Comment
    Letter

PMID: 1649433 [PubMed - indexed for MEDLINE]

5691: Brain. 1991 Jun;114 ( Pt 3):1181-96.

Herpes zoster myelitis.

Devinsky O, Cho ES, Petito CK, Price RW.

Department of Neurology, New York Hospital-Cornell University Medical Center, NY 
10003.

We studied the clinical (10 patients) and pathological (9 patients) findings in
13 patients with herpes zoster myelitis, all of whom had systemic illnesses
associated with immunosuppression. The median interval between the onset of the
herpes zoster rash and myelopathic symptoms was 12 days, and the subsequent
median interval to maximal deficit was 10.5 days. Presenting neurological
symptoms were characteristically ipsilateral to the rash, with motor dysfunction 
predominating, followed by a spinothalamic and, less often, posterior column
sensory deficit. Pathological involvement was most severe in the dorsal root
entry zone and posterior horn of the spinal cord segment corresponding to the
involved dermatome. There was variable spread both horizontally and vertically in
the spinal cord. Direct varicella-zoster virus (VZV) infection of neuroectodermal
cells, particularly oligodendrocytes, was demonstrated by immunostaining viral
antigens (8 cases), and by the presence of Cowdry type A intranuclear inclusions 
(7 cases) and often was associated with focal demyelination (6 cases). In 4
patients a VZV vasculitis was associated with leptomeningitis and haemorrhagic
necrosis (spinal cord in 1; brainstem or cerebellum in 3). The protracted
evolution in many cases and the pathologically documented direct viral infection 
of the spinal cord provide a rational basis for the use of antiviral therapy in
preventing or attenuating the evolving myelopathy.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1648419 [PubMed - indexed for MEDLINE]

5692: Gene. 1991 May 30;101(2):203-8.

Sequence analysis of the 4.7-kb BamHI-EcoRI fragment of the equine herpesvirus
type-1 short unique region.

Elton DM, Halliburton IW, Killington RA, Meredith DM, Bonass WA.

Department of Microbiology, University of Leeds, U.K.

To localize gene that may encode immunogens potentially important for recombinant
vaccine design, we have analysed a region of the equine herpesvirus type-1
(EHV-1) genome where a glycoprotein-encoding gene had previously been mapped. The
4707-bp BamHI-EcoRI fragment from the short unique region of the EHV-1 genome was
sequenced. This sequence contains three entire open reading frames (ORFs), and
portions of two more. ORF1 codes for 161 amino acids (aa), and represents the C
terminus of a possible membrane-bound protein. ORF2 (424 aa) and ORF3 (550 aa)
are potential glycoprotein-encoding genes; the predicted aa sequences contain
possible signal sequences, N-linked glycosylation sites and transmembrane
domains; they also show homology to the glycoproteins gI and gE of herpes simplex
virus type-1 (HSV-1), and the related proteins of pseudorabies virus and
varicella-zoster virus. The predicted aa sequence of ORF4 shares no homology with
other known herpesvirus proteins, but the nucleotide sequence shows a high level 
of homology with the corresponding region of the EHV-4 genome. ORF5 may be
related to US9 of HSV-1.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1647359 [PubMed - indexed for MEDLINE]

5693: Pediatr Infect Dis J. 1991 May;10(5):412-3.

Herpes zoster in a five-month-old infant after intrauterine exposure to
varicella.

Vachvarichsanong P.

Department of Pediatrics, Faculty of Medicine, Prince of Songkla University,
Thailand.

Publication Types: 
    Case Reports

PMID: 2067896 [PubMed - indexed for MEDLINE]

5694: Laryngorhinootologie. 1991 May;70(5):260-6.

[T-lymphocyte subpopulation and HLA-DR antigens in hearing loss of vestibular
neuropathy, Meniere's diseases and Bell's palsy]

[Article in German]

Bumm P, Muller EC, Grimm-Muller U, Schlimok G.

Krankenhaus Zweckverband Augsburg HNO-Klinik.

In patients with various otoneurological diseases like hearing loss, neuronitis
vestibularis, Meniere's disease and Bell's palsy, analyses concerning the
immunoregulation and immunogenetics were done. For analysing the immunoregulation
the T-helper (CD4) T-suppressor (CD8) ratio was determined. In contrast to
patients with hearing loss caused by otobasal fractures and a healty control
group, this ratio was elevated in 50% of the patients suffering from hearing
loss. The elevation of the CD4/CD8 ratio was mainly caused by a reduction of CD8 
positive cytotoxic-suppressor T-lymphocytes. The CD4/CD8 ratio may be of
prognostic value, since an elevated ratio was found more often in patients with
relapse of hearing loss, fluctuations, persistence of tinnitus or vestibular
symptoms. An elevated ratio could also be detected in 48% of the patients with
neuronitis vestibularis, in 50% of the patients with Meniere's disease and in 39%
of the patients with Bell's palsy. A normal value was found in paralysis of the
facial nerve of known origin like a state after trauma or after herpes zoster
oticus paralysis. Immunogenetics was tested by HLA-DR typing. In patients with
hearing loss HLA-DR4 antigen was distinctly increased, the relative risk was 2.8.
The presence of the HLA-DR4 antigen proved to be an unfavourable sign, since in
44% of the patients presenting these antigens we found no improvement of the
hearing. In patients with neuronitis vestibularis we found a relative risk of
3.12 and in patients with Meniere's disease a relative risk of 3.64, both for
HLA-DR4.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    English Abstract

PMID: 2064703 [PubMed - indexed for MEDLINE]

5695: Br J Cancer. 1991 May;63(5):769-72.

Medical history and the risk of multiple myeloma.

Gramenzi A, Buttino I, D'Avanzo B, Negri E, Franceschi S, La Vecchia C.

Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.

The relationship between various diseases and immunisations and the risk of
multiple myeloma was analysed using data from a hospital-based case-control study
conducted in Northern Italy on 117 patients with multiple myeloma and 477
controls. Associations were observed for clinical history of scarlet fever
(relative risk, RR = 2.0; 95% confidence interval, CI = 1.1-3.9), tuberculosis
(RR = 2.3%; 95% CI = 0.9-5.7) and BCG immunisation (RR = 3.0; 95% CI = 1.4-6.4). 
The relative risk was 1.8 (95% CI = 0.9-3.5) for episodes of Herpes zoster
infection, but most of the excess cases occurred within 10 years of diagnosis,
suggesting that this might have been an early manifestation of the disease. No
association emerged for common childhood viral infections or any other
immunisation practice. When various classes of infectious or inflammatory
diseases were grouped together according to their aetiology, there was a
significant positive association with chronic bacterial illnesses (RR = 1.8; 95% 
CI = 1.1-2.8), and the relative risk estimates increased with the number of
bacterial diseases. The trend in risk with number of diseases was significant
(chi 21 = 4.5, P = 0.03). A negative association was found between allergic
conditions and risk of multiple myeloma (RR = 0.6; 95% CI = 0.3-1.0).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2039702 [PubMed - indexed for MEDLINE]

5696: J Intraven Nurs. 1991 May-Jun;14(3 Suppl P):S25-9.

Treatment modalities for patients with HIV disease.

Molaghan JB.

Pharmacologic and psychosocial interventions begin at the time HIV infection is
diagnosed and continue to the end of the patient's life. It is important that the
nurse and patient communicate effectively with one another about the significance
of being HIV positive, including disease progression and treatment modalities.
Symptoms of and treatments for early infection (e.g., oral candidiasis, aphthous 
stomatitis, staphylococcal folliculitis, and herpes zoster) are reviewed.
Pneumocystis carinii infection is a major concern; pentamidine, dapsone, and
trimethoprim--sulfamethoxazole may be used for prophylaxis. Regimens and
guidelines for zidovudine treatment are discussed. Promising antiretroviral
therapies include ddI, ddC, CD4, protease inhibitors, and compound Q. Ultimately,
vaccines may be available.

PMID: 2033484 [PubMed - indexed for MEDLINE]

5697: Med Clin North Am. 1991 May;75(3):661-75.

Diagnosis and treatment of headache in the elderly.

Baumel B, Eisner LS.

Neurological Center for Headache, Miami Beach, Florida.

The diagnosis and management of some causes of headache in the elderly are
reviewed. Etiologic theories have been presented for each condition. Treatment
modalities include pharmacologic, nonpharmacologic, and surgical therapies. The
treatment course set forth in this article can help the clinician provide proper 
relief for the patient in pain.

Publication Types: 
    Review

PMID: 2020221 [PubMed - indexed for MEDLINE]

5698: Klin Monatsbl Augenheilkd. 1991 May;198(5):470-3.

[Usefulness of the Laser FLare Cell Meter (LFCM, Kowa FC-1000) for evaluating
inflammation of the anterior chamber in clinical practice]

[Article in French]

Herbort CP, Bigar F, Pittet N.

Hopital Ophthalmique Jules Gonin, Departement d'Ophtalmologie, Universite de
Lausanne.

The Laser Flare Cell Meter (LFCM, Kowa FC-1000), an instrument measuring aqueous 
flare and cells in a quantitative, objective and non-invasive way, has been
mainly used so far to measure inflammation in clinical and experimental research.
In the light of some illustrative examples, its practical clinical usefulness is 
presented; the LFCM was found to be specially helpful in 3 types of situations.
1. In acute anterior uveitis (AAU) patients, precise LFCM monitoring of
inflammation made it possible to avoid excessive corticosteroid therapy, mainly
by more rapid and controlled tapering at the end of an inflammatory episode, so
possibly minimizing steroid side effects in a group of patients prone to numerous
uveitis recurrences. In a steroid-responder patient it allowed successful
treatment of a flare-up of AAU with a combination of systemic and topical
diclofenac (Voltaren), a potent nonsteroidal antiinflammatory drug. 2. LFCM
monitoring of inflammation in patients undergoing laser treatments allowed
optimal adjustment of antiinflammatory therapy. Diclofenac drops (Voltarene
Ophta), were sufficient to treat inflammation in all patients, undergoing Nd-YAG 
laser posterior capsulotomy or Argon laser trabeculoplasty. 3. In patients with
acyclovir treated herpes simplex or herpes zoster uveitis corticosteroid
treatment should be avoided whenever possible, because of the tendency to develop
steroid dependency. LFCM monitoring of this group of patients gave a precise
evolutionary pattern of inflammation and permitted to avoid steroid treatment in 
many patients.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1886388 [PubMed - indexed for MEDLINE]

5699: Klin Monatsbl Augenheilkd. 1991 May;198(5):358-60.

[Prevention of ocular complications of herpes zoster ophthalmicus by adequate
treatment with acyclovir]

[Article in French]

Borruat FX, Buechi ER, Piguet B, Fitting P, Zografos L, Herbort CP.

Hopital Ophtalmique Jules Gonin, Lausanne.

We compared the frequency of severe ocular complications secondary to Herpes
Zoster Ophthalmicus (HZO) in 232 patients. They were divided into three groups:
1) patients without treatment (n = 164); 2) patients treated adequately (n = 48) 
with acyclovir (ACV; 5 x 800 mg/d orally and ophthalmic ointment 5 x /d for a
minimum of 7 days, given within three days after skin eruption); and, 3) patients
treated inadequately (n = 20) with ACV (only topical treatment, insufficient
doses, interrupted treatment, delayed treatment). Patients with no treatment or
with inadequate treatments showed the same frequency of severe ocular
complications (21% (34/164) and 25% (5/20), respectively). In contrast, when
adequate treatment of ACV was given complications occurred in only 4% (2/48) of
cases. This study emphasizes the need for prompt (within three days after skin
eruption) and adequate (5 x 800 mg/d for at least 7 days) treatment of ACV to
prevent the severe complications of HZO.

Publication Types: 
    English Abstract

PMID: 1886356 [PubMed - indexed for MEDLINE]

5700: Am J Otol. 1991 May;12(3):163-8.

Gadolinium-enhanced magnetic resonance imaging of the facial nerve in herpes
zoster oticus and Bell's palsy: clinical implications.

Korzec K, Sobol SM, Kubal W, Mester SJ, Winzelberg G, May M.

Facial Paralysis Center, Shadyside Hospital, Pittsburgh, Pennsylvania.

Gadolinium-enhanced magnetic resonance imaging was used in the evaluation of the 
facial nerve in four patients with idiopathic facial paralysis and six with
herpes zoster oticus (HZO). Enhancement of the facial nerve was seen in all
patients with Bell's palsy, and 50 percent of patients with HZO. The most
consistent area of enhancement in both disorders involved the premeatal and
labyrinthine segments. Although the images showed changes consistent with the
type of viral process that is known to occur in these disorders, we found no
significant correlation between the intensity or pattern of facial nerve
enhancement on the images, the severity or duration of the disease, or the
patient's prognosis for recovery. Nevertheless, gadolinium-enhanced MRI does have
a place in the evaluation and decisions for management of select cases of facial 
paralysis.

PMID: 1882962 [PubMed - indexed for MEDLINE]

5701: Mt Sinai J Med. 1991 May;58(3):257-66.

Acute herpetic and postherpetic neuralgia: clinical features and management.

Galer BS, Portenoy RK.

Department of Neurology, Albert Einstein College of Medicine, Bronx, NY.

Herpes zoster is a prevalent disorder that is transitory in most patients.
Postherpetic neuralgia is defined by the persistence of pain following herpes
zoster for some arbitrarily defined period, such as two months. Although most
patients with postherpetic neuralgia experience a gradual remission of the pain, 
symptoms are prolonged in many, and intractable pain occurs in a few. This review
describes the clinical characteristics and management of these syndromes.

Publication Types: 
    Review

PMID: 1875964 [PubMed - indexed for MEDLINE]

5702: Cancer Causes Control. 1991 May;2(3):157-64.

Non-occupational risk factors for adult soft-tissue sarcoma in northern Italy.

Serraino D, Franceschi S, Talamini R, Frustaci S, La Vecchia C.

Epidemiology Unit, Aviano Cancer Center, Italy.

The role of socioeconomic and anthropometric indicators, tobacco, alcohol
consumption, dietary habits, and medical history in the etiology of soft-tissue
sarcoma (STS) was examined in a hospital-based case-control study, conducted in
the Friuli-Venezia Giulia region of northeast Italy, between 1985 and 1990. A
total of 88 STS cases (53 males and 35 females; median age: 52 years) and of 610 
controls (306 males and 304 females; median age: 54 years) were interviewed.
There were significant excess risks associated with a history of herpes zoster
infection (odds ratio [OR] = 2.4, 95 percent confidence interval [CI] = 1.1-5.3),
chicken pox (OR = 2.2, CI = 1.2-4.3) and mumps in childhood (OR = 2.0, CI =
1.1-3.9). History of diabetes was also linked to a nonsignificant increase in STS
risk (OR = 1.8, CI = 0.6-5.4), whereas exposure to radiation for diagnostic or
therapeutic purposes was not related to the probability of developing STS. None
of the investigated socioeconomic and anthropometric indicators seemed to affect 
STS risk; neither did tobacco smoking, nor consumption of alcohol, coffee, and
tea beverages. Conversely, among the dietary habits investigated, a significant
positive association emerged with an increasing frequency of consumption of dairy
products (chi 2 for trend = 6.8, P less than 0.01) and oil (chi 2 for trend =
4.3, P less than 0.05), while a negative association was seen for intake of whole
grain bread and pasta (OR for highest cf lowest tertile = 0.4, CI = 0.2-0.9).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1873445 [PubMed - indexed for MEDLINE]

5703: J Neurol Sci. 1991 May;103(1):101-4.

Intrathecal humoral immune reaction in zoster infections.

Schadlich HJ, Nekic M, Jeske J, Karbe H.

Neurological Clinic, University of Cologne, F.R.G.

Intrathecal humoral immune reaction in 26 patients with a reactivation of
varicella-zoster virus was analyzed. 11 suffered from ganglionitis, in 7 cases an
additional affection of the lower motor neuron was demonstrable. In 8 patients,
meningitis, myelitis or cerebral infarctions by zoster angiitis were diagnosed.
Intrathecal immune reaction in ganglionitis was weak whereas an intense IgG
synthesis became demonstrable in all meningomyelitis/cerebral infarction cases.
As demonstrated by immunoblotting, in early stages of the disease immune reaction
in serum and cerebrospinal fluid differed only quantitatively. In the further
course, most intrathecally synthesized antibodies were directed against low
molecular antigens whereas serum pattern did not change. In some patients,
additional antibodies not detectable in serum were demonstrable. Though intensity
markedly differed, no qualitative differences between the immune response in
ganglionitis and more widespread zoster infections of the CNS were detectable.

PMID: 1865223 [PubMed - indexed for MEDLINE]

5704: Ann Neurol. 1991 May;29(5):492-7.

Epidemiology of encephalitis in children: a 20-year survey.

Koskiniemi M, Rautonen J, Lehtokoski-Lehtiniemi E, Vaheri A.

Department of Virology, University of Helsinki, Finland.

Four hundred five children from the Helsinki area who were 1 month to 16 years
old were treated for acute encephalitis at the Children's Hospital, University of
Helsinki, from January 1968 through December 1987. Encephalitis occurred most
commonly in children 1 to 1.9 years of age, among whom the incidence was 16.7 per
100,000 child-years. The incidence remained quite high until the age of 10 years,
and then gradually declined to 1.0 per 100,000 child-years at the age of 15
years. Since 1983, when mumps, measles, and rubella vaccination eradicated the
encephalitides associated with these microbes, the major associated agents have
been varicella-zoster, Mycoplasma pneumoniae, and respiratory and enteroviruses. 
In infants younger than 1 year of age, the major agents were enteroviruses,
herpes simplex virus, and the group of "others," whereas in older children,
respiratory viruses and Mycoplasma pneumoniae, as well as varicella-zoster virus,
dominated. In children aged 1 to 11 months, the causal agent could not be
identified in one-half of all cases, whereas in children who were at least 10
years old, the etiology remained unknown in only one-fourth of cases. Male
dominance was most evident in the 4- to 9-year age group. The difference in
etiology between males and females was significant (p = 0.02); mumps and
varicella were more common in boys, and adenovirus and Mycoplasma pneumoniae were
more common in girls. The overall male-to-female ratio was 1.4:1. Characteristic 
seasonal variation occurred in encephalitides associated with mumps, measles, and
entero- and respiratory viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 1859180 [PubMed - indexed for MEDLINE]

5705: J Gen Virol. 1991 May;72 ( Pt 5):1113-21.

Sequence of the HindIII T fragment of human cytomegalovirus, which encodes a DNA 
helicase.

Martignetti JA, Barrell BG.

Medical Research Council Laboratory of Molecular Biology, Cambridge, U.K.

The DNA sequence of the HindIII T fragment of human cytomegalovirus strain AD169 
has been determined. This 6225 bp sequence has been analysed for transcription
signals and probable open reading frames. Similarities with herpes simplex virus,
varicella-zoster virus and Epstein-Barr virus genes were observed for three of
the predicted open reading frames; a virion protein and a unique DNA helicase are
believed to be the functional products of two of these open reading frames. Two
other open reading frames are novel in that no homologues could be found, either 
in the known herpesvirus sequences or in the Protein Identification Resource
database. Both of these open reading frames also lie in the genomic coding region
of a 5.0 kb RNA which is transcribed throughout the infectious cycle.

PMID: 1851811 [PubMed - indexed for MEDLINE]

5706: J Virol. 1991 May;65(5):2320-6.

Antigenic and protein sequence homology between VP13/14, a herpes simplex virus
type 1 tegument protein, and gp10, a glycoprotein of equine herpesvirus 1 and 4.

Whittaker GR, Riggio MP, Halliburton IW, Killington RA, Allen GP, Meredith DM.

Department of Microbiology, University of Leeds, United Kingdom.

Monospecific polyclonal antisera raised against VP13/14, a major tegument protein
of herpes simplex virus type 1 cross-reacted with structural equine herpesvirus 1
and 4 proteins of Mr 120,000 and 123,000, respectively; these proteins are
identical in molecular weight to the corresponding glycoprotein 10 (gp10) of each
virus. Using a combination of immune precipitation and Western immunoblotting
techniques, we confirmed that anti-VP13/14 and a monoclonal antibody to gp10
reacted with the same protein. Sequence analysis of a lambda gt11 insert of
equine herpesvirus 1 gp10 identified an open reading frame in equine herpesvirus 
4 with which it showed strong homology; this open reading frame also shared
homology with gene UL47 of herpes simplex virus type 1 and gene 11 of
varicella-zoster virus. This showed that, in addition to immunological
cross-reactivity, VP13/14 and gp10 have protein sequence homology; it also
allowed identification of VP13/14 as the gene product of UL47.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1850013 [PubMed - indexed for MEDLINE]

5707: Ann Ophthalmol. 1991 May;23(5):188-9.

Treatment for herpes zoster ophthalmicus: stellate ganglion block as a treatment 
for acute pain and prevention of postherpetic neuralgia.

Currey TA, Dalsania J.

Eye Specialists Association, Germantown, TN 38138-3653.

PMID: 1750737 [PubMed - indexed for MEDLINE]

5708: J Indian Med Assoc. 1991 May;89(5):117-9.

Clinical profile of herpes zoster ophthalmicus.

Nigam P, Kumar A, Kapoor KK, Sarkari NB, Gupta AK, Lal BB, Mukhija RD.

BRD Medical College, Gorakhpur.

Herpes zoster ophthalmicus was seen in 22 cases out of 195 cases of herpes zoster
(11.3% incidence). It was affecting mainly adults (90.9%). Oedema over the lids
(81.8%) was invariably present and lead to ptosis. Mucopurulent conjunctivitis,
predominantly mucoid (72.7%) was the commonest manifestation associated with
vesicles over the lid margins. Sectorial (22.7%) and diffuse (9.1%) episcleritis 
appeared in later part of first week, while nodular episcleritis was observed in 
one case only on 12th day of the disease. Nummular keratitis was seen in 31.8% of
cases between 8-10 days. Iritis and iridocyclitis was seen in 45.4% of cases out 
of which 36.3% had secondary ocular hypertension (glaucoma). Neuroparalytic
keratitis and internal ophthalmoplegia were detected in one patient each.
Postherpetic neuralgia occurred in 22.7% of cases and was uncommon in younger age
group (below 40 years, 4.5%). Carbamazepine was effective in relieving the
herpetic pain.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 1748774 [PubMed - indexed for MEDLINE]

5709: Antiviral Res. 1991 May;15(4):341-4.

Drug testing for activity against varicella-zoster virus in hairless guinea pigs.

Myers MG, Stanberry LR.

Division of Infectious Diseases, Children's Hospital Research Foundation,
Cincinnati, OH 45229-2899.

Inoculation of congenitally hairless guinea pigs with varicella-zoster virus
(VZV) (Oka strain) results in a self-limited exanthematous infection analogous to
varicella in children. Administration of acyclovir or 6-methoxypurine arabinoside
modified the course of infection. This model should facilitate pre-clinical
testing of putative anti-VZV agents.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1659314 [PubMed - indexed for MEDLINE]

5710: Ann Neurol. 1991 May;29(5):569-72.

Fatal varicella-zoster virus meningoradiculitis without skin involvement.

Dueland AN, Devlin M, Martin JR, Mahalingam R, Cohrs R, Manz H, Trombley I,
Gilden D.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

A 77-year-old man with T-cell lymphoma developed an acute fatal
meningoradiculitis of cranial nerve roots and cauda equina, pathologically and
virologically confirmed to be caused by varicella-zoster virus. This is the first
report of fatal varicella-zoster virus-induced neurological disease in the
absence of skin lesions. Varicella-zoster virus should be included in the
differential diagnosis of acute radiculoneuropathy in the immunocompromised
patient, particularly because antiviral treatment for varicella-zoster virus
exists.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1650163 [PubMed - indexed for MEDLINE]

5711: Antimicrob Agents Chemother. 1991 May;35(5):851-7.

6-Methoxypurine arabinoside as a selective and potent inhibitor of
varicella-zoster virus.

Averett DR, Koszalka GW, Fyfe JA, Roberts GB, Purifoy DJ, Krenitsky TA.

Wellcome Research Laboratories, Research Triangle Park, North Carolina 27709.

Seven 6-alkoxypurine arabinosides were synthesized and evaluated for in vitro
activity against varicella-zoster virus (VZV). The simplest of the series,
6-methoxypurine arabinoside (ara-M), was the most potent, with 50% inhibitory
concentrations ranging from 0.5 to 3 microM against eight strains of VZV. This
activity was selective. The ability of ara-M to inhibit the growth of a variety
of human cell lines was at least 30-fold less (50% effective concentration,
greater than 100 microM) than its ability to inhibit the virus. Enzyme studies
suggested the molecular basis for these results. Of the seven 6-alkoxypurine
arabinosides, ara-M was the most efficient substrate for VZV-encoded thymidine
kinase as well as the most potent antiviral agent. In contrast, it was not
detectably phosphorylated by any of the three major mammalian nucleoside kinases.
Upon direct comparison, ara-M was appreciably more potent against VZV than either
acyclovir or adenine arabinoside (ara-A). However, in the presence of an
adenosine deaminase inhibitor, the arabinosides of adenine and 6-methoxypurine
were equipotent but not equally selective; the adenine congener had a much less
favorable in vitro chemotherapeutic index. Again, this result correlated with
data from enzyme studies in that ara-A, unlike ara-M, was a substrate for two
mammalian nucleoside kinases. Unlike acyclovir and ara-A, ara-M had no
appreciable activity against other viruses of the herpes group. The potency and
selectivity of ara-M as an anti-VZV agent in vitro justify its further study.

Publication Types: 
    Comparative Study

PMID: 1649571 [PubMed - indexed for MEDLINE]

5712: Br J Ophthalmol. 1991 May;75(5):292-7.

Acute retinal necrosis syndrome.

Gartry DS, Spalton DJ, Tilzey A, Hykin PG.

St Thomas's Hospital, Department of Ophthalmology, London.

Acute retinal necrosis (ARN) is a rare syndrome with characteristic fundal
appearances which can have devastating effects on vision. We present six cases
(nine eyes) seen in the Medical Eye Unit of St Thomas's Hospital over the past
six years and discuss the clinical features, aetiology, and management. Our
findings support the present consensus that the condition is caused by varicella 
zoster virus (VZV) or herpes simplex virus (HSV). One of our patients, who was
atypical in having common variable hypogammaglobulinaemia, had suffered a
widespread zosteriform rash immediately prior to the onset of ARN, while another 
had suffered a herpes simplex uveomeningoencephalitis. All cases had
characteristic confluent peripheral retinal necrosis, and three of the nine eyes 
developed retinal detachment. Retinal arteritis was a prominent and helpful
diagnostic feature in one case. From combining all reports to date of this rare
condition it is possible to conclude that ARN is unilateral in 65% of cases.

Publication Types: 
    Case Reports

PMID: 1645179 [PubMed - indexed for MEDLINE]

5713: Nurs Stand. 1991 Apr 24-30;5(31):28-32.

Diseases of the herpes viruses.

Kedzierski M.

PMID: 1645178 [PubMed - indexed for MEDLINE]

5714: J Clin Laser Med Surg. 1991 Apr;9(2):121-6.

Evaluation of analgesic effect of low-power He:Ne laser on postherpetic neuralgia
using VAS and modified McGill pain questionnaire.

Iijima K, Shimoyama N, Shimoyama M, Mizuguchi T.

Department of Anesthesiology, Chiba University School of Medicine, Japan.

In order to investigate the efficacy of low-power He:Ne laser in treatment of
pain, we irradiated 18 outpatients with severe postherpetic neuralgia. The
efficacy of the low-power laser treatment was evaluated using a four-grade
estimation, visual analog scale (VAS), and modified McGill pain questionnaire
(m-MPQ) after every 10 of as many as 50 irradiations. The efficacy rate using a
four-grade estimation at the end of 50 treatments was 94.4%. VAS decreased from
6.2 before irradiation therapy to 3.6 after 50 treatments, and the degree of pain
relief was reduced to 44.6% and correlated with the number of treatments. The
total numbers of words and the total scores of the m-MPQ decreased as the number 
of treatments increased. No complications attributable to the laser therapy were 
observed. These results suggest that repeated irradiation with low-power He:Ne
laser is an effective and safe therapy for postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 10149452 [PubMed - indexed for MEDLINE]

5715: Int J Dermatol. 1991 Apr;30(4):288-90.

Prevention of post-herpetic neuralgia. Evaluation of treatment with oral
prednisone, oral acyclovir, and radiotherapy.

Benoldi D, Mirizzi S, Zucchi A, Allegra F.

Department of Dermatology, University of Parma, Italy.

The effects of prednisone, oral acyclovir, and radiotherapy were compared with
placebo in the prevention of post-herpetic neuralgia. No treatment used was able 
to prevent, with statistical significance, post-herpetic neuralgia, although
prednisone and acyclovir showed some pain reduction in the acute phase.
Radiotherapy was of no value in either the acute or post-herpetic phase.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Randomized Controlled Trial

PMID: 2050460 [PubMed - indexed for MEDLINE]

5716: Clin Pharm. 1991 Apr;10(4):301-2.

Preventing recurrent varicella and herpes zoster with oral acyclovir in
HIV-seropositive patients.

Dellamonica P, Carles M, Lokiec F, Mondain V, Bernard E, Johanson F.

Archet Hospital, Nice, France.

Publication Types: 
    Case Reports

PMID: 2032448 [PubMed - indexed for MEDLINE]

5717: Arch Ophthalmol. 1991 Apr;109(4):471-2.

Orbital myositis associated with herpes zoster.

Volpe NJ, Shore JW.

Publication Types: 
    Case Reports
    Letter

PMID: 2012541 [PubMed - indexed for MEDLINE]

5718: J Gen Virol. 1991 Apr;72 ( Pt 4):949-54.

DNA sequence and organization of genes in a 5.5 kbp EcoRI fragment mapping in the
short unique segment of Marek's disease virus (strain RB1B).

Ross LJ, Binns MM, Pastorek J.

AFRC Institute for Animal Health, Houghton Laboratory, Huntingdon,
Cambridgeshire, U.K.

The DNA sequence of a 5.5 kbp EcoRI fragment located in the short unique region
(US) of the 'highly oncogenic' strain RB1B of Marek's disease virus (MDV) was
determined. The sequence contained six open reading frames (ORFs), four of which 
were homologous to proteins mapping in the US region of herpes simplex virus type
1 (HSV-1). These include the homologues of HSV-1 protein kinase, glycoprotein D
(gD), glycoprotein I (gI) and US2 which is of unknown function. The MDV ORFs had 
a marked bias for A or T in the third codon position and analysis of the
dinucleotide frequencies showed a marginal deficit in ApG/CpT but no overall
deviation of CpG from random expectations. Comparison of genes in the US region
of MDV to herpesvirus proteins confirmed and extended our previous observation
that MDV is more closely related to alphaherpesviruses than to
gamma-herpesviruses. We also showed that MDV possessed a homologue of HSV-1 gD
which is lacking in varicella-zoster virus (VZV) but that MDV probably lacked
homologues of US4 and US5 of HSV-1. These results show that in contrast to the
genes in the long unique region which were grossly collinear in HSV, VZV and MDV,
those mapping in US show greater diversity.

Publication Types: 
    Comparative Study

PMID: 1849977 [PubMed - indexed for MEDLINE]

5719: J Infect Dis. 1991 Apr;163(4):873-5.

Varicella-zoster virus-specific immunity after herpes zoster.

Hayward A, Levin M, Wolf W, Angelova G, Gilden D.

Department of Pediatrics, University of Colorado School of Medicine, Denver
80262.

The frequency of varicella-zoster virus (VZV)-specific T lymphocytes was higher
in elderly subjects who had herpes zoster infections than in age-matched
controls. This increase in T cell response persisted for at least 2 years while
antibody levels to VZV returned to control values at this time. There were no
differences in T cell or antibody responses to VZV between individuals with and
without postherpetic neuralgia. Elderly subjects who had not had herpes zoster
had a comparable increase in VZV-specific T responder cell frequency after
immunization with Oka strain VZV. The data suggest that the potential for a boost
in T cell response to VZV persists in the elderly, and that immunization can
elicit a T cell response in this age group.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1849165 [PubMed - indexed for MEDLINE]

5720: DICP. 1991 Apr;25(4):381-7.

Topical capsaicin in dermatologic and peripheral pain disorders.

Rumsfield JA, West DP.

Department of Pharmacy Practice, Colleges of Pharmacy, University of Illinois,
Chicago 60612.

Topical capsaicin has been introduced in the U.S. and Canada as a cream indicated
for temporary relief of neuralgia following episodes of herpes zoster infections 
and in the treatment of diabetic neuropathy. Although capsaicin is clinically
used as an external analgesic for temporary relief of neuralgia, it has also been
widely used as a research tool to study peripheral pain. Capsaicin apparently
works to release substance P from sensory nerve fibers and after repeated
applications, depletes neurons of substance P. Clinical investigations of topical
capsaicin include trials in chronic pain syndromes such as postherpetic
neuralgia, postmastectomy neuroma, reflex sympathetic dystrophy syndrome,
diabetic neuropathy, rheumatoid arthritis, psoriasis, hemodialysis-associated
itching, and vulvar vestibulitis. In addition, therapeutic benefits of capsaicin 
cream on apocrine chromhidrosis have been described. Further clinical studies are
warranted in several of these conditions to establish the efficacy of topical
capsaicin. Serious or unexpected adverse reactions from clinical use have not
been reported to date. Considering the paucity of safe and effective treatments
for the conditions mentioned above, capsaicin cream appears to warrant further
clinical investigations to establish its efficacy in a variety of chronic pain
syndromes.

Publication Types: 
    Review

PMID: 1656616 [PubMed - indexed for MEDLINE]

5721: Clin Ter. 1991 Mar 15;136(5):327-32.

[Therapeutic indications in herpes zoster]

[Article in Italian]

Carco F, Gili C, Gobber M, Bianchi B, Guazzotti G.

Divisione Malattie Infettive, U.S.S.L. 45, Ospedale Provinciale S. Andrea,
Vercelli.

Fifty-two patients with acute Herpes Zoster were divided into two groups and
treated respectively as follows: 25 received i.v. acyclovir and 27 received s.c. 
thymopentin, an immunomodulating drug. Both drugs proved effective in promoting
the recovery from herpetic lesions and in relieving the painful symptomatology
within approximately the same period of time. Thymopentin apparently has an
antiphlogistic effect and is believed to prevent post-herpetic neuropathy through
its immunomodulating activity. Further studies based on a larger number of
patients would be necessary to confirm the results achieved and for statistical
evaluation.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 1828198 [PubMed - indexed for MEDLINE]

5722: Nippon Naika Gakkai Zasshi. 1991 Mar 10;80(3):477-81.

[Virus diseases]

[Article in Japanese]

Matsumoto K.

Publication Types: 
    Review

PMID: 1856570 [PubMed - indexed for MEDLINE]

5723: AIDS. 1991 Mar;5(3):295-300.

Perinatal transmission of HIV-1: lack of impact of maternal HIV infection on
characteristics of livebirths and on neonatal mortality in Kigali, Rwanda.

Lepage P, Dabis F, Hitimana DG, Msellati P, Van Goethem C, Stevens AM,
Nsengumuremyi F, Bazubagira A, Serufilira A, De Clercq A, et al.

Department of Paediatrics, Centre Hospitalier de Kigali, Rwanda.

We present the baseline results of a prospective cohort study on the perinatal
transmission of HIV-1 in Kigali, Rwanda. HIV-1-antibody testing was offered to
all women of urban origin delivering a live newborn at the maternity ward of the 
Centre Hospitalier de Kigali from November 1988 to June 1989; 218 newborns of 215
HIV-positive mothers were matched to 218 newborns of 216 HIV-negative mothers.
The matching criteria were maternal age and parity. No differences in
socioeconomic characteristics were observed between HIV-positive and HIV-negative
women. HIV-positive mothers more frequently reported a history of at least one
death of a previously born child (P less than 0.01) and a history of abortion (P 
less than 0.001). Most of the HIV-positive women were asymptomatic, but 72.4% of 
them had a CD4; CD8 ratio less than 1 versus 10.1% in the HIV-negative group (P
less than 0.001). The frequency of signs and symptoms was not statistically
different in the two groups, except for a history of herpes zoster or chronic
cough, which was more frequent among HIV-positive women. The rates of
prematurity, low birth weight, congenital malformations and neonatal mortality
were comparable in the two groups. However, infants of HIV-positive mothers had a
mean birth weight 130 g lower than the infants of HIV-negative mothers (P less
than 0.01). The impact of maternal HIV-1 infection on the infant seems limited
during the neonatal period.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2059369 [PubMed - indexed for MEDLINE]

5724: Vestn Otorinolaringol. 1991 Mar-Apr;(2):44-8.

[AIDS in otorhinolaryngological practice]

[Article in Russian]

Nikitin KA, Chaika NA.

The acquired immune deficiency syndrome (AIDS) presents a global problem of XX
century medicine. The speed with which this pathology spreads is great and the
number of AIDS patients is increasing in geometric progression. At present AIDS
is a real threat to the health and life of millions of people. It is very
difficult to clinically diagnose AIDS because it manifests in the form of various
tumors and opportunistic infections, with lesions localized on the skin and
mucosa or in the viscera (lungs, brain, esophagus, gastro-intestinal tract). The 
most typical AIDS manifestations are: preumocystosis, oropharyngeal and esophagal
candidosis, herpes simplex, herpes zoster, Kaposi's sarcoma, "hairy" leukoplakia,
extranodal non-Hodgkin's lymphoma, etc. In the case of HIV infection and AIDS
many lesions are located in ENT. This means that ENT doctors are to be well aware
of their clinical manifestations to be able to detect this pathology.

Publication Types: 
    English Abstract

PMID: 2048253 [PubMed - indexed for MEDLINE]

5725: Vrach Delo. 1991 Mar;(3):86-9.

[Experience in treating a herpetic infection with trypsin]

[Article in Russian]

Sichko ZhV, Kozlova OL.

Results are reported of trypsin treatment of 150 patients with herpetic infection
(age of the patients: from 7 to 65 years). The results were compared with routine
treatment in 200 patients. High efficacy of trypsin treatment as compared with
routine treatment methods has been revealed. Trypsin treatment results in control
of the pathological signs and symptoms not only in the acute period but also
resulted in absence of recurrences of the infection and postherpetic neuralgia
for 3 successive years. The efficacy of trypsin treatment has been thus
established and the necessity of active detection and treatment of chronic
carriers of herpetic infection by the proposed method is advocated.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 2042362 [PubMed - indexed for MEDLINE]

5726: Surv Ophthalmol. 1991 Mar-Apr;35(5):327-43.

Diagnosis and management of the acute retinal necrosis (ARN) syndrome.

Duker JS, Blumenkranz MS.

Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical
School, Boston.

The acute retinal necrosis (ARN) syndrome represents a specific pattern of
clinical presentation for certain herpes virus infections in the posterior
segment of the eye. The classically described triad of the ARN syndrome consists 
of (1) an arteritis and phlebitis of the retinal and choroidal vasculature, (2) a
confluent, necrotizing retinitis that preferentially affects the peripheral
retina, and (3) a moderate to severe vitritis. Anterior segment inflammation,
optic neuritis, and late retinal detachment are also common features of this
disorder. Definitive evidence now implicates at least two members of the herpes
virus family; varicella zoster virus and herpes simplex virus as causative
agents. This paper summarizes the clinical presentation, as well as the currently
recommended treatment regimen for the ARN syndrome, highlighting recent advances 
that have resulted in a significant improvement in the visual prognosis for
affected patients.

Publication Types: 
    Review

PMID: 2038718 [PubMed - indexed for MEDLINE]

5727: J R Soc Med. 1991 Mar;84(3):184.

Comment on:
    J R Soc Med. 1990 Oct;83(10):617-9.

Epidemiology of shingles.

[No authors listed]

Publication Types: 
    Comment
    Letter

PMID: 2013914 [PubMed - indexed for MEDLINE]

5728: Am J Med. 1991 Mar;90(3):401.

Comment on:
    Am J Med. 1990 Jan;88(1):77-80.

Successful acyclovir therapy of severe varicella hepatitis in an adult renal
transplant recipient.

Morales JM.

Publication Types: 
    Comment
    Letter

PMID: 2003524 [PubMed - indexed for MEDLINE]

5729: Am J Med. 1991 Mar;90(3):295-8.

Herpes zoster in patients with rheumatoid arthritis treated with weekly, low-dose
methotrexate.

Antonelli MA, Moreland LW, Brick JE.

Section of Rheumatology, West Virginia University School of Medicine, Morgantown 
26506.

PURPOSE: Herpes zoster occurred in nine patients with methotrexate-treated
rheumatoid arthritis. We compared these patients to a large group of
methotrexate-treated rheumatoid arthritis patients in order to uncover potential 
factors explaining the occurrence of herpes zoster. PATIENTS AND METHODS: Data
from 187 patients taking methotrexate were reviewed and compared with data from
another nine patients who developed herpes zoster while taking the drug for
rheumatoid arthritis, all from the same university-based arthritis clinic.
Literature pertinent to infection in rheumatoid arthritis patients treated with
methotrexate is reviewed. RESULTS: Herpes zoster occurred in 14.5 cases per 1,000
patient-years in our methotrexate-treated rheumatoid arthritis patients, as
compared with the general population incidence of 1.3 to 4.8 cases per 1,000
patient-years. The infection was unrelated to duration of methotrexate usage,
prednisone treatment, or the co-existence of diabetes mellitus, but appeared to
occur in patients with high titers of rheumatoid factor and an overall longer
duration of rheumatoid arthritis. There were no cases of systemic dissemination
or recurrence of herpes zoster despite 27.4 years cumulative follow-up on
continued methotrexate therapy. CONCLUSIONS: Herpes zoster may occur more
frequently in patients with rheumatoid arthritis treated with low-dose
methotrexate than in the general population. Herpes zoster in rheumatoid
arthritis patients treated with methotrexate appears to be self-limited, benign, 
and statistically related to methotrexate use in the presence of longer-term
rheumatoid disease.

PMID: 2003511 [PubMed - indexed for MEDLINE]

5730: J Comput Assist Tomogr. 1991 Mar-Apr;15(2):223-7.

MR fat suppression combined with Gd-DTPA enhancement in optic neuritis and
perineuritis.

Tien RD, Hesselink JR, Szumowski J.

Department of Radiology, University of California, School of Medicine, San Diego,
La Jolla.

A fat suppression MR technique used in combination with Gd-DTPA enhancement was
investigated to determine its value in cases of inflammatory optic nerve lesions.
This technique, the so-called hybrid method, is a derivative of the chopper fat
suppression technique and provides water-only images without increasing the
imaging or postprocessing time. The study group consisted of four patients with
acute visual loss, all of whom received Gd-DTPA. Conventional T2-weighted and fat
suppression post-Gd-DTPA T1-weighted images were obtained in all patients; in
addition, in one patient a post-Gd-DTPA T1-weighted image without fat suppression
was obtained. In three patients, the conventional T2-weighted images failed to
reveal any abnormality. In contrast, the enhanced optic nerve and enhanced
perineural inflammatory infiltrate were easily identified on T1-weighted images
after administration of Gd-DTPA and application of fat suppression technique. The
lesions in inflammatory optic neuritis or perineuritis were easily distinguished 
from the surrounding fat, which had been suppressed. This combined technique
resulted in significantly improved definition of normal anatomic structures and
made the enhancing lesions more conspicuous, especially in areas with large
amounts of fat such as the retrobulbar orbit.

PMID: 2002098 [PubMed - indexed for MEDLINE]

5731: Northwest Dent. 1991 Mar-Apr;70(2):31.

Extensive endodontic involvements following herpes zoster attack to facial area; 
report of a case.

Wadden JV.

Publication Types: 
    Case Reports

PMID: 1870958 [PubMed - indexed for MEDLINE]

5732: Acta Med Port. 1991 Mar-Apr;4(2):91-2.

Herpes zoster and controlateral hemiplegia in an African patient infected with
HIV-1.

Carneiro AV, Ferro J, Figueiredo C, Costa L, Campos J, de Padua F.

Servico de Medicina IV, Hospital Universitario de Santa Maria, Lisboa.

One of the neurologic complications of human immunodeficiency virus infection are
cerebrovascular accidents. In HIV infected patients, ischemic strokes have been
reported secondary to nonbacterial thrombotic endocarditis and cerebral
arteritis. We describe an unusual cause of stroke in HIV-1 infection: Herpes
Zoster ophtalmicus with contralateral hemiplegia.

PIP: A rare case of ischemic stroke related to Herpes zoster infection of the eye
and documented arteritis in an HIV-positive patient is analyzed. The woman, aged 
32, who was born in Angola and lived in Zaire, was diagnoses at the Hospital
Universitario de Santa Maria, Lisbon. She presented with a 5-month history of
sudden hemiplegia, 4 months after onset of herpes zoster ophthalmicus. Among
extensive diagnosis tests, she was positive for HIV by ELISA and Western blot,
hepatomegaly, and generalized lymphadenopathy. She has left Herpes zoster
ophthalmicus with ptosis bulbi and mottled discoloration of the skin over the
distribution of the 1st division of the left trigeminal nerve, and right spastic 
hemiparesis. Her helper T-cell count was 952/cubic mm, and her T-cell ratio was
0.9. She had anemia, hypoalbuminemia, positive serology for cytomegalovirus,
Herpes simplex, Epstein Barr virus, and hepatitis B. She had no bacterial
infections, but her stool contained Trichuris trichiura eggs and giardia lamblia 
cysts. Her cardiovascular system and cerebrovascular fluid were negative.
Computed tomography of the head showed an old left capsular infarct. Cerebral
angiography showed arteritis of the left choroidal artery with occlusion. She was
treated with metronidazole and mebendazole, and had surgery for removal of the
left eye with a prosthetic replacement. Strokes are common in AIDS patients,
resulting from fungal infections, endocarditis, infectious or non-infectious
emboli, or arteritis from herpes zoster infections. This is the 1st published
case of hemiplegia and Herpes zoster in a European or African patient with HIV-1.

Publication Types: 
    Case Reports

PMID: 1867123 [PubMed - indexed for MEDLINE]

5733: Rev Med Interne. 1991 Mar-Apr;12(2):139-40.

[Urine retention following herpes zoster meningoencephalitis]

[Article in French]

Thevenon A, Pollez B, Lemaire JP, Salomez F, Rigot JM, Petit H, Dewailly P.

Centre de Soins Pour Personnes agees, Lille.

A case of retention of urine after ophthalmic zoster is reported. The sphincter
vesicae disorder was of central origin, being caused by a meningoencephalitis.
The patient progressively recovered. The respective responsibilities of brain
suffering and meningeal involvement in these urinary tract disturbances are
discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1852996 [PubMed - indexed for MEDLINE]

5734: J Gen Virol. 1991 Mar;72 ( Pt 3):475-86.

Varicella-zoster virus. The Fourteenth Fleming lecture.

Davison AJ.

MRC Virology Unit, University of Glasgow, U.K.

Publication Types: 
    Review

PMID: 1848588 [PubMed - indexed for MEDLINE]

5735: J Virol. 1991 Mar;65(3):1149-59.

The conserved DNA-binding domains encoded by the herpes simplex virus type 1
ICP4, pseudorabies virus IE180, and varicella-zoster virus ORF62 genes recognize 
similar sites in the corresponding promoters.

Wu CL, Wilcox KW.

Department of Microbiology, Medical College of Wisconsin, Milwaukee 53226.

Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), pseudorabies virus (PRV),
varicella-zoster virus (VZV), and equine herpesvirus 1 (EHV-1) are all classified
as Alphaherpesvirinae. Each of these five viruses encodes an essential
immediate-early (IE) regulatory protein referred to as HSV-1 ICP4, HSV-2 ICP4,
PRV IE180, VZV ORF62 protein, and EHV-1 IE1, respectively. These five proteins
share extensive homology with each other in domains referred to as regions 2 and 
4. The HSV-1 ICP4 region 2 domain contains residues that are required for the
DNA-binding capability of ICP4. In this report, we describe the expression of
region 2 domains from the ICP4, IE180, and ORF62 genes as fusion proteins in
Escherichia coli. DNA-binding assays revealed that each of these region 2 fusion 
proteins binds to a sequence that overlaps the transcription start site in the
promoter for the gene encoding the corresponding protein. Each of the sites with 
high affinity for one or more of these fusion proteins contains the sequence
5'-ATCGT-3'. This sequence spans the mRNA cap site in the HSV-2 ICP4 gene
promoter and is immediately upstream from the transcription start site in the
EHV-1 IE1 gene. These results suggest that formation of a specific complex
between an IE protein and its own gene promoter may be a common mechanism used by
Alphaherpesvirinae to autoregulate transcription of an essential IE gene.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 1847444 [PubMed - indexed for MEDLINE]

5736: Ma Zui Xue Za Zhi. 1991 Mar;29(1):559-63.

[Transcutaneous electrical nerve stimulation for the treatment of abdominal
zoster paresis]

[Article in Chinese]

Chan-Liao M, Liao J, Wu YW, Liao CS.

Publication Types: 
    Case Reports

PMID: 1836823 [PubMed - indexed for MEDLINE]

5737: Rev Clin Esp. 1991 Mar;188(5):263-4.

[Ramsay-Hunt syndrome in primary care]

[Article in Spanish]

Ponce de Leon Roca M, Caballero Domenech JC, Asenjo Vazquez C.

Publication Types: 
    Case Reports
    Letter

PMID: 1788463 [PubMed - indexed for MEDLINE]

5738: Cent Afr J Med. 1991 Mar;37(3):88-93.

Peripheral facial nerve palsy related to HIV infection: relationship with the
immunological status and the HIV staging in Central Africa.

Belec L, Georges AJ, Bouree P, Schuller E, Vuillecard E, Di Costanzo B, Martin
PM.

Institu Pasteur de Bangui, Republique Centrafricaine.

Twelve cases of infranuclear facial nerve palsy associated with infection by the 
human immunodeficiency virus in the heterosexual African are reported with
clinical and immunological studies. Eight cases were healthy HIV carriers, three 
patients manifested AIDS-related complex and one case fulfilled the CDC criteria 
for AIDS. Nine patients had a typical Bell's palsy, two presented cephalic Herpes
zoster infection with Ramsay Hunt syndrome and one, who suffered from progressive
facial weakness, could be considered as having a cephalic form of Guillain-Barre 
syndrome.

PIP: 12 cases of peripheral facial nerve palsy in African patients attending the 
Centre National Hospitalier Universitaire de Bangui, Central African Republic,
with HIV infections are described with clinical and serological findings. All
sera were tested with ELISA and confirmed with Western blot for both HIV-1 and
HIV-2 (ELAVIA 1, ELAVIA 2, LAV BLOT I, LAV BLOT II, Diagnostics Pasteur). All 12 
were HIV-1 positive and HIV-2 negative. Clinically, 1 patient met the clinical
definition of AIDS, 3 had AIDS-related complex, and 8 had been previously health.
In 11 cases, facial nerve palsy was the 1st presenting syndrome of HIV infection.
ONset was acute in all, and associated with flu-like symptoms in 7. The palsy
resembled Bell's palsy in 9, but was associated with unilateral vesicular
eruptions suggestive of Ramsay-Hunt syndrome, or varicella-zoster, in 2 cases. In
1 19-year old woman complete facial paralysis with peri-oral numbness and
paresthesia of the cheek developed in 1 hour. All recovered in 2 weeks to 3
months. The T4 lymphocyte counts averaged 764 in the healthy patients and 373 in 
the ARC and AIDS patients, compared to 1949 in controls. T4/T8 ratios averaged
0.66 and 0.45 in these groups compared to 1.32 in controls. 4 other cases of
facial palsy in persons testing negative for HIV are also described. Speculative 
explanations for the pathophysiology of these palsies were offered: local
infection of the facial nerve or ganglion by HIV, inflammatory demyelinating
neuropathy, or secondary infection, due to immunosuppression, by agents such as
Herpes zoster.

PMID: 1680026 [PubMed - indexed for MEDLINE]

5739: Southeast Asian J Trop Med Public Health. 1991 Mar;22(1):139-40.

Reactivation of varicella-zoster virus during acute malaria.

Brown AE, Pipithkul J, Webster HK.

Department of Immunology and Biochemistry, Armed Forces Research Institute of
Medical Sciences (AFRIMS), Bangkok, Thailand.

Publication Types: 
    Case Reports

PMID: 1658946 [PubMed - indexed for MEDLINE]

5740: Antiviral Res. 1991 Mar-Apr;15(3):193-204.

The mechanism of action of the anti-herpes virus compound
2,3-dimethyl-6(2-dimethylaminoethyl)-6H-indolo-(2,3-b)quinoxaline.

Harmenberg J, Akesson-Johansson A, Graslund A, Malmfors T, Bergman J, Wahren B,
Akerfeldt S, Lundblad L, Cox S.

Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.

The compound 2,3-dimethyl-6(2-dimethylaminoethyl)6H-indolo-(2,3-b)quinoxaline
(B-220) has been shown to exhibit potent antiviral activity against herpes
simplex virus type 1 (HSV-1), varicella-zoster virus (VZV) and cytomegalovirus
(CMV). The mechanism of antiviral action of B-220 against HSV-1 has been studied;
from the results it appears that B-220 binds by intercalation into the DNA helix 
and then disturbs steps that are vital for viral uncoating.

PMID: 1653556 [PubMed - indexed for MEDLINE]

5741: J Am Acad Dermatol. 1991 Mar;24(3):429-33.

Granulomatous vasculitis occurring after cutaneous herpes zoster despite absence 
of viral genome.

Langenberg A, Yen TS, LeBoit PE.

Department of Dermatology, School of Medicine, University of California, San
Francisco 94143-0506.

Granuloma annulare, sarcoidal and other granulomatous dermatitides,
pseudolymphoma, lymphoplasmacytoid lymphoma, and Kaposi's sarcoma have been
described as sequelae of herpes zoster. We report a new postzoster reaction,
granulomatous vasculitis, that caused flat-topped papules restricted to the
affected dermatome. Polymerase chain reaction failed to detect varicella-zoster
virus in a biopsy specimen. These results suggest that granulomatous vasculitis
occurs without persistence of the viral genome and, perhaps, is a reaction to
minute amounts of viral proteins.

Publication Types: 
    Case Reports
    Review

PMID: 1648109 [PubMed - indexed for MEDLINE]

5742: Rev Clin Esp. 1991 Feb;188(2):114-5.

[Meningoencephalitis caused by varicella-zoster herpesvirus: treatment with
acyclovir]

[Article in Spanish]

Jimenez Jimenez FJ, Molina Arjona JA, Fernandez Ballesteros A, Roldan Montaud A, 
Santa Velasco J, Zancada Diez de Entresotos F.

Publication Types: 
    Case Reports
    Letter

PMID: 2041899 [PubMed - indexed for MEDLINE]

5743: Can J Neurol Sci. 1991 Feb;18(1):105.

Recurrent cerebral infarction and central retinal artery occlusion following
mandibular zoster.

Pullicino P, Fava S.

Publication Types: 
    Case Reports
    Letter

PMID: 2036611 [PubMed - indexed for MEDLINE]

5744: J Neurol. 1991 Feb;238(1):51-4.

Ischaemic myelopathy secondary to disseminated intravascular coagulation in AIDS.

Fenelon G, Gray F, Scaravilli F, Mahieux F, Gherardi R, Chemouilli P, Guillard A.

Service des Maladies due Systeme Nerveux, Hopital Tenon, Paris, France.

A 39-year-old patient with AIDS presented with a rapidly progressive myelopathy
with a partial Brown-Sequard syndrome. He died, 9 weeks after onset of the first 
neurological signs, from diffuse encephalopathy. Neuropathological examination
revealed multiple, usually small, frequently haemorrhagic, infarcts or various
ages and numerous fibrin thrombi in medium and small penetrating vessels and
capillaries of the brain and spinal cord, characteristic of disseminated
intravascular coagulation. There were no inflammatory changes.
Immunohistochemical studies for human immunodeficiency virus, cytomegalovirus,
varicella zoster virus, herpes simplex virus type 1 and type 2 were negative.
Ischaemic spinal cord lesions due to disseminated intravascular coagulation may
represent an unusual cause of focal, non-inflammatory, non-tumoral, myelopathic
syndrome in AIDS.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 2030375 [PubMed - indexed for MEDLINE]

5745: Aust Dent J. 1991 Feb;36(1):22-8.

A case of AIDS presenting as intra-oral malignant lymphoma.

Donkor P, Punnia-Moorthy A, Painter DM.

Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of
Sydney, Surry Hills, New South Wales.

A range of oral manifestations in a patient who was subsequently confirmed as
infected with the human immune deficiency virus are presented. Most of these
lesions have been previously reported in the literature, and represent
opportunistic infection changes resulting from immune deficiency. The rare
occurrence of a malignant large cell lymphoma intra-orally in this patient is
also reported. The need for clinicians to treat all oral lesions as potentially
infective and to wear gloves routinely is stressed.

Publication Types: 
    Case Reports

PMID: 2029228 [PubMed - indexed for MEDLINE]

5746: Int J Dermatol. 1991 Feb;30(2):139-46.

Treatment of pemphigus.

Piamphongsant T, Ophaswongse S.

Research Section and Immunology Lab, Institute of Dermatology, Bangkok, Thailand.

Ninety-eight cases of various types of pemphigus were treated between 1978-1987. 
Sixty-one cases were pemphigus vulgaris (PV), 22 cases were pemphigus foliaceus, 
generalized type (PFG) in which one case developed pemphigus vegetans, 11 cases
were pemphigus foliaceus localized type (PFL), and four cases were pemphigus
erythematosus (PE). Fifteen mild cases of PV and three mild PFG were treated with
corticosteroid (prednisolone or prednisone) alone, and dapsone or
cyclophosphamide (CP) were added as treatment failed in two cases of each.
Dapsone alone was used effectively in three cases of mild PV. Eight cases of
moderate and three cases of severe PV, as well as five cases of moderate PFG,
failed to respond to corticosteroid alone but were cleared by the addition of CP.
Thirty-two moderate cases of PV and PFG treated with a combination of
corticosteroid 60 mg/day plus initial CP and 14 severe cases of PV and PFG
treated with corticosteroid 120 mg/day plus initial CP, resulted in clearing skin
lesions in 2 months. Azathioprine or chlorambucil were substituted in three cases
who developed CP toxicity. Addition of gold sodiumthiomalate in six refractory
cases when the above regimens failed, caused a complete remission in two and
partial control in four. Higher dosage of prednisolone or prednisone more than
120 mg/day has never been used. Eleven cases of PFL and four cases of PE were
treated with uneventfully good results. Intercellular antibody titers became
negative within 4.67 months except in refractory cases, however, the treatment
was continued for at least 3 years. Herpes simplex superimposed infection was
more common than herpes zoster infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 2001906 [PubMed - indexed for MEDLINE]

5747: Int J Cancer. 1991 Feb 1;47(3):352-7.

Socio-economic indicators, infectious diseases and Hodgkin's disease.

Serraino D, Franceschi S, Talamini R, Barra S, Negri E, Carbone A, La Vecchia C.

Epidemiology Unit, Aviano Cancer Centre, Italy.

The relationship between socio-economic indicators, family size, history of
tonsillectomy, infectious mononucleosis (IM) and other diseases and the risk of
Hodgkin's disease (HD) was investigated in a hospital-based case-control study,
conducted in the province of Pordenone, North-east Italy, between June, 1985 and 
March, 1990. One hundred and fifty-two HD cases (88 men and 64 women) and 613
controls (357 men and 256 women) were interviewed. Patients with 14 or more years
of education had a 2-fold increased HD risk (95% confidence interval, CI:
1.0-3.9); such risk tended to be higher in patients with nodular sclerosis (NS)
HD (odds ratio, OR: 4.4, 95% CI 1.8-11.0). Sibship size, birth order and
tonsillectomy were not associated with HD risk. Cases and controls did not differ
in the frequency or age at occurrence of common childhood infections. A history
of IM, however, was found to be an important predictor of HD risk, in particular 
among NS HD (OR = 13.1, 95% CI 1.0-176.7). Past episodes of herpes zoster and of 
skin and genital warts were also associated with significantly increased HD
risks. These data lend further support to the role of the IM agent (i.e., the
Epstein-Barr virus) and, perhaps, of other viral infections and immunological
alterations in the development of HD.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1993542 [PubMed - indexed for MEDLINE]

5748: Otolaryngol Head Neck Surg. 1991 Feb;104(2):196-203.

Otolaryngology problems in the immune compromised patient--an evolving natural
history.

Corey JP, Seligman I.

Department of Otolaryngology-Head and Neck Surgery, University of Chicago, IL.

As the human immunodeficiency virus is being detected in increasing numbers of
asymptomatic individuals at risk, newer earlier patterns of disease have become
apparent--including cranial and cervical herpes zoster, oral hairy leukoplakia,
and oral candidiasis--thus linking viral and other disease to the development of 
acquired immunodeficiency disease (AIDS). Many similarities between patients with
AIDS and other immunosuppressed patients have emerged. As immunosuppressed
patients survive longer, they begin to manifest cancers such as lymphomas and
squamous cell cancers in addition to Kaposi's sarcoma. Otolaryngologists can
learn to identify and treat otitis and sinusitis in the immunosuppressed patient,
to identify predictive early signs such as oral hairy leukoplakia, herpes simplex
virus, and oral candidiasis, and to diagnose and treat Kaposi's sarcomas of the
head and neck, lymphomas, squamous cell cancers, and opportunistic infections as 
the immunodeficiency disease progresses.

Publication Types: 
    Case Reports
    Review

PMID: 1901147 [PubMed - indexed for MEDLINE]

5749: Acta Paediatr Jpn. 1991 Feb;33(1):57-60.

Incidence of herpes zoster in infancy in Japan.

Taki M, Inamochi H.

Department of Pediatrics, National Tsu Hospital, Mie, Japan.

A search of the literature has revealed only 12 reports of herpes zoster during
infancy in Japan. Of these, seven cases were thought to be mother-child
infections where the mother had been infected with varicella and transmitted the 
VZV to the fetus, producing postnatal herpes zoster. The earliest case of
maternal varicella infection occurred at 14 weeks of gestation. In the remaining 
6 cases infection took place between the 17th and 32nd week of gestation.
Postnatal onset of herpes zoster in the infants occurred within three months in
two cases and at seven to eight months in the other four cases. In two cases it
was unclear whether it was a mother-child infection. In three cases no clinical
manifestations of maternal VZV infection were observed, but in these cases during
early infancy the patients might have acquired asymptomatic infection.

Publication Types: 
    Review

PMID: 1853713 [PubMed - indexed for MEDLINE]

5750: J Neurol Neurosurg Psychiatry. 1991 Feb;54(2):167-8.

Use of the polymerase chain reaction to detect herpes simplex virus DNA in
paraffin sections of human brain at necropsy.

Nicoll JA, Maitland NJ, Love S.

Department of Neuropathology, Frenchay Hospital, Bristol, UK.

The feasibility of detecting herpesvirus DNA in paraffin sections of routinely
fixed and processed human necropsy brains by use of the polymerase chain reaction
(PCR) was assessed. A 110 bp segment of the thymidine kinase gene of herpes
simplex virus type 1 (HSV1) could readily be amplified in sections from the
brains of six patients with acute HSV1 encephalitis but not from those of six
patients with other neurological diseases, including varicella-zoster
encephalitis and herpes simplex virus type 2 encephalitis. Primers suitable for
amplifying c-myc were included in the PCRs for assessment of DNA preservation.
This was found to be adequate to allow amplification of c-myc DNA in sections
from all of the brains studied. The PCR provides a simple and specific means of
detecting HSV1 DNA in routinely processed necropsy material.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1850452 [PubMed - indexed for MEDLINE]

5751: Pediatrics. 1991 Feb;87(2):166-70.

Lack of transmission of the live attenuated varicella vaccine virus to
immunocompromised children after immunization of their siblings.

Diaz PS, Au D, Smith S, Amylon M, Link M, Smith S, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California
94305.

The safety of administering the live attenuated Oka/Merck varicella vaccine to
the well siblings of children with malignancy was evaluated as a strategy for
reducing the risk of household exposure to varicella among immunocompromised
children. Susceptible well children were eligible for vaccination if the child
with malignancy had leukemia, lymphoma, or solid tumor in remission for 3 months 
or longer. No evidence of vaccine virus transmission was found among 30 children 
with malignancy whose 37 healthy susceptible siblings were immunized with
varicella vaccine. Varicella-zoster virus was not isolated from the oropharyngeal
secretions taken from 17 vaccinees or their 14 immunocompromised siblings. None
of the 30 immunocompromised children had vaccine-related rashes or showed
immunologic evidence of subclinical varicella-zoster virus infection based on
testing for varicella-zoster virus IgG antibodies and T-lymphocyte proliferation 
to varicella-zoster virus. Four healthy vaccinees eventually had mild
breakthrough cases of varicella, with transmission to the high-risk sibling in 3 
cases. However, even in these families, the immunocompromised children had been
protected from household exposure varicella for at least 20 months early in the
course of their immunosuppressive treatment.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1846236 [PubMed - indexed for MEDLINE]

5752: J Virol. 1991 Feb;65(2):992-5.

Chloroquine enhances replication of Semliki Forest virus and encephalomyocarditis
virus in mice.

Maheshwari RK, Srikantan V, Bhartiya D.

Department of Pathology, Uniformed Services University of the Health Sciences,
Bethesda, Maryland 20814-4799.

Chloroquine (CHL) has been suggested to play an important role in the development
of Burkitt's lymphoma by enhancing Epstein-Barr virus expression. Herpes zoster
virus incidence is markedly increased following malaria infection in children
being treated with CHL. Recently, CHL has also been shown to dramatically
increase the transactivation of Tat protein purified from human immunodeficiency 
virus. These previous studies indirectly suggest that CHL may be involved in the 
enhancement of virus replication. This study demonstrates for the first time that
CHL indeed enhances Semliki Forest virus and encephalomyocarditis virus
replication in mice. These results raise the possible connection between the
increased spread of AIDS in endemic malaria areas and the wide use of CHL in
those areas for the chemotherapy of malaria.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1846212 [PubMed - indexed for MEDLINE]

5753: J Med Virol. 1991 Feb;33(2):128-32.

Differentiation of oka varicella vaccine strain from wild varicella-zoster virus 
strains isolated from vaccinees and household contact.

Shiraki K, Horiuchi K, Asano Y, Yamanishi K, Takahashi M.

Department of Virology, Osaka University, Japan.

The Oka varicella vaccine strain can be differentiated from wild-type strains by 
its unique restriction endonuclease fingerprinting (REFP: HpaI-K and EcoRI-P)
pattern of the gpV-coding region of the varicella-zoster virus (VZV) genome.
VZV-DNAs from patients with complicated clinical courses related to vaccination
were examined to determine whether they were vaccine-derived or wild-type. A
virus was isolated from a one year-old boy with acute lymphocytic leukemia (ALL) 
who developed typical varicella 28 days after vaccination (case A). Another virus
was isolated from a four-year-old boy without clinical symptoms following
household contact with varicella patients at the age of two months, and he
developed zoster 14 months after vaccination (case B). Also, two strains (OK1 and
OK2) were isolated from household contacts (mother and sister) with a vaccine
with ALL in Oklahoma who developed varicella 18 days after vaccination (case C). 
In case C, BgII-REFP did not determine conclusively whether the two strains (OK1 
and OK2) were vaccine-derived or wild-type because the patterns obtained were
different from both the Oka varicella vaccine strain and American wild-type
strains [Gelb et al., Journal of Infectious Diseases, 155:633-640, 1987]. All VZV
strains examined in the present study were identified as wild-type by our method 
using HpaI-K and EcoRI-P fragments as marker fragments. Thus it is becoming
evident that REFP using HpaI and EcoRI endonucleases is a convenient and reliable
means of distinguishing between the Oka vaccine virus strain and wild-type
viruses isolated from individuals developing vesicular rashes shortly and long
after varicella vaccination.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1675658 [PubMed - indexed for MEDLINE]

5754: Antiviral Res. 1991 Feb;15(2):87-100.

Synergistic topical therapy by acyclovir and A1110U for herpes simplex virus
induced zosteriform rash in mice.

Lobe DC, Spector T, Ellis MN.

Division of Virology, Burroughs Wellcome Co., Research Triangle Park, North
Carolina 27709.

Combination therapy with A1110U, an inactivator of the herpes simplex virus (HSV)
and the varicella zoster virus ribonucleotide reductase, and acyclovir (ACV) was 
evaluated for treatment of cutaneous herpetic disease in athymic mice infected on
the dorsum. In this model, infection with HSV produces a 'zosteriform-like' rash 
that is first visible on day 3 or 4 post-infection (p.i.) and eventually extends 
from the anterior mid-line to the dorsal mid-line of the affected flank. In
untreated mice, the infection is fatal at about day 7 p.i. presumably due to
central nervous system involvement. Topical treatment of infections induced by
either wild-type (wt) HSV-1 or wt HSV-2 with 3% A1110U in combination with 5% ACV
resulted in synergistic (P less than 0.01) reductions in lesion scores. Therapy
was also synergistic in mice infected with an ACV-resistant thymidine
kinase-deficient mutant and an ACV-resistant TK-altered mutant HSV-1 isolated.
Combination therapy was very effective in reducing lesion scores of mice infected
with an ACV-resistant HSV-1 DNA polymerase mutant, but did not result in
statistically significant synergy (P = 0.07) because of the enhanced efficacy of 
A1110U alone against this virus. These results provide encouragement that the
combination of A1110U and ACV may offer an effective therapy for topical
treatment of cutaneous HSV infections in humans.

PMID: 1650166 [PubMed - indexed for MEDLINE]

5755: J Med Virol. 1991 Feb;33(2):100-5.

Antibody avidity following varicella-zoster virus infections.

Kangro HO, Manzoor S, Harper DR.

Virology Department, St. Bartholomew's Hospital, London, England.

The avidity of IgG antibodies following varicella-zoster virus (VZV) infections
was investigated using urea treatment of antigen-bound serum antibody by indirect
radioimmunoassay (RIA) and immunoblotting techniques. Sequential sera from 16
patients with varicella and 17 patients with zoster were tested, as well as sera 
from 80 seropositive individuals without a recent history of VZV disease. Both
types of assay showed that low-avidity antibodies predominate early after primary
infection, but that antibody avidity increases markedly during convalescence.
Using RIA, all sera taken up to 12 weeks after the onset of varicella showed
greater than 50% reduction in antibody titre after treatment with 8 M urea but
thereafter the proportion of urea resistant antibody increased with time. In
contrast, after recurrent infection, high avidity antibodies were found to
predominate at all times. Only 6 of 47 sera tested from zoster cases showed
greater than 30% reduction after urea treatment and all these were taken within 2
weeks after onset of rash. Immunoblotting also showed that the highly immunogenic
p32/p36 nucleoproteins appear to induce predominantly low avidity antibodies,
even after recurrent VZV infection. The results of this study indicate that
treatment with 8 M urea in RIA for IgG antibodies may be a simple and reliable
method for distinguishing primary and anamnestic antibody responses against VZV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1646852 [PubMed - indexed for MEDLINE]

5756: Hautarzt. 1991 Feb;42(2):72-6.

[Results of virostatic treatment of varicella with various severity]

[Article in German]

Stary A.

Ludwig Boltzmann-Institut zur Erforschung infektioser venero-dermatologischer
Erkrankungen, Wien.

Chickenpox is the result of primary infection with the varicella zoster virus
(VZV), which--like other herpes-viruses--has the ability to remain latent within 
the nervous system; reactivation then sometimes causes shingles many decades
later. While chickenpox is benign in normal children, infection in the
immunocompromised patient is characterized by a period of prolonged viral
replication, delayed healing and a high frequency of extracutaneous
manifestations, such as pneumonitis and involvement of the nervous system.
Therefore, current therapeutic research efforts have focused on both the
prevention of VZV infections through the development of a live, attenuated
vaccine and improved therapeutic modalities. The existing antiviral drug
acyclovir has been shown to be effective in reducing severe complications in risk
groups. It has been generally accepted that the varicella vaccine is useful in
immunocompromised children with acute leukaemia or solid malignant tumours.
Healthy seronegative siblings will also benefit from the varicella vaccine. In
addition, zoster hyperimmunoglobulin has also been shown to provide protection
against primary VCV infection in the incubation period. Preventive and
therapeutic efforts should mean that varicella will soon no larger be a medical
problem even for immunocompromised patients.

Publication Types: 
    English Abstract
    Review

PMID: 1645331 [PubMed - indexed for MEDLINE]

5757: Presse Med. 1991 Jan 19;20(2):71-4.

[Perineal neuralgia]

[Article in French]

Amarenco G, Le Cocquen-Amarenco A, Kerdraon J, Lacroix P, Adba MA, Lanoe Y.

Service de Neurologie et de Reeducation, C.H.G. Robert-Ballanger,
Aulnay-sous-Bois.

Ninety cases of chronic perineal pain of neurological origin are reported.
Alcock's canal syndrome, consecutive to damage of the pudendal nerve in the
ischiorectal fossa, is the most frequent of these neuralgias. It is characterized
by burning pain or paraesthesia increased in sitting position and relieved by
standing up. The specific treatment is CT-guided infiltrations of the pudendal
nerve. Other neurological causes are spinal cord lesions (notably tumours of the 
conus medullaris), sacral meningoradiculitis (perineal herpes zoster), plexitis
and pudendal nerve neuritis. In some cases the responsibility of perineal
stretching neuropathy may be considered. In all patients, electrophysiological
exploration of the perineum (detection of perineal floor muscles, sacral latency,
somatosensory and motor evoked potentials of the pudendal nerve) are necessary to
confirm the aetiological diagnosis and guide neurological investigations.

Publication Types: 
    English Abstract

PMID: 1825707 [PubMed - indexed for MEDLINE]

5758: Ugeskr Laeger. 1991 Jan 14;153(3):197-9.

[Herpes zoster induced reversible neurogenic bladder dysfunction. Urodynamic
documentation of reversible bladder paralysis]

[Article in Danish]

Jensen FS, Walter S.

Urologisk afdeling, Aalborg Sygehus Nord.

A case of sacral herpes zoster with reversible neurogenic bladder dysfunction
causing urinary retention is presented. Gradual reversibility of the motoric
paralysis of the detrusor was demonstrated in cystometrograms. It is stressed
that treatment should be primarily conservative and that repeated urodynamic
examinations is essential.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1998243 [PubMed - indexed for MEDLINE]

5759: Hum Pathol. 1991 Jan;22(1):75-80.

Type-specific identification of herpes simplex and varicella-zoster virus antigen
in autopsy tissues.

Martin JR, Holt RK, Langston C, Gilden DH, Richardson EP Jr, Manz HJ, Singer DB.

Laboratory of Experimental Neuropathology, National Institutes of Health,
Bethesda, MD 20892.

To identify antigens of herpes simplex virus (HSV) types 1 and 2 and
varicella-zoster virus (VZV) in human tissue, polyclonal antisera and an
immunoperoxidase method were used to examine formalin-fixed, paraffin-embedded
tissues from autopsy cases and experimentally infected animals. These antisera
readily distinguished between HSV and VZV antigen, with no evident
cross-reactivity. Antiser ato HSV-1 and HSV-2 were more strongly reactive with
antigen of the homologous virus than with that of heterologous virus. This
difference in immunoreactivity was used to discriminate between HSV-1 and HSV-2
antigens in experimentally infected animal tissues containing HSV antigens of
known type and, by extrapolation, to distinguish between these antigens in human 
autopsy tissues. Thus, with appropriate antisera and tissue controls, HSV-1,
HSV-2, and VZV can be identified in paraffin sections.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1845866 [PubMed - indexed for MEDLINE]

5760: J Acquir Immune Defic Syndr. 1991;4(12):1199-207.

Increasing CD8+ T lymphocytes predict subsequent development of intraoral lesions
among individuals in the early stages of infection by the human immunodeficiency 
virus.

Melnick SL, Hannan P, Decher L, Little JW, Rhame FS, Balfour HH Jr, Volberding P.

Division of Epidemiology, School of Public Health, University of Minnesota,
Minneapolis 55454-1015.

Determining the progression of human immunodeficiency virus (HIV) type 1
infection based on cellular and clinical markers has become increasingly
important. Although a number of studies have shown a relationship between the
presence of certain oral lesions and progression to AIDS, few data exist
regarding the association with T lymphocyte counts. In this study, the question
of whether intraoral lesions preceded or were the consequences of changes in T
lymphocyte counts was examined. A total of 116 HIV-infected patients
participating in two randomized double-blind placebo-controlled trials of
zidovudine at the University of Minnesota AIDS Clinical Trials Unit (ACTU) were
enrolled in a prospective dental study. Patients were examined for the presence
of hairy leukoplakia, candidiasis, herpes simplex, herpes zoster, aphthae,
atypical gingivitis, HIV-associated periodontitis, and necrotizing ulcerative
gingivitis, as well as other oral lesions, every 3 months for a maximum of four
examinations over a 1-year period. T lymphocyte counts before and after each
patient's oral examination were obtained. No significant differences were found
at examination 1 for differences in gender, race, age, education, tobacco smoking
status, ethanol consumption habits, duration in ACTU drug protocol, duration in
dental study protocol, or mean T lymphocyte counts between individuals with or
without oral lesions at any time in the dental study.(ABSTRACT TRUNCATED AT 250
WORDS)

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1682473 [PubMed - indexed for MEDLINE]

5761: Scand J Infect Dis Suppl. 1991;80:69-74.

Varicella-zoster virus infections in the immunocompromised host. Natural history 
and treatment.

Balfour HH Jr.

Department of Laboratory Medicine and Pathology, and Pediatrics, University of
Minnesota Health Sciences Center, Minneapolis 55455.

Varicella-zoster virus (VZV) causes significant morbidity and even mortality in
immunocompromised patients. Varicella has more serious consequences than herpes
zoster, although zoster is more common. This paper reviews the natural history of
varicella-zoster infections, as well as strategies for prevention and treatment. 
Although initial studies supported the use of either vidarabine or acyclovir for 
treatment of varicella in immunocompromised children, subsequent data have shown 
acyclovir to be superior for this purpose. Recent data in bone marrow transplant 
patients indicated that acyclovir was also more effective in preventing
progression of herpes zoster in the immunocompromised host. The question of using
steroids to prevent postherpetic neuralgia remains controversial. With the advent
of effective antiviral chemotherapy, treatment of VZV infections in the
immunocompromised host has become a reality. The potential problem of
acyclovir-resistant VZV strains justifies continued development of other anti-VZV
agents. Several new compounds are presently in or slated for clinical trials.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1666447 [PubMed - indexed for MEDLINE]

5762: Minerva Anestesiol. 1991 Jan-Feb;57(1-2):17-9.

[Therapeutic approach in the treatment of acute cervico-brachial Herpes zoster]

[Article in Italian]

Viglietti G, Viglietti A, Bignone P.

Servizio di Anestesia-Rianimazione, Ospedale Civile, Mondovi, Cuneo.

A highly specialized experimental treatment was used in the therapy of Herpes
zoster, which was aimed at inducing good control over acute pain and the
prevention of post herpic neuritis using poly-pharmacologic al infiltration of
ganglia and of relevant roots.

Publication Types: 
    English Abstract

PMID: 2057085 [PubMed - indexed for MEDLINE]

5763: Neurol Neurochir Pol. 1991 Jan-Feb;25(1):95-100.

[Two cases of ophthalmic zoster follow by hemiplegia]

[Article in Polish]

Czlonkowska A, Kruszewska J, Szpakowa G, Tarnowska-Dziduszko E, Kryst-Widzgowska 
T.

Kliniki Chorob Naczyniowych, Instytutu Psychiatrii i Neurologii w Warszawie.

Two cases of ophthalmic zoster are reported in which several weeks after the
appearance of skin changes hemiplegia developed. In one case the clinical course 
was unfavourable, and on autopsy extensive vasculitis was found in the brain with
ischaemic foci situated mainly on the side of zoster. In the second case with
favourable outcome CT demonstrated ischaemic foci probably of vascular origin,
again on the side of zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2034340 [PubMed - indexed for MEDLINE]

5764: Neurol Neurochir Pol. 1991 Jan-Feb;25(1):79-86.

[Ophthalmic zoster with contralateral hemiplegia]

[Article in Polish]

Czlonkowska A.

Klinika Chorob Naczyniowych Ukladu Nerwowego, Instytut Psychiatrii i Neurologii w
Warszawie.

Herpes zoster ophthalmicus may be followed several weeks after the appearance of 
skin changes by contralateral hemiplegia. Local angiitis is the most important
cause of the brain ischaemic lesions. Based on the literature, in the present
work the clinical, pathological and immunological observations are reviewed.

Publication Types: 
    English Abstract
    Review

PMID: 2034338 [PubMed - indexed for MEDLINE]

5765: Rev Neurol (Paris). 1991;147(2):164-6.

[Polyradiculoneuritis following lumbosacral zona with adrenal cortex adenoma]

[Article in French]

Ribot C, Flocard F, Escarment J, Straboni JP, Caffin JP, Desportes JC.

Service de Neurologie, Hopital d'Instruction des Armees, Desgenettes, Lyon.

We report a case of severe polyradiculoneuritis consecutive to a lumbosacral
herpes zoster and concomitant with an adrenal adenoma with hypercorticism. The
patient improved after surgery and plasmaphereses.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 2028153 [PubMed - indexed for MEDLINE]

5766: J Tenn Med Assoc. 1991 Jan;84(1):19-20.

Unsteady gait and seventh nerve palsy in an elderly woman.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 1999923 [PubMed - indexed for MEDLINE]

5767: Am Fam Physician. 1991 Jan;43(1):197-204.

Antiviral drug therapy.

Goodpasture HC.

University of Kansas School of Medicine-Wichita.

Major advances in molecular virology have led to the development of new antiviral
compounds. These drugs include ribavirin, used in the treatment of severe
respiratory syncytial virus infection in children; amantadine, used in the
prophylaxis and treatment of influenza A infection; acyclovir, used in a variety 
of herpesvirus infections, including primary gingivostomatitis, genital herpes
and herpes zoster; ganciclovir, used in the treatment of retinitis due to
cytomegalovirus, and zidovudine, used in the prophylaxis and treatment of human
immunodeficiency virus infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 1986488 [PubMed - indexed for MEDLINE]

5768: Laryngoscope. 1991 Jan;101(1 Pt 1):71-4.

Hilger facial nerve stimulator: a 25-year update.

Lewis BI, Adour KK, Kahn JM, Lewis AJ.

Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente Medical
Center, Oakland, CA 94611.

Percutaneous nerve excitability testing using the Hilger facial nerve stimulator 
was introduced about 25 years ago. The test is reliable, easy to use, and
inexpensive; it continues to be the most frequently used method for predicting
prognosis of facial nerve disorders. Between 1966 and 1974, we recorded 10,243
nerve excitability tests on 865 patients with a mean of 3.29 tests for each
peripheral branch and 3.43 for the trunk. Using a multiple regression model, we
determined the effect on nerve stimulation values of age, sex, race, diabetes,
hypertension, partial or complete clinical paralysis, diagnosis of herpes zoster,
year of testing, and eventual facial paralysis recovery profile. We discuss
statistical reliability, provide a table of interpretive results, and offer "tips
and traps" invaluable to the practitioner. A prospective study of 25 patients
with residual facial paralysis was evaluated by two separate otolaryngologists to
determine intertester reliability.

PMID: 1984555 [PubMed - indexed for MEDLINE]

5769: AIDS Care. 1991;3(3):271-9.

HIV and AIDS in Haiti: recent developments.

Desvarieux M, Pape JW.

Department of Medicine, Cornell University Medical College.

PIP: Both the seroprevalence and epidemiology of human immunodeficiency virus
(HIV) infection have demonstrated substantial changes in Haiti since the
beginning of the epidemic in the early 1980s. Although seroprevalence rates vary 
greatly according to the population group tested, surveys of healthy urban adults
have indicated an increase in HIV infection from about 8% in 1986 to 11% in 1991.
The rate in rural areas remains at about 3%. Tuberculosis, herpes zoster,
malignant prurigo, and weight loss are the most common signs of HIV infection
before the virus progresses to acquired immunodeficiency syndrome (AIDS). The
most significant changes in the pattern of HIV transmission in Haiti have been a 
decline in the proportion of cases among bisexuals/homosexuals (from 50% in 1983 
to 1% since 1987) or related to blood transfusion. Also striking has been a
change in the geographic distribution of HIV. In 1982, 80% of those infected with
HIV were from the capital Port-au-Prince, 10% were from other major cities, and
10% were from other countries. In 1990, only 65% of cases originated from the
Port-au-Prince area. Finally, there has been a shift in the sex distribution of
HIV, with women contributing 38% of cases in 1989-90 compared to only 15% in
1979-82. Disturbing are survey findings that HIV-infected women, or those with an
infected partner, continue to have unprotected sexual intercourse and to take no 
steps to avoid pregnancy. As a result of the growing number of AIDS cases among
women, children under 14 years of age now comprises 6.6% of all AIDS cases
compared to 2.4% in 1988. Development of a form of contraception that is as
effective against HIV transmission as the condom yet could be used without the
consent of the male partner would be an important advance in AIDS prevention in
Haiti.

Publication Types: 
    Review

PMID: 1932190 [PubMed - indexed for MEDLINE]

5770: Fundam Appl Toxicol. 1991 Jan;16(1):61-70.

Acute testicular toxicity of 1,3-dinitrobenzene and ethylene glycol monomethyl
ether in the rat: evaluation of biochemical effect markers and hormonal
responses.

Reader SC, Shingles C, Stonard MD.

ICI plc., Central Toxicology Laboratory, Cheshire, United Kingdom.

The studies described in this paper were undertaken to evaluate the use of plasma
enzymes of testicular origin and plasma hormones as markers of acute testicular
toxicity. Rats were dosed by gavage with a single dose of either
1,3-dinitrobenzene (1,3-DNB) or ethylene glycol monomethyl ether (EGME). Two
experimental designs were used: a dose response and a time-dose response course. 
Lactate dehydrogenase isozyme C4 (LDH-C4) and sorbitol dehydrogenase (SDH) were
used as germ cell markers and leucine aminotransferase (LAT) and androgen binding
protein (ABP) were used as Sertoli cell markers. Luteinizing hormone (LH),
follicle-stimulating hormone (FSH), and testosterone were also monitored.
Histopathology confirmed the known testicular toxicity of 1,3-DNB and EGME.
1,3-DNB induced Sertoli cell damage with associated degenerative changes in late 
pachytene spermatocytes. The effects of EGME were mainly on early and late
pachytene and dividing spermatocytes. No changes in either testicular or plasma
SDH or LAT were found. Similarly no effects were observed for plasma LH or
testosterone. However testicular LDH-C4 and testosterone, plasma LDH-C4, ABP, and
FSH did show compound related effects. LDH-C4 was reduced in testis and increased
in plasma with both compounds and plasma LDH-C4 remained elevated up to 14 days
after dosing. ABP levels in plasma were increased with 1,3-DNB and EGME. A
reduction in testicular testosterone levels was recorded and plasma FSH
concentrations were elevated after EGME treatment. It is concluded that plasma
LDH-C4 activity and ABP may be of diagnostic value in acute testicular toxicity. 
Increases in plasma LDH-C4 precede noticeable histological findings.

PMID: 1902188 [PubMed - indexed for MEDLINE]

5771: Scand J Infect Dis. 1991;23(3):283-5.

Varicella-zoster infection in adults with cystic fibrosis: role of acyclovir.

Ong EL, Mulvenna P, Webb KA.

Regional Department of Infectious Diseases and Tropical Medicine, Monsall
Hospital, University of Manchester School of Medicine, United Kingdom.

Of 159 adult patients with cystic fibrosis, 5 were documented to have
varicella-zoster infection that resulted in an infective pulmonary exacerbation
that required intravenous acyclovir and additional antibiotic treatment. Stable
serial pulmonary function values were observed over a 1-year period in 4 patients
and no complications resulted from treatment. Early treatment with acyclovir in
combination with appropriate antibiotics may prevent pulmonary deterioration in
adult patients with cystic fibrosis who develop varicella-zoster infection.

PMID: 1882193 [PubMed - indexed for MEDLINE]

5772: J Neuroradiol. 1991;18(1):32-48.

Intracerebral stenosing arteriopathies. Contribution of three radiological
techniques to the diagnosis.

[Article in English, French]

Pierot L, Chiras J, Debussche-Depriester C, Dormont D, Bories J.

Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris.

Fifty-one patients with intracerebral stenosing arteriopathy were studied by
computerized tomography (CT), magnetic resonance imaging (MRI) and cerebral
arteriography. Clinical symptoms were varied, included impaired cognitive
functions, progressive neurological deficit, headache and vomiting, and were
sometimes not suggestives of the diagnosis. CT scans of the brain were normal in 
25 percent of the cases or they were not probative because of various and
non-specific abnormalities (hypodensity of various types or haemorrhagic
hyperdensity). MRI always showed abnormalities but in many cases the lesions
observed on T2-weighted images consisted of non-specific focal areas of
high-intensity signal in the white matter. High-intensity signals in both white
matter and cortex seemed to be more suggestive of the diagnosis. In this as in
other studies, arteriography therefore remains the reference examination for
stenosing arteriopathies. Inflammatory, infectious and atheromatous processes are
the main causes of these arterial lesions. The aetiological value of radiological
examinations is poor, and in most cases the morphology and distribution of the
lesions does not point to any specific origin. However, herpes zoster arteritis
usually affects the proximal segments of the anterior and middle cerebral
arteries and spares the carotid siphon.

PMID: 1880560 [PubMed - indexed for MEDLINE]

5773: Curr Eye Res. 1991;10 Suppl:87-95.

External ocular herpesvirus infections in immunodeficiency.

Pepose JS.

Department of Ophthalmology, Washington University School of Medicine, St. Louis,
MO 63110.

Infections of the eye with members of the herpes family of viruses (e.g. HSV,
CMV, VZV) are frequent manifestations of acquired and inherited defects in cell
mediated immunity. Herpesvirus infections in the immunocompromised may reflect
frequent viral reactivation from the latent state, as well as extensive
productive infection of ocular structures following reactivation or primary
infection. A review of experimental and clinical studies of both acquired and
inherited immune dysfunction implicates specific immune mechanisms influencing
the establishment of latency, viral reactivation and the control of active viral 
replication in ocular tissues.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1864093 [PubMed - indexed for MEDLINE]

5774: Curr Eye Res. 1991;10 Suppl:177-82.

Oral acyclovir in herpes zoster ophthalmicus.

Harding SP, Porter SM.

St. Paul's Eye Hospital, Liverpool, UK.

46 patients with acute herpes zoster ophthalmicus of less than 72 hours duration 
were recruited into a placebo controlled trial to assess the efficacy of oral
acyclovir, 800 mg 5 times daily, in preventing or modifying ocular complications 
and pain. Fewer acyclovir recipients developed intraocular complications and
these were less severe but neither difference was statistically significant.
However, active ocular disease was significantly less common in the acyclovir
group (p = 0.01) at 6 months. Pain was significantly less severe in the acyclovir
group between 2 and 6 months. The proportion of patients with pain scores greater
than 0 was significantly lower in the acyclovir group between 2 and 3 months.
Oral acyclovir appears to modify the disease process in herpes zoster
ophthalmicus, to reduce the severity and incidence of postherpetic pain and
especially to protect against long-term ocular complications.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 1864092 [PubMed - indexed for MEDLINE]

5775: Curr Eye Res. 1991;10 Suppl:171-5.

High-dose oral acyclovir in acute herpes zoster ophthalmicus: the end of the
corticosteroid era.

Herbort CP, Buechi ER, Piguet B, Zografos L, Fitting P.

Hopital Ophtalmique Jules Gonin, Department of Ophthalmology, University of
Lausanne, Switzerland.

Systemic acyclovir (ACV), a new potent anti-herpes drug, was shown to reduce
effectively the morbidity in the acute phase of herpes zoster ophthalmicus
(AHZO). Using high dose oral ACV (5 X 800 mg/day) our aim in this study was: (1) 
to compare disease profiles in the ACV-treated group and in a group of zoster
patients having had no ACV, analysed retrospectively; (2) to establish if
high-dose ACV was able to prevent severe long term complications of AHZO; and (3)
to determine the present role of corticosteroids in AHZO. From 1984 to 1988, 48
patients with AHZO of less than 3 days' duration were included. All patients
received at least 7 days of oral ACV (5 X 800 mg/d) associated with topical ACV. 
Steroids were not given unless severe uveitis occurred. Follow-up was 2 years in 
43 patients and 1 year in all 48 patients. Main conclusions from our study are:
1. Ocular involvement occurred in 67% of ACV-treated cases, a rate comparable to 
our retrospective group (59%) and to the literature (71%). However the rate of
severe long term complications was minimal (4%) when compared to our non-treated 
retrospective group (21%). 2. Steroid treatment was not necessary in any of the
ACV-treated patients. 3. ACV was well tolerated and did not have to be
discontinued in any of the patients. High dose ACV and avoidance of steroids
seems to eliminate the severe complications of AHZO.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 1864091 [PubMed - indexed for MEDLINE]

5776: Curr Eye Res. 1991;10 Suppl:125-30.

Chronic ocular zoster.

Zaal MJ, Maudgal PC, Rietveld E, Suir EP.

Department of Ophthalmology, Academisch Ziekenhuis Vrije Universiteit, Amsterdam,
The Netherlands.

In a prospective open trial 40 patients suffering from acute herpes zoster
ophthalmicus were treated with systemic acyclovir. An additional 10 patients were
treated by topical acyclovir alone and dexamethasone eye-drops were administered 
to 5 of them to suppress ocular inflammation. In the topical treatment group the 
period of new skin lesion formation and progression of ocular inflammatory signs 
were significantly prolonged. Therapy with systemic acyclovir however resulted in
a quick and complete resolution of ocular inflammation in all patients. Chronic
ocular inflammation developed in 4 out of 10 patients treated with topical
acyclovir. We consider chronic ocular zoster as a distinct clinical entity,
possibly expressing a failing local immune response against VZV.

Publication Types: 
    Case Reports

PMID: 1864089 [PubMed - indexed for MEDLINE]

5777: Compendium. 1991 Jan;12(1):46, 48-51.

The many faces of adult leukemia.

Dreizen S.

University of Texas Dental Branch, Houston.

This article describes the facial complications of adult leukemia, as derived
from a study of more than 3,000 patients treated at the University of Texas M.D. 
Anderson Hospital during the past 25 years. Facial leukemia cutis,
leukemia-associated facial hemorrhages, leukemia-induced cranial nerve facial
palsies, and leukemia-provoked pure and mixed facial infections are discussed.

PMID: 1860114 [PubMed - indexed for MEDLINE]

5778: Arch Virol. 1991;117(3-4):165-71.

Immunosuppressive dose of azathioprine inhibits replication of human
cytomegalovirus in vitro.

Shiraki K, Ishibashi M, Okuno T, Namazue J, Yamanishi K, Sonoda T, Takahashi M.

Department of Virology, Osaka University School of Medicine, Osaka, Japan.

Azathioprine (Aza) was found to have anti-human cytomegalovirus (HCMV) activity
in vitro at concentrations used for immunosuppression therapy. The dose of Aza
for 50% plaque reduction was 0.592 micrograms ml for HCMV in human embryonic lung
(HEL) cells, but those of Aza for 50% plaque reduction for herpes simplex virus
(HSV) and varicella-zoster virus were more than 20 micrograms/ml. The dose of Aza
for 50% reduction of the HCMV yield in infected cells was 0.25 micrograms/ml,
while that for 50% reduction of the HSV yield in infected cells was more than 50 
micrograms/ml. The dose of Aza for 50% growth inhibition of HEL cells was 30
micrograms/ml, and 50.7 and 120 times greater than the doses for 50% reduction of
the plaque formation and the yield of HCMV, respectively. Thus Aza was found to
have a strong anti-HCMV activity at concentrations used for immunosuppression.
When HCMV infected cells were treated with cyclosporine (CsA: 0.2 microgram/ml)
and prednisolone (Pred: 0.3 microgram/ml) simultaneously with Aza, the doses of
Aza for 50% reduction of plaque formation and the yield of HCMV were 0.73 and
0.32 micrograms/ml, respectively. Thus an inhibitory effect of Aza was also
observed in HCMV-infected cells treated with CsA and Pred at their concentrations
used for immunosuppression. Maintenance of an anti-HCMV dose of Aza in
combination with CsA and Pred might establish not only satisfactory
immunosuppression but also suppression of HCMV infection in transplant
recipients.

PMID: 1850228 [PubMed - indexed for MEDLINE]

5779: Acta Neurol Scand. 1991 Jan;83(1):55-60.

Acute peripheral facial palsy: CSF findings and etiology.

Roberg M, Ernerudh J, Forsberg P, Fridell E, Fryden A, Hyden D, Linde A, Odkvist 
L.

Department of Infectious Diseases, Linkoping University, Sweden.

CSF and serum were examined in acute and convalescence phase from 56 patients
with acute idiopathic peripheral facial palsy. CSF protein analysis, viral and
borrelia serology were performed. Borrelia infection was found in 9/56 cases and 
was often associated with inflammatory CSF findings. One patient each had
serological evidence for a recent or ongoing infection with herpes simplex,
varicella zoster, adeno, influenza B, echo and Epstein-Barr virus, but none had
specific intrathecal antibody synthesis; 11 patients had a serological pattern
compatible with a reactivated Epstein-Barr virus infection. Eleven patients
displayed mononuclear CSF pleocytosis. Four of them had a borrelia infection. A
disturbed blood-brain barrier was observed in 19 patients. Intrathecal
immunoglobulin synthesis as indicated by elevated IgM-indices was found in 16
patients and by IgG indices in three. Nine patients had oligoclonal IgG bands in 
serum and CSF, three exclusively in CSF. It is concluded that patients with
facial palsy often have inflammatory CSF findings, indicating a generalised
central nervous system affection, and not only a mononeuritis. The importance of 
viral infections in the pathogenesis is still obscure. Borrelia is the most
common infectious cause of facial palsy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1849336 [PubMed - indexed for MEDLINE]

5780: Acta Neurol Scand. 1991 Jan;83(1):45-51.

Peripheral nervous system and spinal cord involvement in lymphoma.

Correale J, Monteverde DA, Bueri JA, Reich EG.

Division of Neurology, Jose Maria Ramos Mejia, Hospital, Buenos Aires, Argentina.

Nine-hundred-eighty-nine patients with diagnosis of lymphoma were studied.
Forty-six cases (4.6%) had compressions of the spinal cord or roots. Forty-two
patients (4.2%) had Herpes zoster virus infections, which in 6 cases were of
disseminated type. The major predisposing factors for infection were: advanced
stage of lymphoma, previous systemic chemotherapy and splenectomy. Toxic
polyneuropathy secondary to chemotherapy was found in 39 patients (3.9%). In 14
cases, the polyneuropathic symptoms were the main complaint (Group 1), while in
the remaining 25 cases the diagnosis was made during neurological consultations
because of unrelated symptoms (Group 2). Both groups did not have significant
differences in the total dose of chemotherapy received. The electrophysiological 
studies showed an axonal neuropathy in both groups. The discontinuation of
chemotherapy was found to be a limiting factor in the appearance of neuropathic
symptoms. Other less frequent forms of involvement were: compression of
peripheral nerves or nerve plexi from lymphadenopathies (3 cases), radiation
myelopathy (1 case), and Guillain-Barre Syndrome associated with Hodgkin's
Lymphoma (1 case).

PMID: 1849335 [PubMed - indexed for MEDLINE]

5781: J Med Chem. 1991 Jan;34(1):57-65.

Synthesis and antiviral activity of 9-alkoxypurines. 2.
9-(2,3-Dihydroxypropoxy)-, 9-(3,4-dihydroxybutoxy)-, and
9-(1,4-dihydroxybut-2-oxy)purines.

Bailey S, Harnden MR, Jarvest RL, Parkin A, Boyd MR.

Beecham Pharmaceuticals Research Division, Biosciences Research Centre, Epsom,
Surrey, U.K.

Reaction of alkenoxyamines (3,5) or (R,S)-, (R)-, and (S)-hydroxy-protected
derivatives of hydroxyalkoxyamines (20a,b, 37a-c) with
4,6-dichloro-2,5-diformamidopyrimidine (4) and cyclization of the resultant
6-[(alkenoxy)amino]-and 6-(alkoxyamino)pyrimidines (6,7,21a,b, 38a,b,c) by
heating with diethoxymethyl acetate afforded 9-alkenoxy- and
9-alkoxy-6-chloropurines (9,10,22a,b, 39a-c, 40a). These were subsequently
converted to 9-(2,3-dihydroxypropoxy), 9-(3,4-dihydroxybutoxy), and
9-(1,4-dihydroxybut-2-oxy) derivatives of guanine and 2-aminopurine (13-16,
25-28, 41a-c, 42a). A 2-amino-6-methoxypurine derivative (17) was also prepared. 
The racemic guanine derivative 13 showed potent and selective activity against
herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), but was less active against
varicella zoster virus (VZV). Its antiviral activity is attributable to the S
isomer (28), which was found to be more active than acyclovir against HSV-1 and
HSV-2 and about 4 times less active than acyclovir against VZV. The S enantiomer 
of 9-(1,4-dihydroxybut-2-oxy)guanine (41c) also showed noteworthy antiviral
activity in cell culture. Although this acyclonucleoside (41c) is only weakly
active against HSV-1 and inactive against HSV-2, it is about twice as active as
acyclovir against VZV.

Publication Types: 
    Comparative Study

PMID: 1846922 [PubMed - indexed for MEDLINE]

5782: J Virol. 1991 Jan;65(1):195-205.

The three major immediate-early transcripts of bovine herpesvirus 1 arise from
two divergent and spliced transcription units.

Wirth UV, Vogt B, Schwyzer M.

Institut fur Virologie, Universitat Zurich, Switzerland.

Among 54 transcripts expressed in a temporal cascade during lytic infection with 
bovine herpesvirus 1, we have previously identified three major immediate-early
(IE) RNAs, IER4.2 (4.2 kb), IER2.9 (2.9 kb), and IER1.7 (1.6 to 1.8 kb depending 
on the virus strain) transcribed from the HindIII C genome region (U. V. Wirth,
K. Gunkel, M. Engels, and M. Schwyzer, J. Virol. 63:4882-4889, 1989). Northern
(RNA) blot, S1 nuclease protection, and primer extension analysis used in the
present study demonstrated that all three IE transcripts were spliced and
originated from two divergent transcription units with start sites located in the
inverted repeat. Transcription unit 1 encoded two alternative spliced
transcripts, IER4.2 and IER2.9, with a common exon 1 located at 0.797 to 0.795
map units (m.u.) and an exon 2 for IER4.2 (0.792 to 0.762 m.u.) in the inverted
repeat; exon 2 for IER2.9 (0.754 to 0.738 m.u.) was located in the unique long
sequence and transcribed in antisense orientation to latency-related RNA.
Transcription unit 2 (0.818 to 0.836 m.u.), further characterized by cDNA
cloning, encoded the spliced IER1.7 with three exons in the inverted repeat.
Additional minor IE transcripts were interpreted as unspliced precursors and
splicing variants. With regard to the number and layout of IE genes, bovine
herpesvirus 1 occupies an intermediate position between pseudorabies virus and
equine herpesvirus 1 on the one hand and varicella-zoster virus and herpes
simplex virus type 1 on the other.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1845884 [PubMed - indexed for MEDLINE]

5783: Przegl Epidemiol. 1991;45(4):273-7.

[Effect of Bioglobulin on the clinical course of selected diseases of viral and
bacterial etiologies]

[Article in Polish]

Janeczko J, Olejnik Z, Lipowski D, Przyjalkowski W, Romanowska B.

Klinika Chorob Zakaznych dla Dorosych Instytutu Chorob Zakaznych Pasozytniczych
Akademii Medycznej, Warszawie.

The therapeutic effect of Bioglobulin was studied in some diseases of viral or
bacterial etiology. It was found favorable as it seemed to lessen the clinical
and the shorten the acute as well as the hospitalisation periods. Because in the 
very serious and serious diseases of viral or bacterial etiology the antibodies
deficiency, absolute or relative, total or selective is common, Bioglobulin may
be a valuable agent in the comprehensive treatment.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 1841402 [PubMed - indexed for MEDLINE]

5784: Dermatologica. 1991;182(3):160-3.

HLA-DR antigen expression on peripheral T cell subsets in pityriasis rosea and
herpes zoster.

Yoshiike T, Aikawa Y, Wongwaisayawan H, Ogawa H.

Department of Dermatology, Juntendo University, School of Medicine, Tokyo, Japan.

Using 2-color fluorescein-activated cytometric analysis, HLA-DR antigen
expression on peripheral blood T cell subsets was studied in patients with herpes
zoster (HZ), pityriasis rosea (PR) and psoriasis. In HZ and PR, HLA-DR was found 
to be significantly expressed on T cell surfaces (CD3+ cells), when compared to
that of the normal control (HZ: p less than 0.001, PR: p less than 0.05). Among T
cell subsets, such HLA-DR antigen was predominantly expressed on
suppressor/cytotoxic cells (CD8+) in HZ (vs. normal control, p less than 0.01).
However, in the case of PR, it was predominantly expressed on helper cells (CD4+;
vs. control, p less than 0.05). On the other hand, activated T cell antigen
(CD25+) was not significantly expressed on T cells (CD3+) in either HZ or PR. In 
the T cell subsets, HLA-DR antigen expression returned to normal levels during
the recovery phases of HZ and PR.

PMID: 1831772 [PubMed - indexed for MEDLINE]

5785: Int J Immunopharmacol. 1991;13 Suppl 1:91-8.

Chemotherapy of the acquired immune deficiency syndrome (AIDS): acyclic
nucleoside phosphonate analogues.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

The acyclic nucleoside phosphonate analogues (HPMPA, HPMPC, PMEA, FPMPA) show
great promise for the treatment of infections with such important human pathogens
as adeno, pox (vaccinia) and hepadna (hepatitis B) viruses (HPMPA), herpes
(herpes simplex, varicella-zoster, cytomegalo, Epstein-Barr) viruses (HPMPC), and
retro (human immunodeficiency) viruses (PMEA, FPMPA). All these compounds seem to
be targeted at the viral DNA polymerase, with which they interact, as either
competitive inhibitors or alternative substrates (or chain terminators),
following their intracellular phosphorylation to the diphosphoryl derivatives. Of
particular interest is the prolonged anti-viral action, lasting for several days 
or even weeks, that has been noted both in vitro and in vivo after a single
administration of the acyclic nucleoside phosphonates.

Publication Types: 
    Review

PMID: 1823910 [PubMed - indexed for MEDLINE]

5786: Przegl Epidemiol. 1991;45(3):175-81.

[Clinical types of herpes zoster in clinical observations 1985-1989]

[Article in Polish]

Leszczyszyn-Pynka M, Niscigorska J.

Klinika Chorob Zakaznych PAM, Szczecinie.

The clinical types of herpes zoster in 286 patients were observed. The
differences in the course of disease in persons with and without decreased
immunity are described. Some of the neurological complications depending on the
localization of the herpes zoster are presented.

Publication Types: 
    English Abstract

PMID: 1819813 [PubMed - indexed for MEDLINE]

5787: Scand J Infect Dis Suppl. 1991;80:62-8.

Zoster-associated chronic pain: an overview of clinical trials with acyclovir.

Crooks RJ, Jones DA, Fiddian AP.

Wellcome Research Laboratories, Beckenham, U.K.

An overview of all the available placebo-controlled trial data for oral acyclovir
in acute herpes zoster infection has confirmed that a dose of 800 mg five times
daily for seven to ten days is effective in reducing the incidence of
post-herpetic neuralgia and the duration of pain. Although one study failed to
demonstrate such an effect, three other studies and a combined analysis, using
the log rank test, did so. The duration of pain was shortened from an average of 
86 to 49 days (p less than 0.001). Future studies will need to take account of
these findings since oral acyclovir is most likely to be used as the standard
reference therapy.

Publication Types: 
    Review

PMID: 1803501 [PubMed - indexed for MEDLINE]

5788: Scand J Infect Dis Suppl. 1991;80:53-61.

Herpes zoster and pain.

Wood MJ.

Department of Communicable and Tropical Diseases, East Birmingham Hospital,
England.

Pain is frequently the most distressing symptom of herpes zoster. Pain occurs in 
most patients during the acute phase and sometimes continues as postherpetic
neuralgia (PHN) for months or years after the rash has healed. Both the acute
pain and the incidence and duration of postherpetic pain are influenced by the
age of the patient and the distribution of the rash. The acute pain is probably
related to neuronal inflammation induced by the replicating varicella-zoster
virus and can be helped by antiviral agents and by steroids. As yet, the
pathophysiology of PHN is poorly understood and may well be multifactorial,
perhaps accounting for the two clearly different types of PHN described.
Prevention of PHN is not possible but there are some data suggesting the use of
antiviral agents during the acute phase may be helpful. Once PHN has become
established conventional analgesics are ineffective and tricyclic antidepressants
seem to be the optimal therapy.

Publication Types: 
    Review

PMID: 1803500 [PubMed - indexed for MEDLINE]

5789: Optom Clin. 1991;1(4):45-58.

Herpetic keratitis.

Mitchell PC.

Herpes simplex and herpes zoster cause a wide range of acute and chronic corneal 
disease. The primary care clinician should be aware of the varied presentations
of these two viruses. This paper presents the clinical features and treatment
options that are available.

Publication Types: 
    Review

PMID: 1799835 [PubMed - indexed for MEDLINE]

5790: Stereotact Funct Neurosurg. 1991;56(3):166-78.

Anatomic examination of a case of open trigeminal nucleotomy (nucleus caudalis
dorsal root entry zone lesions) for facial pain.

Spiegelmann R, Friedman WA, Ballinger WE, Tedeschi H.

Department of Neurosurgery, University of Florida, Gainesville.

Nucleus caudalis dorsal root entry zone lesions (open trigeminal nucleotomy) are 
a surgical procedure which can achieve pain control without major complications
in the difficult clinical setting of deafferentation-type facial pain. Two
patients are reported, who had relief of pain, but also experienced neurological 
complications. One patient succumbed to pulmonary complications, which provided
the opportunity for anatomic analysis of the lesioned area, which is discussed in
detail. Potential modifications of the surgical technique are suggested.

Publication Types: 
    Case Reports

PMID: 1796221 [PubMed - indexed for MEDLINE]

5791: Fortschr Ophthalmol. 1991;88(6):705-11.

[Acute retinal necrosis and HIV infection]

[Article in German]

Pfaffl W, Fabricius EM, Scheidegger K, Brommer M.

Augenabteilung Stadtischen Krankenhauses Munchen-Harlaching, Bundesrepublik
Deutschland.

Acute retinal necrosis (ARN) is increasingly being observed among patients with
HIV infection. Varicella-zoster virus (VZV) and herpes simplex virus (HSV) are
recognized as being the etiologic agents in this syndrome. Among the 538 patients
with HIV infection (261 of these with AIDS), who were followed up in our
department between 1985 and 1990, we diagnosed ARN in 4 cases. Three of these
patients suffered from AIDS. Thus, ARN was the third-most-frequent form of
retinitis in our patients with AIDS (prevalence 1.1%), following Cytomegalovirus 
(CMV) retinitis (17.2%) and toxoplasmosis-retinochorioiditis (2.7%). The course
of ARN in patients with AIDS is demonstrated in four case reports. Special
features of the retina are documented by photographs of the fundus. The authors
suggest that patients with AIDS who experienced an episode of VZV- or HSV
infection which necessitated high-dose systemic aciclovir therapy are at risk of 
developing ARN. We recommend that they be kept on virustatic maintenance therapy.

Publication Types: 
    Case Reports
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 1794795 [PubMed - indexed for MEDLINE]

5792: Nephrol Dial Transplant. 1991;6(9):649-55.

Ocular complications in renal allograft recipients.

Das T, Gupta A, Sakhuja V, Gupta KL, Minz M, Chugh KS.

Department of Nephrology, Postgraduate Institute of Medical Education and
Research, Chandigarh, India.

Ocular complications in renal allograft recipients are a significant cause of
morbidity. Of 80 renal transplant recipients, 42 (52.5%) developed ocular
complications. These included posterior subcapsular cataract in 22 patients
(27.5%), opportunistic ocular infections by CMV, cryptococcus, mucormycosis,
herpes simplex and herpes zoster in five (6.25%), steroid-induced raised
intraocular pressure in four (5%) and primary disease-related vascular
complications in ten (12.5%). Our findings highlight the importance of regular
ocular examination of all allograft recipients in the post-transplant period.

Publication Types: 
    Case Reports

PMID: 1745389 [PubMed - indexed for MEDLINE]

5793: Przegl Epidemiol. 1991;45(4):267-71.

[Effect of isoprinosine and acyclovir on the clinical course of chickenpox and
herpes zoster]

[Article in Polish]

Janeczko J, Baranowska M, Romanowska B.

Klinika Chorob Zakaznych dla Doroslych Instytutu Chorob Zakaznych, Pasozytniczych
Akademii Medycznej, Warszawie.

The therapeutic effect of isoprinosine and acyclovir have been studied in 352 and
284 patients with chicken-pox and herpes zoster respectively. The patients were
divided into 4 groups: the first one was given palliative treatment only, the
second--both palliative and isoprinosine ones, the third--palliative and
acyclovir treatment, and the fourth group was given all these. The best
therapeutic effect was achieved when acyclovir and isoprinosine was applied
jointly, the one of acyclovir alone was less pronounced and that of isoprinosine 
only was the smallest. According to the authors acyclovir should be the treatment
of choice in the very severe and severe cases of chicken-pox and herpes zoster;
in the early stage of disease it should be supplemented with isoprinosine and
passive immunotherapy.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial
    English Abstract

PMID: 1726758 [PubMed - indexed for MEDLINE]

5794: Viral Immunol. 1991 Fall;4(3):151-66.

Human T cells recognize multiple epitopes of an immediate early/tegument protein 
(IE62) and glycoprotein I of varicella zoster virus.

Bergen RE, Sharp M, Sanchez A, Judd AK, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California.

Infection with varicella zoster virus (VZV) elicits persistent cell-mediated
immunity directed against the immediate early (IE62) protein and the glycoprotein
I (gp I) in most healthy subjects. In these experiments, synthetic peptides
corresponding to residues of the IE62 protein and gp I were used to identify
linear amino acid sequences of these immunogenic VZV proteins that were
recognized by peripheral blood T lymphocytes from VZV-immune individuals of known
major histocompatibility complex (MHC) type. All of 12 VZV-immune donors had
T-cell proliferative responses, defined as a stimulation index (SI) greater than 
or equal to 2.0, to at least two of ten synthetic IE62 peptides; the mean number 
of IE62 peptides recognized by T cells from VZV-immune donors was seven. Five of 
the ten IE62 peptides stimulated T cells from 75% to 83% of the VZV-immune
donors; the other five IE62 peptides were recognized by T cells from 42% to 67%
of the subjects. All VZV-immune donors also had T proliferation responses to at
least two of ten synthetic gp I peptides; the mean number of peptides recognized 
was six. Six of the ten gp I peptides were recognized by T cells from 67% to 92% 
of the VZV-immune donors; the frequency of donors responding to the other gp I
peptides ranged from 42% to 58%. None of five nonimmune donors demonstrated
T-cell proliferation to any of the IE62 or gp I peptides. A combination of two
IE62 peptides provided epitopes that could be recognized by T cells from all
twelve VZV-immune donors, regardless of DR type. Similarly, one gp I peptide in
combination with either of two other gp I peptides induced proliferation of T
cells from all immune subjects. Memory T cells with specificity for multiple
short amino acid sequences of the IE62 protein and gp I were detected in subjects
who had had primary VZV infection more than 20 years earlier. These observations 
indicate that natural VZV infection elicits a diverse cell-mediated immune
response to viral proteins that is not restricted to only one or two
immunodominant regions. Although the usefulness of peptide vaccines remains to be
established, multiple epitopes of the IE62 protein and gp I were identified that 
could be presented by antigen-presenting cells (APC) and recognized by T cells
from most subjects in an "outbred" human population.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1725699 [PubMed - indexed for MEDLINE]

5795: J Immunol. 1991 Jan 1;146(1):257-64.

Equivalent recognition of a varicella-zoster virus immediate early protein (IE62)
and glycoprotein I by cytotoxic T lymphocytes of either CD4+ or CD8+ phenotype.

Arvin AM, Sharp M, Smith S, Koropchak CM, Diaz PS, Kinchington P, Ruyechan W, Hay
J.

Department of Pediatrics, Stanford University School of Medicine, CA 94305.

Immunity to varicella-zoster virus (VZV), a member of the alpha-herpes virus
family, exemplifies the host response to an ubiquitous human viral pathogen. In
this investigation of the cytotoxic T lymphocyte (CTL) response to VZV, the
depletion of CD4+ T lymphocytes made it possible to demonstrate CD8(+)-mediated
cytotoxic function against autologous VZV-infected lymphoblastoid cells targets. 
CTL recognition of two major VZV proteins, the immediate early protein (IE62) and
gp I, was demonstrated in limiting dilution cultures of T lymphocytes obtained
from immune donors, stimulated with inactivated VZV Ag, and tested against
lymphoblastoid cells infected with vaccinia recombinants expressing these VZV
proteins. Among 11 VZV donors tested at least 20 y after primary infection, the
mean precursor frequency for T lymphocytes that recognized the IE62 protein was
1:105,000 +/- 85,000 SD, with a range of 1:13,000 to 1:231,000. The mean
frequency of CTL precursors specific for gp I in 11 subjects was equivalent, with
a mean of 1:121,000 +/- 86,000 SD (range 1:15,000 to 1:228,000) (p = 0.68).
Limiting dilution cultures were also prepared using purified CD4+ or CD8+ T
lymphocyte populations recovered from PBMC by sterile fluorescence-activated cell
sorting. CTL precursors that recognized the IE62 protein or gp I were derived
from each of the major T lymphocyte populations by stimulation with inactivated
VZV Ag; CD4+ and CD8+ CTL precursor frequencies for the IE62 protein and gp I
were equivalent (p = 0.2). We conclude that antiviral CTL activity against
targets expressing VZV proteins was mediated equally well by T lymphocytes of the
CD4+ or CD8+ phenotype and that antiviral CTL function could be elicited in each 
subpopulation by exposure to non-infectious viral Ag.

Publication Types: 
    In Vitro
    Research Support, U.S. Gov't, P.H.S.

PMID: 1670603 [PubMed - indexed for MEDLINE]

5796: G Batteriol Virol Immunol. 1991 Jan-Dec;84(1-12):41-52.

[Serologic follow-up of cytomegalovirus, herpes simplex and varicella-zoster
infections in kidney transplant recipients]

[Article in Italian]

Merlino C.

Istituto di Microbiologia, Universita di Torino.

In the present paper the characteristics of cytomegalovirus (CMV), herpes simplex
virus (HSV) and varicella-zoster virus (VZV) infections were serologically
investigated in renal transplant recipients. At transplantation
CMV-seropositivity was 88.2%. At the end of the study, the frequency of primary
CMV-infections was 58.3% and the frequency of recurrent infections (reinfections 
or reactivations) was 84.4%. The 57.1% of primary infections and the 64.5% of
recurrent infections occurred between the first and the third month after
transplantation. There was no correlation between recurrent infections and type
of immunosuppressive treatment (CyA vs. Triple). The 70% of pairs of patients who
received a kidney from the same CMV-seropositive donor reacted in the same way:
or neither had any infection or both had active CMV-infection. There was no
correlation between rejection and active CMV-infection. HSV-seropositivity was
96.2%. Primary HSV-infections didn't occur and the frequency of reactivation in
seropositive patients was 31.4%. No correlation was found between rejection and
active HSV-infection as well. As regards VZV-infection, seropositivity at
transplantation was 90%. Primary VZV-infections didn't occur. During the study,
seropositive patients showed variations in VZV-antibody titers which returned to 
initial values. Clinical signs of zoster were observed in 6% of patients at third
and ninth month after transplantation and were serologically confirmed.

Publication Types: 
    English Abstract

PMID: 1668971 [PubMed - indexed for MEDLINE]

5797: DNA Seq. 1991;1(4):241-9.

Sequence characteristics of a gene in equine herpesvirus 1 homologous to
glycoprotein H of herpes simplex virus.

Robertson GR, Scott NA, Miller JM, Sabine M, Zheng M, Bell CW, Whalley JM.

School of Biological Sciences, Macquarie University, Sydney, Australia.

A gene in equine herpesvirus 1 (EHV-1, equine abortion virus) homologous to the
glycoprotein H gene of herpes simplex virus (HSV) was identified and
characterised by its nucleotide and derived amino acid sequence. The EHV-1 gH
gene is located at 0.47-0.49 map units and contains an open reading frame capable
of specifying a polypeptide of 848 amino acids, including N- and C-terminal
hydrophobic domains consistent with signal and membrane anchor regions
respectively, and 11 potential sites for N-glycosylation. Alignment of the amino 
acid sequence with those published for HSV gH, varicella zoster virus gpIII,
Epstein Barr virus gp85 and human cytomegalovirus p86 shows similarity of the EHV
gene with the 2 other alpha-herpesviruses over most of the polypeptide, but only 
the C-terminal half could be aligned for all 5 viruses. The identical positioning
of 6 cysteine residues and a number of highly conserved amino acid motifs
supports a common evolutionary origin of this gene and is consistent with its
role as an essential glycoprotein of the herpesvirus family. An origin of
replication is predicted to occur at approximately 300 nucleotides downstream of 
the EHV-1 gH coding region, on the basis of similarity to other herpesvirus
origins.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1666854 [PubMed - indexed for MEDLINE]

5798: Scand J Infect Dis Suppl. 1991;80:33-9.

One year acyclovir suppression of frequently recurring genital herpes: a study of
efficacy, safety, virus sensitivity and antibody response.

Molin L, Ruhnek-Forsbeck M, Svennerholm B.

Department of Dermatology, Orebro Medical Center Hospital, Sweden.

The efficacy of oral acyclovir 400 mg twice daily in suppressing frequently
relapsing genital herpes simplex was evaluated in an open multicenter study.
Seventy-one patients were treated for 12 months. During treatment, 73% of the
patients were completely free of symptoms when taking the tablets continuously,
and another 14% had mild symptoms such as erythema and/or itching at single
occasions. An accidental treatment interruption for 2-4 days led to mild but
definite herpes episodes within a few days in 5 otherwise symptom free patients. 
Definite herpes episodes despite acyclovir medication occurred in 3 cases (4%).
No noteworthy side effects were recorded during the acyclovir treatment. After
withdrawal of acyclovir, herpes relapsed within 1-4 weeks in 69% of the patients.
The frequency of relapses during the following months was reported to be equal to
that before the treatment period in most of the patients. Acyclovir
susceptibility of the isolated herpes simplex virus (HSV) strains did not change 
during treatment. The mean titres of antibodies against HSV type-common
glycoprotein antigen, HSV-2 type-specific antigen and varicella zoster virus
antigens decreased significantly during treatment with acyclovir.

Publication Types: 
    Clinical Trial
    Multicenter Study
    Research Support, Non-U.S. Gov't

PMID: 1666444 [PubMed - indexed for MEDLINE]

5799: Scand J Infect Dis Suppl. 1991;80:15-20.

Herpesvirus infection: an overview of the clinical manifestations.

Peterslund NA.

Department of Haematology, Aarhus Amtssygehus, Denmark.

Herpesviruses include seven human viruses and numerous animal viruses. The human 
herpesviruses, in addition to their trivial names, are named from 1 to 7. The two
most recently discovered herpesviruses thus being Human herpesvirus 6 and 7.
Human herpesvirus 6 is the aetiologic agent causing exanthema subitum. Human
herpesvirus 7 has, as yet, not been associated with any disease. A characteristic
feature of the herpesviruses is the persistence in a latent form after primary
infection which may later cause reactivated infection resulting in considerable
morbidity, for example, in genital herpes. The clinical spectrum of herpes
infections is very broad. In general, the primary infection is more severe than
the reactivated. Other important determinants of morbidity are the patients' age 
and immune status. Many severe herpes infections are almost exclusively seen in
immunocompromised patients. This review deals with the clinical manifestations of
herpetic infections in normal and immunocompromised hosts with emphasis on the
clinical recognition.

Publication Types: 
    Review

PMID: 1666443 [PubMed - indexed for MEDLINE]

5800: Scand J Infect Dis Suppl. 1991;80:105-9.

Virological and clinical characteristics of human herpesvirus 6.

Wahren B, Linde A.

Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.

Six distinct human herpesviruses have been identified. They include Herpes
simplex virus type 1 and type 2 (HSV-1 and HSV-2), Cytomegalovirus (CMV),
Varicella-zoster virus (VZV), Epstein-Barr virus and the recently described Human
herpesvirus 6 (HHV-6). With the exception of HSV-2, the members of the family are
ubiquitous and infect most of the human population in the first decade of life.
HHV-6 possesses morphological and structural features characteristic of members
from the herpesvirus family but it is both genetically and immunologically
distinct from other members. The virus was first identified in 1986 by the group 
at the National Institutes of Health, Bethesda. Not until 1988 was the primary
disease identified as that of a common childhood disease, exanthema subitum.
There are independent reports on isolations of HHV-6 from the USA, Japan, U.K.,
Australia and Africa, demonstrating that the virus is a widespread agent. Its
possible involvement in chronic fatigue disease and as a cofactor of development 
of AIDS are still subjects for discussion.

Publication Types: 
    Review

PMID: 1666441 [PubMed - indexed for MEDLINE]

5801: Zh Nevropatol Psikhiatr Im S S Korsakova. 1991;91(10):117-21.

[Cerebrovascular syndromes in ocular herpes zoster convalescents (review of the
literature)]

[Article in Russian]

Smirnov IuK, Shishov AS.

Publication Types: 
    Review

PMID: 1665639 [PubMed - indexed for MEDLINE]

5802: Ophthalmologica. 1991;203(4):172-5.

Acute retinal necrosis: a new pathophysiological hypothesis.

Schwoerer J, Othenin-Girard P, Herbort CP.

Hopital Opthalmique Jules-Gonin, University of Lausanne, Switzerland.

A 76-year-old woman with unilateral acute retinal necrosis had an elevated titer 
of cytomegalovirus (CMV) antibodies with both in the aqueous humor and serum. The
serological pattern indicated recent CMV infection, and the Goldmann-Witmer
coefficient comparing aqueous and serum titers was above 4 indicating intraocular
production of specific antibodies. The clinical characteristics and results as
well as a new possible etiopathogenic hypothesis are presented.

Publication Types: 
    Case Reports

PMID: 1664506 [PubMed - indexed for MEDLINE]

5803: Viral Immunol. 1991 Summer;4(2):133-7.

Viral serology after bone marrow transplantation.

Epstein JB, Phillips K, Sherlock CH.

Division of Oral Medicine and Clinical Dentistry, Vancouver General Hospital,
B.C., Canada.

Bone marrow transplantation (BMT) may change the recipient's pretransplant
serostatus for herpes group viruses. We reviewed 68 patient records (1 year's
transplants) to determine how frequently this occurs. Only 7 had data on
serostatus before as well as at days 20 to 35 and greater than 100 after BMT.
Serostatus was assessed by complement fixation and ELISA. All patients received a
variety of blood-product support after BMT. One patient converted from
anti-varicella zoster virus (VZV) positive to negative after BMT and developed
clinical chickenpox; an additional patient converted from anti-VZV negative to
positive after BMT but reverted to seronegative by day 102. One patient converted
from anti-cytomegalovirus (CMV) positive pre-BMT to persistently anti-CMV
negative post-BMT (donor: anti-CMV negative). Two patients had a greater than
4-fold fall in anti-herpes simplex (HSV) antibody post-BMT, and both shed HSV
after BMT. Most seronegative recipients of marrow from seropositive donors
developed herpesvirus antibodies. We conclude that the herpesvirus serostatus of 
BMT recipients should be determined again after BMT to aid in decisions about
antiviral prophylaxis and diagnosis of clinical disease.

PMID: 1662045 [PubMed - indexed for MEDLINE]

5804: Clin Neurol Neurosurg. 1991;93(3):245-7.

Cervical herpes zoster and delayed brainstem infarction.

Willeit J, Schmutzhard E.

Department of Neurology, University of Innsbruck, Austria.

Varicella-zoster (VZ) virus is a rare cause of CNS angiitis, which commonly
presents as herpes zoster ophthalmicus with contralateral hemiplegia due to
hemispheric infarction. We report the first case of VZ-angiitis with infarction
in the ventral pons, following cervical herpes zoster.

Publication Types: 
    Case Reports

PMID: 1660382 [PubMed - indexed for MEDLINE]

5805: Annu Rev Microbiol. 1991;45:265-82.

Varicella-zoster virus latency.

Croen KD, Straus SE.

Department of Medicine, University of Cincinnati College of Medicine, Ohio 45267.

Publication Types: 
    Review

PMID: 1660255 [PubMed - indexed for MEDLINE]

5806: Am J Nephrol. 1991;11(3):229-36.

Varicella-zoster virus immune status in CAPD and chronic hemodialysis patients.

Smetana Z, Leventon-Kriss S, Broide A, Jedwab M, Smetana SS.

Central Virology Laboratory, Chaim Sheba Medical Center, Holon, Israel.

Patients on chronic dialysis who are supposed to disclose an impairment of the
immune potential, seldom show clinical viral illnesses. Since severe
varicella-zoster virus (VZV) infection develops in immunocompromised patients, we
have examined the proliferative activity to VZV in the blood lymphocytes of 16
patients on continuous ambulatory peritoneal dialysis (CAPD) and compared it to
healthy matched controls. The cellular in vitro response of these patients to
specific VZV antigens was essentially normal. The mean stimulation index for CAPD
patients was 7.06, and for matched controls 3.68 (p greater than 0.05). The mean 
percentage of lymphocytes in CAPD patients as determined by CD3 monoclonal
antibodies was 57%, the CD4 helper and CD8 suppressor cells were 41 and 21%,
respectively. When those 16 CAPD patients were followed up for the presence of
anti-VZV IgA, IgM and IgG immunofluorescent antibody to membrane antigen
antibodies during a period of 6 months, the recrudescence of VZV was documented
by the appearance of IgA and IgM antibodies and/or fourfold increase in IgG titer
in some patients, but no clinical illness was observed. The frequent reactivation
of the virus without clinical symptoms in patients undergoing long-term
intermittent chronic hemodialysis (HD) or CAPD was strengthened by the presence
of increased anti-VZV geometric mean titers (52.68 and 53.00, respectively) in
these patients as compared to control subjects (11.75).

PMID: 1660222 [PubMed - indexed for MEDLINE]

5807: Comp Immunol Microbiol Infect Dis. 1991;14(2):81-95.

The glycoproteins of the human herpesviruses.

Manservigi R, Cassai E.

Institute of Microbiology, University of Ferrara, Italy.

The herpesvirus family contains several important human pathogens. Human
herpesviruses include herpes simplex virus type 1 and 2, varicella-zoster virus, 
human cytomegalovirus, Epstein-Barr virus and human T-cell lymphotropic virus.
The general property of herpesviruses is their ability to establish latency and
to be periodically reactivated. All human herpesviruses contain a subset of genes
encoding viral glycoproteins that are clearly homologous, and their similarity is
significantly greater among members of the same subfamily. Membrane glycoproteins
specified by human herpesviruses are important determinants of viral
pathogenicity. They are exposed on the viral envelope and on the surface of
infected cells. They mediate entry of the virus into cells and cell-to-cell
spread of infection and also influence tissue tropism and host range. Viral
membrane glycoproteins are also the most important elicitors of protective immune
response and are therefore the best candidates for subunit vaccines.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 1657514 [PubMed - indexed for MEDLINE]

5808: Bull World Health Organ. 1991;69(3):277-83.

Diagnosis of human herpesviruses: memorandum from a WHO meeting.

[No authors listed]

PIP: The frequent reactivation of disease in immunosuppressed patients represents
a serious health complication for acquired immunodeficiency syndrome (AIDS)
patients with herpesviruses. Since the herpesviruses are often associated with
the development of complication such as pneumonia and lymphoma, an emphasis is
being placed on the rapid laboratory diagnosis of herpes simplex viruses 1 and 2,
varicella- zoster, Epstein-Barr virus, and cytomegalovirus. Diagnostic methods
that utilize monoclonal antibodies to detect viral antigens in clinical specimens
are now within the scope of general laboratories and detection methods for viral 
DNA in clinical specimens are being advanced. Each of the viruses requires its
own diagnostic procedures, however, and consideration should be given to
practical and economic issues. The World Health Organization (WHO) has
recommended that developing countries use rapid diagnostic techniques that do not
require expensive, labor-intensive virus replication. Serological diagnosis can
facilitate disease surveillance of the herpesviruses in different population
groups in countries with little information on this infection's epidemiology. Who
is recommending that regional or national reference laboratories establish
confirmatory testing facilities to support the routing virological or
microbiological services offered by local laboratories. Other WHO recommendations
include the development of international standard preparations and reference
reagents, compilation of a list of monoclonal antibodies available for
collaborative diagnostic studies, and promotion of studies on the rapid diagnosis
of herpesvirus-promoted encephalitides.

Publication Types: 
    Review

PMID: 1654224 [PubMed - indexed for MEDLINE]

5809: Microbiol Immunol. 1991;35(2):139-45.

Inhibition of DNA synthesis in varicella-zoster virus-infected cells by BV-araU.

Machida H, Watanabe Y.

Biology Laboratory, R & D Division, Yamasa Shoyu Co., Ltd, Chiba.

The inhibitory effect of BV-araU on DNA synthesis in human embryonic lung cells
infected with varicella-zoster virus (VZV) or herpes simplex virus type 1 (HSV-1)
was compared with that of acyclovir. Cellular uptake of [3H]thymidine and its
incorporation into DNA was markedly stimulated by the infection with VZV or
HSV-1, suggesting that the incorporation was mainly due to viral DNA synthesis.
DNA synthesis in VZV-infected cells was dose-dependently suppressed by BV-araU
and acyclovir, although cellular uptake of [3H]thymidine decreased in cells
treated with a high concentration of drugs for an extended time. DNA synthesis in
HSV-1-infected cells was also markedly inhibited by both drugs in a
dose-dependent manner, without affecting cellular uptake of [3H]thymidine. The
concentration of drugs inhibiting DNA synthesis was well correlated to their in
vitro anti-VZV and anti-HSV-1 activities. The inhibitory concentration of BV-araU
for DNA synthesis in VZV-infected cells was one-thousandth of that of acyclovir. 
Our results suggest that the antiviral action of BV-araU against VZV and HSV-1 is
based on the inhibition of DNA synthesis in herpesvirus-infected cells.

Publication Types: 
    Comparative Study

PMID: 1653394 [PubMed - indexed for MEDLINE]

5810: Int J Pept Protein Res. 1991 Jan;37(1):72-9.

Studies on in vitro proteolytic sensitivity of peptides inhibiting herpes simplex
virus ribonucleotide reductases lead to discovery of a stable and potent
inhibitor.

Paradis H, Langelier Y, Michaud J, Brazeau P, Gaudreau P.

Institut du Cancer de Montreal, Canada.

The nonapeptide, HSV R2-(329-337), corresponding to the subunit 2 (R2) carboxyl
terminus of herpes simplex virus (HSV) ribonucleotide reductases, specifically
inhibits this enzyme activity. We report here that under standard reductase assay
conditions, this peptide was rapidly degraded by proteases present in the
partially purified enzyme extract. The main process of proteolysis involves the
successive removal of Tyr329 and Ala330, which corresponds to an aminopeptidase
activity. Determination of the proteolytic susceptibility of HSV R2-(329-337)
analogs showed that natural modifications which are present in the homologous
varicella zoster virus (VZV) nonapeptide decreased its susceptibility to protease
action 1.5-fold. Nx-acetylation, a modification known to protect peptides against
aminopeptidase attacks, greatly improved the proteolytic resistance of HSV and
VZV nonapeptides. Moreover, Ac-VZV R2-(298-306) exhibited a 15-fold higher
potency on reductase inhibition than HSV R2-(329-337). The degradation process of
HSV R2-(329-337) was partially inhibited by amastatin, bestatin, and leupeptin
whereas it was completely abolished by bacitracin, suggesting a combined action
of more than one aminopeptidase activity. Moreover, bacitracin protected most of 
these nonapeptide analogs from proteolysis, although it was less effective in
preventing HSV R2-(332-337) degradation. Our results indicate that it is possible
to determine, in the presence of bacitracin, the relative inhibitory potencies of
HSV R2-(329-337) analogs with minimal error due to proteolytic susceptibility.
Moreover, HSV R2-(329-337) modifications that were found to protect the peptide
against degradation might be useful to increase its efficacy in vivo.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't

PMID: 1646184 [PubMed - indexed for MEDLINE]

5811: Eur Neurol. 1991;31(3):164-7.

A case of herpes zoster myelitis: positive magnetic resonance imaging finding.

Hwang YM, Lee BI, Chung JW, Ahn JH, Kim KW, Kim DI.

Department of Neurology, Asan Medical Center, Ulsan University, Seoul, Korea.

A 33-year-old man developed a progressive myelopathy after a characteristic skin 
lesion of herpes zoster involving the right C3 and C4 dermatomes. The lesions
were recognizable in the T2-weighted image of the magnetic resonance imaging
(MRI) as increased signal intensities throughout the long segments of the spinal 
cord with maximal in the cervical portion, which was compatible with the
pathological findings reported in autopsy studies.

Publication Types: 
    Case Reports

PMID: 1646111 [PubMed - indexed for MEDLINE]

5812: Br Dent J. 1990 Dec 8-22;169(11):370-2.

Comment in:
    Br Dent J. 1991 Apr 20;170(8):287.    Br Dent J. 1991 Feb 9;170(3):91.

Recognition of oral lesions of HIV infection. 3. Gingival and periodontal disease
and less common lesions.

Scully C, Epstein JB, Porter S, Luker J.

Department of Oral Medicine, Surgery and Pathology, Bristol Dental Hospital and
School.

This is the last of a series of three articles on the recognition of oral lesions
of HIV infection. It deals with the less common, and some rare lesions.

PMID: 2275839 [PubMed - indexed for MEDLINE]

5813: Presse Med. 1990 Dec 8;19(42):1950.

Comment on:
    Presse Med. 1990 Apr 21;19(16):752-4.

[Sacral zona complicated by acute bladder retention. One other indication of
acyclovir]

[Article in French]

Caumes E, Katlama C, Bournerias I, Danis M, Gentilini M.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 2147766 [PubMed - indexed for MEDLINE]

5814: Med Clin (Barc). 1990 Dec 8;95(20):782-4.

[Postherpetic vasculopathy. A study of 3 cases in immunosuppressed patients]

[Article in Spanish]

Alvarez R, Graus F, Abos J, Miro JM, Carreras J, Mercader JM, Tolosa E.

Servicio de Neurologia, Hospital Clinic i Provincial, Barcelona.

We report three cases of postherpetic vasculopathy in immunologically compromised
patients. Two had ophthalmic herpes zoster, contralateral to the physical signs, 
and the third case developed after disseminated herpes zoster. The initial CT
images consisted of small ischemic infarcts in capsular regions and basal
ganglia. The arteriography showed images consistent with vasculitis or thrombosis
of great vessels of the Willis' polygon, which were ipsilateral to the herpetic
lesion in two cases. In one patient the neurological defect remained stable,
while the other two developed new ischemic episodes, all in the same cerebral
hemisphere. It can be assumed from the delayed development of neurologic disease 
after cutaneous lesions that some cases go unnoticed if the zoster infection is
not specifically looked for in retrospect.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2131383 [PubMed - indexed for MEDLINE]

5815: Med Clin (Barc). 1990 Dec 8;95(20):774-6.

[Neurological disorders following a varicella-zoster virus infection]

[Article in Spanish]

Polo JM.

Publication Types: 
    Editorial

PMID: 2131380 [PubMed - indexed for MEDLINE]

5816: Minn Med. 1990 Dec;73(12):11-2.

Comment on:
    Minn Med. 1990 Apr;73(4):37-40.

AMP for acute and postherpetic neuralgia.

Sklar SH.

Publication Types: 
    Comment
    Letter

PMID: 2292995 [PubMed - indexed for MEDLINE]

5817: Pediatr Infect Dis J. 1990 Dec;9(12):865-9.

Comment in:
    Pediatr Infect Dis J. 1991 Jun;10(6):476.

Consensus: varicella-zoster infections in pregnancy and the perinatal period.

Prober CG, Gershon AA, Grose C, McCracken GH Jr, Nelson JD.

Department of Pediatrics, Stanford University Medical Center, CA.

Publication Types: 
    Consensus Development Conference
    Review

PMID: 2277741 [PubMed - indexed for MEDLINE]

5818: Pediatr Ann. 1990 Dec;19(12):721-6.

Varicella vaccine.

Feldman S, Moffitt JE.

Pediatric Infectious Diseases, University of Mississippi Medical Center, Jackson 
39216.

Publication Types: 
    Clinical Trial

PMID: 2177874 [PubMed - indexed for MEDLINE]

5819: J Gen Virol. 1990 Dec;71 ( Pt 12):2999-3003.

The product of varicella-zoster virus gene 62 autoregulates its own promoter.

Disney GH, McKee TA, Preston CM, Everett RD.

MRC Virology Unit, Glasgow, U.K.

Varicella-zoster (VZV) gene 62 encodes a protein with a predicted Mr of 140,000
(140K) which has considerable amino acid identity with the major immediate early 
(IE) protein Vmw175 (ICP4) of herpes simplex virus type I (HSV-1). Vmw175 is an
essential virus polypeptide with a pivotal role in the activation of early and
late viral gene expression and also in the repression of IE gene expression. The 
VZV 140K protein has been shown to function as a strong transcriptional activator
in transfection assays and largely complements for the loss of Vmw175 function in
HSV-1. We report the results of cotransfection experiments which demonstrate that
the 140K protein strongly represses expression from its own promoter, that of
gene 62, thus establishing further functional similarity between it and Vmw175.
However, whereas Vmw175 can substitute for the 140K protein in repression of the 
gene 62 promoter, the 140K protein does not repress the HSV-1 IE3 promoter in the
reciprocal experiment. The integrity of a domain of Vmw175 (designated region 2),
previously shown to be crucial for repression of the HSV-1 IE3 promoter, is also 
required for repression of the gene 62 promoter. Moreover, a similar requirement 
for the highly similar region 2 of the 140K protein for repression is
demonstrated, suggesting that VZV 140K protein and HSV-1 Vmw175 autoregulate IE
gene expression by a related mechanism.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2177091 [PubMed - indexed for MEDLINE]

5820: Virology. 1990 Dec;179(2):834-44.

Varicella-zoster virus infection of human astrocytes, Schwann cells, and neurons.

Assouline JG, Levin MJ, Major EO, Forghani B, Straus SE, Ostrove JM.

Section on Molecular Virology and Genetics, NINDS, National Institutes of Health,
Bethesda, Maryland 20892.

Human fetal cell cultures enriched for astrocytes, Schwann cells, or dorsal root 
ganglia neurons were infected with cell-free varicella-zoster virus (VZV), and
the course of these infections was compared with that in fetal fibroblasts. Virus
replication was detected in each neural cell type as early as 10-16 hr
postinfection. Permissiveness of each cell type was confirmed by electron
microscopy. However, the kinetics of virus spread varied between the neural cell 
types. Moreover, the accumulation, progression, and localization of VZV putative 
immediate early (IE), early (E), and late proteins was neural cell-type specific.
VZV replication was slower in Schwann cells and neurons than in astrocytes. In
Schwann cells and neurons VZV E proteins could be detected before IE proteins, a 
reversal of the order of accumulation noted with astrocytes and fibroblasts.
There was also relatively more VZV IE protein in the perinuclear cytoplasm of
Schwann cells and neurons, suggesting a delay in the transport of this antigen to
its nuclear site. The permissiveness of non-neuronal cell types suggests that
they could play a role in the pathogenesis of herpes zoster.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2173263 [PubMed - indexed for MEDLINE]

5821: Clin J Pain. 1990 Dec;6(4):284-90.

Clinical and neurophysiological observations on acute herpes zoster.

Nurmikko TJ, Rasanen A, Hakkinen V.

Department of Neurology, University Central Hospital, Tampere, Finland.

We studied 31 patients with acute herpes zoster (AHZ) less than 28 days'
duration. Clinical characteristics (pain, allodynia, course of disease) and
somatosensory perception thresholds (thermal discrimination, hot pain, and
vibration) of the affected dermatome and the contralateral homologous area were
assessed. Touch-evoked allodynia was found in 17 (55%) and dysesthesia in a
further 5 (16%). Thermal and vibration perception thresholds demonstrated
significant elevations when compared to the contralateral side. Thermal threshold
abnormalities were significantly associated with the prevalence of postherpetic
neuralgia (PHN) at 3 months. The effect of nerve blockade was less favorable on
allodynia than spontaneous pain. The results of possible pathophysiological
mechanisms are discussed.

PMID: 2135028 [PubMed - indexed for MEDLINE]

5822: Br J Clin Pract. 1990 Dec;44(12):757-9.

Bilateral sensorineural hearing loss due to mumps.

Kayan A, Bellman H.

Department of Audiological Medicine, Nuffield Hearing and Speech Centre, Royal
National Throat, Nose and Ear Hospital, London.

Viral infections implicated in acute hearing loss include rubella, measles,
mumps, herpes zoster, cytomegalovirus and influenza. Mumps' deafness is the best 
documented disorder. We describe a case where bilateral sensorineural hearing
loss, following a severe mumps infection at the age of two, remained unnoticed
until the age of four when the patient presented with delayed speech and
language. This report emphasises the risk of permanent hearing loss as a
complication of mumps infection and discusses strategies for early diagnosis and 
prevention.

Publication Types: 
    Case Reports

PMID: 2102231 [PubMed - indexed for MEDLINE]

5823: Br J Clin Pract. 1990 Dec;44(12):596-8.

Observations on herpes zoster: 1. Residual scarring and post-herpetic neuralgia; 
2. Handedness and the risk of infection.

Battcock TM, Finn R, Barnes RM.

Department of Medicine, Royal Liverpool Hospital.

The risk of developing post-herpetic neuralgia is related to the degree of
residual scarring. Subjects over the age of 60 with more than 10 cm2 of residual 
scarring have a very high risk of developing intractable post-herpetic neuralgia.
Left-handed subjects are less likely to develop herpes zoster, and this could be 
due to a more efficient immune system.

PMID: 2102153 [PubMed - indexed for MEDLINE]

5824: J Rheumatol. 1990 Dec;17(12):1642-8.

C-reactive protein levels during disease exacerbations and infections in systemic
lupus erythematosus: a prospective longitudinal study.

ter Borg EJ, Horst G, Limburg PC, van Rijswijk MH, Kallenberg CG.

Department of Internal Medicine, University Hospital Groningen, The Netherlands.

We prospectively studied the value of measuring C-reactive protein (CRP) levels
in patients with systemic lupus erythematosus (SLE) to distinguish between
disease exacerbation and infection. During a 2 year followup of 71 lupus
patients, 38 episodes of disease exacerbation and 36 episodes of infection could 
be analyzed. Plasma samples were obtained at least once a month. CRP levels were 
increased (greater than 6 mg/l) during 25 of the 38 exacerbations and during 32
of the 36 infections. Median CRP levels during infection (60 mg/l; range 1-400)
were higher than during disease exacerbation (16.5 mg/l; range 1-375) (p less
than 0.05). Levels of CRP rose prior to the exacerbation (p less than or equal to
0.01) and fell afterwards (p less than or equal to 0.01). During exacerbations
accompanied by serositis, median levels of CRP (76 mg/l; range 2-375) were higher
than during exacerbations without serositis (16 mg/l; range 1-53) (p less than
0.02). CRP levels exceeding 60 mg/l during exacerbations without serositis
indicated infection in all cases. Thus, measurement of CRP in SLE is valuable to 
distinguish between infection and exacerbation only in the absence of serositis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2084238 [PubMed - indexed for MEDLINE]

5825: Ital J Neurol Sci. 1990 Dec;11(6):559-65.

Neurological complications of herpes zoster.

Guidetti D, Gabbi E, Motti L, Ferrarini G.

Divisione Neurologica, Arcispedale Santa Maria Nuova, Reggio Emilia.

We report 31 cases of herpes zoster (HZ) with neurological complications: 14 with
cranial nerve deficits, 1 with cranial nerve deficit associated with segmental
motor disorder, 3 with segmental motor deficits, 2 with meningoencephalitis, 2
with meningoencephalitis associated with cranial neuropathy or myelitis, 2 with
meningitis, 2 with hemiplegia contralateral to the ophthalmic HZ. 1 with
hemiplegia and motor deficit and finally 1 with hemiplegia and a cranial
neuropathy. Smoking was the putative risk factor in 53% of our patients together 
with diabetes, which has already been mentioned in the literature. We frequently 
observed more than one complication in succession (19.3%) that could not easily
be related to the cutaneous distribution. Acyclovir had no demonstrable positive 
effects on neurological complication in our patients.

PMID: 2081679 [PubMed - indexed for MEDLINE]

5826: Tanpakushitsu Kakusan Koso. 1990 Dec;35(17):3034-40.

[Application of PCR to DNA diagnosis and molecular epidemiology of
varicella-zoster virus infection]

[Article in Japanese]

Hondo R, Inouye S, Ohsawa S, Itho S.

Department of Pathology, University of Tokyo, Japan.

PMID: 1962869 [PubMed - indexed for MEDLINE]

5827: Postgrad Med. 1990 Nov 15;88(7):49-50, 53-6.

Viral pneumonias. A diagnostic and therapeutic challenge.

Ramsey KM.

University of South Alabama College of Medicine, Mobile 36688.

Viral pneumonias are both a diagnostic and a therapeutic challenge for primary
care physicians. The illness should be suspected when an upper respiratory tract 
infection progresses to include dyspnea and cyanosis. Rapid diagnostic tests are 
now available to detect most of the viruses that cause pneumonias. Fortunately,
viral pneumonias usually resolve without specific antiviral therapy; however,
ribavirin is indicated for respiratory syncytial virus pneumonia in children and 
ganciclovir sodium (Cytovene) for cytomegalovirus pneumonia in immunocompromised 
patients. Acyclovir (Zovirax) is indicated for pneumonias due to herpes simplex
virus and varicella-zoster virus infections. A high index of suspicion for
bacterial superinfections is essential to reduce the risk of death from this
complication.

PMID: 2235793 [PubMed - indexed for MEDLINE]

5828: Med J Aust. 1990 Nov 5;153(9):562.

An unusual presentation of herpes zoster.

Moorhead RG, Tyllis M.

Publication Types: 
    Case Reports
    Letter

PMID: 2233482 [PubMed - indexed for MEDLINE]

5829: Med J Aust. 1990 Nov 5;153(9):555-6.

Diaphragmatic paralysis following cervical herpes zoster.

Stowasser M, Cameron J, Oliver WA.

Prince Charles Hospital, Chermside, Qld.

A 74-year-old man was found to have a paralysed left hemidiaphragm within four
months of the appearance of a typical herpes zoster rash involving his left
shoulder and neck. Investigations, including bronchoscopy and computed tomography
of the chest, failed to detect a cause for the diaphragmatic paralysis. We
believe that the cervical zoster and diaphragmatic paralysis were causally
related, a rare but recognised association.

Publication Types: 
    Case Reports

PMID: 2233481 [PubMed - indexed for MEDLINE]

5830: Kansenshogaku Zasshi. 1990 Nov;64(11):1394-9.

Herpes zoster in patients with polymyositis and dermatomyositis.

Nagaoka S, Tani K, Ishigatsubo Y, Chiba J, Kato K, Matsunaga K, Narita M,
Igarashi T, Okubo T.

First Department of Internal Medicine, Yokohama City University, School of
Medicine.

Twenty-two patients with polymyositis and dermatomyositis (PM-DM) were
retrospectively studied with regard to development of herpes zoster. Herpes
zoster occurred with high frequency in patients with PM-DM. The clinical courses 
of zoster infections were uneventful; no severe complications nor deaths
occurred, and only one patient had post-therapeutic neuralgia. No specific
therapy for this infection was necessary. Zoster tended to occur in the inactive 
stage of PM-DM. PM-DM patients with herpes zoster had a significantly higher
incidence of antinuclear antibody. There seemed to be no relationship between
steroid therapy and herpes zoster infection.

PMID: 2286782 [PubMed - indexed for MEDLINE]

5831: Int J Dermatol. 1990 Nov;29(9):652-4.

Chronic lymphocytic leukemia and cutaneous granulomas at sites of herpes zoster
scars.

Pujol RM, Matias-Guiu X, Planaguma M, de Moragas JM.

Department of Dermatology, Hospital de Sant Pau, Barcelona, Spain.

Publication Types: 
    Case Reports

PMID: 2272738 [PubMed - indexed for MEDLINE]

5832: Klin Padiatr. 1990 Nov-Dec;202(6):430-2.

[Facial paralysis in a 2 1/2-year-old girl due to herpes zoster oticus. Results
of the reactivation of a chickenpox infection in infancy]

[Article in German]

Bokenkamp A, Laubert A, Heyer R.

Kinderklinik, Medizinischen Hochschule Hannover.

A case of herpes zoster oticus in a 2 1/2 year-old girl with a history of
varicella at the age of 4 months is reported. Peripheral facial palsy was the
prominent clinical symptom. Following treatment with Acyclovir 15 mg/kg/day i.v. 
for 7 days a complete remission was noted. Course, treatment and prognosis of
zoster oticus are discussed, as well as the increased incidence of herpes zoster 
in children who had varicella before the age of 1 year.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2266711 [PubMed - indexed for MEDLINE]

5833: Ann Ophthalmol. 1990 Nov;22(11):414-5.

Herpes zoster ophthalmicus and iris cysts.

Karlin JD.

Department of Ophthalmology, University of California, Los Angeles 91307.

Herpes zoster ophthalmicus has been associated with numerous complications such
as neuropathy, keratitis, anterior uveitis, and neuralgia. To my knowledge, there
have been no reports of secondary iris cyst formation. I hereby report the case
of a patient who developed an iris cyst during a Herpes zoster ophthalmicus
infection.

Publication Types: 
    Case Reports

PMID: 2264662 [PubMed - indexed for MEDLINE]

5834: Minn Med. 1990 Nov;73(11):7-8.

Comment on:
    Minn Med. 1990 Apr;73(4):37-40.

Chronic pain treatment.

Yue SK.

Publication Types: 
    Comment
    Letter

PMID: 2259308 [PubMed - indexed for MEDLINE]

5835: Can J Anaesth. 1990 Nov;37(8):839-43.

Comment in:
    Can J Anaesth. 1990 Nov;37(8):836-8.

Cerebrospinal norepinephrine concentrations and the duration of epidural
analgesia.

Goto F, Fujita N, Fujita T.

Department of Anesthesiology and Resuscitology, Gunma University School of
Medicine, Japan.

This study was performed to determine whether the addition of norepinephrine to
local anaesthetics prolongs epidural analgesia in man. In addition, cerebrospinal
fluid norepinephrine (NE) concentrations were measured. In the first part of the 
study, epidural catheters were inserted in 14 patients before herniotomy.
Mepivacaine, 1.5 per cent (0.35 ml.kg-1), was administered and norepinephrine (5 
micrograms.ml-1) was added in seven patients. The duration of anaesthesia was
prolonged from 54 +/- 11 min to 83 +/- 12 min (P less than 0.05) and CSF NE
concentrations increased from 68 +/- 12 pg.ml-1 to 336 +/- 85 pg.ml-1 in the NE
group (P less than 0.01). In the second part, eight patients with herpetic
neuralgia received epidural analgesia at the fourth to eighth thoracic
interspace, using bupivacaine 0.25 per cent, with and without NE. The CSF NE
concentrations in this group were greater than in the surgical patients before
operation and increased from 254 +/- 58 to 406 +/- 58 pg.ml-1 30 min after
administration of bupivacaine with NE. The duration of pain relief was prolonged 
with NE. These results suggest that adding NE to local anaesthetics prolongs
epidural analgesia. Moreover, NE concentrations in surgical patients increased to
levels similar to those found in patients suffering from herpetic analgesia. This
suggests that the increase of CSF NE in chronic pain states has an
antinociceptive effect.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 2253290 [PubMed - indexed for MEDLINE]

5836: Optom Vis Sci. 1990 Nov;67(11):845-9.

True posterior ischemic optic neuropathy associated with herpes zoster
ophthalmicus.

Kothe AC, Flanagan J, Trevino RC.

Ecole d'Optometrie, Universite de Montreal, Quebec, Canada.

Although previous reports of ischemic optic neuropathy resulting from herpes
zoster have appeared in the literature, these reports have not been convincing of
a true optic neuropathy. The case presented is a true posterior ischemic optic
neuropathy due to inflammation of the medial posterior ciliary artery, diagnosed 
on the basis of a deep, steep-sided altitudinal visual field defect. The herpes
zoster infection also resulted in retinitis, damage to the iris sphincter, and
corneal scarring. The effects of herpes zoster on the visual system are reviewed.

Publication Types: 
    Case Reports

PMID: 2250894 [PubMed - indexed for MEDLINE]

5837: Arch Dis Child. 1990 Nov;65(11):1245-8.

Central nervous system vasculitis after chickenpox--cause or coincidence?

Shuper A, Vining EP, Freeman JM.

Department of Neurology, Johns Hopkins Medical Institution, Baltimore, MD 21205.

A 7.5 year old boy, known to have a seizure disorder, presented with an infarct
in the left middle cerebral artery territory, 10 weeks after severe chickenpox.
Immunofluorescent antibody titre to the varicella zoster virus in the
cerebrospinal fluid was 1:32. Cerebral angiography showed evidence of focal
vasculitis. He presented again seven months later with an acute exacerbation of
seizures. Magnetic resonance imaging of the brain showed an old posterior
extension of the infarct, but a repeated angiography demonstrated an improvement 
in the vasculitic process. Cerebrospinal fluid antibody titre was again 1:32.
Although this may have been an unfortunate coincidence, a possible association
between chickenpox and vasculitis, similar to that reported with herpes zoster,
and with potentially significant clinical implications, should be considered. As 
a definite proof can be obtained only by a brain biopsy, however, which is
generally not indicated in such cases, only additional clinical reports can lead 
to delineation of this association as a definite entity.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 2248537 [PubMed - indexed for MEDLINE]

5838: J Am Geriatr Soc. 1990 Nov;38(11):1188-94.

Are stressful life events risk factors for herpes zoster?

Schmader K, Studenski S, MacMillan J, Grufferman S, Cohen HJ.

Department of Medicine, Duke University Medical Center, Durham, North Carolina
27710.

To determine if psychologically stressful life events are risk factors for herpes
zoster, we conducted a case-control study of zoster and self-reported recent
negative life events and major changes in spousal relationships. The subjects
were 101 healthy community-dwelling cases of zoster and 101 healthy controls
matched for age, sex, and race and generated by random digit dialing. The
Geriatric Scale of Recent Life Events was administered to case and control
subjects, and additional questions were asked regarding the perception of the
life event. The results showed that case subjects experienced negative life
events significantly more often than subjects in the control groups in the 2
months before zoster onset by analysis of discordant pairs (26 versus 10, odds
ratio 2.60, 95% confidence interval [CI] 1.13, 6.27, P = .012), 3 months before
(29 versus 11, odds ratio 2.64, 95% CI 1.20, 6.04, P = .007), or 6 months before 
(35 versus 16, odds ratio 2.00, 95% CI 1.04, 3.93, P = .012). The mean number of 
total life events was significantly higher in cases at 6 months before zoster
(case means = 2.64, control means = 1.82, P = .008), but there were no
significant differences at 2, 3, or 12 months before. There were no significant
differences between case subjects and control subjects for spousal events, or any
given single life event. In conclusion, we found that whereas patients with
herpes zoster experienced the same kinds of life events in the year preceding the
illness as did control subjects, recent events perceived as stressful were
significantly more common among patients with zoster.(ABSTRACT TRUNCATED AT 250
WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 2246455 [PubMed - indexed for MEDLINE]

5839: J Clin Pharmacol. 1990 Nov;30(11):997-1000.

Intraperitoneal administration of acyclovir in patients receiving continuous
ambulatory peritoneal dialysis.

Burgess ED, Gill MJ.

Division of Renal Medicine, Faculty of Medicine, University of Calgary, Alberta, 
Canada.

In subjects with normal renal function, acyclovir is rapidly removed from the
body via the kidneys. In subjects with end-stage renal disease, the half-life is 
significantly prolonged. The half-life in subjects receiving hemodialysis and
continuous ambulatory peritoneal dialysis (CAPD) is similarly prolonged (10.0 +/-
2.2 and 13.2 +/- 4.7 hours, respectively). After intravenous dosage, peritoneal
clearance was 3.4 +/- 0.2 mL/min. Intraperitoneal dosing in subjects receiving
CAPD resulted in a bioavailability of 61 +/- 10% and drug levels sufficient to
inhibit herpes simplex virus (HSV) and varicella zoster virus (VZV).
Intraperitoneal administration is an alternative route of administration in
patients with poor vascular access.

Publication Types: 
    Comparative Study

PMID: 2243158 [PubMed - indexed for MEDLINE]

5840: Am Surg. 1990 Nov;56(11):691-4.

Association of acute colonic pseudo-obstruction (Ogilvie's syndrome) with herpes 
zoster.

Pai NB, Murthy RS, Kumar HT, Gerst PH.

Department of Surgery, Bronx-Lebanon Hospital Center, New York 10457.

Ogilvie's syndrome, or acute pseudo-obstruction of the colon is characterized by 
massive distension of the colon in the absence of organic distal obstruction. The
syndrome is associated with various unrelated and, most often, extra-abdominal
causes. An association between Ogilvie's syndrome and herpes zoster has been
reported only once, by Ceccese et al. in 1985. We present a second such case.
This patient did not show evidence of any active illness other than the
involvement of the T10 dermatome by herpes zoster. The patient's symptoms of
colonic obstruction subsided with resolution of the zosteriform rash.

Publication Types: 
    Case Reports

PMID: 2240863 [PubMed - indexed for MEDLINE]

5841: Transplantation. 1990 Nov;50(5):773-5.

Methotrexate as an adjunct in the treatment of persistent mild cardiac allograft 
rejection.

Olsen SL, O'Connell JB, Bristow MR, Renlund DG.

Utah Transplantation Affiliated Hospitals (UTAH) Cardiac Transplant Program, Salt
Lake City.

Because methotrexate arrests inflammation in autoimmune disease, we studied its
efficacy in persistent low-grade cardiac allograft rejection. Seventeen patients 
aged 39.5 +/- 0.9 years (mean +/- SE) had persistent rejection despite previous
therapy with high dose corticosteroids. Maintenance immunosuppression consisted
of prednisone, azathioprine, and cyclosporine. The rejection episode treated with
methotrexate occurred 180 +/- 55.4 days posttransplantation. Patients had
incurred 2.7 +/- 0.3 previous episodes of rejection with the first episode
occurring 30.6 +/- 6.2 days post transplant. Methotrexate was administered orally
in 3 doses to an average weekly dose of 12.8 +/- 0.8 mg. The duration of
methotrexate therapy was 9.0 +/- 1.1 weeks. Sixteen of the seventeen persistent
rejection episodes resolved by 22.8 +/- 3.2 days of methotrexate therapy. Using
methotrexate, the prednisone dose was decreased from 22.4 +/- 4.8 mg/day at
initiation of methotrexate to 9.7 +/- 1.4 mg/day at the completion of
methotrexate therapy (P less than 0.01). Over a 306 +/- 35-day follow-up, 9 of 17
patients (53%) have remained rejection-free. Leukopenia, necessitating reduction 
in azathioprine occurred in 10 patients. One patient developed herpes zoster
during therapy. These data indicate that methotrexate is effective in resolving
persistent cardiac allograft rejection with minimal morbidity. In addition, the
use of methotrexate for treatment of rejection allows reduction in maintenance
corticosteroid doses.

PMID: 2238053 [PubMed - indexed for MEDLINE]

5842: J Comput Assist Tomogr. 1990 Nov-Dec;14(6):991-3.

MR findings in a patient with Ramsay-Hunt syndrome.

Osumi A, Tien RD.

Department of Radiology, University of California, San Diego, School of Medicine,
La Jolla.

A case of Ramsay Hunt syndrome (herpes zoster oticus) was studied with Gd
diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging using a
surface coil rather than a conventional head coil. This allowed us to demonstrate
in detail the inflammatory changes of the multiple structures, involved.

Publication Types: 
    Case Reports

PMID: 2229582 [PubMed - indexed for MEDLINE]

5843: J Heart Transplant. 1990 Nov-Dec;9(6):707-11.

Role of cytomegalovirus infection in the development of coronary artery disease
in the transplanted heart.

Loebe M, Schuler S, Zais O, Warnecke H, Fleck E, Hetzer R.

Department of Surgery, German Heart Institute Berlin, F.R.G.

In heart transplantation, accelerated graft arteriosclerosis leading to late
postoperative graft failure is still an unsolved problem, and its pathogenesis is
poorly understood. The existence of multiple underlying mechanisms has been
discussed without conclusive results. In kidney transplantation, a negative
influence of cytomegalovirus infection on long-term graft function and patient
survival could be demonstrated. To evaluate the role of this infection on the
incidence of coronary artery disease in the transplanted heart, we have analyzed 
the cytomegalovirus serostatus in 38 long-term survivors of orthotopic heart
transplantation. In 14 patients (group A) graft arteriosclerosis was diagnosed by
means of coronary angiography. In 24 patients (group B) the coronary vessels
showed no pathologic findings. In 10 patients (71%) of group A serologic study
showed evidence of cytomegalovirus infection, whereas only five patients (24%) of
group B revealed cytomegalovirus infection. In two further patients of this group
herpes zoster infection occurred (p less than 0.0001). Cytomegalovirus infection 
seems to be an important factor in the development of accelerated graft
arteriosclerosis in the transplanted heart.

Publication Types: 
    Comparative Study

PMID: 2177497 [PubMed - indexed for MEDLINE]

5844: J Gen Virol. 1990 Nov;71 ( Pt 11):2681-9.

A herpes simplex virus type 1 recombinant with both copies of the Vmw175 coding
sequences replaced by the homologous varicella-zoster virus open reading frame.

Disney GH, Everett RD.

MRC Virology Unit, Glasgow, U.K.

Varicella-zoster virus (VZV) gene 62 encodes a protein with a predicted Mr of
140,000 (VZV 140K) that shares considerable amino acid homology with the
immediate early (IE) regulatory protein Vmw175 of herpes simplex virus type 1
(HSV-1) and is believed to be its functional equivalent. We have tested this
hypothesis by insertion of VZV gene 62 (expressed from the HSV-1 IE3 promoter)
into both IE3 gene loci in the short region repeats of the HSV-1 genome. The
parent virus used for this manipulation was D30EBA, which is a variant of HSV-1
from which the majority of the Vmw175 coding sequences have been deleted. Like
other HSV-1 viruses lacking Vmw175 functions, D30EBA is able to grow only in cell
lines which express Vmw175 constitutively. The resulting recombinant virus.
HSV-140, is able to propagate (but unable to form obvious plaques) on normal cell
lines. The properties of HSV-140 were studied by monitoring the time course of
polypeptide expression and DNA replication during normal infection. We found that
at high multiplicity HSV-140 synthesized apparently normal amounts of many viral 
polypeptides but that the expression of certain late genes was reduced; this
slight defect may be related to less efficient DNA replication by HSV-140. At low
multiplicity HSV-140 expressed viral proteins inefficiently. Surprisingly, VZV
140K was produced in large amounts at later times of a normal infection,
indicating that the polypeptide fails to autoregulate the IE3 promoter. The
results strongly suggest that VZV 140K is able to perform most of the functions
of Vmw175 during growth of HSV-1, but that differences in detail lead to less
efficient virus growth.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2174959 [PubMed - indexed for MEDLINE]

5845: J Am Acad Dermatol. 1990 Nov;23(5 Pt 1):928-30.

Postsurgical zosteriform herpes simplex 2 in noncontiguous dermatomes.

Groisser D, Taylor S, Grossman ME.

Columbia-Presbyterian Medical Center, New York, NY 10032.

Publication Types: 
    Case Reports

PMID: 2174931 [PubMed - indexed for MEDLINE]

5846: J Infect Dis. 1990 Nov;162(5):1031-5.

Use of polymerase chain reaction for successful identification of asymptomatic
genital infection with herpes simplex virus in pregnant women at delivery.

Hardy DA, Arvin AM, Yasukawa LL, Bronzan RN, Lewinsohn DM, Hensleigh PA, Prober
CG.

Department of Pediatrics, Stanford University School of Medicine, CA 94305.

The polymerase chain reaction was adapted to the amplification of a herpes
simplex virus (HSV) DNA sequence, common to HSV types 1 and 2 (HSV-1, HSV-2). The
amplified product was detectable by ethidium-bromide staining or Southern
hybridization of gels and by dot hybridization. The HSV polymerase chain reaction
detected HSV DNA in samples obtained from eight patients with genital lesions
from which HSV-2 was isolated in tissue culture and from four patients with
labial lesions from which HSV-1 was isolated. The HSV polymerase chain reaction
identified HSV in clinical specimens obtained from 11 women who had asymptomatic 
genital HSV infections at delivery. None of 11 samples obtained at delivery from 
women who had antibodies to HSV-2, but whose delivery cultures were negative,
were positive by polymerase chain reaction and no false-positive reactions were
obtained when the reaction mixture contained human cell DNA or varicella-zoster
virus, cytomegalovirus, Epstein-Barr virus, or human papillomavirus DNA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2172392 [PubMed - indexed for MEDLINE]

5847: Aten Primaria. 1990 Nov;7(10):681-2.

Comment in:
    Aten Primaria. 1991 Sep;8(8):654; author reply 654-5.

[Postherpetic facial paralysis]

[Article in Spanish]

Fernandez P, Cenoz JA, Jaurequi ML.

Publication Types: 
    Case Reports
    Letter

PMID: 2104125 [PubMed - indexed for MEDLINE]

5848: Acta Otorrinolaringol Esp. 1990 Nov-Dec;41(6):387-91.

[Ramsay Hunt syndrome. Effects of the treatment with acyclovir (preliminary
study)]

[Article in Spanish]

Ramos Macias A, Gomez Gonzalez JL, de Miguel Martinez MI, Lopez Alburquerque T,
Lavilla Martin MJ, Ruiz Martin F.

Servicio de ORL, Hospital Clinico, Facultad de Medicina, Universidad de
Salamanca.

Herpes zoster oticus has a poor prognosis with permanent facial nerve
dysfunction. We have studied 11 patients in a total group of 131 facial palsies
seen in our service for a 20 month period. Four patients had no treatment. Two
were treated with prednisone, and five were infused with acyclovir (10 mg/kg
every 8 hours over a 10 day hospitalization period) and prednisone. These
treatments were observed for 3 to 6 months. Patients follow up was, acyclovir
group, 2 patients have achieved a House grade I, 1 patient grade II, 1 patient
grade III and 1 left this treatment because side effects was observed. The other 
patients, 1 have achieved grade I, 2 patients grade II, 2 patients grade III and 
1 patient grade V. The differences and final results are discussed.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 2092730 [PubMed - indexed for MEDLINE]

5849: Rev Clin Esp. 1990 Nov;187(8):434-5.

[Myelitis due to herpes zoster]

[Article in Spanish]

Sureda Ramis B, Gomez Aranda F, Bautista Lorite J.

Publication Types: 
    Case Reports
    Letter

PMID: 2091145 [PubMed - indexed for MEDLINE]

5850: Nippon Hifuka Gakkai Zasshi. 1990 Nov;100(13):1352-4.

[Postherpetic neuralgia]

[Article in Japanese]

Niimura M.

Publication Types: 
    Review

PMID: 2079747 [PubMed - indexed for MEDLINE]

5851: Kansenshogaku Zasshi. 1990 Nov;64(11):1367-71.

[The detection of VZV DNA in the smear cells of the patients of herpes zoster by 
in situ hybridization using biotinylated DNA probe]

[Article in Japanese]

Takahashi S, Kazuyama Y.

Department of Dermatology of Keio University School of Medicine.

We performed the in situ hybridization (ISH) study of the smear cells taken from 
the patients of herpes zoster. We used the biotinylated EcoRI-B, H fragment of
varicella-zoster-virus (VZV) DNA as the probe. In the control study of ISH
VZV-infected cells showed strong staining, but no staining was observed in the
infected cells by other herpes virus. We examined the smear cells of 19 patients 
of herpes zoster and 2 patients of herpes simplex by ISH. 30 of the 35 specimens 
of herpes zoster was positive by ISH. We detected VZV DNA in the smear cells of
all cases of the bullous stage, but the sensitivity was about 75% in the later
stage. Smear cells of herpes simplex was not stained by ISH. We also performed
virus isolation of 13 cases of herpes zoster. But the sensitivity of ISH was
higher than that of virus isolation in the other stages of herpes zoster. This
method is very simple and can be completed in about 1 hour. It also has high
specificity and sensitivity. So this method is very useful for the rapid
diagnosis of VZV infection.

Publication Types: 
    English Abstract

PMID: 1962810 [PubMed - indexed for MEDLINE]

5852: Hautarzt. 1990 Nov;41(11):591-601.

[Herpesvirus infections--indications for chemotherapy in dermato-venereology]

[Article in German]

Gross GE, Schumann J.

Universitats-Hautklinik Hamburg-Eppendorf.

Specific antivirals like acyclovir have ameliorated the outcome of severe
herpesvirus infections, especially in immunocompromised patients. Varicella can
be prevented in high-risk patients after exposure by therapy with
varicella-zoster immunoglobulin. Despite this favorable development, there are
many unresolved problems in the management of herpesvirus infections, such as the
use of acyclovir during pregnancy, the treatment of both motoric neuropathy and
postherpetic neuralgia. Chemotherapy-resistant herpesvirus may cause severe
syndromes in patients suffering from HIV infection or from iatrogenic
immunosuppression. Isolation of resistant viruses provides the stimulus to
establish tests of viral resistance and to use antiviral drugs more carefully.

Publication Types: 
    English Abstract
    Review

PMID: 1703519 [PubMed - indexed for MEDLINE]

5853: Hosp Pract (Off Ed). 1990 Oct 30;25(10A):61-71, 75-6.

Zoster and its complications.

Krause PR, Straus SE.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda.

Publication Types: 
    Case Reports

PMID: 2120265 [PubMed - indexed for MEDLINE]

5854: Am J Ophthalmol. 1990 Oct 15;110(4):341-8.

Comment in:
    Am J Ophthalmol. 1991 Feb 15;111(2):255-6.

Rapidly progressive outer retinal necrosis in the acquired immunodeficiency
syndrome.

Forster DJ, Dugel PU, Frangieh GT, Liggett PE, Rao NA.

Department of Ophthalmology, Doheny Eye Institute, University of Southern
California School of Medicine, Los Angeles 90033.

Two patients, both seropositive for the human immunodeficiency virus, developed
rapidly progressive retinal necrosis associated with a systemic herpes zoster
infection. The retinitis in these patients was characterized by primary
involvement of the outer retina, with sparing of the inner retina and retinal
vasculature until late in the disease process; a rapidly progressive course; poor
response to intravenous acyclovir; and development of rhegmatogenous retinal
detachment. In one of the patients, the retinitis was initially multifocal.
Electron microscopy of a retinal biopsy specimen from one of the patients
demonstrated virus particles consistent with a herpesvirus, and polymerase chain 
reaction disclosed herpesvirus in a retinal biopsy specimen of the other patient.
This entity may represent a distinct form of acute retinal necrosis that is seen 
in immunocompromised individuals.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2220967 [PubMed - indexed for MEDLINE]

5855: Lancet. 1990 Oct 13;336(8720):947.

Comment on:
    Lancet. 1990 Sep 1;336(8714):537-8.

Corticosteroids and post-herpetic neuralgia.

Naldi L, Zucchi A, Brevi A, Cavalierid'Oro L, Cainelli T.

Publication Types: 
    Comment
    Letter
    Meta-Analysis

PMID: 1976963 [PubMed - indexed for MEDLINE]

5856: Rev Prat. 1990 Oct 11;40(23):2136-40.

[Clinical aspects of AIDS in Africa]

[Article in French]

Itoua-Ngaporo A.

Service de gastro-enterologie et de medecine interne, Centre hospitalier et
universitaire, Brazzaville, Congo.

The clinical manifestations of HIV infection in Africa are similar to those
observed in Europe and North America. However, some features related to
ecological and diagnostic factors give the disease a certain African peculiarity.
In more than 80 p. 100 of the cases AIDS is characterized by deep alteration of
the subject's general condition, with chronic diarrhoea, severe asthenia,
prolonged fever and massive loss of weight. This "slim disease" is only found at 
the terminal stage of AIDS in North America. Opportunistic infections are
multiple, often associated, and their frequency differs from that found in Europe
and the USA. Thus, pulmonary pneumocystosis is rare (12.5 to 21 p. 100 of the
cases, as against 50 to 80 p. 100 in Europe). Isosporosis is frequent (4 to 48 p.
100 of the cases instead of 0.2 p. 100 in the USA), and this also applies to
cryptosporidiosis (7 to 21 p. 100 of the cases, compared with 3.3 p. 100 in the
USA). Gastrointestinal candidiasis occurs in 21 to 49 p. 100 and cryptococcosis
in 10 to 30 p. 100 of the patients. Material problems make it impossible to
evaluate the prevalence of certain infections, notably toxoplasma and CMV
infections. The prevalence of Kaposi's sarcoma is low (15 to 20 p. 100).
Dermatological manifestations occur at an early stage and are both common and
varied (papular eruption, prurigo, herpes zoster, changes in the hair and skin
appearance); they characterize the "African aspect" of AIDS. Tuberculosis is
particularly frequent: in Africa, 30 to 40 p. 100 of tuberculous patients are HIV
seropositive, as opposed to 10-25 p. 10 in Western countries.(ABSTRACT TRUNCATED 
AT 250 WORDS)

Publication Types: 
    English Abstract
    Review

PMID: 2237220 [PubMed - indexed for MEDLINE]

5857: Geburtshilfe Frauenheilkd. 1990 Oct;50(10):798-805.

[Pregnancy following organ transplantation]

[Article in German]

Kraemer-Hansen H, Goepel E, Ulmer HU, Bitzan M, Press C, Kopp A, Henne-Bruns D,
Kremer B.

Urologische Klinik, Universitats-Krankenhaus Hamburg-Eppendorf.

In 17 of 74 patients, in the 20-40 years of age group, who had undergone an organ
transplantation (kidney or liver), the course and outcome of pregnancy were
evaluated. In three cases, the pregnancies ended in premature miscarriage and in 
five cases they were terminated for medical reasons. Nine infants were born alive
between the 32nd to the 40th week of gestation, six of them spontaneously, three 
of them by abdominal Caesarean section. One of these infants born in the 32nd
week of gestation with a birth weight of 800 grams died on the second day after
birth. One infant born in the 33rd week of gestation showed incidence of a
persistent ductus arteriosis Botalli. Four of the nine newborns suffered from
intrauterine dystrophy. The birth weight of four further infants corresponded to 
the 10th to 25th percentile. Neither the incidence of a maternal varicella zoster
infection in the early stages of pregnancy nor the reactivation of a herpes
simplex (HSV) and cytomegalia virus infection during the pregnancy resulted in
any perceptible damage to the infant or transplant. During pregnancy, three of
the mothers were treated with immunosuppressants, either with a combination of
azathioprine and prednisone (conventional) or cyclosporine (CSA) and prednisone, 
or with a combination of all three drugs (triple therapy). As opposed to the
newborn of those mothers, who had been treated conventionally, the newborn of
those treated with CSA showed post partum a tendency towards hypocalcaemia. Two
of the mothers gave birth to their infants outside the Federal Republic of
Germany.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    English Abstract

PMID: 2286320 [PubMed - indexed for MEDLINE]

5858: Ear Nose Throat J. 1990 Oct;69(10):696-7.

The prognostic value of the stapedius reflex in peripheral facial palsy.

Portmann M, Dauman R, Negrevergne M, Cazenave M.

Department of Otolaryngology, Pellegrin Hospital, Bordeaux, France.

Stapedius reflex can provide useful prognostic information in FPs when the middle
ear is normal. Its preservation may have a favorable significance in partial FP
and Bell's palsy. Its loss, even though less reliable, can also have some value
as an indicator for a poor prognosis in patients with total and herpes zoster
FPs. Most importantly, our findings have shown that the SR alone is not
sufficient to be of prognostic value, but is useful if combined with other
clinical parameters and electrical responses.

PMID: 2286165 [PubMed - indexed for MEDLINE]

5859: Nippon Ganka Gakkai Zasshi. 1990 Oct;94(10):889-902.

[Viral diseases of the outer eye--rapid diagnosis by immunohistochemistry]

[Article in Japanese]

Uchida Y.

Department of Ophthalmology, Tokyo Women's Medical College.

Rapid diagnosis of viral diseases of the outer eye was attempted by means of
immunohistochemical methods. Specimens were obtained with a nitrocellulose
membrane, used as a blotter of immunoblotting test. An impression of the corneal 
or conjunctival surface was obtained by anesthetizing the eye and lightly
pressing the membrane against the tissues. In some cases, scraping materials were
taken on a slide glass. Viral antigens in the specimens were detected by
peroxidase-antiperoxidase (PAP) method, ABC system (Vectastain), or
immunofluorescence. Four common diseases were studied. Dendritic corneal lesions 
caused by herpes simplex virus (HSV) were impressed on the membrane, and
exhibited exact duplicates of lesions which were composed of PAP-positive
epithelial cells. Under a high magnification, pathologic changes such as
margination of chromatin, intranuclear inclusion bodies, and multinucleated giant
cells were observed. Of 27 cases of epithelial herpetic keratitis, 25 showed
positive results. The impression can permit examination of a minute lesion,
therefore, is superior to scraping. Dendritic lesions caused by varicella-zoster 
virus (VZV) have a characteristic morphology different from those of HSV.
Impressions showed the virus antigen, when treated with fluorescein-labeled
anti-VZV monoclonal antibody. Appearance of such a dendrite in disorders of
unknown cause indicates the etiology. Conjunctival impressions of adenovirus
(Adv) conjunctivitis examined by the PAP method revealed Adv-antigen containing
cells. Of 64 cases analyzed, 24 PAP-positive cases were compared with the 35
culture-proven cases. The sensitivity of PAP method was 69%, and the specificity 
was 97%. The detection rate varied according to serotype, and was especially low 
(33%) in type 3. Guinea pig antisera with high titers against enterovirus type 70
(EV70) and a variant of coxsackievirus A type 24 (CA24v), the causative viruses
of acute hemorrhagic conjunctivitis (AHC), were obtained. Using these sera as the
primary antibody, the antigen of each virus was localized in the cytoplasm of
infected HeLa cells by either ABC, or immunofluorescence. Conjunctival cells from
patients with EV70 AHC were antigen-positive for 3 days after the onset of
disease. Though epidemics of CA24v AHC have only been experienced in Okinawa,
sporadic cases have been observed in other districts of Japan.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2278234 [PubMed - indexed for MEDLINE]

5860: West J Med. 1990 Oct;153(4):445-6.

Herpes zoster ophthalmicus--the changing epidemiology and its implications for
treatment.

Seiff SR, Mehta AM.

Publication Types: 
    Letter

PMID: 2244385 [PubMed - indexed for MEDLINE]

5861: Int J Dermatol. 1990 Oct;29(8):562-6.

Clinicopathologic study of cutaneous plasmacytoma.

Torne R, Su WP, Winkelmann RK, Smolle J, Kerl H.

Department of Dermatology, Mayo Clinic, Rochester, MN 55905.

Eight patients with skin tumor lesions composed of dense, predominantly plasma
cell infiltrates were studied. Primary cutaneous plasmacytoma can be reactive
(polyclonal) or neoplastic (monoclonal). In four of the patients skin lesions
were associated with multiple myeloma. Specific skin lesions usually consisted of
reddish or purple nodules located on the trunk. In one case the cutaneous lesions
developed at the site of previous herpes zoster. Histologically, the cutaneous
plasmacytic infiltrate was mainly diffuse and monomorphous. Most of the plasma
cells were mature, but in some cases immature immunoblasts and mitoses were
observed. Serum immunoelectrophoresis findings correlated with the monoclonality 
or polyclonality of the plasmacytoma. Presence or absence of systemic involvement
cannot be predicted from the appearance of clinical lesions or from maturity of
plasma cell infiltration in the skin.

Publication Types: 
    Review

PMID: 2242944 [PubMed - indexed for MEDLINE]

5862: Int Ophthalmol. 1990 Oct;14(5-6):365-9.

The possible role of herpes viruses in multifocal choroiditis and panuveitis.

Frau E, Dussaix E, Offret H, Bloch-Michel E.

Department of Virology, Bicetre Hospital.

7 cases of multifocal choroiditis and panuveitis are reported here (6 females, 1 
male). All clinical data were carefully considered. In all cases an aqueous
sampling was made for the detection of anti-herpes virus antibodies in aqueous
and serum. 3 specificities were tested: herpes simplex (HSV), herpes zoster (HVZ)
and cytomegalovirus (CMV). An intraocular synthesis of specific antibodies was
found against VZV in 2 cases and against HSV in 1 case. There was another
presumptive case for HSV.

PMID: 2174419 [PubMed - indexed for MEDLINE]

5863: J Gen Virol. 1990 Oct;71 ( Pt 10):2361-7.

Evolutionary relationships of virion glycoprotein genes in the S regions of
alphaherpesvirus genomes.

McGeoch DJ.

MRC Virology Unit, University of Glasgow, U.K.

The short region in the genome of herpes simplex virus type 1 contains a
contiguous array of five genes (US4, US5, US6, US7 and US8) which encode known or
proposed virion-surface glycoprotein species. Counterparts for certain of these
have been described in the genomes of other alphaherpesviruses, namely herpes
simplex virus type 2, pseudorabies virus and varicella-zoster virus. Within each 
of the US4-, US6- and US7-related sets, the amino acid sequences are most
conserved in a region containing several cysteine residues. Comparisons in this
region among the three sets were carried out by first aligning three cysteine
residues which were very similarly placed in each set, and a number of other
similarities were then visible. It was concluded that the US4, US6 and US7 sets
of genes are related, and thus have evolved by duplication and divergence. The
US8-related sequences are distinct from the US4, US6 and US7 sequences, although 
possible signs of a distant relationship were detected. The US8 set contains two 
clusters of cysteine residues, and the sequences around these show some
similarity, which was interpreted as evidence for occurrence of an intramolecular
duplication event.

Publication Types: 
    Comparative Study

PMID: 2172448 [PubMed - indexed for MEDLINE]

5864: Doc Ophthalmol. 1990 Oct;75(3-4):225-31.

Laboratory tests in uveitis. New developments in the analysis of local antibody
production.

Kijlstra A, van den Horn GJ, Luyendijk L, Baarsma GS, Schweitzer CM, Zaal MJ,
Timmerman Z, Beintema M, Rothova A.

The Netherlands Ophthalmic Research Institute, Amsterdam.

Analysis of local intraocular antibody production is a valuable tool with which
to confirm a suspected clinical diagnosis in uveitis. We have analysed paired
serum and aqueous samples for the presence of specific antibodies against
toxoplasma, cytomegalovirus, herpes simplex virus and varicella zoster virus. Of 
the patients retrospectively diagnosed as having toxoplasma chorioretinitis 75%
had a positive antibody coefficient indicating specific antibody production in
the eye. Local antibody production in the eye directed against CMV confirmed the 
suspected diagnosis of CMV retinitis in 50% of the AIDS patients investigated. So
far we have not been able to demonstrate local antibody production against herpes
simplex virus (26 samples tested). Two of three patients with acute retinal
necrosis had a positive antibody coefficient against varicella zoster virus. Both
of these patients had an even higher titer in the aqueous than in serum. Since
the choice of therapy, in infectious uveitis, depends on the causative organisms,
it is very important to confirm a suspected clinical diagnosis by means of
aqueous humor analysis.

PMID: 2090396 [PubMed - indexed for MEDLINE]

5865: Med Trop (Mars). 1990 Oct-Dec;50(4):441-3.

[Ophthalmologic manifestations of acquired immunodeficiency syndrome (AIDS) in
central Africa]

[Article in French]

Auzemery A, Queguiner P, Georges AJ, Di Costanzo B, Georges-Courbot MC, Vohito
MD.

Service Ophtalmologie du Centre National Hospitalier Universitaire, Bangui,
Republique Centrafricaine.

In central Africa, the authors have performed an ophthalmological examination of 
77 adult patients (18-55 years) with AIDS: 33.7% had ocular abnormalities.
Frequent manifestations included cotton-wool patches and retinal hemorrhages,
while lacrymal hyposecretion, palpebral and conjunctival kaposi sarcoma, ocular
palsy, ptosis, herpes zoster, papillar oedema, cytomegalovirus retinitis and
periphlebitis were less frequent. The authors underline the necessity to perform 
an ocular examination for each patient with AIDS.

Publication Types: 
    English Abstract

PMID: 2077323 [PubMed - indexed for MEDLINE]

5866: Rev Odontol Univ Sao Paulo. 1990 Oct-Dec;4(4):349-52.

[Simultaneous oral and skin manifestations of herpes zoster. Report of a case]

[Article in Portuguese]

Consolaro A, Oliveira DT.

Departamento de Patologia da Faculdade de Odontologia de Bauru-USP.

A case of herpes zoster involving the trigeminal nerve, with simultaneous skin
and oral manifestation is presented. The diagnostic and treatment used are
discussed, emphasizing the necessity of an intraoral examination, when skin
facial lesions are observed by professionals.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1966920 [PubMed - indexed for MEDLINE]

5867: J R Soc Med. 1990 Oct;83(10):617-9.

Comment in:
    J R Soc Med. 1991 Mar;84(3):184.

Epidemiology of shingles.

Glynn C, Crockford G, Gavaghan D, Cardno P, Price D, Miller J.

Oxford Regional Pain Relief Unit, Abingdon Hospital, Leeds.

One thousand and nineteen patients with acute varicella zoster viral infection
were referred to the physiotherapy department for treatment between 1978 and
1986. Sixty per cent were women and 40% were men with a mean age of 58 years
(range 9-96 years). The prevalence varied between 1.3 and 1.6 per 1000 per annum.
The left side was affected in 52% while the right was affected in 48%. The
thoracic dermatomes were the most commonly affected (56%) followed by cervical
(17%), lumbar (10%), sacral (5%), and the trigeminal nerve was infected in 12%.
There was a significant seasonal (P less than 0.001) variation in the prevalence 
of acute varicella zoster virus infection, most common in the summer and least
common in the spring. There was no clustering in time and space so that it is
unlikely that the varicella zoster virus is infective or that re-exposure to the 
virus causes reactivation of the latent virus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1962821 [PubMed - indexed for MEDLINE]

5868: Wien Klin Wochenschr. 1990 Sep 28;102(18):536-8.

[Tractotomy and partial nucleotomy as a form of therapy in refractory pain of the
trigeminal nerve and cancer pain in the head and neck area]

[Article in German]

Kostron H, Plangger C, Russegger L.

Universitatsklinik fur Neurochirurgie, Innsbruck.

Persistent trigeminal neuralgia, herpes zoster neuralgia of the first division of
the trigeminal nerve and pain caused by cancer situated in the head and neck pose
frustrating problems for patients and physicians. Tractotomy and/or partial
vertical nucleotomy of the subnucleus caudalis nervi trigemini offers a logical
approach to the treatment of such pain, since these structures contain fibres of 
the Vth nerve, as well as the somatosensory fibres of the VIIth, IXth and Xth
nerve. Tactile and some thermal sensitivity of the face is preserved and
anaesthesia dolorosa and keratitis neuroparalytica is avoided. Over the past 30
years 370 patients with therapy-refractory trigeminal pain, pain due to cancer of
the head and neck and herpes zoster trigeminal pain were treated by means of
tractotomy (personal series of V. Grunert), including 30 patients who underwent
partial vertical nucleotomy. The mean age of the patients was 68 years (range
54-84 years). The mortality in this series was 0.9% (4 patients; one operative
mortality due to air embolism, one postoperative cardiac failure following
myocardial infarction and two intracerebral haematomas). 60% of the patients with
persistent trigeminal neuralgia were pain-free and 28% improved, whereas 12% were
unchanged or suffered from recurrent pain. Of the patients with cancer who
complained of pain derived from the Vth, VIIth, IXth and Xth nerve, 40%
demonstrated marked pain relief and 60% showed no improvement. Tractotomy and
partial vertical nucleotomy offer a valuable method in experienced hands for
relieving pain where other methods have failed.

Publication Types: 
    English Abstract

PMID: 1702247 [PubMed - indexed for MEDLINE]

5869: Ned Tijdschr Geneeskd. 1990 Sep 22;134(38):1870-1.

[Herpes zoster and acyclovir in normal and dysfunctional general immunity, also
that due to AIDS]

[Article in Dutch]

Van den Broek PJ, Van der Meer JW.

Publication Types: 
    Letter

PMID: 2215762 [PubMed - indexed for MEDLINE]

5870: Schweiz Rundsch Med Prax. 1990 Sep 11;79(37):1045-6.

[What is your diagnosis? Herpes zoster]

[Article in German]

Fluckiger R.

Dermatologische Universitatsklinik, Kantonsspital, Basel.

Publication Types: 
    Case Reports

PMID: 2218230 [PubMed - indexed for MEDLINE]

5871: Tidsskr Nor Laegeforen. 1990 Sep 10;110(21):2785-7.

[Herpesvirus latency]

[Article in Norwegian]

Langeland N.

Biokjemisk institutt/Senter for virologisk forskning, Universitetet i Bergen.

The article reviews present knowledge about the molecular mechanisms involved in 
herpes virus latency. The work on herpes virus latency has created a foundation
for much of our knowledge about viral latency in general. Herpes simplex virus is
perhaps best known in this respect. This virus resides latently in sensory
ganglia. No herpes simplex-specific proteins have been found, but a specific RNA 
transcript has been identified. In varicella-zoster virus latency several
latency-associated transcripts are known and, as for herpes simplex virus,
sensory ganglia harbour the latent infection. There is still some dispute as to
whether Epstein-Barr virus is truly latent or not. However, evidence for specific
proteins associated with latency is accumulating. Little is known about
cytomegalovirus latency.

Publication Types: 
    English Abstract
    Review

PMID: 2171156 [PubMed - indexed for MEDLINE]

5872: N Engl J Med. 1990 Sep 6;323(10):627-31.

Latent varicella-zoster viral DNA in human trigeminal and thoracic ganglia.

Mahalingam R, Wellish M, Wolf W, Dueland AN, Cohrs R, Vafai A, Gilden D.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262.

BACKGROUND. Some human herpesviruses become latent in dorsal-root ganglia.
Primary infection with the varicella-zoster virus causes chickenpox, followed by 
latency, and subsequent reactivation leading to shingles (zoster), but the
frequency and distribution of latent virus have not been established. METHODS.
Using the polymerase chain reaction, we performed postmortem examinations of
trigeminal and thoracic ganglia of 23 subjects 33 to 88 years old who had not
recently had chickenpox or shingles to identify the presence of latent
varicella-zoster viral DNA. Oligonucleotide primers representing the origin of
replication of the varicella-zoster virus and varicella-zoster virus gene 29 were
used for amplification. RESULTS. Among the 22 subjects seropositive for the
antibody to the virus, both the viral origin-of-replication and gene-29 sequences
were detected in 13 of 15 subjects (87 percent) in whom trigeminal ganglia were
examined and in 9 of 17 (53 percent) in whom thoracic ganglia were examined.
Viral DNA was not detected in brain or mononuclear cells from the seropositive
subjects. None of three thoracic ganglia from the one seronegative subject
contained varicella-zoster viral DNA. CONCLUSIONS. These findings indicate that
after primary infection with varicella-zoster virus (varicella), the virus
becomes latent in many ganglia--more often in the trigeminal ganglia than in any 
thoracic ganglion--and that more than one region of the viral genome is present
during latency.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2166914 [PubMed - indexed for MEDLINE]

5873: J Oral Maxillofac Surg. 1990 Sep;48(9):1000-3.

Tooth exfoliation and necrosis of the mandible--a rare complication following
trigeminal herpes zoster: report of a case.

Muto T, Tsuchiya H, Sato K, Kanazawa M.

Department of Oral and Maxillofacial Surgery, School of Dentistry,
Higashi-Nippon-Gakuen University, Hokkaido, Japan.

Publication Types: 
    Case Reports

PMID: 2395037 [PubMed - indexed for MEDLINE]

5874: Chest. 1990 Sep;98(3):754-6.

Fever, pulmonary infiltrates, and pleural effusion following acyclovir therapy
for herpes zoster ophthalmicus.

Pusateri DW, Muder RR.

Department of Medicine, Mercy Hospital of Pittsburgh.

A 71-year-old man presented with herpes zoster ophthalmicus and ocular
involvement. Following the institution of intravenous therapy with acyclovir, the
patient developed fever, hemoptysis, and a pleural friction rub. A
ventilation-perfusion lung scan showed no defects; roentgenograms showed
bilateral infiltrates and a left-sided pleural effusion. The fever abated
promptly following discontinuation of acyclovir, and radiographic abnormalities
resolved over ten days. No other anti-infective therapy was given. To our
knowledge, the syndrome of fever, pulmonary infiltrates, and pleural effusion
following use of acyclovir has not been previously reported.

Publication Types: 
    Case Reports

PMID: 2394154 [PubMed - indexed for MEDLINE]

5875: Vestn Oftalmol. 1990 Sep-Oct;106(5):65.

[Injury of the cornea by a bee sting complicated by Pseudomonas aeruginosa and
herpesvirus infections]

[Article in Russian]

Babushkin AE, Gimranov RM.

Publication Types: 
    Case Reports

PMID: 2264238 [PubMed - indexed for MEDLINE]

5876: DICP. 1990 Sep;24(9):851-4.

Griseofulvin: a new look at an old drug.

Araujo OE, Flowers FP, King MM.

Department of Pharmacy Practice, College of Pharmacy, Gainesville, FL.

Griseofulvin is the oral antifungal agent of choice for the treatment of
dermatophytoses. This article reviews the history, pharmacokinetics, adverse
reactions, and traditional therapeutic applications of griseofulvin. In addition,
reports since 1960 of the use of the drug in the treatment of Raynaud's
phenomenon, progressive systemic sclerosis, lichen planus, mycosis fungoides,
herpes zoster, eosinophilic fasciitis, and molluscum contagiosum are discussed,
noting the varying degree of therapeutic success.

Publication Types: 
    Review

PMID: 2260345 [PubMed - indexed for MEDLINE]

5877: Ann Ophthalmol. 1990 Sep;22(9):347-51.

Central retinal artery obstruction in herpes zoster ophthalmicus and cerebral
vasculopathy.

Wilson CA, Wander AH, Choromokos EA.

Department of Ophthalmology, University of Cincinnati College of Medicine, Ohio.

We present a case of acute central retinal artery obstruction in association with
Herpes zoster ophthalmicus and delayed cerebral vasculopathy. Retinal vascular
obstruction is rare in zoster, and its occurrence during postherpetic cerebral
vasculopathy has not been reported previously to our knowledge. The syndrome of
delayed cerebral vasculopathy is discussed as is its possible relationship to
central retinal artery obstruction.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 2248493 [PubMed - indexed for MEDLINE]

5878: Masui. 1990 Sep;39(9):1239-44.

[Relief of intractable post-herpetic neuralgia with gasserian ganglion block
using methyl prednisolone acetate and with TENS]

[Article in Japanese]

Yamashiro H, Hara K, Gotoh Y.

Department of Anesthesia, Hamamatsu Medical Center.

A 58 year old man had been suffering from intractable left ophthalmic post
herpetic neuralgia (PHN) for 7 years. He has also been treated for polyarteritis 
nodosa for 10 years. For pain relief, he was treated initially with frequent (4
times a day) stellate ganglion block (SGB) and peripheral ophthalmic nerve block 
for a month without relief. Then supraorbital nerve block with neurolytics, TENS 
and acupuncture were done with a slight relief of his pain. Recently his pain
became worse even with imipramine 75 mg and carbamazepine 100 mg a day which
relieved effectively the patient from the pain for the last 3 years. The pain was
so severe to disturb his usual daily activity. Gasserian ganglion block with
methyl prednisolone acetate 10 mg was done. After the block, his ADL improved
markedly. Three months after the block, he had no spontaneous pain and slight
pain with light touch on the injured skin did not annoy him. Several days before 
the block, electric stimulation to control his pain was tested. Stimulation with 
the electricity (4.5 mA, 10 cycle and 400 microseconds) brought him complete
relief from the pain during the stimulation. Trigeminal SEP showed no response to
the stimulation of injured skin.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2246814 [PubMed - indexed for MEDLINE]

5879: Clin Pediatr (Phila). 1990 Sep;29(9):539-41.

Zoster-like eruption associated with herpes simplex virus infection in children.

Harel L, Cohen AH, Amir J, Varsano I.

Department of Pediatrics, Hasharon Hospital, Petach Tikvah, Israel.

Publication Types: 
    Case Reports
    Review

PMID: 2242649 [PubMed - indexed for MEDLINE]

5880: J Ophthalmic Nurs Technol. 1990 Sep-Oct;9(5):186-92.

Health promotion and disease prevention in ophthalmology.

Garber N.

There is a new trend in the US government's perception regarding health care
today. It involves an increased awareness of how disease can be prevented and
health promoted. The US government is supporting this concept with its Healthy
People 2000 project. Specific pediatric concerns about health promotion and
disease prevention in ophthalmology include amblyopia and strabismus, ophthalmia 
neonatorum, ocular trauma, radiation injury, xerophthalmia, herpes simplex,
herpes zoster, infections and metabolic and genetic disorders. Adult health
promotion/disease prevention priorities include glaucoma; trauma; diabetic
retinopathy; corneal problems; iatrogenic infections; exposure keratitis; ocular 
toxicity from drugs, chemicals, and the environment; visual loss from neglect;
and those mentioned in the pediatric area.

PMID: 2213891 [PubMed - indexed for MEDLINE]

5881: J Med Virol. 1990 Sep;32(1):53-7.

Adenovirus infection in patients with Kawasaki disease.

Okano M, Thiele GM, Sakiyama Y, Matsumoto S, Purtilo DT.

Department of Pathology, University of Nebraska Medical Center, Omaha 68198-3135.

Two outbreaks of Kawasaki disease at different times and areas (Kyoto in 1982 and
Sapporo in 1985) of Japan were studied retrospectively for the presence of
antibodies to adenoviruses and herpesviruses. Only 2 of 12 (16.7%) consecutive
acute phase sera of patients from the outbreak in 1982 and 1 of 10 (10.0%) sera
from 1985 showed positive antibodies for the common adenovirus antigen by a
complement fixation (CF) test, whereas 10 of 16 (62.5%) age- and sex-matched
controls during the outbreak of Kawasaki disease in 1985 were seropositive by the
CF test. In contrast, using a recently developed enzyme-linked immunosorbent
assay (ELISA), 9 patients (75.0%) in 1982 and 9 patients (90.0%) in 1985 had
antibodies to adenovirus type 2. In addition, 5 of 10 (50.0%) of the 1982 and 6
of 9 (66.7%) of the 1985 patients who were seronegative for CF antibodies were
positive for IgM antibodies to adenovirus type 2. Fifteen (93.8%) controls were
positive for antibodies to adenovirus type 2 by ELISA and only two sera showed
negative CF antibodies with positive IgM antibodies to adenovirus type 2.
Sequential sera from 4 patients in 1985 had either IgM or IgG antibodies by ELISA
and eventually three became seropositive by the CF test in time. Additionally, no
significant difference was noted with antibody status to herpes simplex virus
type 1 and 2 (HSV-1 and HSV-2), varicella zoster virus (VZV), and cytomegalovirus
(CMV) between patients and controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2173738 [PubMed - indexed for MEDLINE]

5882: J Gen Virol. 1990 Sep;71 ( Pt 9):2175-8.

Induction of cervical neoplasia in the mouse by an extract of cells infected by
varicella-zoster virus.

Heggie AD, Wentz WB, Sorensen K, Anthony DD.

Department of Pediatrics, Case Western Reserve University School of Medicine,
Cleveland, Ohio.

Since several human herpesviruses, including varicella-zoster virus (VZV), have
been demonstrated to transform mammalian cells in vitro, VZV was tested in a
mouse model of virus-induced cervical neoplasia to determine whether it is
oncogenic in vivo. Herpes simplex viruses types 1 and 2 and cytomegalovirus have 
been previously shown to induce cervical neoplasia in this mouse model. VZV was
propagated in WI-38 cell cultures and inactivated by ultraviolet irradiation.
Control material was prepared in an identical manner from uninfected cell
cultures. Cotton tampons, saturated with inactivated virus or control material,
were inserted into the vaginas of C57BL mice three times a week for 60 weeks.
Cervical dysplasia was detected in 40% and invasive carcinoma in 34% of
virus-exposed mice by histological examination. No lesions were detected in
control animals. These observations indicate that VZV, or some product of
virus-infected cells, is oncogenic in vivo for the mouse cervix.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2170577 [PubMed - indexed for MEDLINE]

5883: Arch Neurol. 1990 Sep;47(9):1033-5.

Comment in:
    Arch Neurol. 1991 Sep;48(9):900.

Cerebral vasculopathy associated with primary varicella infection.

Caekebeke JF, Peters AC, Vandvik B, Brouwer OF, de Bakker HM.

Department of Neurology, University Hospital, Leiden, The Netherlands.

A previously healthy 5-year-old boy developed cerebral vasculopathy, presenting
as two episodes of acute hemiparesis 3 and 9 months, respectively, after a
primary varicella infection (chickenpox). This association has not been reported 
before, to our knowledge, although cerebral vasculopathy is a well-known
complication of herpes zoster ophthalmicus. The diagnosis was based on the
presence of oligoclonal varicella-specific IgG in the cerebrospinal fluid and
angiographic findings. Clinical and angiographic follow-up, and serial thymidine 
kinase activity levels in the cerebrospinal fluid suggested a self-limiting
course of the virus-induced vasculopathy. Varicella zoster virus seems to be
another potential causative agent to be considered in acute childhood hemiplegia.

Publication Types: 
    Case Reports

PMID: 2168697 [PubMed - indexed for MEDLINE]

5884: J Med Chem. 1990 Sep;33(9):2494-501.

Synthesis and antiviral activity of 3'-deoxy-3'-C-hydroxymethyl nucleosides.

Bamford MJ, Coe PL, Walker RT.

School of Chemistry, University of Birmingham, Edgbaston, England.

A series of 3'-branched-chain sugar nucleosides, in particular
3'-deoxy-3'-C-hydroxmethyl nucleosides, have been synthesized and evaluated as
antiviral agents. Reaction of 1-(2,3-epoxy-5-O-trityl-beta-D-lyxo-pentofuranosyl)
derivatives 12 and 13, of uracil and thymine, respectively, with
5,6-dihydro-2-lithio-5-methyl-1,3,5-dithiazine 14 afforded the corresponding
3'-functionalized nucleosides 15 and 16, respectively. Replacement of the trityl 
group with tertbutyldiphenylsilyl allowed high yielding hydrolysis of the
3'-function to give the 3'-deoxy-3'-C-formyl-beta-D-arabino-pentofuranosyl
nucleosides 21 and 22. Desilylation afforded the 1-(3-deoxy-3-C-formyl-beta-
D-lyxo-pentofuranosyl) 3',5'-O-hemiacetal nucleosides 33 and 34, respectively.
Reduction of the formyl group of 21 and 22, followed by desilylation, yielded the
3'-deoxy-3'-C-(hydroxymethyl)-beta-D-arabino- pentofuranosyl) analogues 7 and 8, 
respectively. The uracil base moiety of 7 was converted to 5-iodouracil and then 
to (E)-5-(2-bromovinyl)uracil to furnish an analogue 10 of BVaraU. The
1-(3-deoxy-3-C-(hydroxymethyl)-beta-D-lyxo-pentofuranosyl) and
1-(2,3-dideoxy-3-C-(hydroxymethyl)-beta-D-erythro-pentofuranosyl) derivatives of 
uracil (31 and 6, respectively) and 5-iodouracil (32 and 9, respectively) were
also obtained. All novel, fully deprotected nucleoside analogues were evaluated
for antiviral activity against human immunodeficiency virus type-1, herpes
simplex virus types-1 and -2, varicella zoster virus, human cytomegalovirus and
influenza A. Of the compounds tested only (E)-5-(2-bromovinyl)-1-[3-deoxy-
3-C-(hydroxymethyl)-beta-D-arabino-pentofuranosyl]uracil (10) inhibited VZV
(alone), but did so at concentrations well below the cytotoxicity threshold.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2167981 [PubMed - indexed for MEDLINE]

5885: Virology. 1990 Sep;178(1):263-72.

Cell surface expression of the varicella-zoster virus glycoproteins and Fc
receptor.

Litwin V, Sandor M, Grose C.

Department of Microbiology, University of Iowa College of Medicine, Iowa City
52242.

Varicella-zoster virus (VZV) specifies the synthesis of viral glycoproteins which
are important antigens for induction of the host immune response. In this report 
the technology of laser-activated flow cytometry has been employed to measure the
membrane expression of VZV glycoproteins gpI, gpII, gpIII, and gpIV. By use of
biotinylated monoclonal antibodies as probes, all four glycoproteins were
demonstrated on the infected cell surface. The temporal appearance of the viral
glycoproteins was defined in a time course experiment and shown to be maximal
about 24 hr postinfection. The issue whether VZV induces the cell surface
expression of an Fc receptor (FcR) was investigated with biotinylated nonimmune
human IgG, followed by streptavidin-phycoerythrin. By this technique a 10-fold
increase in fluorescence intensity was seen in the VZV-infected cells as compared
to the mock-infected controls. When the experiment was repeated with purified
human Fc fragment rather than whole IgG, a similar degree of binding was seen.
Both the VZV glycoproteins and the VZV FcR were exquisitely sensitive to trypsin 
treatment (1 mg/ml); likewise, the cell surface expression of these VZV products 
was diminished by treatment of the infected cultures with monensin, an inhibitor 
of glycoprotein transport. In order to prove that VZV infection was not causing
the induction of a cellular Fc gamma R, the VZV-infected and mock-infected cells 
were stained with monoclonal antibodies directed against each of the three human 
cellular IgG FcR, but no differences were observed. Therefore, the FcR activity
seen in the infected culture was not due to one of the known cellular Fc gamma R.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2167554 [PubMed - indexed for MEDLINE]

5886: J Infect Dis. 1990 Sep;162(3):627-33.

Antibodies to varicella-zoster virus glycoproteins I, II, and III in leukemic and
healthy children.

LaRussa PS, Gershon AA, Steinberg SP, Chartrand SA.

Department of Pediatrics, Columbia University, College of Physicians & Surgeons, 
New York City, NY 10032.

A dot ELISA was used to analyze the antibody response to varicella-zoster virus
glycoproteins I, II, and III in leukemic and healthy children who either
developed natural varicella or received the live attenuated varicella vaccine.
Both groups of children showed an antibody response to these viral glycoproteins.
The antibody response to all three glycoproteins showed excellent persistence
over the 3-year period of study. None of the glycoproteins provoked an antibody
response that could be shown to correlate with protection from breakthrough
varicella after household exposure to chickenpox or from zoster in leukemic
vaccinees.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2167335 [PubMed - indexed for MEDLINE]

5887: J Infect Dis. 1990 Sep;162(3):621-6.

Subclass distribution of the serum and intrathecal IgG antibody response in
varicella-zoster virus infections.

Echevarria JM, Tellez A, Martinez-Martin P.

Centro Nacional de Microbiologia, Virologia e Inmunologia Sanitarias, Madrid,
Spain.

The subclass distribution of the varicella-zoster virus (VZV)-specific IgG
antibody response was studied in serum samples from 22 patients with primary
varicella and 34 with recurrent VZV infections and in cerebrospinal fluid (CSF)
samples from 22 patients with recurrent infection who presented with symptoms of 
aseptic meningitis. IgG1 and 3 were the dominant subclasses among patients with
primary and recurrent infections; IgG1 was also prevalent in the CSF samples. The
VZV IgG subclass distribution patterns did not allow differentiation between
primary and recurrent infections. However, seroconversions for IgG2, 3, or 4 were
observed among patients with recurrences who were negative for specific IgM,
suggesting that qualitative tests for serum IgG subclass antibody could be
helpful for diagnosis in such cases. Herpes simplex virus-specific IgG was found 
in CSF samples from several patients with meningitis. The results suggest that
calculation of the antibody to albumin index is better than IgG subclass antibody
assays for discriminating the causative agent in these cases.

PMID: 2167334 [PubMed - indexed for MEDLINE]

5888: Int J Dermatol. 1990 Sep;29(7):523-7.

Postherpetic neuralgia and systemic corticosteroid therapy. Efficacy and safety.

Lycka BA.

Department of Dermatology, University of Minnesota School of Medicine,
Minneapolis.

Corticosteroids are frequently advocated for use in prevention of postherpetic
neuralgia (PHN), although their use is replete with controversy. The present
study is a meta-analysis of the four well-controlled clinical studies conducted
on this issue. The results indicated there is a statistically significant
decrease in proportions affected at 6 and 12 weeks. Standard difference scores
were -2.0559 and -4.1442, respectively, and 95% confidence intervals were -3.98% 
to -31.80% and -14.16% to -43.84%, respectively. At 24 weeks, no differences were
detectable between placebo- and corticosteroid-treated groups (SD = 0.6603, p
greater than 0.05, 95% confidence intervals of -6.78% to 24.67%). Side effects of
treatment were rare and mild, affecting only 2.5% of patients treated with
corticosteroids. No patients had dissemination of disease. Systemic
corticosteroid treatment decreases the proportion of patients affected by PHN,
especially when it is defined as pain occurring at 6 or 12 weeks after the acute 
event.

Publication Types: 
    Meta-Analysis

PMID: 2146232 [PubMed - indexed for MEDLINE]

5889: Rev Inst Med Trop Sao Paulo. 1990 Sep-Oct;32(5):364-9.

[HIV seropositivity in patients with herpes zoster]

[Article in Portuguese]

Vasconcellos MR, Castro LG, dos Santos MF.

Disciplina de Dermatologia da Escola Paulista de Medicina, Hospital das Clinicas,
Sao Paulo, Brasil.

Relationship between zoster and seropositivity for HIV is studied. Serum samples 
from 66 patients presenting acute zoster infection were tested for HIV
antibodies, using ELISA. There was no previous selection of patients, what
rendered the population studied unbiased. Seven patients (10.6%) were positive
for HIV antibodies. Among them six belonged to AIDS risk groups, all were males
and six had ages between 19 and 39 years (mean age value 31.7). Results suggest
that the finding of zoster in younger age groups is not necessarily linked to HIV
infection. When zoster is diagnosed in patients who belong to AIDS risk groups,
independently from their age, the association with HIV infection is statistically
significative. In these cases zoster can even be considered as a marker for HIV
infection and it is mandatory to test these patients for HIV antibodies.

PIP: The relationship between zoster and seropositivity for HIV is studied. Serum
samples from 66 patients presenting acute zoster infection were tested for HIV
antibodies using ELISA. There was no previous selection of patients, which
rendered the population studied unbiased. 7 patients (10.6%) were positive for
HIV antibodies; 6 belonged to AIDS risk groups, all were male, and 6 were between
the ages of 19 and 39 years (mean age = 31.7). Results suggest that the finding
of zoster in younger age groups is not necessarily linked to HIV infection. When 
zoster is diagnosed in patients who belong to AIDS risk groups. Independently
from their age, the association with HIV infection is statistically significant. 
In these cases, zoster can even be considered as a marker for HIV infection and
it is mandatory to test these patients for HIV antibodies. (author's modified)

Publication Types: 
    English Abstract

PMID: 2135478 [PubMed - indexed for MEDLINE]

5890: AJR Am J Roentgenol. 1990 Sep;155(3):573-9.

Contrast-enhanced MR imaging of the facial nerve in 11 patients with Bell's
palsy.

Tien R, Dillon WP, Jackler RK.

Department of Radiology, University of California, San Francisco 94143.

Contrast-enhanced MR images (at 1.5 T) were obtained in 11 patients with facial
palsy. The group included five people with acute idiopathic facial (Bell's)
palsy, three with chronic idiopathic facial palsy, and one each with acute facial
palsy after local radiation therapy, acute facial palsy resulting from herpes
zoster virus infection, and facial palsy caused by facial neuroma. Eight of the
11 patients demonstrated marked enhancement of the affected facial nerve from the
labyrinthine portion through the descending canal. Three patients also
demonstrated mild enhancement of the distal canalicular portion of the facial
nerve, simulating small distal acoustic neuromas. No difference in the pattern of
enhancement between the acute or chronic Bell's palsy patients was seen.
Radiographic resolution appeared to lag behind clinical resolution. The facial
neuroma appeared distinct from the other lesions as a focally enhancing mass. The
enhancement pattern in the Bell's group correlated with the histopathologic
features of Bell's palsy and is consistent with the viral hypothesis of the
syndrome. Thin-section contrast-enhanced MR scans are recommended for individuals
with atypical presentation of facial paralysis. In the proper clinical setting,
contrast-enhanced MR imaging may permit a positive radiographic diagnosis of
Bell's palsy, which has previously been a diagnosis of exclusion.

PMID: 2117359 [PubMed - indexed for MEDLINE]

5891: Br J Clin Pract Suppl. 1990 Sep;71:109-13.

Skin manifestations in AIDS patients.

Staughton R.

Department of Dermatology, Westminster Hospital, London, UK.

Skin lesions occur in virtually all patients during the unfolding evolution of
their HIV infection--usually a succession of conditions reflecting the gradual
decline of immunity. Hairy leucoplakia can occur at any stage and in all risk
groups. Kaposi's sarcoma is seen only in homosexually acquired AIDS. A transient 
rash may accompany the initial HIV seroconversion illness, but may go unnoticed. 
Documented examples show macular red oval lesions, similar to pityriasis rosea,
but extending onto the face, palms and soles, preceded by a flu-like illness with
lymphadenopathy and lymphopenia simulating glandular fever. Seroconversion occurs
within weeks. During the following weeks or years the gradually declining
immunity may only be documented by decreasing numbers of CD4 positive lymphocytes
with the emergence of 'idiopathic' inflammatory skin conditions (eg, seborrhoeic 
dermatitis, psoriasis), as well as autoimmune conditions (eg, thrombocytopenia,
morphoea or alopecia areata). As immunity itself declines, skin infections
emerge. Shingles affects over 25% of HIV-positive patients--sometimes involving
numerous dermatomes, accompanied by multiple distant chicken pox lesions and
followed by post-herpetic neuralgia. Onychomycosis and tinea pedis are universal,
but sometimes occult patterns with follicular lesions due to Trichophyton rubrum 
may spread widely over the beard and chest. Uncomfortable mucosal candidosis,
sometimes with oesophageal extension, may only become controllable with oral
imidazoles. Molluscum contagiosum may be seen in hundreds over large areas, whole
soles can be shod in verrucae and vulgar warts appear in the most unusual sites, 
for example on the palate or up nostrils. Dry skin develops into acquired
ichthyosis and eczema crackele.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Review

PMID: 2091731 [PubMed - indexed for MEDLINE]

5892: Lancet. 1990 Sep 1;336(8714):537-8.

Comment in:
    Lancet. 1990 Oct 13;336(8720):947.

Postherpetic neuralgia.

[No authors listed]

Publication Types: 
    Editorial

PMID: 1975041 [PubMed - indexed for MEDLINE]

5893: Rev Inst Med Trop Sao Paulo. 1990 Sep-Oct;32(5):338-45.

Cytomegalovirus and other herpesviruses infections in heart and bone marrow
transplant recipients.

Weinberg A, Boas LS, Feher O, Strabelli TM, Fink MC, Dulley FL, Uip DE, Bellotti 
G, Chamone DA, Amato Neto V, et al.

Virology Laboratory, Instituto de Medicina Tropical, Sao Paulo, Brasil.

From January 1988 to January 1989 all the heart transplant and bone marrow
recipients at the Instituto do Coracao of the Hospital das Clinicas of the
University of Sao Paulo Medical School were studied for the incidence and
morbidity associated with herpesviruses infections after transplantation. Five
bone marrow and 5 heart transplant recipients were followed for a mean of 4.2
months post-transplantation. All the patients were seropositive for
cytomegalovirus (CMV) before admission and 80% experienced one or more
recurrences during the observation period. Of the 12 episodes of CMV infection,
that were identified in this study, 83% were accompanied by clinical or
laboratory abnormalities. However, there was only one case of severe disease. The
overall incidence of infection for herpes simplex (HSV) was 50%. Although most of
HSV reactivations were oral or genital, one case of HSV hepatitis occurred. One
of the 6 episodes of HSV infections that were treated with acyclovir showed an
unsatisfactory response and was successfully managed with ganciclovir. All the
individuals had anti-varicella zoster virus antibodies, but none of them
developed infection. The study emphasizes the importance of active diagnostic
surveillance of herpesvirus infections in transplant patients. Both CMV and HSV
reactivations showed high incidence and important morbidity and thus, deserve
prophylactic therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1966923 [PubMed - indexed for MEDLINE]

5894: Brain Pathol. 1990 Sep;1(1):6-10.

Neurotropic herpesviruses, neural mechanisms and arteritis.

Martin JR, Mitchell WJ, Henken DB.

Laboratory of Experimental Neuropathology, National Institutes of Health,
Bethesda, MD 20892.

Cumulative evidence suggests that varicella-zoster virus (VZV) can infect walls
of CNS arteries, causing stroke in man. We review observations relating infection
with this neurotropic virus to the development of arteritis in the CNS and note
evidence supporting the hypothesis that VZV spreads from ganglionic reactivation 
sites to the arterial wall by neural pathways. Problems relating to the
pathogenesis of arteritis and experimental approaches to their solution are
suggested.

Publication Types: 
    Review

PMID: 1669695 [PubMed - indexed for MEDLINE]

5895: Schweiz Med Wochenschr. 1990 Aug 18;120(33):1200-3.

[Renal and neurological toxicity of acyclovir. Apropos of a case]

[Article in French]

Fischer A, Fellay G, Regamey C.

Clinique medicale, Hopital cantonal de Fribourg.

The occurrence of anuria and stupor in a patient treated with acyclovir afforded 
the opportunity to discuss the renal and neurological toxicity of this drug.
Acute renal insufficiency by crystallization of acyclovir and intratubular
obstruction is a not infrequent side effect. The risk depends on the dose, the
administration mode, the patient's state of hydration and preexisting renal
failure. The evolution is typified by a rapid onset (after 24-48 h) and a prompt 
recovery after ending the treatment. The demonstration in urinalysis of crystals 
within leukocytes helps to establish the diagnosis. Neurological involvement can 
vary from confusion to coma. The cerebrospinal fluid is normal and the
electroencephalogram shows diffuse slowing. A favorable outcome after ending
treatment is the rule. Awareness of the risk factors associated with renal and
neurological toxicity should lead to a reduction of its frequency.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2396095 [PubMed - indexed for MEDLINE]

5896: J Clin Pathol. 1990 Aug;43(8):633-7.

Virus infections in bone marrow transplant recipients: a three year prospective
study.

Taylor CE, Sviland L, Pearson AD, Dobb M, Reid MM, Kernahan J, Craft AW, Hamilton
PJ, Proctor S.

Department of Virology, Royal Victoria Infirmary, Newcastle upon Tyne.

Over three years 81 consecutive bone marrow transplant recipients (32 allogeneic 
and 49 autologous) who received prophylaxis with acyclovir, were studied for
symptomatic virus infection. Thirty nine infections were documented in a total of
28 patients. Thirty two infections were mild, five were moderately severe, and
two were severe. Cytomegalovirus infection occurred in only six allogeneic
recipients. Herpes simplex virus and varicella zoster virus infections occurred
infrequently. Seven patients who were considered at the time of death to have
died due to an infectious cause were studied virologically at necropsy. In only
one patient was a virus infection thought to have been the cause of death.
Prophylaxis with acyclovir may have influenced the rate and clinical prominence
of herpes virus infections. In this study viruses were considered to have had a
relatively minor role in causing morbidity and mortality.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2401731 [PubMed - indexed for MEDLINE]

5897: Arch Dermatol. 1990 Aug;126(8):1105-6.

Comment in:
    Arch Dermatol. 1990 Aug;126(8):1086-8.

Chronic localized herpes zoster in the acquired immunodeficiency syndrome.

Disler RS, Dover JS.

Publication Types: 
    Case Reports
    Letter

PMID: 2383039 [PubMed - indexed for MEDLINE]

5898: Z Hautkr. 1990 Aug;65(8):713-6.

[Therapy of herpes zoster neuralgia. Acute and residual neuralgia in herpes
zoster]

[Article in German]

Malin JP.

Neurologische Klinik und Poliklinik, Ruhr-Universitat Bochum.

We discuss the latest findings regarding the therapy of acute herpes zoster and
postherpetic neuralgia. Aside from the conventional modes of treatment. We
especially refer to the therapy with aciclovir. In addition, we present the
techniques of transcutaneous electrostimulation and neurosurgery.

Publication Types: 
    English Abstract
    Review

PMID: 2284830 [PubMed - indexed for MEDLINE]

5899: Aust Dent J. 1990 Aug;35(4):328-32.

Herpes zoster virus infection: a clinicopathologic review and case reports.

Barrett AP.

Westmead Hospital Dental Clinical School, Department of Medicine.

Herpes zoster virus (HZV) infection, particularly of the trigeminal nerve, can be
a disabling and disfiguring condition with variable clinical presentations.
Acyclovir is a highly effective treatment modality during the acute clinical
phase; however, pain control may be very difficult particularly with protracted
and severe post herpetic neuralgia (PHN). The clinicopathologic features are
reviewed and two cases in immunosuppressed patients with HZV infection of
different divisions of the trigeminal nerve are presented.

Publication Types: 
    Case Reports
    Review

PMID: 2275650 [PubMed - indexed for MEDLINE]

5900: Hautarzt. 1990 Aug;41(8):455-7.

[Post-zoster-specific skin infiltrates in chronic lymphatic leukemia]

[Article in German]

Aberer W, Zonzits E, Soyer HP, Kerl H.

I. Universitats-Hautklinik Wien.

Eight weeks after suffering from herpes zoster of the right 5th cranial nerve, an
80-year-old woman with chronic lymphocytic leukaemia developed zoster-like
pseudovesicular lesions in the same nerve segment. Histological and
immunohistological investigations revealed specific infiltrates of chronic
lymphocytic leukaemia. Chemotherapy for the underlying disease was intensified,
and the cutaneous infiltrates disappeared quickly. The patient died shortly
afterwards due to exacerbation of the lymphoma.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2272830 [PubMed - indexed for MEDLINE]

5901: Aust N Z J Ophthalmol. 1990 Aug;18(3):273-9.

Current management of ophthalmic zoster.

Marsh RJ.

St Mary's Hospital, London, England.

Most ophthalmic zoster occurs in healthy people and ocular complications occur in
50%. The mainstay of ocular therapy is topical steroid, but careful follow-up and
withdrawal are essential. The place of systemic steroid therapy and acyclovir in 
immunocompetent patients with zoster is uncertain.

Publication Types: 
    Review

PMID: 2261174 [PubMed - indexed for MEDLINE]

5902: Vrach Delo. 1990 Aug;(8):107-10.

[The immunomodulating therapy of herpes zoster (a review of the literature)]

[Article in Russian]

Turkot LA, Andreichin MA, Savchak VI.

Publication Types: 
    Review

PMID: 2256267 [PubMed - indexed for MEDLINE]

5903: Ther Umsch. 1990 Aug;47(8):653-7.

[Antiviral substances: against what? For whom?]

[Article in German]

Hirschel B.

Division des maladies infectieuses, Hopital cantonal universitaire, Geneve.

Acyclovir and zidovudine are the two most widely used antiviral drugs. Acyclovir 
is efficacious against all infections caused by herpes simplex virus, but
treatment must start early to be effective. Herpes zoster virus is less
susceptible to acyclovir, but high doses shorten the duration of skin lesions,
although the effect on post-herpetic neuralgia is uncertain. Zidovudine
diminishes short-term mortality in patients with HIV infection and serious
opportunistic infections. In those patients, the average increase in life
expectancy is about one year. Because of myelotoxicity, frequent monitoring of
blood counts is necessary. Recent results in patients who have few or no symptoms
of HIV infection indicate that the drug decreases the chance of progressing to
AIDS. Therefore, indications for treatment now include asymptomatic patients with
unfavourable laboratory parameters.

Publication Types: 
    English Abstract

PMID: 2218967 [PubMed - indexed for MEDLINE]

5904: Arch Dermatol. 1990 Aug;126(8):1086-8.

Comment on:
    Arch Dermatol. 1990 Aug;126(8):1033-6.    Arch Dermatol. 1990 Aug;126(8):1048-50.    Arch Dermatol. 1990 Aug;126(8):1105-6.

Varicella-zoster virus disease in patients with human immunodeficiency virus
infection.

Gulick RM, Heath-Chiozzi M, Crumpacker CS.

Department of Infectious Diseases, Beth Israel Hospital, Boston, MA 02215.

Publication Types: 
    Comment
    Review

PMID: 2200349 [PubMed - indexed for MEDLINE]

5905: Z Hautkr. 1990 Aug;65(8):709-12.

[Pathophysiology of pain perception and pain transmission in herpes zoster]

[Article in German]

Malin JP.

Neurologische Klinik und Poliklinik, Ruhr-Universitat Bochum.

Publication Types: 
    English Abstract

PMID: 2178294 [PubMed - indexed for MEDLINE]

5906: Neuropathol Appl Neurobiol. 1990 Aug;16(4):305-16.

Studies on the pathogenesis of neurological diseases associated with
Varicella-Zoster virus.

Kennedy PG, Barrass JD, Graham DI, Clements GB.

Glasgow University Department of Neurology, Southern General Hospital.

Immunocytochemical techniques and in situ hybridization with three different
Varicella-Zoster Virus (VZV)-specific RNA probes have been used to study the
pathogenesis of VZV-associated neurological syndromes. Varicella-Zoster Virus
antigens were not detected using the avidin-biotin peroxidase technique with a
polyvalent anti-VZV antibody in any of the formalin-fixed tissue sections from
eight cases of VZV-associated neurological disease (encephalitis, myelitis,
ganglionitis); one case was immunosuppressed although inflammatory lesions were
present. Intense labelling was detected within the inflammatory lesions in
several representative VZV cases with a monoclonal antibody against Class II MHC 
antigens, whereas cases of Herpes Simplex Virus encephalitis and normal controls 
were not so labelled. Three VZV probes from open reading frames 62, 16 and 40,
which show homology with the Herpes Simplex Virus immediate early 175 kd protein,
the 65 kd DNA binding protein and the major capsid protein respectively, were
used for in situ hybridization studies in these VZV tissues. Although the probes 
were able to detect VZV RNA in VZV-infected CV-1 and Flow 2002 cell cultures and 
formalin-fixed VZV skin biopsy sections, positive hybridization was not seen in
any of the neurological cases studied. Thus neither VZV nucleic acid nor antigens
were detected in any of the cases of VZV-associated neurological disease. It is
proposed that the mechanism of neurological damage in the syndromes is
immune-mediated, there being increased expression of Class II MHC antigens
associated with persistent inflammation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2172854 [PubMed - indexed for MEDLINE]

5907: Ann Rheum Dis. 1990 Aug;49(8):630-3.

High incidence of herpes zoster in patients with systemic lupus erythematosus: an
immunological analysis.

Nagasawa K, Yamauchi Y, Tada Y, Kusaba T, Niho Y, Yoshikawa H.

First Department of Internal Medicine, Faculty of Medicine, Kyushu University
Fukuoka, Japan.

The incidence of herpes zoster was determined in patients with systemic lupus
erythematosus (SLE) and the cellular and humoral immunity to varicella zoster
virus (VZV) investigated in 45 of these 92 patients. The incidence of herpes
zoster was high, occurring in 40 patients (43%), though it was benign in all.
Patients with SLE who had had zoster showed significantly higher antibody titres 
than normal subjects. On the other hand, only 13 of 43 (30%) patients with SLE
showed positive delayed hypersensitivity skin reactions to VZV antigen, despite a
history of infections with VZV, whereas all 15 normal subjects had positive
reactions. Skin reactions to VZV correlated directly with the ratio of OKT4+ to
OKT8+ T cells and inversely with the dose of corticosteroids. These results
suggest that the high incidence of herpes zoster in patients with SLE is probably
due to defects in cellular immunity and that normal or higher titres of
antibodies to VZV will not act as a preventive against zoster. In addition,
reactivation of VZV, whether symptomatic or not, seemed often to occur in
patients with SLE.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2168693 [PubMed - indexed for MEDLINE]

5908: J Gen Virol. 1990 Aug;71 ( Pt 8):1793-800.

The nucleotide sequence of an equine herpesvirus 4 gene homologue of the herpes
simplex virus 1 glycoprotein H gene.

Nicolson L, Cullinane AA, Onions DE.

Department of Veterinary Pathology, University of Glasgow Veterinary School,
Bearsden, U.K.

The equine herpesvirus 4 (EHV-4) gene glycoprotein H (gH) gene homologue was
localized by virtue of the conserved genomic position of this gene throughout
members of the herpesvirus family. The gene maps immediately downstream of the
thymidine kinase gene at approximately 0.49 to 0.51 map units within genomic
fragment BamH1 C. The EHV-4 gH primary translation product is predicted to be a
polypeptide of Mr 94,100, 855 amino acids long, which possesses features
characteristic of a membrane glycoprotein, namely an N-terminal signal sequence, 
a large hydrophilic domain containing 11 putative N-linked glycosylation sites, a
C-terminal transmembrane domain, and a charged cytoplasmic tail. Comparison to
other herpesvirus glycoproteins revealed identities of 85%, 26% and 32% with the 
gH counterparts of the alphaherpesviruses EHV-1, herpes simplex virus 1 and
varicella-zoster virus, respectively, and of 17% and 18% with those of human
cytomegalovirus, herpesvirus saimiri and Epstein-Barr virus. The EHV-4 gH
exhibits features previously reported to be conserved throughout the gH
polypeptides of herpesviruses of all three subgroups. A region of direct repeat
elements and a possible origin of DNA replication are located immediately
downstream of the gH gene.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2167933 [PubMed - indexed for MEDLINE]

5909: J Gen Virol. 1990 Aug;71 ( Pt 8):1747-55.

Identification of two genes in the unique short region of pseudorabies virus;
comparison with herpes simplex virus and varicella-zoster virus.

van Zijl M, van der Gulden H, de Wind N, Gielkens A, Berns A.

Division of Molecular Genetics, The Netherlands Cancer Institute, Amsterdam.

We have determined the nucleotide sequence of two genes in the unique short
region of the genome of pseudorabies virus (PRV). Near the internal repeat,
upstream of the gene encoding glycoprotein gX, we identified an open reading
frame (ORF) encoding a protein of 390 amino acids. We designated this gene PK
because the predicted protein contains most of the conserved motifs of a
eukaryotic protein kinase. The protein shares amino acid homology with the
protein kinases encoded by gene US3 of herpes simplex virus type 1 (HSV-1) and
gene 66 of varicella-zoster virus. Near the terminal repeat, downstream of a gene
encoding an 11K protein, we identified an ORF encoding a protein of 256 amino
acids. We designated this gene 28K, the Mr of the predicted protein. Part of the 
amino acid sequence of 28K is homologous to the predicted US2 protein of HSV-1.
Northern blot analysis revealed a 2.7 kb mRNA encoding the putative protein
kinase and a 1.2 kb mRNA encoding the 28K protein in PRV-infected cells. The 5'
ends of the mRNAs were mapped by primer extension. Two transcriptional start
sites were identified for the PK mRNA: a minor start site immediately upstream of
the ORF and a major start site (greater than 95% of the mRNA) within the ORF, 64 
nucleotides upstream of an internal ATG codon. A single transcriptional start
site was identified for the 28K mRNA immediately upstream of the ORF. Immunoblot 
analysis with anti-peptide sera revealed that, in cells infected with PRV, the PK
gene was translated into two proteins with Mrs of 53K and 41K, and the 28K gene
into a single protein with an Mr of 28K.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2167928 [PubMed - indexed for MEDLINE]

5910: Arch Dermatol. 1990 Aug;126(8):1048-50.

Comment in:
    Arch Dermatol. 1990 Aug;126(8):1086-8.

Prolonged cutaneous herpes zoster in acquired immunodeficiency syndrome.

Hoppenjans WB, Bibler MR, Orme RL, Solinger AM.

Department of Dermatology, University of Cincinnati, Ohio, College of Medicine.

We described the development of prolonged disseminated cutaneous herpes zoster in
two patients with acquired immunodeficiency syndrome. Both patients developed
hyperkeratotic, verrucous lesions that progressed despite acyclovir therapy. The 
biopsy specimens were typical of herpes infection. The development of
acyclovir-resistant varicella-zoster virus during therapy was suspected
clinically in the first patient and documented in vitro in the second patient.
The inability to mount an effective cell-mediated immune response contributed to 
the prolonged course of cutaneous zoster in our patients. The hyperkeratotic
nature of the skin lesions may reflect their chronic nature. Treatment with
inadequate doses of acyclovir, allowing viral persistence and the selection of
resistant strains of virus, may also be implicated. We recommend prolonged
high-dose intravenous acyclovir therapy in the initial management of herpes
zoster in patients with acquired immunodeficiency syndrome.

Publication Types: 
    Case Reports

PMID: 2166483 [PubMed - indexed for MEDLINE]

5911: Arch Dermatol. 1990 Aug;126(8):1033-6.

Comment in:
    Arch Dermatol. 1990 Aug;126(8):1086-8.

Varicella in patients infected with the human immunodeficiency virus.

Perronne C, Lazanas M, Leport C, Simon F, Salmon D, Dallot A, Vilde JL.

Service des Maladies Infectieuses et Tropicales, Hopital Claude-Bernard, Paris,
France.

In a retrospective study of 421 patients infected with human immunodeficiency
virus, 15 (3.5%) had varicella. Twelve patients had a typical varicella.
Complications were as follows: profuse eruption, 6; hemorrhagic eruption, 1;
hepatitis, 5; and pulmonary involvement, 1; 1 patient developed an intravascular 
disseminated coagulation and died of varicella. Three patients with acquired
immunodeficiency syndrome, having a history of varicella, presented with an
atypical form of varicella with a small number of disseminated cutaneous poxlike 
lesions; 1 of these patients experienced three relapses of atypical varicella.
Assay of serum antibodies to varicella zoster virus showed that, while typical
varicella was the primary varicella zoster virus infection, atypical varicella
was a reactivation of varicella zoster virus infection. Acyclovir was given to 11
patients and vidarabine to 1 patient. The one patient who died and the one who
suffered a relapse had received acyclovir. Thus, varicella in patients infected
with human immunodeficiency virus may be complicated and even lethal. Atypical
forms of varicella could be, as is the case with herpes zoster, a reactivation of
endogenous varicella zoster virus.

PMID: 2166482 [PubMed - indexed for MEDLINE]

5912: Virology. 1990 Aug;177(2):570-7.

Analysis of the binding sites for the varicella-zoster virus gene 51 product
within the viral origin of DNA replication.

Stow ND, Weir HM, Stow EC.

Medical Research Council Virology Unit, Institute of Virology, Glasgow, United
Kingdom.

The C-terminal 322 amino acids of the varicella-zoster virus (VZV) gene 51
product were expressed in Escherichia coli and shown to bind to specific DNA
sequences within the VZV origin of DNA replication. The gene 51 product and its
herpes simplex virus type 1 homolog (the UL9 protein) are capable of recognizing 
identical DNA sequences but the arrangement of binding sites within the origin
regions of the two viruses differs. Three binding sites for the VZV gene 51
protein were identified within the VZV origin region and these lie in the same
orientation and on the same side of the origin palindromic DNA sequence. DNA
replication assays in transfected tissue culture cells demonstrated that the site
closest to the palindrome is essential for origin activity whereas the most
distal site is dispensable. The middle binding site may play an auxiliary role in
DNA synthesis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2164726 [PubMed - indexed for MEDLINE]

5913: Am J Epidemiol. 1990 Aug;132(2):203-10.

Risk factors for progression of human immunodeficiency virus (HIV) infection
among seroconverted and seropositive homosexual men.

van Griensven GJ, de Vroome EM, de Wolf F, Goudsmit J, Roos M, Coutinho RA.

Municipal Health Service, Department of Public Health and Environment, Amsterdam,
The Netherlands.

For identification of risk factors for progression of human immunodeficiency
virus (HIV) infection, 746 homosexual men participating in a cohort study in
Amsterdam, The Netherlands, were studied since October 1984. A total of 234 of
these men were HIV antibody-positive at baseline, and 52 seroconverted during
follow-up. These 286 individuals were categorized as high- and low-risk for
progression to the acquired immunodeficiency syndrome (AIDS) on the basis of the 
presence or absence of HIV antigenemia, antibody to HIV core antigen, or a number
of T helper lymphocytes less than 0.5 x 10(9)/liter during three or more
subsequential blood samples. Ninety-six (41%) of the seropositives and 32 (62%)
of those who seroconverted remained low-risk throughout the study period.
Bivariate analyses revealed that educational level and a history of herpes zoster
were associated with a low- and high-risk status, respectively. In multivariate
analyses, a history of herpes zoster and a history of sexual intercourse with a
person who had AIDS were associated with a more rapid disease progression. While 
herpes zoster is considered to be a marker of progressive immunodeficiency, a
history of having sexual intercourse with a person who had AIDS points to the
more virulent properties of HIV in these persons. Because both seropositives and 
seroconverters who had sexual intercourse with a person with AIDS had a more
rapid disease progression, it seems plausible that being infected by a person
with AIDS is a risk factor for a relative short incubation period.

PMID: 1973594 [PubMed - indexed for MEDLINE]

5914: Lancet. 1990 Jul 21;336(8708):192.

Screening hospital staff for antibodies to varicella-zoster virus.

Murray A, Kangro HO, Heath RB.

Publication Types: 
    Letter

PMID: 1973522 [PubMed - indexed for MEDLINE]

5915: Cancer. 1990 Jul 15;66(2):382-6.

Predictors of 5-year survival and curability in small cell lung cancer.

Crown JP, Chahinian AP, Jaffrey IS, Glidewell OJ, Kaneko M, Holland JF.

Department of Neoplastic Diseases, Mount Sinai Medical Center, New York.

A retrospective analysis of various characteristics in 81 small cell lung cancer 
patients treated at the Mount Sinai Medical Center, New York, from 1974 to 1982
was carried out to identify factors which had prognostic significance for
long-term survival, defined as actual disease-free survival for at least 5 years 
from initiation of therapy. Six patients, five female patients (16.7%) and one
male patient (2%), including four limited disease (9.7%) and two extensive
disease patients (5%) were long-term survivors (73 to 96+ months from onset of
therapy), and among them three remain alive and disease-free at 84, 84, and 96
months from first treatment, respectively. Although several factors, including
sex, stage of disease (limited versus extensive), and occurrence of herpes zoster
predicted overall survival duration, female sex and an occurrence of herpes
zoster were the only variables which were statistically significantly related to 
5-year survival. Herpes zoster was a relatively late occurrence whereas female
sex was an independent positive prognostic factor.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2164438 [PubMed - indexed for MEDLINE]

5916: Br J Cancer. 1990 Jul;62(1):105-8.

Full dose chemotherapy in elderly patients with non-Hodgkin's lymphoma: a
feasibility study using a mitoxantrone containing regimen.

Sonneveld P, Michiels JJ.

Department of Haematology, University Hospital Rotterdam Dijkzigt, The
Netherlands.

A prospective study was performed to evaluate the feasibility of full dose
chemotherapy given on schedule in elderly patients with unfavourable
non-Hodgkin's lymphoma, stage IE, III and IV. Using a combination regimen of six 
courses of cyclophosphamide, mitoxantrone, vincristine and prednisone (CNOP)
given every 4 weeks, no serious toxicity was encountered in a group of 30
consecutive patients with a mean age of 70.4 years. A 60% complete response rate 
was observed and a total response rate of 90%. The disease-free survival of
complete responders was 50% at 1 year. The overall survival was also 50% at 1
year. In 148 courses of CNOP only two serious infectious episodes were noted,
i.e. one herpes zoster infection and one case of bronchopneumonia. Asymptomatic
transient thrombocytopenia and granulocytopenia were commonly observed. Nadirs of
white blood cells were WHO grade 1, 2, 3 and 4 in six, five, twelve and two
patients respectively and nadirs of thrombocytopenia were WHO grade 0 and 1 (22
patients) or 2 (three patients). Based on low white blood cell counts, a delay of
1 week before administration of the next course of CNOP was necessary in 7% of
the courses. No dose reductions were applied. Toxicity other than transient
granulocytopenia was minor and consisted of alopecia and nausea. WHO grade 0-2.
CNOP related toxicity was never a reason to stop treatment. It is concluded that 
CNOP chemotherapy without initial dose reduction in elderly patients with
intermediate and high grade malignant non-Hodgkin's lymphoma is feasible and that
no major toxicity is observed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2390469 [PubMed - indexed for MEDLINE]

5917: Am J Nurs. 1990 Jul;90(7):15-6.

Clues: pain, burning, and itching.

Cuzzell JZ.

PMID: 2363451 [PubMed - indexed for MEDLINE]

5918: Cancer. 1990 Jul 1;66(1):75-9.

Radiation therapy in the management of bulky mediastinal Hodgkin's disease.

Behar RA, Hoppe RT.

Department of Radiation Oncology, Stanford University Medical Center, CA 94305.

From July 1981 to July 1985, 20 patients with bulky mediastinal Hodgkin's Disease
(maximum mediastinal width divided by the maximum intrathoracic diameter for a
mediastinal mass ratio (MMR) greater than 0.33 were treated at Stanford
University with definitive radiation therapy alone. The majority of these
patients were selected to receive radiation therapy because they had the more
favorable characteristics of minimal extralymphatic involvement, mediastinal
masses that were superior and central in location, and a MMR less than or equal
to 0.50. All 20 patients were laparotomy staged, and 17 received some radiation
to the mantle before laparotomy. Seventeen patients had pathologic stage (PS) II 
disease (13 PS IIA, 4 PS IIB), two had PS IIISA, and one had PS IB. Eleven
patients (55%) had extralymphatic involvement. All patients were irradiated to
the mantle field using a shrinking field technique (mediastinal dose, 4400 to
5500 cGy, mean 4990 cGy). After completion of the mantle, all patients with good 
clinical responses received infradiaphragmatic radiation. Treatment complications
included two cases of mild radiation pneumonitis, five of hypothyroidism, five of
localized Herpes zoster, one of amenorrhea, one of non-Hodgkin's lymphoma, and
one of sepsis. Four patients relapsed. All had an intrathoracic component to
their failure. All four patients were salvaged with MOP(P) chemotherapy and are
currently alive and free of disease. For the entire group, the actuarial freedom 
from relapse is 80% at 7 years and the survival is 100%. Median follow-up time is
67 months. The authors conclude that radiation therapy alone is effective in the 
management of selected patients with Hodgkin's disease who have extensive
mediastinal involvement, even when the MMR exceeds 1/3.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2354412 [PubMed - indexed for MEDLINE]

5919: Jpn J Med. 1990 Jul-Aug;29(4):397-8.

Guillain Barre syndrome following herpes zoster: a case report and review of
literature.

Rabbani MU, Gupta D.

Department of Medicine, Jawaharlal Nehda Medical College, Aligarh Muslim
University, New Delhi.

Herpes zoster is known to exhibit various neurological complications. Guillain
Barre syndrome following herpes zoster is rare and only 25 cases have been
reported to date. In this report, a case is presented and the pertinent
literature is reviewed.

Publication Types: 
    Case Reports

PMID: 2273623 [PubMed - indexed for MEDLINE]

5920: Nippon Jinzo Gakkai Shi. 1990 Jul;32(7):791-9.

[Effect of methylprednisolone pulse therapy in patients with lupus nephritis
assessed by WHO morphologic classification]

[Article in Japanese]

Makino H, Yamasaki Y, Hayashi Y, Haramoto T, Shikata K, Kumagai I, Taniai K,
Takahashi K, Ota Z.

Third Department of Medicine, Okayama University Medical School.

To determine indications for treatment with high-dose intravenous
methylprednisolone pulse therapy in lupus nephritis, we retrospectively assessed 
the response to pulse therapy over oral prednisolone administration in 120 biopsy
proven lupus nephritis patients according to WHO morphologic classification. In
the pulse group, 1 g of methylprednisolone was administered on three consecutive 
days and oral steroid therapy (40-30 mg) was started. In many occasions in
treating class III and IV-b, repeated pulse therapy was performed. In control
oral prednisolone group, middle-dose steroid therapy (50-30 mg) was started. In
patients with minor glomerular abnormalities and mesangial lupus nephritis, rapid
improvement of serological activities was observed in pulse group assessed by
serum complement level, anti-DNA antibodies, and anti-nuclear antibodies. In
patients with focal lupus nephritis, rapid rise in serum complement level and
fall in proteinuria was observed in the pulse group. In patients with diffuse
proliferative lupus nephritis with active necrotizing lesions, faster rise in
serum complement level and proteinuria were observed in the pulse group. In
patients with membranous lupus nephritis there was no significant difference
between two groups. In comparison with the effect of pulse therapy among each
morphologic class, the rise of serum complement level was slowest in class IV-b. 
Both group of IV-b and V manifested nephrotic syndrome and by pulse therapy the
decrease in urinary protein was faster and more significant in class IV-b
compared with class V. No significant adverse effect of methylprednisolone was
observed during about 150 times of pulse therapy. Bacterial, viral infections
such as herpes zoster and fungal infections were observed in pulse group as often
as control group.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2273595 [PubMed - indexed for MEDLINE]

5921: Vrach Delo. 1990 Jul;(7):71-4.

[Nervous system involvement in herpes zoster (a review of the literature)]

[Article in Russian]

Andreichin MA, Savchak VI, Turkot LA.

Publication Types: 
    Review

PMID: 2238605 [PubMed - indexed for MEDLINE]

5922: East Afr Med J. 1990 Jul;67(7):522-6.

Herpes Zoster Ophthalmicus in a child with acquired immune deficiency syndrome.

Awan HR, Adala HS.

Department of Surgery, College of Health Sciences, University of Nairobi.

A case is described of an 8 year old child who presented with Herpes Zoster
Ophthalmicus involving the left eye. He had a positive history of pulmonary
tuberculosis, repeated hospital admissions and blood transfusion. He was
confirmed to have Acquired Immune Deficiency Syndrome. During the course of his
followup, he developed cotton-wool spots and perivasculitis in the right eye. The
mother was found to be seropositive while the father was seronegative.

Publication Types: 
    Case Reports

PMID: 2226233 [PubMed - indexed for MEDLINE]

5923: J Cardiovasc Surg (Torino). 1990 Jul-Aug;31(4):531-2.

Disseminated cutaneous herpes zoster following cardiac surgery.

Dirbas FM, Swain JA.

Surgery Branch, National Heart, Lung and Blood Institute, Bethesda, MD.

Our case report describes disseminated cutaneous Herpes Zoster in the early
post-operative period following cardiac surgery with cardiopulmonary bypass. This
has not been reported previously in the absence of immunosuppressive therapy.
Despite associated neurologic and respiratory impairment, our patient was treated
successfully with intravenous Acyclovir and subsequently discharged.

Publication Types: 
    Case Reports

PMID: 2211810 [PubMed - indexed for MEDLINE]

5924: Br J Clin Pract. 1990 Jul;44(7):284-5.

Zoster sine herpete.

Rudra T.

Princess of Wales Hospital.

A 61-year-old man presented with acute facial pain and subsequently developed the
rash of herpes zoster in a distal dermatome. Treatment with acyclovir was
commenced before development of the rash. The atypical presentation and the
benefits of early diagnosis and treatment are discussed.

Publication Types: 
    Case Reports

PMID: 2206828 [PubMed - indexed for MEDLINE]

5925: Pediatr Neurol. 1990 Jul-Aug;6(4):279-81.

Varicella with delayed hemiplegia.

Ichiyama T, Houdou S, Kisa T, Ohno K, Takeshita K.

Division of Child Neurology, Tottori University School of Medicine, Yonago,
Japan.

We report 4 children who developed acute hemiplegia 7 weeks to 4 months after
varicella infection. In 2 patients, carotid angiography demonstrated segmental
narrowing and occlusion of the middle cerebral artery. Their clinical and
angiographic features were similar to those associated with contralateral
hemiplegia after herpes zoster ophthalmicus, the pathogenesis of which comprises 
cerebral angiitis due to varicella zoster viral infection. We believe that our
patients had the same pathogenesis. In a survey of infectious diseases in our
region, the frequency of varicella with delayed hemiparesis was roughly 1:6,500
varicella patients.

Publication Types: 
    Case Reports

PMID: 2206164 [PubMed - indexed for MEDLINE]

5926: Ear Nose Throat J. 1990 Jul;69(7):451-3.

Otologic disease in the acquired immunodeficiency syndrome.

Morris MS, Prasad S.

Department of Otolaryngology-Head and Neck Surgery, Georgetown University School 
of Medicine, Washington, DC.

It appears that true otologic manifestations of AIDS are rare and that incidental
otologic disease associated with AIDS is more common. A review of the literature 
revealed that otitis externa, acute otitis media, recurrent acute otitis media,
otitis media with effusion, chronic suppurative otitis media with cholesteatoma, 
and herpes zoster oticus may all represent incidental otologic disease occurring 
in patients with AIDS. Chronic otitis media without cholesteatoma (P
carinii-infected aural polyps), sensorineural hearing loss, acceleration of
otosyphilis from the latent stage, and development of Kaposi's sarcoma of the
external auricle or nasopharynx may represent true otologic manifestations of
AIDS.

Publication Types: 
    Review

PMID: 2205469 [PubMed - indexed for MEDLINE]

5927: Z Hautkr. 1990 Jul;65(7):640-4.

[Skin manifestations in patients with HIV infection]

[Article in German]

Eichmann A.

Stadtische Poliklinik fur Haut- und Geschlechtskrakheiten Zurich.

Cutaneous manifestations are common in patients with HIV infection and mainly due
to the immunodeficiency. In the initial stage of HIV infection, we frequently
observe a rash of macular lesions. During the asymptomatic phase, the patients
may typically show the following skin diseases: seborrhoic dermatitis, acneiform 
folliculitis, persistent herpes simplex, and infections with the human papilloma 
virus. In ARC and AIDS patients, 3 groups of skin disorders are found: cutaneous 
infections, skin tumors, and other mixed skin diseases. Herpes simplex and herpes
zoster may develop into ulcerating and necrotising forms especially in patients
with advanced immunodeficiency. The most frequent skin tumors in AIDS patients
are the disseminated Kaposi's sarcoma and non-Hodgkin's lymphoma. More than 50%
of the AIDS patients treated with trimethoprim/sulfamethoxazole developed a
severe drug eruption. African and Caribbean patients with AIDS frequently suffer 
from pruritic skin lesions, the pathogenesis of which is not known. Aside from
these cutaneous manifestations, a variety of other skin disorders have been
reported in patients with HIV infection, ARC, or AIDS; future research will
furnish definite proof whether they are correlated with HIV infection.

Publication Types: 
    English Abstract
    Review

PMID: 2205061 [PubMed - indexed for MEDLINE]

5928: Blood. 1990 Jul 1;76(1):235-44.

T-cell-depleted autologous bone marrow transplantation therapy: analysis of
immune deficiency and late complications.

Anderson KC, Soiffer R, DeLage R, Takvorian T, Freedman AS, Rabinowe SL, Nadler
LM, Dear K, Heflin L, Mauch P, et al.

Division of Tumor Immunology, Dana-Farber Cancer Institute, Boston, MA 02115.

Fourteen patients with T-cell-derived leukemia and lymphoma underwent high-dose
chemoradiotherapy and anti-T-cell monoclonal antibody-treated autologous bone
marrow transplantation (ABMT). All patients were either in sensitive relapse or
had adverse prognostic features, and five patients had a history of bone marrow
involvement with disease. Patients received a median of 2 (1 to 3) prior
chemotherapy regimens; 10 patients received local radiotherapy. After high-dose
ablative therapy, greater than 500/mm3 granulocytes and greater than 20,000
untransfused platelets/mm3 were noted at a median of 23 (13 to 48) and 26 (15 to 
43) days post-ABMT, respectively. Natural killer (NK) cells, T cells
(predominantly T8+), and monocytes were noted within the first 1 to 2 months
post-AMBT, as seen in other series. Disease-free survival was a median of 10.1
months, 5.9 months for patients with T acute lymphoblastic leukemia or
lymphoblastic lymphoma and 25.6 months for patients with T non-Hodgkin's lymphoma
(NHL). Toxicities were common and severe. Thirty-six percent of patients
developed bacteremias early post-BMT. Late complications included a skin rash
consistent with graft versus host disease; infections with Herpes zoster,
hepatitis, and Pneumocystis carinii; and the development of Epstein-Barr virus
associated lymphoproliferative syndrome. Our findings suggest that patients who
have undergone T-depleted ABMT have a profound immunodeficiency not reflected in 
the phenotypic reconstitution of the T and NK cells. Characterization of the
functional deficiency may facilitate the development of methods to reduce the
long-term toxicity of AMBT in these patients.

PMID: 2194591 [PubMed - indexed for MEDLINE]

5929: J Neuroimmunol. 1990 Jul;28(2):111-8.

Fine specificities of antibodies in sera and cerebrospinal fluid in herpes virus 
infections of the central nervous system as detected by the antigen variable
immunoblot technique.

Neumann B, Ritter K, Felgenhauer K.

Department of Neurology, University of Gottingen, F.R.G.

Applying the immunoblot technique a sensitive and specific method was developed
for the detection of intrathecally synthesized antibodies against individual
specific proteins that are antigens of various infectious agents causing
encephalitis. Paired serum and cerebrospinal fluid (CSF) samples from five
patients with herpes virus infections of the central nervous system (CNS) (three 
herpes simplex virus encephalitis, one varicella zoster virus encephalitis, one
zoster ganglionitis) were investigated for the presence of locally produced IgG
against the electrophoretically separated antigens of herpes simplex virus (HSV),
varicella zoster virus (VZV) and human cytomegalovirus (HCMV), as well as for IgM
antibodies in one case of HSV encephalitis. In two cases (HSV encephalitis and
VZV encephalitis) four and one antibody, respectively, were found that were
synthesized intrathecally only. In the other cases the patterns of sera and CSF
antibodies were similar, the CSF antibodies showing an all-over stronger
reaction, at identical IgG concentrations. In contrast to the conception of a
'limited heterogeneity' of intrathecal antibody synthesis in encephalitis, we
thus found an 'expanded heterogeneity' of the intrathecally synthesized
antibodies in comparison to the corresponding serum antibodies.

Publication Types: 
    Case Reports

PMID: 2163408 [PubMed - indexed for MEDLINE]

5930: Contact Dermatitis. 1990 Jul;23(1):43-5.

Allergic contact dermatitis from idoxuridine.

Senff H, Engelmann L, Kunze J, Hausen BM.

Department of Dermatology, St. Barbara-Hospital, Duisburg, FRG.

Publication Types: 
    Case Reports

PMID: 2144808 [PubMed - indexed for MEDLINE]

5931: AJNR Am J Neuroradiol. 1990 Jul-Aug;11(4):735-41.

Contrast-enhanced MR imaging of the facial nerve in 11 patients with Bell's
palsy.

Tien R, Dillon WP, Jackler RK.

Department of Radiology, University of California, San Francisco 94143.

Contrast-enhanced MR images (at 1.5 T) were obtained in 11 patients with facial
palsy. The group included five people with acute idiopathic facial (Bell's)
palsy, three with chronic idiopathic facial palsy, and one each with acute facial
palsy after local radiation therapy, acute facial palsy resulting from herpes
zoster virus infection, and facial palsy caused by facial neuroma. Eight of the
11 patients demonstrated marked enhancement of the affected facial nerve from the
labyrinthine portion through the descending canal. Three patients also
demonstrated mild enhancement of the distal canalicular portion of the facial
nerve, simulating small distal acoustic neuromas. No difference in the pattern of
enhancement between the acute or chronic Bell's palsy patients was seen.
Radiographic resolution appeared to lag behind clinical resolution. The facial
neuroma appeared distinct from the other lesions as a focally enhancing mass. The
enhancement pattern in the Bell's group correlated with the histopathologic
features of Bell's palsy and is consistent with the viral hypothesis of the
syndrome. Thin-section contrast-enhanced MR scans are recommended for individuals
with atypical presentation of facial paralysis. In the proper clinical setting,
contrast-enhanced MR imaging may permit a positive radiographic diagnosis of
Bell's palsy, which has previously been a diagnosis of exclusion.

PMID: 2114760 [PubMed - indexed for MEDLINE]

5932: Virus Genes. 1990 Jul;4(2):105-20.

In-vitro synthesis of functional varicella zoster and herpes simplex viral
thymidine kinase.

Mahalingam R, Cabirac G, Wellish M, Gilden D, Vafai A.

Department of Neurology, University of Colorado Health Sciences Center, Denver
80262.

The varicella zoster virus (VZV) and herpes simplex virus type 1 (HSV-1)
thymidine kinase (TK) genes were cloned into the transcription vector pGEM4.
In-vitro translation (ivt) of RNA transcribed from these genes showed prominent
expression of functional TK proteins with the expected molecular weights of 36 kD
for VZV and 43, 39, and 38 kD for HSV-1. The TK proteins were recognized by
rabbit anti-VZV and anti-HSV-1 antibodies, respectively. Analysis of the ivt
products by thin-layer chromatography revealed the conversion of thymidine to its
phosphorylated forms (TMP, TDP, and TTP) by both the VZV and HSV-1 TK genes. The 
estimated specific activities of the in-vitro translated VZV and HSV-1 TKs were
comparable. VZV TK templates were linearized at internal restriction sites and
RNAs transcribed from these templates directed the synthesis of polypeptides with
sizes consistent with the colinearity of the VZV TK gene. Deletion of 107 amino
acids at the carboxy terminus of the VZV TK gene abolished the in-vitro TK
activity. In addition, immunoprecipitation of truncated proteins synthesized in
vitro suggested the possible involvement of the region between amino acid
residues 101 and 168 from the amino terminus of the VZV TK molecule in the
formation of structures necessary for antigenicity.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1698324 [PubMed - indexed for MEDLINE]

5933: Rev Prat. 1990 Jun 21;40(18):1656-9.

[The other types of viral hepatitis]

[Article in French]

Miguet JP, Coaquette A, Bresson-Hadni S, Lab M.

Service d'hepatologie, CHU Jean-Minjoz, Besancon.

Hepatitis due to viruses other than A, B, C, D, E are numerous but uncommon in
adults. Among the group of Herpesviridae (HSV, CMV, EBV, VZV), clinical hepatitis
is usually suggestive of disseminated viral infection. Fulminant hepatitis
occasionally observed in immunocompromised hosts are due to HSV, and VZV, but
exceptionally to EBV. Many new techniques using specific monoclonal antibodies
permit an accurate and fast diagnosis. Three drugs (vidarabine, acyclovir,
ribavirine) have been shown to be efficient in the treatment of severe forms of
the disease. Hepatitis due to exotic viruses (Amaril, Ebola, Lassa) are
exceptional in France, but require specific prophylactic measures.

Publication Types: 
    English Abstract

PMID: 2164704 [PubMed - indexed for MEDLINE]

5934: Lancet. 1990 Jun 16;335(8703):1460-1.

Comment on:
    Lancet. 1990 May 5;335(8697):1100-1.

Varicella and zoster in hospitals.

[No authors listed]

Publication Types: 
    Comment
    Letter

PMID: 1972230 [PubMed - indexed for MEDLINE]

5935: Ned Tijdschr Geneeskd. 1990 Jun 2;134(22):1105-6.

[The treatment of post-herpetic neuralgia using capsaicin ointment]

[Article in Dutch]

van Horssen N.

Publication Types: 
    Letter

PMID: 2352566 [PubMed - indexed for MEDLINE]

5936: Ned Tijdschr Geneeskd. 1990 Jun 2;134(22):1080-4.

[Herpes zoster and acyclovir in normal and deficient general immunity, also that 
due to AIDS]

[Article in Dutch]

van Joost T.

Academisch Ziekenhuis Rotterdam-Dijkzicht, afd. Dermatologie en Venereologie,
Rotterdam.

Publication Types: 
    Review

PMID: 2191225 [PubMed - indexed for MEDLINE]

5937: Ital J Neurol Sci. 1990 Jun;11(3):297-300.

MRI evaluation of a case of herpes zoster ophthalmicus with delayed contralateral
hemiplegia.

Cavaletti G, Bogliun G, Tagliabue M.

Clinica Neurologica, Ospedale S. Gerardo dei Tintori, Monza, Milano.

We report the case of a patient affected by contralateral hemiplegia during
herpes zoster ophthalmicus (HZO) evaluated both with serial CT scans and with
MRI. We suggest that MRI examination of patients affected by HZO could be useful 
for the detection of early signs of cerebral arterial damage which are not yet
clinically and radiologically apparent.

Publication Types: 
    Case Reports

PMID: 2387702 [PubMed - indexed for MEDLINE]

5938: Ear Nose Throat J. 1990 Jun;69(6):416-9, 422-3.

Head and neck manifestations of the acquired immunodeficiency syndrome in
children.

Chow JH, Stern JC, Kaul A, Pincus RL, Gromisch DS.

Department of Pediatric Infectious Diseases, New York Medical College (Lincoln
Hospital), NY.

The head-and-neck manifestations of HIV infection in children are very different 
from those in the adult population. Recurrent bacterial and viral infections are 
common manifestations, and persistent sinusitis or otitis media should make the
otolaryngologist suspicious of HIV infection if the child has been exposed to the
virus. Other common problems include mucocutaneous and esophageal candidiasis,
recurrent herpes I and II and zoster infections, parotid swelling, and cervical
lymphadeopathy.

Publication Types: 
    Review

PMID: 2198161 [PubMed - indexed for MEDLINE]

5939: J Am Dent Assoc. 1990 Jun;120(6):679-81.

Diagnosis and treatment of orofacial herpes zoster: report of cases.

McKenzie CD, Gobetti JP.

Oral Medicine/Diagnosis Clinic, University of Michigan School of Dentistry, Ann
Arbor 48109-1078.

Herpes zoster is considered a disease of elderly or immunocompromised patients.
These cases are unusual since clinical signs of the disease occurred in two
healthy, young adults. Various diagnostic and treatment considerations for herpes
zoster infections are presented.

Publication Types: 
    Case Reports
    Review

PMID: 2191025 [PubMed - indexed for MEDLINE]

5940: Arch Ophthalmol. 1990 Jun;108(6):782-3.

Herpes zoster optic neuritis in human immunodeficiency virus infection.

Litoff D, Catalano RA.

Publication Types: 
    Case Reports

PMID: 2190546 [PubMed - indexed for MEDLINE]

5941: Am Fam Physician. 1990 Jun;41(6):1729-42.

Dermatologic manifestations of HIV infection.

Berger TG, Obuch ML, Goldschmidt RH.

San Francisco General Hospital, California.

Nearly all patients infected with the human immunodeficiency virus (HIV) will
develop cutaneous or mucous membrane manifestations. Oral cavity lesions
associated with HIV disease include candidiasis, hairy leukoplakia and Kaposi's
sarcoma. Skin infections such as herpes simplex, herpes zoster, molluscum
contagiosum, Staphylococcus aureus folliculitis and warts are often more severe
than usual and may be refractory to therapy. Seborrheic dermatitis is the most
common cutaneous eruption. The appearance of Kaposi's sarcoma in a patient
younger than 60 years of age or in any individual with laboratory evidence of HIV
infection is diagnostic of acquired immunodeficiency syndrome. Serious drug
reactions may occur, despite the depressed cellular immunity associated with HIV 
infection.

Publication Types: 
    Review

PMID: 2190455 [PubMed - indexed for MEDLINE]

5942: Nippon Jibiinkoka Gakkai Kaiho. 1990 Jun;93(6):920-4.

[Detection of herpes simplex virus, varicella zoster virus and cytomegalovirus in
aphthous stomatitis]

[Article in Japanese]

Ogawa H, Kazuyama Y, Hashiguchi K.

E.N.T. Clinic, Kitasato Institute Hospital, Tokyo.

Attempts were made to demonstrate herpes simplex virus (HSV) type 1 and type 2,
varicella zoster virus (VZV) and cytomegalovirus (CMV) in specimens obtained from
aphthous ulceration lesions by the immunofluorescent method using
fluorescein-labeled monoclonal antibodies. HSV-1 and VZV were detected in 2 and 4
out of 30 patients, respectively. Although almost all viruses that can infect the
oral cavity could occasionally cause stomatitis, neither HSV-2 nor CMV was not
found in this study. VZV was detected in 1 out of 8 patients with recurrent
aphthous ulceration. After treatment with acyclovir, the patient's symptoms has
become less severe and recurrence rates of attacks reduced, however, the patient 
has not been totally free of the disease. There were no differences in clinical
aspects of stomatitis between the patients with and without viral isolation.
Further clinical investigation is encouraged to confirm the relationship between 
aphthous stomatitis and viral infection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2170607 [PubMed - indexed for MEDLINE]

5943: AIDS. 1990 Jun;4(6):577-9.

Emergence of acyclovir-resistant varicella zoster virus in an AIDS patient on
prolonged acyclovir therapy.

Linnemann CC Jr, Biron KK, Hoppenjans WG, Solinger AM.

Department of Medicine, University of Cincinnati College of Medicine, Ohio
45267-0560.

We demonstrate for the first time the appearance of acyclovir resistance in
serial varicella zoster isolates from a patient treated with acyclovir. We
recovered varicella zoster virus three times over a period of 5 months from the
skin lesions of this patient with AIDS who was treated with three courses of
intravenous acyclovir and prolonged low-dose oral acyclovir. The isolate
recovered from a typical zoster lesion before acyclovir, and one obtained from a 
hyperkeratotic lesion 2 months later, after intravenous and oral acyclovir, were 
sensitive to acyclovir and produced normal amounts of thymidine kinase. In
contrast, virus recovered from lesions 5 months after the onset, when the patient
had received repeated courses of acyclovir, was acyclovir-resistant and
thymidine-kinase-deficient. Resistance to acyclovir was associated with
persistence of lesions which failed to improve with intravenous acyclovir, but
was not associated with new lesion formation.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 2167103 [PubMed - indexed for MEDLINE]

5944: Virus Res. 1990 Jun;16(2):195-210.

Monoclonal antibody to immediate early protein encoded by varicella-zoster virus 
gene 62.

Forghani B, Mahalingam R, Vafai A, Hurst JW, Dupuis KW.

Viral and Rickettsial Disease Laboratory, California State Department of Health
Services, Berkeley 94704.

Monoclonal antibodies (mAbs) were prepared against varicella-zoster virus
(VZV)-infected cell proteins, and 10 mAbs which reacted with nuclear antigens
were selected. These mAbs recognized a major 175-180 kDa and three minor
VZV-specific phosphoprotein species. Immunofluorescence staining of VZV-infected 
cells showed that the 175-180 kDa protein was synthesized within 6 h after
infection. The synthesis of this protein was inhibited by cycloheximide (CH);
however, reversal of CH treatment and addition of actinomycin D (ActD) resulted
in the synthesis of the 175-180 kDa protein. To determine whether the 175-180 kDa
protein seen in the infected cells is encoded by VZV immediate early (IE) gene
62, the predicted open reading frames of VZV genes 61 and 62 were cloned into
pGEM transcription vectors. RNA was transcribed from each gene, translated in
vitro and immunoprecipitated with a mAb which recognizes a major 175-180 kDa and 
three minor proteins. The reactivity of the in vitro translation products encoded
by gene 62 with this mAb suggested that the 175-180 kDa protein is encoded by VZV
IE gene 62.

PMID: 2166981 [PubMed - indexed for MEDLINE]

5945: Pathol Biol (Paris). 1990 Jun;38(5 ( Pt 2)):568-71.

[Acyclovir and specific anti-varicella-herpes zoster immunoglobulins in the
treatment of varicella-zoster virus infection in 113 adults]

[Article in French]

Senneville E, Chidiac C, Brouillard M, Beuscart C, Leroy O, Sivery B, Beaucaire
G, Mouton Y.

Service Regional des Maladies Infectieuses, Centre Hospitalier, Tourcoing.

From January 1978 to December 1988, 54 males and 59 females were treated for
varicella, zoster and disseminated zoster by varicella-zoster immunoglobulin
(group I) or acyclovir (group II). 67 patients had immune deficiency disease.
Treatment was successful for 92/100 patients in group I and for 100/100 patients 
in group II. Thrombophlebitis and renal failure were observed in group II and
regressed when acyclovir was stopped. Varicella-zoster immunoglobulin and
acyclovir are two effective therapeutics in the treatment of varicella and zoster
in adults including immunocompromised patients. The use of acyclovir could not
reduce the duration of hospitalization.

Publication Types: 
    English Abstract

PMID: 2166935 [PubMed - indexed for MEDLINE]

5946: J Clin Microbiol. 1990 Jun;28(6):1469-72.

Microplate hybridization of amplified viral DNA segment.

Inouye S, Hondo R.

Department of Microbiology, University of Tokyo, Japan.

We have developed a simple hybridization method for a DNA segment which is
amplified by the polymerase chain reaction: after heat denaturation, the
amplified DNA segment with a length of more than 300 bases is adsorbed to
microplate wells in the presence of 1.5 M NaCl or 0.5 M ammonium sulfate; the
immobilized DNA is hybridized with a biotin-labeled DNA probe; then, the
hybridization signal is detected by streptavidin-conjugated beta-galactosidase or
peroxidase. This method has several advantages over the conventional dot blot
hybridization method: (i) radioisotopes are not used, (ii) synthetic
oligonucleotide for the probe is not needed, (iii) the time required for washing 
of the solid phase is greatly reduced, and (iv) the baking and prehybridization
procedures are eliminated. By this method, we were able to detect viral genomes
in vesicle specimens from patients infected with varicella-zoster virus.

PMID: 2166086 [PubMed - indexed for MEDLINE]

5947: Hematol Oncol Clin North Am. 1990 Jun;4(3):603-23.

Viral infections associated with bone marrow transplantation.

Zaia JA.

Division of Pediatrics, City of Hope National Medical Center, Duarte, California.

Bone marrow transplantation is complicated by a sequential occurrence of viral
infections, the predictability of which influences disease management. Among
these infections are herpes simplex virus, cytomegalovirus, varicella zoster
virus, Epstein-Barr virus, respiratory viral infections, hepatitis viral
infections, and gastrointestinal infections. The approach to the treatment and
prevention of these infections is discussed.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2162815 [PubMed - indexed for MEDLINE]

5948: J Gen Virol. 1990 Jun;71 ( Pt 6):1379-85.

Two binding sites for the herpes simplex virus type 1 UL9 protein are required
for efficient activity of the oriS replication origin.

Weir HM, Stow ND.

Medical Research Council Virology Unit, Institute of Virology, Glasgow, U.K.

Two sites within the short region origin of DNA replication (oriS) in herpes
simplex virus type 1 (HSV-1) which bind the product of the UL9 gene have
previously been identified. One of these sites (site I) contains an 11 bp
sequence which is also present in oriS of varicella-zoster virus, and the other
(site II) includes a related element differing in two positions. A third sequence
(motif III), which lies close to binding site I, differs from the site I element 
at only a single position. We have deleted specifically each of these three 11 bp
sequences from within functional copies of HSV-1 oriS and have examined the
effects on origin activity and binding of the UL9 protein. Gel retardation
analyses confirmed the important roles of the regions deleted from sites I and II
in interacting with the UL9 protein. In transient replication assays, copies of
oriS lacking the site I or II elements exhibited undetectable or residual (4 to
8%) activity respectively. The UL9 protein did not bind to motif III even in the 
absence of site I sequences, although removal of the motif III sequence caused a 
small reduction in oriS activity. A single base change which converted the
sequence within binding site I to that of motif III was sufficient to abolish
both the interaction of the UL9 gene product at this locus and the replicative
ability of oriS. Therefore, interaction of the UL9 protein with binding site I is
essential for origin activity, but the presence of binding site II is also
required for efficient replication.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2161905 [PubMed - indexed for MEDLINE]

5949: J Gen Virol. 1990 Jun;71 ( Pt 6):1365-72.

Murine herpesvirus 68 is genetically related to the gammaherpesviruses
Epstein-Barr virus and herpesvirus saimiri.

Efstathiou S, Ho YM, Hall S, Styles CJ, Scott SD, Gompels UA.

Department of Pathology, University of Cambridge, U.K.

Short nucleotide sequence analysis of seven restriction fragments of murine
herpesvirus 68 (MHV-68) DNA has been undertaken and used to determine the overall
genome organization and relatedness of this virus to other well characterized
representatives of the alpha-, beta- and gammaherpesvirus subgroups. Nine genes
have been identified which encode amino acid sequences with greater similarity to
proteins of the gammaherpesvirus Epstein-Barr virus (EBV) than to the homologous 
products of the alphaherpesviruses varicella-zoster virus and herpes simples
virus type 1 or the betaherpesvirus human cytomegalovirus. In addition, the
genome organization of MHV-68 is shown to have an overall collinearity with that 
of the gammaherpesviruses EBV and herpesvirus saimiri. In common with these
viruses, dinucleotide frequency analysis of MHV-68 coding sequences reveals a
marked reduction in CpG dinucleotide frequency thus implicating a dividing cell
population as the site of latency in vivo.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2161903 [PubMed - indexed for MEDLINE]

5950: Ann Otol Rhinol Laryngol. 1990 Jun;99(6 Pt 1):461-5.

Detection of specific IgA antibodies to varicella zoster virus in serum of
patients with Ramsay Hunt syndrome.

Hadar T, Tovi F, Sidi J, Sarov B, Sarov I.

Department of Otolaryngology and Head and Neck Surgery, Beilinson Medical Center,
Petah-Tiqva, Israel.

Varicella zoster virus (VZV)-specific IgG and IgA antibody titers were determined
in serial serum samples of 23 patients with Ramsay Hunt syndrome by the
immunoperoxidase assay. Varicella zoster virus-specific IgG antibodies were found
in the first serum samples of all the patients. In 80% of 20 patients in whom a
serum sample was available within 5 days after the onset of the disease.
VZV-specific IgA antibodies were detected. The second serum sample was
VZV-specific IgA-positive in all of the patients. While all the healthy age- and 
sex-matched control subjects had VZV-specific IgG antibodies, VZV-specific IgA
antibodies were detected in a low titer (dilution = 2) in only three of the
subjects. By using VZV-specific IgA antibody titers greater than or equal to 2
and greater than or equal to 4 by the immunoperoxidase assay as a "cutoff" for
younger and older patients with Ramsay Hunt syndrome, respectively, an early
diagnosis of the disease can be obtained in 89% of the younger and in 64% of the 
older patients by a single serum sample.

PMID: 2161635 [PubMed - indexed for MEDLINE]

5951: Zhonghua Er Bi Yan Hou Ke Za Zhi. 1990 Jun;25(3):142-4, 189-90.

[Decompression of geniculate ganglion of facial nerve]

[Article in Chinese]

Ge X.

Shanghai Sixth People's Hospital.

Decompression of geniculate ganglion of facial nerve in 20 cases of facial palsy 
caused by temporal bone fracture, herpes zoster otitic and Bell's palsy was
reported. Sixteen cases had been followed up for half to four years. Complete
recovery was observed in 13 cases and partial recovery in 3 cases.
Transmastoid-attical approach was used. The geniculate ganglion and the distal
part of the labyrinthine segment of the facial nerve could be exposed by this
approach. The authors emphasized the importance of decompression of the
geniculate ganglion, because of the anatomic characteristics and the pathologic
features. The indications, the surgical approach and the precautions during
operation were discussed.

Publication Types: 
    English Abstract

PMID: 2100537 [PubMed - indexed for MEDLINE]

5952: Lancet. 1990 May 26;335(8700):1279.

Acyclovir and post-herpetic neuralgia.

Freestone DS, Brigden WD.

Publication Types: 
    Clinical Trial
    Letter

PMID: 1971343 [PubMed - indexed for MEDLINE]

5953: JAMA. 1990 May 23-30;263(20):2750.

Fluphenazine and postherpetic neuralgia.

Hurtig HI.

Publication Types: 
    Letter

PMID: 2332917 [PubMed - indexed for MEDLINE]

5954: Vestn Oftalmol. 1990 May-Jun;106(3):24-7.

[Clinical aspects and methods of immunotherapy of ophthalmic herpes in bacterial 
sensitization]

[Article in Russian]

Maichuk IuF, Kazachenko MA, Mikuli SG, Murav'eva TV.

Publication Types: 
    Comparative Study

PMID: 2385898 [PubMed - indexed for MEDLINE]

5955: Kinderkrankenschwester. 1990 May;9(5):134-7.

[Exanthematic pediatric diseases .1]

[Article in German]

Peller P.

PMID: 2383495 [PubMed - indexed for MEDLINE]

5956: J Neurosci Res. 1990 May;26(1):83-9.

An in vivo model of varicella-zoster virus latent infection of dorsal root
ganglia.

Sadzot-Delvaux C, Merville-Louis MP, Delree P, Marc P, Piette J, Moonen G,
Rentier B.

Department of Microbiology-Virology, University of Liege, Belgium.

We describe here the first in vivo model of varicella-zoster virus (VZV) latent
infection in the adult rat peripheral nervous system. Infected Mewo cells were
injected subcutaneously along the spine of healthy adult rats. No clinical sign
of infection was observed even 9 months after inoculation. Humoral immune
response to VZV was detected in all infected animals throughout the study (9
months). The presence of viral material in dissociated and cultured dorsal root
ganglia (DRG) from inoculated animals was studied by immunoperoxidase and in situ
hybridization. When DRGs from infected animals were plated in culture from 1
month and up to 9 months after inoculation, viral nucleic acids and proteins were
detected in neurons. Furthermore, trypsinization and subcultivation of infected
neurons in culture is needed to reactivate infectious virus at least in some of
the neurons. This model provides a useful tool for studying 1) the molecular
mechanisms leading to an in vivo latency, 2) the role of the immune system, in
particular cellular immunity, on the establishment, maintenance, and reactivation
of latency, 3) the neurotropism of mutant viruses, and 4) the effects of
antiviral agents.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2359148 [PubMed - indexed for MEDLINE]

5957: Ann Otol Rhinol Laryngol. 1990 May;99(5 Pt 1):327-9.

Pathologic findings in the labyrinthine segment of the facial nerve in a case of 
facial paralysis.

Jackson CG, Johnson GD, Hyams VJ, Poe DS.

Otology Group, Nashville, Tennessee 37203.

The histopathologic findings for a patient with acute facial paralysis caused by 
herpes zoster oticus who obtained no return of active facial function after 1
year are presented. All imaging studies were nondiagnostic. Biopsy of the
labyrinthine segment was performed. Histopathologic analysis showed a sharp line 
of demarcation between sclerotic nerve proximal to and necrotic nerve distal to
the meatal foramen area of the fallopian canal. This finding is consistent with
observations that the lesion producing Bell's palsy and herpes zoster oticus
usually is situated at the meatal foramen.

Publication Types: 
    Case Reports

PMID: 2337309 [PubMed - indexed for MEDLINE]

5958: Am J Med. 1990 May;88(5):550-1.

Varicella zoster virus transverse myelitis without cutaneous rash.

Heller HM, Carnevale NT, Steigbigel RT.

State University of New York, Stony Brook.

Publication Types: 
    Case Reports

PMID: 2337114 [PubMed - indexed for MEDLINE]

5959: Laryngoscope. 1990 May;100(5):494-7.

Atypical findings in cephalic herpes zoster polyneuritis: case reports and
radiographic findings.

Golden LI, Deeb ZE, deFries H.

Department of Otolaryngology-Head and Neck Surgery, Georgetown University
Hospital, Washington, DC.

The purpose of this presentation is to report six patients who were seen because 
of multiple cranial nerve deficits occurring within a clinical picture of herpes 
zoster of the head and trunk. The clinical behavior, diagnostic methods,
treatment, and outcome of the patients in this series are reviewed. The vagus and
cochleovestibular nerves were affected in all of the patients. Three patients had
radiographic evidence of a mass in the nasopharyngeal region. Malignancies were
ruled out by repeated biopsies.

Publication Types: 
    Case Reports

PMID: 2329906 [PubMed - indexed for MEDLINE]

5960: Reg Anesth. 1990 May-Jun;15(3):113-7.

Interpleural analgesia in the treatment of severe thoracic postherpetic
neuralgia.

Reiestad F, McIlvaine WB, Barnes M, Kvalheim L, Haraldstad P, Pettersen B.

Department of Anesthesiology, University of Colorado Health Sciences Center,
Denver.

Effective, long-lasting pain relief was produced in 26 patients suffering from
severe thoracic postherpetic neuralgia by intermittent administration of local
anesthetics into the pleural space through a percutaneously placed interpleural
catheter. The duration of treatment varied from seven to 21 days. During this
period, 30 ml of 0.5% bupivacaine with epinephrine (5 micrograms/ml) were
injected every 24 hours. The injections were continued for three days after the
patients were pain free or had reached an analgesic plateau. All patients
achieved good to excellent pain relief. During a follow-up period of five to 15
months, their level of pain has not increased from the level achieved at the end 
of the treatment program.

PMID: 2265163 [PubMed - indexed for MEDLINE]

5961: Neurologia. 1990 May;5(5):151-4.

[Intrathecal secretion of antiviral antibodies in multiple sclerosis in patients 
in Seville]

[Article in Spanish]

Izquierdo G, Druetta E, Navarro G, Galan A, Borobio MV, Angulo S, Quesada MA,
Martinez-Parra C.

Servicio de Neurologia, Hospital Universitario, Sevilla.

To assess the presence of antiviral antibody synthesis in the cerebrospinal fluid
in patients with multiple sclerosis, concurrent plasma and spinal fluid
determination of antibody titers against measles, varicella-zoster, rubella,
mumps, cytomegalovirus, and herpes viruses were performed in 29 samples and were 
compared with a control group. The study revealed an increased titre of antiviral
antibodies in the spinal fluid in patients with multiple sclerosis. This
increased activity was markedly significant for the varicella-zoster and
cytomegalovirus in patients with clinical symptoms of multiple sclerosis. There
was also and increased antibody titre against cytomegalovirus and
varicella-zoster in patients with well defined illness. No antibody reaction was 
observed in the control group. The study of the antiviral antibody activity in
the spinal fluid in patients with multiple sclerosis is useful in the follow-up
control and in the diagnosis of the disorder specially in our community, where
the investigation of antibodies anti cytomegalovirus appears to be the most
appropriate method due to its high sensitivity and absence of false positive
tests.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 2169273 [PubMed - indexed for MEDLINE]

5962: J Dermatol. 1990 May;17(5):326-8.

Unusual varicella zoster virus infection in a patient with colon carcinoma and
Evans syndrome--delayed virus shedding generalized recurrent necrotic herpes
zoster.

Hata S, Tamaki T.

Department of Dermatology, Osaka Rosai Hospital, Japan.

A 53-year-old Japanese woman with Evans syndrome and colon cancer had two
episodes of herpes zoster. The first painful vesicular rashes involved the right 
lower abdomen and buttock and healed in one month. After one more month, a second
attack occurred on the right thigh and leg and developed into generalized
hemorrhagic lesions, which became crusted in about 90 days. The patient died 131 
days after the second attack, when the lesions had almost subsided.
Varicella-zoster virus (VZV) was isolated on the 59th day of the second attack.
Her intracutaneous reactions to VZV antigen was negative, but the humoral
antibodies were continuously positive.

Publication Types: 
    Case Reports

PMID: 2166097 [PubMed - indexed for MEDLINE]

5963: J Clin Pathol. 1990 May;43(5):416-9.

In situ hybridisation in herpetic lesions using a biotinylated DNA probe.

Dictor M, Renfjard E, Brun A.

Department of Pathology, University Hospital, Lund, Sweden.

In situ hybridisation was performed with a biotinylated DNA probe for herpes
simplex virus (HSV) using high temperature denaturation on formalin fixed,
paraffin wax sections of lung, brain, ganglion and keratinising and
non-keratinising squamous epithelia. Eosinophilic viral nuclear inclusions or
characteristically moulded multiple nuclei with altered chromatin, which were
present in two cases of HSV encephalitis and one case of viral pneumonitis, all
showed complete hybridisation visualised by an alkaline phosphatase/nitroblue
tetrazolium detector system. HSV encephalitis and trigeminal ganglionitis, which 
were confirmed serologically or clinicopathologically but lacked nuclear changes,
also gave positive dense nuclear signal in neurons, glias and satellite cells. No
staining was present in the ganglion cells in trigeminal zoster, the glia in
progressive multifocal leucoencephalopathy, or in a variety of cells in a lung
coinfected with cytomegalovirus. In 10 herpetic blisters of squamous epithelia,
infected cells hybridised strongly, while morphologically similar herpes zoster
lesions remained negative. In neural tissues non-hybridisation staining was most 
obtrusive in corpora amylacea and seemed to reflect nonspecific probe adherence. 
In squamous epithelium, major non-hybridisation staining was caused by probe and 
antibody possibly adhering to intracellular keratin. The HSV probe permits
specific detection of virus in the absence of characteristic nuclear changes and 
allows varicella zoster virus to be differentiated from HSV, provided that the
aforementioned problems with non-hybridisation staining are borne in mind.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2164533 [PubMed - indexed for MEDLINE]

5964: Mo Med. 1990 May;87(5):287-90.

Viral infection and HIV disease.

Bailey TC.

Department of Medicine, Washington University School of Medicine.

HIV-positive patients are at risk for a number of serious viral infections. The
author presents on overview of some common viral infections these patients are
susceptible to and stresses the importance of early diagnosis for appropriate
treatment.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2164135 [PubMed - indexed for MEDLINE]

5965: J Neurosci Res. 1990 May;26(1):90-7.

Acute and persistent varicella-zoster virus infection of human and murine
neuroblastoma cell lines.

Bourdon-Wouters C, Merville-Louis MP, Sadzot-Delvaux C, Marc P, Piette J, Delree 
P, Moonen G, Rentier B.

Department of Microbiology-Virology, University of Liege, Belgium.

Human and murine neuroblastoma cell lines were infected in vitro with
varicella-zoster virus (VZV). Infected human neuroblastoma cells (IMR-32)
supported the synthesis of abundant viral antigens as detected by indirect
immunoperoxidase labeling using human serum rich in anti-VZV antibodies and did
not survive the infection. In situ hybridization (ISH) with VZV-cloned probes
revealed a strong hybridization signal in these infected cells. During
cultivation, the virus was released in the culture medium, and viral polypeptides
were revealed by Western blotting of infected cells, using either a monoclonal
anti-gpI antibody or a rabbit antiserum. All these findings indicate that IMR-32 
cells support a productive and lytic infection by VZV, whether infected by
cell-free virus or by cocultivation with infected cells. Murine neuroblastoma
cells (neuro-2A) survived VZV infection and did not produce any infectious virus.
No VZV-specific proteins were detected in infected cells either by immunolabeling
or by Western blotting. However, viral nucleic acids could be detected by ISH,
indicating that mouse neuroblastoma cells displayed a nonproductive, nonlytic
infection. Infected neuro-2A cells have been examined by ISH using probes
corresponding to immediate early (IE) genes 4, 62, and 63 and late (L) gene 31
encoding gpII. A strong hybridization signal was detected when infected cells
were probed with a fragment containing the IE genes 62 and 63. Lower levels of
hybridization were detected with the other probes, corresponding to IE or L
genes. These systems allow comparative molecular analysis of persistent and acute
infection of nerve cells by VZV.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2162972 [PubMed - indexed for MEDLINE]

5966: Ann Otol Rhinol Laryngol. 1990 May;99(5 Pt 1):359-62.

Middle ear mucosa in Ramsay Hunt syndrome.

Fujiwara Y, Yanagihara N, Kurata T.

Department of Otolaryngology, Ehime University School of Medicine, Japan.

We report two patients with Ramsay Hunt syndrome, together with histopathologic
findings of the middle ear mucosa near the facial canal. An attempt was made to
find specific antigens of varicella zoster virus (VZV) and herpes simplex virus
(HSV) by an immunofluorescence method. Histopathologic examination revealed
inflammation of the middle ear mucosa. Specific VZV antigens were demonstrated in
the cytoplasm and nucleus of elliptically shaped cells and round cells, but no
specific antigens of HSV were found. The findings suggest a pathogenetic
relationship between VZV infection and inflammatory changes in the middle ear
mucosa.

Publication Types: 
    Case Reports

PMID: 2159753 [PubMed - indexed for MEDLINE]

5967: Rinsho Shinkeigaku. 1990 May;30(5):557-9.

[Measurement of gamma-interferon in sera and CSF in patients with multiple
sclerosis and inflammatory neurological diseases]

[Article in Japanese]

Hirayama M, Kiyosawa K, Nakazaki S, Fujiki N, Iida M.

Second Department of Internal Medicine, Fukui Medical School.

We examined whether gamma-interferon (gamma-IFN) can be detected in serum and CSF
of patients with multiple sclerosis and other inflammatory neurological diseases.
Gamma-IFN was assayed by solid phase radioimmunoassay on the forward sandwich
principle. In 7 serum samples in acute stage of multiple sclerosis without
corticosteroid, in 2 CSF samples in acute stage, gamma-IFN was not detected. In
stable stage there was no case with positive gamma-IFN. The patient with
tuberculous meningitis showed high titer in CSF but not in serum. One case with
herpes zoster meningitis, one case out of 2 aseptic encephalitis showed positive 
gamma-IFN in CSF. In one case with Vogt-Koyanagi-Harada disease, gamma-IFN was
detected both in serum and CSF. One case with Neuro-Behcet syndrome showed
positive gamma-IFN in CSF. No gamma-IFN was detected in 2 cases with
Guillain-Barre syndrome, one case with Crow-Fukase syndrome, Fisher syndrome, 2
cases with polymyosits. gamma-IFN in CSF was detected in meningitis and
encephalitis, but not in serum. This suggests that the locally infiltrating cells
produce gamma-IFN. However, we could not detect gamma-IFN in either CSF or serum 
of patients with multiple sclerosis. Negative results of gamma-IFN in patients
with multiple sclerosis can be interpreted in 2 ways. 1. The half life of
gamma-IFN is very short in vivo, and the level of gamma-IFN may not be detected
at the time of sampling. 2. Generalized augmentation of gamma-IFN production may 
not be observed but locally infiltrating cells or astrocytes might produce
gamma-IFN.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2119268 [PubMed - indexed for MEDLINE]

5968: Ugeskr Laeger. 1990 Apr 23;152(17):1214-7.

[Herpes zoster paresis. A review of the literature and case reports]

[Article in Danish]

Lyngberg KK, Svensson BH.

Bispebjerg Hospital, Kobenhavn.

The incidence of paresis due to herpes zoster (HZ) infections are reported very
differently in the literature with rates varying from 0.5 to 31%. Many of the
paresis are presumed to be undiagnosed on account of topographic dissociation,
variable periods from the cutaneous affection to the muscular involvement,
masking of the paresis by pain, paresis of the intercostal and abdominal muscles 
which are not obvious and difficulties in correlating the visceral symptoms with 
a herpes zoster eruption. Paresis of the cranial nerves are easily diagnosed and 
50% of all HZ paresis are diagnosed from this region. Early acyclovir treatment
has improved the prognosis. Four cases of hypotonic herpes zoster paresis in
immunocompetent persons are described and the diagnostic difficulties are
discussed.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 2158682 [PubMed - indexed for MEDLINE]

5969: Presse Med. 1990 Apr 21;19(16):752-4.

Comment in:
    Presse Med. 1990 Dec 8;19(42):1950.

[Zona in 50 patients infected by human immunodeficiency virus. Clinical
manifestations and prognostic value]

[Article in French]

Perronne C, Lazanas M, Bellou A, Leport C, Canton P, Vilde JL.

Service des Maladies infectieuses et tropicales, Hopital Claude-Bernard, Paris.

Between January 1981 and April 1989, 50 patients infected with HIV were examined 
for herpes zoster. Herpes zoster enabled HIV infection to be detected in 23
patients (46 percent). It had only one localisation (involving contiguous
dermatomes) in 37 patients, two localisations in 6 patients, three or four
localisations in 1 patient each, and was disseminated in 5 patients.
Localisations were mostly thoracic and cervicofacial. Herpes zoster was treated
with acyclovir in 29 patients. All patients, treated or untreated, recovered from
herpes zoster, but 9 of them (18 percent) had sequelae: pain in 8 and hypoacousia
in 1. Herpes zoster recurred once in 8 patients and twice in 2. Among the
patients with AIDS related complex 20 percent developed AIDS after herpes zoster 
at one year and 30 percent at two years. Among all the patients, the proportion
of deaths after herpes zoster was 13 percent at one year and 34 percent at two
years.

Publication Types: 
    English Abstract

PMID: 1971106 [PubMed - indexed for MEDLINE]

5970: AIDS Action. 1990 Apr;(10):2-3.

Skin conditions common to people with HIV infection or AIDS.

Kalibala S.

PIP: The World Health Organization clinical criteria for AIDS diagnosis in Africa
include Kaposi's sarcoma, Herpes zoster, Herpes simplex, and pruritic
maculopapular rash, which have a predictive value for HIV seropositivity of
71-98%. Skin conditions may be classified as: 1) generalized dermatitis, 2)
bacterial, fungal, viral, and parasitic infections, and 3) skin tumors. Pruritic 
maculopapular rash (prurigo) is often the first outward sign of HIV infection.
Soothing preparations such as calamine lotion or E45 emollient cream can be
applied. Occasionally antihistamine may be necessary, e.g., 10 mg of
chlorpheniramine 8 hourly. Skin lesions may become secondarily infected with
bacteria; usually Staphylococcus aureus and Streptococcus species. Persistent
folliculitis or carbuncles should be treated with flucloxacillin 250 mg QDS for 7
days. In HIV/AIDS fungal infections often develop secondary infection.
Candidiasis (thrush) is caused by yeasts, mainly Candida albicans and a small
percentage by Tolurosis glabrata. Many HIV-infected patients suffer from
seborrheic dermatitis. Fungal diseases more typically present as ringworms of the
scalp (Tinea capitis). Whitfield's ointment is effective for ringworm. Antifungal
creams such as miconazol or clotrimazole and systemic antifungal tablets such as 
ketoconazole, fluconazole, and itraconazole are also effective. Gentian violet
lotion twice daily and Acyclovir tablets, 200 mg 5 times daily for 5 days, may
help to reduce secondary Herpes simplex infection. HIV has been associated with
an increased incidence of Herpes zoster (shingles). It is often necessary to give
analgesics like aspirin or paracetamol to control the pain. Gentian violet paint 
may help to prevent secondary infection. When shingles affects the eye, Acyclovir
tablets (800 mg 5 times daily) should be given. Kaposi's sarcoma affects wider
age groups, and it is disseminated and more aggressive than the endemic type.
Treatment options include radiotherapy and systemic cytotoxics such as
vincristine. Intralesional injections of the drug interferon have also given
successful results with some patients.

PMID: 12342834 [PubMed - indexed for MEDLINE]

5971: Rinsho Shinkeigaku. 1990 Apr;30(4):452-4.

[A case of herpes zoster myelitis improved with acyclovir]

[Article in Japanese]

Yasuda Y, Akiguchi I, Kameyama M.

Department of Neurology, Kyoto City Hospital.

A case of herpes zoster myelitis improved with acyclovir was reported. A
71-year-old female showed a rash over the S2-4 dermatomes on the right side.
After that, paraplegia and dysuria progressed. Patellar tendon reflex was
exaggerated, but Achilles tendon reflex was normal. Babinski and Chaddock sign
were bilaterally elicited. Superficial sense was markedly decreased below the
Th12 dermatome. Vibration sense was slightly decreased but position sense was
normal on the lower extremities. Cerebrospinal fluid analysis revealed
pleocytosis, and an elevation of IgG and varicella-zoster virus antibody titer.
Acyclovir (250 mg bid/day) was given for ten days. Paraplegia, sensory
disturbance and dyschezia improved but dysuria did not. In this case acyclovir
administration was started on the 18th day after the onset of myelopathy. Early
initiation of acyclovir treatment might lead to recovery of dysuria. As the
pathogenic mechanism of herpes zoster myelitis is considered to be direct viral
invasion of the spinal cord with subsequent necrosis, early initiation of
acyclovir treatment is necessary for the recovery.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2387118 [PubMed - indexed for MEDLINE]

5972: J Am Acad Nurse Pract. 1990 Apr-Jun;2(2):64-8.

Herpes zoster: etiology, clinical course, and suggested management.

Boley T, Curtis J.

Herpes zoster is an acute viral infection that results from reactivation of a
latent varicella-zoster virus often acquired as chickenpox during childhood.
Fifty percent of all people living to the age of 85 will have an attack of
zoster. The goal of intervention is to reduce associated pain and discomfort. A
prompt diagnosis and appropriate management can best be achieved by understanding
the disease and treatment options. While herpes zoster occurs with greater
frequency in the geriatric population, it can occur throughout an individual's
life span. The nurse practitioner working in any setting is likely to see
patients present with herpes zoster. A protocol for patient management is
included in this article as a resource for the nurse practitioner who encounters 
this diagnosis.

PMID: 2354080 [PubMed - indexed for MEDLINE]

5973: Ulster Med J. 1990 Apr;59(1):77-81.

Cerebral vasculitis associated with shingles.

Edgar JD, Crosbie JJ, Hawkins SA.

Department of Medicine, Queen's University of Belfast.

Publication Types: 
    Case Reports

PMID: 2349753 [PubMed - indexed for MEDLINE]

5974: Arch Dermatol. 1990 Apr;126(4):546-7.

Skin lesions as the sole manifestation of the fetal varicella syndrome.

Lloyd KM.

Publication Types: 
    Case Reports
    Letter

PMID: 2322006 [PubMed - indexed for MEDLINE]

5975: J Clin Oncol. 1990 Apr;8(4):721-30.

Treatment of hairy cell leukemia with alternating cycles of pentostatin and
recombinant leukocyte A interferon: results of a phase II study.

Martin A, Nerenstone S, Urba WJ, Longo DL, Lawrence JB, Clark JW, Hawkins MJ,
Creekmore SP, Smith JW 2nd, Steis RG.

Biological Response Modifiers Program and Program Resources, Inc, National Cancer
Institute-Frederick Cancer Research Facility, MD 21701.

Fifteen patients with hairy cell leukemia (HCL) were treated with deoxycoformycin
(pentostatin; dCF) (4 mg/m2 intravenous [IV] every week x 3) and recombinant
interferon-alpha 2a (rIFN-alpha 2a) (3 x 10(6) units subcutaneously [SC] daily x 
4 weeks) in alternating months for a total of 14 months. Eleven patients had
undergone splenectomy; four had received prior systemic therapy with chlorambucil
and/or steroids. All 15 are evaluable for toxicity and peripheral blood response,
while 14 are assessable for bone marrow response. Toxicity was tolerable with
grade 3 or 4 nausea and vomiting in three patients, neutropenic fevers in five,
transient but significant depression in eight, and localized cutaneous herpes
zoster in four. Circulating hairy cells were undetectable by the end of the first
month in 10 of 13 patients, and by the end of the second month in the other
three. Fourteen patients had bilateral bone marrow biopsies performed at baseline
after 6 months of treatment, at the end of treatment (14 months), and at 6-month 
intervals during follow-up. Before treatment, all patients had hypercellular
marrows with hairy cels replacing normal marrow elements; all showed at least a
95% clearing of their hairy cell infiltrate by 6 months of therapy. However,
small collections of residual hairy cells could be detected intermittently on at 
least one side of bilateral samples in all patients. All patients have completed 
treatment with a median duration of follow-up off therapy of 27 months (range, 15
to 31 months). To date, all peripheral counts and serum soluble interleukin-2
receptor (sIL2R) levels remain stable, and no patient has had progression of the 
hairy cell infiltrate in the bone marrow. Although no patient achieved a
pathologic complete response, alternating monthly cycles of dCF and rIFN-alpha 2a
produced durable partial remissions (PRs) in all patients. Continued follow-up is
required to determine the length of such remissions.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2313337 [PubMed - indexed for MEDLINE]

5976: Minn Med. 1990 Apr;73(4):37-40.

Comment in:
    Minn Med. 1990 Dec;73(12):11-2.    Minn Med. 1990 Nov;73(11):7-8.

Treatment of acute herpetic neuralgia. A case report and review of the
literature.

Hess TM, Lutz LJ, Nauss LA, Lamer TJ.

Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.

Herpes zoster (shingles) is a viral infection that results from a reactivation of
a dormant varicella zoster virus. It has been estimated that more than 300,000
new cases are seen in the United States each year. Several factors influence the 
incidence of infection, with increasing age being the most consistent.
Postherpetic neuralgia is the No. 1 cause of intractable, debilitating pain in
the elderly and is the leading cause of suicide in chronic pain patients over the
age of 70.

Publication Types: 
    Case Reports
    Review

PMID: 2186265 [PubMed - indexed for MEDLINE]

5977: Rinsho Shinkeigaku. 1990 Apr;30(4):413-5.

[A case of unilateral VIIIth, IXth and Xth cranial nerve involvement with herpes 
zoster]

[Article in Japanese]

Yoshioka A, Kitagawa Y, Kawada J, Negami T, Hirose G.

Department of Neurology, Asanogawa General Hospital.

A 46-year-old healthy man suffered from sore throat, fever and right otalgia. On 
the next day, he developed hoarseness and difficulty in swallowing. On the 6th
day, he suffered from vertigo, nausea and vomiting associated with unsteady gait.
He was admitted to the otorhinolaryngology department in our hospital and pointed
out to have vesicles at his right ear. On the 13th day, he was referred to our
service. On admission, no vesicles were noted at the right ear or pharynx.
Neurological examination revealed mild nuchal rigidity and marked hoarseness,
associated with poor elevation of soft palate and loss of pharyngeal reflex on
the right side. He also had horizontal-clockwise rotatory nystagmus in primary
gaze and ataxic gait. There was no hearing loss nor facial palsy. No other
abnormal neurological findings were noted. The cerebrospinal fluid showed
pleocytosis associated with increased protein. The viral antibody titre for
herpes zoster was significantly elevated on 18th day in serum as well as in
cerebrospinal fluid. Vertigo, nausea, vomiting, ataxia and difficulty in
swallowing were all disappeared by the 25th day, whereas hoarseness was improved 
but still noted 6 months later. Among cranial nerves, trigeminal and facial
nerves are the most commonly affected in patients with herpes zoster, but there
have been a few reported cases of the 9th and 10th cranial nerve involvement in
the literature. In these previously reported cases, all were written before the
era of serological diagnosis, and herpes zoster was diagnosed by the vesicles at 
the ear or pharynx.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Case Reports
    English Abstract

PMID: 2167188 [PubMed - indexed for MEDLINE]

5978: Avian Dis. 1990 Apr-Jun;34(2):479-84.

Identification of the cross-reactive antigens between Marek's disease virus and
pseudorabies virus by monoclonal antibodies.

Nakajima K, Kweon CH, An SH, Shibayama T, Wakamiya N, Kato S, Hirai K.

Department of Pathology, Osaka University, Japan.

Among the 33 monoclonal antibodies (MAbs) against pseudorabies virus (PRV)
examined, three MAbs (24-17, 74-26, and 8) were found to react with cells
infected with Marek's disease virus (MDV)-related viruses by immunofluorescence
test. Two of the MAbs (24-17 and 74-26) reacted with the nuclei of cells infected
with MDV serotype 1 (MDV1), MDV serotype 2 (MDV2), and herpesvirus of turkeys
(HVT), whereas MAb 8 reacted with the cytoplasm of MDV2- and HVT-infected cells. 
However, none of the MAbs against MDV1, MDV2, and HVT that were examined reacted 
with PRV-infected cells. None of these three MAbs against PRV reactive with
MDV-related viruses cross-reacted with the cells infected with other
herpesviruses, such as herpes simplex virus type 1, herpes simplex virus type 2, 
varicella zoster virus, Epstein-Barr virus, or human herpesvirus 6. Southern-blot
hybridization under stringent or less-stringent conditions showed that no
significant DNA homology was detected between PRV DNA and MDV DNA.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2164393 [PubMed - indexed for MEDLINE]

5979: J Neurol. 1990 Apr;237(2):73-6.

Demonstration of herpes simplex virus DNA in CSF cells by in situ hybridization
for early diagnosis of herpes encephalitis.

Bamborschke S, Porr A, Huber M, Heiss WD.

Klinik und Poliklinik fur Neurologie und Psychiatrie der Universitat zu Koln,
Federal Republic of Germany.

Herpes simplex virus (HSV) was studied by in situ DNA hybridization with a
biotinylated cDNA probe in 56 air-dried methanol-fixed cerebrospinal fluid (CSF) 
cell preparations which had been collected from 12 patients with herpes simplex
encephalitis (HSE) during the previous 5 years. In three additional HSE cases,
freshly prepared acetone-fixed CSF cell preparations were available. In all
cases, CSF cell preparations were obtained by cytocentrifugation. Herpes simplex 
virus DNA could be demonstrated in 8 of the 12 HSE cases with methanol-fixed
cells (66%) and in all 3 cases with fresh acetone-fixed CSF cells. The earliest
CSF sample was available at the onset of symptoms and showed positive DNA
hybridization. In three cases hybridization was positive after a clinical course 
of more than 5 weeks but was usually found in the 1st week of illness before the 
beginning of specific inthrathecal IgG synthesis. In 54 control cases with other 
acute inflammatory diseases of the CNS, including 14 cases of varicella-zoster
meningitis, no positive hybridization was detected. These findings strongly
suggest that in situ hybridization in CSF cells is a reliable tool for the early 
and rapid diagnosis of HSE, especially at the onset of the disease, when no
antibodies can be detected.

PMID: 2162383 [PubMed - indexed for MEDLINE]

5980: J Gen Virol. 1990 Apr;71 ( Pt 4):897-906.

Control of expression of the varicella-zoster virus major immediate early gene.

McKee TA, Disney GH, Everett RD, Preston CM.

Medical Research Council Virology Unit, Glasgow, U.K.

The cis-acting DNA sequences and trans-acting proteins that control the
expression of the major immediate early (IE) gene of varicella-zoster virus (VZV)
were investigated. The location of the IE mRNA 5' terminus was determined by
primer extension and S1 nuclease analyses and the functional activities of DNA
sequences upstream of this site were analysed by a transfection assay. The VZV IE
promoter exhibited low activity in BHK and HeLa cells, but was transactivated by 
the herpes simplex virus type 1 (HSV-1) virion protein Vmw65. DNA sequences
between positions -131 and +57 were responsible for promoter activity, whereas
sequences between -410 and -131 mediated the response to Vmw65. Two short
elements in the -410 to -131 region formed protein-DNA complexes with HeLa cell
nuclear proteins and formed a ternary complex when Vmw65 was added. One of the
elements, ATGTAAATGAAAT, possessed a strong similarity to the HSV-1 TAATGARAT.
The VZV homologue of Vmw65, encoded by open reading frame (ORF) 10, failed to
trans-activate expression from HSV-1 or VZV IE promoters and did not form a
ternary complex with functional TAATGARAT elements and HeLa cell proteins.
Therefore, stimulation of VZV IE transcription by Vmw65 can occur by a mechanism 
similar to that employed by HSV-1, but VZV ORF 10 does not function as a
trans-activator of IE gene expression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2157801 [PubMed - indexed for MEDLINE]

5981: J Gen Virol. 1990 Apr;71 ( Pt 4):851-61.

A mutant of herpes simplex virus type 1 immediate early polypeptide Vmw175 binds 
to the cap site of its own promoter in vitro but fails to autoregulate in vivo.

Paterson T, Preston VG, Everett RD.

MRC Virology Unit, Institute of Virology, Glasgow, U.K.

Vmw175, the product of herpes simplex virus type 1 immediate early (IE) gene 3,
is essential for viral replication. It is required for the activation of
transcription from both early and late gene promoters and also for the repression
of IE gene expression. Vmw175 is able to bind specifically to certain DNA
sequences, some of which (including that at the cap site of IE gene 3) contain
the consensus sequence ATCGTC. The presence of this sequence at the cap site has 
been correlated with the ability of Vmw175 to autoregulate its own promoter. This
report describes the characterization of five viruses with temperature-sensitive 
(ts) lesions in Vmw175. Four of these mutants express Vmw175 which is ts in its
ability to bind to DNA in vitro and to autoregulate IE-3 gene expression in the
infected cell. Although Vmw175 produced by the remaining mutant, ts1225, fails to
autoregulate IE-3 expression at the non-permissive temperature (NPT) its
DNA-binding properties are indistinguishable from those of the wild-type protein.
This suggests that the ability of Vmw175 to bind to the IE-3 cap site (as
measured in vitro) is insufficient for autoregulation (in vivo). All five newly
characterized ts mutants are partially permissive for early gene transcription at
the NPT, although Vmw175 expressed by four of them is unable to bind to the IE-3 
cap site sequence at elevated temperatures. This suggests that binding to one
class of recognition sequences by Vmw175, as measured in vitro, is not absolutely
required for the activation of early gene promoters during virus infection. The
lesions in these five ts mutants lie in the carboxy-terminal third of the
polypeptide; three of the mutations (those in ts1219, ts1221 and ts1225) were
identified by DNA sequence analysis and were found to affect amino acid residues 
that are conserved in the homologous proteins from varicella-zoster virus and
pseudorabies virus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2157798 [PubMed - indexed for MEDLINE]

5982: Arch Dermatol. 1990 Apr;126(4):537-9.

Comment on:
    Arch Dermatol. 1989 Sep;125(9):1243-6.

Cutaneous cytomegalovirus or disseminated verrucous varicella zoster.

Berger TG.

Publication Types: 
    Comment
    Letter

PMID: 2157374 [PubMed - indexed for MEDLINE]

5983: J Infect Dis. 1990 Apr;161(4):680-4.

Erratum in:
    J Infect Dis 1990 Aug;162(2):573.

Epstein-Barr virus and other herpesvirus infections in Kawasaki syndrome.

Marchette NJ, Melish ME, Hicks R, Kihara S, Sam E, Ching D.

Department of Tropical Medicine, John A. Burns School of Medicine, University of 
Hawaii, Honolulu.

Epstein-Barr virus (EBV), a possible cause of Kawasaki syndrome (KS), is not
pathenogenically associated with KS in Hawaii. The prevalence of EBV capsid
antibody in KS patients was found not to differ significantly from that in
controls, and the antibody response in those infected with EBV was the same as
that in other children similarly infected. No EBV was isolated from acute-phase
patients. All patients with capsid antibody at the onset of KS also had
Epstein-Barr nuclear antigen antibody: 36 patients developed antibody within 3
months after onset of KS; in 10, EBV infection could have been coincidental with 
the disease. Cytomegalovirus (CMV) was isolated from 9 patients with KS and 10
controls. A similar number of controls and patients had antibody to human
herpesvirus 6 (HHV6); one patient seroconverted. None of the herpes viruses (EBV,
CMV, HHV6, varicella-zoster virus, or herpes simplex virus) plays a unique or
dominant role in the etiology or pathogenesis of KS in Hawaii.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2156943 [PubMed - indexed for MEDLINE]

5984: Acta Neurol Scand. 1990 Apr;81(4):341-5.

Specific in vitro IgG subclass synthesis and lymphocyte proliferation responses
in herpes virus encephalitis.

Mathiesen T, Olding-Stenkvist E, Linde A, Olsson O, Wahren B.

Department of Virology, Karolinska Institute, Stockholm, Sweden.

Cerebrospinal fluid, peripheral blood lymphocytes (PBL) and sera from 5 patients 
with herpes simplex encephalitis (HSVE), 3 with varicellae zoster (VZV)
meningoencephalitis and 5 with encephalitis of unknown origin (NUD) were
analyzed. Lymphocytes from both blood and CSF were shown to synthesize anti-VZV
IgG subclasses in VZV meningoencephalitis and anti-HSV IgG subclasses in HSVE.
The subclass patterns of CSF and in vitro synthesized anti-viral IgG were
similar, suggesting that a considerable portion of the antiviral IgG subclasses
detected are synthesized in the CNS compartment. Antigen presentation in vitro
seemed to produce a heterologous IgG4 and/or 3 response in 3 patients. Lymphocyte
proliferation was detectable in response to HSV and VZV, respectively.

PMID: 2113757 [PubMed - indexed for MEDLINE]

5985: Microbiologica. 1990 Apr;13(2):165-78.

Selective virus inhibitors.

De Clercq E.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

Our recent efforts have been directed at the development of selective inhibitors 
of different classes of viruses, including adeno, pox, and herpesviruses [herpes 
simplex virus type 1 (HSV-1) and type 2 (HSV-2), varicella-zoster (VZV),
cytomegalovirus (CMV), Epstein-Barr virus (EBV)], (+/-)RNA viruses (reo- and
rotavirus), (-)RNA viruses (influenza, parainfluenza, measles, respiratory
syncytial, vesicular stomatitis and rabies virus) and retroviruses [i.e. human
immunodeficiency virus (HIV), the causative agent of AIDS]. In this search, the
following molecular targets were envisaged: for DNA viruses in general, the viral
DNA polymerase; for herpes simplex virus and varicella-zoster virus, the viral
DNA polymerase via a specific phosphorylation by the viral 2'-deoxythymidine
(dThd) kinase; for (+/-)RNA and (-)RNA viruses, S-adenosylhomocysteine (SAH)
hydrolase, a key enzyme in transmethylation reactions required for the maturation
of viral mRNA; for retroviruses, reverse transcriptase as initiator of virus
replication and/or cell transformation; and for several enveloped viruses (i.e.
retro-, herpes- and rhabdoviruses), virus adsorption to the outer cell membrane. 
Several new compounds have been developed that appear to act at these targets:
i.e. (E)-5-(2-bromovinyl)-2'-deoxyuridine [bromovinyldeoxyuridine (BVDU)] and
derivatives thereof [i.e. carbocyclic BVDU (C-BVDU)] as well as derivatives of
acyclovir (i.e. 8-substituted acyclovir derivatives) as inhibitors of
herpesviruses; (S)-9-(3-hydroxy-2-phosphonylmethoxypropyl)adenine [(S)-HPMPA],
9-(2-phosphonylmethoxyethyl)adenine (PMEA) and other
phosphonylmethoxyalkylpurines and -pyrimidines as inhibitors of DNA viruses and
retroviruses; acyclic and carbocyclic analogues of adenosine [such as
(S)-9-(2,3-dihydroxypropyl)adenine [S)-DHPA), carbocyclic 3-deazaadenosine
(C-c3Ado), (RS)-3-adenin-9-yl-2-hydroxypropanoic acid (AHPA) alkyl esters,
neplanocin A, 3-deazaneplanocin A and the 5'-nor derivatives of neplanocin A and 
3-deazaneplanocin A] as inhibitors of (+/-)RNA and (-)RNA viruses;
2',3'-dideoxynucleoside analogues as inhibitors of retroviruses; and sulfated
polysaccharides (i.e. heparin, dextran sulfate, pentosan polysulfate, mannan
sulfate), sulfated polyvinylalcohol and co-polymers of sulfated polyvinylalcohol 
with acrylic acid as inhibitors of retro-, herpes- and rhabdoviruses.

Publication Types: 
    Review

PMID: 1693749 [PubMed - indexed for MEDLINE]

5986: Unfallchirurgie. 1990 Apr;16(2):95-106.

[New viewpoints on the clinical picture, diagnosis and pathophysiology of reflex 
sympathetic dystrophy (Sudeck's disease)]

[Article in German]

Blumberg H, Griesser HJ, Hornyak M.

Neurologische Klinik und Poliklinik, Universitat Freiburg.

Reflex sympathetic dystrophy can be elicited by various factors (e. g. trauma,
herpes zoster, myocardial infarction). Independent of kind and site of a lesion, 
symptoms occur most often in the whole distal part of the affected extremity.
There in most cases, a triad of autonomic, motor and sensory disturbances can be 
found clinically. For early diagnosis--beside clinical investigation--a
comparative measurement of skin temperatures on both sides of finger or toe tips,
respectively, is recommended. Hereby the clinical finding of a warmer or colder
extremity can be proved, which supplies evidence of a disturbed skin blood flow. 
In case, the above mentioned triad and a disturbance of skin circulation is
found, diagnosis of sympathetic reflex dystrophy can be made with great
certainty. With regard to the underlying pathophysiology, symptoms can be
explained at this time satisfactory only by the assumption of a vicious circle.
Starting from a painful event (e.g. trauma, mark in a plaster cast, nerve lesion 
or myocardial infarction) a functional disturbance of the sympathetic nervous
system is initiated. This results in a disturbance of the circulation in all of
the affected tissues (skin, muscle, bone and joint), which finally gives rise to 
an abnormal excitation of afferent receptors, particularly of nociceptors. This
excitation maintains the disturbance of the sympathetic nervous system at central
nervous level (vicious circle). The most relevant pathomechanism in this process 
seems to be the occurrence of an imbalance between the activity of sympathetic
vasoconstrictor neurons supplying arteries and those, supplying veins. A
sympatholytic therapy, if applied in time, is able to cut off the vicious circle,
which may lead to a restitutio ad integrum. Further investigations will show to
what extent psychological factors are involved in developing the central nervous 
disturbance of the sympathetic nervous system and may also show if in addition
the motor system is affected.

Publication Types: 
    English Abstract
    Review

PMID: 1693244 [PubMed - indexed for MEDLINE]

5987: Lancet. 1990 Mar 24;335(8691):732.

Advertising acyclovir.

Jones K.

Publication Types: 
    Letter

PMID: 1969091 [PubMed - indexed for MEDLINE]

5988: Gene. 1990 Mar 15;87(2):249-55.

Characterization of the gene and an antigenic determinant of equine herpesvirus
type-1 glycoprotein 14 with homology to gB-equivalent glycoproteins of other
herpesviruses.

Guo PX.

Wadsworth Center for Laboratories and Research, New York State Department of
Health, Albany 12201.

The gene encoding glycoprotein 14 (gp14) of equine herpesvirus type 1 was
sequenced. Nucleotide sequence analysis revealed a complete transcription unit
composed of a CAT box, a TATA box, a ribosome-binding sequence, a polyadenylation
signal and an open reading frame (ORF) of 2940 bp transcribed from left to right.
The amino acid (aa) sequence deduced from this ORF corresponded to that of a
protein with 979 aa and had the characteristic features of membrane gp including 
a 20-aa signal sequence at the N terminus, a 743-aa surface domain, a 40-aa
membrane anchoring region, a 108-aa hydrophilic cytoplasmic domain at the C
terminus and eleven potential sites for N-linked glycosylation. An unusual
feature of this protein was an exceptionally long (66aa) sequence, with a
preponderance of hydrophilic residues, preceding the hydrophobic signal core. An 
antigenic determinant recognized by an anti-gp14 monoclonal antibody was present 
in the N terminus of the postulated surface domain. Comparison of gp 14 with the 
gp of other herpesviruses indicated that gp14 was highly homologous to
corresponding gp of pseudorabies (gII), bovine herpesvirus (gI), varicella-zoster
virus (gII), as well as of herpes simplex virus, Epstein-Barr virus and human
cytomegalovirus (gB).

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 1692002 [PubMed - indexed for MEDLINE]

5989: Orv Hetil. 1990 Mar 11;131(10):529-30.

[Herpes zoster infection with acute urinary retention]

[Article in Hungarian]

Jakab G, Komoly S, Juhasz E.

Semmelweis Orvostudomanyi Egyetem, Neurologiai Klinika.

The history of a young female patient is presented. She developed urine retention
of sudden onset as a complication of herpes zoster infection manifested in the
sacral dermatomes. Symptomatic and antiviral treatments were introduced with full
recovery of bladder function. The correct diagnosis of this rare and benign
complication of herpes zoster infection can help to avoid unnecessary and
invasive examinations.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1690375 [PubMed - indexed for MEDLINE]

5990: Indian J Cancer. 1990 Mar;27(1):28-30.

Herpes zoster in mesothelioma. A case report.

Dwivedi S, D'Souza C.

Department of medicine, Kasturba Medical College Hospital, Karnataka, India.

Diffuse mesothelioma with a large pleural effusion was diagnosed nine months
after the appearance of herpes zoster in the overlying thoracic segment in a
patient presenting with chest pain mimicking post-herpetic neuralgia. Clinical
implications of such an association are discussed.

Publication Types: 
    Case Reports

PMID: 2391128 [PubMed - indexed for MEDLINE]

5991: Neurologia. 1990 Mar;5(3):98-101.

[Granulomatous angiitis of the basilar artery related to herpes zoster of the 7th
cranial nerve]

[Article in Spanish]

Romero Lopez J, Sarasa Corral JL, Yanez Bana RM, Pareja Grande JA, Gonzalez-Elipe
J.

Servicio de Neurologia, Fundacion Jimenez Diaz, Universidad Autonoma de Madrid.

Granulomatous angiitis of the central nervous system is an uncommon condition
characterized by vascular wall necrosis, inflammatory exudate and development of 
giant cells in medium and small size vessels. The pathogenesis of this disease
remains unknown, but it has been associated with immune complexes, mechanical
factors and infection by the varicella-zoster virus. We report a young patient
who presented with herpes zoster involving the VII cranial nerve and
contralateral hemiplegia. Subsequently, pontine infarct and fatal subarachnoid
hemorrhage developed. The pathological study showed granulomatous angiitis of
basilar artery.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2361047 [PubMed - indexed for MEDLINE]

5992: AIDS. 1990 Mar;4(3):233-8.

Opportunistic infections and malignancies in 231 Danish AIDS patients.

Pedersen C, Gerstoft J, Tauris P, Lundgren JD, Gotzsche PC, Buhl M, Salim Y,
Schmidt K.

Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen,
Denmark.

We analysed cumulative disease frequencies in the first 231 adult Danish AIDS
patients with life tables. There was a certain hierarchical pattern in the
occurrence of complicating diseases. Herpes zoster, Kaposi's sarcoma and
Pneumocystis carinii pneumonia were early manifestations, whereas diseases caused
by cytomegalovirus and atypical mycobacteria tended to occur later in the course 
of AIDS. Compared with all other AIDS patients, homosexual men were more likely
to develop Kaposi's sarcoma, cytomegalovirus chorioretinitis and mucocutaneous
herpes simplex virus infection. The proportion of patients who developed
particular diseases changed with calendar time. Most striking was a three to
fourfold decrease in diseases caused by cytomegalovirus. In conclusion, the study
showed that disease frequencies in patients with AIDS may vary with the patients 
risk behaviour and duration of AIDS, and that the frequencies of particular
diseases may change with calendar time.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2350442 [PubMed - indexed for MEDLINE]

5993: Clin Exp Dermatol. 1990 Mar;15(2):155-6.

Comment on:
    Clin Exp Dermatol. 1989 Jan;14(1):56-7.

Herpes zoster following spinal surgery.

Jordaan HF, du Toit G.

Publication Types: 
    Comment
    Letter

PMID: 2347111 [PubMed - indexed for MEDLINE]

5994: Minerva Med. 1990 Mar;81(3 Suppl):95-103.

[Antalgic treatment of acute herpes zoster. A clinical contribution]

[Article in Italian]

Di Laura I, Tiboldo F.

U.S.S.L. n. 47, Ospedale degli Inferni, Biella (Vercelli).

The paper considers the difficulty of pain control in acute herpes zoster and the
considerable incidence of NPH in patients given the conventional medical
therapies. After a short account of physiopathology of herpetic pain, the
treatment of acute cases with epidural or sympathetic blockages using
anaesthetics and cortisone is proposed. Personal experience in a series of
patients with either acute herpes zoster or NPH who were treated with this method
is reported with details of peculiarities and results.

Publication Types: 
    English Abstract

PMID: 2325877 [PubMed - indexed for MEDLINE]

5995: Pediatr Neurol. 1990 Mar-Apr;6(2):131-4.

Varicella with delayed contralateral hemiparesis detected by MRI.

Liu GT, Holmes GL.

Division of Neurology, Brigham and Women's Hospital, Boston, Massachusetts 02115.

We report a 3 1/2-year-old boy who developed a hemiparesis 4 weeks after the
onset of a varicella infection. In previously described cases of varicella with
delayed contralateral hemiparesis, computed tomography typically revealed
infarcts in the basal ganglia and internal capsule. To our knowledge, our patient
is the first studied by magnetic resonance imaging. The pathogenesis of this
syndrome may be a varicella zoster virus-related vasculopathy similar to that
observed in herpes zoster ophthalmicus with delayed contralateral hemiparesis.

Publication Types: 
    Case Reports
    Review

PMID: 2187441 [PubMed - indexed for MEDLINE]

5996: Clin Pharmacol Ther. 1990 Mar;47(3):305-12.

Desipramine relieves postherpetic neuralgia.

Kishore-Kumar R, Max MB, Schafer SC, Gaughan AM, Smoller B, Gracely RH, Dubner R.

Neurobiology and Anesthesiology Branch, National Institute of Dental Research,
National Institute of Health, Bethesda, MD 20892.

Desipramine has the least anticholinergic and sedative effects of the first
generation tricyclic antidepressant agents, but its pain-relieving potential has 
received little study. Other antidepressant agents--notably amitriptyline--are
known to ameliorate postherpetic neuralgia, but those agents are often toxic. In 
a randomized double-blind crossover design, we gave 26 postherpetic neuralgia
patients 6 weeks of treatment with desipramine (mean dose, 167 mg/day) and
placebo. Nineteen patients completed both treatments; 12 reported at least
moderate relief with desipramine and two reported relief with placebo. Pain
relief with desipramine was statistically significant from weeks 3 to 6.
Psychiatric interview at entry into the study produced a diagnosis of depression 
for 4 patients; pain relief was similar in depressed and nondepressed patients
and was statistically significant in the nondepressed group alone. We conclude
that desipramine administration relieves postherpetic neuralgia and that pain
relief is not mediated by mood elevation. Blockade of norepinephrine reuptake, an
action shared by desipramine, amitriptyline, and other antidepressant agents that
have relieved neuropathic pain, may be involved in relief of postherpetic
neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 2178851 [PubMed - indexed for MEDLINE]

5997: Acta Stomatol Belg. 1990 Mar;87(1):15-56.

[Clinical approach to herpesviruses. A composite overview]

[Article in French]

Piette E.

Department of Oral Surgery and Oral Medicine, Prince Philip Dental Hospital,
University of Hong Kong.

This review article describes the lesions due to herpesviruses: herpes simplex,
chickenpox, herpes zoster (shingles), and infections due to cytomegalovirus and
Epstein-Barr virus. Based on current literature, clinical signs, diagnostic
methods and therapeutic possibilities are given for each type of infection. B
virus infections of humans are also briefly described.

Publication Types: 
    English Abstract
    Review

PMID: 2164319 [PubMed - indexed for MEDLINE]

5998: Semin Respir Infect. 1990 Mar;5(1):38-49.

Viral pneumonia in recipients of solid organ transplants.

Anderson DJ, Jordan MC.

Department of Medicine, University of Minnesota Medical School, Minneapolis.

Viral pulmonary infections are a major cause of morbidity and mortality in solid 
organ transplant recipients. The herpes viruses-cytomegalovirus, herpes simplex
virus, varicella zoster virus, and Epstein-Barr virus--cause most of the viral
infections in this population. Respiratory syncytial virus, adenovirus, and human
immunodeficiency virus also cause pneumonitis in the transplant recipient.
Differences in the clinical and laboratory presentation of pneumonitis due to the
various viral agents can provide clues to the etiology. However, definitive
diagnosis requires laboratory identification of the virus or appropriate
serologic changes. With cytomegalovirus, herpes simplex virus, Epstein-Barr
virus, and adenovirus, one must take care to distinguish between asymptomatic
shedding of the virus and disease produced by the virus. Advances in diagnostic
techniques such as rapid antigen detection, nucleic acid hybridization, and gene 
amplification may allow an earlier diagnosis of viral pneumonia. Advances in risk
reduction with appropriate pairing of donors and recipients, improved
immunosuppressive regimens, vaccination, and prophylactic administration of
antiviral agents may reduce the incidence of viral infection. Finally, advances
in anti-viral therapy have made possible the successful treatment of pneumonia
due to some of the viral agents.

Publication Types: 
    Review

PMID: 2160718 [PubMed - indexed for MEDLINE]

5999: Infect Dis Clin North Am. 1990 Mar;4(1):159-73.

Prospects for use of a varicella vaccine in adults.

Hardy IR, Gershon AA.

Department of Pediatrics, Columbia University, College of Physicians and
Surgeons, New York, New York.

Five to 10% of people reach adulthood still susceptible to VZV, which generally
causes more severe primary disease in adults than seen in children. A live
attenuated varicella vaccine was developed in Japan in the early 1970s and has
now been tested in several trials in healthy children, immunocompromised
children, and healthy adults. The vaccine is highly immunogenic in healthy
children, conferring immunity for at least 7 to 10 years with a high degree of
protective efficacy. In several trial in adults, the vaccine has been shown to be
highly immunogenic. Humoral and cell-mediated immunity wanes in vaccinated
adults, however, with antibodies to VZV detectable in approximately only 80% of
vaccinated individuals after 1 year, and in approximately 70% from 2 to 6 years
after vaccination. In leukemic children who have been vaccinated, however, this
loss of detectable antibody has not been correlated with a reduction in
protection during this time. Similar analyses have not been made in vaccinated
adults because the numbers intimately exposed to VZV have been small. Protective 
efficacy after household exposure is approximately 65% in adults; however, when
breakthrough (i.e., in those who have seroconverted) illness has occurred, it has
invariably been mild, so that efficacy in preventing severe disease has been
100%. "Vaccine failures," however, may develop full-blown varicella. Side effects
of immunization in adults are mild: a transient local reaction occurs in 10 to
21% and a mild rash in 6 to 8%. There is a theoretical risk of transmission of
the attenuated virus if a vaccine-induced rash occurs, which has been documented 
only in contacts of vaccinated leukemics (any secondary disease has also been
mild). To date, there has been no evidence that vaccination increases the risk of
developing zoster; on the contrary, studies in leukemic children, who may be
considered a "sentinel population" in this regard, suggest that the risk of
zoster after vaccination may be reduced compared with the risk after natural
infection. Susceptible adults who would most benefit from vaccination against VZV
include health care workers, those who care for small children, women of
child-bearing age prior to pregnancy, military recruits, and college students.

Publication Types: 
    Review

PMID: 2155261 [PubMed - indexed for MEDLINE]

6000: DICP. 1990 Mar;24(3):289-95.

Cimetidine: an immunomodulator.

Kumar A.

Department of Pediatrics and Human Development, Michigan State University, East
Lansing 48824.

Suppressor T lymphocytes possess histamine2 (H2) receptors and contribute
significantly to the function of the immune system. Experimentally, cimetidine,
an H2-receptor antagonist, has been shown to enhance a variety of immunologic
functions both in vivo and in vitro because of its inhibitory effects on
suppressor-cell function. Successful tumor immunotherapy, as well as some
protection from infection, has been reported in experimental animals. Patients
receiving cimetidine have been shown to exhibit enhanced cell-mediated immunity
as evaluated by increased response to skin-test antigens, restoration of
sensitivity following development of acquired tolerance, and increased responses 
of lymphocytes to mitogen stimulation. Preliminary reports also indicate that
cimetidine may offer therapeutic benefits for patients with Varicella zoster and 
Herpes simplex infections, as well as those suffering from mucocutaneous
candidiasis and common variable hypogammaglobulinemia. These immunoregulatory
effects are dose-related but are not always consistent. Because of its inhibitory
effect on suppressor function, cimetidine treatment may be deleterious in
patients with organ transplant and autoimmune disorders. Cimetidine should be
used as an immunomodulator on an experimental basis only.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2138376 [PubMed - indexed for MEDLINE]

6001: AJNR Am J Neuroradiol. 1990 Mar-Apr;11(2):409.

Ramsay Hunt syndrome mimicking intracanalicular acoustic neuroma on
contrast-enhanced MR.

Anderson RE, Laskoff JM.

Orlando Regional Medical Center, FL 32806.

Publication Types: 
    Case Reports

PMID: 2107729 [PubMed - indexed for MEDLINE]

6002: Rev Chil Pediatr. 1990 Mar-Apr;61(2):77-80.

[Varicella-zoster virus infection in children with Hodgkin's disease in advanced 
stages III and IV]

[Article in Spanish]

Zolezzi P, Wenzel MS, Delgado MO.

Instituto de Pediatria, Facultad de Medicina, Universidad Austral de Chile.

Over a 10-year period, among 22 children with Hodgkin's disease (stages III and
IV), 10 (45.5%) developed varicella-zoster virus (VZV) infection, varicella in 8 
cases (36.4%) and herpes zoster (HZ) in 3 (13.6%) (one patient had varicella and 
six months later). Three patients with varicella had significant pneumonitis, one
of them showed clinical evidence of dissemination and died. Two patients had
localized HZ and one had disseminated HZ without visceral involvement. All cases 
of VZV infections occurred in the first year of treatment: the primary infection 
presented while patients were under induction therapy and the secondary one after
radiotherapy.

Publication Types: 
    English Abstract

PMID: 1967047 [PubMed - indexed for MEDLINE]

6003: Lancet. 1990 Feb 3;335(8684):288.

Advertising acyclovir.

Anderton D.

Publication Types: 
    Letter

PMID: 1967739 [PubMed - indexed for MEDLINE]

6004: South Med J. 1990 Feb;83(2):247-9.

Herpes zoster infection of the chest wall and the syndrome of inappropriate
antidiuretic hormone secretion.

Sato TL, Jones JS, McGrail MA, MacLean DB.

Department of Medicine, Bowman Gray School of Medicine, Wake Forest University,
Winston-Salem, NC.

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) can result
from diverse conditions. There have been only two published reports linking this 
syndrome with herpes zoster infections--one disseminated and the other confined
to the chest wall. We have reported a case in which herpes zoster infection of
the chest wall probably precipitated the development of this syndrome.

Publication Types: 
    Case Reports
    Review

PMID: 2406941 [PubMed - indexed for MEDLINE]

6005: Can J Ophthalmol. 1990 Feb;25(1):42-3.

External ophthalmomyiasis associated with herpes zoster ophthalmicus.

Verma L, Pakrasi S, Kumar A, Sachdev MS, Mandal AK.

Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of
Medical Sciences, Ansari Nagar, New Delhi.

Ophthalmomyiasis is a rare entity caused by infestation with certain dipterous
larvae. We describe a 71-year-old farmer with herpes zoster ophthalmicus on the
left side of the face in whom the blisters became secondarily infested with
Chrysomyia bezziana maggots. The maggots were removed mechanically, and the
corneal involvement secondary to zoster ophthalmicus responded to therapy with
topical steroids and cycloplegics. To our knowledge this is the first report of
external ophthalmomyiasis due to C. bezziana.

Publication Types: 
    Case Reports

PMID: 2328437 [PubMed - indexed for MEDLINE]

6006: Masui. 1990 Feb;39(2):248-52.

[A case of herpes zoster ophthalmicus with complete ophthalmoplegia]

[Article in Japanese]

Fujiwara M, Odashiro M, Mizoguchi H, Hayashi I, Kawamura J, Hashimoto T, Tamura
K.

Department of Anesthesiology, Kin-ikyo Chuo Hospital, Sapporo.

A 58-year old man with herpes zoster ophthalmicus developed complete
ophthalmoplegia, dissemination of herpetic lesions and meningitis. Eye movements 
improved two month after the onset of zoster. Five months later, eye movements
recovered completely, but his sight was disturbed severely due to corneal ulcer.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2325259 [PubMed - indexed for MEDLINE]

6007: J Laryngol Otol. 1990 Feb;104(2):104-8.

Audiological manifestations of Ramsay Hunt syndrome.

Wayman DM, Pham HN, Byl FM, Adour KK.

Department of Otolaryngology, Kaiser Permanente Medical Center, Oakland, CA
94611-5693.

Ramsay Hunt syndrome is known to cause audiological signs and symptoms, including
sudden, unexpected hearing loss. We carried out a retrospective review of the
audiological manifestations of 186 patients with Ramsay Hunt syndrome, measuring 
their hearing loss patterns, hyperacusis, tinnitus, herpetic rash, facial
paralysis, pain and vertigo. Statistical correlations of these parameters were
equated with prognosis. Prognosis for eventual hearing recovery is, in general,
excellent. Prognostic indicators of poor hearing recovery include advanced age,
retrocochlear hearing loss, male gender, vertigo, and speech frequency hearing
loss.

PMID: 2324614 [PubMed - indexed for MEDLINE]

6008: J Neurol Neurosurg Psychiatry. 1990 Feb;53(2):135-41.

Somatosensory findings in postherpetic neuralgia.

Nurmikko T, Bowsher D.

Pain Relief Foundation, Walton Hospital, Liverpool.

Somatic sensory perception thresholds (warm, cold, hot pain, touch, pinprick,
vibration, two-point discrimination), allodynia and skin temperature were
assessed in the affected area of 42 patients with unilateral postherpetic
neuralgia (PHN) and 20 patients who had had unilateral shingles not followed by
PHN (NoPHN), and in the mirror-image area on the other side. There was no
difference between the two groups for age or length of time after the acute
herpes zoster infection. The PHN group showed significant changes in all sensory 
threshold measurements when the affected area was compared with the mirror-image 
area on the unaffected side, while the NoPHN group exhibited no threshold
changes. Mechanical allodynia was present in 87% of the PHN group; half of the 12
patients with ophthalmic PHN showed extension of allodynia to the maxillary
distribution. No differences in skin temperature were recorded between affected
and unaffected regions in either group. Our findings show a deficit of sensory
functions mediated by both large and small primary afferent fibres and also
suggest major central involvement in the pathophysiology of the condition. If PHN
does not occur following acute herpes zoster, recovery of neural functions
appears to be good.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2313300 [PubMed - indexed for MEDLINE]

6009: Pain. 1990 Feb;40(2):131-5.

Benzydamine cream for the treatment of post-herpetic neuralgia: minimum duration 
of treatment periods in a cross-over trial.

McQuay HJ, Carroll D, Moxon A, Glynn CJ, Moore RA.

Oxford Regional Pain Relief Unit, Abingdon, Oxon, U.K.

In a double-blind multiple-dose cross-over study benzydamine 3% cream was
compared with placebo for the treatment of post-herpetic neuralgia. Pain relief, 
pain intensity, sleep, escape analgesic consumption and side effects were
assessed by diary methods for the 2 week treatment periods, with 1 week run-in
and 1 week wash-out. There were no significant differences between the 2
treatments. The implications of the results for other antiprostaglandin remedies 
recommended for treatment of post-herpetic neuralgia are discussed. An important 
observation with methodological significance for similar studies of chronic
conditions was that short treatment periods may produce false positive results.
Patients' expectations are high, and if the first study treatment is ineffective,
initial significant benefit may be noted when crossing over to the next
treatment; this may not last longer than 1 week. Cross-over studies in which
neither treatment is effective may, therefore, produce erroneous results if
treatment periods are shorter than 2 weeks.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 2308759 [PubMed - indexed for MEDLINE]

6010: Surg Neurol. 1990 Feb;33(2):132-8.

Primary spinal intramedullary malignant lymphoma. A case report.

Slowik F, Mayer A, Afra D, Deak G, Havel J.

National Institute of Neurosurgery, Weil Emil Municipal Hospital, Budapest,
Hungary.

A rare case of primary malignant intramedullary lymphoma, localized in the
cervical part of the spinal cord, is presented. The onset of clinical symptoms
was associated with herpes zoster infection. Surgery led to the histological
diagnosis. The clinical investigations excluded the presence of lymphoma in other
sites in the central nervous system and in the extraneural organs. Postoperative 
irradiation and chemotherapy effected relict of neurological symptoms.

Publication Types: 
    Case Reports

PMID: 2305357 [PubMed - indexed for MEDLINE]

6011: Ann Intern Med. 1990 Feb 1;112(3):187-91.

Acyclovir-resistant varicella zoster virus infection after chronic oral acyclovir
therapy in patients with the acquired immunodeficiency syndrome (AIDS).

Jacobson MA, Berger TG, Fikrig S, Becherer P, Moohr JW, Stanat SC, Biron KK.

University of California, San Francisco.

Four patients with human immunodeficiency virus (HIV) infection who received
chronic oral acyclovir therapy for suppression of recurrent varicella zoster or
herpes simplex virus infection developed persistent disseminated hyperkeratotic
papules that failed to heal with intravenous or high-dose oral acyclovir therapy.
Varicella zoster virus, resistant to acyclovir in vitro, was isolated from skin
lesions of all four patients. Three patients were adults in whom the acquired
immunodeficiency syndrome (AIDS) had been diagnosed 12 to 20 months before
isolation of acyclovir-resistant varicella zoster virus. The fourth patient was a
perinatally HIV-infected child who developed primary varicella infection at age 7
years when profoundly immunosuppressed (absolute CD4+ lymphocyte count less than 
50 cells/microL). Mean antiviral susceptibilities (ED50 values) of the four
clinical isolates compared with the ED50 values of the reference strain Oka were 
85 compared with 3.3 mumol/L for acyclovir, 1.4 compared with 0.8 mumol/L for
vidarabine, and 123 compared with 117 mumol/L for foscarnet. When assayed by
[125I]-dC plaque autoradiography, 90% to 100% of the viral isolate populations
had altered or no measurable thymidine kinase function. Acyclovir-resistant
varicella zoster virus infection may complicate long-term oral acyclovir
administration in patients with AIDS and may be associated with the appearance of
atypical hyperkeratotic papules.

Publication Types: 
    Case Reports

PMID: 2297195 [PubMed - indexed for MEDLINE]

6012: J Otolaryngol. 1990 Feb;19(1):46-9.

Speculation into the etiologic role of viruses in the development of Bell's palsy
and disorders of inner ear dysfunction: a case history and review of the
literature.

Bance M, Rutka J.

Institute of Medical Sciences, University of Toronto, Ontario, Canada.

It has long been postulated that Bell's palsy and a number of inner ear disorders
may have as their basis a common underlying viral etiology. The change from one
recognizable inner ear disorder into another is not unusual in the same patient
and has been recognized by neurotologists. The case history of a patient who
initially presented with an idiopathic facial palsy that years later developed
into a spectrum of vestibular dysfunction associated with the clinical stigmata
of herpes zoster is discussed. Although difficult to prove, support for this
continuum theory is reviewed, taking into account known viral involvement in
other cranial nerves and various histopathologic findings from disorders
involving the inner ear and facial nerve.

Publication Types: 
    Case Reports
    Review

PMID: 2179576 [PubMed - indexed for MEDLINE]

6013: Nippon Rinsho. 1990 Feb;48 Suppl:324-7.

[Serodiagnosis of varicella zoster virus infection]

[Article in Japanese]

Takayama M.

Department of Virology and Ricketsiology, National Institute of Health.

PMID: 2162422 [PubMed - indexed for MEDLINE]

6014: Kansenshogaku Zasshi. 1990 Feb;64(2):224-30.

[A clinical and pathological study on varicella-zoster virus pneumonia]

[Article in Japanese]

Tashiro T, Masuda M, Saburi Y, Shieno H, Goto J, Nasu M.

Second Department of Internal Medicine, Medical College of Oita.

A 48-year-old male with Adult T-cell leukemia (case 1) and a 57-year-old with
acute lymphocytic leukemia (case 2) died of rapid progressive pneumonia and
pleuritis. Histopathological findings of the lungs were multifocal hemorrhagic
coagulation necrosis, and typical Cowdry type A and full type intranuclear
inclusion bodies were observed in alveolar cells, bronchial cells, fibroblast,
endothelial cells of small vessels, bronchial gland cells and pleural cells.
Antigen against varicella-zoster virus (VZV) was positive in these cells by
immunostaining, and the antigen was also demonstrated in other organs such as
liver, spleen, pancreas, kidney, adrenal gland, esophagus, stomach, intestine and
so on. Furthermore, cytomegalovirus was simultaneously superinfected lungs of
both cases, and concomitant candida gastritis (case 1), aspergillus lung abscess 
and candida liver abscess (case 2) were observed. In the immunocompromised host
VZV may involve the visceral organs and death may result from VZV pneumonia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2159968 [PubMed - indexed for MEDLINE]

6015: Kansenshogaku Zasshi. 1990 Feb;64(2):195-201.

[Diagnosis of varicella-zoster virus (VZV) infection by using FITC-labeled
monoclonal antibodies]

[Article in Japanese]

Niimura M, Honda M, Kurata T, Sata T, Sakaoka H, Kawana R, Kawana T, Hidano A,
Tamaki K, Hondo R, et al.

Department of Dermatology, Jikeikai University School of Medicine.

Anti-varicella zoster virus (VZV) mouse monoclonal antibodies conjugated with
fluorescein isothiocyanate were evaluated for their usefulness as a practical
diagnostic tool in the clinical field by examining cells infected with isolated
herpes viruses and 431 clinical samples. The kit stained clearly the cells
infected with 14 isolated VZV strains without cross reaction to 15 isolated
herpes simplex virus type-1 strains (HSV-1) and 14 type-2 (HSV-2) strains. In
clinical specimens, viral antigens of VZV were detected in 92/105 (87.6%) cases
of varicella and in 176/190 (92.6%) cases of herpes zoster. Specific fluorescence
of VZV was also observed in 5 out of 96 cases diagnosed as HSV infections,
although these samples had no specific reaction to HSV when tested by the
commercially available diagnostic kit. In 24 cases which could not be clinically 
diagnosed as herpes zoster or herpes simplex, the VZV antigen was demonstrated in
9 cases. All 109 VZV-positive cases in virus isolation by culture were also
judged VZV-antigen positive by the kit, while all 69 HSV-positive cases in virus 
isolation were VZV-antigen negative. Furthermore, the VZV antigen was detected by
the kit in 53/60 clinical diagnoses of varicella or herpes zoster without
successful virus isolation. These results clearly indicate the usefulness of the 
kit as a practical VZV diagnostic reagent, especially in terms of specific
sensitivity and easy technical manipulation.

Publication Types: 
    Clinical Trial
    English Abstract
    Multicenter Study

PMID: 2159967 [PubMed - indexed for MEDLINE]

6016: Virus Res. 1990 Feb;15(2):163-74.

Antigenic cross-reaction between a varicella-zoster virus nucleocapsid protein
encoded by gene 40 and a herpes simplex virus nucleocapsid protein.

Vafai A, Wroblewska Z, Graf L.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

Human sera from varicella-zoster virus (VZV) and herpes simplex virus type 1
(HSV-1) seropositive individuals contain antibody to a 155-kilodalton (155 kDa)
viral protein. In this study, we show that monoclonal antibodies (mAb10.1 and
mAb1A1.4) prepared against VZV and HSV-1 proteins, respectively, reacted with
nuclear antigens and recognized a 155 kDa protein in the infected cells.
Immunoprecipitation of whole virions and viral nucleocapsids with these mAbs
showed that the 155 kDa protein is located in VZV and HSV-1 nucleocapsids. In
addition, immunofluorescence and cross-reaction experiments revealed the
antigenic cross-reactivity between the VZV and HSV-1 155 kDa nucleocapsid
proteins. To map the coding region of the VZV 155 kDa protein, a truncated DNA
fragment from the predicted open reading frame 40 was cloned into an in vitro
transcription vector (pGEM). The RNA transcribed from the inserted DNA was
translated in vitro and immunoprecipitated with mAb10.1. The reactivity of the in
vitro translation products with mAb10.1 indicated that the 155 kDa nucleocapsid
protein is encoded by VZV gene 40. These findings demonstrated that the VZV 155
kDa nucleocapsid protein encoded by gene 40 induces humoral response which
cross-reacts with both VZV and HSV.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2157317 [PubMed - indexed for MEDLINE]

6017: West J Med. 1990 Feb;152(2):192-4.

Herpes zoster phrenic neuritis with respiratory failure.

Melcher WL, Dietrich RA, Whitlock WL.

Department of Medicine, Letterman Army Medical Center, Presidio of San Francisco 
94129-6700.

Publication Types: 
    Case Reports

PMID: 2154900 [PubMed - indexed for MEDLINE]

6018: Virology. 1990 Feb;174(2):533-42.

Structural organization of the conserved gene block of Herpesvirus saimiri coding
for DNA polymerase, glycoprotein B, and major DNA binding protein.

Albrecht JC, Fleckenstein B.

Institut fur Klinische und Molekulare Virologie der Friedrich-Alexander
Universitat, Erlangen, Federal Republic of Germany.

Lymphotropic herpesviruses such as Epstein-Barr virus and Herpesvirus saimiri are
commonly grouped as gamma-herpesviruses, although overall genome organization and
numerous biological properties are quite different in the viruses. To define the 
relationship more precisely, we sequenced the Kpnl fragments F (6.5 kb) and C
(9.8 kb) of the H.saimiri strain No. 11 genome; these DNA fragments were found to
contain the genes coding for equivalents of the major DNA binding protein, a
putative glycoprotein transport polypeptide, the glycoprotein B, and the DNA
polymerase of herpes simplex virus. This DNA segment represents the longest block
of contiguous genes with pronounced sequence homologies between herpesviruses of 
known DNA primary structure. Comparisons confirmed that the two
gamma-herpesviruses are related; the group is, however, even more diverse than
the alpha-herpesviruses represented by their prototypes, herpes simplex virus and
varicella-zoster virus. H. saimiri DNA is strongly depleted in the dinucleotide
CpG, possibly the consequence of de novo methylation of persisting viral DNA in
lymphoid cells.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2154888 [PubMed - indexed for MEDLINE]

6019: J Med Chem. 1990 Feb;33(2):723-30.

Synthesis and inhibitory potency of peptides corresponding to the subunit 2
C-terminal region of herpes virus ribonucleotide reductases.

Gaudreau P, Paradis H, Langelier Y, Brazeau P.

Neuroendocrinology Laboratory, Notre-Dame Hospital Research Center, Montreal,
Canada.

H-Tyr329-Ala330-Gly331-Ala332-Val333-Va l334-Asn335-Asp336-Leu337-OH, the
C-terminal end of herpes simplex virus ribonucleotide reductase subunit 2 (HSV
R2), specifically inhibits viral enzyme activity by interacting with subunit 1
(HSV R1). In a previous structure-activity study, we identified four sites on the
nonapeptide where the inhibitory potency could be modulated: a minimum active
core 333-337, a spacer segment 330-332, and the N- and C-termini. To further
explore the structural features of HSV R2-(329-337) that are required to obtain a
potent inhibition, a series of analogues comprising modifications in these four
regions were synthesized by solid-phase methodology. Changes in the segment
333-337 of the molecule decreased the inhibitory potency by more than 2-fold,
except for the Ile334 substitution, which resulted in a 1.5-fold increase in
potency. Replacement of Tyr329 by other aromatic or aliphatic amino acids
diminished the nonapeptide activity from 1.4-fold to 5.9-fold. The spacer segment
contributed to enhance potency. Modification with amino acids that could induce
conformational changes, such as Pro or D-Ala, generated compounds with a similar 
or lower activity, respectively. Amidation or amino acyl addition at the
carboxylic end was detrimental while acylation of the N-terminus was generally
beneficial for the inhibitory potency. Disubstitution in position 332 and 334 by 
Thr and Ile, which are present in the C-terminal portion of varicella-zoster
virus ribonucleotide reductase subunit 2, resulted in a peptide that is 4.0 times
more potent than HSV R2-(329-337), while each monosubstitution alone generated
peptides with 150% of the activity of HSV R2-(329-337) nonapeptide. These results
indicate a synergistic effect of the disubstitution which confers to this
analogue physicochemical properties enhancing its ability to interact with its R1
binding site.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2153825 [PubMed - indexed for MEDLINE]

6020: Blood. 1990 Feb 1;75(3):806-9.

Studies on transfer of varicella-zoster-virus specific T-cell immunity from bone 
marrow donor to recipient.

Kato S, Yabe H, Yabe M, Kimura M, Ito M, Tsuchida F, Tsuji K, Takahashi M.

Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.

The transfer of antigen-specific cellular immunity in human bone marrow
transplantation (BMT) was studied in 49 donor-recipient pairs, using a
varicella-zoster-virus (VZV) specific lymphoproliferative response (LPR) assay.
Posttransplant VZV-LPR could be serially measured in 31 long-term surviving
recipients. VZV-specific T-cell immunity was detected in the early posttransplant
period in 4 of 16 recipients who were, and whose donors were, immune to VZV
before BMT, but two of those positive responses diminished in the first 100 days 
posttransplant. No positive response was detected in the immediate posttransplant
period when either only the recipient or the donor was immune to VZV
pretransplant. Herpes zoster or chickenpox developed in the recipients depending 
on a history of pretransplant VZV infection when the VZV-LPR became negative, and
recovery from VZV infection was always followed by quick conversion of VZV-LPR.
Long-lasting positive VZV-LPR was observed in the two recipients who experienced 
VZV infection in the immediate pretransplant period and received marrow graft
from an immune donor. Our results indicate that a simple or direct transfer of
VZV-specific cellular immunity from a marrow donor to a recipient cannot be
expected in usual clinical bone marrow transplantation and that there might be a 
collaboration or recruitment of immune responses involving both donor and
recipient that permits the VZV-LPR to remain positive posttransplant.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2153426 [PubMed - indexed for MEDLINE]

6021: Otolaryngol Head Neck Surg. 1990 Feb;102(2):177-9.

Ramsay-Hunt syndrome in a patient with HIV infection.

Mishell JH, Applebaum EL.

Department of Otolaryngology-Head and Neck Surgery, University of Illinois
College of Medicine, Chicago.

Publication Types: 
    Case Reports

PMID: 2113244 [PubMed - indexed for MEDLINE]

6022: Adv Exp Med Biol. 1990;278:243-53.

Acyclovir: the past ten years.

Whitley RJ, Middlebrooks M, Gnann JW Jr.

Department of Pediatrics, University of Alabama, Birmingham 35294.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 1963040 [PubMed - indexed for MEDLINE]

6023: Br Med Bull. 1990 Jan;46(1):113-23.

Treatment of post herpetic neuralgia in the elderly.

Robertson DR, George CF.

Geriatric Medicine, Southampton General Hospital, UK.

The incidence of acute herpes zoster and post herpetic neuralgia (PHN) increases 
with age. PHN resolves spontaneously within three months in approximately 50% of 
cases, although 22% experience discomfort for more than a year. There is little
good evidence that treatment with antiviral agents, corticosteroids, local and
regional anaesthesia, amantadine or levodopa in the acute stage can prevent the
development of PHN. However, few studies have sufficient statistical power to
allow firm conclusions to be drawn. Amitriptyline is beneficial in patients with 
established PHN and has an analgesic effect which is independent of its
antidepressant action. Anticonvulsants and neuroleptics are of unproven efficacy 
and should be avoided in the elderly as side effects are common. Various local
anaesthetic and surgical techniques may provide temporary relief in individual
patients although none has been shown to produce consistent benefit.
Transcutaneous electrical nerve stimulation (TENS) is free from adverse effects
and appears to benefit some patients. Intractable pain often results in
over-prescribing with the risk of adverse drug reactions. Drug therapy should be 
minimized with careful assessment of the risk/benefit ratio for any additional
medication.

Publication Types: 
    Review

PMID: 2405937 [PubMed - indexed for MEDLINE]

6024: Am J Pediatr Hematol Oncol. 1990 Summer;12(2):160-3.

Retrovir therapy in hemophilic children with symptomatic human immunodeficiency
virus infection: efficacy and toxicity.

Warrier I, Lusher JM.

Children's Hospital of Michigan, Wayne State University School of Medicine,
Detroit 48201.

In desperation, we have used retrovir in five hemophilic children (10-16 years
old) over the past 22 months. All had presented with various clinical
manifestations of acquired-immune-deficiency-syndrome (AIDS)-related complex or
AIDS. Our decision to treat with retrovir was based on clinical manifestations
and very low numbers of CD4 cells (less than 200). The most common clinical
presentation was recurrent oral moniliasis. Other significant findings included
recurrent herpes zoster, thrombocytopenia, growth failure, and biliary tract
infection. Initially, all five children received the full adult dosage of
retrovir (200 mg q 4 h x 6 doses/day). This dosage had to be reduced in four
children because of toxicity. The most commonly observed toxic side effects were 
anemia and neutropenia. Alanine aminotransferase (ALT) levels rose to 4-10 times 
the upper limit of normal in four of five children. One was on concomitant
ketokonazole prior to the rise in ALT level. Myalgia and headache were reported
by two patients. Improvement in clinical and immunological status was observed in
all children initially. After 12-18 months of retrovir therapy, infectious
complications secondary to prolonged neutropenia were seen in these
immunocompromized children. However, compared to historic controls, these
children have had fairly stable disease. We feel that all hemophilic children
with symptomatic human immunodeficiency virus infection should be offered this
drug, even though the optimal dosage for children is not yet established.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2378412 [PubMed - indexed for MEDLINE]

6025: J Perinat Med. 1990;18(2):101-9.

Is there an association between fetal viral infection and fetal malformation? I. 
Detection of specific IgM antibodies in the serum of malformed fetuses.

Rakocevic S, Presecki V, Jurkovic D, Kurjak A.

Institute of Immunology, Zagreb, Yugoslavia.

Determinations of IgG and IgM antibodies specific for cytomegalovirus (CMV),
herpes simplex virus (HSV1), herpes simplex virus (HSV2), varicella-zoster virus 
(VZV), rubella, echo, Coxsackie and morbilli viruses were performed in 20 sera
from malformed fetuses. Demonstration of a fetal infection by increased fetal
serum IgM permits linkage to a detected fetal malformation. In parallel, 14
maternal sera and 17 amniotic fluid samples were examined. Laser nephelometry (a 
quantitative method) was used for the determination of IgM and IgG class
immunoglobulins. None of the fetal sera were found to contain IgM class
antibodies specific for the viral antigens studies. While IgM CMV-specific
antibodies were present in one maternal serum, the specific IgM was absent in the
fetus. The absence of specific IgM antibodies appears to warrant the conclusion
that the malformed fetuses were uninfected by any of the above viruses. IgM
antibodies were detected in two fetal sera by quantitative methods. The IgM
antibodies present in two fetuses probably were generated in response to some
other introduced antigen.

PMID: 2366130 [PubMed - indexed for MEDLINE]

6026: Neurologia. 1990 Jan;5(1):4-10.

[Meningitis of viral or possible viral etiology in adults: study of 325 cases]

[Article in Spanish]

Martinez-Martin P, Herreros A, Tellez A, Echevarria JM.

Servicio de Neurologia, Hospital del Rey, Majadahonda, Madrid.

During five consecutive years, 325 patients older than 14 years with acute
possibly viral acute meningitis (VAM) were evaluated. Demographical, clinical and
laboratory data were obtained. In 50.5% of cases the etiological investigation of
the disease was undertaken with different methods. From the diagnostic point of
view, the findings can be nonspecific or equivocal, and only the judicious
assessment of clinical, laboratory (blood CRP) and the overall CSF measurements
can prevent errors in an early phase. The viral studies demonstrated a specific
etiology in 46% of the instances where they were carried out. The viruses
accounting for VAM which were more commonly identified included varicella-zoster,
enteroviruses, parotiditis and herpes simplex.

Publication Types: 
    English Abstract

PMID: 2361032 [PubMed - indexed for MEDLINE]

6027: Ter Arkh. 1990;62(1):99-103.

[Herpes zoster in cancer patients]

[Article in Russian]

Bogomolov BP, Bakhur EG.

In cancer patients, the development of herpes zoster (HZ) is accompanied by
protracted period of skin rash exudation and by slower scab rejection. Unlike
hematological patients, no unfavourable outcomes with infection generalization
are observed. The disease is associated with the rise of the content of total
IgM, IgA (to a lesser degree) and with the normal level of IgG. There is a
tendency towards the reduction of the count of T and B lymphocytes. The cases of 
primary diagnosis of a malignant tumor in HZ patients are more frequent (2 out of
36).

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 2333632 [PubMed - indexed for MEDLINE]

6028: Rev Med Interne. 1990 Jan-Feb;11(1):25-8.

[Peliosis hepatis in dermatomyositis treated with azathioprine and corticoids]

[Article in French]

Lorcerie B, Grobost O, Lalu-Fraisse A, Piard F, Camus P, Portier H, Martin F.

Service de Medecine I, Medecine Interne, C.H.U., Dijon.

We report a case of peliosis hepatis in a 47-year old male patient with
dermatomyositis treated with azathioprine and corticosteroids. Three months after
the combined treatment was initiated, the patient developed right thoracic herpes
zoster, agranulocytosis and liver enlargement with signs of portal hypertension. 
Needle biopsy of the liver revealed peliosis. Azathioprine was withdrawn. The
clinical and laboratory abnormalities disappeared progressively. The main causes 
of peliosis hepatis are considered. Up to now, azathioprine had been held
responsible for peliosis hepatis only in renal transplant recipients.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2326554 [PubMed - indexed for MEDLINE]

6029: Graefes Arch Clin Exp Ophthalmol. 1990;228(1):1-4.

Cutaneous eruption with or without ocular complications in patients with herpes
zoster involving the trigeminal nerve.

Yamada K, Hayasaka S, Yamamoto Y, Setogawa T.

Department of Ophthalmology, Shimane Medical University, Izumo, Japan.

We examined 62 patients with acute herpes zoster involving the trigeminal nerve; 
13 had eruptions only and 49 (51 eyes) had eruptions with ocular complications.
Bilateral involvement was found in two patients. The frequency of the disease
appeared to increase with age, and the disease was least active in November.
Patients with eruptions only demonstrated affected areas along the first, second,
and/or third divisions of the trigeminal nerve. Ocular complications occurred in 
patients who had eruptions along the first and/or second divisions of the nerve, 
and they were usually noted in patients with eruptions on the tip and one side of
the node. The ocular complications and associated systemic conditions varied.

PMID: 2311939 [PubMed - indexed for MEDLINE]

6030: Nervenarzt. 1990 Jan;61(1):46-51.

[Post-herpetic neuralgia: clinical predictors and psychopathologic findings]

[Article in German]

Leplow B, Lamparter U, Risse A, Wassilev SW.

Institut fur Psychologie, Christian-Albrechts-Universitat, Kiel.

48 patients, who had had acute Herpes zoster were screened for a retrospective
investigation concerning the development of post-herpetic neuralgia. Subjects
with and without neuralgia were compared with respect to medical, demographic and
psychological variables. Nine patients were excluded from the investigation
because of reported pain, which was not due to Herpes zoster. From the 39
subjects who remained in the analysis, 59% had postherpetic neuralgia for at
least three months, and 28% for more than a year. No medical or demographic risk 
factor was sufficient for a prediction of the pain group. By applying objective
criteria to psychometric test protocols, an index was constructed which differed 
between the groups. The pain-group showed a higher frequency of
psychopathological impairment than those without post-herpetic neuralgia.
However, the psychopathology was not consistently related to the length of
neuralgia or the intensity of persistent pain.

Publication Types: 
    English Abstract

PMID: 2308660 [PubMed - indexed for MEDLINE]

6031: Masui. 1990 Jan;39(1):106-10.

[A complete relief of intractable postherpetic neuralgia with intrathecal
methylprednisolone acetate]

[Article in Japanese]

Yamashiro H, Ogata R, Kawahara K.

Department of Anesthesia, Hamamatsu Medical Center.

A 72-year-old man, 154 cm tall, weighing 53 kg was suffering from severe herpetic
neuralgia on his left 10th intercostal nerve area. His pain continued even he was
treated with frequent epidural nerve block (4 to 5 times per week) by an
anesthesiologist. He was referred to our hospital on his 105th pain day. He
complained severe continuous pain and numbness on his left 10th intercostal nerve
area. Touching the painful skin induced lightning pain. His pain was so severe
that his sleeping was disturbed and also he could not maintain his usual life.
Epidural nerve block at 10th thoracic nerve was done with 20mg methylprednisolone
acetate and 5ml of 1% lidocaine. After the treatment, his pain was reduced to
3/10 of the one he had on admission, and also his sleep was not disturbed
further. Epidural nerve blocks with methylprednisolone weekly for a month induced
no more remission. At his 154th pain day, a dose of 20mg methyl prednisolone
acetate and 1% lidocaine 5ml was given intrathecally through 2nd lumber
intervertebral space. The pain was relieved completely after the block. And he
complained nothing about the skin area which had been disturbing his life for a
long time. Auditory brainstem response which was recorded during the block showed
prolongation of the latency of phase III and phase V at 40 minutes after the
intrathecal injection of lidocaine.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2304244 [PubMed - indexed for MEDLINE]

6032: J Am Acad Dermatol. 1990 Jan;22(1):130-1.

Lymphoplasmocytoid lymphoma arising in herpes zoster scars.

Aloi FG, Appino A, Puiatti P.

Department of Dermatology, University of Turin, Italy.

Publication Types: 
    Case Reports

PMID: 2298951 [PubMed - indexed for MEDLINE]

6033: J Acquir Immune Defic Syndr. 1990;3(1):87-91.

Clinical and epidemiological features of HIV infection at a referral clinic in
Zambia.

Hira SK, Ngandu N, Wadhawan D, Nkowne B, Baboo KS, Macuacua R, Kamanga J, Mpoko
B, Heiba IM, Perine PL.

School of Medicine, University of Zambia.

Among 1,350 patients with serologically confirmed HIV-1 infection evaluated at
the Dermatovenerealogy Clinic, University Teaching Hospital. Lusaka, through
March 1987, 125 (9.3%) had AIDS, 1,178 (87.3%) had AIDS-related complex, and 46
(3.5%) were asymptomatic. The male to female ratio of cases was 1.5:1 and women
were younger (mean age of 26.2 years) than were men (mean age of 31.2 years).
HIV-infected persons had significantly more lifetime sex partners than uninfected
persons; other risk factors were a prior history of venereal disease, blood
transfusion, travel abroad, and a positive syphilis serology. Clinical features
in decreasing order of frequency were weight loss, persistent generalized
lymphadenopathy, chronic cough, multidermatomal herpes zoster, diarrhea,
recurrent fevers, tuberculosis, and oropharyngeal candidiasis. The WHO clinical
case definition for the diagnosis of AIDS had a low positive predictive value for
the 125 Zambians with AIDS, but among all those infected with HIV, the positive
predictive value was 76.4%. Thirty (35.3%) of 85 patients who were HIV
seronegative when first examined acquired HIV infections during a 12- to 39-month
(means = 21.8 months) period of observation. Heterosexual intercourse unrelated
to prostitution appears to be the major mode of HIV transmission in Lusaka.

PIP: The clinical and epidemiologic characteristics of the 1st 1350 individuals
diagnosed at Zambia's Dermatovenerealogy Clinic in Lusaka between August
1985-December 1986 as a positive for human immunodeficiency virus (HIV) infection
were evaluated. 125 (9.3%) of these seropositive individuals presented with
aggressive Kaposi's sarcoma or an opportunistic infection and were thus diagnosed
with acquired immunodeficiency syndrome (AIDS), 1178 (87.3%) had AIDS-related
complex (ARC), and a further 47 (3.5%) were asymptomatic. The male to female
ratio of HIV-positive cases was 1.5 to 1. Female patients were younger (mean age 
26.1 years) than male patients (mean age, 31.2 years). The only sexual practice
acknowledged by the vast majority of cases was heterosexual vaginal intercourse, 
although infected men and women had significantly more lifetime sexual partners
than uninfected controls. Other significant risk factors for HIV seropositivity
were (for men) blood transfusion, travel outside of Zambia, and a history of
syphilis; for women, these risk factors were blood transfusion and a history of
venereal disease. The most common clinical features in AIDS and ARC patients
were, in decreasing order of frequency, weight loss greater than 10%, generalized
lymphadenopathy, chronic cough, multidermatomal herpes zoster, recurrent
diarrhea, recurrent fever, tuberculosis, and oropharyngeal candidiasis. The
provisional WHO clinical case definition of AIDS in Africa has a positive
predictive value of 82.1 for the sample as a whole, but only 46.3 for the 125
patients diagnosed with AIDS. 17 of the HIV-positive patients had died by the
18-month follow-up.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 2293647 [PubMed - indexed for MEDLINE]

6034: Adv Exp Med Biol. 1990;278:267-75.

A double-blind clinical study in patients with herpes zoster to establish YN-72
(Brovavir) dose.

Niimura M.

Department of Dermatology, Jikei University School of Medicine, Tokyo.

Double-blind clinical trials were performed with a placebo to determine the
optimum dose of YN-72 in patients with herpes zoster. YN-72 at 10, 50, and 100 mg
was administered orally three times daily for 7 days. A total of 226 patients
entered the present trial. Six of the 226 patients were excluded from statistical
analysis of data. Furthermore, seven patients were excluded from the analysis for
efficacy and usefulness, and included in the analysis for safety. The numbers of 
patients included in the analyses for efficacy and usefulness were 50 in the
placebo group, 54 in the YN-72 30-mg/day group, 56 in the 150-mg/day group, and
53 in the 300-mg/day group. The numbers of patients included in analysis for
safety were 53 in the placebo group, 58 in the YN-72 30-mg/day group, 56 in the
150-mg/day group and 53 in the 300-mg/day group. The effectiveness rate at the
end of administration was 42.0% in the placebo group, 79.6% in the YN-72
30-mg/day group, 80.4% in the 150-mg/day group, and 61.5% in the 300-mg/day
group. The rates in the YN-72 groups were significantly higher than in the
placebo group. Evaluation at the end of the trials revealed that administration
of YN-72 was effective. Among skin symptoms, administration of YN-72 accelerated 
the disappearance of erythema and vesicles and the formation of crust.
Administration of YN-72 tended to accelerate the reduction and disappearance of
pain. Reduction and disappearance in the YN-72 150-mg/day group occurred
significantly earlier than in the placebo group (log-rank test).(ABSTRACT
TRUNCATED AT 250 WORDS)

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Multicenter Study

PMID: 2288297 [PubMed - indexed for MEDLINE]

6035: Vestn Dermatol Venerol. 1990;(11):48-9.

[A case of generalized herpes zoster ending fatally]

[Article in Russian]

Dovzhanskii SI, Sherstneva VN, Kozbeva VI, Vedishcheva VA, Rozhdestvenskaia EI.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2288156 [PubMed - indexed for MEDLINE]

6036: Scand J Infect Dis Suppl. 1990;71:30-5.

Varicella-zoster infections in late pregnancy.

Sterner G, Forsgren M, Enocksson E, Grandien M, Granstrom G.

Department of Infectious Diseases, Danderyd Hospital, Sweden.

Publication Types: 
    Guideline

PMID: 2287913 [PubMed - indexed for MEDLINE]

6037: Vestn Dermatol Venerol. 1990;(10):62-3.

[The gangrenous form of herpes zoster in a patient with disseminated psoriasis]

[Article in Russian]

Romanenko VN, Makhmud D.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 2278201 [PubMed - indexed for MEDLINE]

6038: Curr Med Res Opin. 1990;12(3):169-76.

Double-blind, placebo-controlled clinical trial of a mixture of gangliosides
('Cronassial') in post-herpetic neuralgia.

Staughton RC, Good J.

Skin Department, Westminster Hospital, London, England.

A double-blind, parallel-group clinical trial was carried out in 25 patients with
post-herpetic neuralgia to determine the efficacy and tolerability of a mixture
of gangliosides ('Cronassial') compared with placebo. Patients were allocated at 
random to receive treatment with either 'Cronassial' (100 mg in 2 ml buffered
solution) or placebo given by 11 subcutaneous injections over a period of 27
days, and their symptoms assessed on entry and after 2, 4 and 8 weeks. The four
aspects of pain considered (overall pain, hyperaesthesia, stabbing pain and
constant ache) all showed maintained reductions in severity with 'Cronassial'
treatment, but not with placebo. In the case of hyperaesthesia, this difference
between treatments was statistically significant (both during and after the
course of injections), even with the relatively small number of patients in this 
study. Sleep patterns showed significant sustained improvements with
'Cronassial', but not with placebo treatment. Other psychological assessments
(general psychological state, appetite and mood) showed little difference between
'Cronassial' and placebo treatment. Although 'Cronassial' was well tolerated
systemically, 1 of the 12 patients was withdrawn because of general malaise, and 
5 patients had local pain at the injection sites. Two of these 5 patients were
withdrawn from the study. There were no withdrawals in the placebo group. It is
suggested that further studies employing greater numbers of patients should be
carried out to confirm the efficacy of gangliosides in improving symptoms of
patients with post-herpetic neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 2272191 [PubMed - indexed for MEDLINE]

6039: Med Cutan Ibero Lat Am. 1990;18(3):151-3.

[Zosteriform eruption in a girl during resolution of varicella]

[Article in Spanish]

del Pozo LJ, Vilella J.

Servicio de Dermatologia, Hospital del Insalud, Soria.

We show the case of a six-years-old little girl with a herpes zoster which
appeared while a varicella was resolving. We are discussing the diagnosis
difficulties of this process.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2263089 [PubMed - indexed for MEDLINE]

6040: Vestn Dermatol Venerol. 1990;(8):62-4.

[Herpes zoster in 2 sisters]

[Article in Russian]

Bukharovich AM, Kviatkovskaia GV, Kucher LN.

Transmission of herpes zoster infection from one sister to the other is
described, resultant from close everyday contacts. Clinical manifestations of the
disease (severity, dissemination, course and type of involvement) were much more 
marked in the elder sister, suffering from disseminated Darier's dyskeratosis and
marked debility. Herpes was complicated with vasculitis, necrosis, Pseudomonas
aeruginosa infection, development of pneumonia and keratitis. Problems of
treatment of such patients are discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2256385 [PubMed - indexed for MEDLINE]

6041: Acta Paediatr Hung. 1990;30(2):263-70.

Early relapses of varicella-zoster virus infection in immunocompromised children 
treated with acyclovir.

Meszner Z, Gyarmati E, Nyerges G, Simon M, Koller M.

Postgraduate Medical School, Central Municipal Hospital for Infectious Diseases, 
Budapest.

Authors observed one or more early VZV relapses in 8 out of 98 Acyclovir treated 
immunocompromised children with varicella. None of the 8 children developed VZV
antibodies by the end of the 5-day ACV treatment. All VZV relapses were
successfully treated with ACV or Vidarabine, but were stopped only after the
appearance of VZV antibodies in the patients' sera. The possible role of ACV
treatment in pathogenesis of early VZV relapses could be excluded by comparing
the VZV antibody production of patients treated with ACV from the first day of
varicella on with the antibody response of those, who received ACV as late as on 
the 5th day of varicella. By prolonging the ACV treatment till the appearance of 
VZV antibodies, early relapses could be avoided.

PMID: 2248805 [PubMed - indexed for MEDLINE]

6042: Ann Otolaryngol Chir Cervicofac. 1990;107(4):270-2.

[How many peripheral facial paralyses are manifestations of Lyme disease? A
French multicenter study]

[Article in French]

Ruel M.

Service de Medecine II, Centre Hospitalier de Senlis.

The diagnosis of Lyme disease is easy on the basis of clinical features only when
it combines migrans chronic erythema, severe root pain affecting the limbs and
facial paralysis, above all when bilateral. When pain is transient and slight and
when erythema and the tick bite are absent facial paralysis may be mistaken for
Bell's palsy. The risk is that of failing to recognise Lyme disease which may
subsequently manifest itself as severe neurologic complications minimally
sensitive to antibiotics. The multicenter study envisaged is designed to
determine the incidence of Borrelia burgdorferi seroconversion in all individuals
with a non-traumatic peripheral facial paralysis seen between 1.1.90 and
12.31.90. Serology is difficult to interpret on an individual basis. A large
series will be necessary in order to be able to draw reliable conclusions. Two
control series will be used: one consisting of a sub-group of facial paralyses
with herpes zoster vesicles and the other based upon pairing of two control sera 
for each Borrelia burgdorferi positive serum. This should show whether Lyme
disease need really be feared in presence of an apparently isolated FP.

Publication Types: 
    Clinical Trial
    English Abstract
    Multicenter Study

PMID: 2221718 [PubMed - indexed for MEDLINE]

6043: Srp Arh Celok Lek. 1990 Jan-Feb;118(1-2):23-8.

[Acute meningitis without cutaneous manifestations caused by varicella zoster
virus--intrathecal synthesis of specific antibodies]

[Article in Serbian]

Nikolic S, Vujosevic M, Zerajev S, Dulovic O.

The results of virusologic and cytobiochemical evaluation of CSF and serum
samples of four patients with acute viral meningitis (AVM), most probably induced
by varicella zoster virus (VZV), are reported. In no case VZV infection was not
cutaneously manifested. Aetiologic diagnosis was established according to the
presence of specific anti VZV AVM, in spite of their presence in the sera. On
samples detected by indirect enzyme immunoassay (EIA). Four different antibody
indexes were used to prove that the antibodies were intrathecally synthesized.
Other viral antibodies (HSV, mumps) were not evident in the CSF samples of the
patients with VZV avm, in spite of their presence in the sera. On the other hand,
anti VZV antibodies could not be identified in the CSF samples of the controls
(AVM of other aetiology, meningism) in spite of their presence in the sera. A
possible aetiologic link between anti VZV antibodies presence in the CSF samples 
and some neurologic syndromes is discussed.

Publication Types: 
    English Abstract

PMID: 2218729 [PubMed - indexed for MEDLINE]

6044: Jpn J Med. 1990 Jan-Feb;29(1):99-103.

Herpes zoster ophthalmicus with delayed contralateral hemiparesis.

Tojo K, Onozawa T, Toyohara K, Shimojo S, Sakai O.

Second Department of Medicine, Jikei University School of Medicine, Tokyo, Japan.

A 35-year-old previously healthy woman developed left hemiparesis sixteen weeks
after the onset of right herpes zoster ophthalmicus. Cerebral angiography showed 
complete occlusion of right middle cerebral artery at the origin and segmental
narrowing of the right posterior cerebral artery. Computerized tomography (CT)
and magnetic resonance imaging (MRI) also revealed a right hemispheric lesion
consistent with angiographic findings. Reports from the literature along with the
present case suggest that arteritis followed by cerebral infarction is the most
probable cause of delayed contralateral hemiparesis.

Publication Types: 
    Case Reports

PMID: 2214356 [PubMed - indexed for MEDLINE]

6045: Psychosomatics. 1990 Summer;31(3):287-92.

A double-blind, placebo-controlled study of oral acyclovir in postherpetic
neuralgia.

Surman OS, Flynn T, Schooley RT, Baer L, Parker S, Hirsch MS, Davis LG.

Department of Psychiatry, Massachusetts General Hospital, Boston 02114.

Twenty-one patients with postherpetic neuralgia of two- to 84-months duration
participated in a double-blind, placebo-controlled study of oral acyclovir. Pain 
perception was assessed with the Melzack Pain Questionnaire at baseline and at
two-to six-week intervals during the ensuing six months. Clinically significant
pain reduction occurred in eight patients: four received acyclovir, and four
received a placebo. Several treatment strategies have been advocated for relief
of postherpetic neuralgia. Results of the present study demonstrate the need for 
a double-blind, placebo-controlled paradigm to substantiate the efficacy of new
clinical approaches. The same caveat applies to the more common syndromes
encountered in psychiatric practice.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 2201992 [PubMed - indexed for MEDLINE]

6046: Trans R Soc Trop Med Hyg. 1990;84 Suppl 1:7-8.

Virus infections in patients with AIDS.

Griffiths PD.

Department of Virology, Royal Free Hospital School of Medicine, Hampstead,
London, UK.

Virus infections are common in patients with acquired immune deficiency syndrome 
(AIDS). Viruses can have two distinct relationships with human immunodeficiency
virus (HIV); they can be opportunists if the second virus takes advantage of
decreased immune function in the host or they can act as co-factors to accelerate
the rate at which AIDS develops. Viruses acting as opportunists may cause no
symptoms or may be life-threatening. Several, including herpes simplex, varicella
zoster, cytomegalovirus and Epstein-Barr virus, can be treated with antiviral
agents. Before concluding that a virus can act as a co-factor for HIV, several
other possible relationships must be excluded including opportunism,
co-parameters of lifestyle and prognostic markers. Studies in vitro may suggest
which viruses are potential co-factors but clear evidence can come only from
carefully defined cohorts of patients. Recent evidence showing that
cytomegalovirus can meet these criteria is presented.

Publication Types: 
    Review

PMID: 2201112 [PubMed - indexed for MEDLINE]

6047: Trans R Soc Trop Med Hyg. 1990;84 Suppl 1:1-6.

Opportunistic infections in AIDS in developed and developing countries.

Fleming AF.

Department of Medicine and Infectious Diseases, Liverpool School of Tropical
Medicine, UK.

The acquired immune deficiency syndrome (AIDS) is fundamentally the same disease 
in all parts of the world, but the prevalence of microorganisms in an environment
governs the patterns of disease arising from reactivated latent infections,
invading pathogens and opportunistic infections. AIDS in Africa has certain
characteristic presentations. Enteropathic AIDS is most common: Cryptosporidium
and Isospora belli are identified in up to 60% of patients, but it is uncertain
whether they are the causes of diarrhoea. Pneumocystis carinii pneumonia is rare.
Tuberculosis, both pulmonary and extrapulmonary, is the supreme complicating
infection. Herpes zoster is frequently the first clinical presentation, and has a
95% positive predictive value for HIV positivity. Measles may be more frequent in
infants born to HIV-infected mothers, and appears to be worse in HIV-infected
children. There is accelerated progress of both diseases in patients infected by 
HIV and Mycobacterium leprae. Salmonellosis is frequent. There is no direct
interaction between malaria and HIV, but, by being a potent cause of anaemia,
malaria enhances transmission of HIV to children through blood transfusion.
HIV-positive subjects are liable to new or reactivated visceral leishmaniasis
with dissemination to unusual sites. Cerebral toxoplasmosis is common. There are 
no apparent interactions between HIV and helminths, although there is one report 
of hyperinfection with Strongyloides stercoralis. Cryptococcal meningitis has
high frequency. Infections with Histoplasma encapsulatum are common in tropical
America, but there has been no increase of frequency of H. duboisii in Africa
since the advent of AIDS.

Publication Types: 
    Review

PMID: 2201107 [PubMed - indexed for MEDLINE]

6048: Fortschr Ophthalmol. 1990;87(2):124-7.

[Incidence and function of Langerhans cells in various corneal diseases]

[Article in German]

Philipp W, Gottinger W.

Universitats-Klinik fur Augenheilkunde, Innsbruck.

Using immunohistochemical techniques, we investigated the distribution and
frequency of Langerhans cells in corneal buttons obtained from patients who
underwent corneal transplantation because of various corneal diseases. The
frequency of these dendritic cells was similar to that in the normal epidermis in
corneas with epidermalization after severe alkali burns. Numerous Langerhans
cells, albeit in smaller numbers, were also present in the central corneal
epithelium of patients with keratitis due to infection with herpes simplex virus,
keratitis due to herpes zoster virus, bacterial corneal ulcers, corneal scars,
corneal ulcers associated with rheumatoid arthritis, and patients with chronic
corneal allograft reactions. The presence and persistence of Langerhans cells in 
diseased corneas may account for, at least in part, a breakdown of corneal immune
privilege with a higher rate of rejection episodes after corneal transplantation.
Furthermore, it is probable that Langerhans cells as potent antigen-presenting
cells may also play an important role in the initiation and the progression of
immune responses in various inflammatory corneal diseases.

Publication Types: 
    English Abstract

PMID: 2192971 [PubMed - indexed for MEDLINE]

6049: Baillieres Clin Haematol. 1990 Jan;3(1):177-205.

AIDS in Africa.

Fleming AF.

PIP: The seroprevalence, clinical epidemiology, modes of transmission, clinical
presentation in adults, pregnancy women and children, diagnosis, impact and
control strategies of AIDS in Africa are covered in this review. HIV-1, the
causative virus in AIDS, is epidemic in a central Africa belt from Gabon to the
east coast, and from Uganda to Zimbabwe, with the highest prevalence in the lakes
and highlands of Central Africa. HIV-2 causes a milder disease in Western Africa 
centered in Senegal. HIV infections occur primarily in young adult men aged
30-34, women aged 20-24, infants and children under 4, and a few girls.
Transmission patterns vary widely depending on sexual customs in the ethnically
diverse continent. Prevalence tends to be high in cities and among subgroups such
as prostitutes, where promiscuity is restricted. Where female sexual
permissiveness exists, seropositivity is high in women generally. Besides sexual 
behavior, risk factors for HIV in Africa also include uncircumcised man, oral
contraception, STDs causing genital ulceration and Chlamydia infection.
Transmission to neonates occurs, especially if the mother has advanced AIDS, but 
transmission by breast milk is uncertain. Transmission by blood transfusion is
common because transfusion are up to 10 times as common in Africa as in the West,
especially in obstetrics and pediatrics. Clinically, HIV infections present as
herpes zoster in 95% of Africans, and commonly as slim disease: weakness, fever, 
chronic watery diarrhea and weight loss of unknown cause. Associated infection
are candidiasis, cryptosporidiosis, isosporiasis, tuberculosis and salmonellosis.
Other presenting symptoms are unusual sites of lymphadenopathy, cough and sepsis.
Diagnosis can be made by the WHO clinical case definition, or be screening tests,
which are now more reliable for African patients than formerly. In Africa, AIDS
can cause destitution and disgrace for families, and will probable severely
affect progress made national economies because of deaths of young productive
adults. Strategies for control of HIV in Africa are outlined.

Publication Types: 
    Review

PMID: 2182139 [PubMed - indexed for MEDLINE]

6050: Eye. 1990;4 ( Pt 5):732-6.

The value of laboratory testing in uveitis.

Kijlstra A.

Dept. Ophthalmo-Immunology, The Netherlands Opthalmic Research Institute,
Amsterdam, The Netherlands.

Accurate diagnosis of uveitis is of great importance since the treatment for the 
various uveitis entities may differ considerably. In a large number of cases the 
clinical picture is sufficient to make an adequate diagnosis. There are cases in 
which the diagnosis cannot be made on clinical grounds alone and support is
needed from laboratory tests. Only a limited number of tests have been proven to 
be useful as a diagnostic or prognostic aid. These include HLA-B27 typing in
patients presenting with anterior uveitis and testing for angiotensin converting 
enzyme and lysozyme in case of suspected sarcoid uveitis. Toxoplasma serology is 
only useful to exclude the diagnosis and a positive test has very low specific
value. Analysis of local intraocular antibody production is a valuable tool to
confirm a suspected clinical diagnosis in uveitis. It is now possible to analyse 
paired serum and aqueous samples for the presence of specific antibodies against 
toxoplasma, cytomegalovirus, herpes simplex virus and varicella zoster virus
using commercially available kits. Of the patients retrospectively diagnosed as
having toxoplasma chorioretinitis 75% were shown to have a positive antibody
coefficient indicating specific intraocular antibody production. Local antibody
production in the eye directed against CMV confirmed the suspected diagnosis of
CMV retinitis in 50% of the AIDS patients investigated. Until now we have not
been able to measure local antibody production against herpes simplex virus (26
samples tested). Two of three patients with acute retinal necrosis had a positive
antibody coefficient against varicella zoster virus. Both of these patients even 
had a higher titre in the aqueous than in serum. Since the choice of treatment,
in infectious uveitis, depends on the causative organisms, it is very important
to confirm a suspected clinical diagnosis with aqueous humor analysis.

PMID: 2178095 [PubMed - indexed for MEDLINE]

6051: Cancer Invest. 1990;8(5):509-21.

Herpesvirus and enteric viral infections in bone marrow transplantation: clinical
presentations, pathogenesis, and therapeutic strategies.

Holland HK, Wingard JR, Saral R.

Oncology Center, Johns Hopkins Medical Institutions, Baltimore, Maryland.

Publication Types: 
    Review

PMID: 2176125 [PubMed - indexed for MEDLINE]

6052: Scand J Infect Dis. 1990;22(5):519-26.

Early diagnosis of enteroviral meningitis by a solid-phase reverse immunosorbent 
test and virus isolation.

Glimaker M, Ehrnst A, Magnius L, Berglund P, Forsgren M, Vikerfors T, Olcen P.

Department of Infectious Diseases, Orebro Medical Center Hospital, Stockholm,
Sweden.

45 cases of aseptic meningitis/meningoencephalitis were studied with regard to
enteroviral etiology by virus isolation and solid-phase reverse immunosorbent
test (SPRIST), a cross-reacting test for enterovirus IgM. An etiological
diagnosis was reached in 37/45 (82%) patients. Etiological diagnoses other than
enteroviruses were found in 8 patients: Borrelia burgdorferi in 4,
varicella-zoster virus in 2, herpes simplex virus in 1 and mumps virus in 1
patient. Enteroviruses (echovirus 6, 21 and 30) were isolated from cerebrospinal 
fluid (CSF) in 26/37 (70%) and from stool samples of 20/21 (95%) of patients with
no other etiology. Altogether enteroviruses were isolated from CSF and/or faecal 
samples in 29 patients. Echovirus 30 dominated as etiologic agent. In 34/40 (85%)
of the samples with an enterovirus, a cytopathogenic effect was observed in cell 
culture within 4 days. In patients with an enterovirus isolate a SPRIST IgM
response to echovirus 3, 5, 7 and/or coxsackievirus B3 was detected in 6/13 (46%)
sera sampled 3-4 days after the onset of meningeal symptoms and in altogether
17/25 patients (68%). In 4 out of these virus isolation positive and SPRIST
negative patients a single serum for SPRIST was available less than 4 days after 
onset of meningeal symptoms. Antigen from echovirus 5 gave the highest diagnostic
yield. The SPRIST IgM test was positive in 2 cases where virus isolation,
complement fixation and neutralization tests were negative. Epidemiological data 
however supported an enteroviral diagnosis in both of them. In conclusion, both
SPRIST and virus isolation seem to be valuable for the early diagnosis of
enteroviral meningitis.

PMID: 2175448 [PubMed - indexed for MEDLINE]

6053: Crit Rev Neurobiol. 1990;5(3):265-311.

Microenvironment of the peripheral nervous system under normal and pathological
conditions.

Olsson Y.

Laboratory of Neuropathology, Uppsala University, Sweden.

The peripheral nervous system (PNS) is composed of neurons and their processes
which are located in a special fluid microenvironment. As is well known, complex 
biological functions such as those going on in peripheral nerves are best carried
out when there is homeostasis, i.e., in a constant internal milieu. This paper is
concerned with the maintenance of the homeostasis in the PNS under normal and
pathological conditions. Diffusion barriers located in the intrinsic vessels of
the PNS and the perineurium have the capacity to regulate the environment around 
the nerve fibers and to keep it away from the blood and the extracellular fluid
outside the PNS. Endoneurial vascular permeability has similarities to that in
the central nervous system, but compared with the blood-brain barrier the
blood-nerve barrier is less efficient. This implies that toxic and infectious
agents as well as some drugs have easier access to the parenchyma in nerves than 
to the brain parenchyma. However, ganglionic vessels lack an efficient vascular
barrier to many substances which is important in intoxications caused by, e.g.,
doxorubicin, lead, mercury, and cadmium. It has also a significance in herpes
zoster infection and presumably in Guillain-Barre syndrome. The diffusion
barriers may themselves be influenced by pathologic processes and can then
respond with an increased permeability. This may lead to the formation of edema
in the PNS, i.e., one of the cardinal features of many diseases in nerves of
traumatic, toxic, and inflammatory nature. Such a response had negative as well
as positive implications. Severe edema may disturb the normal microcirculation in
the endoneurial vessels and stimulate collagen production and fibrosis. However, 
the presence of a protein-rich endoneurial edema may well be important in repair 
processes such as reduplication of Schwann cells and growth of axons.

Publication Types: 
    Review

PMID: 2168810 [PubMed - indexed for MEDLINE]

6054: Virchows Arch A Pathol Anat Histopathol. 1990;417(3):247-53.

Dyskeratosis congenita (Zinsser-Cole-Engman syndrome). An autopsy case presenting
with rectal carcinoma, non-cirrhotic portal hypertension, and Pneumocystis
carinii pneumonia.

Kawaguchi K, Sakamaki H, Onozawa Y, Koike M.

Department of Pathology, Tokyo Metropolitan Komagome Hospital, Japan.

A 24-year-old Japanese man presented with dyskeratosis congenita (DC,
Zinsser-Cole-Engman syndrome) complicated by non-cirrhotic portal hypertension,
signet ring carcinoma of the rectum and Pneumocystis carinii pneumonia. At the
age of 9 years, he was diagnosed as having DC on the basis of typical clinical
manifestations including atrophic lingual papillae, hyperpigmentation of the
skin, thrombocytopenia, and ophthalmological abnormalities. A few years later
pancytopenia and splenomegaly developed. At 24 years, signet ring carcinoma of
the rectum was detected but could not be resected because of the severity of the 
pancytopenia. Death was due to respiratory failure from P. carinii pneumonia. At 
autopsy the case illustrated several unique findings for DC, including
non-cirrhotic portal hypertension, atrophy of frontal lobe and markedly slender
folia of the cerebellum and superimposed infections with herpes zoster virus and 
P. carinii. Striking lymphocyte depletion and atrophy of lymphoid parenchyma in
lymph nodes, tonsils, spleen, gastrointestinal tract, or thymus were seen
histologically. The morphological picture supports the suggestion that there is a
defect in the cell-mediated immune system in patients with DC, although
immunoglobulin levels in the blood are normal. The cell-immune deficiency is a
major factor in the poor prognosis.

Publication Types: 
    Case Reports

PMID: 2166977 [PubMed - indexed for MEDLINE]

6055: Curr Eye Res. 1990;9 Suppl:7-11.

Detection of locally produced antibodies to herpes viruses in the aqueous of
patients with acquired immune deficiency syndrome (AIDS) or acute retinal
necrosis syndrome (ARN).

Luyendijk L, vd Horn GJ, Visser OH, Suttorp-Schulten MS, vd Biesen PR, Rothova A,
Kijlstra A.

Department of Ophthalmo-Immunology, The Netherlands Ophthalmic Research
Institute.

Intraocular synthesis of IgG antibodies against HSV (herpes simplex virus), CMV
(cytomegalovirus) and VZV (varicella zoster virus) is considered as an indirect
proof of uveoretinal infection. Paired serum and aqueous samples obtained from 16
patients with retinitis associated with AIDS, 3 patients with ARN, 8 patients
with posterior uveitis not related to AIDS or ARN and 5 patients with senile
cataract were tested for total immunoglobulin G levels and antibodies to HSV, CMV
and VZV by the fixed cell immunofluorescence technique. Since therapy must often 
be started before results of cultures are available, rapid detection of locally
produced anti-Herpes Virus antibodies can be a precious tool in the diagnosis of 
ocular viral infection. Using this technique we were able to confirm the
clinically suspected diagnosis in more than 50% of AIDS patients with retinitis
and in two out of three patients with ARN.

PMID: 2166640 [PubMed - indexed for MEDLINE]

6056: Arch Virol. 1990;112(3-4):203-13.

HSV-1 gB and VZV gp-II crossreactive antibodies in human sera.

Kuhn JE, Klaffke K, Munk K, Braun RW.

Institute for Medical Virology, University of Heidelberg, Federal Republic of
Germany.

The specificity and prevalence of human IgG antibodies crossreactive between
HSV-1 (ANG) and VZV (Ellen) was examined in immunoblots. Using antibody fractions
purified on HSV- and VZV-coated affinity chromatography columns and by
preadsorption of sera with HSV and/or VZV lysates a crossreactivity between HSV-1
gB and VZV gp-II was demonstrated. Crossreaction of human IgG antibodies among
other structural and nonstructural viral proteins, however, was not detected. The
frequency of human IgG antibodies crossreactive between HSV-1 gB and VZV gp-II
was highest in HSV-seropositive patients experiencing an acute primary VZV
infection (4 out of 5 sera tested). In contrast, no crossreactive antibodies were
found in sera of HSV-seronegative patients with acute primary VZV infection (0/6)
or in sera from individuals with acute recurrent HSV or VZV infection (0/12).
Analysis of sera from individuals with previous HSV and/or VZV infection showed
the presence of antibodies crossreactive between HSV-1 gB and VZV gp-II in 3 out 
of 30 sera tested.

PMID: 2165766 [PubMed - indexed for MEDLINE]

6057: Microbiol Immunol. 1990;34(4):407-11.

Drug susceptibilities of isolates of varicella-zoster virus in a clinical study
of oral brovavir.

Machida H, Nishitani M.

Biology Laboratory, R & D Division, Yamasa Shoyu Co., Ltd., Chiba.

Susceptibilities to brovavir
[1-beta-D-arabinofuranosyl-E-5-(2-bromovinyl)-uracil] and acyclovir of clinical
isolates of varicella-zoster virus obtained from 58 patients with herpes zoster, 
included in a clinical trial of oral brovavir, were tested by a plaque reduction 
method. All 101 isolates were significantly susceptible to brovavir; 50%
effective dose of brovavir for these isolates ranged between 0.6-4.0 ng/ml
(average: 1.29 ng/ml). Brovavir was about 3,000 times more potent than acyclovir 
against these isolates. No marked change in the susceptibility of isolates from
these patients during treatment with brovavir was observed.

PMID: 2163486 [PubMed - indexed for MEDLINE]

6058: Verh K Acad Geneeskd Belg. 1990;52(1):69-99.

New acquisitions in the chemotherapy of viral infections.

De Clercq E.

Department of Human Biology, Rega Institute for Medical Research, Katholieke
Universiteit Leuven, Belgium.

The development of new antiviral agents has gained increasing momentum. It has
kept pace with the identification of specific sites ("targets") in the virus
replicative cycle at which potential antiviral drug can interact. The current
armamentarium of available antiviral drugs consists of amantadine and rimantadine
(against influenza A), ribavirin (against respiratory syncytial virus infection),
idoxuridine and trifluridine (against herpetic keratitis), vidarabine and
acyclovir (against herpes simplex virus infections), ganciclovir (against
cytomegalovirus infections) and Retrovir (against AIDS). Various new compounds
have been found which selectively inhibit those viruses [i.e. adenovirus,
varicella-zoster virus, thymidine kinase-deficient (TK-) herpes simplex virus
strains, and rhinoviruses] that are insensitive or poorly sensitive to the
presently available antivirals. Several new compounds have also proven active
against human immunodeficiency virus, the causative agent of AIDS; and, as a
spin-off of the search for anti-AIDS drugs, new agents may also be expected that 
are effective against other retrovirus infections as well as hepadnavirus (i.e.
hepatitis B virus) infections.

Publication Types: 
    Review

PMID: 2162118 [PubMed - indexed for MEDLINE]

6059: Microbiol Immunol. 1990;34(3):269-82.

Detection of varicella-zoster virus DNA by field-inversion gel electrophoresis.

Arao Y, Yoshida M, Bai ZL, Kori Y, Nakatsukasa A, Takei Y, Aoji K, Yamada M, Uno 
F, Miyoshi K, et al.

Department of Virology, Okayama University Medical School.

A new method for detection of varicella-zoster virus (VZV) DNA using
field-inversion gel electrophoresis (FIGE) was devised. VZV-genomic DNA could be 
differentiated from the host cell DNA of human embryonic lung (HEL) fibroblasts
infected with VZV under electrophoretic conditions allowing resolution of linear 
and double-stranded DNAs in the 49-230 kilobase pairs (Kb) range. The detection
of VZV-genomic DNA from infected HEL cells was successful regardless of whether
the VZV was a laboratory strain, live vaccine strain, or fresh isolate. Under the
same electrophoretic conditions, DNA of VZV-infected HEL cells could be clearly
differentiated from DNA obtained from HEL cells infected with herpes simplex
virus type 1 (HSV-1), type 2 (HSV-2), or human cytomegalovirus (HCMV).
Furthermore, VZV genomic DNA could be detected from as small a sample as 1.9 x
10(4) VZV-infected HEL cells. Finally, we could detect VZV genomic DNA from 10
samples of vesicle tissue (blister lids, each about 1-4 mm2) and one sample of
vesicle fluid (about 5 microliters) obtained from patients diagnosed as having
herpes-zoster. The results of this study indicate that FIGE is a simple and
promising method for the detection of VZV from clinical materials as well as
infected in vitro cultured cells.

Publication Types: 
    Comparative Study

PMID: 2161996 [PubMed - indexed for MEDLINE]

6060: Cancer Immunol Immunother. 1990;31(3):191-5.

Viral reactivation as a cause of unexplained fever in patients with progressive
metastatic breast cancer.

Rasoul-Rockenschaub S, Zielinski CC, Muller C, Tichatschek E, Popow-Kraupp T,
Kunz C.

2nd Department of Medicine, University Hospital, Vienna, Austria.

Patients suffering from metastatic breast cancer and recurrent fever were
investigated for viral reactivation or new viral infection as a possible cause of
these febrile episodes. Three groups of patients were included in the study: (a) 
patients under adjuvant chemotherapy with cyclophosphamide, methotrexate and
fluoruracil, (b) patients with stable metastatic disease treated with
cyclophosphamide, fluoruracil and Adriamycin or mitoxantrone and (c) patients
with progressive metastatic disease who also received the latter treatment.
During the time of observation, patients under adjuvant chemotherapy did not
present with fever or asymptomatic viral reactivation or bacterial infections at 
all. Out of 7 patients with stable disease, 2 had bacterial infections that
coincided with the leukocyte nadir, and 1 presented with asymptomatic
reactivation of cytomegalovirus. In contrast, fever in 9 of 11 patients with
progressive disease was associated with a reactivation of herpes simplex virus
(HSV) and in 3 of them with a consecutive reactivation of varicella zoster virus 
(VZV). The increase in complement-fixing anti-HSV or anti-VZV antibodies occurred
in close association with a rise of the respective preexisting antibodies of the 
IgG class. In addition, HSV-infected cells were recovered from the urine of 7
patients with progressive disease further corroborating the serological data.
Incidentally, natural killer cell activity, which has been postulated to be
connected with the defense against viral infections, was found to be
significantly lower in the group of patients with progressive disease, as
compared to the group of patients under adjuvant chemotherapy (P less than 0.05) 
or to the group of patients with stable disease (P less than 0.05). We conclude
that unexplained fever in patients with progressive metastatic breast cancer may 
result from viral reactivation.

PMID: 2159848 [PubMed - indexed for MEDLINE]

6061: Virus Res. 1990 Jan;15(1):57-68.

Trans-activation of viral tk promoters by proteins encoded by varicella zoster
virus open reading frames 61 and 62.

Cabirac GF, Mahalingam R, Wellish M, Gilden DH.

Rocky Mountain Multiple Sclerosis Centers, Colorado Neuroscience Institute,
Department 7500LB, Englewood 80150-0101.

Plasmids containing the varicella zoster virus (VZV) open reading frames (ORFs)
61 and 62 were used in a transient co-transfection assay to test for
trans-activation of the VZV and herpes simplex virus type 1 (HSV-1) thymidine
kinase (tk) promoters. The trans-activating potential of the polypeptides encoded
by these VZV ORFs, designated p51 and p140, was compared to that of their HSV-1
homologs ICP0 and ICP4, respectively. VZV p51 was functionally inactive in this
system while p140 appeared to be a much stronger transcriptional activator than
ICP4. Co-transfection of plasmids encoding VZV p140 and HSV-1 ICP0 resulted in a 
synergistic activation of the reporter gene as has been shown for the combination
of ICP4 and ICP0.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2156390 [PubMed - indexed for MEDLINE]

6062: J Clin Pathol. 1990 Jan;43(1):63-7.

Viral and toxoplasma gondii infections in children after liver transplantation.

Salt A, Sutehall G, Sargaison M, Woodward C, Barnes ND, Calne RY, Wreghitt TG.

Public Health Laboratory, Addenbrooke's Hospital, Cambridge, England.

The incidence and morbidity of viral and Toxoplasma gondii infections were
studied in 40 children who underwent liver transplantation between December 1983 
and February 1988. The incidence of primary and reactivated cytomegalovirus (CMV)
infection was 19% and 47%, respectively; primary infection caused clinical
disease in all five cases affected and was fatal in one. Primary Epstein-Barr
virus (EBV) infection occurred in 10 (26%) recipients but caused only mild
disease. No reactivated EBV infection was recorded and no lymphoproliferative
disorders associated with EBV were found after a maximum of four years' follow
up. Adenovirus infection occurred in seven (18%) patients; this was associated in
one case with fatal pneumonia and fulminant hepatitis, but otherwise with only
mild respiratory disease. Primary T gondii infection was detected in one patient 
who remained asymptomatic. Other viruses causing infection included herpes
simplex, varicella zoster, and respiratory syncytial virus. Surveillance for
these infections and the long term sequelae should be included in the follow up
of all children who undergo transplantation.

PMID: 2155947 [PubMed - indexed for MEDLINE]

6063: Infection. 1990 Jan-Feb;18(1):12-5.

Prevalence of antibodies to human herpesvirus 6 in different age groups, in
children with exanthema subitum, other acute exanthematous childhood diseases,
Kawasaki syndrome, and acute infections with other herpesviruses and HIV.

Enders G, Biber M, Meyer G, Helftenbein E.

Inst. f. med. Virologie u. Infektions-epidemiologie, Stuttgart, FR Germany.

We determined IgG antibodies against Human Herpesvirus-6 (strain Uganda 1102, M. 
D. Griffin, London) in the indirect immunofluorescence test in sera from 1105
persons of various age groups. Of these sera 570 were retested using HHV-6 strain
St. W. (Prof. Schneweis, Bonn). We could confirm that maternal antibodies
decrease between birth and six months of age and the seropositive rate rises
rapidly between seven months and five years of age up to 79.5%. Between six and
ten years and up to 40 years, the antibody-positive rate lies around 81.3% and
66%, respectively. To confirm the causal nature of human herpes virus type 6
(HHV-6) for exanthema subitum we could demonstrate eight seroconversions testing 
sera from 14 patients with roseola infantum. In addition, the virus was isolated 
from peripheral blood lymphocytes of children during the acute fever phase in
four cases in tissue culture and in six cases the virus was detected by positive 
hybridization. In single and some paired sera from patients with acute
exanthematous diseases, rubella (n = 28), parvovirus B 19 (n = 24), measles (n = 
17), mumps (n = 27), adenovirus (n = 27) and parinfluenza virus type 3 (n = 28)
and in sera from patients with Kawasaki syndrome (n = 20), acute
varicella-zoster- (n = 27), acute herpes simplex- (n = 18) and HIV-1 infection (n
= 50), we found no HHV-6 IgM antibodies and no HHV-6 IgG antibody rises. We could
only demonstrate an HHV-6 seropositive rate according to our age-prevalence
study.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 2155875 [PubMed - indexed for MEDLINE]

6064: J Med Virol. 1990 Jan;30(1):45-9.

Antibody response to herpes simplex virus glycoproteins gB and gD.

Bernstein DI, Frenkel LM, Bryson YJ, Myers MG.

Clinical Virology Division, James N. Gamble Institute of Medical Research,
Cincinnati, OH 45219.

The antibody response to herpes simplex virus (HSV) glycoproteins B and D was
evaluated using these cloned glycoproteins in an ELISA assay and compared to a
standard Western blotting procedure. The ELISA assay appeared to be more
sensitive for detecting gB and gD antibodies. Antibodies to gB but not gD were
detected in the acute sera of patients presenting with their first episode of
true primary genital herpes. The geometric mean HSV gB titer (log 2) was also
significantly higher than the geometric mean gD titer in the convalescent sera of
these patients (7.9 +/- 0.7 vs. 5.5 +/- 0.9, P less than .003). A cross-reaction 
between HSV gB and varicella zoster virus (VZV) gp II was demonstrated. Thus, it 
is possible that a previous VZV infection could prime the immune system to
respond rapidly and more vigorously to HSV gB. Indeed, in this report we
demonstrated a significant correlation between the VZV ELISA absorbance and the
titer to HSV gB and also detected a higher VZV ELISA absorbance and HSV gB titer 
in the acute sera of patients with a true primary HSV infection compared to other
HSV seronegative VZV seropositive patients. Use of this quantitative assay should
allow further investigation into the relationship of the immune response to these
important targets and the clinical course of HSV disease.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2154542 [PubMed - indexed for MEDLINE]

6065: Proc Natl Acad Sci U S A. 1990 Jan;87(2):748-52.

Erratum in:
    Proc Natl Acad Sci U S A 1990 Oct;87(19):7797.

Isolation of a new herpesvirus from human CD4+ T cells.

Frenkel N, Schirmer EC, Wyatt LS, Katsafanas G, Roffman E, Danovich RM, June CH.

Laboratory of Viral Diseases, National Institute of Allergy and Infectious
Diseases/Twinbrook II, National Institutes of Health, Rockville, MD 20852.

A new human herpesvirus has been isolated from CD4+ T cells purified from
peripheral blood mononuclear cells of a healthy individual (RK), following
incubation of the cells under conditions promoting T-cell activation. The virus
could not be recovered from nonactivated cells. Cultures of lymphocytes infected 
with the RK virus exhibited a cytopathic effect, and electron microscopic
analyses revealed a characteristic herpesvirus structure. RK virus DNA did not
hybridize with large probes derived from herpes simplex virus, Epstein-Barr
virus, varicella-zoster virus, and human cytomegalovirus. The genetic relatedness
of the RK virus to the recently identified T-lymphotropic human herpesvirus 6
(HHV-6) was investigated by restriction enzyme analyses using 21 different
enzymes and by blot hybridization analyses using 11 probes derived from two
strains of HHV-6 (Z29 and U1102). Whereas the two HHV-6 strains exhibited only
limited restriction enzyme polymorphism, cleavage of the RK virus DNA yielded
distinct patterns. Of the 11 HHV-6 DNA probes tested, only 6 cross-hybridized
with DNA fragments derived from the RK virus. Taken together, the maximal
homology amounted to 31 kilobases of the 75 kilobases tested. We conclude that
the RK virus is distinct from previously characterized human herpesviruses. We
propose to designate it as the prototype of a new herpesvirus, the seventh human 
herpesvirus identified to date.

Publication Types: 
    Comparative Study

PMID: 2153965 [PubMed - indexed for MEDLINE]

6066: J Med Chem. 1990 Jan;33(1):187-96.

Synthesis and antiviral activity of 9-alkoxypurines. 1. 9-(3-Hydroxypropoxy)- and
9-[3-hydroxymethyl)propoxy]purines.

Harnden MR, Wyatt PG, Boyd MR, Sutton D.

Beecham Pharmaceuticals Research Division, Biosciences Research Centre, Epsom,
Surrey, U.K.

Reaction of hydroxyl-protected derivatives of hydroxyalkoxyamines (3a,b,c) with
either 4,6-dichloro-2,5-diformamidopyrimidine (5) or
4,6-dichloro-5-formamidopyrimidine (31) and subsequent cyclization of the
resultant 6-(alkoxyamino)pyrimidines (6, 17, 32, 35) by heating with
diethoxymethyl acetate afforded 9-alkoxy-6-chloropurines (7, 18, 33, 36), which
were converted subsequently to 9-(3-hydroxypropoxy)- and
9-[3-hydroxy-2-(hydroxymethyl)propoxy] derivatives of guanine,
2-amino-6-chloropurine, 2-amino-6-alkoxypurines, 2-aminopurine,
2,6-diaminopurine, adenine, hypoxanthine, and 6-methoxypurine (8, 12, 13, 19-21, 
23-26, 34, 37-39). Carboxylic acid esters (9-11, 14-16, 27-29) and a cyclic
phosphate derivative (22) of the 9-(hydroxyalkoxy)guanines (8, 21) and
2-amino-9-(hydroxyalkoxy)purines (13, 26) were also prepared. The guanine
derivatives (8, 21) showed potent and selective activity against herpes simplex
virus types 1 and 2 and varicella zoster virus in cell cultures and 8 is more
active than acyclovir. Although without significant antiviral activity in cell
cultures, the 2-aminopurines (13, 14-16, 26-29) and 2-amino-6-alkoxypurines (12, 
23-25) are well absorbed after oral administration to mice and are converted
efficiently to the antiviral guanine derivatives (8, 21) in vivo.

Publication Types: 
    Comparative Study

PMID: 2153202 [PubMed - indexed for MEDLINE]

6067: J Virol. 1990 Jan;64(1):287-99.

Human herpesvirus 6 is closely related to human cytomegalovirus.

Lawrence GL, Chee M, Craxton MA, Gompels UA, Honess RW, Barrell BG.

Medical Research Council Laboratory of Molecular Biology, Cambridge, United
Kingdom.

A sequence of 21,858 base pairs from the genome of human herpesvirus 6 (HHV-6)
strain U1102 is presented. The sequence has a mean composition of 41% G + C, and 
the observed frequency of CpG dinucleotides is close to that predicted from this 
mononucleotide composition. The sequence contains 17 complete open reading frames
(ORFs) and part of another at the 5' end of the sequence. The predicted protein
products of two of these ORFs have no recognizable homologs in the genomes of
other sequenced human herpesviruses (i.e., Epstein-Barr virus [EBV], human
cytomegalovirus [HCMV], herpes simplex virus [HSV], and varicella-zoster virus
[VZV]). However, the products of nine other ORFs are clearly homologous to a set 
of genes that is conserved in all other sequenced herpesviruses, including
homologs of the alkaline exonuclease, the phosphotransferase, the spliced ORF,
and the major capsid protein genes. Measurements of similarity between these
homologous sequences showed that HHV-6 is clearly most closely related to HCMV.
The degree of relatedness between HHV-6 and HCMV was commensurate with that
observed in comparisons between HSV and VZV or EBV and herpesvirus saimiri and
significantly greater than its relatedness to EBV, HSV, or VZV. In addition, the 
gene for the major capsid protein and its 5' neighbor are reoriented with respect
to the spliced ORFs in the genomes of both HHV-6 and HCMV relative to the
organization observed in EBV, HSV, and VZV. Three ORFs in HHV-6 have recognizable
homologs only in the genome of HCMV. Despite differences in gross composition and
size, we conclude that the genomes of HHV-6 and HCMV are closely related.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2152817 [PubMed - indexed for MEDLINE]

6068: Dermatologica. 1990;181(1):65-7.

Contact dermatitis sparing the eruption of herpes zoster and its periphery.

Katayama H, Karube S, Ueki Y, Yaoita H.

Department of Dermatology, Jichi Medical School, Tochigi-ken, Japan.

A 63-year-old male developed allergic contact dermatitis with antibiotic ointment
applied to the skin eruptions of herpes zoster. From the result of patch test,
fradiomycin sulfate contained in the ointment was identified as the contact
sensitizing antigen. Strangely, this contact dermatitis was confined to the area 
surrounding the sores, sparing the lesions and their periphery. We postulated
that a decrease in Langerhans cell activity in the herpes zoster lesions and
their peripheral area was primarily responsible for this phenomenon, since an
important role of Langerhans cells in host defence against herpes virus infection
has recently been demonstrated.

Publication Types: 
    Case Reports

PMID: 2144251 [PubMed - indexed for MEDLINE]

6069: Int J Dermatol. 1990 Jan-Feb;29(1):24-30.

Skin diseases in children with HIV infection and their association with degree of
immunosuppression.

Lim W, Sadick N, Gupta A, Kaplan M, Pahwa S.

Department of Pediatrics, North Shore University Hospital, Manhasset, NY 11030.

Since the recognition of the acquired immunodeficiency syndrome (AIDS) in 1981,
several dermatologic manifestations have been associated with the syndrome,
including candidiasis, dermatophyte infection, molluscum contagiosum, herpes
simplex and zoster, bacterial infection, and malignancy. Skin diseases have been 
observed in both the adult and the pediatric human immunodeficiency virus (HIV)
infection in an academic hospital setting in relationship to the current CDC
classification of pediatric HIV infection. The severity of dermatologic
manifestations is correlated with the immune status of the patients. The latter
was determined by T4 helper cell numbers and lymphoproliferative responses to
mitogens and recall antigens. More severe T helper cell depletion was associated 
with a wider spectrum and increased severity of dermatologic manifestations.

Publication Types: 
    Comparative Study

PMID: 2139434 [PubMed - indexed for MEDLINE]

6070: Biomed Pharmacother. 1990;44(9):455-9.

Acyclovir and postherpetic neuralgia.

Klenerman P, Luzzi GA.

Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Headington,
Oxford, UK.

Studies have demonstrated the benefit of acyclovir, given intravenously or
orally, on the acute illness in herpes zoster (HZ). Whether or not such treatment
influences the subsequent development of postherpetic neuralgia (PHN) has been
the subject of recent controversy. Intravenous acyclovir has not been shown to
influence PHN significantly in prospective studies. Oral acyclovir in large doses
may reduce PHN during the 3 months after acute HZ, but this effect has not been
observed consistently in well-designed studies. From 3 months onwards, no trial
has demonstrated a significant effect of oral acyclovir in reducing PHN. The way 
forward is discussed.

Publication Types: 
    Review

PMID: 2081273 [PubMed - indexed for MEDLINE]

6071: Acta Neurochir (Wien). 1990;107(3-4):121-8.

Facial pain. II. A prospective survey of 1052 patients with a view of: character 
of the attacks, onset, course, and character of pain.

Rasmussen P.

University Clinics of Neurosurgery, Aarhus Municipal Hospital, Denmark.

The material, definition, delimitation, and classification of facial pain,
general data, hereditary conditions, and previous diseases have been discussed in
a preceding study. According to the character of the attacks the material has
been classified into TTN = Typical Trigeminal Neuralgia (1/4), ATN = Atypical
Trigeminal Neuralgia (1/4), and NNFP = Non-neuralgiform Facial Pain (1/2). The
typical Trigeminal Neuralgia is a transitory, shooting pain, well defined. The
other two groups are less well defined. The patients come to be treated by
specialists 1-5 years after the onset of pain. The oral cavity is often perceived
as the origin of the pain. A systematic examination shows that demonstrable
pathological diseases in the masticatory organs are rarely connected with the
pain condition. Dental treatment has provided poor results. Facial pain is a very
constant phenomenon which does not- or only to a negligible degree--change over
an agelong course. In the present material 8 characters of pain are used:
Shooting-cutting, boring, squeezing-pressing, throbbing-hammering, dull,
burning-smarting, prickling-sticking, paraesthetic. With the exception of a few
cases of apoplexy and herpes zoster there is no pain reaction which can be
referred to on an aethilogical basis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2077848 [PubMed - indexed for MEDLINE]

6072: Acta Derm Venereol. 1990;70(2):121-5.

Argon laser induced cutaneous sensory and pain thresholds in post-herpetic
neuralgia. Quantitative modulation by topical capsaicin.

Bjerring P, Arendt-Nielsen L, Soderberg U.

Department of Dermatology, Marselisborg Hospital, Aarhus, Denmark.

Sensory and pain thresholds to cutaneous argon laser stimulation were determined 
in patients with post-herpetic neuralgia before and during treatment with topical
capsaicin. Before treatment both thresholds were significantly elevated on the
affected side compared to the contralateral normal area. After one week of
capsaicin treatment both thresholds were significantly increased compared to the 
pre-treatment values, and the subjective pain relief, measured on a visual
analogue scale (VAS) was 24%. More than 10% decrease in VAS pain score was
obtained by 62.5% of the patients. Laser stimulations at levels at which the
sensory and pain thresholds are reached were initially described as burning or
stinging with pain projecting outside the stimulated area. This allodynia to
laser stimulations changed during capsaicin treatment towards normal sensory and 
pain perception qualities. Both sensory and pain thresholds and the subjective
pain score evaluated on a visual analogue scale were attenuated during the
capsaicin treatment, suggesting a significant role of the cutaneous sensory and
pain receptors in postherpetic neuralgia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 1969195 [PubMed - indexed for MEDLINE]

6073: J Clin Lab Immunol. 1990 Jan;31(1):17-21.

Cytotoxic activity against varicella-zoster virus-infected target cells after
marrow transplantation.

Ljungman P, Bowden RA, Meyers JD.

Fred Hutchinson Research Center, Seattle, Wa.

Cytotoxic activity by peripheral blood lymphocytes against varicella-zoster virus
(VZV) infected matched and mis-matched fibroblasts and K562 targets was studied
in 17 allogeneic marrow transplant recipients during the first 100 days after
transplantation. Lysis of HLA mis-matched VZV infected target cells by patient's 
lymphocytes was significantly reduced after transplant compared to healthy
normals (p less than 0.05). In contrast, lysis of K562 targets by peripheral
blood lymphocytes from patients was similar or increased compared to controls.
Three patients developed herpes zoster during the study. No significant
difference was found in the lysis of VZV infected mis-matched target cells
between patients who developed herpes zoster compared to those patients who did
not. With the exception of in one patient shortly after the occurrence of herpes 
zoster, no HLA-restricted lysis could be detected. Depressed natural killer cell 
activity against VZV infected targets might be important for the development and 
outcome of VZV infection but studies in more patients and with longer follow-up
time are needed.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1966979 [PubMed - indexed for MEDLINE]

6074: Microbiol Immunol. 1990;34(11):959-65.

Antiviral potencies of BV-araU and related nucleoside analogues against
varicella-zoster virus in different cell lines.

Machida H, Ijichi K, Ohta A, Honda M, Niimura M.

Biology Laboratory, Yamasa Shoyu Co., Ltd., Chiba.

1-beta-D-Arabinofuranosyl-E-5-(2-bromovinyl)uracil (BV-araU) and nine other
antiherpesviral nucleoside analogues were compared for their potencies against
four strains of varicella-zoster virus (VZV) on three different cell lines: HEL
cells, Vero cells, and MS cells established from a human malignant schwannoma. In
contrast to the activity against herpes simplex virus type 1 previously reported,
BV-araU showed extremely marked antiviral activity against VZV even on Vero
cells. ED50, 50% plaque reduction dose, of BV-araU for VZV was 0.20-3.1 and
0.14-0.63 ng/ml on Vero cells and on HEL cells, respectively. Potency of BV-araU 
on MS cells was similar to that on these cell lines. There was not significant
variation in anti-VZV activities of other nucleoside analogues on these three
different cell lines except a few combinations of VZV strain and test compound.

PMID: 1965323 [PubMed - indexed for MEDLINE]

6075: Med Dosw Mikrobiol. 1990;42(1-2):89-94.

[Antiviral activity of commercial immunoglobulin preparations]

[Article in Polish]

Litwinska B, Bucholc B, Sadowski W, Kantoch M.

Zaklad Wirusologii PZH w Warszawie.

Immunoglobulin preparations for intravenous use of five different firms--Biotest,
Hoechst, Merieux, Sandoz, WWSS--were used for the study. Antibody level for
Epstein-Barr, cytomegalia, herpes simplex, varicella-zoster and measles viruses
was determined in these preparations stored at 4 degrees C and in order to
determine their stability they were tested after incubation at 37 degrees C and
61 degrees C. The influence of immunoglobulin (Bioglobulin and Sandoglobulin) on 
mouse survival infected with HSV-1 was determined. Results of serological studies
revealed differentiated antibody level for particular virus antigens both in
various series of a given preparation as well as between immunoglobulins of
different producers. Protective activity of immunoglobulin was mainly found when 
given 24 hours before challenge with HSV-1. This was the case not only when
preparations stored at 4 degrees C were given but also for those which were
incubated at 37 degrees C for months. Forty percent higher rate of survival of
mice as compared to control group was seen when immunoglobulin were given 8 hours
after infection.

Publication Types: 
    Comparative Study
    English Abstract
    In Vitro

PMID: 1964995 [PubMed - indexed for MEDLINE]

6076: Adv Exp Med Biol. 1990;278:71-81.

The T-lymphocyte response to varicella-zoster viral proteins.

Arvin AM, Koropchak CM, Sharp M, Bergen R, Diaz PS.

Department of Pediatrics, Infectious Diseases Division, Stanford University
School of Medicine, California 94305.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 1963047 [PubMed - indexed for MEDLINE]

6077: Skin Pharmacol. 1990;3(4):268-71.

Effect of glycyrrhizin on pain and HLA-DR antigen expression on CD8-positive
cells in peripheral blood of herpes zoster patients in comparison with other
antiviral agents.

Aikawa Y, Yoshiike T, Ogawa H.

Department of Dermatology, Juntendo University School of Medicine, Tokyo, Japan.

Glycyrrhizin (GL) is a saponin widely used as an anti-inflammatory agent. Pain
intensity and HLA-DR antigen expression on CD8+ cells were assessed during and
after treatment with GL. Other agents such as acyclovir, gamma-globulin and
interferon beta were also administered for comparison. Pain resolved most rapidly
among those treated with acyclovir followed by those treated with GL. Pain
resolution correlated with the regression of HLA-DR+ in CD8+ subpopulations in
peripheral blood. GL is suggested to be an alternative or additive antiviral
agent to herpes zoster.

Publication Types: 
    Comparative Study

PMID: 1707284 [PubMed - indexed for MEDLINE]

6078: Viral Immunol. 1990 Fall;3(3):217-24.

Individual NK cell clones lyse both tumor cell targets and herpes simplex
virus-infected fibroblasts in the absence of interferon.

Canessa A, Chatterjee S, Whitley RJ, Prasthofer EF, Grossi CE, Tilden AB.

Department of Pediatrics, University of Alabama.

The target specificity of natural killer (NK) cells for either tumor cells or
virus-infected cells has been investigated. Lymphocyte clones with the surface
phenotype of NK cells (CD3-, CD16+) were obtained by limiting dilution of
peripheral blood mononuclear cells stimulated with PHA, Herpes simplex virus type
1 (HSV-1), or Varicella-Zoster antigens. Clones were maintained in media with
recombinant interleukin 2 (IL-2). Both NK-sensitive (K562 cells) and NK-resistant
(Raji cells) targets were lysed by three cloned lines of NK cells. The ability to
lyse NK-resistant target cells was largely lost when the cloned lymphocytes were 
cultured overnight in the absence of IL-2. Effector cells from all three clones
were also capable of specifically lysing HSV-1 infected human fibroblasts in
comparison with uninfected fibroblasts. We also showed that lysis of HSV-1
infected targets by NK cloned cells was independent of interferons in the culture
system.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 1701642 [PubMed - indexed for MEDLINE]

6079: JAMA. 1989 Dec 22-29;262(24):3455-8.

Clinical and biological differences between recurrent herpes simplex virus and
varicella-zoster virus infections.

Straus SE.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Md 20892.

Publication Types: 
    Case Reports

PMID: 2555578 [PubMed - indexed for MEDLINE]

6080: Am J Ophthalmol. 1989 Dec 15;108(6):733-5.

Multifocal choroiditis uveitis occurring after herpes zoster ophthalmicus.

Bloom SM, Snady-McCoy L.

Department of Ophthalmology, Tufts-New England Medical Center, Boston, MA 02111.

Publication Types: 
    Case Reports

PMID: 2596557 [PubMed - indexed for MEDLINE]

6081: Acta Neurol Scand. 1989 Dec;80(6):579-83.

Beta-2-microglobulin in the cerebrospinal fluid of patients with infections of
the central nervous system.

Peterslund NA, Black FT, Geil JP, Mogensen CE.

Department of Medicine and Infectious Diseases, Marselisborg Hospital, Aarhus,
Denmark.

Beta-2-microglobulin was determined in 147 patients admitted to hospital because 
of suspicion of CNS disease. Patients with meningism were chosen as control
group. The concentration of beta-2-microglobulin in the spinal fluid of control
patients was correlated with age. Reference values for 0-40 years were 0.34-1.58 
mg/l. Above 40 years of age the values were 0.46-3.14 mg/l. CSF
beta-2-microglobulin levels of patients with meningism, aseptic and bacterial
meningitis overlap too much to be relevant in distinguishing between these
entities. Five patients with herpes simplex encephalitis had markedly elevated
levels ranging from 4.4 to 9.0 mg/l. Ten patients with herpes zoster-associated
encephalitis had values from 1.1 to 6.1 mg/l. In the patient groups with CNS
infections, the ratio of serum to spinal fluid beta-2-microglobulin was
significantly more frequently less than 1 as compared with the meningism group,
indicating intrathecal production of the protein. Further studies on the clinical
relevance of CSF beta-2-microglobulin in the diagnosis of encephalitis seem
warranted.

PMID: 2694728 [PubMed - indexed for MEDLINE]

6082: Ma Zui Xue Za Zhi. 1989 Dec;27(4):377-80.

Interpleural analgesia for herpetic neuralgia.

Chen JY, Susetio L.

Publication Types: 
    Case Reports

PMID: 2633024 [PubMed - indexed for MEDLINE]

6083: J Tradit Chin Med. 1989 Dec;9(4):256-8.

Treatment of pain by laser irradiation--a report of 76 cases.

Hu GZ.

Publication Types: 
    Case Reports

PMID: 2630812 [PubMed - indexed for MEDLINE]

6084: Rinsho Shinkeigaku. 1989 Dec;29(12):1546-9.

[Neuropathology of AIDS: Montefiore experience]

[Article in Japanese]

Hirano A.

From September 1982 to December 1988 113 cases of AIDS have been autopsied and
the brains examined at Montefiore Medical Center. Findings in four areas were
presented; 1. Opportunistic infections In approximately one third of cases there 
were opportunistic infections which were often the cause of death. Cryptococcus, 
cytomegalovirus and toxoplasma were the three most common infections followed by 
papovavirus (progressive multifocal leukoencephalopathy) and herpes zoster.
Tuberculosis, aspergillosis, histoplasmosis and infection with mycobacterium
avium-intracellulare infection were found in only one case each. 2. Malignant
lymphoma Both primary and metastatic lymphomas were seen in almost 10% of the
cases. 3. HIV encephalitis This conclusion is regarded as the pathological
substrate of "AIDS dementia complex" described by the neurologists. In general,
it was characterized by cerebral atrophy and diffuse pallor of the white matter
with gliosis. The basal ganglia and other areas of the CNS were also often
involved. Histologically, there was perivascular infiltration of lymphocytes,
macrophages and multinucleated giant cells. Microglial nodules were commonly
seen. Electron microscopic and other techniques demonstrates the HIV virus within
macrophages and multinucleated cells. 4. Cerebrovascular lesions These lesions
are known in AIDS but their high frequency is not generally appreciated unless a 
careful search for microinfarcts is made. Microinfarcts were found in
approximately 1/3 of our cases.

Publication Types: 
    English Abstract

PMID: 2630149 [PubMed - indexed for MEDLINE]

6085: Klin Med (Mosk). 1989 Dec;67(12):91-3.

[Variants of the Ramsay Hunt syndrome]

[Article in Russian]

Mikhailenko AA.

Out of 776 patients having polymorphic syndromes caused by herpes simplex or
zoster infection 25 patients exhibited Ramsay Hunt syndrome. Altogether 5
clinical variants of the syndrome were recognized. Neurological symptoms and
liquor investigations show that the process goes far beyond the ganglion of the
facial nerve and therefore can be characterized as multiradiculoganglioneuritis. 
There are also frequent associated meningeal and encephalitic symptoms.
Etiologically, some clinical variants of Ramsay Hunt syndrome arise from herpes
simplex infection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2628625 [PubMed - indexed for MEDLINE]

6086: Pain. 1989 Dec;39(3):301-5.

EMLA cream in the treatment of post-herpetic neuralgia. Efficacy and
pharmacokinetic profile.

Stow PJ, Glynn CJ, Minor B.

Pain Relief Unit, Abingdon Hospital, Oxford, U.K.

The analgesic efficacy of 5% of EMLA cream (5 or 10 g) when applied for 24 h
periods was evaluated in 5 female and 7 male patients (mean age 69 years, range
50-85 years) with refractory post-herpetic neuralgia (PHN). Mean visual analogue 
pain intensity scores for all patients were significantly improved 6 h after
application (P less than 0.05). In a subgroup of patients with facial PHN
receiving EMLA cream, 5 g (n = 4), there were significant improvements in pain
intensity scores at 6 h (P less than 0.05). 8 h (P less than 0.01) and 10 h (P
less than 0.01) after application. Plasma lignocaine and plasma prilocaine
concentrations were well below potentially toxic levels in all patients after
application.

PMID: 2616182 [PubMed - indexed for MEDLINE]

6087: Masui. 1989 Dec;38(12):1597-604.

[Clinical investigation of 200 patients with acute herpes zoster--factor
influencing treatment of herpetic pain]

[Article in Japanese]

Murakawa K, Ishimoto E, Noma K, Kono K, Ishida H, Izumi R.

Two hundred patients were treated by various nerve blocks with (A; 100 cases) or 
without (B; 100 cases) acyclovir (ACV) for acute herpes zoster, and studied
retrospectively to determine the factors influencing the duration of pain. All
patients started to receive the treatment within 2 weeks after manifestation of
herpetic rash, and were divided equally into two groups by the severity of pain. 
The severe (I) and moderate (II) pain groups had similar locations of skin
lesions. Group I had significantly larger population of the aged, and higher
proportion of patients who had preherpetic pain than group II. The period of pain
was significantly longer in group I B than group I A, in group II B than group II
A, in group I A than group II A and in group I B than group II B. However,
distribution of the rash, age and occurrence of preherpetic pain were not related
to the duration of pain in the groups with the same degree of pain and treatment.
These results showed that ACV was effective in inflammatory pain and accelerated 
healing in the acute phase of herpes zoster. The severity of pain had the
greatest influence on the duration of pain. The age and preherpetic pain closely 
correlated with the severity of pain.

Publication Types: 
    English Abstract

PMID: 2614887 [PubMed - indexed for MEDLINE]

6088: Neurology. 1989 Dec;39(12):1640.

Cerebral infarction following herpes zoster: the enlarging clinical spectrum.

Joy JL, Carlo JR, Velez-Borras JR.

Department of Neurology, University of Alabama, Birmingham 35244.

Publication Types: 
    Case Reports

PMID: 2586782 [PubMed - indexed for MEDLINE]

6089: Acta Virol. 1989 Dec;33(6):565-8.

Enhancement of plaque formation of herpes simplex virus (HSV) and
varicella-zoster virus (VZV) by subinhibitory dose of acyclovir (ACV).

Shiraki K, Miyaki C, Namazue J, Yamanishi K, Takahashi M.

Department of Virology, Osaka University, Japan.

Acyclovir (9-/2-hydroxyethoxymethyl/guanine) enhanced the plaque formation of HSV
and VZV at subinhibitory dose and inhibited at higher concentration but not in
thymidine kinase deficient viruses. The enhancement was neutralized by thymidine.
Induction of viral thymidine kinase activity was not affected with ACV. These
results suggest that the enhancement may be mediated by viral thymidine kinase.

PMID: 2576598 [PubMed - indexed for MEDLINE]

6090: Virology. 1989 Dec;173(2):710-4.

Differential regulation by varicella-zoster virus (VZV) and herpes simplex virus 
type-1 trans-activating genes.

Inchauspe G, Ostrove JM.

Laboratory of Clinical Investigation, National Institute of Allergy and
Infectious Diseases, Bethesda, Maryland 20892.

Transient expression assays were performed in Vero cells in order to compare
varicella-zoster virus (VZV)-encoded trans-activating proteins [defined by the
products of open reading frames (ORF) 4 and 62] with herpes simplex virus type-1 
(HSV-1) trans-activating proteins, ICP4 and ICP0, with respect to activation of
gene expression. We demonstrate that the product of VZV ORF4 and ORF62 (which are
the HSV-1 analogs of ICP27 and ICP4, respectively) stimulate a variety of viral
and cellular gene promoters, including the HSV-1 thymidine kinase (tk) promoter. 
On the other hand, expression of a recombinant vector containing the VZV tk
promoter could not be stimulated, by HSV-1 infection or by the HSV-1 ICP4 or ICP0
proteins expressed during cotransfection experiments. These data suggest
different mechanisms of activation of the VZV and the HSV-1 tk gene promoters by 
"trans-activating" factors.

Publication Types: 
    Comparative Study

PMID: 2556849 [PubMed - indexed for MEDLINE]

6091: Am J Dis Child. 1989 Dec;143(12):1448-50.

Study of virus isolation from pharyngeal swabs in children with varicella.

Ozaki T, Matsui Y, Asano Y, Okuno T, Yamanishi K, Takahashi M.

Department of Pediatrics, Showa Hospital, Kohnan, Japan.

We performed virus isolations from the pharyngeal swabs in 117 children with
varicella who were aged from 22 days to 15 years and 70 healthy children who were
aged from 3 months to 15 years, by using human embryonic lung cell cultures.
Viral isolates were confirmed by an indirect immunofluorescence method or by
neutralization with well-characterized antibodies. Five varicella-zoster virus
isolates (4.3%), 23 cytomegalovirus isolates (19.7%), five herpes simplex virus
isolates (4.3%), and one respiratory syncytial virus isolate (0.9%) were found in
the patients with varicella. Ten cytomegalovirus isolates (14.3%), two herpes
simplex virus isolates (2.9%), one respiratory syncytial virus isolate (1.4%),
and one poliovirus isolate (1.4%) were found in the swabs of the healthy control 
children. The varicella-zoster virus isolation rate from the pharyngeal swabs in 
children with varicella was low as compared with the rate from those pharyngeal
swabs in the children with cytomegalovirus and herpes simplex virus. No
varicella-zoster virus isolates could be found in the swabbed materials after
filtration (0.45 microns). On the other hand, cytomegalovirus and herpes simplex 
virus could be isolated from the filtrated swabs, as well as from the unfiltrated
swabs. The method of testing by filtration could have affected the results.

PMID: 2556024 [PubMed - indexed for MEDLINE]

6092: J Infect Dis. 1989 Dec;160(6):919-28.

Cellular and humoral immunity to varicella zoster virus glycoproteins in immune
and susceptible human subjects.

Giller RH, Winistorfer S, Grose C.

Department of Pediatrics, University of Iowa College of Medicine, Iowa City.

To further delineate the immune responses that protect against serious primary
varicella zoster virus (VZV) infection and inhibit viral reactivation, antibody
responses and T lymphocyte reactivity to three major VZV glycoproteins, gpI,
gpII, and gpIII, were studied. Individual viral glycoproteins were purified using
murine monoclonal antibodies. Cellular immunity was measured by lymphocyte
proliferation. Antibody responses were tested in enzyme-linked immunosorbent
assays. Individual glycoproteins induced VZV-specific proliferation by
mononuclear cells from 15 of 20 immune subjects. Serologic responses to the VZV
glycoproteins occurred in 16 of 20 immune subjects. Of note, gpII served as a
potent T and B cell antigen during both acute infection and convalescence.
Cell-mediated responses to the glycoprotein antigens represented proliferation by
T lymphocytes and required antigen presentation by adherent mononuclear cells.
These findings indicate that virally encoded glycoproteins contain epitopes that 
stimulate VZV-specific cellular and humoral immune responses.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2555419 [PubMed - indexed for MEDLINE]

6093: J Clin Neuroophthalmol. 1989 Dec;9(4):229-33; discussion 234-5.

Herpes zoster ophthalmicus, contralateral hemiplegia, and recurrent ocular
toxoplasmosis in a patient with acquired immune deficiency syndrome-related
complex.

Pillai S, Mahmood MA, Limaye SR.

Department of Ophthalmology, D.C. General Hospital, Washington, D.C. 20003.

A 42-year-old man presented with herpes zoster ophthalmicus on the right side. He
was found to have acquired immune deficiency syndrome-related complex. Two weeks 
later he developed toxoplasmic retinochoroiditis in the left eye. He also
presented later with left hemiplegia, which was probably caused by herpes zoster 
arteritis. Nine months after the retinal lesion resolved he developed another
area of toxoplasmic retinochoroiditis adjacent to the first lesion. Herpes zoster
may be the first presentation of acquired immune deficiency syndrome-related
complex in a young healthy individual. Ophthalmologists are encountering patients
with acquired immune deficiency syndrome who may have multiple organisms as the
cause for their ocular infections and this might pose a treatment dilemma. The
combination of herpes zoster ophthalmicus and ocular toxoplasmosis in this
patient makes this case unusual.

Publication Types: 
    Case Reports
    Review

PMID: 2531159 [PubMed - indexed for MEDLINE]

6094: Acta Paediatr Jpn. 1989 Dec;31(6):702-5.

Comparison of acyclovir and vidarabine in immunocompromised children with
varicella-zoster virus infection.

Kunitomi T, Akazai A, Ikeda M, Oda M, Kodani N.

Intravenous acyclovir and vidarabine were compared in the treatment of
varicella-zoster virus (VZV) infection in 25 immunocompromised children--13 with 
acute lymphocytic leukemia, three with other types of cancer, two with
immunodeficiency and in seven undergoing prednisolone treatment. Thirteen had
varicella and 12 had herpes zoster. Acyclovir was given intravenously to five
patients with varicella and to four with herpes zoster at a dose of 5-10 mg/kg
every eight hours. Vidarabine was given intravenously to eight patients with
varicella and to eight with herpes zoster at a dose of 10 mg/kg/day. In
varicella, vidarabine significantly shortened the time from the start of
treatment to cessation of new lesion formation compared with acyclovir. However, 
there was no significant difference in time to complete crusting between the two 
treatments. In herpes zoster, acyclovir significantly shortened the time from the
onset of the skin lesions to complete crusting. A slight raise of GOT in two
cases was reported. While acyclovir and vidarabine were equally effective for VZV
infection, in herpes zoster acyclovir was more effective.

Publication Types: 
    Comparative Study

PMID: 2516397 [PubMed - indexed for MEDLINE]

6095: Cornea. 1989 Dec;8(4):270-3.

Diagnostic impression cytology for external eye disease.

Maskin SL, Heitman KF, Lawton AW, Yee RW.

Department of Ophthalmology, University of Texas Health Science Center, San
Antonio 78284-7779.

The authors describe their experience with the use of impression cytology (IC) as
a diagnostic aid in the evaluation of external eye disorders. IC is shown to be
useful for diagnosis of epithelial cell storage disorders, infectious diseases,
and allergic disorders.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2509135 [PubMed - indexed for MEDLINE]

6096: An Med Interna. 1989 Dec;6(12):639-40.

[Herpes zoster ophthalmicus with contralateral hemiplegia]

[Article in Spanish]

Sureda Ramis B, Bautista J, Martinez Navarro ML.

A 57-year-old patient nonimmunosuppressed who had zoster ophthalmicus associated 
to contralateral hemiplegia is presented. We noticed on the CT scan an infarction
of left caudate nucleus, as well as in the angiography signs of vasculitis. We
comment on the clinical and diagnosis features and suggest possible benefit
effects of the treatment with acyclovir.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2491475 [PubMed - indexed for MEDLINE]

6097: Ugeskr Laeger. 1989 Nov 27;151(48):3239-41.

[Herpes zoster in immunosuppressed patients with immuno-inflammatory disease]

[Article in Danish]

Schou M, Andersen V.

We analysed 19 episodes of herpes zoster in 16 patients, who received cytotoxic
drugs or cyclosporin for immuno-inflammatory disease. Reactivation of
varicella-zoster virus was not associated with increased activity of the
rheumatic disease nor with increased intensity of immunosuppressive therapy. Six 
of the patients who had received the largest cumulative doses of cytotoxic drugs 
had fever and/or vesicles outside the primarily affected dermatome. Two of these 
patients developed post-herpetic neuralgia. Although not encountered in this
material, immunocompromised patients may develop severe complications of herpes
zoster, and therefore prompt treatment with acyclovir is recommended in all
cases. It is suggested that oral acyclovir therapy is sufficient in uncomplicated
cases but this question has not been elucidated in controlled studies.

Publication Types: 
    English Abstract

PMID: 2595854 [PubMed - indexed for MEDLINE]

6098: Dtsch Med Wochenschr. 1989 Nov 10;114(45):1729-33.

[Differential diagnosis of atypical plasma cells in the cerebrospinal fluid]

[Article in German]

Kraft R, Altermatt HJ, Nguyen-Tran Q.

Abteilung fur klinische Zytologie, Universitat Bern.

2102 samples of lumbar cerebrospinal fluid (CSF) were examined by qualitative
cytology for atypical plasma cells. Samples from seven patients contained such
cells. Retrospective investigation of these patients revealed that four of them
had had neuroborreliosis, one had multiple sclerosis, one herpes zoster and one
malignant non-Hodgkin lymphoma. It is concluded that in a case of unexplained
meningoradiculitis with lymphoplasmocytic reaction in the CSF, morphological
analysis of the plasma cells can provide important diagnostic pointers.

Publication Types: 
    English Abstract

PMID: 2806105 [PubMed - indexed for MEDLINE]

6099: J Hand Surg [Br]. 1989 Nov;14(4):447-8.

Isolated anterior interosseous nerve palsy following herpes zoster infection: a
case report and review of the literature.

Nee PA, Lunn PG.

Department of Orthopaedics, Derbyshire Royal Infirmary, Derby.

A 64-year-old lady noticed weakness of her thumb within two weeks of having
developed "shingles" causing vesicular lesions on her arm and hand. Clinical and 
neurophysiological testing confirmed a lesion of the anterior interosseous nerve.
Although motor involvement after herpes zoster infection is recognised, this
usually has a myotomal distribution; isolated involvement of a branch of a
peripheral motor nerve has not previously been described.

Publication Types: 
    Case Reports
    Review

PMID: 2695590 [PubMed - indexed for MEDLINE]

6100: Bone Marrow Transplant. 1989 Nov;4(6):613-5.

A randomized trial of oral versus intravenous acyclovir for treatment of herpes
zoster in bone marrow transplant recipients. Nordic Bone Marrow Transplant Group.

Ljungman P, Lonnqvist B, Ringden O, Skinhoj P, Gahrton G.

Department of Medicine, Huddinge Hospital, Sweden.

Twenty-seven bone marrow transplant patients who developed localized herpes
zoster were treated with acyclovir in a randomized study comparing oral and
intravenous drug administration. Fourteen patients received oral and 13 patients 
received intravenous treatment. None of the patients developed disseminated
disease. No differences were found between the treatment groups in the number of 
days that new lesions continued to develop, in number of days with pain, or in
the number of days from start of treatment until all lesions were crusted over.
We suggest that oral acyclovir may be as effective as intravenous acyclovir in
the treatment of localized herpes zoster after bone marrow transplantation.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 2684306 [PubMed - indexed for MEDLINE]

6101: Tandlaegebladet. 1989 Nov;93(16):623-7.

Tooth exfoliation and necrosis of the alveolar bone following trigeminal herpes
zoster in HIV-infected patient.

Schwartz O, Pindborg JJ, Svenningsen A.

Publication Types: 
    Case Reports

PMID: 2635428 [PubMed - indexed for MEDLINE]

6102: Minerva Med. 1989 Nov;80(11):1251-2.

[A case of Ramsay Hunt syndrome]

[Article in Italian]

Diamante A, D'Angelo C, Liistro S, Lutri W.

U.S.L. Divisione di Medicina Generale.

We describe a clinical case of RH syndrome (Auricular Herpes zoster, facial
paralysis, hearing loss).

Publication Types: 
    Case Reports
    English Abstract

PMID: 2601878 [PubMed - indexed for MEDLINE]

6103: Pain. 1989 Nov;39(2):129-44.

Post-herpetic neuralgia: the relation of pain complaint, sensory disturbance, and
skin temperature.

Rowbotham MC, Fields HL.

Department of Neurology, School of Medicine, University of California, San
Francisco 94143.

Twelve otherwise healthy patients with longstanding postherpetic neuralgia (PHN) 
were prospectively studied using clinical examination, infrared thermography and 
response to local anesthetic skin infiltration. All had at least 2 of 3 possible 
components to their PHN pain: continuous, neuralgic, or allodynic. In patients
with allodynia, maximal reported pain and the location of maximal allodynia on
sensory examination were largely overlapping and were often warm
thermographically. Areas of dense sensory loss and skin scarring without
allodynia were usually cool thermographically. Local anesthetic skin infiltration
produced substantial pain relief in all 9 patients (essentially complete relief
in 7) with allodynia: the 3 patients with predominantly continuous pain were not 
relieved. In 7 of 8 skin infiltration responders, the same dose of lidocaine i.m.
in the deltoid muscle also produced significant, though less complete pain
relief. These results suggest that PHN patients can be divided into at least 2
clinical groups: those with predominantly continuous pain localized to a region
of significant sensory loss and those in whom allodynia is the most prominent
sensory disturbance. The latter group has pain localized to areas with relatively
preserved sensation. The differences in clinical features and response to
lidocaine suggest that there are at least 2 different mechanisms contributing to 
the pain of PHN.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2594392 [PubMed - indexed for MEDLINE]

6104: Virus Genes. 1989 Nov;3(2):127-40.

Comparison of the sequence of the secretory glycoprotein A (gA) gene in Md5 and
BC-1 strains of Marek's disease virus type 1.

Ihara T, Kato A, Ueda S, Ishihama A, Hirai K.

Nippon Institute for Biological Science, Tokyo, Japan.

DNA fragments containing the secretory glycoprotein A (gA) gene of Marek's
disease virus type 1 (MDV1) were cloned from the DNA libraries of very virulent
Md5 and virulent BC-1 strains and sequenced. Two open reading frames (ORF1 and
ORF2) were identified for both strains. The ORF1 has the potential to code for a 
protein of 501 amino acids with a molecular weight of 56 kD that contains strong 
hydrophobic regions in both the amino and carboxyl termini, and nine potential
N-linked glycosylation sites, while the ORF2 is capable of coding for a 24-kD
protein. These results indicate that the ORF1 codes for the unprocessed form of
gA. Between the Md5 and BC-1 strains, only two sequence mismatches exist in the
DNA fragment. More differences appear to exist in the gA sequence of the MDV1 GA 
strain (12), which lacks a strong hydrophobic anchor sequence. Similarities
between the predicted amino acid sequences of the MDV1 gA and the proteins of the
other herpesviruses such as herpes simplex type I gC, pseudorabies virus gIII,
and varicella zoster virus gpV were noted.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2559540 [PubMed - indexed for MEDLINE]

6105: J Virol Methods. 1989 Nov;26(2):237-43.

Rapid sampling of multiple enzyme reactions.

Spector T, Harrington JA.

Wellcome Research Laboratories, Research Triangle Park, North Carolina 27709.

A simple method of initiating and sampling six simultaneous reactions was
devised. A commercially available vial rack was fitted with a Plexiglas
overlaying sheet to stabilize the vials for the addition and sampling procedures.
Glass vials were routinely used because of their thermal conductivity advantages.
Samples were added and removed, and the reactions were mixed with a multichannel 
pipet using every other channel. The data showing six simultaneous progress
curves for the rapid inactivation of herpes simplex virus ribonucleotide
reductase were presented and analyzed. In addition, the time course of 12
reactions catalyzed by varicella zoster virus thymidine kinase were assayed at
one min intervals generating 96 data points within 8.5 min. A second experiment
generated data points every 30 s for six simultaneous replicate thymidine kinase 
reactions. The ease of use and high reproducibility of the method are
demonstrated by these data.

PMID: 2559105 [PubMed - indexed for MEDLINE]

6106: Arteriosclerosis. 1989 Nov-Dec;9(6):877-80.

Unlikely association between clinically apparent herpesvirus infection and
coronary incidence at older ages. The Framingham Heart Study.

Havlik RJ, Blackwelder WC, Kaslow R, Castelli W.

National Center for Health Statistics, Hyattsville, MD 20782.

Experimental studies in chickens have shown a relationship of a herpesvirus to
atherosclerosis. The hypothesis of an association in humans was tested by using
data on the history of cold sores and other manifestations of herpes infections
reported by 658 male and 919 female participants (ages 58 to 89) in the
Framingham Heart Study from 1977 to 1979 and on the prevalence and subsequent
6-year incidence of coronary heart disease (CHD). Approximately 40% of the men
and 52% of the women reported a history of ever having "fever blisters or cold
sores." Overall, there was no association between a history of such oropharyngeal
manifestations and prevalent CHD. Only in the subgroup of women with recurrent
infections was there a suggestion of a possible relationship (relative risk =
1.5, 95% confidence interval 1.0 to 2.1). Among members of the cohort without CHD
at baseline there was no association between the history of cold sores, chicken
pox, shingles, or infectious mononucleosis and 6-year CHD incidence. However, a
possible interaction among women with recurrent herpes, lower levels of serum
cholesterol, and incidence of angina pectoris without myocardial infarction was
suggested in post hoc analyses. These data from the Framingham cohort do not
support the notion that any self-reported clinically manifest herpesvirus
infection has a strong etiological role in older persons, but they do raise
issues to be addressed in any further research.

PMID: 2556099 [PubMed - indexed for MEDLINE]

6107: J Gen Virol. 1989 Nov;70 ( Pt 11):3085-9.

Identification of 21 genes of infectious laryngotracheitis virus using random
sequencing of genomic DNA.

Griffin AM.

AFRC Institute for Animal Health, Houghton Laboratory, Huntingdon,
Cambridgeshire, U.K.

DNA from infectious laryngotracheitis virus (ILTV) was randomly sheared and
cloned into the M13 bacteriophage. Clones containing ILTV DNA were sequenced and 
the predicted amino acid sequences were compared to the known sequences of other 
herpesviruses using computer analysis. Twenty-one ILTV genes were identified, 20 
by comparison to varicella-zoster virus and 19 by comparison to herpes simplex
virus type 1; only 12 genes, giving consistently lower homology scores, were
found by comparison with the gammaherpesvirus Epstein-Barr virus, indicating that
ILTV sequences bear greater similarity to other alpha- than to gammaherpesvirus
sequences.

Publication Types: 
    Comparative Study

PMID: 2555439 [PubMed - indexed for MEDLINE]

6108: Chin Med J (Engl). 1989 Nov;102(11):819-24.

Clinical analysis of four Chinese hemophiliacs with human immunodeficiency virus 
infection.

Tang DJ, Xu YH, Dai D, Han YJ, Wang BC, Lang YM, Liang Y, Zeng Y.

Human immunodeficiency virus (HIV) is now considered as the causative agent of
acquired immunodeficiency syndrome (AIDS). A high risk of AIDS has been reported 
among patients with hemophilia who received lyophilized commercial factor VIII
and IX concentrates of American origin. At a prevalent survey from September to
December 1985, HIV antibodies were found in all four patients with hemophilia
treated with the batch number W87307, 955 I.U. of American commercial factor VIII
concentrate supplied by Armour Pharmaceutical Company, USA. One of the
sero-positive patients developed AIDS-related complex (ARC) and died of cerebral 
hemorrhage. The other three sero-positive patients had abnormalities in
cell-mediated immunity. Of them two developed left lumbosacral radiculopathy and 
hemorrhagic herpes zoster and one remained well so far.

Publication Types: 
    Case Reports

PMID: 2517721 [PubMed - indexed for MEDLINE]

6109: Otolaryngol Head Neck Surg. 1989 Nov;101(5):562-5.

Comment in:
    Otolaryngol Head Neck Surg. 1990 Oct;103(4):672.

MRI findings in two cases of acute facial paralysis.

LaBagnara J Jr, Jahn AF, Habif DV Jr, Solomon EM.

Department of Surgery, University of New Jersey, Newark.

This article describes the use of magnetic resonance imaging (MRI) in the
evaluation of the facial nerve paralysis of Bell's palsy and herpes zoster
oticus. Identification of the nature of inflammatory facial nerve paralysis often
presents a diagnostic dilemma. The site of involvement along the course of the
nerve may have importance when treatment options are being considered. We have
found MRI to be a unique method for localizing the site of nerve injury in both
Bell's palsy and Ramsay Hunt syndrome.

Publication Types: 
    Case Reports

PMID: 2512536 [PubMed - indexed for MEDLINE]

6110: Ugeskr Laeger. 1989 Oct 30;151(44):2901.

[Local therapy of herpes zoster pain]

[Article in Danish]

Andersen S.

Publication Types: 
    Letter

PMID: 2588379 [PubMed - indexed for MEDLINE]

6111: Ann Intern Med. 1989 Oct 15;111(8):641-9.

6-Mercaptopurine in the management of inflammatory bowel disease: short- and
long-term toxicity.

Present DH, Meltzer SJ, Krumholz MP, Wolke A, Korelitz BI.

Lenox Hill Hospital, New York, New York.

We assess toxicity related to 6-mercaptopurine in the treatment of inflammatory
bowel disease by reporting our experience with 396 patients (120 patients with
ulcerative colitis, 276 with Crohn disease) observed over 18 years. Follow-up
data for a mean period of 60.3 months were obtained for 90% of the patients.
Toxicity directly induced by 6-mercaptopurine included pancreatitis in 13
patients (3.3%), bone marrow depression in 8 (2%), allergic reactions in 8 (2%), 
and drug hepatitis in 1 (0.3%). These complications were reversible in all cases 
with no mortality. Most cases of marrow depression occurred earlier in our
experience, when the initial drug doses used were higher. Infectious
complications were seen in 29 patients (7.4%), of which 7 (1.8%) were severe,
including one instance of herpes zoster encephalitis. All infections were
reversible with no deaths. Twelve neoplasms (3.1%) were observed, but only 1
(0.3%), a diffuse histiocytic lymphoma of the brain, had a probable association
with the use of 6-mercaptopurine. Our data, showing a low incidence of toxicity
in 396 patients, coupled with the previously demonstrated efficacy of
6-mercaptopurine in the treatment of inflammatory bowel disease, indicate that
the drug is a reasonable alternative in the management of patients with
intractable inflammatory bowel disease.

PMID: 2802419 [PubMed - indexed for MEDLINE]

6112: Z Hautkr. 1989 Oct 15;64(10):848-50.

[Therapy of herpes zoster]

[Article in German]

Engst R.

Dermatologische Klinik und Poliklinik der Technischen Universitat Munchen.

Regarding the treatment of herpes zoster, aciclovir (ACV) is as the most
effective and safe drug available. ACV reduces the viral shedding time and
promotes the cutaneous healing and pain resolution. Oral ACV in high doses (5 x
800 mg daily), as well, has proved effective in the treatment of acute herpes
zoster. If there is no convincing effect on the pain, additional application of
corticoids in high doses may be of benefit.

Publication Types: 
    English Abstract
    Review

PMID: 2686242 [PubMed - indexed for MEDLINE]

6113: Br Dent J. 1989 Oct 7;167(7):235-8.

Rapid diagnosis of oral herpes simplex or zoster virus infections by
immunofluorescence: comparison with Tzanck cell preparations and viral culture.

Bagg J, Mannings A, Munro J, Walker DM.

This study compared viral culture with routine cytology and immunofluorescent
staining of oral epithelial cell smears for the diagnosis of orofacial infections
due to herpes simplex virus (HSV) or herpes zoster (HZ). Twenty-one patients were
studied. Viral culture gave the greatest number of positive results, with an
assumed sensitivity and specificity of 100%, but the test took at least 24 hours.
For haematoxylin and eosin cytology, the corresponding figures for sensitivity
and specificity were 54% and 100%, respectively. Direct staining of epithelial
smears with FITC-conjugated monoclonal antibodies to HSV type 1, HSV type 2 and
HZ had a sensitivity of 82% and specificity of 71%. Smears prepared from oral
washings, and stained with the same fluorescent antibodies, yielded a sensitivity
of 83% and specificity of 86%. To allow rapid diagnosis, oral epithelial smears
for immunofluorescent examination should also be prepared, since in more than 80%
of cases such smears will confirm an herpetic infection in less than one hour.

Publication Types: 
    Comparative Study

PMID: 2675949 [PubMed - indexed for MEDLINE]

6114: Am J Med Sci. 1989 Oct;298(4):264-6.

Herpes zoster myelitis occurring during treatment for systemic lupus
erythematosus.

Baethge BA, King JW, Husain F, Embree LJ.

Department of Medicine, Louisiana State University Medical Center, Shreveport
71130.

A 15-year-old girl with systemic lupus erythematosus suddenly developed fever,
meningismus, and herpes zoster. Within 48 hours, transverse myelitis developed at
the level of the nerve root involvement of the herpes zoster. Since both systemic
lupus erythematosus and varicella-zoster have been reported to cause myelitis,
therapy was initiated for both. The rapid and simultaneous resolution of both the
herpes zoster and the neurologic deficits strongly supports the causal
association of both with varicella-zoster. This is the second reported case of
herpes zoster-associated transverse myelitis in a patient with systemic lupus
erythematosus.

Publication Types: 
    Case Reports

PMID: 2801761 [PubMed - indexed for MEDLINE]

6115: J Neurol. 1989 Oct;236(7):411-4.

Peripheral facial paralysis and HIV infection: report of four African cases and
review of the literature.

Belec L, Gherardi R, Georges AJ, Schuller E, Vuillecard E, Di Costanzo B, Martin 
PM.

Institut Pasteur, Bangui, Central African Republic.

Four cases of infranuclear facial palsy associated with infection by the human
immunodeficiency virus in young heterosexual African patients are reported. Two
cases were healthy HIV carriers, one patient manifested AIDS-related complex, and
one case fulfilled the CDC criteria for AIDS. Two patients had a typical Bell's
palsy, one presented with manifest cephalic Herpes zoster infection and one, who 
suffered from facial diplegia, could be considered to have a cephalic form of
Guillain-Barre syndrome. A review of the literature confirmed that peripheral
facial palsy can occur at any stage of HIV infection and in various clinical
contexts. In stages I and II of the HIV infection, patients may develop either
Bell's palsy or Guillain-Barre syndrome. In stages III and IV, when the cellular 
immunity has begun to decline, Herpes zoster-related facial paralysis, seventh
cranial nerve involvement secondary to meningeal lymphomatosis, and peripheral
facial paralysis as one aspect of widespread chronic peripheral neuropathy may
also occur.

Publication Types: 
    Case Reports
    Review

PMID: 2681544 [PubMed - indexed for MEDLINE]

6116: AIDS Res Hum Retroviruses. 1989 Oct;5(5):551-4.

High prevalence of serum antibody against human T cell leukemia virus type I
(HTLV-I) among the Bismam Asmat population (Indonesian New Guinea).

Re MC, Tommaseo M, Furlini G, La Placa M.

Institute of Microbiology, University of Bologna, Italy.

An unusually high prevalence (45%) of serum antibodies to human T cell leukemia
virus type I (or to an antigenically related virus) in comparison with that
observed against other viral pathogens (human immunodeficiency virus type 1,
herpes simplex virus, human cytomegalovirus, varicella zoster virus, and
respiratory syncytial virus) has been observed in a group of Bismam Asmat (Papua)
subjects, living in a very limited and geographically isolated area of Indonesian
New Guinea.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2590558 [PubMed - indexed for MEDLINE]

6117: Acta Paediatr Jpn. 1989 Oct;31(5):523-8.

Natural killing of varicella-zoster virus (VZV)-infected fibroblasts in normal
children, children with VZV infections, and children with Hodgkin's disease.

Ihara T, Kamiya H, Starr SE, Arbeter AM, Lange B.

We studied mononuclear cell (MNC)-mediated natural killing (NK) of
varicella-zoster virus (VZV)-infected fibroblasts in normal children, children
with VZV infections, and children with Hodgkin's disease. NK activity was tested 
in 18 hr 51Cr release assays. NK activity for adults was significantly higher
than that for children 1-3 years old or 4-6 years old (p less than 0.05).
Serological status did not affect NK activity. NK activity in normal children was
not increased 4-6 weeks after immunization with varicella vaccine. Seven normal
children with natural varicella showed significantly higher NK activity against
VZV-infected and uninfected targets. Eight immunosuppressed children with herpes 
zoster showed significantly reduced NK activity within 72 hours of the onset of
herpes zoster. However, their NK activity rose to the normal level one to two
weeks later. Children with Hodgkin's disease had low NK activity. These results
suggested that NK cells might play an initial defensive role in VZV infections,
and that low NK activity in immunocompromised hosts might contribute to their
high incidence of herpes zoster.

PMID: 2559575 [PubMed - indexed for MEDLINE]

6118: Kansenshogaku Zasshi. 1989 Oct;63(10):1171-7.

[A clinicopathological study on cytomegalovirus infection]

[Article in Japanese]

Tashiro T, Goto Y, Shigeno H, Goto J, Nasu M.

A clinicopathological study was carried out in 200 autopsied cases experienced in
our department from 1981 to 1988. Cytomegalovirus infection was detected in 18
cases (9.0%). Eleven patients were male and 7 were female, and their ages ranged 
from 21 to 72 with a mean of 58.1 years. Primary diseases were mainly
Non-Hodgkin's lymphoma (7 cases) and Adult T-cell leukemia (4 cases), and
corticosteroid had been administered to all of them. The most commonly involved
organ was lung (77.8%), followed by adrenal (55.6%), esophagus, pancreas, ovary
(22.2%), stomach, small intestine, thyroid (16.7%), liver, kidney, tongue
(11.1%), and so on. Concomitant infections were frequently complicated, which
were bacterial pneumonia (5 cases), fungal pneumonia (3 cases), disseminated
varicella-zoster infection (2 cases) and herpes simplex virus esophagitis or
stomatitis (5 cases), while, ten patients died of cytomegalovirus pneumonia.
Cytomegalovirus infection was one of the fatal opportunistic infections in
immunocompromised, especially cell-mediated immunity impaired, hosts such as the 
patients with lymphocytic malignancies.

Publication Types: 
    English Abstract

PMID: 2559121 [PubMed - indexed for MEDLINE]

6119: Haematologica. 1989 Oct;74(5 Suppl):310-9.

[Viral infections in the granulocytopenic patient]

[Article in Italian]

Moroni M, Esposito R.

PMID: 2556334 [PubMed - indexed for MEDLINE]

6120: EMBO J. 1989 Oct;8(10):3121-5.

Molecular cloning of human uracil-DNA glycosylase, a highly conserved DNA repair 
enzyme.

Olsen LC, Aasland R, Wittwer CU, Krokan HE, Helland DE.

Laboratory of Biotechnology, University of Bergen, Norway.

Uracil-DNA glycosylase is the DNA repair enzyme responsible for the removal of
uracil from DNA, and it is present in all organisms investigated. Here we report 
on the cloning and sequencing of a cDNA encoding the human uracil-DNA
glycosylase. The sequences of uracil-DNA glycosylases from yeast, Escherichia
coli, herpes simplex virus type 1 and 2, and homologous genes from
varicella-zoster and Epstein-Barr viruses are known. It is shown in this report
that the predicted amino acid sequence of the human uracil-DNA glycosylase shows 
a striking similarity to the other uracil-DNA glycosylases, ranging from 40.3 to 
55.7% identical residues. The proteins of human and bacterial origin were
unexpectedly found to be most closely related, 73.3% similarity when conservative
amino acid substitutions were included. The similarity between the different
uracil-DNA glycosylase genes is confined to several discrete boxes. These
findings strongly indicate that uracil-DNA glycosylases from phylogenetically
distant species are highly conserved.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2555154 [PubMed - indexed for MEDLINE]

6121: J Virol. 1989 Oct;63(10):4189-98.

Expression in recombinant vaccinia virus of the equine herpesvirus 1 gene
encoding glycoprotein gp13 and protection of immunized animals.

Guo PX, Goebel S, Davis S, Perkus ME, Languet B, Desmettre P, Allen G, Paoletti
E.

Wadsworth Center for Laboratories and Research, New York State Department of
Health, Albany 12201.

The equine herpesvirus 1 (EHV-1) gene encoding glycoprotein 13 (gp13) was cloned 
into the hemagglutinin (HA) locus of vaccinia virus (Copenhagen strain).
Expression of the gp13 gene was driven by the early/late vaccinia virus H6
promoter. Metabolically radiolabeled polypeptides of approximately 47 and 44
kilodaltons and 90 kilodaltons (glycosylated form) were precipitated with both
polyclonal and gp13-specific monoclonal antibodies. Presentation of gp13 on the
cytoplasmic membrane of cells infected with the recombinant gp13 vaccinia virus
was demonstrated by immunofluorescence of unfixed cells. Inoculation of the
recombinant gp13 vaccinia virus into guinea pigs induced neutralizing antibodies 
to both EHV-1 and vaccinia virus. Hamsters vaccinated with the recombinant gp13
vaccinia virus survived a lethal challenge with the hamster-adapted Kentucky
strain of EHV-1. These results indicate that expression in vaccinia virus vectors
of EHV-1 gp13, the glycoprotein homolog of herpes simplex virus gC-1 and gC-2,
pseudorabies virus gIII, and the varicella-zoster virus gpV may provide useful
vaccine candidates for equine herpesvirus infections.

PMID: 2550665 [PubMed - indexed for MEDLINE]

6122: Turk J Pediatr. 1989 Oct-Dec;31(4):317-21.

Erythroblastopenia and leukopenia in the patient with severe herpes zoster
treated with intravenous acyclovir.

Tuncer AM, Evis B, Kunak B, Akcayoz N, Ertem U.

Department of Pediatrics, Dr. Sami Ulus Children's Hospital, Anakara.

A seven-year-old girl with transient leukopenia and erythroblastopenia which
developed after the administration of acyclovir is presented. Acyclovir infusion 
was given in a dose of 5 mg/kg/every eight hours. On the third day of therapy the
hemoglobin level fell to 9.9 g/dl, the hematocrit was 26%, the white blood cell
count 4000 percent/mm3, red blood cells 3.2 million percent/mm3. Bone marrow
aspiration showed a decrease in the number of erythoblasts and a relative
increase in the number of promyelocytes and myelocytes. Therapy was discontinued 
on the fifth day, and on the seventh day the findings were normal including the
bone marrow aspiration. We could not find any other reason which would cause
transient erythroblastopenia and leukopenia in our patient.

Publication Types: 
    Case Reports

PMID: 2486432 [PubMed - indexed for MEDLINE]

6123: Am J Med. 1989 Oct;87(4):405-7.

Interferon and interferon inhibitor levels in patients infected with
varicella-zoster virus, acquired immunodeficiency syndrome, acquired
immunodeficiency syndrome-related complex, or Kaposi's sarcoma, and in normal
individuals.

Ambrus JL, Poiesz BJ, Lillie MA, Stadler I, Di Berardino LA, Chadha KC.

Department of Molecular Biology, State University of New York, Buffalo.

PURPOSE: Previous studies had reported that normal individuals do not have
measurable levels of interferons in their circulation, whereas high levels have
been found in patients in the early stages of AIDS (acquired immunodeficiency
syndrome) and in those with AIDS-related complex (ARC). This study was undertaken
to compare levels of interferon and interferon inhibitors in plasma samples from 
patients with AIDS, ARC, Kaposi's sarcoma, or varicella-zoster virus infection,
and from control subjects. PATIENTS AND METHODS: A total of 206 persons were
tested for the presence of interferon and interferon inhibitors in their plasma: 
76 with ARC or AIDS, with or without Kaposi's sarcoma or lymphoma; 32 with
varicella-zoster infection; 12 with AIDS-unrelated Kaposi's sarcoma; and 86
normal control subjects at high or low risk of AIDS with or without positive
antibody levels to human immunodeficiency virus-1. Total interferon activity was 
measured by bioassay and the subtypes were not separated. RESULTS: Of 86 normal
control subjects, 85 had no significant levels of interferon or interferon
inhibitor. One disease-free homosexual exhibited measurable interferon levels.
Patients acutely infected with varicella-zoster virus showed no measurable
interferon or inhibitor levels except if they were in a high-risk group for AIDS.
Seventy-six patients with ARC or AIDS exhibited measurable circulating interferon
levels. Only patients with AIDS had interferon inhibitors in their circulation.
Of 12 patients with Kaposi's sarcoma unrelated to AIDS, none had measurable
interferon inhibitor levels, but some exhibited measurable interferon levels.
CONCLUSION: It is suggested that levels of interferon inhibitor should be
considered when interferon is used therapeutically in viral or neoplastic
diseases.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2478016 [PubMed - indexed for MEDLINE]

6124: Med J Aust. 1989 Sep 18;151(6):360.

Treatment of prodromal shingles.

Petersons VV.

Publication Types: 
    Letter

PMID: 2593954 [PubMed - indexed for MEDLINE]

6125: BMJ. 1989 Sep 16;299(6701):740-1.

Treatment of shingles and post-herpetic neuralgia.

[No authors listed]

Publication Types: 
    Letter

PMID: 2508905 [PubMed - indexed for MEDLINE]

6126: Am J Ophthalmol. 1989 Sep 15;108(3):327-8.

Aqueous chamber tap and serology in acute retinal necrosis.

Suttorp-Schulten MS, Zaal MJ, Luyendijk L, Bos PJ, Kijlstra A, Rothova A.

Department of Ophthalmology, University of Amsterdam, The Netherlands.

Publication Types: 
    Case Reports

PMID: 2549793 [PubMed - indexed for MEDLINE]

6127: Nurs Times. 1989 Sep 13-19;85(37):55-8.

Systems of life no. 175. Senior systems--40.

Roberts A.

PMID: 2813116 [PubMed - indexed for MEDLINE]

6128: Lancet. 1989 Sep 2;2(8662):559.

Reduced CD4+ count, infections, and immune thrombocytopenia without HIV
infection.

Daus H, Schwarze G, Radtke H.

Publication Types: 
    Case Reports
    Letter

PMID: 2570254 [PubMed - indexed for MEDLINE]

6129: J Ophthalmic Nurs Technol. 1989 Sep-Oct;8(5):189-92.

Acquired immunodeficiency syndrome and ophthalmology.

Fong AC.

1. Ocular manifestations of AIDS are, for the most part, due to the opportunistic
infections and neoplasias seen in the syndrome. 2. Ocular infections seen in AIDS
patients include cytomegalovirus, Toxoplasma gondii, Candida sp, Cryptococcus sp,
herpes simplex or zoster, Mycobacterium sp, and ocular syphilis. 3. Handwashing
and disinfection of instruments are recommended to prevent transmission of
infection in the ophthalmic practice.

PMID: 2795668 [PubMed - indexed for MEDLINE]

6130: Cutis. 1989 Sep;44(3):216-9.

Zosteriform porokeratosis: a report of two cases.

Veraldi S, Bocor M, Gasparini G.

First Department of Dermatology and Pediatric Dermatology, University of Milan,
Italy.

The authors describe two cases of zosteriform porokeratosis occurring in two
female patients, aged seventeen and fourteen years. In both patients the
dermatosis was localized to the thigh; one patient also presented with linear
lesions in the thoracoabdominal and dorsal regions. Histopathologic examination
confirmed the clinical diagnosis and excluded the presence of atypical cells.

Publication Types: 
    Case Reports

PMID: 2791643 [PubMed - indexed for MEDLINE]

6131: Vopr Virusol. 1989 Sep-Oct;34(5):630-3.

[Use of immunoenzyme analysis for serological study of patients with ophthalmic
herpes]

[Article in Russian]

Ebralidze LK, Gorbovitskaia GE, Mal'tseva NN, Kasparov AA.

PMID: 2692304 [PubMed - indexed for MEDLINE]

6132: Eur J Cancer Clin Oncol. 1989 Sep;25(9):1369-74.

Chemoprophylaxis of viral infection in immunocompromised patients.

Meyers JD.

Fred Hutchinson Cancer Research Center, Seattle WA.

Viral infections are of increasing importance in the compromised host,
particularly herpesvirus infections. Both intravenous and oral acyclovir are
effective in preventing reactivation of herpes simplex virus infection; oral
regimens are less expensive but compliance may be problematic. Varicella zoster
virus reactivation can be suppressed for 6-12 months after marrow transplant
using oral acyclovir, although infection may occur at the usual rate when
prophylaxis is stopped. Intravenous acyclovir given for 30 days after marrow
transplant reduced cytomegalovirus disease by 50%. New agents such as ganciclovir
or foscarnet promise better control of cytomegalovirus infection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2680516 [PubMed - indexed for MEDLINE]

6133: Prim Care. 1989 Sep;16(3):823-45.

Diagnostic and therapeutic techniques. For evaluation and treatment of skin
disorders.

Pariser DM.

Division of Dermatology, Eastern Virginia Medical School, Norfolk.

Many infectious diseases of the skin can be diagnosed accurately and rapidly by
simple bedside techniques. This article describes several of the more useful and 
commonly performed techniques for diagnosing superficial fungus infection, herpes
simplex, zoster, and varicella as well as the techniques for identification of
the ectoparasite-producing scabies and pediculosis in addition to techniques of
skin biopsy. Also the therapeutic techniques of cryotherapy and curettage and
electrode-siccation are discussed.

Publication Types: 
    Review

PMID: 2678182 [PubMed - indexed for MEDLINE]

6134: Prim Care. 1989 Sep;16(3):577-89.

Cutaneous viral infections: herpes simplex and varicella-zoster.

Pariser DM.

Division of Dermatology, Eastern Virginia Medical School, Norfolk.

Herpes simplex and varicella-zoster infections of the skin are commonly seen in
primary care practice. For the patient to be managed most effectively, clinical
diagnoses must be accurately made and supported by laboratory confirmation using 
the Tzanck smear and/or viral culture. Topical therapy and systemic acyclovir can
be of help to most patients with these infections.

Publication Types: 
    Review

PMID: 2678171 [PubMed - indexed for MEDLINE]

6135: J Assoc Physicians India. 1989 Sep;37(9):606-9.

Contralateral hemiplegia in herpes zoster ophthalmicus. Role of temporal artery
biopsy.

Behari M, Mishra NK, Sarkar C, Roychowdhery D, Prasad K, Maheshwari MC.

We describe clinical, radiological and pathological findings in a case of herpes 
zoster ophthalmicus who developed contralateral hemiplegia. The CT scan showed
discrete infarction of the right internal capsule and the right carotid angiogram
showed concentric narrowing of the supraclinoid portion of right internal carotid
artery. Superficial temporal artery biopsy showed infiltration by lymphocytes and
plasma cells without any granuloma formation or giant cells. The importance of
trigemino-vascular connections in the pathogenesis of this complication of herpes
zoster ophthalmicus and the role of temporal artery biopsy in the diagnosis of
arteritis following herpes zoster are discussed.

Publication Types: 
    Case Reports

PMID: 2632564 [PubMed - indexed for MEDLINE]

6136: Acta Virol. 1989 Sep;33(5):428-34.

Increased migration inhibition factor production by leukocytes of patients with
herpes zoster given the leukocyte ultrafiltrate.

Lackovicova M, Zachar V, Necas S, Mayer V.

Institute of Virology, Slovak Academy of Science, Bratislava, Czechoslovakia.

Using the direct leukocyte migration inhibition assay, the cell-mediated immune
response was followed in together 47 patients suffering from herpes zoster. Of
these, 19 persons were treated with partially purified and concentrated lysed
leukocyte ultrafiltrate. Enhancement and/or earlier production of the leukocyte
migration inhibition factor--in the presence of varicella-zoster virus
antigen--was observed by leukocytes from patients given the ultrafiltrate on days
2-3 since the onset of the vesicular stage of the disease. Highly significant
(alpha = 1%, P less than 0.01) differences in the migration inhibition values
were observed between non-treated patients and patients given one dose of the
ultrafiltrate during the days 3-12 after appearance of the first herpes zoster
vesicles; on days 13-30 these values were not significant.

PMID: 2576583 [PubMed - indexed for MEDLINE]

6137: Acta Virol. 1989 Sep;33(5):417-27.

Semipurified human leukocyte ultrafiltrate in herpes zoster. I. Large-scale
preparation and biochemical analysis.

Borvak J, Mayer V, Kotuliak J.

Institute of Virology, Slovak Academy of Sciences, Bratislava, Czechoslovakia.

Nine batches of lysed human leukocyte ultrafiltrate (LLU) prepared from buffy
coats of random healthy donors, as well as their semipurified
subfractions--P2/II--were compared in terms of protein, orcinol-reactive material
(ORM) content, and ratios of the average values of their ORM and protein
contents. Two-step ethanol precipitation and size exclusion chromatography on
Sephadex G-15 were used for partial purification and concentration. In comparison
to the starting material, approximately 4.4 - fold increase in the ORM/protein
ratio of P2/II has been effected. Relatively high variation in both, protein and 
ORM content of the crude LLU individual batches (ranges: 365 micrograms/1 ml -
962 micrograms/1 ml; 157 micrograms/1 ml - 660 micrograms/1 ml, respectively), as
well as of those of P2/II fractions (ranges: 16.5 micrograms/1 ml - 207.5
micrograms/1 ml; 150 micrograms/1 ml - 480 micrograms/1 ml, respectively) could
be observed. The suggested combined purification procedure removed from the LLU
about 85% proteins and 33% ORM. The removed material contained inhibitors of the 
cell-mediated immunity (CMI)-inducing and/or augmenting properties of LLU. This
is in good agreement with the observed improved therapeutic effect of P2/II
fraction in herpes zoster treatment of otherwise noncompromised adults, as
described in the companion paper.

PMID: 2576582 [PubMed - indexed for MEDLINE]

6138: J Oral Pathol Med. 1989 Sep;18(8):481-4.

Explants of human oral epithelium exposed to viruses and cancer
chemotherapeutics.

Ebbesen P, Petersen PM, Jepsen A, Norskov-Lauritsen N, Nielsen CM, Philipsen HP, 
Arenholt-Bindslev D, Nara P.

Danish Cancer Society, Department of Virus and Cancer, Aarhus.

Cultures of proliferating epithelial cells were established from explants of
normal human oral epithelium from healthy young volunteers. The epithelial cells 
were found permissive for herpes simplex virus type 1 and type 2, coxsackie virus
A-4 and A-16, adenovirus type 5, measles vaccine, rubella and influenza type A
virus-. Medium from DEAE-pretreated epithelial cultures infected with two
subtypes of human immunodeficiency virus-1 showed an increasing content of
virusprotein with time by antigen ELISA testing. In contrast there was no
evidence of infection with coxsackie virus type B-2, cytomegalovirus,
Epstein-Barr virus and varicella zoster virus. Treatment of the epithelial cells 
with a non-cytotoxic dose of cancer chemotherapeutic prior to or after infection 
with coxsackie virus A-4 or herpes simplex virus type 1 influenced the virus
production dependent on both compound, mode of application, and virus. Adriamycin
(doxorubicin) in low dose was found to stimulate the production of the two
viruses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2558179 [PubMed - indexed for MEDLINE]

6139: Hautarzt. 1989 Sep;40(9):582-5.

[Disseminated herpes zoster in chronic lymphatic leukemia]

[Article in German]

Grimm W, Korting HC, Stolz W.

Dermatologische Klinik und Poliklinik, Ludwig-Maximilians-Universitat Munchen.

A 73-year-old woman suffering from chronic lymphatic leukemia presented a rare
variant of zoster with disseminated eruptions. Ultrastructural negative staining 
revealed viruses of the herpes group. Herpes simplex was excluded by means of
fluorescence-labelled monoclonal antibodies (HSV-1/HSV-2 direct specimen
identification/typing test). It is proposed that the conventional classification 
of zoster into a segmental and a generalized variant should be supplemented.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2553644 [PubMed - indexed for MEDLINE]

6140: Br J Dermatol. 1989 Sep;121(3):287-96.

Rapid diagnosis in varicella and herpes zoster: re-evaluation of direct smear
(Tzanck test) and electron microscopy including colloidal gold immuno-electron
microscopy in comparison with virus isolation.

Folkers E, Vreeswijk J, Oranje AP, Duivenvoorden JN.

Department of Dermatology, Hospital 'de Heel', Zaandam; The Netherlands.

The Tzanck test and electron microscopy with the technique of colloidal gold
labelling in varicella-zoster virus (VZV) infections were compared with virus
isolation in 54 patients with clinically suspected varicella or herpes zoster
infection. The Tzanck test and direct electron microscopy can determine whether
or not an eruption is herpetic but cannot distinguish between herpes simplex
virus (HSV) and VZV infection. However, colloidal gold immuno-electron
microscopy, using monoclonal antibodies against HSV and anti-VZV IgG, can
distinguish between these two herpes viruses. This achieves the same specificity 
as virus isolation followed by virus neutralization or virus typing using
immunofluorescence techniques. The Tzanck test was positive in 91%, virus
isolation, under optimal conditions of sampling and transportation, in 80%,
direct electron microscopy (negative staining) in 80%, and colloidal gold
immuno-electron microscopy after a virus concentration procedure in 95% of the
cases. The colloidal gold technique offers a rapid diagnosis in patients with
suspected VZV infection.

Publication Types: 
    Comparative Study

PMID: 2553095 [PubMed - indexed for MEDLINE]

6141: Pediatr Infect Dis J. 1989 Sep;8(9):584-5.

Comment on:
    Pediatr Infect Dis J. 1989 Sep;8(9):586-90.

Varicella-zoster virus infections: chronic disease in the immunocompromised host:
evidence for persistent excretion of virus.

Whitley RJ.

Department of Pediatrics, University of Alabama, Birmingham.

Publication Types: 
    Comment
    Review

PMID: 2552389 [PubMed - indexed for MEDLINE]

6142: Virology. 1989 Sep;172(1):223-36.

DNA sequence and comparative analyses of the equine herpesvirus type 1 immediate 
early gene.

Grundy FJ, Baumann RP, O'Callaghan DJ.

Department of Microbiology and Immunology, Louisiana State University Medical
Center, Shreveport 71130-3932.

The immediate early (IE) proteins of herpesviruses are important regulatory
factors which control the expression of genes at the transcriptional level. We
report the DNA sequence of the immediate early gene of the alphaherpesvirus
equine herpesvirus type 1 (EHV-1). This sequence is shown to be extremely rich in
guanine and cytosine, resulting in a highly biased codon usage. The IE gene
region possesses 38 open reading frames (ORFs) greater than 300 bp in length, 11 
of which have coding regions of at least 100 amino acids (aa) following potential
translation initiator codons. The largest ORF consists of 1487 codons (4461 bp)
starting with the first ATG and would encode a protein of MW 155,000. TATA and
CCAAT sequences as well as several potential cis-acting elements lie upstream to 
the major ORF. The deduced amino acid sequence for the 155,000 protein has a high
degree of homology to the herpes simplex virus type 1 (HSV-1) ICP4 protein and
its varicella-zoster virus (VZV) homolog. The regions of the EHV-1 IE protein
that are homologous with these proteins correspond to the previously determined
pattern of homology between the HSV and VZV IE polypeptides. However, there are
are a number of differences within these broadly defined regions. It is therefore
expected that this comparative study will facilitate the identification of
functionally important residues within the amino acid sequence of IE proteins.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 2549711 [PubMed - indexed for MEDLINE]

6143: Blood. 1989 Sep;74(4):1424-7.

Herpes zoster infection after autologous bone marrow transplantation.

Schuchter LM, Wingard JR, Piantadosi S, Burns WH, Santos GW, Saral R.

Johns Hopkins Oncology Center, Baltimore.

One hundred fifty-three patients who underwent autologous bone marrow transplant 
(ABMT) were studied retrospectively to determine the frequency, outcome, and
risk-factors associated with varicella-zoster infections (VZV). Forty-three
patients (28%) developed VZV infection after transplant. The median onset of
infection was the fifth month, with 91% of cases occurring within the first year.
Thirty-three patients (77%) had localized herpes zoster, and ten patients (23%)
had varicella. Cutaneous dissemination developed in 15% of patients and probable 
visceral dissemination developed in 5%. Overall morbidity was 25% and included
scarring, alopecia, postherpetic neuralgia, and neurologic dysfunction. There
were no deaths from VZV infection. The majority of patients (79%) were treated
with intravenous (IV) acyclovir. The only significant risk factor associated with
VZV infection was the underlying disease. VZV infection occurred most frequently 
in patients with Hodgkin's and non-Hodgkin's lymphoma (46%) as compared with
patients with leukemia (23%) or solid tumors (9%) (P less than .002). The
frequency of VZV infection in ABMT patients appears to be comparable to that
reported for allogeneic BMT patients and other immunocompromised patients.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2548641 [PubMed - indexed for MEDLINE]

6144: J Virol. 1989 Sep;63(9):3792-800.

Identification and characterization of a human cytomegalovirus gene coding for a 
membrane protein that is conserved among human herpesviruses.

Lehner R, Meyer H, Mach M.

Institut fur Klinische und Molekulare Virologie, Universitat Erlangen-Nurnberg,
Federal Republic of Germany.

A rabbit antiserum was raised against envelope material from purified human
cytomegalovirus strain AD169. The serum recognized polypeptides 200, 170, 160,
75, 58, and 45 kilodaltons in size. It was used to screen a cDNA library
constructed from poly(A)+ RNA from human cytomegalovirus-infected cells in the
expression vector lambda gt11. A recombinant bacteriophage expressing
cytomegalovirus-specific sequences was identified, and the corresponding gene was
mapped to the HindIII R fragment. The gene is transcribed into a late
1.5-kilobase RNA. The nucleotide sequence of the coding region was determined.
Computer analysis of the gene product revealed a polypeptide containing multiple 
potential membrane-spanning domains, representing a type of protein not
identified in the envelope of herpesviruses before. The protein shows homology on
the amino acid level to hypothetical proteins from reading frames BBRF3 of
Epstein-Barr virus, UL10 of herpes simplex virus type 1, and ORF50 of
varicella-zoster virus. By using an antiserum raised against procaryote-expressed
parts of the cytomegalovirus membrane protein, a 45-kilodalton structural
component of the virus was identified as the gene product.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2547996 [PubMed - indexed for MEDLINE]

6145: J Infect Dis. 1989 Sep;160(3):535-7.

Erratum in:
    J Infect Dis 1989 Dec;160(6):1095.

Herpes zoster in an adult recipient of live attenuated varicella vaccine.

Hammerschlag MR, Gershon AA, Steinberg SP, Clarke L, Gelb LD.

Department of Pediatrics, SUNY Health Science Center, Brooklyn, New York.

A healthy 30-y-old female physician who was immunized with two doses of live
attenuated varicella vaccine developed a localized case of zoster involving the
right T8-10 dermatomes 36 mo after vaccination. The virus isolated from her rash 
was an unusual wild-type of varicella-zoster virus. After immunization she
developed detectable antibodies to varicella-zoster virus, but antibodies were no
longer detectable after 20 mo. Six months before development of zoster, she was
exposed to a patient with varicella; however, she did not develop a clinical
illness although she again became seropositive. To date, this is the only
reported case of zoster among 187 healthy adult vaccinees.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 2547882 [PubMed - indexed for MEDLINE]

6146: Arch Esp Urol. 1989 Sep;42(7):686-9.

[Neurogenic bladder secondary to herpes zoster. Urodynamic evaluation]

[Article in Spanish]

Sanroma Ortueta I, Garrido Rivas MC, Garmendia Larrea JC, Lopez Garcia JA,
Arocena Lanz F.

A case of urinary retention from infranuclear neurogenic bladder secondary to
perineal herpes zoster infection is described. We discuss the different
urological compromise (neurologic and vesico-prostatic) following herpes zoster
infection and the importance of correct diagnosis and patient follow-up. We do
not recommend instituting drug therapy. Intermittent use of a catheter is
advocated as the only treatment modality for this condition, which is reversible 
in most of the cases.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2490355 [PubMed - indexed for MEDLINE]

6147: Reg Anesth. 1989 Sep-Oct;14(5):244-6.

Pleural analgesia for the treatment of acute severe thoracic herpes zoster.

Reiestad F, Kvalheim L, McIlvaine WB.

Department of Anaesthesia, Ulleval Sykehus, Oslo, Norway.

Effective pain relief was produced in 18 patients having acute or subacute
thoracic herpes zoster by the intermittent administration of local anesthetics
into the pleural space via a percutaneously placed catheter. The duration of
treatment varied from 16 to 21 days. During this period, the intervals between
subsequent doses of 20 ml of 0.5% bupivacaine with 1:200,000 epinephrine
increased in all patients from two doses per 24 hours to one dose per 24 hours.
Patients became pain-free between 16 and 21 days after the beginning of
treatment. The catheters were then removed, and a follow-up period of more than
one year showed no signs of postherpetic neuralgia in any of the 18 patients. No 
side effects were observed during the treatment period.

PMID: 2486647 [PubMed - indexed for MEDLINE]

6148: Pain. 1989 Sep;38(3):297-301.

Topical lidocaine reduces pain in post-herpetic neuralgia.

Rowbotham MC, Fields HL.

Department of Neurology, School of Medicine, University of California San
Francisco 94143.

We report the results of a single session, non-blinded, trial of topical
application of 10% lidocaine in gel form to the painful skin of 11 patients with 
well established post-herpetic neuralgia (PHN). Pain decreased as measured by 100
mm VAS pain scale and 100 mm VAS pain relief scale in both trigeminal and
thoracic PHN patients.

PMID: 2478945 [PubMed - indexed for MEDLINE]

6149: Fortschr Med. 1989 Aug 30;107(25):541-4.

[The significance of herpesviridae in ophthalmology]

[Article in German]

Sundmacher R.

Herpesviruses are the most common causes of infection-related loss of vision or
blindness in our part of the world. A better understanding of the underlying
pathophysiology, together with major pharmaceutical advances have led to medical 
and surgical therapy which enables us to preserve or restore useful vision in
most patients.

Publication Types: 
    English Abstract
    Review

PMID: 2553563 [PubMed - indexed for MEDLINE]

6150: Fortschr Med. 1989 Aug 30;107(25):537-40.

[Herpes virus infections in immunosuppressed patients. Herpes simplex and
varicella zoster virus: prevention and therapy]

[Article in German]

Mertens T.

Herpes simplex virus (HSV) and varicella-zoster virus (VZV) giving rise to
primary or recurrent infections still threaten immunocompromised patients.
However, such prophylactic measures as passive and active immunisation against
VZV infection, and antiviral chemoprophylaxis and chemotherapy of HSV- and
VZV-infections have improved the prognosis of these patients considerably.

Publication Types: 
    English Abstract
    Review

PMID: 2553562 [PubMed - indexed for MEDLINE]

6151: Fortschr Med. 1989 Aug 30;107(25):533-6.

[Virus latency in infections with herpesviridae. Herpes simplex and varicella
zoster virus: pathogenesis, clinical consequences]

[Article in German]

Schneweis KE.

Once the organism has been invaded, all herpesviruses persist. This is
accomplished by a change in the acute productive phase of the infection into the 
latent form. Reactivation of the latent virus ensures renewed transmissibility of
the infection. This pathogenetic principle is ensured by an extremely finely
tuned virus-host interrelationship which has developed in a unique specific
manner for each herpesvirus. Pathogenetic fundamentals are discussed taking
herpes simplex and the varicella-zoster virus as examples, and the resulting
clinical consequences are shown.

Publication Types: 
    English Abstract
    Review

PMID: 2553561 [PubMed - indexed for MEDLINE]

6152: Fortschr Med. 1989 Aug 30;107(25):529-32.

[Neurologic diseases in herpesvirus infections]

[Article in German]

Prange HW.

Herpes viruses can give rise to numerous virological infections. Life-threatening
situations arise with encephalitis caused by HSV or VZV. Zoster vasculitis is
probably more frequent than its diagnosis would suggest, and usually results in
paralysis. A particularly troublesome condition is post-herpetic neuralgia that
requires a wearisome and often complex treatment. Cerebral nerve involvement and 
polyradiculitis may be associated with almost all the human pathogenic herpes
viruses. In patients with herpetic CNS involvement, early treatment is necessary.

Publication Types: 
    English Abstract
    Review

PMID: 2553560 [PubMed - indexed for MEDLINE]

6153: Pol Tyg Lek. 1989 Aug 21-28;44(34-35):799-800.

[Results of acyclovir treatment of chickenpox and herpes zoster in children with 
immune tolerance]

[Article in Polish]

Jankowska H, Szczepanska-Putz M, Wojnarowski M.

Acyclovir was used for the treatment of Varicella-zoster virus infections in 53
children (10 neonates and 43 children aged between 2 an 15 years) with
immunological system deficiency hospitalized at the Department of the Infectious 
Diseases of Childhood in the Medical Academy in Warszawa. The obtained results of
therapy were favourable except one fatal case of the child with visceral
dissemination of the virus prior to acyclovir treatment. Compared with other
antiviral agents used by the authors previously, acyclovir proved to be the most 
effective.

Publication Types: 
    English Abstract

PMID: 2485894 [PubMed - indexed for MEDLINE]

6154: Am J Ophthalmol. 1989 Aug 15;108(2):118-22.

Clinical indications for and procedures associated with penetrating keratoplasty,
1983-1988.

Brady SE, Rapuano CJ, Arentsen JJ, Cohen EJ, Laibson PR.

Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107.

We reviewed the preoperative clinical indications and associated surgical
procedures for 2,299 penetrating keratoplasties performed at our institution from
1983 through 1988. Pseudophakic bullous keratopathy was the most common
indication overall, accounting for 526 cases (23%). A marked increase was noted
in the incidence of pseudophakic bullous keratopathy as an indication for
penetrating keratoplasty beginning in 1985. The association of anterior chamber
intraocular lenses in eyes with pseudophakic bullous keratopathy undergoing
penetrating keratoplasty increased from 19 of 43 cases (44%) in 1983 to 79 of 108
cases (73%) in 1988. The incidence of intraocular lens exchange at the time of
penetrating keratoplasty in cases of pseudophakic bullous keratopathy increased
from six of 43 (14%) in 1983 to 63 of 108 (58%) in 1988. Other major indications 
for penetrating keratoplasty included Fuchs' dystrophy (375 cases, 16%),
keratoconus (348 cases, 15%), aphakic bullous keratopathy (331 cases, 14%), and
regraft (233 cases, 10%). Cataract extraction, with or without intraocular lens
implantation, was combined with penetrating keratoplasty in 397 of 1,532 phakic
eyes (26%). The incidence of triple procedure (penetrating keratoplasty, cataract
extraction, and intraocular lens implantation) increased from 27 of 248 phakic
eyes (11%) in 1983 to 68 of 258 phakic eyes (26%) in 1988.

PMID: 2667369 [PubMed - indexed for MEDLINE]

6155: Med Klin (Munich). 1989 Aug 15;84(8):369-72.

[HIV infection in stage IV C-2 (CDC). Increase in the p24 antigen value before
critical decrease in CD4+ lymphocytes]

[Article in German]

Pees HW, Hofmann H, Stute R.

The Center for Disease Control proposed a classification system of HIV-infection 
including a symptomatic stage IV C-2 with secondary infections like thrush, oral 
hairy leukoplakia and herpes zoster. Because the prognostic value of these
symptoms for the development of AIDS has been proven and the CDC-classification
does not include any immunological parameters we analyzed the numbers of
CD4+-lymphocytes and the frequency of HIV-antigen in 65 HIV-infected individuals.
When entering stage IV C-2, the incidence of HIV-antigenemia was as high as in
full blown AIDS (53% and 60%, respectively). However, we observed no decrease of 
CD4+-lymphocytes as compared to earlier CDC-stages.--We conclude that in stage IV
C-2 the increase of viral protein production proceeds independently from
CD4+-status.

Publication Types: 
    English Abstract

PMID: 2571919 [PubMed - indexed for MEDLINE]

6156: Lancet. 1989 Aug 12;2(8659):371-3.

Outcome in newborn babies given anti-varicella-zoster immunoglobulin after
perinatal maternal infection with varicella-zoster virus.

Miller E, Cradock-Watson JE, Ridehalgh MK.

Public Health Laboratory Service Communicable Disease Surveillance Centre,
London.

281 newborn babies whose mothers had chickenpox and 25 whose mothers had herpes
zoster during the perinatal period were investigated. IgG antibody was present at
birth in all babies born more than 7 days after the onset of maternal chickenpox.
When the mother's rash appeared 7-3 days before delivery progressively fewer
babies were born with antibody, and no infant born less than 3 days after the
onset had antibody at birth. Infants were given 100 or 250 mg of
anti-varicella-zoster immunoglobulin (VZIG) shortly after birth or the onset of
post-natal maternal chickenpox. 1 infant died, without neonatal varicella. Of the
280 surviving infants 169 (60%) were infected--134 (48%) with chickenpox and 35
(13%) without clinical features. The clinical attack rate was highest (60%) in
infants whose mothers had chickenpox between 7 days before and 7 days after
delivery. Chickenpox was severe in 19 infants, 16 of whom were exposed to
maternal chickenpox between 4 days before and 2 days after delivery. There was no
evidence that a severe outcome was associated with transplacentally acquired
infection. Perinatal maternal herpes zoster did not cause neonatal infection.
VZIG should be given to infants at risk, including those whose mothers have
chickenpox during the last 7 days of pregnancy.

PMID: 2569560 [PubMed - indexed for MEDLINE]

6157: BMJ. 1989 Aug 5;299(6695):392-3.

Comment on:
    BMJ. 1989 Jun 10;298(6687):1537-8.

Treatment of shingles and post-herpetic neuralgia.

[No authors listed]

Publication Types: 
    Comment
    Letter

PMID: 2506989 [PubMed - indexed for MEDLINE]

6158: Am Fam Physician. 1989 Aug;40(2):55.

Comment on:
    Am Fam Physician. 1989 Feb;39(2):89-98.

Oral acyclovir in maternal zoster.

Crim M.

Publication Types: 
    Comment
    Letter

PMID: 2818727 [PubMed - indexed for MEDLINE]

6159: J Trop Pediatr. 1989 Aug;35(4):171-4.

Herpes simplex virus type 1 (HSV-1) and varicella-zoster virus (VZV) infections
in Saudi Arabia.

Hossain A.

The seroepidemiology of infection due to herpes simplex type 1 (HSV-1) and
varicella-zoster (VZV) viruses was investigated in 224 Saudi children aged from
under 1 year to 15 years and 452 adults (healthy male blood donors and pregnant
women) using a presently available sensitive indirect immunofluorescence
technique to detect antibodies to these viruses in order to determine the age of 
primary infection. Age-specific prevalence of IgG antibodies to HSV-1 and VZV
showed a progressive increase with age in both males and females with no obvious 
sex-related variation in the level. The overall prevalence of antibodies was 60
per cent for HSV-1 and 68 per cent for VZV in children whereas about 90 per cent 
of the adults showed the presence of antibodies to both viruses. Virological and 
serological confirmation of two cases in children of herpes simplex encephalitis 
(HSE) due to HSV-1 and VZV reactivation in two adults is described.

PMID: 2810461 [PubMed - indexed for MEDLINE]

6160: Ophthalmology. 1989 Aug;96(8):1187-93.

Comment in:
    Ophthalmology. 1990 Sep;97(9):1091.

Toxic ulcerative keratopathy. An unrecognized problem.

Schwab IR, Abbott RL.

Department of Ophthalmology, West Virginia University, Morgantown.

The authors describe 19 patients with toxic ulcerative keratopathy. These
patients were referred with other diagnoses and were victims of overtreatment.
Fourteen of these patients had iatrogenic toxic keratopathy, and the other five
had self-induced keratoconjunctivitis. The corneal defects tended to be inferior 
or inferonasal and associated with an intense, coarse superficial keratitis in
"comet's impact" fashion. Conjunctival hyperemia, chemosis, and conjunctival
staining were considerably more prominent inferiorly and inferonasally. Diagnosis
was the key element in management. Treatment consisted of discontinuation of the 
offending medication or preservative. Other important measures included
preservative-free medications, patching, therapeutic contact lenses, goggles, and
viscoelastic agents. Many of the patients with iatrogenically induced toxic
keratopathy had significant ocular surface disease such as keratoconjunctivitis
sicca (6 patients), previous intraocular surgery (6 patients), herpes simplex
infection (1 patient), or herpes zoster infection (1 patient).

Publication Types: 
    Case Reports

PMID: 2797722 [PubMed - indexed for MEDLINE]

6161: Br J Dermatol. 1989 Aug;121(2):280.

Comment on:
    Br J Dermatol. 1987 Oct;117(4):503-10.

Reticulate hyperpigmentation distributed in a zosteriform fashion.

Patrizi A, Di Lernia V, Varotti C.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 2775652 [PubMed - indexed for MEDLINE]

6162: J Am Acad Dermatol. 1989 Aug;21(2 Pt 1):265-70.

Topical capsaicin treatment of chronic postherpetic neuralgia.

Bernstein JE, Korman NJ, Bickers DR, Dahl MV, Millikan LE.

Department of Clinical Research, GenDerm Corp., Northbrook, IL.

Uncontrolled studies have indicated that topically applied capsaicin may be a
safe and effective treatment for postherpetic neuralgia. In a double-blind study 
32 elderly patients with chronic postherpetic neuralgia were treated with either 
capsaicin cream or its vehicle for a 6-week period. Response to treatment was
evaluated by visual analogue scales of pain and of pain relief, together with
changes in a categoric pain scale and in a physician's global evaluation.
Significantly greater relief in the capsaicin-treated group compared with vehicle
was observed for all efficacy variables. After 6 weeks almost 80% of
capsaicin-treated patients experienced some relief from their pain. Because
capsaicin avoids problems with drug interactions and systemic toxicity, we
suggest that topical capsaicin be considered for initial management of
postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2768576 [PubMed - indexed for MEDLINE]

6163: Neurology. 1989 Aug;39(8):1132-3.

Topical lidocaine for relief of superficial pain in postherpetic neuralgia.

Kissin I, McDanal J, Xavier AV.

Department of Anesthesiology, School of Medicine, University of Alabama,
Birmingham 35294.

Publication Types: 
    Case Reports

PMID: 2761713 [PubMed - indexed for MEDLINE]

6164: J Indian Med Assoc. 1989 Aug;87(8):190.

Ramsay Hunt syndrome.

Kalam A, Tahseen M, Islam SF, Rahmatullah M, Khan AA, Faruqi NA.

Publication Types: 
    Case Reports

PMID: 2621363 [PubMed - indexed for MEDLINE]

6165: Virus Genes. 1989 Aug;2(4):335-46.

Nucleotide sequence of the pseudorabies virus immediate early gene, encoding a
strong transactivator protein.

Vlcek C, Paces V, Schwyzer M.

Institute of Molecular Genetics, Czechoslovak Academy of Sciences, Prague.

We report the complete DNA sequence of teh pseudorabies virus (PRV) immediate
early (IE) gene and its flanking nucleotide sequences, together comprising 5091
base pairs. An open reading frame starts with an ATG codon in position 263 from
the transcription-initiation site and ends with a TGA codon in position 4601,
thus encoding a predicted protein of 1446 amino acids (150 kD). The PRV IE
protein exhibits significant homology with the functionally related
transactivator proteins, ICP4 of herpes simplex virus-1 (HSV-1) and p140 of
varicella zoster virus (VZV). The extent of homology varies widely along the
three sequences: Two regions of the PRV IE protein extending from amino acids 482
to 659 and 959 to 1350 exhibit 50% to 60% identity with the cognate sequences,
whereas the remaining sequence reveals little homology apart from a common
polyserine stretch. The base composition of the PRV IE coding region is 80% G +
C, compared with 81.5% for HSV-1 and 64.1% for VZV. Yet the PRV IE protein
appears to be as closely related to VZV p140 as to HSV-1 ICP4. The regions of
strong homology are also apparent in plots predicting secondary structure.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2554582 [PubMed - indexed for MEDLINE]

6166: Virus Genes. 1989 Aug;2(4):299-305.

Persistence of varicella-zoster virus DNA in blood mononuclear cells of patients 
with varicella or zoster.

Gilden DH, Devlin M, Wellish M, Mahalingham R, Huff C, Hayward A, Vafai A.

Department of Neurology, University of Colorado School of Medicine, Denver 80262.

Varicella-zoster virus (VZV) DNA was detectable by in-situ hybridization in blood
mononuclear cells (MNCs) of patients with varicella or zoster for 2-56 days after
the onset of a rash. VZV DNA was present in many MNCs from one acute varicella
patient 2 days after the onset of the rash and was rarely found in MNCs during
acute zoster, convalescent zoster, and convalescent varicella. The morphology of 
MNCs containing VZV was heterogenous, although most viral-DNA-containing MNCs
were large monocytoid cells. Serial examination of blood MNCs from one adult with
varicella revealed VZV DNA up until 8 weeks, but not 16 weeks, after the
appearance of the rash; parallel studies in four zoster patients showed VZV DNA
up until 3 weeks, but not later than 7 weeks after the appearance of the rash.
These results indicate that MNCs become infected with VZV during the primary
encounter with VZV (varicella) and during reactivation (zoster) and that
infection continues for weeks after the onset of the skin rash. Furthermore, the 
detection of VZV DNA in blood MNCs of uncomplicated zoster patients coincides
with the period during which these patients experience pain.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2554580 [PubMed - indexed for MEDLINE]

6167: Semin Perinatol. 1989 Aug;13(4):278-93.

Pathogenesis of congenital infection with three diverse viruses: varicella-zoster
virus, human parvovirus, and human immunodeficiency virus.

Grose C, Itani O.

Department of Pediatrics, University of Iowa College of Medicine, Iowa City.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2549641 [PubMed - indexed for MEDLINE]

6168: Clin Pediatr (Phila). 1989 Aug;28(8):354.

Clinical herpes zoster shortly following primary varicella in two HIV-infected
children.

Patterson LE, Butler KM, Edwards MS.

Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030.

Publication Types: 
    Case Reports

PMID: 2547541 [PubMed - indexed for MEDLINE]

6169: Acta Neurol Scand. 1989 Aug;80(2):142-4.

The incidence of herniated disc and varicella zoster virus infection in
lumboradicular syndrome.

Jensen PK, Andersen EB, Boesen F, Dissing I, Vestergaard BF.

Department of Neurology and Radiology, Hvidovre Hospital, Copenhagen, Denmark.

121 patients suffering from lumboradicular syndrome were examined for the
presence of varicella zoster virus (VZV) infection. Lumbar myelography was
carried out on all. VZV-antibody determination in blood, as well as in spinal
fluid, was by indirect ELISA. In 40% of cases lumbar myelography revealed no
signs of a herniated disc; none had raised antibody titre in spinal fluid.
VZV-antibody titre in blood indicated VZV infection in only 3.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2530747 [PubMed - indexed for MEDLINE]

6170: Zhonghua Nei Ke Za Zhi. 1989 Aug;28(8):466-8, 509.

[Clinical analysis of 4 Chinese hemophiliacs with human immunodeficiency virus
infection]

[Article in Chinese]

Tang DJ, Xu YH, Dai D.

Human immunodeficiency virus (HIV-is) now considered the causative agent of
acquired immunodeficiency syndrome(AIDS). A high risk of AIDS has been reported
among patients with hemophilia who received lyophilized commercial factor VIII
and IX concentrates of American origin. In a prevalence survey conducted from
September to December 1985, HIV antibodies were found in all the 4 patients with 
hemophilia treated with the batch number W87307, 955 I.U. of American commercial 
factor VIII concentrate supplied by Armour pharmaceutical Company U.S.A. One of
the seropositive patients developed AIDS-related complex (ARC) and died of
cerebral hemorrhage. The other three sero-positive patients had abnormalities in 
cell mediated immunity; among them two developed left lumbosacral radiculopathy
and hemorrhagic herpes zoster and one remains well so far.

Publication Types: 
    English Abstract

PMID: 2513171 [PubMed - indexed for MEDLINE]

6171: Kidney Int. 1989 Aug;36(2):280-5.

Presence of an anti-viral factor in peritoneal dialysis effluent.

Pomeranz A, Korzets Z, Smetana O, Yuhas Y, Elan I, Bernheim J.

Department of Nephrology, Meir General Hospital, Kfar Saba, Israel.

Viral peritonitis is an exceptionally rare occurrence in peritoneal dialysis. In 
fact, up to now, only one case report has been documented in the literature. In a
prospective study, peritoneal dialysis effluent (PDE) was specifically cultured
for the following viruses: the herpes group of viruses, including herpes simplex 
types I (HSV) and II, cytomegalovirus (CMV) and varicella-zoster (V-Z), and the
enteroviruses group including coxsackie B-5 (Cox B), echo, enterovirus and polio.
Cultures were performed under both basal conditions and in the presence of
peritonitis. No viral growth was demonstrated. The possible existence of an
anti-viral factor in the PDE was therefore raised. In order to investigate this
hypothesis, the PDE of 16 patients undergoing intermittent peritoneal dialysis
and of 24 patients on continuous ambulatory peritoneal dialysis were examined for
anti-viral activity. The method used was analogous to that employed for testing
the anti-viral effect of interferon (IFN). The inhibition of the cytopathic
effect (CPE) of various viruses was examined in the following tissue cultures:
Vero cells (a line of monkey kidney cells) incubated with HSV, vesicular
stomatitis virus (VSV) and Cox B; human kidney cells incubated with parainfluenza
3 (Para-3); human foreskin fibroblasts incubated with CMV, HSV and VSV and L-929 
(a line of mouse cells) incubated with VSV. As control, unused Dianeal (Travenol,
Ashdod, Israel) 1.5 and 4.25 g/dl, normal saline and 5 g/dl dextrose solutions
were tested under the same conditions using VSV on Vero. The PDE was also
examined for the presence of specific anti-viral antibodies by
microneutralization and ELISA tests.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 2476580 [PubMed - indexed for MEDLINE]

6172: N Z Med J. 1989 Jul 26;102(872):379-81.

Remission induced by chlorambucil in steroid-responsive, frequently relapsing
nephrotic syndrome that relapsed after cyclophosphamide.

Bailey RR.

Department of Nephrology, Christchurch Hospital.

Five patients with a steroid-responsive, frequently relapsing nephrotic syndrome 
who had failed at least one course of treatment with cyclophosphamide were all
put into a long term remission with chlorambucil. One patient developed a severe 
neutropenia and herpes zoster and another with an epileptic tendency developed
myoclonic jerks. The indications and potential hazards of using chlorambucil in
this context are discussed.

Publication Types: 
    Case Reports

PMID: 2797556 [PubMed - indexed for MEDLINE]

6173: J Immunol. 1989 Jul 15;143(2):470-5.

Viral antigen stimulation of the production of human monokines capable of
regulating HIV1 expression.

Clouse KA, Robbins PB, Fernie B, Ostrove JM, Fauci AS.

Department of Microbiology, Georgetown University, Washington, D.C. 20007.

We have previously described model systems for cytokine-induced regulation of
chronically HIV-infected promonocyte and T cell clones. Using these systems, we
have shown that monokines contained in supernatants from LPS-stimulated human
monocyte/macrophages (MO) up-regulate HIV expression, reflected by an increase in
reverse transcriptase activity, viral RNA levels, and expressed viral proteins.
Current studies were designed to determine whether viral Ag can interact with MO 
and secondarily affect HIV1 expression by stimulating monokine production. We
found that certain herpes-group viruses, including CMV and EBV, augment HIV1
expression by inducing monokine production, whereas others, such as HSV1, HSV2,
varicella-zoster virus, and human herpes virus 6 were unable to function in this 
capacity. The HSV1 and HSV2 Ag which failed to stimulate monokine production did 
not interfere with MO stimulation by CMV Ag, suggesting that failure to induce
HIV expression was not attributable to MO suppression. When nonherpes group
viruses were tested, we found that human adenovirus, hepatitis B virus, and
vaccinia virus all failed to stimulate the production of monokines capable of
activating HIV in the chronically infected cell lines. In contrast, HIV1 can
augment its own expression by inducing the secretion of monokines which
up-regulate HIV expression in the infected cells. The viral Ag-induced MO
supernatants capable of up-regulating HIV expression did so in a dose-dependent
manner, whereas viral Ag alone produced no significant change. Monokine
production mediated by viral Ag was not attributable to contaminating endotoxin. 
These studies provide a model to determine whether other opportunistic infections
may induce the expression of HIV by indirect mechanisms, such as the stimulation 
of cytokine production.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2544645 [PubMed - indexed for MEDLINE]

6174: Practitioner. 1989 Jul 8;233(1472):1005.

Herpes ophthalmicus.

Burton J, Hood C.

Always ensure that patient consent is obtained before any type of photography is 
undertaken, as the patient has the right to decide what is to happen to the
images.

Publication Types: 
    Case Reports

PMID: 2594664 [PubMed - indexed for MEDLINE]

6175: J Chemother. 1989 Jul;1(4 Suppl):1304.

Thoracic herpes zoster treated with intravenous Acyclovir in three cancer
patients.

Affronti M, Malta R, Di Rosa S, Maggio AM, Vassallo L, Occhino C, Scardavi M,
Renda M, Scarpinati P.

Department of Internal Medicine, University of Palermo, Italy.

PMID: 16312876 [PubMed - indexed for MEDLINE]

6176: J Chemother. 1989 Jul;1(4 Suppl):1117-8.

Efficacy of acyclovir in the treatment of recurring herpes labialis, genitalis
and acute herpes zoster.

Peralta S, Ribisi La Spina AM, Pirrotta P, Collura D, Formica P, Tinnirello D,
Citarrella P, Mansueto S.

Cattedra di Patologia Speciale Medica e Metodologia Clinica University of
Palermo, Italy.

PMID: 16312797 [PubMed - indexed for MEDLINE]

6177: J Chemother. 1989 Jul;1(4 Suppl):873-4.

Clinical experience in gynecology on the enhancement of specific therapy using
alkyl amino-ethylglycine, an amphoteric surfactant with amino acid structure.

Oliveri S, Caruso S, Cianci P, Greco AM, Pinizzotto MR.

Institute of Microbiology, University of Catania, Italy.

PMID: 16312680 [PubMed - indexed for MEDLINE]

6178: Vrach Delo. 1989 Jul;(7):112-3.

[Creatine phosphokinase in the cerebrospinal fluid of patients with acute
meningitis]

[Article in Russian]

Smirnov VV, Skorniakov VI, Popov AS, Shestakova TI, Khot'ko LP.

A study is presented of the general activity and isoenzymatic spectrum of
creatine phosphokinase (CPK) in the cerebrospinal fluid (CSF) in patients with
acute meningitis of different etiology. The enzymatic activity proved to be
increased due to the cerebral (CPK-BB) isoform. Liberation of CPK-BB from the
brain tissue and its penetration into the intercellular fluid and then into the
CSF was related to the functional-structural changes in the cellular membranes of
the brain in meningitis.

Publication Types: 
    English Abstract

PMID: 2800482 [PubMed - indexed for MEDLINE]

6179: Arch Ophthalmol. 1989 Jul;107(7):960-1.

Varicella-zoster retinitis in human immunodeficiency virus infection. Case
report.

Chambers RB, Derick RJ, Davidorf FH, Koletar SL, Dangel ME.

Publication Types: 
    Case Reports

PMID: 2787629 [PubMed - indexed for MEDLINE]

6180: Am J Hematol. 1989 Jul;31(3):221-2.

Comment on:
    Am J Hematol. 1988 Nov;29(3):172-3.

Acyclovir as treatment for aplastic anemia.

Tuncer AM.

Publication Types: 
    Case Reports
    Comment
    Letter

PMID: 2741918 [PubMed - indexed for MEDLINE]

6181: Clin Exp Dermatol. 1989 Jul;14(4):273-6.

Clinical features of human immunodeficiency virus-associated disseminated herpes 
zoster virus infection--a review of the literature.

Cohen PR, Grossman ME.

Some similarities and several differences in the epidemiological, morphological, 
therapeutic, and prognostic features of HIV-associated disseminated HZV infection
and disseminated HZV infection occurring in HIV-seronegative immunosuppressed
patients exist. The severity of the cutaneous disseminated HZV infection, the
potential for significant HZV-related morbidity, and the poor prognosis
associated with this infection in HIV-seropositive patients, warrants prompt
therapeutic intervention. The emergence of acyclovir-resistant HZV infection
emphasizes the importance of continued investigation of alternative therapies for
individuals with coincident HIV infection.

Publication Types: 
    Review

PMID: 2686873 [PubMed - indexed for MEDLINE]

6182: Srp Arh Celok Lek. 1989 Jul-Aug;117(7-8):483-9.

[Detection of antibodies to cytomegaloviruses, herpes simplex viruses and
varicella-zoster viruses in persons positive for human immunodeficiency virus
antibodies]

[Article in Serbian]

Kuljic-Kapulica N, Zivanovic-Marinkovic V, Saric A, Djokic M.

Forty-seven anti-HIV positive sera and 47 sera of normal individuals were
analyzed to the presence of IgG and IgM antibodies versus CMV, HSV and VZ. IgG
antibodies in comparison to CMV were found in 27 cases (57.44%); in comparison to
HSV in 40 (85.1%) subject and to VZ in 33 anti-HIV positive subjects. The mean
absorbance value was higher in anti-HIV positive cases than in controls. IgM
antibodies in comparison to CMV were found in 3, and in comparison to HSV in 2
anti-HIV positive sera. No IgM antibodies were found in the control group.

Publication Types: 
    English Abstract

PMID: 2556804 [PubMed - indexed for MEDLINE]

6183: Zh Mikrobiol Epidemiol Immunobiol. 1989 Jul;(7):72-4.

[The relation of seasonal manifestations of herpes zoster and the seasonal
periodicity of normal humoral immunity]

[Article in Russian]

Dizik GM, Iurik OE, Otrublenko OA.

29 practically healthy persons and 97 herpetic ganglionitis patients were
examined at different periods during 1986-1987. The seasonal changes of humoral
immunity both in clinically healthy persons and in herpetic ganglionitis patients
were established. The conclusion was made that clinical manifestations of
herpetic ganglionitis are linked with a decrease in the level of IgG ensuring
natural resistance to chickenpox virus.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 2554625 [PubMed - indexed for MEDLINE]

6184: Arch Ophthalmol. 1989 Jul;107(7):1068-72.

Ocular varicella-zoster virus infection in the guinea pig. A new in vivo model.

Pavan-Langston D, Dunkel EC.

Eye Research Institute of Retina Foundation, Boston, MA 02114.

Corneal intrastromal inoculation of guinea pigs with approximately 10(4)
plaque-forming units of live, adapted varicella-zoster virus (VZV) resulted in
reproducible, acute, superficial corneal disease in all animals. The
culture-positive VZV ocular infection progressed to involve 30% to 40% of the
corneal surface in a diffuse punctate keratitis and 10% to 15% of this surface
with microdendrites, characteristic of VZV-induced ocular disease. Retrograde
dissemination of VZV to the trigeminal ganglia, midbrain, cerebellum, and
superior cervical ganglia was demonstrated by whole-cell coculture VZV recovery. 
Central nervous system VZV dissemination, manifested by transient neurologic
symptoms and pneumonitis, was evident in 60% of the animals. Varicella-zoster
virus spread to the trigeminal ganglion during acute and early-latent infection
was evident by electron microscopy.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2546523 [PubMed - indexed for MEDLINE]

6185: Transplantation. 1989 Jul;48(1):111-5.

The influence of T cell depletion on recovery of T cell proliferation to
herpesviruses and Candida after allogeneic bone marrow transplantation.

de Gast GC, Gratama JW, Verdonck LF, van Heugten JG, Zwaan FE, Phillips DI, Mudde
GC.

Department of Haematology, University Hospital Utrecht, The Netherlands.

To test the influence of T cell depletion of the marrow in allogeneic bone marrow
transplantation on functional T cell recovery, in vitro lymphocyte proliferation 
tests (LPTs) to microbial antigens were regularly performed in 23 recipients of
normal BM and in 25 patients receiving BM with a fixed low number of T cells (1 x
10(5) T cells/kg body weight; recipients of T-depleted BM). The long-term
recovery of positive LPT to at least 1 of the 4 tested microbial
antigens--Candida, herpes simplex virus (HSV), varicella-zoster virus (VZV), and 
cytomegalovirus--was nearly similar in both groups: 16/23 versus 18/25. Recovery 
of LPT to Candida and HSV in the first 3 months appeared to be greatly influenced
by prophylactic measures; only 2/23 recipients of normal BM, receiving
amphotericin B, showed a positive LPT to Candida versus 13/25 recipients of
T-depleted BM (P less than 0.01). In contrast, only 1/23 seropositive recipients 
of T-depleted BM, receiving acyclovir, showed a positive LPT to HSV versus 9/22
recipients of normal BM (P less than 0.05). A positive LPT to CMV in the first 3 
months was found in 9/9 seropositive recipients of normal BM, versus in 5/11
seropositive recipients of T-depleted BM (P less than 0.05). Five of the 6
patients with a negative LPT died of CMV-interstitial pneumonia versus 1/14 with 
positive LPT (P less than 0.01). We conclude that in CMV-seropositive recipients 
of allogeneic BM, T cell depletion of the graft affects the early recovery of T
cell proliferation to CMV, which is associated with a higher risk of fatal
CMV-interstitial pneumonia.

Publication Types: 
    Comparative Study

PMID: 2546299 [PubMed - indexed for MEDLINE]

6186: J Gen Virol. 1989 Jul;70 ( Pt 7):1789-804.

Nucleotide sequence and characterization of the Marek's disease virus homologue
of glycoprotein B of herpes simplex virus.

Ross LJ, Sanderson M, Scott SD, Binns MM, Doel T, Milne B.

AFRC Institute for Animal Health, Houghton Laboratory, Cambridgeshire, U.K.

The Marek's disease virus (MDV) homologue of the herpes simplex virus (HSV) gene 
encoding glycoprotein B (gB) has been identified within BamHI fragments I3 and K3
of the 'highly oncogenic' strain RB1B of MDV. The entire nucleotide sequence of
the gene has been determined and its predicted amino acid sequence shown to share
gross overall structural features with the gB genes of HSV, varicella-zoster
virus (VZV) and other mammalian herpesviruses. In particular, all 10 cysteine
residues were conserved in MDV gB and there was extensive homology throughout the
gene with VZV, HSV and pseudorabies virus except for the N and C termini. The
overall percentage amino acid identity between MDV gB and gB of the
alphaherpesviruses had a mean of 50% which was almost twice that between
cytomegalovirus and Epstein-Barr virus. Northern blot analysis showed that the
main RNA transcribed from this gene is approx. 2.7 kb in size. Antibodies raised 
against synthetic peptides (residues 250 to 271 and 304 to 330) allowed the
identification of a family of serologically related glycoproteins of Mr 110K, 64K
and 48K in extracts of MDV-infected cells using immunoblots. Furthermore, the
antisera were able to differentiate between the antigens of MDV and herpesvirus
of turkeys in immunoblots. Immunofluorescence tests indicated that MDV gB is
associated with granules in the cytoplasm and is present at the surface of
MDV-infected cells.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2544666 [PubMed - indexed for MEDLINE]

6187: BMJ. 1989 Jul 1;299(6690):55.

Comment on:
    BMJ. 1989 Jun 10;298(6687):1537-8.

Treatment of shingles and post-herpetic neuralgia.

Schieff C.

Publication Types: 
    Comment
    Letter

PMID: 2503218 [PubMed - indexed for MEDLINE]

6188: Postgrad Med J. 1989 Jul;65(765):478-80.

Algoneurodystrophy following herpes zoster.

Foster O, Askaria A, Lanham J, Perry D.

Whipps Cross Hospital, Leytonstone, London, UK.

Algoneurodystrophy frequently follows an identifiable triggering event. It is not
widely recognized that herpes zoster can precipitate algoneurodystrophy and three
such cases are described here. In one, the affected dermatome did not correspond 
to the limb involved by the algoneurodystrophy.

Publication Types: 
    Case Reports

PMID: 2481303 [PubMed - indexed for MEDLINE]

6189: Nucleic Acids Res. 1989 Jun 26;17(12):4637-46.

DNA nucleotide sequence analysis of the immediate-early gene of pseudorabies
virus.

Cheung AK.

USDA, National Animal Disease Center, Ames, IA 50010.

The complete DNA sequence coding for the immediate-early protein (IE180) of
pseudorabies virus was determined. The coding region of IE180 is 4380 nucleotides
for 1460 amino acid residues. G+C content of the non-coding portion of the IE
gene is 70.3% while the G+C content of the coding portion is considerably higher 
at 80.1%. Correspondingly, codons consisting mainly of Gs and Cs are favoured.
Clusters of amino acid homologies are observed among IE180 of pseudorabies virus,
ICP4 of herpes simplex virus type-1 and IE140 of varicella-zoster virus, and are 
organized similarly in all three polypeptides. Functions exhibited by IE180 are
assigned, tentatively, to structural domains of the molecule by analogy to the
HSV-1 ICP4 polypeptide.

Publication Types: 
    Comparative Study

PMID: 2546124 [PubMed - indexed for MEDLINE]

6190: Schweiz Med Wochenschr. 1989 Jun 24;119(25):902-10.

[Autologous bone marrow transfusion in the treatment of adults with hematologic
neoplasms. Experiences from Bern]

[Article in German]

Brun del Re GP, Tschopp L, Cerny T, Bucher U.

Hamatologisches Zentrallabor Universitat, Inselspital Bern.

21 patients with hematological neoplasias (8 ALL, 4 AML, 4 NHL, 5 HD) were
treated with high dose therapy and autologous bone marrow rescue (ABMT). At the
time of ABMT 12 patients were in CR, 6 in PR and 3 in relapse. 66% of the
patients were at high risk at the time of diagnosis. Before ABMT patients
received an ablative regimen such as cyclophosphamide or ARA-C, VP-16, DNR and 12
Gy TBI in 6 fractions. In 9 patients the bone marrow was treated in vitro with
monoclonal antibodies and complement. The hospital stay was a median 33 (24-57)
days and isolation 19 (9-49) days. Complications were septicemia (7), herpes
stomatitis (7), infections (6), fungal sepsis (1) and hemorrhagic cystitis (2).
Late complications (up to 6 months after ABMT) were pneumococcal sepsis (1),
cerebral toxoplasmosis (1) and herpes zoster (3). 10 of 19 evaluable patients are
alive and relapse-free 1-33 months (median 10) after ABTM, and 3 of 10 more than 
2 years later: 4 of 5 were transplanted in 1. CR, 4 of 6 in greater than or equal
to 2. CR and 2 of 8 in PR. 4 patients are living in therapy sensitive relapse 2, 
11, 11 and 39 months after ABMT in 2. CR or PR. 5 patients died 1-13 (median 3.5)
months on relapse, 2 of 21 from septicemia. The morbidity of ABMT is comparable
with conventional high dose chemotherapy. Relapse-free survival was significantly
influenced by the remission status at ABMT. Long-term survivors can be expected
even in patients with high risk hematological malignancies. However, only wider
trials will serve to establish the efficacy of ABMT.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2667130 [PubMed - indexed for MEDLINE]

6191: Wien Klin Wochenschr. 1989 Jun 23;101(13):448-50.

[Human herpesvirus 6 (HHV-6): incidence in healthy blood donors and in patients
with acute infections caused by other herpes viruses]

[Article in German]

Larcher C, Huemer HP, Honlinger M, Margreiter R, Dierich MP.

Institut fur Hygiene, Universitat Innsbruck.

Antibodies to HHV-6 were detected by immunofluorescence in 8.04% of 460 healthy
blood donors in West Austria. Testing sera from patients with acute or
reactivated infections with other herpesviruses, such as cytomegalovirus (CMV),
Epstein-Barr virus (EBV), herpes simplex virus (HSV) and varicella zoster virus
(VZV) we observed a remarkably higher prevalence of antibodies to HHV-6 in
patients with CMV infections (75%) and also in patients with EBV infections
(50%). Patients with HSV and VZV infections were positive for HHV 6 in 12.5% and 
6.6% of cases, respectively. Many of the patients with CMV infection were
transplant recipients. The high incidence of positive HH 6 serology in these
patients could be due to new infection by HHV 6 or to the reactivation of a
previous infection with HHV 6 by means of allogenic cell stimulation.
Furthermore, preliminary results from our laboratory point to a serological
cross-reaction between HHV 6 and CMV, which may also contribute to this result.

Publication Types: 
    English Abstract

PMID: 2548350 [PubMed - indexed for MEDLINE]

6192: Med J Aust. 1989 Jun 19;150(12):727.

Treatment of prodromal shingles.

Bateman PP.

Publication Types: 
    Case Reports
    Letter

PMID: 2733628 [PubMed - indexed for MEDLINE]

6193: BMJ. 1989 Jun 10;298(6687):1537-8.

Comment in:
    BMJ. 1989 Aug 26;299(6698):568.    BMJ. 1989 Aug 5;299(6695):392-3.    BMJ. 1989 Jul 1;299(6690):55.

Treatment of shingles and post-herpetic neuralgia.

Jolleys JV.

Publication Types: 
    Review

PMID: 2503110 [PubMed - indexed for MEDLINE]

6194: Am J Dermatopathol. 1989 Jun;11(3):259-69.

Lichenoid lymphocytic vasculitis with a high component of histiocytes.
Histogenetic implications in a specified clinical setting.

Ferguson DL, Hawk RJ, Covington NM, Reed RJ.

Department of Pathology, Tulane University School of Medicine, New Orleans, LA
70112.

PMID: 2729528 [PubMed - indexed for MEDLINE]

6195: Postgrad Med. 1989 Jun;85(8):297-300.

Chickenpox and pregnancy. What are the risks?

Rosenfeld JA.

Family Practice Residency Program, St Francis Hospital, Wilmington, DE 19805.

PMID: 2726645 [PubMed - indexed for MEDLINE]

6196: Vrach Delo. 1989 Jun;(6):112-5.

[Clinical aspects and treatment of herpes zoster in middle and old age (a review 
of the literature)]

[Article in Russian]

Andreichin MA, Savchak VI.

Publication Types: 
    Review

PMID: 2675465 [PubMed - indexed for MEDLINE]

6197: J Antimicrob Chemother. 1989 Jun;23 Suppl E:23-30.

Prophylaxis and treatment of cytomegalovirus infections in the bone marrow
transplant recipient.

Prentice HG.

Dept of Haematology, Royal Free Hospital, Hampstead, London, UK.

Almost all viral infections after bone marrow transplant (BMT) are attributable
to reactivation of latent DNA viruses, especially those of the Herpesvirus
family. The first to reactivate is herpes simplex virus, followed by
cytomegalovirus (CMV) with a reported peak incidence between 60 and 90 days in
most studies and varicella zoster virus about three to 18 months after BMT.
Epstein-Barr virus rarely causes detectable illness after BMT and reactivation is
only seen in the most profoundly immunosuppressed. The most lethal infection and 
indeed the most prominent cause of failure overall after allogenic BMT is
interstitial pneumonitis which is frequently due to CMV infection. This article
considers prophylactic measures against viral infection and preliminary studies
of regimens for the treatment of established CMV infections.

Publication Types: 
    Review

PMID: 2550409 [PubMed - indexed for MEDLINE]

6198: Semin Respir Infect. 1989 Jun;4(2):147-54.

Pulmonary infection in human immunodeficiency disease: viral pulmonary
infections.

Wallace JM.

Department of Medicine, Olive View Medical Center, Sylmar, CA 91342.

Viral pneumonitides are among the known pulmonary complications of human
immunodeficiency virus (HIV) infection. Cytomegalovirus (CMV) pneumonitis is the 
most frequently recognized viral infection involving the lung. Although CMV may
occasionally be the sole pathogen found to be responsible for severe pneumonitis 
in patients with the acquired immunodeficiency syndrome (AIDS), in most cases,
its role in causing pulmonary disease is less clear, primarily because of the
propensity to infect with a variety of other copathogens. CMV pneumonitis has
been difficult to diagnose during life, although techniques utilizing in situ DNA
hybridization or monoclonal antibodies for detection of the virus may improve the
diagnostic yield of less invasive procedures such as bronchoalveolar lavage.
Pneumonitis due to herpes simplex virus, varicella-zoster, and respiratory
syncytial virus have occasionally been reported in AIDS patients, and are of
practical importance because of the availability of effective treatment. The role
of influenza and adenoviruses in causing HIV-related pulmonary complications is
unknown, but could be of importance during outbreaks of these infections.
Finally, data from several studies now suggest that Epstein-Barr virus or HIV
itself or both have a role in the pneumonitis. Further study in this area could
provide information leading to more effective management of this common
complication of childhood AIDS.

Publication Types: 
    Case Reports
    Review

PMID: 2546236 [PubMed - indexed for MEDLINE]

6199: Am J Clin Pathol. 1989 Jun;91(6):695-700.

Rapid detection of cytomegalovirus by 24-well plate centrifugation with the use
of a monoclonal antibody to an early nuclear antigen.

Woods GL, Thiele GM.

Department of Pathology and Microbiology, University of Nebraska Medical Center, 
Omaha 68105.

Two methods for the detection of cytomegalovirus (CMV) in 457 clinical specimens 
were compared: (1) centrifugal inoculation of MRC-5 cells seeded on coverslips in
24-well plates and staining with a monoclonal antibody to CMV early nuclear
antigen after incubation for both 16-18 hours (EA-1) and four days (EA-4); and
(2) conventional tube cell culture. CMV was identified in 50 (11%) specimens from
34 different patients. EA-1 and EA-4 had positive results for CMV in 32 (64%) and
36 (73%) of the specimens, respectively. Positive inclusions were present on only
one coverslip in 31% of the cases by EA-1 and in 10% by EA-4. The number of
inclusions was not necessarily predictive of tissue culture results. CMV was
recovered by conventional tissue culture from 27 specimens (54%) after an average
of 17 days (range, 6-26 days). One specimen, positive for CMV by EA-4, yielded
herpes simplex virus (HSV), and from 9 of the 407 CMV-negative specimens, another
virus was recovered: HSV from 6 specimens and varicella zoster virus, adenovirus,
and enterovirus from one specimen each. CMV was detected in significantly more
specimens by EA-4 than by tissue culture (P = 0.037). However, there was no
significant difference in the detection of CMV between EA-1 and EA-4 or between
EA-1 and conventional culture. The authors' data suggest that for maximum
recovery of CMV from clinical specimens, both an early antigen assay and
conventional tissue culture should be performed. For urine specimens it appears
that inoculation of two coverslips followed by staining after overnight
incubation is adequate. To optimize the yield of the early antigen assay when
testing specimens other than urine, the authors recommend inoculating three
coverslips, two of which should be stained after overnight incubation, and, if
necessary, the third coverslip could be stained after a more prolonged incubation
period.

Publication Types: 
    Comparative Study

PMID: 2543211 [PubMed - indexed for MEDLINE]

6200: Higashi Nippon Shigaku Zasshi. 1989 Jun;8(1):47-55.

[Report of a case of Herpes zoster]

[Article in Japanese]

Tanaka T, Murase H, Miyata M, Taira H, Aso T, Harada N, Kitamura K, Tomita K,
Kanazawa M.

Herpes Zoster is a viral disease of the skin and mucosa characterized by grouped 
vesicula eruptions and neuralgic pain along a peripheral nerve. A case of Herpes 
Zoster in the right region along the second and third trigeminal nerve branches
of a 24-year-old male was reported. The first disorder appeared as a grouped
vesicular eruption in the center of the lower lip. This was followed by a
cutaneous lesion in the area of the right second trigeminal nerve branch. From
the first day of hospitalization, the patient began receiving a daily dose of
2500mg of immunoglobulin. The administration of immunoglobulin, cured the oral
and cutaneous lesion.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2519919 [PubMed - indexed for MEDLINE]

6201: Med Clin (Barc). 1989 May 27;92(20):797.

[Metastasis of an adenocarcinoma of unknown origin as a localizing factor of
herpes zoster]

[Article in Spanish]

Fonseca E, Rugarcia M, Valverde J.

Publication Types: 
    Case Reports
    Letter

PMID: 2796424 [PubMed - indexed for MEDLINE]

6202: N Z Med J. 1989 May 10;102(867):227.

Acyclovir resistance.

Mansell C.

Publication Types: 
    Letter

PMID: 2717106 [PubMed - indexed for MEDLINE]

6203: Cas Lek Cesk. 1989 May 5;128(19):590-4.

[Iontophoretic administration of vinblastine in the control of refractory spinal 
root pain and postherpetic neuralgia]

[Article in Czech]

Opavsky J, Penickova V, Jezdinsky J.

Iontophoretic administration of substances which influence the function of
microtubuli in the peripheral nerves is one of the new ways how to suppress some 
types of refractory chronic pain. Based on a number of experimental data and
encouraging clinical results, the authors used in the submitted work repeated
iontophoretic administration of 0.01% Vinblastine (G. Richter, Hungary) into the 
painful zone in a group of 20 patients with several types of non-malignant pain. 
Objectivization of the evaluation was partly also due to the authors' own version
of McGill Pain Questionnaire, along with the graphic presentation of algetic
zones. Clinically detectable mitigation of pain was achieved in 14 subjects, in
eight improvement persisted for more than six months and one year resp. No
serious undesirable side-effects were observed in the investigated subjects.

Publication Types: 
    English Abstract

PMID: 2743383 [PubMed - indexed for MEDLINE]

6204: Rinsho Ketsueki. 1989 May;30(5):680-5.

[Allogeneic bone marrow transplantation in a case of acute lymphoblastic leukemia
with positive Philadelphia chromosome]

[Article in Japanese]

Kitoh T, Tabata Y, Akiyama Y, Kiriyama Y, Kubota M, Mikawa H.

A 12-year-old boy with Philadelphia chromosome positive acute lymphoblastic
leukemia received bone marrow transplantation (BMT) from an HLA identical sibling
during the second remission. The diagnosis was made at the age of nine.
Laboratory examination on admission revealed remarkable leukocytosis
(92,000/microliters) with 93% lymphoblasts in the peripheral blood. Blastic cells
were FAB L1 common ALL. Chromosomal study on both peripheral blood and bone
marrow cells showed that lymphoblasts had an abnormal karyotype of 47, XY, inv
(9), t(9; 22), +17. One month later he achieved remission by induction therapy
consisting of vincristine, L-asparaginase, doxorubicin, and prednisolone. He was 
given intrathecal injection of methotrexate and cranial irradiation of 24 Gy for 
CNS prophylaxis. The cells with Philadelphia chromosome disappeared during
remission. Hematological relapse occurred twenty one months later after first
remission on April, 1986. He received re-induction therapy including L-Asp VDP,
and high-doses of cyclophosphamide, methotrexate and araC. He obtained karyotypic
remission on October 1986. Subsequently, bone marrow transplantation was
performed following high-dose araC, CY and TBI as preconditioning on December 18,
1986. Methotrexate and cyclosporin A were given intravenously to prevent GVHD. On
day 14, karyotypic conversion was detected, suggesting the successful bone marrow
grafting. Acute GVHD appeared on day 25, and was treated with prednisolone and
cyclosporin A. Prednisolone was tapered by day 80. On day 91, cyclosporin A was
discontinued because herpes zoster occurred. Acyclovir was effective, but skin
GVHD reappeared. With low-dose prednisolone, skin GVHD improved. Sicca syndrome
soon appeared and was followed by chronic GVHD.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Case Reports
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2795882 [PubMed - indexed for MEDLINE]

6205: J Neurol. 1989 May;236(4):238-42.

Total, anti-viral, and anti-myelin IgG subclass reactivity in inflammatory
diseases of the central nervous system.

Mathiesen T, von Holst H, Fredrikson S, Wirsen G, Hederstedt B, Norrby E,
Sundqvist VA, Wahren B.

Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.

Total IgG subclass levels, anti-viral, anti-myelin basic protein (anti-MBP), and 
anti-ganglioside 1 (anti-GM1) IgG subclass levels were measured in 6 patients
with herpes simplex virus encephalitis (HSVE), 16 with borreliosis, 8 with other 
bacterial infections, 12 with multiple sclerosis (MS), 13 with subacute
sclerosing panencephalitis (SSPE), 5 with glioblastoma and 12 controls. Total
IgG1 levels were elevated in cerebrospinal fluid (CSF) from all patient groups
(but not in the controls), IgG2 in bacterial infections, IgG3 in HSVE and
borreliosis and IgG4 in some SSPE patients. The anti-viral (anti-measles,
varicella zoster virus and rubella) IgG antibodies in MS were restricted to IgG1,
anti-measles IgG to IgG1 and sometimes IgG4 in SSPE, anti-borrelia IgG to IgG1,
IgG2 and IgG3. In contrast to anti-viral antibodies, anti-MBP and GM1 antibodies 
belonged to IgG1, IgG3 or IgG4 in MS. The nature of the immunological activation 
appears to be reflected in the subclass patterns elicited in the central nervous 
system. Different IgG subclass patterns in infectious diseases and MS suggest a
difference between antigen-specific and non-specific B-cell activation.

PMID: 2760636 [PubMed - indexed for MEDLINE]

6206: Zentralbl Hyg Umweltmed. 1989 May;188(1-2):127-43.

[Fiber emissions from weathered asbestos cement products. 1. Fiber release in
ambient air]

[Article in German]

Spurny K, Marfels H, Boose C, Weiss G, Opiela H, Wulbeck FJ.

Fraunhofer-Institut fur Umweltchemie und Okotoxikologie in
Schmallenberg-Grafschaft.

Emissions of fibrous aerosols were measured on buildings with weathered and
corroded asbestos-cement-plates (roofing and facade shingles) by means of an
already published equipment and procedure. The measured emission factors for
asbestos fibers longer than 5 microns were in the range of 10(6) to 10(8)
fibers/m2.h. They depended on the type of the AC-plates as well as on their age
and corrosion intensity.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2757737 [PubMed - indexed for MEDLINE]

6207: J Rheumatol. 1989 May;16(5):618-22.

Rheumatoid factor in patients with systemic lupus erythematosus.

Feldman D, Feldman D, Ginzler E, Kaplan D.

Department of Medicine, State University of New York, Brooklyn 11203.

One hundred sixty-six patients with systemic lupus erythematosus (SLE) were
surveyed and their sera tested for the presence of rheumatoid factor (RF).
Fifteen were positive whenever tested, with titers of at least 1:40; the
remainder were either positive only in titers of 1:20, were inconsistently
positive or were persistently negative. The former group were less likely to have
severe manifestations of SLE, less likely to have required treatment with
"high-dose" steroids or a cytotoxic drug, and less likely to have had an episode 
of herpes zoster. We conclude that in patients with SLE, RF may be a reflection
of relative immune competence so that they are partially protected against the
more serious manifestations of SLE and the development of herpes zoster.

PMID: 2754666 [PubMed - indexed for MEDLINE]

6208: Acta Neurol Scand. 1989 May;79(5):407-11.

Electroencephalographic changes in patients with herpes zoster.

Peterslund NA, Hansen JH.

Department of Medicine and Infectious Diseases, Marselisborg Hospital, Aarhus,
Denmark.

EEGs of 42 patients with herpes zoster and 6 with herpes zoster-associated
encephalitis were studied to characterize the nature and prevalence of EEG
abnormalities in apparently uncomplicated herpes zoster. Thirty-one percent of
herpes zoster patients had EEG changes with reduced rhythm frequency ranging from
7 to 2 Hz activity. Frontotemporal localization was observed in 54% of the
abnormal EEGs. When compared to EEG in herpes zoster associated encephalitis, the
findings were qualitatively the same, but tended to be more severe in the
encephalitis cases. No effect of acyclovir on the EEG could be demonstrated.

PMID: 2741671 [PubMed - indexed for MEDLINE]

6209: Compr Ther. 1989 May;15(5):3-9.

Herpes zoster ophthalmicus.

Pavan-Langston D, Dunkel EC.

Eye Research Institute, Harvard Medical School, Boston, MA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2659251 [PubMed - indexed for MEDLINE]

6210: Neurol Clin. 1989 May;7(2):231-48.

Postherpetic neuralgia.

Watson CP.

Department of Medicine, Irene Eleanor Smythe Pain Clinic, University of Toronto, 
Ontario, Canada.

Postherpetic pain persisting 1 month or longer occurs in only a small percentage 
of all patients with herpes zoster. In most patients, PHN tends to diminish with 
time. The incidence is, however, directly related to age. Any therapeutic claim
for prophylaxis or treatment of PHN has to be evaluated with these observations
in mind. There is some information about the pathologic features and a concept of
the pathogenesis can be suggested. There is evidence for an imbalance in fiber
input (reduced large, inhibitory fibers, and intact or increased small,
excitatory fibers) to an abnormal dorsal horn that may contain hypersensitive
neurons. Prevention of PHN remains difficult. There is evidence that systemic
steroids exert a preventive effect when employed in the treatment of herpes
zoster in the immunocompetent patient. A reasonable regimen is 60 mg of
prednisone tapered over 10 to 14 days. One double-blind, controlled study
supports the use of amantadine in this situation; this drug is an option in
patients for whom steroids are contraindicated, such as those with peptic ulcer, 
diabetes mellitus or compromised immune function. The dosage of amantadine used
in this study was 100 mg twice daily for a month. Although a number of other
therapies have been suggested, these remedies remain in need of further, more
scientific study. For established PHN, there is firm support for the reduction of
pain from severe to mild in two thirds of patients administered low doses of
amitriptyline followed by gradual, small increments. In the age group over 65
years, one may use as small a dose as 10 mg with an increase of 10 mg every 5 to 
7 days. In those younger than 65, a dose of 25 mg to start is reasonable, with
increments of 25 mg. Although unproved, the addition of a phenothiazine, such as 
fluphenazine, may provide further pain relief. Preliminary studies also indicate 
that topical capsaicin may be a useful new treatment. Although widely used, there
is no good evidence for the use of anticonvulsants alone in this disorder.
Studies of local anesthetic sprays with vibration and continuous TENS are
uncontrolled, but these modalities may be of some merit. One uncontrolled study
reported benefit from epidural steroids. DREZ lesions are a possibility in failed
medical cases, but other surgical procedures appear to be of little or no use.
Although the measures described here will benefit a number of patients, PHN
remains an intractable problem in some cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Publication Types: 
    Review

PMID: 2566900 [PubMed - indexed for MEDLINE]

6211: Am J Med. 1989 May;86(5):533-8.

Progression to AIDS in patients with lymphadenopathy or AIDS-related complex:
reappraisal of risk and predictive factors.

Murray HW, Godbold JH, Jurica KB, Roberts RB.

Division of Infectious Diseases, Cornell University Medical College, New York,
New York.

PURPOSE: In 1985, we reported that acquired immunodeficiency syndrome (AIDS)
developed in 14 of 81 (17%) men with generalized lymphadenopathy followed
prospectively for an average of 13 months. The presence of oral thrush or
constitutional symptoms, or both, or severely impaired T4+ cell responses to
specific antigen (interferon-gamma production) accurately identified patients at 
immediate risk for AIDS. The purpose of the current report is to describe the
progress of these 81 patients during the three and a half years since enrollment 
and to include new data on initial serum levels of beta 2 microglobulin and human
immunodeficiency virus (HIV) p24 antigen. PATIENTS AND METHODS: The mean age of
the 81 patients was 35.4 years; 79 were homosexuals and two were drug abusers.
Immunologic testing was performed once at the time of enrollment in all patients.
Seventy-seven of the 81 patients were seropositive for HIV antibody. Frozen
samples of serum, also obtained at initial study, were assayed in 1988 for beta 2
microglobulin and HIV p24 antigen. The clinical status of patients was determined
six, 14, and 36 months after enrollment was closed (June 1984) by either
interview and examination or telephone contact with private physicians. RESULTS: 
After three and a half years of follow-up, 42 patients have developed AIDS,
including (1) 77% who had had thrush or symptoms, or both, (2) 80% to 88% of
those who originally demonstrated marked immunologic abnormalities (skin test
anergy, less than 200 T4+ cells/mm3, T4/T8 cell ratio of less than 0.5, severely 
impaired interferon-gamma production [less than 25 U/mL], or elevated serum beta 
2 microglobulin level [greater than 3.0 mg/L], and (3) 95% of patients with HIV
p24 antigenemia. However, AIDS also developed in 51% of patients who had had more
apparently benign initial manifestations (lymphadenopathy alone, herpes zoster), 
in 41% to 54% despite normal initial results for either T4+ cell number,
interferon-gamma secretion, beta 2 microglobulin, or skin testing, and in 44% of 
those whose sera did not contain HIV antigen. CONCLUSION: These updated results
demonstrate the remarkably poor prognosis of patients with generalized
lymphadenopathy or AIDS-related complex irrespective of initial clinical,
immunologic, and serologic findings, and suggest that essentially all such
persons may be candidates for antiviral therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2565690 [PubMed - indexed for MEDLINE]

6212: J R Soc Med. 1989 May;82(5):278-80.

AIDS: neurological opportunist infections in central London.

Guiloff RJ.

Department of Neurology, Westminster Hospital, London.

Twenty six (41%) of 64 central London cases of AIDS with nervous system
involvement during the course of the illness had neurological opportunist
infection. Cytomegalovirus and Toxoplasma gondii were the commonest agents in 22 
cases with central nervous system (CNS) infection. Eight cases had herpes zoster 
radiculopathy. Other infections included those caused by Cryptococcus neoformans,
Mycobacterium tuberculosis and papova JC virus. Prognosis was generally poor,
irrespective of whether the opportunist infection was treatable.

PMID: 2547063 [PubMed - indexed for MEDLINE]

6213: J Neurol Neurosurg Psychiatry. 1989 May;52(5):578-82.

Antiviral IgM and IgG subclasses in varicella zoster associated neurological
syndromes.

Mathiesen T, Linde A, Olding-Stenkvist E, Wahren B.

Department of Neurosurgery, Karolinska Institute, Stockholm, Sweden.

The varicella zoster virus (VZV) and herpes simplex virus (HSV) IgGl-4 subclasses
were compared in serum and cerebrospinal fluid (CSF) of 22 patients with
VZV-associated neurological symptoms, 12 patients with HSV-associated
neurological symptoms and 14 controls. The clinical syndromes of the
VZV-associated diseases comprised meningo-encephalitis, myelitis, myelopathies
and polyneuropathies, mostly with a favourable outcome. A characteristic finding 
was an intrathecal synthesis of VZV IgG1 and HSV-3. Commonly also IgG2 and 4 were
seen in CSF of VZV patients. Their intrathecally synthesised HSV IgG was
restricted to IgG1. VZV IgG3 occurred in serum and/or CFS together with VZV IgM
in 14 cases and may be a marker of recent VZV replication. In patients with
HSV-associated neurological disease, a multi-IgG subclass HSV response and
concomitant VZV antibodies restricted to IgG1 was found. Intrathecal synthesis of
both HSV and VZV IgG occurred in 20 patients. Detection of two or more VZV or HSV
specific IgG subclasses synthesised intrathecally identified the aetiological
agent in 19 of these 20 cases.

Publication Types: 
    Comparative Study

PMID: 2543794 [PubMed - indexed for MEDLINE]

6214: J Med Virol. 1989 May;28(1):30-7.

Antibodies against varicella-zoster virus and herpes simplex virus deoxythymidine
kinase in heterologous infections.

Kallander CF, Torfason EG, Olding-Stenkvist E, Sundqvist VA, Diderholm H,
Gronowitz JS.

Department of Medical Virology, Uppsala University, Sweden.

Antibody responses to varicella-zoster virus (VZV) deoxythymidine kinase (dTK)
and herpes simplex virus (HSV) dTK in homologous and heterologous infections were
studied. Antibodies blocking the enzymatic activity of VZV-dTK appeared late
after varicella and decreased more or less in parallel with the decreasing
complement fixing [CF] titre. In herpes zoster, on the other hand, antibodies to 
VZV-dTK appeared soon after infection. Antibodies against HSV dTKs appeared long 
after primary infection, but they were subsequently present in all other HSV-CF
positive sera. In recurrent HSV, all acute sera were already HSV-dTK antibody
positive, and three of nine persons showed an increase in titer between their
acute and convalescent sera. Blocking antibodies to VZV-dTK appeared rapidly in
specimens from three of 18 individuals positive by an immunofluorescence
VZV-immunity test during HSV infection, whereas all other specimens remained
devoid of blocking antibodies against VZV-dTK. A rise in antibody titre against
HSV-dTK during VZV infections was observed in serum specimens from three of 13
HSV-CF positive patients, whereas an antibody response against HSV-dTK was not
found in HSV-CF negative individuals in connection with VZV infections. The
relevance of the sporadic increase in the titres of antibodies against
heterologous viral dTKs is discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2542443 [PubMed - indexed for MEDLINE]

6215: J Med Virol. 1989 May;28(1):1-6.

Rapid detection of varicella-zoster virus in clinical specimens using monoclonal 
antibodies on shell vials and smears.

Schirm J, Meulenberg JJ, Pastoor GW, van Voorst Vader PC, Schroder FP.

Regional Public Health Laboratory, University Hospital, Groningen, The
Netherlands.

Monoclonal antibodies were used for detecting varicella-zoster virus (VZV) by
immunofluorescence (IF) in clinical specimens inoculated on shell vial cultures. 
Vesicles of 74 patients with varicella or herpes zoster-like eruptions were
tested by this method and by conventional cell culture. Further diagnostic tests 
were direct IF on smears (42 patients), the cytological Tzanck test (28
patients), and serology (30 patients). Both IF assays were performed with the
commercial VZV-specific monoclonal antibody 3B3 (Ortho). Using the shell vial
technique, we found VZV in 37 (50%) of the patients, on average after 3 days. The
conventional culture method yielded 26 positives (35%), on average after 7.5
days. Twenty-nine of the shell vial IF-positive patients were also positive by
direct IF on smears (30 tested), while 15 gave positive Tzanck smears (18
tested). The sensitivities of the shell vial IF test, the direct IF test, the
conventional culture method, and the Tzanck test were about 95%, 97%, 70%, and
79%, respectively. For the specificities, we found at least 97% for the shell
vial IF test, at least 91% for the direct IF test, and about 78% for the Tzanck
test. We conclude that both VZV IF tests are much more reliable than the
conventional cell culture method and the Tzanck test for the laboratory diagnosis
of VZV infections.

Publication Types: 
    Comparative Study

PMID: 2542440 [PubMed - indexed for MEDLINE]

6216: J Infect Dis. 1989 May;159(5):1000-1.

Zoster in normal children after varicella vaccine.

Plotkin SA, Starr SE, Connor K, Morton D.

Publication Types: 
    Case Reports
    Letter

PMID: 2540244 [PubMed - indexed for MEDLINE]

6217: J Virol. 1989 May;63(5):2392-5.

Investigation of varicella-zoster virus infection of lymphocytes by in situ
hybridization.

Koropchak CM, Solem SM, Diaz PS, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, California
94305.

Peripheral blood mononuclear cells harboring viral gene sequences were detected
during primary varicella-zoster virus (VZV) infection of the human host and the
strain 2 guinea pig by in situ hybridization with a 3H-labeled VZV DNA probe.
Activated T lymphocytes were permissive for VZV infection at low frequency in
vitro.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2539528 [PubMed - indexed for MEDLINE]

6218: J Virol. 1989 May;63(5):2169-79.

Physical mapping and nucleotide sequence of a herpes simplex virus type 1 gene
required for capsid assembly.

Pertuiset B, Boccara M, Cebrian J, Berthelot N, Chousterman S, Puvion-Dutilleul
F, Sisman J, Sheldrick P.

Institut de Recherches Scientifiques sur le Cancer, Villejuif, France.

In this report, we describe some phenotypic properties of a temperature-sensitive
mutant of herpes simplex type 1 (HSV-1) and present data concerning the physical 
location and nucleotide sequence of the genomic region harboring the mutation.
The effect of shifts from the permissive to the nonpermissive temperature on
infectious virus production by the mutant A44ts2 indicated that the mutated
function is necessary throughout, or late in, the growth cycle. At the
nonpermissive temperature, no major differences were detected in viral DNA or
protein synthesis with respect to the parent A44ts+. On the other hand, electron 
microscopy of mutant-infected cells revealed that neither viral capsids nor
capsid-related structures were assembled at the nonpermissive temperature.
Additional analyses employing the Hirt extraction procedure showed that A44ts2 is
also unable to mature replicated viral DNA into unit-length molecules under
nonpermissive conditions. The results of marker rescue experiments with intact
A44ts2 DNA and cloned restriction fragments of A44ts+ placed the lesion in the
coordinate interval 0.553 to 0.565 (1,837 base pairs in region UL) of the HSV-1
physical map. No function has previously been assigned to this region, although
it is known to be transcribed into two 5' coterminal mRNAs which code in vitro
for a 54,000-molecular-weight polypeptide (K. P. Anderson, R. J. Frink, G. B.
Devi, B. H. Gaylord, R. H. Costa, and E. K. Wagner, J. Virol. 37:1011-1027,
1981). We sequenced the interval 0.551 to 0.565 and found an open reading frame
(ORF) for a 50,175-molecular-weight polypeptide. The predicted product of this
ORF exhibits strong homology with the product of varicella-zoster virus ORF20 and
lower, but significant, homology with the product of Epstein-Barr virus BORF1.
For the three viruses, the corresponding ORFs lie just upstream of the gene
coding for the large subunit of viral ribonucleotide reductase. The ORF described
here corresponds to the ORF designated UL38 in the recently published nucleotide 
sequence of the HSV-1 UL region (D. J. McGeoch, M. A. Dalrymple, A. J. Davison,
A. Dolan, M. C. Frame, D. McNab, L. J. Perry, J. E. Scott, and P. Taylor, J. Gen.
Virol. 69:1531-1574, 1988).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2539510 [PubMed - indexed for MEDLINE]

6219: Chin Med J (Engl). 1989 May;102(5):395-9.

Experimental studies on the prevention and treatment of chickenpox and herpes
zoster with measles vaccine.

Li WH, Ming ZL, Chen Q, Li Y.

In 151 chickenpox patients treated with live attenuated measles vaccine, the cure
rate was 100%. In 145 cases of herpes zoster, the effective rate was 100%
(completely cured in 91.7% and improved in 8.3%). In the treated group, the time 
needed for the subsidence of fever and skin rash and the duration of the disease 
were markedly shorter than those in the control group (P less than 0.01). It is
particularly effective for alleviating pain, preventing and relieving
postherpetic neuralgia in patients with zoster. The application of measles
vaccine to the patients in the chickenpox incubation period might prevent the
development of the disease, and decrease the incidence and death rate of
varicella zoster virus infection in highly susceptible patients. The mechanism of
its anti-viral action and production of interferon in the body is discussed.

PMID: 2509165 [PubMed - indexed for MEDLINE]

6220: N Z Med J. 1989 Apr 26;102(866):201.

Acyclovir and herpes zoster.

Thomas MG, Ellis-Pegler RB.

Publication Types: 
    Letter

PMID: 2710456 [PubMed - indexed for MEDLINE]

6221: Rev Prat. 1989 Apr 20;39(12):1064-6.

[Herpes zoster. Epidemiology, physiopathology, diagnosis, course and prognosis]

[Article in French]

Piette F, Delaporte E.

PMID: 2740773 [PubMed - indexed for MEDLINE]

6222: Ugeskr Laeger. 1989 Apr 17;151(16):1005.

[Herpesvirus and acute peripheral facial paresis]

[Article in Danish]

Esmann V.

PMID: 2756590 [PubMed - indexed for MEDLINE]

6223: Z Hautkr. 1989 Apr 15;64(4):253-4.

[Should every case of herpes zoster be treated immediately with acyclovir
(Zovirax)?]

[Article in German]

Nasemann T.

PMID: 2735084 [PubMed - indexed for MEDLINE]

6224: Z Hautkr. 1989 Apr 15;64(4):255-6, 259-62, 265.

[New knowledge regarding herpes zoster]

[Article in German]

Stary A.

Ambulatorium fur Pilzinfektionen und andere infektiose venero-dermatologische
Erkrankungen, Wien.

Zoster is the clinical manifestation of the endogenous reactivation of the
varicella-zoster virus. Current observations of viral reactivation emphasize the 
role of cellular immunity and show an inverse correlation between the specific
cellular immune response of the host and the incidence of zoster. Thus,
immunocompromised persons like patients with immune deficiency syndrome,
lymphoproliferative cancer, or immunosuppressive therapy are at a high risk for
the development of disseminated zoster, which may either involve the skin only,
or affect more than one organ. During the last few years zoster has been proved a
prognostic marker for HIV-positive persons. The incidence of zoster and
post-zoster neuralgia increases with advancing age. In young children,
immunosuppressive therapy and varicella in utero or during the first year of life
are the only risk factors for zoster infection. Prevention of dissemination has
been one of the major goals in antiviral chemotherapy of zoster in
immunocompromised patients. Among the antiviral drugs available at present,
aciclovir has proved especially useful, acting as an inhibitor of viral DNA
polymerase. It is well-tolerated and can be applied together with corticoids,
analgetics, and retrovir. It is most effective in reducing complications of
zoster.

Publication Types: 
    English Abstract
    Review

PMID: 2660444 [PubMed - indexed for MEDLINE]

6225: Am J Ophthalmol. 1989 Apr 15;107(4):373-80.

The spectrum of optic nerve disease in human immunodeficiency virus infection.

Winward KE, Hamed LM, Glaser JS.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami
School of Medicine, Florida 33101.

We studied four patients with HIV-associated optic neuropathies. One had
syphilitic optic perineuritis, which responded promptly and completely to
penicillin therapy. The second had cytomegalovirus papillitis and visual acuity
subsequently deteriorated to no light perception. The third showed varicella
zoster optic neuritis, which improved after intravenous acyclovir treatment. The 
fourth patient developed cryptococcal retrobulbar neuritis and died shortly
thereafter. Optic neuropathy was among the initial symptoms of HIV infection in
two of the four cases.

Publication Types: 
    Case Reports

PMID: 2539020 [PubMed - indexed for MEDLINE]

6226: N Z Med J. 1989 Apr 12;102(865):168.

Treatment of herpes zoster.

Humphrey AR.

Publication Types: 
    Letter

PMID: 2704467 [PubMed - indexed for MEDLINE]

6227: Ugeskr Laeger. 1989 Apr 10;151(15):935-7.

[A mini epidemic of varicella zoster virus reinfection at a department of
hematology]

[Article in Danish]

Junker K, Avnstorp C, Nielsen CM, Hansen NE.

Whereas primary infection with varicella zoster virus (VZV) (chickenpox) and
reactivation of VZV (shingles) are common and recognized, clinical reinfection
with VZV is rare. A little epidemic of presumed reinfection with VZV in six
immune-compromised adults is presented here. The epidemic lasted for three
months, during which a healthy young woman also developed a primary VZV infection
in the form of chickenpox. In the immune-compromised patients, the clinical
picture was dominated by disseminated, prolonged and frequently haemorrhagic and 
necrotic eruptions which may cause diagnostic difficulties. Skin biopsy proved
helpful in the diagnosis while demonstration of the VZV antigen in the skin
elements was specific and sensitive. All of the patients, with one exception,
were treated with acyclovir and dissemination of the infection to the inner
organs did not occur. One patient may have died on account of the VZV infection. 
In conclusion, immune-incompetent patients must be warned against infection from 
chickenpox or disseminated herpes zoster. In cases of proved exposure,
prophylactic treatment with acyclovir should be considered and, in cases of
clinical disease, immediate treatment with 10 mg acyclovir per kg body weight
should be administered intravenously thrice daily.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2540583 [PubMed - indexed for MEDLINE]

6228: Gan To Kagaku Ryoho. 1989 Apr;16(4 Pt 2-1):1108-14.

[Infection and immunosuppression in cancer patients]

[Article in Japanese]

Kitahara T, Takenaka T, Yoshino M.

Dept. of Internal Medicine, National Cancer Center Hospital, Tokyo.

Septicemia in hematologic malignancies and infection of herpes zoster in cancer
patients were studied, and trend in organisms in a cancer hospital was
investigated. 1) Septicemia in hematologic malignancies. The success rate of
antibiotic therapy for septicemia was 76% if the patients were not under
antibiotic therapy when septicemia developed. But recovery from septicemia was
only 25% if the patients were undergoing antibiotic therapy when septicemia
developed. Some 90% of neutropenic patients under 500/microliters, who were not
under antibiotic therapy when septicemia developed, recovered from septicemia if 
the neutrophil count increased in the following 5 days. Change in the neutrophil 
count was an important factor determining the success or failure of antibiotic
therapy for septicemia. The use of granulocyte colony-stimulating factor may
prevent chemotherapy-induced neutropenia. Shortening of the period of neutropenia
or preventing its occurrence should reduce the incidence and the severity of
infection. 2) Infection of herpes zoster in cancer patients. Thirty-four cancer
patients were associated with herpes zoster. Eleven of them were patients with
malignant lymphoma and ten of them were patients of breast cancer. Most patients 
were heavily pretreated by chemotherapy and/or radiotherapy before the
development of herpes zoster. Marked lymphocytopenia was observed at the onset of
herpes zoster. Absolute lymphocyte count was under 1000/microliters in 71% of
these patients. Development of herpes zoster in cancer patients was considered to
be due to the depression of cell-mediated immunity which was the result of
repeated and continued anticancer therapy. Acyclovir was found to be effective to
treat herpes zoster in these patients. 3) Trend of organisms detected in cancer
hospital. The frequency of organisms isolated from clinical materials in the
National Cancer Center Hospital was compared during the period from 1978 to 1982 
and the period from 1983 to 1987. The most common organism detected in both
periods was P. aeruginosa and no change in frequency was observed. But the
frequency of gram-negative bacilli, E. coli, Klebsiella and Serratia, decreased
significantly in the latter period while the frequency of gram-positive cocci,
Enterococcus and Staphylococcus increased markedly in the latter period. The use 
of cephems of third generation in the latter period could be one reason for the
recent change of organisms detected in the hospital. Appropriate therapy for
infection based on the latest and accurate information should be used.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2730015 [PubMed - indexed for MEDLINE]

6229: J Otolaryngol. 1989 Apr;18(3):99-100.

Recurrent vestibulopathy: support for a viral etiology.

Longridge NS.

Department of Otolaryngology, Vancouver General Hospital, B.C., Canada.

Over an 18-month period, mother, father and child were seen with dizziness. The
mother had Ramsay Hunt syndrome prior to developing recurrent vestibulopathy. A
viral cause for recurrent vestibulopathy is suggested.

Publication Types: 
    Case Reports

PMID: 2716093 [PubMed - indexed for MEDLINE]

6230: J Am Acad Dermatol. 1989 Apr;20(4):637-42.

Disseminated ecthymatous herpes varicella-zoster virus infection in patients with
acquired immunodeficiency syndrome.

Gilson IH, Barnett JH, Conant MA, Laskin OL, Williams J, Jones PG.

Department of Medicine, University of Wisconsin Medical School, Mount Sinai
Medical Center, Milwaukee.

Herpesvirus infections are among the most common and debilitating opportunistic
infections in patients with acquired immunodeficiency syndrome (AIDS), and they
may have atypical clinical features. We describe the cases of three patients with
AIDS in whom atypical persistent ulcerative skin lesions developed as a result of
varicella-zoster virus infection. Two patients had disseminated infection without
a vesicular stage; one patient had underlying asteatotic eczema. All responded
well to acyclovir. One patient was treated with azidothymidine, and typical
dermatomal herpes zoster subsequently developed. The profound loss of helper T
cell function in AIDS may lead to multiple abnormalities in local immune response
to cutaneous herpesvirus infections and may be responsible for the atypical
morphology and a prolonged course.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 2715411 [PubMed - indexed for MEDLINE]

6231: Arthritis Rheum. 1989 Apr;32(4):506-7.

Articular presentation of herpes zoster eruption.

Leventhal LJ, Bomalaski JS.

Publication Types: 
    Letter

PMID: 2706034 [PubMed - indexed for MEDLINE]

6232: Nippon Hifuka Gakkai Zasshi. 1989 Apr;99(4):443-7.

[HLA-DR antigen expression on peripheral T cell subsets in pityriasis rosea
Gibert, herpes zoster, and psoriasis]

[Article in Japanese]

Aikawa Y, Yoshiike T, Ogawa H.

Using 2 color fluorescein activated cytometric analysis, HLA-DR antigen
expression in T cell subsets was studied in pityriasis rosea (PR) and compared to
the results from herpes zoster (HZ) of viral origin and psoriasis (Ps). In HZ and
PR, HLA-DR was significantly expressed on the T cell surface (Leu-4+ cells).
Among the T cell subsets, HLA-DR antigen was predominantly expressed on
suppressor/cytotoxic cells (Leu-2a+) in HZ. In contrast, it was predominantly
expressed on helper cells (Leu-3a+) in PR. However, activated T cell antigen
(Tac) was not significantly expressed on T cells (Leu-4+) in either HZ or in PR. 
This HLA-DR antigen expression of T cell subsets was depressed to the normal
level in the recovery phases of HZ and PR.

Publication Types: 
    English Abstract

PMID: 2614989 [PubMed - indexed for MEDLINE]

6233: Nippon Hifuka Gakkai Zasshi. 1989 Apr;99(4):457-61.

[A case of herpes zoster duplex with generalized eruption--study of the
pathogenesis of the eruptions]

[Article in Japanese]

Yoshida M, Hondo R.

A 77-year-old man who developed herpes zoster duplex with generalized eruptions
is presented. Three strains of varicella-zoster virus (VZV) were isolated from 2 
skin lesions of herpes zoster and one of the generalized eruptions. For strain
differentiation, these 3 strains were investigated by restriction endonuclease
analysis of the viral DNA. The 3 strains were identical, suggested that a single 
strain of VZV had been residing in a latent form in multiple spinal ganglions of 
this patient. We speculate that this strain of VZV in remote ganglions was
reactivated by the operation of gastric cancer as a trigger, and, as a result,
the 2 skin lesions of herpes zoster appeared, followed by development of
generalized eruptions due to virus propagation from zoster lesions.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2559215 [PubMed - indexed for MEDLINE]

6234: J Neurosurg. 1989 Apr;70(4):519-24.

Spinal cord stimulation in management of chronic pain. A 9-year experience.

Meglio M, Cioni B, Rossi GF.

Institute of Neurosurgery, Catholic University, Rome, Italy.

Between 1978 and 1986, 109 patients with chronic pain underwent spinal cord
stimulation (SCS) at the authors' institute as part of their pain treatment
program. The results of SCS in these patients at the end of the test period and
at the latest follow-up examination are analyzed in relation to the etiology of
their pain. In 40 patients pain was associated with an obstructive peripheral
vasculopathy, in 10 with a previous herpes zoster infection, in 15 with an
incomplete traumatic spinal cord lesion, in nine with root and/or nerve damage,
in 11 with cancer, and in 19 with previous back surgery. The etiology of the pain
in five patients was uncertain. This experience supports the conclusion that the 
best indications for SCS are vasculopathic pain and post-herpetic neuralgia. No
clinical usefulness was found for SCS in cancer pain or in central
deafferentation types of pain.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2538588 [PubMed - indexed for MEDLINE]

6235: AIDS. 1989 Apr;3(4):221-5.

Evaluation and simplification of the World Health Organization clinical case
definition for paediatric AIDS.

Lepage P, van de Perre P, Dabis F, Commenges D, Orbinski J, Hitimana DG,
Bazubagira A, van Goethem C, Allen S, Butzler JP, et al.

Department of Paediatrics, Centre Hospitalier de Kigali, Rwanda.

The World Health Organization (WHO) clinical case definition for paediatric AIDS 
was tested during a 1-month period on 221 consecutive hospitalized children in
Kigali, Rwanda. Relevant clinical features not included in the WHO case
definition were also evaluated. Thirty-four out of the 221 children (15.4%) were 
HIV seropositive. Although the specificity of the WHO case definition was high
(92%), the sensitivity and the positive predictive value (PPV) were low (41 and
48%, respectively). The following individual signs had a PPV at least equal to
the complete WHO case definition: chronic diarrhoea (47%), respiratory distress
secondary to lower respiratory tract infection (50%), oral candidiasis (53%),
parotitis (67%), generalized lymphadenopathy (88%), and herpes zoster infection
(100%). When logistic regression analysis was done on the nine variables included
in the WHO case definition, confirmed maternal infection was the best predictive 
variable for HIV seropositivity in children (P less than 10(-5). We further
excluded the serological status of the mother from the analysis and performed a
stepwise logistic regression analysis on the 18 clinical signs and symptoms for
which information had been collected. Those signs and symptoms contributing the
most to the regression were: respiratory distress, chronic diarrhoea and
generalized lymphadenopathy. Based on these findings, we propose a simplified
clinical case definition for paediatric AIDS in Africa with better sensitivity,
specificity and PPV than the WHO case definition. Further work is needed using
this approach to develop case definitions useful for epidemiological surveillance
and for case management.

PIP: The World Health Organization (WHO) clinical case definition for pediatric
acquired immunodeficiency syndrome (AIDS) was evaluated over a 1-month period in 
221 consecutive hospitalized children in Kigali, Rwanda. The median age of the
children studied was 18 months (range, 1 month-14 years); 55% were boys. 34 (15%)
of these 221 children were seropositive for the human immunodeficiency virus
(HIV). Although the specificity of the WHO case definition was high (92%), its
sensitivity was only 41% and the positive predictive value was 48%. The following
individual signs had a positive predictive value at least equal to the complete
WHO case definition: chronic diarrhea (47%), respiratory distress secondary to
lower respiratory tract infection (50%), oral candidiasis (53%), parotitis (67%),
generalized lymphadenopathy (88%), and herpes zoster infection (100%). Logistic
regression analysis on the 9 variables included in the WHO case definition
indicated that confirmed maternal HIV infection was the best predictive variable 
for HIV seropositivity in children. When maternal serological status (rarely
available in Rwanda) was excluded from the analysis and a stepwise logistic
regression analysis was performed on the 18 clinical signs and symptoms for which
data had been collected, respiratory distress, chronic diarrhea, and generalized 
lymphadenopathy emerged as the signs contributing the most. On the basis of these
findings, a simplified clinical case definition of pediatric AIDS is proposed for
settings where resources are limited and HIV seroprevalence is high. According to
this definition, pediatric AIDS should be suspected in a child presenting with 1 
or both of the following clinical signs: respiratory distress secondary to lower 
respiratory tract infection and/or generalized lymphadenopathy. However, it is
necessary to test this definition on a larger scale in Central Africa and in
other parts of the world with different rates of HIV seroprevalence.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2500955 [PubMed - indexed for MEDLINE]

6236: Zentralbl Bakteriol Mikrobiol Hyg [B]. 1989 Apr;187(4-6):508-26.

[Infections which humans in the household transmit to dogs and cats]

[Article in German]

Mayr A.

Institut fur Medizinische Mikrobiologie, Infektions- und Seuchenmedizin,
Tierarztliche Fakultat, Ludwig-Maximilians-Universitat Munchen.

An overview of the most important infections which can be transmitted from humans
to pet dogs and cats is presented. Two quite different sources of infection stand
diametrically opposite each other: 1. The transmission of active human infections
to dogs and cats and 2. the transmission of infectious agents by feeding raw
meat, offal, unsterilized milk products, kitchen scraps and contaminated
feedstuffs. Humans can be the source of the following infections: 1. Zoonoses
with reciprocal modes of transmission, e.g. Campylobacter and E. coli infections,
trichophyton and microsporum infections, reo-, parainfluenza-, adeno, rota- and
corona infections. 2. Zoonoses in which the main direction of infection is
human----animal, e.g. tuberculosis and influenza A. 3. Infections originally
pathogenic to humans which meet an impasse in dogs and cats (blind alley hosts), 
e.g. herpes simplex, varicella-zoster, measles and Corynebacterium diphtheriae.
Listeria, salmonella, campylobacteria, toxoplasma, fungi, yeasts and viruses are 
transmitted via feed. The most dangerous virus infection to be transmitted to
cats and dogs via raw pork leftovers is Aujeszky's disease. The dog or cat, which
is the last link in the infection chain, suffers an agonizing death. The other
infections originating from feed must be assessed quite differently. They are
links in infection chains, which spread pathogens and endanger the health of man 
and animal in turn. A typical example is toxoplasmosis. Man becomes infected via 
sporulated oocysts from feces. Pet cats mainly become infected via raw pork
containing cysts.

Publication Types: 
    English Abstract
    Review

PMID: 2500809 [PubMed - indexed for MEDLINE]

6237: Hosp Pract (Off Ed). 1989 Mar 30;24(3A):21-2, 27, 31-2.

Questions and controversies about varicella-zoster infections.

Bialecki C, Feder HM Jr.

University of Connecticut School of Medicine, Farmington.

Publication Types: 
    Review

PMID: 2538487 [PubMed - indexed for MEDLINE]

6238: BMJ. 1989 Mar 25;298(6676):832.

Antiviral treatment and postherpetic neuralgia.

Klenerman P, Peto TE, Luzzi GA, Juel-Jensen BE.

Publication Types: 
    Letter

PMID: 2496880 [PubMed - indexed for MEDLINE]

6239: Practitioner. 1989 Mar 22;233(1465):398-403.

Shingles in general practice.

Peto T.

Patients over 50 with simple shingles should be offered topical idoxuridine or
intravenous acyclovir to reduce the risk of post-herpetic neuralgia. For younger 
patients, specific treatment with high dose intravenous acyclovir is needed only 
for complications or in immunosuppressed patients.

PMID: 2594625 [PubMed - indexed for MEDLINE]

6240: Am J Ophthalmol. 1989 Mar 15;107(3):257-61.

Penetrating keratoplasty for herpes zoster keratopathy.

Reed JW, Joyner SJ, Knauer WJ 3rd.

Department of Ophthalmology, Bowman Gray School of Medicine, Wake Forest
University Medical Center, Winston-Salem, NC 27103.

We reviewed retrospectively the records of 12 patients with herpes zoster
keratopathy who had undergone penetrating keratoplasty. Preoperatively, seven
patients (58%) had noninflamed eyes with visually significant corneal scarring or
edema. Five patients (42%) had progressive neurotrophic corneal ulceration, and
four of those had corneal perforation. Tarsorrhaphies were placed in ten patients
and appeared to be beneficial in preventing postoperative breakdown of the
corneal surface. At an average follow-up time of 36 months, ten of the 12 grafts 
(83%) remained clear, with nine patients (75%) having a visual acuity of 20/80 or
better.

PMID: 2646934 [PubMed - indexed for MEDLINE]

6241: N Z Med J. 1989 Mar 8;102(863):93-5.

Oral acyclovir in the treatment of herpes zoster in general practice.

Morton P, Thomson AN.

Wellcome New Zealand Ltd, Auckland.

A double-blind, randomised trial evaluated the efficacy of oral acyclovir, 800 mg
5 times daily for 7 days, in acute herpes zoster and postherpetic neuralgia.
Forty patients aged 16 years or over, presenting to their general practitioners
within 3 days of rash onset, received acyclovir, while 43 patients received
placebo. Acyclovir reduced the extent and duration of the rash, the spread of the
rash to adjacent dermatomes and the incidence of disseminated lesions. It
shortened the period of new lesion formation and reduced the incidence of
ulceration. The weekly prevalence of pain was reduced on acyclovir by the fourth 
week, with a reduction in the monthly prevalence of chronic pain in the second
and third months and a reduction in associated local neurological symptoms
between months 3-6. Total analgesic use in the first 4 weeks was reduced by
acyclovir, but during follow up there was no difference in the prevalence of
analgesic use between groups. There were slightly fewer medical events on
acyclovir in the second week, but the frequency was the same in each group for
the rest of the 6 months. Biochemical and haematological tests showed no adverse 
effects of treatment.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 2648213 [PubMed - indexed for MEDLINE]

6242: J Am Acad Dermatol. 1989 Mar;20(3):523-4.

Comment on:
    J Am Acad Dermatol. 1988 Mar;18(3):605-10.

Corticosteroids and postherpetic neuralgia.

[No authors listed]

Publication Types: 
    Comment
    Letter

PMID: 2918127 [PubMed - indexed for MEDLINE]

6243: J Virol. 1989 Mar;63(3):1123-33.

Identification and nucleotide sequence of the glycoprotein gB gene of equine
herpesvirus 4.

Riggio MP, Cullinane AA, Onions DE.

Department of Veterinary Pathology, University of Glasgow Veterinary School,
Bearsden, Scotland.

The nucleotide sequence of the glycoprotein gB gene of equine herpesvirus 4
(EHV-4) was determined. The gene was located within a BamHI genomic library by a 
combination of Southern and dot-blot hybridization with probes derived from the
herpes simplex virus type 1 (HSV-1) gB DNA sequence. The predominant portion of
the coding sequences was mapped to a 2.95-kilobase BamHI-EcoRI subfragment at the
left-hand end of BamHI-C. Potential TATA box, CAT box, and mRNA start site
sequences and the translational initiation codon were located in the BamHI M
fragment of the virus, which is located immediately to the left of BamHI-C. A
polyadenylation signal, AATAAA, occurs nine nucleotides past the chain
termination codon. Translation of these sequences would give a 110-kilodalton
protein possessing a 5' hydrophobic signal sequence, a hydrophilic surface domain
containing 11 potential N-linked glycosylation sites, a hydrophobic transmembrane
domain, and a 3' highly charged cytoplasmic domain. A potential internal
proteolytic cleavage site, Arg-Arg/Ser, was identified at residues 459 to 461.
Analysis of this protein revealed amino acid sequence homologies of 47% with
HSV-1 gB, 54% with pseudorabies virus gpII, 51% with varicella-zoster virus gpII,
29% with human cytomegalovirus gB, and 30% with Epstein-Barr virus gB. Alignment 
of EHV-4 gB with HSV-1 (KOS) gB further revealed that four potential N-linked
glycosylation sites and all 10 cysteine residues on the external surface of the
molecules are perfectly conserved, suggesting that the proteins possess similar
secondary and tertiary structures. Thus, we showed that EHV-4 gB is highly
conserved with the gB and gpII glycoproteins of other herpesviruses, suggesting
that this glycoprotein has a similar overall function in each virus.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2915378 [PubMed - indexed for MEDLINE]

6244: Hum Pathol. 1989 Mar;20(3):292-5.

Bulbar encephalitis complicating trigeminal zoster in the acquired immune
deficiency syndrome.

Rosenblum MK.

Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
10021.

A 30-year-old homosexual man with the acquired immune deficiency syndrome and a
recent history of zoster involving the mandibular division of the right
trigeminal nerve was found at autopsy to have a predominantly demyelinating
lesion restricted to the ipsilateral spinal trigeminal tract and nucleus. Cowdry 
A inclusions were readily apparent in the nuclei of numerous glia and isolated
neurons, and inclusion-bearing cells were immunoreactive with an antiserum to the
varicella zoster virus (VZV). This represents the first demonstration that
zoster-associated trigeminal encephalitis is the result of brainstem invasion by 
VZV. The restricted topography of this lesion implicates axonal transport in its 
pathogenesis.

Publication Types: 
    Case Reports

PMID: 2722178 [PubMed - indexed for MEDLINE]

6245: Laryngorhinootologie. 1989 Mar;68(3):141-3.

[Therapy of facial paralysis in herpes zoster oticus with acyclovir]

[Article in German]

Schrader B, Laskawi R, Schroder M, Chilla R, Brauneis J.

HNO-Klinik des Zentralkrankenhauses, Bremen.

In the present study patients suffering from facial nerve palsy caused by a
herpes zoster oticus were treated with aciclovir. After therapy all patients
could be controlled via clinical grading system and electromyographic
observations. Aciclovir therapy did not yield any results superior to those
obtained with other forms of therapy presented in the literature.

Publication Types: 
    English Abstract

PMID: 2712973 [PubMed - indexed for MEDLINE]

6246: Cutis. 1989 Mar;43(3):262-3.

Herpes zoster infection with trigeminal and facial nerve involvement.

Waterman G, Epstein JD, Fenske NA.

Division of Dermatology, University of South Florida, Tampa.

In most cases, herpes zoster (shingles) infections are benign and self-limited,
requiring no treatment. However, if patients are elderly or immuno-compromised,
they are at increased risk of complications such as visceral dissemination,
cranial and nerve palsies, ophthalmic zoster, and postherpetic neuralgia. We
present a case of herpes zoster infection complicated by both motor and sensory
involvement in an elderly man.

Publication Types: 
    Case Reports

PMID: 2707055 [PubMed - indexed for MEDLINE]

6247: J R Soc Med. 1989 Mar;82(3):145-6.

Severe herpes zoster infection in the United Kingdom: experience in a regional
infectious disease unit.

Bannister P, Crosse B.

Department of Geriatric Medicine, Bristol Royal Infirmary, Bristol.

Seventy-three cases of severe herpes zoster infection admitted to a regional
infectious disease unit over a 3-year period were reviewed. Complications were
common. Elderly patients were in the majority (55%), were hospitalized for longer
and accounted for 78% of all complications. Acyclovir therapy was used in 44
cases with a reduction in both the duration of hospital stay and complication
rate.

PMID: 2704012 [PubMed - indexed for MEDLINE]

6248: Anesth Prog. 1989 Mar-Apr;36(2):35-40.

Herpes zoster management.

Katz JA, Phero JC, McDonald JS, Green DB.

Publication Types: 
    Review

PMID: 2690678 [PubMed - indexed for MEDLINE]

6249: Tissue Antigens. 1989 Mar;33(3):415-7.

HLA-antigens in renal transplanted patients with varicella-zoster infection.

Forsberg B, Johnson U.

Department of Medicine, Malmo General Hospital, Sweden.

The frequency of the HLA B 40 antigen was significantly higher among renal
transplanted patients with herpes zoster infection than in controls. The presence
of HLA B 40 may be related to impaired immune response in transplanted and
immunosuppressed carriers.

PMID: 2662473 [PubMed - indexed for MEDLINE]

6250: Monatsschr Kinderheilkd. 1989 Mar;137(3):130-5.

[Exogenous causes of disordered embryonal morphogenesis]

[Article in German]

Kunze J.

Kinderklinik und Institut fur Humangenetik, Freie Universitat Berlin.

Recent advances in exogenous factors known to cause embryopathies are reviewed.
Among the non-infectious agents alcohol is the most important, followed by a
combination of anticonvulsant drugs, valproic acid, retinoic acid, lithium,
coumarin derivates, methyl mercury, aminopterin and methotrexate, cocaine and
amniogenic bands. Rubella embryopathy is well known. Varicella zoster and herpes 
simplex type II viruses are now also known to be teratogenic in some cases.
Erythema infectiosum has recently been detected as a cause of embryonic death.
Diabetic women and women with phenylketonuria must be carefully examined before
and during pregnancy. There does not seem to be a world trend towards increased
frequency of genetically and non genetically conditioned malformations.

Publication Types: 
    English Abstract
    Review

PMID: 2654619 [PubMed - indexed for MEDLINE]

6251: Drugs. 1989 Mar;37(3):233-309.

Acyclovir. An updated review of its antiviral activity, pharmacokinetic
properties and therapeutic efficacy.

O'Brien JJ, Campoli-Richards DM.

ADIS Drug Information Services, Auckland, New Zealand.

Acyclovir (aciclovir) is a nucleoside antiviral drug with antiviral activity in
vitro against members of the herpes group of DNA viruses. As an established
treatment of herpes simplex infection, intravenous, oral and to a lesser extent
topical formulations of acyclovir provide significant therapeutic benefit in
genital herpes simplex and recurrent orofacial herpes simplex. The effect of
acyclovir therapy is maximised by early initiation of treatment, especially in
non-primary infection which tends to have a less protracted course than the
primary episode. Long term prophylactic oral acyclovir, in patients with frequent
episodes of genital herpes simplex, totally suppresses recurrences in the
majority of subjects; as with other infections responding to acyclovir, viral
latency is not eradicated and pretreatment frequencies of recurrence return after
discontinuation of treatment. Caution should accompany the prophylactic use of
acyclovir in the general population, due to the theoretical risk of the emergence
of viral strains resistant to acyclovir and other agents whose mechanism of
action is dependent on viral thymidine kinase. Intravenous acyclovir is the
treatment of choice in biopsy-proven herpes simplex encephalitis in adults, and
has also been successful in the treatment of disseminated herpes simplex in
pregnancy and herpes neonatorium. Intravenous and oral acyclovir protect against 
dissemination and progression of varicella zoster virus infection, but do not
protect against post-herpetic neuralgia. In immunocompromised patients,
intravenous, oral and topical acyclovir shorten the clinical course of herpes
simplex infections while prophylaxis with oral or intravenous dosage forms
suppresses reactivation of infection during the period of drug administration.
Ophthalmic application of 3% acyclovir ointment rapidly heals herpetic dendritic 
corneal ulcers and superficial herpetic keratitis. Thus, despite an inability to 
eradicate latent virus, acyclovir administered in therapeutic or prophylactic
fashion is now the standard antiviral therapy in several manifestations of herpes
simplex virus infection, and indeed represents a major advance in this regard.
With the exception of varicella zoster virus infections, early optimism
concerning the use of the drug in diseases due to other herpes viruses has
generally not been supported in clinical investigations.

Publication Types: 
    Review

PMID: 2653790 [PubMed - indexed for MEDLINE]

6252: Bone Marrow Transplant. 1989 Mar;4(2):191-4.

Varicella-zoster virus infections after autologous bone marrow transplantation in
children.

Wacker P, Hartmann O, Benhamou E, Salloum E, Lemerle J.

Department of Pediatrics, Institut Gustave-Roussy, Villejuif, France.

We report a retrospective analysis of children who underwent autologous bone
marrow transplantation (ABMT) and subsequently developed a varicella-zoster virus
(VZV) infection. Among 236 patients transplanted between January 1979 and
December 1987, 54 (23%) aged 2 to 18.5 years (mean 7.2) developed 60 VZV
infections (25%); there were 10 cases of chicken-pox in 10 patients, 43 zoster
infections in 41 patients and seven disseminated zoster infections in seven
patients. Eighty-seven percent of VZV infections occurred within the first 6
months after bone marrow transplantation, with a mean interval of 89 days. No
significant risk factors for the development of zoster infections were
identified. The incidence of VZV infections following ABMT was similar to that
observed after allogeneic bone marrow transplant but the onset was earlier after 
ABMT (3 vs 5 months) and there were fewer complications (2 vs 18%). Acyclovir
and/or adenine arabinoside were administered to 46 patients. One child who had
had chicken-pox died of interstitial pneumonitis due to VZV despite antiviral
therapy. No other symptomatic visceral dissemination was observed.

PMID: 2650789 [PubMed - indexed for MEDLINE]

6253: Postgrad Med. 1989 Mar;85(4):369-70, 375.

Dermatologic symptoms without signs. Seeking the cause of itching, pain, and
burning.

Wooldridge WE.

A patient may seek medical help because of dermatologic itching, pain, or burning
that is unaccompanied by visible lesions. Although referral to a dermatologist
may be necessary, the primary care physician is at times able to manage such
patients if he or she is aware of some of the common causative diseases,
including preeruptive herpes zoster, polyneuritis, and aquagenic pruritus.

Publication Types: 
    Review

PMID: 2648364 [PubMed - indexed for MEDLINE]

6254: Nurse Pract. 1989 Mar;14(3):30, 35-6, 38 passim.

Herpes zoster and postherpetic neuralgia: the need for early intervention in the 
elderly.

LeFort SM.

Memorial University of Newfoundland, St. John's, Canada.

Herpes zoster is an acute nervous system infection that commonly affects the
elderly. Because the causative agent is a virus, herpes zoster is often treated
symptomatically in the primary care setting. While this approach is acceptable
for immunocompetent patients less than 50 years of age, it can leave older
patients at greater risk of developing painful and debilitating complications
such as postherpetic neuralgia. There is evidence that appropriate treatment
initiated within 48 to 72 hours after the onset of the zoster eruption can
decrease healing time, reduce acute pain, decrease ocular complications and may
prevent the development of postherpetic neuralgia in this age group. The health
care practitioner in a primary care setting is ideally placed to identify elderly
clients with herpes zoster in the early stages; to consult with physicians about 
therapies such as steroids, antiviral agents and sympathetic nerve blocks; to
monitor treatment effects; and to provide supportive therapy to those who develop
postherpetic neuralgia.

Publication Types: 
    Review

PMID: 2648208 [PubMed - indexed for MEDLINE]

6255: Semin Neurol. 1989 Mar;9(1):50-9.

The aging neuromuscular system.

Baker PC.

Hawke's Bay Hospital Board, Napier, New Zealand.

Publication Types: 
    Case Reports

PMID: 2547239 [PubMed - indexed for MEDLINE]

6256: Jpn J Med. 1989 Mar-Apr;28(2):219-22.

Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated
with Ramsay Hunt syndrome: report of a case and review of the literature.

Kageyama Y, Nakamura M, Sato A, Sato M, Nakayama S, Komatsuzaki O, Fukuda H.

Department of Internal Medicine, Tochigi National Hospital, Utsunomiya, Japan.

A case of syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
associated with Ramsay Hunt syndrome is reported. A 59-year-old man was admitted 
to our department for treatment of left facial pain that had persisted for three 
days. A left renal tumor had been diagnosed and a radical nephrectomy had been
performed two months earlier. On admission, vesicular lesions were found in the
left external auditory canal and ear lobe. Additionally found were left facial
nerve palsy and hearing loss. Acyclovir 5 mg/kg, three times per day, was
started. Five days after admission, the patient became confused and
disorientated. Further investigation revealed hyponatremia 118 mEq/l, low serum
osmolality, high urine osmolality, normal renal function, normal adrenal and
thyroid hormones, and high plasma vasopressin 30 pg/ml. Although cerebrospinal
fluid (CSF) examination revealed a mild elevation in protein and cells, no
malignant cells were present and bacterial examinations were negative. Antibodies
to varicella-zoster virus (VZV) in both IgG and IgM were present in high titers
not only in the serum but also in the CSF. Intravenous hypertonic saline and
water restriction were started, and the patient's sensorium was improved in
accordance with the increase in serum sodium concentration. These results
indicate that the hyponatremia in this case was due to SIADH and that SIADH was
caused by an increased release of vasopressin probably because of the infection
of VZV in the central nervous system.

Publication Types: 
    Case Reports
    Review

PMID: 2543853 [PubMed - indexed for MEDLINE]

6257: Jpn J Med. 1989 Mar-Apr;28(2):159-64.

Detection of viral antigens in patients with IgA nephropathy.

Tomino Y, Yagame M, Suga T, Miura M, Endoh M, Nomoto Y, Sakai H.

Department of Internal Medicine, School of Medicine, Tokai University, Isehara,
Japan.

Immunofluorescent analysis of viral antigens in the cultured fibroblasts and
renal tissues in patients with IgA nephropathy was described. Freeze and thawed
extracts of pharyngeal cells obtained from patients with IgA nephropathy, chronic
proliferative glomerulonephritis without IgA deposition (PGN) and healthy adults 
were cultured with human fibroblasts, i.e. Hel cells, with or without addition of
5-iodine 2'-deoxy-uridine (IUDR) at 37 degrees C for 2 weeks. These fibroblasts
and renal sections were stained with several kinds of FITC-labeled antiviral
antibodies. Deposition of adeno, herpes simplex, varicella zoster or
parainfluenza 3 was observed not only in the renal sections but also in the
nuclear regions and/or cytoplasm of Hel cells after incubation of extracts of
pharyngeal cells with or without IUDR from patients with IgA nephropathy. It is
indicated that antigenic stimulation in the upper respiratory tracts may be due
to several different types of DNA and/or RNA viruses in patients with IgA
nephropathy. It appears that these antigenic substances show some heterogeneity
among these patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2543852 [PubMed - indexed for MEDLINE]

6258: J Gen Virol. 1989 Mar;70 ( Pt 3):695-704.

Complementation of a herpes simplex virus type 1 Vmw110 deletion mutant by human 
cytomegalovirus.

Stow EC, Stow ND.

MRC Virology Unit, Institute of Virology, Glasgow, U.K.

The herpes simplex virus type 1 (HSV-1) mutant dl1403 contains a 2 kb deletion
within the sequences encoding the immediate early polypeptide Vmw110. Previous
experiments showed that although dl1403 exhibits normal patterns of gene
expression following infection at an m.o.i. of 5 p.f.u./cell its growth and
plaquing efficiency are impaired in low multiplicity infections, particularly in 
human foetal lung (HFL) cells. We have now investigated the ability of two other 
human herpesviruses, varicella-zoster virus (VZV) and human cytomegalovirus
(HCMV), to compensate for this defect at low m.o.i. in HFL cells. Co-infection
with HCMV resulted in greatly increased plaque numbers and the apparent
particle/p.f.u. ratios of dl1403 stocks were reduced to values similar to those
exhibited by wild-type HSV-1 stocks. Complementation of dl1403 in low
multiplicity infections by HCMV and VZV was also demonstrated by an increased
yield of the mutant virus and an increase in synthesis of dl1403 DNA. Ultraviolet
irradiation of HCMV abolished its ability to complement dl1403 and the presence
of adenovirus 5 had no stimulatory effect on dl1403 DNA replication. When HFL
monolayers were infected with dilutions of dl1403 stocks such that no plaques
were produced, replication of the mutant virus could be induced by superinfection
with HCMV 7 days after the initial infection. These results indicate that a
non-lytic interaction between dl1403 and HFL cells is a more likely consequence
of a low multiplicity infection than plaque formation.

PMID: 2543754 [PubMed - indexed for MEDLINE]

6259: J Med Virol. 1989 Mar;27(3):224-30.

Definition of high-proficiency serological markers for diagnosis of
varicella-zoster virus infections by enzyme immunoassay.

Echevarria JM, de Ory F, Leon P, Tellez A.

Centro Nacional de Microbiologia, Virologia e Inmunologia Sanitarias, Madrid,
Spain.

The levels of Varicella-zoster virus (VZV)-specific IgG, IgM, and IgA antibodies 
produced in 22 cases of varicella, 22 cases of cutaneous zoster, and 12 cases of 
acute aseptic meningitis due to VZV in the absence of cutaneous lesions, were
measured by indirect enzyme immunoassay (EIA) and compared with those observed in
a group of 34 age-matched controls. The definition of cutoff titres for each
serological marker and combinations of them allowed early diagnosis of infection 
in 82% of varicella patients and 91% of patients with acute aseptic meningitis
lacking cutaneous lesions on a single serum sample, the specificity being over
90%. The system was as sensitive as the demonstration of intrathecally produced
IgG antibodies for the early diagnosis of the infection in 22 cases of
neurological disease due to VZV. A working protocol for the serological diagnosis
of VZV infections, using currently available EIA reagents, is described.

PMID: 2542432 [PubMed - indexed for MEDLINE]

6260: J Gen Intern Med. 1989 Mar-Apr;4(2):83-9.

Are current therapies useful for the prevention of postherpetic neuralgia? A
critical analysis of the literature.

Schmader KE, Studenski S.

Geriatric Research, Education and Clinical Center (GRECC), Durham Veterans
Administration Medical Center, North Carolina.

STUDY OBJECTIVE: To determine whether current therapies are useful in preventing 
postherpetic neuralgia (PHN) by analysis of study designs and pooled results.
Design: Meta-analysis of all controlled studies investigating PHN prevention in
the immunocompetent host. Articles were identified through MEDLINE, Index Medicus
and bibliographic reviews of major texts and review articles. Studies meeting
eligibility criteria were independently assessed using explicit methodologic
criteria for validity and generalizability in clinical trials. Pooled analysis
was also performed where appropriate. MEASUREMENTS AND MAIN RESULTS: Twenty-one
investigations met eligibility criteria and primarily addressed the use of
antiviral agents and corticosteroids. Among studies with strong designs, no
evidence of benefit was found for acyclovir or corticosteroids. Pooled results
showed no significant effect of acyclovir on the prevention of PHN (odds ratio
0.81, 95% confidence interval 0.56, 1.11). The strongest studies that found
potential efficacy in PHN prevention involved adenosine monophosphate and
idoxuridine in dimethyl sulfoxide, but problems with clinical application limit
the use of these compounds. Outcome definition, compliance assessment, power
estimation, and method of randomization were infrequently addressed aspects of
design. CONCLUSION: Currently there is no proven useful therapy for the
prevention of PHN. The benefits of acyclovir and corticosteroids are limited but 
key questions remain regarding these medications. A clear consensus definition of
PHN is needed to improve future investigations.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 2540301 [PubMed - indexed for MEDLINE]

6261: Br J Cancer. 1989 Mar;59(3):434-8.

The prophylactic role of intravenous and long-term oral acyclovir after
allogeneic bone marrow transplantation.

Selby PJ, Powles RL, Easton D, Perren TJ, Stolle K, Jameson B, Fiddian AP,
Tryhorn Y, Stern H.

Institute of Cancer Research, Royal Marsden Hospital, Surrey, UK.

Eighty-two patients were randomly allocated to receive intravenous acyclovir 5 mg
kg-1 t.d.s. for 23 days followed by oral acyclovir 800 mg 6-hourly for 6 months
or matching placebos after allogeneic bone marrow transplantation. Herpes simplex
and varicella zoster virus infections were significantly reduced during the
period of administration of acyclovir. No reduction in cytomegalovirus infection 
was demonstrated. The drug was not toxic.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 2539180 [PubMed - indexed for MEDLINE]

6262: J Virol. 1989 Mar;63(3):1345-53.

Identification of the major capsid protein gene of human cytomegalovirus.

Chee M, Rudolph SA, Plachter B, Barrell B, Jahn G.

Institut fur Klinische und Molekulare Virologie, Universitat Erlangen-Nurnberg,
Federal Republic of Germany.

The coding region for the major capsid protein (MCP) of human cytomegalovirus
(HCMV) was identified by comparing the protein sequence with the respective
sequences of herpes simplex virus (HSV), Epstein-Barr virus, and varicella-zoster
virus. The predicted length of the HCMV MCP was 1,370 amino acids. Comparison of 
the MCP sequences of the different human herpesviruses showed a homology of 25%
to the MCP of HSV type 1, a homology of 29% to the MCP of Epstein-Barr virus, and
a homology of 23% to the MCP of varicella-zoster virus. A subfragment of the HSV 
type 1 KpnI i fragment encoding the MCP VP5 cross-hybridized with the HCMV
HindIII U fragment containing part of the MCP gene. Northern (RNA) blot analyses 
with subclones out of the coding region for the HCMV MCP detected one large
transcript of about 8 kilobases. A portion of the open reading frame was
expressed in Escherichia coli plasmid pBD2 IC2OH as a beta-galactosidase fusion
protein and was used to generate polyclonal antibodies in New Zealand White
rabbits. The obtained antisera reacted in Western immunoblots with the MCP of
purified HCMV virions. A monoclonal antibody against the human MCP and a
monospecific rabbit antiserum against strain Colburn of simian cytomegalovirus
detected the fusion protein as well as the MCP of purified virions in
immunoblots.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2536837 [PubMed - indexed for MEDLINE]

6263: J Infect Dis. 1989 Mar;159(3):444-51.

IgM and IgG responses to varicella-zoster virus p32/p36 complex after chickenpox 
and zoster, congenital and subclinical infections, and vaccination.

Harper DR, Grose C.

Department of Virology, Medical College of St. Bartholomew's Hospital, London,
United Kingdom.

Varicella-zoster virus (VZV) directs the synthesis of a nonglycosylated
polypeptide complex with two prominent species with relative molecular masses of 
32,000 and 36,000; the p32/p36 complex is present in both the viral nucleocapsid 
and the nuclear matrix of the infected cell. We have now further characterized
the humoral immune response of VZV-infected humans to this complex and
established that it is a major viral antigen. Antibodies to VZV p32/p36 were
detected in sera from patients with both primary VZV infection (chickenpox) and
VZV reactivation (zoster); the response after zoster was more pronounced. When
the IgM and IgG components of the immune response were distinguished, IgM to the 
viral nucleoproteins was observed following chickenpox and zoster and, to a
lesser extent, in recipients of VZV vaccine. An IgM response to VZV p32 also was 
detected during intrauterine VZV infection and subclinical VZV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2536788 [PubMed - indexed for MEDLINE]

6264: J Neuroimmunol. 1989 Mar;22(1):69-76.

Cimetidine as an immunomodulator in the treatment of herpes zoster.

Miller A, Harel D, Laor A, Lahat N.

Department of Neurology, Lady Davis Carmel Hospital, Haifa, Israel.

As there is evidence of a possible immunoregulatory role for H2-histamine
receptor antagonists, we carried out a prospective randomized trial to evaluate
the in vivo and in vitro effect of cimetidine, an H2-blocker, in the treatment of
herpes zoster infection. Cimetidine treatment shortened the median interval until
the first decrease in pain, the median interval until the complete resolution of 
pain and promoted faster complete healing of skin lesions than symptomatic
treatment. The immunological trends observed in vitro support an important role
for histamine in the induction of immunosuppression, as measured by the response 
to the mitogen phytohemagglutinin. This effect of histamine was antagonized by
cimetidine.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 2521868 [PubMed - indexed for MEDLINE]

6265: Klin Monatsbl Augenheilkd. 1989 Mar;194(3):184-6.

[Herpes zoster ophthalmicus with subsequent oculomotor paralysis and homolateral 
media infarct]

[Article in German]

Pfeifer B, Kempkes K, Kramer G.

Neurologische Universitatsklinik Mainz.

Oculomotor palsy is a well-known complication of herpes zoster ophthalmicus
(HZO). Combination with homolateral cerebral media infarction and contralateral
hemiplegia is very rare. Since the first paper on HZO and cerebral ischemia was
published, in 1919, about 70 cases have been described. Zoster infection is
thought to encroach from the fifth cranial nerve on to a cerebral artery at the
base of the brain. The authors describe a case of HZO seen by them, with
oculomotor palsy and ipsilateral media infarction with contralateral hemiplegia
and aphasia. A review of the literature is given and etiologic and therapeutic
aspects are discussed.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 2470951 [PubMed - indexed for MEDLINE]

6266: J Neuroimmunol. 1989 Mar;22(1):63-8.

Sequestration of virus-specific T cells in the cerebrospinal fluid of a patient
with varicella zoster viral meningoencephalitis.

Duby AD, Weiner HL, Benjamin DS, Seidman JG, Hafler DA.

Department of Genetics, Harvard Medical School, Boston, MA 02115.

The frequency of virus-specific T cells in the cerebrospinal fluid of a patient
with viral infection of the brain and meninges was determined by using a
single-T-cell cloning technique where a representative sampling of T cells was
cloned from the cerebrospinal fluid of a patient with varicella zoster viral
(VZV) meningoencephalitis. That the derived T-cell clones were in fact clonal was
shown by demonstrating, on Southern blot analyses, unique rearrangements of the
T-cell antigen-receptor beta-chain genes of each clone. Five out of the 15 of the
T4+ (CD4), 0/4 of the T8+ (CD8), and 0/1 of the T4+T8+ T-cell clones proliferated
to VZV, while no clones proliferated to mumps virus or myelin basic protein.
There was no clonal expansion of any VZV-reactive T cell in this patient's
cerebrospinal fluid. As VZV meningoencephalitis is thought to be due to the
reactivation of a dormant herpes zoster viral infection, it can be regarded as a 
secondary immune response. The presence of different T-cell receptor beta-chain
gene rearrangements in each T-cell clone suggests that the T-cell response was
polyclonal. These results demonstrate that a high frequency of polyclonal, T4+
antigen-specific T cells can be found in a naturally occurring, localized, immune
response.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2465314 [PubMed - indexed for MEDLINE]

6267: Med J Aust. 1989 Feb 20;150(4):227-8.

Treatment of prodromal shingles.

Kowal L.

Publication Types: 
    Case Reports
    Letter

PMID: 2785634 [PubMed - indexed for MEDLINE]

6268: BMJ. 1989 Feb 18;298(6671):431.

Lack of effect of acyclovir on postherpetic neuralgia.

McKendrick MW, McGill JI, Wood MJ.

Department of Medicine and Communicable Diseases, Lodge Moor Hospital, Sheffield.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 2495051 [PubMed - indexed for MEDLINE]

6269: J Laryngol Otol. 1989 Feb;103(2):205-6.

Aberrant reinervation of the stapedius muscle following facial palsy.

McFerran DJ, Baguley D, Moffat DA.

Addenbrooke's Hospital, Cambridge.

This case report describes the clinical course of a patient with Ramsay Hunt
Syndrome. Partial recovery of the lower motor neuron facial palsy was associated 
with decreased hearing and a reduction of the middle ear compliance on voluntary 
contraction of the facial musculature. It is suggested that this is due to
misdirection of regenerating nerve fibres, normally destined for facial muscles, 
to stapedius muscle.

Publication Types: 
    Case Reports

PMID: 2926271 [PubMed - indexed for MEDLINE]

6270: Eur J Pediatr. 1989 Feb;148(5):468-9.

Neurogenic bladder due to herpes zoster infection in an infant.

Gold I, Azizi E, Eshel G.

Department of Dermatology, Assaf Harofeh Medical Centre, Sackler School of
Medicine, Tel Aviv University, Zerifin, Israel.

A case is presented of Herpes zoster (HZ) infection in a 2.5-month-old infant
with the added complication of a neurogenic bladder. The patient's mother
suffered from varicella during the 18th week of pregnancy. The patient had a
typical herpetic rash at the age of 2.5 months, and developed constipation and a 
neurogenic bladder. While the constipation improved, bladder atonicity led to
hydroureters necessitating bilateral ureterostomies. Urinary tract involvement of
HZ is well known in adults and is reversible. To our knowledge this is the first 
report of such a complication of HZ infection in infants.

Publication Types: 
    Case Reports

PMID: 2920755 [PubMed - indexed for MEDLINE]

6271: Postgrad Med. 1989 Feb 1;85(2):57, 60, 63.

Delayed diagnosis of herpes zoster.

Brings HA.

Branch Medical Clinic, Marine Corps Air Station, Beaufort, SC 29904.

Herpes zoster may cause diagnostic confusion and mimic other diseases during the 
early stage before development of the characteristic rash. Although the disease
is usually self-limited, oral acyclovir (Zovirax) shows promise in reducing the
duration and severity of symptoms in uncomplicated cases.

Publication Types: 
    Case Reports

PMID: 2915962 [PubMed - indexed for MEDLINE]

6272: Ann Ophthalmol. 1989 Feb;21(2):47-8.

Pediatric herpes simplex masquerading as varicella-zoster.

Aguirre Vila-Coro A, del Cotero JF, Bonafonte S.

University of Texas Health Science Center, Houston, Texas 77030-1697.

A three-year-old girl developed a generalized cutaneous Herpes simplex infection 
and a dendritic corneal ulcer. The clinical appearance of the lesions led to the 
diagnosis of varicella by a pediatrician and of Herpes zoster corneal ulcer by an
ophthalmologist, who prescribed topical adrenocorticosteroids. An enzyme-linked
immunosorbent assay and cultures were positive for the Herpes simplex virus.
Topical antiviral treatment was applied, and the lesions healed without
significant sequelae.

Publication Types: 
    Case Reports

PMID: 2785359 [PubMed - indexed for MEDLINE]

6273: Klin Med (Mosk). 1989 Feb;67(2):37-40.

[Clinical variants of herpes zoster]

[Article in Russian]

Andreichin MA, Savchak VI.

The clinical course of herpes zoster has been analysed in 132 in-patients and a
variety of the clinical forms shown which were initially disguised as the
internal diseases. In addition to typical variants, the following types of herpes
zoster have been found: gangrenous, bullous, hemorrhagic and disseminated.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 2724885 [PubMed - indexed for MEDLINE]

6274: Nippon Rinsho. 1989 Feb;47(2):434-9.

[Clinical signs and symptoms and chemotherapy of herpes zoster]

[Article in Japanese]

Ozawa A.

PMID: 2724576 [PubMed - indexed for MEDLINE]

6275: Hautarzt. 1989 Feb;40(2):110-1.

[Post-zoster granuloma anulare]

[Article in German]

Kleber R, Landthaler M, Burg G.

Dermatologische Klinik, Ludwig-Maximilians-Universitat, Munchen.

Five weeks after a herpes zoster infection of the right 6th thoracic segment, a
57-year-old male patient developed papular skin lesions in the same area.
Histological examination allowed a diagnosis of granuloma anulare.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2714986 [PubMed - indexed for MEDLINE]

6276: Nippon Hinyokika Gakkai Zasshi. 1989 Feb;80(2):175-84.

[Infectious diseases in kidney transplant recipients treated with cyclosporin]

[Article in Japanese]

Takahashi K, Yagisawa T, Hiroshi T, Teraoka S, Fuchinoue S, Honda H, Goya N,
Tanabe K, Ebihara K, Ooba S, et al.

Cyclosporin (CYA) is now recognized as an effective immunosuppressant to lead to 
a marked improvement in graft survival in organ transplant recipients. Although
the incidence of infection in the CYA group has been decreased compared with that
in the azathioprine group, infectious diseases in 400 kidney transplant
recipients treated with CYA were noted in our single center. Treatment strategy
for infectious diseases: Antibiotics and/or gamma-Globulin were administered to
all recipients with bacterial infections. Aciclovir was added in recipients with 
herpes simplex virus (HSV) infection or varicella zoster virus (VZV) infection.
Human interferon-beta (HuIFN-beta) was used in recipients who had
life-threatening viral infection, especially cytomegalovirus (CMV) pneumonitis.
Glycyrrhizin was used for acute hemorrhagic cystitis and nephropathy due to
adenovirus (AV). Trimethoprim sulfamethoxazole and/or pentamidine were added in
recipients complicated with Pneumocystis carinii (Pc) pneumonitis or in order to 
prevent Pc pneumonitis. Infectious diseases: One hundred and six recipients had
infectious diseases 129 times in this series, seventy-six percent of all
infections occurred during the first 4 months after the transplantation. Urinary 
tract infection (UTI), herpes zoster and pulmonary infection were the most common
infectious diseases, occurring in 28.7%, 24.0% and 23.2%, respectively.
Septicemia or bacteremia developed in 9 recipients, secondary to UTI in 8 and to 
surgical wound infection in one. Sixty-one symptomatic viral infections occurred 
in 57 recipients. A total of 5 recipients (1.3%) died of interstitial
pneumonitis. Infectious organisms: Viral and bacterial infections were most
common, occurring in 47.3% and 41.9%, respectively. Viral species detected in
these recipients with the frequency were HSV 14 times, CMV 9 times, VZV 31 times 
and AV 7 times. 1) The incidence of viral infections in kidney transplant
recipients treated with CYA is relatively high compared to bacterial infections. 
2) HuIFN-beta therapy is effective in the treatment of serious opportunistic
herpes virus infections, especially CMV pneumonitis. 3) Glycyrrhizin therapy is
effective in the treatment of acute hemorrhagic cystitis and nephropathy due to
AV and hepatic dysfunction. 4) Aerosolised pentamidine therapy is very useful for
prophylaxis of Pc pneumonitis.

Publication Types: 
    English Abstract

PMID: 2664294 [PubMed - indexed for MEDLINE]

6277: Nippon Rinsho. 1989 Feb;47(2):395-400.

[High risk group of patients with infection of herpes group virus]

[Article in Japanese]

Masaoka T.

Publication Types: 
    Clinical Trial

PMID: 2657136 [PubMed - indexed for MEDLINE]

6278: Jpn J Med Sci Biol. 1989 Feb;42(1):1-11.

Varicella-zoster virus prevalence in Japan: no significant change in a decade.

Taylor-Wiedeman J, Yamashita K, Miyamura K, Yamazaki S.

Central Virus Diagnostic Laboratory, National Institute of Health, Tokyo.

A seroepidemiologic time-comparison study was conducted to evaluate changes in
IgG antibody to varicella-zoster virus (VZV) and to determine VZV prevalence in
Japan with randomly collected serum samples from two healthy Japanese
populations: 1973 (n = 670) vs. 1984 (n = 677). Enzyme-linked immunosorbent assay
(ELISA) was found to be superior to the immune adherence hemagglutination test
(IAHA) especially for detecting seropositivity in adults. Serologic results
showed essentially no significant difference between the 1973 and the 1984
age-specific prevalences; with the exception of a slightly lower prevalence in
the 5-year-old age group in 1973 than that in 1984. In general, the age-specific 
prevalence was lowest in the 1-year-old group (mean 11%) and increased in a
linear fashion until age 9 (mean 82.9%); prevalence continued to increase slowly 
after age 9 and plateaued at 100% for ages greater than or equal to 25-29.

Publication Types: 
    Comparative Study

PMID: 2550689 [PubMed - indexed for MEDLINE]

6279: Nippon Rinsho. 1989 Feb;47(2):424-8.

[Efficacy of live varicella vaccine strain (Oka) in high-risk patients]

[Article in Japanese]

Eizuru Y, Minamishima Y.

PMID: 2542665 [PubMed - indexed for MEDLINE]

6280: Nippon Rinsho. 1989 Feb;47(2):378-83.

[Chemotherapy to thymidine kinase producing virus (HSV-1, HSV-2, VZV) infection]

[Article in Japanese]

Goto H, Shimada K.

PMID: 2542661 [PubMed - indexed for MEDLINE]

6281: Nippon Rinsho. 1989 Feb;47(2):356-60.

[Diagnosis of varicella-zoster virus infection by immunological method]

[Article in Japanese]

Sata T, Kurata T.

PMID: 2542657 [PubMed - indexed for MEDLINE]

6282: Nippon Rinsho. 1989 Feb;47(2):331-9.

[DNA diagnosis and epidemiologic analysis of varicella-zoster virus infection]

[Article in Japanese]

Hondo R.

PMID: 2542653 [PubMed - indexed for MEDLINE]

6283: Am J Infect Control. 1989 Feb;17(1):26-30.

Susceptibility of hospital-based health care personnel to varicella-zoster virus 
infections.

McKinney WP, Horowitz MM, Battiola RJ.

Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee.

Varicella-zoster virus (VZV) transmission poses a major infection risk for health
care workers in the hospital environment. Immunologically normal adults who
contract varicella have 9 to 25 times the risk of major morbidity or death from
infection compared with healthy children. Moreover, varicella infection during
pregnancy is associated with a high rate of complications and the risk of the
congenital varicella syndrome. To evaluate susceptibility to VZV infection among 
hospital workers, the employee health service screened 241 personnel for VZV
antibody by the indirect fluorescent antibody technique. Overall, 7 (2.9%) of 241
personnel lacked VZV antibody and were therefore presumed susceptible to
infection. Susceptibility varied dramatically by age and was significantly higher
among persons 35 years of age and younger (7/93 = 7.5%) than among those aged 36 
years and older (0/148 = 0%, p = 0.001). Persons 35 years old or younger with a
clinical history of chickenpox or herpes zoster were much less likely to lack
immunity (3/71 = 4.2%) than those stating they had no history of either (4/11 =
36.4%, p = 0.005). Screening strategies for VZV immunity in hospital employees
could be made more efficient by performing serologic tests only on those persons 
aged 35 years or younger with a negative or uncertain history of the disease.
Persons who lack antibody may be considered for preexposure immunization with
live attenuated varicella vaccine as an alternative to varicella-zoster immune
globulin or enforced absence from patient care after exposure to a VZV-infected
patient.

PMID: 2538095 [PubMed - indexed for MEDLINE]

6284: J Med Virol. 1989 Feb;27(2):117-9.

Titration of IgG antibodies against varicella zoster virus before bone marrow
transplantation is not predictive of future zoster.

Webster A, Grint P, Brenner MK, Prentice HG, Griffiths PD.

Department of Virology, Royal Free Hospital School of Medicine, London, England.

Serum antibodies to varicella zoster virus (VZV) were measured in 77 patients
about to undergo allogeneic bone marrow transplantation, and in 65 of their
donors. Ten patients developed zoster within the first 6 months following
transplant. There was no significant difference in the mean pretransplant
antibody titre between those patients who did or did not subsequently develop
zoster. Likewise, the level of antibody to VZV amongst donors had no effect on
the subsequent development of zoster. We conclude that the pretransplant level of
antibody to VZV is not predictive of subsequent zoster infection, and would not
be helpful in identifying patients for trials of antiviral prophylaxis. These
results contrast with those previously found for another herpesvirus, herpes
simplex (HSV), where antibody level pretransplant is predictive of future HSV
recurrence.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2537881 [PubMed - indexed for MEDLINE]

6285: Am Fam Physician. 1989 Feb;39(2):89-98.

Comment in:
    Am Fam Physician. 1989 Aug;40(2):55.

Varicella-zoster virus infections in pregnancy.

Fox GN, Strangarity JW.

Pennsylvania State University College of Medicine, Hershey.

Varicella-zoster virus can cause a distinct congenital syndrome, a potentially
fatal neonatal infection and life-threatening maternal illness. Physicians can
reduce morbidity from these conditions by advising nonimmune pregnant women to
avoid exposure to chickenpox and herpes zoster and, when indicated, by promptly
administering varicella-zoster immune globulin. When prevention fails, acyclovir 
may be effective therapy.

Publication Types: 
    Review

PMID: 2537001 [PubMed - indexed for MEDLINE]

6286: Proc Natl Acad Sci U S A. 1989 Feb;86(3):1051-5.

2-Acetylpyridine 5-[(dimethylamino)thiocarbonyl]-thiocarbonohydrazone (A1110U), a
potent inactivator of ribonucleotide reductases of herpes simplex and
varicella-zoster viruses and a potentiator of acyclovir.

Spector T, Harrington JA, Morrison RW Jr, Lambe CU, Nelson DJ, Averett DR, Biron 
K, Furman PA.

Division of Experimental Therapy, Wellcome Research Laboratories, Research
Triangle Park, NC 27709.

2-Acetylpyridine 5-[(dimethylamino)thiocarbonyl]thiocarbonohydrazone (A1110U) was
found to be a potent inactivator of the ribonucleotide reductases (EC 1.17.4.1)
encoded by herpes simplex virus types 1 and 2 and by varicella-zoster virus and
to be a weaker inactivator of human ribonucleotide reductase. It also markedly
potentiated the antiherpetic activity of acyclovir against these viruses in
tissue culture. A1110U both decreased the dGTP pool that builds up when infected 
cells are treated with acyclovir and induced a large increase in the pool of
acyclovir triphosphate. The resultant 100-fold increase in the ratio of the
concentrations of acyclovir triphosphate to dGTP should facilitate the binding of
the fraudulent nucleotide to its target enzyme, herpes virus-encoded DNA
polymerase, and could account for the synergy between A1110U and acyclovir. A
similar change in the acyclovir triphosphate-to-dGTP ratio was previously
reported to be induced by another ribonucleotide reductase inhibitor,
2-acetylpyridine 4-(2-morpholinoethyl)thiosemicarbazone (A723U). However, A1110U 
is considerably more potent and may have better clinical potential. Synergistic
toxic interactions between A1110U and acyclovir were not detected in uninfected
cells.

PMID: 2536930 [PubMed - indexed for MEDLINE]

6287: J Infect Dis. 1989 Feb;159(2):331-5.

Enhancement of simian varicella virus infection in African green monkeys by
recombinant human tumor necrosis factor alpha.

Soike KF, Czarniecki CW, Baskin G, Blanchard J, Liggitt D.

Delta Regional Primate Research Center, Tulane University, Covington, Louisiana.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2536783 [PubMed - indexed for MEDLINE]

6288: Hum Pathol. 1989 Feb;20(2):174-9.

Erratum in:
    Hum Pathol 1989 Aug;20(8):820.

Transsynaptic spread of varicella zoster virus through the visual system: a
mechanism of viral dissemination in the central nervous system.

Rostad SW, Olson K, McDougall J, Shaw CM, Alvord EC Jr.

Department of Pathology, University of Washington School of Medicine, Seattle
98195.

We report a patient with pathologic evidence of anterograde spread of varicella
zoster virus (VZV) through the visual system. A 29-year-old homosexual man
developed the acquired immunodeficiency syndrome (AIDS) 2 months before the onset
of left herpes zoster ophthalmicus. During the next 11 months, the zoster
infection progressed to involve the left eye, with resultant keratitis, iritis,
retinitis, and eventual blindness. Later, the patient developed bilateral
blindness, left hemiparesis, and fatal pneumonia. At autopsy, the brain revealed 
destruction of the visual system and adjacent structures, with sparing of the
remainder of the brain. Glial cells near the areas of necrosis showed Cowdry type
A intranuclear inclusions. In situ hybridization with probes to VZV nucleic acid 
sequences were positive in the necrotic brain and retinal areas. Hybridization
with probes to cytomegalovirus, herpes simplex virus type II, human
immunodeficiency virus, and Epstein-Barr virus were negative. Electron microscopy
revealed characteristic herpes group nucleocapsids. This case provides insight
into the mechanisms of virus dissemination and the production of encephalitis.

Publication Types: 
    Case Reports

PMID: 2536632 [PubMed - indexed for MEDLINE]

6289: BMJ. 1989 Jan 28;298(6668):253.

Lignocaine-prilocaine cream in postherpetic neuralgia.

Milligan KA, Atkinson RE, Schofield PA.

Publication Types: 
    Case Reports
    Letter

PMID: 2493878 [PubMed - indexed for MEDLINE]

6290: J Immunol. 1989 Jan 15;142(2):636-41.

T lymphocyte cytotoxicity with natural varicella-zoster virus infection and after
immunization with live attenuated varicella vaccine.

Diaz PS, Smith S, Hunter E, Arvin AM.

Department of Pediatrics, Stanford University School of Medicine, CA 94305.

Varicella-zoster virus (VZV) specific cytotoxicity was investigated during acute 
primary VZV infection, in naturally immune subjects and after vaccination with
the live attenuated varicella vaccine by using T cell cultures (TCC) generated by
stimulating PBMC with VZV Ag and autologous VZV-superinfected lymphoblastoid cell
lines as targets. Lysis of VZV-infected lymphoblastoid cell lines was observed by
TCC from acutely infected subjects, naturally immune subjects, and recipients of 
the varicella vaccine. VZV glycoprotein I induced cytotoxic T cells but killing
was less efficient than killing by TCC stimulated with VZV Ag. The TCC were
primarily CD4+ (mean 86.6%) T lymphocytes with 15.2% of the cells coexpressing
Leu-19. TCC were predominantly restricted by HLA class II as demonstrated by lack
of any blocking using class I mAb and blocking of 15 to 71% by L243, a mAb to
class II. Unrestricted killing as measured by killing of K562 cells occurred in
all TCC but was minimally greater than that observed against uninfected
autologous targets. Phenotypes of PBMC during acute infection had an initial
increase in CD4+ cells and an overall decrease in the percentage of circulating
Leu-11+ (CD16). No enhanced K562 killing was demonstrated in PBMC from subjects
with acute infection compared to subjects without infection. CD4+ CTL may
function as an important primary host response in acute varicella. Immunization
with live attenuated varicella vaccine induced VZV-specific, memory CTL responses
comparable to those of naturally immune subjects. The demonstration of their
persistence long after primary VZV infection may indicate a role for CTL in
restriction of viral replication during episodes of VZV reactivation from
latency.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2536059 [PubMed - indexed for MEDLINE]

6291: Int J Cancer. 1989 Jan 15;43(1):67-71.

Epstein-Barr virus-infected B cells persist in the circulation of
acyclovir-treated virus carriers.

Yao QY, Ogan P, Rowe M, Wood M, Rickinson AB.

Department of Cancer Studies, University of Birmingham, Medical School, UK.

In this study, infectious Epstein-Barr virus (EBV) shedding in the oropharynx and
numbers of virus-infected B cells in the blood have been monitored in long-term
virus carriers receiving acyclovir (ACV) therapy for herpes zoster. Eleven
patients on oral ACV were followed prospectively before, during and for 2 weeks
after treatment. As expected, the low levels of EBV shedding in these virus
carriers (measured as cord-blood lymphocyte transforming activity in throat
washings) were eliminated during the period of ACV treatment and returned at
later times. Over the same period, however, the frequency of virus-infected B
cells in the blood (measured by spontaneous transformation in limiting dilution
assay) remained completely unchanged. Regression assays showed that these same
patients had normal levels of EBV-specific cytotoxic T-cell immunity, so that the
in vivo persistence of virus-infected B cells could not be ascribed to a defect
in T-cell surveillance. We infer that the in vivo half-life of the virus-infected
B-cell pool in long-term virus carriers is measured in months rather than days.
We further suggest that such persistence requires a novel form of virus:B-cell
interaction distinct from the type of "latent" infection displayed by in
vitro-transformed cells.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2536009 [PubMed - indexed for MEDLINE]

6292: Ugeskr Laeger. 1989 Jan 9;151(2):90-2.

[Acyclovir in the treatment of facial palsy due to zoster virus]

[Article in Danish]

Albeck H, Ninn-Pedersen K.

The varicella zoster virus (VZV) is the cause of 7-10% of the cases of atraumatic
facial palsy. In untreated cases, recovery is only partial. Out of five patients,
treatment with acyclovir resulted in complete recovery after three weeks in four 
in whom treatment was commenced within three days of the onset of the palsy. In
one patient in whom treatment was commenced more than four days after the onset
of the palsy, only partial recovery had occurred after one year.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2911904 [PubMed - indexed for MEDLINE]

6293: Lancet. 1989 Jan 7;1(8628):31-4.

Effect of measles, mumps, rubella vaccination on pattern of encephalitis in
children.

Koskiniemi M, Vaheri A.

Children's Hospital, Helsinki, Finland.

462 patients (269 males, 193 females, aged from 1 month to 16 years) with
encephalitis were treated at the Children's Hospital, University of Helsinki,
over a 20-year period. The incidence of encephalitis was 8.3/100,000 child-years 
(range 19.8 in 1974 to 2.5 in 1985 and 1986). The organisms most commonly
associated with encephalitis in children were mumps, measles, and varicella
viruses, and Mycoplasma pneumoniae. After the start of the nationwide measles,
parotitis, and rubella (MPR) vaccination programme in 1982 in Finland,
encephalitides associated with these viruses seem to have totally vanished.
Currently the pathogens most often associated with childhood encephalitides are
varicella-zoster, M pneumoniae, and enteroviruses. 3% of the 462 patients died
from their illness, and 7% became severely damaged, with the poorest outcome
occurring after multiple infections, and herpes simplex virus, cytomegalovirus or
M pneumoniae infections. The decline in the total number of cases of encephalitis
was not accompanied by a decrease in number of patients with a poor outcome.
Patients with treatable encephalitides due, for example, to M pneumoniae and
herpes viruses, need prompt attention.

PMID: 2563011 [PubMed - indexed for MEDLINE]

6294: Nord Med. 1989;104(3):72-5.

[Herpes zoster neuralgia--a persistent therapeutic problem]

[Article in Swedish]

Poyhia R, Tigerstedt I.

Most patients with acute herpes zoster (AHN) who are younger than 50 yrs recover 
spontaneously and need no more specific medication than NSAID-analgetics.
However, older patients and those treated with immunosuppressive medication are
at high risk of developing postherpetic neuralgy (PHN), and may need intensive
treatment for severe pain. Unfortunately there is no specific method so far to
prevent PHN. In the prevention of PHN some promising results have been gained
with antiviral drugs, sympathetic blocks, corticosteroids, psychotropic and
anticonvulsive drugs. The earlier any of these treatments is started in AHM, the 
better results. When PHN has developed, in most cases there is no effective
treatment to be offered. In the Pain Clinic of Helsinki University Hospital
antidepressive and neuroleptic drugs as well as transcutaneous neurostimulation
have been used for PHN treatment.

Publication Types: 
    English Abstract

PMID: 2922251 [PubMed - indexed for MEDLINE]

6295: J Neurol. 1989 Jan;236(1):26-8.

Demonstration of zoster virus antibodies in cerebrospinal fluid cells.

Beuche W, Thomas RS, Felgenhauer K.

Department of Neurology, University of Gottingen, Federal Republic of Germany.

A method is presented that allows the immunocytochemical detection of varicella
zoster virus antigen-binding cerebrospinal fluid cells in zoster ganglionitis.
Antigen-binding cells were found only in patients suffering from this disease.
The technique is sensitive, specific, inexpensive and relatively fast, and is
potentially applicable to other inflammatory central nervous system diseases with
immunoglobulin-containing cells (ICC) in CSF. The detection of antigen-binding
CSF cells may represent a very early diagnostic test comparable with the early
IgM antibodies of the systemic immune response.

PMID: 2915223 [PubMed - indexed for MEDLINE]

6296: Vestn Dermatol Venerol. 1989;(8):63-5.

[Paraneoplastic gangrenous-bullous herpes zoster]

[Article in Russian]

Savchak VI.

A female patient aged 65 is described. Two years after mastectomy for right-side 
mammary carcinoma she developed herpes zoster round the cicatrix; this condition 
anticipated metastases. The patient died of cancerous cachexia in 3 months after 
gangrenous herpes zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2816036 [PubMed - indexed for MEDLINE]

6297: Vestn Dermatol Venerol. 1989;(8):62-3.

[The generalized form of herpes zoster in a patient with mycosis fungoides]

[Article in Russian]

Kilinskas SIu.

The described case is marked for a dissemination of the skin process, its
severity, and manifest intoxication. A considerable reduction of the body
reactivity because of mycosis fungoides is responsible for the development of the
generalized process; another reason is prolonged intake of corticosteroids and
cytostatics for the underlying condition.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2816035 [PubMed - indexed for MEDLINE]

6298: Przegl Dermatol. 1989 Jan-Mar;76(1):45-9.

[Griseofulvin in the treatment of herpes zoster]

[Article in Polish]

Gwiezdzinski Z, Protas-Drozd F.

The authors applied griseofulvin in 46 patients (28 women and 18 men) aged from
21 to 82 years with various forms of zoster. The locations of lesions was
different: concerned very often the face and the thorax, rarely the extremities
and sometimes the lesions were generalized. The treatment was started in
beginning stadium of disease. The total daily oral dose of Griseofulvin-Forte
(Medexport/SU were 500 mg (taken in two doses with 2 tablets a 125 mg). A average
time of therapy was 10 days. Subjective troubles, pain and burning regressed
rapidly and the regression endured. In author's opinion treatment with
griseofulvin is efficacious and secure. The time of therapy is very short. The
above mentioned method can be recommended to wide, general use.

Publication Types: 
    English Abstract

PMID: 2813817 [PubMed - indexed for MEDLINE]

6299: Acta Neurochir Suppl (Wien). 1989;46:65-6.

Spinal cord stimulation (SCS) in the treatment of postherpetic pain.

Meglio M, Cioni B, Prezioso A, Talamonti G.

Istituto di Neurochirurgia, Universita Cattolica, Roma, Italy.

SCS is considered to be of poor value in treating postherpetic pain. We have
retrospectively analyzed the results obtained in 10 patients suffering from
postherpetic neuralgia. An epidural electrode was implanted, aiming the tip in a 
position where stimulation could produce paraesthesiae over the painful area. At 
the end of the test period 6 out of 10 patients reporting a mean analgesia of
52.5% underwent a permanent implant. At mean follow-up (15 months) all the 6
patients were still reporting a satisfactory pain relief (74% of mean analgesia).
These figures remained unchanged at the next follow-ups (max 46 months). The
result of SCS in our patients, although positive in only 60% of them, are
remarkably stable with time. We therefore recommend a percutaneous test trial of 
SCS in every case of postherpetic neuralgia resistent to medical treatment.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2788976 [PubMed - indexed for MEDLINE]

6300: Ann Ophthalmol. 1989 Jan;21(1):34-5.

Autoimmune endotheliopathy and chronic herpetic conjunctivitis.

Coppeto JR, Stern A, Bisson B.

St. Mary's Hospital, Waterbury, Connecticut.

A migrating endothelial line of keratic precipitates associated with overlying
corneal edema suggests an immune attack on the corneal endothelium. This is seen 
most commonly in corneal allotransplantation rejection. The etiology of such
lines in the absence of this condition is unclear. We document the presence of an
intranuclear virus compatible with herpesvirus in this condition.

Publication Types: 
    Case Reports

PMID: 2784651 [PubMed - indexed for MEDLINE]

6301: Prof Nurse. 1989 Jan;4(4):186-8.

Caring for patients with herpes zoster ophthalmicus.

Milbourn S.

PMID: 2784213 [PubMed - indexed for MEDLINE]

6302: Blood. 1989 Jan;73(1):38-46.

Deoxycoformycin-induced immunosuppression in patients with hairy cell leukemia.

Urba WJ, Baseler MW, Kopp WC, Steis RG, Clark JW, Smith JW 2nd, Coggin DL, Longo 
DL.

Program Resources, National Cancer Institute-Frederick Cancer Researh Facility,
MD 21701.

Immune function in patients with hairy cell leukemia (HCL) was examined serially 
during treatment with alternating monthly cycles of recombinant interferon
alpha-2a and 2'-deoxycoformycin (dCF). At presentation, most patients had normal 
numbers of T lymphocytes and their cells had normal proliferative responses to
mitogens [phytohemagglutinin (PHA) and concanavalin A (Con A)] and alloantigens. 
Patients had severe monocytopenia, decreased delayed-type hypersensitivity (DTH) 
reactions, and decreased peripheral blood natural killer (NK) activity. Treatment
caused a profound decrease in all lymphocyte subpopulations. T cells were more
affected than B cells or NK cells. Numbers of CD4+ and CD8+ lymphocytes decreased
to levels less than 200 cells/microliters in all patients during treatment. This 
decrease in T cell number was associated with a marked decrease in proliferative 
responsiveness to PHA, Con A, and alloantigens. These abnormalities persisted
throughout the 14 months of treatment and have continued for up to 6 months
beyond discontinuation of treatment. NK cell activity increased during treatment,
but cycled depending on the phase of treatment; highest activities were observed 
after interferon (IFN)-alpha and lower levels of activity were observed after
dCF. DTH responses generally did not improve during therapy. Levels of IgM, IgG, 
IgA, and IgD did not change during treatment, but IgE levels rose in most
patients. All immunosuppressive effects were attributable to dCF since patients
receiving IFN-alpha 2a alone did not exhibit these same immunosuppressive
effects, and patients receiving dCF alone after IFN failure exhibited similar
abnormalities. Despite this severe immunosuppression from dCF, life-threatening
opportunistic infections have not been observed in our patient population. Six
patients developed localized Herpes zoster infection among 21 patients who had
received dCF. Pending the results of long-term follow-up, we recommend that dCF
be reserved for patients who have failed splenectomy and IFN therapy.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2783373 [PubMed - indexed for MEDLINE]

6303: Leuk Res. 1989;13(6):465-72.

The epidemiology of non-Hodgkin's lymphoma in the north-east of Italy: a
hospital-based case-control study.

Franceschi S, Serraino D, Bidoli E, Talamini R, Tirelli U, Carbone A, La Vecchia 
C.

Epidemiology Unit, Aviano Cancer Center, Italy.

We concluded a study on 208 cases of non-Hodgkin's lymphoma and 401 controls in
the North-East of Italy in order to investigate the role of indicators of
socio-economic status, personal habits, past history of various disorders and
medical treatments potentially affecting the immune system, and occupational
exposures in the aetiology of such neoplasia. None of the several investigated
characteristics appeared to be a strong determinant, i.e. relative risk, RR
greater than 2.0, of non-Hodgkin's lymphoma. Cases and controls appeared to be
very similar as regards education, main life-time occupation and alcohol
consumption. Positive associations, however, emerged with chronic infectious
diseases, mainly tuberculosis and malaria (RR = 1.8, 95% confidence interval, CI:
1.1-2.9). Non significantly increased risks were also found for smoking habit (RR
ever vs never smokers = 1.5, 95% CI: 1.0-2.3), episodes of herpes zoster
infection (RR = 1.4; 95% CI: 0.7-2.6) and occupation in chemical and
petrochemical industries (RR = 1.6; 95% CI: 0.9-3.1, and 1.8; 95% CI: 0.9-3.8,
respectively). Conversely, farming as well as specific exposure to herbicides and
pesticides did not seem to affect the risk of non-Hodgkin's lymphoma in the
present investigation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2770331 [PubMed - indexed for MEDLINE]

6304: Dermatologica. 1989;179(1):45-6.

Granuloma formation in herpes zoster scars.

Wright AL, Cotton DW, Winfield DA, Messenger AG.

University Department of Dermatology, Royal Hallamshire Hospital, Sheffield, UK.

An 82-year-old male with chronic lymphocytic leukaemia developed an erythematous 
papular eruption over the trunk. Lesions occurred at the site of scars related to
a disseminated herpes zoster infection 3 months previously. Biopsy of a lesion
showed granuloma formation. The rash resolved spontaneously over 6-8 weeks.

Publication Types: 
    Case Reports

PMID: 2767297 [PubMed - indexed for MEDLINE]

6305: J Antimicrob Chemother. 1989 Jan;23(1):3-5.

The chemotherapeutic approach to zoster.

McKendrick MW.

Lodge Moor Hospital, Sheffield, UK.

PMID: 2745254 [PubMed - indexed for MEDLINE]

6306: Curr Probl Dermatol. 1989;18:152-7.

Reinfection with varicella-zoster virus in immunocompromised patients.

Junker K, Avnstorp C, Nielsen CM, Hansen NE.

Department of Haematology and Internal Medicine, Gentofte Hospital, Denmark.

A small epidemic of varicella/atypical generalized zoster among 6
immunocompromised patients and one previously healthy person is described. The 6 
immunocompromised patients suffered from lymphoproliferative diseases in terminal
stages treated with chemotherapy and reported varicella in their childhood. They 
developed a generalized maculopapular rash with hemorrhagic bullae and necroses. 
The infection passed from one patient to another during a 3-month period in the
department. They were placed in adjacent rooms and nursed by the same staff. The 
most specific diagnostic tool was the detection of varicella-zoster virus antigen
from vesicles by ELISA technique. The epidemic was supposed to be caused by
exogenous reinfection with varicella-zoster virus, and illustrated that
generalized zoster may be even so infectious as varicella and that
immunocompromised patients should be protected against reinfection.

Publication Types: 
    Case Reports

PMID: 2743800 [PubMed - indexed for MEDLINE]

6307: Med Trop (Mars). 1989 Jan-Mar;49(1):21-8.

[Infection by the human immunodeficiency virus (HIV) in French Guyana.
Dermato-venereologic problems]

[Article in French]

Pradinaud R, Sainte-Marie D, Girardeau I, Cassiede P.

Service de Dermato-Venereologie, Centre Hospitalier de Cayenne, Guyane Francaise.

Dermato-venereal manifestations in HIV infection and its severe evolution stage, 
AIDS, is of particular importance in tropical zones: We may be suspicious of the 
viral infection and consequently to request serologic tests to confirm it. We get
an explanation of the virus transmission during heterosexual relations by the
frequent occurrence and importance of the genital manifestations, leading to
consider AIDS as a true sexually transmitted disease. Beside the classical
opportunistic infections, the authors draw the attention to three types of
manifestations: prurigo, already well known in Haiti and Africa capillary
dystrophies, already reported in Haiti donovanosis that, because its
epidemiological and etiopathological peculiarities, should be listed within the
possible opportunistic infection if we take into consideration the regional
pathological environment. In an other correction, syphilis, lepra and cutaneous
leishmaniasis have to be carefully monitored, because they are capable to
evaluate unexpectedly in some immunodepressive diathesis. Importance of
dermato-venereal pathology in black people in tropical zone is explained by the
weakness of cutaneous corneal stratum, immunologic disorders linked up to
accumulated parasitic pathologies, socio-cultural life with a sexuality without
complex.

PIP: Cutaneous manifestations of AIDS in the 1st 91 cases diagnosed in French
Guiana between 1982-October 1987 included 40 cases of candidiasis, 29 of prurigo,
13 of herpes simplex, 5 of trichomoniasis, 7 of human papilloma virus, 3 of
shingles, 3 of donovanoses, and 1 of Kaposi's sarcoma. There were also 7 cases of
seborrheic dermatitis, 6 of capillary dystrophies, and 1 of leucoplasia. 26 of
the 40 cases of candidiasis were buccal or buccopharyngeal and 14 were vaginal.
Such infections are intense, chronic, and easy to diagnose. Local treatment with 
Nystatin or Amphotericin B in solution for buccal cases and with imidazole
derivatives for vaginal cases should be supplemented with systemic medications
such as ketoconazole. Most herpes simplex cases are type 2 genital infections
which may be chronic and extensive. A perfusion of Aciclovir usually gives good
results in 5 or 6 days. Shingles during AIDS often has nonthoracic localizations;
involves itching, pain, and burning sensations; is recurrent, perhaps on the
contralateral side; and may leave scars. Sensitivity to Aciclovir is less than
for herpes simplex. Human papilloma virus lesions that are not too large are
treated locally. Although tuberculosis is in 2nd place after candidiasis among
opportunistic infections in AIDS patients in French Guiana. Only 2 cases of
cutaneous tuberculosis were observed. 3 cases of Donovanosis due to
Calymmatobacterium granulomatis were observed, with 2 cases with 1 couple.
Chronic prurigo has been observed frequently in AIDS patients in Africa and
Haiti. Along with asthenia, polyadenopathies, and shingles, it is often an early 
sign of AIDS. The pruritus becomes more and more intense and the only treatment
providing some relief is local corticotherapy. The dermatovenereal signs of AIDS 
in tropical environments should raise suspicions of the disease in undiagnosed
cases, and they also provide an explanation for the high rate of heterosexual
transmission in individuals with various disorders involving genital lesions.
Some dermatological disorders common in French Guiana have not been observed in
AIDS patients to date.

Publication Types: 
    English Abstract

PMID: 2725241 [PubMed - indexed for MEDLINE]

6308: Med Trop (Mars). 1989 Jan-Mar;49(1):11-6.

[The human immunodeficiency virus (HIV) and the acquired immunodeficiency
syndrome (AIDS) in New Caledonia]

[Article in French]

Capdevielle P, Gueziec J, Menager C, Brethes B, Louis F, Desforges S, Daynes C,
Calen P, Bobin P, Gras C.

Medecin des hopitaux des Armees, service de medecine, Centre hospitalier
territorial, Noumea.

The authors report on 15 HIV seropositive cases detected within 2 years in New
Caledonia (150,000 inhabitants). Testing HIV antibodies was systematic among
blood donors (9,917 persons) and was carried out in defined samples (1,475
persons): population at risk, rural area, and tests required by clinicians. All
seropositive individuals belong to "high risk group". One certain AIDS case,
group IV C (as defined by CDC Atlanta), another probable one (early death) and
several opportunistic infections: herpes zoster, oral and candidosis, were
observed. Biological exploration is quite good (Pasteur Institute in Noumea).
However, therapy is problematic in this South Pacific Island, and management of
seropositive patients is difficult.

Publication Types: 
    English Abstract

PMID: 2725239 [PubMed - indexed for MEDLINE]

6309: Jpn J Med. 1989 Jan-Feb;28(1):100-4.

Treatment of disseminated herpes zoster in six severely immunocompromised
patients: acyclovir and vidarabine.

Nagafuchi S, Moriyama K, Takamatsu Y, Hayashi S, Niho Y, Takenaka A, Minagawa H, 
Mori R.

First Department of Internal Medicine, Faculty of Medicine, Kyushu University,
Fukuoka, Japan.

We treated 6 patients with disseminated herpes zoster (D-H-Z) and in a severely
immunocompromised condition. Three were effectively treated with 15 mg/kg/day of 
acyclovir. Ten mg/kg/day of vidarabine alone was given to two patients, but
without positive effects. In two patients, acyclovir was effective in limiting
the progression of the lesions. The skin lesions looked like a "stitch" on
vesicles, thereby suggesting that the "stitch like appearance" may be a useful
marker to identify the resistance to acyclovir treatment. In one patient,
acyclovir was given for 58 days, but with limited effectiveness. When vidarabine 
was given in addition to acyclovir, the lesions dramatically disappeared. These
findings suggest that acyclovir is superior to vidarabine for treating D-H-Z and 
the combination therapy with acyclovir and vidarabine should be considered for
prescription for patients with D-H-Z, if acyclovir alone is not completely
effective.

PMID: 2724639 [PubMed - indexed for MEDLINE]

6310: Z Arztl Fortbild (Jena). 1989;83(3):136-8.

[Varicellas and herpes zoster in children with oncologic diseases. 2: Prevention 
and therapy]

[Article in German]

Heidl M, Scholz H, Dorffel W, Wutzler P.

Institut fur Infektionskrankheiten im Kindesalter, Klinikum Berlin-Buch.

PMID: 2718521 [PubMed - indexed for MEDLINE]

6311: Z Arztl Fortbild (Jena). 1989;83(3):133-5.

[Varicellas and herpes zoster in children with oncologic diseases. 1: Clinical
characteristics]

[Article in German]

Heidl M, Scholz H, Dorffel W, Wutzler P.

Institut fur Infektionskrankheiten im Kindesalter, Klinikum Berlin-Buch.

PMID: 2718520 [PubMed - indexed for MEDLINE]

6312: Rev Esp Anestesiol Reanim. 1989 Jan-Feb;36(1):54-6.

[Cardiorespiratory failure caused by delayed dural perforation]

[Article in Spanish]

Miralles Pardo FS, Carrillo Ruiperez E, Velasco Martinez RJ, Sanchez-Jauregui E, 
Lopez Rodriguez F.

The epidural administration of drugs is today a common approach to chronic pain
therapy. Many patients benefit from this therapeutic modality. However, the more 
extensively this method is used, the bigger are the number of reported
complications. In this case we describe a time-delayed dural tap and a secondary 
respiratory arrest on a patient with an epidural cervical catheter for treatment 
of a postherpetic neuralgia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2710984 [PubMed - indexed for MEDLINE]

6313: Folia Med Cracov. 1989;30(1-2):71-7.

[Effect of Zovirax on the course of Varicella-zoster virus (VZV) infections in
children with decreased immune response]

[Article in Polish]

Czajka H, Kluba-Wojewoda U.

In 21 children with weakened immune response++ (18 patients after
immunosuppression and/or after radiotherapy because of neoplastic disease, 1
patients with diagnosed hepatitis chronica persistens, 1 patient with
streptococcal septicemia and one infant with protein deficiency and severe
anemia) Zovirax was applied in treatment of Varicella virus infection. Clinical
observation showed a positive effect of Zovirax in treatment of VZV infection
which was manifested by a milder course of the infection and disappearance
symptoms. Better effects were obtained when the treatment was started in the
first 72 hours of infection.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 2701820 [PubMed - indexed for MEDLINE]

6314: Eur J Haematol Suppl. 1989;51:157-63.

Autologous bone marrow transplantation therapy for multiple myeloma.

Anderson KC, Barut BA, Ritz J, Freedman AS, Nadler LM.

We have begun an autologous bone marrow transplantation (ABMT) treatment protocol
for patients with myeloma who achieve a minimal disease (less than 10% marrow
plasma cells) status. Sites of bony disease are irradiated before BMT. Melphalan 
70 mg/m2 on days 1 and 2 is followed by 1200 rads total-body irradiation
administered in fractionated doses over 3 d. Autologous marrow which has been
previously treated with anti-CALLA, B1, and PCA-1 monoclonal antibodies is then
thawed and reinfused. 4 males and 2 females with median age of 46 yr (41-56) have
been treated. Granulocytes greater than 500/mm3 and platelets greater than
20,000/mm3 were noted at 21 (12-46) and 23 (12-53) d post-transplant (PT),
respectively. Acute mucositis and dermatomal Herpes zoster developed in 3
patients each; all patients are clinically well at 233 (30-807) d PT. All
patients achieved pathologically normal marrows, but monoclonal plasma cells and 
marrow myelofibrosis were each noted in a single patient at 486 and 272 d PT,
respectively. A single patient has responded to alpha 2 interferon therapy PT;
all others have received no therapy. AMBT offers an exciting new treatment for
myeloma; however, relapses post-ABMT suggest that improved ablative regimens
and/or marrow purging methods may be required.

PMID: 2697588 [PubMed - indexed for MEDLINE]

6315: Adv Exp Med Biol. 1989;257:289-91.

Multiple sclerosis and zoster encephalomyelitis: a probable common
etiopathogenesis.

Viel R.

Department of Neurology General Hospital, Udine, Italy.

Publication Types: 
    Review

PMID: 2694821 [PubMed - indexed for MEDLINE]

6316: Eye. 1989;3 ( Pt 3):313-7.

Ocular surgery in ophthalmic zoster.

Marsh RJ, Cooper M.

Department of Clinical Ophthalmology, Moorfields Eye Hospital, London.

Surgical outcome after ophthalmic zoster was analysed with respect to cataract,
glaucoma, corneal ulceration and scarring. We used data from the Zoster Clinic
and Hospital Activity Analysis (HAA) at Moorfields Eye Hospital and a lipid
keratopathy database at the Western Ophthalmic Hospital. Conventional surgery for
cataract, glaucoma and corneal scarring gave good results which were probably no 
different from experience with routine cases, although there was a tendency for
prolonged post-operative inflammation. Lateral and central tarsorrhaphy for
neuroparalytic ulceration almost invariably led to rapid healing.

PMID: 2693137 [PubMed - indexed for MEDLINE]

6317: Eur J Cancer Clin Oncol. 1989;25 Suppl 2:S53-61.

Infections in compromised hosts: considerations on prevention.

Klastersky J.

Clinique H.J. Tagnon, Institut J. Bordet, Centre des Tumeurs de l'Universite
Libre de Bruxelles, Belgium.

Compromised patients are predisposed to the acquisition of resistant bacteria
from the hospital environment. In compromised hosts, gram-negative bacillary and 
staphylococcal infection is often nosocomial, being a result of the severity of
the underlying disease and frequent and/or prolonged hospitalizations. The level 
of colonization of these patients by gram-negative bacilli can be reduced by the 
use of effective antibiotics administered to the oropharyngeal area or
administered orally, by careful handwashing by the hospital personnel and the
administration of low microbial diets to the patients. Infections caused by
Staphylococcus epidermidis can be reduced by careful attention to i.v. devices;
for the streptococcal infections, no clearly effective prophylaxis is available, 
as the mechanisms of acquisition have not been elucidated. Administration of
non-absorbable antibiotics has been used for gastro-intestinal decontamination in
order to prevent gram-negative infections in granulocytopenic patients. These
regimens are poorly tolerated and have been replaced by the quinolones and
cotrimoxazole. This latter drug is also effective for the prevention of
Pneumocystis carinii infections. There is no consensus about the optimal
prevention of fungal infections, especially as far as Aspergillus is concerned.
For the prevention of infections caused by Candida spp., systemically absorbed
imidazoles such as ketoconazole are probably effective. The infections caused by 
cytomegalovirus can be prevented by sero-negative blood products. In seropositive
patients, ganciclovir or acyclovir might be active to some extent. Immune
globulins can prevent Herpes zoster-Varicella infections and acyclovir is
effective in preventing Herpes simplex virus infections.

Publication Types: 
    Review

PMID: 2693110 [PubMed - indexed for MEDLINE]

6318: Rev Pneumol Clin. 1989;45(3):99-105.

[Prospects and current data in antiviral chemotherapy]

[Article in French]

Huraux JM, Ingrand D, Agut H, Devillechabrolle A.

Lab. de Bacteriologie-Virologie, Groupe Hospitalier Pitie-Salpetriere, Paris.

The advances achieved in our knowledge on the virus multiplication cycle and the 
challenge created by the advent of AIDS have resulted in a rational development
of new antiviral agents. However, antiviral chemotherapy is hindered by several
obstacles: (1) most antiviral drugs are cytotoxic, with the exception of
acyclovir which owes its remarkable safety to its activation by the thymidine
kinase of the herpes simplex viruses and of the varicella-zoster virus; (2) the
risk of selecting resistant strains by mutation of viral enzymes is the
unavoidable price to pay for the specificity of new antiviral agents which
interfere with these enzymes; so far, this risk seems to apply only to
immunocompromised patients; (3) latent viral infection, defined as the lack of
active multiplication of the virus, cannot be eradicated by the antiviral drugs
available at present since these drugs are inhibitors of viral multiplication.
However, anti-sens oligonucleotides could, at least in theory, be used to treat
this type of infection which is not limited to the Retroviridae or Herpesviridae 
families. Finally, antiviral drugs active against life-threatening infections
that are as common as rabies and the severe forms of measles or viral hepatitis
remain to be discovered.

Publication Types: 
    English Abstract
    Review

PMID: 2685967 [PubMed - indexed for MEDLINE]

6319: J Gynecol Obstet Biol Reprod (Paris). 1989;18(5):679-83.

[Acyclovir and pregnancy: current aspects]

[Article in French]

Haddad J, Messer J, Willard D, Ritter J.

Service de Neonatologie, CHU Hautepierre, Strasbourg.

Acyclovir (ACV), an antiviral nucleoside analog, is active against Herpes simplex
viruses (HSV1, HSV2) and varicella virus (VZV). These viruses seems to be
prejudicial to the pregnant woman and to the fetus. Yet, ACV is not recommended
for use in pregnancy. However in certain cases, this drug has been used. We
review in this paper, the pharmacokinetics and transplacental passage of ACV,
indications, and whether the benefits of the administration of ACV in pregnancy
outweigh the theoretical risks. Peak and trough plasma concentrations of ACV in
pregnant women seem to be lower as compared to those of non-pregnant adults but
effective. This drug crosses the placenta. Levels of ACV in cord blood ranged
from 0.5 to 3 mumol/l. In as much as in vitro inhibitory doses 50 (ID 50) for
HSV1, HSV2 and VZV ranged from 0.1 to 3 mumol/l, it is quite likely that levels
noted above may be effective for in utero inhibition of viral replication. No
adverse effects were noted in newborn exposed in utero to ACV. But one must be
careful about the direct effects of this drug on nucleic acid metabolism despite 
encouraging results on animal fetuses. Based on these findings and from our
experience, ACV can be administered in pregnancy in two particular situations: in
cases of maternal severe viral infections and in order to inhibit in utero VZV
replication. Doses required for pregnant women range from 5 to 15 mg/kg/8 hours
given intravenously, and 200 mg of oral Acyclovir 5 times daily.

Publication Types: 
    English Abstract
    Review

PMID: 2681370 [PubMed - indexed for MEDLINE]

6320: ORL J Otorhinolaryngol Relat Spec. 1989;51(4):251-4.

Ramsay-Hunt syndrome in a preschool infant.

Bjerkhoel A, Hyden D.

Department of Otolaryngology, Jonkoping Central Hospital, Sweden.

The Ramsay-Hunt syndrome affects mostly adults. The recovery of facial nerve
function, according to recent literature, seems better than has been generally
accepted. A small number of children with herpes zoster oticus have been
reported. We describe a case of Ramsay-Hunt syndrome in a healthy 3 1/2-year-old 
girl. She still had an obvious facial palsy after 12 months. Three out of 6
reported children with herpes zoster oticus have had a slow recovery of the
facial nerve function. This suggests a less favorable prognosis in children than 
in adults. Although not successful in this case, acyclovir should be tried early 
in the course of the disease.

Publication Types: 
    Case Reports
    Review

PMID: 2664634 [PubMed - indexed for MEDLINE]

6321: Ann Med Interne (Paris). 1989;140(1):14-8.

[2 cases of vascular syndrome of the cranial nerves of ischemic origin]

[Article in French]

Mrabet A, Jellouli M, Touibi S, Ben Hamida M.

Service de Neurologie, Institut National de Neurologie, Tunisie.

The authors report the cases of two patients who had sudden unilateral
alternating and regressive attacks of the cranial nerves. The first patient, a 63
year old diabetic woman, suffered regressive paralysis of the right third nerve, 
followed two months later by paresthesia of the same side of the face,
accompanied by difficulty in swallowing and dysarthria. Six months later, she
developed a right facial paralysis while pharyngeal and lingual involvement
entirely disappeared. Right carotid angiography revealed stenosis of the middle
meningeal artery. Nine months later she developed left-sided ophthalmoplegia
followed by a homolateral facial paralysis. The second patient, a 24 year old
woman, developed homolateral regressive attacks of the II, V, VII and VIIb, and
VIII nerves during recovery from herpes zoster of the right geniculate ganglion. 
Doppler studies showed inversion of the flow in the right ophthalmic artery. The 
pathogenesis of these multiple paralyses of the cranial nerves is discussed, a
possible cause being ischaemic attacks of the vascular territories of the cranial
nerves.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 2660650 [PubMed - indexed for MEDLINE]

6322: Graefes Arch Clin Exp Ophthalmol. 1989;227(2):118-22.

Topical BVDU plus low-dosage steroids in the treatment of chronic relapsing
zoster keratouveitis. A pilot study.

Ameye C, Sundmacher R, de Clercq E.

Universitats-Augenklinik, Dusseldorf, Federal Republic of Germany.

A therapeutic trial with topical bromovinyldeoxyuridine (BVDU) plus low-dosage
steroids was conducted in five patients with chronic zoster keratouveitis, who
had previously received topical acyclovir (ACV) and steroids. In all cases, BVDU 
(plus steroids) was found to be superior to ACV (plus steroids). Yet BVDU was not
able to keep the patients from having chronic relapsing varicella-zoster
keratouveitis. This can probably be explained by pathophysiological reasons,
i.e., the persistence and low-grade multiplication of the varicella-zoster virus 
in peripheral eye tissues during the chronic carrier stage. It is possible that
this chronic carrier status could be obviated by vigorous antiviral treatment
during the acute phase of the illness.

Publication Types: 
    Case Reports
    Clinical Trial

PMID: 2656415 [PubMed - indexed for MEDLINE]

6323: Clin Dermatol. 1989 Jan-Mar;7(1):49-55.

Consequences of varicella-zoster infection: advances in treatment and prevention.

Olney L, Meissner C.

Anna Jaques Hospital, Newburyport, Massachusetts.

Publication Types: 
    Review

PMID: 2647263 [PubMed - indexed for MEDLINE]

6324: Clin Dermatol. 1989 Jan-Mar;7(1):37-48.

Herpes zoster.

Blumberg EA, Molavi A.

Division of Infectious Disease, Hahnemann University School of Medicine,
Philadelphia, Pennsylvania.

Publication Types: 
    Review

PMID: 2647262 [PubMed - indexed for MEDLINE]

6325: Br J Ophthalmol. 1989 Jan;73(1):19-21.

Penetrating keratoplasty for corneal scarring due to herpes zoster ophthalmicus.

Soong HK, Schwartz AE, Meyer RF, Sugar A.

Department of Ophthalmology, WK Kellogg Eye Center, University of Michigan School
of Medicine, Ann Arbor 48105.

We retrospectively studied the postoperative results in nine patients with
corneal scarring due to herpes zoster ophthalmicus who underwent penetrating
keratoplasty. This was a highly selected group that satisfied all of the
following criteria: (a) absence of active disease of the ocular surface and
eyelids, (b) intraocular pressure under control, and (c) absence of active
keratouveitis. Penetrating keratoplasty after herpes zoster ophthalmicus may do
well in patients with long preoperative quiescent periods in whom these
restrictive preoperative criteria are observed.

PMID: 2645929 [PubMed - indexed for MEDLINE]

6326: Reg Anaesth. 1989 Jan;12(1):1-12.

[The single intercostal block--surgical and therapeutic indications]

[Article in German]

Niesel HC, Klimpel L, Kaiser H, al-Rafai S.

Anaesthesie-Abteilung, St. Marien, Ludwigshafen.

Since the first paravertebral blockade was carried out by Sellheim in 1905, this 
method has proved effective for the isolated blockade of spinal nerves. The
efficacy of preoperative intercostal blockade (ICB) in combination with
neuroleptanalgesia (NLA) or Pentothal-pentazocine-N2O anesthesia (Pe-Pz) was
studied (unilateral analgesia for cholecystectomy). Group 1: NLA; group 2: NLA
with ICB; group 3: Pe-Pz; group 4: Pe-Pz with ICB. The analgesic requirement
differed significantly between groups 1 (0.33 mg fentanyl) and 2 (0.15 mg
fentanyl) and groups 3 (63.5 mg pentazocine) and 4 (31.5 mg pentazocine). There
were also significant differences in circulatory responses. The maximum deviation
from the initial value at the beginning of the operation in group 1 compared to
group 2 was pulse rate + 28.7% vs + 2.4%, mean arterial pressure (Part) + 24.6%
vs + 3.1%, and systolic pressure (Psyst) + 33% vs +/- 0%; group 3 compared to
group 4: pulse rate + 16.4% vs + 3.2%, Part + 24.5% vs 0.0%, and Psyst + 26.5% vs
+ 196. The times of action of ICB extended from 7.54 h to 11.33 h for partial
analgeisa, time to the first dose of analgesic from 12.3 h to 16.9 h (etidocaine 
0.5% and 1% respectively without and with epinephrine). The mean blood levels
after 100 mg bupivacaine-CO2 rose to 1.16 micrograms/ml after 5 min and reached a
maximum after 15 min (1.29 micrograms/ml) as compared to 0.98 micrograms/ml after
addition of ornithine-vasopressin. These values are very much higher than those
after the use of bupivacaine-HCl solution. Etidocaine and bupivacaine-HCl have
comparable durations of analgesia. Toxicologically, both substances can be
applied safely with consideration of all pharmacological data for ICB. Of a total
of 3,485 intercostal blockades, 2,775 were applied perioperatively (pre- and
postoperatively); 265 were carried out for trauma patients (rib fractures) and
445 for therapeutic indications (herpes zoster neuralgia, tumor pain,
costovertebral pain). In 8 blocks 10% ammonium sulfate, in 4 blocks absolute
alcohol, and in 19 blocks 5% phenol were used for neurolysis. In 2 cases a
marginal pneumothorax was seen, which was resorbed spontaneously (0.06%).
Altogether 16,270 single intercostal nerves were blocked. Single-session
intercostal blockade can be combined as unilateral analgesia with general
anesthesia. This combination is characterized by stable circulatory conditions
with avoidance of hypertensive reactions. The long-lasting analgesia allows early
mobilization and physiotherapy both postoperatively and posttraumatically in
patients with unilateral thoracic and abdominal pain.(ABSTRACT TRUNCATED AT 400
WORDS)

Publication Types: 
    English Abstract
    Review

PMID: 2645621 [PubMed - indexed for MEDLINE]

6327: Clin Exp Dermatol. 1989 Jan;14(1):56-7.

Comment in:
    Clin Exp Dermatol. 1990 Mar;15(2):155-6.

Herpes zoster following spinal surgery.

Weiss R.

The onset of most cases of herpes zoster is usually sudden and unexpected. A
precipitating factor is seldom obvious. Depressed cellular immunity or an
underlying neoplasm are found in only a small number of patients. The
relationship between trauma and reactivation of the varicella-zoster virus is
uncertain and most of the published cases follow trivial external injury.

Publication Types: 
    Case Reports

PMID: 2641675 [PubMed - indexed for MEDLINE]

6328: CES Odontol. 1989;2(2):114-7.

[Stomatological atlas. Viral infection]

[Article in Spanish]

Pena JC.

PMID: 2638864 [PubMed - indexed for MEDLINE]

6329: Acta Otolaryngol Suppl. 1989;468:341-2.

Galvanic testing in neuro-otological diagnostics.

Skurczynski W, Ernst A.

ENT Department, Martin Luther University, Halle-Wittenberg, GDR.

From 1980 to 1986, a total of 436 patients were investigated by galvanic testing.
Pathological findings resulted in 45 (out of 54) patients with a suspect tumour
of the cerebellopontine angle (CPA), 7 (out of 7) patients with a Herpes zoster
infection, 25 (out of 32) patients with an isolated, unilateral loss of
vestibular function, 4 (out of 14) patients with head injuries. No pathological
results of galvanic testing were found in patients with sudden deafness,
Meniere's disease, vertebrobasilar or cerebrovascular insufficiency, etc.

PMID: 2635530 [PubMed - indexed for MEDLINE]

6330: Scand J Infect Dis. 1989;21(5):497-505.

Dermatitis of the face, yellow toe nail changes, hairy leukoplakia and oral
candidiasis are clinical indicators of progression to AIDS/opportunistic
infection in patients with HIV infection.

Morfeldt-Manson L, Julander I, Nilsson B.

Department of Infectious Diseases, Roslagstull Hospital, Stockholm, Sweden.

In a prospective longitudinal study of 89 men with HIV infection and persistent
generalized lymphadenopathy (PGL) we tried to find clinical signs predictive of
development to AIDS/opportunistic infection (OI). The mean observation time was
47 months. 27 patients (30%) developed AIDS/OI after a mean of 37 months. The
estimated median time from diagnosis of PGL to AIDS/OI was 68 months. Four
clinical signs of progression towards AIDS/OI were identified: dermatitis of the 
face, yellow toe nail changes, hairy leukoplakia and oral candidiasis. One or
more of these signs were recorded in 25/27 (93%) of the patients before the
development of AIDS/OI. The estimated median time from registration of each sign 
to AIDS/OI was: dermatitis of the face, 29 months; yellow toe nail changes, 21
months; hairy leukoplakia, 18 months; and oral candidiasis, 10 months. The
estimated median time from herpes zoster to AIDS was only slightly shorter than
the estimated time from diagnosis of PGL to AIDS/OI.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2587953 [PubMed - indexed for MEDLINE]

6331: Bull Soc Belge Ophtalmol. 1989;230:27-32.

[Uveitis of viral origin]

[Article in French]

Vadot E.

Most well-defined viral uveitis cases are due to herpes viruses. Thus, HSV and
VZV may cause a chronic anterior uveitis, usually with other characteristic
signs. Cytomegalovirus causes a necrotic and haemorrhagic retinitis in
immunosuppressed patients. Acute retinal necrosis also seems to be caused by
members of the herpes virus family. Many cases of intraocular inflammation have
been described in association with viral diseases, but this does not necessarily 
imply the presence of virus in the eye.

Publication Types: 
    English Abstract

PMID: 2562202 [PubMed - indexed for MEDLINE]

6332: Pediatrie. 1989;44(8):645-7.

[Zona in a 6-month-old infant. Apropos of one case]

[Article in French]

Loras-Duclaux I, Roy P, Lachaux A, Fournier V, Zerbib C, Hermier M.

Service d'hepatogastroenterologie infantile, pavillion S, hopital
Edouard-Herriot, Lyon, France.

The authors report an unusual case of zona in a 6-month-old infant whose mother
was affected by varicella on the fourth month of pregnancy. The course and
outcome were benign.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2560158 [PubMed - indexed for MEDLINE]

6333: Arch Virol. 1989;108(3-4):247-57.

Rapid identification and typing of herpes simplex virus by a new enzyme
immunoassay with peroxidase-labeled complement C1q.

Lee SM, Taguchi F.

Department of Microbiology, School of Hygienic Sciences, Kitasato University,
Kanagawa, Japan.

A new enzyme-linked immunoassay system (TC-ELISA) was developed for the rapid,
specific detection and typing of herpes simplex virus (HSV) using anti-HSV immune
sera and enzyme-labeled complement component C1q (P*-C1q). The method is based on
viral antigen produced in HSV-infected cells being detected by simultaneous
addition of immune serum and P*-C1q (ELISA-CF). With this assay, it was found
that HSV was detected with anti-HSV immune serum and P*-C1q and that HSV type 1
and HSV type 2 could be differentiated with anti-HSV-1 and anti-HSV-2 immune sera
and P*-C1q. The TC-ELISA test was HSV specific and not reactive with measles
virus, cytomegalovirus, mumps virus or varicella-zoster virus. The whole assay
procedure can be completed within 3 hours, as long as HSV-inoculated cell
cultures with more than 10% cytopathic effect are used. These results suggest
that TC-ELISA is useful in the diagnosis of viral infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2557809 [PubMed - indexed for MEDLINE]

6334: Allergy. 1989;44 Suppl 9:79-83.

Infections as contributing factors to atopic dermatitis.

Rystedt I, Strannegard IL, Strannegard O.

Dept. of Occupational Dermatology, National Board of Occupational Health,
Stockholm, Sweden.

Certain cutaneous viral infections, such as Herpes simplex, vaccinia and
varicella infections are known to occasionally run an usually severe course in
AD. Patients with AD display increased frequencies of recurrent cold sores and
Herpes zoster and they also have increased antibody titers to Epstein-Barr virus.
Heavy colonization of the skin with staphylococci and streptococci is common. The
findings of increased severity and/or frequencies of these infections in AD may
be explained by dysfunctional cell-mediated immunity and by cutaneous changes
associated with AD. There is suggestive, but not any firm evidence, that
infections play a causal role in the precipitation and exacerbation of AD.
Infections are thus, in most cases, probably consequences rather than causes of
the disease.

Publication Types: 
    Review

PMID: 2554744 [PubMed - indexed for MEDLINE]

6335: Med Microbiol Immunol. 1989;178(5):255-68.

Immunological diagnosis in viral infections of the central nervous system: course
of antibody titres against homo- and heterologous viruses.

Dennin RH, Herb E.

Institut fur Medizinische Mikrobiologie, Medizinische Universitat zu Lubeck,
Federal Republic of Germany.

In clinical cases suspected for viral encephalitis or meningoencephalitis, the
estimation of virus-specific antibodies especially in liquor requires high
sensitivity as well as specificity. With enzyme immunoassays the sensitivity in
detecting antibodies has increased compared to e.g., complement fixation tests.
This report concerns the determination of virus-specific antibodies with a
commercial enzyme-linked immunosorbent assay (ELISA) in paired liquor/serum
samples of four patients with encephalitis or meningoencephalitis. Up to six
virus-specific antibodies of the IgG and IgM classes have been determined [herpes
simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus, mumps virus, 
measles virus, and rubella virus]. Additionally, serum samples from several
patients suffering, or recovered from, diseases caused by HSV and VZV without CNS
involvement have been included as controls. The results showed that besides the
virus-specific antibody development (IgG and IgM) against the leading virus,
i.e., principally concerned in the disease manifestation assumed to be primarily 
causing the disease, virus-specific antibodies of the IgG and IgM class against a
heterologous virus (e.g., VZV) could also be measured with substantial titers.
"Cross-reacting" antibodies to both HSV and VZV with the ELISA only appeared and 
were present in cases where the infection mainly affected the CNS: no such
immunological "cross-reactivity" was observed in serum of individuals in
"clinically silent" stages of both HSV and VZV infections. The same situation
with no measurable "cross-reacting" antibodies was found in cases of acute HSV or
VZV diseases where the CNS was not involved. These findings have been discussed
with respect to the findings of common antigens, especially between HSV and VZV, 
and with respect to an unspecific stimulation of immunocompetent cells.

Publication Types: 
    Case Reports

PMID: 2550755 [PubMed - indexed for MEDLINE]

6336: Curr Probl Dermatol. 1989;18:137-51.

Herpesvirus infections in the immunocompromised host. Clinical spectrum,
diagnosis, management and prophylaxis.

Schuler G, Sepp N.

Department of Dermatology, University of Innsbruck, Austria.

Publication Types: 
    Review

PMID: 2545413 [PubMed - indexed for MEDLINE]

6337: Crit Rev Oncol Hematol. 1989;9(2):149-95.

Epstein-Barr virus: the hematologic and oncologic consequences of virus-host
interaction.

Giller RH, Grose C.

Department of Pediatrics, University of Iowa Hospitals, Iowa City.

Varicella-zoster virus (VZV) and Epstein-Barr virus (EBV) are two of the human
herpesviruses. The others include herpes simplex virus (HSV) type 1, HSV type 2, 
and cytomegalovirus (CMV). In a series of two articles, we review the clinical
diseases caused by VZV and EBV infections; we pay particular attention to the
manifestations of these two viral infections in immunosuppressed and
immunocompromised patients. In addition to the clinical reviews, each of the two 
articles begins with a brief discussion of the molecular aspects of VZV and EBV, 
respectively; this introduction describes features of the genome and immunogenic 
viral proteins which have clinical relevance. A model for pathogenesis is
included. The first review concerns VZV infections. Recent data about the DNA
sequence of the entire VZV genome are included, as well as a review of the VZV
glycoproteins. Primary VZV infection (chickenpox) and VZV reactivation (zoster)
are described in detail in both healthy individuals and people with cancer. The
decade-long VZV vaccine trials in children with leukemia receive special emphasis
because they have engendered considerable interest and debate. The second review 
(published here) covers EBV infections. This virus has been implicated in the
causation of a wide variety of human hematological and oncological disorders,
besides classical infectious mononucleosis. In particular, Burkitt's lymphoma,
nasopharyngeal carcinoma, and lymphoproliferative disorders are strongly
associated with EBV infection of the transformed cells. In addition,
immunologically mediated cytopenias occasionally follow EBV infection. Finally,
treatment regimens with antiviral chemotherapy and other agents are discussed for
both VZV and EBV infections.

Publication Types: 
    Review

PMID: 2545365 [PubMed - indexed for MEDLINE]

6338: Med Microbiol Immunol. 1989;178(2):61-7.

Comparative restriction endonuclease analysis of varicella-zoster virus clinical 
isolates.

Takayama M, Takayama N, Kameoka Y, Hachimori K, Kaneda K, Minamitani M.

National Institute of Health, Japan, Tokyo.

The DNAs of 67 isolates of varicella-zoster virus (VZV) obtained from 31
individuals were compared by restriction endonuclease analysis using BamHI,
EcoRI, PstI and SmaI. All of the epidemiologically unrelated 26 isolates could be
differentiated using SmaI and another one or two enzymes. However, the DNA
cleavage profiles of multiple VZV isolates from the same patient and the isolates
from a group of patients who were infected with VZV from the same source were
found to be identical to each other, as reported previously. No patients were
found who were simultaneously infected with different VZV strains. Moreover, VZV 
showed no change in DNA fragment profiles after serial passages not only through 
human embryonic lung cells but also through patients.

Publication Types: 
    Comparative Study

PMID: 2543893 [PubMed - indexed for MEDLINE]

6339: Eur Neurol. 1989;29(3):124-7.

Transient intrathecal IgG synthesis in herpes zoster myelitis: 2 case reports.

Ceroni M, Mazzarello P, Poloni M, Camana C, Maurelli M, Savoldi F.

Clinica Neurologica, Universita di Pavia, Italia.

Alterations in cerebrospinal fluid in 2 cases of viral myelopathy associated with
herpes zoster infection are reported. Viral myelopathy is a rare complication of 
herpes zoster. Quantitatively there was a slight increase in IgG production and
oligoclonal IgG bands were detected by isoelectric focusing. These parameters
returned to normal after 1 year suggesting a transient involvement of the central
nervous system.

Publication Types: 
    Case Reports

PMID: 2543579 [PubMed - indexed for MEDLINE]

6340: Zh Nevropatol Psikhiatr Im S S Korsakova. 1989;89(2):3-7.

[Pathogenesis of herpes zoster]

[Article in Russian]

Smirnov IuK, Shishov AS.

Long-term follow-up of 2000 patients with herpes zoster (HZ) in the department of
viral neuroinfections as well as special HZ studies provided evidence for
comprehensive evaluation of HZ pathogenesis. In addition to peripheral nervous
system involvement, HZ is shown to cause systemic disorders typical for
neuroviral infections. The principles of adequate pathogenetic therapy are
validated. It is believed that relevant pathogenetic studies contribute to the
development of general pathology.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2543167 [PubMed - indexed for MEDLINE]

6341: Int Ophthalmol Clin. 1989 Summer;29(2):98-104.

External ocular disease and anterior segment disorders associated with AIDS.

Shuler JD, Engstrom RE Jr, Holland GN.

AIDS Unit, UCLA Uveitis Center.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 2541098 [PubMed - indexed for MEDLINE]

6342: Int Ophthalmol Clin. 1989 Summer;29(2):108-18.

Infections of the retina in AIDS.

Culbertson WW.

Bascom Palmer Eye Institute, Miami, FL 33101.

Publication Types: 
    Review

PMID: 2541096 [PubMed - indexed for MEDLINE]

6343: Klin Monatsbl Augenheilkd. 1989 Jan;194(1):52-8.

[Acute necrotizing retinitis following varicella zoster virus infection]

[Article in German]

Zierhut M, Thiel HJ, Weidle EG, Vallbracht A.

Universitat-Augenklinik Tubingen.

As far as we know today, acute retinal necrosis is caused by infection with a
virus of the herpes group. Reports are occasionally published of retinitis
developing before or after herpes zoster dermatitis. The present paper reports
the case of a patient who developed a retinitis of the right eye five years after
a herpes zoster infection of the ophthalmic nerve. Studies and treatment of VZV
retinitis and retinitis before or after zoster retinitis reported in the
literature are summarized. The possible mechanisms of generalization (neurogenic 
or hematogenous) are analyzed.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 2540379 [PubMed - indexed for MEDLINE]

6344: J Virol Methods. 1989 Jan;23(1):13-8.

Rapid diagnosis of varicella-zoster virus infection with a monoclonal antibody
based direct immunofluorescence technique.

Rawlinson WD, Dwyer DE, Gibbons VL, Cunningham AL.

Department of Infectious Diseases and Microbiology, Westmead Hospital, Australia.

Diagnosis of varicella-zoster virus (VZV) infection in immunocompromised patients
is difficult because of the frequent atypical appearance. Accurate and early
diagnosis is important to allow rapid commencement of antiviral chemotherapy,
with consequent improvement in antiviral efficacy. A monoclonal based direct
immunofluorescence antibody technique (VZV IFA) was assessed in parallel with
viral culture in 56 patients with suspected VZV infection. A subgroup of 17
patients from this group with classical dermatomal herpes zoster all had positive
VZV IFA tests. Only 6 patients (35%) were positive on viral culture. None of the 
15 patients with proven herpes simplex virus infection had a positive VZV IFA,
nor did any patient with positive VZV viral culture have a negative VZV IFA. The 
VZV IFA test is a rapid and sensitive technique for detecting infection with VZV.

PMID: 2536379 [PubMed - indexed for MEDLINE]

6345: J Virol. 1989 Jan;63(1):450-5.

Identification of new protein kinase-related genes in three herpesviruses, herpes
simplex virus, varicella-zoster virus, and Epstein-Barr virus.

Smith RF, Smith TF.

Molecular Biology Computer Research Resource, Dana-Farber Cancer Institute,
Boston, Massachusetts.

By using amino acid sequence patterns (motifs) diagnostic of conserved regions
within the catalytic domains of protein kinases, homologous open reading frames
of three herpesviruses were identified as protein kinase-related genes. The three
sequences, herpes simplex virus gene UL13, varicella-zoster virus gene 47, and
Epstein-Barr virus gene BGLF4, resemble serine/threonine kinases rather than
tyrosine kinases.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2535748 [PubMed - indexed for MEDLINE]

6346: Rinsho Ketsueki. 1989 Jan;30(1):89-93.

[Primary macroglobulinemia with severe neutropenia, leading to a rapid
development of septic shock]

[Article in Japanese]

Umeki S, Shibayama T, Izumi K, Sezaki T.

A 88-year-old man was admitted because of the left chest pain due to herpes
zoster for 1 week. Blood analyses and immunoelectrophoresis revealed anemia,
severe neutropenia, rouleaux formation and IgM, lambda-type monoclonal
gammopathy. The HE staining and peroxidase-anti-peroxidase staining of biopsy
specimens of the cervical lymph node swelling appeared from the fifth hospital
day, revealed an increase in atypical lymphocytes bearing IgM, lambda-type
immunoglobulin. Then a diagnosis of primary macroglobulinemia was made. Although 
the patient's clinical findings transiently improved after chemotherapy with
prednisolone and vindesine, he died of a septic shock which appeared after
klebsiella pneumonia and sepsis. We reported an unusual case of primary
macroglobulinemia with severe neutropenia, leading to a rapid development of
septic shock after the chemotherapy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2497264 [PubMed - indexed for MEDLINE]

6347: J Acquir Immune Defic Syndr. 1989;2(2):125-8.

Beta-interferon and early stage HIV infection.

Oka S, Hirabayashi Y, Mouri H, Sakurada S, Goto H, Ohnishi K, Kimura S, Mitamura 
K, Shimada K.

Department of Infectious Diseases, University of Tokyo, Japan.

beta-Interferon (IFN-beta) was evaluated prospectively for its antiviral
activities in early stage human immunodeficiency virus (HIV) infection. Ten
patients with hemophilia and HIV infection [8 asymptomatic carriers (AC) and 2
AIDS-related complex (ARC)] were intravenously injected with 1 million IU of
IFN-beta twice a week for 6 months. For comparison, seven patients (six AC and
one ARC) with hemophilia and HIV infection were observed for the same time period
without any drugs. One episode of localized herpes zoster each occurred during
the trial in the IFN group and in the control group. There were no significant
differences in the absolute number of CD4+ lymphocytes and ratios of CD4+/CD8+
lymphocytes between the two groups. Recipients had flu-like symptoms but no
serious toxicities. No clinical and immunological benefits to patients with early
stage HIV infection were observed during the 6 months of treatment.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2495347 [PubMed - indexed for MEDLINE]

6348: AIDS Care. 1989;1(3):319-25.

Clinical care as part of integrated AIDS management in a Zambian rural community.

Chela CM, Campbell ID, Siankanga Z.

Salvation Army, Chikankata Hospital, Mazabuka, Zambia.

Inpatient and community-based care can be complementary in relation to the
management of HIV disease. Some special features and advantages of
community-based care are described, drawing on experience from Zambia.

PIP: Inpatient and community-based care can be complementary in relation to the
management of HIV disease. Medical records from 200 inpatients of Chikankata
Hospital near Lusaka, Zambia and 200 home based patients were examined and
compared for the common symptoms of presentation of HIV disease, associated
opportunistic infections, and treatment protocols. Drug costs of both groups were
also compared. The most common respiratory symptoms in the 2 groups are cough,
chest pains, weight loss, and hemoptysis. Treatment employed for these symptoms
were cortimoxazole, penicillin V, erthromycin, and tetracycline. Acetyl saliclic 
acid and paracetamol were used for pain relief in both groups. Gastointestinal
system symptoms for both groups were diarrhea, weight loss, abdominal pain, and
vomiting. Cotrimoxazole and metronidazole were used in treating diarrhea.
Additional treatment protocol for the 2 patient samples included oral rehydration
therapy for dehydration, antacid or bismuth subsalicylate for diarrhea and
enteritis, and mycostatin for oral candidiasis. Central nervous system
symptomatology included headache, dementia, neckace, and lethargy.
Chloramphenicol was employed in treating bacterial meningitis. Diazepam and
chlorpromazine were effective for restless patients. Genito-urinary system
symptomatology for the 2 groups included dysuria, genital ulcers, hematuria,
viral warts, and buboes. Antibodies were used for sexually transmitted diseases
and infections. Skin symptomatology included rash and dermatitis, herpes zoster, 
abscess, kaposi's sarcoma, ulcers, furunculosis, and discharging anal sinus. In
treating these symptoms, hospital based care and home based care were similar.
Overall, it was found that hospital treatment protocols were detailed, expensive,
and time consuming. Furthermore, hospital treatment for HIV positive patients is 
more expensive than HIV negative patients; hospital costs for 50 HIV negative
patients totaled US$415.94 compared to US$1204.98 HIV positive/PTB negative
patients and US$1705.62 for HIV positive/PTB positive patients. Drug cost/patient
admission is increased by 469% if HIV positive. (author's modified).

PMID: 2488294 [PubMed - indexed for MEDLINE]

6349: Bol Asoc Med P R. 1989 Jan;81(1):24-5.

The syndrome of cerebral infarction following herpes zoster ophthalmicus.

Joy JL, Colon HF, Velez-Borras JR.

Delayed contralateral hemiparesis following herpes zoster (HZ) ophthalmicus is an
unusual but distinct clinical entity, presumably caused by HZ-induced arteritis
with subsequent cerebral infarction. We report a case showing typical clinical
and angiographic findings.

Publication Types: 
    Case Reports

PMID: 2486902 [PubMed - indexed for MEDLINE]

6350: Ter Arkh. 1989;61(11):147-9.

[Modern therapy of herpes zoster]

[Article in Russian]

Turkot LA, Savchak VI, Andreichin MA.

Publication Types: 
    Review

PMID: 2483761 [PubMed - indexed for MEDLINE]

6351: Scand J Infect Dis. 1989;21(1):15-8.

Isoprinosine does not influence the natural history of herpes zoster or
postherpetic neuralgia.

Payne CM, Menday AP, Rogers T, Staughton RC.

Westminster Hospital, Charing Cross & Westminster Medical School, University of
London, Great Britain.

In a double-blind randomised trial, 38 elderly patients with acute herpes zoster 
received either isoprinosine (IP) or placebo. IP neither shortened the acute
phase of herpes zoster nor prevented postherpetic neuralgia. Transient
asymptomatic hyperuricaemia affected one third of IP treated patients.
Shortcomings in study design and misleading interpretation of results are common 
in previously published clinical trials of herpes zoster and postherpetic
neuralgia. Guidelines for future studies are proposed.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 2471260 [PubMed - indexed for MEDLINE]

6352: Wien Med Wochenschr. 1988 Dec 31;138(23-24):604-11.

[Virus diseases of the nervous system in selected patients at a neurologic
specialty unit during a 9-year period]

[Article in German]

Oder W, Scholz H, Barolin GS.

Neurologische Universitatsklinik, Wien.

During a 9-year period an unselected population of 377 patients with clinically
suspected viral diseases of the nervous system were hospitalized. Due to the
serological findings a definite viral etiology could be established in 123 (33%).
With respect to clinical syndromes serological evidence of viral etiology was
found in 74% of mono- respectively oligoneuritides, 43% of meningoencephalitides,
whereas in polyneuritis only in 18%. Concerning different virus strains varicella
zoster virus appears to be largely ahead (65 cases), then come the enterovirus
and herpes simplex virus. Clinical features are presented, some exceptional
features are discussed. As regards severity of clinical symptoms and course
nearly all patients made a good recovery. Only 2 patients died due to
complications of the viral infection. In some cases it seems worth noting the
association of another virus to a well determined etiology, this occurring
simultaneously.

Publication Types: 
    English Abstract

PMID: 3222963 [PubMed - indexed for MEDLINE]

6353: BMJ. 1988 Dec 24-31;297(6664):1636.

Erosive pustular dermatosis of the scalp presenting as herpes zoster.

Shall L, Shuttleworth D.

Department of Dermatology, University Hospital of Wales, Cardiff.

PMID: 3147771 [PubMed - indexed for MEDLINE]

6354: Am J Ophthalmol. 1988 Dec 15;106(6):758-9.

Successful treatment of postherpetic neuralgia with capsaicin.

Bucci FA Jr, Gabriels CF, Krohel GB.

Department of Ophthalmology, Albany Medical College.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3264116 [PubMed - indexed for MEDLINE]

6355: Schweiz Med Wochenschr. 1988 Dec 10;118(49):1830-7.

[Antiviral drugs--1988]

[Article in German]

Hirschel B.

Division des maladies infectieuses, Hopital cantonal universitaire, Geneve.

Acyclovir (Zovirax) and zidovudine (Retrovir) dominate antiviral therapy. They
interfere with the multiplication of herpes viruses (acyclovir) and HIV
(zidovudine) by incorporation into nascent DNA chains and interruption of the
further linking of nucleotides. All types of infection caused by herpes simplex
virus are potentially treatable by acyclovir, but treatment has to start to be
effective. It is especially important to treat immunosuppressed patients because 
their infections are more prolonged and severe. A typical attack of herpes zoster
in an immunocompetent patient is shortened by about 2 days if high doses of
acyclovir are given within 3 days of the start of the skin lesions, but
unfortunately the incidence of post-herpetic neuralgia is not diminished.
Zidovudine lowers early mortality in patients with AIDS and pneumocystis carinii 
pneumonia. However, much of the effectiveness of zidovudine is lost later; the
average prolongation of life in treated patients is estimated to be about 1 year.
Some two thirds of patients with AIDS can be treated with zidovudine; in the
others the drug is ineffective (Kaposi's sarcoma) or contraindicated. Frequent
blood counts are necessary to monitor myelotoxicity.

Publication Types: 
    English Abstract
    Review

PMID: 2851167 [PubMed - indexed for MEDLINE]

6356: Nucleic Acids Res. 1988 Dec 9;16(23):11005-25.

The regions of the herpes simplex virus type 1 immediate early protein Vmw175
required for site specific DNA binding closely correspond to those involved in
transcriptional regulation.

Paterson T, Everett RD.

MRC Virology Unit, Institute of Virology, Glasgow, UK.

The immediate-early (IE) protein Vmw175 (ICP4) of HSV-1 is required for the
transcription of later classes of viral genes and the repression of IE gene
expression. We have previously constructed a panel of plasmid-borne insertion and
deletion mutants of the gene encoding Vmw175 and assayed their ability to
regulate transcription in transient transfection assays. By this approach we have
mapped the regions of the Vmw175 amino acid sequence that are required for
transcriptional activation and repression of herpes virus promoters. This paper
describes the use of nuclear extracts, made from cells transfected with these
mutant plasmids, in gel retardation DNA binding assays in order to define the
regions of Vmw175 involved in binding to a specific Vmw175 DNA binding site. The 
results show that amino acid residues 275-495 (a region which is highly conserved
between Vmw175 and the varicella-zoster virus "IE" 140K protein) include
structures which are critically required for specific DNA binding,
transactivation and repression. This raises the interesting paradox that although
the specific DNA sequence recognized by Vmw175 is not commonly found in its
target promoters, the protein domain required for recognition of this sequence is
required for promoter activation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2849757 [PubMed - indexed for MEDLINE]

6357: AIDS Action. 1988 Dec;(5):5.

Uganda: paediatric AIDS.

Ndugwa CM, Friesen H.

PIP: The occurrence of reported cases of AIDS in children in Uganda, and the most
common symptoms are discussed. By May 1988, 359 cases of AIDS in children has
been reported. All but 12 were in babies less than 2 years of age, suggesting
that maternal transmission, rather than casual contact, had caused the infection.
Information was available on HIV status of 224 mothers. 42% of these had AIDS or 
ARC (AIDS related complex). 85 of 87 mothers whose sera had been tested were
positive for HIV. Blood testing is not accurate in children until about 15 months
of age, since maternal antibodies persist after birth. The most common symptoms
seen in childhood AIDS in Uganda are weight loss, failure to thrive, chronic
diarrhea, and repeated, chronic oral thrush (candidiasis). Other indicators are
otitis media, generalized dermatitis, tuberculosis, septicemia and meningitis.
Less common signs are shingles, Kaposi's sarcoma and Cryptospor meningitis. Some 
of these clinical findings are common in this area, so it is important to define 
a working clinical case definition of pediatric AIDS.

PMID: 12281632 [PubMed - indexed for MEDLINE]

6358: Ophthalmology. 1988 Dec;95(12):1663-72.

Acute multifocal hemorrhagic retinal vasculitis.

Blumenkranz MS, Kaplan HJ, Clarkson JG, Culbertson WW, Williams GA, Kleiner RC,
Meissner RH.

William Beaumont Hospital, Royal Oak, MI 48072.

The authors present a series of seven patients with acute visual loss associated 
with mild anterior uveitis, multifocal retinal vasculitis, retinal capillary
nonperfusion, retinal hemorrhage, disc swelling, and vitreitis. Oral prednisone
was of some benefit in these patients and oral acyclovir was generally
ineffective. Neovascular complications including retinal, disc, choroidal, and
iris new vessels were common, requiring photocoagulation in five patients.
Horseshoe tears developed in two patients in zones of uninvolved retina but
retinal detachment did not occur. The etiology remains unknown, although it may
represent either a localized ocular form of Behcet's disease or other systemic
syndrome, infection with a herpes group virus other than zoster varicella virus, 
or a manifestation of an undefined infectious agent.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3266000 [PubMed - indexed for MEDLINE]

6359: Can J Ophthalmol. 1988 Dec;23(7):311-4.

Infectious crystalline keratopathy.

Zabel RW, Mintsioulis G, MacDonald I, Tuft S.

Department of Ophthalmology, Ottawa Civic Hospital, Ont.

Crystalline deposits developed in the anterior third of the stroma in a
60-year-old woman. The deposits resolved only after aggressive treatment with
intravenously given penicillin and topical erythromycin and vancomycin
hydrochloride. Review of reported cases indicated that infectious crystalline
keratopathy is caused by chronic colonization of the stroma by bacteria, usually 
streptococci of the viridans group. Local tissue trauma, concomitant use of
topical corticosteroids, an intact overlying epithelium and use of a bandage-type
soft contact lens are factors in the development of the infection. Patients with 
crystalline formations in this setting should undergo early lamellar biopsy for
histologic examination, culture and sensitivity testing, followed by aggressive
therapy with appropriate antibiotics.

Publication Types: 
    Case Reports

PMID: 3265890 [PubMed - indexed for MEDLINE]

6360: Ann Ophthalmol. 1988 Dec;20(12):480-2.

Use of intravenous acyclovir for treatment of herpes zoster ophthalmicus in
patients at risk for AIDS.

Seiff SR, Margolis T, Graham SH, O'Donnell JJ.

Department of Ophthalmology, San Francisco General Hospital, California.

Patients who are homosexual, intravenous drug abusers, or have received multiple 
blood transfusions are at greater risk to contract the immunosuppressive
disorders of acquired immunodeficiency syndrome (AIDS) and AIDS-related complex
(ARC). These persons also have a greater chance of developing serious neurologic 
complications after an episode of Herpes zoster. We present two cases which
emphasize the serious complications of Herpes zoster ophthalmicus in such
patients. Since systemically administered acyclovir may shorten the disease
course and reduce the complications of Herpes zoster in immunocompromised
individuals, the authors favor treatment of all such patients who have Herpes
zoster ophthalmicus with a seven-day course of high-dose (30 mg/kg/day)
intravenous acyclovir. To minimize serious neurologic complications in such
patients, treatment should be instituted immediately before the results of human 
immunodeficiency virus (HIV) testing are known.

Publication Types: 
    Case Reports

PMID: 3265292 [PubMed - indexed for MEDLINE]

6361: Am J Med. 1988 Dec;85(6):885-6.

Successful combination therapy with acyclovir and vidarabine for disseminated
varicella zoster virus infection with retinal involvement in a patient with
B-cell lymphoma and adult T-cell leukemia.

Moriyama K, Asano Y, Fujimoto K, Okamura T, Shibuya T, Harada M, Niho Y.

First Department of Internal Medicine, Faculty of Medicine, Kyushu University,
Fukuoka, Japan.

Publication Types: 
    Case Reports

PMID: 3264113 [PubMed - indexed for MEDLINE]

6362: Cutis. 1988 Dec;42(6):523-4.

Herpes zoster and facial palsy.

Feldman SR, Ford MJ, Briggaman RA.

Department of Dermatology, North Carolina Memorial Hospital, University of North 
Carolina, Chapel Hill 27514.

A case of facial palsy associated with herpes zoster is presented. A good
response was obtained using treatment with acyclovir and prednisone.

Publication Types: 
    Case Reports

PMID: 3229142 [PubMed - indexed for MEDLINE]

6363: J Neuroimmunol. 1988 Dec;20(2-3):253-7.

Encephalomyelitis and demyelinating diseases in patients with extracerebral
malignant tumors.

Peiffer J.

Institute of Brain Research, University of Tubingen, F.R.G.

We examined central nervous system (CNS) lesions in 456 patients with primary
extracerebral malignant tumors. Inflammatory reactions caused by viral
(progressive multifocal leukoencephalopathy (PML), herpes zoster varicella),
fungal, or bacterial infections could be demonstrated in 20 patients. In a
further 19 patients, the brain tissue showed lymphocyte infiltrates of unknown
etiology and, in four of these, autopsy revealed probable paraneoplastic,
non-bacterial, endocarditis as a possible explanation for the local inflammatory 
reaction. The frequency of thrombophlebitis, non-arteriosclerotic thrombosis and 
arteritis was significantly higher than in a control group of 2052 tumor-free
patients. Focal spongiform-axonopathic lesions (24 cases) as well as diffuse
leukoencephalopathy (11 cases) were interpreted as probably being at least in
part paraneoplastic because the same alterations could also be observed in
patients who had never undergone cytostatic or radiation therapy. The possible
pathogenetic conditions are discussed and a classification of these
tumor-accompanying, but not always tumor-dependent, lesions suggested.

PMID: 3198751 [PubMed - indexed for MEDLINE]

6364: Antimicrob Agents Chemother. 1988 Dec;32(12):1807-12.

Pharmacokinetics and antiviral activity in simian varicella virus-infected
monkeys of (R,S)-9-[4-hydroxy-2-(hydroxymethyl) butyl]guanine, an
anti-varicella-zoster virus drug.

Lake-Bakaar DM, Abele G, Lindborg B, Soike KF, Datema R.

Department of Antiviral Therapy, Research and Development, Astra Alab AB,
Sodertalje, Sweden.

The acyclic guanosine analog (R,S)-9-[4-hydroxy-2-(hydroxymethyl)butyl]guanine,
(+/-)2HM-HBG, is an effective inhibitor of herpes simplex virus and
varicella-zoster virus infections in vitro. This report is concerned with the
pharmacokinetic evaluation of the drug in rats and monkeys and its antiviral
activity in African green monkeys infected with simian varicella virus (SVV), a
virus closely related to varicella-zoster virus that is also susceptible to
inhibition by (+/-)2HM-HBG. Elimination half-lives in plasma following
intravenous administration to monkeys (100 mumol/kg of body weight) ranged from
1.8 to 2.2 h, and total body clearance was 9.0 +/- 0.4 ml/min per kg (mean +/-
standard error). After oral administration, levels in plasma were low, with a
maximum concentration of the drug of only 3.1 +/- 0.8 microM, a time to reach
maximum concentration of drug of 2.7 +/- 0.4 h, and an oral bioavailability of
10.6 +/- 1.4%. Because of the low oral bioavailability, SVV-infected monkeys were
treated intramuscularly with (+/-)2HM-HBG. (+/-)2HM-HBG at a dosage of 10 mg/kg
of body weight per day allowed moderate viremia, whereas a dosage of 30 mg/kg of 
body weight per day strongly suppressed viremia with minimal numbers of virus
plaques from blood specimens collected at days 3, 5, and 7 postinfection and
complete clearance at day 9 postinfection. Titers of antibody to SVV were also
low. Treatment three times daily was somewhat more efficacious than treatment
twice daily. Thus, (+/-)2HM-HBG is an effective inhibitor of SVV replication in
vivo, despite the fact that leves of (+/-)2HM-HBG in plasma were low at extended 
periods of time and below the concentration of drug giving 50% inhibition of
plaque formation obtained in vitro.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2854453 [PubMed - indexed for MEDLINE]

6365: Z Gesamte Inn Med. 1988 Dec 1;43(23):677-80.

[5-(2-bromovinyl)-2'-deoxyuridine therapy of herpes zoster diseases in patients
with malignant primary diseases]

[Article in German]

Wutzler P, Wutke K, Barwolff D, Reefschlager J.

Institut fur Medizinische Mikrobiologie, der Medizinischen Akademie Erfurt, DDR.

BVDU [(E)-5-(2-bromovinyl)-2'-deoxyuridine] has proved effective in the treatment
of varicella-zoster virus diseases in patients with malignancies. In 13 out of 20
patients a prompt cessation of new vesicle formation accompanied by rapid
resolution of fever, crusting and complete epithelialisation of cutaneous lesions
were noted. Only in few cases a prolonged recovery from the severe zoster
occurred. When starting the treatment later than 48 hours after the onset of
initial rash the dissemination of epithelial lesions could not be prevented. BVDU
was well tolerated. Laboratory abnormalities were observed only in some cases and
did not result in interruption of treatment.

Publication Types: 
    English Abstract

PMID: 2854331 [PubMed - indexed for MEDLINE]

6366: Ophthalmic Surg. 1988 Dec;19(12):876-84.

Management of viral retinitis.

Schulman JA, Peyman GA.

Department of Ophthalmology, Louisiana State University Medical Center,
Shreveport.

Cytomegalovirus, herpes simplex, and herpes zoster are responsible for the
majority of cases of viral retinitis. Herpes zoster also has been strongly
incriminated as a causal agent in acute retinal necrosis. Effective chemotherapy 
exists for retinitis caused by herpes simplex and herpes zoster, along with acute
retinal necrosis. Conventional antiviral therapy and immunomodulators are
ineffective in the treatment of cytomegalovirus retinitis in patients with
acquired immune deficiency disorder. Ganciclovir, a new antiviral agent, has
significantly reduced visual morbidity in these patients. Recurrence of the
infection is not uncommon while patients are on the drug or when the agent is
discontinued, because ganciclovir is virostatic and does not stop viral
replication in the retina. The inability to control this viral retinitis using
presently available chemotherapy indicates a need to examine other therapeutic
modalities.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2852786 [PubMed - indexed for MEDLINE]

6367: Antiviral Res. 1988 Dec 1;10(4-5):235-51.

Broad-spectrum antiviral activity of the acyclic guanosine phosphonate
(R,S)-HPMPG.

Terry BJ, Mazina KE, Tuomari AV, Haffey ML, Hagen M, Feldman A, Slusarchyk WA,
Young MG, Zahler R, Field AK.

Microbial Biochemistry, Squibb Institute for Medical Research, Princeton, New
Jersey 08540.

(R,S)-9-(3-hydroxy-2-phosphonomethoxypropyl)guanine [(R,S)-HPMPG] exhibits broad 
spectrum antiviral activity with an ED50 of less than 1 microM against herpes
simplex virus (HSV) types 1 and 2, varicella zoster virus, human cytomegalovirus 
(HCMV) and vaccinia in plaque reduction assays. Wild type HSV-2 and its thymidine
kinase deficient variant are equally sensitive to (R,S)-HPMPG. (R,S)-HPMPG is
100-fold more potent than acyclovir (ED50 = 0.45 microM vs. 44 microM,
respectively) against HCMV in cell culture, and 10-fold more active than
acyclovir in extending survival time in mice intraperitoneally infected with 70
LD50 HSV-1. However, (R,S)-HPMPG is toxic when administered repeatedly at 44
mg/kg/day in uninfected adult mice. The diphosphoryl derivative of HPMPG was
enzymatically synthesized and is a competitive inhibitor of HSV-1 DNA polymerase 
relative to dGTP (K1 = 0.03 microM). HPMPG-PP is 70-fold less active at
inhibiting HeLa DNA polymerase alpha than HSV-1 DNA polymerase. At concentrations
between 0.3 and 1.5 microM (R,S)-HPMPG inhibited HSV-1 DNA replication greater
than or equal to 50% in infected cells as measured by nucleic acid hybridization.
Consistent with inhibition of viral DNA synthesis, 6 to 30 microM (R,S)-HPMPG
reduces late viral polypeptide synthesis in HSV-1 infected cells. These data
indicate that (R,S)-HPMPG is a thymidine kinase independent broad spectrum
antiviral drug which is capable of inhibiting viral DNA polymerase.

Publication Types: 
    Comparative Study

PMID: 2852486 [PubMed - indexed for MEDLINE]

6368: Pain. 1988 Dec;35(3):368-9.

King and Robert, concerning the management of pain associated with herpes zoster 
and of postherpetic neuralgia.

Kassirer MR.

Publication Types: 
    Case Reports
    Letter

PMID: 2852345 [PubMed - indexed for MEDLINE]

6369: J Virol Methods. 1988 Dec;22(2-3):255-71.

The use of colloidal gold immunoelectron microscopy to diagnose varicella-zoster 
virus (VZV) infections by rapid discrimination between VZV, HSV-1 and HSV-2.

Vreeswijk J, Folkers E, Wagenaar F, Kapsenberg JG.

Central Veterinary Institute, Department of Virology, Lelystad, The Netherlands.

Colloidal gold immunoelectron microscopy was used to diagnose rapidly 53 cases
clinically suspected of varicella-zoster virus (VZV) infection and one special
case selected from another study on typical herpes simplex virus (HSV)
infections. The viruses were identified and subsequently typed within 2.5 h by a 
direct labelling test for VZV, and within 3.5 h by an indirect labelling test
with monoclonal antibodies against HSV type 1 and type 2. The protein A purified 
IgG fraction of human anti-VZV immunoglobulins was adsorbed to colloidal gold
particles, and the specificity of the gold-labelled antibodies was tested with
several human and animal herpesviruses. Viral envelopes did not crossreact in the
direct labelling test. However, an indirect labelling procedure revealed that a
small fraction of the anti-VZV antibodies crossreacted with the cores of herpes
simplex virus and pseudorabies virus (Aujeszky disease virus). Virus-infected
cellular material taken from typical herpetic lesions was used directly without
virus propagation for virus typing. All cases (N = 54) were analyzed without
knowing the clinical description of the results of cytopathologic examination
(Tzanck smear) and viral culture. Forty-four cases were identified as VZV;
however, 5 of the supposed VZV infections were proved to be HSV infections.
Although the viral culture of the one HSV case was HSV- and VZV-negative,
colloidal gold labelling identified the case as VZV infection. In 16 cases virus 
immunoglobulin complexes were detected by using gold-tagged antibodies against
human immunoglobulins. Immunoglobulins on the viral envelopes did not interfere
with virus typing by immunogold labelling.

Publication Types: 
    Comparative Study

PMID: 2851604 [PubMed - indexed for MEDLINE]

6370: Proc Natl Acad Sci U S A. 1988 Dec;85(24):9773-7.

Patterns of gene expression and sites of latency in human nerve ganglia are
different for varicella-zoster and herpes simplex viruses.

Croen KD, Ostrove JM, Dragovic LJ, Straus SE.

Medical Virology Section, National Institutes of Allergy and Infectious Diseases,
Bethesda, MD 20892.

The cellular localization and viral transcription patterns of acute and latent
varicella-zoster virus (VZV) infections of human sensory nerve ganglia were
studied by in situ hybridization and compared with those of latent herpes simplex
virus (HSV) infection. Trigeminal and dorsal root ganglia obtained at autopsy
were hybridized with 35S-labeled single-stranded RNA probes homologous to VZV or 
HSV fragments. We have reported that HSV persists in human sensory neurons and
expresses only one family of transcripts that overlap extensively with, but are
opposite in polarity to, the mRNA encoding the immediate early protein termed
infected cell protein 0 (ICP0). In the present study we find that latent VZV
infection involves nonneuronal cells, and multiple, but not all, VZV genes are
transcribed. In contrast, during varicella both neuronal and nonneuronal cells
are infected, with all regions of the VZV genome analyzed being expressed. Thus, 
the patterns of gene expression and cellular locations of VZV and HSV infections 
of human ganglia differ. The differences may underlie clinical features that
distinguish these infections.

PMID: 2849116 [PubMed - indexed for MEDLINE]

6371: Clin Immunol Immunopathol. 1988 Dec;49(3):341-8.

IgG subclass distribution of antiviral antibodies in common variable
immunodeficiency: effect of substitution therapy.

Linde A, Hammarstrom L, Smith CI.

Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.

Immunoglobulin G subclass titers to three herpesviruses (herpes simplex; HSV;
cytomegalovirus, CMV; varicella zoster virus, VZV) were examined in patients with
common variable immunodeficiency (CVI) before and after immunoglobulin
substitution. Like healthy controls, CVI patients expressed IgG1 and IgG3 to HSV 
and CMV, but only IgG1 to VZV. Individual titers varied as in healthy
individuals, but as a mean, specific IgG titers were lowered in proportion to the
decrease of total IgG. HSV and CMV IgG3 titers were relatively higher than the
IgG1 titers in CVI patients, resulting in a lower IgG1/IgG3 ratio than in healthy
individuals (P = 0.025 and 0.05, respectively). The high IgG3 titers in CVI
patients could be due to subclinical reactivations of HSV and CMV in these
patients. Low VZV IgG1 and absence of IgG3 could explain the increased frequency 
of zoster infections reported in CVI patients. After immunoglobulin substitution,
herpesvirus-specific IgG1 titers increased while HSV and CMV IgG3 decreased or
remained stationary. In two unsubstituted patients, HSV and CMV titers remained
stationary during 1 and 5 years, respectively, while an increase of VZV IgG1 and 
IgG3 indicated VZV reactivation although the patients remained asymptomatic.

PMID: 2847890 [PubMed - indexed for MEDLINE]

6372: Drug Ther Bull. 1988 Nov 28;26(24):93-4.

Erratum in:
    Drug Ther Bull 1989 Jan 9;27(1):4.

Oral acyclovir for herpes zoster.

[No authors listed]

Publication Types: 
    Review

PMID: 3060343 [PubMed - indexed for MEDLINE]

6373: JAMA. 1988 Nov 18;260(19):2879-82.

Continuous varicella-zoster infection associated with acyclovir resistance in a
child with AIDS.

Pahwa S, Biron K, Lim W, Swenson P, Kaplan MH, Sadick N, Pahwa R.

Department of Pediatrics, North Shore University Hospital, Manhasset, NY 11030.

Acyclovir has become the treatment of choice for varicella-zoster virus (VZV)
infections in immunocompromised individuals. This article describes a 4-year-old 
girl congenitally infected with human immunodeficiency virus who developed a
continuous cutaneous infection with VZV that persisted over a 14-month period
until her death. Initial episodes of varicella and zoster were responsive to
acyclovir treatment; however, subsequent recurrences necessitated administration 
of multiple courses of acyclovir. Lesions became markedly hyperkeratotic, slow
healing, and persistent despite acyclovir therapy. Numerous attempts to isolate
virus from the lesions yielded only one isolate late in the course of therapy.
This virus clearly demonstrated acyclovir resistance in vitro. Bizarre
manifestations of VZV infection could present both diagnostic and therapeutic
dilemmas. Prolonged acyclovir treatment of highly immunocompromised patients with
acquired immunodeficiency syndrome and severe VZV may lead to the appearance of
resistant virus.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3184352 [PubMed - indexed for MEDLINE]

6374: Ann Ophthalmol. 1988 Nov;20(11):431-5, 438.

Zoster-related bilateral acute retinal necrosis syndrome as presenting sign in
AIDS.

Chess J, Marcus DM.

Albert Einstein College of Medicine, Bronx, New York.

The acute retinal necrosis (ARN) syndrome has recently been associated with
intraocular infections with one or more members of the herpesvirus family. There 
have been 14 cases in the literature linking ARN with a preceding or subsequent
herpetic dermatitis. We report the development of bilateral ARN (BARN) after
unilateral Herpes zoster ophthalmicus as the presenting sign of acquired
immunodeficiency syndrome (AIDS) in a previously healthy man. The development of 
BARN after diffuse Herpes simplex dermatitis in AIDS patients is also discussed. 
These cases further illustrate the central role of the herpes-virus family in the
etiology of ARN and alert the clinician to a new presenting sign for AIDS.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 3266067 [PubMed - indexed for MEDLINE]

6375: Anesth Analg. 1988 Nov;67(11):1105-8.

Continuous subpleural-paravertebral block in acute thoracic herpes zoster.

Johnson LR, Rocco AG, Ferrante FM.

Pain Treatment Service, Brigham and Women's Hospital, Harvard Medical School,
Boston, Massachusetts 02115.

Publication Types: 
    Case Reports

PMID: 3189902 [PubMed - indexed for MEDLINE]

6376: J Gen Intern Med. 1988 Nov-Dec;3(6):525-32.

The clinical prognosis of HIV-1 infection: a review of 32 follow-up studies.

Cooper GS, Jeffers DJ.

Department of Medicine, Uniformed Services University of Health Sciences,
Bethesda, MD 20814-4799.

Thirty-two follow-up studies of patients with HIV-1 infection, but without AIDS
at baseline, were examined for information on the risk of developing AIDS or
other conditions. Disease progression in asymptomatic groups was similar to that 
found in patients with persistent generalized lymphadenopathy (PGL) without other
symptoms. Among these asymptomatic and PGL groups, the risk of developing AIDS
reached 10% to 15% between 24 and 36 months of follow up. The risk of progression
to AIDS continued to increase in the studies with longer follow-up periods,
reaching 36% at 88 months. However, more than 40% of "high-risk" groups
(characterized by the presence of constitutional symptoms, oral thrush, herpes
zoster, and/or low T4 counts) developed AIDS after only 36 months of follow-up.
Reliable information about progression to other states (e.g., AIDS-related
complex) has not been consistently provided.

Publication Types: 
    Review

PMID: 3068338 [PubMed - indexed for MEDLINE]

6377: Antimicrob Agents Chemother. 1988 Nov;32(11):1720-4.

Antiherpesvirus activity and mechanism of action of indolo-(2,3-b)quinoxaline and
analogs.

Harmenberg J, Wahren B, Bergman J, Akerfeldt S, Lundblad L.

Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.

The antiherpesvirus activity of 14 derivatives of indoloquinoxaline was tested.
The most active was 2,3-dimethyl(dimethylaminoethyl)5H-indolo-(2,3-b)quinoxaline,
also called B-220. The antiherpesvirus mechanism of B-220 was sought. The
compound inhibited replication of herpes simplex virus type 1, cytomegalovirus,
and varicella-zoster virus in tissue culture at concentrations of 1 to 5 microM, 
depending on the cell type used for assay and the amount of virus. Cellular
toxicity was seen at a concentration of 10 to 30 microM, and antiviral activity
in the human bladder cancer and human embryonic lung fibroblast cell lines tested
was found at concentrations 3 to 15 times lower than the concentrations causing
cellular toxicity. Viral DNA synthesis, as well as production of early and late
viral proteins, was inhibited at 0.5 to 4.5 microM B-220, but viral DNA
polymerases tested in vitro were not inhibited at these concentrations. There was
no interaction with the pyrophosphate analog foscarnet, and no reversal of the
antiviral activity of B-220 occurred with naturally occurring nucleosides. We
conclude that the antiviral effect depends on the multiplicity of infection and
may occur at the level of viral DNA synthesis and that no interference occurs
with pyrophosphate analogs or nucleosides. The more potent activity against viral
DNA than against cellular DNA may be caused by a true selectivity for herpesvirus
DNA or by the higher metabolism of viral DNA in infected cells.

Publication Types: 
    Comparative Study

PMID: 2855298 [PubMed - indexed for MEDLINE]

6378: Rofo. 1988 Nov;149(5):550-1.

Varicella-zoster angiitis with inflammatory and angiomatous angiographic signs.

Kutluk K, Schumacher M, Muller-Lantzsch N.

Section of Neuroradiology, University of Freiburg, FRG.

Publication Types: 
    Case Reports

PMID: 2848294 [PubMed - indexed for MEDLINE]

6379: Virology. 1988 Nov;167(1):25-30.

The cleavage recognition signal is contained within sequences surrounding an a-a 
junction in herpes simplex virus DNA.

Nasseri M, Mocarski ES.

Department of Microbiology and Immunology, Stanford University School of
Medicine, California 94305.

Herpesvirus genome maturation involves site-specific cleavage of viral DNA
concatemers and encapsidation of unit-length molecules, processes that are
apparently coupled. Here, applying a transfection-infection approach, we have
investigated the arrangement of the DNA sequence elements involved in cleavage
and shown that specific cleavage occurs independently of DNA replication. We show
that the cis-acting signal for cleavage is located within a 179-bp fragment from 
across an a-a junction formed as part of the genome maturation process of herpes 
simplex virus 1. Plasmids carrying the 179-bp fragment are cleaved at the
appropriate site even though they are unable to replicate in HSV-infected cells. 
When linked to an origin, the same 179-bp a-a fragment will replicate and package
into progeny virus as a defective genome. Two highly conserved homologies, pac1
and pac2, that have been observed in all herpesviruses examined, including
cytomegalovirus, Epstein-Barr virus, varicella-zoster virus, and herpes simplex
virus 2 as well as the herpes simplex virus 1 genome, are contained within the
179-bp fragment. This suggests that a common mechanism is utilized for genome
maturation in the herpesvirus group.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2847414 [PubMed - indexed for MEDLINE]

6380: J Gen Virol. 1988 Nov;69 ( Pt 11):2819-29.

Conservation of glycoprotein H (gH) in herpesviruses: nucleotide sequence of the 
gH gene from herpesvirus saimiri.

Gompels UA, Craxton MA, Honess RW.

Division of Virology, National Institute for Medical Research, Mill Hill, London,
U.K.

We present the nucleotide sequence of the glycoprotein H (gH) gene of herpesvirus
saimiri (HVS), a representative of the T lymphotropic herpesviruses of New World 
monkeys, and compare the predicted amino acid sequence with sequences of
homologous proteins from four human herpesviruses. The HVS gH gene is located
within a block of genes encoding products conserved in all herpesvirus subgroups 
as represented by the human herpesviruses herpes simplex virus, varicella-zoster 
virus, cytomegalovirus and Epstein-Barr virus. In agreement with the biological
grouping of HVS as a lymphotropic gammaherpesvirus, its gH amino acid sequence
shows greatest similarity to that of the B lymphotropic Epstein-Barr virus,
although the nucleotide sequences of their respective gH genes show little
similarity given different G + C compositions of 31% and 54%. The similarity
observed between the gH amino acid sequences of the two representative
gammaherpesviruses is greater than that between the two human alphaherpesviruses 
varicella-zoster virus and herpes simplex virus. The members of the gH family
range in size from 706 to 743 amino acid residues for the beta- and
gammaherpesviruses, to 838 to 841 for the alphaherpesviruses, giving
non-glycosylated precursors with Mr values of 78,322 to 93,651. The difference in
size is due to heterogeneity in the poorly conserved N-terminal regions of the
larger alphaherpesviruses compared to the smaller beta- and gammaherpesvirus
molecules. Greatest similarity is observed in the C-terminal halves of the
proteins including residues surrounding four conserved cysteine residues, a
conserved N-linked glycosylation site (within the sequence NGTV) 13 to 18
residues proximal to the membrane-spanning sequences, and a short cytoplasmic
domain of seven or eight residues for the beta- and gammaherpesviruses' and 14 or
15 residues for the alphaherpesviruses' gH. Thus, the representatives of all
subgroups of herpesviruses, including those with a non-human host, encode gH
homologues. Together with the observation that gH of these viruses are major
targets for virus neutralization by antibody, this suggests that this
glycoprotein family is essential among all herpesviruses and represents a major
component involved in herpesvirus infectivity.

Publication Types: 
    Comparative Study

PMID: 2846759 [PubMed - indexed for MEDLINE]

6381: Hosp Pract (Off Ed). 1988 Oct 30;23(10A):16.

Local-anesthetic analgesia--'no humbug'.

Stadtner DA.

Publication Types: 
    Letter

PMID: 3141434 [PubMed - indexed for MEDLINE]

6382: Cancer. 1988 Oct 15;62(8):1641-6.

Risk factors for varicella zoster disseminated infection among adult cancer
patients with localized zoster.

Rusthoven JJ, Ahlgren P, Elhakim T, Pinfold P, Stewart L, Feld R.

Princess Margaret Hospital, Ontario Cancer Institute, Toronto, Canada.

Varicella zoster (VZ) infection can be a highly morbid and potentially fatal
disease among immunocompromised patients; 811 episodes of VZ infection among
adult cancer patients seen at the Princess Margaret Hospital from 1970 to 1980,
were identified. Seven hundred twelve patients with first episodes of localized
VZ infection (zoster) were analyzed for potential risk factors for dissemination.
Significant risk factors after univariate analysis included the diagnosis of
Hodgkin's disease, decreasing age, chemotherapy within 6 months of VZ infection, 
and extensive tumor at initial tumor diagnosis. Complete tumor remission at the
time of infection, previous radiotherapy, and breast or gynecologic cancer were
associated with reduced risk in this analysis. After multivariate analysis the
following factors were independently associated with increased risk: Hodgkin's
disease (P less than 0.001), non-Hodgkin's lymphoma (P = 0.016), and head and
neck cancer (P = 0.043). Complete tumor remission and previous radiotherapy were 
again related to a reduced risk of infection. This study identifies risk factors 
that define specific subgroups of adult cancer patients with zoster infections
who are at increased risk for VZ dissemination. These factors may be useful in
prospectively defining high-risk groups in the design of antiviral therapy trials
and may have a role in deciding which cancer patients with zoster will benefit
most from receiving antiviral therapy to prevent dissemination.

PMID: 3167779 [PubMed - indexed for MEDLINE]

6383: J R Coll Gen Pract. 1988 Oct;38(315):470-1.

Erosive pustular dermatosis of the scalp following zoster ophthalmicus.

Grattan CE.

Publication Types: 
    Letter

PMID: 3267192 [PubMed - indexed for MEDLINE]

6384: Rev Med Suisse Romande. 1988 Oct;108(10):889-92.

[Current treatment of acute ophthalmic herpes zoster (or, vive la difference!)]

[Article in French]

Buchi ER, Piguet B, Fitting P, Herbort CP.

PMID: 3264614 [PubMed - indexed for MEDLINE]

6385: Ned Tijdschr Geneeskd. 1988 Oct 1;132(40):1861-3.

[Minor complaints in family practice; herpes zoster]

[Article in Dutch]

[No authors listed]

Publication Types: 
    Letter

PMID: 3263578 [PubMed - indexed for MEDLINE]

6386: Br J Clin Pract. 1988 Oct;42(10):412-4.

The prevention of postherpetic neuralgia: a retrospective view of patients
treated in the acute phase of herpes zoster.

Rutgers MJ, Dirksen R.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3255420 [PubMed - indexed for MEDLINE]

6387: Rev Med Chir Soc Med Nat Iasi. 1988 Oct-Dec;92(4):733.

[Herpes zoster and its stomatologic aspects]

[Article in Romanian]

Domnisoru L, Ilin Z.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3253925 [PubMed - indexed for MEDLINE]

6388: Am J Clin Hypn. 1988 Oct;31(2):107-13.

Hypnosis in the management of postherpetic neuralgia: three case studies.

Dane JR, Rowlingson JC.

Publication Types: 
    Case Reports

PMID: 3228059 [PubMed - indexed for MEDLINE]

6389: Med Trop (Mars). 1988 Oct-Dec;48(4):409-11.

[Zona in human immunodeficiency virus (HIV-1) infection in Bangui (Central
Africa)]

[Article in French]

Lesbordes JL, Coulaud X.

Medecin des Hopitaux des Armees, Toulouse, France.

In Bangui (Central African Republic) where HIV1 prevalence was 7.8% in 1987, 61
cases of herpes zoster have been studied: 17 "during" AIDS and 44 "isolated"
cases. During AIDS, herpes zoster has no prognosis value. When it seems to be
"isolated", herpes zoster is closely linked to HIV1: 42 seropositives out of 44
(predictive value of 95%) and it announces the outbreak of AIDS in the 2 years to
come.

Publication Types: 
    English Abstract

PMID: 3221791 [PubMed - indexed for MEDLINE]

6390: Med Trop (Mars). 1988 Oct-Dec;48(4):351-7.

[Clinical aspects of human immunodeficiency virus (HIV) infection in Central
Africa: 6 years' experience at a hospital in an endemic area]

[Article in French]

Lesbordes JL.

Medecin des Hopitaux des Armees, Service de Medecine Interne et Cardiologie,
Centre Hospitalier des Armees Hippolyte Larrey, Toulouse, France.

In Bangui (Central African Republic), where seroprevalence of HIV is 11% in the
adult population, AIDS presents some clinical aspects different from the ones
known in the west; the clinical experience reported in this paper is based on 504
cases infested by HIV group 4; diagnosis is very often made thanks to the
clinical score recommended by World Health Organization (predictive value of
66%). Predominant manifestations (14%) are: asthenia (100%), emaciation (100%),
fever (88%), diarrhea (42%), pulmonary attacks (37%), adenopathies, cutaneous
manifestations (35%), neurological manifestations (14%). Some affections call for
HIV infection with a significant predictive value: herpes zoster (96%), Kaposi's 
symptom (68%), mouth candidiasis (71%), pulmonary tuberculosis (56%: as far as
some others are concerned, HIV has to be suspected: infant denutrition, acute
infections, neurological disorders. Development is severe: 45% of the patients
examined died in the 4 months coming after diagnosis. Epidemiology speaking, they
are young patients (mean age 27.4 years), neither addicted nor "doped",
heterosexual with multiple partners, with female prostitution occasionally; sex
ratio is 0.95. Recognized transmission by transfusion is the exception (2/504).
The transmission due to vaccination or injection is rare and difficult to
evaluate. Only radical alteration of sexual behaviour will modify HIV
dissemination.

Publication Types: 
    English Abstract

PMID: 3221783 [PubMed - indexed for MEDLINE]

6391: Anaesthesia. 1988 Oct;43(10):901.

Benzydamine cream in post-herpetic neuralgia.

Coniam SW, Hunton J.

Publication Types: 
    Clinical Trial
    Letter
    Randomized Controlled Trial

PMID: 3202315 [PubMed - indexed for MEDLINE]

6392: Trop Doct. 1988 Oct;18(4):147-50.

Clinical manifestations of AIDS in tropical countries.

Carswell JW.

PIP: Diagnosis of clinical AIDS can be difficult for clinicians in Africa, where 
there is only limited access to the sophisticated bacteriological diagnostic
facilities needed for diagnoses based on the criteria laid down by the Center for
Disease Control in the US. The most common presentation of AIDS in Africa is as
an enteropathic condition known as 'Slim.' Based on this and other common
presentations of the disease in Africa, a group of clinicians in Bangui, Central 
African Republic, drew up a list of criteria for the diagnosis of AIDS in Africa 
which are based on patient history and examination and the exclusion of other
conditions rather than on serological confirmation of HIV infection. The major
criteria are 1) unexplained fever for longer than 1 month; 2) unexplained
diarrhea for longer than 1 month; and 3) weight loss greater than 10% of previous
weight. Minor symptoms are presence of a maculopapular rash, oral candidiasis or 
thrush, herpes zoster or shingles, aggressive or uncontrollable herpes simplex,
unexplained cough for longer than 1 month, or enlarged lymph nodes in more than 1
extrainguinal site. The finding of 2 major symptoms and at least 1 minor one is
enough for diagnosis. These criteria have been found to be useful. However, they 
do not cover all the presentations which have been associated with AIDS. Unusual 
presentations of HIV infected persons which have been seen in Africa include
serially developing abscesses in pyomyositis, gall bladder diseases, pericarditis
or myocarditis, diseases of the Central Nervous System (cryptococcal meningitis, 
toxoplasmosis, non-specific leuko-encephalitis, atraumatic paraplegia, acute
psychosis or chronic deterioration in mental capacity, lymphoma of the brain),
prodromal illnesses, swollen lymph nodes, herpes zoster or shingles in young
adults, or tumours of the lymphatic system. Differential diagnosis is extremely
important.

PMID: 3194942 [PubMed - indexed for MEDLINE]

6393: Acta Anaesthesiol Scand. 1988 Oct;32(7):593-4.

Horner's syndrome after intrapleural anesthesia with bupivacaine for
post-herpetic neuralgia.

Sihota MK, Holmblad BR.

Department of Anesthesiology, University of Illinois College of Medicine,
Chicago.

We observed the development of Horner's syndrome 25 min after the intrapleural
administration of 30 cc of 0.5% bupivacaine to a patient with post-herpetic
neuralgia in the thoracic region. The patient reported immediate relief of pain. 
There was no change in blood pressure or pulse rate, and no discernible level of 
anesthesia to pinprick was detected.

Publication Types: 
    Case Reports

PMID: 3188830 [PubMed - indexed for MEDLINE]

6394: Brain. 1988 Oct;111 ( Pt 5):1187-98.

Distant referral of cutaneous sensation (Mitempfindung). Observations on its
normal and pathological occurrence.

Schott GD.

National Hospital for Nervous Diseases, Queen Square, London.

Certain normal individuals when scratching a small area of skin often experience 
simultaneously an additional punctate sensation (Mitempfindung) at a remote site 
on the body. Four patients are described with acquired Mitempfindungen, the
sensation being referred to the region that had been rendered abnormal by damage 
to the nervous system. The differences between normal and pathological
Mitempfindungen and other patterns of cutaneous referral are considered, and
mechanisms underlying Mitempfindungen, including the possible role of the
spinocervical tract, are discussed.

Publication Types: 
    Case Reports

PMID: 3179689 [PubMed - indexed for MEDLINE]

6395: Invest Ophthalmol Vis Sci. 1988 Oct;29(10):1552-8.

Viral antibodies in normal tears.

Coyle PK, Sibony PA.

Department of Neurology, SUNY, Stony Brook 11794.

Viruses are a common cause of eye infection. The local mucosal response, with
production of antibodies released into tears, is believed to provide an important
immune defense against these agents. However very little information exists on
the viral specificity of normal tear immunoglobulins. In this study we obtained
tears, parotid saliva and serum from 40 normal subjects without eye disease.
Samples were examined by enzyme linked immunosorbent assay (ELISA) for antibodies
to seven common viruses which invade mucosa: cytomegalovirus (CMV), Epstein Barr 
(EBV), herpes simplex type I (HSVI), measles, mumps, rubella and varicella zoster
virus (VZV). The majority of normal tears contained antibodies to HSVI (73%) and 
EBV (65%), occasionally to mumps (30%), rubella (30%), and VZV (20%), and rarely 
to CMV (5%). Tear viral antibodies were mainly IgA class, but it was not unusual 
to find IgG antibodies to HSVI, VZV, rubella and measles. Tear and parotid saliva
immunoglobulins from the same individual had entirely different viral reactivity.
In most cases tear viral antibodies were reflected in serum viral antibodies,
although the immunoglobulin class might differ. However, 15% of normal tears had 
antibodies to HSVI without detectable serum antibodies. From this study we
conclude that normal tear immunoglobulins contain antibodies to common viruses,
in particular to HSVI and EBV. These tear antibodies are mainly IgA, but can
consist of IgG. Viral antibodies in tears are independent of the antibodies
present in parotid saliva, suggesting that there is preferential homing of
committed B lymphocytes to different mucosal surfaces.(ABSTRACT TRUNCATED AT 250 
WORDS)

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3170127 [PubMed - indexed for MEDLINE]

6396: Postgrad Med J. 1988 Oct;64(756):832-3.

Post-herpetic abdominal wall herniation.

McLoughlin R, Waldron R, Brady MP.

Publication Types: 
    Case Reports
    Letter

PMID: 2978429 [PubMed - indexed for MEDLINE]

6397: Ophthalmology. 1988 Oct;95(10):1394-8.

Demonstration of varicella-zoster virus antigens in the vitreous aspirates of
patients with acute retinal necrosis syndrome.

Soushi S, Ozawa H, Matsuhashi M, Shimazaki J, Saga U, Kurata T.

Department of Ophthalmology, Tokai University School of Medicine, Tokyo, Japan.

Four cases of acute retinal necrosis (ARN) syndrome were studied virologically.
Varicella-zoster virus (VZV) antigen was demonstrated by immunofluorescence in
cells from vitreous aspirates of two cases. No herpes simplex virus (HSV) or
cytomegalovirus (CMV) antigens were detected by the same technique. Antibody to
VZV in vitreous fluid was present in two cases; however, it was not detected in
sera. Although virus isolation was unsuccessful, these findings strongly suggest 
that VZV may play an important role in the etiology of ARN syndrome.

Publication Types: 
    Case Reports

PMID: 2852337 [PubMed - indexed for MEDLINE]

6398: J Dermatol. 1988 Oct;15(5):448-50.

Viral activity in skin lesions of herpes zoster.

Hata S, Sugai T, Asoh S, Asada Y, Nishijima S, Soh Y, Doi A, Baba K.

PMID: 2851618 [PubMed - indexed for MEDLINE]

6399: Acta Paediatr Jpn. 1988 Oct;30(5):594-600.

Clinical use of Oka live varicella vaccine.

Kamiya H, Sakurai M, Ihara T, Ito M, Torigoe S, Ota Y, Kamiya T, Horiuchi K,
Asano Y, Baba K, et al.

PMID: 2849859 [PubMed - indexed for MEDLINE]

6400: J Clin Microbiol. 1988 Oct;26(10):2013-7.

Herpes simplex virus detection by macroscopic reading after overnight incubation 
and immunoperoxidase staining.

Ziegler T, Waris M, Rautiainen M, Arstila P.

Department of Virology, University of Turku, Finland.

Human diploid foreskin fibroblast cells grown in 24-well plates were inoculated
with clinical specimens by centrifugation at 1,000 X g for 45 min. Cultures were 
incubated at 37 degrees C overnight, fixed, and stained with peroxidase-labeled
monoclonal antibodies against herpes simplex virus types 1 and 2. Stained plaques
of infected cells were large enough to be detected with the naked eye, and
microscopic examination did not reveal any further positive specimens. The method
was compared with standard isolation in human fibroblasts grown in shell vials
and inoculated by centrifugation at 4,000 X g, observed microscopically for the
occurrence of typical cytopathogenic effect three times a week for 10 days, and
then typed by enzyme immunoassay. Of the 289 specimens tested, 105 were positive 
and 174 were negative by both methods. Six specimens were positive by standard
isolation only, two of them containing varicella-zoster virus, and two specimens 
were stored frozen before being tested by immunoperoxidase staining. Two
specimens found negative by standard isolation were positive by immunoperoxidase 
staining. For two specimens negative by immunoperoxidase staining, the standard
isolation cultures were lost due to microbial contamination. Forty-two specimens 
found positive by standard isolation were clearly positive when stained only 8 h 
after inoculation. By standard isolation, positive results were reported on the
average 3 to 4 days after inoculation, whereas by immunoperoxidase staining the
result was available within less than 24 h. Immunoperoxidase staining of infected
cells is a sensitive method for rapid laboratory diagnosis of herpes simplex
virus infections, and 24-well plates are convenient for the handling of a large
number of specimens.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2846634 [PubMed - indexed for MEDLINE]

6401: Virology. 1988 Oct;166(2):542-9.

Sequence of a bovine herpesvirus type-1 glycoprotein gene that is homologous to
the herpes simplex gene for the glycoprotein gB.

Misra V, Nelson R, Smith M.

Department of Veterinary Microbiology, Western College of Veterinary Medicine,
University of Saskatchewan, Saskatoon, Canada.

The 130-kDa bovine herpesvirus-1 (BHV-1) glycoprotein GVP 6 was found to
cross-react immunologically with the herpes simplex glycoprotein gB. Antibodies
in polyclonal serum against gB immunoprecipitated GVP 6 and its cleavage products
from a lysate of BHV-1-infected cells. Conversely, polyclonal serum against GVP 6
precipitated gB from HSV-1-infected cell lysates. Sera against the other
glycoproteins did not demonstrate cross-reactivity. A 3.6-kb Kpnl-Hpal fragment
of BHV-1 DNA that hybridized to the gene for gB was cloned and the nucleotide
sequence of both strands was determined. The longest codon reading frame in the
fragment coded for a protein that showed extensive homology with gB1 and related 
sequences from pseudorabies virus, varicella-zoster virus, cytomegalovirus, and
Epstein-Barr virus. The strongest homologies were observed in two segments of the
ectodomain, the transmembrane domain, and sequences adjacent to the transmembrane
domain.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2845660 [PubMed - indexed for MEDLINE]

6402: J Gen Virol. 1988 Oct;69 ( Pt 10):2585-93.

Molecular analysis of the pyrimidine deoxyribonucleoside kinase gene of wild-type
and acyclovir-resistant strains of varicella-zoster virus.

Sawyer MH, Inchauspe G, Biron KK, Waters DJ, Straus SE, Ostrove JM.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

The pyrimidine deoxyribonucleoside kinase (dPK) genes from five wild-type and
four acyclovir-resistant varicella-zoster virus (VZV) strains were studied. One
of the acyclovir-resistant strains was isolated from a patient receiving chronic 
acyclovir therapy. Acyclovir-resistant strains expressed the 1.8 kb VZV dPK
transcript but lacked dPK activity. To determine the basis for the lack of enzyme
activity the dPK gene from each strain was cloned and its DNA sequence
determined. The VZV dPK gene was found to be highly conserved among strains, with
greater than 99% nucleotide and amino acid homology. Each acyclovir-resistant VZV
strain differed from its wild-type parent in only a single amino acid. The dPK
genes from the acyclovir-resistant strains contained either point mutations near 
the putative thymidine-binding site of the enzyme or ones that resulted in the
premature termination of protein synthesis. Single point mutations were
sufficient to render these strains dPK-negative and highly resistant to
acyclovir. The molecular basis for acyclovir resistance at the dPK locus of VZV
is similar to that previously noted to render herpes simplex viruses resistant to
acyclovir.

PMID: 2844967 [PubMed - indexed for MEDLINE]

6403: J Infect Dis. 1988 Oct;158(4):780-8.

Varicella-zoster virus-specific HLA-restricted cytotoxicity of normal immune
adult lymphocytes after in vitro stimulation.

Cooper EC, Vujcic LK, Quinnan GV Jr.

Division of Virology, Food and Drug Administration, Bethesda, Maryland 20892.

Varicella-zoster virus (VZV)-specific cytotoxic T cell responses were studied in 
35 presumably immune and two nonimmune adult donors and in two patients with
herpes zoster. Peripheral blood lymphocytes (PBLs) were stimulated for five or 12
days with autologous, irradiated, VZV-infected PBLs. Cytotoxicity was measured in
a chromium-release assay. Target cells were usually cryopreserved,
phytohemagglutinin-stimulated PBLs, either infected with VZV or uninfected. In
testing the presumably immune adults, VZV-specific cytotoxicity was observed in
32 (91%) of 35 cases after five days and in 19 (90%) of 21 cases after 12 d of
stimulation. Lysis of HLA-matched target cells was significantly greater than
that of mismatched, VZV-infected target cells after both intervals. Responses
were similar when PBLs from two patients with acute zoster were tested after in
vitro stimulation and in one of those two tested without in vitro stimulation.

PMID: 2844916 [PubMed - indexed for MEDLINE]

6404: Schmerz. 1988 Sep;2(3):125-143.

[Development and therapy of the pain syndrome of reflex sympathetic dystrophy.
Clinical expression, experimental investigations, and new pathophysiological
considerations.]

[Article in German]

Blumberg H.

Neurologische Klinik und Poliklinik Albert Ludwigs-Universitat, Hansastra?e 9,
D-7800, Freiburg i. Br..

Reflex sympathetic dystrophy (RSD) is a disease of the extremities that can be
elicited by different factors, occurring at different sites (e.g., trauma, herpes
zoster, myocardial infarction). Independently of its etiology, however, the
clinical symptoms of RSD are found most often in distal parts of the extremities 
affected (hand or foot). In a generalized distribution pattern, the following
signs, representing a triad of autonomic, motoric and sensory disturbances, are
commonly observed in these regions: 1. dysregulation of blood flow to the skin
and of sweating, together with diffuse swelling, 2. impairment of movement and
muscular strength; 3. diffuse sensory skin disturbances and spontaneous pain of
ariable character (e.g., burning, throbbing, aching, shooting). Pain sensation is
generally diffuse; in most cases it is deep and less often, superficial (probably
representing bone or skin pain, respectively). This triad occurs at the very
onset of RSD. If the distribution pattern is generalized, it can be used as a
diagnostic criterion for RSD. Our experimental results support the idea of
disturbances of skin blood flow related to abnormal vasoconstrictor outflow. This
assumption is primarily based on two observations: 1. 73% of 97 RSD patients
(upper extremity affected) showed systematic side differences in fingertip
temperatures at room temperature. All points measured on the affected side had
higher (n=51) or lower (n= 20) temperature values than corresponding sites on the
healthy extremity. Such systematic side differences were found only in 16% out of
79 healthy subjects (p</=0.0001). 2. Whole-body cooling, hands excluded, induced 
abnormal changes in skin blood flow of the hands affected (e.g., faster or slower
decrease in blood flow on the affected side compared to the healthy extremity).
This generally leads to higher mean side differences in skin temperature during
the whole cooling period in 38 RSD patients as compared with 18 healthy subjects 
(2.5 degrees vs 0.9 degrees C,p</=0.001). Such abnormalities of skin blood flow
were found in the whole distal extremity, independent of the factor eliciting RSD
(e.g. proximal or distal trauma, partial nerve lesion). In most cases the
predominant symptoms of RSD are swelling of a distal extremity and spontaneous
pain. It is presumed that these symptoms are primarily initiated by a noxious
event, which can be recognized as a common factor in the history of the disease
preceding RSD in most cases. Nociceptor impulses during this event may induce
disturbances of sympathetic vasoconstrictor outflow via reflex mechanisms. Most
relevant to these symptoms is the hypothesized imbalance between activity (tone) 
of vasoconstrictor neurons supplying arteries (AVT) and those supplying veins
(VVT). If VVT becomes higher than AVT, venous return is impaired, capillary
pressure increases, and edema results. Disturbed micromilieu and increased local 
pressure lead finally to excitation of nociceptors in the tissues affected (e.g.,
skin and bones). This excitation, in turn, maintains the abnormal vasoconstrictor
outflow via reflex mechanisms, thus initiating a vicious circle. Sympatholytic
therapy can interrupt the abnormal vasoconstrictor outflow, leading to increased 
venous return and reducing interstitial pressure and nociceptor activation
(interruption of the vicious circle). If sympatholytic therapy is applied early, 
full recovery may occur.

PMID: 18415324 [PubMed - as supplied by publisher]

6405: Anesth Analg. 1988 Sep;67(9):897-9.

Effect of stellate ganglion block with fentanyl on postherpetic neuralgia with a 
sympathetic component.

Fine PG, Ashburn MA.

Department of Anesthesiology, University of Utah Health Sciences Center, Salt
Lake City 84132.

Publication Types: 
    Case Reports

PMID: 3415003 [PubMed - indexed for MEDLINE]

6406: Neurology. 1988 Sep;38(9):1427-32.

Amitriptyline, but not lorazepam, relieves postherpetic neuralgia.

Max MB, Schafer SC, Culnane M, Smoller B, Dubner R, Gracely RH.

Neurobiology and Anesthesiology Branch, National Institute of Dental Research,
Bethesda, MD 20892.

In a double-blind, randomized, crossover study, 58 patients with postherpetic
neuralgia received 6-week courses of amitriptyline, 12.5 to 150 mg/d; lorazepam, 
0.5 to 6 mg/d; or lactose placebo. Doses were titrated to the maximum level
tolerated. Patients rated pain in a diary, using lists of verbal descriptors.
Forty-seven percent of patients reported moderate or greater relief with
amitriptyline, 16% with placebo, and 15% with lorazepam. Mean amitriptyline dose 
was 65 mg/d. Greater relief was associated with higher amitriptyline doses, up to
the maximum dose of 150 mg/d, and with higher serum tricyclic levels. Lorazepam
did not relieve pain and was associated with severe depressive reactions in four 
patients.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3412591 [PubMed - indexed for MEDLINE]

6407: Z Gesamte Inn Med. 1988 Sep 1;43(17):488-91.

[Associated glomerulonephritis in immunocytoma]

[Article in German]

Klette H.

Inneren Abteilung, St.-Elisabeth-Krankenhauses Halle.

It is reported on a 43-year-old patient in whom a mesangio-proliferative
glomerulonephritis with nephrotic syndrome was diagnosed 7 months before
manifestation of an immunocytoma. Under the treatment of the tumourous disease
with chemotherapy and radiation a complete remission of the glomerulonephritis
developed. The patient died of a generalized herpes zoster after 2 years 10
months. At the postmortem examination no pathological changes on the kidneys
could be proved. After a survey of cases with tumour-associated
glomerulonephirits published up to now possible pathogenetic mechanisms and
clinical data of the glomerulonephritis as paraneoplastic syndrome are discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3266394 [PubMed - indexed for MEDLINE]

6408: J Neurol. 1988 Sep;235(7):400-6.

Specific IgG subclass reactivity in herpes simplex encephalitis.

Mathiesen T, Linde A, Olding-Stenkvist E, Wahren B.

Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.

Serum and cerebrospinal fluid (CSF) samples from 19 patients with a previous
diagnosis of herpes simplex virus encephalitis (HSVE), from 14 patients with a
previous diagnosis of non HSVE encephalitis and from 21 healthy subjects were
examined to detect IgG subclasses 1-4 reactive with herpes simplex virus (HSV),
cytomegalovirus (CMV) and varicella zoster virus (VZV). Antibodies to HSV were
detected in CSF and serum from the 14 HSVE-patients with a reactivated HSV
infection and from 3 of the 5 patients with a primary HSV infection. The
predominant subclass pattern was an early HSV-specific IgG1 rise, followed by
IgG3 and, more seldom, IgG4; HSV IgG2 was rarely seen. In HSVE patients, HSV IgG3
was absent in early samples and usually appeared 10-20 days after onset of
disease. In 14 out of 16 seropositive healthy controls, on the other hand, HSV
IgG3 was present in the CSF. Rising VZV IgG levels in serum and CSF were found in
11 HSVE patients. Eight of them showed signs of intrathecal VZV IgG1 synthesis.
The VZV IgG reactivity was restricted to IgG1 in 7 of these whereas the HSV IgG
subclass response also included IgG3 or 4. The appearance of several HSV IgG
subclasses appeared to serve as a marker of HSV infection in spite of the
serological VZV reaction, usually restricted to VZV IgG1. Intrathecal synthesis
of the quantitatively minor HSV IgG3 and 4 subclasses was detected earlier than
intrathecal synthesis of total HSV IgG, dominated by IgG1 in 4 patients with
HSVE.

PMID: 3221245 [PubMed - indexed for MEDLINE]

6409: An Esp Pediatr. 1988 Sep;29(3):257-8.

[Infantile herpes zoster generalized after intrauterine transmission caused by
varicella]

[Article in Spanish]

Rodriguez Cimadevilla JC, de la Morena Pardo ML, Prados Bueno R, de Inocencio
Arcena J, Chamorro Romero MI, Maroto Alvaro E, Garcia Fernandez EJ.

Servicio di Pediatria II, Hospital Gregorio Maranon, Madrid.

Publication Types: 
    Case Reports

PMID: 3195873 [PubMed - indexed for MEDLINE]

6410: Pain. 1988 Sep;34(3):315-7.

Report of Higa et al.

Yanagida H, Suwa K.

Publication Types: 
    Letter

PMID: 3186279 [PubMed - indexed for MEDLINE]

6411: Clin Nucl Med. 1988 Sep;13(9):667-8.

Gallium-67 localization in herpetic skin lesion.

Acio ER, Balasubramanian N, Vieras F, Smith JJ.

Nuclear Medicine Service, Veterans Administration Medical Center, Washington,
D.C. 20422.

Previous cases of gallium localization in various cutaneous lesions have been
reported, including sporotrichosis, acne vulgaris, sarcoid, lymphoma, and
exfoliative erythroderma. This is a report of a case of gallium localization in
cutaneous lesions of herpes zoster.

Publication Types: 
    Case Reports

PMID: 3180617 [PubMed - indexed for MEDLINE]

6412: Pediatr Pol. 1988 Sep;63(9):574-80.

[Results of the antiviral treatment of chickenpox and herpes zoster in children
with neoplasms]

[Article in Polish]

Jankowska H, Rybacka-Atamaniuk J, Szczepanska-Putz M, Wojnarowski M.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 3075736 [PubMed - indexed for MEDLINE]

6413: J Heart Transplant. 1988 Sep-Oct;7(5):390-4.

Infection as a complication of heart transplantation.

Linder J.

Department of Pathology and Microbiology, University of Nebraska Medical Center, 
Omaha 68105.

Infection and cardiac rejection are the most significant causes of morbidity and 
mortality after heart transplantation. At some transplant centers, more than half
of the early transplantation-related deaths are the result of infection. The
infectious agents may be transmitted to the host by means of the allograft,
through blood transfusion, by nosocomial or environmental routes, or they may
represent endogenous microbial flora or reactivation of a prior infection. The
frequency of infectious complications is generally related to the degree of
immunosuppressive therapy required to prevent graft rejection. Both the
composition of the immunosuppressive regimen and the dosage of the
immunosuppressive drugs affect the infection rate. Recent protocols, employing a 
combination of cyclosporine, steroids, and azathioprine cause less toxicity and
lower infection rates than protocols that rely solely on cyclosporine and
steroids or protocols utilized in the 1970s, which did not contain cyclosporine. 
A literature review of data reported from 12 transplant centers, encompassing 384
patients who received their transplantation in the era of cyclosporine, revealed 
infections in 221 patients (57.6%), with 20 infection-related deaths (5.2%). All 
classes of microorganisms infected the heart transplant recipients. The most
frequent agents included staphylococci, gram-negative enteric, Nocardia
(bacterial); Aspergillus, Candida, Cryptococcus (fungal); cytomegalovirus, herpes
simplex, herpes zoster (viral); and Pneumocystis carinii, Toxoplasma gondii
(protozoal). The respiratory tract, urinary tract, and skin were the most common 
sites of infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Review

PMID: 3058911 [PubMed - indexed for MEDLINE]

6414: J Virol Methods. 1988 Sep;21(1-4):61-72.

Chronic herpes simplex virus and varicella zoster virus infection.

Mertens T, Eggers HJ.

Virology Institute, University of Cologne, F.R.G.

After defining such terms as persistent and chronic infection, latency,
recurrence, recrudescence, and exogenous reinfection they are applied to
infections with HSV and VZV. Possible factors determining pathogenicity are
discussed, and an overview is given of the wide range of illnesses and case
reports ascribed to HSV and VZV infections. Various types of infection afford
different diagnostic procedures. Besides virus isolation supplemented by viral
antigen identification IgG antibody tests (increase in titer) may be useful. IgG 
subtype and IgA antibody determinations appear to be of limited value. Despite
the rather large number of available tests, there are still considerable
shortcomings in their ultimate significance as to the patient's disease. Thus,
some new experimental approaches are mentioned.

Publication Types: 
    Review

PMID: 3053746 [PubMed - indexed for MEDLINE]

6415: J Am Acad Dermatol. 1988 Sep;19(3):451-7.

Cutaneous manifestations of human immunodeficiency virus in Lusaka, Zambia.

Hira SK, Wadhawan D, Kamanga J, Kavindele D, Macuacua R, Patil PS, Ansary MA,
Macher AM, Perine PL.

University Teaching Hospital, Lusaka, Zambia.

Of the 1124 human immunodeficiency virus (HIV)-infected patients studied, one or 
more cutaneous lesions were found in 113 (98.3%) of the 115 patients with
acquired immunodeficiency syndrome (AIDS) and in 541 (53.6%) of 1009 patients
with AIDS-related complex (ARC). Kaposi's sarcoma, multidermatomal, necrotic
herpes zoster, and pruritic maculopapular rashes are common cutaneous
manifestations of AIDS and its related complex (ARC) in Zambia. The maculopapular
rash results from a lymphoplasmacytic angiitis in the dermis, possibly in
response to the presence of HIV in the dermis. Candidiasis, severe genital
herpes, extensive molluscum contagiosum, and tinea corporis were less frequent
and usually refractory to treatment. Drug reactions are also frequent in Zambians
with AIDS. In seven patients given streptomycin, thiacetazone, and rifampicin for
treatment of pulmonary tuberculosis, Stevens-Johnson syndrome occurred shortly
after therapy was begun, and two died despite high-dose prednisone and
discontinuance of tuberculosis therapy. Extensive seborrheic dermatitis
refractory to topical fluorinated corticosteroids is also an associated condition
in AIDS patients who have pulmonary tuberculosis.

PIP: Cutaneous manifestations of AIDS and AIDS-related complex were studied in a 
population of 1124 HIV seropositive patients at a hospital in Lusaka, Zambia. 115
of the patients had AIDS, and 1009 had AIDS-related complex. Drug eruptions
occurred in 22 patients; 2 died of Stevens-Johnson syndrome subsequent to drug
therapy for tuberculosis. The most frequently seen cutaneous manifestations were 
candidiasis, Kaposi's sarcoma, herpes zoster, seborrheic dermatitis, herpes
genitalis, and papular dermatoses. The pruritic maculopapular eruption occurred
in crops, healed, and recurred. It was one of the most unique dermatologic
manifestations of AIDS found in Africa. Seborrheic dermatitis occurred frequently
in patients who also had pulmonary tuberculosis.

PMID: 2971691 [PubMed - indexed for MEDLINE]

6416: J Clin Neuroophthalmol. 1988 Sep;8(3):185-93.

Herpes zoster ophthalmoplegia. Report of six cases.

Archambault P, Wise JS, Rosen J, Polomeno RC, Auger N.

Department of Ophthalmology, Sir Mortimer B. Davis-Jewish General Hospital,
McGill University, Montreal, Quebec, Canada.

Ophthalmoplegia occurs infrequently in herpes zoster ophthalmicus. The third
nerve appears to be the most commonly affected and the fourth nerve the least. We
describe herein the clinical course of six patients with herpes zoster
ophthalmoplegia. Spontaneous recovery occurred in four patients. The pathogenesis
and clinical features of this syndrome are described.

Publication Types: 
    Case Reports

PMID: 2971683 [PubMed - indexed for MEDLINE]

6417: Neurology. 1988 Sep;38(9):1423-7.

CSF somatostatin is elevated in patients with postzoster neuralgia.

Unger J, Weindl A, Ochs G, Struppler A.

Department of Neurology, Technical University of Munich, Federal Republic of
Germany.

We evaluated the concentration of the neuropeptide somatostatin (SOM) in the CSF 
of patients with several neurologic diseases. Since SOM is localized in high
concentrations in primary sensory pathways, such as the dorsal root ganglia and
dorsal horn of the spinal cord, it might be involved in conditions of chronic
pain due to functional alterations of nociceptive neurons, such as postinfectious
zoster neuralgia. Our study indicated a marked elevation of SOM in patients
suffering from postzoster neuralgia compared with controls. Comparison with other
neurologic diseases revealed decreased CSF SOM levels in Parkinson's and
Alzheimer's disease, unchanged values in patients with amyotrophic lateral
sclerosis, and increased concentrations in patients with brain tumors. In
neurodegenerative disorders, SOM levels in CSF seemed to reflect the anatomic
distribution as well as a reduction or preservation of the peptide in certain
brain areas affected by the disease process. In postzoster patients,
postinfectious degeneration of dorsal root ganglia cells might cause
deafferentation of dorsal horn neurons and activation of SOM-containing systems
with increased release either locally from neurons in the dorsal horn of the
spinal cord or from descending fiber projections. The results suggested that SOM 
may take part in the modulation of nociceptive responses.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2901053 [PubMed - indexed for MEDLINE]

6418: Nippon Naika Gakkai Zasshi. 1988 Sep;77(9):1355-7.

[Viral infections in medicine. 5. EB virus, cytomegalovirus, herpesvirus
infections diseases]

[Article in Japanese]

Osato T.

PMID: 2854545 [PubMed - indexed for MEDLINE]

6419: J Clin Microbiol. 1988 Sep;26(9):1623-5.

Use of murine monoclonal antibodies for laboratory diagnosis of varicella-zoster 
virus infection.

Gleaves CA, Lee CF, Bustamante CI, Meyers JD.

Program in Infectious Diseases, Fred Hutchinson Cancer Research Center, Seattle, 
Washington.

The laboratory diagnosis of varicella-zoster virus (VZV) infection was
reevaluated by direct immunofluorescent-antibody staining (DFA) and
centrifugation culture with newly available murine monoclonal antibodies.
Specimen smears were examined by DFA using monoclonal antibodies to VZV and to
herpes simplex virus types 1 and 2. Specimens were also inoculated into shell
vials for centrifugation culture and into standard tube cell culture. Of 68
specimens tested from 60 patients, 39 (57%) were positive for VZV by at least one
method. DFA was positive in 36 of 39 (92%); centrifugation culture was positive
at 24 h in 23 of 39 (59%) and at 48 h in 31 of 39 (79%); and standard culture was
positive in 25 of 39 (64%). Twenty-three of the 39 positive specimens (59%) were 
positive by all three techniques. Forty-three of the 60 patients were considered 
to have VZV by clinical criteria, and 35 of these 43 (81%) had laboratory
confirmation of the diagnosis. These data confirm that DFA is the method of
choice for the rapid laboratory confirmation of VZV infection. The centrifugation
culture assay can provide an alternative method to DFA for the laboratory
diagnosis of VZV infection.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 2846644 [PubMed - indexed for MEDLINE]

6420: J Virol Methods. 1988 Sep;21(1-4):73-8.

Non-lymphoid tissue lesions induced by or associated with herpesvirus.

Weiland LH.

Mayo Graduate School of Medicine, Mayo Clinic Scottsdale, Arizona.

The members of herpesvirus group are variable in their effects on tissues of the 
human body. This results in a wide variety of clinical diseases and syndromes.
Some produce impressive pathological lesions. Those produced by the viruses with 
tropism for ectodermally derived cells include herpes simplex virus and varicella
zoster virus are well recognized by practically all medical specialists and even 
by those who are not medically oriented. Cytomegalovirus has tropism for
epithelial cells that are ectodermally derived. Epstein-Barr virus (EBV) and
human lymphotropic virus induce profound changes in the proliferative
capabilities of lymphoid tissues. The non-lymphoid lesions induced by EBV are
unique and fascinating. Leading the list is nasopharyngeal carcinoma (NPC), not
all of which seem related to EBV. Only the non-keratinizing NPC has a convincing 
relationship to the virus. Other unusual lesions with suggested association with 
EBV are salivary glands tumors (benign and malignant) and undifferentiated thymic
carcinomas. Both malignant lymphoepithelial lesions (anaplastic carcinoma) of
salivary glands and anaplastic carcinoma of the thymus have microscopic
similarity to undifferentiated NPC.

Publication Types: 
    Review

PMID: 2846621 [PubMed - indexed for MEDLINE]

6421: J Virol Methods. 1988 Sep;21(1-4):305-13.

Treatment of persistent active herpesvirus infections.

Straus SE.

Medical Virology Section, National Institutes of Allergy and Infectious Diseases,
Bethesda, Maryland 20892.

All human herpesviruses cause chronic infections in which latent virus is
periodically reactivated. Persistently active infections are uncommon, however,
and occur exclusively in individuals whose immune systems fail to control virus
multiplication and spread. This paper summarizes the management of these unusual 
infections.

Publication Types: 
    Review

PMID: 2846620 [PubMed - indexed for MEDLINE]

6422: Virology. 1988 Sep;166(1):186-96.

Mutational dissection of the HSV-1 immediate-early protein Vmw175 involved in
transcriptional transactivation and repression.

Paterson T, Everett RD.

Institute of Virology, Glasgow, Scotland.

Vmw175 is one of five immediate-early (IE) proteins encoded by herpes simplex
virus type-1 (HSV-1). It is required for the transcription of later classes of
genes and for the accompanying repression of IE expression. Vmw175 has been shown
to be a transactivator of transcription and also to autoregulate its own
synthesis. We have made a large number of small, in-frame, insertion and deletion
mutants of a plasmid-borne copy of the gene encoding Vmw175. Study of the
activity of the resultant mutant polypeptides in transient transfection assays
has defined the regions of the protein important for the repression of its own
promoter, and for the transactivation of an HSV early promoter in synergy with
another HSV IE protein, Vmw110. Large stretches of the protein are relatively
unimportant for either function, while the regions most sensitive to disruption
correlate to sequences conserved between Vmw175 and VZV 140K, the corresponding
transactivating protein of Varicella-Zoster virus. The region from amino acids
275 to 490 is particularly important for both repression and transactivation,
whereas that from around 840 to 1100 seems to be more important for
transactivation than repression. The nuclear localization signal has been mapped 
to within residues 682-774.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2842944 [PubMed - indexed for MEDLINE]

6423: J Virol. 1988 Sep;62(9):3250-7.

Conservation of sequence and function between the product of the 52-kilodalton
immediate-early gene of herpesvirus saimiri and the BMLF1-encoded transcriptional
effector (EB2) of Epstein-Barr virus.

Nicholas J, Gompels UA, Craxton MA, Honess RW.

Division of Virology, National Institute for Medical Research, Mill Hill, London,
United Kingdom.

We present a sequence of 2,220 nucleotides from a region of the genome of
herpesvirus saimiri (HVS) which includes the coding and putative regulatory
sequences for the 52-kilodalton (kDa) immediate-early (IE) phosphoprotein of the 
virus. The amino acid sequence predicted for this protein shows it to be
homologous to the EB2 transcriptional effector encoded by the BMLF1 open reading 
frame of Epstein-Barr virus (EBV), the IE 68-kDa protein of varicella-zoster
virus, and the IE 63-kDa (alpha 27) protein of herpes simplex virus (HSV). By
measuring the function of the HVS 52-kDa-protein gene in transient expression
assays, we also showed that it can substitute with comparable efficiency for the 
EB2 product of EBV in the EB1-dependent activation of the EBV DR promoter. The
alpha 27 gene of HSV was an inefficient trans-activator in similar assays. We
conclude that the IE 52-kDa protein of HVS is structurally and functionally more 
similar to the homologous protein of the human lymphotropic virus, EBV, than to
the corresponding proteins from the neurotropic viruses, varicella-zoster virus
and HSV.

Publication Types: 
    Comparative Study

PMID: 2841477 [PubMed - indexed for MEDLINE]

6424: Nippon Naika Gakkai Zasshi. 1988 Sep;77(9):1358-61.

[Viral infections in medicine. Antiviral agents]

[Article in Japanese]

Matsumoto K.

Publication Types: 
    Case Reports

PMID: 2469749 [PubMed - indexed for MEDLINE]

6425: J Virol Methods. 1988 Sep;21(1-4):147-59.

Epitope-mapping on the Epstein-Barr virus major capsid protein using systematic
synthesis of overlapping oligopeptides.

Middeldorp JM, Meloen RH.

Scientific Development Group, Organon International BV, Oss, The Netherlands.

Systematic solid-phase synthesis of all possible overlapping nonapeptides of the 
1381 amino acid sequence of the Epstein-Barr virus major capsid protein (EBV-MCP)
was used to identify the position of linear antigen epitopes on this protein as
recognised by human polyclonal antisera. Antisera were selected for reactivity
with EBV-MCP on immunoblots. The results show that antibodies from different
individual donors may recognise EBV-MCP through binding to a variety of different
epitopes. These epitopes are localized at random over the protein backbone though
some non-binding areas are also present. In addition, ten 'hot-spots' were
identified containing closely-spaced reactive peptides (epitope-clusters)
recognised by most (greater than or equal to 70%) individuals. No significant
correlation was found between the actual location of these epitope-clusters and
computer predictions using either hydrophilicity plots, secondary structure plots
or a combination of (additional) parameters. Epitope-clusters generally were
located in regions of indifferent or hydrophilic nature and mostly contained
predicted beta-turn configurations. Only one epitope-cluster was located within a
region of sequence homology with the MCPs of herpes simplex virus type 1 and
varicella-zoster virus. The present study demonstrates the potential of using
systematic peptide synthesis to define serologically relevant linear epitopes on 
large and relatively unexplored viral polypeptides.

Publication Types: 
    Comparative Study

PMID: 2460480 [PubMed - indexed for MEDLINE]

6426: Am J Med. 1988 Aug 29;85(2A):99-101.

Prevention of herpes zoster in patients by long-term oral acyclovir after
allogeneic bone marrow transplantation.

Perren TJ, Powles RL, Easton D, Stolle K, Selby PJ.

Department of Medicine, Royal Marsden Hospital, Sutton, Surrey, United Kingdom.

Following allogeneic bone marrow transplantation for leukemia, herpes zoster
infections that are potentially severe with a high risk of dissemination develop 
in 30 to 50 percent of patients. Intravenous acyclovir is an effective treatment 
for established zoster in immunocompromised persons. Oral acyclovir has
relatively low bioavailability, which has made the value of this route of
administration for the treatment or prophylaxis of herpes zoster infections
uncertain. In this trial, 82 patients undergoing allogeneic bone marrow
transplantation for leukemia were randomly assigned to receive either intravenous
acyclovir for 23 days followed by oral acyclovir for six months, or matched
placebos; the random groups were well-matched in all clinical characteristics.
During the six-month period of acyclovir/placebo administration, no patient
receiving acyclovir developed herpes zoster, whereas six patients receiving
placebo did so (p = 0.006). During the six-month follow-up, there were six cases 
of zoster in the treatment arm of the study and two cases in the placebo arm.
Herpes zoster was not restricted to those patients who had positive evidence of
antibody before transplant. This study shows that oral acyclovir is capable of
preventing zoster infection during its period of administration; once the drug
treatment is stopped, infections occur. In selected patients, the use of
long-term oral acyclovir may be of value in preventing zoster infections during
the time of greatest immunosuppression.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 3044103 [PubMed - indexed for MEDLINE]

6427: Am J Med. 1988 Aug 29;85(2A):96-8.

Current therapy of varicella zoster virus infection in immunocompromised
patients. A comparison of acyclovir and vidarabine.

Shepp DH, Dandliker PS, Meyers JD.

Fred Hutchinson Cancer Research Center, Seattle, Washington.

Both acyclovir and vidarabine are effective treatment for varicella zoster virus 
(VZV) infection in immunosuppressed patients. To determine which is preferable,
therapy with these two agents was compared in a prospective, randomized trial. A 
total of 22 immunocompromised patients undergoing treatment for hematologic
malignancies and presenting with VZV infection within 72 hours of the onset of
rash were randomly assigned to receive intravenous acyclovir or vidarabine; 11
patients were randomly assigned to each treatment group. Acyclovir was
significantly more effective than vidarabine in preventing complications of VZV
infection, and treatment failures requiring a change to the alternate therapy
occurred only among those treated with vidarabine. As compared with vidarabine,
acyclovir shortened the median period during which results of viral culture
specimens were positive and new lesions formed. Acyclovir also shortened the
median interval until the first decrease in pain, the crusting of all lesions,
and the complete healing of lesions. Acyclovir is more effective than vidarabine 
in the treatment of VZV infection in severely immunocompromised patients and
should be considered the treatment of choice in such cases.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 3044102 [PubMed - indexed for MEDLINE]

6428: Am J Med. 1988 Aug 29;85(2A):94-5.

Treatment of chickenpox in immunocompromised children.

Nyerges G, Meszner Z.

1st Chair of Pediatrics, Postgraduate Medical School, Budapest, Hungary.

In Hungary since 1981, 98 immunocompromised children have been treated with
intravenous acyclovir for varicella zoster virus infections. They were treated in
an open study or a double-blind study. Results of both are discussed briefly.
Overall, five of 74 patients with varicella died, whereas all 24 patients with
herpes zoster recovered. Treatment failures occurred in patients in whom
treatment started late and in those with severe lymphocytopenia. In some
children, varicella zoster virus-specific antibodies failed to develop by the end
of treatment, and a proportion of these suffered recurrent episodes of varicella.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 3044101 [PubMed - indexed for MEDLINE]

6429: Am J Med. 1988 Aug 29;85(2A):90-3.

Reduction of the ocular complications of herpes zoster ophthalmicus by oral
acyclovir.

Cobo M.

Department of Ophthalmology, Duke University School of Medicine, Durham, North
Carolina 27710.

Herpes zoster ophthalmicus (HZO) is a unique form of zoster dermatitis associated
with a high rate of ocular complications that tend to be chronic and may cause
vision loss. The ocular complications are highly varied, with keratitis and
uveitis being more persistent sequellae of HZO. Oral acyclovir treatment of acute
HZO reduces the incidence of the more common ocular complications, including
keratitis and uveitis. Although patients treated early in the course of this
disease experience a greater clinical response, treatment as late as seven days
after onset of cutaneous lesions confers a beneficial prophylactic effect with
respect to the ocular complications of HZO.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Review

PMID: 3044100 [PubMed - indexed for MEDLINE]

6430: Am J Med. 1988 Aug 29;85(2A):84-9.

Therapy of herpes zoster with oral acyclovir.

Huff JC, Bean B, Balfour HH Jr, Laskin OL, Connor JD, Corey L, Bryson YJ, McGuirt
P.

University of Colorado School of Medicine, Denver 80262.

Oral acyclovir therapy for herpes zoster has been studied in double-blind,
placebo-controlled trials of two dosages, 400 mg and 800 mg five times per day
for 10 days. Compared with placebo recipients, recipients of the high-dosage
acyclovir experienced a significantly shortened period of viral shedding,
significantly accelerated time to 50 percent scabbing, significantly accelerated 
time to 50 percent healing, and after two days of therapy, significantly less
frequent formation of new lesions. The duration and severity of acute pain were
less in acyclovir recipients, with differences in pain severity achieving
statistical significance (p = 0.03) between Days 3 and 10 and correlating with
the treatment differences in new lesion formation. In studies of the 400 mg five 
times per day dose schedule, differences between acyclovir and placebo recipients
were not significant. In a six-month follow-up of recipients in the higher dosage
study, the acyclovir recipients experienced less post-zoster pain than placebo
recipients; differences in the prevalence of pain were most significant for the
presence of a persistent pain in the first three months of follow-up. Oral
acyclovir at these dosages appears to be free of adverse reactions. In summary,
oral acyclovir at a dosage of 800 mg five times per day for 10 days for treatment
of acute herpes zoster is superior to 400 mg five times per day and favorably
alters the course of the disease.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 3044099 [PubMed - indexed for MEDLINE]

6431: Am J Med. 1988 Aug 29;85(2A):79-83.

Efficacy of oral acyclovir treatment of acute herpes zoster.

Wood MJ, Ogan PH, McKendrick MW, Care CD, McGill JI, Webb EM.

Department of Communicable and Tropical Diseases, East Birmingham Hospital,
United Kingdom.

Oral acyclovir, 800 mg five times per day for seven days, was compared with
placebo in a randomized, double-blind trial conducted at three centers in the
United Kingdom. The study group consisted of 364 elderly immunocompetent patients
with herpes zoster who were entered within 72 hours of the onset of rash.
Acyclovir significantly reduced the times to last new lesion formation (p less
than 0.01), loss of vesicles (p less than 0.01), and full crusting (p = 0.03). No
significant hastening of rash healing was seen in those who started therapy later
than 48 hours after the onset of rash. There was also a significant reduction
pain during treatment with acyclovir (p = 0.02). Acyclovir produced no effects on
the frequency or severity of post-herpetic neuralgia. No clinically important
adverse effects of acyclovir were reported.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 3044098 [PubMed - indexed for MEDLINE]

6432: Am J Med. 1988 Aug 29;85(2A):74-8.

Management of varicella zoster infections in immunocompetent hosts.

Peterslund NA.

Department of Medicine and Infectious Diseases, Marselisborg Hospital, Aarhus,
Denmark.

Varicella in otherwise healthy children usually requires no antiviral treatment. 
In severe cases, however, such as are seen in neonates and adults, treatment must
be given. Anecdotal evidence suggests the efficacy of intravenous acyclovir in
such patients. Herpes zoster in immunocompetent patients may be severe enough to 
warrant antiviral therapy, particularly in elderly patients. Both idoxuridine and
acyclovir have been investigated in placebo-controlled double-blind studies. Due 
to its low toxicity, ease of administration, and the possibility of systemic
administration, acyclovir has largely replaced older antivirals in the management
of herpes zoster in the normal host. Recent studies have shown the efficacy of
oral acyclovir. In addition, oral acyclovir may prevent the ocular complications 
of ophthalmic zoster. When acyclovir is given, it should be administered as early
as possible, preferably no later than four days after the onset of the rash. The 
combination of acyclovir and prednisolone for the prevention of post-herpetic
neuralgia has not proved effective.

Publication Types: 
    Clinical Trial
    Review

PMID: 3044097 [PubMed - indexed for MEDLINE]

6433: Am J Med. 1988 Aug 29;85(2A):68-73.

Varicella zoster virus infections in immunocompromised hosts. A review of the
natural history and management.

Balfour HH Jr.

Department of Laboratory Medicine and Pathology, University of Minnesota Health
Sciences Center, Minneapolis 55455.

Varicella is relatively mild in otherwise normal children, in whom new lesions
form for a mean of four days after onset and heal 50 percent of their lesions in 
eight days. New lesions form in most immunocompromised children for longer than
five days and those not treated with antiviral drugs have a 28 percent incidence 
of pneumonitis and a 7 percent mortality rate. Untreated immunocompromised adults
with herpes zoster shed virus for longer (7.0 days) than otherwise normal adults 
(5.3 days). Herpes zoster is much more likely to disseminate cutaneously in
immunocompromised than in immunocompetent hosts. Visceral dissemination, which is
a rare event in immunocompetent patients, occurred in 8 percent of prospectively 
followed untreated immunocompromised hosts with herpes zoster. Acyclovir has been
found to be superior to vidarabine for treatment of both chickenpox and herpes
zoster. Whether or not steroids should be used to treat herpes zoster remains
controversial. Concerns about the use of intravenous acyclovir include the side
effects of renal and central nervous system dysfunction and the possibility of
emergence of resistant viral strains. None of these concerns has proved to be an 
impediment to successful treatment of immunocompromised patients. The major
future challenge is to find an optimal way to treat varicella zoster virus
infections with oral formulations of acyclovir or its congeners.

Publication Types: 
    Historical Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 3044096 [PubMed - indexed for MEDLINE]

6434: Am J Med. 1988 Aug 29;85(2A):129-34.

Viral sensitivity following the introduction of acyclovir.

Collins P.

Department of Biochemical Virology, Wellcome Research Laboratories, Beckenham,
Kent, United Kingdom.

Extensive use of acyclovir for the treatment or prevention of herpes simplex and 
varicella zoster infections in immunocompetent patients has not resulted in
significant changes in virus sensitivity. Some minor reductions have been
observed, but these have not affected clinical responses. In severely
immunosuppressed patients, virus with reduced acyclovir sensitivity has very
occasionally been isolated and this has sometimes been associated with clinical
resistance. Resistance has, in all but one instance, resulted from the inability 
of the virus to express thymidine kinase. Follow-up where possible to subsequent 
recurrences has in all cases revealed sensitive virus. Therefore, resistance to
acyclovir in the clinical setting seems to be transient and its significance
slight.

Publication Types: 
    Review

PMID: 2841855 [PubMed - indexed for MEDLINE]

6435: Am J Med. 1988 Aug 29;85(2A):1-2.

Antiviral chemotherapy.

Lietman PS.

Division of Clinical Pharmacology, Johns Hopkins University School of Medicine,
Baltimore, Maryland 21205.

PMID: 2457312 [PubMed - indexed for MEDLINE]

6436: Epidemiol Infect. 1988 Aug;101(1):187-95.

Detection of specific IgM in varicella and herpes zoster by antibody-capture
radioimmunoassay.

Kangro HO, Ward A, Argent S, Heath RB, Cradock-Watson JE, Ridehalgh MK.

Department of Virology, St Bartholomew's Hospital, West Smithfield, London.

A simple and sensitive M antibody-capture radioimmunoassay (MACRIA) is described 
which utilizes crude commercial VZV antigen and a single monoclonal anti-VZV
antibody. This was compared to the immunofluorescence (IF) test for IgM antibody 
and was used to study IgM responses in sera from 261 patients with varicella and 
220 patients with herpes zoster. With MACRIA, IgM antibodies were detected in all
patients with varicella. The IgM antibodies appeared shortly after onset of rash,
reached peak levels between 1 and 4 weeks after onset and then declined to low or
undetectable levels in most, though not all, patients after 3 months. IgM
antibodies were also detected in 98.2% of patients with herpes zoster, but the
levels of IgM were significantly lower than after varicella and there was wider
individual variation both in magnitude and duration of the IgM responses, in some
cases only lasting 2-3 weeks. Comparison between MACRIA and IF showed good
agreement in the detection of IgM antibodies following varicella. Discordant
results were obtained with 13% of sera, of which 81% were taken either early or
late after onset of rash and contained very low IgM levels. In contrast, 62 (28%)
of the 220 sera from patients with zoster gave discordant results in the two
tests, all except five being MACRIA-positive but IF-negative. The largest
proportion of discordant results were obtained with sera taken more than 3 months
after onset of rash, but 18 (29%) contained high IgM levels and were taken during
the period of peak IgM responses. The diagnostic applications of the VZV MACRIA
are discussed.

PMID: 3402547 [PubMed - indexed for MEDLINE]

6437: Neurology. 1988 Aug;38(8):1331.

Brainstem infarction following cervical herpes zoster.

Snow BJ, Simcock JP.

University Geriatric Unit, North Shore Hospital, Auckland, New Zealand.

Publication Types: 
    Case Reports

PMID: 3399086 [PubMed - indexed for MEDLINE]

6438: Dig Dis Sci. 1988 Aug;33(8):1050.

Gastroparesis and herpes.

Eisenberg D.

Publication Types: 
    Case Reports
    Letter

PMID: 3391078 [PubMed - indexed for MEDLINE]

6439: Bull Soc Ophtalmol Fr. 1988 Aug-Sep;88(8-9):1079-81.

[Ophthalmic zona in a LAV+ infant]

[Article in French]

Lagier J, Lods F, Ghenassia G, Szepetowski G, Gillon P.

Publication Types: 
    Case Reports

PMID: 3266930 [PubMed - indexed for MEDLINE]

6440: Can J Ophthalmol. 1988 Aug;23(5):249.

Contralateral hemiparesis: late complication of herpes zoster ophthalmicus.

Mallek D.

Publication Types: 
    Letter

PMID: 3263177 [PubMed - indexed for MEDLINE]

6441: Hautarzt. 1988 Aug;39(8):514-8.

[Acute primary stage of HIV infection and progression to AIDS with Kaposi sarcoma
24 months later]

[Article in German]

Bratzke B, Orfanos CE.

Universitats-Hautklinik, Klinikum Steglitz, Freien Universitat Berlin.

The case is reported of a 31-year-old homosexual male who developed distinct
maculopapular and papulovesicular exanthema with aphthous-like, painful lesions
of the oral mucosa, together with marked general symptoms (fever, diarrhoea,
lymphadenopathy). This clinical picture suggested the primary acute phase of an
initial HIV infection; during this phase the HIV-ELISA and Western blot test were
negative. One year later the patient was found to be HIV-positive, showing oral
candidosis, generalized lymphadenopathy, seborrhoeic eczema and zoster infection 
(L5/S1). A further year later, the patient developed full-blown AIDS with
disseminated Kaposi's sarcoma. This observation underlines the acute inflammatory
character of the primary phase of HIV infection with initial exanthema and
documents the appearance of AIDS-associated Kaposi's sarcoma in a time period of 
maximally 2 years thereafter.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3220765 [PubMed - indexed for MEDLINE]

6442: Int J Cardiol. 1988 Aug;20(2):257-62.

The scale of myocardial involvement in varicella myocarditis.

Lorber A, Zonis Z, Maisuls E, Dembo L, Palant A, Iancu TC.

Heart Institute, Carmel Hospital, Haifa.

Two patients with varicella myocarditis are described. An arrhythmia associated
with complete recovery occurred in the first patient whereas intractable
congestive heart failure complicated by hemiplegia resulted in a fatal outcome in
the other case. We stress the extent of myocardial involvement produced by the
herpes zoster virus in the setting of varicella.

Publication Types: 
    Case Reports

PMID: 3209256 [PubMed - indexed for MEDLINE]

6443: Acta Neurol Belg. 1988 Aug-Oct;88(4):203-20.

[Antibody activity of CSF oligoclonal IgG in infectious neurological diseases.
Detection using immunoblotting]

[Article in French]

Bukasa KS, Sindic CJ, Limet JN, Laterre C.

Laboratoire de Neurochimie, Universite Catholique de Louvain, Bruxelles,
Belgique.

The authors describe various applications of an immunoblot technique which allows
the qualitative determination of the specific antibody activity of oligoclonal
IgG intrathecally synthesized in infectious diseases of the nervous system. After
dilution of sera to the same IgG concentration as the paired CSF samples, 10
microliters of both fluids are applied side by side on agarose gel plates and
isoelectrically focused. Precipitated IgG or specific IgG antibodies are then
blotted onto a nitrocellulose sheet previously coated with either a rabbit
anti-IgG antiserum or the antigen under study, respectively. The immunoblot is
successively incubated with biotinylated anti-IgG antiserum and with the
streptavidin-biotin-peroxidase complex before staining with 4 chloro-1-naphthol. 
This method was applied to samples from patients with subacute sclerosing
panencephalitis, herpetic encephalitis, meningoradiculitis due to Herpes Zoster, 
neuro-AIDS, neurobrucellosis, meningoradiculitis or encephalomyelitis due to
Borrelia burgdorferi, and tuberculous meningitis. In each case, specific
oligoclonal IgG antibodies, superimposed or not on a diffuse polyclonal synthesis
were detected in the CSF, but not, or more faintly, in the corresponding serum.
This was taken as evidence for an intra-thecal synthesis of these antibodies. In 
contrast, when a "mirror effect" was observed, i.e. similar oligoclonal bands in 
both serum and CSF after dilution at the same IgG concentration, an intra-thecal 
synthesis was ruled out.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 3206996 [PubMed - indexed for MEDLINE]

6444: Pain. 1988 Aug;34(2):129-38.

Post-herpetic neuralgia: post-mortem analysis of a case.

Watson CP, Morshead C, Van der Kooy D, Deck J, Evans RJ.

Irene Eleanor Smythe Pain Clinic, Toronto General Hospital, Ont., Canada.

The morphological and biochemical substrates of the severe pain in post-herpetic 
neuralgia (PHN) are unclear. This report is an autopsy study of a 67-year-old
male with severe PHN during the last 5 years of his life over the right T7-8
dermatomes. The dorsal horn of the thoracic spinal cord of the affected side was 
atrophic from T4 to T8, with loss of both myelin and axons. Despite this, only
the T8 ganglion was affected by fibrosis and cell loss and only the nerve roots
at that level appeared affected. Markers of unmyelinated afferents (substance P),
substantia gelatinosa neurons (opiate receptors), glial cells (glial fibrillary
acidic protein), and descending spinal projections (dopamine-beta-hydroxylase and
serotonin) were not different at affected versus non-affected spinal cord levels.
The pain of PHN may result from the uninhibited activity of unmyelinated primary 
afferents as a result of the loss of myelinated afferent fibers and the possible 
presence of hypersensitive neurons in the dorsal horn.

Publication Types: 
    Case Reports

PMID: 3174152 [PubMed - indexed for MEDLINE]

6445: J Neurol Sci. 1988 Aug;86(1):61-72.

Immunocytochemical analysis of immunoglobulin-containing cells in CSF and blood
in inflammatory disorders of the central nervous system.

Weber T, Rieckmann P, Jurgens S, Prange HW, Felgenhauer K.

Neurologische Klinik und Poliklinik der Universitat Gottingen, F.R.G.

Cells containing immunoglobulins G, A, and M were evaluated in paired
cerebrospinal fluid (CSF) and peripheral blood (PB) samples. These were obtained 
from 12 patients with bacterial meningitis, 14 patients with viral meningitis, 6 
cases of lymphocytic meningoradiculitis (LMR), 10 cases of multiple sclerosis
(MS), 6 cases of herpes zoster ganglionitis and 27 patients with non-infectious
disorders of the CNS. PB cells from 20 healthy donors served as controls. Using
alkaline phosphatase (AP)-conjugated antibodies to human immunoglobulin (Ig) G,
A, and M in a carrageenan solution it was possible to demonstrate repeatedly
intracytoplasmic Igs over more than 1 year without any detectable loss of
specificity and staining intensity. Immunoglobulin-containing cells (ICC) could
be detected in the CSF of 96% of patients with inflammatory diseases of the
central nervous system (CNS) or with MS but not in the control cases.

PMID: 3171597 [PubMed - indexed for MEDLINE]

6446: J Am Dent Assoc. 1988 Aug;117(2):288, 290.

Herpes zoster infection.

Iacono FR.

Publication Types: 
    Letter

PMID: 3166473 [PubMed - indexed for MEDLINE]

6447: Am J Med. 1988 Aug;85(2):147-51.

Recombinant interferon alpha-2a for treatment of herpes zoster in
immunosuppressed patients with cancer.

Winston DJ, Eron LJ, Ho M, Pazin G, Kessler H, Pottage JC Jr, Gallagher J,
Sartiano G, Ho WG, Champlin RE, et al.

Department of Medicine, UCLA Center for the Health Sciences 90024.

PURPOSE: Acyclovir and high doses of intramuscular leukocyte interferon have been
shown to prevent dissemination of herpes zoster in cancer patients with localized
herpes zoster. With the availability of recombinant interferon, we decided to
conduct a multicenter, placebo-controlled, double-blind trial of intramuscular
recombinant interferon alpha-2a to assess its efficacy and safety in the
treatment of localized herpes zoster in immunosuppressed patients with cancer.
PATIENTS and METHODS: Immunosuppressed cancer patients with localized herpes
zoster were randomly assigned to receive placebo, 36 X 10(6) units of recombinant
interferon alpha-2a per day, or 68 X 10(6) units of recombinant interferon
alpha-2a per day. Due to frequent adverse effects, the 68 X 10(6) unit dose of
interferon was discontinued prior to conclusion of the trial. RESULTS:
Dissemination of herpes zoster occurred in 14 of the 24 patients (58 percent) who
received placebo but in only four of 24 recipients (17 percent) of 36 X 10(6)
units of interferon per day (p = 0.003). Adverse effects (fever, chills,
headaches, gastrointestinal irritability, fatigue, and myalgias) were more common
or severe in interferon-treated patients. CONCLUSION: These results suggest that 
interferon modifies the severity of herpes zoster in immunosuppressed patients
with cancer but is associated with frequent side effects.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3041829 [PubMed - indexed for MEDLINE]

6448: J Med Virol. 1988 Aug;25(4):371-85.

Virus isolation and immune studies in a cohort of homosexual men.

Buimovici-Klein E, Lange M, Ong KR, Grieco MH, Cooper LZ.

Department of Pediatrics, St. Luke's-Roosevelt Hospital Center, New York, NY
10019.

Virus shedding was detected in 77% of homosexual subjects and in only 6% of
heterosexual controls. The overall virus isolation rate in homosexual subjects
was not significantly different among HIV-seropositive (79%) and HIV-seronegative
(74%) individuals. In about 20% of homosexual subjects, virus shedding from
multiple sites was observed. The most frequently isolated virus was
cytomegalovirus (CMV) (41%), followed by enteroviruses (23%), herpes simplex
virus (HSV) (7%), and adenoviruses (6%). In the control group, about 50% of
subjects were seronegative for HSV-1 and 2, and about 70% were negative for CMV
and Epstein-Barr virus (EBV). Only 2% of homosexuals were seronegative for CMV,
about 5% for HSV-1 and 2, and about 20% for EBV. No differences were found in
antibody levels against varicella-zoster virus (VZV) among the control and
homosexual groups. The proportion of seronegatives for Coxsackie and hepatitis
viruses was significantly higher in control than in homosexual subjects. However,
no differences in the proportion of seronegatives for measles, mumps, and rubella
were observed. No HIV-antibody-negative individual was detected with an OKT4/OKT8
ratio of less than 0.75. On the other hand, only HIV-positive subjects, with a
ratio of less than 0.75, had high serum IFN alpha titers. The results suggest
that the high rate of virus shedding among HIV-negative homosexual subjects might
be a factor in the development of AIDS in this high-risk population.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2902192 [PubMed - indexed for MEDLINE]

6449: Nippon Ganka Gakkai Zasshi. 1988 Aug;92(8):1398-405.

[The detection of varicella-zoster virus (VZV) antigen from vitreous humor of 3
cases with Kirisawa-Urayama type uveitis]

[Article in Japanese]

Usui M, Gotoh H, Shima Y, Takamura K, Kurata T, Sata T.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2848401 [PubMed - indexed for MEDLINE]

6450: Clin Otolaryngol Allied Sci. 1988 Aug;13(4):289-98.

The natural history of facial paralysis in herpes zoster.

Devriese PP, Moesker WH.

Academic Medical Centre, Department of Facial Research, Amsterdam, The
Netherlands.

A group of 102 patients with facial palsy caused by herpes zoster was studied in 
order to determine the course and prognosis without treatment. In most cases, the
eruption and the paralysis appeared at the same time. The maximal degree of loss 
of function was usually reached within 1 week and was clearly related to the age 
of the patient. Recovery was better when the vesicles preceded complete loss of
function. Complete recovery was achieved in about 10% of patients after a
complete loss of function and in about 66% after an incomplete loss.

PMID: 2846216 [PubMed - indexed for MEDLINE]

6451: J Med Virol. 1988 Aug;25(4):387-98.

Serological responses in varicella and zoster assayed by immunoblotting.

Harper DR, Kangro HO, Heath RB.

Virology Department, St. Bartholomew's Hospital, London, England.

Acute and convalescent zoster sera taken from 11 patients with varicella and 12
patients with zoster were assayed using immunoblotting for the presence of IgG-
and IgM-class antibodies to proteins present in varicella-zoster virus-infected
cells. All patients exhibited a detectable virus-specific response with both
antibody classes. The IgG responses involved up to 28 protein bands between 28
and 255 kilodaltons (kDa). The reactivity was particularly strong in the
78-114-kDa region, with additional bands observed with all patients at 32, 35,
66, and 220 kDa. This pattern of reactivity typically developed more slowly and
was weaker and more variable in patients with varicella compared to those with
zoster. The reactivity of IgM antibodies in immunoblotting was similar after
varicella and after zoster. Individual sera showed up to 25 bands, with the major
reactivity being directed against the 78-96-kDa region and two bands at 32 and 35
kDa. Some differences were apparent between the primary and anamnestic responses 
with both IgG and IgM antibodies, but this did not allow reliable discrimination 
of the two types of infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2844983 [PubMed - indexed for MEDLINE]

6452: Postgrad Med. 1988 Aug;84(2):181-4, 187-90.

Mucocutaneous herpetic infections during cancer chemotherapy.

Dreizen S, McCredie KB, Bodey GP, Keating MJ.

Department of Oral Oncology, University of Texas Dental Branch, Houston 77225.

Adults who are given immunosuppressive and myelosuppressive cancer chemotherapy
have a heightened risk for development of herpetic infections during treatment.
The impact is much greater in patients who are given antineoplastic drugs for
leukemia and lymphoma than in those who are given such drugs for carcinoma and
sarcoma. In the series reported here, the incidence of herpes simplex infections 
exceeded that of herpes zoster infections in patients treated for leukemia by a
ratio of more than 12:1, compared to slightly more than 2:1 in patients treated
for solid tumor. The frequency of herpes simplex and herpes zoster infections
during treatment for leukemia was 25%. Corresponding frequencies for patients
with lymphoma, carcinoma, and sarcoma were 28%, 8%, and 3%, respectively.

Publication Types: 
    Comparative Study

PMID: 2840648 [PubMed - indexed for MEDLINE]

6453: J Virol. 1988 Aug;62(8):2850-8.

Characterization of an equine herpesvirus type 1 gene encoding a glycoprotein
(gp13) with homology to herpes simplex virus glycoprotein C.

Allen GP, Coogle LD.

Department of Veterinary Science, University of Kentucky, Lexington 40546-0099.

The molecular structure of the equine herpesvirus type 1 (EHV-1) gene encoding
glycoprotein 13 (gp13) was analyzed. The gene is contained within a 1.8-kilobase 
AccI-EcoRI restriction fragment mapping at map coordinates 0.136 to 0.148 in the 
UL region of the EHV-1 genome and is transcribed from right to left.
Determination of the nucleotide sequence of the DNA fragment revealed a complete 
transcriptional unit composed of typical regulatory promoter elements upstream to
a long open reading frame (1,404 base pairs) that encoded a 468-amino-acid
primary translation product of 51 kilodaltons. The predicted protein has the
characteristic features of a membrane-spanning protein: an N-terminal signal
sequence, a hydrophobic membrane anchor region, a charged C-terminal cytoplasmic 
tail, and an exterior domain with nine potential N-glycosylation sites. The EHV-1
DNA sequences expressed in lambda gt11 as gp13 epitopes were present in the open 
reading frame. Amino acid sequences composing a major antigenic site, recognized 
by 35% of a panel of 42 anti-gp13 monoclonal antibodies, were identified in the
N-terminal surface domain of the deduced gp13 molecule. Comparison of the EHV-1
gp13 DNA sequence with that encoding glycoproteins of other alphaherpesviruses
revealed no detectable homology. However, a search for homology at the amino acid
level showed regions of significant sequence similarity between the amino acids
of the carboxy half of EHV-1 gp13 and those of the same region of gC-like
glycoproteins of herpes simplex virus (gC-1 and gC-2), pseudorabies herpesvirus
(gIII), and varicella-zoster virus (gp66). The sequences of the N-terminal
portion of gp13, by contrast, were much less conserved. The results of these
studies indicate that EHV-1 gp13 is the structural homolog of herpes simplex
virus glycoprotein C and further suggest that the epitope-containing N-terminal
amino acid sequences of the herpesvirus gC-like glycoproteins have undergone more
extensive evolutionary divergence than the C-terminal sequences.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 2455821 [PubMed - indexed for MEDLINE]

6454: N Z Med J. 1988 Jul 13;101(849):461.

A new shingles therapy.

Acland RH.

Publication Types: 
    Letter

PMID: 3399188 [PubMed - indexed for MEDLINE]

6455: Ned Tijdschr Geneeskd. 1988 Jul 2;132(27):1235-7.

[Minor symptoms in family practice; herpes zoster]

[Article in Dutch]

Bergink GJ, Gill K.

PMID: 2840583 [PubMed - indexed for MEDLINE]

6456: South Med J. 1988 Jul;81(7):929-30.

Herpes zoster causing acute urinary retention.

Patel BR, Rivner MH.

Department of Neurology, Medical College of Georgia, Augusta 30912-2323.

Publication Types: 
    Case Reports

PMID: 3393956 [PubMed - indexed for MEDLINE]

6457: Heart Lung. 1988 Jul;17(4):331-4.

Transmissible infections in critical care.

Gurevich I.

Infection Control Section, Winthrop-University Hospital, Mineola, NY 11501.

Personnel caring for critically ill patients in emergency or trauma care
settings, or in adult and pediatric intensive care units, face considerable risk 
of acquiring infections from their patients. Obvious infections are less
hazardous than obscure, unsuspected, or unreported ones. Although postexposure
prophylaxis is available in some cases, it can add its own risks for uninformed
persons. Examples of inadvertent but unnecessary exposures, with their
consequences, are discussed in this article. Emphasis is on how ethical and
considerate behavior toward others, along with clinical awareness, diagnostic
clues, and early communication with the infection control service, could have
prevented these exposures and might do so in other instances.

Publication Types: 
    Case Reports

PMID: 3391786 [PubMed - indexed for MEDLINE]

6458: Arch Dermatol. 1988 Jul;124(7):1011-3.

Unusual varicella zoster virus infection in patients with the acquired
immunodeficiency syndrome.

Alessi E, Cusini M, Zerboni R, Cavicchini S, Uberti-Foppa C, Galli M, Moroni M.

Publication Types: 
    Case Reports
    Letter

PMID: 3389843 [PubMed - indexed for MEDLINE]

6459: Laryngoscope. 1988 Jul;98(7):776-9.

Herpes zoster oticus: treatment with intravenous acyclovir.

Dickins JR, Smith JT, Graham SS.

Ear and Nose-Throat Clinic, P.A., Little Rock, AR 72205-6358.

Herpes zoster oticus generally has a poor prognosis, leaving many patients with
permanent facial nerve dysfunction. This preliminary report describes results in 
seven patients treated for zoster; all were given intravenous acyclovir. Patients
were infused with 10 mg/kg every 8 hours over a 7-day hospitalization period.
Five of the seven patients showed some return of facial function at the time of
discharge. At follow-up, 4 patients had achieved a House grade I result, 1
patient a grade II, and 2 patients a grade III. Reasons for the differences in
final results are discussed, along with a recommended regimen for treatment.

PMID: 3386386 [PubMed - indexed for MEDLINE]

6460: Arch Intern Med. 1988 Jul;148(7):1561-6.

Varicella-zoster infection in adult cancer patients. A population study.

Rusthoven JJ, Ahlgren P, Elhakim T, Pinfold P, Reid J, Stewart L, Feld R.

Toronto-Bayview Regional Cancer Center, Canada.

In a retrospective review of varicella-zoster (V-Z) Infections in adult cancer
patients, 766 episodes of V-Z Infection were studied among 740 patients seen at a
large comprehensive cancer center from 1972 to 1980. The highest risk of
infection was present among patients with lymphoma and leukemia. The risk of
dissemination of V-Z Infection was significantly associated with the presence of 
active tumor at the time of Infection. The site of the primary tumor correlated
with the site of subsequent zoster Infection among patients with breast cancer,
cancer of the respiratory tract, and gynecologic cancer. Pain attributable to V-Z
Infection was present in a large majority of episodes. The median time from the
completion of therapy to the onset of Infection was seven months for patients
receiving radiotherapy and less than one month for those receiving chemotherapy. 
Various attributes of this study group were compared with those of previously
studied cancer and noncancer populations.

PMID: 3382302 [PubMed - indexed for MEDLINE]

6461: J Dermatol Surg Oncol. 1988 Jul;14(7):774-8.

Zosteriform metastasis: case presentation and review of the literature.

Matarasso SL, Rosen T.

Department of Dermatology, Baylor College of Medicine, Houston, Texas 77030.

In contrast to benign tumors, malignant tumors, by definition, are characterized 
by the potential of giving rise to metastases. Albeit infrequently, skin
metastases do occur, and their clinical appearance varies over a wide morphologic
spectrum. We present the case of a 65-year-old male with zosteriform metastasis
secondary to bronchogenic adenocarcinoma. A review of cutaneous metastasis is
presented with emphasis on dermatomal distribution and possible mechanisms of
dissemination.

Publication Types: 
    Case Reports
    Review

PMID: 3292614 [PubMed - indexed for MEDLINE]

6462: J Infect. 1988 Jul;17(1):57-63.

A double-masked, placebo-controlled trial of acyclovir cream in immunocompetent
patients with herpes zoster.

Mandal BK, Dunbar EM, Ellis ME, Ellis J, Dowd P.

Regional Department of Infectious Diseases and Tropical Medicine, Monsall
Hospital, Manchester, U.K.

Sixty-four patients with herpes zoster were entered into a randomised
double-masked, placebo-controlled trial of 5% acyclovir cream applied five times 
daily for 5 days. Of these patients, 56 were included in the final analysis (26
acyclovir, 30 placebo). Significant and objective differences in either
progression of the rash, severity of acute pain or incidence of post-herpetic
neuralgia were not observed. Although significantly more rashes involuted in the 
acyclovir group, this isolated finding cannot be explained. Twenty-two patients
(12 acyclovir, 10 placebo) experienced erythema or desquamation or both during
treatment with the cream. The similar incidence of skin reactions in both groups 
suggests that they were related to the cream base rather than the acyclovir.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3060542 [PubMed - indexed for MEDLINE]

6463: Virus Genes. 1988 Jul;1(4):351-67.

Computer-assisted primary and secondary structure analyses of DNA polymerases of 
herpes simplex, Epstein-Barr and varicella zoster viruses reveal conserved
domains with some homology to DNA-binding domain in E. coli DNA pol I.

Becker Y.

Department of Molecular Virology, Faculty of Medicine, Hebrew University,
Jerusalem, Israel.

The primary and secondary structure of herpes simplex virus type 1 (HSV-1),
varicella-zoster (VZV) and Epstein-Barr virus (EBV) DNA polymerases was
calculated by means of computer programs. The comparison of HSV-1 polymerase
(pol) sequence to the known primary and tertiary structure of E. coli DNA pol I
revealed five short homologous sequences, one of which coincided with the
alpha-helical structure of the DNA-binding domain of E. coli DNA pol. Comparison 
by primary and secondary structure computer programs of the three DNA polymerases
coded by herpesviruses HSV-1, VZV and EBV led to the identification of
polypeptide sequences shared by the three DNA pols. In a similar way, the
secondary structure of the DNA pol polypeptide in the vicinity of the mutation
leading to PAA resistance in HSV-1 DNA pol helped to identify the role of this
sequence in the binding of phosphate donated by the nucleoside triphosphate
molecule which binds to the DNA pol. Although the computer secondary structure
programs are about 60% accurate, it was possible to obtain new information on the
properties of certain domains in the DNA polymerases of HSV-1, VZV and EBV.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2852411 [PubMed - indexed for MEDLINE]

6464: Nippon Jibiinkoka Gakkai Kaiho. 1988 Jul;91(7):1078-84.

[Early diagnosis of varicella-zoster virus infection in acute facial
paralysis--significance of VZV antigen skin test and CSF examination]

[Article in Japanese]

Okuno H.

Publication Types: 
    English Abstract

PMID: 2846806 [PubMed - indexed for MEDLINE]

6465: Clin Exp Immunol. 1988 Jul;73(1):6-10.

CD4 and CD8 cell responses to herpes simplex virus in Behcet's disease.

Young C, Lehner T, Barnes CG.

Department of Immunology, United Medical School, Guy's Hospital, London, UK.

The finding of part of the Herpes simplex virus type 1 (HSV1) genome in
peripheral blood leucocytes of some patients with Behcet's disease (BD) led to
investigations of T cell responses to HSV1 in this disease. A significantly
impaired uptake of 3H-thymidine by CD4 cells was found in BD, as compared with
healthy HSV1 sero-positive subjects. The impaired cellular response appeared to
be specific to HSV1, as neither cytomegalovirus nor varicella-zoster virus showed
depressed CD4 cell responses in BD. A similar impairment of CD4 cell responses to
HSV1 was found in patients with recurrent herpetic infections, known to be caused
by latent HSV1 infections. However, in rheumatoid arthritis which was selected as
an unrelated autoimmune disease. 3H-thymidine uptake by CD4 cells stimulated with
HSV1 was enhanced. CD8 cells showed generally rather a low uptake of
3H-thymidine, nevertheless, the values in BD and recurrent herpetic infection
were again lower than those in sero-positive controls or rheumatoid arthritis.
The results are consistent with the hypothesis that HSV1 might be involved in the
immunopathogenesis of BD.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2844457 [PubMed - indexed for MEDLINE]

6466: Acta Otolaryngol. 1988 Jul-Aug;106(1-2):1-9.

Anti-herpes IgG and IgG subclass antibodies in Bell's palsy.

Jonsson L, Sundqvist VA, Thomander L.

Department of Otolaryngology, Uppsala University, Akademiska Sjukhuset, Sweden.

To ascertain if there is an association between Bell's palsy and infection by
viruses of the herpes group, 78 patients and 59 controls were investigated. The
specific antiviral IgG subclass pattern in serum against cytomegalovirus (CMV),
herpes simplex virus type 1 (HSV-1) and varicella zoster virus (VZV) was analysed
using an enzyme-linked immunosorbent assay (ELISA) combined with monoclonal
antibodies directed against the four subclasses of human IgG. Additional ELISA
assays of IgG and IgM antibodies were also used. The mean titres of IgG
antibodies against HSV-1 were higher in the acute and convalescent stages
compared with controls. The frequency of values greater than 0.2 for all
subclasses was raised in the patients, but not significantly so. The mean values 
for the subclasses were alike in patients and controls. The mean titres of IgG
antibodies against CMV and VZV were similar throughout the palsy and also in
controls. In the patients, the pattern of IgG subclasses was different from the
controls, but not statistically so. The patients and controls were not
seropositive for IgM against CMV and VZV. Four patients in the acute phase, 4 in 
the convalescent phase and 3 controls were positive for IgM against HSV-1. While 
the subclass pattern of IgG antibodies against HSV-1 is not diagnostic of
reactivation of the virus, the raised IgG antibodies may suggest reactivation of 
a disease process and/or a superadded infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2844053 [PubMed - indexed for MEDLINE]

6467: Curr Eye Res. 1988 Jul;7(7):661-6.

Rapid detection of herpes simplex virus (HSV) antigen in human ocular infections.

Dunkel EC, Pavan-Langston D, Fitzpatrick K, Cukor G.

Department of Ophthalmology, Harvard Medical School, Boston, MA 02114.

The new HERPCHEK (Dupont, No. Billerica, MA) enzyme immunosorbent assay (EIA) was
used in a double-blind clinical study for rapid and specific detection of ocular 
herpes simplex virus (HSV) infection. This 4-hour assay can be used to
demonstrate conclusively the presence of HSV antigen without culture and thereby 
rapidly differentiate between HSV and other clinically similar ocular infectious 
diseases. Ocular samples were collected from 180 individuals including 30
patients with acute HSV, 90 with latent HSV (ie, currently asymptomatic but with 
a positive history), 11 with acute or latent varicella zoster virus, 30 with
nonherpetic infections (due to adenovirus, Acanthamoeba or bacteria), and 19
normal controls. A clinical diagnosis was made by one of us (DPL) and duplicate
tear-film samples obtained by swabbing the conjunctival cul-de-sac and cornea.
Coded samples were tested by routine viral culture on Vero cell monolayers and
also were run independently in the HERPCHEK test. During active HSV infection,
the HERPCHEK correlated 100% with clinical diagnosis, and virus culture
correlated 90% with clinical diagnosis. In all latent HSV ocular infections,
other nonherpetic ocular infections and normal samples, both the HERPCHEK and
culture assays were negative.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2843320 [PubMed - indexed for MEDLINE]

6468: J Gen Virol. 1988 Jul;69 ( Pt 7):1531-74.

The complete DNA sequence of the long unique region in the genome of herpes
simplex virus type 1.

McGeoch DJ, Dalrymple MA, Davison AJ, Dolan A, Frame MC, McNab D, Perry LJ, Scott
JE, Taylor P.

MRC Virology Unit, University of Glasgow, U.K.

We have determined the DNA sequence of the long unique region (UL) in the genome 
of herpes simplex virus type 1 (HSV-1) strain 17. The UL sequence contained
107,943 residues and had a base composition of 66.9% G + C. Together with our
previous work, this completes the sequence of HSV-1 DNA, giving a total genome
length of 152,260 residues of base composition 68.3% G + C. Genes in the UL
region were located by the use of published mapping analyses, transcript
structures and sequence data, and by examination of DNA sequence characteristics.
Fifty-six genes were identified, accounting for most of the sequence. Some 28 of 
these are at present of unknown function. The gene layout for UL was found to be 
very similar to that for the corresponding part of the genome of varicella-zoster
virus, the only other completely sequenced alphaherpesvirus, and the amino acid
sequences of equivalent proteins showed a range of similarities. In the whole
genome of HSV-1 we now recognize 72 genes which encode 70 distinct proteins.

Publication Types: 
    Review

PMID: 2839594 [PubMed - indexed for MEDLINE]

6469: J Infect Dis. 1988 Jul;158(1):124-31.

Infections with cytomegalovirus and other herpesviruses in 121 liver transplant
recipients: transmission by donated organ and the effect of OKT3 antibodies.

Singh N, Dummer JS, Kusne S, Breinig MK, Armstrong JA, Makowka L, Starzl TE, Ho
M.

Department of Infectious Diseases and Microbiology, Graduate School of Public
Health, University of Pittsburgh, Pennsylvania 15261.

One hundred twenty-one adult liver transplant recipients were studied for the
incidence, risk factors, and morbidity associated with herpesviruses infections
after transplantation. The overall incidence of infection was 59% for
cytomegalovirus (CMV), 35% for herpes simplex virus (HSV), 25% for Epstein-Barr
virus (EBV), and 7% for varicella-zoster virus (VZV). Primary CMV infection
occurred in 46% and reactivation CMV infection in 67% of the susceptible
recipients. Symptomatic and disseminated CMV diseases were more common when
patients developed primary infection (P less than .01, for both comparisons). The
donor organ appeared to be the only important source of CMV infection in
seronegative recipients. The use of OKT3 antibodies was associated with
disseminated CMV disease in patients with primary infection (P = .04) but not
with reactivation infection (P greater than .10). Although most HSV infections
were oral or genital reactivations, three cases of HSV hepatitis occurred--one
was a primary infection. Symptomatic reactivations of HSV were observed in 53% of
HSV-seropositive recipients who received OKT3, versus 31% of seropositive
recipients who did not receive OKT3 (P = .05).

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2839576 [PubMed - indexed for MEDLINE]

6470: Neurology. 1988 Jul;38(7):1150-3.

Chronic progressive varicella-zoster virus encephalitis in an AIDS patient.

Gilden DH, Murray RS, Wellish M, Kleinschmidt-DeMasters BK, Vafai A.

Department of Neurology, Veterans Administration Medical Center, Denver, CO.

A patient with AIDS developed chronic, progressive encephalitis. Pathologic
changes indicated that the encephalitis was produced primarily by a human
herpesvirus. Hybridization of radiolabeled RNA probes transcribed from cloned DNA
fragments of varicella-zoster virus (VZV), herpes simplex virus, cytomegalovirus,
and the human immunodeficiency virus to DNA extracted from the patient's brain
identified VZV as the causative agent. The results suggest that VZV should be
considered in the differential diagnosis of chronic encephalitis of unknown
etiology, particularly in immunosuppressed patients.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 2838767 [PubMed - indexed for MEDLINE]

6471: N Engl J Med. 1988 Jun 23;318(25):1669-79.

Case records of the Massachusetts General Hospital, Weekly clinicopathological
exercises. Case 25-1988. Back and abdominal pain followed by disseminated
intravascular coagulation in a five-year-old boy with leukemia in remission.

[No authors listed]

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3163775 [PubMed - indexed for MEDLINE]

6472: Am J Med. 1988 Jun;84(6):1076-80.

Disseminated herpes zoster in patients with human immunodeficiency virus
infection.

Cohen PR, Beltrani VP, Grossman ME.

Department of Dermatology, College of Physicians and Surgeons of Columbia
University, New York, New York 10032.

Herpes zoster virus infections occur in persons with decreased cellular immunity.
A 45-year-old man is described who presented with disseminated herpes zoster as
the initial manifestation of his human immunodeficiency virus infection.
Disseminated herpes zoster virus infections have been reported in human
immunodeficiency virus-seropositive patients. Similar to disseminated herpes
zoster virus infections that occur in immunosuppressed patients seronegative for 
human immunodeficiency virus, an increased morbidity and responsiveness to
acyclovir is observed. In contrast, the morphology of the skin lesions and the
clinical course have been more severe, and the mortality has been increased.
Visceral involvement has not been described.

Publication Types: 
    Case Reports

PMID: 3376978 [PubMed - indexed for MEDLINE]

6473: Stroke. 1988 Jun;19(6):784.

Radiation-induced cerebral vasculitis revisited.

Devinsky O.

Publication Types: 
    Case Reports
    Letter

PMID: 3376172 [PubMed - indexed for MEDLINE]

6474: Ann Intern Med. 1988 Jun;108(6):907.

Varicella-zoster virus infection.

Sugar SJ.

Publication Types: 
    Letter

PMID: 3369785 [PubMed - indexed for MEDLINE]

6475: J Korean Med Sci. 1988 Jun;3(2):79-82.

Herpes zoster ophthalmicus and delayed contralateral hemiparesis.

Sung KB, Kim SH, Kim JH, Chung KC, Kim MH.

Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.

Central nervous system is often involved by herpes zoster but it is very rarely
seen that contralateral hemiparesis or hemiplegia developed after herpes zoster
ophthalmicus. We report a case of herpes zoster ophthalmicus followed by the
delayed contralateral hemiparesis. A 33-year-old man developed acute cerebral
infarction and resultant right hemiparesis 44 days after herpes zoster
ophthalmicus in the left side. Brain CT disclosed hypodense area in the left
basal ganglia. Cerebral angiography revealed segmental narrowing of M1 portion of
the right middle cerebral artery.

Publication Types: 
    Case Reports

PMID: 3267358 [PubMed - indexed for MEDLINE]

6476: Ital J Neurol Sci. 1988 Jun;9(3):265-9.

Herpes zoster ophthalmicus and ipsilateral infarction in the territory of the
anterior choroidal artery.

Kniahynicki C, Castellano AE, Mossuto-Agatiello L.

Divisione di Neurologia, Istituto Sanatrix, Venafro.

We report a further case of retarded contralateral hemiplegia syndrome after
herpes zoster ophthalmicus in which the motor deficit was caused by an ischemic
infarction in the territory supplied by the anterior choroidal artery. We discuss
the clinical and physiopathogenetic features of the case and consider the
computed tomographic and neurological patterns of anterior choroidal infarction.

Publication Types: 
    Case Reports

PMID: 3261282 [PubMed - indexed for MEDLINE]

6477: Scott Med J. 1988 Jun;33(3):267-8.

Phenytoin monitoring: clinical or scientific?

Fulton JD, McGovern EM, McCarron BN, Carlile AK.

Department of Geriatric Medicine, Stobhill General Hospital, Glasgow.

Phenytoin is an established therapy for post-herpetic neuralgia. In order to
maintain serum phenytoin levels in the normal therapeutic range, serum phenytoin 
monitoring is required. This range may, however, be misleading in certain
clinical conditions. We report here a patient with hypoalbuminaemia who developed
marked clinical phenytoin toxicity despite maintenance of the serum total
phenytoin concentration within the therapeutic range.

Publication Types: 
    Case Reports

PMID: 3175605 [PubMed - indexed for MEDLINE]

6478: AIDS. 1988 Jun;2(3):219-21.

Evaluation of the WHO clinical case definition for AIDS in rural Zaire.

De Cock KM, Colebunders R, Francis H, Nzilambi N, Laga M, Ryder RW, Bondjobo M,
McCormick JB, Piot P.

Division of Viral Diseases, Center for Infectious Diseases, Atlanta, GA 30333.

The clinical case definition for AIDS proposed by WHO for use in Africa was
evaluated against HIV antibody status in 72 patients in rural Zaire. Twenty-one
(29%) of the patients were antibody-positive. For diagnosing anti-HIV
seropositivity, the case definition had a sensitivity of 52%, a specificity of
78%, a positive predictive value of 50% and a negative predictive value of 80%.
Calculation of the positive predictive value at different levels of prevalence of
HIV infection suggests that the case definition operates at maximum reliability
in selected high-risk groups. Modifications to the case definition should be
evaluated to try and improve its sensitivity and positive predictive value.

PIP: In many areas of Africa where AIDS is endemic, facilities for laboratory
diagnosis are too limited to reliably diagnose opportunistic infections.
Therefore, the World Health Organization defined a clinical case definition of
AIDS in which 2 major signs and at least 1 minor sign must be present to diagnose
AIDS. The major signs are: weight loss greater than 10%, diarrhea for more than 1
month, and prolonged fever for more than 1 month. The minor signs are: persistent
cough for more than 1 month, generalized pruritic dermatitis, recurrent herpes
zoster, oropharyngeal candidiasis, chronic disseminated herpes simplex, and
generalized lymphadenopathy. (The presence of Kaposi's sarcoma or cryptococcal
meningitis are sufficient by themselves for a diagnosis of AIDS.) 72 patients in 
4 hospitals in Equateur Province of Zaire were used to test the reliability of
the clinical case definition. 21 (29%) of the patients were HIV seropositive, and
22 (32%) fulfilled the clinical criteria. From these data the sensitivity of the 
case definition was 52%, specificity was 78%, positive predictive value was 50%, 
and negative predictive value was 80%. Since positive predictive value rises with
prevalence and HIV infection is maximal in the 20-40 age group, restricting the
case definition to this age group would increase its predictive value. Exclusion 
of patients with tuberculosis would reduce the number of false positive results.

PMID: 3134918 [PubMed - indexed for MEDLINE]

6479: Arch Fr Pediatr. 1988 Jun-Jul;45(6):393-7.

[Infections and bone marrow autograft carried out for leukemias in children.
Apropos of 47 cases]

[Article in French]

Amsallem D, Plouvier E, Estavoyer JM, Leroy J, Talon D, Lab M, Herve P, Noir A.

Unite d'Hematologie Pediatrique, Centre de Transfusion Sanguine, CHU, Besancon.

This study included 44 children undergoing autologous marrow transplantation for 
leukemia between August 1979 and June 1987. Three of them received a second
transplant. In the phase of neutropenia, 38 children presented with fever.
Nineteen septicemia occurred (13 Gram positive cocci, 6 Gram negative bacteria), 
and 2 interstitial pneumonitis were observed. All children with documented
infection or a fever of unknown origin recovered after treatment, except 3, who
died from infection. The latest antimicrobial therapy used was a combination of
an aminoglycoside and a third generation cephalosporin. When necessary,
vancomycin or amphotericin B were added. After engraftment (granulocyte count
greater than 0.5 X 10(9)/l) 14 septicemia (which recovered) and 10 herpes zoster 
infections were observed. Only one patient died of infection (herpes zoster with 
encephalitis).

Publication Types: 
    English Abstract

PMID: 3064729 [PubMed - indexed for MEDLINE]

6480: HNO. 1988 Jun;36(6):234-40.

[Herpes zoster cephalicus]

[Article in German]

Kainz J, Friedrich G.

Universitats-HNO-Klinik Graz.

The clinical features of ENT infections induced by the herpes zoster virus are
presented. Detailed descriptions of two cases affecting the ear and one affecting
the larynx are given, supplemented by photographs. The possible cranial nerve
lesions are demonstrated by a review of the literature. An attempt is made to
assign the distribution of dermomucosal eruptions and associated sensory and
motor dysfunctions to the appropriate neuroanatomical structures.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 3045057 [PubMed - indexed for MEDLINE]

6481: J Neurol Neurosurg Psychiatry. 1988 Jun;51(6):885-6.

Abdominal muscle paralysis from herpes zoster.

Glantz RH, Ristanovic RK.

Publication Types: 
    Case Reports
    Letter

PMID: 2969958 [PubMed - indexed for MEDLINE]

6482: Nippon Hifuka Gakkai Zasshi. 1988 Jun;98(7):721-30.

[Studies on meningitis phenomena in herpes zoster]

[Article in Japanese]

Higuchi Y, Morishima T.

Publication Types: 
    English Abstract

PMID: 2854865 [PubMed - indexed for MEDLINE]

6483: Infect Dis Clin North Am. 1988 Jun;2(2):495-509.

Herpesvirus infections (cytomegalovirus, herpes simplex virus, varicella-zoster
virus). How to use ganciclovir (DHPG) and acyclovir.

Drew WL, Buhles W, Erlich KS.

Laboratory Medicine, University of California, San Francisco.

Herpes viruses (HSV, CMV, VZ) are very frequent in AIDS patients and often exist 
in a chronic or progressive form. Clinically evident CMV retinitis occurs in
approximately 10 per cent of AIDS patients but can be effectively treated with a 
new nucleoside analogue DHPG (Gancyclovir). Perianal ulcers, proctitis, and other
clinical syndromes caused by HSV can be effectively treated with acyclovir (ACV) 
and HSV recurrences can be prevented by daily administration of ACV. Zoster in a 
young adult may be the first indication of immunodeficiency due to HIV. Because
VZV is less susceptible to ACV than HSV, intravenous ACV or high-dose oral
therapy is required to achieve inhibitory blood levels.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2849621 [PubMed - indexed for MEDLINE]

6484: Semin Respir Infect. 1988 Jun;3(2):148-61.

Diagnosis of viral pneumonia.

Sullivan CJ, Jordan MC.

University of Minnesota Medical School, Minneapolis 55455.

The diagnosis of viral pneumonia has changed during the past decade from a purely
clinical diagnosis to one that is both clinical and laboratory in nature. Viral
pneumonias can be divided into two clinical groups: the so-called "atypical"
pneumonias in otherwise normal hosts, and viral pneumonitis in the
immunocompromised host. Clinical factors such as patient age, immune status, time
of year, illness in other family members, community outbreaks, onset, severity,
duration of symptoms, and the presence of a rash remain important aids in
diagnosing viral causes of both atypical pneumonia and pneumonia in the
immunocompromised patient. However, advances in virus culture methodologies and
the use of monoclonal antibodies coupled with immunofluorescence and ELISA
techniques have markedly enhanced both the sensitivity, specificity, and rapidity
of the diagnosis of viral pneumonias. Further advances are expected in the future
as nucleic acid hybridization techniques are increasingly applied to both viral
cultures and direct analysis of clinical specimens.

Publication Types: 
    Review

PMID: 2840725 [PubMed - indexed for MEDLINE]

6485: Transplantation. 1988 Jun;45(6):1057-61.

Neurologic complications of liver transplantation.

Vogt DP, Lederman RJ, Carey WD, Broughan TA.

Department of General Surgery, Cleveland Clinic Foundation, Ohio 44106.

Nineteen adult patients underwent 21 orthotopic liver transplants at the
Cleveland Clinic between November 1984, and August 1986. Eight of 19 (42%)
patients developed seizures. One patient suffered a single seizure, and seven
patients had multiple, generalized seizures. Two of these seven patients became
comatose after several days of seizure activity. Over several weeks, both of
these patients regained consciousness--however, they exhibited a cerebellar-type 
syndrome, manifested as severe ataxia, weakness, and dysarthria. Both patients
have improved, but remain neurologically impaired. Laboratory evaluation included
serum electrolytes, magnesium, osmolality, and cyclosporine levels. Neurologic
testing consisted of cerebrospinal fluid (CSF) analysis, computed tomographic
(CT) scanning, and electroencephalography (EEG). Although the CSF protein was
mildly elevated in two patients, all cultures remained sterile. None of the CT
scans demonstrated any abnormalities. In five patients, the EEG showed
generalized slowing consistent with diffuse encephalopathy. Other factors
associated with seizures in transplant patients were analyzed, including fluid
retention, hypertension, high-dose steroids, hypomagnesemia, graft dysfunction,
and demyelinization. Many of our patients had the first three of these factors,
since all but one developed their seizures within the first ten postoperative
days. Only one patient had mild hypomagnesemia. Trough cyclosporine levels (whole
blood, HPLC) were not in the toxic range (greater than 500 ng/mL). The serum
osmolality was elevated in all four patients in whom it was measured, ranging
from 309 to 341 mOsm/kg. Only three patients exhibited graft dysfunction--two
moderate and one severe. The cause of neurologic toxicity following
transplantation is unclear. Although many factors have been implicated, no common
denominator has emerged. Several reports have linked cyclosporine with seizures
and other neurologic problems, such as the cerebellar-type syndrome exhibited in 
two of our patients. Future studies should include magnetic resonance (MR)
imaging of the head and measuring osmolality and cyclosporine levels in the blood
and CSF.

Publication Types: 
    Case Reports

PMID: 2837845 [PubMed - indexed for MEDLINE]

6486: J Virol. 1988 Jun;62(6):2076-82.

Cell lines containing varicella-zoster virus open reading frame 62 and expressing
the "IE" 175 protein complement ICP4 mutants of herpes simplex virus type 1.

Felser JM, Kinchington PR, Inchauspe G, Straus SE, Ostrove JM.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland 20892.

Vero cells were cotransfected with pSV2neo and a recombinant plasmid containing
the varicella-zoster virus (VZV) open reading frame 62 (ORF62). Three
neomycin-resistant cell lines were isolated and shown to complement two different
ICP4 mutants (tsB21 and d120) of herpes simplex virus (HSV) type 1 (HSV-1).
VZV-specific RNA could not be detected in these cell lines, but following
infection with tsB21, a 4.3-kilobase VZV transcript was detected. This RNA
increased in quantity when cells were infected in the presence of cycloheximide. 
A VZV-specific protein of 175 kilodaltons was detected in extracts of all three
cell lines following infection with wild-type HSV-1 but not in uninfected cells. 
That VZV RNA and protein were detected only in HSV-1 infected cells suggests that
a component of the HSV virion activates the expression of VZV ORF62. The increase
in RNA expression seen in the presence of cycloheximide indicates that the
protein encoded by VZV ORF62, "IE"175, may be autoregulatory. These data provide 
further evidence that VZV "IE"175 is the functional analog of the HSV ICP4.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2835512 [PubMed - indexed for MEDLINE]

6487: Pain. 1988 Jun;33(3):333-40.

Post-herpetic neuralgia and topical capsaicin.

Watson CP, Evans RJ, Watt VR.

Smythe Pain Clinic, Toronto General Hospital, University of Toronto, Ont.,
Canada.

Topical 0.025% capsaicin was used to treat 33 patients with post-herpetic
neuralgia (PHN). Thirty-nine percent of those entering the trial achieved at
least a good result and 55% were improved or better. Fifty-six percent of the 23 
patients completing the study had good or excellent pain relief after 4 weeks.
Seventy-eight percent of the 23 noted at least some improvement in pain.
Post-capsaicin burning was a common, untoward effect in most patients and in
about one-third was so unbearable that the trial was terminated prematurely. This
treatment appears to be a useful modality in PHN, particularly in the elderly in 
whom oral medications are often poorly tolerated; however, it does require
supervision. A double-blind, controlled trial is now necessary.

PMID: 2458561 [PubMed - indexed for MEDLINE]

6488: Int J Dermatol. 1988 Jun;27(5):336.

Treatment of oral postherpetic neuralgia with topical capsaicin.

Hawk RJ, Millikan LE.

Department of Dermatology, Tulane University School of Medicine, New Orleans,
Louisiana.

Publication Types: 
    Case Reports

PMID: 2455696 [PubMed - indexed for MEDLINE]

6489: Presse Med. 1988 May 21;17(19):963.

[Zona as a predictive element of the infection by human immunodeficiency type 1
virus in Bangui (Central African Republic)]

[Article in French]

Lesbordes JL, Coulaud X, Georges AJ.

Publication Types: 
    Letter

PMID: 2898140 [PubMed - indexed for MEDLINE]

6490: Am J Ophthalmol. 1988 May 15;105(5):556-8.

Chronic herpes zoster virus keratitis associated with the acquired
immunodeficiency syndrome.

Engstrom RE, Holland GN.

UCLA Uveitis Center, Jules Stein Eye Institute.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3369522 [PubMed - indexed for MEDLINE]

6491: Br J Cancer. 1988 May;57(5):516-20.

Multiple myeloma--a case-control study.

Cuzick J, De Stavola B.

Department of Mathematics, Statistics and Epidemiology, Imperial Cancer Research 
Fund, London, UK.

A total of 399 patients with multiple myeloma and an equal number of match
controls were interviewed about factors possibly related to the causes of their
disease. Factors studied included occupation, chemical exposure, radiation
exposure, prior diseases, immunizations, chronic infections and markers for
defects in immune regulation. A strong risk associated with agriculture/food
processing was observed (RR = 1.8, P = 0.002). The risk could not be restricted
to those exposed to animals or meat products, or those exposed to pesticides.
Significant excesses were also noted for reported exposures to chemicals and
gases/fumes, but no specific agent or group of agents could be identified. Cases 
had fewer tonsillectomies above the age of 10 (P = 0.01). A large excess of
shingles (herpes zoster) was observed in cases (P less than 0.001), but most of
the excess cases occurred within 10 years of diagnosis, suggesting this was a
preclinical manifestation of disease rather than a cause of it.

PMID: 3395559 [PubMed - indexed for MEDLINE]

6492: J Am Acad Dermatol. 1988 May;18(5 Pt 1):1135-6.

Topical capsaicin for treatment of neuralgia associated with herpes zoster
infection.

Don PC.

Publication Types: 
    Case Reports
    Letter

PMID: 3385032 [PubMed - indexed for MEDLINE]

6493: Eur J Haematol. 1988 May;40(5):437-41.

Idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia in Hodgkin's 
disease.

Xiros N, Binder T, Anger B, Bohlke J, Heimpel H.

Department of Internal Medicine, University of Ulm, Fed. Rep. Germany.

Idiopathic thrombocytopenic purpura (ITP) and Coombs' positive hemolytic anemia
(AIHA) were found, respectively, in 5 (1%) and 1 (0.2%) of 492 patients with
Hodgkin's disease (HD). 33 cases of ITP associated with HD reported in the
literature are reviewed. Of our cases, ITP was coincident with the diagnosis of
HD in 1 patient. In another patient ITP preceded the diagnosis of HD by 41 months
and in the remaining 3 patients the diagnosis of ITP was established after they
had been successfully treated for HD. A herpes zoster infection preceded ITP by 1
month in 1 patient and another had herpes zoster at the time of diagnosis of ITP.
AIHA had preceded the diagnosis of HD by 8 months in 1 case. In patients with ITP
the prognosis seems to be related only to the status of the underlying HD.

Publication Types: 
    Case Reports

PMID: 3378597 [PubMed - indexed for MEDLINE]

6494: J Pediatr. 1988 May;112(5):844-5.

Fetal varicella syndrome.

Higa K, Dan K, Manabe H.

Publication Types: 
    Letter

PMID: 3361401 [PubMed - indexed for MEDLINE]

6495: Arch Neurol. 1988 May;45(5):514-8.

Granulomatous angiitis of the brain. An inflammatory reaction of diverse
etiology.

Younger DS, Hays AP, Brust JC, Rowland LP.

Department of Neurology, Columbia University College of Physicians and Surgeons, 
New York, NY.

Granulomatous angiitis of the brain (GAB) is defined histologically by
granulomatous inflammation of intracranial blood vessels. We have studied four
patients with autopsy-proved GAB who had, respectively, Hodgkin's lymphoma,
herpes zoster, neurosarcoidosis, and no associated illness. Headache, fever, or
mental change was followed by hemiparesis or quadriparesis, coma, and death in
all four patients. There were no diagnostic findings from cerebral computed
tomograms, cerebrospinal fluid, or cerebral angiograms; the diagnosis was
established only by postmortem examination. Vasculitis was limited to the brain
in all four patients, and involved large arteries, small arteries and veins, or
both large and small vessels. Differences in etiology and different particulars
of the pathologic conditions imply that GAB is a nonspecific reaction, not a
unique disease. The diagnosis, moreover, cannot be proved without histologic
confirmation. A biopsy specimen is the only way to ascertain the diagnosis in
living patients.

PMID: 3358703 [PubMed - indexed for MEDLINE]

6496: Masui. 1988 May;37(5):586-91.

[Transcutaneous electrical nerve stimulation (TENS) for the treatment of
segmental abdominal zoster paresis]

[Article in Japanese]

Kadota Y, Miyawaki T, Yoshimura N.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3261807 [PubMed - indexed for MEDLINE]

6497: J Assoc Physicians India. 1988 May;36(5):321-2.

Zoster-varicella infection in Hodgkin's disease.

Pahuja R, Parikh PM, Charak BS, Rawat RS, Gopal R, Saikia TK, Advani SH.

PMID: 3182695 [PubMed - indexed for MEDLINE]

6498: An Esp Pediatr. 1988 May;28(5):481-2.

[Cervicofacial herpes zoster in a 2-year-old child]

[Article in Spanish]

del Castillo Martin F, Canete Diaz A, Muro Brussi M, Fonseca Capdevila E.

Servicio de Dermatologia, Clinica Infantil La Paz, Madrid.

Publication Types: 
    Case Reports

PMID: 3178071 [PubMed - indexed for MEDLINE]

6499: AJNR Am J Neuroradiol. 1988 May-Jun;9(3):609.

MR findings in the Ramsay Hunt syndrome.

Daniels DL, Czervionke LF, Millen SJ.

Publication Types: 
    Case Reports

PMID: 3132840 [PubMed - indexed for MEDLINE]

6500: Neurol Clin. 1988 May;6(2):389-403.

Neurologic complications of graft-versus-host disease.

Nelson KR, McQuillen MP.

University of Kentucky Medical Center, Lexington.

BMT has become an important therapy for many hematologic disorders. Following
BMT, the recipient may develop GVHD when it appears that immunocompetent donor
lymphocytes react to host antigens. Acute and chronic GVHD represent two distinct
syndromes. Acute GVHD has not been associated with primary neurologic
involvement. Polymyositis has been reported in 12 patients with chronic GVHD,
with the most common underlying illness being aplastic anemia. The clinical,
serologic, and muscle biopsy features of the myositis in GVHD have been similar
to those observed in idiopathic polymyositis. Weakness was moderate to severe and
responded to prednisone, sometimes with the addition of azathioprine. Prognosis
depended upon the underlying disease and not on the severity of the myositis. MG 
occurs rarely in chronic GVHD. Most patients with MG and GVHD have had aplastic
anemia; those with aplastic anemia are more likely to have anti-AchR prior to
BMT. The clinical manifestations of GVHD MG have not differed from classic
autoimmune MG; each patient had elevated antiacetylcholine receptor antibodies
titers. All patients have responded well to cholinesterase inhibitors but have
received other immunosuppressants. These observations suggest that aplastic
anemia is an important host factor in the development of the autoimmune disorders
seen with chronic GVHD, certainly of myositis and MG. Herpes zoster peripheral
nerve infections have occurred in patients with chronic GVHD. One patient had
mononeuritis multiplex. In both acute and chronic GVHD, CNS impairment is usually
caused by metabolic encephalopathy or infection. Primary CNS involvement has not 
been recognized.

Publication Types: 
    Review

PMID: 3047548 [PubMed - indexed for MEDLINE]

6501: Neurol Clin. 1988 May;6(2):367-76.

Neurologic complications of pancreas transplants.

Kiok MC.

Department of Neurology, University of Pittsburgh School of Medicine,
Pennsylvania.

A review of 15 cases of pancreas transplantation at the Presbyterian University
Hospital in Pittsburgh showed that all of the neurologic complications occurred
outside of the pancreas transplantation surgery itself. Major CNS complications
included hypoxic encephalopathy (20 per cent), cerebral and spinal-cord
infarction (7 per cent), and seizures (13 per cent). These appeared to be closely
associated with cardiovascular collapse or cardiac arrest that often occurred
following septic, hemorrhagic, or additional surgical-anesthetic stresses,
removed in time from the transplantation. When patients who died of sudden
cardiorespiratory arrest were included, the overall frequency of global cerebral 
ischemia was 33 per cent. The occurrence of herpes zoster neuritis (13 per cent) 
was contrasted with the lack of CNS infections. The possible associations of
visual hallucinations with cyclosporine therapy (7 per cent), CSF pleocytosis
with OKT3 therapy (7 per cent), and compressive neuropathy with
operative-anesthetic monitoring (7 per cent) were discussed in relation to
previous reports in the literature. Randomized controlled clinical studies were
suggested to distinguish more clearly the complications due to pancreas
transplantation from those due to the natural history of the underlying diabetes 
and to distinguish the beneficial and adverse effects of pancreas transplants
from those of coexisting renal transplants.

Publication Types: 
    Review

PMID: 3047546 [PubMed - indexed for MEDLINE]

6502: J Am Acad Dermatol. 1988 May;18(5 Pt 1):1142-3.

Peripheral edema and oral acyclovir.

Hisler BM, Daneshvar SA, Aronson PJ, Hashimoto K.

Publication Types: 
    Case Reports
    Letter

PMID: 2968376 [PubMed - indexed for MEDLINE]

6503: Pediatr Dermatol. 1988 May;5(2):127-9.

The Tzanck smear: old, but still of inestimable value.

Oranje AP, Folkers E.

Department of Dermatology and Venereology (Pediatric Dermatology), Sophia
Children's Hospital/University Hospital Rotterdam, The Netherlands.

The Tzanck smear, introduced by the Frenchman Tzanck, has been used for many
years in the diagnosis of bullous and vesicular dermatoses especially herpes
simplex, herpes zoster and varicella. Also, in the vesicular dermatoses of
newborns and immunocompromised patients it is an important diagnostic aid. The
Tzanck smear is easy to perform, simple, reliable (if one is experienced) and
inexpensive. A quick staining can be done by Hemacolor or Diff-Quik within one
minute. The Tzanck smear is certainly useful and very reliable in the diagnosis
of herpes simplex and varicella-zoster infections if obtained in the vesicular
stage. The sensitivity of the Tzanck smear exceeds 80%, and the specificity 90%
when the investigators are experienced. A positive Tzanck smear is an especially 
reliable and useful diagnostic aid. However, a disadvantage is that the smear
cannot differentiate between herpes simplex virus or varicella-zoster virus
infections. The Tzanck smear, although old and simple, remains an important aid
in the diagnosis of vesicular, pustular and bullous diseases, in particular
herpes. Cytology will, however, never replace culturing or histopathology.

PMID: 2842739 [PubMed - indexed for MEDLINE]

6504: Public Health Rep. 1988 May-Jun;103(3):246-54.

The pathology of AIDS.

Macher AM.

Department of Infectious and Parasitic Disease Pathology, Armed Forces Institute 
of Pathology, Washington, DC 20306-6000.

The acquired immunodeficiency syndrome (AIDS) is a devastating new disease caused
by the human immunodeficiency virus (HIV). This retrovirus causes profound
immunoincompetence in its infected hosts, who are thereafter susceptible to
develop myriad severe and relapsing protozoal, fungal, bacterial, viral, and
arthropodal opportunistic infections, as well as unusual malignancies. The more
than 50,000 patients who have developed AIDS in the United States have produced a
sudden unexpected deluge of diagnostic dilemmas that are stressing laboratories
of pathology everywhere. This paper describes the gross and microscopic pathology
of the numerous complications in patients infected by HIV: (a) the prodromal
AIDS-related complex with persistent generalized lymphadenopathy, (b) lymphoid
infiltration of salivary gland and lung, including the complex of lymphoid
interstitial pneumonitis-pulmonary lymphoid hyperplasia, (c) extranodal
non-Hodgkin's lymphomas, (d) multifocal mucocutaneous and visceral Kaposi's
sarcoma, (e) small cell undifferentiated (oat cell) carcinomas, (f) protozoal
infections caused by Pneumocystis carinii, Toxoplasma gondii, Acanthamoeba,
Cryptosporidium species (sp.), and Isospora belli, (g) the causes of chronic
enteritis, (h) mycotic infections caused by Candida sp., Cryptococcus neoformans,
Histoplasma capsulatum, Coccidioides immitis, and Sporothrix schenckii, (i)
bacterial infections caused by Mycobacterium avium-intracellulare, M.
tuberculosis, M. kansasii, Nocardia sp., Listeria monocytogenes, Legionella sp., 
Treponema pallidum, and others, (j) viral infections caused by cytomegalovirus,
herpes simplex and zoster, polyomavirus (progressive multifocal
leukoencephalopathy), hepatitis B, molluscum contagiosum, and papillomavirus, (k)
oral hairy leukoplakia, (l) subacute encephalopathy, and (m) Norwegian scabies.

PMID: 2836878 [PubMed - indexed for MEDLINE]

6505: J Infect Dis. 1988 May;157(5):882-8.

Western blot analysis of antibody to varicella-zoster virus.

Dubey L, Steinberg SP, LaRussa P, Oh P, Gershon AA.

Department of Pediatrics, College of Physicians and Surgeons, Columbia
University, New York, New York 10032.

We used western blot (WB) to compare the IgG response to varicella-zoster virus
(VZV) after chickenpox (CP), zoster, and administration of a live attenuated
varicella vaccine (LAVV). After CP, 13 of 14 normal children had antibody to
glycoprotein (gp) I (99 and 92 kilodaltons [kDa]), 11 had antibody to gpII (133
kDa), and 10 had antibody to gpIII (119 kDa). Bands at 150 and 35 kDa were also
seen in 13 and 11 sera, respectively. Bands to gpI, gpII, and p35 were more
intense after zoster than CP. After one dose of LAVV, eight of eight normal
children had gpI antibody. In leukemic children, gpI antibody appeared in 18
(56%) after one dose and in 25 (89%) after two doses. Upon household exposure,
leukemic vaccinees who developed CP were less likely than those protected to have
prior gpIII and p35 antibodies. As seen after zoster, WBs after breakthrough CP
showed intense responses to VZV antigens. Thus, WB helps distinguish secondary
from primary antibody responses to VZV.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 2834466 [PubMed - indexed for MEDLINE]

6506: Am J Epidemiol. 1988 May;127(5):1071-8.

The epidemiology of infection with the human herpesviruses in Navajo children.

Becker TM, Magder L, Harrison HR, Stewart JA, Humphrey DD, Hauler J, Nahmias AJ.

Division of Sexually Transmitted Diseases, Center for Prevention Services,
Centers for Disease Control, Atlanta, GA.

Investigations of serum antibody status to the five human herpesviruses--herpes
simplex virus type 1, herpes simplex virus type 2, cytomegalovirus, Epstein-Barr 
virus, and varicella-zoster virus--were conducted on 197 Navajo children, aged
1-15 years, at a reservation pediatric outpatient clinic in Crownpoint, New
Mexico, from 1981-1984. To determine the severity of infection with the human
herpesviruses, the authors reviewed lifetime medical records of 166 of the
children for evidence of herpesvirus-related diseases, and to illuminate
potential modes of transmission of the viruses, they completed home interviews on
the families of 87 of the children. The investigation showed that the children
had a high prevalence of antibody to herpes simplex virus type 1 (73% of total
sample), cytomegalovirus (78%), Epstein Barr virus (98%), and varicella-zoster
virus (77%), and that prevalence tended to increase with age. None of the
children demonstrated herpes simplex virus type 2 antibodies. The medical records
showed that 30% of the children had suffered from gingivostomatitis prior to the 
study. When age was controlled for, the study showed herpes simplex virus type 1 
seropositivity to be associated with children who slept in the same bed as their 
parents during infancy (p = 0.003) and with frequent attendance at community
events (p = 0.02); cytomegalovirus seropositivity was shown to be associated with
female sex (p = 0.007) and with living in a traditional Navajo dwelling (p =
0.007). The Navajo children also demonstrated a greater frequency of symptomatic 
oral herpes simplex virus type 1 infection than is usually recorded. The findings
suggest a relation between certain patterns of cultural behavior and transmission
of herpesvirus infections.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2833854 [PubMed - indexed for MEDLINE]

6507: Laryngol Rhinol Otol (Stuttg). 1988 Apr;67(4):188-90.

[Treatment of zoster oticus]

[Article in German]

Bier H, Bergler W, Keilmann A.

Klinik fur Hals-Nasen-Ohrenkrankheiten, Klinikums Mannheim, Fakultat fur
klinische Medizin, Universitat Heidelberg.

On the basis of aetiology and pathophysiology a rational concept for the
treatment of zoster oticus is attempted. The current literature and own
experiences favour the simultaneous application of the virostatic acyclovir and
glucocorticosteroids.

Publication Types: 
    English Abstract

PMID: 3386371 [PubMed - indexed for MEDLINE]

6508: Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-3):1560-3.

[Gastrointestinal carcinoma with skin diseases from the standpoint of surgery]

[Article in Japanese]

Nishidoi H, Koga S, Kanbe N.

1st Dept. of Surgery, Tottori University School of Medicine.

We encountered 21 patients with gastrointestinal carcinoma accompanied with skin 
diseases such as acanthosis nigricans, dermatomyositis, pemphigoid,
erythrodermia, ichthyosis vulgaris, herpes zoster, Leser-Trelat's sign,
Recklinghausen's disease and Gardner's syndrome. We have discussed such cases
from the standpoint of surgery. There were 16 cases (76%) with gastric carcinoma,
which were almost in the far advanced stage. Carcinomas of the other patients
were seen in the esophagus, liver, pancreas, small intestine and rectum. Although
skin lesions appeared before the onset of gastrointestinal symptoms in almost all
cases, detection of carcinomas was very difficult until the symptoms emerged. In 
6 of 21 patients (29%), carcinomas were detected by only skin manifestation, and 
they proved to be gastric cancer in all cases. Although the relationship of
gastrointestinal carcinoma and skin diseases was unclear, we presented a
70-year-old woman with acanthosis nigricans accompanied with gastric cancer,
whose skin manifestation was reduced by the therapy for gastric cancer.
Therefore, some of these skin manifestation may be a symptom of the biological
characteristics of the gastrointestinal carcinoma.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3382227 [PubMed - indexed for MEDLINE]

6509: Pain. 1988 Apr;33(1):73-8.

Concerning the management of pain associated with herpes zoster and of
postherpetic neuralgia.

King RB.

Department of Neurological Surgery, SUNY Health Science Center, Syracuse 13210.

This simple method of achieving substantial pain control in patients with
documented herpes zoster and postherpetic neuralgia has been effective in each of
the patients in whom it has been used (the most recent 12 cases have been
summarized for this report). It has been more effective than narcotic analgesics,
oral anti-inflammatory analgesics, sedatives, tranquilizers, TENS, hypnosis and
the wide variety of operative measures we have tried in the past. Although it was
initially used pragmatically, there is now a reasonable rationale for its
effectiveness that can be proposed based on more recent insights into the anatomy
and neurophysiology of cutaneous nociceptors and the neuropharmacology of
aspirin. In view of the widely held persuasion that the management of pain
syndromes associated with herpes zoster (especially severe postherpetic
neuralgia) is an unsatisfactory and frustrating venture, it seemed reasonable to 
report these more favorable clinical observations.

Publication Types: 
    Case Reports

PMID: 3380554 [PubMed - indexed for MEDLINE]

6510: Int J Dermatol. 1988 Apr;27(3):193-7.

Treatment of herpes zoster. Recombinant alpha interferon versus acyclovir.

Duschet P, Schwarz T, Soyer P, Henk A, Hausmaninger H, Gschnait F.

Department of Dermatology, Hospital Vienna Lainz, Austria.

Sixty-four patients received systemic alpha-interferon (10 million units
subcutaneously daily) and 63 received systemic acyclovir (5 mg/kg body weight
intravenously thrice daily) in a randomized study of acute herpes zoster. Start
of healing, complete healing, development of new skin lesions in the primarily
affected and in other dermatomes, and degree and duration of pain were evaluated.
Both drugs proved equally clinically efficient without statistically different
findings between the two groups; herpes zoster neuralgia was not prevented by
either interferon or acyclovir therapy. Minor clinical side effects occurred
slightly more frequently during interferon treatment and included fever and
nausea. Transient and moderate leukopenia was observed in nearly all patients in 
the interferon group.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 3286547 [PubMed - indexed for MEDLINE]

6511: Clin Pharmacol Ther. 1988 Apr;43(4):363-71.

Association of pain relief with drug side effects in postherpetic neuralgia: a
single-dose study of clonidine, codeine, ibuprofen, and placebo.

Max MB, Schafer SC, Culnane M, Dubner R, Gracely RH.

Neurobiology and Anesthesiology Branch, National Institute of Dental Research,
Bethesda, MD 20892.

In a randomized, double-blind crossover study, 40 patients with postherpetic
neuralgia were given single oral doses of clonidine, 0.2 mg, codeine, 120 mg,
ibuprofen, 800 mg, or inert placebo. Pain relief and side effects were recorded
for 6 hours. Patients reported significantly more relief after clonidine than
after the other three treatments. Codeine and ibuprofen were ineffective.
Sedation, dizziness, and other side effects were more frequent after clonidine
(74%) or codeine (69%) than after placebo (36%) or ibuprofen (28%). Reported pain
relief was greater during trials in which side effects were present. A single,
mild side effect was associated with as much additional pain relief as multiple, 
severe side effects. Clonidine's superiority to codeine, which had a similar
incidence of side effects, argues for a specific analgesic effect. In addition,
side effects may have contributed to clonidine analgesia, perhaps by suggesting
to patients that they had received a potent drug.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 3281774 [PubMed - indexed for MEDLINE]

6512: J Exp Med. 1988 Apr 1;167(4):1313-22.

Erratum in:
    J Exp Med 1988 Jul 1;168(1):459.

Oligoclonal T lymphocytes in the cerebrospinal fluid of patients with multiple
sclerosis.

Hafler DA, Duby AD, Lee SJ, Benjamin D, Seidman JG, Weiner HL.

Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

We have investigated the T cell populations in the cerebrospinal fluid (CSF) of
chronic progressive multiple sclerosis (MS) patients. Individual T cells from the
CSF and blood were cloned before expansion and their clonotypes were defined by
analysis of rearranged T cell receptor beta chain and gamma chain genes. 87 T
cell clones from blood and CSF of two patients with chronic progressive MS were
examined for common TCR gene rearrangement patterns. In one patient, 18 of 28
CSF-derived T cell clones demonstrated common TCR gene rearrangements indicating 
oligoclonal T cell populations; in the blood, two patterns were found twice among
26 T cell clones. In another patient, 5 of 27 CSF-derived clones had common TCR
gene rearrangement patterns. In contrast, no common beta chain rearrangement
pattern was found among 67 T cell clones derived from the blood or CSF of a
patient with subacute sclerosing panencephalitis, among 20 clones from the CSF of
a patient with herpes zoster meningoencephalitis, or among 66 clones from a
normal subject. A subject with atypical, fatal MS of 8-mo duration was also
studied and did not have oligoclonal T cells in the CSF or blood. These results
demonstrate that distinct oligoclonal T cell populations can be found in the CSF 
immune compartment of subjects with nonmalignant inflammatory disease and they
can create a new avenue for the investigation of the specificity of the T cell
response within the central nervous system.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3258624 [PubMed - indexed for MEDLINE]

6513: J Am Dent Assoc. 1988 Apr;116(4):500-4.

Prodromal odontalgia and multiple devitalized teeth caused by a herpes zoster
infection of the trigeminal nerve: report of case.

Goon WW, Jacobsen PL.

Department of Endodontics, University of the Pacific, School of Dentistry, San
Francisco 94115-2399.

A case of oral herpes zoster infection with prodromal odontalgia is presented.
Tooth devitalization, facial scarring, and neuralgia occurred without concurrent 
local and systemic factors. The cause, pathological features, diagnosis, and
management of an oral herpes zoster infection with prodromal odontalgia are
discussed.

Publication Types: 
    Case Reports

PMID: 3164018 [PubMed - indexed for MEDLINE]

6514: Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-1):804-9.

[Gamma interferon therapy of cancer patients]

[Article in Japanese]

Kobayashi Y, Urabe A.

3rd Dept. of Internal Medicine, Faculty of Medicine, University of Tokyo.

A phase I and a phase II study of recombinant gamma-interferon (S 6810) were
conducted on a cooperative basis involving 11 and 57 institutions, respectively. 
In the phase I study, a total of 40 courses were administered to 31 patients.
High fever exceeding 38 degrees C with chills was observed in approximately 80%. 
Other toxicities were fatigue (50%), gastrointestinal symptoms (30-40%), changes 
in hepatic enzymes, and hematological toxicities (20-30%). Dose-limiting factors 
were judged to be hypotension, leucopenia and CNS toxicity. Since the optimal
dose for the phase II study was considered to be 5 X 10(6) U/m2 by daily chronic 
schedule, a further study was conducted using this dose. Response rates were as
follows: 14.3% (renal cell cancer), 11.8% (multiple myeloma) 40.0% (chronic
lymphocytic leukemia), 16.7% (non-Hodgkin lymphoma), and 67% (mycosis fungoides).
Complete response was obtained in one case each of renal cell cancer, malignant
lymphoma and mycosis fungoides. Moreover, intermittent high-dose gamma-interferon
against renal cell cancer induced a response rate of 21.4%, significantly higher 
than the 8.6% obtained by continuous administration. Local injection against
cutaneous malignancies resulted in a 55.3% response rate. Anti-viral effect
against herpes zoster infection was also preliminarily evaluated. Among 4 cases, 
3 responded subjectively well to local injection of gamma-interferon, which is a 
hopeful result, although a randomized trial is still needed.

Publication Types: 
    English Abstract

PMID: 3133983 [PubMed - indexed for MEDLINE]

6515: AIDS. 1988 Apr;2(2):125-7.

Acute HIV illness following blood transfusion in three African children.

Colebunders R, Greenberg AE, Francis H, Kabote N, Izaley L, Nguyen-Dinh P, Quinn 
TC, Van der Groen G, Curran JW, Piot P.

Project SIDA, Department of Public Health, Kinshasa, Zaire.

Three children are described in whom pre-transfusion samples were
HIV-seronegative and post-transfusional samples, obtained within 1 week after
transfusion, were HIV-seropositive. Two of them developed a transient fever
within 1 week of receiving the blood transfusion, and a transient generalized
skin eruption which lasted for about 2 weeks. All three developed persistent
generalized lymphadenopathy. One child developed a lumbar herpes zoster 7 months 
after transfusion. IgM Western blots demonstrated the presence of antibodies to
protein bands p17, p24 and p55 in all three children. These three case reports
suggest that children who receive a seropositive blood transfusion are at high
risk for developing acute manifestations of HIV infection.

PMID: 3132939 [PubMed - indexed for MEDLINE]

6516: Ann Intern Med. 1988 Apr;108(4):643-4.

Herpes zoster, postherpetic neuralgia, and interferon-gamma.

Usuki K, Kitamura K, Urabe A, Takaku F.

Publication Types: 
    Case Reports
    Letter

PMID: 3126691 [PubMed - indexed for MEDLINE]

6517: Am J Med. 1988 Apr;84(4):781-3.

Factitious dermatosis masquerading as recurrent herpes zoster.

Levitz SM, Tan OT.

Evans Memorial Department of Clinical Research, University Hospital, Boston,
Massachusetts 02118.

A 35-year-old nurse's aide presented with monthly episodes, during her menses, of
self-induced cutaneous lesions intended to simulate recurrent herpes zoster.
Features of the clinical presentation that prompted the correct diagnosis are
discussed.

Publication Types: 
    Case Reports
    Review

PMID: 3041813 [PubMed - indexed for MEDLINE]

6518: Nippon Hifuka Gakkai Zasshi. 1988 Apr;98(5):521-32.

[Clinico-pathological studies on herpes zoster (II); Histologic changes in upper 
dermis at different stages on herpes zoster]

[Article in Japanese]

Muraki R.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2853800 [PubMed - indexed for MEDLINE]

6519: Transplantation. 1988 Apr;45(4):737-40.

Nonbacterial nonfungal interstitial pneumonitis following autologous bone marrow 
transplantation in children treated with high-dose chemotherapy without
total-body irradiation.

Valteau D, Hartmann O, Benhamou E, Caillaud JM, Brugieres L, Beaujean F, Patte C,
Flamant F, Lemerle J.

Departement de Pediatrie, Institut Gustave-Roussy, Villejuif, France.

Between February 1979 and May 1986, 165 children were treated with autologous
bone marrow transplantation after high-dose chemotherapy without total-body
irradiation for a hematologic malignancy or a solid tumor. Nonbacterial nonfungal
interstitial pneumonitis was observed in 24 children and was the cause of death
in 11 cases. Of the 24 cases of interstitial pneumonitis, 14 were considered to
be idiopathic. Cytomegalovirus was the major pathogenic agent detected in the 10 
other cases of interstitial pneumonitis (n = 5), followed by Herpes zoster (n =
2), Pneumocystis carinii (n = 1), tumor (n = 1), and adenovirus (n = 1). The only
factor found to correlate significantly with the increased rate of interstitial
pneumonitis was the use of high-dose 1-3 bis chloroethyl-1 nitrosourea (BCNU)
(600 mg/m2), whereas BCNU at a dose of 300 mg/m2 did not affect this rate. These 
data, when compared with the literature, show a lower incidence of interstitial
pneumonitis than in allogeneic transplantations, and an incidence similar to that
observed in syngeneic transplantations, although there was no radiation toxicity 
in this series.

PMID: 2833829 [PubMed - indexed for MEDLINE]

6520: Proc Natl Acad Sci U S A. 1988 Apr;85(8):2767-70.

Expression of varicella-zoster virus in blood mononuclear cells of patients with 
postherpetic neuralgia.

Vafai A, Wellish M, Gilden DH.

Departments of Neurology, University of Colorado School of Medicine, Denver
80262.

Postherpetic neuralgia (PHN), the most frequent complication of varicella-zoster 
virus (VZV) reactivation, is characterized by pain that persists for greater than
1 mo and often for years after zoster rash. To examine whether PHN might be
related to reactivation of VZV, blood mononuclear cells of patients with PHN were
tested for the presence of VZV DNA and proteins. VZV DNA was detected in the
mononuclear cells of one PHN patient. VZV-specific proteins were detected in
mononuclear cells of two acute-varicella patients, one acute zoster patient, and 
six elderly patients with PHN, but these VZV-specific proteins were not detected 
in three elderly zoster patients without PHN. Furthermore, pulse-chase
experiments revealed further processing or degradation of VZV-specific proteins
in the mononuclear cells. These findings strongly suggest that persistence,
reactivation, and expression of VZV may result in PHN.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2833752 [PubMed - indexed for MEDLINE]

6521: Proc Natl Acad Sci U S A. 1988 Apr;85(7):2362-6.

Expression of varicella-zoster virus and herpes simplex virus in normal human
trigeminal ganglia.

Vafai A, Murray RS, Wellish M, Devlin M, Gilden DH.

Department of Neurology, University of Colorado School of Medicine, Denver.

Lysates of radiolabeled explants from four human trigeminal ganglia were
immunoprecipitated with antibodies to varicella-zoster virus (VZV) and to herpes 
simplex virus. Both herpes simplex virus- and VZV-specific proteins were detected
in lysates of all four ganglia. Absence of reactivity in ganglion explants with
monoclonal antibodies suggested that herpes simplex virus and VZV were not
reactivated during the culture period. In situ hybridization studies demonstrated
the presence of RNA transcripts from the VZV immediate early gene 63. This
approach to the detection of herpes simplex virus and VZV expression in human
ganglia should facilitate analysis of viral RNA and proteins in human sensory
ganglia.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2832852 [PubMed - indexed for MEDLINE]

6522: J Virol. 1988 Apr;62(4):1416-22.

Identification and expression of a human cytomegalovirus glycoprotein with
homology to the Epstein-Barr virus BXLF2 product, varicella-zoster virus gpIII,
and herpes simplex virus type 1 glycoprotein H.

Cranage MP, Smith GL, Bell SE, Hart H, Brown C, Bankier AT, Tomlinson P, Barrell 
BG, Minson TC.

Department of Pathology, University of Cambridge, England.

An open reading frame with the characteristics of a glycoprotein-coding sequence 
was identified by nucleotide sequencing of human cytomegalovirus (HCMV) genomic
DNA. The predicted amino acid sequence was homologous with glycoprotein H of
herpes simplex virus type 1 and the homologous protein of Epstein-Barr virus
(BXLF2 gene product) and varicella-zoster virus (gpIII). Recombinant vaccinia
viruses that expressed this gene were constructed. A glycoprotein of
approximately 86 kilodaltons was immunoprecipitated from cells infected with the 
recombinant viruses and from HCMV-infected cells with a monoclonal antibody that 
efficiently neutralized HCMV infectivity. In HCMV-infected MRC5 cells, this
glycoprotein was present on nuclear and cytoplasmic membranes, but in recombinant
vaccinia virus-infected cells it accumulated predominantly on the nuclear
membrane.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2831402 [PubMed - indexed for MEDLINE]

6523: Hosp Pract (Off Ed). 1988 Mar 30;23(3A):113-4, 116-20.

Science, society, and changing viral-host relationships.

Weller TH.

Publication Types: 
    Historical Article

PMID: 2832426 [PubMed - indexed for MEDLINE]

6524: Schweiz Rundsch Med Prax. 1988 Mar 15;77(11):271-3.

[Hepatitis following dextropropoxyphene: a case report]

[Article in German]

Paganoni R, Reymond JF, Herzog C.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3375653 [PubMed - indexed for MEDLINE]

6525: Br Med J (Clin Res Ed). 1988 Mar 5;296(6623):673-6.

Epidemiology of chickenpox in England and Wales, 1967-85.

Joseph CA, Noah ND.

Public Health Service Communicable Disease Surveillance Centre, London.

Routine sources of data on chickenpox morbidity and mortality in England and
Wales were reviewed for 1967-85. Only two epidemics occurred, one in 1967 and one
in 1980, both of which were immediately followed by two to three years of low
incidence. The age distribution of the disease appears to be changing, with more 
cases now being reported in children aged 0-4 years. The number of deaths in
adults have, however, increased, particularly those deaths that are associated
with pneumonia and immunosuppression. At present in England and Wales more deaths
are attributed to chickenpox than to whooping cough and mumps. Widespread use of 
selective immunisation against chickenpox might be justified in England and
Wales, but before routine immunisation of the child population can be considered 
special surveys to determine the incidence and severity of chickenpox and the
effect of the vaccine on the subsequent development of herpes zoster are needed
as well as cost-benefit studies of immunisation.

PMID: 3128363 [PubMed - indexed for MEDLINE]

6526: Science. 1988 Mar 4;239(4844):1145-7.

A gene for dihydrofolate reductase in a herpesvirus.

Trimble JJ, Murthy SC, Bakker A, Grassmann R, Desrosiers RC.

New England Regional Primate Research Center, Harvard Medical School,
Southborough, MA 01772.

The enzyme dihydrofolate reductase (DHFR) is found ubiquitously in both
prokaryotes and eukaryotes. It is essential for de novo synthesis of purines and 
of deoxythymidine monophosphate for DNA synthesis. Among viruses, however, only
the T-even and T5 bacteriophage have been found to encode their own DHFR. In this
study a gene for DHFR was found in a specific subgroup of the gamma or
lymphotropic class of herpesviruses. DNA sequences for DHFR were found in
herpesvirus saimiri and herpesvirus ateles but not in Epstein-Barr virus, Marek's
disease virus, herpes simplex virus, varicella-zoster virus, herpesvirus
tamarinus, or human cytomegalovirus. The predicted sequence of herpesvirus
saimiri DHFR is 186 amino acids in length, the same length as human, murine, and 
bovine DHFR. The human and herpesvirus saimiri DHFRs share 83 percent positional 
identity in amino acid sequence. The herpesvirus saimiri DHFR gene is devoid of
intron sequences, suggesting that it was acquired by some process involving
reverse transcription. This is to our knowledge the first example of a mammalian 
virus with a gene for DHFR.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 2830673 [PubMed - indexed for MEDLINE]

6527: N Engl J Med. 1988 Mar 3;318(9):573-5.

Hell's fire and varicella-vaccine safety.

Plotkin SA.

Publication Types: 
    Editorial

PMID: 3340138 [PubMed - indexed for MEDLINE]

6528: N Engl J Med. 1988 Mar 3;318(9):543-8.

The risk of zoster after varicella vaccination in children with leukemia.

Lawrence R, Gershon AA, Holzman R, Steinberg SP.

Department of Pediatrics, New York University Medical Center, New York.

We examined the incidence of zoster in 346 children with underlying acute
lymphoblastic leukemia who were immunized with live attenuated varicella vaccine 
while in remission. We also compared a subset of 84 of these children with a
matched group of 84 children with leukemia who had had natural infection with
varicella. Of the 346 vaccinated children, 5 (1.45 percent) became infected with 
zoster after 10,878 months of observation, for an incidence of 0.552 case per 100
person-years. Among the matched pairs of subjects, zoster occurred in 3 (3.6
percent) of the 84 vaccinated subjects during 2936 months of observation--an
incidence of 1.23 cases per 100 person-years--and in 11 (13.1 percent) of the
subjects with natural infection during 4245 months--an incidence of 3.11 cases of
zoster per 100 person-years. Although the incidence of zoster was more than twice
as high in the control children as in the vaccinated children (3.11 vs. 1.23
cases per 100 person-years), a Kaplan-Meier product-limit analysis revealed no
significant differences in incidence between the two groups. Children from both
groups in whom leukemia recurred were more likely to contract zoster than those
who did not have a recurrence (7 of 35 vs. 7 of 133, P less than 0.025). Zoster
was not a marker for impending relapse. No case of zoster was severe or
disseminated. We conclude that the incidence of zoster following immunization
with live attenuated varicella vaccine is no greater than that following natural 
varicella infection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2828948 [PubMed - indexed for MEDLINE]

6529: AIDS Forsch. 1988 Mar;3(3):116-38.

AIDS in Africa--an update.

Fleming AF.

PIP: At least 1 million people in Central and East Africa are infected with
HIV-1, and there are 10,000 new cases of AIDS per year. HIV-1 is spreading into
the Ivory Coast, Ghana, Mozambique, Angola and southern Africa. HIV-2 is
prevalent in West Africa, particularly Senegal and Guinea-Bissau. Groups at
greatest risk for HIV-1 are prostitutes, their customers, and patients with a
history of sexually-transmitted diseases, which cause breaches in mucosal
epithelium. 24% of pregnant women in Uganda are infected, and the risk of
transplacental infection is estimated to be between 17% and 79%. Blood
transfusion is the 3rd most frequent mode of infection, largely due to need for
blood by anemic women. Repeated pregnancy is a cofactor in the progression of
AIDS, and infected infants suffer intrauterine growth retardation, premature
birth, low birth weight, and high mortality in the 1st week of life. AIDS in
adults is often accompanied by tuberculosis, herpes zoster, hepatitis B, herpes
type 2, and leprosy. Clinical diagnosis of AIDS is made by enzyme-linked
immunosorbent assay, but African patients have a high frequency of anti-p24
antibody which masks the p24 antigenemia. Some African countries have AIDS
education programs, condom distribution and blood screening, but AIDS control
programs need to be integrated with primary health care.

PMID: 12315604 [PubMed - indexed for MEDLINE]

6530: Indian J Pediatr. 1988 Mar-Apr;55(2):301-3.

Herpes zoster.

Bharija SC, Kanwar AJ, Belhaj MS.

PMID: 3403026 [PubMed - indexed for MEDLINE]

6531: J Neurol Neurosurg Psychiatry. 1988 Mar;51(3):425-6.

Bell's palsy and HIV infection.

Brown MM, Thompson A, Goh BT, Forster GE, Swash M.

Department of Neurology, London Hospital, UK.

Unilateral infranuclear facial palsy developed in three young homosexual men. All
three were positive for antibodies to human immunodeficiency virus (HIV). Two had
persistent generalised lymphadenopathy, but the clinical criteria for the
acquired immune deficiency syndrome (AIDS) were not fulfilled. There were no
features of generalised neuropathy, and no other cause for facial palsy was
evident. Recovery was excellent in each patient.

Publication Types: 
    Case Reports

PMID: 3361335 [PubMed - indexed for MEDLINE]

6532: J Am Acad Dermatol. 1988 Mar;18(3):584-5.

Chronic varicella zoster infection in acquired immunodeficiency syndrome.

Janier M, Hillion B, Baccard M, Morinet F, Scieux C, Perol Y, Civatte J.

Publication Types: 
    Case Reports
    Letter

PMID: 3351019 [PubMed - indexed for MEDLINE]

6533: Am J Obstet Gynecol. 1988 Mar;158(3 Pt 1):586-8.

Acyclovir in human breast milk.

Meyer LJ, de Miranda P, Sheth N, Spruance S.

Department of Internal Medicine, University of Utah School of Medicine, Salt Lake
City.

Acyclovir concentration was measured by radioimmunoassay in the serum and milk of
a lactating woman who was treated with oral acyclovir for herpes zoster. Daily
serum and milk samples showing milk concentrations that averaged being 3.24-fold 
higher than serum levels suggest a low infant dose. The elimination phase
demonstrated a half-life of 2.8 hours in milk.

Publication Types: 
    Case Reports

PMID: 3348321 [PubMed - indexed for MEDLINE]

6534: Am Fam Physician. 1988 Mar;37(3):185-92.

Neurologic complications of herpes zoster.

Bucci FA Jr, Schwartz RA.

Albany Medical College of Union University, New York.

Encephalitis, contralateral hemiplegia and postherpetic neuralgia are the most
serious neurologic sequelae of herpes zoster infections. Encephalitis occurs more
frequently in the presence of cutaneous dissemination and cranial nerve lesions. 
Contralateral hemiplegia following herpes zoster ophthalmicus results from
vasculitic and thrombotic lesions. The combination of a tricyclic antidepressant 
and a phenothiazine is the most effective medical treatment for postherpetic
neuralgia.

PMID: 3348118 [PubMed - indexed for MEDLINE]

6535: J Am Acad Dermatol. 1988 Mar;18(3):605-10.

Comment in:
    J Am Acad Dermatol. 1989 Mar;20(3):523-4.

Do corticosteroids prevent postherpetic neuralgia? A review of the evidence.

Post BT, Philbrick JT.

Department of Medicine, University of Virginia, School of Medicine,
Charlottesville 22908.

A short course of corticosteroids is frequently used in herpes zoster to prevent 
postherpetic neuralgia. To clarify the evidence behind this routine practice, we 
reviewed the three randomized controlled trials on this subject. Although in all 
three similar dosages of corticosteroids (40 mg to 60 mg prednisone daily for 2
to 4 weeks) were used, deficiencies in reported clinical characteristics of study
subjects, the potential for bias in the ascertainment of pain duration, and the
inability to exclude type II error make it impossible to determine whether or not
this practice is effective. More research on this subject is needed, with greater
attention to good study methodology.

Publication Types: 
    Clinical Trial
    Review

PMID: 3280625 [PubMed - indexed for MEDLINE]

6536: Baillieres Clin Obstet Gynaecol. 1988 Mar;2(1):55-71.

Infection of the fetus and the newborn: prevention, treatment and related
handicap.

Rudd P, Peckham C.

Congenital infection is uncommon and the cause of only a small proportion of
handicap seen in children but some infections may be preventable or even
treatable. As an example, the congenital rubella syndrome first described in the 
1940s is preventable by use of the vaccine but cases still occur. It is hoped
that with the introduction of the measles, mumps, rubella immunization for young 
children, rubella will become as rare in the UK as it is in the USA.
Cytomegalovirus is now a more common cause of handicap than rubella but no
vaccine has been developed. Although antiviral drugs are available for herpes
simplex virus and vaccinia, infection mortality in the newborn is high, even
following the use of these agents; many HSV infections in the newborn arise
following primary and asymptomatic maternal infections so that treatment may
start late in the course of the illness. The obstetrician needs to understand the
natural history as well as possible investigations available for congenital
infections. There may be warning signs which require action, such as herpetic
lesions in the genital tract of the mother. Less specific abnormalities during
pregnancy, such as intra-uterine growth retardation and spontaneous onset of
preterm labour, may point to congenital infection. This chapter describes both
antenatal and postnatal management of the major congenital infections. We have
included recent research data that should influence clinical practice; studies on
HSV which suggest that, for women with a history of recurrent infection, routine 
viral culture of the genital tract at the end of pregnancy is unnecessary;
reports from both the USA and the UK that rubella immunization performed
inadvertently during early pregnancy has not resulted in the congenital rubella
syndrome. The chapter would not have been complete without a discussion of human 
immunodeficiency virus, of concern to the obstetrician and midwife. There is
still much to be learned about the natural history of this infection in both the 
mother and infant.

Publication Types: 
    Review

PMID: 2843313 [PubMed - indexed for MEDLINE]

6537: J Infect. 1988 Mar;16(2):193-7.

Severe and recurrent varicella-zoster virus infection in a patient with the
acquired immune deficiency syndrome.

Acheson DW, Leen CL, Tariq WU, Mandal BK.

Regional Department of Infectious Diseases and Tropical Medicine, Monsall
Hospital, Manchester, U.K.

We report a case of recurrent varicella-zoster virus infection in a patient with 
severe acquired immune deficiency syndrome in whom the infection has become
clinically unresponsive to treatment with acyclovir.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 2832482 [PubMed - indexed for MEDLINE]

6538: J Virol. 1988 Mar;62(3):802-9.

Identification and characterization of a varicella-zoster virus DNA-binding
protein by using antisera directed against a predicted synthetic oligopeptide.

Kinchington PR, Inchauspe G, Subak-Sharpe JH, Robey F, Hay J, Ruyechan WT.

Department of Biochemistry, Uniformed Services University of the Health Sciences,
Bethesda, Maryland 20814-4799.

We have identified, in varicella-zoster virus (VZV)-infected cells, the product
of the gene predicted to code for the VZV analog of the herpes simplex virus
major DNA-binding protein. The open reading frame of the VZV gene has the
potential to code for a protein with a predicted molecular weight of 132,000 (a
132K protein). To detect the protein, a 12-amino-acid oligopeptide corresponding 
to the carboxyl terminus of the putative open reading frame was synthesized and
used to prepare antisera in rabbits. The resulting antibodies reacted
specifically in Western immunoblot analysis and immunoprecipitation with a single
130K polypeptide found in VZV-infected cells. The specific reactivity of the
antisera with the 130K polypeptide was inhibited by the addition of synthetic
peptide. Immunofluorescence studies with the antisera as probe for the 130K
polypeptide suggested that this peptide is located predominantly within the
nuclei of infected cells. Analysis of proteins that bind to single-stranded DNA
immobilized on cellulose matrices indicated that 30 to 50% of the 130K
polypeptide is capable of interacting with single-stranded DNA and that this
interaction is overcome with 0.5 M NaCl. Thus, we have prepared a specific
polyclonal antiserum that identifies a VZV DNA-binding protein whose properties
are similar to those of the herpes simplex virus ICP8 (Vmw130) DNA-binding
protein.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 2828675 [PubMed - indexed for MEDLINE]

6539: J Virol. 1988 Mar;62(3):757-67.

Conservation of gene organization in the lymphotropic herpesviruses herpesvirus
Saimiri and Epstein-Barr virus.

Gompels UA, Craxton MA, Honess RW.

Division of Virology, National Institute for Medical Research, London, United
Kingdom.

By analyses of short DNA sequences, we have deduced the overall arrangement of
genes in the (A + T)-rich coding sequences of herpesvirus saimiri (HVS) relative 
to the arrangements of homologous genes in the (G + C)-rich coding sequences of
the Epstein-Barr virus (EBV) genome and the (A + T)-rich sequences of the
varicella-zoster virus (VZV) genome. Fragments of HVS DNA from 13 separate sites 
within the 111 kilobase pairs of the light DNA coding sequences of the genome
were subcloned into M13 vectors, and sequences of up to 350 bases were determined
from each of these sites. Amino acid sequences predicted for fragments of open
reading frames defined by these sequences were compared with a library of the
protein sequences of major open reading frames predicted from the complete DNA
sequences of VZV and EBV. Of the 13 short amino acid sequences obtained from HVS,
only 3 were recognizably homologous to proteins encoded by VZV, but all 13 HVS
sequences were unambiguously homologous to gene products encoded by EBV. The HVS 
reading frames identified by this method included homologs of the major capsid
polypeptides, glycoprotein H, the major nonstructural DNA-binding protein,
thymidine kinase, and the homolog of the regulatory gene product of the BMLF1
reading frame of EBV. Locally as well as globally, the order and relative
orientation of these genes resembled that of their homologs on the EBV genome.
Despite the major differences in their nucleotide compositions and in the nature 
and arrangements of reiterated DNA sequences, the genomes of the lymphotropic
herpesviruses HVS and EBV encode closely related proteins, and they share a
common organization of these coding sequences which differs from that of the
neurotropic herpesviruses, VZV and herpes simplex virus.

Publication Types: 
    Comparative Study

PMID: 2828671 [PubMed - indexed for MEDLINE]

6540: Presse Med. 1988 Feb 13;17(5):211-2.

[Gastric zoster ulcerations]

[Article in French]

Durin S, Chapelon C, Ziza JM, Frances C, Malki B, Perreau P, Godeau P.

Publication Types: 
    Case Reports
    Letter

PMID: 2965383 [PubMed - indexed for MEDLINE]

6541: Aesthetic Plast Surg. 1988 Feb;12(1):23-4.

Herpes zoster as a complication of a face lift.

Bailey MH, McKinney P.

Division of Plastic Surgery, St. Michael's Hospital, Toronto, Ontario, Canada.

A case of herpes zoster neuritis (shingles) is reported, closely following a face
lift with adjunctive dermabrasion and chemical peel. The etiologic relationships 
are unclear. However, the mental nerve distribution suggests mechanical
irritation of the nerve as a possible factor. Management of this complication is 
conservative. It is suggested that herpes zoster be included in the differential 
diagnosis of unusual alterations of sensation or persistent pain following
procedures for facial aging.

Publication Types: 
    Case Reports

PMID: 3376780 [PubMed - indexed for MEDLINE]

6542: Kekkaku. 1988 Feb;63(2):143-8.

[A case of Mycobacterium scrofulaceum lung infection associated with giant
bullae, leading to development of herpes zoster]

[Article in Japanese]

Umeki S, Okamoto Y, Hisamoto N, Tanaka Y, Hara Y.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3373936 [PubMed - indexed for MEDLINE]

6543: Nervenarzt. 1988 Feb;59(2):113-7.

[Varicella zoster virus infection of the central nervous system with symptoms
resembling cardiac phobia and schizophrenia]

[Article in German]

Ullmann H, Kuhn J.

Psychiatrische Klinik, Universitat Heidelberg.

Publication Types: 
    Case Reports

PMID: 3362259 [PubMed - indexed for MEDLINE]

6544: Br J Dermatol. 1988 Feb;118(2):223-8.

Clinical features and course of type A and type B vitiligo.

Koga M, Tango T.

Department of Dermatology, Tokyo Medical College Hospital, Japan.

Four hundred and eighty one cases of vitiligo (acquired idiopathic
depigmentation) were studied clinically. They were divided into two types, type
B, in which depigmented patches are confined to a definite dermatome in the same 
manner as herpes zoster, and type A, which included all cases of vitiligo not
classified as type B. The ratio of type A:type B was approximately 3:I. Onset of 
type A vitiligo could occur at any age, whereas type B generally affected the
young. The activity of type B vitiligo usually ceased after one year, following
rapid spread over the particular dermatomal area. However, in type A vitiligo new
depigmented patches continued to appear throughout the patients' lives.
Association with halo naevus and Kobner's phenomenon were observed exclusively in
type A. Association with diseases with a proven or suggested allergic or
immunological aetiology was more often found in type A. These findings support
our hypothesis that type A and type B vitiligo have a different pathogenesis and 
that autoimmune mechanisms play a role only in type A.

PMID: 3348967 [PubMed - indexed for MEDLINE]

6545: J Am Acad Dermatol. 1988 Feb;18(2 Pt 2):448-51.

Kaposi's sarcoma occurring in a dermatome previously involved by herpes zoster.

Niedt GW, Prioleau PG.

Department of Pathology, New York Hospital-Cornell Medical Center, NY 10021.

A 31-year-old black man with a history of intravenous drug abuse developed a mass
in his neck, a biopsy of which revealed Kaposi's sarcoma. The patient underwent
radiation therapy, and the mass diminished in size. Approximately 2 months later 
the patient developed a herpes zoster infection in the left T3 distribution. The 
vesicular eruption resolved, but postherpetic neuralgia remained. Two months
after the herpes zoster infection, the patient developed many small nodules in
the area of the prior vesicular eruption. Biopsy revealed these nodules to be
Kaposi's sarcoma. At this time no other cutaneous lesions were present. We
believe that these nodules represent the occurrence of the Koebner phenomenon in 
a patient with Kaposi's sarcoma and the acquired immunodeficiency syndrome.

Publication Types: 
    Case Reports

PMID: 3343414 [PubMed - indexed for MEDLINE]

6546: Arch Pathol Lab Med. 1988 Feb;112(2):173-7.

Varicella-zoster virus leukoencephalitis and cerebral vasculopathy.

Morgello S, Block GA, Price RW, Petito CK.

Department of Pathology (Neuropathology), New York Hospital, NY 10021.

Two patients with varicella-zoster virus leukoencephalitis and acquired
immunodeficiency syndrome are described. Neither patient had cutaneous or
disseminated varicella-zoster virus infection within the last six months of life.
Demyelinated lesions resembling those of progressive multifocal
leukoencephalopathy were seen in their brains at autopsy. Numerous cells with
Cowdry type A intranuclear inclusions surrounded the lesions; these cells stained
positively for varicella-zoster virus with immunohistochemistry and contained
herpesvirus nucleocapsids by electron microscopy. Leptomeningeal vessels
accompanying the lesions displayed a zoster-induced vasculopathy in one of the
two patients. Vascular and parenchymal central nervous system infections with
varicella-zoster virus are rare in the absence of cutaneous lesions, and to our
knowledge, the presence of both in one patient has not yet been described.

Publication Types: 
    Case Reports

PMID: 3337629 [PubMed - indexed for MEDLINE]

6547: J Infect Dis. 1988 Feb;157(2):314-8.

Herpes zoster in African patients: a clinical predictor of human immunodeficiency
virus infection.

Colebunders R, Mann JM, Francis H, Bila K, Izaley L, Ilwaya M, Kakonde N, Quinn
TC, Curran JW, Piot P.

Project SIDA, Department of Public Health, Kinshasa, Zaire.

A recent episode or a history of herpes zoster was found in 30 (11%) of 284
patients hospitalized with human immunodeficiency virus (HIV) infection at Mama
Yemo Hospital, Kinshasa, Zaire. Of 146 African patients with a history of herpes 
zoster who were referred to us by physicians at the Mama Yemo Hospital, 133 (91%)
were HIV seropositive. The clinical characteristics of the herpes zoster episodes
did not differ between HIV-seropositive and -seronegative individuals, except
that 23% of the HIV-seropositive patients experienced recurrences compared with
none of the HIV-seronegative patients (P = .05). No patient developed a
generalized herpes zoster eruption, and only patients with ophthalmic zoster
developed related complications. Patients who experienced severe pain during
their herpes zoster attack lost more weight than did those who had only minor
pain (P = .0003).

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3335810 [PubMed - indexed for MEDLINE]

6548: Arthritis Rheum. 1988 Feb;31(2):167-75.

Comment in:
    Arthritis Rheum. 1989 Jan;32(1):115-6.    Arthritis Rheum. 1990 Jan;33(1):151-2.

Long-term prospective trial of low-dose methotrexate in rheumatoid arthritis.

Weinblatt ME, Trentham DE, Fraser PA, Holdsworth DE, Falchuk KR, Weissman BN,
Coblyn JS.

Department of Medicine, Harvard Medical School, Boston, Massachusetts.

Twenty-six patients with severe rheumatoid arthritis who had completed a
randomized crossover trial of methotrexate elected to continue to receive the
drug in a long-term prospective study. At 36 months, 16 patients remained in the 
study. Over this period of time, significant improvement was noted in the number 
of painful and swollen joints, physician and patient global assessments,
erythrocyte sedimentation rate, and prednisone dose. Adverse reactions occurred
in 16 patients (62%), including nausea, alopecia, headache, stomatitis, herpes
zoster, and diarrhea. Mild leukopenia (3 patients), thrombocytopenia (3
patients), and elevated transaminase levels (8 patients) resolved with temporary 
drug discontinuation. No patient withdrew due to drug toxicity. Liver biopsy
specimens in 17 patients after 24 months of treatment showed no evidence of
fibrosis or cirrhosis. A significant increase in the percentage of T3 and T4
blood cells and increases in lymphocyte proliferation to concanavalin A and
purified protein derivative of tuberculin were found after 2 years of therapy.
Our findings indicate that methotrexate has remained effective over 36 months of 
therapy, with acceptable toxicity levels and no evidence of systemic
immunosuppression.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3279962 [PubMed - indexed for MEDLINE]

6549: Bull Soc Ophtalmol Fr. 1988 Feb;88(2):189-92.

[Efficacy of acyclovir by oral route in ophthalmic herpes zoster: preliminary
study of 20 cases]

[Article in French]

Hoang-Xuan T, Thenault JC, Denis J, Thenault S, Frot P, Clay C, Pouliquen Y.

PMID: 3265078 [PubMed - indexed for MEDLINE]

6550: Br J Clin Pract. 1988 Feb;42(2):79-82.

Lower motor neurone paralysis due to herpes zoster.

Bhattacharyya PK, Chakravorty NK.

Publication Types: 
    Case Reports

PMID: 3179177 [PubMed - indexed for MEDLINE]

6551: AIDS. 1988 Feb;2(1):55-60.

Prevalence and risk factors of HIV infections among drug users and drug-using
prostitutes in Amsterdam.

van den Hoek JA, Coutinho RA, van Haastrecht HJ, van Zadelhoff AW, Goudsmit J.

Municipal Health Service, Department of Infectious Diseases, Amsterdam, The
Netherlands.

In December 1985 we started a study to determine the prevalence and risk factors 
of HIV infection among drug users and drug-using prostitutes in Amsterdam.
Recruitment took place at methadone posts (not drug-free; i.e. a low-threshold
programme on which some drug users continue to use hard drugs, but at a lower
level) and the weekly evening sexually transmitted diseases (STD) clinic for
drug-addicted prostitutes. Three hundred and ten drug users have so far been
tested and interviewed. Eighty-one per cent reported intravenous drug use; 83% of
the 166 females and 15% of the 144 men reported prostitution. Female prostitutes 
practised mainly vaginal and orogenital intercourse and reported frequent use of 
condoms (89% of vaginal and 64% of orogenital contact). Male prostitutes
practised mainly orogenital and manual contact. At entry 88 of the 310 (28%) were
HIV-antibody-seropositive; 85 of these 88 were intravenous drug users and three
were male homosexuals. HIV-antigen was detected in two seropositive and one
seronegative intravenous drug-user. Antibodies to HTLV-I were found in four out
of 308. Risk factors independently associated with HIV-antibody seropositivity
among intravenous drug users were: frequency of borrowing used needle or syringe,
date of first intravenous drug use, recent intravenous drug use, time living in
Amsterdam and German nationality. Of medical history data, an attack of herpes
zoster in the previous 5 years had the greatest value in the prediction of the
presence of HIV antibodies (relative risk 20.90; 95% confidence interval
2.41-167.27).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3128998 [PubMed - indexed for MEDLINE]

6552: Arch Phys Med Rehabil. 1988 Feb;69(2):132-4.

Herpes zoster: a consideration in the differential diagnosis of radiculopathy.

Burkman KA, Gaines RW Jr, Kashani SR, Smith RD.

Department of PM&R, Rusk Rehabilitation Center, Columbia, MO 65212.

Herpes zoster probably occurs more often than generally thought. Since it
produces a radicular distribution of pain, it should be included in the
differential diagnosis of radiculopathy. A case is presented in which evaluating 
the radicular low back pain before the characteristic rash appears was
misleading. Careful history-taking concerning the exact nature of the pain and
sensory changes is needed to differentiate between zoster and radiculopathy, if
no rash is evident.

Publication Types: 
    Case Reports

PMID: 2963601 [PubMed - indexed for MEDLINE]

6553: J Hosp Infect. 1988 Feb;11 Suppl A:90-5.

Prevention of varicella by vaccination.

Heath RB.

Department of Virology, St. Bartholomew's Hospital, London, UK.

PMID: 2896753 [PubMed - indexed for MEDLINE]

6554: J Hosp Infect. 1988 Feb;11 Suppl A:29-36.

Herpes virus infections.

Snoeck R, Griffiths PD.

Virology Department, Royal Free Hospital, London, England.

PMID: 2896721 [PubMed - indexed for MEDLINE]

6555: Biosci Rep. 1988 Feb;8(1):85-94.

Methyl gallate, methyl-3,4,5-trihydroxybenzoate, is a potent and highly specific 
inhibitor of herpes simplex virus in vitro. I. Purification and characterization 
of methyl gallate from Sapium sebiferum.

Kane CJ, Menna JH, Yeh YC.

Department of Biochemistry & Molecular Biology, College of Medicine, University
of Arkansas for Medical Sciences, Little Rock 72205.

A potent anti-herpetic compound was identified and purified to homogeneity from
the leaves of Sapium sebiferum by plaque reduction assay using herpes simplex
virus type 2. The chemical structure of the purified compound was determined by
mass spectroscopy and proton and carbon-13 nuclear magnetic resonance as methyl
gallate, methyl-3,4,5-trihydroxybenzoate. This is the first demonstration that
methyl gallate is a potent anti-herpetic compound in vitro, present in high
concentration in the leaves of S. sebiferum, a Chinese folk medicine for
shingles.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2840132 [PubMed - indexed for MEDLINE]

6556: Antimicrob Agents Chemother. 1988 Feb;32(2):265-7.

Anti-human immunodeficiency virus agent 3'-azido-3'-deoxythymidine inhibits
replication of Epstein-Barr virus.

Lin JC, Zhang ZX, Smith MC, Biron K, Pagano JS.

Lineberger Cancer Research Center, School of Medicine, University of North
Carolina, Chapel Hill 27514.

We show that the anti-human immunodeficiency virus agent,
3'-azido-3'-deoxythymidine (AZT), which suppresses infectivity and cytopathic
effects of human immunodeficiency virus, also effectively inhibits Epstein-Barr
virus (EBV) DNA replication. However, AZT has no effect on four other human
herpesviruses: cytomegalovirus, varicella-zoster virus, and herpes simplex virus 
types 1 and 2. The combination of acyclovir and AZT, while it is not synergistic,
has an additive effect against EBV replication. AZT may prove to be a useful drug
for treatment of coinfections with human immunodeficiency virus and EBV.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2834997 [PubMed - indexed for MEDLINE]

6557: Pain. 1988 Feb;32(2):147-57.

Factors influencing the duration of treatment of acute herpetic pain with
sympathetic nerve block: importance of severity of herpes zoster assessed by the 
maximum antibody titers to varicella-zoster virus in otherwise healthy patients.

Higa K, Dan K, Manabe H, Noda B.

Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.

Antibody responses to varicella-zoster virus (VZV) were serially investigated by 
the complement-fixation test in 72 Japanese of both sexes, suffering from herpes 
zoster (HZ), but otherwise healthy. Our objective was to elucidate whether there 
were mutual relationships among severities of skin lesion, maximum antibody
titers to VZV, and duration of treatment for acute herpetic pain (AHP). Patients 
were divided into 3 groups: mild group (n = 26), moderate group (n = 26) and
severe group (n = 20), according to the severity of the skin lesions. The 3
groups did not differ significantly with respect to age (P greater than 0.6). All
patients were treated with regional sympathetic nerve blocks (SNBs) until pain
relief was achieved. The durations of treatment for AHP became significantly
longer as HZ increased in severity; the mean log10 durations of treatment (+/-
S.E.) for the mild, moderate, and severe groups were 1.383 +/- 0.037, 1.616 +/-
0.055, and 1.888 +/- 0.069 days, respectively (P less than 0.01 for the mild
group vs. the moderate group, and P less than 0.001 for the moderate group vs.
the severe group). Irrespective of age, the maximum antibody titers closely
paralleled the severities of the skin lesion of HZ; the mean maximum log2
antibody titers (+/- S.E.) for the mild, moderate, and severe groups were 5.12
+/- 0.24, 6.73 +/- 0.20, and 8.00 +/- 0.18, respectively (P less than 0.001 for
the mild group vs. the moderate group and for the moderate group vs. the severe
group).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2834685 [PubMed - indexed for MEDLINE]

6558: J Cutan Pathol. 1988 Feb;15(1):49-52.

Linear IgA deposition associated with cutaneous varicella-zoster infection: a
case report.

Blickenstaff RD, Perry HO, Peters MS.

Department of Dermatology, Mayo Clinic, Rochester, MN 55905.

The homogeneous linear deposition of IgA along the basement membrane zone of
uninvolved skin is a distinguishing feature of linear IgA dermatosis in adults
and chronic bullous dermatosis of childhood. Although linear IgA deposition may
be seen in other cutaneous diseases, to our knowledge, there are no previous
reports of a direct association with cutaneous infection. We describe the finding
of intense fluorescence, in a linear pattern, of IgA at the basement membrane
zone in an elderly man with disseminated cutaneous varicella-zoster infection.

Publication Types: 
    Case Reports

PMID: 2832459 [PubMed - indexed for MEDLINE]

6559: Eur J Immunol. 1988 Feb;18(2):269-75.

Human cytomegalovirus-specific cytotoxic T cells: their precursor frequency and
stage specificity.

Borysiewicz LK, Graham S, Hickling JK, Mason PD, Sissons JG.

Department of Medicine, Royal Postgraduate Medical School, London, GB.

Human virus-specific cytotoxic T (Tc) cells may be important in maintaining the
virus/host equilibrium during persistent herpes virus infections such as that
with human cytomegalovirus (HCMV). We have previously shown that HCMV-specific Tc
cells are present in peripheral blood in normal asymptomatic seropositive
individuals (L. K. Borysiewicz et al., Eur. J. Immunol. 1983. 13: 804). In this
study we have used limiting dilution analysis to estimate the precursor frequency
of these Tc cells and to further delineate their specificity for viral proteins
expressed at different stages of the virus replicative cycle. HCMV-specific Tc
precursor cells were present in peripheral blood lymphocytes (PBL) at a frequency
of 1/5000 to 20,000 E+ PBL. This frequency was higher than that observed for
varicella-zoster virus (VZV)-specific Tc cells (1/30,000 to greater than 500,000)
in asymptomatic individuals and was similar to the VZV Tc precursor cell
frequencies observed following clinical reactivation (1/30,000). When the stage
specificity of clonally derived HCMV-specific Tc cells was analyzed, using target
cells treated with phosphonoformate to allow expression of only the nonstructural
viral proteins, the majority (60%) of Tc cells lysed these cells. A number of Tc 
cells lysed only cells which expressed the structural or late HCMV proteins.
These results suggest a high precursor frequency of HCMV-specific Tc cells in
PBL, and that there are subpopulations of such Tc cells specific for HCMV
antigens expressed at different stages of the virus replicative cycle. However,
the relative frequencies of these subpopulations suggest that the immunodominant 
HCMV antigens with respect to the Tc response are expressed at immediate early
and/or early times.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2832181 [PubMed - indexed for MEDLINE]

6560: W V Med J. 1988 Feb;84(2):18-21.

Varicella zoster virus infections.

Neely JL.

Publication Types: 
    Case Reports

PMID: 2830722 [PubMed - indexed for MEDLINE]

6561: Ann Intern Med. 1988 Feb;108(2):221-37.

Erratum in:
    Ann Intern Med 1988 Sep 1;109(5):438-9.

NIH conference. Varicella-zoster virus infections. Biology, natural history,
treatment, and prevention.

Straus SE, Ostrove JM, Inchauspe G, Felser JM, Freifeld A, Croen KD, Sawyer MH.

National Institutes of Health, U.S. Department of Health and Human Services,
Bethesda, Maryland.

During the last 10 years, there have been major advances in the understanding of 
varicella-zoster virus and the diseases it causes. The molecular biology of the
virus is being unraveled with the aid of new molecular technologies. Varicella,
usually a benign manifestation of primary infection, and zoster, a result of
reactivation of latent virus, can cause considerable morbidity in patients with
immune impairment. Antiviral drugs, especially acyclovir, ameliorate severe
infections but still have little role in the treatment of most normal patients
with varicella or zoster. Varicella can be prevented when necessary by patient
isolation and passive prophylaxis with varicella-zoster immune globulin. An
experimental live vaccine also prevents varicella, but problems regarding its
virulence for immunosuppressed patients and the durability of the protective
response are still being addressed.

Publication Types: 
    Review

PMID: 2829675 [PubMed - indexed for MEDLINE]

6562: J Virol. 1988 Feb;62(2):444-53.

Structures of herpes simplex virus type 1 genes required for replication of virus
DNA.

McGeoch DJ, Dalrymple MA, Dolan A, McNab D, Perry LJ, Taylor P, Challberg MD.

Institute of Virology, University of Glasgow, United Kingdom.

Recently, a method has been developed to identify regions in the genome of herpes
simplex virus type 1 (HSV-1) which contain genes required for DNA synthesis from 
an HSV-1 origin of DNA replication, and seven genomic loci have been identified
as representing the necessary and sufficient gene set for such replication (C. A.
Wu, N. J. Nelson, D. J. McGeoch, and M. D. Challberg, J. Virol. 62:435-443,
1988). Two of the loci represent the well-known genes for DNA polymerase and
major DNA-binding protein, but the remainder had little or no previous
characterization. In this report we present the DNA sequences of the five newly
identified genes and their deduced transcript organizations and encoded amino
acid sequences. These genes were designated UL5, UL8, UL9, UL42, and UL52 and
were predicted to encode proteins with molecular weights of, respectively,
99,000, 80,000, 94,000, 51,000, and 114,000. All of these genes had clear
counterparts in the genome of the related alphaherpesvirus varicella-zoster
virus, but only UL5 and UL52 were detectably conserved in the distantly related
gammaherpesvirus Epstein-Barr virus, as judged by amino acid sequence similarity.
The sequence of the UL5 protein, and of its counterparts in the other viruses,
contained a region closely resembling known ATP-binding sites; this could be
indicative, for instance, of a helicase or primase activity.

PMID: 2826807 [PubMed - indexed for MEDLINE]

6563: J Infect Dis. 1988 Feb;157(2):392-3.

Restriction endonuclease analysis of viral DNA from a patient with bilateral
herpes zoster lesions.

Takayama M, Takayama N, Hachimori K, Minamitani M.

Publication Types: 
    Case Reports
    Letter

PMID: 2826618 [PubMed - indexed for MEDLINE]

6564: Br Med J (Clin Res Ed). 1988 Jan 23;296(6617):257-61.

ABC of dermatology. Viral infections.

Buxton PK.

Royal Infirmary, Edinburgh.

Publication Types: 
    Review

PMID: 2829988 [PubMed - indexed for MEDLINE]

6565: Orv Hetil. 1988 Jan 17;129(3):111-7.

Erratum in:
    Orv Hetil 1988 Jun 19;129(25):1343.

[The significance of varicella zoster infections today]

[Article in Hungarian]

Nyerges G.

Publication Types: 
    English Abstract
    Review

PMID: 3281090 [PubMed - indexed for MEDLINE]

6566: Klin Wochenschr. 1988 Jan 4;66(1):21-5.

Chronic HIV encephalitis--I. Cerebrospinal fluid diagnosis.

Luer W, Poser S, Weber T, Jurgens S, Eichenlaub D, Pohle HD, Felgenhauer K.

Neurologische Klinik und Poliklinik, Universitat Gottingen.

To establish a reliable procedure for the early detection of central nervous
system involvement in HIV infection, paired cerebrospinal fluid and serum samples
of 59 patients were analysed. Fifteen were HIV antibody positive without clinical
symptoms (stage I), 12 had lymphadenopathy syndrome or AIDS-related complex
(stage II), and 32 had AIDS (stage III). Intrathecal synthesis of HIV antibodies 
was determined by a modified ELISA. Antibodies in CSF and serum were evaluated at
identical immunoglobulin G levels to correct for the actual blood-CSF-barrier
permeability. A CSF/serum quotient above 1.5 is indicative of intrathecal
antibody synthesis, which was found in 47% of the patients in stage I, 67% in
stage II, and 84% in stage III. These findings indicate an early and frequent
invasion of the CNS.

PMID: 2830432 [PubMed - indexed for MEDLINE]

6567: Bull Soc Pathol Exot Filiales. 1988;81(2):159-62.

[Acquired immunodeficiency syndrome (AIDS) in Lubumbashi. Clinical and
epidemiological observations]

[Article in French]

Masengo-Bwanga, Bula Bula A, Tambwe Mbuyi M, Maloba Nday, Kalenga B, Luboya N.

Service de medecine interne, Cliniques universitaires de Lubumbashi, Zaire.

26 AIDS cases (13 males and 13 females) have been noticed in the internal
medicine service of the Lubumbashi University Clinics, town at the boundary of
the south-east of Zaire. The clinical data are conventional: only heterosexual
transmission seems prevalent. The shortage of HIV diagnosis means restrain larger
survey, but 5 to 7% of blood givers are AIDS carriers. The risk of AIDS
dissemination is real, even in rural areas of some regions with permanent
connections of larger urban centres.

PIP: Observation of 13 male and 13 female AIDS patients hospitalized in the
internal medicine service at the Lubumbashi University Clinics between June
1985-October 1987 indicates that AIDS is a threat in other large cities of Zaire 
besides Kinshasa. Patient ages ranged from 14 to 65 and averaged 35. All 26
experienced profound weight loss, 17 had chronic diarrhea, 10 had fevers, and 10 
had pneumathies. 5 had esophageal moniliasis, 2 had dermatoses, 1 had meningeal
cryptococcosis, 1 had Kaposi's sarcoma, 1 had shingles, and 1 had salmonellosis. 
ELISA tests were administered in only 16 cases due to their cost. 17 of the
patients were from Lubumbashi.

Publication Types: 
    English Abstract

PMID: 3416403 [PubMed - indexed for MEDLINE]

6568: Scand J Infect Dis. 1988;20(3):277-82.

Herpes zoster in African patients: an early manifestation of HIV infection.

Van de Perre P, Bakkers E, Batungwanayo J, Kestelyn P, Lepage P, Nzaramba D,
Bogaerts J, Serufilira A, Rouvroy D, Uwimana A, et al.

AIDS project, Belgian-Rwandese Medical Cooperation, Kigali, Rwanda.

During a 3-month period, 131 cases of herpes zoster were diagnosed in Kigali,
Rwanda. There were 46 female and 85 male patients. Mean age was 29 years (range
1-66). An unusually high proportion of patients presented with cranial and sacral
nerve localisation of their cutaneous lesions. 55/131 patients (42%) had
involvement of more than one dermatome. None of the patients had an underlying
condition known to favour herpes zoster. 120/131 (92%) had antibodies to HIV
detected by an immunoenzymatic assay (EIA) and indirect immunofluorescence.
92/125 adult patients (74%) had no sign or symptom related to HIV infection other
than herpes zoster. This study suggests that herpes zoster in Central Africa is
an early and readily detectable manifestation of HIV-induced immunosuppression.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3406666 [PubMed - indexed for MEDLINE]

6569: Appl Neurophysiol. 1988;51(2-5):164-9.

Dorsal root entry zone lesions in the treatment of pain following brachial plexus
avulsion, spinal cord injury and herpes zoster.

Friedman AH, Bullitt E.

Department of Surgery, Duke University Medical Center, Durham, N.C.

This paper details the long-term results in patients treated with dorsal root
entry zone (DREZ) lesions for the treatment of pain following brachial plexus
avulsion, spinal cord injury, and herpes zoster. With our current operative
technique, 82% of patients with brachial plexus avulsion injuries were afforded
long-term pain relief. Patients with pain confined to dermatomes just below the
level of spinal injury also did well with DREZ lesions, although the results were
less good in patients with diffuse pain or with sacral pain. The postoperative
results in patients with postherpetic pain were disappointing.

PMID: 3389792 [PubMed - indexed for MEDLINE]

6570: Virologie. 1988 Jan-Mar;39(1):21-4.

[Treatment of cutaneous herpes and herpes zoster with Nivcrisol-D]

[Article in French]

Giurcaneanu F, Crisan I, Esanu V, Cioca V, Cajal N.

Hopital Colentina, Service de Dermatologie, Bucarest, Roumanie.

The results obtained at the Dermatological service of the Colentina Hospital show
that the product NIVCRISOL-D, containing propolis, has a significant
therapeutical effect against recurrent herpes and zona zoster.

Publication Types: 
    English Abstract

PMID: 3376426 [PubMed - indexed for MEDLINE]

6571: Ann Neurol. 1988 Jan;23(1):49-55.

Neurological complications of human immunodeficiency virus infection in patients 
with lymphadenopathy syndrome.

Janssen RS, Saykin AJ, Kaplan JE, Spira TJ, Pinsky PF, Sprehn GC, Hoffman JC,
Mayer WB Jr, Schonberger LB.

Division of Viral Diseases, Center for Infectious Diseases, Atlanta, GA 30333.

To determine if there is a relationship between neurological abnormalities and
human immunodeficiency virus (HIV) infection in patients with lymphadenopathy
syndrome (LAS), we studied 39 homosexual/bisexual men with LAS (mean duration of 
LAS, 4.1 years) and 38 homosexual/bisexual men who were seronegative for HIV
(controls). Six LAS patients had histories of symptoms suggesting mononeuropathy,
9 had symptoms suggesting distal symmetrical polyneuropathy, and 9 had histories 
of herpes zoster radiculitis. Overall, significantly more LAS patients (18) than 
controls (3) had histories of symptoms or signs of neurological abnormality (odds
ratio, 10.0; p = 0.0003). By neuropsychological assessment, 9 of 18 LAS patients 
and 2 of 26 controls were abnormal (odds ratio, 12.0; p = 0.004). Of those
abnormal on the neuropsychological assessment, the majority scored in the mildly 
impaired range. Magnetic resonance imaging was abnormal in 1 LAS patient and in 1
control. Neither neurological nor neuropsychological abnormalities correlated
with duration of LAS, absolute T-helper lymphocyte count, or
T-helper/T-suppressor lymphocyte ratio. These results indicate an association of 
neurological and neuropsychological abnormalities with HIV in patients with LAS. 
They suggest that mild neurological abnormalities in LAS are common and that HIV 
may directly or indirectly be the cause.

PMID: 3345067 [PubMed - indexed for MEDLINE]

6572: Hematol Oncol. 1988 Jan-Mar;6(1):57-63.

Experience with the Portacath.

Lambert ME, Chadwick GA, McMahon A, Scarffe JH.

Department of Medical Oncology, Christie Hospital, Manchester, U.K.

Fifty Portacaths have been inserted in patients undergoing prolonged outpatient
chemotherapy, most for haematological disease. Twenty-one are still working at a 
median duration of 12 months (range 1-27) and a further 15 were functioning
normally at the time of the patients death (median survival 6 months). Four
functioning Portacaths have been removed, three suspected of causing septicaemia 
and one believed erroneously to have occluded. Ten have ceased to function and
nine of these have been removed. The causes of these failures are nearly all
avoidable and are discussed in detail; many occurred early in our experience.
With careful attention to detail and with management by trained and interested
staff, the Portacath is a safe and reliable device for intermittent vascular
access.

PMID: 3343028 [PubMed - indexed for MEDLINE]

6573: J Allergy Clin Immunol. 1988 Jan;81(1):47-51.

Fatal varicella in steroid-dependent asthma.

Silk HJ, Guay-Woodford L, Perez-Atayde AR, Geha RS, Broff MD.

Division of Allergy, Children's Hospital, Boston, Mass.

Disseminated varicella infection is a potentially life-threatening complication
of chronic high-dose corticosteroid (CS) or immunosuppressive therapy. A review
of the literature indicates that, with one possible exception, this complication 
has not occurred in a CS-dependent subject with asthma. We present in this
article the clinical features and autopsy findings of a steroid-dependent subject
with asthma who died of acute, disseminated varicella. A 16-year-old poorly
compliant, steroid-dependent subject with asthma received two courses of
high-dose intravenous methylprednisolone during a 3-week period, followed by a
tapering schedule of oral prednisone. During this time, she was exposed to
chickenpox. She subsequently developed a classic varicella rash, sever back pain,
rapidly progressive hepatic failure, pneumonitis, and encephalopathy. Death
ensued 3 days after the onset of the rash. Evidence of disseminated varicella
infection was confirmed at autopsy. This case illustrates that a small number of 
subjects with severe asthma receiving high-dose CS need to be considered as a
separate, high-risk group for developing disseminated varicella. We recommend
that the immune status of these patients to varicella-zoster virus be assessed by
a serum titer. If these patients are nonimmune, they would be candidates for
varicella-zoster immune globulin on exposure, and for acyclovir therapy should
varicella dissemination occur.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 3339190 [PubMed - indexed for MEDLINE]

6574: J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):232-4.

Comments on vaccines, August 1987.

Wheeler CE Jr.

Department of Dermatology, University of North Carolina School of Medicine, North
Carolina Memorial Hospital, Chapel Hill 27514.

Because of latency and infectious recurrences, eradication of herpes simplex and 
herpes zoster from the world by vaccines is likely to be much more difficult to
accomplish than eradication of smallpox. For some time we may have to settle for 
control of these diseases rather than their eradication. The live, attenuated
varicella vaccine protects immunocompromised and normal persons against clinical 
chickenpox but it does not completely prevent subsequent infection with natural
chickenpox virus or latency. With herpes simplex vaccines we may have to be
satisfied with amelioration or control of clinical infections and diminution of
latency and recurrent disease. Varicella zoster immune globulin plays a useful
role in attenuation of varicella in immunocompromised or special-risk persons
exposed to varicella zoster virus. Passive immunization for herpes simplex
(herpes simplex immune globulin or other antibody preparations) has been studied 
very little. Maybe passive immunization will have a place in future therapies,
especially for serious herpes simplex virus infections in immunocompromised
hosts.

PMID: 3339145 [PubMed - indexed for MEDLINE]

6575: J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):204-6.

Antiviral treatment in chickenpox and herpes zoster.

Huff JC.

Department of Dermatology, University of Colorado Health Sciences Center, Denver 
80262.

Intravenous acyclovir is effective for varicella in adults and immunocompromised 
children, causing more rapid resolution of the illness and fewer complications.
Intravenous acyclovir in immunocompromised patients with herpes zoster decreases 
new lesion formation, decreases acute pain, halts dissemination of the virus, and
lessens visceral complications. Intravenous acyclovir may also be effective in
zoster encephalitis. Intravenous vidarabine also has a favorable affect on
chickenpox and herpes zoster. Topical acyclovir may benefit herpes zoster in
immunosuppressed patients by accelerating cutaneous healing. Oral acyclovir
appears to be effective in varicella and zoster in immunocompromised patients. It
is also effective in otherwise normal patients, but its effect seems less
dramatic and the drug must be given early. Neither acyclovir nor vidarabine has
been proven clearly to prevent postherpetic neuralgia. Because varicella zoster
virus is less sensitive to acyclovir than is herpes simplex, intravenous doses of
500 mg/m2 or 10 mg/kg every 8 hours or oral doses of 800 mg five times a day are 
recommended. At these doses adequate hydration and urine flow must be maintained,
the mental status of the patient must be monitored, and impaired renal function
requires regulation of dosage downward.

PMID: 3339143 [PubMed - indexed for MEDLINE]

6576: J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):186-8.

Prophylactic and suppressive treatment with acyclovir and the management of
herpes in patients with acquired immunodeficiency syndrome.

Conant MA.

Department of Dermatology, University of California, San Francisco 94117.

During 1 year of continuous suppressive therapy for frequent recurrent genital
herpes, about 44% of patients taking 400 mg acyclovir twice a day had no
recurrences and 4% of patients taking placebo had no recurrences (i.e., fewer
patients taking acyclovir had recurrences, and when they did there were fewer
recurrences). Toxicity of continuous suppressive acyclovir treatment appears to
be minimal, and viral resistance developing to the drug during use of suppressive
therapy has not been a problem, although it does occur. Patients with acquired
immunodeficiency syndrome with recurrent herpes may be given 400 mg acyclovir
five times a day for 5 days or until the eruption clears and then 400 mg three
times a day for 1 or 2 months followed by 400 mg twice a day thereafter. Herpes
zoster of immunocompromised patients, including patients with acquired
immunodeficiency syndrome, may be treated with 800 mg oral acyclovir five or six 
times a day for 5 to 10 days depending on the response, and they may derive
additional benefit from concomitant topical acyclovir.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 3339140 [PubMed - indexed for MEDLINE]

6577: J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):161-238.

Antiviral drugs and vaccines for herpes simplex and herpes zoster. Proceedings of
a symposium. American Academy of Dermatology forty-fourth annual meeting.
December 11, 1985, Las Vegas, NV.

[No authors listed]

PMID: 3339137 [PubMed - indexed for MEDLINE]

6578: Ann Intern Med. 1988 Jan;108(1):154-5.

Thrombotic thrombocytopenic purpura and herpes zoster infection.

Satoh K, Takahashi H, Nagai K, Shibata A.

Publication Types: 
    Case Reports
    Letter

PMID: 3337505 [PubMed - indexed for MEDLINE]

6579: Pharmacotherapy. 1988;8(1):52-68.

Human infection with herpes zoster: etiology, pathophysiology, diagnosis,
clinical course, and treatment.

Strommen GL, Pucino F, Tight RR, Beck CL.

Department of Pharmacy Practice, College of Pharmacy, North Dakota State
University, Fargo 58105.

Herpes zoster is a cutaneous vesicular eruption resulting from recrudescence of
the chickenpox virus. It is mainly a disease of adults, with a predisposition for
the elderly or immunocompromised. Although usually localized, the disease can
disseminate to visceral organs. Diagnosis is often made based on the
characteristic pattern of the lesion and clinical features. Tzanck smear, viral
isolation, seroconversion, antibody titers, and monoclonal antibodies may further
aid or confirm the diagnosis. Clinical features of herpes zoster may follow a
progression through 3 stages, prodromal, acute, and chronic. The prodromal and
acute phases seldom require more than symptomatic management. The chronic pain
syndrome, postherpetic neuralgia (PHN), demands a more aggressive approach.
Pharmacologic intervention, neuroaugmentation, and/or surgery may prevent or
alleviate PHN, but universal response to any of these therapeutic approaches is
unlikely. Tricyclic antidepressants remain the first choice in treating this pain
syndrome. A trial of antiviral therapy may be warranted in patients with
disseminated disease or in immunocompromised patients with localized disease. Of 
the antiviral agents, acyclovir is considered the drug of choice by most
clinicians.

Publication Types: 
    Review

PMID: 3287356 [PubMed - indexed for MEDLINE]

6580: Int Ophthalmol Clin. 1988 Spring;28(1):5-13.

Indications for corneal transplant surgery.

Stanley JA.

Department of Ophthalmology, University of California, San Francisco.

PMID: 3279006 [PubMed - indexed for MEDLINE]

6581: Am J Dis Child. 1988 Jan;142(1):71-2.

Herpes zoster in children with acute lymphocytic leukemia.

Novelli VM, Brunell PA, Geiser CF, Narkewicz S, Frierson L.

Department of Pediatrics, University of Texas Health Science Center, San Antonio.

Herpes zoster (HZ) occurred in 25% (28/88) of a population of children with acute
lymphocytic leukemia (ALL) who were seropositive for varicella zoster virus
antibody before its onset; 16.5% (33/199) of the total group of children with ALL
developed HZ. There were no deaths and only one significant complication,
cutaneous disseminated disease, as a result of HZ. The small number of patients
studied may have accounted for the failure to find a significant association
between the occurrence of HZ and the type of ALL or chemotherapy protocol
employed. Although HZ seemed to be more common in those patients who experience
relapses of their leukemia, it did not portend a poor outcome for ALL.

PMID: 3277389 [PubMed - indexed for MEDLINE]

6582: Int J Radiat Oncol Biol Phys. 1988 Jan;14(1):197-203.

Total lymphoid irradiation for multiple sclerosis.

Devereux CK, Vidaver R, Hafstein MP, Zito G, Troiano R, Dowling PC, Cook SD.

Department of Radiation Oncology, Clara Maass Medical Center, Belleville, NJ
07109.

Although chemical immunosuppression has been shown to benefit patients with
chronic progressive multiple sclerosis (MS), it appears that chemotherapy has an 
appreciable oncogenic potential in patients with multiple sclerosis. Accordingly,
we developed a modified total lymphoid irradiation (TLI) regimen designed to
reduce toxicity and applied it to a randomized double blind trial of TLI or sham 
irradiation in MS. Standard TLI regimens were modified to reduce dose to 1,980
rad, lowering the superior mantle margin to midway between the thyroid cartilage 
and angle of the mandible (to avert xerostomia) and the lower margin of the
mantle field to the inferior margin of L1 (to reduce gastrointestinal toxicity by
dividing abdominal radiation between mantle and inverted Y), limiting spinal cord
dose to 1,000 rad by custom-made spine blocks in the mantle and upper 2 cm of
inverted Y fields, and also protecting the left kidney even if part of the spleen
were shielded. Clinical efficacy was documented by the less frequent functional
scale deterioration of 20 TLI treated patients with chronic progressive MS
compared to to 20 sham-irradiated progressive MS patients after 12 months (16%
versus 55%, p less than 0.03), 18 months (28% versus 63%, p less than 0.03), and 
24 months (44% versus 74%, N.S.). Therapeutic benefit during 3 years follow-up
was related to the reduction in lymphocyte count 3 months post-irradiation (p
less than 0.02). Toxicity was generally mild and transient, with no instance of
xerostomia, pericarditis, herpes zoster, or need to terminate treatment in TLI
patients. However, menopause was induced in 2 patients and staphylococcal
pneumonia in one. Our data suggest that this modified TLI regimen has clinical
efficacy and sufficiently low toxicity to make it suitable for investigative
immunosuppressive treatment of patients with progressive MS or other
non-malignant conditions.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 3275601 [PubMed - indexed for MEDLINE]

6583: Clin Exp Neurol. 1988;25:71-84.

Effects of topical capsaicin on normal skin and affected dermatomes in herpes
zoster.

Westerman RA, Roberts RG, Kotzmann RR, Westerman DA, Delaney C, Widdop RE, Carter
BE.

Department of Physiology, Monash University, Clayton, Vic.

Hyperalgesia and allodynia, lasting for months or even years, occurs in the form 
of post-herpetic neuralgia in approximately 70% of adults previously infected
with the varicella herpes zoster virus. The present study aimed at testing the
analgesic desensitising actions and reversibility of repeated application of
topical capsaicin on disordered polymodal nociceptors and peptidergic sensory
fibres mediating warm and pain sensation. Cutaneous nociceptor desensitisation
was measured using the Glasgow automated thermal threshold test (Medelec TTT).
For normal subjects (n = 69) the mean forearm warm threshold was 0.15 +/- 0.07
degrees C and the cold threshold was 0.14 +/- 0.10 degrees C. A variable degree
of partial desensitisation of herpes-affected skin was found in 15 patients with 
post-herpetic neuralgia before capsaicin treatment where the mean threshold
elevation for warm detection was 1.19 degrees C and 0.7 degrees C for cold
detection, compared with the corresponding normal skin. In preliminary studies of
15 patients with post-herpetic neuralgia, good pain relief averaging 30% or 77%
occurred in the affected dermatome(s) after 3 to 4 weeks of 0.01% or 0.05%
capsaicin cream respectively, applied 3-4 times daily. The warm thresholds, after
chronic capsaicin treatment, increased between 0.1 and 7.60 degrees C, the
average elevation being 3.69 degrees C. By contrast cold thresholds after
capsaicin altered inconsistently and by only an average of 0.08 degrees C. The
results suggest that elevation of the warm threshold may indicate the
desensitisation achieved by capsaicin treatment of skin polymodal nociceptors.
Cold detection, being dependent upon A-delta cold fibre function, is unaffected
by capsaicin treatment. There was a poor correlation between pain relief and
elevation of warm detection in response to capsaicin treatment. Generally, it was
found that those patients with less initial desensitisation to warm detection as 
a consequence of post-herpetic neuralgia experienced better pain relief after
capsaicin was applied. The method used permits determination of the minimum
effective desensitising dose of capsaicin, enables patient compliance and
progress to be monitored and should allow the prediction of patients likely to
achieve the best response to treatment.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3267488 [PubMed - indexed for MEDLINE]

6584: Ophthalmologica. 1988;196(4):185-7.

Herpes zoster ophthalmicus complicated by hyphema and hemorrhagic glaucoma.

Hayasaka S, Watanabe M, Yamamoto Y, Noda S, Sekimoto M, Setogawa T.

Department of Ophthalmology, Shimane Medical University, Izumo, Japan.

We treated two patients with herpes zoster ophthalmicus in whom hyphema and
hemorrhagic glaucoma occurred. Case 1 complained of facial skin eruption, and was
given intravenous acyclovir for 7 days. Hyphema and high intraocular pressure
occurred in the left eye 10 days after the onset of the skin eruption. Case 2 had
severe pain and blisters on her face, and was given intravenous acyclovir for 7
days. An intracameral hemorrhage and glaucoma developed in the right eye 15 days 
after the onset of the skin lesion. Intravenous acyclovir may be necessary for
longer than 7-day periods if the iridocyclitis remains.

Publication Types: 
    Case Reports

PMID: 3262845 [PubMed - indexed for MEDLINE]

6585: Dermatol Monatsschr. 1988;174(8):466-71.

[Alternative treatment possibilities of herpetic diseases with low frequency
electric currents]

[Article in German]

Rathkolb O, Ammer K, Hein B, Hein L.

Publication Types: 
    English Abstract

PMID: 3262541 [PubMed - indexed for MEDLINE]

6586: Jpn J Ophthalmol. 1988;32(1):64-9.

Endogenous uveitis in Chinese--an analysis of 240 cases in a uveitis clinic.

Chung YM, Yeh TS, Liu JH.

Department of Ophthalmology, National Yang-Ming Medical College, Taipei, Taiwan, 
Republic of China.

A review of 240 consecutive Chinese patients with endogenous uveitis seen over a 
3-year period was made in Taiwan. The frequency of major types of uveitis was 110
cases (45.8%) of acute anterior uveitis, 43 cases (17.9%) of Behcet's disease, 22
cases (9.2%) of Harada's disease, 10 cases (4.2%) of peripheral uveitis, 6 cases 
(2.5%) of virus-induced uveitis and 5 cases (2.1%) of Fuchs' heterochromic
cyclitis. Only 1 case (0.4%) of sarcoidosis was found. Of the 110 cases of acute 
anterior uveitis, 80.9% presented with HLA-B27 antigen. The incidences of types
of endogenous uveitis in Chinese differ from those in Caucasians, Japanese and
Negro races in the USA.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3261815 [PubMed - indexed for MEDLINE]

6587: Zh Nevropatol Psikhiatr Im S S Korsakova. 1988;88(2):33-5.

[Ocular herpes zoster with contralateral hemiplegia]

[Article in Russian]

Mikhailenko AA, Osetrov BA.

A total of 375 patients with neurologic syndromes of herpes zoster were studied. 
Ten of them presented, along with the involvement of the first branch of the
trigeminal nerve and other cranial nerves, contralateral pyramidal
symptomatology. Apart from the typical syndrome of herpes zoster ophthalmicus
with contralateral hemiplegia the authors distinguished clinical variants in
which contralateral pyramidal symptomatology was associated with acute
meningoencephalitis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3259770 [PubMed - indexed for MEDLINE]

6588: Nervenarzt. 1988 Jan;59(1):45-7.

[Multiple brain infarcts in zoster infection]

[Article in German]

Karenberg A, Schadlich HJ, Karbe H, Neveling M, Thun F.

Universitats-Nervenklinik, Universitat zu Koln.

The clinical, CSF, CCT and PET findings in a 14-year-old female patient are
reported. CCT and PET investigations demonstrated multiple cerebral infarctions; 
CSF examinations revealed inflammatory changes. Zoster antibodies were
synthesized intrathecally, as detected by an ELISA after adjusting serum and CSF 
to identical IgG concentrations. Therefore the diagnosis of a cerebral zoster
angiitis was made. Diagnostic and therapeutic problems of inflammatory vascular
lesions are discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3258411 [PubMed - indexed for MEDLINE]

6589: Cornea. 1988;7(1):50-6.

Corneal complications of herpes zoster ophthalmicus. Prevention and treatment.

Cobo LM.

Department of Ophthalmology, Duke University Medical Center, Durham, North
Carolina 27710.

Corneal complications of herpes zoster ophthalmicus include pseudodendritic
keratitis, late mucous adherent keratopathy, varied forms of stromal keratitis,
and exposure/neurotrophic keratopathy. Prophylactic therapy of acute herpes
zoster ophthalmicus with oral acyclovir is of proven benefit in reducing the
incidence of early pseudodendritic keratopathy and stromal keratitis but has no
evident effect on exposure/neurotrophic keratopathy. Although early
pseudodendritic keratitis is due to virus infection of epithelial cells, it is
self-limited and does not require topical antiviral therapy. Stromal keratitis
and associated epithelial mucous adherent keratopathy are responsive to topical
corticosteroids but chronic therapy is often required and may prolong the
duration of keratitis and result in cataract or secondary glaucoma. Exposure and 
neurotrophic keratopathy may respond to topical lubricants and correction of lid 
abnormalities but severely affected corneas may require tarsorrhaphy or
conjunctival flap to maintain corneal integrity.

PMID: 3258220 [PubMed - indexed for MEDLINE]

6590: Aust Fam Physician. 1988 Jan;17(1):38.

Alive, well and not to be forgotten.

Colquhoun JP.

Publication Types: 
    Case Reports

PMID: 3257869 [PubMed - indexed for MEDLINE]

6591: Ann Dermatol Venereol. 1988;115(11):1205-7.

[Sinus histiocytosis with cutaneous lesions and thoracic herpes zoster]

[Article in French]

Delisle B, Gilbert M.

Service de Dermatologie, Hopital Saint-Francois d'Assise, Quebec, PQ, Canada.

Publication Types: 
    Case Reports

PMID: 3239916 [PubMed - indexed for MEDLINE]

6592: Scand J Infect Dis. 1988;20(6):583-92.

Herpes zoster associated encephalitis: clinical findings and acyclovir treatment.

Peterslund NA.

Department of Medicine and Infectious Diseases, Marselisborg Hospital, Aarhus,
Denmark.

The clinical course of herpes zoster associated encephalitis (HZAE) with special 
emphasis on the treatment with acyclovir is described from the experience in 14
own patients and 47 review cases. Immunosuppression and dissemination involved
increased risk of HZAE, whereas cranial zoster implied no or only a slightly
increased risk. The symptoms were mainly disturbances of mental function and
ataxia. Nuchal rigidity was noted in approximately one third of cases. The median
duration from dermatomal lesion to HZAE was 15 days in immunosuppressed patients 
versus 5 days in non-immunosuppressed patients. Abnormal spinal fluid findings
included mononuclear pleocytosis, occasionally with low glucose concentration.
Protein was elevated in half of the patients. Serum sodium levels were often low.
Brain CAT scans were generally normal and EEGs always abnormal. Recurrence of
HZAE was noted in 2 patients. Treatment with acyclovir seemed to have a
beneficial effect. The results, however, need cautious interpretation due to the 
heterogenous patient material. Two patients developed signs of HZAE while on
treatment with desciclovir but recovered during ongoing therapy.

PMID: 3222675 [PubMed - indexed for MEDLINE]

6593: Rev Neurol (Paris). 1988;144(10):586-9.

[Polyneuritis of cranial nerves and acquired immunodeficiency syndrome (AIDS): 5 
cases]

[Article in French]

Uldry PA, Regli F.

Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse.

Cranial neuropathies were present in 5 patients with positive serology for the
human immunodeficiency virus. Two patients presented with abnormalities of ocular
movements (3rd, 4th), two with an isolated unilateral facial nerve palsy and one 
with a lesion of the accessory nerve. Neurological symptoms and signs are present
in approximately 60 to 80 p. 100 of cases of the acquired immunodeficiency
syndrome, but cranial neuropathies affect only 2 to 3 p. 100 of the patients. The
isolation of the human immunodeficiency virus from the nerve suggest a direct
role, but an indirect immune mechanism may also be present. Some of the patients 
with aseptic meningitis or subacute encephalopathy have demonstrated involvement 
of cranial nerves, mainly 2nd, 7th and 8th. Systemic tumors (lymphoma) may
involve the central nervous system by diffuse meningeal invasion with lesions of 
3rd, 4th and 6th nerves. Opportunist infections like Herpes zoster or
Cytomegalovirus may produce cranial neuropathies (2nd, 5th). Isolated
mononeuropathies or cranial nerves palsies have also been reported in patients
treated with chemotherapeutic agents like vinca alkaloids.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3194606 [PubMed - indexed for MEDLINE]

6594: Acta Otolaryngol Suppl. 1988;446:81-4.

Studies with electrocochleography and auditory brainstem response in Ramsay Hunt 
syndrome.

Kusakari J, Takeyama M, Kawase T, Takahashi K, Sasaki Y, Takasaka T.

Department of Otolaryngology, Tohoku University School of Medicine, Sendai,
Japan.

Eighteen cases of Ramsay Hunt syndrome were examined with electrocochleography
and auditory brainstem response. Hearing was normal in 4 cases, while the other
14 exhibited sensorineural hearing loss ranging from mild to moderate in
severity. Although the I-V interwave latency in all cases was within or slightly 
outside of the normal limits, the N1 latency was significantly prolonged in 8
cases proportionately to the degree of hearing loss at 4 and 8 kHz. The
histopathological findings reported so far have indicated that the main lesion in
this syndrome is in the internal auditory canal (2, 3, 4, 5). The results
obtained in the present study, however, clearly show that the main site
responsible for the hearing loss is not in the retrocochlear region, but in the
cochlea. The possible mechanism of the cochlear involvement in this syndrome was 
discussed.

PMID: 3166594 [PubMed - indexed for MEDLINE]

6595: Acta Otolaryngol Suppl. 1988;446:42-6.

Electrodiagnostic findings in the early stages of Bell's palsy and Ramsay-Hunt's 
syndrome.

Kanzaki J.

Department of Otolaryngology, School of Medicine, Keio University, Tokyo, Japan.

The incidence of denervation, as determined electrodiagnostically (nerve
excitability test and electroneuronography), was analysed during the course of
the disease in 150 patients with Bell's palsy and 45 with Ramsay-Hunt's syndrome.
Of all 150 patients, 14.2% of those with Bell's palsy and 44% of the patients
with Ramsay-Hunt syndrome either showed denervation at the time of the initial
examination or developed denervation from neurapraxia within 3 weeks after the
onset of paralysis.

PMID: 3166587 [PubMed - indexed for MEDLINE]

6596: Acta Otolaryngol Suppl. 1988;446:111-3.

Effects of Aciclovir in Ramsay Hunt syndrome.

Inamura H, Aoyagi M, Tojima H, Koike Y.

Department of Otolaryngology, Yamagata University School of Medicine, Japan.

Nine patients with Ramsay Hunt syndrome were treated with Aciclovir and the
effects of this treatment were observed for 6 months. The results were excellent 
in 5 cases, fair in 3, and poor in one case. Otalgia and auricular herpes was
improved rapidly after the administration of Aciclovir. No severe side effect was
observed in this study.

PMID: 3166577 [PubMed - indexed for MEDLINE]

6597: Zhen Ci Yan Jiu. 1988;13(1):6-9, 5.

Comments on the technique of the treatment of herpes zoster.

[Article in Chinese, English]

Serres G.

PMID: 3143505 [PubMed - indexed for MEDLINE]

6598: Eur J Cancer Clin Oncol. 1988;24 Suppl 1:S15-23.

Prophylaxis of infection in bone marrow transplants.

Winston DJ, Ho WG, Gale RP, Champlin RE.

Department of Medicine, UCLA Center for the Health Sciences 90024.

Bone marrow transplants experience severe immuno-deficiency as a consequence of
pretransplant radiation and chemotherapy, transient granulocytopenia before
marrow engraftment, and post-transplant prevention and treatment of
graft-versus-host disease with immuno-suppressive agents. During periods of
granulocytopenia, chemoprophylaxis with the oral fluorinated quinolones can
prevent colonization and infection with gram-negative bacilli, is better
tolerated than oral non-absorbable antibiotics or trimethoprim-sulfamethoxazole
and is more cost-effective than laminar-air-flow isolation or prophylactic
granulocyte transfusions. Antifungal prophylaxis with oral nystatin, ketoconazole
or amphotericin B, however, has not been consistently effective; empiric
intravenous amphotericin B therapy is still the most reliable way to prevent
fatal fungal infections. Following marrow engraftment, cytomegalovirus infection 
and interstitial pneumonia can be prevented in cytomegalovirus-seronegative
patients by the use of cytomegalovirus-seronegative blood products and
cytomegalovirus immune globulin. In cytomegalovirus-seropositive patients,
prophylactic DHPG (ganciclovir) is currently being evaluated in a controlled
clinical trial. Herpes simplex and varicella-zoster infections can be treated
effectively with intravenous acyclovir, but routine acyclovir prophylaxis is not 
cost-effective. Trimethoprim-sulfamethoxazole is used for prophylaxis of
Pneumocystis carinii pneumonia and may be continued in patients with chronic
graft-versus-host disease for prevention of late post-transplant bacterial
infections.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 3127217 [PubMed - indexed for MEDLINE]

6599: Metab Pediatr Syst Ophthalmol. 1988;11(1-2):43-6.

Ten years of experience with human fibroblast interferon in treatment of viral
ophthalmic infections.

Romano A, Sadan Y.

Maurice and Gabriela Goldschleger Eye Institute, Chaim Sheba Medical Center,
Tel-Hashomer, Israel.

This review of ten years of experience presents the results of clinical use of
human beta-interferon (Frone) in viral ocular disease. Two forms of human
beta-interferon have been used: (a) Frone cream 20,000 IU/g (Inter-Yeda Ltd.) for
local treatment and prevention of HSV-1 periocular skin lesions and for Herpes
zoster ophthalmicus. (b) Frone eye drops (500,000-1,000,000 U) for prophylaxis
and treatment of adenovirus infections and for prevention of recurrent HSV-1
keratitis. Our results show that Frone cream or drops, applied at an early stage,
is: (a) Effective in significantly shortening the course of the disease; (b) Has 
a drying effect on herpetic skin lesions, and tear secretion in adeno viral
disease; (c) Reduces the frequency from 1.2 to 0.04 attacks per year for patients
with known biological rhythm of the disease; (d) Prevents subepithelial keratitis
in 45% of the study population; (e) Prophylactic treatment of interferon in
families reduces the incidence of contamination from 65% to 20%.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 3076609 [PubMed - indexed for MEDLINE]

6600: Br Med Bull. 1988 Jan;44(1):101-14.

Clinical aspects of HIV infection in developing countries.

Conlon CP.

PIP: The HIV epidemic probably arose in Africa at about the same time as in the
West, and there is a significant seroprevalence of HIV in the central African
region. However, the epidemiology and clinical course of AIDS are different in
Africa and in the West. In Africa males are infected as often as females, and the
commonest means of transmission is heterosexual intercourse. Many HIV-infected
people are symptomless, but many others present with or progress to generalized
lymphadenopathy, pruritus, herpes zoster, herpes simplex, cellulitis, and oral
candidiasis. The World Health Organization developed a clinical case-definition
of AIDS in Africa, which was found to have a specificity of 90% and a sensitivity
of 59% when tested in Zaire. The Kaposi's sarcoma seen in African AIDS patients
is more aggressive than that seen in the West and is often visceral.
Gastrointestinal AIDS (the "slim" disease) with weight loss and diarrhea is
common in Africa, as are oral and esophageal candidiasis. In Africa Pneumocystis 
carinii pneumonia is rare, but pulmonary tuberculosis is common. Neurological
manifestations include cerebral toxoplasmosis, cytomegalovirus infection,
headache, and terminal encephalopathy. About 60% of infants born to seropositive 
women are infected and die within the 1st year of life. Lack of drugs and
diagnostic facilities make both diagnosis and treatment of opportunistic
infections difficult.

Publication Types: 
    Review

PMID: 3058240 [PubMed - indexed for MEDLINE]

6601: Zh Nevropatol Psikhiatr Im S S Korsakova. 1988;88(8):51-6.

[Encephalitis in the acute period of herpes zoster in children]

[Article in Russian]

Shishov AS.

The data from the author's files and literature are reviewed with respect to the 
occurrence, clinical characteristics and treatment of encephalitis in children
with herpes zoster. A differential-diagnostic table is designed to present the
clinical features of this form of encephalitis in different age groups and
infantile encephalitis in chickenpox and herpes simplex.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract
    Review

PMID: 3057782 [PubMed - indexed for MEDLINE]

6602: Recent Results Cancer Res. 1988;108:61-70.

Managing fungal and viral infection in the immunocompromised host.

Jehn U.

Medizinische Klinik III, Ludwig-Maximilians-Universitat, Munchen, FRG.

The increasing number of opportunistic fungal infections in neutropenic cancer
patients has become of major concern. Postmortem examinations have shown that
more than half of the deaths attributed to infection were due to disseminated
fungal infections. Candida species are the major pathogens. Unfortunately, the
early diagnosis of serious fungal invasion is exceedingly difficult in these
patients, since the manifestations of infection are ill-defined and the organisms
can only rarely be isolated from blood cultures. Therefore, empirical antifungal 
therapy in febrile patients early in the course of disease appears necessary to
prevent fungal superinfections and to control clinically undetected fungal
invasion. Even if a fungal infection is diagnosed, treatment options are limited 
to a small number of drugs, and the chance of successful treatment is slim.
Amphotericin B remains the most effective drug for systemic fungal infection;
however, it is also the most toxic antimicrobical in use. Reduction of its
toxicity and, simultaneously, improvement of its effectiveness can be achieved by
incorporation into liposomes, although liposomal amphotericin B is not yet
available commercially. The newer azoles, such as ketoconazole, vibunazole, and
itraconazole are orally active and less toxic. Azoles have been successfully used
in the treatment of superficial candidal infections; they are not very active in 
systemic candidiasis. Inhibitors of the cell wall biosynthesis of candida species
include inhibitors of chitin and glucan biosynthesis. Echinocandins and
papulacandins interfer with the glucan synthesis and show good anticandidal
activity. Their therapeutic potential is currently being explored in clinical
trials. Neutropenic patients and particularly bone marrow transplant (BMT)
recipients are, in addition to fungal infections, at very high risk for
herpesvirus infections: herpes simplex virus (HSV) 0-20 days after BMT,
cytomegalovirus (CMV) 40-80 days after BMT, varicella zoster virus (VZV) 100-160 
days after BMT, and Epstein-Barr virus (EBV) 14-21 days after BMT. Acyclovir and 
vidarabine are, at present, the only antiviral drugs available for HSV and VZV
infections, acyclovir apparently being the more effective. It is also the drug of
choice for prevention of HSV infections in severely immunocompromised, i.e., BMT,
patients. Bromovinyldeoxyuridine seems to be suitable for systemic treatment of
HSV-1 and VZV infections in these patients. Its potency in inhibiting HSV-1 and
VZV replication is superior to that of ACV, and in therapeutic doses it is
nontoxic to hematopoietic progenitor cells.(ABSTRACT TRUNCATED AT 400 WORDS)

Publication Types: 
    Review

PMID: 3051213 [PubMed - indexed for MEDLINE]

6603: Neurochirurgie. 1988;34(2):106-9.

[Treatment of atypical post-traumatic and postoperative facial neuralgias by
chronic stimulation. Apropos of 2 cases, with review of the literature]

[Article in French]

Probst C.

Clinique de Neurochirurgie, Hopital Cantonal, Aarau, Suisse.

This article describes the case of two patients suffering from deafferentation
pain after surgery or traumatic lesions in the area of the peripheric trigeminal 
branches on the Gasserian ganglion. Chronic electrical stimulation by an
electrode implanted in the Gasserian ganglion led to a good permanent result in
both cases, within a follow-up period of one year and one year and a half,
respectively. The pre-operative test was carried out percutaneously via the
foramen ovale, the definitive implantation by surgery with subtemporal access.
This method can only be used when at least part of the ganglion cells of the
Gasserian ganglion are intact. According to identical observations by other
authors, it is mostly adequate for surgical and traumatic trigeminal lesions,
whereas for pain due to herpes zoster, the stimulation of specific thalamus
nuclei is a much better method.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 3043244 [PubMed - indexed for MEDLINE]

6604: AIDS. 1988;2 Suppl 1:S191-3.

Treatment of opportunistic viral infections.

Crumpacker CS.

Division of Infectious Diseases, Beth Israel Hospital, Boston, MA.

Publication Types: 
    Review

PMID: 2852503 [PubMed - indexed for MEDLINE]

6605: Acta Otolaryngol Suppl. 1988;456:49-54.

Acute profound deafness in Ramsay Hunt syndrome. Two case reports.

Hiraide F, Kakoi H, Miyoshi S, Morita M.

Department of Otolaryngology, School of Medicine, Jichi Medical School, Tochigi, 
Japan.

Two patients with sudden progressive profound hearing loss resulting from Ramsay 
Hunt syndrome are reported. Case 1: A 63-year-old woman was admitted to Jichi
Medical School Hospital with sudden, progressing deafness of the left ear,
vertigo, sore throat, and hoarseness. An otoscopic examination revealed the
external ear and the tympanic membrane to be normal. Pure-tone audiometry
revealed profound deafness in the left ear. A horizontal nystagmus in the
non-affected direction was observed by gaze nystagmus test. An endoscopic
examination revealed herpetic vesicles and shallow ulcers on the left side of the
pharynx and the larynx. There was complete paralysis of the left recurrent nerve.
Hearing acuity of the left ear did not recover at all with steroid hormone
therapy. Case 2: A 75-year-old man was referred to the ENT Clinic by a
dermatologist for hearing evaluation in Ramsay Hunt syndrome. The man had noticed
severe otalgia and sudden progressive deafness of the right ear approximately 2
weeks prior to admission. Physical examination revealed herpetic vesicles and
ulcers in the right external ear and lateral neck. Complete paralysis of the
right facial nerve was noted. Profound hearing loss in the affected ear was
observed by pure-tone audiometry. A gaze nystagmus test revealed a horizontal
nystagmus in the non-affected direction. No recovery of the cochlear function was
noted following administration of antiviral drug. The pertinent literature is
briefly reviewed.

Publication Types: 
    Case Reports

PMID: 2852431 [PubMed - indexed for MEDLINE]

6606: Gerontology. 1988;34(5-6):242-9.

Detection of antibodies to varicella-zoster virus proteins in sera from the
elderly.

Vafai A, Mahalingam R, Zerbe G, Wellish M, Gilden DH.

Department of Neurology, University of Colorado School of Medicine, Denver.

Sera from 40 elderly individuals ranging in age from 60 to 94 years were tested
for the presence of antibodies to varicella-zoster virus (VZV)-specific proteins.
Sodium dodecylsulfate polyacrylamide gel electrophoresis analysis of lysates of
VZV-infected BSC-1 cells labeled with either [35S]methionine or [3H]mannose and
immunoprecipitated with human sera revealed the variable presence of VZV-specific
antibodies to four VZV glycoproteins (gpI, gpII, gpIII, and gpIV), and three
nonglycosylated proteins (155, 140, 32 kilodaltons, kDa). The predominant
antibody response in the sera from the elderly was to VZV gpII and the 155-kDa
species. In addition, some sera from elderly individuals without an identifiable 
history of varicella or zoster contained antibodies to VZV proteins, suggesting a
possible subclinical infection in these patients. Finally a history of zoster in 
the elderly was significantly correlated (p = 0.02) with the presence of antibody
to gpIV.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2851500 [PubMed - indexed for MEDLINE]

6607: Arch Otorhinolaryngol. 1988;245(4):230-3.

Serology in facial paralysis caused by clinically presumed herpes zoster
infection.

Njoo FL, Wertheim-van Dillen P, Devriese PP.

Faculty of Medicine, University of Amsterdam, The Netherlands.

In some cases of peripheral facial palsy due to a clinically suspected varicella 
zoster virus (VZV) infection, the clinical diagnosis is not supported by
serological tests. In a retrospective study, we examined the sera from 63
patients with clinical findings compatible with VZV infection: 57 had paired sera
and 6 had single sera. In the paired-sera group, 18 cases were serologically
negative initially by complement fixation (CF), while 9 of these cases were
actually positive for VZV when CF was combined with ELISA. Moreover, evidence for
a recent mumps virus infection was found in 6 patients and 1 patient was
diagnosed as having recent mumps and cytomegalo-virus (CMV) infections. In the 6 
single sera studied, the ELISA was suggestive of a recent infection with VZV (4
cases) and CMV (1 case).

PMID: 2845904 [PubMed - indexed for MEDLINE]

6608: Am J Pediatr Hematol Oncol. 1988 Fall;10(3):196-205.

Virus-associated histiocytic proliferations in children. Frequent association
with Epstein-Barr virus and congenital or acquired immunodeficiencies.

McClain K, Gehrz R, Grierson H, Purtilo D, Filipovich A.

Department of Pediatrics, University of Minnesota, Minneapolis.

Nineteen children who presented with fever, hepato-splenomegaly, bone marrow
and/or hepatic failure, and biopsy evidence of histiocytic proliferations were
evaluated for lymphocyte dysfunction and evidence of prior viral infection.
Seventeen of the children had erythrophagocytosis consistent with the previously 
described virus-associated hemophagocytosis syndrome (VAHS) or Familial
erythrophagocytic lymphohistiocytosis (FEL). The other two had benign histiocytic
proliferations in the central nervous system (CNS) with liver and bone marrow
dysfunction. There were two sibling pairs and six patients with known disorders
of immune deficiency. The remaining nine cases appeared to be sporadic and
idiopathic. Epstein-Barr Virus (EBV) was identified in patients by serologic or
DNA hybridization studies (15), EBV and cytomegalovirus (CMV) (1), adenovirus
plus EBV and CMV (1), or adenovirus and EBV (1). Herpes zoster was associated
with reactivation of symptoms in one patient. Immunologic impairment was
evidenced by lymphopenia in 10 of 19 patients. More extensive evaluations could
be done at diagnosis on only some of the children because the histiocytic
proliferative syndrome was not recognized or because there were insufficient
numbers of lymphocytes in samples obtained. For those who could be evaluated, the
following immune deficiencies were found: decreased lymphocyte proliferation to
mitogens (4 of 9), absent or markedly decreased natural killer function (5 of 5),
and decreased cytotoxic lymphocyte reactivity to allogenic EBV-infected target
cells (3 of 3). A new finding reported here is a higher than expected prevalence 
of HLA types A30, B8, and A1/B8 among the patients tested.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2845831 [PubMed - indexed for MEDLINE]

6609: Acta Otolaryngol Suppl. 1988;446:23-6.

Viral infection in acute peripheral facial palsy. Investigation in Yamagata
Prefecture.

Inamura H, Aoyagi M, Tojima H, Koike Y.

Department of Otolaryngology, Yamagata University School of Medicine, Japan.

We studied viral involvement in Bell's palsy and Ramsay Hunt syndrome. In the CF 
test, viral infection was confirmed in 2 of 84 patients. Of the 12 patients with 
Ramsay Hunt syndrome, 5 showed a significantly high titre for varicella zoster
and one for rubella. The ELISA test, performed in 60 patients with Bell's palsy, 
revealed significantly high titres for varicella zoster in 5 patients and for
herpes simplex in 4 patients. All 5 patients with Ramsay Hunt syndrome showed
significantly high titres for varicella zoster. The ELISA test showed a higher
sensitivity than the CF test. The incidence of viral infection in the present
study was lower than that in similar investigations. Possible reasons for this
are epidemicity or regional differences year from year.

PMID: 2844058 [PubMed - indexed for MEDLINE]

6610: Acta Otolaryngol Suppl. 1988;446:17-22.

Viral infections in acute peripheral facial paralysis. Nationwide analysis
centering on CF.

Kukimoto N, Ikeda M, Yamada K, Tanaka M, Tsurumachi M, Tomita H.

Department of Otorhinolaryngology, Nihon University School of Medicine, Tokyo,
Japan.

The degree of participation and regional specificity of virus infection in
relation to atraumatic acute peripheral facial palsy was studied, placing
particular emphasis on change in the CF titre of varicella zoster virus (VZV),
herpes simplex virus (HSV) and adenovirus (adeno). The subjects of the study were
91 patients with Hunt's syndrome and 396 patients with Bell's palsy treated at 17
institutions all over Japan in the period between April 1985 and November 1986.
Among the cases of Hunt's syndrome, the positive conversion rate of CF antibody
titre of VZV was 81%. In Bell's palsy cases, virus participation was detectable
in 8% with VZV, 4% with HSV and 4% with adeno. With regard to the age
distribution, Bell's palsy cases with possible virus involvement tended to be
observed in younger patients than those without that possibility. As to regional 
specificity, the incidence of Bell's palsy with possible virus involvement tended
to be higher in densely populated areas. With regard to the main cause of acute
peripheral facial palsy, virus infection has been implicated, as well as
insufficient blood circulation (ischemia). Even in cases of acute peripheral
facial palsy, in which herpes zoster oticus is not observed, the participation of
varicella zoster virus (VZV) as a cause of paralysis has been pointed out in some
cases (zoster sine herpete). Furthermore, it is known that the serum antibody
titres of various viruses such as herpes simplex virus (HSV) change significantly
in some cases of Bell's palsy (2, 5-13).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 2844057 [PubMed - indexed for MEDLINE]

6611: Acta Otolaryngol Suppl. 1988;446:10-6.

An ELISA study on varicella-zoster virus infection in acute peripheral facial
palsy.

Tomita H, Tanaka M, Kukimoto N, Ikeda M.

Department of Otorhinolaryngology, Nihon University School of Medicine, Tokyo,
Japan.

ELISA was applied to atraumatic acute peripheral facial palsy for the purpose of 
examining the usefulness of the method with respect to early diagnosis of
varicella-zoster virus (VZV) infection. The material for this study consisted of 
287 cases of Bell's palsy, 64 cases of Hunt's syndrome and 12 cases of zoster
sine herpete diagnosed by the CF method, obtained from 16 institutions throughout
Japan. In view of the results thus obtained, it was provided that cases of
specific anti-VZV-IgG antibodies (anti-VZV-IgG) with a titre of 0.6 or more or
specific anti-VZV-IgM antibodies (anti-VZV-IgM) with a titre of 0.2 or more were 
to be regarded as cases of VZV infection. By adopting ELISA, a diagnostic ratio
of 94.3% in Hunt's syndrome was achieved. Moreover, possible cases of zoster sine
herpete increased further by 28. Furthermore, most of the cases became
diagnosable in the second week after onset of the facial palsy. It was therefore 
presumed that ELISA makes possible diagnosis in the comparatively early stages
with only one testing, and that it is a more useful method than CF.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2844055 [PubMed - indexed for MEDLINE]

6612: J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):176-9.

History, pharmacokinetics, and pharmacology of acyclovir.

King DH.

Department of Infectious Diseases, Burroughs Wellcome Company, Corte Madera, CA.

A screening program for antiviral drugs begun at Burroughs Wellcome in the 1960s 
resulted in the discovery of acyclovir in 1974. Preclinical investigation brought
the drug to clinical trials in 1977 and the first form of the drug (topical) was 
available to physicians in 1982. Activity of acyclovir is greatest against herpes
1 and herpes 2, less against varicella zoster, still less against Epstein-Barr,
and very little against cytomegalovirus. Acyclovir is an antiviral agent only
after it is phosphorylated in infected cells by a viral-induced thymidine kinase.
Acyclovir monophosphate is phosphorylated to diphosphate and triphosphate forms
by cellular enzymes in the infected host cell where the drug is concentrated.
Acyclovir triphosphate inactivates viral deoxyribonucleic acid polymerase.
Acyclovir incorporation into the growing viral deoxyribonucleic acid chain causes
its termination. The antiviral process has relatively little effect on normal,
uninfected cells. An important toxic effect of acyclovir is its potential to
cause obstructive nephropathy. The drug is excreted primarily by the kidney,
which may require smaller doses in patients with decreased kidney function. Oral 
dosages of acyclovir as recommended for herpes simplex are probably not adequate 
for varicella zoster infections.

Publication Types: 
    Historical Article

PMID: 2828440 [PubMed - indexed for MEDLINE]

6613: J Med Chem. 1988 Jan;31(1):268-71.

Synthesis and antiviral properties of
(E)-5-(2-bromovinyl)-2'-deoxycytidine-related compounds.

Jones AS, Sayers JR, Walker RT, De Clercq E.

Chemistry Department, University of Birmingham, Great Britain.

Treatment of 3',5'-di-O-acetyl-(E)-5-(2-bromovinyl)-2'-deoxyuridine (2) with
p-chlorophenyl phosphorodichloridate and 1,2,4-triazole gave
1-(3,5-di-O-acetyl-2-deoxy-beta-D-erythro-pentofuranosyl)-(E)-5-(2-br o movinyl)-
4-(1,2,4-triazol-1-yl)pyrimidin-2(1H)-one (3). Reaction of 3 with ammonia gave
(E)-5-(2-bromovinyl)-2'-deoxycytidine (1), the overall yield from 2 being 60%. A 
similar 4-(1,2,4-triazol-1-yl) derivative (4) was obtained from
3',5'-di-O-acetyl-thymidine by the use of phosphoryl chloride as the condensing
agent. Treatment of thymidine with trimethylsilyl chloride and then with
phosphoryl chloride and 1,2,4-triazole gave upon workup
1-(2-deoxy-beta-D-erythro-pentofuranosyl)-5-methyl-4(1,2,4-triazol -1-yl)
pyrimidin-2(1H)-one (5). (E)-5-(2-Bromovinyl)-2'-deoxyuridine (BVDU) when
similarly treated gave the corresponding (E)-5-(2-bromovinyl) compound 7. A minor
product formed in both cases was a 4-(1,2,4-triazol-1-yl) derivative in which the
nucleoside 5'-hydroxyl group had been replaced by chlorine (6 and 8). Whereas
compounds 4-6 and 8 did not exhibit a selective antiviral effect, compounds 1-3
and 7 proved almost as active as the reference compound BVDU. In particular,
compound 7, the 4-triazolyl derivative of BVDU, would seem worth pursuing for its
potential as an inhibitor of herpes simplex virus type 1 and varicella-zoster
virus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2826786 [PubMed - indexed for MEDLINE]

6614: Acta Derm Venereol. 1988;68(5):440-3.

Skin and oral mucosal changes in patients infected with human immunodeficiency
virus.

Sindrup JH, Weismann K, Sand Petersen C, Rindum J, Pedersen C, Mathiesen L, Worm 
AM, Kroon S, Sondergaard J, Lange Wantzin G.

Department of Dermato-venerology, Bispebjerg Hospital, University of Copenhagen, 
Denmark.

During a 6-month-period, 150 patients infected with Human Immunodeficiency Virus 
(HIV) were repeatedly examined by dermatologists and dentists for lesions of skin
and oral mucosa. The most frequently encountered diseases were: oral hairy
leukoplakia (21%), dermatophytosis (including tinea unguium/tinea pedis et
inguinalis) (20%), seborrheic dermatitis (19%), viral infections (10%), oral
candidiasis (7%), acne vulgaris (6%), and folliculitis (5%). A variety of other
manifestations were seen, with frequencies less than 5%. Herpes zoster was seen
in 3% of the patients, indicating a rate of 60/1,000 per annum. The presence of
seborrheic dermatitis was statistically associated with low T-helper lymphocyte
count. Patients with low T-helper lymphocyte count had on average twice as many
mucocutaneous lesions as patients with a normal or moderately decreased count.
Any one of the manifestations seborrheic dermatitis, oral candidiasis or oral
hairy leukoplakia was associated with a greater average number of additional
mucocutaneous changes than seen in patients exhibiting none of these three
conditions. The high proportion of HIV-infected patients with cutaneous and oral 
lesions underlines the importance of referring the patients to dermatologists and
dentists for examination. Prospective examinations of the study population remain
to elucidate the prognostic significance of mucocutaneous manifestations of
HIV-infected patients.

PMID: 2461031 [PubMed - indexed for MEDLINE]

6615: Rev Med Suisse Romande. 1988 Jan;108(1):41-5.

[Zona and post-zoster pain: therapeutic approach]

[Article in French]

Uldry PA, Regli F.

PMID: 2450394 [PubMed - indexed for MEDLINE]

6616: J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):218-21.

New diagnostic tests for herpes simplex and varicella zoster infections.

Solomon AR.

Department of Dermatology, University of Texas Medical Branch, Galveston 77550.

Laboratory tests for herpetic infections can be divided into (1) morphologic, (2)
immunomorphologic, (3) serologic, and (4) virologic. Tzanck smears are easy to
do, inexpensive, and compare favorably with cultures and immunofluorescence tests
for specificity and sensitivity, but they require considerable experience to
interpret accurately and they cannot differentiate between herpes type 1, herpes 
type 2, and varicella zoster infections. Biopsies are useful when clues to a
diagnosis are being sought. Peroxidase-antiperoxidase and avidin-biotin tests
present technical difficulties but interpretational difficulties are low and the 
results are available in a few hours. They can distinguish between herpes type 1,
herpes type 2, and varicella zoster virus, as can immunofluorescence using
monoclonal antibodies. Serologic tests are used primarily to distinguish between 
primary and recurrent herpes simplex infections. Virus isolation in tissue
cultures is the gold standard for identifying herpes simplex virus but it is not 
100% specific or 100% sensitive. Restriction endonuclease analysis identifies
types and strains of virus by their deoxyribonucleic acid composition and it is
very useful in epidemiologic studies. Ability to find virus by whatever method is
influenced by the stage of the lesion. As lesions age, less infectivity and
antigen result in less sensitivity of the tests.

Publication Types: 
    Review

PMID: 2448353 [PubMed - indexed for MEDLINE]

6617: J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):212-8.

Promising new antiviral drugs.

Bryson YJ.

Department of Pediatrics, University of California, School of Medicine, Los
Angeles 90024.

We now have a basis for a more rational approach to rapid evaluation and
development of antiviral drugs by screening for activity in vitro, testing for
toxicity and efficacy in animals, and clinical testing in humans. Acyclovir is a 
prototype of this improved process. Interferon has a beneficial effect against
CMV infection in renal transplant patients and has promising results in the
treatment of papillomas and rhinovirus infections. It does not seem to be as
effective against genital herpes or varicella zoster as acyclovir. Ribavirin is
effective against respiratory syncytial virus infections and Lassa fever.
Varicella-zoster virus is highly sensitive to bromovinyl deoxyuridine in vitro.
Phosphonoformate is effective in herpes simplex in animals but of little clinical
benefit topically in human recurrent A2 herpes. Zidovudine may decrease mortality
rates and infectious complications in patients with acquired immunodeficiency
syndrome. DHPG (9-(1,3-dihydroxy-2-propoxymethyl]guanine is useful in treatment
of cytomegalovirus and infection in immunocompromised patients. The prodrug of
acyclovir results in high blood levels of acyclovir and shows promise in the
treatment of varicella-zoster infections. Many halogenated pyrimidine nucleoside 
analogs are being developed. Buciclovir is another acyclic guanosine analog
effective against herpes simplex virus in vitro. 2'-nor-cyclic guanosine
monophosphate has a broad antiviral spectrum of action. Interleukin-2 is being
investigated. Combined therapies of two or more antiviral drugs or antiviral
drugs and other treatments are being studied.

Publication Types: 
    Review

PMID: 2448352 [PubMed - indexed for MEDLINE]

6618: Hosp Pract (Off Ed). 1987 Dec 15;22(12):33-5, 38, 40 passim.

Eye pain: ocular and nonocular causes.

Kohrman BD, Warfield CA.

Harvard Medical School, Boston.

PMID: 3119639 [PubMed - indexed for MEDLINE]

6619: Biochem Pharmacol. 1987 Dec 15;36(24):4341-6.

Ribonucleotide reductase induced by varicella zoster virus. Characterization, and
potentiation of acyclovir by its inhibition.

Spector T, Stonehuerner JG, Biron KK, Averett DR.

Wellcome Research Laboratories, Research Triangle Park, NC 27709.

An enzyme that catalyzes the conversion of CDP to 2'-dCDP in the presence of
dithiothreitol (DTT) was detected in ammonium sulfate fractionated-extracts of
varicella zoster virus (VZV)-infected cells. This ribonucleotide reductase was
antigenically distinguishable from the isofunctional eucaryotic enzyme as well as
the ribonucleotide reductases induced by herpes simplex virus types 1 and 2
(HSV-1 and HSV-2). The VZV-induced enzyme was purified to the extent that most of
the contaminating enzymes, which would significantly deplete the substrate, were 
removed. The VZV-induced ribonucleotide reductase exhibited maximum activity in
the absence of ATP and/or magnesium and was only weakly inhibited by
2'-deoxynucleoside triphosphates. Furthermore, ADP, UDP and GDP competitively
inhibited CDP reduction with Ki (Km) values of 15, 20, 1.8 and 0.88 microM,
respectively. These kinetic properties were very similar to those of the
correspondingly purified ribonucleotide reductases induced by HSV-1 [Averett et
al., J. biol. Chem. 258, 9831 (1983)] and HSV-2 [Averett et al., J. Virol. 52,
981 (1984)] and were dissimilar to the allosterically regulated mammalian enzyme.
A723U, an inactivator of HSV-1 ribonucleotide reductase that potentiates the
anti-HSV-1 activity of acyclovir [Spector et al., Proc. natn. Acad. Sci. U.S.A.
82, 4254 (1985)], also appeared to inactivate this VZV-induced ribonucleotide
reductase and to potentiate the anti-VZV activity of acyclovir.

PMID: 2825724 [PubMed - indexed for MEDLINE]

6620: Aichi Gakuin Daigaku Shigakkai Shi. 1987 Dec;25(4):513-9.

[Two cases of herpes zoster in trigeminal nerve region]

[Article in Japanese]

Horii M, Takai Y, Suzuki A, Kinoshita Y, Tuji S, Yoshida K, Kakami K, Fukaya M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3506803 [PubMed - indexed for MEDLINE]

6621: Mayo Clin Proc. 1987 Dec;62(12):1108-15.

Antiviral agents.

Hermans PE, Cockerill FR 3rd.

Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Jacksonville,
Florida.

Amantadine is well established as the preferred antiviral agent for the
prophylaxis of influenza A and may also be beneficial therapeutically when used
early in the course of the disease. Idoxuridine is applicable only in the
treatment of herpetic keratitis. Currently, acyclovir is the most effective agent
for the treatment of herpes simplex and varicella-zoster virus infections.
Ribavirin has recently been released for use in aerosol form for severe
respiratory syncytial virus infections that occur in infants and young children. 
Vidarabine, which previously was the drug of choice in the treatment of severe
herpetic infections, has now been replaced by the more effective acyclovir.
Ganciclovir, an experimental agent, has shown promise against cytomegalovirus
infections in patients who have undergone kidney or liver transplantation, but
its effects are only temporary in patients who have undergone bone marrow
transplantation and patients with acquired immunodeficiency syndrome (AIDS) who
have cytomegalovirus infections.

PMID: 3500376 [PubMed - indexed for MEDLINE]

6622: Antiviral Res. 1987 Dec;8(5-6):261-72.

Antiviral activity of phosphonylmethoxyalkyl derivatives of purine and
pyrimidines.

De Clercq E, Sakuma T, Baba M, Pauwels R, Balzarini J, Rosenberg I, Holy A.

Rega Institute for Medical Research, Katholieke Universiteit Leuven, Belgium.

Various 3-hydroxy-2-phosphonylmethoxypropyl (HPMP) and 2-phosphonylmethoxyethyl
(PME) derivatives of purine [adenine (A), guanine (G), 2,6-diaminopurine (DAP),
2-monoaminopurine (MAP), hypoxanthine (HX)] and pyrimidine [cytosine (C), uracil 
(U), thymine (T)] have been evaluated for their antiviral properties. PMEDAP,
(S)-HPMPA [and the cyclic phosphonate thereof, (S)-cHPMPA)], (S)-HPMPC, PMEG,
PMEA, HPMPG and HPMPDAP proved to be effective inhibitors of herpes simplex virus
type 1 (HSV-1) and type 2 (HSV-2). (S)-HPMPA and (S)-cHPMPA were the most
effective inhibitors of varicella-zoster virus (VZV), and (S)-HPMPC was the most 
effective inhibitor of cytomegalovirus (CMV). Against adenovirus (types 2, 3 and 
4) and vaccinia virus again (S)-HPMPA and (S)-cHPMPA showed the greatest
inhibitory activity. As a rule, the PME derivates were much less inhibitory to
VZV, CMV, vaccinia and adenovirus than the HPMP derivatives. However, PMEA,
PMEDAP and PMEMAP showed marked and selective activity against the human
immunodeficiency virus (HIV). (S)-HPMPA was selected for further evaluation in
animal model infections. It proved efficacious in the topical treatment of HSV-1 
keratitis in rabbits and cutaneous HSV-1 infection in hairless mice, and in the
systemic treatment of both HSV-1 and vaccinia virus infections in mice.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3451698 [PubMed - indexed for MEDLINE]

6623: Postgrad Med J. 1987 Dec;63(746):1087-8.

Guillain-Barre syndrome associated with herpes zoster.

Hart IK, Kennedy PG.

Department of Neurology, Southern General Hospital, Glasgow, UK.

A case of Guillain-Barre syndrome following herpes zoster is described. This is a
rare association and the possible pathogenesis is discussed.

Publication Types: 
    Case Reports

PMID: 3451236 [PubMed - indexed for MEDLINE]

6624: Zh Mikrobiol Epidemiol Immunobiol. 1987 Dec;(12):45-50.

[Epidemiology of herpes zoster. The herpes zoster patient as a source of
infection with chickenpox]

[Article in Russian]

Shishov AS, Smirnov IuK.

The authors analyse the inpatient findings accumulated from 2,179 observations on
herpes zoster cases for 10 years. The clinico-epidemiological characterization of
herpes zoster patients as the potential source of chickenpox infection is
presented. The clinical data speak for the droplet transfer of the agent
(varicella zoster virus) in this infection, which has permitted the formulation
of exact practical recommendations of quarantine and isolation measures in the
focus of herpes zoster.

Publication Types: 
    English Abstract

PMID: 3445730 [PubMed - indexed for MEDLINE]

6625: Ann Ophthalmol. 1987 Dec;19(12):453-6, 460.

Acute retrobulbar neuritis complicating herpes zoster ophthalmicus.

Tunis SW, Tapert MJ.

Department of Ophthalmology, Medical University of South Carolina, Charleston.

Acute retrobulbar neuritis occurred 24 days after an episode of Herpes zoster
ophthalmicus in an otherwise healthy, 19-year-old man. Profound visual loss with 
consecutive optic atrophy ensued. Neurologic evaluation was normal and supported 
the presumptive diagnosis of parainfectious Herpes zoster retrobulbar neuritis.

Publication Types: 
    Case Reports
    Review

PMID: 3322138 [PubMed - indexed for MEDLINE]

6626: Clin Lab Med. 1987 Dec;7(4):853-68.

Treatment of varicella-zoster virus infections.

Bean B, Englund JA.

Department of Pathology, Michael Reese Hospital, Chicago, Illinois.

Effective antiviral therapy is now available for many forms of infection due to
varicella-zoster virus. Acyclovir is the most widely prescribed treatment, but
the virus is not exquisitely sensitive to this drug, and others are under study. 
The goals of therapy differ among different kinds of patients and must be
considered when designing a treatment program.

Publication Types: 
    Review

PMID: 3319369 [PubMed - indexed for MEDLINE]

6627: Arch Ophthalmol. 1987 Dec;105(12):1656-9.

Transcorneal extrusion of anterior chamber intraocular lenses. A report of three 
cases.

McKnight GT, Richards SC, Apple DJ, Stanko ML, O'Morchoe DJ, Solomon KD.

Department of Ophthalmology, University of Utah Health Sciences Center, Salt Lake
City 84132.

We examined three cases of transcorneal extrusion of anterior chamber intraocular
lenses. In each case a preexisting condition (rheumatoid arthritis, glaucoma, and
herpes zoster ophthalmicus, respectively) contributed to corneal necrosis and
subsequent extrusion of the pseudophakos. The clinicopathologic correlations of
this condition are discussed, as well as some causes of corneal decompensation
associated with anterior chamber lenses. We emphasize the need for careful
evaluation of patients who have preexisting disease before intraocular lens
implantation.

Publication Types: 
    Case Reports

PMID: 3318770 [PubMed - indexed for MEDLINE]

6628: Ann Intern Med. 1987 Dec;107(6):859-74.

Drugs five years later: acyclovir.

Dorsky DI, Crumpacker CS.

Department of Medicine, Beth Israel Hospital, Harvard Medical School, Boston,
Massachusetts.

In the 5 years since its release for clinical use, acyclovir
(9-[2-hydroxyethoxymethyl]guanine) has proved to be a safe and effective agent
for therapy of herpes simplex and varicella-zoster infections. The drug's
availability in topical, oral, and intravenous preparations has allowed its use
in a range of clinical situations. Acyclovir must be phosphorylated by viral
thymidine kinase in infected cells, where it then acts to inhibit viral DNA
replication specifically. Epstein-Barr virus and human cytomegalovirus infections
do not seem to respond to acyclovir therapy, although in-vitro effects on these
viruses may be seen. Acyclovir is well absorbed and distributed, with
cerebrospinal fluid levels 50% that of plasma. Clearance is almost entirely by
the renal route, with a half-life of 20 hours in the anuric patient. Acyclovir
has an excellent safety profile, its major adverse effect being transient serum
creatinine elevations during high-dose intravenous use. Major uses include
treatment of primary and recurrent genital herpes and herpes encephalitis and
prophyllaxis and therapy of mucocutaneous herpes and varicella-zoster infections 
in immunocompromised patients. Resistance to acyclovir in herpes simplex virus is
rarely encountered and does not seem to be due to long-term chronic suppressive
therapy.

Publication Types: 
    Review

PMID: 3318610 [PubMed - indexed for MEDLINE]

6629: AIDS. 1987 Dec;1(4):217-21.

Prevalence of HIV infection in healthy subjects and groups of patients in
Tanzania.

Mhalu F, Bredberg-Raden U, Mbena E, Pallangyo K, Kiango J, Mbise R, Nyamuryekunge
K, Biberfeld G.

Muhimbili Medical Centre, University of Dar es Salaam, Tanzania.

During 1986 sera from 2508 individuals representing various groups of healthy
subjects and patients in Dar es Salaam (the capital city of Tanzania), Bukoba
(the capital of Kagera region in the northwest corner of Tanzania), Arusha (in
the northeast of Tanzania) and Mbeya (in the southwest of Tanzania) were screened
for antibodies to HIV by enzyme-linked immunosorbent assay (ELISA). All
ELISA-positive sera were also tested by Western blot analysis. In Dar es Salaam
HIV antibodies were demonstrated in 3.6% of 192 pregnant women, 5.2% of 784 blood
donors, 29.0% of 224 barmaids, 8.0% of 50 male bar workers, 9.25% of 400 male and
12.2% of 90 female patients attending a clinic for sexually transmitted diseases 
(STDs), 85.7% of 35 patients with herpes zoster and in 97.6% of 84 patients
clinically suspected of AIDS. Among the barmaids the seropositivity rate was
higher in younger women (45%) than in middle-aged women (11%). Only three (4.6%) 
out of 65 HIV-seropositive barmaids had HIV-related symptoms. The prevalence of
HIV seropositivity among healthy low-risk subjects was highest in Bukoba, namely 
16% of 100 pregnant women and 13.9% of 36 blood donors, while in Arusha only one 
(0.7%) of the 144 pregnant women and none of 41 bar workers, none of 42 blood
donors and none of 61 patients with STD were positive. In Mbeya, 3.4% of 118
pregnant women and 11.8% of 34 men with STD were seropositive. Thus the
prevalence of HIV infection differs considerably in various population groups and
in various parts of Tanzania.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3126768 [PubMed - indexed for MEDLINE]

6630: Jpn J Exp Med. 1987 Dec;57(6):339-46.

Detection of varicella-zoster virus DNA in cultured cells and tissue specimens by
in situ hybridization using biotin-labeled probes.

Hondo R, Yogo Y, Kurata T, Aoyama Y.

Department of Pathology, University of Tokyo, Japan.

A method of in situ hybridization with biotinylated probes is described for
specific detection of varicella-zoster virus (VZV) DNA in infected cell cultures 
and in human biopsied or autopsied materials. From molecularly cloned
EcoRI-fragments of VZV DNA, we selected as probes for in situ hybridization three
fragments (B, H, and K) which had any detectable homology neither with human cell
DNA nor with DNAs of VZV-related viruses (herpes simplex virus type 1, type 2 and
human cytomegalovirus). The procedure of in situ hybridization was based on that 
of Brigati et al. (Virology 126, 32-50, 1983), but following modifications were
made. 1) The concentration of probe DNA was lowered to 100 ng per ml. 2)
Streptavidin-biotin system was used for detection of hybridization. 3) Acid
phosphatase was used to generate color development discernible from melanin
present in skin. 4) Before hybridization, deparaffinized sections were treated
with trypsin by the procedure routinely employed for detection of viral antigens 
in paraffin-embedded sections.

PMID: 2836643 [PubMed - indexed for MEDLINE]

6631: Uirusu. 1987 Dec;37(2):179-91.

[Chemotherapy of varicella-zoster virus infection]

[Article in Japanese]

Shigeta S, Yokota T.

Publication Types: 
    Review

PMID: 2833837 [PubMed - indexed for MEDLINE]

6632: Afr J Med Med Sci. 1987 Dec;16(4):197-201.

Clinical study of unilateral peripheral facial nerve paralysis in Nigerians.

Bademosi O, Ogunlesi TO, Osuntokun BO.

Department of Medicine, University College Hospital, Ibadan, Nigeria.

The clinical feature of isolated unilateral peripheral facial nerve paralysis
(PFP), seen in 153 consecutive Nigerians over a 14-year period at the University 
College Hospital (UCH), Ibadan, are presented. The hospital incidence rate was
2.67 per 10,000 with a mean annual rate of 11 per 100,000. Although males (61%)
were more frequently affected than females (39%), the peak incidence for both
sexes was in the third decade, and 53% of the cases were between 20 years old and
39 years old. Bell's palsy (ninety-three cases) was the most common type
encountered. Hypertension (eleven cases) was associated with PFP only in patients
above 50 years old. Herpes zoster infection (six cases) and otogenous (eight
patients) were not uncommon. Although conjunctivitis (8%) was the most frequent
complication, post-paralytic motor features in the form of synkinesia (eight
cases), hemispasmas or contractures, and autonomic disturbances such as the
crocodile-tear phenomenon (three cases) and auriculo-temporal syndrome (one case)
were rare.

PMID: 2830781 [PubMed - indexed for MEDLINE]

6633: Clin Lab Med. 1987 Dec;7(4):759-76.

Laboratory diagnosis of herpesvirus infections.

Erlich KS.

Department of Medicine, University of California, San Francisco.

The diagnosis of infection due to herpesviruses can be performed by several
laboratory techniques, including virus culture, demonstration of virus-specific
cellular antigens, detection of virus-induced serum antibodies, detection of
viral nucleic acids (using radiolabeled probes), or visualization of histologic
changes in infected tissue. Virus culture is the most sensitive technique for
diagnosis of most infections due to herpes simplex virus (HSV) and
cytomegalovirus (CMV), but is insensitive for the diagnosis of varicella-zoster
(VZV) infection and not routinely available for Epstein-Barr virus (EBV).
Identification of viral antigens on infected cells with monoclonal antibodies is 
useful for definitive identification of virus in cell culture and for rapid
diagnosis of infection due to HSV, VZV, or CMV. Serologic studies are useful for 
the diagnosis of EBV infection, because clinical symptoms and an antibody
response occur simultaneously, and other diagnostic tests are generally
unavailable. Although serologic studies may be used retrospectively to diagnose
infections due to HSV, VZV, or CMV, these results are seldom available in time to
be useful in managing the acute infection or in guiding antiviral chemotherapy.
Newer diagnostic techniques, such as detection of viral nucleic acids using
radiolabeled probes, may become useful in the future for the rapid diagnosis of
EBV or CMV infection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2826074 [PubMed - indexed for MEDLINE]

6634: Virology. 1987 Dec;161(2):599-602.

Varicella-zoster virus gpI and herpes simplex virus gE: phosphorylation and Fc
binding.

Edson CM, Hosler BA, Waters DJ.

Department of Pathology, Tufts University School of Medicine, Boston,
Massachusetts 02111.

gpI, the predominant varicella-zoster virus (VZV) envelope glycoprotein, was
shown to be phosphorylated exclusively on serine and threonine residues, and
phosphorylated gpI was detected in isolated virions. In cells infected with
herpes simplex virus type 1 (HSV-1), a related neurotropic alpha-herpesvirus, HSV
gE, the homolog to VZV gpI, and HSV gB, the homolog to VZV gpII, were also
phosphorylated. The phosphate on gB and gE was alkali labile and resistant to
endo H, suggesting linkage to serine and/or threonine. Although VZV gpI and HSV
gE share sequence homology and similar post-translational modifications, no
Fc-binding activity similar to that associated with gE was detected for gpI or
any of the VZV glycoproteins.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 2825425 [PubMed - indexed for MEDLINE]

6635: J Clin Microbiol. 1987 Dec;25(12):2344-6.

Comparison of antigen assay and reverse transcriptase assay for detecting human
immunodeficiency virus in culture.

Feorino P, Forrester B, Schable C, Warfield D, Schochetman G.

AIDS Program, Centers for Disease Control, Atlanta, Georgia 30333.

We compared an antigen capture assay (Abbott Laboratories, North Chicago, Ill.)
with a reverse transcriptase assay to identify and quantify human
immunodeficiency virus (HIV) in culture. In direct comparisons of serial
dilutions of lymphadenopathy-associated virus type 1, the antigen assay was
100-fold more sensitive than the reverse transcriptase assay in detecting the
virus. The antigen assay reacted strongly with 60 different HIV isolates but did 
not cross-react with human T-cell lymphotropic virus type I, human T-cell
lymphotropic virus type II, cytomegalovirus, varicella-zoster virus, herpes
simplex virus type 1, Epstein-Barr virus, adenovirus type 5, or poliovirus type 1
or with extracts from four different control human cell lines and eight different
phytohemagglutinin-stimulated normal human lymphocytes. Peripheral blood
lymphocyte samples from 50 individuals were evaluated by both the antigen assay
and the reverse transcriptase assay. The cells from the 34 seropositive
individuals were all positive by the antigen assay (range, 3 to 9 days; average
time, 5.9 days) and the reverse transcriptase assay (range, 7 to 16 days; average
time, 9.6 days). Cells from the 16 seronegative individuals were negative by both
assays. These results indicate that the antigen assay is an important addition to
the monitoring of HIV production in the lymphocytes of infected patients.

Publication Types: 
    Comparative Study

PMID: 2448334 [PubMed - indexed for MEDLINE]

6636: Pol Tyg Lek. 1987 Nov 9;42(45):1429.

[The course of encephalitis caused by varicella-zoster virus in patients treated 
with acyclovir]

[Article in Polish]

Caban J, Sykut L, Sznajder J.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3447107 [PubMed - indexed for MEDLINE]

6637: Ann Intern Med. 1987 Nov;107(5):783.

Herpes zoster infection in a patient on methotrexate given prednisone to prevent 
post-herpetic neuralgia.

Anderson DJ, Janoff EN.

Publication Types: 
    Case Reports
    Letter

PMID: 3662298 [PubMed - indexed for MEDLINE]

6638: Br J Ophthalmol. 1987 Nov;71(11):806-9.

Severe herpes zoster ophthalmicus in young African adults: a marker for HTLV-III 
seropositivity.

Kestelyn P, Stevens AM, Bakkers E, Rouvroy D, Van de Perre P.

Centre Hospitalier de Kigali, Rwanda.

This report proves the relationship between herpes zoster ophthalmicus and
seropositivity for HTLV-III in young and often apparently healthy African
patients. The ophthalmologist should screen patients with herpes zoster
ophthalmicus for antibodies against HTLV-III in areas where this virus is endemic
or if the patient belongs to a known risk group. If the test is positive, the
patient should be instructed about the infectious nature of his condition to
prevent spread of this sexually transmitted disease. As the rate of corneal
involvement and postherpetic neuralgia are very high in these patients, it would 
be worthwhile to ascertain whether routine use of acyclovir treatment in HTLV-III
seropositive patients with herpes zoster has a beneficial effect on these
complications.

PMID: 3500743 [PubMed - indexed for MEDLINE]

6639: Br J Ophthalmol. 1987 Nov;71(11):805.

Herpes zoster ophthalmicus and AIDS.

[No authors listed]

Publication Types: 
    Editorial

PMID: 3500742 [PubMed - indexed for MEDLINE]

6640: Gen Dent. 1987 Nov-Dec;35(6):464-5.

Herpes zoster.

Hager TS, Connor JP.

Publication Types: 
    Case Reports

PMID: 3481730 [PubMed - indexed for MEDLINE]

6641: CMAJ. 1987 Nov 1;137(9):788.

Herpes zoster in psychogeriatric practice.

Hontela S.

Publication Types: 
    Letter

PMID: 3442766 [PubMed - indexed for MEDLINE]

6642: J Antimicrob Chemother. 1987 Nov;20(5):743-51.

Open study of 2-amino-9-(hydroxyethoxymethyl)-9H-purine (desciclovir) in the
treatment of herpes zoster.

Peterslund NA, Esmann V, Geil JP, Petersen CM, Mogensen CE.

Department of Medicine and Infectious Diseases, Marselisborg Hospital, Aarhus,
Denmark.

An oral pro-drug of acyclovir, 2-amino-9-(2-hydroxyethoxymethyl)-9H-purine
(desciclovir) was evaluated in an open study comprising of 20 patients with
herpes zoster. The clinical effects were comparable to those obtained with oral
and intravenous acyclovir, even with a dosage of only 125 mg thrice daily. There 
was adequate absorption though considerable individual variation occurred. No
effects of concomitant food intake were demonstrated. The finding of possible
impaired conversion of desciclovir to acyclovir in one patient was unexplained
and deserves attention in future studies. Likewise, more studies are needed to
understand the occurrence of transient high peak plasma concentrations of
acyclovir. Side-effects other than those already known with the use of acyclovir,
namely reversible tubular damage, were not observed.

PMID: 3429375 [PubMed - indexed for MEDLINE]

6643: Antimicrob Agents Chemother. 1987 Nov;31(11):1722-6.

Pharmacokinetics of acyclovir suspension in infants and children.

Sullender WM, Arvin AM, Diaz PS, Connor JD, Straube R, Dankner W, Levin MJ,
Weller S, Blum MR, Chapman S.

Department of Pediatrics, Stanford University School of Medicine, California
94305.

Eighteen children from 3 weeks to 6.9 years of age were given an oral acyclovir
suspension for herpes simplex or varicella-zoster virus infections. Thirteen
patients who were 6 months to 6.9 years old received 600 mg/m2 per dose, and
three infants and two children less than 2 years old were given 300 mg/m2 per
dose. The drug was given four times a day, except to one infant who was treated
with three doses a day. Among the 13 children who received the 600-mg/m2 dose,
the maximum concentration in plasma (Cmax) was 0.99 +/- 0.38 microgram/ml (mean
+/- standard deviation), the time to maximum concentration (Tmax) was 3.0 +/-
0.86 h, the area under the curve (AUC) was 5.56 +/- 2.17 micrograms.h/ml, and the
elimination half-life (t1/2) was 2.59 +/- 0.78 h. The three infants less than 2
months of age who received the 300-mg/m2 dose had a Cmax of 1.88 +/- 1.11
micrograms/ml, a Tmax of 4.10 +/- 0.48 h, an AUC of 6.54 +/- 4.32
micrograms.h/ml, and a t1/2 of 3.26 +/- 0.33 h. The acyclovir suspension was well
tolerated by young children. No adverse effects requiring discontinuation of the 
drug occurred.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2829714 [PubMed - indexed for MEDLINE]

6644: J Clin Microbiol. 1987 Nov;25(11):2193-6.

Specificity of skin test with varicella-zoster virus antigen in varicella-zoster 
and herpes simplex virus infections.

Baba K, Shiraki K, Kanesaki T, Yamanishi K, Ogra PL, Yabuuchi H, Takahashi M.

Department of Pediatrics, School of Medicine, Osaka University, Japan.

Specificity of the skin test with varicella-zoster virus (VZV) antigen was
examined in guinea pigs infected with herpes simplex virus (HSV) type 1 or VZV
and in children with a history of HSV infection who developed varicella. Infected
guinea pigs responded positively only to homologous virus. No cross-reaction
between HSV and VZV was detected in the skin test, as well as in the
neutralization test in infected guinea pigs, suggesting that the VZV skin test is
specific for immunity to VZV infection. Twelve children were infected with HSV
during an HSV epidemic and subsequently developed varicella in institutional
settings. During the 2.5-month period between the HSV and VZV infections, the
immune status of the children to VZV was negative both in the skin test and in
the antibody test, although antibody to HSV was detected by an immune adherence
hemagglutination test. After VZV infection, all responded positively both in the 
skin test and in the antibody test (immune adherence hemagglutination test) to
VZV. These results suggest that the VZV skin test is specific for immunity to VZV
infection, not cross-reactive to HSV infection in humans. This specificity will
be of value in screening susceptibility or immunity to VZV, irrespective of prior
HSV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2826535 [PubMed - indexed for MEDLINE]

6645: J Virol. 1987 Nov;61(11):3463-9.

Varicella-zoster virus-specific cytotoxic T lymphocytes (Tc): detection and
frequency analysis of HLA class I-restricted Tc in human peripheral blood.

Hickling JK, Borysiewicz LK, Sissons JG.

MRC Clinical Immunology Research Group, Royal Postgraduate Medical School,
London, United Kingdom.

The cytotoxic T-cell (Tc) response to varicella-zoster virus (VZV) is
incompletely characterized. We investigated whether VZV-specific Tc restricted by
class I products of the major histocompatibility complex can be generated from
the peripheral blood of VZV-immune donors. Cell lines were established from
peripheral blood lymphocytes (PBL) of seropositive donors by secondary in vitro
restimulation. If cell-free VZV was used as the stimulating antigen, the
resulting lines were predominantly CD4+ and did not show class I-restricted
cytotoxicity; when autologous infected fibroblasts were used for in vitro
stimulation, the resultant lines were usually cytotoxic, although in only 4 of 11
subjects tested was this cytotoxicity HLA restricted and virus specific. PBL were
also tested for Tc activity without prior restimulation; VZV-specific Tc activity
was only demonstrable in the PBL of a subject convalescent following zoster but
not from subjects with recent varicella infection or from normal subjects.
VZV-specific Tc precursor frequencies were then determined in six selected
subjects by limiting-dilution analysis. A measurable frequency was detectable in 
four of the six seropositive subjects, ranging from 11/10(6) T cells in an
asymptomatic carrier, to 63/10(6) T cells in a subject with recent zoster. We
conclude that virus-specific major histocompatibility complex class I-restricted 
Tc precursors may be present in the peripheral blood of normal individuals
seropositive for VZV but at a frequency lower than that for other herpesviruses
with nonneuronal sites of latency.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2822954 [PubMed - indexed for MEDLINE]

6646: J Med Chem. 1987 Nov;30(11):2026-30.

Synthesis and antiviral activity of carbocyclic analogues of xylofuranosides of
2-amino-6-substituted-purines and 2-amino-6-substituted-8-azapurines.

Vince R, Turakhia RH, Shannon WM, Arnett G.

Department of Medicinal Chemistry, College of Pharmacy, University of Minnesota, 
Minneapolis 55455.

(+/-)-(1 alpha,2 beta,3 alpha,5 alpha)-3-[(2,5-Diamino-6-chloro-4-
pyrimidinyl)amino]-5-(hydroxymethyl)-1,2-cyclopentanediol (7) was synthesized
from 2-amino-4,6-dichloropyrimidine and the carbocyclic xylofuranosylamine
(+/-)-(1 alpha,2 beta,3 alpha,5
alpha)-3-amino-5-(hydroxymethyl)-1,2-cyclopentanediol (2) by subsequent
preparation of the 5-[(4-chlorophenyl)azo] derivative of the resulting pyrimidine
and reduction of the azo moiety with zinc and acetic acid. The carbocyclic
analogue of 2-amino-4-chloropurine xylofuranoside (8) and the corresponding
8-azapurine 11 were prepared from 7. The carbocyclic analogues
xylofuranosylguanine (9), xylofuranosyl-2,6-diaminopurine (10),
xylofuranosyl-8-azaguanine (13), and xylofuranosyl-8-aza-2,6-diaminopurine (14)
were prepared from 8 and 11. Compounds 9 and 13 were active against herpes
simplex virus (types 1 and 2), with 9 being the more potent against both viruses.
Analogue 9 also exhibited potent activity against human cytomegalovirus and
varicella-zoster virus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2822928 [PubMed - indexed for MEDLINE]

6647: Wiad Lek. 1987 Oct 15;40(20):1417-21.

[Encephalitis in herpes zoster]

[Article in Polish]

Nicpon K, Ochmanski S, Slotala T.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3445628 [PubMed - indexed for MEDLINE]

6648: J Immunol. 1987 Oct 15;139(8):2799-802.

Cooperation between CD16(Leu-11b)+ NK cells and HLA-DR+ cells in natural killing 
of herpesvirus-infected fibroblasts.

Oh SH, Bandyopadhyay S, Miller DS, Starr SE.

Division of Infectious Diseases, Joseph Stokes, Jr. Research Institute,
Children's Hospital of Philadelphia, PA 19104.

We reported previously that natural killer (NK) cell-mediated lysis of
cytomegalovirus-infected targets requires the presence of HLA-DR+ nonadherent
peripheral blood mononuclear cells (NPBMC). In the present study we determined
whether NK cell-mediated lysis of other herpesvirus-infected targets also
requires HLA-DR+ cells. Depletion of either cluster designation (CD)16+ NK cells 
or HLA-DR+ cells from NPBMC significantly reduced their ability to lyse herpes
simplex virus (HSV)- and varicella-zoster virus (VZV)-infected fibroblasts. When 
CD16- and HLA-DR- populations were mixed, lysis of both HSV- and VZV-infected
targets was virtually completely restored, indicating that NK cells and HLA-DR+
cells were required for lysis to occur. Cell-free supernatants, obtained by
incubating NPBMC or CD16- cells with HSV-o-VZV-infected targets, contained
antiviral activity and stimulated HLA-DR-cells to mediate lysis of corresponding 
virus-infected targets. The addition of anti-interferon-alpha to supernatants
abolished their ability to stimulate lysis. Thus, secretion of interferon-alpha
by HLA-DR+ cells contributes to NK cell-mediated lysis of herpesvirus-infected
targets.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2821120 [PubMed - indexed for MEDLINE]

6649: Br Med J (Clin Res Ed). 1987 Oct 10;295(6603):926-7.

Acyclovir for shingles.

Chase AO.

Publication Types: 
    Letter

PMID: 3119110 [PubMed - indexed for MEDLINE]

6650: Practitioner. 1987 Oct 8;231(1436):1336-40.

Trial of ultrasonic therapy for acute herpes zoster.

Jones RJ, Silman GM.

PMID: 3505029 [PubMed - indexed for MEDLINE]

6651: Lancet. 1987 Oct 3;2(8562):800.

Post-herpetic neuralgia.

Cooper M.

Publication Types: 
    Letter

PMID: 2889015 [PubMed - indexed for MEDLINE]

6652: Am Fam Physician. 1987 Oct;36(4):233-5.

Herpes zoster as a sign of AIDS-related complex.

Wilkerson MG, Jordan WP, Kerkering TM.

Medical College of Virginia, Richmond.

Herpes zoster has recently been reported in young patients with risk factors for 
AIDS. In high-risk patients under age 55, herpes may be the first manifestation
of AIDS or AIDS-related complex. Dissemination of zoster does not appear to be
greatly increased in this group, but corticosteroid therapy should be withheld.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3673868 [PubMed - indexed for MEDLINE]

6653: Klin Med (Mosk). 1987 Oct;65(10):116-9.

[Clinical differentiation of herpetic ganglioneuritis]

[Article in Russian]

Mikhailenko AA.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 3501503 [PubMed - indexed for MEDLINE]

6654: Br J Ophthalmol. 1987 Oct;71(10):725-8.

Ophthalmic zoster: mucous plaque keratitis.

Marsh RJ, Cooper M.

Department of Clinical Ophthalmology, Moorfields Eye Hospital, London.

Data taken from 1221 patients attending the Zoster Clinic of Moorfields Eye
Hospital over the past 15 years were used to characterise the clinical appearance
and behaviour of zoster mucous plaque keratitis (MPK). The typical greyish
branching plaques are usually accompanied by a limbitis, stromal keratitis, or
decrease in corneal sensation and are commonly associated with cataract, raised
intraocular pressure, or corneal ulceration. MPK may begin at any time within two
years of onset of the rash, but when it appears after three months there are more
complications. Usually MPK settles within one month if appropriate treatment with
topical steroids and acetylcysteine drops is given, but surgical intervention is 
sometimes required to control glaucoma or neuroparalytic keratitis or to remove
cataracts. The results of surgery are surprisingly good.

PMID: 3499932 [PubMed - indexed for MEDLINE]

6655: Ann Acad Med Singapore. 1987 Oct;16(4):631-5.

Acyclovir in the treatment of herpes simplex virus infection.

Cheong WK, Thirumoorthy T.

Middle Road Hospital, Singapore.

Acyclovir is a highly potent inhibitor of herpes simplex virus types 1 and 2 and 
varicella zoster virus, and has a remarkably low toxicity for normal host cells. 
It is now available as an ophthalmic ointment, skin cream and oral and
intravenous formulations. Clinical trials in the past few years have shown
acyclovir to be clinically useful in the therapy of certain aspects of genital
herpes infection. Acyclovir has also been shown to be useful in herpes zoster,
especially in immunocompromised patients. A retrospective study on the use of
acyclovir was carried out on 14 patients with first episode genital herpes and 3 
patients with eczema herpeticum. In patients with genital herpes, relief of
symptoms was experienced within three days of treatment and lesions showed
healing within five to seven days of treatment. Two out of the three patients
with eczema herpeticum showed dramatic response to acyclovir; the lesions healed 
completely after six days of treatment.

Publication Types: 
    Case Reports

PMID: 3446004 [PubMed - indexed for MEDLINE]

6656: Klin Med (Mosk). 1987 Oct;65(10):119-21.

[Hyperbaric oxygenation in the complex treatment of patients with herpes zoster]

[Article in Russian]

Shishov AS, Sibirev AA, Rudometov IuP, Smagulov KZ, Chekal' LV.

Publication Types: 
    English Abstract

PMID: 3431038 [PubMed - indexed for MEDLINE]

6657: Drug Intell Clin Pharm. 1987 Oct;21(10):803-5.

Effect of cimetidine on herpes zoster infection.

Bense L, Marcusson JA, Ramsten T.

Department of Lung Medicine, Huddinge University Hospital, Sweden.

Cimetidine was administered to two patients for herpes zoster infection. An acute
pain-relieving effect was observed. The patients were followed for 11 and 14
months without developing postherpetic neuralgia. Possible mechanisms for
prevention of postherpetic neuralgia by cimetidine are discussed.

Publication Types: 
    Case Reports

PMID: 3428139 [PubMed - indexed for MEDLINE]

6658: Dermatol Clin. 1987 Oct;5(4):733-7.

Oral mucosal manifestations of AIDS?

Greenspan D, Greenspan JS.

Department of Stomatology, School of Dentistry, University of California, San
Francisco.

Oral lesions of opportunistic infections and neoplasms are associated with
immunosuppression caused by the human immunodeficiency virus (HIV). These include
oral candidiasis, viral lesions such as warts, herpes simplex, herpes zoster and 
hairy leukoplakia, as well as Kaposi's sarcoma and an aggressive form of
periodontal disease. Many of these can occur as the first clinical signs of HIV
infection. Thus, careful oral examination is an important part of the clinical
evaluation.

Publication Types: 
    Review

PMID: 3315352 [PubMed - indexed for MEDLINE]

6659: Br J Dermatol. 1987 Oct;117(4):495-501.

Oral acyclovir for herpes zoster: a double-blind controlled trial in normal
subjects.

Wassilew SW, Reimlinger S, Nasemann T, Jones D.

University of Hamburg, UKE Hautklinik, FRG.

Sixty immunocompetent patients with herpes zoster of various dermatomes were
treated 5 times a day for 5 days with either acyclovir at a dose of 400 mg or
placebo. Acyclovir was shown to reduce significantly the time to full crusting (P
= 0.02). There were also trends in favour of acyclovir for time to first dry
vesicle and time to first day without macules or papules, but these were not
statistically significant. There were no differences between the groups in the
occurrence of adverse events or postherpetic neuralgia.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3314973 [PubMed - indexed for MEDLINE]

6660: J Neurol Sci. 1987 Oct;81(1):45-53.

The intrathecal immune response in the early stage of multiple sclerosis.

Sandberg-Wollheim M, Vandvik B, Nadj C, Norrby E.

Department of Neurology, University Hospital, Lund, Sweden.

Sequential pairs of cerebrospinal fluid (CSF) and serum samples from 10 patients 
followed for 2.5-12 years after onset of unilateral optic neuritis (ON) were
studied. Eight patients developed definite multiple sclerosis (MS) during the
observation period. All patients had normal CSF protein patterns on agar or
agarose gel electrophoresis at onset. Six patients developed oligoclonal
immunoglobulin (Ig) bands in the CSF during the observation period. Imprint
immunofixation of electrofocused specimens disclosed intrathecal synthesis of
oligoclonal IgG antibodies to 1 or more of 6 viruses (measles, herpes simplex
type 1, varicella-zoster, cytomegalo, mumps, rota) during the observation period 
in 8 patients. Changes in patterns of intrathecally synthesized viral antibodies,
characterized by the appearance of "new" antibody populations and the waxing or
waning of others were observed in 6 patients. The results suggest that the early 
stage of MS in some patients is associated with transient as well as permanent
recruitment of B cell clones producing viral antibodies of different
specificities.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3119780 [PubMed - indexed for MEDLINE]

6661: J Virol. 1987 Oct;61(10):2951-5.

Successful infection of the common marmoset (Callithrix jacchus) with human
varicella-zoster virus.

Provost PJ, Keller PM, Banker FS, Keech BJ, Klein HJ, Lowe RS, Morton DH, Phelps 
AH, McAleer WJ, Ellis RW.

The common marmoset, Callithrix jacchus, can be infected with human
varicella-zoster virus (VZV), both wild-type strain KMcC and attenuated vaccine
strain Oka/Merck. Infection was accomplished with either whole-cell-associated or
cell extract VZV by combined oral-nasal-conjunctival application and was
characterized by substantial and persistent anti-VZV antibody responses. The
infectivity of VZV for marmosets was destroyed by treatment of inocula with heat 
or UV light. Diluted inocula with as few as 40 PFU/ml were infectious for
marmosets. The lungs were demonstrated to be a major site of viral replication;
both the presence of viral antigens and signs of pneumonia were demonstrated in
lung tissues. Four serial passages of VZV KMcC were carried out in C. jacchus by 
a process of in vitro isolation and culturing of VZV from infected lung tissue
and reapplication of the cultured isolates to fresh animals. The isolated viruses
were identified as VZV both serologically and by restriction endonuclease
analyses. The C. jacchus infectivity model should prove useful for determining
the efficacy of subunit and live recombinant VZV vaccines as well as for the
study of zoster.

PMID: 3041014 [PubMed - indexed for MEDLINE]

6662: Minerva Med. 1987 Sep 30;78(18):1404-5.

[Herpes zoster]

[Article in Italian]

Stagnaro-Neri M, Stagnaro S.

Ospedale di Sestri Levante, Genova.

Publication Types: 
    Letter

PMID: 2821453 [PubMed - indexed for MEDLINE]

6663: J Biol Chem. 1987 Sep 15;262(26):12413-6.

Structure-activity studies on synthetic peptides inhibiting herpes simplex virus 
ribonucleotide reductase.

Gaudreau P, Michaud J, Cohen EA, Langelier Y, Brazeau P.

Herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) ribonucleotide reductase
is formed by the association of two nonidentical subunits. A peptide
corresponding to the COOH terminus of the subunit 2,
Tyr-Ala-Gly-Ala-Val-Val-Asn-Asp-Leu (H2-(7-15)), has been shown to completely
inhibit the reductase activity (IC50 = 36 microM) without affecting the host
isoenzyme. In order to study the relationship between chemical requirements and
inhibitory potencies, a series of peptides, including fragments and analogs of
H2-(7-15), were synthesized. The minimum active core can be assigned to the
Val-Val-Asn-Asp-Leu sequence (IC50 = 760 microM). N alpha-Extended peptides, such
as Ser-Thr-Ser-Tyr-Ala-Gly-Ala-Val-Val-Asn-Asp-Leu (H2-(4-15)) and
Glu-Cys-Arg-Ser-Thr-Ser-Tyr-Ala-Gly-Ala-Val-Val-Asn-Asp-Leu (H2-(1-15) ),
respectively, have inhibitory potencies 2.1- and 1.4-fold greater than the
nonapeptide H2-(7-15). N alpha-Deamination or acetylation of H2-(7-15) increases 
its potency by 1.8- and 3.0-fold, respectively, whereas amidation of the
alpha-carboxylic function diminishes its activity by 3.2-fold. These results
indicate that the alpha-amino group is not essential for maximum potency but
suggest that a free carboxylic function is required. Substitution of Tyr7 or Ala8
by their respective D-isomer leads to a decrease of potency, suggesting that a
specific conformation of the NH2-terminal portion is required to have a maximum
activity. Monosubstitution in positions 11, 13, 14, and 15, by L-alanine
completely abolishes activity stressing the importance of each amino acid residue
contained in the minimum active core. Finally, nonapeptides corresponding to the 
COOH-terminal portion of the subunit 2 of Epstein-Barr and varicella-zoster virus
ribonucleotide reductases also inhibit the HSV-1 reductase activity. The
varicella-zoster virus nonapeptide is 4.0 times more potent than H2-(7-15),
whereas the Epstein-Barr virus nonapeptide is 3.1 times less potent. These
results should help us to design a new generation of potent inhibitors of herpes 
virus ribonucleotide reductases.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 3040743 [PubMed - indexed for MEDLINE]

6664: Lancet. 1987 Sep 5;2(8558):576.

Prednisolone does not prevent post-herpetic neuralgia.

Finn R.

Publication Types: 
    Letter

PMID: 2887875 [PubMed - indexed for MEDLINE]

6665: Schmerz. 1987 Sep;1(2):107-113.

[Pain syndromes in tick-borne neuroborreliosis. Clinical aspects and differential
diagnosis.]

[Article in German]

Kohler J, Thoden U.

Neurologische Universitatsklinik, Hansastra?e 9, D-7800, Freiburg i.Br..

Tick-borne borreliosis (Borrelia burgdorferi) is a common and complex disorder
affecting the skin, the joints and the nervous system. It progresses through
different clinical stages. The clinical spectrum of neuroborreliosis has expanded
since the introduction and widespread application of specific serological tests. 
We have investigated 41 patients with Bannwarth's meningopolyneuritis (MPN) as
the classical form of neuroborreliosis, in a prospective (26 patients) and a
retrospective (15 patients) study. When questioned, 19/41 patients reported a
tick bite and only 15/41, erythema migrans as the characteristic early skin
lesion. In 34/41 patients typical MPN characterized by painful radiculoneuritis
and/or cranial neuritis, especially facial palsy, were seen. Among these, 3 had a
complicated form with a progressive remitting relapsing course or focal central
nervous system involvement (hemiparesis, cerebellar syndrome); 2 had mild
meningitis and facial nerve palsy bilaterally without radicular pain; and in 5
radicular pain was the only symptom. MPN associated with Lyme arthritis was
observed only once. In 2 patients in the retrospective study (no antibiotics in
the acute stage) we saw a chronic spinal cord disorder with spastic paresis
several years after uncomplicated MPN, accompanied in 1 of them by acrodermatitis
chronica atrophicans (ACA), the typical late-onset borrelia-induced dermatosis.
In the acute stage of the disease 40/41 patients had a cerebrospinal fluid (CSF) 
syndrome compatible with MPN (mononuclear pleocytosis, blood-brain barrier
dysfunction, elevated IgG and/or oligoclonal bands). IgG antibody titers against 
borrelia antigen were elevated in all patients in the serum and in 21/30 also in 
the CSF. In all patients pain was an early and prominent symptom; the first
symptoms are usually felt in the region of the tick bite or the erythema,
initially as diffuse myalgia, arthralgia or pain in the connective tissue. In the
further course the migrating pain becomes more radicular in character, without
being limited to defined dermatomic areas or peripheral nerves. The intense,
burning pain is characterized by exacerbation during the night. Peripherally and 
centrally acting analgesics have only minor effects. Often neurological deficits 
are still absent at this time. Erythema migrans with radicular pain in the region
of the dermatological lesion was observed in 2 patients. This is an early
manifestation of MPN. After MPN and/or Lyme arthritis a sympathetic reflex
dystrophy (SRD) developed in 2 patients. In a further patient SRD was observed
right at the beginning of the illness, immediately before MPN. There is a close
clinical similarity between SRD and the acute stage of ACA. Therefore,
borreliosis can be assumed to produce a painful skin dystrophy like SRD or ACA by
direct injury to the sympathetic nerves even in the early clinical stage of the
infection. The main conditions to be considered in the differential diagnosis are
polymyalgia rheumatica; lumbar disk herniation; inflammatory radiculopathies of
other origin (e.g. herpes zoster); painful neuropathies, including the diabetic
thoraco-abdominal form; internal disorders of chest and abdomen with referred
pain; lymphocytic meningitis of other origin, encephalomyelitis; and sympathetic 
reflex dystrophy. High-dose penicillin G i.v. is a potent analgesic in all
patients with tick-borne neuroborreliosis.

PMID: 18415556 [PubMed - as supplied by publisher]

6666: Arch Esp Urol. 1987 Sep;40(7):480-4.

[Urinary retention caused by herpes zoster. Urodynamic follow-up]

[Article in Spanish]

Broseta E, Martinez Agullo E, Dominguez C, Gimenez Edo M, Jimenez Cruz JF.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3688992 [PubMed - indexed for MEDLINE]

6667: Rev Infect Dis. 1987 Sep-Oct;9(5):1020-5.

Infectious disease rounds: headache, diminished mentation, and leg pain.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 3685758 [PubMed - indexed for MEDLINE]

6668: J Neurol Sci. 1987 Sep;80(2-3):343-9.

The prevalence of locally-synthesized virus antibodies in various forms of
multiple sclerosis.

Schadlich HJ, Karbe H, Felgenhauer K.

Neurologic University Clinic, Cologne, F.R.G.

In 125 patients with multiple sclerosis, intrathecally synthesized antibodies
against measles, rubella and zoster viruses were determined with an ELISA. 70% of
patients with chronic progressive disease synthesized measles antibodies in
comparison to 50% with a relapsing course. Women suffering from chronic
progressive multiple sclerosis exhibited zoster antibodies 3 times as frequent as
the other patients. These data indicate that relapsing and chronic progressive
forms of multiple sclerosis exhibit different antiviral responses within the
central nervous system which remain stable during the course of the disease.

PMID: 3681338 [PubMed - indexed for MEDLINE]

6669: J Laryngol Otol. 1987 Sep;101(9):975-7.

Superior orbital fissure syndrome in trigemino-facial zoster.

Gupta D, Vishwakarma SK.

A case of trigemino-facial zoster presenting as Superior Orbital Fissure Syndrome
is reported. Geniculate ganglion involvement was limited to the vestibular branch
of the cochleo-vestibular nerve, without any hearing impairment or facial palsy. 
This case clearly illustrates that herpes zoster cranialis is a polyneuropathy of
multifocal asynchronous viral activity and can present in numerous forms.

Publication Types: 
    Case Reports

PMID: 3668384 [PubMed - indexed for MEDLINE]

6670: Int J Epidemiol. 1987 Sep;16(3):484-5.

Herpes zoster and multiple sclerosis.

De Keyser J.

Publication Types: 
    Letter

PMID: 3667053 [PubMed - indexed for MEDLINE]

6671: Anesthesiology. 1987 Sep;67(3):441-2.

Prevention of postherpetic neuralgia.

Bauman J.

Publication Types: 
    Letter

PMID: 3631618 [PubMed - indexed for MEDLINE]

6672: Am J Gastroenterol. 1987 Sep;82(9):859-64.

Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire.

Colebunders R, Francis H, Mann JM, Bila KM, Izaley L, Kimputu L, Behets F, Van
der Groen G, Quinn TC, Curran JW, et al.

Ninety-eight (40%) of 243 acquired immune deficiency syndrome inpatients at Mama 
Yemo Hospital, Kinshasa, Zaire, presented with a history of diarrhea for at least
1 month. To determine the predictive value of persistent diarrhea for human
immune deficiency virus (HIV) infection, 128 consecutive patients presenting at
Mama Yemo Hospital with persistent diarrhea were tested for the presence of HIV
antibodies. One-hundred seven (84%) of the 128 patients with diarrhea lasting at 
least 1 month were found to be HIV seropositive. HIV seropositive patients with
persistent diarrhea more often had a generalized papular pruritic eruption (p =
0.02), a genital herpes simplex infection (p = 0.05), a history of herpes zoster 
(p = 0.08), and infection with cryptosporidia (p = 0.006) than HIV seronegative
patients with persistent diarrhea. Bacterial enteric pathogens were found in 5
(7%) of the 76 seropositive and in none of the 14 seronegative patients in whom
stool cultures were performed. Presently persistent diarrhea in adults in central
Africa is strongly associated with HIV infection, but the pathophysiological
mechanisms causing this diarrhea remain unclear.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3631032 [PubMed - indexed for MEDLINE]

6673: Showa Shigakkai Zasshi. 1987 Sep;7(2):213-7.

[A case of herpes zoster treated with acyclovir]

[Article in Japanese]

Osawa K, Kakuta S, Tone K, Tokuoka T, Kimura Y, Nagumo M.

Publication Types: 
    Case Reports

PMID: 3505091 [PubMed - indexed for MEDLINE]

6674: Arthritis Rheum. 1987 Sep;30(9):980-7.

2,000-centiGray total lymphoid irradiation for refractory rheumatoid arthritis.

Trentham DE, Belli JA, Bloomer WD, Anderson RJ, Lane H, Reinherz EL, Austen KF.

Department of Medicine, Harvard Medical School, Boston, Massachusetts.

Because toxicity with the use of 3,000 centiGray (cGy) of total lymphoid
irradiation (TLI) was observed in an earlier study, 2,000-cGy treatments were
delivered in a 2-portal format to 7 patients and in a modified 3-portal fashion
to 6 patients, as part of a randomized, investigator-blinded trial of TLI
treatment for refractory rheumatoid arthritis. Analysis of combined data from the
13 patients revealed statistically significant improvement in 5 clinical
indicators of disease activity at the end of TLI and 6 and 12 months later,
accompanied by T4-specific immunosuppression. Management considerations resulted 
in the introduction of prednisone therapy in 5 patients, methotrexate in 4, and
azathioprine in 1 during the interval of 8-12 months post-TLI. Herpes zoster
occurred in 5 patients prior to the initiation of this additional therapy. These 
data indicate that, in patients with rheumatoid arthritis, a TLI dose of 2,000
cGy is sufficient to produce measurable benefit that lasts for 6 months, and that
the improvement can be maintained at 12 months by the use of prednisone and
methotrexate.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3499154 [PubMed - indexed for MEDLINE]

6675: Neurology. 1987 Sep;37(9):1537-8.

Infantile herpes zoster ophthalmicus and acute hemiparesis following intrauterine
chickenpox.

Leis AA, Butler IJ.

A 17-month-old boy developed herpes zoster ophthalmicus (HZO) and delayed
contralateral hemiparesis following intrauterine varicella exposure. CT
demonstrated multiple areas of hypodensity in the left basal ganglia, and
angiography showed occlusion of left lenticulostriate arteries. As in most adults
with HZO and delayed hemiparesis, this infant had a self-limiting course with
excellent recovery.

Publication Types: 
    Case Reports

PMID: 3498130 [PubMed - indexed for MEDLINE]

6676: J Virol. 1987 Sep;61(9):2877-84.

Assembly and processing of the disulfide-linked varicella-zoster virus
glycoprotein gpII(140).

Montalvo EA, Grose C.

Varicella-zoster virus (VZV) specifies the synthesis of at least four families of
glycoproteins, which have been designated gpI, gpII, gpIII, and gpIV. In this
report we describe the assembly and processing of VZV gpII, a structural protein 
of an apparent Mr of 140,000, which is the homolog of gB of herpes simplex virus.
For these studies, we used two anti-gpII monoclonal antibodies which exhibited
both complement-independent neutralization activity and inhibition of
virus-induced cell-to-cell fusion. Pulse-chase labeling experiments identified a 
124,000-Mr intermediate which was chased to the mature 140,000-Mr product when
analyzed in nonreducing gels; in the presence of a reducing agent, the native
gp140 was cleaved into two closely migrating species (gp66 and gp68). The
biosynthesis of VZV gpII was further analyzed in the presence of the following
inhibitors of glycoprotein processing: tunicamycin, monensin, castanospermine,
swainsonine, and deoxymannojirimycin. All intermediate and mature forms were
digested with endoglycosidases H and F, neuraminidase, and O-glycanase to further
define high-mannose, complex, and O-linked glycans. Finally, the addition of
sulfate residues was investigated. This characterization of VZV gpII revealed the
following results. (i) gp128 and gp124 were early high-mannose forms, (ii) gp126 
was an intermediate form with complex N-linked oligosaccharides, (iii) gp130 was 
a later intermediate with both N-linked and O-linked glycans, and (iv) the mature
product gp140 contained a mixture of N-linked and O-linked glycans which were
both sialated and sulfated. Further investigations indicated that gpII sulfation 
was inhibited by tunicamycin and castanospermine but not by deoxymannojirimycin
or swainsonine. We also concluded that VZV gpII displayed many biological and
biochemical properties similar to those of its herpes simplex virus homolog gB.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3039175 [PubMed - indexed for MEDLINE]

6677: J Infect Dis. 1987 Sep;156(3):430-5.

Antibodies to the three major glycoproteins of varicella-zoster virus: search for
the relevant host immune response.

Brunell PA, Novelli VM, Keller PM, Ellis RW.

Clinical manifestations of chickenpox have occurred in individuals known to have 
seroconverted after vaccination against varicella. To determine whether these
"breakthroughs" might be due to the absence of specific antibodies, we tested
sera from vaccinees before or at the time of exposure to varicella for antibodies
to the three major glycoproteins of varicella-zoster virus (VZV). Protection
could not be correlated with the presence or level of any of these antibodies.
Levels of antibodies to glycoproteins before onset of zoster were similar to
those in sera of individuals who had had varicella previously and did not develop
varicella after household exposure. Thus, protection against infections with VZV 
cannot be explained by the presence of specific antibodies to glycoproteins.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3039010 [PubMed - indexed for MEDLINE]

6678: Semin Respir Infect. 1987 Sep;2(3):177-83.

Pneumonia in the immunocompromised child.

Hughes WT.

Department of Child Health Sciences, St Jude Children's Research Hospital,
Memphis, TN 38101.

Certain types and causes of pneumonia are unique to the immunocompromised host.
The most frequent causes are cytomegalovirus, Pneumocystis carinii, varicella
zoster virus, Candida species and Aspergillus species. Lymphoid interstitial
pneumonia has recently been recognized in children with the acquired
immunodeficiency syndrome. With the exception of varicella-zoster pneumonitis, an
invasive procedure, such as open lung biopsy, is required to establish a
definitive diagnosis. Infrequent causes of pneumonitis in immunocompromised
children include Toxoplasma gondii; Cryptosporidium; Herpes simplex; adenovirus, 
gram-negative bacillary infections (Pseudomonas aeruginosa, Klebsiella
pneumoniae, Escherichia coli, Legionella pneumophilia); Nocardia spp;
zygomycetes, and Cryptococcus neoformans. The discovery of any of the
aforementioned pneumonias suggests the patient may have a serious underlying
immunodeficiency.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2825316 [PubMed - indexed for MEDLINE]

6679: J Med Virol. 1987 Sep;23(1):23-30.

Cell-mediated immunity to varicella-zoster virus infection in strain 2 guinea
pigs.

Jenski L, Myers MG.

Division of Hematology, Children's Hospital Research Foundation, Cincinnati, Ohio
45229-2899.

Young adult male strain 2 guinea pigs were inoculated intramuscularly with
varicella-zoster virus (VZV) cultured in fetal guinea pig tissue cultures.
Lymphocyte proliferation and interleukin 2 secretion in response to viral antigen
challenge in vitro were measured at weekly intervals for 2 months and
periodically thereafter. VZV-specific immunity was apparent 2 weeks after
infection, peaking after 2 weeks (lymphoproliferation) or 1-2 months (interleukin
2 secretion). Diminished but significant anamnestic responses were detected as
late as 30 months after infection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2824676 [PubMed - indexed for MEDLINE]

6680: Eur J Cancer Clin Oncol. 1987 Sep;23(9):1277-81.

Nasopharyngeal carcinoma in Israel: epidemiology and Epstein-Barr virus-related
serology.

Bogger-Goren S, Gotlieb-Stematsky T, Rachima M, Barkowsky E, Schlomo-David J.

Central Virology Laboratory, Chaim Sheba Medical Center, Tel-Aviv University,
Sackler School of Medicine, Ramat-Aviv, Israel.

Epidemiological, histological and serological characteristics of nasopharyngeal
carcinoma (NPC) were investigated. Included were 25 patients aged 10-70 with male
to female ratio 2:1. Among 23 Jewish patients, 18 were of Asian-African (AA) and 
five of European (Eur) descent; two were Arabs (Ar). The dominant histological
type among AA patients was undifferentiated carcinoma (UCNT) and among Eur
squamous cell carcinoma (SCC). Elevated IgG and IgA antibodies to Epstein-Barr
(EBV) viral capsid, early and nuclear antigens were observed in patients, as
compared to 34 healthy controls matched by age, sex and ethnic origin. Although
not statistically significant, antibodies to EBV were elevated in AA, as compared
to Eur patients. No significant differences in IgG and IgA antibodies to Herpes
simplex, Cytomegalo and Varicella-zoster viruses were demonstrated among patients
and controls. The study suggests that NPC in Israel, as elsewhere, is associated 
with EBV and genetic or environmental factors may influence the prevalence of NPC
among certain ethnic groups.

PMID: 2824207 [PubMed - indexed for MEDLINE]

6681: Hosp Pract (Off Ed). 1987 Aug 15;22(8):223, 228-32.

Evaluating and treating the patient with neck pain.

Gilbert R, Warfield CA.

PMID: 3114276 [PubMed - indexed for MEDLINE]

6682: Ugeskr Laeger. 1987 Aug 3;149(32):2138-9.

[Cimetidine in herpes zoster. A double-blind study in general practice]

[Article in Danish]

Brint-Nielsen P, Christiansen LV, Damsbo N, Norrelund N.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 3329788 [PubMed - indexed for MEDLINE]

6683: Aust Fam Physician. 1987 Aug;16(8):1133, 1137-40.

Herpes zoster in general practice.

Trollor J.

PMID: 3675350 [PubMed - indexed for MEDLINE]

6684: Antimicrob Agents Chemother. 1987 Aug;31(8):1238-42.

Antiherpesvirus activity of 9-(4-hydroxy-3-hydroxy-methylbut-1-yl)guanine (BRL
39123) in cell culture.

Boyd MR, Bacon TH, Sutton D, Cole M.

The activity of 9-(4-hydroxy-3-hydroxymethylbut-1-yl)guanine (BRL 39123) against 
several herpesviruses was compared with that of acyclovir (ACV). In plaque
reduction tests with clinical isolates of herpes simplex virus type 1 (HSV-1),
herpes simplex virus type 2 (HSV-2), and varicella-zoster virus, mean 50%
inhibitory concentrations (IC50S) (n = number tested) for BRL 39123 were 0.4 (n =
17), 1.5 (n = 13), and 3.1 (n = 5) micrograms/ml, respectively. Corresponding
IC50S for ACV were 0.2, 0.6, and 3.8 micrograms/ml. Cytomegalovirus was
relatively resistant to BRL 39123 (IC50, 51 micrograms/ml), but equid herpesvirus
1, bovid herpesvirus 2, and felid herpesvirus 1 were susceptible (IC50S, 1.6,
1.2, and 0.9 micrograms/ml, respectively). BRL 39123 was inactive against an
HSV-1 strain which does not express thymidine kinase activity, but a DNA
polymerase mutant selected for resistance to ACV was sensitive to BRL 39123
(IC50, 1.5 micrograms/ml). In contrast to the results from plaque reduction
tests, BRL 39123 was more active than ACV against HSV-1 and of equal activity
against HSV-2 in virus yield reduction assays in MRC-5 cells. After treatment of 
HSV-infected cultures for short periods, BRL 39123 was considerably more
effective than ACV at reducing virus replication, and furthermore, after removal 
of extracellular BRL 39123, virus replication remained depressed for long
periods, whereas such persistent activity was not observed with ACV. Neither
compound significantly affected MRC-5 cell replication at 100 micrograms/ml, but 
at 300 micrograms/ml BRL 39123 was more inhibitory than ACV.

PMID: 3631945 [PubMed - indexed for MEDLINE]

6685: J Am Acad Dermatol. 1987 Aug;17(2 Pt 1):239-45.

Primary care physicians' errors in handling cutaneous disorders. A prospective
survey.

Pariser RJ, Pariser DM.

This study analyzes the errors made by primary care physicians in handling skin
disorders in patients seen prospectively over a 20-month period in a dermatologic
practice. There were 319 errors in 260 patients. Eighty-eight percent of the
errors were in diagnosis. There was a striking tendency to overdiagnose
infectious dermatoses such as bacterial pyodermas, superficial mycoses, scabies, 
and herpes simplex and to underdiagnose inflammatory dermatoses such as contact
dermatitis, nummular dermatitis, pityriasis rosea, and psoriasis. In 218 cases
(68%) the error probably could have been prevented if the following diagnostic
criteria were considered mandatory: positive culture or potassium hydroxide
preparation for dermatophytosis or candidiasis, positive Tzanck smear or viral
culture for herpes simplex, zoster, or varicella, and demonstration of
ectoparasite for scabies. These findings have implications for the medical
education of primary care physicians and for the practitioner who handles
cutaneous disorders.

PMID: 3624563 [PubMed - indexed for MEDLINE]

6686: Hinyokika Kiyo. 1987 Aug;33(8):1266-71.

[Urinary retention secondary to herpes zoster]

[Article in Japanese]

Tanikawa K, Kawamura N, Baba S.

Department of Urology, Faculty of Medicine, Tokai University.

We present a case of urinary retention and constipation secondary to Herpes
zoster in the distribution of the second and third sacral dermatomes in a
68-year-old woman. Vesical irritability was not observed. Cystometry revealed a
flaccid type bladder. Cell count of spinal fluid increased but clinical symptoms 
and physical findings of myelitis were not observed. A Foley catheter was left
indwelling for five days due to urinary retention. After removal of the catheter,
bladder paresis gradually improved. Skin eruption and disturbance of urination
completely improved about three weeks later. Forty-seven cases of bladder
involvement secondary to Herpes zoster including our case have been reported in
the Japanese literature.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 3321960 [PubMed - indexed for MEDLINE]

6687: Can J Neurol Sci. 1987 Aug;14(3):312-4.

Herpes zoster ophthalmicus with delayed cerebral infarction and
meningoencephalitis.

Freedman MS, Macdonald RD.

Department of Neurology, Wellesley Hospital, Toronto, Ontario, Canada.

Herpes zoster ophthalmicus can be complicated by a delayed ipsilateral cerebral
angiitis which may cause infarction and a smoldering meningoencephalitis. We
describe such a case treated successfully with steroids and acyclovir. It is
important to consider the diagnosis of this disorder early since therapeutic
intervention may prevent an otherwise high morbidity and mortality. Steroids may 
have to be continued for some time after clinical resolution, using the ESR as a 
guideline for decreasing dosages.

Publication Types: 
    Case Reports
    Review

PMID: 3311326 [PubMed - indexed for MEDLINE]

6688: Pediatr Dermatol. 1987 Aug;4(2):67-74.

Pediatric human immunodeficiency virus infection and its cutaneous
manifestations.

Prose NS, Mendez H, Menikoff H, Miller HJ.

Department of Dermatology, State University of New York-Health Science Center,
Brooklyn 11203.

Acquired immunodeficiency syndrome was first observed in children in 1982. Human 
immunodeficiency virus (HIV) is now known to be the etiologic agent of this
disease complex. Children acquire the viral infection in utero or perinatally, or
by receiving contaminated blood products. The cutaneous manifestations include
persistent oral thrush, herpes simplex, herpes zoster, molluscum contagiosum, and
a variety of fungal and bacterial skin infections. Vasculitis, unusual drug
eruptions, and cutaneous manifestations of nutritional deficiencies are also
seen.

Publication Types: 
    Review

PMID: 3309907 [PubMed - indexed for MEDLINE]

6689: J Neurol. 1987 Aug;234(6):437-9.

Guillain-Barre syndrome after varicella-zoster infection. Report of two cases.

Sanders EA, Peters AC, Gratana JW, Hughes RA.

Department of Neurology, United Medical School, Guy's Hospital, London, England.

Two patients developed Guillain-Barre syndrome after varicella-zoster infection; 
a 4-year-old boy after chickenpox and a 74-year-old man after shingles. Both had 
decreased CD8-positive lymphocytes in the blood during the course of their
illness. These cases and others reported in the literature suggest that
varicella-zoster infection is a significant but rare trigger factor of
Guillain-Barre syndrome. An alteration in the balance of helper and suppressor
lymphocytes may be an important pathogenetic mechanism.

Publication Types: 
    Case Reports
    Review

PMID: 3309194 [PubMed - indexed for MEDLINE]

6690: Blood. 1987 Aug;70(2):516-23.

Effects of herpes virus carrier status on peripheral T lymphocyte subsets.

Gratama JW, Naipal AM, Oosterveer MA, Stijnen T, Kluin-Nelemans HC, Ginsel LA,
den Ottolander GJ, Hekker AC, D'Amaro J, van der Giessen M, et al.

We studied the effects of herpes virus carrier status on peripheral blood T
lymphocyte subsets in 334 healthy individuals. IgG-class antibodies against
cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV), and 
varicella-zoster virus (VZV) were used as markers for the carrier status of those
viruses. CMV carrier status was associated with significant increases in the
numbers of some T cell subsets, whereas the carrier status of EBV, HSV, and VZV
had no significant effects. The 159 CMV-seropositive individuals had higher
numbers of HNK1+ T cells than did the 175 CMV-seronegative individuals [mean
(SD), 292 (196)/microL v 164 (89)/microL, respectively], including the CD4+HNK1+ 
T cells [38 (48)/microL v 9 (13)/microL, respectively] and the CD8+HNK1+ T cells 
[166 (146)/microL v 73 (54)/microL, respectively]. Morphological and cytochemical
studies showed that the expression of HNK1 by the CD4+ and CD8+ T cells was
associated with the occurrence of azurophilic cytoplasmatic granules and a loss
of nonspecific esterase activity. The numbers of CD4+HNK1+ and CD8+HNK1+ T cells 
increased proportionally to the levels of the IgG-class CMV antibody titers. We
suggest that the increased numbers of CD4+HNK1+ and CD8+HNK1+ granular T cells in
CMV carriers reflect the persistent interaction between CMV and the immune system
of its hosts.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3038215 [PubMed - indexed for MEDLINE]

6691: J Infect Dis. 1987 Aug;156(2):273-9.

Epstein-Barr virus, cytomegalovirus, and other viral infections in children after
liver transplantation.

Breinig MK, Zitelli B, Starzl TE, Ho M.

We studied 51 consecutive pediatric patients for the frequency and morbidity of
viral infections after liver transplantation. The incidence of primary (67%) and 
reactivation (48%) Epstein-Barr virus (EBV) infections and reactivation (88%)
cytomegalovirus (CMV) infection was comparable to that seen in adult transplant
recipients. However, fewer pediatric than adult transplant recipients experienced
primary CMV infection (P less than .01). Five (38%) of 13 CMV infections were
symptomatic and included hepatitis, pneumonitis, enteritis, and mononucleosis.
Two of 14 patients with primary EBV infection subsequently developed, at two
months and two years after initial infection, an EBV-associated
lymphoproliferative syndrome, and one of 10 patients with reactivated EBV
infection developed a possible EBV-associated febrile encephalopathy. Other
viruses causing infection in these children included herpes simplex virus,
varicella-zoster virus, adenovirus, parainfluenza virus, respiratory syncytial
virus, and rotavirus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3036964 [PubMed - indexed for MEDLINE]

6692: Klin Monatsbl Augenheilkd. 1987 Aug;191(2):95-105.

[Eye involvement in AIDS]

[Article in German]

Fabricius EM, Jager H, Lander T, Prantl F, Hogel B, Greite JH.

Augenabteilung des Stadtischen Akademischen Lehrkrankenhauses Munchen-Harlaching.

Between 1984 and 1987 (over two-and-a-half years) 30 hospitalized patients with
HIV infections of different degrees of severity were ophthalmologically examined.
Ocular involvement was found in 17 patients (approx. 57%). In 16 of these 17
patients with pathologic ophthalmologic findings (approx. 94%), AIDS was already 
fully developed. Ocular involvement is therefore a sign of poor prognosis.
Fourteen patients had a microvascular retinal syndrome and four patients had
infectious (chorio-)retinitis (causative organisms: cytomegalovirus in three
cases, Cryptococcus neoformans in one). Further findings included sicca syndrome 
with superficial punctate keratitis in two cases, keratitis in one patient with
generalized mucocutaneous candidiasis, Kaposi's sarcoma of the eyelids in two
cases, Kaposi's sarcoma of the conjunctiva in one case, papilledema with
cryptococcal meningitis in one case, and atypical hordeolum in one case.
Morphologic and pathogenetic aspects of the ophthalmologic findings, their
importance and course in AIDS patients, and therapeutic problems are discussed.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2822996 [PubMed - indexed for MEDLINE]

6693: An Esp Pediatr. 1987 Aug;27(2):89-93.

[Pediatric kidney transplants and herpesvirus infections]

[Article in Spanish]

Reyes Martin A, Luque de Pablos A, Canals Badia MJ, Morales Sanjose MD, Niembro
de Rasche E.

Hospital Provincial de Madrid.

Twenty seven children were followed up prospectively after renal transplant for
evidence of infection and illness due to cytomegalovirus (CMV), Epstein-Barr
virus (EBV) and varicella zoster virus (VZV). Virus shedding and serological
status were tested at transplant day, biweekly for two months, monthly for six
months and trimestrialy thereafter. Determinations were done by complement
fixation test. CMV isolation was established by microscopic examination of
urinary cultures. Primary infections were objetivated in 27 cases (18 CMV, 1 EBV,
8 VZV) and reinfection in 3 (2 CMV, 1 VZV). Irreversible allograft rejection
related to infection was disclosed in 2 patients (1 primary CMV infection, 1 VZV 
reinfection). Renal function impairment occurred only with CMV (6 primary and 1
secondary infections). One patient died with CMV over infection.

Publication Types: 
    English Abstract

PMID: 2821861 [PubMed - indexed for MEDLINE]

6694: Minerva Med. 1987 Jul 31;78(14):1029-30.

[Cluster headache appearing after Ramsey Hunt syndrome and antigens of the HLA
system. Description of a case]

[Article in Italian]

Giacovazzo M, Martelletti P.

Publication Types: 
    Case Reports

PMID: 3601146 [PubMed - indexed for MEDLINE]

6695: Br Med J (Clin Res Ed). 1987 Jul 25;295(6592):270-1.

Herpes zoster of second and third segments causing ipsilateral Horner's syndrome.

Vernon SA.

Publication Types: 
    Letter

PMID: 3115408 [PubMed - indexed for MEDLINE]

6696: Lancet. 1987 Jul 18;2(8551):126-9.

Prednisolone does not prevent post-herpetic neuralgia.

Esmann V, Geil JP, Kroon S, Fogh H, Peterslund NA, Petersen CS, Ronne-Rasmussen
JO, Danielsen L.

In a randomised, double-blind, controlled study of the effect of prednisolone on 
the development of post-herpetic neuralgia 78 patients with herpes zoster whose
pain and exanthema had been present for less than 96 h were given 800 mg
acyclovir five times daily for 7 days and prednisolone in a total dose of 575 mg,
starting with 40 mg daily in the first week and tapering off over the next 2
weeks. 18 (23%) of the patients had post-herpetic neuralgia at 6 months after the
acute zoster, 9 (24.3%) having received prednisolone and 9 (22.5%) placebo. The
95% CI for the difference between the placebo and prednisolone groups in the
proportion of patients having pain at 6 months was minus 17% to plus 20%.
Prednisolone, however, relieved pain for the first 3 days. The 1-2 week interval 
between admission and reappearance of pain and development of triggered pain
seems to be the time needed to establish neuralgia. Once established, the type
and intensity of pain remained largely unaltered.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 2885599 [PubMed - indexed for MEDLINE]

6697: CMAJ. 1987 Jul 15;137(2):109-13.

The Vancouver Lymphadenopathy-AIDS Study: 7. Clinical and laboratory features of 
87 cases of primary HIV infection.

Boyko WJ, Schechter MT, Craib KJ, Willoughby B, Douglas B, Sestak P, McLeod WA,
O'Shaughnessey M.

In an ongoing prospective study of homosexual men conducted in Vancouver since
November 1982, 87 cases of human immunodeficiency virus (HIV) seroconversion have
been documented to date. Comparison of laboratory results obtained a mean of 4.9 
months before and 5.4 months after the estimated date of seroconversion revealed 
that a significant increase in the serum IgG level (from 1149 to 1335 mg/dl on
average) and in C1q binding (from 8.8% to 14.2% on average) was associated with
early HIV infection (p less than 0.001). A marginally significant decrease in the
ratio of helper to suppressor (CD4 to CD8) cells (from 1.55 to 1.29 on average)
was also noted (p = 0.025). A marked decrease in absolute number of CD4 cells was
not seen with seroconversion, which suggests that profound loss of these cells
may be a long-term effect of HIV infection. The occurrence of symptoms (including
fatigue, fever, night sweats, unintentional weight loss, diarrhea, joint pains,
cough unrelated to smoking, shortness of breath, oral thrush, herpes zoster and
rash) did not increase with seroconversion. This finding suggests that most cases
of HIV seroconversion may be asymptomatic or associated with relatively minor
symptoms. On the other hand, generalized lymphadenopathy was found to develop
after HIV seroconversion in about 50% of cases.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3647808 [PubMed - indexed for MEDLINE]

6698: Klin Med (Mosk). 1987 Jul;65(7):100-4.

[Herpes zoster in patients with hematologic diseases]

[Article in Russian]

Bogomolov BP, Bakhur EG.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3669563 [PubMed - indexed for MEDLINE]

6699: G Ital Dermatol Venereol. 1987 Jul-Aug;122(7-8):397-402.

[Possibility of therapy in post-zoster neuralgia]

[Article in Italian]

Clausi-Schettini C.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3666800 [PubMed - indexed for MEDLINE]

6700: J Am Acad Dermatol. 1987 Jul;17(1):93-6.

Treatment of chronic postherpetic neuralgia with topical capsaicin. A preliminary
study.

Bernstein JE, Bickers DR, Dahl MV, Roshal JY.

Continuing pain following herpes zoster is common in patients 60 years of age or 
older. Current treatments are generally unsatisfactory. The endogenous
neuropeptide substance P is an important chemomediator of nociceptive impulses
from the periphery to the central nervous system and has been demonstrated in
high levels in sensory nerves supplying sites of chronic inflammation. In an
attempt to alleviate the pain of 14 patients with postherpetic neuralgia,
capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide), known to deplete substance P,
was applied topically to painful areas of skin for 4 weeks. Of the 12 patients
completing this preliminary study, 9 (75%) experienced substantial relief of
their pain. The only adverse reaction was an intermittent, localized burning
sensation experienced by one patient with application of capsaicin. Although
these results are preliminary, they suggest that topical application of capsaicin
may provide a useful approach for alleviating postherpetic neuralgia and other
syndromes characterized by severe localized pain.

PMID: 3611458 [PubMed - indexed for MEDLINE]

6701: J Ophthalmic Nurs Technol. 1987 Jul-Aug;6(4):151-5.

Nursing grand rounds: herpes zoster ophthalmicus.

Pederson KM, Nulty G.

Publication Types: 
    Case Reports

PMID: 3497280 [PubMed - indexed for MEDLINE]

6702: Neurology. 1987 Jul;37(7):1264-5.

Herpes zoster ophthalmicus and delayed ipsilateral intracerebral hemorrhage.

Mossuto-Agatiello L, Iovine C, Kniahynicki C.

Publication Types: 
    Case Reports

PMID: 3496558 [PubMed - indexed for MEDLINE]

6703: Nippon Hifuka Gakkai Zasshi. 1987 Jul;97(8):931-6.

[Immunological studies on natural killer-cell activity in herpes zoster]

[Article in Japanese]

Nagai T.

PMID: 3430791 [PubMed - indexed for MEDLINE]

6704: Dent Update. 1987 Jul-Aug;14(6):255-6, 258-60.

Herpes zoster and post-herpetic neuralgia: diagnosis and management.

Watts PG.

Publication Types: 
    Case Reports
    Review

PMID: 3332642 [PubMed - indexed for MEDLINE]

6705: Br J Ind Med. 1987 Jul;44(7):435-42.

Occupational hazards in hospitals: risk of infection.

Gestal JJ.

In this review of the risk of infection to hospital staff, attention is drawn to 
the continuing risk presented by hepatitis B and pulmonary tuberculosis, which
are more common than diseases such as typhoid fever, brucellosis, histoplasmosis,
whooping cough, infectious gastroenteritis, measles, and parotiditis. Other items
considered include the susceptibility of female hospital staff to rubella and the
importance of their undergoing screening and vaccination; the risks currently
presented by epidemic keratoconjunctivitis and by herpes viruses (herpes simplex,
varicella zoster, and cytomegalovirus); and the risk of contracting the new
infectious diseases (Legionnaires' disease, Marburg disease, Lassa fever, and the
acquired immune deficiency syndrome).

Publication Types: 
    Review

PMID: 3304395 [PubMed - indexed for MEDLINE]

6706: Zhonghua Yan Ke Za Zhi. 1987 Jul;23(4):212-4.

[Herpes zoster ophthalmicus]

[Article in Chinese]

Song XW.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3127162 [PubMed - indexed for MEDLINE]

6707: Hematol Oncol. 1987 Jul-Sep;5(3):213-22.

VAD chemotherapy--toxicity and efficacy--in patients with multiple myeloma and
other lymphoid malignancies.

Anderson H, Scarffe JH, Lambert M, Smith DB, Chan CC, Chadwick G, McMahon A,
Chang J, Crowther D, Swindell R.

CRC Department of Medical Oncology, Christie Hospital, Manchester, U.K.

Thirty-three patients with multiple myeloma (11 untreated, 15 refractory and
seven relapsed patients) have received vincristine and adriamycin infusion
therapy with oral dexamethasone (VAD). The median number of course received was
five. In addition 16 patients with lymphoid malignancy have received a median of 
four courses of VAD. Three patients who relapsed after VAD have received further 
VAD therapy making 52 patient treatments assessable for toxicity. Ten per cent
had nausea, 4 per cent vomiting, 4 per cent total alopecia, 25 per cent
constipation, 33 per cent paraesthesiae, 8 per cent proximal myopathy, 33 per
cent dyspepsia, 23 per cent proven bacteraemia, and 19 per cent chest infections.
Infections were not usually associated with neutropenia. Shingles was seen in
four patients with myeloma, but none of the patients with lymphoid malignancy.
The response rate in myeloma was 9/11, for previously untreated patients, 3/7 for
relapsed, and 8/15 for refractory patients. Responses have been seen in other
lymphoid malignancies-1/2 patients with relapsed acute lymphoblastic leukaemia
had a complete remission. Two out of seven patients with chronic lymphocytic
leukaemia achieved a partial remission, and a further three had a clinical
improvement. Three out of six patients with non-Hodgkin lymphoma and one patient 
with macroglobulinaemia achieved a partial remission.

PMID: 3115884 [PubMed - indexed for MEDLINE]

6708: AJNR Am J Neuroradiol. 1987 Jul-Aug;8(4):615-9.

Mycotic aneurysm in angiitis associated with herpes zoster ophthalmicus.

O'Donohue JM, Enzmann DR.

Varicella zoster (VZ) is an unusual cause of CNS angiitis, usually occurring in
older patients and immunocompromised hosts. The infection most commonly presents 
as herpes zoster ophthalmicus with contralateral hemiplegia. Mycotic aneurysm
formation associated with VZ angiitis is rare. We report two cases of VZ angiitis
with mycotic aneurysm formation (both aneurysms eventually ruptured) and one case
of probable VZ angiitis with distal carotid occlusion and cerebral infarction.
The CT and angiographic appearances, clinical course, and histopathology are
presented.

Publication Types: 
    Case Reports

PMID: 3113199 [PubMed - indexed for MEDLINE]

6709: HNO. 1987 Jul;35(7):310-3.

[Acute viral infections in association with idiopathic peripheral facial
paralysis]

[Article in German]

Mang WL, Bonkowsky VM.

The possible association of some viral infections with the onset of Bell's palsy 
was examined in a study of 29 patients. The results were compared with a sex- and
age-matched control group. The number of probable recent viral infections, as
judged by a fourfold increase in antibody titers or the presence of specific IgM 
antibodies, differed statistically from that found in the control group. In seven
patients with Bell's palsy the enzyme-linked-immunosorbent assay (ELISA)
indicated an acute viral infection (herpes simplex 4; varicella zoster 2;
cytomegalovirus 1). All these infections were due to viruses belonging to the
herpesvirus group. Clinical evidence of herpesvirus infection was found in three 
cases (Herpetic eruption). The aetiological relationship between the virological 
findings and Bell's palsy is discussed. Reactivated herpes simplex virus and
transient demyelination of the facial nerve could be one cause of an idiopathic
facial palsy.

Publication Types: 
    English Abstract

PMID: 3040643 [PubMed - indexed for MEDLINE]

6710: Pediatr Infect Dis J. 1987 Jul;6(7):644-7.

Magnetic resonance imaging of the brain in childhood herpesvirus infections.

Bale JF Jr, Andersen RD, Grose C.

We used magnetic resonance imaging (MRI) to evaluate nine children with
neurologic disorders caused by infections with members of the herpesvirus family.
MRI studies were abnormal in eight children and demonstrated a wide range of
central nervous system lesions, including cystic encephalomalacia, ventricular
enlargement, cerebral atrophy and focal parenchymal lesions. When compared with
conventional computed tomographic scanning, MRI was more sensitive in detecting
abnormalities of white matter and in defining the extent of parenchymal lesions. 
These studies indicate that MRI scans are highly useful in children with
herpesvirus infections involving the central nervous system.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 3039447 [PubMed - indexed for MEDLINE]

6711: Virology. 1987 Jul;159(1):193-5.

A small open reading frame in pseudorabies virus and implications for
evolutionary relationships between herpesviruses.

Petrovskis EA, Post LE.

An open reading frame coding for an 11-kDa protein was located downstream from
the gI gene of pseudorabies virus (PRV). This open reading frame is homologous to
an open reading frame (US9) in an analogous position in herpes simplex virus and 
to an open reading frame (US1) in a different position in varicella zoster virus.
The open reading frame encoding the 11-kDa protein is in a region known to be
deleted in live attenuated vaccine strains of PRV.

PMID: 3037781 [PubMed - indexed for MEDLINE]

6712: J Med Chem. 1987 Jul;30(7):1199-204.

2'-Fluorinated arabinonucleosides of 5-(2-haloalkyl)uracil: synthesis and
antiviral activity.

Griengl H, Wanek E, Schwarz W, Streicher W, Rosenwirth B, De Clercq E.

The synthesis of 5-(2-fluoroethyl)-2'-deoxyuridine (FEDU, 4b), its 2'-fluoro
analogue 1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)-5-(2-fluoroethyl)-1H,3H-
pyrimidine-2,4-dione (FEFAU, 4k), and the 2'-fluoro analogue of the potent
antiherpes virus compound 5-(2-chloroethyl)-2'-deoxyuridine (CEDU),
5-(2-chloroethyl)-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)-1H,3H-pyr imidine 
- 2,4-dione (CEFAU, 4i), is described. The antiviral activities of these
compounds were determined in cell culture against herpes simplex virus (HSV)
types 1 and 2 and varicella zoster virus (VZV). All compounds were shown to
possess significant and selective antiviral activity. FEDU proved less potent
than CEDU against VZV replication; however, it was more active against HSV-2.
CEFAU showed marked activity against HSV-1, HSV-2, and VZV. The compound
containing fluorine at both positions, FEFAU, exhibited the strongest antiviral
potency against HSV-1, HSV-2, and VZV. It inhibited HSV-1 at a concentration of
0.03-0.2 microgram/mL, HSV-2 at 0.1-0.3 microgram/mL, and VZV at 0.03
microgram/mL. Neither FEDU nor CEFAU or FEFAU exerted a significant inhibitory
effect on cell proliferation at a concentration of 100 micrograms/mL. Thus, the
cytotoxicity of these compounds is as low as that of CEDU and compares favorably 
to that of previously described 2'-fluoroarabinosyl nucleoside analogues.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3037079 [PubMed - indexed for MEDLINE]

6713: Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol. 1987
Jul-Sep;31(3):221-4.

[Zona ophthalmica of superacute evolution in a patient with cortisone
immunodepression]

[Article in Romanian]

Saninoiu M.

Publication Types: 
    Case Reports

PMID: 2962245 [PubMed - indexed for MEDLINE]

6714: Riv Neurol. 1987 Jul-Aug;57(4):274-6.

Segmental abdominal zoster paresis.

Jandolo B, Biolcati G, Montanari U, Pietrangeli A, Fazio M.

Istituto Regina Elena per lo Studio e la Cura dei Tumori, Servizio di Neurologia,
Roma.

A case of uncommon feature of herpes zoster, a segmental abdominal paresis, is
described. The importance of searching a motor defect in the thoracoabdominal
segments and the utility of the electromyographic examination are stressed.

Publication Types: 
    Case Reports

PMID: 2961042 [PubMed - indexed for MEDLINE]

6715: Virus Res. 1987 Jul;8(1):25-31.

Isomerization of the UL region of varicella-zoster virus DNA.

Hayakawa Y, Hyman RW.

Department of Microbiology, Pennsylvania State University, College of Medicine,
Hershey 17033.

Varicella-zoster virus (VZV) DNA exists principally as two isomers. Despite the
presence of inverted repeats bounding the long sequence region, the unique long
sequence, UL, is found in one (prototype) orientation in 95-98% of VZV DNA
molecules and in the inverted orientation in only 2-5% of the molecules. In
searching for an explanation for this disparity, we superinfected VZV-infected
cells with herpes simplex virus type 1 or pseudorabies virus. Neither
superinfecting virus produced a measurable change in the frequency of
isomerization of the VZV DNA long sequence region.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2821706 [PubMed - indexed for MEDLINE]

6716: Klin Oczna. 1987 Jul;89(7):307-8.

[Isoprinosine in the treatment of virus diseases of the visual system]

[Article in Polish]

Debicka A.

Publication Types: 
    English Abstract

PMID: 2447324 [PubMed - indexed for MEDLINE]

6717: J Am Acad Dermatol. 1987 Jul;17(1):64-9.

Comparison of detection of varicella-zoster virus by the Tzanck smear, direct
immunofluorescence with a monoclonal antibody, and virus isolation.

Sadick NS, Swenson PD, Kaufman RL, Kaplan MH.

A study comparing direct immunofluorescence assay using a new monoclonal antibody
specific for a varicella-zoster virus glycoprotein complex, the Tzanck smear, and
virus isolation for detection of varicella-zoster virus in 56 patients with
clinically apparent herpes zoster is presented. Of 47 patients with clinical
herpes zoster and with cultures negative for herpes simplex virus, 30 (64%) had
positive Tzanck smears, direct immunofluorescence assay results were positive in 
26 (55%), and cultures were positive in only 12 (26%). Both direct
immunofluorescence assay and the Tzanck smear were found to be superior to
culture technics; however, direct immunofluorescence assay was found to have
greater specificity.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 2440920 [PubMed - indexed for MEDLINE]

6718: Lancet. 1987 Jun 27;1(8548):1477-9.

Corticosteroids as adjunctive therapy in treatment of Pneumocystis carinii
pneumonia in patients with acquired immunodeficiency syndrome.

MacFadden DK, Edelson JD, Hyland RH, Rodriguez CH, Inouye T, Rebuck AS.

10 patients with the acquired immunodeficiency syndrome whose respiratory failure
due to Pneumocystis carinii pneumonia (PCP) was deteriorating rapidly had 7 days 
of intravenous methylprednisolone added to their antibiotic regimen. 8 similar
patients were treated with antibiotic therapy alone. 9 of the 10
methylprednisolone-treated patients survived their episode of PCP, compared with 
2 of the 8 conventionally treated patients. Clinical improvement was evident
within 2 days of the start of steroid therapy, and in none of the 10 patients did
clinical deterioration or recurrence of PCP occur on cessation of steroid
therapy. In 1 steroid-treated patient disseminated herpes zoster developed 2 days
after discontinuation of methylprednisolone. Methylprednisolone seems to be a
useful adjunctive therapeutic agent for patients with AIDS in whom Pneumocystis
carinii is the sole respiratory pathogen.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 2885462 [PubMed - indexed for MEDLINE]

6719: S Afr Med J. 1987 Jun 20;71(12):799.

Anti-varicella zoster immunoglobulin and herpes simplex infections.

Schoub BD.

Publication Types: 
    Letter

PMID: 3037709 [PubMed - indexed for MEDLINE]

6720: Br Med J (Clin Res Ed). 1987 Jun 6;294(6585):1463.

Herpes zoster of second and third segments causing ipsilateral Horner's syndrome.

Wimalaratna HS, Capildeo R, Lee HY.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3111588 [PubMed - indexed for MEDLINE]

6721: Masui. 1987 Jun;36(6):971-5.

[Treatment with total spinal block of severe herpetic neuralgia accompanying
median and ulnar nerve palsy]

[Article in Japanese]

Yamashiro H, Hirano K.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3656663 [PubMed - indexed for MEDLINE]

6722: J Neurol. 1987 Jun;234(5):308-14.

Cerebrospinal fluid immunoglobulins and virus-specific antibodies in disorders
affecting the facial nerve.

Weber T, Jurgens S, Luer W.

Sixty-two patients with acute idiopathic peripheral facial nerve palsy (AIPFP)
and 31 patients with lymphocytic meningoradiculitis (Garin-Bujadoux or
Bannwarth's syndrome) are described. Results of cerebrospinal fluid (CSF)
analysis, including the measurement of immunoglobulins (Ig) G, A, and M, indicate
that pleocytosis and/or disturbance of the blood-CSF barrier (BCB) and/or local
immunoglobulin synthesis within the central nervous system (CNS) do occur in
about 25% of patients with AIPFP. The commonest finding is a slight to moderate
breakdown of BCB function without evidence of intrathecal immunoglobulin
synthesis. In only about 10% of patients, further support for an inflammatory
process within the CNS is found by intrathecal synthesis of oligoclonal IgG
and/or localized synthesis of IgG and/or IgA. The majority of cases (75%) do not 
show any signs of an inflammatory process within the CNS. In contrast,
lymphocytic meningopolyradiculitis (LMR) has a characteristic CSF profile with
early impairment of BCB permeability as well as with rapid and predominant
intrathecal IgM synthesis, which helps to distinguish monosymptomatic LMR from
AIPFP. By applying a sensitive enzyme-linked immunosorbent assay to identical
concentrations of IgG in serum and CSF, evidence of intrathecal synthesis of
virus-specific antibodies was found only in 2 of 13 patients with AIPFP. In
contrast, all 4 patients with herpes zoster oticus and peripheral facial palsy
(Ramsay Hunt syndrome) showed an intrathecal IgG synthesis to varicella zoster
virus lasting for up to 4 months after onset of disease.

PMID: 3612202 [PubMed - indexed for MEDLINE]

6723: Ann Neurol. 1987 Jun;21(6):559-63.

Postherpetic gustatory flushing and sweating.

Drummond PD, Boyce GM, Lance JW.

An 11-year-old girl who had suffered right facial herpes zoster at the age of 6
years was left with anesthetic scars in the distribution of the third division of
the trigeminal nerve. Since then, certain tastes provoked flushing and sweating
localized to the scarred areas, lasting for 10 to 15 minutes after a latency of a
few seconds. The response was evoked most readily from the ipsilateral posterior 
section of the tongue and was virtually abolished by local administration of
anesthesia to the tongue. It remained unaltered after blockade of the
sphenopalatine and stellate ganglia but was diminished by blockade of the
mandibular nerve. Thermoregulatory sweating and flushing were diminished in the
scarred areas. Patchy destruction of sympathetic fibers, which are known to
accompany peripheral trigeminal nerve branches, and reinnervation of the affected
areas by parasympathetic fibers that normally mediate salivation may explain the 
phenomenon. It is thus analogous to the gustatory flushing and sweating that may 
follow damage to the auriculotemporal nerve in the region of the parotid gland
(Frey's syndrome).

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3606044 [PubMed - indexed for MEDLINE]

6724: J Am Acad Dermatol. 1987 Jun;16(6):1261-3.

Granuloma formation in herpes zoster scars.

Fischer G, Jaworski R.

Publication Types: 
    Case Reports
    Letter

PMID: 3597868 [PubMed - indexed for MEDLINE]

6725: Chemioterapia. 1987 Jun;6(2 Suppl):663-4.

Treatment of herpes virus ocular pathology with acyclovir.

Gorgone G, Cavallaro N, Spina F.

Department of Ophthamology, University of Catania, Italy.

PMID: 3509940 [PubMed - indexed for MEDLINE]

6726: J Indian Dent Assoc. 1987 Jun-Sep;59(6,7,8,9):170-2.

Herpes zoster of facial structures.

Bhatia B, Bhatia KK, Aparna.

PMID: 3509565 [PubMed - indexed for MEDLINE]

6727: Chemioterapia. 1987 Jun;6(2 Suppl):748-50.

Varicella-zoster infection in patients with neoplastic diseases.

Panagos G, Boukis H, Coutsouradis T, Voskaridou E, Papadakou M, Flevaris C.

2nd Department of Medicine, A. Anargiri Cancer Hospital, N. Kifisia, Greece.

Publication Types: 
    Comparative Study

PMID: 3509539 [PubMed - indexed for MEDLINE]

6728: Ophthalmology. 1987 Jun;94(6):602-6.

Association of varicella zoster dermatitis with acute retinal necrosis syndrome.

Browning DJ, Blumenkranz MS, Culbertson WW, Clarkson JD, Tardif Y, Gourdeau A,
Minturn J.

The authors report seven patients in whom the acute retinal necrosis (ARN)
syndrome developed shortly after cutaneous varicella zoster infection. The length
of time between the skin infection and ARN varied from 5 days to 3 months. Both
eyes were affected in one of seven cases. The ophthalmic branch of cranial nerve 
V ipsilateral to an affected eye was involved by the zoster dermatitis in only
two of the seven cases. The association lends further support to the proposal
that herpes zoster virus is a major cause of ARN. A history of recent zoster
dermatitis should be sought in patients with ARN.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3498140 [PubMed - indexed for MEDLINE]

6729: Klin Med (Mosk). 1987 Jun;65(6):128-9.

[A case of contralateral hemisyndrome in the ophthalmic form of herpes zoster]

[Article in Russian]

Shishov AS, Smirnov IuK, Rusakova IuP.

Publication Types: 
    Case Reports

PMID: 3498090 [PubMed - indexed for MEDLINE]

6730: Chemioterapia. 1987 Jun;6(2 Suppl):671-3.

Recent developments in the management of herpes zoster (shingles).

Wood MJ, McKendrick M, McGill JI.

Department of Communicable & Tropical Diseases, Birmingham Hospital, England.

Publication Types: 
    Clinical Trial
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 3334658 [PubMed - indexed for MEDLINE]

6731: Infect Dis Clin North Am. 1987 Jun;1(2):367-82.

The management of varicella and zoster infections.

Straus SE.

Medical Virology Section, National Institute of Allergy and Infectious Diseases, 
Bethesda, Maryland.

The varicella-zoster virus causes chickenpox and shingles. Antiviral drugs like
acyclovir ameliorate certain severe forms of these infections, particularly as
they present in immunodeficient patients. Varicella-zoster immune globulin
prevents chickenpox, but a more desirable and effective strategy entails
administration of a live-attenuated vaccine.

Publication Types: 
    Review

PMID: 3332795 [PubMed - indexed for MEDLINE]

6732: Semin Respir Infect. 1987 Jun;2(2):84-94.

Varicella zoster and herpes simplex virus pneumonias.

Feldman S, Stokes DC.

Division of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, 
TN 38101.

Varicella zoster (VZV) and herpes simplex (HSV) viruses commonly cause
self-limited infection of the skin and mucous membranes. However, certain groups 
of subjects, including neonates, cancer patients, organ and bone marrow
transplant recipients and those with congenital or acquired deficiencies of cell 
mediated immunity, are at increased risk for dissemination of either virus to the
lungs and/or other viscera. The highest risk for VZV pneumonitis is in bone
marrow transplant recipients, 44%, and in children with acute leukemia, 32%. The 
mortality from this complication of VZV infection in the preantiviral era was at 
least 25%. Except for neonates, dissemination and mortality rates for HSV
infections are less than for VZV infections in the high risk groups.
Cell-mediated immunity has a major role in both recovery from primary infection
and modulation of latent infection, but antiherpes antibodies also have an
important role in moderating the extent and severity of infection. Both viruses
cause a patchy nodular pneumonia with scattered necrotic and hemorrhagic foci.
Physical examination is often misleading and rapid progression of pneumonia can
occur within hours. Intravenous acyclovir, administered early in the course of
HSV and VZV infection at dosages of 250 mg/m2 and 500 mg/m2 every eight hours,
respectively, has nearly eliminated the risk of severe symptomatic pneumonitis.
Treatment of established pneumonitis with acyclovir at these doses has also
reduced the mortality of herpesvirus pneumonias.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Review

PMID: 3321272 [PubMed - indexed for MEDLINE]

6733: J Clin Pathol. 1987 Jun;40(6):657-62.

Changes in plasma beta 2 microglobulin concentrations after allogeneic bone
marrow transplantation.

Norfolk DR, Forbes MA, Cooper EH, Child JA.

Plasma concentrations of beta 2 microglobulin (B2M), the light chain of the class
I major histocompatibility complex, were measured serially in 26 patients
undergoing allogeneic bone marrow transplantation (BMT). The concentrations fell 
after conditioning treatment, and recovered when the marrow was transplanted.
Bacterial infection did not influence B2M concentration, but nine of 22 episodes 
of acute graft versus host disease were associated with raised concentrations.
Increased plasma B2M concentrations were also a feature of eight episodes of
chronic graft versus host disease, and these fell after treatment. Reactivation
of herpes simplex, varicella zoster, or cytomegalovirus infections were also
accompanied by raised B2M concentrations. Three patients with cytomegalovirus
pneumonitis had high concentrations of plasma B2M, the rise starting between five
and 22 days before onset of symptoms. Although it is non-specific, serial
measurement of plasma B2M in patients undergoing BMT may be clinically useful in 
monitoring chronic graft versus host disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3301908 [PubMed - indexed for MEDLINE]

6734: Gynecol Endocrinol. 1987 Jun;1(2):177-93.

Trial of 17-hydroxyprogesterone caproate (Proluton Depot) in women with
long-standing infertility; failure of estrogen positive feedback the following
cycle.

Mavroudis K, Petsos P, Zulkifli Z, Cantrill J, Shingles C, Newman M, Mamtora H,
Ratcliffe WA, Anderson DC.

University of Manchester Department of Medicine, (Endocrinology), Hope Hospital, 
Salford, UK.

In open and double-blind studies 40 women with long-standing unexplained
infertility were investigated and treated with 17 alpha-hydroxyprogesterone
caproate (17HPC, Proluton Depot). In the open study, 16 women with a high index
of suspicious abortions were given 500 mg 17HPC imtramuscularly (i.m.) weekly for
6-16 weeks. Six of the women received the drug from a time preceding the expected
date of a period; 2 of these conceived that cycle and their pregnancies continued
to term, while 4 were not pregnant. Ten women (9 with definite previous
abortions) were given 17HPC when they suspected (correctly) that they were
pregnant. Their pregnancies continued to term in all but 1, who had a premature
delivery (still-birth) at 34 weeks. In the double-blind study 24 women were given
injections of 17HPC or placebo i.m. at weekly intervals, from about 4 days before
the expected period (day -4), provided that the level of progesterone (Prog) (on 
days -9 to -7) was greater than 10 nmol/l. After placebo no delay in menstruation
or disruption of the succeeding cycle was observed. In 14 of 16 cycles in 14
women given 500 mg 17HPC the withdrawal period was delayed by a few days, and
then followed by highly erratic bleeding over the next 1-3 months. The dose was
therefore reduced to 250 mg 17HPC but the same problem resulted in 8 of 29 cycles
in 16 women (including the above studied in later cycles). Regular cycles were
eventually restored in all cases but in 3 this necessitated treatment with the
contraceptive pill (Microgynon). In most of the post-treatment cycles there was a
progressive and prolonged estradiol (E2) rise, which was not preceded by changes 
either in serum FSH concentration or in the LH/FSH ratio nor associated with the 
expected positive feedback rise in LH. We conclude that 17HPC disrupts the
following cycle, probably by allowing follicular development while interfering
with positive LH feedback. None of the patients of the double-blind study had
conceived (as evidenced by undetectable hCG levels). Our study confirmed that
this progestogen exerts no direct luteolytic effect. However, in order to
establish the efficacy or otherwise of 17HPC given before the end of the cycle,
women should be selected with a very high index of suspicion of recurrent early
implantation failure or abortion.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 3140580 [PubMed - indexed for MEDLINE]

6735: Eur J Clin Microbiol. 1987 Jun;6(3):245-61.

Perinatal viral infections.

Prober CG, Arvin AM.

In comparison to older children and adults, neonates are immunologically
incompetent. They are susceptible to infections caused by a variety of
microorganisms, including bacteria, fungi and viruses. These infectious agents
may be acquired by neonates either prenatally, during the intrapartum period or
postnatally. The purpose of this review is to emphasize the potential impact of
viral infections contracted by neonates at the time of delivery or within the
neonatal period. The viruses reviewed include the herpes group of viruses
(cytomegalovirus, herpes simplex viruses and varicella-zoster virus), type B
hepatitis virus, human immunodeficiency virus, respiratory viruses,
enteroviruses, rotavirus and human papilloma virus. For each virus the potential 
sources and incidence of the infection, the common manifestations of the illness,
and possible means of prevention and therapy are discussed. Although infections
caused by bacteria tend to be more clinically dramatic and more immediately
life-threatening, it is emphasized that infections caused by viruses are common
and associated with substantial long-term morbidity. Perinatal viral infections
need to be recognized as early in life as possible so that their natural history 
can be more completely defined and any possible intervention made.

Publication Types: 
    Review

PMID: 3040392 [PubMed - indexed for MEDLINE]

6736: Minn Med. 1987 Jun;70(6):333-5.

Response of immunocompromised patients with acute herpes zoster to intravenous
acyclovir.

McMonigal KA, Balfour HH Jr, Bean B.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3037291 [PubMed - indexed for MEDLINE]

6737: Pharmazie. 1987 Jun;42(6):407-11.

[(E)-5-(2-bromovinyl)-2'-desoxyuridine--a new nucleoside analog with selective
inhibitory action against herpesviruses. Studies in cell culture and animal
experiments]

[Article in German]

Reefschlager J, Wutzler P, Thiel KD, Topke H, Barwolff D, Langen P.

Abteilung Molekulare Virologie und Chemotherapie, Bereiches Medizin (Charite) der
Humboldt-Universitat zu Berlin.

(E)-5-(2-Bromovinyl)-2'-deoxyuridine (1; BrVUdR) inhibits the replication of
herpes simplex virus type 1 (HSV-1) and of varicella-zoster virus (VZV) in vitro 
at concentrations of 0.01 to 0.23 mumol/l, whereas herpes simplex virus type 2
(HSV-2) is influenced only at 5.5 to 27 mumol/l. In comparison to some classical 
and newly developed antiherpetics, i. e. 5-iodo-2'-desoxyuridine (2; idoxuridine,
IDU), 9-beta-D-arabinofuranosyladenine (4; vidarabine Ara-A),
9-(2-hydroxyethoxymethyl) guanine (5; acyclovir, ACV) and
2'-fluoro-5-iodo-1-beta-D-aracytosine (6;FIAC) the following order of decreasing 
activity was found:1 greater than 6 greater than 5 greater than 2 greater than 4 
(against HSV-1) and 6 greater than 2 greater than 5 greater than 1 greater than 4
(against HSV-2). The high selectivity of the antiviral effect of BrVUdR towards
HSV-1 and TZV is based on the fact, that proliferation of different mammalian
cell lines is inhibited by 50% only at concentrations as high as 90 to 170
mumol/l, resulting in a therapeutical index of 1000 to 10,000. Successful
treatment of an HSV-1 encephalitis in mice as well as an HSV-1 keratitis of
rabbits confirmed the efficiency of 1 in experimental animal infections. No toxic
side effects in both local and systemic applications were observed. Promising
data from cell culture and animal experiments recommend 1 as a potential
candidate for the local and systemic treatment of HSV-1 and VZV infections in
man.

Publication Types: 
    English Abstract

PMID: 2823299 [PubMed - indexed for MEDLINE]

6738: Am J Ophthalmol. 1987 May 15;103(5):711-2.

Treatment of neurotrophic ulcers with conjunctival flaps.

Lugo M, Arentsen JJ.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3495182 [PubMed - indexed for MEDLINE]

6739: Fortschr Med. 1987 May 10;105(14):280-2.

[Acyclovir in acute herpes zoster. Effect of early intravenous treatment on pain 
intensity and the course of pain]

[Article in German]

Christe W, Kolmel HW.

Publication Types: 
    English Abstract

PMID: 3596449 [PubMed - indexed for MEDLINE]

6740: Med Clin (Barc). 1987 May 9;88(18):741.

[Generalized herpes zoster and infection by the human immunodeficiency virus]

[Article in Spanish]

Fonseca Capdevila E, Almagro Sanchez M.

Publication Types: 
    Case Reports
    Letter

PMID: 3613717 [PubMed - indexed for MEDLINE]

6741: Schweiz Med Wochenschr. 1987 May 2;117(18):669-75.

[Common infections in immunocompromised patients]

[Article in German]

Malinverni R.

Immunocompromised patients are at increased risk for life-threatening as well as 
non life-threatening infectious complications. In contrast to the acutely
granulocytopenic patient, the infectious syndromes occurring in other
immunocompromised hosts are easily detected clinically. From a precise knowledge 
of the underlying specific host defense abnormality it is possible to predict the
spectrum of the most likely causative organisms and the course of the infection. 
In the case of a defect in cell-mediated host defense, the variety of potential
pathogens is wide and includes characteristically intracellular microorganisms. A
defect in humoral immunity places patients at increased risk for infection due to
encapsulated, extracellular organisms. Patients with qualitative defects of
polymorphonuclear leukocyte defense are particularly susceptible to S. aureus
infections. The lack of integrity of anatomical barriers (skin, mucous membranes)
may lead to increased risk of localized or invasive infections by the colonizing 
microbial flora. Virtually every decision on antimicrobial therapy must be based 
upon careful evaluation of the integrity of all these host defense mechanisms.
These relationships are illustrated by discussion of four infectious diseases:
urinary tract infections, Candida mucositis, Varicella-Zoster virus infections
and fever in the asplenic patient.

Publication Types: 
    English Abstract

PMID: 3589624 [PubMed - indexed for MEDLINE]

6742: Laryngol Rhinol Otol (Stuttg). 1987 May;66(5):290-1.

[Treatment of herpes zoster]

[Article in German]

Wilmes E.

PMID: 3613783 [PubMed - indexed for MEDLINE]

6743: Ophthalmic Surg. 1987 May;18(5):367-70.

Herpetic canalicular obstruction.

Harley RD, Stefanyszyn MA, Apt L, Nelson LB.

The viruses of primary herpes simplex, herpes zoster, chicken pox, and vaccinia
may produce inflammatory changes in the epithelial lining of the lacrimal
canaliculi, resulting in varying degrees of obstruction. Five cases are described
and compared with previously reported cases. A review of the literature suggests 
that the association of ocular viral infections and canalicular complications may
be more prevalent than previously suspected. The possible important role of
antiviral agents is considered. Early recognition and intubation can often
prevent permanent canalicular obstruction, but late cases may require the Jones
tube procedure, conjunctivodacryocystorhinostomy.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3601344 [PubMed - indexed for MEDLINE]

6744: J Am Podiatr Med Assoc. 1987 May;77(5):249-51.

An unusual manifestation of herpes zoster.

Marsh NS, Black JR.

Publication Types: 
    Case Reports

PMID: 3585757 [PubMed - indexed for MEDLINE]

6745: Drug Intell Clin Pharm. 1987 May;21(5):399-405.

Clinical use of antiviral drugs.

Nahata MC.

Remarkable progress has been made in antiviral chemotherapy. Six approved
antiviral drugs are now available for the treatment of various viral infections. 
Trifluridine, idoxuridine and vidarabine are all effective in patients with
herpes keratitis; trifluridine is preferred due to its low toxicity. Acyclovir is
the drug of choice in patients with infections due to herpes simplex viruses,
including genital herpes, herpes encephalitis, and neonatal herpes, and
infections due to varicella-zoster virus. Amantadine is the only drug currently
available for prophylaxis and treatment of influenza A, but an investigational
drug, rimantadine, appears to be equally effective and less toxic than
amantadine. Ribavirin is the most recently approved antiviral agent for the
treatment of respiratory syncytial virus infections. Numerous antiviral drugs are
being studied in patients with acquired immunodeficiency syndrome. Although
currently available drugs have improved our ability to manage a variety of viral 
illnesses, much needs to be learned about specific dosage guidelines based on the
studies of pharmacokinetics, pharmacodynamics, potential adverse effects and
viral resistance, and the role of combination therapy to optimize therapy.

Publication Types: 
    Review

PMID: 3556126 [PubMed - indexed for MEDLINE]

6746: Medicine (Baltimore). 1987 May;66(3):157-80.

The neurologic presentation of vasculitic and rheumatologic syndromes. A review.

Sigal LH.

Most rheumatologic and vasculitic syndromes can affect the central nervous system
(CNS). In the vast majority of cases, however, the systemic disease is present at
the time of first CNS manifestations. Certain of these diseases, including SLE,
PSS, Behcet syndrome, cryoglobulinemia and lymphomatoid granulomatoses can
present with CNS findings in the absence of any peripheral evidence of the
underlying process. The CNS presentations of these and the other rheumatologic
and vasculitic syndromes which may affect the CNS are discussed. Isolated CNS
vasculitis may be due to granulomatous angiitis of the nervous system (GANS) or
delayed contralateral hemiplegia following HZO. These are distinct clinical
entities which can be differentiated by clinical and angiographic findings. The
former is often severe and diffuse in nature, whereas the latter is usually
milder and more focal. There are few if any peripheral findings in either
syndrome. The cause of GANS is unknown, but the hemiplegia following HZO is
clearly due to a virus-induced vasculitis spread from the overlying Gasserian
nucleus; the history of preceding herpes zoster ophthalmicus strongly suggests
the diagnosis. The collected evidence suggests that an aggressive evaluation,
including meningeal biopsy, and early therapy with steroids (and perhaps
cytotoxic agents) can alter the prognosis in GANS. It is not clear that
hemiplegia following HZO requires treatment. GANS and HZO-associated CNS damage
should be considered in the differential diagnosis of isolated CNS dysfunction in
the absence of history, signs, or laboratory abnormalities suggestive of systemic
disease.

Publication Types: 
    Review

PMID: 3553845 [PubMed - indexed for MEDLINE]

6747: Indian J Ophthalmol. 1987 May-Jun;35(3):160-1.

Herpes zoster maxillaries--a case report.

Tandon MP, Verma SK.

PMID: 3507414 [PubMed - indexed for MEDLINE]

6748: Br J Ophthalmol. 1987 May;71(5):353-8.

Natural history of herpes zoster ophthalmicus: predictors of postherpetic
neuralgia and ocular involvement.

Harding SP, Lipton JR, Wells JC.

Seventy-one patients presenting with acute herpes zoster ophthalmicus were
followed up for six months for a prospective analysis of the natural history of
the disease. Acute and chronic ocular complications, nasociliary nerve
involvement, age, sex, rash, and pain were assessed, and the results are
presented. Acute pain was measured by a visual analogue scale. Postherpetic
neuralgia (PHN) was more likely in patients over 80 and in those who scored their
pain highly at presentation. Duration of rash was longer in patients who
developed PHN. No other associations between the parameters studied were found.
Nasociliary nerve involvement was associated with subsequent ocular disease.

PMID: 3495293 [PubMed - indexed for MEDLINE]

6749: Surv Ophthalmol. 1987 May-Jun;31(6):384-410.

Acquired immunodeficiency syndrome (AIDS).

Schuman JS, Orellana J, Friedman AH, Teich SA.

The Acquired Immunodeficiency Syndrome (AIDS), caused by the human
immunodeficiency virus (HIV), also called the human T-lymphotropic virus type
III/lymphadenopathy-associated virus [HTLV-III/LAV], has affected over 23,000
people; more than half of those with the disease have died. The actual case
fatality rate approaches 100%. AIDS affects all groups and classes of people,
although some are at special risk. Distribution of the disease is worldwide. The 
illness' effects on the body are widespread; of special interest are the
ophthalmologic manifestations. The eye may be infected by various viruses
(cytomegalovirus, varicella-zoster virus, herpes simplex virus or HIV itself),
toxoplasma gondii, candida sp, cryptococcus neoformans, M. tuberculosis, or M.
avium-intracellulare. Kaposi's sarcoma may affect the eye as well. Retinal
vascular abnormalities (e.g., cotton-wool spots, vasculitis) are not uncommon in 
AIDS. The syndrome may present with neuro-ophthalmologic manifestations. No
effective treatment for the illness is currently available, although several hold
promise and there is hope for an AIDS vaccine. Prevention of infection through
reduction of risks appears to be the only defense against AIDS at this time.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 3303395 [PubMed - indexed for MEDLINE]

6750: Infect Control. 1987 May;8(5):215-8.

Clinical review of ribavirin.

Eggleston M.

The recent approval of ribavirin aerosol for the treatment of severe respiratory 
syncytial virus (RSV) in infants and young children is a significant addition to 
the antiviral drugs available today. When administered as an aerosolized form by 
face mask or mist tent for 20 to 21 hours per day, ribavirin effectively
decreases the symptoms of RSV infection and the shedding of RSV virus. Studies of
other viral infections such as viral hepatitis, influenza A and B, Lassa fever,
genital herpes, and herpes zoster have demonstrated promising, but inconclusive
results. Further studies are needed to justify ribavirin therapy for these
indications.

Publication Types: 
    Review

PMID: 3298116 [PubMed - indexed for MEDLINE]

6751: J Clin Microbiol. 1987 May;25(5):958-9.

Detection of herpes simplex virus in direct specimens by immunofluorescence assay
using a monoclonal antibody.

Pouletty P, Chomel JJ, Thouvenot D, Catalan F, Rabillon V, Kadouche J.

A monoclonal antibody (MAb), designated CHA 437, was developed against herpes
simplex virus (HSV). This MAb (isotype, immunoglobulin G2b K) reacted with HSV
type 1 and HSV type 2. It showed no cross-reactivity with varicella-zoster virus,
cytomegalovirus, or Epstein-Barr virus. Direct detection of HSV antigen in
clinical specimens using indirect immunofluorescence with this MAb was compared
with tissue culture isolation. For the 682 specimens tested, the direct specimen 
test gave a sensitivity of 84.6% and a specificity of 95.7%.

Publication Types: 
    Comparative Study

PMID: 3034970 [PubMed - indexed for MEDLINE]

6752: J Infect Dis. 1987 May;155(5):959-67.

Aseptic meningitis due to varicella-zoster virus: serum antibody levels and local
synthesis of specific IgG, IgM, and IgA.

Echevarria JM, Martinez-Martin P, Tellez A, de Ory F, Rapun JL, Bernal A, Estevez
E, Najera R.

We used an indirect enzyme immunoassay to describe the evolution of serum levels 
and the intrathecal production of IgG, IgA, and IgM antibodies to
varicella-zoster virus (VZV) in eight patients with a syndrome of acute aseptic
meningitis (AAM) and evidence of intrathecal production of VZV-specific IgG
antibodies. Four of the eight patients showed no cutaneous zoster while
hospitalized. Our results suggested an etiologic relation between VZV and AAM in 
all cases. Furthermore, we observed some differences in the pattern of evolution 
of antibodies in serum and cerebrospinal fluid in relation to the presence or
absence of cutaneous lesions in our patients. These differences could reflect
different pathogenic mechanisms in the spread of VZV to the central nervous
system and in the production of the AAM syndrome.

PMID: 3031175 [PubMed - indexed for MEDLINE]

6753: Masui. 1987 May;36(5):771-7.

[Factors influencing the prognosis of herpetic pain--statistical analysis of
cases with acute herpes zoster]

[Article in Japanese]

Shiotani M.

Publication Types: 
    English Abstract

PMID: 2443732 [PubMed - indexed for MEDLINE]

6754: Ned Tijdschr Geneeskd. 1987 Apr 25;131(17):721-5.

[Facial nerve paralysis]

[Article in Dutch]

Devriese PP.

PMID: 3587388 [PubMed - indexed for MEDLINE]

6755: Br Med J (Clin Res Ed). 1987 Apr 11;294(6577):974.

Oral acyclovir in acute herpes zoster.

Juel-Jensen BE.

Publication Types: 
    Letter

PMID: 3107684 [PubMed - indexed for MEDLINE]

6756: Arch Otolaryngol Head Neck Surg. 1987 Apr;113(4):397-400.

Evidence of persistent viral infection in Meniere's disease.

Williams LL, Lowery HW, Shannon BT.

Aspects of humoral and cell-mediated immunity that might characterize the
continuation of symptoms in 25 patients with chronic Meniere's disease were
examined. We found significant elevations of both humoral and cellular immune
responses to viral antigens of herpes simplex I, varicella-zoster, rubella, and
cytomegalovirus. Serum immunoglobulins were quantitatively abnormal in 24 of 25
patients, without a consistent pattern. These immune responses may be linked to
persistent viral infection in chronic Meniere's disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3814390 [PubMed - indexed for MEDLINE]

6757: Reg Anaesth. 1987 Apr;10(2):55-8.

[Indications and possibilities of blockade of the sympathetic nerve]

[Article in German]

Meyer J.

Treatment of chronic pain through permanent or temporary interruption of
sympathetic activity is marked by great clinical success, but nevertheless there 
are rather skeptical reports about long-term results of these blocks as
therapeutic measures. There are many symptoms and signs of chronic pain, while
diagnosis is expensive, the pathogenesis is complex, and the etiology is
generally due to multiple factors. Indications for sympathetic blockade depend
upon the possible means of access, as in the cervicothoracic, thoracic, lumbar,
or sacral regions. General indications are: symptoms not limited segmentally
within peripheral body areas; pain resulting from microtraumata and lesions of
peripheral nerve branches; and pain caused by intensified sympathetic tone with
consequent circulatory disturbances. Peripheral circulatory disturbances are the 
most common indication for sympathetic blockade, as the block produces a
vasomotor reaction that leads to increased capillary circulation. Pain caused by 
herpes zoster, sudden hearing loss, hyperhidrosis, and pseudesthesia can also be 
influenced by sympathetic blockade. There are several possibilities for reducing 
or interrupting sympathetic activity; for us, however, blocking of the
sympathetic trunk is the most important. During the last 16 years we performed
15,726 sympathetic blockades on 2385 patients, which included: 3735 stellate
ganglion blocks, 6121 blocks of the lumbar sympathetic trunk, 5037 continuous
peridural anesthesias, 29 blocks of the thoracic sympathetic trunk, and 12 celiac
blocks. In 792 cases sympathetic blocks were performed using neurolytic drugs, in
most cases 96% ethyl alcohol and less often 10% ammonium sulphate. Other
possibilities, such as enteral administration or infusion of sympatholytic drugs,
were not taken into consideration; regional intravascular injection of
guanethidine can be recommended, however.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    English Abstract

PMID: 3615980 [PubMed - indexed for MEDLINE]

6758: Med Monatsschr Pharm. 1987 Apr;10(4):100-2.

[Herpes zoster (shingles)]

[Article in German]

Cremer H.

PMID: 3587110 [PubMed - indexed for MEDLINE]

6759: Nippon Ika Daigaku Zasshi. 1987 Apr;54(2):153-61.

[Delayed hypersensitivity response in patients with herpes zoster]

[Article in Japanese]

Yajima J.

Publication Types: 
    English Abstract

PMID: 3584405 [PubMed - indexed for MEDLINE]

6760: J Am Acad Dermatol. 1987 Apr;16(4):883-4.

Herpes zoster incidence in younger age groups.

Funaki B, Elpern DJ.

Publication Types: 
    Letter

PMID: 3571553 [PubMed - indexed for MEDLINE]

6761: Am J Med. 1987 Apr;82(4):861-3.

Herpes zoster and zosteriform herpes simplex virus infections in immunocompetent 
adults.

[No authors listed]

Publication Types: 
    Letter

PMID: 3565445 [PubMed - indexed for MEDLINE]

6762: Clin Pediatr (Phila). 1987 Apr;26(4):177-80.

Sporadic congenital Caffey's disease.

Marshall GS, Edwards KM, Wadlington WB.

Caffey's disease is an inflammatory skeletal disorder of infancy manifested
clinically by fever, soft-tissue swelling, and constitutional signs with
radiographic evidence of periosteal new bone formation. Although prevalent
between 1940 and 1960, nonfamilial cases have become extraordinarily rare. The
authors report the sporadic occurrence of congenital Caffey's disease in a
premature infant and note an interesting association with maternal herpes zoster 
early during gestation. The etiology of this mysterious disease is likely to
remain elusive as new cases become scarce.

Publication Types: 
    Case Reports

PMID: 3549106 [PubMed - indexed for MEDLINE]

6763: SAAD Dig. 1987 Apr;6(10):216-21.

Update on antiviral drugs. Acyclovir in dental practice.

Cawson RA.

PMID: 3473693 [PubMed - indexed for MEDLINE]

6764: Rheum Dis Clin North Am. 1987 Apr;13(1):47-56.

Studies of immunosuppressive drugs in the treatment of lupus nephritis.

Klippel JH, Austin HA 3rd, Balow JE, leRiche NG, Steinberg AD, Plotz PH, Decker
JL.

Long-term, controlled trials to evaluate the efficacy and toxicities of
immunosuppressive drug therapies compared to treatment with corticosteroids alone
in the management of patients with lupus nephritis have been performed. The
studies demonstrate that immunosuppressive drug regimens, particularly
intravenous cyclophosphamide, reduce the likelihood of end-stage renal failure.
However, toxicities such as herpes zoster and ovarian failure were found to be
increased in patients with cyclophosphamide.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3306824 [PubMed - indexed for MEDLINE]

6765: J Dermatol. 1987 Apr;14(2):126-31.

Rabbit zosteriform eruption induced by intra-arterial inoculation of herpes
simplex virus, type 1.

Matsubara M, Kishimoto S, Yasuno H, Sotomatsu S, Yoshioka A, Tanaka A, Ueda K,
Ohashi M.

PMID: 3038980 [PubMed - indexed for MEDLINE]

6766: Virus Res. 1987 Apr;7(2):117-29.

Varicella-zoster virus infection of human mononuclear cells.

Gilden DH, Hayward AR, Krupp J, Hunter-Laszlo M, Huff JC, Vafai A.

Varicella-zoster virus (VZV) DNA was detected in mononuclear cells (MNC) of 7
humans with acute zoster 1-23 days after the onset of skin lesions. To further
study the interaction of VZV with human MNC, cells obtained from seropositive
normal donors were infected with VZV and analyzed for the presence of viral DNA
and proteins. VZV-DNA was detected in T, B, and OKM 1 (monocyte-macrophage)
positive cells, and virus-specific proteins were demonstrated by indirect
immunofluorescence and immunoprecipitation. Hybridization studies revealed that
VZV-DNA did not replicate in human MNC.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3035815 [PubMed - indexed for MEDLINE]

6767: Virology. 1987 Apr;157(2):552-5.

Identification of an Epstein-Barr virus glycoprotein which is antigenically
homologous to the varicella-zoster virus glycoprotein II and the herpes simplex
virus glycoprotein B.

Emini EA, Luka J, Armstrong ME, Keller PM, Ellis RW, Pearson GR.

The Epstein-Barr virus (EBV) antigenic homologue of the varicella-zoster virus
glycoprotein II and the herpes simplex virus (HSV) glycoprotein B (gB) was
identified through cross-reactivity with anti-glycoprotein II and
anti-glycoprotein B peptide sera. The homologue is the previously characterized
EBV glycoprotein, with an apparent molecular weight of 125,000 Da, which is
synthesized late during productive EBV infection and appears to be encoded by the
BamHI A EBV fragment. This glycoprotein, but not other EBV proteins, reacted with
the antisera in immunoprecipitation experiments and by ELISA. In addition,
absorption of the sera with the purified EBV 125-kDa glycoprotein removed the
cross-reacting antibody. Whether the EBV gB homologue has the same biological
functions associated with HSV gB has yet to be determined.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 3029988 [PubMed - indexed for MEDLINE]

6768: J Infect Dis. 1987 Apr;155(4):633-40.

Molecular epidemiology of live, attenuated varicella virus vaccine in children
with leukemia and in normal adults.

Gelb LD, Dohner DE, Gershon AA, Steinberg SP, Waner JL, Takahashi M, Dennehy PH, 
Brown AE.

Restriction endonuclease analysis of varicella-zoster virus (VZV) DNA has been
used in unraveling the complex epidemiology of VZV infections in individuals
immunized with a live, attenuated varicella virus vaccine. Early rashes appearing
within the first six weeks after vaccination are invariably due to vaccine virus.
True breakthrough infections with wild-type VZV also occur in vaccinees. Five
cases of zoster have been seen in leukemic children vaccinated while in
remission. One case appeared 22 months after vaccination in the same general area
as the inoculation. The virus isolated was vaccine derived. A second case of
zoster appeared in a dermatome unrelated to the sites of vaccination
approximately 19 months after apparently natural varicella. This virus was wild
type. Vaccine virus can therefore establish latency and can later reactivate as
herpes zoster.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 3029239 [PubMed - indexed for MEDLINE]

6769: Cutis. 1987 Apr;39(4):352-3.

Capsaicin in the treatment of dermatologic disease.

Bernstein JE.

Capsaicin cream is the first of a class of neuropeptide active agents to be
introduced into dermatologic therapy. Capsaicin's effects appear primarily
related to its ability to deplete the neuropeptide substance P from local sensory
terminals in the skin. The use of capsaicin cream in the treatment of
postherpetic neuralgia and psoriasis is discussed. I believe that capsaicin and
other neuropeptide active agents may become important therapeutic modalities for 
the dermatologist in the near future.

PMID: 2438089 [PubMed - indexed for MEDLINE]

6770: Lancet. 1987 Mar 28;1(8535):728-31.

Risk of AIDS after herpes zoster.

Melbye M, Grossman RJ, Goedert JJ, Eyster ME, Biggar RJ.

In a closed internal medicine practice for homosexual men in Central Manhattan
herpes zoster developed in 112 men between 1980 and mid-1986. In these patients
the incidence of acquired immunodeficiency syndrome (AIDS) was high: Kaplan-Meier
survival analysis indicated cumulative incidences of AIDS of 22.8% within 2 years
after herpes zoster, 45.5% within 4 years, and an estimated 72.8% after 6 years. 
Severity of zoster (relative risk, RR = 4.6), degree of pain (RR = 3.4), and
zoster of the cranial or cervical dermatomes (RR = 2.2) were all associated with 
a poor outcome. Oral thrush, oral hairy leucoplakia, amoebiasis, and superficial 
(tinea) fungal infections also indicated an increased risk of AIDS among zoster
patients. Oral thrush and oral hairy leucoplakia manifestations were diagnosed an
average of 1.2 and 1.1 years, respectively, after the diagnosis of herpes zoster;
thus zoster is an early indicator of an impaired immunity. Herpes zoster can be
used as a predictor of AIDS and in AIDS risk groups should be regarded as a poor 
prognostic sign.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2882139 [PubMed - indexed for MEDLINE]

6771: Med Clin (Barc). 1987 Mar 21;88(11):476-7.

[Meningoencephalitis and ocular herpes zoster]

[Article in Spanish]

[No authors listed]

Publication Types: 
    Letter

PMID: 3494892 [PubMed - indexed for MEDLINE]

6772: Med Clin (Barc). 1987 Mar 14;88(10):432-3.

[Hypoglycorrhachia in varicella zoster meningoencephalitis]

[Article in Spanish]

Pujadas R, Fernandez-Monras F, Sort MD, Jane J.

Publication Types: 
    Case Reports
    Letter

PMID: 3573843 [PubMed - indexed for MEDLINE]

6773: Br Med J (Clin Res Ed). 1987 Mar 14;294(6573):704.

Oral acyclovir in acute herpes zoster.

Marsh RJ, Cooper M.

Publication Types: 
    Letter

PMID: 3105699 [PubMed - indexed for MEDLINE]

6774: Dtsch Med Wochenschr. 1987 Mar 6;112(10):407-8.

[Pain intensity and outcome in acute herpes zoster under acyclovir therapy]

[Article in German]

Christe W, Kolmel HW.

PMID: 3816588 [PubMed - indexed for MEDLINE]

6775: Wien Klin Wochenschr. 1987 Mar 6;99(5):149-53.

[Physical treatment of herpetic diseases. Report of a pilot study with
low-frequency electrotherapy]

[Article in German]

Hein L, Ammer K, Rathkolb O, Krcevsky N.

Standard methods employed in physiotherapy are seldom applied to florid herpes
zoster since they bring little benefit. Initial experience with electrotherapy
for herpes is reported. Pulsed galvanic current at a frequency of 30 hertz was
applied to the region of the affected segmental nerve. In two centres (Vienna and
Maribor) treatment was carried out on 32 patients with herpes zoster (recovery in
Vienna after a mean duration of treatment of 6.3 days; in Maribor recovery after 
20 days of treatment) and 18 patients with herpes simplex (recovery after 5 or
6.5 days respectively) were treated. Follow up of all patients treated in Vienna 
showed that only one patient out of the zoster group developed post-herpetic
neuralgia. Three patients with herpes simplex had a relapse of the disease, but
it was less severe than before treatment. The better results in Vienna were
explained by the use of strictly monopolar wave forms and the fact that treatment
was applied every day, while in Maribor patients received no treatment over a
weekend.

Publication Types: 
    English Abstract

PMID: 3495073 [PubMed - indexed for MEDLINE]

6776: Am J Med. 1987 Mar;82(3):560-2.

Rapid response to acyclovir in herpes zoster-associated encephalitis.

Johns DR, Gress DR.

A previously healthy patient became acutely encephalopathic, with complete
disorientation and amnesia, several days after the onset of thoracic herpes
zoster. She had transiently abnormal electroencephalographic results,
abnormalities on radionuclide brain scanning, and cerebrospinal fluid
pleocytosis. There was no evidence of a toxic/metabolic encephalopathy except for
a mildly elevated ammonia level. Intravenously administered acyclovir (30 mg/kg
per day) induced a dramatic response, with complete resolution of the
encephalopathy within 72 hours and normalization of the electroencephalographic
results. The scant clinical experience with the successful use of acyclovir in
the treatment of herpes zoster-associated encephalitis is reviewed.

Publication Types: 
    Case Reports

PMID: 3826110 [PubMed - indexed for MEDLINE]

6777: Postgrad Med. 1987 Mar;81(4):321-2.

Postherpetic neuralgia. Prevention and treatment.

Diamond S.

PMID: 3822967 [PubMed - indexed for MEDLINE]

6778: Dig Dis Sci. 1987 Mar;32(3):318-22.

Transient gastroparesis associated with cutaneous herpes zoster.

Kebede D, Barthel JS, Singh A.

We report a patient who developed delayed gastric emptying with vomiting and
weight loss simultaneously with herpes zoster in the sixth right thoracic
dermatome. Sequential radionuclide solid egg meal gastric emptying studies were
used to document gastroparesis, the response to metoclopramide and its transient 
nature. We present a possible explanation for this phenomenon within the context 
of the known pathophysiology of varicella-zoster infection.

Publication Types: 
    Case Reports

PMID: 3816485 [PubMed - indexed for MEDLINE]

6779: Yale J Biol Med. 1987 Mar-Apr;60(2):159-67.

Latent herpesvirus infections of neurons in guinea pigs and humans.

Tenser RB, Hyman RW.

Latent herpes simplex virus (HSV) infection of the trigeminal ganglion of guinea 
pigs and latent varicella-zoster virus (VZV) infection of the trigeminal ganglion
of humans were studied by in situ nucleic acid hybridization. Guinea pig
trigeminal ganglia were removed during the period of viral latency (four to five 
weeks after corneal inoculation of HSV), and human ganglia were removed at
autopsy. Radiolabeled HSV and VZV DNAs were used to probe ganglion tissue
sections for viral-specified RNA. Hybridization detected only over neurons was
present in 46 percent of ganglia from 22 latently infected guinea pigs and from
33 percent of ganglia from 10 human subjects. These results support the
conclusion that some viral transcription occurred during HSV and VZV latency.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3495074 [PubMed - indexed for MEDLINE]

6780: Am Fam Physician. 1987 Mar;35(3):121-8.

Herpes zoster ophthalmicus.

Bucci FA Jr, Savia PV Jr, Mauriello JA Jr.

The incidence and severity of herpes zoster ophthalmicus have increased because
of the growing number of immunocompromised patients. Uveitis and keratitis are
the most common inflammatory complications. Corneal exposure from scarring and
contraction of the upper lid may require reconstructive plastic surgery.
Preliminary studies of oral acyclovir, specifically targeted at preventing ocular
complications, are encouraging.

PMID: 3493673 [PubMed - indexed for MEDLINE]

6781: J Oral Maxillofac Surg. 1987 Mar;45(3):264-6.

Spontaneous tooth exfoliation and osteonecrosis following a herpes zoster
infection of the fifth cranial nerve.

Mostofi R, Marchmont-Robinson H, Freije S.

Spontaneous exfoliation of teeth and osteonecrosis of the alveolar bone are rare 
complications of HZ infection that usually follow the acute phase of infection.
Awareness of osteonecrosis associated with secondary HZ infection is important
for early detection and treatment of the condition to prevent further
complications, particularly in high-risk patients.

Publication Types: 
    Case Reports

PMID: 3469368 [PubMed - indexed for MEDLINE]

6782: Infection. 1987 Mar-Apr;15(2):93-8.

Serologic detection of active infections with human herpes viruses (CMV, EBV,
HSV, VZV): diagnostic potential of IgA class and IgG subclass-specific
antibodies.

Doerr HW, Rentschler M, Scheifler G.

In 175 sera from healthy persons as well as those suffering from primary or
secondary herpes virus infections/reactivations, serum antibodies were assessed
by an indirect ELISA in the immunoglobulin classes A, G and M and the subclasses 
G1-4, using carrier-fixed antigens (CMV, VZV, HSV) and monoclonal tracer
antibodies. In a similar way EBV-specific antibodies were tested by an indirect
IFT. Only IgG1 antibodies were detectable in nearly all persons. Virus-specific
IgA and IgG3 may support conventional serological methods (IgM, IgG) indicating
recent infection/reactivation with VZV, EBV and possibly CMV. Furthermore,
differentiation of primary and secondary CMV and VZV infection was possible in
some cases, when IgG3 was detectable before IgG1 in subsequent blood specimens.
Recurrent herpes lesions could not be diagnosed serologically.

PMID: 3036714 [PubMed - indexed for MEDLINE]

6783: Eur J Immunol. 1987 Mar;17(3):359-64.

Hybridomas producing human monoclonal antibodies against varicella-zoster virus.

Sugano T, Matsumoto Y, Miyamoto C, Masuho Y.

Hybridomas producing human monoclonal antibodies (mAb) against varicella-zoster
virus (VZV) were generated by fusing human splenic lymphocytes with mouse myeloma
cells. Before cell fusion, lymphocytes were stimulated in vitro with viral
antigens and pokeweed mitogen. This combination synergistically increased the
generation of VZV-specific hybridomas. Five established hybridomas have been
stably producing mAb for at least 9 months. These mAb, designated V1, V2, V6, V8 
and V9, were of the IgG1, lambda isotype. They bound to all 6 tested VZV strains 
but not to other herpes viruses, with the exception that V1 bound to herpes
simplex virus (HSV) as well as VZV. Immunoprecipitation analysis showed that V1, 
V6 and V9 recognized glycoprotein gpII, whereas V2 and V8 recognized gpI. In
addition, V1 reacted with the gB glycoprotein of HSV. All these mAb neutralized
viral infectivity. The neutralizations by V2 and V8 were more effective and more 
complement dependent than those by V1, V6 and V9. Immunofluorescence tests
revealed that all these mAb bound to the surface membrane of VZV-infected cells. 
These results suggest that cell fusion between in vitro stimulated lymphocytes
and mouse myeloma cells is a reliable method for the generation of hybridomas
capable of stable production of human mAb. The human mAb thus developed may
provide a new means of passive immunization of humans against VZV infection.

PMID: 3032647 [PubMed - indexed for MEDLINE]

6784: J Neurol Neurosurg Psychiatry. 1987 Mar;50(3):247-51.

Search for viral nucleic acid sequences in the post mortem brains of patients
with schizophrenia and individuals who have committed suicide.

Carter GI, Taylor GR, Crow TJ.

Molecular hybridisation has been used to screen several areas of post mortem
brain from 20 patients with schizophrenia, 23 individuals who were suspected of
having committed suicide and 21 control cases, for viral nucleic acids. Cloned
probes were able to detect picogram levels of viral DNA and to quantify herpes
simplex type 1 DNA from encephalitic brain, but no sequences hybridising to
cytomegalovirus, varicella zoster virus, herpes simplex type I or JC or BK
papovaviruses were detected in any of the experimental samples. These findings
are discussed with reference to the viral hypothesis of the aetiology of
psychiatric disease.

PMID: 3031219 [PubMed - indexed for MEDLINE]

6785: Nippon Shishubyo Gakkai Kaishi. 1987 Mar;29(1):233-43.

[The gingival findings of herpes zoster]

[Article in Japanese]

Fukai K, Otaki K, Hasegawa A, Ishikawa K.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 2851628 [PubMed - indexed for MEDLINE]

6786: Rev Hosp Clin Fac Med Sao Paulo. 1987 Mar-Apr;42(2):55-8.

[Vaccine against varicella-zoster]

[Article in Portuguese]

Nicodemo AC, Nicodemo EL, Amato Neto V.

Publication Types: 
    English Abstract
    Review

PMID: 2831610 [PubMed - indexed for MEDLINE]

6787: Oncogene. 1987 Mar;1(1):13-8.

Transactivation of human immunodeficiency virus by herpesviruses.

Rando RF, Pellett PE, Luciw PA, Bohan CA, Srinivasan A.

Viral Exanthems and Herpesvirus Branch, Centers for Disease Control, Atlanta,
Georgia 30333.

We examined the interaction of human immunodeficiency virus (HIV) and herpes
group viruses. For this purpose, a chimeric plasmid (pLTR-CAT) was constructed in
which the long terminal repeat (LTR) sequences derived from a molecular clone of 
HIV were fused to a bacterial chloramphenicol acetyltransferase gene (CAT).
Transient expression assays in transfected tissue culture cells were used to
monitor the activity of the LTR. Basal levels of CAT activity were measured in
HeLa and human lung fibroblast (HLF) cells transfected with pLTR-CAT. When HeLa
or HLF cells transfected with pLTR-CAT were infected with herpesviruses, HIV
LTR-directed expression of the CAT gene was detected. An enhancement of the HIV
LTR-directed expression of CAT was observed for herpes simplex virus (HSV)-1 and 
HSV-2, cytomegalovirus and varicella zoster virus. Enhanced CAT expression
directed by the LTR was also shown by cotransfection of recombinant plasmids
containing two non-overlapping regions of HSV-1, a fragment from HSV-2 which is
non-colinear with the regions used from HSV-1, the immediate early gene of
pseudorabies virus and the adenovirus early gene EIA. HIV LTR-directed expression
may be a useful model for studying the effects on HIV of various infectious
agents known to be present in individuals with AIDS or HIV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2830574 [PubMed - indexed for MEDLINE]

6788: J UOEH. 1987 Mar 1;9(1):45-51.

[Usefulness of nerve block therapy in patients with herpetic pain]

[Article in Japanese]

Tsubaki T, Fukui J, Tanaka T, Ogata M, Nakamura S.

A retrospective study was performed on 230 patients with Herpes zoster. Among
these patients, 156 patients (67.8%) were over 50 years old. Ninety-four percent 
of the patients who received the nerve block therapy within a month from the
onset became ultimately free from pain while only seventy-nine percent of the
patients upon whom this therapy was started after 2 months or more were relieved 
of pain. It was suggested that the earlier the therapy and the younger the
patients, the more easily herpetic pain could be controlled. In conclusion, it
became apparent that early treatment of Herpes zoster with nerve block therapy,
is extremely important for prevention of post-herpetic neuralgia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2437634 [PubMed - indexed for MEDLINE]

6789: Wiad Lek. 1987 Feb 15;40(4):278-81.

[Use of acyclovir in the treatment of herpes zoster with severe clinical course]

[Article in Polish]

Domanski P, Wankowicz Z, Knapp J.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3617750 [PubMed - indexed for MEDLINE]

6790: J Immunol. 1987 Feb 15;138(4):1229-33.

Analysis of immune function in herpes zoster patients: demonstration and
characterization of suppressor cells.

Cauda R, Grossi CE, Whitley RJ, Tilden AB.

We sought to identify imbalances of immune regulatory cells that might contribute
to the depression of cell-mediated immunity that occurs during an episode of
herpes zoster. Peripheral blood mononuclear cells (PBMC) were obtained from
patients with herpes zoster during the acute (less than 7 days after disease
onset) and convalescent (more than 10 days after disease onset) phases of illness
and from healthy seropositive donors. The PBMC were analyzed for:
lymphoproliferative responses to varicella-zoster virus (VZV) antigens, Leu-3
(helper/inducer):Leu-2 (cytotoxic/suppressor) ratios, and percentages of
suppressor cells as defined by coexpression of the Leu-2 and OKM1 antigens.
Significantly depressed proliferative responses of VZV antigens and Leu-3:Leu-2
ratios, and increased percentages of Leu-2+ OKM1+ suppressor cells were observed 
in PBMC of acute phase herpes zoster patients as compared with the PBMC of
convalescent patients or healthy donors. These differences were also observed in 
individual patients sequentially studied during both phases of disease.
Cryopreserved acute phase PBMC suppressed the proliferative response of
autologous convalescent phase PBMC to VZV antigens, but not to herpes simplex
virus (HSV) antigens. The acute phase PBMC suppressor cell was radiation
sensitive and was identified as a Leu-2+ cell by fluorescence-activated cell
sorting. Thus, depression of cell-mediated immunity during the acute phase of
herpes zoster was associated with a relative increase of lymphocytes expressing a
suppressor cell phenotype and the activation of a radiosensitive Leu-2+
suppressor cell with some degree of antigen specificity.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3027175 [PubMed - indexed for MEDLINE]

6791: Med Clin (Barc). 1987 Feb 14;88(6):249-51.

[Treatment of herpes infections with acyclovir]

[Article in Spanish]

Rello J.

PMID: 3031392 [PubMed - indexed for MEDLINE]

6792: Postgrad Med J. 1987 Feb;63(736):85-9.

Herpes zoster and its neurological complications.

Chang CM, Woo E, Yu YL, Huang CY, Chin D.

Department of Medicine, Queen Mary Hospital, University of Hong Kong.

Ninety-three Chinese patients with cutaneous herpes zoster were seen during a
4-year period. Thoracic zoster occurred most commonly, followed by ophthalmic,
cervical and lumbosacral zoster. Neurological complications were present in
eleven patients (11.8%), the commonest being Ramsay-Hunt syndrome and segmental
limb paresis. The clinical picture, pathogenesis, treatment and outcome of
segmental limb paresis, myelitis and delayed contralateral hemiparesis following 
zoster ophthalmicus are discussed. Nine immunocompromised patients received
intravenous adenine arabinoside (vidarabine) or acycloguanosine (acyclovir), and 
no cutaneous or visceral spread occurred in these patients.

PMID: 3671248 [PubMed - indexed for MEDLINE]

6793: Ann Ophthalmol. 1987 Feb;19(2):77-8.

Optic neuropathy and central retinal artery occlusion in a case of herpes zoster 
ophthalmicus.

Scharf Y, Kraus E, Zonis S.

In this case report the authors present a patient in whom loss of vision
developed in the left eye in the early stage of herpes zoster ophthalmicus. He
suffered from optic neuropathy followed by central retinal artery occlusion.
Ophthalmologists should be aware of this rare and early complication of herpes
zoster.

Publication Types: 
    Case Reports

PMID: 3566029 [PubMed - indexed for MEDLINE]

6794: Br J Ophthalmol. 1987 Feb;71(2):118-25.

The enigma of herpes stromal disease.

McGill J.

Herpes stromal disease is due to direct damage as a result of viral replication, 
virally induced immune mechanisms, or a combination of the two. Viral replication
may have a major initiating role in the production of herpes simplex and herpes
zoster induced stromal disease, and steroids may initially be harmful in their
treatment. On topical antiviral drugs alone, in patients who never previously had
had topical steroids, 14 of 15 cases of herpes simplex induced disciform
keratitis responded favourably in an average of 44 days of treatment. This
compared with one out of 14 responding if steroids had previously been used, 13
of 14 requiring topical steroids and an average 112 days' treatment. In herpes
zoster stromal disease cases 78% had epithelial involvement, 54 of 57 responded
to topical antivirals alone without the use of steroids, 2% recurred, and
treatment averaged a total of 62 days. If steroids were used alone or in
combination with antivirals, there was a 50% recurrence rate and 200 day total
treatment duration.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 3548807 [PubMed - indexed for MEDLINE]

6795: Transplant Proc. 1987 Feb;19(1 Pt 3):2190-3.

Effectiveness of oral acyclovir prophylaxis in renal transplant recipients.

Stoffel M, Squifflet JP, Pirson Y, Lamy M, Alexandre GP.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 3547919 [PubMed - indexed for MEDLINE]

6796: J Am Dent Assoc. 1987 Feb;114(2):235-6.

Multiple oral and labial ulcers in an immunocompromised patient.

Jensen JL, Kanas RJ, DeBoom GW.

Herpes simplex virus infections in immunocompromised individuals have clinical
features that are often quite different from primary and secondary HSV infections
in otherwise healthy people. These infections should be recognized early and
treated promptly to prevent progression of the lesions and the possible systemic 
dissemination of the virus. Cytological and biopsy examination frequently
discloses changes characteristic of HSV-1, HSV-2, or Varicella-zoster virus. To
ensure the most precise diagnosis, however, these examinations should be
complemented by viral isolation and serological studies.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 3469271 [PubMed - indexed for MEDLINE]

6797: Kansenshogaku Zasshi. 1987 Feb;61(2):134-9.

[Herpes zoster in patients with systemic lupus erythematosus]

[Article in Japanese]

Kusaba T, Iwahashi T, Hayashida I, Nagasawa K, Hachimine K, Mayumi T.

Publication Types: 
    English Abstract

PMID: 3039018 [PubMed - indexed for MEDLINE]

6798: Antiviral Res. 1987 Feb;7(2):99-107.

Antiviral activity of glycyrrhizin against varicella-zoster virus in vitro.

Baba M, Shigeta S.

One of the plant extracts, glycyrrhizin (GL) was investigated for its antiviral
action on varicella-zoster virus (VZV) in vitro. When human embryonic fibroblast 
(HEF) cells were treated with GL after inoculation of virus (post-treatment), the
average 50%-inhibitory dose (ID50) for five VZV strains was 0.71 mM, and the
selectivity index (ratio of ID50 for host-cell DNA synthesis to ID50 for VZV
replication) was 30. GL was also effective against VZV replication when HEF cells
were treated 24 h before the inoculation (pretreatment). Furthermore, at a
concentration of 2.4 mM GL inactivated more than 99% of virus particles within 30
min at 37 degrees C. In combination with other anti-herpes drugs (acyclovir,
adenine arabinoside, bromovinyldeoxyuridine, and phosphonoformate) or human
native beta-interferon, GL had an additive or slightly synergistic effect on VZV 
replication. The mechanism of anti-VZV action is still unclear. We postulate that
GL inhibits the penetration, uncoating or release of virus particles.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3034150 [PubMed - indexed for MEDLINE]

6799: Ital J Neurol Sci. 1987 Feb;8(1):67-70.

Zoster sine herpete causing encephalomyelitis.

Mancardi GL, Melioli G, Traverso F, Tabaton M, Farinelli M, Terragna A.

The case of a patient with encephalomyelitis and laboratory signs of a central
nervous system herpes zoster infection without cutaneous lesions is reported. The
diagnosis was supported by the serological evidence of intrathecal synthesis of
specific antibodies against Varicella-zoster virus (VZV).

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3032844 [PubMed - indexed for MEDLINE]

6800: Infect Control. 1987 Feb;8(2):48.

Erratum in:
    Infect Control 1987 Aug;8(8):305.

Medical students and community physicians also susceptible to varicella-zoster
virus.

Murray DL.

Publication Types: 
    Letter

PMID: 3030950 [PubMed - indexed for MEDLINE]

6801: Transplant Proc. 1987 Feb;19(1 Pt 3):2142-9.

Viral infections in kidney transplant patients immunosuppressed with
cyclosporine.

Takahashi K, Yagisawa T, Teraoka S, Toma H, Agishi T, Ota K, Kobayashi S.

Publication Types: 
    Case Reports

PMID: 3029916 [PubMed - indexed for MEDLINE]

6802: Obstet Gynecol. 1987 Feb;69(2):214-22.

Varicella-zoster virus infections during pregnancy: hypothesis concerning the
mechanisms of congenital malformations.

Higa K, Dan K, Manabe H.

An analysis of the data on 52 infants whose mothers had contracted varicella
during pregnancy revealed that 27 had congenital malformations ascribed to the
maternal varicella infections, while another 25 developed herpes zoster in the
early postnatal period. Most of the mothers whose infants had congenital
malformations had contracted varicella within the first 20 weeks of gestation,
whereas most of the mothers whose infants developed herpes zoster had varicella
after 21 weeks of gestation. The clinical features of the various congenital
malformations and dysfunctions after maternal varicella were diverse; however,
there were peculiar segmental manifestations of anomalies of the skin, the
peripheral nervous, the autonomic nervous, and the musculoskeletal systems, all
of which receive common innervations from the same levels of the spinal cord.
Most other dysfunctions may be ascribed to an encephalitis. Therefore, the
mechanism of congenital malformations caused by varicella-zoster virus seems to
be due not to fetal varicella but to the development of herpes zoster in utero
and to an encephalitis associated with herpes zoster. At least one infant had
congenital malformations that were due to maternal herpes zoster infection.

Publication Types: 
    Review

PMID: 3027637 [PubMed - indexed for MEDLINE]

6803: J Antimicrob Chemother. 1987 Feb;19(2):255-62.

Efficacy of acyclovir combined with immunopotentiating agents in the treatment of
varicella-zoster.

Tanphaichitra D, Srimuang S.

In-vitro and in-vivo evaluation of cellular immune reactions (T-cell subset,
E-rosette formation, 2,4-dinitrochlorobenzene, were made in patients with
varicella-zoster infection (VZ) and with other intracellular infections. The data
demonstrated depressed cellular immunity including a decrease in the number of
T-helper cells and a fall in the T-helper/T-suppressor lymphocyte subset ratio to
less than 0.7. Three groups of patients with VZ infections were randomly assigned
to three regimens: nine patients were given acyclovir alone for five days; ten
patients received acyclovir for five days and isoprinosine for ten days; and
twelve patients acyclovir for five days and levamisole twice weekly for three
weeks. In patients with VZ infections treated with acyclovir and either
levamisole or isoprinosine cellular immunity improved faster, while VZ infections
in those treated with levamisole healed more rapidly. One patient treated with
acyclovir alone had recurrent VZ infection and required a further course of
therapy.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 2437095 [PubMed - indexed for MEDLINE]

6804: J Clin Microbiol. 1987 Feb;25(2):416-20.

Enzyme immunofiltration staining assay for immediate diagnosis of herpes simplex 
virus and varicella-zoster virus directly from clinical specimens.

Cleveland PH, Richman DD.

A simple, sensitive, 30-min assay for the detection of herpes simplex virus (HSV)
and varicella-zoster virus (VZV) antigens in clinical specimens is described. The
assay utilizes a filter manifold, biotinylated monoclonal antibodies,
streptavidin-horseradish peroxidase conjugate, and the substrate
aminoethylcarbazole. The method stains infected cells and cell debris a bright
red and is easily interpreted with a dissecting microscope. Reconstruction
experiments indicated that as few as two virus-infected cells per swab could be
detected. This was equivalent to an infectivity titer of 29 to 160 50% tissue
culture infective doses per infected cell and 250 times more sensitive than an
enzyme immunofiltration assay which detects a soluble reaction product. Clinical 
swab specimens collected from ocular, oral, skin, and genital lesions were
cultured for virus, and the remaining cell debris was immobilized on glass fiber 
filters and stained for the presence of virus antigens. Of 71 HSV
culture-positive specimens, 66 (93%) were positive for HSV antigens. All of nine 
VZV culture-positive specimens were positive for VZV antigens. Of 98
culture-negative specimens, 7 were positive for either HSV (n = 3) or VZV (n = 4)
antigens.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 2434523 [PubMed - indexed for MEDLINE]

6805: N Engl J Med. 1987 Jan 15;316(3):166-7.

High frequency of herpes zoster in young hemophiliacs.

Verroust F, Lemay D, Laurian Y.

Publication Types: 
    Letter

PMID: 3796690 [PubMed - indexed for MEDLINE]

6806: Pediatr Infect Dis J. 1987 Jan;6(1):84.

Acyclovir treatment in a case of facial paralysis caused by herpes zoster.

Ivarsson S, Andreasson L, Ahlfors K.

Publication Types: 
    Case Reports
    Letter

PMID: 3822626 [PubMed - indexed for MEDLINE]

6807: J Ky Med Assoc. 1987 Jan;85(1):15-7.

Nerve blocks utilizing 0.5% bupivacaine in the treatment of post-herpetic
neuralgia.

Ackerman WE.

PMID: 3819583 [PubMed - indexed for MEDLINE]

6808: Postgrad Med. 1987 Jan;81(1):229-31, 233, 236.

Medical complications of herpes zoster in immunocompetent patients.

Murray BJ.

The vast majority of the more than 300,000 annual cases of herpes zoster in the
United States occur among healthy, immunocompetent persons. Most patients recover
from reactivated varicella-zoster infection, but some experience complications.
The most common of these is postherpetic neuralgia, but other neurologic as well 
as ocular and dermatologic complications can occur as well. Zoster during
pregnancy is not of serious concern. Ongoing trials of antiviral agents are aimed
at resolving the infection quickly and decreasing the incidence and severity of
postherpetic neuralgia.

PMID: 3809038 [PubMed - indexed for MEDLINE]

6809: Anesthesiology. 1987 Jan;66(1):73-6.

No prophylactic effect of early sympathetic blockade on postherpetic neuralgia.

Yanagida H, Suwa K, Corssen G.

PMID: 3800039 [PubMed - indexed for MEDLINE]

6810: J Assoc Pediatr Oncol Nurses. 1987;4(1-2):23-9.

Herpes-zoster infections in children with Hodgkin's disease.

Hammond E.

PMID: 3694499 [PubMed - indexed for MEDLINE]

6811: Ophthalmologica. 1987;195(1):38-44.

Cytological and immunological study of the aqueous humor in acute retinal
necrosis syndrome.

Matsuo T, Nakayama T, Koyama T, Matsuo N.

Department of Ophthalmology, Okayama University Medical School, Japan.

We experienced 4 cases of acute retinal necrosis syndrome, and performed anterior
chamber paracentesis as a diagnostic aid in their acute and convalescent phases. 
The aqueous humor obtained by it was used for measuring antibody titers to herpes
group virus and electron microscopic observation. One case showed elevated titer 
to herpes simplex virus type 1 in the convalescent phase, while the other to
varicella-zoster virus, suggesting that these 2 viruses could cause this disease.
Electron microscopy showed persistent lymphocytes and macrophages throughout the 
course, while plasma cells appeared at the height of the inflammation
corresponding to the locally elevated antibody titers. There was no electron
microscopic evidence of viral infection in the aqueous cells examined.

Publication Types: 
    Case Reports

PMID: 3658335 [PubMed - indexed for MEDLINE]

6812: Eye. 1987;1 ( Pt 3):413-21.

The epidemiology of herpes zoster.

Cooper M.

Moorfields Eye Hospital, London.

The epidemiology of Zoster is analysed by means of data acquired from the Zoster 
Clinic at Moorfields and the RCGP Research Unit. It complements and extends
previous surveys, using much larger and consistent data, showing the effects of
age, sex and season. The behaviour in the population as a whole and the
pathogenesis are discussed; a model is proposed to explain the characteristics of
some of the data, particularly the effects of age and non-specific stresses.

PMID: 3653445 [PubMed - indexed for MEDLINE]

6813: Vestn Dermatol Venerol. 1987;(6):41-3.

[Generalized forms of herpes in lymphocytic leukemia]

[Article in Russian]

Raznatovskii IM, Mikheev GN, Iastrebov VV, Ugriumova LF, Kolb ZK.

Publication Types: 
    Case Reports

PMID: 3630363 [PubMed - indexed for MEDLINE]

6814: Retina. 1987 Spring;7(1):9-13.

Presumed varicella zoster retinitis in immunocompromised patients.

Jabs DA, Schachat AP, Liss R, Knox DL, Michels RG.

The acute retinal necrosis (ARN) syndrome is a morphologically defined
necrotizing retinitis, occurring in apparently otherwise healthy patients. It has
been shown that the varicella zoster virus is at least one cause of the ARN
syndrome; treatment with acyclovir has proven to be effective for the infectious 
component of ARN. We report three immunocompromised patients who developed
cutaneous herpes zoster and a necrotizing retinitis that was morphologically
similar to the ARN syndrome. All three patients responded promptly to treatment
with acyclovir, an agent highly effective against varicella zoster and herpes
simplex viruses, but ineffective in the treatment of cytomegalovirus. While
cytomegalovirus retinitis is more common in immunocompromised patients, these
patients may occasionally develop an ARN-like retinitis, presumably as a result
of the varicella zoster virus, which responds to treatment with acyclovir.

Publication Types: 
    Case Reports

PMID: 3602608 [PubMed - indexed for MEDLINE]

6815: Ter Arkh. 1987;59(4):136-7.

[Herpes zoster--an unusual complication of gold therapy]

[Article in Russian]

Murav'ev IuV, Tsurko VV, Sigidin IaA.

The authors observed the development of herpes zoster in 2 rheumatoid arthritic
patients against a background of chrysanol therapy. Such a complication should be
regarded as an indication for aurum drug cancellation. The study provided an
opportunity for specifying some aspects in the mechanism of action and indicated 
a possible immunodepressive effect.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3589991 [PubMed - indexed for MEDLINE]

6816: Curr Eye Res. 1987 Jan;6(1):231-5.

Acyclovir (Zovirax) ophthalmic ointment: a review of clinical tolerance.

Grant DM.

Twenty nine published clinical trials with acyclovir (ACV) ophthalmic ointment in
the treatment of herpes simplex virus (HSV) corneal disease have been reviewed in
which ACV has been demonstrated to be effective in the treatment of simple
dendritic ulcers, geographic ulcers, deep corneal HSV infections and ocular
disease associated with herpes zoster (VZV) infection affecting the ophthalmic
division of the trigeminal nerve. 998 patients were studied. The most commonly
occurring adverse reactions were superficial punctate keratopathy (in 9.8% of
patients) and burning or stinging on application of the ointment (4%). ACV
ophthalmic ointment was first licensed for the treatment of HSV infections of the
eye in September 1981. Spontaneous reports of adverse reactions to ACV ophthalmic
ointment to both the UK Committee on Safety of Medicines and the Wellcome Group
Adverse Reactions Reporting Centre total 43 cases. These include conjunctivitis, 
inflammation and pain in the treated eye. In this time it is estimated that there
have been approximately one million exposures to the ointment. Thus in general
use, tolerance to ACV treatment has been extremely good, and clinical trial data 
demonstrate that it compares favourably with alternative therapies for HSV
corneal disease.

Publication Types: 
    Clinical Trial
    Review

PMID: 3549163 [PubMed - indexed for MEDLINE]

6817: J Infect. 1987 Jan;14(1):1-5.

Herpes zoster and the immunocompromised.

Mandal BK.

Publication Types: 
    Review

PMID: 3546510 [PubMed - indexed for MEDLINE]

6818: Bull Soc Belge Ophtalmol. 1987;224:9-14.

The management of herpes zoster ophthalmicus.

Collum LM, Hillery M, McDermott M, Benedict-Smith A, Hope-Ross M, Mullaney P,
Kinsella F, Hickey-Dwyer M.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 3509911 [PubMed - indexed for MEDLINE]

6819: Przegl Epidemiol. 1987;41(4):369-75.

[Clinical evaluation of herpes zoster in old age]

[Article in Polish]

Obodowska-Zysk W.

Publication Types: 
    English Abstract

PMID: 3502188 [PubMed - indexed for MEDLINE]

6820: Arch Dermatol Res. 1987;279(6):374-8.

Reduction of the number of immunocompetent cells in the acute stage of herpes
zoster.

Baadsgaard O, Lindskov R, Geisler C.

Department of Dermatology, Gentofte Hospital, Copenhagen.

Circulating and in situ mononuclear cell subsets were phenotypically
characterized during both the acute and convalescent phase of herpes zoster
infections in 14 patients. In peripheral blood a significant reduction in the
absolute number of Leu 4+ T cells, Leu 2a+ suppressor/cytotoxic T cells, Leu 3a+ 
helper/inducer T cells, Leu 7+ killer cells, and B1+ B cells were found during
the acute stage compared to convalescents and normal controls. In contrast no
change in the absolute number of MO2+ monocytes was seen in the acute stage of
the disease. During convalescence a return to normal values in the lymphocyte
subsets and killer cells was seen within 1-2 months after the initial disease
presentation. In skin biopsy specimens from 4 of the 14 patients with active
herpes zoster lesions the cellular infiltrate consisted of T cells (Leu 4+) the
majority being helper/inducer T cells (Leu 3a+). Most of the cells expressed
HLA-DR (Ia) antigens and were according to this in an activated state. The
observed changes in effector and regulatory cell numbers may have implications
for the acquisition of Varicella-zoster virus infections, the immune deficiency
state associated with the disease, and/or the immune response to resolve the
infection.

Publication Types: 
    Case Reports

PMID: 3499870 [PubMed - indexed for MEDLINE]

6821: Clin Exp Neurol. 1987;23:219-24.

Herpes zoster arteritis: pathological findings.

Mackenzie RA, Ryan P, Karnes WE, Okazaki H.

Concord Hospital, New South Wales.

This paper describes the pathological findings in two cases of delayed
contralateral hemiparesis following herpes zoster arteritis. Both died of
cerebral haemorrhage and a necrotizing angiitis was found involving the major
vessels of the ipsilateral cerebral hemisphere. No feature of granulomatous
arteritis or of encephalitis was found. It is likely that the virus spreads along
intracranial branches of the ophthalmic nerve supplying the major arteries and
causes the inflammatory reaction by direct invasion of vascular muscle.

Publication Types: 
    Case Reports

PMID: 3499267 [PubMed - indexed for MEDLINE]

6822: Fortschr Ophthalmol. 1987;84(3):252-4.

[Therapy of bacterial infections in varicella-zoster kerato-uveitis]

[Article in German]

Bialasiewicz AA, Jahn GJ.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3497859 [PubMed - indexed for MEDLINE]

6823: Curr Eye Res. 1987 Jan;6(1):195-9.

Observations on the natural history of herpes zoster ophthalmicus.

Cobo M, Foulks GN, Liesegang T, Lass J, Sutphin J, Wilhelmus K, Jones DB.

We have studied certain aspects of the natural history of acute herpes zoster
ophthalmicus in placebo-treated patients followed prospectively over one year as 
part of a therapeutic drug trial. Observations on the incidence of ocular
complications relating to the efficacy of oral acyclovir in this disease have
been previously published. This report provides supplemental observations on the 
natural history of frequently observed ocular complications of zoster
ophthalmicus: corneal hypesthesia, episcleritis, dendritiform keratopathy,
stromal keratitis, anterior uveitis, and post herpetic neuralgia. These ocular
complications of zoster typically present within the first two weeks of the
diagnosis. This report characterizes the onset of corneal hypesthesia,
episcleritis, dendritiform keratopathy, stromal keratitis, and anterior uveitis
as well as interrelationships amongst these sequellae of herpes zoster
ophthalmicus. Post-herpetic neuralgia occurs in 52% of patients and persists
beyond a year in 22% of those affected.

PMID: 3493883 [PubMed - indexed for MEDLINE]

6824: Acta Neurochir Suppl (Wien). 1987;39:147-50.

Tractotomy and partial vertical nucleotomy--for treatment of special forms of
trigeminal neuralgia and cancer pain of face and neck.

Plangger CA, Fischer J, Grunert V, Mohsenipour I.

Department of Neurosurgery, School of Medicine, University of Innsbruck, Austria.

The therapy of face and neck pain has often been elusive. We attempted to improve
the condition of these patients and tried to influence 1. pain of trigeminal
neuralgia, where other forms of therapy had failed, 2. pain due to tumours in the
distribution of the Vth, IXth and Xth nerve, when all other methods had proved to
be unsuccessful, 3. pain due to a traumatic lesion of the Vth nerve after severe 
injury of the face and 4. pain in the first division of the Vth nerve after
herpes zoster infection, when other forms of therapy had failed. After tractotomy
the subnucleus caudalis n.V. is partially destroyed. Aim of the partial vertical 
nucleotomy is the interruption between the first and second neuron of the Vth
nerve conveying pain and thermal sensibility, but also of the IXth and Xth nerve,
which end in the subnucleus caudalis n.V. as well. Tactile and some thermal
sensibility in the face is so retained, and anesthesia dolorosa or keratitis
neuroparalytica avoided. Medially of and vertically to the tractotomy a 4-6 mm
long incision both cranially and caudally of the tractotomy was made. For the
first division of the Vth nerve the nucleotomy is performed on the lateral end of
the tractotomy incision. In the patients with cancer of the face and neck a
rhizotomy C 1/2 was added. 7 of the 12 patients with trigeminal neuralgia and 3
of the 6 patients with tumors of the face and neck were pain-free. The rest also 
showed a marked improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 3478977 [PubMed - indexed for MEDLINE]

6825: Haematol Blood Transfus. 1987;30:182-7.

Special aspects of supportive therapy in childhood acute leukemias.

Ritter J, Voigt D, Hoese G, Schellong G.

PMID: 3476355 [PubMed - indexed for MEDLINE]

6826: Duodecim. 1987;103(23-24):1494.

[Management of herpes zoster]

[Article in Finnish]

Hanninen P.

PMID: 3455386 [PubMed - indexed for MEDLINE]

6827: Duodecim. 1987;103(11):714-7.

[Varicella zoster encephalitis and its treatment]

[Article in Finnish]

Savola J, Vehvilainen O, Jussila A.

Publication Types: 
    Case Reports

PMID: 3454325 [PubMed - indexed for MEDLINE]

6828: Duodecim. 1987;103(18):1099-1101.

[Varicella-zoster encephalitis and its treatment]

[Article in Finnish]

Suhonen R, Hannuksela M, Karvonen J, Reunala T.

PMID: 3450503 [PubMed - indexed for MEDLINE]

6829: Akush Ginekol (Sofiia). 1987;26(6):84-6.

[A rare case of a complication in ovarian cancer]

[Article in Bulgarian]

Simeonova L, Simeonov S.

Publication Types: 
    Case Reports

PMID: 3442315 [PubMed - indexed for MEDLINE]

6830: Med Pregl. 1987;40(5-6):217-20.

[Herpes zoster in lymphoproliferative diseases]

[Article in Croatian]

Svilar V, Cvetic L.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3441234 [PubMed - indexed for MEDLINE]

6831: Zh Nevropatol Psikhiatr Im S S Korsakova. 1987;87(10):1455-7.

[Differential diagnosis of paralytic poliomyelitis and paralytic herpes zoster in
a child with a congenital immunologic deficiency state]

[Article in Russian]

Smirnov IuK.

A child aged 4 years and 10 months with congenital immunodeficient status
(agammaglobulinemia) developed an acute viral disease combined with torpid arm
paralysis, which is considered as paralytic zoster. This disorder is
differentiated from the spinal form of poliomyelitis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3425044 [PubMed - indexed for MEDLINE]

6832: Ophthalmologica. 1987;194(2-3):145-9.

New approaches to the detection of locally produced antiviral antibodies in the
aqueous of patients with endogenous uveitis.

Dussaix E, Cerqueti PM, Pontet F, Bloch-Michel E.

A local synthesis of IgG antibodies against herpes simplex virus,
cytomegalovirus, varicella-zoster virus and Chlamydia trachomatis was assayed for
in aqueous humor and sera from 226 patients with various clinical types of
uveitis. Comparison of the ratios of specific antibodies tested for in aqueous
humor and serum (C') and the evaluation of the Goldmann-Witmer coefficient (C) to
each specific antibody were simultaneously studied in each case. The combination 
of these two methods allowed for the diagnosis of viral uveitis in 37.7% of
selected uveitis patients and in 13.27% of randomized uveitis patients.

PMID: 3302799 [PubMed - indexed for MEDLINE]

6833: Infection. 1987;15 Suppl 1:S9-13.

Oral acyclovir for acute herpes zoster infections in immune-competent adults.

Wood MJ, McKendrick MW, McGill JI.

Previous studies have shown that intravenous acyclovir does modify rash
development, reduce viral shedding and alleviate acute pain in herpes zoster. To 
assess the clinical efficacy of an oral dosage regimen with 800 mg acyclovir five
times daily, double-blind, placebo-controlled studies were carried out at three
centres within the U.K., using a common protocol. According to inclusion criteria
(immune competent patients over 60 years of age with a clinical diagnosis of
herpes zoster with rash of no more than 72 h duration, no previous systemic
antiviral treatment, no history of renal insufficiency) 205 patients were
recruited after they had given their informed consent. Patients were randomly
assigned to receive either two 400 mg tablets acyclovir (41 men, 59 women) or
matching placebo (46 men, 59 women) five times daily for seven days. Treatment
was predominantly domiciliary based. According to clinical assessment and pain
score acyclovir recipients showed a significant benefit in terms of reduction in 
rash progression if treatment was started within 48 h of the onset of rash, and
alleviation of pain during the acute phase of herpes zoster. Overall, the number 
of patients developing extradermal lesions was significantly lower in the
acyclovir group than in the placebo group (p = 0.02). However, there were no
significant differences in rash progression and pain response in patients with
herpes zoster affecting the ophthalmic division of the trigeminal nerve in
patients who received acyclovir (n = 21) compared to those who received placebo
(n = 32). 12 acyclovir and 13 placebo recipients reported symptoms, predominantly
gastrointestinal in nature, possibly or probably related to therapy.(ABSTRACT
TRUNCATED AT 250 WORDS)

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 3298071 [PubMed - indexed for MEDLINE]

6834: Clin Exp Neurol. 1987;24:169-74.

Herpes zoster arteritis. Clinical and angiographic features.

Herkes GK, Storey CE, Joffe R, Mackenzie RA.

Department of Neurology, Royal North Shore Hospital, NSW.

Herpes zoster ophthalmicus is a common condition, and has now been widely
recognised as associated with the delayed onset of neurological events,
associated with angiographic evidence of arteritis. The time lag between the
zoster and subsequent neurological symptoms, along with the age of the patients, 
often leads to a missed diagnosis. As more cases are recognised, the pathogenic
mechanisms will be better characterised and treatment may become more effective.

Publication Types: 
    Case Reports

PMID: 3268343 [PubMed - indexed for MEDLINE]

6835: Arch Odonto Estomatol. 1987 Jan-Feb;3(1):45-8.

[Herpes zoster with bilateral involvement of the oral mucosa]

[Article in Spanish]

Bullon Fernandez P, Camacho Martinez F.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3136734 [PubMed - indexed for MEDLINE]

6836: Cornea. 1987;6(4):283-5.

Secondary bacterial keratitis in herpes zoster ophthalmicus.

Lyon DB, Newman SA.

Department of Ophthalmology, University of Virginia School of Medicine,
Charlottesville 22903.

We report a case of an unusual complication of herpes zoster ophthalmicus,
secondary bacterial keratitis. Compared with previously reported cases, ours is
unique in its early occurrence in the course of zoster and the lack of
predisposing factors such as steroid use, contact lens use, or prior corneal
disease or surgery. The opportunistic pathogen Branhamella cattarhalis responded 
well to medical therapy. We feel that bacterial superinfection must always be a
concern in patients with herpes zoster keratitis, even early in their often
prolonged chronic disease.

Publication Types: 
    Case Reports

PMID: 3121255 [PubMed - indexed for MEDLINE]

6837: Pediatrician. 1987;14 Suppl 1:15-7.

Differential diagnosis of unusual skin diseases in infants.

Honda M.

There are a number of relatively unique clinical skin diseases that may develop
on the buttocks of infants. These include iatrogenic skin diseases caused by
external medicine; skin tumors caused by methylrosaniline chloride (Pyoktanin);
atrophy of the skin due to steroidal liniments; nevus and tumor diseases, such as
nevoxanthoendothelioma and Letterer-Siwe disease. Finally, there is chronic
granulomatous disease. These unusual cases are reviewed and their differential
diagnoses discussed.

Publication Types: 
    Case Reports

PMID: 3110751 [PubMed - indexed for MEDLINE]

6838: Infection. 1987;15 Suppl 1:S32-3.

Management of viral infections in AIDS patients.

Drucker JL, King DH.

Viral infections, predominantly those of the herpes virus family, account for up 
to 16% of all clinically significant infections in AIDS patients. Acyclovir has
provided successful treatment in AIDS patients suffering from severe herpes
simplex and herpes zoster virus infections. Preliminary results are presented on 
newly developed acyclovir analogues. Desciclovir, an oral prodrug of acyclovir
which is metabolized to acyclovir in vivo, allows treatment of virus infections
per os, where high serum levels are needed, e.g. in Epstein-Barr virus
infections. BW B759U, another analogue of acyclovir, has been used for the
treatment of life-threatening or sight-threatening cytomegalovirus infections in 
AIDS patients. More than 80% of the patients treated for retinitis experienced
stabilization or clinical improvement. Antiviral efficacy was demonstrated in 73%
of the patients. Azidothymidine, a nucleoside analogue of thymidine, has been
developed specifically to treat the HIV infection. Its antiviral activity is
based on inhibition of reverse transcriptase. Phase I studies have demonstrated
that azidothymidine is well tolerated. Its ability to cross the blood brain
barrier makes it an attractive candidate for treatment of HIV. Trials to
determine efficacy are in progress.

PMID: 3036716 [PubMed - indexed for MEDLINE]

6839: Laryngol Rhinol Otol (Stuttg). 1987 Jan;66(1):41-4.

[Therapy of herpes simplex and varicella zoster infections in the ENT area]

[Article in German]

Elies W, Hermes H, Schlondorff G.

The article reports on 41 patients having infections induced by Herpes simplex
and Herpes zoster virus. Systemic intravenous administration of acyclovir results
in a very rapid reduction of pain and mucosal changes in herpetic stomatitis. In 
cutaneous lesions of the trigeminal nerve branches induced by Herpes zoster virus
there is also a very rapid reduction of pain and efflurescence after 3 days. In
16 patients suffering from Ramsay Hunt syndrome, also known as Herpes zoster
oticus, lesions of the facial nerve function were present. 8 Patients
demonstrated cochleovestibular signs and symptoms, 2 had flat inner ear hearing
loss of 40 dB, 1 reduced unilateral caloric response. Treatment was effected by
intravenous administration of acyclovir and simultaneous classical symptomatic
therapy consisting of intravenously administered dextrane, cortisone and
antiinflammatory drugs. Symptomatic therapy is necessary because acyclovir stops 
the replication of viruses but does not influence the disturbed nerve function.
In 2 cases with a damage of more than 90% of the facial nerve fibres, endaural
decompression of the geniculate ganglion was performed. Cochleovestibular
deficits improved to normal during one week and all facial lesions within 8
months. Drug-related side effects were seen in one patient who had an exanthema.

Publication Types: 
    English Abstract

PMID: 3031395 [PubMed - indexed for MEDLINE]

6840: Pediatr Infect Dis J. 1987 Jan;6(1):56-8.

Oral therapy with acyclovir in infants and children.

Arvin AM.

Publication Types: 
    Review

PMID: 3029659 [PubMed - indexed for MEDLINE]

6841: J Med Virol. 1987 Jan;21(1):57-66.

Detection of varicella-zoster virus in lymphocytes by DNA hybridization.

Vonsover A, Leventon-Kriss S, Langer A, Smetana Z, Zaizov R, Potaznick D, Cohen
IJ, Gotlieb-Stematsky T.

The availability of cloned varicella-zoster virus (VZV) DNA probes allows rapid
detection of viral-specific DNA by "dot-blot" hybridization in lymphocytes or in 
lesion aspirates. Thirty-six blood specimens were obtained from 25 patients with 
suspected varicella or zoster. VZV-specific DNA was demonstrated in 15 lymphocyte
preparations of nine patients with varicella and in one with disseminated zoster 
out of five patients with zoster. VZV-specific DNA was detected prior to rise in 
antibodies, indicating early viremia in these patients. Virus isolation from
lesions and serological tests confirmed VZV infections. VZV-specific DNA was
detected in lymphocytes of three patients out of six with active herpetic
lesions, whereas it was not detected in lymphocyte specimens from two patients
with undiagnosed rash or four with lymphoproliferative diseases, who did not
present varicella or zoster, or from 18 healthy controls. No signal was obtained 
in herpes simplex virus (HSV)-infected and -uninfected cell lines. The
hybridization assay proved that specific and viral or cellular DNAs other than
VZV did not cross-hybridize with the probe. The sensitivity limit of detection
was 4-15 pg of homologous DNA, and the assay was accomplished within 72-96 hr.
These results point to the possible rapid diagnosis of VZV infection in patients 
suspected of varicella or generalized zoster. In addition, simultaneous infection
with both VZV and HSV seems to occur in some patients.

PMID: 3025357 [PubMed - indexed for MEDLINE]

6842: J Virol. 1987 Jan;61(1):225-8.

Varicella-zoster virus complements herpes simplex virus type 1
temperature-sensitive mutants.

Felser JM, Straus SE, Ostrove JM.

Varicella-zoster virus (VZV) can complement temperature-sensitive mutants of
herpes simplex virus. Of seven mutants tested, two, carrying mutations in the
immediate-early ICP4 and ICP27 proteins, were complemented. This complementation 
was not seen in coinfections with adenovirus type 5 or cytomegalovirus. Following
transfection into CV-1 cells, a DNA fragment containing the VZV short repeat
sequence complemented the ICP4 mutant. These data demonstrate a functional
relationship between VZV and herpes simplex virus and have allowed localization
of a putative VZV immediate-early gene.

Publication Types: 
    Comparative Study

PMID: 3023701 [PubMed - indexed for MEDLINE]

6843: Viral Immunol. 1987;1(2):145-52.

T-cell imbalances and NK activity in varicella-zoster virus infections.

Cauda R, Prasthofer EF, Tilden AB, Whitley RJ, Grossi CE.

Clinica Malattie Infettive, Universita Cattolica S. Cuore, Roma, Italy.

Samples of peripheral blood lymphocytes (PBMC) were serially obtained from 30
patients with herpes zoster (HZ) and 10 patients with chickenpox (CP). Cells were
assayed for NK-cell function and for the expression of surface membrane antigens 
which identify T-cell and NK-cell subsets. During the acute phase of disease
(less than 7 days from onset), PBMC from patients with HZ had low proportions of 
T-helper (CD 4+) cells and a large number of T-suppressor (CD 8+) cells,
resulting in a low T-helper/T-suppressor ratio. There was an increased percentage
of nonspecific suppressor cells (GD 8+-CD 11+ cells) and increased expression of 
HLA-DR determinants on both CD 8+ and CD 4+ cells. The NK activity was depressed 
with no concomitant decrease in NK cells (CD 16+ or Leu 7+ cells). In the early
convalescing phase of disease (8-14 days), there was a significant increase in CD
16+ cells and increased expression of HLA-DR on these cells, correlating with
increased NK activity. In the late recovery phase (greater than 14 days), NK
activity and levels of T-cell subpopulations were normal with the exception of
increased CD 4+ cells and, consequently, of the helper/suppressor ratios. In the 
acute phase of CP (less than 7 days), the T-cell imbalances were similar to those
encountered with HZ patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Comparative Study

PMID: 2978454 [PubMed - indexed for MEDLINE]

6844: Arch Dermatol Res. 1987;279 Suppl:S52-4.

Cutaneous pseudolymphoma at the site of prior herpes zoster eruption.

Wolff HH, Wendt V, Winzer M.

Clinic of Dermatology and Venereology, Medical University of Lubeck, Federal
Republic of Germany.

A 55-year old woman with a history of herpes zoster in the dermatome supplied by 
the mandibular branch of the trigeminal nerve developed cutaneous red papules and
umbilicated nodules within the same segment. The clinical and histological
diagnosis was pseudolymphoma. The lesions showed a polymorphous infiltrate
without germinal center formation. Immunologic phenotyping with monoclonal
antibodies revealed the predominance of helper T cells and distinct
compartmentalization of B and T cells. The lesions healed up within 7 weeks. The 
development of pseudolymphomas at the site of previous herpes zoster eruptions
seems to be extremely rare.

Publication Types: 
    Case Reports

PMID: 2959212 [PubMed - indexed for MEDLINE]

6845: Acta Virol. 1987 Jan;31(1):19-24.

Varicella-zoster virus IgM antibody fraction separated by minicolumn gel
filtration in serodiagnosis of acute infection.

Kovac J, Zachar V, Reichel M, Necas S.

Gel filtration through Sephadex G-200 or Ultrogel AcA 34 minicolumns was applied 
to isolate IgM antibodies from sera of patients with varicella and herpes zoster 
(HZ). Serum samples were stained with Sudan III and Evan's Blue in order to
monitor the separation process visually when running several columns at the same 
time. The presence of specific IgM antibodies was demonstrated by enzyme linked
immunosorbent assay (ELISA). Rapid separation of stained sera by diffusion
chromatography on minicolumns with successive determination of specific IgM
antibodies in ELISA proved suitable for serological diagnosis of varicella,
whereas the significance of IgM-specific antibody response in HZ seems uncertain.

PMID: 2883853 [PubMed - indexed for MEDLINE]

6846: Arch Virol. 1987;93(1-2):1-12.

Genome variation among varicella-zoster virus isolates derived from different
individuals and from the same individuals.

Hondo R, Yogo Y, Kurata T, Aoyama Y.

We have used 12 restriction enzymes to analyse the DNA of 24 clinical isolates of
VZV derived from 12 patients in order to compare isolates derived from different 
individuals and derived serially from the same individual. As reported
previously, only a small proportion of the isolates differed with respect to the 
presence or absence of restriction sites. However, we found that the size of DNA 
fragments generated from all the isolates derived from different patients varied 
in any of four regions, one of which was first recognized in this study. In one
case, where multiple isolates recovered from the same individual were analysed,
each was distinguished from the others not only by differences in the variable
regions but also by the presence or absence of a restriction site in a
nonvariable region. This suggests that multiple strains of VZV can be present in 
the same human host.

PMID: 2880576 [PubMed - indexed for MEDLINE]

6847: J Cell Sci Suppl. 1987;7:67-94.

The genome of herpes simplex virus: structure, replication and evolution.

McGeoch DJ.

Institute of Virology, University of Glasgow, Scotland.

The objectives of this paper are to discuss the structure and genetic content of 
the genome of herpes simplex virus type 1 (HSV-1), the nature of virus DNA
replicative processes, and aspects of the evolution of the virus DNA, in
particular those bearing on DNA replication. We are in the late stages of
determining the complete sequence of the DNA of HSV-1, which contains about
155,000 base pairs, and thus the treatment is primarily from a viewpoint of DNA
sequence and organization. The genome possesses around 75 genes, generally
densely arranged and without long range ordering. Introns are present in only a
few genes. Protein coding sequences have been predicted, and the functions of the
proteins are being pursued by various means, including use of existing genetic
and biochemical data, computer based analyses, expression of isolated genes and
use of oligopeptide antisera. Many proteins are known to be virion structural
components, or to have regulatory roles, or to function in synthesis of virus
DNA. Many, however, still lack an assigned function. Two classes of genetic
entities necessary for virus DNA replication have been characterized: cis-acting 
sequences, which include origins of replication and packaging signals, and genes 
encoding proteins involved in replication. Aside from enzymes of nucleotide
metabolism, the latter include DNA polymerase, DNA binding proteins, and five
species detected by genetic assays, but of presently unknown functions. Complete 
genome sequences are now known for the related alphaherpesvirus varicella-zoster 
virus and for the very distinct gammaherpesvirus Epstein-Barr virus. Comparisons 
between the three sequences show various homologies, and also several types of
divergence and rearrangement, and so allow models to be proposed for possible
events in the evolution of present day herpesvirus genomes. Another aspect of
genome evolution is seen in the wide range of overall base compositions found in 
present day herpesvirus DNAs. Finally, certain herpesvirus genes are homologous
to non-herpesvirus genes, giving a glimpse of more remote relationships.

Publication Types: 
    Comparative Study
    Review

PMID: 2846596 [PubMed - indexed for MEDLINE]

6848: Boll Ist Sieroter Milan. 1987;66(3):198-201.

[Seroepidemiologic studies in 63 patients given organ transplants in relation to 
cytomegalovirus, herpes simplex, varicella-zoster and HTLV-III: validity and
limits]

[Article in Italian]

Lilli D, Lorino G, Cipriani P, Berloco P, Pretagostini R, Mancini C.

II Cattedra di Microbiologia, Universita La Sapienza, Roma.

We carried out a seroepidemiological study on 63 patients undergoing organ
transplantation in order to determine viral markers like CMV, HTLV III, HS and
V/Z. The antibodies valuation was carried out by enzyme-linked immunosorbent
assays (ELISA-Abbott) and complement fixation test. All the tested markers give a
high percentage of positivity even if the values relevant to anti-HTLV III
antibodies can not be related to infection but, probably, to anti-HLA-Dr
antibodies.

Publication Types: 
    English Abstract

PMID: 2829945 [PubMed - indexed for MEDLINE]

6849: Ann Fr Anesth Reanim. 1987;6(6):523-4.

[Zona after spinal anesthesia: coincidence or consequence?]

[Article in French]

Junke E, Boussard N, Pertek JP, Coissard A, Helmer J.

Departement d'Anesthesie-Reanimation, CHU de Nancy-Brabois, Vandoeuvre-les-Nancy.

A case is reported of a herpes zoster infection occurring a few days after spinal
anaesthesia in a man with severe cardiac disease who had undergone transurethral 
endoscopic resection of a prostatic epithelioma. The question as to whether there
was a relationship between the two events had to be asked, all the more so as the
rash seemed to be centered on the puncture wound. Others factors involved may
have been the effect of anaesthesia on the body's defence mechanisms, the use of 
prophylactic antibiotics and the neoplasm.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2450493 [PubMed - indexed for MEDLINE]

6850: Lymphokine Res. 1987 Fall;6(4):309-18.

Antiviral effects of recombinant human tumor necrosis factor.

Ito M, O'Malley JA.

Department of Biological Resources, Roswell Park Memorial Institute, Buffalo, NY 
14263.

The antiviral action of recombinant human tumor necrosis factor (TNF) was studied
using assay systems to determine inhibition of viral cytopathic effect (CPE), as 
well as suppression of virus growth measured by plaque assays. TNF was cloned and
prepared by Asahi Chemical Industry, Japan. Antiviral activity against human
herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), varicella-zoster
virus (VZ), vesicular stomatitis virus (VSV) and encephalomyocarditis virus
(EMC), was demonstrated in human diploid fibroblasts following pretreatment with 
TNF overnight. The antiviral action was completely neutralized by anti-interferon
(IFN)-beta serum, but not by anti-IFN-alpha or -gamma antibodies. This suggested 
the induction of IFN-beta by TNF. The antiviral action was synergistically
enhanced by human IFN-gamma. Several non-human cell lines were tested but 10 of
11 failed to be protected from VSV- and/or EMC-induced CPE following pretreatment
by TNF. The anticellular effects of TNF were tested in human and in non-human
tumor cell lines. The results indicate that the susceptibility of cells to the
two activities of TNF, antiviral and anticellular, was distinct, and that
antiviral activity of TNF is more species-specific than its anticellular action.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2448553 [PubMed - indexed for MEDLINE]

6851: Arch Dermatol Res. 1987;279(4):283-4.

Rosette-formation in herpes simplex and herpes zoster lesions as demonstrated in 
Tzanck smears.

Nieboer C, Beljaards R, van der Veen JP.

Free University Hospital, Department of Dermatology, Amsterdam, The Netherlands.

PMID: 2445307 [PubMed - indexed for MEDLINE]

6852: Annu Rev Med. 1987;38:51-9.

Interferon for the treatment of infections.

Ho M.

Interferon, both natural and recombinant, has been shown in controlled clinical
studies to be effective against herpes simplex virus infections, herpes zoster,
the common cold caused by rhinoviruses, and some papilloma virus infections. In
some cases, it is in competition with other antivirals, and in others its precise
clinical indication is still unclear. Thus, further work and developments are
required before interferon becomes a clinically recognized antiviral agent.

Publication Types: 
    Review

PMID: 2437854 [PubMed - indexed for MEDLINE]

6853: Presse Med. 1986 Dec 20;15(45):2255.

[Peripheral neurogenic bladder due to perineal zona]

[Article in French]

Amarenco G, Savatovsky I, Amarenco P, Goudal H.

Publication Types: 
    Case Reports
    Letter

PMID: 2949262 [PubMed - indexed for MEDLINE]

6854: Hosp Pract (Off Ed). 1986 Dec 15;21(12):16, 21.

Xylocaine treatment for acute herpes zoster.

Stadtner DA.

Publication Types: 
    Letter

PMID: 3098751 [PubMed - indexed for MEDLINE]

6855: Br Med J (Clin Res Ed). 1986 Dec 13;293(6561):1536-7.

Effectiveness of intravenous acyclovir in immunocompetent patient with herpes
zoster encephalitis.

Whyte MK, Ind PW.

Publication Types: 
    Case Reports

PMID: 3099946 [PubMed - indexed for MEDLINE]

6856: Br Med J (Clin Res Ed). 1986 Dec 13;293(6561):1529-32.

Oral acyclovir in acute herpes zoster.

McKendrick MW, McGill JI, White JE, Wood MJ.

Oral acyclovir at a dose of 800 mg five times daily for seven days was compared
with placebo in a randomised double blind trial conducted at three centres in the
United Kingdom. The study group comprised 205 elderly immune competent patients
suffering from herpes zoster who were entered within 72 hours of the onset of
rash. Acyclovir significantly reduced the times to arrest of new lesion formation
(p = 0.005), loss of vesicles (p less than 0.001), and full crusting (p = 0.02)
in those patients entered within 48 hours of the onset of rash. In addition,
there was a significant reduction in pain during treatment with acyclovir as
compared with placebo (p = 0.008). Of the patients with severe pain on entry, 40%
(10/25) of those treated with acyclovir had no or only mild pain at the end of
treatment, whereas in the placebo group all had residual moderate or severe pain 
(p less than 0.001). No clinically important adverse effects of acyclovir were
reported. Oral acyclovir may modify acute herpes zoster and reduce pain.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 3099943 [PubMed - indexed for MEDLINE]

6857: Br Med J (Clin Res Ed). 1986 Dec 13;293(6561):1523.

Acyclovir update.

Jeffries DJ.

Publication Types: 
    Editorial

PMID: 3099939 [PubMed - indexed for MEDLINE]

6858: AIDS Res. 1986 Dec;2 Suppl 1:S131-40.

AIDS-related benign lymphadenopathy and malignant lymphoma: clinical aspects and 
virologic interactions.

Abrams DI, Kaplan LD, McGrath MS, Volberding PA.

Infection with the human immunodeficiency virus (HIV) leads to selective
depletion of the helper/inducer lymphocyte subset and a subsequent state of
acquired cellular immunodeficiency. Simultaneously, evidence of B-cell
hyper-activity may exist. A subset of patients infected with HIV demonstrates a
syndrome of persistent generalized lymphadenopathy (PGL). Lymph node biopsies
reveal benign reactive changes with a pattern of florid follicular hyperplasia. A
polyclonal hypergammaglobulinemia reflects humoral immune dysfunction. Patients
with PGL are similar to those with full-blown AIDS with regards to demographics, 
immune and virologic studies. Our prospective natural history study of PGL
patients initiated in November 1981 reveals a 15% rate of evolution to AIDS in
the 200 patient cohort. Factors associated with increased risk of transformation 
to AIDS include severity of constitutional symptoms, shrinking adenopathy, oral
candidiasis or viral hairy leukoplakia, peripheral cytopenias, elevated
erythrocyte sedimentation rate or an antecedent episode of herpes zoster.
Therapeutic interventions to prevent evolution to AIDS in high risk subsets of
lymphadenopathy patients have been investigated. In addition to benign B-cell
proliferation associated with HIV infection, malignant lymphomas have also been
diagnosed in 29 patients in AIDS risk groups in our clinic population. All
patients were male; 26 homosexuals, 2 IV drug abusers and 1 multiply transfused
sickle cell anemia patient. Seven patients had antecedent PGL. Non-Hodgkin's
lymphoma was diagnosed in 19 patients. Histologies were predominantly diffuse
undifferentiated or large cell. Eleven patients were Stage IV at diagnosis. Of 10
patients with mixed cellularity Hodgkin's disease, 7 were Stage IV-B at
presentation. Extranodal disease was frequent in patients with lymphomas.
Fourteen patients lacked peripheral lymphadenopathy. Response to chemotherapy was
good, but complicated by prolonged marrow suppression and development of
AIDS-related opportunistic infections. Median survival was 7 months. Laboratory
studies investigating the possible role of lymphotropic retroviruses in the
development of AIDS-related lymphomas revealed that serum from all patients with 
high grade non-Hodgkin's lymphoma contained antibodies to HIV and that the
majority also expressed antibodies to HTLV-I. This degree of seroreactivity to
HTLV-I and HIV was characteristic only of lymphoma patients as sera from only 10 
- 15% of AIDS and ARC patients in San Francisco had similar findings.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3828009 [PubMed - indexed for MEDLINE]

6859: Ital J Neurol Sci. 1986 Dec;7(6):617-22.

Herpes zoster myelitis: nervous system complications.

Boiardi A, Ferrante P, Porta E, Sghirlanzoni A, Bussone G.

Transverse myelitis after a zoster viral infection is an exceptional occurrence. 
In this case we documented an antibody activity against varicella zoster (V-Z) in
the cerebrospinal fluid in association with Coxsackie A enterovirus. The clinical
course was atypical because of a second episode of myelitis 2 years after the
first episode of neurologic viral complications. The positive outcome of therapy 
with Acyclovir is noteworthy. This case was retrieved in a review of neurologic
complications observed in the last few years in patient affected by zoster in our
hospital.

Publication Types: 
    Case Reports

PMID: 3804716 [PubMed - indexed for MEDLINE]

6860: Arch Dermatol. 1986 Dec;122(12):1357-8.

Metastatic transitional cell carcinoma mimicking zoster sine herpete.

Jaworsky C, Bergfeld WF.

Publication Types: 
    Case Reports

PMID: 3789766 [PubMed - indexed for MEDLINE]

6861: Am J Dis Child. 1986 Dec;140(12):1213-4.

Prognosis of herpes zoster in healthy children.

Garty BZ, Danon YL, Nitzan M, Ingber A.

Publication Types: 
    Letter

PMID: 3776930 [PubMed - indexed for MEDLINE]

6862: J Rheumatol. 1986 Dec;13(6):1190-1.

Herpes zoster: serological study and cranial giant cell arteritis.

Barrier JH, de Haldat du Lys F, Billaudel S, Peltier D, Ponge T.

Publication Types: 
    Letter

PMID: 3560114 [PubMed - indexed for MEDLINE]

6863: Ann Neurol. 1986 Dec;20(6):651-64.

Acute herpetic and postherpetic neuralgia: clinical review and current
management.

Portenoy RK, Duma C, Foley KM.

The pain of acute herpes zoster (HZ) may be severe, but it is usually transitory.
A minority of patients, with the elderly at particular risk, go on to develop
persistent, severe, often disabling pain called postherpetic neuralgia. Though
the clinical features of these conditions are well known, the pathology of PHN is
poorly described and the pathogenesis of the pain in both remains conjectural.
During the past 60 years, an extraordinary number of pharmacological, anesthetic,
and surgical therapies have been applied in an attempt to ameliorate the symptoms
of acute herpes zoster, enhance its healing, prevent its transition to
postherpetic neuralgia, and treat the pain of those with this complication.
Relatively few treatments have been studied in a controlled manner, and fully
reliable, safe, and effective therapeutic approaches for preventing and treating 
postherpetic neuralgia have not yet been found. This review summarizes current
information on the epidemiology, clinical features, and pathology of herpes
zoster and postherpetic neuralgia, and critically examines the accumulated
experience with the various treatments. Guidelines for management are suggested.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 3545049 [PubMed - indexed for MEDLINE]

6864: Clin Pharm. 1986 Dec;5(12):961-76.

Recent advances in antiviral therapy.

Deeter RG, Khanderia U.

Virus replication is described, and the clinical trials and indications for
amantadine, rimantadine, vidarabine, vidarabine phosphate, acyclovir, ribavirin, 
and other promising antiviral agents are reviewed. Amantadine and rimantadine are
useful for the treatment and prophylaxis of viral influenza A infections.
Vidarabine is a second-line agent and is effective for the treatment of herpes
simplex encephalitis, neonatal herpes simplex types 1 and 2, and varicella-zoster
infections. Vidarabine phosphate (also known as vidarabine monophosphate) has a
similar spectrum of activity and can be administered in smaller volumes than
vidarabine. Acyclovir has demonstrated clinical efficacy for chickenpox, shingles
(herpes zoster), genital herpes, and other herpes simplex infections. Acyclovir
is also useful for the suppression of herpes infections. Systemically
administered ribavirin is indicated for the treatment of Lassa fever. Aerosol
ribavirin is effective for the treatment of respiratory syncytial virus pneumonia
in children and infants and influenza A infections in adults. Only acyclovir,
amantadine, ribavirin, and vidarabine are used in clinical practice. Vidarabine
phosphate and investigational agents such as rimantadine, ganciclovir (DHPG, BW
B759U), phosphonoformate, and bromovinyl-deoxyuridine (BVDU) need further
investigation.

Publication Types: 
    Review

PMID: 3542344 [PubMed - indexed for MEDLINE]

6865: Klin Monatsbl Augenheilkd. 1986 Dec;189(6):486-90.

[Complications following temporary occlusion of the nasolacrimal duct with tissue
adhesive (Histoacryl)]

[Article in German]

Kohler U.

This paper presents 4 cases in which the punctum had been temporarily occluded
with tissue adhesive, still showing toxic tissue reaction years later. Abscess,
dacryocystitis, dacryocystitis with dacryolithiasis, dacryocellulitis and
polyposis were found. In the light of these findings and the relevant
literature-especially with regard to late injuries-it is not advisable to use
tissue adhesive, at least not for the purpose of punctal occlusion.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3494156 [PubMed - indexed for MEDLINE]

6866: Acta Neurol Scand. 1986 Dec;74(6):460-6.

Herpes zoster ophthalmicus with cerebral angiitis and reduced cerebral blood
flow.

Gjerstad L, Nyberg-Hansen R, Bjorland O, Nakstad P, Russell D, Rootwelt K.

Two patients with herpes zoster ophthalmicus (HZO) who experienced a delayed
contralateral hemiparesis, the so-called crossed zoster syndrome, are described. 
Particular emphasis is paid to the cerebral blood flow (CBF) findings studied
with the Xenon-133 inhalation technique using single photon emission computed
tomography (SPECT). In a 40-year-old female with right-sided hemiparesis,
angiography showed multiple segmental narrowings of the intracerebral arteries.
Cerebral computer tomography (CT) scans were normal. The CBF studied 11 months
after the HZO showed a generalized reduction of flow which, however, was more
pronounced in the left hemisphere. On re-examination 8 months later both the mean
hemispheric flow and regional CBF (rCBF) had increased to normal values. In a
66-year-old male with dysphasia and right-sided hemiparesis, cerebral CT scans
demonstrated two small deep left-sided infarcts. CBF examination showed a
generalized reduction of flow in the left hemisphere. The flow was slightly
increased on re-examination 12 months later. These findings suggest that the
Xenon-133 inhalation method represents a useful way to demonstrate the CBF
pattern in this group of patients.

Publication Types: 
    Case Reports

PMID: 3493617 [PubMed - indexed for MEDLINE]

6867: Biken J. 1986 Dec;29(3-4):91-7.

Antibody responses to early antigens of varicella-zoster virus (VZV) during
varicella and zoster.

Namazue J, Kato T, Yamanishi K, Takahashi M, Asano Y, Muraki R.

The antibody responses to membrane and early antigens and thymidine kinase of
varicella-zoster virus (VZV) were studied in sera during both varicella and
zoster by a test with fluorescent antibody to membrane antigen (FAMA), staining
the biochemically transformed cells by the immunofluorescent technique and
neutralization of virus-specific thymidine kinase activity, respectively. Similar
increases in FAMA antibody titers were demonstrated in sera from patients with
varicella and zoster. IgM was detected in both groups, but appeared earlier
during varicella than during zoster. Furthermore, the antibody titers to early
antigens and virus-specific thymidine kinase were higher in patients with zoster 
than in those with varicella. These data suggest that different types of antibody
responses occur during varicella and zoster.

PMID: 3039973 [PubMed - indexed for MEDLINE]

6868: Int J Epidemiol. 1986 Dec;15(4):561-6.

Infections due to the human herpesviruses in southern India: a
seroepidemiological survey.

Venkitaraman AR, Seigneurin JM, Lenoir GM, John TJ.

We studied the prevalence of IgG and IgM antibodies to the human herpesviruses in
a hospital-based population of 181 individuals aged 0 to 25 years, who were
resident in Vellore, south India or surrounding rural areas. Antibodies to the
Epstein-Barr virus (EBV) viral capsid antigen were determined by indirect
immunofluorescence, while antibodies to the remaining herpesviruses were
determined by enzyme-linked immunosorbent assay. The age-specific prevalence
rates of IgG antibodies to EBV and cytomegalovirus (CMV) rose rapidly after birth
to reach a value of over 90% by the fourth year of life. High age-specific IgM
prevalence rates and geometric mean titres (GMT) of IgG antibody in children 6
months to 2 years of age, and the early median age of virus infection (1.4 years 
for EBV and less than 1 year for CMV) indicate that primary infection with these 
viruses occurs early in life. In contrast, age-specific prevalence rates of IgG
antibodies to varicella-zoster virus (VZV) and herpes simplex virus (HSV) rose
gradually after birth to attain maximal values of only 72% (VZV) and 83% (HSV) in
the 15-25 year age group, and the median ages of infection were delayed (12.25
years for VZV and 8.2 years for HSV). The age-specific IgG prevalence rates of
VZV and HSV, and of EBV and HSV showed statistically significant positive
correlations, suggesting that common epidemiological factors may underlie the
pattern of infections due to these groups of viruses.(ABSTRACT TRUNCATED AT 250
WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3028971 [PubMed - indexed for MEDLINE]

6869: Cutis. 1986 Dec;38(6):363-5.

Response of varicella zoster virus and herpes zoster to silver sulfadiazine.

Montes LF, Muchinik G, Fox CL Jr.

The addition of silver sulfadiazine to cultures of varicella zoster virus
resulted in inactivation of the viral infectivity. At a concentration of 10
micrograms/ml or higher the virus was inactivated after thirty minutes exposure
at 37 degrees C. Forty-two patients with herpes zoster were treated topically
with 1 percent silver sulfadiazine cream applied four times a day. All patients
experienced complete drying of vesicles, marked reduction erythema and edema, and
striking elimination of pain and burning sensation within twenty-four to
seventy-two hours. The sooner the treatment began after the onset of symptoms,
the more dramatic was the response. Postherpetic neuralgia was either mild or did
not occur. Signs of local, systemic, or laboratory-documented toxicity were not
observed.

PMID: 3026736 [PubMed - indexed for MEDLINE]

6870: Bone Marrow Transplant. 1986 Dec;1(2):185-92.

Long-term acyclovir prophylaxis in bone marrow transplant recipients and
lymphocyte proliferation responses to herpes virus antigens in vitro.

Ljungman P, Wilczek H, Gahrton G, Gustavsson A, Lundgren G, Lonnqvist B, Ringden 
O, Wahren B.

Department of Medicine, Karolinska Institute, Stockholm, Sweden.

In this randomized double-blind and placebo controlled trial of 6 months'
prophylaxis with acyclovir (ACV) in 42 bone marrow transplant (BMT) recipients,
patients receiving ACV had fewer herpes simplex virus (HSV) and varicella-zoster 
virus (VZV) infections during the prophylaxis compared to the placebo treated
patients (P less than 0.05). During the first 6 months after the prophylaxis had 
been discontinued the frequency of clinical HSV reactivations was low both in the
ACV (1/13) and in the placebo (1/13) treated patient groups. Altogether the ACV
treated patients had significantly fewer HSV reactivations during the first year 
after BMT (P less than 0.05). The HSV-specific lymphocyte proliferation response 
was also lower in the ACV treated group at 3, 6 and 12 months after BMT (P less
than 0.05). VZV infections recurred rather frequently, however, after
discontinuation of ACV prophylaxis. Therefore no difference was found in the
number of VZV infections during the first year after BMT. The VZV-specific
lymphocyte proliferation response was significantly lower in the ACV treated
group only at 6 months (P less than 0.05). ACV prophylaxis had no effect on the
frequency of CMV infections; CMV-specific lymphocyte proliferative responses were
not decreased.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 2844333 [PubMed - indexed for MEDLINE]

6871: Proteins. 1986 Dec;1(4):376-84.

Structural features of ribonucleotide reductase.

Nikas I, McLauchlan J, Davison AJ, Taylor WR, Clements JB.

MRC Virology Unit, Institute of Virology, Glasgow, Scotland, U.K.

Herpes simplex virus type 1 (HSV-1) encodes a ribonucleotide reductase which
comprises two polypeptides with sizes of 136,000 (RR1) and 38,000 mol. wt. (RR2).
We have determined the entire DNA sequence specifying HSV-1 RR1 and have
identified two adjacent open reading frames in varicella-zoster virus (VZV) which
have homology to HSV RR1 and RR2; the predicted sizes for the VZV RR1 and RR2
polypeptides are 87,000 and 35,000 mol. wt. respectively. Amino acid comparisons 
with RR1 and RR2 polypeptides from other organisms indicate that HSV-1 RR1
contains a unique N-terminal domain which is absent from other RR1 polypeptides
apart from HSV-2 RR1. These N-terminal amino acid sequences are poorly conserved 
between HSV-1 and HSV-2 in contrast to the remainder of the protein which shows
greater than 90% homology. Polypeptide structural predictions suggest that the
HSV-1 N-terminal domain may be separated into two regions, namely, a beta-sheet
structure followed by a nonstructured area. Across the remainder of RR1 and RR2, 
comparisons also reveal blocks of amino acids conserved between the different
ribonucleotide reductases, and these may be important for enzyme activity. From
predictions on the structure of these conserved blocks, we have proposed that the
location of a substrate binding site within RR1 is centered on three conserved
glycine residues in a region which is predicted to adopt a
beta-sheet/turn/alpha-helical structure; this approximates to the structure for
ADP nucleotide binding folds. Finally, we propose that the promoters for the HSV 
and Epstein-Barr virus (EBV) RR2 transcripts have evolved by separate
evolutionary routes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2835765 [PubMed - indexed for MEDLINE]

6872: Proc Natl Acad Sci U S A. 1986 Dec;83(24):9759-63.

Trans-activation of the human immunodeficiency virus long terminal repeat
sequence by DNA viruses.

Gendelman HE, Phelps W, Feigenbaum L, Ostrove JM, Adachi A, Howley PM, Khoury G, 
Ginsberg HS, Martin MA.

To investigate whether DNA viruses can augment gene expression of the human
immunodeficiency virus (HIV), cotransfection experiments were carried out in
which a recombinant plasmid containing the HIV long terminal repeat (LTR) linked 
to the chloramphenicol acetyltransferase (CAT) gene was transfected into cultured
cells along with plasmids containing DNA from various distinct classes of DNA
viruses. Molecular clones containing JC virus, BK virus, lymphotropic
papovavirus, bovine papilloma virus, type 1 herpes simplex virus (HSV-1), and
varicella-zoster virus sequences increased CAT expression directed by the HIV
LTR. Trans-activation of the HIV LTR varied in different cell lines, but in each 
case the HIV tat gene product elicited the greatest stimulation. Primer-extension
assays specific for HIV LTR mRNA revealed increased levels of steady-state RNA
following transfection with HIV tat as well as with several of the DNA viruses.
Virus-specific RNA expression paralleled the stimulation of CAT activity.
More-than-additive effects were observed at both the RNA and protein levels when 
tat plus type 1 herpes simplex virus DNAs or tat plus JC virus DNAs were
transfected into cells with the HIV LTR-CAT plasmid. These data suggest that
coinfection of cells by HIV and some DNA viruses can stimulate the expression of 
HIV.

PMID: 2432602 [PubMed - indexed for MEDLINE]

6873: Int Ophthalmol. 1986 Dec;9(4):247-51.

Isolation of the human T-cell leukemia/lymphotropic virus type III from aqueous
humor in two patients with perivasculitis of the retinal vessels.

Kestelyn P, Van de Perre P, Sprecher-Goldberger S.

The human T-cell leukemia/lymphotropic virus type III (HTLV-III) has been
isolated from aqueous humor in two patients with perivasculitis of the peripheral
retinal vessels, an AIDS-related ocular manifestation. Both patients had
antibodies to HTLV-III and although they presented with herpes zoster
ophthalmicus, they did not present other symptoms known to be associated with
HTLV-III infection. The isolation of HTLV-III from aqueous humor in these two
patients with retinal perivasculitis suggests that the virus itself may play a
role in the etiology of this ocular sign. The presence of infectious HTLV-III in 
the anterior chamber further emphasises the necessity to discard corneas from
HTLV-III infected donors.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2432026 [PubMed - indexed for MEDLINE]

6874: Hosp Pract (Off Ed). 1986 Nov 30;21(11A):81, 84-6, 92-3.

Managing the pain of herpes zoster.

Sandrock NJ, Warfield CA.

PMID: 3097040 [PubMed - indexed for MEDLINE]

6875: Br Med J (Clin Res Ed). 1986 Nov 22;293(6558):1349-51.

Thirty one years of herpes zoster in a rural practice.

Wilson JB.

The principal finding in this study of 151 cases of herpes zoster in a rural
practice was the predominance of patients who had a lesion on the right side.
This supports the proposition that the site of occurrence may be determined by
repeated trauma. The decline in the frequency of attacks in older men was
significant. Studying these cases and published reports has elucidated some of
the problems of the occurrence and distribution of herpes zoster in the body,
which still await definition. Others may be encouraged to carry these studies
further.

PMID: 3098346 [PubMed - indexed for MEDLINE]

6876: Orv Hetil. 1986 Nov 16;127(46):2805-7.

[Otic zoster (Hunt syndrome)]

[Article in Hungarian]

Karg E, Kishonti J, Kosaras B.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3796978 [PubMed - indexed for MEDLINE]

6877: Wiad Lek. 1986 Nov 15;39(22):1532-4.

[Cryotherapy of herpes zoster]

[Article in Polish]

Kudejko J, Tyszlukiewicz D, Przyszlak-Szabala M.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 3554766 [PubMed - indexed for MEDLINE]

6878: Lancet. 1986 Nov 15;2(8516):1113-5.

Evidence for heterosexual transmission and clinical manifestations of human
immunodeficiency virus infection and related conditions in Lusaka, Zambia.

Melbye M, Njelesani EK, Bayley A, Mukelabai K, Manuwele JK, Bowa FJ, Clayden SA, 
Levin A, Blattner WA, Weiss RA, et al.

In a hospital-based survey in Lusaka, Zambia, 189 (17.5%) of 1078 subjects had
antibodies against the human immunodeficiency virus (HIV). The prevalence of
antibodies was low in subjects aged less than 20 or greater than 60 years; in men
the peak prevalence (32.9%) occurred in those aged 30-35 years, and in women
(24.4%) it occurred in the 20-25 year age-group. There was no significant
difference in prevalence by sex after adjusting for age. High educational level
was independently associated with HIV seropositivity; the antibody against HIV
was found in 18.4% of blood donors and in 19.0% of hospital workers. Among
patients the antibody prevalence ranged from 8.7% in antenatal women and 9.3% in 
orthopaedic patients to 29.2% in those attending sexually transmitted disease
(STD) clinics (the prevalence being 37.3% in previous attenders and 22.8% in
first-time attenders). Seropositivity rates were higher in patients with an
infectious problem (23.4%) than in those without (11.4%, p = 0.0002). Herpes
zoster, oral thrush, diarrhoea, tuberculosis, and weight loss were independently 
correlated with seropositivity. The data strongly suggest that HIV infection is
prevalent in Africa and is transmitted heterosexually. The restricted
distribution of seropositivity to the sexually active age-groups indicates that
the epidemic, at least in this part of Africa, is newly introduced; this has
substantial implications for prevention.

PIP: In a hospital-based survey conducted in Lusaka, Zambia, 189 (17.5%) of 1078 
patients, blood donors, and health workers had antibodies against human
immunodeficiency virus (HIV). The prevalence of antibodies (seropositivity) was
low in study subjects under age 20 and over age 60. Seropositivity was highest
among men age 30-35 (32.9%) and among women age 20-25 (24.4%). There was no
significant difference in prevalence by sex, after adjusting for age. Increasing 
years of education was highly correlated with seropositivity, even after
adjustment for age, sex, and marital status. This association presumably reflects
the greater opportunities for travel and social interaction--and thus HIV
exposure--among the better educated. The antibody against HIV was detected in
18.4% of blood donors and 19.0% of hospital workers. Among clinic patients,
antibody prevalence was lowest among pregnant women (8.7%) and orthopedic
patients (9.3%) and highest among those attending the dermatology (26.8%) and
sexually transmitted disease (29.2%) clinics. Moreover, patients who had attended
the sexually transmitted disease clinic more than once were more likely to be
seropositive (37.3%) than first-time attendees (22.8%). Finally, patients with
infectious conditions had significantly higher seropositivity rates (23.4%) than 
those with noninfectious problems (11.4%). Herpes zoster, oral thrush, diarrhea, 
tuberculosis, and weight loss were independently associated with seropositivity. 
These findings strongly suggest that HIV infection is prevalent in Africa and is 
transmitted heterosexually. The concentration of seropositivity in the sexually
active age groups indicates that the epidemic is newly introduced, at least in
this part of Africa.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2877269 [PubMed - indexed for MEDLINE]

6879: Schweiz Med Wochenschr. 1986 Nov 8;116(45):1550-60.

[Diagnosis and differential diagnosis of back pain from the neurological point of
view]

[Article in German]

Mattle H.

Affections of the vertebral body, the intervertebral disc, the epidural and
subdural space, the nerve root, and the spinal cord may have back pain as the
main symptom. Initially a topical diagnosis is established in the light of the
neurologic symptoms and signs (segmental "beltlike" pain, radicular motor and
sensory signs, central mono-, para-, and tetraparesis, as well as sensory signs
and bladder dysfunction). Degenerative changes and herniated discs are the most
frequent causes of cervical and lumbar spinal disease with neurologic signs,
followed by extramedullary tumors. In the extradural space metastases,
plasmocytoma, lymphomas and primary bone tumors are the most common, and
neurinomas and meningiomas in the intradural space. In the spinal cord
ependymomas and astrocytomas are found, as well as benign cavities
(syringomyelia). Conditions which are rare, but very important because treatable 
at an early stage, are spinal epidural hematomas with anticoagulation and spinal 
epidural abscesses. Vertebral osteomyelitis must also be considered in
differential diagnosis. Inflammatory nerve root lesions seldom cause pain, except
for subacute demyelinating polyneuropathy responding to corticosteroid treatment,
and radiculitis caused by borrelia and herpes zoster.

Publication Types: 
    English Abstract
    Review

PMID: 2947322 [PubMed - indexed for MEDLINE]

6880: Ugeskr Laeger. 1986 Nov 3;148(45):2916-8.

[The Marstock method. A method for measuring sensitivity and pain thresholds]

[Article in Danish]

Fogh H, Bisgaard H, Kristensen JK.

Publication Types: 
    English Abstract

PMID: 3787833 [PubMed - indexed for MEDLINE]

6881: Ophthalmology. 1986 Nov;93(11):1418-22.

Acute retinal necrosis syndrome following herpes zoster dermatitis.

Yeo JH, Pepose JS, Stewart JA, Sternberg P Jr, Liss RA.

The acute retinal necrosis (ARN) syndrome has been recently linked to intraocular
infection with one or more members of the herpesvirus family. The authors report 
two cases of ARN following herpes zoster skin eruptions, and one case following
ipsilateral facial nerve palsy (Ramsay Hunt syndrome). Evaluation of serial serum
antibody titers against cytomegalovirus (CMV), herpes simplex virus (HSV) (types 
1 and 2), and varicella zoster (VZ) virus revealed diagnostic changes for VZ
virus alone following the retinitis. Immune precipitation of radiolabeled VZ
proteins by these sera followed by gel fractionation yielded radioimmune
precipitation profiles characteristic of a recent zoster reactivation. These
cases further implicate a central role for VZ virus infection in the etiology of 
the ARN syndrome.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3808602 [PubMed - indexed for MEDLINE]

6882: J Am Acad Dermatol. 1986 Nov;15(5 Pt 1):1049-50.

Granuloma annulare arising after herpes zoster.

Shideler SJ, Richards M.

Publication Types: 
    Case Reports
    Letter

PMID: 3782519 [PubMed - indexed for MEDLINE]

6883: Postgrad Med. 1986 Nov 1;80(6):211-3, 216.

Neurogenic bladder from occult herpes zoster.

Rothrock JF, Walicke PA, Swenson MR.

Active infection with herpes zoster may cause acute urinary retention, especially
when it involves sacral dermatomes. Although frank retention usually develops
days to weeks after eruption of the typical rash, bladder incompetence
infrequently develops first, raising concern over other, more ominous etiologies.
In the case presented, rash appearance was delayed until six weeks after the
initial onset of urinary retention, a much longer interval than previously
reported. Occult herpes zoster infection should be considered in patients
presenting with an acute neurogenic bladder of obscure cause.

Publication Types: 
    Case Reports

PMID: 3774661 [PubMed - indexed for MEDLINE]

6884: Geriatrics. 1986 Nov;41(11):67-9, 74-7, 80.

Management of common infections in the elderly outpatient.

Nagami P.

Bacteriuria is not thought to cause progressive renal damage in the asymptomatic 
adult. Therefore, in the elderly patient with relapsing asymptomatic bacteriuria,
further antibiotic therapy may be withheld, and the patient instructed to return 
in the event of symptomatic exacerbations. Postherpetic neuralgia is particularly
frequent and severe in the elderly, occurring in 25 to 40% of patients over age
60 with herpes zoster. When the patient is seen within the first week, a 3-week
regimen of oral corticosteroid therapy may shorten the duration of neuralgia.

PMID: 3770484 [PubMed - indexed for MEDLINE]

6885: Geriatrics. 1986 Nov;41(11):34-6, 41-3, 47-8.

Postherpetic neuralgia: a workable treatment plan.

Portenoy RK.

Management of established postherpetic neuralgia should proceed on several fronts
simultaneously and may include pain-oriented treatments that are pharmacologic,
neuroaugmentative, anesthetic, physiatric, psychological, and surgical. Many
patients develop a pattern of abnormal illness behavior, manifesting loss of
interest in work or avocations, social withdrawal, and disturbance of family
roles. Improvement in these impairments must be a goal that is as important as
amelioration of the pain itself.

PMID: 3770482 [PubMed - indexed for MEDLINE]

6886: Indian J Pediatr. 1986 Nov-Dec;53(6):817-9.

Lacrimal canalicular obstruction following herpes zoster ophthalmicus.

Panda A, Vasisht S, Patnaik NK.

Publication Types: 
    Case Reports

PMID: 3493218 [PubMed - indexed for MEDLINE]

6887: Klin Padiatr. 1986 Nov-Dec;198(6):471-5.

[Herpesvirus infections in children with acute lymphatic leukemia]

[Article in German]

Farber I, Sauerbrei G, Wutzler P, Weinmann G.

33 children with acute lymphatic leukemia and 33 healthy controls were
longitudinally studied for herpesvirus infections. Active herpes simplex-virus,
varicella-zoster virus and cytomegalovirus (CMV) infections were more frequent in
patients than in controls. CMV and Epstein-Barr virus infections were often
inapparent or associated with infections of the upper respiratory tract. Analysis
of serological datas revealed a coincidence of active CVM infection and lethal
course of the leukemia. This may be a result of the immunodeficiency in leukemia 
patients caused by disease and therapy. An additional influence of the
immunosuppressive effect of active CMV infections on the course of the disease is
discussed.

Publication Types: 
    English Abstract

PMID: 3027445 [PubMed - indexed for MEDLINE]

6888: J Clin Pathol. 1986 Nov;39(11):1254-8.

Importance of anticomplement immunofluorescence antibody titration for diagnosing
varicella-zoster virus infection in Bell's palsy.

Shigeta S, Baba M, Ogata M, Nozaki H, Okuaki A, Nakamura S.

Anticomplement Immunofluorescence was used for antibody titration against
varicella-zoster virus (VZV) in 43 patients with peripheral facial palsy. Nine of
31 patients (29%) with Bell's palsy and eight of 12 patients (75%) with
Ramsey-Hunt syndrome had anticomplement immunofluorescence antibody titres of
greater than or equal to 1/10. On the other hand, none of 14 patients with herpes
simplex virus (HSV) infection and 51 healthy adults showed anticomplement
immunofluorescence antibody titres of greater than or equal to 1/10. The
anticomplement immunofluorescence antibody titre in two patients with Ramsey-Hunt
syndrome increased later and decreased sooner than the indirect
immunofluorescence antibody titre, becoming undetectable at 66 and 104 days,
respectively, after onset of the disease. There was no cross reaction between
anti-VZV and anti-HSV antibodies in the patients who showed a positive antibody
rise for VZV. As the acute stage of VZV infection is obscure in the patients with
peripheral facial palsy without herpes the screening of anticomplement
immunofluorescence antibody to VZV at titres greater than or equal to 1/10 may be
useful for the diagnosis of VZV infection in patients with peripheral facial
palsy.

PMID: 3025268 [PubMed - indexed for MEDLINE]

6889: EMBO J. 1986 Nov;5(11):3057-63.

Identification of the human cytomegalovirus glycoprotein B gene and induction of 
neutralizing antibodies via its expression in recombinant vaccinia virus.

Cranage MP, Kouzarides T, Bankier AT, Satchwell S, Weston K, Tomlinson P, Barrell
B, Hart H, Bell SE, Minson AC, et al.

A human cytomegalovirus (HCMV) glycoprotein gene with homology to glycoprotein B 
(gB) of herpes simplex virus and Epstein-Barr virus and gpII of varicella zoster 
virus has been identified by nucleotide sequencing. The gene has been expressed
in recombinant vaccinia virus and the gene product recognized by monoclonal
antibodies and human immune sera. Rabbits immunized with the recombinant vaccinia
virus produced antibodies that immunoprecipitate gB from HCMV-infected cells and 
neutralize HCMV infectivity in vitro. These data demonstrate a role for this
protein in future HCMV vaccines.

PMID: 3024973 [PubMed - indexed for MEDLINE]

6890: J Clin Immunol. 1986 Nov;6(6):472-80.

Reduced cellular immunity to varicella zoster virus during treatment for acute
lymphoblastic leukemia of childhood: in vitro studies of possible mechanisms.

Giller RH, Bowden RA, Levin MJ, Walker LJ, Tubergen DG, Hayward AR.

To determine the effect of antileukemic therapy on preexisting immunity to
varicella zoster virus, we studied 20 children with acute lymphoblastic leukemia 
maintained in complete continuous remission for greater than 1 year. Cellular
immunity was tested by lymphocyte proliferation in response to varicella antigen.
Antiviral antibody was measured using the fluorescent antibody to membrane
antigen technique. Reduced lymphocyte proliferation was found in 9 of 16
seropositive patients when compared to an age-related control group. On the other
hand, antibody titers in patients receiving chemotherapy remained positive and
were essentially unchanged from pretreatment values. Shingles occurred in two of 
nine children with diminished and none of seven patients with normal cellular
immunity, suggesting that proliferative responses to varicella antigen may have
predicative value in identifying patients at risk for viral reactivation.
Additional studies were done to determine if defective antigen presentation or
reduced lymphocyte responder-cell frequency could account for the subnormal
proliferative responses. Intact presentation of varicella antigens by patient
mononuclear cells to parental, virus-specific T-cell blasts suggested that
antigen processing was not defective. However, varicella-specific responder-cell 
frequencies measured by limiting dilution analysis were found to be depressed in 
most patients, including some with normal proliferative responses. Our findings
indicate that therapy for acute lymphoblastic leukemia in children can be
associated with depressed cell-mediated immunity to varicella zoster virus even
though patients remain seropositive. Further studies suggest that while
monocyte-mediated antigen presentation remains intact, virus-specific lymphocyte 
numbers decline and probably contribute to decreased cellular immunity to
varicella zoster virus in children being treated for leukemia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3023433 [PubMed - indexed for MEDLINE]

6891: Am J Med. 1986 Nov;81(5):775-8.

Herpes zoster and zosteriform herpes simplex virus infections in immunocompetent 
adults.

Kalman CM, Laskin OL.

Among 111 immunocompetent patients referred to a general hospital setting with
the clinical diagnosis of herpes zoster, viral cultures were obtained from 47
patients. Six of these patients (13 percent) had herpes simplex virus isolated,
with four of the six infections involving the facial distribution, and the other 
two involving the T4 (breast) distribution. Excluding those in whom herpes
simplex virus was isolated, the mean age (+/- SD) of the remaining 105 patients
was 50 +/- 19 years. Thirty-two percent of the patients were at least 65 years
old; however, 39 percent were younger than 40 years of age. Thus, herpes zoster
frequently occurs in young, immunocompetent adults. Also, since zosteriform
rashes may be caused by herpes simplex virus, viral cultures of lesions are
useful to differentiate infections caused by herpes simplex virus from those due 
to varicella-zoster virus. The need to distinguish between these two viruses may 
be important with the advent of antiviral drugs and for use of the proper
epidemiologic isolation procedures.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3022586 [PubMed - indexed for MEDLINE]

6892: J Neuropathol Exp Neurol. 1986 Nov;45(6):635-46.

Neuropathology of acquired immunodeficiency syndrome (AIDS): an autopsy review.

Petito CK, Cho ES, Lemann W, Navia BA, Price RW.

In the brains and spinal cords of 153 adult patients dying with acquired
immunodeficiency syndrome (AIDS) at New York and Memorial Hospitals a subacute
encephalitis with multinucleated cells was present in 28% of all patients. This
encephalitis was characterized by multinucleated cells primarily located in the
white matter and associated with myelin pallor and sparse infiltrates of rod
cells, macrophages, gemistocytic astrocytes and lymphocytes. The incidence per 12
month period ranged from 0 to 43% and significantly increased between 1983-84
(14%) and 1984-85 (43%). Recent virologic and pathologic studies suggest that
this encephalitis may be caused by direct LAV/HTLV-III infection of the central
nervous system (CNS). Cytomegalovirus encephalomyelitis and toxoplasmosis were
the most common opportunistic infections (26% and 10%, respectively). Progressive
multifocal leukoencephalopathy, herpes simplex ventriculitis, varicella-zoster
leukoencephalitis and fungal infections were infrequent (less than 3% each). A
nonspecific encephalitis with microglial nodules and with mild white matter
changes occurred in 17%, vacuolar myelopathy in 29% and CNS lymphoma in 6%. Less 
than 20% of patients had either normal brains or terminal metabolic
encephalopathies. This survey shows that neuropathologic complications of AIDS
are frequent. Infections are the most common complication and are caused by
probable LAV/HTLV-III infection, or by opportunistic organisms.

PMID: 3021914 [PubMed - indexed for MEDLINE]

6893: Am J Public Health. 1986 Nov;76(11):1362-3.

Varicella-zoster dilemma: common sense in medical education.

Murray DL, Cleveland RP, Keefe C.

Publication Types: 
    Case Reports
    Letter

PMID: 3021007 [PubMed - indexed for MEDLINE]

6894: Drugs. 1986 Nov;32(5):383-424.

Inosine pranobex. A preliminary review of its pharmacodynamic and pharmacokinetic
properties, and therapeutic efficacy.

Campoli-Richards DM, Sorkin EM, Heel RC.

Inosine pranobex is a synthetic compound formed from the p-acetamido benzoate
salt of N-N dimethylamino-2-propanol and inosine in a 3:1 molar ratio. It has
been reported to exert antiviral and antitumour activities in vivo which are
secondary to an immunomodulating effect, and early results suggest beneficial
clinical effects in several diseases and infections including mucocutaneous
Herpes simplex infections, subacute sclerosing panencephalitis, genital warts,
influenza, zoster, and type B viral hepatitis, as well as in homosexual men with 
persistent generalised lymphadenopathy. However, many of the studies have been
preliminary in nature and deficient in design or in the reporting of their
results. One must therefore conclude that while inosine pranobex may prove to be 
a valuable and innovative therapy for a number of diseases and infections for
which no satisfactory therapy exist, further long term well controlled studies in
larger numbers of patients are required before definitive conclusions about the
efficacy of inosine pranobex in these disorders will be possible.

Publication Types: 
    Review

PMID: 2431857 [PubMed - indexed for MEDLINE]

6895: Science. 1986 Oct 31;234(4776):601-3.

Genomic analysis of the human B-lymphotropic virus (HBLV).

Josephs SF, Salahuddin SZ, Ablashi DV, Schachter F, Wong-Staal F, Gallo RC.

The human B-lymphotropic virus (HBLV) has a double-stranded DNA genome of greater
than 110 kilobase pairs, which is consistent with its morphological
classification as a herpesvirus. A 9000-base pair cloned probe of HBLV detected
specific sequences in DNA and RNA of infected cells but did not hybridize to the 
genomic DNA of other human herpesviruses including the Epstein-Barr virus, human 
cytomegalovirus, herpes simplex type I, and varicella-zoster virus. Conversely,
while probes obtained from each of the known human herpesvirus readily detected
the homologous viral DNA, they did not hybridize to genomic HBLV DNA. This
evidence, in addition to serological and morphological distinctions and the
biological effects of this virus demonstrate that HBLV is a novel human
herpesvirus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3020691 [PubMed - indexed for MEDLINE]

6896: Med Clin (Barc). 1986 Oct 18;87(12):522.

[Meningoencephalitis and paralysis of the 3d pair of cranial nerves as a
complication of herpes zoster in an immunocompetent patient]

[Article in Spanish]

Dominguez A, Gonzalez J, Olascoaga B, Pena JM.

Publication Types: 
    Case Reports
    Letter

PMID: 3491265 [PubMed - indexed for MEDLINE]

6897: Am J Ophthalmol. 1986 Oct 15;102(4):531-2.

Oral acyclovir in the treatment of acute herpes zoster ophthalmicus.

Buchi ER, Herbort CP, Ruffieux C.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3532807 [PubMed - indexed for MEDLINE]

6898: Am J Ophthalmol. 1986 Oct 15;102(4):532-3.

A new fundus finding in patients with zoster ophthalmicus.

Amano Y, Ohashi Y, Haruta Y, Kinoshita S, Tano Y, Manabe R.

PMID: 3490181 [PubMed - indexed for MEDLINE]

6899: Hosp Pract (Off Ed). 1986 Oct 15;21(10):92C-92K, 92O-92P, 92S passim.

Pain and its management.

Lasagna L.

Publication Types: 
    Case Reports

PMID: 3093498 [PubMed - indexed for MEDLINE]

6900: Nature. 1986 Oct 2-8;323(6087):464-7.

A novel selective broad-spectrum anti-DNA virus agent.

De Clercq E, Holy A, Rosenberg I, Sakuma T, Balzarini J, Maudgal PC.

A new compound has been found, (S)-9-(3-hydroxy-2-phosphonylmethoxypropyl)adenine
((S)-HPMPA), that has potent and selective activity against a broad spectrum of
DNA viruses, including herpes simplex virus (types 1 and 2); varicella zoster
virus; thymidine kinase-deficient (TK-) mutants of herpes simplex and varicella
zoster virus; human cytomegalovirus; phocid, simian, suid, bovid and equid
herpesviruses; African swine fever virus; vaccinia virus; and human adenoviruses.
It is also active against retroviruses. We also report that, in mice and rabbits 
in vivo, the compound is effective against both local and systemic infections
with herpes simplex virus type 1, including herpetic keratitis caused by a TK-
mutant which is resistant to the classical anti-herpes drugs.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3762696 [PubMed - indexed for MEDLINE]

6901: Ital J Neurol Sci. 1986 Oct;7(5):541-3.

Lumbosacral herpes zoster myelitis.

Schoenhuber R, Bortolotti P, Panzetti P, Guerzoni MC, Colombo A.

We present a case of herpes zoster (HZ) with some uncommon features, namely
lumbar localization and muscle weakness with a distribution different from the
site of cutaneous eruptions and sensory deficits. Spread of HZ virus from sensory
ganglion to anterior horn cells seems the only possible explanation of these
clinical features. Urinary retention and CSF data confirm the hypothesis of HZ
myelitis.

Publication Types: 
    Case Reports

PMID: 3804709 [PubMed - indexed for MEDLINE]

6902: Aust Fam Physician. 1986 Oct;15(10):1343-4.

Herpes zoster.

Newton-John H, Murtagh J.

PMID: 3778348 [PubMed - indexed for MEDLINE]

6903: Am J Dermatopathol. 1986 Oct;8(5):456-8.

Giant cells in lesions of varicella and herpes zoster.

King DF, King LA.

Publication Types: 
    Letter

PMID: 3777382 [PubMed - indexed for MEDLINE]

6904: Pediatrics. 1986 Oct;78(4 Pt 2):723-7.

Population-based studies of varicella complications.

Guess HA, Broughton DD, Melton LJ 3rd, Kurland LT.

Population-based data on varicella complications are presented using information 
both from national sample surveys of hospitalizations and physician office visits
and from reviews of medical records for all cases occurring within one community 
(Olmsted County, Minnesota) during a specified period. Acute cerebellar ataxia is
the most common neurologic complication of varicella and occurs about once in
4,000 varicella cases among children younger than 15 years of age. Among adults, 
varicella pneumonia is the most common complication and results in
hospitalization about once in every 400 varicella cases. Overall, varicella
accounts for approximately 4,000 hospitalizations and 364,000 physician office
visits annually in the United States and represents an important continuing
source of childhood and adult morbidity.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3763290 [PubMed - indexed for MEDLINE]

6905: Hautarzt. 1986 Oct;37(10):533-6.

[Acyclovir in mycosis fungoides and lymphomatoid papulosis]

[Article in German]

Burg G, Klepzig K, Kaudewitz P, Wolff H, Braun-Falco O.

A survey is given on 23 patients (10 of our own, 13 reported in personal
communications and in the literature) suffering from lymphoproliferative diseases
and treated with acyclovir (ACV). In 5 patients (3 of 18 with cutaneous T-cell
lymphomas, 2 of 5 with lymphomatoid papulosis) partial remission could be
achieved. Since herpes simplex virus, cytomegalovirus and viruses like
Epstein-Barr and varicella-zoster do not play an etiologic role and since HTLV-I 
virus, due to its lack of thymidine kinase, cannot activate ACV, the following
mechanisms should be discussed regarding the possible effectiveness of ACV in
lymphoproliferative diseases: a direct cytopathic effect; activation of ACV by
the thymidine kinase of viruses not yet detected in cutaneous lymphoproliferative
disorders; ACV activation by cellular thymidine kinase, which has been found to
be elevated in lymphoproliferative disorders. Preliminary clinical observations
suggest that ACV may exhibit an antiproliferative effect intravenously in some
patients with lymphomatoid papulosis.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 3539873 [PubMed - indexed for MEDLINE]

6906: J Med Virol. 1986 Oct;20(2):127-34.

Comparative trial of acyclovir and vidarabine in disseminated varicella-zoster
virus infections in immunocompromised patients.

Vilde JL, Bricaire F, Leport C, Renaudie M, Brun-Vezinet F.

A comparative assessment of vidarabine and acyclovir in the treatment of
varicella and disseminated zoster in immunosuppressed patients was undertaken.
Thirty-eight immunosuppressed patients with varicella (N = 18) or disseminated
zoster (N = 20) were treated intravenously with 10 mg/kg/day of vidarabine or 30 
mg/kg/day of acyclovir for 5 days according to a preestablished code within each 
diagnosis group--varicella and disseminated zoster. Two deaths, although not
directly related to VZV infection, were observed in the vidarabine-treated
varicella group. The times to cessation of formation of new lesions and to the
disappearance of fever were similar for vidarabine and acyclovir in each group.
In the varicella group, VZV was isolated on day 5 in four out of five vidarabine 
patients versus one out of five acyclovir patients. No severe adverse effects
were observed with either drug. Neutropenia present in patients of both drug
groups was transitory and most often related to previous cytolytic chemotherapy. 
These data suggest that either vidarabine or acyclovir could be used in the
treatment of severe VZV infections in immunosuppressed patients, although a
larger number of patients would be required for definitive conclusion. Because of
the large amount of solute required for vidarabine administration, acyclovir may 
be preferred when the risk of cardiorespiratory failure is high.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 3534140 [PubMed - indexed for MEDLINE]

6907: Bull Soc Ophtalmol Fr. 1986 Oct;86(10):1239-40.

[The ophthalmic zona-ipsilateral cerebral ischemia syndrome]

[Article in French]

Bec P, Camuzet F, Maillard P, Mathis A, Arne JL.

Publication Types: 
    Case Reports

PMID: 3495359 [PubMed - indexed for MEDLINE]

6908: Aust N Z J Surg. 1986 Oct;56(10):807-8.

Segmental abdominal herpes zoster paresis.

Tjandra J, Mansel RE.

A case of segmental abdominal paresis due to thoraco-abdominal herpes zoster in a
63 year old man is reported. This is caused by peripheral motor paresis. It has a
good prognosis with spontaneous resolution.

Publication Types: 
    Case Reports

PMID: 3464246 [PubMed - indexed for MEDLINE]

6909: Otolaryngol Head Neck Surg. 1986 Oct;95(3 Pt 1):292-7.

Ramsay Hunt facial paralysis: clinical analyses of 185 patients.

Robillard RB, Hilsinger RL Jr, Adour KK.

In a prospective study of 1507 patients, evaluated consecutively for facial palsy
in the Cranial Nerve Research Clinic at the Kaiser Permanente Medical Center,
Oakland, California, between 1966 and 1976, 185 cases (12%) were diagnosed as
Ramsay Hunt syndrome. In 46 cases (25%), the diagnosis of herpes zoster was
confirmed by acute and convalescent serum titers for varicella-zoster virus. In
139 cases (75%), viral titers were not performed and the diagnosis was based on
the characteristic clinical presentation of the Ramsay Hunt syndrome. The data
were subjected to multivariate analysis evaluating age, sex, race, signs, and
symptoms at onset, severity of paralysis, associated medical problems with
concomitant neurologic deficits, and response to therapy. These were compared
with data of 1202 patients with Bell's (herpes simplex) palsy. The facial palsy
of Ramsay Hunt syndrome was found to be more severe, to cause late neural
denervation, and to have a less favorable recovery profile than Bell's (herpes
simplex) facial palsy. Prognostic factors and treatment recommendations are
discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3108776 [PubMed - indexed for MEDLINE]

6910: Pediatrics. 1986 Oct;78(4 Pt 2):728-35.

Varicella: complications and costs.

Preblud SR.

Varicella (chickenpox) has long been considered a benign, inevitable disease of
childhood. Complications are generally mild and rarely severe, and virtually
every individual is infected by adulthood. Infection is associated, however, with
a high risk of serious complications in certain high-risk groups, such as
leukemic children. Concerns about the severity of varicella in this population
have led to the development and testing of a live, attenuated vaccine. Because of
the favorable results thus far available, the vaccine may soon be licensed for
use in high-risk individuals. The fact that a vaccine may soon be available has
led to an increased interest in the potential benefits of a childhood varicella
vaccine program. The costs associated with varicella infection in normal persons 
without a varicella vaccination program have been estimated to be approximately
$400 million, 95% of which is the cost of caring for a child at home. Vaccination
of normal 15-month-old children with a safe and effective vaccine with
long-lasting immunity could reduce the cost by 66% and result in a savings of $7 
for every dollar spent on the vaccination program. This assumes that vaccine
would be administered only once with measles, mumps, and rubella vaccine, that
there would be no increase in the number of varicella cases in older persons who 
are at increased risk for complications, and that there would be no deleterious
effect on the occurrence and severity of herpes zoster.(ABSTRACT TRUNCATED AT 250
WORDS)

Publication Types: 
    Review

PMID: 3093966 [PubMed - indexed for MEDLINE]

6911: Neurosurgery. 1986 Oct;19(4):599-603.

Reactivation of herpesvirus in neurosurgical patients.

Nabors MW, Francis CK, Kobrine AI.

The authors are presenting seven patients who had operations between July 1984
and July 1985 and who developed herpes infections postoperatively. Four of the
patients developed their infections in a dermatomal distribution that correlated 
with the nerve roots manipulated at operation. A spectrum of localized herpes
reactivation is demonstrated in this series. The use of corticosteroids and other
associated variables are discussed. Like reactivation of herpes simplex after
trigeminal nerve operation, we believe reactivation of herpes simplex and herpes 
zoster can occur in operation of the cervical, thoracic, or lumbosacral spine.

Publication Types: 
    Case Reports

PMID: 3024061 [PubMed - indexed for MEDLINE]

6912: Antiviral Res. 1986 Oct;6(6):329-41.

Efficacy of 2'-nor-cyclicGMP in treatment of experimental herpes virus
infections.

Field AK, Davies ME, DeWitt CM, Perry HC, Schofield TL, Karkas JD, Germershausen 
J, Wagner AF, Cantone CL, MacCoss M, et al.

9-[(2-Hydroxy-1,3,2-dioxaphosphorinan-5-yl)oxymethyl]guanine P-oxide
(2'-nor-cGMP), the cyclic phosphate of 2'-nor-deoxyguanosine (2'-NDG) was
synthesized by phosphorylation of 2'-NDG and evaluated for antiherpetic activity 
in cell cultures and in animal protection studies. 2'-nor-cGMP was effective in
cell culture against both thymidine kinase deficient and wild-type herpes simplex
virus type 1 strains and also against herpes simplex virus type 2. The
anti-herpes activity of 2'-nor-cGMP against thymidine kinase deficient HSV-1 was 
confirmed by animal protection studies. Also, in comparative cell culture
protection studies, the ED50 (microM) of 2'-nor-cGMP was approximately 10-fold
lower than that of 2'-NDG against three strains of varicella zoster virus. In
addition, 2'-nor-cGMP was effective orally in preventing HSV-1 orofacial
infection and HSV-2 genital infection of mice. Topical therapeutic applications
of 2'-nor-cGMP prevented orofacial HSV-1 lesion development in mice and
development of HSV-2 genital lesions in guinea pigs. Subcutaneous application of 
2'-nor-cGMP to intracerebral HSV-1 challenged weanling mice significantly
prolonged survival. These studies indicate that 2'-nor-cGMP is not dependent on
viral thymidine kinase for its antiviral activity and is highly effective in
preventing experimental HSV infections.

PMID: 3022643 [PubMed - indexed for MEDLINE]

6913: J Med Virol. 1986 Oct;20(2):151-63.

Binding and internalization of herpes simplex virus-antibody complexes by
polymorphonuclear leukocytes.

Smith JW, Jachimowicz JR, Bingham EL.

We studied the interactions between rabbit polymorphonuclear leukocytes (PMN) and
the RE strain of herpes simplex virus type 1 (HSV-1) to determine better the role
of inflammatory cells in herpetic stromal keratitis. PMN were found to be
nonpermissive for HSV replication and were unable to bind virus in the absence of
antibody. However, PMN did bind and internalize HSV-antibody complexes in vitro
as was demonstrated visually by electron microscopic studies and quantitatively
by measurement of activity associated with radiolabeled HSV-antibody complexes.
Virus used for immune complex formation was labeled with either 125Iodine or
35S-methionine. In some experiments, anti-HSV IgG used for immune complex
formation was labeled with 125Iodine before incubation with virus. Use of all
three radiolabeling approaches resulted in the same general pattern of binding,
indicating a requirement for both antibody and virus for interaction with PMN.
The activity associated with PMN was increased by preincubation with complement. 
The results suggest an active role for PMN in controlling HSV infection through
their ability to bind and ingest virus-antibody complexes.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3021898 [PubMed - indexed for MEDLINE]

6914: Pediatrics. 1986 Oct;78(4 Pt 2):757-62.

Live attenuated varicella vaccine use in immunocompromised children and adults.

Gershon AA, Steinberg SP, Gelb L.

Live attenuated varicella vaccine has been administered to 307 children with
leukemia in remission and to 86 healthy adults. The vaccine was well tolerated
and immunogenic. The major side effect in leukemic children receiving maintenance
chemotherapy was development of a vaccine-associated rash. Vaccinees in whom a
rash developed were potentially somewhat infectious to others about 1 month after
immunization. Vaccination was not associated with an increase in the incidence of
herpes zoster or in relapse of leukemia. Vaccination provided excellent
protection against severe varicella. It was associated with a significant
decrease in the attack rate of chickenpox following an intimate exposure to
varicella-zoster virus, conferring about 80% protection in leukemic children. The
cases of breakthrough varicella that occurred were mild. Thus, the vaccine may
either prevent or modify varicella in high-risk individuals. It may also have use
for prevention of nosocomial varicella.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3020495 [PubMed - indexed for MEDLINE]

6915: Pediatrics. 1986 Oct;78(4 Pt 2):748-56.

Varicella vaccine studies in healthy children and adults.

Arbeter AM, Starr SE, Plotkin SA.

Immunization of normal children and adults with Oka strain live varicella vaccine
from several manufacturers has been studied in our laboratory and elsewhere. This
paper summarizes clinical trials designed to obtain information on minimum dose
immunogenicity pre- and postexposure prophylaxis, immunization of various age
groups, and booster immunizations for seropositive individuals. These studies
documented a 94% to 100% seroconversion rate with 95% to 100% persistence of
antibodies at 3 to 4 years. Protective efficacy was more than 90%, and the
vaccine was successful in preventing varicella when a high dose was given
postexposure. Clinical reactions were limited to temperature elevations and minor
papulovesicular rashes that occurred in 5% to 10% of vaccinees. Herpes zoster has
been absent in vaccinated healthy individuals.

PMID: 3020494 [PubMed - indexed for MEDLINE]

6916: Pediatrics. 1986 Oct;78(4 Pt 2):736-41.

Clinical overview of varicella vaccine: development and early studies.

Takahashi M.

A live varicella vaccine was developed in 1973 and has been used effectively and 
safely in normal as well as high-risk children. Some precautions are necessary
for use in the high-risk children.

PMID: 3020493 [PubMed - indexed for MEDLINE]

6917: J Gen Virol. 1986 Oct;67 ( Pt 10):2279-86.

DNA sequence of the major capsid protein gene of herpes simplex virus type 1.

Davison AJ, Scott JE.

The DNA sequence of the region of the herpes simplex virus type 1 genome encoding
the major capsid protein was determined. The predicted protein contains 1374
amino acid residues and has a molecular weight of 149,075. Comparisons of the
amino acid sequence of this protein with those predicted from the published DNA
sequences of two other herpesviruses, varicella-zoster virus and Epstein-Barr
virus, resulted in the identification of the major capsid protein gene in each
genome.

Publication Types: 
    Comparative Study

PMID: 3020164 [PubMed - indexed for MEDLINE]

6918: J Virol. 1986 Oct;60(1):185-93.

Use of lambda gt11 to isolate genes for two pseudorabies virus glycoproteins with
homology to herpes simplex virus and varicella-zoster virus glycoproteins.

Petrovskis EA, Timmins JG, Post LE.

A library of pseudorabies virus (PRV) DNA fragments was constructed in the
expression cloning vector lambda gt11. The library was screened with antisera
which reacted with mixtures of PRV proteins to isolate recombinant bacteriophages
expressing PRV proteins. By the nature of the lambda gt11 vector, the cloned
proteins were expressed in Escherichia coli as beta-galactosidase fusion
proteins. The fusion proteins from 35 of these phages were purified and injected 
into mice to raise antisera. The antisera were screened by several different
assays, including immunoprecipitation of [14C]glucosamine-labeled PRV proteins.
This method identified phages expressing three different PRV glycoproteins: the
secreted glycoprotein, gX; gI; and a glycoprotein that had not been previously
identified, which we designate gp63. The gp63 and gI genes map adjacent to each
other in the small unique region of the PRV genome. The DNA sequence was
determined for the region of the genome encoding gp63 and gI. It was found that
gp63 has a region of homology with a herpes simplex virus type 1 (HSV-1) protein,
encoded by US7, and also with varicella-zoster virus (VZV) gpIV. The gI protein
sequence has a region of homology with HSV-1 gE and VZV gpI. It is concluded that
PRV, HSV, and VZV all have a cluster of homologous glycoprotein genes in the
small unique components of their genomes and that the organization of these genes
is conserved.

Publication Types: 
    Comparative Study

PMID: 3018284 [PubMed - indexed for MEDLINE]

6919: Am J Nurs. 1986 Oct;86(10):1138-41.

Aging skin.

Berliner H.

PMID: 2945435 [PubMed - indexed for MEDLINE]

6920: Pharmacol Res Commun. 1986 Oct;18(10):991-6.

Griseofulvin-methisoprinol combination in the treatment of herpes zoster.

Castelli M, Zanca A, Giubertoni G, Zanca A, Bertolini A.

A total of 57 herpes zoster patients (28 men and 28 women) were randomly assigned
to one of the following four treatments: griseofulvin, 125 mg four times daily;
methisoprinol, 1 g four times daily; griseofulvin plus methisoprinol (dosage
schedules as above); placebo, four times daily. Griseofulvin had no effect at
all, methisoprinol both significantly accelerated drying of vesicles and reduced 
pain, and the combination of griseofulvin and methisoprinol turned out to be
significantly more effective in reducing pain than methisoprinol alone. The
present results suggest a new effective treatment for herpes zoster disease.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 2433701 [PubMed - indexed for MEDLINE]

6921: Br Dent J. 1986 Sep 20;161(6):217-8.

Oral herpes zoster with contralateral skin involvement.

Hill PA, Lamey PJ.

Publication Types: 
    Case Reports

PMID: 3463341 [PubMed - indexed for MEDLINE]

6922: Lancet. 1986 Sep 20;2(8508):694-5.

Viral origin of hairy leukoplakia.

Friedman-Kien AE.

Publication Types: 
    Case Reports
    Letter

PMID: 2876171 [PubMed - indexed for MEDLINE]

6923: Arch Otolaryngol Head Neck Surg. 1986 Sep;112(9):925-8.

Electrocochleography and brain-stem potentials in Ramsay Hunt syndrome.

Abramovich S, Prasher DK.

Audiometric investigations and electrophysiologic recordings of cochlear and
brain-stem auditory evoked potentials (BAEPs) were performed in 13 patients to
elucidate further the type of hearing disorders in Ramsay Hunt syndrome.
Transtympanic electrocochleography showed no enhancement of summating potential
and did not suggest secondary endolymphatic hydrops. The recording of BAEPs was
clearly abnormal in several of the 13 patients. The striking feature of the
abnormalities in these patients was the prolongation of the latencies of waves
III and V with the preservation of wave I, which clearly suggests retrocochlear
involvement. In all the patients tested, abnormalities of the BAEPs were present 
only on the affected side. It is possible, on the basis of BAEP findings, to
suggest that in Ramsay Hunt syndrome both cochlear and retrocochlear involvement 
may occur.

PMID: 3741657 [PubMed - indexed for MEDLINE]

6924: Histopathology. 1986 Sep;10(9):953-62.

Haemolytic-uraemic syndrome in recipients of bone marrow transplants not treated 
with cyclosporin A.

Marshall RJ, Sweny P.

We report three cases of haemolytic-uraemic syndrome following bone marrow
transplantation in young males. None of them was treated with cyclosporin A. All 
died in renal failure. Renal histology showed the typical appearances of
haemolytic-uraemic syndrome. Immunoperoxidase examination of renal biopsies
showed IgM and complement in blood vessels and glomeruli of all three cases.
Cytomegalovirus infection was present in two cases and probable in the third. Two
cases had been infected with herpes zoster. All had episodes of graft-versus-host
disease. Possible pathogenetic mechanisms are discussed.

Publication Types: 
    Case Reports

PMID: 3536715 [PubMed - indexed for MEDLINE]

6925: J Infect. 1986 Sep;13(2):159-62.

Renal failure in the course of reactivation of varicella-zoster virus infection
in a renal transplant recipient.

Bourbigot B, Quillien MC, Airiau J, Hardy E, Guiserix J, Leroy JP, Cledes J,
Chastel C.

Renal failure developed in a 20-year-old female renal transplant recipient in the
course of reactivation of varicella-zoster virus infection. The patient was
treated with acyclovir and immunosuppression was continued. The year later renal 
function in the transplanted kidney was satisfactory.

Publication Types: 
    Case Reports

PMID: 3531351 [PubMed - indexed for MEDLINE]

6926: J Infect Dis. 1986 Sep;154(3):430-6.

2'-Fluoro-5-iodoarabinosylcytosine, a new potent antiviral agent: efficacy in
immunosuppressed individuals with herpes zoster.

Leyland-Jones B, Donnelly H, Groshen S, Myskowski P, Donner AL, Fanucchi M, Fox
J.

2'-Fluoro-5-iodoarabinosylcytosine (FIAC) has potent antiviral activity in vivo
against herpes simplex virus types 1 and 2 and cytomegalovirus. For examination
of the clinical efficacy of FIAC, a randomized, double-blind study of FIAC versus
adenine arabinoside (ara-A) was conducted in 34 immunosuppressed individuals with
varicella-zoster virus infections. The median time to the appearance of the last 
new lesion was shorter in patients who received FIAC relative to those who
received ara-A (two versus five days, respectively; P less than .001) FIAC also
reduced pain and accelerated initial crusting within 72 hr in a significantly
greater proportion of patients when compared with ara-A (P = .004 and P = .0009, 
respectively). FIAC caused few toxic reactions (mild nausea and transient
elevation in activity of serum aspartate aminotransferase). Thus FIAC is
therapeutically superior to ara-A for the treatment of varicella-zoster virus
infections in immunosuppressed subjects.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3525694 [PubMed - indexed for MEDLINE]

6927: Cancer. 1986 Sep 1;58(5):1047-54.

Pulmonary complications occurring after allogeneic bone marrow transplantation. A
study of 130 consecutive transplanted patients.

Cordonnier C, Bernaudin JF, Bierling P, Huet Y, Vernant JP.

This report deals with 81 pulmonary episodes occurring in 130 consecutive
patients who underwent allogeneic bone marrow transplantation for hematologic
malignancy in the same unit over a 5-year period. These episodes observed in
69/130 patients (53%) were mostly of infectious origin, and were investigated by 
bronchoalveolar lavage (BAL). The main causes of pneumonia were: cytomegalovirus 
(CMV) (n = 25), bacterial pneumonia (n = 17), invasive aspergillosis (n = 11) and
pulmonary hemorrhage (n = 9). The overall mortality due to or associated with
pneumonia was 26/130 (20%). Graft-versus-host disease clearly increased the
incidence of infectious pneumonia and the mortality due to or associated with
pneumonia. Granulocyte transfusions did not influence the incidence of CMV
pneumonitis. The main causes and risk factors for pneumonia are discussed. The
role of BAL as a noninvasive procedure is stressed.

PMID: 3524798 [PubMed - indexed for MEDLINE]

6928: Cancer Treat Rep. 1986 Sep;70(9):1117-20.

Association of severe and fatal infections and treatment with pentostatin.

O'Dwyer PJ, Spiers AS, Marsoni S.

Pentostatin (dCF), an inhibitor of adenosine deaminase, has shown activity in the
treatment of several lymphoid malignancies, even in the earliest phase I trials. 
An analysis of the first 300 patients treated in such trials shows a high
incidence of severe infection (8%) during the relatively brief period of
treatment. Of 24 patients in whom infection was diagnosed, 17 had no evidence of 
myelosuppression. The causative organisms included viruses, fungi, and bacteria
of both high and low pathogenicity. Two-thirds of the infections were fatal. It
is suggested that dCF may cause a syndrome similar to severe combined
immunodeficiency during the course of treatment. Patients treated with dCF who
show evidence of infection, even in the absence of neutropenia, should receive
vigorous and rapid diagnostic evaluation to establish the cause of their
infection, and aggressive treatment of suspected organisms.

PMID: 3488805 [PubMed - indexed for MEDLINE]

6929: Zhonghua Kou Qiang Ke Za Zhi. 1986 Sep;21(5):305-6.

[Herpes zoster of the trigeminal nerve]

[Article in Chinese]

Liu YJ.

Publication Types: 
    Case Reports

PMID: 3472835 [PubMed - indexed for MEDLINE]

6930: Nippon Rinsho. 1986 Sep;44(9):2028-35.

[Pathology of herpesvirus infections]

[Article in Japanese]

Kurata T, Sata T.

PMID: 3025475 [PubMed - indexed for MEDLINE]

6931: Stroke. 1986 Sep-Oct;17(5):1024-8.

Subarachnoid hemorrhage and granulomatous angiitis of the basilar artery:
demonstration of the varicella-zoster-virus in the basilar artery lesions.

Fukumoto S, Kinjo M, Hokamura K, Tanaka K.

A 70-year-old man, with regional herpes zoster (C2) of 10 weeks duration, died
following subarachnoid hemorrhage caused by the rupture of an aneurysm in the
basilar artery. Granulomatous angiitis, with multinucleated giant cells, was
found at autopsy in the wall of the aneurysm. Electron microscopy of the basilar 
artery disclosed intracytoplasmic viral particles with an envelope which measured
150-220 nm in diameter. Immunohistochemistry studies revealed
varicella-zoster-virus-related antigen in the cytoplasm and/or in the nucleus of 
histiocytes in the vessel wall. These findings suggest that varicella-zoster
virus may be linked to the development of granulomatous angiitis.

Publication Types: 
    Case Reports

PMID: 3020742 [PubMed - indexed for MEDLINE]

6932: Scand J Immunol. 1986 Sep;24(3):261-71.

Production of specific antibodies by cerebrospinal fluid lymphocytes in patients 
with herpes zoster, mumps meningitis and herpes simplex virus encephalitis.

Forsberg P, Kam-Hansen S, Fryden A.

We applied a new method consisting of short-term culture (18 h) of lymphocytes
from cerebrospinal fluid (CSF-L) and peripheral blood (PBL) in viral
antigen-coated ELISA plates and subsequent measurement of IgG and IgM antibodies 
bound to antigen. Utilizing mumps virus, herpes simplex virus (HSV), varicella
zoster virus (VZV), and measles virus as antigens, we demonstrated production by 
CSF-L of antibodies against the aetiological agent only in all patients with
mumps meningitis and HSV encephalitis and also in all patients with herpes zoster
without central nervous system (CNS) symptoms. This might be considered as direct
evidence that specific antibodies are produced within the CNS in inflammatory
nervous system diseases. CSF-L usually produced higher amounts of antibodies than
the corresponding number of PBL. In comparison with concentrations of free
antibodies determined in parallel, our method had higher specificity and
sensitivity and gave more precise information about the antibody response in
infections of the nervous system.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3018917 [PubMed - indexed for MEDLINE]

6933: J Gen Virol. 1986 Sep;67 ( Pt 9):1817-29.

Analysis of varicella-zoster virus DNAs of clinical isolates by endonuclease
HpaI.

Hayakawa Y, Yamamoto T, Yamanishi K, Takahashi M.

The DNAs of 20 strains of varicella-zoster virus (VZV) isolated from
epidemiologically unrelated individuals, and of 15 strains isolated from vesicles
of vaccinees with varicella or zoster after vaccination, were compared by
restriction enzyme cleavage using HpaI. Differences were found in the sizes of
the HpaI-F, -G and -K fragments of the wild strains. The gel migration patterns
of the HpaI-F and -G fragments, but not of the HpaI-K fragment, were polymorphic 
in the different strains isolated from the vaccinees. The effects of serial
passages in vitro and in humans on the genome stability of VZV were investigated 
by HpaI analysis. The DNA profiles of the HpaI-K fragments from six isolates
recovered from room-mates infected in a single outbreak were identical, but the
mobilities of their HpaI-F and -G fragments varied. The DNA profiles of the Oka
vaccine virus after 10 and 85 passages in human embryo cells differed only in the
HpaI-F fragment. The profiles of these fragments in DNA derived from two isolates
obtained at different times from a vaccinee with varicella followed by zoster
were compared with those of the Oka (parental) and Oka (vaccine) strains, and
identical results were obtained for the two viruses. In addition, the same DNA
profiles of HpaI fragments were obtained from three sequential isolates from one 
person and also from two isolates from another with varicella and zoster. Thus,
it was concluded that: three variable fragments (HpaI-K, -F and -G) were not
changed in the DNAs of isolates derived from the same patient; HpaI-K was stable 
both on passage in vitro and after human transmission in the case of the same
outbreak, but was different among all wild-type strains isolated in
epidemiologically unrelated outbreaks; HpaI-F was very unstable both on passage
in vitro and in human infections by either vaccine or wild-type strains; HpaI-G
was not influenced by passage in vitro but varied among wild-type strains. Using 
physical maps of VZV DNA established by others, three variable regions on the
viral genome were identified. One was located near the 0.16 coordinate, which is 
covered by HpaI-K (variable region I, VRI). Another was represented by HpaI-F
(VRII), the most unstable fragment, and mapped at about the 0.35 coordinate. The 
third was VRIII near the right terminus, covered by HpaI-G.

Publication Types: 
    Comparative Study

PMID: 3018125 [PubMed - indexed for MEDLINE]

6934: J Gen Virol. 1986 Sep;67 ( Pt 9):1759-816.

The complete DNA sequence of varicella-zoster virus.

Davison AJ, Scott JE.

The entire DNA sequence of varicella-zoster virus (VZV) was determined using the 
M13-dideoxynucleotide technology. The genome is variable in size, but the
sequence which was obtained comprises 124884 bp. Analysis of the sequence
indicated that the genome contains 70 genes distributed about equally between the
two DNA strands. The genes are organized compactly, but regions of overlap
between protein-coding regions are not extensive. Many of the genes are arranged 
in 3'-coterminal families, and at least one is spliced. The discerned
organization of VZV genes and that deduced for herpes simplex virus type 1
(HSV-1) from published transcript mapping data indicate that these two members of
the Alphaherpesvirinae are very similar in gene layout. Comparisons of the
predicted amino acid sequences of VZV proteins with those available for HSV-1
proteins generally suggest evolution from an ancestral genome, and allow the
functions of several VZV genes to be deduced, although limited regions where the 
genomes differ in functional organization were also identified.

PMID: 3018124 [PubMed - indexed for MEDLINE]

6935: Virology. 1986 Sep;153(2):230-47.

The properties and sequence of glycoprotein H of herpes simplex virus type 1.

Gompels U, Minson A.

The map position of the coding sequence of glycoprotein H of herpes simplex virus
type 1 was determined by marker transfer studies in which DNA fragments cloned
from a virus resistant to neutralisation by an anti-gH monoclonal antibody were
used to transfer antibody resistance to wild type virus DNA following
cotransfection. The gH coding sequence was mapped to the BglII "m" fragment of
HSV-1 DNA (map coordinates 0.27-0.312), confirming the map position previously
determined by intertypic recombinant analysis (Buckmaster et al., 1984). The
complete nucleotide sequence of the BglII "m" fragment revealed two large open
reading frames in addition to the thymidine kinase gene. The open reading frame
lying immediately 3' of the thymidine kinase gene has a predicted translation
product with the features of a large glycoprotein. This open reading frame
translates to an amino acid sequence of 90,323 mol wt with a signal peptide, a
membrane anchor sequence, a large external domain containing potential
N-glycosylation sites, and a charged C- terminal cytoplasmic domain. We suppose
that this amino acid sequence corresponds to gH of HSV-1, and A. Davison
(personal communication) has noted the existence of homologous glycoproteins
predicted from the nucleotide sequences of Varicella-zoster virus and
Epstein-Barr virus. The properties of monoclonal antibody LP11, directed against 
gH show remarkable similarities to the properties for gD antibodies. LP11
efficiently neutralizes virus infectivity, blocks cell fusion by syncytial virus 
strains, and inhibits the formation of plaques when added to cell monolayers
after infection. These similarities in antibody activity imply functional
relatedness between gH and gD of herpes simplex virus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3016991 [PubMed - indexed for MEDLINE]

6936: J Virol. 1986 Sep;59(3):660-8.

Putative glycoprotein gene of varicella-zoster virus with variable copy numbers
of a 42-base-pair repeat sequence has homology to herpes simplex virus
glycoprotein C.

Kinchington PR, Remenick J, Ostrove JM, Straus SE, Ruyechan WT, Hay J.

A strain variation of varicella-zoster virus that maps to the UL region of the
genome was found to be due to different copy numbers of a high GC 42-base-pair
repeat. DNA sequence analysis of this variable region showed the sequence to be
5-GCGGGATCGGGCTTTCGGG(A/T)AGCGGCCGAGGTGGGCGCGACG-3. Strains Scott and Webster
both contain 7 and 32/42 copies of the repeat, whereas strain Oka has exactly 4
copies less. Microheterogeneity exists within the repeated sequences, depending
on the strain and the repeat number. Sequencing of the entire EcoRI P fragment
(which contains the repeated sequences) and part of the adjacent EcoRI M and
EcoRI Q fragments from strain Scott showed that the repeats are part of a large
open reading frame that could code for a polypeptide core with a molecular weight
of 66,000. Several potential TATA boxes exist upstream and two polyadenylation
signals are found downstream of the open reading frame. The predicted protein
bears several characteristics of a glycoprotein. The region is transcriptionally 
active in varicella-zoster virus-infected cells, specifying at least three RNA
species of 1.7, 1.95, and 2.5 kilobases, which are transcribed from the same DNA 
strand. Part of the predicted protein has a high degree of homology to the herpes
simplex virus type 1 glycoprotein gC.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3016329 [PubMed - indexed for MEDLINE]

6937: Semin Respir Infect. 1986 Sep;1(3):193-201.

Viral pneumonia in the immunocompromised patient.

Shanley JD, Jordan MC.

Section of Infectious Diseases, University of Minnesota School of Medicine,
Minneapolis.

Publication Types: 
    Review

PMID: 2825314 [PubMed - indexed for MEDLINE]

6938: Urologe A. 1986 Sep;25(5):286-7.

[Urinary retention in herpes zoster]

[Article in German]

Persson C, Melchior H.

We report on 4 cases of transient neurogenic dysfunction of the urinary bladder
caused by herpes zoster. All patients noticed a slow urinary stream leading to
complete urinary retention and loss of sensation following the vesicular stage of
herpes zoster, necessitating the insertion of a suprapubic tube. Urodynamic
evaluations revealed a detrusor acontractility, cystoscopic findings included a
unilateral cystitis. Symptoms and residual urine spontaneously disappeared after 
2 to 3 weeks. The cause is a sacral meningo-radiculitis with herpes zoster virus 
leading to a transient neuromotoric paralysis of the urinary bladder.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2431531 [PubMed - indexed for MEDLINE]

6939: J Clin Microbiol. 1986 Sep;24(3):474-7.

Confirmation of human cytomegalovirus by reverse passive hemagglutination with
monoclonal antibodies reactive to the major glycosylated peptide (GP-66).

Kim KS, Sapienza V, Chen CM.

Sheep erythrocytes coated with three monoclonal antibodies, each reactive to a
different epitope of the 66-kilodalton cytomegalovirus (CMV) matrix protein, were
used in a reverse passive hemagglutination test with CMV-infected cell lysate to 
identify and confirm the CMV. The test is specific only for CMV, since 5
laboratory strains of CMV (AD169, Davis, Espilat, C-87, and Towne) and 10
clinical isolates reacted well, but uninfected MRC-5 cell lysate, lysates of
herpes simplex virus types 1 and 2, varicella-zoster virus, and adenoviruses did 
not react. The reactive CMV lysate was confirmed by the pretreatment of CMV
lysate with the three monoclonal antibodies followed by the addition of
antibody-coated erythrocytes. The reverse passive hemagglutination test and the
confirmatory blocking test are performed at the same time, requiring 2 h to
complete. Since V-bottom microtiter 96-well plates and a 25-microliter pipette
can be used to perform the test, it is ideal for CMV confirmation, especially
when the equipment to read the fluorescent-antibody test or enzyme-linked
immunosorbent assay is not available.

PMID: 2428828 [PubMed - indexed for MEDLINE]

6940: Dtsch Med Wochenschr. 1986 Aug 22;111(34):1303.

[Herpes zoster in early gastric carcinoma]

[Article in German]

Ebker E.

Publication Types: 
    Case Reports
    Letter

PMID: 3017672 [PubMed - indexed for MEDLINE]

6941: J Immunol. 1986 Aug 15;137(4):1346-51.

Immunity to varicella-zoster viral glycoproteins, gp I (gp 90/58) and gp III (gp 
118), and to a nonglycosylated protein, p 170.

Arvin AM, Kinney-Thomas E, Shriver K, Grose C, Koropchak CM, Scranton E, Wittek
AE, Diaz PS.

Humoral and cellular immunity against two major glycoproteins (gp) of
varicella-zoster virus (VZV), gp I (gp 90/58) and gp III (gp 118), and against a 
nonglycosylated phosphoprotein (p 170) was demonstrated in human subjects.
Primary VZV infection was accompanied by the development of IgG to gp I (mean
titer 1:200), gp III (mean titer 1:132), and p 170 (mean titer 1:331). Increased 
IgG antibody production to each of the VZV proteins occurred during recurrent VZV
infection with mean titers to gp I of 1:29512, to gp III of 1:15848, and to p 170
of 1:15848. Persistent high titers to gp III (mean titer 1:891) and to p 170
(mean titer 1:2238) were observed in 75% and 88% of VZV-immune subjects,
respectively. T lymphocytes which proliferated on stimulation with gp I, gp III, 
and p 170 developed with primary VZV infection. VZV-immune subjects had mean
transformation indices of 4.2 +/- 0.70 SE to gp I, 4.7 +/- 1 SE to gp III, and 3 
+/- 0.39 SE to p 170. Among individual subjects, humoral and cellular immunity
was not always detected to all three of the VZV proteins. Resolution of primary
VZV infection and maintenance of VZV latency did not require a host response to
each of these major viral proteins.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3016094 [PubMed - indexed for MEDLINE]

6942: Rinsho Shinkeigaku. 1986 Aug;26(8):797-800.

[A case of sarcoidosis accompanied by herpes zoster encephalitis]

[Article in Japanese]

Kobayashi H, Ota K, Yamane K, Kabayashi I, Maruyama S.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3802672 [PubMed - indexed for MEDLINE]

6943: Vrach Delo. 1986 Aug;(8):114-6.

[Nervous system lesions in herpes zoster]

[Article in Russian]

Rudenko AE, Lushchin IuK, Muravskaia LV, Novikova OV.

Publication Types: 
    English Abstract

PMID: 3776146 [PubMed - indexed for MEDLINE]

6944: J Otolaryngol. 1986 Aug;15(4):224-7.

Head and neck pain in the elderly.

MacRae DL.

Pain in the head and neck region is a common symptom in elderly people, with
degenerative disease and neoplasms being the most frequent causes. Pain of
neuralgic, orbital and vascular origin requires a multidisciplinary approach.
Adequate suppression of pain by appropriate medical or surgical methods is of
paramount importance to the patient's well-being even when the underlying disease
cannot be cured.

PMID: 3747016 [PubMed - indexed for MEDLINE]

6945: South Med J. 1986 Aug;79(8):1026-8.

Trigeminal herpes zoster causing mandibular osteonecrosis and spontaneous tooth
exfoliation.

Manz HJ, Canter HG, Melton J.

We have described a 60-year-old woman with polymyalgia rheumatica treated
initially with prednisone but ultimately with azathioprine and cyclophosphamide. 
Herpes zoster infection along the mandibular division of the right trigeminal
nerve ensued with spontaneous exfoliation of two teeth. She subsequently died.
Medical practitioners need to be made aware of this rare complication of a common
disease.

Publication Types: 
    Case Reports

PMID: 3738577 [PubMed - indexed for MEDLINE]

6946: Postgrad Med. 1986 Aug;80(2):241-9.

Blistering diseases in children. How to recognize and treat the most common.

Weston WL.

The most common blistering diseases encountered in children are impetigo, burns, 
acute dermatitis, friction blisters, viral blisters, insect bite reactions, and
linear IgA dermatosis. Diagnosis should be based on specific clinical
manifestations and, when necessary, results of a Tzanck test or skin biopsy. A
search for an intact blister is always warranted when erosions, oozing, or crusts
are noted.

PMID: 3737496 [PubMed - indexed for MEDLINE]

6947: Arch Ophthalmol. 1986 Aug;104(8):1176-7.

Abnormal spatial localization in patients with herpes zoster ophthalmicus.
Evidence for the presence of proprioceptive information.

Campos EC, Chiesi C, Bolzani R.

Patients with herpes zoster of the ophthalmic branch of the trigeminal nerve and 
normal ocular motility were examined. They were asked to point to targets without
the sight of their own hand. Significant errors were found on the affected side. 
Proprioceptive information of the extraocular muscles is assumed to travel in the
trigeminal nerve, and these results thus suggest the existence of peripheral
afferent signals influencing eye-hand coordination.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3488730 [PubMed - indexed for MEDLINE]

6948: Clin Haematol. 1986 Aug;15(3):873-904.

Infection and transfusion therapy in acute leukaemia.

Ho WG, Winston DJ.

Granulocytopenia is the single most important risk factor for infection in
patients with acute leukaemia. There are limitations to the effective prophylaxis
of infection in granulocytopenic patients, but practical measures include the
management of the patient in a private hospital room, the requirement of all
medical personnel and visitors to wash their hands carefully and to wear masks,
restricting the patient to a low-bacteria diet devoid of fresh fruit, vegetables 
and salads, and the administration of oral antimicrobial agents for
gastrointestinal decontamination. When fever develops, empirical therapy with a
combination of an aminoglycoside plus an antipseudomonal beta-lactam should be
started promptly. A double beta-lactam combination of cefoperazone or ceftazidime
plus piperacillin can be substituted if nephrotoxicity is a concern. The addition
of empirical intravenous amphotericin may be useful in patients who remain
febrile and granulocytopenic on broad-spectrum antibiotics, especially if
surveillance cultures indicate fungal colonization. Amphotericin is also the most
reliable agent for the treatment of established fungal infections. Acyclovir is
not recommended for prophylaxis in acute leukaemia patients but should be
reserved for the treatment of well-documented and clinically significant herpes
simplex viral infections. During periods of remission, most patients with AML
remain free of infection except when they become granulocytopenic again during
intensification or consolidation chemotherapy. On the other hand, children with
ALL in remission may experience frequent infections unrelated to granulocytopenia
as a consequence of their maintenance chemotherapy. Pneumocystis carinii,
varicella zoster, and other viruses are common pathogens.
Trimethoprim-sulphamethoxazole is effective prophylaxis against Pneumocystis
carinii pneumonia in patients with ALL, while intravenous acyclovir is the drug
of choice for treatment of varicella zoster infection. Transfusion therapy in the
acute leukaemia patient is guided by the patient's peripheral blood counts and
degree of sensitization to blood products. Generally, packed red blood cells are 
given in order to maintain the haematocrit at greater than 30%, while
random-donor platelets are administered to keep the platelet count at greater
than 20 X 10(9)/l. If refractoriness to platelet transfusions develops,
HLA-matched platelets from family members or selected unrelated donors can be
used. Similarly, washed or filtered red blood cells may be given to patients with
previous and recurrent non-haemolytic febrile reactions to red blood cell
transfusions.(ABSTRACT TRUNCATED AT 400 WORDS)

Publication Types: 
    Review

PMID: 3096621 [PubMed - indexed for MEDLINE]

6949: Laryngoscope. 1986 Aug;96(8):870-7.

The relationship of the herpesvirus family to sudden hearing loss: a prospective 
clinical study and literature review.

Wilson WR.

The herpesvirus family is associated with sudden hearing loss syndrome and the
evidence includes clinical findings (HV-Z), temporal bone studies (CMV and HV-Z),
and serologic studies. The data presented demonstrate that herpes infections, in 
association with sudden viral hearing loss, occur as part of a multiple viral
infection in 70% of instances. This feature is unique to the herpesvirus
infections when compared to other neurotropic viral agents. The study also
demonstrates that the variables of viral hearing loss, such as degree of hearing 
loss, percentage of recovery, or the incidence of vertigo are unaffected by the
presence of herpesvirus infection. Mechanisms for inner ear injury may be
influenced by temporary alterations in cellular immunity secondary to
simultaneous viral infections as well as the native virulence of the infecting
herpesvirus.

PMID: 3016434 [PubMed - indexed for MEDLINE]

6950: J Gen Virol. 1986 Aug;67 ( Pt 8):1613-23.

Identification of a varicella-zoster virus origin of DNA replication and its
activation by herpes simplex virus type 1 gene products.

Stow ND, Davison AJ.

We have identified and characterized an origin of DNA replication in the genome
of the human herpesvirus, varicella-zoster virus (VZV). This origin of
replication (VZV ORIS) is located within the major inverted repeats in a position
equivalent to that occupied by one of the herpes simplex virus type 1 (HSV-1)
replication origins. Products encoded by both VZV and HSV-1 activate cloned
copies of VZV ORIs, generating high molecular weight molecules consisting of
tandem duplications of the input plasmid. The VZV ORIS region contains a tract of
alternating A and T residues located at the centre of symmetry of an almost
perfect palindrome of 45 bp, and the use of plasmid deletion mutants has
demonstrated that this tract is an important functional element of the origin.
Two sequences common to the VZV ORIS region and the regions specifying the two
HSV-1 origins (ORIS, located within the TRS/IRS regions, and ORIL, located within
the UL region) were identified and these may represent important recognition
sites. One is an 11 bp sequence (CGTTCGCACTT), and the other is represented by
the tract of alternating A and T residues. VZV does not appear to contain an
origin of replication in a position equivalent to that of HSV-1 ORIL.

PMID: 3016156 [PubMed - indexed for MEDLINE]

6951: Contact Dermatitis. 1986 Aug;15(2):114-5.

Contact allergy to antiviral agents.

Angelini G, Vena GA, Meneghini CL.

PMID: 2946523 [PubMed - indexed for MEDLINE]

6952: Arch Neurol. 1986 Aug;43(8):836-40.

Postherpetic neuralgia. A review.

Watson PN, Evans RJ.

Postherpetic pain persisting one month or longer occurs in 9% to 14% of patients 
with herpes zoster, diminishing with time. The incidence and duration are
directly related to age. The pathologic features have been described but the
pathogenesis of postherpetic neuralgia is unknown. Treatment remains difficult.
It is reasonable to hope for a reduction in pain from severe to mild in two of
three cases. There is evidence to support the use of low doses of tricyclic
antidepressants, especially amitriptyline hydrochloride, with gradual small
increments, and also the use of phenothiazines. Corticosteroids may exert a
preventive effect when used in the acute phase. There is some support for the use
of local physical modalities. Neurosurgical procedures are a possibility in
failed medical cases. Controlled studies of newer approaches are necessary.

PMID: 2873807 [PubMed - indexed for MEDLINE]

6953: Br Dent J. 1986 Jul 19;161(2):53-60.

Acquired immune deficiency syndrome: review.

Scully C, Cawson RA, Porter SR.

PIP: Acquired immunodeficiency syndrome (AIDS) is reviewed for dental
practitioners, with an emphasis on oral findings; the clinical course, diagnosis,
reporting, treatment, prognosis, transmission, and epidemiology are also covered.
HIV infection has an incubation period that may be associated with glandular
fever, a prodrome called AIDS-Related Complex (ARC) characterized by
lymphadenopathy, low fever, weight loss, night sweats, diarrhea, oral candidosis,
nonproductive cough and recurrent infections. AIDS is characterized by
opportunistic infections. Over 50% present with pneumocystis carinii pneumonia,
21% with Kaposi's sarcoma, and 6% have both. The AIDS virus causes direct
neurological symptoms in some cases. Oral candidosis (thrush) in a young male
without a local cause such as xerostomia or immune suppression is strongly
suggestive of AIDS. Other oral manifestations are severe herpes simplex,
varicella-zoster, Epstein-Barr virus, cytomegalovirus, venereal warts, aphthous
ulceration, mycobacterial oral ulcers, oral histoplasmosis, sinusitis and
osteomyelitis of the jaw. Hairy leukoplakia, usually seen on the lateral border
of the tongue, is probably caused by Epstein-Barr virus. Kaposi's sarcoma, an
endothelial cell tumor, is characteristic of AIDS, and in 50% of patients is oral
or perioral. Cervical lymph node enlargement will be seen in those with ARC as
well as AIDS. No guidelines have been issued by the Department of Health and
Social Security for dental surgeons in the UK for reporting AIDS cases. Although 
HIV virions have been isolated from saliva, there are no known incidents of
transmission via saliva. HIV is less likely to be transmitted by needle stick
injuries than, for example hepatitis B (25% risk), especially if the blood is
from a carrier rather than a full blown AIDS case.

Publication Types: 
    Review

PMID: 3524629 [PubMed - indexed for MEDLINE]

6954: Virology. 1986 Jul 15;152(1):181-91.

Identification and structure of the gene encoding gpII, a major glycoprotein of
varicella-zoster virus.

Keller PM, Davison AJ, Lowe RS, Bennett CD, Ellis RW.

The genome of varicella-zoster virus (VZV) encodes three major families of
glycoproteins (gpI, gpII, and gpIII). mRNA from VZV-infected cells was hybrid
selected using a library of VZV recombinant plasmids and translated in vitro;
polypeptide products were immunoprecipitated by polyclonal monospecific guinea
pig antibodies to gpII. The mRNA encoding a 100-kD polypeptide precipitable by
anti-gpII antibodies mapped to the HindIII D fragment near the center of the UL
region. DNA sequence analysis of this region of the VZV genome revealed a 2.6-kbp
open reading frame (ORF) potentially encoding a 98-kDa polypeptide possessing the
characteristics of a glycoprotein. The 100-kDa polypeptide was specified by mRNA 
isolated by hybrid selection using a plasmid containing part of the 2.6-kbp ORF, 
and immunoprecipitation of this protein by anti-gpII antibodies and by
convalescent zoster serum was blocked specifically by purified gpII. We conclude 
that the 2.6-kbp ORF encodes gpII. The imputed primary amino acid sequence of
gpII shows a high degree of homology to that of herpes simplex virus type 1
(HSV-1) gB, a result consistent with the equivalent map locations of the
respective genes in the HSV and VZV genomes and with the recently reported
serological cross-reactivity of HSV-1 gB and VZV gpII. Unlike the mature gene
products of gB, those of gpII have been described as a pair of glycoproteins with
approximate molecular weights of 60 kDa in reducing gels, products of a single
glycoprotein species with approximate mol mass of 125-140 kDa in nonreducing
gels. Amino-terminal sequences of purified gpII were determined and compared to
the imputed amino acid sequence. This comparison implies that the primary
translational product is cleaved approximately into halves in vivo and suggests
that mature gpII is a disulfide-linked heterodimer.

Publication Types: 
    Comparative Study

PMID: 3012867 [PubMed - indexed for MEDLINE]

6955: Med J Aust. 1986 Jul 7;145(1):60.

Herpes zoster and corticosteroid therapy.

Mills K.

Publication Types: 
    Letter

PMID: 3724640 [PubMed - indexed for MEDLINE]

6956: Dtsch Med Wochenschr. 1986 Jul 4;111(27):1068-73.

[Neurologic manifestations in acquired immunodeficiency syndrome (AIDS)]

[Article in German]

Kesselring J.

Publication Types: 
    Review

PMID: 3013565 [PubMed - indexed for MEDLINE]

6957: Masui. 1986 Jul;35(7):1099-106.

[Results of nerve block treatment in 1,000 patients with zoster-related pain]

[Article in Japanese]

Noda B, Dan K, Higa K, Manabe H.

Publication Types: 
    English Abstract

PMID: 3773256 [PubMed - indexed for MEDLINE]

6958: Rinsho Shinkeigaku. 1986 Jul;26(7):689-92.

[A case report of myoclonus following herpes zoster infection]

[Article in Japanese]

Matsumoto Y, Tsuchiya I, Kayanuma K, Uono M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3769315 [PubMed - indexed for MEDLINE]

6959: Anticancer Res. 1986 Jul-Aug;6(4):549-56.

Potential of bromovinyldeoxyuridine in anticancer chemotherapy.

De Clercq E.

Bromovinyldeoxyuridine (BVDU) is a highly potent and selective antiherpetic agent
which offers great potential for the treatment of severe herpes simplex virus
type 1 (HSV-1) and varicella-zoster virus (VZV) infections in cancer patients.
BVDU inhibits the replication of HSV-1 and VZV at a concentration as low as 1-10 
ng/ml; and the proliferation of tumor cells transformed with the HSV-1 thymidine 
kinase gene is even inhibited by BVDU concentrations lower than 1 ng/ml.
Moreover, BVDU is inhibitory to Epstein-Barr virus replication in vitro at a
concentration of 0.02 micrograms/ml. Due to the action of pyrimidine nucleoside
phosphorylases, BVDU is rapidly degraded to the free pyrimidine base
bromovinyluracil (BVU). In contrast to BVDU, which is cleared from the
bloodstream within 2-3 hours, BVU persists in the plasma for at least 24 hours.
During this period BVU can be converted again to BVDU upon administration of
deoxythymidine, deoxyuridine or any other deoxyribonucleoside capable of
transferring its deoxyribosyl moiety onto BVU. BVU owes its long persistence in
the bloodstream to the fact that it does not act as substrate for dihydrothymine 
dehydrogenase, the enzyme that catalyzes the first step in the catabolic pathway 
of pyrimidines. On the contrary, BVU acts as an efficient inhibitor of this
enzyme and thereby prevents the degradation of fluorouracil (FU), a well-known
anticancer agent. As a consequence, BVDU via BVU enhances the antitumor activity 
of FU, as has been demonstrated in the murine P388 leukemia model. Thus, BVDU may
be useful in anticancer chemotherapy from several viewpoints, e.g. for treatment 
of intercurrent herpesvirus infections, and, in combination with FU, for
treatment of those malignant diseases that are amenable to FU therapy.

PMID: 3752935 [PubMed - indexed for MEDLINE]

6960: Neurochirurgia (Stuttg). 1986 Jul;29(4):109-10.

[Partial vertical nucleotomy as a modification of tractotomy of the trigeminal
nerve]

[Article in German]

Grunert V, Witzmann A, Grunert P.

The authors report on partial vertical nucleotomy, a modification of tractotomy
of the quintothalamic tract. In 1979 eight patients underwent this procedure.
Three of them showed a recurrence of pain from genuine trigeminal neuralgia.
Three patients had symptomatic trigeminal neuralgia, one patient atypical
neuralgia of the face without organic cause, whereas in one case the neuralgia
occurred subsequent to a herpes zoster. At the time of examination all patients
were free from pain.

Publication Types: 
    English Abstract

PMID: 3748261 [PubMed - indexed for MEDLINE]

6961: J Neurol Neurosurg Psychiatry. 1986 Jul;49(7):824-6.

Auditory dysfunction in Ramsay Hunt syndrome.

Iragui VJ.

A 48-year-old woman with a Ramsay Hunt syndrome due to herpes zoster had a
hearing deficit. Brainstem auditory evoked potentials (BAEPs) localised the site 
of dysfunction to the ipsilateral eighth nerve. Clinical improvement was
associated with improvement of the BAEP. Conventional audiological studies and
BAEPs provided no evidence of involvement of the cochlea or the brainstem. In
Ramsay Hunt syndrome, BAEPs may help to localise the site of involvement within
the auditory pathway and follow the course of the disease.

Publication Types: 
    Case Reports

PMID: 3746312 [PubMed - indexed for MEDLINE]

6962: J Laryngol Otol. 1986 Jul;100(7):839-41.

Herpes zoster of the larynx after intubational trauma.

Wackym PA, Gray GF Jr, Avant GR.

Multiple or prolonged endotracheal intubations may result in laryngeal trauma.
This case illustrates that recrudescence of latent varicella-zoster virus as
herpes zoster of the larynx, with subsequent laryngeal paralysis, can complicate 
intubation. Consequently, physicians should strive to minimize laryngeal injury
in this setting. It is advised that careful laryngeal examination follow
extubation.

Publication Types: 
    Case Reports

PMID: 3734605 [PubMed - indexed for MEDLINE]

6963: Pediatr Infect Dis. 1986 Jul-Aug;5(4):482-3.

Almost simultaneous occurrence of varicella and zoster in an otherwise healthy
child.

Mietens C.

Publication Types: 
    Case Reports

PMID: 3725660 [PubMed - indexed for MEDLINE]

6964: Clin Chem. 1986 Jul;32(7):1347-9.

Lactate dehydrogenase inhibition by immunoglobulin G in human serum.

Maekawa M, Sudo K, Iwahara K, Kanno T.

Low lactate dehydrogenase (LD; EC 1.1.1.27) activity and an abnormal LD pattern
in electrophoretograms of LD isoenzymes in the sera of two patients were caused
by inhibition of LD by immunoglobulin G. One of these showed inhibitor activity
in the serum upon direct analysis, while the other showed activity only after the
immunoglobulin was stripped from the LD. As judged from the LD isoenzyme patterns
in serum, the LD inhibitor appeared to act against M subunits. However,
quantification of binding affinities to each isolated isoenzyme showed that the
LD inhibitor had a stronger effect on LD isoenzymes 2 and 3 (H3M1 and H2M2,
respectively).

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3719944 [PubMed - indexed for MEDLINE]

6965: Ann Intern Med. 1986 Jul;105(1):58-60.

Total lymphoid irradiation in refractory systemic lupus erythematosus.

Ben-Chetrit E, Gross DJ, Braverman A, Weshler Z, Fuks Z, Slavin S, Eliakim M.

In two patients with systemic lupus erythematosus, conventional therapy was
considered to have failed because of persistent disease activity and unacceptable
side effects. Both were treated with total lymphoid irradiation without clinical 
benefit, despite adequate immunosuppression as documented by markedly reduced
numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative
responses in vitro. The first patient developed herpes zoster, gram-negative
septicemia, neurologic symptoms, and deterioration of lupus nephritis. The second
patient developed massive bronchopneumonia, necrotic cutaneous lesions, and
progressive nephritis and died 2 weeks after completion of radiotherapy. These
observations, although limited to two patients, indicate that total lymphoid
irradiation in patients with severe systemic lupus erythematosus should be
regarded as strictly experimental.

Publication Types: 
    Case Reports

PMID: 3717808 [PubMed - indexed for MEDLINE]

6966: Isr J Med Sci. 1986 Jul-Aug;22(7-8):582-6.

Cerebral toxoplasmosis complicating bone marrow transplantation.

Ackerman Z, Or R, Maayan S.

Cerebral toxoplasmosis occurred in a 34-year-old patient with chronic myelogenous
leukemia following bone marrow transplantation. The clinical picture included
headaches, nuchal rigidity, and right-sided hemiparesis during a course of
disseminated cutaneous herpes zoster. The diagnosis of toxoplasmosis was based on
serologic evidence and typical computed tomography scan of the brain as well as
clinical improvement following specific anti-Toxoplasma treatment. To the best of
our knowledge, this is the first report of cerebral toxoplasmosis in Israel.

Publication Types: 
    Case Reports

PMID: 3536798 [PubMed - indexed for MEDLINE]

6967: Int J Dermatol. 1986 Jul-Aug;25(6):369-71.

A rapid immunoperoxidase technique to distinguish herpetic types.

Ganderup G, Newburger AE, Barr RJ, Riley RJ.

The United States is experiencing an epidemic of herpetic infections. Rapid
specific diagnosis of herpes simplex types and herpes zoster is important
epidemiologically and also for individual cases since treatment as well as
prognosis for recurrence or dissemination varies with virus type. We report a
rapid test for the diagnosis and differentiation of these infections. This test
uses scrapings from viral vesicles. It employs standard immunoperoxidase
techniques and takes 2 hours to perform at 37C. Smears from 13 patients with
clinical and/or culture confirmation of viral type were tested. Eleven of eleven 
who had fresh smears (vesicles present less than 5 days) had positive staining
for the viral type expected clinically. Two patients with vesicles 5 days or
older showed nonspecific staining.

PMID: 3531043 [PubMed - indexed for MEDLINE]

6968: Dent Clin North Am. 1986 Jul;30(3):421-46.

Treatment of common orofacial conditions.

Glass BJ, Kuhel RF, Langlais RP.

The conditions discussed in this article are those most likely to cause a patient
to seek emergency care, primarily for pain. All the characteristics given for the
conditions to aid in the diagnosis do not necessarily need to be present and
other characteristics not mentioned may in fact be present. A complete
differential diagnosis, especially of more obscure lesions, was also not
attempted. An attempt was made to provide the practitioner with enough
information to develop a working diagnosis from which to alleviate the patient's 
discomfort. A definitive diagnosis may not be available in an emergency setting. 
However, it must be emphasized that the final responsibility of the dentist is to
make a definitive diagnosis at a later time if one cannot be made when emergency 
treatment is sought. Alleviating pain without dealing with the underlying cause
may be more detrimental to the patient's health in the long run, as palliative
therapy may mask a more severe condition.

Publication Types: 
    Review

PMID: 3522291 [PubMed - indexed for MEDLINE]

6969: Klin Monatsbl Augenheilkd. 1986 Jul;189(1):46-7.

[Bandage lenses in neuroparalytic keratitis]

[Article in German]

Annen D.

The successful treatment of two cases of neuroparalytic keratitis with bandage
lenses is described. The possible pathogenesis of epithelial damage and our
experience with the problems of fitting soft contact lenses on anesthetic corneas
are discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3489859 [PubMed - indexed for MEDLINE]

6970: Acta Pathol Microbiol Immunol Scand [A]. 1986 Jul;94(4):263-9.

Herpes zoster ophthalmicus and the mesencephalic nucleus. A neuropathological
study.

Reske-Nielsen E, Oster S, Pedersen B.

The ganglion Gasseri and the brainstem were examined in three old patients with
herpes zoster without predisposing diseases with special reference to the
mesencephalic trigeminal nucleus. The primary lesions in the semilunar ganglion
vary with the length of the course. Secondary changes in the brainstem were as
expected from pons to the second cervical segment of the cord. Besides, we
observed degeneration, inflammation and glial nodules in the mesencephalic
trigeminal nucleus in two patients. According to Brodal this nucleus presumably
corresponds to the semilunar and spinal ganglia. As herpes zoster virus is prone 
to attack the sensory nuclei our findings support this hypothesis.

PMID: 3489349 [PubMed - indexed for MEDLINE]

6971: Neurology. 1986 Jul;36(7):1011.

Small-vessel angiitis without angiographic signs of arteritis.

Bahar S, Tolun R, Gursoy G.

Publication Types: 
    Case Reports
    Letter

PMID: 3487045 [PubMed - indexed for MEDLINE]

6972: Clin Exp Immunol. 1986 Jul;65(1):182-9.

Interleukin 2 enhances natural killing of varicella-zoster virus-infected
targets.

Ito M, Bandyopadhyay S, Matsumoto-Kobayashi M, Clark SC, Miller D, Starr SE.

Preincubation of peripheral blood non-adherent mononuclear cells with purified or
recombinant interleukin 2 (IL-2) significantly enhanced natural killer (NK)
activity against uninfected and varicella-zoster virus (VZV)-infected targets,
while antibody-dependent cellular cytotoxicity (ADCC) against VZV-infected
targets was not increased. Preincubation of effector cells with IL-2 had no
effect on conjugate formation, but lysis of both targets was increased in single 
cell assays. IL-2-enhanced NK against VZV-infected targets was independent of
gamma-interferon (gamma-IFN) production.

Publication Types: 
    In Vitro
    Research Support, Non-U.S. Gov't

PMID: 3098472 [PubMed - indexed for MEDLINE]

6973: Pediatr Med Chir. 1986 Jul-Aug;8(4):443-52.

[Congenital infections caused by TORCH agents]

[Article in Italian]

Fabris C, Mombro M, Lio C.

The frequency of transplacental infections varies depending on the pathogen
responsible. Of the TORCH infections this paper studies the epidemiology,
pathogenesis, clinics, therapy and prophylaxis of infections caused by Rubella,
Varicella-Zoster, Cytomegalo and Herpes Simplex Viruses and by Toxoplasma Gondii,
Treponema Pallidum.

Publication Types: 
    English Abstract

PMID: 3033613 [PubMed - indexed for MEDLINE]

6974: J Clin Lab Immunol. 1986 Jul;20(3):121-7.

Antibodies against herpes simplex virus in a group of healthy humans without
reactions to herpes simplex virus antigens in blasttransformation assays.

Moller-Larsen A.

22 healthy individuals with different reactions in humoral and cell-mediated
immunity to herpes simplex virus (HSV), as found in complement-fixation,
neutralization, and blasttransformation assays have been further investigated
using antibody-dependent cell-mediated immunity (ADCC) as a serological test.
Sera from all individuals were absorbed on HSV-infected, varicella zoster virus
(VZV)-infected or uninfected cell monolayers, before they were used in ADCC with 
HSV-infected cells, as target. The results with absorbed sera were compared with 
the results from unabsorbed sera. Fresh uninactivated sera have also been used in
some of the investigations. By these experiments a group of individuals was
found, who were HSV-positive in ADCC, but negative in all other, above-mentioned 
tests. Because of these reactions they are proposed to be HSV-positives without a
latent infection.

PMID: 3018253 [PubMed - indexed for MEDLINE]

6975: J Med Virol. 1986 Jul;19(3):277-86.

Nucleic acid hybridization for detection of herpes viruses in clinical specimens.

Schuster V, Matz B, Wiegand H, Polack A, Corsten B, Neumann-Haefelin D.

A diagnostic hybridization assay for detecting varicella zoster virus (VZV),
herpes simplex virus (HSV), and Epstein-Barr virus (EBV) in different clinical
specimens was developed using cloned viral DNAs as probes. All probes detected at
least 5 pg of homologous DNA and did not cross-react with other viral or cellular
DNA. Results of cell culture, serology, and DNA assay were highly concordant.
Using a simple standardized protocol for preparation of specimens, hybridization,
and washing procedures, this sensitive and specific assay appears to be useful
for screening clinical specimens and may be helpful in confirming the serological
diagnosis of HSV encephalitis and persistent EBV infections or EBV-associated
diseases.

PMID: 3016169 [PubMed - indexed for MEDLINE]

6976: Diagn Microbiol Infect Dis. 1986 Jul;5(2):113-26.

Varicella-zoster-specific immune responses in acute herpes zoster during a
placebo-controlled trial of oral acyclovir therapy.

Mitchell CD, Gehrz RC, Balfour HH Jr.

During a placebo-controlled trial of oral acyclovir therapy for acute zoster in
immunocompetent patients, we examined the blastogenic response of peripheral
blood mononuclear cells and antibody titers in both placebo and acyclovir
recipients to determine whether the drug affected the cell-mediated or humoral
immune responses. Proliferative responses to mitogens and two dilutions of
varicella-zoster virus antigen were not inhibited when fresh peripheral blood
mononuclear cells were simultaneously tested in autologous sera collected before 
and on day 7 of a 10-day course of 2 g/day of oral acyclovir (plasma drug levels 
averaged 4.6 microM). Using cryopreserved cells from study days 0, 3, 7, 14, and 
30, thawed and tested simultaneously, there was no significant difference at the 
p less than or equal to 0.05 level between the net proliferative responses at
each time point for the two groups. On day 14, however, the proliferative
response of the acyclovir group was approximately 50% lower than that of the
placebo group. Geometric mean antibody titer rises to varicella-zoster virus were
also lower among drug recipients but not significantly so. Although this dose of 
acyclovir did not have a statistically significant effect on lymphocyte
proliferative responses to varicella-zoster virus antigen or antibody titers, the
lower values in drug recipients may be a reflection of the ability of acyclovir
to terminate viral replication, thus reducing the patient's antigenic burden.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3013495 [PubMed - indexed for MEDLINE]

6977: J Infect Dis. 1986 Jul;154(1):190.

Herpes zoster and the classification of HTLV-III/LAV-related diseases.

Deresinski SC.

Publication Types: 
    Letter

PMID: 3011924 [PubMed - indexed for MEDLINE]

6978: Postgrad Med. 1986 Jul;80(1):109-10, 113-4, 117-20.

Antiviral therapy. New drugs and their uses.

Bean B.

PMID: 2425347 [PubMed - indexed for MEDLINE]

6979: N Engl J Med. 1986 Jun 12;314(24):1582-3.

Disseminated herpes zoster or varicella following herpes zoster:
restriction-endonuclease digestion analysis.

Embil JA, McFarlane ES, Embree JE.

Publication Types: 
    Case Reports
    Letter

PMID: 3012337 [PubMed - indexed for MEDLINE]

6980: N Engl J Med. 1986 Jun 12;314(24):1542-6.

Intrauterine infection with varicella-zoster virus after maternal varicella.

Paryani SG, Arvin AM.

We investigated the consequences of maternal infection with varicella-zoster
virus in a prospective study of 43 pregnancies complicated by varicella and 14
pregnancies complicated by herpes zoster. Nine of 43 pregnant women with
varicella had associated morbidity--pneumonia (4 women), death (1), premature
labor (4 of 42), premature delivery (2 of 42), and herpes zoster (1).
Intrauterine varicella infection was identified on the basis of clinical evidence
(anomalies characteristic of the congenital varicella syndrome, acute varicella
at birth, or herpes zoster in infancy) or immunologic evidence (IgM antibody to
varicella-zoster in the neonatal period, persistent IgG antibody to
varicella-zoster at one to two years of age, or in vitro lymphocyte proliferation
in response to varicella-zoster virus antigen). The congenital varicella syndrome
occurred in 1 of 11 infants of women with first-trimester varicella. Immunologic 
evidence of intrauterine varicella infection was present in 7 of 33 infants
tested; 4 of these infants were asymptomatic. According to clinical or
immunologic criteria, 8 of 33 infants had evidence of intrauterine varicella
infection. These observations show that varicella during pregnancy was associated
with maternal morbidity and evidence of fetal infection, but that herpes zoster
was not.

PMID: 3012334 [PubMed - indexed for MEDLINE]

6981: G Clin Med. 1986 Jun;67(3):173-5.

[Varicella-zoster virus infections in pregnancy]

[Article in Italian]

Lisi B.

PMID: 3792725 [PubMed - indexed for MEDLINE]

6982: Aust Fam Physician. 1986 Jun;15(6):810.

An awful earful.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 3753335 [PubMed - indexed for MEDLINE]

6983: Klin Med (Mosk). 1986 Jun;64(6):138-40.

[Acute myopericarditis in herpes zoster]

[Article in Russian]

Novikov IuI, Kotliarova LA.

Publication Types: 
    Case Reports

PMID: 3747427 [PubMed - indexed for MEDLINE]

6984: Z Hautkr. 1986 Jun 1;61(11):773-8.

[Value of glucocorticoid treatment in herpes zoster]

[Article in German]

Wassilew SW, Lilie M.

48 patients suffering from severe acute zoster pain were treated with
methylprednisolone 1 mg/kg body weight daily, if bed rest and analgetics had not 
been effective. The pain completely vanished in 33.3% of the patients; only 20.9%
still suffered from unaltered pain. This therapy proved only to be effective if
it was applied during the first 5 to 10 days after the appearance of the first
lesions. There was no exacerbation observed in any patient. 66.6% of the patients
developed postherpetic neuralgia accompanied by rather low pains, as 61.8% of the
patients did not need analgetics.

Publication Types: 
    English Abstract

PMID: 3739396 [PubMed - indexed for MEDLINE]

6985: Arthritis Rheum. 1986 Jun;29(6):801-7.

Methotrexate therapy in juvenile rheumatoid arthritis: a retrospective study.

Truckenbrodt H, Hafner R.

Nineteen selected patients with severe, mostly systemic onset, juvenile
rheumatoid arthritis were treated with methotrexate (MTX) for an average of 10.5 
months. Twelve patients showed statistically significant improvement, as measured
by the number of affected, swollen, tender, and functionally impaired joints, and
by decreases in erythrocyte sedimentation rate and C-reactive protein and an
increase in hemoglobin level. Systemic manifestations improved in 6 of 8
patients. In 10 children receiving corticosteroids, the dosage was reduced. Seven
patients did not respond to MTX therapy. Six of them showed an unchanged disease 
course, and 1 had a relapse after 4 months of MTX treatments. Probable side
effects included gastrointestinal symptoms, elevated liver enzymes, and herpes
zoster infection. MTX treatment should be considered for children with
life-threatening or severe disabling arthritis that is unresponsive to other
therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3718568 [PubMed - indexed for MEDLINE]

6986: Neurology. 1986 Jun;36(6):745-9.

Neurologic complications of carcinoid.

Patchell RA, Posner JB.

We reviewed the records of all patients treated for carcinoid tumors at Memorial 
Sloan-Kettering Cancer Center from 1974 through 1984. Of 219 patients, 90
developed metastatic complications, and of these, 36 developed neurologic
complications. Metastases, the most common neurologic complication, included
epidural spinal cord compression (14 patients), intracranial metastases (13
patients), leptomeningeal metastases (1 patient), and peripheral nerve lesions (5
patients). Nonmetastatic complications were hepatic encephalopathy (six
patients), herpes zoster infection (two patients), cerebral infarction due to
septic emboli (one patient), superior sagittal sinus thrombosis (one patient),
and carcinoid myopathy (one patient). The carcinoid syndrome was seen in eight
patients (4%). Response of neurologic metastases to conventional radiation
therapy was usually favorable. We conclude that (1) the frequency and type of
neurologic complications associated with carcinoid tumors are similar to those
seen with other systemic cancers; (2) CNS metastases are relatively common in
patients with metastatic carcinoid (29%); and (3) the carcinoid syndrome is less 
common than CNS metastasis.

PMID: 3703281 [PubMed - indexed for MEDLINE]

6987: Ophthalmology. 1986 Jun;93(6):763-70.

Oral acyclovir in the treatment of acute herpes zoster ophthalmicus.

Cobo LM, Foulks GN, Liesegang T, Lass J, Sutphin JE, Wilhelmus K, Jones DB,
Chapman S, Segreti AC, King DH.

Seventy-one nonimmunocompromised patients with herpes zoster ophthalmicus,
presenting within seven days of onset of characteristic skin eruption, were
enrolled in a prospective, longitudinal, randomized, double-masked,
placebo-controlled trial with oral acyclovir. In a previous interim report we
noted more prompt resolution of dermatomal signs and symptoms with acyclovir
treatment. There was also a reduction of viral shedding in acyclovir-treated
patients coupled with a trend to greater rate of microdissemination of the virus 
in placebo-treated patients (Cobo LM, et al. Ophthalmology 1985; 92:1574-83).
While further substantiating these findings, we report that a ten-day course of
treatment with oral acyclovir (600 mg, five times a day) is well-tolerated and
significantly reduces the incidence and severity of the most common complications
of herpes zoster ophthalmicus: dendritiform keratopathy, stromal keratitis, and
uveitis. While this acyclovir treatment regimen reduces the zoster-related pain
during the acute phase of the disease, especially in patients treated within 72
hours of onset of skin lesions, it has no evident effect on either incidence,
severity, or duration of post-herpetic neuralgia in the patients studied.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 3488532 [PubMed - indexed for MEDLINE]

6988: Minerva Stomatol. 1986 Jun;35(6):589-94.

[Case of herpes zoster of Gasser's ganglion. Etiopathogenic and clinical
considerations]

[Article in Italian]

Parascandolo S, Grulliero A, Tortora P, Rusciano A, Bianco R.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3462473 [PubMed - indexed for MEDLINE]

6989: J Am Acad Dermatol. 1986 Jun;14(6):1023-8.

Herpes zoster: a possible early clinical sign for development of acquired
immunodeficiency syndrome in high-risk individuals.

Friedman-Kien AE, Lafleur FL, Gendler E, Hennessey NP, Montagna R, Halbert S,
Rubinstein P, Krasinski K, Zang E, Poiesz B.

Zoster is uncommon before the age of 50 years in immunologically normal
individuals, but it occurs with increased frequency in people who are
immunosuppressed. A retrospective review of 300 patients with acquired
immunodeficiency syndrome associated with Kaposi's sarcoma, revealed that 8% had 
prior zoster, a rate that is sevenfold greater than historic controls of the same
age. We prospectively examined forty-eight patients, with no known
immunodeficiency or signs of AIDS or AIDS related complex (ARC), who presented
with zoster localized to the thoracic region. Forty-one patients had known risk
factors for AIDS and thirty-five had antibody to the AIDS-associated virus (AAV) 
at the time of presentation. One seropositive subject had no known risk factors. 
Absolute lymphocyte counts, lymphocyte OKT4/OKT8 ratios, and lymphocyte mitogen
responses were all depressed in subjects with antibody to AAV when compared with 
seronegative individuals. Seven of thirty-three AAV antibody-positive subjects,
who could be followed longitudinally, developed AIDS from 1 to 28 months (mean = 
13) after zoster. One antibody-negative subject seroconverted to become AAV
seropositive 16 months after zoster and developed Kaposi's sarcoma 1 month later.
These eight subjects had persistently low lymphocyte OKT4/OKT8 ratios and
elevated beta-2 microglobulin. In patients at risk for AIDS, the occurrence of
zoster may be one sign that heralds the marked depression of cellular immunity
associated with AIDS or ARC.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 3013955 [PubMed - indexed for MEDLINE]

6990: Fortschr Neurol Psychiatr. 1986 Jun;54(6):73-81.

[Neurological complications and therapy in herpesvirus diseases]

[Article in German]

Bleistein J, Tackmann W.

An overview on the diversity of neurologic complications of infections with
different human herpes virus strains is given. Encephalitis, meningoencephalitis 
and the Guillain-Barre-syndrome are of major importance. Affection of single
cranial nerves and mononeuropathies occur in a lesser frequency, while myelitis
and isolated disturbances of the autonomic nervous system are rare complications.
Therapeutically the application of acyclovir in herpes simplex and varicella
zoster virus infections has given encouraging outlooks, whereas no convincing
results exist with respect to cytomegalovirus and Epstein-Barr virus infections.

Publication Types: 
    English Abstract

PMID: 3013738 [PubMed - indexed for MEDLINE]

6991: Br J Ophthalmol. 1986 Jun;70(6):431-4.

Development of an immunofluorescence test for the serodiagnosis of herpes zoster 
ophthalmicus.

Walpita P, Darougar S, Marsh RJ, Cooper M.

An indirect immunofluorescence test has been developed and evaluated for the
serodiagnosis of herpes zoster ophthalmicus (HZO) by the detection of
antivaricella zoster virus (VZV) antibody. The results show that, in patients
with HZO, anti-VZV IgG antibody titre usually rises rapidly after onset. One
hundred and seven of the 134 sera (80%) from patients with a clinical diagnosis
of HZO had an anti-VZV IgG titre of greater than or equal to 256, and IgM
antibody at a level of 1 in 8 was present in six of them. In comparison only two 
of the 216 sera (1%) from patients with a clinical diagnosis of ocular infections
other than those caused by VZV had such IgG titres. It was concluded that, on the
basis of results of a single sample of serum, it is possible to make a
provisional diagnosis of HZO with a high degree of confidence.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3013281 [PubMed - indexed for MEDLINE]

6992: Transplantation. 1986 Jun;41(6):719-24.

Cellular immunity to vaccinations and herpesvirus infections after bone marrow
transplantation.

Gratama JW, Verdonck LF, van der Linden JA, van Heugten JG, Kreeft HA, D'Amaro J,
Zwaan FE, de Gast GC.

The cellular immune response to herpesviruses was studied in 46 recipients of
marrow grafts (23 autologous, 23 allogeneic). That study was performed in vitro
by evaluating the degree of lymphocyte proliferative responses to herpes simplex 
virus (HSV), cytomegalovirus (CMV), and varicella zoster virus (VZV). No primary 
infections with any of those viruses were noted after bone marrow transplantation
(BMT). The incidence of active infection in seropositive patients was
significantly lower after autologous BMT than after allogeneic BMT (HSV, 2/22 vs.
11/22 patients, respectively, P = 0.007; CMV, 4/12 vs. 9/10 patients,
respectively, P = 0.02; VZV, 3/23 vs. 11/23 patients, respectively, P = 0.02).
After autologous BMT, the restoration of cellular immunity to the three viruses
occurred at a clearly faster rate than after allogeneic BMT. That pattern may
have contributed to the low incidence of active infections with those viruses
after autologous BMT. Recipients of allogeneic marrow from donors with a positive
lymphocyte proliferation test to HSV had a significantly increased incidence of
active HSV infection post-BMT (8/9 patients) than those who received marrow from 
donors with a negative test (3/13 patients; P = 0.008). Acute or chronic
graft-versus-host disease (GVHD) decreased the cellular immune response to the
three herpes viruses, but not significantly. Our program of vaccinations with
diphtheria and tetanus toxoids started in the fourth month post BMT. Chronic GVHD
patients who were vaccinated had a clearly impaired cellular immune response to
both toxoids as compared with those without chronic GVHD.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3012833 [PubMed - indexed for MEDLINE]

6993: Infect Control. 1986 Jun;7(6):312-6.

Hospital experience with varicella-zoster virus.

Krasinski K, Holzman RS, LaCouture R, Florman A.

Varicella-zoster virus (VZV), one of the most common highly communicable agents
of disease, stimulates aggressive infection control measures. In a 1-year period,
at one hospital, at least 93 inpatients (82 adult patients, 11 pediatric
patients) and 2 hospital staff with active varicella-zoster infections served as 
potential sources of nosocomial infection. Six incidents of exposure to the virus
that occurred without the protection of standard infection control precautions
were investigated by the infection control surveillance team. One hundred
fifty-six patients and 353 hospital staff were exposed. Fifty-one patients had no
history of varicella-zoster infection, but only five were susceptible by
serologic testing. One hundred one staff members had no history of
varicella-zoster, but only 11 were susceptible by serologic testing. These
exposures resulted in three secondary varicella-zoster infections, six courses of
varicella-zoster immune globulin prophylaxis and furlough of 13 staff members.
Epidemiologic investigation consumed approximately 356 hours of staff time, and
management of exposed persons cost approximately $41,500. Prospective knowledge
of the immune status of health care workers would vastly decrease the time and
effort required to control hospital VZV exposures.

PMID: 3011693 [PubMed - indexed for MEDLINE]

6994: J Immunol. 1986 Jun 1;136(11):4243-8.

Demonstration of NK cell-mediated lysis of varicella-zoster virus (VZV)-infected 
cells: characterization of the effector cells.

Tilden AB, Cauda R, Grossi CE, Balch CM, Lakeman AD, Whitley RJ.

Infection with varicella-zoster virus (VZV) rendered RAJI cells more susceptible 
to lysis by non-adherent blood lymphocytes. At an effector to target ratio of
80:1 the mean percentage of 51Cr release of VZV-infected RAJI cells was 41 +/-
12%, whereas that of uninfected RAJI cells was 15 +/- 6%. The increased
susceptibility to lysis was associated with increased effector to target
conjugate formation in immunofluorescence binding assays. The effector cells
cytotoxic for VZV-infected RAJI cells were predominantly Leu-11a+ Leu-4- granular
lymphocytes as demonstrated by fluorescence-activated cell sorting. The effector 
cell active against VZV-infected RAJI cells appeared similar to those active
against herpes simplex virus (HSV)-infected cells, because in cold target
competition experiments the lysis of 51Cr-labeled VZV-infected RAJI cells was
efficiently inhibited by either unlabeled VZV-infected RAJI cells (mean 71%
inhibition, 2:1 ratio unlabeled to labeled target) or HSV-infected RAJI cells
(mean 69% inhibition) but not by uninfected RAJI cells (mean 10% inhibition). In 
contrast, competition experiments revealed donor heterogeneity in the overlap
between effector cells for VZV- or HSV-infected RAJI vs K-562 cells.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 3009620 [PubMed - indexed for MEDLINE]

6995: Klin Med (Mosk). 1986 Jun;64(6):50-4.

[Drug hypersensitivity and infectious allergy in the clinical picture of herpes
zoster]

[Article in Russian]

Smirnov IuK, Shishov AS, Rudometov IuP, Kupriianova LV.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2943932 [PubMed - indexed for MEDLINE]

6996: J Clin Neuroophthalmol. 1986 Jun;6(2):113-5.

Herpes zoster maxillaris with delayed occipital infarction.

Powers JM.

A case of occipital infarction following herpes zoster involving the maxillary
division of the trigeminal nerve is presented. Herpes zoster ophthalmicus is
followed occasionally by an angiitis and cerebral infarction, usually manifest as
a hemiplegia. Cerebral angiitis has not been reported previously following herpes
zoster involving the maxillary or mandibular divisions. Patients with herpes
zoster involving any trigeminal division may be at risk for delayed stroke. The
distribution of rash and angiitis in this case supports the hypothesis that the
virus extends directly to the large vessels adjacent to the gasserian ganglion,
instead of being transmitted along intracranial nerves.

PMID: 2942567 [PubMed - indexed for MEDLINE]

6997: Am J Med. 1986 Jun;80(6):1199-202.

Abatement of Sezary syndrome lesions following treatment with acyclovir.

Scheman AJ, Steinberg I, Taddeini L.

Sezary syndrome is a malignant form of cutaneous T cell lymphoma in which
patients characteristically present with generalized pruritic erythroderma and
large numbers of circulating Sezary cells in the peripheral blood. Several
previous studies have proposed that viruses may play a role in the cause of
cutaneous T cell lymphoma. This report describes a 68-year-old man with Sezary
syndrome who received a seven-day course of intravenous acyclovir for treatment
of disseminated herpes zoster and was noted to have almost complete disappearance
of generalized erythroderma and pruritus. Since acyclovir has been shown to
selectively inhibit viral DNA polymerase, the observed clinical response is
strong evidence that viruses play a role in the cause of cutaneous T cell
lymphoma. Mechanisms that could explain the observed response are discussed, and 
further studies on the utility of antiviral agents for treatment of cutaneous T
cell lymphoma and on possible inhibitory effects of acyclovir on retroviruses are
recommended.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 2942033 [PubMed - indexed for MEDLINE]

6998: Int J Dermatol. 1986 Jun;25(5):273-9.

Interferons in the treatment of skin disease.

Ringenberg QS, Anderson PC.

Publication Types: 
    Clinical Trial
    Review

PMID: 2424849 [PubMed - indexed for MEDLINE]

6999: Br Med J (Clin Res Ed). 1986 May 31;292(6533):1428.

Relief of acute pain in herpes zoster ophthalmicus by stellate ganglion block.

Harding SP, Lipton JR, Wells JC, Campbell JA.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3087456 [PubMed - indexed for MEDLINE]

7000: N Engl J Med. 1986 May 29;314(22):1456.

Inversion of T-cell subsets before herpes zoster infection.

Neumeyer DA, Hirsch MS.

Publication Types: 
    Letter

PMID: 2939348 [PubMed - indexed for MEDLINE]

7001: Nucleic Acids Res. 1986 May 27;14(10):4281-92.

DNA sequence of the herpes simplex virus type 1 gene encoding glycoprotein gH,
and identification of homologues in the genomes of varicella-zoster virus and
Epstein-Barr virus.

McGeoch DJ, Davison AJ.

We have determined the sequence of herpes simplex virus type 1 DNA around the
previously mapped location of sequences encoding an epitope of glycoprotein gH,
and have deduced the structure of the gH gene and the amino acid sequence of gH. 
The unprocessed polypeptide is predicted to contain 838 amino acids, and to
possess an N-terminal signal sequence and a C-terminal transmembrane sequence.
Temperature-sensitive mutant tsQ26 maps within the predicted gH coding sequence. 
Homologous genes were identified in the genomes of two other herpesviruses,
namely varicella-zoster virus and Epstein-Barr virus.

Publication Types: 
    Comparative Study

PMID: 3012465 [PubMed - indexed for MEDLINE]

7002: Am J Dis Child. 1986 May;140(5):477-8.

Prognosis of herpes zoster in healthy children.

Wurzel CL, Kahan J, Heitler M, Rubin LG.

Previous investigators have suggested that herpes zoster may be the presenting
sign of a malignancy. However, no data have been available concerning the
prognosis of herpes zoster in normal children. To assess outcome and prognosis
for healthy children with a diagnosis of herpes zoster, we collected and reviewed
22 cases of herpes zoster from 90 pediatric practices in our community. In all
cases, the illness was of short duration and resolved completely. Patients were
followed up by their pediatricians for a mean of 4.2 years, and in no case did
malignancy manifest subsequent to the zoster infection. We conclude that herpes
zoster is a relatively benign infection in children and, given the period of
follow-up, the onset of zoster does not appear to herald the occurrence of
malignancy in this population.

PMID: 3962944 [PubMed - indexed for MEDLINE]

7003: Postepy Hig Med Dosw. 1986 May-Jun;40(3):331-46.

[Acquired immunodeficiency syndrome (AIDS) in the African environment]

[Article in Polish]

Kornaszewski W, Kornaszewska M, Skotnicki AB.

PIP: The characteristics of AIDS in Africa differ sharply from those in North
America with respect to diagnosis and epidemiology, and in a clinical sense. The 
study of 78 patients treated in Kinshasa, Zaire during the period of October
1983-July 1984 yielded the following results: 159 out of a total of 1051
hospitalized patients were suspected of having AIDS, and there were 78 proven
cases (54 of them died). The average age of 40 women and 38 men was 27 and 31
years, respectively, and the ratio of married people was 35% and 74%,
respectively, with a lot of men living in polygamous relationships. In the first 
stage of the disease weight loss appeared in 100%, recurrent diarrhea in 83.3%,
significant loss of strength in 75.6%, febrile conditions in 68.3%, and skin
lesions in 58.9%. The ratio of men to women was 5:5, since heterosexuality and
polygamy prevailed. Cigarette smoking was the main addition, thus drug addition
per se did not appear as a risk factor. Blood transfusions occurred frequently
(for instance, in malaria), but hemophilic patients receiving lyophilized
preparations were rare. Haitians visited in fairly large numbers after the 1960's
propagating the risk of AIDS. Black Africans accounted for 100% of cases. The
number of concomitant, opportunistic diseases in AIDS patients in Zaire were: 34 
cases of tuberculosis, 32 cases of candidiasis, 30 fungal infections, 21 Herpes
labialis and/or genitalis, 19 cases of dermal and cerebral cryptococcosis, 12
cases of cryptosporidiosis, 9 cases of Kaposi's sarcoma, 5 cases of Herpes
zoster, 3 cases of aseptic cerebral infections, 3 cases of coccidiosis, 2 cases
of toxoplasmosis, and 1 case of pneumonia (Pneumocystis). Tuberculosis,
cryptococcosis, cryptosporidiosis, and toxicosis were more frequent opportunistic
diseases in Zaire than in the U.S.A., while pneumonia caused by Pneumocystis and 
Kaposi's sarcoma were relatively rare.

Publication Types: 
    English Abstract

PMID: 3822954 [PubMed - indexed for MEDLINE]

7004: Hautarzt. 1986 May;37(5):259-62.

[Virostatics in dermatology]

[Article in German]

Wassilew SW.

Many antiviral substances are known, but only a few are clinically effective in
certain disease resulting from herpes virus infections. Early diagnosis is
essential. Antiviral chemotherapy is discussed in respect to herpes infections in
immunocompetent patients, and in patients with primary genital herpes, eczema
herpeticum, genital and gluteal recurrent herpes and herpes zoster.

Publication Types: 
    English Abstract

PMID: 3733445 [PubMed - indexed for MEDLINE]

7005: Aust Fam Physician. 1986 May;15(5):554-6.

Postherpetic neuralgia.

Armstrong PJ, Murphy TM.

PMID: 3729805 [PubMed - indexed for MEDLINE]

7006: Antimicrob Agents Chemother. 1986 May;29(5):933-5.

Vidarabine-associated encephalopathy and myoclonus.

Vilter RW.

A 24-year-old man with disseminated herpes zoster, which occurred 9 months after 
bone marrow transplantation for chronic myeloid leukemia, developed
encephalopathy and immobilizing myoclonus after 7 days of vidarabine treatment
(10 mg/kg of body weight per day). Only mild hepatic dysfunction was a risk
factor for a toxic reaction. After the vidarabine therapy was stopped, the
symptoms worsened until treatment with hydration, large doses of
chlordiazepoxide, and protective care gave symptomatic relief.

Publication Types: 
    Case Reports

PMID: 3729352 [PubMed - indexed for MEDLINE]

7007: Klin Padiatr. 1986 May-Jun;198(3):281-4.

[Specific immunoglobulin and acyclovir in the prevention and treatment of
varicella zoster infections in children with neoplastic diseases]

[Article in German]

Lakomek M, Tillmann W, Schrewe H, Prindull G.

Immunocompromised children with acute leukemias and solid tumors are at high risk
of fatal varicella infection. Reviewing a total of 242 patients at risk we have
found that zoster immune plasma from reconvalescent patients (ZIP) and
commercially available specific varicella/zoster immune globulin (VZIG) both
prevent fatal disease. In addition, Acyclovir was effective against
VZV-infections in this group of patients. We summarize our present policy of
prophylaxis and treatment of immunocompromised children with neoplastic disease
who have been exposed to VZV.

Publication Types: 
    English Abstract

PMID: 3723992 [PubMed - indexed for MEDLINE]

7008: Br J Dermatol. 1986 May;114(5):575-82.

Recurrent viral infections in patients with past or present atopic dermatitis.

Rystedt I, Strannegard IL, Strannegard O.

Histories of recurrent infections were obtained from 955 adults with past or
present atopic dermatitis (AD) and from 199 controls. Patients who had previously
been hospitalized in childhood because of severe AD had a significantly higher
incidence of recurrent (greater than 5 episodes per year) cold sores and upper
respiratory tract infections as well as a higher incidence of herpes zoster, than
non-atopic controls. Patients with milder AD in childhood (never hospitalized)
had lower incidence of these diseases, but as regards cold sores, the frequency
of recurrent infections was still significantly higher than that of the controls.
AD patients with past or present respiratory allergy had a slight but not
statistically significant increased incidence of recurrent infections, as
compared to AD patients without concomitant respiratory allergy. The factors
predisposing to frequent infections appeared to be those related to severity of
the atopic condition, i.e. ongoing AD, need for hospitalization in childhood and 
extent of dermatitis. The increased susceptibility to recurrent viral infections 
in AD patients is most probably related to dysfunctioning cell-mediated immunity.

PMID: 3718847 [PubMed - indexed for MEDLINE]

7009: J Am Acad Dermatol. 1986 May;14(5 Pt 1):764-70.

Granuloma annulare arising in herpes zoster scars. Report of two cases and review
of the literature.

Friedman SJ, Fox BJ, Albert HL.

We present two patients who developed granuloma annulare in the scars from
previous herpes zoster. The development of granuloma annulare in herpes zoster
scars may represent an atypical delayed hypersensitivity immune reaction to
herpes zoster/varicella virus antigen(s) or a tissue antigen altered by the
virus.

Publication Types: 
    Case Reports

PMID: 3711380 [PubMed - indexed for MEDLINE]

7010: Pain. 1986 May;25(2):165-70.

Iontophoresis of vincristine versus saline in post-herpetic neuralgia. A
controlled trial.

Layman PR, Argyras E, Glynn CJ.

Twenty patients with post-herpetic neuralgia (median duration 28.5 months) were
randomly allocated to receive transdermal iontophoresis of either vincristine or 
saline. Although significant improvement in pain by word score and visual
analogue scale (P = 0.05) was reported by 6 out of 10 of the vincristine group,
none of the patients considered themselves 'cured.' There was no significant
change in the saline group. No adverse haematological or neurological side
effects were seen, but skin irritation and painless electrical burns were common 
in both groups. The dramatic relief of pain in patients with post-herpetic
neuralgia of 3 months or less reported elsewhere was not seen in our group who
had pain of a longer duration. This present trial does not confirm the value of
vincristine iontophoresis in the treatment of post-herpetic neuralgia of over 6
months duration.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 3523393 [PubMed - indexed for MEDLINE]

7011: Nervenarzt. 1986 May;57(5):298-301.

[Optic neuritis caused by herpes zoster ophthalmicus. Case report and review of
the literature]

[Article in German]

Schlegel U, Tackmann W, Cordt A.

Publication Types: 
    Case Reports

PMID: 3487740 [PubMed - indexed for MEDLINE]

7012: J Endod. 1986 May;12(5):210-3.

Herpes zoster revisited: implicated in root resorption.

Solomon CS, Coffiner MO, Chalfin HE.

Publication Types: 
    Case Reports

PMID: 3459806 [PubMed - indexed for MEDLINE]

7013: Ophthalmology. 1986 May;93(5):559-69.

Varicella zoster virus is a cause of the acute retinal necrosis syndrome.

Culbertson WW, Blumenkranz MS, Pepose JS, Stewart JA, Curtin VT.

We studied two blind eyes enucleated during the active phase of the acute retinal
necrosis syndrome. Both eyes showed similar histopathologic findings of
necrotizing retinitis, retinal arteritis, and optic neuropathy. A virus
morphologically consistent with a herpes group virus was found on electron
microscopy and immunocytopathologic stains showed this virus to be varicella
zoster in both cases. Varicella zoster virus was cultured from the vitreous of
one of the eyes. We conclude that varicella zoster virus retinal infection is a
cause of the acute retinal necrosis syndrome.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3014414 [PubMed - indexed for MEDLINE]

7014: J Clin Microbiol. 1986 May;23(5):978-9.

Sensitivity of different assay systems for immunoglobulin M responses to
varicella-zoster virus in reactivated infections (zoster).

Schmidt NJ, Arvin AM.

An immunoglobulin M response to varicella-zoster virus was detected in 70% of
zoster patients by solid-phase radioimmunoassay, in 52% by indirect
immunofluorescence, in 48% by neutralization on sucrose density gradient
fractions, and in 27% by an antibody class capture enzyme immunoassay. The
patients showed marked variations in their varicella-zoster virus immunoglobulin 
M responses detectable in the different assays.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 3011851 [PubMed - indexed for MEDLINE]

7015: Am J Obstet Gynecol. 1986 May;154(5):1116-7.

Excretion of varicella-herpes zoster virus in breast milk.

Frederick IB, White RJ, Braddock SW.

Two cases involving breast-feeding and varicella-herpes zoster virus infection
are presented. The possibility of viral excretion in the breast milk and its
effects on continued breast-feeding are discussed. In neither case was the virus 
isolated from the breast milk.

Publication Types: 
    Case Reports

PMID: 3010724 [PubMed - indexed for MEDLINE]

7016: J Infect Dis. 1986 May;153(5):840-7.

Clinical and subclinical reactivations of varicella-zoster virus in
immunocompromised patients.

Ljungman P, Lonnqvist B, Gahrton G, Ringden O, Sundqvist VA, Wahren B.

The frequencies of reactivated disease due to varicella-zoster virus (VZV) in
immunocompromised patients were determined by enzyme-linked immunosorbent assay
for antibody and also by the lymphocyte proliferation response to VZV antigen.
Subclinical reactivations were as common as classical herpes zoster in all
patient groups. Among bone marrow transplant (BMT) recipients, 36% developed
herpes zoster and 26%, a subclinical reactivation. The corresponding frequencies 
for patients with leukemia during induction therapy were 5% and 10%; in renal
transplant recipients, 0% and 26%; and in patients with seminoma, 0% and 6%,
respectively. Subclinical reactivation of VZV thus appears to be a common finding
in severely immunocompromised patients. A regained lymphocyte proliferation
response to VZV antigen is a sensitive indicator of subclinical reactivation of
VZV in BMT recipients. None of 19 BMT recipients with subclinical disease due to 
VZV later developed clinical reactivation of VZV. Acyclovir given as prophylaxis 
against infection with herpes simplex virus reduced the number of clinical and
subclinical reactivations of VZV during treatment in BMT recipients, but not
thereafter.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3009635 [PubMed - indexed for MEDLINE]

7017: Pain. 1986 May;25(2):149-64.

Herpes zoster and postherpetic neuralgia.

Loeser JD.

Publication Types: 
    Review

PMID: 2873549 [PubMed - indexed for MEDLINE]

7018: Wien Med Wochenschr. 1986 Apr 30;136(7-8):163-72.

[Current status of interferon therapy]

[Article in German]

Dittrich C.

Interferons (IFN) are potent antiviral, cytostatic-cytotoxic and immunomodulatory
agents. Although gene technology has made available an unlimited supply of all
different kinds and types of IFN, their basic modes of action have not been
clarified up to now. The therapeutic effects proven differ gradually between the 
individual disease entities. They comprise prophylaxis, prevention of recurrences
and direct therapeutic effect, either of reducing the actual disease symptoms, or
of inducing a complete recovery. For the following viral diseases a positive
therapeutic effect has been shown: infections by herpes-viruses (herpes simplex
keratitis , herpes zoster, herpes simplex), cytomegalovirus infections,
chronic-hepatitis B virus infection, acute respiratory virus infections by
rhino-, corona- and influenza viruses. Especially for the group of
virus-associated tumors and papillomas, IFN is considered to be therapeutically
effective. IFN has been accepted to be the first line treatment for laryngeal
papillomatosis. In condylomata acuminata too, IFN is a potent therapeutic agent. 
Moreover, IFN represents the most effective therapeutic modality for Kaposi's
sarcoma in patient with AIDS. Hairy cell leukemia, malignant lymphoma, multiple
myeloma, melanoma and hypernephroma are the malignancies, for which a therapeutic
effect of IFN could be proven. Furthermore, IFN is considered to be the therapy
of first choice for hairy cell leukemias. Although there are some signs, that IFN
could be a potent agent for adjuvant therapy, this question can not be answered -
not even on principle - because of lacking sufficient data so far. Up to date,
the therapeutic efficacy of IFN seems to be established only for hairy cell
leukemia, laryngeal papillomatosis, Kaposi's sarcoma in patients with AIDS and
partly for condylomata acuminata. For all other indications, first of all,
sufficient phase-II-study data will have to be evaluated, before prospectively
controlled studies, comparing the IFN treatment results with placebo and standard
therapy results, can be initiated for the individual disease entities. Then, it
will be possible to assess the therapeutic efficacy of IFN. Already now, IFN
represent a valuable enrichment of the therapeutic modalities for malignancies
and viral diseases.

Publication Types: 
    English Abstract

PMID: 2425497 [PubMed - indexed for MEDLINE]

7019: J Allergy Clin Immunol. 1986 Apr;77(4):639-45.

Occupational asthma caused by eastern white cedar (Thuja occidentalis) with
demonstration that plicatic acid is present in this wood dust and is the causal
agent.

Cartier A, Chan H, Malo JL, Pineau L, Tse KS, Chan-Yeung M.

A worker developed symptoms of work-related asthma a few weeks after starting to 
work in a sawmill where eastern white cedar (Thuja occidentalis) was transformed 
into shingles. The diagnosis of occupational asthma was confirmed by monitoring
of peak expiratory flow rates and bronchial responsiveness to histamine off work 
and at work, and specific inhalation challenges in the laboratory that
demonstrated an isolated late asthmatic reaction after exposure for 4 hours to
the wood dust. Specific inhalation challenges with western red cedar (thuja
plicata) for 2 hours and plicatic acid (PA) for 7 minutes also caused an isolated
late asthmatic reaction. Elevated specific IgE levels to PA were present.
Antiserum was produced in rabbits that were immunized with PA conjugated to human
serum albumin. With this antiserum in inhibition experiments, cross-reactivity
between western red cedar and eastern white cedar, both belonging to the family
of arborvitae, was found. It is estimated that eastern white cedar contains
approximately half the amount of PA present in western red cedar.

Publication Types: 
    Case Reports

PMID: 3958393 [PubMed - indexed for MEDLINE]

7020: Am J Clin Pathol. 1986 Apr;85(4):522-6.

Varicella-zoster infection with pleural involvement. A cytologic and
ultrastructural study of a case.

Charles RE, Katz RL, Ordonez NG, MacKay B.

Cytologic evidence of herpes viral infection within cells from body cavity
effusions is extremely uncommon. The authors report the case of a 57-year-old
woman who was treated with chemotherapy and irradiation for malignant lymphoma
and subsequently developed disseminated varicella-zoster infection with pleural
involvement. Cytologic examination of pleural fluid revealed cytopathic changes
caused by the varicella-zoster virus, which were confirmed by electron microscopy
and viral culture of the effusion. The cytologic and ultrastructural features of 
the virus-infected cells are described, and the pathogenesis of the effusion and 
sequence of events in varicella-zoster virus-cell interaction are discussed.

Publication Types: 
    Case Reports

PMID: 3953509 [PubMed - indexed for MEDLINE]

7021: J Am Geriatr Soc. 1986 Apr;34(4):309-12.

Herpes zoster ophthalmicus and granulomatous angiitis. An ill-appreciated cause
of stroke.

Verghese A, Sugar AM.

The syndrome of granulomatous angiitis related to varicella zoster virus
infection often manifests as herpes zoster ophthalmicus followed by contralateral
hemiplegia. Forty-five cases have been reported to date, and the authors'
experience with two additional cases seen in a one-year period is described.
Given the frequency of both stroke and herpes zoster ophthalmicus in an aging
population, the authors postulate that granulomatous angiitis is underdiagnosed. 
There is need for increased awareness of this disease by the non-neurologist.
Diagnostic and therapeutic considerations are reviewed.

Publication Types: 
    Case Reports

PMID: 3485127 [PubMed - indexed for MEDLINE]

7022: Postgrad Med. 1986 Apr;79(5):150-54, 159-67.

Acute exanthems in children. Clues to differential diagnosis of viral disease.

Bligard CA, Millikan LE.

The numerous viral skin diseases that affect children present a diagnostic
challenge to the clinician. Most of these diseases may be conveniently grouped
according to the clinical appearance of the exanthem as maculopapular, petechial,
papular, or vesicular. In some situations, viral infection may be difficult to
differentiate clinically from nonviral disease; thus, extensive laboratory
evaluation is sometimes necessary to pinpoint the virus involved. Nonviral
disease should be considered in the differential diagnosis of a patient with skin
eruptions, especially of the maculopapular type. Common nonviral causes include
Kawasaki disease, toxic shock syndrome, and drug reactions.

PMID: 3008138 [PubMed - indexed for MEDLINE]

7023: J Gen Virol. 1986 Apr;67 ( Pt 4):597-611.

Evolutionary comparisons of the S segments in the genomes of herpes simplex virus
type 1 and varicella-zoster virus.

Davison AJ, McGeoch DJ.

The genomes of herpes simplex virus type 1 (HSV-1) and varicella-zoster virus
(VZV) consist of two covalently joined segments, L and S. Each segment comprises 
an unique sequence flanked by inverted repeats. We have reported previously the
DNA sequences of the S segments in these two genomes, and have identified
protein-coding regions therein. In HSV-1, the unique sequence of S contains ten
entire genes plus the major parts of two more, and each inverted repeat contains 
one entire gene; in VZV, the unique sequence of S contains two entire genes plus 
the major parts of two more, and each inverted repeat contains three entire
genes. In this report, an examination of polypeptide sequence homology has shown 
that each VZV gene has an HSV-1 counterpart, but that six of the HSV-1 genes have
no VZV homologues. Thus, although these regions of the two genomes differ in gene
layout, they are related to a significant degree. The analysis indicates that the
inverted repeats are evidently capable of large-scale expansion or contraction
during evolution. The differences in gene layout can be understood as resulting
from a small number of recombinational events during the descent of HSV-1 and VZV
from a common ancestor.

Publication Types: 
    Comparative Study

PMID: 3007657 [PubMed - indexed for MEDLINE]

7024: Ann Intern Med. 1986 Apr;104(4):496-500.

Long-term seropositivity for human T-lymphotropic virus type III in homosexual
men without the acquired immunodeficiency syndrome: development of immunologic
and clinical abnormalities. A longitudinal study.

Melbye M, Biggar RJ, Ebbesen P, Neuland C, Goedert JJ, Faber V, Lorenzen I,
Skinhoj P, Gallo RC, Blattner WA.

The long-term effects of seropositivity for human T-lymphotropic virus type III
(HTLV-III) on T-lymphocyte subsets and health status were evaluated in
longitudinal studies of 250 initially healthy homosexual men. The relative risk
of having an inverted T-lymphocyte helper-to-suppressor ratio rose from 14.3-fold
among short-term seropositive subjects (less than 19 months) to 46.9-fold among
long-term seropositive subjects (greater than 29 months) in comparison with the
risk among seronegative subjects. Overall, 91.7% of long-term seropositive men
had inverted ratios, compared with 12.9% of seronegative men. None of the
seropositive men who developed an inverted ratio later reestablished a normal
ratio. Both decreased T-helper cell number and percentage (p = 0.003) and
increased T-suppressor cell number and percentage (p = 0.03) were significantly
correlated with duration of seropositivity. Among seropositive persons,
lymphadenopathy was a highly significant short-term as well as long-term
consequence, whereas diarrhea, oral thrush, and herpes zoster were correlated
with long-term seropositivity. Overall, 50% of long-term seropositive men
compared with 16% of seronegative men developed at least one of five clinical
symptoms (p less than 0.003). We conclude that a high proportion of persons
infected with HTLV-III will develop measurable immunologic and clinical
abnormalities.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3006568 [PubMed - indexed for MEDLINE]

7025: J Infect Dis. 1986 Apr;153(4):757-62.

Typing of herpes simplex virus with synthetic DNA probes.

Peterson EM, Aarnaes SL, Bryan RN, Ruth JL, de la Maza LM.

Three single-stranded oligonucleotide probes, 22 bases long, homologous to unique
regions of herpes simplex virus (HSV) types 1 (HSV-1) and 2 (HSV-2) and a region 
common to both were chemically synthesized with use of a modified
phosphochloridite protocol. For hybridization experiments each probe was labeled 
with use of polynucleotide kinase and [gamma-32P] ATP to a specific activity of
approximately 2 X 10(9) cpm/micrograms. Two hundred one clinical isolates of HSV 
(96 HSV-1 and 105 HSV-2) collected from vesicles in the mucocutaneous junction of
the mouth or from the genital area were analyzed. There was a 99% (199 of 201)
agreement between hybridization and monoclonal antibody typing; the two
discrepant isolates of HSV-2 that were negative by monoclonal antibody typing
were confirmed as HSV-2 by restriction endonuclease analysis. The probes detected
between 10(4) and 10(5) HSV infectious units and from 150 to 600 HSV-infected
Vero cells. No binding was detected between any of the three probes and isolates 
of cytomegalovirus, Epstein-Barr virus, and varicella-zoster virus.

PMID: 3005436 [PubMed - indexed for MEDLINE]

7026: Masui. 1986 Apr;35(4):605-9.

[Enkephalin metabolism in human serum; serum Leu-enkephalin concentration in
patients with acute and chronic pain]

[Article in Japanese]

Machi T, Hazato T, Katayama T.

Publication Types: 
    English Abstract

PMID: 2943909 [PubMed - indexed for MEDLINE]

7027: Bol Asoc Med P R. 1986 Apr;78(4):142-5.

Varicella and herpes zoster infections in immunocompromised host: prevention and 
treatment.

Ramirez Palacios RM, Sanchez J, Bermudez RH, Ramirez Ronda CH.

PMID: 2424477 [PubMed - indexed for MEDLINE]

7028: Int J Dermatol. 1986 Apr;25(3):169-70.

The Tzanck smear. Viable and valuable in the diagnosis of herpes simplex, zoster,
and varicella.

Solomon AR.

PMID: 2422130 [PubMed - indexed for MEDLINE]

7029: Med J Aust. 1986 Mar 31;144(7):375, 378-80.

Should we treat herpes zoster with corticosteroid agents?

Dickinson JA.

Herpes zoster is a common disease which is frequently followed by severe
long-term pain--post-herpetic neuralgia. The arrival of new antiviral agents, not
yet widely available, may lead to the neglect of the older, effective and
inexpensive method of treatment with systemic corticosteroid agents. Evidence for
the value of corticosteroid therapy is strong, while published data discouraging 
its use is weak. Consequently, the administration of these agents should be the
standard treatment for painful acute zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3959952 [PubMed - indexed for MEDLINE]

7030: Lancet. 1986 Mar 29;1(8483):744.

Varicella zoster in the newborn.

Trompeter RS, Bradley JM, Griffiths PD.

Publication Types: 
    Letter

PMID: 2870256 [PubMed - indexed for MEDLINE]

7031: Br Dent J. 1986 Mar 22;160(6):189.

Bilateral shingles.

Cousin GC, Ferguson MM.

Publication Types: 
    Case Reports
    Letter

PMID: 3456780 [PubMed - indexed for MEDLINE]

7032: Lancet. 1986 Mar 22;1(8482):682.

Unusual shingles and chickenpox.

Dawson TA, Scott KW.

Publication Types: 
    Letter

PMID: 2869372 [PubMed - indexed for MEDLINE]

7033: Lancet. 1986 Mar 15;1(8481):581-3.

Isolation of retroviruses from two patients with "common variable"
hypogammaglobulinaemia.

Webster AD, Dalgleish AG, Malkovsky M, Beattie R, Patterson S, Asherson GL, North
M, Weiss RA.

Retroviruses related to human T-lymphotropic virus III/lymphadenopathy-associated
virus (HTLV-III/LAV) have been isolated from peripheral-blood mononuclear cells
of two patients with "common variable" hypogammaglobulinaemia who were being
treated with intravenous gammaglobulin. One has had three different opportunistic
infections. In both patients hypogammaglobulinaemia developed within 6 years of a
longlasting undiagnosed viral-like illness in adolescence, and it is suggested
that the virus causing that illness also gave rise to the hypogammaglobulinaemia.
However, iatrogenic infection from intravenous gammaglobulin cannot be ruled out.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 2869303 [PubMed - indexed for MEDLINE]

7034: Br J Dermatol. 1986 Mar;114(3):311-8.

Cold urticaria and virus infections: a clinical and serological study in 39
patients.

Doeglas HM, Rijnten WJ, Schroder FP, Schirm J.

Thirty-nine patients with cold urticaria seen over a 12-year-period were
re-examined. All but 12 still had positive skin tests for cold and only five of
these had shown a spontaneous cure. Fourteen patients were prone to collapse on
cold exposure. The incidence of atopy in this group was comparable to that in
control groups. Cold urticaria is an extremely chronic disease. The mean disease 
duration was 9.3 years. Serum antibodies to Epstein-Barr virus, measles virus,
cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), 
Chlamydia psittaci and Mycoplasma pneumoniae were determined in all 39 patients
and compared with control groups. The EBV-antibody patterns (heterophile
antibodies and different types of EBV-specific antibodies) showed no evidence of 
current or of recent primary or secondary infection with EBV. Complement fixing
antibody titres to measles virus, CMV, HSV and Mycoplasma pneumoniae were
significantly higher in cold urticaria patients than in controls. The existence
of a basic immuno-regulatory defect responsible for both the cold urticaria and
the elevated antibody levels is proposed.

PMID: 3954951 [PubMed - indexed for MEDLINE]

7035: Anesth Analg. 1986 Mar;65(3):309-11.

Herpes zoster and reflex sympathetic dystrophy.

Grosslight KR, Rowlingson JC, Boaden RW.

Publication Types: 
    Case Reports

PMID: 3954095 [PubMed - indexed for MEDLINE]

7036: J Laryngol Otol. 1986 Mar;100(3):337-40.

The use of acyclovir in Ramsay Hunt syndrome.

Stafford FW, Welch AR.

Acyclovir is a specific anti-viral agent which has been used in the treatment of 
the Ramsay Hunt Syndrome with encouraging results. To our knowledge, no previous 
study has been published utilizing this treatment. A discussion is also
undertaken of the underlying pathology and prognosis of the Ramsay Hunt Syndrome,
with a summary of those cases in which Acyclovir was prescribed.

Publication Types: 
    Case Reports

PMID: 3950504 [PubMed - indexed for MEDLINE]

7037: J Tradit Chin Med. 1986 Mar;6(1):17-8.

Observation of the efficacy of Ampelopsis brevipedunculata Trautv. in the
treatment of herpes zoster.

Sun X, Guan YX, Luo XL, Yu YA, Gao HZ.

Publication Types: 
    Case Reports

PMID: 3736094 [PubMed - indexed for MEDLINE]

7038: Gan No Rinsho. 1986 Mar;32(3):287-92.

[Treatment of oral carcinoma in elderly patients--case reports and associated
problems]

[Article in Japanese]

Kato I, Osaki T, Ohno A, Nakao K, Tomita Y, Umazume M, Yoneda K.

Three very elderly patients (more than 90 years old) suffering from oral
carcinoma are reported with a discussion concerning complications of treatment
and safety of surgery. In all cases, pretreatment with chemotherapy and/or chemo-
and radiotherapy could be uncomplicatedly followed by surgery to excise the
primary lesion done neck dissection. In one case, however, surgery after potent
therapy with PLM, 5-FU and irradiation for the recurrence at the primary site was
complicated by any severe consequences. Based on the clinical course of the
patients, surgical treatment seems to be rather beneficial in very elderly cancer
victims with the aim of avoiding complications caused by the usual conservative
therapies.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3712768 [PubMed - indexed for MEDLINE]

7039: Monatsschr Kinderheilkd. 1986 Mar;134(3):118-21.

[Varicella and herpes zoster]

[Article in German]

Spiess H.

The identity of the virus for herpes zoster and chickenpox has long been guessed 
by pediatricians and eventually proven in 1958. The patients are infectious 2
days before the rash appears until 7 days later. Specific antibodies are found 2 
days after the rash appeared. Varicella induce life long immunity which can
weaken in old age or during immuno suppressive therapy, so that reactivation of
the virus, most likely located in the spinal ganglia, causes the clinical
symptoms of herpes zoster. About 7% of women in child-bearing age have no
antibodies against the virus. Varicella during pregnancy may induce abortion or
especially during the first 3 months severe embryopathies with organic lesions.
Therefore young women who have not had the illness should be tested along with
the test for rubella-antibodies, and subsequently vaccinated, at least 3 months
before any planned pregnancy. The rather expensive varicella vaccination is
justified in immunodeficient patients without varicella-antibodies, or in
patients under immunosuppressive therapy without varicella-antibodies (minimal
requirements of 1200 lymphocytes, interruption of cytostatics one week before and
until 1 week after the vaccination, no irradiation for 3 months), or in women
planning pregnancy, personnel caring for pregnant women or personnel who has no
antibodies in intensive-care units for hematological-onkological patients.

Publication Types: 
    English Abstract

PMID: 3702883 [PubMed - indexed for MEDLINE]

7040: Hautarzt. 1986 Mar;37(3):152-5.

[Acyclovir-corticosteroid therapy in herpes zoster]

[Article in German]

Soltz-Szots J.

Thirty patients between 60 and 86 years of age (average 73.6 years) [8, 9, 11]
with high risk of having the disease for an extraordinarily long time or of
developing neuritis were treated for 5 days with 4-5 mg acyclovir per kilogram
body weight. They were not immunocompromised and received the drug intravenously 
at 8-h intervals. Of this group, 20 patients received daily 40-80 mg
methylprednisolone simultaneously. All patients were hospitalized because of
extensive, hemorrhagic lesions, which in 8 cases were necrotizing. The primary
site of the disease was the head in 13 patients (43.3%), the neck or trunk in 15 
(50%) and the extremities in 2 (6.7%). In addition, 8 (26.7%) showed generalized 
lesions. The duration of the disease could be reduced by one-third by acyclovir
treatment, as compared with reference groups, and the methylprednisolone group
had even better results. Individual pain was more promptly resolved by the
combined treatment than by acyclovir alone. No persistent neuritis was observed
in the methylprednisolone-acyclovir group, but occurred in two out of ten
patients who had received acyclovir alone. No side effects were reported. The
antiviral effect of acyclovir obviously reduces the risk of possible
generalization during corticosteroid treatment to negligible amounts. Because of 
the possible selection of resistant strains, acyclovir should usually only be
given to high-risk zoster patients beyond the age of 60. Administration must be
initiated in the early phase of the disease, since no effect can be expected
after viral shedding has been terminated.

Publication Types: 
    English Abstract

PMID: 3700103 [PubMed - indexed for MEDLINE]

7041: Biken J. 1986 Mar;29(1):1-6.

Susceptibility of varicella-zoster virus to thymidine analogues.

Machida H.

Ten strains of varicella-zoster virus (VZV) were tested for susceptibility to 17 
nucleoside analogues by a plaque reduction assay using human embryonic lung
fibroblast cells. The compounds employed were 5-substituted arabinosyluracils and
2'-deoxyuridines, 2'-fluoro-arabinosylpyrimidines (F-araPyr) and acyclovir. In
terms of the 50% plaque reduction dose (PD50), 4- to 40-fold difference were
found between the 10 strains of VZV in susceptibilities to each compound. VZV was
highly susceptible to 5-halogenovinyl-arabinosyluracils (XV-araUs); the PD50
values of these compounds were less than 0.001 micrograms/ml. VZV was much more
susceptible than herpes simplex virus (HSV) type 1 to XV-araUs, but less
susceptible than either HSV type 1 or type 2 to 5-ethyl-2'-deoxyuridine,
5-ethyl-arabinosyluracil and acyclovir.

PMID: 3022708 [PubMed - indexed for MEDLINE]

7042: Antimicrob Agents Chemother. 1986 Mar;29(3):524-6.

Comparison of susceptibilities of varicella-zoster virus and herpes simplex
viruses to nucleoside analogs.

Machida H.

The susceptibilities of varicella-zoster virus (VZV) and herpes simplex virus
type 1 (HSV-1) and type 2 (HSV-2) to 17 nucleoside analogs were compared by a
plaque reduction assay with human embryonic lung fibroblast cells. The
susceptibility of VZV to certain nucleoside analogs was different from that of
HSV-1. Against VZV the 5-halogenovinyl-arabinosyluracils were the most potent of 
the compounds tested.

Publication Types: 
    Comparative Study

PMID: 3013088 [PubMed - indexed for MEDLINE]

7043: Tohoku J Exp Med. 1986 Mar;148(3):275-83.

Inhibitory effects of selected antiviral compounds on newly isolated clinical
varicella-zoster virus strains.

Baba M, Konno K, Shigeta S, De Clercq E.

Nine anti-herpes compounds, idoxuridine (IDU), bromovinyldeoxyuridine (BVDU),
bromovinylarabinofuranosylurasil (BVaraU), carbocyclic bromovinyldeoxyuridine
(C-BVDU), chloroethyldeoxyuridine (CEDU), acyclovir (ACV),
dihydroxypropoxymethylguanine (DHPG), adenine arabinoside (Ara-A), and
phosphonoformate (PFA) were examined for their inhibitory activities against the 
replication of twenty-six newly isolated clinical strains of varicella-zoster
virus (VZV) in human embryonic fibroblast cell cultures. The order of
(decreasing) efficacy was: BVaraU greater than BVDU greater than or equal to
C-BVDU greater than CEDU greater than or equal to IDU greater than ACV greater
than Ara-A greater than DHPG greater than PFA. There was little variation in the 
susceptibility of the 26 VZV strains to each particular compound, except for one 
strain which was resistant to IDU.

PMID: 3010502 [PubMed - indexed for MEDLINE]

7044: Monatsschr Kinderheilkd. 1986 Mar;134(3):122-9.

[Antiviral chemotherapy]

[Article in German]

Eggers HJ.

After a discussion of the principles of antiviral chemotherapy, treatment and
chemoprophylaxis of the following virus infections are reviewed in detail: the
various manifestations of herpes simplex virus infections, varicella-zoster,
cytomegalovirus infections, Epstein-Barr virus infections, laryngeal papillomas, 
and influenza A. Special reference is made to the treatment of immunocompromized 
patients. Acycloguanosine (acyclovir) has been found particularly useful in the
treatment of herpes simplex virus and varicella zoster virus infections in
immunocompromized patients and for herpesencephalitis. Varicella-zoster can also 
be treated effectively with bromovinyldeoxyuridine (BVDU). Toxicity of the
currently used antiviral drugs is discussed as well as the problem of drug
resistance.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 3010086 [PubMed - indexed for MEDLINE]

7045: Immunology. 1986 Mar;57(3):437-42.

Human immune responses to herpes simplex virus, varicella-zoster and
cytomegalovirus in vitro.

Williamson SA, Parish N, Chambers JD, Knight RA.

The cell principally responsible for lymphocyte proliferation to herpes simplex
virus (HSV), varicella-zoster (VZ) and cytomegalovirus (CMV) has been shown to be
a T cell of helper phenotype. Lymphocytes from a proportion of
proliferation-positive normal individuals produced anti-viral antibody in vitro. 
Although in some cases, and at some time-points, the antibody was specific for
the priming virus, in others, antibodies to more than one virus were detected.
Similarly, some T-cell clones proliferated specifically to the priming virus,
whereas others were not specific for the virus used in the priming culture. Two
clones helped the production of HSV-specific antibody, one by autologous, the
other by both autologous and allogeneic non-T cells.

PMID: 3007334 [PubMed - indexed for MEDLINE]

7046: Arch Dermatol. 1986 Mar;122(3):282-5.

A comparison of the Tzanck smear and viral isolation in varicella and herpes
zoster.

Solomon AR, Rasmussen JE, Weiss JS.

We compared the usefulness of the Tzanck smear to viral culture in patients with 
varicella and herpes zoster. All 11 patients with early lesions of varicella had 
a positive Tzanck preparation, while only seven (64%) of 11 had a positive
culture. Twelve (80%) of 15 patients with zoster had a positive Tzanck
preparation, while only nine (60%) of 15 had a positive culture. The predominance
of the Tzanck yield over the culture is probably due to the increased difficulty 
in isolation of the varicella zoster virus. These results suggest that the Tzanck
preparation is a valuable tool in the diagnosis of patients with varicella and
zoster and offers a much more immediate answer than does viral culture, which
often takes one to two weeks. These results contrast with those of our previous
study of the Tzanck preparation and herpes simplex, in which the viral culture
was more accurate than the Tzanck preparation.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 3006599 [PubMed - indexed for MEDLINE]

7047: J Virol. 1986 Mar;57(3):1195-7.

New common nomenclature for glycoprotein genes of varicella-zoster virus and
their glycosylated products.

Davison AJ, Edson CM, Ellis RW, Forghani B, Gilden D, Grose C, Keller PM, Vafai
A, Wroblewska Z, Yamanishi K.

The accumulation of recent data concerning the reactivity of monoclonal
antibodies with particular varicella-zoster virus (VZV) glycoproteins and the
mapping of several of their respective genes on the VZV genome has led to a
unified nomenclature for the glycoprotein genes of VZV and their mature
glycosylated products. Homologs to herpes simplex virus glycoprotein genes are
noted.

PMID: 3005621 [PubMed - indexed for MEDLINE]

7048: J Pediatr. 1986 Mar;108(3):372-7.

Increased incidence of herpes zoster in normal children infected with varicella
zoster virus during infancy: community-based follow-up study.

Baba K, Yabuuchi H, Takahashi M, Ogra PL.

We surveyed outbreaks of varicella zoster virus (VZV) and herpes zoster virus,
involving 31 outbreaks of chicken pox, in a semiclosed institution in Osaka Japan
during the 34 years between 1949 and 1984. Eight hundred forty-nine infants and
children who had had clinical varicella during the first 4 years of life and
those who had resided in the institution at least 12 to 144 months after the
onset of varicella were included in the study. Nine cases of zoster were observed
among children who had acquired varicella during the first year of life, but
there was no case of zoster in those who had acquired varicella after 1 year of
age. In 61,800 person-months of observation, the overall incidence rate of zoster
was calculated as 0.15 per 1000 person-months for the population at risk. The
incidence rate in children infected with VZV when younger than 2 months was 1.0
per 1000 person-months during the first decade of life. This rate was
significantly (P less than 0.005) greater than that (0.19 per 1000 person-months)
in children who had varicella when they were 2 to 11 months of age. These
observations suggest that zoster occurs at a significantly shorter interval if
VZV infection is acquired during infancy. More than 85% of subjects with prior
infection were intimately reexposed to epidemic varicella during their residency 
in the institution, before having zoster. Epidemic reexposure to varicella during
follow-up resulted in enhancement of preexisting immunologic reactivity, but did 
not prevent subsequent zoster in the population studied.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3005536 [PubMed - indexed for MEDLINE]

7049: J Infect Dis. 1986 Mar;153(3):605-8.

Varicella-Zoster virus does not become more resistant to acyclovir during
therapy.

Cole NL, Balfour HH Jr.

Publication Types: 
    Clinical Trial
    In Vitro
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3005428 [PubMed - indexed for MEDLINE]

7050: Ann Allergy. 1986 Mar;56(3):206, 241-3.

Intravenous gammaglobulin treatment of profound herpes varicella zoster
associated thrombocytopenia.

DiTuro WJ, Goldsmith PM, Frenkel LD, Jadeja NG, Dennis TR.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 2420239 [PubMed - indexed for MEDLINE]

7051: Nucleic Acids Res. 1986 Feb 25;14(4):1765-77.

Alphaherpesviruses possess a gene homologous to the protein kinase gene family of
eukaryotes and retroviruses.

McGeoch DJ, Davison AJ.

The US3 genes of herpes simplex virus serotypes 1 and 2, and the corresponding
gene of varicella-zoster virus, encode proteins whose sequences are clearly
homologous to members of the protein kinase family of eukaryotes and
retroviruses. Similarity is most characteristic, and strongest, in an 80 residue 
region comprising part of the catalytic structure of the kinases. In this region 
the herpesvirus proteins are most like a yeast cell division control protein, and
least like the retrovirus protein-tyrosine kinases. We consider that the
herpesvirus proteins are probably involved in modulation of cellular processes
during lytic infection, although other roles are also possible, for example in
latent infection.

Publication Types: 
    Comparative Study

PMID: 3005981 [PubMed - indexed for MEDLINE]

7052: Nucleic Acids Res. 1986 Feb 25;14(4):1727-45.

Complete DNA sequence of the short repeat region in the genome of herpes simplex 
virus type 1.

McGeoch DJ, Dolan A, Donald S, Brauer DH.

We report the complete DNA sequence of the short repeat region in the genome of
herpes simplex virus type 1, as 6633 base pairs of composition 79.5% G+C. This
contains immediate early gene 3, encoding the IE175 protein, an important
transcriptional activator of later virus genes. The IE175 coding region was
identified as a 3894 base sequence of 81.5% G+C DNA. The base composition of this
gene is thus the most extreme yet determined, and the IE175 predicted amino acid 
composition is correspondingly biased, most notably with an alanine content of
20.9%. Functionally important regions of the IE175 polypeptide were tentatively
identified by comparison with the sequence of the homologous protein from
varicella-zoster virus and from locations of ts mutations, and were correlated
with properties of the amino acid sequence. Aspects of the evolution of such an
extreme composition DNA sequence were discussed.

Publication Types: 
    Comparative Study

PMID: 3005980 [PubMed - indexed for MEDLINE]

7053: Am J Ophthalmol. 1986 Feb 15;101(2):153-5.

Herpes zoster ophthalmicus in patients at risk for the acquired immune deficiency
syndrome (AIDS).

Sandor EV, Millman A, Croxson TS, Mildvan D.

In a prospective investigation of 54 consecutive cases of herpes zoster
ophthalmicus, conducted over a two-year period, immunologic evaluations included 
enumeration of T lymphocyte subsets and serum immunoglobulin levels. Herpes
zoster ophthalmicus occurred with frequent ocular complications in a subgroup of 
adults distinguishable by their young age, the presence of AIDS-risk factors,
alterations in T-cell subpopulations, and polyclonal increases of serum
gammaglobulin. Over the study duration, 21% (three of 14) of the AIDS-risk
subgroup patients have developed AIDS with a 14% (two of 14) mortality. Herpes
zoster ophthalmicus in AIDS-risk group members appeared to be an early clinical
marker for the immune deficiency induced by AIDS retroviral infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3484904 [PubMed - indexed for MEDLINE]

7054: Ann Neurol. 1986 Feb;19(2):182-8.

Progressive encephalitis three months after resolution of cutaneous zoster in a
patient with AIDS.

Ryder JW, Croen K, Kleinschmidt-DeMasters BK, Ostrove JM, Straus SE, Cohn DL.

A 37-year-old homosexual man with the acquired immune deficiency syndrome (AIDS) 
developed progressive, ultimately fatal, neurological deficits 12 weeks after a
course of cutaneous zoster. Premortem radiological procedures and cerebrospinal
fluid analyses were nondiagnostic. At postmortem examination, several
opportunistic infections associated with AIDS were recognized. Throughout the
brain, necrotic and demyelinative lesions were present, suggestive of progressive
multifocal leukoencephalopathy. However, light microscopical examination showed
numerous Cowdry type A intranuclear inclusions in astrocytes, oligodendrocytes,
and neurons near the periphery of the lesions. Herpes zoster encephalomyelitis
was diagnosed and confirmed by electron microscopy, peroxidase-antiperoxidase
staining, and by Southern blot analysis of DNA extracted from brain tissue. This 
case provides insight into the pathogenesis of zoster-associated
encephalomyelitis and suggests another agent to be considered in the differential
diagnosis of encephalopathy in patients with AIDS and other disorders of
immunological impairment.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3963760 [PubMed - indexed for MEDLINE]

7055: J Hand Surg [Br]. 1986 Feb;11(1):115-6.

Shingles following axillary nerve block. A case report.

Percival NJ.

Axillary nerve blocks are now frequently used for emergency and elective upper
limb surgery. The method gives reliable anaesthesia with few complications. A
case is described in which a patient developed Herpes Zoster following an
Axillary Nerve Block, a hitherto unreported complication.

Publication Types: 
    Case Reports

PMID: 3958530 [PubMed - indexed for MEDLINE]

7056: Hawaii Med J. 1986 Feb;45(2):37-9.

The patterns of herpesvirus infection in a multiracial population Kauai County,
Hawaii, 1981-1985.

Brinkworth S, Elpern DJ.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3957653 [PubMed - indexed for MEDLINE]

7057: Am J Med Sci. 1986 Feb;291(2):115-8.

SIADH during disseminated Herpes varicella-zoster infections: relationship to
vidarabine therapy.

Semel JD, McNerney JJ Jr.

Three patients with the syndrome of inappropriate secretion of antidiuretic
hormone (SIADH) during the course of disseminated Herpes Varicella-Zoster (HVZ)
virus infections are reported. In one patient and two previously reported
patients, SIADH occurred at or shortly after admission, prior to antiviral drug
therapy. In two patients and one previously reported patient, SIADH began or
hyponatremia worsened after vidarabine therapy was begun. Therefore, SIADH may
occur during the course of untreated, disseminated HVZ infection. However, the
relatively high fluid volume required to dilute vidarabine may play a role in the
development of the clinical and laboratory manifestations of SIADH, in patients
receiving the drug. Physicians should avoid excess fluid intake and monitor serum
sodium carefully when caring for patients with disseminated HVZ infections. Doses
of vidarabine greater than 10 mg/kg/day may increase the likelihood of SIADH.
Acyclovir therapy was not associated with worsening of hypotonic hyponatremia in 
our patients.

Publication Types: 
    Case Reports

PMID: 3946467 [PubMed - indexed for MEDLINE]

7058: Brain. 1986 Feb;109 ( Pt 1):207-16.

Cranial nerve ischaemic arterial syndromes. A review.

Lapresle J, Lasjaunias P.

Topographical vascular disorders involving combinations of cranial nerves are
reviewed in this study. These are indicated by the correspondence between
groupings of clinical manifestations and anatomical vascular distributions.
Confirmatory evidence is provided by mishaps, following diagnostic or therapeutic
angiography. Three systems play a role in the vascularization of cranial nerves: 
the inferolateral trunk (ILT), most often arising from the internal carotid
artery, the middle meningeal system (MMS), and the ascending pharyngeal system
(APS); the latter two are both derived from the external carotid artery.
Conclusions concerning the ILT are least definite because of variations in
vascular territory and the lack of confirmation from embolic events in a vascular
region that is rarely the site of embolization. The specific ILT territory
includes cranial nerve III and also nerves IV, VI and V1. Knowledge of the
vascularization of nerve III may furnish explanations as to its different modes
of involvement in diabetes mellitus. For the MMS, the cranial nerves concerned
are V2, V3 and VII. Two vascular territories for the intrapetrous portion of
nerve VII are defined: the first (stylomastoid artery) is limited to nerve VII;
the second (MMS) supplies VII and V. Two examples of involvement of VII and V
following selective MMS embolization are presented. A study of Bell's palsy
associated with nerve V impairment is summarized. The APS supplies nerves IX, X, 
XI and XII; XI has a dual vascularization which explains why it can either be
spared (as was the case in an angiographic accident) or involved (as in a case of
herpes zoster). A vascular mechanism should be considered when cranial nerve
lesions occur in the syndromes described here.

Publication Types: 
    Case Reports

PMID: 3942855 [PubMed - indexed for MEDLINE]

7059: Nihon Kyobu Shikkan Gakkai Zasshi. 1986 Feb;24(2):195-9.

[Two cases of primary varicella pneumonia]

[Article in Japanese]

Aizawa H, Ohsaki Y, Sakai E, Ikeda Y, Kuwajima T, Onodera S.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3735830 [PubMed - indexed for MEDLINE]

7060: J Assoc Physicians India. 1986 Feb;34(2):161.

Unusual cases of herpes zoster involving cranial nerves.

Bhattacharya SK, Sundar S.

Publication Types: 
    Case Reports
    Letter

PMID: 3711014 [PubMed - indexed for MEDLINE]

7061: Neurol Clin. 1986 Feb;4(1):265-83.

CNS diseases associated with varicella zoster virus and herpes simplex virus
infection. Pathogenesis and current therapy.

Barnes DW, Whitley RJ.

In recent years, herpes simplex virus has been recognized as an important CNS
pathogen in neonates and adults. The recent development of effective antiviral
therapy has substantially reduced the excessive morbidity and mortality
associated with these infections. For neonatal herpes simplex infections, the
current drug of choice is vidarabine. The results of ongoing clinical trials
comparing vidarabine with acyclovir in neonatal herpes may lead to a change in
the recommended therapy. In the adult, the therapy of choice for herpes simplex
encephalitis is acyclovir. Although effective, the present therapies for herpes
simplex infections of the CNS leave much room for improvement. In addition to the
development of more effective antiviral drugs and less invasive diagnostic
techniques, prevention of these often devastating infections will be important in
reducing morbidity and mortality. The CNS diseases associated with varicella and 
herpes zoster may have a different pathogenesis. The implication for therapy in
these diseases favors nonspecific supportive therapy in the varicella-associated 
syndromes. The few anecdotal reports of the use of vidarabine and acyclovir in
herpes zoster encephalitis and the histopathologic evidence suggesting viral
invasion of the CNS in many cases of zoster-associated neurologic syndromes makes
the use of specific antiviral therapy in zoster encephalomyelitis more rational. 
However, appropriate therapeutic recommendations will have to be based on
controlled clinical trials that have not yet been performed.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 3523204 [PubMed - indexed for MEDLINE]

7062: Klin Monatsbl Augenheilkd. 1986 Feb;188(2):97-100.

[Total lid replacement by an autologous and homologous combination graft in
emergencies]

[Article in German]

Neubauer H.

Report on 3 cases with total loss of a lid which required an "emergency lid" in
order to protect the cornea. In all cases the tarsus was replaced by a strip of
dura mater, the eye-lid skin by a free retroauricular graft. In all 3 cases the
attempt was made to mobilize the levator and other adjacent tissue and fix them
to the tarsus replacement. In one case the upper palpebral and bulbar conjunctiva
was also replaced by 2 flaps of lip mucosa. In this case the lower half of the
tarsal zone was rejected; however, the situation was mastered by
tarsoconjunctival shifting of the lower lid with a free lid skin graft from the
other eye. All "emergency lids" resulted in lid closure which protected the
cornea sufficiently. The 2 patients in whom the upper lid was replaced had active
lid movement of 3 to 4 mm.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3520123 [PubMed - indexed for MEDLINE]

7063: South Med J. 1986 Feb;79(2):256-7.

Recurrent varicella-zoster infection after acyclovir therapy in immunocompromised
patients.

Oblon DJ, Elfenbein GJ, Rand K, Weiner RS.

Varicella-zoster virus (VZV) infection is a late complication of bone marrow
transplantation in almost half of the long-term survivors. We have reported the
clinical relapse of VZV infection in two marrow transplant recipients treated
with standard regimens of acyclovir, a new antiviral agent with activity against 
VZV. Since most VZV infections occur after discharge from a transplant center,
primary care physicians must be alert to the possibility of relapse of VZV
infection after acyclovir therapy.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3511542 [PubMed - indexed for MEDLINE]

7064: Rinsho Shinkeigaku. 1986 Feb;26(2):133-6.

[Herpes zoster ophthalmicus with delayed ipsilateral cerebellar ataxia]

[Article in Japanese]

Yamamoto T, Inoue N, Tsuji S, Murai Y, Tsukamoto Y.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3486079 [PubMed - indexed for MEDLINE]

7065: Tohoku J Exp Med. 1986 Feb;148(2):143-9.

Application of immune adherence hemagglutination test in the screening of blood
donors carrying a high titer antibody to varicella-zoster virus.

Kawai H, Sakuma T, Sasaki K, Sato M, Watanabe T, Honda M, Ozaki S, Azuma M.

The immune adherence hemagglutination (IAHA) test was compared with the
complement fixation (CF) test and fluorescent antibody (FA) test to measure the
antibody titer to varicella-zoster virus (VZV) in 70 sera of convalescents 2 to 8
weeks after herpes zoster onset. The IAHA titer correlated with the FA titer, but
not with the CF titer which was lower than the IAHA and FA titers. Then, the IAHA
test was used for screening of blood donors with a high titer (higher than 64
units) of antibody to VZV from 2,592 blood donors. About 14% of the sera from the
donors aged 16 to 19 years had an antibody titer higher than 64 units, about 10% 
of sera from the donors aged 20 to 49 years, and 5.6% of sera from the donors
older than 50 years. An average positive rate was about 9%, indicating that an
enough VZV immune plasma with a high titer of antibody might be obtained from
blood donors.

PMID: 3008376 [PubMed - indexed for MEDLINE]

7066: Lancet. 1986 Feb 1;1(8475):273-4.

Shingles clusters.

Palmer SR, Tillett H.

Publication Types: 
    Letter

PMID: 2868283 [PubMed - indexed for MEDLINE]

7067: Virology. 1986 Feb;149(1):74-82.

Induction of neutralizing antibody against varicella-zoster virus (VZV) by VZV
gp3 and cross-reactivity between VZV gp3 and herpes simplex viruses gB.

Kitamura K, Namazue J, Campo-Vera H, Ogino T, Yamanishi K.

Glycoprotein gp3 (64K) is one of the major proteins specified by varicella-zoster
virus (VZV). This glycoprotein was purified on an immunoadsorbent consisting of
monoclonal antibody (clone 8) against gp3 linked to protein A-Sepharose. Rabbits 
were then immunized with the purified antigen to obtain monospecific antisera
against gp3. The monospecific antisera and monoclonal antibody immunoprecipitated
polypeptides with the same molecular weights of approximately 64,000 (64K), 106K,
and 116K from a lysate of labeled cells infected with VZV. The monoclonal
antibodies against gp3 did not have neutralizing activity against VZV, but
anti-gp3 monospecific sera neutralized VZV infectivity. The antigenic relation of
VZV to herpes simplex virus (HSV) was investigated by the immunofluorescent test,
immunoprecipitation followed by analysis by sodium dodecyl sulfate-polyacrylamide
gel electrophoresis and the neutralizing antibody test with monoclonal antibodies
and monospecific antisera. In the indirect immunofluorescent test, the cytoplasm 
of cells infected with HSV-type 1 or HSV-type 2 was stained with anti-gp3
monospecific antiserum but not with anti-gp3 monoclonal antibodies. This serum
also precipitated the polypeptides of HSV-type 1 and HSV-type 2 with molecular
weight of approximately 120,000, possibly corresponding to gB of HSV-1 or HSV-2, 
and this immunoprecipitation was blocked by anti-gB monoclonal antibody. However,
anti-gp3 monospecific antisera did not neutralize either HSV-type 1 or HSV-type 2
infectivity. These results suggest that gp3 induces neutralizing antibody against
VZV and that it also has a cross-reacting antigenic determinant with gB of HSV.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2418583 [PubMed - indexed for MEDLINE]

7068: N Engl J Med. 1986 Jan 23;314(4):208-12.

Treatment of varicella-zoster virus infection in severely immunocompromised
patients. A randomized comparison of acyclovir and vidarabine.

Shepp DH, Dandliker PS, Meyers JD.

In a prospective, randomized trial, we compared intravenous acyclovir and
vidarabine in the treatment of varicella-zoster virus infection in severely
immunocompromised patients who presented within 72 hours of onset of the
infection. Eleven patients were treated in each group. Cutaneous dissemination of
infection occurred in none of the 10 acyclovir recipients and in 5 of the 10
vidarabine recipients who had presented with localized dermatomal disease (P =
0.016). As compared with vidarabine, acyclovir treatment shortened the median
periods during which cultures were positive for the virus (four vs. seven days, P
= 0.004) and new lesions formed (three vs. six days, P = 0.03). Acyclovir also
shortened the median interval until the first decrease in pain (4 vs. 7 days, P =
0.005), the pustulation of all lesions (4 vs. 7 days, P = 0.0004), the crusting
of all lesions (7 vs. 17 days, P = 0.0003), and the complete healing of lesions
(17 vs. 28 days, P = 0.003). In addition, acyclovir reduced the incidence of
fever (two vs. eight patients, P = 0.015). We conclude that acyclovir is better
than vidarabine for the treatment of varicella-zoster infection in
immunocompromised patients.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3001523 [PubMed - indexed for MEDLINE]

7069: Lancet. 1986 Jan 18;1(8473):160.

Varicella-zoster: reactivation or reinfection?

Pallett AP, Nicholls MW.

Publication Types: 
    Letter

PMID: 2867379 [PubMed - indexed for MEDLINE]

7070: JAMA. 1986 Jan 17;255(3):387-8.

Acyclovir therapy for herpes zoster: advantages and adverse effects.

Balfour HH Jr.

Publication Types: 
    Editorial

PMID: 3941520 [PubMed - indexed for MEDLINE]

7071: JAMA. 1986 Jan 17;255(3):385-6.

Vesicular eruption. A local complication of concentrated acyclovir infusions.

Sylvester RK, Ogden WB, Draxler CA, Lewis FB.

Publication Types: 
    Case Reports

PMID: 3510331 [PubMed - indexed for MEDLINE]

7072: Minerva Med. 1986 Jan 14;77(1-2):47-50.

[Drug therapy of so-called postherpetic neuralgia, the only valid alternative.
Clinical experience in 43 treated cases]

[Article in Italian]

Bianchetti L.

The efficacy of tricyclic antidepressants in association with neuroleptics having
been demonstrated in patients suffering from so-called tardive post-herpetic
neuralgia, 43 patients were given this treatment either alone or in association
with transcutaneous nerve stimulation (TENS). Of the 33 patients given drug
treatment alone, 25 found relief from pain in 3-18 months, 5 produced a partial
result and in 3 the treatment failed. The results obtained suggest that this is
the most effective treatment as long as it is continuous and given for at least
3-6 months. The use of TENS produced no benefit.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 2868434 [PubMed - indexed for MEDLINE]

7073: Wien Klin Wochenschr. 1986 Jan 10;98(1):20-4.

[Experiences with acyclovir in herpes virus infections]

[Article in German]

Fortelny A, Heinz R, Waldner R, Baumgartner G, Lutz D.

46 patients suffering from various malignancies (17 non Hodgkin lymphomas, 12
Hodgkin's diseases, 11 acute leukaemias, 4 myelomas, 2 carcinomas), 6 patients
with haematological disorders such as ITP, SAA, myeloproliferative disease, LAS
and 3 patients without preexisting disease were treated with acyclovir for herpes
virus infection diagnosed by clinical means. All but 7 patients had been given
intensive treatment with various cytostatic agents and/or irradiation. Most
patients were treated with 1500 mg acyclovir daily for 5 to 13 days. Dosage was
adjusted according to renal function and clinical response in the remaining 10
cases. 11 patients received intravenous immunoglobulins in addition. Side effects
were negligible (local irritation, minimal rise in serum creatinine levels in 5
patients). All patients responded to treatment; 6 patients complained of severe
neuralgia lasting for more than one month; 5 patients relapsed.

Publication Types: 
    English Abstract

PMID: 3006362 [PubMed - indexed for MEDLINE]

7074: Ugeskr Laeger. 1986 Jan 6;148(2):66-8.

[Postherpes neuralgia. Optimal treatment of pain in acute herpes zoster is
essential]

[Article in Danish]

Andersen S.

Publication Types: 
    English Abstract

PMID: 3952825 [PubMed - indexed for MEDLINE]

7075: Nervenarzt. 1986 Jan;57(1):14-8.

[Specific antibody activity as a marker of pathogen-stimulated immune response in
the central nervous system. Exemplified by syphilis and zoster diseases]

[Article in German]

Prange HW, Ritter G.

Under normal conditions the portion of any antigen specific IgG of total IgG is
identical in serum and CSF. This thesis was investigated in 51 patients who were 
found to have seropositive syphilis without CNS involvement. For this purpose a
special index (ITpA-index) was used, based on the ratio of specific IgG per total
IgG of CSF to specific IgG per total IgG of serum. This index has a value of 1
(0.5-2), if there is no antibody synthesis in the CNS, as confirmed on the 51
seropositive control patients. In patients with syphilitic CNS involvement the
index rose above 2 (3-430), due to local antibody synthesis in the CNS. When
there is an ITpA-index below 2.0 in patients with seropositive syphilis who show 
any CNS symptoms whatsoever, it can be presumed that the actual CNS disease is
not a consequence of the former syphilitic infection, but is caused by a
condition other than syphilis. In 6 patients with reactive syphilis tests,
moderate CSF pleocytosis and increased CSF total IgG, the ITpA-index was below
0.5. Among these 6 patients the inflammatory CNS process was non-syphilitic. The 
principle of the ITpA-index is applicable to other bacterial or viral CNS
diseases insofar as a local humoral immune response takes place. This could be
demonstrated in cases of herpes zoster.

Publication Types: 
    English Abstract

PMID: 3960215 [PubMed - indexed for MEDLINE]

7076: Clin Exp Immunol. 1986 Jan;63(1):179-87.

Human lymphocyte, monocyte and polymorphonuclear leucocyte mediated
antibody-dependent cellular cytotoxicity against varicella-zoster virus-infected 
targets.

Ihara T, Ito M, Starr SE.

The ability of lymphocytes, monocytes and polymorphonuclear leucocytes (PMN) to
mediate antibody-dependent cellular cytotoxicity (ADCC) against varicella-zoster 
virus (VZV) infected fibroblasts was tested in 51Cr release and single-cell
assays. Lymphocytes had the greatest lytic activity, monocytes were intermediate 
in activity and PMN were the least active. Lymphocyte-mediated ADCC was complete 
by as early as 4 h, while maximal monocyte and PMN-mediated ADCC required 18 h.
In single-cell assays, monocytes formed conjugates with both uninfected and
VZV-infected targets, but did not cause lysis. PMN failed to bind or lyse either 
target. Few lymphocytes formed conjugates with uninfected targets, while a higher
percentage bound to VZV-infected targets and caused lysis. In the presence of
human antibodies to VZV conjugate formation and lysis of VZV-infected targets was
significantly increased with each of the effector-cell populations. Lymphocytes
had the highest lytic activity in single-cell assays as well as in 51Cr release
assays, and were responsible for most of the ADCC detected in adult peripheral
blood against VZV-infected targets.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3955882 [PubMed - indexed for MEDLINE]

7077: J Am Osteopath Assoc. 1986 Jan;86(1):34-6.

Epidural phenol in the treatment of postherpetic neuralgia.

Neuendorf TL.

Publication Types: 
    Case Reports

PMID: 3949557 [PubMed - indexed for MEDLINE]

7078: Int J Dermatol. 1986 Jan-Feb;25(1):58-9.

Dermatologic dyspnea.

O'Doherty CJ, Savin JA.

Publication Types: 
    Case Reports

PMID: 3949433 [PubMed - indexed for MEDLINE]

7079: Zentralbl Gynakol. 1986;108(21):1273-81.

[New aspects of therapy with standard immunoglobulin preparations]

[Article in German]

Briese V.

Both, in vitro and in vivo studies have shown that intravenous immunoglobulin
administration in high doses is of usefulness in the therapy of bacterial
infections because of synergistic effects with antibiotics. Unmodified,
polyvalent immunoglobulin for intravenous administration is actually used for
therapy in patients with severe generalized infections, in patients with
autoimmune diseases such as idiopathic thrombocytopenic purpura (ITP). ITP
patients were treated with IgG i.v. 400 mg/kg KG. One can hope for practical
purposes that IgG preparations administrated prophylactically decrease infectious
complications in myelosuppressive phases during aggressive tumor therapy.

Publication Types: 
    English Abstract

PMID: 3811676 [PubMed - indexed for MEDLINE]

7080: Vestn Dermatol Venerol. 1986;(9):54-5.

[Keloid scars as a sequel of herpes zoster]

[Article in Russian]

Manikhas MG, Egorova MA, Orlova EV.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3799054 [PubMed - indexed for MEDLINE]

7081: Adv Exp Med Biol. 1986;195 Pt B:689-92.

2-5A synthetase activities in herpes virus infection and after interferon
treatment.

Mejer J, Justesen J, Ernst P.

PMID: 3766247 [PubMed - indexed for MEDLINE]

7082: Antimicrob Agents Chemother. 1986 Jan;29(1):49-51.

An influenza virus inhibitor that acts late in the replication cycle.

Antonelli G, Dianzani F, Coppenhaver DH, Baron S, Calandra P, Folchitto G.

An inhibitor which is active against influenza A virus was found in Neuramide, a 
complex tissue extract that is used as an anti-herpes zoster virus treatment.
Kinetic studies showed that significant inhibition of virus production occurred
when the inhibitor was added to infected cultures up to 5 h after virus
penetration. Molecular sieving fractionation showed that the antiviral activity
was contained in a low-molecular-weight fraction (molecular weight, less than
1,000).

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3755313 [PubMed - indexed for MEDLINE]

7083: J Tongji Med Univ. 1986;6(2):109-11.

The efficacy of long-dan-xie-gan-tang in the treatment of herpes zoster: a
clinical trial and animal experimental data.

Shen LL, Wu HS, Wang XY.

PMID: 3746978 [PubMed - indexed for MEDLINE]

7084: Neoplasma. 1986;33(3):355-9.

Ph1-positive acute leukemia in a patient with Hodgkin's disease treated by
irradiation and chemotherapy.

Yavorkovsky LL, Yavorkovsky LI, Bondare DK.

A case of acute undifferentiated leukemia with a Ph1-chromosome and a typical
translocation t(9;22) is reported in a 54-year-old female with Hodgkin's disease.
The interval from diagnosis of Hodgkin's disease to the development of acute
leukemia was 19 months. Treatment of Hodgkin's disease consisted of combined
cytotoxic therapy including irradiation and chemotherapy. Detection of
Ph1-chromosome in undifferentiated blasts supports the suggestion of leukemogenic
chromosomal aberration within uncommitted hemopoietic cells.

Publication Types: 
    Case Reports

PMID: 3736721 [PubMed - indexed for MEDLINE]

7085: J R Coll Gen Pract. 1986 Jan;36(282):24-8.

Postherpetic neuralgia.

Robinson PN, Fletcher N.

PMID: 3701690 [PubMed - indexed for MEDLINE]

7086: Clin Neuropharmacol. 1986;9(6):533-41.

Treatment of postherpetic neuralgia.

Watson PN, Evans RJ.

Publication Types: 
    Review

PMID: 3542206 [PubMed - indexed for MEDLINE]

7087: Vestn Dermatol Venerol. 1986;(1):56-7.

[A case of generalized herpes zoster in a patient with reticulosarcomatosis]

[Article in Russian]

Nemkaeva RM, Unzhakov VP, Kuz'min IK.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3515801 [PubMed - indexed for MEDLINE]

7088: Curr Probl Dermatol. 1986;15:111-6.

Applications of laser light of low power density. Experimental and clinical
investigations.

Brunner R, Haina D, Landthaler M, Waidelich W, Braun-Falco O.

Publication Types: 
    Clinical Trial

PMID: 3512177 [PubMed - indexed for MEDLINE]

7089: J Med Virol. 1986 Jan;18(1):11-20.

Oral bromovinyldeoxyuridine therapy for herpes simplex and varicella-zoster virus
infections in severely immunosuppressed patients: a preliminary clinical trial.

Tricot G, De Clercq E, Boogaerts MA, Verwilghen RL.

Twenty-five patients with haematological diseases were treated orally with the
highly potent and selective anti-herpes agent, bromovinyldeoxyuridine (BVDU), in 
a dosage of 7.5 mg/kg/day (divided over three or four doses a day) for 5 days for
an intercurrent mucocutaneous herpesvirus infection. Of these 25 patients, 8 were
severely granulocytopenic at the time of the viral infection, and 12 recently had
undergone bone-marrow transplantation; 5 were under cytotoxic therapy for a
lymphoproliferative disorder; 13 had herpes simplex virus type 1 (HSV-1); 1 had
herpes simplex virus type 2 (HSV-2); and 11 had varicella-zoster virus (VZV)
infection. In all but two patients, BVDU arrested progression of the HSV or VZV
infection within 1-2 days after treatment was started. One of the two patients
who failed to respond to BVDU had an HSV-2 infection. The other had an HSV-1
infection, which was highly sensitive to BVDU in vitro; BVDU may have failed in
this patient because of incomplete drug intake or profuse diarrhoea, or both. The
results of this preliminary uncontrolled clinical trial suggest that BVDU may be 
an effective and safe drug for the oral treatment of HSV-1 and VZV infections in 
severely immunosuppressed patients.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 3511181 [PubMed - indexed for MEDLINE]

7090: Int Ophthalmol Clin. 1986 Winter;26(4):29-48.

Peripheral corneal infections.

Taylor PB, Tabbara KF.

PMID: 3492477 [PubMed - indexed for MEDLINE]

7091: Vox Sang. 1986;51 Suppl 2:39-43.

Immunoglobulin in chronic inflammatory diseases.

Cottier H, Hassig A.

Several case studies are presented to illustrate the success of intravenous
gammaglobulin (IVIG) therapy in ulcerative colitis, Crohn's disease, chronic
anterior uveitis, herpes zoster, and relapsing genital herpes simplex.
Hypothetical mechanisms explain the marked improvement of the chronic disorders, 
with particular emphasis on substitution of specific antibodies. The recently
recognized heterogeneity of the major histocompatibility complex (MHC) is
explored as one possible explanation for low and high responders to particular
antigens. It is suggested that various chronic inflammatory disorders result from
ineffective immune responses, and that the administration of IVIG may shift the
delicate balance between the pathogen and the host to favor the latter.

Publication Types: 
    Case Reports

PMID: 3490055 [PubMed - indexed for MEDLINE]

7092: Agents Actions Suppl. 1986;19:321-9.

Pyrazolone drugs in outpatient pain treatment.

Baar HA.

Even today, pyrazolone drugs still play an essential role in outpatient pain
treatment. Their applications and limitations are discussed from the point of
view of the general practitioner treating outpatients.

PMID: 3489360 [PubMed - indexed for MEDLINE]

7093: An Otorrinolaringol Ibero Am. 1986;13(2):185-93.

[The crocodile tear syndrome. Apropos of a case]

[Article in Spanish]

De la Fuente Arjona L.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3487989 [PubMed - indexed for MEDLINE]

7094: Clin Exp Immunol. 1986 Jan;63(1):141-6.

Cellular interactions in the lysis of varicella-zoster virus infected human
fibroblasts.

Hayward AR, Herberger M, Lazslo M.

The in vitro lysis of varicella-zoster virus (VZV) infected human fibroblasts by 
blood mononuclear cells (MNC) is inhibited by cyclosporin A, whether or not the
effector and target cells chare HLA A or B antigens. Interleukin 2 (IL-2)
reversed the inhibition by cyclosporin A (CyA) and also induced a further
increase in target cell lysis by MNC in the absence of CyA. MNC depleted of
OKM-1+ or Leu-11+ cells showed reduced lysis of VZV infected fibroblasts and this
reduction was not overcome by adding IL-2. Depletion of monocytes from the MNC
effectors reduced target cell lysis and this effect was reversed by adding
Interleukin 1 (IL-1). The results indicate that NK cells contribute to the lysis 
of VZV infected cells and suggest that IL-2 release by T cells, as a result of
HLA matching or antigen representation, may amplify this mechanism.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3485481 [PubMed - indexed for MEDLINE]

7095: Arch Otorhinolaryngol Suppl. 1986;2:146-59.

[The larynx, the trachea]

[Article in German]

[No authors listed]

PMID: 3469945 [PubMed - indexed for MEDLINE]

7096: J Oral Med. 1986 Jan-Mar;41(1):25-8.

Facial herpes zoster. Description and therapeutic update.

Kinni ME, Wedell DW.

Publication Types: 
    Case Reports

PMID: 3457111 [PubMed - indexed for MEDLINE]

7097: Pediatrics. 1986 Jan;77(1):53-6.

Risk of herpes zoster in children with leukemia: varicella vaccine compared with 
history of chickenpox.

Brunell PA, Taylor-Wiedeman J, Geiser CF, Frierson L, Lydick E.

A study was undertaken to determine whether children immunized with live
varicella vaccine are at greater risk of acquiring herpes zoster than children
who have had varicella. Children with acute lymphocytic leukemia who had had
varicella were compared with those who received live varicella vaccine. During
the period of observation, 15 of 73 children who had varicella acquired herpes
zoster and none of the 34 children who had been vaccinated. If the time of
observation was adjusted for and the vaccinees who failed to have a sustained
antibody response or who acquired chickenpox were removed, the risk of herpes
zoster was still less in vaccinees (P = .0075). Because herpes zoster is common
in children with acute lymphocytic leukemia, differences in the two groups could 
be discerned more readily than if normal children were compared. There is no
reason to suspect that recipients of live varicella vaccine would be more likely 
to acquire herpes zoster than children who get varicella.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3455669 [PubMed - indexed for MEDLINE]

7098: Adv Pediatr Infect Dis. 1986;1:99-115.

Varicella zoster infections of the fetus, neonate, and immunocompromised child.

Feldman S.

Division of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, 
Tennessee.

Publication Types: 
    Review

PMID: 3331278 [PubMed - indexed for MEDLINE]

7099: J Med. 1986;17(3-4):267-70.

Connection between varicella and herpes zoster.

Jako GJ, Jako RA.

Publication Types: 
    Biography
    Historical Article

Personal Name as Subject: 
    Bokay J

PMID: 3295093 [PubMed - indexed for MEDLINE]

7100: Indian J Ophthalmol. 1986;34:107-8.

Autoserum therapy and zoster keratitis.

Satsangi SK, Verma S, Singh YP, Pandey DJ, Bist HK, Choudhary RM.

PMID: 3155040 [PubMed - indexed for MEDLINE]

7101: Indian J Ophthalmol. 1986;34:101-3.

A clinical study of acyclovir in herpes zoster ophthalmicus.

Matalia P.

PMID: 3155038 [PubMed - indexed for MEDLINE]

7102: Ophthal Plast Reconstr Surg. 1986;2(1):1-6.

The complications of dermal tattooing.

Wilkes TD.

Department of Ophthalmology, University of Arkansas for Medical Sciences, Little 
Rock 72205.

Dermal tattooing has been performed for over 4,000 years. Some of the reported
complications from tattooing include pyogenic infections, viral hepatitis,
syphilis, tuberculosis cutis, rubella, herpes simplex, herpes zoster, psoriasis, 
lichen planus, lupus, pigment allergy and sensitivity, keloids, sarcoidal
granulomas, erythema multiforme, malignant melanoma, squamous cell carcinoma, and
basal cell carcinoma. Most complications can be avoided by utilizing proper
aseptic technique and avoiding exotic pigments. A survey of the members of the
American Society of Ophthalmic Plastic and Reconstructive Surgery was taken to
determine the prevalence of eyelid tattooing and complications encountered. The
findings of this survey are presented.

PMID: 3154532 [PubMed - indexed for MEDLINE]

7103: Pediatr Hematol Oncol. 1986;3(3):267-71.

Short-time and low-dose intravenous acyclovir therapy in varicella zoster
infections with malignant disease in children receiving combined chemotherapy.

Sarialioglu F, Buyukpamukcu M, Cevik N, Kutluk MT, Akyol H, Kansu E.

Department of Paediatric Oncology, Faculty of Medicine, Hacettepe University,
Ankara, Turkey.

The effects of low-dose and short-time acyclovir therapy in 14 children with
malignant disease of ages 4-18 years who had developed varicella zoster virus
infections while receiving aggressive chemo-/+radiotherapy are reported. Ten of
them had chickenpox and 4 herpes zoster. Acyclovir 5 mg/kg was infused IV every
12 h in 9 patients and every 8 h in 5 patients for a median of 4 days' duration. 
We resumed the primary therapy when the patients' lesions had dried out and
became crusted and new lesions had not reappeared. The period of initiation of
the acyclovir therapy to the resumption of oncological treatment was 8.4 +/- 2.7 
days for chickenpox and 12.0 +/- 3.4 days for herpes zoster patients. After
restarting the oncological therapy, no adverse effects of acyclovir or
complication of infection were observed. The efficiency of early, short-term, and
relatively low dose acyclovir therapy is discussed and compared to the results in
the relevant literature.

PMID: 3153239 [PubMed - indexed for MEDLINE]

7104: Jpn J Ophthalmol. 1986;30(4):472-9.

Immunological studies of uveitis. 1. Immune complex containing herpes virus
antigens in four patients with acute retinal necrosis syndrome.

Matsuo T, Nakayama T, Matsuo N, Koide N.

Four patients with acute retinal necrosis syndrome were examined. Three of them
showed elevated antibody titers to varicella-zoster virus during the convalescent
stage, while one of them showed an elevated titer to herpes simplex virus type 1,
especially in the intraocular fluid. Also, these patients had an elevated
circulating immune complex in the acute phase. Western blotting demonstrated that
the immune complexes contained varicella-zoster or herpes simplex type 1 antigen,
corresponding to the elevated antibody titer to either virus.

PMID: 3035258 [PubMed - indexed for MEDLINE]

7105: Year Immunol. 1986;2:267-78.

The role of T cell immunity in infection with the herpes group viruses.

Finberg R, Hom R.

Publication Types: 
    Review

PMID: 3033947 [PubMed - indexed for MEDLINE]

7106: Czech Med. 1986;9(4):203-5.

Acyclovir in the treatment of infection due to herpes viruses.

Zicha J, Stafova J, Vacek V.

Intravenous infusions of acyclovir were administered to 15 patients suffering
from herpes simplex or varicella-zoster infections. The therapeutic effect of the
drug consisted in rapid cessation of progression of the disease and in
considerable shortening of duration of clinical symptoms. There were no adverse
reaction in our groups of patients. There were no relapses after the treatment
with acyclovir had been stopped. From what has been stated above, we take
acyclovir for a highly efficient and safe drug for therapy of HSV and VZV
infections.

PMID: 3028734 [PubMed - indexed for MEDLINE]

7107: Adv Exp Med Biol. 1986;202:95-118.

Herpesvirus infections in the immunocompromised host: diagnosis and management.

Whitley RJ.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 3024455 [PubMed - indexed for MEDLINE]

7108: Jpn J Ophthalmol. 1986;30(2):158-64.

Viral conjunctivitis with special reference to adenovirus type 37 and enterovirus
70 infection.

Aoki K, Kawana R, Matsumoto I, Wadell G, de Jong JC.

The clinical and etiological findings in 727 patients with viral conjunctivitis
treated from January 1982 through December 1984 at Aoki Eye Clinic in Sapporo,
Japan, were presented. The age of the patients ranged from 11 days to 88 years,
and the monthly incidences of the disease from 18 to 131 cases, with a clustering
in the summer season. The etiological diagnosis was established in 399 (54.9%) of
the 727 patients: adenovirus (Ad) 3 in 45 cases; Ad4 in 98 cases; Ad8 in 57
cases; Ad19 in 23 cases; Ad37 in 51 cases; untyped Ad in 33 cases; enterovirus
(EV) 70 in 60 cases; herpes simplex virus type I in 24 cases and varicella-zoster
virus in 4 cases. The clinical pictures of adenovirus 37 conjunctivitis were
generally similar to those of adenovirus 8 conjunctivitis, and subconjunctival
hemorrhage was more frequently seen in cases of EV70 conjunctivitis. EV70 cases
showed nosocomial infection. In addition to Ad8, Ad37 seems to play an important 
role as a causative agent of epidemic keratoconjunctivitis in Japan.

PMID: 3020290 [PubMed - indexed for MEDLINE]

7109: Int J Cell Cloning. 1986;4 Suppl 1:155-73.

Therapeutic use of newer antiviral agents.

Sacks SL.

PMID: 3018100 [PubMed - indexed for MEDLINE]

7110: Auris Nasus Larynx. 1986;13(1):11-34.

Vestibular neuronitis--serum and CSF virus antibody titer.

Matsuo T.

The cerebrospinal fluid (CSF) findings of patients with vestibular neuronitis
were virologically evaluated and discussed in contrast to those of herpes zoster.
CSF samples obtained from seven patients with vestibular neuronitis, aged 28 to
55 years, were examined. The results were as follows: The CSF protein level in
the vestibular neuronitis showed the peculiar change; i.e. its level was normal
at the onset period of vertigo, but it rose to abnormal levels mostly in the
period of two weeks, while the cell count remained normal throughout all phases
of our study. Herpes simplex virus (HSV) type 1 IgG antibody titers measured by
indirect immunofluorescent antibody technique (IF) in paired sera rose in one of 
the seven cases of vestibular neuronitis, but the antibody titers of the same
virus in the CSF were not detected. HSV type 1 IgG antibody titers measured by IF
in the CSF were detected in two of seven cases of vestibular neuronitis, but not 
significant. The ratio of EB virus (EBV) capsid antigen IgG antibody titers in
CSF to that in serum ranged from 1:160 to 1:80 in vestibular neuronitis. There
was no direct available evidence that vestibular neuronitis caused a break in
blood-CSF barrier, an increase in IgG synthesis in the central nervous system or 
active infection with HSV, varicella zoster virus (VZV), or EBV. In this paper,
we summarized the recent information on studies of the CSF and a latent herpes
virus infection in order to give perspective to the pathogenesis of vestibular
neuronitis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3017280 [PubMed - indexed for MEDLINE]

7111: Arch Virol. 1986;88(3-4):265-77.

Inoculation of guinea pigs with varicella-zoster virus via the respiratory route.

Walz-Cicconi MA, Rose RM, Dammin GJ, Weller TH.

Guinea pigs were inoculated by the respiratory route with wild-type (Cyr) or
vaccine (Oka) strain varicella zoster virus (VZV). Wild-type cell-free virus
obtained by sonication produced neutralizing antibody responses in
steroid-treated animals when given via the intratracheal route, and induced
neutralizing antibody as well as a pneumonitis in normal animals when given via
the intrabronchial (i.b.) route. A humoral response also followed i.b.
instillation of cell-associated wild-type or vaccine strain VZV. Prior i.b.
administration of thioglycollate or exposure to hyperoxia altered the number and 
function of pulmonary macrophages, respectively, but viral susceptibility of the 
guinea pigs was not enhanced. Both strains of VZV could be isolated from
bronchial washings up to 48 hours after i.b. instillation of cell-associated
virus, but neither strain was isolated thereafter from cultures of bronchial
washings or explanted lung tissues.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3010908 [PubMed - indexed for MEDLINE]

7112: Nippon Hifuka Gakkai Zasshi. 1986 Jan;96(1):1-7.

[Clinico-pathological studies on herpes zoster; [I]. Changes in antibody titers
on herpes zoster]

[Article in Japanese]

Muraki R.

PMID: 3009931 [PubMed - indexed for MEDLINE]

7113: Adv Nephrol Necker Hosp. 1986;15:353-78.

Viral infections in renal transplant recipients: an evolutionary problem.

Charpentier B.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 3006452 [PubMed - indexed for MEDLINE]

7114: Ann Neurol. 1986 Jan;19(1):7-14.

Thrombotic cerebral vasculopathy associated with herpes zoster.

Eidelberg D, Sotrel A, Horoupian DS, Neumann PE, Pumarola-Sune T, Price RW.

We describe the clinical, radiographic, and pathological findings in 3 patients
with large-vessel cerebral vasculopathy following herpes zoster. Two of the
patients were studied at postmortem examination, and a brain biopsy was performed
in the third. Each of the 3 patients suffered thrombotic occlusions of large
vessels without notable inflammatory or granulomatous changes following
trigeminal or segmental herpes zoster infection. In the 2 autopsied patients,
varicella-zoster virus (VZV) antigens were detected by immunoperoxidase staining 
within the media of the affected cerebral arteries. Little or no inflammation was
associated with the foci of the VZV antigens. These studies provide evidence that
the vasculopathy following herpes zoster may result from direct VZV infection of 
the artery and the in situ thrombosis can develop within the infected vessels in 
the absence of clear inflammatory vasculitis.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3004319 [PubMed - indexed for MEDLINE]

7115: J Med Virol. 1986 Jan;18(1):61-7.

Age-specific prevalence of antibodies to pyrimidine kinase enzymes of herpes
simplex virus types 1 and 2, and of varicella zoster virus.

Bardy B, Seuna L, Hovi T.

The age-specific prevalence of antibodies to pyrimidine kinase enzymes of herpes 
simplex virus types 1 (HSV-1) and 2 (HSV-2) and of varicella zoster virus (VZV)
was measured in serum specimens from 360 persons. Specific inhibition of viral
enzyme activity by the serum was used as an indication of the presence of
antibodies to the enzyme. For HSV-1 and HSV-2 together the overall prevalence of 
positive sera increased with age and reached about 50% in the older age groups,
the major part of the positive sera being HSV-1 positive. Sera inhibitory to the 
VZV pyrimidine kinase enzyme were detected only sporadically. Six percent of the 
tested sera repeatedly inhibited the cytosolar corresponding enzyme of uninfected
host cells by an unidentified mechanism. The results of the pyrimidine kinase
antibody-assay test were compared to those obtained by complement fixation (CF)
and enzyme immunoassay (EIA) in a separate set of 50 sera. The correlation
between the CF and the EIA tests was good in this selected serum set with CF
titres from less than 8 to 64. Twenty-four percent of the CF positive sera were
negative by the pyrimidine kinase antibody assay, while all
pyrimidine-kinase-antibody-positive sera also had antibodies detectable by the
two other methods. These results confirm and extend earlier observations on the
occurrence of antibodies in human sera to HSV and VZV pyrimidine kinase enzymes.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3003247 [PubMed - indexed for MEDLINE]

7116: Acta Derm Venereol. 1986;66(2):127-33.

Diagnostic value of Tzanck smear in herpetic and non-herpetic vesicular and
bullous skin disorders in pediatric practice.

Oranje AP, Folkers E, Choufoer-Habova J, Duivenvoorden JN.

The diagnostic value of the Tzanck smear was investigated in 76 patients of a
pediatric hospital population suffering from vesicular, erosive or bullous skin
disorders. Examination took place by two investigators together (AB), besides the
smears were examined by two others (C and D) double blind. Sensitivity for
patients with clinical herpetic infections was greater than 80%, specificity for 
those without herpetic infections was greater than 90%. These figures are higher 
than expected from literature. Reliability was also high; between the three
investigators no significant differences were found. The Tzanck smear is simple, 
inexpensive, easy to perform and rapid; it does not require a specialized
laboratory, but experience and correct technique of sampling is required.

Publication Types: 
    Comparative Study

PMID: 2424235 [PubMed - indexed for MEDLINE]

7117: Graefes Arch Clin Exp Ophthalmol. 1986;224(3):313-6.

Sectorial corneal infiltrates and pannus in herpes zoster ophthalmicus.

Mondino BJ, Farley MK, Aizuss DH.

We report four patients with herpes zoster ophthalmicus who developed a dense
pannus limited to a sector of the superior cornea that advanced to the central
region of the cornea. The pannus appeared to develop in response to peripheral
infiltrates in a subepithelial or anterior stromal location and not in
association with disciform corneal edema, interstitial keratitis, or scleritis.
The corneal pannus developed insidiously as a late complication without
associated ulceration and with little or no anterior uveitis or conjunctival
reaction. Additionally, all four patients developed anterior and mid-stromal
infiltrates in a punctate or incomplete ring configuration at the leading border 
of the pannus that threatened the visual axis. In the three patients that were
treated with topical corticosteroids, the infiltrates resolved with preservation 
of visual acuity. The other patient developed central scarring with a permanent
reduction in vision. Patients with infiltrates and pannus in a sector of the
cornea should be followed carefully and treated with topical corticosteroids when
infiltrates appear to prevent progression to the central cornea.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 2423418 [PubMed - indexed for MEDLINE]

7118: Lancet. 1985 Dec 21-28;2(8469-70):1433-4.

Clusters of shingles.

[No authors listed]

Publication Types: 
    Letter

PMID: 2867432 [PubMed - indexed for MEDLINE]

7119: N Engl J Med. 1985 Dec 19;313(25):1564-71.

Replication of Epstein-Barr virus within the epithelial cells of oral "hairy"
leukoplakia, an AIDS-associated lesion.

Greenspan JS, Greenspan D, Lennette ET, Abrams DI, Conant MA, Petersen V, Freese 
UK.

We conducted a study to identify the viruses in tissue specimens of oral "hairy" 
leukoplakia, a lesion that is found in immunosuppressed male homosexuals and that
is associated with the subsequent development of the acquired immunodeficiency
syndrome. When stained for papillomavirus core antigen, 49 of 67 biopsy specimens
(73 per cent) yielded positive results in epithelial-cell nuclei. Electron
microscopy showed papillomavirus-like particles in all of 25 specimens, and the
herpes-type virus described in a previous report was seen in 23 of the 25
specimens. Three specimens had both types of particle in the same individual
epithelial cells. Immunofluorescence for herpes simplex virus, varicella-zoster
virus, and cytomegalovirus gave negative results in all cases, but 19 of 20
specimens showed intense nuclear staining in epithelial cells for the viral
capsid antigen of Epstein-Barr virus (EBV). DNA hybridization using EBV probes in
Southern blots demonstrated EBV DNA in all of 13 specimens and found 200 or more 
viral DNA molecules per cellular genome in 11 of the 13. The whole EBV genome was
also demonstrated in the specimens and found to be in linear virion form. We
conclude that EBV replicates within the epithelial cells in hairy leukoplakia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2999595 [PubMed - indexed for MEDLINE]

7120: Nurs Times. 1985 Dec 18-31;81(51):22-4.

Herpes zoster ophthalmicus.

Fox J.

PMID: 3878963 [PubMed - indexed for MEDLINE]

7121: N Engl J Med. 1985 Dec 12;313(24):1504-10.

Patients at risk for AIDS-related opportunistic infections. Clinical
manifestations and impaired gamma interferon production.

Murray HW, Hillman JK, Rubin BY, Kelly CD, Jacobs JL, Tyler LW, Donelly DM,
Carriero SM, Godbold JH, Roberts RB.

We studied 81 men (79 homosexuals and 2 drug abusers) with persistent
lymphadenopathy to determine whether those at risk for AIDS-related opportunistic
infections could be identified prospectively. (Sixty-nine of 76 [91 per cent] had
antibodies to human T-cell lymphotropic virus Type III [HTLV-III], and 76 of 79
[96 per cent] had abnormal T4/T8 cell ratios.) During the follow-up period (mean 
+/- S.E.M., 12.9 +/- 0.5 months; range, 8 to 19), infections developed in none of
38 patients with lymphadenopathy alone and in only 1 of 15 (7 per cent) with
antecedent herpes zoster infection; however, 13 of 28 (46 per cent) with
lymphadenopathy accompanied by constitutional symptoms or oral candidiasis or
both had opportunistic infections within the follow-up period. Among the results 
of various T-cell assays, only antigen-stimulated lymphocyte proliferation and
gamma interferon generation, which were absent or barely measurable in those in
whom AIDS ultimately developed, were of prognostic value. T cells from 15
patients, 11 of whom had constitutional symptoms or thrush, failed to generate
antigen-induced gamma interferon; infections developed in 10 of these 15 (67 per 
cent) within a mean of 8.2 months. These results suggest that patients with
AIDS-related complex who are at risk for opportunistic infections within a year
can be identified by correlating clinical manifestations with antigen-stimulated 
T-cell responses--in particular, with the production of gamma interferon.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3934537 [PubMed - indexed for MEDLINE]

7122: J Infect Dis. 1985 Dec;152(6):1172-81.

Infection with varicella-zoster virus after marrow transplantation.

Locksley RM, Flournoy N, Sullivan KM, Meyers JD.

Infection with varicella-zoster virus (VZV) occurred in 231 (16.6%) of 1,394
patients undergoing marrow transplantation in Seattle, Washington, between 1969
and 1982. The probability of VZV infection was 30% by one year after transplant. 
Eighty percent of infections occurred within the first nine months after
transplant, and of these cases 45% had cutaneous or visceral dissemination.
Twenty-three deaths were associated with VZV infection, all within the initial
nine months after transplant. Postherpetic neuralgia, scarring, and bacterial
superinfection were also significantly more frequent among patients with VZV in
the first nine months after transplant (32%) than among patients with later
infection (19%; P less than .05). By multivariate analysis, allogeneic
transplant, acute or chronic graft-vs.-host disease, patient age between 10 and
29 years, diagnosis other than chronic myelogenous leukemia, and posttransplant
use of antithymocyte globulin were each risk factors for VZV infection. Among
infected patients, the only significant risk factor for VZV dissemination or
death was acute graft-vs.-host disease (P less than .03 and P less than .0002,
respectively.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 3905982 [PubMed - indexed for MEDLINE]

7123: Pain. 1985 Dec;23(4):381-6.

Treatment of post-herpetic neuralgia. A review of 77 consecutive cases.

Milligan NS, Nash TP.

The treatment of 77 consecutive cases of post-herpetic neuralgia is reviewed.
Stellate blockade proved helpful in 75% of patients with pain of less than 1
year's duration; 40% became virtually pain free. Drug treatment and electrical
counterirritation methods gave improvement in 60% of cases but only 15% became
pain free. Stellate block carried out after 1 year of pain proved helpful in only
44% of patients, and only 22% became pain free. Stellate blockade carried out
within 1 year of the onset of symptoms would appear to be one of the treatments
of choice for post-herpetic neuralgia. It would be of interest to see the results
of a controlled randomised trial.

PMID: 3878959 [PubMed - indexed for MEDLINE]

7124: Quintessenz. 1985 Dec;36(12):2385-9.

[Herpes virus diseases in mouth, lip and facial regions]

[Article in German]

Mastalier O.

PMID: 3869704 [PubMed - indexed for MEDLINE]

7125: Nippon Hifuka Gakkai Zasshi. 1985 Dec;95(14):1519-22.

[A case of reticulate hyperpigmentation distributed in zosteriform fashion]

[Article in Japanese]

Yoshida M, Tezuka T.

Publication Types: 
    Case Reports

PMID: 3831437 [PubMed - indexed for MEDLINE]

7126: Aust N Z J Med. 1985 Dec;15(6):712-6.

Paralysis in herpes zoster.

Rosenfeld T, Price MA.

Herpes zoster is a relatively common disease which affects predominantly the
middle-aged and elderly. The segmentally distributed cutaneous eruption, sensory 
changes, and pain make up the well known zoster syndrome. Motor loss is another
aspect of this syndrome which is less well known but occurs in a significant
number of cases, and is probably far more frequent than is recognised because the
weakness is readily obscured by pain. Four cases of herpes zoster with motor
involvement are described. Two cases had zoster paresis affecting the arm and
hand, and one of these had, in limb, and one case had urinary retention owing to 
an atonic bladder. These cases serve to illustrate many of the clinical features 
of the zoster syndrome with motor involvement. The significant functional
implications of unrecognised motor deficit, particularly in the elderly, are a
prominent feature and highlight the importance of early accurate diagnosis and
management. The pathogenesis and clinical features of this syndrome are discussed
in the literature review.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3010924 [PubMed - indexed for MEDLINE]

7127: J Neurol Sci. 1985 Dec;71(2-3):291-9.

Cerebrospinal fluid virus antibodies. A diagnostic indicator for multiple
sclerosis?

Felgenhauer K, Schadlich HJ, Nekic M, Ackermann R.

Specific antibody activities (antibody per weight unit IgG) of serum and CSF
against a broad variety of viruses were compared in multiple sclerosis and
certain inflammatory diseases of the central nervous system, e.g. neurosyphilis, 
as well as herpes simplex and zoster encephalitis. No "unspecific" antiviral
activities within the CSF compartment were found in the non-MS diseases. The most
frequent antibodies locally produced were directed against measles, rubella and
zoster antigens. A diagnostic test with these three viruses would give positive
results in about 80% of patients with MS. This finding is not as frequent as the 
oligoclonal pattern of the CSF gamma-globulins but would have a considerably
greater diagnostic significance.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3003256 [PubMed - indexed for MEDLINE]

7128: J Neurol Neurosurg Psychiatry. 1985 Dec;48(12):1193-207.

Treatment of peripheral neuropathies.

Hallett M, Tandon D, Berardelli A.

There are three general approaches to treatment of peripheral neuropathy. First, 
an attempt should be made to reverse the pathophysiological process if its nature
can be elucidated. Second, nerve metabolism can be stimulated and regeneration
encouraged. Third, even if the neuropathy itself cannot be improved, symptomatic 
therapy can be employed. This review outlines the options available for each
approach.

PMID: 3003254 [PubMed - indexed for MEDLINE]

7129: Br J Exp Pathol. 1985 Dec;66(6):655-62.

Alopecia in mice infected with murine cytomegalovirus (MCMV).

Mims CA.

When mouse cytomegalovirus was injected subcutaneously into 4-12 day old CDI mice
there was infection of dermal cells and the dermal papillae of hair follicles.
Infected cells were never seen in the epidermis nor in the epithelium of hair
follicles. When larger doses of virus (5 X 10(4) pfu) were given, dermal
infection led to gross necrosis of the skin, ulceration, scabbing and healing
with alopecia. Smaller doses (10(4) pfu) did not cause gross necrosis but damage 
to follicles resulted in alopecia or sparse hair growth. Skin lesions were not
seen after infection of 4-8 week old mice, even when the inoculated skin area had
been epilated, or when hyaluronidase was mixed with the virus inoculum. These
experiments show that cytomegalovirus, in contrast to herpes simplex and
varicella-zoster viruses, infects dermal but not epidermal cells, and that dermal
tropism is age-restricted.

PMID: 3002414 [PubMed - indexed for MEDLINE]

7130: J Infect Dis. 1985 Dec;152(6):1349.

Determination of infection and immunity to varicella-zoster virus with an
enzyme-linked immunosorbent assay.

Sirpenski SP, Brennan T, Mayo DR.

Publication Types: 
    Letter

PMID: 2999261 [PubMed - indexed for MEDLINE]

7131: Pain. 1985 Dec;23(4):387-94.

A comparative trial of amitriptyline and zimelidine in post-herpetic neuralgia.

Watson CP, Evans RJ.

Serotoninergic pathways are believed to be important in pain mechanisms.
Accordingly, we studied the action of zimelidine, a very highly serotoninergic
antidepressant, in relieving the pain of post-herpetic neuralgia. Fifteen
patients received zimelidine and amitriptyline in that order in an open-label
cross-over study. Only one patient with zimelidine obtained a good result,
whereas 8 patients on amitriptyline amitriptyline has a pain-relieving action, at
least in post-herpetic neuralgia, which is not primarily linked with its
serotoninergic effects and which is also independent of its effects on
depression.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 2935772 [PubMed - indexed for MEDLINE]

7132: Am Rev Respir Dis. 1985 Dec;132(6):1366-7.

Respiratory muscle dysfunction after herpes zoster.

Passerini L, Cosio MG, Newman SL.

We report an unusual neurologic complication of herpes zoster. After thoracic
herpes zoster, our patient complained of severe shortness of breath as a result
of myoclonus of the abdominal muscles as documented by electromyography. The
myoclonus resulted in repetitive interruption of expiratory air flow, resulting
in shortness of breath and a staccato speech. This case demonstrates the need to 
evaluate the function of all the respiratory muscles in a patient complaining of 
dyspnea.

Publication Types: 
    Case Reports

PMID: 2934014 [PubMed - indexed for MEDLINE]

7133: J Virol Methods. 1985 Dec;12(3-4):199-208.

Lymphocyte proliferation and IgG production with herpesvirus antigens in solid
phase.

Ljungman P, Wahren B, Sundqvist VA.

A technique for simultaneous specific lymphocyte proliferation and IgG production
with herpesvirus antigens in solid phase was developed. The cell mediated immune 
response was highly specific. Stronger cellular responses were found after
stimulation with nucleocapsid antigens than with membrane antigens.
Varicella-zoster virus (VZV) and herpes simplex virus (HSV) specific antibody
production in vitro were found in almost 100% of seropositive individuals, while 
cytomegalovirus (CMV) antibody production was detectable in 70%. A higher
specific IgG production was found after stimulation with CMV and VZV membrane
antigens than with CMV nucleocapsid and VZV cell antigens. No differences in IgG 
production were found with the two types of HSV antigens. A method for viral IgG 
subclass determination in vitro was also developed. These methods may be used for
monitoring immunosuppressed patients for immunological responsiveness to
herpesvirus infections.

PMID: 2422193 [PubMed - indexed for MEDLINE]

7134: Med Clin (Barc). 1985 Nov 23;85(17):715-26.

[A 47-year-old male, hemophiliac, with fever, cough and dyspnea
(clinicopathologic conference)]

[Article in Spanish]

Coca A, Egido R.

Publication Types: 
    Case Reports

PMID: 3003469 [PubMed - indexed for MEDLINE]

7135: N Engl J Med. 1985 Nov 21;313(21):1327-30.

Herpesvirus infections of pregnancy. Part II: Herpes simplex virus and
varicella-zoster virus infections.

Stagno S, Whitley RJ.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 3903503 [PubMed - indexed for MEDLINE]

7136: Lancet. 1985 Nov 16;2(8464):1108-11.

An outbreak of shingles?

Palmer SR, Caul EO, Donald DE, Kwantes W, Tillett H.

7 of 101 staff within one department of a large office complex had shingles, as
diagnosed by a general practitioner, within a three-month period. This incidence 
was significantly greater than that in the remaining workforce.
Varicella-zoster-specific IgM antibody was detected in all 4 cases from whom
early convalescent serum samples were obtained but in none of 22 controls. Within
the index department there was evidence of clustering in time and by work area. A
case/control study showed that a recent preceeding illness might have been a risk
factor for shingles in the outbreak cases, but not for sporadic cases in other
departments of the same office complex. This outbreak suggests that shingles can 
be provoked by reexposure to varicella-zoster virus.

PMID: 2865576 [PubMed - indexed for MEDLINE]

7137: Lancet. 1985 Nov 16;2(8464):1105-6.

Outbreaks of shingles.

[No authors listed]

Publication Types: 
    Editorial

PMID: 2865573 [PubMed - indexed for MEDLINE]

7138: Nucleic Acids Res. 1985 Nov 11;13(21):7865-79.

DNA sequence of the herpes simplex virus type 1 gene whose product is responsible
for transcriptional activation of immediate early promoters.

Dalrymple MA, McGeoch DJ, Davison AJ, Preston CM.

Previous work has shown that transcriptional activation of herpes simplex virus
type 1 (HSV-1) immediate early genes is mediated by a protein species (Vmw65)
present in the tegument of infecting virions. This paper describes DNA sequence
analysis and mRNA mapping of the Vmw65 gene in HSV-1 strain 17. The Vmw65 coding 
region was identified as a 490 codon sequence encoding a polypeptide of molecular
weight 54,342 and characterised by a high proportion of charged amino acid
residues. A homologue to Vmw65 was detected in the genome of varicella-zoster
virus, another human herpesvirus. Apart from its role in trans-activation, Vmw65 
is a major constituent of the virion. Its possible significance in virus
structure is discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2999707 [PubMed - indexed for MEDLINE]

7139: J Immunol Methods. 1985 Nov 7;83(2):337-42.

Immunological cross-reactivities among three herpesviruses.

Ndumbe PM, Levinsky RJ.

Sixty adults were tested for humoral and cell-mediated immunity to varicella
zoster virus (VZV), type 1 herpes simplex virus (HSV-1) and the human
cytomegalovirus (CMV). Since herpesviruses share common antigens, we compared
results in these individuals to assess whether our tests gave false positives due
to cross-reactions. Of the 60, IgG antibody to VZV, HSV-1, CMV tested by ELISA
was detected in 51 (85%), 34 (57%) and 20 (33%) respectively. All possible
permutations of results were obtained and there was no evidence of
cross-reactivity among the viruses. Lymphocyte transformation performed in 20 was
found to be positive in 16 (80%), 13 (65%) and 8 (40%) for VZV, HSV-1 and CMV
respectively. Similarly, all possible permutations of results were obtained. In
addition, 8 subjects were found to have positive lymphocyte transformation
responses for one or other of the viral antigens but no specific antibody was
found in their sera. Thus, the antibody and lymphocyte transformation test were
not influenced by possible cross-reacting antigens among the 3 herpesviruses we
studied. Both tests are necessary to firmly establish whether a subject has had a
prior infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2997331 [PubMed - indexed for MEDLINE]

7140: Acta Paediatr Scand. 1985 Nov;74(6):979-81.

Herpes zoster in a 2-week-old premature infant with possible congenital varicella
encephalitis.

Bennet R, Forsgren M, Herin P.

This report concerns a case of neonatal herpes zoster associated with maternal
gestational varicella. The child developed skin lesions at 18 days of age
virologically confirmed to be varicella-zoster. The baby also had encephalitis
and aspiration probably due to bulbar paralysis. Multiple small necrotic areas
were found in the thalamus at post-mortem examination.

Publication Types: 
    Case Reports

PMID: 4090975 [PubMed - indexed for MEDLINE]

7141: Anaesthesia. 1985 Nov;40(11):1133-4.

Post-herpetic neuralgia.

Alexander JI.

Publication Types: 
    Letter

PMID: 4073436 [PubMed - indexed for MEDLINE]

7142: Am J Otol. 1985 Nov;Suppl:80-7.

Evoked serial electromyography in the evaluation of the paralyzed face.

Silverstein H, McDaniel AB, Hyman SM.

Serial evoked electromyography (EEMG) is a reliable, objective, repeatable test
of facial nerve function. It is very important in the initial patient evaluation 
in determining percent degeneration of the facial nerve. A response of 0-20% will
usually result in incomplete return of facial function while responses of 60% or 
better will usually result in normal function. With viral facial paralysis
(Bell's palsy, herpes zoster oticus), serial EEMG after several weeks has little 
value in predicting the final percent recovery of facial function. If there is no
EEMG response, the diagnosis of viral facial paralysis is questionable and serial
tests should be done until facial function begins to return. If there is no
return of facial function or EEMG responses, the diagnosis is probably a tumor
and the nerve should be explored. When surgical manipulation of the facial nerve 
has resulted in partial facial weakness, EEMG helps predict the degree of
recovery of facial function. EEMG results of 60% or better will result in normal 
facial function while EEMG results of 25% or less will result in incomplete
return of facial function. Serial testing is not necessary in this group of
patients. After transection and repair of the facial nerve, serial EEMG is of
value in showing continuity of the repair. Lack of improvement in EEMG over 5-12 
months and no return of facial function indicates poor prognosis.

Publication Types: 
    Comparative Study

PMID: 4073249 [PubMed - indexed for MEDLINE]

7143: Arch Ophthalmol. 1985 Nov;103(11):1666-8.

Idiopathic corneal endotheliopathy. A report of two cases.

Ohashi Y, Kinoshita S, Mano T, Kiritoshi A, Ohji M.

Two male patients had corneal endotheliopathy of unknown origin. In both patients
it was characterized by continuously progressing bullous keratopathy preceded by 
a line of keratic precipitates resembling a rejection line. The disease was
progressive and did not respond to intensive corticosteroid therapy. No virus
could be isolated from the aqueous humor, and the aqueous-antibody titers to
herpes simplex, varicella zoster, and measles viruses were below detection level.

Publication Types: 
    Case Reports

PMID: 4062632 [PubMed - indexed for MEDLINE]

7144: Lijec Vjesn. 1985 Nov-Dec;107(11-12):506-10.

[Topical administration of human leukocyte interferon in patients with herpes
zoster]

[Article in Croatian]

Aglic V, Smerdel S, Delimar N, Jusic D, Soos E.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 3908864 [PubMed - indexed for MEDLINE]

7145: Ophthalmology. 1985 Nov;92(11):1542-9.

Necrotizing scleritis. A clinico-pathologic study of 41 cases.

Rao NA, Marak GE, Hidayat AA.

Scleritis is not a single clinical or pathologic entity. It has several distinct 
forms. A clinico-pathologic study of 41 cases of necrotizing scleritis suggests
that these different histopathologic forms of disease may reflect different
mechanisms of immunopathogenesis. These cases were divided into three main
groups: (1) scleral inflammations associated with various systemic autoimmune
diseases, including 11 cases of rheumatoid arthritis, three cases of Wegener's
granulomatosis, one case of polychondritis, and one case of Goodpasture's
syndrome; (2) infectious scleritis, consisting of four cases of herpes zoster
ophthalmicus and two cases of pseudomonas scleritis; and (3) idiopathic
scleritis, without evidence of systematic disorder, consisting of 19 cases. The
first group exhibited predominantly necrosis of the sclera surrounded by
granulomatous inflammation and vasculitis. None of these cases showed lymphoid
follicles, or healing attempts manifested by proliferation of fibroblasts and
blood vessels at the site of inflammation. The idiopathic group revealed few
small foci of scleral necrosis and mainly non-granulomatous inflammation. In
addition, there was evidence of proliferation of granulation tissue and lymphoid 
follicles in this group of eyes.

PMID: 3878485 [PubMed - indexed for MEDLINE]

7146: Ophthalmology. 1985 Nov;92(11):1574-83.

Oral acyclovir in the therapy of acute herpes zoster ophthalmicus. An interim
report.

Cobo LM, Foulks GN, Liesegang T, Lass J, Sutphin J, Wilhelmus K, Jones DB,
Chapman S, Segreti A.

A prospective, randomized, double-masked, placebo-controlled clinical trial was
conducted to study the effects of oral acyclovir on 55 patients with acute herpes
zoster ophthalmicus. Treatment with oral acyclovir resulted in more prompt
resolution of signs and symptoms, particularly in patients treated within 72
hours after onset of skin rash (P less than 0.05), and shortened the duration of 
viral shedding (P = 0.02). Vesicular skin lesions involving other dermatomes
(microdissemination) occurred in five (19%) placebo-treated patients but in no
acyclovir-treated patients (P = 0.03). Interim analysis of this longitudinal
study suggests that the incidence and severity of secondary ocular inflammatory
disease was reduced by acyclovir. Prolonged observation of these patients is
ongoing to determine if oral acyclovir reduces post-herpes zoster neuralgia or
the late ocular complications of ophthalmic zoster.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3001610 [PubMed - indexed for MEDLINE]

7147: Ann Neurol. 1985 Nov;18(5):611-4.

Recovery of herpesviruses from cerebrospinal fluid of immunodeficient homosexual 
men.

Dix RD, Bredesen DE, Erlich KS, Mills J.

Over a one-year period the cerebrospinal fluid (CSF) obtained from a series of
homosexual men immunocompromised with either Hodgkin's disease or acquired immune
deficiency syndrome (AIDS) was cultured to assess the frequency with which
infectious viruses could be recovered. Of 58 patients examined, 4 (6.9%) had CSF 
cultures that showed a cytopathology consistent with a virus infection. All
isolates proved to be herpesviruses. Cytomegalovirus (CMV) and varicella-zoster
virus were isolated from CSF obtained from 2 patients with neurological features 
consistent with a subacute encephalitis common among AIDS patients. CMV was also 
recovered from the CSF of an AIDS patient who developed an ascending myelitis of 
herpesvirus origin. Finally, a CSF sample obtained from an immunodeficient
homosexual man who showed no detectable neurological abnormalities consistently
yielded herpes simplex virus type 1 in culture. These results suggest that
seeding of the CSF with infectious virus is an uncommon event in this patient
population. However, our experience should not dissuade attempts to culture
viruses from CSF in similar cases. Successful isolations may prove beneficial in 
the diagnosis of an accompanying neurological illness and facilitate treatment
with antiviral therapy when indicated.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3000285 [PubMed - indexed for MEDLINE]

7148: J Virol. 1985 Nov;56(2):600-6.

Transcription mapping of the varicella-zoster virus genome.

Ostrove JM, Reinhold W, Fan CM, Zorn S, Hay J, Straus SE.

RNA was isolated from varicella-zoster virus-infected Flow 5000 cells (diploid
fibroblasts) at late times after infection. With the use of overlapping DNA
probes representing all regions of the varicella-zoster genome, an extensive
Northern blot analysis of the RNA was carried out. The analysis revealed at least
58 discrete transcripts ranging in size from approximately 0.8 to 6.5 kilobases. 
RNAs were found to be homologous to all probes used except for those mapping at
approximately map unit 0.3, where no RNA transcripts could be detected.
Comparison of the sizes and locations of RNA transcripts mapping in the
right-hand ends of the varicella-zoster virus and the herpes simplex virus DNAs
shows a number of striking analogies, suggesting their similar genomic
organization.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2997479 [PubMed - indexed for MEDLINE]

7149: J Virol. 1985 Nov;56(2):466-74.

Analysis of the genomic termini of tupaia herpesvirus DNA by restriction mapping 
and nucleotide sequencing.

Albrecht M, Darai G, Flugel RM.

A recombinant plasmid harboring both genomic termini of tupaia herpesvirus (THV) 
DNA was characterized by restriction enzyme analysis and by determination of the 
nucleotide sequence. A unique NotI cleavage site was found that is located
approximately 19 base pairs upstream of the THV terminal junction. THV DNA
fragments from virion DNA were analyzed by using the same restriction enzymes as 
for the recombinant plasmid. The comparative fine mapping of virion THV DNA
revealed heterogeneous molecules of variable lengths with the NotI cleavage site 
conserved. A number of short direct and inverted repeats and palindromes were
found surrounding the THV terminal joint. The THV repetitive sequences were
compared with the repeats reported for the DNA termini of herpes simplex virus,
varicella-zoster virus, and Epstein-Barr virus and are discussed in respect to
signals for a site-specific endonuclease required for packaging.

PMID: 2997469 [PubMed - indexed for MEDLINE]

7150: J Infect Dis. 1985 Nov;152(5):859-62.

Live attenuated varicella vaccine.

Gershon AA.

Publication Types: 
    Clinical Trial

PMID: 2995509 [PubMed - indexed for MEDLINE]

7151: J Clin Oncol. 1985 Nov;3(11):1490-4.

Allogeneic marrow transplantation in the treatment of MOPP-resistant Hodgkin's
disease.

Appelbaum FR, Sullivan KM, Thomas ED, Buckner CD, Clift RA, Deeg HJ, Neiman PE,
Sanders JE, Stewart P, Storb R.

Eight patients with disseminated Hodgkin's disease resistant to MOPP
(mechlorethamine, vincristine, procarbazine, and prednisone) chemotherapy were
treated with high-dose chemoradiotherapy and marrow transplantation from an
HLA-identical sibling. Two patients remain alive in unmaintained complete
remission (CR) at 38 and 39 months after transplant. In the other six patients,
reasons for failure included relapse of lymphoma (two patients), or death due to 
complications of the transplant procedure, including Legionnaire's disease,
disseminated zoster, graft-v-host disease, and aspiration pneumonia secondary to 
severe mucositis. These results demonstrate that some patients with
MOPP-resistant Hodgkin's disease can obtain prolonged CR following intensive
chemoradiotherapy and allogeneic marrow transplantation.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2414410 [PubMed - indexed for MEDLINE]

7152: Clin Ter. 1985 Oct 31;115(2):79-82.

[Use of acyclovir in zoster encephalitis]

[Article in Italian]

Traverso F, Romagnoli P, Bacigalupo F.

Publication Types: 
    Case Reports
    Clinical Trial
    English Abstract

PMID: 3907941 [PubMed - indexed for MEDLINE]

7153: Ugeskr Laeger. 1985 Oct 21;147(43):3401-3.

[Herpes zoster in general practice]

[Article in Danish]

Christensen P, Norrelund N.

Publication Types: 
    English Abstract

PMID: 4071778 [PubMed - indexed for MEDLINE]

7154: JAMA. 1985 Oct 11;254(14):1905.

False hope on drug availability.

Klapp D, Bean S.

Publication Types: 
    Letter

PMID: 4046116 [PubMed - indexed for MEDLINE]

7155: J Rheumatol. 1985 Oct;12(5):967-70.

Chlorambucil in the treatment of intractable Uveitis associated with juvenile
chronic arthritis.

Palmer RG, Kanski JJ, Ansell BM.

The response to prolonged low dose chlorambucil for chronic active uveitis in 6
patients with juvenile chronic arthritis and one patient with juvenile ankylosing
spondylitis is described. Only 2 patients were judged to have had longterm
benefit from treatment in both eyes and one had a transient benefit in one eye.
Drug induced adverse effects occurred in 3 patients.

Publication Types: 
    Case Reports

PMID: 4087273 [PubMed - indexed for MEDLINE]

7156: Int J Dermatol. 1985 Oct;24(8):539.

Tinea in a site of healed herpes zoster (isoloci response?)

Wolf R, Wolf D.

Publication Types: 
    Case Reports
    Letter

PMID: 4066096 [PubMed - indexed for MEDLINE]

7157: J Am Acad Dermatol. 1985 Oct;13(4):590-6.

Topical acyclovir treatment of herpes zoster in immunocompromised patients.

Levin MJ, Zaia JA, Hershey BJ, Davis LG, Robinson GV, Segreti AC.

Topical acyclovir favorably influences the healing of localized herpes zoster in 
immunocompromised patients. This therapy, or placebo, was applied to forty-three 
patients in a random access, double-blind trial, four times daily for 10 days,
beginning within 72 hours after the onset of skin lesions. The mean time to
pustulation is decreased from 12.4 to 6.7 days and the mean time to crusting is
decreased from 16.0 to 11.4 days (p = 0.038 and 0.086, respectively) by topical
treatment. The mean time to 50% healing is decreased from 24.5 to 15.2 days and
the mean time to 100% healing is decreased from 34.9 to 25.8 days (p = 0.023 and 
0.033, respectively). Favorable effects in treated patients are not associated
with a more rapid decline in lesion virus titer, but do accrue without any
toxicity.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3908504 [PubMed - indexed for MEDLINE]

7158: Am J Infect Control. 1985 Oct;13(5):199-209.

Infectious complications of neoplastic disease.

Polsky B, Armstrong D.

Progress has been made in the diagnosis and treatment of infection in patients
with neoplastic disease. Among the advances is the appreciation that certain
opportunistic infections occur in association with particular host immune defects
and epidemiologic factors. Such immune defects are seen secondary to or as a
consequence of treatment for the patient's basic disease. Improved methods such
as serology, open lung biopsy, and fiberoptic bronchoscopy have allowed for
earlier diagnosis and treatment of opportunistic infections. The development of
empiric antibiotic regimens, particularly aminoglycosides and the antipseudomonal
penicillins, have improved the outcome in the febrile neutropenic patient. The
benefits of protective environments have been challenged; prophylactic
antibiotics and various forms of immunotherapy are of interest but remain
investigational.

PMID: 3877475 [PubMed - indexed for MEDLINE]

7159: Neurology. 1985 Oct;35(10):1531-2.

Herpes zoster ophthalmicus with ipsilateral cerebellar infarction.

Filloux F, Townsend J.

Publication Types: 
    Case Reports
    Letter

PMID: 3875808 [PubMed - indexed for MEDLINE]

7160: Pediatrics. 1985 Oct;76(4):512-7.

Epidemiology of herpes zoster in children and adolescents: a population-based
study.

Guess HA, Broughton DD, Melton LJ 3rd, Kurland LT.

Medical records were reviewed for all 173 cases of herpes zoster diagnosed among 
residents of Rochester, Minnesota, less than 20 years of age during the period
1960 through 1981. The incidence of zoster increased with age from 20 cases per
100,000 person-years in those residents less than five years of age to 63 cases
per 100,000 person-years in those aged 15 to 19. Morbidity was less than has been
described in adults, as only two patients required hospitalization and no
postherpetic neuralgia or other late complications were diagnosed. The single
case of subsequent cancer found in 1,288 person-years of follow-up was not
significantly different from the number expected based on cancer incidence in the
general Rochester population. The incidence of childhood zoster in patients with 
acute lymphocytic leukemia was 122 times higher than in children without an
underlying malignancy. Chickenpox in the first year of life was found to be a
risk factor for childhood zoster, with a relative risk between 2.8 and 20.9.
Neither chickenpox in the second year of life nor recent vaccinations were found 
to be risk factors for childhood zoster.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 3863086 [PubMed - indexed for MEDLINE]

7161: Indian J Dermatol. 1985 Oct;30(4):25-8.

Herpes zoster: multicentric.

Chattopadhyay SP, Arora PN, Chakraborty BN.

Publication Types: 
    Case Reports

PMID: 3038738 [PubMed - indexed for MEDLINE]

7162: J Clin Microbiol. 1985 Oct;22(4):505-9.

Virus-specific polymeric immunoglobulin A antibodies in serum from patients with 
rubella, measles, varicella, and herpes zoster virus infections.

Negro Ponzi A, Merlino C, Angeretti A, Penna R.

More than 85% of the immunoglobulin A (IgA) antibodies in normal adult serum are 
monomeric (m-IgA). By contrast, virus-specific IgA is mainly polymeric (p-IgA) in
sera from patients with rubella, measles, and varicella. Specific m-IgA
antibodies only reach quantitative significance in late convalescence. In
patients with herpes zoster, on the other hand, a varying response was observed: 
in three of six sera, specific IgA was absent or at a very low titer, whereas in 
the remaining three cases, a high titer of both p-IgA and m-IgA was noted. These 
results suggest that in the initial response to rubella, measles, and
varicella-zoster viruses, specific IgA first appears as p-IgA and only later
becomes, or is replaced by, m-IgA.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3001129 [PubMed - indexed for MEDLINE]

7163: Am J Infect Control. 1985 Oct;13(5):193-8.

An algorithm for the control of nosocomial varicella-zoster virus infection.

Weitekamp MR, Schan P, Aber RC.

Inadvertent or uncontrolled introduction of varicella-zoster virus into the
hospital environment occurs commonly and must be investigated in a systematic and
efficient manner to minimize secondary spread to patients (particularly the
immunocompromised) or hospital personnel. On the basis of a review of the
literature and our practical experience with 11 such exposures to
varicella-zoster virus during a 2-year period, we have developed a working
algorithm for such investigations. Index cases most often are children, resident 
physicians, students, young nurses, and ancillary personnel, or adult patients
with herpes zoster. A negative or uncertain past history of this infection is an 
unreliable predictor of susceptibility among the exposed and should be confirmed 
by serology tests or delayed hypersensitivity skin testing. An
incubation-contagion timetable, coupled with a stratification of risk among the
exposed, permits a prioritized response in dealing with an introduction of
varicella-zoster virus. The preemployment screening of all hospital workers for
susceptibility to varicella-zoster virus should be considered as a practical and 
cost effective policy.

PMID: 2998229 [PubMed - indexed for MEDLINE]

7164: J Virol. 1985 Oct;56(1):333-6.

Cross-reactivity between herpes simplex virus glycoprotein B and a 63,000-dalton 
varicella-zoster virus envelope glycoprotein.

Edson CM, Hosler BA, Respess RA, Waters DJ, Thorley-Lawson DA.

Cross-reactive monoclonal antibodies recognizing both herpes simplex virus (HSV) 
glycoprotein B and a major 63,000-dalton varicella-zoster virus (VZV) envelope
glycoprotein were isolated and found to neutralize VZV infection in vitro. None
of the other VZV glycoproteins was recognized by any polyclonal anti-HSV serum
tested. These results demonstrate that HSV glycoprotein B and the 63,000-dalton
VZV glycoprotein share antigenic epitopes and raise the possibility that these
two proteins have a similar function in infection.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2993665 [PubMed - indexed for MEDLINE]

7165: Br Med Bull. 1985 Oct;41(4):357-60.

Skin infections.

Brigden D.

Publication Types: 
    Review

PMID: 2413950 [PubMed - indexed for MEDLINE]

7166: Br Med Bull. 1985 Oct;41(4):351-6.

Viral keratitis.

McGill J, Scott GM.

Publication Types: 
    Review

PMID: 2413949 [PubMed - indexed for MEDLINE]

7167: Life Sci. 1985 Sep 30;37(13):1213-20.

Intrathecal administration of beta-endorphin and dynorphin-(1-13) for the
treatment of intractable pain.

Wen HL, Mehal ZD, Ong BH, Ho WK, Wen DY.

Seven cases of chronic pain were treated by intrathecal administration of 30
micrograms of beta-endorphin and dynorphin-(1-13). Compared with saline, both
peptides were able to suppress pain for periods up to 4.5 and 7 hours on the
average, respectively. No significant side reactions were noticed during the
entire investigation.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2864619 [PubMed - indexed for MEDLINE]

7168: Wiad Lek. 1985 Sep 1;38(17):1204-7.

[Clinical course of herpes zoster in elderly patients]

[Article in Polish]

Ellert-Zygadlowska J, Trocha H, Lemanska M, Witczak-Malinowska K, Gajda A.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 4090492 [PubMed - indexed for MEDLINE]

7169: Ann Neurol. 1985 Sep;18(3):358-60.

Chickenpox with delayed contralateral hemiparesis caused by cerebral angiitis.

Kamholz J, Tremblay G.

Chickenpox and herpes zoster ophthalmicus are caused by the same virus. Herpes
zoster ophthalmicus can be followed by contralateral hemiparesis, which is
thought to be caused by spread of varicella-zoster virus to blood vessels
contiguous to the trigeminal nerve and its branches. We report what we believe to
be the first case of a patient with chickenpox followed by hemiparesis in whom
there was angiographic evidence of an associated vasculitis similar to that found
with herpes zoster ophthalmicus.

Publication Types: 
    Case Reports

PMID: 4051463 [PubMed - indexed for MEDLINE]

7170: Acta Stomatol Belg. 1985 Sep;82(3):183-8.

[Alveolar bone necrosis as a complication of herpes zoster infection]

[Article in Dutch]

De Biscop J, Wackens G.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3866489 [PubMed - indexed for MEDLINE]

7171: Southeast Asian J Trop Med Public Health. 1985 Sep;16(3):414-20.

Susceptibility to varicella-zoster virus in Thai children and young adults.

Kositanont U, Wasi C, Oonsombat P, Suvatte V, Thongcharoen P.

During 1982-1983, susceptibility to varicella-zoster virus (VZV) in 224 Thai
subjects at high risk for varicella infection was studied. The immune adherence
hemagglutination (IAHA) and VZ skin test were carried out to determine VZV
immunity in immunocompromised children and young adults. The history of varicella
and herpes zoster from each subject was recorded. The mean +/- SD age in children
and young adults were 7.3 +/- 2.8 and 19.6 +/- 1.2. Negative IAHA test was found 
in 74.2% of 62 children and 35.2% of 162 young adults. The increase in immune
individuals was demonstrated with advancing age. Response to VZ skin test showed 
positive results in 79 of 162 (48.8%) young adults. The seronegativity was
related to the negative VZ skin test (p less than 0.001, X2 test). Regardless of 
antibody detection or VZ skin test, 47 of 162 (29%) young adults were
susceptible. According to the positive history of varicella and of herpes zoster 
obtained from 95 young adults, 80% had developed varicella during 1 to 10 years
of age and 8.8% had positive history of herpes zoster. The findings suggest that 
the IAHA and VZ skin test should be used together for assessing VZ immunity.
Varicella vaccination is highly recommended for susceptible persons who may
develop severe illness.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3006266 [PubMed - indexed for MEDLINE]

7172: Clin Pharm. 1985 Sep-Oct;4(5):539-54.

Treatment of infectious complications of acquired immunodeficiency syndrome.

Furio MM, Wordell CJ.

The infectious complications of the acquired immunodeficiency syndrome (AIDS) are
discussed, and the conventional and nonconventional therapies used for these
infections are reviewed. The infections most commonly encountered in patients
with AIDS are Pneumocystis carinii pneumonia (58%), Candida esophagitis (31%),
toxoplasmosis (21%), cytomegalovirus infections (15%), and herpes-simplex virus
infections (12%). Pneumocystis carinii pneumonia is the most common
life-threatening process in these patients. Trimethoprim-sulfamethoxazole
(TMP-SMZ) is considered the drug of choice for its treatment. Oral candidiasis
often indicates the progression to AIDS in the high-risk populations of
homosexual or bisexual men, intravenous drug abusers, and individuals with
hemophilia. Nystatin suspension is commonly used to treat oral candidiasis, while
Candida esophagitis demands systemic therapy with ketoconazole. Toxoplasmosis
most commonly manifests itself in patients with AIDS as a cerebral mass lesion.
The recommended therapy includes sulfadiazine and pyrimethamine. AIDS patients
frequently experience protozoal invasion of the intestinal tract with Giardia
lamblia, Isospora belli, and Cryptosporidium muris. Various drugs have been tried
for these infections, including quinacrine hydrochloride, metronidazole, TMP-SMZ,
and spiramycin. Cytomegalovirus (CMV) infections commonly involve the lungs,
gastrointestinal tract, eyes, brain, and nervous system. Attempts to treat these 
disseminated CMV infections with antiviral agents, including acyclovir, have not 
been successful. However, acyclovir has been found beneficial in the treatment of
herpes-simplex virus infections. Multiple infectious complications may occur in
patients with AIDS as a result of the cellular-immune deficiency associated with 
this disease. Until more research is done with AIDS patients, therapy must be
based on the data available from the treatment of these infections in
immunosuppressed patients without AIDS.

Publication Types: 
    Review

PMID: 2996829 [PubMed - indexed for MEDLINE]

7173: Pediatr Infect Dis. 1985 Sep-Oct;4(5):480-6.

Clinical manifestations of herpesvirus infections in pediatric renal transplant
recipients.

Trachtman H, Weiss RA, Spigland I, Greifer I.

We report our experience with 29 symptomatic herpesvirus infections occurring
during the course of 87 pediatric transplant procedures performed over the
10-year period, 1973 to 1982. The yearly attack rate ranged from 0.05 to 0.40
case per cumulative patient years at risk. A greater proportion (9 of 14) of
children who received more than 10 units of whole blood or packed red blood cells
prior to transplantation developed a viral infection compared with those given 10
transfusions or fewer (8 of 25) (P = 0.10). Fever occurred in 22 (76%) children, 
pulmonary disease in 8 (28%), hepatitis in 11 (35%), leukopenia in 7 (24%),
thrombocytopenia in 9 (31%) and central nervous system disease in 3 (10%).
Herpesvirus infections were responsible for allograft loss in 7 (24%) patients.
However, no differences in the actuarial graft survival curves were noted for
transplants performed since 1979 in children with and without viral infection.
The etiologic viral agents were cytomegalovirus in 19 (65%) episodes, herpes
simplex virus in 8 (28%), Epstein-Barr virus in 2 (7%) and varicella-zoster virus
in 2 (7%). Cytomegalovirus-infected patients were younger and more commonly
developed primary infection compared with children with herpes simplex virus
disease who were more likely to have secondary infection and to manifest a
mucocutaneous vesicular rash. We conclude that the etiologic agents and clinical 
features of herpesvirus infections are similar in pediatric and adult renal
allograft recipients. Moreover except for distinctive syndromes such as
mucocutaneous vesicular eruption or a central nervous system lymphoma, the
various herpes-viruses cause clinically indistinguishable illnesses in pediatric 
transplant patients with similar end organ involvement and untoward renal
consequences.

Publication Types: 
    Comparative Study

PMID: 2995934 [PubMed - indexed for MEDLINE]

7174: Neurology. 1985 Sep;35(9):1381-4.

Antivirus antibodies in myasthenia gravis.

Klavinskis LS, Willcox N, Oxford JS, Newsom-Davis J.

Serum antibodies to influenza A, measles, rubella, cytomegalovirus, varicella
zoster, herpes simplex type 1, and mumps have been assayed in 104 patients with
myasthenia gravis, grouped according to clinical features plus thymus pathology, 
and compared with matched controls. No significant differences in incidence or
antibody titer were detected. In 37 patients with recent onset of symptoms, the
incidence of antibody to coxsackieviruses B1-B6 was less than in controls.
Juvenile-onset cases also demonstrated antibody to Epstein-Barr virus at the
expected frequency. These results weaken the case for any of these common
viruses, or the response to them, contributing to the pathogenesis of myasthenia 
gravis.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2991819 [PubMed - indexed for MEDLINE]

7175: JAMA. 1985 Aug 16;254(7):912.

Herpes zoster: adenosine monophosphate for the prevention of post-neuralgia.

Sklar SH, Alexander EJ, Blue WT, Bodian CA.

Publication Types: 
    Letter

PMID: 4021022 [PubMed - indexed for MEDLINE]

7176: Practitioner. 1985 Aug;229(1406):747-9.

A treatment of herpes zoster.

Fothergill WT, Ninaber V, Thick GC.

PMID: 4034486 [PubMed - indexed for MEDLINE]

7177: J Trop Med Hyg. 1985 Aug;88(4):261-4.

Herpes zoster in children following malaria.

Cook IF.

Herpes zoster is uncommon in normal children in the 0-9 year age group. However, 
its incidence is markedly increased in those who are immunosuppressed. Six Papua 
New Guinean children under 9 years of age developed herpes zoster following an
episode of malaria, due to Plasmodium falciparum or Plasmodium vivax which was
treated with chloroquine. The reactivation of the varicella-zoster virus in these
patients may reflect transient depression of cell-mediated immunity by these
malaria parasites, possibly augmented by the chloroquine used in their treatment.

PMID: 3910848 [PubMed - indexed for MEDLINE]

7178: Z Hautkr. 1985 Aug 1;60(15):1237-40.

[Generalized zoster in 2 girls responding well to therapy with intravenous
acyclovir]

[Article in German]

Ingber A, Ianiv J, Grunwald Z, Bialowons M, Garti B.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3876660 [PubMed - indexed for MEDLINE]

7179: Cancer. 1985 Aug 1;56(3):642-8.

The incidence of herpes zoster in patients with Hodgkin's disease. An analysis of
prognostic factors.

Guinee VF, Guido JJ, Pfalzgraf KA, Giacco GG, Lagarde C, Durand M, van der Velden
JW, Lowenberg B, Jereb B, Bretsky S, et al.

The incidence of zoster in 717 patients with Hodgkin's disease was determined by 
a retrospective chart review. All patients had been treated and followed in one
of six cancer centers. Prognostic factors that might predict the subsequent
incidence of zoster were examined by univariate and multivariate analytic
techniques. Intensity of treatment was a key factor in the incidence of zoster.
Thirty-six months after initiation of treatment, patients receiving
chemotherapy-radiation-chemotherapy had twice the attack rate (27.3%) of those
receiving radiation alone (11.5%). The pediatric age group had a significantly
higher attack rate (26.6%) than did adults (18.7%). Stage, histology, and
laparotomy did not influence the incidence of zoster.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 3873986 [PubMed - indexed for MEDLINE]

7180: Shikai Tenbo. 1985 Aug;Spec No:81-4.

[Diagnosis and management of pain. Pain in the maxillofacial area caused by
various reasons]

[Article in Japanese]

Ono T.

PMID: 3868123 [PubMed - indexed for MEDLINE]

7181: Dent Update. 1985 Aug;12(7):429-30, 432-4, 436.

The tongue: 3. Infections and mucosal atrophy.

Lamey PJ, Lewis MA.

PMID: 3864695 [PubMed - indexed for MEDLINE]

7182: J Infect Dis. 1985 Aug;152(2):266-73.

Viral infections in childhood leukemia.

Wood DJ, Corbitt G.

The importance of viral infections in 150 children receiving therapy for leukemia
was studied prospectively by application of comprehensive viral diagnostic
procedures. One hundred five viral infections were identified, with herpes
simplex virus and varicella-zoster virus being the most common agents. The
spectrum of viruses associated with serious illness was wider than that in
previous studies, and adenoviruses, parainfluenza viruses, rhinoviruses, and
enteroviruses were important causes of morbidity. Viral isolation was the most
sensitive diagnostic procedure used because complement fixation serology was
falsely negative in two-thirds of cases. The occurrence of viral infection may be
a previously overlooked important cause of respiratory tract infection and acute 
pyrexia of unknown origin. Viral infection rates were highest in patients with
acute myeloblastic leukemia, in induction and relapse, and in patients treated
with newer chemotherapeutic schedules. Thus, viruses are important pathogens in
children with leukemia.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3861716 [PubMed - indexed for MEDLINE]

7183: J Clin Gastroenterol. 1985 Aug;7(4):309-13.

Ogilvie's syndrome associated with herpes zoster infection.

Caccese WJ, Bronzo RL, Wadler G, McKinley MJ.

Acute colonic pseudo-obstruction that occurs in the setting of an underlying
medical condition is known as Ogilvie's syndrome. The etiology of Ogilvie's
syndrome is unknown, and associated medical illnesses are varied and often
extra-abdominal. While herpes zoster infection has been reported to cause
constipation and hypomotility, the association with massive colonic distention
has not so far been described. We present a patient with Ogilvie's syndrome in
the setting of herpes zoster infection. There was no evidence of other active
illnesses, and the patient has continued to do well since the resolution of the
zoster. We believe that this is the first reported association of Ogilvie's
syndrome and herpes zoster infection.

Publication Types: 
    Case Reports

PMID: 3840187 [PubMed - indexed for MEDLINE]

7184: J Med Virol. 1985 Aug;16(4):343-9.

Persistence of serum IgA antibodies to herpes simplex, varicella-zoster,
cytomegalovirus, and rubella virus detected by enzyme-linked immunosorbent
assays.

Morris GE, Coleman RM, Best JM, Benetato BB, Nahmias AJ.

Enzyme-linked immunosorbent assays were used to detect IgG and IgA antibodies to 
herpes simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus (CMV), 
and rubella virus in sera from 68 adult female gynaecological patients. Of the
patients who had virus-specific IgG antibodies, the proportion who also had
virus-specific IgA was 98% for HSV, 75% for VZV, 73% for rubella virus, and 42%
for CMV. IgA antibodies to all four viruses were only found when specific IgG
antibodies were also detected in the serum. These results suggest that
virus-specific IgA may persist for several years; possible explanations for this 
are discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2993502 [PubMed - indexed for MEDLINE]

7185: J Infect Dis. 1985 Aug;152(2):280-5.

Human monoclonal antibodies neutralizing varicella-zoster virus.

Foung SK, Perkins S, Koropchak C, Fishwild DM, Wittek AE, Engleman EG, Grumet FC,
Arvin AM.

Hybridomas secreting human monoclonal antibodies to varicella-zoster virus were
produced by fusing B cells of a patient recovering from acute varicella infection
with a human-mouse cell line. Two hybrid lines have continued to secrete IgG1,
one with kappa and the other with lambda chains, for at least 12 months. Each
antibody neutralizes virus infectivity between 1-5 micrograms of partially
purified immunoglobulin/ml, each shows a different pattern of immunofluorescent
staining of virus-infected cells, and one identifies three viral proteins with
molecular weights of 60,000, 95,000, and 97,000.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2993433 [PubMed - indexed for MEDLINE]

7186: J Gen Virol. 1985 Aug;66 ( Pt 8):1795-9.

Affinity-purified varicella-zoster virus glycoprotein gp1/gp3 stimulates the
production of neutralizing antibody.

Wroblewska Z, Gilden D, Green M, Devlin M, Vafai A.

Varicella-zoster virus glycoprotein gp1/gp3 was purified by affinity
chromatography using anti-gp1/gp3 monoclonal antibody 19.1 linked to
CNBr-activated Sepharose CL-4B. Rabbits immunized with purified glycoprotein
gp1/gp3 developed mono-specific neutralizing antibody.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2991442 [PubMed - indexed for MEDLINE]

7187: J Gen Virol. 1985 Aug;66 ( Pt 8):1785-93.

Antibody response to varicella-zoster virus surface glycoproteins in chickenpox
and shingles.

Larkin M, Heckels JE, Ogilvie MM.

Varicella-zoster virus (VZV)-infected cell surface proteins were investigated
using extrinsic radiolabelling of the cell surface, immunoprecipitation of
detergent-solubilized extract of the same cell surface and fractionation of the
immunoprecipitates using SDS-PAGE. Glycosylated proteins were identified by their
affinity for Ricinus communis lectin. Six glycoproteins with apparent mol. wt. of
170K, 105K, 93K, 81K, 53K and 45K were identified. The 170K glycoprotein was
shown to be disulphide-linked since under reducing conditions for SDS-PAGE it was
cleaved to a protein of 63K mol. wt. The IgG responses to these glycoproteins
during various clinical circumstances are described. In acute sera from all
chickenpox patients and in the majority of acute shingles sera, antibodies
reactive with glycoproteins could not be detected. In chickenpox convalescence,
antibodies reactive with glycoproteins of mol. wt. 170K, 105K, 53K and 45K were
identified, whilst during zoster convalescence antibodies to all six were
prominent. Antibodies to the disulphide-linked glycoprotein persisted for many
years following both the primary disease and its reactivation. Disseminated
zoster was associated with significantly low levels of antibodies to these
surface glycoproteins.

PMID: 2991441 [PubMed - indexed for MEDLINE]

7188: Virology. 1985 Aug;145(1):62-71.

Varicella-zoster virus envelope glycoproteins: biochemical characterization and
identification in clinical material.

Edson CM, Hosler BA, Poodry CA, Schooley RT, Waters DJ, Thorley-Lawson DA.

Varicella-zoster virus (VZV)-infected human foreskin fibroblasts synthesize viral
glycoproteins of 125,000 (gp125), 118,000 (gp118), 92,000 (gp92), 63,000 (gp63), 
59,000 (gp59), and 47,000 (gp47) Da. In biochemical studies, all of these VZV
glycoproteins were shown to contain asparagine-linked (N-linked) oligosaccharide 
chains and, except for gp125 and gp47, to be sialoglycoproteins. Experiments with
endo-beta-N-acetylglucosaminidase H (endo H) demonstrated that gp92 contained
only complex type (endo H-resistant) N-linked glycosyl chains, while the other
mature glycoproteins contained both high-mannose (endo H-sensitive) and
complex-type oligosaccharides. Monoclonal antibodies recognizing multiple
glycoproteins, gp63/gp125 or gp92/gp59/gp47, neutralized virus infection,
suggesting the glycoproteins were important components of the virus envelope.
This was confirmed for gp92/gp59/gp47 by immunoelectron microscopy, which
revealed dense staining localized exclusively to the virion envelope and to the
plasma membrane of virus-producer cells. The mature forms of all of these
glycoproteins were also present in viral material isolated from vesicles of
varicella and zoster patients, indicating that in infected individuals the viral 
glycoproteins are synthesized and processed in a manner similar to that in tissue
culture cells.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2990103 [PubMed - indexed for MEDLINE]

7189: Antimicrob Agents Chemother. 1985 Aug;28(2):265-73.

High-pressure liquid chromatographic methods for determining
arabinosyladenine-5'-monophosphate, arabinosyladenine, and arabinosylhypoxanthine
in plasma and urine.

McCann WP, Hall LM, Siler W, Barton N, Whitley RJ.

New high-pressure liquid chromatographic methods for determining concentrations
of arabinosyladenine (Ara-A), its 5'-monophosphate (Ara-AMP), and
arabinosylhypoxanthine (Ara-H) in plasma and urine are presented. A fluorescence 
detector is used for Ara-A and Ara-AMP, which are first converted to highly
fluorescent derivatives with chloroacetaldehyde. This increases sensitivity
greatly over previous methods. The sensitivities of the methods (in micrograms
per milliliter) are as follows: in plasma, Ara-AMP, 0.002; Ara-A, 0.0015; and
Ara-H, 0.35; and in urine, 9 times these values, respectively. Drug concentration
data are also presented, which were obtained after doses of Ara-AMP were given
intramuscularly to two patients treated with this drug for severe herpes zoster. 
One patient was given 13 mg of Ara-AMP per kg of body weight once daily, and the 
other was given 6.5 mg/kg twice daily. Peak Ara-AMP and Ara-A levels in plasma
occurred within 1 h after the doses, and neither exceeded 2 micrograms/ml.
Ara-AMP and Ara-A concentrations in plasma fell to less than 0.01 micrograms/ml
in both patients by 4 to 6 h after the doses. Peak Ara-H concentrations in plasma
occurred within 1 to 2 h after doses and were 21 micrograms/ml in patient 1 and
2. The highest concentration of Ara-AMP in urine was 0.09 micrograms/ml. The
highest Ara-A concentration in urine was 62 micrograms/ml, and the highest Ara-H 
concentration in urine was 1,080 micrograms/ml. An interfering substance of
unknown nature, cochromatographing with Ara-H, was encountered sporadically in
urine samples. An algorithm based on differential spectrophotometry to identify
and correct for this problem is described. Estimates of the renal clearances of
Ara-AMP, Ara-A, and Ara-H are also given.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2423028 [PubMed - indexed for MEDLINE]

7190: Strahlentherapie. 1985 Jul;161(7):406-9.

[The immune status of patients with irradiated testicular neoplasms]

[Article in German]

Stefanits K, Kuhn E, Csere T.

The authors present the results of investigations of the immune reactivity of 72 
patients irradiated for testicle tumors. The responses to tuberculin and DNCB
(2.4-dinitrochlorobenzol) were examined before the treatment, within twelve
months after radiotherapy and three years after radiotherapy and when metastases 
appeared. After radiotherapy, the number of positive responses was slightly
decreased in both examination methods, but the difference was in no case
significant. Patients with metastases showed a significantly decreased response
to DNCB compared to the results obtained before radiotherapy. 5.6% of the
patients had suffered from herpes zoster. The incidence of other infective
diseases was not increased. The conclusion is drawn that the moderate
immunosuppression caused by radiotherapy does not exert any influence on the
further way of living of patients with testicle tumors.

Publication Types: 
    English Abstract

PMID: 4024164 [PubMed - indexed for MEDLINE]

7191: Pediatr Infect Dis. 1985 Jul-Aug;4(4):413.

Contagiousness of zoster in a day care setting.

Riegle L, Cooperstock M.

PMID: 4022807 [PubMed - indexed for MEDLINE]

7192: Mykosen. 1985 Jul;28(7):332-5.

[Generalized follicular pustular candidiasis following herpes zoster]

[Article in German]

Ginter G, Kresbach H.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3897855 [PubMed - indexed for MEDLINE]

7193: Cancer Res. 1985 Jul;45(7):2943-50.

Selectivity--key to chemotherapy: presidential address.

Elion GB.

Publication Types: 
    Review

PMID: 3891079 [PubMed - indexed for MEDLINE]

7194: J Indian Dent Assoc. 1985 Jul;57(7):267-71.

Herpes zoster of the trigeminal nerve with dental involvement.

Sofat JR, Greval RS, Minocha YC.

Publication Types: 
    Case Reports

PMID: 3869151 [PubMed - indexed for MEDLINE]

7195: Infirm Fr. 1985 Jul;(267):23-5.

[Zona]

[Article in French]

Harlay A.

PMID: 3850067 [PubMed - indexed for MEDLINE]

7196: Drug Intell Clin Pharm. 1985 Jul-Aug;19(7-8):518-24.

Evaluation of oral acyclovir therapy.

Fletcher C, Bean B.

Acyclovir is a specific antiviral agent. The triphosphate form inhibits viral DNA
replication by competing for incorporation into the replicating DNA chain or by
inhibiting viral DNA polymerase. Cells not infected with herpesvirus are
generally unaffected. Oral acyclovir inhibits most herpes simplex virus types 1
and 2, and varicella-zoster virus at concentrations used clinically. Oral
acyclovir has an average plasma half-life of three hours and is eliminated
primarily by renal mechanisms. Peak plasma concentrations occur 1.5 to 2.5 hours 
after administration and the oral bioavailability is 15 to 30 percent. Acyclovir 
distributes into most body tissues, including vesicular fluid and the central
nervous system. Oral acyclovir is effective treatment of initial and recurrent
genital herpes and can suppress frequently recurring genital herpes in both
immunocompetent and immunocompromised patients. It is also effective for acute
herpes zoster in the immunocompetent and possibly immunocompromised patient. No
role is established in either Epstein-Barr virus or cytomegalovirus infections.
Oral acyclovir appears to be effective and relatively safe, nontoxic therapy when
administered in doses of 1-4 g/d. Oral acyclovir represents a major therapeutic
advance in the treatment of herpesvirus infections.

Publication Types: 
    Clinical Trial
    Review

PMID: 2992899 [PubMed - indexed for MEDLINE]

7197: J Virol. 1985 Jul;55(1):45-53.

DNA-binding proteins present in varicella-zoster virus-infected cells.

Roberts CR, Weir AC, Hay J, Straus SE, Ruyechan WT.

DNA-binding proteins present in varicella-zoster virus-infected cells were
identified by DNA-cellulose chromatography of radioactively labeled cell
extracts. Seven virus-specific proteins, ranging in molecular weight from
approximately 175,000 to 21,000, showed affinity for single- or double-stranded
DNA or both. These proteins include the varicella-zoster virus major capsid
protein, a phosphorylated tegument protein, and a 125,000-molecular-weight
species which may be analogous to the major DNA-binding protein of herpes simplex
virus. We also identified a number of DNA-binding phosphoproteins by these
procedures. Finally, protein blot studies were carried out to determine whether
these proteins bind preferentially to virus rather than to host cell DNA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2989559 [PubMed - indexed for MEDLINE]

7198: J Infect Dis. 1985 Jul;152(1):230.

The significance of specific IgA antibodies in the serum in the early diagnosis
of zoster.

Tovi F, Hadar T, Sidi J, Sarov B, Sarov I.

Publication Types: 
    Letter

PMID: 2989386 [PubMed - indexed for MEDLINE]

7199: Harefuah. 1985 Jun 16;108(12):598-601.

[Neurological complications in herpes zoster and possible mechanisms]

[Article in Hebrew]

Miller A, Gross B, Tourezkite T.

Publication Types: 
    Review

PMID: 3905541 [PubMed - indexed for MEDLINE]

7200: Presse Med. 1985 Jun 15;14(24):1328-30.

[Benign paralysis of the last 4 cranial nerves. Arguments in favor of an ischemic
mechanism]

[Article in French]

Devoize JL, Rouanet J, Cellerier P, Georget AM, Tournilhac M.

The last four cranial nerves are fed by the ascending pharyngeal artery, a branch
of the external carotid artery. The fact that paralysis of these nerves may occur
immediately after arteriography of the external carotid artery demonstrates that 
ischaemic truncular neuropathies do exist. The deficit is sudden and usually
regressive. Ischaemia may account for regressive paralysis of these nerves
reported in diabetes, herpes zoster and after some traumas. Apparently idiopathic
and benign paralysis might be due to the same mechanism. All 4 nerves may be
affected, or only the IXth, Xth and XIth nerves, or the XIth nerve may be spared,
being fed by two arteries. Apart from the obvious case of arteriographic
accident, the diagnosis of paralysis of ischaemic origin can only be made after
other causes, notably compression, have been excluded, since direct evidence of
arterial obstruction is exceptionally obtainable; regression at follow-up is a
major argument in favour of ischaemia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3161022 [PubMed - indexed for MEDLINE]

7201: J Rheumatol. 1985 Jun;12(3):625.

Herpes zoster and cranial giant cell arteritis.

Mussini JM, Ponge T, Barrier J, Mussini-Montpellier J, Grolleau JY.

Publication Types: 
    Letter

PMID: 4045865 [PubMed - indexed for MEDLINE]

7202: Rev Clin Esp. 1985 Jun;177(1):29-30.

[Motor disorders of the extremities in herpes zoster. Presentation of 4 cases]

[Article in Spanish]

Kulisevsky Bojarski J, Peiro Grasa A, Illa Sendra L, Escartin Siquier AE, Pradas 
Orozco J, Grau Veciana JM.

Publication Types: 
    English Abstract

PMID: 4035035 [PubMed - indexed for MEDLINE]

7203: Semin Oncol. 1985 Jun;12(2):180-91.

Prevention of infectious complications in acute lymphoblastic leukemia.

Hughes WT, Feldman S, Gigliotti F, Shenep J, Sixbey J.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 3925557 [PubMed - indexed for MEDLINE]

7204: Pediatrics. 1985 Jun;75(6):1127-31.

Nephrotic syndrome associated with varicella infection.

Lin CY, Hsu HC, Hung HY.

A 4-year-old boy developed nephrotic syndrome following varicella infection.
Serologic studies during the early phase of the disease demonstrated a decrease
in serum C3, C4, and properdin factor B. Renal biopsy revealed an acute
proliferative glomerulonephritis with deposition of immunoglobulins A (IgA) and
M, C3, C1q, and varicella virus antigen in the glomerulus, suggesting an immune
complex deposition. Ultrastructurally, this suggested a postinfectious immune
complex glomerulonephritis. These phenomena suggested that varicella virus
antigen antibody complexes were deposited in the glomerulus and activated the
classic and alternative pathway of complements, leading to an immune complex
glomerulonephritis. During the nephrotic phase, an increase in OKT8 cells and
decrease of the OKT4 cells were demonstrated. Two months later, this alteration
returned to normal as the renal disease was in remission. This change of
lymphocyte subsets during varicella infection may play a role in the pathogenesis
of nephrotic syndrome.

Publication Types: 
    Case Reports

PMID: 3873641 [PubMed - indexed for MEDLINE]

7205: Acta Stomatol Belg. 1985 Jun;82(2):131-41.

[Zona of the facial nerve]

[Article in French]

Peiffer R, Cesteleyn L, Peiffer A.

Publication Types: 
    Case Reports

PMID: 3861085 [PubMed - indexed for MEDLINE]

7206: Arq Neuropsiquiatr. 1985 Jun;43(2):194-7.

[Polymioclonia-opsoclonus: Kinsbourne's syndrome. Report of a case]

[Article in Portuguese]

Vieira JB, Rosa ED.

Case report of a 9 years old boy with Kinsbourne's syndrome. This condition was
characterized by the subacute onset of polymyoclonia, cerebellar ataxia and
opsoclonus that set later, following an herpes zoster infection. Steroid therapy 
resulted in rapid dramatic improvement of neurological symptoms.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2998307 [PubMed - indexed for MEDLINE]

7207: Antiviral Res. 1985 Jun;5(3):145-56.

Comparison of the in vitro and in vivo antiherpes virus activities of the acyclic
nucleosides, acyclovir (Zovirax) and
9-[(2-hydroxy-1-hydroxymethylethoxy)methyl]guanine (BWB759U).

Collins P, Oliver NM.

The antiherpes virus activities of acyclovir and its close analogue
3-[(2-hydroxy-1-hydroxymethylethoxy)methyl]guanine (BWB759U) were compared in
vitro and in vivo. The activities of both compounds against herpes simplex virus 
and varicella-zoster virus were similar in the majority of cell lines. However,
in mouse-derived and HeLa cells, BSB759U was more effective than acyclovir
against herpes simplex virus. Mutants of herpes simplex virus deficient in
thymidine kinase and resistant to acyclovir were found to vary in their
sensitivity to BWB759U. In two mouse models of herpes simplex virus infection
BWB759U was more effective than acyclovir.

Publication Types: 
    Comparative Study

PMID: 2992369 [PubMed - indexed for MEDLINE]

7208: J Immunol. 1985 Jun;134(6):4184-8.

Characterization of the human newborn response to herpesvirus antigen.

Chilmonczyk BA, Levin MJ, McDuffy R, Hayward AR.

An investigation was made into the human newborn cellular response to herpes
simplex virus type 1 (HSV), cytomegalovirus (CMV), and varicella zoster virus
(VZV) to understand more about the nature of the neonate's susceptibility to
overwhelming infection by these viruses. Newborn mononuclear cells sustained the 
proliferation in culture of maternal (i.e., haplotype-matched) T cell blasts with
specificity for HSV, CMV, or VZV (p less than 0.05). This is evidence for intact 
antigen-processing capability by newborn monocytes. The response of the maternal 
T cell blasts appeared to be HLA-haplotype-restricted as suggested by experiments
in which maternal T cell blasts were limited in number. Our culture conditions
elicited responses predominantly from the T4+ lymphocyte subset. A low frequency 
of herpesvirus-specific T4+ lymphocytes in newborn blood might contribute to
deficient viral immunity, so we evaluated the virus-specific T cell responding
frequency in human newborns in limiting dilution cultures. We were unable to find
a herpesvirus-specific responder cell frequency greater than 1:1,400,000 in
nonimmune newborns. Three of seven adults who had no serum antibody to CMV had a 
CMV responder cell frequency (RCF) of 1:100,000 to 1:200,000. The RCF to HSV in
immune children, ages 18 mo to 12 yr, and adults, ages 13 to 80 yr, ranged from
1:14,000 to 1:18,000. We conclude that newborn monocyte processing of herpesvirus
antigen is intact, that T cell RCF is low in neonates, and that immunity to HSV
after infection outside the newborn period results in comparable RCF between
adults and children.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2580908 [PubMed - indexed for MEDLINE]

7209: Klin Monatsbl Augenheilkd. 1985 Jun;186(6):421-3.

[Therapy of herpetic diseases of the anterior eye segment]

[Article in German]

Sundmacher R.

Clinico-virologic investigations and the availability of the new antiviral drug
Acyclovir have changed our therapeutic approach to deep herpetic diseases.
Treatment of the symptoms alone with steroids should now be avoided. Basic
treatment should consist of optimal dosages of Acyclovir. However, additional
steroid therapy is still necessary. Significant progress in the treatment of
dendritic keratitis is to be expected as soon as high-titer interferon
preparations become commercially available. Treatment of dendritic keratitis with
a combination of a modern antiviral drug and high-titer interferon will reduce
the average time the corneal epithelium takes to heal from the present 6 days to 
3 days. While considerable progress has been made in the treatment of herpes, no 
more than a step in the right direction has been taken with herpes zoster
varicellosus virus, owing to its greater resistance to Acyclovir.

Publication Types: 
    English Abstract

PMID: 2413240 [PubMed - indexed for MEDLINE]

7210: Clin Ter. 1985 May 31;113(4):315-22.

[Drug therapy in auricular pathology]

[Article in Italian]

Tripodi D, Rotolo A, Rossi M.

Publication Types: 
    English Abstract

PMID: 4017509 [PubMed - indexed for MEDLINE]

7211: Biochem Biophys Res Commun. 1985 May 16;128(3):1329-35.

2'-Nor-cGMP: a seco-cyclic nucleotide with powerful anti-DNA-viral activity.

Tolman RL, Field AK, Karkas JD, Wagner AF, Germershausen J, Crumpacker C,
Scolnick EM.

As part of our study of antiherpetic acyclonucleosides, we synthesized a cyclic
GMP analog, 9-[(2-hydroxy-1,3,2-dioxaphosphorinan-5-yl)oxymethyl]guanine P-oxide,
sodium salt (2'-nor-cGMP), and discovered its potent and broad spectrum
anti-DNA-viral activities. 2'-Nor-cGMP inhibits the replication of many DNA
viruses, including herpes simplex virus, human cytomegalovirus, vaccinia, SV40,
and adenovirus, but does not inhibit RNA viruses. In plaque reduction studies
this potent antiviral agent is also approximately 10-fold more potent than
9-(1,3-dihydroxy-2-propoxymethyl)guanine (2'NDG) against varicella-zoster virus
and inhibits cell transformation by bovine papilloma virus. Unlike 2'NDG, the
potent activity of 2'-nor-cGMP against herpes virus is not dependent upon the
action of virus-specified thymidine kinase. Intercellular metabolism of
2'-nor-cGMP produced small amounts of 2'NDG triphosphate which were insufficient 
to account for the antiviral activity observed, implying that this potent
anti-DNA-viral agent operates by a mechanism different from that of known
acyclonucleosides.

Publication Types: 
    Comparative Study

PMID: 2988534 [PubMed - indexed for MEDLINE]

7212: Can Med Assoc J. 1985 May 15;132(10):1112.

Vidarabine therapy for herpes zoster.

Diosy A.

Publication Types: 
    Letter

PMID: 3995428 [PubMed - indexed for MEDLINE]

7213: Lancet. 1985 May 11;1(8437):1103.

Acyclovir in herpes zoster oticus.

Hall SJ, Kerr AG.

Publication Types: 
    Letter

PMID: 2860316 [PubMed - indexed for MEDLINE]

7214: J Assoc Physicians India. 1985 May;33(5):373-4.

Varicella--zoster involving multiple cranial nerves with meningo-encephalitis.

Mathur SL, Bhandari R, Banerjee K, Mathur A, Kothari D, Mathur M.

Publication Types: 
    Case Reports

PMID: 4044508 [PubMed - indexed for MEDLINE]

7215: Vestn Dermatol Venerol. 1985 May;(5):54-6.

[Herpes zoster and chickenpox]

[Article in Russian]

Kogan AI.

Publication Types: 
    Case Reports
    English Abstract

PMID: 4036295 [PubMed - indexed for MEDLINE]

7216: Rev Clin Esp. 1985 May;176(8):429.

[Acute polyradiculoneuritis and herpes zoster]

[Article in Spanish]

Perez Garcia C, Anton Aranda E, Tiberio Lopez G, Martinez Ibanez F.

Publication Types: 
    Case Reports
    Letter

PMID: 4023329 [PubMed - indexed for MEDLINE]

7217: Acta Neurol Scand. 1985 May;71(5):337-53.

Central nervous system involvement in patients with acquired immune deficiency
syndrome (AIDS).

Koppel BS, Wormser GP, Tuchman AJ, Maayan S, Hewlett D Jr, Daras M.

Central nervous system involvement occurred in 28 of 121 patients with acquired
immune deficiency syndrome (AIDS). The major risk factor in this AIDS population 
was intravenous drug abuse (64%). A neurologic symptom or disability was the
principal reason for hospitalization in 16 cases (57%). Three patients had
primary lymphoma of the brain and the remainder had opportunistic infections.
Patients with focal neurological features usually had toxoplasmosis. Progressive 
headache and meningeal signs occurred with cryptococcosis. A progressive subacute
dementia was probably due to cytomegalovirus. Other infections included atypical 
mycobacteria, candida, herpes zoster and possible progressive multifocal
leukoencephalopathy.

PMID: 4013658 [PubMed - indexed for MEDLINE]

7218: Arch Dermatol. 1985 May;121(5):588-9.

A case of herpes zoster involving a skin graft.

Ramos-Caro FA, Jackson DB.

Publication Types: 
    Case Reports
    Letter

PMID: 3888121 [PubMed - indexed for MEDLINE]

7219: Antimicrob Agents Chemother. 1985 May;27(5):733-8.

Biotransformation and elimination of [2-14C]-1-(2-deoxy-2'-fluoro-beta-D
-arabinofuranosyl)-5-iodocytosine in immunosuppressed patients with herpesvirus
infections.

Feinberg A, Leyland-Jones B, Fanucchi MP, Hancock C, Fox JJ, Watanabe KA, Vidal
PM, Williams L, Young CW, Philips FS.

The metabolism of the drug [2-14C]-1-(2'-deoxy-2'-fluoro-beta-D
-arabinofuranosyl)-5-iodocytosine (FIAC), a potent inhibitor of herpesvirus
replication, was studied in immunosuppressed patients with herpesvirus
infections. FIAC was administered intravenously by 15-min infusion and by mouth
24 h later to four patients at doses of 50 or 100 mg/m2. FIAC was cleared from
the plasma primarily by biotransformation in liver, kidney, and peripheral blood,
with a terminal-phase half-life of 0.92 to 1.80 h (mean, 1.36 h) after
intravenous administration. The area under the concentration-time curve from zero
to infinity (AUC0-infinity) for FIAC was 1.6 to 4.7% (mean, 3.4%) of the
AUC0-infinity for total radioactivity.
1-(2'-Deoxy-2'-fluoro-beta-D-arabinofuranosyl)-5-iodouracil (FIAU) was the major 
metabolite; the AUC0-infinity for FIAU was 54.3 to 72.5% (mean, 63.4%) of the
AUC0-infinity for total radioactivity. The terminal-phase half-life for FIAU was 
3.32 to 4.49 h (mean, 3.91 h); FIAU was cleared from plasma by renal elimination 
and further biotransformation. lesser amounts of
1-(2'-deoxy-2'-fluoro-beta-D-arabinofuranosyl)uracil,
1-(2'-deoxy-2'-fluoro-beta-D-arabinofuranosyl)cytosine, the glucuronide
conjugates of these metabolites, and the glucuronide conjugates of FIAC and FIAU 
were also formed. A comparison of the AUC0-infinity for total radioactivity after
intravenous and oral administration suggested that nearly all of the oral dose
was absorbed. Plasma levels of FIAU, also a potent inhibitor of herpesvirus
replication in vitro, exceeded the 50% effective dose for herpes simplex virus
and varicella-zoster virus as late as 12 h after administration of FIAC.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2990323 [PubMed - indexed for MEDLINE]

7220: J Virol. 1985 May;54(2):639-42.

Fine mapping and sequencing of a variable segment in the inverted repeat region
of varicella-zoster virus DNA.

Casey TA, Ruyechan WT, Flora MN, Reinhold W, Straus SE, Hay J.

A strain variation in the internal and terminal repeats which bind the short
unique sequence of varicella-zoster virus (VZV) DNA was found to be due to an
insertion or deletion of DNA sequences at a single site. DNA sequence analysis
showed that the nucleotide sequence CCGCCGATGGGGAGGGGGCGCGGTACC is tandemly
duplicated a variable number of times in different VZV strains and is responsible
for the observed variation in mobilities of restriction fragments from this
region of VZV DNA. The variable region sequence shares some homology with
tandemly repeated regions in the a and c sequences of herpes simplex virus type 1
and probably exists in a noncoding region of the VZV genome.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2985828 [PubMed - indexed for MEDLINE]

7221: Orv Hetil. 1985 Apr 21;126(16):1001-2.

[Difficulty of the etiological diagnosis of viral nervous system diseases: double
virus infection]

[Article in Hungarian]

[No authors listed]

Publication Types: 
    Case Reports
    Letter

PMID: 4000663 [PubMed - indexed for MEDLINE]

7222: Rev Prat. 1985 Apr 11;35(21):1223-30.

[Pains of deafferentiation]

[Article in French]

Laurent B.

Publication Types: 
    English Abstract

PMID: 2988103 [PubMed - indexed for MEDLINE]

7223: Tex Hosp. 1985 May;40(12):10.

Persons contract varicella following exposures to herpes zoster.

Lister J.

PMID: 10272569 [PubMed - indexed for MEDLINE]

7224: J R Coll Physicians Lond. 1985 Apr;19(2):96-8.

Cimetidine in the treatment of herpes zoster.

Levy DW, Banerjee AK, Glenny HP.

Publication Types: 
    Clinical Trial
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 3889322 [PubMed - indexed for MEDLINE]

7225: J Neurol Neurosurg Psychiatry. 1985 Apr;48(4):338-41.

Contralateral hemiparesis following herpes zoster ophthalmicus.

Gasperetti C, Song SK.

A case of herpes zoster ophthalmicus was followed, after a latent period of four 
weeks, by contralateral hemiparesis. An attempt is made to clarify the anatomical
relationships involved in the pathogenesis of postherpetic cerebral
complications. Detailed presentation of neuropathological findings in this case
may provide evidence of vasculitis in the syndrome, with better understanding of 
the pathological anatomy.

Publication Types: 
    Case Reports

PMID: 3873518 [PubMed - indexed for MEDLINE]

7226: Am Rev Respir Dis. 1985 Apr;131(4):662-5.

A case of invasive penicilliosis in Hong Kong with immunologic evaluation.

So SY, Chau PY, Jones BM, Wu PC, Pun KK, Lam WK, Lawton JW.

A 53-yr-old Chinese sailor developed prolonged pyrexia with unresolved lobar
pneumonia, cervical lymphadenopathy, generalized subcutaneous abscesses, and
pericardial effusion. Penicillium marneffei was isolated from pericardial fluid
and subcutaneous pus and was demonstrated on histologic sections of lymph nodes
and lung tissue. The penicilliosis was treated successfully with amphotericin B, 
ketoconazole, and 5-fluorocytosine. Subsequently, he also developed other
T-lymphocyte-related opportunistic infections such as disseminated cutaneous
herpes zoster and chronic osteomyelitis of sternum caused by Salmonella
typhimurium. He was also a chronic carrier of cytomegalovirus. Further
investigations showed that he had persistent depression of T-lymphocyte function 
and enhancement of B-lymphocyte activity, the cause of which was undetermined.

Publication Types: 
    Case Reports

PMID: 3873195 [PubMed - indexed for MEDLINE]

7227: Compend Contin Educ Dent. 1985 Apr;6(4):298-308.

Clinical virology of the head and neck.

Eversole R.

PMID: 3858049 [PubMed - indexed for MEDLINE]

7228: Ala J Med Sci. 1985 Apr;22(2):193-207.

Therapy for human herpesvirus infections. A perspective.

Whitley RJ.

Publication Types: 
    Clinical Trial
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2988359 [PubMed - indexed for MEDLINE]

7229: Semin Hematol. 1985 Apr;22(2):81-114.

Lymphocyte markers and infectious diseases.

Blumberg RS, Schooley RT.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2988132 [PubMed - indexed for MEDLINE]

7230: J Neurosurg. 1985 Apr;62(4):475-95.

Neurological manifestations of the acquired immunodeficiency syndrome (AIDS):
experience at UCSF and review of the literature.

Levy RM, Bredesen DE, Rosenblum ML.

In this review of the acquired immunodeficiency syndrome (AIDS), the authors have
evaluated a total of 352 homosexual patients with AIDS or generalized
lymphadenopathy managed at the University of California, San Francisco (UCSF),
between 1979 and 1984. Of an initial unselected group of 318 patients, 124 (39%) 
were neurologically symptomatic, and one-third already had their neurological
complaints at the time of presentation. An additional 210 AIDS patients with
neurological symptoms have been reported in the literature. Thus, a total of 366 
neurologically symptomatic patients with AIDS or lymphadenopathy are reviewed.
Central nervous system (CNS) complications, encountered in 315 patients, included
the following viral syndromes: subacute encephalitis (54), atypical aseptic
meningitis (21), herpes simplex encephalitis (nine), progressive multifocal
leukoencephalopathy (six), viral myelitis (three), and varicella-zoster
encephalitis (one). Non-viral infections were caused by Toxoplasma gondii (103), 
Cryptococcus neoformans (41), Candida albicans (six), Mycobacteria (six),
Treponema pallidum (two), coccidioidomycosis (one), Mycobacterium tuberculosis
(one), Aspergillus fumigatus (one), and Escherichia coli (one). Neoplasms
included primary CNS lymphoma (15), systemic lymphoma with CNS involvement (12), 
and metastatic Kaposi's sarcoma (three). Cerebrovascular complications were seen 
in four patients with hemorrhage and five with infarction. Five patients in the
UCSF series had multiple intracranial pathologies, including two cases of
simultaneous Toxoplasma gondii infections and primary CNS lymphoma, two cases of 
coexistent Toxoplasma gondii and viral infections, and one case of combined
Toxoplasma gondii and atypical mycobacterial infection. Cranial or peripheral
nerve complications, seen in 51 patients, included cranial nerve syndromes
secondary to chronic inflammatory polyneuropathy (five), lymphoma (five), and
Bell's palsy (five). Peripheral nerve syndromes included chronic inflammatory
polyneuropathy (12), distal symmetrical neuropathy (13), herpes zoster
radiculitis (six), persistent myalgias (two), myopathy (two), and polymyositis
(one). In light of the protean behavior of AIDS and the problems related to the
clinical, radiological, and serological diagnosis of the unusual and varied
associated nervous system diseases, patients with AIDS and neurological
complaints require a rigorous and detailed evaluation. The authors' experience
suggests that biopsy of all CNS space-occupying lesions should be performed for
tissue diagnosis prior to the institution of other therapies.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 2983051 [PubMed - indexed for MEDLINE]

7231: JAMA. 1985 Mar 22-29;253(12):1722-3.

Zoster after exposure to varicella-zoster virus.

Morens DM.

Publication Types: 
    Case Reports
    Letter

PMID: 2983129 [PubMed - indexed for MEDLINE]

7232: Schweiz Med Wochenschr. 1985 Mar 16;115(11):368-73.

[2-dimensional electrophoresis of cerebrospinal fluid in various neurological
patients]

[Article in German]

Wiederkehr F, Vonderschmitt DJ.

At present two-dimensional (2D) electrophoresis is the best method of resolution 
for separating complex protein mixtures, and this method has been successfully
adapted for resolving CSF proteins. CSF from over 200 patients with a wide
spectrum of neurological diseases were analyzed by 2D electrophoresis in addition
to agarose electrophoresis. After a 2D run several hundred fractions of proteins 
were obtained. By perfecting this method the authors have succeeded in
demonstrating oligoclonal zone patterns not previously described in the light
chain region of the immunoglobulins in CSF samples. All patients with definite
diagnosis of multiple sclerosis (MS), and also other diseases such as neurolues, 
myelitis, herpes zoster, etc. showed particular oligoclonal zone patterns. This
experience indicates that the detection of oligoclonal zones in the region of the
Ig-light chain is of major diagnostic significance. Moreover, the region of the
so-called "CSF-specific" proteins deserves special attention.

Publication Types: 
    English Abstract

PMID: 3920755 [PubMed - indexed for MEDLINE]

7233: Science. 1985 Mar 15;227(4692):1296-303.

Antiviral chemotherapy and chemoprophylaxis.

Dolin R.

Antiviral compounds have been developed for use in chemoprophylaxis and
chemotherapy of a variety of infections in humans, including those caused by
influenza viruses, respiratory syncytial virus, and herpesviruses. The efficacy
of several of these compounds has been demonstrated in rigorously controlled
trials. Advances in molecular virology have led to the identification of
biochemically defined, virus-specific functions that serve as appropriate targets
for the future development of antiviral compounds. Clinical investigators and
practicing physicians are now confronting questions previously raised with the
use of antibacterial antibiotics. These questions concern appropriate routes of
administration for antiviral compounds, optimal dosage regimens, risks of
long-term prophylaxis, and the emergence of resistant organisms.

Publication Types: 
    Clinical Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 2983421 [PubMed - indexed for MEDLINE]

7234: JAMA. 1985 Mar 8;253(10):1444-5.

Adenosine monophosphate for the treatment of varicella zoster infections: a large
dose of caution.

Sherlock CH, Corey L.

Publication Types: 
    Editorial

PMID: 3968776 [PubMed - indexed for MEDLINE]

7235: JAMA. 1985 Mar 8;253(10):1427-30.

Herpes zoster. The treatment and prevention of neuralgia with adenosine
monophosphate.

Sklar SH, Blue WT, Alexander EJ, Bodian CA.

Thirty-two adults were enrolled in a randomized, placebo-controlled double-blind 
trial of intramuscular injections of gel-sustained adenosine monophosphate (AMP) 
given three times a week for up to four weeks for acute herpes zoster. Adenosine 
monophosphate moderately reduced the pain soon after the start of treatment,
decreased desquamation time, and promoted faster healing of the skin than placebo
treatment. Adenosine monophosphate treatment reduced virus shedding and cleared
the virus faster than in placebo-treated subjects. At the end of the initial
four-week treatment period, 88% of AMP-treated patients were pain free, as
opposed to only 43% in the placebo group. After four weeks, all patients who had 
not recovered from pain started receiving AMP treatment without breaking the
code. All these patients recovered from pain within three weeks after initiation 
of treatment. No recurrence of pain or lesions was experienced from three to 18
months after the end of treatment. Adenosine monophosphate, a natural cellular
metabolite, showed no side effects or toxicity during and after the treatment.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3968773 [PubMed - indexed for MEDLINE]

7236: Masui. 1985 Mar;34(3):339-42.

[Treatment of herpes zoster]

[Article in Japanese]

Kato Y, Kato Y, Amagasa S, Tada T, Ono T, Ichiyanagi K.

Publication Types: 
    English Abstract

PMID: 4021079 [PubMed - indexed for MEDLINE]

7237: Nippon Ronen Igakkai Zasshi. 1985 Mar;22(2):110-5.

[Vasculitis as a cause of cerebrovascular disease among the elderly]

[Article in Japanese]

Ogata J.

Publication Types: 
    English Abstract

PMID: 4010036 [PubMed - indexed for MEDLINE]

7238: Med Clin North Am. 1985 Mar;69(2):399-413.

Viral meningitis.

Ratzan KR.

Viral meningitis is part of the aseptic meningitis syndrome but must be
distinguished from bacterial meningitis on the basis of a careful examination of 
the CSF and sound clinical judgment. Enteroviruses probably account for the bulk 
of cases of aseptic meningitis that occur in the United States and which are
reported to the Centers for Disease Control each year. The seasonal pattern in
the incidence of aseptic meningitis is largely due to the seasonal variation of
enteroviral infections. Early on, the CSF in patients with viral meningitis
frequently contains a predominance of polymorphonuclear leukocytes and may even
have a low glucose level. The presence of neutrophils in the initial CSF sample
is especially common in patients with enteroviral infections. A CSF glucose level
lower than 50 per cent of a simultaneously drawn blood glucose determination is
not uncommon in patients with viral meningitis due to mumps, LCM, and herpes
simplex. In a patient with a predominance of polymorphonuclear leukocytes in the 
initial CSF specimen and in whom a viral infection is suspected, antibiotics may 
be withheld if a spinal tap is repeated within 12 hours. A shift from
polymorphonuclear leukocytes to mononuclear cells makes viral meningitis the
likely diagnosis. Both herpes simplex and varicella-zoster may infect the
meninges by means of spread from cervical and dorsal root ganglia in a retrograde
fashion much the way they spread in an antegrade fashion to the skin. HSV-2 is
more likely to cause the clinical syndrome of viral meningitis, while HSV-1 is
more likely to cause a meningoencephalitis with serious brain dysfunction. The
identification of a specific viral agent in body fluids, especially the CSF, in a
patient with aseptic meningitis is of more than academic interest, since it can
shorten duration of hospital stay and eliminate unnecessary antimicrobial
therapy. The diagnosis of enteroviral infections depends upon the isolation of a 
virus from CSF, stool, or throat plus a fourfold antibody response in the serum
to the viral isolate. The 60-odd serotypes of enterovirus, each with different
antigenic determinants, preclude serologic testing alone as a useful diagnostic
test to identify the patient infected with coxsackievirus or echovirus. For
infections, due to herpes simplex, varicella-zoster, LCM, and arboviruses, a
serologic test alone can be useful.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID: 3990441 [PubMed - indexed for MEDLINE]

7239: Clin Pharm. 1985 Mar-Apr;4(2):170-6.

Nontraditional analgesics for the management of postherpetic neuralgia.

Thompson M, Bones M.

The pathogenesis and clinical manifestations of herpes zoster and postherpetic
neuralgia and the use of nontraditional analgesics in the management of
postherpetic neuralgia are reviewed. Herpes zoster represents the reactivation in
an immunocompromised host of dormant varicella-zoster virus (Herpesvirus
varicellae) contracted during a previous episode of chickenpox. Fever, neuralgia,
and paresthesia occur four to five days before skin lesions develop. Acute herpes
zoster pain usually does not last more than two weeks after all skin lesions have
healed. Postherpetic neuralgia is defined as pain that persists in the affected
dermatomes after the disappearance of all skin crusts. The neuralgia can vary
from "lightninglike" stabbing pain to constant, burning pain with hyperesthesia; 
it can persist for years and is often refractory to traditional analgesic
therapy. A number of nontraditional analgesic agents have been used in the
management of postherpetic neuralgia. Tricyclic antidepressants, especially
amitriptyline, have been used alone and in combination with phenothiazines or
anticonvulsants (carbamazepine, phenytoin, valproate sodium), with good results. 
The effectiveness of phenothiazines or anticonvulsants as sole therapeutic agents
has not been demonstrated. Although the intralesional administration of
corticosteroids appears to be beneficial, considerable fear about the potential
for these agents to precipitate widespread viral dissemination exists. Positive
results have been reported with levodopa, amantadine, and interferon, but the
role of these agents in the prevention of postherpetic neuralgia remains unclear.
Nontraditional analgesic agents are useful in the management of postherpetic
neuralgia, but patients must be selected and monitored appropriately. A tricyclic
antidepressant (especially amitriptyline) is a reasonable first choice.

PMID: 3987215 [PubMed - indexed for MEDLINE]

7240: Ann Intern Med. 1985 Mar;102(3):421.

Acyclovir and disseminated varicella zoster and encephalitis.

Ehrensaft DV, Safani MM.

Publication Types: 
    Case Reports
    Letter

PMID: 3970498 [PubMed - indexed for MEDLINE]

7241: Ophthalmology. 1985 Mar;92(3):316-24.

Corneal complications from herpes zoster ophthalmicus.

Liesegang TJ.

Of 94 patients with acute herpes zoster ophthalmicus who were seen during a
six-year period, 61 had corneal involvement. The corneal complications in the
order of chronological clinical occurrence were punctate epithelial keratitis in 
51%, early pseudodendrites in 51%, anterior stromal infiltrates in 41%,
sclerokeratitis in 1%, kerato-uveitis/endothelitis in 34%, serpiginous ulceration
in 7%, delayed corneal mucous plaques in 13%, disciform keratitis in 10%,
neurotrophic keratitis in 25%, and exposure keratitis in 11%. Some of the earlier
lesions seemed to result from viral infection, whereas later lesions resulted
from limbal vasculitis, an immunologic mechanism to soluble viral antigen, a
delayed hypersensitivity reaction, or damage to nerves and tissues. An
elucidation of the lesions awaits better viral and immunologic detection
techniques and further histopathologic study. Modern topical and systemic
antiviral therapy, corticosteroids, and surgery have a role in treatment.

PMID: 3873048 [PubMed - indexed for MEDLINE]

7242: Neurology. 1985 Mar;35(3):444.

Trigeminovascular neurons and the arteritis complicating herpes zoster
ophthalmicus.

Moskowitz MA, Henrikson BM.

Publication Types: 
    Letter

PMID: 3871925 [PubMed - indexed for MEDLINE]

7243: Neurology. 1985 Mar;35(3):442-4.

Angiography in herpes zoster ophthalmicus and delayed contralateral hemiparesis.

Tabbaa M, Selhorst JB.

Publication Types: 
    Case Reports
    Letter

PMID: 3871924 [PubMed - indexed for MEDLINE]

7244: Med Sestra. 1985 Mar;44(3):39-43.

[Herpes zoster (shingles)]

[Article in Russian]

Malkova EV, Malkov GF.

PMID: 3846735 [PubMed - indexed for MEDLINE]

7245: Infect Control. 1985 Mar;6(3):120-1.

Lack of nosocomial spread of Varicella in a pediatric hospital with negative
pressure ventilated patient rooms.

Anderson JD, Bonner M, Scheifele DW, Schneider BC.

All patients at the new British Columbia's Children's Hospital with chickenpox or
Herpes zoster are nursed with appropriate precautions in single-bed rooms
provided with negative pressure ventilation. Over a period of 1 year, no
nosocomial infections were detected on follow-up of 110 susceptible patients who 
had been on wards at the same time as six cases of chickenpox and one
immunocompromised patient with cutaneous dissemination of Varicella zoster. In a 
preceding study at the previous hospital, with similar staff, control measures,
and patient population, in an isolation facility without negative pressure
ventilation, nosocomial infections occurred in seven out of 41 susceptible
patients who were on the same ward as two patients with chickenpox. These
findings suggest that a simple negative pressure ventilation system without air
locks is a useful adjunct in the control of cutaneous Varicella infections.

PMID: 3845064 [PubMed - indexed for MEDLINE]

7246: Geriatr Nurs. 1985 Mar-Apr;6(2):74-8.

Understanding herpes zoster and relieving its discomfort.

Hallal JC.

PMID: 3844359 [PubMed - indexed for MEDLINE]

7247: Acta Pathol Jpn. 1985 Mar;35(2):517-25.

Congenital nephrotic syndrome (Finnish type).

Fujinami M, Hane Y, Ito K, Kajita A.

The case was a one year and four months old boy, who had been diagnosed as
congenital nephrotic syndrome on the 4th day of life. He died of septicemia from 
peritonitis. Large pale kidneys, dilated trunk of pulmonary artery, and thickened
left atrial endocardium were observed at autopsy. Renal histology seemed to be
compatible with congenital nephrotic syndrome of the Finnish type. Viral antigens
of herpes simplex type 1 and varicella-zoster in paraffin-embedded sections were 
proven to be negative. Besides renal change, increased number of pancreatic
islets without hypertrophy was noticed.

Publication Types: 
    Case Reports

PMID: 2992230 [PubMed - indexed for MEDLINE]

7248: Med Clin North Am. 1985 Mar;69(2):415-29.

Acute viral encephalitis.

Ho DD, Hirsch MS.

Clinical manifestations of acute viral encephalitis are described, differential
diagnoses are outlined, and a diagnostic approach is recommended. Encephalitic
syndromes caused by arboviruses, herpesviruses, enteroviruses, and parainfectious
processes are discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2985888 [PubMed - indexed for MEDLINE]

7249: J Med Virol. 1985 Mar;15(3):215-22.

Identification and typing of herpes simplex virus types 1 and 2 by monoclonal
antibodies, sensitivity to the drug (E)-5-(2-bromovinyl)-2'-deoxyuridine, and
restriction endonuclease analysis of viral DNA.

Zimmerman DH, Mundon FK, Croson SE, Henchal LS, Docherty JJ, O'Neill SP.

With development of antiviral drugs, the need to identify a virus as to drug
sensitivity becomes increasingly of importance. The compound
(E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) has been shown to be much more
inhibitory to the replication of herpes simplex virus type 1 (HSV-1) and
varicella-zoster virus as opposed to herpes simplex virus type 2 (HSV-2). We have
typed over 170 isolates, using an immunofluorescent technique and sensitivity to 
the drug BVDU. These results were then compared to the typing of isolates by
analysis of viral DNA after restriction endonuclease digestion (EcoRI). Without
exception the results were in agreement between the monoclonal antibody results
and sensitivity to the drug BVDU. Furthermore, the typing with monoclonal
antibodies was also in excellent agreement with the DNA analysis. Only those
isolates inhibited with BVDU showed DNA characteristics of HSV-1 and reacted only
with the S-200 antibody. On the other hand, those isolates which reacted with the
monoclonal antibody S-141 were insensitive to BVDU, and again this was in
agreement with the DNA analysis. These results could provide the basis for
developing a diagnostic test using the two monoclonal antibodies to type either
isolates or direct smears and to use the results as a basis for possible drug
therapy.

Publication Types: 
    Comparative Study

PMID: 2984324 [PubMed - indexed for MEDLINE]

7250: Am J Clin Pathol. 1985 Mar;83(3):371-4.

Detection of viral and chlamydial antigens in open-lung biopsy specimens.

Gleaves CA, Smith TF, Wold AD, Wilson WR.

The recovery of viruses and Chlamydia trachomatis from cell cultures and the
detection of their antigens in impression smears prepared from open-lung biopsy
(OLB) specimens from immunocompromised adults were compared. Touch impression
smears were prepared on three slides, each containing eight wells. OLB tissue was
homogenized (Stomacher) and inoculated into MRC-5, primary monkey kidney, and
McCoy cell cultures. The direct and indirect immunofluorescence (IF) tests were
used to detect antigens to the following organisms: herpes simplex virus,
adenovirus, parainfluenza types 1 and 3, respiratory syncytial virus,
cytomegalovirus (CMV), Chlamydia trachomatis, influenza types A and B, and
varicella-zoster virus. Of 105 OLB specimens, 21 viral isolates (20%) were
recovered in cell culture; 20 were CMV and one was an influenza virus type A
(H3N2). Both culture and IF results were positive with 12 specimens, but in nine 
instances a virus was isolated and IF was negative or eight times culture results
did not yield the organism but IF test results were positive. Chlamydia
trachomatis was never isolated or detected by IF. The authors recommend that for 
optimal detection of CMV from OLB specimens a new rapid centrifugation-enhanced
cell culture system be used in preference, or in conjunction with a preliminary
IF screen of impression smears for CMV detection.

PMID: 2983526 [PubMed - indexed for MEDLINE]

7251: Transplantation. 1985 Mar;39(3):279-81.

Prophylactic oral acyclovir after renal transplantation.

Pettersson E, Hovi T, Ahonen J, Fiddian AP, Salmela K, Hockerstedt K, Eklund B,
von Willebrand E, Hayry P.

In a double-blind, controlled study 35 herpes simplex virus (HSV)
antibody-positive patients were randomized to receive oral acyclovir 200 mg X 4
daily or placebo for 28 days following renal transplantation. The incidence of
herpes virus infection was compared in both groups by weekly virus
demonstration/isolation testing from throat swabs and urine, and by serum
antibody demonstration. None of the 18 patients allocated to acyclovir showed any
signs of HSV or varicella zoster virus (VZV) infection during the trial period,
whereas 9 of 17 receiving placebo had signs of HSV (P less than 0.001) and 2 of
VZV (P less than 0.05) infection. Because of systemic as well as local symptoms
of infection in five of the placebo patients, the trial was interrupted and
treatment with oral acyclovir instituted. All of them responded well with rapid
disappearance of all symptoms. Cytomegalovirus (CMV) was isolated from the urine 
of two patients in both groups during the trial period; a significant antibody
rise was seen later in three of them. There was no evidence of drug-related
toxicity during the study.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2983461 [PubMed - indexed for MEDLINE]

7252: Med J Aust. 1985 Feb 18;142(4):283-4.

Herpes zoster and cimetidine.

[No authors listed]

Publication Types: 
    Letter

PMID: 3974481 [PubMed - indexed for MEDLINE]

7253: Br Med J (Clin Res Ed). 1985 Feb 16;290(6467):509-11.

Long term effects of exposure to viral infections in utero.

Fine PE, Adelstein AM, Snowman J, Clarkson JA, Evans SM.

An analysis was conducted of the major findings of a long term follow up study of
3076 subjects who were exposed to viral infections in utero and who at the time
of analysis were up to 40 years of age. Mortality and morbidity were compared
with those in a control population matched for sex and date and area of birth. An
excess of cancers (16 cases against seven) appeared to be clustered among those
exposed to herpes viruses (varicella or cytomegalovirus). There was evidence of
an increased risk of diabetes among those exposed to mumps during the first
trimester (four cases among 128 subjects against none in 148 controls). The most 
surprising finding was a decrease of diseases of the skin and subcutaneous tissue
and of the nervous system among subjects exposed to antenatal varicella zoster
infection. The mechanism for the association may include production of fetal
anti-idiotype antibodies in response to transplacentally acquired maternal
autoantibodies.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3918651 [PubMed - indexed for MEDLINE]

7254: Can Med Assoc J. 1985 Feb 15;132(4):392-5.

Neurotoxic effects during vidarabine therapy for herpes zoster.

Burdge DR, Chow AW, Sacks SL.

Two cases of neurotoxic effects resulting from therapy with vidarabine are
described. Both patients were undergoing treatment for cutaneously disseminated
herpes zoster complicating therapy for solid malignant tumours. Both had normal
renal function. The serum levels of hepatic enzymes were normal in one patient
and slightly elevated in the other. Neurotoxicity was first manifested in both
patients by the development of intention tremors that progressed to gross
tremors. Obtundation, coma and death ensued in one patient and pain syndromes in 
the other. Vidarabine-induced neurotoxic effects, which may occur in the absence 
of hepatic or renal dysfunction or treatment with another drug, may be mild
initially but may progress rapidly to more serious, even life-threatening,
conditions. Presentation of neurotoxic effects should be considered an indication
for withdrawal of vidarabine.

Publication Types: 
    Case Reports

PMID: 3971255 [PubMed - indexed for MEDLINE]

7255: Clin Ter. 1985 Feb 15;112(3):203-16.

[Nosology, clinical aspects and therapy of herpes zoster]

[Article in Italian]

Gottwald W.

Publication Types: 
    English Abstract
    Review

PMID: 3896619 [PubMed - indexed for MEDLINE]

7256: Fortschr Med. 1985 Feb 14;103(6):130-2.

[Therapy of recurrent herpes infections with oral acyclovir]

[Article in German]

Nolting S.

Publication Types: 
    English Abstract

PMID: 3988215 [PubMed - indexed for MEDLINE]

7257: N Z Med J. 1985 Feb 13;98(772):70.

Cimetidine and herpes zoster.

Pryor WJ.

Publication Types: 
    Letter

PMID: 3856143 [PubMed - indexed for MEDLINE]

7258: Emerg Med Serv. 1985 Mar-Apr;14(2):48.

Chickenpox, shingles and EMS.

West KH.

PMID: 10269642 [PubMed - indexed for MEDLINE]

7259: Med Clin (Barc). 1985 Feb 2;84(4):138-42.

[Clinical features and application of enzyme immunoassay in a herpes zoster
meningitis series]

[Article in Spanish]

Martinez Martin P, Estevez Guerra E, Grande Perez J, Valenzuela Conthe MP, Rapun 
Pac JL, Garcia Saiz A, Echevarria Mayo JM.

Publication Types: 
    English Abstract

PMID: 2984486 [PubMed - indexed for MEDLINE]

7260: J Assoc Physicians India. 1985 Feb;33(2):185.

Pre-eruption herpes zoster myelitis.

Yeolekar ME, Banavali S, Menon PS.

Publication Types: 
    Case Reports
    Letter

PMID: 3997768 [PubMed - indexed for MEDLINE]

7261: Acta Neurol (Napoli). 1985 Feb;7(1):32-4.

Brachial monoparesis following herpes zoster.

Verma AK, Maheshwari MC.

Publication Types: 
    Case Reports

PMID: 3993457 [PubMed - indexed for MEDLINE]

7262: Postgrad Med J. 1985 Feb;61(712):145-6.

A case of herpes zoster associated encephalitis with rapid response to acyclovir.

Cheesbrough JS, Finch RG, Ward MJ.

A case of herpes zoster encephalitis which responded very rapidly to acyclovir is
presented. The differential serum: cerebrospinal fluid antibody response was
followed and its value in making the diagnosis is discussed. The penetration of
acyclovir into the cerebrospinal fluid was measured, and found to be in agreement
with predicted values.

Publication Types: 
    Case Reports

PMID: 3983042 [PubMed - indexed for MEDLINE]

7263: N C Med J. 1985 Feb;46(2):83-4.

Successful therapy of postherpetic neuralgia of the trigeminal nerve.

Grosshandler S, Gray W.

Publication Types: 
    Case Reports

PMID: 3920535 [PubMed - indexed for MEDLINE]

7264: J Neurol Neurosurg Psychiatry. 1985 Feb;48(2):122-7.

Herpes zoster ophthalmicus followed by contralateral hemiparesis: report of two
cases and review of literature.

Reshef E, Greenberg SB, Jankovic J.

Two patients with herpes zoster ophthalmicus and contralateral hemiparesis are
described, and their findings compared with 49 patients previously reported.
These patients presented with delayed contralateral hemiparesis approximately
seven weeks after the onset of herpes zoster ophthalmicus. Most patients had
evidence of infarction of the ipsilateral middle cerebral artery by angiography
or by CT scan. Cerebrospinal fluid pleocytosis and elevated protein commonly were
found. Twenty per cent of the reported patients died, but they were older than
the patients who survived and predisposed to have diffuse CNS lesions. The
pathogenesis of this syndrome is thought to be due to direct viral invasion of
the blood vessel wall with resulting angiitis. Further studies need to be
performed to clarify the role of specific antiviral therapy or anti-inflammatory 
agents in treating this complication of herpes zoster.

Publication Types: 
    Case Reports
    Review

PMID: 3884741 [PubMed - indexed for MEDLINE]

7265: J Infect Dis. 1985 Feb;151(2):362-5.

Adverse effects of high-dose intravenous acyclovir in ambulatory patients with
acute herpes zoster.

Bean B, Aeppli D.

Publication Types: 
    Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 3881542 [PubMed - indexed for MEDLINE]

7266: Soins. 1985 Feb;(447):33-4.

[Zona]

[Article in French]

Reinert P.

PMID: 3846363 [PubMed - indexed for MEDLINE]

7267: RN. 1985 Feb;48(2):52-62.

Easing the discomfort of herpes zoster.

Hallal JC.

Publication Types: 
    Case Reports

PMID: 3844277 [PubMed - indexed for MEDLINE]

7268: Aust N Z J Med. 1985 Feb;15(1):43-4.

A case of herpes zoster associated encephalitis treated with acyclovir.

Bowman RV, Lythall DA, de Wytt CN.

The case of a 67 year old male who developed severe encephalitis associated with 
herpes zoster ophthalmicus is described. Encephalitis occurred in the absence of 
cutaneous dissemination and recovery followed treatment with Acyclovir.

Publication Types: 
    Case Reports

PMID: 2988489 [PubMed - indexed for MEDLINE]

7269: Zentralbl Bakteriol Mikrobiol Hyg [B]. 1985 Feb;180(2-3):107-20.

[Prevention and therapy of herpesvirus infections]

[Article in German]

Abb J.

The group of the human-pathogenic herpesviruses comprises five subgroups: Herpes 
simplex virus type 1 (HSV-1), Herpes simplex virus type 2 (HSV-2), varicella
zoster virus (VZV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). Primary 
infection with these ubiquitous herpesviruses usually occurs in childhood or
during adolescence and frequently remains inapparent. However, it can also give
rise to a variety of clinical pictures. Important clinical manifestations of
herpesvirus infections are mucocutaneous lesions (HSV-1, HSV-2, VZV)
self-limited, lymphoproliferative diseases (CMV, EBV) and congenital
malformations (CMV). Primary infection with herpesviruses leads to a persistent
infection of the host. This clinically silent condition of latency can be
interrupted and may cause pathological symptoms to recur by reactivation of
latent herpesviruses. A classical example of the clinical manifestation of
herpesvirus reactivation is herpes zoster following an overcome varicella
disease. The mechanism of herpesvirus reactivation has not yet been fully
clarified. Reactivation of herpesviruses might be attributable to a weakening of 
the cellular immunodefence. For the control of viral infections mainly two
cellular effector systems are responsible: unspecific, cytotoxic, natural killer 
(NK) cells and specific cytotoxic thymus-dependent (T) lymphocytes. The
functional impairment of these cytotoxic active cells my cause herpesvirus
reactivation in immunodeficient or immunosuppressed persons. Interference with
the immunological control function may also contribute to the genesis of
herpesvirus-associated tumours. Such an association between herpesviruses and
human tumours is assumed to exist especially in the case of EBV. The frequently
life-endangering severity of local or disseminated herpesvirus infections calls
for suitable measures ensuring efficient prophylaxis and therapy. However, the
possibilities of a specific immunoprophylaxis (vaccine, special immunoglobulins) 
against herpesvirus infections are still rather limited. The development of
antiviral substances has greatly benefited from the introduction of new agents
(Acyclovir) and the production of sufficient quantities of interferon (IFN)
preparations during the last few years. Impressive results were obtained with the
nucleoside-related substance Acyclovir in the prevention and therapy of primary
or reactivated HSV-1 or HSV-2 infections. The use of Acyclovir as prophylactic
agent produced the effect that recipients of bone-marrow transplants were no
longer afflicted by HSV-1 infections.(ABSTRACT TRUNCATED AT 400 WORDS)

Publication Types: 
    English Abstract
    Review

PMID: 2986378 [PubMed - indexed for MEDLINE]

7270: Internist (Berl). 1985 Feb;26(2):68-72.

[Latent persistent infection caused by herpes simplex and varicella zoster virus]

[Article in German]

Schneweis KE.

PMID: 2984134 [PubMed - indexed for MEDLINE]

7271: J Med Virol. 1985 Feb;15(2):183-95.

Use of enzyme-labeled antigen for the detection of immunoglobulin M and A
antibody to herpes simplex virus in serum and cerebrospinal fluid.

van Loon AM, van der Logt JT, Heessen FW, van der Veen J.

A direct enzyme-linked immunosorbent assay (ELISA that used peroxidase-labeled
antigen) was developed for detection of IgM and IgA antibody to herpes simplex
virus (HSV). The assay uses immuno-affinity-purified antihuman IgM or IgA
antibody-coated wells of microtiter plates to separate IgM or IgA from other
classes of antibody in serum or cerebrospinal fluid (CSF). The presence of
specific IgM or IgA is detected by subsequent, consecutive incubation with
peroxidase-labeled antigen and substrate. HSV antigen was purified by sucrose
gradient centrifugation and coupled with peroxidase by the periodate method. By
examining sucrose-gradient-fractionated sera the assays were shown to be specific
for IgM and IgA classes of antibody. None of the sera from patients with
Epstein-Barr virus (n = 20), cytomegalovirus (n = 20), or varicella-zoster virus 
(n = 8) infection or with both rheumatoid factor and IgG antibody to HSV (n = 13)
reacted positively. Only one out of 78 sera from healthy persons was positive for
IgA antibody to HSV, and none for IgM antibody. All 33 patients with HSV
infection developed HSV-IgA, 22 developed HSV-IgM. Of the 11 patients with
primary infection, all had IgM antibody in their first sera and six had IgA
antibody. The corresponding figures for the 22 patients with recurrent infection 
were five and nine. Furthermore, HSV-IgA antibody was found in serum and CSF of
all five patients with HSV encephalitis in the second week after onset of
symptoms, indicating the usefulness of the assay as a noninvasive technique for
diagnosing HSV encephalitis.

PMID: 2983012 [PubMed - indexed for MEDLINE]

7272: J Pediatr. 1985 Feb;106(2):259-61.

Herpes zoster following varicella vaccine in a child with acute lymphocytic
leukemia.

Williams DL, Gershon AA, Gelb LD, Spraker MK, Steinberg S, Ragab AH.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2982006 [PubMed - indexed for MEDLINE]

7273: JAMA. 1985 Jan 25;253(4):511.

Fulminant varicella hepatitis following bone marrow transplantation.

Morishita K, Kodo H, Asano S, Fujii H, Miwa S.

Publication Types: 
    Case Reports
    Letter

PMID: 2982045 [PubMed - indexed for MEDLINE]

7274: Br Med J (Clin Res Ed). 1985 Jan 19;290(6463):177-8.

Clinical use of acyclovir.

Jeffries DJ.

Publication Types: 
    Editorial

PMID: 3917742 [PubMed - indexed for MEDLINE]

7275: Pol Tyg Lek. 1985 Jan 14;40(2):45-6.

[Results of treatment of herpes simplex and herpes zoster with isoprinosine]

[Article in Polish]

Polubiec A, Kolakowska-Polubiec K, Stepka K.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 2579368 [PubMed - indexed for MEDLINE]

7276: Orv Hetil. 1985 Jan 13;126(2):63-6.

[Diagnostic antibody tests for the detection of central nervous system diseases
caused by herpes simplex and varicella zoster viruses]

[Article in Hungarian]

Simon M, Koller M.

Publication Types: 
    English Abstract

PMID: 2982121 [PubMed - indexed for MEDLINE]

7277: Med J Aust. 1985 Jan 7;142(1):78.

Cimetidine for herpes zoster.

Fitzhenry J.

Publication Types: 
    Case Reports
    Letter

PMID: 3965888 [PubMed - indexed for MEDLINE]

7278: Eur Neurol. 1985;24(5):314-8.

Fisher's syndrome following trigeminal herpes zoster.

Uematsu D, Satoh T, Tanahashi N, Koto A, Gotoh F.

A case of Fisher's syndrome associated with trigeminal herpes zoster is reported 
for the first time. Retrograde propagation of the virus to the brainstem through 
the trigeminal root was thought to be the most probable pathogenic mechanism. We 
provide additional evidence suggesting that the focus of Fisher's syndrome is in 
the brainstem.

Publication Types: 
    Case Reports

PMID: 4054180 [PubMed - indexed for MEDLINE]

7279: Med Pregl. 1985;38(1-2):45-7.

[Generalized varicelliform herpes zoster]

[Article in Croatian]

Madle-Samardzija N, Tesin S, Milovanov A.

Publication Types: 
    Case Reports
    English Abstract

PMID: 4033555 [PubMed - indexed for MEDLINE]

7280: Minerva Anestesiol. 1985 Jan-Feb;51(1-2):45-50.

[Treatment of pain in acute herpes zoster and post-herpetic neuritis]

[Article in Italian]

Bassino P, Bandini M, Dal Tio R.

Publication Types: 
    English Abstract

PMID: 4022404 [PubMed - indexed for MEDLINE]

7281: Rev Neurol (Paris). 1985;141(3):234-6.

[Zoster myelitis. Immunological study and treatment with acyclovir]

[Article in French]

Mas JL, Lapresle J.

A case of thoracic herpes zoster in a 52 year old man was succeeded by
myelopathy. Intrathecal synthesis of varicella-zoster antibodies was
demonstrated. Myelopathy rapidly improved upon treatment with acyclovir.

Publication Types: 
    Case Reports
    English Abstract

PMID: 4001711 [PubMed - indexed for MEDLINE]

7282: Eur J Pediatr. 1985 Jan;143(3):198-202.

Oral BVDU treatment of varicella and zoster in children with cancer.

Benoit Y, Laureys G, Delbeke MJ, De Clercq E.

In the period June 1980-April 1983, 21 children with malignant disease were
admitted because of an intercurrent varicella or zoster infection. They were
treated with the new antiviral drug BVDU [(E)-5-(2-bromovinyl)-2'-deoxyuridine]. 
The drug was administered orally at a dose of 15 mg/kg per day for 5 days. All
our patients responded promptly to BVDU treatment and recovered completely from
their varicella or zoster infections without complications. No toxic side-effects
due to the drug were observed.

PMID: 3987714 [PubMed - indexed for MEDLINE]

7283: Z Hautkr. 1985 Jan;60(1-2):204, 207-10.

[Passive immunotherapy in herpes zoster. A pilot study with intravenous
hyperimmune globulin]

[Article in German]

Kaufmann R.

While passive immunisation with hyperimmune globulin proved beneficial for the
prevention of varicella infections in immuno-compromised patients, there has been
no reliable evidence for such preparations to be effective with the treatment of 
or prophylaxis against zoster complications. This may be partly due to the minor 
significance of the humoral immune response in herpes zoster as well as to
insufficient bioavailability of the preparation when administered
intramuscularly. In an openly and prospectively conducted study, a recently
available varicella-zoster hyperimmune globulin was intravenously given to an
unselected group of 20 in-patients suffering from herpes zoster. There have not
been observed any side effects. If therapy was started within the first week of
manifestation of the disease (15 test persons), the patients showed rapid and
uncomplicated healing.

Publication Types: 
    English Abstract

PMID: 3984430 [PubMed - indexed for MEDLINE]

7284: J Pediatr. 1985 Jan;106(1):71-3.

Tooth exfoliation and osteonecrosis of the maxilla after trigeminal herpes
zoster.

Garty BZ, Dinari G, Sarnat H, Cohen S, Nitzan M.

Publication Types: 
    Case Reports

PMID: 3965684 [PubMed - indexed for MEDLINE]

7285: Rev Clin Basic Pharm. 1985 Jan-Jun;5(1-2):1-33.

Medical use of dimethyl sulfoxide (DMSO).

Swanson BN.

DMSO is a clear odorless liquid, inexpensively produced as a by-product of the
paper industry. It is widely available in the USA as a solvent but its medical
use is currently restricted by the FDA to the palliative treatment of
interstitial cystitis and to certain experimental applications. Cutaneous
manifestations of scleroderma appear to resolve (albeit equivocally) following
topical applications of high concentrations of DMSO. A limited number of small
clinical trials indicate that intravenous DMSO may be of benefit in the treatment
of amyloidosis, possibly by mobilizing amyloid deposits out of tissues into
urine. Dermal application of DMSO seems to provide rapid, temporary, relief of
pain in patients with arthritis and connective tissue injuries. However, claims
for antiinflammatory effects or acceleration of healing are currently
unwarranted. There is no evidence that DMSO can alter progression of degenerative
joint disease, and, for this reason, DMSO may be considered for palliative
treatment only and not to the exclusion of standard antiinflammatory agents. The 
safety of DMSO in combination with other drugs has not been established;
neurotoxic interactions with sulindac have been reported. In experimental
animals, intravenous DMSO is as effective as mannitol and dexamethasone in
reversing cerebral edema and intracranial hypertension. An initial clinical trial
in 11 patients tends to support this latter application. DMSO enhances diffusion 
of other chemicals through the skin, and, for this reason, mixtures of
idoxuridine and DMSO are used for topical treatment of herpes zoster in the UK.
Adverse reactions to DMSO are common, but are usually minor and related to the
concentration of DMSO in the medication solution. Consequently, the most frequent
side effects, such as skin rash and pruritus after dermal application,
intravascular hemolysis after intravenous infusion and gastrointestinal
discomfort after oral administration, can be avoided in large part by employing
more dilute solutions. Most clinical trials of DMSO have not incorporated the
components of experimental design necessary for objective, statistical evaluation
of efficacy. Randomized comparisons between DMSO, placebo and known active
treatments were rarely completed. Final approval of topical DMSO for treatment of
rheumatic diseases in particular will require a multi-center, randomized
comparison between high and low concentrations of DMSO and an orally-active,
nonsteroidal antiinflammatory agent.(ABSTRACT TRUNCATED AT 400 WORDS)

Publication Types: 
    Review

PMID: 3916302 [PubMed - indexed for MEDLINE]

7286: Clin Ther. 1985;8(1):90-9.

Infections in immunocompromised patients. I. Pathogenesis, etiology, and
diagnosis.

Klastersky J.

Granulocytopenia is the major factor predisposing cancer patients to infection,
chiefly by bacteria. Most of the infections are caused by gram-negative aerobic
organisms (Escherichia coli, Pseudomonas aeruginosa, and Klebsiella sp) that
arise from endogenous gastrointestinal, mucosal, or cutaneous flora (often
modified by hospital-acquired pathogens). Some fungi (Candida sp and Aspergillus 
sp) are also likely to invade granulocytopenic patients. The next most important 
factor predisposing cancer patients to infection is alteration of anatomic
barriers. Mucosal and skin protection is compromised by tumors, radiotherapy,
chemotherapy, surgical diagnostic and therapeutic procedures, and intravenous
lines and other devices. The pathogens found in cases of altered anatomical
barriers are similar to those encountered in patients with granulocytopenia,
which is a major cause of alteration of anatomical barriers. The third factor
predisposing patients to serious bacterial and nonbacterial infections is
immunosuppression, especially in patients with lymphomas, multiple myelomas, and 
chronic lymphatic leukemia. The pathogens isolated in these patients include
Listeria monocytogenes, Salmonella sp, Brucella sp, Mycobacterium sp, and
Nocardia asteroides, although P aeruginosa and staphylococci may be found as
well. Viruses (herpes simplex, herpes zoster, and vaccinia), parasites, fungi,
and Pneumocystis carinii and Toxoplasma gondii are involved in many infections in
these patients, in whom cell-mediated immunity is impaired. In neutropenic
patients, antimicrobial or antifungal therapy should be instituted before the
microbiological diagnosis is made; in immunosuppressed patients, therapy is
optimally guided by a specific microbiological diagnosis.

PMID: 3914372 [PubMed - indexed for MEDLINE]

7287: Scand J Infect Dis Suppl. 1985;47:80-4.

The treatment of herpes zoster infections.

Peterslund NA.

A review of the many past and present therapeutic attempts in herpes zoster is
given. Serious candidates are interferon, idoxuridine, adenine arabinoside, and
acyclovir. Cumbersome administration and risk of side effects make acyclovir
today's choice. The treatment with acyclovir has been improved by the
availability of an oral formulation. The development of a well-absorbed prodrug, 
6-deoxyacyclovir may in the future replace conventional acyclovir tablets in
non-emergency cases.

Publication Types: 
    Clinical Trial

PMID: 3912976 [PubMed - indexed for MEDLINE]

7288: Scand J Infect Dis Suppl. 1985;47:76-9.

Oral acyclovir in herpes zoster.

McKendrick MW.

Zoster is a common disease that may be associated with severe and protracted
pain. Antiviral therapy with acyclovir intravenously has been shown to modify the
course of the disease and reduce pain during the acute phase. The results of two 
studies using doses of 400 mg and 800 mg of acyclovir orally are outlined. The
data suggest a significant benefit of the higher dose treatment on the course of 
the illness and the pain.

Publication Types: 
    Clinical Trial

PMID: 3912975 [PubMed - indexed for MEDLINE]

7289: Scand J Infect Dis Suppl. 1985;47:145-8.

Acyclovir and renal transplantation.

Pettersson E, Eklund B, Hockerstedt K, Salmela K, Ahonen J.

The efficacy of oral acyclovir to prevent reactivation of herpes simplex virus
(HSV) in seropositive renal allograft recipients was tested in a double-blind
placebo controlled study. None of the 18 patients allocated to acyclovir showed
any signs of HSV infection. In contrast, 11/17 on placebo (p less than 0.001),
had signs of HSV or varicella zoster virus (VZV) infection--in 5 patients severe 
enough to interrupt the trial and initiate treatment with oral acyclovir. Soon
after cessation of the trial, HSV was isolated from the throats of 6 patients on 
acyclovir, and 1 developed shingles 3 months later. Oral acyclovir prophylaxis
thus effectively protected the patients from reactivation of HSV and VZV while
they were receiving the drug, but could not prevent disease once off the drug.
Treatment with acyclovir brought rapid relief of both local and general symptoms 
in all patients. No adverse reactions were seen. As a consequence of these
experiences our goal in subsequent transplant patients has been either early
therapeutic intervention with oral acyclovir whenever signs of HSV or VZV
infection have been noted, or prophylactic remedy in patients at particular risk 
to develop troublesome herpetic lesions after renal transplantation.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't

PMID: 3912970 [PubMed - indexed for MEDLINE]

7290: Med Pr. 1985;36(2):123-30.

[Ototoxic factors requiring consideration in the diagnosis of occupational
hearing loss]

[Article in Polish]

Grzesik J, Rzymelka S.

In the practice of diagnosing occupational deafness resulting from noise effects 
of factors determining workers' hearing, such as living conditions, working
conditions, nutritional and other habits, diseases and their therapy, are often
neglected. Discussed in the paper are the significance and ototoxic effects of
such factors as: aminoglycoside antibiotics, diuretics, salicylic acid
derivatives, fenacetin, quinine, fluorine compounds, cytotoxic drugs, chemical
compounds other than drugs (carbon monoxide, carbon disulphide, lead, organic
solvents), ethyl alcohol, diseases (abdominal typhus, bacillary dysentery,
diphtheria, brucellosis, epidemic parotiditis, poliomyelitis, rubella, aural
shingles, syphilis, diabetes mellitus, chronic renopathies, hypothyroidism,
serologic conflict, pigmentary retinitis). Exposure to intense noise is more and 
more frequently juxtaposed with the impact of the mentioned factors. If
industrial physicians get aware of this association the prevention of deafness
and reliability of treatment may be largely promoted.

Publication Types: 
    English Abstract
    Review

PMID: 3906348 [PubMed - indexed for MEDLINE]

7291: Ariz Med. 1985 Jan;42(1):16-9.

Treatment of pain due to herpes zoster infections.

Borowsky S, Shetter AG.

Publication Types: 
    Review

PMID: 3883956 [PubMed - indexed for MEDLINE]

7292: West J Med. 1985 Jan;142(1):117-8.

Treatment of herpes zoster with corticosteroids--fact or faith?

Levinson W, Shaw JC.

Publication Types: 
    Clinical Trial

PMID: 3883657 [PubMed - indexed for MEDLINE]

7293: Scand J Infect Dis Suppl. 1985;47:85-8.

Herpes zoster ocular infection.

McGill J.

A retrospective analysis of 171 patients with herpes zoster ocular infection has 
been carried out to determine the effect of treatment with either topical
acyclovir, topical steroids, or a combination of both. Acyclovir was superior to 
steroids and to the combination. Treatment with topical acyclovir was on average 
54 days compared with 200 days with steroids, and recurrences were 6% with
acyclovir compared with 50% with steroids.

PMID: 3879378 [PubMed - indexed for MEDLINE]

7294: Cornea. 1985-1986;4(1):14-8.

Bacterial infection of a neurotrophic cornea in an immunocompromised subject.

Webb RM, Duke MA.

The following is a case report of a 61-year-old woman with a 10-year history of
pemphigus vulgaris, successfully treated with steroids and cytotoxic agents. The 
patient developed severe herpes zoster ophthalmicus, complicated by a
staph-indolent corneal ulcer. This case illustrates several of the many
unfortunate ophthalmological complications that may develop in the
immunocompromised patient.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 3879210 [PubMed - indexed for MEDLINE]

7295: Am J Pediatr Hematol Oncol. 1985 Spring;7(1):9-14.

Spontaneous remission of Burkitt's lymphoma associated with herpes zoster
infection.

McClain K, Warkentin P, Kay N.

A 12-year-old white female with recurrent Burkitt's lymphoma had a spontaneous
remission associated with a localized herpes zoster infection. The remission
lasted nearly 2 months before the tumor recurred in the central nervous system.
LDH isoenzyme determinations done on an earlier ovarian tumor and serum at time
of bone marrow relapse showed different predominant LDH isoenzyme patterns. These
data might be interpreted as showing that different malignant cell clones were
responsible for ovarian and bone marrow relapses. Studies to elucidate the
mechanism of spontaneous remission at the time of zoster infection demonstrated
serum factor(s) which stimulated normal B lymphocytes.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 3876039 [PubMed - indexed for MEDLINE]

7296: Ter Arkh. 1985;57(5):127-30.

[Clinical course of herpes zoster in middle-aged and elderly persons]

[Article in Russian]

Bogomolov BP, Bakhur EG.

The clinical progress of herpes zoster (HZ) was studied in 216 patients under 60 
years and in elderly and senile persons. A clear relationship was revealed
between the gravity of the clinical progress of HZ and the patients' age. The
number of patients with grave HZ patterns and with HZ of medium gravity was found
to be increasing in elderly and senile persons. It was also established that HZ
took a graver course in patients aggravated with concomitant pathology. The
concomitant diseases are demonstrated to have a multifactorial aggravating effect
on the progress of HZ.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 3875159 [PubMed - indexed for MEDLINE]

7297: Zh Nevropatol Psikhiatr Im S S Korsakova. 1985;85(2):180-4.

[Immunologic characteristics of the pathogenesis of herpes zoster]

[Article in Russian]

Seletskaia TA, Shishov AS, Sysoeva KR.

Patients suffering from herpes zoster were subjected to immunological studies
including the determination of the levels of the main immunoglobulin classes
(IgA, IgM, IgG) in 102 subjects and the blast transformation test (19 subjects). 
Sufficiently tense humoral immunity and low reserve potentialities of
cell-mediated immunity were discovered. Based on the data obtained the authors
point to the necessity of using immunocorrecting agents, particularly levamisole,
in combined therapy of herpes zoster.

Publication Types: 
    English Abstract

PMID: 3872543 [PubMed - indexed for MEDLINE]

7298: Ann Ophthalmol. 1985 Jan;17(1):46-51.

Acute phthisis bulbi and external ophthalmoplegia in herpes zoster ophthalmicus.

Amanat LA, Cant JS, Green FD.

A patient developed acute phthisis bulbi and external ophthalmoplegia with herpes
zoster ophthalmicus (HZO). The clinical course and ocular complications of HZO
are described briefly and the cause of phthisis bulbi and external
ophthalmoplegia in zoster ophthalmicus is discussed. It is suggested that the
acute hypotonia in HZO is due to an ischemic necrosis of the ciliary body,
resulting from an occlusive vasculitis which may also be responsible for the
external ophthalmolplegia.

Publication Types: 
    Case Reports

PMID: 3872092 [PubMed - indexed for MEDLINE]

7299: Int Ophthalmol Clin. 1985 Spring;25(1):77-96.

Herpes zoster ophthalmicus.

Liesegang TJ.

PMID: 3871748 [PubMed - indexed for MEDLINE]

7300: Ter Arkh. 1985;57(5):105-7.

[Use of cytosar (cytosine arabinoside) in the control of herpetic complications
in patients with acute leukemia and lymphogranulomatosis]

[Article in Russian]

Berliner GB, Mendeleev IM, Polezhaev IuN, Arkavina EA, Miasnikov AA.

The authors report the use of the cytostatic drug cytosar in the control of
herpetic complications in patients with acute leukemia and lymphogranulomatosis. 
A distinct effect was obtained as a result of intravenous drip of cytosar in a
dose of 0.03-0.05 g for 2 days. It is desirable that cytosar therapy may be
instituted within the first days of the development of herpetic infection.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3860998 [PubMed - indexed for MEDLINE]

7301: Dtsch Z Mund Kiefer Gesichtschir. 1985 Jan-Feb;9(1):38-42.

[Apical osteitis and herpes zoster in the 3rd branch of the trigeminal nerve. A
case history]

[Article in German]

Rixecker H, Tetsch P.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3858038 [PubMed - indexed for MEDLINE]

7302: Appl Neurophysiol. 1985;48(1-6):277-80.

A method for bulbospinal trigeminal nucleotomy in the treatment of facial
deafferentation pain.

Siqueira JM.

Many types of facial pain are difficult to treat, such as postherpetic,
posttraumatic, or pain following denervation procedures used in the treatment of 
trigeminal neuralgia (anesthesia dolorosa), all of which involve deafferentation 
of the spinal trigeminal nucleus.

PMID: 3837649 [PubMed - indexed for MEDLINE]

7303: Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol. 1985
Jan-Mar;29(1):45-7.

[Therapeutic problems in zona ophthalmica]

[Article in Romanian]

Leibovici M, Nemoianu V.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3159051 [PubMed - indexed for MEDLINE]

7304: Rev Med Interna Neurol Psihiatr Neurochir Dermatovenerol Neurol Psihiatr
Neurochir. 1985 Jan-Mar;30(1):25-9.

[Clinical and physiopathological aspects of a case of recurrent
polyradiculoneuritis zoster]

[Article in Romanian]

Trusca E, Grubneac A, Stoica I.

Publication Types: 
    Case Reports
    English Abstract

PMID: 3158051 [PubMed - indexed for MEDLINE]

7305: Postgrad Med J. 1985;61 Suppl 4:85-92.

Vaccination of children with malignant disease against varicella.

Slordahl SH, Wiger D, Stromoy T, Degre M, Thorsby E, Lie SO.

Nineteen seronegative children and one young adult with malignant disease in
remission and on maintenance chemotherapy were immunized with the Oka-strain live
attenuated varicella vaccine (Varilrix). Side effects were moderate and a rash
was seen in 50% of the patients after vaccination. Humoral immune response to the
vaccine was tested by the fluorescent antibody to membrane antigen (FAMA) test, a
simpler indirect immunofluorescence test (IFT), and an enzyme-linked
immunosorbent assay (ELISA). The seroconversion rate after immunization varied
according to the method used. Seven out of 8 responded by FAMA, 15 out of 20 by
IFT, and 12 out of 20 by ELISA. A decline in post-vaccination varicella-zoster
virus (VZV) antibodies was seen in some responders. In 2 children, detectable
levels of passively transferred VZV antibodies at the time of vaccination, due to
varicella-zoster immune globulin, may have interfered with or modified the
response to the vaccine. Cross-reacting antibodies to herpes simplex virus may
have possibly interfered with vaccine response in a third child. Six out of 8
children receiving a second vaccine dose showed a good serological response.
Specific cell-mediated immune response to the vaccine, measured by lymphocyte
proliferation tests, corresponded well with the humoral response in the initial
study of 8 patients. Two children who had responded to the vaccine were exposed
to varicella in their families without contracting the clinical disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3014484 [PubMed - indexed for MEDLINE]

7306: Postgrad Med J. 1985;61 Suppl 4:7-14.

Clinical and pathogenetic aspects of varicella-zoster.

Plotkin SA.

In this review article the pathogenetic mechanisms of infection with the
varicella-zoster virus (VZV) and its short- and long-term clinical consequences
are discussed. It is concluded that the impact of VZV is severe enough to
seriously consider widespread immunization against it.

Publication Types: 
    Review

PMID: 3014481 [PubMed - indexed for MEDLINE]

7307: Postgrad Med J. 1985;61 Suppl 4:69-72.

Active immunization against varicella of children with acute leukaemia or other
malignancies on maintenance chemotherapy.

Haas RJ, Belohradsky B, Dickerhoff R, Eichinger K, Eife R, Holtmann H, Goetz O,
Graubner U, Peller P.

Twenty-six patients with acute leukaemia and other malignancies susceptible to
varicella were vaccinated with the Oka-strain live attenuated varicella vaccine
during maintenance chemotherapy. All recipients showed no adverse clinical
reactions. There was no spread of vaccine virus. Seroconversion was 94% in
seronegative patients. Among those having low antibody titres before vaccination,
a booster effect was demonstrable in 56%. None of the seroconverted recipients
contracted varicella despite documented contact exposure. No case of herpes
zoster occurred. The results suggest that, in immunocompromised children, live
varicella vaccination has a protective effect against varicella infection which
may result in a mortality rate of up to 7% in these patients.

PMID: 3014480 [PubMed - indexed for MEDLINE]

7308: Postgrad Med J. 1985;61 Suppl 4:61-7.

Clinical experience with Oka live varicella vaccine in Japan.

Takahashi M, Kamiya H, Baba K, Asano Y, Ozaki T, Horiuchi K.

A live varicella vaccine (Oka strain) has been developed and used since 1974 in
normal and diseased children, particularly those at high risk. Children with
acute leukaemia were usually vaccinated while in remission when showing a normal 
cell-mediated immunity as assessed with phytohaemagglutinin (PHA) or other
reagents, and during suspension of all anticancer therapy, except
6-mercaptopurine from 1 week before to 1 week after vaccination. While clinical
reactions were observed in only 40 out of 263 (15.2%) of these patients, they
were noted in 30 out of 72 (41.7%) children immunized without suspension of
chemotherapy. Symptoms were mostly mild; only a few cases of the latter group
with T-cell leukaemia or malignant lymphoma developed severe symptoms. An immune 
response was observed in most vaccinees, but some (11%) developed clinical
symptoms after exposure to natural varicella due to immunodepression caused by
continuing anticancer chemotherapy. In these cases, revaccination seems
advisable. The incidence and severity of zoster in vaccinated acute leukaemic
children were less than in those with natural infection. Satisfactory immune
responses with few concomitant clinical reactions were observed in approximately 
1,500 vaccinees having nonmalignant diseases and in about 4,000 normal children. 
A 7-10-year follow-up study revealed that the vaccine had conferred solid
immunity on the children. These results indicate that live varicella vaccine of
the Oka strain is useful in preventing varicella in high-risk as well as in
normal children.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 3014479 [PubMed - indexed for MEDLINE]

7309: Postgrad Med J. 1985;61 Suppl 4:23-30.

Management of varicella-zoster contact and infection in pregnancy using a
standardized varicella-zoster ELISA test.

Enders G.

An ongoing 5-year prospective study of the outcome of contact with
varicella-zoster virus (VZV) and infection in pregnant women has made use of a
standardized VZV enzyme-linked immunosorbent assay for the determination of
immune status and as a guide for therapeutic management. Out of of a total of 778
such cases investigated to date in the Federal Republic of Germany, 93.1% have
been shown to be VZV immune, whereas 6.9% were seronegative and, therefore,
susceptible to infection. Those of the latter group who received zoster
hyperimmunoglobulin (ZIG) between 24-96 hours after varicella contact remained
symptom-free, while women receiving ZIG from the 3rd-10th day after contact
developed a modified varicella. For the prevention of varicella, ZIG with known
titres should be administered at doses of 0.2-0.4 ml/kg. It is also recommended
for the newborn when maternal infection occurs within 4 days before until 2-4
days after delivery. The prevention and attenuation of varicella in pregnancy is 
justified since the outcomes may include spontaneous abortion in early pregnancy,
the congenital varicella syndrome, and severe neonatal disease with a rather high
mortality around term.

PMID: 3014475 [PubMed - indexed for MEDLINE]

7310: Postgrad Med J. 1985;61 Suppl 4:155-62.

The future of varicella vaccine.

Plotkin SA, Arbetter AA, Starr SE.

Based on conservative figures, an estimated 60 million varicella-zoster cases
occur annually worldwide, highlighting the global significance of this disease.
The development of a viable varicella vaccine, therefore, raises important
questions as to the indications for its use in normal children, normal
seropositive and seronegative adults, and immunocompromised patients. A review of
the available data addresses the potential future role of the varicella vaccine
in these groups.

Publication Types: 
    Review

PMID: 3014474 [PubMed - indexed for MEDLINE]

7311: Postgrad Med J. 1985;61 Suppl 4:147-50.

Stimulation of specific immune response to varicella antigens in the elderly with
varicella vaccine.

Duchateau J, Vrijens R, Nicaise J, D'Hondt E, Bogearts H, Andre FE.

Ageing is associated with several immune defects that probably lead to the
increased incidence of zoster observed after the 5th decade. In a double-blind
study to assess an eventual stimulation of the specific immune response against
the varicella-zoster virus by vaccination, either the Oka-strain live varicella
vaccine or a placebo was administered to 30 healthy volunteers over 70 years of
age, after a 4-week pretreatment period with either zinc acetate as an
immunostimulant or a placebo. Specific skin delayed hypersensitivity and antibody
levels measured by the fluorescent antibody to membrane antigen method were
recorded at the start of the pretreatment period, just before vaccination, and
two weeks or one month after vaccination. Initially decreased delayed-type
responses to varicella antigens were observed when compared with reported values 
for younger subjects despite normal levels of skin reactivity to common bacterial
antigens (Multitest). The varicella-specific responses were markedly boosted in
the 3 groups by repeated skin testing. As a result, the effects of zinc
pretreatment and vaccination were masked. On the other hand, treatment with zinc 
acetate was shown to increase tuberculin delayed reactions. Preexisting specific 
antibody titres were elevated and no significant changes occurred in the 3 study 
groups. The data suggest that it is not the potential for an immune response that
is decreased in the elderly but rather the speed of the response. This might be
the defect responsible for the increased incidence of zoster in this age group.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3014473 [PubMed - indexed for MEDLINE]

7312: Postgrad Med J. 1985;61 Suppl 4:143-5.

Restoration of varicella-zoster virus cell-mediated immune response after
varicella booster vaccination.

Berger R, Luescher D, Just M.

In older age groups, an increasing proportion of healthy adults with a positive
varicella history have lost their capacity for a cell-mediated immune (CMI)
response to varicella-zoster virus (VZV) antigen despite the presence of
virus-specific humoral antibodies. While it remains a matter of speculation
whether this decline is connected with a predisposition to herpes zoster, it is
known that a second zoster attack is rare in immunocompetent individuals. In
order to determine whether the VZV-specific CMI response can be restored through 
varicella vaccination, the immune status of a group with naturally occurring
herpes zoster was compared with that of a group of vaccinated subjects. Twenty
zoster patients were tested for VZV antibody and VZV-specific CMI within the
first 4 days of the disease. Antibodies were present in normal or moderately high
titres (mean: 2,900). Lymphocyte reactivity to VZV antigen was negative or weakly
positive in 17 of the 20 patients. After 6 weeks, antibody titres rose
significantly (mean: 36,000) and the lymphocyte response was highly positive in
11, weakly positive in 6, and remained negative in 3 patients. Thirty-three
healthy adults ranging in age from 55-65 years with a negative VZV-specific CMI, 
but positive VZV antibodies (mean: 190), were immunized with the Oka-strain
varicella vaccine (Varilrix). After 6 weeks, the mean antibody titre had only
increased slightly (mean: 400). However, a positive VZV-specific CMI response
occurred in 28 out of 33 subjects, while 5 remained negative. Therefore,
conversion from a negative to a positive CMI response can be achieved by
varicella vaccination of seropositive subjects. This raises the question whether 
booster vaccination of CMI-negative subjects could prevent zoster.

PMID: 3014472 [PubMed - indexed for MEDLINE]

7313: Postgrad Med J. 1985;61 Suppl 4:137-41.

Delayed hypersensitivity skin test to detect susceptibility to varicella and
zoster.

Berger R, Luescher D, Just M, D'Hondt E, Bogaert H.

A crude varicella skin-test antigen corresponding to an inactivated
partly-purified high-titre varicella Oka-strain vaccine was prepared at Smith
Kline-RIT. It was used for a delayed hypersensitivity skin test in 60 healthy
adults for determination of their immune status. The findings were analysed
according to the presence or absence of humoral antibodies to varicella-zoster
virus (VZV), and of a specific cell-mediated immune (CMI) response as measured by
the VZV-specific lymphocyte transformation test. The immune status to varicella
could be determined in all subjects provided that the amount of antigenic
material in the skin-test antigen was sufficiently high. The 2 tests for the CMI 
response, the delayed hypersensitivity skin test and the lymphocyte
transformation test, gave concordant results in both seropositive and
seronegative individuals. The inactivated skin-test antigen cannot replace
vaccination with the live varicella vaccine since it is unable to induce
seroconversion in seronegatives or an antibody booster response in seropositives.
Furthermore, seropositive and seronegative subjects showing a negative response
to the varicella-zoster-specific lymphocyte transformation test remained negative
2 weeks after the injection of the skin-test antigen.

Publication Types: 
    Comparative Study

PMID: 3014471 [PubMed - indexed for MEDLINE]

7314: Postgrad Med J. 1985;61 Suppl 4:103-6.

Varicella vaccine in children with chronic renal insufficiency.

Broyer M, Boudailliez B.

This study reports the antibody response and clinical follow-up of uraemic
children awaiting kidney transplantation after administration of the Oka-strain
varicella vaccine (Varilirix). Seroconversion was observed in 20 out of 23
patients found to be seronegative when tested by the fluorescent antibody to
membrane antigen technique, and an antibody booster response was observed in 41
out of 47 seropositive patients. Mild clinical varicella occurred in 5 vaccinated
patients and herpes zoster in 3 initially seropositive ones. Nevertheless, a
dramatic decrease in the incidence of both varicella and herpes zoster was
observed in a series of 330 consecutive transplantations after the introduction
of the varicella vaccine.

PMID: 3014466 [PubMed - indexed for MEDLINE]

7315: Scand J Urol Nephrol Suppl. 1985;92:41-4.

Clinical experiences with phosphonoformate (foscarnet) treatment of viral
diseases following renal transplantation.

Ahlmen J, Wijnween AC, Brynger H, Lycke E.

The effect of the antiviral drug phosphonoformate (Foscarnet) was studied in 32
patients following renal transplantation. Viral diagnosis was verified in 29 of
33 episodes of suspected clinical virosis. The clinical effect of Foscarnet was
good in 12 of 14 primary cytomegalovirus infections. In 5 of 7 varicella-zoster
virus, in 4 of 6 secondary cytomegalovirus and in 2 herpes simplex virus (type 1;
type 2) infections the effect of the treatment was clinically judged as good. The
beneficial effect could in these patients be overestimated as the natural courses
of the viral infections were unknown. No clinical side effects of Foscarnet were 
found. Clinically unimportant changes in s-calcium were noted in 6 patients. The 
dosage of Foscarnet was increased during the study. At present an initial bolus
dose followed by 14 days of parenteral infusions can be recommended.

PMID: 3008316 [PubMed - indexed for MEDLINE]

7316: Scand J Urol Nephrol Suppl. 1985;92:15-21.

Cytomegalovirus (CMV) infections in renal transplant recipients. Preliminary
results of prophylaxis by an intramuscular human hyperimmune CMV IgG.

Dreikorn K, Doerr HW, Geursen RG.

Infectious diseases are the most serious complications in immunosuppressed
patients and the major cause of death in renal transplant recipients (23, 44).
Besides bacterial, fungal and protozoan infections, viruses of the human herpes
group (herpes simplex virus, varicella-zoster virus, Epstein-Barr virus,
cytomegalovirus) are known to be of major importance (21, 37). The most common
and clinically relevant virus of this group is the cytomegalovirus (CMV).

Publication Types: 
    Clinical Trial

PMID: 3008312 [PubMed - indexed for MEDLINE]

7317: Scand J Infect Dis Suppl. 1985;47:9-15.

Virological aspects on herpesvirus infections.

Lycke E.

The family herpesviridae include five important human pathogens, herpes simplex
virus types 1 and 2 (HSV-1, HSV-2), varicella-zoster virus (VZV) and
cytomegalovirus (CMV). The five viruses are represented in all three herpesvirus 
subfamilies, a subdivision based on differences in phenotypic properties such as 
length of replication cycle, cytotoxic properties and host cell range. The
herpesviruses have DNA genomes sharing characteristic anatomical features. They
replicate in the nuclei of eukaryotic cells and produce virions consisting of
enveloped icosahedral nucleocapsids. Although all herpesviruses can establish
latent infections in selected target cells, conditions for establishment and
maintenance of latency vary between the members of the herpesvirus family.

PMID: 3006235 [PubMed - indexed for MEDLINE]

7318: Scand J Infect Dis Suppl. 1985;47:44-50.

Herpesvirus infection in man.

Zachariae H.

Herpesviruses which affect man are herpes simplex virus type 1 and type 2,
varicella-zoster virus, cytomegalovirus and Epstein-Barr virus. The review deals 
with the more common clinical manifestations of human herpesvirus infections,
which occur ubiquitously in all populations throughout the world. Primary
infections most commonly occur in childhood. It is a characteristic feature of
herpesvirus that they generally remain in a latent form after clearance of the
primary infection. The overall majority of clinical problems are related to
activated latent infections, viz. recurrent lesions of herpes simplex, herpes
zoster with remaining neuralgia in older patients, and in particular herpesvirus 
infections and reactivation in immunodeficient individuals. Herpes infection
during pregnancy may result in severe generalised infection of the newborn. A
possible relationship between herpesvirus and cancer, especially between
herpesvirus type 2 and cervical cancer and between Epstein-Barr virus and
Burkitt's lymphoma are of major interest today.

Publication Types: 
    Review

PMID: 3006233 [PubMed - indexed for MEDLINE]

7319: Scand J Infect Dis Suppl. 1985;47:165-73.

Present and future of acyclovir.

Yeo JM, Fiddian AP.

Acyclovir is now established as an effective and well tolerated therapeutic agent
for the management of at least the more common infections of the herpes virus
group. Evaluation of the drug nevertheless continues, primarily to verify its
value in those infections caused by cytomegalovirus (CMV) and Epstein-Barr virus 
(EBV). Furthermore with the development of analogues of acyclovir with better
absorption profiles or enhanced anti-viral activity the future for this area of
anti-viral therapy looks optimistic.

Publication Types: 
    Review

PMID: 3006231 [PubMed - indexed for MEDLINE]

7320: Scand J Infect Dis Suppl. 1985;47:137-44.

Acyclovir prophylaxis in bone marrow transplant recipients.

Lundgren G, Wilczek H, Lonnqvist B, Lindholm A, Wahren B, Ringden O.

Forty-two patients undergoing bone marrow transplantation were included in a
randomised, double-blind and placebo controlled trial of prolonged acyclovir
prophylaxis against infections with viruses of the herpes group. Twenty patients 
were allocated to receive acyclovir and 22 to receive placebo. Acyclovir or
placebo was administered i.v. at a dose of 250 mg/m2 twice daily, starting 5 days
before transplantation. At 5 weeks after transplantation, administration was
changed to tablets, 400 mg three times daily (children less than 6 years, 200 mg 
three times daily) and continued until 6 months after transplantation. In the
placebo group, 10 acute herpes simplex virus (HSV) infections occurred in 7
patients (5 HSV-1 and 2 HSV-2), and another patient repeatedly shed HSV in throat
washings. Five patients developed herpes zoster. Among patients receiving
acyclovir only one episode of HSV infection occurred and no herpes zoster. The
difference in the number of infection episodes and the number of infected
patients was strongly significant (p = 0.0002 and 0.0017, respectively). The only
acyclovir patient who reactivated HSV was terminally ill, and it is highly likely
that she did not absorb a sufficient amount of the orally administered drug to
control infection. All HSV and varicella zoster virus (VZV) infections were
reactivations, and 9 of 10 patients who developed HSV infections or shed virus
had a pre-transplantation HSV IgG titer of greater than 10 000 (ELISA). Acyclovir
had no effect on cytomegalovirus (CMV), time of engraftment, or graft versus host
disease (GVHD). Apart from a possible allergic reaction (skin rash) to acyclovir 
tablets, no adverse reactions were seen during this long prophylaxis with
acyclovir.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 3006228 [PubMed - indexed for MEDLINE]

7321: Scand J Infect Dis Suppl. 1985;47:121-7.

Herpesvirus infections in the immunocompromised patient.

Skinhoj P.

The herpes group viral infections in the T cell immunocompromised host may be
seen as a disturbance of a delicate balance between the host and well adapted
commensals. The clinical aspect of this disturbance is highly variable but may
cause the destruction of the host due to widespread organ damage or prolonged
debilitating illnesses. An important aspect is the immunosuppressive effect of
the infections themselves leading to a number of superinfections, often with
unusual pathogens, difficult to treat. Further problems arise from the potential 
onchogenic effect of some of these viruses such as EBV induced lymphomas. On the 
threshold to the era of effective antiviral chemotherapy, two major problems are 
still present: identification of the precise immunological mechanisms controlling
the latency/reactivation of the different viruses and the establishment of
reliable methods for rapid diagnosis, crucial for the treatment of patients with 
atypical clinical presentation and atypical serological responses.

PMID: 3006227 [PubMed - indexed for MEDLINE]

7322: Antiviral Res. 1985;Suppl 1:35-44.

Therapy of varicella-zoster virus infection--mechanism of action of
(E)-5-(2-bromovinyl)-2'-deoxyuridine.

Shigeta S, Yokota T, De Clercq E.

Publication Types: 
    In Vitro

PMID: 3002264 [PubMed - indexed for MEDLINE]

7323: Antiviral Res. 1985;Suppl 1:241-50.

Treatment and prevention of virus infections in immunosuppressed patients.

Lietman PS, Saral R.

Publication Types: 
    Clinical Trial
    Review

PMID: 3002259 [PubMed - indexed for MEDLINE]

7324: Antiviral Res. 1985;Suppl 1:107-10.

Rapid detection of herpes simplex- and varicella-zoster virus antigens from
clinical specimens by enzyme immunoassay.

Ziegler T, Halonen PE.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 3002249 [PubMed - indexed for MEDLINE]

7325: Ann Dermatol Venereol. 1985;112(3):265-6.

[Large necrotic ulcerations caused by varicella-zona virus in an immunosuppressed
patient]

[Article in French]

Prigent F, Ferrier E, Dontenwille MN, Mathieu A, Restout S, Perol Y, Civatte J.

Publication Types: 
    Case Reports

PMID: 2998258 [PubMed - indexed for MEDLINE]

7326: Boll Ist Sieroter Milan. 1985;64(3):240-3.

[Sero-epidemiological results in subjects receiving a renal transplant]

[Article in Italian]

Rivanera D, Lorino G, Dessy P, Mancini C, Filadoro F, Pretagostini R, Alfani D.

In this study a sero-epidemiological investigation on 127 renal allograft
recipients was examined. In these patients, treated with Cyclosporine A or
conventional drugs, antibody response to various antigens (Cytomegalovirus,
Herpes simplex, Varicellae/Zoster and Mycoplasma pneumoniae) was examined. The
data were compared to the healthy population and dialyzed subjects.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 2994693 [PubMed - indexed for MEDLINE]

7327: Eur Arch Psychiatry Neurol Sci. 1985;234(6):404-7.

Hemichorea associated with varicella-zoster reinfection and endocarditis. A case 
report.

Hammann KP, Henkel B, Erbel R, Kramer G.

A 20-year-old woman developed transient right-sided hemichoreatic movements after
household exposure to varicella-zoster. Some days before the appearance of
involuntary movements a vesicular rash had occurred. About 6 months later an
elevated IgG serum titer against varicella virus was found and two-dimensional
echocardiography showed signs of an endocarditis. During the following 2 months
the IgG value returned to within the normal range and the choreatic movements
disappeared almost totally. The possibility is discussed that endocarditis had
been caused and maintained by serum antibodies to varicella-zoster virus which
cross-reacted with valvular tissue. Embolization to the region of the left
striatum and/or postinfectious encephalitis in this region are assumed to be the 
most plausible causes of the transient hemichorea.

Publication Types: 
    Case Reports

PMID: 2992991 [PubMed - indexed for MEDLINE]

7328: Trans Ophthalmol Soc U K. 1985;104 ( Pt 3):243-7.

Ocular disease in immunosuppressed patients.

Sarkies NJ, Blach RK.

New therapies and diseases causing immunosuppression have provoked new and
devastating ocular diseases. The possible reasons for the vulnerability of the
retina to opportunistic infections are discussed. The clinical patterns of
disease caused by common opportunistic agents are described, and current
treatment available is reviewed.

Publication Types: 
    Review

PMID: 2992127 [PubMed - indexed for MEDLINE]

7329: Bull World Health Organ. 1985;63(2):185-201 contd.

Prevention and control of herpesvirus diseases. Part 1. Clinical and laboratory
diagnosis and chemotherapy. A WHO meeting.

[No authors listed]

PMID: 2990748 [PubMed - indexed for MEDLINE]

7330: Eur Neurol. 1985;24(4):225-8.

Delayed contralateral hemiplegia following herpes zoster ophthalmicus: should
antiviral therapy be used?

Booss J, Haak BB, Leroy RF.

We review clinical virological studies in the syndrome of delayed contralateral
hemiplegia following herpes zoster ophthalmicus. Virus could not be isolated from
the cerebrospinal fluid (CSF) of the present case, nor was antiviral antibody
found in the CSF. There appear to have been no reports of successful virus
isolation from the CSF although there are reports of antibody in the spinal
fluid. Thus the evidence for ongoing viral replication in the central nervous
system is marginal. It is suggested that the sensitive antibody assay against
membrane antigens (FAMA) be used in the future as a guide to antiviral therapy.

Publication Types: 
    Case Reports

PMID: 2988963 [PubMed - indexed for MEDLINE]

7331: Acta Derm Venereol Suppl (Stockh). 1985;114:121-4.

Viral infections in atopic dermatitis.

Strannegard O, Strannegard IL, Rystedt I.

In a study of almost 1000 patients with past or present atopic dermatitis (AD) it
was found that histories of recurrent (greater than 5 episodes/year) cold sores
and upper respiratory infections, as well as histories of zoster were
significantly more common in AD patients than in non-atopic controls. Serological
studies revealed that AD patients have clearly elevated titers of antibodies
against Epstein-Barr virus. These findings suggest that the increased
susceptibility to viral infections in AD is due to immune dysfunction rather than
to cutaneous alterations which are associated with the disease. The mechanisms
underlying the increased susceptibility to infections may be related to
immunological aberrations that are secondary to a basic abnormality in the fatty 
acid or cyclic AMP metabolism.

PMID: 2988250 [PubMed - indexed for MEDLINE]

7332: Proc Eur Dial Transplant Assoc Eur Ren Assoc. 1985;21:317-20.

Herpes virus infection prevalence in regular haemodialysis patients--a
comparative evaluation of complement fixation, indirect immunofluorescence and
Elisa tests.

Scolari F, Manca N, Sandrini S, Cristinelli L, Prati E, Setti G, Savoldi S,
Turano A, Maiorca R.

The presence and titres of specific serum IgG and IgM antibodies to
cytomegalovirus, herpes simplex virus and varicella-zoster virus were evaluated
in 50 haemodialysis patients by complement fixation, immunofluorescence and Elisa
tests. A second serum sample was tested in 24 patients after four weeks. Specific
serum IgG antibodies to Epstein-Barr virus were also measured by
immunofluorescence in 26 patients. By immunofluorescence and Elisa tests, the
prevalence of cytomegalovirus, herpes simplex virus and Epstein-Barr virus
infection is approximately 100 per cent, and varicella-zoster virus 60 per cent. 
High titres of IgG specific antibodies found by Elisa tests, detection of IgM
antibodies in 16-18 per cent of patients and sero-conversion in 25 per cent of
patients, suggests continuous antigenic stimulation.

Publication Types: 
    Comparative Study

PMID: 2986100 [PubMed - indexed for MEDLINE]

7333: J Neurol. 1985;231(6):307-12.

Long-term persistence of intrathecal virus-specific antibody responses after
herpes simplex virus encephalitis.

Vandvik B, Skoldenberg B, Forsgren M, Stiernstedt G, Jeansson S, Norrby E.

Paired sera and cerebrospinal fluids (CSF) from nine surviving patients were
collected 4.5 to 8 years after acute herpes simplex (HS) virus encephalitis.
Oligoclonal bands of IgG were detected in the CSF of all, and seven patients had 
an elevated CSF IgG index. Antibodies to HS, varicella-zoster (VZ), measles, and 
cytomegalo viruses were analysed by enzyme-linked immunosorbent assay (ELISA) and
by imprint immunofixation (IIF) of specimens separated by electrophoresis and by 
thin-layer electrofocusing. Intrathecal synthesis of HS and VZ IgG antibodies was
demonstrated in all and of measles IgG antibodies in one patient by both methods.
Intrathecal synthesis of HS IgA antibodies was demonstrated by ELISA in three and
by IIF in seven patients; the latter method also disclosed intrathecal synthesis 
of VZ IgA antibodies in two. No patient had intrathecal synthesis of viral IgM
antibodies. The intrathecally synthesized antibodies demonstrated by IIF
displayed oligoclonal characteristics. The IIF analyses as well as virus
absorption tests indicated that the intrathecally synthesized VZ IgG and IgA
antibodies could be explained as HS antibodies cross-reacting with VZV. The
results indicate that a long-term persistence of intrathecal antibody responses
to HS virus is a common feature after acute HS encephalitis. The intrathecal
production of measles IgG antibodies in one case may reflect a similar
persistence of non-specific immune responses induced during the acute infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 2983032 [PubMed - indexed for MEDLINE]

7334: Isr J Med Sci. 1985 Jan;21(1):27-31.

Intravenous acyclovir for herpesvirus in immunocompromised patients.

Dan M, Michaeli D, Siegman-Igra Y.

Severe herpesvirus infections in 18 immunocompromised patients (25 episodes) were
treated with i.v. acyclovir. Six patients had 13 episodes of mucocutaneous herpes
simplex infections, eight children had varicella, three patients had generalized 
zoster, and one patient had cytomegalovirus pneumonia. No patient died from
infections. In 18 episodes treatment with acyclovir produced a beneficial effect,
in 5 episodes acyclovir was probably beneficial, and in 2 patients the effect
could not be evaluated. No serious side effects could be definitely attributed to
acyclovir administration. These data support the previous experience that i.v.
acyclovir may be useful in the treatment of herpesvirus infections in
immunocompromised patients.

PMID: 2982763 [PubMed - indexed for MEDLINE]

7335: Br Med Bull. 1985 Jan;41(1):46-9.

Opportunistic viral infections.

Burns WH, Saral R.

Publication Types: 
    Review

PMID: 2982446 [PubMed - indexed for MEDLINE]

7336: Transplantation. 1985 Jan;39(1):21-3.

Late-onset interstitial pneumonia following allogeneic bone marrow
transplantation.

Wingard JR, Santos GW, Saral R.

Although most episodes of interstitial pneumonia (IP) following allogeneic bone
marrow transplantation occur during the second or third month, occasional cases
occur later. The records of 139 patients transplanted for leukemia over 6 years
were reviewed in this study to examine cases of IP occurring beyond 100 days
following marrow transplantation. Ten episodes of IP occurred among the 67
patients who survived 100 days (an actuarial probability of 18%). All cases
occurred within the first year. An infectious cause was established in 80%. The
case fatality rate was 60%. Although most infectious cases of IP occurring before
100 days are caused by cytomegalovirus, the late-onset cases in this study were
caused by a heterogeneous group of pathogens, some of which were amenable to
specific therapies. Thus, an aggressive approach to establishing a specific
diagnosis should be made in cases of IP occurring more than 100 days after marrow
transplantation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2981443 [PubMed - indexed for MEDLINE]

7337: J Infect Dis. 1985 Jan;151(1):106-13.

Varicella-zoster virus infection of strain 2 guinea pigs.

Myers MG, Stanberry LR, Edmond BJ.

Weanling strain 2 guinea pigs are susceptible to infection with varicella-zoster 
virus cultured in embryonic guinea pig tissue. Animals inoculated by an
intramuscular route develop mononuclear cell viremia that may persist for as long
as three weeks. During the period of viremia, virus may be recovered from the
nasopharynx and a variety of tissues. In addition, virus may be recovered from
neural tissues in the absence of viremia, although infectious virus has not been 
cultivated from neural tissues after the 23rd day. The strain 2 guinea pig should
provide an animal model to study the pathophysiology of infections caused by
varicella-zoster virus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 2981274 [PubMed - indexed for MEDLINE]

7338: Acta Derm Venereol Suppl (Stockh). 1985;117:1-59.

Hand eczema and long-term prognosis in atopic dermatitis.

Rystedt I.

A follow-up study of 1177 adult patients who had had atopic dermatitis (AD)
(Groups 1 and 2) or respiratory allergy (Group 3) in childhood is reported.
Patients who had had AD in childhood had received in-patient (Group 1) or
out-patient treatment (Group 2) for their dermatitis. 183 patients in Group 1 and
162 in Group 2 were examined clinically. Further, 445 patients who had recently
been treated for hand eczema at a department for occupational dermatoses were
studied (Group 5). A group of 199 people who had no personal or family history of
atopy served as controls (Group 4). The essential findings were as follows: The
healing rate was lower (38%) in patients with severe (Group 1) than in those with
moderate (60%) childhood dermatitis (Group 2). Although the healing rate was
comparatively low in both groups, persistent eczema was in most cases of mild
degree. The commonest localization of persistent dermatitis was the hands. The AD
had developed earlier in patients who had had severe childhood dermatitis than in
those whose childhood AD was moderate. Severe childhood AD was also associated
with a significantly higher frequency of family history of atopy and associated
respiratory allergy. The inheritance pattern was specific for the different types
of atopic disease. A family history of AD was significantly commoner in people
with AD than in people with respiratory allergy, and, conversely, people with a
family history of respiratory allergy had developed asthma or allergic rhinitis
rather than AD. The serum IgE level was raised in 45% and 26% of the clinically
examined individuals in Groups 1 and 2, respectively. A comparatively large
proportion of patients with persistent or recurrent dermatitis had normal IgE
values. There was a strong correlation between the extent of persistent
dermatitis and serum IgE levels. It is concluded that the serum IgE cannot be
used to establish the diagnosis of atopic dermatitis. The number of contact
sensitized people was greater in Group 2 (23%) than in Group 1 (17%). Occurrence 
of contact sensitivity, which was demonstrable in a total of 20% of the patch
tested individuals from Groups 1 and 2, was not correlated to prevalence of
healing at the time of examination. Fragrance-mix and balsam of Peru were the
commonest contact sensitizers. People with a history of AD showed a higher
incidence of recurrent (greater than 5 episodes per year) cold sores, upper
respiratory infection, and herpes zoster than non-atopic controls.(ABSTRACT
TRUNCATED AT 400 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 2931938 [PubMed - indexed for MEDLINE]

7339: Kansenshogaku Zasshi. 1985 Jan;59(1):57-61.

[A case of herpes zoster with a dramatic response to cimetidine]

[Article in Japanese]

Shibuya T, Etoh H.

Publication Types: 
    Case Reports
    English Abstract

PMID: 2860189 [PubMed - indexed for MEDLINE]

7340: Scand J Infect Dis Suppl. 1985;47:128-36.

Treatment of herpesvirus infections in the immunocompromised host.

Meyers JD.

Major advances have been made in the treatment of herpesvirus infections in the
compromised host. Acyclovir is clearly effective in the treatment of HSV
infection, and preferable to vidarabine for this purpose. Additional information 
about the optimal use of acyclovir for treatment or prophylaxis and about the
ultimate significance of the phenomena of acyclovir resistance and possible
suppression of the specific immune response are needed. The major challenge at
this time is the rapid clinical or virologic diagnosis of HSV infection,
especially the rarer manifestations such as HSV pneumonia or encephalitis, so
that effective therapy can be initiated. The serious manifestations of VZV
infection (e.g. cutaneous and visceral dissemination) can also be controlled with
either vidarabine or acyclovir, although definition of the agent of choice is
still lacking. More information is needed to define the relative efficacy of
acyclovir compared with vidarabine, and also to define better treatment regimens 
for the prevention of post-herpetic neuralgia which remains a major source of
morbidity. Use of either oral or topical acyclovir and anti-inflammatory agents
in combined regimens is being studied. Interferon, although effective, has little
present role in view of the availability of both acyclovir and vidarabine,
although it is of interest as a model of an agent that can be administered to
outpatients or used in synergistic regimens. The challenge for treatment of CMV
is the development of an agent which is effective in vivo. Several promising
agents are on the horizon, but much initial work must be done before their
effectiveness will become apparent.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 2419973 [PubMed - indexed for MEDLINE]

7341: Int J Tissue React. 1985;7(6):449-57.

The modulation of cutaneous inflammatory reactions by peptide-containing sensory 
nerves.

Jancso G, Obal F Jr, Toth-Kasa I, Katona M, Husz S.

In the present experiments the role of unmyelinated sensory fibres in the
mechanism of cutaneous inflammatory reactions under normal and pathological
conditions has been studied in man and animals. Dye leakage responses to
histamine, serotonin, compound 48/80, bradykinin and substance P were
significantly reduced, while neurogenic inflammation was completely abolished in 
rats treated neonatally with capsaicin, as studied quantitatively by the Evans
blue technique. Neurogenic inflammation could also be elicited by mustard oil in 
normally innervated human skin, but not in skin areas affected by herpes zoster
or in a patient suffering from congenital analgesia. Repeated topical treatment
of the skin with capsaicin (local desensitization) abolished the neurogenic
inflammatory response for several days. Chemical pain sensitivity was strongly
reduced, and thresholds for warmth and heat pain sensations were significantly
elevated. Local capsaicin desensitization of the skin prevented whealing, flare
and itch in patients with acquired cold and heat urticaria. The findings indicate
that peptide-containing sensory nerves are involved in the mediation of
chemogenic and heat pain, and possibly itch, and are responsible for initiation
of the neurogenic inflammatory response. The results also provide direct evidence
of the involvement of these particular sensory nerves in the modulation of the
permeability-increasing effects of putative mediators of acute inflammatory
reactions. It is concluded that, through modulation of cutaneous vascular
reactions, peptidergic sensory nerves may play a hitherto unrecognized role in
the pathomechanism of certain diseases of human skin.

PMID: 2417973 [PubMed - indexed for MEDLINE]

7342: Acta Derm Venereol. 1985;65(4):355-8.

Candidiasis: the isomorphic response.

Witkowski JA, Parish LC.

Two uncontrolled insulin dependent diabetic patients had Candida albicans
infection with the unique manifestation of erythematous scaling papulopustules at
the sites of excoriation. In one patient, the clinical presentation suggested
herpes zoster. Recognition of this picture and the contributing factors, i.e.
Candida infected finger nails and elevated blood sugar will permit early use of
appropriate antifungal therapy.

Publication Types: 
    Case Reports

PMID: 2413698 [PubMed - indexed for MEDLINE]

7343: Lancet. 1984 Dec 22;2(8417-8418):1428-30.

Amino (hydroxyethoxymethyl) purine: a new well-absorbed prodrug of acyclovir.

Selby P, Powles RL, Blake S, Stolle K, Mbidde EK, McElwain TJ, Hickmott E,
Whiteman PD.

Acyclovir is an effective treatment for herpes simplex and herpes zoster
infections, but it is somewhat limited by low oral absorption.
2-amino-9-[(2hydroxyethoxy)methyl]-9H-purine (BW A515U), a new prodrug of
acyclovir, when evaluated in 10 patients with haematological malignancies, was
well tolerated, excellently absorbed, and produced high plasma concentrations of 
acyclovir which were comparable to those with intravenous acyclovir. The plasma
concentrations after oral BW A515U were much higher than those after oral
acyclovir.

Publication Types: 
    Comparative Study

PMID: 6151046 [PubMed - indexed for MEDLINE]

7344: Am J Ophthalmol. 1984 Dec 15;98(6):825-7.

Skin test with varicella-zoster virus antigen for ophthalmic herpes zoster.

Pepose JS.

Publication Types: 
    Letter

PMID: 6095668 [PubMed - indexed for MEDLINE]

7345: N Z Med J. 1984 Dec 12;97(769):852-4.

Antiviral drugs today.

Goldwater PN.

Publication Types: 
    Clinical Trial
    Review

PMID: 6392956 [PubMed - indexed for MEDLINE]

7346: Med J Aust. 1984 Dec 8-22;141(12-13):903.

Herpes zoster and cimetidine.

Arnot RS.

Publication Types: 
    Case Reports
    Letter

PMID: 6503811 [PubMed - indexed for MEDLINE]

7347: Med J Zambia. 1984 Dec;18(4):14-5.

Herpes zoster with pulmonary tuberculosis: a report of 4 cases.

Verma RC, Hira SK.

Publication Types: 
    Case Reports

PMID: 6600052 [PubMed - indexed for MEDLINE]

7348: Neurosurgery. 1984 Dec;15(6):969-70.

Dorsal root entry zone lesions for the treatment of postherpetic neuralgia.

Friedman AH, Nashold BS Jr.

These investigators attempted to diminish postherpetic neuralgia in 17 patients
by making dorsal root entry zone (DREZ) lesions. They describe the clinical
syndrome of pain after herpes zoster, the incidence of which increases with age, 
and discuss its pathology. They briefly review the medical and surgical treatment
of postherpetic neuralgia. The results and complications of the DREZ procedure
are reported.

PMID: 6514174 [PubMed - indexed for MEDLINE]

7349: Neurosurgery. 1984 Dec;15(6):928-32.

Deafferentation pain after posterior rhizotomy, trauma to a limb, and herpes
zoster.

Sweet WH.

After incisional or alcoholic destruction of trigeminal posterior rootlets,
constant dysesthesias of major degree referred to some part of the markedly
denervated zone develop in 5 to 15% of the patients. The full severity may not
appear for weeks or months. There is no allodynia or hyperpathia of the
denervated zone. Bulbar trigeminal tractotomy with sparing of touch sensation
produces severe dysesthesias in a tiny percentage of the patients, as does
selective destruction of pain fibers by radiofrequency heating or glycerol.
Spinal posterior rhizotomy elicits in less than 4% a lasting dysesthesia entirely
different in temporal sequence, locus, and type of pain: (a) it tends to be
maximal early after operation and to improve, (b) the spontaneous pain is
accompanied by severe allodynia, and (c) the pain is usually referred beyond the 
margins of the insentient (rhizotomized) zone and may even be referred to the
corresponding area on the opposite side. Sindou's "selective posterior
rhizotomy," i.e., cutting of the small fiber lateral component of each rootlet as
it enters the cord, has not given rise to dysesthesias. These do occur briefly in
50% of the cases following spinal ganglionectomy, the sensations being referred
to the dermatomal segment of the ganglion in question. The secondary afferent
neurons in the mesencephalic, principal, oral, and interpolar nuclei for the
trigeminal posterior roots have no counterpart in the spinal cord for the spinal 
posterior roots. We suggest that the explanation for the fact that neither
trigeminal neuralgia nor trigeminal anesthesia dolorosa have a spinal clinical
counterpart is related to the as yet unexplained special functions of the
elaborate trigeminal secondary afferent neuronal apparatus.(ABSTRACT TRUNCATED AT
250 WORDS)

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6514166 [PubMed - indexed for MEDLINE]

7350: J Neurol Neurosurg Psychiatry. 1984 Dec;47(12):1351-4.

Vidarabine encephalopathy.

Cullis PA, Cushing R.

Vidarabine (adenine arabinoside, ara-a) has been found to be useful in the
treatment of various viral infections. Its adverse neurological effects include
tremor and encephalopathy. Two cases of vidarabine encephalopathy are reported
and the five other cases in the literature are reviewed. The clinical features of
the tremor and encephalopathy are discussed.

Publication Types: 
    Case Reports

PMID: 6512557 [PubMed - indexed for MEDLINE]

7351: J Antimicrob Chemother. 1984 Dec;14(6):661-5.

Oral acyclovir in herpes zoster.

McKendrick MW, Care C, Burke C, Hickmott E, McKendrick GD.

Forty-one patients with herpes zoster were treated with acyclovir or placebo at a
dosage of 400 mg five times a day by mouth for five days in a double-blind
randomized domiciliary study. Acyclovir was shown to reduce the days of new
lesion formation within the effected dermatome after day 0 (P = 0.049). No other 
statistical difference was demonstrated between the two groups although the
trends for new lesion formation outside the dermatome, full crusting, involution 
and diminution of acute pain all favoured acyclovir.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6394572 [PubMed - indexed for MEDLINE]

7352: Arq Neuropsiquiatr. 1984 Dec;42(4):402-7.

[Ocular herpes zoster and delayed cerebrovascular accident: report of a case]

[Article in Portuguese]

Guerreiro CA, Guerreiro MM.

A sixty-nine year old man suffered a stroke fourteen weeks after the onset of
right herpes zoster ophthalmicus (HZO). Hemispheric infarction was documented by 
a computed tomography which showed a small hypodense zone in the right internal
capsula; after contrast there was enhancement of this hypodense area. Cerebral
angiography and cerebral-spinal fluid were not done. Despite of a diagnosis of
probability the authors report the case and review the literature. A long latency
between the HZO and onset of neurological deficit is stressed. New antiviral
agents may prevent the ictus.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6336029 [PubMed - indexed for MEDLINE]

7353: Br J Ophthalmol. 1984 Dec;68(12):904-5.

Acyclovir and steroids in herpes zoster keratouveitis.

Marsh RJ, Cooper M.

Publication Types: 
    Letter

PMID: 6334535 [PubMed - indexed for MEDLINE]

7354: Gan To Kagaku Ryoho. 1984 Dec;11(12 Pt 1):2568-72.

[Treatment for advanced malignant lymphoma in patients with compromised bone
marrow--a combination therapy using pepleomycin, vincristine and high-dose
adrenocorticoids (POP regimen)]

[Article in Japanese]

Tamura K, Araki Y, Seita M.

It is often very frustrating for clinicians when in cases where Hodgkin's disease
or non-Hodgkin's lymphoma is relapsing rapidly, sufficient doses of cytotoxic
agents and/or radiation therapy cannot be given because of cytopenia due either
to previous treatment or to bone marrow infiltration by the lymphoma. We have
been treating such patients with a combination chemotherapy consisting of
vincristine 0.25 mg/day i.v. push daily for 4 days, pepleomycin 5 mg/day s.c. by 
continuous infusion daily for 4 days, and prednisolone 1 g/day p.o. or
methylprednisolone 1 g/day d.i.v. every other day for 4 days POP combination)
administered every 2 to 3 weeks until an improvement in cytopenia occurs. Twelve 
patients with advanced non-Hodgkin's lymphoma, including 8 T-cell lymphoma
patients, entered this pilot study when they were cytopenic or had been treated
with cytotoxic agents or radiation therapy immediately prior to POP therapy. All 
patients responded and experienced more than 50% tumor reduction associated with 
improved general condition. Untoward effects included transient glycosuria, mild 
decline of serum immunoglobulin levels, herpes zoster and temporary aggravation
of cutaneous or oral fungal infection in each of one to two patients. Since this 
treatment is switched to other forms of treatment when bone marrow function has
recovered, duration of the response cannot be determined. The survival time was
rather short because of poor general condition and aggravation of concurrent
active pulmonary infection before the start of treatment. This treatment is
sufficient effective, however, to be tried on patients with active lymphoma, not 
necessarily associated with poor bone marrow function, unless active infection
supervention.

Publication Types: 
    English Abstract

PMID: 6210054 [PubMed - indexed for MEDLINE]

7355: Am J Dermatopathol. 1984 Dec;6(6):561-5.

Leukocytoclastic vasculitis associated with cutaneous infection by herpesvirus.

Cohen C, Trapuckd S.

Two patients with leukocytoclastic vasculitis of dermal vessels and evidence of
infection by herpesvirus in the overlying epidermis showed, by conventional
microscopy, viral inclusions in endothelial cells and in dermal fibroblasts
adjacent to them and, by electron microscopy, viral inclusions in endothelial
cells and pericytes of involved vessels. It is speculative whether viral
involvement of the latter structures was the result of direct spread of the virus
along dermal nerves, from the overlying intraepidermal viral vesicles, or from
hematogenous dissemination of the virus.

Publication Types: 
    Case Reports

PMID: 6098188 [PubMed - indexed for MEDLINE]

7356: Isr J Med Sci. 1984 Dec;20(12):1189-92.

Herpes zoster encephalitis: isolation of virus from cerebrospinal fluid.

Ophir O, Siegman-Igra Y, Vardinon N, Liron M.

Two elderly female patients developed symptoms and signs of encephalitis,
coincident with a cutaneous zoster eruption ("shingles"). One recovered slowly
with mild residual motor dysfunction, and the other died. Varicella-zoster virus 
was isolated from the cerebrospinal fluid of the two patients. Review of the
literature revealed only eight previously described patients in whom herpes
zoster virus was isolated from the cerebrospinal fluid.

Publication Types: 
    Case Reports

PMID: 6097567 [PubMed - indexed for MEDLINE]

7357: J Gen Virol. 1984 Dec;65 ( Pt 12):2141-7.

Investigation of varicella-zoster virus-infected cell proteins that elicit
antibody production during primary varicella using the immune transfer method.

Palumbo PE, Arvin AM, Koropchak CM, Wittek AE.

The varicella-zoster virus-infected cell proteins (VZV-ICPs) against which IgG,
IgM and IgA antibodies were made in the course of primary varicella-zoster virus 
(VZV) infection were analysed by the immune transfer method. IgG antibodies were 
made against one or more of 18 VZV-ICPs by patients with varicella. IgM
antibodies were produced which reacted with 21 VZV-ICPs. The spectrum of IgG
antibody production during the first week after the onset of infection was
limited to an average of three VZV-ICPs while IgM antibodies which reacted with
an average of seven VZV-ICPs were detectable in the acute phase of varicella.
Equivalent VZV IgG or IgM antibody titres by radioimmunoassay did not correlate
with a similar pattern of antibody specificity for VZV-ICPs by immune transfer. A
detectable immune response to all VZV-ICPs was not required for the recovery of
individual patients from primary VZV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6096492 [PubMed - indexed for MEDLINE]

7358: Ann Intern Med. 1984 Dec;101(6):852-8.

Whither immunization against viral infections?

Hilleman MR.

Economic and social considerations with respect to the infectious diseases demand
increased application of preventive measures. Vaccines provide high benefit at
low cost and low risk. Past vaccines have emphasized use of live attenuated, or
killed whole, or fractionated organisms. Future vaccines will involve recombinant
and synthetic antigens, with emphasis on control of many different infections
with single polyvalent vaccines directed against individual epitopes rather than 
complex antigens. Heightened interest in preventive medicine is evident among
physicians, aided by the activities of the World Health Organization and
governments, and individual academic and public health initiatives. An overview
of the past, present, and future with respect to technological possibilities and 
other practical considerations for vaccines is presented.

PMID: 6093664 [PubMed - indexed for MEDLINE]

7359: N Engl J Med. 1984 Nov 22;311(21):1362-4.

Endonuclease analysis of viral DNA from varicella and subsequent zoster
infections in the same patient.

Straus SE, Reinhold W, Smith HA, Ruyechan WT, Henderson DK, Blaese RM, Hay J.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 6092956 [PubMed - indexed for MEDLINE]

7360: Schweiz Med Wochenschr. 1984 Nov 17;114(46):1645-50.

[Acquired immunodeficiency syndrome, chronic coccidiosis and Salmonella
typhimurium septicemia in a couple from Zaire. Immunological functions and
attempt at immunostimulation by thymopentin]

[Article in French]

Martin-Du Pan RC, Roth A, Stamenkovic AR, Hirschel B, Male PJ, Bolla K, Despond
JP, Jeannet M, Dayer JM.

A clinical review of a young couple from Zaire with acquired immunodeficiency
syndrome (AIDS) is reported. Both had opportunistic infections such as Salmonella
typhimurium septicemia, genital herpes and digestive candidiasis. The husband was
hospitalized for diarrhea from Isospora belli infection and for hemoptysis from
an aspergilloma. His wife was admitted for a thoracic herpes zoster infection and
left hemiplegia preceding subacute encephalitis. In both patients the biological 
immune functions were compatible with AIDS: presence of antibody against
lymphadenopathy virus, decreased in OKT4+/OKT8+ ratio, and lack of lymphocyte
response to mitogens which was partially restored in vitro after addition of
interleukin 2 and thymopentin (TP-5) in the husband. In vitro monocyte cultures
showed increased production of prostaglandins E2 (PGE2) and a slight decrease in 
interleukin 1 production. The symptomatic treatments and an attempt at
immunostimulation with TP-5 in the husband are described.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6393326 [PubMed - indexed for MEDLINE]

7361: Pol Tyg Lek. 1984 Nov 5;39(45):1485-7.

[Use of acyclovir in varicella-zoster virus infection with severe clinical course
in a patient with glomerulonephritis treated with immunosuppressive drugs]

[Article in Polish]

Panasiuk E, Przybylska W, Kalczak M, Wankowicz Z.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6514628 [PubMed - indexed for MEDLINE]

7362: Am J Ophthalmol. 1984 Nov;98(5):552-7.

Penetrating keratoplasty for exogenous Paecilomyces keratitis followed by
postoperative endophthalmitis.

Kozarsky AM, Stulting RD, Waring GO 3rd, Cornell FM, Wilson LA, Cavanagh HD.

Three patients developed Paecilomyces lilacinus keratitis while being treated
with topical corticosteroids and antibiotics. The first patient, a diabetic man, 
suffered superficial ocular trauma while being treated for recurrent anterior
uveitis related to an iris-fixated intraocular lens. The second patient developed
keratitis while being treated for anterior segment inflammation associated with
herpes zoster ophthalmicus. The third patient, a woman with chronic lymphoma in
remission, was receiving topical antibiotics and corticosteroids for a corneal
transplant performed one year previously. All three patients underwent
penetrating keratoplasty after progression to perforation or failure of medical
therapy. Two eyes (cases 1 and 2) eventually required enucleation. The fungal
isolates demonstrated in vitro resistance to amphotericin and natamycin with
greater sensitivity to imidazole derivatives. Thus, we recommend prompt and
prolonged topical treatment with miconazole or other imidazole derivatives along 
with avoidance of penetrating keratoplasty and corticosteroids.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 6541878 [PubMed - indexed for MEDLINE]

7363: Pediatr Infect Dis. 1984 Nov-Dec;3(6):505-9.

Varicella: clinical manifestations, epidemiology and health impact in children.

Preblud SR, Orenstein WA, Bart KJ.

PMID: 6514591 [PubMed - indexed for MEDLINE]

7364: J R Coll Gen Pract. 1984 Nov;34(268):627-8.

Ultrasound therapy for herpes zoster pain.

Walker E.

Publication Types: 
    Case Reports
    Letter

PMID: 6502574 [PubMed - indexed for MEDLINE]

7365: G Ital Dermatol Venereol. 1984 Nov-Dec;119(6):XXIII-VII.

[Rifamycin SV in the treatment of herpes zoster. Results of a multicenter
clinical investigation]

[Article in Italian]

Bruni L, Califano A, De Angelis G, Montagnani A, Pisani M, Pezzarossa G, Pozzo G,
Reali D, Rebora A, Zanca A.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 6397429 [PubMed - indexed for MEDLINE]

7366: Clin Exp Dermatol. 1984 Nov;9(6):557-63.

ACTH versus prednisone and placebo in herpes zoster treatment.

Clemmensen OJ, Andersen KE.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 6388918 [PubMed - indexed for MEDLINE]

7367: J Infect Dis. 1984 Nov;150(5):707-13.

Characteristics of autoantibodies to human interferon in a patient with
varicella-zoster disease.

Pozzetto B, Mogensen KE, Tovey MG, Gresser I.

A patient with varicella-zoster disease was found to have antibodies to human
interferon. These antibodies included all IgG subclasses, showed a high combined 
affinity (average dissociation constant, 10(-11)M), and were present in serum at 
a concentration of 10(-9)M. The antibodies neutralized the activity of a series
of human alpha-interferons prepared from recombinant DNA as well as that of
naturally occurring mixtures of alpha-type interferon prepared by viral
stimulation of human cells. Examination of the patient's lymphoid cells revealed 
normal production of interferon and normal expression of interferon receptors.
Interferon from the patient's cells was neutralized by her serum. The
neutralizing capacity of this serum was analyzed with regard to levels of
interferon previously detected in patients with varicella-zoster infections.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 6238105 [PubMed - indexed for MEDLINE]

7368: J Am Geriatr Soc. 1984 Nov;32(11):789-93.

Zoster in the elderly: clinical, immunologic and therapeutic considerations.

Harnisch JP.

Herpes zoster is common in the elderly. Persons over the age of 50 years have an 
attack rate double that of patients less than 50 years old. In the very aged,
this rate nearly doubles again. The loss of cell-mediated immunity for the VZ
virus appears to be the primary factor in the disruption of the dynamic
containment process responsible for VZ virus latency within the sensory ganglion.
Humoral immunity may play a role in the maintenance of latency, but the degree is
unproven, except in the case of dissemination where loss of detectable antibodies
seems to correlate with extradermatomal dissemination. Severe forms of the
disease and its complications, e.g., postherpetic neuralgia, are likely among the
elderly. Direct immunofluorescent staining or cytologic examination is useful for
early diagnosis, and serologic changes can document the confusing clinical entity
of zoster sine herpete.

PMID: 6094642 [PubMed - indexed for MEDLINE]

7369: J Am Acad Dermatol. 1984 Nov;11(5 Pt 2):1000-6.

Pruritus, cutaneous pain, and eccrine gland and sweating disorders.

Tuckett RP, Denman ST, Chapman CR, Gilchrest BA, Kraning KK, Sato K.

Publication Types: 
    Review

PMID: 6094620 [PubMed - indexed for MEDLINE]

7370: Drug Intell Clin Pharm. 1984 Nov;18(11):885-8.

2'Fluoro-5-iodo-arabinosyl-cytosine: a new agent for herpes infections in the
immunosuppressed patient.

Donner AL, Leyland-Jones B.

Concurrent with our increased understanding of mechanisms of viral replication,
new antiviral agents were developed with greater selectivity and sensitivity.
Acyclovir was the first of these. We now present the initial compound of a series
of 2'-Fluoro pyrimidine nucleosides with potent antiviral activity. This agent
demonstrates both potency and sensitivity in vitro and in vivo against herpes
simplex virus types I and II, and varicella zoster virus and is selective in
vitro against cytomegalovirus. Initial clinical trials show the drug to be well
tolerated and to be more effective than adenine arabinoside against varicella
zoster in the immunosuppressed patient. Future developmental plans with the drug 
are outlined. FIAC (2'-Fluoro-5-iodo-aracytosine) is still at an early stage of
clinical development and any comparison with acyclovir is premature; rather,
therapy of severe viral infections in the future should consider combinations of 
such agents that show differential selectivity at multiple sites of action.

PMID: 6094133 [PubMed - indexed for MEDLINE]

7371: Can Med Assoc J. 1984 Nov 1;131(9):1045-6.

Acyclovir for intravenous use. Committee on Infectious Diseases and Immunization,
Canadian Paediatric Society.

[No authors listed]

PMID: 6093977 [PubMed - indexed for MEDLINE]

7372: Lancet. 1984 Oct 20;2(8408):925.

Oral acyclovir for herpes zoster.

McKendrick MW, McGill JI, Bell AM, Hickmott E, Burke C.

Publication Types: 
    Clinical Trial
    Letter

PMID: 6148641 [PubMed - indexed for MEDLINE]

7373: Fortschr Med. 1984 Oct 4;102(37):932-4.

[Therapeutic experiences with the immunostimulator inosine pranobex]

[Article in German]

Darlath W, Wybran J.

The reason for giving substances with immunostimulatory properties is to restore 
or normalize immune functions. Since various human pathogenic viruses can induce 
immunodepression, the administration of immunostimulants offers a possibility for
therapeutic intervention in the immune system. This could be demonstrated.
Various virus infections can effectively be influenced by the synthetic
immunostimulating agent Inosine Pranobex.

Publication Types: 
    English Abstract

PMID: 6209193 [PubMed - indexed for MEDLINE]

7374: Talanta. 1984 Oct;31(10 Pt 2):889-93.

Enzyme-linked immunosorbent assay (ELISA) of antibodies to eight common
neurotropic viruses.

Earle JA, McFerran NV, Wisdom GB.

Department of Biochemistry, The Queen's University of Belfast, Medical Biology
Centre, Belfast, U.K.

Enzyme-linked immunosorbent assay (ELISA) methods were developed for determining 
serum levels of antibodies to adenovirus, cytomegalovirus, Epstein-Barr virus,
herpes simplex type I virus, measles virus, mumps virus, rubella virus, and
varicella zoster virus. The assays were evaluated for specificity, range,
precision and accuracy and found to give satisfactory performances. Serum samples
from 76 blood donors were assayed for the different antibodies. The antibodies to
adenovirus and the members of the Herpesviridae had wide concentration ranges,
with a significant minority of the samples having zero or very low levels,
whereas the antibodies to measles, mumps and rubella had narrower distributions, 
with very few samples having levels below the detection limit of the ELISA.

PMID: 18963764 [PubMed - in process]

7375: West J Med. 1984 Oct;141(4):527.

Herpes Zoster Neuralgia.

Dille RS.

22 Tacoma Medical Center, 1212 South 11th Street, Tacoma, WA 98405.

PMID: 18749652 [PubMed - as supplied by publisher]

7376: Am J Otol. 1984 Oct;5(6):499-502.

Current medical treatment for facial palsy.

Adour KK, Hetzler DG.

Medical treatment for facial palsy includes an accurate diagnosis and reliable
estimate of prognosis as well as appropriate medication. Cranial polyneuritis
(Bell's palsy and Ramsay Hunt syndrome), the most common cause of facial palsy,
is an inflammatory, autoimmune, demyelinating disease best treated by parenteral 
steroids without surgical intervention. The antiviral agent acyclovir is now
being tested as an adjunct to or replacement for steroid therapy. Trauma, the
second most common cause of facial palsy, is often treated with steroids, but no 
controlled study has ever been performed. However, animal experiments clearly
demonstrate that steroid treatment of a compressed facial nerve accelerates
repair of the mechanical injury and decreases time of recovery. Acute otitis
media with facial palsy is best treated with myringotomy, appropriate
antibiotics, and steroid therapy. The use of steroids with antibiotics improves
the resolution of middle ear exudate fourfold, compared with the use of
antibiotics alone. Other treatment modes in selected cases are discussed.
Physiotherapy in the form of electrical stimulation of the facial muscles is not 
advised.

PMID: 6517137 [PubMed - indexed for MEDLINE]

7377: Vestn Dermatol Venerol. 1984 Oct;(10):59-61.

[Generalized form of herpes zoster]

[Article in Russian]

Korsunskaia IM, Kotov AA, Anton'ev AA.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6516576 [PubMed - indexed for MEDLINE]

7378: Aust Fam Physician. 1984 Oct;13(10):770-1.

Developing a hypothesis. A question about herpes zoster.

Dickinson JA.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6508646 [PubMed - indexed for MEDLINE]

7379: Lijec Vjesn. 1984 Oct;106(10):414-7.

[Clinical and epidemiologic characteristics of herpes zoster in patients treated 
at the Clinic during a 5-year period]

[Article in Croatian]

Puntaric V.

Publication Types: 
    English Abstract

PMID: 6503593 [PubMed - indexed for MEDLINE]

7380: J Clin Microbiol. 1984 Oct;20(4):696-700.

Use of bone marrow fibroblasts to prepare targets for an HLA
restricted-cytotoxicity assay system.

Bowden RA, McGavren L, Hayward AR, Levin MJ.

Methods are described for obtaining and growing fibroblasts from bone marrow for 
use as virus-infected targets. Fibroblasts obtained at the time of routine marrow
examination were maintained through 12 to 18 passages as confluent monolayers.
Bone marrow fibroblasts could be infected with varicella-zoster virus, and these 
infected cells were suitable targets for a 51Cr-release cytotoxicity assay. Since
these virus-infected cells retain their HLA-A and -B antigens, they are readily
available to study the immune cells which mediate virus-specific cytotoxicity.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6490855 [PubMed - indexed for MEDLINE]

7381: Kansenshogaku Zasshi. 1984 Oct;58(10):1033-7.

[Clinical study on dermatomyositis-polymyositis complicated with herpes zoster]

[Article in Japanese]

Nagaoka S, Ishigatsubo Y, Chiba J, Kato K, Narita M, Sakamoto H, Tani K, Ito A,
Okubo T.

Publication Types: 
    English Abstract

PMID: 6442317 [PubMed - indexed for MEDLINE]

7382: J Tenn Med Assoc. 1984 Oct;77(10):575-8.

Management of post-herpetic neuralgia.

Parris WC.

Publication Types: 
    Case Reports

PMID: 6389985 [PubMed - indexed for MEDLINE]

7383: Antiviral Res. 1984 Oct;4(5):281-91.

Efficacy of bromovinyldeoxyuridine in the treatment of herpes simplex virus and
varicella-zoster virus eye infections.

Maudgal PC, De Clercq E, Missotten L.

As has been established in rabbits, (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU)
is superior to 5-iodo-2'-deoxyuridine (IDU) in the topical treatment of
epithelial HSV-1 (herpes simplex virus type 1) keratitis, and superior to
5-trifluoromethyl-2'-deoxyuridine (TFT) in the topical treatment of deep stromal 
HSV-1 keratitis and HSV-1 uveitis. BVDU 0.1% eye drops have also proven
efficacious in the treatment of patients with dendritic corneal ulcers,
geographic corneal ulcers and stromal keratitis, and combined treatment of BVDU
0.1% eye drops with oral BVDU at 375 mg/day for 5 days led to a prompt healing of
keratouveitis and skin lesions in patients with ophthalmic herpes zoster.

PMID: 6335020 [PubMed - indexed for MEDLINE]

7384: Z Hautkr. 1984 Oct 1;59(19):1303-8, 1311.

[Motor function loss in zoster neuritis versus encephalitis--clinical case and
review of literature]

[Article in German]

Kempkes K, Hillert-Kempkes US, Pfeifer B.

Motor lesions following herpes zoster are quite common. Hemiparesis, paraparesis,
pareses of the facial and other cranial nerves as well as segmental pareses can
be observed. We report on a patient suffering from zoster ophthalmicus
complicated by paresis of the third cranial nerve. As a cause, a partial brain
stem-encephalitis was diagnosed. The patient recovered after antiviral treatment 
(Aciclovir, Inosiplex).

Publication Types: 
    Case Reports
    English Abstract

PMID: 6209868 [PubMed - indexed for MEDLINE]

7385: J Virol Methods. 1984 Oct;9(2):153-61.

Comparison of an enzyme-linked immunoassay with an indirect hemagglutination
assay for the detection of antibodies to cytomegalovirus.

Chairez R, Schleicher JB, Cesario AJ.

Because of the morbidity associated with cytomegalovirus (CMV) infections in
neonates, immunosuppressed and transplant patients, there is a need for a rapid, 
sensitive, and reliable assay for the presence of antibody to CMV. Such an assay 
would permit the identification of CMV antibody negative blood or plasma for
transfusion into these high-risk patients. The indirect hemagglutination assay
(IHA) is often employed to detect antibodies to CMV, but results must be
interpreted subjectively. Thus, an indirect enzyme immunoassay (EIA) was
developed to detect antibodies to CMV, and was compared to IHA. 531 sera from a
population of healthy blood donors were assayed by both methods. Compared with
IHA the sensitivity of the indirect EIA was 98.5% (267/271) and the specificity
was 93.1% (242/260). Antibodies to Epstein-Barr, herpes-zoster, or herpes simplex
viruses did not react in the EIA. The EIA and IHA correlated well in the
detection of antibodies to CMV in sera from acute CMV infections. The presence of
rheumatoid factor did not interfere with the EIA or IHA results. This indirect
EIA is a rapid, simple, and reproducible method to identify seronegative sera or 
plasma.

Publication Types: 
    Comparative Study

PMID: 6096389 [PubMed - indexed for MEDLINE]

7386: Clin Haematol. 1984 Oct;13(3):645-60.

Herpes virus infections: clinical manifestations and therapeutic strategies in
immunocompromised patients.

Saral R, Burns WH, Prentice HG.

Herpesvirus infections are a major cause of morbidity and mortality in
immunosuppressed patients. Bone marrow and organ transplant recipients are model 
patient populations for studying the natural history of herpesvirus infections
because the infections occur predictably after transplantation. Herpes simplex
virus infections occur within the first month after transplantation and may cause
severe mucocutaneous disease. Cytomegalovirus infections occur one to three
months after transplantation and are the major viral cause of morbidity and
mortality. Varicella-zoster virus infections occur four to five months after
transplantation and rarely cause life-threatening infection. Further studies of
Epstein-Barr virus are necessary to determine its significance as a pathogen. The
development of new antiviral agents has introduced effective therapeutic
approaches for herpes simplex virus infections and varicella-zoster virus
infections. Efforts to treat or prevent cytomegalovirus infections in transplant 
recipients have had limited success. However, new therapeutic strategies may lead
to therapies which may reduce the severity of these infections and lead to
increased survival in bone marrow transplant and organ transplant recipients.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6094062 [PubMed - indexed for MEDLINE]

7387: J Clin Pathol. 1984 Oct;37(10):1140-3.

Serum beta 2-microglobulin and C reactive protein concentrations in viral
infections.

Cooper EH, Forbes MA, Hambling MH.

Serum beta 2-microglobulin concentrations were assayed in a number of virus
diseases. Infectious mononucleosis, cytomegalovirus, and influenza A were
associated with pronounced increases in serum beta 2-microglobulin concentration.
Smaller increases, with values generally less than 4 mg/l, were noted in other
viral infections. Apart from in acute influenza A, the C reactive protein and
beta 2-microglobulin responses were not associated.

PMID: 6092437 [PubMed - indexed for MEDLINE]

7388: Clin Exp Immunol. 1984 Oct;58(1):217-22.

Antibody-dependent cell-mediated cytotoxicity to Varicella zoster.

Babbage J, Sigfusson A, Souhami RL.

Antibody-dependent cell-mediated cytotoxicity (ADCC) against Varicella zoster
(VZ) infected fibroblasts is described. ADCC requires antibody to VZ and is
greater with heavily infected targets. It is not dependent on the immune status
of the effector cells. The effector cells responsible for ADCC are present in
sheep red cell (E) positive and E-fractions of peripheral blood, and in the G10
non-adherent population. The ADCC activity is present in microexudate
non-adherent cells and in the adherent population to a lesser extent. The
technique provides a means to study host defence against VZ infection in immune
compromised individuals.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6090042 [PubMed - indexed for MEDLINE]

7389: Lancet. 1984 Sep 22;2(8404):677-82.

Antiviral therapy. Varicella-zoster virus infections, herpes labialis and
mucocutaneous herpes, and cytomegalovirus infections.

Nicholson KG.

Publication Types: 
    Review

PMID: 6147701 [PubMed - indexed for MEDLINE]

7390: Ugeskr Laeger. 1984 Sep 19;146(38):2888-92.

[Acyclovir (Zovirax). A new antiviral agent against herpes infections]

[Article in Danish]

Kroon S, Petersen CS, Krebs HJ.

PMID: 6515916 [PubMed - indexed for MEDLINE]

7391: Lancet. 1984 Sep 8;2(8402):575.

Oral acyclovir for herpes zoster.

Finn R, Smith MA.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Letter

PMID: 6147619 [PubMed - indexed for MEDLINE]

7392: Lakartidningen. 1984 Sep 5;81(36):3132.

[Cimetidine effective in herpes zoster]

[Article in Swedish]

Bjorklund O, Strandberg L.

Publication Types: 
    Case Reports

PMID: 6482593 [PubMed - indexed for MEDLINE]

7393: Ann Pathol. 1984 Sep-Nov;4(4):305-7.

[Ultrastructural aspects of a cutaneous biopsy in acquired immune deficiency
syndrome (AIDS)]

[Article in French]

Bruneval P, Tricottet V, Camilleri JP, Reynes M, Daniel F.

Herpes zoster blister was biopsied in an homosexual man presenting and AIDS.
Ultrastructural findings were as follows: typical herpes virus particles,
tubuloreticular inclusions (TRI), helical polyribosomes. The association of these
three findings suggests that TRI may represent rather a particular way of
cellular reaction than an etiologic ultrastructural marker in AIDS.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6508886 [PubMed - indexed for MEDLINE]

7394: J Am Acad Dermatol. 1984 Sep;11(3):480-2.

Herpes zoster and occult malignancy.

Fueyo MA, Lookingbill DP.

Herpes zoster and malignancy have both been associated with conditions of immune 
suppression. It has been well documented that herpes zoster occurs more
frequently in patients with a previously diagnosed malignancy, especially
lymphoma. To determine whether there is an increased frequency of malignancy
subsequent to the diagnosis of herpes zoster, we studied fifty outpatients with
herpes zoster and compared them with fifty control patients with psoriasis. In a 
follow-up period ranging from 24 to 68 months, one individual in the herpes
zoster group developed a subsequent malignancy, in comparison to none in the
control population and to 1.5 cancer cases expected in the general population.
These results support the view that herpes zoster is not a marker for an occult
malignancy.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 6480952 [PubMed - indexed for MEDLINE]

7395: Med J Aust. 1984 Sep 1;141(5):320.

Treatment of herpes zoster.

[No authors listed]

Publication Types: 
    Case Reports
    Letter

PMID: 6472173 [PubMed - indexed for MEDLINE]

7396: Hosp Pract (Off Ed). 1984 Sep;19(9):67-9, 72, 74-6 passim.

Diagnosis of eyelid and periorbital abnormalities.

Meltzer MA.

PMID: 6432825 [PubMed - indexed for MEDLINE]

7397: Infection. 1984 Sep-Oct;12(5):338-41.

Limited value of acyclovir in the treatment of uncomplicated herpes zoster: a
placebo-controlled study.

van den Broek PJ, van der Meer JW, Mulder JD, Versteeg J, Mattie H.

The effect of intravenous acyclovir (at a dosage of 30 mg/kg per day for five
days) on uncomplicated herpes zoster was investigated in 51 patients in a
double-blind study. Although existing herpes zoster lesions tended to heal more
rapidly and new lesions ceased to appear somewhat earlier in the acyclovir group,
these differences were not statistically significant. During treatment, patients 
on acyclovir had significantly lower pain scores than placebo-treated patients.
At follow-up, however, there was no difference between the two groups.
Complications of herpes zoster occurred only in the placebo groups
(generalization in two and keratitis in two cases). With the possible exception
of trigeminal zoster or severe pain, acyclovir seems to offer little benefit for 
immunocompetent patients with herpes zoster.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6392105 [PubMed - indexed for MEDLINE]

7398: Med Radiol (Mosk). 1984 Sep;29(9):66-74.

[Complications of radiotherapy and chemoradiotherapy of lymphogranulomatosis]

[Article in Russian]

Kholin AV.

Publication Types: 
    Review

PMID: 6384718 [PubMed - indexed for MEDLINE]

7399: J Dermatol Surg Oncol. 1984 Sep;10(9):718-20.

Cutaneous metastatic squamous-cell carcinoma in zosteriform distribution.

Buecker JW, Ratz JL.

A renal transplant patient on immunosuppressives with a history of multiple
premalignant and malignant skin tumors developed cutaneous metastatic
squamous-cell carcinoma in a typical zosteriform distribution on the right arm
and chest. This distribution of a squamous-cell carcinoma is unique to the
English literature and serves to emphasize the necessity for frequent follow-up
and aggressive treatment in this high-risk population.

Publication Types: 
    Case Reports

PMID: 6384303 [PubMed - indexed for MEDLINE]

7400: South Med J. 1984 Sep;77(9):1149-56.

Herpes zoster: epidemiology, clinical features, and management.

Reuler JB, Chang MK.

Herpes zoster is a commonly encountered infectious disease primarily affecting
the elderly and immunosuppressed. The natural history and complications of the
disease and the principles of management are often not appreciated by clinicians 
in a variety of disciplines who may see the patient during the acute phase.
Recent literature has furthered our understanding of the virology of herpes
zoster and the roles of corticosteroid and antiviral therapy. We review the
clinical features, diagnostic principles, and management controversies of herpes 
zoster.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6207596 [PubMed - indexed for MEDLINE]

7401: Biken J. 1984 Sep;27(2-3):99-102.

Immunization of acute leukemic children with a live varicella vaccine (Oka
strain).

Kamiya H, Kato T, Isaji M, Torigoe S, Oitani K, Ito M, Ihara T, Sakurai M,
Takahashi M.

A total of 52 acute leukemic children have been safely and effectively vaccinated
with live varicella (Oka strain) vaccine given under close clinical and
immunological observation. The incidence of zoster in the vaccinated children
group was slightly less than that in the group that had experienced natural
varicella.

PMID: 6100066 [PubMed - indexed for MEDLINE]

7402: Biken J. 1984 Sep;27(2-3):73-5.

A clinical trial of live attenuated varicella vaccine (Biken) in children with
malignant diseases.

Konno T, Yamaguchi Y, Minegishi M, Goto Y, Tsuchiya S.

The live attenuated varicella vaccine (Biken) derived from the Oka strain was
used for immunization of childhood cancer patients in remission but on
chemotherapy. Thirty nine patients were immunized without any severe adverse
effects but 6 recipients had a small number of vesicles. Seroresponses were
observed in 90% of recipients examined. During the follow-up period 6 leukemia
recipients were suffered from natural varicella in family or community contacts. 
No vaccinee developed herpes-zoster during this study period.

Publication Types: 
    Clinical Trial

PMID: 6100062 [PubMed - indexed for MEDLINE]

7403: Biken J. 1984 Sep;27(2-3):51-8.

Effect and follow-up study on varicella vaccine.

Katsushima N, Yazaki N, Sakamoto M.

Attenuated liver varicella vaccine (Oka strain) was used to vaccinate 242
children and 5 adults between August 1976 and December 1982; namely emergency
vaccinations were given to 163 cases, including 35 high risk children, on 17
occasions, and non-emergency vaccinations were given to 84 cases including 7 high
risk ones in remission. The viral doses varied from 250 to 3,000 PFU.
Vaccinations prevented subsequent infection in all cases. Emergency vaccinations 
were given within 100 h after contact of the subjects with cases of varicella.
Humoral and/or cellular immunity was acquired in 97.6% (40/41) of the high risk
group and 91.8% (179/195) of the non-high risk group. As clinical reactions,
rashes and fever developed in 43.9% (18/41) and in 17.0% (7/41) of high risk
patients, and 7.8% (16/204) and 1.0% (2/204) of the non-high risk patients
respectively. Reactions were generally slight, but were severe or atypical in 3
immunocompromized patients. Follow-up studies were carried out every year since
1980. Among the 41 high risk patients, herpes-zoster developed in 4, and
varicella in 5 patients. Among the 179 non-high risk patients, there were no
cases of herpes-zoster but 21 cases (12.3%) of varicella, which were mostly
extremely mild. Six patients were revaccinated because of their humoral and/or
cellular immunity decreased, and as a result acquired an immune response again.
Criteria for varicella vaccination and details of the results of vaccination and 
follow-up studies are described.

PMID: 6100058 [PubMed - indexed for MEDLINE]

7404: Biken J. 1984 Sep;27(2-3):43-9.

A live varicella vaccine in a pediatric community.

Yabuuchi H, Baba K, Tsuda N, Okada S, Nose O, Seino Y, Tomita K, Ha K, Mimaki T, 
Ogawa M, et al.

A total of 663 children with various underlying diseases were immunized with a
live varicella vaccine at the vaccine clinic of Osaka University Hospital during 
a period of seven years from October, 1975. Clinical reactions after vaccination 
occurred in 32.4% (24/74) of the children with malignancies and in 0.3% (2/591)
of those in other groups. Vaccine-induced immunity was detected for more than 6
years, by FAMA (fluorescent antibody to membrane antigen) and IAHA (immune
adherence hemagglutination) tests, and a skin-test for varicella-zoster virus
(VZV). During an observation period of more than 7 years, clinical varicella
developed in 12 children, 8 of whom were in the group with malignancies. Zoster
occurred in only 4 (9.1%) of 44 vaccinees with acute leukemia, this incidence
being significantly less (p less than 0.05) than that (21.6%, 8/37) in
un-vaccinated leukemic children.

PMID: 6100057 [PubMed - indexed for MEDLINE]

7405: Biken J. 1984 Sep;27(2-3):137-41.

Prevention of varicella in immunocompromised patients on unpredictable occurrence
of the disease in a children's ward: vaccine-boostered immune whole blood
transfusion (VIB) method.

Hirao T.

For prevention of secondary varicella infection in patients whose immunities were
extremely impaired by intensive chemotherapy or immunosuppressive agents, we have
been using the vaccine-boostered immune whole blood transfusion (VIB) method when
there was an unpredictable case of varicella in the children's ward. By this
method passive transfer of humoral and cellular immunity is achieved. There have 
been 25 unpredictable occurrences of varicella or herpes-zoster in the ward of
our children's hospital between April 1977 and May 1983 and during these episodes
16 patients, mostly with malignant diseases, have been treated by this method.
There has been no case of secondary varicella infection among these patients and 
no serious troubles associated with the VIB method.

PMID: 6100052 [PubMed - indexed for MEDLINE]

7406: Biken J. 1984 Sep;27(2-3):103-9.

Evaluation of varicella vaccine in childhood leukemia. Observation over 6 years.

Oka T, Iseki K, Oka R, Sakuma S, Yoshioka H, Takahashi M.

Since 1977, we have used a live attenuated varicella vaccine to immunize 10
children with acute leukemia. 8 patients had no adverse clinical reaction but 2
patients developed mild fever and papulovesicular rash after vaccination. All 9
tested children became seropositive after the vaccination. Also in all 3 children
who were observed for more than 4 years, persistence of neutralizing antibody was
detected. Most of the recipients were prevented from developing symptoms of
varicella in spite of contact exposure. Two patients developed varicella when
they were in severe immunosuppressive states but their symptoms were mild. None
of the children developed herpes-zoster during the 6 year follow-up period. The
results suggest that the varicella vaccine is effective in children with acute
leukemia, and that long-term effectiveness can be expected.

PMID: 6100045 [PubMed - indexed for MEDLINE]

7407: Cutis. 1984 Sep;34(3):278-81.

Treatment of varicella-zoster pneumonia with transfer factor.

Winkelmann RK, DeRemee RA, Ritts RE Jr.

A 29-year-old woman with a long history of immunoreactive
disease--thrombocytopenic purpura, bullous pemphigoid, nephropathy, and hemolytic
anemia--contracted generalized herpes zoster and varicella pneumonia. Respiratory
failure requiring assisted respiration accompanied progressive chest findings.
She recovered rapidly simultaneous with the administration of transfer factor
from a healing herpes zoster patient. We believe that this therapy should be
attempted in similar desperate circumstances.

Publication Types: 
    Case Reports

PMID: 6092003 [PubMed - indexed for MEDLINE]

7408: Mol Pharmacol. 1984 Sep;26(2):376-80.

Comparative inhibition of DNA polymerases from varicella zoster virus (TK+ and
TK-) strains by (E)-5-(2-bromovinyl)-2'-deoxyuridine 5'-triphosphate.

Yokota T, Konno K, Shigeta S, De Clercq E.

The inhibitory effect of (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU)
5'-triphosphate on varicella zoster virus (VZV) DNA polymerase was studied using 
the parent strain (TK+-VZV) and the mutant strain (TK--VZV). The mutant strain
was deficient in thymidine kinase (TK)-inducing activity and resistant to BVDU.
In the absence of BVDU, TK--VZV and TK+-VZV induced an equivalent level of viral 
DNA polymerase activity in human embryo fibroblasts. In the presence of 5 microM 
BVDU, TK--VZV still induced viral DNA polymerase activity, whereas TK+-VZV failed
to do so. BVDU 5'-triphosphate (BVDUTP) was considerably more inhibitory to the
TK+- and TK--VZV DNA polymerases than to the cellular DNA polymerases. There were
no significant differences in the affinity for dTTP as substrate and the
sensitivity to BVDUTP as inhibitor between the TK+- and TK--VZV DNA polymerases. 
The Km value for dTTP and the Ki value for BVDUTP of the VZV DNA polymerases were
1.43 microM and 0.55 microM, respectively. The inhibitory effect of BVDUTP to VZV
DNA polymerase was competitive with respect to the natural substrate.

PMID: 6090888 [PubMed - indexed for MEDLINE]

7409: J Gen Virol. 1984 Sep;65 ( Pt 9):1477-86.

Pathogenesis of zosteriform spread of herpes simplex virus in the mouse.

Blyth WA, Harbour DA, Hill TJ.

Zosteriform spread of herpes simplex virus (HSV) infection occurs after primary
inoculation of the skin of both outbred and inbred mice. With HSV type 1 strain
SC16 few outbred animals died if they were inoculated when 8 weeks old whereas up
to 50% of animals died if inoculated when 4 weeks old. However, at either age,
zosteriform spread of infection occurred in almost all animals as it did when
4-week-old outbred animals were inoculated with the avirulent strain KOS. Thus,
control of zosteriform spread must act by different mechanisms from those
controlling the encephalitis which leads to death. During replication in the
epidermis virus enters axons and could first be found in sensory ganglia 2 days
after inoculation of the skin. Thereafter, it was found in the nerve roots and in
skin within the same dermatome but remote from the site of inoculation. When
sensory nerves to this latter area were cut during the 4 days after primary
inoculation lesions developing as a result of zosteriform spread were either
completely inhibited or, with later section, decreased in incidence. Mortality
was not affected by such nerve section. Latent infection must be established in
neurons serving areas of skin remote from the inoculation site since with HSV-1
strain SC16, recrudescent lesions on the pinna could be induced by stripping the 
skin of the ear when the original inoculation had been in the skin of the neck.
Such recrudescent disease was not demonstrated in animals infected with HSV-1
strain KOS even though this virus efficiently established latent infection in
sensory ganglia.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 6088680 [PubMed - indexed for MEDLINE]

7410: Chest. 1984 Sep;86(3 Suppl):6S-9S.

Cell-mediated immunity and pregnancy.

Lederman MM.

Publication Types: 
    Review

PMID: 6088180 [PubMed - indexed for MEDLINE]

7411: JAMA. 1984 Aug 24-31;252(8):1012.

Hemiparesis and Bell's palsy following brachial plexus herpes zoster.

Economou PG.

Publication Types: 
    Case Reports
    Letter

PMID: 6748204 [PubMed - indexed for MEDLINE]

7412: Can Med Assoc J. 1984 Aug 15;131(4):279.

Treatment of herpes zoster with cimetidine.

Shandera R.

Publication Types: 
    Letter

PMID: 6744172 [PubMed - indexed for MEDLINE]

7413: Ugeskr Laeger. 1984 Aug 13;146(33):2487-8.

[Herpes zoster in infants]

[Article in Danish]

Siersted HC, Pfeiffer P, Trommer B.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6515860 [PubMed - indexed for MEDLINE]

7414: Nucleic Acids Res. 1984 Aug 10;12(15):5969-78.

Trans activation of plasmid-borne promoters by adenovirus and several herpes
group viruses.

Everett RD, Dunlop M.

This paper describes experiments to test the ability of a number of viruses of
the Herpes group, and also Adenovirus-2 and SV40, to activate transcription from 
the Herpes simplex virus-1 glycoprotein D and the rabbit beta-globin promoters.
Plasmids containing these genes were transfected into HeLa cells which were then 
infected with various viruses. Transcriptional activation in trans of the
plasmid-borne promoters was monitored by quantitative S1 nuclease analysis of
total cytoplasmic RNA isolated after infection. The results showed that Herpes
simplex viruses 1 and 2, Pseudorabies virus, Variella Zoster virus, Human
Cytomegalovirus, Equine herpes virus-1 and Adenovirus-2 activate transcription
from both promoters tested. In contrast, SV40 did not activate transcription in
trans in this assay. The possible mechanisms of this activation are discussed.

PMID: 6089105 [PubMed - indexed for MEDLINE]

7415: Med J Aust. 1984 Aug 4;141(3):200.

Herpes zoster in the S3 dermatome.

Fitzhenry J.

Publication Types: 
    Case Reports
    Letter

PMID: 6749045 [PubMed - indexed for MEDLINE]

7416: N Engl J Med. 1984 Aug 2;311(5):329-30.

Varicella and herpes zoster.

[No authors listed]

Publication Types: 
    Letter

PMID: 6738644 [PubMed - indexed for MEDLINE]

7417: Klin Med (Mosk). 1984 Aug;62(8):130-2.

[Clinical aspects of herpes infection]

[Article in Russian]

Shul'tsev GP.

Publication Types: 
    Case Reports

PMID: 6492703 [PubMed - indexed for MEDLINE]

7418: Cutis. 1984 Aug;34(2):177-9.

Granuloma annulare in herpes zoster scars.

Packer RH, Fields JP, King LE Jr.

We have described a patient in whom GA developed at the site of remotely healed
herpes zoster scars. This case represents another example of GA occurring in
traumatized or injured skin and provides further evidence for the existence of
the isomorphic response in the pathogenesis of this common disorder.

Publication Types: 
    Case Reports

PMID: 6478880 [PubMed - indexed for MEDLINE]

7419: Mil Med. 1984 Aug;149(8):479-81.

Esophageal stricture following esophagitis in a patient with herpes zoster: case 
report.

Kroneke K, Cuadrado R.

Publication Types: 
    Case Reports

PMID: 6433236 [PubMed - indexed for MEDLINE]

7420: J Antimicrob Chemother. 1984 Aug;14(2):185-9.

Oral and intravenous acyclovir are equally effective in herpes zoster.

Peterslund NA, Esmann V, Ipsen J, Christensen KD, Petersen CM.

In a double-blind randomised trial 40 patients above 60 years old with acute
herpes zoster received either 5 mg/kg acyclovir three times daily intravenously
or 400 mg acyclovir five times daily orally for five days. Identical results were
obtained with respect to duration of pain and rate of healing. Twenty per cent of
orally administered acyclovir was absorbed and gave satisfactory concentrations
of acyclovir in the vesicular fluid.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6389470 [PubMed - indexed for MEDLINE]

7421: Onkologie. 1984 Aug;7(4):210-2.

[Improved clinical course of herpes zoster in immunosuppressed patients treated
with fibroblast interferon]

[Article in German]

Heidemann E, Dietz K, Obert HJ, Wilms K.

In a randomized study with patients suffering from herpes zoster spread of
eruptions was inhibited and segmental pain was reduced rapidly by continuous
infusion of daily 0.5 X 10(6) IE fibroblast interferon/kg body weight for 3-5
days. Postherpetic neuralgia was observed more rarely and interferon healing of
eruptions was accelerated by interferon compared to the controls.


Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 6384863 [PubMed - indexed for MEDLINE]

7422: J Antimicrob Chemother. 1984 Aug;14 Suppl A:85-95.

The antiviral spectrum of (E)-5-(2-bromovinyl)-2'-deoxyuridine.

De Clercq E.

The antiviral activity spectrum of (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVdU) is
not restricted to herpes simplex virus type 1 (HSV-1) and varicella-zoster virus 
(VZV) but also encompasses several other herpesviruses such as suid herpesvirus
type 1 (SHV-1), bovid herpesvirus type 1 (BHV-1), simian varicella virus (SVV),
herpesvirus saimiri, herpesvirus platyrrhinae, and the baculovirus Trichoplusia
ni multiple nuclear polyhedrosis virus. Other herpesviruses such as herpes
simplex virus type 2, cytomegalovirus and Epstein-Barr virus are also inhibited
by BVdU, albeit to a lesser extent than HSV-1, VZV, SHV-1, BHV-1 and SVV.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 6092320 [PubMed - indexed for MEDLINE]

7423: J Antimicrob Chemother. 1984 Aug;14 Suppl A:57-74.

Treatment of human herpesvirus infections with special reference to encephalitis.

Whitley RJ.

Publication Types: 
    Clinical Trial
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6092319 [PubMed - indexed for MEDLINE]

7424: J Am Acad Dermatol. 1984 Aug;11(2 Pt 1):165-91.

The varicella-zoster virus: systemic and ocular features.

Liesegang TJ.

Although the varicella-zoster virus infections are usually benign skin diseases, 
they can have serious systemic manifestations and complications. This article
reviews the current concepts concerning the anatomy and physiology of the virus
and the epidemiology, pathogenesis, pathology, immunology, and laboratory
diagnosis of these infections. The information gained in these areas has improved
our knowledge of the disease, permitted the detection of susceptible patients,
allowed the earlier use of new antiviral treatment, and provided a background for
the use of active and passive immunization. The clinical features and
consequences of both varicella and herpes zoster are described. The prevention
and treatment are underscored, especially with regard to the newer systemic
antiviral therapy. Herpes zoster ophthalmicus is specifically detailed because of
its frequency and because of serious ocular and systemic implications for both
the dermatologist and the ophthalmologist. The nerve innervation of the eye and
ocular adnexa as it pertains to herpes zoster ophthalmicus is outlined, and a
description is given of the multiple ocular complications for the dermatologist. 
Data on the role of antiviral agents and of topical and systemic corticosteroids 
in herpes zoster ophthalmicus are presented. Postherpetic neuralgia, probably the
most difficult management problem of herpes zoster ophthalmicus, is addressed
from a descriptive, preventive, and treatment view.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 6090512 [PubMed - indexed for MEDLINE]

7425: Immun Infekt. 1984 Aug;12(4):187-91.

[Antiviral therapy of immunocompromised patients]

[Article in German]

Eggers HJ.

For immunocompromised patients virus infections represent a definite risk,
particularly infections with measles virus and viruses of the herpes group
(primary infections or reactivations). Vidarabine, acyclovir and
bromovinyldeoxyuridine are therapeutically active against varicella, zoster, and 
herpes simplex, provided they are administered early in the course of disease.
For zoster at least, the efficacy of interferon has been documented in controlled
studies. No convincing therapy is so far available for the severe cytomegalovirus
infections. Interferons obtained with DNA recombinant techniques are of
significant promise in the near future.

Publication Types: 
    English Abstract

PMID: 6090308 [PubMed - indexed for MEDLINE]

7426: Am J Ophthalmol. 1984 Jul 15;98(1):7-10.

Skin test with varicella-zoster virus antigen for ophthalmic herpes zoster.

Tanaka Y, Harino S, Danjo S, Hara J, Yamanishi K, Takahashi M.

We assessed delayed dermal hypersensitivity to varicella-zoster virus by a
varicella skin test in 12 patients (nine women and three men ranging in age from 
27 to 85 years) with ophthalmic herpes zoster during the acute stage and in a
group of 27 healthy controls (15 women and 12 men ranging in age from 18 to 58
years). Of the 27 healthy individuals, 25 had positive skin test reactions
whereas only one of the 12 patients with ophthalmic herpes zoster had a positive 
skin test reaction within two weeks after the onset of the eruption, suggesting
that cellular immunity to varicella-zoster virus antigens is impaired in the
development of ophthalmic herpes zoster. Our study also showed that the varicella
skin test is a convenient way to diagnose ophthalmic herpes zoster during the
acute stage of the disease.

PMID: 6331167 [PubMed - indexed for MEDLINE]

7427: Virology. 1984 Jul 15;136(1):241-6.

Simian varicella virus DNA shares homology with human varicella-zoster virus DNA.

Gray WL, Oakes JE.

Delta herpesvirus (DHV) and Medical Lake Macaque (MLM) virus are cell-associated 
simian herpesviruses that cause varicella-like disease in nonhuman primates, and 
are antigenically related to human varicella-zoster virus (VZV). The results of
studies designed to determine if homology exists between the DNA of DHV and MLM
and the DNA of VZV are reported here. Southern blot hybridizations conducted at
Tm-20 degrees did not detect DNA homology between the VZV and simian varicella
virus genomes. However, under conditions of lower stringency (Tm-36 degrees and
Tm-43 degrees), VZV DNA probes hybridized to specific HindIII fragments within
DNA isolated from simian varicella virus-infected cells. Under similar
hybridization conditions, DNA homology was not detected between VZV DNA and
herpes simplex virus DNA. Further studies using cloned VZV DNA HindIII fragments 
as probes suggested that the homology between VZV DNA and DHV DNA is distributed 
across the viral genomes. These results demonstrate that the genomes of VZV and
simian varicella virus share regions of conserved nucleotide sequences, and
indicate a close evolutionary relationship between VZV and simian varicella
viruses. In addition, the studies show that the DHV and MLM strains of simian
varicella virus are more closely related to each other than to human VZV.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 6330994 [PubMed - indexed for MEDLINE]

7428: JAMA. 1984 Jul 6;252(1):72-7.

Herpesvirus infections in the acquired immune deficiency syndrome.

Quinnan GV Jr, Masur H, Rook AH, Armstrong G, Frederick WR, Epstein J,
Manischewitz JF, Macher AM, Jackson L, Ames J, et al.

Herpesvirus infections were studied in persons with or at risk for the acquired
immune deficiency syndrome (AIDS). The infections diagnosed were as follows:
patients with AIDS, cytomegalovirus (CMV) in 34 of 34, Epstein-Barr virus (EBV)
in 33 of 34, herpes simplex viruses (HSV) in eight of 34, and varicella zoster
virus in four of 34; patients with chronic lymphadenopathy syndrome, CMV in eight
of nine and EBV in nine of nine; in healthy homosexual men, CMV in five of 13 and
EBV in seven of eight. Cytomegalovirus infections were frequently related to
disease and death. Herpesvirus infections are frequent causes of serious diseases
in AIDS. The prevalence of EBV and CMV infections in AIDS and the chronic
lymphadenopathy syndrome may be the result of an important interaction between
these viruses and the cause of AIDS.

PMID: 6328055 [PubMed - indexed for MEDLINE]

7429: Postgrad Med. 1984 Jul;76(1):95-7, 100-2, 105.

Facial nerve paralysis. 2. 'All that palsies is not Bell's'.

Olsen KD.

Management of the patient with facial nerve paralysis challenges the diagnostic
skills and clinical judgment of the attending physician. The clinician should not
assume that all facial paralysis is Bell's palsy; the disease possibilities are
broad and fascinating. Therapeutic options are still being evaluated, debated,
and assessed. Appropriate management of the patient with facial nerve paralysis
requires a complete history and precise examination.

Publication Types: 
    Case Reports

PMID: 6739387 [PubMed - indexed for MEDLINE]

7430: Arch Ophthalmol. 1984 Jul;102(7):1027-9.

Herpes zoster ophthalmicus and acquired immune deficiency syndrome.

Cole EL, Meisler DM, Calabrese LH, Holland GN, Mondino BJ, Conant MA.

Acquired immune deficiency syndrome (AIDS) is a recently recognized disease
characterized by abnormalities in cell-mediated immunity that predispose affected
persons to severe opportunistic infections and unusual malignant neoplasms. We
describe four cases of herpes zoster ophthalmicus in four previously healthy
homosexual men. Two had signs and symptoms consistent with AIDS, and two had
signs and symptoms of a lymphadenopathic syndrome associated with AIDS. We
suggest that underlying AIDS be considered in young, healthy persons with herpes 
zoster ophthalmicus and no known cause of immunosuppression.

Publication Types: 
    Case Reports

PMID: 6611148 [PubMed - indexed for MEDLINE]

7431: Geriatrics. 1984 Jul;39(7):79-80, 85-7, 91 passim.

Herpes zoster: protecting older patients' vision.

Lass JH.

PMID: 6610604 [PubMed - indexed for MEDLINE]

7432: Pediatr Med Chir. 1984 Jul-Aug;6(4):573-4.

[Herpes zoster in a 12-month-old girl subsequent to intrauterine exposure to the 
varicella-zoster virus]

[Article in Italian]

Della Porta G, Pullini A, Pascucci T.

A few cases have been recorded in which zoster was presumably due to reactivation
of V-Z virus acquired during the intrauterine life. In our patient, a
12-month-old infant, the mother had chickenpox during her seventh month of
pregnancy.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6543465 [PubMed - indexed for MEDLINE]

7433: Int J Dermatol. 1984 Jul-Aug;23(6):404-7.

Cutaneous angiosarcoma in a site of healed herpes zoster.

Hudson CP, Hanno R, Callen JP.

A 57-year-old woman presented with an erythematous plaque of the left
postauricular area that was diagnosed as metastatic carcinoma on clinical and
histologic bases. It was revealed that herpes zoster had been diagnosed in the
same dermatomal distribution 10 years previously. The lesion recurred 2 years
after irradiation, and angiosarcoma was diagnosed. Recent evidence linking viral 
infection and vascular tumors is examined as it might apply to the pathogenesis
of angiosarcoma. Repeat biopsy, reticulum stain, and electronmicroscopic
examination of a lesion of the head and neck region that histologically suggests 
metastatic carcinoma are recommended if no primary malignancy is discovered.

Publication Types: 
    Case Reports

PMID: 6541210 [PubMed - indexed for MEDLINE]

7434: Pediatr Infect Dis. 1984 Jul-Aug;3(4):345-8.

The use of acyclovir in children.

Bryson YJ.

Acyclovir represents a significant advance in the treatment of herpes simplex and
varicella zoster virus infections and appears to be safe and well-tolerated.
Physicians now have several drugs to choose from in the treatment of these
infections. Hopefully there will be other antiviral chemotherapeutic agents that 
will be effective for therapy of cytomegalovirus and Epstein-Barr virus
infections. Coincident with the development of antivirals, continued progress in 
the area of rapid viral diagnosis is critical for early institution of therapy.
Direct diagnosis of HSV or VZV from clinical specimens or lesions using
monoclonal antibodies, enzyme-linked immunoassays or DNA probes are promising
techniques for the future. Investigation into improved rapid diagnosis for
neonatal and maternal HSV infections and HSV encephalitis should further improve 
outcome with antiviral therapy.

PMID: 6540867 [PubMed - indexed for MEDLINE]

7435: Eur J Cancer Clin Oncol. 1984 Jul;20(7):871-2.

Therapy of Herpes zoster infections.

Hirsch MS.

PMID: 6540187 [PubMed - indexed for MEDLINE]

7436: Vestn Dermatol Venerol. 1984 Jul;(7):43-5.

[Use of the Soviet antiviral preparation methisazone in herpes zoster]

[Article in Russian]

Beliaev NV, Anton'ev AA, Korsunskaia IM.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6475278 [PubMed - indexed for MEDLINE]

7437: Rev Otoneuroophtalmol. 1984 Jul-Dec;56(4-5):487-90.

[Electrooculographic study of ocular motility changes in ophthalmic zona]

[Article in French]

Gorgone G, Tomarchio S, Dal Bello A.

Publication Types: 
    English Abstract

PMID: 6335772 [PubMed - indexed for MEDLINE]

7438: Rev Otoneuroophtalmol. 1984 Jul-Dec;56(4-5):315-21.

[Ophthalmic zona and motor involvement]

[Article in French]

Lauvin R, Maugendre D, Darcel F, Sabouraud O.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6335770 [PubMed - indexed for MEDLINE]

7439: J Virol. 1984 Jul;51(1):110-6.

Human polymorphonuclear leukocyte-mediated cytotoxicity against varicella-zoster 
virus-infected fibroblasts.

Ihara T, Starr SE, Ito M, Douglas SD, Arbeter AM.

Polymorphonuclear leukocytes (PMN) were studied for their ability to mediate
cytotoxicity against varicella-zoster virus (VZV)-infected and uninfected human
fibroblasts in 51Cr release assays. PMN were capable of mediating
antibody-dependent cellular cytotoxicity (ADCC) against VZV-infected targets.
Maximal ADCC was obtained with effector-to-target ratios of 100:1 and 18 h of
incubation. Percent 51Cr release for 26 normal adults was 14.1 +/- 0.6 (mean +/- 
standard error) in the presence of pooled human seropositive sera (final
dilution, 1:100) and 0.5 +/- 0.6 in the presence of pooled human seronegative
sera. Addition of phorbol myristate acetate (PMA) enhanced PMN-mediated
cytotoxicity against VZV-infected and uninfected targets. PMA-stimulated
cytotoxicity was optimal with PMA concentrations of 200 ng/ml and
effector-to-target ratios of 10:1, and antibody was not required; killing was
detected as early as 3 h after incubation and was maximal after 18 h. Highly
purified PMN were capable of mediating both ADCC and PMA-stimulated lysis.
Catalase completely inhibited PMA-stimulated PMN cytotoxicity, but had no effect 
on PMN-mediated ADCC. PMN from patients with chronic granulomatous disease were
capable of mediating ADCC, but not PMA-stimulated killing, against VZV-infected
targets. Thus, PMN could kill VZV-infected targets by two different mechanisms:
ADCC, which required antibody but not hydrogen peroxide (H2O2), and
PMA-stimulated cytotoxicity, which required H2O2 but not antibody.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6328030 [PubMed - indexed for MEDLINE]

7440: Zhonghua Yan Ke Za Zhi. 1984 Jul;20(4):211-3.

[Observation on the effect of cyclocytidine in herpes zoster of the eye]

[Article in Chinese]

Ni RZ.

Publication Types: 
    Case Reports

PMID: 6210182 [PubMed - indexed for MEDLINE]

7441: J Invest Dermatol. 1984 Jul;83(1 Suppl):116s-120s.

Advances in antiviral therapy.

Chou S.

Recent developments have increased the options for treatment of viral infections.
Vidarabine, an agent originally released for herpes simplex encephalitis, has
more recently been shown to be of benefit in neonatal herpes simplex infection
and in varicella-zoster infections in immunocompromised hosts. The introduction
of acyclovir represents a major advance in antiviral therapy because of its low
host toxicity and marked selectivity for herpes simplex and varicella-zoster
viruses. Extensive controlled clinical trials demonstrate efficacy in the
treatment of infections caused by these viruses in the immunocompromised host and
in genital herpes simplex infections in normal hosts. The use of recombinant DNA 
technology has increased the purity, variety, and availability of interferons for
clinical trial. Earlier experience with natural buffy coat-derived alpha
interferon showed efficacy in the treatment of varicella-zoster infections in the
immunocompromised host, as well as prophylaxis of herpes virus infections in
high-risk populations. These results have to be confirmed using the newer
interferon preparations. Under development are a variety of new drugs with
broadened viral spectrum and improved pharmacokinetic properties. These include
nucleoside analogues and novel interferons with modified amino acid sequences.
One or more of these agents, used singly or in combination, may prove useful in
the more difficult therapeutic problems, such as cytomegalovirus and hepatitis B 
infections.

Publication Types: 
    Review

PMID: 6203990 [PubMed - indexed for MEDLINE]

7442: Rev Otoneuroophtalmol. 1984 Jul-Dec;56(4-5):379-88.

[A case of facial contracture in acute polyradiculopathy with electromyographic
myokymia and permanent activity. Regressive development]

[Article in French]

Bastard J, Blanguernon R, Goas JY, Dorval JC, Masse R.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6099603 [PubMed - indexed for MEDLINE]

7443: Pediatr Dermatol. 1984 Jul;2(1):64-70.

Advances in antiviral therapy: acyclovir.

Chadwick EG, Shulman ST.

Acyclovir [9-(2-hydroxyethoxymethyl)guanine] is a newly licensed acyclic
nucleoside analog that is active in vitro and in vivo against herpes simplex
virus (HSV) and varicella zoster virus (VZV). This agent is available in the
United States in topical and intravenous forms, and the oral preparation is
currently being evaluated in clinical trials. The precise therapeutic role for
acyclovir in patients with herpesvirus infections is still evolving. This article
reviews the current status of this exciting new antiviral agent.

Publication Types: 
    Review

PMID: 6095238 [PubMed - indexed for MEDLINE]

7444: Pediatr Infect Dis. 1984 Jul-Aug;3(4):358-68.

Ocular viral infections.

Matoba A.

The ocular manifestations of viral infection vary greatly. Involvement of the
anterior segment is generally mild and self-limited, except in cases of
congenital infection which are often associated with significant alteration of
ocular structures or in cases of childhood infection with herpes simplex virus or
varicella-zoster virus, in which prolonged inflammation may lead to corneal
thinning or perforation, glaucoma and cataract formation. Involvement of the
posterior structures is potentially sight-threatening. Retinal or optic nerve
involvement should be suspected in any patient who complains of acute onset of
blurred vision in the absence of anterior segment inflammation or opacities in
the ocular media. Fortunately retinal viral infection is rare in immunocompetent 
hosts. Optic neuropathy may occur as an isolated sign but is more often
associated with more generalized involvement of the central nervous system. While
specific therapy is not always available, early diagnosis of ocular viral disease
should aid in the amelioration of acute symptoms and prevention of long term
complications.

Publication Types: 
    Review

PMID: 6089128 [PubMed - indexed for MEDLINE]

7445: J Infect Dis. 1984 Jul;150(1):149-54.

Detection of varicella-zoster viral antigens in clinical specimens by solid-phase
enzyme immunoassay.

Ziegler T.

Forty-two vesicular specimens from patients with a clinical diagnosis of
varicella-zoster virus (VZV) infection were tested in a four-layer solid-phase
enzyme immunoassay (EIA) for VZV antigens. Guinea pig and rabbit immunoglobulins 
to purified VZV nucleocapsids and a commercially obtained conjugate were used as 
immunoreagents. Thirty-nine specimens were positive by EIA, and the results were 
verified by a confirmatory test with normal guinea pig immunoglobulins as a first
layer. None of 20 specimens reacted in a similar EIA for herpes simplex virus
(HSV) antigens. One of 60 specimens from which HSV had veen isolated gave a weak 
positive reaction in the VZV assay; no reaction was detected after further
dilution of the specimen. Of 24 specimens from which VZV isolation was attempted,
virus was isolated from eight, but 21 were shown to contain VZV antigen by EIA.
Thus this EIA enables a rapid and specific diagnosis of VZV infections.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6086769 [PubMed - indexed for MEDLINE]

7446: J Clin Microbiol. 1984 Jul;20(1):94-8.

Virus-specific immunoglobulin G subclasses in herpes simplex and varicella-zoster
virus infections.

Sundqvist VA, Linde A, Wahren B.

The subclass specificities of antiviral immunoglobulin G (IgG) produced in
response to herpes simplex and varicella-zoster virus infections were
investigated. IgG1 and IgG3 with anti-herpes simplex virus activity were seen in 
patients with primary and reactivated disease, as well as in healthy seropositive
subjects and in immunoglobulin preparations. IgG4 was occasionally seen alone or 
together with IgG1 and IgG3 in patients. In varicella, IgG3-specific antiviral
antibodies were predominant, whereas in zoster, IgG1 was the dominant subclass.

PMID: 6086711 [PubMed - indexed for MEDLINE]

7447: Med J Aust. 1984 Jun 23;140(13):804.

Herpes zoster in the S3 dermatome.

Spence GC.

Publication Types: 
    Case Reports
    Letter

PMID: 6727765 [PubMed - indexed for MEDLINE]

7448: Presse Med. 1984 Jun 16;13(25):1551-4.

[Delayed contralateral hemiplegia complicating ophthalmic herpes zoster]

[Article in French]

Thevenet JP, Clavelou P, Devoize JL, Tournilhac M.

Contralateral hemiplegia may develop a few weeks after the onset of an ophthalmic
herpes zoster. This complication, which is not part of the herpetic
encephalopathy, generally coexists with lesions of arteritis demonstrable by
arteriography, affecting in most cases the proximal segments of the middle and
anterior cerebral arteries and resulting in infarcts. The pathophysiology of
these lesions is uncertain, but the vessels appear to be invaded by contiguity.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6234538 [PubMed - indexed for MEDLINE]

7449: Nature. 1984 Jun 14-20;309(5969):633-5.

Glycoprotein C of herpes simplex virus 1 acts as a receptor for the C3b
complement component on infected cells.

Friedman HM, Cohen GH, Eisenberg RJ, Seidel CA, Cines DB.

Receptors for the Fc portion of immunoglobulins or for the third component of
complement (C3) are present on a variety of circulating and fixed tissue cells
including granulocytes, monocytes, lymphocytes and glomerular epithelial cells.
Cells which lack Fc receptors may express them after infection by herpes simplex 
virus (HSV)-1, HSV-2, cytomegalovirus or varicella zoster virus. We recently
reported that infection by HSV-1 induces both Fc and C3 receptors on human
endothelial cells. Glycoprotein E of HSV-1 has been shown to function as an Fc
receptor. We now demonstrate that glycoprotein C (gC) of HSV-1 functions as a C3b
receptor. This receptor appears following HSV-1, but not HSV-2, infection.
Detection of the C3b receptor is blocked by monoclonal antibodies to glycoprotein
C (gC) of HSV-1, but not by monoclonal antibodies to other HSV-1 glycoproteins.
In addition, the MP mutant of HSV-1, which lacks gC, fails to express a C3b
receptor. These results assign a new function of gC of HSV-1 and demonstrate
potentially important differences between HSV-1 and HSV-2 glycoproteins.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6328323 [PubMed - indexed for MEDLINE]

7450: Med J Aust. 1984 Jun 9;140(12):715-20.

Antiviral chemotherapy.

White DO.

Progress in antiviral chemotherapy has taken place as a logical strategy for the 
design of antiviral agents has emerged. The second-generation nucleoside
analogues, led by acyclovir, have proved their worth against herpesviruses and
should now become a standard part of medical practice. Meanwhile, recombinant DNA
technology has lowered the cost of interferons to the point at which the several 
human subtypes of these naturally occurring hormones can be subjected
individually to controlled clinical trials against the viral diseases in the
treatment of which they show promise. Yet, optimism about the future of antiviral
chemotherapy must be tempered by the observation that most of the agents
discussed in this review are described more accurately as promising rather than
proven, and several of these have not yet been released in Australia at the time 
of writing.

Publication Types: 
    In Vitro
    Review

PMID: 6203021 [PubMed - indexed for MEDLINE]

7451: J Am Acad Dermatol. 1984 Jun;10(6):1074.

Cimetidine and herpes zoster.

Wagner RF Jr.

Publication Types: 
    Letter

PMID: 6736334 [PubMed - indexed for MEDLINE]

7452: J Neurosurg. 1984 Jun;60(6):1258-62.

Dorsal root entry zone lesions for the treatment of post-herpetic neuralgia.

Friedman AH, Nashold BS Jr, Ovelmen-Levitt J.

Post-herpetic pain was treated in 12 patients using dorsal root entry zone ( DREZ
) lesions. All patients had failed to receive adequate pain relief from
conservative therapy consisting of transcutaneous nerve stimulation,
carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to 
include the involved dermatomes plus one-half of the dermatomes above and below
the painful areas. Eight patients reported good pain relief with follow-up
periods ranging from 6 to 21 months. A ninth patient obtained satisfactory pain
relief, but the superior 1 cm of the original painful area was not included in
the distribution of the DREZ lesions. Patients whose lesions were performed using
a thermally controlled lesion probe suffered no significant postoperative
neurological deficit. Dorsal root entry zone lesions appeared to be a
satisfactory treatment for post-herpetic neuralgia in patients who have failed to
respond to more conservative modes of therapy.

PMID: 6726370 [PubMed - indexed for MEDLINE]

7453: Arch Dermatol. 1984 Jun;120(6):747-50.

Chronic neuralgia incidence following local anesthetic therapy for herpes zoster.

Riopelle JM, Naraghi M, Grush KP.

We treated 72 patients, referred to a pain clinic for acute herpes zoster
neuralgia, with local anesthetics administered by nerve block and infiltration.
Only those patients with severe pain initially proved to be at risk for the
development of chronic postherpetic neuralgia (defined as pain in the involved
dermatomes lasting at least six months). Although local anesthetic injections
effectively relieved the acute pain of active herpes zoster, they did not prevent
the development of chronic postherpetic neuralgia.

PMID: 6721540 [PubMed - indexed for MEDLINE]

7454: Ann Intern Med. 1984 Jun;100(6):920.

Severe but reversible neurotoxicity from acyclovir.

Cohen SM, Minkove JA, Zebley JW 3rd, Mulholland JH.

Publication Types: 
    Case Reports
    Letter

PMID: 6721312 [PubMed - indexed for MEDLINE]

7455: J Assoc Physicians India. 1984 Jun;32(6):535.

Unusual cases of herpes zoster involving cranial nerves.

Bhattacharya SK, Sunder S.

Publication Types: 
    Case Reports
    Letter

PMID: 6511737 [PubMed - indexed for MEDLINE]

7456: Rinsho Shinkeigaku. 1984 Jun;24(6):581-5.

[A case of segmental zoster paresis]

[Article in Japanese]

Honda H, Mano Y, Takayanagi T.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6499332 [PubMed - indexed for MEDLINE]

7457: Isr J Med Sci. 1984 Jun;20(6):547-8.

Disseminated herpes zoster and hypernephroma: chance incidence or first reported 
case?

Cohen N, Weissgarten J, Pik A, Modai D.

Publication Types: 
    Case Reports

PMID: 6469577 [PubMed - indexed for MEDLINE]

7458: Arch Intern Med. 1984 Jun;144(6):1241-6.

Acyclovir. Pharmacology and clinical experience.

Laskin OL.

Acyclovir is a selective antiherpes agent. Its selective activity is by
exploitation of differences between the herpes-specific and host cell enzymes.
The major route of elimination of acyclovir is via the kidney by glomerular
filtration and renal tubular secretion. In immunocompromised patients, acyclovir 
is effective for the prophylaxis and therapy of herpes simplex virus infections
and for the treatment of herpes zoster and varicella. In nonimmunocompromised
patients, acyclovir is beneficial in the therapy of herpes keratoconjunctivitis
and in the therapy of genital herpes, with maximal benefit seen in those patients
who have primary genital herpes. There is some benefit from acyclovir
administration in patients with herpes zoster who are otherwise normal. The toxic
reactions to acyclovir consist of phlebitis, local irritation, and occasionally, 
reversible renal dysfunction. Dose reduction is recommended in patients with
impaired renal function.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 6329117 [PubMed - indexed for MEDLINE]

7459: Transplantation. 1984 Jun;37(6):571-4.

Acyclovir treatment of varicella-zoster virus infection in the compromised host.

Meyers JD, Wade JC, Shepp DH, Newton B.

Forty marrow transplant patients were treated with acyclovir for varicella-zoster
virus infection. Median duration of virus positivity and of new lesion formation 
was 2.1 and 2.2 days, and pustulation , crusting, and healing occurred at medians
of 3.5, 8, and 28 days, respectively. Acute pain ceased at a median of 7 days,
though seven patients had later recurrence of pain and eight had pain that
persisted for more than 28 days. Three patients had recurrence of infection
within 4 days after the end of treatment and were successfully treated in each
case with a second course of acyclovir. Side effects were minimal. These data
compare favorably with published data both from the treatment of normal persons
with acyclovir and treatment of normal persons with acyclovir and treatment of
immunocompromised patients with vidarabine, and they indicate that acyclovir is
safe and effective for the treatment of varicella-zoster virus infection in the
severely immunocompromised host.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6328703 [PubMed - indexed for MEDLINE]

7460: Ann Intern Med. 1984 Jun;100(6):866-80.

Latent herpesviruses of humans.

Jordan MC, Jordan GW, Stevens JG, Miller G.

The herpesviruses that infect humans characteristically establish a latent
infection that may be reactivated later. The consequences of reactivation range
from asymptomatic shedding to severe disseminated infection. Varicella-zoster and
herpes simplex viruses are both highly neurotropic, establishing nonreplicating
infections in sensory ganglia. Latent herpes simplex virus is known to reside in 
neurons, and the virus-cell interactions involved have been defined to an extent.
Cytomegalovirus and Epstein-Barr virus interact with peripheral blood leukocytes.
Latent cytomegalovirus infection of human leukocytes has not been proved,
although studies in a murine model have implicated B lymphocytes as a repository 
of latent virus. Epstein-Barr virus is known to persist in a non-replicating
state as extrachromosomal DNA in B lymphocytes and to cause "immortalization" of 
the infected cell; persistence of the viral genome in epithelial cells may also
result in malignant transformation, such as nasopharyngeal carcinoma.

Publication Types: 
    Review

PMID: 6326635 [PubMed - indexed for MEDLINE]

7461: Compr Ther. 1984 Jun;10(6):20-9.

Diagnosis and management of viral infections.

Turner PA, Rytel MW.

With the introduction of new diagnostic techniques and the expanding choices of
antiviral agents, clinical virology is rapidly becoming an important field in
infectious diseases. While effective therapy for several respiratory viruses,
cytomegalovirus, hepatitis B virus, and Epstein-Barr virus is not currently
available, herpes simplex, varicella zoster, and influenza A associated diseases 
can be adequately treated in many cases at the present time. New agents such as
interferon, other nucleoside analogues, and immunomodulators are being
investigated for their role in the treatment of viral illnesses, and many such
illnesses with high morbidity and mortality may soon have effective therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 6203680 [PubMed - indexed for MEDLINE]

7462: Antiviral Res. 1984 Jun;4(3):99-117.

Acyclovir: an update of the clinical applications of this antiherpes agent.

Fiddian AP, Brigden D, Yeo JM, Hickmott EA.

This paper reviews the clinical evaluation of acyclovir in the treatment of
herpes-virus infections, predominantly those due to herpes simplex and
varicella-zoster viruses. Intravenous, oral and topical acyclovir have been
reported to be effective in the therapy of a wide variety of established herpes
simplex virus infections and the systemic drug has been shown to be capable of
suppressing reactivation of that virus. Although acyclovir has less activity
against varicella-zoster virus, infections caused by this agent are also
susceptible to intravenous and possibly oral therapy. Clinical efficacy against
Epstein-Barr virus and cytomegalovirus infections has not been demonstrated but
several studies are currently in progress. Limited evidence of in vivo activity
against hepatitis B virus also requires further evaluation. Continued studies on 
tolerance of the drug in clinical use has confirmed the early promise of this
selective antiviral, whilst initial concern about the development of widespread
resistance has not been borne out in practice.

Publication Types: 
    Clinical Trial
    Review

PMID: 6089659 [PubMed - indexed for MEDLINE]

7463: J Clin Microbiol. 1984 Jun;19(6):880-3.

Factors influencing quantitative isolation of varicella-zoster virus.

Levin MJ, Leventhal S, Masters HA.

Optimal conditions are described for the recovery of cell culture-derived
varicella-zoster virus (VZV). Of the cells tested, human embryonic lung
fibroblasts were the most sensitive. Storage and handling procedures were
examined to determine the stability of VZV in viral transport medium. When the
initial VZV titer was high (2 X 10(4) PFU/ml) 40% of the VZV survived room
temperature for 24 h and 75% of the VZV remained viable for this long at 4
degrees C. Recovery was 5- to 10-fold less at lower initial VZV titers (less than
2 X 10(3) PFU/ml). Other factors which influenced VZV recovery included freezing 
at -20 degrees C, the use of cotton or calcium alginate swabs, and filtration to 
remove bacterial contaminants. The tissue culture methods described were used in 
a reconstruction experiment to demonstrate that VZV could be recovered from a
laboratory coat or human skin (0.1 to 0.3% of input VZV) or from a stethoscope
(19% of input VZV) as late as 30 min after inoculation. During a clinical trial
using optimal VZV recovery procedures, 76% of the patients with herpes zoster
yielded VZV when first cultured, and 60% remained culture positive for an
additional 48 h.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6088572 [PubMed - indexed for MEDLINE]

7464: CDA J. 1984 Jun;12(6):27-31.

Herpes viruses and the human race.

Beierle JW.

PMID: 6088092 [PubMed - indexed for MEDLINE]

7465: Pol Tyg Lek. 1984 May 21;39(21):701-3.

[Herpes zoster in children treated for Hodgkin's disease]

[Article in Polish]

Armata J, Balwierz W, Rytlewska M.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 6483673 [PubMed - indexed for MEDLINE]

7466: Am J Med. 1984 May 15;76(5A):61-8.

Treatment of respiratory infections in the patient at risk.

Young LS.

Therapeutic intervention of varying potency and toxicity is now available for
bacterial, fungal, parasitic, and viral pneumonia, but the problem of
establishing the precise origin to evaluate treatment protocols remains.
Antibacterial agents reduce postinfluenzal morbidity and mortality. Earlier
appropriate treatment of gram-positive coccal infections has reduced mortality to
less than 10 percent unless bacteremia is present. Gram-negative bacillary
pneumonia remains a major problem and response rates do not exceed 65 percent
except in selected series in which two effective antimicrobial agents have been
used. Nevertheless, the superiority of two agents has not convincingly been
demonstrated in any retrospective series or prospective randomized trial; more
efficacy data in patients with gram-negative pneumonia treated with the newer
beta-lactam agents would be useful. Little information is available on the
laboratory correlates of successful treatment of gram-negative pneumonia, such as
sputum antibiotic levels. Moreover, aerosolization of antimicrobial agents has
been used with reported success by some investigators, but this therapeutic
approach remains controversial. Pneumonia or lung abscess due to anaerobes may
require increasingly larger doses of penicillin or alternative antianaerobe
agents. Parasitic pneumonias such as those due to Pneumocystis carinii have
responded well to trimethoprim-sulfamethoxazole. Acyclovir appears effective
against some herpes viruses (simplex and varicella zoster), but it has failed to 
affect cytomegalovirus pneumonia even when combined with interferon.
Opportunistic fungal pneumonias are poorly treated with all available agents and 
usually do not respond unless there is amelioration of predisposing factors or
improvement in underlying disease. The latter statement appears relevant in most 
patients with severely compromised host defenses and pulmonary infection.

Publication Types: 
    Clinical Trial
    Review

PMID: 6372480 [PubMed - indexed for MEDLINE]

7467: West J Med. 1984 May;140(5):790.

More on Herpes Zoster.

Franklin A.

PMID: 18749558 [PubMed - as supplied by publisher]

7468: Can Med Assoc J. 1984 May 1;130(9):1109.

Course of herpes zoster.

Tyrrell DL.

Publication Types: 
    Letter

PMID: 6713324 [PubMed - indexed for MEDLINE]

7469: Arthritis Rheum. 1984 May;27(5):481-8.

Total lymphoid irradiation therapy in refractory rheumatoid arthritis. Fifteen-
to forty-month followup.

Brahn E, Helfgott SM, Belli JA, Anderson RJ, Reinherz EL, Schlossman SF, Austen
KF, Trentham DE.

Twelve patients with refractory rheumatoid arthritis were treated with total
lymphoid irradiation (TLI) to a total cumulative dose of 3,000 rads. Post-TLI
morbidity/mortality included 8 patients with xerostomia, 4 with weight loss of
greater than 10 kg, 3 with loss of 4 or more teeth, 3 with herpes zoster, 4 with 
bacterial infection that was fatal in 2, 3 with hypothyroidism, 1 with cutaneous 
vasculitis, and death from myocardial infarction in 1 patient and
cardiorespiratory arrest in another. Ten of the patients were reevaluated 15-40
months (mean +/- SE, 30 +/- 2) after completion of TLI, and significant
improvement was noted in several disease parameters including number of swollen
joints, duration of morning stiffness, and 50-foot walking time. Blood
lymphopenia and a decrease in helper T cells (T4) were also noted. These data
suggest that changes in immunoregulation induced by TLI can produce longlasting
alterations in rheumatoid arthritis, although adverse effects may limit its
efficacy.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6609705 [PubMed - indexed for MEDLINE]

7470: Taiwan Yi Xue Hui Za Zhi. 1984 May;83(5):491-8.

[Adult-onset Still's disease complicated with bone marrow anomalies and herpes
zoster]

[Article in Chinese]

Yang BY, Chang JG, Liao ST, Wei CF, Siauw CP, Chen PH.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6590781 [PubMed - indexed for MEDLINE]

7471: Neurol Clin. 1984 May;2(2):215-40.

Herpes simplex and herpes zoster. Nervous system involvement.

Tenser RB.

Mainly discussed are neurologic complications of two neurotropic herpesviruses:
herpes simplex viruses types 1 and 2 and varicella-zoster virus. Briefly
discussed are cytomegalovirus and Epstein-Barr virus. Treatment of
immunosuppressed and nonimmunosuppressed patients is reviewed.

PMID: 6503937 [PubMed - indexed for MEDLINE]

7472: Arch Fr Pediatr. 1984 May;41(5):345-7.

[Acute encephalitis in zoster infection]

[Article in French]

Billard C, Goudeau A, Santini JJ, Boudeux J, Lebon P.

A case of herpes zoster acute meningo-encephalitis is reported. It is
characterized by a profuse intra-cerebral hemorrhage on CT scan and a favorable
outcome after treatment with acyclovir. The serological basis for the diagnosis, 
the mechanism of the encephalitis (viral invasion or immuno-allergic type of
reaction), and the origin of the hemorrhagic lesion are discussed. The
effectiveness of acyclovir in treating the extention of the infection to the
nervous system in patients suffering from varicella-zoster is also discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6466035 [PubMed - indexed for MEDLINE]

7473: N Y State J Med. 1984 May;84(5):245-51.

Vesicular rash and bilateral pulmonary infiltrates in a 67-year-old woman with
Hodgkin's disease.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 6377143 [PubMed - indexed for MEDLINE]

7474: N Y State J Med. 1984 May;84(5):241-4.

Viral infections in immunosuppressed patients.

Hirschman SZ.

Publication Types: 
    Review

PMID: 6330629 [PubMed - indexed for MEDLINE]

7475: J Clin Microbiol. 1984 May;19(5):606-9.

Antibody class capture assays for varicella-zoster virus.

Forghani B, Myoraku CK, Dupuis KW, Schmidt NJ.

Pooled monoclonal antibodies to varicella-zoster virus (VZV) were used as
"detector" antibodies in a four-phase enzyme immunofluorescence assay for
determination of immunoglobulin M (IgM), IgA, and IgG antibodies to VZV.
Polyclonal antisera specific for heavy chains of human IgM, IgA, and IgG were
employed as "capture" antibodies on the solid phase. The antibody class capture
assay (ACCA) for VZV IgM antibody detected high titers of virus-specific IgM in
all patients with varicella and in 5 of 10 zoster patients. VZV IgM antibody was 
not detected in patients with primary herpes simplex virus infections or in other
individuals without active VZV infection, with one exception, a patient with
encephalitis who had other serological findings compatible with a reactivated VZV
infection. VZV-specific IgA and IgG antibody titers demonstrable by ACCA were
compared with those measured by solid-phase indirect enzyme immunofluorescence
assay (EIFA). VZV IgA antibody titers detected in patients with varicella and
zoster were variable and could not be considered to be reliable markers of active
VZV infection. IgA antibody titers detected by ACCA tended to be higher than
those demonstrated by solid-phase indirect EIFA in varicella and zoster patients.
VZV IgG antibody titers detected by ACCA in patients with varicella, and to a
lesser extent in zoster patients, were as high as or higher than those
demonstrated by solid-phase indirect EIFA. However, ACCA was totally insensitive 
in detecting VZV IgG antibody in individuals with past infections with VZV and
would not be a suitable approach for determination of immunity status to VZV.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6330163 [PubMed - indexed for MEDLINE]

7476: J Infect Dis. 1984 May;149(5):741-9.

Molecular dissection of the humoral immune response to individual
varicella-zoster viral proteins during chickenpox, quiescence, reinfection, and
reactivation.

Weigle KA, Grose C.

The sequence of antibody formation to molecularly defined varicella-zoster virus 
(VZV) proteins was examined during the course of chickenpox, quiescence, and
subsequent VZV reactivation and reinfection. The first antibodies produced after 
primary VZV infection were to two virion envelope glycoproteins, gp66 and gp118 ,
and the nucleocapsid protein p155 . Within one to two months, antibodies to a
greater array of viral proteins and glycoproteins were observed. Antibodies to
the immunodominant viral proteins ( gp66 , gp118 , and p155 ) persisted for years
after varicella and were, therefore, excellent markers of prior VZV infection.
Subclinical VZV reinfection also was associated with transient rises in levels of
the same polypeptide-specific antibodies as during primary disease. The
immunoglobulin response to zoster appeared more rapidly than that to chickenpox
or reinfection and was to the broadest complement of viral proteins, including
the distinctive VZV polypeptide p32. These radioimmune-precipitation profiles
could be subdivided into six different patterns characteristic of the following
clinical states: acute- and convalescent-phase chickenpox, quiescence, acute- and
convalescent-phase zoster, and postzoster quiescence.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6327848 [PubMed - indexed for MEDLINE]

7477: J Virol. 1984 May;50(2):615-8.

Physical maps of varicella-zoster virus DNA derived with 11 restriction enzymes.

Mishra L, Dohner DE, Wellinghoff WJ, Gelb LD.

Varicella-zoster virus DNA was digested with 11 restriction endonucleases, and
the resulting fragments were separated on agarose gels. Terminal fragments were
identified by lambda exonuclease digestion. Physical maps were then constructed
using a combination of double restriction enzyme digestion and hybridization to
cloned BamHI fragments to place the remaining fragments in order.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 6323760 [PubMed - indexed for MEDLINE]

7478: Pediatr Infect Dis. 1984 May-Jun;3(3 Suppl):S34-6.

Prevention and treatment of varicella-zoster virus infection.

Gershon AA.

PMID: 6204323 [PubMed - indexed for MEDLINE]

7479: Ugeskr Laeger. 1984 Apr 30;146(18):1345-7.

[Oculomotor paralysis in ophthalmic herpes zoster]

[Article in Danish]

Johnsen T, Ahrendt N.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6333745 [PubMed - indexed for MEDLINE]

7480: Med J Aust. 1984 Apr 28;140(9):567.

Herpes zoster: an unusual case.

Curry M.

Publication Types: 
    Case Reports
    Letter

PMID: 6708909 [PubMed - indexed for MEDLINE]

7481: N Engl J Med. 1984 Apr 26;310(17):1118-9.

Herpes zoster ophthalmicus in patients at risk for AIDS.

Sandor E, Croxson TS, Millman A, Mildvan D.

Publication Types: 
    Letter

PMID: 6608691 [PubMed - indexed for MEDLINE]

7482: Virology. 1984 Apr 15;134(1):64-71.

Analysis of proteins, helper dependence, and seroepidemiology of a new human
parvovirus.

Georg-Fries B, Biederlack S, Wolf J, zur Hausen H.

A new type of defective parvovirus, tentatively designated as adeno-associated
virus type 5 (AAV-5), is characterized as far as its proteins, its helper
dependence, and its seroepidemiology are concerned. The protein analysis of AAV-5
in polyacrylamide gels demonstrated the presence of three structural
polypeptides, corresponding to VP 1, VP 2, and VP 3 of other AAV types. The
preparation of monoclonal antibodies against AAV-5 permitted the analysis of
viral structural antigen expression by using adenovirus type 12 (Ad 12) or
several herpes group viruses as helper viruses, respectively. AAV-5-infected cell
cultures coinfected with either Ad 12, Herpes simplex virus (HSV),
Cytomegalovirus (CMV), or Varicella Zoster virus (VZV) efficiently synthesize
AAV-5 specific antigens. Epstein-Barr virus (EBV) and Herpesvirus saimiri, in
contrast, provide only a very weak helper activity for AAV 5 antigen expression. 
The development of a specific ELISA test permitted screening of human sera for
antibodies to AAV-5. Forty-five percent of 926 sera from all age groups and
approximately 60% of the adult population reveal antibodies to structural
components of this virus. The seroepidemiology differs from that reported for
other AAV serotypes. Highest average titers against AAV-5 are observed in the age
group between 15 and 20 years. Sera from patients with cervical carcinoma
revealed average titers of antibodies well below those of age-matched control
groups. Attempts to find higher antibody levels against AAV-5 in specific human
diseases failed thus far.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6200995 [PubMed - indexed for MEDLINE]

7483: N Engl J Med. 1984 Apr 12;310(15):987-8.

Acyclovir for varicella zoster infection.

Fanelli C, Sattler FR.

Publication Types: 
    Clinical Trial
    Letter

PMID: 6366564 [PubMed - indexed for MEDLINE]

7484: Presse Med. 1984 Apr 7;13(15):943.

[Herpes zoster gastritis associated with Hodgkin's disease]

[Article in French]

Roussignol B, Maechel H, Morlans E, Kazi M, Royneau L.

Publication Types: 
    Case Reports
    Letter

PMID: 6231636 [PubMed - indexed for MEDLINE]

7485: Schweiz Rundsch Med Prax. 1984 Apr 3;73(14):455-61.

[Clinico-pathological conference: necrotizing angiitis of leptomeningeal vessels 
and fatal brainstem hemorrhage following ocular herpes zoster]

[Article in German]

Probst A, Wuthrich R, Vogtli J.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6144156 [PubMed - indexed for MEDLINE]

7486: Eur J Clin Microbiol. 1984 Apr;3(2):158-9.

Antibody response of patas monkeys to experimental infection with Delta
herpesvirus.

Achilli G, Sarasini A, Gerna G, Iltis JP, Madden DL.

Publication Types: 
    Letter

PMID: 6723641 [PubMed - indexed for MEDLINE]

7487: Geriatrics. 1984 Apr;39(4):108, 113-4.

A common agent explains a case of idiopathic lupus.

Dickstein ES.

Publication Types: 
    Case Reports

PMID: 6706115 [PubMed - indexed for MEDLINE]

7488: Am J Clin Pathol. 1984 Apr;81(4):529-32.

Giant cell granulomatous angiitis of the central nervous system in a patient with
leukemia and cutaneous herpes zoster.

Ojeda VJ, Peters DM, Spagnolo DV.

Pontine infarcts associated with granulomatous (giant cell) arteritis were the
terminal events in a 71-year-old man treated for chronic myeloid leukemia with
intermittent Busulphan therapy during the previous ten years. The final admission
was precipitated by a severe episode of herpes-zoster infection of the scalp.
Since 1950 there have been 25 papers in the English language medical literature
describing 36 cases of granulomatous angiitis of the central nervous system
(CNS). Seven cases, including this report, were associated with lymphoid
malignancies, and five had cutaneous herpes-zoster as well. Virus-like particles 
were detected in the affected vessels in three patients and in the nearby glial
cells of a further case.

Publication Types: 
    Case Reports

PMID: 6702756 [PubMed - indexed for MEDLINE]

7489: J Clin Lab Immunol. 1984 Apr;13(4):183-8.

Transient autoantibodies with elevated complement levels in common viral
diseases.

Niwa Y, Sakane T, Kanoh T, Shichijo S, Wiederhold MD, Yokoyama MM.

Autoantibodies including rheumatoid factor (RF), anti-DNA antibody (ADA), and
anti-nuclear factor (ANF) in addition to cold agglutinin and heterophil antibody 
titers were tested for in a total of 219 patients with common viral diseases. The
diseases included varicella, influenza, measles, mumps, herpes zoster,
hand-foot-mouth syndrome, and exanthem subitum . A high incidence of RF (23%) was
demonstrated in varicella patients, and ADA and ANF (16% and 12%, respectively)
were most frequently detected in the influenza cases. Those autoantibodies were
most frequently found in patients with influenza. Each serum complement component
and total hemolytic complement (CH50) were also assayed. Elevated levels of the
fourth (C4) and ninth (C9) components of complement, along with elevated CH50,
were observed in most patients. Follow-up studies indicated that those
autoantibodies as well as other antibodies disappeared 3 to 8 weeks after the
onset of infection. The present study indicates that substantial but transient
alterations in the immune system accompanied by autoimmune phenomena and elevated
levels in the complement components can occur in viral infections.

Publication Types: 
    Comparative Study

PMID: 6610766 [PubMed - indexed for MEDLINE]

7490: Oral Surg Oral Med Oral Pathol. 1984 Apr;57(4):388-9.

An unusual oral complication of herpes zoster infection.

Smith S, Ross JW, Scully C.

This paper describes a complication of herpes zoster infection of the orofacial
region involving a 15-year-old girl who, following herpes zoster of the right
mandibular division of the trigeminal nerve at the age of 7 years, suffered
abnormal development of the permanent teeth in this quadrant.

Publication Types: 
    Case Reports

PMID: 6584833 [PubMed - indexed for MEDLINE]

7491: Riv Neurobiol. 1984 Apr-Sep;30(2-3):336-42.

[Bannwarth syndrome. Observation apropos of 1 case]

[Article in Italian]

Marotta P, Sozzi G.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6544485 [PubMed - indexed for MEDLINE]

7492: Eur J Cancer Clin Oncol. 1984 Apr;20(4):471-6.

Oral (E)-5-(2-bromovinyl)-2'-deoxyuridine treatment of severe herpes zoster in
cancer patients.

Wildiers J, De Clercq E.

BVDU [(E)-5-(2-bromovinyl)-2'-deoxyuridine] is a highly potent and selective
anti-herpes drug. It is particularly active against Varicella zoster virus, as
demonstrated in cell culture and animals (monkeys). BVDU has been administered
orally, at a dose of 7.5 mg/kg/day for 5 days, to 20 patients with severe
localised or disseminated Herpes zoster. All patients had a malignant disorder
for which they had been given intensive chemo- or radiotherapy. Upon BVDU
treatment a rapid cessation of the acute Herpes zoster episode was noted in all
but one patient. In the majority of patients progression of the infection was
arrested within 1 day of starting treatment. No toxic side-effects could be
attributed to the drug at the dosage used.

PMID: 6539202 [PubMed - indexed for MEDLINE]

7493: Nowotwory. 1984 Apr-Jun;34(2):181-8.

[Preliminary evaluation of acyclovir treatment of patients with herpes zoster at 
the Chemotherapy Clinic, Institute of Oncology, in Warsaw]

[Article in Polish]

Rubach M, Zborzil J.

Publication Types: 
    English Abstract

PMID: 6494000 [PubMed - indexed for MEDLINE]

7494: Semin Hematol. 1984 Apr;21(2):101-8.

The early complications of bone marrow transplantation.

Champlin RE, Gale RP.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6377500 [PubMed - indexed for MEDLINE]

7495: Klin Med (Mosk). 1984 Apr;62(4):28-34.

[Chronic viral infections]

[Article in Russian]

Boriskon IuS, Bogomolova NN.

Publication Types: 
    Review

PMID: 6376937 [PubMed - indexed for MEDLINE]

7496: Transplantation. 1984 Apr;37(4):366-8.

Fatal central nervous system infection with varicella-zoster virus in renal
transplant recipients.

Peterson LR, Ferguson RM.

Three renal transplant patients with culture-positive central nervous system
infections resulting from varicella-zoster virus died of the virus infection. No 
finding predicting a poor outcome in these patients could be identified.
Varicella-zoster infection in transplant recipients is a potentially fatal
disease, and upon diagnosis should it be treated by (1) reduction in
immunosuppression, and (2) initiation of either vidarabine or acyclovir as
specific antiviral therapy.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 6369667 [PubMed - indexed for MEDLINE]

7497: J Infect Dis. 1984 Apr;149(4):501-4.

Biologic and immunologic characterization of the soluble skin-test antigen of
varicella-zoster virus.

Shiraki K, Yamanishi K, Takahashi M.

A sensitive method for assay of the potency of the skin-test antigen of
varicella-zoster virus was established. Potency was determined by a reverse
passive hemagglutination test, and the results correlated well with the cutaneous
reaction of sensitized guinea pigs and an immune human adult to the antigen.
Cutaneous reactivity was not induced by repeated inoculation of the antigen, but 
humoral neutralizing antibody was detected in most guinea pigs when a large
amount of antigen was used. No cutaneous cross-reactivity between
varicella-zoster virus and herpes simplex virus was noted; however, positive
cutaneous reactions and neutralizing antibody responses to homologous virus were 
detected in infected guinea pigs. These results suggest that both skin tests are 
specific and support the clinical usefulness of the varicella-zoster skin test.

PMID: 6327833 [PubMed - indexed for MEDLINE]

7498: Eur J Clin Microbiol. 1984 Apr;3(2):96-107.

Antiherpes drugs: promises and pitfalls.

de Clercq E.

In recent years several selective antiherpes drugs have been developed which all 
show great promise for the systemic and topical treatment of herpes simplex virus
and varicella-zoster virus infections. These new antiherpes agents include
acyclovir, bromovinyldeoxyuridine, fluoroiodoaracytosine and phosphonoformate.
Acyclovir has already been licensed for both topical and systemic use, and it is 
expected that other compounds will follow soon. Although this new generation of
antiherpes drugs suffer from some drawbacks, i.e. narrow spectrum of activity,
inefficacy during virus latency, and the possible emergence of drug-resistant
virus strains, these limitations by no means outweigh the potentials of these
drugs in the therapy and prophylaxis of herpesvirus infections in humans.

Publication Types: 
    Review

PMID: 6327297 [PubMed - indexed for MEDLINE]

7499: Diagn Microbiol Infect Dis. 1984 Apr;2(2):157-60.

Diagnosis of herpesvirus infections: correlation of Tzanck preparations with
viral isolation.

Motyl MR, Bottone EJ, Janda JM.

Evaluation of Giemsa-stained smears of scrapings from the base of vesicles or
ulcers ( Tzanck preparation) for the presence of multinucleated giant cells
and/or intracellular inclusions were diagnostic for herpesvirus in 18 of 21 cases
(86%) of culturally proved herpesvirus infections. Smears from four patients with
varicella-zoster infection also revealed cytologic alterations characteristic of 
herpesvirus.

Publication Types: 
    Comparative Study

PMID: 6201317 [PubMed - indexed for MEDLINE]

7500: Clin Dermatol. 1984 Apr-Jun;2(2):117-32.

Acyclovir: new era in antiviral chemotherapy.

Keeney RE, Wilson SJ.

Publication Types: 
    Clinical Trial
    Review

PMID: 6100713 [PubMed - indexed for MEDLINE]

7501: Lancet. 1984 Mar 31;1(8379):702-5.

Cancer, warts, and sunshine in renal transplant patients. A case-control study.

Boyle J, MacKie RM, Briggs JD, Junor BJ, Aitchison TC.

94 renal transplant patients were examined for the presence of cutaneous
malignancies, actinic keratoses, warts, and cutaneous fungal infection, and a
history was taken of infection with herpes simplex and herpes zoster. Each
patient had a control matched for age, sex, and sun exposure. Of the 17 patients 
with high exposure to sunshine (more than 3 months in a tropical or subtropical
climate or more than 5 years in an outdoor occupation), 2 had squamous cell
carcinoma and 7 actinic keratoses. These lesions did not occur in the other renal
transplant patients or the control group. The immunosuppressive effect of
ultraviolet radiation in the sunburn spectrum (290-320 nm) in man and animals may
be related to the increased incidence of cutaneous malignancy, actinic keratoses,
and warts. Transplant patients should be under regular surveillance for the early
detection and treatment of premalignant cutaneous lesions, and they should
receive advice on avoiding sun exposure.

PMID: 6143041 [PubMed - indexed for MEDLINE]

7502: Am J Med. 1984 Mar 30;76(3A):124-7.

Varicella zoster antibody titers after the administration of intravenous immune
serum globulin or varicella zoster immune globulin.

Paryani SG, Arvin AM, Koropchak CM, Wittek AE, Amylon MD, Dobkin MB, Budinger MD.

Varicella is a serious infection in the immunocompromised patient. Prophylaxis
with varicella zoster immune globulin is known to decrease the incidence of
severe varicella infection. The titers of antibody to varicella zoster virus were
compared in patients who received either varicella zoster immune globulin or
intravenous immune globulin, 4 ml or 6 ml/kg per dose. The titers of antibody to 
varicella zoster virus were comparable in each group.

Publication Types: 
    Comparative Study

PMID: 6324585 [PubMed - indexed for MEDLINE]

7503: Minerva Med. 1984 Mar 10;75(9-10):457-62.

[Use of high-dose lysozyme in the treatment of herpes zoster and flat warts]

[Article in Italian]

Cavicchini S.

Lysozyme is a natural enzyme with antiviral, antibacterial and immunomodulating+ 
action. This drug has several dermatological applications particularly in the
therapy of some viral skin diseases as herpes zoster, viral warts and aphthous
stomatitis. In this work the Author has valued the efficacy of high dosage
lysozyme in the treatment of 30 patients with herpes zoster infection and in 10
patients affected with viral plane warts. The good results obtained in this
clinical trial confirm those reported in previous papers and denote the
usefulness of this therapy.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 6369176 [PubMed - indexed for MEDLINE]

7504: Med J Aust. 1984 Mar 3;140(5):310.

Unusual herpes zoster.

Heise G.

Publication Types: 
    Case Reports
    Letter

PMID: 6700479 [PubMed - indexed for MEDLINE]

7505: Plant Physiol. 1984 Mar;74(3):705-710.

Effects of Glycolate Pathway Intermediates on Glycine Decarboxylation and Serine 
Synthesis in Pea (Pisum sativum L.).

Shingles R, Woodrow L, Grodzinski B.

Department of Horticultural Science, University of Guelph, Guelph, Ontario N1G
2W1, Canada.

Glycine decarboxylation and serine synthesis were studied in pea (Pisum sativum
L.) leaf discs, in metabolically active intact chloroplasts, and in mitochondria 
isolated both partially by differential centrifugation (i.e. ;crude') and by
further purification on a Percoll gradient. Glycolate, glyoxylate, and formate
reduced glycine decarboxylase activity ((14)CO(2) and NH(3) release) in the crude
green-colored mitochondrial fractions, and in the leaf discs without markedly
altering serine synthesis from [1-(14)C]glycine. Glycolate acted because it was
converted to glyoxylate which behaves as a noncompetitive inhibitor (K(i) = 5.1
+/- 0.5 millimolar) on the mitochondrial glycine decarboxylation reaction in both
crude and Percoll-purified mitochondria. In contrast, formate facilitates glycine
to serine conversion by a route which does not involve glycine breakdown in the
crude mitochondrial fraction and leaf discs. Formate does not alter the
conversion of two molecules of glycine to one CO(2), one NH(3), and one serine
molecule in the Percoll-purified mitochondria. In chloroplasts which were unable 
to break glycine down to CO(2) and NH(3), serine was labeled equally from
[(14)C]formate and [1-(14)C]glycine. The maximum rate of serine synthesis
observed in chloroplasts is similar to that in isolated metabolically active
mitochondria. Formate does not appear to be able to substitute for the one-carbon
unit produced during mitochondrial glycine breakdown but can facilitate serine
synthesis from glycine in a chloroplast reaction which is probably a secondary
one in vivo.

PMID: 16663485 [PubMed - as supplied by publisher]

7506: Physiotherapy. 1984 Mar;70(3):96-7.

Ultrasound for post-herpetic neuralgia. A study to investigate the results of
treatment.

Payne C.

PMID: 6718571 [PubMed - indexed for MEDLINE]

7507: Physiotherapy. 1984 Mar;70(3):94-6.

Treatment of acute herpes zoster using ultrasonic therapy. Report on a series of 
twelve patients.

Jones RJ.

PMID: 6718570 [PubMed - indexed for MEDLINE]

7508: J Infect Dis. 1984 Mar;149(3):478.

Acyclovir administered perorally in immunocompromised children with
varicella-zoster infections.

Novelli VM, Marshall WC, Yeo J, McKendrick GD.

PMID: 6715905 [PubMed - indexed for MEDLINE]

7509: Am J Vet Res. 1984 Mar;45(3):523-30.

Pathologic changes of experimental simian varicella (Delta herpesvirus) infection
in African green monkeys (Cercopithecus aethiops).

Roberts ED, Baskin GB, Soike K, Gibson SV.

Gross and microscopic lesions of experimental simian varicella (Delta
herpesvirus) infection in African green monkeys (Cercopithecus aethiops) are
described. In stratified squamous epithelium, such as the epidermis, tongue, and 
esophagus, focal areas of epidermal hyperplasia, ballooning degeneration, and
blood-filled vesicle formation with ulceration were apparent. Most visceral
organs were involved, and the changes included necrosis, hemorrhage, and
characteristic intranuclear eosinophilic inclusions in a variety of cells. A
generalized vascular involvement was present with intranuclear inclusions in the 
endothelial and smooth muscle cells in various organs. The nervous system was
normal on gross and microscopic examination. Virus titer and serum transferase
values were correlated with the clinical signs of infection.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6711981 [PubMed - indexed for MEDLINE]

7510: Ann Intern Med. 1984 Mar;100(3):462.

Herpes zoster and the acquired immunodeficiency syndrome.

Cone LA, Schiffman MA.

Publication Types: 
    Letter

PMID: 6696374 [PubMed - indexed for MEDLINE]

7511: Helv Paediatr Acta. 1984 Mar;39(1):63-70.

Varicella and herpes zoster in immunosuppressed children: preliminary results of 
treatment with intravenous immunoglobulin.

Sulliger JM, Imbach P, Barandun S, Gugler E, Hirt A, Luthy A, Rossi E, Tonz O,
Wagner HP.

Seven immunosuppressed children with varicella and two with herpes zoster were
treated with large intravenous doses of polyvalent, intact immunoglobulin (IgG
i.v.). In all patients the treatment was effective for controlling fever and skin
lesions and for preventing progression and complications, even if this therapy
was started late and/or if the patient was severely lymphopenic . More IgG was
needed to control disseminated than less advanced varicella. No untoward effects 
of IgG therapy were observed. The preliminary results suggest that in future
trials i.v. IgG should be used for comparison with antiviral agents.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6609911 [PubMed - indexed for MEDLINE]

7512: Ann Neurol. 1984 Mar;15(3):311-2.

Angiographic changes in intracranial arteritis of ophthalmic herpes zoster.

Fryer DG, Crane R, Margolis MT.

Publication Types: 
    Case Reports
    Letter

PMID: 6609681 [PubMed - indexed for MEDLINE]

7513: Klin Monatsbl Augenheilkd. 1984 Mar;184(3):163-7.

[Corneal endotheliitis. Definition and clinical classification]

[Article in German]

Sundmacher R.

Corneal endotheliitis in the narrower sense is the term applied to immune
reactions directed against the endothelial cells themselves. Virus antigens,
histocompatibility antigens and autoantigens in the cell membrane represent the
target for immune attack. The most significant clinical sign of endotheliitis is 
a strict correlation between the area of endothelial damage and the area of the
(immune) precipitates.

Publication Types: 
    English Abstract

PMID: 6374261 [PubMed - indexed for MEDLINE]

7514: Pediatr Infect Dis. 1984 Mar-Apr;3(2):142-5.

Complete spectrum of the varicella congenital defects syndrome in 5-year-old
child.

Kotchmar GS Jr, Grose C, Brunell PA.

Chickenpox in the pregnant woman occasionally leads to infection and
teratogenesis of the early to midgestational embryo. We describe the
developmental assessment and clinical management of a 5-year-old girl with
classic varicella congenital defects syndrome. This patient is unique with
respect to (1) a generally favorable outcome in spite of the severity of her
anomalies involving the eyes, limbs and skin, (2) a completely normal evaluation 
of her immunologic status and (3) a serologically documented herpes zoster
infection at age 41 months.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 6328456 [PubMed - indexed for MEDLINE]

7515: J Am Acad Dermatol. 1984 Mar;10(3):486-90.

"Recurrent herpes zoster": an unproved entity?

Heskel NS, Hanifin JM.

Physicians sometimes misdiagnose recurrent zosteriform herpes simplex virus (HSV)
skin infections as "zoster" or "recurrent zoster." Misdiagnosis can lead to
inappropriate therapy with potentially harmful consequences, particularly in
patients with ophthalmitis or immunosuppression, in which early institution of
the correct antiviral therapy may be crucial. We report three patients who were
originally misdiagnosed to have recurrent herpes zoster skin infections before we
cultured HSV from their vesicles. We suggest: (1) that most recurrent zosteriform
eruptions are caused by HSV; (2) that "recurrent zoster" has yet to be
documented; and (3) that the diagnosis of "recurrent zoster" be reserved for
those patients who have laboratory confirmation of recurrent varicella zoster
(VZ). Viral culture or examination of vesicle contents by indirect
immunofluorescent technic can provide definitive diagnosis of the etiology of a
zosteriform eruption.

Publication Types: 
    Case Reports

PMID: 6327783 [PubMed - indexed for MEDLINE]

7516: Am J Med. 1984 Mar;76(3):464-78.

Herpes virus infections in patients with neoplastic disease. Diagnosis and
therapy.

Wong KK, Hirsch MS.

Herpes viruses are among the most common and troublesome opportunistic pathogens 
infecting patients with neoplastic diseases. The recent development of partially 
effective and relatively nontoxic antiviral agents offers promise for the
prophylaxis or therapy of these infections in high-risk groups. Vidarabine and
acyclovir have shown efficacy in several herpes virus infections and are now
licensed in the United States. Alpha interferon may also be useful in the
prophylaxis or early therapy of certain herpes virus infections. Newer antiviral 
agents and combination therapies are under study. Early and rapid diagnosis of
such infections is critical to the development of effective therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6199972 [PubMed - indexed for MEDLINE]

7517: Dtsch Z Mund Kiefer Gesichtschir. 1984 Mar-Apr;8(2):90-2.

[Clinical picture of viral infections in the oral cavity]

[Article in German]

Haneke E.

Publication Types: 
    English Abstract

PMID: 6098398 [PubMed - indexed for MEDLINE]

7518: Biken J. 1984 Mar;27(1):23-9.

A simplified immunofluorescence technique for antibody to varicella-zoster
membrane antigen (FAMA).

Baba K, Yoshida M, Tawa A, Yabuuchi H, Maeda K, Takahashi M.

Indirect fluorescent antibody to varicella-zoster membrane antigens (FAMA) was
measured by a new technique. The procedure gives rapid, sensitive and accurate
results and is suitable for use in diagnosis or screening of susceptibility to
varicella-zoster virus (VZV) infection. The test procedure was simplified by
using Terasaki tissue culture plates for the reaction and for direct observation 
by fluorescence microscopy. Preparations of VZV-infected Vero cells stored in
liquid nitrogen could be used as antigen in this FAMA-test.

PMID: 6091617 [PubMed - indexed for MEDLINE]

7519: Lancet. 1984 Feb 18;1(8373):404-5.

Production of specific antibodies by CSF lymphocytes in patients with herpes
zoster.

Forsberg P, Fryden A, Kam-Hansen S.

Publication Types: 
    Letter

PMID: 6141474 [PubMed - indexed for MEDLINE]

7520: N Engl J Med. 1984 Feb 2;310(5):318-9.

Cimetidine for herpes zoster.

Mavligit GM, Talpaz M.

Publication Types: 
    Letter

PMID: 6690956 [PubMed - indexed for MEDLINE]

7521: West J Med. 1984 Feb;140(2):292.

Other treatments for herpes zoster neuralgia.

[No authors listed]

Publication Types: 
    Letter

PMID: 6730483 [PubMed - indexed for MEDLINE]

7522: Klin Med (Mosk). 1984 Feb;62(2):111-4.

[Generalized form of herpes zoster]

[Article in Russian]

Bakhur VT, Shkatova KS, Korovina AF, Aleksandrova NG.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6708430 [PubMed - indexed for MEDLINE]

7523: Gastrointest Endosc. 1984 Feb;30(1):26-7.

Shingles esophagitis: endoscopic diagnosis in two patients.

Gill RA, Gebhard RL, Dozeman RL, Sumner HW.

Publication Types: 
    Case Reports

PMID: 6706086 [PubMed - indexed for MEDLINE]

7524: Arch Dermatol. 1984 Feb;120(2):261-2.

Eccrine duct involvement by herpes zoster.

Rinder HM, Murphy GF.

Publication Types: 
    Case Reports

PMID: 6696483 [PubMed - indexed for MEDLINE]

7525: Arch Neurol. 1984 Feb;41(2):137.

Myelopathy after herpes zoster.

Cullis PA.

Publication Types: 
    Letter

PMID: 6691809 [PubMed - indexed for MEDLINE]

7526: Scand J Haematol. 1984 Feb;32(2):130-4.

Effectiveness of pentostatin (2'-deoxycoformycin) in refractory lymphoid
neoplasms.

Spiers AS, Ruckdeschel JC, Horton J.

Pentostatin (2'-deoxycoformycin, DCF) was administered to 17 patients with a
variety of lymphoid neoplasms, both T- and B-cell, that were refractory to
conventional treatments. Several responses and 2 complete remissions occurred.
Toxic effects were less severe than previously described: this may be
attributable to relatively low doses of DCF or to precautions taken to prevent
tumour lysis syndrome. DCF appears valuable as a second-line treatment in
non-Hodgkin's lymphomas and as initial treatment in T-cell chronic lymphocytic
leukaemia and mycosis fungoides. Although myelosuppression is mild,
immunosuppression and superinfection are potential hazards of treatment with DCF.
The ocular toxicity of DCF, previously described as conjunctivitis, appears to be
a keratitis of moderate severity which requires further study.

Publication Types: 
    Case Reports

PMID: 6608139 [PubMed - indexed for MEDLINE]

7527: N C Med J. 1984 Feb;45(2):137.

Herpes zoster ophthalmicus.

Friewald MJ.

Publication Types: 
    Letter

PMID: 6608057 [PubMed - indexed for MEDLINE]

7528: Arch Ophthalmol. 1984 Feb;102(2):195.

Benign intracranial tumors and zoster ophthalmicus.

Naumann GO, Procher G.

Publication Types: 
    Case Reports
    Letter

PMID: 6607725 [PubMed - indexed for MEDLINE]

7529: Am J Infect Control. 1984 Feb;12(1):2-5.

Herpes zoster causing varicella (chickenpox) in hospital employees: cost of a
casual attitude.

Hyams PJ, Stuewe MC, Heitzer V.

Varicella is a benign exanthematous disease of childhood, with adult infection
usually occurring in the immunocompromised patient. Hospital employees may be
exposed to the varicella virus through contact with patients having either
varicella or herpes zoster. Two nurses developed varicella 11 and 15 days after
contact with a patient with disseminated herpes zoster. Twenty-five susceptible
employees were excluded from work. The cost to the hospital for this paid leave
was $10,941. Additional nurses were hired to staff the 189 uncovered
supplementary nursing shifts; the accrued cost was $8,093. Ninety patients were
exposed. There were no secondary cases in either employees or patients.
Nosocomial varicella in hospital employees can be both costly to the hospital and
disruptive of patient care. Measures to prevent such an occurrence are discussed.

PMID: 6561002 [PubMed - indexed for MEDLINE]

7530: Gan To Kagaku Ryoho. 1984 Feb;11(2):221-6.

[Interferon in skin diseases]

[Article in Japanese]

Niimura M.

In the dermatological field, interferon is used in clinical trials for viral skin
diseases and for malignant skin tumors such as malignant melanoma. In regard to
viral diseases, clinical trials have shown promising results in viral warts,
herpes simplex and herpes zoster. In the double-blind trial, patients with
bilateral common warts of the extremities were treated at weekly intervals with
intralesional injections of either human fibroblast interferon or placebo. More
than 81% of the interferon-treated extremities were either cured by or responded 
effectively to the therapy, while only 17% of the placebo responded. Although our
data has confirmed that interferon is effective in the treatment of common warts 
diseases, the method of application and repeated injections indicate that this
therapy may not be helpful in routine cases but only in selected patients in whom
other therapy has failed. However, development of new delivery systems or
modification of dosages may increase the value of interferon therapy for warts
disease. Interferon seems also effective for herpes zoster. But herpes zoster
usually regresses spontaneously within three weeks, therefore, it is not easy to 
define efficacy of interferon in this disease. Therefore, we need to examine the 
effect of interferon on herpes zoster both in placebo controlled and double-blind
trials involving patients with immunocompromised diseases.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 6364993 [PubMed - indexed for MEDLINE]

7531: Monatsschr Kinderheilkd. 1984 Feb;132(2):105-9.

[Acyclovir therapy in varicella/zoster diseases in immunocompromised children
with cancer]

[Article in German]

Kuhn N, Landbeck G.

21 patients, aged 1 to 15 years, who developed manifest varicella/zoster-virus
infection while on chemotherapy for malignant disease were treated with
acyclovir. Drug dosage was 10 mg/kg every eight hours for 5 days as a one hour
infusion. The clinical course of the infection in all patients was mild. 1 to 4
(median 2,2) days after beginning of acyclovir therapy the formation of new
lesions stopped. Within 4 to 8 (median 5,9) days all vesicles were scabbed . In
13 patients with fever in the beginning the temperature fell within 2 to 6
(median 2,6) days of treatment. The development of visceral involvement was not
observed during or after acyclovir therapy. Acyclovir was well tolerated. Tests
of the hematopoietic, liver and renal functions before and after acyclovir
therapy revealed no adverse effects of the drug. Also the immunologic response
seemed not to be impaired. With one exception, all patients investigated had
antibodies against varicella/zoster-virus after recovery. In order to prevent
varicella infection after household exposure two immunocompetent patients were
treated prophylactically with acyclovir tablets (400 mg 5 times a day for 5
days). Both children did not exhibit manifest varicella/zoster infection, but
five weeks later they had antibodies against varicella/zoster-virus (KBR 1:10,
resp. KBR 1:20).

Publication Types: 
    English Abstract

PMID: 6328285 [PubMed - indexed for MEDLINE]

7532: J Virol Methods. 1984 Feb;8(1-2):137-45.

Enzyme immunoassay for antibodies to membrane associated antigen of varicella
zoster virus.

Cox JC, Moloney MB, Herrington RW, Hampson AW, Hurrell JG.

An in situ enzyme immunoassay to viral membrane antigen was developed to enable
the specific estimation of antibodies to varicella zoster (VZ) virus. The
technique was compared with a modified fluorescent antibody to membrane antigen
(FAMA) procedure and with the complement fixation (CF) test by parallel assay of 
352 plasma samples. The enzyme immunoassay (EIA) procedure showed very good
correlation with the modified FAMA procedure, and both were far more specific
than the CF test. This specificity was achieved by the use, in the EIA, of VZ
virus-infected cells grown and fixed in situ with glutaraldehyde. Thus the only
virus antigens accessible to antibody were the VZ-specific antigens expressed at 
the cell membrane, cross-reactions with herpes simplex virus antibodies thereby
being avoided.

Publication Types: 
    Comparative Study

PMID: 6323506 [PubMed - indexed for MEDLINE]

7533: Am J Infect Control. 1984 Feb;12(1):34-63.

CDC guidelines for the prevention and control of nosocomial infections. Guideline
for infection control in hospital personnel.

Williams WW.

PMID: 6322620 [PubMed - indexed for MEDLINE]

7534: J Infect Dis. 1984 Feb;149(2):137-42.

Clinical reinfection with varicella-zoster virus.

Gershon AA, Steinberg SP, Gelb L.

Eight patients became clinically reinfected with varicella-zoster virus despite
the presence of specific antibody in the blood three days to six months before
the onset of illness. One patient had had varicella previously; a second had been
immunized with live, attenuated varicella vaccine 10 months earlier. While it was
suspected that these patients experienced a reactivation of latent virus that
caused atypical disseminated zoster rather than varicella, detailed study of the 
vaccinated child suggests that this was not the case; by restriction-endonuclease
techniques, this vaccinee was shown to have been infected with wild-type
varicella-zoster virus despite the presence of specific antibody and cellular
immunity to the virus. All cases clinically resembled chickenpox. Thus, not only 
subclinical varicella (manifested by a rise in antibody titer after close
exposure) but also clinical reinfection with the virus can occur. Clinical
reinfection probably develops more frequently in immunocompromised than in
immunocompetent individuals. Reinfections are usually mild.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6321605 [PubMed - indexed for MEDLINE]

7535: Br J Dermatol. 1984 Feb;110(2):151-4.

Mechanisms of pustule formation in cutaneous bacterial and viral infections:
alterations of neutrophil membrane surface receptors.

Imaizumi S, Iwatsuki K, Yamada M, Tagami H.

Changes in membrane surface receptors have been demonstrated by rosetting methods
in polymorphonuclear leukocytes obtained from the pustules of different
infectious dermatoses. There was a distinct difference in numbers of receptors in
neutrophils from bacterial and viral pustules, i.e., C3b receptors were decreased
on neutrophils from both bacterial and viral pustules, whereas IgG-Fc receptors
were decreased only in neutrophils from viral pustules. The difference appears to
be due to variations in the defence mechanisms against the invading
micro-organisms.

PMID: 6230096 [PubMed - indexed for MEDLINE]

7536: Ugeskr Laeger. 1984 Jan 16;146(3):193.

[Herpes zoster ophthalmicus with retrobulbar atrophy]

[Article in Danish]

Schmidt P.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6608169 [PubMed - indexed for MEDLINE]

7537: Lancet. 1984 Jan 14;1(8368):103-4.

Shingles in seven homosexuals.

Rowland Payne CM, Farthing C, Byrom N, Staughton RC.

Publication Types: 
    Letter

PMID: 6140400 [PubMed - indexed for MEDLINE]

7538: Rev Laryngol Otol Rhinol (Bord). 1984;105(1):63-5.

[Various etiologic rarities in facial paralysis in the child and in the adult]

[Article in French]

Coll J.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6729283 [PubMed - indexed for MEDLINE]

7539: Kekkaku. 1984 Jan;59(1):39-63.

[Clinico-immunological factors relating to the onset of tuberculosis]

[Article in Japanese]

Mikami R.

Publication Types: 
    English Abstract

PMID: 6716753 [PubMed - indexed for MEDLINE]

7540: J Neurol. 1984;231(2):96-8.

Herpes zoster ophthalmicus with contralateral hemiplegia and normal pressure
hydrocephalus.

Inoue N, Shiraishi S, Tsuda T, Yamato T, Murai Y, Tsukamoto Y, Nakata H.

A case of herpes zoster ophthalmicus complicated by contralateral hemiplegia and 
normal pressure hydrocephalus is presented. The hydrocephalus is considered to be
caused by recurrent haemorrhage from extensive cerebral arteritis.

Publication Types: 
    Case Reports

PMID: 6610727 [PubMed - indexed for MEDLINE]

7541: Int Ophthalmol Clin. 1984 Summer;24(2):39-48.

Herpes zoster.

Olson RJ.

PMID: 6609904 [PubMed - indexed for MEDLINE]

7542: J R Coll Physicians Lond. 1984 Jan;18(1):51-5.

Cytotoxic chemotherapy and viral infections: the role of acyclovir.

Anderson H, Sutton RN, Scarffe JH.

PMID: 6584619 [PubMed - indexed for MEDLINE]

7543: Nuovi Ann Ig Microbiol. 1984 Jan-Feb;35(1):79-83.

[Antiviral action of a 40% solution of 5-iodo-2'-deoxyuridine]

[Article in Italian]

Simonetti N, Strippoli V, Scalzo M.

Publication Types: 
    English Abstract

PMID: 6536923 [PubMed - indexed for MEDLINE]

7544: Indian J Dermatol. 1984 Jan;29(1):31-4.

Relation of herpes zoster with lepromatous leprosy (report of two cases).

Shafique M, Singa AK, Prakash AP.

Publication Types: 
    Case Reports

PMID: 6526431 [PubMed - indexed for MEDLINE]

7545: Cleve Clin Q. 1984 Winter;51(4):667-9.

Leukemia cutis presenting as a chronic herpes zoster ulceration.

Mikesell JF, Bailin PL, Bergfeld WF.

Publication Types: 
    Case Reports

PMID: 6525762 [PubMed - indexed for MEDLINE]

7546: Breast Cancer Res Treat. 1984;4(4):289-95.

Pros and cons of aminoglutethimide for advanced postmenopausal breast cancer.

Bruning PF, Bonfrer JG, Engelsman E, Hamersma-vd Linden E, de Jong-Bakker M,
Nooyen W.

In a phase II clinical trial, 38 postmenopausal women with advanced breast cancer
were treated with aminoglutethimide and replacement hydrocortisone. All women had
previously received up to 4 modalities of endocrine therapy. Seventeen patients
had also been treated with cytostatic drugs. Twenty-five percent of the 29
evaluable patients experienced objective tumor regression, lasting from 11 to
more than 18 months. In 29% the disease was stabilized for 3 to more than 15
months. Toxicity was significant, necessitating drug withdrawal in 3 patients.
One patient died within 3 weeks of therapy from multiple perforated gastric
ulcers. Two patients developed herpes zoster within 4 weeks of treatment. Many
side effects were minor and transient. However, treatment resulted in overt
primary hypothyroidism in 25% of the evaluable patients and in a strongly
increased need of acenocoumarin in all 3 patients on anticoagulant therapy.

PMID: 6518295 [PubMed - indexed for MEDLINE]

7547: Ter Arkh. 1984;56(8):138-40.

[Diagnostic difficulties in herpes zoster]

[Article in Russian]

Bogomolov BP, Bakhur EG.

The authors have analysed the clinical and laboratory findings in 170 patients
with herpes zoster (HZ). Of these, 21 patients (12.3%) had been erroneously
diagnosed before the appearance of herpetic eruption as having other diseases
(erysipelas, renal colic, acute pancreatitis, acute abdomen, and so forth). The
authors point to the difficulties encountered in making the diagnosis at the
initial disease period with emphasis on the great importance for early diagnosis 
of HZ of the analysis of the clinical findings, prodromal period and hemogram
data.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6495196 [PubMed - indexed for MEDLINE]

7548: Sante Publique (Bucur). 1984;27(2):99-114.

Herpes zoster and herpes simplex--public health matter; chelatotherapy in these
acute neuroviroses.

Dinu R, Dinu I.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 6441289 [PubMed - indexed for MEDLINE]

7549: Virchows Arch A Pathol Anat Histopathol. 1984;403(2):205-12.

Kaposi's sarcoma and malignant lymphoma in AIDS.

Leu HJ, Schneider J, Hardmeier T, Maurer R, Luthy R, Burger R, Burger HR, Krause 
M.

A 48-year-old homosexual with contacts in different countries, including Haiti,
presented with multiple pigmented or bluish nodules on both lower legs and upper 
arms. He had a history of secondary syphilis, hepatitis B and herpes zoster
ophthalmicus. Biopsies of the skin tumors revealed a typical Kaposi's sarcoma of 
low grade malignancy. The endothelial origin of the tumor was indicated by the
presence of specific endothelial organelles (Weibel-Palade bodies) in the
cytoplasma of the tumor cells. Erythrocyte phagocytosis was found in tumor cells 
within and without the vascular channels. Laboratory tests were compatible with
the clinical diagnosis of an acquired immune deficiency syndrome (AIDS) with a
helper: suppressor T-lymphocyte ratio of 0.28 and a cutaneous anergy. In the
course of the illness tumors of the stomach and duodenum were detected. Histology
showed a malignant non-Hodgkin lymphoma of high grade malignancy. Within weeks
the patient died in a cachectic state. Autopsy revealed a Kaposi's sarcoma of the
skin with metastases in the stomach and a wide-spread malignant lymphoma in the
gastrointestinal tract, in several visceral organs and in many lymph nodes.

Publication Types: 
    Case Reports

PMID: 6426164 [PubMed - indexed for MEDLINE]

7550: Med Oncol Tumor Pharmacother. 1984;1(2):87-96.

The clinical application of fibroblast interferon--an overview.

Billiau A.

Preclinical as well as clinical studies with fibroblast interferon (IFN) are
still lagging behind on those with leukocyte interferon. Its side-effects seem to
be less pronounced than those of human IFN-alpha, yet it may be slightly
pyrogenic after intravenous injection. Pyrogenicity of current impure
preparations might for the larger part be due to impurities. Higher doses of
HuIFN-beta than of HuIFN-alpha are required to obtain measurable blood titers by 
intramuscular injections. Since there is concern about this being due to
destruction of the interferon before it has reached its target organ(s), most
current clinical studies use either local (e.g. intratumoral) treatment or
intravenous infusions. A study of topical treatment for acute rhinovirus
infection has indicated that there is very little if any chance for fibroblast
interferon to be a clinically useful substance to prevent or cure common cold. In
herpetic dendritic keratitis eye drops of fibroblast interferon may be useful as 
such or in combination with debridement. Topical treatment of warts (multiple
intralesional injections) has been shown to yield a high success rate, especially
in the case of verrucae vulgares, but less so in the case of verrucae planae
juveniles. Studies on condyloma accuminatum are not so far advanced as to permit 
a documented conclusion. Topical (intralesional) treatment of neoplastic diseases
has been investigated, especially in Japan, to demonstrate that fibroblast
interferon does have an antineoplastic effect in vivo. While there seems to be
little doubt that local delivery does indeed cause tumor nodules to regress, the 
question is whether this procedure can offer a true clinical benefit to the
patient. Systemic (intravenous) administration for chronic hepatitis B has been
investigated further: given alone or in combination with adenine-arabinoside,
fibroblast interferon seems to be able to reduce the level of viral activity.
Whether this will lead to a generally accepted treatment of chronic active
hepatitis is difficult to say at this moment. In treating herpes zoster in cancer
patients, results have been obtained which are comparable to those found for
leukocyte interferon. The practical significance of this finding must be seen in 
the perspective of recent developments in the chemotherapy of herpes zoster. In
breast cancer patients given intramuscular injections, metastases in the skin,
but not in other organs, showed alterations suggestive of an effect on tumor
progression. Yet there was no true clinical benefit for the patient. In other
tumors, e.g. head and neck epithelioma, no effect was seen.(ABSTRACT TRUNCATED AT
400 WORDS)

Publication Types: 
    Review

PMID: 6400034 [PubMed - indexed for MEDLINE]

7551: J Int Med Res. 1984;12(4):255-60.

Herpes zoster treatments: results of a clinical trial relative to the use of
rifamycin SV versus neuramide.

Bruni L, Tagliapietra G, Innocenti P.

The authors describe a controlled clinical study in which rifamycin SV 250 mg
intramuscularly and topical b.i.d. was compared to intramuscular neuramide b.i.d.
plus, where necessary, other drugs (antibiotics, polivitamins, analgesics, etc.) 
for the treatment of two groups of thirty randomly selected patients suffering
from herpes zoster. In all patients the symptoms were controlled by both
treatments but statistical tests revealed that rifamycin SV was able to heal pain
(p less than 0.05), vesicles, crusts and burning sensation (p less than 0.1)
faster than neuramide. Furthermore, by the seventh day of therapy, the authors
found that rifamycin SV reduced the intensity of both pain and erythema (p less
than 0.01 for pain; p less than 0.05 for erythema) more than neuramide.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 6381169 [PubMed - indexed for MEDLINE]

7552: Clin Neuropharmacol. 1984;7(1):51-82.

Anticonvulsant drugs and chronic pain.

Swerdlow M.

Publication Types: 
    Clinical Trial
    Review

PMID: 6367974 [PubMed - indexed for MEDLINE]

7553: Geriatrics. 1984 Jan;39(1):56-61, 64-6.

Corneal disease: an approach to primary care.

Schlichtemeier WR.

PMID: 6360796 [PubMed - indexed for MEDLINE]

7554: Acta Clin Belg. 1984;39(3):159-62.

[A rare complication of ophthalmic zona: spreading cerebral arteritis]

[Article in French]

Andre C, Bury J, Fillet G, Moonen G.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6333129 [PubMed - indexed for MEDLINE]

7555: Trans Ophthalmol Soc N Z. 1984;36:57-8.

Pain relief in herpes ophthalmicus.

Fernando LC, Talbot AN.

PMID: 6332404 [PubMed - indexed for MEDLINE]

7556: Sov Med. 1984;(4):121-2.

[Enzymatic profile of peripheral blood leukocytes in herpes zoster]

[Article in Russian]

Il'inskii IuA, Dvurechenskaia GS, Dzhordzhadze NS, Markova EA.

PMID: 6330911 [PubMed - indexed for MEDLINE]

7557: Clin Invest Med. 1984;7(1):13-9.

Neonatal cytomegalovirus infections: the relative role of neonatal blood
transfusion and maternal exposure.

Rawls WE, Wong CL, Blajchman M, Venturelli J, Watts J, Chernesky M, Saigal S.

A prospective study of premature infants admitted to an intensive care neonatal
unit was undertaken to evaluate the relative role of blood transfusions and
maternal exposure in infections caused by cytomegalovirus (CMV), varicella zoster
virus (VZV) and herpes simplex virus (HSV). During the first year of life, 13.7%,
4.8% and 4% of the infants became infected with CMV, VZV and HSV, respectively,
as determined by virus isolation or seroconversion. Transfusion in the newborn
period did not influence the rates of VZV or HSV infections. A higher rate of CMV
infections occurred in transfused (18.8%) than in non-transfused (11%) infants
but the difference was not statistically significant. A significant correlation
was found between maternal antibody titers and the rate of CMV infection in
infants whether or not transfusion occurred. An even stronger association was
found between breast feeding and CMV infections. The risk of alloimmunization to 
erythrocyte and leucocyte antigens was also assessed; no evidence of increased
alloimmunization to these antigens was associated with transfusion.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6327133 [PubMed - indexed for MEDLINE]

7558: Annu Rev Med. 1984;35:279-91.

Acyclovir and other chemotherapy for herpes group viral infections.

Balfour HH Jr.

The recent profusion of antiviral research has resulted in significant advances
toward prevention and treatment of herpes group virus infections. The most
promising new agent is acyclovir, which is available in topical, intravenous, and
oral formulations. Results of clinical trials of acyclovir for prevention and
treatment of herpes simplex, varicella-zoster virus, cytomegalovirus, and
Epstein-Barr virus infections are discussed, and the potential problem of
antiviral resistance considered. Vidarabine therapy is reviewed briefly, and
future new drugs with activity against herpesviruses are mentioned.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6326661 [PubMed - indexed for MEDLINE]

7559: Adv Intern Med. 1984;29:25-58.

The five human herpesviruses: infection, prevention, and treatment.

Galasso GJ, Myers MW.

Publication Types: 
    Review

PMID: 6324554 [PubMed - indexed for MEDLINE]

7560: Br J Clin Pract. 1984 Jan;38(1):21-4.

Steroidstoss therapy in the treatment of herpes zoster.

Sutton G.

PMID: 6322830 [PubMed - indexed for MEDLINE]

7561: Prog Med Virol. 1984;29:166-96.

Varicella-zoster virus infection in pregnancy.

Enders G.

Publication Types: 
    Review

PMID: 6322232 [PubMed - indexed for MEDLINE]

7562: Oral Surg Oral Med Oral Pathol. 1984 Jan;57(1):41-4.

Acyclovir and herpesvirus infections. A review of the literature.

Pallasch TJ, Joseph CE, Gill CJ.

Acyclovir (Zovirax) is a qualified success as an effective and nontoxic antiviral
chemotherapeutic agent and at present is approved for the treatment of initial
genital herpes and limited life-threatening cutaneous herpes simplex viral
infections in the immunocompromised host. Its efficacy in Epstein-Barr,
varicella-zoster, and cytomegalorvirus infections appears less promising.
According to one controlled study, its efficacy in the treatment of herpes
labialis (HSV-1) infections has been disappointing. The highly selective action
of acyclovir against viral DNA polymerase and its inhibition of viral DNA chain
elongation result in a low incidence of human (host cell) toxicity, as manifested
by local irritation at injection sites and a modest incidence of adverse renal
effects, which can be reduced by judicious drug use. Newer antiviral agents now
under development hold substantial promise for the future of antiviral
chemotherapy.

Publication Types: 
    Clinical Trial

PMID: 6320078 [PubMed - indexed for MEDLINE]

7563: J Med Virol. 1984;13(1):53-61.

Detection of varicella-zoster virus by dot-blot hybridization using a molecularly
cloned viral DNA probe.

Seidlin M, Takiff HE, Smith HA, Hay J, Straus SE.

Varicella-zoster virus (VZV) infection can be definitively diagnosed by isolation
of virus in cell culture, a process that usually takes 7-14 days. In order to
facilitate the more rapid detection of this virus, we developed a technique for
hybridization of DNA from clinical specimens using an in vitro-labeled mixture of
cloned fragments of VZV DNA as a probe. The assay can be completed in 36-48 hr
and can be successfully carried out in the range of 10 pg to 10 ng of viral DNA. 
In analyses of 38 specimens from patients with a clinical diagnosis of VZV
infection, the results of viral isolation and this assay were highly concordant. 
The sensitivity of standard cell culture for detection of VZV was 58%, whereas
the sensitivity of the assay was 76%, not significantly different (P = 0.14). The
specificity of cell culture was 100%, whereas that of the assay was 94% (P =
0.49). The technique appears to be sensitive, specific, and useful for analyses
of tissues and body fluids.

PMID: 6319586 [PubMed - indexed for MEDLINE]

7564: J Med Virol. 1984;13(1):1-12.

Class-specific antibody responses to early and late antigens of varicella and
herpes simplex viruses.

Schmidt NJ, Gallo D.

Antibody responses to early antigens of varicella-zoster virus (VZV), simian
varicella virus, and herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) were
studied in primary, secondary, and latent infections. IgG antibody responses to
the early antigens occurred in primary and secondary VZV and HSV infections, and 
antibodies to early antigens were also demonstrable in healthy individuals with
latent VZV and HSV infections, indicating that the presence of antibodies to
early antigens cannot be taken as evidence of active infection with the viruses. 
Patients with current VZV or HSV infections showed heterotypic IgG antibody
responses to early antigens of VZV and HSV to the same extent as to late
antigens. In all groups of patients, IgG antibody titers to early antigens were
similar to those against the corresponding late antigens, and no difference was
seen in the reactivity of early antigens produced with four different blocking
agents (cytosine arabinoside, bromodeoxyuridine, trisodium phosphonoformate, and 
cycloheximide). Antibodies of the IgM and IgA classes reacted with both early and
late antigens of HSV, but only with late antigens of VZV and simian varicella
virus, suggesting that these antibodies may be directed against late proteins
that are expressed to a greater extent in HSV-infected cells treated with
blocking agents than they are expressed in treated VZV-infected cells. Homologous
IgM antibody responses occurred in both primary and secondary VZV infections, but
only in primary HSV infections. Heterotypic IgM responses to HSV-2 antigen were
noted in a few VZV patients who did not have demonstrable IgG antibody to HSV,
suggesting that even in patients without prior experience with HSV, a VZV
infection may stimulate the production of IgM antibodies that react with antigens
that are shared by VZV and HSV-2. IgA antibodies to late antigens of VZV and HSV 
were demonstrable in latent, as well as active, infections with these viruses.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6319583 [PubMed - indexed for MEDLINE]

7565: Am J Dis Child. 1984 Jan;138(1):56-9.

Varicella-zoster antibody titers in children with leukemia and lymphoma.
Relationship of titer to varicella-zoster infection.

Hutter JJ Jr, Minnich LL, Ray CG.

Serum varicella-zoster (VZ) antibody titers were determined by a simple, indirect
immunofluorescent antibody technique in 50 children with leukemia or
non-Hodgkin's lymphoma. Sixteen children had initial antibody titers that were
not detectable at a serum dilution of 1:8 and were considered to be susceptible
to varicella. Thirty-one patients had initial serum VZ antibody titers of 1:16 or
greater, while three had levels of 1:8. The serum antibody titer was 1:8 or
greater in 16 children with a history of varicella. Seven episodes of localized
herpes zoster were observed in children whose VZ titer was 1:8 or greater prior
to onset. Two nonfatal infections with primary varicella developed in children
with leukemia in remission whose initial titers were less than 1:8 and were
associated with a convalescent rise in VZ antibody to levels greater than 1:16.
Three susceptible children received zoster immune plasma or zoster immune
globulin for varicella exposure, causing a transient rise in serum VZ titer. The 
assessment of serum VZ titer by this immunofluorescent antibody technique
combined with the prior varicella history is useful in defining the population of
children with leukemia and non-Hodgkin's lymphoma who are susceptible to primary 
varicella.

PMID: 6318551 [PubMed - indexed for MEDLINE]

7566: Ann N Y Acad Sci. 1984;437:559-62.

A longitudinal study of cellular immunity in male homosexuals in London.

Pinching AJ, Weber J, Rogers LA, Jeffries DJ, Harris JR.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6242008 [PubMed - indexed for MEDLINE]

7567: Ann Med Interne (Paris). 1984;135(8):662-8.

[Cutaneous paraneoplastic syndromes]

[Article in French]

Barriere H.

The authors list the really significant paraneoplastic cutaneous syndromes:
acanthosis nigricans, paraneoplastic acrokeratosis, acquired ichthyosis (and
eventually the "explosive" onset of seborrheic warts) and a special type of
desquamative circinate erythema (erythema gyratum repens). The possible
paraneoplastic character of other conditions is also discussed: dermatomyositis, 
necrosing vasculitis, autoimmune bullous conditions and pruritus "sine materia".

Publication Types: 
    English Abstract

PMID: 6241441 [PubMed - indexed for MEDLINE]

7568: Acta Biomed Ateneo Parmense. 1984;55(5-6):269-71.

[Sacral herpes zoster: a cause of urination and defecation disorders]

[Article in Italian]

Bassissi P, Benoldi D, Alinovi A.

A case of sacral herpes zoster associated with alteration of urination and
defecation is presented. The pathogenetic mechanisms of these unusual
complications are discussed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6241410 [PubMed - indexed for MEDLINE]

7569: Henry Ford Hosp Med J. 1984;32(2):116-22.

Prospects for the medical use of interferon in 1984.

Postic B, Arroyo JC.

Publication Types: 
    Clinical Trial
    Review

PMID: 6210270 [PubMed - indexed for MEDLINE]

7570: Acta Derm Venereol. 1984;64(4):275-80.

Naturally occurring T lymphocytotoxic antibody in viral and related skin
diseases.

Hosokawa H, Horio S, Takiuchi Y, Maruyama N, Asada Y.

The naturally occurring T lymphocytotoxic antibodies in patients with viral and
related skin diseases were investigated and compared with those of systemic lupus
erythematosus (SLE). The incidences of T lymphocytotoxic antibodies in exanthema 
suspected of viral infection, infectious mononucleosis, rubella and pityriasis
rosea were 28%, 44%, 8% and 28% respectively. Sera from patients with herpes
zoster and erythema infectiosum did not show positivity. Incidence in SLE sera as
positive control was 82%. The T lymphocytotoxic antibodies detected in skin
diseases were similar in nature to those of SLE patients, but were transient and 
lower in titer than those of SLE.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6209882 [PubMed - indexed for MEDLINE]

7571: Folia Haematol Int Mag Klin Morphol Blutforsch. 1984;111(3):343-9.

Isoprinosine in the treatment of herpes virus infections in children with
leukaemia and malignant lymphoma.

Ochocka M, Chmielewska D, Matysiak M.

Isoprinosine was given to 15 children with lymphoblastic diseases and 3 adults
during infections with herpes viruses - herpes simplex (HSV) and varicella-zoster
viruses (VZV). The control group included 7 children who had previously suffered 
from infections with HSV and VZV without being treated with isoprinosine. The
clinical observations showed a significant inhibitory effect of isoprinosine on
viral infections, with the duration of the disease being shortened considerably. 
The authors think isoprinosine treatment to be justified in viral infections,
especially in children with neoplastic diseases, because of the immunostimulating
action of the drug, rapid clinical improvement and good tolerance of the drug.

PMID: 6205962 [PubMed - indexed for MEDLINE]

7572: Acupunct Electrother Res. 1984;9(1):11-29.

Acupuncture--a therapeutic concept in the treatment of painful conditions and
functional disorders. Report on 971 cases.

Fischer MV, Behr A, von Reumont J.

The results in 971 outpatients who have been treated with acupuncture for
different diseases are reported. The outcome of treatments and number of sessions
are discussed in relation to the different diseases. Acupuncture treatment was
regarded as successful when 1. the patients had no pain at all without medication
and 2. there was a significant improvement (no long-term medication, only mild
pain under unusual strain, minimal medication under such circumstances). We
obtained positive results in cephalalgias , sinusitis, cervical spine syndrome,
shoulder-arm syndrome, ischialgias , back pain, constipation, herpes zoster,
allergic rhinitis and disturbances of peripheral blood flow. For the following
ailments, in order to reduce the medication, we recommend acupuncture despite a
high rate of recurrence: Trigeminal neuralgia, colitis ulcerosa, bronchial asthma
and cancer pain. Results in the treatment of mental disturbances were
unsatisfactory, and in cases of tinnitus results were negative.

PMID: 6145308 [PubMed - indexed for MEDLINE]

7573: Pharmacol Ther. 1984;26(1):1-44.

Synthesis and antiviral properties of 5-vinylpyrimidine nucleoside analogs.

De Clercq E, Walker RT.

5-Vinylpyrimidine nucleosides can be readily synthesized via organometallic
intermediates from commercially available nucleosides. Highly potent and
selective inhibitors of herpes simplex virus type 1 (HSV-1) and varicella-zoster 
virus (VZV) are (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) and some related
analogs such as (E)-5-(2-iodovinyl)-2'-deoxyuridine (IVDU),
1-beta-D-arabinofuranosyl-(E)-5-(2-bromovinyl)uracil (BVaraU) and
(E)-5-(2-bromovinyl)-2'-deoxycytidine (BVDC). The selective antiviral action of
BVDU is based upon a specific phosphorylation by the virus-encoded deoxythymidine
kinase (TK), inhibition of the viral DNA polymerase and/or incorporation into
viral DNA. The efficacy of BVDU against HSV-1 and VZV infections has been
demonstrated in animal models and phase I clinical trials. Possible limitations
in the clinical usefulness of 5-vinylpyrimidine nucleosides in general and BVDU
in particular are discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 6099893 [PubMed - indexed for MEDLINE]

7574: Immunol Lett. 1984;8(6):317-8.

Inappropriate peripheral blood lymphocyte responses to herpes viruses in patients
with Behcet's syndrome.

Efthimiou J, Harikumar MK, Knight RA, Snaith ML.

Specific antibody production and the proliferative response of peripheral blood
lymphocytes (PBLs) to a variety of viruses, including herpes simplex virus-type-1
(HSV-1) and varicella zoster (VZ), were studied in 7 patients with Behcet's
syndrome. None of the patients produced an antibody response against HSV-1 or VZ.
Furthermore, none of the patients showed a proliferative response to VZ, and
three of them also failed to mount a response to HSV-1. These results suggest
that the PBLs of patients with Behcet's syndrome make an inappropriately poor
antibody and proliferative response when stimulated by HSV-1 and VZ.

Publication Types: 
    Comparative Study
    In Vitro

PMID: 6098552 [PubMed - indexed for MEDLINE]

7575: Clin Exp Neurol. 1984;20:129-40.

Segmental motor paralysis in herpes zoster.

Rice JP.

Herpes zoster infection may be complicated by motor involvement, the most common 
example of this being facial palsy in the Ramsay Hunt syndrome. Segmental lower
motor neurone weakness is an uncommon disorder which does occur in the limbs,
such paralysis usually occurring in the same segments as the dermatomes involved,
or in those immediately contiguous. Nine cases of limb weakness are described,
the weakness often being severe and accompanied by wasting and segmental reflex
impairment. Long tract signs were absent. The cervical region was affected more
commonly than the lumbosacral area. The prognosis for recovery was usually good. 
The condition reflects anterior horn cell or anterior nerve root involvement by
the herpes zoster virus at the same or adjacent segmental levels as the sensory
lesion.

PMID: 6096053 [PubMed - indexed for MEDLINE]

7576: Diagn Immunol. 1984;2(3):137-42.

Serologic study by enzyme-linked immunosorbent assay of the IgM antibody response
in the patas monkey following experimental simian varicella virus infection.

Iltis JP, Achilli G, Madden DL, Sever JL.

The time course of IgM and IgG antibody appearance in sera following experimental
simian varicella virus infection in the patas monkey was studied. Serum IgM and
IgG antibody to Delta herpes virus (DHV) were measured by a double indirect and
indirect ELISA test, respectively. IgM antibody was detected 5-8 days
postinfection (p.i.) and IgG antibody was present 10-14 days p.i., which was 5-7 
days after IgM. Viremia preceded detectable IgM antibody by 2 days. Sucrose
gradient separation of serum IgM and IgG was carried out to determine whether IgG
competed significantly with IgM. Results of these studies indicated that
competition by IgG with IgM antibody did not occur except when IgM had declined
to a low level some 40 days p.i. Comparison of the double indirect ELISA test
with a double indirect immunofluorescent antibody test for detection of IgM
antibody to DHV antigen indicated the ELISA test was more sensitive.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6094088 [PubMed - indexed for MEDLINE]

7577: Zentralbl Neurochir. 1984;45(2):152-8.

[Virologico-serologic studies in patients with brain tumors]

[Article in German]

Wohlrabe P, Sprossig M, Farber I, Wutzler P, Steube D, Schreiber D.

The etiological role played by human pathogenic herpes viruses for diseases of
the central nervous system has been verified (Herpes simplex virus, varicella
zoster virus) or is being discussed (cytomegalo virus, Epstein-Barr virus). In
this study, the significance of herpes virus infections for surgically treated
cerebral tumour patients is examined. In a total of 30 patients with various
cerebral tumours, infectious virus from cerebral tumour tissue could be isolated 
in none of the cases. The mean geometric antibody titres against herpes virus in 
the patients did not differ from those of comparable healthy controls. In
patients with cerebral tumours, however, acute herpes virus infections were
serologically identified with a significantly greater frequency than in the
control group. They are mainly an expression of endogenous re-infections with
these viruses which inhabit latently the human organism. Possible causes of the
observed asymptomatically proceeding herpes virus reactivations are discussed.

Publication Types: 
    English Abstract

PMID: 6091370 [PubMed - indexed for MEDLINE]

7578: Int Arch Allergy Appl Immunol. 1984;75(2):179-83.

Increased serum levels of antibodies to Epstein-Barr virus in adults with history
of atopic dermatitis.

Rystedt I, Strannegard IL, Strannegard O.

Serum antibodies to Epstein-Barr virus (EBV), varicella-zoster (VZV) and herpes
simplex virus (HSV) were determined in 140 patients with active or healed atopic 
dermatitis (AD) and 48 control individuals. Antibody titers against EBV were
significantly higher in AD patients than in the controls irrespective of whether 
the AD was active or healed at the time of blood sampling. No difference in EBV
antibody titers were observed between AD patients with asthma and/or hay fever
and those without such additional atopic manifestations. There was no correlation
between EBV antibody titers and serum IgE levels. The frequency of seropositivity
and the magnitude of antibody titers against VZV and HSV in AD patients were not 
significantly different from the controls. Increase in EBV antibody titers may
reflect basic immunoregulatory disturbances in AD but it is also possible that
EBV may play a role in the pathogenesis of atopic disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6088400 [PubMed - indexed for MEDLINE]

7579: Probl Med Wieku Rozwoj. 1984;13:176-84.

[Interferon]

[Article in Polish]

Smogorzewska E.

Twenty five years ago Isaas and Lindenmann discovered that virus-infected cells
may release a protein capable of reacting with normal cells and render them
resistant to infection by a variety of viruses. That protein, a major mediator of
viral interference was called interferon. Three main types of interferon have
been identified and originally designated as fibroblast, leukocyte and immune
interferon. According to the newly adopted nomenclature (as defined by the
International Committee on Interfern Nomenclature) these interferons are now
called beta, alpha and gamma interferon, respectively. The use of interferon as a
therapeutic agent for tumor-bearing patients has gained considerable interest
after reports demonstrated potent enhancing effects of interferon on the
immunologic system. Thus, besides its direct effect on tumor cell multiplication,
interferon may influence the host-tumor relationship by activating cells with
potential antitumor activity such as natural-killer (NK) cells, killer (K) cells 
or macrophages. Interferon can also modify the metabolism of molecules involved
in immunologic functions, such as antigen receptors, histocompatibility antigens 
or receptors for Fc fragment of immunologlobulins. Systematic clinical trials
with interferon have been greatly expanded over the last three or four years. At 
this time the data support a cautious optimism for the therapeutic value of
interferon in both viral and neoplastic diseases.

Publication Types: 
    English Abstract

PMID: 6085167 [PubMed - indexed for MEDLINE]

7580: Wiad Lek. 1983 Dec 15;36(24):2019-23.

[Skin changes and symptoms in Hodgkin's disease]

[Article in Polish]

Gabrys K, Medras E, Wolowiec D, Miklaszewska M.

Publication Types: 
    English Abstract

PMID: 6675313 [PubMed - indexed for MEDLINE]

7581: Can Med Assoc J. 1983 Dec 15;129(12):1284-5.

Herpes zoster: treatment with cimetidine.

Hayne ST, Mercer JB.

The active phase of herpes zoster can be predicted from the length of time it
takes for all the vesicles to erupt. A case is reported in which cimetidine
therapy appeared to reduce the expected length of the active phase from 35 days
or longer to 10 days.

Publication Types: 
    Case Reports

PMID: 6652595 [PubMed - indexed for MEDLINE]

7582: N Engl J Med. 1983 Dec 8;309(23):1434-40.

Varicella and herpes zoster. Changing concepts of the natural history, control,
and importance of a not-so-benign virus.

Weller TH.

New knowledge of the relationship between the varicella-zoster virus and its host
suggests a heretofore unappreciated dynamic pattern. Molecular finger-printing
has demonstrated a degree of heterogeneity between different strains of virus. It
is probable that exogenous reinfection with different strains and endogenous
reactivation are commonplace events, although usually asymptomatic. The lability 
of the endogenous interaction inversely parallels the responsiveness of the
cell-mediated immune system--a major factor in viral containment by the human
host. Thus, the therapeutic use of immunosuppressive or cytotoxic substances
increases the morbidity and mortality associated with varicella-zoster. Promising
new approaches to the prevention and treatment of the virus should alter the
balance in favor of the host.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6195526 [PubMed - indexed for MEDLINE]

7583: Pain. 1983 Dec;17(4):361-8.

Acupuncture compared with placebo in post-herpetic pain.

Lewith GT, Field J, Machin D.

A single blind randomised controlled study of auricular and body acupuncture
compared with placebo (mock transcutaneous nerve stimulation) was performed in 62
patients with post-herpetic neuralgia. There was no difference in the amount of
pain relief recorded in the two groups during or after treatment; 7 patients in
the placebo group and 7 patients in the acupuncture group experienced significant
improvement in their pain at the end of treatment. This suggests that acupuncture
is of little value as an analgesic therapy for post-herpetic neuralgia. However
the study method and the use of a mock transcutaneous nerve stimulator as a
placebo may be of value when assessing the effects of acupuncture in other
conditions.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 6664681 [PubMed - indexed for MEDLINE]

7584: Ann Intern Med. 1983 Dec;99(6):882-3.

Acyclovir and neurologic manifestations.

Auwerx J, Knockaert D, Hofkens P.

Publication Types: 
    Case Reports
    Letter

PMID: 6651045 [PubMed - indexed for MEDLINE]

7585: Am Fam Physician. 1983 Dec;28(6):138-44.

Herpes zoster.

Yardley DE, Schwartz RA, Adams HG.

Herpes zoster ("shingles") is usually a benign, self-limited disease. However, it
can be debilitating or even fatal. The potentially serious complications of
ocular involvement or postherpetic neuralgia and the confusing therapeutic
regimens that are often advocated make this a complicated subject. Dissemination 
is more common in immunosuppressed and elderly febrile patients, and the
complications are more serious. Herpes zoster patients may benefit from treatment
with vidarabine, currently the only antiviral agent approved for use in this
disease. Corticosteroids may be helpful in selected patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6650330 [PubMed - indexed for MEDLINE]

7586: Cutis. 1983 Dec;32(6):521-7.

Epidermolysis bullosa acquisita: an autoimmune disease with distinctive
immunoultrastructural features.

Woodley DT, Gammon WR.

Epidermolysis bullosa acquisita is a subepidermal bullous disease of the skin
with distinctive clinical, histologic, immunologic, and ultrastructural features.
A case of epidermolysis bullosa acquisita is presented in which the onset of the 
disease was heralded by inflammatory blisters similar to herpes simplex or herpes
zoster. The immunofluorescent findings were indistinguishable from bullous
pemphigoid. Although some inflammatory blisters persisted throughout the
evolution of the disease, the patient eventually developed noninflammatory
blisters that healed with milia formation and scarring, lesions typical of
classic epidermolysis bullosa acquisita. The diagnosis of epidermolysis bullosa
acquisita was definitely made by electron and immunoelectron microscopy which
showed a sub-lamina-densa blister cleavage plane and immune deposits beneath the 
lamina densa. This case illustrates that some cases of epidermolysis bullosa
acquisita may have an inflammatory stage and immunofluorescent findings that make
it difficult to distinguish from inflammatory bullous diseases. The value of
electron microscopy and immunoelectron microscopy in making a firm diagnosis of
epidermolysis bullosa acquisita is emphasized.

Publication Types: 
    Case Reports

PMID: 6357643 [PubMed - indexed for MEDLINE]

7587: Eur J Clin Microbiol. 1983 Dec;2(6):581-7.

Rapid and direct detection of herpes simplex virus and varicella-zoster virus
antigens in clinical specimens by staphylococcal reagent and membrane filtration.

Dishon T, Mogensen SC.

Herpes simplex virus was detected rapidly and directly in 31 and varicella-zoster
virus in two of 50 clinical specimens using specific antisera, stabilized
staphylococci rich in protein A and membrane filtration. Microscopical
examination of the cells retained on the filter membrane revealed attached
staphylococci only on cells harbouring viral antigens but not on non-infected
cells or cells from healthy donors. Infected cells treated with negative control 
sera and stabilized staphylococci and subsequently subjected to membrane
filtration were also devoid of the marker. It was also possible to detect herpes 
simplex virus antigens in three specimens which were culture negative. Similar
results were obtained with staphylococci specifically sensitized with anti-herpes
simplex rabbit serum. No interfering, non-specific background of unattached
staphylococci was observed on the filter membrane. The results were confirmed by 
the direct immunofluorescent test. The method is sensitive, specific, and
provides results within 3 h. It could be employed for the rapid screening of
populations at risk, e.g. pregnant women, medical personnel, and societies with a
growing incidence of genital herpes. Since no special, expensive equipment is
required, the method is also suitable for modestly equipped clinical
laboratories.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6321167 [PubMed - indexed for MEDLINE]

7588: Pediatr Clin North Am. 1983 Dec;30(6):1123-44.

Ocular findings in pediatric systemic disease.

Richard JM, Friendly DS.

The many diseases and disorders that frequently have ophthalmologic implications 
in the pediatric age group are discussed.

PMID: 6316240 [PubMed - indexed for MEDLINE]

7589: Nature. 1983 Dec 1-7;306(5942):478-80.

Varicella-zoster virus DNA in human sensory ganglia.

Gilden DH, Vafai A, Shtram Y, Becker Y, Devlin M, Wellish M.

Varicella-zoster virus (VZV) causes chickenpox and shingles. Clinical and
epidemiological evidence indicates that following an episode of childhood
chickenpox (varicella), VZV becomes latent, presumably in dorsal root ganglia,
and is reactivated many years later to produce shingles (zoster) in adults. VZV
has been demonstrated in ganglia by electron microscopy and by indirect
immunofluorescence, and infectious viral particles have been isolated from
acutely infected ganglia of patients who died of disseminated VZV infection.
However, VZV has not been detected in the ganglia of humans without recent
exposure to VZV. Tissue culture explant methods that have been successful in the 
isolation of herpes simplex virus from ganglia have so far failed in the
isolation or reactivation of VZV from trigeminal and other dorsal root ganglia.
We describe here the detection of VZV DNA sequences in an acutely infected human 
sacral ganglion and in normal trigeminal ganglia. These findings support the
hypothesis that VZV is latent in normal human ganglia.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6316159 [PubMed - indexed for MEDLINE]

7590: N Engl J Med. 1983 Dec 1;309(22):1362-8.

Varicella and herpes zoster. Changing concepts of the natural history, control,
and importance of a not-so-benign virus.

Weller TH.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6314138 [PubMed - indexed for MEDLINE]

7591: Orv Hetil. 1983 Nov 27;124(48):2913-8.

[Intravenous acyclovir (ACV, Zovirax) therapy of varicella zoster infections in
immunologically endangered patients]

[Article in Hungarian]

Kerpel-Fronius S, Nyerges G, Meszner Z, Eckhardt S, Walker E, Bridgen D.

Publication Types: 
    English Abstract

PMID: 6657237 [PubMed - indexed for MEDLINE]

7592: Lancet. 1983 Nov 26;2(8361):1223-5.

DNA mapping of paired varicella-zoster virus isolates from patients with
shingles.

Pichini B, Ecker JR, Grose C, Hyman RW.

Varicella-zoster virus (VZV) was isolated from two separate sites in each of
three patients with shingles (herpes zoster). The DNAs of the six VZV isolates
were compared by high-resolution restriction endonuclease analysis with HindIII, 
KpnI, and HpaI. DNA cleavage patterns for each pair of VZV isolates were
indistinguishable. These studies suggest that clinical shingles is the
manifestation of a single VZV strain that becomes reactivated and causes both a
viraemia and a dermatomal exanthem.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6139571 [PubMed - indexed for MEDLINE]

7593: MMW Munch Med Wochenschr. 1983 Nov 18;125(46):1067-70.

[Infections caused by viruses of the herpesvirus group. Possibilities of rapid
diagnosis]

[Article in German]

Schneweis KE.

Publication Types: 
    English Abstract

PMID: 6316132 [PubMed - indexed for MEDLINE]

7594: N Engl J Med. 1983 Nov 17;309(20):1254-5.

Acyclovir for immunocompromised patients with herpes zoster.

[No authors listed]

Publication Types: 
    Case Reports
    Letter

PMID: 6633579 [PubMed - indexed for MEDLINE]

7595: Med Clin (Barc). 1983 Nov 12;81(15):693.

[Cutaneous hyperpigmentation and vidarabine]

[Article in Spanish]

Cirera L, Palou J, Estape J.

Publication Types: 
    Case Reports
    Letter

PMID: 6656419 [PubMed - indexed for MEDLINE]

7596: Aust Fam Physician. 1983 Nov;12(11):800-1.

The many faces of herpes zoster.

[No authors listed]

PMID: 6667191 [PubMed - indexed for MEDLINE]

7597: Rev Med Suisse Romande. 1983 Nov;103(11):997-9.

[Treatment of zona]

[Article in French]

Lasserre B.

PMID: 6665385 [PubMed - indexed for MEDLINE]

7598: Klin Med (Mosk). 1983 Nov;61(11):116-21.

[Viral infections in hemoblastoses]

[Article in Russian]

Loginskii VE, Doroshenko LG.

Publication Types: 
    English Abstract

PMID: 6664044 [PubMed - indexed for MEDLINE]

7599: West J Med. 1983 Nov;139(5):718-20.

Clinical aspects of herpes zoster.

Glaser RB.

PMID: 6606904 [PubMed - indexed for MEDLINE]

7600: Ann Neurol. 1983 Nov;14(5):591-2.

Intracerebral hemorrhage with herpes zoster ophthalmicus.

Elble RJ.

Publication Types: 
    Case Reports
    Letter

PMID: 6606388 [PubMed - indexed for MEDLINE]

7601: Ann Neurol. 1983 Nov;14(5):543-53.

Herpes zoster ophthalmicus and delayed contralateral hemiparesis caused by
cerebral angiitis: diagnosis and management approaches.

Hilt DC, Buchholz D, Krumholz A, Weiss H, Wolinsky JS.

Four patients with herpes zoster ophthalmicus and delayed contralateral
hemiparesis are described, and their findings are compared with those in patients
previously reported in the English language literature. The current patients
evidenced multifocal ipsilateral cerebral angiitis by angiography and multifocal 
infarcts in the distribution of the ipsilateral middle cerebral artery by
computed tomographic scanning. Cerebrospinal fluid showed mononuclear
pleocytosis, positive oligoclonal bands, and an elevated immunoglobulin G index. 
Two patients were treated with corticosteroids and acyclovir, and 1 with
corticosteroids alone, all without apparent response. Necrotizing angiitis
ipsilateral to the herpes zoster ophthalmicus was demonstrated postmortem in 1
patient with multifocal cerebral infarction and progressive leukoencephalopathy. 
Neither herpes varicella zoster immunocytochemical reactivity nor viral
inclusions were seen. The leukoencephalopathy associated with herpes varicella
zoster either may be caused by cerebral angiitis or, as previously reported, may 
be a temporally remote manifestation of persistent herpes varicella zoster
infection. The cerebral angiitis associated with herpes varicella zoster is
histologically similar to granulomatous angiitis, and both may be related to
herpes varicella zoster infection of the cerebral vasculature.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 6606387 [PubMed - indexed for MEDLINE]

7602: Br J Ophthalmol. 1983 Nov;67(11):751-4.

Endothelial cell loss in herpes zoster keratouveitis.

Reijo A, Antti V, Jukka M.

Fourteen patients were followed up with slit-lamp, noncontact, and wide-field
specular microscopical examination for anterior segment changes during unilateral
attacks of keratouveitis due to varicella zoster virus (VZV). Ten patients had
severe keratouveitis. Their affected eyes presented nonreflecting endothelial
changes in different phases of the disease. The first non-reflecting changes
suggesting virus endothelitis were observed at the onset of keratouveitis. These 
changes later recurred for several months. When the corneal oedema had subsided, 
the mean endothelial cell density of the affected eyes was on average 15.3% lower
(p less than 0.01) than in the healthy fellow eyes. During early uveitis
transient high intraocular pressure (IOP) developed in 5 patients. Patients with 
severe disease and an episode of high IOP had a 20.2% lower cell count in the
diseased than in the healthy fellow eye. During the follow-up interstitial
keratitis developed in 2 cases and focal iris atrophy in another 2. Four patients
presented with mild keratouveitis. The posterior cornea and endothelial cell
density in this group remained unchanged.

PMID: 6605764 [PubMed - indexed for MEDLINE]

7603: Neurology. 1983 Nov;33(11):1428-32.

Herpes zoster ophthalmicus and delayed ipsilateral cerebral infarction.

Bourdette DN, Rosenberg NL, Yatsu FM.

We studied five patients who had acute cerebral infarctions 5 weeks to 6 months
after herpes zoster ophthalmicus (HZO). All had infarcts of the cerebral
hemisphere ipsilateral to the HZO, and one also had a cerebellar infarct.
Cerebral arteriography in one patient disclosed narrowing of the middle cerebral 
artery, occlusion of the anterior cerebral artery ipsilateral to the HZO and
narrowing of the opposite anterior cerebral artery. In another case,
arteriography revealed occlusion of the distal internal carotid artery on the
side of the HZO.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6605495 [PubMed - indexed for MEDLINE]

7604: J Antimicrob Chemother. 1983 Nov;12(5):489-96.

Subjective response to lysine in the therapy of herpes simplex.

Walsh DE, Griffith RS, Behforooz A.

To test the effect of lysine supplementation on herpes infection, 1543 subjects
were surveyed by questionnaire after a six-month trial period. The study included
subjects with cold sores, canker sores, and genital herpes. Of these, 54% had
been diagnosed and treated by a physician. The results showed that the average
dosage used was 936 mg of lysine daily. Eighty-four per cent of those surveyed
said that lysine supplementation prevented recurrence or decreased the frequency 
of herpes infection. Whereas 79% described their symptoms as severe or
intolerable without lysine, only 8% used these terms when taking lysine. Without 
lysine, 90% indicated that healing took six to 15 days, but with lysine 83%
stated that lesions healed in five days or less. Overall, 88% considered
supplemental lysine an effective form of treatment for herpes infection.

PMID: 6423612 [PubMed - indexed for MEDLINE]

7605: Br J Ophthalmol. 1983 Nov;67(11):746-50.

A comparison of topical acyclovir with steroids in the treatment of herpes zoster
keratouveitis.

McGill J, Chapman C.

Topical acyclovir has been compared with topical steroids in a coded controlled
trial of the treatment of keratouveitis caused by herpes zoster in 40 patients.
Topical acyclovir was significantly superior to topical steroids in terms of
treatment duration (75 days to 280 days), with no recurrences after the patients 
were weaned off treatment; there was a 63% recurrence rate in the steroid group. 
Corneal epithelial disease resolved significantly quicker in the acyclovir
treated group. If recurrences occurred in the steroid group, other parts of the
eye not initially affected were also involved. Treatment of such recurrences was 
more difficult than treatment of the initial attack.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 6357273 [PubMed - indexed for MEDLINE]

7606: Blood. 1983 Nov;62(5):941-64.

Allogenic bone marrow transplantation: current status and future directions.

O'Reilly RJ.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6354307 [PubMed - indexed for MEDLINE]

7607: Haematologica. 1983 Nov-Dec;68(6):812-6.

An open trial with acyclovir for the treatment of viral infections in marrow
graft recipients.

Van Lint MT, Frassoni F, Melioli G, Marmont A, Lombardi A, Bacigalupo A.

Publication Types: 
    Clinical Trial

PMID: 6321303 [PubMed - indexed for MEDLINE]

7608: Isr J Med Sci. 1983 Nov;19(11):989-91.

Clinical and virological observations in childhood Hodgkin's disease in Israel.

Bogger-Goren S, Zaizov R, Vogel R, Leventon-Kriss S, Sayar Y, Gotlieb-Stematsky
T.

Antibody levels to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes
simplex virus (HSV) and varicella-zoster virus (VZV) were determined in children 
with Hodgkin's disease (HD) before therapy, as well as in healthy, age-matched
controls. Included were 21 Israeli-born children, aged 2.5 to 14.5 years: 13 Jews
whose parents were of African-Asian origin, 1 Jew whose parents were of European 
origin, and 7 Arabs. Most of them were from large families (average 5.5 children 
per family) and low socioeconomic class. Antibody levels were not statistically
different between patient and control groups with respect to CMV, HSV and VZV.
Geometric mean titer of antibody to EBV viral capsid antigen in HD patients was
100.0 compared with 10.8 in controls. Thirty-three percent of controls were
seronegative to EBV, and none had titers greater than or equal to 1:160. All
patients but one were seropositive to EBV, and 8 of 20 had titers greater than or
equal to 1:160. Among patients, 13 experienced onset of symptoms in the cold
season (October to March) and 8 in the hot season (April to September). Onset
during the cold season was usually abrupt with acute symptoms, Stage III to IV,
involving the mediastinum and neck. Onset during the hot season was insidious,
Stage I to II, with the affected area frequently located below the diaphragm. It 
is suggested that children of Arab and African-Asian Jewish origin with high
serum titers to EBV are at increased risk for HD and for seasonal
onset-associated clinical presentation.

PMID: 6319327 [PubMed - indexed for MEDLINE]

7609: Isr J Med Sci. 1983 Nov;19(11):984-6.

Transfer of viral antibodies from mother to infant.

Gotlieb-Stematsky T, Modan M, Meron I, Fogel A, Sayar Y, Leventon-Kriss S,
Gurewitz R, Insler V.

Antibody titers to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes
simplex virus (HSV) Type 1, varicella-zoster virus (VZV) and rubella virus (RV)
were determined in maternal and in newborn cord sera in 258 consecutive
deliveries. Infants born with one or more of the following risk factors--weight
less than 2.5 kg, Apgar score less than 7, clinical jaundice, meconium-stained
amniotic fluid, birth defects and respiratory distress syndrome--were considered 
to be at risk. Similar geometric mean titers (GMT) of antibodies to EBV and HSV
were seen in cord blood. Anti-VZV maternal antibody levels were significantly
higher than those of cord blood (P less than 0.01). Levels of antibody to CMV and
RV, the two viruses most implicated in fetal damage were significantly higher in 
cord blood than in maternal blood (P = 0.02, and P less than 0.001,
respectively). Lower GMTs of antibodies to all five viruses were found in both
maternal and cord sera of the group of infants at risk, as compared with infants 
without risk factors, while the ratio of maternal to cord blood antibody levels
remained similar. It appears that inefficient production of antibodies correlates
with the presence of risk factors in the newborn.

Publication Types: 
    Comparative Study

PMID: 6319326 [PubMed - indexed for MEDLINE]

7610: Isr J Med Sci. 1983 Nov;19(11):959-62.

Human fibroblast interferon in treatment of viral diseases of the skin and mucous
membranes.

Isacsohn M, Berson B, Sternberg I, Morag A.

The therapeutic effect of human fibroblast interferon (HFIF) was studied in 33
patients. Seven had ophthalmic lesions (three due to adenovirus Type 8, four to
herpes simplex virus, and one to herpes zoster) and were treated with HFIF. In
the four patients with herpes simplex keratitis, HFIF was given in addition to
standard therapy or together with other antiviral agents. Ten other patients, 8
with herpes simplex or herpes zoster skin or mucous membrane lesions, were
treated with HFIF. HFIF was incorporated into an ointment as well as into a
solution for subconjunctival infections. Although the number of cases was small, 
our results showed that HFIF was effective in shortening the course of the
disease.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 6319325 [PubMed - indexed for MEDLINE]

7611: J Clin Microbiol. 1983 Nov;18(5):1146-9.

Serum immunoglobulin A antibody to varicella-zoster virus in subjects with
primary varicella and herpes zoster infections and in immune subjects.

Wittek AE, Arvin AM, Koropchak CM.

Immunoglobulin A (IgA) antibodies to varicella-zoster virus (VZV) were measured
in sera from subjects with acute varicella and herpes zoster, VZV-immune subjects
remote from infection, and recipients of a live attenuated varicella vaccine,
using a solid-phase radioimmunoassay. Primary infection with VZV was associated
with early production of IgA antibodies. Among 36 subjects with varicella tested 
1 to 5 days after onset, 22 had detectable IgA, and all of the negative sera were
obtained before day 3 of the varicella exanthem. VZV IgA was detected in one of
three sera obtained more than 60 days after onset of the illness. Four of five
sera obtained from subjects within 1 week of the onset of herpes zoster had
measurable levels of IgA. Between 1 and 4 weeks after onset of zoster, all 10
subjects tested had detectable IgA to VZV. VZV IgA was detected as late as 63
days after the onset of herpes zoster. Of 10 vaccine recipients, 5 developed VZV 
IgA which was detected as early as 4 weeks and persisted for as long as 16 weeks 
after vaccination. VZV IgA was not detected in sera from 42 children who had no
detectable IgG antibody to VZV. VZV IgA was found on only 3 of 23 sera from
adults who had varicella more than 20 years before.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6315766 [PubMed - indexed for MEDLINE]

7612: Drugs. 1983 Nov;26(5):378-438.

Acyclovir. A review of its pharmacodynamic properties and therapeutic efficacy.

Richards DM, Carmine AA, Brogden RN, Heel RC, Speight TM, Avery GS.

Acyclovir (aciclovir) is a nucleoside analogue antiviral drug related to
cytarabine, idoxuridine, trifluridine and vidarabine. In common with these
earlier antivirals, acyclovir is active against some members of the herpesvirus
group of DNA viruses. The efficacy of topical acyclovir has been convincingly
demonstrated in ocular herpetic keratitis, and in initial and primary initial
genital herpes infection, but little or no clinical benefit was seen when
non-primary initial genital infections were assessed separately. Acyclovir
ointment demonstrated little benefit in recurrent genital herpes but topical
acyclovir cream decreased the course of the infection by 1 to 2 days. Orally and 
intravenously administered acyclovir were beneficial in initial genital herpes
infections, and oral therapy shortened the duration of recurrent infections by 1 
to 2 days but did not ameliorate pain. In non-immunocompromised patients with
recurrent herpes simplex labialis, generally little clinical benefit was seen
with the use of topical acyclovir ointment even when therapy was initiated during
the prodromal phase, while topical acyclovir cream effected small but significant
improvements in the clinical but not the symptomological course of the disease.
However, in immunocompromised patients, both intravenous and topical acyclovir
shortened the clinical course of herpes simplex virus infections occurring mainly
on the lips, oral mucosa and face, and prophylaxis with either oral or
intravenous acyclovir suppressed the appearance of recurrent lesions from latent 
virus for the period of drug administration, but acyclovir did not eradicate
latent herpesviruses. In non-immunocompromised patients, intravenous acyclovir
was shown to decrease the acute pain of zoster, especially in the elderly, but
postherpetic neuralgia was not ameliorated. When immunocompromised patients were 
studied, intravenous acyclovir inhibited the progression of zoster infections and
shortened the healing time and duration of viral shedding in patients with
cutaneous disseminated zoster. However, acute and post-herpetic pain were not
significantly affected. Well designed controlled studies are underway to
establish the efficacy of acyclovir in herpes simplex encephalitis and
cytomegalovirus infections in immunocompromised patients, infections due to
Epstein-Barr virus, and neonatal herpesvirus infections. Despite some aspects of 
the drug's use which require further clarification, acyclovir will make a major
impact on the treatment of herpesviral infections. Barring unexpected findings
with wider clinical use, it will become the agent of choice in several
conditions.

Publication Types: 
    Clinical Trial
    Review

PMID: 6315332 [PubMed - indexed for MEDLINE]

7613: N Engl J Med. 1983 Oct 20;309(16):963-70.

Drug therapy. Treatment of herpesvirus infections.

Hirsch MS, Schooley RT.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6194435 [PubMed - indexed for MEDLINE]

7614: Lancet. 1983 Oct 8;2(8354):814-6.

Varicella-zoster virus RNA in human trigeminal ganglia.

Hyman RW, Ecker JR, Tenser RB.

The technique of in situ hybridisation was used to examine human trigeminal
ganglia for the presence of varicella-zoster virus (VZV) RNA. The ganglia were
removed from fresh cadavers of individuals without a history of current or recent
herpes zoster. Of the various types of cell in the ganglia, only the neurons
appeared positive for VZV RNA. 0 to 0.3% of neurons were positive for VZV RNA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6137648 [PubMed - indexed for MEDLINE]

7615: Arch Neurol. 1983 Oct;40(10):637-42.

Microorganisms as antineoplastic agents in CNS tumors.

Kapp JP.

In two patients, malignant tumors unexpectedly regressed following infections. I 
reviewed the extensive body of literature, both experimental and clinical,
concerning the antineoplastic potential of bacteria and viruses. Substantial
evidence exists to indicate that microorganisms may, by growing in or near
tumors, completely or partially inhibit tumor growth, or alternatively may have
no effect at all. In fact, oncolysis may occur only when a specific organism
infects a specific tumor.

Publication Types: 
    Case Reports

PMID: 6688521 [PubMed - indexed for MEDLINE]

7616: J Assoc Physicians India. 1983 Oct;31(10):669-71.

Two unusual cases of herpes zoster involving cranial nerves.

Baruah MC, Lal S, Padiyar NV.

Publication Types: 
    Case Reports

PMID: 6671938 [PubMed - indexed for MEDLINE]

7617: J Assoc Physicians India. 1983 Oct;31(10):617-8.

Interesting new findings regarding the age old shingles.

Sainani GS, Deshpande DV.

Publication Types: 
    Editorial

PMID: 6671929 [PubMed - indexed for MEDLINE]

7618: Indian J Dermatol. 1983 Oct;28(4):173-4.

Ophthalmic zoster in infancy. A case report.

Bharija SC, Kanwar AJ, Singh G.

Publication Types: 
    Case Reports

PMID: 6608489 [PubMed - indexed for MEDLINE]

7619: Isr J Med Sci. 1983 Oct;19(10):874-5.

Rapid viral diagnosis: a review.

Gershon AA.

PMID: 6363344 [PubMed - indexed for MEDLINE]

7620: Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol.
1983 Oct-Dec;32(4):361-5.

[Herpes zoster varicellosus in a case of silicotuberculosis]

[Article in Romanian]

Ispas TL, Caruntu V, Dumitrescu V.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6320342 [PubMed - indexed for MEDLINE]

7621: Neurosurgery. 1983 Oct;13(4):420-6.

Intraarterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and systemic
chemotherapy for malignant gliomas: a follow-up study.

West CR, Avellanosa AM, Barua NR, Patel A, Hong CI.

Twenty-five adults who harbored malignant gliomas received 72 courses of
intraarterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) (100 mg/m2) and 67
courses of systemic vincristine (1.0 mg/m2) and procarbazine (100 mg/m2) as
induction therapy (BVP) followed by 106 courses of systemic
1-(2-chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea (methyl-CCNU) (130 mg/m2),
vincristine, and procarbazine as maintenance therapy (MVP). With a 6-week
interval between each treatment, the median and range for the number of courses
of BVP were 3 and 1 to 4 and those for MVP were 3 and 0 to 14, respectively.
Fifteen patients (60%) responded to both BVP and MVP, and 10 (40%) did not. The
overall median survival time was 12.7 months (range, 1.8 to 48.5+ months). Two of
3 patients who had recurrent gliomas responded and survived for 37+ to 45+
months. Seven of 10 who had nonirradiated glioblastomas responded and survived
for 9 to 22 months. Four who had nonirradiated anaplastic astrocytomas all
responded and survived for 38+ to 48.5+ months. Two who also received
radiotherapy (1 glioblastoma and 1 primitive neuroectodermal tumor) benefited and
survived for 16.9 and 28.5+ months. All who did not respond favorably died within
8 months. During the infusion of BCNU, complications included transient orbital
and head pain, periorbital and scleral erythema in all patients, and a focal
seizure in 1 (4%). During the 6-month induction periods, leukopenia and
thrombocytopenia occurred in 1 (4%), deep vein thrombosis occurred in 9 (36%),
pulmonary emboli occurred in 8 (32%), upper respiratory infections occurred in 6 
(24%), pneumonia occurred in 9 (36%), and herpes zoster occurred in 1
(4%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 6314173 [PubMed - indexed for MEDLINE]

7622: J Infect Dis. 1983 Oct;148(4):630-8.

Common expression of varicella-zoster viral glycoprotein antigens in vitro and in
chickenpox and zoster vesicles.

Weigle KA, Grose C.

Human cells infected with varicella-zoster virus (VZV) produce at least three
major virus-specific, immunogenic glycoproteins: gp118, gp98, and gp62. Since
glycoproteins gp98 and gp62 were found to be prominent constituents of the
infected cell membrane, a murine monoclonal antibody (clone 3B3) that reacted
avidly with this glycoprotein complex was selected as a probe for detection of
VZV replication in laboratory and clinical settings. Cultured cells of human,
simian, and caviid origin, when infected with wild-type isolates as well as
laboratory and vaccine strains of VZV all expressed these viral glycoproteins.
The monoclonal antibody immunostained the basal and malpighian epithelial layers 
of a zoster vesicle biopsy specimen and also reacted with all specimens of
vesicular cells obtained from epidemiologically unrelated patients with
chickenpox and zoster. Thus, these studies demonstrate that the VZV-specific
glycoprotein complex gp98/gp62 is highly conserved, abundantly expressed, and
easily detected with a monoclonal antibody probe.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6313814 [PubMed - indexed for MEDLINE]

7623: Cancer Res. 1983 Oct;43(10):5006-9.

Phase I evaluation of 2'-fluoro-5-iodo-1-beta-D-arabinofuranosylcytosine in
immunosuppressed patients with herpesvirus infection.

Young CW, Schneider R, Leyland-Jones B, Armstrong D, Tan CT, Lopez C, Watanabe
KA, Fox JJ, Philips FS.

2'-Fluoro-5-iodo-1-beta-D-arabinofuranosylcytosine (FIAC) is a potent selective
inhibitor of the replication of herpes simplex virus types 1 and 2 (HSV-1,
HSV-2), varicella zoster virus, and cytomegalovirus in cell culture systems. FIAC
produces an unequivocal therapeutic effect in mice that have been inoculated with
a lethal burden of HSV-1. We have administered FIAC to 32 host compromised
patients, 30 with advanced cancer, who were experiencing acute herpesvirus
infections (varicella zoster, 29; HSV-1, 2; HSV-2, 1); the drug was given by 20
min i.v. infusion twice a day for 7 days. The dosage levels explored were 60,
120, 240, 400, and 600 mg/sq m/day. Drug-induced myelosuppression became evident 
at 600 mg/sq m/day; thrombocytopenia exceeded leukopenia. The toxic low dose was 
400 mg/sq m/day with mild nausea and rare myelosuppression. All 24 varicella
zoster patients with cutaneous disease receiving FIAC, greater than or equal to
120 mg/sq m/day, experienced stabilization of cutaneous lesions within 48 to 72
hr; healing began promptly thereafter.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6309380 [PubMed - indexed for MEDLINE]

7624: Minn Med. 1983 Oct;66(10):623-5.

Varicella-zoster infections. Advances in the prevention and treatment.

Bean B, Balfour HH Jr.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6196611 [PubMed - indexed for MEDLINE]

7625: Presse Med. 1983 Sep 17;12(32):1998.

[Simultaneous infection by 2 viruses of the Herpesviridae family, Herpes simplex 
virus and varicella-zoster virus]

[Article in French]

Binet O, Petit G, Rabary G, Vilmer C, Ferchal F.

Publication Types: 
    Case Reports
    Letter

PMID: 6310541 [PubMed - indexed for MEDLINE]

7626: Vestn Dermatol Venerol. 1983 Sep;(9):57-9.

[Treatment of herpes zoster with methisazone]

[Article in Russian]

Sergeev SIa, Milevskaia SG, Oksenov BS, Levitskaia NS, Labzovskaia NP.

Publication Types: 
    English Abstract

PMID: 6649872 [PubMed - indexed for MEDLINE]

7627: Z Hautkr. 1983 Sep 1;58(17):1268-72.

[Observations on pityriasis rosea patients]

[Article in German]

Vigh G.

In the Institute of Skin and Veneral Diseases 252 patients suffering from
pityriasis rosea were treated yearly since 1970. As opposed to descriptions
published so far several differences were observed. The disease occurs not only
in young adults, but also in infants and in old age. It may be observed not only 
in certain months, but throughout the year. The disease becomes manifest more
frequently in workers of larger collectives. It does not leave behind prolonged
immunity, but may return after an intervall of 1-12 years with milder symptoms.
The repeated incidence was 3,57 per cent. Recurrence was observed in two cases
within one family. P.r. was followed by herpes zoster in 3 cases, which is
indicative of increased susceptibility for viral infection. The point of attack
of the supposed pathogen is the pharyngeal mucous membrane, which may explain the
difficulty of isolation of the unknown virus as this region has a rich
microflora.

Publication Types: 
    English Abstract

PMID: 6636928 [PubMed - indexed for MEDLINE]

7628: J Infect Dis. 1983 Sep;148(3):607.

Immunoglobulin levels in serum and cerebrospinal fluid in certain viral
infections of the central nervous system.

Prasad R.

It is seriously debated whether the presence of immunoglobulins in CSF is due to 
local production, diffusion of proteins through the blood-brain barrier, or both.
Tourtellotte et al [1] strongly suggest that in both healthy and diseased
individuals, immunoglobulins are synthesized extravascularly and subsequently
diffuse into the CSF. Cohen and Bannister [2] demonstrated that lymphocytes from 
the CSF of patients with multiple sclerosis could produce IgA and IgG in vitro.
Although such evidence suggests the likelihood of local production of
immunoglobulins, others believe that elevated protein levels in CSF are due to
migration of immunoglobulins from serum to CSF because of damage to the
blood-brain barrier [3]. Thus, the elevated IgG level in CSF could be an
expression of such an impaired blood-brain barrier. A further implication of this
hypothesis is that the more the function of this barrier is impaired, the more
extensive is the transudation. This includes the migration of large molecules
such as IgM during the inflammatory state, a condition which increases not only
the number of theoretical filters but also the size of the pores. IgG levels in
CSF and serum were elevated in all five infections studied except viral
encephalitis, in which this value remained normal. The serum IgA level was
elevated in all five lesions, but the IgA level in CSF was elevated only in viral
encephalitis, Guillain-Barre syndrome, and meningeal carcinomatosis.(ABSTRACT
TRUNCATED AT 250 WORDS)

PMID: 6619581 [PubMed - indexed for MEDLINE]

7629: Arch Dermatol. 1983 Sep;119(9):788-9.

Cutaneous sarcoid granuloma formation in herpes zoster scars.

Bisaccia E, Scarborough DA, Carr RD.

Publication Types: 
    Case Reports

PMID: 6614968 [PubMed - indexed for MEDLINE]

7630: South Med J. 1983 Sep;76(9):1189-92.

Thymic hyperplasia in a case of Hodgkin's disease.

Grissom JR, Durant JR, Whitley RJ, Flint A.

Publication Types: 
    Case Reports

PMID: 6604334 [PubMed - indexed for MEDLINE]

7631: Rev Med Interne. 1983 Sep;4(3):289-93.

[Efficacy and tolerability of acyclovir in immunosuppressed patients with herpes 
simplex, herpes zoster or cutaneomucous chicken-pox. Multicenter trial apropos of
50 cases]

[Article in French]

Dellamonica P, Bernard E, Chichmanian RM.

A multicenter trial of Acyclovir was carried out in 50 immunodepressed patients. 
The dose used was 15 mg/kg/day for 5 days in herpes simplex and 30 mg/kg/day for 
10 days in herpes zoster and chicken pox by three one-hourly intravenous infusion
per day. Acyclovir had a clear cut effect in 42 cases, a partial effect in 1
case, no effect in 1 case, and its action could not be assessed in 6 cases. The
cutaneous and mucous membrane lesions were stabilised after an average of two
days' treatment, and regression was observed from the third day. Of the 21 cases 
of zoster, 15 were cured without sequellae and 5 with post-zoster pain. The
treatment failed in one patient. Of the 21 cases of cutaneous and/or mucous
membrane herpes simplex, 20 satisfactory and 1 partial result were obtained. The 
outcomes of the 2 cases of chicken pox were favourable. There were three relapses
after the end of therapy (2 herpes simplex, 1 zoster) but their outcomes were
favourable after a second course of Acyclovir. In 20 cases it was possible to
maintain the immuno-suppressive therapy. General tolerance was satisfactory.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 6364284 [PubMed - indexed for MEDLINE]

7632: Pharmacotherapy. 1983 Sep-Oct;3(5):275-83.

Acyclovir: mechanism of action, pharmacokinetics, safety and clinical
applications.

Gnann JW Jr, Barton NH, Whitley RJ.

Acyclovir is a new antiviral drug that acts as a specific inhibitor of
herpesvirus DNA polymerase. It shows good in vitro activity against herpes
simplex and varicella-zoster viruses. The drug may be administered topically to
the skin, intravenously, orally, or topically to the eye (only topical and
intravenous preparations are currently available). Acyclovir kinetics are
described by a two-compartment open model. The drug and its metabolites are
excreted by the kidney via glomerular filtration and tubular secretion. Dosage
adjustment is required in patients with renal failure. Safety and tolerance
studies in animals and humans have shown acyclovir to be very well tolerated. The
most important adverse effect is crystalluria and elevated serum creatinine
related to bolus intravenous administration. Other reported adverse effects
include infusion site inflammation and rash. Topical acyclovir is effective for
treating initial genital herpes and mucocutaneous herpes in the compromised host,
but has not been shown to be clinically useful for recurrent labial or genital
herpes. Intravenous acyclovir is effective for mucocutaneous herpes infections in
the compromised host and initial genital herpes in the normal host; it is being
evaluated for the treatment of herpes simplex virus encephalitis and
varicella-zoster infections. An investigational oral preparation may prove to be 
effective therapy for both initial and recurrent genital herpes. Acyclovir
therapy does not eliminate latent virus or prevent subsequent recurrences.

Publication Types: 
    Clinical Trial
    Review

PMID: 6359082 [PubMed - indexed for MEDLINE]

7633: Ophthalmic Surg. 1983 Sep;14(9):763-5.

Cicatricial ectropion secondary to herpes zoster.

Nasr AM, Beyer-Machule CK, Yeatts RP.

We present three patients with cicatricial ectropion of the upper and lower lids 
secondary to herpes zoster. Surgical release of the lid traction, excision of
scars, and full thickness skin grafting were performed with satisfactory results.

Publication Types: 
    Case Reports

PMID: 6358990 [PubMed - indexed for MEDLINE]

7634: J Antimicrob Chemother. 1983 Sep;12 Suppl B:45-9.

A review of acyclovir treatment of ocular herpes zoster and skin infections.

McGill J, Chapman C, Copplestone A, Maharasingam M.

Intravenous acyclovir had a significant effect on the resolution of the skin rash
in patients with acute zoster, but the 5-day course of therapy was not, in
itself, sufficient to treat coexisting ocular involvement. In an open study,
topical acyclovir was found to control herpes zoster kerato-uveitis, without
recurrences and in a shorter time than if steroids alone were used. The use of
steroids in combination with acyclovir led to prolonged treatment and high
recurrence rates. A comparative trial of topical acyclovir versus steroids in the
treatment of acute herpes zoster kerato-uveitis showed significant differences in
favour of acyclovir in terms of the time to resolution of corneal epithelial
disease, total treatment duration and the numbers of patients having a recurrence
of infection. The reductions in treatment duration and recurrence rate would be
expected to result in a reduced incidence of ocular damage and visual loss in
acyclovir treated patients.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial
    Review

PMID: 6355050 [PubMed - indexed for MEDLINE]

7635: J Antimicrob Chemother. 1983 Sep;12 Suppl B:123-7.

Acyclovir in shingles.

Bean B, Aeppli D, Balfour HH Jr.

Acyclovir given intravenously in either low dose (5 mg/kg every 8 h) or high dose
(500 mg/m2 every 8 h) significantly reduced pain and accelerated skin healing in 
acute herpes zoster occurring in otherwise healthy adults. The higher dose also
significantly reduced the duration of viral shedding. No significant effect on
post-herpetic neuralgia could be demonstrated, although the higher dose showed a 
promising trend. No adverse effects were associated with the lower dose, but
acyclovir at 500 mg/m2 resulted in nausea, vomiting and transiently elevated
serum creatinine in a substantial number of patients.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Review

PMID: 6355047 [PubMed - indexed for MEDLINE]

7636: Br J Clin Pract. 1983 Sep;37(9):304-6.

Prevention of post-herpetic neuralgia by amantadine hydrochloride (Symmetrel).

Galbraith AW.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6354236 [PubMed - indexed for MEDLINE]

7637: Ariz Med. 1983 Sep;40(9):616-20.

Acyclovir.

Wood D.

PMID: 6314944 [PubMed - indexed for MEDLINE]

7638: J Reprod Med. 1983 Sep;28(9):600-3.

Pregnancy complicated by herpes zoster. A report of two cases and literature
review.

Eyal A, Friedman M, Peretz BA, Paldi E.

Herpes zoster during pregnancy is rare, with only 13 reported cases. Although the
prognosis is usually favorable, the disease can be associated with congenital
malformations. We treated two pregnant women with herpes zoster at 25 and 31
weeks of gestation. The disease was diagnosed clinically and confirmed by
serology and virus isolation. Both women delivered normal infants with normal
development.

Publication Types: 
    Case Reports

PMID: 6313918 [PubMed - indexed for MEDLINE]

7639: J Clin Microbiol. 1983 Sep;18(3):658-62.

Effect of sucrose phosphate and sorbitol on infectivity of enveloped viruses
during storage.

Howell CL, Miller MJ.

Cytomegalovirus and varicella-zoster virus recovery from sucrose phosphate (0.2 M
SP) and 70% sorbitol (sorbitol) was compared after storage at -70, 4, and 20
degrees C over time. Recovery from 0.2 M SP was uniformly better. More tissue
culture infective doses and infectious foci were recovered in cell monolayers
inoculated with 0.2 M SP virus stocks as compared with viruses stored in 70%
sorbitol. Although both viruses were isolated from diluted fresh stocks (10(-1)
through 10(-4], freezing diluted virus suspensions generally resulted in
diminished recovery. Similar stabilizing effects on respiratory syncytial virus
and herpes simplex virus type 1 infectivities were observed when stocks were
preserved in 0.2 M SP, as compared with 70% sorbitol. Overall, 0.2 M SP was
better than 70% sorbitol for stabilizing cytomegalovirus, varicella-zoster virus,
respiratory syncytial virus, and herpes simplex virus type 1 infectivities under 
the conditions tested.

PMID: 6313747 [PubMed - indexed for MEDLINE]

7640: J Antimicrob Chemother. 1983 Sep;12 Suppl B:9-17.

The biochemistry and mechanism of action of acyclovir.

Elion GB.

Acyclovir, 9-(2-hydroxyethoxymethyl)guanine, is an acyclic nucleoside analogue
which has a high activity and selectivity for herpes viruses, particularly herpes
simplex viruses types 1 and 2 and varicella zoster virus. This selectivity is due
to the initial activation of the drug by phosphorylation by a herpes
virus-specified thymidine kinase. Normal cellular enzymes do not phosphorylate
acyclovir to any significant degree. Acyclovir monophosphate is subsequently
converted to a triphosphate which is a more potent inhibitor of herpes virus DNA 
polymerases than of cellular DNA polymerases. The relationship between the amount
of acyclovir triphosphate formed and its inhibition constant (Ki) for the
particular viral or cellular DNA polymerase is predictive of the inhibitory
activity of acyclovir on DNA replication.

Publication Types: 
    Review

PMID: 6313600 [PubMed - indexed for MEDLINE]

7641: J Antimicrob Chemother. 1983 Sep;12 Suppl B:195-9.

The present and future for acyclovir.

Brigden D, Keeney RE, King DH.

Publication Types: 
    Review

PMID: 6313599 [PubMed - indexed for MEDLINE]

7642: J Antimicrob Chemother. 1983 Sep;12 Suppl B:19-27.

The spectrum of antiviral activities of acyclovir in vitro and in vivo.

Collins P.

In vitro sensitivity data suggest that acyclovir should be effective against
clinical manifestations of herpes simplex virus types 1 and 2, varicella-zoster
virus and possibly Epstein-Barr virus. The clinical potential against herpes
simplex virus types 1 and 2 is further supported by results in animal models.
Human cytomegalovirus and the veterinary herpes viruses, with the possible
exception of equine herpes virus type 1, may be insufficiently sensitive to be
amenable to treatment.

Publication Types: 
    In Vitro
    Review

PMID: 6313598 [PubMed - indexed for MEDLINE]

7643: J Antimicrob Chemother. 1983 Sep;12 Suppl B:169-79.

Acyclovir therapy of varicella-zoster virus infections in immunocompromised
patients.

Balfour HH Jr, McMonigal KA, Bean B.

In a randomized, placebo-controlled, double-blind trial of intravenous acyclovir 
in the treatment of varicella zoster virus (VZV) infections, 8 of 20
immunocompromised children with varicella received acyclovir (500 mg/m2/dose
three times daily for 7 days). There was no significant difference in skin
healing between the acyclovir and placebo groups although there was a significant
reduction in the incidence of development of pulmonary involvement during
acyclovir treatment. Nineteen out of 34 patients received vidarabine (10
mg/kg/day for 5 days). Vidarabine significantly shortened the duration of new
vesicle formation. Both drugs significantly reduced the incidence of visceral
varicella, the most serious complication of VZV infection. An open trial also
concluded that early treatment of varicella in these patients is essential. Of
the 94 patients with zoster infection, 52 received acyclovir (500 mg/m2/dose
infused over one hour three times daily for 7 days). Acyclovir recipients healed 
more rapidly, had fewer days of pain and shorter duration of viral shedding
compared with placebo patients. The most important finding was that acyclovir
significantly protected against progression of zoster as defined by development
or progression of cutaneous dissemination and development of visceral zoster.
Vidarabine seemed to be equally effective in this respect. The likelihood of
cutaneous dissemination is related to the nature of the underlying condition. The
in vitro sensitivity of VZV isolates from patients with second episode VZV
infection during the trial did not change appreciably which suggests that VZV
does not become resistant to acyclovir during therapy.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6313596 [PubMed - indexed for MEDLINE]

7644: J Antimicrob Chemother. 1983 Sep;12 Suppl B:153-9.

Use of acyclovir for prophylaxis of herpes infections in severely
immunocompromised patients.

Prentice HG.

Two consecutive studies are reported. In study 1, 59 patients with acute
leukaemia undergoing remission induction therapy or bone marrow transplantation
were given either acyclovir (5 mg/kg) or placebo by intravenous infusion twice
daily during the period of neutropenia. All patients were seropositive (greater
than or equal to 1:8) for herpes simplex virus. Acyclovir provided total
protection against herpes simplex virus infection in bone marrow transplant
patients with 0/10 versus 5/10 infections in the placebo group (P = 0.033). For
the remission induction therapy group 2/19 on acyclovir developed HSV versus
10/20 receiving placebo (P = 0.018). Only one episode of cytomegalovirus (CMV)
infection was seen and this was in a patient on acyclovir. Epstein-Barr virus
secretion studies were inconclusive. No varicella zoster virus (VZV) infections
were seen. In Study 2, 20 consecutive HSV seropositive (greater than or equal to 
1:8) bone marrow transplant recipients received oral acyclovir. Five (25%)
developed HSV infections, one of which was in a non-compliant patient, who
subsequently developed a fatal infection whilst receiving therapeutic (5 mg/kg 8 
hourly) intravenous acyclovir for this HSV infection. Intravenous acyclovir is
effective in preventing HSV infections in the immunocompromised host but it seems
unlikely that CMV will be amenable to acyclovir in its present formulation.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Review

PMID: 6313594 [PubMed - indexed for MEDLINE]

7645: Med Clin North Am. 1983 Sep;67(5):973-90.

Ocular viral infections.

Pavan-Langston D.

The most important viral organisms involving the eye are the DNA viruses herpes
simplex, varicella-zoster, cytomegalovirus, adenovirus, and vaccinia virus. All
of these agents except CMV may cause acute epithelial infection, sterile trophic 
ulceration due to basement membrane damage, deep corneal stromal immune reaction,
and iritis. Although there are three excellent antiviral drugs commercially
available, only HSV and vaccinia virus are highly sensitive to therapy with these
antimetabolites; varicella-zoster virus and CMV are equivocally responsive and
adenovirus has not been shown to be susceptible to these agents. In selected
situations, topical or systemic corticosteroids are useful for managing any
associated immune reactions in the eyes, but patients on these drugs should be
monitored carefully both for superinfections and for interference with tissue
healing that might ultimately threaten the integrity of the globe.

Publication Types: 
    Review

PMID: 6312219 [PubMed - indexed for MEDLINE]

7646: Med Clin North Am. 1983 Sep;67(5):1075-92.

Viral infections in immunocompromised patients.

Wong DT, Ogra PL.

Publication Types: 
    Review

PMID: 6312214 [PubMed - indexed for MEDLINE]

7647: J Infect Dis. 1983 Sep;148(3):472-6.

Enzyme-linked immunosorbent assay for susceptibility to varicella.

Shehab Z, Brunell PA.

Nonspecific reactions to the membrane antigen of varicella-zoster virus were
found by fluorescent antibody assay in the sera of three children susceptible to 
the virus; one of these children subsequently developed varicella. None of the
three sera, however, contained antibody to varicella-zoster virus that was
detectable by enzyme-linked immunosorbent assay (ELISA). Moreover, the results of
the ELISA clearly distinguished immune from susceptible individuals. The negative
range was established with sera obtained from 15 individuals prior to the onset
of varicella, and the positive range was established with sera obtained from 75
healthy donors with a history of varicella. The results of the ELISA correlated
well with those of the fluorescent antibody assay (r = +0.84). Heterologous
reactions to herpes simplex virus were found in one of seven sera tested, and
such reactions to cytomegalovirus were found in two of five sera. Heterologous
reactions to Epstein-Barr virus were found in none of eight sera tested. ELISA is
easy, sensitive, and reproducible and can be used for routine screening for
susceptibility to varicella.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 6311911 [PubMed - indexed for MEDLINE]

7648: Drug Intell Clin Pharm. 1983 Sep;17(9):623-8.

The clinical use of intravenous acyclovir.

Hopefl AW.

Acyclovir (acycloguanosine) is a new antiviral compound with activity against
certain herpes viruses. Acyclovir is phosphorylated preferentially in
virus-infected cells into its active form, acyclovir triphosphate, an inhibitor
of viral-induced DNA polymerase. Acyclovir, which possesses an acyclic
carbohydrate moiety, also causes premature DNA chain termination. Acyclovir has
shown clinical activity against herpes simplex virus (HSV) types 1 and 2 and
varicella zoster virus (VZV), but its usefulness in cytomegalovirus, Epstein-Barr
virus, and chronic hepatitis B infections requires further study. In randomized
clinical trials of infections caused by HSV and VZV, intravenous acyclovir has
been shown to shorten the duration of viral shedding and lesion pain and hasten
the resolution of skin lesions, with minimal toxicity.

Publication Types: 
    Clinical Trial
    Review

PMID: 6311503 [PubMed - indexed for MEDLINE]

7649: Pediatrics. 1983 Sep;72(3):291-4.

Five-year follow-up study of recipients of live varicella vaccine using enhanced 
neutralization and fluorescent antibody membrane antigen assays.

Asano Y, Albrecht P, Vujcic LK, Quinnan GV Jr, Kawakami K, Takahashi M.

Twenty-six healthy children susceptible to varicella were inoculated with the OKA
strain of live attenuated varicella vaccine. All of the recipients showed good
antibody responses without adverse clinical reactions. The seropositivity rate 5 
years after vaccination was 100% by the enhanced neutralization test and 96% by
the fluorescent antibody membrane antigen (FAMA) test. None of the recipients
contracted varicella in spite of documented contact exposure. None of the
children developed herpes zoster during the 5-year observation period. The
results suggest that attenuated varicella vaccine has long-term protective
efficacy.

PMID: 6310478 [PubMed - indexed for MEDLINE]

7650: J Gen Virol. 1983 Sep;64 (Pt 9):1927-42.

Location and orientation of homologous sequences in the genomes of five
herpesviruses.

Davison AJ, Wilkie NM.

Molecular hybridization experiments were carried out to investigate homologous
regions in the genomes of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2),
equid herpesvirus 1 (EHV-1), pseudorabies virus (PRV) and varicella-zoster virus 
(VZV). Virion DNA probes from EHV-1, PRV and VZV hybridized to similar regions of
the HSV genome, and the use of cloned DNA probes allowed heterologous genomes to 
be oriented with respect to homologous regions. The HSV-1 and HSV-2 genomes are
colinear, the EHV-1 and VZV genomes are colinear with the IL or ISL genome
arrangement of HSV, and the PRV genome is essentially colinear with the IL genome
arrangement of HSV except that the region 0.1 to 0.4 fractional genome units
appears to be inverted. A detailed analysis of sequences in the HSV-2 and PRV
genomes to which the HSV-1 major capsid protein gene hybridized was carried out
in order to demonstrate the application of molecular hybridization to the
location of genes in heterologous genomes. The lesion in a DNA-positive
temperature-sensitive mutant of PRV was mapped within the putative PRV major
capsid protein gene. We conclude that the herpesviruses we have studied possess
several highly conserved genes, and propose that they are similar in genetic
organization despite presumably separate evolutionary histories.

PMID: 6310033 [PubMed - indexed for MEDLINE]

7651: Med Clin North Am. 1983 Sep;67(5):1163-72.

Antiviral drugs 1983.

Douglas RG Jr.

A number of antiviral compounds are currently available, and several others are
of great interest. Trifluridine, idoxuridine, and vidarabine are effective
topically in herpes simplex virus keratoconjunctivitis infection. Vidarabine (and
presumably acyclovir) is effective in herpes simplex virus encephalitis and in
herpes zoster infections in the immunocompromised host. Acyclovir is effective
topically, orally, and intravenously in primary herpes genitalis, and the oral
and intravenous forms are effective in recurrent herpes genitalis as well.
Amantadine and rimantadine are effective prophylactically and therapeutically in 
influenza A infections. Ribavirin and interferon, although not licensed, are of
great interest. Ribavirin may be useful in respiratory syncytial virus
infections, and interferon may be of benefit in common colds and related
disorders.

Publication Types: 
    Clinical Trial
    Review

PMID: 6194388 [PubMed - indexed for MEDLINE]

7652: JAMA. 1983 Aug 19;250(7):936-7.

Herpes zoster infection and use of oral anticoagulants. A potentially dangerous
association.

Blumenkopf B, Lockhart WS Jr.

Publication Types: 
    Case Reports

PMID: 6864976 [PubMed - indexed for MEDLINE]

7653: Arthritis Rheum. 1983 Aug;26(8):937-46.

Sustained improvement of intractable rheumatoid arthritis after total lymphoid
irradiation.

Field EH, Strober S, Hoppe RT, Calin A, Engleman EG, Kotzin BL, Tanay AS, Calin
HJ, Terrell CP, Kaplan HS.

Total lymphoid irradiation (TLI) was administered to 11 patients who had
intractable rheumatoid arthritis that was unresponsive to conventional medical
therapy, including aspirin, multiple nonsteroidal antiinflammatory drugs, gold
salts, and D-penicillamine. Total lymphoid irradiation was given as an
alternative to cytotoxic drugs such as azathioprine and cyclophosphamide. After
radiotherapy, 9 of the 11 patients showed a marked improvement in clinical
disease activity as measured by morning stiffness, joint tenderness, joint
swelling, and overall functional abilities. The mean improvement of disease
activity in all patients ranged from 40-70 percent and has persisted throughout a
13-28 month followup period. This improvement permitted the mean daily steroid
dose to be reduced by 54%. Complications included severe fatigue and other
constitutional symptoms during radiotherapy, development of Felty's syndrome in 1
patient, and an exacerbation of rheumatoid lung disease in another. After
therapy, all patients exhibited a profound T lymphocytopenia, and a reversal in
their T suppressor/cytotoxic cell to helper cell ratio. The proliferative
responses of peripheral blood mononuclear cells to phytohemagglutinin,
concanavalin A, and allogeneic leukocytes (mixed leukocyte reaction) were
markedly reduced, as was in vitro immunoglobulin synthesis after stimulation with
pokeweed mitogen. Alterations in T cell numbers and function persisted during the
entire followup period, except that the mixed leukocyte reaction showed a
tendency to return to normal values.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6882488 [PubMed - indexed for MEDLINE]

7654: Am J Dis Child. 1983 Aug;137(8):801-2.

Herpes zoster in normal and immunocompromised children.

Latif R, Shope TC.

PMID: 6869342 [PubMed - indexed for MEDLINE]

7655: Singapore Med J. 1983 Aug;24(4):218-20.

Herpes zoster in patients with systemic lupus erythematosus.

Wang F, Chua CT, Bosco J.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6648552 [PubMed - indexed for MEDLINE]

7656: Vestn Dermatol Venerol. 1983 Aug;(8):36-7.

[6 cases of recurring herpes zoster]

[Article in Russian]

Korsunskaia IM, Anton'ev AA, Fokin MA.

Publication Types: 
    English Abstract

PMID: 6637068 [PubMed - indexed for MEDLINE]

7657: J Neurol Neurosurg Psychiatry. 1983 Aug;46(8):786-7.

Hemispheric infarction after herpes zoster ophthalmicus.

Menkes DB, Bishara SN, Corbett AJ.

Publication Types: 
    Case Reports
    Letter

PMID: 6604135 [PubMed - indexed for MEDLINE]

7658: N C Med J. 1983 Aug;44(8):500-1.

Shingles.

Heald PW, Burton CS, Callaway JL.

PMID: 6579360 [PubMed - indexed for MEDLINE]

7659: Clin Exp Immunol. 1983 Aug;53(2):297-307.

Defective in vitro antibody production to Varicella zoster and other virus
antigens in patients with Hodgkin's disease.

Souhami RL, Babbage J, Sigfusson A.

Cultures of blood mononuclear cells stimulated with Varicella zoster antigen
(VZA) produced specific anti-VZA antibody in 20 of 27 normal adults but only 10
of 47 patients with treated Hodgkin's disease. Serum anti-VZA antibody levels
were the same in normals and patients. The deficiency of in vitro production was 
found in patients who had been off treatment for 6 or more years and was not
related to splenectomy. Each of 11 untreated patients had absent in vitro
production from blood cells but spleen cultures produced antibody readily. Using 
combinations of autologous spleen and blood cells, the defect was attributable to
the blood B cells. Defective production was also found in response to influenza
viruses and herpes simplex. We suggest that an abnormality in B cell circulation 
with localization of antibody producing B cells in spleen and lymph nodes, is a
feature of treated and untreated Hodgkin's disease.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6309443 [PubMed - indexed for MEDLINE]

7660: Ann Intern Med. 1983 Aug;99(2):151-8.

National case-control study of Kaposi's sarcoma and Pneumocystis carinii
pneumonia in homosexual men: Part 2.Laboratory results.

Rogers MF, Morens DM, Stewart JA, Kaminski RM, Spira TJ, Feorino PM, Larsen SA,
Francis DP, Wilson M, Kaufman L.

The Centers for Disease Control conducted a case-control study to investigate an 
outbreak of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual
men. The occurrence of these diseases was found to be associated with certain
aspects of lifestyle, including a greater number of male sex partners per year,
exposure to feces during sex, history of syphilis and non-B hepatitis, treatment 
for enteric parasites, and use of various illicit substances. Laboratory studies 
reflected both this lifestyle and the probable underlying cause of the Kaposi's
sarcoma and P. carinii pneumonia--cellular immune deficiency. Patients were found
to have lymphopenia, specifically a deficiency of the T-helper subpopulation,
resulting in a reversal of the T-helper to T-suppressor ratio. Levels of IgG and 
IgA were increased. When compared with controls, patients were also found to have
significantly higher titers of antibody to Epstein-Barr virus and
cytomegalovirus, a higher prevalence of antibody to hepatitis A virus and
Treponema pallidum, a lower prevalence of antibody to varicella zoster virus, and
a higher frequency of isolation of cytomegalovirus.

PMID: 6309049 [PubMed - indexed for MEDLINE]

7661: J Med Microbiol. 1983 Aug;16(3):303-8.

Virological course of herpes zoster in otherwise normal hosts.

Cevenini R, Donati M, Rumpianesi F, Moroni A, Tosti A, Patrizi A, Varotti C,
Negosanti M.

The virological course of herpes zoster infection in 42 otherwise normal hosts
was studied by virus isolation and antibody titration. Varicella-zoster virus
(VZV) was isolated from vesicle fluid from all three patients examined on the
first day of the vesicular eruption and from five out of six examined on the
second day. The isolation rate fell to one out of six patients on the seventh day
of illness and VZV was not isolated from patients at a later stage of the
illness. IgG antibodies were detected by IFAMA and ELISA, in sera from all the
patients by the end of the first week of illness; IgG antibody titres were
highest during the second and the third weeks. IgM antibodies to VZV were
detected in sera from six of the 42 patients with herpes zoster after
fractionation by ion-exchange chromatography.

PMID: 6308258 [PubMed - indexed for MEDLINE]

7662: J Clin Microbiol. 1983 Aug;18(2):331-43.

Production and characterization of monoclonal antibodies specific for a
glycosylated polypeptide of human cytomegalovirus.

Kim KS, Sapienza VJ, Chen CM, Wisniewski K.

Nine hybrid cell lines producing antibodies specific for cytomegalovirus (CMV)
antigen were obtained after fusion of P3/X63-Ag8 myeloma cells with spleen cells 
from BALB/c mice immunized with CMV complement-fixing antigen. By the immunoblot 
technique, five of nine antibodies (4D11, 7B4, 7D2, 8E3, and 8E10) were
identified as being reactive to a CMV glycosylated polypeptide with molecular
weight of 66,000 (GP66). Four other antibodies (1B8, 8E9, 4D2, and 7E2) appeared 
to be reactive with CMV antigen(s) only if the antigen was not denatured by
sodium dodecyl sulfate. These remain unassigned until further studies are done.
With the enzyme-linked immunosorbent assay (ELISA), competitive bindings were
performed with a constant amount of horseradish peroxidase-conjugated antibody
and various concentrations of unconjugated homologous and heterologous antibodies
on CMV antigen-coated ELISA wells, and the antigenic determinant specific for
each antibody was determined. The nine antibodies could be classified into six
different groups, each group reacting with a different epitope or a different
region with two or more antigenic determinants which are so close to each other
that they cause binding inhibition. They are groups A (4D11), B (7B4, 8E10), C
(7D2), D (4D2, 7E2, 8E9), E (8E3), and F (1B8). The extent of competition among
antibodies within each group was the same. By using the two antibodies that
reacted with different epitopes on GP66, a double-antibody sandwich ELISA method 
was developed. The method was sensitive enough to detect as little as 50% of the 
antigen present in one infected cell or 0.000245 U of CMV complement-fixing
antigen per test well. Other strains of CMV (David, Kerr, Espilat, C-87, and five
clinical isolates) gave positive results, whereas herpes simplex virus types 1
and 2, varicella-zoster virus and Epstein-Barr virus nuclear antigen preparations
did not. By the indirect immunofluorescence assay, antibodies 4D11 and 8E3 were
able to detect GP66 in the nucleus of CMV-infected F-5000 human embryonic
fibroblasts as early as 2 h postinfection and were superior in this respect to
the remaining seven antibodies tested. By the double-antibody sandwich ELISA, the
presence of GP66 in CMV-infected cells was detected as early as 2 h
postinfection.

PMID: 6194174 [PubMed - indexed for MEDLINE]

7663: Ned Tijdschr Geneeskd. 1983 Jul 2;127(27):1191-4.

[A 5-year-old girl with generalized herpes zoster]

[Article in Dutch]

Hoekstra GR.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6888585 [PubMed - indexed for MEDLINE]

7664: Arch Neurol. 1983 Jul;40(7):445-6.

Myelopathy after herpes zoster.

Muder RR, Lumish RM, Corsello GR.

A 73-year-old woman with a remote history of carcinoma of the ovary had herpes
zoster involving several lumbosacral dermatomes. There subsequently developed a
progressive myelopathy with normal myelographic findings and CSF pleocytosis.
Vidarabine (15 mg/kg/day) was given for ten days. No further progression
occurred. The syndrome of progressive myelopathy following herpes zoster is rare;
direct viral invasion of the cord with subsequent necrosis appears to be the
pathogenic mechanism. Antiviral therapy may have halted progression, but it did
not lead to recovery of function.

Publication Types: 
    Case Reports

PMID: 6860184 [PubMed - indexed for MEDLINE]

7665: Am J Med. 1983 Jul;75(1):97-109.

Infection among 210 patients with surgically staged Hodgkin's disease.

Coker DD, Morris DM, Coleman JJ, Schimpff SC, Wiernik PH, Elias EG.

To determine the incidence and types of infections in Hodgkin's disease,
particularly those related to the overwhelming pneumococcal sepsis syndrome, 210 
consecutive patients with previously untreated Hodgkin's disease who underwent
staging laparotomy with splenectomy from March 1968 to October 1979 were
reviewed. For 178 patients (85 percent) alive at the end of the study, the mean
follow-up time was 68.1 months. Eighty-two serious infections occurred among 59
(28 percent) of the patients; 47 (57 percent) serious infections were
microbiologically documented and 35 (43 percent) were clinically documented.
Forty-seven microbiologically documented serious infections occurred in 34
patients and consisted of 23 episodes of pneumonia, 10 cases of bacteremia, seven
wound infections, two cases of disseminated herpes zoster, one subphrenic
abscess, and four miscellaneous infections. Microbiologically documented serious 
infections occurring during initial treatment or remission had lower incidences
of leukopenia (29 versus 58 percent) (p = 0.09) and death (11 versus 53 percent) 
(p = 0.005) than those occurring after relapse of Hodgkin's disease. Of the
microbiologically documented serious infections, 76 percent were associated with 
a predisposing factor(s) (leukopenia, postoperative state, steroids, peripheral
neuropathy, leukemia), of which 34 percent were fatal. Microbiologically
documented serious infections unassociated with a predisposing factor were never 
fatal, including the only episode of pneumococcal sepsis in the series. In
contrast to microbiologically documented serious infections, only 14 percent of
clinically documented serious infections (versus 38 percent) were fatal. The
overwhelming pneumococcal sepsis syndrome and other infections thought to be
associated with the asplenic state are uncommon problems in patients with
Hodgkin's disease after splenectomy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6859090 [PubMed - indexed for MEDLINE]

7666: Pathologica. 1983 Jul-Aug;75(1038):557-63.

[Virus-associated hematophagocytic syndrome observed in 2 cases of fatal
varicella-zoster infections]

[Article in Italian]

Bontempini L, Doglioni C, Brandi G, Alloi I, Colombari R.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6669414 [PubMed - indexed for MEDLINE]

7667: Aust Fam Physician. 1983 Jul;12(7):500.

Herpes zoster (shingles).

Murtagh JE.

PMID: 6639484 [PubMed - indexed for MEDLINE]

7668: Harefuah. 1983 Jul;105(1-2):11-3.

[Idiopathic hypoparathyroidism in the elderly]

[Article in Hebrew]

Sirkis I, Okun G, Leventhal H, Strauss Z.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6629178 [PubMed - indexed for MEDLINE]

7669: Rinsho Shinkeigaku. 1983 Jul;23(7):613-6.

[Case of herpes zoster ophthalmicus with contralateral hemiplegia and normal
pressure hydrocephalus]

[Article in Japanese]

Tsuda T, Inoue N, Shiraishi S, Yamato T, Tsukamoto Y.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6607150 [PubMed - indexed for MEDLINE]

7670: Ann Neurol. 1983 Jul;14(1):84-5.

Herpes zoster ophthalmicus with contralateral hemiplegia: identification of
cause.

Doyle PW, Gibson G, Dolman CL.

A patient with herpes zoster ophthalmicus developed hemiparesis that at first
responded to steroids but, when these were reduced, culminated in massive
cerebral infarction and death. The cause was an extensive necrotizing arteritis
of large and small cerebral arteries. Herpes-like virions were identified in
smooth muscle cells of the middle cerebral artery.

Publication Types: 
    Case Reports

PMID: 6604495 [PubMed - indexed for MEDLINE]

7671: Quintessenz. 1983 Jul;34(7):1407-13.

[Therapy of viral oral mucosal diseases]

[Article in German]

Haneke E.

PMID: 6583738 [PubMed - indexed for MEDLINE]

7672: Stomatologiia (Mosk). 1983 Jul-Aug;62(4):78-9.

[Necrotic form of herpes zoster of the maxillofacial area]

[Article in Russian]

Poliak GB, Rusak MK, Kaspina AI.

Publication Types: 
    Case Reports

PMID: 6578631 [PubMed - indexed for MEDLINE]

7673: Oral Surg Oral Med Oral Pathol. 1983 Jul;56(1):39-46.

Alveolar bone necrosis and tooth loss. a rare complication associated with herpes
zoster infection of the fifth cranial nerve.

Wright WE, Davis ML, Geffen DB, Martin SE, Nelson MJ, Straus SE.

Eleven case reports involving herpes zoster infection associated with alveolar
bone necrosis and tooth loss were reviewed in order to develop a patient profile 
for this rare combination of physical findings. The clinical course of a
56-year-old white woman with herpes zoster infection of the fifth cranial nerve
and related alveolar bone necrosis, tooth loss, and oroantral fistula development
is reported. The etiology and management of herpes zoster infection associated
with destructive oral sequelae are discussed.

Publication Types: 
    Case Reports

PMID: 6576309 [PubMed - indexed for MEDLINE]

7674: Bol Asoc Med P R. 1983 Jul;75(7):308-10.

[Effects of acyclovir on mucocutaneous herpes]

[Article in Spanish]

Garib JL, Gurrea C, Torres A, Bermudez RH.

Publication Types: 
    English Abstract

PMID: 6335969 [PubMed - indexed for MEDLINE]

7675: Z Geburtshilfe Perinatol. 1983 Jul-Aug;187(4):155-67.

[Virus and other infections in pregnancy: diagnosis and prevention. 2]

[Article in German]

Enders G.

The various viral and other microbial infections represent only a small
proportion (5-10%) of the noxae which threaten pregnancy and the fetus. However, 
interest is centered on them because methods of controlling them are now
available. These include preventive measures, e.g., active immunization prior to 
pregnancy for measles, mumps, and rubella; passive prophylaxis with
immunoglobulins when the pregnant women comes into contact with, e.g., rubella
and varicella, and passive-active prophylaxis with hyperimmunoglobulin and
simultaneous active immunization of the newborns from HBsAg and HBeAg-positive
resp. anti-HBe-negative mothers and early therapy. The latter is possible for
acute herpes simplex and toxoplasmosis infection; it is effective for lues and
infections with gonococci, listeriae, beta-hemolytic streptococci, chlamydiae and
mycoplasmas. In cases of acute rubella during the first 17 weeks of pregnancy
termination of pregnancy must also be considered a prophylactic measure.
Laboratory diagnosis today includes, in addition to the conventional tests for
antibodies and pathogens, determination of IgG (permanent) and IgM (early)
antibodies as well as demonstration of antigens. Depending on the type of
pathogen and the diagnostic problem, several types of serologic tests must be
combined for rapid determination of the immune status on contact or for detection
of acute infections in pregnancy; necessitating in some instances also the
isolation of the pathogen. Diagnostic procedures are similar for identifying
prenatal and perinatal infection with and without abnormalities in the neonate.
Modern laboratory diagnosis is therefore very important for prophylactic and
therapeutic measures in pregnancy as well as for further management and
supportive care of congenitally infected infants.

Publication Types: 
    English Abstract

PMID: 6312703 [PubMed - indexed for MEDLINE]

7676: Tex Med. 1983 Jul;79(7):27-9.

What's new: acyclovir for treatment of ocular viral infections.

Wilhelmus KR, Jones DB.

PMID: 6312627 [PubMed - indexed for MEDLINE]

7677: J Virol Methods. 1983 Jul;7(1):1-9.

Solid-phase enzyme-immunoassay for the detection of herpes simplex virus antigens
in clinical specimens.

Ziegler T, Meurman OH, Arstila PP, Halonen PE.

An indirect solid-phase enzyme-immunoassay (EIA) for the detection of herpes
simplex virus (HSV) antigens in clinical specimens was developed. Rabbits and
guinea pigs were hyperimmunized with highly purified nucleocapsids of HSV type 1.
Microtitre plates were coated with 0.25 microgram of guinea pig anti-herpes
simplex type 1 immunoglobulins per well. Clinical specimens, diluted in phosphate
buffered saline containing fetal calf serum and detergents, were sonicated and
incubated in the test wells overnight at 37 degrees C. Rabbit anti-HSV
immunoglobulins were added as a secondary antibody at a concentration of 3.2
micrograms per well, and peroxidase conjugated swine antibodies against rabbit
immunoglobulins, diluted 1:1,000, were used as a fourth layer. Clinical specimens
which were sent for virus isolation or for isolation of Chlamydia trachomatis
were tested by the developed assay and 20 out of 27 isolation positive specimens 
were found positive by EIA. Five out of 67 specimens negative by isolation gave
positive results by EIA. The specificity of the results was confirmed by a
control test using wells coated with normal guinea pig immunoglobulins. The test 
detected antigens from both serotypes of HSV. Cross reactions with
varicella-zoster- or with cytomegalovirus were not found, and antigens from
uninfected cells did not result in false positive results.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 6311854 [PubMed - indexed for MEDLINE]

7678: South Med J. 1983 Jul;76(7):905-9.

Acyclovir.

Appelboom TM, Flowers FP.

Acyclovir, the new virucidal drug recently approved by the Food and Drug
Administration for the treatment of herpes simplex virus (HSV), is the first
available effective drug to treat such infections. Acyclovir boasts activity
against four of the five major herpes-group viruses, including herpes simplex
(types 1 and 2), varicella-zoster, and Epstein-Barr. The drug, phosphorylated
preferentially in viral cells, exclusively attacks infected cells possessing
virus-specific DNA polymerase, giving acyclovir low toxicity coupled with high
efficacy. Problems of renal toxicity and viral resistance now dampen some of the 
initial expectations. Present-day research continues to reveal insights into the 
mechanism and action of acyclovir.

Publication Types: 
    Review

PMID: 6306847 [PubMed - indexed for MEDLINE]

7679: Proc Natl Acad Sci U S A. 1983 Jul;80(13):4139-43.

9-([2-hydroxy-1-(hydroxymethyl)ethoxy]methyl)guanine: a selective inhibitor of
herpes group virus replication.

Field AK, Davies ME, DeWitt C, Perry HC, Liou R, Germershausen J, Karkas JD,
Ashton WT, Johnston DB, Tolman RL.

9-([2-Hydroxy-1-(hydroxymethyl)ethoxy]methyl)guanine (2'-nor-2'-deoxyguanosine;
2'NDG) selectively inhibits the replication of herpes group viruses. In cell
culture studies 2'NDG was at least 10-fold more potent than acyclovir (ACV) in
inhibition of human cytomegalovirus replication and Epstein-Barr virus-induced
lymphocyte transformation and was about as effective as ACV in inhibition of
herpes simplex viruses 1 and 2 and varicella zoster virus. Orally administered
2'NDG was 6- to 50-fold more efficacious than ACV in treating systemic or local
HSV-1 infection or HSV-2 intravaginal infection in mice. The mode of action of
2'NDG appears to involve phosphorylation by herpes simplex virus thymidine kinase
and subsequent phosphorylations by cellular kinases to produce 2'NDG
triphosphate, which is a potent inhibitor of herpes virus DNA polymerase.
Compared to ACV, 2'NDG was a more efficient substrate for HSV-1 thymidine kinase 
(Vmax/Km for 2'NDG 30-fold higher than that of ACV), whereas 2'NDG monophosphate 
is a more efficient substrate for GMP kinase (Vmax/Km for 2'NDG monophosphate
492-fold higher than that for ACV monophosphate). The combined effect is more
rapid production of the inhibitory triphosphate from 2'NDG than from ACV.

PMID: 6306664 [PubMed - indexed for MEDLINE]

7680: J Natl Cancer Inst. 1983 Jul;71(1):39-43.

Cytomegalovirus isolations from cell cultures derived from Epstein-Barr
virus-associated nasopharyngeal carcinoma.

Desgranges C, Seigneurin JM, Baccard M, Nejmi S.

Cytomegalovirus (CMV) was isolated in cell cultures derived from 2 of 11
nasopharyngeal carcinoma (NPC) biopsy specimens from North African patients. All 
these cases were Epstein-Barr virus (EBV)-associated NPC. Morphologic cytopathic 
changes and viral replication not associated with EBV were observed after 2
months in culture. Virus identification was achieved by immunofluorescence
studies, and cell culture antigens were tested by the use of complement fixation 
and indirect hemagglutination. All these NPC patients had been infected by herpes
simplex virus, varicella-zoster virus, and CMV, but the antibody titers
determined by complement fixation and immunofluorescence were normal. CMV, which 
is not associated with this cancer, could nevertheless favor carcinogenesis in
facilitating fusion between epithelial cells and EBV-positive lymphocytes.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6306325 [PubMed - indexed for MEDLINE]

7681: Am J Clin Pathol. 1983 Jul;80(1):57-60.

Treatment of varicella-zoster meningoencephalitis with acyclovir--demonstration
of virus in cerebrospinal fluid by electron microscopy.

Steele RW, Keeney RE, Bradsher RW, Moses EB, Soloff BL.

Disseminated varicella-zoster (V-Z) infection developed in three
immunocompromised patients, with direct invasion of the central nervous system by
virus. For two of these patients, diagnosis was confirmed by electron microscopic
examination of cerebrospinal fluid (CSF) and detection of viral particles.
Extensive immunologic evaluation demonstrated impairment of cellular immune
function. All were treated with acyclovir at a dose of 1,500 mg/m2/day for 5-7
days. Peak and trough plasma levels of this antiviral agent were monitored during
the course of therapy and were shown to be well above V-Z virustatic levels.
Clinical response was noted by the third day of therapy. Vesicles and CSF were
culture negative at termination of treatment. Administration of this high dose of
acyclovir was not associated with hematologic, immunologic, hepatic, renal, or
gastrointestinal toxicity as judged by frequent laboratory and clinical
evaluation.

PMID: 6305186 [PubMed - indexed for MEDLINE]

7682: Geriatrics. 1983 Jul;38(7):91-100.

Herpes: a problem in older age groups.

Adams HG.

PMID: 6303910 [PubMed - indexed for MEDLINE]

7683: Pediatr Pol. 1983 Jul;58(7):591-7.

[Isoprinosine in the treatment of herpesvirus infections in children with
leukemia and malignant lymphoma]

[Article in Polish]

Ochocka M, Chmielewska D, Matysiak M.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 6197693 [PubMed - indexed for MEDLINE]

7684: J Antimicrob Chemother. 1983 Jul;12(1):79-87.

Effect of low dose acyclovir (5 mg/kg) on virus shedding, interferon and humoral 
immunity in herpes zoster.

Larkin M, Ogilvie MM, McGill JI.

In a double-blind randomized trial, virological studies were carried out in
non-immunocompromised patients with herpes zoster who received either acyclovir
(5 mg/kg) or placebo intravenously three times daily for five days. Mean duration
of virus shedding was not significantly different in the two groups and all
patients developed high titres of antibody to varicella-zoster virus. Interferon 
levels in vesicle fluid reached a peak significantly sooner (P less than 0.025)
and at a lower level in eight treated patients compared with eight given placebo,
corresponding with significantly earlier cessation of vesicle formation in the
treated group (P less than 0.05). Pretreatment virus isolates tested for
sensitivity to the drug showed ED50 values from 4 +/- 0.7 to 17.5 +/- 1 microM
acyclovir. Treatment with a dose of acyclovir greater than 5 mg/kg, but not
exceeding 10 mg/kg, is recommended for herpes zoster.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6194145 [PubMed - indexed for MEDLINE]

7685: Fukushima J Med Sci. 1983 Jul;29(3-4):101-11.

A mutant strain of varicella-zoster virus deficient in thymidine kinase-inducing 
activity.

Yokota T, Ogata M, Shigeta S.

PMID: 6088377 [PubMed - indexed for MEDLINE]

7686: Orv Hetil. 1983 Jun 26;124(26):1551-3.

[Incidence of herpes zoster among patients with Hodgkin's disease]

[Article in Hungarian]

Stefanits K, Kuhn E, Csere T, Nador G.

Publication Types: 
    English Abstract

PMID: 6888907 [PubMed - indexed for MEDLINE]

7687: Med J Aust. 1983 Jun 25;1(13):597-8.

Antiviral drugs today.

Harkness JL, Atkinson K.

Publication Types: 
    Editorial

PMID: 6855672 [PubMed - indexed for MEDLINE]

7688: Med J Aust. 1983 Jun 25;1(13):637-8.

Acyclovir therapy in patients with malignant disease and disseminated herpes
zoster.

Ackland SP, Bishop JF, Whiteside MG.

Acyclovir is a new antiviral agent which is active in vitro and in vivo against a
variety of herpesviruses. Two cases are reported in which intravenous
administration of acyclovir arrested the progress of disseminated herpes zoster
within 24 to 48 hours after the beginning of therapy. There was no evidence of
toxicity. Thus, acyclovir appears to be useful in the therapy of herpes zoster,
but this requires evaluation.

Publication Types: 
    Case Reports

PMID: 6687918 [PubMed - indexed for MEDLINE]

7689: N Engl J Med. 1983 Jun 16;308(24):1448-53.

Acyclovir halts progression of herpes zoster in immunocompromised patients.

Balfour HH Jr, Bean B, Laskin OL, Ambinder RF, Meyers JD, Wade JC, Zaia JA,
Aeppli D, Kirk LE, Segreti AC, Keeney RE.

We conducted a placebo-controlled, double-blind study of acyclovir therapy for
acute herpes zoster in immunocompromised patients. Of the 94 patients enrolled in
the study, 52 had localized skin lesions at entry, and 42 had disseminated
cutaneous zoster. A one-week course of intravenous acyclovir (1500 mg per square 
meter of body-surface area per day) halted progression of zoster in both groups, 
as determined by development or progression of cutaneous dissemination,
development of visceral zoster, or proportion of cases deemed treatment failures.
Significantly fewer patients treated with acyclovir within the first three days
after the onset of exanthem had complications of zoster, as compared with
patients treated with placebo (P = 0.02 by Fisher's exact test), but acyclovir
also stopped progression of zoster in patients treated after three days of rash
(P = 0.05 by Fisher's exact test). Acyclovir recipients with disseminated
cutaneous zoster had a significantly accelerated rate of clearance of virus from 
vesicles, as compared with placebo recipients (P = 0.05 by the Breslow test).

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6343861 [PubMed - indexed for MEDLINE]

7690: Fortschr Med. 1983 Jun 9;101(22):1039-41.

[Treatment of zoster, post-zoster pain and herpes simplex recidivans in loco with
laser light]

[Article in German]

Landthaler M, Haina D, Waidelich W.

Red light of a krypton laser (lambda = 647 nm) was used for treatment of patients
suffering from herpes zoster (n = 4), postherpetic neuralgias (n = 8) and herpes 
simplex recidivans in loco (n = 13). The afflicted skin was irradiated daily for 
ten days (laserpower 50 mw, exposure time 90 sec). Improvement was observed in 7 
out of the 12 patients suffering from herpes zoster and postherpetic neuralgias
respectively, and in 8 out of 13 patients afflicted with recurrent herpes
simplex.

Publication Types: 
    English Abstract

PMID: 6873857 [PubMed - indexed for MEDLINE]

7691: J Neurol Neurosurg Psychiatry. 1983 Jun;46(6):582-3.

Meningitis and disseminated cutaneous zoster complicating herpes zoster
infection.

Karp SJ.

Publication Types: 
    Case Reports
    Letter

PMID: 6875597 [PubMed - indexed for MEDLINE]

7692: Arch Neurol. 1983 Jun;40(6):347-50.

Parainfectious optic neuritis. Report and review following varicella.

Selbst RG, Selhorst JB, Harbison JW, Myer EC.

Severe loss of vision and bilateral optic disc edema occurred in a 10-year-old
girl 38 days after the rash of varicella first appeared and subsequent
encephalitis developed. Recovery of visual function was nearly complete, but
optic atrophy persisted. Parainfectious optic neuritis following other viral
infections, with the exception of herpes zoster, has a similar clinical profile: 
delayed onset, severe visual loss, optic disc edema, bilaterality, good recovery,
and residual optic atrophy. Conduction delays in our patient's patterned visual
evoked potentials implicated demyelination within the optic nerves. The often
favorable recovery, frequency of delayed onset, and bilateral involvement of the 
optic nerves support an autoimmune process in the pathogenesis of parainfectious 
optic neuritis.

Publication Types: 
    Case Reports

PMID: 6847439 [PubMed - indexed for MEDLINE]

7693: Srp Arh Celok Lek. 1983 Jun;111(6):841-51.

[Herpes zoster oticus. Case reports]

[Article in Serbian]

Brkic M, Zecevic M, Popovic V.

Publication Types: 
    Case Reports

PMID: 6665630 [PubMed - indexed for MEDLINE]

7694: Acta Ophthalmol (Copenh). 1983 Jun;61(3):501-9.

Herpes zoster ophthalmicus with retrobulbar neuritis. A case report.

Schmidt P.

In ophthalmic zoster, involvement of the optic nerve is very rare, and most of
the published cases have resulted in optic atrophy. This case report presents a
woman who developed a severe visual loss in her right eye 4 weeks after the
primary attack. Computer tomography and ultrasonic B-scan showed a spindle-shaped
thickening of the optic nerve. Eight months later the visual acuity was 2/60 and 
the optic nerve showed atrophy. The computer tomography was normal, and the
Visual Evoked Potential had reduced amplitudes. Earlier reports and pathogenesis 
are discussed.

Publication Types: 
    Case Reports

PMID: 6605018 [PubMed - indexed for MEDLINE]

7695: Diagn Microbiol Infect Dis. 1983 Jun;1(2):117-28.

Detection of herpes simplex virus in clinical specimens by DNA hybridization.

Redfield DC, Richman DD, Albanil S, Oxman MN, Wahl GM.

An assay to detect herpes simplex virus (HSV) DNA in clinical specimens has been 
developed. It utilizes nucleic acid hybridization with a 32P-labeled DNA probe
prepared from a fragment of HSV DNA cloned in a plasmid vector. This assay can
detect 5 X 10(4) plaque-forming units of cell-free HSV and as few as four
virus-infected cells. The assay has a sensitivity of 78% and a specificity of
100% compared to virus culture for the detection of HSV in swab specimens from
genital lesions. No hybridization is observed with uninfected, varicella-zoster
virus infected, or cytomegalovirus infected cells, and specimens from herpes
zoster lesions are uniformly negative. While hybridization with a 32P-labeled
probe is not optimally suited for routine diagnostic use, this report establishes
the feasibility of using nucleic acid hybridization to detect HSV in clinical
specimens.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 6325080 [PubMed - indexed for MEDLINE]

7696: J Clin Microbiol. 1983 Jun;17(6):1081-91.

Viral antibody screening system that uses a standardized single dilution
immunoglobulin G enzyme immunoassay with multiple antigens.

Blomberg J, Nilsson I, Andersson M.

We present an enzyme-linked immunosorbent assay (ELISA) system for the
simultaneous determination of immunoglobulin G antibodies directed against
several viruses. Antibodies to up to eight different viruses could be determined 
for three different sera on one microtitration plate. After subtraction of the
absorbance values obtained with the control antigens, the viral antigen
absorbancies were expressed as percentages of the absorbance obtained with a
pooled immunoglobulin standard. This value, the relative antibody activity, was
rapidly calculated by means of a computer directly connected to the ELISA
photometer and was stored on magnetic disks, thereby facilitating
seroepidemiological studies. The reproducibility of the relative antibody
activity was calculated to at best +/- 3.6% (standard deviation) in an intraassay
test and to at worst +/- 20.4% (standard deviation) in an interassay test. Each
serum was analyzed only at a dilution of 1/75. The sensitivity of this
single-dilution ELISA (SD-ELISA) method for the detection of titer rises was
compared with those of conventional methods, mostly complement fixation but also 
hemagglutination inhibition. A total of 142 of 155 (92%) paired sera showing
fourfold complement fixation or hemagglutination inhibition rises also showed
significant results in SD-ELISA. A total of 22 of 57 (39%) significant relative
antibody activity rises were significant in complement fixation or
hemagglutination inhibition. Overall, up to twice as many significant titer rises
could be detected with SD-ELISA. Most of these seemed to have a sound correlation
with clinical data. The specificity of SD-ELISA was found to be similar to that
of complement fixation, with some cross-reactions occurring between herpes
simplex and varicella-zoster virus antigens and between parainfluenza viruses. We
have found SD-ELISA to be a valuable clinical virological tool that supplements
conventional serology.

PMID: 6308038 [PubMed - indexed for MEDLINE]

7697: Arch Intern Med. 1983 Jun;143(6):1270-1.

Disseminated varicella-zoster virus infection with the syndrome of inappropriate 
antidiuretic hormone.

Ingraham IE Jr, Estes NA, Bern MM, DeGirolami PC.

A patient with non-Hodgkin's lymphoma who was previously treated with
chemotherapy and radiotherapy was seen with intestinal pseudoobstruction due to
paralytic ileus associated with herpes zoster (varicella zoster) infection. The
infection was accompanied by a polydermatomal rash with typical morphologic
characteristics, followed by cutaneous dissemination and the syndrome of
inappropriate antidiuretic hormone (SIADH), as well as myotomal paresis. The
diagnosis was supported by cytology and by culture of the virus from the CSF. The
isolation of the virus from the CSF, coupled with abnormalities of the patient's 
mental status and CSF, indicate that meningoencephalitis occurred and probably
accounted for the SIADH. The patient had a spontaneous and complete recovery. To 
our knowledge, this is the first report of SIADH associated with herpes zoster
infection.

Publication Types: 
    Case Reports

PMID: 6305297 [PubMed - indexed for MEDLINE]

7698: J Infect Dis. 1983 Jun;147(6):974-81.

Infections due to herpesviruses in cardiac transplant recipients: role of the
donor heart and immunosuppressive therapy.

Preiksaitis JK, Rosno S, Grumet C, Merigan TC.

The role of the donor heart and immunosuppressive therapy on infection due to
herpesviruses in 74 cardiac transplant recipients (CTRs) was determined. When
cellular blood products from donors seronegative for antibody to cytomegalovirus 
(anti-CMV) were used, all primary CMV infections were attributable to
transmission from donor heart. None of eight CTRs negative for anti-CMV before
transplant and who received an anti-CMV donor heart and anti-CMV blood products
developed CMV infection compared to one (20%) of five who received unscreened
blood. A change from high-dosage anti-thymocyte globulin, azothioprine, and
prednisone (ATG regimen) to low-dosage anti-thymocyte globulin, cyclosporin A,
and prednisone (CsA regimen) significantly decreased the severity and prevalence 
of lesions due to herpes simplex virus and the duration of CMV shedding in
patients with recurrent CMV infection. CTRs with recurrent CMV infection treated 
with the ATG regimen had significantly more fever, required more parenteral
antibiotics, and were more likely to be infected with opportunistic pathogens
than were CsA-treated patients.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6304206 [PubMed - indexed for MEDLINE]

7699: J Clin Pathol. 1983 Jun;36(6):683-92.

Problems of infection after bone marrow transplantation.

Watson JG.

Representatives of 17 bone marrow transplant (BMT) teams met to discuss the
problems of infection after BMT. With experience of more than 2200 transplanted
patients over the past 10 yr, the changes in the patterns of infection were
surprisingly similar. Deaths due purely to bacterial infection have greatly
diminished and the major early problems today result from fungi and
cytomegalovirus. The role of non-herpes group viruses has only recently received 
attention. With increasing numbers of survivors, late bacterial infections are
assuming importance. The meeting also provided an opportunity to document the
measures adopted to prevent infection during BMT and following discharge.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6304151 [PubMed - indexed for MEDLINE]

7700: J Clin Neuroophthalmol. 1983 Jun;3(2):111-4.

Herpes zoster ophthalmicus with contralateral hemiparesis. A case report and
review of the literature.

Chan C, Huffaker G.

An 80-year-old man developed right herpes zoster ophthalmicus complicated by
contralateral hemiparesis after right cataract extraction. Although herpes zoster
ophthalmicus is a frequent occurrence among the elderly, the association with
contralateral hemiparesis is probably overlooked by many ophthalmologists. A
review of the literature has been made to outline the etiology of this problem
and to make diagnosis more likely. The varicella virus probably spreads in a
retrograde fashion from the gasserian ganglion toward the cavernous sinus to
involve cranial nerves 3, 4, or 6. Involvement of the ipsilateral carotid
arterial system by the progressive inflammatory reaction can result in the
contralateral hemiparesis. Standard therapy includes topical steroids and topical
antibiotics for the ocular and surface lesions. The efficacy of systemic steroids
to minimize the hemiparesis is still in question.

Publication Types: 
    Case Reports

PMID: 6224810 [PubMed - indexed for MEDLINE]

7701: S Afr Med J. 1983 May 21;63(21):820-1.

Pain relief in herpes zoster.

Schreuder M.

The severity of pain as a symptom of herpes zoster and post-herpetic neuralgia
has seldom been emphasized in the literature. In this report on a series of 113
patients, a treatment which gives immediate relief of pain and prevents
post-herpetic neuralgia is described. Provided that the steroid solution could be
placed accurately in the epidural space adjacent to the affected nerves, the
method was 100% successful. Failure to provide relief of pain after the initial
effect of the local anaesthetic had worn off was taken as an indication that the 
epidural injection had been misplaced, and it was repeated.

PMID: 6845108 [PubMed - indexed for MEDLINE]

7702: S Afr Med J. 1983 May 7;63(19):735-6.

Syndrome of inappropriate antidiuretic hormone secretion in association with
herpes zoster of the chest wall. A case report.

Maze SS, Klaff LJ, Yach D.

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) occurs in a 
number of diverse medical conditions. We report a case in which SIADH and herpes 
zoster of the chest wall occurred concurrently. In the absence of other
recognized causes we suggest that the two conditions may have been related and
speculate on possible mechanisms.

Publication Types: 
    Case Reports

PMID: 6845086 [PubMed - indexed for MEDLINE]

7703: Klin Med (Mosk). 1983 May;61(5):36-9.

[Herpes zoster and heart disease]

[Article in Russian]

Bakhur VT.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6876698 [PubMed - indexed for MEDLINE]

7704: J Virol Methods. 1983 May;6(5):271-82.

Computer-based virus sensitivity assay and neutralization method. Applications
for herpesviruses.

Wahren B, Wahren P, Harmenberg J, Sundqvist VA.

A method for computerized analysis of the antiviral efficiency of drugs and
immunoglobulins was developed. The sensitivities of herpes simplex virus (HSV),
cytomegalovirus (CMV) and varicella-zoster virus (VZV) to antiviral drugs were
determined. A new type of neutralization assay could be performed rapidly and
accurately with HSV and CMV. Combining immunological methods for herpesvirus
antigen detection with a computerized analysis permitted rapid, sensitive
measurement of drug sensitivities, comparison of antiviral activities at various 
virus concentrations and selection of potent neutralizing antisera.

Publication Types: 
    Comparative Study

PMID: 6874878 [PubMed - indexed for MEDLINE]

7705: Cutis. 1983 May;31(5):489.

Herpes zoster presenting as soft abdominal mass with obstipation.

Rexinger EL.

Publication Types: 
    Case Reports
    Letter

PMID: 6851642 [PubMed - indexed for MEDLINE]

7706: Neurology. 1983 May;33(5):648-9.

Epidemiologic investigation of the association between herpes zoster and multiple
sclerosis.

Ragozzino MW, Kurland LT.

The apparent association between MS and herpes zoster reported in the literature 
was investigated in a community-based epidemiologic study. Five hundred ninety
residents of Rochester, Minnesota, diagnosed with herpes zoster from 1945 through
1959 were followed 9,389 person-years for onset of MS. No cases were observed,
whereas 0.2 case was expected, using Rochester incidence rates for MS.
Calculation of the power of this study indicated that approximately 200,000
person-years of follow-up of herpes zoster patients is necessary in order to
detect a threefold increase in incidence of MS with 85% probability. Conversely, 
48 Rochester residents diagnosed with MS were followed for 860 person-years for
subsequent onset of herpes zoster. Three cases were observed, whereas 1.8 cases
were expected for a relative risk of 1.7, which is not significantly different
from unity.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6682503 [PubMed - indexed for MEDLINE]

7707: Compr Ther. 1983 May;9(5):33-42.

Diagnosis and therapy of common eye infections: bacterial, viral, fungal.

Pavan-Langston D.

PMID: 6602028 [PubMed - indexed for MEDLINE]

7708: J Infect. 1983 May;6(1 Suppl):31-6.

High-dose intravenous acyclovir in the treatment of zoster: a double-blind,
placebo-controlled trial.

Juel-Jensen BE, Khan JA, Pasvol G.

In a randomised, double-blind, controlled trial, 40 patients with zoster of short
duration (rash present for less than three days) were given either 10 mg/kg
acyclovir (20) or placebo (20) intravenously three times daily for five days.
Pain was reduced in the treatment group both in the acute phase and at follow-up,
when compared with the placebo group, but this difference did not reach
statistically significant levels. Healing of the lesions was also better, but not
significantly so, in the acyclovir group. No complications of the disease were
seen in the six cases of ophthalmic zoster given acyclovir whereas, of the four
cases in the placebo group, two developed seventh cranial nerve palsies and one
secondary glaucoma. No evidence of renal or other major toxicity was detected in 
the acyclovir group, although three patients developed mild thrombophlebitis. We 
conclude that acyclovir, given by the route and in the dose and frequency as used
in this study, is free from major side effects, but is only of marginal benefit
in the treatment of zoster.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6350473 [PubMed - indexed for MEDLINE]

7709: Yale J Biol Med. 1983 May-Jun;56(3):203-9.

Failure to demonstrate concomitant antibody changes to viral antigens other than 
Epstein-Barr virus (EBV) during or after infectious mononucleosis.

Evans AS, Wanat J, Niederman JC.

A search for antibody rises to viral antigens other than to Epstein-Barr virus,
the causative agent, has been carried out in serial serum samples from 82
patients with infectious mononucleosis (IM). Fourfold or greater rises in titer
rarely occurred and did did not cluster in time. No rises occurred to
cytomegalovirus, only 1.2 percent to herpes simplex virus, and 8.5 percent to
varicella zoster virus. Rises to measles antibody were found in 7.5 percent of
patients and to rubella in 10.4 percent; these may represent natural infections
or immunizations. A few patients also showed rises to respiratory viruses but
there was no apparent connection to IM.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6318461 [PubMed - indexed for MEDLINE]

7710: Z Geburtshilfe Perinatol. 1983 May-Jun;187(3):109-16.

[Viral and other infections in pregnancy: diagnosis and prevention. Rubella,
cytomegalic inclusion disease, herpes simplex, varicella zoster, Epstein-Barr,
measles, mumps, enteroviruses, hepatitis, toxoplasmosis, syphilis. 1.]

[Article in German]

Enders G.

Publication Types: 
    English Abstract
    Review

PMID: 6310904 [PubMed - indexed for MEDLINE]

7711: Acta Otolaryngol. 1983 May-Jun;95(5-6):528-31.

Peripheral facial palsy and viral replication.

Mair IW, Traavik T.

Significant levels of specific IgM and/or IgG antibodies against the
cytomegalovirus (CMV) have been demonstrated in 64 (73%) of a consecutive series 
of 88 patients with acute peripheral facial palsy. Herpes varicella-zoster
infection was serologically confirmed in 3 other cases. There were no detectable 
clinical differences between patients with and without immunological response to 
CMV antigens. The facial palsy and the CMV immunological response are
contemporaneous, but these two phenomena need not necessarily be pathogenetically
related.

PMID: 6308946 [PubMed - indexed for MEDLINE]

7712: Biochem J. 1983 May 1;211(2):439-45.

Antiviral activity of the 3'-amino derivative of
(E)-5-(2-bromovinyl)-2'-deoxyuridine.

De Clercq E, Descamps J, Balzarini J, Fukui T, Allaudeen HS.

3'-NH2-BV-dUrd, the 3'-amino derivative of (E)-5-(2-bromovinyl)-2'-deoxyuridine, 
was found to be a potent and selective inhibitor of herpes simplex virus type 1
(HSV-1) and varicella-zoster virus (VZV) replication. 3'-NH2-BV-dUrd was about
4-12 times less potent but equally selective in its anti-herpes activity as
BV-dUrd. Akin to BV-dUrd, 3'-NH2-BV-dUrd was much less inhibitory to herpes
simplex virus type 2 than type 1. It was totally inactive against a thymidine
kinase-deficient mutant of HSV-1. The 5'-triphosphate of 3'-NH2-BV-dUrd
(3'-NH2-BV-dUTP) was evaluated for its inhibitory effects on purified herpes
viral and cellular DNA polymerases. Among the DNA polymerases tested, HSV-1 DNA
polymerase and DNA polymerase alpha were the most sensitive to inhibition by
3'-NH2-BV-dUTP (Ki values 0.13 and 0.10 microM, respectively). The Km/Ki ratio
for DNA polymerase alpha was 47, as compared with 4.6 for HSV-1 DNA polymerase.
Thus, the selectivity of 3'-NH2-BV-dUrd as an anti-herpes agent cannot be
ascribed to a discriminative effect of its 5'-triphosphate at the DNA polymerase 
level. This selectivity most probably resides at the thymidine kinase level.
3'-NH2-BV-dUrd would be phosphorylated preferentially by the HSV-1-induced
thymidine kinase (Ki 1.9 microM, as compared with greater than 200 microM for the
cellular thymidine kinase), and this preferential phosphorylation would confine
the further action of the compound to the virus-infected cell.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6307280 [PubMed - indexed for MEDLINE]

7713: Appl Environ Microbiol. 1983 May;45(5):1555-9.

Variation in human herpesvirus susceptibility to enhancement by the pesticide
carbaryl.

Jerkofsky M, Abrahamsen LH.

The ability of various human herpesviruses to be enhanced by the pretreatment of 
human embryonic lung cells with the pesticide carbaryl
(1-naphthyl-N-methyl-carbamate) differs according to the virus tested. Different 
strains of varicella-zoster virus produced different patterns of susceptibility
to enhancement. Laboratory-adapted strains were less sensitive to enhancement
than were wild-type strains recently isolated from clinical specimens. The
related human herpes simplex viruses types 1 and 2 and cytomegalovirus were
negative for susceptibility to enhancement when either laboratory-adapted or
wild-type strains were tested. No difference in the pattern of susceptibility was
detected whether virus yields were determined by cell-associated or cell-free
virus assay or when the input multiplicity was varied 10-fold.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6307144 [PubMed - indexed for MEDLINE]

7714: Compr Ther. 1983 May;9(5):9-14.

Viral infections of infancy.

Gershon AA.

PMID: 6303679 [PubMed - indexed for MEDLINE]

7715: Przegl Dermatol. 1983 May-Jun;70(3):283-90.

[Isoprinosine in the treatment of herpes zoster and herpes recurrens]

[Article in Polish]

Bowszyc J, Janicka D, Silny W, Neumann E, Stepien B.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 6198697 [PubMed - indexed for MEDLINE]

7716: J Immunol Methods. 1983 Apr 15;59(1):121-7.

Rapid fractionation of serum immunoglobulins by high pressure liquid gel
permeation chromatography. Application to routine serologic procedures.

Sann G, Schneider G, Loeke S, Doerr HW.

High pressure liquid chromatography (HPLC) was applied to separation of IgM from 
IgG and IgA for the detection of virus-specific antibodies by routine serologic
methods. Serum samples of 250 microliter were fractionated on a HPLC protein
column after filtration for use in rubella haemagglutination inhibition after
preabsorption with kaolin. The protein fractions were examined for IgM, IgG and
IgA content and for cross contamination. The relative recovery after kaolin
absorption was satisfactory: IgM greater than 60%, IgG greater than 90%, IgA
greater than 90%. The immunoglobulin M was well separated. IgG/IgA contamination 
of the fraction was less than 0.2%/ less than 0.5%. The IgM and IgG fractions
were used without further treatment in haemagglutination inhibition, complement
fixation and enzyme-linked immunosorbent assay. Highly specific results in the
diagnosis of acute viral diseases (Rubella, Herpes zoster, cytomegalovirus) and
Mycoplasma pneumoniae were obtained.

PMID: 6833774 [PubMed - indexed for MEDLINE]

7717: Pediatriia. 1983 Apr;(4):64-5.

[Herpes zoster in a 5-month-old infant, prenatally infected with varicella-zoster
virus]

[Article in Russian]

Shishov AS, Kozlovskaia LP, Smirnov IuK, Kantor GS.

Publication Types: 
    Case Reports

PMID: 6603605 [PubMed - indexed for MEDLINE]

7718: Vestn Dermatol Venerol. 1983 Apr;(4):49-51.

[Clinical manifestations and therapy of Gasser's ganglion involvement in herpes
zoster]

[Article in Russian]

Korsunskaia IM, Anton'ev AA, Fokin MA.

Publication Types: 
    English Abstract

PMID: 6603079 [PubMed - indexed for MEDLINE]

7719: J Gerontol Nurs. 1983 Apr;9(4):221-3, 226, 245.

The scourge of the aged: herpes zoster.

Truesdell ML.

PMID: 6551399 [PubMed - indexed for MEDLINE]

7720: Gan To Kagaku Ryoho. 1983 Apr;10(4 Pt 1):944-52.

[The clinical effects of a new antiviral 9-(2-hydroxyethoxymethyl) guanine
(aciclovir) against herpes virus infections]

[Article in Japanese]

Masaoka T, Shibata H, Amaki I, Takeo H, Sakurai K, Ise T, Ohhira M, Tanaka M,
Shimoyama M, Ishihara K, Shibata A, Moriyama Y, Arimori S, Nagao T, Yamada K,
Ohno R, Kodera Y, Yamada H, Hirota Y, Fujiwara Y, Nakaide Y, Yoshikawa S,
Yoshikawa H, Akao Y, Hattori K, Funada H, Yoshida T, Tsujino G, Sako M, Nagai K, 
Kanamaru A, Fujita S, Tasaka E, Hamada T, Takahashi M.

The clinical effects of a new anti-viral 9-(2-hydroxymethoxymethyl) guanine
(Aciclovir) against Herpes virus infections have been investigated. The patients 
had malignant tumours or auto-immune disease complicated by shingles and chicken 
pox due to Vaicella zoster virus (VZV) (43 cases), Herpes simplex virus (HSV) (10
cases) and 9 cases which were clinically diagnosed as Herpes, though the virus
was not confirmed as the causative agent. As a general principle the dosage of
Aciclovir was 5 mg/kg, t. i. d. for 5 days by slow intravenous infusion. The
clinically effective rate against VZV was 93%, being excellent in 42% and against
HSV it was 80%, being excellent in 40% and when the results of the cases of
unknown origin were included it was excellent in 40% and the cumulative effective
rate was 88%. Concerning the efficacy in reduction of pain, swelling,
disappearance of vesicles and new scab formation, the effect was most noticeable 
after the third day of treatment. Treatment given early in the disease is likely 
to provide better results. Concerning side effects, one of 62 patients had
proteinuria and the other had a drug rash and an abnormal liver function test. It
is likely that the combination of treatment and the primary disease had some
influence, but the cause/effect relationship to Aciclovir treatment is not clear.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 6347078 [PubMed - indexed for MEDLINE]

7721: J Infect Dis. 1983 Apr;147(4):737-43.

Evaluation of varicella-zoster immune globulin: protection of immunosuppressed
children after household exposure to varicella.

Zaia JA, Levin MJ, Preblud SR, Leszczynski J, Wright GG, Ellis RJ, Curtis AC,
Valerio MA, LeGore J.

Varicella-zoster immune globulin (VZIG), an immunoglobulin prepared from normal
donor plasma selected for high titer of antibody to varicella-zoster virus (VZV),
and zoster immune globulin (ZIG), prepared from the plasma of donors convalescing
from herpes zoster, were compared in a double-blind, randomized clinical trial to
determine their relative efficacy in protecting immunosuppressed children from
severe varicella. VZV infection occurred in 49 (60.4%) of 81 recipients of VZIG
and in 57 (68.6%) of 83 recipients of ZIG. These rates and the clinical severity 
of varicella were not significantly different; however, the subclinical infection
rate was significantly higher in ZIG recipients (31.3% vs. 16.0%). This
difference was accounted for by a subgroup of patients receiving
immunosuppressive therapy for nonneoplastic diseases. Doubling the dose of VZIG
administered reduced the rate of subclinical infection. These data indicate that 
VZIG can be used to protect immunosuppressed children from severe chicken pox.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

PMID: 6341478 [PubMed - indexed for MEDLINE]

7722: Mayo Clin Proc. 1983 Apr;58(4):217-22.

Antiviral agents.

Hermans PE, Cockerill FR 3rd.

Only a few agents with antiviral activity are available for routine clinical use.
Amantadine hydrochloride is effective in the prophylaxis of influenza A. In
addition, accumulated evidence shows that amantadine has some therapeutic effect 
when used early in the course of an influenza A infection. Idoxuridine and
adenine arabinoside have found application as topical agents in the treatment of 
herpes simplex keratitis. Adenine arabinoside has also been approved for the
treatment of disseminated infections due to herpes zoster and herpes simplex.
Acyclovir sodium has been approved as a topical agent in the treatment of limited
mucocutaneous herpes simplex viral infections in immunosuppressed patients and of
initial episodes of genital herpes simplex infections in patients with normal
immunity. Ribavirin, an experimental agent with a wide spectrum of activity in
vitro, has not fulfilled expectations in clinical trials. Because of the
eradication of smallpox, methisazone has become obsolete as a prophylactic agent 
in smallpox.

Publication Types: 
    Review

PMID: 6339831 [PubMed - indexed for MEDLINE]

7723: Infect Immun. 1983 Apr;40(1):381-8.

Monoclonal antibodies against three major glycoproteins of varicella-zoster
virus.

Grose C, Edwards DP, Friedrichs WE, Weigle KA, McGuire WL.

Varicella-zoster virus (VZV) codes for three prominent glycoproteins--gp62, gp98,
and gp118--in infected cell cultures. To characterize individually these known
immunogens, we first inoculated BALB/c mice with crude VZV extracts, produced
hybridoma cultures by Kohler-Milstein cell-fusion technology, and screened
culture supernatants by indirect immunofluorescence for reactivity directed
against unfixed VZV-infected cells (FAMA assay). Supernatants from five
independently derived and subcloned hybridomas with a high VZV-FAMA titer but no 
reactivity against either uninfected or herpes simplex virus-infected cells were 
further analyzed by immunoprecipitation of [3H]fucose-labeled and
detergent-solubilized VZV antigen preparations. Fractionation of the precipitates
by sodium dodecyl sulfate-polyacrylamide gel electrophoresis demonstrated that
four monoclonal antibodies reacted with both gp62 and gp98, and one precipitated 
only gp118. The profiles were unchanged whether performed under reducing or
nonreducing conditions. When assayed for neutralizing activity, the secretory
product of the single anti-gp118 hybridoma, but not the supernatants from the
four anti-gp62/gp98 clones, inhibited VZV plaque formation by greater than 80%.
Thus, at least one of the glycosylated antigens detected by the FAMA assay is a
determinant which elicits neutralizing activity.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6299963 [PubMed - indexed for MEDLINE]

7724: Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol. 1983
Apr-Jun;27(2):139-42.

[Neurotropic viral infection and optic neuritis (Considerations on diagnosis and 
treatment)]

[Article in Romanian]

Cinciu G, Popa DP, Calinescu G.

Publication Types: 
    English Abstract

PMID: 6227040 [PubMed - indexed for MEDLINE]

7725: Cancer. 1983 Mar 15;51(6):987-93.

Stage III nodular lymphomas. Preliminary results of a combined
chemotherapy/radiotherapy program.

Flippin T, McLaughlin P, Conrad FG, Fuller LM, Velasquez WS, Butler JJ,
Shullenberger CC.

Since 1975, all histologic subtypes of Stage III and IIIE nodular lymphoma
patients were treated with a combination of radiotherapy and multiple-agent
chemotherapy consisting of cyclophosphamide, doxorubicin, vincristine,
prednisone, and bleomycin (CHOP-Bleo). Fifty-eight patients were treated through 
1979. Treatment consisted of two cycles of CHOP-Bleo alternating with sequential 
radiotherapy to clinically involved regions, and further CHOP-Bleo to a total of 
ten cycles. Radiotherapy doses ranged between 3000 and 4000 rad delivered in
three to four weeks. Forty-six patients completed treatment. In the other 12
patients, treatment was interrupted because of progressive disease in seven, and 
myelosuppression in five. Overall five-year survival and disease-free survival
results were 82% and 47%, respectively. Survival for those patients who completed
therapy was 93%. By histopathology, survivals for all patients were: poorly
differentiated lymphocytic, 100%; mixed cell, 80%; and histiocytic, 39%.
Disease-free figures for all 58 patients were: poorly differentiated lymphocytic,
44%; mixed cell, 65%; and histiocytic, 35%. The extent of abdominal disease
influenced five-year survival as follows: 100% for those who had only occult
disease at staging laparotomy; 88% for those who were Stage III on the basis of a
positive lymphangiogram; and 50% for those who had a palpable mass or required an
exploratory laparotomy for symptoms. Five of seven patients with progression
during protocol therapy have died. No patients died as a result of
myelosuppression. A number of patients developed complications during treatment, 
none of which were fatal. Eight patients developed herpes zoster, four patients
developed transient radiation hepatitis, and four patients had miscellaneous
complications.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6821873 [PubMed - indexed for MEDLINE]

7726: Nippon Naika Gakkai Zasshi. 1983 Mar 10;72(3):327-32.

[Case of Hodgkin's disease with cerebral infarction presumably due to cerebral
angiitis]

[Article in Japanese]

Aburatani H, Takahashi T, Kodama T, Sekihara H, Murakami T, Hashimoto Y, Kudo S, 
Kosaka K, Mori S.

Publication Types: 
    Case Reports

PMID: 6864055 [PubMed - indexed for MEDLINE]

7727: ZFA (Stuttgart). 1983 Mar 10;59(7):342-7.

[Varicella zoster immunoglobulin. Prophylactic use in risk patients]

[Article in German]

Geursen RG.

PMID: 6303013 [PubMed - indexed for MEDLINE]

7728: N Engl J Med. 1983 Mar 3;308(9):526-7.

Vidarabine for herpes zoster.

Topiel MS, Simon GL.

Publication Types: 
    Letter

PMID: 6823274 [PubMed - indexed for MEDLINE]

7729: J Am Acad Dermatol. 1983 Mar;8(3):433-6.

Unusual treatments for herpesvirus infections. II. Herpes zoster.

Thiers BH.

PMID: 6833550 [PubMed - indexed for MEDLINE]

7730: Postgrad Med. 1983 Mar;73(3):297-303.

Acyclovir in the treatment of herpesvirus infections.

Bean B.

PMID: 6681899 [PubMed - indexed for MEDLINE]

7731: Harefuah. 1983 Mar 1;104(5):176-7.

[Hemiparesis and convergence spasm associated with herpes zoster]

[Article in Hebrew]

Bornstein N, Korczyn AD.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6607195 [PubMed - indexed for MEDLINE]

7732: Ann Otol Rhinol Laryngol. 1983 Mar-Apr;92(2 Pt 1):187-91.

Peripheral blood T and B lymphocyte subpopulations in Bell's palsy.

Aviel A, Ostfeld E, Burstein R, Marshak G, Bentwich Z.

A prospective clinical, virological and immunological study was performed on 25
consecutive Bell's palsy (BP) patients. Multiple cranial nerve involvement was
found in 15 patients. A significant decrease in the peripheral blood T lymphocyte
percentage as well as an increase in B lymphocyte percentage (p less than 0.001) 
were found in 13 of the BP patients during the first 24 days from the clinical
onset of the paralysis. No correlation was found between the peripheral blood
lymphocyte subpopulations and the patient's age, sex, degree of paralysis or
recovery rate. No changes were detected in the levels of immunoglobulins (IgG,
IgM), complement (C3, C4) and antiviral antibodies to herpes simplex and zoster, 
EBV, cytomegalic virus, adenovirus, influenza and mumps. The clinical and
immunological data of BP show a similar pattern to those of Guillain-Barre
syndrome suggesting that BP may be an antoimmune demyelinating cranial
polyneuritis which may be caused by a preceding viral infection.

PMID: 6601468 [PubMed - indexed for MEDLINE]

7733: Arch Pathol Lab Med. 1983 Mar;107(3):126-8.

Granulomatous angiitis of the brain with herpes zoster and varicella
encephalitis.

Blue MC, Rosenblum WI.

We studied a case of herpes zoster with varicella encephalitis in which a
granulomatous necrotizing vasculitis was present in the optic nerve and brain.
The vasculitis was observed even in foci devoid of inflammatory reaction in
surrounding tissue, and was therefore interpreted as a primary vasculitis caused 
by varicella. To our knowledge, this is the first time a granulomatous vasculitis
has been described as an integral part of varicella encephalitis, although others
have made similar observations in the eye and even in viscera. These findings
support the recent suggestion that so-called granulomatous angiitis of the CNS
may be caused by the varicella virus.

Publication Types: 
    Case Reports

PMID: 6600918 [PubMed - indexed for MEDLINE]

7734: Arch Dermatol. 1983 Mar;119(3):235-6.

Ipsilateral deafness and herpes zoster ophthalmicus.

Scott MJ Sr, Scott MJ Jr.

Three cases of ipsilateral deafness occurred in association with herpes zoster
ophthalmicus. Although our review of the literature did not disclose any
identical cases, we believe that this complication may not be rare. If vertigo,
tinnitus, abnormal auditory sensations, or ear pain occur with herpes zoster of
any cranial nerve, an audiogram is indicated immediately to detect possible
hearing loss. There is no known satisfactory treatment for sudden deafness due to
herpes zoster infection.

Publication Types: 
    Case Reports

PMID: 6600599 [PubMed - indexed for MEDLINE]

7735: J Infect. 1983 Mar;6(2):157-61.

Intravenous acyclovir in acute herpes zoster infection.

McGill J, MacDonald DR, Fall C, McKendrick GD, Copplestone A.

In a double-blind, randomised trial, immune-competent adults with acute herpes
zoster received either 5 mg/kg acyclovir (17) or placebo (20) intravenously three
times daily. Acyclovir significantly improved rash development, as evidenced by
reducing the time of new lesion formation and the times to vesicle collapse and
full crusting. Pain at the end of treatment and at three months was less in the
treated group but the difference was not statistically significant. Ocular
involvement was not affected.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6348177 [PubMed - indexed for MEDLINE]

7736: Med Clin North Am. 1983 Mar;67(2):531-43.

Dermatological aspects of aging.

Carter DM, Balin AK.

Publication Types: 
    Comparative Study
    Review

PMID: 6338328 [PubMed - indexed for MEDLINE]

7737: Med Clin North Am. 1983 Mar;67(2):273-93.

Infectious diseases in the elderly.

Berk SL, Smith JK.

Publication Types: 
    Review

PMID: 6338316 [PubMed - indexed for MEDLINE]

7738: J Virol Methods. 1983 Mar;6(3):161-9.

Human cytomegalovirus specific IgA antibodies detected by immunoperoxidase assay 
in serum of patients with cytomegalovirus infections.

Sarov I, Haikin H.

Cytomegalovirus (CMV)-specific IgA antibodies were determined by an
immunoperoxidase assay in sequential serum samples of 10 patients with CMV
infection in order to evaluate the feasibility of the use of this technique for
diagnosis. In parallel, IgM and IgG antibodies to CMV were studied by
enzyme-linked immunosorbent assay (ELISA) and by the immunoperoxidase assay,
respectively. CMV IgA antibodies were detected in all 10 CMV patients studied.
Specific IgM was detected earlier than IgA in only one of these ten patients. No 
CMV-specific IgA antibodies (titer less than 2) were detected in 45 medical
students. Neither were they found in paired sera of 5 patients with herpes
simplex infection, 5 patients with varicella, 6 patients with zoster and 2
patients with Epstein-Barr virus infection. The potential application of the
indirect immunoperoxidase IgA assay for serodiagnosis of CMV infections is
discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6306032 [PubMed - indexed for MEDLINE]

7739: J Virol Methods. 1983 Mar;6(3):135-40.

A comparison of indirect immunofluorescence and radioimmunoassay for detecting
antibody to varicella-zoster virus.

Campbell-Benzie A, Heath RB, Ridehalgh MK, Cradock-Watson JE.

Immunofluorescence (IF) and radioimmunoassay (RIA) were found to be more
sensitive methods than complement fixation (CF) for detecting antibody to
varicella-zoster (V-Z) virus. RIA yielded titres about 30 times greater than
those obtained by IF, but for screening purposes RIA was only about six times
more sensitive since the minimum serum dilutions that could be tested were 1/100 
and 1/16 respectively. When 539 sera from subjects of different ages were
screened for V-Z antibody, IF and RIA gave concordant results with 527 specimens 
(98%). When 19 patients were tested who had not previously had varicella but were
experiencing primary infection with herpes simplex (HS) virus, crossreacting
antibodies to V-Z antigens were detected in six patients by IF but in only two of
these by RIA. IF and RIA are preferable to CF as tests for immune status because 
of their greater sensitivity, but weak positive reactions caused by presumptive
low titres of homologous antibody or by higher titres of heterologous antibody
can occur in one or both tests. Such reactions could cause difficulty in
assessing the need for vaccine or for specific immune globulin, and in
interpreting the response to vaccination.

Publication Types: 
    Comparative Study

PMID: 6306029 [PubMed - indexed for MEDLINE]

7740: Am J Med Technol. 1983 Mar;49(3):157-62.

Uses of immunofluorescence in diagnostic virology.

Gallo D.

PMID: 6301279 [PubMed - indexed for MEDLINE]

7741: Ann Intern Med. 1983 Mar;98(3):287-90.

Acquired immunodeficiency syndrome with Pneumocystis carinii pneumonia and
Mycobacterium avium-intracellulare infection in a previously healthy patient with
classic hemophilia. Clinical, immunologic, and virologic findings.

Poon MC, Landay A, Prasthofer EF, Stagno S.

A previously healthy patient with classic hemophilia who was on a home infusion
program with factor VIII concentrates developed an acquired immunodeficiency
syndrome manifested by a dramatic weight loss (47 kg over 12 months), lassitude, 
transient thrombocytopenia, and opportunistic infections with Varicella zoster,
Pneumocystis carinii, and Mycobacterium avium-intracellulare. The patient was not
homosexual and had no history of intravenous drug abuse. Immunologic studies
showed a persistent lymphopenia with reversal of helper/suppressor-cytotoxic
T-lymphocyte ratios, depression of human natural killer cell function, and
in-vitro lymphocyte proliferative responses to mitogens and viral antigens. Serum
IgA levels were also elevated. Serum antibodies against cytomegalovirus, herpes
simplex viruses 1 and 2, Epstein-Barr virus, Varicella zoster, and hepatitis B
virus were shown, suggesting previous infection by these agents. Reactivation of 
cytomegalovirus infection was suggested by a rising titer of antibodies against
cytomegalovirus concurrent with pneumocystis pneumonia, and was confirmed by the 
growth of this virus in a throat culture 2 months later.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 6299153 [PubMed - indexed for MEDLINE]

7742: Medicine (Baltimore). 1983 Mar;62(2):81-97.

Herpes zoster-associated encephalitis: clinicopathologic report of 12 cases and
review of the literature.

Jemsek J, Greenberg SB, Taber L, Harvey D, Gershon A, Couch RB.

Herpes-zoster associated encephalitis (HZAE) is an uncommon complication of
herpes zoster. Over 8 years, we evaluated 12 patients with this clinical
diagnosis. The majority of our patients were elderly, immunosuppressed, and found
to have disseminated skin lesions prior to the onset of CNS symptoms. All
patients had abnormal EEGs, and CSF pleocytosis was found in most. In the seven
patients who were tested, specific antibody to the varicella-zoster membrane
antigen (FAMA) was detected in spinal fluid during the course of the illness.
Although three patients died during the period of active infection, the virus
could not be definitively implicated as the cause of death. These HZAE patients
could not be distinguished from our other herpes zoster patients on the basis of 
age, initially involved dermatome, or mortality rate. However, among herpes
zoster patients who survived, duration of hospitalization was significantly
longer in those with a diagnosis of HZAE. All surviving HZAE patients had a slow 
but eventual return to their prior cognitive status.

Publication Types: 
    Case Reports
    Review

PMID: 6298562 [PubMed - indexed for MEDLINE]

7743: Aktuelle Gerontol. 1983 Mar;13(2):67-71.

[Infectious diseases and pneumonias in advanced age in morbidity statistics]

[Article in German]

Gsell O.

Based on the new statistics of diagnoses from over 7 700 000 cases each year of
the Swiss Hospital Association it can be demonstrated that all infectious
diseases can also occur in the older age up of 65 years. Statistical data are
given for each single infection. The morbidity of old people is rarely seized in 
contrary to mortality. The Swiss morbidity statistic shows that older persons are
concerned in over 50% by pneumonia and herpes zoster, in 25-45% by septicemias,
erysipelas and pulmonary tuberculosis, in only 1 until few percent by the
classical children infections. The morbidity shows yearly considerable
fluctuations depending on local epidemics (p.e. influenza), on the preexistent
immunity (p.x. vaccinations) and the lesser resistance by risk factors of the
individuals.

Publication Types: 
    English Abstract

PMID: 6133475 [PubMed - indexed for MEDLINE]

7744: JAMA. 1983 Feb 18;249(7):922-3.

Varicella zoster and staphylococcal toxic shock syndrome in a young man.

Jacobson JA, Burke JP, Benowitz BA, Clark PV.

Publication Types: 
    Case Reports

PMID: 6218314 [PubMed - indexed for MEDLINE]

7745: Schweiz Rundsch Med Prax. 1983 Feb 8;72(6):194-7.

[Temporal arteritis with the appearance of zoster-like skin necroses]

[Article in German]

Panizzon R, Stieger M, Haubensak T, Leu HJ.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6835938 [PubMed - indexed for MEDLINE]

7746: Acta Pathol Microbiol Immunol Scand [C]. 1983 Feb;91(1):69-75.

Characterization of classes of intrathecally synthesized antibodies by imprint
immunofixation of electrophoretically separated sera and cerebrospinal fluids.

Vartdal F, Vandvik B.

The use of imprint immunofixation (IIF) method to identify IgG, IgA and IgM
classes of microbial antibodies in electrophoretically separated sera and
cerebrospinal fluids (CSF) is described. The method was applied to the analysis
of intrathecal antibody responses in mumps meningitis, subacute sclerosing
panencephalitis (SSPE), neurosyphilis and multiple sclerosis (MS). Intrathecally 
synthesized mumps virus-specific IgG, IgA and IgM antibodies were demonstrated in
the CSF of patients with mumps meningitis. The intrathecally synthesized IgG and 
IgM antibodies displayed oligoclonal characteristics, while the IgA antibodies
appeared to be mainly polyclonal. The intrathecal measles antibody responses in
SSPE appeared to be confined to IgG antibodies. In neurosyphilis, the intrathecal
treponemal antibody response was predominantly of the IgG class, but IgA
antibodies were demonstrated in two of nine patients. Intrathecally synthesized
IgG antibodies to measles and/or varicella-zoster viruses were demonstrated in 17
of 18 patients with MS; IgA or IgM antibodies to these viruses were not detected.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6869017 [PubMed - indexed for MEDLINE]

7747: Ann Neurol. 1983 Feb;13(2):217-8.

Herpes zoster and central retinal artery occlusion.

Hall S, Carlin L, Roach ES, McLean WT Jr.

Publication Types: 
    Case Reports
    Letter

PMID: 6830188 [PubMed - indexed for MEDLINE]

7748: Arthritis Rheum. 1983 Feb;26(2):236-7.

Acute monarticular arthritis in association with herpes zoster.

Devereaux MD, Hazelton RA.

Publication Types: 
    Case Reports
    Letter

PMID: 6824520 [PubMed - indexed for MEDLINE]

7749: Geriatrics. 1983 Feb;38(2):105-6, 111-3, 116.

Infections and the nervous system in the elderly.

Roeltgen DP.

PMID: 6822339 [PubMed - indexed for MEDLINE]

7750: Shikai Tenbo. 1983 Feb;61(2):207-13.

[Illustrated guide to the diagnosis of oral diseases. 2]

[Article in Japanese]

Enomoto S.

PMID: 6588573 [PubMed - indexed for MEDLINE]

7751: Arch Fr Pediatr. 1983 Feb;40(2):95-9.

[Varicella-zoster virus infections in the immunosuppressed child. Treatment with 
Acyclovir and controls]

[Article in French]

Peyramond D, Denoyel GA, Philip T, Souillet G, Philippe N, Bertrand JL, Bertoye
A.

Sixty minutes intravenous infusions of Acyclovir were given at 5 to 10 mg/kg 3
times daily for 6 to 11 days in 20 immunodeficient children with varicella (9
cases) and herpes zoster (11 cases) in a controlled open study. Twelve patients
had a life-threatening illness. All patients who received therapy before the
first 4 days had a more rapid cessation of new vesicles formation and more rapid 
scarring. Fourteen controlled children had accelerated clearance of viral
antigens from vesicles. In 19 cases, virus was no longer isolated after the 3rd
day. Eighteen patients recovered within 6 to 10 days. No relapse of varicella
zoster virus infections had been observed 1 to 18 months after the end of
treatment. Two children with varicellous interstitial pneumonia died 8 and 32
days after the end of treatment. In 3 cases, zoster pains reappeared 8 days after
Acyclovir therapy was stopped. The drug was well-tolerated, but control of renal 
functions is necessary.

Publication Types: 
    English Abstract

PMID: 6347116 [PubMed - indexed for MEDLINE]

7752: J Clin Microbiol. 1983 Feb;17(2):280-7.

Rapid diagnosis of varicella-zoster virus infection by detection of viral
deoxythymidine kinase in serum and vesicle fluid.

Kallander CF, Gronowitz JS, Olding-Stenkvist E.

A sensitive enzyme assay utilizing [125I]iododeoxyuridine as the substrate and
CTP as the phosphate donor in combination with isozyme-specific antisera was used
for direct detection and typing of herpesvirus deoxythymidine kinase (dTk) in
clinical specimens. An investigation of 16 coded vesicle fluid specimens, taken
in connection with varicella-zoster virus (VZV) and herpes simplex virus
infections, revealed viral dTk activity in 14 samples. All positive samples
except one were taken within 5 days after the onset of illness. Serological
typing of the dTk activities easily established whether the vesicles were caused 
by VZV, herpes simplex virus type 1, or herpes simplex virus type 2. The results 
were obtainable within 5 h and were in agreement with the results achieved by
immunofluorescence tests or by virus isolation when positive. Acute- and
convalescent-phase sera from patients with VZV infections were analyzed with
regard to dTk isozyme composition. All sera collected within 5 days after the
onset of varicella were found to contain elevated levels of dTk activity. By the 
use of isozyme-specific antisera and gel electrophoresis, it was possible to show
the presence of both cellular and VZV dTk's. Among the 13 acute-phase sera from
zoster patients, only 2 were found to be VZV dTk positive. Convalescent sera, in 
most cases collected 15 days or more after the onset of illness, were also found 
to be devoid of VZV dTk. The relevance of the results and the possible use of
these methods for viral diagnostics are discussed.

PMID: 6339548 [PubMed - indexed for MEDLINE]

7753: Acta Pathol Microbiol Immunol Scand [B]. 1983 Feb;91(1):83-8.

Rapid detection of herpes simplex virus and varicella-zoster virus in clinical
specimens by the use of Staphylococcus aureus rich in protein A.

Mogensen SC, Dishon T.

Herpes simplex virus (HSV) type 1 and type 2 and varicella-zoster virus (VZV)
were detected in cytospin preparations from clinical material by using specific
antisera and Staphylococcus aureus, Cowan 1 strain, rich in protein A (SRA).
Virus was isolated in tissue culture from 22 of the 30 specimens submitted for
examination. Eighteen isolates showed cytopathic effect characteristic of HSV
infection and 4 of VZV. In the cytospin preparations of the same samples HSV was 
detected in 15, two contained too few cells to allow a reliable diagnosis and one
sample was negative when the SRA reagent was used. In the cytospin preparations
of 2 of the 8 samples, which did not show cytopathic effect on isolation in
tissue culture, HSV was detected by the SRA. This points to the possible presence
of inactive virus in the specimens. All 4 cases of VZV infection were diagnosed
correctly with the staphylococcal reagent. No reaction was observed between VZV
antigens and rabbit anti-HSV sera. Cells in which viral infection was detected by
specific antisera and SRA did not show staphylococcal adherence to their surface 
after interaction with normal rabbit or normal human serum. Similarly, cells from
healthy donors, treated with positive and negative sera were found negative. The 
method is easy to perform and results can be obtained within three hours from the
time specimens are received at the laboratory. Its use offers a rapid diagnosis
in suspected cases of herpetic infections in which early therapy is recommended.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 6306990 [PubMed - indexed for MEDLINE]

7754: J Dermatol. 1983 Feb;10(1):13-6.

Cell-mediated immunity to varicella-zoster virus demonstrated by lymphocyte
transformation in herpes zoster.

Hata S.

Publication Types: 
    Comparative Study
    In Vitro
    Research Support, Non-U.S. Gov't

PMID: 6306084 [PubMed - indexed for MEDLINE]

7755: Clin Exp Immunol. 1983 Feb;51(2):197-206.

Immunological parameters in multiple sclerosis patients with special reference to
the herpes virus group.

Haahr S, Moller-Larsen A, Pedersen E.

A group of multiple sclerosis (MS) patients (n = 50), most of them in a stable or
slightly progressive phase was studied together with a group of neurological
control (NC) patients with CNS lesions (n = 38) comparable in age and disability 
and an age matched group of healthy persons (n = 46). On stimulation of
lymphocytes with herpes simplex virus (HSV), cytomegalovirus (CMV) and varicella 
zoster virus (VZV) a significantly lower interferon production was found in MS
patients compared with the NC patients and the healthy controls; when the NC
patients were compared with the healthy controls a significantly lower production
was also found. The lymphocyte transformation reaction in seropositive MS
patients was significantly lower than that seen in the seropositive control
groups when HSV was used as antigen. Lower responses, although insignificant,
were found when CMV and VZV were used as antigens. There were no differences
among the three groups when Con A was used as mitogen in three different
concentrations. Likewise spontaneous lymphocyte transformations were equal. The
lower interferon production and the lower transformation reactions in MS patients
could not be correlated to age, duration of disease, disability, disease activity
or impairment. No significant differences in humoral immunity to HSV, CMV and VZV
were found in the three groups, a few MS patients were 'true' seronegative to HSV
type 1 and 2. Suppressor cell activity induced by Con A and measles virus was
comparable in the three groups, although a few MS patients in an active relapsing
phase were found to have low suppressor cell activity. Natural killer cell
activity against two different cell lines was found equal in the three groups,
and there was no difference in the potentiating effect of interferon.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6188564 [PubMed - indexed for MEDLINE]

7756: Lancet. 1983 Jan 29;1(8318):243-4.

Impaired renal function after bolus injections of acyclovir.

Peterslund NA, Black FT, Tauris P.

Publication Types: 
    Case Reports
    Letter

PMID: 6130275 [PubMed - indexed for MEDLINE]

7757: Tidsskr Nor Laegeforen. 1983 Jan 20;103(2):147-8.

[Treatment of herpes zoster]

[Article in Norwegian]

Kolflaath J, Holmboe J.

Publication Types: 
    English Abstract

PMID: 6845307 [PubMed - indexed for MEDLINE]

7758: Arch Psychiatr Nervenkr. 1983;233(2):103-10.

Combined recordings of compound nerve action potentials and spinal cord evoked
potentials in differential diagnosis of spinal root lesions.

Stohr M, Buettner UW, Wietholter H, Riffel B.

Three cases are presented to demonstrate the diagnostic value of sensory
neurography in combination with somatosensory evoked potentials in the diagnosis 
of proximally located neuropathy and its differentiation to centrally located
demyelinating processes. Simultaneous recording of cortical and spinal evoked
potentials, as well as peripheral nerve action potentials, revealed in two cases 
(herpes zoster, Guillain-Barre syndrome) a site of lesion at the spinal roots
suggesting radiculitis and in one case (tick bite) a site of lesion central to
the source of lumbar evoked potentials suggesting myelitis. In all cases almost
complete recovery of sensory conduction velocities suggests a complete repair
myelination not previously described.

Publication Types: 
    Case Reports

PMID: 6882180 [PubMed - indexed for MEDLINE]

7759: Neurol Neurochir Pol. 1983 Jan-Feb;17(1):25-31.

[Fluorescence method of evaluation of the lysosomes of the lymphoid cells of the 
cerebrospinal fluid in meningitis and meningism]

[Article in Polish]

Kucharska-Demczuk K.

The fluorescence method of Blume et al. was found to be useful for identification
and morphological evaluation of lysosomes in cerebrospinal fluid cells. The
investigations were carried out in 49 patients with viral and bacterial
meningitis or meningismus. It was demonstrated that the CSF cells in most
patients with purulent meningitis contained no fluorescent granules in an early
stage of the disease before introduction of antibacterial therapy. These granules
were found in CSF cells in cases of leptospirosis, viral meningitis and
meningismus of various aetiology in acute stage of the disease and even in
convalescence, and in purulent meningitis in convalescence. In bacterial
meningitis large lysosomal granules were observed, and in viral meningitis these 
granules were small. The method visualizes easily bacteria (meningococci and
pneumococci) in the cerebrospinal fluid.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 6877497 [PubMed - indexed for MEDLINE]

7760: Med Microbiol Immunol. 1983;172(1):67-74.

Viral antibodies in maternal and cord sera.

Gotlieb-Stematsky T, Meron I, Modan M, Sayar Y, Leventon-Kriss S, Fogel A,
Gurewitz R, Insler V.

Viral antibodies were determined in paired maternal and cord blood sera of 258
consecutive deliveries. Antibodies to Epstein-Barr virus (EBV), cytomegalovirus
(CMV), herpes simplex type 1 (HSV-1), adenovirus (ADV), and varicella zoster
(VZV) were tested by indirect immunofluorescence and to rubella (RUB) by
hemagglutination inhibition. Analysis of the overall pattern of differences
between maternal and cord blood showed a highly significant difference for all
six viruses. Analysis regarding individual viruses showed significantly higher
titers to CMV and RUB in cord blood, a higher titer to VZV in maternal blood, and
similar levels of antibodies to EBV, HSV-1, and ADV in maternal and cord blood.
Infants with one or more risk indicators (weight less than 3 kg, Apgar score less
than or equal to 7, clinical jaundice, meconium-stained amniotic fluid,
respiratory distress syndrome) were defined as "at risk." Infants free of such
indicators were defined as "normal." Significantly lower antibody levels to all
six viruses were found in both maternal and cord blood of the "at risk" as
compared to the "normal" group, while the ratios between the maternal and cord
blood levels remained similar. Birth defects were found to have no effect on
antibody titers. These results indicate an efficient and selective transfer
through the placenta of certain viral antibodies and the possible association of 
lower antibody production with the presence of risk indicators in the infants.

PMID: 6877173 [PubMed - indexed for MEDLINE]

7761: J Chronic Dis. 1983;36(7):501-5.

Herpes zoster and diabetes mellitus: an epidemiological investigation.

Ragozzino MW, Melton LJ, Kurland LT.

Five hundred and ninety Rochester, Minnesota, residents were initially diagnosed 
with herpes zoster in the period 1945-59. Fifteen had diabetes mellitus before
the onset of herpes. The expected number was 15.7. The entire herpes zoster
cohort was followed subsequently for nearly 9400 person-years and 33 new cases of
diabetes mellitus developed while the expected number was 30.6. The clinical
spectrum of herpes zoster in individuals with diabetes mellitus was not different
from that of zoster patients from the general population. We conclude that herpes
zoster is not a risk factor for diabetes mellitus and that diabetes mellitus is
not a risk factor for herpes zoster.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 6874881 [PubMed - indexed for MEDLINE]

7762: Intensive Care Med. 1983;9(3):105-7.

Viruses and intensive care.

Jeffries DJ.

PMID: 6863719 [PubMed - indexed for MEDLINE]

7763: Zh Nevropatol Psikhiatr Im S S Korsakova. 1983;83(2):213-8.

[Serous meningitis in patients with herpes zoster]

[Article in Russian]

Shishov AS, Smirnov IuK, Karmysheva VIa, Mal'tseva NN.

CSF was studied in 110 patients with herpes zoster. The whole complex of symptoms
helped to diagnose serous meningitis in 62% of cases and so-called "asymptomatic 
meningitis" in 18% of cases. CSF cells were characterized by lymphocyte
transformation and the presence of antigen to Varicella zoster virus determined
by the fluorescent antibody method. Specific antibodies titer appeared to be at
zero or minimal level. The disease pathogenesis is discussed.

Publication Types: 
    English Abstract

PMID: 6858479 [PubMed - indexed for MEDLINE]

7764: Ann Otolaryngol Chir Cervicofac. 1983;100(2):135-43.

[Idiopathic and zoster vestibular neuritis. Course and prognosis]

[Article in French]

Francois M, Vacher S, Freyss G, Frachet B, Pialoux P.

112 cases of vestibular neuritis were studied. 77% were relatively pure lesions, 
whilst in 23% of cases there were more extensive lesions with abnormalities of
the saccadic oculomotor system and BERA abnormalities. Spontaneous nystagmus
disappeared in 2 to 3 months in general. In 54% of cases there was complete
recovery of absolute reflex activity within normal limits on the affected side.
There was restoration of normal difference of reflectivity in 22%. In 13% there
was normal absolute reflex activity, normal hypovalence and normal directional
preponderance. Age appeared to influence the course of directional preponderance 
and the extent of lesions on the course of hypovalence. Early mobilisation of the
patient is of primordial importance.

Publication Types: 
    English Abstract

PMID: 6847070 [PubMed - indexed for MEDLINE]

7765: Hautarzt. 1983 Jan;34(1):1-5.

[Possibilities and limits of chemotherapy of diseases caused by herpes simplex
and varicella-zoster virus]

[Article in German]

Wassilew SW.

The available antiviral chemotherapeutic agents for the treatment of herpes
simplex type 1 and 2 and varicella zoster virus infections are discussed in
respect of their mechanism of action, clinical effects, and side effects.
Although effective under experimental conditions most of the antiherpetic drugs
need further evaluation of clinical efficacy in controlled trials. It is possible
to reduce initial herpetic pain mainly in patients with zoster by topical
application of 5% 5-iodo-2'-deoxyuridine solved in dimethylsulphoxide when
treatment starts within the first 3 days of blister eruption. The postzosteric
neuralgia is not influenced. A shortening of pain seems also possible in primary 
herpes simplex virus type 2 infection. For recurrent herpes simplex there is no
proven effect on duration or frequency of recurrences with available antiherpetic
drugs. The indication for antiviral chemotherapy is limited not only by the
unpredictable, mainly self-limited, course of herpes simplex and zoster but also 
by the possible side effects of chemotherapeutic agents. Severe and
life-threatening herpes disease, e.g., in immunosuppressed patients or newborns, 
can be defeated with vidarabin applied i.v. and, in the near future, with
acyclovir.

Publication Types: 
    English Abstract

PMID: 6841073 [PubMed - indexed for MEDLINE]

7766: Clin Exp Dermatol. 1983 Jan;8(1):27-31.

Impairment of axon reflex vasodilatation after herpes zoster.

Jancso G, Husz S, Simon N.

PMID: 6839534 [PubMed - indexed for MEDLINE]

7767: J Clin Microbiol. 1983 Jan;17(1):122-7.

Thymidine plaque autoradiography of thymidine kinase-positive and thymidine
kinase-negative herpesviruses.

Tenser RB, Jones JC, Ressel SJ, Fralish FA.

Plaques formed by herpes simplex virus (HSV), pseudorabies virus, and
varicella-zoster virus were studied by plaque autoradiography after
[14C]thymidine labeling. Standard thymidine kinase-positive (TK+) viruses and TK-
mutants of HSV types 1 and 2 and pseudorabies virus were studied, including cell 
cultured viruses and viruses isolated from animals. Autoradiography was performed
with X-ray film with an exposure time of 5 days. After development of films, TK+ 
plaques showed dark rims due to isotope incorporation, whereas TK- plaques were
minimally labeled. Plaque autoradiography of stock TK- viruses showed reversion
frequencies to the TK+ phenotype of less than 10(-3). Autoradiography indicated
that TK- virus retained the TK- phenotype after replication in vivo. In addition,
it was shown that TK- HSV could be isolated from mouse trigeminal ganglion tissue
after corneal inoculation of TK- HSV together with TK+ HSV. The plaque
autoradiographic procedure was very useful to evaluate proportions of TK+ and TK-
virus present in TK+-TK- virus mixtures.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6826696 [PubMed - indexed for MEDLINE]

7768: Cancer. 1983 Jan 1;51(1):30-3.

Diffuse thymic hyperplasia following chemotherapy for nodular sclerosing
Hodgkin's disease. An immunologic rebound phenomenon?

Shin MS, Ho KJ.

Diffuse thymic hyperplasia following chemotherapy for nodular sclerosing
Hodgkin's disease is reported in an 18-year-old woman. The patient's course was
complicated by drug-induced pulmonary fibrosis and disseminated herpes zoster.
Subsequently she developed genuine diffuse thymic hyperplasia with disappearance 
of herpes zoster and apparently complete remission of Hodgkin's disease. We
stress that restoration of the host immune system, particularly the cell-mediated
immunity, is essential for successful control of Hodgkin's disease and the thymic
hyperplasia is most likely a favorable sign for it, which should not be confused 
with recurrence of Hodgkin's disease.

Publication Types: 
    Case Reports

PMID: 6821803 [PubMed - indexed for MEDLINE]

7769: Semin Perinatol. 1983 Jan;7(1):47-56.

Fetal and neonatal varicella-zoster infections.

Brunell PA.

Maternal varicella during pregnancy may have a variety of effects on the fetus
and newborn infant. Infection early in pregnancy may result in fetal
malformations. Zoster early in life appears to be a sequela of maternal infection
at any period during pregnancy. Infants may escape disease, may have mild
varicella, or fatal illness following maternal varicella just prior to delivery. 
The outcome appears to be related to the onset of maternal and newborn illness
relative to delivery. A variety of management options are available to the
physician. Choices will be dictated by weighing the risks of VZV infection in a
particular situation with the risks and benefits of other proposed intervention. 
In many cases, recommendations must be made on the basis of very limited data. It
is hoped that additional information will lead to a more rational approach to VZV
infection of the fetus and newborn.

PMID: 6682573 [PubMed - indexed for MEDLINE]

7770: J Clin Apher. 1983;1(2):104-8.

Immune globulin intravenous replacement after plasma exchange.

Dau PC.

The infusion of high-dose (275 mg/kg body weight) immune globulin intravenous
(IGIV) after 466 plasma exchanges in 64 patients with autoimmune disease was
studied. Side effects occurred during 15% of IGIV infusions. For the most part
they were transient and mild, and could be controlled by slowing the infusion
rate. Two percent of infusions had to be terminated because of more persistent or
severe side effects. Chills were the most common side effect, followed by nausea,
flushing, anxiety, and nausea. Serum IgG levels were immediately restored into
the normal range by IGIV infusions, and they were much more effective in
restoring IgG levels after plasma exchange than intramuscular injection of 9.9 g 
of immune serum globulin (ISG). Up to 15 weekly high-dose IGIV infusions were
well tolerated without unusual side effects. These patients did not have any
major bacterial infections, but were not protected from developing Herpes zoster 
at the dosages used. In patients with myasthenia gravis, a short term impact of a
single IGIV infusion on titers of antibody to acetylcholine receptor could not be
demonstrated. This study showed IGIV to be a safe and effective preparation for
the replacement of normal IgG removed during plasma exchange.

PMID: 6681480 [PubMed - indexed for MEDLINE]

7771: Arch Immunol Ther Exp (Warsz). 1983;31(5):655-61.

Clinical studies on the effectiveness of Wratizolin in the treatment of some
dermatoses.

Szarmach H, Wronski A, Laudanska H, Niczyporuk W.

Clinical studies on therapeutic effectiveness of ITCL applied as 2-3% ointment,
2% cream and 2-3% lotion were carried out. The study material included 96
patients at the age of 9-80. Of this group, 19 patients were with herpes zoster, 
16 with herpes simplex, 29 with eczema complicated by secondary bacterial
infection, 30 with palm and foot pustulosis, 1 patient with actinic cheilitis and
1 with varicella. The results obtained have revealed that the preparation is
particularly effective in the treatment of dermatoses induced by herpes zoster
and herpes simplex virus.

PMID: 6675573 [PubMed - indexed for MEDLINE]

7772: Arch Immunol Ther Exp (Warsz). 1983;31(5):649-54.

Studies on the therapeutic effect of Wratizolin in selected dermatoses.

Michalowski R, Olejnicka Z, Kozak S, Urban J.

Clinical investigations of ITCL drug ("Polfa") were carried out on 50 patients
(15 women, 16 men, 19 children, at the age of 4-80). ITCL has been successful in 
non-specific inflammations accompanying some virus dermatoses (zoster, herpes
simplex), in streptococcal pyoderma (impetigo, ecthyma), and in some allergic
dermatoses (disseminated eczema and atopic dermatitis). Encouraging results were 
obtained with ITCL in the treatment of psoriasis. It seems that the further
attempts with this should be continued in psoriasis. The capillaroscopic
examinations in 6 patients revealed ITCL to have vasoconstrictive effect on the
nail wall cutis capillaries 6 h after its application. This may be associated
with the anti-inflammatory effect of the drug.

PMID: 6675572 [PubMed - indexed for MEDLINE]

7773: Arch Immunol Ther Exp (Warsz). 1983;31(5):645-8.

Results of Wratizolin treatment of selected skin diseases with particular
reference to those of viral etiology.

Wasik F, Gasior-Chrzan B, Woyton A, Cislo M, Dabrowska-Widera J.

A newly synthetized compound, p-chlorophenylamide of
3-methyl-5-benzoylaminoisothiazole-4-carboxylic acid (ITCL) was used for local
treatment in 68 patients with the following skin diseases: herpes simplex, herpes
zoster, eczema complicated by bacterial infection, aphthae of the mucosa. In all 
cases examined, a good tolerance of the drug, rapid subsidence of pathologic
symptoms, mainly of inflammation, pain and edema could be seen. The drug was
found to reduce markedly the duration of the disease, particularly in the case of
herpes simplex and aphthae.

PMID: 6675571 [PubMed - indexed for MEDLINE]

7774: Arch Immunol Ther Exp (Warsz). 1983;31(5):641-4.

Wratizolin ITCL in the treatment of herpes simplex and recurrent and zoster.

Moskalewska K, Dabrowska H, Rozanski J, Grzywa Z.

Herpes simplex and zoster are frequent skin diseases of viral origin and the
mechanism of their development as well as their course are not yet fully known.
Fully effective methods of treating these diseases are not known. The authors
evaluated the results of the externally applied ITCL preparation in the form of a
2% cream. A group of 92 patients was treated, 64 with herpes simplex or
recurrent, 16 with zoster, 9 with purulent skin lesions and 3 with verruca plana.
Very good results, that is earlier regression of lesions with inhibition of
further dissemination, were obtained in 83% of patients with herpes, in over half
of the cases of zoster, and in nearly all cases with purulent skin lesions. In
most cases the tolerance of the drug was good.

PMID: 6675570 [PubMed - indexed for MEDLINE]

7775: Med Pregl. 1983;36(9-10):405-7.

[Personal experience in the use of Ditamin in the treatment of herpes zoster]

[Article in Croatian]

Krstic A, Ilic-Krstic B.

Publication Types: 
    English Abstract

PMID: 6674725 [PubMed - indexed for MEDLINE]

7776: Brain Dev. 1983;5(5):494-9.

Acute hemiplegia with lacunar infarct after varicella infection in childhood.

Eda I, Takashima S, Takeshita K.

We report 4 cases of acute hemiplegia and a small low-density lesion on
computerized tomography (CT) after varicella infection. In 3 of them, CT in the
acute hemiplegic stage, and later, reveals the development of lacunar infarct
around the internal capsule. Focal low density may be caused by occlusive
vascular lesions of the penetrating arteries. Varicella infection may play an
important role as one of the causes of acute hemiplegia in childhood producing
lacunar infarct, as well as delayed hemiplegia, reported previously in herpes
zoster ophthalmicus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6660422 [PubMed - indexed for MEDLINE]

7777: Zh Nevropatol Psikhiatr Im S S Korsakova. 1983;83(10):1467-71.

[Clinical picture and treatment of herpes zoster in children]

[Article in Russian]

Shishov AS, Smirnov IuK, Kulikova VA.

The symptoms and the course of herpes zoster are analyzed in 85 children aged 5
months to 15 years. Many systems of the body were shown to be involved in the
process of the disease which is characteristic of neuroviral infections. The
authors postulate the etiologic unity of chicken pox and herpes zoster as two
clinical forms of the same epidemic process. The questions of treatment are
outlined.

Publication Types: 
    English Abstract

PMID: 6659778 [PubMed - indexed for MEDLINE]

7778: Neth J Med. 1983;26(10):301-3.

Occurrence of herpes zoster varicella infections after completion of treatment
for Hodgkin's disease.

De Pauw BE, Janssen JT, Vaissier P, Haanen C.

PMID: 6656975 [PubMed - indexed for MEDLINE]

7779: Int Anesthesiol Clin. 1983 Winter;21(4):79-96.

Management of head and neck pain.

Burney RG, Moore PA, Duncan GH.

PMID: 6642703 [PubMed - indexed for MEDLINE]

7780: Ann Dermatol Venereol. 1983;110(6-7):507-11.

[Treatment of herpes zoster]

[Article in French]

Revuz J, Huraux JM.

A critical study of therapeutic trial reports on herpes zoster is presented. It
is noteworthy that authors are frequently unaware of the natural history of
herpes zoster; therapeutic trials are not always correctly designed;
misinterpretation of the data is not unfrequent. Proof of efficacy is missing for
several commonly used drugs. Two groups of drug seem promising: -- Modern
antiviral nucleoside analogues : Acyclovir, Vidarabine, Bromovinyl-desoxyuridine 
are probably effective for severe herpes zoster in immunocompromized patients.
-Systemic adrenal steroids are effective as a prevention of post-herpetic
neuralgia in elderly patients. The real usefulness of these two treatment
procedures, as a whole and for individual patient, remains to be established by
well-designed controlled trials. Other treatments should be surrended.

Publication Types: 
    English Abstract

PMID: 6638780 [PubMed - indexed for MEDLINE]

7781: Adv Otorhinolaryngol. 1983;31:184-90.

Pathological findings and surgical implications in herpes zoster oticus.

Etholm B, Schuknecht HF.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 6624594 [PubMed - indexed for MEDLINE]

7782: Fortschr Ophthalmol. 1983;80(2):100-2.

[Neuroparalytic keratitis]

[Article in German]

Turss R, Kolodziej I.

Publication Types: 
    English Abstract

PMID: 6604683 [PubMed - indexed for MEDLINE]

7783: Acta Acad Med Wuhan. 1983;3(1):58-9.

Moyamoya disease associated with herpes zoster ophthalmicus: a case report with
angiographic findings.

Mei YW, Hu JD.

Publication Types: 
    Case Reports

PMID: 6602958 [PubMed - indexed for MEDLINE]

7784: Am J Otol. 1983 Jan;4(3):269.

The facial nerve.

May M.

PMID: 6600885 [PubMed - indexed for MEDLINE]

7785: Arch Ophthalmol. 1983 Jan;101(1):42-5.

Complications of herpes zoster ophthalmicus.

Womack LW, Liesegang TJ.

Of 86 patients with herpes zoster ophthalmicus seen at the Mayo Clinic,
Rochester, Minn, from 1975 to 1980, 61 had some form of ocular involvement.
Corneal disease was seen in 47, uveitis in 37, postherpetic neuralgia in 15,
scleritis in three, and ocular motor palsies in three. No case of optic nerve or 
retinal involvement was found. Of serious concern were four patients with
neurologic complications, including two with contralateral hemiplegia and two
with segmental cerebral arteritis. Because the neurologic complications occur
several months after the episode of herpes zoster ophthalmicus, the association
is often overlooked and the opportunity to treat with corticosteroids for
systemic effect is missed.

PMID: 6600391 [PubMed - indexed for MEDLINE]

7786: J La State Med Soc. 1983 Jan;135(1):34-7.

Just another case of "shingles"?

Morse RH.

Publication Types: 
    Case Reports

PMID: 6405001 [PubMed - indexed for MEDLINE]

7787: Br Med J (Clin Res Ed). 1983 Jan 1;286(6358):60.

Outbreak of chickenpox from a patient with immunosuppressed herpes zoster in
hospital.

Juel-Jensen BE.

Publication Types: 
    Letter

PMID: 6401472 [PubMed - indexed for MEDLINE]

7788: Trans Ophthalmol Soc U K. 1983;103 ( Pt 1):111-4.

Acyclovir therapy in herpes zoster infection. A practical guide.

McGill J, Chapman C, Mahakasingam M.

The effect of acyclovir on the skin rash and herpes zoster keratouveitis has been
studied. It has been shown to have a significant effect on both disease
processes, and to be superior to topical steroids in the treatment of herpes
zoster keratouveitis. Steroids have been found to have an adverse effect with
prolonged treatment and frequent recurrences.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 6362108 [PubMed - indexed for MEDLINE]

7789: Schweiz Med Wochenschr Suppl. 1983;14:26-9.

Studies in the prophylaxis of herpes infections in severely immunocompromised
patients using acyclovir.

Prentice HG, Hann IM.

That acyclovir is effective therapeutically in herpes simplex virus (HSV) and
herpes zoster (VZV) infections in immunocompromised patients has been established
[13]. This paper reviews our subsequent studies in prophylaxis of herpes group
infections in a high risk group of patients suffering from acute leukaemia. In
study 1 we randomised HSV seropositive (greater than or equal to 1:8) patients to
receive intravenous acyclovir or placebo. In this stratified study bone marrow
transplant (BMT) recipients were completely protected from HSV infections by
acyclovir compared with a 50% failure rate for those on placebo. There was
significant protection also in the non-BMT group [8]. In study 2 oral acyclovir
prophylaxis failed to provide complete protection in BMT recipients despite the
achievement of apparently adequate blood levels. In study 1 the secretion of EBV 
in saliva before and during the trial gave inconclusive results. In each of the
first two studies one patient on "active" acyclovir developed a cytomegalovirus
(CMV) infection. Thus, at the dosage of drug used, prophylaxis of CMV was
unsuccessful suggesting that claims of therapeutic efficacy are unlikely to be
supported in controlled trials. Study 3 is current and concerns the
pharmacokinetics of an acyclovir prodrug (BW 134U) taken by mouth. This drug is
near 100% absorbed and achieves approximately twice the level of active acyclovir
in vivo, following conversion by adenosine deaminase (ADA), in normal volunteers.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6361988 [PubMed - indexed for MEDLINE]

7790: Annu Rev Med. 1983;34:205-17.

Dermatologic manifestations of infection in the compromised host.

Wolfson JS, Sober AJ, Rubin RH.

The skin occupies an important position in the prevention and evaluation of
infection in patients who are immunocompromised. The skin can provide a portal of
entry for both locally invasive and disseminated infection; and, not
infrequently, skin lesions may be the first sign of disseminated infection from
other primary sites. The first clinical principle in approaching this problem is 
that the skin must be protected from trauma, maceration, or alteration in its
normal microbial flora. The second principle is that any lesion, no matter how
innocuous, should be carefully evaluated in this patient population. Since the
gross morphology of the lesion is so frequently modified by the altered
inflammatory response of the immunocompromised patient, an aggressive biopsy
approach is essential for diagnosis and therapy.

Publication Types: 
    Review

PMID: 6344755 [PubMed - indexed for MEDLINE]

7791: Zh Nevropatol Psikhiatr Im S S Korsakova. 1983;83(4):511-5.

[Levamisole in the treatment of different forms of herpes zoster]

[Article in Russian]

Smirnov IuK, Shishov AS, Bagrov FI, Rudometov IuP, Sverdlova LL.

Fifty patients with early stages of herpes zoster (23 patients with the
ophthalmic form and 27 with other localizations of the lesion) were treated with 
levamisol, since it was assumed that the disease is caused by the activation of
the varicellazoster virus in association with cellular immunodeficiency. The
control group consisted of 63 subjects, including 26 with the ophthalmic form.
Beneficial results such as faster skin clearance and fewer days of
hospitalization suggest that this agent should be recommended for combined
treatment of patients suffering from herpes zoster.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 6344521 [PubMed - indexed for MEDLINE]

7792: Ophthalmologica. 1983;186(3):141-50.

[Clinical and immunological studies of Behcet's disease]

[Article in German]

Richard G, Dieckhues B.

8 patients with clinically diagnosed Behcet disease were immunologically
investigated. Uveitis was present in 7 of these patients. Although uveitis is a
rare presentation of Behcet's disease, it tends to be bilateral when it does
occur and to involve both the anterior and posterior segments repeatedly.
Nowadays it is rare to observe a hypopyon, thanks to early initiation of therapy.
In the late stages, recurrent vitreous haemorrhage complicates the course of the 
disease and can lead to blindness. HLA-B5 can frequently be demonstrated in
patients with Behcet's disease. Detailed serological investigations, as measles
hemagglutination inhibition test+complement fixation test (CFT), rubella
hemagglutination inhibition test, hepatitis HB2 antigen, adenovirus antigen,
varicella zoster CFT, mumps CFT, herpes simplex CFT, anticytomegalovirus IgM and 
IgG, toxoplasmosis immunofluorescence, tuberculosis Middlebrock-Dubois, were
unable to uncover a connection with past or present infections. Determinations of
haptoglobulin, lactate dehydrogenase, albumin and ceruloplasmin showed nothing
worth remarking. Electrophoresis can indicate the duration of the illness. In 1
patient the lymphocyte adherence inhibition test was abnormal.

Publication Types: 
    English Abstract

PMID: 6341918 [PubMed - indexed for MEDLINE]

7793: Ann N Y Acad Sci. 1983;420:192-207.

Detection of viral antigens in formalin-fixed specimens by enzyme treatment.

Kurata T, Hondo R, Sato S, Oda A, Aoyama Y, McCormick JB.

Enzyme treatment (protease or trypsin) was applied to formalin-fixed
paraffin-embedded materials and virus-infected cultured cells to detect viral
antigens by immunofluorescence. The viral antigens were demonstrated in several
organs of autopsy or biopsy cases of which diagnoses had been established by
immunofluorescence or virus isolation using frozen materials, or suspected on the
basis of serology and/or histopathological findings. These included herpes
simplex, varicella-zoster, cytomegalo, subacute sclerosing panencephalitis,
progressive multifocal leukoencephalopathy, Japanese B encephalitis, measles,
acute hemorrhagic conjunctivitis, Lassa and Korean hemorrhagic fever. Antigen
could be recovered also in virus-infected cells (herpes simplex, measles, Lassa, 
Ebola, Marburg, Rift Valley, Congo and Korean Hemorrhagic fever) by enzyme
treatment after periods of formalin fixation of four weeks and storage of three
months. In herpes simplex virus-infected mouse brain, antigen was detected after 
fixation for three months in formalin.

PMID: 6326644 [PubMed - indexed for MEDLINE]

7794: Adv Virus Res. 1983;28:285-356.

Chickenpox virus.

Takahashi M.

Publication Types: 
    Comparative Study
    Review

PMID: 6318539 [PubMed - indexed for MEDLINE]

7795: Scand J Infect Dis. 1983;15(4):327-34.

Zoster immunoglobulin in varicella prophylaxis. A study among high-risk patients.

Hanngren K, Falksveden L, Grandien M, Lidin-Janson G.

The efficacy of zoster immunoglobulin (ZIG) in preventing varicella was studied
among patients in a high-risk group. 173 non-immune patients were observed after 
exposure to varicella-zoster (VZ) virus and subsequent administration of ZIG. For
138 patients (80%) no sign of varicella was recorded, 16 patients (9%) had a
subclinical infection and 19 patients (11%) developed varicella. 12/19 patients
with varicella contracted a very mild disease (less than 20 pocks, negligible
fever), 5 got mild or normal disease and 2 children, both with acute lymphatic
leukemia, developed more pronounced symptoms. Three patients protected by 0.15 ml
ZIG/kg body weight after heavy exposure to VZ virus, were not protected at a
second exposure 2 weeks later. In an enlarged study group of high-risk patients
where 52 patients receiving ZIG developed varicella, the mean incubation period
for 42 patients was 21 days. Leukemic patients were found to have a higher
frequency of clinical varicella, more pronounced symptoms and a slightly longer
incubation period than other high-risk patients. VZ specific antibody titers were
compared for various immunoglobulin preparations and found to be 30 times higher 
in zoster immunoglobulins than in normal immunoglobulins.

PMID: 6318302 [PubMed - indexed for MEDLINE]

7796: J Med Virol. 1983;12(4):237-45.

Specific IgG and IgA antibodies to herpes simplex virus and varicella zoster
virus in acute peripheral facial palsy patients.

Hadar T, Tovi F, Sidi J, Sarov B, Sarov I.

The role of herpes simplex virus (HSV) and varicella zoster virus (VZV) in acute 
peripheral facial palsy (APFP) was evaluated in 153 patients. The sera of
patients were examined for IgG and IgA antibodies to HSV and VZV by the
immunoperoxidase antibody-membrane antigen (IPAMA) technique. The prevalence of
IgG and IgA seropositivity to HSV was significantly higher in the APFP patients
than in the matched control group. No significant difference was found in the
geometric mean titer (GMT) to HSV antibodies in the APFP patients compared to the
matched control groups. The prevalence of IgA antibodies to VZV was significantly
higher in the APFP patients group than in the matched control group. The GMT for 
VZV IgG antibodies was significantly higher in the APFP patients than in the
matched control group. No significant difference was found in the GMT of VZV IgA 
antibodies. Eleven of 83 patients for whom paired sera were available had
significantly increased or decreased IgG and IgA antibody titers to VZV on
subsequent examination. Four of these patients did not show any evidence of
zosterian eruption. These studies support the concept that VZV and HSV might have
a role in the etiopathogenesis of APFP in some of the patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6317798 [PubMed - indexed for MEDLINE]

7797: Arch Geschwulstforsch. 1983;53(5):417-22.

Antibodies against herpesviruses in patients with Hodgkin's disease.

Wutzler P, Farber I, Sprossig M, Sauerbrei A, Wutke K, Hoche D, Rudiger KD,
Wockel W, Scheibner K.

The antibody titres to Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes
simplex virus (HSV) and varicella-zoster virus (VZV) were determined in 57 adult 
patients with Hodgkin's disease and a group of age- and sex-matched controls. In 
the group of patients, the geometric mean antibody titres to EBV capsid antigen, 
CMV early and late antigens, and also VZV, were significantly higher than in the 
healthy controls. Antibodies to early antigens of EBV and CMV were found more
commonly in patients than in controls. The raised antibody titres to
herpesviruses were taken to be the result of the disturbed cellular immunity in
Hodgkin's disease.

PMID: 6316868 [PubMed - indexed for MEDLINE]

7798: Microbiol Immunol. 1983;27(9):767-77.

Incomplete growth of varicella-zoster virus in human monocytes.

Baba M, Shigeta S.

Infection of human peripheral blood monocytes by varicella-zoster virus (VZV) was
investigated. When freshly isolated monocytes of young adult volunteers were
infected with cell-free VZV and examined by indirect immunofluorescence, specific
antigens appeared at 8 hr and the number of antigen-positive cells reached the
maximum between 24 and 48 hr postinfection. The proportion of antigen-positive
cells to total cells was similar to that of the permissive control (HeLa cells), 
while very few infectious centers (IC) of monocytes were formed in comparison
with the infected control cells. Monocytes isolated from infants and old persons 
formed a larger number of IC than those of young adults. Electron microscopic
study of VZV-infected monocytes from three young adult volunteers demonstrated
that the proportion of VZV particle-positive cells to total cells was similar to 
that of antigen-positive cells, and most of the particles seen in the nuclei were
low in density and lacked a central core. These results suggest that the growth
of VZV in human adult monocytes is incomplete. This restriction of VZV growth by 
monocytes may play an important role in defense against VZV infection.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6316116 [PubMed - indexed for MEDLINE]

7799: Intervirology. 1983;20(2-3):123-8.

Detection of varicella-zoster virus-specific IgA antibodies in varicella and
zoster patients and in healthy adults of various ages by solid-phase
radioimmunoassay.

Levy E, Mosovitz B, Friedman M, Sarov I.

The varicella-zoster virus(VZV)-specific serum immunoglobulin A(IgA) response was
studied in varicella and zoster patients and in healthy adults of various ages by
a sensitive solid-phase radioimmunoassay technique. Significant rises in
VZV-specific IgA titer were found for both varicella and zoster patients, while
VZV-specific IgA was also detected in greater than 90% of healthy adults but at
lower titers. No significant decrease in VZV-specific IgA titer with increasing
age was found. The role of humoral versus cell-mediated immunity in VZV
reactivation is discussed.

PMID: 6313543 [PubMed - indexed for MEDLINE]

7800: Proc Eur Dial Transplant Assoc. 1983;19:513-26.

Viral infection in the renal transplant patient.

Rubin RH, Tolkoff-Rubin NE.

With the advances that have occurred over the last two decades in the prevention 
and treatment of bacterial and fungal infection, viral infection has been
recognised as an important problem in renal transplant patients. Four groups of
viruses--the herpesviruses, hepatitis viruses, papovaviruses, and adenoviruses - 
appear to have a particular impact on this patient population, especially the
first two of these. The effects of these viruses can be categorised as follows:
the production of infectious diseases by the virus itself; the production of an
immunosuppressed state that predisposes to opportunistic superinfection; the
production of a unique form of allograft injury; and the production of
malignancy. It is the recognition of these last three categories of viral effect 
that has led to a reawakening of interest in these agents in recent years. In
particular, the interaction among rejection, innovative forms of
immunosuppression, and reactivated viral infection in the pathogenesis of
malignant disease, which occurs at a markedly increased rate in this patient
population, offers a major frontier of human biology whose importance extends far
beyond the renal transplant population.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6308602 [PubMed - indexed for MEDLINE]

7801: Curr Top Microbiol Immunol. 1983;104:235-45.

A sensitive assay for detection of deoxythymidine kinase and its application to
herpesvirus diagnosis.

Gronowitz JS, Kallander CF.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Review

PMID: 6307593 [PubMed - indexed for MEDLINE]

7802: Zh Nevropatol Psikhiatr Im S S Korsakova. 1983;83(4):504-11.

[Etiotropic and pathogenetic therapy of painful neurologic syndromes of
peripheral origin]

[Article in Russian]

Akimov GA, Lobzin VS, Shapkin VI, Mikhailenko AA.

Publication Types: 
    English Abstract

PMID: 6305067 [PubMed - indexed for MEDLINE]

7803: Semin Perinatol. 1983 Jan;7(1):57-63.

Laboratory diagnosis of herpesvirus infections.

Sever JL, Jacob AJ.

PMID: 6302914 [PubMed - indexed for MEDLINE]

7804: Int J Dermatol. 1983 Jan-Feb;22(1):19-21.

When is systemic antiviral therapy indicated?

Chou S.

PMID: 6299984 [PubMed - indexed for MEDLINE]

7805: J Infect Dis. 1983 Jan;147(1):47-56.

Zoster in children with cancer: radioimmune precipitation profiles of sera before
and after illness.

Grose C.

Sera collected from children with cancer before and for extended periods after
the onset of zoster were analyzed by radioimmune precipitation techniques. The
percent recovery of both [3H]fucose- and [35S]methionine-labeled varicella-zoster
virus (VZV)-specific antigens increased severalfold immediately after zoster and 
declined slowly during convalescence; however, within two years serum panels from
two patients exhibited serologic evidence of subclinical reactivation of VZV.
After electrophoretic fractionation of the immunoprecipitates, the polypeptide
profile after zoster closely resembled that described for high titer xenoantisera
to VZV and contained at least 16 constituents ranging in molecular weight from 32
to 174,000. In contrast, sera obtained before zoster were easily distinguished
because they precipitated poorly, if at all, two major VZV glycoproteins (gp62
and gp98) and several nonglycosylated polypeptides. The emergence of zoster,
therefore, was associated with the appearance of previously undetectable
antibodies to VZV-specific proteins.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6296242 [PubMed - indexed for MEDLINE]

7806: J Infect Dis. 1983 Jan;147(1):149-54.

Interferon prophylaxis against simian varicella in Erythrocebus patas monkeys.

Arvin AM, Martin DP, Gard EA, Merigan TC.

Erythrocebus patas monkeys were given placebo or human leukocyte interferon (5 x 
10(5) units/kg of body weight per day im) for five days during an epizootic of
simian varicella. During the 14 days beginning with the first day of treatment,
the attack rate for simian varicella was 14.3% (two of 14) among interferon
recipients compared to 70% (nine of 13) among placebo recipients (P less than
0.025). Excluding animals with antibody to simian varicella when the study began,
18% (two) of 11 interferon recipients had symptoms of infection compared to 80%
(nine) of 11 placebo recipients (P less than 0.025). The epizootic began in a
room housing male animals. The incidence of infection in male placebo recipients 
was 100% (seven of seven) compared to 14% (one of seven) in male interferon
recipients (P less than 0.01). The efficacy of interferon prophylaxis in the
simian varicella model supports its continued evaluation for the management of
human varicella in high-risk patients.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6296238 [PubMed - indexed for MEDLINE]

7807: Clin Exp Pharmacol Physiol. 1983 Jan-Feb;10(1):45-52.

Is Fleming's lysozyme an analgesic agent? Experiments on mice.

Bianchi C.

1. Antinociceptive activity of hen egg white lysozyme (Fleming's lysozyme) was
determined against abdominal contractions provoked by irritants injected
intraperitoneally into mice. Carrageenan (2 mg) (CA) injected with arachidonic
acid (15 micrograms) (AA) or prostaglandins PGE1 or PGF2 alpha (0.04 ng),
brewer's yeast (10 mg), caolin (10 mg), mepartricin (80 U) and phenylquinone (50 
micrograms) were used as irritants. 2. Lysozyme was active at 400-800 mg/kg i.v. 
against CA + AA, CA + PG, brewer's yeast and caolin nociceptive stimulation. The 
compound was more effective against CA + AA than against CA + PG. Acetylsalicylic
acid at 50-100-200 mg/kg p.o. was equally active against CA + AA and CA + PG. 3. 
Lysozyme was inactive in the tail pinch and hot plate tests that mainly detect
central analgesics. 4. The results are discussed in relation to the claim
advanced years ago that lysozyme is an effective analgesic agent in humans. The
compound was found active against herpes zoster or cancer pain but did not find
use despite the favourable reports presented. 5. The experimental results
obtained on laboratory animals do not contradict the conclusions drawn after the 
clinical use of the compound.

PMID: 6220850 [PubMed - indexed for MEDLINE]

7808: Acta Derm Venereol. 1983;63(6):540-3.

Acquired immune deficiency syndrome (AIDS) manifesting as anogenital herpes
zoster eruption: demonstration of virus-like particles in lymphocytes.

Thune P, Andersson T, Skjorten F.

A case of AIDS manifesting as a necrotic, haemorrhagic anogenital herpes zoster
and lymphadenopathy, is described. Investigations of T-lymphocyte subsets showed 
decreased T4 and slight increase of T8. Electronmicroscopy revealed
tubuloreticular virus-like structures in lymphocytes.

Publication Types: 
    Case Reports

PMID: 6198847 [PubMed - indexed for MEDLINE]

7809: Prog Brain Res. 1983;59:97-103.

Interferon in acute and chronic viral infections.

Brigden D, Freestone DS.

Publication Types: 
    Clinical Trial

PMID: 6198685 [PubMed - indexed for MEDLINE]

7810: Lab Delo. 1983;(11):53-6.

[Cytomorphology of the cerebrospinal fluid in nervous system infections studied
with the method of cell sedimentation on slides]

[Article in Russian]

Smirnov IuK, Podgornaia GV, Shishov AS, Aleshina BG.

Publication Types: 
    English Abstract

PMID: 6197582 [PubMed - indexed for MEDLINE]

7811: Ann Dermatol Venereol. 1983;110(6-7):563.

[Generalization of zona in a nonimmunosuppressed patient receiving isoprinosine
and rifamycin SV]

[Article in French]

Revuz J, Guillaume JC, Roujeau JC, Perroud AM.

Publication Types: 
    Case Reports
    Letter

PMID: 6195953 [PubMed - indexed for MEDLINE]

7812: J Med Virol. 1983;12(2):149-53.

Comparative use of adenine arabinoside and adenine arabinoside monophosphate in
varicella and disseminated zoster in immunosuppressed patients.

Vilde JL, Bricaire F, Huchon A, Brun-Vezinet F.

Adenine arabinoside monophosphate (ARA AMP) was used in ten immunosuppressed
patients suffering from varicella or disseminated zoster, and compared to adenine
arabinoside (vidarabine) in ten other similar patients. Good results were
obtained with both drugs: the fever stopped suddenly in three or four days and no
new vesicles were observed after the third day. ARA AMP is more soluble than
vidarabine and is thus easier to handle; it could be an effective treatment of
severe varicella-zoster virus infections in immunosuppressed patients.

Publication Types: 
    Comparative Study

PMID: 6194253 [PubMed - indexed for MEDLINE]

7813: Acta Derm Venereol. 1983;63(2):180-1.

Herpes zoster in a 6-month-old infant.

Helander I, Arstila P, Terho P.

Publication Types: 
    Case Reports

PMID: 6189345 [PubMed - indexed for MEDLINE]

7814: Acta Otolaryngol. 1983 Jan-Feb;95(1-2):69-73.

Interferon anti-viral system in Bell's palsy.

Aviel A, Hahn T, Levin S, Ostfeld E, Bregman V, Marshak G.

Thirty-two consecutive Bell's palsy patients were examined clinically and
virologically. All the patients were assayed for serum interferon (IFN) levels at
onset of the disease and most of them had repeated IFN assays during the course
of the disease. In 15 patients the peripheral blood mononuclear cells (PBMC) were
also evaluated for the presence of an anti-viral state (AVS). In viral
infections, blood IFN levels are invariably increased, and the PBMC are usually
in an AVS. Twenty-three patients (72%) had increased serum IFN values or were in 
an AVS. The mean serum IFN level was 95 U/ml (normal less than or equal to 16
U/ml) during the first 3 days following onset of the disease, declining later to 
normal values from the seventh day onwards. No patient had increased antibody
titers to herpes simplex and varicella-zoster viruses. The increased blood IFN
levels and the AVS of blood cells are compatible with an acute viral infection.
It is concluded that the etiology of Bell's palsy is most likely an acute viral
infection, possibly due to an unidentified or unusual virus, or to reactivation
of a latent virus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6187177 [PubMed - indexed for MEDLINE]

7815: N Engl J Med. 1982 Dec 30;307(27):1706-7.

Cancer and herpes zoster.

Riegelman R.

Publication Types: 
    Letter

PMID: 7144870 [PubMed - indexed for MEDLINE]

7816: Ugeskr Laeger. 1982 Dec 13;144(50):3750-1.

[Gastrointestinal dysfunction in zoster]

[Article in Danish]

Storm TL.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7168070 [PubMed - indexed for MEDLINE]

7817: J La State Med Soc. 1982 Dec;134(9):30-2, 34.

Chronic pain review. A surprising case of "shingles".

Morse RH.

Publication Types: 
    Case Reports

PMID: 7175341 [PubMed - indexed for MEDLINE]

7818: Br J Clin Pract. 1982 Dec;36(11-12):404, 407.

Herpes zoster and electrocardiographic changes.

Bilimoria S, Hutton WN, Keczkes K.

Publication Types: 
    Case Reports

PMID: 7165770 [PubMed - indexed for MEDLINE]

7819: J Hyg (Lond). 1982 Dec;89(3):421-37.

Studies of herpes virus latency in the sensory spinal ganglia of rabbits.

Tosolini FA, McCarthy K, Baker BF.

Experimental latent herpes infection of rabbit dorsal root ganglia (DRG) is
reported. The simian herpes virus used was derived from fatal natural infection
in owl monkeys and has limited neurotropism in the rabbit. Following intradermal 
injection of the flank it causes a local lesion followed only by dorsal root
ganglionitis; segmental paraesthesia and/or sensory loss going on to clinical
recovery. Methods were developed for mapping sensory losses. Virus could be
immediately re-isolated from skin or DRG homogenates in the acute (first week)
stage but from 8-550 days by DRG organ culture only. Spontaneous recurrence does 
not occur but reactivation can be provoked. The system provides an improved
analogue model for the study of the pathogenesis and symptomatic treatment of
herpes zoster.

PMID: 7153508 [PubMed - indexed for MEDLINE]

7820: Ann Allergy. 1982 Dec;49(6):326-9.

Transfer factor.

Massicot JG, Goldstein RA.

A workshop on transfer factor, sponsored by the Immunology, Allergic and
Immunologic Diseases Program of the National Institute of Allergy and Infectious 
Diseases, National Institutes of Health, was held in Bethesda, Maryland, on
February 25, 1981. The purpose of the meeting was two-fold: (1) to review the
state of the art of transfer factor and (2) to suggest future directions for
research in this area, specifically in regard to the prophylactic use of transfer
factor for varicella-zoster in leukemic children.

PMID: 7149349 [PubMed - indexed for MEDLINE]

7821: Int J Oral Surg. 1982 Dec;11(6):364-71.

Tooth exfoliation, osteonecrosis of the jaw and neuralgia following herpes zoster
of the trigeminal nerve.

Schwartz O, Kvorning SA.

Publication Types: 
    Case Reports

PMID: 6820009 [PubMed - indexed for MEDLINE]

7822: Hosp Pract (Off Ed). 1982 Dec;17(12):21.

Postherpetic neuralgia.

Lyles YM.

Publication Types: 
    Letter

PMID: 6815060 [PubMed - indexed for MEDLINE]

7823: Am J Med. 1982 Dec;73(6):795-801.

Herpes zoster in patients with carcinoma of the lung.

Feld R, Evans WK, DeBoer G.

Herpes zoster was observed in only four of 250 (1.6 percent) patients with small 
cell carcinoma of the lung, who were treated in a prospective, combined modality 
therapy trial. Induction chemotherapy in this study consisted of six courses of
cyclophosphamide, doxorubicin, and vincristine (CAV), followed by intrathoracic
and cranial irradiation. Those with extensive disease also received single doses 
of upper half-body irradiation. Patients did not receive maintenance chemotherapy
(CAV2 protocol). This contrasted with our previous study (CAV1 protocol), which
consisted of three courses of the same induction chemotherapy, the same
intrathoracic irradiation, but with one year of oral maintenance chemotherapy.
During the CAV1 regimen, we observed that herpes zoster developed in 13 of 161
(8.1 percent) patients in association with their therapy. A retrospective
analysis of 6,576 patients with lung cancer revealed that herpes zoster developed
in 58 (0.9 percent). This complication developed in 10 of 622 (1.6 percent)
patients with small cell carcinoma of the lung, as compared to 48 of 5,954 (0.8
percent) patients with non-small cell carcinoma of the lung. The risk of
development of herpes zoster in the CAV1 group was significantly greater than the
historical group (p = 0.007) and was also greater than the CAV2 group (p =
0.031). However, there was no significant difference between the historical group
and the CAV2 group. Attempts to explain the differences in the rate of herpes
zoster in our three studies and those in the literature suggest that the duration
of therapy, the type of chemotherapy used, and the improving survival rate may be
important contributing factors to this complication in patients aggressively
treated for small cell carcinoma of the lung. The literature and our own studies 
suggest that procarbazine is the most likely chemotherapeutic agent predisposing 
to this complication.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6293307 [PubMed - indexed for MEDLINE]

7824: Arch Neurol. 1982 Dec;39(12):785.

CNS varicella-zoster vasculitis.

Vilchez-Padilla JJ, Redon J, Ruiz A, Lopez-Aldeguer J.

Publication Types: 
    Case Reports
    Letter

PMID: 6291496 [PubMed - indexed for MEDLINE]

7825: Nouv Presse Med. 1982 Nov 27;11(48):3547-50.

[Adenine arabinoside treatment of varicella and generalized herpes zoster in 43
immunosuppressed patients]

[Article in French]

Vilde JL, Bricaire F, Huchon A, Dournon E, Brun-Vezinet F, Leport C, Bastin R.

Forty-three immunosuppressed patients presenting with varicella or generalized
herpes zoster were treated with adenine arabinoside (as monophosphate in 10
patients). All those who received the recommended 5-day course were rapidly cured
without relapse; the skin lesions were virus-free after the 5th days of
treatment. Five patients with malignant varicella involving several organs and
who had only been treated for a few hours died. It is concluded that adenine
arabinoside is a useful drug in VZ virus infections, although it has no immediate
action. The monophosphate presentation, more soluble and requiring lesser amounts
of solvent, is easier to administer and as effective as the ordinary
presentation.

Publication Types: 
    English Abstract

PMID: 7155866 [PubMed - indexed for MEDLINE]

7826: Z Arztl Fortbild (Jena). 1982 Nov 15;76(22):966-9.

[Epidemiology and clinical problems of herpetic eye diseases (retrospective
analysis)]

[Article in German]

Pietruschka G.

PMID: 6984990 [PubMed - indexed for MEDLINE]

7827: Hosp Employee Health. 1982 Dec;1(12):162-3.

Restricting employees with herpes; who and for how long?

Valenti WM.

PMID: 10257425 [PubMed - indexed for MEDLINE]

7828: Pol Tyg Lek. 1982 Nov 1;37(41-42):1233-5.

[Cytosine arabinoside in the treatment of herpes zoster]

[Article in Polish]

Glab-Kordecka E.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7163071 [PubMed - indexed for MEDLINE]

7829: Klin Monatsbl Augenheilkd. 1982 Nov;181(5):362-3.

[Unusual course of malignant lymphoma]

[Article in German]

Skorpik C, Binder S.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7162084 [PubMed - indexed for MEDLINE]

7830: Hawaii Med J. 1982 Nov;41(11):420-2.

Corticosteroid therapy of zoster: oral vs. sublesional injection.

Epstein E.

Publication Types: 
    Comparative Study

PMID: 7161091 [PubMed - indexed for MEDLINE]

7831: J R Coll Gen Pract. 1982 Nov;32(244):709, 711.

Ultrasound therapy for herpes zoster pain.

Garrett AS, Garrett M.

Publication Types: 
    Letter

PMID: 7153972 [PubMed - indexed for MEDLINE]

7832: Srp Arh Celok Lek. 1982 Nov;110(11):1299-304.

[Neuro-ophthalmologic manifestations in persons with herpes zoster of the visual 
organs]

[Article in Serbian]

Sasic M, Petrovic M, Lesic Lj, Drincic V.

PMID: 6985234 [PubMed - indexed for MEDLINE]

7833: Ophthalmology. 1982 Nov;89(11):1250-3.

Sodium hyaluronate and tissue adhesive in treating corneal perforations.

Hirst LW, De Juan E Jr.

The injection of sodium hyaluronate through perforation sites prior to tissue
adhesive application has extended the current use of this modality to large
perforations and perforations in which intraocular tissue is incarcerated. Three 
clinical cases are described in which the conjoint therapy was used, and four
monkey eyes were studied clinically and histopathologically to test for adverse
drug interactions.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 6984163 [PubMed - indexed for MEDLINE]

7834: Vestn Dermatol Venerol. 1982 Nov;(11):43-5.

[Paraneoplastic lesions of the skin]

[Article in Russian]

Fedorovskaia RF, Rutshtein LG.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6760590 [PubMed - indexed for MEDLINE]

7835: J Clin Microbiol. 1982 Nov;16(5):878-84.

Comparison of the Raji cell line fluorescent antibody to membrane antigen test
and the enzyme-linked immunosorbent assay for determination of immunity to
varicella-zoster virus.

Iltis JP, Castellano GA, Gerber P, Le C, Vujcic LK, Quinnan GV Jr.

A prospective study was performed comparing the fluorescent antibody to membrane 
antigen (FAMA) test and the enzyme-linked immunosorbent assay (ELISA) for
identifying susceptibility and seroconversion to varicella-zoster virus (VZV)
infection. A total of 75 sera were collected from index cases and from sibling
and parent contacts in 10 families. Varicella-zoster virus-infected human diploid
embryonic fibroblasts and continuous lymphoblastoid cells (Raji cells) were
compared as indicator cells in the FAMA test. Equivalent results were obtained
with both types of cell. Results of the FAMA test and the ELISA were identical in
two ways. (i) The same 11 individuals were initally defined as susceptible
(seronegative), and 9 of them (82%) developed fourfold rises in antibody titers, 
clinical varicella, or both. (ii) Of 21 immune (seropositive) individuals, 4
developed fourfold antibody rises by FAMA tests, and 3 of these 4 responded by
ELISA. Infection was asymptomatic in these individuals. The geometric mean titer 
by ELISA was significantly higher than by the FAMA test. The results indicated
that the ELISA and the FAMA test have similar capacities to define susceptibility
to varicella-zoster virus and that subclinical infection with varicella-zoster
virus may be common.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 6759530 [PubMed - indexed for MEDLINE]

7836: Laryngol Rhinol Otol (Stuttg). 1982 Nov;61(11):644-7.

[Antibodies against viruses of the herpes group in cerebrospinal fluid in
idiopathic facial paralysis. Enzyme immuno-serologic studies]

[Article in German]

Mees K, Wolf H.

In a prospective study, paired CSF samples and sera of 12 patients suffering from
Bell's palsy were examined for IgG and IgM antibodies against Herpes simplex
virus (HSV), Varicella-zoster virus (VZV) and Cytomegalovirus (CMV). For
determination of antibodies an enzyme-linked immunosorbent assay was carried out.
CSF- and serum samples were taken within one week after Bell's palsy had been
diagnosed and were compared with further CSF- and serum samples taken 2 weeks
later. The results are discussed.

Publication Types: 
    English Abstract

PMID: 6757615 [PubMed - indexed for MEDLINE]

7837: Thorax. 1982 Nov;37(11):870-1.

Hemidiaphragmatic paresis after cervical herpes zoster.

Derveaux L, Lacquet LM.

Publication Types: 
    Case Reports

PMID: 6298966 [PubMed - indexed for MEDLINE]

7838: J Neurol Sci. 1982 Nov-Dec;57(1):121-32.

Intrathecal synthesis of virus-specific oligoclonal IgG, IgA and IgM antibodies
in a case of varicella-zoster meningoencephalitis.

Vartdal F, Vandvik B, Norrby E.

Varicella-zoster (VZ) virus meningoencephalitis was diagnosed in a 72-year-old
man without other clinical signs of VZ infection, on the basis of intrathecal
virus-specific IgG, IgA and IgM antibody responses demonstrated by imprint
immunofixation (IIF) and by serological analyses of serum and CSF. The
intrathecally produced antibodies displayed oligoclonal characteristics. The
intrathecal production of VZ-IgG and -IgA antibodies persisted throughout the
observation period of 20 months, while that of VZ-IgM antibodies was not
detectable later than 3 months after onset. Part of the intrathecally produced
VZ-IgG and -IgA antibody populations, but no IgM antibodies, were shown to
cross-react with herpes simplex virus. Oligoclonal IgG bands were demonstrated in
the CSF throughout the observation period. The bulk of the IgG bands was shown to
represent VZ-specific antibodies.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 6296323 [PubMed - indexed for MEDLINE]

7839: J Virol Methods. 1982 Nov;5(3-4):229-41.

Improved yields and assay of simian varicella virus, and a comparison of certain 
biological properties of simian and human varicella viruses.

Schmidt NJ.

Studies were performed to define conditions under which propagation, assay and
stabilization of the Delta herpesvirus (DHV) strain of simian varicella virus
might be improved, and to compare biological properties of DHV with those of
human varicella zoster virus (VZV). A mycoplasma contaminant was successfully
eliminated from the DHV seed virus by treatment with a specific anti-serum. DHV
was found to replicate more efficiently in the BS-C-1 line of African green
monkey kidney cells than in Vero cells, and seed virus preparations in the form
of virus-infected cells were produced which had infectivity titers greater than
or equal to 1 X 10(6) p.f.u./ml. Greater yields of virus were produced in
cultures infected as dispersed cells than as preformed monolayers. Infectious DHV
could be released from host cells by sonic treatment of heavily infected cultures
at 48 h post infection. Certain agents reported to enhance replication of herpes 
viruses (caffeine, carbaryl, the tumor promoter
12-0-tetra-decanoyl-phorbol-13-acetate, and DEAE-dextran) had no enhancing effect
on replication of DHV. However, DEAE-dextran in the maintenance medium enhanced
spontaneous release of DHV into culture fluids. Plaquing efficiency and plaque
size of DHV were greater in BS-C-1 than in Vero cells, and plaque assays and
plaque reduction neutralization tests were developed in this cell system using a 
solid overlay medium with neutral red vital stain. Neutralization of DHV was
markedly enhanced by fresh guinea pig complement. The newly developed
neutralization test demonstrated more vigorous antibody responses to DHV in
active and latent VZV infections than were demonstrated with previous procedures.
In addition to their preferential growth in monkey and human cells respectively, 
DHV and VZV were found to differ markedly in their rates of attachment to host
cells, with DHV requiring over 6 h of adsorption, while VZV adsorption was
essentially complete at 1 h. Also, cell-free DHV was much more resistant than
cell-free VZV to repeated cycles of freezing and thawing.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 6296181 [PubMed - indexed for MEDLINE]

7840: J Virol Methods. 1982 Nov;5(3-4):219-27.

Frequency and specificity of varicella zoster virus IgM response.

Sundqvist VA.

A direct ELISA was developed for determination of IgM antibody to varicella
zoster virus (VZV). With this sensitive method VZV IgM antibodies were detected
in all patients with a varicella and in 84% with a herpes zoster infection. All
but one of 28 renal allograft recipients had previously had varicella. A primary 
infection was seen in the last patient, and reactivated infections in 11 of the
others. The VZV IgM response seems to be specific since patients with a herpes
simplex virus (HSV) infection and a heterotypic VZV IgG titer rise did not have
detectable VZV IgM. An indirect enzyme-linked immunosorbent assay (ELISA) for
detection of IgG antibodies has been used for serodiagnosis of VZV infections and
to determine the immune status. After injection of zoster immune globulin, it was
possible to measure passively transferred antibodies.

PMID: 6296180 [PubMed - indexed for MEDLINE]

7841: Am J Med. 1982 Nov;73(5):769-72.

Zoster encephalitis. Isolation of virus and measurement of
varicella-zoster-specific antibodies in cerebrospinal fluid.

Andiman WA, White-Greenwald M, Tinghitella T.

Varicella-zoster virus (VZV) was isolated on two occasions from the cerebrospinal
fluid of an elderly woman with encephalomyelitis complicating thoracic zoster.
Antibodies to ZV-induced membrane antigen (FAMA) were present in cerebrospinal
fluid in a titer of 1:64; serum antibodies were 64-fold higher. Further evidence 
for local antibody production was derived from simultaneous measurements of
immunoglobulin G and albumin in cerebrospinal fluid and serum and calculation of 
a cerebrospinal fluid-IgG index.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 6291390 [PubMed - indexed for MEDLINE]

7842: Am J Med. 1982 Nov;73(5):679-87.

Specific cell-mediated immunity and infections with herpes viruses in cardiac
transplant recipients.

Pollard RB, Arvin AM, Gamberg P, Rand KH, Gallagher JG, Merigan TC.

Immune responses and infections with herpes viruses were studied prospectively in
36 cardiac transplant recipients. Specific lymphocyte transformation and
interferon production in response to viral antigens, viral culture results,
antibody levels, responses to phytohemagglutinin, and T-cell numbers were
determined. Responses to phytohemagglutinin and T-cell numbers were depressed for
six to 12 weeks. Cytomegalovirus infection occurred in 100 percent of
seropositive patients and in 62 percent of seronegative patients. Primary
infection was more frequently symptomatic. Heart implantation from a seropositive
patient wwas significantly correlated with subsequent infection in seronegative
patients. Depression of transformation in response to cytomegalovirus correlated 
with prolonged shedding. Herpes simplex infection occurred in 95 percent of
seropositive patients but decreased after 12 weeks. Asymptomatic shedding was
rare, and primary infection did not occur. Return of transformation in response
to herpes simplex was associated with decreased infection. Herpes zoster occurred
in 22 percent during the first year, and transformation responses to
varicella-zoster returned thereafter. Depression of interferon production in
response to viruses did not correlate with infection as well as did lymphocyte
transformation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6291387 [PubMed - indexed for MEDLINE]

7843: ZFA (Stuttgart). 1982 Oct 31;58(30):1679-80.

[A new type of treatment for herpes zoster]

[Article in German]

Wachter K.

Publication Types: 
    Case Reports

PMID: 7157955 [PubMed - indexed for MEDLINE]

7844: Br Med J (Clin Res Ed). 1982 Oct 30;285(6350):1223-4.

Acyclovir.

Timbury MC.

Publication Types: 
    Editorial

PMID: 6289962 [PubMed - indexed for MEDLINE]

7845: Lancet. 1982 Oct 16;2(8303):884.

Subsequent risk of rheumatoid arthritis in patients diagnosed with herpes zoster.

Ragozzino MW, Kurland LT.

Publication Types: 
    Letter
    Research Support, U.S. Gov't, P.H.S.

PMID: 6126748 [PubMed - indexed for MEDLINE]

7846: N Engl J Med. 1982 Oct 14;307(16):971-5.

Early vidarabine therapy to control the complications of herpes zoster in
immunosuppressed patients.

Whitley RJ, Soong SJ, Dolin R, Betts R, Linnemann C Jr, Alford CA Jr.

We conducted a double-blind, placebo-controlled trial to assess the value of
vidarabine therapy for the prevention of complications from herpes zoster in
immunocompromised patients. Of 121 patients with localized herpes zoster of 72
hours duration or less, 63 received vidarabine and 58 received the placebo.
Populations were matched for pertinent characteristics. Therapy accelerated
cutaneous healing and decreased the rates of cutaneous dissemination (from 24 per
cent [14 patients] to 8 per cent [5 patients]) (P = 0.014); and of zoster-related
visceral complications (from 19 per cent [11 patients] to 5 per cent [3
patients]) (P = 0.015). therapy also decreased the total duration of
post-herpetic neuralgia (P = 0.047). Patients with lymphoproliferative cancers
and those 38 years of age or older were at greatest risk for complications and
benefited most from therapy. There was no serious drug toxicity. We conclude that
vidarabine therapy, when started within the first three days, is valuable for the
reduction of complications related to herpes zoster.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7110300 [PubMed - indexed for MEDLINE]

7847: Br Med J (Clin Res Ed). 1982 Oct 9;285(6347):1022-3.

Outbreak of chickenpox from a patient with immunosuppressed herpes zoster in
hospital.

Faizallah R, Green HT, Krasner N, Walker RJ.

PMID: 6812728 [PubMed - indexed for MEDLINE]

7848: Vet Rec. 1982 Oct 2;111(14):330.

Canine 'shingles'.

Gravestock JD.

Publication Types: 
    Case Reports
    Letter

PMID: 7147650 [PubMed - indexed for MEDLINE]

7849: Lancet. 1982 Oct 2;2(8301):763-4.

Vasculitis in association with chickenpox treatment in childhood acute
lymphoblastic leukemia.

Platt MP, Eden OB.

Publication Types: 
    Case Reports
    Letter

PMID: 6125827 [PubMed - indexed for MEDLINE]

7850: Laryngoscope. 1982 Oct;92(10 Pt 1):1160-3.

Laryngeal papillomatosis: recurrence after 33-year remission.

Bergstrom L.

After repeated laryngeal papilloma excisions, a 4-year-old Caucasian male became 
symptom-free. Benign squamous papilloma recurred in the larynx and trachea at age
37 after a gunshot wound, prolonged nasogastric intubation, several laparotomies,
endotracheal anesthesias, and massive weight loss. This case and others in the
literature suggest that current therapy produces prolonged remission, not "cure."
Its course reinforces accumulating evidence for the existence of human papilloma 
viruses (HPV) whose DNA apparently becomes incorporated into host laryngeal cell 
DNA, supporting an hypothesis that HPV remains in normal-appearing epithelium
adjacent to papilloma. Like herpes zoster varicella virus, HPV may lie dormant
until reactivated by host immunosuppression, trauma, malnutrition or sepsis,
features also present in the patient described. Repeated intubation probably
injured and destroyed cells, releasing viral material. Papilloma patients in
remission probably should be warned of factors, including intubation for elective
surgery, which could induce recurrence.

Publication Types: 
    Case Reports

PMID: 7132518 [PubMed - indexed for MEDLINE]

7851: Postgrad Med. 1982 Oct;72(4):195-203, 206-7.

Viral skin infections: challenges in differential diagnosis and therapy.

Millikan LE.

PMID: 7122352 [PubMed - indexed for MEDLINE]

7852: Klin Monatsbl Augenheilkd. 1982 Oct;181(4):261-2.

[Further indications for corneal incision]

[Article in German]

Nagy Z.

The results of operations for disjunctio epithelialis corneae following recurrent
keratitis herpetica and injury are reported. The operation is indicated in every 
chronic or recurrent corneal disease where circumstances do not allow
keratoplasty to be carried out; the pain can be alleviated by incisio corneae.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6982999 [PubMed - indexed for MEDLINE]

7853: Cancer Nurs. 1982 Oct;5(5):361-70.

Herpes zoster in the immunocompromised patient.

Couillard-Getreuer DL.

PMID: 6923771 [PubMed - indexed for MEDLINE]

7854: Ir J Med Sci. 1982 Oct;151(10):318-9.

Pseudo obstruction of the colon associated with varicella-zoster infection.

Walsh TN, Lane D.

Publication Types: 
    Case Reports

PMID: 6897397 [PubMed - indexed for MEDLINE]

7855: J Am Optom Assoc. 1982 Oct;53(10):813-4.

Herpes zoster dendritic keratitis.

Jones WL.

Publication Types: 
    Case Reports

PMID: 6815255 [PubMed - indexed for MEDLINE]

7856: Hosp Pract (Off Ed). 1982 Oct;17(10):166, 171, 174 passim.

Shingles, dyspnea, and wild irrational behavior.

Kandel G, Aberman A.

Publication Types: 
    Case Reports

PMID: 6811401 [PubMed - indexed for MEDLINE]

7857: Blood. 1982 Oct;60(4):877-87.

Nonrandom chromosome abnormalities in angioimmunoblastic lymphadenopathy.

Kaneko Y, Larson RA, Variakojis D, Haren JM, Rowley JD.

Cytogenetic and pathologic studies were performed on six patients with
angioimmunoblastic lymphadenopathy (AILD). All six had diffuse lymphadenopathy;
five had fever, four had weight loss, and four had a diffuse erythematous rash.
All patients except one had a polyclonal elevation of immunoglobulin. All
patients had diagnostic findings in lymph node (LN) and bone marrow (BM)
biopsies. Two patients died of progressive AILD; one patient died after
transformation of AILC to immunoblastic sarcoma (IBS); one patient died of
gastrointestinal bleeding of unknown cause. The remaining two patients, who have 
achieved complete remission with intensive chemotherapy, are alive 20 and 8 mo
after the diagnosis; one of these had AILD and the other, both AILD and IBS.
Despite diagnostic BM biopsy findings, none of the patients had chromosome
abnormalities in their BM cells. In studying LN cels of 5 patients, however, we
found chromosome abnormalities in each; clonal abnormalities were detected in
two, both clonal and nonclonal abnormalities in two, and only nonclonal
single-cell abnormalities in one. An extra chromosome 3, seen in four patients,
was clonal in two and nonclonal in the two others. Cells with +5, +15, +19, +21, 
+22 were seen in two patients. All patients had 50% or more normal dividing cells
in their LN. The mosaicism of unrelated abnormal cells in their LN. The mosaicism
of unrelated abnormal karyotypes that was seen in four patients suggests that
this malignant tumor is not necessarily monoclonal in its early stages, but that 
one clone may be selected and predominate in the late stage. Because nonrandom
acquired clonal chromosome abnormalities are a consistent feature of
malignancies, our data suggest that AILD may be a malignant disease despite its
original description as a benign proliferative process. Therefore, it may require
aggressive chemotherapy.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 6180784 [PubMed - indexed for MEDLINE]

7858: Medicine (Baltimore). 1982 Sep;61(5):310-6.

Population-based study of herpes zoster and its sequelae.

Ragozzino MW, Melton LJ 3rd, Kurland LT, Chu CP, Perry HO.

The epidemiology of herpes zoster and its sequelae have been investigated in a
community-based study. The incidence rates observed in Rochester, Minnesota, are 
lower than those determined in practice-based series; and this may reflect some
selectivity in practice-based series compared to population-based studies. No
significant sex difference or seasonal variation was observed but the incidence
did increase markedly with age. An increase in incidence was also observed over
the 15-year period studied. The dermatomal distribution of herpes zoster observed
in Rochester was quite similar to previous studies, despite their inherent biases
in case ascertainment, except for a lower proportion with cranial nerve zoster.
Herpes ophthalmicus (V1) appears to affect a slightly different population than
zoster of the other dermatomes, with elderly males being more at risk. Also,
herpes ophthalmicus is associated with a higher complication rate compared to the
other dermatomes primarily due to the fragility of the involved organ. The
elderly are also at greatest risk for the most common complication, post-herpetic
neuralgia. The rate of PHN is not significantly increased in any particular
dermatome but is significantly decreased in lumbar herpes zoster.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6981045 [PubMed - indexed for MEDLINE]

7859: Hosp Pract (Off Ed). 1982 Sep;17(9):96A-96O.

Herpes zoster and postherpetic neuralgia.

Stein JM, Warfield CA.

PMID: 6809590 [PubMed - indexed for MEDLINE]

7860: Med Clin North Am. 1982 Sep;66(5):1105-18.

Herpes zoster: an approach to systemic therapy.

Price RW.

Publication Types: 
    Review

PMID: 6752600 [PubMed - indexed for MEDLINE]

7861: Biken J. 1982 Sep;25(3):149-56.

Deoxythymidine kinases in varicella-zoster virus infected and biochemically
transformed cells.

Ogino T, Lopetegui P, Yamanishi K.

Deoxythymidine kinase (TK) activity induced in varicella-zoster virus
(VZV)-infected human embryonic fibroblast (HEF) cells was immunologically
distinguishable from that in non infected HEF cells and also from that in herpes 
simplex virus type 1 (HSV-1) infected HEF cells. The TKs in VZV-biochemically
transformed cells were immunologically the same as that induced in VZV-infected
human cells and immunologically different from that in Ltk- cells or in
HSV-biochemically transformed cells. One peak of TK activity with an Rm value of 
0.8-0.9, corresponding to mitochondrial TK, was observed on polyacrylamide gel
electrophoresis of Ltk- cell extracts. VZV infected Ltk- cells had two peaks of
TK activity with Rm values of 0.45-0.5 (peak I) and 0.8-0.9 (peak II). Peak I and
II were concluded to be virus-specific TK and mitochondrial TK, respectively.
VZV-biochemically transformed cells had a peak of activity with an Rm value of
0.4-0.5, corresponding to peak I in VZV-infected Ltk- cells; that is VZV-specific
TK activity. The present study indicates that VZV has a gene coding for its own
TK.

PMID: 6299267 [PubMed - indexed for MEDLINE]

7862: Pediatr Infect Dis. 1982 Sep-Oct;1(5):304-7.

Interview with Philip A. Brunell: contagion and varicella-zoster virus.

Brunell PA.

PMID: 6296801 [PubMed - indexed for MEDLINE]

7863: Ther Umsch. 1982 Sep;39(9):675-82.

[Herpesvirus infections in immunosuppressed patients]

[Article in German]

Stalder H.

Publication Types: 
    English Abstract

PMID: 6294896 [PubMed - indexed for MEDLINE]

7864: J Infect Dis. 1982 Sep;146(3):443.

Serum amyloid A levels in patients with infections due to cytomegalovirus,
varicella-zoster virus, and herpes simplex virus.

Sarov I, Shainkin-Kestenbaum R, Zimlichman S, Winikoff Y, Chaimovitz C, Pras M.

Publication Types: 
    Comparative Study

PMID: 6286800 [PubMed - indexed for MEDLINE]

7865: Geriatrics. 1982 Sep;37(9):107-13.

The ten major problems of aging skin.

Shelley WB, Shelley ED.

PMID: 6213448 [PubMed - indexed for MEDLINE]

7866: Blood. 1982 Sep;60(3):714-20.

Analysis of late infections after human bone marrow transplantation: role of
genotypic nonidentity between marrow donor and recipient and of nonspecific
suppressor cells in patients with chronic graft-versus-host disease.

Atkinson K, Farewell V, Storb R, Tsoi MS, Sullivan KM, Witherspoon RP, Fefer A,
Clift R, Goodell B, Thomas ED.

Infections occurring 6 mo or later after bone marrow transplantation for severe
aplastic anemia or hematologic malignancy were analyzed in 98 long-term
survivors. Varicella-zoster (VZ) infections were analyzed separately from all
other infections. The factor predisposing most strongly to late VZ infection was 
genotypic nonidentity for HLA between marrow donor and recipient. There was a
suggestion that chronic graft-versus-host disease (GVHD) associated with the
presence of nonspecific suppressor cells also predisposed to late VZ infection,
while age less than 10 yr was protective against such infections. Chronic GVHD
predisposed to late non-VZ infections, but this was not increased by the presence
of nonspecific suppressor cells. HLA nonidentify between patient and marrow donor
further increased the risk of late non-VZ infections over and above that due to
the presence of chronic GVHD. Receipt of a syngeneic transplant appeared
protective for late non-VZ infections. These findings suggest that full genotypic
identity for HLA between donor and recipient may be required for optimal immune
reconstitution after marrow transplantation and may denote a possible biologic
role for nonspecific suppressor T cells in humans.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6213276 [PubMed - indexed for MEDLINE]

7867: Jpn J Antibiot. 1982 Sep;35(9):2241-8.

[Cyclocytidine therapy for the herpes-group virus infection in children. A
preliminary study]

[Article in Japanese]

Meguro H, Araki K, Fujii R, Yonezawa H, Togo T, Hashira S.

Cyclocytidine (Cyclo-C) was evaluated as an antiviral chemotherapeutic agent in
10 children with herpes-group virus infections. The diagnoses of the patients
were severe cytomegalovirus (CMV) syndrome with pneumonitis in acute leukemia
(2), congenital or infantile CMV infections (3), herpes zoster encephalitis in
acute leukemia (1), severe nosocomial varicella in compromised patients (2),
varicella pneumonia (1) and acute encephalitis due to herpes simplex type-1 (1). 
Cyclo-C was effective in all the cases with acute infections, although it had no 
benefit on the course of chronic CMV infection with irreversible damages.
However, complete or transient ceasing of viral shedding was obtained in all the 
5 cases with CMV infections. From the present small open study, further
evaluation of Cyclo-C as an antiviral agent especially in acute CMV infections is
warranted.

Publication Types: 
    English Abstract

PMID: 6183467 [PubMed - indexed for MEDLINE]

7868: S Afr Med J. 1982 Aug 21;62(9):274-5.

Treatment of post-herpetic neuralgia and acute herpetic pain with amitriptyline
and perphenazine.

Weis O, Sriwatanakul K, Weintraub M.

A fixed-ratio combination of amitriptyline and perphenazine was successful in
treating 8 of 9 patients suffering from post-herpetic neuralgia. Side-effects
were minimal. Summaries of 4 case histories are presented. In addition, 3
patients suffering from severe acute herpetic pain were successfully treated with
the same drug combination.

Publication Types: 
    Case Reports

PMID: 7112329 [PubMed - indexed for MEDLINE]

7869: N Engl J Med. 1982 Aug 12;307(7):393-7.

Risk of cancer after herpes zoster: a population-based study.

Ragozzino MW, Melton LJ 3rd, Kurland LT, Chu CP, Perry HO.

Herpes zoster has been associated with immune suppression, as has an increased
risk of cancer. To determine whether patients with herpes zoster are at increased
risk for subsequent cancer, we followed 590 residents of Rochester, Minnesota,
for 9389 person-years after the diagnosis of herpes zoster. Subsequent relative
cancer risks, overall and by specific site, were determined for the entire cohort
and selected subgroups. In addition, relative risks of cancer during various
intervals after the diagnosis of herpes zoster were determined. The overall
relative risk was 1.1 (95 per cent confidence interval, 0.9 to 1.3). Relative
risks of specific cancer sites were not different from unity except for those for
colon and bladder tumors in women, both of which were slightly elevated. Patients
with disseminated, recurrent, or gangrenous zoster, with postherpetic neuralgia, 
and with ophthalmic zoster wee not at elevated risk for subsequent cancer. These 
findings do not support the investigation of patients for occult cancer at the
time of diagnosis of herpes zoster or enhanced surveillance for cancer after such
a diagnosis.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6979711 [PubMed - indexed for MEDLINE]

7870: N Engl J Med. 1982 Aug 5;307(6):348-51.

Current concepts in neurology: diagnosis and management of facial paralysis.

Adour KK.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7088100 [PubMed - indexed for MEDLINE]

7871: Ugeskr Laeger. 1982 Aug;144(34):2496-7.

[Herpes zoster with paresis]

[Article in Danish]

Boesen F, Christensen JD.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7179525 [PubMed - indexed for MEDLINE]

7872: Neurology. 1982 Aug;32(8):914-6.

Hemispheric infarction after herpes zoster ophthalmicus.

[No authors listed]

Publication Types: 
    Case Reports
    Letter

PMID: 6980380 [PubMed - indexed for MEDLINE]

7873: Am J Reprod Immunol. 1982 Aug;2(4):217-21.

Epstein-Barr virus in normal pregnant women.

Sakamoto K, Greally J, Gilfillan RF, Sexton J, Barnabei V, Yetz J, Bechtold T,
Seeley JK, O'Dwyer E, Purtilo DT.

Acquired immune suppression accompanying normal pregnancy may be associated with 
reactivation of Epstein-Barr virus (EBV). Pregnant women with reactivated EBV
having anti-EA antibodies show high titers of antiviral capsid antigen (VCA)
geometric mean titers (GMT) of 522 versus 170 in those lacking anti-early antigen
(EA). Among twenty-seven seropositive women at parturition, 17 (63%) had
generated antibody to EA, and all 27 (100%) demonstrated significant increases in
antibody to VCA (p less than 0.01). In contrast, antibody titers to
cytomegalovirus, herpes hominis, varicella-zoster, and rubella viruses in the
pregnant women were comparable to those found in nonpregnant controls. (Am J
Reprod Immunol. 1982; 2:217-221.)

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6291416 [PubMed - indexed for MEDLINE]

7874: J Gen Virol. 1982 Aug;61 (Pt 2):255-69.

Polypeptides of varicella-zoster virus (VZV) and immunological relationship of
VZV and herpes simplex virus (HSV).

Shiraki K, Okuno T, Yamanishi K, Takahashi M.

Varicella-zoster virus (VZV), labelled with [35S]methionine or [14C]glucosamine, 
was purified by centrifugation through sucrose gradients followed by equilibrium 
centrifugation in CsCl, and analysed by SDS-polyacrylamide gel electrophoresis
(SDS-PAGE). At least 32 polypeptides ranging in mol. wt. from approx. 280 X 10(3)
to 21.5 X 10(3) (280K to 21.5K) and six glycopeptides ranging in mol. wt. from
approx. 115K to 45K (gp1 to gp6) were found in the virion. The immunological
relationship of VZV and herpes simplex virus (HSV) was investigated. In
neutralization (NT) tests, no cross-neutralization was observed between VZV and
HSV-1 or -2. In fluorescent antibody staining, however, a cross-reaction was
observed between VZV- and HSV-1-infected human embryonic lung (HEL) cells and
heterologous antiserum. When cross-reactions were investigated by
immunoprecipitation followed by SDS-PAGE, several cross-reacting polypeptides
were discovered. Cross-reacting glycopeptides of 64K (gp3) and 55K (gp5) were
isolated from VZV-infected cell lysates by affinity column chromatography to
immobilized HSV-1 antibodies.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't

PMID: 6288857 [PubMed - indexed for MEDLINE]

7875: J Clin Microbiol. 1982 Aug;16(2):373-6.

Evaluation of the anticomplement immunofluorescence test for detection of
antibody to varicella-zoster virus.

Preissner CM, Steinberg SP, Gershon AA, Smith TF.

The anticomplement immunofluorescence (ACIF) test was compared with complement
fixation and fluorescent antibody to membrane antigen procedures for the
detection of antibody to varicella-zoster virus. All of 50 sera from pregnant
women contained antibody measured by ACIF (titer, greater than or equal to 1:10);
only 27 (54%) were positive by complement fixation (P less than 0.01). For 16
paired sera obtained before and after varicella-zoster virus infection and tested
by ACIF and fluorescent antibody to membrane antigen, the result agreed in 27
determinations (sensitivity, 94%; specificity, 81%). Of 99 sera submitted for
routine determinations of immune status to the virus, 89 showed comparable
results for both tests (sensitivity, 92.5%; specificity, 88%). The ACIF test
offers a specific and sensitive alternative to the fluorescent antibody to
membrane antigen procedure for the detection of antibody to varicella-zoster
virus. In addition, the ACIF test is rapid, easy to perform, and uses
commercially available reagents.

Publication Types: 
    Comparative Study

PMID: 6288766 [PubMed - indexed for MEDLINE]

7876: Infect Immun. 1982 Aug;37(2):407-12.

Experimental infection and immune response of guinea pigs with varicella-zoster
virus.

Matsunaga Y, Yamanishi K, Takahashi M.

An immune response (fluorescent antibody to membrane antigen) was detected in
guinea pigs inoculated with varicella-zoster virus (VZV) adapted to guinea pig
embryonic cells, including the Oka vaccine strain, even when inoculation was by
an external route, i.e., nasal or corneal. Live or UV-inactivated virus having
the same virus titer before irradiation was administered to guinea pigs by the
corneal route, and antibody induction was detected only with live virus. The
transmission of VZV from infected guinea pigs to noninfected ones was suggested
by the appearance of antibody in the serum of the latter, who were kept in the
same cage. The time course of the appearance of humoral and cellular immune
responses in guinea pigs was examined by the fluorescent antibody to membrane
antigen test and the skin reaction, with varicella antigen representing
delayed-type hypersensitivity. When VZV was injected subcutaneously, skin
reaction appeared as early as 4 days after inoculation, which preceded the
appearance of detectable antibody by 2 to 6 days. In in vitro studies, the Oka
vaccine showed a higher adsorption rate and better growth in guinea pig embryonic
cells than did other wild-type strains when assayed by the infectious center
assay. These results suggest that a system of VZV adapted to guinea pig cells and
guinea pigs provides a good animal experimental model for immunological study of 
VZV infection.

PMID: 6288560 [PubMed - indexed for MEDLINE]

7877: Scand J Haematol. 1982 Aug;29(2):168-74.

Interferon production, cellular and humoral immunity in splenectomized patients.

Lanng Nielsen J, Haahr S.

Undetectable levels of circulating interferon were found in 35 splenectomized
patients and in 14 controls. In addition, no differences in virus, purified
protein derivative (PPD), and phytohaemagglutinin (PHA) induced interferon
production were observed between the patients and the controls. Virus induced
lymphocyte transformation tended to be reduced after splenectomy, but only the
herpes simplex virus (HSV) induced transformation index was significantly reduced
in splenectomized patients without residual splenic tissue (P less than 0.05). In
contrast, the PHA lymphocyte transformation was unchanged in patients and
controls. The number of natural viral antibodies in splenectomized patients did
not differ from that of controls. Furthermore, there were no major differences in
the magnitude of the titers of the sero-positive cases between the various
groups. Thus, splenectomy does not interfere with interferon production in vitro,
and as seen from natural viral antibodies, no impairment of humoral immunity was 
observed. The reduced HSV lymphocyte transformation may indicate an impaired
lymphocyte function after splenectomy.

PMID: 6182609 [PubMed - indexed for MEDLINE]

7878: Am J Med. 1982 Jul 20;73(1A):320-5.

Therapy of acute herpes zoster with acyclovir in the nonimmunocompromised host.

Esmann V, Ipsen J, Peterslund NA, Seyer-Hansen K, Schonheyder H, Juhl H.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 7102712 [PubMed - indexed for MEDLINE]

7879: Am J Med. 1982 Jul 20;73(1A):286-9.

Use of acyclovir in herpetic ocular infection.

McGill J, Tormey P.

Acyclovir has veen shown to have potent antiviral activity against both herpes
simplex and herpes zoster viruses, especially the former, with low cellular
toxicity, preferentially affecting virally infective cells by inhibiting viral
DNA synthesis [1,2]. In experimental herpes simplex corneal infection, acyclovir 
has been found to be effective [3,4] and in early clinical trials it has been
found to be at least as good as idoxuridine [5-7]. Acyclovir has also been found 
to have antiviral activity against the herpes zoster virus in tissue culture [1] 
and to affect favorably the course of the disease in immunosuppressed patients
[8]. This paper describes the use of acyclovir in patients with either herpes
simplex or herpes zoster ocular infections. Topical acyclovir has been compared
with adenine arabinoside in the treatment of herpes simplex corneal ulceration in
a coded clinical trial. The use of acyclovir will also be described in patients
with complicated herpes simplex eye disease. Our initial results with topical
acyclovir in herpes zoster keratouveitis are also described.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 7102708 [PubMed - indexed for MEDLINE]

7880: Am J Med. 1982 Jul 20;73(1A):271-4.

Acyclovir in severe herpes virus infections.

van der Meer JW, Versteeg J.

Forty-five patients with severe herpes virus infections were treated with
acyclovir intravenously for five days. Nine patients had varicella (eight of whom
were immuno- or myelocompromised), 23 had herpes zoster (14 compromised patients)
and 13 had herpes simplex (nine compromised patients). No patient died from the
viral infection and in eight of the patients the beneficial effect of acyclovir
was beyond doubt. Six of these patients had herpes simplex infections. In 21
patients acyclovir was probably beneficial, whereas in 16 patients the effect was
doubtful or absent. As expected, in patients with established neurologic damage
there was no effect. Except for transient elevation in transaminases in one
patient and occasional infusion thrombophlebitis, no toxicity of acyclovir was
encountered in this series.

PMID: 7102706 [PubMed - indexed for MEDLINE]

7881: Am J Med. 1982 Jul 20;73(1A):165-71.

Pharmacokinetics of acyclovir in humans following intravenous administration. A
model for the development of parenteral antivirals.

Whitley RJ, Blum MR, Barton N, de Miranda P.

Data are reported from three step-wise pharmacokinetic studies in 43 patients who
received acyclovir. Dosage regimens began at 0.5 mg/kg administered as a single
dose intravenously and were increased to 15 mg/kg per dose given three times
daily for five days. All patients evaluated were immunocompromised by underlying 
disease or received cytolytic and/or cytotoxic therapy. Patients with
virologically confirmed herpes simplex or zoster infections were assessed in the 
multiday, multidose pharmacokinetic trial. Postinfusion plasma concentrations of 
acyclovir declined in a biphasic manner such that the plasma-concentration time
data were fitted by a two-compartment, open-model with zero-order input. The
drug's half-life showed little variation with a mean of 3.16 +/- 0.20 hours. In
both single-dose and multiple-dose studies there was dose proportionality with
peak plasma levels and area under the plasma concentration-time curve indicating 
dose-independent pharmacokinetics. The kidney was the principal route of drug
clearance with a mean recovery of 60 +/- 12 percent. Renal clearance exceeded
creatinine clearance indicating renal tubular secretion of drug. No significant
clinical or laboratory evidence of toxicity appeared. These studies provide a
foundation for the evaluation of acyclovir in controlled trials.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 7102700 [PubMed - indexed for MEDLINE]

7882: Am J Med. 1982 Jul 20;73(1A):7-13.

Mechanism of action and selectivity of acyclovir.

Elion GB.

Acyclovir, an acrylic purine nucleoside analog, is a highly potent inhibitor of
herpes simplex virus (HSV), types 1 and 2, and varicella zoster virus, and has
extremely low toxicity for the normal host cells. This selectivity is due to the 
ability of these viruses to code for a viral thymidine kinase capable of
phosphorylating acyclovir to a monophosphate; this capability is essentially
absent in uninfected cells. The acyclovir monophosphate (acyclo-GMP) is
subsequently converted to acyclovir triphosphate (acyclo-GTP) by cellular
enzymes. Acyclo-GTP persists in HSV-infected cells for many hours after acyclovir
is removed from the medium. The amounts of acyclo-GTP formed in HSV-infected
cells are 40 to 100 times greater than in uninfected Vero cells. Acyclo-GTP acts 
as a more potent inhibitor of the viral DNA polymerases than of the cellular
polymerases. The DNA polymerases of HSV-1 and HSV-2 also use acyclo-GTP as a
substrate and incorporate acyclo-GMP into the DNA primer-template to a much
greater extent than do the cellular enzymes. The viral DNA polymerase binds
strongly to the acyclo-GMP-terminated template, and in thereby inactivated.

Publication Types: 
    Review

PMID: 6285736 [PubMed - indexed for MEDLINE]

7883: Am J Med. 1982 Jul 20;73(1A):383-6.

Selection and preliminary characterization of acyclovir-resistant mutants of
varicella zoster virus.

Biron KK, Fyfe JA, Noblin JE, Elion GB.

A series of acyclovir-resistant mutants of varicella zoster virus (VZV) were
selected in vitro by serial passage of VZV-infected human fibroblasts in
increasing drug concentrations, or by continuous exposure of cultures infected at
high multiplicity to 100 microM acyclovir. The in vitro susceptibility of these
mutants to several antiherpetic agents was measured by the plaque-reduction
assay. The capacity of extracts of cells infected with these mutants to
phosphorylate acyclovir was examined and compared with that of their
acyclovir-sensitive parent strains. Based on these studies, VZV could be shown to
acquire resistance to acyclovir through diminished acyclovir phosphorylation.
This was presumable due to loss of viral specific thymidine kinase (TK) function.
Two acyclovir-resistant mutants remained TK competent but demonstrated phenotypic
changes in sensitivity to antiviral agents known to act at the herpes simplex
virus (HSV)-specific DNA polymerase level. These results suggest that the
resistance of VZV to acyclovir results from qualitative or quantitative
alterations in the virus-specified TK or DNA polymerase.

PMID: 6285728 [PubMed - indexed for MEDLINE]

7884: Am J Med. 1982 Jul 20;73(1A):380-2.

Sensitivity of herpes virus isolates from acyclovir clinical trials.

Collins P, Appleyard G, Oliver NM.

Clinical isolates of herpes simplex virus and varicella zoster virus have been
examined for changes in drug sensitivity after treatment of patients with
acyclovir. Some preliminary sensitivity results determined by plaque reduction
assays in Vero cells for herpes simplex virus and MRC-5 cells for varicella
zoster virus are presented. Where both pretreatment and posttreatment virus
isolates were available, no significant changes in sensitivity to acyclovir were 
observed. Similarly, isolates taken after treatment was begun, without a
pretreatment sample, gave IC50 values no greater than expected when compared with
other pretreatment isolates.

PMID: 6285727 [PubMed - indexed for MEDLINE]

7885: Am J Med. 1982 Jul 20;73(1A):275-80.

Treatment of herpes virus infections in immunocompromised patients with acyclovir
by continuous intravenous infusion.

Spector SA, Hintz M, Wyborny C, Connor JD, Keeney RE, Liao S.

Sixteen immunocompromised patients with herpes virus infections were treated for 
three to five days with continuously administered intravenous acyclovir. Patients
received initial acyclovir infusions over 5 minutes in dosages ranging from 1.5
to 5.0 mg/kg followed by continuously infused acyclovir at 7.2, 14.4, 21.6, 28.8,
36.0, or 43.2 mg/kg per day. The mean serum plateau levels of acyclovir
determined by radioimmunoassay ranged from 4.1 microM for the 7.2 mg/kg per day
dosage to 36.6 microM for the 43.2 mg/kg per day dose. A mean of 75 percent of
acyclovir administered was recovered in the urine of patients treated. Eleven of 
13 patients with varicella-zoster virus (VZV) infections had no new vesicle
formation after three days of acyclovir treatment and all patients ceased to have
new vesicles after five days of therapy. For the nine patients from whom complete
viral cultures were available, six ceased to shed virus at three days, and viral 
shedding ceased by five days in all patients treated with acyclovir. No clinical 
or laboratory adverse reactions were associated with acyclovir therapy. These
data suggest that acyclovir given by continuous intravenous infusion may be
useful in the treatment of herpes virus infections in immunocompromised patients.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6285719 [PubMed - indexed for MEDLINE]

7886: Am J Med. 1982 Jul 20;73(1A):225-8.

Acyclovir treatment of herpes simplex virus infections in immunocompromised
humans. An overview.

Alford CA.

As reflected in the preclinical and early clinical data, acyclovir seems destined
to have a very useful role in the treatment and/or prophylaxis of herpes virus
(HSV) infections in immunosuppressed humans. If the preclinical predictions can
be extrapolated to varicella-zoster (V-Z) infections, acyclovir could well also
play a meaningful role in therapy of V-Z infections in the immunosuppressed host;
however, this conjecture awaits proof of controlled studies in humans. Clearly
the usefulness of acyclovir for treatment of V-Z infections should be compared
with that of adenine arabinoside (ara-A) to put into proper perspective the
relative efficacies of the two drugs for future therapeutic regimens. The need
for comparative studies is most important at this early stage of antiviral drug
development, to avoid ethical problems that will cloud the knowledge needed to
move forward in a positive way. In any event, the development of acyclovir, with 
its targeted approach, represents a real fundamental advance in antiviral drug
development. Together with the development and deployment of ara-A, it should
provide the needed impetus for a surge in the creation of new antiviral compounds
for tomorrow.

Publication Types: 
    Review

PMID: 6285714 [PubMed - indexed for MEDLINE]

7887: Lancet. 1982 Jul 17;2(8290):118-21.

Acyclovir therapy for acute herpes zoster.

Bean B, Braun C, Balfour HH Jr.

31 adults took part in a randomised, placebo-controlled, double-blind trial of
intravenous acyclovir therapy (500 mg/m2 intravenously 3 times daily for 5 days) 
for acute herpes zoster. Acyclovir reduced pain, decreased erythema, prevented
the formation of new lesions, and healed skin faster than did placebo. The
duration of viral shedding was also significantly shorter in acyclovir recipients
(2 days versus 5 days). However, 6(35%) of 17 acyclovir recipients had recurrence
of pain after the drug was discontinued, and acyclovir did not appear to affect
post-herpetic neuralgia. Acyclovir therapy was associated with a transient rise
in serum creatinine levels, and may have been related to nausea and vomiting.
Intravenous acyclovir was effective therapy for acute herpes zoster but the ideal
treatment regimen might be a lower daily dose given for a longer period.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 6123837 [PubMed - indexed for MEDLINE]

7888: Riv Neurobiol. 1982 Jul-Dec;28(3-4):328-33.

[Ozone in the treatment of herpes zoster]

[Article in Italian]

Bassi P, Sbrascini S, Mattassi R, D'Angelo F, Franchina A.

Publication Types: 
    English Abstract

PMID: 7187109 [PubMed - indexed for MEDLINE]

7889: Strahlentherapie. 1982 Jul;158(7):395-404.

[Risk of infection by iatrogenic asplenia--a study about the indication of
exploratory laparotomy with splenectomy (LS) in case of Hodgkin's disease]

[Article in German]

Slanina J, Wannenmacher M, Heidemann S.

A retrospective evaluation of the data of all patients with Hodgkin's disease
(collective of Freiburg) treated between 1964 and 1977 was made in order to find 
out if there was an increased risk of infection after a diagnostic laparotomy
with splenectomy (LS). Among a total number of 592 patients, 277 had been
submitted to LS (since 1969). 185 patients had a total remission, 130 of them
after primary LS, 34 after secondary LS, and 21 without any treatment of the
spleen. An inquiry conducted by means of a questionnaire showed no differences
between the compared groups as to the frequency of not septic infections such as 
pulmonary tuberculosis, angina tonsillaris, pyodermia, sinusitis, complications
in wound healing, urinary tract infections, and infections of the intestine.
However, there was a significant increase of unspecific pneumonias and herpes
zoster manifestations after (long-term observation) secondary LS. There were no
differences regarding the frequency of febrile and not febrile colds, but after
LS, the colds had a longer and more severe course.--The analysis of the cause of 
death in the 277 patients who died showed a lethal septicaemia in seven cases.
All these patients had been submitted to LS. In three of these patients, a
recurrence was proved or could not be excluded, four presented as total remission
with respect to Hodgkin's disease.--These results and the communications of
literature permit to conclude that the iatrogenic asplenia represents an
additional immunological risk. They suggest a further reduction of the indication
for LS, the criteria of which are discussed.

Publication Types: 
    English Abstract

PMID: 7135435 [PubMed - indexed for MEDLINE]

7890: Conn Med. 1982 Jul;46(7):373-4.

Disseminated herpes zoster and the syndrome of inappropriate antidiuretic
hormone.

White TM, Hoffman JH, Holmes WH, Huntley RG.

Publication Types: 
    Case Reports

PMID: 7116837 [PubMed - indexed for MEDLINE]

7891: Med Clin North Am. 1982 Jul;66(4):807-17.

Common viral infections of the skin and their treatment.

Smith EB, Raimer SS.

PMID: 7098620 [PubMed - indexed for MEDLINE]

7892: Semin Hematol. 1982 Jul;19(3):193-226.

Infectious complications in leukemic patients.

Bodey GP, Bolivar R, Fainstein V.

Publication Types: 
    Review

PMID: 7051289 [PubMed - indexed for MEDLINE]

7893: Psychiatr Neurol Med Psychol (Leipz). 1982 Jul;34(7):429-32.

[Cutaneous thermography in cerebral processes]

[Article in German]

Lauschke HP.

PMID: 6982481 [PubMed - indexed for MEDLINE]

7894: Laryngol Rhinol Otol (Stuttg). 1982 Jul;61(7):380-2.

[Treatment of Zoster oticus (author's transl)]

[Article in German]

Helms J.

Conservative treatment of zoster oticus seems to be possible by promoting
increased activity of the immunological system. The techniques to be applied were
described by Mayr, Stickl and coworkers. These researchers used a special
preparation of an attenuated virus. A transtemporal decompression of the facial
nerve should be performed after Fisch and Esslen when more than 90% of the
neurons of the facial nerve are lost. Signs of vestibular and cochlear damage are
additional arguments for decompression surgery. A case is described in which one 
year after the onset of the disease necrosis of the facial nerve at the fundus of
the internal auditory meatus and the beginning of the Fallopian canal (canalis
facialis Fallopii) was seen and histologically proven. This was repaired by
inserting a nerve graft. Motility of the face returned. An earlier decompression 
operation would most probably have prevented this course of the disease.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6981042 [PubMed - indexed for MEDLINE]

7895: Czas Stomatol. 1982 Jul-Aug;35(7-8):487-92.

[Treatment of herpes zoster using low temperature]

[Article in Polish]

Hutowska-Lukasiewicz M.

Publication Types: 
    Case Reports

PMID: 6964124 [PubMed - indexed for MEDLINE]

7896: Hokkaido Igaku Zasshi. 1982 Jul;57(4):507-10.

[Treatment of herpetic and postherpetic pain]

[Article in Japanese]

Ogawa H.

Publication Types: 
    Review

PMID: 6757080 [PubMed - indexed for MEDLINE]

7897: Antimicrob Agents Chemother. 1982 Jul;22(1):55-61.

A new nucleoside analog, 9-[[2-hydroxy-1-(hydroxymethyl)ethoxyl]methyl]guanine,
highly active in vitro against herpes simplex virus types 1 and 2.

Smith KO, Galloway KS, Kennell WL, Ogilvie KK, Radatus BK.

A novel nucleoside analog, 9-[[2-hydroxy-1-(hydroxymethyl)ethoxy]methyl]-guanine 
(BIOLF-62), was found to have potent antiviral activity against herpes simplex
virus types 1 and 2 at concentrations well below cytotoxic levels. For example,
the Patton strain of herpes simplex virus type 1 was susceptible at
concentrations 140- to 2,900-fold below that which inhibited cell division by
50%, depending upon the cell line used for assay. Different herpesvirus strains
varied considerably in their susceptibility to the drug, as did results obtained 
with the same virus strain in different cell lines. BIOLF-62 compared favorably
with 5-iodo-2'-deoxyuridine and acyclovir with respect to ratios of viral to cell
inhibitory drug concentrations. Patterns of drug resistance to herpesvirus
mutants suggested that the primary mode of action of BIOLF-62 is different from
that of known antiviral compounds. Human adenovirus type 2, varicella-zoster
virus, and Epstein-Barr virus were inhibited by this drug but at concentrations
within the cell inhibitory range. Vaccinia virus and human cytomegalovirus were
not inhibited at high drug concentrations.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6289741 [PubMed - indexed for MEDLINE]

7898: Riv Neurobiol. 1982 Jul-Dec;28(3-4):412-5.

[Herpes zoster of the geniculate ganglion (Ramsay-Hunt syndrome). Therapeutic
aspects]

[Article in Italian]

Baldini D, Tomaiuolo S, Lozza M, Pieczuro A, Votta I.

Publication Types: 
    English Abstract

PMID: 6195724 [PubMed - indexed for MEDLINE]

7899: N Engl J Med. 1982 Jun 24;306(25):1553.

Symptomatic relief in herpes zoster.

Tepperman J.

Publication Types: 
    Letter

PMID: 7078618 [PubMed - indexed for MEDLINE]

7900: Klin Wochenschr. 1982 Jun 15;60(12):625-9.

Effect of human fibroblast interferon on natural killer cell activity:
stimulation in vitro and inhibition in vivo.

Heidemann E, Reichmann U, Wilms K, Treuner J, Niethammer D.

This paper describes the influence of human fibroblast interferon (IFN-beta) on
the cytotoxic activity of natural killer cells (NK) in vitro and in vivo using
the blood of healthy donors and myeloma patients. IFN-beta stimulates NK activity
against all target cells tested in vitro in a dose-dependent way up to 250% of
pretreatment values. At higher IFN concentrations, stimulation returned to
baseline values. Stimulation was most pronounced in the lowest lymphocyte to
target cell ratio. 1- to 2-h preincubation of effector cells with IFN was enough 
to achieve maximal stimulation. The effector cells of IFN-treated
myeloma-patients, or patients with herpes zoster, showed a clear reduction of
toxicity against all cells tested during the first infusion, as compared to the
pretreatment values.

PMID: 6180219 [PubMed - indexed for MEDLINE]

7901: Fortschr Med. 1982 Jun 10;100(22):1067-70.

[The effect of epicutaneous heparin treatment]

[Article in German]

Stuttgen G.

Former suggestions that local treatment with external heparin could accelerate
healing of zoster could be confirmed. The antitoxic and antiphlogistic components
of heparin could be proved by long-term pre-treatment with heparin ointment,
based on clinical experimental trials of inhibition of the pyrexal reaction and
reduction of erythema, weal and heat radiation produced by histamin and
bradykinin i.c. The effectiveness of heparin could be presumed more in its
character as a linear anionic polyelectrolyte than as effect on the coagulation
process.

Publication Types: 
    English Abstract

PMID: 7106672 [PubMed - indexed for MEDLINE]

7902: Plant Physiol. 1982 Jun;69(6):1435-1438.

Alternative Pathway Respiration and Lipoxygenase Activity in Aged Potato Slice
Mitochondria.

Shingles RM, Arron GP, Hill RD.

Department of Plant Science, University of Manitoba, Winnipeg, Canada R3T 2N2.

Mitochondrial preparations isolated from aged white potato (Solanum tuberosum L.)
slices exhibited classical cyanide-insensitive O(2) uptake which was inhibited by
salicylhydroxamic acid and tetraethylthiuram disulfide (disulfiram). These
mitochondria also possessed lipoxygenase activity, as determined by O(2) uptake
in the presence of 4 millimolar linoleic acid. Purification of the mitochondrial 
preparation on a continuous Percoll gradient resulted in a large decrease in
lipoxygenase activity whereas cyanide-insensitive (disulfiram sensitive) O(2)
consumption was still observed. These data indicate that cyanide-insensitive O(2)
consumption in mitochondrial preparations isolated from aged white potato slices 
is of mitochondrial origin and not due to lipoxygenase contamination.

PMID: 16662418 [PubMed - as supplied by publisher]

7903: Rinsho Shinkeigaku. 1982 Jun;22(6):514-20.

[Three cases herpes zoster myelitis]

[Article in Japanese]

Kanehisa Y, Hokezu Y, Nagamatsu K.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7140099 [PubMed - indexed for MEDLINE]

7904: Z Arztl Fortbild (Jena). 1982 Jun 1;76(11):495-6.

[Pain caused by herpes zoster]

[Article in German]

Meffert H.

PMID: 7124007 [PubMed - indexed for MEDLINE]

7905: Voen Med Zh. 1982 Jun;(6):54-6.

[Clinical and treatment characteristics of herpes zoster]

[Article in Russian]

Zaitsev RZ, Orekhov EG, Shtabtsov VI.

PMID: 7113009 [PubMed - indexed for MEDLINE]

7906: Cutis. 1982 Jun;29(6):611-2.

Herpes zoster as a cause of neurogenic bladder.

Weaver SM, Kelly AP.

Publication Types: 
    Case Reports

PMID: 7105835 [PubMed - indexed for MEDLINE]

7907: Arch Neurol. 1982 Jun;39(6):384.

Cluster headache after herpes zoster ophthalmicus.

Sacquegna T, D'Alessandro R, Cortelli P, de Carolis P, Baldrati A.

Publication Types: 
    Case Reports
    Letter

PMID: 7092621 [PubMed - indexed for MEDLINE]

7908: Pathol Biol (Paris). 1982 Jun;30(6 Pt 2):596-602.

[Acyclovir therapy of varicella-zoster virus infections in the immunosuppressed
children ]

[Article in French]

Peyramond D, Denoyel GA, Bertrand JL, Bertoye A.

We evaluated Acyclovir therapy in 16 immunodeficient children with varicella (7
cases) and zoster (9 cases) in a controlled open study. infections were serious
in 12 patients. Each patient had daily clinical, biological and virological
tests. Sixty minutes intra-venous infusions of Acyclovir were given three times a
day (5 to 10 mg/kg/8 hours) for 6 ou 11 days. All patients who received therapy
before the first four days, ahd a more rapid cessation of new vesicles formation 
and more rapid scaring, than those with delayed treatment. Ten controlled
children had accelerated clearance of viral antigens from vesicles. In 15 cases, 
virus was not isolated after the third day. Two children with varicellous
interstitial pneumonia died, 8 and 25 days after the end of treatment. Fourteen
patients recovered in 8 to 10 days. No relapses of varicella-zoster virus
infections had been observed 1 to 14 months after therapy. The drug was
well-tolerated, but supervising of renal functions is necessary. Acyclovir had a 
good therapeutic efficacy to treat chickenpox and shingles in the
immunocompromised patients.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    English Abstract

PMID: 6750532 [PubMed - indexed for MEDLINE]

7909: J Clin Pathol. 1982 Jun;35(6):645-9.

Determination of specific IGA antibodies to varicella zoster virus by
immunoperoxidase assay.

Haikin H, Sarov I.

An indirect peroxidase technique was developed for determination of IgA
antibodies to varicella zoster virus (VZV). The antigen consisted of
acetone-fixed trypsinised VZV-infected cells. Rabbit antihuman IgA peroxidase
conjugate was used to detect human IgA antibodies bound to viral antigen. In
parallel IgG antibodies to VZV were determined by an immunoperoxidase antibody to
membrane antigen (IPAMA) technique. Varicella zoster virus IgA antibodies were
detected in all five varicella and seven zoster patients. No VZV IgA antibodies
(less than 2) were detected in 45 healthy control sera. Neither were they found
in paired sera of five patients with herpes simplex infection, five patients with
human cytomegalovirus infection and two patients with Epstein-Barr virus
infection. Application of immunoperoxidase IgA technique in serodiagnosis of
primary and reactivated VZV infections is discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6282941 [PubMed - indexed for MEDLINE]

7910: Med Lett Drugs Ther. 1982 May 28;24(610):51-3.

Varicella-zoster immune globulin.

[No authors listed]

PMID: 7078520 [PubMed - indexed for MEDLINE]

7911: Dtsch Med Wochenschr. 1982 May 28;107(21):822-5.

[Zoster encephalitis without rash: report of two cases (author's transl)]

[Article in German]

Moller A, Ackermann R, Felgenhauer K, Ulm H.

Two previously healthy men, aged 54 and 41 years, fell ill with headaches and
increased fatiguability, one also with vomiting, the other with fever, transitory
visual disturbances and slight weakness of the left hand. Both of them had a
stiff neck and clouded consciousness. The EEG had moderate to severe dysrhythmia,
predominantly over the temporal area, CSF showed an increased cell count of
1000/3, predominantly lymphocytes, and increased protein. The younger patient
also had global aphasia and the computed tomography indicated an area of
decreased density in the left temporal region. In the CSF there were locally
produced IgG. The clinical findings were similar to those of herpes encephalitis,
but were milder and regressed more quickly. Severe months later only a few minor 
organic behavioural changes were present. Antibody findings in CSF and serum
suggest varicella-zoster virus as the causative agent, although in both instances
no rash was observed throughout the entire period of observation.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7075505 [PubMed - indexed for MEDLINE]

7912: Dtsch Med Wochenschr. 1982 May 7;107(18):695-7.

[Fibroblast-interferon in the treatment of herpes zoster: a pilot study (author's
transl)]

[Article in German]

Heidemann E, Wilms K, Treuner J, Niethammer D.

Publication Types: 
    English Abstract

PMID: 6176414 [PubMed - indexed for MEDLINE]

7913: Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi. 1982 May;15(2):125-31.

[Clinical experience in systemic lupus erythematosus (author's transl)]

[Article in Chinese]

Lin SC, Jeng GS, Yang IJ, Liao ST, Wei CF, Siauw CP, Chen PH.

Thirty-four cases of SLE treated during the past seven years (1974-1981) in
Taipei Municipal Jen-Ai Hospital are reported and analyzed. Diagnosis of SLE was 
based on ARA preliminary criteria and Hahn's preliminary criteria. There were 32 
females (94.2%) and 2 males (5.8%). The mean age at diagnosis was 28.5 years
(range 14-51). Clinical manifestations were as follows: facial erythema 24 cases 
(70.6%), Raynaud's phenomenon 4 cases (11.4%), oral or nasopharyngeal ulceration 
7 cases (20.6%), arthritis without deformity 22 cases (64.7%), proteinuria 21
cases (61.8%), pleural or pericardial effusions 13 cases (38.2%), psychosis or
convulsions 9 cases (26.5%), hematological abnormalities 25 cases (73.5%).
Laboratory findings were as follows: positive ANA test 33/34 (97.0%),
hypocomplementemia 10/13 (76.9%), direct Coombs' test 4/18 (22.2%), indirect
Coombs' test 1/13 (7.6%), LE cell 19/34 (55.9%), RA Latex 7/17 (41.7%),
polyclonal gammopathy 15/17 (88.2%), anemia 25/34 (73.5%), leukopenia 12/34
(35.3%), thrombocytopenia 10/34 (29.4%). Three cases were complicated by herpes
zoster, one by hyperthyroidism, and one by autoimmune thyroiditis. Ten cases
died, including 4 renal failure, 2 heart failure, 2 cases of committed suicide
and 1 case of CNS involvement.

Publication Types: 
    English Abstract

PMID: 7094684 [PubMed - indexed for MEDLINE]

7914: Otolaryngol Clin North Am. 1982 May;15(2):421-38.

Infectious diseases in the geriatric patient.

Corcoran JG, Axline SG.

PMID: 7088569 [PubMed - indexed for MEDLINE]

7915: Int J Dermatol. 1982 May;21(4):198-202.

The risk of photochemotherapy.

Stuttgen G.

Publication Types: 
    Review

PMID: 7047417 [PubMed - indexed for MEDLINE]

7916: Practitioner. 1982 May;226(1367):901-23.

Eyelid problems.

Moriarty PA, Collin JR.

PMID: 6980409 [PubMed - indexed for MEDLINE]

7917: Practitioner. 1982 May;226(1367):839-44.

The infected eye.

Falcon MG.

PMID: 6980406 [PubMed - indexed for MEDLINE]

7918: Australas Nurses J. 1982 May;11(4):20-1.

Vitamin C: the use of megascorbate therapy in general practice. A clinical
experience.

Goldbaum JS.

Publication Types: 
    Case Reports

PMID: 6921985 [PubMed - indexed for MEDLINE]

7919: Yale J Biol Med. 1982 May-Aug;55(3-4):343-50.

The functions of a university-based viral diagnostic laboratory: recent
experiences at Yale-New Haven Hospital.

Andiman WA.

Publication Types: 
    Case Reports

PMID: 6295010 [PubMed - indexed for MEDLINE]

7920: Pediatr Infect Dis. 1982 May-Jun;1(3):164-7.

IgM to varicella-zoster virus: demonstration in patients with and without
clinical zoster.

Gershon AA, Steinberg SP, Borkowsky W, Lennette D, Lennette E.

Antibody to varicella-zoster (VZ) virus of the IgM type was detected in sera from
50% of persons with clinical zoster, 67% of asymptomatic varicella immunes with a
recent intimate exposure to VZ virus and 22 to 40% of varicella immunes with no
symptoms of zoster or known exposure to the virus. No VZ IgM was found in newborn
sera or in sera from persons susceptible to varicella, demonstrating specificity 
of the VA IgM assay. Since development of specific IgM is associated with acute
infection, these data suggest that reinfection with VA virus occurs and also that
antigenic stimulation due to exposure to endogenous VZ virus may occur. We
hypothesize that during reactivation of VZ virus, persons with intact VZ
cell-mediated immunity (CMI) remain asymptomatic but that those with depressed VZ
CMI may develop clinical zoster. These data suggest that there is an unstable
relationship between VZ virus and the human host.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6292875 [PubMed - indexed for MEDLINE]

7921: Otolaryngol Clin North Am. 1982 May;15(2):271-85.

Dermatologic problems of the head and neck in the aged.

Lynch PJ.

PMID: 6211646 [PubMed - indexed for MEDLINE]

7922: JAMA. 1982 Apr 16;247(15):2132-5.

Acyclovir treatment of herpes zoster infections. Use in children undergoing bone 
marrow transplantation.

Serota FT, Starr SE, Bryan CK, Koch PA, Plotkin SA, August CS.

Three patients in whom herpes zoster infections developed following bone marrow
transplantation were treated with acyclovir. The patients experienced pain relief
within 24 hours of starting treatment. The progression of their skin lesions
halted within 1, 2, and 4 days of therapy, respectively, and healed completely
within two weeks of therapy. Pharmacokinetic studies indicated that acyclovir
plasma concentration-time profiles approximated biexponential equations. The drug
half-lives were 3.91, 3.83, and 3.40 hours, respectively. Acyclovir was not
myelotoxic and may be helpful in aborting varicella-zoster virus infections in
bone marrow transplant recipients.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 7038177 [PubMed - indexed for MEDLINE]

7923: Br J Urol. 1982 Apr;54(2):166-9.

Urinary retention and granulomatous prostatitis following sacral Herpes Zoster
infection. A report of 2 cases with a review of the literature.

Clason AE, McGeorge A, Garland C, Abel BJ.

Publication Types: 
    Case Reports

PMID: 7200822 [PubMed - indexed for MEDLINE]

7924: Vestn Dermatol Venerol. 1982 Apr;(4):42-4.

[Acupuncture in combined treatment of disseminated herpes zoster varioliformis]

[Article in Russian]

Shupen'ko NM, Samosiuk IZ, Krasun LE.

Publication Types: 
    Case Reports

PMID: 7090540 [PubMed - indexed for MEDLINE]

7925: Am J Hosp Pharm. 1982 Apr;39(4):612-8.

Design of a revised controlled substances distribution system.

Somani SM, Giese RM, Roberts AW.

A controlled substances distribution system that uses daily audit and disposition
forms for three different groups of drug products is described. In the previously
used system, only Schedule II drugs were controlled, using shingled proof-of-use 
forms for each product. All other controlled substances were dispensed like
regular prescriptions. Accountability, record retrieval, and security weaknesses 
led to the development of a new system. The new system has a separate audit and
disposition form for Schedule II injections, Schedule II orals and miscellaneous 
drugs, and Schedule III and IV oral and injectable drug products. Each form lists
the most frequently prescribed products in the category. Nurses record daily
shift counts on the bottom of the form. Twenty-one shingles are attached to the
form that are similar to the shingles on the proof-of-use forms of the old
system; these serve as patient charge slips. Each nursing station uses at least
one of each form every day. Pharmacy reviews these forms daily for discrepancies 
and to determine the restocking needs of the nursing stations. A quality
assurance program to assess the performance of the new system is described. Use
of the daily audit and disposition forms for controlled substances combines
accountability, security, and efficiency for nursing personnel with an effective 
charging mechanism.

PMID: 7081238 [PubMed - indexed for MEDLINE]

7926: Cancer Treat Rep. 1982 Apr;66(4):1015-22.

Long-term complications of MOPP chemotherapy in patients with Hodgkin's disease.

Cunningham J, Mauch P, Rosenthal DS, Canellos GP.

Two hundred and sixty-three patients in long-term remission from Hodgkin's
disease were evaluated for complications of chemotherapy. All patients were
interviewed by telephone conversation and reported complications were documented 
by chart review. Treatment consisted of mantle and para-aortic irradiation in 127
patients, total nodal irradiation (TNI) in 32, TNI and MOPP in 34, and
mechlorethamine, vincristine, prednisone, and procarbazine (MOPP) chemotherapy
alone or with lesser irradiation in 70. In this study, greater than 90% of the
men who received MOPP remain infertile. In contrast, a substantial portion of
female patients treated with MOPP chemotherapy have retained normal menses (58%) 
and only a small proportion have had persistent amenorrhea (9%). Five of eight
female patients desiring families after MOPP chemotherapy have had normal
children. The risk of developing a major infection requiring hospitalization was 
greatest in those patients who had received TNI and MOPP chemotherapy. The risk
of developing a herpes zoster infection was greatest during or within the first
year following therapy and was greatest in those patients receiving combined
radiation therapy and chemotherapy. Nearly 100% of patients continue to lead
normal lives following treatment for Hodgkin's disease. Only a small percent of
patients (1.5%) have been totally disabled following treatment.

PMID: 7074629 [PubMed - indexed for MEDLINE]

7927: Klin Monatsbl Augenheilkd. 1982 Apr;180(4):271-4.

[The corneal endothelium in ophthalmic zoster (author's transl)]

[Article in German]

Sundmacher R, Muller O.

Up till now corneal endothelium changes in ophthalmic zoster have practically
escaped general attention. According to our observations, however, a corneal
endotheliitis is a regular feature in acute ocular zoster and often occurs as a
late complication as well. The authors report on individual controls of the
corneal endothelium by means of specular microscopy in six zoster patients who
were treated with steroid eye drops.

Publication Types: 
    English Abstract

PMID: 6979659 [PubMed - indexed for MEDLINE]

7928: Kansenshogaku Zasshi. 1982 Apr;56(4):272-7.

[Herpes zoster and SLE]

[Article in Japanese]

Ishigatsubo Y, Tani K, Sakamoto H, Abe S, Narita M, Nagaoka S, Kato K, Matsunaga 
K, Chiba J, Fukushima K, Tani S.

Publication Types: 
    English Abstract

PMID: 6813389 [PubMed - indexed for MEDLINE]

7929: Teratology. 1982 Apr;25(2):227-37.

Infections in pregnancy: highlights from the collaborative perinatal project.

Sever JL.

The longitudinal study of approximately 60,000 pregnant women was conducted at 14
major medical centers throughout the United States. Clinical data was obtained
under prescribed protocols for each of the study women throughout their
pregnancy, at delivery, and through the postpartum period. The children were
followed with uniform examinations from birth through seven years of age. In
addition blood samples were taken from the pregnant women at registration, every 
two months through pregnancy, at delivery, and six weeks postpartum. Cord blood
samples were also taken from the children during the last half of the study. We
have used this material from the Collaborative Perinatal Project for the
investigation of the role of infections in the production of damage to the fetus 
and newborn. The frequency of clinically recognizing infection during pregnancy
was determined and geographic variation was demonstrated. Serological tests were 
used to document certain diseases. The frequency of confirmed clinical cases per 
10,000 were: rubella, 8; rubeola, 0.6; mumps, 10; varicella-zoster, 5. The
epidemiology and clinical findings associated with infections were studied using 
serological methods. This has provided data on the frequencies of infections such
as cytomegalovirus, herpes simplex, mumps, rubeola, respiratory syncytial virus, 
and others. The study of abnormal pregnancies and matched controls is in progress
using serological techniques. A number of specific studies have been reported on 
infections including rubella, neonatal meningitis, cytomegalovirus, maternal
urinary tract infections, and toxoplasmosis. Further testing is now in progress
employing more sophisticated laboratory methods and more complete data analysis.

PMID: 6285538 [PubMed - indexed for MEDLINE]

7930: Practitioner. 1982 Apr;226(1366):766-8, 770.

Herpes zoster in childhood.

Hartley WJ, Mandal BK.

Publication Types: 
    Case Reports

PMID: 6283515 [PubMed - indexed for MEDLINE]

7931: Am J Epidemiol. 1982 Apr;115(4):569-76.

A population study of herpesvirus infections and HLA antigens.

Blackwelder WC, Dolin R, Mittal KK, McNamara PM, Payne FJ.

In a population-based study of herpesvirus infection and human leukocyte antigen 
(HLA) phenotype, conducted during the period 1977-1979 in the Framingham Study
cohort, HLA-Bw16 was found less often and HLA-Cw2 more often in individuals with 
histories of herpes labialis than in other individuals. Similarly, both geometric
mean antibody titer to herpes simplex type 1 and proportion of individuals with
detectable antibody were higher in those without Bw16 and in those with Cw2. No
strong association was found between HLA and history of herpes zoster or titer to
herpes simplex type 2, varicella-zoster virus or cytomegalovirus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6280494 [PubMed - indexed for MEDLINE]

7932: Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol. 1982
Apr-Jun;26(2):145-8.

[Deep neuroparalytic keratitis following ophthalmic zona]

[Article in Romanian]

Cernea P, Stefanescu A.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6216514 [PubMed - indexed for MEDLINE]

7933: Infect Immun. 1982 Apr;36(1):30-7.

Human serum antibodies to varicella-zoster virus thymidine kinase.

Kallander CF, Gronowitz JS, Torfason EG.

The conditions required for the production of varicella-zoster virus
(VSV)-induced deoxythymidine kinase (dTk) have been studied. Extracts from Vero
cells harvested 62 h after VZV infection were found to contain VZV-induced dTk
activity, with a minimal contribution from the cellular dTk activity. VZV dTK was
shown to have a broad substrate specificity phosphorylating both deoxythymidine, 
deoxycytidine, and iododeoxyuridine. Deoxythymidine triphosphate inhibition
studies revealed an intermediate deoxythymidine triphosphate sensitivity when
compared with that of the cellular cytosolar enzyme and the deoxythymidine
triphosphate-insensitive herpes simplex virus dTk. An assay for VZV dTk-blocking 
antibodies was developed, with [125I]iododeoxyuridine as a substrate in the
presence of a deoxythymidine triphosphate concentration which selectively blocked
the dTK of host cell origin. A total of 79 serum samples were studied; these
included serum pairs from patients with varicella or herpes zoster and single
sera from immune and nonimmune adults. VZV dTk blocking antibodies were detected 
exclusively in sera from patients with herpes zoster. All serum pairs showing VZV
dTK seroconversion also showed a parallel conversion of complement fixation
titers. The VZV dTk antibodies were found to be of the immunoglobulin G class.
The immunological specificity of VZV dTK was investigated, and no
cross-reactivity with herpes simplex virus type 1 or 2 dTk was found.

PMID: 6176544 [PubMed - indexed for MEDLINE]

7934: Acta Urol Belg. 1982 Apr;50(2):259-62.

[Indications for bethanechol in acute urinary retention caused by herpes zoster. 
Case study]

[Article in French]

Polito M, Muzzonigro G, Laraia G, Iacopini M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6126108 [PubMed - indexed for MEDLINE]

7935: Sem Hop. 1982 Mar 25;58(12):739-45.

[Viral etiology of aseptic lymphocytic meningitis. Twenty-four cases seen over a 
nine-year period (author's transl)]

[Article in French]

Becq-Giraudon B, Cremault A, Marechaud R, Abadie JC, Castets M, Sudre Y.

Among 208 cases of aseptic lymphocytic meningitis seen over a nine-year period,
24 were diagnosed as viral infections. Diagnosis was established by both
isolation of the virus from one or several specimens (feces, pharyngeal mucus,
CSF) and significant rise in specific antibody titres. The usual clinical and
epidemiological characteristics of these benign infections were demonstrated in
our series: prevalence in males; recrudescence in summer; infectious syndrome
associated with an unequivocal, though moderately severe, meningeal syndrome, and
occasionally with various visceral manifestations (exanthema, pharyngitis, acute 
respiratory disease, myalgia); clear CSF usually with pleiocytosis (relative but 
not absolute predominance of lymphocytes) and normal chemical findings. All the
cases in our series were due to enteroviruses, Echo or coxsackie. Isolation of a 
poliovirus (type III) in one case deserves mention. Cases where clinical
examination led to unequivocal diagnosis of mumps or herpes zoster were not
included in our study.

Publication Types: 
    English Abstract

PMID: 6283647 [PubMed - indexed for MEDLINE]

7936: Acta Paediatr Scand. 1982 Mar;71(2):269-73.

Herpes zoster and varicella in children with Hodgkin's disease.

Skovby F, Sullivan MP.

Thirty-nine episodes of herpes zoster and varicella in 94 children with Hodgkin's
disease were studied to determine the incidence and complications of these
infections and their effect on the prognosis of Hodgkin's disease in children
under multimodal treatment. Twenty-nine children (31%) developed herpes zoster
and seven (7%) had varicella. Three children had herpes zoster on two occasions. 
All children with varicella had uncomplicated infections. One patient died and
three had visceral complications secondary to herpes zoster infections.
Disseminated herpes zoster in nine children (10%) was more often associated with 
recurrent or active Hodgkin's disease and led to more complications than
localized herpes zoster. Although varicella-zoster infection does not impair the 
prognosis of Hodgkin's disease, it is a potentially fatal infection and an
affected child deserves vigorous treatment and support.

PMID: 7136635 [PubMed - indexed for MEDLINE]

7937: Practitioner. 1982 Mar;226(1365):531-2.

Shingles in diabetes mellitus.

McCulloch DK, Fraser DM, Duncan LP.

PMID: 7088846 [PubMed - indexed for MEDLINE]

7938: J Clin Microbiol. 1982 Mar;15(3):402-7.

Rapid serological technique for typing herpes simplex viruses.

Cleveland PH, Richman DD, Oxman MN, Worthen DM.

A rapid technique is described which can accurately identify a herpes simplex
virus (HSV) isolate as type 1 or type 2. Filter paper disks were used to
immobilize viral antigens, which were then identified by means of an
(125)I-labeled staphylococcal protein A immunoassay. The assay was performed in a
specially designed 96-well filtration device which served as both an incubation
chamber and a filter manifold. By using this system and cross-absorbed antisera
to HSV types 1 and 2, 69 coded clinical isolates of HSV were correctly and
unequivocally typed. HSV was also clearly distinguished from varicella-zoster
virus and cytomegalovirus. This assay can be rapidly executed (less than 2 h) and
yielded an objective endpoint; it required only minute quantities of typing sera 
and can be easily performed with the cells from a single infected roller tube
culture. Thus, it can be used to type initial clinical isolates of HSV, yielding 
results within hours after the first appearance of cytopathic effects in the
culture used for primary virus isolation. Moreover, it is particularly well
suited to the simultaneous analysis of many specimens and is amenable to
automation. These characteristics suggest that this (125)I-labeled staphylococcal
protein A immunofiltration technique will be applicable to the rapid
identification of other herpesviruses, as well as other clinical isolates.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 7076813 [PubMed - indexed for MEDLINE]

7939: J Med Assoc State Ala. 1982 Mar;51(9):43-9.

Shingles, herpes, sex and mononucleosis.

Clemmons LH.

Publication Types: 
    Letter

PMID: 7069308 [PubMed - indexed for MEDLINE]

7940: Rinsho Byori. 1982 Mar;30(3):247-53.

[Application of indirect immunoperoxidase technique for diagnosis of viral
infections (author's transl)]

[Article in Japanese]

Nakamura Y, Aoki Y.

PMID: 7050467 [PubMed - indexed for MEDLINE]

7941: Acta Otorhinolaryngol Ital. 1982 Mar-Apr;2(2):153-62.

[Associated auricular zona]

[Article in Italian]

Fini-Storchi O, Ciampa G, Tardani T.

Publication Types: 
    Case Reports
    English Abstract
    Review

PMID: 6758475 [PubMed - indexed for MEDLINE]

7942: Fukuoka Igaku Zasshi. 1982 Mar;73(3):131-45.

[Immunological response of patients with herpes zoster (author's trans)]

[Article in Japanese]

Higa K.

Publication Types: 
    English Abstract
    Research Support, Non-U.S. Gov't

PMID: 6286440 [PubMed - indexed for MEDLINE]

7943: Mol Pharmacol. 1982 Mar;21(2):432-7.

Differential phosphorylation of (E)-5-(2-bromovinyl)-2'-deoxyuridine
monophosphate by thymidylate kinases from herpes simplex viruses types 1 and 2
and varicella zoster virus.

Fyfe JA.

5-(2-Bromovinyl)-2'-deoxyuridine (BrVdUrd) is a potent and selective inhibitor of
herpes simplex virus Type I (HS-I) and varicella zoster (VZ) virus replication
but is much less potent against herpes simplex virus Type II (HS-II) replication.
A possible enzymatic basis for this difference is reported here to involve the
virus-coded dThd-dTMP kinases (EC 2.7.1.75) from the three virus strains. The
thymidine kinases from the three virus strains were purified by affinity
chromatography. In addition to catalyzing the phosphorylation of nucleosides,
each of the three purified enzymes catalyzed the phosphorylation of thymidylate
to its diphosphate but at strikingly different rates. The relative amounts of
extractable virus-coded thymidylate kinases were estimated to be 100/2/40 for
cells infected with HS-I, HS-II, and VZ viruses, respectively. Extracts of cells 
infected with HS-I virus catalyzed the phosphorylation of the monophosphate of
BrVdUrd to its diphosphate. In contrast, the product was not detected with
extracts from cells infected with HS-II virus. THe ratios of rates with 0.5 mM
BrVdUrd monophosphate versus 0.1 mM dTMP as substrates for each of the purified
dThd-dTMP kinases from HS-I, HS-II, and VZ viruses and the dTMP kinase from host 
cells were, respectively, 0.09, less than 0.002, 0.03, and less than 0.0002.
These observations correlate with the relative sensitivities of these viruses to 
BrVdUrd in cell culture and suggest that, if BrVdUrd exerts its effect as a
triphosphate, the inefficient phosphorylation of the monophosphate contributes to
the insensitivity of HS-II virus to this agent.

Publication Types: 
    Comparative Study

PMID: 6285172 [PubMed - indexed for MEDLINE]

7944: Aust Fam Physician. 1982 Mar;11(3):173-7.

Herpes zoster: complications pathogenesis and pathology. The specialist view.

MacLeod C, Murphy A.

The term herpes zoster is derived from the Greek herpes: to creep and zoster: a
belt or girdle. Shingles is from the Latin cingere: to gird, which was corrupted 
to mean a belt of girdle for the human form. A typical attack of herpes zoster is
usually not difficult to recognise, but it is important to be aware of uncommon
manifestations and complications.

PMID: 6280661 [PubMed - indexed for MEDLINE]

7945: Aust Fam Physician. 1982 Mar;11(3):167-72.

Herpes zoster. The gp view.

Manzie PP.

Herpes zoster is a fascinating disease with many lessons for the general
practitioner. This article raises some practical questions about its diagnosis
and management.

PMID: 6280660 [PubMed - indexed for MEDLINE]

7946: West J Med. 1982 Mar;136(3):227-35.

Advances in interferon research - Medical Staff Conference.

Creasey AA, Merigan TC.

Publication Types: 
    Clinical Trial
    Review

PMID: 6178224 [PubMed - indexed for MEDLINE]

7947: Rev Med Liege. 1982 Feb 1;37(3):82-5.

[Vidarabine: an active antiherpetic treatment by parenteral administration]

[Article in French]

Tjean M, Bury J, Fillet G.

Publication Types: 
    Case Reports

PMID: 7079648 [PubMed - indexed for MEDLINE]

7948: J Kans Med Soc. 1982 Feb;83(2):57-8.

Herpes zoster: a ten-year experience with cytosine arabinoside treatment.

McFarland HR.

PMID: 7061912 [PubMed - indexed for MEDLINE]

7949: J Dermatol. 1982 Feb;9(1):59-62.

Sympathetic ganglion block therapy for herpes zoster.

Toyama N.

PMID: 7047608 [PubMed - indexed for MEDLINE]

7950: Am J Dermatopathol. 1982 Feb;4(1):45-8.

In memory of Professor Dr. Felix von Barensprung by Otto Veit. 1865.

[No authors listed]

Publication Types: 
    Biography
    Historical Article

Personal Name as Subject: 
    von Barensprung F

PMID: 7044172 [PubMed - indexed for MEDLINE]

7951: Environ Health Perspect. 1982 Feb;43:21-5.

Chemotherapy-induced immunosuppression.

Rasmussen L, Arvin A.

Chemotherapeutic agents are used widely in clinical medicine for the treatment of
conditions where diminution of the host immune response is a goal. The clinical
use of immunosuppression is indicated for immunologically mediated disease,
lymphoproliferative diseases, and prevention of graft rejection. Five categories 
of agents are useful for these purposes; they are ionizing irradiation,
corticosteroids, biological alkylating agents, antilymphocyte sera and
antimetabolites. While the specific molecular action of many of these drugs is
known, how they affect cellular events in immune responses is less clear. One of 
the unfortunate sequelae of chemotherapy induced immunosuppression is an
increased susceptibility of the host to opportunistic pathogens or malignancies. 
Specific methods are described for monitoring the various parameters of both
humoral and cellular immunity. Studies of immunologic function in lymphoma
patients and cardiac transplant patients treated with immunosuppressive drugs
have shown specific defects in cell mediated immunity to herpes viruses which may
relate to their increased susceptibility to infection by these agents.

Publication Types: 
    Review

PMID: 7037385 [PubMed - indexed for MEDLINE]

7952: J Indian Dent Assoc. 1982 Feb;54(2):57-8.

Herpes zoster of oral and facial structures (a case report).

Tupkari JV, Gururaja Rao TR, Patni VM.

Publication Types: 
    Case Reports

PMID: 6985255 [PubMed - indexed for MEDLINE]

7953: Ophthalmology. 1982 Feb;89(2):165-77.

The progression of the ocular abnormalities of herpes zoster. Histopathologic
observations of nine cases.

Hedges TR 3rd, Albert DM.

The ocular pathologic findings from nine patients who suffered from herpes zoster
ophthalmicus are described. Autopsy material from four patients who died within
weeks of the illness and ocular specimens from five patients who required surgery
for complications of the disease months to years later demonstrated how the
ocular abnormalities caused by zoster may progress in severity with time. The
changes ranged from superficial keratitis and mild uveitis to severe
granulomatous inflammation of the ciliary body, choroid, and optic nerve within
the first several weeks of the disease. In some instances damage secondary to
vasculitis predominated, and in others inflammation directly involved ocular
tissue. In some chronically affected eyes, granulomatous reaction to Descemet's
membrane persisted for years, whereas in others the inflammatory reaction
apparently resolved, allowing successful penetrating keratoplasty to be performed
in one case.

Publication Types: 
    Case Reports

PMID: 6978475 [PubMed - indexed for MEDLINE]

7954: Am J Ophthalmol. 1982 Feb;93(2):254-5.

Acute retinal necrosis.

Jampol LM.

Publication Types: 
    Case Reports
    Letter

PMID: 6978072 [PubMed - indexed for MEDLINE]

7955: Cutis. 1982 Feb;29(2):167-70, 182.

Dermatology: 1981 report.

Sauer GC.

PMID: 6460596 [PubMed - indexed for MEDLINE]

7956: Cutis. 1982 Feb;29(2):158-64.

Nonrashes. Part I: The Koebner nonreaction.

Bernhard JD, Haynes HA.

"Nonrashes" range from pruritus that may signal an underlying systemic illness to
delusional parasitosis associated with severe psychological disturbance. We
report another kind of nonrash, the Koebner nonreaction or isomorphic
nonresponse, that was manifested by the absence of a drug rash at the site of
recently administered x-irradiation. We also present a compilation of a number of
other nonrashes, such as the mitempfindungen (referred itch) and the prodrome of 
herpes zoster. The recognition of certain types of nonrashes may be lifesaving.

Publication Types: 
    Case Reports

PMID: 6460595 [PubMed - indexed for MEDLINE]

7957: Jpn J Exp Med. 1982 Feb;52(1):17-25.

Enzymatic treatment of formalin-fixed and paraffin-embedded specimens for
detection of antigens of herpes simplex, varicella-zoster and human
cytomegaloviruses.

Hondo R, Kurata T, Sato S, Oda A, Aoyama Y.

Attempts were made to detect antigens of herpes simplex (HS), varicella-zoster
(VZ) and human cytomegalo (CM) viruses in pathological preparations made by
formalin fixation and paraffin embedding as well as in infected culture cells by 
means of enzymatic treatment followed by indirect immunofluorescent staining, and
the following results were obtained. 1) Specimens from autopsy cases, in which
diagnosis was established by detection of viral antigens or virus isolation,
showed specific antigens in specimens of various organs of all cases of HS (6
cases), VZ (3 cases) and CM (2 cases). In 17 other cases, which were suspected
for those viral infections on the basis of ordinary light microscopic
observation, also demonstrated respective viral antigens specifically, enabling
differential diagnosis. In one case, HS antigen was detected in the esophagus and
CM antigen in the liver, testifying occurrence of a double infection. 2) The time
spun during which the specific antigens could be preserved was tested, and it was
learned that preservation of stainable antigens was better in paraffin-embedded
specimens than in specimens kept in formalin. It was possible to detect HS and VZ
antigens in paraffin-embedded specimens prepared 20 and 18 years ago,
respectively. 3) The optimal conditions of trypsin treatment varied depending
upon the organ as well as upon each individual specimen, but a commonly
recommendable procedure was found to by warming at 37 degrees C for 3 hours with 
0.25% trypsin. A test with HS virus-infected Vero cells indicated that the effect
of trypsin treatment was influenced by the concentration of formalin and the time
of fixation.

PMID: 6290714 [PubMed - indexed for MEDLINE]

7958: Antimicrob Agents Chemother. 1982 Feb;21(2):358-61.

Inhibitory effects of antiherpesviral thymidine analogs against varicella-zoster 
virus.

Machida H, Kuninaka A, Yoshino H.

Thymidine analogs highly active against herpes simplex virus were compared in
their inhibitory action against seven strains of varicella-zoster virus by a
plaque reduction assay. E-5-Bromovinyl-arabinosyluracil (BV-ara-U) was most
active, followed by E-5 chlorovinyl-arabinosyluracil,
E-5-bromovinyl-2'-deoxyuridine (BV-dUrd), 2'-fluoro-5-methyl-arabinosyluracil,
2'-fluoro-5-iodo-arabinosylcytosine, arabinosylthymine, 5-vinyl-arabinosyluracil,
acycloguanosine, and 5-iodo-2'-deoxyuridine, in order to decreasing activity.
BV-ara-U was more than 10 times as active as BV-dUrd and almost completely
inhibited plaque development of five strains of varicella-zoster virus at a
concentration as low as 1 ng/ml.

PMID: 6280604 [PubMed - indexed for MEDLINE]

7959: Geriatrics. 1982 Feb;37(2):67-9, 73, 76.

Drugs for pain in the elderly.

Pfeiffer RF.

Aspirin and acetaminophen are, as a rule, effective and well-tolerated compounds 
for use in mild pain of various etiologies. The major advantage of acetaminophen 
is the absence of gastrointestinal irritation. Tricyclic antidepressants, such as
amitriptyline, imipramine, doxepin, and amoxapine are often given with good
results to patients who manifest pain as a somatization of depression.

PMID: 6120120 [PubMed - indexed for MEDLINE]

7960: Sem Hop. 1982 Jan 28;58(4):204-8.

[Non-gonadic complications of chemoradiotherapy in Hodgkin's disease. A study of 
eighty-three patients (author's transl)]

[Article in French]

Bolla M, Sotto JJ, Barjhoux R, Kolodie H, Vincent F, Michallet M, Sarrazin R,
Vrousos C, Hollard D.

Eighty-three patients with Hodgkin's disease were treated with a combination of
chemotherapy and radiotherapy. 43 were included in protocol 1 (from january 1970 
to january 1974) and 40 in protocol 2 (february 1974 to december 1977). In
protocol 1, staging laparotomy was not systematically performed (20 cases).
Treatment consisted of 2 intravenous injections in Vinblastine and total nodal
irradiation. In protocol 2, laparotomy was systematic in patients over 50 (35
cases). Patients with stages 1 and II treated as mentioned above. Patients with
stage III received two Mopp courses followed by total nodal irradiation. Patients
older than 50 with stages I and II and poor prognosis factors received
chemotherapy only. Laparotomy was associated with a 0% mortality rate and a 3,6% 
morbidity rate. No myelitis or pericarditis were observed. Herpes zoster occurred
in 24% of the patients, pulmonary apex fibrosis in 6%, hypothyroiditis in 2,4%,
and leucopenia in 3,6%. Two late infectious complications were fatal. No solid
tumor was apparent. Acute leukemia and non-Hodgkin malignant lymphoma developed
in two patients. Good tolerance, shortness of treatment, and remission rate,
warrant the pursuit of protocol 2 in which systematic laparotomy for patients
under 50 allows total nodal irradiation and therefore reduction of chemotherapy.

Publication Types: 
    English Abstract

PMID: 6280286 [PubMed - indexed for MEDLINE]

7961: Nouv Presse Med. 1982 Jan 23;11(3):191-3.

[Isoprinosine treatment of herpes zoster. Results of a control study in 36
subjects (author's transl)]

[Article in French]

Lesourd B, Laude J, Meunier P, Doumerc S, Moulias R.

A double-blind trial comparing isoprinosine with a placebo was conducted in 36
subjects. Improvement of skin lesions was significantly better in the treatment
group (p less than or equal to 0.01). Before entering the trial, patients in the 
treatment group had significantly more severe pain than those in the placebo
group (p less than or equal to 0.01), the difference disappeared after treatment.
Healing of skin lesions was more rapid in patients treated before the 5th day of 
the disease (p less than or equal to 0.03). None of the subjects developed
post-zoster neuralgia. The clinical effects of the drugs were accompanied by a
decrease in serum rosette activity. We consider isoprinosine as an innocuous and 
effective treatment of herpes zoster.

Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 6173843 [PubMed - indexed for MEDLINE]

7962: Med Klin [Prax]. 1982 Jan 15;77(2):44-5, 48.

[Rapid diagnosis: temporal arteritis]

[Article in German]

Bardach H, Gebhart W, Knobler R.

Publication Types: 
    Case Reports

PMID: 7070345 [PubMed - indexed for MEDLINE]

7963: Otolaryngol Pol. 1982;36(5-6):291-5.

[Conservative and surgical treatment of facial paralysis of viral etiology]

[Article in Polish]

Pietruski J.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 7182731 [PubMed - indexed for MEDLINE]

7964: Am J Nephrol. 1982;2(2):95-7.

Cure of cryptococcemia in an immunocompromised patient with lupus nephritis.

Eiser AR, Neff MS, Slifkin RF.

The first documented cure of cryptococcosis with cryptococcemia is reported. The 
patient had systemic lupus erythematosis and had received corticosteroids and
immunosuppressive drugs for diffuse proliferative nephritis. She had additional
poor prognostic factors including high serum cryptococcal antigen titer, low
cerebrospinal leukocyte count, and absence of anticryptococcal antibody.
Pulmonary tuberculosis was diagnosed concurrently and subsequently she developed 
disseminated herpes zoster. During amphotericin B therapy, renal function
worsened. Cure of cryptococcosis with cryptococcemia was accomplished despite
multiple concurrent infections and transient worsening of renal function.

Publication Types: 
    Case Reports

PMID: 7180906 [PubMed - indexed for MEDLINE]

7965: Ann Dermatol Venereol. 1982;109(12):1057-9.

[Alveolar necrosis of the maxillary bone following trigeminal zona]

[Article in French]

Rodrigues JB, Poiares Baptista A, Leitao A, Lopes T.

Publication Types: 
    Case Reports

PMID: 7171203 [PubMed - indexed for MEDLINE]

7966: Ann Med Interne (Paris). 1982;133(8):553-6.

[Acute respiratory failure disclosing bilateral diaphragmatic paralysis]

[Article in French]

Francois T, Mayaud C, Carette MF, Levy J, Castaigne S, Cohen-Salmon D, Houacine
S, Akoun G.

In the case of three patients an acute respiratory failure with alveolar
hypoventilation is related to bilateral diaphragmatic paralysis apparently
isolated from any other neurologic abnormalities. The current initial diagnosis
of pulmonary embolism leading to admission in an intensive respiratory care unit,
because of the severity of the acute respiratory failure, has to be rectified
then. Bilateral diaphragmatic paralysis is suspected on account of the absence of
any patent etiology, on increasing dyspnea in supine position and paradoxic
movements of the upper abdomen (whether spontaneously or in attempted weaning of 
ventilation support). Bilateral diaphragmatic paralysis is asserted by
electromyogram with measurement of nerve conduction velocities of the two phrenic
nerves. In the first case, it appears early in the course of an amyotrophic
lateral sclerosis; in the second case, it occurs before the presence of a
herpes-zoster becomes patent. In the third case, paralysis seems to be
idiopathic. Evolution is promising in the last two cases, owing to the
reversibility of the lesions. The difficulty of diagnosis, the varying nature of 
etiology and prognosis encountered in these three cases are also apparent in the 
15 cases published in medical literature. The small number of cases published up 
to now, contrasting with the cases we have witnessed over the last 3 years, leads
us to think that this disease must exist more often and may remain unknown to us.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7171180 [PubMed - indexed for MEDLINE]

7967: J Assoc Physicians India. 1982 Jan;30(1):57-8.

Ramsay Hunt syndrome with zoster meningitis.

Khandelwa AV, Sinha LL.

Publication Types: 
    Case Reports

PMID: 7169403 [PubMed - indexed for MEDLINE]

7968: Prog Clin Biol Res. 1982;107:397-411.

Thermographic evaluation of the benign diseases and reactive changes of the skin.

Stuttgen G.

White Erythema is combined with an augmentation of heat radiation only if the
convection of heat is increased, reflectoric flush phenomenon is detected more
reliably by thermography than reflex photometrics. Urticarial exanthema shows an 
increased heat radiation if the edema derives from the deeper layers of the skin 
vessels, whereas a cooling effect results from an edema affecting the superficial
layers of the skin. Papular lesions with inflammation are characterized by
increased heat radiation. Most of the benign skin tumors are not characterized by
an increased convection of heat and show approximately the same temperature as
the surrounding skin. Diminished heat isolation by atrophy of the subcutaneous
fat is followed by an increase of heat radiation by the conduction of heat from
the warm inside of the core. The blood storage capacity of the deeper venous
plexus and varicose veins of the lower legs maintain a raised skin temperature
which can be decreased by pharmacological vasoconstriction of these veins by
catecholamines and serotonin. Finally, the pharmacological effectiveness of
topically applied drugs can change the blood flow through the skin vessels and
alter the heat radiation of the skin surface.

PMID: 7167494 [PubMed - indexed for MEDLINE]

7969: Laryngoscope. 1982 Jan;92(1):65-7.

Herpes zoster oticus: surgery based upon prognostic indicators and results.

May M, Blumenthal F.

We studied 28 patients with herpes zoster oticus prospectively over the six-year 
period between August 1974 and June 1980. We found that the results of measuring 
tear production, submandibular salivary flow, the response to maximal
stimulation, and evoked electromyography gave us sufficient information to group 
these patients according to prognosis--either unfavorable or favorable--for
spontaneous return of facial function. When the test results were 26% or more of 
normal, 100% of the patients had complete recovery without treatment; when the
test results were 25% or less of normal, 69% had incomplete recovery: 19% had
fair and 50% had poor recovery. Of the 31% with complete recovery, 4 were
operated upon. The natural history of herpes zoster oticus in patients with a
poor prognosis was improved if a transmastoid extralabyrinthine subtemporal
decompression of the labyrinthine segment of the facial nerve was performed
within 10 days of onset of the paralysis. The decision to perform this surgery
was based upon the results of the prognostic tests mentioned above.

PMID: 7162299 [PubMed - indexed for MEDLINE]

7970: Vestn Otorinolaringol. 1982;(5):76-8.

[Herpes zoster of the ear]

[Article in Russian]

Kondrashkina AG, Podlasaia LI.

Publication Types: 
    Case Reports

PMID: 7147574 [PubMed - indexed for MEDLINE]

7971: Rev Laryngol Otol Rhinol (Bord). 1982;103(1):65-7.

[Stage IV zona of the ear]

[Article in French]

Paiva A, Verhulst J, Noyon P, Crovetto M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7111930 [PubMed - indexed for MEDLINE]

7972: Pediatr Med Chir. 1982 Jan-Apr;4(1-2):5-20.

[Diagnostic and therapeutic problems in lupus nephritis]

[Article in Italian]

Genova R, Guerra A, Canonaco F.

A review of the SLE in the paediatric age in performed to underline the
peculiarity of the disease in children: age, frequency, symptomatology, renal
histology, clinical course, therapy and correlated side effects are reported
according to literature data. The A.A. describe six cases of lupus nephritis,
observed in the last few years, which confirm the diagnostic difficulties and the
wide variety in the evolution of the disease. A favourable course of the disease 
was obtained in three cases, with corticosteroid and immuno-depressive treatment 
(used in association and/or alternatively); a fourth case developed some
therapeutic complications among which an avascular bilateral bone necrosis,
leucopenia, alopecia and herpes zoster. In two cases the SLE led to chronic renal
failure owing to many relapses of the disease, enhanced by therapeutic break or
dosage reduction. A careful surveillance of these patients is of fundamental
importance in the management of the disease in order to obtain the longer
survival and the lesser side effects.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7111039 [PubMed - indexed for MEDLINE]

7973: Postgrad Med J. 1982 Jan;58(675):39-40.

Spinal cord haemorrhage following herpes zoster: a possible complication of
warfarin therapy.

Friedland ML, Wittels EG.

Haemorrhage is the most serious and common side-effect of warfarin therapy.
Bleeding had commonly been observed in the gastrointestinal and genitourinary
tracts as well as in the skin and subcutaneous tissue. Central nervous system
bleeding has also been reported and has usually been associated with marked
prolongation of the prothrombin time. Spinal cord haemorrhage has been
infrequently observed. The patient reported here may represent a previously
undescribed complication of herpes zoster infection with haemorrhage in the
involved dorsal root ganglia. Possible mechanisms are discussed.

Publication Types: 
    Case Reports

PMID: 7088759 [PubMed - indexed for MEDLINE]

7974: J Neurol Neurosurg Psychiatry. 1982 Jan;45(1):94.

Herpes zoster myelitis treated with vidarabine.

Cullis PA, Gilroy J, Cushing R.

Publication Types: 
    Case Reports
    Letter

PMID: 7062080 [PubMed - indexed for MEDLINE]

7975: Clin Neuropharmacol. 1982;5(1):115-29.

Pharmacology of antiviral chemotherapeutic agents useful in human viral
infections of the nervous system.

McKendall RR.

Several drugs that have antiviral activity and acceptably low toxicity for
systemic use in humans have been discussed in this paper. For ara-A,
acycloguanosine, and interferon, there is convincing evidence of effectiveness in
limiting certain viral diseases of the nervous system. At this moment use of
these drugs cannot be justified for benign, self-limiting, and uncomplicated
viral diseases (e.g., localized herpes labialis). However, data from large
controlled clinical trials are just beginning to be available and therefore the
indications for use of these drugs may change rapidly. It is anticipated that
these drugs will have a definite and welcome role in medical therapeutics.

Publication Types: 
    Review

PMID: 7046922 [PubMed - indexed for MEDLINE]

7976: Int J Tissue React. 1982;4(1):27-30.

The take of skin allograft following necrotizing herpes zoster in chronic
lymphatic leukaemia (report of a case).

Hauben J, Baruchin AM, Mahler D.

A case of herpes zoster involving the lumbar dermatomes is presented, where an
unusual necrosis of the whole skin corresponding to the affected dermatomes was
observed. Although it is well known that herpes zoster links with malignancies
including chronic lymphatic leukaemia, the necrotizing stage of the skin is
unfamiliar. In spite of the fact that malignancy contributes to a decreased host 
resistance, there is evidence suggesting that herpes zoster virus is the cause of
skin necrosis. An allograft skin transplantation was performed successfully in
the presence of immune deficient status over a period of six months.

Publication Types: 
    Case Reports

PMID: 7044962 [PubMed - indexed for MEDLINE]

7977: Am J Otolaryngol. 1982 Jan-Feb;3(1):61-6.

Ramsay Hunt syndrome: a cranial polyneuropathy.

Aviel A, Marshak G.

Publication Types: 
    Case Reports

PMID: 6981355 [PubMed - indexed for MEDLINE]

7978: Clin Prev Dent. 1982 Jan-Feb;4(1):16-8.

Herpes.

Medansky RS, Handler RS.

PMID: 6980079 [PubMed - indexed for MEDLINE]

7979: Appl Neurophysiol. 1982;45(1-2):179-84.

Monopolar electrical stimulation of nucleus ventroposteromedialis thalami for
postherpetic facial pain.

Siegfried J.

PMID: 6977319 [PubMed - indexed for MEDLINE]

7980: Trans Ophthalmol Soc U K. 1982;102 Pt 3:355-8.

Rubella and virus induced cataracts.

Hertzberg R.

Gregg's discovery is acknowledged. The effects of the rubella virus on the lens
is discussed, including virus persistence in the lens, post-natal development and
post-natal spontaneous absorption of cataract. The effect of herpes simplex,
herpes zoster, cytomegalic inclusion disease echovirus and smallpox on the lens
are described.

PMID: 6964280 [PubMed - indexed for MEDLINE]

7981: Neurology. 1982 Jan;32(1):77-80.

Leukemic infiltration of the cerebellum in acute myelomonocytic leukemia.

Saper CB, Jarowski CI.

A 31-year-old woman with acute myelomonocytic leukemia presented with meningeal
signs and a cerebellar mass attributed to leukemic infiltration. The mass
disappeared with radiation therapy and intraventricular chemotherapy, but the
patient subsequently suffered several spinal nerve root recurrences, disseminated
herpes zoster, and progressive multifocal leukoencephalopathy. At autopsy, there 
was no trace of the meningeal leukemia or cerebellar infiltrate. This case
illustrates several of the neurologic complications of acute nonlymphocytic
leukemia, and raises the question whether patients with the myelomonocytic form
of this disease might benefit from prophylactic central nervous system treatment.

Publication Types: 
    Case Reports

PMID: 6948173 [PubMed - indexed for MEDLINE]

7982: Ann Rheum Dis. 1982;41 Suppl 1:37-9.

Side-effects of azathioprine treatment in rheumatoid arthritis: analysis of 10
years of experience.

Speerstra F, Boerbooms AM, van de Putte LB, van Beusekom HJ, Kruijsen MW,
Vandenbroucke JP.

Our experience with azathioprine in the treatment of rheumatoid arthritis covers 
ten years, during which 91 rheumatoid patients (66 female and 25 male) received
this drug, with a median treatment period of 36 months. Total follow-up
experience, during and after treatment, was 399 person years. Twelve patients
died. The principal causes of death were malignant neoplasm (six patients) and
cardiovascular diseases (three patients). The mortality in our patients was
compared to that of the general Dutch population by the Standardised Mortality
Ratio (SMR). In the male patient group a significant excess of both total
mortality and mortality from malignancy was observed. The female patients showed 
no differences from the general population. In this follow-up study, no
lymphoreticular tumours occurred during or after azathioprine therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6802081 [PubMed - indexed for MEDLINE]

7983: Dev Biol Stand. 1982;52:221-36.

Serodiagnosis of Varicella-Zoster virus infection in pregnancy and
standardization of the ELISA IgG and IgM antibody tests.

Enders G.

It is recognized that varicella virus infection in early pregnancy may cause
severe congenital malformation and that varicella virus infection during the last
4 days of gestation until 48 h. after delivery can be dangerous for the child.
Maternal Zoster has also been suggested as a cause of some congenital defect, but
this association is poorly documented. Sensitive, specific and rapid indirect
(ELISA) and direct (ELA) enzyme-linked-immunoassays for detecting Varicella and
Herpes simplex virus, IgM-, IgA and IgG antibodies are employed for serodiagnosis
of infection in the mother and the newborn and for determining the immunity
status in high risk individuals who are exposed to V-Z infection. In the latter
situation serological findings may serve as a guide for passive immunisation with
Zoster-hyperimmunoglobulin (ZIG). The antibody concentration of the latter can
now easily be standardized by the indirect ELISA-IgG-test. For determining the
antibody concentration in the patient's sera in the indirect and direct ELISA
with the method of Mona (Multiples of normal activity) a standardized test
procedure using 2 optimal working dilutions has been established.

PMID: 6762304 [PubMed - indexed for MEDLINE]

7984: Fukushima J Med Sci. 1982;28(3-4):93-103.

Antibody dependent cellular protection against the cell to cell spread of
varicella- zoster virus.

Shigeta S, Ito M, Ogata M, Konno K, Suzuki H.

PMID: 6313498 [PubMed - indexed for MEDLINE]

7985: Riv Neurobiol. 1982 Jan-Jun;28(1-2):48-58.

[Herpes zoster in C3 which paralysis of the homolateral 7th cranial nerve (a
frequent combination with is difficult to interpret)]

[Article in Italian]

Simonetti C, Della Pina D.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6308747 [PubMed - indexed for MEDLINE]

7986: Dev Biol Stand. 1982;52:391-7.

Clinical trial of live attenuated Varicella vaccine in high risk susceptibles--a 
preliminary report.

Gershon AA, Steinberg S, Borkowsky W.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6299849 [PubMed - indexed for MEDLINE]

7987: Dev Biol Stand. 1982;52:245-53.

Development of sensitive and enzyme-linked immunoassays for herpesvirus antigens 
and some applications.

Sundqvist VA, Wahren B.

Sensitive enzyme-linked immunoassays for herpes simplex virus (HSV),
cytomegalovirus (CMV) and varicella-zoster virus (VZV) were developed. Both a
sandwich technique, using antiviral antibodies from two species to detect the
antigen, and an inhibition assay where the sample antigen was incubated with one 
antiserum, could be used. Around 4-50 ng of viral antigens (measured as protein
content) could be detected. The ELISA inhibition technique using type-specific
antisera could differentiate between HSV-1 and HSV-2 strains. These could also be
distinguished in clinical samples. For CMV, both early and late antigens could be
measured as well as the antigenic activity of CMV DNA polymerases. CMV activity
in clinical specimens could be detected. The inhibition technique for VZV antigen
determination appeared suitable for direct typing of clinical material. No
cross-reaction with HSV was seen.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6299833 [PubMed - indexed for MEDLINE]

7988: Dev Biol Stand. 1982;52:193-204.

The use of herpes virus induced dTk as a marker for serological and direct
identification of herpes virus infection in man.

Gronowitz JS, Kallander CF.

This report summarizes the essential features of a sensitive deoxythymidine
kinase (dTk) assay, which can be used for the diagnosis of Herpes virus
infections. A type specific antibody response towards the different Herpes virus 
dTk isozymes, the Herpes simplex virus (HSV) type 1, type 2, and Varicella Zoster
virus (VZV), was found in human sera. The occurrence of dTk antibody in relation 
to complement fixing (cf) antibody and the state of infection, was found to
differ between HSV and VZV. The VZV dTk antibody was only found in patients with 
Herpes Zoster, while most HSV cf positive individuals had HSV dTk antibody.
Absence of dTk in HSV cf positive individuals was related to a "recent primary
infection". The type specificity of the dTk isozymes makes these antigens
suitable for typing of isolates, and this in combination with the sensitivity of 
the assay, made it possible to verify and type HSV infection by direct analysis
of blister secrete without previous virus isolation. Such results can be obtained
within five hours. Combined with conventional isolation procedures the dTk typing
assay also detects dTk negative "therapy resistant" strains. The use of the dTk
assay for diagnostic purposes is discussed.

PMID: 6299830 [PubMed - indexed for MEDLINE]

7989: Scand J Infect Dis. 1982;14(3):181-7.

Acute encephalitis of viral origin.

Koskiniemi ML, Vaheri A.

75 patients with acute encephalitis of confirmed or suggestive viral or
virus-like etiology showed a predominance of herpes simplex virus (HSV) as an
etiological agent (13.3-32.0%) in all age groups without seasonal variation and
increasing in number during years. Mumps, occurring mainly in female patients,
was next in order and thereafter coxsackievirus B, varicella-zoster, and
adenoviruses, followed by multiple coincident infections, and a large number of
occasional agents. HSV seems to have displaced tick-borne encephalitis virus as
the major cause of acute encephalitis in Finland. Pregnancy appeared to increase 
susceptibility to HSV encephalitis. The outcome was associated with the
etiological agent in the first hand, HSV and nonviral microbes appeared
unfavourable, but also with the clinical symptomatology, particularly altered
consciousness, mental symptoms and focal neurological signs. The need for exact
and rapid diagnosis in all cases of acute encephalitis is underlined in view of
the possibility of specific therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6293046 [PubMed - indexed for MEDLINE]

7990: Med Microbiol Immunol. 1982;171(2):77-83.

Peripheral facial palsy and infections- findings and problems.

Mertens T, Thomas JP, Zippel C, Eggers HJ.

Eighty-four patients of the Cologne University ENT Clinic with a diagnosis of
idiopathic peripheral facial palsy (PEP) were examined - both clinically and
virologically. In addition, examinations were carried out on 33 further
PFP-patients from different practising physicians (Group B) where the clinical
information, however, was much less detailed. In the ENT Clinical Group (84
patients), there was a total of 12 recent virus infections (9 varicella zoster
virus, 2 herpes simplex virus, 1 coxsackie B4). Proof of a recent infection
depended strongly on the diagnostic prerequisites: if early and paired sera were 
available a virological diagnosis was possible in 32% of the cases, while in some
of the other patients a recent infection could at most be suspected by the
serological results. Group B with the 33 unselected patients yielded no
virologically significant results. The aetiological relationship between the
virological findings and PEP is discussed.

Publication Types: 
    Comparative Study

PMID: 6292678 [PubMed - indexed for MEDLINE]

7991: Zh Nevropatol Psikhiatr Im S S Korsakova. 1982;82(4):11-6.

[Use of stimulation electromyography in the diagnosis of peripheral nervous
system lesions in herpes zoster patients]

[Article in Russian]

Smirnov IuK, Shishov AS.

Publication Types: 
    Comparative Study

PMID: 6283773 [PubMed - indexed for MEDLINE]

7992: Antimicrob Agents Chemother. 1982 Jan;21(1):33-8.

In vitro susceptibility of varicella-zoster virus to
E-5-(2-bromovinyl)-2'-deoxyuridine and related compounds.

De Clercq E, Descamps J, Ogata M, Shigeta S.

The in vitro susceptibility of eight strains of varicella-zoster virus (VZV) to
E-5-(2-bromovinyl)-2'-deoxyuridine (BVDU) was examined in human embryonic
fibroblasts by the following techniques: inhibition of focus formation by either 
cell-free VZV (4-day assay) or cell-associated VZV (2-day assay), inhibition of
viral antigen formation (2-day assay), and inhibition of viral cytopathogenicity 
(15-day assay). The 50% inhibitory dose (ID50) of BVDU ranged from 0.001
microgram/ml (2-day assay) to 0.01 microgram/ml (15-day assay). BVDU appeared
highly selective in its anti-VZV activity since even at concentrations as high as
100 micrograms/ml, BVDU did not markedly affect the viability of the host cells. 
The ID50 of BVDU for VZV was comparable to that of IVDU
(E-5-(2-iodovinyl)-2'-deoxyuridine). Both drugs inhibited the replication of VZV 
at a much lower concentration than did other antiviral compounds such as
iododeoxyuridine, ethyldeoxyuridine, arabinosylcytosine, arabinosyladenine,
phosphonoacetic acid, iododeoxycytidine, and acycloguanosine. BVDU and IVDU were 
virtually inactive against a thymidine kinase-deficient VZV mutant, suggesting
that phosphorylation by the viral enzyme is responsible, at least in part, for
the selective anti-VZV activity of the compounds.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6282207 [PubMed - indexed for MEDLINE]

7993: J Med Virol. 1982;9(1):27-36.

Further evidence for common antigens in herpes simplex and varicella-zoster
viruses.

Schmidt NJ.

To elucidate the mechanism of heterologous antibody responses to herpes simplex
virus (HSV) and varicella-zoster virus (VZV) which occur in some patients with
HSV or VZV infections, stronger evidence was sought for the existence of
cross-reacting antibodies to these viruses, using antibody absorption procedures.
Absorption of sera from initial HSV infections with HSV antigen was found to
abolish heterologous antibody titer rises to VZV, as demonstrated in complement
fixation, neutralization, and anti-complement immunofluorescence test systems. In
most instances, convalescent-phase titers to heterologous VZV were reduced by HSV
absorption to levels comparable to those in the acute-phase serum, indicating
that cross-reacting antibodies were, in fact, responsible for the heterologous
antibody titer rises. Absorption of convalescent-phase sera from HSV or VZV
patients with homologous antigen also abolished or greatly diminished
immunoprecipitating activity with the heterologous antigen, furnishing additional
evidence of the existence of cross-reacting antibodies. Absorption of sera with
insolubilized IgG to re-remove rheumatoid factor, which was present in a number
of the sera studied, had no effect on either homologous or heterologous antibody 
titer increases. The demonstration of cross-reacting antibodies to HSV and VZV
supports the concept that these two human herpesviruses share common antigen(s).

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6278070 [PubMed - indexed for MEDLINE]

7994: Ann Intern Med. 1982 Jan;96(1):122-3.

Herpes zoster in small-cell carcinoma of the lung.

Markman M, Abeloff MD.

Publication Types: 
    Letter

PMID: 6274236 [PubMed - indexed for MEDLINE]

7995: J Med. 1982;13(3):247-51.

Studies with electro-acupuncture.

Rico RC, Trudnowski RJ.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6217269 [PubMed - indexed for MEDLINE]

7996: Interferon. 1982;4:177-200.

Interferon in ocular viral diseases.

Sundmacher R.

Publication Types: 
    Review

PMID: 6195112 [PubMed - indexed for MEDLINE]

7997: J Neurol. 1982;228(4):283-7.

Ophthalmic herpes zoster with contralateral hemiparesis: a case report.

Federico F, Pedone D, Lamberti P, Achille P, Camicia M, Carella A, Ferrari E.

Herpes zoster of the ophthalmic division of the left fifth cranial nerve with
contralateral hemiparesis was observed in a 30-year-old man. Left carotid
angiography showed segmental constrictions consistent with cerebral arteritis,
possibly provoked by direct viral infection along the intracranial part of the
ophthalmic nerve. An ischaemic lesion revealed by computed tomographic scan was
considered secondary to arteritis and responsible for the hemiparesis. The
presence of an immune response within the blood-CSF barrier was suggested by an
increase of oligoclonal CSF IgG and IgA.

Publication Types: 
    Case Reports

PMID: 6188816 [PubMed - indexed for MEDLINE]

7998: Dev Biol Stand. 1982;52:81-6.

Cellular immunity in herpesvirus, Thai hemorrhagic fever and other cellular
infections with emphasis on isoprinosine.

Tanphaichitra D.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6187617 [PubMed - indexed for MEDLINE]

7999: Dev Biol Stand. 1982;52:527-33.

Systemic antivirals for therapy of herpesvirus diseases.

Merigan TC.

Several chemicals and interferons have been utilized in the prophylaxis and the
treatment of a number of human herpesvirus infections. For example, adenine
arabinoside as well as acyclovir and human leukocyte interferon appear active
against acute varicella zoster and herpes simplex infections in controlled
trials. Some of these agents have transient in vivo actions against CMV and EBV
as well. Further open trial work with these 2 viruses appears necessary to
improve dose regimens or to employ combination therapy or study new derivatives
or agents before controlled trials are warranted. Recombinant DNA methodology is 
currently providing much greater yields of pure interferon for such uses. Recent 
successes in eradicating chronic hepatitis B virus infection suggest that it is
even possible in the future that persistent herpesviruses in the CNS or
lymphoreticular systems may be amenable to long-term therapy. As hyperimmune
globulin appears to diminish the severity of CMV disease, it is also possible
that human monoclonal antibodies may provide a useful approach for
immunoprophylaxis as therapy.

Publication Types: 
    Clinical Trial

PMID: 6187616 [PubMed - indexed for MEDLINE]

8000: J Neurol. 1982;228(1):25-38.

Herpes simplex virus encephalitis: intrathecal synthesis of oligoclonal
virus-specific IgG, IgA and IgM antibodies.

Vandvik B, Vartdal F, Norrby E.

Paired specimens of serum and CSF from seven patients with acute herpes simplex
virus encephalitis were examined during the acute illness or the convalescent
stage or during both stages. Imprint immunofixation analyses of viral antibodies 
separated by agarose electrophoresis and by electrofocusing disclosed intrathecal
production of herpes simplex virus IgG antibodies in all seven patients, and of
IgA and IgM antibodies in six and three of six patients, respectively.
Intrathecal production of herpes simplex virus-specific IgG and IgA was observed 
in two patients from whom samples were collected after 1 year, while intrathecal 
production of virus-specific IgM was not demonstrated later than 5 weeks after
onset. The intrathecally synthesized IgG and IgM, and to a lesser extent IgA
antibodies displayed oligoclonal characteristics. Oligoclonal bands of IgG were
observed in the CSF of all patients. Evidence is presented to show that the bulk 
of the oligoclonal CSF IgG represents herpes simplex virus-specific antibodies.
Intrathecally synthesized populations of herpes simplex virus antibodies
cross-reacting with varicella-zoster virus were identified in three of the
patients.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6184456 [PubMed - indexed for MEDLINE]

8001: J Neurol. 1982;227(1):49-53.

Granulomatous angiitis of the nervous system: a clinicopathological study of one 
case.

De Reuck J, Crevits L, Sieben G, De Coster W, vander Eecken H.

The clinical history is presented of a 69-year-old man with a disease starting
with a herpes zoster infection and an acute ascending myelopathy, and ending with
an intracerebral hemorrhage. The postmortem examination revealed multiple
angiitis lesions, restricted to the central nervous system. In review of the 31
previously described cases there were four other patients in whom the
granulomatous angiitis of the nervous system (GANS) was associated with a herpes 
zoster infection. The relation between both disorders is discussed.

Publication Types: 
    Case Reports

PMID: 6176694 [PubMed - indexed for MEDLINE]

8002: Int J Dermatol. 1982 Jan-Feb;21(1):12-8.

The human interferon system.

Berman B, Frankfort HM.

Publication Types: 
    Clinical Trial
    Review

PMID: 6174471 [PubMed - indexed for MEDLINE]

8003: Ann Intern Med. 1982 Jan;96(1):80-93.

UCLA conference. Interferon: immunobiology and clinical significance.

Stiehm ER, Kronenberg LH, Rosenblatt HM, Bryson Y, Merigan TC.

Interferons are proteins elaborated by infected cells that protect noninfected
cells from viral infection. These proteins produce a temporary "antiviral state" 
by altering nucleotide metabolism and cytoplasmic enzyme induction. Interferons
appear early after viral infection locally and systematically to limit spread of 
viral infection; they also affect cell differentiation, growth, surface, antigen 
expression, morphologic findings, and immunoregulation. Several human disorders
have diminished interferon production. Newborns have normal interferon alpha but 
deficient interferon gamma production. Infants with congenital infections may
also have defects in interferon production. Immunosuppressed patients receiving
transplants (marrow, heart, of kidney) have diminished interferon production,
particularly immediately after transplant. Deficiencies of interferon have also
been noted in Down's syndrome, cellular immunodeficiencies, uremia, malnutrition,
and hematopoietic malignancy. Leukocyte interferon has been of therapeutic value 
in herpes zoster infections, in patients with cancer, and in patients with
hepatitis B infection. Interferon has not been proved to help children with
congenital cytomegalovirus or rubella. Interferon can shrink lymphoid tumors,
particularly non-Hodgkin's lymphoma.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6172066 [PubMed - indexed for MEDLINE]

8004: Aktuelle Gerontol. 1982 Jan;12(1):23-5.

[Anesthesia dolorosa in the higher ages - example of problems in therapy
(author's transl)]

[Article in German]

Danke F.

Chronic forms of facial pain in higher decades of age demonstrate problems of
therapy in this period of life. Following herpetic infections and operations in
the course of the trigeminal nerve the anesthesia dolorosa is a complication
often resistant to therapy. Observations in two patients with typical pain
syndrome made clear, that besides common problems of therapy in the higher ages, 
disorders of communication influence especially every cooperation and every step 
of therapy, which the patient does. Independent os success in therapy,
longtime-care and permanent allocation in the older patient must compensate the
deficit of communication.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6121502 [PubMed - indexed for MEDLINE]

8005: Boll Ist Sieroter Milan. 1982;61(3):245-7.

Serum antibody profile against herpesviruses in renal transplant recipients.

Carpi C, Donati M, Musiani M, Zerbini M, Cevenini R, Feletti C.

Forty-eight renal allograft recipients who had received a kidney graft 2 months
to 8 years previously, were followed for the presence of serum antibody against
Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Herpes simplex virus (HSV), and 
Varicella-Zoster virus (VZV). These investigations were performed over a 6 months
period and in at least two serum samples from each patient, obtained at intervals
of 2-3 months. The presence of serological signs of recent or active infection
were observed in 31 patients for CMV, in 22 patients for EBV (18 patients were
positive both for CMV and EBV) and only in 3 patients for HSV, while no patients 
showed serological signs of recent or active infection by VZV.

PMID: 6100358 [PubMed - indexed for MEDLINE]

8006: Wien Klin Wochenschr. 1981 Dec 25;93(24):753-5.

[Herpes zoster oticus -- neuropathologic contribution to the genesis of
concomitant facial paralysis (author's transl)]

[Article in German]

Pilz P.

A woman of 71 years suffered from herpes zoster oticus, 7th and 10th nerve
paralysis, vertigo and hearing loss; she died after 5 weeks. Neuropathologic
examination revealed intensive inflammation in the pons and medulla oblongata and
necrotizing arteritis in the cerebello-pontine angle, predominantly on the
clinically affected side. The adjacent facial nerve was severely damaged. For the
first time, necrotizing arteritis appears as important cause of facial paralysis 
in the Ramsey-Hunt syndrome.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7342470 [PubMed - indexed for MEDLINE]

8007: Wien Klin Wochenschr. 1981 Dec 25;93(24):744-6.

[Herpes zoster]

[Article in German]

Fritsch P.

This paper summarizes present knowledge on pathogenesis and therapy of herpes
zoster. Formerly, zoster was considered a reinfection of a partly immune
individual by the varicella-zoster virus localized into a body segment of lowered
resistance. Recent epidemiological and virological evidence, however, suggests a 
different mode of pathogenesis: in the course of varicella, VZV migrates via the 
sensory nerves to the dorsal root ganglia where it remains in an inactive form.
It may be reactivated in response to a local or systemic lowering of the level of
host resistance, resulting in painful ganglionitis and, by descension, in the
characteristic segmental skin lesions of herpes zoster. Treatment with systemic
corticosteroids in the early stages of zoster helps to decrease the frequency and
severity of postzosteric neuralgias. Corticosteroids ought to be given at a
relatively high dosage and be tapered only slowly in the course of a few weeks.
They are particularly useful in older individuals, who constitute a population
prone to postzosteric neuralgias. In severe cases of generalized zoster,
corticosteroids should not be given to avoid further lowering of host resistance.
Recently, antiviral drugs have been developed which combine high effectiveness
with very tolerable side effects, namely vidarabine and acyclovir.

Publication Types: 
    English Abstract
    Review

PMID: 6281992 [PubMed - indexed for MEDLINE]

8008: Laryngol Rhinol Otol (Stuttg). 1981 Dec;60(12):612-4.

[The role of zoster oticus as a paraneoplastic syndrome (author's transl)]

[Article in German]

Huttenbrink KB, Blattermann A, Deitmer T.

The relation between malignant neoplasms and zoster oticus as a paraneoplastic
syndrome is discussed based on a bibliographic review and catamnestic evaluations
of own patients. 19 patients who had suffered from zoster oticus were included in
a follow-up study covering a period up to 13 years after the affection. The
symptoms of zoster oticus as described in the literature are reviewed and
compared with the findings in our patients. Although there were no indications of
neoplasms in our patients a general check-up is recommended in all cases of
zoster oticus in accordance with the rules established in internal medicine and
dermatology.

Publication Types: 
    English Abstract

PMID: 7345296 [PubMed - indexed for MEDLINE]

8009: Klin Monatsbl Augenheilkd. 1981 Dec;179(6):442-4.

[Electron-microscopic examinations in cases of keratitis dendritica (author's
transl)]

[Article in German]

Conrads H, Blaschke R, Krug U.

Scanning electron-microscopic and transmission electron-microscopic examination
of cornea affected with herpes simplex (DNS) and which developed the clinical
picture of keratitis dendritica, showed typical test results, which are described
in detail. The ultramicroscopic findings show that the metabolism of the
epithelial cells is of considerable degree. It was proved that there were virus
particles in the protoplasm of the epithelial cells. A comparison with a case of 
zoster keratitis showed the same morphological changes.

Publication Types: 
    English Abstract

PMID: 7343729 [PubMed - indexed for MEDLINE]

8010: J Otolaryngol. 1981 Dec;10(6):449-58.

Surgery of the facial nerve.

Silverstein H.

The diagnosis and management of facial nerve disorders are challenging aspects of
neurotological practice. In Bell's palsy and Herpes Zoster oticus facial nerve
decompression is indicated in approximately 10 per cent of cases within the first
three weeks if 90-95 per cent degeneration has occurred. The presence of a dry
eye determines whether the lesion is proximal to the geniculate ganglion and a
middle fossa approach is necessary. Injury to the facial nerve occurs most
commonly as a result of temporal bone fractures, from either blunt trauma or
penetrating wounds. Occasionally iatrogenic injury occurs during ear surgery.
Injury resulting in immediate and total facial paralysis with degeneration
confirmed by appropriate electrical testing requires facial nerve exploration. In
the presence of an injury proximal to the geniculate ganglion and hearing
preservation, exploration of the nerve via middle fossa approach is indicated. If
the hearing is lost then the translabyrinthine approach is appropriate. In the
event the entire interosseous segment requires exposure, both mastoid and middle 
fossa exposures are required. If the traumatized facial nerve has not been
divided it is decompressed proximal and distal to the injury site. In the event
the nerve is divided, a direct anastomosis is the ideal treatment. Rerouting is
necessary to achieve adequate length for the anastomosis. Nerve grafting is done 
when required.

Publication Types: 
    Case Reports

PMID: 7334569 [PubMed - indexed for MEDLINE]

8011: West J Med. 1981 Dec;135(6):441-5.

Important infections in elderly persons.

Yoshikawa TT.

Elderly persons are prone to more frequent or greater morbidity and higher
mortality from selected infectious diseases than the average population. Factors 
that may affect this increased predilection or poorer prognosis include
environmental exposure, normal physiological changes of aging, coexistence of
chronic diseases and alteration of host defense mechanisms.Infections to which
the aged are particularly vulnerable are pneumonia, influenza, tuberculosis,
urinary tract infection, Gram-negative bacteremia, intra-abdominal sepsis, soft
tissue infection, infective endocarditis, bacterial meningitis, bacterial
arthritis and herpes zoster infection.

Publication Types: 
    Review

PMID: 7039132 [PubMed - indexed for MEDLINE]

8012: Hautarzt. 1981 Dec;32(12):632-3.

[Determination of carcinoembryonal antigens in the blood of bullous and
genetically determined skin diseases]

[Article in German]

Krause W, Stahl N.

It was reported that increased levels of carcinoembryonic antigen (CEA) in blood 
were observed in patients with epidermolysis bullosa. We tested a group of total 
82 patients with bullous dermatoses (bullous pemphigoid, pemphigus, epidermolysis
bullosa, dermatitis herpetiformis), vesicular dermatoses (herpes simplex und
zoster) as well as hereditary dermatoses (psoriasis, atopic dermatitis,
dyskeratosis follicularis). The CEA levels were all within the range of healthy
control persons (10.3-42.1 ng/ml). Our patients do not support the suggestion
that certain dermatoses cause an increased production of CEA-like substances.

Publication Types: 
    English Abstract

PMID: 7033181 [PubMed - indexed for MEDLINE]

8013: Prim Care. 1981 Dec;8(4):715-31.

Herpes zoster: a challenge in management.

Frengley JD.

Although herpes zoster is not a fatal disease, its legacy of postherpetic
neuralgia gives rise to a great deal of misery and distress, especially in
elderly patients. Furthermore, in the immunocompromised patient herpes zoster is 
an important complication. The management of the sequelae of herpes zoster
continues to be extremely difficult. Although work on agents to control viral
replication holds promise for the future, at present meticulous management of the
pain and depression in the early phases and much patience and understanding in
the later phases of the condition are necessary.

PMID: 6915592 [PubMed - indexed for MEDLINE]

8014: Laryngol Rhinol Otol (Stuttg). 1981 Dec;60(12):609-11.

[On the viral etiology of Bell's palsy (An enzyme-linked immunosorbent assay
study) (author's transl)]

[Article in German]

Mees K, Wolf H, Roggendorf M.

In a prospective study paired sera of 14 patients suffering from Bell's palsy
were examined for antibodies against Varicella-zoster Virus (VZV), Herpes-simplex
Virus (HSV), Cytomegalovirus (CMV) and Epstein-Barr Virus (EBV). For
determination of antibodies against VZV, HSV and CMV an enzyme-linked
immunosorbent assay was carried out. Indirect immunofluorescence was carried out 
to determine antibodies against EBV. Serum samples were taken within 5 days of
Bell's palsy having been diagnosed and were compared with further serum samples
taken 4 weeks later. No evidence of significant differences between the antibody 
titers of the paired sera was found. The viral etiology of Bell's palsy due to an
exogenous infection or by activation of a latent infection seems unlikely.

Publication Types: 
    English Abstract

PMID: 6285096 [PubMed - indexed for MEDLINE]

8015: Ned Tijdschr Geneeskd. 1981 Nov 28;125(48):1953-8.

[Experiences with intravenously administered acyclovir in severe herpesvirus
infections]

[Article in Dutch]

van der Meer JW, Versteeg J.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6273756 [PubMed - indexed for MEDLINE]

8016: Lancet. 1981 Nov 28;2(8257):1227-8.

Patient with circulating antibodies to alpha-interferon.

Mogensen KE, Daubas P, Gresser I, Sereni D, Varet B.

Publication Types: 
    Case Reports
    Letter
    Research Support, Non-U.S. Gov't

PMID: 6171694 [PubMed - indexed for MEDLINE]

8017: N Engl J Med. 1981 Nov 26;305(22):1349.

Acyclovir and herpes zoster.

von Schulthess GK, Sauter C.

Publication Types: 
    Case Reports
    Letter

PMID: 7290161 [PubMed - indexed for MEDLINE]

8018: N Z Med J. 1981 Nov 25;94(696):384-6.

A multicentre trial of Zostrum (5 percent idoxuridine in dimethyl sulphoxide) in 
herpes zoster.

Burton WJ, Gould PW, Hursthouse MW, Sears PJ, Larnder DA, Stringer HC, Turnbull
BC.

Forty-six patients with herpes zoster were randomised into two groups treated
with DMSO alone and 5 percent IDU in DMSO, provided that treatment started within
48 hours of the appearance of a rash. In the IDU group the interval before pain
improved was significantly shorter than in the control DMSO group, and
significantly fewer new vesicles developed at the three day follow up in the
active group compared with the control group. These findings are in agreement
with previously published work and confirm the usefulness of Zostrum (5 percent
IDU in DMSO) in the treatment of herpes zoster.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 6459547 [PubMed - indexed for MEDLINE]

8019: Z Hautkr. 1981 Nov 15;56(22):1457-66.

[Immunostimulative therapy of herpes zoster (three years' experience with
inosiplex) (author's transl)]

[Article in German]

Bunta S, Peris Z.

The authors report on their three years' experience in treating 69 patients with 
herpes zoster of different localization by Inosiplex. The clinical study was
carried out in two dermatological centres. Comparison of the results with those
of the usual symptomatic treatment leads to the conclusion that the results
achieved in the group treated with Inosiplex are significantly better.

Publication Types: 
    English Abstract

PMID: 6171939 [PubMed - indexed for MEDLINE]

8020: Br Med J (Clin Res Ed). 1981 Nov 14;283(6302):1298-9.

Long-term morbidity of herpes zoster ophthalmicus.

Kritzinger EE.

PMID: 6794827 [PubMed - indexed for MEDLINE]

8021: Hokkaido Igaku Zasshi. 1981 Nov;56(6):623-6.

[Statistical observations on patients with herpes zoster and postherpetic
neuralgia (author's transl)]

[Article in Japanese]

Makise H, Sasaki K, Nishida N, Igarashi O, Kubota M, Goto Y.

From 1969 to 1980, 83 patients with herpes zoster and postherpetic neuralgia were
referred to our clinic. They consisted of 36 male and 47 female, whose ages
ranged from 18 to 91 years. They were tested mainly with stellate ganglion block 
or epidural block. Patients with postherpetic neuralgia received imipramine 60 mg
per day in addition. About half of the patients were relieved of pain or
considerably improved after treatment. Other half of the patients somewhat
improved excluding those patients whose therapeutic effect could not be assessed.
More favourable results were obtained in patients whose treatment was instituted 
within 2 weeks from onset of herpes zoster than patients over 2 weeks from onset.
Duration of treatment was shorter in younger patients (approximately 59 years)
than older patients (60 years approximately), but results were same in both age
groups. About 10% of the patients had concomitant malignant disease or autoimmune
disease. No relationship between the localization of herpes zoster and the site
of malignant disease was found.

Publication Types: 
    English Abstract

PMID: 7338339 [PubMed - indexed for MEDLINE]

8022: J Neurol Sci. 1981 Nov-Dec;52(2-3):351-7.

[Unilateral involvement of IX, X, Xi and XII in cervical zoster. Cranial nerve
contribution to vascular pathology]

[Article in French]

Lapresle J, Faux N.

The authors report a case of a cervical zoster (C2 - C4) with unilateral
involvement of the IXth, Xth, XIth and XIIth cranial nerves. Angiography failed
to opacify the ascending pharyngeal artery on the same side, presumably because
of a thrombosis secondary to the zoster infection. As the ascending pharyngeal
artery is known to supply the last four cranial nerves, this study should be seen
as a further example of the varied cranial nerve involvement which may arise on a
vascular basis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7310438 [PubMed - indexed for MEDLINE]

8023: HNO. 1981 Nov;29(11):349-56.

[Vestibular neuronitis and its differential diagnosis (author's transl)]

[Article in German]

Reker U.

The study gives a survey of the different terminologies, opinions regarding
etiology, and differential diagnoses. In accordance with animal experiments, and 
our own experience with 71 patients, an activating therapy, including exercises, 
is recommended instead of bed-rest. Under special circumstances diagnosis may be 
difficult. For instance, a centrally reduced thermal reactivity of the healthy
labyrinth may mimic a bilateral canal paresis. The vestibular type of Meniere's
disease, disseminated encephalomyelitis, herpes zoster oticus, or the
complication of a chronic otitis media cannot always be differentiated from a
unilateral vestibular paralysis.

Publication Types: 
    English Abstract

PMID: 7309579 [PubMed - indexed for MEDLINE]

8024: Ann Intern Med. 1981 Nov;95(5):549-55.

Infections during intensive chemotherapy for non-Hodgkin's lymphoma.

Bishop JF, Schimpff SC, Diggs CH, Wiernik PH.

Records of 133 infections occurring in 73 of 125 patients with late-stage
non-Hodgkin's lymphoma on intensive chemotherapy programs for a median of 23
months were reviewed. Granulocytopenia, usually related to chemotherapy, was the 
major predisposing factor, association with 51% of infections. The incidence of
infection in chemotherapy courses associated with less than 500
granulocytes/microL was higher than those with 500 or more granulocytes/microL (p
= 0.0004). Splenectomized patients tended to have a higher incidence of
chemotherapy courses with an infection (p = 0.06); marrow involvement was not a
significant predisposing factor to infection. The commonest sites of infection
were lung, skin, and alimentary canal. Gram-negative organisms and Staphylococcus
aureus caused 83% of documented infections; Pseudomonas aeruginosa was the major 
cause of pneumonia and bacteremia; and herpes zoster and fungi each caused only
3% of infections. Other infections associated with impaired cellular or humoral
immunity were uncommon. Poor prognosis was associated with infections in
granulocytopenic patients with stable or falling granulocyte counts, infection at
multiple sites, and bacteremia, especially polymicrobial bacteremia.

PMID: 7294544 [PubMed - indexed for MEDLINE]

8025: Vojnosanit Pregl. 1981 Nov-Dec;38(6):453-6.

[Vestibular lesions in herpes zoster oticus]

[Article in Serbian]

Risavi A, Pilipovic S.

Publication Types: 
    Case Reports

PMID: 6977234 [PubMed - indexed for MEDLINE]

8026: Antiviral Res. 1981 Nov;1(4):203-12.

Acyclovir - a review of the preclinical and early clinical data of a new
antiherpes drug.

Brigden D, Fiddian P, Rosling AE, Ravenscroft T.

A review of the literature on acyclovir (Zovirax), a new antiherpes drug, with
particular activity against herpes simplex virus types I and II and also against 
varicella-zoster, Epstein-Barr, cytomegalo and herpes B viruses, is presented.
The article deals with 'in vitro' and 'in vivo' efficacy in animals, animal
toxicity, latency and resistance, the mechanism of action and early clinical
experience.

Publication Types: 
    Clinical Trial
    Review

PMID: 6280605 [PubMed - indexed for MEDLINE]

8027: J Virol. 1981 Nov;40(2):516-25.

Structure of varicella-zoster virus DNA.

Straus SE, Aulakh HS, Ruyechan WT, Hay J, Casey TA, Vande Woude GF, Owens J,
Smith HA.

Varicella-zoster virus (VZV) DNA was prepared from nucleocapsids and from
enveloped virions of a laboratory strain (Ellen) and directly from the vesicle
fluids of patients with zoster infections. VZV Ellen nucleocapsid DNA was cleaved
with 11 different restriction endonucleases and electrophoresed in agarose gels. 
The restriction profiles of the nucleocapsid DNA were identical to those of the
DNA recovered from purified virions, but differed from those of another VZV
strain (KM). In vitro-labeled VZV K.M. DNA purified directly from vesicle fluid
yielded a distinct restriction pattern which appeared to be unchanged after
several tissue culture passages of the isolate from that fluid. Restriction
endonuclease analysis (EcoRI or BglII) of VZV DNA revealed the presence of four
cleavage fragments with a molar ratio of approximately 0.5. No individual
fragments with molar ratios of 0.25 were noted. This observation suggests that
the VZV genome may contain one invertible segment. Comparison of the
electrophoretic migrations of VZV DNA fragments relative to those of DNAs of
known size permitted calculation of the VZV genome size to be 72 X 10(6) to 80 X 
10(6) daltons. These results were confirmed by electron microscopy which
demonstrated a genome size of about 76 X 10(6) daltons for passaged and
unpassaged VZV DNA. Electron microscopy also revealed that some of the DNA
molecules recovered from nucleocapsids or directly from vesicle fluids were
superhelical circles.

PMID: 6275100 [PubMed - indexed for MEDLINE]

8028: Transfusion. 1981 Nov-Dec;21(6):732-4.

Preparation of varicella-herpes zoster immunoglobulin.

Janot C, Stoltz JF, Avenard G, Perrier P, Schooneman F, Streiff F.

The efficacy of zoster immunoglobulin in prophylaxis of varicella and herpes
zoster is reported by many authors. The screening for zoster's antibodies is
performed in the blood donor population and in persons convalescing from herpes
zoster. The results show that 25 per cent of blood donors and 83.5 per cent of
convalescents, respectively, have CF antibody titer of l6. Varicella zoster
immunoglobulin prepared by alcohol fractionation has a fluorescent antibody titer
of 1,024 and a CF antibody titer of 512. These results are discussed and compared
with those of the literature.

PMID: 6274067 [PubMed - indexed for MEDLINE]

8029: J Clin Microbiol. 1981 Nov;14(5):539-43.

Comparison of anticomplement immunofluorescence and fluorescent
antibody-to-membrane antigen tests for determination of immunity status to
varicella-zoster virus and for serodifferentiation of varicella-zoster and herpes
simplex virus infections.

Gallo D, Schmidt NJ.

The anticomplement immunofluorescence (ACIF) test was compared with the
fluorescent antibody-to-membrane antigen (FAMA) test for determining
varicella-zoster virus antibody levels as a measure of varicella-zoster virus
immunity status. The ACIF test was found to be comparable to the FAMA test in
sensitivity and could be used for examining sera at low dilutions of 1:2 and 1:4.
In addition, the ACIF method proved to be a more economical procedure in terms of
antigen required and personnel time necessary to perform the test. Heterologous
varicella-zoster virus antibody titer rises were demonstrated by the FAMA test
with 10 serum pairs from patients with clinically diagnosed genital herpes
simplex virus infection, indicating that the FAMA test is no more suitable than
other serological methods for serodifferentiation of those herpes simplex virus
and varicella-zoster virus infections in which antibody increases occur to both
antigens.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 6273453 [PubMed - indexed for MEDLINE]

8030: Ann Neurol. 1981 Nov;10(5):458-64.

Angiographic findings in herpes zoster arteritis.

MacKenzie RA, Forbes GS, Karnes WE.

Four adults patients who experienced an ipsilateral hemispheric deficit 6 to 8
weeks after having developed herpes zoster ophthalmicus were seen during a
six-month period. All four patients underwent full-circle angiography, including 
study of the extracranial arteries in the three older patients. Each examination 
demonstrated areas of segmental constriction of arteries on the ipsilateral side;
two locations that were especially affected were the A2 segment of the
pericallosal artery beneath the genu of the corpus callosum and the M4 segment of
the middle cerebral artery. The cerebral arteries of the opposite hemisphere and 
the extracranial vessels did not contain demonstrable abnormalities. Pathological
studies suggest that patients with this syndrome may have a necrotizing arteritis
of ipsilateral blood vessels; in patients with disseminated zoster, a
granulomatous angiitis of cerebral blood vessels has been found. We propose that 
the pattern of angiographic abnormalities described here is characteristic of
herpes zoster arteritis; furthermore, the distribution pattern of the lesions
suggests that the virus may spread to these arteries via branches of the
ophthalmic division of the trigeminal nerve.

PMID: 6118088 [PubMed - indexed for MEDLINE]

8031: Lancet. 1981 Oct 17;2(8251):827-30.

Acyclovir in herpes zoster.

Peterslund NA, Seyer-Hansen K, Ipsen J, Esmann V, Schonheyder H, Juhl H.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6116951 [PubMed - indexed for MEDLINE]

8032: ZFA (Stuttgart). 1981 Oct 10;57(28):1894-7.

[Differential diagnosis of the lumbo-radicular syndrome--a tabulated review]

[Article in German]

Plangger C, Fischer J, Twerdy K.

PMID: 7293376 [PubMed - indexed for MEDLINE]

8033: JAMA. 1981 Oct 9;246(15):1703-5.

Fatal vidarabine toxicity in a patient with normal renal function.

Van Etta L, Brown J, Mastri A, Wilson T.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 7277649 [PubMed - indexed for MEDLINE]

8034: JAMA. 1981 Oct 2;246(14):1564-7.

Vestibular vertigo. A form of polyneuritis?

Adour KK, Sprague MA, Hilsinger RL Jr.

Vestibular vertigo traditionally has been considered to be of viral origin and
some forms (acute vestibular neuronitis, acute labyrinthitis, acute vertigo) may 
be manifestations of a viral cranial polyneuritis. To test this hypothesis,
otoneurologic signs and serum complement-fixation titers to herpes simplex and
herpes zoster were determined in 16 patients with acute vertigo during their
attack and several weeks later. One hundred unselected patients seen for
nonotoneurologic problems served as control subjects. In addition to vestibular
nerve abnormality, all patients with vertigo had some form of cranial nerve
abnormality that cleared within four weeks of onset. These transient acute
cranial nerve findings in patients with vestibular vertigo support the concept of
inflammatory polyneuritis, and preliminary studies indicate that an
anti-inflammatory agent such as prednisone may be the preferred treatment.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6268853 [PubMed - indexed for MEDLINE]

8035: Arch Neurol. 1981 Oct;38(10):668.

CSF in herpes zoster meningoencephalitis.

Reimer LG, Beller LB.

Publication Types: 
    Case Reports

PMID: 7295116 [PubMed - indexed for MEDLINE]

8036: Proc Natl Acad Sci U S A. 1981 Oct;78(10):6476-80.

Adult T-cell leukemia: antigen in an ATL cell line and detection of antibodies to
the antigen in human sera.

Hinuma Y, Nagata K, Hanaoka M, Nakai M, Matsumoto T, Kinoshita KI, Shirakawa S,
Miyoshi I.

Indirect immunofluorescence of certain human sera demonstrated an antigen(s) in
the cytoplasm of 1--5% of the cells of a T-cell line, MT-1, from a patient with
adult T-cell leukemia (ATL), which is endemic in southwestern Japan. The antigen 
was not detected in other human lymphoid cell lines, including six T-cell lines, 
seven B-cell lines, and four non-T non-B cell lines. The antigen did not show
cross antigenicity with that of herpesviruses, including Epstein--Barr virus,
herpes simplex virus, cytomegalovirus, varicella-zoster virus, herpesvirus
saimiri, and Marek disease virus. The proportion of antigen-bearing cells was
increased by a factor of approximately 5 on culture in the presence of
5-iodo-2'-deoxyuridine. Antibodies against the antigen in MT-1 cells were found
in all 44 patients with ATL examined and in 32 of 40 patients with malignant
T-cell lymphomas (most of them had diseases similar to ATL except that leukemic
cells were not found in the peripheral blood). The antibodies were also detected 
in 26% of the healthy adults examined from ATL-endemic areas but in only a few of
those examined from ATL-non-endemic areas. On electron microscopy, extracellular 
type C virus particles were detected in pelleted MT-1 cells cultured in the
presence of 5-iodo-2'-deoxyuridine.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7031654 [PubMed - indexed for MEDLINE]

8037: J Am Dent Assoc. 1981 Oct;103(4):610.

Painful, ulcerated lesions of the palate and facial skin.

Correll RW, Wescott WB, Birkholz H.

Herpes zoster is an acute viral infection that principally affects the skin. It
occasionally may involve the oral region with patients sometimes initially
complaining of toothache. Generalized skin involvement by the disease should
alert the clinician to the possibility of an underlying malignancy. Dentists
should also be aware that the disease is infectious and can be transmitted,
especially to susceptible individuals.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 6945347 [PubMed - indexed for MEDLINE]

8038: Clin Exp Immunol. 1981 Oct;46(1):98-105.

Specific in vitro antibody response to varicella zoster.

Souhami RL, Babbage J, Callard RE.

Peripheral blood mononuclear cells from normal donors were stimulated in vitro by
varicella zoster (VZ) antigen and antibody measured by an ELISA technique.
Antibody was produced in 14 of 19 individuals. This antibody was specific for VZ 
with no binding to herpes simplex virus (HSV), even when the mononuclear cells
were taken from individuals who had circulating antibody to VZ and HSV. The
failure of antibody production in mononuclear cell cultures from some normals,
all of whom had serum antibody, was analysed using reciprocal combinations of E+ 
and E- cells from producers and non-producers. E+ cells from producers could help
E- producer cells make antibody, but E+ cells from non-producers could not help
E- cells from non-producers to do so. This result suggests a deficiency in
circulating E- cells in non-producers. Four of four patients with untreated
Hodgkin's disease were non-producers using blood mononuclear cell cultures, but
their spleen cells produced antibody readily. This suggests that failure of in
vitro antibody production in immune individuals may be due to sequestration of
responsive B cells in spleen and other sites. This technique allows further study
of the mechanisms of immunity to VZ in normal and immune-compromised individuals.

Publication Types: 
    In Vitro

PMID: 6279341 [PubMed - indexed for MEDLINE]

8039: Indian J Dermatol. 1981 Oct;25(4):17-21.

Dermatosis of viral origin in children.

Chakravarti SK, Mukherjee KK, Chakraborty MS.

PMID: 6273304 [PubMed - indexed for MEDLINE]

8040: Br Med J (Clin Res Ed). 1981 Sep 12;283(6293):698-9.

Herpes-zoster myelitis treated successfully with vidarabine.

Corston RN, Logsdail S, Godwin-Austen RB.

Publication Types: 
    Case Reports

PMID: 6793130 [PubMed - indexed for MEDLINE]

8041: Klin Med (Mosk). 1981 Sep;59(9):66-72.

[Disseminated variants of herpes zoster]

[Article in Russian]

Shishov AS, Umanskii KG.

Publication Types: 
    English Abstract

PMID: 7311435 [PubMed - indexed for MEDLINE]

8042: Vestn Dermatol Venerol. 1981 Sep;(9):72-4.

[2 cases of a generalized form of herpes zoster]

[Article in Russian]

Lipets ME, Gavrikov VV, Shibaeva LN, Prokof'eva NM.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7303889 [PubMed - indexed for MEDLINE]

8043: Arch Neurol. 1981 Sep;38(9):544-52.

Plasmapheresis in idiopathic inflammatory myopathy. Experience with 35 patients.

Dau PC.

Thirty-five patients with idiopathic inflammatory myopathy (IM) were treated with
plasmapheresis. They had had inadequate clinical responses to prednisone or to
prednisone and cytotoxic immunosuppressive drug therapy. All patients received
cyclophosphamide or chlorambucil in addition to plasmapheresis; 33 also received 
prednisone. Strength increased in 32 patients during combined therapy; patients
with the most active disease experienced substantial improvement that approached 
clinical remission in some cases. Clinical improvement was documented by muscle
testing, forced vital capacity, electromyography, muscle biopsy, and serum
creatine phosphokinase activity. The major side effect of treatment was herpes
zoster. Primary biliary cirrhosis improved in one patient. Although the effects
of plasmapheresis cannot be dissociated from those of the concomitantly
administered immunosuppressive drugs, the improvement seen in patients with
active disease suggests that plasmapheresis with immunosuppressive drug therapy
may find a place in their treatment and implicates circulating factors in the
pathogenesis of IM.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 7271533 [PubMed - indexed for MEDLINE]

8044: Otolaryngol Head Neck Surg. 1981 Sep-Oct;89(5):841-8.

Facial paralysis in children: differential diagnosis.

May M, Fria TJ, Blumenthal F, Curtin H.

The differential diagnosis in 170 patients between birth and 18 years of age is
reviewed. There are a number of obvious physical findings and historical features
that allow one to make a diagnosis rather quickly. Pain, vesicles, a red pinna,
vertigo, and sensorineural hearing loss suggest herpes zoster oticus. Slow
progression beyond three weeks, recurrent facial paralysis involving the same
side, facial twitching, weakness, or no return of function after six months
indicate a neoplasm. Bilateral simultaneous facial paralysis indicates a cause
other than Bell's palsy, such as Guillain-Barre syndrome, pseudobulbar palsy,
sarcoidosis, and leukemia. Recurrent facial paralysis associated with a fissured 
tongue, facial edema, and a positive family history should suggest
Melkersson-Rosenthal syndrome.

PMID: 6799919 [PubMed - indexed for MEDLINE]

8045: Ophthalmic Surg. 1981 Sep;12(9):657-60.

Combined keratoplasty, cataract extraction, and intraocular lens implantation:
experience at the Wilmer Institute.

Bruner WE, Stark WJ, Maumenee AE.

A review of 12 cases of combined keratoplasty, cataract extraction and IOL
implantation performed during the past five years at the Wilmer Institute is
presented. The results show 80% of cases with 6/12 (20/40) vision or better with 
a follow-up of at least six months. All but one of the grafts remained clear. Our
current technique for keratoplasty, extracapsular cataract extraction and
posterior-chamber IOL implantation is described. This technique has several
advantages, including the following: an intact posterior capsule, no anterior
vitrectomy, protection of the cornea from the IOL by the iris, and potential for 
full pupil dilation after surgery. Conservative and highly selective use of the
procedure is recommended.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6763178 [PubMed - indexed for MEDLINE]

8046: Scand J Haematol. 1981 Sep;27(3):171-80.

Cellular and humoral immunity in Hodgkin's disease. I Patients in continuous
long-term remission.

Skovmann-Sorensen O, Schroder H, Moller-Larsen A, Haahr S.

Cell-mediated and humoral immunity to herpes simplex virus (HSV), cytomegalovirus
(CMV) and varicella zoster virus (VZV) were examined in 37 patients with
Hodgkin's disease in continuous long term remission. This group had lower
blast-transformation than a matched control group to all 3 antigens. Patients
originally showing B-symptoms had higher transformation to VZV than those with
A-symptoms. Patients treated with irradiation only had higher transformation than
those treated with either chemotherapy or a combination of chemotherapy and
irradiation. There was a clear tendency towards lower transformation in patients 
having been in remission for 2 years or less. Phytohaemagglutinin (PHA)
stimulation gave lower response in the patient group than in the control group.
Patients with B-symptoms had lower response than those with A-symptoms.
Interferon production was specially impaired in patients with B-symptoms. The
patient group had higher CF titers against HSV and CMV while the control group
had higher titers against VZV. B-symptom patients had higher titers against VZV
than A-symptom patients. It is concluded that HD patients have impaired immune
function many years after discontinuation of therapy, but there are certain
differences regarding the in vitro immunity within the patient groups.

PMID: 6171864 [PubMed - indexed for MEDLINE]

8047: Hosp Infect Control. 1981 Sep;8(9):127-8.

Chickenpox exposures cost hospital $20,000.

Heitzer V.

Publication Types: 
    Interview

PMID: 10252268 [PubMed - indexed for MEDLINE]

8048: Postgrad Med J. 1981 Aug;57(670):507-8.

Encephalitis and polyneuritis complicating varicella zoster infection.

Twomey JA, Jefferson D.

Publication Types: 
    Case Reports

PMID: 7301699 [PubMed - indexed for MEDLINE]

8049: Am J Ophthalmol. 1981 Aug;92(2):215-20.

Herpes simplex type 1 retinitis in an adult with systemic herpes zoster.

Partamian LG, Morse PH, Klein HZ.

A 72-year-old man developed bullous skin lesions two months before he was
discovered to have malignant lymphoma. Herpes zoster virus grew from the skin
bullae. He developed encephalitis, keratitis in the left eye, and bilateral
retinitis 18 months later. Herpes simplex virus type 1 grew from cultures of the 
eyelid vesicles and corneal scrapings from the left eye. The patient died two
years after the diagnosis of malignant lymphoma. Virus particles believed to be
herpes simplex virus were demonstrated on electron microscopy in the necrotic
retinal cells.

Publication Types: 
    Case Reports

PMID: 7270636 [PubMed - indexed for MEDLINE]

8050: J Am Acad Dermatol. 1981 Aug;5(2):218-9.

Intralesional corticosteroids.

[No authors listed]

Publication Types: 
    Letter

PMID: 7263966 [PubMed - indexed for MEDLINE]

8051: Otolaryngol Clin North Am. 1981 Aug;14(3):631-52.

Control of pain in the head and neck.

Carron H.

The patient with head or neck pain should be managed primarily with medication
that will adequately prevent, rather than relieve, pain. The terminal patient
should receive medication to which he will not develop tolerance and that will
permit him to function in his normal environment. Although nerve blocks are not a
panacea for all pain syndromes, in carefully selected subjects, chemical
interruption of nerve pathways can provide significant relief for chronic pain
sufferers.

Publication Types: 
    Review

PMID: 7029415 [PubMed - indexed for MEDLINE]

8052: Br J Ophthalmol. 1981 Aug;65(8):542-5.

Topical acyclovir in herpes zoster ocular involvement.

McGill J.

Topical acyclovir has been found in 15 out of 18 patients to control, without
recurrences and in an appreciably shorter time than if steroids were used,
keratoconjunctivitis induced by herpes zoster. Once steroids were started,
recurrences occurred during withdrawal of steroids or after they had been
stopped.

Publication Types: 
    Clinical Trial

PMID: 7028083 [PubMed - indexed for MEDLINE]

8053: Br J Ophthalmol. 1981 Aug;65(8):539-41.

Herpes zoster ophthalmicus: a medical review.

Lightman S, Marsh RJ, Powell D.

Patients with herpes zoster undergo extensive screening to detect underlying
malignant disease which is compromising their immunity. In a retrospective survey
of 1000 patients with herpes zoster ophthalmicus 12 patients had malignant
disease which was known on presentation. No new cases were detected or discovered
on follow-up. Three patients developed a disseminated rash, but none of these had
an underlying malignant disease.

PMID: 6975119 [PubMed - indexed for MEDLINE]

8054: Nervenarzt. 1981 Aug;52(8):477-80.

[Transcutaneous electrical nerve stimulation (TNS) in the treatment of chronic
neurological pain (author's transl)]

[Article in German]

Klingler D, Kepplinger B.

PMID: 6974312 [PubMed - indexed for MEDLINE]

8055: Neurology. 1981 Aug;31(8):1030-2.

Hemispheric infarction after herpes zoster ophthalmicus: computed tomography and 
angiography.

Kuroiwa Y, Furukawa T.

Publication Types: 
    Case Reports

PMID: 6973708 [PubMed - indexed for MEDLINE]

8056: Infect Immun. 1981 Aug;33(2):491-7.

Differentiation of members of the human herpesviridae family by radioimmunoassay.

Smith KO, Kennell W.

Many individuals who are seronegative for one member of the human Herpesviridae
family are strongly seropositive for other members. Using sera from such
individuals, the radioimmunoassay technique demonstrated absence of
antigen-antibody cross-reactions between varicella-zoster virus (VZV) and herpes 
simplex virus (HSV) at levels of less than one part in 1,000. Sera containing
antibody to both HSV and VZV were absorbed with antigens of one agent without
significantly altering the amount of remaining antibody to the other antigen.
This further suggests that HSV and VZV do not share a common antigen. The same
radioimmunoassay technique and serum absorption method that revealed no
serological cross-reactions between HSV and VZV revealed the expected
cross-reaction between HSV type 1 (HSV-1) and HSV-2. Reciprocally absorbed
anti-HSV-1 and anti-HSV 2 sera were able to differentiate the two HSV types
reliably. No cross-reactions were seen between cytomegalovirus, VZV, and HSV or
between Epstein-Barr virus, VZV, and HSV. We postulate that heterotypic antibody 
responses sometimes observed for VZV after primary infections by HSV may not be
due to shared antigens, but to activation of latent VZV infections, release of
new VZV antigens, and consequent stimulation of new antibody production to VZV.

PMID: 6268545 [PubMed - indexed for MEDLINE]

8057: Am J Dis Child. 1981 Aug;135(8):750-3.

Viral infections in pediatric burn patients.

Linnemann CC Jr, MacMillan BG.

Bacterial and fungal infections are frequent complications of burns, but the
frequency of viral infections has not been defined. In a retrospective survey of 
serum for viral antibodies in pediatric burn patients, 22% had fourfold increases
in antibodies to cytomegalovirus (CMV); 8% had increases to herpes simplex virus 
and to Epstein-Barr virus; and 5% had increases to varicella-zoster virus. None
of the patients had evidence of adenovirus or hepatitis B virus infection. On the
basis of these observations, a prospective study of viral infections, using both 
serologic and viral culture techniques, was performed. This study showed that in 
33% of the children CMV infection developed; in 25%, herpes simplex infection;
and in 17%, adenovirus infection. In all of the most severely burned children CMV
infections developed, and both primary and reactivation infections were observed.
Unexplained fevers are common in pediatric burn patients, and this study shows
that some of these may be due to CMV infection.

PMID: 6267934 [PubMed - indexed for MEDLINE]

8058: Drugs. 1981 Aug;22(2):111-28.

Ribavirin and inosiplex: a review of their present status in viral diseases.

Chang TW, Heel RC.

A considerable amount of information has accumulated during the past 10 years in 
the search for antiviral agents. Ribavirin and inosiplex are 2 interesting
developments to come out of this search. Ribavirin, a synthetic nucleoside, has
an unusually wide spectrum of antiviral activity, especially when tested in
vitro. A large number of RNA and DNA viruses are sensitive, especially herpes
viruses, poxvirus, influenza, parainfluenza, reovirus, togavirus, and RNA tumour 
viruses. The in vivo antiviral spectrum of activity is much narrower, with
activity against herpes virus, influenza, parainfluenza, measles and
adenoviruses. However, controlled clinical trials have not been uniformly
successful in treating influenza, hepatitis, herpes simplex and herpes zoster.
Inosiplex has been shown to have antiviral activity in vivo against influenza,
herpes simplex, rhinovirus and vaccinia virus infections. However, antiviral
activity has not been consistently demonstrated, and this observation led to
further studies which revealed its immunomodulating effects. The accumulated
evidence has indicated that inosiplex is more a prohost agent rather than an
antiviral drug. Immune functions which are depressed during viral infection can
be restored to normal by inosiplex therapy. At present, neither ribavirin nor
inosiplex alone has been shown to be uniformly successful in the treatment of
human viral diseases. Nevertheless, their potential place in chemotherapy should 
not be neglected, although further data are needed to determine what this place
will be. Whether combining them with other antiviral agents such as interferon,
acyclovir, Ara-A, and so on, would produce a potentiation of action and improved 
antiviral chemotherapy, will be an interesting area for further study.

Publication Types: 
    Clinical Trial
    In Vitro
    Review

PMID: 6167418 [PubMed - indexed for MEDLINE]

8059: JAMA. 1981 Jul 17;246(3):236-41.

Immunization: Evaluation of some currently available and prospective vaccines.

Sabin AB.

Acute respiratory and diarrheal diseases cannot be expected to be effectively
controlled by vaccines for a variety of reasons but largely because of the great 
multiplicity of causative agents. Measles could be eradicated by appropriate
strategies. Paralytic poliomyelitis caused by polioviruses can be controlled by
oral poliovirus vaccine in both developed and undeveloped countries but by
different strategies. Vaccines cannot be expected to have a beneficial effect on 
recurrent genital, ocular, and facial herpes. Since naturally acquired immunity
does not prevent subsequent fetal intrauterine infection with cytomegalovirus, it
is still necessary to establish whether it can nevertheless prevent congenital
defects. Prospective hepatitis B vaccines cannot be expected to be useful in the 
general population. There is reason to believe that both varicella and herpes
zoster could be prevented by widespread use of the Japanese attenuated vaccine.

PMID: 7241763 [PubMed - indexed for MEDLINE]

8060: Minerva Med. 1981 Jul 14;72(28):1863-8.

[Methisoprinol in the therapy of herpes zoster]

[Article in Italian]

Tinozzi CC, Romagna E, Macchi G.

PMID: 6166902 [PubMed - indexed for MEDLINE]

8061: JAMA. 1981 Jul 10;246(2):132-4.

Administration of levodopa for relief of herpes zoster pain.

Kernbaum S, Hauchecorne J.

Forty-seven outpatients with herpes zoster, seen within five days of onset of the
eruption, received ten days' administration of oral levodopa and benserazide or
placebo in a double-blind controlled study. Both the total patient group and
high-risk group, eg, those with either ophthalmic zoster or those older than 65
years, were analyzed. Both groups were comparable in terms of demographic and
pathological criteria. Vomiting was the only side effect observed in both groups.
A significant decrease in intensity of pain was seen in the group receiving
levodopa from the third day, and complete cessation of both pain and sleep
disturbances was more frequent in the patients. Two months later, postherpetic
neuralgia was also less frequent in the group that received levodopa.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 7017177 [PubMed - indexed for MEDLINE]

8062: Rev Med Chir Soc Med Nat Iasi. 1981 Jul-Sep;85(3):443-5.

[Clinical aspects of the varicella-zoster virus infection]

[Article in Romanian]

Brauner E, Mihalache D, Radulescu A, Cercel I, Mihul V, Oana C, Iosefsohn I,
Iosifescu V.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7335992 [PubMed - indexed for MEDLINE]

8063: West J Med. 1981 Jul;135(1):62-6.

Reflex sympathetic dystrophy of the lower extremity: a complication of herpes
zoster with dramatic response to propranolol.

Visitsunthorn U, Prete P.

Publication Types: 
    Case Reports

PMID: 7257382 [PubMed - indexed for MEDLINE]

8064: Hosp Pract (Off Ed). 1981 Jul;16(7):109-21.

Antiviral agents: clinical status report.

Whitley RJ, Alford CA.

Recently, the clinical focus in antiviral chemotherapy has been on the use of
ara-A in herpes infections-HSV encephalitis, zoster in the immunosuppressed, and 
neonatal herpes. In this last article of a four-part series, the authors review
clinical studies that have to date led to the licensing of ara-A for HSV
encephalitis but have not yet clearly defined its role in the immunosuppressed or
in neonates.

PMID: 6788666 [PubMed - indexed for MEDLINE]

8065: J Gen Virol. 1981 Jul;55(Pt 1):201-5.

The plaque-forming factor for mink lung cells present in cytomegalovirus and
herpes-zoster virus stocks identified as Mycoplasma hyorhinis.

Darai G, Flugel RM, Zoller L, Matz B, Kreig A, Gelderblom H, Delius H, Leach RH.

Previous investigation of the ability of cytomegalovirus and varicella-zoster
virus to replicate in a variety of cell lines suggested that both virus types
plaqued with high efficiency in mink lung cells. However, many of the virus
isolates used appeared to be contaminated with mycoplasma. We now report that the
observed cytopathic effect is due to a mycoplasma which grows lytically to high
titre in mink lung cells, but is difficult to cultivate in cell-free media. The
mycoplasma was plaque-purified and shown to contain DNA with a buoyant density of
1.684 g/ml, with restriction endonuclease patterns identical to the porcine
mycoplasma M. hyorhinis. This was confirmed by serological identification.

PMID: 6271903 [PubMed - indexed for MEDLINE]

8066: Immun Infekt. 1981 Jul;9(4):140-6.

[Experiences with the ELISA at the serodiagnosis of infections with viruses of
the herpes-group (author's transl)]

[Article in German]

Lindenschmidt EG.

A commercially available and standardized enzymeimmunoassay was applied at 737
patients in order to diagnose immunologically a recent or reactivated infection
with Herpes simplex, Herpes zoster V. and/or Cytomegalovirus. During this course 
of investigation rises or falls of the titer of virus specific IgG between the
range of 1 : 320, 1 : 1280 and greater than or equal to 1 : 5120 turned out to
mark mainly recent infections with one of the three herpes viruses. Statistical
evaluations of the tests performed proved the elevated sensitivity of the
IgG-ELISA as compared with the complement binding reaction. The range of
specificity of the two tests was similar. A significant titer of IgM (greater
than or equal to 1 : 40) as a marker of a recent infection with one of the three 
herpes viruses could only be demonstrated at 13-19% of the cases of recent herpes
viral infection. Controls of the sera with a significant virus specific IgM-titer
in the ELISA by sucrose gradient centrifugation or with a reference-ELISA
confirmed their virus specific mu-specificity in almost all of the cases (96%).

Publication Types: 
    Comparative Study
    English Abstract

PMID: 6268528 [PubMed - indexed for MEDLINE]

8067: Hum Pathol. 1981 Jul;12(7):663-5.

Post-transplantation pancreatitis associated with cytomegalovirus (report of a
case).

Parham DM.

Cytomegalovirus inclusions were identified at autopsy in the pancreas and skin of
a patient with acute pancreatitis and herpes zoster who had had a renal
transplant. No inclusions were found in any of the other organs examined.
Etiologic implications are discussed.

Publication Types: 
    Case Reports

PMID: 6268526 [PubMed - indexed for MEDLINE]

8068: Am J Med Sci. 1981 Jul-Aug;282(1):12-7.

Antibody responses to varicella-zoster virus and the role of antibody in host
defense.

Gershon AA, Steinberg SP.

Antibody titers to varicella-zoster (VZ) virus in persons aged 1-85 years were
measured. Through age 50, the percent of seropostitive individuals continued to
rise. There was no fall in geometric mean titer with aging, and there may have
been an increase in VZ antibody titer in older persons. Thus, a fall in VZ
antibody with increasing age does not seem likely to account for the increased
incidence of zoster in the elderly. Similarly, immunocompromised patients who are
more likely to develop zoster than normals did not have lower VZ antibody titers 
than normal persons. Finally, immunocompromised persons with disseminated zoster 
had antibody titers that were somewhat higher that those of immunocompromised
persons with localized zoster. It appears that humoral immunity has little or no 
influence on either the development or the course of herpes zoster.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6267940 [PubMed - indexed for MEDLINE]

8069: Minerva Pediatr. 1981 Jun 15;33(11):549.

[Brachial zoster in an infant]

[Article in Italian]

De Benedetto F.

Publication Types: 
    Case Reports
    Letter

PMID: 7254159 [PubMed - indexed for MEDLINE]

8070: Z Arztl Fortbild (Jena). 1981 Jun 1;75(11-12):553-5.

[Difficult diagnoses or diagnostic errors in general practice]

[Article in German]

Brandt H.

PMID: 7303754 [PubMed - indexed for MEDLINE]

8071: Arch Dermatol. 1981 Jun;117(6):377.

Cutaneous pseudolymphoma at the site of resolving herpes zoster.

Sanchez JL, Mendez JA, Palacio R.

Publication Types: 
    Case Reports

PMID: 7247435 [PubMed - indexed for MEDLINE]

8072: Ann Allergy. 1981 Jun;46(6):344.

Influenza vaccine treatment of herpes of the eye.

Baker J.

Publication Types: 
    Case Reports
    Letter

PMID: 6972716 [PubMed - indexed for MEDLINE]

8073: Antiviral Res. 1981 Jun;1(2):73-96.

An assessment of antiviral drugs for the management of infectious diseases in
humans.

Galasso GJ.

Publication Types: 
    Review

PMID: 6175275 [PubMed - indexed for MEDLINE]

8074: Infect Immun. 1981 Jun;32(3):995-9.

Inhibition of human herpesviruses by combination of acyclovir and human leukocyte
interferon.

Levin MJ, Leary PL.

Human leukocytes interferon in low concentrations (1 to 5 U/ml) enhanced the
antiviral effect of acyclovir against herpes simplex virus, varicella-zoster
virus, and cytomegalovirus grown in human fibroblasts. This occurred without
additive inhibition of the division of human fibroblasts or proliferation of
peripheral blood mononuclear cells. The combined antiviral effect was additive
against clinical isolates of cytomegalovirus and was synergistic against clinical
isolates of the other two viruses. The magnitude of the effect with
cytomegalovirus was the same when laboratory and wild-type virus were compared.
The persistence of varicella-zoster virus in the presence of acyclovir in
infected human cells was also reduced by the addition of interferon.

Publication Types: 
    Comparative Study
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6166569 [PubMed - indexed for MEDLINE]

8075: Rev Clin Esp. 1981 May 31;161(4):265-7.

[Severe thrombopenia in disseminated herpes zoster]

[Article in Spanish]

Cuesta J, Montalar J, Redon J, Lacruz J, Herranz C, Caballero M.

Publication Types: 
    Case Reports

PMID: 7280336 [PubMed - indexed for MEDLINE]

8076: Lancet. 1981 May 30;1(8231):1183-6.

Presence of elevated antibody titres to Epstein-Barr virus before Hodgkin's
disease.

Evans AS, Comstock GW.

Sera taken 12 and 21 months before the diagnosis of Hodgkin's disease in two
patients showed higher antibody levels to several Epstein-Barr-virus (EBV)
antigens than did sera from eight matched controls. In one case the titres of all
EB antibodies except that to nuclear antigen were raised in a serum sample
obtained 45 months after the diagnosis was made. Antibody levels to herpes
simplex, cytomegalovirus, and varicella zoster viruses were normal in both cases.
A third patient with histiocytic lymphoma had normal EBV and other herpes
antibody titres in a serum sample taken 40 months before diagnosis.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 6112530 [PubMed - indexed for MEDLINE]

8077: Harefuah. 1981 May 15;100(10):463-4.

[Herpes zoster and paralytic ileus]

[Article in Hebrew]

Burshtein A, Resnick Z.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6895509 [PubMed - indexed for MEDLINE]

8078: Nippon Ganka Gakkai Zasshi. 1981 May 10;85(5):415-8.

[Serum complement fixing antibody in herpetic ocular diseases (author's transl)]

[Article in Japanese]

Wu JS, Yamanishi R, Kaneko M, Uchida Y.

Publication Types: 
    English Abstract

PMID: 6973922 [PubMed - indexed for MEDLINE]

8079: Med Clin (Barc). 1981 May 10;76(9):377-80.

[Infections due to herpes-varicella viruses in Hodgkin's disease (author's
transl)]

[Article in Spanish]

Redon J, Herranz C, Montalar J, Navarro JR, Blanes A, Munarriz B, Reynes G,
Caballero M.

The infections due to herpes-varicella viruses occurring in 191 patients with
Hodgkin's disease form the basis of this report. There were overall 41 episodes
(26.7%) in 40 patients, distributed as follows: varicella in three cases,
atypical herpes-varicella in two cases, and herpes zoster in 36 cases, the latter
showing systemic spread in seven instances, one to the central nervous system
(myelitis) and six to the skin. The mortality was 2.5% of all infections, and 33%
of the varicella cases. Morbidity was apparent as postherpetic neuralgia in seven
patients (19.4%), postherpetic paraplegia in one case (2.5%), and severe
thrombocytopenia in another case (2.5%). The statistical study of the factors
contributing to the development of reactivation episodes demonstrated that
neither age, sex, or previous splenectomy were influential. The results obtained 
in relation to the stage and histologic type of Hodgkin's disease can not be
fully evaluated because of the artifact introduced by other variables such as
type of therapy and observation time. There was a clear relationship with the
aggressiveness of therapy, because 81.7% of the viral episodes occurred in
patients submitted to total radiotherapy with or without chemotherapy, or with
partial radiotherapy plus chemotherapy. In the patients with systemic spread
there was a clear relationship with prior splenectomy (p less than 0.005). The
clinical features of these patients are commented upon.

Publication Types: 
    English Abstract

PMID: 6264237 [PubMed - indexed for MEDLINE]

8080: Eur J Pharmacol. 1981 May 8;71(2-3):211-21.

Is Fleming's lysozyme an analgesic agent? An experimental reappraisal of clinical
data.

Bianchi C.

Hen egg white lysozyme (Fleming's lysozyme) was tested for antinociceptive
activity in rats against foot hyperalgesia provoked by a subplantar injection of 
a number of irritants: arachidonic acid, brewer's yeast, carrageenan, kaolin,
mepartricin and rabbit anti-rat serum (Randall-Selitto method). The compound was 
active when given p.o., i.m. or i.v. (100-200-400 mg/kg) as well as when injected
locally in the foot pad concurrently with the irritant (1-2-4 mg/rat). Lysozyme
decreased the sensitivity of the inflamed paw to the nociceptive stimulation,
left unmodified the sensitivity of the normal paw and did not reduce the oedema
of the inflamed paw. It differed in its activity from steroidal and non-steroidal
anti-inflammatory drugs and from central analgesics that were used as standard
reference drugs. Its activity was not shared by hen egg white and ovalbumin.
Contrary to dextran, lysozyme i.p. did not induce anaphylactoid reactions.
Lysozyme did not provoke tolerance and did not interfere with the antinociceptive
activity of morphine. The results are in agreement with clinical data published
years ago. Lysozyme was claimed to be an active agent against herpes zoster and
cancer pain.

PMID: 6166485 [PubMed - indexed for MEDLINE]

8081: Wiad Lek. 1981 May 1;34(9):775-7.

[Case of cutaneous systemic herpes zoster]

[Article in Polish]

Marcinow M, Sysak-Wrobel H.

Publication Types: 
    Case Reports

PMID: 7281679 [PubMed - indexed for MEDLINE]

8082: Dermatol Monatsschr. 1981 May;167(5):303-4.

[Combined treatment of herpes zoster using microwaves, ultrasonics, vitamins and 
antiseptics (author's transl)]

[Article in German]

Todorov N, Kirjakova N, Madjarova J.

PMID: 7274498 [PubMed - indexed for MEDLINE]

8083: Arch Fr Pediatr. 1981 May;38(5):337-43.

[Varicella and herpes zoster in 83 children treated for malignancies (author's
transl)]

[Article in French]

Gruson S, Mouchnino G, Reinert P, Patte C.

57 children treated for malignant diseases presented with varicella and 26 with
herpes zoster. Evolution of varicella was benign in 33 children but was
complicated in 24, resulting in the death of 6 children. No child died of herpes 
zoster. The severity of skin and lung symptoms was of no prognostic value but
digestive symptoms were associated with severe forms of the disease.
Immuno-stimulation was of no use. Vidarabine did not improve the death rate;
acycloguanosine is currently under study.

Publication Types: 
    English Abstract

PMID: 7259420 [PubMed - indexed for MEDLINE]

8084: Ann Ophthalmol. 1981 May;13(5):579-80.

Cicatricial ectropion of the upper lid secondary to herpes zoster ophthalmicus.

Smith JP, Lavine DM.

Publication Types: 
    Case Reports

PMID: 6973306 [PubMed - indexed for MEDLINE]

8085: Ann Intern Med. 1981 May;94(5):712-3.

Herpes zoster during gold therapy.

Fam AG, Paton TW, Cowan DH.

Publication Types: 
    Letter

PMID: 6786152 [PubMed - indexed for MEDLINE]

8086: Neurol Neurochir Pol. 1981 May-Jun;15(3):283-9.

[Suppressor cell activity in multiple sclerosis and other nervous system
diseases. Preliminary report]

[Article in Polish]

Czernicki J, Offierska M, Maciejek Z, Tchorzewski H, Chmielewski H.

3H-Thymidine incorporation was assessed in concanavalin A-stimulated cultures of 
peripheral blood lymphocytes of healthy subjects and multiple sclerosis patients.
At the same time the counts of T and B lymphocytes were determined in peripheral 
blood and the activity of suppressor cells was determined in vitro by the method 
of Shou et all. in these patients and in other neurological diseases. The studied
immunological parameters showed some variability in patients with multiple
sclerosis: at the time of exacerbations the activity of suppressor cells
decreased and the mitogenic response to Con A was impaired. In remissions and in 
slowly progressive cases of multiple sclerosis the activity of suppressor cells
was increased, particularly in elderly patients. The reported investigations
demonstrated that disturbances in the functions of suppressor cells occur also in
other neurological diseases. The role of the observed disturbances in the
pathogenesis of multiple sclerosis is discussed.

Publication Types: 
    English Abstract
    In Vitro

PMID: 6458774 [PubMed - indexed for MEDLINE]

8087: Postgrad Med. 1981 May;69(5):159-63, 166-9, 172.

Common groin eruptions: diagnosis and treatment.

Fragola LA Jr, Watson PE.

Most common groin lesions are caused by fungi, bacteria, psychogenic factors,
viruses, parasites, or tumors. The workup of all patients with an inguinal skin
disorder should include a history, physical examination, microscopic examination 
and culture of scrapings from the eruption, and examination of the eruption by
Wood's light. Agents useful in treating groin lesions include topical and
systemic corticosteroids and antibiotics, antipruritic agents, Burow's solution, 
and lindane. Prolonged use of high-potency topical corticosteroids can be
deleterious.

PMID: 6453332 [PubMed - indexed for MEDLINE]

8088: J Infect Dis. 1981 May;143(5):693-9.

A rapid radioimmunoassay using 125I-labeled staphylococcal protein A for antibody
to varicella-zoster virus.

Richman DD, Cleveland PH, Oxman MN, Zaia JA.

A sensitive radioimmunoassay for serum antibody to varicella-zoster virus is
described; it uses 125I-labeled staphylococcal protein A and a specially designed
immunofiltration apparatus. The assay accurately distinguishes between
individuals who are susceptible and those who are immune to infection with
varicella-zoster virus. In addition, it can detect passive antibody in recipients
of varicella-zoster immune globulin. This radioimmunoassay also detects the
heterologous antibody responses that occasionally occur in patients infected with
herpes simplex virus, which also have been detected by other antibody assays. The
particular advantages of this assay are the use of noninfectious reagents, the
speed of execution (less than 3 hr), the requirement for only small quantities of
serum (30 microliters), the objectivity of end-point determination, and the
capability of screening large numbers of sera. Consequently, this
radioimmunoassay is especially useful for the rapid identification of susceptible
individuals, which is essential for the appropriate management of patients and
hospital personnel after exposure to varicella.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 6263987 [PubMed - indexed for MEDLINE]

8089: Rev Clin Esp. 1981 Apr 30;161(2):99-102.

[Immunologic observations on healthy children with a background of herpes zoster]

[Article in Spanish]

Santana R, Ramirez A, Ruiz-Maldonado R, Plaza A.

Publication Types: 
    English Abstract

PMID: 6974384 [PubMed - indexed for MEDLINE]

8090: Minerva Med. 1981 Apr 28;72(17):1071-82.

[Pharmacokinetic and clinical evaluation of cefoxitin]

[Article in Italian]

Soranzo ML, Eandi M, Capra E, Salassa B, Bosio G, Bramato C, Andrini L, Andreoni 
G, Di Nola F.

An investigation conducted on healthy volunteers showed that cefoxitin quickly
reaches high plasma concentrations, and is almost completely excreted via the
urine within 6 hours. In a series of 21 cases treated with 2 g i.v. in 100 ml of 
a 5% glucose solution two or three times a day, a clinical cure was achieved in
20, and marked improvement in the remaining patient.

Publication Types: 
    English Abstract

PMID: 6785672 [PubMed - indexed for MEDLINE]

8091: Neuropatol Pol. 1981 Apr-Jun;19(2):229-41.

[Macrophage reactions of the cerebrospinal fluid in the course of viral and
bacterial meningitis]

[Article in Polish]

Polewska-Jeske A.

Publication Types: 
    English Abstract

PMID: 6272162 [PubMed - indexed for MEDLINE]

8092: Indian J Ophthalmol. 1981 Apr;29(1):37-8.

Herpes zoster ophthalmicus in children (reports of two cases).

Panda A, Sood NN, Dayal Y, Bhatia IM.

Publication Types: 
    Case Reports

PMID: 6269994 [PubMed - indexed for MEDLINE]

8093: Clin Exp Immunol. 1981 Apr;44(1):49-56.

Detection of anti-platelet antibodies in patients with idiopathic
thrombocytopenic purpura (ITP) and in patients with rubella and herpes group
viral infections.

Kahane S, Dvilansky A, Estok L, Nathan I, Zolotov Z, Sarov I.

A highly sensitive enzyme-linked immunosorbent assay (ELISA) technique was
observed for serological detection of antibodies against platelets. A covalently 
bound to Sepharose CL-4B was used to enrich sera in the IgG3 subclass of
antibodies. The ELISA procedure as applied to detect anti-platelet antibodies in 
patients with herpes or rubella viral infections and in patients with idiopathic 
thrombocytopenic purpura (ITP). Twenty-eight sera from 13 thrombocytopenic
patients showed high levels of anti-platelet antibodies. Two splenectomized
patients in remission became negative for anti-platelet antibodies. Seventy-four 
sera from patients with serological diagnosis of herpes group viral infections
comprising 10 cases of cytomegalovirus, nine cases of varicella or zoster, six
cases of herpes simplex and four cases of Epstein-Barr virus were examined for
the presence of anti-platelet antibodies. Except for two patients with varicella 
and zoster and one patient with rubella infection, all cases examined showed
positive titres of anti-platelet antibodies. Sera from a group of 51 healthy
controls were evaluated for anti-platelet antibodies. Forty-nine (96%) were
negative (less than 40), whereas the other two were only slightly positive.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6266723 [PubMed - indexed for MEDLINE]

8094: J Virol Methods. 1981 Apr;2(5):301-12.

An interchangeable ELISA for cytomegalovirus antigen and antibody.

Sundqvist VA, Wahren B.

An enzyme-linked immunosorbent assay (ELISA) was developed to demonstrate
cytomegalovirus (CMV) antibodies and antigen. A nuclear antigen from CMV-infected
cells was used for detection of IgG and IgM antibodies. Significant rises of
CMV-IgG and significant levels of CMV-IgM were found in sera from patients with
acute CMV only, and not with other herpesvirus infections. CMV antigens were
demonstrated in cells and in culture medium by a sandwich or by an inhibition
ELISA technique. In the sandwich technique, the plates were coated with monkey
anti-CMV IgG and rabbit anti-CMV IgG was used as the second antibody. Both early 
and late CMV antigens were identified with this method. Treatment of CMV
containing samples using freeze--thawing or detergent reduced the infectivity,
but the antigenicity was not affected. There was no cross-reactivity with herpes 
simplex or varicella-zoster virus.

PMID: 6262352 [PubMed - indexed for MEDLINE]

8095: Am J Med. 1981 Apr;70(4):882-6.

Successful treatment with acyclovir of an immunodeficient patient infected
simultaneously with multiple herpesviruses.

Cupps TR, Straus SE, Waldmann TA.

A patient with recurrent simultaneous chronic infections, including
cytomegalovirus pneumonia, disseminated zoster and perineal herpes simplex
infection, whose immune responses were deficient (immunodeficient), is presented.
Following treatment with acyclovir (19-(2-hydroxyethoxymethyl)guanine), this
patient had a rapid remission of these viral infections. The patient's clinical
improvement is remarkable considering the duration of the viral infections and
the continued immune deficiency. Acyclovir appears to act by a highly selective
activation by and inhibition of viral enzymes. Prospective trials of this agent
in immunosuppressed patients with herpes virus infections seem warranted.

Publication Types: 
    Case Reports

PMID: 6259942 [PubMed - indexed for MEDLINE]

8096: Infect Immun. 1981 Apr;32(1):24-7.

Decrease of the lymphoproliferative response to varicella-zoster virus antigen in
the aged.

Berger R, Florent G, Just M.

Humoral antibodies and specific cellular immune reactions (proliferative immune
response in the lymphocyte transformation test) to varicella-zoster virus antigen
were measured in children, young adults, and elderly people. In children and
young adults, the humoral varicella-zoster-specific antibodies and the
virus-specific cellular immune response generally coincided. In the over-60 age
group, however, a discrepancy was often observed between these parameters. Ninety
percent of the elderly subjects showed humoral antibodies, but only 64% still had
a measurable varicella-zoster-specific immune response. There was no correlation 
between the magnitude of the virus antigen-specific immune response and the
mitogen-induced lymphoproliferative response (phytohemagglutinin stimulation).
One in three elderly people, therefore, showed no cellular immune response to the
varicella-zoster virus antigen, and this person could probably be regarded as a
potential herpes zoster patient.

PMID: 6163722 [PubMed - indexed for MEDLINE]

8097: N Engl J Med. 1981 Mar 26;304(13):789.

No predisposition to herpes zoster with chemotherapy of breast cancer.

Markman M, Abeloff MD.

Publication Types: 
    Letter

PMID: 7464891 [PubMed - indexed for MEDLINE]

8098: Wiad Lek. 1981 Mar 1;34(5):435-7.

[Case of paralysis of the lower limb in herpes zoster]

[Article in Polish]

Klimek A, Bogucki A.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7281669 [PubMed - indexed for MEDLINE]

8099: Bol Med Hosp Infant Mex. 1981 Mar-Apr;38(2):313-22.

[Infections in the child with acute leukemia]

[Article in Spanish]

Carrillo JM, Jimenez E, Jimenez R.

One hundred and twenty-five febrile episodes in 82 children with acute leukemia
were studied; 46% of the patients were from urban and 54% from rural areas. The
origin of the fever was identified in 91% of the episodes, prevailing pneumonia, 
septicemia, chickenpox and herpes zoster. The etiological agent was identified in
46% of the cases. A viral predominance was evident, and among them
varicela-zoster, following in importance gram-negative bacteria. Histoplasma
capsulatum and Pneumocystis carinii were isolated in two occassions each. Sepsis 
was found more frequently in children with active leukemia than in those in
remission (p less than 0.001). Forty-four febrile episodes occurred in patients
with less than 1,000 neutrophils/ul. The daily-risk rate of infection was higher 
in children fom rural than in those from urban areas (p less than 0.001). After
clinical and laboratory studies, methicillin and gentamicin were used, in
addition to carbenicillin or trimethoprim-sulfamethoxazole is selected cases.
This treatment was effective in 86% of the cases. Twelve (15%) children died, 6
of whom were in remission at that moment.

Publication Types: 
    English Abstract

PMID: 7259849 [PubMed - indexed for MEDLINE]

8100: Br J Dermatol. 1981 Mar;104(3):351-2.

Herpes zoster.

Sklar SH, Wigand JS.

Publication Types: 
    Letter

PMID: 7213570 [PubMed - indexed for MEDLINE]

8101: Arch Ophthalmol. 1981 Mar;99(3):460-3.

Complications of cryosurgery.

Wood JR, Anderson RL.

We describe 70 patients who underwent cryosurgery to the lids during a two-year
period. Of the 58 receiving adequate follow-up, approximately one fourth had
complications thought to be directly caused by cryosurgery. These include visual 
loss, lid notching, corneal ulcer, acceleration of symblepharon formation,
xerosis, cellulitis, activation of herpes zoster, skin depigmentation, and severe
soft-tissue reaction. In addition, 9% of the lids showed possible induction of
trichiasis in areas adjacent to treatment. More than two thirds of patients with 
conjunctival shrinkage or grafted or irradiated lids had adverse effects, with
one case of permanent visual loss. Misdirected lashes were successfully
eliminated with a single double freeze-thaw technique in 90% of lids treated.
Cryosurgery for aberrant lashes and some benign lid lesions is the most effective
method of therapy presently available, but one must be aware of its potential
complications. It has a low complication rate in "normal" lids, but should be
used with caution in patients with conjunctival shrinkage or in those with
grafted and/or irradiated lids.

PMID: 7213166 [PubMed - indexed for MEDLINE]

8102: Acta Neurol Scand. 1981 Mar;63(3):181-8.

Cystometry and mictometry as tools in diagnosing neurogenic impotence.

Rydin E, Lundberg PO, Brattberg A.

Thirty-six males with erective impotence underwent neurological and urological
examinations. Six of the patients were known to have a neurological disorder at
the time of referral (four multiple sclerosis, one myelomeningocele, one diabetic
polyneuropathy). Four further cases of neurological disorders were found (one
multiple sclerosis, one myelopathy of unknown cause, one Shy-Drager syndrome, one
sequelae of sacral herpes zoster). Five of these 10 patients gave a history of
urinary troubles, but in all of them objective signs of bladder dysfunction were 
found at cystometry and/or mictometry. Among the 26 patients with impotence and
no indication of a neurological disorder all invariably had normal
cystometrograms, though some had abnormal mictiograms, probably due to local
urological disorders. A neurological examination should be included in the
evaluation of patients with erective impotence. Cystometry and mictometry may be 
of value by giving additional indications that the impotence is neurogenic. This 
is explained by the fact that the anatomical structures regulating sexual
function lie close to corresponding structures regulating bladder function at the
spinal level.

PMID: 7211183 [PubMed - indexed for MEDLINE]

8103: J Pediatr. 1981 Mar;98(3):368-73.

Prophylaxis of varicella in high-risk children: dose-response effect of zoster
immune globulin.

Orenstein WA, Heymann DL, Ellis RJ, Rosenberg RL, Nakano J, Halsey NA, Overturf
GD, Hayden GF, Witte JJ.

Immunodeficient patients who were presumed to be susceptible received zoster
immune globulin prophylaxis after exposure to varicella. The highest clinical
attack rate (35.9%) was seen in household contacts; the lowest attack rate (0%)
was observed in children exposed at school. Among household contacts, 48 of 100
patients who received high titer ZIG (reciprocal complement fixation titer
greater than or equal to 2,560) developed fourfold rises in serum CF antibody
between pre- and 48-hour post-treatment specimens, compared to only one of 34
patients treated with lower titer ZIG lots (P less than 0.001). Patients who
developed fourfold antibody rises were significantly less likely to contract
clinical varicella (P less than 0.01). Patients who received high titer ZIG also 
had significantly lower risks of death (P = 0.025) and complications (P = 0.006).
Among ZIG-treated patients who contracted clinical varicella, 80% developed mild 
disease (less than 100 pox), and the median incubation period was prolonged.
Immunodeficient children exposed to varicella benefit from ZIG prophylaxis and
higher titer ZIG is of greatest benefit.

PMID: 7205447 [PubMed - indexed for MEDLINE]

8104: Rev Med Suisse Romande. 1981 Mar;101(3):221-7.

[Ocular complications of zona ophthalmica]

[Article in French]

Zografos L, Chamot L.

PMID: 6973181 [PubMed - indexed for MEDLINE]

8105: Ann Neurol. 1981 Mar;9(3):251-66.

Multifocal varicella-zoster virus leukoencephalitis temporally remote from herpes
zoster.

Horten B, Price RW, Jimenez D.

Two patients with cancer, one with Hodgkin's disease and the other with a
granulosa cell tumor of the ovary, developed a progressive, eventually fatal
infection of the central nervous system exhibiting multifocal symptoms and signs.
Pathologically, gross abnormalities of the brain resembled those in progressive
multifocal leukoencephalopathy (PML), with discrete and confluent plaque-like
lesions concentrated in the white matter, particularly along the gray-white
junction. Microscopically, pathological changes differed distinctly from those
associated with PML; in addition to confluent foci of white matter injury
characterized by early demyelination and subsequent necrosis, prominent Cowdry
type A eosinophilic intranuclear inclusions were noted in oligodendrocytes,
astrocytes, and neurons. By electron microscopy, intranuclear spherical particles
consistent in size and appearance with herpesvirus nucleocapsids were found
within the lesions. Immunoperoxidase studies detected varicella-zoster virus
(VZV) antigens in infected cells, implicating this virus as the responsible agent
despite a lapse of many months between the cutaneous herpes zoster and onset of
cerebral symptoms in both patients.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 6261672 [PubMed - indexed for MEDLINE]

8106: J Clin Neuroophthalmol. 1981 Mar;1(1):53-5.

Stellate block for trigeminal zoster.

Olson ER, Ivy HB.

Stellate ganglion block for relief of pain and prevention of ophthalmic
complications in trigeminal herpes zoster has been advised for many years. In a
series of 27 patients, control of pain was dramatic after local anesthetic block 
of the stellate ganglion. This report is presented to stimulate renewed interest 
in this old form of therapy. Because of the retrospective nature of this
investigation, the lack of adequate numbers and the absence of controls, no
conclusions on efficacy of treatment can be made. However, enough hope of success
is presented to justify a controlled series in a large metropolitan area where
adequate numbers of patients can be accumulated for a double-blind protocol.

PMID: 6213645 [PubMed - indexed for MEDLINE]

8107: Radiography. 1981 Mar;47(555):67-72.

What do we really know about Interferon ?

Cartwright S.

PMID: 6168004 [PubMed - indexed for MEDLINE]

8108: Nippon Gan Chiryo Gakkai Shi. 1981 Feb 20;16(1):1-7.

[Herpes zoster infection and radiation therapy (author's transl)]

[Article in Japanese]

Hayakawa K, Okazaki A, Mitsuhashi N, Ito I, Niibe H.

Publication Types: 
    English Abstract

PMID: 7264410 [PubMed - indexed for MEDLINE]

8109: Geriatrics. 1981 Feb;36(2):53-63.

Office management of viral skin infections in the elderly.

Raimer SS, Pursley TV.

PMID: 7450510 [PubMed - indexed for MEDLINE]

8110: Tohoku J Exp Med. 1981 Feb;133(2):121-8.

Cytological and immunological examination of cerebrospinal fluid in 9 patients
with Ramsay Hunt's syndrome.

Nakamura S, Takase S, Itahara K, Ogata M, Shigeta S.

The purpose of the present study was to carry out the immunological and
cytological examination of cerebrospinal fluid in 9 patients with Ramsay Hunt's
syndrome. The results obtained were as follows: Among the serum immunoglobulins, 
IgG in 1 and IgM in 5 of 9 cases increased. The Varicella Zoster antibody titer
was significantly elevated in sera of all 9 cases and in CSF of all 7 examined
cases. There ws positive fluorescence to Varicella Zoster virus in 2 (Cases 8 and
9) of 4 cases in which CSF smears were examined. The cells showing fluorescence
were 10.5% in the former and 1.5% in the latter. Pleocytosis was found in all
cases and CSF cell counts ranged from 52 to 2,000/3 mm3 in the early stage. In 3 
cases immunoglobulin containing cells (IgG and IgM) were seen about 2-20% within 
2 weeks of onset. IgG contents in all and IgG% in 8 of 9 cases, IgA concentration
in 7 and IgA% in 7 of 9 cases were increased. These results support the view that
the Varicella Zoster virus spreads to the meninges and CSF from ganglions in
patients with Ramsay Hunt's syndromes.

PMID: 6267732 [PubMed - indexed for MEDLINE]

8111: J Infect Dis. 1981 Feb;143(2):274-80.

Rapid diagnosis of varicella-zoster virus infections by countercurrent
immunoelectrophoresis.

Frey HM, Steinberg SP, Gershon AA.

A simple, accurate, and rapid method for laboratory diagnosis of varicella-zoster
virus (VZV) infections using countercurrent immunoelectrophoresis (CIE) is
described. CIE uses zoster convalescent-phase serum to detect VZV antigen in
vesticular fluid. Eighty-six patients were studied, 58 with VZV infections and 28
with vesicular or bullous rashes due to causes other than VZV infection. All
patients with documented VZV infection had positive CIE tests for VZV, and the
controls were uniformly negative. VZV antigen could be detected up to 15
(varicella) or 16 (zoster) days after the onset of rash. The sensitivity of CIE
for detection of VZV antigen was compared with results of viral isolation, immune
adherence hemmagglutination, and an indirect enzyme-linked immunosorbent assay.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 6260875 [PubMed - indexed for MEDLINE]

8112: Cesk Dermatol. 1981 Feb;56(1):11-6.

[An immunological study of herpes zoster patients III--specific immunity
(author's transl)]

[Article in Czech]

Vacek Z, Trlifajova J, Doutlik S, Vasickova M, Ryba M.

Publication Types: 
    English Abstract

PMID: 6260390 [PubMed - indexed for MEDLINE]

8113: Wiad Lek. 1981 Feb 1;34(3):199-204.

[Current methods of treating herpes zoster]

[Article in Polish]

Rubisz-Brzezinska J, Zebracka T, Brzezinska-Wcislo L.

Publication Types: 
    English Abstract

PMID: 6167075 [PubMed - indexed for MEDLINE]

8114: Cutis. 1981;27(1):40-2.

Recurrences of herpes zoster.

Nordlund JJ.

Publication Types: 
    Case Reports
    Letter

PMID: 7471805 [PubMed - indexed for MEDLINE]

8115: J Pediatr. 1981 Jan;98(1):71-3.

Zoster in infancy: failure to maintain virus latency following intrauterine
infection.

Brunell PA, Kotchmar GS Jr.

Publication Types: 
    Case Reports

PMID: 7452407 [PubMed - indexed for MEDLINE]

8116: Acta Neurochir (Wien). 1981;58(3-4):259-63.

Symptomatic herpes zoster and sciatica. A case report.

Clavel M.

The author reports a case of a 44-year-old woman with sciatica due to a herniated
lumbar disc complicated by the appearance of a zoster eruption over the same, or 
nearly the same, dermatome. Among the causative factors that trigger herpes
zoster prolapsed intervertebral disc is not usually included.

Publication Types: 
    Case Reports

PMID: 7315555 [PubMed - indexed for MEDLINE]

8117: Scand J Infect Dis. 1981;13(4):301-2.

Herpes zoster and hepatitis B: detection of Hepatitis B surface antigen in
vesicle fluid.

Norkrans G, Vahlne A, Iwarson S.

Publication Types: 
    Case Reports

PMID: 7313584 [PubMed - indexed for MEDLINE]

8118: Intervirology. 1981;15(2):103-10.

Detection of specific IgA antibodies in serum of patients with varicella and
zoster infections.

Levy E, Sarov I.

A sensitive solid-phase, enzyme-linked immunosorbent assay (ELISA) was developed 
for detection of serum IgA antibodies to varicella-zoster virus (VZV). The
antigen consisted of a sonically disrupted extract of VZV-infected human embryo
cells. Rabbit antihuman IgA peroxidase conjugate was used to detect human IgA
bound to viral antigens. In parallel, IgM and IgG antibodies to VZV were studied 
by ELISA and by an immunoperoxidase antibody to membrane antigen technique,
respectively. VZV IgA antibodies were detected in high titers in all 5 varicella 
and 8 zoster patients. Specific VZV IgM antibodies were detected in all 5
varicella patients, but only in 2 of 8 zoster patients. No VZV IgA antibodies
(less than 40) were detected in 50 healthy control sera. Neither were they found 
in paired sera of 5 patients with herpes simplex infections, 2 patients with
Epstein-Barr virus infections, and 5 patients with human cytomegalovirus
infections. The potential application of ELISA IgA techniques in serodiagnosis of
both primary and reactivated VZV infections is discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7298297 [PubMed - indexed for MEDLINE]

8119: Eur Neurol. 1981;20(4):330-3.

Amyotrophic lateral sclerosis following Herpes zoster infection in a patient with
immunodeficiency.

Maida E, Kristoferitsch W.

Publication Types: 
    Case Reports

PMID: 7274314 [PubMed - indexed for MEDLINE]

8120: Otolaryngol Pol. 1981;35(1):17-25.

[Loss of chorda tympani function and the secretory efficiency of the parotid
gland (author's transl)]

[Article in Polish]

Kulczynski B.

Publication Types: 
    English Abstract

PMID: 7254850 [PubMed - indexed for MEDLINE]

8121: Zh Nevropatol Psikhiatr Im S S Korsakova. 1981;81(2):47-52.

[Clinical picture and pathogenesis of generalized forms of herpes zoster]

[Article in Russian]

Smirnov IuK, Shishov AS, Mal'tseva NN, Kharin IO, Papilova BI.

Clinical examination of 83 patients with generalized herpes zoster has given the 
authors grounds to regard this disease as a result of activation of latent
varicella-zoster virus. This assumption was confirmed by the results of indirect 
hemagglutination inhibition tests with 37 serum specimens taken from 18 patients.
Treatment with antibiotics, the drug proper-myl, and by dehydration was the more 
effective, the earlier the patients were admitted to the clinic. Dehydration,
proper-myl and combination of chloramphenicol with dehydration produced a more
beneficial effect than the antibiotic alone. Five patients died. Problems of
pathogenesis are discussed.

Publication Types: 
    English Abstract

PMID: 7234260 [PubMed - indexed for MEDLINE]

8122: Int J Dermatol. 1981 Jan-Feb;20(1):65-8.

Treatment of herpes zoster and postzoster neuralgia by subcutaneous injection of 
triamcinolone.

Epstein E.

Based on a study of 400 patients (272 patients with herpes zoster and 128 with
postzoster neuralgia), the subcutaneous injection of triamcinolone in saline is
concluded to be a safe and effective measure for reducing pain. The acute
eruption and symptoms of herpes zoster cleared in an average of less than four
days. Postzoster neuralgia developed in only 2.9% of the patients, although
nearly 70% of these patients were more than 50 years of age. In cases of
postzoster neuralgia, 35% cleared completely; 28.9% improved enough so that they 
could live with the occasional pain, itching, or numbness, and therapy was not
beneficial for an additional 15.6%, and it failed in 18.7% of the cases. The
results were satisfactory in 63.9% of the patients, and the side effects were
minimal.

Publication Types: 
    Comparative Study

PMID: 7203770 [PubMed - indexed for MEDLINE]

8123: Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1981;217(4):325-30.

[Immunological examinations in Vogt-Koyanagi-Harada disease (author's transl)]

[Article in German]

Richard G, Dieckhues B, Junemann G.

In eight patients with clinical sure Vogt-Koyanagi Harada-syndrome (VKHS)
immunological examinations were performed. We tested whether there were signs of 
former or present infections (measles HHT and complement fixation test (C.F.T.), 
rubella HHT, hepatitis HBs-antigen, adenovirus AG, varicella-zoster C.F.T.,
herpes simplex C.F.T., cytomegaly IgM and IgG, toxoplasmosis immunofluorescence, 
tuberculosis Middlebr. Dubois). In none of all cases we could find HLA B12. The
rheumatic tests, LDH, albumin an electrophoresis, coeruloplasmin and haptoglobin 
were negative. The uveal pigment failed to stimulate the leucocyte cultures from 
VKHS-patients in leucocyte-migration-inhibition-test and in
leucocyte-adherence-inhibition-test.

Publication Types: 
    English Abstract

PMID: 7034582 [PubMed - indexed for MEDLINE]

8124: Scand J Infect Dis. 1981;13(4):257-62.

Treatment of trigeminal and thoracic zoster with idoxuridine.

Wildenhoff KE, Esmann V, Ipsen J, Harving H, Peterslund NA, Schonheyder H.

A double-blind random selection comparison was made of the therapeutic effects in
acute herpes zoster of 40% idoxuridine (IDU) dissolved in dimethyl sulphoxide
(DMSO) compared with DMSO and saline flavoured with garlic. Thoracic (80
patients) and trigeminal (42 patients) zoster were investigated separately. The
patients were evaluated daily until skin healing and then at 1, 3 and 6 months by
registering pain, paraesthesia and sensitivity disturbances as well as by
clinical and photographic evaluation of the skin lesions. Duration of pain was
positively correlated to age, to delayed healing and to elevated temperature in
the acute phase of zoster. The period of pain before skin eruption was
considerably longer in thoracic than in trigeminal zoster, while the latter was
associated with a more severe inflammatory reaction, more neurologic sequelae,
but also by a faster healing of the skin lesions. IDU was highly effective in
shortening the period of pain and improving skin healing in trigeminal zoster,
while no effect of IDU was observed in thoracic zoster. The reason for this
difference is presently not understood.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 7031859 [PubMed - indexed for MEDLINE]

8125: Vutr Boles. 1981;20(1):34-9.

[Our experience with the dispensary observation and treatment of kidney
transplant patients]

[Article in Bulgarian]

Stefanov G, Beleva B.

The authors report the results from the follow-up of 14 patients with
transplanted kidney, three out of them with a lethal end--mycotic sepsis--1,
purulent peritonitis--1 and of transplant lung-syndrome--1. The rest (11-78,5%)
were in a good condition during 1 year and 8 months to 6,5 years (an average of 4
years and 10 days by April 30, 1980). Eleven of the patients had their
transplantations performed by Prof. Sumakov--Prof. Levizkii in Moscow and
three--by Prof. Hamburger, Prof. Crosnier, Prof. Lacomb in Necker Hospital,
Paris. During the follow-up period those 14 patients had the following
complications: 15 acute crises of rejection, successfully coped, with residual
phenomena in 4 of them; 10--uroinfections, 7--other infections, one mycotic
sepsis and one purulent peritonitis with a lethal end; three with epidermic
hepatitis, one--Herpes zoster, two bronchopneumonias, one perinephritis, 6--with 
arterial hypertension that necessitated binephrectomy in two, three patients with
steroid diabetes--cured, four with aseptic osteonecrosis of the head of the
femur, necessitating prosthesis of the femoral joint in one patient, 5--with
surgical complications, corrected at the transplantation centers. Furthermore,
one case with transplant lung-syndrome, successfully restored to health as
reported by the authors. All those 11 patients with transplantations are in good 
health (one with a chronic rejection crisis) and 8 of them--work. The authors
stress upon the follow-up of the renal patients with transplantation as an
important step, consolidating the remote results of renal transplantation.

Publication Types: 
    English Abstract

PMID: 7018086 [PubMed - indexed for MEDLINE]

8126: Acta Neuropathol Suppl. 1981;7:139-41.

Immunohistochemical demonstration of viral antigens in paraffin embedded autopsy 
specimens of virally infected central nervous system.

Lohler J.

Viral antigens are preserved in routinely processed and paraffin embedded CNS
tissue to an extent that they can be traced by the highly sensitive and specific 
unlabeled antibody method. Using this method, it was possible to visualize
antigens of measles, influenza A, polio, varicella-zoster, herpes simplex,
cytomegalo, parainfluenza I, lymphocytic choriomeningitis, Moloney, and Friend
virus.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 7013411 [PubMed - indexed for MEDLINE]

8127: Trans Ophthalmol Soc U K. 1981;101(1):3-5.

Drug treatment of herpes zoster.

McGill J, James C, Hiscott P, Worstman T, Williams JH, Copplestone A, Larkin M.

PMID: 6985235 [PubMed - indexed for MEDLINE]

8128: Bull Soc Belge Ophtalmol. 1981;193:49-56.

Preliminary results of oral BVDU treatment of herpes zoster ophthalmicus.

Maudgal PC, Dralands L, Lamberts L, De Clercq E, Descamps J, Missotten L.

PMID: 6979370 [PubMed - indexed for MEDLINE]

8129: Ophthalmologica. 1981;183(3):143-7.

Unilateral inferior altitudinal hemianopsia, Argyll Robertson pupil and dendritic
keratitis in a young patient with herpes zoster.

Sammartino A, Fusco R, de Crecchio G, Magli A.

The authors describe a young patient with herpes zoster and discuss the
etiopathogenesis of the complications which included unilateral inferior
altitudinal hemianopsia, Argyll Robertson pupil and dendritic keratitis.

Publication Types: 
    Case Reports

PMID: 6975913 [PubMed - indexed for MEDLINE]

8130: Vasa. 1981;10(1):58-63.

[Larvate temporal arteritis with skin manifestation following herpes zoster
ophthalmicus]

[Article in German]

Bardach H, Lindemayr H, Obiditsch-Mayer I.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6972129 [PubMed - indexed for MEDLINE]

8131: Acta Neuropathol Suppl. 1981;7:156-9.

"Thalamic" dementia in herpes encephalitis: clinico-pathological report.

Pilleri G, Pietrini V, Tagliavini F, Trabattoni G, Lechi A.

Herpes zoster (HZ) primary affections of the CNS are rare and, in most of the
reported patients, are representing variously extended forms of ascending
myelitis. Our examination concerns a man who at the age of 37 developed apathy
after a feverish episode with iridocyclitis. Six months later an ophthalmic HZ
was diagnosed and thenceforth the patient showed a dementia with Korsakow's
syndrome, apathy and a right hemipalsy, and diplopia appeared; the later symptoms
remitted after steroid therapy. Post-mortem examination revealed a slowly
progressive encephalitis with symmetrical impairment of the anterior ventral,
medial, and centrum medianum of the thalamus. The HZ origin of the lesions and
the relation between their site and the peculiar form of dementia, to be ascribed
to the "thalamic" ones, are discussed. A vasculitis process can be hypothesized
considering both the symmetrical localisation and the microscopical aspects of
the lesions.

Publication Types: 
    Case Reports

PMID: 6971556 [PubMed - indexed for MEDLINE]

8132: Geriatrics. 1981 Jan;36(1):81-90.

Herpes zoster and the aging eye.

Weingeist TA.

Although most patients with herpes zoster are otherwise healthy, all should be
screened for occult neoplastic disease. Treatment is frustrating and nonspecific.
Postherpetic neuralgia is especially difficult to manage and tends to be more
severe among geriatric patients. All patients with trigeminal nerve involvement
should be referred to an ophthalmologist for evaluation and possible treatment of
ocular complications.

PMID: 6969681 [PubMed - indexed for MEDLINE]

8133: Feldsher Akush. 1981;46(10):55-7.

[Shingles: herpes zoster]

[Article in Russian]

Sagalov GM.

Publication Types: 
    Case Reports

PMID: 6913509 [PubMed - indexed for MEDLINE]

8134: J Fr Otorhinolaryngol Audiophonol Chir Maxillofac. 1981 Jan;30(1):59-61.

[Auricular zona]

[Article in French]

Martin C.

PMID: 6450822 [PubMed - indexed for MEDLINE]

8135: J Fr Otorhinolaryngol Audiophonol Chir Maxillofac. 1981 Jan;30(1):11-7.

[Facial paralysis and generalized infectious diseases]

[Article in French]

Martin C, Martin H, Viala JJ, Guastalla JP.

Publication Types: 
    Case Reports

PMID: 6450813 [PubMed - indexed for MEDLINE]

8136: Verh Dtsch Ges Pathol. 1981;65:203-7.

[Investigations to demonstrate latent viral infection of varicella-Zoster-virus
in human spinal ganglia]

[Article in German]

Wolff MH, Buchel F, Gullotta F, Helpap B, Schneweis KE.

Publication Types: 
    English Abstract

PMID: 6289549 [PubMed - indexed for MEDLINE]

8137: Intervirology. 1981;16(4):244-9.

Antibody pattern to human cytomegalovirus in patients with adenocarcinoma of the 
colon.

Avni A, Haikin H, Feuchtwanger MM, Sacks M, Naggan L, Sarov B, Sarov I.

The role of human cytomegalovirus (CMV) was examined according to serological
patterns in 37 patients with adenocarcinoma of the colon (ACC). The sera were
examined for the presence of IgG antibodies by the immunoperoxidase antibody to
membrane antigens (IPAMA) method and by the complement-fixation (CF) test.
Antibody determinations were also performed by the IPAMA method for three other
members of the herpesvirus group: Epstein-Barr virus (EBV), herpes simplex virus 
(HSV) and varicella-zoster virus (VZV). Comparison groups included normal
subjects, ACC patients treated with chemotherapy, and patients operated on for
benign diseases. No significant difference was found in the geometric mean titers
(GMTs) for CMV and the other herpesviruses in the sera of nontreated ACC patients
when compared with the control groups. However, a significantly elevated antibody
titer to CMV was found in chemotherapy-treated ACC patients by both the IPAMA and
CF methods. In this group, elevated titers were found by the IPAMA method for EBV
and HSV, but not for VZV. The significance of serological studies in elucidating 
the role of CMV in ACC patients is discussed.

Publication Types: 
    Comparative Study

PMID: 6282775 [PubMed - indexed for MEDLINE]

8138: Ter Arkh. 1981;53(10):135-40.

[Viral infections in pregnancy]

[Article in Russian]

Farber NA.

Publication Types: 
    Review

PMID: 6274053 [PubMed - indexed for MEDLINE]

8139: Scand J Infect Dis. 1981;13(4):297-300.

Intrauterine varicella: a report of two cases associated with
hyper-A-immunoglobulinemia.

Taranger J, Blomberg J, Strannegard O.

Varicella during pregnancy may occasionally harm the fetus. This report described
one case of congenital varicella syndrome and another of infantile herpes zoster 
after maternal varicella in the 16th and 29th week of pregnancy, respectively. A 
remarkable finding was that both mothers and infants had raised levels of serum
IgA. This suggests that varicella is prone to lead to congenital disease in
infants of pregnant women with an immunologic, perhaps genetically determined
abnormality.

PMID: 6274000 [PubMed - indexed for MEDLINE]

8140: Prog Clin Pathol. 1981;8:239-267.

Advances in clinical virology.

Peterson LR, Balfour HH Jr.

Publication Types: 
    Review

PMID: 6272358 [PubMed - indexed for MEDLINE]

8141: J Med Virol. 1981;8(2):89-101.

Detection of antibody to varicella-zoster virus by competitive and IgM-antibody
capture immunoassay.

Tedder RS, Mortimer PP, Lord RB.

A simple, sensitive, and specific competitive solid phase immunoassay for
antibody to varicella-zoster virus (anti-VZV) is described. The assay uses
reagents that can easily be prepared and is sparing of viral antigen. Using a
solid phase coated with sheep IgG from a serum raised against human mu-Fc, the
same reagents will accurately detect anti-VZV IgM. The competitive assay divided 
sera from children from adults into immune and nonimmune groups that closely
correlated with a history of previous VZV illness. It was not affected by the
presence or absence of antibody to other herpes viruses. The IgM antibody capture
assay demonstrated the presence of anti-VZV IgM in sera from patients with both
varicella and zoster and gave negative results in patients with infections
unrelated to VZV and in healthy blood donors.

PMID: 6271923 [PubMed - indexed for MEDLINE]

8142: J Med Virol. 1981;7(2):85-96.

Solid-phase radioimmunoassay of serum IgG, IgM, and IgA antibodies to
cytomegalovirus.

Torfason EG, Kallander C, Halonen P.

A radioimmunoassay (RIA) using polystyrene beads as the solid phase for
cytomegalovirus (CMV) antigen and iodinated immunosorbent purified anti-human
IgG, IgM, and IgA as indicator antibodies was developed for the detection of
immunoglobulin class-specific antibodies to CMV. An antigen prepared from
extracellular virus was essential for reliable results, and a preparation
ultracentrifuged and sonicated twice was better than a crude antigen. The optimal
antigen gave low cpm values with a negative reference serum, resulting in cpm
ratios of 10 or higher between early convalescent phase serum and negative
reference serum. Of six patients with an increase in CMV CF titres, all six had
an increase in RIA IgG titres, four had an increase in IgA titres, and all had
IgM antibodies. The IgG titres were high, up to 1/64,000. In a group of 17
infants negative in CMV CF test, 14 had CMV IgG antibodies in RIA test,
indicating mainly low levels of maternal antibodies. In six of seven patients
with CMV isolations from urine specimens, an increase in IgG or IgA titres or the
presence of IgM antibodies was found, and only one of these patients had an
increase in CMV CF titre. The specificity of the developed CMV RIA test was
further demonstrated by detecting no significant increase in RIA titres in serum 
specimens of patients with primary herpes simplex infection, chickenpox, herpes
zoster, or infectious mononucleosis.

PMID: 6267191 [PubMed - indexed for MEDLINE]

8143: J Immunol Methods. 1981;43(3):283-90.

Production of monospecific antibodies to varicella zoster virus antigen in
rabbits tolerant to human IgG and immunized with antigen immunoprecipitated with 
human IgG from zoster reconvalescent sera.

Hansen BL, Vestergaard BF, Hansen GN.

A method for production of antisera specific to a single antigen of a human
infectious agent is described with varicella zoster virus (VZV) as a model.
Microisolation of immunochemically pure antigen contained in defined
immunoprecipitates was achieved by crossed immunoelectrophoresis of a crude
antigenic preparation (detergent solubilized, VZV infected cells) into agarose
gel containing zoster reconvalescent immunoglobulin. Immunization of rabbits made
tolerant to human IgG with immunoprecipitates resulted in the production of
antibodies to the antigen part of the immunoprecipitate. The method represents a 
short cut to the production of heterologous diagnostic antisera to defined
antigens of human infectious agents.

PMID: 6265561 [PubMed - indexed for MEDLINE]

8144: Infect Immun. 1981 Jan;31(1):436-44.

Immune response after exposure to varicella zoster virus: characterization of
virus-specific antibodies and their corresponding antigens.

Zweerink HJ, Neff BJ.

Fourteen varicella zoster virus antigens were identified that induce antibodies
during primary and recurrent infections. These antigens, which included the major
nucleocapsid polypeptide (molecular weight, 155,000) and three glycoproteins
(molecular weights, 130,000, 88,000, and 60,000, respectively) plus a number of
minor antigens, were identified in radioimmunoprecipitation assays, using
[35S]methionine-labeled extracts of cells infected with varicella zoster virus
and sera from patients with primary and recurrent viral infections. No
significant and reproducible differences were observed between early convalescent
sera from cases with natural chicken pox and sera from cases with zoster in their
ability react with viral antigens. Sera that were taken many years after episodes
of chicken pox still retained their ability to react with the major viral
antigens.

PMID: 6260665 [PubMed - indexed for MEDLINE]

8145: Arch Neurol. 1981 Jan;38(1):49-51.

Recurrent herpes zoster encephalitis. A complication of systemic lupus
erythematosus.

O'Donnell PP, Pula TP, Sellman M, Camenga DL.

A middle-aged woman had five discrete episodes of herpes zoster. The first attack
consisted of uncomplicated herpes zoster ophthalmicus. The subsequent four
episodes involved thoracic, cervical, and finally sacral dermatomes and were
complicated by myelitis or encephalomyelitis. During the most recent attack,
while she was receiving corticosteroids, varicella-zoster virus was cultured from
the CSF. In addition, the patient had strong evidence of systemic lupus
erythematosus, with a history of Raynaud's phenomenon, migratory arthralgia, and 
unexplained anemia before the first attack of zoster with subsequent development 
of a positive lupus cell preparation and elevated antinuclear antibody levels.

Publication Types: 
    Case Reports

PMID: 6257212 [PubMed - indexed for MEDLINE]

8146: Tex Rep Biol Med. 1981-1982;41:532-7.

Effect of interferon on systemic herpesvirus infections.

Kern ER, Glasgow LA.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6189219 [PubMed - indexed for MEDLINE]

8147: Microbiol Immunol. 1981;25(3):295-303.

Anticomplement immunofluorescence for the titration of antibody to
varicella-zoster virus.

Shigeta S, Baba M, Ogata M, Iijima S, Murai C.

Anticomplement immunofluorescence (ACIF) was tested for its use for the titration
of antibody against varicella-zoster virus (VZV). ACIF antibody responses of
patients with VZV infection were specific for VZV antigen and heterotypic
responses to herpes simplex virus type-1 and cytomegalovirus antigens were not
observed. Comparative studies of ACIF, membrane immunofluorescence (MIF) and
indirect immunofluorescence (IF), using acetone-fixed antigen, were carried out
with nonimmune sera and convalescent sera of patients who had recovered from
varicella, herpes zoster and Rumsey Hunt disease. Nonspecific staining occurred
with some nonimmune sera at a 1:4 dilution in the MIF and IF tests, after
freezing and thawing of the serum, but not in the ACIF test. The antibody titers 
in convalescent sera agreed well in these three methods and the highest titer was
obtained by MIF. The titers in ACIF and IF were similar but the ACIF antibody
decreased earlier than the IF antibody during convalescence. On the other hand
there was a discrepancy between the titers of ACIF and those of MIF and IF
antibody in the sera of healthy adults, all sera with titers higher than 10 in
the MIF and IF tests had titers below 10 in the ACIF test. The average titer of
ACIF antibody declined to less than 10 with increasing age (13 to more than 20
years), whereas the MIF antibody increased during the same period of life.

Publication Types: 
    Comparative Study

PMID: 6166838 [PubMed - indexed for MEDLINE]

8148: Antimicrob Agents Chemother. 1981 Jan;19(1):193-5.

Short-course human leukocyte interferon in treatment of herpes zoster in patients
with cancer.

Merigan TC, Gallagher JG, Pollard RB, Arvin AM.

Because of encouraging results when human leukocyte interferon was given for 5 to
7 days to treat early localized herpes zoster in patients with cancer, a small
placebo-controlled, randomized, double-blind trial was set up involving only 48 h
of therapy. In this trial, there was no effect on acute pain or disease
progression in the primary dermatome. However, a modest but significant effect
was noted in that distal cutaneous spread was diminished in the treated patients 
compared with the controls and the treated patients had diminished severity and
duration of postherpetic neuralgia. No evidence of impairment in
varicella-zoster-specific lymphocyte transformation was observed in
interferon-treated patients.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 6166245 [PubMed - indexed for MEDLINE]

8149: Antimicrob Agents Chemother. 1981 Jan;19(1):170-8.

Comparison of the effects of arabinosyladenine, arabinosylhypoxanthine, and
arabinosyladenine 5'-monophosphate against herpes simplex virus, varicella-zoster
virus, and cytomegalovirus with their effects on cellular deoxyribonucleic acid
synthesis.

Gephart JF, Lerner AM.

In a single line of human foreskin fibroblasts, minimum inhibitory concentrations
(MICs) and the minimum intracellular virus inactivation concentrations (MIICs) of
arabinosyladenine, arabinosylhypoxanthine, and arabinosyladenine 5'-monophosphate
were assayed for a number of recent isolates of herpes simplex virus types 1 and 
2 (HSV-1, HSV-2), varicella-zoster virus (VZV), and cytomegalovirus (CMV). (The
term MIIC is used here to describe the selective qualitative intracellular
inhibition of the virus inoculum in the primary tissue cultures. The inoculum is 
not recoverable in subcultures free of antiviral agent.) MICs and MIICs of each
of the antiviral agents were readily obtained for each strain of HSV-1, HSV-2,
and VZV tested, but all seven strains of CMV tested were much more resistant. At 
the endpoint, there was little variation in the MICs or MIICs among strans of the
same virus. Final MIC results for HSV-1 and HSV-2 were complete after 3 days of
incubation; CMV and VZV results required as long as 6 days. The MIC for each
herpesvirus increased with incubation, but at the endpoint the MIC and MIIC were 
approximately equal. VZV was most susceptible to each drug, followed by HSV-1 and
HSV-2. The latter two viruses were quite similar. There was no difference in
antiviral susceptibilities among any of the strains of HSV-1, HSV-2, VZV, or CMV 
tested. The toxicities of arabinosyladenine, arabinosylhypoxanthine, and
arabinosyladenine 5'-monophosphate were simultaneously compared by using both
microscopic cytotoxicity and inhibition of uptakes of [14C]thymidine into
cellular deoxyribonucleic acid and of 14C-labeled amino acids into protein. The
selective inhibition of each antiviral agent against viral and cellular
deoxyribonucleic acid polymerases was confirmed. Simultaneous assays of antiviral
and anticellular activities of antiviral agents may be useful in projecting
further in vivo experiments.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 6166244 [PubMed - indexed for MEDLINE]

8150: Lab Delo. 1981;(4):249.

[Micromethod of detecting spontaneous rosette-forming T-lymphocytes]

[Article in Russian]

Semenova EN, Mal'khonov VB.

PMID: 6164870 [PubMed - indexed for MEDLINE]

8151: J Neurol. 1981;224(4):297-300.

Transient contralateral hemiplegia after ophthalmic zoster. Therapeutic problems 
in elderly patients.

Landi G, Calloni MV, Scarlato G.

Delayed ipsilateral carotid arteritis is a known complication of herpes zoster
ophthalmicus. The case of a 70-year-old man with two TIAs following ophthalmic
zoster is reported, and the therapeutic problems in elderly patients are
discussed.

Publication Types: 
    Case Reports

PMID: 6162932 [PubMed - indexed for MEDLINE]

8152: Rev Med Interna Neurol Psihiatr Neurochir Dermatovenerol Med Interna. 1981 
Jan-Feb;33(1):93-6.

[Generalized zona zoster, induced repeatedly by cytosine-arabinoside and
rubidomycin therapy, in a patient with chronic granulocytic leukemia in a blastic
crisis]

[Article in Romanian]

Ciocoiu A, Munteanu N, Berceanu S.

Publication Types: 
    Case Reports

PMID: 6114541 [PubMed - indexed for MEDLINE]

8153: Cutis. 1981;27(1):40.

Dehydroemetine therapy for herpes zoster.

Hoehn GH.

Publication Types: 
    Letter

PMID: 6110514 [PubMed - indexed for MEDLINE]

8154: Can Med Assoc J. 1980 Dec 6;123(11):1115-9.

Breast cancer, cough and vesicular eruptions.

Wigle RD, Treloar ME.

Publication Types: 
    Case Reports

PMID: 6257367 [PubMed - indexed for MEDLINE]

8155: Am J Med. 1980 Dec;69(6):881-5.

Herpes zoster in patients with treated Wegener's granulomatosis. A possible role 
for cyclophosphamide.

Cupps TR, Silverman GJ, Fauci AS.

In review of the ongoing protocol for the treatment of Wegener's granulomatosis
with cyclophosphamide at te National Institutes of Health, an increased incidence
of herpes zoster infection was noted. There were a total of nine episodes in
seven of a total of 65 patients with a 255 patient year follow-up. The infections
occurred while the patients were in complete clinical remission during
immunosuppressive therapy. Cutaneous dissemination was noted in two episodes, but
no visceral or central nervous system involvement was noted despite continuation 
of immunosuppressive therapy. The major causal factor of the increased incidence 
of herpes zoster appeared to be the cyclophosphamide therapy.

PMID: 7446553 [PubMed - indexed for MEDLINE]

8156: Nippon Rinsho. 1980 Dec;38(12):4686-91.

[Liver cirrhosis with manifest Hunt's syndrome: pleural and ascitic fluid]

[Article in Japanese]

Nakura E, Miyazaki R, Ishibashi J, Mikami R, Takahashi H, Saeki K.

Publication Types: 
    Case Reports

PMID: 7253245 [PubMed - indexed for MEDLINE]

8157: J Neurol Neurosurg Psychiatry. 1980 Dec;43(12):1146-7.

Cranial herpes zoster: a case report and a hypothesis.

Ward C, Karsh J, Calne DB.

Publication Types: 
    Case Reports
    Letter

PMID: 7217963 [PubMed - indexed for MEDLINE]

8158: Pain. 1980 Dec;9(3):355-62.

Cryocautery of sensitized skin areas for the relief of pain due to post-herpetic 
neuralgia.

Suzuki H, Ogawa S, Nakagawa H, Kanayama T, Tai K, Saitoh H, Ohshima Y.

Fourteen patients whose post-herpetic neuralgia could not be alleviated by
conventional methods were treated with cryocautery using a stick of solid carbon 
dioxide (dry ice) applied directly to the hyperesthetic skin areas of the
cutaneous scars. Follow-up evaluation revealed that 5 of 14 subjects maintained
excellent pain relief and another 5 subjects showed good relief. Ten subjects
discontinued further therapeutic procedures after cryocautery even though some
low grade pain persisted. We believe that cryocautery of localized skin areas is 
a valuable method for treating patients with post-herpetic neuralgia who have not
been improved by conventional methods. Disadvantages of this procedure are
discussed.

PMID: 7208080 [PubMed - indexed for MEDLINE]

8159: J Dermatol. 1980 Dec;7(6):443-7.

Disseminated zoster.

Nigam P, Dayal SG, Dubey AL.

PMID: 7026639 [PubMed - indexed for MEDLINE]

8160: Ophthalmology. 1980 Dec;87(12):1202-7.

Common viral eye diseases and latent infections.

Nesburn AB.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6972503 [PubMed - indexed for MEDLINE]

8161: Klin Monatsbl Augenheilkd. 1980 Dec;177(6):794-7.

[Diagnosis and treatment of neuroparalytic zoster keratitis (author's transl)]

[Article in German]

Turss R.

In severe zoster keratitis many pathogenic factors are involved. In addition to
viral manifestations, the cornea is often affected by anterior uveitis or
secondary glaucoma. Neuroparalytic keratitis causes lowered blinking frequency
and decreased tear secretion. In addition, zoster ulcerations of the upper lid
margin mechanically disturb reformation of the tear film and weaken the lipid
layer by necrosis of the Meibomian glands. Ointments reduce break-up time and
parasympathicolytic mydriatics further decrease tear secretion. When the average 
time between two blinks is shorter than the tear film break-up time, a "dry eye" 
condition usually develops. The appropriate treatment in such cases is thorough
prevention of evaporation.

Publication Types: 
    English Abstract

PMID: 6970853 [PubMed - indexed for MEDLINE]

8162: J Clin Microbiol. 1980 Dec;12(6):764-7.

Varicella-zoster-associated encephalitis: detection of specific antibody in
cerebrospinal fluid.

Gershon A, Steinberg S, Greenberg S, Taber L.

Varicella-zoster (VZ) antibody measured by indirect immunofluorescence was used
to identify patients with encephalitis due to VZ virus. In 15 of 16 (94%)
patients with VZ infection and clinical evidence of central nervous system
involvement, VZ antibody was present at a titer of 1:2 or greater in
cerebrospinal fluid. In contrast, no VZ antibody was detected in the
cerebrospinal fluid of seven patients with VZ infections without clinical signs
of central nervous system involvement, nor was any detected in the cerebrospinal 
fluid of 25 patients with malignant or demyelinating disease or encephalitis due 
to other viral or toxic agents. All of these patients had detectable serum VZ
antibody. Thus, in this study the presence of detectable VZ antibody in
cerebrospinal fluid measured by indirect immunofluorescence seemed to correlate
with clinical evidence of central nervous system involvement due to this virus.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6273449 [PubMed - indexed for MEDLINE]

8163: Vox Sang. 1980 Dec;39(6):335-8.

Screening blood donors for high titre antibody to herpes varicella-zoster.

Hejjas M, Salker R, Barbara JA.

As a method of increasing supplies of varicella-zoster immunoglobulin,
semi-automated screening of blood donors for high titre complement-fixing
antibody was initiated. This was compared with the previously used method of
donor selection based on a history of varicella or zoster in the past 6 months.
About one-third of the "history" donors had titres of greater than or equal to 1 
in 64 and generally these levels declined rapidly. In contrast, although only
1.1% of donors in random screening had antibody titres greater than or equal to 1
in 64, these levels usually remained high during repeated donation, enabling the 
production of pools entirely composed of high titre plasma packs.

PMID: 6267817 [PubMed - indexed for MEDLINE]

8164: Antimicrob Agents Chemother. 1980 Dec;18(6):957-61.

Anti-herpes simplex virus and anti-human cell growth activity of
E-5-propenyl-2'-deoxyuridine and the concept of selective protection in antivirus
chemotherapy.

Cheng YC, Grill S, Ruth J, Bergstrom DE.

E-5-Propenyl-2'-deoxyuridine (E-5-propenyl-dUrd) inhibited the growth of herpes
simplex virus (HSV) types 1 (HSV-1) and 2 in culture. The concentration of drug
required to give a 2-log reduction in virus titer was 5 microM for HSV-1 and 23
microM for HSV-2. The anti-HSV-1 activity of this agent was more potent than
5-propyl-dUrd, equivalent to E-5(3,3,3-trifluoropropenyl)-dUrd, and less potent
than E-5-bromovinyl-dUrd. The HSV-1 mutant (B2006) lacking the ability to induce 
virus-specific thymidine kinase could not be inhibited by E-5-propenyl-dUrd. The 
binding constants of E-5-propenyl-dUrd to HSV-1, HSV-2, varicella-zoster virus,
and human mitochondrial thymidine kinases were established to be 0.2, 6.2, 0.3,
and 0.8 microM, respectively. Thymidine phosphorylation catalyzed by human
cytosol thymidine kinase could not be inhibited by E-5-propenyl-dUrd at a
concentration 10-fold higher than the thymidine in the assay. When thymidine and 
E-5-propenyl-dUrd were added concomitantly at equal concentrations to
virus-infected cells, the antiviral activity was not reversed in HSV-1 and only
partially reversed in HSV-2. E-5-Propenyl-dUrd also inhibited the growth of human
cells in culture with 50% inhibitory dose of 50 microM. Since this inhibition
could be readily reversed by a lower concentration of thymidine, the idea of
selective protection is proposed. This approach could avoid the cytotoxic effect 
of an antiviral agent with properties similar to E-5-propenyl-dUrd without
sacrificing antiviral activity.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6263181 [PubMed - indexed for MEDLINE]

8165: Ophthalmology. 1980 Dec;87(12):1236-8.

Interferon as an antiviral and anti-tumor therapeutic agent.

Arvin AM.

Clinical trials of the antiviral action of interferon have shown an effect on the
replication of several viruses including varicella zoster, herpes simplex,
cytomegalovirus and hepatitis B. These studies indicate that administration early
in the course of infection, or in some clinical circumstances, prophylactic
administration, is likely to result in viral inhibition. The studies of
interferon efficacy in topical application, as in prevention of recurrent herpes 
simplex keratitis, have shown limited efficacy except with very high doses. These
studies are being pursued with more concentrated preparations of interferon. The 
evaluation of interferon in human malignancy is just beginning, but some
encouraging results have been obtained in open trials of the drug in patients
with non-Hodgkin's lymphoma, melanoma, osteogenic sarcoma, and other diseases.
With newer methods for the production of interferon, it may be possible to
evaluate its antiviral and anti-tumor effects in carefully controlled studies
with larger numbers of subjects.

Publication Types: 
    Review

PMID: 6165951 [PubMed - indexed for MEDLINE]

8166: Acta Virol. 1980 Dec;24(6):406-14.

Cell-mediated immunity to varicella-zoster virus as assessed by the migration
inhibition test.

Trlifajova J, Svejcar J, Svandova E, Ryba M, Pekarek J.

The migration inhibition method was used to test cell-mediated immunity to
varicella-zoster (VZ) virus in 10 varicella and 11 herpes zoster patients.
Control groups consisted of eight children susceptible to VZ infection on
serological evidence and 49 normal persons of different age categories. Depending
on the positivity criterion adopted, positive results during disease were
obtained in 43% or 90% or all tests performed in varicella patients and 47% or
74% in herpes zoster patients. Irrespective of which criterion of positivity was 
applied, a high rate of positive results was obtained in the normal control
groups; in the age range from 20--44 years it was comparable to that for
patients. This finding would suggest a high activity of VZ virus among the human 
population. Since a positive result in migration inhibition test offers evidence 
of recent contact with antigen, either exogeneous contact with VZ infection or
endogenous contact with latent VZ virus must have been involved.

PMID: 6111201 [PubMed - indexed for MEDLINE]

8167: Cutis. 1980 Nov;26(5):524-5.

Disseminated Herpes zoster: a rapid diagnostic test using electron microscopy.

Burkhart CG, DeStephens J.

Publication Types: 
    Case Reports

PMID: 7460624 [PubMed - indexed for MEDLINE]

8168: J Antimicrob Chemother. 1980 Nov;6(6):733-6.

Triple drug therapy of Herpes zoster infection occurring in patients with
reticulo-endothelial neoplasia--a preliminary study.

Busk CM, Earl HM, Wrigley PF, Lister TA.

PMID: 7440466 [PubMed - indexed for MEDLINE]

8169: Br Med J. 1980 Nov 1;281(6249):1178.

Oral (E)-5-(2-bromovinyl)-2'-deoxyuridine in severe herpes zoster.

de Clercq E, Degreef H, Wildiers J, de Jonge G, Drochmans A, Descamps J, de Somer
P.

PMID: 7427624 [PubMed - indexed for MEDLINE]

8170: Am J Gastroenterol. 1980 Nov;74(5):423-7.

Fatal massive hepatic necrosis from varicella-zoster hepatitis.

Ross JS, Fanning WL, Beautyman W, Craighead JE.

An unusual case of varicella-zoster hepatitis is reported which resulted in fatal
massive hepatic necrosis in a 64-year old white female. The patient had had
chickenpox 30 years prior to death but no cutaneous zoster at any time. The liver
showed typical eosinophilic intranuclear inclusions and herpesvirus virions were 
demonstrated by electron microscopy. Indirect immunofluorescent serologic studies
confirmed remote and recent infection by varicella-zoster virus. The potential
significance of an incidental splenectomy performed 14 months before death and
the general role of immunosuppression in the incidence and dissemination of
varicella-zoster are discussed. The features of 13 reported cases of herpes
simplex hepatitis are briefly reviewed.

Publication Types: 
    Case Reports

PMID: 7234819 [PubMed - indexed for MEDLINE]

8171: Int J Dermatol. 1980 Nov;19(9):510-1.

Segmental abdominal zoster paresis.

Garcia RL.

Publication Types: 
    Case Reports

PMID: 6448826 [PubMed - indexed for MEDLINE]

8172: J Clin Microbiol. 1980 Nov;12(5):651-5.

Direct immunofluorescence staining for detection of herpes simplex and
varicella-zoster virus antigens in vesicular lesions and certain tissue
specimens.

Schmidt NJ, Gallo D, Devlin V, Woodie JD, Emmons RW.

Direct immunofluorescence (IF) staining was compared with virus isolation for
detection of herpes simplex viruses (HSV) and varicella-zoster virus (VZV)
directly in clinical materials. These included 199 vesicular lesion specimens and
280 tissue specimens. Correspondence between IF and isolation results was 88% in 
testing for HSV in lesion specimens and 98% in testing for HSV in various tissue 
(mostly brain) specimens. Overall, IF was positive for 82% of the specimens in
which HSV was demonstrated, and virus was isolated from 89% of the HSV-positive
specimens. IF was markedly more sensitive than isolation for demonstrating VZV in
lesion and tissue specimens, detecting all of the specimens positive for VZV,
whereas isolation detected only 23%. IF detected VZV antigen in a number of
lesion specimens taken late after onset, past the time when they would be
expected to yield infectious virus. Specificity of positive IF reactions for HSV 
or VZV in the absence of virus isolation was supported by the facts that (i)
staining was obtained with only a single, presumably homologous, immune
conjugate, (ii) clinical symptoms were compatible with infection with the virus
for which positive IF findings were obtained, and (iii) positive electron
microscopy findings for herpesviruses or positive serological results for VZV
were also obtained in some instances. Factors to be considered in achieving
specificity of IF staining for these human herpesviruses are discussed.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6268653 [PubMed - indexed for MEDLINE]

8173: Med J Aust. 1980 Nov 1;2(9):518.

Herpes zoster and tetracosactrin.

Silberman D.

Publication Types: 
    Letter

PMID: 6259503 [PubMed - indexed for MEDLINE]

8174: Int J Dermatol. 1980 Nov;19(9):514-6.

Herpes zoster in a husband and wife.

Feinstein A, Trau H, Schewach-Millet M.

The wife of a 75-year-old man with zoster began to suffer from this disease some 
24 days after is appeared in her husband. Although zoster is generally regarded
to be an endogenously noncommunicable disease, the case reported herein suggests 
that the infection was exogenously communicated. The literature pointing up that 
zoster may possibly be acquired exogenously, particularly in immunosuppressed
patients, is extensively reviewed.

Publication Types: 
    Case Reports

PMID: 6253406 [PubMed - indexed for MEDLINE]

8175: Srp Arh Celok Lek. 1980 Nov;108(11):1111-7.

[Immunological status in herpes zoster]

[Article in Serbian]

Petrovic M, Kostic A, Lesic Lj, Sasic M.

PMID: 6171894 [PubMed - indexed for MEDLINE]

8176: Antimicrob Agents Chemother. 1980 Nov;18(5):709-15.

Pharmacology, tolerance, and antiviral activity of vidarabine monophosphate in
humans.

Whitley RJ, Tucker BC, Kinkel AW, Barton NH, Pass RF, Whelchel JD, Cobbs CG,
Diethelm AG, Buchanan RA.

Vidarabine (adenine arabinoside) is a purine nucleoside useful in humans for
therapy of herpes simplex virus encephalitis and herpes zoster virus infections
in immunocompromised patients. However, the potential usefulness of vidaribine is
limited by its poor solubility, which requires continuous infusion in relatively 
large volumes of intravenous fluid. Vidarabine 5'-monophosphate is highly soluble
and has the advantage that it can be administered intermittently intramuscularly 
or intravenously. In a clinical, pharmacokinetic study, plasma levels and urinary
excretion of vidarabine 5'-monophosphate were determined after intravenous and
intramuscular administration in 29 immunosuppressed patients with herpes simplex 
or zoster virus infections at dosages of 15 to 30 mg/kg per day administered for 
5 days. As determined by high-pressure liquid chromatography, vidarabine
5'-monophosphate was metabolized in a fashion comparable to the metabolism of
vidarabine and its major metabolite in plasma was arabinosyl hypoxanthine. After 
administration, 40 to 50% of the vidarabine 5'-monophosphate was recovered from
the urine as arabinosyl hypoxanthine, and 3 to 4% was recovered as vidarabine.
Determinations of areas under the curve for arabinosyl hypoxanthine were not
statistically different by dosage for intramuscular or intravenous routes of
administration. At all dosages studied, viral clearance appeared to occur with
therapy. The advantage of increased solubility will lead to controlled clinical
investigations in which vidarabine 5'-monophosphate is administered by
intramuscular or intravenous routes against targeted human herpesvirus
infections.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6160811 [PubMed - indexed for MEDLINE]

8177: Wiad Lek. 1980 Oct 1;33(19):1587-90.

[Neurological complications of generalized herpes zoster]

[Article in Polish]

Chmielewski H, Pniewski S, Lisiewicz J.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7467335 [PubMed - indexed for MEDLINE]

8178: Cutis. 1980 Oct;26(4):417-9.

Herpes zoster developing after a spider bite.

Heller AW, Kelly AP.

A patient was bitten on the hand by a spider and subsequently hemorrhagic herpes 
zoster developed at the site of the bite as well as over most of the area distal 
to the elbow (innervated by cutaneous nerves C5-C8). Mild systemic symptoms of
nausea, abdominal cramping, and visual disturbances responded to the intravenous 
administration of calcium gluconate. There was residual paresthesia of the C5-C8 
dermatome but no atrophy. This is the first reported case of herpes zoster
precipitated by a spider bite.

Publication Types: 
    Case Reports

PMID: 7418443 [PubMed - indexed for MEDLINE]

8179: Cutis. 1980 Oct;26(4):378-9.

Recurrences in herpes zoster.

Epstein E.

Five persons who had had two attacks of zoster were culled from a series of 400
persons with herpes zoster or postzoster neuralgia (incidence, 1.25 percent). The
likelihood of a person having an attack of this virus infection is considered to 
be between 1 and 2 percent. Hence it is possible that an episode of herpes zoster
confers only temporary protection against a second attack. These figures indicate
that recurrences are uncommon but do appear as often as primary attacks appear in
those who never had this condition previously.

Publication Types: 
    Case Reports

PMID: 7418436 [PubMed - indexed for MEDLINE]

8180: Drugs. 1980 Oct;20(4):267-82.

Vidarabine: a preliminary review of its pharmacological properties and
therapeutic use.

Whitley R, Alford C, Hess F, Buchanan R.

Vidarabine is the first drug to become generally available in the USA for
parenteral treatment of life-threatening or debilitating herpes simplex virus
infections of man. For the past decade laboratory and clinical studies have been 
in progress to assess the pharmacology of the compound, its mechanism of action
and its potential usefulness in clinical investigations. Currently, clinical
usefulness has been established for herpes simplex infections of the eye and
brain. Further studies in progress are evaluating the drug's ability to prevent
progressive disease from herpes zoster in the immunocompromised patient, reduce
mortality and morbidity from neonatal herpes simplex virus infection and improve 
outcome of chronic hepatitis B infection.

Publication Types: 
    Review

PMID: 6998693 [PubMed - indexed for MEDLINE]

8181: Clin Otolaryngol Allied Sci. 1980 Oct;5(5):303-10.

Acute facial paralysis: a virological study.

Mulkens PS, Bleeker JD, Schroder FP.

A serological study using the complement fixation reaction for herpes zoster
virus (HZV) and herpes simplex virus (HSV) was carried out on 120 patients with
Bell's palsy and 5 with Ramsay-Hunt syndrome. Three Bell's palsy patients (2.5%) 
showed a significant HZV antibody titre rise. In no case was a rise of HSV
antibody titre observed. Two Ramsay-Hunt patients showed a significant rise of
HZV antibody titre. Rise of HSV antibody titre was not observed in this group
either. The Monosticon test to exclude infectious mononucleosis, proved to be
negative in all cases of Bell's palsy. In 2 cases of Bell's palsy, a biopsy
specimen for virus isolation was obtained during a decompression operation. No
virus could be cultured from the epineurium of the first patient. That of the
second patient was found to contain HSV type I. There was no serological evidence
of a HSV antibody titre rise.

Publication Types: 
    Case Reports

PMID: 6254700 [PubMed - indexed for MEDLINE]

8182: Arch Neurol. 1980 Oct;37(10):610-5.

Comprehensive viral immunology of multiple sclerosis. II. Analysis of serum and
CSF antibodies by standard serologic methods.

Cremer NE, Johnson KP, Fein G, Likosky WH.

Sera and CSFs of 85 patients with multiple sclerosis (MS), 49 patients with
probable MS, and 165 control patients with other neurologic diseases were assayed
for antibodies to rubella, mumps, measles, parainfluenza I (strain 6/94), herpes 
simplex, cytomegalovirus, varicella-zoster, and vaccinia viruses. Methods
included complement fixation (CF), hemagglutination inhibition (HI), and
complement-dependent plaque reduction (CPR). Significant differences between the 
groups with MS and the control groups were higher serum antibody titers to
measles virus in the groups with MS, higher proportion of patients with MS with
CSF antibodies to measles, rubella, and vaccinia viruses, and greater percentage 
of patients with MS with more than one CSF viral antibody. Duration and severity 
of disease in the patients with MS were associated with presence of multiple CSF 
antibodies. Presence of CSF antibody was positively correlated with the height of
the correspnding serum titer, yet a high serum titer did not ensure the presence 
of CSF antibody. Oligoclonal bands were present in the CSFs of equal proportions 
of patients with MS with and without CSF viral antibody. Our data support the
hypothesis of local antibody synthesis within the CNS. However, we favor the view
that preprogrammed antibody-forming lymphocytes enter the CNS and then produce
antibody either because of nonspecific polyclonal activation in situ or because
of failure of normal regulation.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

PMID: 6252874 [PubMed - indexed for MEDLINE]

8183: Br J Haematol. 1980 Oct;46(2):211-23.

Abolished production of interferon by leucocytes of patients with the acquired
cytogenetic abnormalities 5q -- or -- 5 in secondary and de-novo acute
non-lymphocytic leukaemia.

Pedersen-Bjergaard J, Haahr S, Philip P, Thomsen M, Jensen G, Ersboll J, Nissen
NI.

Interferon production by leucocytes on stimulation with inactivated antigens from
herpes simplex virus, varicella zoster virus and cytomegalovirus was determined
in 19 patients with preleukaemia or acute non-lymphocytic leukaemia, in 15
following treatment for other tumours. Production of interferon was abolished in 
10 patients and preserved in nine cases after stimulation with herpes simplex
antigen. Cytogenetic studies of bone marrow demonstrated an abnormal karyotype in
13/15 patients with secondary preleukaemia or leukaemia. Characteristics were (a)
hypodiploid cell lines demonstrated in eight cases, (b) a B-chromosome defect
found in five cases and verified as 5q -- in four, and (c) defects in C-group
chromosomes in 10, verified as monosomy 7 in nine. All four patients with de-novo
preleukaemia or leukaemia had abnormal cytogenetic findings, two B-chromosome
abnormalities verified as monosomy 5. A relationship between abnormalities in
chromosome no. 5 and abolished production of interferon was demonstrated, as only
one of seven patients with 5q --, --5 or --B produced interferon by the
leucocytes, compared with eight of a total of 12 patients with other cytogenetic 
defects or a normal karyotype (P=0.04). The results are remarkable, as chromosome
no. 5 has recently been discovered to contain a gene for interferon production.
Furthermore abolished production of interferon by leucocytes seemed correlated to
previous irradiation and to disease-related fever.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6158987 [PubMed - indexed for MEDLINE]

8184: Br Med J. 1980 Sep 27;281(6244):871.

Acupuncture and postherpetic neuralgia.

Jolly C.

Publication Types: 
    Letter

PMID: 7427486 [PubMed - indexed for MEDLINE]

8185: N Engl J Med. 1980 Sep 18;303(12):703.

Atypical generalized zoster with lymphadenitis mimicking lymphoma.

Kaplowitz LG.

Publication Types: 
    Letter

PMID: 7402262 [PubMed - indexed for MEDLINE]

8186: Schweiz Med Wochenschr. 1980 Sep 6;110(36):1307-13.

[Dermatological complications in immunosuppressed patients after kidney
transplantation]

[Article in German]

L'Eplattenier JL, Binswanger U, Ott F, Largiader F.

205 recipients of renal allotransplants were evaluated either by clinical
examination (n = 91) or by study of records (n = 114). More than 75% of the
patients studied had dermatologic problems in the late post transplant phase, 25%
having 2 or more such conditions. Steroid related complications were most often
observed, i.e. cushingoid in 42%, acne in 26%, hirsutism in 19%, purpura in 12%, 
and rubeosis in 12%. Infections included warts (29%), herpes simplex (13%),
herpes zoster (7%), and candidiasis (29%). 9 patients (4.4%) had skin carcinomas 
which were diagnosed on average 6.2 years after transplantation. The frequency of
skin lesions during immunosuppressive therapy after renal allotransplantation
requires regular skin inspections and information to patients on the potential
risks.

Publication Types: 
    English Abstract

PMID: 6255558 [PubMed - indexed for MEDLINE]

8187: Rinsho Shinkeigaku. 1980 Sep;20(9):713-6.

[A case of Ramsay Hunt syndrome with encephalitis (author's transl)]

[Article in Japanese]

Yamasaki M, Nomura S, Sera H, Segawa Y, Sarai K.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7460433 [PubMed - indexed for MEDLINE]

8188: Rev Fr Transfus Immunohematol. 1980 Sep;23(4):439-48.

[Anti-varicella-zona immunoglobulins. Discovery of antibodies and method of
formation]

[Article in French]

Janot C, Perrier P, Schooneman F, Streiff F, Stoltz JF, Avenard G, Amouch JP.

The screening of zoster's antibodies has been performed in blood donors
population and persons convalescing from herpes zoster. The results show that 25%
of blood donors and 83,5% of convalescents have respectively a titer of CF
antibody of 8. Plasma units were pooled and the pool had a final titer of CF
antibody of 16. Varicella zoster immunoglobulin prepared by alcohol fractionation
had a fluorescent antibody titer of 1 024 and a CF antibody of 512. These results
are discussed and compared with those of literature.

Publication Types: 
    English Abstract

PMID: 7455486 [PubMed - indexed for MEDLINE]

8189: Arch Ophthalmol. 1980 Sep;98(9):1656.

Stellate block for trigeminal herpes zoster.

Olson ER, Ivy HB.

Publication Types: 
    Letter

PMID: 7425932 [PubMed - indexed for MEDLINE]

8190: Vestn Dermatol Venerol. 1980 Sep;(9):54-6.

[Herpes zoster in a patient with chronic lympholeukemia]

[Article in Russian]

Zabel J, Karas Z, Lugowska D.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7424160 [PubMed - indexed for MEDLINE]

8191: J Indian Med Assoc. 1980 Sep 1;75(5):95.

Ramsay Hunt syndrome with an unusual presentation.

Shrivastava MP.

Publication Types: 
    Case Reports

PMID: 7217697 [PubMed - indexed for MEDLINE]

8192: Int J Dermatol. 1980 Sep;19(7):362-74.

Ulcerative lesions of the oral cavity.

Cohen L.

Publication Types: 
    Review

PMID: 6998877 [PubMed - indexed for MEDLINE]

8193: Kango Gijutsu. 1980 Sep;26(12):1657-63.

[Clinical course and nursing of patients with herpes zoster]

[Article in Japanese]

Shinahara S, Shimada Y, Shoji K, Hosoda T.

PMID: 6903617 [PubMed - indexed for MEDLINE]

8194: Rev Infect Dis. 1980 Sep-Oct;2(5):761-800.

Infections in patients with Hodgkin's disease: a clinical study of 300
consecutive adult patients.

Notter DT, Grossman PL, Rosenberg SA, Remington JS.

Patterns of infection were investigated in 300 consecutive adult patients with
Hodgkin's disease who were followed for an average of 5.7 years after diagnosis. 
Serious infection other than cutaneous herpes zoster infection developed in 21%
of the 300 patients. Sixty percent of the episodes of serious infection were
microbiologically documented (MDSI). Bacteremia was the most frequent MDSI, and
Streptococcus pneumoniae was the most common organism causing MDSI. Bacteremia
due to S. pneumoniae occurred in 3% of the 300 patients, was rarely fatal, and
almost always was associated with prior relapse of Hodgkin's disease and with
prior extensive combined modality therapy. The incidence of bacteremia due to S. 
pneumoniae among patients who had received extensive radiation therapy plus
chemotherapy was 5.5%. Identifiable factors predisposing patients to infection
were present at the time of all but two of the 68 episodes of MDSI that were
observed. Patients who had received extensive radiotherapy plus chemotherapy had 
a higher incidence of subsequent episodes of serious infection and MDSI than did 
those who had received extensive radiotherapy alone. Among patients without
Hodgkin's disease at autopsy but with infection contributing to death, only four 
patients lacked other major compromising illnesses. Patients cured of Hodgkin's
disease who remained free of major second illnesses or long-term complications of
prior treatment rarely developed MDSI other than infections caused by the
post-splenectomy spectrum of organisms, regardless of the extent of prior
cumulative immunosuppressive therapy.

Publication Types: 
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6763305 [PubMed - indexed for MEDLINE]

8195: J Clin Microbiol. 1980 Sep;12(3):367-74.

Immunoglobulins M and G to varicella-zoster virus measured by solid-phase
radioimmunoassay: antibody responses to varicella and herpes zoster infections.

Arvin AM, Koropchak CM.

Both immunoglobulin M (IgM) and IgG antibodies to varicella-zoster virus (VZV)
were detectable in a solid-phase radioimmunoassay with 125I-labeled goat antisera
to human immunoglobulins. Primary infection with VZV was associated with early
production of IgM and IgG antibodies and rapid development of lymphocyte
transformation to VZV antigen. Among eight subjects with varicella tested 1 to 4 
days after onset, seven patients had IgG and six patients had IgM antibodies; all
patients had both IgG and IgM antibodies within 7 days. An IgM response was
documented by radioimmunoassay in 18 of 26 patients with herpes zoster. VZV
antibodies could be assayed by radioimmunoassay in unfractionated serum with
commercial goat antisera to human immunoglobulins and commercial VZV antigen.
VZV-specific IgG binding was present in all sera from 42 subjects with a VZB
antibody titer of greater than or equal to 1:8 as determined by indirect
immunofluorescence and cellular immunity to VZV as determined by lymphocyte
transformation and who had had varicella at least 20 years before testing. The
geometric mean titer was 1:6,309, and titers were greater than or equal to
1:16,384 in 20 subjects. Antibody was present as determined by radioimmunoassay
in 14 samples negative by complement fixation and in five samples negative by
complement fixation and immune adherence hemagglutination. No specific binding
was observed in 21 sera from subjects who were not immune to VZV as determined by
indirect immunofluorescence or lymphocyte transformation despite the presence of 
herpes simplex or cytomegalovirus antibody indicated by complement fixation in 15
sera. High titers of VZV IgM antibody were detected in unfractionated sera
despite the presence of high titers of VZV IgG antibody. The VZV radioimmunoassay
provided a sensitive and practical method for measuring VZV IgG and IgM
antibodies.

Publication Types: 
    Comparative Study

PMID: 6260833 [PubMed - indexed for MEDLINE]

8196: Ann Neurol. 1980 Sep;8(3):248-55.

Viral and bacterial antibody responses in multiple sclerosis.

Vartdal F, Vandvik B, Norrby E.

An imprint electroimmunofixation method (IEIF) was used to characterize
antibodies to eight viral antigens (measles, mumps, rubella, herpes simplex type 
1, varicella-zoster, vaccinia, cytomegalovirus, adenovirus) and four bacterial
antigens (beta-hemolytic streptococcus, Hemophilus influenzae type B, Escherichia
coli, enterococcus) in serum and cerebrospinal fluid (CSF) of 12 patients with
multiple sclerosis (MS). Twelve patients matched for age and sex sex served as
controls. Evidence for intrathecal synthesis of oligoclonal antibodies to one or 
more antigens was found in all 12 MS patients and in 1 of the controls. In the MS
group, antibodies to viruses with neurotropic properties were more frequently
associated with local synthesis than antibodies to other viruses and bacteria.
The types and number of locally synthesized antibodies showed no correlation with
disease duration and severity. The antibodies were not associated with
oligoclonal CSF IgG and appear to account for only a minor fraction of the
locally synthesized CSF IgG in MS.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6254433 [PubMed - indexed for MEDLINE]

8197: Ann Intern Med. 1980 Sep;93(3):414-9.

An outbreak of varicella-zoster virus infection among cancer patients.

Morens DM, Bregman DJ, West CM, Greene MH, Mazur MH, Dolin R, Fisher RI.

An outbreak of varicella-zoster infection occurred among patients of the Medicine
Branch, National Cancer Institute, National Institutes of Health. Epidemiologic
investigation suggested that the outbreak was due to two distinct types of
disease. One type was acquired without previous exposure to other diseased
patients and invariably associated with dermatomal lesions. The other, an a
typical form, was associated with person-to-person transmission and equivocal
initial dermatomal distribution and had an incubation period of approximately 11 
to 25 days. Despite the diagnosis of zoster, the latter probably was varicella,
occurring in patients who were immunodeficient because of disease, debility, and 
chemotherapy.

PMID: 6254415 [PubMed - indexed for MEDLINE]

8198: Antimicrob Agents Chemother. 1980 Sep;18(3):443-7.

In vitro susceptibility of varicella-zoster virus to acyclovir.

Biron KK, Elion GB.

The in vitro susceptibility of five strains of varicella-zoster virus to
acyclovir was examined by the plaque-reduction method in human diploid lung
cells. The 50% effective doses of acyclovir ranged from 2.06 microM to 6.28
microM in a 7-day assay, with a mean of 3.65 microM. Irreversible inhibition of
plaque formtation was achieved by drug doses exceeding the 50% effective dose for
plaque reduction but nontoxic to the cells. Studies on the relative in vitro
susceptibility of varicella-zoster virus and herpes simplex virus types 1 and 2
to acyclovir suggested that varicella-zoster virus is two- to eightfold less
susceptible to the drug. The antiviral potency of acyclovir for varicella-zoster 
virus in vitro was compared with that of several other nucleoside analogs.
Analysis of the metabolism of acyclovir in varicella-zoster virus-infected WI-38 
cells revealed that, as with herpes simplex virus types 1 and 2, the formation of
the triphosphate forms of the drug is specific to viral infection.

PMID: 6252836 [PubMed - indexed for MEDLINE]

8199: Hosp Pract. 1980 Sep;15(9):91-3, 97, 100-1 passim.

Varicella vaccination: where do we go from here?

Brunell PA.

Although meager knowledge of the virus raises serious safety questions, the risk 
of death from varicella in immunocompromised children justifies further trials.
In the meantime, passive immunization is a safe and relatively effective
alternative.

PMID: 6250972 [PubMed - indexed for MEDLINE]

8200: Antibiotiki. 1980 Sep;25(9):695-710.

[Clinical use of interferon and its inducers]

[Article in Russian]

Nosik NN, Ershov FI.

Publication Types: 
    Clinical Trial
    Review

PMID: 6158289 [PubMed - indexed for MEDLINE]

8201: Br Med J. 1980 Aug 30;281(6240):622.

Acupuncture and postherpetic neuralgia.

Lewith GT, Field J.

Publication Types: 
    Letter

PMID: 7427403 [PubMed - indexed for MEDLINE]

8202: Lancet. 1980 Aug 30;2(8192):474.

Idoxuridine for herpes zoster.

Esmann V, Wildenhoff KE.

Publication Types: 
    Clinical Trial
    Letter
    Randomized Controlled Trial

PMID: 6106115 [PubMed - indexed for MEDLINE]

8203: Lancet. 1980 Aug 16;2(8190):354-8.

Pancreatic islet-cell damage in children with fatal viral infections.

Jenson AB, Rosenberg HS, Notkins AL.

The pancreases from 250 children with fatal infections caused by at least
fourteen different viruses were examined for lesions in the islets of Langerhans.
Viral cytopathology was found in 4 of 7 cases of Coxsackievirus B infection, 20
of 45 cases of cytomegalovirus infection, 2 of 14 cases of varicella-zoster
infection, and 2 of 45 cases of congenital rubella. Destruction of beta cells and
acute and chronic inflammatory infiltrates were found in islets from cases with
Coxsackievirus B infections. Characteristic inclusion bodies were observed in
islets from cases with cytomegalovirus and varicella-zoster infections. This
survey provides further evidence that some viruses can infect and damage human
beta cells.

Publication Types: 
    Case Reports

PMID: 6105486 [PubMed - indexed for MEDLINE]

8204: Am Fam Physician. 1980 Aug;22(2):117-8.

Lymphoma with herpes zoster.

Andrus MS, Cigtay OS.

A herpes zoster infection in patients with lymphoma has been associated with
subsequent metastatic disease involving the spinal cord and vertebrae of the
affected dermatome segment. This correlation can be used in planning radiation
therapy to avert neurologic complications secondary to spinal cord involvement.

Publication Types: 
    Case Reports

PMID: 7405780 [PubMed - indexed for MEDLINE]

8205: AJR Am J Roentgenol. 1980 Aug;135(2):263-7.

CT of central nervous system infections in immunocompromised patients.

Enzmann DR, Brant-Zawadzki M, Britt RH.

The computed tomographic (CT) scan appearance of parenchymal central nervous
system (CNS) infection in 12 immunosuppressed patients was unlike that of the
usual bacterial abscess in immunologically intact hosts. The lesions were poorly 
circumscribed and of low density. Contrast enhancement was minimal and did not
assume a "ring" configuration. These CT scan findings heralded a poor prognosis. 
Compared to the neuropathologic findings, the CT scan generally underestimated
the extent of involvement. Three other compromised patients were better able to
localize the infection. This successful defense was manifested on their CT scans 
as the more typical "ring" pattern of contrast enhancement. Patients with this CT
scan appearance of their CNS infection had a better prognosis.

PMID: 6773324 [PubMed - indexed for MEDLINE]

8206: Isr J Med Sci. 1980 Aug;16(8):576-80.

Viral infection and acute peripheral facial palsy. A study with herpes simplex
and varicella zoster viruses.

Tovi F, Sidi J, Haikin H, Sarov B, Sarov I.

The role of herpes simplex virus (HSV) and varicella zoster virus (VZV) in acute 
peripheral facial palsy (APFP) was evaluated according to clinical symptomatology
and serologic findings in a series of 70 patients seen over a one-year period.
Peak morbidity of APFP occurred in the 21 to 30 years age group. Most patients
were under 40 years of age and there were more female than male patients.
Concomitant dysfunction of one or more other cranial nerves was present in most
patients. The sera of patients were examined for IgG antibodies to HSV and VZV by
the indirect immunoperoxidase technique. The geometric mean titer for VZV
antibodies was significantly higher in the VZV-seropositive APFP patients than in
the seropositive matched healthy control subjects. Nine APFP patients had
increased or fourfold-rising VZV antibody titers on subsequent examinations,
although six of them had presented without any evidence of zosterian eruption.
The proportion of APFP patients with HSV antibodies at the time of admission was 
significantly higher than that of matched control subjects. No significant
difference was found in the geometric mean titer for HSV antibodies between
seropositive APFP patients and the seropositive control subjects. Only one
patient in the series showed a fourfold rise in HSV antibodies, although the
clinical symptomatology was compatible with this infection in 17 patients. The
significance of serologic studies in determining the etiology of APFP is
discussed.

PMID: 6252119 [PubMed - indexed for MEDLINE]

8207: Ann Intern Med. 1980 Aug;93(2):282-3.

Herpes zoster in patients with small-cell carcinoma of the lung receiving
combined modality treatment.

Feld R, Evans WK, DeBoer G.

Herpes zoster, a rare complication in patients with solid tumours, was observed
in 13 of 161 (8.1%) patients with small-cell anaplastic carcinoma of the lung
treated in a prospective combined modality therapy trial. Induction therapy
consisted of three courses of cyclophosphamide, doxorubicin, and vincristine,
followed by thoracic radiation. Maintenance chemotherapy with oral lomustine,
procarbazine, and methotrexate was given for 1 year. Most herpes zoster cases
(11) occurred while patients were on maintenance chemotherapy. Three patients
developed nonfatal disseminated herpes zoster and one, postherpetic neuralgia.
Herpes zoster may be a relatively frequent complication of prolonged aggressive
treatment of small-cell carcinoma of the lung.

PMID: 6250436 [PubMed - indexed for MEDLINE]

8208: Infect Immun. 1980 Aug;29(2):369-75.

Cell-mediated and humoral immunity to herpesviruses during and after herpes
zoster infections.

Sorensen OS, Haahr S, Moller-Larsen A, Wildenhoff K.

The influence of herpes zoster virus infection on cell-mediated and humoral
immunity to varicella-zoster virus (VZV), cytomegalovirus, and herpes simplex
virus (HSV) was followed in 17 zoster patients from the first week to 6 months
after start of eruptions. The clinical responses were registered and correlated
to the immune responses. A significant depression in blast transformation on
stimulation of lymphocytes with all three antigens was found on days 1 to 5
compared with transformations later after zoster eruptions and compared with
controls. Phytohemagglutinin exhibited the same stimulation in the different
groups and controls. No significant differences in interferon production in the
various groups and controls were found on stimulation with the VZV and HSV
antigens. All zoster patients became seropositive by complement fixation to VZV a
few days after start of the zoster eruption. Two zoster patients showed a
fourfold rise in complement fixation antibodies to HSV. Three patients had
changes in complement fixation titers to cytomegalovirus, which could indicate
new infection or reactivation of infection with this virus. A significant lower
transformation index to VZV was found during the first 9 days in zoster patients 
with fever compared with patients without fever. The relevance of this
observation is discussed in relation to a previous similar observation from our
group.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6163709 [PubMed - indexed for MEDLINE]

8209: Med Hypotheses. 1980 Aug;6(8):773-9.

Delivery of antiviral chemotherapeutic agents to neurons by retrograde axonal
transport.

Fox JS, White DO.

It may be possible to eliminate herpes simplex or zoster viruses from the neurons
of carriers by treatment with an antiviral chemotherapeutic agent such as adenine
arabinoside, ribavirin or acyclovir, coupled to a compound such as horseradish
peroxidase that undergoes retrograde axonal transport.

PMID: 6160375 [PubMed - indexed for MEDLINE]

8210: S Afr Med J. 1980 Jul 19;58(3):112-6.

Cimetidine in the treatment of herpesvirus infections.

van der Spuy S, Levy DW, Levin W.

In August 1977 a patient developed herpes zoster just before she commenced a
course of cimetidine (Tagamet; Smith, Kline & French) for a chronic gastric
ulcer. She experienced both rapid relief of the ulcer symptoms and, rather
unexpectedly, dramatic relief of the herpetic pain and rapid disappearance of the
eruption. On the basis of this observation cimetidine was prescribed to 21
patients with herpes zoster. The results continued to be encouraging in all but 3
patients. The trial was therefore extended to other herpesvirus infections. In
all but 1 of 7 patients with herpes labialis the blisters were aborted, and in 1 
patient with herpes keratitis the result was also encouraging, the attacks being 
markedly shortened in duration and reduced in frequency. The results of this
preliminary trial warrant a systematic scientific inquiry into the potential role
of cimetidine in the treatment of hypesvirus infection, as well as a study of the
mechanisms involved.

Publication Types: 
    Case Reports

PMID: 6250237 [PubMed - indexed for MEDLINE]

8211: Lancet. 1980 Jul 19;2(8186):154-5.

Varicella-zoster virus affecting immigrant nurses.

Hastie IR.

Publication Types: 
    Case Reports
    Letter

PMID: 6105332 [PubMed - indexed for MEDLINE]

8212: Lancet. 1980 Jul 5;2(8184):43.

Herpes zoster of upper gastrointestinal tract.

Gatell Artigas JM, Bru Saumell C, Aused Faure R, Llebaria C.

Publication Types: 
    Case Reports
    Letter

PMID: 6104261 [PubMed - indexed for MEDLINE]

8213: Riv Neurol. 1980 Jul-Aug;50(4):231-40.

[Selective percutaneous thermorhizotomy in the surgical treatment of facial pain:
personal considerations in light of 180 patients treated]

[Article in Italian]

Frank F, Gaist G, Frank G, Galassi E, La Pace L, Benfenati A, Zoni R.

The purpose of this paper is to report the experience of the authors regarding
the treatment of the primitive and secondary facial pains by Percutaneous
Selective Thermorhizotomy (P.S.T.), 180 patients having been treated in the
period of two years. The immediate postoperative control has obtained 156 good
results (86,6%), 10 medium results (5,5%) and 14 (7,7%) unsuccessful. The failure
of the P.S.T. in the treatment of the post-zosterian neuralgias, in the atypical 
and in the vascular pains is stated. The P.S.T. appears resolutive in the "tic
doloreux" and secondary painful syndromes. A far follow up was performed (4
months-2 years) on 94 patients and a good result was kept at 64,2% among all of
them. The shortage of the postoperative not expected collateral effect is also
stated. The causes of unsuccessful and poor results (mistaking in the choice of
the patient or tecnical mistaking) are discussed. It is finally suggested a
careful personal value of the patient candidated to operation, in order to reduce
the poor results and therefore improve the successful ones.

Publication Types: 
    English Abstract

PMID: 7466219 [PubMed - indexed for MEDLINE]

8214: Med Tekh. 1980 Jul-Aug;(4):47-9.

[Thermography and ultrasonic methods of diagnosis in neurology]

[Article in Russian]

Karlov VA, Stulin ID, Shmyrev VI.

The results of a 10-year experience with application in a neurological clinic of 
modern non-invasive thermovision and ultrasonic methods are described. Some 5000 
patients with various distrubances in the central and peripheral nervous system, 
and 1000 nonneurological patients were examined with a view to detect subclinical
forms of cerebrovascular insufficiency. Recommendations are given for improving
technical characteristics of the Soviet thermovisors.

Publication Types: 
    English Abstract

PMID: 7402040 [PubMed - indexed for MEDLINE]

8215: J Neurol Sci. 1980 Jul;47(1):21-34.

The process dynamics of viral and bacterial diseases of the central nervous
system.

Felgenhauer K, Ackermann R, Schliep G.

Several patients with herpes simplex encephalitis developed a prolonged humoral
immune reaction within the central nervous system, which was evaluated by the
measurement of locally synthesized immunoglobulin fractions in cerebrospinal
fluid. Such phasic immune responses seem to occur predominantly in CNS infections
with herpes and myxo/paramyxo viruses. In many cases the B-cell response follows 
a primary neutrophilic and a secondary mononuclear phase. Most benign viral
encephalomeningitis cases lack this type of strong local B-cell activity. This is
also true in most cases of bacterial meningitis, that recover after a strong
neutrophilic attack and a minor mononuclear reaction. The initial phase of a
purulent meningitis is characterized by a complete breakdown of the blood-CSF
barrier. This occurs also in some cases of "apurulent bacterial meningitis", that
are characterized by very low CSF-cell counts in spite of a totally broken
barrier. The "compartmental leucopenia" is interpreted as an imbalance between
the supply from the blood and an intense phagocytic consumption within the CSF
space. The influence of the hydrodynamic size of viruses on the mode of entry
into the central nervous system and on the dynamics of the inflammatory reactions
is discussed.

PMID: 6967952 [PubMed - indexed for MEDLINE]

8216: Geriatrics. 1980 Jul;35(7):41-50.

Ocular pain in the elderly: simple symptom or hidden danger?

Stokoe NL.

PMID: 6966597 [PubMed - indexed for MEDLINE]

8217: Trans Ophthalmol Soc U K. 1980 Jul;100(Pt 2):253-6.

Neurogenic facial pain.

Schott GD.

Neurogenic facial pain can be classified as either paroxysmal or persistent.
Trigeminal neuralgia is the commonest example of the former, and postherpetic
neuralgia, atypical facial pain, and tension head and facial pains are examples
of the latter. The cause of many of these pains is poorly understood, the complex
neuroanatomy of the head and neck being a contributory factor. Even when the
aetiology is known, the mechanism whereby pain is produced is usually obscure.
While treatment with drugs and surgical measures for trigeminal neuralgia are
often satisfactory, and acupuncture for pain due to "muscle tension" may be
beneficial, there is often little effective treatment for a considerable
proportion of patients with neurogenic facial pain.

PMID: 6943844 [PubMed - indexed for MEDLINE]

8218: J Clin Microbiol. 1980 Jul;12(1):46-51.

Solid-phase enzyme immunoassay for determination of antibodies to
cytomegalovirus.

Krishna RV, Meurman OH, Ziegler T, Krech UH.

A solid-phase enzyme immunoassay for the determination of immunoglobulin H (IgG) 
and IgM antibodies to cytomegalovirus is described. The enzyme immunoassay gave
reliable and consistent results which were in concordance with those obtained by 
the complement fixation test and the indirect immunofluorescence test. Antibodies
to herpes simplex and varicella-zoster viruses did not interfere in the enzyme
immunoassay for cytomegalovirus IgM antibodies. In a few patients with IgM
antibodies to Epstein-Barr virus, cytomegalovirus IgM antibodies were also
detected. False-positive cytomegalovirus IgM antibody results were observed in
sera containing both the rheumatoid factor and cytomegalovirus IgG antibodies.
This rheumatoid factor interference was overcome by the absorption of sera with
polymerized human gamma globulin. The absorption did not affect true
cytomegalovirus IgM antibody titers. Also described is a simple enzyme
immunoassay that makes possible a more sensitive detection of the rheumatoid
factor than the latex agglutination test.

Publication Types: 
    Comparative Study

PMID: 6252241 [PubMed - indexed for MEDLINE]

8219: Dtsch Med Wochenschr. 1980 Jun 27;105(26):916.

[Post-zosteric pain]

[Article in German]

Dorndorf W.

Publication Types: 
    Letter

PMID: 7408670 [PubMed - indexed for MEDLINE]

8220: Ned Tijdschr Geneeskd. 1980 Jun 21;124(25):1023-4.

[Course and prognosis of herpes zoster in unselected patients]

[Article in Dutch]

Sanders HW.

PMID: 7402380 [PubMed - indexed for MEDLINE]

8221: Lancet. 1980 Jun 21;1(8182):1337-9.

Antiviral treatment of varicella zoster and herpes simplex.

[No authors listed]

Publication Types: 
    Editorial

PMID: 6155581 [PubMed - indexed for MEDLINE]

8222: Z Hautkr. 1980 Jun 15;55(12):773-81.

[Results of a field study using idoxuridine in dimethylsulfoxide in the treatment
of herpes zoster and herpes simplex]

[Article in German]

Reichhart W.

PMID: 7415359 [PubMed - indexed for MEDLINE]

8223: Orv Hetil. 1980 Jun 8;121(23):1393-5.

[Isoprinosine: therapeutic action and studies in recurrent herpes]

[Article in Hungarian]

Nekam K, Torok K, Lang I, Gergely P, Petranyi G.

PMID: 6160447 [PubMed - indexed for MEDLINE]

8224: Semin Oncol. 1980 Jun;7(2):174-83.

Complications of radiation treatment of Hodgkin's disease.

Thar TL, Million RR.

Publication Types: 
    Comparative Study

PMID: 7444471 [PubMed - indexed for MEDLINE]

8225: Arch Neurol. 1980 Jun;37(6):391.

Herpes zoster with facial paralysis: an unusual manifestation.

Krol TC, Mullen GM.

Publication Types: 
    Case Reports

PMID: 7387475 [PubMed - indexed for MEDLINE]

8226: Arch Surg. 1980 Jun;115(6):753-4.

Posttraumatic herpes zoster.

Stahl RS, Frazier WH.

Musculoskeletal trauma and its sequelae account for a large proportion of visits 
to acute health care facilities and practitioners of multiple medical
specialties. There is a long-recognized association of posttraumatic pain with
herpes zoster and three illustrative cases were encountered. Simple bony, nerve
root, or soft-tissue abnormality may be mimicked by various stages of such
processes. Serial observations are emphasized and proposed pathophysiology and
therapy reviewed. Studies of acute and convalescent complement fixation titers
and viral cultures of vesicular fluid in such cases would be of further interest.

Publication Types: 
    Case Reports

PMID: 7387363 [PubMed - indexed for MEDLINE]

8227: Am J Dis Child. 1980 Jun;134(6):618-9.

Herpes zoster in early infancy.

Dworsky M, Whitley R, Alford C.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 7386437 [PubMed - indexed for MEDLINE]

8228: Semin Oncol. 1980 Jun;7(2):202-11.

Hodgkin's disease in children.

Derek R, Jenkin T, Berry MP.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 7003718 [PubMed - indexed for MEDLINE]

8229: Arch Surg. 1980 Jun;115(6):751-2.

Varicella-zoster infections in pediatric renal transplant recipients.

Hurley JK, Greenslade T, Lewy PR, Ahmadian Y, Firlit C.

Varicella-zoster infections developed in ten of 76 children receiving a renal
transplant during 1973 to 1978. Two children had varicella and one died during
this infection. Eight children had herpes zoster and one experienced
encephalitis. In the latter group, reduction of prednisone and azathioprine
therapy resulted in rejection and loss of the graft in two of three patients in
whom this drug therapy was altered.

PMID: 6992736 [PubMed - indexed for MEDLINE]

8230: Neurology. 1980 Jun;30(6):582-7.

Selective decline in cellular immune response to varicella-zoster in the elderly.

Miller AE.

The incidence of herpes zoster rises markedly in the aged. We evaluated the
hypothesis that cellular immunity to varicella-zoster (VZ) viral antigens may be 
impaired in aged subjects. We found that the lymphocyte proliferation to VZ
antigen was less in older asymptomatic individuals than in normal young controls.
In contrast, responses to other antigens did not differ. Antibody titers to VZ
were similar in both young and old subjects. Impairment of cellular immunity to
VZ, on a population basis, may contribute to the increased risk of herpes zoster 
in the elderly.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 6247671 [PubMed - indexed for MEDLINE]

8231: Med Times. 1980 Jun;108(6):47-52.

Herpes zoster--the best approach.

Nuss DD.

Publication Types: 
    Clinical Trial

PMID: 6155589 [PubMed - indexed for MEDLINE]

8232: Fortschr Med. 1980 May 22;98(19):731-5.

[Lesions of the oral mucosa in dermatologic diseases]

[Article in German]

Zaun H.

Concerning differential diagnosis of mucosal lesions of the mouth the frequent
occurrence of eruptions of skin diseases in the oral cavity has to be taken into 
consideration. The accompanying mucosa symptoms of dermatological diseases are
observed under the clinical picture of aphthae, leucoplacia or stomatitis like
phenomenon.

Publication Types: 
    English Abstract

PMID: 7399384 [PubMed - indexed for MEDLINE]

8233: MMW Munch Med Wochenschr. 1980 May 16;122(20):761-2.

[Multifactorial therapy of chest pain in medical practice]

[Article in German]

Gross D.

PMID: 6771590 [PubMed - indexed for MEDLINE]

8234: MMW Munch Med Wochenschr. 1980 May 16;122(20):747-50.

[Pulmological aspects of diagnosis of thoracic pain (author's transl)]

[Article in German]

Meier-Sydow J.

A number of medical disciplines are involved in the diagnosis and therapy of
thoracic pain. The origin may be somatic or visceral. Individual diseases are
discussed in particular such as myalgia epidemica, intercostal neuralgia, herpes 
zoster, pleuritis and pneumonia, pulmonary embolism, pneumothorax, mediastinal
emphysema, mediastinitis, pulmonary hypertension and the hyperventilation
syndrome. Differential diagnosis is also referred to.

Publication Types: 
    English Abstract

PMID: 6771586 [PubMed - indexed for MEDLINE]

8235: JAMA. 1980 May 16;243(19):1903-5.

Visceral herpesvirus infections in leukemic patients receiving cytarabine.

Buss DH, Scharyj M, White DR.

Autopsy evidence of herpesvirus infection was found in visceral organs of four
leukemic patients who had received large doses of cytarabine (cytosine
arabinoside; Ara-C) shortly before their death. In three of these patients the
infection was clinically unsuspected; in the fourth, cutaneous herpes zoster
developed after administration of 300 mg of cytarabine daily for the preceding
five days. Although cytarabine exhibits pronounced in vitro virucidal activity
against herpes viruses and has been successfully used in clinical treatment of
severe herpesvirus infections, the present findings and a review of the recent
literature cast doubt on the antiviral effectiveness of this drug, particularly
in already immunosuppressed patients, and suggest instead that such patients
actually have an increased risk for development of disseminated herpesvirus
infection owing to further depression of host defenses by the drug.

Publication Types: 
    Case Reports

PMID: 6245286 [PubMed - indexed for MEDLINE]

8236: Can J Neurol Sci. 1980 May;7(2):153-5.

Herpes zoster mandibularis.

Lewis ME, Warren KG.

A case of Herpes zoster of the mandibular nerve in an 80 year old man is
reported. Herpes zoster infection affecting only the mandibular branch of the
trigeminal nerve is rare. It is proposed that the distribution of lesions is a
consequence of a unique latent site of the virus within neurons of the gasserian 
ganglion innervating the mandibular division of the trigeminal nerve.

Publication Types: 
    Case Reports
    Research Support, Non-U.S. Gov't

PMID: 7407721 [PubMed - indexed for MEDLINE]

8237: Vrach Delo. 1980 May;(5):101-6.

[Clinical and laboratory diagnosis of herpes type diseases]

[Article in Russian]

Mikhailenko AA, Kuznetsova EE, Iovlev VI.

Publication Types: 
    English Abstract

PMID: 7395152 [PubMed - indexed for MEDLINE]

8238: Br J Dermatol. 1980 May;102(5):551-5.

Do corticosteroids prevent post-herpetic neuralgia?

Keczkes K, Basheer AM.

Forty otherwise healthy patients over 50 years of age with early, severe painful 
herpes zoster were randomly allocated to two groups for treatment. Twenty
patients received prednisolone 40 mg daily with gradual reduction over a period
of 4 weeks, whilst the other twenty patients received carbamazepine 100 mg four
times daily. Thirteen of the twenty patients (65%) in the carbamazepine treated
group developed post-herpetic neuralgia lasting up to 2 years, whilst only three 
of the twenty prednisolone treated patients (15%) had post-herpetic neuralgia
lasting up to 6 months only. Thus the incidence and duration of post-herpetic
neuralgia were considerably redudced in the prednisolone treated group. In
neither group did disseminated zoster or other complications occur.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 7387900 [PubMed - indexed for MEDLINE]

8239: Endoscopy. 1980 May;12(3):134-5.

Gastric involvement in herpes zoster.

Wisloff F, Bull-Berg J, Myren J.

A 76-year-old man with herpes zoster affecting the 7th thoracic dermatome on the 
right side was referred for gastroscopy because of anorexia, nausea, vomiting and
burning epigastric pain. Lesions were seen along the greater curvature of the
stomach suggesting mucosal herpes zoster.

Publication Types: 
    Case Reports

PMID: 7379763 [PubMed - indexed for MEDLINE]

8240: J Med Assoc Ga. 1980 May;69(5):345-9.

Current trends in dermatology.

Pirozzi DJ.

PMID: 7373172 [PubMed - indexed for MEDLINE]

8241: Clin Pharmacol Ther. 1980 May;27(5):690-6.

Plasma levels and urinary excretion of vidarabine after repeated dosing.

Buchanan RA, Kinkel AW, Alford CA Jr, Whitley RJ.

Vidarabine (Vira-A) was given intravenously for 5 days to 5 immunosuppressed
patients with herpes zoster. The daily dose, 10 mg/kg, was given by slow infusion
over 12 hr. Blood samples were taken at 0, 1, 2, 4, 8, and 12 hr on days 1, 3,
and 5. Twenty-four-hour urine specimens were collected before treatment and on
days 1, 3, and 5. Blood and urine specimens were assayed for vidarabine and its
principal metabolite, hypoxanthine arabinoside (ara-Hx), by high pressure liquid 
chromatography. The results showed that vidarabine is quickly deaminated;
virtually all of the drug present in the plasma and urine was in the form of
ara-Hx. The highest plasma level, approximately 3 microgram/ml, was at the end of
the infusion period. The urinary excretion of ara-Hx accounted for between 40%
and 50% of the dose. The renal clearance values varied, but were close to the
expected glomerular filtration rate of 125 ml/min. The plasma levels and the
excretion levels were much the same on days 1, 3, and 5, indicating that drug did
not cumulate. The results of the study were consistent with those observed in
single-dose studies. The results indicated that the infusion of vidarabine is
clinically appropriate, since therapeutic plasma levels are reached promptly,
drug is rapidly excreted, and there is no cumulation.

PMID: 7371366 [PubMed - indexed for MEDLINE]

8242: J Assoc Physicians India. 1980 May-Jun;28(5-6):125-32.

Herpes-zoster in malignancy.

Gopal R, Advani SH, Dinshaw KT, Nair CN, Desai PB.

PMID: 7216984 [PubMed - indexed for MEDLINE]

8243: Internist (Berl). 1980 May;21(5):260-5.

[The acute headache from the neurological viewpoint]

[Article in German]

Poeck K.

PMID: 7002844 [PubMed - indexed for MEDLINE]

8244: Ann Surg. 1980 May;191(5):604-16.

Diagnosis of impaired renal function after kidney transplantation using renal
scintigraphy, renal plasma flow and urinary excretion of hippurate.

Diethelm AG, Dubovsky EV, Whelchel JD, Hartley MW, Tauxe WN.

The use of 131I-orthiodohippurate (OIH) scintigraphy combined with the estimated 
renal plasma flow (ERPF) and excretion index (EI) has been beneficial in
separating impaired renal function due to graft rejection from acute tubular
necrosis, ureteral obstruction, urinary extravasation and in some instances renal
artery occlusion. The radionuclide data accurately identified acute and chronic
rejection, confirmed by the clinical course, increase in BUN and serum creatinine
and on occasion renal biopsy. Reversible and irreversible acute tubular necrosis 
(ATN) were clearly differentiated from acute rejection. When the ERPF and EI were
plotted on a graph, multiple sequential radionuclide studies accurately predicted
graft survival when chronic rejection existed. The limitation of this technique
was the inability to discriminate between renal artery stenosis, ureteral
obstruction and inflammatory disease. Scintigraphic studies did not distinguish
between renal artery stenosis and chronic rejection. In these circumstances
arteriography was the diagnostic procedure of choice. Although ureteral
obstruction often can be correctly diagnosed by scintigrams, the ERPF, EI and
intravenous pyelogram remained the most accurate diagnostic procedures. Recurrent
glomerulonephritis, gram negative septicemia and generalized viral illness
(herpes zoster or cytomegalovirus) simulated acute rejection and had to be
separated by renal biopsy or the clinical course. The most valuable features of
the radionuclide technique included: 1) the noninvasive method, 2) the
simplicity, 3) the rapidity and 4) the reproducibility.

PMID: 6989332 [PubMed - indexed for MEDLINE]

8245: Klin Med (Mosk). 1980 May;58(5):47-9.

[Clinical aspects of VZ viral hepatitis and the aggravating effect of herpes
zoster on the course of infectious and serum viral hepatitis]

[Article in Russian]

Pak SG, Brodov LE, Burnatseva VV, Bogin IB.

Publication Types: 
    Case Reports
    English Abstract

PMID: 6247538 [PubMed - indexed for MEDLINE]

8246: Br Heart J. 1980 May;43(5):597-9.

Herpes zoster pericarditis.

Winfield CR, Joseph SP.

A healthy 22-year-old man developed acute varicella pericarditis, characterised
by an enanthem with diagnostic rising titres of varicella zoster antibodies but
without the typical exanthem. This, the third reported case of varicella
pericarditis, is the first to be documented without a typical varicella eruption.

Publication Types: 
    Case Reports

PMID: 6246908 [PubMed - indexed for MEDLINE]

8247: Monatsschr Kinderheilkd. 1980 May;128(5):248-50.

[Preliminary animal experimental results and clinical experiences with the
antiviral agent adenine arabinoside monophosphate in encephalitis from herpes
group and varicella-zoster infections]

[Article in German]

Sauer O, Huth E, Lenard HG, Schneider H, von Haselberg L, Nettesheim HJ, Werner
GT.

PMID: 6158680 [PubMed - indexed for MEDLINE]

8248: Rev Infect Dis. 1980 May-Jun;2(3):393-407.

Live attenuated Varicella-Zoster vaccine.

Gershon AA.

Varicella-zoster (VZ) virus causes two diseases, varicella and zoster. Because it
was recognized that, after varicella, latent VZ virus persisted in the host and
because varicella was thought to be a milde disease, there was little impetus in 
North America to develop a live VZ vaccine. More recently, it has become apparent
that currently available methods of prevention and treatment of severe varicella 
are not always efficacious. With the development of a live attenuated VZ vaccine 
by Takahashi and the successful use of the vaccine in immunocompromised children 
in Japan, there has been an increased interest in North America in immunization
against varicella. In this article the natural history of VZ infections and the
immunologic reactions to VZ virus are described, and the development and use of
VZ vaccine in Japan are reviewed. Plans for trials of VZ vaccine in
immunocompromised North American children are outlined. The major questions
concerning the large-scale use of VZ vaccine are presented.

Publication Types: 
    Review

PMID: 6158080 [PubMed - indexed for MEDLINE]

8249: J Am Acad Dermatol. 1980 May;2(5):443-7.

Herpes-varicella-zoster.

Thiers B.

PMID: 6155389 [PubMed - indexed for MEDLINE]

8250: N Engl J Med. 1980 Apr 17;302(16):903-7.

Drug therapy: antiviral agents (first of two parts).

Hirsch MS, Swartz MN.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 6987519 [PubMed - indexed for MEDLINE]

8251: N Engl J Med. 1980 Apr 10;302(15):848-51.

Atypical generalized zoster with lymphadenitis mimicking lymphoma.

Patterson SD, Larson EB, Corey L.

Publication Types: 
    Case Reports

PMID: 6244490 [PubMed - indexed for MEDLINE]

8252: Contact Dermatitis. 1980 Apr;6(3):170-1.

Contact allergy to idoxuridine. Sensitization following treatment of herpes
zoster.

Thormann J, Wildenhoff KE.

A total of 45 of 60 patients with herpes zoster previously treated with topical
idoxuridine 5-40% in dimethylsulfoxide were patch tested 2 years later with
idoxuridine 0.5% and 5% in petrolatum. Three (7%) showed positive reactions.
Idoxuridine is considered a weak sensitizer, but in strong concentrations and in 
active solvents, which increases absorption, there seems to be a risk of
sensitization.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 7389323 [PubMed - indexed for MEDLINE]

8253: J Dermatol. 1980 Apr;7(2):161-2.

Local anesthesia for Herpes Zoster.

Ogata A, Tomoda T, Tanaka S, Kudo S.

PMID: 6991573 [PubMed - indexed for MEDLINE]

8254: J Dermatol. 1980 Apr;7(2):157-9.

A semiquantitative analysis of skin sensitivity changes in Herpes zoster.

Matsubara M, Kagami K, Maeda M, Yasuno H, Uchida T, Suzuki N.

PMID: 6991572 [PubMed - indexed for MEDLINE]

8255: Arch Dermatol. 1980 Apr;116(4):408-12.

Herpes zoster-varicella in cutaneous T-cell lymphomas.

Vonderheid EC, van Voorst Vader PC.

The overall frequency of herpes zoster-varicella (HZV) infection in 221 patients 
with histologically confirmed cutaneous T-cell lymphoma was 10% (22 patients).
The frequency of HZV infection and serious complications (viral dissemination,
bacteremia) was relatively high in patients with evidence of extracutaneous
involvement, especially in patients with Sezary syndrome. The major factors
identified to account for this predisposition to HZV infection include intensive 
treatment with radiation therapy or drugs given for systemic effect and/or
immunologic deficiency consequent to advanced disease. These observations are
quite similar to those made in patients with Hodgkin's disease.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6245621 [PubMed - indexed for MEDLINE]

8256: J Clin Invest. 1980 Apr;65(4):869-78.

Cellular and humoral immunity in the pathogenesis of recurrent herpes viral
infections in patients with lymphoma.

Arvin AM, Pollard RB, Rasmussen LE, Merigan TC.

86 patients with lymphoma were evaluated prospectively for clinical and
laboratory evidence of recurrent varicella-zoster, herpes simplex, and
cytomegalovirus infections during the first 16 mo of treatment. Cellular immunity
to the viral antigens was measured by in vitro lymphocyte transformation and
interferon production. Antibody titers and nonspecific measures of cellular
immunity, including T-cell quantitation and transformation to phytohemagglutinin,
were also assessed. The patients treated with radiation and chemotherapy had the 
highest incidence of reactivation of each of the viruses (15-19%). Greater
susceptibility to herpes viral reactivation in these patients correlated with
suppression of cell-mediated immunity to the specific virus. In individual
patients, suppression of cellular immunity to the specific herpes viral antigen
preceded each episode of reactivation, but recurrent infection did not occur in
all patients with diminished specific lymphocyte transformation. Absence of the
response appears to be a necessary but not a sufficient condition for the
recrudescence of latent infection. Better preservation of cellular immunity to
herpes simplex antigen during treatment was associated with infrequent
reactivation of herpes simplex. In 25 patients with acute herpes zoster,
uncomplicated recovery from the infection was accompanied by the development of
lymphocyte transformation and interferon production to varicella-zoster antigen. 
Quantitation of T-cell numbers and phytohemagglutinin transformation did not
correlate with the presence of viral cellular immunity in treated patients.
Responses returned while T-cell numbers were low, and the recovery of
phytohemagglutinin transformation often preceded recovery of the responses to
viral antigens. Although some patients had deficiencies in viral cellular
immunity at diagnosis, the duration of the suppression of specific antiviral
responses resulting from treatment appears to be the most important factor
predisposing to the recurrence of herpes infections in lymphoma patients.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6244336 [PubMed - indexed for MEDLINE]

8257: Cutis. 1980 Apr;25(4):424-6.

Dehydroemetine therapy for herpes zoster. A comparison with corticosteroids.

Hernandez-Perez E.

A study involving forty patients, all sixty years of age or over, compared the
use of dehydroemetine in twenty and triamcinolone in twenty for the treatment of 
herpes zoster. Pretreatment evolution was less than ten days. Patients treated
with dehydroemetine did not experience postherpetic neuralgia, and in fourteen
pain completely disappeared at the end of only one series of treatment, which in 
four patients consisted of only three injections. Postherpetic neuralgia
developed in only eight patients out of those treated with triamcinolone, and in 
four pain persisted for more than six months. The results of laboratory tests,
including cardiovascular evaluation, remained normal with both drugs.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 6102504 [PubMed - indexed for MEDLINE]

8258: Clin Ter. 1980 Mar 15;92(5):561-4.

[List of prescriptions for therapy of herpes zoster]

[Article in Italian]

Fanelli V.

PMID: 7449328 [PubMed - indexed for MEDLINE]

8259: Ned Tijdschr Geneeskd. 1980 Mar 15;124(11):377-9.

[The importance of early diagnosis of herpes zoster]

[Article in Dutch]

van der Drift JH.

Publication Types: 
    Case Reports

PMID: 6966034 [PubMed - indexed for MEDLINE]

8260: Ugeskr Laeger. 1980 Mar 10;142(11):694-5.

[Urinary retention in herpes zoster]

[Article in Danish]

Nielsen SS.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7368341 [PubMed - indexed for MEDLINE]

8261: HNO. 1980 Mar;28(3):73-9.

[Causes of inner ear deafness; a critique of therapy (author's transl)]

[Article in German]

Lehnhardt E, Hesch RD.

In spite of recent criticisms, the diagnosis of inner ear hearing impairment is
based on both pure tone thresholds and suprathreshold tests. The acoustico-facial
reflex is useful only when used in conjunction with the suprathreshold
tests.--Noise-induced deafness is generally confined to the higher frequencies of
sound, and only exceptionally involve the middle frequencies as well. Low-tone
hearing impairment may represent a partial symptom of Meniere's Disease as well
as functional hearing loss. Zoster oticus produces a sensory hearing impairment
but not a neural one, as might be expected from the neurotropy of the Herpes
virus. Patients with socalled presbyacusis exhibit criteria of inner ear
pathology which may represent a summation of different noxious agents damaging
the inner ear throughout life rather than result from the physiologic process of 
aging. Traumatic hearing impairment seldom progresses, and usually involves
central parts of the auditory pathways following blunt trauma.--We believe that
uncritical therapy with vasodilating drugs is not useful in sensory hearing loss,
especially if it is continued for months and if several drugs are employed at the
same time. The danger of an unintended decrease in blood pressure is greater in
these patients since many also suffer from hypotension which can then cause
vascular insufficiency to the inner ear, similar to the "steal" effect. Therapy
for inner ear hearing loss remains the responsibility of the otolaryngologist,
and should still be based on proper diagnosis.

Publication Types: 
    English Abstract

PMID: 7451254 [PubMed - indexed for MEDLINE]

8262: J Am Optom Assoc. 1980 Mar;51(3):296-7.

Soft contact lens bandage for Ramsay Hunt syndrome with facial palsy.

Yamane SJ.

A patient under the primary care of a physician was referred to a military O.D.
who subsequently referred the patient to the author as a consulting contact lens 
specialist. The patient exhibited the Ramsay Hunt Syndrome and was unable to
blink or close her right eye. Patching had been attempted but was discontinued
due to the neuralgia of the epidermal tissue of the lids. A hydrophilic contact
lens was used to bandage the cornea. The patient was thereby able to maintain
corneal integrity until the viral problem subsided and she regained her ability
to function normally through the interdisciplinary cooperation of the eye care of
professionals.

Publication Types: 
    Case Reports

PMID: 7372990 [PubMed - indexed for MEDLINE]

8263: Am J Med. 1980 Mar;68(3):386-8.

Arthralgia associated with acute urinary retention. A syndrome of probable viral 
etiology.

Murphy TF, Senterfit LB, Christian CL.

Four patients are described in whom paresthesia and arthralgia developed in
association with acute urinary retention. Neurologic and musculoskeletal
complaints persisted for varying periods, up to five year, after cessation of
urinary symptoms. Significantly elevated titers to Herpes simplex and Herpes
zoster viruses were observed in three and four subjects, respectively, although
none exhibited cutaneous lesions of herpetic infection. The symptom complex,
presumably the result of viral radiculitis, may present in varying patterns that 
can be confused with lumbar disc protrusion, obstructive uropathy or primary
rheumatic disorder. Diagnostic studies requisite for documentation of a viral
etiology of the syndrome are discussed.

Publication Types: 
    Case Reports

PMID: 7361806 [PubMed - indexed for MEDLINE]

8264: J Urol. 1980 Mar;123(3):426-7.

Acute motor paralytic bladder in renal transplant patients with anogenital herpes
infection.

Jacobs SC, Herbert LA, Piering WF, Lawson RK.

We report on 2 renal transplant patients in whom acute urinary retention
developed after anogenital herpes infections. In 1 case a reversible bladder
motor and sensory neuropathy occurred secondary to herpes simplex virus
infections. In the other case a motor paralytic bladder developed secondary to an
anogenital varicella-zoster infection. Documentation was by carbon dioxide
cystometrography and denervation hypersensitivity testing. Both cases were
reversible without alteration of the immunosuppressive regimens.

Publication Types: 
    Case Reports

PMID: 6987416 [PubMed - indexed for MEDLINE]

8265: Bull Soc Ophtalmol Fr. 1980 Mar;80(3):289-90.

[Ocular zona and herpes in patients under immunosuppressive agents. Apropos of 9 
cases]

[Article in French]

Lagoutte F, Campagne JC, Monroy J, Le Rebeller MJ.

Publication Types: 
    Case Reports

PMID: 6965894 [PubMed - indexed for MEDLINE]

8266: Stomatologiia (Mosk). 1980 Mar-Apr;59(2):25-6.

[DNAse treatment of herpes of the maxillofacial area]

[Article in Russian]

Mashkilleison NA, Tkach EV.

Publication Types: 
    English Abstract

PMID: 6929581 [PubMed - indexed for MEDLINE]

8267: Rinsho Byori. 1980 Mar;28(3):227-34.

[Autopsy study on disseminated herpes virus infection (author's transl)]

[Article in Japanese]

Yamada T, Sakurai I, Uchida T, Shikata T.

Publication Types: 
    Case Reports

PMID: 6246290 [PubMed - indexed for MEDLINE]

8268: Br Med J. 1980 Feb 23;280(6213):561-2.

Herpes zoster in pregnancy.

McKinlay WJ.

Publication Types: 
    Case Reports
    Letter

PMID: 7370577 [PubMed - indexed for MEDLINE]

8269: Lancet. 1980 Feb 16;1(8164):354-6.

Human anti-chickenpox immunoglobulin in the prevention of chickenpox.

Evans EB, Pollock TM, Cradock-Watson JE, Ridehalgh MK.

Human anti-chickenpox immunoglobulin (zoster immune globulin, ZIG) was largely
ineffective in preventing infection in forty-three high-risk contacts of
chickenpox. Twenty-nine of these non-immune infants and children who had been in 
close contact with cases of varicella became infected, and symptoms developed in 
twenty-four. Since ZIG may modify chickenpox it should continue to be given to
high-risk contacts until the availability of a simple and sensitive test makes it
possible to identify those who are susceptible. However, ZIG is not necesary for 
infants whose mothers have chickenpox or zoster five or more days before
delivery, since all such infants (eleven) had varicella-zoster antibody at birth.

PMID: 6101802 [PubMed - indexed for MEDLINE]

8270: Med Klin. 1980 Feb 15;75(4):133.

[Trends in the chemotherapy of viral infections]

[Article in German]

Eggers HJ.

PMID: 7374614 [PubMed - indexed for MEDLINE]

8271: Pediatriia. 1980 Feb;(2):23-6.

[Complications of glomerulonephritis in children]

[Article in Russian]

Naumova VI, Fonareva LP, Lukillianova NS, Zakharchenko LP.

Publication Types: 
    English Abstract

PMID: 7360583 [PubMed - indexed for MEDLINE]

8272: Arch Dermatol. 1980 Feb;116(2):160.

Herpes zoster in a 4-month-old infant.

Laude TA, Rajkumar S.

Publication Types: 
    Case Reports
    Comparative Study
    Letter

PMID: 7356346 [PubMed - indexed for MEDLINE]

8273: Srp Arh Celok Lek. 1980 Feb;108(2):143-8.

[Treatment of zoster paralysis of the facial nerve]

[Article in Serbian]

Brkic M, Zecevic M, Cancarevic M.

PMID: 7244860 [PubMed - indexed for MEDLINE]

8274: Am J Ophthalmol. 1980 Feb;89(2):255-8.

Penetrating keratoplasty in Mooren's ulcer.

Brown SI, Mondino BJ.

Two patients had bilateral, simultaneous Mooren's ulcers that progressed to
almost total loss of the corneal stroma in all eyes. The conjunctival epithelium 
eventually healed over these thinned corneas and the eyes were free of pain and
inflammation. Three of the four eyes had combined 7.5-mm penetrating corneal
transplants and cataract extractions performed at least four months after disease
activity had subsided. All transplants have remained transparent from one to
three years postoperatively and there has been no evidence of recurrence of
Mooren's ulcers.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 6986779 [PubMed - indexed for MEDLINE]

8275: Isr J Med Sci. 1980 Feb;16(2):111-7.

Enzyme-linked immunosorbent assay for detection of antibodies to varicella zoster
virus.

Goldberg RD, Sarov I.

A sensitive enzyme-linked immunosorbent assay (ELISA) is described for detection 
of varicella zoster virus (VZV) IgG antibodies. The antigen consisted of a
sonicated extract of VZV-infected human embryo cells. Goat antihuman IgG
peroxidase conjugate was used to detect human IgG bound to viral antigen. The
results have been compared with those obtained by the indirect peroxidase
antibody to membrane antigen technique (IPAMA). Comparison of titers obtained by 
ELISA with those obtained by IPAMA in sera of 41 medical students, six chickenpox
patients and six herpes zoster patients showed good agreement between the tests
as to the presence or absence of antibody. ELISA was about 88 times more
sensitive than IPAMA. The specificity and sensitivity of ELISA as compared to
other serologic techniques for detection of antibody to VZV is discussed.

Publication Types: 
    Comparative Study

PMID: 6245042 [PubMed - indexed for MEDLINE]

8276: Am J Ophthalmol. 1980 Feb;89(2):259-62.

Varicella dendritic keratitis.

Uchida Y, Kaneko M, Hayashi K.

A 7-year-old boy and a 3-year-old girl suffered from unilateral disciform
keratitis and iritis associated with varicella. While they were treated with
topical corticosteroid, idoxuridine, and atropine drops, dendritic lesions
typical of herpes zoster appeared four months after the onset of eruptive skin
lesions. Using the direct immunofluorescent method, we showed varicella-zoster
virus antigen in the epithelial cells scraped from the dendritic lesion.

Publication Types: 
    Case Reports

PMID: 6243866 [PubMed - indexed for MEDLINE]

8277: Am J Med. 1980 Feb;68(2):214-8.

Herpes zoster and small cell bronchogenic carcinoma.

Huberman M, Fossieck BE Jr, Bunn PA Jr, Cohen MH, Ihde DC, Minna JD.

In nine of 74 (12 per cent) consecutive, previously untreated patients with small
cell bronchogenic carcinoma receiving combination chemotherapy herpes zoster
developed. This is the highest frequenzy reported for this viral infection in
patients with nonlymphoproliferative solid tumors. Cutaneous dissemination
developed in six of the nine patients, but visceral involvement did not occur.
The major difference between the patients with herpes zoster and those without
was the superior duration of median survival for the infected patients. No
relationship could be established between the development of herpes zoster and
the extent of neoplastic disease, prior radiotherapy, treatment with specific
chemotherapeutic agents or corticosteroids, cutaneous anergy or granulocytopenia.
Serum specimens obtained from six of the nine patients prior to their infection
demonstrated the preexistence of varicella zoster antibodies. As more effective
and intensive chemotherapy prolongs the survival of patients with solid tumors,
it is possible that the frequency of herpes zoster infection may approach that
observed in patients with lymphoproliferative malignancies.

PMID: 6243858 [PubMed - indexed for MEDLINE]

8278: Med Klin. 1980 Jan 4;75(1):6.

[What is the treatment for herpes zoster pain?]

[Article in German]

Wassilew S.

PMID: 7366524 [PubMed - indexed for MEDLINE]

8279: JAMA. 1980 Jan 4;243(1):56-8.

Herpes zoster after splenectomy. A study of patients without malignancy.

Manning DM, Luparello FJ, Arena VC Jr.

Follow-up information was obtained on 102 unselected patients who had undergone
splenectomy for nonmalignant disease (ie, trauma, surgical complications, and
hematologic indications). In 422 postsplenectomy years, three cases of herpes
zoster were observed, two of which were associated with generalized cutaneous
dissemination. This incidence is no greater than that reported elsewhere for
age-matched normal population. We conclude that in patients without malignancy,
splenectomy does not predispose to herpes zoster, but may play a role in
cutaneous dissemination.

Publication Types: 
    Case Reports

PMID: 6965312 [PubMed - indexed for MEDLINE]

8280: Acta Neuropathol. 1980;52(1):59-68.

Changes of the central nervous system in herpes zoster.

Ruppenthal M.

Postmortem examination was conducted in eight cases of neurocutaneous herpes
zoster. One generalized case with diffuse and focal meningoencephalomyelitis
showed numerous infiltrates in the subarachnoid space and along the cerebral
ventricles. Intranuclear inclusion bodies could be demonstrated for the first
time in ependymal and in arachnoidal cells, and viral capsids were found in the
latter. The parenchymal lesions, lying predominantly in the white matter, were
characterized by inflammation, hemorrhage, axonal swellings, demyelination, and
intranuclear inclusions in oligodendrocytes. In the second generalized case there
was a granulomatous giant cell angiitis with intranuclear inclusions bodies in
the vessel walls. Out of four cases with localized damage of the central nervous 
system (CNS), three showed demyelination as the main alteration. In another case 
there was a hitherto undescribed calcifying coagulation necrosis of a spinal
ganglion.

Publication Types: 
    Case Reports

PMID: 7435157 [PubMed - indexed for MEDLINE]

8281: Ter Arkh. 1980;52(9):44-7.

[Herpes zoster in lymphogranulomatosis]

[Article in Russian]

Shishkin IP, Oliper TV.

Publication Types: 
    English Abstract

PMID: 7434230 [PubMed - indexed for MEDLINE]

8282: Med Pregl. 1980;33(1-2):9-11.

[An analysis of the clinical picture of herpes zoster]

[Article in Serbian]

Stankovic K, Arneric S, Jankovic D, Kojic D, DjorDjevic L.

Publication Types: 
    English Abstract

PMID: 7412728 [PubMed - indexed for MEDLINE]

8283: Pediatriia. 1980;(1):71-2.

[Varicella-zoster infection in kidney diseases in children]

[Article in Russian]

Naumova VI, Lukillianova NS, Fonareva LP.

Publication Types: 
    Case Reports

PMID: 7383777 [PubMed - indexed for MEDLINE]

8284: Vestn Otorinolaringol. 1980 Jan-Feb;(1):50-5.

[Clinical aspects and diagnosis of herpes zoster oticus]

[Article in Russian]

Romanenko DA.

PMID: 7376320 [PubMed - indexed for MEDLINE]

8285: Acta Med Iugosl. 1980;34(1):55-62.

Treatment of herpes zoster with PUVA. A clinical, serological and histological
follow-up-study.

Vukas A, Gligora M, Batistic B, Zambal Z.

PMID: 7368961 [PubMed - indexed for MEDLINE]

8286: Int J Dermatol. 1980 Jan-Feb;19(1):49-50.

Acquired leukonychia striata.

Zizmor J, Deluty S.

Publication Types: 
    Case Reports

PMID: 7358442 [PubMed - indexed for MEDLINE]

8287: Arch Dermatol. 1980 Jan;116(1):20.

Progressive zosteriform macular pigmented lesions.

Simoes GA, Piva N.

Publication Types: 
    Case Reports
    Letter

PMID: 7352760 [PubMed - indexed for MEDLINE]

8288: Henry Ford Hosp Med J. 1980;28(1):67-70.

Herpes zoster encephalitis: successful therapy with vidarabine.

Wees SJ, Madhavan T.

Publication Types: 
    Case Reports

PMID: 7287499 [PubMed - indexed for MEDLINE]

8289: Haematologia (Budap). 1980;13(1-4):225-37.

Lymphocyte marker testing in relation to the clinical use of dialyzed leukocyte
extract containing transfer factor (DLE-LTF).

Peetoom F, Florey MJ.

PMID: 7250812 [PubMed - indexed for MEDLINE]

8290: Med Cutan Ibero Lat Am. 1980;8(1-3):33-45.

[Melanoma (Hutchinson's lentigo maligna) having spontaneous regression. A case of
immunologic importance]

[Article in Spanish]

Grinspan D, Paz A, Abulafia J, Mosto S.

I. A brief description is given of the general aspects of skin melanomas,
including some personal observations. II. Immunologic facts are mentioned
demonstrating: A) The existence of specific circulating antibodies demonstrated
by immunofluorescence techniques, by the useful action of blood from patients
with duly controlled melanoma injected into other melanoma patients, and by the
verification that blood serum from a melanoma patient inhibits cultures thereof. 
B) As regards cell-mediated immunity, this is normal when a melanoma cure is
obtained, and abnormal when no cure takes place. C) There exist melanoma
remissions in patients treated with specific or non-specific (BCG) antigens.
Spontaneous regression has also been observed in some melanomas. III. A case is
presented: a) with spontaneous regression of facial malignant lentigo; b)
manifestation of a cervical lymph node metastasis after the primitive tumor had
subsided; c) low-degree cell-mediated immunity recuperated spontaneously in an
exaggerated manner after radical neck dissection in which none of the lymph nodes
proved metastatic; d) manifestation of herpes zoster while the patient presented 
her best immunologic index; and 2) 11 years' survival since the melanoma made its
appearance, and more than 2 years (up to March 1979) since the manifestation of
the lymph node metastases.

Publication Types: 
    Case Reports
    English Abstract

PMID: 7022050 [PubMed - indexed for MEDLINE]

8291: Acta Neurochir Suppl (Wien). 1980;30:245-58.

Deep brain stimulation in mesencephalic lemniscus medialis for chronic pain.

Mundinger F, Salomao JF.

Stereotactic deep brain stimulation (DBS) with chronically implanted special
devices intermittently activated by the patient himself has led to a new concept 
in the treatment of chronic central pain, such as the thalamic pain syndrome,
herpes-zoster neuralgia, anaesthesia dolorosa, radicular and plexus lacerations, 
stump pain with and without causalgia and cancer pain. Our results in 32 cases
(March 31, 1979) with lemniscus medialis stimulation, including the specific and 
nonspecific somatosensory nuclei or periaqueductal gray matter show in 53% of our
cases, a reduction of pain of over 50%. The follow-up period was 47 months. These
results are better than those obtained from stimulating only one of the systems. 
Mesencephalic lemniscus medialis DBS, introduced by one of the authors
(Mundinger), leads to a functional blockade of spinothalamic, lemniscus medialis 
and spino-reticular systems. In cases where a positive morphine test had been
done previously, endorphin secretion also plays a role. It is assumed that the
effect of endorphin production lasts longer than the stimulation itself,
especially in periaqueductal mesencephalic gray matter and medial pulvinar
stimulation.

PMID: 7008520 [PubMed - indexed for MEDLINE]

8292: J Int Med Res. 1980;8(1):1-6.

Preliminary results of a clinical trial relative to the use of rifamycin SV in
the treatment of herpes zoster.

Bruni L, Califano A, De Angelis G, Montagnani A, Pisani M, Pezzarossa G, Pozzo G,
Reali D, Rebora A, Zanca A.

In a controlled clinical trial undertaken in ten Italian centres, rifamycin SV
was compared to associations of various drugs such as erythromycin, aureomycin,
multivitamin preparations, etc, in the treatment of herpes zoster. Up to now 144 
patients, suffering from herpes zoster at different localizations, were divided
into three groups and randomly given either rifamycin SV by intramuscular
injection and topically, or rifamycin SV by injection only, or the routine
treatment used at the particular centre in question. To evaluate the
effectiveness of the treatments, the presence of subjective and objective
symptoms was determined before treatment started and daily thereafter. The
duration, in days, of the most important symptoms, such as erythema, vesicles,
scabs and pain, was considered for this partial evaluation. All the
above-mentioned symptoms constantly showed a shorter duration in the two groups
treated with rifamycin SV compared to the group treated with other therapies,
with differences as significant on statistical calculation as they were important
on the level of a clinical evaluation of the disease's course.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 6987112 [PubMed - indexed for MEDLINE]

8293: Bull Soc Belge Ophtalmol. 1980;187(1):1-192.

Superficial keratitis.

Maudgal PC, Missotten L.

PMID: 6970603 [PubMed - indexed for MEDLINE]

8294: Eur Neurol. 1980;19(5):327-9.

A case of facial diplegi following herpes zoster ophthalmicus.

Shoji H, Hirose K, Uono M, Koya M.

A 71-year-old man developed a facial diplegia following right ophthalmic zoster. 
Neurological examination also revealed loss of reflexes in the lower limbs with
increase of CSF protein. Unusual cases of the Ramsay Hunt syndrome and
Guillain-Barre syndrome seen with herpes zoster were reviewed. These cases
including our case may suggest that the bilateral involvement or its wider spread
throughtout nervous tissue can rarely occur in the Ramsay Hunt syndrome and its
subgroups.

Publication Types: 
    Case Reports

PMID: 6967406 [PubMed - indexed for MEDLINE]

8295: Neuroradiology. 1980;19(5):279-82.

Post-herpetic aneurysm in the intrapetrosal portion of the internal carotid
artery.

Gursoy G, Aktin E, Bahar S, Tolun R, Ozden B.

The occurrence of an aneurysm, 2 x 2.5 cm in size, in the intrapetrosal portion
of the internal carotid artery in a 24-year-old female patient, during the course
of herpes zoster ophthalmicus, is described.

Publication Types: 
    Case Reports

PMID: 6967196 [PubMed - indexed for MEDLINE]

8296: Agents Actions Suppl. 1980;7:49-54.

Cytotoxic drugs in rheumatoid arthritis.

Amor B.

PMID: 6941686 [PubMed - indexed for MEDLINE]

8297: Zh Nevropatol Psikhiatr Im S S Korsakova. 1980;80(4):607-18.

[Pain: neurophysiologic and clinical aspects]

[Article in Russian]

Starobinets MKh, Volkova LD.

Publication Types: 
    Review

PMID: 6773277 [PubMed - indexed for MEDLINE]

8298: Bull Soc Belge Ophtalmol. 1980;190:71-86.

Varicella-zoster virus in the human corneal endothelium: a case report.

Maudgal PC, Missotten L, De Clercq E, Descamps J.

Publication Types: 
    Case Reports

PMID: 6269677 [PubMed - indexed for MEDLINE]

8299: J Med Virol. 1980;6(3):249-57.

Determination of IgA antibodies to human cytomegalovirus by enzyme-linked
immunosorbent assay (ELISA).

Levy E, Sarov I.

A sensitive enzyme-linked immunosorbent assay (ELISA) is described for detection 
of IgA antibodies cytomegalovirus (CMV). The antigen consisted of a sonicated
extract of CMV infected human embryo cells. The tested sera were absorbed with
staphylococcus aureus (strain Cowan 1) before analysis. Rabbit antihuman IgA
peroxidase conjugate was used to detect human IgA bound to viral antigen. In
parallel, Igm and IgG antibodies to CMV were studied by ELISA and by the
immunoperoxidase antibody to membrane antigen (IPAMA) technique, respectively.
CMV IgA was detected in high titers by ELISA in eight of nine CMV patients. The
maximal IgA titers were generally lower than the IgM titers detected by ELISA. No
CMV IgA antibodies (titer less than 20) were detected by ELISA in 57 control sera
(healthy adults, hospitalized patients with various other diseases), paired sera 
of five patients with acute herpes simplex, infection, two patients with
Epstein-Barr infections, one patients with varicella, and one with zoster
infections. The potential application of the ELISA CMV IgA technique in
serodiagnosis of CMV infections is discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6262458 [PubMed - indexed for MEDLINE]

8300: J Med Virol. 1980;5(3):195-203.

Detection of human cytomegalovirus-specific IgG antibodies by a sensitive
solid-phase radioimmunoassay and by a rapid-screening test.

Kimmel N, Friedman MG, Sarov I.

A radioimmunoassay (RIA) for the detection of human IgG antibodies to
cytomegalovirus (CMV) which utilizes extracts of CMV-infected cells as antigen is
described. Sera of 66 healthy adults were titered by the RIA and by the
complement fixation (CF) test. These same subjects were also used in the
evaluation of a rapid screening radioimmunoassay (RSRIA) developed to detect IgG 
antibodies to CMV in small serum samples. The specificity of the RIA was
evaluated by testing sera of seven CMV patients and ten patients with heterotypic
titer rises to herpes simplex virus or varicella zoster virus (HSV or VZV). The
RIA proved to be sensitive and specific. Possible applications of the RSRIA
modification are discussed.

Publication Types: 
    Research Support, Non-U.S. Gov't

PMID: 6262448 [PubMed - indexed for MEDLINE]

8301: Prog Clin Biol Res. 1980;47:21-49.

New developments with new vaccines.

Hilleman MR.

Publication Types: 
    Review

PMID: 6259664 [PubMed - indexed for MEDLINE]

8302: Q J Med. 1980 Spring;49(194):219-31.

The effects of viral infections on renal transplants and their recipients.

Warrell MJ, Chinn I, Morris PJ, Tobin JO.

A prospective study of viral infections occurring after 188 renal transplants in 
167 patients showed active cytomegalovirus (CMV) infection after 52 per cent of
transplantations. All 37 CMV seronegative cases who received grafts from
seronegative donors remained free of infection, while 24 (70.6 per cent) of 34
seronegative recipients whose donors were seropositive developed primary CMV
infection (p less than 0.001). The diagnosis of 92 per cent of these primary
infections was made between one and two months after grafting. Secondary CMV
infection was found in 71 (62 per cent) of 114 seropositive cases, and the
frequency of infection was not affected by the CMV status of the renal donor.
Neither acute rejection episodes nor total graft rejections were associated with 
primary or secondary infections. CMV was isolated from a colonic abscess and the 
relationship of the virus to the intestinal disease is discussed. Herpes simplex 
virus was isolated from 47 per cent of cases and 32 per cent had an increase in
antibody titre. Zoster was seen in nine patients, representing an incidence of
3.4 per cent per year. Other viral or mycoplasmal infections diagnosed included
71 due to respiratory tract pathogens, and a single case of hepatitis B. None of 
these infections was particularly severe or frequent and no association with
graft rejection was detected.

PMID: 6254109 [PubMed - indexed for MEDLINE]

8303: Int Ophthalmol Clin. 1980 Fall;20(3):149-61.

Ocular antiviral therapy.

Pavan-Langston D.

Publication Types: 
    Review

PMID: 6252111 [PubMed - indexed for MEDLINE]

8304: Arch Dermatol Res. 1980;268(1):65-70.

Skin test with Varicella-zoster virus antigen on herpes zoster patients.

Hata S.

Intracutaneous injection of Varicella-zoster (V-Z) viral antigen was performed on
55 patients with herpes zoster. All of them reacted positively after 10 days. The
patients in the acute stage responded weakly wereas those in the convalescent
phase developed a stronger reaction. The intensity of the reaction did not
correlate with the number of days of illness. Positive reactions were observed in
those patients who had suffered from herpes zoster several years ago. Complement 
fixing antibody titers did not parallel the intensity of skin reaction.

PMID: 6251751 [PubMed - indexed for MEDLINE]

8305: J Hyg Epidemiol Microbiol Immunol. 1980;24(2):192-9.

Varicella morbidity in Czechoslovakia.

Trlifajova J, Svandova E, Havrlantova M, Galetkova A.

Data are presented on varicella and herpes zoster morbidity notified in
Czechoslovakia in the years 1970 to 1978. The notified varicella incidence is
compared with serologically confirmed varicella incidence among the selected
groups of children up to the age of 12 from the North-Moravia region. Comparative
analysis revealed a considerable difference between the notified and
serologically detected cases of varicella. The highest rate of notified varicella
was recorded in children of 3 and 4 years of age, while the highest incidence of 
seropositive cases was detected among the 2-year-old children. The cumulative
notified morbidity involved about 35% of 6-year-old and 45% of 12-year-old
children, whereas specific antibodies against the varicella-zoster virus were
found in about 60% of 6-year-old and 90% of 12-year-old children. The titres of
virus-specific antibodies were determined by the method of indirect
hemagglutination reaction. No serological methods are applicable for herpes
zoster morbidity studies in the population.

PMID: 6251130 [PubMed - indexed for MEDLINE]

8306: Intervirology. 1980;13(4):214-22.

Enzyme-linked immunosorbent assay for detection of virus-specific IgM antibodies 
to varicella-zoster virus.

Hacham M, Leventon-Kriss S, Sarov I.

A sensitive enzyme-linked immunosorbent assay (ELISA) is described for detection 
of varicella-zoster virus (VZV) IgM antibodies. The antigen consisted of a
sonically disrupted extract of VZV-infected human embryo cells. The tested sera
were absorbed with Staphylococcus aureus (strain Cowan I) before analysis. Rabbit
anti-human IgM peroxidase conjugate was used to detect human IgM bound to viral
antigen. The results were compared with those obtained by the indirect
fluorescent antibody to membrane antigen (IFAMA) technique. Comparison of titers 
obtained by ELISA with those obtained by IFAMA for sera of chickenpox patients
showed agreement between the results in 8 of 9 patients. In 1 chickenpox patient,
no VZV IgM antibodies could be detected by IFAMA, while a titer of 3,200 was
obtained by ELISA. The ELISA technique described gave titers more than 100 times 
higher than those obtained by IFAMA. VZV IgM antibody was detected by ELISA and
IFAMA in only 1 of 5 zoster patients. No VZV IgM antibodies were found by ELISA
in 45 control sera (healthy adults and hospitalized patients with various other
diseases). Neither were they found in paired sera of 6 patients with acute herpes
simplex infections, 2 patients with Epstein-Barr virus infections, and 3 patients
with human cytomegalovirus infections.

Publication Types: 
    Comparative Study

PMID: 6248482 [PubMed - indexed for MEDLINE]

8307: Transplantation. 1980;29(1):47-50.

Varicella-zoster virus infection after marrow transplantation for aplastic anemia
or leukemia.

Atkinson K, Meyers JD, Storb R, Prentice RL, Thomas ED.

Nearly one-half of marrow transplant recipients who survive at least 6 months
develop varicella-zoster virus (VZV) infection. Of 92 cases studied, 82 occurred 
within the first 12 months after transplant. Only one patient had recurrent
infection. Seventy-seven patients had herpes zoster, 22 with subsequent cutaneous
dissemination, and 15 had varicella. The overall mortality rate was 8%, and all
deaths occurred within 9 months of transplant. Twenty-six of 32 patients studied 
had significant rises in VZV antibody during recovery. Among patients with acute 
leukemia, those with syngeneic transplants had a significantly lower incidence of
VZV infection than those with allogeneic transplants. Incidence was slightly, but
not significantly, decreased among patients with aplastic anemia. In contrast to 
other infections, the incidence of VZV infection was not influenced by
graft-versus-host disease or predicted by the results of dinitrochlorobenzene
skin testing.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 6245486 [PubMed - indexed for MEDLINE]

8308: Arch Intern Med. 1980 Jan;140(1):28-9.

Zoster immune globulin.

Spitler LE.

Publication Types: 
    Comparative Study

PMID: 6243457 [PubMed - indexed for MEDLINE]

8309: Riv Emoter Immunoematol. 1980;27(3-4):142-50.

[Isoprinosine in the therapy of herpes zoster occurring in patients with
malignant lymphoproliferative diseases]

[Article in Italian]

Corridori S, Vender A, Lago A, Cerrato P.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 6176005 [PubMed - indexed for MEDLINE]

8310: Med Cutan Ibero Lat Am. 1980;8(4-6):105-8.

[Herpes simplex and herpes varicella-zoster. Cytological and ultrastructural
study]

[Article in Spanish]

Garcia Canton JA, Navarrete Ortega M, Rafael Ribas E.

Nuclear staining qualities, and cell morphology depart from normal when
epithelial cells are infected by herpes virus hominis and herpes varicella-zoster
(1). The cytopathic changes produced by both viruses are similar and constant
enough to be considered characteristic of the infection. Since the skin vesicles 
are readily accessible for examination, it is easy to scrape infected cells from 
the floor of the exposed blister and establish the diagnosis. The simplest and
most common method would be by light microscopy utilizing conventional staining. 
When the circumstances warrant it and the facilities are available, the virus
itself can be demonstrated by electron microscopy with material obtained in the
same fashion. This paper deals with two cases in which the initial diagnosis of
the disease was made by cytologic examination and the presence of virus
subsequently verified by electron microscopy.

Publication Types: 
    English Abstract

PMID: 6168875 [PubMed - indexed for MEDLINE]

8311: Can Anaesth Soc J. 1980 Jan;27(1):40-6.

The response to epidural steroid injections in chronic dorsal root pain.

Forrest JB.

Thirty-seven patients with long-standing post-herpetic neuralgia and 27 with
post-traumatic neuralgia (PTN) were treated with three epidural injections each
of methylprednisolone acetate (Depo Medrol) given at weekly intervals.
Differential subarachnoid or epidural block was done in all patients and placebo 
responders were excluded from the study. Mean age, duration of symptoms, and pain
intensity measured by visual analogue scale were similar in both groups. Visual
analogue scale ratings were reduced one month after treatments from both groups. 
Visual analogue scale ratings were reduced one month after treatments from
pretreatment values of 84.4 and 78.7 to 9.6 and 15.2 in the post-herpetic and
post-traumatic groups respectively, and were further reduced to 4.6 and 11.6
respectively after one year when 89 per cent of patients in the post-herpetic
group and 59 per cent of patients in the post-traumatic group were completely
pain free. Side effects were minor in all cases. It is suggested that this is the
treatment of choice in post-herpetic and post-traumatic neuralgia where steroid
administration is not contraindicated.

PMID: 6153292 [PubMed - indexed for MEDLINE]

8312: Arch Intern Med. 1980 Jan;140(1):52-4.

Zoster immune globulin prophylaxis of disseminated zoster in compromised hosts. A
randomized trial.

Stevens DA, Merigan TC.

Herpes zoster can be a severe, and sometimes fatal, virus infection in its
disseminated form in immunocompromised hosts. Previous studies have suggested
that delay in appearance of antibody to varicella-zoster virus occurs as one
defect in such patients. In this study, pooled gamma-globulin (normal serum
globulin [NSG]) and zoster immune globulin ([ZIG] prepared from convalescent
zoster patients) were compared for their ability to prevent dissemination of
early localized zoster in immunocompromised hosts. Either agent was given
intramuscularly in randomized double-blind fashion within nine days of onset of
zoster in 97 patients. Despite greater than 100-fold differences in titer of
anti-varicella-zoster virus antibody, ZIG did not appear superior to NSG in
prophylaxis of dissemination or diminishing postherpetic pain in zoster in
immunocompromised hosts. Zoster immune globulins should be reserved for
prophylaxis and modification of varicella, where its beneficial effect has been
demonstrated.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 6153260 [PubMed - indexed for MEDLINE]

8313: Lancet. 1979 Dec 15;2(8155):1267-70.

Parenteral acyclovir therapy for herpesvirus infections in man.

Selby PJ, Powles RL, Janeson B, Kay HE, Watson JG, Thornton R, Morgenstern G,
Clink HM, McElwain TJ, Prentice HG, Corringharn R, Ross MG, Hoffbrand AV, Brigden
D.

Acyclovir is a new antiviral agent which is highly active against herpesviruses
in vitro and in laboratory animals. Twenty-three cancer patients with cutaneous
and/or systemic herpes zoster or herpes simplex infections were treated with
parenteral acyclovir. All had received previous specific treatment for their
malignant disease and ten had undergone bone-marrow transplantation. The drug
seemed to arrest the progress of the infections and was most effective when given
early. Although two patients showed transient increases in blood-urea, possibly
the result of acyclovir, the drug was remarkably non-toxic in the doses used.

PMID: 93183 [PubMed - indexed for MEDLINE]

8314: Antimicrob Agents Chemother. 1979 Dec;16(6):781-7.

Effects of interferon and adenine arabinoside treatment of hepatitis B virus
infection on cellular immune responses.

Hafkin B, Pollard RB, Tiku ML, Robinson WS, Merigan TC.

Fifteen patients with chronic hepatitis B were treated with adenine arabinoside
(Ara-A) or human leukocyte interferon (HLI). Cellular immune response to
hepatitis B virus surface antigen and antigens prepared from herpes simplex
virus, varicella zoster virus, and cytomegalovirus was measured by a lymphocyte
blast transformation assay and an assay for interferon production. Measurements
were made before, during, and after antiviral treatment. Unlike patients
convalescing from acute hepatitis B, only 2 of 15 patients with chronic hepatitis
B had significant blast transformation to hepatitis B surface antigen. One such
response occurred during the pretreatment period of HLI therapy, and the other
was in a patient undergoing low-dose (<10(5) U/kg per day) HLI therapy.
Mononuclear cell cultures were tested for interferon production in the presence
of hepatitis B surface antigen. Cells from only 1 of 15 patients produced
detectable levels of interferon. In contrast, all of these patients had normal
cellular immune responses to herpesvirus antigens. Transformation responses to
herpes antigens decreased three- to fivefold after patients were treated with
>10(5) U of HLI per kg per day. Antiviral therapy with <10(5) U of HLI per kg per
day or Ara-A did not produce a detectable depression of transformation response. 
Ara-A produced marked lymphocytopenia and a marked lymphocyte fragility after 5
or more days of therapy. In vitro Ara-A was toxic to lymphocytes at
concentrations as low as 0.5 mug/ml. These changes in lymphocyte parameters may
affect the outcome of antiviral therapy.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 533259 [PubMed - indexed for MEDLINE]

8315: Vestn Dermatol Venerol. 1979 Dec;(12):40-2.

[Ramsay Hunt syndrome in herpes zoster]

[Article in Russian]

Zorin PM, Spiridonova SP, Korobkova OK, Chumenko NV.

Publication Types: 
    Case Reports
    English Abstract

PMID: 525023 [PubMed - indexed for MEDLINE]

8316: Arch Intern Med. 1979 Dec;139(12):1337-8.

Herpes zoster. Of antibodies and antivirals.

Rand KH.

PMID: 518215 [PubMed - indexed for MEDLINE]

8317: J Am Acad Dermatol. 1979 Dec;1(6):531-7.

Efficacy of mycophenolic acid for the treatment of psoriasis.

Gomez EC, Menendez L, Frost P.

The efficacy of orally administered mycophenolic acid (MPA), an inhibitor of
guanosine monophosphate (GMP) synthesis, for the treatment of psoriasis, was
studied in a double-blind fashion. Of twenty-one patients completing the study
period, ten of eleven patients treated with MPA had a greater than 25% decrease
in severity score compared with only two of ten patients treated with placebo.
The placebo group had a slight increase in severity score compared to almost 50% 
reduction in the average severity score of the MPA-treated group. After
termination of the double-blind portion of the study, the placebo group was
treated with MPA and showed a 60% decrease in severity score. Adverse effects
encountered included anorexia, nausea, vomiting, and diarrhea. One patient had an
uncomplicated episode of herpes zoster. Other than a mild decrease hemoglobin, no
hematologic toxicity was noted.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 393732 [PubMed - indexed for MEDLINE]

8318: Ann Intern Med. 1979 Dec;91(6):842-6.

Prolonged herpes-zoster infection associated with immunosuppressive therapy.

Gallagher JG, Merigan TC.

Unusually prolonged zoster was observed in four patients, two with cardiac
transplants, one with acute lymphocytic leukemia, and one with diffuse
histiocytic lymphoma. Lesions increased in number and persisted for 5 to 24 weeks
before beginning to resolve. Specific cellular-immune responsiveness to
varicella-zoster virus was markedly depressed during these infections. Absolute
numbers of T lymphocytes were also very low. Reducing immunosuppressive therapy
to increase immune responses appeared to initiate resolution of zoster lesions
and halt dissemination. In one patient treatment with adenine arabinoside was
also needed for resolution of disseminated zoster. This syndrome appears to be
counterpart of the prolonged mucocutaneous herpes-simplex infection previously
reported in immunosuppressed cardiac and renal transplant patients.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 391116 [PubMed - indexed for MEDLINE]

8319: Nippon Hifuka Gakkai Zasshi. 1979 Dec;89(14):1031-9.

[A case of disseminated, cutaneous deep candidiasis associated with Hodgkin's
disease (author's transl)]

[Article in Japanese]

Okada T, Iwao E, Kawatsu T, Yamada T, Matsuda K, Machino H, Miki Y.

Publication Types: 
    Case Reports

PMID: 317116 [PubMed - indexed for MEDLINE]

8320: J Fr Ophtalmol. 1979 Dec;2(12):723-6.

[A posterior dislocation of the lens in herpes zoster (author's transl)]

[Article in French]

Loffredo A, Cennamo G, Sammartino A.

The authors report a case of posterior dislocation of the lens during the natural
history of a clinical case of herpes zoster. An echographic B-scan study was
carried out to reveal the position and the size and the shape of dislocated lens,
together with its structure and that of ocular media. After a discussion on the
possible aetiology of the lens dislocation it was considered due to herpes zoster
disease, and are reported the possible mechanism of zonula alteration.

Publication Types: 
    Case Reports
    English Abstract

PMID: 317083 [PubMed - indexed for MEDLINE]

8321: Am J Med. 1979 Dec;67(6):935-40.

Fever in systemic lupus erythematosus.

Stahl NI, Klippel JH, Decker JL.

The frequency, causes, clinical and laboratory features, and outcome of febrile
episodes in 160 hospitalized patients with systemic lupus erythematosus were
reviewed. Eighty-three febrile episodes were identified in 63 patients and were
ascribed to active lupus erythematosus alone (60 per cent), infections (23 per
cent) and miscellaneous causes (17 per cent). Bacteremia was present in nine of
the 19 infectious episodes and resulted in a fatal outcome in a third of the
patients. Leukocytosis, neutrophilia, shaking chills and normal levels of
anti-DNA antibodies were associated with infection in febrile patients with lupus
erythematosus.

PMID: 316284 [PubMed - indexed for MEDLINE]

8322: Aust N Z J Med. 1979 Dec;9(6):702-4.

An unusual case of flaccid paralysis of both lower limbs following herpes zoster.

Chapman BA, Beaven DW.

A 57-year-old man with left T8-9 cutaneous Herpes Zoster lesions and subsequent
development of flaccid paralysis of both lower limbs is reported. Viral studies
strongly supported a diagnosis of Herpes Zoster. No other cause for the paralysis
was found. The time interval between the cutaneous lesions and the motor
weakness, the clinical course and good recovery suggest a causal relationship.
The dermatomal and myotomal dissociation has been well-documented on the
ipsilateral side, but involvement of the contralateral side is rare. This would
appear to be unusual in that there was bilateral weakness of "LMN type".

Publication Types: 
    Case Reports

PMID: 294930 [PubMed - indexed for MEDLINE]

8323: Arch Intern Med. 1979 Dec;139(12):1341-5.

Serum antibody levels as risk factors in the dissemination of herpes zoster.

Mazur MH, Whitley RJ, Dolin R.

Serum antibody levels against varicella-zoster virus (VZV) were examined by
immune adherence hemagglutination assay (IAHA), indirect fluorescent antibody
(IFA) assay, and complement fixation techniques in 67 immunocompromised patients 
with localized and disseminated herpes zoster. In the serum obtained initially,
undetectable IAHA titers were found in 56.5% of the patients with disseminated
zoster compared with 18.2% of those with localized zoster. When serum obtained
within the first seven days of illness was analyzed, undetectable IAHA titers and
IFA titers of less than 32 were noted in 77.8% of those with disseminated zoster 
but in only 18.5% of those with localized disease. Peak serum antibody titers in 
patients with disseminated zoster were eventually equal to or greater than those 
in localized zoster. The patient groups were comparable in age, underlying
disease, and therapy, although Hodgkin's disease was more frequent in patients
with disseminated zoster. Thus, the absent IAHA or low IFA levels of circulating 
antibody early in illness were highly significant risk factors in dissemination
of virus in herpes zoster.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 229783 [PubMed - indexed for MEDLINE]

8324: J Infect Dis. 1979 Dec;140(6):851-7.

Immune response to herpesvirus antigens in adults with acute cytomegaloviral
mononucleosis.

Levin MJ, Rinaldo CR Jr, Leary PL, Zaia JA, Hirsch MS.

The immune response of eight patients with mononucleosis caused by
cytomegalovirus (CMV) was measured early in their illness--when virus was present
in their urine and/or blood--and subsequently during convalescence. Levels of
CMV-specific antibody rose early in the illness, but the proliferative response
of mononuclear cells to CMV antigen did not reach the level characteristic of
CMV-immune donors until several months later. The production of interferon by
mononuclear cells in response to CMV antigen was also low early in the illness.
Although these patients had prior immunity to herpes simplex virus and
varicella-zoster virus, their mononuclear cells responded poorly to antigens
prepared from these viruses. The proliferative response to these antigens
returned to normal in parallel with the development of a normal response to CMV. 
It is suggested that acute CMV mononucleosis suppresses the proliferative
response of human mononuclear cells.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 94336 [PubMed - indexed for MEDLINE]

8325: Lancet. 1979 Nov 24;2(8152):1144.

Herpes zoster of the stomach.

MacGregor GA.

Publication Types: 
    Letter

PMID: 91884 [PubMed - indexed for MEDLINE]

8326: Z Hautkr. 1979 Nov 15;54(22):1002-7.

[Skin diseases and monoclonal gammopathies]

[Article in German]

Kovary PM, Macher E.

PMID: 539033 [PubMed - indexed for MEDLINE]

8327: ZFA (Stuttgart). 1979 Nov 10;55(31):1763-9.

[Herpes zoster. Nosology, clinical aspects and therapy]

[Article in German]

Gottwald W.

PMID: 93829 [PubMed - indexed for MEDLINE]

8328: Lancet. 1979 Nov 3;2(8149):953.

Herpes zoster of the stomach.

Wisloff F, Bull-Berg J, Myren J.

Publication Types: 
    Case Reports
    Letter

PMID: 91038 [PubMed - indexed for MEDLINE]

8329: Ann Dermatol Venereol. 1979 Nov;106(11):917-9.

[Zoster-like Darier's disease]

[Article in French]

Verret JL, Halligon J, Fortier P, Schnitzler L.

Publication Types: 
    Case Reports

PMID: 539703 [PubMed - indexed for MEDLINE]

8330: Ann Intern Med. 1979 Nov;91(5):727-30.

Cardiac ganglionitis associated with sudden unexpected death.

James TN, Zipes DP, Finegan RE, Eisele JW, Carter JE.

In a postmortem study of the hearts of two young women who died suddenly and
unexpectedly, we found a remarkably similar and distinctive ganglionitis,
predominantly in the region of the sinus node. Both women had ventricular
fibrillation at the time of collapse. Vesicular neuritis and older neural
degeneration were present in other regions of the heart. Except for focal
fibromuscular dysplasia of the sinus node artery and atrioventricular node artery
of one heart, there was no other significant anatomic abnormality in either
heart. The functional significance of this cardiac ganglionitis is unclear, but
its location in and around the conduction system makes it a possible cause of the
fatal electrical instability. Recognition that ganglionitis of the heart may be
associated with sudden death should stimulate a number of additionally useful
studies.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 496105 [PubMed - indexed for MEDLINE]

8331: Sb Lek. 1979 Nov-Dec;81(11-12):344-6.

[Investigation of the specific immunological reaction in the course of herpes
zoster by means of the LAI test (author's transl)]

[Article in Czech]

Vasickova M, Fadrhoncova A, Jandova A, Heyberger K, Doutlik S, Vacek Z, Coupek J,
Sanitrak J.

Publication Types: 
    English Abstract

PMID: 390686 [PubMed - indexed for MEDLINE]

8332: J Gen Virol. 1979 Nov;45(2):469-77.

The serological relationship of varicella-zoster virus to other primate
herpesviruses.

Harbour DA, Caunt AE.

The serological relationship between viruses producing varicella-like exanthems
in several subhuman primates, varicella-zoster virus (VZV) and herpes simplex
viruses (HSV) types 1 and 2, was investigated. All the primate viruses were
related to VZV and some to HSV also. These results show that there is a group of 
varicella viruses, comprising four distinct entities, some of which may be useful
for the establishment of an animal model for varicella.

Publication Types: 
    Comparative Study

PMID: 232132 [PubMed - indexed for MEDLINE]

8333: Proc Natl Acad Sci U S A. 1979 Nov;76(11):5825-8.

Antibodies to Epstein-Barr virus-determined antigens in normal subjects and in
patients with seropositive rheumatoid arthritis.

Catalano MA, Carson DA, Slovin SF, Richman DD, Vaughan JH.

Prior studies have shown that patients with seropositive rheumatoid arthritis
(RA) have an increased frequency of precipitating antibody against a nuclear
antigen, the RA nuclear antigen, detected in human B lymphoblastoid cell lines
infected by Epstein-Barr virus. The present investigations demonstrate that
patients with seropositive RA also have specifically elevated titers of
antibodies to another, better-characterized Epstein-Barr virus-associated B cell 
antigen, the Epstein-Barr nuclear antigen, which is detected by anti-complement
immunofluorescence. Titers of these two antibodies were not affected by
absorption of rheumatoid factor from serum. Furthermore, patients with RA did not
have elevated titers of antibodies against the Epstein-Barr virus capsid antigen 
or to three other species of human herpesviruses: herpes simplex type 1,
varicella-zoster virus, and cytomegalovirus. In both normal individuals and RA
patients there was a significant association between the presence of antibodies
to RA nuclear antigen and the titers of antibody to Epstein-Barr nuclear antigen.
Thus, normal subjects with antibody to RA nuclear antigen had titers of antibody 
to Epstein-Barr nuclear antigen equivalent to those of patients with RA and
significantly higher than normal subjects lacking antibody to RA nuclear antigen.
One interpretation of these results is that patients with seropositive RA derive 
from a larger population with enhanced immune responsiveness to B lymphocyte
nuclear antigens determined by the Epstein-Barr virus.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 230491 [PubMed - indexed for MEDLINE]

8334: J Clin Pathol. 1979 Nov;32(11):1075-89.

Cytological diagnosis of virus-infected cells in Papanicolaou smears and its
application in clinical practice.

Coleman DV.

The cytopathic changes of herpes simplex virus, varicella-zoster virus, the human
polyomaviruses, and the trachoma agent can be recognised in smears prepared from 
a wide variety of specimens. The morphology of virus-infected cells is described,
and the clinical value of these observations is discussed. Cytological diagnosis 
offers a rapid and convenient method of detecting infection with these viruses
which can be confirmed by conventional virological method while the patient is
still in the acute stages of the disease. Confirmation can also be made
retrospectively by reprocessing cells, identified in the Papanicolaou smear, for 
electron microscopy. Screening for virus-infected cells in cytological smears is 
a technique that can be developed in any pathology laboratory prepared to provide
a comprehensive cytology service, and it is proving to be a useful tool in
clinical diagnosis and applied research.

PMID: 229124 [PubMed - indexed for MEDLINE]

8335: Curr Probl Pediatr. 1979 Nov;10(1):1-46.

Therapeutic control of viral infections: chemotherapy, interferon and gamma
globulin.

St Geme JW Jr.

Publication Types: 
    Review

PMID: 94280 [PubMed - indexed for MEDLINE]

8336: Klin Padiatr. 1979 Nov;191(6):566-71.

[Preliminary clinical experiences with adenine arabinoside monophosphate
(ARA-AMP) in encephalitis due to viruses of the herpes group and varicella/zoster
infections (author's transl)]

[Article in German]

Sauer O, Werner GT, Schneider H, Lenard HG, von Haselberg L, Nettesheim HJ.

Adenine arabinoside monophosphate (ARA-AMP) is a new antiviral agent with
significant activity against DNA viruses of the herpes group. It appears to be
superior to cytosine arabinoside and iodoxuridine in severe herpes simplex
infections. Unlike cytosine arabinoside and idoxuridine ARA-AMP has only minimal 
myelosuppressive and immunosuppressive properties. The original compound, adenine
arabinoside (ARA-A) which has been used in the United States in the last years
had the disadvantage of poor solubility and tissue penetrance. Compared to
adenine arabinoside the monophosphate ester of this compound has the advantage of
better solubility and is more slowly metabolized in humans. In eight children
with virus induced encephalitis ARA-AMP was well tolerated, we could not observe 
any severe side effects. A case of herpes simplex encephalitis showed a complete 
recovery. However it has to be pointed out that in herpes simplex encephalitis
ARA-AMP should be given early in the course of infection to have a beneficial
effect, therefore an early diagnosis is of utmost importance. A case of
generalized herpes zoster healed up within about a week. Of course these are very
preliminary results which must be confirmed by further experiences.

Publication Types: 
    English Abstract

PMID: 92592 [PubMed - indexed for MEDLINE]

8337: Schweiz Rundsch Med Prax. 1979 Oct 23;68(43):1401-5.

[Clinical experiences with the interferon therapy (author's transl)]

[Article in German]

Flury F, Wegmann T.

Publication Types: 
    English Abstract

PMID: 523431 [PubMed - indexed for MEDLINE]

8338: Br Med J. 1979 Oct 6;2(6194):829-30.

Viral infections in renal allograft recipients treated with long-term
immunosuppression.

Spencer ES, Andersen HK.

Thirty-nine renal allograft recipients who had received continuous
immunosuppression for six to 13 years were examined clinically and virologically 
for evidence of past or present viral infection. Twenty-five had common warts,
usually on the hands. In most the warts had appeared about one year after
transplantation; once present, they never disappeared. Six patients had had a
zoster rash from two months to four years after transplantation. None had had
jaundice, and there was no change in the frequency of colds or non-specific
fibrile illness. Four patients had no cytomegalovirus complement-fixing
antibodies throughout the observation period; in the other 35 the antibody titre 
had risen appreciably during the first three to four months after
transplantation. Antibody titres were high (mean 64) at follow-up, being only
slightly lower than the highest titres achieved during the immediate
postoperative period. None of the patients had had symptomatic cytomegalovirus
infection, and in only two was the virus isolated from the urine at follow-up;
the titres were extremely low. No changes occurred in the frequency of herpes
simplex eruptions. Although all patients had herpes simplex humoral antibody,
none excreted the virus. Although cytomegalovirus antibody titres were high,
virus excretion was rare, indicating that chronic cytomegalovirus infection in
these patients is immunologically well controlled.

PMID: 228789 [PubMed - indexed for MEDLINE]

8339: Dis Colon Rectum. 1979 Oct;22(7):503-4.

Herpes zoster causing apparent low colonic obstruction.

Kesner KM, Bar-Maor JA.

Publication Types: 
    Case Reports

PMID: 583331 [PubMed - indexed for MEDLINE]

8340: Klin Monatsbl Augenheilkd. 1979 Oct;175(4):488-501.

[Herpes simplex virus isolations from the aqueous humor of patients suffering
from focal iritis, endotheliitis, and prolonged disciform keratitis with glaucoma
(author's transl)]

[Article in German]

Sundmacher R, Neumann-Haefelin D.

Aqueous humor from 33 herpes patients, 4 zoster patients, and 14 patients with
etiologically unclear anterior uveitis was cultured for the presence of herpes
viruses. Nine taps from 8 herpes patients with corneal endothelial disease and/or
anterior uveitis yielded herpes simplex virus. In the case of one patient two
taps were positive at 14 days' interval. Control cultures from the surface of
conjunctiva and cornea were consistently virus-negative. Analysis of the
virus-positive cases displayed three remarkable features: 1. Secondary glaucoma
was uniformly present. This in itself is an indication for culturable herpes
simplex virus in the aqueous. 2. Three clinical pictures could be differentiated 
biomicroscopically: focal iritis, peripheral endotheliitis, and prolonged
disciform keratitis. 3. In a proportion of cases, tissue damage resulting from
associated immune reactions seems to be more important for the functional outcome
than tissue damage by viral cytolysis itself. After having tried several
antiviral substances (trifluorothymidine topically,
adeninearabinoside-monophosphate intravenously, human leukocyte interferon
intramuscularly and intracamerally) we presently favour a topical combination
therapy consisting of trifluorothymidine and steroids. This must be complemented 
by cycloplegics and--in cases of high intraocular pressure--by acetazolamide.

Publication Types: 
    Case Reports
    English Abstract

PMID: 548618 [PubMed - indexed for MEDLINE]

8341: Br J Clin Pract. 1979 Oct;33(10):291-3.

Outbreak of chickenpox and herpes zoster in a geriatric hospital.

Rahman M.

Publication Types: 
    Case Reports

PMID: 526415 [PubMed - indexed for MEDLINE]

8342: Cutis. 1979 Oct;24(4):360, 379, 451 passim.

Transfer factor treatment of viral diseases.

Khan A.

PMID: 509979 [PubMed - indexed for MEDLINE]

8343: J Infect Dis. 1979 Oct;140(4):601-4.

Antibody to varicella-zoster virus-induced membrane antigen: immunoperoxidase
assay with air-dried target cells.

Haikin H, Leventon-Kriss S, Sarov I.

A technique using indirect immunoperoxidase antibody to membrane antigen (IPAMA) 
was developed for detection of IgG antibody to varicella-zoster virus (VZV). The 
IPAMA technique utilizes glass slides with air-dried VZV-infected cells, which
can be stored at -70 C and used for several months without loss of sensitivity.
Antibody titers measured by the IPAMA technique were comparable to those measured
by the technique using indirect fluorescent antibody to membrane antigen (IFAMA) 
for sera obtained from 63 medical students as well as sera from three patients
with chicken pox and nine with herpes-zoster infection, and the sensitivity of
the IPAMA was equal to that of the IFAMA technique. No cross-reactivity with
antibodies to other herpesviruses was observed.

Publication Types: 
    Comparative Study

PMID: 229177 [PubMed - indexed for MEDLINE]

8344: J Infect Dis. 1979 Oct;140(4):596-600.

Indirect immunofluorescence test for detection of IgM antibodies to
cytomegalovirus.

Hekker AC, Brand-Saathof B, Vis J, Meijers RC.

A technique for the detection of IgM antibodies to cytomegalovirus (CMV) by
immunofluorescence was developed. In order to prevent interference by rheumatoid 
factor in the sera, IgG was removed by prior immunoabsorption with antiserum to
gamma Fc. Sera from 63 patients with a rise in titer of antibody to CMV,
indicated by complement fixation, were IgM-positive, but yielded negative results
on the Paul-Bunnell-Davidsohn test for infectious mononucleosis.
Convalescent-phase serum samples from 20 patients with a seroconversion to herpes
simplex virus and from 20 patients with a seroconversion to varicella-zoster
virus also had no IgM antibodies to CMV. Sera from six of 10 patients with
infectious mononucleosis and two of 100 normal blood donors were positive for IgM
antibodies to CMV. In 38 of 63 patients, the diagnosis of CMV infection could be 
made several weeks earlier by the immunofluorescence test than by the
complement-fixation test. IgM antibodies to CMV persisted for more than two
months after onset of symptoms of the infection.

Publication Types: 
    Comparative Study

PMID: 229176 [PubMed - indexed for MEDLINE]

8345: Rev Med Interna Neurol Psihiatr Neurochir Dermatovenerol Neurol Psihiatr
Neurochir. 1979 Oct-Dec;24(4):305-8.

[Movement disorders after herpes zoster]

[Article in Romanian]

Antoneanu M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 161055 [PubMed - indexed for MEDLINE]

8346: Ir Med J. 1979 Sep 28;72(9):399-401.

The management of post herpetic pain using sodium valproate and amitriptyline.

Raftery H.

PMID: 389881 [PubMed - indexed for MEDLINE]

8347: Fortschr Med. 1979 Sep 27;97(36):1543-7.

[Chest pain: differential diagnosis in general practice]

[Article in German]

Schranz W.

In patients with chest pain somatic pain (thoracic wall pain) has to be
differentiated from visceral pain (organ pain). History and careful physical
examination are diagnostic in most cases. Presented are rare and not well-known
diseases like valvular aortic stenosis, idiopathic hypertrophic subaortic
stenosis and the mitral valve prolapse syndrome. Not seldom they are masked by
angina pectoris-like symptoms, although in general the coronary arteries are
normal. In acute chest pain differential diagnostic considerations have to
include lung embolism, acute pericarditis, spontaneous pneumothorax, acute
dissecting aneurysm of the aorta and diseases of the gastrointestinal tract as
well. Only after exclusion of any organic cause the diagnosis of "effort
syndrome" may be made.

Publication Types: 
    English Abstract

PMID: 499963 [PubMed - indexed for MEDLINE]

8348: JAMA. 1979 Sep 21;242(12):1259-60.

Distribution of adenine arabinoside and interferon.

Whitley RJ, Arvin A, Galasso G, Dunnick J.

Publication Types: 
    Letter

PMID: 480535 [PubMed - indexed for MEDLINE]

8349: S Afr Med J. 1979 Sep 1;56(12):491-4.

Therapeutic use of zoster-immune plasma: A report of 8 cases.

Dickson DN, Heath M.

Varicella and herpes zoster can be serious or even fatal diseases in
immunocompromised patients. However, they can be prevented or markedly attenuated
by the administration of zoster-immune globulin (ZIG) or zoster-immune plasma
(ZIP), but there is no established treatment once these disorders have occurred. 
Eight such patients were treated with ZIP, with promising results.

Publication Types: 
    Case Reports

PMID: 550378 [PubMed - indexed for MEDLINE]

8350: J Tenn Med Assoc. 1979 Sep;72(9):664-6.

Case report--Herpes zoster affecting three noncontiguous dermatomes in a child
with cancer.

Feldman S, Novak R, Malone W.

Publication Types: 
    Case Reports

PMID: 537357 [PubMed - indexed for MEDLINE]

8351: Geriatrics. 1979 Sep;34(9):41-7.

Herpes zoster: a geriatric disease.

Becker LE.

Both the incidence and the severity of herpes zoster increase with advancing age.
Postherpetic neuralgia may persist for more than a year. Treatment is usually
symptomatic, and early corticosteroid therapy should be considered in patients
over age 50. Psychotropic drugs also may be indicated to overcome depression.

PMID: 467981 [PubMed - indexed for MEDLINE]

8352: Riv Patol Nerv Ment. 1979 Sep-Oct;100(5):275-87.

[Ophthalmic herpes zoster and delayed contralateral hemiparesis: a chance
occurrence (author's transl)]

[Article in Italian]

Barontini F, Tonini R.

A 57 years-old woman developed a right hemiparesis with dysphasia four weeks
after left Herpes Zoster Ophthalmicus. The CSF was normal while cerebral
angiography showed segmental narrowing of the left carotid syphon and terminal
branches. The patient's condition improved during the next few days with almost
full recovery. Herpes Zoster Ophthalmicus followed by a controlateral hemiparesis
or hemiplegia is a relatively infrequent clinical syndrome. After a review of the
relevant literature and discussion of the various theories of causation, the
authors suggest a chance relation between the two pathological conditions.

Publication Types: 
    Case Reports
    English Abstract

PMID: 318026 [PubMed - indexed for MEDLINE]

8353: Clin Perinatol. 1979 Sep;6(2):331-46.

Congenital herpesvirus infections.

Andiman WA.

PMID: 230005 [PubMed - indexed for MEDLINE]

8354: J Clin Pathol. 1979 Sep;32(9):859-81.

Herpesviruses.

Timbury MC, Edmond E.

Publication Types: 
    Review

PMID: 229129 [PubMed - indexed for MEDLINE]

8355: Cutis. 1979 Sep;24(3):279-84.

Therapy update 1979.

Rees RB.

PMID: 157858 [PubMed - indexed for MEDLINE]

8356: Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1979 Sep;211(3):183-6.

Axoplasmic transport blockage therapy in herpes zoster ophthalmicus.

Chihara E.

Three patients with herpes zoster ophthalmicus were treated with an oral
administration of colchicine and corticosteroid, while another seven were given
systemic corticosteroid, vitamins, and sedatives. Colchicine inhibited the
formation of new skin lesions but did not suppress the already grown vesicles.
The effect of colchicine was attributed to a blockage of intra-axonal
dissemination by neurotrophic virus.

PMID: 92895 [PubMed - indexed for MEDLINE]

8357: Nurs Times. 1979 Aug 16;75(33):1405-7.

Ophthalmic herpes zoster.

Marsh RJ.

PMID: 314101 [PubMed - indexed for MEDLINE]

8358: Rheumatol Rehabil. 1979 Aug;18(3):170-3.

Herpes zoster and lower motor neurone paresis.

Molloy MG, Goodwill CJ.

Fifteen cases of herpes zoster with lower motor neurone paresis involving the
upper and lower limbs are reviewed. Five patients had an underlying
disease--three had rheumatoid arthritis, two of whom were on prednisolone; one
had chronic lymphatic leukaemia and one lymphosarcoma. Details are given of the
time relationship between onset of pain, the appearance of the skin eruption and 
the later muscle weakness. Electromyographic evidence was available in 12
patients. The difficulty of assessing the muscle power in the presence of severe 
pain is discussed. Prognosis was generally very good; 11 patients recovered
fully, three improved and one was unchanged after 5 months, when he died of
lymphosarcoma. One patient was lost to follow-up at 5 months but was improving at
the time.

PMID: 582857 [PubMed - indexed for MEDLINE]

8359: Drugs. 1979 Aug;18(2):122-9.

Relief of facial pain.

Anthony M.

PMID: 487956 [PubMed - indexed for MEDLINE]

8360: J Urol. 1979 Aug;122(2):263-4.

Transient neuropathic bladder following herpes simplex genitalis.

Riehle RA Jr, Williams JJ.

A case of transient bladder dysfunction and urinary retention concomitant with
herpes genitalis is presented. The protean manifestations of the herpes simplex
virus, the similar neurotropic behavior of simplex and zoster, and the neurologic
sequelae of the cutaneous simplex eruption are discussed. The possibility of
sacral radiculopathy after herpes genitalis must be considered when evaluating
acute or episodic neurogenic bladders.

Publication Types: 
    Case Reports

PMID: 459029 [PubMed - indexed for MEDLINE]

8361: Med Sestra. 1979 Aug;38(8):42-3.

[Use of diadynamic currents in herpes zoster]

[Article in Russian]

Sviatova VV.

PMID: 316095 [PubMed - indexed for MEDLINE]

8362: Rinsho Shinkeigaku. 1979 Aug;19(8):496-503.

[Herpes zoster ophthalmicus followed by contralateral hemiparesis (author's
transl)]

[Article in Japanese]

Onoda M, Takahashi A.

Publication Types: 
    Case Reports
    English Abstract

PMID: 315296 [PubMed - indexed for MEDLINE]

8363: Aust N Z J Med. 1979 Aug;9(4):440-3.

A study of synovial fluid and cytology in arthritis associated with herpes
zoster.

Cunningham AL, Fraser JR, Clarris BJ, Hobbs JB.

A case of herpes zoster complicated by acute arthritis with effusions is
described. The white cell count in the synovial fluid was low, with a
predominance of neutrophils. The synovium showed superficial deposits of fibrin, 
slight intimal hyperplasia, and subintimal polymorph infiltration. Varicella
virus was not detected by culture or electron microscopy, but varicella antigen
was demonstrated in the cytoplasm of macrophages in the effusion. Other findings 
did not determine whether the antigen had appeared in the joint from circulating 
immune complexes, or following synovial phagocytosis or proliferation of virus.

Publication Types: 
    Case Reports

PMID: 292386 [PubMed - indexed for MEDLINE]

8364: Immunobiology. 1979 Aug;156(1-2):76-82.

Serological studies on the antigenic relationship between herpes simplex virus
and varicella-zoster virus.

Wolff MH, Buchel F, Zoll A.

If crossreacting antibodies between varicella-zoster virus (VZV) and herpes
simplex virus (HSV) exist, one would expect more positive reactions with VZV in a
group of HSV positive patients than in a group of HSV negative patients. This
statement can only apply to a group of individuals where positive and negative
reactions with respect to HSV and VZV are evenly distributed. Such a distribution
can only be found among children. Therefore, the relationship between HSV-1 and
VZV was the only one which was considered in this investigation, since the
incidence of HSV-2 antibodies in children is very rare. The sera from 197
children were examined using the neutralization test (NT), the complement
fixation test (CFT) and the indirect immunofluorescent assay (IFT) and could be
classified as either HSV positive (80) or HSV negative (117). The children's ages
were similar in both groups. Approximately the same proportion of VZV positive
sera was found in both groups when examined using IFT (53% in the HSV positive
and 47% in the HSV negative group). However, when the CFT was applied the
proportion of VZV positive sera in the two groups differed markedly (22% of the
HSV positive sera and 38% of the HSV negative sera). These findings suggest that 
crossreactivity observed between HSV and VZV in acute HSV and VZV infections is
evidently not dependent on crossreacting antibodies but is apparently confined to
the cellular level of the immune response.

PMID: 232073 [PubMed - indexed for MEDLINE]

8365: Hautarzt. 1979 Aug;30(8):432-3.

[Paralytic abdominal hernia in zoster]

[Article in German]

Landthaler M, Heuser M.

In a 56 year old patient with zoster in the thoracic segments 10 and 11 an
abdominal hernia developed. The hernia was caused by peripheral motorial paresis.

Publication Types: 
    Case Reports
    English Abstract

PMID: 159877 [PubMed - indexed for MEDLINE]

8366: Cesk Dermatol. 1979 Aug;54(4):212-4.

[Zoster--treatment by drop infiltration with procaine (author's transl)]

[Article in Czech]

Herold K, Frey T, Holan V, Jiraskova M, Labohy P, Machackova J, Zlosky P.

Publication Types: 
    English Abstract

PMID: 93517 [PubMed - indexed for MEDLINE]

8367: Ugeskr Laeger. 1979 Jul 9;141(28):1891-6.

[Epidemiology, pathogenesis, clinical picture and treatment of herpes zoster]

[Article in Danish]

Gronvall B, Esmann V, Wildenhoff KE.

Publication Types: 
    English Abstract

PMID: 473409 [PubMed - indexed for MEDLINE]

8368: J Postgrad Med. 1979 Jul;25(3):171-3.

Herpes generalisata assoicated with diabetes mellitus and pulmonary tuberculosis 
(a case report).

Panwar RB, Kochar DK, Gupta BS, Bhatnagar LK, Saxena HC.

Publication Types: 
    Case Reports

PMID: 529170 [PubMed - indexed for MEDLINE]

8369: Clin Plast Surg. 1979 Jul;6(3):377-88.

Current surgical treatment of intratemporal facial palsy.

Fisch U.

PMID: 487707 [PubMed - indexed for MEDLINE]

8370: Neurol Neurochir Pol. 1979 Jul-Aug;13(4):439-42.

[Rare care of Ramsay Hunt syndrome associated with herpes zoster of the
glossopharyngeal nerve]

[Article in Polish]

Bluma Z, Lyczak P, Bronowicki E.

The authors describe a rare coexistence of Ramsay Hunt syndrome with
glossopharyngeal zoster in a 67-year-old patient. A trial of systematization of
the nomenclature of Ramsay Hunt syndrome is suggested, on the basis of certain
anatomophysiological data. It is concluded that in zoster involvement of the
sensory elements in the geniculate ganglion and in otic ganglion should be
accompanied by taste sensitivity disturbances, but often the patients fail to
notice these disturbances and routine taste testing shows also no such tase
impairment. Routine use of electrogustometry is postulated since this makes
possible diagnostic-prognostic assessment followed by selection of appropriate
treatment.

Publication Types: 
    Case Reports
    English Abstract

PMID: 481694 [PubMed - indexed for MEDLINE]

8371: Int J Dermatol. 1979 Jul-Aug;18(6):480-4.

Dextranomer in dermatologic conditions.

Parish LC, Witkowski JA.

Dextranomer, a high molecular weight dextran derivative, was evaluated in 43
patients, and found to be the treatment of choice for decubitus ulcers. It is
useful in most leg ulcers and cutaneous wounds, and can aid in the nursing care
of terminal patients with gangrene or uclerating carcinoma. Dextranomer hastens
the postoperative course in dermabrasion patients. Although patients with
bacterial infection show no change with dextranomer, it is useful in hastening
the resolution of herpes simplex and herpes zoster lesions.

Publication Types: 
    Clinical Trial

PMID: 385520 [PubMed - indexed for MEDLINE]

8372: Br J Cancer. 1979 Jul;40(1):62-71.

Family studies in acute leukaemia in childhood: a possible association with
autoimmune disease.

Till M, Rapson N, Smith PG.

Medical histories of themselves and their first-degree relatives were obtained
from parents of 82 leukaemic children (54 acute lymphoblastic (ALL), 28 acute
myeloblastic (AML)) and from control couples matched for age. The possibility of 
a primary familial immunological abnormality as an aetiological factor in
childhood leukaemia was suggested by binding some infections significantly more
frequently reported in parents than in controls, but more strongly supported by
the finding of a significantly (P less than 0.02) increased prevalence of
disorders associated with autoimmunity (but not of other conditions such as
peptic ulceration, infective hepatitis, tuberculosis or malignancy) amongst
members of ALL families compared to those of controls. Analogy with Down's
syndrome and the strain of NZB mice, in which diminished T-cell function is
associated with autoimmune disease and lymphoid neoplasia, is discussed.
Varicella and herpes zoster occurred respectively in 2 ALL mothers during their
pregnancies involving the patients and in none of the other 388 pregnancies here 
reported. This supports previous evidence that antenatal varicella infections may
be of aetiological importance in some cases of ALL.

PMID: 289405 [PubMed - indexed for MEDLINE]

8373: Ann Sclavo. 1979 Jul-Aug;21(4):419-24.

[Serological survey for virus and Mycoplasma infections (author's transl)]

[Article in Italian]

Vazzana A, Picerno G, Fiocca S.

The Authors describe the two years follow up of complement fixing antibodies vs 4
viral antigens (Herpes simplex, Herpes zoster, Cytomegalovirus, respiratory
syncytial virus, Mycoplasma pneumoniae). They evaluate the seasonal trend and the
eventual clinical correlations on 3267 sera and 254 spinal fluids from
hospitalized patients.

Publication Types: 
    English Abstract

PMID: 233415 [PubMed - indexed for MEDLINE]

8374: J Virol. 1979 Jul;31(1):172-7.

Induction of thymidine kinase and DNase in varicella-zoster virus-infected cells 
and kinetic properties of the virus-induced thymidine kinase.

Cheng YC, Tsou TY, Hackstadt T, Mallavia LP.

Thymidine kinase (TK), DNA polymerase, and DNase activities were induced in human
foreskin fibroblasts after varicella-zoster virus infection. The induced TK and
DNase activities have electrophoretic mobilities different from the corresponding
host enzymes. Varicella-zoster virus-induced TK was purified and separated from
the host enzyme by affinity column chromatography. This enzyme has been shown to 
have a broader substrate specificity with respect to either the phosphate donor
or acceptor as compared with human cytoplasmic and mitochondrial TKs. The best
phosphate donor is ATP, with a Km of 16 microM. The Km values of thymidine,
deoxycytidine, and 5-propyl deoxyuridine were estimated to be 0.4, 180, and 0.8
microM, respectively. The Ki values for several analogs of thymidine such as
5-iododeoxyuridine, arabinofuranosylthymine, 5-ethyl deoxyuridine, and
5-cyanodeoxyuridine were also examined. TTP acted as a noncompetitive inhibitor
with respect to thymidine with a Ki of 5 microM. The kinetic behavior of
varicella-zoster virus-induced TK is different from human cytoplasmic, human
mitochondrial, and herpes simplex virus type 1- and 2-induced TKs.

Publication Types: 
    Comparative Study

PMID: 228052 [PubMed - indexed for MEDLINE]

8375: Infect Immun. 1979 Jul;25(1):170-4.

Cellular and humoral immune responses to varicella-zoster virus in
immunocompromised patients during and after varicella-zoster infections.

Gershon AA, Steinberg SP.

Humoral and cell-mediated immune responses to varicella-zoster (V-Z) virus were
assessed in patients during and after V-Z infections. Ongoing V-Z infections was 
associated with minimal cellular immunity but not necessarily with poor humoral
immunity. Recovery from V-Z infection was associated with a vigorous cellular
immune response. Cell-mediated immunity to V-Z virus was demonstrable for years
after varicella, but responses were lower in immunocompromised patients than in
normal individuals.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 225270 [PubMed - indexed for MEDLINE]

8376: J Infect Dis. 1979 Jul;140(1):33-41.

Antibody to early antigens of varicella-zoster virus during varicella and zoster.

Gerna G, Cereda PM, Cattaneo E, Achilli G, Gerna MT.

IgG antibody to the early antigens of varicella-zoster virus (VZV) was studied
during both varicella and zoster by the indirect immunoperoxidase antibody
technique. In parallel, complement-fixing, immune-adherence hemagglutinating,
IgG, and IgM antibodies to VZV were studied. In both varicella and zoster
infections, antibody to the early antigens of VZV appeared three to five days
after onset of infection, reached a peak during the second week, and
progressively decreased in titer until it disappeared, usually within two months.
This antibody usually appeared slightly later than IgG or IgM antibody and
grossly correlated with IgM antibody in varicella. In zoster infections, IgM
antibody to VZV was not found by the immune-adherence hemagglutination assay at a
titer of greater than or equal to 1:4, whereas antibody to the early antigens
showed a curve similar to that found in varicella. It is suggested that antibody 
to the early antigens of VZV be considered as a marker of acute VZV infection,
which is associated with a specific and significant IgM antibody response in
varicella but not in zoster.

PMID: 88490 [PubMed - indexed for MEDLINE]

8377: Tumori. 1979 Jun 30;65(3):363-71.

Angioimmunoblastic lymphadenopathy with dysproteinemia complicated by Kaposi's
sarcoma.

Tosi P, Auteri A, Cintorino M, Pasini FL, Luzi P.

A case of clinically and morphologically typical angioimmunoblastic
lymphadenopathy (AILD) in a 68-year-old man during a prolonged antibiotic
treatment for urinary infection is presented. Lymph node biopsy at first showed
findings suggestive of an exhaustion of the germinal center immunological
activity (like those characterizing angiofollicular lymph any clear transition
into malignant lymphoma. The course of the disease was characterized by the
occurrence of opportunistic infections (toxoplasmosis, herpes zoster), and
finally by the onset of a cutaneous Kaposi's sarcoma. The possible relation of
AILD to Kaposi's sarcoma is discussed, and the main clinical and morphological
data of the case of AILD (about 200) reported in the literature are reviewed.

Publication Types: 
    Case Reports

PMID: 462586 [PubMed - indexed for MEDLINE]

8378: Clin Ter. 1979 Jun 30;89(6):589-93.

[The treatment of herpes zoster with hemocoagulase (Bothrops Jararaca venom)]

[Article in Italian]

De Candia O, Baghiris D.

PMID: 397028 [PubMed - indexed for MEDLINE]

8379: Rev Neuropsiquiatr. 1979 Jun;42(2):104-13.

[Inflammatory reaction in the csf in 2 cases of Herpes Zoster: trigeminal and
facial]

[Article in Spanish]

Cuba JM, Castro C.

Publication Types: 
    English Abstract

PMID: 547346 [PubMed - indexed for MEDLINE]

8380: Monatsschr Kinderheilkd. 1979 Jun;127(6):367-71.

[Present state of antiviral therapy (author's transl)]

[Article in German]

ter Meulen V.

Application of antiviral drugs in viral infections is still limited to few
diseases. Most of the preparations available induce strong side effects since
these substances not only interfere with virus replication but also with cell
metabolism. Therefore, only in severe diseases such as herpes simplex
encephalitis or complications of varizella zoster infection such a treatment is
advisable. From a clinical point of view an antiviral drug would be desirable
which selectively inhibitis virus growths without affecting the host. This can
already be achieved with interferon. However, at the present time the quantities 
of interferon needed for such treatment are not available.

Publication Types: 
    English Abstract
    Review

PMID: 379620 [PubMed - indexed for MEDLINE]

8381: Nursing (Lond). 1979 Jun;(3):115, 125.

Photo test: shingles.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 317145 [PubMed - indexed for MEDLINE]

8382: Laryngoscope. 1979 Jun;89(6 Pt 1):906-17.

Total facial nerve exploration: transmastoid, extralabyrinthine, and subtemporal 
indications and results.

May M.

Increasingly, surgeons are using a middle fossa approach though craniotomy to
reach the labyrinthine segment of the facial nerve and geniculate ganglion in
patients with intact hearing. This paper describes a transmastoid operation that 
provide exposure of the labyrinthine segment of the facial nerve without
performance of a craniotomy. In this procedure the geniculate ganglion and
labyrinthine segments of the facial nerve were exposed, while cochleovestibular
function was spared; recovery of the facial nerve in patients with Bell's palsy
or herpes zoster oticus (even the patients with a dry eye) was favourably
influenced.

PMID: 312987 [PubMed - indexed for MEDLINE]

8383: J Fam Pract. 1979 Jun;8(6):1217-33.

Dermatoses of the scalp.

Osment LS.

By judicious consideration of the clinical appearance, by direct examination with
magnification, and by culture results, skin biopsy, and other laboratory results,
the clinician is able to diagnose most pathological conditions of the scalp. The 
scalp participates in many systemic disorders and frequently is the chief site of
involvement. Similarly, many generalized disorders limited to the skin exhibit
their most typical manifestations in the scalp. Whenever a diagnosis eludes the
investigator, more than likely he or she has not considered all of the
etiological possibilities or has not pursued an adequate laboratory
investigation. A few scalp diseases initially present nonspecific clinical
pictures. By utilizing follow-up examinations at appropriate intervals, the
diagnosis can eventually be made. Once a diagnosis is made, appropriate treatment
will generally produce satisfactory improvement or cure. Nevertheless, a few
generally rare conditions will defy the physician's most enlightened and
aggressive therapy.

PMID: 156243 [PubMed - indexed for MEDLINE]

8384: Am J Ophthalmol. 1979 Jun;87(6):814-8.

Intraocular penetration of trifluridine.

Pavan-Langston D, Nelson DJ.

We studied intraocular penetration of topically applied trifluridine in five
patients with herpetic keratitis undergoing penetrating keratoplasty. We compared
the concentration of trifluridine and its metabolite 5-carboxy 2'-deoxyuridine in
the aqueous humor to those of normal control patients undergoing routine cataract
extraction without preoperative antiviral therapy. Significant concentrations of 
intact trifluridine were achieved in the acqueous humor after topical application
of 1% trifluridine ophthalmic drops. The metabolite, 5-carboxy 2'-deoxyuridine,
was not found in the aqueous humor. Unlike idoxuridine and vidarabine, it is
possible to achieve therapeutic levels of trifluridine at intraocular sites that 
would be advantageous in the treatment of deep herpetic disease involving the
stroma and iris.

PMID: 110152 [PubMed - indexed for MEDLINE]

8385: Ugeskr Laeger. 1979 May 7;141(19):1288-9.

[Idoxuridine treatment of herpes virus infections]

[Article in Danish]

Wildenhoff KE, Esmann V.

PMID: 222029 [PubMed - indexed for MEDLINE]

8386: Rev Laryngol Otol Rhinol (Bord). 1979 May-Jun;100(5-6):313-5.

[Medical and surgical treatment of herpes zoster facial paralysis]

[Article in French]

Pietruski J.

Publication Types: 
    English Abstract

PMID: 542743 [PubMed - indexed for MEDLINE]

8387: Age Ageing. 1979 May;8(2):75-80.

Motor complications of herpes zoster.

Pathy MS.

Motor involvement is uncommon in herpes zoster. Of 14 subjects observed over an
arbitrary period of five years, nine had flaccid limb paralyses, involving the
upper limb in eight patients. Recovery was not always complete and occurred over 
a period of nine weeks to four years.

Publication Types: 
    Case Reports

PMID: 463678 [PubMed - indexed for MEDLINE]

8388: Ann Allergy. 1979 May;42(5):295-305.

Treatment of active herpes virus infections with influenza virus vaccine.

Miller JB.

A system for treating active virus infections with very small, precisely
determined doses of specific killed-virus vaccine is described. Results indicate 
that the discomforts of influenza and herpes virus infections usually disappear
within 30 minutes after injection of the vaccine. The relief occurs during
testing and repeated subcutaneous injections produce rapid healing.

PMID: 453646 [PubMed - indexed for MEDLINE]

8389: Ann Otol Rhinol Laryngol. 1979 May-Jun;88(3 Pt 1):303-10.

Acute vestibular paralysis in herpes zoster oticus.

Proctor L, Perlman H, Lindsay J, Matz G.

A case of herpes zoster oticus is presented in which the lateral and superior
semicircular canals of the labyrinth were affected unilaterally. The results of
several electronystagmographic examinations are described and correlated with the
patient's description of symptoms. This case study indicates that disease
affecting the lateral semicircular canal is reliably detected by the conventional
caloric test. However, the fact that the posterior semicircular canal remained
intact could not be inferred from the results of the caloric test in this case.
Also the appearance of nystagmus upon eye closure appears to have been a more
sensitive index of the state of the disease process than was the caloric test.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 313735 [PubMed - indexed for MEDLINE]

8390: Del Med J. 1979 May;51(5):253-64.

Management of the "red eye".

Lipkowitz J, Abel R Jr.

PMID: 313348 [PubMed - indexed for MEDLINE]

8391: Neurology. 1979 May;29(5):726-9.

Optic neuropathy and ophthalmoplegia in herpes zoster oticus.

Carroll WM, Mastaglia FL.

A 55-year-old man with herpes zoster oticus and minimal cutaneous involvement
developed reversible optic neuropathy, and ocular motor and cerebellar
abnormalities. Serologic changes confirmed infection with herpes zoster. A
demyelinating process seems likely to have been responsible for these lesions. It
is suggested that herpes zoster antibody titers should be measured whenever the
syndrome of polyneuritis cranialis of acute onset is being investigated.

Publication Types: 
    Case Reports

PMID: 312472 [PubMed - indexed for MEDLINE]

8392: Rev Paul Med. 1979 May-Jun;93(5-6):101-3.

[Electron microscopy diagnosis of herpes zoster virus in cancer patients]

[Article in Portuguese]

Leite JB, Marques AF, Teixeira MI, Ueda M, Weigl DR, Bianchi A, De Andrea ML,
Lopes A, Gomes OM.

Publication Types: 
    English Abstract

PMID: 229536 [PubMed - indexed for MEDLINE]

8393: Rinsho Shinkeigaku. 1979 May;19(5):277-82.

[Immunological study of 7 cases with Ramsay Hunt's syndrome (author's transl)]

[Article in Japanese]

Nakamura S, Takase S, Itahara K, Ogata M, Shigeta S.

Publication Types: 
    English Abstract

PMID: 225075 [PubMed - indexed for MEDLINE]

8394: J Pediatr. 1979 May;94(5):743-6.

Zoster immune plasma prophylaxis of varicella: a follow-up report.

Balfour HH Jr, Groth KE.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 221631 [PubMed - indexed for MEDLINE]

8395: J Neurol Neurosurg Psychiatry. 1979 May;42(5):452-7.

Nervous system complications of herpes zoster: immunofluorescent demonstration of
varicella-zoster antigen in CSF cells.

Peters AC, Versteeg J, Bots GT, Lindeman J, Smeets RE.

PMID: 221620 [PubMed - indexed for MEDLINE]

8396: Arch Neurol. 1979 May;36(5):269-73.

CSF viral antibodies. Evaluation in amyotrophic lateral sclerosis and late-onset 
postpoliomyelitis progressive muscular atrophy.

Kurent JE, Brooks BR, Madden DL, Sever JL, Engel WK.

Serum and CSF from 48 patients with amyotrophic lateral sclerosis and six
patients with late-onset postpoliomyelitis progressive muscular atrophy were
investigated for the presence of antibody to poliovirus types 1, 2, and 3,
coxsackie viruses B3 and B4, influenza A, measles, rubella, mumps, herpes simplex
types 1 and 2, cytomegalovirus, varicella-zoster, and Toxoplasma gondii. These
results were compared with those from 53 control patients with neuromuscular
disease matched for age, sex, race, and poliovirus vaccine exposure. There was no
difference either in distribution of serum or CSF antibody titers or the
geometric-mean antibody titers. There was no evidence suggesting the presence of 
locally produced specific viral antibody within the CNS to any of the agents
studied. In particular, there was no serological evidence to suggest an
association between persistent infection with any poliovirus type and amyotrophic
lateral sclerosis or late-onset postpoliomyelitis progressive muscular atrophy.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 220938 [PubMed - indexed for MEDLINE]

8397: N Engl J Med. 1979 Apr 19;300(16):923-4.

Is it true what they say about interferon?

Weimar W, Schellekens H.

Publication Types: 
    Letter

PMID: 423945 [PubMed - indexed for MEDLINE]

8398: Z Hautkr. 1979 Apr 15;54(8):326-7.

[Diagnosis and therapy of virus-induced skin diseases]

[Article in German]

Rohde B.

PMID: 442750 [PubMed - indexed for MEDLINE]

8399: Ann Ophthalmol. 1979 Apr;11(4):568-70.

Trochlear nerve palsy in a case of herpes zoster ophthalmicus.

Scharf J, Meyer E, Zonis S.

A case of trochlear nerve palsy in herpes zoster ophthalmicus is presented. The
rarity of fourth nerve involvement in herpes zoster is emphasized.

Publication Types: 
    Case Reports

PMID: 572196 [PubMed - indexed for MEDLINE]

8400: Postgrad Med. 1979 Apr;65(4):143-50.

Herpes zoster oticus. Uncommon but recognizable cause of facial paralysis.

Vest C, Munneke JA, Smith R.

Three cases of herpes zoster oticus illustrate the manifestations of this
relatively uncommon cause of facial paralysis. Topographic analysis, in which
functions of facial nerve branches are assessed, helps establish the level of
facial nerve involvement. Sequential faradic stimulation testing often is a
sensitive prognostic indicator of recovrey of facial nerve function, particularly
if nerve excitability persists. A few recent reports support the use of systemic 
steroid therapy for herpes zoster oticus; opinions vary regarding the efficacy of
surgical decompression for facial paralysis. Although general principles cannot
be deduced from three cases, each case discussed exemplifies an important aspect 
of management. The prognostic significance of results of nerve stimulation tests 
is illustrated by the complete return of facial nerve function in our first
patient. Our second patient's response to systemic steroid therapy supports
recent reports of the value of such agents in herpes zoster oticus. Partial
return of facial nerve function in our third patient two months after onset of
paralysis accentuates the importance of a period of observation before a nerve
graft or other rehabilitative procedures are undertaken.

Publication Types: 
    Case Reports

PMID: 424347 [PubMed - indexed for MEDLINE]

8401: HNO. 1979 Apr;27(4):129-37.

[Differential diagnosis of facial skin swellings (author's transl)]

[Article in German]

Hornstein OP.

Enlargement of the cheeks may be due to a multitude of disorders, congenital,
neoplastic, and in particular inflammatory. Congenital facial anomalies include
cutaneous (and osseous) hemihypertrophy of the face and unilateral angiomatous
malformations (e.g. Sturge-Weber-Krabbe Syndrome). Buccal enlargement due to
dermal tumours include localized haemangiomas and lymphangiomas, lipomas and
other benign connective tissue neoplasms, generalized disorders of the lymphatic 
or reticuloendothelial system including mycosis fungoides, reticulum cell sarcoma
and other soft tissue malignancies, and cutaneous manifestations of malignant
haemoblastoses, in particular chronic lymphatic leukaemia. Within the very large 
group of inflammatory skin swellings of the face a review is made of some
bacterial pyodermias, severe forms of acne vulgaris, herpes zoster, lupus
vulgaris, erysipelas, rosacea, steroid dermatitis, lupus erythematosus (discoid
and systemic), toxic dermatitis, allergic eczema, urticaria, Quincke's oedema,
and the Melkersson-Rosenthal syndrome. The importance of prevention and early
detection of steroid-induced dermatitis is emphasized. This disorder, which is a 
pseudo-inflammatory disfiguring complication of prolonged topical steroid abuse, 
ranks in frequency with the skin problems most often seen in dermatological
practice.

Publication Types: 
    English Abstract
    Review

PMID: 374316 [PubMed - indexed for MEDLINE]

8402: Klin Monatsbl Augenheilkd. 1979 Apr;174(4):595-8.

[Herpes zoster-exophthalmus without ophthalmoplegia (author's transl)]

[Article in German]

Siegert P, Utermann D, Pohlenz O.

A case of exophthalmic myositis was identified by a secondary herpes zoster
exacerbation. The herpes zoster exophthalmus in this case remained - in contrast 
to all other cases so far published - free of signs of ophthalmoplegia and
retrobulbar neuritis with visual acuity loss.

Publication Types: 
    Case Reports
    English Abstract

PMID: 313475 [PubMed - indexed for MEDLINE]

8403: J Am Optom Assoc. 1979 Apr;50(4):457-63.

Dendriform keratitis.

Terry JE.

Since the cornea responds to various toxic stimuli by swelling and ulcerating,
these changes may assume a dendriform pattern. A case of herpes simplex dendritic
keratitis is presented along with its treatment. In addition, several other
etiologic sources of an arborescent keratitis are discussed as to their
differentiation and management implication.

Publication Types: 
    Case Reports

PMID: 313414 [PubMed - indexed for MEDLINE]

8404: Can J Ophthalmol. 1979 Apr;14(2):99-101.

[Ophthalmic herpes: treatment of herpetic neuralgia by repeated stellate block]

[Article in French]

Laflamme MY, Labrecque B, Mignault G.

Eight cases of herpes zoster with severe neuralgic pain were treated by repeated 
stellate blocks, 5 during the acute stage and the 3 others later on. Of the 5
patients treated during the acute stage 3 were cured, the pain disappearing
completely. Four other patients were substantially improved. Only one case was a 
failure. It is important to begin the injections soon after the beginning of the 
illness, preferably in the first couple of weeks after the rash appears.

Publication Types: 
    English Abstract

PMID: 313235 [PubMed - indexed for MEDLINE]

8405: Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol. 1979
Apr-Jun;23(2):99-102.

[Study of viral uveitis]

[Article in Romanian]

Stefanescu-Dima A.

Publication Types: 
    English Abstract

PMID: 228359 [PubMed - indexed for MEDLINE]

8406: J Hyg (Lond). 1979 Apr;82(2):319-36.

Specific immunoglobulin responses after varicella and herpes zoster.

Cradock-Watson JE, Ridehalgh MK, Bourne MS.

The indirect immunofluorescence technique has been used to titrate the specific
immunoglobulins in 200 sera from 64 patients with varicella, and 195 sera from 67
patients with herpes zoster. IgG and IgM antibodies were detected in all patients
with varicella, and IgA in 59 (92%). All three classes of antibody appeared 2--5 
days after the onset of the rash, increased virtually simultaneously and reached 
maximum titres during the second and third weeks. IgG then declined slowly, but
never became undetectable and was still present in five subjects who were
retested after 2--4 years; it was present in 88 out of 100 healthy young adults
and probably persists indefinitely after varicella. IgA and IgM antibodies
declined more rapidly and were not detected in specimens taken more than a year
after the illness. IgA, however, may possibly persist in some cases since low
titres were found in 8 out of 88 young adults who possessed IgG antibody and had 
presumably had varicella in the past. IgA responses were significantly weaker in 
children under the age of 6 years than in older children and adults. Six out of
67 patients with zoster were tested at various times before the onset of the
rash: IgG antibody was detected in all. IgG was present in all sera taken after
the onset of the rash, increased rapidly after 2--5 days, reached maximum titres 
during the second and third weeks and then declined slowly. IgA antibody was
detected in 66 patients (99%) and IgM in 52 (78%); both types of antibody
followed transient courses, as in varicella. Maximum titres of IgG and
complement-fixing antibodies were greater after zoster than after varicella, but 
the differences were not significant. IgA and IgM titres in young adults with
zoster were significantly lower than in older patients, and also lower than in
young adults with varicella. Increases in varicella-zoster antibody in patients
with herpes simplex virus infections consisted mainly of IgG, sometimes IgA, but 
never IgM.

PMID: 219110 [PubMed - indexed for MEDLINE]

8407: Int J Oral Surg. 1979 Apr;8(2):149-54.

Herpes zoster of the maxillary branch of the trigeminus nerve. Virological and
serological studies.

Sato M, Urade M, Shirasuna K, Yura Y, Yoshida H, Yanagawa T, Morimoto M,
Kobayashi A, Hamamura Y, Kubo K, Miyazaki T.

A 70-year-old male had erythematous and vesiculous lesions in the area of the
right maxillary branch of the trigeminus nerve and was clinically diagnosed as
having herpes zoster; virological and serological investigations of this case
were carried out. Consequently, an electron microscopic observation revealed a
great number of virus particles of herpes type in the vesiculous lesion and in
baby hamster kidney BHK21/WI-21 cells, cultured after inoculating the fluid from 
the vesicle formed on the patient's upper lip or from serum harvested during the 
viremia. When BHK21/WI-21 cells infected with this virus were tested for
antigenicity by an indirect immunofluorescent staining technique, they showed a
positive staining to antivaricella-zoster virus. When serum of this patient was
assayed fof the antibody level against varicella-zoster virus by the complement
fixation test at various time intervals during the therapeutic period, this
antibody titer on recovery period showed a threefold increase in comparison to
that at onset. From these findings, this infectious disease was precisely
diagnosed as herpes zoster.

Publication Types: 
    Case Reports

PMID: 112072 [PubMed - indexed for MEDLINE]

8408: Br Med J. 1979 Mar 24;1(6166):818.

Shingles: a belt of roses from Hell.

Schreuder M, Fothergill WT.

Publication Types: 
    Letter

PMID: 435807 [PubMed - indexed for MEDLINE]

8409: Br Med J. 1979 Mar 24;1(6166):818.

Shingles: a belt of roses from Hell.

Juel-Jensen B.

Publication Types: 
    Letter

PMID: 435806 [PubMed - indexed for MEDLINE]

8410: Lancet. 1979 Mar 24;1(8117):668.

Cranial-nerve involvement in herpes zoster.

Pahor AL.

Publication Types: 
    Letter

PMID: 85899 [PubMed - indexed for MEDLINE]

8411: Lancet. 1979 Mar 24;1(8117):668.

Cranial-nerve involvement in herpes zoster.

Morgan-Capner P, Crofts MA, Sharp JC.

Publication Types: 
    Case Reports
    Letter

PMID: 85898 [PubMed - indexed for MEDLINE]

8412: J Neurol. 1979 Mar 22;220(2):125-30.

Rapid diagnosis of viral neuroinfections by immunofluorescent and
immunoperoxidase technics.

Maltseva N, Manovich Z, Seletskaya T, Kaptsova T, Nikulina V.

The results of immunofluorescent (IF) and immunoperoxidase (IP) technics applied 
for the detection of antigen in cerebrospinal fluid (CSF) cells in patients with 
mumps, herpes zoster and herpes simplex meningitis and meningoencephalitis are
presented. Thirty patients were under study. The detection of mumps and herpes
zoster viral antigen in CSF cells was possible in 100% of cases investigated.
Herpes simplex virus antigen was detected in four of seven cases with symptoms of
severe meningoencephalitis. Complement fixation (CF) antibodies to herpes simplex
virus (type I) and positive seroconversion were detected in the four latter
patients. The diagnostic value of the methods used for the detection of mumps,
herpes simplex and herpes zoster viral antigens in CSF cells of patients is
discussed.

PMID: 87496 [PubMed - indexed for MEDLINE]

8413: Nurs Mirror. 1979 Mar 15;148(11):52, 30.

Picture quiz: herpes zoster.

Iveson-Iveson J.

PMID: 254181 [PubMed - indexed for MEDLINE]

8414: Nouv Presse Med. 1979 Mar 10;8(11):843-5.

[The treatment of organic pain of the peripheral nervous system using
clomipramine. 30 cases (author's transl)]

[Article in French]

Castaigne P, Laplane D, Morales R.

Clomipramine used alone is an affective analgesic against organic pain due to a
lesion of the peripheral nervous system, in particular post-herpetic pain. The
quality of the result is related to the dose, and hence to tolerance.
Fluohydrocortisone is the most powerful drug against orthostatic hypotension, the
chief cause of limitation of treatment. No complications were seen, even in very 
elderly patients.

Publication Types: 
    English Abstract

PMID: 221881 [PubMed - indexed for MEDLINE]

8415: Ann Ophthalmol. 1979 Mar;11(3):405-6.

Optic neuritis in a child with herpes zoster.

Monroe LD.

A 9-year-old black boy was admitted to the hospital for treatment of herpes
zoster involving the trigeminal nerve distribution on the left half of his face. 
Consulting examination of his eye on the involved side revealed moderate iritis
as well as papillitis and diffuse retinitis.

Publication Types: 
    Case Reports

PMID: 453745 [PubMed - indexed for MEDLINE]

8416: Geburtshilfe Frauenheilkd. 1979 Mar;39(3):209.

[On spasm of the bladder sphincter in a case of herpes zoster (author's transl)]

[Article in German]

Grimmeke F.

Report on a 64-year old patient with extensive Herpes zoster of the trunk. The
patient presented with urinary retention which stopped after 4 tablets of the
chemotherapeutic agent Flumidin. This effect of Flumidin was unknown to the
manufacturer and reports on this effect in the literature were not located.

Publication Types: 
    Case Reports
    English Abstract

PMID: 437454 [PubMed - indexed for MEDLINE]

8417: Am J Med. 1979 Mar;66(3):457-62.

Herpesvirus infection of the esophagus and other visceral organs in adults.
Incidence and clinical significance.

Buss DH, Scharyj M.

PMID: 433952 [PubMed - indexed for MEDLINE]

8418: J Antimicrob Chemother. 1979 Mar;5(2):126-8.

Local idoxuridine treatment of herpes simplex and zoster.

Verbov J.

PMID: 429246 [PubMed - indexed for MEDLINE]

8419: West J Med. 1979 Mar;130(3):271.

Autoimmune therapy for herpes zoster.

Lawrence RM.

Publication Types: 
    Letter

PMID: 425513 [PubMed - indexed for MEDLINE]

8420: Int J Dermatol. 1979 Mar;18(2):142-5.

Zosteriform inflammatory metastatic carcinoma.

Hodge SJ, Mackel S, Owen LG.

A 57-year-old man presented with chest wall lesions and swelling of his left arm.
The rapid onset of vesicular lesions in a dermatomal distribution resulted in an 
initial diagnosis of herpes zoster. Cutaneous biopsy revealed adenocarcinoma and 
further evaluation revealed a primary source of pulmonary adenocarcinoma.
Lymphatic spread of tumor cells is the most likely source of the zosteriform skin
lesions, but other possibilities are discussed.

Publication Types: 
    Case Reports

PMID: 422313 [PubMed - indexed for MEDLINE]

8421: Harefuah. 1979 Mar 1;96(5):219-22.

[Laboratory diagnosis of varicella-zoster virus infections]

[Article in Hebrew]

Leventon-Kriss S, Rannon L, Yoffe R.

Publication Types: 
    English Abstract

PMID: 396181 [PubMed - indexed for MEDLINE]

8422: Am J Dis Child. 1979 Mar;133(3):283-4.

Zoster-like eruption due to echovirus 6.

Meade RH 3rd, Chang TW.

A unilateral vesiculobullous eruption associated with fever was seen on the neck,
shoulder, and upper part of the chest of a 7-year-old boy. Although three
dermatomes in all were involved, the lesions resembled herpes zoster. The patient
had had varicella in infancy. Culture of fluid from several bullae yielded
echovirus 6; however, and serum neutralizing antibody to this virus rose in titer
from 1:32 to 1:640. It is suggested that echovirus 6 and other enteroviruses may 
cause a number of vesicular eruptions that resemble herpes zoster and similar
infections. Viral culture, while often difficult to obtain, is the only way to
identify the cause of eruptions like this one.

Publication Types: 
    Case Reports

PMID: 371385 [PubMed - indexed for MEDLINE]

8423: Arch Neurol. 1979 Mar;36(3):179.

Herpes zoster ophthalmicus.

Vincent FM, Sullivan JK, Freemon FR.

Publication Types: 
    Case Reports
    Letter

PMID: 312096 [PubMed - indexed for MEDLINE]

8424: Prim Care. 1979 Mar;6(1):169-94.

Recent developments in immunization.

Fedson DS.

Publication Types: 
    Review

PMID: 223185 [PubMed - indexed for MEDLINE]

8425: Can J Microbiol. 1979 Mar;25(3):254-60.

Persistence, reactivation, and cell transformation by human herpeviruses: herpes 
simplex 1, 2 (HSV-1, HSV-2), cytomegalovirus (CMV), varicella-zoster (VZV),
Epstein-Barr virus (EBV).

Joncas JH.

Publication Types: 
    Review

PMID: 222414 [PubMed - indexed for MEDLINE]

8426: Nouv Presse Med. 1979 Feb 24;8(9):673-5.

[The prevention of chickenpox in high risk children. Comparison of the
effectiveness of specific immunoglobulins and of defibrinated convalescent
plasma. 414 cases (author's transl)]

[Article in French]

Avenard G, Gaiffe M, Herzog F.

Comparison between 157 children treated with defibrinated convalescent plasma and
257 children treated with specific immunoglobulins revealed the improved
effectiveness of the latter treatment in the prevention of chickenpox. Specific
Herpes Zoster-Chickenpox immunoglobulins are prepared by caprylic acid
fractionation of convalescent plasma. The prevention obtained in more than 90% of
cases would appear to be clinically and biologically total as shown by
serological surveillance of certain children with particularly severe immune
depression.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 221885 [PubMed - indexed for MEDLINE]

8427: Br Med J. 1979 Feb 17;1(6161):490.

Shingles: a belt of roses from hell.

[No authors listed]

Publication Types: 
    Letter

PMID: 427427 [PubMed - indexed for MEDLINE]

8428: Dtsch Med Wochenschr. 1979 Feb 16;104(7):265.

[Levodopa therapy of zoster]

[Article in German]

Fuchs T.

Publication Types: 
    Letter

PMID: 761522 [PubMed - indexed for MEDLINE]

8429: Br Med J. 1979 Feb 3;1(6159):346.

Shingles: a belt of roses from Hell.

[No authors listed]

Publication Types: 
    Letter

PMID: 421119 [PubMed - indexed for MEDLINE]

8430: Br Med J. 1979 Feb 3;1(6159):321-3.

ABC of Ophthalmology. Common or difficult diagnoses.

Gardiner PA.

PMID: 311236 [PubMed - indexed for MEDLINE]

8431: J Pediatr. 1979 Feb;94(2):223-30.

Cell-mediated immunity to varicella-zoster virus infection in subjects with
lymphoma or leukemia.

Patel PA, Yoonessi S, O'Malley J, Freeman A, Gershon A, Ogra PL.

Normal subjects and patients with lymphoma or leukemia were tested for the levels
of lymphocytes, E-rosette--forming T-cells, serum and vesicle fluid interferon,
and specific in vitro proliferative response to varicella-zoster antigen after
clinical varicella or herpes zoster illness. The effect of polyinosinic
acid/polycytidilic acid on the immune response was also evaluated. The
development of VZ specific cell-mediated response in normal subjects was
characterized by intense proliferative activity eight to ten days after the onset
of illness, with significant decline 70 to 80 days later. The responses in
subjects with lymphoma or leukemia were much lower. Few subjects with chickenpox 
or zoster with lymphoma or leukemia died during the infection. Death was
associated with significant depletion of E-rosette--forming T-cells, and grossly 
deficient specific cellular response to VZ antigen. Treatment with Poly IC
frequently induced elevations in serum as well as vesicle fluid interferon
levels, and increased the proliferative activity of lymphocytes against VZ
antigen.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 762611 [PubMed - indexed for MEDLINE]

8432: Obstet Gynecol. 1979 Feb;53(2):175-81.

Herpes zoster during pregnancy.

Brazin SA, Simkovich JW, Johnson WT.

Herpes zoster has rarely been noted to occur during pregnancy. We report the case
of a woman at 37 weeks' gestation who developed herpes zoster and 3 weeks later
delivered a normal infant. A 6-month follow-up has revealed no sequelae in the
child. Pertinent clinical aspects of herpes zoster and a review of the literature
indicating a favorable prognosis for infants exposed in utero are presented.

Publication Types: 
    Case Reports

PMID: 418971 [PubMed - indexed for MEDLINE]

8433: Pediatrics. 1979 Feb;63(2):301-19.

Standard and special human immune serum globulins as therapeutic agents.

Stiehm ER.

Publication Types: 
    Review

PMID: 375173 [PubMed - indexed for MEDLINE]

8434: SSO Schweiz Monatsschr Zahnheilkd. 1979 Feb;89(2):125-6.

[Herpes zoster in the mouth]

[Article in German]

Kaldarar G, Golland G.

Herpes zoster is a viral disease with cutaneous and mucous manifestations. They
occur in 30% cases in the trigeminal area and in 7.2% cases in other parts of the
head. Typical manifestations are nevralgias simulating dental pain, also vesicles
with an erythematous halo located in the territory of the second and third
trigemial branch. They erupt on the skin, the lips, tongue, palate and cheeks.
Zosteric nevralgia may extend into the territory of the first trigeminal. There
is no known causal therapy and local treatments are but unsatisfactory
pallatives.

Publication Types: 
    English Abstract

PMID: 293026 [PubMed - indexed for MEDLINE]

8435: Rev Infirm. 1979 Feb;29(2):42-7.

[Zona]

[Article in French]

Ghanassia JP.

PMID: 253383 [PubMed - indexed for MEDLINE]

8436: SSO Schweiz Monatsschr Zahnheilkd. 1979 Feb;89(2):135-45.

[Clinical aspect of herpes zoster and the pathogenesis of symptomatic cranial
nerve zosters]

[Article in German]

Dielert E.

The prognosis of shingles is generally good, however if cranial nerves are
affected, the course of disease may be very serious. It is still doubtful if
latent virus-in the sense of a trigger mechanism-may be activated by dental
surgical interventions and cause a symptomatic herpes zoster of cranial nerves.
Serious loss of teeth as an oral manifestation of shingles, with panostitis and
retarded healing show the seriousness of the tissue changes. The virus can invade
the plexus between the facial and trigeminal nerves and can thus travel within
the same epineural sheath from one nerve to the other. It follows that in each
case of a herpes zoster of cranial nerves, irrespective of location, no dental
surgery should be undertaken, even in the initial stage, because - it may
increase the extension of the disease along the nerves - it may cause a viraemia 
- it may initiate uncalled for intraoperative and postoperative complications.
Therapy with high doses of antibiotics is indicated.

Publication Types: 
    Case Reports
    English Abstract

PMID: 229550 [PubMed - indexed for MEDLINE]

8437: Cutis. 1979 Feb;23(2):144, 146-7, 152.

Immunization: varicella-zoster vaccine.

Heim LR.

PMID: 217569 [PubMed - indexed for MEDLINE]

8438: Br Med J. 1979 Jan 6;1(6155):5.

Shingles: a belt of roses from Hell.

[No authors listed]

Publication Types: 
    Editorial

PMID: 216456 [PubMed - indexed for MEDLINE]

8439: Lancet. 1979 Jan 6;1(8106):38-9.

Herpes zoster of right glossopharyngeal nerve.

Clark J.

Publication Types: 
    Case Reports
    Letter

PMID: 83479 [PubMed - indexed for MEDLINE]

8440: Scand J Infect Dis. 1979;11(3):185-6.

Herpes zoster in infancy.

David TJ, Williams ML.

Three cases of herpes zoster occurring in infancy are reported. In each case the 
mother had chickenpox in pregnancy.

Publication Types: 
    Case Reports

PMID: 524067 [PubMed - indexed for MEDLINE]

8441: Neurol Neurochir Pol. 1979;13(5):565-7.

[Recurrent multifocal lesions of the nervous system after herpes zoster]

[Article in Polish]

Zelazny S, Filar H.

The authors report a case of zoster with signs of transverse myelitis and
peripheral involvement of the facial nerve. The fact that tranverse myelitis
developed late after zoster and was followed by facial nerve palsy is stressed.
The involvement of these nervous structures occurred in a way suggesting
exacerbations. In the light of literature data and the described case the authors
state that zoster with complications in the form of multifocal nervous system
involvement occurring at different time intervals is infrequent.

Publication Types: 
    Case Reports
    English Abstract

PMID: 522944 [PubMed - indexed for MEDLINE]

8442: Eur Neurol. 1979;18(3):149-56.

Zoster meningitis and radiculomeningitis after tick bite. Cytological findings in
cerebrospinal fluid.

Shoji H, Dommasch D.

Cytological changes in 9 samples of cerebrospinal fluid (CSF) from 5 patients
with zoster meningitis and 12 samples from 5 patients with radiculomeningitis
after tick bite were examined. 5 days after the onset of the skin eruption, the
CSF cells in zoster meningitis consisted of many mononuclear blast forms--large
lymphocytes and 'immature' plasma cells. 11-15 days after the onset of the skin
rash, they were replaced by small lymphocytes, some 'mature' plasma cells and
monohistiocytes. In radiculomeningitis after tick bite, however, the CSF cells
examined 10-21 days after the onset of radicular pain consisted of many large
lymphocytes, immature plasma cells and a few neutrophils. From these findings, it
might be suggested that the acute meningeal reaction of zoster meningitis
subsides within about 1 week after the onset of the skin rash, but that of
radiculomeningitis after tick bite continues at least for 2-3 weeks after the
onset of radicular pain.

PMID: 477687 [PubMed - indexed for MEDLINE]

8443: Dermatologica. 1979;158(3):210-3.

[Trigeminal zona with necrosis of the upper jaw]

[Article in French]

Delbrouck-Poot F, Reginster JP.

Publication Types: 
    Case Reports

PMID: 446827 [PubMed - indexed for MEDLINE]

8444: J Laryngol Otol. 1979 Jan;93(1):93-8.

Herpes zoster of the larynx--how common?

Pahor AL.

Herpes zoster of the larynx is considered to be rare, but on reviewing the
literature it is noted that some authors considered it to be more common than
already acclaimed. Herpes may prove to be a common cause of cord palsies
presently labelled as idiopathic and serological tests for herpes should be asked
for. Of note is the fact that the cord palsy of a herpetic lesion can be
short-lived and that earache is a common symptom. In this paper four cases of
herpes laryngis are presented. It is advised that the larynx should be examined
in all cases of herpes zoster of the head and neck.

Publication Types: 
    Case Reports

PMID: 429891 [PubMed - indexed for MEDLINE]

8445: Antimicrob Agents Chemother. 1979 Jan;15(1):142-4.

Inappropriate antidiuretic hormone following adenine arabinoside administration.

Ramos E, Timmons RF, Schimpff SC.

A patient with disseminated herpes zoster developed a syndrome of inappropriate
antidiuretic hormone and profound hyponatremia secondary to the administration of
adenine arabinoside.

Publication Types: 
    Case Reports

PMID: 426502 [PubMed - indexed for MEDLINE]

8446: Int Urol Nephrol. 1979;11(4):363-6.

Herpes zoster and acute rejection crisis of renal homograft.

Jaray J, Perner F, Alfoldy F, Darvas K, Kokas P.

The case of a patient developing acute rejection crisis 8 months after
transplantation in the prodromal stage of a herpes zoster infection is reported. 
The joint therapeutic measures resulted in suppression of rejection and control
of the infection. Complications did not occur. The case suggests a definite
association between the viral infection and acute homograft rejection. The case
report is followed by a critical review of the pertinent literature.

Publication Types: 
    Case Reports

PMID: 395127 [PubMed - indexed for MEDLINE]

8447: Scand J Infect Dis. 1979;11(1):1-9.

Treatment of herpes zoster with idoxuridine ointment, including a multivariate
analysis of symptoms and signs.

Wildenhoff KE, Ipsen J, Esmann V, Ingemann-Jensen J, Poulsen JH.

A double-blind, random selection comparison was made of the therapeutic effects
in acute herpes zoster of (A) 40% idoxuridine (IDU) dissolved in dimethyl
sulphoxide (DMSO), or one of the following ointments: (B) a basis of polyethylene
glycol, (C) a basis with 60% DMSO, (D) a basis with 5% IDU and 60% DMSO, and (E) 
a basis with 40% IDU and 60% DMSO. Each group comprised 20 patients. The patients
were evaluated daily until skin healing and then at 1,3, and 6 months by
registering 4 neurological signs, 5 clinical evaluations of skin pathology and 4 
photographic evaluations of the skin lesions. A 'profile' of the effect of each
treatment was computed by calculating normalized means for each of the 13
variables. A non-random distribution of the clinical and photographic variables
indicated a statistically significant, but small therapeutic effect of treatment 
A on skin healing, whereas no convincing effect on pain or sensitivity
disturbances was established. Treatments B-E were without positive effects. The
information given by the highly interdependent variables were computed for each
variable and for groups of variables after appropriate scoring. It was found that
the photographic evaluation contributed evidence independent of the clinical
evaluation of skin pathology. A multiple correlation analysis revealed that age
was positively correlated to the duration of pain and to delayed healing, that
rapid healing was intimately connected to no or short-lived pain, and
surprisingly that zoster in the trigeminal area healed faster than in other
locations without being correlated to less pain. Treatment A must necessarily be 
reevaluated taking into account proper controls as well as age and affected
dermatomes.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial
    Randomized Controlled Trial

PMID: 368965 [PubMed - indexed for MEDLINE]

8448: Med Pediatr Oncol. 1979;7(3):285-97.

The incidence of post-splenectomy sepsis and herpes zoster in children and
adolescents with Hodgkin disease.

Green DM, Stutzman L, Blumenson LE, Brecher ML, Thomas PR, Allen JE, Jewett TC,
Freeman AI.

The occurrence of sepsis due to Streptococcus pneumoniae and Hemophilus influenza
and of herpes zoster (HZ) was reviewed in a series of 72 consecutive, previously 
untreated children and adolescents with Hodgkin disease. There was not a
statistically significant difference in the risk of developing sepsis within five
years of diagnosis between patients who had (16.6%) or had not (6.2%) undergone
splenectomy. Sepsis occurred most frequently among patients treated initially
with total nodal irradiation and combination chemotherapy. The estimated risk of 
HZ during the first five years after diagnosis was 34%. Patients treated
initially with irradiation and combination chemotherapy had a significantly
greater risk of developing HZ than patients treated initially with only
irradiation (P less than 0.05). Although trends were present which suggested that
splenectomy and the extent of disease at diagnosis may influence the occurrence
of HZ, these did not achieve statistical significance. Survival was not
influenced by the occurrence of HZ.

PMID: 317350 [PubMed - indexed for MEDLINE]

8449: Trans Ophthalmol Soc N Z. 1979;31:64-8.

Assessment of cytosine arabinoside in the management of herpes zoster
ophthalmicus.

Wellings PC.

PMID: 316216 [PubMed - indexed for MEDLINE]

8450: Rev Stomatol Chir Maxillofac. 1979;80(5):239-41.

[Zoster ophthalmicus : a problem in general practice (author's transl)]

[Article in French]

Laufer J, Tsamis JD.

The authors describe several cases of zoster, including some patients who
developed skin or bone necrosis, and discuss the principal therapeutics proposed 
at the present time.

Publication Types: 
    Case Reports
    English Abstract

PMID: 315093 [PubMed - indexed for MEDLINE]

8451: J Pediatr Ophthalmol Strabismus. 1979 Jan-Feb;16(1):33-4.

Isolated pupillary paralysis in a case of herpes zoster.

Sen DK.

The clinical findings in a 16-year-old boy with unilateral isolated pupillary
paralysis in a case of herpes zoster ophthalmicus is described because of the
extreme rarity of the condition. The condition appeared to be due to a partial
third nerve lesion affecting only the fibers subserving the light and near
reflexes.

Publication Types: 
    Case Reports

PMID: 312315 [PubMed - indexed for MEDLINE]

8452: Am J Med. 1979 Jan;66(1):3-5.

Interferons.

Tamm I, Sehgal PB.

Publication Types: 
    Editorial

PMID: 283690 [PubMed - indexed for MEDLINE]

8453: Med Microbiol Immunol. 1979;167(4):275-83.

Infection and persistence of varicella-zoster virus in lymphoblastoid Raji cell
line.

Leventon-Kriss S, Gotlieb-Stematsky T, Vonsover A, Smetana Z.

Infection of Raji cells by varicella-zoster virus (VZV) resulted in permissive
infection with establishment of a persistently infected lymphoblastoid cell line.
VZV antigens of the membrane and nuclear type, as detected by the indirect
immunofluorescence membrane antigen (IFAMA) and anticomplement immunofluorescence
(ACIF) tests, were observed. Minute amounts of infectious virus were detected by 
co-cultivation of VZV-infected Raji cells (Raji-VZV), with permissive human
embryo fibroblasts (HEF). The virus isolated was found to be similar to the
parent strain. Transient induction of Epstein-Barr viral capsid antigen (EB-VCA) 
was also observed. The persistently infected Raji-VZV cell line, when free of
EB-VCA, was found suitable for measuring antibodies to varicella-zoster virus.
The possible interaction in the infected Raji cells between EBV, which is
implicated in human malignancy, and VZV which belongs also to the herpes group of
viruses, is discussed.

PMID: 232537 [PubMed - indexed for MEDLINE]

8454: Intervirology. 1979;12(2):73-83.

Comparative study of herpes group virus-induced DNA polymerases.

Mar EC, Huang ES.

A comparative biochemical study of virus-induced DNA polymerases was made among
the herpes group viruses: namely, herpes simplex virus (HSV) type 1 and type 2,
human cytomegalovirus (HCMV) and varicella-zoster virus (VZV). Although these
virus-induced enzymes shared some biochemical properties, they differed in
several important aspects. All these virus-induced DNA polymerases could
efficiently use poly(dC) . oligo(dG)12--18 and poly(dA) . oligo(dT)12--18 as
template-primers. However, in phosphocellulose chromatography, HSV-1- and
HSV-2-induced enzymes were eluted at the low concentration of 0.18--0.20 M NaCl
and the counterparts of HCMV and VZV were eluted at 0.30--0.32 M. The former two 
enzymes were more sensitive to lower concentrations of phosphonoacetate and ethyl
phosphonoacetate than the latter two enzymes. Moreover, the activity of HSV-1-
and HSV-2-specified DNA polymerases was 5 times greater in the presence of 60 mM 
ammonium sulfate if poly(dA) . oligo(dT)12--18 was used as template-primer, while
HCMV- and VZV-induced enzyme activities were only about twice as great under the 
same conditions. Futhermore, DNase activity was conspicuous in both HSV-1- and
HSV-2-infected WI-38 cells, but was not detectable in HCMV- and VZV-infected
cells. After storage for 1 year at 4 degrees, the HSV-1-induced DNA polymerase
was the most thermostable of the four viral enzymes.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 231586 [PubMed - indexed for MEDLINE]

8455: J Hyg Epidemiol Microbiol Immunol. 1979;23(3):332-9.

Radioimmunoassay for antibodies in varicella-zoster virus serology.

Trlifajova J, Pokorny J, Nemecek V, Ryba M.

The method of RIA for antibodies was employed with success in VZ virus serology. 
The method is suitable for testing VZ antibodies in the course of varicella or
herpes zoster disease as well as for determining anamnestic titres. Its
advantages are stability of antigen, objective reading of results and
applicability to testing large serum sets.

PMID: 231068 [PubMed - indexed for MEDLINE]

8456: Electrodiagn Ther. 1979;16(4):185-209.

[Electrotherapy of peripheral nerve disorders]

[Article in French]

Dumoulin J, de Bisschop G.

PMID: 230956 [PubMed - indexed for MEDLINE]

8457: Bull Cancer. 1979;66(4):373-81.

[Comparative study of anti EBV antibodies in non-Hodgkin's lymphomams and
angio-immunoblastic lymphadenopathies (author's transl)]

[Article in French]

Dumont J, Liabeuf A, Henle W, Ferchal F, Feingold N, Kourilsky FM.

Antibody titers to Epstein-Barr virus (EBV)--related antigens (viral capsid
antigen : VCA; early antigen : EA; and EBV associated nuclear antigen : EBNA)
were determined in the sera of 86 patients and 150 matched control subjects. The 
patients belonged to four histological groups : diffuse and nodular non-hodgkin's
lymphomas angio-immunoblastic lymphadenopathies and apparented syndroms. The
incidence of antibodies to other herpes-viruses (cytomegalovirus, herpes simplex 
virus, and varicella zoster virus) was compared. There was a significantly higher
incidence of anti VCA and anti EA titers in some patients, not associated with an
increase in titres of antibodies to other herpes viruses.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 230873 [PubMed - indexed for MEDLINE]

8458: Adv Ophthalmol. 1979;38:288-96.

Developmental aspects of adenine arabinoside for parenteral therapy of human
herpesvirus infections.

Whitley RJ, Alford CA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 230722 [PubMed - indexed for MEDLINE]

8459: Zh Nevropatol Psikhiatr Im S S Korsakova. 1979;79(8):1011-6.

[Pathogenetic analysis of the Ramsay Hunt syndrome]

[Article in Russian]

Umanskii KG, Smirnov IuK, Shishov AS.

PMID: 225911 [PubMed - indexed for MEDLINE]

8460: Int Urol Nephrol. 1979;11(2):145-50.

"Triple infections" (fungal, bacterial and viral) in immunosuppressed renal
transplant recipients.

Zazgornik J, Schmidt P, Kopsa H, Thurner J, Deutsch E.

In a period of 5 years, 8 out of 77 renal transplant patients showed simultaneous
fungal, bacterial and viral infections. Candida albicans was found in all cases. 
The most severe bacterial complications were infections with Klebsiella,
Pseudomonas and Staphylococcus aureus. Cytomegalovirus, persistent HBsAg positive
hepatitis, herpes zoster, and herpes simplex infections were also found. Seven
patients died of bacterial superinfection and miliary tuberculosis. The data
presented show that "triple infections" are associated with high mortality and
that miliary tuberculosis occurred frequently in immunosuppressed renal
transplant recipients.

PMID: 224003 [PubMed - indexed for MEDLINE]

8461: Int Ophthalmol Clin. 1979 Summer;19(2):135-67.

Ocular surface manifestations of the major viruses.

Chu W, Pavan-Langston D.

The ocular surface is often the first site of involvement by viral infections.
Background information, clinical presentations, and current treatment of three
major viruses--herpes simplex, varicella-zoster, and adenovirus, have been
presented in detail in this chapter. The effects of adenoviruses are usually
transient and may be regarded as a nuisance. Infection with herpes simplex or
varicella-zoster may lead to prolonged activity of the disease and life-long
treatment with occasional loss of useful vision. It is apparent that our
understanding of the clinical behavior of the major viruses has increased in
recent years. Therapeutic criteria and modalities have also improved for some of 
the complications of the viruses. Much work needs to be done for some of the
other manifestations, i.e., failure of reepithelialization, stromal melting,
scarring, vascularization, and inflammation.

PMID: 222704 [PubMed - indexed for MEDLINE]

8462: Indian J Ophthalmol. 1979 Jan;26(4):50-1.

Herpes zoster in children.

Gupta S, Soodan SS, Pahda SP, Bali FS.

Publication Types: 
    Case Reports

PMID: 220193 [PubMed - indexed for MEDLINE]

8463: J Clin Microbiol. 1979 Jan;9(1):1-10.

Sensitive solid-phase radioimmunoassay for detection of human immunoglobulin G
antibodies to varicella-zoster virus.

Friedman MG, Leventon-Kriss S, Sarov I.

A sensitive solid-phase radioimmunoassay for detection of antibodies to
varicella-zoster virus (VZV) is described. The antigen consisted of a sonically
disrupted extract of VZV-infected human embryo cells. 125I-labeled rabbit
anti-human immunoglobulin G (IgG) specific for the Fc portion of human IgG was
used to detect human IgG bound to viral antigen. With this technique, 193 human
sera were evaluated for their IgG antibody titer against ZVZ. Subjects included
62 healthy adults, 33 young children (12 healthy), and 49 patients. Titers
obtained by the radioimmunoassay were compared with those obtained by indirect
fluoresence antibody staining of membrane antigen. The radioimmunoassay technique
described gave titers approximately 5 X 10(4) times higher than those shown by
indirect fluorescence. It can be used for routine diagnosis, but is especially
suited to determining immune status to VZV, as defined by presence or absence of 
antibodies to the virus; for epidemiological studies; or for determining patients
at risk who are exposed to the virus. No heterotypic titer rises to VZV were
observed in sera with fourfold or greater rises to Epstein-Barr virus or
cytomegalovirus. Sera of eight subjects with fourfold or greater titer rises to
herpes simplex virus reacted in various ways: in six cases no significant change 
occurred in titer to VZV; one had a significant decrease in titer by the
radioimmunoassay; and one had a significant increase. Possible reasons for these 
titer changes are discussed.

Publication Types: 
    Comparative Study

PMID: 219015 [PubMed - indexed for MEDLINE]

8464: Arch Virol. 1979;59(1-2):59-67.

Differences in antibody responses in varicella, herpes zoster and after
vaccination.

Kimoto T, Kurimura T.

Difference in antibody responses between varicella and herpes zoster was
reconfirmed by complement fixation (CF) test and by platelet aggregation (PA)
test. Rise in PA antibody level was observed only in patients with herpes zoster,
but not in patients with varicella, while the increase in CF antibody was
demonstrated in both types of the diseases. Among 235 healthy children, CF
antibody was detected in 42 children and out of these 25 also had PA antibody.
Sera of 116 individuals who were vaccinated with a live vaccine comprised of
varicella-herpes zoster virus (VZV) were tested for CF and PA antibodies. Within 
six months after vaccination, 81.3 per cent of the vaccinees demonstrated the
rise in CF antibody alone, and only one vaccinee possessed low level of PA
antibody. Six months to 1 year after vaccination, CF antibody in 12 out of 13
vaccinees fell to undetectable level. Later than 1 year after vaccination, 9 out 
of 28 vaccinees possessed CF antibody. Two out of these 9 vaccinees also had PA
antibody. The PA antigens prepared from viruses isolated either from a varicella 
patient or a herpes zoster patient responded similarly to the sera of herpes
zoster patients, but no response was detected with sera of varicella patients. PA
and CF antibody titers of herpes zoster patients showed a high degree of
correlation.

Publication Types: 
    Comparative Study

PMID: 218537 [PubMed - indexed for MEDLINE]

8465: Clin Lab Haematol. 1979;1(2):95-107.

Allogeneic bone marrow transplantation for severe aplastic anaemia--the London
experience.

Barrett AJ.

Using the Seattle protocol with minor modifications, 23 patients with severe
aplastic anaemia received allogeneic bone marrow transplants from HLA/mixed
leucocyte culture matched sibs in three London centres between 1973 and 1977. Ten
patients (43.5%) are alive 6 months to 5 years after transplantation, and are
well with full haemopoietic reconstitution, two with autologous bone marrow
recovery following the graft procedure. A failure of the marrow graft to take, or
take followed by rejection occurred in 12 patients (52%). Failure of marrow
recovery was associated with a high early mortality from bacterial or fungal
infection. The only survivors amongst those who rejected the first graft were
four patients in whom a subsequent graft from the same donor was successful, and 
two in whom autologous recovery occurred. Graft versus host disease (GVHD)
occurred in seven patients, and was fatal in one case. The most frequent
complication after successful engraftment was varicella-zoster infection which
occurred in five patients and was fatal in one patient. The overall results
compare favourably with those from other transplant centres, but the high rate of
graft rejection and low incidence of GVHD differ from other series. The results
should encourage further referral of patients with severe AA for bone marrow
transplantation.

PMID: 43792 [PubMed - indexed for MEDLINE]

8466: S Afr Med J. 1978 Dec 30;54(27):1119.

[Griseofulvin in the treatment of herpes zoster]

[Article in Afrikaans]

Nel PD.

Publication Types: 
    Case Reports
    Letter

PMID: 746474 [PubMed - indexed for MEDLINE]

8467: Soins. 1978 Dec 20;23(24):27-30.

[Herpes]

[Article in French]

Lachiver LD, Laverdet C.

PMID: 227119 [PubMed - indexed for MEDLINE]

8468: West J Med. 1978 Dec;129(6):465-8.

Herpes zoster.

Reuler JB.

Herpes zoster is a disorder frequently encountered in adults. The natural history
is often poorly appreciated and management is frustrating. Recent studies have
critically evaluated newer therapeutic modalities. The epidemiology, clinical
manifestations, complications and therapeutic alternatives of herpes zoster
deserve review.

PMID: 735044 [PubMed - indexed for MEDLINE]

8469: Cesk Dermatol. 1978 Dec;53(6):363-6.

[Immunological investigation of patients with herpes zoster. II. Autoimmune
reactions (author's transl)]

[Article in Czech]

Doutlik S, Vacek Z, Hanakova L, Vasickova M.

Publication Types: 
    English Abstract

PMID: 729021 [PubMed - indexed for MEDLINE]

8470: Internist (Berl). 1978 Dec;19(12):659-63.

[Interferon: its effects and clinical application]

[Article in German]

Siegert R.

PMID: 370046 [PubMed - indexed for MEDLINE]

8471: Pain. 1978 Dec;5(4):367-71.

Chlorprothixene (taractan) in post-herpetic neuralgia and other severe chronic
pains.

Nathan PW.

Two trials of chlorprothixene were carried out, mainly on patients with moderate 
to severe post-herpetic neuralgia. When the drug was given as 50 mg b.d. to
outpatients, unpleasant side-effects were more important than slight effects in
alleviating pain. When the drug was given as 50 mg 6 hourly to inpatients for 5
days only, there was alleviation of constant chronic pain in a third of the
patients; the effect is still lasting over a period of months in a few patients. 
The side-effects during the course of treatment are prominent. It is concluded
that the drug is worth trying in the course recommended by Farber and Burks [1]
when other means of controlling postherpetic neuralgia have failed. It would be
best to give the course only to inpatients.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 368703 [PubMed - indexed for MEDLINE]

8472: Ann Surg. 1978 Dec;188(6):783-90.

Jaundice after renal allotransplantation.

Mozes MF, Ascher NL, Balfour HH Jr, Simmons RL, Najarian JS.

Of 567 patients receiving renal transplantation at the University of Minnesota
between October 1967 and October 1975, 22 developed clinical jaundice. Of these
22, nine died with their initial episode of hepatitis, six died within three
months of causes associated with liver malfunction, four developed evidence of
chronic hepatic failure and only three totally recovered from their illness. Five
had clear evidence of Australia antigen positive hepatitis B, four of
cytomegalovirus hepatitis, two of herpes hominis hepatitis, one of varicella
zoster hepatitis and three of hepatic failure associated with systemic bacterial 
and/or fungal sepsis. Two of the 22 patients were thought likely to have
cytomegalovirus hepatitis though definite proof was absent and in five patients a
clear-cut etiology could not be made. In many of these patients the diagnosis was
confounded by the previous presence of HB(s)Ag antigen and the frequent
occurrence of a previous or concurrent infection with cytomegalovirus. The role
of various drugs including azathioprine, sulfisoxazole, chlorpromazine,
acetominophen, etc., could not be established but major roles for these agents in
the face of the many viral and bacterial infections present in these patients is 
doubted. No clear-cut therapy could be established although it appears safe to
discontinue azathioprine for longer or shorter periods of time with or without
substitution of cyclophosphamide without serious deterioration of renal function.
The problem of hepatic failure in transplant patients is still unsolved and will 
require a prospective study of etiologic agents and sub-clinical hepatic
dysfunction in order to establish even the first principles of
clinical-pathological correlation.

PMID: 216323 [PubMed - indexed for MEDLINE]

8473: Med Microbiol Immunol. 1978 Nov 17;166(1-4):177-86.

Detection of antibodies to varicella zoster virus by radioimmunoassay and enzyme 
immunoassay techniques.

Friedman MG, Haikin H, Leventon-Kriss S, Joffe R, Goldstein V, Sarov I.

An enzyme assay for the detection of antibodies to varicella-zoster membrane
antigen (IPAMA) and a solid phase radioimmunoassay (RIA) which utilizes infected 
cell lysates as antigen are described. The results have been compared with those 
obtained by the indirect fluorescent antibody to membrane antigen (IFAMA)
technique. It was found that IPAMA was equal in sensitivity to IFAMA. No
cross-reactivity was found with other herpes group viruses. The IPAMA appears to 
give objective results, is easily and rapidly performed, and is recommended as a 
routine test for serological diagnosis of varicella-zoster infection. The RIA
method is about 100 times more sensitive than IPAMA and IFAMA. The RIA is
specific and has the potential of determining lower levels of antibody than other
serological methods currently in use.

Publication Types: 
    Comparative Study

PMID: 82905 [PubMed - indexed for MEDLINE]

8474: Sem Hop. 1978 Nov 8-15;54(37-40):1185-7.

[Interest of the use of pain drug in hyperalgic ophthalmic herpes zoster
(author's transl)]

[Article in French]

Salvadori M, Creisson G.

In ophthalmic herpes, very frequent residual pain may be the cause of severe
facial neuralgia which may persist for many years. These cases of neuralgia often
occur in the elderly and raise difficult therapeutic problems. Tiapride which is 
a neuro-visceral mediator of the substituted benzamide family gave excellent
results in 3 cases of ophthalmic herpes zoster in the elderly. The dosage was 200
to 300 mg daily by the intramuscular route, then by the oral route. Tolerance was
excellent.

Publication Types: 
    Case Reports
    English Abstract

PMID: 33451 [PubMed - indexed for MEDLINE]

8475: Vopr Virusol. 1978 Nov-Dec;(6):742-3.

[Prospects for the clinical use of interferon]

[Article in Russian]

[No authors listed]

Publication Types: 
    Comparative Study

PMID: 749355 [PubMed - indexed for MEDLINE]

8476: Rocky Mt Med J. 1978 Nov-Dec;75(6):317-9.

Myelopathy associated with Herpes Zoster.

Cole M.

Publication Types: 
    Case Reports

PMID: 725440 [PubMed - indexed for MEDLINE]

8477: Am J Med. 1978 Nov;65(5):738-44.

Herpes zoster at the NIH: a 20 year experience.

Mazur MH, Dolin R.

One hundred and seven cases of herpes zoster in a hospitalized population with a 
variety of illnesses during a 20 year period were reviewed. Zoster occurred
throughout the year, without seasonal predominance, and was most frequent in
lymphoproliferative malignancy. In the majority, lesions were confined to the
skin in one or more adjacent dermatomes (localized zoster) and were most frequent
in the thoracic region. In 15 per cent of the cases, cutaneous dissemination of
the lesions developed; this occurred four to 11 days after the onset of
dermatomal lesions, and in one-third of these there was central nervous system
involvement. Dissemination of zoster, however, directly resulted in only one
death. Predisposing factors for zoster included local irradiation and,
occasionally, surgery in subsequently involved areas. There were trends for more 
frequent splenectomies in patients with Hodgkin's disease in whom zoster
subsequently developed, and for more frequent corticosteroid therapy in patiens
with disseminated zoster. Advanced stage of Hodgkin's disease, in itself, was not
associated with development of zoster, and the onset of zoster did not herald a
poor prognosis for the underlying disease. Herpes zoster was, thus, largely a
source of increased morbidity rather than mortality in the population studied,
and multiple factors appeared to predispose to the development of zoster in this 
group of patients.

PMID: 581329 [PubMed - indexed for MEDLINE]

8478: Am J Ophthalmol. 1978 Nov;86(5):611-4.

Peripheral corneal ulcers with herpes zoster ophthalmicus.

Mondino BJ, Brown SI, Mondzelewski JP.

Four patients with herpes zoster ophthalmicus developed peripheral corneal ulcers
with steep central edges. An anterior uveitis was associated with all cases. One 
patient developed bilateral corneal ulcers that were typical of Mooren's ulcer
and eventually destroyed both corneas. The other three cases were unilateral and 
were not relentlessly progressive.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 309729 [PubMed - indexed for MEDLINE]

8479: J Clin Microbiol. 1978 Nov;8(5):545-52.

Antibody assays for varicella-zoster virus: comparison of enzyme immunoassay with
neutralization, immune adherence hemagglutination, and complement fixation.

Forghani B, Schmidt NJ, Dennis J.

An enzyme immunossay (EIA) was adapted for detection of antibody to
varicella-zoster virus, and its sensitivity and specificity were compared with
those of neutralization, immune adherence hemagglutination (IAHA), and complement
fixation tests. Test sera showed little nonspecific reactivity in the EIA system,
and valid results could usually be obtained at serum dilutions as low as 1:8.
Demonstration of the presence or absence of varicella-zoster viral antibody by
EIA showed 94% correlation with results obtained in neutralization tests, but EIA
titers were 2- to 16-fold higher than neutralizing antibody titers. Results by
IAHA showed 87% correlation with those obtained by neutralization. No false
positive IAHA results were seen, but a number of false negative IAHA results were
seen at the 1:8 serum dilution, particularly in older individuals. With
increasing age (>40 years), and presumably increased time from varicella
infection, neutralizing antibody levels generally declined to 1:8 or 1:16, EIA
levels fell to 1:128 or 1:256, and IAHA and complement fixation antibody titers
were usually <1:8 or 1:8. EIA and IAHA were as reliable as the neutralization and
complement fixation tests for serodiagnosis of varicella and zoster infections.
All tests demonstrated heterotypic varicella-zoster antibody titer rises in
selected patients with initial herpes simplex virus infections, but fewer
heterotypic responses were seen by EIA than by the other methods. EIA offers a
rapid, sensitive, and specific method for varicella-zoster antibody assay that is
applicable to use in a clinical setting.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 215602 [PubMed - indexed for MEDLINE]

8480: Zh Mikrobiol Epidemiol Immunobiol. 1978 Nov;(11):121-4.

[Several epidemiologic features of the spread of chickenpox and herpes zoster]

[Article in Russian]

Shargorodskaia VA, Baronin AV.

Epidemiological and statistical data of herpes zoster and chickenpox by such
indices as morbidity level, periodicity and month-by-month changes in the
incidence of these diseases were compared. The study included 2345 herpes zoster 
and 11116 chickenpox cases in the course of 5 years (1972--1976). In comparison
with herpes zoster, the intensity of chickenpox spread among the population was
on the average 4.7 times greater. Of the total number of chickenpox cases the
percentage of herpes zoster contituted 21.0. Chickenpox morbidity had marked
seasonal cyclic nature with the amplitude of seasonal variations of about 8; as
to herpes zoster--there was no annual or seasonal cyclicity. Thus, in the
development of chickenpox and herpes zoster epidemic process there was revealed a
peculiar tendency inherent to each of these infections; no common epidemiological
and statistical regularities in the spread intensity, annual periodicity and
seasonal cyclicity were detected.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 153076 [PubMed - indexed for MEDLINE]

8481: Mil Med. 1978 Nov;143(11):788-9.

Genital Herpes Zoster: a case resembling primary herpes progenitalis with distal 
urethral involvement.

Robinson TA, Kuruc SG, Knauf SP.

Publication Types: 
    Case Reports

PMID: 101907 [PubMed - indexed for MEDLINE]

8482: Minerva Chir. 1978 Oct 15;33(19):1325-38.

[False acute abdomen]

[Article in Italian]

Quarti-Trevano GM, Pagani M, Poma S, Bruni M, Lochis D, Bracale M, Salvini A.

Publication Types: 
    Case Reports

PMID: 692915 [PubMed - indexed for MEDLINE]

8483: S Afr Med J. 1978 Oct 14;54(16):638.

[Griseofulvan in the treatment of herpes zoster]

[Article in Afrikaans, English]

[No authors listed]

Publication Types: 
    Case Reports
    Letter

PMID: 741272 [PubMed - indexed for MEDLINE]

8484: Med Klin. 1978 Oct 13;73(41):1437-41.

[Infectious urethritis]

[Article in German]

Qadripur SA.

PMID: 703671 [PubMed - indexed for MEDLINE]

8485: Med J Aust. 1978 Oct 7;2(8):387.

Herpes zoster followed by "spontaneous" perforation of the colon.

Evans DJ.

Publication Types: 
    Case Reports
    Letter

PMID: 310506 [PubMed - indexed for MEDLINE]

8486: Isr J Med Sci. 1978 Oct;14(10):1014-8.

The relation between therapy and herpes zoster in Hodgkin's disease.

Ramot B, Modan M, Berkowicz M, Meytes D, Shochat J.

The rate of occurrence of herpes zoster (HZ) was analyzed by the life table
method in 108 Hodgkin's disease (HD) patients, diagnosed and treated during the
years 1969 to 1976. Three groups, divided according to the degree of severity of 
the disease, were compared. The cumulative rate of occurrence of HZ at the end of
the third year after diagnosis was higher in the group with intermediately
extensive disease than in that with the most extensive disease (35 vs. 23%), but 
the difference was not significant. At the end of the fifth year, the rate was
almost identical in both groups (35.3 and 35.6%, respectively). The group with
the least severe form of HD had a very low HZ rate (2.2%), which was
significantly different from the other two groups and close to the rate reported 
for normal populations. The five-year mortality rate was 0.0, 20.3 and 40.6%,
respectively, in the three groups. These findings were interpreted to mean that
in more advanced stages of HD, therapy and not the severity of the disease is the
main factor determining the incidence of HZ. Extended field irradiation followed 
by a few courses of combined chemotherapy appear to have an effect similar to
that of prolonged chemotherapy.

PMID: 738866 [PubMed - indexed for MEDLINE]

8487: Radiologe. 1978 Oct;18(10):398-400.

[Varicella pneumonia in a patient with Hodgkin's disease (author's transl)]

[Article in German]

Kuster W, Hofner W, Wicke L, Kuhbock J.

Varicella and primary varicella pneumonia occurred in a patient with advanced
Hodgkin's disease. The radiological characteristics are shown. Various relations 
between varicella, herpes zoster infections and Hodgkin's disease are discussed
briefly.

Publication Types: 
    English Abstract

PMID: 704832 [PubMed - indexed for MEDLINE]

8488: Mo Med. 1978 Oct;75(10):515-8.

Herpes zoster in Hodgkin's disease.

Mill WB, Frisse ME.

PMID: 703748 [PubMed - indexed for MEDLINE]

8489: Arch Pathol Lab Med. 1978 Oct;102(10):527-9.

Glomerulonephritis with Hodgkin's disease and herpes zoster.

Ma KW, Golbus SM, Kaufman R, Staley N, Londer H, Brown DC.

A patient who had been treated for Hodgkin's disease was infected with herpes
zoster. Shortly thereafter, glomerulonephritis mediated by anti-glomerular
basement membrane (anti-GBM) antibody occurred. The diagnosis was confirmed by
the presence of circulating anti-GBM antibody, immunofluorescence, and elution.
Results of immunofluorescence of a lymph node disclosed deposits of IgG on the
vascular and stromal connective tissue, in a pattern similar to that seen when
heterologous anti-GBM antibody reacted with the node. Because of the known
nephritogenic potential of solid lymphoid tissues, this finding suggests a
possible relationship between his tumor and his glomerular disease. The role of
zoster infection remains undefined.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 581342 [PubMed - indexed for MEDLINE]

8490: Zh Mikrobiol Epidemiol Immunobiol. 1978 Oct;(10):58-61.

[Clinical immunological characteristics of herpes zoster]

[Article in Russian]

Smirnov IuK, Shishov AS, Mal'tseva NN.

Changes of antibody formation of 96 patients with various clinical forms of
herpes zoster were traced by indirect hemagglutination inhibition test. Four
variants of the immunological response were distinguished; clinical
characteristics of each of these groups is presented. The initial antibody level 
failed to determine the severity of the course of the disease in herpes zoster.

Publication Types: 
    English Abstract

PMID: 218405 [PubMed - indexed for MEDLINE]

8491: Dermatol Monatsschr. 1978 Oct;164(10):715-9.

[Transketolase activity as a parameter for the vitamin B1 provision in some
dermatoses (herpes zoster, psoriasis, drug eruptions, excema, and urticaria)
(author's transl)]

[Article in German]

Grimm U, Brommel C, Kulbel P.

Publication Types: 
    English Abstract

PMID: 153861 [PubMed - indexed for MEDLINE]

8492: N Engl J Med. 1978 Sep 21;299(12):664.

Sympathetic block for herpes zoster.

DeBacker LJ.

Publication Types: 
    Letter

PMID: 683246 [PubMed - indexed for MEDLINE]

8493: Arthritis Rheum. 1978 Sep-Oct;21(7):798-802.

Herpes zoster in patients with systemic lupus erythematosus.

Moutsopoulos HM, Gallagher JD, Decker JL, Steinberg AD.

In the context of prospective trials of immunosuppressive drugs in systemic lupus
erythematosus (SLE) nephritis, 83 patients were studied with regard to
development of herpes zoster. Herpes zoster was found to occur with high
frequency (21%) in patients with SLE nephritis treated with immunosuppressive
agents. The course of herpes zoster was benign: no deaths occurred and only 2 of 
the 18 patients developed generalized disease, which resolved without sequelae.
Specific antiviral therapy was not necessary and there appears to be no need to
decrease immunosuppressive medications. Zoster occurred when the SLE was
relatively inactive and did not exacerbate the SLE. No statistical difference in 
the incidence of zoster was found among the patient groups treated with different
immunosuppressive regimens.

PMID: 697950 [PubMed - indexed for MEDLINE]

8494: Arch Dermatol. 1978 Sep;114(9):1383.

Granuloma annulare at sites of healing herpes zoster.

Guill MA, Goette DK.

Publication Types: 
    Case Reports

PMID: 686755 [PubMed - indexed for MEDLINE]

8495: J Dent Assoc Thai. 1978 Sep-Oct;28(5):182-8.

[Oral herpes zoster]

[Article in Thai]

Srisuwan S, Sittikong M.

Publication Types: 
    English Abstract

PMID: 291608 [PubMed - indexed for MEDLINE]

8496: Trans Ophthalmol Soc U K. 1978 Sep;98(3):343-7.

Role of the corneal nerves in destructive disease of the cornea.

Mackie IA.

PMID: 224534 [PubMed - indexed for MEDLINE]

8497: Ann Intern Med. 1978 Sep;89(3):375-88.

NIH conference. Herpes zoster-varicella infections in immunosuppressed patients.

Dolin R, Reichman RC, Mazur MH, Whitley RJ.

PMID: 210697 [PubMed - indexed for MEDLINE]

8498: South Med J. 1978 Sep;71(9):1134-40.

Current status of antiviral chemotherapy.

Whitley RJ, Alford CA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 210524 [PubMed - indexed for MEDLINE]

8499: EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1978
Sep;9(3):172-8.

[EMG-findings and nerve conduction velocity in herpes zoster disease (author's
transl)]

[Article in German]

Risos A.

We have performed a myography on three patients and an additional study of the
nerve conduction velocity (CV) on two adult patients suffering from herpes
zoster. It could be demonstrated that the affected muscles can suffer at the same
time a neuropathy as well as a myopathy. We found fibrillations and CV-reduction 
also in clinically healthy nerves and muscles. The abnormal findings were most
prominent in the clinically affected segments and often suggested an in portio
lesion of the motor unit. The infiltration of the spinal ganglion appears to have
no paramount significance for the understanding of this disease.

Publication Types: 
    Case Reports
    English Abstract

PMID: 100313 [PubMed - indexed for MEDLINE]

8500: Cancer. 1978 Sep;42(3):1046-56.

Hodgkin's disease: radiotherapeutic management at a cancer oriented community
hospital.

Saxe BI, Mandel PR.

Seventy-eight patients with Hodgkin's disease were treated with radiation therapy
between July 1966 and July 1976 (30 Stage I, 28 Stage II, 20 Stage III). The mean
follow-up period is greater than 5 years. 90% of Stage I, 86% of Stage II, 65% of
Stage III, and 82% (64/78) of all patients are NED after radiotherapy alone.
Since laparotomy option (1970) 89% (50/56) of patients are NED. Fourteen patients
were failures. Chemotherapy "rescued" 6 of 14. Seven have died, 1 is alive with
disease, and 1 died of leukemia. Absolute survival is 90% (70/78). Failures were 
more frequent in patients with unfavorable histological types (9/14), and Stage
III disease, primarily IIIS+ or B category (7/14). Sites of failures were mainly 
extranodal, primarily lung (10/14) and bone (2/14), and are consistent with
hematogenous dissemination. Laparotomy performed in 41 patients identified
unsuspected splenic involvement in 9 cases (22%), but was a distinct failure in
confirming most "small node" positive lymphangiograms. Two patients developed
acute myelocytic leukemia, both while NED 5 years posttherapy. One patient had
also received adjunctive MOPP. There has been no impairment in the quality of
survival that could be directly attributed to radiotherapy.

PMID: 100196 [PubMed - indexed for MEDLINE]

8501: Antimicrob Agents Chemother. 1978 Sep;14(3):495-7.

Inosiplex for localized herpes zoster in childhood cancer patients: preliminary
controlled study.

Feldman S, Hayes FA, Chaudhary S, Ossi M.

By multiple criteria, inosiplex-a reputed stimulator of virus-sensitized
lymphocytes-had no demonstrable therapeutic effects in a preliminary controlled
study of patients with localized herpes zoster and cancer. Lymphocytes from the
six drug-treated patients were no more responsive to varicella-zoster antigen and
phytohemagglutinin than were lymphocytes from seven patients who received a
placebo.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial
    Randomized Controlled Trial

PMID: 81655 [PubMed - indexed for MEDLINE]

8502: S Afr Med J. 1978 Aug 26;54(9):368-9.

Herpes zoster of the chest wall and gynaecomastia. A case report.

Epstein S.

Herpes zoster in a young male at puberty, associated with aggravation of
gynaecomastia on the same side as the intercostal nerve involvement, is
described.

Publication Types: 
    Case Reports

PMID: 715635 [PubMed - indexed for MEDLINE]

8503: Dtsch Med Wochenschr. 1978 Aug 25;103(34):1317-8.

[Interferon: therapeutic uses in reach?]

[Article in German]

Lindenmann J.

PMID: 679829 [PubMed - indexed for MEDLINE]

8504: Fortschr Med. 1978 Aug 24;96(32):1589-97.

[The virostatic effect of adenine-arabinoside monophosphate. Experimental
findings and preliminary clinical experiences]

[Article in German]

Werner GT, Bomer H, Metzger E, Sauer O, Schneider H, Schubert E, Treuner J.

Adenine arabinoside (Ara-A), a synthetic nucleoside, is an antiviral agent, which
is effective against poxviruses and viruses of the herpes group. The
monophosphate (Ara-AMP) has the great advantage of better solubility, compared to
the parent compound. Experimental studies show the outstanding effect of Ara-AMP 
on the encephalitis by vaccinia-virus in white mice. Even after immunesuppression
by total body irradiation, the survival rate of the Ara-AMP treated animals was
significantly higher compared to the untreated controls. In experimental
vaccinia-virus infections in rabbits, who had undergone total body irradiation.
Ara-AMP has a favourable influence upon the course of the disease and the
prognosis. Some clinical observations in children with immunesuppression, who
suffered from generalized zoster of varicella-infections, are reported.
Furthermore in cases of viral encephalitis Ara-AMP was successful. Controlled
studies of a greater number of patients on the therapeutic value of Ara-AMP in
infections with DNS-viruses are needed.

Publication Types: 
    Case Reports
    English Abstract

PMID: 680620 [PubMed - indexed for MEDLINE]

8505: S Afr Med J. 1978 Aug 5;54(6):224.

Griseofulvin in the treatment of herpes zoster.

Joubert JD.

Publication Types: 
    Case Reports
    Letter

PMID: 715595 [PubMed - indexed for MEDLINE]

8506: West J Med. 1978 Aug;129(2):167.

Herpes Zoster Keratouveitis.

Laibson PR.

PMID: 18748277 [PubMed - as supplied by publisher]

8507: Cancer. 1978 Aug;42(2):787-92.

Childhood Hodgkin's disease in Uganda: a ten year experience.

Olweny CL, Katongole-Mbidde E, Kiire C, Lwanga SK, Magrath I, Ziegler JL.

Between 1967 and 1977, 48 patients with Hodgkin's disease under 16-years-old were
treated with MOPP chemotherapy alone at the Uganda Cancer Institute because
radiotherapy facilities are not available. Thirty-eight percent had early stage
disease (stages I-IIIA). Prolonged first remissions were achieved in 74% of 42
complete responders. Of 11 patients who relapsed, 5 had prolonged second
remissions induced by MOPP. Three patients were lost to follow-up and 15 of the
remaining 45 died: 12 of these from progressive Hodgkin's disease, 2 from
unrelated causes and 1 from Burkitt's lymphoma after 4 months remission from
Hodgkin's disease. Acturial survival for all patients is 67% (75% for stages
I-IIIA and 60% for stages IIIB-IV). Treatment complications included Herpes
zoster and gynaecomastia. The latter is probably related to gonadal dysfunction. 
All stages of childhood Hodgkin's disease can be successfully managed with MOPP
chemotherapy alone.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 687386 [PubMed - indexed for MEDLINE]

8508: South Med J. 1978 Aug;71(8):909-10.

Cytosine arabinoside for varicella zoster: a second look.

DuBois RE.

Herpes zoster and disseminated herpes zoster, or varicella (V-Z), continue to be 
dreaded complications of patients with immunosuppression. Currently, there is no 
available therapy for V-Z, except for general supportive measures. Seven cases of
V-Z are presented, showing the results of cytosine arabinoside administration
when given as an intermittent intravenous infusion. The results compare favorably
with previously unsuccessful continuous intravenous infusion. It is suggested
that further evaluation of the intermittent administration of cytosine
arabinoside for V-Z would be worthwhile.

PMID: 684470 [PubMed - indexed for MEDLINE]

8509: Cancer. 1978 Aug;42(2):437-41.

Complications of total nodal irradiation of Hodgkin's disease stages III and IV.

Poussin-Rosillo H, Nisce LZ, Lee BJ.

One hundred twenty-seven patients with Hodgkin's disease, Stages III-IV, received
total nodal irradiation. Of these, 101 patients were managed primarily by
radiation therapy employing the split course sequential segmental radiation
technique called the "3 & 2". A dose of 3800-4000 rad is delivered in 2 phases in
an overall period of 12 to 13 weeks (TDF 61-64; 1094-1148 rets). For various
reasons, the remaining 26 patients received their mantle irradiation to full
doses 3800-4000 rad in 4 weeks (TDF 63-66; 1112-1184 rets) without rest periods
and a few were irradiated after failing chemotherapy. Of the 101 patients treated
between 1969-1974 using the "3 & 2" technique, 2 developed pericarditis (2.0%),
none manifested symptomatic pneumonitis (0%), and 3 hypothyroidism )3.0%). The
low incidence of severe complications is primarily the result of the technique
employed to give total nodal irradiation. The overall incidence of Herpes Zoster 
was 42% (53/127), and there was a slightly higher incidence when TNI was given
following splenectomy.

PMID: 679147 [PubMed - indexed for MEDLINE]

8510: J Fr Ophtalmol. 1978 Aug-Sep;1(8-9):535-45.

[Viral infections of the anterior segment (author's transl)]

[Article in French]

Lagoutte F.

A focus on the pathogenesis, clinical manifestations and therapy. Contemporary
ideas on viral infections of the anterior segment are examined.--The pathogenesis
of lesions (viral activity, delayed hypersensitivity reaction), the clinical
aspects of herpes infections of the anterior segment are the result of the
relative importance of these two factors. Schematically--dendritic keratitis
infiltrates and stromal necrosis and hypopion represent active viral infection.
Disciform keratitis, oedematous keratitis, serous iridocyclitis represent delayed
hypersensitivity reaction. Corticosteroids are contrindicated in the former cases
and recommended in the latter.--Special features concerning zoster inflammations 
of the anterior segment are considered.--An important number of adenoviral
anterior segment infections are also reported and their benign nature stressed.

Publication Types: 
    English Abstract
    Review

PMID: 152779 [PubMed - indexed for MEDLINE]

8511: Arch Dermatol Res. 1978 Jul 28;262(2):173-6.

Double blind trial in the treatment of herpes simplex and herpes zoster with
adenine arabinoside and idoxuridine.

Theodoridis A, Sivenas C, Vagena A, Capetanakis J.

In a double blind trial adenine arabinoside (Vidarabine) and Idoxuridine (IDU)
were tested in herpes simplex and herpes zoster infections. Adenine arabinoside
covered 19 patients with HSV and 6 with HZ while IDU 19 with HSV and 6 with HZ.
From the statistical analysis it was found that Vidarabine acts shorter than IDU 
in HSV P less than 0.01, while in HZ no significant difference P less than 0.5
was found, possibly due to the small number of patients tested.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 356754 [PubMed - indexed for MEDLINE]

8512: Minerva Med. 1978 Jul 21;69(35):2391-4.

[A case of the Ramsay-Hunt syndrome (herpes zoster of the geniculate ganglion)
with concomitant C2 and C3 nerve involvement]

[Article in Italian]

Cimino T, Giacobbi D.

A case of Ramsay-Hunt syndrome (herpes zoster of the genicular ganglion with
paresis of the facial nerve) presenting concomitant involvement of the sensitive 
nerve roots C2 and C3 is reported. The main aetiopathogenetic hypotheses as
reported in the literature are presented and an attempt made to formulate a
standard aetiopathogenetic theory comprising lesions to the motor nerve fibres
and those of the sensitive nerve fibres.

Publication Types: 
    Case Reports
    English Abstract

PMID: 683589 [PubMed - indexed for MEDLINE]

8513: N Engl J Med. 1978 Jul 20;299(3):130-2.

Current concepts in ophthalmology. Uveitis and the immunologically compromised
host.

O'Connor GR.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 307182 [PubMed - indexed for MEDLINE]

8514: Schweiz Rundsch Med Prax. 1978 Jul 18;67(29):1064-73.

[Trigeminal neuralgia, diagnostic aspects and treatment (author's transl)]

[Article in German]

Mumenthaler M.

PMID: 307757 [PubMed - indexed for MEDLINE]

8515: Lancet. 1978 Jul 8;2(8080):84.

Interferon treatment of herpes zoster.

[No authors listed]

Publication Types: 
    Clinical Trial
    Editorial

PMID: 78306 [PubMed - indexed for MEDLINE]

8516: Surg Neurol. 1978 Jul;10(1):50-3.

Pathological studies of spinal nerve ganglia in relation to intractable
intercostal pain.

Smith FP.

Pathological examination, by light and electron microscopy, of spinal nerve
ganglia surgically removed in treatment of intractable intercostal pain, has
shown changes in sensory cells, whether the etiology of the pain has been trauma 
related to intercostal nerve, or infection by herpes zoster virus. The possible
role of the sensory cell changes in accounting for causalgic type pain is
discussed.

PMID: 684607 [PubMed - indexed for MEDLINE]

8517: Am J Ophthalmol. 1978 Jul;86(1):39-44.

Clinical implications of aqueous humor studies in uveitis.

Witmer R.

We studied the serologic findings in serum and aqueous humor samples from 693
cases of uveitis. Specimens were tested for the presence of humoral antibodies
against tuberculosis, toxoplasmosis, antistreptolysin-O, herpes simplex and
herpes zoster viruses, mumps virus, and adenovirus. Serologic analyses rarely
indicated tuberculous or streptococcal infections, but frequently showed
toxoplasmosis and viral diseases.

PMID: 354395 [PubMed - indexed for MEDLINE]

8518: Arch Ophthalmol. 1978 Jul;96(7):1233-5.

Isolated trochlear nerve palsies in herpes zoster ophthalmicus.

Grimson BS, Glaser JS.

The clinical course of six patients with isolated trochlear nerve palsy as the
only ocular motor manifestation of herpes zoster ophthalmicus has been analyzed. 
Spontaneous recovery occurred in only three. Review of the literature does not
clarify the mechanism of such palsies, which potentially may result from the
following conditions: local orbital muscle inflammation and ischemia; contiguous 
intracavernous spread of inflammation from the trigeminal nerve; and a concurrent
but independent motor neuropathy or ganglionitis.

PMID: 307378 [PubMed - indexed for MEDLINE]

8519: Dent Update. 1978 Jul-Aug;5(5):295, 298-311.

Oral manifestations of communicable diseases.

Scully C, Williams G.

PMID: 290541 [PubMed - indexed for MEDLINE]

8520: Am J Clin Pathol. 1978 Jul;70(1 Suppl):170-4.

Varicella-zoster virus. Prospects for active immunization.

Gershon AA.

A live attenuated varicella-zoster (V-Z) virus vaccine has been developed and
tested by Dr. M. Takahashi and his colleagues in Japan. This vaccine appears to
prevent varicella and is associated with minimal side effects even in patients at
high risk to develop severe varicella. Antibody to V-Z virus appears after V-Z
vaccination. This antibody has been detected by a variety of serologic technics, 
and it has been demonstrated to persist for as long as two years after
vaccination. Thus far, V-Z vaccine has not been associated with subsequent
zoster, but long-term studies will be required before this possibility can be
ruled out.

PMID: 210654 [PubMed - indexed for MEDLINE]

8521: Cutis. 1978 Jul;22(1):61-4.

Cytologic examination and viral and bacterial culture in herpes simplex, herpes
zoster, and varicella.

Veien NK.

Cytologic examination of epithelial cells from the base of vesicles, virus
isolation, and bacterial culture were carried out in thirty-one patients with
herpes simplex, in eleven patients with herpes zoster, and in three patients with
varicella. Determination of herpes simplex complement fixation reaction was made 
in the patients with herpes simplex. Cytologic manifestations consistent with
herpes were found 65 percent of patients with herpes simplex, while herpesvirus
hominis was isolated in 77 percent of these patients. Diagnostic cytologic
manifestations were found in 82 percent of the patients with herpes zoster or
varicella. Varicella-zoster virus was isolated in 27 percent of these patients.
The presence of pathogenic bacteria did not seem to influence the frequency of
virus isolation or finding of characteristic cytologic features.

PMID: 208820 [PubMed - indexed for MEDLINE]

8522: Cancer. 1978 Jul;42(1):159-63.

Cell-mediated immunity to varicella zoster virus in children being treated for
cancer.

Hayes FA, Feldman S.

Stimulation of lymphocytes by varicella-zoster virus (VZV) antigen was measured
in vitro for 37 healthy adults and children and for 35 children who developed
herpes zoster or varicella while receiving anticancer therapy. For 35 of the
control group the history of varicella infection correlated with the in vitro
response of lymphocytes to VZV antigen. A specific lymphocyte response was
observed following 32 of the 37 episodes of VZV infection in the 35 children with
malignancy. Re-evaluation 7--12 months following the acute infection revealed
that the in vitro response to VZV antigen was lost in six of 19 patients who
remained in remission and in all patients who relapsed and received reinduction
therapy. Although there was some suggestion that development of a cell mediated
response early in the infection decreased the incidence of skin dissemination of 
the virus in herpes zoster, no consistent correlation could be made between
lymphocyte responsiveness in vitro and dissemination of disease or the duration
of the appearance of new lesions.

Publication Types: 
    In Vitro
    Research Support, U.S. Gov't, P.H.S.

PMID: 208747 [PubMed - indexed for MEDLINE]

8523: Fortschr Med. 1978 Jun 15;96(23):1253.

[Treatment of herpes simplex]

[Article in German]

[No authors listed]

PMID: 658878 [PubMed - indexed for MEDLINE]

8524: MMW Munch Med Wochenschr. 1978 Jun 2;120(22):757-60.

[Improvement of zoster therapy by adamantine]

[Article in German]

Barolin GS, Saurugg D, Zechner G.

In the course of 3 years we observed a considerable improvement of herpes zoster 
in 44 patients being treated with amantadine. The periods of pain and
efflorescence were shortened to 1/3 of the values usually experienced and painful
post-zoster complications did not occur. The therapeutic effect depends on a)
beginning treatment with high doses as early as possible, b) combination of local
and systemic administration of adamantine, c) continuation of treatment for
several weeks with gradually reducing doses. Harmless side-effects which are
easily controlled are dryness of mouth, slight fall in blood pressure and
insignificant general stimulation. In old people half the standard dose should be
given in the beginning and particular attention paid to symptoms of restlessness 
on account of a possible delirium. Severe disorders of renal function are a
contraindication.

Publication Types: 
    English Abstract

PMID: 307138 [PubMed - indexed for MEDLINE]

8525: Prim Care. 1978 Jun;5(2):263-80.

Cutaneous signs of internal malignant disease.

Sibrack LA.

An awareness of various dermatoses which reflect internal malignancy will
facilitate the physician's ability to recognize or even anticipate malignant
disease. There have been several previous reports on this subject. This review
emphasizes the nonspecific cutaneous changes associated with malignancy. New skin
markers of cancer are also discussed.

PMID: 210475 [PubMed - indexed for MEDLINE]

8526: Pediatrics. 1978 Jun;61(6):832-7.

Infections and other maternal factors as risk indicators for congenital
malformations: a case-control study with paired serum samples.

Koskimies O, Lapinleimu K, Saxen L.

An obstetric population of 48,000 individuals was prospectively followed up for
evidence of possible teratogenic factors that might be associated with congenital
malformations. Serum samples from 274 mothers of defective children and from
paired controls were collected during early pregnancy and approximately one month
after delivery and tested for antibodies against ten different viruses,
Mycoplasma pneumoniae, and Toxoplasma. These data were supplemented with clinical
information on infections, other diseases, drug intake, and other potentially
teratogenic factors during pregnancy. Mothers of defective children had more
seroconversions (fourfold or greater increase in titer) than the controls, 123
vs. 86. This difference was mainly due to an increase in herpes simplex viruses 1
and 2, cytomegalovirus, varicella-zoster virus, and Toxoplasma titers. In
addition, the number of reported diseases during the pregnancy, the intake of
drugs (especially analgesics and hormones), and the number of earlier abortions
were greater in the mothers of the defective children than in the controls.

PMID: 209394 [PubMed - indexed for MEDLINE]

8527: N Engl J Med. 1978 Jun 1;298(22):1239-41.

Current concepts in ophthalmology: Corneal disease.

Thoft RA.

PMID: 206829 [PubMed - indexed for MEDLINE]

8528: Arch Intern Med. 1978 Jun;138(6):912-4.

Skin lesions treated with azathioprine and prednisone. Comparison of
nontransplant patients and renal transplant recipients.

Zimmerman SW, Esch J.

Cutaneous complications were studied in 120 patients who received azathioprine
and prednisone for six months to ten years. Questionnaire, chart review, and
physical examination were used to assess skin infections, rash, verrucae, herpes 
zoster, tumors, condylomata acuminata, hair loss, and color changes. One hundred 
patients with renal allografts were compared with 20 nontransplant patients with 
systemic disease. Dermatologic problems were more frequent in transplant
recipients (P less than .02) than in nontransplant patients. Verrucae were more
frequent in transplant recipients (P less than .001). There was no significant
increase in the total number of skin manifestations with increasing length of
therapy, although warts and herpes zoster increased with time. This study
suggests that the increase in the total number of skin lesions noted in previous 
studies of renal transplant recipients is not as prevalent in nontransplant
patients who receive azathioprine and prednisone, due primarily to fewer verrucae
in nontransplant patients.

Publication Types: 
    Comparative Study

PMID: 148250 [PubMed - indexed for MEDLINE]

8529: Infect Immun. 1978 Jun;20(3):646-51.

Specificity of the blastogenic response of human mononuclear cells to herpesvirus
antigens.

Zaia JA, Leary PL, Levin MJ.

Peripheral blood mononuclear (PBM) cells from donors with a history of prior
infection with herpes simplex virus, varicella-zoster virus, and/or
cytomegalovirus were cultured for 2 to 8 days with glycine-extracted antigens
prepared from these viruses and from infectious bovine rhinotracheitis virus. The
proliferative response of PBM cells from all donors was specific during the first
6 days in culture. During this period the cellular immune responses of the
seronegative donors were clearly different from those of the seropositive donors.
The responses of PBM cells in culture with any of the human herpesvirus antigens 
studied was not influenced by prior infection of the donor with one or more other
human herpesviruses. In contrast, although no donors had antibody to infectious
bovine rhinotracheitis virus, the PBM cells from some of them had a proliferative
response to this bovine herpesvirus, which increased with time. This nonspecific 
response appears to be a host-associated function which may be related to
recognition of a common herpesvirus antigen.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 78901 [PubMed - indexed for MEDLINE]

8530: Wien Klin Wochenschr. 1978 May 26;90(11):372-4.

[Percutaneous cervical anterolateral cordotomy (author's transl)]

[Article in German]

Schrottner O.

A brief history of percutaneous high cervical anterolateral cordotomy is followed
by a review of the anatomy and neurophysiology of the spinothalamic tract. Then a
report is presented of the results of 40 percutaneous cordotomies carried out on 
32 patients at the Department of Neurosurgery, University of Graz. Operative
procedure, indications and advantages of this functional operation are discussed.

Publication Types: 
    English Abstract

PMID: 276205 [PubMed - indexed for MEDLINE]

8531: ZFA (Stuttgart). 1978 May 20;54(14):783-94.

[Radiotherapy of neurologic diseases]

[Article in German]

Walther E.

PMID: 664824 [PubMed - indexed for MEDLINE]

8532: MMW Munch Med Wochenschr. 1978 May 12;120(19):653-6.

[Trigeminal neuralgia and its differential diagnosis (author's transl)]

[Article in German]

Dieckmann H.

Trigeminal neuralgia (Tr. N.) occurring as tic douloureux usually proves to be
senile neuralgia without any etiological background. On the other hand, isolated 
Tr. N. of the first ramus suggests the process. Bilateral Tr. N. are rare yet
most frequently an expression of a multiple sclerosis with attacks first on one
side and then on the other. Symptomatic Tr. N. occurs seldom as perhaps in M.S., 
only as tic douloureux, usually as a continuous pain with more or less acute
exacerbations. Tr. N. are therapeutically problematic after operative treatment
of the maxillary sinuses, still more so after herpes zoster. Other neuralgias and
facial neuralgias (e.g. a glossopharyngeal neuralgia, nasociliary neuralgia,
Sluder's neuralgia, Costen's syndrome, Horton's syndrome etc.) must be
diagnostically differentiated from Tr. N.

Publication Types: 
    English Abstract

PMID: 306538 [PubMed - indexed for MEDLINE]

8533: Minerva Med. 1978 May 5;69(22):1517-22.

[Amyotrophy caused by herpes zoster. Description of 5 cases]

[Article in Italian]

Artuso G, Ferrari G, Fiaschi A.

Radicular paralysis is the most frequent, though usually less serious,
complication of Herpes Zoster, being observed in rather less than 5% of patients.
The site affected--leaving aside exceptional cases--it that of the gangliar and
radicular district where the eruption occurs. A clinical and neurophysiological
study was made of 5 patients with loss of strength and trophism on the part of
muscles in the eruption site within 2 to 5 weeks after the onset of Herpes.
Routine blood chemistry tests were run, together with spinal puncture in three
cases. The EMG data pointed to variously severe neurogenic distress referable to 
myeloradicular involvement. Subsequent clinical and EMG controls demonstrated
gradual, though slow improvement. This finding is in line with the literature
data.

Publication Types: 
    Case Reports
    English Abstract

PMID: 683555 [PubMed - indexed for MEDLINE]

8534: JAMA. 1978 May 5;239(18):1877-9.

Evaluation of zoster immune plasma. Treatment of cutaneous disseminated zoster in
immunocompromised patients.

Groth KE, McCullough J, Marker SC, Howard RJ, Simmons RL, Najarian JS, Balfour HH
Jr.

Zoster immune plasma (ZIP) was evaluated for treatment of cutaneous disseminated 
zoster in immunocompromised hosts. Twenty patients were studied: 13 were enrolled
in a double-blind protocol, five received ZIP under an open protocol, and two
were observed without receiving a transfusion. In the double-blind study, eight
patients actually received ZIP; five were given plasma lacking varicella-zoster
virus antibodies (control plasma). The clinical course of zoster in the group
given ZIP was the same as that of patients given control plasma or no
transfusions. Because ZIP did not alter the clinical course of zoster and because
zoster patients produced high-antibody titers without ZIP, we concluded that ZIP 
is not useful for treatment of cutaneous disseminated zoster and should be
reserved for prevention or modification of varicella in exposed, susceptible
immunocompromised patients.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 205687 [PubMed - indexed for MEDLINE]

8535: N Engl J Med. 1978 May 4;298(18):981-7.

Human leukocyte interferon for the treatment of herpes zoster in patients with
cancer.

Merigan TC, Rand KH, Pollard RB, Abdallah PS, Jordan GW, Fried RP.

We tested the effect of human leukocyte interferon on early localized herpes
zoster infections in three placebo-controlled, randomized double-blind trials
involving 90 patients with cancer. There were no significant differences in
pretreatment severity of infection or nature of underlying disease in the groups.
Higher dosages of more purified interferon in the second and third trials
produced a significant (P less than or equal to 0.01) decrease in cutaneous
dissemination. No dissemination occurred in those receiving the highest dosage
(5.1 x 10(5) U per kilogram per day) (P less than or equal to 0.025). The number 
of days of new-vesicle formation in the primary dermatome decreased (mean, 2.3
days, P less than or equal to 0.05) in this group. Treated patients had a trend
toward less acute pain, and significantly (P less than or equal to 0.05)
diminished severity of post-herpetic neuralgia, at the two highest dosage levels.
Visceral complications were six times less frequent in interferon recipients.
High-dosage interferon appeared effective in limiting cutaneous dissemination,
visceral complications and progression within the primary dermatome.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 347294 [PubMed - indexed for MEDLINE]

8536: Ann Neurol. 1978 May;3(5):388-92.

Papulosis atrophicans maligna (Kohlmeier-Degos disease): a disseminated occlusive
vasculopathy.

McFarland HR, Wood WG, Drowns BV, Meneses AC.

Malignant atrophic papulosis usually presents as pathognomonic skin lesions
followed by acute abdominal pain, bowel perforation, peritonitis, and death. Rare
patients who may lack gastrointestinal symptoms present with central nervous
system manifestations, including headache, paresthesias, weakness, and rapid
deterioration to death. The patient reported here was a 47-year-old man whose
neurological symptoms apparently preceded his cutaneous lesions. His course
consisted of a disseminated neurological disease and exacerbated following a
herpes zoster infection. His condition rapidly deteriorated despite
corticotropin, glucocorticoids, and low-molecular-weight dextran. Necropsy
revealed a disseminated occlusive vasculopathy and diffuse encephalomyelomalacia 
of the brain and spinal cord. A review of autopsied patients with central nervous
system involvement is provided.

Publication Types: 
    Case Reports

PMID: 727717 [PubMed - indexed for MEDLINE]

8537: Rev Laryngol Otol Rhinol (Bord). 1978 May-Jun;99(5-6):307-22.

[Idiopathic facial paralysis and facial paralysis due to herpes zoster (follow-up
and therapeutic indications)]

[Article in French]

Fleury P, Basset JM, Compere JF.

Publication Types: 
    English Abstract

PMID: 705103 [PubMed - indexed for MEDLINE]

8538: Aust Fam Physician. 1978 May;7(5):497-503.

The long term complications of viral illness.

Boughton CR.

PMID: 666663 [PubMed - indexed for MEDLINE]

8539: Mayo Clin Proc. 1978 May;53(5):336-8.

Herpes zoster reactivation of phantom limb pain.

Wilson PR, Person JR, Su DW, Wang JK.

A case is reported in which a herpes zoster infection caused recurrence of
phantom limb pain in a man whose left arm had been amputated 7 years previously. 
It is, to our knowledge, the first such case reported, and it shows the
importance of peripheral mechanisms in the generation of phantom limb pain.

Publication Types: 
    Case Reports

PMID: 642600 [PubMed - indexed for MEDLINE]

8540: Pediatr Clin North Am. 1978 May;25(2):339-55.

Viral infections of the skin. Herpes simplex, herpes zoster, warts, and molluscum
contagiosum.

Jarratt M.

Publication Types: 
    Review

PMID: 353674 [PubMed - indexed for MEDLINE]

8541: Practitioner. 1978 May;220(1319):723-33.

Eye problems.

Stokoe NL.

PMID: 307244 [PubMed - indexed for MEDLINE]

8542: Stomatol DDR. 1978 May;28(5):318-25.

[Pyoderma and dermatoviroses in the maxillofacial region]

[Article in German]

Kleine-Natrop HE.

PMID: 276955 [PubMed - indexed for MEDLINE]

8543: J Infect Dis. 1978 May;137(5):531-40.

Selective impairment of lymphocyte reactivity to varicella-zoster virus antigen
among untreated patients with lymphoma.

Arvin AM, Pollard RB, Rasmussen LE, Merigan TC.

Herpes zoster is a frequent complication of lymphoreticular malignancy. In this
study two assays of in vitro cellular immune response to varicella-zoster virus
(VZV) antigen, lymphocyte transformation and interferon production, were
performed in normal subjects with recent and remote VZV infection. The responses 
of patients with lymphoma were measured before treatment and during long-term
remission and then compared with those of normal subjects. Despite levels of
antibody to VZV that were equivalent to those in normal subjects, 44% of the
untreated lymphoma patients showed a lower transformation response to VZV antigen
than the normal patients. Production of interferon in response to VZV antigen was
absent in 32% of the untreated patients. In contrast, lymphocyte responses in
untreated patients to herpes simplex virus antigen were within the range observed
in a normal population. Interferon production by lymphocytes in response to
cytomegalovirus antigen was also lower among untreated lymphoma patients than
among normal patients, but lymphocyte transformation was not. Twenty-two percent 
of lymphoma patients in long-term remission continued to have diminished cellular
immune responses to VZV antigen. Observations in these patient populations and in
normal subjects with acute herpes zoster suggest that deficiencies in in vitro
lymphocyte responses may correlate with increased susceptibility to clinical
infection with VZV.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 207782 [PubMed - indexed for MEDLINE]

8544: Harefuah. 1978 Apr;94(7-8):243-4.

[Treatment of herpes zoster and chicken pox]

[Article in Hebrew]

Rubinstein E.

Publication Types: 
    Editorial

PMID: 669464 [PubMed - indexed for MEDLINE]

8545: Ann Neurol. 1978 Apr;3(4):374-5.

Granulomatous angiitis with preceding varicella zoster.

Rosenblum WI, Hadfield MG, Young HF.

Publication Types: 
    Letter

PMID: 666286 [PubMed - indexed for MEDLINE]

8546: Wiad Lek. 1978 Apr 1;31(7):477-8.

[2 cases of Ramsay-Hunt syndrome]

[Article in Polish]

Marks E.

Publication Types: 
    Case Reports
    English Abstract

PMID: 664679 [PubMed - indexed for MEDLINE]

8547: Probl Gematol Pereliv Krovi. 1978 Apr;23(4):48-51.

[Herpes zoster in lymphogranulomatosis patients]

[Article in Russian]

Unukova EN, Kuznetsov VP, Kaverzneva MM.

PMID: 652754 [PubMed - indexed for MEDLINE]

8548: SSO Schweiz Monatsschr Zahnheilkd. 1978 Apr;88(4):446-50.

[Multiple "granulomas" of unknown origin; a clinical case]

[Article in French]

Roulet JF, Martin R.

A case of multiple mandibular periapical radiolucencies (granuloma) with unknown 
etiology is presented. A connection with herpes zoster, which formerly had
occurred in the same area could not be found. Several theories are discussed,
however none of them seem to fit the case inspite of thorough examination.

Publication Types: 
    Case Reports
    English Abstract

PMID: 274813 [PubMed - indexed for MEDLINE]

8549: Antimicrob Agents Chemother. 1978 Apr;13(4):613-7.

5,6-Dihydro-5-azathymidine: in vitro antiviral properties against human
herpesviruses.

Renis HE.

5,6-Dihydro-5-azathymidine (DHAdT), a novel water-soluble nucleoside antibiotic, 
inhibits herpes simplex virus type 1 (HSV-1) in appropriately infected cell
cultures to a greater extent than herpes simplex virus type 2 (HSV-2). Vaccinia
virus was less susceptible than HSV-2, and pseudorabies virus yields were not
reduced at the concentrations studied. Plaque formation by varicella-zoster virus
was suppressed by DHAdT. DHAdT was slightly toxic to cells at concentrations that
were inhibitory for HSV-1 and varicella-zoster virus. Thymidine and deoxyuridine 
completely reversed the anti-HSV-1 activity of DHAdT, whereas deoxycytidine was
partially effective. Compared with other nucleoside analogs with activity for
HSV-1, DHAdT was less active than 5-iodo-2'-deoxyuridine or
1-beta-d-arabinofuranosylcytosine and nearly equipotent with
9-beta-d-arabinofuranosyladenine.

PMID: 208459 [PubMed - indexed for MEDLINE]

8550: JAMA. 1978 Mar 13;239(11):1034-5.

Varicella-zoster virus vaccine.

Brunell PA.

Publication Types: 
    Letter

PMID: 203727 [PubMed - indexed for MEDLINE]

8551: Ann Otolaryngol Chir Cervicofac. 1978 Mar;95(3):240-8.

[Effect of herpes zoster virus on the facial nerve (apropos of 33 cases)]

[Article in French]

Bremond G, Garcin M, Magnan J, Pech-Gourg F, Acotto J.

PMID: 666227 [PubMed - indexed for MEDLINE]

8552: Pediatr Pol. 1978 Mar;53(3):389-91.

[Case of congenital zoster]

[Article in Polish]

Kacprzak-Bergman I, Jankowski A.

Publication Types: 
    Case Reports

PMID: 652428 [PubMed - indexed for MEDLINE]

8553: Arch Surg. 1978 Mar;113(3):253-4.

Epidural injection of local anesthetic and steroids for relief of pain secondary 
to herpes zoster.

Perkins HM, Hanlon PR.

We treated 12 cases of cutaneous herpes zoster (HZ) with epidural bupivacaine and
methylprednisolone acetate. Treatment was effective for HZ of less than seven
weeks' duration. The course of HZ of greater than three months' duration
(postherpetic neuralgia) was not improved. The administration of epidural
bupivacaine plus methylprednisolone acetate was no more effective than when
bupivacaine alone was used. Epidural injection of bupivacaine with or without
methylprednisolone acetate is the treatment of choice for the pain of cutaneous
HZ.

PMID: 580364 [PubMed - indexed for MEDLINE]

8554: Bull Soc Ophtalmol Fr. 1978 Mar;78(3):241.

[Blepharorraphy using fascia lata (proceedings)]

[Article in French]

Chassaing J.

Publication Types: 
    Case Reports

PMID: 311702 [PubMed - indexed for MEDLINE]

8555: Am J Ophthalmol. 1978 Mar;85(3):378-82.

Orbital apex syndrome secondary to herpes zoster ophthalmicus.

Kattah JC, Kennerdell JS.

Two women, one with Hodgkin's disease and the other with no malignancy, developed
herpes zoster with optic neuropathy and total ophthalmoplegia. Both patients
developed an associated mild meningoencephalitis with a predominantly lymphocytic
spinal fluid reaction that cleared spontaneously. The patient with Hodgkin's
disease suffered a protracted course of the disease and developed a secondary
bacterial endophthalmitis that necessitated an envisceration of the left eye. The
patient without evidence of immunologic deficit recovered quickly with
administration of corticosteroids.

Publication Types: 
    Case Reports

PMID: 306754 [PubMed - indexed for MEDLINE]

8556: Hautarzt. 1978 Mar;29(3):147-52.

[Severe generalized courses of zoster due to cellular immunologic defects.
Importance of an absolute or relative T-cell deficiency]

[Article in German]

Runne U.

Four patients with chronic lymphatic leukaemia, M. Hodgkin and metastatic breast 
carcinoma developed particularly severe generalised herpes zoster, with
complications of herpes zoster pneumonia, signs of encephalitis and phrenic nerve
paresis. Virus specific complement-fixing antibodies increased regularly or
delayed, without strict correlation to the clinical course. However, in all these
cases there was a relative or absolute deficiency of T-lymphocytes in the
peripheral blood, as a result of the underlying illness and of treatment with
cytostatic agents. Because of the vital role of cell-mediated immunity in the
control of the varicella-zoster virus (VZV), the observed T-cell deficiency seems
to be an important pre-condition for the development of severe generalised herpes
zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 305913 [PubMed - indexed for MEDLINE]

8557: Biken J. 1978 Mar;21(1):15-23.

Studies on neutralization of varicella-zoster virus and serological follow-up of 
cases of varicella and zoster.

Asano Y, Takahashi M.

PMID: 208504 [PubMed - indexed for MEDLINE]

8558: Vopr Virusol. 1978 Mar-Apr;(2):247-51.

[Rapid diagnosis of infections caused by the chickenpox-herpes zoster viruses]

[Article in Russian]

Mal'tseva NN, Marennikova SS, Ertte AP, Avdeenko MM.

A diagnostic preparation for the indirect hemagglutination test (IHA) was
obtained by sensitization of fixed tannin-treated sheep erythrocytes with
IgG-fractions from human herpes zoster convalescent sera. A high specificity of
the preparation was established in comparative experiments. It could detect the
varicella-herpes-zoster virus antigen in 100% of specimens from patients. The IHA
test with this erythrocyte diagnostic preparation is simple, economic, gives the 
results within 1-1 1/2 hours after the specimens arrive in the laboratory. A
great advantage of this test ipesviruses.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 208309 [PubMed - indexed for MEDLINE]

8559: Arthritis Rheum. 1978 Mar;21(2):238-42.

Hyporesponsiveness of lymphocytes to virus antigens in rheumatoid arthritis.

Wolf RE.

The immune response of peripheral blood lymphocytes to measles, rubella,
parainfluenza types 1, 2, and 3 RNA virus antigens and to varicella-zoster and
herpes virus type 1 DNA virus antigens was evaluated in 14 patients with
rheumatoid arthritis (RA) and 14 matched controls by assessing 3H-thymidine
incorporation. The results demonstrated hyporesponsivenss of lymphocytes from RA 
patients to virus antigens and phytohemagglutinin (PHA), which did not appear to 
be nonspecific because of a lack of correlation between response to virus
antigens and response to mitogens. The patterns of decreased responsiveness was
suggestive of a relative restriction of hyporesponsiveness to RNA virus antigens.

Publication Types: 
    Comparative Study
    In Vitro
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 205223 [PubMed - indexed for MEDLINE]

8560: Odontostomatol Proodos. 1978 Mar-Apr;32(2):68-75.

[Clinical study of 227 cases of herpes zoster]

[Article in Greek, Modern]

Katsampas A, Laskares G, Kapetanakes I.

Publication Types: 
    English Abstract

PMID: 111183 [PubMed - indexed for MEDLINE]

8561: Br Med J. 1978 Feb 11;1(6109):343-4.

Prognosis of the Ramsay Hunt syndrome.

Heathfield KW, Mee AS.

Thirty-six cases of herpes zoster complicated by facial paralysis (the Ramsay
Hunt syndrome) seen over 10 years were reviewed to determine the subjective
degree of recovery (ascertained by questionnaire) and residual disability
(ascertained by re-examination). Eighteen patients made a full recovery, most
within three months; 14 patients were left with only mild residual signs. In only
four patients was the final result regarded as unsatisfactory. Outcome was not
adversely influenced by age. The facial paralysis of the Ramsay Hunt syndrome
thus carries a generally favourable prognosis.

PMID: 623985 [PubMed - indexed for MEDLINE]

8562: JAMA. 1978 Feb 6;239(6):518-9.

Ophthalmology.

Blodi FC.

PMID: 304494 [PubMed - indexed for MEDLINE]

8563: Otolaryngol Clin North Am. 1978 Feb;11(1):63-9.

Viral causes of sudden inner ear deafness.

Jaffe BF.

Clinical, pathologic, and laboratory studies suggesting a viral etiology for
sudden deafness have been presented. Although a cause and effect relationship has
not been proven, the frequent close association between viral infection and
sudden deafness constitutes a strong argument in favor of a viral etiology of
sudden deafness in about one of three patients with sudden deafness.

PMID: 662357 [PubMed - indexed for MEDLINE]

8564: Cesk Otolaryngol. 1978 Feb;27(1):29-32.

[Association of herpes zoster with facial nerve paralysis]

[Article in Czech]

Hybasek I, Kristenova I.

Publication Types: 
    Case Reports
    English Abstract

PMID: 657322 [PubMed - indexed for MEDLINE]

8565: Haematologica. 1978 Feb;63(1):56-60.

Treatment with transfer factor of herpes zoster varicella infection in Hodgkin's 
disease.

Silvino G, Rubertelli M, Cristofolini M, Sagramoso Z, Pisciolli F, Dalri P.

Publication Types: 
    Case Reports

PMID: 417972 [PubMed - indexed for MEDLINE]

8566: Klin Oczna. 1978 Feb;48(2):71-2.

[Ophthalmic zoster treated with cytosine arabinoside (author's transl)]

[Article in Polish]

Peterlejtner E.

Publication Types: 
    Case Reports
    English Abstract

PMID: 306475 [PubMed - indexed for MEDLINE]

8567: Oral Surg Oral Med Oral Pathol. 1978 Feb;45(2):214-9.

Intraoral isolated herpes zoster.

Eisenberg E.

A case of herpes zoster limited to the right palate and the edentulous alveolar
ridge in the absence of concurrent skin lesions or predisposing systemic disease 
is presented. Because of the relative rarity of isolated mucous membrane lesions 
of this viral disease, the tendency for intraoral vesicles to break down and
ulcerate early, and, in this patient, the additional clinical findings of marked 
swelling and induration, malignancy rather than herpes zoster was suspected;
cytologic smear furthered the suggestion of the former. A biopsy provided the
definitive diagnosis.

Publication Types: 
    Case Reports

PMID: 272603 [PubMed - indexed for MEDLINE]

8568: J Clin Microbiol. 1978 Feb;7(2):114-7.

Immune adherence hemagglutination test applied to the study of herpes simplex and
varicella-zoster virus infections.

Gillani A, Spence L.

The immune adherence hemagglutination (IAHA) test has been used successfully to
detect antibody to herpes simplex (HS) virus and varicella-zoster (V-Z) virus.
Comparative studies between the complement-fixation (CF) test and the IAHA test
revealed that, in most cases, the IAHA test was more sensitive than the CF test. 
Furthermore, diagnosis on the basis of a fourfold change in antibody titer was
made more rapidly by the IAHA test. The IAHA test was found to be a very simple
and practical technique requiring only a few hours for completion compared with
the conventional CF test which required up to 24 h. In addition, both sera and
cerebrospinal fluids could be tested in very low dilutions in the IAHA test, so
that very low levels of antibody could be detected. Also, the IAHA test detected 
antibody to V-Z virus more frequently than did the CF test in adults with a
history of varicella occurring 9 to 30 years prior to sampling. The level of
cross-reaction between HS and V-Z viruses was examined by both the CF test and
the IAHA test, and no major differences between the two techniques were found.

Publication Types: 
    Comparative Study

PMID: 204662 [PubMed - indexed for MEDLINE]

8569: J Fr Ophtalmol. 1978 Feb;1(2):133-8.

[Light and electron microscopy in one case of herpes zoster keratitis (author's
transl)]

[Article in French]

Berard M, Merlihot JM, Mouillac-Gambarelli N, Choux R, Andrac L.

One case of herpes zoster keratitis studied after corneal graft is described.
Light and electron microscopy investigations show severe pathological changes
under the coneal epithelium: Bowman's layer disruption, superficial stromal
alterations, sub-epithelial phagocyte proliferation with lipid and
mucopolysaccharid vacuolar deposits, abnormal vascularization of the posterior
stroma. The authors stress on this interesting ultrastructural study because of
very rare cases of the same disease reported in the literature.

Publication Types: 
    Case Reports
    English Abstract

PMID: 149810 [PubMed - indexed for MEDLINE]

8570: Br Med J. 1978 Jan 21;1(6106):177.

Cervical herpes zoster and shoulder pain.

Eban R.

Publication Types: 
    Case Reports
    Letter

PMID: 620251 [PubMed - indexed for MEDLINE]

8571: Br Med J. 1978 Jan 7;1(6104):49.

Bell's palsy and herpes simplex.

Juel-Jensen BE.

Publication Types: 
    Case Reports
    Letter

PMID: 620152 [PubMed - indexed for MEDLINE]

8572: Actas Dermosifiliogr. 1978 Jan-Feb;69(1-2):41-52.

[Childhood herpes zoster. Apropos of 14 cases]

[Article in Spanish]

Naranjo R, Delgado V, Armijo Lozano R, Camacho F, De Dulanto F, Herrera E, Armijo
M.

Publication Types: 
    English Abstract

PMID: 749559 [PubMed - indexed for MEDLINE]

8573: Contemp Anesth Pract. 1978;1:55-70.

An outpatient pain service.

Howland DE, Howland LA.

PMID: 738054 [PubMed - indexed for MEDLINE]

8574: Cesk Dermatol. 1978;53(5):303-7.

[Immunological study of patients with herpes zoster. I. General immunological
reactivity (author's transl]

[Article in Czech]

Vacek Z, Doutlik S, Hanakova L, Vasickova M, Fadrhoncova A.

Publication Types: 
    English Abstract

PMID: 729012 [PubMed - indexed for MEDLINE]

8575: Klin Monatsbl Augenheilkd. 1978;172(6):876-9.

[Cotton thread method for measuring lacrimation (author's transl)]

[Article in German]

Kurihashi K.

Instead of filter paper, a fine cotton thread was used. One test consists of 3 or
more consecutive measurements. Six patients with Hunt's syndrome were tested with
this new method. All of the six showed lacrimal deficiency on the involved side.

Publication Types: 
    English Abstract

PMID: 692022 [PubMed - indexed for MEDLINE]

8576: Neurol Neurochir Pol. 1978 Jan-Feb;12(1):97-100.

[Atypical case of the Ramsay-Hunt syndrome]

[Article in Polish]

Filar H, Zelazny S.

The authors report a case of Ramsay-Hunt syndrome during cervical zoster in the
C2--C4 area. The case reserves attention in view of the fact that facial nerve
paralysis and paralysis of both parts of the right acoustic nerve occurred as a
second exacerbation of the disease 16 days after the onset. Permanent hearing
impairment in the right ear after regression of facial nerve paralysis and
paralysis of the vestibular part of the acoustic nerve were also exceptionally
rare signs.

Publication Types: 
    Case Reports
    English Abstract

PMID: 634439 [PubMed - indexed for MEDLINE]

8577: Cancer. 1978 Jan;41(1):95-9.

Herpes zoster and varicella infections in children with Hodgkin's disease: an
analysis of contributing factors.

Reboul F, Donaldson SS, Kaplan HS.

181 children with Hodgkin's disease were analyzed with respect to the occurrence 
of herpes zoster and varicella (HZ-V) infections, possible contributing factors, 
and prognostic significance. The overall frequency of HZ-V was 34.8%. The
occurrence in stage I was significantly lower than in other stages. Previous
splenectomy was not found to increase significantly the risk of infection.
High-risk patients were those receiving extensive radiotherapy plus combination
chemotherapy; 56% developed HZ-V infections in this group. The frequency with
extensive field radiotherapy alone was 23.8%. 80% of infections occurred during
the first year after completion of treatment. Their occurrence was not a poor
prognostic sign in terms of relapse or fatality, even when occurring late. The
high frequency of disseminated infection (27%) with its subsequent morbidity
should lead toward a better understanding of the immunologic deficiencies in
these patients and the possible role of prophylactic measures, in patients
undergoing extensive radiotherapy in combination with multiagent chemotherapy.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 626945 [PubMed - indexed for MEDLINE]

8578: Vrach Delo. 1978 Jan;(1):116-8.

[Treatment of herpes zoster with dimethyl sulfoxide]

[Article in Russian]

Grushkov VM, Todoriv VD.

Publication Types: 
    Case Reports
    English Abstract

PMID: 625924 [PubMed - indexed for MEDLINE]

8579: Z Hautkr. 1978 Jan 1;53(1):5-9.

[Lichen planus zosteriformis]

[Article in German]

Nagy G, Husz S, Szucs L.

Publication Types: 
    Case Reports

PMID: 622849 [PubMed - indexed for MEDLINE]

8580: Geriatrics. 1978 Jan;33(1):95-101.

Differentiating the causes of chest pain.

Zoob M.

PMID: 620930 [PubMed - indexed for MEDLINE]

8581: Scand J Infect Dis. 1978;10(1):21-7.

Effect of transfer factor and zoster immunoglobulin in patients with
varicella-zoster infection and malignancy.

Winsnes R, Froland SS, Degre MI.

Immunotherapy was given to 13 patients suffering from lymphoproliferative
diseases complicated by varicella-zoster (VZ) infection. Five patients received
transfer factor (TF) only, 6 received TF and zoster immunoglobulin (ZIG), and 2
received ZIG only. ZIG did not seem to alter the course of the infection.
Cessation of vesicle formation and initiation of crust formation took place
within 1 day after the first injection of TF in 5 patients with a localized
zoster. In 4 patients suffering from an early dissemination of VZ infection,
cessation of vesicle formation took place within 1 day (1 patient), 2 days (1
patient), 3 days (1 patient) or 4 days (1 patient) after the first injection of
TF. An increase in serum interferon was observed in 4 of 9 patients who received 
TF, while no increase in serum interferon was observed in the control groups.
Administration of a high-titer ZIG preparation did not seem to depress the
humoral antibody response when combined with TF therapy. Therapy with TF in
combination with ZIG seemed to have a beneficial effect in patients with
malignancy when administered early in the acute VZ infection.

PMID: 580314 [PubMed - indexed for MEDLINE]

8582: Proc Eur Dial Transplant Assoc. 1978;15:289-98.

Complement components, degradation products and immune complexes after kidney
transplantation.

Wegmuller E, Louis J, Hodler J.

Levels of complement components and the presence of immune complexes were
determined in blood samples from 23 patients is a function of time after kidney
transplantation. During the first three post-transplantation weeks a decrease in 
the concentration of plasma C3 with a simultaneous increase of one of its
breakdown products (C3d) was generally observed. This pattern often accompanied
acute rejection episodes beyond 4 weeks after transplantation, while in the
absence of complications normal and stable levels prevailed. In contrast, the
presence of circulating immune complexes appeared not to correlate with rejection
reactions. All 7 cases with detectable immune complexes presented with various
concomitant neoplastic (renal carcinoma, Kaposi sarcoma) or infectious diseases
(pneumonia, septicaemia, Herpes zoster or Cytomegalovirus infection). Thus,
monitoring of plasma C3 and C3d may represent a helpful additional criterion for 
the assessment of acute rejection in recipients of kidney allografts; the
presence of circulating immune complexes, although not correlating with graft
rejection, may be taken as a sign of complicating additional disease.

PMID: 368776 [PubMed - indexed for MEDLINE]

8583: Otolaryngol Pol. 1978;32(1):101-3.

[Generalized herpes zoster in the course of reticulosarcoma histiocyticum of the 
tonsil]

[Article in Polish]

Bialowas J, Hervy T.

Publication Types: 
    Case Reports

PMID: 351520 [PubMed - indexed for MEDLINE]

8584: Dent Update. 1978 Jan-Feb;5(1):25, 62.

Picture quiz: basal cell carcinoma, herpes zoster and a dental sinus.

[No authors listed]

PMID: 290519 [PubMed - indexed for MEDLINE]

8585: Klin Padiatr. 1978 Jan;190(1):73-82.

[Treatment of ALL in children. Results and side effects with a modification of
protocol memphis VII (author's transl)]

[Article in German]

Wehinger H, Furste HO, Imm W, Luthardt T, Sauer M, Slania J, Dilger M.

42 patients with ALL were treated according to the following protocol: induction 
with vincristine + prednisone (+/- L-asparaginase), CNS-prophylaxis with cranial 
irradiation (2400 rads) and intrathecal methotrexate, maintenance for 3 years
with 6-MP 50 mg/m2/d p.o. + MTX 75-150 mg/m2/2 wk i.v. X 4, alternating in a
cyclic fashion with 6-MP 50 mg/m2/d p.o. + cyclophophshamide 600 mg/m2/2 wk i.v. 
X 4. The observation time is 24-67 (median 49) months. The actuarial complete
remission curve shows 40% continuous complete remissions at 36 months and 30% at 
60 months.--The frequency and temporal distribution of typical infectious
complications are presented. The incidence of varicella was comparable to that in
a southgerman normal control group (5,7% per year). During treatment there were
two zoster manifestations per one varicella case, the incidence of zoster being 1
case per 106 patient-months, viz 11,4% per year.

Publication Types: 
    English Abstract

PMID: 273117 [PubMed - indexed for MEDLINE]

8586: IARC Sci Publ. 1978;(24 Pt 2):991-7.

Effect of ara-T on the replication of herpes simplex virus, varicella-zoster
virus and cytomegalovirus.

Miller RL, Iltis JP, Rapp F.

The thymidine analogue, 1-beta-arabinofuranosylthymine (ara-T), has previously
been found to selectively inhibit herpes simplex virus (HSV) replication. At a
relatively non-toxic concentration (50 microgram/ml), ara-T reduced HSV yields by
a factor of 10,000-100,000. Ara-T was also effective in inhibiting the
replication of variecella-zoster virus (VZV) in vitro in human embryo
fibroblasts, completely preventing VZV-specific cytopathic effects (CPE). Ara-T
reduced the cell-free virus and plaque-forming cell (PFC) yields of VZV as well
as of the simian varicella-like virus, Delta herpesvirus. In contrast to HSV and 
VZV, cytomegalovirus (CMV) replication was relatively resistant to ara-T. Neither
CPE nor the incorporation of 3H-thymidine into acid-insoluble material in
CMV-infected cells was markedly affected. Interpretation of these results with
regard to virus-induced deoxypyrimidine kinase is discussed.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 221418 [PubMed - indexed for MEDLINE]

8587: IARC Sci Publ. 1978;(24 Pt 2):745-51.

Lymphocyte transformation and interferon production as measures of cellular
immunity in lymphoma patients.

Arvin AM, Pollard RB, Rasmussen LE, Rand KH, Merigan TC.

Our studies of in vitro cellular immune responses to herpesviruses have shown
that, before treatment, lymphoma patients have decreased transformation to
varicella-zoster virus antigen compared to herpes simplex virus and
cytomegalovirus antigens. Interferon production to varicella-zoster virus and
cytomegalovirus antigens is also decreased. During the first six months of
treatment, decreased lymphocyte transformation and interferon production to all
herpesviral antigens was observed. Among patients in long-term remission,
recovery from the suppression associated with treatment was noted except that
interferon production to varicella-zoster virus antigen remained decreased.

Publication Types: 
    In Vitro

PMID: 221398 [PubMed - indexed for MEDLINE]

8588: IARC Sci Publ. 1978;(24 Pt 1):87-96.

Characterization of human varicella-zoster virus DNA.

Hyman RW, Iltis JP, Oakes JE, Rapp F.

The DNA of varicella-zoster virus (VZV) has been characterized by sucrose
gradient sedimentation, restriction enzyme cleavage with either EcoRI or HindIII 
site-specific endonucleases, and by isopycnic banding in caesium chloride.
Comparisons of the DNAs from different clinical isolates have been made. DNAs
from VZVs isolated from either varicella or herpes zoster are indistinguishable
on the basis of size and restriction enzyme cleavage pattern. The buoyant density
in caesium chloride of the DNA of VZV isolated from varicella was reproducibly
slightly lower than that of the DNA of VZV isolated from herpes zoster.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 221365 [PubMed - indexed for MEDLINE]

8589: Adv Exp Med Biol. 1978;110:175-91.

Results of a five-year study of the curative effect of double stranded
ribonucleic acid in viral dermatoses and eye diseases.

Borecky L, Buchvald J, Adlerova E, Stodola I, Obrucnikova E, Gruntova Z, Lackovic
V, Doskocil J.

Double stranded RNA obtained from non-permissive E. coli cells infected with
f2-phage was tested in 5 hospitals in viral dermtoses such as herpes simplex
recidivans, herpes zoster, male genikeratonconjunctivitis herpetica and
conjunctivitis lignosa. The results of clinical tests indicate that the
preparation of phage double stranded RNA applied topically is harmless for man
and has, in the majority of cases, a beneficial effect in the disease. This
conclusion was based on the judgment of physicians, opinion of patients expressed
in a questionnaire, and, results of a double-blind experiment.

Publication Types: 
    Clinical Trial
    Comparative Study
    Controlled Clinical Trial

PMID: 215011 [PubMed - indexed for MEDLINE]

8590: Major Probl Clin Pediatr. 1978;19:184-208.

Viral infections.

Weintraub R.

In summary, viral infections of the skin that occur at adolescence include those 
typical of childhood and those associated with sexual maturity. Herpes simplex
Type II, molluscum contagiosum, and venereal warts, diseases that have shown a
marked increase, are in the latter group. Certain diseases, such as rubella,
herpes simplex, varicella, and condylomata acuminata, which may lead to laryngeal
papillomas, are particularly important because of their effects on the newborn
infant. The epidemiological pattern of viral infections changes, and new viruses 
gain prominence while others fade in importance as causes of disease. Because of 
this, we can expect new viral entities and changes in earlier ones.

PMID: 211352 [PubMed - indexed for MEDLINE]

8591: Arch Virol. 1978;56(1-2):149-56.

Cytomegalovirus infection and graft survival in renal graft recipients.

Cappel R, Hestermans O, Toussaint C, Vereerstraeten P, van Beers D, de Braekeleer
J, Schoutens E.

We have studied 85 patients who received a renal transplant for CMV infection as 
well as for herpes simplex (HSV), herpes zoster (HZ), measles, mumps, rubella and
hepatitis B. We found no evidence of primary or secondary infections for the non 
herpetic viruses except for hepatitis B infection that occurred in 17 per cent of
the patients. CMV infection occurred in 87 per cent of the patients while
antibody rises to HZ and HSV occurred in 30 and 13 per cent of the patients,
respectively. The CMV infections occurred 2 to 4 months after the transplantation
(mean time 11.1 weeks) and seemed to trigger the first episode of renal rejection
that occurred earlier in the CMV infected group (mean time 12.1 weeks) than in
the uninfected group (mean time 18.6 weeks). This difference in time is highly
significant, p less than 0.001). However these CMV injections did not decrease
the longterm survival of the grafted kidneys.

PMID: 204269 [PubMed - indexed for MEDLINE]

8592: J Clin Microbiol. 1978 Jan;7(1):63-9.

Viral antibodies in cerebrospinal fluid of multiple sclerosis and control
patients: comparison between radioimmunoassay and conventional techniques.

Forghani B, Cremer NE, Johnson KP, Ginsberg AH, Likosky WH.

Cerebrospinal fluid antibodies to measles, rubella, vaccinia, herpes simplex, and
varicella-zoster viruses in four patient study groups (clinically definite
multiple sclerosis [MS], early probable MS, optic neuritis, and control patients 
with other neurological diseases) were assayed by radioimmunoassay, complement
fixation, hemagglutination-inhibition, or complement-enhanced plaque reduction
methods. Antibodies were more frequently found and at higher dilutions by
radioimmunoassay than by other techniques. Measles virus antibody, the most
frequently found antibody, was present in the cerebrospinal fluid of 72% of MS
patients and 5% of control patients. The differences between the numbers of MS
patients and control patients with antibodies to other viruses were not as
marked. Thus, 58% of MS patients versus 21% of control patients had antibody to
rubella virus, 20 versus 3% had antibody to vaccinia virus, 50 versus 33% had
antibody to herpes simplex virus, and 25 versus 8% had antibody to varicella
virus. Sixty-seven percent of MS patients and 26% of control patients had
antibodies to two or more viruses in their cerebrospinal fluid.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 203605 [PubMed - indexed for MEDLINE]

8593: J Clin Microbiol. 1978 Jan;7(1):6-11.

Quantitation of antibodies to varicella-zoster virus by immune adherence
hemagglutination.

Wong CL, Castriciano S, Chernesky MA, Rawls WE.

Immune adherence hemagglutination was compared with the complement fixation test 
as a means of measuring antibodies to varicella-zoster virus. Analysis of acute- 
and convalescent-phase sera from patients infected with varicella-zoster or with 
herpes simplex virus showed the immune adherence hemagglutination test to be more
sensitive than the complement fixation test, and greater cross-reactivity between
the two viruses appeared to be associated with the increased sensitivity. The two
assay methods were used to measure antibodies to varicella-zoster virus in 265
sera obtained from patients of different ages as well as sera from 26 patients
with leukemia. There were 35 cases where antibodies were detected by immune
adherence hemagglutination but not by complement fixation, whereas in five cases 
the converse was found. Our findings support the contention that immune adherence
hemagglutination is the method of choice for detecting antibodies to
varicella-zoster virus.

Publication Types: 
    Comparative Study

PMID: 203604 [PubMed - indexed for MEDLINE]

8594: Major Probl Clin Pediatr. 1978;17:327-47.

Prevention, treatment, and antiviral chemotherapy.

Hanshaw JB, Dudgeon JA.

Publication Types: 
    Review

PMID: 202814 [PubMed - indexed for MEDLINE]

8595: Major Probl Clin Pediatr. 1978;17:192-208.

Varicella-zoster infections.

Hanshaw JB, Dudgeon JA.

Publication Types: 
    Review

PMID: 202811 [PubMed - indexed for MEDLINE]

8596: Res Clin Stud Headache. 1978;5:102-21.

Stereotactic treatment of head and neck pain.

Gildenberg PL.

PMID: 79197 [PubMed - indexed for MEDLINE]

8597: Z Orthop Ihre Grenzgeb. 1978;116(2):199-203.

[The Sudeck-Leriche syndrome as a disturbance in distant regions of the body,
clinical picture, and histology (author's transl)]

[Article in German]

Kirsch K.

On the whole, every Sudeck-Leriche syndrome represents a serious complication.
The causal noxae are various in nature. In a large case material during a period 
of observation extending over 26 years a Sudeck-Leriche syndrome was observed as 
a disturbance in distant regions of the body only in rare cases, for example
after herpes zoster, apoplexy, and confusion of the cervical part of the medulla,
with cervical and lumbal root irritations, etc. Histological findings in the case
of Sudeck-Leriche syndrome are very rarely presented in literature. Histological 
investigations by the author carried out on muscle tissue in the case of
Sudeck-Leriche syndrome yielded remarkable findings with a transition from
functional to morphologically irreversible alterations. These alterations were
present both in vessels and muscle fibers.

Publication Types: 
    English Abstract

PMID: 77594 [PubMed - indexed for MEDLINE]

8598: Ann Anesthesiol Fr. 1978;19(5):417-21.

[Transcutaneous electrotherapy in the treatment of chronic post-zoster pain]

[Article in French]

Salar G.

Transcutaneous electrotherapy has been employed in 112 patients with chronic
pains of various origins. The immediate and long term results are not considered,
at whole, satisfactory, especially for length and quality of the obtained
improvement. Only patients with chronic post-zoosterian neuralgia had good
results, or immediate either at long term, especially in intercostal pains. In
the contrary in acute cases of this nevralgia, there were not satisfactory
improvements.

Publication Types: 
    English Abstract

PMID: 29537 [PubMed - indexed for MEDLINE]

8599: Ann Anesthesiol Fr. 1978;19(5):409-16.

[Transcutaneous electroanalgesia in peripheral deafferentation syndromes]

[Article in French]

Sindou M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 29536 [PubMed - indexed for MEDLINE]

8600: Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1977 Dec 31;205(1):29-32.

A search for serum antibodies in Adie's syndrome.

Thompson HS, Burmeister LF, Meek ES.

Serum specimens from a large number of patients with Adie's syndrome were checked
for virus antibody levels: Measles hemagglutination inhibition (HI),
parainfluenza types I, II and III (HI), Epstein-Barr immunofluorescence, Mumps
complement fixation (CF), Adenovirus (CF), Varicella-Zoster (CF), Herpes simplex 
(CF), Cytomegalovirus (CF), Mycoplasma hominis (CF), Toxoplasma gondii passive
hemagglutination. These antibody levels were compared with specimens from a
control group of similar age distribution and sex ratio. No statistically
significant differences between the patients with Adie's syndrome and the control
group could be demonstrated. This observation offers some indirect support to
Harriman's idea that Adie's syndrome is not due to a viral ciliary ganglionitis
but rather to an indolent neuronal degeneration in the ciliary and dorsal root
ganglia.

PMID: 304687 [PubMed - indexed for MEDLINE]

8601: Minerva Med. 1977 Dec 29;68(63):4253-6.

[Cephalic zoster with involvement of the 5th, 7th, 8th, 9th and 10th cranial
nerves]

[Article in Italian]

Cicala S, Di Ciommo V, Massini R.

A case of cephalic zoster with involvement of the 5th, 7th, 8th, 9th and 10th
left cranial nerves is described. The anatomopathological findings are surveyed. 
These show that lesions are often found in several areas of the nervous system.
The pathogenesis of these forms is examined, with particular reference to the
mechanism of involvement of several cranial nerves. It is felt that this is
primarily due to reactivation of the virus in several ganglia.

Publication Types: 
    Case Reports
    English Abstract

PMID: 202894 [PubMed - indexed for MEDLINE]

8602: Clin Ter. 1977 Dec 15;83(5):541-7.

[Treatment of degenerative and inflammatory joint diseases with or without a new 
synthetic substance (parsalmide). Controlled clinical trial]

[Article in Italian]

Napoli A, Alderuccio B, Nannetti A.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract

PMID: 343972 [PubMed - indexed for MEDLINE]

8603: Harefuah. 1977 Dec 1;93(11):362-3.

[Motor lesions in herpes zoster]

[Article in Hebrew]

Streifler M, Weiss S.

Publication Types: 
    Editorial

PMID: 608653 [PubMed - indexed for MEDLINE]

8604: J Laryngol Otol. 1977 Dec;91(12):1073-5.

Bell's palsy--Varicella Zoster and meningitis.

Yalaburgi SB, Mistry PK.

Two cases with Bell's palsy due to Varicella Zoster virus in children are
reported. It is suggested that pyogenic meningitis resulting in lowered body
resistance reactivated the latent V.Z. virus.

Publication Types: 
    Case Reports

PMID: 604398 [PubMed - indexed for MEDLINE]

8605: Pediatrics. 1977 Dec;60(6):810-4.

Clinical and serologic testing of a live varicella vaccine and two-year follow-up
for immunity of the vaccinated children.

Asano Y, Takahashi M.

A live varicella vaccine derived from the Oka strain was given on 181 children
who had no history of varicella and were seronegative by complement fixation (CF)
and neutralization (NT) tests; 125 children were hospitalized and 54 were
receiving steroid therapy. Overall, seroconversion was achieved in 85.1% of the
children by the CF test and in 97.8% by the NT test. Clinical reaction consisting
of mild fever and rash appeared in only two children. One hundred seventy-nine of
the vaccinated children were followed up by questionnaire and 51 were followed up
serologically approximately two years later, at which time 10 of 51 (19.6%) were 
seropositive by the CF test and 50 of 51 (98.0%) by the NT test. Only one out of 
80 children who had postvaccinal contact with varicella contracted mild varicella
16 months after vaccination. None of the vaccinees developed herpes zoster. These
results suggest that this live varicella vaccine may safely and effectively be
used for children with or without underlying diseases, including those receiving 
steroid therapy, and that immunity of at least two years' duration is conferred
upon the vaccinated subjects.

PMID: 202916 [PubMed - indexed for MEDLINE]

8606: J Neurol. 1977 Dec 1;217(1):75-8.

Contralateral facial palsy in a case of cervical zoster.

Shoji H, Krauseneck P, Samtleben T.

Publication Types: 
    Case Reports

PMID: 75255 [PubMed - indexed for MEDLINE]

8607: Clin Ter. 1977 Nov 30;83(4):431-42.

[Current status of the clinical aspects and treatment of infectious diseases in
old age]

[Article in Italian]

[No authors listed]

Publication Types: 
    English Abstract
    Review

PMID: 342179 [PubMed - indexed for MEDLINE]

8608: Br Med J. 1977 Nov 5;2(6096):1193.

Congenital abnormalities and maternal herpes zoster.

Webster MH, Smith CS.

Publication Types: 
    Case Reports

PMID: 412551 [PubMed - indexed for MEDLINE]

8609: Mayo Clin Proc. 1977 Nov;52(11):683-6.

Antiviral agents.

Hermans PE.

Only a few agents with antiviral activity are available for regular clinical use.
Amantadine hydrochloride is effective in the prophylaxis of influenza A2.
Idoxuridine and adenine arabinoside have found application as topical agents in
the treatment of herpes simplex keratitis. Adenine arabinoside is also under
investigation in the treatment of disseminated infections due to herpes zoster
and herpes simplex. Ribavirin, an agent with a wide spectrum of activity in
vitro, has not fulfilled expectations in clinical trials. Because of the near
eradication of smallpox, methisazone has become less important as a prophylactic 
agent in smallpox.

PMID: 926844 [PubMed - indexed for MEDLINE]

8610: Actas Dermosifiliogr. 1977 Nov-Dec;68(11-12):643-50.

[Ramsay Hunt syndrome (region of the geniculate ganglion). Dissemination caused
by cortcioids and treated with griseofulvin]

[Article in Spanish]

Garcia Almagro D, Garcia Perez M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 613740 [PubMed - indexed for MEDLINE]

8611: Practitioner. 1977 Nov;219(1313):731-7.

Facial pain.

Young RF.

PMID: 594025 [PubMed - indexed for MEDLINE]

8612: Chin Med J (Engl). 1977 Nov;3(6):399-406.

Audiofrequency electrotherapy in skin diseases.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 414895 [PubMed - indexed for MEDLINE]

8613: Br J Ophthalmol. 1977 Nov;61(11):677-82.

External ocular motor palsies in ophthalmic zoster: a review.

Marsh RJ, Dulley B, Kelly V.

Seventy-seven new patients suffering from ophthalmic zoster and a selected group 
of 69 old patients were carefully examined with regard to external ocular
movements. An incidence of 31% of ocular pareses was found in the new patients,
and 58 in all were analysed. We were surprised to find several of these were
contralateral and bilateral palsies. 28% of the palsies were asymptomatic, due to
diplopia being present only in extremes of gaze and the rapid development of
suppression in the affected eye. The theories of aetiology of these pareses are
discussed.

Publication Types: 
    Review

PMID: 338027 [PubMed - indexed for MEDLINE]

8614: Med Weter. 1977 Nov;33(11):674-7.

[Clinical and laboratory use of IDU (5-iodo-2-desoxyuridine)]

[Article in Polish]

Swiecicka-Grabowska G.

PMID: 304817 [PubMed - indexed for MEDLINE]

8615: Klin Monatsbl Augenheilkd. 1977 Nov;171(5):791-5.

[Cytarabine treatment of herpes zoster (author's transl)]

[Article in German]

Gruner HJ, Fechner PU.

Systemic treatment of herpes zoster becomes possible by cytarabine. Complications
of herpes zoster ophthalmicus such as relapsing corneal ulceration, perforation
or scarring, secondary glaucoma, Argyll Robertson pupils, extraocular muscle
palsies, and optic atrophy, as well as postherpetic neuralgia can be prevented by
the use of this drug. For this reason the authors believe treatment with
cytarabine to be the therapy of choice in herpes zoster.

Publication Types: 
    Case Reports
    English Abstract

PMID: 304504 [PubMed - indexed for MEDLINE]

8616: Br Dent J. 1977 Nov 1;143(9):297-300.

Tooth exfoliation and osteonecrosis of the jaw following herpes zoster.

Cooper JC.

Publication Types: 
    Case Reports

PMID: 270353 [PubMed - indexed for MEDLINE]

8617: Ann Sclavo. 1977 Nov-Dec;19(6):1133-43.

[Characteristics of the complement-fixing antibody response for varicella-zoster 
virus in patients with herpes zoster]

[Article in Italian]

Trivello R, Peserico A, Moschen ME, Romano M.

Publication Types: 
    English Abstract

PMID: 218503 [PubMed - indexed for MEDLINE]

8618: Nippon Hifuka Gakkai Zasshi. 1977 Nov;87(12):754-6.

[Viral immunofluorescent technic--virus]

[Article in Japanese]

Miyoshi K.

PMID: 203735 [PubMed - indexed for MEDLINE]

8619: Arch Otolaryngol. 1977 Nov;103(11):641-4.

Acute peripheral facial palsy. Part of a cranial polyneuropathy?

Djupesland G, Degre M, Stien R, Skrede S.

In 14 of 16 consecutive patients with acute peripheral facial palsy, one or more 
(up to four) other nerves were involved. The nerves affected in addition to the
facial nerve were as follows: trigeminal (ten patients), vestibular (eight),
cochlear (six), vagus (one), and upper cervical (five). Virus was not isolated
from any of the patients. A fourfold increase or decrease in complement-fixing
antibody titers was present in eight patients (in four, varicella-zoster; in one,
varicella-zoster and mumps; in two, cytomegalovirus; in one, mumps). Further, two
of the patients with varicella-zoster antibodies showed clinical signs of herpes 
zoster oticus. About one fourth of all patients had an increase of ESR and of
alpha2-globulins in serum, and two thirds of them had increased gamma-globulins
in CSF. Acute peripheral facial palsy seems to be part of a cranial
polyneuropathy and may be caused by a viral infection.

PMID: 200210 [PubMed - indexed for MEDLINE]

8620: Virology. 1977 Oct 15;82(2):345-52.

Comparison of the DNAs of varicella-zoster viruses isolated from clinical cases
of varicella and herpes zoster.

Iltis JP, Oakes JE, Hyman RW, Rapp F.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 199993 [PubMed - indexed for MEDLINE]

8621: Z Hautkr. 1977 Oct 1;52(19):988-98.

[Casuistic contribution to zoster with special regard to the viscero-cutaneous
reflexes (VCR) as localization factors]

[Article in German]

Krause H, Eissfeld K.

PMID: 910543 [PubMed - indexed for MEDLINE]

8622: Arch Sci Med (Torino). 1977 Oct-Dec;134(4):481-5.

[Topical treatment of some dystrophic and inflammatory lesions of the skin and
soft tissues]

[Article in Italian]

Palmieri B, Boraldi F.

An investigation has been carried out on lysozyme cleasing antiphlogistic
granulogenic activity when topically applied to various lesions such as varicous 
ulcers, bed sores, herpetic infections or actinic ulcerative processes. 38
patients who had undergone surgery and were affected with these lesions, were
treated with lysozyme ointment applied twice daily for 15 days. Parameters for
evaluating the therapeutic effect of the drug were, besides the typical
subjective symptomatology, planimetry of the lesions, hyperemia and perilesional 
erythema. At the end of the investigation it was observed that lysozyme
applications had favourable restorative effects and, in the case of herpetic
lesions, complete resolution was achieved. Tolerance was satisfactory, although
in 2 cases treatment had to be precautionarily discontinued having the subject
complained of reacutization of pruritus.

Publication Types: 
    English Abstract

PMID: 610695 [PubMed - indexed for MEDLINE]

8623: Br J Ophthalmol. 1977 Oct;61(10):655-9.

The problem of uveitis in Bendel State of Nigeria: experience in Benin City.

Ayanru JO.

A review of 1987 patients with uveitis seen over an 11-year period in Bendel
State of Nigeria has been undertaken; 56% of cases had a posterior/mid-peripheral
uveitis, 15.1% a panuveitis, 21.5% an anterior uveitis. Acute anterior uveitis
with classical symptoms was rarely seen. Its comparative rarity is presumably due
to the absence of HL-A27 in Africans and altered immunological states from
malaria and parasitic infections. Identified aetiological factors in anterior
uveitis were leprosy (1 patient), tuberculosis (1 patient), herpes zoster (16
patients), and onchocerciasis (3 patients). The great majority of cases of
posterior uveitis were of presumed toxoplasmic origin. Further studies are needed
to demonstrate its mode of transmission in a population in which toxoplasmosis is
endemic. Forest onchocerciasis is not a major cause of uveitis in southern
Nigeria in the same way as savanna onchocerciasis is in northern Nigeria.
Syphilis seems to play no part in the causation of uveitis in southern Nigeria.
Better diagnostic facilities are required to determine the role of sarcoidosis
and other possible causative factors. Uveitis is a major cause of blindness in
Nigeria.

PMID: 563237 [PubMed - indexed for MEDLINE]

8624: Neurology. 1977 Oct;27(10):942-6.

Spinal myoclonus.

Hoehn MM, Cherington M.

The focal involuntary muscular contractions of spinal myoclonus have been
associated with neoplastic, infectious, traumatic, and degenerative lesions of
the spinal cord. Four patients are described here. In two, the myoclonus is
associated with severe cervical spondylitis. One patient had herpes zoster. In
the fourth, a segment of thoracic spinal cord is narrow and probably atrophic.
Both tetrabenazine and clonazepam were therapeutically effective.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 561907 [PubMed - indexed for MEDLINE]

8625: Scott Med J. 1977 Oct;22(4):311-3.

Development and therapeutic uses of topical 5% idoxuridine (IDU).

Dawber RP.

Publication Types: 
    Historical Article

PMID: 337484 [PubMed - indexed for MEDLINE]

8626: Arch Neurol. 1977 Oct;34(10):640-1.

Herpes zoster ophthalmicus with contralateral hemiplegia.

Pratesi R, Freemon FR, Lowry JL.

A 48-year-old man developed left hemiparesis nine weeks after herpes zoster skin 
lesions had appeared over the right forehead. Cerebral angiography showed
bilateral changes consistent with cerebral arteritis. The patient's condition
worsened after the angiographic procedure. Reports from the literature as well as
the present case suggest that arteritis and ischemia best explain contralateral
neurological symptoms that occur suddenly following herpes zoster ophthalmicus.

Publication Types: 
    Case Reports

PMID: 303089 [PubMed - indexed for MEDLINE]

8627: Bull N Y Acad Med. 1977 Oct;53(8):731-48.

Herpes simplex and herpes zoster keratouveitis: diagnosis and management.

Pavan-Langston D.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 302725 [PubMed - indexed for MEDLINE]

8628: J Pediatr. 1977 Oct;91(4):597-600.

A viremic phase for herpes zoster in children with cancer.

Feldman S, Chaudary S, Ossi M, Epp E.

Eight childhood cancer patients with herpes zoster were serially tested for the
presence of varicella-zoster virus in blood. Cell cultures of leukocyte-rich
plasma from four patients were positive for the virus. In this study viremia was 
clearly related to dissemination of dermal lesions-the spread of zoster lesions
outside an infected dermatome. The child with the longest viremic phase, five
days, had the longest and most severe course of skin dissemination, as well as
biochemical evidence of hepatitis. One patient with viremia had advanced
embryonal carcinoma and died of disseminated tumor before her clinical course
could be evaluated. These observations, the first to document a viremic phase for
herpes zoster in immunosuppressed children, furnish an added criterion for
evaluation of antiviral drugs and live-virus vaccines in the treatment and
prevention of varicella-zoster infections.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 198521 [PubMed - indexed for MEDLINE]

8629: J Infect Dis. 1977 Oct;136(4):531-40.

Prospective study of prevalence, incidence, and source of herpesvirus infections 
in patients with renal allografts.

Naraqi S, Jackson GG, Jonasson O, Yamashiroya HM.

The prevalence, incidence, and source of infections with different types of
herpesviruses were determined prospectively for 25 persons undergoing
hemodialysis, 30 allograft recipients, and 16 kidney donors. The prevalence of
prior infections with cytomegalovirus (CMV), herpes simplex virus (HSV), and
Epstein-Barr virus (EBV) was high (72%-100%) and was similar for healthy persons 
and those with renal failure. The incidence of infections in patients undergoing 
hemodialysis was no greater than that before dialysis. In allograft recipients,
the incidence of infection with CMV was 73%; HSV, 57%; EBV, 30%; and
varicella-zoster virus (clinical), 7%. Ninety-seven percent of the patients
developed an infection with one or more herpesviruses. Transfusions,
hemodialysis, the allograft, and hospital environment were not significant
sources in transmission. Uremia and splenectomy were unimportant in the
reactivation of infection. Immunosuppressive drugs possibly algmented by a graft 
rejection response account for the high incidence of recrudescent infections with
CMV and HSV.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 198488 [PubMed - indexed for MEDLINE]

8630: Dtsch Med Wochenschr. 1977 Sep 30;102(39):1402.

[Cross infectivity of varicella and herpes zoster]

[Article in German]

Nasemann T.

Publication Types: 
    Letter

PMID: 913265 [PubMed - indexed for MEDLINE]

8631: Nouv Presse Med. 1977 Sep 10;6(29):2601.

[Action of L-dopa on the eruption and pain of zona]

[Article in French]

Bonafe JL, Rumeau H, Durand JR, Coulombel F, Courret B, Carles P, Armand JP,
Jover A.

Publication Types: 
    Letter

PMID: 909741 [PubMed - indexed for MEDLINE]

8632: Nippon Ganka Gakkai Zasshi. 1977 Sep 10;81(9):1260-7.

[Effect of Varicella-zoster virus on cultured human cornea fibroblast (author's
transl)]

[Article in Japanese]

Matsuda K.

Publication Types: 
    English Abstract

PMID: 204175 [PubMed - indexed for MEDLINE]

8633: Nippon Rinsho. 1977 Sep 10;35(9):2758-62.

[Varicella virus and herpes zoster]

[Article in Japanese]

Yasuda T.

PMID: 200776 [PubMed - indexed for MEDLINE]

8634: J Pediatr Ophthalmol. 1977 Sep-Oct;14(5):296-8.

Retrobulbar neuritis and central serous chorioretinopathy.

Godel V, Blumenthal M, Regenbogen L.

Publication Types: 
    Case Reports

PMID: 925845 [PubMed - indexed for MEDLINE]

8635: Br J Cancer. 1977 Sep;36(3):347-54.

Follow-up studies on the immune status of patients with Hodgkin's disease after
splenectomy and treatment, in relapse and remission.

Hancock BW, Bruce L, Dunsmore IR, Ward AM, Richmond J.

Sixty-two patients with Hodgkin's disease have been followed for one year from
the start of treatment. Immunological assessments were repeated after intensive
treatment, in patients relapsing and in those in remission at one year. In
patients achieving remission, overall cellular immunity, after deteriorating with
therapy, particularly cytotoxic chemotherapy, returned to pre-treatment levels in
remission when there was little evidence of cellular immune disturbance. Serum
IgG and IgM levels fell with intensive chemotherapy in splenectomized patients.
IgA and IgM levels were lower (irrespective of splenectomy or therapy status) in 
remission than at presentation or after treatment. Relapse or non-response was
usually associated with deteriorating cellular immunity. Herpes zoster/varicella 
and candida infections (seen in 6 patients) were preceded by, or associated with,
deterioration of cellular immunity.

PMID: 921891 [PubMed - indexed for MEDLINE]

8636: Br J Med Psychol. 1977 Sep;50(3):283-8.

Psychological aspects of post-herpetic neuralgia: some clinical observations.

Pilowsky I.

PMID: 911701 [PubMed - indexed for MEDLINE]

8637: Am Fam Physician. 1977 Sep;16(3):84-92.

Evaluation of the patient with chronic facial pain.

Dalessio DJ.

A major difficulty in the investigation of chronic facial pain has been a
practical classification permitting the selection of appropriate diagnostic
procedures to elucidate the etiology of the pain and to provide appropriate
therapy. Categorization of facial pain syndromes into vascular, neuritic,
muscular, rheumatic, traction and inflammatory and psychogenic groups provides a 
useful approach to the problem. Despite the utility of this method and advances
in noninvasive diagnostic techniques, many pain syndromes remain refractory to
full understanding and/or therapy and will test the physician's patience and
perseverance.

PMID: 900012 [PubMed - indexed for MEDLINE]

8638: J Trop Med Hyg. 1977 Sep;80(9):200-3.

Fatal herpes zoster in Burkitt's lymphoma following contact with chicken pox.

Adeniyi A, Laditan AA, Seriki O.

Burkitt's lymphoma presented atypically in a six-year-old Nigerian girl with back
pain, oliguria and facial oedema following a fall at school. Two weeks later, she
developed bilateral ptosis, hepatomegaly and ascites. Burkitt's lymphoma cells
were found in both ascitic and cerebrospinal fluids. She was successfully treated
with intravenous cyclophosphamide and intrathecal methotrexate but later
developed fatal herpes zoster at the same time as the resident doctor developed
chicken pox. Chart's review showed that she had been in brief contact with
chicken pox during a short stay in a transit ward prior to full admission.

Publication Types: 
    Case Reports

PMID: 592465 [PubMed - indexed for MEDLINE]

8639: AJR Am J Roentgenol. 1977 Sep;129(3):463-7.

Cerebral granulomatous angiitis: case report and literature review.

Faer MJ, Mead JH, Lynch RD.

Granulomatous angiitis is a pathologically distinct central nervous system
segmental vasculitis of unknown etiology and pathogenesis which may be indirectly
related to herpes zoster infections. The condition primarily affects adults and
presents with nonspecific, unexplained progressive neurological dysfunction. The 
cerebrospinal fluid is often under increased pressure and contains excess protein
and white cells, mostly lymphocytes. The necrotizing vasculitis primarily affects
the small intracranial arteries and veins and alters vascular permeability,
ind,cing cerebral edema. Angiography demonstrates segmental, diffuse, distal
vascular irregularity and narrowing, while computed tomography shows poorly
defined, diffuse, non-contrast-enhancing low density areas with or without mass
effect. In the approprite clinical setting, the angiographic and CT findings
should be highly suggestive. The possibility of efficious therapeutic
intervention makes early diagnosis important. CT can also be used to monitor
therapeutic response.

Publication Types: 
    Case Reports

PMID: 409201 [PubMed - indexed for MEDLINE]

8640: Bull Soc Ophtalmol Fr. 1977 Sep-Oct;77(8-9):839-41.

[Post-herpes zoster keratitis: ultrastructural study of a case]

[Article in French]

Berard-Badier M, Merlihot JM, Mulfinger H, Mouillac N, Choux R.

Publication Types: 
    Case Reports
    English Abstract

PMID: 307438 [PubMed - indexed for MEDLINE]

8641: Am J Ophthalmol. 1977 Sep;84(3):329-31.

Herpes zoster ophthalmicus associated with delayed retinal thrombophlebitis.

Hesse RJ.

A 58-year-old woman developed typical herpes zoster ophthalmicus associated with 
delayed retinal thrombophlebitis and subsequent vitreous hemorrhage. Fluorescein 
angiography confirmed a diagnosis of thrombophlebitis and demonstrated sparing of
the arteriolar circulation. The retinopathy cleared spontaneously and visual
acuity returned to 6/6 (20/20).

Publication Types: 
    Case Reports

PMID: 302647 [PubMed - indexed for MEDLINE]

8642: Ann Neurol. 1977 Sep;2(3):249.

Attempts to recover varicella virus from ganglia.

Plotkin SA, Stein S, Snyder M, Immesoete P.

PMID: 215073 [PubMed - indexed for MEDLINE]

8643: J Dermatol. 1977 Aug;4(4):129-35.

Electron microscopic observations on the lesions of herpes zoster with topical
application of interferon.

Uyeda K, Kagami K, Sotomatsu S.

Department of Dermatology, Kyoto Prefectural University of Medicine, 465
Kajii-cho Hirokoji, Kawaramachi, Kamikyoku, Kyoto 603, Japan.

The lesions of herpes zoster in three patients were investigated electron
microscopically before and after topical application of interferon. In the
blister, on the 5th to 7th day after its formation, the following were seen:
acantholytic cells with virus particles in the nucleus and cytoplasm,
multinucleated cells derived from keratinocytes, edematous and degenerated
keratinocytes containing virus particles and tonofibrillar materials, macrophages
with many large vacuoles, neutrophils, lymphocytes and Langerhans's cells. After 
the first application of interferon, the findings for keratinocytes were the same
as those of before application and keratinocytes were frequently found adjacent
to macrophages. The macrophages were large and had numerons large vacuoles in the
cytoplasm. After the second application of interferon, virus particles were often
seen in the vacuoles of the macrophages in comparison with that before
application. In the cytoplasm of macrophages, acantholytic keratinocytes and
tonofibrillar materials were phagocytized. Many virus particles were seen in the 
vacuoles of some acantholytic keratinocytes. It was concluded from these findings
that the macrophages accelerated the phagocytotic activity of the virus
particles.

Publication Types: 
    Comparative Study

PMID: 15461339 [PubMed - indexed for MEDLINE]

8644: Arch Neurol. 1977 Aug;34(8):489-91.

Antibodies to varicella zoster in cerebrospinal fluid.

Bieger RC, Van Scoy RE, Smith TF.

The neurologic complications of varicella-zoster (VZ) virus infections are
manifested as zoster with or without CNS involvement, encephalomyelitis, or
ocular involvement. Usually the association of VZ virus in these conditions has
been determined by finding VZ antibodies in the serum. In a few instances, VZ
antibodies have been detected in the CSF. We report two cases of VZ virus
infection followed by neurologic complications involving the CNS in which VZ
antibodies were present in the CSF. These two cases underscore the need and value
of determining the presence of VZ antibodies in the CSF in certain instances.

Publication Types: 
    Case Reports

PMID: 889481 [PubMed - indexed for MEDLINE]

8645: J Oral Surg. 1977 Aug;35(8):663-6.

The Ramsay Hunt syndrome: a dynamic demonstration of applied anatomy.

Myall RW, Smith MJ.

The clinical features of herpes zoster of the geniculate ganglion were reviewed
and related to the functional anatomy of the seventh cranial nerve. An
illustrative case highlights many of the features of the syndrome that was first 
described by Ramsay Hunt. The significance of facial palsy is discussed in the
light of its distribution.

Publication Types: 
    Case Reports

PMID: 267191 [PubMed - indexed for MEDLINE]

8646: J Laryngol Otol. 1977 Jul;91(7):551-64.

Results of treatment in peripheral facial paralysis. A 25-year study.

Wynn Parry CB, King PF.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 894113 [PubMed - indexed for MEDLINE]

8647: Arch Dermatol. 1977 Jul;113(7):930-2.

Mycophenolic acid in the treatment of psoriasis: long-term administration.

Marinari R, Fleischmajer R, Schragger AH, Rosenthal AL.

Thirty five patients with psoriasis (plaque type 26, guttate 3, pustular 4, and
erythrodermic 2) were treated with oral mycophenolic acid for a period ranging
from 52 to 104 weeks. The average follow-up was 89 weeks, and the dose schedule
ranged from 2,400 to 7,200 mg daily. Excellent response was noted in 20 patients,
good in 13 patients, and poor in 2. The most common clinical side effects were in
the gastrointestinal tract, namely, diarrhea, nausea, abdominal cramps, and soft 
stools. A high incidence of herpes simplex, herpes zoster, and a flu-like
syndrome was noted. Laboratory abnormalities consisted of mild blood hemoglobin
reduction, one case of leukopenia (3,9000 WBCs per cubic millimeter), two cases
with thrombocytopenia and mild elevation of alkaline phosphatase. Mycophenolic
acid appears as a promising drug for the treatment of severe psoriasis.

PMID: 879814 [PubMed - indexed for MEDLINE]

8648: Obstet Gynecol. 1977 Jul;50(1):35-9.

Erosions and ulcers of the vulva: diagnosis, incidence, and management.

Young AW Jr, Tovell HM, Sadri K.

In a study of 877 patients with disorders of the vulva seen at a vulva clinic,
375 (43%) presented with an erosion or ulceration or a condition in which an
erosion or ulceration developed as a complicating feature. One hundred sixty-one 
of these patients had a sexually transmitted disease. This report identifies the 
conditions associated with erosions and ulcerations of the vulva by incidence and
provides a simple clinical classification of them as an aid in diagnosis. Methods
of study of this group of diseases and their management are discussed.

PMID: 876519 [PubMed - indexed for MEDLINE]

8649: Neurology. 1977 Jul;27(7):646-9.

Imitation synkinesia and sensory control of movement.

Cambier J, Dehen H.

Immitation synkinesia is usually associated with thalamic or parietal lesions.
Analysis of three cases shows that the lesions may affect the posterior columns
of the spinal cord or even the peripheral nervous system. In our cases, two facts
stand out, a large measure of integrity of motor activity and predominant
disturbances of lemniscal sensation. Imitation synkinesia should therefore not be
seen as due to a lesion of a particular structure but to the disorganization of
the lemniscal system at any level. Functional interconnection between the
lemniscal and motor systems occurs only in the cerebral cortex. In the light of
this fact, imitation synkinesia can be interpreted as the loss of particular
functions in the principal cortical motor neurons.

Publication Types: 
    Case Reports

PMID: 559970 [PubMed - indexed for MEDLINE]

8650: Int J Dermatol. 1977 Jul-Aug;16(6):464-75.

Antiviral drugs.

Kaufman HE.

Publication Types: 
    Review

PMID: 408279 [PubMed - indexed for MEDLINE]

8651: Int J Dermatol. 1977 Jul-Aug;16(6):476-87.

Laboratory diagnosis of microbiological skin disease.

Benn RA.

Publication Types: 
    Review

PMID: 330425 [PubMed - indexed for MEDLINE]

8652: Nippon Hifuka Gakkai Zasshi. 1977 Jul;87(8):493-500.

[Studies on the effect of herpes virus infections on human cell-mediated
immunity. 1. Lymphocyte subpopulations in the peripheral blood from patients with
herpes zoster and herpes simplex (author's transl)]

[Article in Japanese]

Urushibata O.

PMID: 302873 [PubMed - indexed for MEDLINE]

8653: Z Hautkr. 1977 Jul 1;52(13):691-8.

[Pathogenesis and topography of Herpes zoster in childhood and in adult age]

[Article in German]

Nagy G, Varga G.

PMID: 197719 [PubMed - indexed for MEDLINE]

8654: Compr Ther. 1977 Jul;3(7):42-8.

Ocular and systemic antiviral activity of vidarabine.

Pavan-Langston D, Hess F.

PMID: 195767 [PubMed - indexed for MEDLINE]

8655: Hautarzt. 1977 Jul;28(7):371-4.

[Electron microscopical rapid diagnosis of cutaneous viral diseases]

[Article in German]

Wolff HH, Graser H.

Electron microscopy by negative staining is a well-known, simple and quick
diagnostic method to demonstrate virus particles. A method for routine work is
described. The morphology of important viruses of the herpes and pox group is
shown. In herpes simplex and zoster, the viruses can be detected in most cases
from fresh vesicular fluid, whereas older erosions and crusts are not suitable.
Viruses have been shown in all cases of chicken pox, vaccinia inoculata,
molluscum contagiosum, and ecthyma contagiosum (orf).

Publication Types: 
    English Abstract

PMID: 70421 [PubMed - indexed for MEDLINE]

8656: N Engl J Med. 1977 Jun 16;296(24):1372-7.

Cellular immunity and herpesvirus infections in cardiac-transplant patients.

Rand KH, Rasmussen LE, Pollard RB, Arvin A, Merigan TC.

We observed severe infection with herpes simplex virus in cardiac-transplant
patients despite their high serum antibody levels to this virus. Therefore, we
sought to correlate clinical susceptibility to two herpesvirus (simplex and
zoster) infections with specific cellular immunity, assessed by the
transformation and interferon responses of peripheral blood mononuclear cells to 
heat-inactivated antigens. Transformation and interferon response to herps
simplex virus was maximally depressed immediately after transplantation, the time
when severe and prolonged infection with herps simplex virus occurred. Six months
to six years after transplantation, both clinical susceptibility and cellular
immunity to herpes simplex virus were normal. Herpes zoster infections were more 
frequent than normal at all times after cardiac transplantation; depressed or
absent cellular responses to the varicella zoster virus paralleled that
susceptibility. In these patients the risk of severe herpesvirus infections
correlated with depressed cellular immune responses to the specific viral agent
involved.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 193008 [PubMed - indexed for MEDLINE]

8657: MMW Munch Med Wochenschr. 1977 Jun 10;119(23):817-8.

[Therapy of herpes zoster with sodium pentosan polysulfate]

[Article in German]

Raff M, Fanta D.

Publication Types: 
    In Vitro

PMID: 196192 [PubMed - indexed for MEDLINE]

8658: Aust Fam Physician. 1977 Jun;6(6):643-8.

Chronic pain syndromes in the elderly.

Morley JB.

In this paper the painful syndromes of temporal arteritis, polymyalgla
rheumatica, glaucoma, trigeminal neuralgia, post-herpetic neuralgia, and
temporomandibular joint dysfunction have been described. These conditions occur
commonly in the elderly. The dangers of blindness occurring in temporal arteritis
or polymyalgia rheumatica, the importance of early diagnosis in glaucomatous
headache, the value of Tegretol in trigeminal neuralgia, the paucity of
therapeutic agents in post-herpetic neuralgia and the value of dental treatment
in tempor-mandibular joint dysfunction have been stressed.

PMID: 880167 [PubMed - indexed for MEDLINE]

8659: Arch Dermatol. 1977 Jun;113(6):848-9.

Acquired zosteriform cavernous hemangiomas: brief clinical observation.

Steinway DM, Fretzin DF.

Publication Types: 
    Case Reports
    Letter

PMID: 869560 [PubMed - indexed for MEDLINE]

8660: Klin Monatsbl Augenheilkd. 1977 Jun;170(6):837-42.

[Secondary glaucoma and uveitis: hypertensive uveitis (author's transl)]

[Article in German]

Witmer R.

The secondary rise of i.o. pressure in uveitis may lead to a true secondary
glaucoma or to hypertensive uveitis. The etiology of the endogenous inflammation 
does not seem to play a role. Pathogenetically the occlusion of the pupil with
the formation of iris bombe and the obliteration of the chamber angle by exudate 
are important factors, while the hypersecretion of aqueous humor plays a minor
role. Medical treatment consists in mydriatics and steroids. Surgical treatment
depends on the pathogenetic mechanism and consists either in sector iridectomy or
a filtering procedure.

Publication Types: 
    English Abstract

PMID: 302364 [PubMed - indexed for MEDLINE]

8661: Acta Pathol Microbiol Scand [B]. 1977 Jun;85(3):195-200.

Indirect immunofluorescence detection of human IgM and IgG antibodies against
herpes simplex virus type 1 induced cell surface antigens.

Marttila RJ, Kalimo KO.

An indirect immunofluorescence method, based on the use of infected Hela cell
coverslip cultures was developed to demonstrate human IgM and IgG class
antibodies against herpes simplex virus (HSV) type 1 induced cell surface
antigens. A total of 35 specimens from 20 patients have been tested; including
patients with a clinical diagnosis of HSV type 1 or type 2 primary infection,
patients with recurrent HSV infections, patients without any HSV infections, and 
patients with varicella-zoster virus (VZV) infections. In each patient with a
primary HSV infection both IgM and IgG antibody response was observed, while the 
patients with recurrent HSV infections showed only IgG antibodies. The direct
serological typing of HSV infections was not possible because of cross-reacting
antibodies both in the IgG and IgM test. No cross-reactivity was found in this
test with HSV and VZV antibodies. The HSV fluorescent IgG and IgM antibody titers
were found to parallel the highly sensitive HSV radioimmunoassay antibody titers 
very closely though at a markedly lower level.

PMID: 196479 [PubMed - indexed for MEDLINE]

8662: Monatsschr Kinderheilkd. 1977 Jun;125(6):655-9.

[Prognosis of prenatal varicella-zoster-infections in relation to their onset
during pregnancy (author's transl)]

[Article in German]

Balg G.

7 children were observed, whose mothers had Varicella-Zoster-Virus-infection. 3
of these children developed postnatal Herpes Zoster without Varicella in their
history; 1 child had Varicella in the neonatal period. There are indications that
primary infection with Varicella-Zoster-Virus during the first four months of
pregnancy may cause deformities in the child; the same during the last five days 
of pregnancy increases the risk of varicella with a complicated course in the
newborn. Independent of the time of infection during pregnancy the prognosis of a
secondary Varicella-Zoster-Virus-infection in the mother seems always to be good 
for the child. Aspects of the child's immunological maturation, still incomplete 
at birth, are discussed and can help to understand the different prognoses during
pregnancy. The importance of serological diagnosis has been emphasized.

Publication Types: 
    English Abstract

PMID: 196188 [PubMed - indexed for MEDLINE]

8663: Am J Surg. 1977 Jun;133(6):719-22.

Effect of cytosine arabinoside on Herpes virus infection in renal allograft
recipients.

Chatterjee SN, Fiala M, Myles RA.

Cytosine arabinoside (Ara-C) was used for treatment of severe symptomatic
cytomegalovirus (CMV)-herpes infections that were seen in nineteen of 174 renal
allograft recipients. Ara-C was administered by continuous intravenous infusion
at a mean dose of 35 mg/m2 daily for three to four days. Side effects were few
and minor in nature. All cases of herpes simplex and herpes zoster, which usually
have a prolonged and sometimes unfavorable course in immunosuppressed patients,
cleared promptly with no recurrence. All nine patients, except one who had CMV
infection with the symptom complex of fever and retinitis or pneumonitis,
responded satisfactorily. In the three patients in whom the CMV titers were
available, there was a significant decrease in titer within two weeks after
treatment. This pilot study of Ara-C in treatment of CMV-herpes infections in
immunosuppressed renal allograft recipients suggests a degree of efficacy and
safety in the drug that would justify a carefully designed, controlled study.

PMID: 194496 [PubMed - indexed for MEDLINE]

8664: Am J Ophthalmol. 1977 Jun;83(6):777-88.

Immunosuppression and eye disease. First Vail lecture.

Cogan DG.

Several viral, fungal, and protozoal diseases of the eye are significantly
associated with immunologic deficiencies. Of the viral agents, cytomegaly and
herpes simplex and zoster cause a discrete necrotizing retinopathy that has the
characteristics of vascular occlusion. Measles may result in a delayed
retinopathy that is predominantly macular and associated with subacute
progressive encephalopathy. Of the fungal agents, Candida and Aspergillus are apt
to involve the eye, beginning as choroidal lesions with extension forward to
involve the pigment epithelium and retina secondarily. Mucor and Cryptococcus are
less common. Toxoplasmosis is the one ocular protozoal disease whose incidence is
increased by immunosuppression, and, like the viral diseases, is characterized by
a discrete necrotizing retinopathy and probably results from activation of
dormant organisms in the retina. Autoimmunity undoubtedly plays an important role
in eye disease but its ocular pathogenesis is obscure.

Publication Types: 
    Review

PMID: 194482 [PubMed - indexed for MEDLINE]

8665: Am J Dis Child. 1977 Jun;131(6):693-6.

Prevention or modification of varicella using zoster immune plasma.

Balfour HH Jr, Groth KE, McCullough J, Kalis JM, Marker SC, Nesbit ME, Simmons
RL, Najarian JS.

Zoster immune plasma (ZIP) was given to 31 susceptible immunocompromised children
one to seven days (median, two days) following household, playmate, or hospital
exposures to varicella. The average amount of ZIP transfused was 7 ml/kg.
Twenty-one children did not develop varicella or persistent antibodies to
varicella-zoster virus (VZV). Eight (26%) of the 31 contracted clinical
varicella. Seven cases were mild, but in one child, who was given ZIP seven days 
after exposure, visceral disease developed and the child died. Two children had
subclinical varicella that was documented by persistence of VZV antibodies for at
least ten months after passive immunization. Because none of the 30 children
given ZIP one to six days following exposure had severe varicella, we conclude
that ZIP is effective in preventing or modifying varicella in immunocompromised
patients if given shortly after exposure.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 194476 [PubMed - indexed for MEDLINE]

8666: Angiology. 1977 Jun;28(6):394-402.

Ambulatory use of sympathetic nerve blocks: present day clinical indications.

Rickles JA.

PMID: 68691 [PubMed - indexed for MEDLINE]

8667: Schweiz Rundsch Med Prax. 1977 May 10;66(19):565-72.

[Lupus erythematosus, modern aspects (author's transl)]

[Article in French]

Canavese JC.

Publication Types: 
    English Abstract
    Review

PMID: 69300 [PubMed - indexed for MEDLINE]

8668: Z Hautkr. 1977 May 1;52(9):533-6.

[Interferon and herpes]

[Article in German]

Wyler R.

Interferon, a protein produced by cells, is the only non-toxic antiviral
inhibiting virus multiplication in the cell. Although the industrial-technical
production of the substance is more expensive the exogenic interferon treatment
(interferon which is produced in cell cultures is being administered to the
organism) is preferred to the endogenous interferon therapy (by application of
slightly-toxic substances the organism is stimulated to produce interferon) since
with the first therapy the factor toxicity can be neglected. Clinical trials with
exogenous interferon treatment of herpes virus infections of men gave encouraging
results, they must however be confirmed by double blind studies. Should it come
to a clinical application of interferon on a large scale, first of all methods of
production must be worked out to make available sufficient exogenous interferon
for treatment of patients.

Publication Types: 
    English Abstract

PMID: 868204 [PubMed - indexed for MEDLINE]

8669: Riv Patol Nerv Ment. 1977 May-Jun;98(3):151-8.

[EMG prognosis of facial palsy associated with herpes zoster oticus
(Ramsay-Hunt's syndrome). A longitudinal study of 11 cases (author's transl]

[Article in Italian]

Fardin P, Negrin P, Peserico A.

Eleven patients with peripheral facial palsy associated with geniculate herpes
zoster (Ramsay-Hunt's syndrome) have been followed-up clinically and
electromyographically. Each patient was examined three times: within the first
week, at the end of the third week and 3-4 months after the onset of symptoms.
Only in three cases the facial palsy evolved satisfactorily, with an almost total
recovery within three weeks. In eight cases the recovery was delayed and
incomplete, with residual, and often severe, hemifacial spasm. This study
confirms the rather poor prognosis of peripheral facial palsy in Ramsay-Hunt's
syndrome. The importance of detecting even slight signs of herpetic eruption in
any case of apparently "idiopathic" peripheral facial palsy is emphasized.

Publication Types: 
    English Abstract

PMID: 616017 [PubMed - indexed for MEDLINE]

8670: Fortschr Med. 1977 Apr 28;95(16):1093-4.

[Prevention and therapy of viral diseases with special reference to interferon]

[Article in German]

Neumann-Haefelin D.

Human leukocyte interferon (HLI) was used for treatment of human diploid
fibroblasts before and after infection with vaccinia virus, herpes simplex virus 
type 1 (HSV 1), herpes simplex virus type 2 (HSV 2), and varicella zoster virus
(VZV). Vero cells were infected with Medical Lake macaque herpes virus (MLMV),
and treated with HLI in the same way. In all of these systems HLI exhibited an
antiviral effect when administered before infection, and this effect could be
increased by additional HLI treatment after infection. In vivo studies with HLI
treatment were performed in monkeys experimentally infected with vaccinia virus, 
HSV 1, and MLMV. Vaccinia and herpes keratitis were prevented by local,
prophylactic administration of HLI. Generalized infections with vaccinia virus
and MLMV in monkeys immunosuppressed by antilymphocyte globulin, were
significantly modified by either prophylactic or therapeutic systemic treatment
with HLI.

Publication Types: 
    English Abstract

PMID: 192653 [PubMed - indexed for MEDLINE]

8671: MMW Munch Med Wochenschr. 1977 Apr 22;119(16):543-6.

[Significance of diabetes mellitus in the activation of the varicella zoster
virus (author's transl)]

[Article in German]

Neu I, Rodiek S.

Eruptive herpes zoster infection (VZV) and its primary and secondary diseases are
reported in 28 patients aged between 25 and 85 years. In 2 cases, malignant
primary diseases were found. In 16 patients, a disorder of glucose utilization
was diagnosed, 8 of them accompanied by a disorder of fat metabolism and 5 by a
hyperuricemia. In one case a severe encephalomyelitis was observed. In 2 patients
the activation of the VZV infection was related to the cytostatic or
immunosuppressive therapy of a generalized Hodgkin's disease and a multiple
sclerosis. Once a liver abscess as a sequel to amebic dysentery was diagnosed and
once a megaloplastic anemia with symptoms of a funicular myelopathy following a
vitamin B12 deficiency syndrome. In VZV infection the search for basal metabolic 
disorders is of particular importance.

Publication Types: 
    Case Reports
    English Abstract

PMID: 194145 [PubMed - indexed for MEDLINE]

8672: Lancet. 1977 Apr 16;1(8016):863.

Herpes zoster with bladder involvement.

McCracken D.

Publication Types: 
    Case Reports
    Letter

PMID: 67375 [PubMed - indexed for MEDLINE]

8673: N Engl J Med. 1977 Apr 7;296(14):824.

Real vs. pseudo-shingles.

Siegel AJ.

Publication Types: 
    Letter

PMID: 840294 [PubMed - indexed for MEDLINE]

8674: Probl Gematol Pereliv Krovi. 1977 Apr;22(4):49-51.

[Obtaining interferon-containing donor plasma and a study of its therapeutic
properties in herpes zoster]

[Article in Russian]

Skurkovich SV, Ol'shanskaia NV, Eremkina EI, Arkhipova NA, Klinova EG.

Publication Types: 
    Case Reports
    English Abstract

PMID: 896714 [PubMed - indexed for MEDLINE]

8675: Wiad Lek. 1977 Apr 1;30(7):565-7.

[Diagnostic difficulties in zoster prior to eruption of vesicles]

[Article in Polish]

Batko B.

Publication Types: 
    Case Reports

PMID: 855339 [PubMed - indexed for MEDLINE]

8676: J Am Osteopath Assoc. 1977 Apr;76(8):585-90.

Viral chemotherapy.

Williams BB.

New antiviral compounds are being tested constantly and may be of considerable
value with increasing availability. More than 200 analogues of purines and
pyrimidines have been found to inhibit DNA and RNA viruses. Adenine arabinoside
is most effective against disseminated herpes simplex virus and disseminated
herpes zoster. Idoxuridine is useful in treatment of herpetic keratitis.
Interferon still is in the experimental stage, and, because of its short
half-life and high cost, it probably will not be released in the near future.
Amantadine appears to be useful in prevention of A2 influenza, but its value
against swine flu has not been established. Methisazone is effective in
prevention of smallpox and in the treatment of complications of vaccinia.

PMID: 587711 [PubMed - indexed for MEDLINE]

8677: South Med J. 1977 Apr;70(4):495-7.

Gamma heavy chain disease--presenting as pancytopenia and splenomegaly.

Baker AS, Lankford P, Krantz SB, Buchanan RD.

A patient with gamma heavy chain disease (Franklin's disease) was discovered
during evaluation for pancytopenia and splenomegaly. Lymphadenopathy, palatal
edema, and infiltration of the bone marrow palatal edema, and infiltration of the
bone marrow with abnormal cells were all absent. Serum and urine protein
electrophoresis demonstrated a monoclonal protein migrating in the beta region.
Immunoelectrophoresis showed that it reacted with antibodies against the Fc
fragment of IgG heavy chains (gamma chains) but not with antibodies against kappa
and lambda but not with antibodies against kappa and lambda light chains of Fab
fragments. In the first year after detection of the disease, the patient had
acute cholecystitis and disseminated herpes zoster. Sixteen months after
diagnosis he died of overwhelming pneumonia caused by Pseudomonas aeruginosa and 
lebsiella neumoniae. A striking feature of his illness was his asymptomatic
presentation, with pancytophenia and splenomegaly the only indication of this
disease.

Publication Types: 
    Case Reports

PMID: 403613 [PubMed - indexed for MEDLINE]

8678: Bull Soc Ophtalmol Fr. 1977 Apr;77(4):489-90.

[A rare complication of ophthalmic zona: scleral perforation with hernia of the
ciliary body]

[Article in French]

Jallet G, Lecuyer J, Bechetoille A.

Publication Types: 
    Case Reports
    English Abstract

PMID: 305300 [PubMed - indexed for MEDLINE]

8679: J Infect Dis. 1977 Apr;135(4):659-63.

A longitudinal study of varicella-zoster virus infections in renal transplant
recipients.

Luby JP, Ramirez-Ronda C, Rinner S, Hull A, Vergne-Marini P.

A serum bank maintained for renal transplant recipients allowed for a
longitudinal study of antibody responses before and after herpes zoster. Renal
transplant recipients without herpes zoster served as controls. Antibody
responses to varicella-zoster virus, herpes simplex virus type 1, and
cytomegalovirus were measured. The serological responses following herpes zoster 
were prompt and sustained (in the majority of cases), transient, or not present
at all. Zoster without an eruption occurred (apparent only on retrospective chart
review) and furnished an explanation for unexplained unilateral pain syndromes in
these patients. Asymptomatic rises in titer of antibody to varicella-zoster virus
not explained by rises in antibody to herpes simplex virus occurred in both
groups. This latter finding points to an unstable relation between virus and host
and supports and hypothesis of Hope-Simpson that subclinical release of virus
with resulting antigenic stimulation may maintain immunity to varicella-zoster
virus. Patients with herpes zoster and controls did not differ in several humoral
immune parameters that might have explained the occurrence of herpes zoster.
There was no evidence that herpes zoster precipitated renal graft rejection.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 192807 [PubMed - indexed for MEDLINE]

8680: Boll Ist Sieroter Milan. 1977 Mar 31;56(1):70-3.

Complement fixing antibody to varicella-zoster virus in different age groups and 
after zoster.

Moschen ME, Peserico A, Trivello R.

The titer of complement fixing antibody to Varicella-Zoster virus was studied in 
sera from 215 normal persons living in Padua and its province and from 39 Zoster 
patients. About 74% of sera from normal persons aged 21-80 years had antibody
titers larger than or equal to 1/4. Lower titers were present in the age groups
1-20 years and 81-90 years. Sera from Zoster patients had high titers from the
second week following the onset of the rash. They were still comparatively high
until the fifth month, sometimes remaining detectable even after a year or more.

PMID: 193530 [PubMed - indexed for MEDLINE]

8681: Fortschr Med. 1977 Mar 24;95(12):757-828.

[Common virus infections of the skin. Molluscum contagiosum, herpes zoster,
herpes simplex, condylomata acuminata, verrucae vulgares]

[Article in German]

Menzel I.

The clinical diagnosis, etiology and predisposing factors of these common viral
skin diseases are discussed with special emphasis on new therapeutic approaches.

Publication Types: 
    English Abstract

PMID: 558140 [PubMed - indexed for MEDLINE]

8682: ZFA (Stuttgart). 1977 Mar 20;53(8):441-3.

[Myocardial infarct simulating cases of herpes zoster]

[Article in German]

Revai S, Konig E.

Publication Types: 
    Case Reports

PMID: 860592 [PubMed - indexed for MEDLINE]

8683: Med Welt. 1977 Mar 18;28(11):519-24.

[Inflammatory diseases of the central nervous system with prevalent spinal
symptoms]

[Article in German]

Wolf G.

Publication Types: 
    Case Reports

PMID: 853913 [PubMed - indexed for MEDLINE]

8684: Br Med J. 1977 Mar 5;1(6061):638.

Chemotherapy for varicella-zoster infections.

Juel-Jensen B.

Publication Types: 
    Letter

PMID: 843848 [PubMed - indexed for MEDLINE]

8685: Lancet. 1977 Mar 5;1(8010):551.

Herpes zoster with bladder involvement.

Gottheiner TI, Pokroy N, Gregory MC.

Publication Types: 
    Case Reports
    Letter

PMID: 65653 [PubMed - indexed for MEDLINE]

8686: Ann N Y Acad Sci. 1977 Mar 4;284:284-8.

Clinical experiences using the antiviral
1-beta-D-ribofuranosyl-1,2,4-triazole-3-carboxamide (ribavirin) in Mexico.

Zertuche HF, Perches RD.

Follow-up of the use of ribavirin in 390 human patients in Mexico indicates the
drug has been used to treat a variety of virus infections. No toxic
manifestations of the drug were reported, and the subjective results suggest
possible antiviral efficacy. A double-blind, placebo-controlled study using
topically applied 5% ribavirin in ointment base against herpes zoster in cancer
patients indicates definite efficacy against this specific disease.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 360903 [PubMed - indexed for MEDLINE]

8687: Dtsch Med Wochenschr. 1977 Mar 4;102(9):312-6.

[Is cytarabine an effective drug against herpes zoster? (author's transl)]

[Article in German]

Orfanos CE, Weese A, Runne U, Kratka J, Goerz G.

Although herpes zoster is a viral infection with spontaneous healing, the skin
eruption is painful and there may be serious complications. Cytarabine was
administered to 91 patients with the disease. It was given by quick infusion or
intravenously twice daily for five days. An open, uncontrolled study of 61
patients suggested that the drug was beneficial without serious side effects. But
in a double-blind randomised study of 30 patients there was no significant effect
on the course of the disease. The mean healing time for skin blisters in
segmental uncomplicated zoster was 8.4 days with cytarabine and 6.5 days with a
placebo.

Publication Types: 
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 319973 [PubMed - indexed for MEDLINE]

8688: Ann N Y Acad Sci. 1977 Mar 4;284:60-80.

Effect of a novel adenosine deaminase inhibitor (co-vidarabine, co-V) upon the
antiviral activity in vitro and in vivo of vidarabine (Vira-Atm) for DNA virus
replication.

Sloan BJ, Kielty JK, Miller FA.

A new potent inhibitor of adenosine deaminase (co-vidarabine) was used in
combination studies with adenine arabinoside (vidarabine, Vira-ATM) to protect
this purine nucleoside from enzymatic deamination to the more weakly active
metabolite, hypoxanthine arabinoside. Comparing the combination to vidarabine
alone, a significant increase (10-fold) of the antiviral activity of the combined
drugs was observed against herpes and vaccinia viruses in tissue culture and
subcutaneously, against cranial herpesvirus infections in mice. Several other
investigators have also recently reported several-fold enhancement of vidarabine 
activity by newly described deaminase inhibitors. They observed that plaque
formation by several large DNA-containing viruses (herpes, vaccinia, varicella
zoster) and an RNA-containing oncogenic virus was markedly prevented by the
combination compared to vidarabine alone. In animals, enhanced protection
(increased survivors) and/or highly significant increase in the life span of
dying mice treated with the 2-drug combination, was also observed compared to
vidarabine administered singly. These observations in animals clearly indicate
that combination studies with vidarabine (Vira-ATM) and co-vidarabine (deaminase 
inhibitor) deserve serious consideration as future therapy for systemic virus
infections in man including herpesvirus encephalitis.

PMID: 212990 [PubMed - indexed for MEDLINE]

8689: Cancer. 1977 Mar;39(3):1018-25.

Infections in patients with malignant lymphoma treated with combination
chemotherapy.

Feld R, Bodey GP.

The records of 360 patients with malignant lymphoma treated with various forms of
combination chemotherapy from 1966 to 1974 were reviewed. A total of 181
infections was found in 125 patients. The most frequent types of infection were
pneumonia (31%), skin infections (17%), urinary tract infections (13%) and
septicemia (11%). An etiologic organism was was identified in 133 infections
(73%). The most common causative organisms were bacteria (77%), especially
gram-negative bacilli. Viral infections accounted for 18% of the infections with 
21 of the 24 being due to herpes zoster. These were more frequently found in
patients with Hodgkin's disease (14/21) than in the other lymphomas. Among
patients with Hodgkin's disease, 53% treated with COP developed infections
compared to only 27% treated with MOPP (p = 0.039). Among patients with
non-Hodgkin's lymphoma, infections were more frequent in patients treated with
Adriamycin containing combinations than with COP. Neutropenia (i.e. less than
1,000 neutrophils/mm3) was associated with 35% of infections in this study and
was seen more often in patients with non-Hodgkin's lymphoma (p = 0.048).

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 912645 [PubMed - indexed for MEDLINE]

8690: Actas Dermosifiliogr. 1977 Mar-Apr;68(3-4):195-200.

[Disseminated herpes zoster. Varicella]

[Article in Spanish]

Rodriguez Canas T.

Publication Types: 
    Case Reports
    English Abstract

PMID: 868599 [PubMed - indexed for MEDLINE]

8691: Vojnosanit Pregl. 1977 Mar-Apr;34(2):102-3.

[Etiology of Bell's palsy]

[Article in Serbian]

Rasic M.

Publication Types: 
    English Abstract

PMID: 867933 [PubMed - indexed for MEDLINE]

8692: Zh Ushn Nos Gorl Bolezn. 1977 Mar-Apr;(2):103-4.

[3 cases of herpes zoster oticus]

[Article in Russian]

Gol'dstein MA, Rodina KM.

Publication Types: 
    Case Reports

PMID: 855446 [PubMed - indexed for MEDLINE]

8693: Nervenarzt. 1977 Mar;48(3):145-6.

[Herpes zoster lesion of the sympathetic trunk (author's transl)]

[Article in German]

Schliack H, Godt P.

PMID: 854135 [PubMed - indexed for MEDLINE]

8694: Laryngoscope. 1977 Mar;87(3):372-9.

Auditory symptoms associated with herpes zoster or idiopathic facial paralysis.

Byl FM, Adour KK.

Auditory symptoms (hyperacusis, tinnitus, decreased hearing) have long been
recognized to accompany herpetic or idiopathic facial paralysis. Twenty-nine
percent of 1,080 patients with idiopathic facial paralysis and 37 percent of 172 
with herpes zoster oticus facial paralysis had auditory symptoms. Abnormal
related sensori-neural hearing loss was documented in only 11 of these 377
patients with auditory complaints. All of the 11 had a diagnosis of herpes zoster
oticus. Sensori-neural hearing loss occurs in only about 6.5 percent of patients 
with herpes zoster facial paralysis, and no confirmed case of such loss in
idiopathic facial paralysis has been reported. In patients presenting with
sensori-neural hearing loss accompanying facial paralysis believed to be
idiopathic, herpes zoster should be suspected even in the absence of vesicles.
Factors favorable for recovery of auditory function include age 64 years or
younger, mild initial hearing loss, a cochlear pattern of hearing loss, and
absence of vertigo. Recovery of auditory function does take place; however, a
high-tone sensori-neural loss may persist except in younger patients.

PMID: 557156 [PubMed - indexed for MEDLINE]

8695: Z Hautkr. 1977 Mar 1;52(5):145-50.

[Life-threatening generalized varioloid zoster with zoster pneumonia due to
combined immunologic deficiency. Increased contagiousness of this disease]

[Article in German]

Runne U, Szekeres L.

There is a clear-cut correlation between the clinical course of an herpes zoster 
and the quality of immune response. A varioloid generalized herpes zoster
accompanied by zoster-pneumonia developed in a forty years old female patient
with metastasizing breast cancer treated with x-ray and cytostatic drugs. The
particularly serious course of this herpes zoster was brought about by combined
immune deficiency, consisting of low level of circulating T-lymphocytes (5/mm3)
and for a long time lacking rise of complement fixing antibody titer. Under these
conditions an enhanced replication and massive haematogenous spread of
varicella-zoster virus took place. The increased contagiosity of this case is
indicated by a varicella infection in the patient's two children, appearing after
a regular incubation period. Patients with cellular or combined immune deficiency
are potentially exposed to danger of herpes zoster and may serve as a source of
infection for susceptible persons.

Publication Types: 
    English Abstract

PMID: 300529 [PubMed - indexed for MEDLINE]

8696: Infect Immun. 1977 Mar;15(3):850-4.

Complement-fixing reactivity of Varicella-Zoster virus subunit antigens with sera
from homotypic infections and heterotypic Herpes simplex virus infections.

Schmidt NJ, Dennis J, Lennette EH.

Various subunit antigens of varicella-zoster (V-Z) virus were examined for
complement-fixing (CF) activity with sera from homotypic infections and from
herpes simplex virus (HSV) infections in which a CF antibody titer rise was
demonstrated with crude V-Z antigen. The subunit antigens included nucleocapsids,
envelopes, a soluble antigen produced from infected culture fluids by sucrose
density gradient centrifugation, a soluble antigen produced by reducing the
volume of clarified infected culture fluids, a soluble antigen derived from
infected cell lysates, a "viral" antigen consisting largely of enveloped
particles with a few nucleocapsids, and a cell membrane-associated antigen. None 
was more suitable than crude V-Z antigen for serodifferentiation of V-Z virus and
HSV infections. The envelope antigen, cell membrane antigen, and the soluble
antigen prepared by density gradient centrifugation showed little reactivity with
sera from varicella and HSV infections, but gave high antibody titers with sera
from zoster infections, suggesting that a secondary V-Z virus infection is
required to produce an antibody response to these subunit antigens. Patients with
varicella and zoster infections and the selected patients with HSV infections all
showed significant CF antibody responses to the other V-Z subunit antigens.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 192677 [PubMed - indexed for MEDLINE]

8697: J Virol. 1977 Mar;21(3):1232-5.

Induction of deoxypyrimidine kinase activity in human embryonic lung cells
infected with varicella-zoster virus.

Ogino T, Otsuka T, Takahashi M.

Deoxypyrimidine kinase (deoxythymidine [TdR] kinase and deoxycytidine kinase)
activity was induced in human embryonic lung cells after infection with
varicella-zoster virus (VZ virus). Increased enzyme activity was also produced by
using cell-associated virus as inoculum instead of cell-free virus. Anti-VZ virus
serum inhibited both the appearance of cytopathic effect and the induction of
enzyme activity. The induced TdR kinase activity was more thermostable than that 
induced by herpes simplex virus type 1. Also, the TdR kinase activity of VZ
virus-infected cells was inhibited by dTTP less than in mock-infected cells and
more than in herpes simplex virus type 1-infected cells.

Publication Types: 
    Comparative Study

PMID: 191646 [PubMed - indexed for MEDLINE]

8698: Geriatrics. 1977 Mar;32(3):77-9.

Varicella and herpes zoster: comparisons in the old and young.

Myers MG.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 191332 [PubMed - indexed for MEDLINE]

8699: Rev Fr Transfus Immunohematol. 1977 Mar;20(1):109-15.

[Detection of antibodies against rubella, herpes zoster and chickenpox for
preparation of special or specific gamma globulins]

[Article in French]

Herzog F.

PMID: 70052 [PubMed - indexed for MEDLINE]

8700: JAMA. 1977 Feb 28;237(9):871-2.

Herpesvirus infection.

Sklar SH.

Publication Types: 
    Letter

PMID: 189100 [PubMed - indexed for MEDLINE]

8701: Br Med J. 1977 Feb 5;1(6057):378.

Chemotherapy for varicella-zoster infections.

Walden PA, Newlands ES, Coleman JC, Tattersall MH, Bagshawe KD.

Publication Types: 
    Letter

PMID: 837111 [PubMed - indexed for MEDLINE]

8702: J Med Assoc State Ala. 1977 Feb;46(8):31-4.

Herpes Zoster and herpes simplex management with influenza virus vaccine.

Brown AM.

PMID: 836475 [PubMed - indexed for MEDLINE]

8703: Br J Surg. 1977 Feb;64(2):143-4.

Herpes zoster and paralytic ileus: a case report.

Johnson JN, Sells RA.

A case of herpes zoster presenting as intestinal obstruction is described.
Clinical and radiological evidence of intestinal obstruction was obtained. The
mechanisms by which herpes zoster may cause an ileus are discussed.

Publication Types: 
    Case Reports

PMID: 578122 [PubMed - indexed for MEDLINE]

8704: Mil Med. 1977 Feb;142(2):165-6.

Zoster immune plasma procurement in military hospitals-- a proposal.

Fisher WB.

Publication Types: 
    Editorial

PMID: 401970 [PubMed - indexed for MEDLINE]

8705: Zentralbl Bakteriol [Orig A]. 1977 Feb;237(1):1-34.

[Sulphated glycosaminoglycans as virus inhibitors. 4th communication: clinical
aspects of zoster with the proposal of a new treatment (author's transl)]

[Article in German]

Voss H, Pohle HD, Museteanu C.

On the base of plaque inhibition tests in at least three virus-host-systems and
successful treatment of mice with experimentally induced yellow fever
encephalitis a well known sulphated glycosaminoglycan (GAGPS) "L5" was used as
therapeutic agent in cases of zoster infection in man. The material was applied
as 1% solution in water continuously on lint and rewettet for several days until 
nearly complete healing was achieved. The clinical course of 18 patients of
former years (12 women, 6 men) was compared with 26 cases (19 women, 7 men)
treated additionally with the new substance. All of them were carefully observed 
in the Rudolf-Virchow-Hospital in Berlin. Besides of registrating data as age and
sex of the patients and the seasonal distribution of cases the course of illness 
was analyzed. The mean duration before admission to the hopsital was 4,9 days in 
the control group and 7,2 days in the L5-patients. Signs of organ diseases
possibly acting as trigger mechanism for the remanifestation of the zoster were
nearly twice in number in L5 cases than in the controls. Despite of this
unfavorable stiutation the main parameters showed a clear tendency to return
earlier to normal values in the GAGPS group. The fever was shortened. The blood
lymphocytes normalized better with mean absolute values of 2400 in the L5-group
and 3029 per m(3) in the control cases. The fall of the cell number in the liquor
cerebrospinalis was more rapidly in the GAGPS treatment. The mean stay in the
hospital was 33,2 days in L5 cases and 44,6 days in control patients respectively
in the main group of age between 60 and 80 years. One death in the GAGPS group
corresponded to four in the control group. In the local skin area the edema
disappeared rapidly with beginning of treatment. Confluent vesicles flattened
within 24 to 48 hours and no further efflorescences were seen. Pain diminished in
few days. The good results justify continued trials.

Publication Types: 
    English Abstract

PMID: 190822 [PubMed - indexed for MEDLINE]

8706: ZFA (Stuttgart). 1977 Jan 31;53(3):164-8.

[Infectious exanthemas]

[Article in German]

Grundler E.

Publication Types: 
    Review

PMID: 320776 [PubMed - indexed for MEDLINE]

8707: Br Med J. 1977 Jan 29;1(6056):286.

Chemotherapy for varicella-zoster infections.

Dawber R.

Publication Types: 
    Letter

PMID: 837071 [PubMed - indexed for MEDLINE]

8708: Fortschr Med. 1977 Jan 20;95(3):119-22, 152-8.

[Therapy of herpes zoster through active premunization. 2. Treatment of zoster
patients, results of experimental and clinical studies, treatment results]

[Article in German]

Mayr VA, Stickl H, Westhues M, Gillesberger W, Schwarz D, Bibrack B.

A brief review of the previous and generally inadequate methods for the treatment
of Herpes Zoster is presented. The concept of "active premunization" by
appropriate inducer to provide an objective treatment is defined. A
"Premunization Inducer" (PIND) based on a particular non-infectious preparation
of an avian pox ("avipox") virus has been shown to enhance non-specific defence
mechanisms in the host by T-cell stimulation and to inhibit virus proliferation
by the induction of Interferon. The mode of action, efficacy against different
viruses and the safety of the preparation is described and discussed. 114
patients with Herpes Zoster were treated with this "premunization Inducer" either
orally (for buccal absorption) or by means of a nasal spray. There were no side
effects and in all cases there was a marked reduction in the duration of the
illness up to the shedding of the last scab (about 15 days instead of the more
usual 31 days). Pain was relieved in some cases within 6 hours and in the
remainder within 2 days: a rapid resolution of the inflammation could be
observed. There were practically no signs of postherpetic neurological
complications among the patients treated (the usual incidence of post-herpetic
neuritis is around 18%). The treatment of Herpes I and Herpes II infection other 
viral conditions will be reported elsewhere.

Publication Types: 
    English Abstract

PMID: 838422 [PubMed - indexed for MEDLINE]

8709: Fortschr Med. 1977 Jan 13;95(2):87-93.

[Therapy of herpes zoster uring active premunization. 1. Therapeutic
possibilities: bases and the principle of premunition--premunization]

[Article in German]

Mayr A, Stickl H, Westhues M, Gillesberger W, Schwarz D, Bibrack B.

PMID: 832835 [PubMed - indexed for MEDLINE]

8710: N Z Med J. 1977 Jan 12;85(579):3-6.

Transfer factor therapy: clinical experience and the role of the E rosette assay.

Sutherland DC, Wilson JD, Douglas R.

Transfer factor has been administered to 17 patients, most with infectious
diseases of various kinds. In 12 patients the therapy was followed by a definite 
clinical improvement although in most cases conventional chemotherapy was given
concomitantly. In all cases where clinical improvement followed the sheep red
cell or E rosette assay showed low values initially, with an improvement
following therapy. This test of T lymphocyte function may be useful both in
predicting patients likely to respond to transfer factor, and in monitoring
response to treatment. As no specific assay of transfer factor activity is
available, an in vivo rise in E rosette formation following transfer factor
administration serves as a crude indicator that the injected material has some
biological activity.

PMID: 319390 [PubMed - indexed for MEDLINE]

8711: West J Med. 1977 Jan;126(1):84.

Gamma Globulin for Herpes Zoster.

[No authors listed]

PMID: 18747881 [PubMed - as supplied by publisher]

8712: J Int Med Res. 1977;5(5):378-81.

The use of betadine antiseptic paint in the treatment of Herpes simplex and
Herpes Zoster.

Woodbridge P.

Twenty-two patients with Herpes Simplex were treated with Betadine (povidone
iodine) Antiseptic paint and seven with 5% idoxuridine in dimethyl sulphoxide,
also one patient with bilateral lesions was treated with the two solutions, one
on each side. The povidone iodine alcohol solution appeared to be at least as
effective as the idoxuridine with minimal side-effects (some stinging in two
patients). Good results were also obtained with this solution in twelve patients 
with Herpes Zoster.

PMID: 913866 [PubMed - indexed for MEDLINE]

8713: Acta Neurochir (Wien). 1977;38(1-2):65-72.

Postherpetic craniofacial dysaesthesiae: their management by stereotaxic
trigeminal nucleotomy.

Schvarcz JR.

Publication Types: 
    Case Reports

PMID: 899896 [PubMed - indexed for MEDLINE]

8714: Ophthalmologica. 1977;175(5):263-8.

Internal ophthalmoparesis: an uncommon complication of varicella, a common
disease.

Dubois HF, van Bijsterveld OP.

Two cases are represented with ocular complications after varicella. In one case 
the complication was diagnosed as internal ophthalmoparesis and in the second
patient the complication could be the same; at any rate an iridoplegia was
present. From the cases presented in the literature we found that there seems to 
be a predilection for males to contract this type of ocular complication. The
association of this complication and meningo-encephalitis is rare. Recovery of
the pupillary reactions and accommodative power is almost never complete. The
interesting observation that decrease in cell-mediated immunity but not in
humoral immunity decides whether the clinical disease will manifest itself as
herpes zoster or varicella is brought forward.

Publication Types: 
    Case Reports

PMID: 896157 [PubMed - indexed for MEDLINE]

8715: Neurol Neurochir Pol. 1977;11(3):375-7.

[Case of Frankl-Hochwart syndrome (polyneuritis cranials menieriformis)]

[Article in Polish]

Klimek A.

In a 19-year-old man sudden Bell's palsy developed and after 2 days vertigo and
peripheral-type nystagmus supervened. ENG demonstrated presence of spontaneous
nystagmus on right gaze and lack of excitability of the left horizontal canal.
The cerebrospinal fluid was normal, virological examination failed to demonstrate
presence of antibodies to zoster virus or a rise of antibodies to enteroviruses. 
Vertigo and nystagmus disappeared within several days. Bell's palsy regressed
later. The results of virological investigations cast doubt on the views of these
authors who regard Frankl-Hochwart syndrome as a variety of Ramsay Hung Syndrome.
In the presently reported case the possibility of zoster virus being the cause of
the disease has been ruled out.

Publication Types: 
    Case Reports
    English Abstract

PMID: 882215 [PubMed - indexed for MEDLINE]

8716: Dermatologica. 1977;154(5):301-4.

Motor paralysis complicating herpes zoster.

Nord E, Weinberger A, Benjamin D, Pinkhas J.

Publication Types: 
    Case Reports

PMID: 863072 [PubMed - indexed for MEDLINE]

8717: Nippon Rinsho. 1977 Fall;35 Suppl 2:3150-1, 3516-7.

[Diplopia and frontal headache (protein fractionation and immunoglobulin
analysis): (myeloma and disseminating herpes zoster)]

[Article in Japanese]

Shibata S, Yamada H, Shibata M, Aoyama S, Yamashita S.

Publication Types: 
    Case Reports

PMID: 611266 [PubMed - indexed for MEDLINE]

8718: Sangre (Barc). 1977;22(6):1022-5.

[Agglutinating anti-Duffy antibody of IgM type (author's transl)]

[Article in Spanish]

Martin Vega C, Gallart MT, Murcia C, Ribera A, Armengol R.

Publication Types: 
    Case Reports
    Comparative Study
    English Abstract

PMID: 601669 [PubMed - indexed for MEDLINE]

8719: Int J Radiat Oncol Biol Phys. 1977 Jan-Feb;2(1-2):1-19.

Long-term side effects in irradiated patients with Hodgkin's disease.

Slanina J, Musshoff K, Rahner T, Stiasny R.

PMID: 557465 [PubMed - indexed for MEDLINE]

8720: Scand J Urol Nephrol Suppl. 1977;(42):173-5.

Late complications after successful renal transplantation.

Blohme I, Ahlmen J.

Of the patients treated with renal transplantation in Gothenburg between 1965 and
1972, 128 (38%) eventually had a "successful" transplant, i.e. a well-functioning
graft (primary or secondary) beyond the third year after transplantation. The
actuarial ten-year survival was 75%, 95% of these patients were well
rehabilitated, medically and socially. Slow chronic rejection of the graft was
the most common late complication and was responsible for an annual rate of graft
loss of about five per cent. Avoiding overtreatment with immunosuppressive drugs,
this complication should be met by early retransplantation. Ten out of 17 deaths 
occurred despite continued good graft function, seven of these being due to
arteriosclerotic disease. In patients with continued good transplant function,
negative effects of chronic immunosuppression were relatively uncommon: infection
and malignancy caused the death of one and two patients, respectively. The only
infectious disease seen in increased frequency was Herpes Zoster. This pattern of
late complications with a high incidence of arteriosclerotic disease and a low
incidence of infectious complications in the late transplantation course is not
in accordance with other reports, where the reverse situation has prevailed. This
difference might partly be explained by high age of the patients and adherence to
a low-dose policy for chronic immunosuppression in our programme.

PMID: 356203 [PubMed - indexed for MEDLINE]

8721: J Med Virol. 1977;1(2):79-93.

Pharmacologic effects of polyinosinic-polycytidylic acid in man.

Freeman AI, Al-Bussam N, O'Malley JA, Stutzman L, Bjornsson S, Carter WA.

Twenty-four patients with cancer and concomitant infections with either herpes
virus hominis or varicella zoster virus were treated with
polyinosinic-polycytidylic acid (rIn.rCn) to determine: 1) the reliability of
rIn.rCn to induce interferon production, and 2) the toxicity of the drug. Seven
additional patients with herpes zoster were observed as controls. Two lots of
rIn.rCn were used; Lot 1 was consistently effective in stimulating serum
interferon at doses of 9 and 12 mg/kg, whereas Lot 2 was effective at doses of
3-12 mg/kg. There was no correlation between rIn.rCn doses within these ranges
and the resultant interferon levels. Generally, peak serum interferon occurred
within the first day. Toxicity to rIn.rCn consisted of fever in 21/24 patients,
mild elevation of liver enzymes in 8/24 patients, and laboratory abnormalities of
coagulation in 9 patients. The coagulation abnormalities appeared linearly
related to the dose of rIn.rCn used. All these abnormalities were reversible, and
none were considered severe of life-threatening. Since rIn.rCn was effective in
stimulating interferon and since toxicity was considered acceptable, a randomized
double-blind study was initiated to determine whether rIn.rCn is effective in the
treatment of herpes zoster.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 347034 [PubMed - indexed for MEDLINE]

8722: Bull Mem Soc Fr Ophtalmol. 1977;89:206-10.

[Results of lamellar and perforating grafts in herpetic kerato-uveitis]

[Article in French]

Witmer R.

PMID: 346111 [PubMed - indexed for MEDLINE]

8723: Pathol Biol (Paris). 1977 Jan;25(1):57-66.

[Levamisole, stimulant of the immune system in animal and man (author's transl)]

[Article in French]

Andrieu JM.

Levamisole, a drug initially used for its antihelminthic properties has been
recently emphasized when Renoux proved its immunostimulating effects in mice en
1971. Since this date, numerous publications concerned the immunological activity
of this drug in animals and men. These come to the conclusion that levamisole is 
capable of restoring cellular immunity as demonstrated by clinical and biological
tests (restoration of delayed skin hypersensitivity, increase of the percentage
of rosette forming cells and PHA transformed cells). In men, its seems possible
to confirm the therapeutic activity of this molecule in a wide range of disease
with suspected or proven immunological deficiency. In different forms of cancer, 
when most of the tumor volume is first reduced, levamisole therapy significantly 
increases both remission and survival. In auto immune diseases (rheumatoid
arthritis, systemic lupus erythematosus), levamisole seems to be strikingly
effective. In viral infections (zoster, recurrent herpes, aphthous stomatitis)
levamisole is able to reduce the duration of outbreaks and prolong the disease
free interval. Finally, encouraging results have been obtained in patients with
lepromatous leprosis. Other conditions, where an immunological deficiency is
suspected are under study with levamisole therapy. This low molecular weight
synthetic drug is perhaps the first pharmacological agent which acts on the host 
defense mechanisms.

Publication Types: 
    English Abstract
    Review

PMID: 322037 [PubMed - indexed for MEDLINE]

8724: Cutis. 1977 Jan;19(1):98-100.

Widespread cutaneous herpes simplex type II infection.

Rosenberg FW, Schachter RK, Givan K.

The case of an adult who survived a widespread culture-proven cutaneous herpes
simplex type II infection is presented. The authors believe it is the first such 
case. The virus was demonstrated by its cytopathic effect in Vero cell culture.
Large, swollen syncytial cells and holes in the cell sheet, typical of the
changes produced by the herpes simplex virus type II, were noted. Photodynamic
inactivation therapy with acriflavine dye and fluorescent light was employed.

Publication Types: 
    Case Reports

PMID: 319958 [PubMed - indexed for MEDLINE]

8725: Postgrad Med J. 1977;53 Suppl 4:104-9.

Studies on the concomitant use of carbamazepine and clomipramine for the relief
of post-herpetic neuralgia.

Gerson GR, Jones RB, Luscombe DK.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 304576 [PubMed - indexed for MEDLINE]

8726: Can J Ophthalmol. 1977 Jan;12(1):66-7.

Herpes zoster conjunctival ulceration.

Kline LB, Jackson B.

A 70 year old man acquired a herps zoster infection of the ophthalmic division of
his right trigeminal nerve. During the course of the illness he developed the
rare complication of a cojunctival ulcer. It is suggested that the ulceration may
be the result of an ischemic ischemic vasculitis.

Publication Types: 
    Case Reports

PMID: 300270 [PubMed - indexed for MEDLINE]

8727: Neurology. 1977 Jan;27(1):100-1.

Evidence of viral cause in granulomatous angiitis.

Gilbert GJ.

Publication Types: 
    Letter

PMID: 299928 [PubMed - indexed for MEDLINE]

8728: Trans Ophthalmol Soc N Z. 1977;29:133-6.

Post-herpetic neuralgia, treatment and prevention.

Haas LF.

PMID: 269547 [PubMed - indexed for MEDLINE]

8729: Med Cutan Ibero Lat Am. 1977;5(6):381-93.

[Skin manifestations in renal transplants]

[Article in Spanish]

Ortonne JP, Bustamante R, Perrot CH, Thivolet J.

The authors studied the skin disorders in 50 patients who have undergone renal
transplantation. They observed: -- Viral infections (herpes simplex, herpes
Zoster, warts) in 56% of the patients. -- Bacterial infections in 36%, resulting 
in septicemia in 8% of the cases. -- Fungal infections in 26% of the patients.
These infections appeared more severe than usual and recurred frequently. The
occurence of several infections processes in the same patient was not uncommon.
The clinical aspect and high incidence of various infections is related to
immunosuppresive therapy. However, there is no clear-cut correlation between the 
type of infection and the type of treatment used. -- Squamous cell carcinoma
occured in one patient. A high incidence of malignancies is known to occur in
immunosuppressed patients. -- Skin signs related to hemodialysis (pruritus,
hypermelanosis, skin dryness, vascular disturbances) regressed. -- The incidence 
of adverse reactions to drugs was high. -- 4 cases of ulcerations of the oral
mucosa probably related to Azathioprine were observed.

Publication Types: 
    English Abstract

PMID: 216859 [PubMed - indexed for MEDLINE]

8730: J Med Virol. 1977;1(3):209-17.

Immunotherapy of viral infections with transfer factor.

Mazaheri MR, Hamblin AS, Zuckerman AJ.

It has been reported that dialysable leucocyte extract preparations, thought to
contain transfer factor, may be used therapeutically for the treatment of a
variety of immunodeficiency syndromes. Clinical and laboratory studies have
suggested that such preparations, in addition to transferring specific cellular
immunity may also contain non-specific adjuvant activities. Attempts at
immunotherapy of viral infections are described against a background of current
research on the biological and biochemical properties of leucocyte dialysates.

Publication Types: 
    Review

PMID: 204742 [PubMed - indexed for MEDLINE]

8731: Arch Virol. 1977;55(1-2):1-24.

Virus infections after transplantation in man. Brief review.

Ho M.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 200197 [PubMed - indexed for MEDLINE]

8732: Bull Pan Am Health Organ. 1977;11(2):153-6.

The herpesvirus group.

Melnick JL.

Several agents in the herpesvirus group are known to infect man. They cause a
wide variety of conditions, ranging from coldsores to chickenpox and shingles. At
the same time a number of the herpesviruses have been linked with malignant
diseases in both lower animals and man.

PMID: 198052 [PubMed - indexed for MEDLINE]

8733: Int Ophthalmol Clin. 1977 Fall;17(3):109-20.

Viral uveitis.

Abelson MB, Pavan-Langston D.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 197040 [PubMed - indexed for MEDLINE]

8734: Ateneo Parmense Acta Biomed. 1977;48(2):167-92.

[Trigeminal herpes zoster]

[Article in Italian]

Bottazzi D, Gariboldi L, Pelizza A.

The authors, after a brief discussion about etiopathogenesis, istopathological
changes and principal symptomatologic and therapeutic elements of Herpes Zoster, 
present three personal observations of Herpes Zoster facialis, two affecting only
the third branch of the trigeminus nerve and one only its second branch. Finally 
they discuss, basing on clinical peculiarities, a possible diagnostic
localization of the disease.

Publication Types: 
    English Abstract

PMID: 196603 [PubMed - indexed for MEDLINE]

8735: Intervirology. 1977;8(5):272-80.

A novel approach to study the DNA of herpes zoster virus.

Rapp F, Iltis JP, Oakes JE, Hyman RW.

Herpes zoster virus DNA was isolated from infected human embryo lung cells
because it is released into the "Hirt supernatant". The buoyant density of the
virus DNA was found to be slightly higher than that of cellular DNA. The
molecular weight of this DNA was estimated to be 92 x 10(6) daltons by
cosedimentation with T4 DNA in neutral sucrose gradients. As with the DNA of
other herpesviruses, the DNA of herpes zoster virus is fragmented when denatured 
under alkaline conditions and is therefore "alkali-labile". Studies of virus DNA 
using reassociation kinetics reveal that the kinetic complexity of the DNA
correlates with the genome size as estimated by sucrose gradient sedimentation.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 195912 [PubMed - indexed for MEDLINE]

8736: Arch Virol. 1977;53(3):221-33.

Herpesvirus group antibodies in children with Hodgkin's disease.

Holy J, Hrodek O, Srajer J.

During the period of three years ((1972-1974), serum samples from 60 patients
(children and adolescents) with lympho-hematopoietic system diseases were
examined for antibodies to all four human herpesviruses. Among these were 26
active Hodgkin's disease (AHD) patients and 6 HD patients with a minimum five
years' remission. Simultaneously matched controls (age, sex) of AHD patients were
examined. Antibody levels against the viral capsid antigen of Epstein-Barr virus 
(EBV/VCA) in AHD patients were significantly higher, with overrepresentation of
higher titres (greater than or equal to 1:160), than in matched controls. The
lowest EBV/VCA antibody titres were in the leukemia-non-Hodgkin's lymphoma
patients. We could not prove any significant relationship between cytomegalovirus
or herpes simplex virus type 1 antibody titres and AHD or any other disease of
lympho-hematopoietic system. The varicella-zoster virus antibody titres in AHD
patients were significantly higher than in matched controls. No significant
differences in antibodies against EBV/VCA and the other human herpes viruses
between the evolution and remission period of AHD patients could be detected. No 
differences in EBV/VCA antibody titres were observed between the healthy
school-children aged 10 to 15 years who were and who were not in contact with a
HD patient.

Publication Types: 
    Comparative Study

PMID: 193463 [PubMed - indexed for MEDLINE]

8737: Intervirology. 1977;8(2):83-91.

The effect of phosphonoacetic acid on the in vitro replication of
varicella-zoster virus.

May DC, Miller MR, Rapp F.

Phosphonoacetic acid (PAA) was found to inhibit in vitro varicella-zoster virus
(VZV) replication. At 100 microng/ml, PAA blocked the development and spread of
VZV cytopathology in both growing and contact-inhibited cultures. Formation of
virus plaques by infected cells and cell-free virus was effectively blocked at
concentrations as low as 25 microng/ml. The development of nuclear and
cytoplasmic virus antigens was also inhibited by PAA. Inhibition by PAA suggests 
that VZV DNA replication, like that of other herpes-viruses, involves a
virus-specific DNA polymerase.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 192695 [PubMed - indexed for MEDLINE]

8738: Pediatrics. 1977 Jan;59(1):8-12.

Protective efficacy of vaccination in children in four episodes of natural
varicella and zoster in the ward.

Asano Y, Nakayama H, Yazaki T, Ito S, Isomura S.

It was previously reported that a live varicella vaccine (Oka strain) has been
developed and that the immediate vaccination of hospitalized children was
effective for prevention of spread of varicella in a ward. Six to nine months
later, there were four separate episodes of varicella and zoster in the same
ward. Eighteen children (11 with nephrotic syndrome, 6 with nephritis, and 1 with
hepatitis) with no history of varicella were inoculated with a live vaccine
before or immediately after admittance or occurence of the varicella and zoster
cases. Twelve of them had been receiving steroid therapy and 15 of the 18 were
found to be seronegative by complement fixation and neutralization tests before
the vaccination. All of them became seropositive after vaccination without any
clinical symptoms. The longest period between vaccination and exposure was nine
months. None of the vaccinees exhibited varicella symptoms after exposure.
Serological follow-up of ten vaccinated children was done, and booster responses 
were observed in some of them after exposure. These results suggest that the live
vaccine affords immunity to the recipients. If hospitalized children are
vaccinated before or immediately after exposure, isolation of the patient is
unnecessary.

Publication Types: 
    Comparative Study

PMID: 190584 [PubMed - indexed for MEDLINE]

8739: J Immunol Methods. 1977;14(2):183-95.

Solid-phase radioimmunoassay of herpes simplex virus IgG and IgM antibodies.

Kalimo KO, Ziola BR, Viljanen MK, Granfors K, Toivanen P.

A solid-phase radioimmunoassay for detection of herpes simplex virus-specific IgG
and IgM antibodies in human serum specimens is presented. Virus antigen is
adsorbed on polystyrene balls and antibodies which attach to the antigen are
detected by 125I-labeled antihuman-gamma or antihuman-mu immunoglobulins. A total
of 76 specimens have been tested. The appearance of virus-specific IgG and IgM
antibodies in primary herpetic infections was readily demonstrated. When serum
samples from patients with past exposure to herpes simplex virus were tested,
endpoint titers of virus-specific IgG antibodies were found to be 8 to 2048 times
higher than titers determined by a complement fixation test. Apparent cross
reactivity with varicella-zoster virus was observed in the present
radioimmunoassay.

PMID: 190320 [PubMed - indexed for MEDLINE]

8740: Am J Med. 1977 Jan;62(1):77-85.

Herpes zoster and impaired cell-associated immunity to the varicella-zoster virus
in patients with Hodgkin's disease.

Ruckdeschel JC, Schimpff SC, Smyth AC, Mardiney MR Jr.

Thirty-two patients with Hodgkin's disease and 12 normal donors were studied for 
their in vitro lymphocyte responsiveness to a membrane-associated
varicella-zoster (VZ) antigen. When compared to the normal donors, patients with 
Hodgkin's disease in whom radiotherapy was recently completed and those with
active, recurrent disease had markedly impaired cell-associated immunity to VZ
antigen. In addition, there was a suggestion that patients in long-term remission
who had received primary combined modality therapy (radiotherapy plus
chemotherapy) had an impaired response when compared to normal persons or to
patients who had received single modality therapy. Newly diagnosed, untreated
patients with Hodgkin's disease did not differ significantly from normal persons 
as a group but two of six were unresponsive to the VZ antigen whereas all normal 
subjects were responsive. Most patients in remission for at least one year
following therapy had normal in vitro responsiveness. In two patients herpes
zoster developed after the demonstration of absent in vitro lymphocyte reactivity
to the VZ antigen.

PMID: 189604 [PubMed - indexed for MEDLINE]

8741: J Oral Surg. 1977 Jan;35(1):51-3.

Facial herpes zoster.

Atterbury RA.

Publication Types: 
    Case Reports

PMID: 186575 [PubMed - indexed for MEDLINE]

8742: Dermatologica. 1977;155(3):183-4.

[Intercostal zona and congenital in difference to pain]

[Article in French]

Wilmaers M, Mestdagh C, Stoupel N.

Publication Types: 
    Case Reports

PMID: 70383 [PubMed - indexed for MEDLINE]

8743: Am J Med. 1976 Dec;61(6):892-6.

Mediastinal irradiation for chronic lymphocytic leukemia.

Sawitsky A, Rai KR, Aral I, Silver RT, Glicksman AS, Carey RW, Scialla S, Cornell
CJ Jr, Seligman B, Shapiro L.

Thirty-one patients with chronic lymphocytic leukemia were treated with
mediastinal radiation. In none of the patients was complete remission achieved;
either partial remission or clinical improvement was achieved in 52 per cent, but
the duration of response was short. The response rate was 77 per cent for the
patients receiving a total radiation dose greater than 3,000 rads and 45 per cent
for those receiving less than 3,000 rads. Severe life-threatening toxicity was
noted in 11 patients and seven of these patients died; two patients died with
progressive disease. Severe toxicity was manifested by one or more of the
following: bone marrow aplasia, pancytopenia, gram-negative sepsis, generalized
herpes zoster and severe esophagitis. Neither the total dose of radiation nor the
dose per week correlated withe the severity of reaction or death.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1008073 [PubMed - indexed for MEDLINE]

8744: Nurs Mirror Midwives J. 1976 Dec 9;143(24):75.

ABC of diseases.

[No authors listed]

PMID: 1050721 [PubMed - indexed for MEDLINE]

8745: Lancet. 1976 Dec 4;2(7997):1219-22.

Herpes zoster with dysfunction of bladder and anus.

Jellinek EH, Tulloch WS.

Herpes zoster may give rise to dysfunction of bladder and anus. Mucosal lesions
have been reported, and 7 cases are described with retention, loss of sensation, 
or incontinence. Sacral shingles is associated with sensory loss and flaccid
detrusor paralysis. Lumbar shingles may cause retention, and zoster at higher
levels can also damage the spinal cord. Recovery is usually complete. The
implication for schemes of bladder innervation is discussed.

Publication Types: 
    Case Reports

PMID: 63042 [PubMed - indexed for MEDLINE]

8746: Arch Dermatol. 1976 Dec;112(12):1755-6.

Herpes zoster. Case report of possible accidental inoculation.

Su WP, Muller SA.

A 30-year-old healthy male physician developed grouped, papulovesicular lesions
along the dermatomes of T1 and T2 of the left side of his body. The onset
occurred two days after he accidentally pricked his right index finger with a
needle that had been used to aspirate the acute papulovesicular lesion of a
patient with severe herpes zoster. The clinical appearance and dermatomal
distribution, the subsequent clinical course, the skin biopsy findings, and the
substantial increase in complement-fixing antibody titer to the varicella-zoster 
(V-Z) virus in the convalescent serum samples are strong evidence for herpes
zoster. Although it is generally believed that person-to-person transmission of
zoster is rare and that herpes zoster results from the reactivation of a latent
varicella virus, the present case suggests that zoster can be acquired from
exogenous infection with a V-Z virus, at least in certain circumstances.

Publication Types: 
    Case Reports

PMID: 1008568 [PubMed - indexed for MEDLINE]

8747: Arch Intern Med. 1976 Dec;136(12):1356-62.

The infectious complications of sarcoidosis: a current perspective.

Winterbauer RH, Kraemer KG.

The incidence of indections requiring hospitalization was determined in 122
patients with sarcoidosis. The group was remarkably free of infection except for 
three patients with Aspergillus mycetoma occurring in areas of long-standing
parenchymal involvement with cystic degeneration. There was a single instance of 
complicating pulmonary tuberculosis, and the only extrathoracic infection was a
single instance of disseminated herpes zoster. This study confirms that
aspergillosis, not tuberculosis, is currently the most common infectious
complication of sarcoidosis. Although previous case reports have suggested an
increased incidence of invasive fungal infection in patients with sarcoidosis,
there is little to support this concept. None of the patients in the present
study group developed these fungal infections during a mean 7.2-year follow-up.
The clinical presentation of many of the previously reported cases suggests that 
the entire course of the granulomatous illness was infectious in nature rather
than sarcoidosis with complicating infection.

Publication Types: 
    Case Reports

PMID: 999417 [PubMed - indexed for MEDLINE]

8748: Int J Dermatol. 1976 Dec;15:762-9.

Treatment of zoster and postzoster neuralgia by the intralesional injection of
triamcinolone: a computer analysis of 199 cases.

Epstein E.

On the basis of this study of 111 patients with herpes zoster and 88 with
postherpetic neuralgia, it is suggested that the intradermal injection of
triamcinolone in saline is a valuable treatment. Mild complications were pain,
hemorrhage, abscesses, atrophy, moon face and possibly thrombophlebitis. Zoster
patients required treatment for about half as long as those in previously
reported control series. In patients treated for active herpes zoster, postzoster
neuralgia occurred with about one-third of the frequency noted in other series.
In postzoster neuralgia, the patient was benefited sufficiently in 62.5% of the
cases to find that life was worth living again.

PMID: 992927 [PubMed - indexed for MEDLINE]

8749: Brain. 1976 Dec;99(4):673-94.

The neurological complications of cardiac transplantation.

Hotson JR, Pedley TA.

Review of the neurological complications encountered in 83 patients who received 
cardiac homografts over a seven-year period leads to the following conclusions:
(1) Neurological disorders are common in transplant recipients, occurring in over
50 per cent of patients. (2) Infection was the single most frequent cause of the 
neurological dysfunction, being responsible for one-third of all CNS
complications. (3) The infective organisms were typically those considered to be 
usually of low pathogenicity: fungi, viruses, protozoa and an uncommon bacterial 
strain. (4) Other clinical neurological syndromes were related to vascular
lesions, often apparently from cerebral ischaemia or infarction occurring during 
the surgical procedure, metabolic encephalopathies, cerebral microglioma, acute
psychotic episodes and back pain from vertebral compression fractures. (5) The
infectious complications and probably the development of neoplasms de novo, are
related to immunosuppressive therapy which impairs virtually all host defence
mechanisms and alters the nature of the host's response to infective agents or
other foreign antigens. (6) Because neurological symptoms and signs were usually 
those of behavioural changes or deterioration in intellectual performance, the
neurological examination was often of little value in diagnosing the nature or
even the anatomical site of the neuropathological process. (7) The possibility of
an infectious origin of the neurological manifestations must be aggressively
pursued even in the absence of fever and a significantly abnormal spinal fluid
examination. The diagnostic error made most frequently was to ascribe
neurological symptoms erroneously to metabolic disturbances or to "intensive care
unit psychosis" when they were in fact due to unrecognized CNS infection. (8)
Maintenance of mean cardiopulmonary bypass pressures above 70 mmHg, particularly 
in patients with known arteriosclerosis, may reduce operative morbidity. (9)
Though increased diagnostic accuracy is possible with routine use of a variety of
radiological and laboratory techniques, two further requirements probably must be
met before a significant reduction in the frequency of neurological complications
will occur: the advent of greater immunospecificity in suppressing rejection of
the grafted organ while preserving defences against infection; and a more
effective armamentarium of antiviral and antifungal drugs.

Publication Types: 
    Case Reports

PMID: 192413 [PubMed - indexed for MEDLINE]

8750: J Clin Microbiol. 1976 Dec;4(6):470-8.

Sensitivity of a radioimmunoassay method for detection of certain viral
antibodies in sera and cerebrospinal fluids.

Forghani B, Schmidt NJ, Lennette EH.

An indirect solid-phase radioimmunoassay (RIA) was applied to titration of serum 
and cerebrospinal fluid (CSF) antibodies against a variety of viruses including
rubella, mumps, measles, herpes simplex, varicella-zoster, and vaccinia. The test
used fixed, virus-infected cells as a source of antigen, and conditions for
optimal production of viral antigen were determined for each virus-host cell
system. In acute, uncomplicated viral infections, sera taken 2 to 5 days after
onset generally had low homotypic RIA titers ranging from less than 1:100 to
1:500, whereas convalescent-phase titers ranged from 1:128,000 to 1:512,000.
Rubella and measles antibody titers as high as 1:256,000 were demonstrated by RIA
in CSF from patients with chronic panencephalitis, whereas homologous antibody
titers of 1:4,000 were detected in CSF from acute mumps, herpes simplex, and
varicella-zoster virus infections with central nervous system involvement. Some
heterotypic antibody was demonstrable by RIA in CSF, but, with the exception of
herpes simplex antibody in a mumps virus infection, titers were markedly lower
than those to the infecting virus type. RIA generally demonstrated titers at
least 1,000 times higher than those obtained by conventional assays such as
complement fixation, hemagglutination inhibition, neutralization, and
immunofluorescent staining.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 187618 [PubMed - indexed for MEDLINE]

8751: JAMA. 1976 Nov 8;236(19):2174-5.

Herpes zoster and neoplastic disease.

Rhodes AR.

Publication Types: 
    Letter

PMID: 989806 [PubMed - indexed for MEDLINE]

8752: Compr Psychiatry. 1976 Nov-Dec;17(6):781-5.

Dementia dialytica: a new psychotic organic brain syndrome.

Scheiber SC, Ziesat H Jr.

Publication Types: 
    Case Reports

PMID: 991609 [PubMed - indexed for MEDLINE]

8753: Arthritis Rheum. 1976 Nov-Dec;19(6):1271-7.

Lymphocyte response to virus antigens in systemic lupus erythematosus.

Wolf RE, Ziff M.

The cell-mediated immune response of lymphocytes to rubella, measles,
parainfluenza types 1, 2, and 3, varicella-zoster and herpes virus type 1 virus
antigens was evaluated in 15 SLE patients and 15 matched controls by
incorporating 3H-thymidine in whole blood cultures as a measure of blastic
transformation. SLE patients were less responsive than normal individuals to six 
of eight virus antigens tested. Culture of washed SLE cells in AB plasma did not 
reverse the hyporesponsiveness. The results indicated that a functional
impairment of the circulating lymphocytes appeared to be responsible for the in
vitro hyporesponsiveness of SLE patients to virus antigens.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 187203 [PubMed - indexed for MEDLINE]

8754: J Virol. 1976 Nov;20(2):478-86.

Enzymatic basis for the selective inhibition of varicella-zoster virus by
5-halogenated analogues of deoxycytidine.

Dobersen MJ, Jerkofsky M, Greer S.

5-Bromodeoxycytidine (BrdC) and 5-iododeoxycytidine, at a concentration of 100
mug/ml, effectively inhibit the replication of varicella-zoster (VZ) virus in
tissue culture. No toxicity could be demonstrated in uninfected cells under the
same conditions. Studies on the enzymatic basis for this selective inhibition
were undertaken. Infection of human embryonic lung cell monolayers with VZ
virus-infected cells results in the induction of thymidine (dT), deoxycytidine
(dC), and BrdC kinase activities (which are increased 10-, 40-, and 60-fold,
respectively) and in a 70-fold stimulation in the incorporation of 3H nucleotide 
(5-bromodeoxyuridylate) derived from BrdC into DNA. The thermal stability of the 
VZ virus-induced activities differs significantly from the activities induced by 
herpes simplex virus type 1 and herpes simplex virus type 2 and those present in 
uninfected human embryonic lung cells. The VZ virus-induced dT, dC, and BrdC
kinase are similarly affected by temperature and cofractionate upon Sephadex gel 
filtration, findings consistent with the hypothesis that these activities are the
function of a single enzyme: a pyrimidine deoxyribonucleoside kinase. The
molecular weight, calculated on the basis of the elution pattern on Sephadex
G-150, is 70,000. Kinetic studies, demonstrating that dT and dC competively
inhibit the phosphorylation of BrdC, are consistent with the phosphorylation of
these substrates at a common active site. Kinetic parameters include: KidT = 0.6 
MUM; KidC = 60 muM; KmBrdC = 8.5 muM. In contrast to its relatively high affinity
for the VZ virus-induced kinase, BrdC is a relatively poor substrate for the host
kinases. Therefore, the basis for the selective inhibition of VZ virus by
5-halogenated analogues of dC is reflected in the induction of a pyrimidine
deoxyribonucleoside kinase with a high affinity for BrdC.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 185427 [PubMed - indexed for MEDLINE]

8755: Arch Ophthalmol. 1976 Nov;94(11):1899-1902.

Herpetic corneal epithelial disease.

Marsh RJ, Fraunfelder FT, McGill JI.

The clinical differentiation of corneal epithelial lesions due to herpes simplex 
or herpes zoster may be confusing. Practical clinical tests, including the use of
topical ocular stains, are useful to differentiate corneal epithelial lesions
caused by these two viruses. Two distinctive types of zoster corneal epithelial
disease may be seen; an early dendritic form, and a delayed form characterized by
corneal mucus plaques that may take a dendriform pattern. These plaques are
composed of mucus that is adherent to swollen, degenerating epithelial cells. The
clinical differentiation between these two viruses is essential since topically
applied corticosteroids are contraindicated in epithelial herpes simplex and
often are indicated in the management of epithelial herpes zoster.

PMID: 62568 [PubMed - indexed for MEDLINE]

8756: Wien Klin Wochenschr. 1976 Oct 29;88(20):664-7.

[Virological investigations in peripheral idiopathic facial pareses (author's
transl)]

[Article in German]

Mitschke H.

Virological investigations were carried out on the serum of 62 patients suffering
from peripheral facial pareses. The aetiology was definitely attributable to a
virus infection in 12 of these cases. Neuropathological changes induced by these 
neurotropic viruses, predisposing anatomical features and pathogenesis are
discussed. Since only symptomatic treatment is possible, the importance of active
immunization, where available, is stressed in the prevention of virus diseases; a
decrease in morbidity could lead to a reduction in neurological complications.

Publication Types: 
    English Abstract

PMID: 186960 [PubMed - indexed for MEDLINE]

8757: Med Welt. 1976 Oct 8;27(41):1973-8.

[Basic text: Herpes zoster]

[Article in German]

Clauss H, Dahmer J, Weinrich W.

PMID: 994805 [PubMed - indexed for MEDLINE]

8758: Indian J Ophthalmol. 1976 Oct;24(3):36-7.

Trigeminofacial herpeszoster--a case report.

Anandakannan K.

Publication Types: 
    Case Reports

PMID: 1088557 [PubMed - indexed for MEDLINE]

8759: Ann Otolaryngol Chir Cervicofac. 1976 Oct-Nov;93(10-11):713-6.

[A case of multilocular zona]

[Article in French]

Labayle MJ, Lachmann.

Publication Types: 
    Case Reports

PMID: 1088389 [PubMed - indexed for MEDLINE]

8760: Am J Ophthalmol. 1976 Oct;82(4):628-30.

Temporal artery biopsy in herpes zoster ophthalmicus with delayed arteritis.

Victor DI, Green WR.

A 58-year-old man developed herpes zoster ophthalmicus with delayed hemiparesis. 
Temporal artery biopsy confirmed the presence of a vasculitis. Electron
microscopy of the temporal artery failed to reveal viral particles. Herpes zoster
ophthalmicus with delayed arteritis appeared to be a contiguous spread of
vasculitis to the carotid system and not a direct viral invasion.

Publication Types: 
    Case Reports

PMID: 1086062 [PubMed - indexed for MEDLINE]

8761: Laryngoscope. 1976 Oct;86(10):1572.

Red chorda tympani nerve in Herpes Zoster oticus.

May M.

A red chorda tympani nerve was previously reported as a finding limited to
patients with Bell's palsy. This is a report of red chorda tympani nerve observed
in 3 of 10 patients with Herpes Zoster oticus in whom the chorda tympani was
visible. It is speculated that the red discoloration is due to a viral
inflammatory process and, therefore, when this sign is present in a patient with 
idiopathic peripheral facial paralysis, a viral neuropathy should be suspected.

PMID: 966922 [PubMed - indexed for MEDLINE]

8762: Nouv Presse Med. 1976 Sep 25;5(31):1997.

[Treatment of zona and varicella. Effectiveness of lysozyme]

[Article in French]

Brisset CH.

Publication Types: 
    Letter

PMID: 980721 [PubMed - indexed for MEDLINE]

8763: Ugeskr Laeger. 1976 Sep 13;138(38):2302-5.

[Chronic herpes zoster pain treated with transcutaneous electric stimulation]

[Article in Danish]

Juul-Jensen P, Malmros R, Pedersen B, Sorensen K.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1086017 [PubMed - indexed for MEDLINE]

8764: Ugeskr Laeger. 1976 Sep 13;138(38):2305-9.

[Treatment of acute herpes zoster with acupuncture and sympathetic blocks. A
controlled study]

[Article in Danish]

Nielsen SE, Valentin N, Lewinski A.

Publication Types: 
    Case Reports
    Clinical Trial
    English Abstract
    Randomized Controlled Trial

PMID: 968976 [PubMed - indexed for MEDLINE]

8765: Ugeskr Laeger. 1976 Sep 13;138(38):2299-301.

[Herpes zoster treated by photodynamic inactivation]

[Article in Danish]

Larsen PO, Hage E, Seidelin J.

Publication Types: 
    Clinical Trial
    Comparative Study
    English Abstract
    Randomized Controlled Trial

PMID: 788272 [PubMed - indexed for MEDLINE]

8766: Nippon Hifuka Gakkai Zasshi. 1976 Sep 10;86(10):615-22.

[Clinical study and treatment of herpes zoster (author's transl)]

[Article in Japanese]

Sasada K, Yasue T, Akutsu J, Shinjo H.

PMID: 1034792 [PubMed - indexed for MEDLINE]

8767: Nippon Hifuka Gakkai Zasshi. 1976 Sep 10;86(10):623-8.

[Pathology and pathogenesis of varicella and zoster (author's transl)]

[Article in Japanese]

Aoyama Y, Kurata T, Hondo R, Ogiwara H.

PMID: 189104 [PubMed - indexed for MEDLINE]

8768: Neurol India. 1976 Sep;24(3):159.

Herpes zoster ophthalmicus with abducens nerve inolvement.

Dinakar I.

Publication Types: 
    Case Reports

PMID: 1088176 [PubMed - indexed for MEDLINE]

8769: Rinsho Shinkeigaku. 1976 Sep;16(9):649-53.

[Case of herpes zoster ophthalmicus with contralateral hemiplegia]

[Article in Japanese]

Nishimaru K, Kamei H.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1087597 [PubMed - indexed for MEDLINE]

8770: Zh Nevropatol Psikhiatr Im S S Korsakova. 1976 Sep;76(9):1315-8.

[Intensive therapy of herpes zoster with deoxyribonuclease]

[Article in Russian]

Gutorov AN, Lesnikov EP, Salganik RI.

Publication Types: 
    English Abstract

PMID: 1015134 [PubMed - indexed for MEDLINE]

8771: Klin Med (Mosk). 1976 Sep;54(9):90-7.

[Lesions of the nervous system caused by viruses of the herpes group]

[Article in Russian]

Tsuker MB.

PMID: 1003925 [PubMed - indexed for MEDLINE]

8772: Hautarzt. 1976 Sep;27(9):463.

[Combination of IDU and DMSO in zoster?]

[Article in German]

Nasemann T.

Publication Types: 
    Letter

PMID: 993025 [PubMed - indexed for MEDLINE]

8773: Surv Ophthalmol. 1976 Sep-Oct;21(2):91-9.

Herpes simplex: the primary infection.

Ostler HB.

A primary infection with herpes simplex virus (HSV) occurs at some time in the
life of almost every member of the population, especially among those living in
crowded, unsanitary conditions. In many cases the lesions are subclinical, and in
most cases they are self-limited even when clinical. In a few patients, such as
the newborn infant, the patient with concomitant eczema, or the patient with
reduced immunity, the primary infection may become severe, generalized, and
life-threatening. Type 1 HSV has a predilection for a number of sites, including 
the oral cavity, the eye, and the skin; and type 2 HSV has a predilection for the
genital area and for the newborn.

PMID: 982271 [PubMed - indexed for MEDLINE]

8774: Surv Ophthalmol. 1976 Sep-Oct;21(2):82-90.

Historical observations on herpetic keratitis.

Thygeson P.

The history of herpetic keratitis is presented. The similarities and differences 
between dendritic keratitis and herpes labialis are enumerated, with the
suggestion that the similarities (in onset, pathology, and clinical course) far
outweigh the differences. The principal difference seems to be that the
avascalarity of the cornea retards the immunologic responses. Important points in
the history of herpetic keratitis include (1) the close association of herpetic
disease with malaria around the turn of the century; (2) the relatively benign
nature of the disease, in contrast to herpes zoster keratitis; (3) the
unfavorable response of the disease to immunosuppressive measures and diseases;
(4) the failure of chemotherapy to influence favorably the natural history of the
disease; and (5) the increasing visual damage caused by the disease since 1952
when corticosteroids were introduced into ocular therapy. Mention is made of the 
increasing problem of venereal herpes, with resultant neonatal herpetic
keratitis, retinitis, and encephalitis.

Publication Types: 
    Case Reports
    Historical Article

PMID: 790618 [PubMed - indexed for MEDLINE]

8775: Surv Ophthalmol. 1976 Sep-Oct;21(2):136-4709ENG.

The management of ocular herpesvirus infections.

Ostler HB.

The many treatment methods in current use for every known complaint only seem to 
aggravate the difficulty of treating ocular herpes simplex virus (HSV)
infections, which are generally self-limited in the immunocompetent host. The
cornea is already a somewhat immune-deficient tissue since its lack of blood
vessels separates it partially from the host, and treatment with glucocorticoids,
which are immunosuppressive, increases the risk of damaging complications such as
scarring, prolonged morbidity, bacterial or fungal superinfection, and the
occasional corenal perforation. Accepted methods of treatment of specific
lesions, are discussed, as are some methods that are not yet accepted, but which 
seem promising. Herpes zoster may result in scarring and significant loss of
vision even without the use of glucocorticoids, the disease often manifesting
itself in the already compromised host. The major complication is postherpetic
neuralgia. None of the available treatment methods has been fully satisfactory,
and every effort should be made to prevent eye lesions in patients with early
infection of the ophthalmic branch of the trigeminal nerve. Stimulation of
cellular immunity by various means appears to offer some new promise for control 
of the disease. Management of varicella, cytomegalovirus, and infectious
mononucleosis are also discussed.

Publication Types: 
    Review

PMID: 790617 [PubMed - indexed for MEDLINE]

8776: Surv Ophthalmol. 1976 Sep-Oct;21(2):148-59.

The ocular manifestations of herpes zoster, varicella, infectious mononucleosis, 
and cytomegalovirus disease.

Ostler HB, Thygeson P.

Herpes zoster, caused by varicella-zoster (V-Z) virus which also causes varicella
(chickenpox), is usually a benign self-limited disease. However, when the
ophthalmic division of the trigeminal nerve is affected, the ocular disease
(ophthalmic zoster), although also usually mild and self-limited, may have severe
complications (corneal scarring, glaucoma, iris atrophy, posterior synechiae,
scleritis, motor disturbances, optic neuritis, retinitis, anterior segment
necrosis, and phthisis bulbi and servere postherpetic neuralgia). Varicella
affects the eye rarely (except for the typical lid lesions), but associated
conjunctival and corneal lesions, iridocyclitis, glaucoma, chorioretinitis, and
optic nerve lesions have been described. Infectious mononucleosis may involve the
eye either by direct involvement or from a remote focus such as the central
nervous system. Ocular manifestations of cytomegalovirus disease is usually
limited to the choroid and retina unless involvement of the developing embryo
occurs prior to the development of the eye.

PMID: 185734 [PubMed - indexed for MEDLINE]

8777: Can J Microbiol. 1976 Sep;22(9):1245-51.

Indirect microhemagglutination test for varicella--zoster antibody determination.

Mankikar SD, Petric M, Middleton PJ.

An indirect microhemagglutination assay (IHA) was devised because of a need to
provide an alternative test to complement fixation (CF) for varicella-zoster
(V-Z) antibody determination. Human erythrocytes were sequentially treated with
2% glutaraldehyde, 0.04% tannic acid, and 2% pyruvic aldehyde then exposed to
sonicated V-Z infected cells. This same tanning procedure was suitable for herpes
simplex and Epstein-Barr virus antigen attachment but unsatisfactory for several 
non-herpes-group viruses. V-Z antibody titres determined by IHA were generally 2 
to 6 times higher than CF titres. Cross-reaction with herpes simplex antibody was
minimal.

Publication Types: 
    Comparative Study

PMID: 184904 [PubMed - indexed for MEDLINE]

8778: Cutis. 1976 Sep;18(3):427-32.

Herpes zoster in the elderly.

Miller LH.

Herpes zoster is a self-limited disorder which in most cases resolves without
complications. The specific defect in host immunity that permits activation of
latent V-Z virus and the occurrence of herpes zoster in both healthy and
debilitated individuals has not yet been identified. In some patients,
particularly the aged, complications occur during the acute phase of the disease 
or there are sequelae that may incapacitate the patient later. The most important
of these is postherpetic neuralgia. In the elderly the chance of developing
neuralgia following herpes zoster is about 50%. Involvement of the eye may
produce minimal scarring or permanent blindness. There is an increasing incidence
and severity of herpes zoster in association with malignant disease and in
particular with Hodgkin's disease. Treatment of herpes zoster in the elderly
should be determined by presenting symptoms. Topical medication such as the basic
shake lotion is helpful. Personal experience and published reports suggest that
early systemic administration of corticosteroids to healthy patients with severe 
herpes zoster pain with lessen the occurrence of postherpetic neuralgia.
Administration of herpes zoster immune globulin is only effective in reducing the
morbidity or preventing varicella in high risk individuals. ZIG does not affect
the clinical course of herpes zoster.

PMID: 65246 [PubMed - indexed for MEDLINE]

8779: Vestn Dermatol Venerol. 1976 Aug;(8):71-4.

[Shingles as a provoking factor in psoriasis]

[Article in Russian]

Lipets ME, Gavrikov VV, Shibaeva LN.

Publication Types: 
    Case Reports
    English Abstract

PMID: 983286 [PubMed - indexed for MEDLINE]

8780: Arch Dermatol. 1976 Aug;112(8):1178.

Letter: Glutaraldehyde in treating herpes simplex and herpes zoster.

Gordon HH.

PMID: 821400 [PubMed - indexed for MEDLINE]

8781: AJR Am J Roentgenol. 1976 Aug;127(2):273-6.

Colonic changes of herpes zoster.

Menuck LS, Brahme F, Amberg J, Sherr HP.

The lesions of herpes zoster of the colon were observed in three cases. Small
polygonal mucosal blebs or small ulcerations involving a short segment of the
colon and appearing in a reasonable time relationship with the cutaneous
manifestations either in a corresponding or noncorresponding dermatome should
enable diagnosis of this unusual condition. Recognition of this entity in the
presence of these skin lesions should be obvious and therefore helpful in
avoiding more aggressive and invasive diagnostic procedures.

PMID: 182006 [PubMed - indexed for MEDLINE]

8782: J Neurol Sci. 1976 Aug;28(4):427-47.

Unusual manifestations of herpes zoster. A clinical and electrophysiological
study.

Gardner-Thorpe C, Foster JB, Barwick DD.

The literature on complicated herpes zoster is summarized in this paper. The case
histories of 18 patients with herpes zoster are presented. Two patients had
encephalitis, 2 had myelitis and the other 14 patients had various types of lower
motor neurone disturbance. Both patients with encephalitis--one of who developed 
choreo-athetosis during the illness--recovered fully. Only 1 of the 2 patients
with myelitis recovered fully; the other remains severely paraparetic and the
reason for her incomplete recovery may be related to the presence of generalized 
arteriolar disease associated with seronegative rheumatoid disease. One patient
developed a Guillain-Barre syndrome 3 weeks after the onset of herpes zoster.
Recovery in the 15 patients with lower motor neurone involvement has been slow
butcomplete--or almost complete--in all but 1, a patient with persistent facial
weakness as part of the Ramsay Hunt syndrome and who also had weakness of one
upper limb. Seven other patients had lower limb weakness. In 2 patients the
weakness was confined to abdominal myotomes and 2 other patients had urinary
retention. Electromyographic abnormalities were found in the muscles which were
weak and frequently also in muscles which appeared strong. It is emphasized that 
neurological disturbances other than sensory abnormalities may be found in
patients with herpes zoster. Motor complications of various types are not
uncommon.

Publication Types: 
    Case Reports

PMID: 181539 [PubMed - indexed for MEDLINE]

8783: JAMA. 1976 Jul 26;236(4):345-6.

Letter: "Ramsay Hunt, Ramsay-Hunt, or Hunt's syndrome?".

Litt JZ.

PMID: 947045 [PubMed - indexed for MEDLINE]

8784: Int J Cancer. 1976 Jul 15;18(1):14-23.

Anti-EBV antibody titers in non-Hodgkin lymphomas.

Dumont J, Liabeuf A, Henle W, Feingold N, Kourilsky FM.

Antibody titers to Epstein-Barr virus (EBV)-related antigens, i.e. viral capsid
antigen (VCA), the D and R components of the early antigen (EA) complex and the
EBV-associated nuclear antigen (EBNA), were determined in a series of 86 patients
with non-Hodgkin lymphomas and in 150 matched control subjects. The lymphoma
patients belonged to four histological groups: diffuse, nodular, hyperbasophilic 
malignant lymphoma (HML) and unclassified. The EBV-related serological data were 
compared to the incidence of antibodies to other herpes viruses, i.e.
cytomegalovirus (CMV), herpes simplex virus (HSV) and varicella zoster virus
(VZV), and correlated with immune disorders, which are particularly frequent in
the HML type of lymphoma. The results revealed a significantly higher incidence
of anti-EA-D titers in lymphoma patients and slight but significant increases in 
the geometric mean anti-VCA titers in the HML and unclassified group of patients.
These elevated anti-EBV titers in patients were not associated with an increase
in titres of antibodies to other herpes viruses. They did not correlate with the 
signs of immune deficiency observed or with the incidence of auto-antibodies.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 181335 [PubMed - indexed for MEDLINE]

8785: Trans Ophthalmol Soc U K. 1976 Jul;96(2):334-7.

Current management of ophthalmic herpes zoster.

Marsh RJ.

PMID: 1087768 [PubMed - indexed for MEDLINE]

8786: Can J Ophthalmol. 1976 Jul;11(3):217-22.

[Zona ophthalmica and dendritic keratitis]

[Article in French]

Laflamme MY, Kurstak C, Kurstak E, Moriset R.

Two cases of herpes zoster ophthalmicus with dendritic keratitis are reported.
Virological studies confirmed the double infection with herpes simplex type 1
virus in the corneal lesions and herpes zoster virus in the cutaneous lesions. We
suggest the use of the immunoperoxidase test to identify the viral agent mainly
because of its rapid and specific results. We are against the use of local
steroids in dendritic keratitis unless the etiological agent is proved to be
herpes zoster virus and not herpes simplex virus.

Publication Types: 
    Case Reports
    English Abstract

PMID: 949630 [PubMed - indexed for MEDLINE]

8787: Arch Otolaryngol. 1976 Jul;102(7):403-6.

Viral infection as a cause of acute peripheral facial palsy.

Djupesland G, Berdal P, Johannessen TA, Degre M, Stien R, Skrede S.

Among 51 patients with acute peripheral facial palsy, varicella-zoster virus was 
isolated from the cerebrospinal fluid (CSF) in one case, and Herpesvirus hominis 
from the nasopharynx in two cases. In 12 other cases, complement-fixing antibody 
or hemagglutination inhibition tests indicated a recent viral infection
(varicella-zoster, seven; herpes simplex, one; cytomegalovirus, one; influenza
type B virus, two; and mumps virus, one). One additional patient had clinical
signs of herpes zoster oticus. About one third of these 16 virus-positive
patients, but also one third of the remaining group, had increased levels of
alpha 1-antitrypsin, orosomucoid, haptoglobin, and immunoglobulins. Evidently, an
inflammatory reaction preceded or coincided with the facial palsy in both groups.
In CSF, an increase of total proteins and gamma-globulins was frequently found
among all 20 patients examined (eight were virus-positive).

PMID: 938319 [PubMed - indexed for MEDLINE]

8788: Br J Plast Surg. 1976 Jul;29(3):245-6.

Herpes zoster involving a skin graft.

Kikuchi I, Isa F.

Publication Types: 
    Case Reports

PMID: 779906 [PubMed - indexed for MEDLINE]

8789: Arch Pathol Lab Med. 1976 Jul;100(7):386-91.

Necrotizing retinopathy with herpes zoster ophthalmicus: a light and electron
microscopical study.

Schwartz JN, Cashwell F, Hawkins HK, Klintworth GK.

A necrotizing retinopathy following a vesicular cutaneous eruption in the
distribution of the right trigeminal nerve developed in a patient who had been
receiving systemic corticosteroid therapy one week prior to the onset of herpes
zoster ophthalmicus. Seven weeks after the herpetic symptoms began, the patient
died of pneumonia following an intracerebral hematoma. At postmortem examination,
unexpected multiple focal and confluent lesions, which corresponded to areas of
extensive retinal necrosis, were observed in the fundus of the right eye.
Intranuclear inclusions with a perinuclear halo were identified within the
affected sensory retina. Electron microscopy of the retinal lesions disclosed
round to oval enveloped viral particles that were characteristic of the herpes
viruses. A mild lymphocytic infiltrate was evident in a demyelinated right
Gasserian ganglion. Demyelination and necrosis of the right trigeminal sensory
tract and adjacent areas were evident within the brain stem.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 180930 [PubMed - indexed for MEDLINE]

8790: Wien Klin Wochenschr. 1976 Jun 11;88(12):393-6.

[Dermatological complications after renal transplantation (author's transl)]

[Article in German]

Kopsa H, Schmidt P, Zazgornik J, Kotzaurek R, Pils P, Thurner J.

58 renal transplant patients were submitted to dermatological check-up
investigations at regular intervals over a mean period of 26.2 months after
surgery. 98% of the case material showed dermatological complications. In an
analysis of the findings in 55 patients with infectious complications, viral
infections occurred in 40, bacterial in 30 and mycotic infections in 20 patients.
Dermatological manifestations of non-dermatological complications were mainly due
to immunosuppressive therapy. The data stress the necessity of optimum
cooperation between dermatologists and the attendant physician in the case of
renal transplant patients.

Publication Types: 
    English Abstract

PMID: 133539 [PubMed - indexed for MEDLINE]

8791: Med J Aust. 1976 Jun 5;1(23):862-5.

The response to acupuncture therapy in patients with chronic disabling pain.

Yuen RW, Vaughan RJ, Dyer H, Giles KE.

Twenty-one patients had acupuncture treatment for chronic, disabling pain. Ten
(47.5%) thought they had obtained worthwhile relief by the time treatment was
completed. Six (30%) had no or negligible benefit and five (25%) had some
aggravation of their pain at some stage of the procedure. In this group of
patients, with the technique we describe, we were unable to achieve the high
degree of short-term success claimed by other workers. Until further scientific
studies can confirm the value of acupuncture in medical practice, we urge caution
in the use of this procedure.

PMID: 135199 [PubMed - indexed for MEDLINE]

8792: Arch Fr Pediatr. 1976 Jun-Jul;33(6):569-98.

[Interstitial pneumopathies in children treated for malignant diseases]

[Article in French]

Lemerle J, Backes C, Lallemand D, Lejeune JA, Reinert P.

The authors report 21 cases of severe interstitial pneumonitis observed in 1974
in Paris, in children with malignancies, either solid tumours or leukemias.
Twelve patients died. The incidence of these complications in children with
intensive chemotherapy and the clinical symptoms which may reveal them are
reviewed; the bad prognosis of measles in these patients is stressed.
Radiological findings are described and the possible wrong diagnoses are listed. 
Among viral infections, measles is the severest and its diagnosis is often
difficult. Pneumocystis carinii infection is frequent. The use of surgical
pulmonary biopsy and other diagnostic procedures is discussed. The immune status 
of these patients has been studied, which revealed severe impairement of cellular
immunity, including low lymphocyte count, while humoral immunity was not changed.
Symptomatic treatment may include oxygen supply and mechanical respiratory help, 
dietary management, and attempts towards non specific immune system stimulation. 
Aetiologic treatment is essentially the treatment of Pneumocystis carinii, which 
is discussed. Diagnosis and treatment of pneumonitis in immunosuppressed patients
being very difficult, emphasis is made on the prevention of this accident,
including caution in the handling of chemotherapy protocols.

Publication Types: 
    English Abstract

PMID: 1085139 [PubMed - indexed for MEDLINE]

8793: Aust Fam Physician. 1976 Jun;5(5):616-21.

The mouth in health and disease.

Murrell TG.

Medical, dental and psychiatric conditions may cause dysfunction of the mouth in 
health and disease. The principle of clinical assessment of the patient, which
includes a thorough assessment of the physical, social and psychological factors,
is of paramount importance. This paper has attempted to describe some of the more
common conditions affecting the mouth in general practice, and to underline
important causes of pain which can occur in the face arising from conditions in
the mouth.

PMID: 985213 [PubMed - indexed for MEDLINE]

8794: J Radiol Electrol Med Nucl. 1976 Jun-Jul;57(6-7):549-51.

[The treatment of herpes zoster by ultraviolet actinotherapy. Study of 200 cases 
(author's transl)]

[Article in French]

Szigeti B, Chapiro J, Saint-Girons JM.

The authors analysed the cases of 200 patients treated for early herpes zoster by
ultraviolet actinotherapy. This simple treatment should ideally be applied: - to 
clean skin, without dye nor ointment; - over the entire root area, and not only
to the vesicles; - obtaining from the outset frank erythema, uniform, and without
a healthy skin interval. Under these conditions, 95% of successful results were
obtained in 3 to 8 days. The occasional failures appear to be related either to
faulty technique or to a deep-seated localisation beyond the fied of action of
the ultraviolet rays.

Publication Types: 
    English Abstract

PMID: 957291 [PubMed - indexed for MEDLINE]

8795: Neurology. 1976 Jun;26(6 PT 1):596-7.

Herpes simplex neuropathy.

Krohel GB, Richardson JR, Farrell DF.

Atypical facial pain and permanent sensory loss in the second and third divisions
of the trigeminal nerve developed in a patient who had had multiple attacks of
herpes simplex neuralgia over a period of 8 years. Intravenous cytosine
arabinoside failed to prevent a recurrence of the vasicular eruption, but
carbamazepine produced symtomatic pain relief. This case demonstrates that herpes
simplex can closely mimic herpes zoster as a cause of postherpetic neuralgia and 
suggests a possible etiology of atypical facial pain and/or trigeminal sensory
neuropaty in some patients.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 945505 [PubMed - indexed for MEDLINE]

8796: Neurochirurgie. 1976 Jun;22 suppl 1:5-164.

[Present state of pain surgery]

[Article in French]

Mazars G, Merienne L, Cioloca C.

This report presented to the Societe de Neurochirurgie de Langue Francaise is
based on 34 years of unique practice in neurosurgical management of pain; during 
that long period the author and his associates have collected an unusually large 
experience in almost every field of neurosurgical management of pain; they have
improved or fully devised several new techniques which allow them to ground an
appreciation of the procedures still worthy to be used in various pain syndromes.
The first part of the report deals with "Cybernetics of pain". This rather long
chapter is based both on classical data and personal observations on man during
and following operations, meant to relieve pain. Though supporting HEAD and
HOLMES, theory on Control of protopathic by epicritic Stimuli, the authors
consider that the type of pain associated with noxious stimulation as
representative of just one among other types of pain, not induced by nociception 
and not associated with protection reflexes. Sensory deafferentation as can be
produced by amputations, herpes zoster, dorsal column or medullary lesions,
cannot be included in Sherrington's scheme of psychical mechanisms associated
with protection reflexes and yet is responsible for most of the chronic
unbearable and often intractable pain. Moreover, an important modulation of pain 
as such depends on conditioning, on inherited and acquired patterns of behaviour 
and on a multiplicating factor which is provisionally named "algogenic neurosis".
The fact that an intact nucleus ventralis posterolateralis is a necessity for a
"no pain status" tends to prove that this thalamic nucleus acts as a major
inhibiting relay on the pain integrating system and for several additional
reasons is the level of integration of epicritic versus protopathic stimuli in
case of true nociception...

Publication Types: 
    English Abstract
    Review

PMID: 787819 [PubMed - indexed for MEDLINE]

8797: Clin Haematol. 1976 Jun;5(2):311-28.

Viral infections and haematological malignancies.

Feldman S, Cox F.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 181191 [PubMed - indexed for MEDLINE]

8798: J Infect Dis. 1976 Jun;133 Suppl:A192-8.

Toxicity of adenine arabinoside in humans.

Ross AH, Julia A, Balakrishnan C.

Six forms of reversible adverse reactions to adenine arabinoside (vidarabine)
were observed in a two-year period among 42 patients (19 of whom had lymphomas,
leukemias, or other malignancies) who were treated for complicated infections
with varicella-zoster or herpes simplex virus. Six patients received placebo. Ten
patients received 10 mg of adenine arabinoside/kg per day; three received 15
mg/kg; 22 received 20 mg/kg; and one received 30 mg/kg. Patients were treated (by
continuous intravenous injection) for an average of seven days. Toxic effects
were nausea and vomiting, weight loss, weakness (often with impaired ambulation),
megaloblastosis in erythroid series in bone marrow, tremors five to seven days
after the start of therapy (including tremors in one patient with abnormal
electroencephalograms that were consistent with toxic-metabolic encephalopathy), 
and thrombophlebitis at the intravenous site. Side effects clearly predominated
in patients who received 20 mg/kg per day. Therefore, treatment with 10 mg/kg per
day appears preferable until the relation of toxicity to dosage level can be
clarified.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 180199 [PubMed - indexed for MEDLINE]

8799: J Infect Dis. 1976 Jun;133 Suppl:A184-91.

Adenine arabinoside for therapy of herpes zoster in immunosuppressed patients:
preliminary results of a collaborative study.

Ch'ien LT, Whitley RJ, Alford CA Jr, Galasso GJ.

Eighty-seven immunosuppressed patients (53 with localized and 34 with
disseminated herpes zoster) from 10 institutions were enrolled in a controlled
therapeutic trial of adenine arabinoside. A crossover design was employed; thus, 
47 patients received drug for five days and then received placebo, and 40 were
given the two substances in the opposite order. Resolution of acute pain and the 
cutaneous lesions were graded during a 10-day observation period. During the
initial five-day period, treated patients showed a statistically significant
resolution of pain and cutaneous lesions. Surprisingly, in many untreated
patients, natural resolution occurred during this period so that crossover data
could not be adequately assessed. Effects on visceral disease also could not be

judged, because such disease was uncommon. Ratings of late complications such as 
postherpetic neuralgia were confused by the crossover design. Toxicity posed no
problem. The data further emphasized the potential usefulness of adenine
arabinoside as an antiviral chemotherapeutic agent, but also clearly indicated
the need for a double-blind study to define this usefulness and to determine how 
it can most practically be used, if the risk-benefit factor remains favorable.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 180198 [PubMed - indexed for MEDLINE]

8800: J Infect Dis. 1976 Jun;133 Suppl:A101-8.

Treatment of infections due to Herpesvirus in humans: a critical review of the
state of the art.

Alford CA Jr, Whitley RJ.

Results of experimental trials with antiviral agents in humans have varied from
encouraging to controversial to negative, usually as a result of the difficulty
in defining the true therapeutic index (ratio of efficacy to toxicity) of toxic
drugs for the treatment of diseases that are potentially severely debilitating or
lethal. Reasons for current difficulties relate mainly to inadequacies of
preclinical studies and the lack of appropriate controls. The inadequacies
include poor definition of the effect of drugs or viruses on cellular metabolism,
incomplete pharmacologic studies in animals or humans, and, because of the
latter, inappropriate animal models. In human trials, historical data have often 
been used instead of true controls because of the presumed severity of candidate 
diseases. Use of such data led to a false impression of drug efficacy, an
impression later refuted when proper control studies demonstrated that the range 
of disease was much greater than had been previously supposed. Data bearing on
these points for the most commonly employed experimental compounds (cytosine
arabinoside, adenine arabinoside, and 5-iodo-2'-deoxyuridine) are contrasted to
highlight difficulties as well as to provide perspectives for antiviral
chemotherapy of herpesvirus infections.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 180191 [PubMed - indexed for MEDLINE]

8801: JFORL J Fr Otorhinolaryngol Audiophonol Chir Maxillofac. 1976
Jun;25(6):435-43.

[Facial paralysis in children. Apropos of 82 cases]

[Article in French]

Garcin M, Magnan J, Long FX, Bremond G.

Publication Types: 
    Case Reports

PMID: 137275 [PubMed - indexed for MEDLINE]

8802: N Engl J Med. 1976 May 27;294(22):1233-4.

Editorial: Efficacy of adenine arabinoside in herpes zoster.

Merigan TC.

Publication Types: 
    Clinical Trial

PMID: 772429 [PubMed - indexed for MEDLINE]

8803: N Engl J Med. 1976 May 27;294(22):1193-9.

Adenine arabinoside therapy of herpes zoster in the immunosuppressed. NIAID
collaborative antiviral study.

Whitley RJ, Ch'ien LT, Dolin R, Galasso GJ, Alford CA Jr.

We evaluated adenine arabinoside treatment of herpes zoster in immunodeficient
patients in a randomized, controlled crossover study. The two study groups had
similar characteristics. In spite of rapid natural healing, those receiving
adenine arabinoside over the first five days had accelerated clearance of virus
from vesicles (P = 0.01), and cessation of new vesicle formation (P = 0.004), and
a shorter time to total pustulation (P = 0.001). Factors modifying the response
to therapy included age, underlying disease, and the duration of zoster prior to 
therapy. Clinical toxicity was minimal. Laboratory assessment of bone-marrow,
liver and renal function showed insignificant alterations as a result of therapy.
These studies show that adenine arabinoside is a drug with promise for therapy of
systemic herpes zoster in immunocompromised patients. It is most efficacious when
administered during the first six days of disease (P = 0.001) to those who have
reticuloendothelial neoplasia (P = 0.001) and are less than 38 years of age (P = 
0.001).

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 177866 [PubMed - indexed for MEDLINE]

8804: Nouv Presse Med. 1976 May 15;5(20):1285-8.

[Preventive and therapeutic effect convalescent zona and varicella sera in high
risk children (659 cases)]

[Article in French]

Gaiffe M, Herzog F, Schweisguth O.

Study of 659 cases treated with serum from patients convalescent after herpes
zoster and chickenpox over a period of two and a half years in French hospital
departments, showed the obvious effectiveness of this type of therapy which seems
to be better than that of zoster specific gamma globulin used by other workers
since we obtained protection against chickenpox in 90 p. cent of cases, and
attenuation of chickenpox in 82 p. cent. It would seem that these results could
be improved by increasing the doses used.

Publication Types: 
    English Abstract

PMID: 59342 [PubMed - indexed for MEDLINE]

8805: South Med J. 1976 May;69(5):576-8.

Herpes zoster: correlation of age, sex, distribution, neuralgia, and associated
disorders.

Brown GR.

The influence of sex and age on the distribution of lesions, incidence of
postherpetic neuralgia, and related disorders in herpes zoster is reported.
Results were obtained by reviewing the records of 140 outpatients with herpes
zoster seen over a ten-year period. Trigeminal involvement and post-herpetic
neuralgia were more common in patients over 50 years of age. The most common
sites of lesions in all ages were the thoracic dermatomes, between T-1 and T-8.
The distribution of lesions and the incidence of postherpetic neuralgia did not
vary between the sexes. High incidences of diabetes and cataracts were found to
be associated with herpes zoster infection. Clinical carcinoma of the prostate
was a frequent finding in men with herpes zoster over age 50. In those patients
with malignancies, there was no correlation between distribution of zoster
lesions and location of malignancy.

PMID: 1273613 [PubMed - indexed for MEDLINE]

8806: J Natl Cancer Inst. 1976 May;56(5):891-8.

Epidemiology of diseases in adult males with leukemia.

Gibson R, Graham S, Lilienfeld A, Schuman L, Levin M, Swanson M.

In the Tri-State Leukemia Survey, the history of diseases in 605 adult male
leukemia cases 15 years and older and in 668 adult male population controls was
examined. These diseases occurred at least 1 year before leukemia was diagnosed. 
The data were based on respondents' answers that the disease was diagnosed by a
physician; the respondent was either the subject or his spouse. Of 30 diseases
studied, 7 showed an excess among the patients with leukemia: infectious
hepatitis, eczema, psoriasis, diabetes, arthritis and rheumatism, heart disease, 
and ankylosing spondylitis. Mumps had a lower reported occurrence among the
cases, whereas pneumonia was less frequent in acute lymphatic cases than in
population controls. Three diseases occurred significantly less in controls than 
in persons with specific histologic types of leukemia. Our data revealed a more
frequent history of herpes zoster (shingles) in chronic lymphatic leukemia, more 
hives in acute chronic myeloid cases, and meningitis in acute myeloid leukemia.
When we only considered the patients' responses, more of them admitted having had
acne than did our controls. The remaining diseases--childhood viral diseases,
infectious mononucleosis, smallpox, typhoid fever, dysentery, scarlet fever,
tuberculosis, asthma, hay fever, and goiter did not occur more frequently in
cases than in controls. The findings were consistent with evidence from previous 
laboratory and clinical studies. The increased occurrence of infectious hepatitis
in our case series is consistent with the findings of other studies showing an
increased frequency of Australia antigen in patients with hepatitis, leukemia,
and Down's syndrome.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 994201 [PubMed - indexed for MEDLINE]

8807: Masui. 1976 May;25(5):484-9.

[Application of acupuncture to the treatment of herpes zoster]

[Article in Japanese]

Nagai Y, Ito T, Inoue S, Maehara K, Yamada S.

Publication Types: 
    English Abstract

PMID: 987258 [PubMed - indexed for MEDLINE]

8808: J Trop Med Hyg. 1976 May;79(5):94-6.

Lactation associated with herpes zoster pectoralis.

Bhattacharya SK, Girgla HS.

The phenomenon of lactation associated with herpes zoster is unexpected. To our
knowledge such an association has been reported only once. A case is reported in 
whom spontaneous lactation occurred in the ipsilateral breast following herpes
zoster. It is believed to have resulted from stimulation of the intercostal nerve
endings supplying the overlying skin of the breast.

Publication Types: 
    Case Reports

PMID: 945354 [PubMed - indexed for MEDLINE]

8809: Monatsschr Kinderheilkd. 1976 May;124(5):411-3.

[Varicella-zoster virus infections. Course, virologic findings and therapeutic
trials in healthy and in immunologic disease children]

[Article in German]

Luthardt T, Wehinger H.

PMID: 934134 [PubMed - indexed for MEDLINE]

8810: Acta Otolaryngol. 1976 May-Jun;81(5-6):462-7.

Acute facial palsy. Some clinical and virological observations.

Berg R, Forsgren M, Schiratzki H.

A prospective clinical and virological study on 44 patients with acute,
peripheral facial paralysis was carried out in consecutive cases during one year.
In 9 cases varicella-zoster infections were serologically established. In 5
additional patients an associated varicella-zoster, or herpes simplex, infection 
was possible. Of the 9 confirmed cases, 6 were clinically diagnosed as zoster
oticus, whereas on clinical grounds, 3 were regarded as Bell's palsy. No evidence
was obtained of associated enterovirus, mumps, measles, cytomegalovirus,
tick-borne encephalitis virus, para-influenza virus, mononucleosis or Mycoplasma 
pneumoniae infection.

PMID: 179268 [PubMed - indexed for MEDLINE]

8811: ASDC J Dent Child. 1976 May-Jun;43(3):184-6.

Herpes zoster in Hodgkin's disease: unusual oral sequelae.

Chenitz JE.

Publication Types: 
    Case Reports

PMID: 178705 [PubMed - indexed for MEDLINE]

8812: Ann Sclavo. 1976 May-Jun;18(3):393-446.

[Problems of the prenatal prophylaxis of the viral infections (author's transl)]

[Article in Italian]

Piersantelli N, Guida B, Robert L.

The present review will supply an simple notice over the characters of every one 
viral infection interesting the materne-faetal conditions, and also propose the
most convenient intervention for each observed type. A not small lot of these
problems are not resolved in the field of the antiviral immunity regarding the
mother and newborn.

Publication Types: 
    English Abstract

PMID: 65942 [PubMed - indexed for MEDLINE]

8813: Med Klin. 1976 Apr 23;71(17):706-10.

[CSF-evaluation in unilateral, bilateral and alternant facial paralysis (author's
transl)]

[Article in German]

Engelhardt P.

Etiology of idiopathic facial paralysis remains mostly unknown because further
investigations seem unnecessary being the only symptom. Differentiated evaluation
of CSF however for cytological or proteinous abnormalities should be performed
aside serological examinations. In 9 patients treated within 8 months in our
hospital diagnosis could be made by these procedures. Inflammation, if cause of
facial paralysis, can only call pleocytosis, if localised within or next to the
leptomeninges; protein of CSF perhaps will increase, if local inflammation of the
nerve is more distant to subarachnoid space. "Idiopathic facial paralysis"
however will not exclude focal inflammation far from subarachnoid space. Surgical
decompression should not be performed without previous examination of CSF in
regard of it's uncertain success.

Publication Types: 
    English Abstract

PMID: 1272168 [PubMed - indexed for MEDLINE]

8814: Lakartidningen. 1976 Apr 14;73(16):1537.

[Case of herpes zoster in a 4-month-old child]

[Article in Swedish]

Quiding-Bostrom R.

Publication Types: 
    Case Reports

PMID: 1263679 [PubMed - indexed for MEDLINE]

8815: Minerva Med. 1976 Apr 14;67(18):1196-203.

[Association of leukemias and tumors. Studies of 502 cases of leukemia]

[Article in Italian]

Paolino W, Rossi M, Infelise V, Degani G, Levis A.

Nineteen association of leukaemia and tumour were noted in a series of 502 cases 
of leukaemia: 12/180 (6.6%, compared with 4.7% of 5136 cases in the liteature)
for Chr. L.L. (hypogammaglobulinaemia, reduction in single Ig. serious herpes
zoster and the T-lymphocyte nature of leukaemia were not more frequent in these
associations); 2/102 (1.9%, compared with 2.6% of 1267 cases in the literure) for
Chr. M.L.; 5/220 (2.2%, compared with 2.19% of 1138 cases in the literature) for 
A.L. The mean age of the overall leukaemia series was virtually the same for A.L.
(47 yr in a group composed of subjects aged over 12 yr) and Chr. M.L. (48 yr),
with the same incidence of association (2.2 and 1.9%), whereas it was 64 yr and
6.6% incidence in Chr. L.L. The bilogarithmic increase in the incidence of
tumours with age may itself explain the higher incidence of Chr. L.L.
associations. The duration of leukaemia and the age of incidence must be taken
into account in any discussion of the significance of such associations.

Publication Types: 
    English Abstract

PMID: 1064758 [PubMed - indexed for MEDLINE]

8816: Med J Aust. 1976 Apr 3;1(14):472-3.

Surgical relief of post-herpetic pain by excision of scarred skin.

Weidmann MJ.

This paper deals with the problems of post-herpetic pain. The various modes of
treatment which have been tried for its relief are discussed as is our experience
of excision of the scarred area of skin. The procedure has been found to offer
worthwhile pain relief to a significant number of patients.

PMID: 933921 [PubMed - indexed for MEDLINE]

8817: Zentralbl Bakteriol [Orig A]. 1976 Apr;234(3):413-6.

Varicella-zoster antibodies in adult patient with haemoblastoses.

Trlifajova J, Lukasova M, Janele J, Jelinek J.

Indirect haemagglutination (IH) antibodies to varicella-zoster (VZ) virus were
investigated, under the identical conditions of a single experiment, in a group
of patients with haemoblastoses and 80 normal adults of equal age groups.
Statistical significance of the differences in VZ antibody geometric mean titres 
between the individual haemoblastoses and normal controls was examined by means
of variance analysis. A significantly raised mean titre was still found in the
Hodgkin's disease group.

PMID: 180728 [PubMed - indexed for MEDLINE]

8818: J Laryngol Otol. 1976 Apr;90(4):373-9.

Peripheral facial palsy and herpes zoster infection.

Mair IW, Flugsrud LB.

A clinical and virological study of 133 consecutive cases of peripheral facial
palsy has provided evidence for simultaneous infection with the varicella-zoster 
virus in 9 patients (6-8 per cent). Seven of these presented differing but
typical manifestations of the Ramsay Hunt syndrome, and the diagnosis was
therefore strongly suspected on the basis of the clinical findings alone. The
remaining two patients had neither herpetiform rash nor involvement of the eighth
cranial nerve, and had been diagnosed in the clinic as typical cases of Bell's
palsy. In this series the incidence of zoster infection in apparent idiopathic
facial palsy was 1-8 per cent.

PMID: 178812 [PubMed - indexed for MEDLINE]

8819: J Laryngol Otol. 1976 Apr;90(4):365-71.

Varicella-zoster virus and facial palsy.

Leeming RD.

Two cases of Ramsey-Hunt Syndrome are reported, one of which presented features
of the Guillain-Barre Syndrome. It is suggested that the varicella-zoster virus
is an aetiological factor in the Guillain-Barre Syndrome.

Publication Types: 
    Case Reports

PMID: 178811 [PubMed - indexed for MEDLINE]

8820: Proc Soc Exp Biol Med. 1976 Apr;151(4):762-5.

Detection of antibody to Varicella-Zoster virus by immune adherence
hemagglutination.

Gershon AA, Kalter ZG, Steinberg S, Kuhns WJ.

A serologic test for measurement of antibody to V-Z virus by immune adherence
hemagglutination is described. Initial evaluation of the test has shown it to be 
highly sensitive, specific, rapid, and simple to perform. The V-Z antigen may be 
stored at -70 degrees, and the test could be performed in any routine serology
laboratory.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 177988 [PubMed - indexed for MEDLINE]

8821: JAMA. 1976 Mar 29;235(13):1339-42.

Vidarabine therapy for severe herpesvirus infections. An unusual syndrome of
chronic varicella and transient immunologic deficiency.

Aronson MD, Phillips CF, Gump DW, Albertini RJ, Phillips CA.

Six patients with severe herpesvirus infections were successfully treated with
vidarabine. One patient had a previously undescribed syndrome of chronic
cutaneous varicella infection of eight months' duration, associated with
transient but complete duppression of lymphocyte response to conconavalin A.
Other diagnoses were severe varicella pneumonia, progressive cytomegalovirus
pneumonia associated with acute lymphocytic leukemia, herpes simplex
encephalitis, severe zoster associated with stage IV lymphoma, and disseminated
herpes simplex in a patient receiving high doses of steroids. All patients showed
cessation of new lesions or abrupt clinical improvement between days 2 and 4
after initiation of therapy, and all were cured of their clinical infection.
Dramatic improvement in all of our patients and the minimal toxicity observed
make vidarabine suitable for use in severe herpesvirus infections.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.

PMID: 175176 [PubMed - indexed for MEDLINE]

8822: Wiad Lek. 1976 Mar 15;29(6):537-9.

[Case of severe encephalitis in zoster]

[Article in Polish]

Kucharska-Demczuk K, Fabian F.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1266233 [PubMed - indexed for MEDLINE]

8823: Wiad Lek. 1976 Mar 15;29(6):525-7.

[Embryopathia herpetica]

[Article in Polish]

Maszkiewicz W, Zaniewska J.

Publication Types: 
    Case Reports

PMID: 1266231 [PubMed - indexed for MEDLINE]

8824: Br J Ophthalmol. 1976 Mar;60(3):163-91.

Scleritis and episcleritis.

Watson PG, Hayreh SS.

The data from 159 patients (217 eyes) with episscleritis and 207 patients (301
eyes) with scleritis have been investigated in detail and the results analysed
with the help of a computer. Of these patients, 91 per cent were followed-up
during a period of one to eight years. A new classification is presented which is
as follows: Episcleritis (217 eyes) Simple episcleritis (170 eyes) Nodular
episcleritis (47 eyes) Scleritis (301 eyes) Diffuse anterior scleritis (119 eyes)
Nodular anterior scleritis (134 eyes) Necrotizing scleritis (42 eyes). Of these, 
13 were regarded as scleromalacia perforans. Posterior scleritis (6 eyes) The
diagnosis is based on an exact clinical examination which is fully described.
Episcleritis has been shown to be a benign recurring condition, a mild keratitis 
being the only occasional complication. Episcleritis does not progress to
scleritis, except in the case of herpes zoster which sometimes starts as an
episcleritis with the vesicular stage of the eruption, to reappear three months
later as a scleritis in the same site. No clear conclusions could be drawn as to 
the aetiology of episcleritis.

PMID: 1268179 [PubMed - indexed for MEDLINE]

8825: Am J Med. 1976 Mar;60(3):441-3.

Guillain-Barre syndrome following administration of live measles vaccine.

Grose C, Spigland I.

In a 19 month old girl and a 10 month old girl the Guillain-Barre syndrome
developed within a week after they received, respectively, live measles-rubella
vaccine and live measles vaccine. The older child was immune to the rubella at
the time of vaccination, but both girls demonstrated a primary measles antibody
response. Serum obtained during the acute and convalescent stages from the
younger child was tested for antibodies against the herpes viruses (herpes
simplex, Epstein-Barr virus, cytomegalovirus and varicella-zoster) and found to
be negative.

PMID: 1258890 [PubMed - indexed for MEDLINE]

8826: Postgrad Med. 1976 Mar;59(3):181-4.

Eye disorders: Looking at the eye for clues to systemic disease.

Sacks JG.

There are many systemic diseases in which eye signs detectable without an
ophthalmoscope may be present. Examples are congenital glaucoma in
neurofibromatosis, corneal involvement in mycosis fungoides, chloroma in
leukemia, and uveitis and glaucoma in herpes zoster.

PMID: 817277 [PubMed - indexed for MEDLINE]

8827: J Clin Microbiol. 1976 Mar;3(3):364-72.

Immunoperoxidase technique for detection of antibodies to human cytomegalovirus.

Gerna G, McCloud CJ, Chambers RW.

The indirect immunoperoxidase antibody technique (IPA) has been applied to
determine immunoglobulin (Ig)G to humans cytomegalovirus (CMV) antibodies in 114 
blood donor sera, four cases of congenital cytomegalic inclusion disease, and
four cases of acquired CMV infection. The results have been compared with those
obtained with the CMV complement fixation (CF) test and indirect fluorescent
antibody technique (IFA) for broad spectrum CMV antibody (sigmaAb) detection. IgG
antibody has been detected by both CF and IPA. In healthy adult people IPA titers
are usually higher than CF titers. In addition, IFA sigmaAb titers are generally 
higher than CF titers. Some sera negative by CF and IPA are positive at low
dilutions by IFA sigmaAb antibody determination, due to the detection of small
amounts of IgA or noncomplement-fixing IgG. Nonspecific results seem unlikely,
since only nuclear inclusion fluorescence was interpreted as specific, as
demonstrated by blocking tests. In acute CMV infection, the IFA sigmaAb and IPA
IgG titers are essentially the same, except during the first weeks of infection, 
when IFA titers are higher and IgM is detectable. No cross-reactivity with other 
herpes group viruses, herpes simplex and varicella-zoster, was observed. Although
some problems of nonspecific staining of cytoplasmic inclusions are shared by
both methods, the IPA technique seems to possess the same degree of sensitivity
and specificity as the IFA technique, but interpretation is easier and various
procedural steps can be delayed without the technical problems associated with
fluorescence microscopy.

Publication Types: 
    Comparative Study

PMID: 178690 [PubMed - indexed for MEDLINE]

8828: Br J Oral Surg. 1976 Mar;13(3):282-8.

Dental complications of cytotoxic therapy in Hodgkin's disease--a case report.

Vickery IM, Midda M.

A case of trigeminal zoster in a patient with disseminated Hodgkin's disease is
described. Although one case of maxillary tooth loss in a comparable patient has 
previously been recorded, this is the first report of mandibular tooth loss. The 
aetiological significance of Beomycin and
I-(2-chloroethyl)-3-cyclohexyl-I-nitrosourea (C.C.N.U.) is discussed and an
hypothesis for post-zoster tooth exfoliation is suggested.

Publication Types: 
    Case Reports

PMID: 56949 [PubMed - indexed for MEDLINE]

8829: Nurs Times. 1976 Feb 19;72(7):262-5.

Herpes zoster--a parasitic fossil.

Hope-Simpson RE.

PMID: 175355 [PubMed - indexed for MEDLINE]

8830: MMW Munch Med Wochenschr. 1976 Feb 6;118(6):155-60.

[The problem of vitamin B6/B12 acne. A contribution on acne medicamentosa
(author's transl)]

[Article in German]

Braun-Falco O, Lincke H.

Deterioration of acne vulgaris or eruption of an acneiform exanthema could be
established during treatment with vitamin B6 and/or vitamin B12 in 14 patients.
Females were by far the more frequently affected. The appearance of skin
symptoms, even outside the age groups typically affected by acne vulgaris is
characteristic. The clinical appearance of acneiform exanthema occurring during
treatment with vitamin B6 or B12 consists of loosely disseminated small papules
or papulopustules on the face (especially on the forehead and chin), on the upper
parts of the back and chest and spreading to the upper arm. The pathogensis of
the change is not yet certain. The acneiform rash generally fades within a short 
time after vitamin B6 or vitamin B12 treatment has been stopped.

Publication Types: 
    Case Reports
    English Abstract

PMID: 130553 [PubMed - indexed for MEDLINE]

8831: Radiology. 1976 Feb;118(2):429-31.

Herpes zoster in children with stage I-III Hodgkin's disease.

Goodman R, Jaffe N, Filler R, Cassady JR.

Herpes zoster infection developed in 12 (52%) of 23 children with Stage I-III
Hodgkin's disease but had no prognostic significance. Of these 23 patients, 22
are presently alive without evidence of active Hodgkin's disease. The authors
conclude that a combination of factors is important in the high incidence of
herpes zoster, including more aggressive staging as well as more aggressive
irradiation and chemotherapy, and that the results in their series would seem to 
justify continuation of this approach to staging and treatment in such cases.

PMID: 1250979 [PubMed - indexed for MEDLINE]

8832: J Assoc Physicians India. 1976 Feb;24(2):123-6.

Association of herpes zoster with antigen positive hepatitis and chronic active
hepatitis.

Singh RP, Pullimood BM, Johnson S.

Publication Types: 
    Case Reports

PMID: 1002658 [PubMed - indexed for MEDLINE]

8833: Pathol Biol (Paris). 1976 Feb;24(2):127-31.

[Virus infections in man during immunodepression (author's transl)]

[Article in French]

Bricout F, Huraux JM, Nicolas JC, Bogossian M, Descamps P.

The authors review virus infections observed in patients undergoing
immunosuppressive treatment. The herpes virus, in particular the cytomegalovirus,
are the most important cause. However, the role of the virus itself in an
unfavourable course is variously assessed. The mechanism of the virus infection
is discussed, whether primary infection, exogenous or endogenous re-infection.
The latter seems to be the most frequent, at least in the case of the herpes
viruses.

Publication Types: 
    English Abstract
    Review

PMID: 179044 [PubMed - indexed for MEDLINE]

8834: JFORL J Fr Otorhinolaryngol Audiophonol Chir Maxillofac. 1976
Feb;25(2):105-7.

[Clinical aspects of paralysis caused by cold and viral paralysis]

[Article in French]

Perrin C.

PMID: 130439 [PubMed - indexed for MEDLINE]

8835: Br Med J. 1976 Jan 24;1(6003):224.

Letter: Intravenous cytarabine in treatment of herpes zoster in haematological
malignancy.

Kernbaum S.

PMID: 1247798 [PubMed - indexed for MEDLINE]

8836: Nouv Presse Med. 1976 Jan 17;5(3):148.

[Letter: Treatment of recurrent corneal herpes and ophthalmic zona with
levamisole]

[Article in French]

Lods F.

PMID: 1083507 [PubMed - indexed for MEDLINE]

8837: Br Med J. 1976 Jan 17;1(6002):131-2.

Trigeminal zoster producing facial paralysis and postural hypotension.

[No authors listed]

Publication Types: 
    Case Reports

PMID: 174771 [PubMed - indexed for MEDLINE]

8838: J Indian Med Assoc. 1976 Jan 16;66(2):41-2.

Herpes zoster-transverse myelitis.

Rao KS, Ramana Murty DV.

Publication Types: 
    Case Reports

PMID: 1032505 [PubMed - indexed for MEDLINE]

8839: Sem Hop. 1976 Jan 9;52(2):99-103.

[Infectious complications observed during the use of antimitotic agents in
hematology]

[Article in French]

Schaison G, Weil M, Backes C, Jacquillat CL, Bussel A, Perol Y.

During acute lymphoblastic leukemia in children, bacterial infections occur
during initial treatment, whereas virus infections are observed during remission.
Mycoses and pneumocystis carinii infections are the commonest late complications.
During agranulocytosis, any prolonged fever should be considered as due to
infection and probably septicemia. The bacteria are usually of digestive origin. 
Antibiotic therapy is only very inconstantly efficacious, and the course follows 
closely the number of granular cells, thus justifying the use of white cell
transfusions.

Publication Types: 
    English Abstract

PMID: 185705 [PubMed - indexed for MEDLINE]

8840: J Laryngol Otol. 1976 Jan;90(1):101-4.

Oral vesiculo-bullous lesions.

Haskell R.

PMID: 1254998 [PubMed - indexed for MEDLINE]

8841: Int J Dermatol. 1976 Jan-Feb;15(1):67-8.

Letter: Herpes zoster, simplex and steroids.

Sauer GC.

PMID: 1245373 [PubMed - indexed for MEDLINE]

8842: Oftalmol Zh. 1976;(2):150-1.

[Herpes zoster ophthalmicus hemorrhagicus associated with late skin porphyria,
staphylococcal pyoderma and diabetes mellitus]

[Article in Russian]

Gytsu FI, Bobu IF, Boishtian VI.

Publication Types: 
    Case Reports

PMID: 1088178 [PubMed - indexed for MEDLINE]

8843: ADM. 1976 Jan-Feb;33(1):52-4.

[Herpes zoster]

[Article in Spanish]

Schein B.

Publication Types: 
    Case Reports

PMID: 1072723 [PubMed - indexed for MEDLINE]

8844: Verh Dtsch Ges Inn Med. 1976;82 Pt 2:1614-6.

[Herpes zoster in splenectomized patients with Hodgkin's disease]

[Article in German]

Zeile G, Roux A, Gamm H.

PMID: 1030060 [PubMed - indexed for MEDLINE]

8845: Klin Anasthesiol Intensivther. 1976;(12):49-67.

[Significance of opsonification in antimicrobial defense and its therapeutic
consequences]

[Article in German]

Mondorf AW, Schaffstein A, Fischer M.

PMID: 1029768 [PubMed - indexed for MEDLINE]

8846: Zh Ushn Nos Gorl Bolezn. 1976;(6):75-7.

[Herpes zoster oticus]

[Article in Russian]

Parkhomovskii MA, Gadzhiev RSh.

Publication Types: 
    Case Reports

PMID: 1023681 [PubMed - indexed for MEDLINE]

8847: Cutis. 1976 Jan;17(1):63-6.

Herpes zoster: a cause of acute detrusor muscle paralysis.

Plotnick H.

The essence of this report is to apprise the dermatologist of this fascinating
but unusual complication of herpes zoster and to underscore the help he may give 
in establishing the diagnosis along with assisting in the management of this
disorder.

Publication Types: 
    Case Reports

PMID: 1017225 [PubMed - indexed for MEDLINE]

8848: Acta Otorhinolaryngol Belg. 1976;30(1):84-9.

The transmeatal approach to the geniculate ganglion.

Helms J.

PMID: 983703 [PubMed - indexed for MEDLINE]

8849: Am J Chin Med (Gard City N Y). 1976 Autumn;4(3):219-37.

A contribution to our knowledge of Leonurus L., i-mu-ts'ao, the Chinese
motherwort.

Hu S.

This article deals with the ethnobotanical aspects of the Chinese motherwort.
Since time immemorial the Chinese people have used various parts of motherwort to
meet different physical needs. By the time a written language was developed and
the medical uses were recorded. , motherwort was treated as an article of
superior quality. At present, under the name of i-mu-ts'ao, the plant is used for
improving bloodflow both by official physicians and herbal practitioners
throughout the country as well as by villagers in isolated areas. According to
Chinese classical literature on materia medica, the early uses were limited to
the parts of the plant which met the most obvious needs of the prehistorical
people in their struggle for existence-food and pain reliever. Evidently, in
their search for food, the ancient people found that the four nutlets contained
in the dry and spinose calyx of the Chinese motherwort resemble the seasame seed 
in size and oil content. They gathered them and used them for food in similar
manner as with the sesame. Consequently, they discovered the good effects to the 
eyesight, the improvement of strength, and the uplift of spirit. These
discoveries led to the use of the seed of the species as an eye medicine for
improving the eyesight, and as a tonic for the increase of strength and the
elevation of spirit. Contagious skin diseases caused serious problems for the
ancient people. The use of the leafy shoot for a bath to release the discomfort
of itches and shingles was also recorded in the 42-word first medicinal record of
the species in the earliest known Chinese materia medica-the Shen-nung
pen-ts'ao-ching. Translators of the Chinese classics have included the records of
i-mu-ts'ao. According to my knowledge, these works are all partial translations
with the selections of the medicinal properties and the omissions on the methods 
of preparation. They have the outline and abandon the details. Consequently most 
of them are not clear. In order to provide complete information on the
discoveries of the ancient Chinese people on the uses of i-mu-ts'ao, all the
records up to the end of the sixteenth century are organized and translated under
the following headings: (1) ecological and morphological observations; (2)
preparations; (3) physical and therapeutical properties; (4) special
prescriptions for internal and external uses-including pills for pregnant women, 
for mothers post partum, as an emmenagogue, and as a corrective agent, condensed 
liquid, powder, fresh juice, baby bath and washes, poultices, charred shoots,
gargles, drops and cakes; (5) other economic uses-including cosmetics and food;
and (6) etymology. The distribution of i-mu-ts'ao is significant in
photogeography and in the nomenclature of the species. I-mu-ts'ao was purposely
introduced from South China to Linnaeus in Sweden before the publication of the
Species Plantarum in 1753. Linnaeus planted the seed in the botanical garden of
the University of Uppsala...

PMID: 970356 [PubMed - indexed for MEDLINE]

8850: Acta Neurol (Napoli). 1976 Jan-Feb;31(1):104.

[Anatomo-clinical study of a case of encephalitis due to Herpes zoster]

[Article in Italian]

Leonardi A, Vitale A, Meneghini S.

Publication Types: 
    Case Reports

PMID: 970251 [PubMed - indexed for MEDLINE]

8851: Acta Neurol Belg. 1976 Jan-Feb;76(1):21-5.

The syndrome of the posterior retroparotid space.

De Vooght H, Van den Bergh R.

A case of Villaret's syndrome, possibly secondary to herpes zoster, is presented.
The topography of the lesion in this rare disease is discussed as well as the
differential diagnosis.

Publication Types: 
    Case Reports

PMID: 961371 [PubMed - indexed for MEDLINE]

8852: Arch Otorhinolaryngol. 1976;213(1):333-62.

[Virus diseases of the mouth mucosa]

[Article in German]

Nasemann T.

Zentrum der Dermatologie und Venerologie, J.W. Goethe-Universitat Frankfurt am
Main.

In accordance with the system of viral species, viral disorders of the oral
mucosa may be classified with regard to their intensity of affection. There are
but few viral infections exclusively affecting the oral mucosa like e.g. 1.
Glossitis papulosa of Michelson, representing a special form of vaccinia
inoculata, 2. Gingivo-stomatitis herpetica and 3. warts of the mucosa or
condyloma-like papillomas of the oral mucosa including oral papillomatosis, that,
itself shows morphological and clinical similarities to laryngeal papilloma. A
second group of disorders mainly affecting the oral mucosa includes the "Aphthoid
of Pospischill and Feyrter", Zahorsky's herpangina and other viral infections by 
the Coxsackie group, like vesicular stomatitis. The 3rd group represents viral
infections of other organs in which affection of the oral mucosa is a
prerogative, e.g. smallpox, varicella, foot-and-mouth disease and
pharyngo-conjunctival fever. A 4th group includes those viral infections of the
organs in which co-affection of oral mucosa occurs frequently or once in a while 
(at occasions). Here, we find eczema vaccinatum, herpes zoster, herpes simplex of
the oral mucosa mostly on the hard palate, eczema herpeticatum, post-herpetic
Erythema exsudativum multiforme, Mononucleosis infectiosa Pfeiffer, viral flu,
German measles, parotitis epidemica, rubeola and ECHO-exanthema. A 5th and last
group is made up by viral infections of other organs, in which affection of the
oral mucosa hardly occurs at all. This group contains paravaccinal Ecthyma
contagiosum, poliomyelitis, viral infection of the city of Marburg and some
Arbovirus infections. Relatively few viral disorders never co-exist with lesions 
on the oral mucosa like e.g. Virus-hepatitis or some viral encephalitides. Groups
1 and 2, most important of all, are presented in detail regarding clinics,
diagnostics, differential-diagnosis and therapy. The disorders within the other 3
groups are discussed only regarding their importance in the field of ENT-related 
symptoms of the oral mucosa. A number of pictures and tables completes important 
clinical details and give further hints to their differential-diagnosis.

Publication Types: 
    English Abstract
    Review

PMID: 830106 [PubMed - indexed for MEDLINE]

8853: Rev Inst Med Trop Sao Paulo. 1976 Jan-Feb;18(1):24-7.

[Treatment of herpes zoster with cytarabine]

[Article in Portuguese]

de Moraes VM, Neto VA, Pasternak J, Oselka GW, Levi GC.

Publication Types: 
    Clinical Trial
    English Abstract

PMID: 778975 [PubMed - indexed for MEDLINE]

8854: Res Clin Stud Headache. 1976;4:18-36.

Headaches and head pains associated with diseases of the eye.

Behrens MM.

Publication Types: 
    Review

PMID: 775580 [PubMed - indexed for MEDLINE]

8855: Am J Ophthalmol. 1976 Jan;81(1):86-8.

Zosteriform herpes simplex.

Forrest WM, Kaufman HE.

Publication Types: 
    Case Reports
    Research Support, U.S. Gov't, P.H.S.
    Review

PMID: 766634 [PubMed - indexed for MEDLINE]

8856: Ophthalmic Semin. 1976;1(3):227-52.

Herpes zoster ophthalmicus.

Weinhoff ML.

Herpes zoster ophthalmicus is not an uncommon disease and is more prevalent among
debilitated and seriously ill patients. It is caused by the same virus causing
varicella. The exact trigger mechanism is unknown, as well as much of the
pathogenesis. The disease is more uncommon among the elderly and usually runs a
benign course. Approximately 50% of the patients develop ocular complications
,the most frequent of these being keratitis, iritis, secondary glaucoma and
extraocular muscle involvement. The most striking pathologic features are the
lymphocytic infiltration of the long ciliary nerves and the vasculitis of the
vessels accompanying them. The most controversial aspect of the disease is that
of treatment. Almost every therapeutic regimen has been attempted in a disease
whose natural course is self-limited. The future will add more to our knowledge
of the pathogenesis of the disease and shed more light on the efficacy of various
treatments.

Publication Types: 
    Review

PMID: 191772 [PubMed - indexed for MEDLINE]

8857: Neoplasma. 1976;23(4):377-88.

Varicella-zoster antibodies in patients with Hodgkin's disease.

Trlifajova J, Lukasova M, Raffersberg B, Jelinek J.

In an endeavour to find an explanation for th raised incidence of herpes zoster
in hemoblastoses, serum samples of 50 patients with histologically confirmed
Hodgkin's disease and 80 control sera of normal persons of similar age groups
were tested for the presenchods of indirect hemagglutination (IH), complement
fixation (CF), and immunodiffusion (ID). The geometric mean titer of IH
antibodies and the rate of positive ID results were significantly higher in the
patients' group. The geometric mean titers of CF antibodies did not differ
significantly in the two groups. A certain correlation between serological
results and the histological type of Hodgkin's disease was found, but it was not 
statistically significant. No other correlation of serological results with
clinical data was ascertained.

PMID: 187967 [PubMed - indexed for MEDLINE]

8858: Int J Radiat Oncol Biol Phys. 1976 Jan-Feb;1(3-4):317-20.

Virus infections.

Stevens DA, Merigan TC.

PMID: 184072 [PubMed - indexed for MEDLINE]

8859: Wien Klin Wochenschr Suppl. 1976;53:3-28.

[Prognostic assessment in peripheral facial nerve paralysis with particular
reference to electroneurography (author's transl)]

[Article in German]

Mamoli B.

Electrophysiological investigations were carried out on 20 healthy controls and
130 patients with peripheral facial nerve paralysis. The aetiology was as
follows: idiopathic (Bell's palsy) in 60 cases, viral in 29, traumatic in 18,
postoperative in 4, in connexion with chronic otitis media in 6, diabetes
mellitus in 4, positive rheumatological tests in 3, disturbed lipid metabolism in
2, the Melkersson-Rosenthal syndrome in 1, as a complication of pregnancy in 2,
and in association with a tumour in 1 case. The compound action potential (CAP)
of the orbicularis oris muscle was determinedi n 370 occasions in a right/left
comparision, the record of the muscle response was intergrated over the time of
action (IAR) on 32 occasions and trison of 255 occasions. The normal values are
given in the first place and their dependence of the age of the subject. Then,
the prognostic sifnficance of the above-mentioned parameters is investigated in
cases of peripheral facial nerve paralysis. It is apparent that the determination
of the CAP in a right/left comparison is a valuable prognostic guide as early as 
the 4th day, insofar as a decrease in this parameter of under 50% can be
interpreted as a favourable sign and satisfactory reversal of the paralysis can
be expected within 6-8 weeks. By contrast, a decrease of over 70% in the CAP is a
bad prognostic sign, indicative of presumably only a poor trend to reversal of
the paralysis. An intermediate depression of the CAP in the range of 50-70%
signifies an expected moderate recovery within 6-8 weeks ahe case of CAP
determination at the time of maximum amplitude depression (as opposed to the 4th 
day), then a decrease of less than 70% is taken to be indicative of satisfactory 
functional recovery within 6-8 weeks; a decrease of 95-100% signifies a bad
prognosis, whilst a decrease amounting to between 70 and 95% carries an uncertain
prognosis. The maximum decrease in amplitude was registered on the 8th day on
average; the range lay between the 4th and the 14th day. An exception to these
figures was the delayed response of the CAP in the case of 6 patients, 5 of whom 
showed a maximum decrease during the 3rd week and the last patient as late as the
4th week following the onset of facial nerve paresis. Similar reliance can be
placed on the prognostic value of the IAR. however, the decrease in the IAR is
smaller than that of the CAP measured on the same potential in a right/left
comparison, so that a decrease in the IAR of over 60% can already herald a poor
recovery. Repeated determination of the latency in cases of facial nerve
paralysis showed that the mean latency value for the entire group of patients was
slightly prolonged at the end of the 1st week, but the latency values obtained in
any one particular patient are of no prognostic significance. A comparison
between CAP and latency values obtained with the opposite (i.e...

Publication Types: 
    English Abstract

PMID: 181919 [PubMed - indexed for MEDLINE]

8860: Scand J Infect Dis. 1976;8(1):27-35.

Early diagnosis of virus-caused vesicular rashes by immunofluorescence on skin
biopsies. I. Varicella, zoster and herpes simplex.

Olding-Stenkvist E, Grandien M.

The use of immunofluorescence (IF) for the rapid identification of
varicella-zoster (V-Z) and herpes simplex (HS) antigen in frozen sections of
biopsies of early non-vesicular skin lesions was investigated. Direct IF, using
fluorescein- isothiocyanate- conjugated immuoglobulin (FITC Ig) of paired human
anti-V-Z sera and FITC-conjugated negative and positive anti-V-Z-monkey Ig,
yielded specific fluorescence of virus antigen in all 14 varicella cases
investigated and in 10/11 zoster cases. In contrast, indirect IF, using paired
human anti-zoster sera and a sheep anti-human Ig FITC, was not satisfactorily
specific, since staining with the anti-human Ig FITC alone also yielded
fluorescence of infected cells in some cases. In 6/8 cases of HS infection,
specific fluorescence of virus antigen was obtained by direct IF, using
FITC-conjugated negative and positive guinea-pig anti-HS Ig. Because of the often
predominant distribution of virus antigen to the corium and the skin appendages, 
punch biopsies are apparently better than scraped material, at least in the
prevesicular stage.

PMID: 178050 [PubMed - indexed for MEDLINE]

8861: Intervirology. 1976;7(6):309-27.

An immunofluorescence technique with counterstain on fixed cells for the
detection of antibodies to human herpesviruses; antibody patterns in patients
with Hodgkin's disease and nasopharyngeal carcinoma.

Hilgers F, Hilgers J.

An indirect immunofluorescence (IF) test on fixed cells with Evans' blue
counterstain is described for all four human herpesviruses, i.e., herpes simplex 
virus type 1 and type 2 (HSV-1 and HSV-2), varicella-zoster virus (VZV),
cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Comparison with
immunodiffusion (ID) for HSV-2 and with ID and complement fixation (CF) for VZV
and CMV demonstrated the specificity and high sensitivity of the IF test. Also
introduced is a modification of the anti-complement immunofluorescence (ACIF)
test for EBV-determined nuclear antigen (EBNA), permitting simultaneous titration
of antibodies to this nuclear antigen and of the anti-nuclear factor (ANF).
Seroepidemiological studies of these viruses in patients with Hodgkin's disease
(HD) in the Netherlands revealed the following pattern: (1) in nodular sclerosing
(NS) HD there is a 4-fold (significant) elevation in antibody titer to EBV-VAC,
but no elevation to EBV-EA and EBNA; (2) in mixed cellularity (MC) HD a 10-fold
(significant) elevation to both EBV-VCA and EA, but no elevation to EBNA is found
compared to the control groups. These patterns in NS and MC HD are different from
the pattern in nasopharyngeal carcinoma (NPC) which manifests elevations in
antibody titers to EBV-VCA and EA as well as to EBNA. Antibody titers to HSV, VZV
and CMV are not significantly elevated in either HD or NPC.

Publication Types: 
    Comparative Study

PMID: 67099 [PubMed - indexed for MEDLINE]

8862: Cutis. 1976 Jan;17(1):103-9.

Herpes zoster: a combined therapy regimen.

Ferrara RJ.

A combined method of therapy for the routine management of herpes zoster in most 
all age groups is presented. The uniformly gratifying results of this treatment
prompted this report. A total of 105 known cases of acute herpes zoster in which 
this regimen was employed during the past 15 years was analyzed in this study.
Clinical observations before and after treatment are presented with discussion of
clinical factors, treatment and conclusions.

PMID: 65242 [PubMed - indexed for MEDLINE]

8863: Folia Haematol Int Mag Klin Morphol Blutforsch. 1976;103(5):660-71.

[Possibilities for the treatment of varicella-herpes zoster infections in
juvenile leukemia]

[Article in German]

Exadaktylos P, Gravinghoff J.

Chicken pox and herpes zoster represent afraid complications in patients with
malignant diseases which may take a noxious course. During the sequence of two
chicken pox epidemias in 1973 in children with acute lymphoblastic leukaemias,
the prevention and therapeutic possibilities were checked again. Chicken pox or
herpes zoster convalescent sera being compatible for blood groups and
zoster-immunoglobulin were not available. At the time of the epidemia the first
reports on the effect of cytarabine (Alexan) were published. Moreover, we
received an information on the therapeutic application of small pox vaccine
inactivated with formaldehyde (vaccinia antigen) in adults with herpes zoster and
herpes labialis. From 10 children with leukaemias, who were affected with chicken
pox or herpes zoster, 7 received up to 1.0 ml of inactivated small pox vaccine
intramuscularly on the first day of manifestation. In 6 of the patients there
were no new efflorescences on the third day. A third child died. First of all it 
seems probable that this influence may be due to an induction of interferon
formation. Further studies will have to elucidate to what extent this mechanism
will also be efficient in severe cases of immunosuppression.

Publication Types: 
    English Abstract

PMID: 64406 [PubMed - indexed for MEDLINE]

8864: Ther Umsch. 1976 Jan;33(1):37-48.

[Genital infections by viruses, mycoplasma and chlamydozoa (author's transl)]

[Article in German]

Nasemann TH, Nolte B.

Publication Types: 
    English Abstract

PMID: 61630 [PubMed - indexed for MEDLINE]

8865: Scand J Infect Dis. 1976;8(3):129-37.

Early diagnosis of virus-caused vesicular rashes by immunofluorescence on skin
biopsies. II. Poxvirus (vaccinia).

Olding-Stenkvist E, Grandien M, Espmark A.

Immunofluorescence (IF) was used to demonstrate vaccinia virus antigen in frozen 
sections of skin biopsies from the site of revaccination in 42 individuals. The
immunoglobulin (Ig) of a rabbit anti-vaccinia serum and the Ig of the pre-immune 
serum conjugated with fluorescein-isothiocyanate (FITC) was employed. 11/13
biopsies taken 1 day after vaccination were positive in the IF test as were 13/13
biopsies taken 2 days and 14/16 biopsies taken 3 days after vaccination. Even
minute quantities of virus antigen were easily detected. The applicability of the
test and the advantage of using biopsy material in early rashes of vaccinia and
variola is discussed. The reliability of the direct IF using conjugated antisera 
against vaccinia-variola, varicella-zoster and herpes simplex virus for
differentiating between maculopapular rashes was proved in a coded test.

PMID: 61622 [PubMed - indexed for MEDLINE]

8866: J Neurol. 1976;213(3):269-71.

Meningitis associated with herpes zoster. Immunofluorescent demonstration of
varicella-zoster antigens in CSF cells.

Shoji H, Koya M, Ogiwara H.

Publication Types: 
    Case Reports

PMID: 61267 [PubMed - indexed for MEDLINE]

8867: MMW Munch Med Wochenschr. 1975 Dec 19;117(51-52):1999-2004.

[Eight years experience of pain clinics (author's transl)]

[Article in German]

Nakazaki K, Yuda Y, Wakasugi B.

The first pain clinic in Japan was organized and operated by anesthesiologists at
the University of Tokyo. Today, many universities and large hospitals have set up
pain clinics in their anesthetics department and have made great progress in the 
management of diseases in this filed. Almost all those institutions use oriental 
methods like acupuncture, ryodoraku and kyo in addition to standard methods. At
our pain clinic, nerve block has been the sole method from the beginning. Neither
drugs (except carbamazepine, imipramine and ergotamine) nor oriental methods have
been used. The pain clinic ought to be separated from the anesthetics department 
and operated independently, having its own wards.

Publication Types: 
    English Abstract

PMID: 818509 [PubMed - indexed for MEDLINE]

8868: Acta Neuropathol. 1975 Dec 8;33(2):105-17.

Pathology of the human spinal ganglia in varicella-zoster virus infection.

Nagashima K, Nakazawa M, Endo H.

Spinal ganglia from a patient who died on the 6th day of varicella infection were
examined by immunofluorescence and electron microscopy, and were compared with
spinal ganglia from a patient dying on the 17th day of herpes zoster infection.
In herpes zoster, typical intranuclear inclusion bodies were found in neurons,
satellite cells and fibroblast-like cells of the ganglia, which contained
numerous naked virus particles. In varicella, few changes were found by light
microscopy but viral antigen was detected in a few neurons and satellite cells by
immunofluorescence. Electron microscopy revealed scattered virus particles near
the nuclear membrane of a neuron, satellite cells and capsular cells and
enveloped particles in the cytoplasm of satellite cells. The particles in the
nuclei were mostly naked virions with specific crescent-like inner-nuclear
structure; those in the cytoplasm had complete and incomplete envelopes and
showed pleomorphism. A "virus-like" intranuclear filament found in mononuclear
cells in herpes zoster and a "plexiform vermicellar array" found in the nuclei of
neurons in varicella are at present considered to be non-specific nuclear changes
caused probably by viral infections.

Publication Types: 
    Comparative Study

PMID: 173126 [PubMed - indexed for MEDLINE]

8869: JAMA. 1975 Dec 8;234(10):1049-51.

Should patients with zoster receive zoster immune globulin?

Uduman SA, Gershon AA, Brunell PA.

Zoster developed in 55 patients, and 15, generalized disease occurred. Twelve of 
14 patients with dissemination had prompt appearance of both complement-fixing
(CF) antibody and fluorescent antibody against varicella-zoster (VS) membrane
antigen (FAMA). The geometric mean titers of VZ antibody from the first to the
fifth and the sixth through the tenth days following onset of zoster were similar
in patients with localized and generalized involvement. Two patients with
disseminated zoster had undetectable CF antibody, but VZ FAMA was demonstrable.
Because the clinical course of zoster appears to be unrelated to the serologic
response to VZ virus, it is unlikely that administration of antibody with zoster 
would be benefit in this disease.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 171458 [PubMed - indexed for MEDLINE]

8870: Med J Malaysia. 1975 Dec;30(2):156-9.

Ramsay-Hunt syndrome with complete recovery of cranial nerves.

Ponniah RD.

Publication Types: 
    Case Reports

PMID: 1228383 [PubMed - indexed for MEDLINE]

8871: Z Hautkr. 1975 Dec 1;50(23):947-50.

[Herpes zoster as cause of an epidemic spread of varicella and zoster in a
children's hospital]

[Article in German]

Gunther S.

During infancy zoster is not so rare as generally stated. In this age group the
infection seems often to be unrecognised, because commonly it produces little or 
atypical body reactions. In children the infectivity of zoster is more serious
than in adults, but in the absence of antibodies, varicella develops. Therefore
zoster has been considered as an immunologically modified form of varicella. In
my own experience, one case of zoster caused epidemics of varicella and zoster in
a paediatric hospital. The pathogenesis and epidemiology of the two diseases have
been discussed.

Publication Types: 
    English Abstract

PMID: 1202778 [PubMed - indexed for MEDLINE]

8872: Arch Dermatol. 1975 Dec;111(12):1658.

Letter: Herpes zoster in early pregnancy.

Jackson R.

PMID: 1200673 [PubMed - indexed for MEDLINE]

8873: Br Med J. 1975 Nov 8;4(5992):335-7.

Diseases of the central nervous system. Meningitis and encephalitis.

Smith CC.

PMID: 172185 [PubMed - indexed for MEDLINE]

8874: Lijec Vjesn. 1975 Nov;97(10):585-6.

[Long-term results in the treatment of zoster by rimaktan]

[Article in Croatian]

Brnobic A, Balic A.

Publication Types: 
    English Abstract

PMID: 1223572 [PubMed - indexed for MEDLINE]

8875: J Assoc Physicians India. 1975 Nov;23(11):783-4.

Zoster myelitis (a case report).

Sachdeva JR, Behal RA, Singh J.

Publication Types: 
    Case Reports

PMID: 1223078 [PubMed - indexed for MEDLINE]

8876: Vestn Otorinolaringol. 1975 Nov-Dec;(6):116-7.

[Circinate herpes of the ear (herpes zoster oticus)]

[Article in Russian]

Maerovich IM.

Publication Types: 
    Case Reports

PMID: 1209846 [PubMed - indexed for MEDLINE]

8877: Am J Med. 1975 Nov;59(5):695-701.

Infections in 92 splenectomized patients with Hodgkin's disease. A clinical
review.

Schimpff SC, O'Connell MJ, Greene WH, Wiernik PH.

Infections that occurrred in 92 previously untreated patients with Hodgkin's
disease were reviewed from the time of laprotomy and splenectomy. Pneumonias
occurred in nine patients with urinary tract infections in twelve during the
immediate postoperative period. Severe bacterial infections did not occur in any 
patients during initial radiation therapy, adjuvant chemotherapy (stages I
through IIIA), initial intensive chemotherapy (stages IIIB and IV) or during
remission. Severe infections occurred in eight profoundly granulocytopenic
patients with recurrent Hodgkin's disease. Streptococcus (Diplococcus) pneumoniae
and Hemophilus spp infections were distinctly uncommon during the remission
period. Herpes zoster, however, was very common developing in 22 of 92 (24 per
cent) patients. Predisposing factors to herpes zoster included sex (female more
than male), therapy (radiation plus chemotherapy more than chemotherapy alone),
and age (less than 30 years of age more often than 30 to 50 years of age). Severe
infection was uncommon in these patients except in ascociation with specific
predisposing factors such as the immediate postoperative state of prolonged
granulocytopenia associated with recurrent Hodgkin's disease or its therapy.
Splenectomy per se did not affect either the incidence or the severity of
infection during this period of 12+ months of observations per patient.

PMID: 1200037 [PubMed - indexed for MEDLINE]

8878: Am Fam Physician. 1975 Nov;12(5):142-4.

Sympathetic block in herpes zoster.

Masud KZ, Forster KJ.

PMID: 1199909 [PubMed - indexed for MEDLINE]

8879: Z Hautkr. 1975 Nov 1;50(21):909-11.

[Possibilities in the use of interferon inducer substance in the treatment of
viral dermatoses]

[Article in German]

Buchvald J, Borecky L, Doskocil J.

Publication Types: 
    Clinical Trial

PMID: 1108471 [PubMed - indexed for MEDLINE]

8880: Nippon Ganka Gakkai Zasshi. 1975 Oct 10;79(10):1542-9.

[Study of Herpes zoster keratitis; demonstration of virus particles in corneal
scrapings (author's transl)]

[Article in Japanese]

Hayashi S.

Publication Types: 
    English Abstract

PMID: 173166 [PubMed - indexed for MEDLINE]

8881: Nihon Kyobu Shikkan Gakkai Zasshi. 1975 Oct;13(10):621-5.

[Varicella-zoster pneumonia--an adult case occuring in the course of Hodgkin's
disease following herpes zoster (author's transl)]

[Article in Japanese]

[No authors listed]

Publication Types: 
    Case Reports
    English Abstract

PMID: 1241046 [PubMed - indexed for MEDLINE]

8882: Minerva Anestesiol. 1975 Oct;41(10):468-77.

[Postherpetic neuralgias]

[Article in Italian]

Delfino U.

Publication Types: 
    English Abstract

PMID: 1230661 [PubMed - indexed for MEDLINE]

8883: Srp Arh Celok Lek. 1975 Oct;103(10):895-8.

[Case of herpes zoster and varicella in a child]

[Article in Serbian]

Hadzic M, Kujundzic M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1228914 [PubMed - indexed for MEDLINE]

8884: J Pediatr Surg. 1975 Oct;10(5):677-84.

Complications of abdominal exploration and splenectomy in staging children with
Hodgkin's disease.

Wayne ER, Kosloske A, Holton CP, Burrington JD, Hatch EI.

Until alternate diagnostic methods are discovered, the staging procedure seems to
be the most reliable method to establish the presence or absence of abdominal
involvement in Hodgkin's disease. Our experience with staging laparotomy in 22
children raises serious questions as to both the risk of operation and the
prognostic value of a negative abdominal exploration. Routine use of the staging 
laparotomy may not be justified in clinical Stage IA patients with
lymphocyte-predominant cell type. Because of the hazards and limitations of the
staging procedure, vigorous attempts would seem to be indicated to identify
subcategories of patients in whom the likelihood of intraabdominal involvement is
so small as to negate the value of surgical staging.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 1185454 [PubMed - indexed for MEDLINE]

8885: J Infect Dis. 1975 Oct;132(4):421-33.

Epidemiology of cytomegalovirus infection after transplantation and
immunosuppression.

Fiala M, Payne JE, Berne TV, Moore TC, Henle W, Montgomerie JZ, Chatterjee SN,
Guze LB.

Viral infections and clinical complications were studied during hemodialysis and 
after renal transplantation. Active cytomegalovirus infection developed in 96% of
patients after renal transplantation; reactivation of herpes simplex,
varicella-zoster, and Epstein-Barr viruses was found in 35%, 24%, and 0% of
patients, respectively. Cytomegalovirus viremia developed in 42% of patients an
average of two months after renal transplantation, lasted 1.75 (+/- 1.5) months
(except in one patient with chronic viremia), and was followed by chronic
viruria. Higher titers of infectious cytomegalovirus were found in the
polymorphonuclear than in the mononuclear leukocyte fraction. Reactivation of a
latent infection and, less likely, respiratory infection appear to be the most
probable mechanisms of cytomegalovirus infection after renal transplantation. One
to three months after transplant, cytomegalovirus infection may be related to
fever, arthralgia, pneumonitis, and leukopenia; three to four months after
transplant, the virus may be related to hepatitis; and 12-30 months after
transplant, it may be related to retinitis in patients with chronic viremia.
Although other causes of these complications are possible, herpes simplex virus, 
Epstein-Barr virus, varicella-zoster virus, measles virus, adenovirus, hepatitis 
B virus, and Toxoplasma gondii appear to be of lesser importance than
cytomegalovirus in this respect.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 171315 [PubMed - indexed for MEDLINE]

8886: Dent Clin North Am. 1975 Oct;19(4):643-56.

General dentistry and oral medicine in the hospital.

Greenberg MS.

General dentistry in a hospital should not be confined to restorative dentistry
happens to be performed in a hospital dental clinic. In addition to expertise in 
restorative dentistry and other dental specialties, general practitioners
participating in hospital programs must also be students of two major areas--
diagnosis of diseases involving the head and neck as well as dental management of
patients with severe medical disease. In the preceding short review a few
examples of disorders about which the hospital dentist may be consulted were
reviewed along with the proper protocol for requesting and answering
consultations. This list is necessarily short and incomplete. A different group
of disorders could have been discussed in this article. The competent hospital
dentist must be a continual student of disease and its possible effect upon
dental treatment and oral diagnosis. The task is formidable but rewarding and
interesting.

PMID: 169170 [PubMed - indexed for MEDLINE]

8887: N Engl J Med. 1975 Sep 18;293(12):610.

Letter: Possbile relation between herpes simplex and zoster.

Ikada J.

PMID: 168491 [PubMed - indexed for MEDLINE]

8888: Vestn Otorinolaringol. 1975 Sep-Oct;(5):91.

[Case of herpes zoster oticuls]

[Article in Russian]

Khanamiran RM, Grigorian MA.

Publication Types: 
    Case Reports

PMID: 1231148 [PubMed - indexed for MEDLINE]

8889: Antimicrob Agents Chemother. 1975 Sep;8(3):289-94.

Evaluation of topical polyinosinic acid-polycytidylic acid in treatment of
localized herpes zoster in children with cancer: a randomized, double-blind
controlled study.

Feldman S, Hughes WT, Darlington RW, Kim HK.

Twenty-four children with cancer and localized herpes zoster were randomized to
receive either topical polyinosinic acid-polycytidylic acid [poly(I:C)] or a
saline placebo. Solutions containing 1.0 or 2.5 mg of drug per ml were applied to
the lesions every 3 h, seven times a day for 7 consecutive days. Serial,
standardized color photographs were used to evaluate the progression of lesions
and maximum percentage of dermatome involvement. In patients receiving poly(I:C),
the median days of new lesions after therapy was 2.0 days as opposed to 3.5 days 
in placebo-treated patients. This difference was not statistically significant.
Moreover, the total median days of lesions and percentage of dermatome
involvement were similar in both groups, as were complications. Neither the
concentration nor the total dose of drug was related to the outcome of infection.
We conclude that topical poly(I:C), as used in this study, was of no benefit in
treatment of localized herpes zoster.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 1101820 [PubMed - indexed for MEDLINE]

8890: Vestn Oftalmol. 1975 Sep-Oct;(5):63-5.

[Combined viral infections and their role in the development and clinical course 
of keratitis in children]

[Article in Russian]

Katargina LA, Zaitseva NS, Murav'eva TV.

PMID: 190751 [PubMed - indexed for MEDLINE]

8891: Proc Soc Exp Biol Med. 1975 Sep;149(4):835-9.

Antibody titers by mixed agglutination to varicella-zoster, herpes simplex and
vaccinia viruses in patients with multiple sclerosis.

Ito M, Barron AL, Olszewski WA, Milgrom F.

Antibody titers to varicella-zoster (V-Z), herpes simplex (HSV) and vaccinia
viruses were determined in sera collected in Buffalo, NY, from patients with
multiple sclerosis (MS), patients with other diseases, and normal individuals.
The mixed agglutination test employing cell cultures infected with one of the
above viruses as a source of antigen was used to determine antibody titers. The
geometric mean titer (GMT) for V-Z in 59 MS cases was significantly higher than
that observed in patients with other diseases and in normal individuals. The GMT 
for vaccinia was also higher in MS patients but the difference was not as great
as for V-Z. No difference was observed in the titer of antibodies for HSV.
Similar results were obtained for 51 MS patients compared to healthy controls
matched for sex and age. Higher antibody titers for V-Z and HSV were observed in 
cerebrospinal fluids from MS cases than in those from non-MS CNS patients in
Baltimore, MD. Antibodies to V-Z, HSV and vaccinia were detected in washing
fluids from brain homogenates of MS cases.

PMID: 170625 [PubMed - indexed for MEDLINE]

8892: Infect Immun. 1975 Sep;12(3):606-13.

Neutralizing antibody responses to varicella-zoster virus.

Schmidt NJ, Lennette EH.

Neutralization of varicella-zoster (V-Z) virus by human sera and immune rhesus
monkey sera was enhanced by fresh guinea pig complement. There was no marked
difference in the degree to which complement enhanced neutralization by sera from
current V-Z virus infections and sera from long-past varicella infections.
Immunoglobulin G neutralizing antibody in sera from varicella cases was enhanced 
by complement to a slightly higher degree than was immunoglobulin M (IgM)
antibody, and immunoglobulin G neutralizing antibody in immune monkey sera was
enhanced to a much greater degree than was IgM antibody. There was a rapid
decline in the complement requirement of IgM neutralizing antibodies over the
course of immunization of the rhesus monkeys. V-Z neutralizing antibody titers in
the presence of complement were higher than complement-fixing titers of the same 
sera in all groups of individuals studied. IgM neutralizing antibody for V-Z
virus was demonstrable in all cases of varicella but in only 1 of 22 zoster
cases, and V-Z IgM neutralizing antibody was not detectable in primary herpes
simplex virus infections in which heterotypic antibody titer rises occurred to
V-Z virus. Complement-fixing antibody for V-Z virus was absent in 19S serum
fractions which contained IgM neutralizing antibody for the virus.

PMID: 170206 [PubMed - indexed for MEDLINE]

8893: Vestn Dermatol Venerol. 1975 Sep;(9):58-61.

[Hemodesis and rheopolyglucine in the treatment of patients with some dermatoses]

[Article in Russian]

Fedotov VP, Chekina AP.

Publication Types: 
    English Abstract

PMID: 133560 [PubMed - indexed for MEDLINE]

8894: JAMA. 1975 Aug 25;233(8):886-9.

Epithelioid granulomas in Hodgkin disease. A favorable prognostic sign?

O'Connell MJ, Schimpff SC, Kirschner RH, Abt AB, Wiernik PH.

Histologic sections of spleen and liver prepared from tissue obtained during
exploratory laparotomy and splenectomy in 91 untreated patients with Hodgkin
disease were reviewed to assess the incidence and possible implications of
noncaseating, epitheliod, sarcoid-like granulomas. The 17 patients with
granulomas and the 74 patients without granulomas did not differ appreciably with
respect to pretreatment indexes. All patients were observed for at least 15
months following laparotomy or until the time of death (range, 15 to 67 months;
median, 25 months). The 17 patients with granulomas tended to have fewer
relapses, longer survival, and lower incidence of subsequent herpes zoster
infection compared to the 74 without granulomas. The presence of epithelioid
granulomas in association with Hodgkin disease may reflect a host response to the
tumor with favorable prognostic implications.

Publication Types: 
    Comparative Study

PMID: 168415 [PubMed - indexed for MEDLINE]

8895: JAMA. 1975 Aug 11;233(6):527-30.

Herpes simplex virus in idiopathic facial paralysis (Bell palsy).

Adour KK, Bell DN, Hilsinger RL Jr.

Sera from all 41 adult patients with idiopathic facil paralysis (Bell palsy) and 
35 (85%) of 41 matched controls who had never had Bell palsy contained antibodies
to herpes simplex virus (P smaller than.05). The frequency of antibodies to
herpes zoster virus did not differ in patients and controls. A rise in antibody
titer, indicating primary herpes simplex virus infection, was not found in these 
patients. That Bell palsy may be caused by reactivation of herpes simplex virus
is suggested by (1) clinical, neurologic, laboratory, and immunologic
similarities between idiopathic facial paralysis and known manifestations of
reactivated herpes simplex virus infection, and (2) the known neurotropism of
herpes simplex virus, including its presence in latent form in the trigeminal
ganglia, and parallels with known facial paralysis due to varicella zoster virus,
a closely related agent. The presence of antibodies to herpes simplex virus is
the only common factor among the patients tested in this study.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 167209 [PubMed - indexed for MEDLINE]

8896: Med J Aust. 1975 Aug 9;2(6):224-5.

The management of facial pain.

Eadie MJ.

PMID: 1160773 [PubMed - indexed for MEDLINE]

8897: J R Coll Gen Pract. 1975 Aug;25(157):571-5.

Postherpetic neuralgia.

Hope-Simpson RE.

PMID: 1195231 [PubMed - indexed for MEDLINE]

8898: Va Med Mon (1918). 1975 Aug;102(8):609-13.

Facial nerve paralysis in herpes oticus.

McGovern FH.

PMID: 1163098 [PubMed - indexed for MEDLINE]

8899: South Med J. 1975 Aug;68(8):1043-5.

Bladder dysfunction secondary to herpes zoster.

Kent MW, Guerriero WG.

PMID: 1162403 [PubMed - indexed for MEDLINE]

8900: Practitioner. 1975 Aug;215(1286):226-9.

Idoxuridine in the treatment of herpes zoster.

Simpson JR.

An uncontrolled, double-blind, random-selection study of fifty consecutive
patients with attacks of herpes zoster treated with one of two concentrations (5 
per cent or 40 per cent) of idoxuridine (IDU) in dimethyl sulphoxide (DMSO) has
shown that, over all, the patients fared better than would have been expected had
they been treated only symptomatically. There was no apparent difference between 
the two concentrations of idoxuridine in regard to either side-effects or
benefits. In 17 of the fifty patients the skin lesions healed more rapidly than
would have been expected without treatment, and pain was relieved more rapidly
than expected in 26 of the 47 patients in whom it was a feature of the attack.
Side-effects, which included a transient stinging or burning sensation in 29
patients and acute sensitivity to idoxuridine (confirmed by patch-testing) in
one, did not lead to withdrawal of any patient from the trial. Three patients
complained of an unpleasant, garlicky taste during treatment. No significant
abnormalities were noted in liver-function tests and in white-cell or platelet
counts in patients in either treatment group. The solutions of idoxuridine in
dimethyl sulphoxide were provided by W.B. Pharmaceutical Ltd.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 1101247 [PubMed - indexed for MEDLINE]

8901: Eur J Cancer. 1975 Aug;11suppl:79-94.

Non-bacterial infections associated with neoplastic disease.

Armstrong D, Chmel H, Singer C, Tapper M, Rosen PP.

Publication Types: 
    Review

PMID: 176031 [PubMed - indexed for MEDLINE]

8902: Laryngol Rhinol Otol (Stuttg). 1975 Aug;54(8):654-8.

[Neurootological findings in zoster oticus (author's transl)]

[Article in German]

Aust G.

Zoster oticus is an important disorder in neurootological routine diagnostics.
However, the neurotoxic zoster virus is not being confined to the nerval
periphery. Therefore as well typical peripheral as well as typical central as
well as combined reactional patterns are to be found by neurootological functions
tests. By selection and adaptation of tests optimal diagnostics can be completed 
in the vestibular-ocular, the vestibular-spinal and retinal-ocular sensory motory
systems. Thus disorders as such can be identified and additionally localised. The
peripheral zoster oticus can be differentiated from the central zoster
encephalitis. These findings are demonstrated by typical case reports.

Publication Types: 
    Case Reports
    English Abstract

PMID: 129636 [PubMed - indexed for MEDLINE]

8903: Indian J Ophthalmol. 1975 Jul;23(2):15-7.

Internal ophthalmolplegia in a young child suffering from Herpes zoster.

Buch H, Vaid RL, Wali V, Singh D.

Publication Types: 
    Case Reports

PMID: 1236445 [PubMed - indexed for MEDLINE]

8904: Hautarzt. 1975 Jul;26(7):383-4.

[Anorectal symptom complex in zoster sacralis]

[Article in German]

Reichardt F, Vogt HJ.

Disorder by hemorrhoids can occasionally be caused by sacral herpes zoster. Only 
exact local inspection in connection with the anamnestic statement of neuralgic
pain as well as hurting sensations of the rectum leads to the proper diagnosis.

Publication Types: 
    English Abstract

PMID: 1213893 [PubMed - indexed for MEDLINE]

8905: Surg Neurol. 1975 Jul;4(1):9-11.

Intracerebral toxoplasmosis presenting as a mass lesion.

Schulhof LA, Russell JR.

Intracerebral toxoplasmosis is an uncommon condition and for it a produce an
intracerebral mass is rare. A case is reported in a patient also suffering from
lymphosarcoma, who had received immunosuppressive therapy and who had recently
had herpes zoster ophthalmica.

Publication Types: 
    Case Reports

PMID: 1174391 [PubMed - indexed for MEDLINE]

8906: Physiotherapy. 1975 Jul;61(7):217.

SWD for herpes zoster.

Barnett M.

PMID: 1161861 [PubMed - indexed for MEDLINE]

8907: Arch Dermatol. 1975 Jul;111(7):910-2.

Low-dosage cytarabine therapy for herpes zoster with pneumonia.

Baron M, Wechsler HL.

Disseminated herpes zoster infection is frequently fatal. Cytarabine (cytosine
arabinoside), a drug of variable efficacy, has offered some hope in the treatment
of this condition. In this case of disseminated herpes zoster infection with
pneumonia, there was remarkable recovery after low-dosage cytarabine infusion.
The findings suggest that doses of the drug not exceeding 30 mg/sq m of body
surface per 24 hours (30 mg/sq m/24 hr) may well be virucidal but not
cytohematotoxic.

PMID: 1147637 [PubMed - indexed for MEDLINE]

8908: Geriatrics. 1975 Jul;30(7):110-5.

Facial pain: diagnostic dilemma, therapeutic challenge.

Poser CM.

PMID: 1140563 [PubMed - indexed for MEDLINE]

8909: Can J Ophthalmol. 1975 Jul;10(3):356-60.

Uveitis: report of a 10-year survey in Northern Finland.

Saari M, Miettinen R, Alanko H.

In order to determine the distribution of etiologic and diagnostic categories of 
uveitis at the Oulu University Eye Hospital, 653 patients with uveitis treated
during the years 1964-1974 were reviewed. Of the 653 patients, 321 were men and
332 women; 547 had anterior, 64 posterior and 42 generalzied uveitis; 524
unilateral and 129 bilateral; 570 acute and 83 chronic; and 446 single and 207
recurrent. The etiologic factors were distributed into rheumatoid (7.2%),
streptococcal (4.1%), tuberculosis (3.7%), toxoplasmosis (3.3%), varicella-zoster
(1.7%), sarcoidosis (1.4%), staphylococcal (1.1%), leptospirosis (0.6%),
lymphatic leucemia (0.5%), herpes simplex (0.5%), yersinosis (0.1%) and
undetermined cases (75.8%). There were no cases of syphilis. Most of the cases in
this series were anterior and acute uveitis occurring mainly in the age group
20-59 years.

PMID: 1080070 [PubMed - indexed for MEDLINE]

8910: Dtsch Krankenpflegez. 1975 Jul;28(7):396-8.

[Examination report on nursing care of a child with herpes zoster and
lymphogranulomatosis]

[Article in German]

Maier R.

Publication Types: 
    Case Reports

PMID: 1040566 [PubMed - indexed for MEDLINE]

8911: J Immunol. 1975 Jul;115(1):230-3.

Characteristics of immune interferon produced by human lymphocyte cultures
compared to other human interferons.

Valle MJ, Jordan GW, Haahr S, Merigan TC.

A factor with antiviral activity has been produced in vitro by combined
macrophage-lymphocyte cultures from patients with recent herpes labialis in
response to HSV antigen stimulation. It has been designated "immune interferon"
and characterized in comparison to several other human interferons. It was shown 
to be relatively unstable at pH 2 and at 56 degrees C. Rabbit anti-human
leukocyte interferon serum was shown to be less active against immune interferon 
than against diploid cell interferon or against vesicle fluid interferon. The
possibility of immune interferon being a totally different anti-viral protein or 
a protein with certain shared antigen determinants or structures with classical
viral interferon is discussed. A simplified method for the assay of
anti-interferon sera with microtiter plates is also described.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 239056 [PubMed - indexed for MEDLINE]

8912: J Infect Dis. 1975 Jul;132(1):49-54.

Varicella-Zoster Immunoglobulins during Varicella, Latency, and Zoster.

Brunell PA, Gershon AA, Uduman SA, Steinberg S.

Antibodies to membrane antigens of cells infected by varicella-zoster virus were 
detected by immunofluorescence. Rises in varicella-zoster IgA, IgG, and tigM were
detected after both varicella and zoster. Prompt antibody responses were observed
in patients with generalized zoster as well as in those with localized zoster. A 
delayed response was found, moreover, in one patient who did not develop
disseminated disease. Antibody to varicella-zoster virus was detected in the sera
of all three patients tested prior to and in all but one of 63 patients tested
soon after onset of zoster. The level of varicella-zoster IgA and IgG rose in two
of three immune patients after household exposure to infection with
varicella-zoster virus. Varicella-zoster IgG was detected in the cord blood of
infants whose mothers were immune to varicella.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 169308 [PubMed - indexed for MEDLINE]

8913: Infect Immun. 1975 Jul;12(1):148-55.

Effect of human leukocyte interferon on vaccinia-and herpes virus-infected cell
cultures and monkey corneas.

Neumann-Haefelin D, Sundmacher R, Sauter B, Karges HE, Manthey KF.

Pretreatment of human fibroblast cultures with human leukocyte interferon (HIF,
1,000 IU/ml) resulted in a 24-h delay of virus replication after infection with
vaccinia virus and herpes simplex virus type 1 and type 2. Additional HIF
treatment 24 h after infection effectively lowered the maximum yield of viral
infectivity. Equal results were obtained in simian cells with 3,000 IU of HIF per
ml. The spread of two cell-bound herpesviruses, varicella zoster virus and
Medical Lake macaque herpesvirus, was inhibited by 2,000 IU of HIF per ml in
human fibroblasts and Vero cells, respectively. Varicella zoster virus
infectivity was notably reduced by HIF, whereas the latter system showed a low
sensitivity. To study the effect of HIF in the infected cornea, keratitis was
induced experimentally in both eyes of 12 rhesus monkeys and 12 African green
monkeys by inoculation with vaccinia virus and herpes simplex virus,
respectively. In each monkey one eye served as a control for the full cycle of
disease. In the other eye HIF treatment was initiated prophylactically 15 h
before or simultaneously with the challenge virus infection or 6 to 20 h
postinfectionally or therapeutically after onset of the disease, and the
treatment was continued for 2 to 7 days. Prophylactic and simultaneous
administration equally resulted in inhibition of both vaccinia and herpes
keratitis. Postinfectional and therapeutic administration of interferon moderated
the course of keratitis slightly and shortened the period of virus shedding.

PMID: 166924 [PubMed - indexed for MEDLINE]

8914: J Neurol. 1975 Jun 9;209(2):149-50.

A case of peripheral facial palsy following varicella.

Shoji H, Hirose K, Uono M, Sugita R, Hondo R.

Publication Types: 
    Case Reports

PMID: 51052 [PubMed - indexed for MEDLINE]

8915: Can Med Assoc J. 1975 Jun 7;112(11):1329-32.

Mastocytosis: unusual manifestation; clinical and radiologic changes.

Gagnon JH, Kalz F, Kadri AM, Graefe IV.

Two patients with mast cell disease presented with unusual features. In one the
absence of skin lesions made the diagnositic problem a challenging one. Certain
of the laboratory findings, especially those related to the serum cholesterol
concentration and platelet function tests, were particularyl interesting.
Chemotherapy induced partial remission. The second patient had a long, relatively
benign course complicated by two episodes of herpes zoster, the last being
associated with the Landry-Guillain-Barre syndrome. In both patients the skeletal
abnormalities were radiologically similar. When these are present they should be 
considereed sufficiently characteristic to indicate strongly a diagnosis of
mastocytosis.

PMID: 804988 [PubMed - indexed for MEDLINE]

8916: Br J Dermatol. 1975 Jun;92(6):625-30.

Viral warts, herpes simplex and herpes zoster in patients with secondary immune
deficiencies and neoplasms.

Morison WL.

The incidence of viral warts, recurrent herpes simplex and herpes zoster has been
assessed in a group of patients with possible secondary immune deficiency states 
and compared to a control group. Patients with cell-mediated immune deficiency
appear to be more prone to warts and zoster infection as compared to patients
with humoral immune deficiency. Recurrent herpes simplex infection was not
increased in either group.

Publication Types: 
    Clinical Trial
    Comparative Study

PMID: 1101940 [PubMed - indexed for MEDLINE]

8917: Acta Ophthalmol (Copenh). 1975 Jun;53(3):450-7.

Conjunctival sensitivity in pathological cases, with simultaneous measurement of 
corneal and lid margin sensitivity.

Norn MS.

A total of 209 pathological eyes each had 17 localities tested for sensitivity
(cornea, caruncle, upper and lower lid margins (centrally, medially and
laterally), and corresponding localities on the palpebral conjunctiva, and upper 
and lower halves of the bulbar conjunctiva). Reduced conjunctival sensitivity is 
seen in pemphigoid (excluding the lid margin) in contact lens wearers, at sites
of nerves transected during operation and in rare cases of infectious
conjunctivitis. Isolated corneal hypaesthesia is seen in bacterial or fungal
keratitis. In herpes, the hypaesthesia extends over the bulbar conjunctiva, in
zoster, over wider areas (including the lid margin). The sensitivity is normal in
keratoconjunctivitis sicca and chronic conjunctivitis. In neurological diseases
the hyposensitivity could include the cornea, conjunctiva and lid margin. The
conclusion is drawn that a study of the conjunctivo-corneal sensitivity can give 
differential diagnostic information, provided the normal sensitivity range is
known. This has been set out in a Table in 10-year age groups.

PMID: 1101626 [PubMed - indexed for MEDLINE]

8918: Int J Dermatol. 1975 Jun;14(5):341-4.

Corticosteroids in herpes simplex and zoster.

Smith EB, Powell RF.

PMID: 1080136 [PubMed - indexed for MEDLINE]

8919: Ann Intern Med. 1975 Jun;82(6):778-83.

Ineffectiveness of subcutaneous cytosine arabinoside in localized herpes zoster.

Betts RF, Zaky DA, Douglas RG Jr, Royer G.

Cytosine arabinoside (cytarabine) was evaluated in a randomized double-blind
controlled study for the treatment of localized herpes zoster. Cytarabine was
administered subcutaneously in a dose of 50 mg/m-2 body surface area once daily
for 4 days, always within 14 days of onset of the first symptom and usually
within 7 days. Thirty patients given cytarabine and 30 patients given placebo
were well matched with respect to age, sex, and length and severity of presenting
rash and pain as well as underlying disease. There was no difference in the rate 
of disappearance of pain or rash in either treatment group. More patients given
cytarabine than patients given placebo had minimal pain and significantly more
cytarabine-treated patients had persistence of neurological symptoms at 6 months'
follow-up. Acute side effects, though mild, were significantly increased in the
cytarabine-treated patients especially with respect to nausea and vomiting and
decrease in platelet count. Cytarabine administered in this dose subcutaneously
had no beneficial effect and was associated with mild side effects and
persistence of neurological symptoms.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 166586 [PubMed - indexed for MEDLINE]

8920: JFORL J Fr Otorhinolaryngol Audiophonol Chir Maxillofac. 1975
Jun;24(6):463-4.

[Auricular zona and associated forms]

[Article in French]

Claux J, Coll J.

Publication Types: 
    Case Reports

PMID: 126296 [PubMed - indexed for MEDLINE]

8921: Dtsch Med Wochenschr. 1975 May 23;100(21):1205.

[Letter: Zoster therapy]

[Article in German]

Nasemann T.

PMID: 1132334 [PubMed - indexed for MEDLINE]

8922: Nurs Times. 1975 May 8;71(19):732-3.

Post-herpetic neuralgia.

Nathan PW.

PMID: 1129191 [PubMed - indexed for MEDLINE]

8923: Ann Otolaryngol Chir Cervicofac. 1975 May-Jun;92(4-5):229-34.

[Facial paralysis in children]

[Article in French]

Muler H, Paquelin F, Cotin G, Luboinski B, Henin JM.

Facial paralyses in children may be grouped under headings displaying a certain
amount of individuality. Chronologically, first to be described are neonatal
facial paralyses. These are common and are nearly always cured within a few days.
Some of these cases are due to the mastoid being crushed at birth with or without
the use of forceps. The intra-osseous pathway of the facial nerve is then
affected throughout its length. However, a cure is often spontaneous. When this
desirable development does not take place within three months, the nerve should
be freed by decompressive surgery. The special anatomy of the facial nerve in the
new-born baby makes this a delicate operation. Later, in all stages of acute
otitis, acute mastoiditis or chronic otitis, facial paralysis can be seen.
Treatment depends on the stage reached by the otitis: paracentesis,
mastoidectomy, various scraping procedures, and, of course, antibiotherapy. The
other causes of facial paralysis in children are very much less common: a frigore
or viral, traumatic, occur ring in the course of acute poliomyelitis, shingles or
tumours of the middle ear. To these must be added exceptional causes such as
vitamin D intoxication, idiopathic hypercalcaemia and certain haemopathies.

Publication Types: 
    English Abstract

PMID: 1217818 [PubMed - indexed for MEDLINE]

8924: Am J Med Sci. 1975 May-Jun;269(3):399-401.

Herpes zoster induced urinary retention in Hodgkin's disease.

Shaukat MS.

A patient with Hodgkin's disease with acute urinary retention caused by herpes
zoster is presented. Two other similar cases previously reported in the
literature are reviewed along with a review of English literature on herpes
zoster causing urinary retention and on other genitourinary problems in Hodgkin's
disease. Because of increased incidence of herpes zoster in Hodgkin's disease,
recognition of this complication is stressed since other causes of actue urinary 
retention in Hodgkin's disease have serious implications.

PMID: 1155496 [PubMed - indexed for MEDLINE]

8925: Arch Ophthalmol. 1975 May;93(5):382-3.

Delayed trochlear nerve palsy in a case of zoster oticus.

Keane JR.

A 57-year-old man with herpes zoster oticus developed a delayed fourth nerve
palsy followed by transient intermittent sixth nerve weakness. Trochlear nerve
lesions occur rarely with zoster, particularly in the absence of zoster
ophthalmicus. A knowledge of the wide range of motor manifestations and the
chronicity of meningitis with zoster will afford earlier diagnosis without resort
to arteriography.

PMID: 1147811 [PubMed - indexed for MEDLINE]

8926: Hautarzt. 1975 May;26(5):287-8.

[Letter: Isolation of zoster patients]

[Article in German]

Nasemann T.

PMID: 168169 [PubMed - indexed for MEDLINE]

8927: J Infect Dis. 1975 May;131(5):509-15.

Cellular events in zoster vesicles: relation to clinical course and immune
parameters.

Stevens DA, Ferrington RA, Jordan GW, Merigan TC.

The cellular responses in zoster vesicles was studied chronologically in 30
patients, some of whom were compromised hosts with disseminated disease. Cell
counts were low initially but rose abuptly later. Polymorphonuclear leukocytes
predominated at all times in the vesicular fluid and in the cells adherent to the
vesicle base. The abrupt rise in the number of cells generally coincided with an 
abrupt rise in the titer of vesicular interferon; both increases preceded
resolution of local infection and cessation of cutaneous dissemination in
disseminated disease, but the sequence of the increases was variable. The peak
interferon titer correlated with cessation of dissemination better than did peak 
cell counts, and the timing of the local events contrasted with appearance of
complement-fixing antibody, which commonly occurred after the resolution of
disease. Possible interpretations are that a few sensitized lymphocytes may
initiate the defensive response, produce interferon, and/or produce chemotactic
factors that augment the polymorphonuclear response. The appearance of
polymorphonuclear cells may be a nonspecific inflammatory response, or these
cells or the deeper mononuclear infiltrate seen in biopsies may contribute to the
rise in local interferon.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 165243 [PubMed - indexed for MEDLINE]

8928: J Immunol. 1975 May;114(5):1454-7.

Partial characterization of a soluble antigen preparation from cells infected
with human cytomegalovirus: properties of antisera prepared to the antigen.

Waner JL.

Soluble antigen (SA) preparations were obtained from cell cultures infected with 
either the Davis or AD169 strains of cytomegalovirus (CMV). Fractionation of SA
preparations through Sephadex G-200 resulted in a molecular weight value ranging 
from 67,000 to 85,000. Rate-zonal centrifugation produced an approximate value of
5.5S for the CMV antigenic material. Antisera to SA prepared from either AD169-
or Davis-infected cells lacked neutralizing activity but produced specific
fluorescence confined to CMV intranuclear inclusion material when used in the
indirect fluorescent antibody test (IFA). The specific fluorescing inclusion
reaction was seen when either AD169 or Davis antisera were used with cells
infected with the Davis, AD169, Kerr, or C-87 strains of CMV. Fluorescence was
not observed in cells infected with a strain of Herpes simplex type 1,
varicella-zoster virus, an EBV transformed lymphocyte line, the Cx-90-3B human
CMV transformed hamster embryo cell line or CMV-infected cell cultures treated
with cytosine arabinoside (Ara-C) and showing only antigens expressed in the
absence of viral DNA synthesis. Antisera prepared to SA preparations obtained
from CMV-infected cells apparently react with specific CMV antigens that are
dependent on viral DNA synthesis and are common to several strains.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 164507 [PubMed - indexed for MEDLINE]

8929: Ugeskr Laeger. 1975 Apr 28;137(18):1003.

[Letter: Treatment of herpes zoster]

[Article in Danish]

Ibsen B.

PMID: 1145814 [PubMed - indexed for MEDLINE]

8930: N Engl J Med. 1975 Apr 3;292(14):755.

Letter: Ara-C and disseminated zoster.

Hines JD, Cowan DH, Nankervis GA.

PMID: 1113791 [PubMed - indexed for MEDLINE]

8931: Wiad Lek. 1975 Apr 1;28(7):585-8.

[Vincristine neurotoxicity and zoster. A possible potentiating effect]

[Article in Polish]

Jedrzejczak WW, Chmielowski K, Siekierzynski M.

Publication Types: 
    English Abstract

PMID: 1130055 [PubMed - indexed for MEDLINE]

8932: Indian J Ophthalmol. 1975 Apr;23(1):39-41.

Herpes simplex uveitis in zoster ophthalmicus.

Dhir SP, Jain IS, Sehghal S.

Publication Types: 
    Case Reports

PMID: 169199 [PubMed - indexed for MEDLINE]

8933: Hautarzt. 1975 Apr;26(4):181-90.

[Virus propagation, virus replication and virus elimination in the human skin in 
zoster]

[Article in German]

Orfanos CE, Runne U.

The purpose of this study was to investigate the spreading, the replication and
the elimination of Varicella-Zoster-Virus (ZV) in human skin. Typical skin
lesions of thoracic zoster in different stages of development and of exanthematic
vesicles in ophthalmic zoster were examined under the electron microscope. We
found that ZV may be detected in fully developed vesicular skin lesions only,
whereas in immature lesions and in the surrounding non involved skin axonal
alterations may be seen, with no ZV present. The replication of the virus in the 
skin takes place almost exclusively in the malpighian keratinocytes of the
involved epidermis. Blister formation in zoster is basically a result of the
acantholysis of the infected epidermal cells. Mature ZV are then extruded into
the intercellar space and become phagocytised by mononuclear cells which
infiltrate the epidermis and eliminate the virus in large phagolysosomes. Only
few virions were found in the dermis extracellularly or in dermal macrophages. In
some of these cells stages of ZV-replication were also seen. Other cell types
(i.e. Langerhans cells) were rarely infected. The application of the periodic
acid-silver methenamine technique (PASM) in zoster revealed that a
glycoprotein-rich coat surrounds each mature virion, obviously originating from
the plasma membrane of the infected keratinocytes. This coat may be reason for
the ability of the ZV to adhere on the cell surface and to infect the cell.

Publication Types: 
    English Abstract

PMID: 168168 [PubMed - indexed for MEDLINE]

8934: Cancer. 1975 Apr;35(4):1027-30.

Prophylaxis of varicella in children with neoplastic disease: comparative results
with zoster immune plasma and gamma globulin.

Geiser CF, Bishop Y, Myers M, Jaffe N, Yankee R.

The incidence and severity of varicella following a close family contact were
evaluated in children with neoplastic diseases who received prophylaxis either
with commerical gamma globulin or with zoster immune plasma, as compared to
patients who did not receive any prophylaxis. In the untreated group, all 14
patients developed varicella, complicated by 1 case of encephalitis and 2 cases
of fatal pneumonia. In the group of 17 patients who received 0.6-1.2 ml/kg body
weight of gamma globulin, 16 developed varicella, complicated by pneumonia in 2
cases, with 1 death. In the third group of 27 patients who received 10 ml/kg body
weight of zoster immune plasma (ZIP), obtained from healthy adults convalescing
from herpes zoster, there were only 8 cases of varicella, all very mild. Thus,
prophylaxis with ZIP significantly reduced the incidence of clinical varicella (p
less than 0.01) and attenuated the severity of its course.

Publication Types: 
    Comparative Study
    Research Support, U.S. Gov't, P.H.S.

PMID: 46775 [PubMed - indexed for MEDLINE]

8935: Nouv Presse Med. 1975 Mar 29;4(13):976.

[Letter: L-dopa and zona]

[Article in French]

Peraldi A.

PMID: 1144043 [PubMed - indexed for MEDLINE]

8936: Biochim Biophys Acta. 1975 Mar 20;417(1):25-53.

Oncogenic Herpes viruses.

zur Hausen H.

PMID: 164249 [PubMed - indexed for MEDLINE]

8937: Ugeskr Laeger. 1975 Mar 17;137(12):689-90.

[Letter: Treatment of herpes zoster]

[Article in Danish]

Larsen AK.

PMID: 1145794 [PubMed - indexed for MEDLINE]

8938: Lakartidningen. 1975 Mar 12;72(11):1087-8.

[Is zoster a sign of undiagnosed cancer?]

[Article in Swedish]

Molin L.

Publication Types: 
    English Abstract

PMID: 1128038 [PubMed - indexed for MEDLINE]

8939: Med Times. 1975 Mar;103(3):49-55.

Dermatology mediquiz. Case 9.

Leavell UW Jr.

Publication Types: 
    Case Reports

PMID: 1113637 [PubMed - indexed for MEDLINE]

8940: Scand J Urol Nephrol. 1975 Mar 6-7;(29 Suppl):133-4.

Herpesvirus infections in renal allograft recipients.

Spencer ES.

17 of 37 immunosuppressed renal allograft recipients developed clinical and/or
serological evidence of herpes simplex virus infections, 7 of 83 developed a
zoster rash, 85 of loo had evidence of cytomegalovirus infection and in 3 of 30
an active Epstein-Barr virus was seen.

PMID: 181840 [PubMed - indexed for MEDLINE]

8941: Neurol Neurochir Pol. 1975 Mar-Apr;9(2):211-5.

[Ramsay Hunt syndrome with involvement of facial and statoacoustic nerves]

[Article in Polish]

Fryze C, Kugler R, Standziak A.

Publication Types: 
    English Abstract

PMID: 1153055 [PubMed - indexed for MEDLINE]

8942: Acta Otolaryngol. 1975 Mar-Apr;79(3-4):221-7.

The role of viral infection in acute peripheral facial palsy.

Djupesland G, Berdal P, Johannessen TA, Degre M, Stien R, Skrede S.

Thirty-three patients with acute non-traumatic peripheral facial palsy were
studied. In one patient, varicella-zoster virus was isolated from CSF. Antibody
against the same virus was present in CSF, and rising titre was demonstrated in
serum. In two cases, herpes virus hominis was isolated from the nasopharynx.
CF-antibody tests indicated recent viral infection in 7 other cases. One
additional patient had clinical signs of herpes zoster oticus. In most of these
11 patients, but also in the majority of the remaining 22 patients, an acute
phase reaction was present, and serum and CSF immunoglobulins were increased.
Thus, an active or recent infection (probably viral) seemed to precede or
coincide with the facial palsy in most cases in both groups.

PMID: 1136761 [PubMed - indexed for MEDLINE]

8943: Ann Med Interne (Paris). 1975 Mar;126(3):177-81.

[Paraneoplastic dermatoses]

[Article in French]

Barriere H.

PMID: 1122088 [PubMed - indexed for MEDLINE]

8944: Arch Dermatol. 1975 Mar;111(3):396.

Letter: Post-herpes zoster neuralgia: response to vitamin E therapy.

Cochrane T.

PMID: 1119838 [PubMed - indexed for MEDLINE]

8945: Riv Patol Nerv Ment. 1975 Mar-Apr;96(2):82-6.

[Motor complications during Herpes zoster of the ophtalmic branch of the
trigeminal nerve. Electromyographic study of 7 cases (author's transl)]

[Article in Italian]

Negrin P, Peserico A.

It has been recently shown that in addition to ganglia the nerve is involved
during Herpes Zoster. Electromyographic investigations of the masseter muscle,
were carried out on the side of the skin lesions in 7 cases of Herpes Zoster of
the first trigeminal branch. In 4 cases there was a partial denervation, possibly
due to a mononeuritis of the motor branch of the trigeminal nerve. It is probable
that systematic electromyographic examinations may demonstrate a higher
proportion of motor complications during Herpes Zoster than previously accepted.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1084549 [PubMed - indexed for MEDLINE]

8946: Med Times. 1975 Mar;103(3):88-9.

10 questions in neurology.

[No authors listed]

PMID: 803603 [PubMed - indexed for MEDLINE]

8947: J Infect Dis. 1975 Mar;131(3):225-9.

Treatment of varicella-zoster virus infections with adenine arabinoside.

Johnson MT, Buchanan RA, Luby JP, Mikulec D.

Twenty-three patients with complicated varicella-zoster virus infections were
treated with adenine arabinoside. Of 14 patients with herpes zoster, 13 had
malignancy treated with irradiation and cytotoxic agents or steroids. Although
the duration of active vesicle formation in these patients ranged from two to 14 
days before therapy, no new lesions appeared after the fourth day of treatment
with adenine arabinoside. Zoster encephalitis developed in one patient on the
third day of treatment, and severe postherpetic neuralgia was seen in three
patients. Of nine treated patients with primary varicella, six improved,
including five with evidence of varicella pneumonia. Two of the three patients
with varicella who died were immunosuppressed and had progressive viral pneumonia
with persistently high titers of virus in vesicular fluid; the third pateint was 
a child with Reye's syndrome. Double-blind controlled studies will be necessary
to demonstrate the efficacy of adenine arabinoside in the treatment of infections
with varicella-zoster virus.

PMID: 165242 [PubMed - indexed for MEDLINE]

8948: Rev Clin Esp. 1975 Feb 28;136(4):365-9.

[Transitory acute glaucoma: complication of herpes zoster]

[Article in Spanish]

Jordano J, Abu-Yaghi EN, Sanchez Ortega R.

PMID: 1079366 [PubMed - indexed for MEDLINE]

8949: Ned Tijdschr Geneeskd. 1975 Feb 22;119(8):313-4.

[Facial paralysis]

[Article in Dutch]

Jongkees LB.

PMID: 1143589 [PubMed - indexed for MEDLINE]

8950: Drug Ther Bull. 1975 Feb 14;13(4):13-5.

Drugs for herpes zoster.

[No authors listed]

PMID: 1218508 [PubMed - indexed for MEDLINE]

8951: Med Welt. 1975 Feb 14;26(7):306-8.

[Pseudo-epitheliomatic hyperplasia on herpes zoster cicatrices in a patient with 
chronic myelosis]

[Article in German]

Korting GW, Brokelschen HU.

PMID: 1054778 [PubMed - indexed for MEDLINE]

8952: Geriatrics. 1975 Feb;30(2):87-8, 91-5.

Skin infections may be outward signs of inner disorders.

Allison JR Jr, Rist T.

PMID: 1123158 [PubMed - indexed for MEDLINE]

8953: Antimicrob Agents Chemother. 1975 Feb;7(2):203-7.

Effects of adenine arabinoside on cellular immune mechanisms in humans.

Steele RW, Chapa IA, Vincent MM, Hensen SA, Keeney RE.

In vitro lymphocyte blastogenic responses to the commonly employed mitogens,
phytohemagglutinin, pokeweed, and concanavalin A, were evaluated when adenine
arabinoside (ara-A) in a concentration of 3 mug/ml was added to the culture
materials. Similarly, blastogenic and cytotoxic responses to cell cultures
persistently infected with herpes simplex virus 1, herpes simplex virus 2, and
varicella-zoster virus were determined in the presence of ara-A. No depression of
these cellular immune responses by ara-A was demonstrated. This was in contrast
to the effect of cytosine arabinoside, which at a concentration of 3 mug/ml
severely inhibited these immune responses. Further studies examined lymphocyte
blastogenic responses to the mitogens and blastogenic and cytotoxic responses
specific for the herpes group virus infecting patients who were subsequently
treated with ara-A; determinations were made before, during, and after treatment.
In vitro responses during and after treatment with ara-A were unchanged or often 
enhanced as compared to pretreatment values. Therefore, the antiviral
chemotherapeutic agent, ara-A, does not appear to depress the host's cellular
immune responses, which are vital to successful elimination of invading herpes
group viruses.

Publication Types: 
    In Vitro
    Research Support, U.S. Gov't, Non-P.H.S.

PMID: 1137371 [PubMed - indexed for MEDLINE]

8954: Vrach Delo. 1975 Feb;(2):151-2.

[Case of encephalitis in herpes zoster]

[Article in Russian]

Aleksandrov IuS.

Publication Types: 
    Case Reports

PMID: 1136397 [PubMed - indexed for MEDLINE]

8955: Rinsho Shinkeigaku. 1975 Feb;15(2):75-80.

[Cytosine arabinoside treatment for ophthalmic herpes zoster with meningitis]

[Article in Japanese]

Shoji H, Hanakago R, Uono M, Koya M, Ogiwara H.

Publication Types: 
    Case Reports
    English Abstract

PMID: 1088884 [PubMed - indexed for MEDLINE]

8956: Geriatrics. 1975 Feb;30(2):117-24, 129-31.

Tracing the outward course of leukemia-lymphomas.

Bluefarb SM.

PMID: 123518 [PubMed - indexed for MEDLINE]

8957: Ann N Y Acad Sci. 1975 Jan 27;243:395-402.

Dimethyl sulfoxide therapy in various dermatological disorders.

Sehtman L.

PMID: 1055556 [PubMed - indexed for MEDLINE]

8958: Med Klin. 1975 Jan 24;70(4):141-5.

[Ocular complications in ophthalmic zoster (author's transl)]

[Article in German]

Schmitt H.

Ocular complications occur in about 50% of cases of ophthalmic zoster. They
include inflammatory reactions of the eyelid, conjunctivitis, scleritis,
keratitis, iridocyclitis, secondary glaucoma, optic neuritis, internal
ophthalmoplegia, ocular motor palsies and exophthalmos. Very dangerous
complications are a concomitant facial paralysis and a neuroparalytic keratitis. 
Then a tarsorrhaphy should be done in time. An ophthalmologist should be
consulted, when the side of the tip of the nose presents vesicles (Hutchinson's
rule).

Publication Types: 
    English Abstract

PMID: 1079072 [PubMed - indexed for MEDLINE]

8959: Nurs Times. 1975 Jan 16;71(3):97-9.

Pain in the face.

Sambrook MA.

PMID: 1110906 [PubMed - indexed for MEDLINE]

8960: J Endod. 1975 Jan;1(1):32-5.

Herpes zoster associated with pulpless teeth.

Gregory WB Jr, Brooks LE, Penick EC.

PMID: 1061768 [PubMed - indexed for MEDLINE]

8961: Acta Otorhinolaryngol Belg. 1975;29(6):976-96.

[Topical and differential diagnosis of facial paralysis. Study based on 1000
cases]

[Article in Dutch]

Clement PA, Devriese PP.

The functional and clinical investigation of peripheral facial paralysis is
discussed by the authors in brief. On ground of the scheme of Sturm the
relativity of topographical diagnosis is demonstrated. According to their
frequency in a statistic of 1009 cases the different causes of facial palsy are
discussed as well as the problems involved in differential diagnosis.

Publication Types: 
    English Abstract

PMID: 1229825 [PubMed - indexed for MEDLINE]

8962: J Cutan Pathol. 1975;2(6):322-3.

Herpes zoster.

Myers RP, Montes LF.

Publication Types: 
    Case Reports

PMID: 1219049 [PubMed - indexed for MEDLINE]

8963: Dermatologica. 1975;150(6):366-8.

Generalized mastocytosis, relapsing herpes zoster and polyradiculoneuritis.

Kalz F.

A 68-year-old woman suffering from a longstanding urticaria pigmentosa with mast 
cell infiltrations in bones had two attacks of herpes zoster. The second herpes
zoster attack was followed by a severe polyradiculoneuritis (Guillain-Barre
syndrome). The sequence of events suggests an immunological deficiency.

Publication Types: 
    Case Reports

PMID: 1201812 [PubMed - indexed for MEDLINE]

8964: Biomedicine. 1975 Jan;22(1):1-4.

The macrophage and host defense mechanisms.

Twomey JJ.

Macrophages participate in a variety of host defense mechanisms. The delivery of 
macrophage precursors from the bone marrow to the tissues may be reduced with
bone marrow failure and macrophage function may be impaired with certain virus
infections such as herpes zoster or infectious mononucleosis. Defective
macrophage function may impair cell mediated immunity more than humoral immunity 
which is manifested clinically by cutaneous anergy. One disease associated with
chronic macrophage dysfunction is chronic mucocutaneous candidiasis.

PMID: 1180972 [PubMed - indexed for MEDLINE]

8965: J R Coll Gen Pract. 1975 Jan;25(150):29-32.

Herpes zoster in general practice.

Ross CA, Brown WK, Clarke A, Caldwell WF, Gordon ER, Harvey J, McAlister AM,
McGlone J, Prentice RT, Thorburn W, Tobias C.

PMID: 1177201 [PubMed - indexed for MEDLINE]

8966: ORL J Otorhinolaryngol Relat Spec. 1975;37(1):1-18.

An evoked electromyographic test for peripheral facial palsy.

Sato I, Kumagami H.

The purpose of the present study was to determine the degree of nerve
degeneration in patients with facial palsy from the number of spikes in M-wave
which were induced from the facial muscle by means of a bipolar concentric needle
electrode when the facial nerve was stimulated. Ten normal cases between 14 and
72 years of age and 46 cases with facial palsy between 12 and 73 years of age
were examined. Histopathological findings of ten denervated nerves were studied
to determine to what extent this method may reflect the state of nerve
degeneration.

PMID: 1169741 [PubMed - indexed for MEDLINE]

8967: Eur Neurol. 1975;13(4):332-8.

Motor lesions in herpes zoster. Incidence and special features.

Weiss S, Streifler M, Weiser HJ.

In the review of 117 patients hospitalized for herpes zoster (HZ) during the
10-year-period of 1960-1969, six patients with motor paralysis of the limbs were 
found. The incidence of motor paralysis in HZ which ranges in the literature
between 0.5 and 31%, was 18% in our series. Reasons for these differences are
discussed. An uncommon feature, local recurrence of HZ with motor deficit
pertaining to the same segments is reported, and joint subluxation, a rare
complication of motor HZ, is also described. The importance of looking for
diaphragmatic paralysis and motor deficit in the thoracoabdominal segments, not
readily revealed in routine examination, is stressed.

PMID: 1149753 [PubMed - indexed for MEDLINE]

8968: Birth Defects Orig Artic Ser. 1975;11(1):367-9.

Effects of fetal thymus transplantation on defective cellular immunity.

Kirkpatrick CH, Wells SA, Burdick JF, Smith TK.

PMID: 1148387 [PubMed - indexed for MEDLINE]

8969: Trans Pa Acad Ophthalmol Otolaryngol. 1975 Spring;28(1):36-41.

Interpretation of hearing tests in retrocochlear lesions.

Young IM.

PMID: 1145700 [PubMed - indexed for MEDLINE]

8970: Scand J Infect Dis. 1975;7(1):7-10.

Herpes zoster and recurrent herpes simplex.

Ross CA.

87 patients with the clinical diagnosis of herpes zoster were seen during a
one-year period in 8 general practices in Glasgow, the rate per 1 000 practice
population being approximately 2.4. Of these, 78 (90%) had serological evidence
of active infection with herpes zoster. A history of recurrent herpes simplex was
obtained in 25 (32%) of the 78 patients with confirmed herpes zoster; 63 (81%) of
these 78 had complement-fixing (CF) antibodies to herpes simplex. Thus, latent
herpes simplex infection did not prevent herpes zoster nor modify the severity of
herpes zoster. In most of the patients CF antibodt to varicella-zoster was not
detected within 5 days from appearance of the rash. After the acute phase of the 
illness CF antibody titres fell fairly rapidly, the geometric mean titre being
189 at 2-4 weeks after the rash, 27 from 3-6 months, and 8 from 12-18 months. The
rapid rise and decline in CF antibody after herpes zoster infection compared with
the unchanging CF titres associated with recurrent herpes simplex infection
suggest that varicella-zoster and herpes simplex virus differ in their mechanism 
of latency.

PMID: 1145136 [PubMed - indexed for MEDLINE]

8971: Arch Intern Med. 1975 Jan;135(1):147-52.

Remission maintenance therapy for multiple myeloma.

[No authors listed]

The effects of various regimens of melphalan combination chemotherapy were
evaluated in 508 patients with multiple myeloma. No value was confirmed from the 
addition of procarbazine or vincristine sulfate to melphalan-prednisone
combinations. Ninety-six patients who responded to treatment were allocated at
random to one of three maintenance regimens, namely intermittent courses of
carmustine with prednisone, continued courses of melphalan with prednisone, or no
chemotherapy. There were no differences in the frequency of relapse, the
remission duration, or the survival time among these maintenace groups. The
frequencies of pneumonia and herpes zoster were higher in patients receiving
continued chemotherapy. Continued melphalan-prednisone chemotherapy after the
first year is of no major value to responding patients with multiple cyeloma.
Attempts to reduce tumor mass maximally with a change in therapy are justified.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

PMID: 1111463 [PubMed - indexed for MEDLINE]

8972: Am Fam Physician. 1975 Jan;11(1):108-10.

Otalgia.

Beddoe GM.

PMID: 1109535 [PubMed - indexed for MEDLINE]

8973: Trans St Johns Hosp Dermatol Soc. 1975;61(1-2):35-43.

Laboratory diagnosis of cutaneous herpes simplex and varicella--zoster
infections.

Kurtis B.

PMID: 1105909 [PubMed - indexed for MEDLINE]

8974: Scand J Infect Dis. 1975;7(1):1-5.

Human interferon therapy for herpes zoster in adults.

Emodi G, Rufli T, Just M, Hernandez R.

Of 37 patients with herpes zoster 28 were treated with human exogenous interferon
and 9 received only culture medium. The interferon was produced in leukocyte
cultures and was given intramuscularly in one daily dose of 1 million units for
5-8 days. In the interferon-treated patients interferon was detectable in serum
(peak level 1-5 hours after interferon injections) and in vesicle fluid, and in
some patients also in urine samples. Anti-interferon antibodies were not found.
Of the 28 interferon-treated patients 8 had a slight temperature increase and 4
showed a transient local reaction. In the interferon treated group of patients
the duration of pain was shortened and the development of crust formation was
enhanced compared with the control group.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 1096292 [PubMed - indexed for MEDLINE]

8975: Bull Soc Ophtalmol Fr. 1975 Jan;75(1):37-40.

[Ophthalmic zona in a child. Attempt at treatment by macrophagic stimulation]

[Article in French]

Lods MF.

Publication Types: 
    Case Reports

PMID: 1081918 [PubMed - indexed for MEDLINE]

8976: Ophthalmologica. 1975;171(3):237-43.

Ocular toxoplasmosis, trigeminal herpes zoster and pulmonary tuberculosis in a
patient with Hodgkin's disease.

Troussaint D, Vanderhaeghen JJ.

PMID: 1079591 [PubMed - indexed for MEDLINE]

8977: Int Ophthalmol Clin. 1975 Winter;15(4):171-85.

Varicella-zoster ophthalmicus.

Pavan-Langston D.

Publication Types: 
    Review

PMID: 178619 [PubMed - indexed for MEDLINE]

8978: Chemotherapy. 1975;21(3-4):221-30.

Antiviral activity of a pyrazino-pyrazine derivative.

Verini MA, Fioretti A, Casazza AM, Sanfilippo A, Palamidessi G, Ghione M.

The 2,3-dihydroxy-6-bromo-pyrazino-[2,3-beta]-pyrazine is a substance selected
during the antiviral screening of pyrazino-pyrazine derivatives. The compound
shows antiviral activity in vitro against measles, NDV, some influenza viruses
and against herpes simplex and zoster, infectious canine hepatitis and vaccinia
viruses. It had no effect on ECHO 9 virus. Therapeutic trials showed activity
also on herpetic keratoconjunctivitis experimentally induced in rabbits.

PMID: 169110 [PubMed - indexed for MEDLINE]

8979: Acta Otolaryngol. 1975 Jan-Feb;79(1-2):67-80.

Degenerative changes in the human vestibular sensory epithelia.

Rosenhall U, Rubin W.

A study of the vestibular end organs from humans of different ages is presented. 
The inner ears were exposed by microdissection, and the vestibular sensory
regions were either sectioned and studied with light or electron microscopy, or
prepared and studied with the surface specimen technique. A change, which can be 
related to aging, is the accumulation of lipofuscin inclusions in sensory and
supporting cells, especially pronounced in the type I sensory cell. Changes of
the hair bundles, such as disarrangement of cilia, increased fragility of cilia
and formation of giant cilia, have also been observed in aged individuals. In
three cases there was a history of vestibular disturbance of vertigo. All three
cases had shown caloric hypo-reactivity. In two cases, one with a history of
herpes zoster oticus and another with a brain stem glioma, no morphological
changes which could be attributed to the diseases, were found. The third case
showed degeneration of macula utriculi and the lateral and superior cristae,
possibly as a result of vascular disturbance.

Publication Types: 
    Research Support, U.S. Gov't, Non-P.H.S.
    Research Support, U.S. Gov't, P.H.S.

PMID: 167544 [PubMed - indexed for MEDLINE]

8980: Kansenshogaku Zasshi. 1975 Jan;49(1):18-24.

[Seroepidemiological study of varicella-zoster virus by complement fixation
reaction]

[Article in Japanese]

Ono Y, Takahashi C, Miyoshi K, Ideguchi S, Sasaki M.

Publication Types: 
    English Abstract

PMID: 165248 [PubMed - indexed for MEDLINE]

8981: J Natl Cancer Inst. 1975 Jan;54(1):49-51.

Elevated immunofluorescence antibody titers to several herpesviruses in Burkitt's
lymphoma patients: are high titers unique?

Hilgers F, Dean AG, de-The G.

Antibody titers for viral capsid antigens of all four human herpesviruses were
measured by immunofluorescence in the sera of 16 Burkitt's lymphoma (BL)
PATIENTS, 16 AGE-, SEX-, AND LOCALITY-MATCHED CONTROLS, AND 136 FAMILY MEMBERS
FROM THE West Nile District of Uganda. Among family members, titers greater than 
1:4 were found in 98% for herpes simplex virus (HSV), 86% for varicella-zoster
virus (VZV), 100% FOR CYTOMEGALOVIRUS (CMV), AND 94% FOR Epstein-Barr (EBV).
Titers in patients averaged approximately equal to 2 logs (fourfold) higher than 
those in matched controls for EBV, VZV, and CMV (P EQUALS 0.001); titers for HSV 
were only slightly higher in cancer patients. The mothers of patients had
someuhat higher EBV titers (0.05 smaller than or equal to P SMALLER THAN OR EQUAL
TO 0.01) than the mothers of controls, but no other differences between patient
and control families were found. By immunofluorescence, a method which apparently
has not been used for all four human herpesviruses in BL patients, the patients
had elevated antibody titers not only to EBV but also to CMV and VZV. The
elevated titers to three of the four human herpesviruses were not due to
serologic cross reactions.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 163324 [PubMed - indexed for MEDLINE]

8982: Pathol Microbiol (Basel). 1975;42(4):287-94.

[Pathophysiological implications of antigen-antibody complexes (author's transl)]

[Article in French]

Zubler R, Nydegger UE, Izui S, Lambert PH, Miescher PA.

Seventy years after the description of the Arthus phenomenon, the concept of
immune complex mediated pathology is widely recognized in clinical
pathophysiology. The availability of methods for the detection of soluble immune 
complexes opens new paths for clinical investigation in this field. This is
demonstrated for systemic lupus erythematosus, viral hepatitis B and herpes
zoster disease. New experimental approaches deal with the question of tissue
localization of immune complex mediated diseases, e.g. through affinity of
antigens for certain tissue structures.

Publication Types: 
    English Abstract
    Review

PMID: 132628 [PubMed - indexed for MEDLINE]

8983: Neurochirurgie. 1975 Jan-Feb;21(1):29-42.

[Results of selective posterior radiculetomy at the lumbar and cervical level]

[Article in French]

Vlahovitch B, Fuentes JM.

At the light of authors' present experience, radicletomy appears as an excellent 
antalgic operative procedure in the case of roots with high functional risk
(brachial plexus and lumbar plexus). In the absence of any motor deficiency or
ataxia, it appears that radicletomy is of help in the cure of severe hypertonies 
of the extremities (sequelae of cerebral stem contusions). Conversely, in the
spastic sequelae of hemi- or paraparesias, lumbar-sacral posterior selective
radicotomy is a sure procedure that procures results nearly super-imposable to
radicletomy with an appreciable gain in time. At last, for what concerns the
motor involvements of the upper extremity ending in spasticity, selective
radicletomy recovers its rights and has to be preferred to S.P.R. The indications
may be summarized as follows: -- At the level of the lower extremities: in the
case of paraparetic sequelae or of sequelae due to spastic paraplegia, a S.P.R.
has to be performed; for what concerns antalgic surgery, in the absence of motor 
deficiency, the best indication is radicletomy. -- At the level of the upper
extremities: in the case of dystonic sequeale of the cerebral stem, spastic pain 
bound with hemiplegia or with carcinoma etc. (herpes zoster..), radicletomy
constitutes the ideal surgical procedure.

Publication Types: 
    English Abstract

PMID: 52851 [PubMed - indexed for MEDLINE]

8984: Eur J Cancer. 1975 Jan;11(1):51-7.

Herpes zoster-varicella infection in malignant lymphomas. Influence of
splenectomy and intensive treatment.

Monfardini S, Bajetta E, Arnold CA, Kenda R, Bonadonna G.

PMID: 48460 [PubMed - indexed for MEDLINE]

8985: Int Arch Allergy Appl Immunol. 1975;48(2):161-70.

Determination of serum C9 level by immunodiffusion. Elevation in patients with
infectious or allergic skin diseases.

Kawachi-Takahashi S, Tanaka K, Takahashi M, Kawashima T, Shimada K.

The measurement of the ninth component of complement (C9) in human serum can be
easily carried out by the Mancini method using antiserum raised against purified 
C9. The average C9 level in 29 healthy adults was 44.5 plus or minus 10.6 mug/ml.
The serum C9 level was often elevated in patients with infectious or allergic
skin diseases. The C9 level remained normal in most patients with collagen
diseases. The availability of the monospecific antiserum has permitted
identifying C9 in human serum as alpha2-globulin.

PMID: 46851 [PubMed - indexed for MEDLINE]

8986: Lakartidningen. 1974 Dec 24;71(52):5352.

[Herpes zoster in children]

[Article in Swedish]

Melgard BJ.

PMID: 4449300 [PubMed - indexed for MEDLINE]

8987: Tidsskr Nor Laegeforen. 1974 Dec 10;94(34-36):2409.

[Letter: Prevention against varicella and herpes zoster in individuals with
impaired immunological defence]

[Article in Norwegian]

Moe FJ.

PMID: 4374773 [PubMed - indexed for MEDLINE]

8988: Lancet. 1974 Dec 7;2(7893):1396-7.

Letter: Serum-copper in Hodgkin's disease before and after herpes zoster.

Thorling EB, Thorling K.

Publication Types: 
    Comparative Study

PMID: 4143363 [PubMed - indexed for MEDLINE]

8989: Physiotherapy. 1974 Dec;60(12):386.

Short-wave diathermy for herpes zoster.

Allberry J, Manning FR, Smith EE.

PMID: 4467201 [PubMed - indexed for MEDLINE]

8990: Vestn Dermatol Venerol. 1974 Dec;(12):58-60.

[Therapeutic efficacy of oxoline and adimal in viral and presumedly viral
dermatoses]

[Article in Russian]

Samsonov VA, Nikitina MN, Mizonova TP.

Publication Types: 
    English Abstract

PMID: 4446746 [PubMed - indexed for MEDLINE]

8991: J Infect Dis. 1974 Dec;130(6):673-6.

Cytosine arabinoside for localized herpes zoster in patients with cancer: failure
in a controlled trial.

Schimpff SC, Fortner CL, Greene WH, Wiernik PH.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 4372276 [PubMed - indexed for MEDLINE]

8992: J Miss State Med Assoc. 1974 Dec;15(12):512-4.

Recurrent radial nerve palsy.

Grotta JC, Tipton AC Jr.

PMID: 4216637 [PubMed - indexed for MEDLINE]

8993: Transplant Proc. 1974 Dec;6(4):389-93.

Infectious complications of marrow transplantation.

Clift RA, Buckner CD, Fefer A, Lerner KG, Neiman PE, Storb R, Murphy M, Thomas
ED.

PMID: 4155156 [PubMed - indexed for MEDLINE]

8994: Antimicrob Agents Chemother. 1974 Nov;6(5):598-602.

Assessment of cytosine arabinoside as an antiviral agent in humans.

Lauter CB, Bailey EJ, Lerner AM.

Cytotoxicity, minimal inhibitory concentrations of herpesviruses, and
pharmacokinetic studies of cytosine arabinoside (ara-C) were done. Ara-C compared
favorably with idoxuridine in in vitro studies of antiviral activity versus
herpes simplex, varicella-zoster, and cytomegalovirus. However, ara-C was 10
times more toxic to tissue cultures, and concentrations in serum and urine of
three patients who were given ara-C at acceptable dosages (1 mg/kg per day) were 
not measurable by our assay. These studies predict that ara-C is not likely to be
a useful antiviral agent in humans because its therapeutic to toxic ratio
approaches unity. These predictions of little clinical efficacy seem now to have 
been confirmed by clinical trails in humans. Pharmacokinetic studies outlined
here should precede and help formulate controlled clinical trials of potential
antiviral agents in humans.

PMID: 15825312 [PubMed - indexed for MEDLINE]

8995: South Med J. 1974 Nov;67(11):1365-7.

Vesicular metastatic melanoma.

MacWilliams P, Noojin RO.

PMID: 4610774 [PubMed - indexed for MEDLINE]

8996: J Am Osteopath Assoc. 1974 Nov;74(3):244-6.

Herpes zoster oticus: report of a case.

Gilroy GL.

PMID: 4496990 [PubMed - indexed for MEDLINE]

8997: Pediatrics. 1974 Nov;54(5):658.

Letter: Zoster immune globulin shortage!

Brunell PA, Gershon AA.

PMID: 4453479 [PubMed - indexed for MEDLINE]

8998: Vestn Dermatol Venerol. 1974 Nov;(11):55-6.

[Spinal cord involvement in herpes zoster]

[Article in Russian]

Bateiko VIa, Sonina EE.

Publication Types: 
    Case Reports
    English Abstract

PMID: 4446728 [PubMed - indexed for MEDLINE]

8999: Can J Neurol Sci. 1974 Nov;1(4):239-41.

Spinal myoclonus in association with herpes zoster infection: two case reports.

Dhaliwal GS, McGreal DA.

Two cases of segmental spinal myoclonus, attributed to herpes zoster infection,
are presented. The findings support the suggestion made by Campbell and Garland
(1956) that "subacute myoclonic spinal neuronitis" is of viral origin. Both
patients were receiving immuno-suppressive treatment when the myoclonus
developed. The value of carbamazepine in therapy is mentioned.

PMID: 4441989 [PubMed - indexed for MEDLINE]

9000: Rocky Mt Med J. 1974 Nov;71(11):645-9.

Acute lymphoblastic leukemia of childhood: results of combination therapy.

Hutter JJ Jr, Hays T, Holton CP, Mayer CM, Baum ES, Chapman KE, Phillips LK,
Haerr M.

PMID: 4372664 [PubMed - indexed for MEDLINE]

9001: J Infect Dis. 1974 Nov;130(5):495-501.

Cell-mediated immunity to varicella-zoster virus: in vitro lymphocyte responses.

Jordan GW, Merigan TC.

Publication Types: 
    Comparative Study

PMID: 4370611 [PubMed - indexed for MEDLINE]

9002: Cah Med. 1974 Oct 30;15(11):703-6.

[Ocular herpes zoster]

[Article in French]

Deodati F, Arne JL.

PMID: 4548855 [PubMed - indexed for MEDLINE]

9003: Br Med J. 1974 Oct 19;4(5937):165.

Letter: Post-herpetic pruritus.

Liddell K.

PMID: 4153745 [PubMed - indexed for MEDLINE]

9004: Br Med J. 1974 Oct 12;4(5936):108.

Letter: Zoster in families.

Mackenzie J.

PMID: 4370162 [PubMed - indexed for MEDLINE]

9005: Nippon Ganka Gakkai Zasshi. 1974 Oct 10;78(10):1073-8.

[Study on herpes zoster keratitis]

[Article in Japanese]

Uchida Y, Kameyama K, Kameko M, Inoue S, Yoda Y.

Publication Types: 
    Comparative Study
    English Abstract

PMID: 4616619 [PubMed - indexed for MEDLINE]

9006: Wien Med Wochenschr. 1974 Oct 5;124(40):577-81.

[Myoclonus: Features, pathophysiology and clinical importance]

[Article in German]

Bauer G.

Publication Types: 
    Review

PMID: 4215238 [PubMed - indexed for MEDLINE]

9007: Klin Monatsbl Augenheilkd. 1974 Oct;165(4):650-5.

[On-suturing of cornea as therapy for serious chronic corneal diseases (author's 
transl)]

[Article in German]

Reuscher A.

Publication Types: 
    English Abstract

PMID: 4615206 [PubMed - indexed for MEDLINE]

9008: Med Times. 1974 Oct;102(10):78-92.

"All that palsies is not Bell's".

Glasscock ME 3rd.

PMID: 4456133 [PubMed - indexed for MEDLINE]

9009: South Med J. 1974 Oct;67(10):1171-4.

Herpes zoster with motor paresis.

Goodman CE, Kenrick MM.

PMID: 4413670 [PubMed - indexed for MEDLINE]

9010: Practitioner. 1974 Oct;213(1276 SPEC NO):508-18.

Virus diseases.

Juel-Jensen BE.

PMID: 4376235 [PubMed - indexed for MEDLINE]

9011: Rev Chir Oncol Radiol O R L Oftalmol Stomatol Otorinolaringol. 1974
Oct-Dec;19(5):389-93.

[Pharyngeal zona]

[Article in Romanian]

Florescu V, Florescu R.

Publication Types: 
    Case Reports
    English Abstract

PMID: 4283191 [PubMed - indexed for MEDLINE]

9012: Pol Tyg Lek. 1974 Sep 30;29(39):1665-7.

[Marcaine block in the treatment of zoster]

[Article in Polish]

Aronski A, Wasik F, Majda A.

Publication Types: 
    English Abstract

PMID: 4410073 [PubMed - indexed for MEDLINE]

9013: Lakartidningen. 1974 Sep 18;71(38):3489.

[Confusion of uncertain etiology in Hodgkin's disease]

[Article in Swedish]

Mannheimer C.

PMID: 4409023 [PubMed - indexed for MEDLINE]

9014: Wiad Lek. 1974 Sep 15;27(16):1513-6.

[Zoster in the course of acute leukemia in children]

[Article in Polish]

Armata J, Zajaczkowski J, Depowska T.

Publication Types: 
    English Abstract

PMID: 4528376 [PubMed - indexed for MEDLINE]

9015: Z Hautkr. 1974 Sep 15;49(18):781-9.

[Lethality problems in dermatology]

[Article in German]

Janner M.

PMID: 4282787 [PubMed - indexed for MEDLINE]

9016: Br Med J. 1974 Sep 14;3(5932):686.

Letter: Chickenpox from herpes zoster.

Wilkinson PJ, Jones JV, Reeves DS, Asplin CM.

PMID: 4425803 [PubMed - indexed for MEDLINE]

9017: Br Med J. 1974 Sep 7;3(5931):609-10.

Epidermolysis in a case of severe cytomegalovirus infection.

Muller-Stamou A, Senn HJ, Emody G.

PMID: 4370972 [PubMed - indexed for MEDLINE]

9018: Br Med J. 1974 Sep 7;3(5931):626.

Letter: Zoster in three children in family.

Hope-Simpson RE.

PMID: 4370956 [PubMed - indexed for MEDLINE]

9019: Cesk Oftalmol. 1974 Sep;30(5):370-4.

[Unusual cerebral complication in ocular herpes zoster]

[Article in Czech]

Rehurek J, Hanak L, Rehurkova M.

Publication Types: 
    English Abstract

PMID: 4547113 [PubMed - indexed for MEDLINE]

9020: Przegl Dermatol. 1974 Sep-Oct;61(5):697-700.

[Gangrenous zoster in the course of acute lymphatic leukemia]

[Article in Polish]

Czarnacki P, Czarecki S.

Publication Types: 
    English Abstract

PMID: 4529181 [PubMed - indexed for MEDLINE]

9021: Oral Surg Oral Med Oral Pathol. 1974 Sep;38(3):372-7.

Carcinoembryonic antigen and herpes zoster as diagnostic aids in malignant
neoplasia. Report of a case.

Burns JC.

PMID: 4528457 [PubMed - indexed for MEDLINE]

9022: Ital Gen Rev Dermatol. 1974 Sep-Dec;11(3):207-13.

Skin and diabetes. II. Incidence of diabetes in a group of patients with herpes
zoster.

Calandra P, Lisi P.

PMID: 4470104 [PubMed - indexed for MEDLINE]

9023: Arch Dermatol. 1974 Sep;110(3):466-7.

Letter: Flexible collodion.

Krulig L, Jacobs PH.

PMID: 4451402 [PubMed - indexed for MEDLINE]

9024: Z Hautkr. 1974 Sep 1;49(17):733.

[Dynamics of the viral attack and cellular rejection reaction in the skin during 
segmental and exanthematous zoster]

[Article in German]

Orfanos CE, Runne U.

PMID: 4440077 [PubMed - indexed for MEDLINE]

9025: Sov Med. 1974 Sep;0(9):150-1.

[Vesicular dermatoses in elderly and aged persons]

[Article in Russian]

Dobzhanskii SI, Suvorov AP.

PMID: 4411496 [PubMed - indexed for MEDLINE]

9026: Hum Pathol. 1974 Sep;5(5):519-50.

Lymphadenopathy simulating the malignant lymphomas.

Dorfman RF, Warnke R.

Publication Types: 
    Review

PMID: 4137045 [PubMed - indexed for MEDLINE]

9027: Br Med J. 1974 Aug 24;3(5929):523.

Letter: Idoxuridine in herpes zoster.

Simpson JR.

PMID: 4414264 [PubMed - indexed for MEDLINE]

9028: Br Med J. 1974 Aug 17;3(5928):473.

Letter: Treatment of genital herpes.

Gosling PH.

PMID: 4414450 [PubMed - indexed for MEDLINE]

9029: Fortschr Med. 1974 Aug 8;92(22):877-81 contd.

[Localization of skin diseases in the face. Visceral-reflectoric facial zones]

[Article in German]

Hauser W.

PMID: 4278441 [PubMed - indexed for MEDLINE]

9030: Ned Tijdschr Geneeskd. 1974 Aug 3;118(31):1194-6.

[Virus and sudden loss of perceptive hearing]

[Article in Dutch]

Bom MM.

Publication Types: 
    Review

PMID: 4602551 [PubMed - indexed for MEDLINE]

9031: Am J Surg. 1974 Aug;128(2):219-24.

Clinical manifestations of adrenal hemorrhage.

Clark OH, Hall AD, Schambelan M.

PMID: 4846502 [PubMed - indexed for MEDLINE]

9032: Am J Ophthalmol. 1974 Aug;78(2):255-61.

Iritis and iris atrophy in Herpes zoster ophthalmicus.

Marsh RJ, Easty DL, Jones BR.

PMID: 4546563 [PubMed - indexed for MEDLINE]

9033: Proc R Soc Med. 1974 Aug;67(8):757-9.

Lupus nephritis: response to azathioprine.

Forbes MJ, Sinclair L.

PMID: 4424087 [PubMed - indexed for MEDLINE]

9034: Ugeskr Laeger. 1974 Jul 29;136(31):1751-2.

[Letter: Cortisone treatment in herpes zoster]

[Article in Danish]

Hoher AJ.

PMID: 4547052 [PubMed - indexed for MEDLINE]

9035: JAMA. 1974 Jul 22;229(4):457-8.

Editorial: Focus on cutaneous host-defense failure in transplant recipients.

Hersh EM, Freireich EJ.

PMID: 4600401 [PubMed - indexed for MEDLINE]

9036: JAMA. 1974 Jul 15;229(3):302-4.

Herpes zoster ophthalmicus and delayed contralateral hemiparesis. Relationship of
the syndrome to central nervous system granulomatous angiitis.

Gilbert GJ.

PMID: 4546095 [PubMed - indexed for MEDLINE]

9037: Br Med J. 1974 Jul 6;3(5922):41.

Idoxuridine in Herpes Zoster.

[No authors listed]

Publication Types: 
    Clinical Trial

PMID: 4601209 [PubMed - indexed for MEDLINE]

9038: J Urol. 1974 Jul;112(1):100-4.

Diamminodichloroplatinum in the chemotherapy of testicular tumors.

Higby DJ, Wallace HJ Jr, Albert D, Holland JF.

PMID: 4858106 [PubMed - indexed for MEDLINE]

9039: South Med J. 1974 Jul;67(7):808-12.

Chlorprothixene therapy for herpes zoster neuralgia.

Farber GA, Burks JW.

PMID: 4834739 [PubMed - indexed for MEDLINE]

9040: J Infect Dis. 1974 Jul;130(1):56-62.

Administration of human leukocyte interferon in herpes zoster. I. Safety,
circulating, antiviral activity, and host responses to infection.

Jordan GW, Fried RP, Merigan TC.

PMID: 4601181 [PubMed - indexed for MEDLINE]

9041: Rev Odontostomatol (Paris). 1974 Jul-Aug;3(4):357-8.

[Post-operative viral complication]

[Article in French]

Treyssac P.

PMID: 4532788 [PubMed - indexed for MEDLINE]

9042: Stomatologiia (Mosk). 1974 Jul-Aug;53(4):93-4.

[Clinical picture and treatment of herpes zoster of the mouth mucosa]

[Article in Russian]

Danilov LN.

PMID: 4529340 [PubMed - indexed for MEDLINE]

9043: N Y State J Med. 1974 Jul;74(8):1367-72.

Zoster immune globulin. Regional production and allocation.

Ross AH, Klein SW, McKennett B, Kraminer A, Caifa K.

PMID: 4528120 [PubMed - indexed for MEDLINE]

9044: Z Hautkr. 1974 Jul 1;49(13):582.

[Case demonstration: Neviform telangiectases following herpes zoster, Fegeler's
syndrome?]

[Article in German]

Kuhlhoff A.

Publication Types: 
    Case Reports

PMID: 4419038 [PubMed - indexed for MEDLINE]

9045: Arch Belg Dermatol. 1974 Jul-Sep;30(3):117-58.

[Internal malignant tumors and cutaneous symptoms]

[Article in French]

De Bersaques J, Dockx P.

Publication Types: 
    Review

PMID: 4377396 [PubMed - indexed for MEDLINE]

9046: Hautarzt. 1974 Jul;25(7):313-8.

[Interferon and interferon stimulation. New items in therapy of viral infections]

[Article in German]

Fanta D, Soltz-Szotz J.

PMID: 4369595 [PubMed - indexed for MEDLINE]

9047: Br J Dermatol. 1974 Jul;91(1):111-3.

Recurrent herpes simplex virus infections.

Higgins PG.

PMID: 4369124 [PubMed - indexed for MEDLINE]

9048: J Natl Med Assoc. 1974 Jul;66(4):284-91.

Microbial opportunism in clinical medicine.

Poindexter HA, Washington TD.

Publication Types: 
    Review

PMID: 4367817 [PubMed - indexed for MEDLINE]

9049: Am J Chin Med (Gard City N Y). 1974 Jul;2(3):247-60.

Effect of auriculo-acupuncture on pain.

Leung CY, Spoerel WE.

PMID: 4278068 [PubMed - indexed for MEDLINE]

9050: Blood. 1974 Jul;44(1):56-75.

Treatment of established human graft-versus-host disease by antithymocyte
globulin.

Storb R, Gluckman E, Thomas ED, Buckner CD, Clift RA, Fefer A, Glucksberg H,
Graham TC, Johnson FL, Lerner KG, Neiman PE, Ochs H.

PMID: 4275768 [PubMed - indexed for MEDLINE]

9051: Lancet. 1974 Jun 22;1(7869):1293.

Letter: Herpes simplex and herpes zoster in neoplasia.

Morison WL.

Publication Types: 
    Comparative Study

PMID: 4134180 [PubMed - indexed for MEDLINE]

9052: Ugeskr Laeger. 1974 Jun 17;136(25):1398-9.

[Letter: Observation of herpes zoster patients during ACTH (Synacten depot)
treatment]

[Article in Danish]

Roesdahl H.

PMID: 4366486 [PubMed - indexed for MEDLINE]

9053: Br Med J. 1974 Jun 8;2(5918):526-7.

Idoxuridine in herpes zoster: further evaluation of intermittent topical therapy.

Dawber R.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 4600903 [PubMed - indexed for MEDLINE]

9054: Br J Dermatol. 1974 Jun;90(6):718.

Letter: Anogenital herpes zoster in two cases of Wegener's granulomatosis.

Roupe G.

PMID: 4852692 [PubMed - indexed for MEDLINE]

9055: J Med Assoc State Ala. 1974 Jun;43(12):742-4.

Management of herpes zoster with H-influenza vaccine, a preliminary report.

Brown AM.

PMID: 4847301 [PubMed - indexed for MEDLINE]

9056: J Infect Dis. 1974 Jun;129(6):747.

Letter: Zoster-immune globulin for congenital varicella.

St Geme JW Jr.

PMID: 4834286 [PubMed - indexed for MEDLINE]

9057: Bruns Beitr Klin Chir. 1974 Jun;221(4):309-12.

[The significance of serotherapy in herpes zoster diseases following kidney
allotransplantation]

[Article in German]

Hierholzer E, Bosse K, Kackell MY, Holscher M, Zuhlke V.

Publication Types: 
    English Abstract

PMID: 4607452 [PubMed - indexed for MEDLINE]

9058: Otolaryngol Clin North Am. 1974 Jun;7(2):369-73.

Herpes zoster oticus and facial paralysis.

Crabtree JA.

Publication Types: 
    Review

PMID: 4600185 [PubMed - indexed for MEDLINE]

9059: Otolaryngol Clin North Am. 1974 Jun;7(2):433-6.

Facial nerve paralysis in children.

Linthicum FH Jr.

Publication Types: 
    Review

PMID: 4599266 [PubMed - indexed for MEDLINE]

9060: Otolaryngol Clin North Am. 1974 Jun;7(2):309-30.

The pathophysiology of otologic facial paralysis.

Antoli-Candela F Jr, Stewart TJ.

Publication Types: 
    Review

PMID: 4599259 [PubMed - indexed for MEDLINE]

9061: Lijec Vjesn. 1974 Jun;96(6):375-7.

[Clinical use of interferon]

[Article in Croatian]

Vodopija A.

PMID: 4549315 [PubMed - indexed for MEDLINE]

9062: Srp Arh Celok Lek. 1974 Jun;102(6):467-71.

[Hypertensive keratoiritis in Herpes zoster]

[Article in Serbian]

Tomovic J, Artiko G, Parunovic A.

Publication Types: 
    English Abstract

PMID: 4548771 [PubMed - indexed for MEDLINE]

9063: Hautarzt. 1974 Jun;25(6):267-77.

[Virus diseases of the skin]

[Article in German]

Soltz-Szots J, Fanta D.

Publication Types: 
    Review

PMID: 4368308 [PubMed - indexed for MEDLINE]

9064: Am Fam Physician. 1974 Jun;9(6):70-4.

Recent therapeutic advances for common cutaneous problems.

Zuehlke RL.

PMID: 4275327 [PubMed - indexed for MEDLINE]

9065: JAMA. 1974 May 13;228(7):876.

Editorial: Varicella-zoster infections: zoster immune globulin.

Hussey HH.

PMID: 4362716 [PubMed - indexed for MEDLINE]

9066: Lancet. 1974 May 4;1(7862):871.

Letter: Possible prevention of bronchial carcinoma by recurrent Herpes simplex.

Ross CA, Tyrrell WF.

PMID: 4132827 [PubMed - indexed for MEDLINE]

9067: Arch Dermatol. 1974 May;109(5):692-4.

Herpes zoster with neurogenic bladder dysfunction.

Izumi AK, Edwards J Jr.

PMID: 4828538 [PubMed - indexed for MEDLINE]

9068: Trans Am Acad Ophthalmol Otolaryngol. 1974 May-Jun;78(3):OP391-8.

Therapeutic experience with soft contact lenses.

Gould HL.

PMID: 4546205 [PubMed - indexed for MEDLINE]

9069: Dent Update. 1974 May-Jun;1(7):354-6, 358, 360 passim.

The diagnosis and mangement of oral ulceration. Part 2.

Nally FF.

PMID: 4531399 [PubMed - indexed for MEDLINE]

9070: Dent Update. 1974 May-Jun;1(7):354-6. 358, 360 passim.

The diagnosis and management of oral ulceration. Part 2.

Nally FF.

PMID: 4531398 [PubMed - indexed for MEDLINE]

9071: Oral Surg Oral Med Oral Pathol. 1974 May;37(5):657-62.

Necrosis of maxilla in patient with herpes zoster. Report of a case.

Hall HD, Jacobs JS, O'Malley JP.

PMID: 4524373 [PubMed - indexed for MEDLINE]

9072: J Am Osteopath Assoc. 1974 May;73(9):762-4.

Hunt's syndrome: report of a case.

Vogelgesang GW.

PMID: 4494605 [PubMed - indexed for MEDLINE]

9073: Arch Pathol. 1974 May;97(5):331-3.

Herpesvirus varicellae isolated from human dorsal root ganglia.

Bastian FO, Rabson AS, Yee CL, Tralka TS.

Publication Types: 
    Case Reports

PMID: 4362032 [PubMed - indexed for MEDLINE]

9074: J Lab Clin Med. 1974 May;83(5):768-77.

The monocyte disorder with herpes zoster.

Twomey JJ, Gyorkey F, Norris SM.

PMID: 4274508 [PubMed - indexed for MEDLINE]

9075: N Engl J Med. 1974 Apr 18;290(16):914.

Letter: Possible bone-marrow depression by Ara-A therapy for disseminated herpes 
zoster.

Gottlieb JA, Bodey GP Sr.

PMID: 4816977 [PubMed - indexed for MEDLINE]

9076: Masui. 1974 Apr;23(4):340-5.

[Statistical observation on 1,000 cases of facial nerve paralysis--with special
refernce to the etiology of Bell's palsy]

[Article in Japanese]

Totoki T, Yuda Y, Tamesa T, Kawahara M, Tsumeda M.

Publication Types: 
    English Abstract

PMID: 4858653 [PubMed - indexed for MEDLINE]

9077: Masui. 1974 Apr;23(4):333-9.

[Treatment of herpes zoster in the pain clinic]

[Article in Japanese]

Tamesa T, Wakasugi B, Yuda Y, Nishisaka T, Kato H.

Publication Types: 
    English Abstract

PMID: 4858652 [PubMed - indexed for MEDLINE]

9078: Br J Urol. 1974 Apr;46(2):193-200.

The genito-urinary manifestations of herpes zoster. Three case reports and a
review of the literature.

Richmond W.

PMID: 4823892 [PubMed - indexed for MEDLINE]

9079: Pediatrics. 1974 Apr;53(4):476-80.

Efficacy of zoster immune globulin.

Judelsohn RG, Meyers JD, Ellis RJ, Thomas EK.

PMID: 4823323 [PubMed - indexed for MEDLINE]

9080: Uirusu. 1974 Apr;24(1):83-4.

[Complement-binding antibody level in herpes zoster patients]

[Article in Japanese]

Hata S.

PMID: 4478245 [PubMed - indexed for MEDLINE]

9081: Uirusu. 1974 Apr;24(1):78-80.

[Antibody response in chickenpox and herpes zoster]

[Article in Japanese]

Moda S, Ota E, Miura H, Iijima S.

PMID: 4478243 [PubMed - indexed for MEDLINE]

9082: JAMA. 1974 Apr 1;228(1):27.

Letter: Smallpox vaccine for herpes zoster.

Chang SL.

PMID: 4406140 [PubMed - indexed for MEDLINE]

9083: Clin Exp Immunol. 1974 Apr;16(4):565-73.

Cell-mediated and humoral immune responses or renal transplant recipients with
cytomegalovirus infections.

Lopez C, Simmons RL, Park BH, Najarian JS, Good RA.

Publication Types: 
    Research Support, U.S. Gov't, P.H.S.

PMID: 4377553 [PubMed - indexed for MEDLINE]

9084: Riv Ital Stomatol. 1974 Apr-Jun;29(4,6):227-56.

[Oral manifestations of eruptive infections viewing the disease in general]

[Article in Italian]

Gombos F, Matarasso S, Valletta G.

Publication Types: 
    English Abstract

PMID: 4373816 [PubMed - indexed for MEDLINE]

9085: S Afr Med J. 1974 Mar 31;47(12):506.

Letter: Herpes zoster.

Abelson JB.

Publication Types: 
    Case Reports

PMID: 4826754 [PubMed - indexed for MEDLINE]

9086: Nippon Rinsho. 1974 Mar;32(3):632-5.

[Herpes zoster occurring consecutively in hospitalized children with systemic
lupus erythematosus]

[Article in Japanese]

Ueda K, Arihiro H, Nunoue T, Hirano Y, Goya N.

PMID: 4858995 [PubMed - indexed for MEDLINE]

9087: Przegl Dermatol. 1974 Mar-Apr;61(2):187-91.

[Molluscum contagiosum and zoster gangrenosus in the course of
lymphogranulomatosis maligna]

[Article in Polish]

Wranicz A, Dyla G.

PMID: 4832862 [PubMed - indexed for MEDLINE]

9088: Z Hautkr. 1974 Mar 1;49(5):183-8.

[Experiences with a new treatment of skin virus diseases]

[Article in German]

Schule D.

PMID: 4828150 [PubMed - indexed for MEDLINE]

9089: Ann Intern Med. 1974 Mar;80(3):310-20.

Chronic mucocutaneous candidiasis: immunologic and antibiotic therapy.

Kirkpatrick CH, Smith TK.

PMID: 4816171 [PubMed - indexed for MEDLINE]

9090: Int J Dermatol. 1974 Mar-Apr;13(2):69-75.

Herpes simplex and varicella-zoster: comparative histopathology of 77 cases.

McSorley J, Shapiro L, Brownstein MH, Hsu KC.

Publication Types: 
    Comparative Study

PMID: 4596285 [PubMed - indexed for MEDLINE]

9091: Indian J Ophthalmol. 1974 Mar;22(1):36-7.

Herpes zoster ophthalmicus and varicella.

Maria DL, Kulkarni RG.

Publication Types: 
    Case Reports

PMID: 4548690 [PubMed - indexed for MEDLINE]

9092: Neurochirurgie. 1974 Mar-Apr;20(2):117-24.

[Treatment of certain types of pain with implantable thalamic stimulators]

[Article in French]

Mazars G, Merienne L, Cioloca C.

PMID: 4418054 [PubMed - indexed for MEDLINE]

9093: Am J Med. 1974 Mar;56(3):280-9.

Association of renal allograft rejection with virus infections.

Lopez C, Simmons RL, Mauer SM, Najarian JS, Good RA, Gentry S.

PMID: 4360465 [PubMed - indexed for MEDLINE]

9094: N Engl J Med. 1974 Feb 14;290(7):409-10.

Letter: Cytosine arabinoside for herpes zoster.

[No authors listed]

PMID: 4543931 [PubMed - indexed for MEDLINE]

9095: Orv Hetil. 1974 Feb 10;115(6):327-8.

[Psoriasis against the background of herpes zoster]

[Article in Hungarian]

Angyal J, Magyar M.

PMID: 4839527 [PubMed - indexed for MEDLINE]

9096: Dtsch Med Wochenschr. 1974 Feb 8;99(6):262.

[Letter: Therapy of zoster]

[Article in German]

Kraus S.

PMID: 4812424 [PubMed - indexed for MEDLINE]

9097: Br J Dermatol. 1974 Feb;90(2):235.

Letter: Herpes zoster of the anogenital area affecting urination and defaecation.

Waugh MA.

PMID: 4819143 [PubMed - indexed for MEDLINE]

9098: Z Gesamte Hyg. 1974 Feb;20(2):116.

[Artificial polynucleotides as inducers of interferon]

[Article in German]

Heidel G.

Publication Types: 
    Review

PMID: 4598964 [PubMed - indexed for MEDLINE]

9099: Gut. 1974 Feb;15(2):94-8.

Viral antibodies and autoantibodies in chronic liver disease.

Triger DR, Kurtz JB, Wright R.

Our previous observations of highly significant increases in high titre
antibodies to measles and rubella in patients with chronic active hepatitis have 
been extended and it has been shown that these reactions do not occur in other
forms of liver disease. Significant increases in antibody titres to
cytomegalovirus have also been found in patients with chronic active hepatitis
(p<0.001) and alcoholic and primary biliary cirrhosis (p<0.05). Antibody titres
to herpes simplex, varicella/zoster, parainfluenza I, and Mycoplasma pneumoniae
in all forms of chronic liver disease did not differ from controls.
Immunofluorescent autoantibodies were correlated with the viral antibodies and a 
highly significant correlation with strongly positive antismooth muscle and
antinuclear antibodies and measles antibody titres in particular was noted. The
possible significance of this correlation is discussed in terms of the hypothesis
that the intact liver plays a significant role in the sequestering of antigens.

PMID: 4362374 [PubMed - indexed for MEDLINE]

9100: Arch Ophtalmol Rev Gen Ophtalmol. 1974 Feb;34(2):115-9.

[A case of zona ophthalmica in a child]

[Article in French]

Spiritus M, Michiels J, Evrard P.

Publication Types: 
    English Abstract

PMID: 4277115 [PubMed - indexed for MEDLINE]

9101: Internist (Berl). 1974 Feb;15(2):66-70.

[Immunologic phenomena in lymphogranulomatosis]

[Article in German]

Scheurlen PG.

PMID: 4151855 [PubMed - indexed for MEDLINE]

9102: N Engl J Med. 1974 Jan 31;290(5):243-5.

Zoster immune globulin. A further assessment.

Gershon AA, Steinberg S, Brunell PA.

PMID: 4358055 [PubMed - indexed for MEDLINE]

9103: Br Med J. 1974 Jan 5;1(5896):33-5.

Medicine in old age. Disturbances of the special senses and other functions.

Nicholson WJ.

PMID: 4808821 [PubMed - indexed for MEDLINE]

9104: Pol Przegl Radiol Med Nukl. 1974;38(2):205-10.

[Symptomatic zoster in patients with Hodgkin's disease treated at the
Radiotherapy Department of the Medical Academy in the years 1960-1971]

[Article in Polish]

Kukolewska-Machnicka J.

Publication Types: 
    English Abstract

PMID: 4840287 [PubMed - indexed for MEDLINE]

9105: Vrach Delo. 1974;4:149-51.

[Treatment of dermatoses of viral and non-viral etiology with interferon]

[Article in Russian]

Borzov MV, Kuznetsov VP, Lobanovskii GI.

PMID: 4831848 [PubMed - indexed for MEDLINE]

9106: Otolaryngol Pol. 1974;28(1):95-8.

[Late results of treatment of herpes zoster oticus]

[Article in Polish]

Kowalska-Kulesza K.

PMID: 4821574 [PubMed - indexed for MEDLINE]

9107: Br J Dermatol. 1974 Jan;90(1):110-1.

Letter: Herpes zoster following primary smallpox vaccination.

Verbov J.

Publication Types: 
    Case Reports

PMID: 4811832 [PubMed - indexed for MEDLINE]

9108: Adv Neurol. 1974;6:107-26.

Transfer factor in diseases of the central nervous system.

Graybill JR.

Publication Types: 
    Review

PMID: 4614652 [PubMed - indexed for MEDLINE]

9109: Int Ophthalmol Clin. 1974 Spring-Summer;14(1-2):422-68.

The eye and its disorders. 23. The cornea and sclera.

Trevor-Roper PD.

PMID: 4608134 [PubMed - indexed for MEDLINE]

9110: Can J Ophthalmol. 1974 Jan;9(1):72-8.

Therapeutic soft contact lenses. A survey.

Hurwitz JJ, Dixon WS, Sloan A.

PMID: 4544901 [PubMed - indexed for MEDLINE]

9111: Khirurgiia (Sofiia). 1974;27(6):544-5.

[Simulation of acute cholecystitis by herpes zoster]

[Article in Bulgarian]

Lomkin AN, Danailov LN.

Publication Types: 
    Case Reports

PMID: 4465509 [PubMed - indexed for MEDLINE]

9112: Verh Dtsch Ges Inn Med. 1974;80:1693-6.

[Experiences with cytosine-arabinoside in treatment of zoster]

[Article in German]

Bruntsch U, Reis HE, Schmidt CG.

PMID: 4454516 [PubMed - indexed for MEDLINE]

9113: Folia Med Cracov. 1974;16(4):441-61.

[Functional state of the facial nerve and organ of hearing and equilibrium
following aural Herpes zoster]

[Article in Polish]

Kwiatkowska J.

Publication Types: 
    English Abstract

PMID: 4448427 [PubMed - indexed for MEDLINE]

9114: Med Chir Dig. 1974;3(3):179-80.

[Herpetic esophagitis. Endoscopic diagnosis]

[Article in French]

Favier C, Barbotte P, Davouze R, Balmes JL, Bert JM.

PMID: 4431263 [PubMed - indexed for MEDLINE]

9115: Neurol Neurochir Pol. 1974 Jan-Feb;8(1):127-30.

[Polyneuropathy with leukemoid reaction in cerebrospinal fluid as a late
complication of zoster]

[Article in Polish]

Stroinska-Kusiowa B, Ciszewska L.

PMID: 4407721 [PubMed - indexed for MEDLINE]

9116: Trans Pac Coast Otoophthalmol Soc Annu Meet. 1974;55:129-36.

The changing characteristics of herpes zoster keratouveitis.

Thygeson P.

Publication Types: 
    Case Reports
    Comparative Study

PMID: 4377330 [PubMed - indexed for MEDLINE]

9117: Dev Biol Stand. 1974;27:31-6.

Studies on the purification of normal immunoglobulin for intravenous use.

Walsh JJ.

PMID: 4376994 [PubMed - indexed for MEDLINE]

9118: Zh Nevropatol Psikhiatr Im S S Korsakova. 1974;74(11):1637-42.

[Neuritis of the facial nerve]

[Article in Russian]

Khondkarian OA, Zavalishin IA.

Publication Types: 
    English Abstract

PMID: 4375372 [PubMed - indexed for MEDLINE]

9119: Adv Neurol. 1974;6:53-67.

Viral infections of the developing nervous system.

Johnson KP.

PMID: 4374881 [PubMed - indexed for MEDLINE]

9120: Arch Gesamte Virusforsch. 1974;45(4):382-5.

Varicella virus isolation from spinal ganglion.

Shibuta H, Ishikawa T, Hondo R, Aoyama Y, Kurata K, Matumoto M.

PMID: 4374161 [PubMed - indexed for MEDLINE]

9121: Rev Otoneuroophtalmol. 1974 Jan-Feb;46(1):53-64.

[Neuro-ophthalmologic complications of ophthalmic zoster. Discussion of 126
observations]

[Article in French]

Flament J, Bronner A.

PMID: 4373812 [PubMed - indexed for MEDLINE]

9122: Clin Neurosurg. 1974;21:278-310.

Stimulation of the posterior columns of the spinal cord for pain control:
indications, technique, and results.

Sweet WH, Wepsic JG.

PMID: 4371724 [PubMed - indexed for MEDLINE]

9123: Prog Med Virol. 1974;18(0):160-77.

Persistent infections with herpesviruses.

Jack I.

Publication Types: 
    Review

PMID: 4371164 [PubMed - indexed for MEDLINE]

9124: Scand J Infect Dis. 1974;6(2):113-6.

Rapid diagnosis and typind of herpesvirus hominis by the fluorescent antibody
method.

Vestergaard BF, Thybo H.

PMID: 4369110 [PubMed - indexed for MEDLINE]

9125: Arch Neurol. 1974 Jan;30(1):109.

Decreased cerebrospinal fluid glucose level in herpes zoster meningitis. Report
of a case.

Wolf SM.

PMID: 4357129 [PubMed - indexed for MEDLINE]

9126: Arch Ophtalmol Rev Gen Ophtalmol. 1974 Jan;34(1):45-59.

[Therapeutic and optical fitting of soft hydrophilic contact lenses. (Apropos of 
53 cases]

[Article in French]

Lumbroso P, Fourny A.

Publication Types: 
    English Abstract

PMID: 4278931 [PubMed - indexed for MEDLINE]

9127: Scand J Immunol. 1974;3(1):51-60.

Complex formation between monoclonal IgM and albumin.

Harboe M, Folling I.

PMID: 4208200 [PubMed - indexed for MEDLINE]

9128: Zentralbl Bakteriol [Orig A]. 1974;227(1-4):392-400.

[Use of the IgM fraction from patients' sera in general virus serology for
diagnostic purposes]

[Article in German]

Wolff MH, Marklein G, Schneweis KE, Stifter G.

PMID: 4154618 [PubMed - indexed for MEDLINE]

9129: Scand J Urol Nephrol. 1974;8(2):96-9.

Herpes zoster as a cause of urinary retention.

Pettersson S, Schersten T, Sundin T.

PMID: 4134361 [PubMed - indexed for MEDLINE]

9130: Br Med J. 1973 Dec 22;4(5894):693-5.

Treatment of acute herpes zoster with amantadine hydrochloride (Symmetrel).

Galbraith AW.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 4591000 [PubMed - indexed for MEDLINE]

9131: Pol Tyg Lek. 1973 Dec 10;28(50):1983-4.

[Oxolin in treatment of zoster]

[Article in Polish]

Niedzielska H, Tkaczewski W.

PMID: 4771020 [PubMed - indexed for MEDLINE]

9132: Dtsch Med Wochenschr. 1973 Dec 7;98(49):2373.

[Letter: No corticosteroids in acute herpes zoster]

[Article in German]

Windischbauer G.

PMID: 4543528 [PubMed - indexed for MEDLINE]

9133: Int J Clin Pharmacol. 1973 Dec;8(4):337-49.

[Diagnosis and therapy of the secondary disease: dermatology]

[Article in German]

Tronnier H.

PMID: 4787609 [PubMed - indexed for MEDLINE]

9134: Arch Dermatol. 1973 Dec;108(6):855-6.

Letter: Post-herpes zoster neuralgia: response to vitamin E therapy.

Ayres S Jr, Mihan R.

PMID: 4764718 [PubMed - indexed for MEDLINE]

9135: Klin Monatsbl Augenheilkd. 1973 Dec;163(6):762-4.

[Use of contact lenses in the treatment of chronic keratopathies (author's
transl)]

[Article in German]

Hilsdorf C, Gussmann H.

PMID: 4596606 [PubMed - indexed for MEDLINE]

9136: Klin Monatsbl Augenheilkd. 1973 Dec;163(6):661-71.

[The artificial corneal epithelium (author's transl)]

[Article in German]

Turss R, Reim M.

PMID: 4545186 [PubMed - indexed for MEDLINE]

9137: Laryngoscope. 1973 Dec;83(12):2029-34.

Electronystagmographic comparison of acute idiopathic and herpes zoster facial
paralysis.

Adour KK, Doty HE.

Publication Types: 
    Comparative Study

PMID: 4358988 [PubMed - indexed for MEDLINE]

9138: J Urol Nephrol (Paris). 1973 Dec;79(12 Pt 2):487-8.

[Spontaneously cured pancytopenia due to intravesical thio-tepa, apropos of one
case]

[Article in French]

Archimbaud JP, Calcat P, Martel JP.

PMID: 4216648 [PubMed - indexed for MEDLINE]

9139: Lancet. 1973 Dec 1;2(7840):1276.

Letter: Varicella may protect against zoster.

Ikada J, Kagami K, Yamamoto Y.

PMID: 4128615 [PubMed - indexed for MEDLINE]

9140: Dtsch Med Wochenschr. 1973 Nov 30;98(48):2293-8.

[Treatment of herpes zoster with cytarabine (author's transl)]

[Article in German]

Reis HE, Bruntsch U, Schmidt CG.

PMID: 4587114 [PubMed - indexed for MEDLINE]

9141: Ugeskr Laeger. 1973 Nov 26;135(48):2634.

[Topical treatment of herpes zoster]

[Article in Danish]

Jensen JI.

PMID: 4782910 [PubMed - indexed for MEDLINE]

9142: Br Med J. 1973 Nov 24;4(5890):475-8.

Diseases of the skin. Treatment of skin infections and infestations.

Ive FA.

PMID: 4758454 [PubMed - indexed for MEDLINE]

9143: Med J Aust. 1973 Nov 24;2(21):956.

Editorial: Herpes zoster ophthalmicus treated with cytarabine.

[No authors listed]

PMID: 4543929 [PubMed - indexed for MEDLINE]

9144: Minerva Med. 1973 Nov 17;64(82):4354-66.

[Clinical studies of the therapeutic activity of an association of dicloxacillin 
and hetacillin]

[Article in Italian]

Giannelli F, Cattaneo E.

PMID: 4765439 [PubMed - indexed for MEDLINE]

9145: Nouv Presse Med. 1973 Nov 17;2(41):2752.

[Letter: Cytosine arabinoside and generalized zoster]

[Article in French]

Huis J, Van Vaerenbergh PM, Kindt R.

Publication Types: 
    Clinical Trial

PMID: 4589880 [PubMed - indexed for MEDLINE]

9146: Sem Hop. 1973 Nov 14;49(46):3073-8.

[Skin manifestations of Hodgkin's disease. Apropos of a study of 94 patients with
this disease]

[Article in French]

Amblard P, Schaerer R, Sotto JJ, Martel J, Bensa JC, Fillon JP.

PMID: 4360043 [PubMed - indexed for MEDLINE]

9147: Z Allgemeinmed. 1973 Nov 10;49(31):1522-3.

[A severe neck-shoulder-arm syndrome as a prodrome of segmental herpes zoster]

[Article in German]

Briese HH.

PMID: 4131490 [PubMed - indexed for MEDLINE]

9148: Dtsch Med Wochenschr. 1973 Nov 2;98(44):2098.

[Letter: Neuralgia following zoster]

[Article in German]

Ueberholz FK.

PMID: 4758634 [PubMed - indexed for MEDLINE]

9149: Nervenarzt. 1973 Nov;44(11):604-5.

[Is there a syndrome of the arteria sulcocommissuralis?]

[Article in German]

Suchenwirth R.

PMID: 4773627 [PubMed - indexed for MEDLINE]

9150: Psychiatr Pol. 1973 Nov-Dec;7(6):649-53.

[Cerebral complications in the course of herpes zoster. Description of a case]

[Article in Polish]

Jezyna C, Kosc B.

PMID: 4773053 [PubMed - indexed for MEDLINE]

9151: Urology. 1973 Nov;2(5):568-70.

Bladder dysfunction with herpes zoster.

Masih BK, Brosman SA.

PMID: 4767178 [PubMed - indexed for MEDLINE]

9152: Eye Ear Nose Throat Mon. 1973 Nov;52(11):416-7.

Intralesional triamcinolone therapy in herpes zoster and postzoster neuralgia.

Epstein E.

PMID: 4757429 [PubMed - indexed for MEDLINE]

9153: Ann Intern Med. 1973 Nov;79(5):747-8.

Letter: Herpes zoster: transfer factor therapy.

Drew WL, Blume MR, Miner R, Silverberg I, Rosenbaum EH.

PMID: 4751749 [PubMed - indexed for MEDLINE]

9154: Arch Phys Med Rehabil. 1973 Nov;54(11):528-9.

Herpes zoster-induced bladder paralysis.

Pryor J.

PMID: 4748322 [PubMed - indexed for MEDLINE]

9155: Br J Ophthalmol. 1973 Nov;57(11):849-51.

Virus aetiology of certain cases of lacrimal obstruction.

Bouzas AG.

PMID: 4544774 [PubMed - indexed for MEDLINE]

9156: J Med Soc N J. 1973 Nov;70(11):836-8.

Herpes zoster and multiple myeloma.

Saidi P, Uhlman WE, Goldberg I.

PMID: 4518508 [PubMed - indexed for MEDLINE]

9157: Arch Neurol. 1973 Nov;29(5):309-13.

Herpes zoster myelitis. Evidence for viral invasion of spinal cord.

Hogan EL, Krigman MR.

PMID: 4355263 [PubMed - indexed for MEDLINE]

9158: N Engl J Med. 1973 Oct 25;289(17):912-3.

Cytosine arabinoside versus virus or man?

Karchmer AW, Hirsch MS.

Publication Types: 
    Clinical Trial

PMID: 4580785 [PubMed - indexed for MEDLINE]

9159: N Engl J Med. 1973 Oct 25;289(17):873-8.

Adverse effect of cytosine arabinoside on disseminated zoster in a controlled
trial.

Stevens DA, Jordan GW, Waddell TF, Merigan TC.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 4354007 [PubMed - indexed for MEDLINE]

9160: Arch Otolaryngol. 1973 Oct;98(4):258-64.

Histopathology of deafness due to postnatal viral disease.

Lindsay JR.

PMID: 4778641 [PubMed - indexed for MEDLINE]

9161: J Neurol Sci. 1973 Oct;20(2):149-59.

Herpes zoster oticus and facial paralysis (Ramsay Hunt syndrome).
Clinico-pathologic study and review of literature.

Aleksic SN, Budzilovich GN, Lieberman AN.

PMID: 4750874 [PubMed - indexed for MEDLINE]

9162: Arch Ophthalmol. 1973 Oct;90(4):268-70.

Dendritic lesions in herpes zoster ophthalmicus.

Piebenga LW, Laibson PR.

PMID: 4542874 [PubMed - indexed for MEDLINE]

9163: Arch Otolaryngol. 1973 Oct;98(4):218-27.

Fetal consequences of maternal viral infections in pregnancy.

Hardy JB.

Publication Types: 
    Review

PMID: 4360342 [PubMed - indexed for MEDLINE]

9164: J Am Dent Assoc. 1973 Oct;87(5):1055-73.

Virologic and immunologic aspects of major oral ulcerations.

Lennette EH, Magoffin RL.

Publication Types: 
    Review

PMID: 4359602 [PubMed - indexed for MEDLINE]

9165: J Invest Dermatol. 1973 Oct;61(4):212-22.

Varicella-zoster virus.

Luby JP.

PMID: 4355281 [PubMed - indexed for MEDLINE]

9166: Med Klin. 1973 Sep 28;68(39):1261-5.

[Generalized herpes zoster with Landry's ascending paralysis (author's transl)]

[Article in German]

Schley G, Anlauf M, Kratzsch E, Cremer W, Kuwert E.

PMID: 4746853 [PubMed - indexed for MEDLINE]

9167: Neurol Psihiatr Neurochir. 1973 Sep-Oct;18(5):407-22.

[On the role of the infectious factor in pathology of the temporal lobe]

[Article in Romanian]

Cinca I, Dimitriu R.

PMID: 4790476 [PubMed - indexed for MEDLINE]

9168: Br J Dermatol. 1973 Sep;89(3):285-8.

Herpes zoster of the anogenital area affecting urination and defaecation.

Fugelso PD, Reed WB, Newman SB, Beamer JE.

PMID: 4743431 [PubMed - indexed for MEDLINE]

9169: Arch Dermatol. 1973 Sep;108(3):427.

Varicella, herpes zoster infections, and congenital defects.

Rosenthal D, Morris N.

PMID: 4729772 [PubMed - indexed for MEDLINE]

9170: Indian J Ophthalmol. 1973 Sep;21(3):131-3.

Herpes zoster ophthalmicus followed by varicella in a young adult.

Shukla IM, Tiwari SK, Billore OP.

Publication Types: 
    Case Reports

PMID: 4549850 [PubMed - indexed for MEDLINE]

9171: Kokubyo Gakkai Zasshi. 1973 Sep;40(3):264-8.

[A case of topical application of Rifampicin with blocks of the infra-orbital
nerve and the stellate ganglion in the treatment of herpes zoster (author's
transl)]

[Article in Japanese]

Motegi K, Banba S, Shimizu M, Ueno T, Suzuki N.

PMID: 4519999 [PubMed - indexed for MEDLINE]

9172: Tumori. 1973 Sep-Oct;59(5):343-50.

Immunologic deficiency in Hodgkin's disease.

Sokal JE.

PMID: 4360756 [PubMed - indexed for MEDLINE]

9173: Appl Microbiol. 1973 Sep;26(3):410-6.

Complement-fixing antigens produced by varicella-zoster virus in tissue culture.

Martin ML, Palmer EL.

The complement-fixing antigens present in tissue cultures infected with
varicella-zoster virus were separated into four components. There were (i) a
cell-free soluble antigen, (ii) a cell-associated soluble antigen, (iii) a cell
membrane-associated antigen, and (iv) a virion antigen. All four antigens were
reactive with sera from patients with varicella or zoster, and about 90% of the
total complement-fixing activity was found to be nonvirion associated.

PMID: 4356464 [PubMed - indexed for MEDLINE]

9174: J Natl Cancer Inst. 1973 Sep;51(3):733-42.

Clinical and laboratory investigations on man: systemic administration of potent 
interferon to man.

Strander H, Cantell K, Carlstrom G, Jakobsson PA.

PMID: 4355215 [PubMed - indexed for MEDLINE]

9175: Harefuah. 1973 Aug 15;85(4):176-7.

[Herpes zoster with severe constipation and urinary retention]

[Article in Hebrew]

Ben-Assuly S, Bassan H.

PMID: 4756190 [PubMed - indexed for MEDLINE]

9176: Br Med J. 1973 Aug 4;3(5874):275-9.

Antiviral chemotherapy: the first decade.

Bauer DJ.

Publication Types: 
    Review

PMID: 4579293 [PubMed - indexed for MEDLINE]

9177: Vestn Dermatol Venerol. 1973 Aug;47(8):16-9.

[Treatment of herpes zoster with emetine]

[Article in Russian]

Damtsov VI.

PMID: 4767947 [PubMed - indexed for MEDLINE]

9178: Br J Dermatol. 1973 Aug;89(2):175-7.

Herpes zoster complicating myocardial infarction.

Benaim ME, Smith DR.

PMID: 4726893 [PubMed - indexed for MEDLINE]

9179: Am J Dis Child. 1973 Aug;126(2):178-84.

Herpes zoster in children with cancer.

Feldman S, Hughes WT, Kim HY.

PMID: 4353308 [PubMed - indexed for MEDLINE]

9180: Ann Intern Med. 1973 Aug;79(2):225-8.

Herpes B virus encephalomyelitis presenting as ophthalmic zoster. A possible
latent infection reactivated.

Fierer J, Bazely P, Braude AI.

PMID: 4125441 [PubMed - indexed for MEDLINE]

9181: Br Med J. 1973 Jul 21;3(5872):149.

Infantile herpes zoster after intrauterine exposure to varicella.

Lewkonia IK, Jackson AA.

PMID: 4352725 [PubMed - indexed for MEDLINE]

9182: Lancet. 1973 Jul 14;2(7820):57-60.

Treatment of intractable pain by acupuncture.

Bowsher D, Mumford J, Lipton S, Miles J.

PMID: 4123617 [PubMed - indexed for MEDLINE]

9183: Ugeskr Laeger. 1973 Jul 2;135(27):1428-30.

[Use of the fluorescent antibody method in rapid diagnosis of Herpesvirus hominis
(herpes simplex virus)]

[Article in Danish]

Vestergaard BF, Thybo H.

Publication Types: 
    Comparative Study

PMID: 4357008 [PubMed - indexed for MEDLINE]

9184: Klin Med (Mosk). 1973 Jul;51(7):40-2.

[Herpes zoster infection in patients with lymphoid proliferative diseases]

[Article in Russian]

Loginskii VE.

PMID: 4786260 [PubMed - indexed for MEDLINE]

9185: Zh Ushn Nos Gorl Bolezn. 1973 Jul-Aug;33(4):107-8.

[Herpes zoster oticus]

[Article in Russian]

Mironenko IuT.

PMID: 4771238 [PubMed - indexed for MEDLINE]

9186: Minerva Anestesiol. 1973 Jul-Aug;39(7):356-9.

[Osmotic subarachnoidal neurolysis in the treatment of cervico-thoracic pain]

[Article in Italian]

Comelli FL, Manzin E, Manani G, Andrioli G, Salar G, Nori L.

PMID: 4753515 [PubMed - indexed for MEDLINE]

9187: Hautarzt. 1973 Jul;24(7):298-301.

[New possibilities of herpes simplex therapy in the dermatological practice]

[Article in German]

Weitgasser H.

PMID: 4541990 [PubMed - indexed for MEDLINE]

9188: Int Surg. 1973 Jul;58(7):469-72.

Therapeutic effect of flush fitting scleral lenses and hydrogel bandage lenses.

Gould HL.

PMID: 4541534 [PubMed - indexed for MEDLINE]

9189: Ann Otol Rhinol Laryngol. 1973 Jul-Aug;82(4):577-83.

Viral disease of the labyrinth. I. Review of the literature and discussion of the
role of cytomegalovirus in congenital deafness.

Strauss M, Davis GL.

Publication Types: 
    Review

PMID: 4366282 [PubMed - indexed for MEDLINE]

9190: Infect Immun. 1973 Jul;8(1):48-521.

Surface antigens produced by Herpesviruses Varicella-Zoster virus.

Ito M, Barron AL.

Surface antigen(s) was demonstrated by the mixed agglutination technique on cell 
cultures infected with varicella-zoster virus (V-Z). The reactions appeared to be
specific for V-Z, and no cross-reaction was obtained with herpes simplex virus
(HSV). V-Z surface antigen had similar physicochemical properties to that of HSV.
It was stable to heating at 56 C and treatment with 1% Formalin,
2,4-dinitrophenol, and periodate, whereas it was undetectable after exposure to
acetone or ethanol. Antibodies detecting surface antigen were present in high
titer in sera from varicella or herpes zoster patients and paralleled titers
obtained by the complement fixation test.

PMID: 4352455 [PubMed - indexed for MEDLINE]

9191: JAMA. 1973 Jun 25;224(13):1748-9.

Herpes zoster and neurogenic bladder dysfunction.

Izumi AK, Edwards J Jr.

PMID: 4740167 [PubMed - indexed for MEDLINE]

9192: Dtsch Med Wochenschr. 1973 Jun 22;98(25):1275-6.

[Therapy of herpes zoster]

[Article in German]

Nasemann T.

PMID: 4541370 [PubMed - indexed for MEDLINE]

9193: Nurs Mirror Midwives J. 1973 Jun 22;136(25):30-1.

Post-herpetic neuralgia.

Hardy TK.

PMID: 4489271 [PubMed - indexed for MEDLINE]

9194: Proc R Soc Med. 1973 Jun;66(6):541-3.

Treatment of pain: organization of a pain clinic: treatment of acute herpes
zoster.

Colding A.

PMID: 4781808 [PubMed - indexed for MEDLINE]

9195: Practitioner. 1973 Jun;210(260):794-8.

The management of neuralgias complicating herpes zoster.

Gale DA.

PMID: 4731061 [PubMed - indexed for MEDLINE]

9196: J Urol. 1973 Jun;109(6):938-40.

Anuria secondary to mechanical obstruction caused by a Candida fungus ball.

Turner RW, Grigsby TH, Enright JR, Chance HL, Frazier TC, Womack CT, Lang EK.

PMID: 4575809 [PubMed - indexed for MEDLINE]

9197: Invest Ophthalmol. 1973 Jun;12(6):391-7.

National Eye Institute: summary report of the cornea task force.

Morris JM.

PMID: 4574984 [PubMed - indexed for MEDLINE]

9198: Indian J Ophthalmol. 1973 Jun;21(2):92-3.

Herpes zoster ophthalmicus and varicella (a case report).

Malik SR, Bansal RK.

Publication Types: 
    Case Reports

PMID: 4545230 [PubMed - indexed for MEDLINE]

9199: Clin Exp Immunol. 1973 Jun;14(2):181-5.

Cell-mediated immunity to Varicella-Zoster antigen in acute Herpes zoster
(shingles).

Russell AS, Maini RA, Bailey M, Dumonde DC.

PMID: 4352254 [PubMed - indexed for MEDLINE]

9200: Arch Pathol. 1973 Jun;95(6):411-5.

Spinal ganglion in herpes zoster. A light and electron microscopic study.

Ghatak NR, Zimmerman HM.

PMID: 4349633 [PubMed - indexed for MEDLINE]

9201: Minerva Med. 1973 May 29;64(39):2077-9.

[Use of distamycin A in the therapy of various viral cutaneous diseases due to
VZ]

[Article in Italian]

Bassetti D.

Publication Types: 
    Clinical Trial

PMID: 4352475 [PubMed - indexed for MEDLINE]

9202: Nouv Presse Med. 1973 May 12;2(19):1306.

[Therapeutic action of emetine in zona]

[Article in French]

Bolgert M.

PMID: 4712675 [PubMed - indexed for MEDLINE]

9203: Natl Cancer Inst Monogr. 1973 May;36:465-8.

Herpes zoster: recent studies.

Stevens DA, Merigan TC.

PMID: 4744604 [PubMed - indexed for MEDLINE]

9204: Natl Cancer Inst Monogr. 1973 May;36:463-4.

Herpes zoster infections in lymphoma patients.

Goffinet DR, Glastein E, Kaplan HS.

PMID: 4744603 [PubMed - indexed for MEDLINE]

9205: Rheumatol Rehabil. 1973 May;12(2):74-6.

Paralysis and arthropathy in herpes zoster.

Quin CE.

PMID: 4741421 [PubMed - indexed for MEDLINE]

9206: Postgrad Med. 1973 May;53(6):207-10.

Neuralgia.

Loeser JD.

PMID: 4701613 [PubMed - indexed for MEDLINE]

9207: Br J Ophthalmol. 1973 May;57(5):344-6.

Retinal arteritis complicating herpes zoster ophthalmicus.

Brown RM, Mendis U.

PMID: 4541366 [PubMed - indexed for MEDLINE]

9208: Ann Clin Lab Sci. 1973 May-Jun;3(3):224-33.

Unusual pulmonary infections in immunodeficiency.

Valdes-Dapena MA.

PMID: 4540864 [PubMed - indexed for MEDLINE]

9209: Odontol Foren Tidskr. 1973 May;37(2):95-100.

[Different degrees of pain in the area of teeth and jaws]

[Article in Swedish]

Ahlberg T.

PMID: 4516861 [PubMed - indexed for MEDLINE]

9210: Clin Pediatr (Phila). 1973 May;12(5):299-301.

The prevention and treatment of varicella-zoster infection in patients at high
risk.

Movassaghi N.

PMID: 4349544 [PubMed - indexed for MEDLINE]

9211: Am J Ophthalmol. 1973 May;75(5):795-8.

Fluorescent antibody study of herpes zoster keratitis.

Hayashi K, Uchida Y, Oshima M.

PMID: 4122380 [PubMed - indexed for MEDLINE]

9212: JAMA. 1973 Apr 2;224(1):122-3.

Failure of cytarabine in varicella-zoster infections.

Davis CM, VanDersarl JV, Coltman CA Jr.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 4347648 [PubMed - indexed for MEDLINE]

9213: Am Rev Respir Dis. 1973 Apr;107(4):661-4.

In vitro and in vivo cellular immunity in anergic miliary tuberculosis.

Waxman J, Lockshin M.

PMID: 4697674 [PubMed - indexed for MEDLINE]

9214: J Clin Pathol. 1973 Apr;26(4):268-72.

Indirect cutaneous immunofluorescence. II. Clinical significance.

Burnham TK.

Sera of 532 patients with bullous diseases, connective tissue diseases and
malignancies were tested for pemphigus epidermal intercellular fluorescence (ICF)
and for the bullous pemphigoid ;tubular' band by the indirect fluorescent
antibody technique. Human normal skin cryostat sections were used.The band and
ICF were seen primarily only in bullous pemphigoid and pemphigus respectively,
Some indirect band and ICF-negative patients demonstrated positive direct results
in involved skin. suggesting that direct tests should be performed in indirect
negative patients clinically thought to have pemphigus or bullous pemphigoid.No
close correlation was found between disease activity and positive or negative
indirect tests in bullous pemphigoid and pemphigus. Steroids did not interfere
with positive results of this diagnostically extremely valuable test.

PMID: 4573789 [PubMed - indexed for MEDLINE]

9215: J Infect Dis. 1973 Apr;127(4):415-23.

Passive immunization against varicella-zoster infections and other modes of
therapy.

Brunell PA, Gershon AA.

Publication Types: 
    Review

PMID: 4571702 [PubMed - indexed for MEDLINE]

9216: Bull Soc Ophtalmol Fr. 1973 Apr;73(4):613-5.

[Oculomotor paralysis with late recognition of its etiology. Apropos of 2 cases]

[Article in French]

Catros MA.

PMID: 4546637 [PubMed - indexed for MEDLINE]

9217: Radiology. 1973 Apr;107(1):109-10.

Cranial arteritis associated with herpes zoster. Case report with angiographic
findings.

Walker RJ 3rd, el-Gammal T, Allen MB Jr.

PMID: 4540172 [PubMed - indexed for MEDLINE]

9218: Br Med J. 1973 Mar 31;1(5856):799-800.

Herpes simplex and zoster.

[No authors listed]

PMID: 4348480 [PubMed - indexed for MEDLINE]

9219: Br Med J. 1973 Mar 24;1(5855):737-8.

Herpes simplex and zoster.

[No authors listed]

PMID: 4694698 [PubMed - indexed for MEDLINE]

9220: Br Med J. 1973 Mar 17;1(5854):679.

Postherpetic neuralgia.

Pearce J.

PMID: 4692724 [PubMed - indexed for MEDLINE]

9221: Med Klin. 1973 Mar 16;68(11):351-5.

[Differential diagnosis and therapy of headache]

[Article in German]

Funk F.

PMID: 4691983 [PubMed - indexed for MEDLINE]

9222: Minerva Med. 1973 Mar 3;64(11):517-24.

[Detection of complement fixing antibodies against Herpes simplex virus (and
other neurotropic viruses) in patients with multiple sclerosis]

[Article in Italian]

Ortona L, Pizzigallo E, Gelfo P.

PMID: 4350584 [PubMed - indexed for MEDLINE]

9223: Lancet. 1973 Mar 3;1(7801):481.

The windmills of shingles.

Macrae AD.

PMID: 4120386 [PubMed - indexed for MEDLINE]

9224: Rev Otoneuroophtalmol. 1973 Mar-Apr;45(2):153-6.

[A case of probable bilateral otitic zona]

[Article in French]

Delobel R, Charbonnel A, Feve JR, Hervochon JP.

PMID: 4792628 [PubMed - indexed for MEDLINE]

9225: Vestn Dermatol Venerol. 1973 Mar;47(3):73-4.

[2 cases of herpes zoster in children with infectious hepatitis]

[Article in Russian]

Vanat SV, Vanat IM.

PMID: 4730106 [PubMed - indexed for MEDLINE]

9226: Vestn Dermatol Venerol. 1973 Mar;47(3):68-73.

[Clinical aspects and therapy of the neurological lesions in herpes zoster]

[Article in Russian]

Kalamkarian AA, Kochetkov VD.

PMID: 4730105 [PubMed - indexed for MEDLINE]

9227: Ann Otolaryngol Chir Cervicofac. 1973 Mar;90(3):214-9.

[Cervico-cephalic zona with multiple localizations, complicated by facial
paralysis, successfully treated by surgery]

[Article in French]

Lallemant Y, Gehanno P, Happich JL.

PMID: 4717373 [PubMed - indexed for MEDLINE]

9228: Union Med Can. 1973 Mar;102(3):624-8.

[The pain clinic at the Centre Hospitalier de l'Universite Laval]

[Article in French]

Paradis B.

PMID: 4713501 [PubMed - indexed for MEDLINE]

9229: Monatsschr Kinderheilkd. 1973 Mar;121(3):101-4.

[Herpes zoster in childhood]

[Article in German]

Panteliadis CP.

PMID: 4696920 [PubMed - indexed for MEDLINE]

9230: Vestn Dermatol Venerol. 1973 Mar;47(3):8-13.

[Use of interferons and interferonogens in dermatology (a review)]

[Article in Russian]

Shcherbakov IM.

Publication Types: 
    Review

PMID: 4581062 [PubMed - indexed for MEDLINE]

9231: Med Sestra. 1973 Mar;32(3):8-10.

[Herpes zoster]

[Article in Russian]

Bol'shakova GM.

PMID: 4540817 [PubMed - indexed for MEDLINE]

9232: Br Med J. 1973 Feb 17;1(5850):406-10.

Herpes simplex and zoster.

Juel-Jensen BE.

PMID: 4347938 [PubMed - indexed for MEDLINE]

9233: Lancet. 1973 Feb 17;1(7799):369.

"Catching" shingles?

Slack PM, Taylor-Robinson D.

PMID: 4121953 [PubMed - indexed for MEDLINE]

9234: Lancet. 1973 Feb 3;1(7797):267-8.

Dermal transmission of virus as a cause of shingles.

Smith JH.

PMID: 4119415 [PubMed - indexed for MEDLINE]

9235: N Engl J Med. 1973 Feb 1;288(5):266-7.

Ramsay Hunt with contralateral Bell's.

Kelly A.

PMID: 4682226 [PubMed - indexed for MEDLINE]

9236: Wiad Lek. 1973 Feb 1;26(3):259-61.

[Rare case of damage of the ophthalmic and oculomotor nerves during zoster]

[Article in Polish]

Lebensztejn W, Jackiewicz H.

PMID: 4347619 [PubMed - indexed for MEDLINE]

9237: Med J Aust. 1973 Jan 6;1(1):22-6.

Clinical uses of human blood fractions.

Schiff P.

PMID: 4686436 [PubMed - indexed for MEDLINE]

9238: Lancet. 1973 Jan 6;1(7793):38-9.

Cytosine arabinoside in herpes zoster.

Rojkind M, Uribe M, Kershenobich D.

PMID: 4118555 [PubMed - indexed for MEDLINE]

9239: Lancet. 1973 Jan 6;1(7793):38.

Cytosine arabinoside in herpes zoster.

Fortuny IE, Weiss R, Theologides A, Kennedy BJ.

PMID: 4118554 [PubMed - indexed for MEDLINE]

9240: Munch Med Wochenschr. 1973 Jan 5;115(1):10-2.

[Diagnosis of smallpox]

[Article in German]

Ehrengut W.

PMID: 4346543 [PubMed - indexed for MEDLINE]

9241: Trans Am Ophthalmol Soc. 1973;71:246-53.

The changing character of infectious corneal disease: emerging opportunistic
microbial forms (1928-1973).

Thygeson P, Spencer WH.

PMID: 10949603 [PubMed - indexed for MEDLINE]

9242: Scand J Infect Dis. 1973;5(4):277-8.

Herpes simplex-herpes zoster immunity.

Kouvalainen K, Ruuskanen O, Eskola J, Hopsu-Havu VK.

PMID: 4780364 [PubMed - indexed for MEDLINE]

9243: Zh Nevropatol Psikhiatr Im S S Korsakova. 1973;73(2):172-4.

[Experience with the treatment of acute viral meningitis with nucleases]

[Article in Russian]

Panov AG, Lobzin VS, Sichko ZhV.

PMID: 4743264 [PubMed - indexed for MEDLINE]

9244: Adv Otorhinolaryngol. 1973;20:144-54.

Otological manifestations of viral disease.

Paparella MM.

PMID: 4710506 [PubMed - indexed for MEDLINE]

9245: Otorinolaringologie. 1973 Jan-Feb;18(1):53-5.

[Total otic zona with involvement of other cranial nerves]

[Article in Romanian]

Tantareanu C, Jurca N.

PMID: 4691995 [PubMed - indexed for MEDLINE]

9246: HNO. 1973 Jan;21(1):19-20.

[Taste disorders at the soft palate in facial paralysis]

[Article in German]

Rollin H.

PMID: 4687662 [PubMed - indexed for MEDLINE]

9247: Ann Intern Med. 1973 Jan;78(1):149-50.

Infections after splenectomy.

Cormia FE Jr, Campos LT.

PMID: 4682302 [PubMed - indexed for MEDLINE]

9248: Trans Ophthalmol Soc U K. 1973;93(0):181-92.

Herpes zoster keratitis.

Marsh RJ.

PMID: 4546383 [PubMed - indexed for MEDLINE]

9249: Vestn Oftalmol. 1973;3:58-62.

[Classification of herpetic eye disease]

[Article in Russian]

Kasparov AA.

PMID: 4543276 [PubMed - indexed for MEDLINE]

9250: Zh Nevropatol Psikhiatr Im S S Korsakova. 1973;73(3):352-5.

[Movement disorders in herpes zoster]

[Article in Russian]

Krison ED.

Publication Types: 
    Case Reports

PMID: 4542636 [PubMed - indexed for MEDLINE]

9251: Klin Padiatr. 1973 Jan;185(1):57-63.

[Herpez zoster in childhood--demonstration of complicated forms]

[Article in German]

Kellerer H, Kerl H.

PMID: 4540237 [PubMed - indexed for MEDLINE]

9252: Arch Ophthalmol. 1973 Jan;89(1):21-4.

Herpes zoster ophthalmicus treated with cytarabine.

Pierce LE, Jenkins RB.

PMID: 4539773 [PubMed - indexed for MEDLINE]

9253: Diastema. 1973;4(1):9-12 passim.

Herpes zoster--a review of the literature and a case-history of trigeminal nerve 
involvement.

Adami AA.

PMID: 4525622 [PubMed - indexed for MEDLINE]

9254: Annee Ther Clin Ophtalmol. 1973;24:105-25.

[Ophthalmic herpes zoster: current data]

[Article in French]

Bronner A, Flament J.

PMID: 4374896 [PubMed - indexed for MEDLINE]

9255: Int Ophthalmol Clin. 1973 Winter;13(4):103-23.

Corticosteroid therapy in corneal disease. I.

Hyndiuk RA, Chin GN.

PMID: 4361430 [PubMed - indexed for MEDLINE]

9256: Adv Otorhinolaryngol. 1973;20:155-77.

Cochlear pathology in viral disease.

Friedmann I.

PMID: 4351033 [PubMed - indexed for MEDLINE]

9257: J Hyg Epidemiol Microbiol Immunol. 1973;17(1):26-36.

Indirect haemagglutination reaction with varicella-zoster virus antigen.

Trlifajova J, Pokorny J, Ryba M, Strizova V.

Publication Types: 
    Comparative Study

PMID: 4350836 [PubMed - indexed for MEDLINE]

9258: Arch Ophthalmol. 1973 Jan;89(1):25-9.

Herpes zoster dendritic keratitis.

Pavan-Langston D, McCulley JP.

PMID: 4346381 [PubMed - indexed for MEDLINE]

9259: Zentralbl Allg Pathol. 1973;117(2):127-31.

[Vascular lesions of the liver and of the spleen in Zoster generalisatus
(author's transl)]

[Article in German]

Timmel H.

PMID: 4147771 [PubMed - indexed for MEDLINE]

9260: Acta Derm Venereol. 1973;53(5):359-62.

Synthetic lysine vasopressin in herpetic neuralgia.

Forssman O, Leczinsky CG, Mulder J.

PMID: 4127469 [PubMed - indexed for MEDLINE]

9261: Padiatr Padol. 1973;8(4):412-9.

[Zoster Pneumonia in Children (author's transl)]

[Article in German]

Kellerer K.

PMID: 4126833 [PubMed - indexed for MEDLINE]

9262: Br Med J. 1972 Dec 2;4(5839):522-3.

Specific IgM antibody in serum of patients with herpes zoster infections.

Ross CA, McDaid R.

PMID: 4566017 [PubMed - indexed for MEDLINE]

9263: Pediatrics. 1972 Dec;50(6):930-1.

Report of severe herpes zoster in a 13 and one-half-year-old boy whose chickenpox
infection may have been acquired in utero.

Lyday JH.

PMID: 4673901 [PubMed - indexed for MEDLINE]

9264: Vrach Delo. 1972 Dec;12:128-9.

[Chickenpox associated with herpes zoster in an adult]

[Article in Russian]

Vasilenko RA, Svirid GM, Bitiuk AB.

Publication Types: 
    Case Reports

PMID: 4659201 [PubMed - indexed for MEDLINE]

9265: Br J Clin Pract. 1972 Dec;26(12):553-4.

Audiological findings in patients with Bell's palsy.

Korczyn AD.

PMID: 4649364 [PubMed - indexed for MEDLINE]

9266: Klin Monatsbl Augenheilkd. 1972 Dec;161(6):635-40.

[Suture problems in keratoplasty in cases of cicatrical and dystrophic corneas]

[Article in German]

Mackensen G, Witschel H.

PMID: 4570631 [PubMed - indexed for MEDLINE]

9267: Surg Clin North Am. 1972 Dec;52(6):1501-12.

Infection and renal transplantation.

Turcotte JG.

PMID: 4564431 [PubMed - indexed for MEDLINE]

9268: Ann Ocul (Paris). 1972 Dec;205(12):1339-44.

[Solitary chorioretinal site and M paraproteinemia]

[Article in French]

Bianchi G, Stucchi CA.

PMID: 4541115 [PubMed - indexed for MEDLINE]

9269: Clin Obstet Gynecol. 1972 Dec;15(4):1010-4.

Herpes zoster of the vulva.

Brown D.

PMID: 4346315 [PubMed - indexed for MEDLINE]

9270: Arch Ophthalmol. 1972 Dec;88(6):697.

Anaphylactic shock and corticotropin.

Shapiro RD.

PMID: 4343606 [PubMed - indexed for MEDLINE]

9271: Munch Med Wochenschr. 1972 Nov 17;114(46):2029-34.

[The neck, shoulder and arm pain syndrome. Diagnosis and surgical therapy]

[Article in German]

Kollmannsberger A, Leheta F, Mackert B.

PMID: 4678703 [PubMed - indexed for MEDLINE]

9272: Pediatrics. 1972 Nov;50(5):718-22.

Prevention of varicella in high risk children: a collaborative study.

Brunell PA, Gershon AA, Hughes WT, Riley HD Jr, Smith J.

PMID: 5084186 [PubMed - indexed for MEDLINE]

9273: Bull Soc Ophtalmol Fr. 1972 Nov;72(11):1073-6.

[Diagnostic problems in herpes simplex and zona]

[Article in French]

Martenet AC.

PMID: 4542919 [PubMed - indexed for MEDLINE]

9274: Mich Med. 1972 Nov;71(32):929-35.

Motor neuropathy associated with herpes zoster.

Levine MC.

PMID: 4343425 [PubMed - indexed for MEDLINE]

9275: Science. 1972 Oct 20;178(58):306-7.

Herpesvirus hominis: isolation from human trigeminal ganglion.

Bastian FO, Rabson AS, Yee CL, Tralka TS.

Herpesvirus hominis was isolated from the trigeminal ganglion obtained at autopsy
from 1 of 22 patients with no clinical evidence of active herpetic disease, and
from one patient with malignant lymphoma who died with herpes zoster on the
abdomen, pulmonary cytomegalic inclusion disease, and possible oral herpes
simplex. Virus was isolated by cocultivation of explants of ganglion with
monolayers of Vero green monkey kidney cells and required 3 weeks of culture
before viral cytopathic effects were evident. These observations support the
concept that latent infection of sensory ganglia may be the source of virus in
recurrent herpetic disease in man.

PMID: 4342752 [PubMed - indexed for MEDLINE]

9276: Pediatr Pol. 1972 Oct;47(10):1287-8.

[Case of abducent nerve palsy in the course of lumbar herpes zoster in a
3-year-old boy]

[Article in Polish]

Split W, Zawadzki Z.

PMID: 5085414 [PubMed - indexed for MEDLINE]

9277: Z Haut Geschlechtskr. 1972 Oct 1;47(19):33-4 passim.

[Simultanous occurrence of herpes simplex and herpes zoster]

[Article in German]

Angyal J.

Publication Types: 
    Case Reports

PMID: 4636984 [PubMed - indexed for MEDLINE]

9278: J Neurosurg. 1972 Oct;37(4):412-7.

Stereotaxic trigeminal tractotomy for post-herpetic facial pain.

Hitchock ER, Schvarcz JR.

PMID: 4560952 [PubMed - indexed for MEDLINE]

9279: Rev Otoneuroophtalmol. 1972 Oct-Dec;44(5):431-2.

[Cephalic zona]

[Article in French]

Bronner A, Gerhard JP, Flament J.

PMID: 4542219 [PubMed - indexed for MEDLINE]

9280: Rev Circ Argent Odontol. 1972 Oct;35(3):22-5.

[Treatment of viral lesions--herpes simplex, herpes zoster and herpangina--with
the antiviral agent isoprinosine]

[Article in Spanish]

Muracciole JC, Vilarino JA, Muracciole MA.

PMID: 4512766 [PubMed - indexed for MEDLINE]

9281: J Laryngol Otol. 1972 Oct;86(10):1031-55.

Herpes zoster of the head and neck.

Payten RJ, Dawes JD.

PMID: 4342869 [PubMed - indexed for MEDLINE]

9282: J Med Lyon. 1972 Sep 5;53(232):1105-7.

[Terebrant and recurring herpes and zona in the course of hemopathies (treated
with immunosuppressive agents)]

[Article in French]

Laugier P, Orusco M.

PMID: 4344441 [PubMed - indexed for MEDLINE]

9283: Tohoku J Exp Med. 1972 Sep;108(1):55-62.

Virologic studies of generalized herpes zoster.

Ikeda S, Kimura A, Shiono H, Kogasaka R, Nakao T.

PMID: 4346171 [PubMed - indexed for MEDLINE]

9284: Med Clin North Am. 1972 Sep;56(5):1175-92.

Herpes genitalis.

Young AW Jr.

PMID: 4340869 [PubMed - indexed for MEDLINE]

9285: Med Klin. 1972 Aug 25;67(34):1094.

[Therapy of herpes zoster]

[Article in German]

Vivell O.

PMID: 5071457 [PubMed - indexed for MEDLINE]

9286: Sygeplejersken. 1972 Aug 24;72(33):8-10.

[Treatment of shingles (herpes zoster) with sympathetic blocking]

[Article in Danish]

Colding A.

PMID: 4488937 [PubMed - indexed for MEDLINE]

9287: Z Allgemeinmed. 1972 Aug 20;48(23):1050-3.

[Herpes zoster and its therapy using honey-procaine]

[Article in German]

Fink G.

PMID: 5075044 [PubMed - indexed for MEDLINE]

9288: N Y State J Med. 1972 Aug 15;72(16):2094-6.

Guillain-Barre syndrome in herpes zoster.

Singh S, Malhotra V, Malhotra RP.

Publication Types: 
    Case Reports

PMID: 4505338 [PubMed - indexed for MEDLINE]

9289: Practitioner. 1972 Aug;209(250):204.

Corticosteroids and herpes.

Gold S.

PMID: 5078233 [PubMed - indexed for MEDLINE]

9290: Z Laryngol Rhinol Otol. 1972 Aug;51(8):494-8.

[Exogenous factors in acute hearing disorders]

[Article in German]

Stange G.

PMID: 5076575 [PubMed - indexed for MEDLINE]

9291: Arch Dermatol. 1972 Aug;106(2):204-7.

Herpes zoster in children.

Rogers RS 3rd, Tindall JP.

PMID: 5048220 [PubMed - indexed for MEDLINE]

9292: South Med J. 1972 Aug;65(8):995-7.

Cytosine arabinoside therapy for Herpes Zoster in a patient with systemic lupus
erythematosus.

Vandersarl JV, Davis CM, Fenton RM, Panettiere F.

PMID: 5044434 [PubMed - indexed for MEDLINE]

9293: Klin Monatsbl Augenheilkd. 1972 Aug;161(2):206-9.

[Zoster ophthalmicus leading to loss of the eye]

[Article in German]

Hubner H.

PMID: 4539180 [PubMed - indexed for MEDLINE]

9294: N Z Med J. 1972 Aug;76(483):112-3.

Muscle paralysis and herpes zoster.

[No authors listed]

PMID: 4508810 [PubMed - indexed for MEDLINE]

9295: J Infect Dis. 1972 Aug;126(2):193-5.

Rapid diagnosis of varicella-zoster infections by agar-gel diffusion.

Uduman SA, Gershon AA, Brunell PA.

PMID: 4340928 [PubMed - indexed for MEDLINE]

9296: Z Haut Geschlechtskr. 1972 Aug 1;47(15):Suppl:17-9.

[Gangrenous herpes zoster imitating penicilline lesions]

[Article in German]

Angyal J, Mesko E.

PMID: 4264078 [PubMed - indexed for MEDLINE]

9297: Nurs Mirror Midwives J. 1972 Jul 28;135(4):25-7.

Facial pain.

Foster JB.

PMID: 4484255 [PubMed - indexed for MEDLINE]

9298: Br Med J. 1972 Jul 15;3(5819):130-1.

Zoster and Hodgkin's disease.

[No authors listed]

PMID: 5039773 [PubMed - indexed for MEDLINE]

9299: Pol Tyg Lek. 1972 Jul 3;27(27):1051-3.

[Generalized zoster in the course of chronic myelocytic leukemia]

[Article in Polish]

Koscinski R, Durkalec J.

PMID: 4506284 [PubMed - indexed for MEDLINE]

9300: Rev Asoc Odontol Argent. 1972 Jul;60(7):335-7.

[Herpes zoster of the 2d trigeminal branch with prodromal toothache]

[Article in Spanish]

Banquer E, Laterza A.

PMID: 4504628 [PubMed - indexed for MEDLINE]

9301: J Am Dent Assoc. 1972 Jul;85(1):139-41.

Postherpetic (trigeminal) neuralgia: report of case.

Weisengreen HH.

Publication Types: 
    Case Reports

PMID: 4503585 [PubMed - indexed for MEDLINE]

9302: Pediatr Pol. 1972 Jul;47(7):833-41.

[Infectivity period of varicella and zoster in the light of virological
examinations]

[Article in Polish]

Czubkowska I.

PMID: 4341032 [PubMed - indexed for MEDLINE]

9303: Arch Dermatol. 1972 Jul;106(1):130.

Use of cytarabine for herpesvirus infections.

Gordon HH.

PMID: 4339022 [PubMed - indexed for MEDLINE]

9304: Am J Ophthalmol. 1972 Jul;74(1):142-4.

Herpes zoster ophthalmicus with nasociliary nerve involvement.

Schwartz DE.

PMID: 4338611 [PubMed - indexed for MEDLINE]

9305: Munch Med Wochenschr. 1972 Jun 30;114(26):1234-6.

[Ciclacillin in the dermatologic practice]

[Article in German]

Weitgasser H.

PMID: 5068222 [PubMed - indexed for MEDLINE]

9306: Ann Otol Rhinol Laryngol. 1972 Jun;81(3):331-8.

Temporal bone pathology in herpes oticus.

Zajtchuk JT, Matz GJ, Lindsay JR.

PMID: 5030759 [PubMed - indexed for MEDLINE]

9307: J Neurosurg. 1972 Jun;36(6):751-5.

Evaluation of rhizotomy. Review of 12 years' experience.

Onofrio BM, Campa HK.

PMID: 5030403 [PubMed - indexed for MEDLINE]

9308: Am J Clin Pathol. 1972 Jun;57(6):737-50.

Laboratory diagnosis of viral infections: general principles.

Lennette EH.

PMID: 4554720 [PubMed - indexed for MEDLINE]

9309: Infect Immun. 1972 Jun;5(6):835-9.

Indirect hemagglutination test for varicella-zoster infection.

Furukawa T, Plotkin SA.

An indirect hemagglutination test has been adapted for use with varicella-zoster 
serology. Antigen was made in infected WI-38 human diploid cell line. The
indirect hemagglutination antigen seemed to be a subunit of the virus particle.
The antibodies measured in the test are well correlated with neutralizing and
complement-fixing antibodies in cases of zoster but not in cases of varicella.

PMID: 4344091 [PubMed - indexed for MEDLINE]

9310: Nippon Ganka Gakkai Zasshi. 1972 Jun;76(6):344-51.

[Study of herpes simplex skin test in herpetic keratitis. I]

[Article in Japanese]

Kameyama K.

PMID: 4340972 [PubMed - indexed for MEDLINE]

9311: Wien Klin Wochenschr. 1972 May 26;84(21):337-40.

[Differential diagnosis of smallpox]

[Article in German]

Soltz-Szots J, Fanta D.

Publication Types: 
    Review

PMID: 4114305 [PubMed - indexed for MEDLINE]

9312: Practitioner. 1972 May;208(247):687-8.

Treatment of herpes zoster with short-wave diathermy to the spinal cord.

Allberry J, Manning FR, Smith EE.

PMID: 5070968 [PubMed - indexed for MEDLINE]

9313: J Clin Invest. 1972 May;51(5):1170-8.

Interferon, antibody, and other host factors in herpes zoster.

Stevens DA, Merigan TC.

The influence of several factors on the course of herpes zoster was studied in
151 patients. Dissemination of zoster was associated with the presence of a
concurrent disease, especially Hodgkin's disease, and/or the use of
immunosuppressive therapy. Several host-immune parameters, including quantitative
immunoglobulins, circulating lymphocyte counts, delayed hypersensitivity to
multiple skin test antigens, and lymphocyte transformation to phytohemagglutinin 
did not correlate with dissemination of disease. Development of virus-specific
complement-fixing antibody (CFA) was delayed in some patients with disseminated
disease.Vesicle interferon (V-IF) titers were low early in the disease in
patients with localized and disseminated zoster and then rose, usually abruptly, 
to a peak value and declined as pustulation and crusting occurred. However,
titers in patients with localized disease rose at an earlier time. This could be 
seen in terms of time to development of intermediate values of V-IF or by the day
on which the sharpest rise occurred. In 15 carefully studied patients with
disseminated disease, the development of the maximum V-IF response was followed
within 48 hr by cessation of dissemination. Half of the patients in this group
had no CFA detectable until after dissemination had ceased.These findings suggest
at least two host factors whose interaction might determine host response to
zoster; local interferon production (possibly mediated by sensitized lymphocytes)
and humoral antibody, acting to prevent or shorten dissemination of an initially 
local disease.

PMID: 5020430 [PubMed - indexed for MEDLINE]

9314: Neurology. 1972 May;22(5):459-66.

Segmental zoster paresis--a disease profile.

Thomas JE, Howard FM Jr.

PMID: 4673442 [PubMed - indexed for MEDLINE]

9315: Klin Monatsbl Augenheilkd. 1972 May;160(5):540-50.

[The influence of various factors of donor material on the success of corneal
transplantation]

[Article in German]

Meyer HJ, Arnecke H.

PMID: 4561732 [PubMed - indexed for MEDLINE]

9316: Rev Otoneuroophtalmol. 1972 May-Jun;44(3):267-9.

[Ophthalmic zoster and vascular pseudo-papillitis]

[Article in French]

Rossazza C, Jezegabel C, Moser M, Larmande AM.

PMID: 4541053 [PubMed - indexed for MEDLINE]

9317: Practitioner. 1972 May;208(247):607-13.

Herpes zoster.

Church R.

PMID: 4538457 [PubMed - indexed for MEDLINE]

9318: Dent Dig. 1972 May;78(5):242-6.

Herpes zoster of the maxillary nerve: report of a case.

Hatziotis JC.

Publication Types: 
    Case Reports

PMID: 4503358 [PubMed - indexed for MEDLINE]

9319: Ther Umsch. 1972 May;29(5):320-5.

[Maternal infections and pregnancy]

[Article in French]

Meylan J.

Publication Types: 
    Review

PMID: 4339081 [PubMed - indexed for MEDLINE]

9320: J Natl Med Assoc. 1972 May;64(3):217-21.

Hodgkin's disease, failing immunity and varicella-zoster.

Camiel MR, Benninghoff DL.

PMID: 4338490 [PubMed - indexed for MEDLINE]

9321: Ann Rheum Dis. 1972 May;31(3):192-5.

Antibody levels to parainfluenza, herpes simplex, varicella-zoster, cytomegalo
virus, and measles virus in patients with connective tissue diseases.

Kalliomaki JL, Halonen P.

PMID: 4338106 [PubMed - indexed for MEDLINE]

9322: Appl Microbiol. 1972 May;23(5):1001-9.

Immunoperoxidase localization of herpes zoster virus and simian virus 40 in cell 
culture.

Shabo AL, Petricciani JC, Kirschstein RL.

The immunoperoxidase technique was used in an electron microscopy study to
localize the virions of herpes zoster virus and simian virus 40 in cell cultures.
Intranuclear and intracytoplasmic virions of herpes zoster virus were easily and 
specifically identified due to intense staining by the finely granular, black
reaction product. With simian virus 40, intranuclear virions were not stained,
whereas intracytoplasmic particles appeared densely black. There was essentially 
no background staining. Advantages of this technique over the ferritin-labeled
antibody method include simpler preparative procedures for reagents, greater
penetrability of the antibody conjugate, and internal amplification which
substantially improves the ability to localize sites of antigen-antibody
reaction. We believe that the immunoperoxidase method can be successfully applied
to a wide variety of problems involving viral antigens.

PMID: 4113252 [PubMed - indexed for MEDLINE]

9323: Nippon Ganka Gakkai Zasshi. 1972 Apr 15;76 Suppl:5.

[Herpes corneae--methods of diagnosis]

[Article in Japanese]

Uchida Y.

PMID: 4555174 [PubMed - indexed for MEDLINE]

9324: Nippon Ganka Gakkai Zasshi. 1972 Apr 15;76 Suppl:7.

[Herpes corneae--a virological study]

[Article in Japanese]

Kobayashi S.

PMID: 4537377 [PubMed - indexed for MEDLINE]

9325: Nippon Ganka Gakkai Zasshi. 1972 Apr 15;76 Suppl:6.

[Herpes cornea--a morphological study]

[Article in Japanese]

Kitano S.

PMID: 4537376 [PubMed - indexed for MEDLINE]

9326: J Neurol Neurosurg Psychiatry. 1972 Apr;35(2):170-5.

Polyneuritis and herpes zoster.

Dayan AD, Ogul E, Graveson GS.

PMID: 5037030 [PubMed - indexed for MEDLINE]

9327: Arch Otolaryngol. 1972 Apr;95(4):383-90.

Electrogustometry in facial palsy.

Tomita H, Okuda Y, Tomiyama H, Kida A.

PMID: 5018262 [PubMed - indexed for MEDLINE]

9328: Arch Otolaryngol. 1972 Apr;95(4):376-82.

Electrodiagnosis in facial palsy.

Yanagihara N, Kishimoto M.

PMID: 5018261 [PubMed - indexed for MEDLINE]

9329: Saishin Igaku. 1972 Apr;27(4):685-91.

[Cryosurgery in ophthalmology]

[Article in Japanese]

Takeuchi M.

Publication Types: 
    Review

PMID: 4554712 [PubMed - indexed for MEDLINE]

9330: Neurology. 1972 Apr;22(4):348-54.

Granulomatous angiitis of the nervous system in cases of herpes zoster and
lymphosarcoma.

Rosenblum WI, Hadfield MG.

PMID: 4552715 [PubMed - indexed for MEDLINE]

9331: Bull Soc Ophtalmol Fr. 1972 Apr;12(4):437-9.

[Symptomatic ophthalmic zona associated with intracranial aneurysm]

[Article in French]

Hamard H, Fougeres R, Said G, Bonsch M, Bregeat P.

PMID: 4540645 [PubMed - indexed for MEDLINE]

9332: Dermatol Monatsschr. 1972 Apr;158(4):278-81.

[Herpes zoster encephalitis (case report)]

[Article in German]

Profirov D.

Publication Types: 
    Case Reports

PMID: 4537398 [PubMed - indexed for MEDLINE]

9333: Bord Med. 1972 Apr;5(7):771-6.

[Herpesvirus infection in Hodgkin's disease]

[Article in French]

Hoerni B, Simon G, Chauvergne J.

PMID: 4341310 [PubMed - indexed for MEDLINE]

9334: Dtsch Zahnarztl Z. 1972 Apr;27(4):273-82.

[Acute inflammation of the marginal periodontium. Cytological characteristics of 
the acute gingivitis]

[Article in German]

Lange DE.

PMID: 4339270 [PubMed - indexed for MEDLINE]

9335: Lab Invest. 1972 Apr;26(4):391-402.

Electron microscopy of zosteriform herpes simplex infection in the mouse.

Dillard SH, Cheatham WJ, Moses HL.

PMID: 4336537 [PubMed - indexed for MEDLINE]

9336: Arch Otolaryngol. 1972 Apr;95(4):364-8.

Varicella-Zoster virus in idiopathic facial palsy.

Tomita H, Hayakawa W.

PMID: 4336152 [PubMed - indexed for MEDLINE]

9337: Dtsch Gesundheitsw. 1972 Mar 30;27(13):583-6.

[Geriatric problems in herpes zoster]

[Article in German]

Harnack K, Bruschke G, Schulz FH.

PMID: 5040768 [PubMed - indexed for MEDLINE]

9338: Pol Tyg Lek. 1972 Mar 20;27(12):463-4.

[Treatment of herpes zoster with ionoflux]

[Article in Polish]

Aleksandrowicz J.

PMID: 5020086 [PubMed - indexed for MEDLINE]

9339: Med J Malaya. 1972 Mar;26(3):201-4.

Herpes zoster with severe neurological complication. A report of two cases.

Ghee LT.

PMID: 5031016 [PubMed - indexed for MEDLINE]

9340: Prensa Med Mex. 1972 Mar-Apr;37(3):159-60.

[Treatment of U herpes zoster and herpes simplex with isoprinosine]

[Article in Spanish]

Stenberg TH, Macotela Ruiiz E.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 4559678 [PubMed - indexed for MEDLINE]

9341: Med Clin North Am. 1972 Mar;56(2):353-70.

Viral infection and immunity.

Dent PB, Larke RP.

Publication Types: 
    Review

PMID: 4553194 [PubMed - indexed for MEDLINE]

9342: Hautarzt. 1972 Mar;23(3):140-2.

[Experience with furosemide in the therapy of ophthalmic herpes zoster]

[Article in German]

Felten G.

PMID: 4537261 [PubMed - indexed for MEDLINE]

9343: J Mich State Dent Assoc. 1972 Mar;54(3):102-5.

Case report: odontalgia resulting from prodromal herpes zoster.

Heiman JL.

PMID: 4501023 [PubMed - indexed for MEDLINE]

9344: Acta Cytol. 1972 Mar-Apr;16(2):178-85.

Cytology of ocular lesions.

Naib ZM.

PMID: 4335757 [PubMed - indexed for MEDLINE]

9345: Trans Am Acad Ophthalmol Otolaryngol. 1972 Mar-Apr;76(2):297-300.

XXVII Wherry Memorial Lecture. Steroid therapy in otolaryngology.

Baker DC Jr.

PMID: 4147548 [PubMed - indexed for MEDLINE]

9346: Dtsch Med Wochenschr. 1972 Feb 25;97(8):307.

[Pleural effusion in herpes zoster]

[Article in German]

Ackermann R.

PMID: 5058431 [PubMed - indexed for MEDLINE]

9347: Cancer. 1972 Feb;29(2):461-5.

Herpes zoster in Hodgkin's disease. Clinical, histologic, and immunologic
correlations.

Wilson JF, Marsa GW, Johnson RE.

PMID: 5013547 [PubMed - indexed for MEDLINE]

9348: Ann Intern Med. 1972 Feb;76(2):241-54.

Varicella-Zoster infection in patients with cancer.

Schimpff S, Serpick A, Stoler B, Rumack B, Mellin H, Joseph JM, Block J.

PMID: 4333228 [PubMed - indexed for MEDLINE]

9349: Ann Intern Med. 1972 Feb;76(2):235-40.

Herpes Zoster-Varicella infections and lymphoma.

Goffinet DR, Glatstein EJ, Merigan TC.

PMID: 4333227 [PubMed - indexed for MEDLINE]

9350: Ned Tijdschr Geneeskd. 1972 Jan 29;116(5):200.

[Cytosine arabinoside in the treatment of severe herpes zoster and varicella]

[Article in Dutch]

Goudsmit R.

PMID: 5028760 [PubMed - indexed for MEDLINE]

9351: Med J Aust. 1972 Jan 29;1(5):227-30.

"Atypical" Ramsay Hunt syndrome.

Steffen R, Selby G.

PMID: 4337072 [PubMed - indexed for MEDLINE]

9352: Lancet. 1972 Jan 29;1(7744):263.

Causation of shingles.

Thomas M, Robertson WJ.

PMID: 4109722 [PubMed - indexed for MEDLINE]

9353: Lancet. 1972 Jan 15;1(7742):151.

Exogenous or endogenous causation of shingles.

Taylor-Robinson D, Slack PM.

PMID: 4109010 [PubMed - indexed for MEDLINE]

9354: Pediatrics. 1972 Jan;49(1):102-9.

Facial paralysis in children.

Manning JJ, Adour KK.

PMID: 5062083 [PubMed - indexed for MEDLINE]

9355: Rev Port Estomatol Cir Maxilofac. 1972 Jan-Jun;12(1):37-65.

[Dermatological diseases with oral localization]

[Article in Portuguese]

da Silva N.

PMID: 5028377 [PubMed - indexed for MEDLINE]

9356: Cesk Neurol Neurochir. 1972;35(6):318-23.

[Spinal ganglionectomy in intercostal postherpetic neuralgia]

[Article in Czech]

Zverina E, Fuchsova M.

Publication Types: 
    Case Reports
    English Abstract

PMID: 4681789 [PubMed - indexed for MEDLINE]

9357: Cesk Neurol. 1972;35(6):318-23.

[Spinal ganglionectomy during intercostal postherpetic neuralgia]

[Article in Czech]

Zverina E, Fuchsova M.

PMID: 4669256 [PubMed - indexed for MEDLINE]

9358: Annee Ther Clin Ophtalmol. 1972;23:229-34.

[Deep herpetic keratitis]

[Article in French]

Francois P.

PMID: 4615622 [PubMed - indexed for MEDLINE]

9359: Ann Ocul (Paris). 1972 Jan;205(1):69-71.

[Procedure to follow in metaherpetic keratitis]

[Article in French]

Hervouet F.

PMID: 4556603 [PubMed - indexed for MEDLINE]

9360: Can J Ophthalmol. 1972 Jan;7(1):13-8.

The practical management of ocular infections. II. Viral infections.

DeVoe AG.

Publication Types: 
    Review

PMID: 4550705 [PubMed - indexed for MEDLINE]

9361: Bull Mem Soc Fr Ophtalmol. 1972;85(0):378-84.

[Immunologic examination in cases of ophthalmic zona]

[Article in French]

Trux E, Veres J.

PMID: 4546621 [PubMed - indexed for MEDLINE]

9362: Dermatologica. 1972;145(2):146-53.

[Clinical case reports]

[Article in French]

Laugier P, Brun R, Orusco M, Hunziker N, Reiffers J, Vidmar B, Bauquis R,
Posternak F.

Publication Types: 
    Case Reports

PMID: 4542006 [PubMed - indexed for MEDLINE]

9363: Am J Ophthalmol. 1972 Jan;73(1):62-7.

Cellular immunity in chronic ophthalmic disorders. 2. Leukocyte migration
inhibition in diseases of the cornea.

Shore B, Leopold IH, Henley WL.

PMID: 4536637 [PubMed - indexed for MEDLINE]

9364: Am J Ophthalmol. 1972 Jan;73(1):56-61.

Cellular immunity in chronic ophthalmic disorders. I. Lymphocyte stimulation and 
protein synthesis.

Henley WL, Okas S, Waithe W, Hirschhorn K, Leopold IH.

PMID: 4536636 [PubMed - indexed for MEDLINE]

9365: Acta Neurol Scand Suppl. 1972;51:397-400.

Relapsing herpes zoster myelitis.

Nyberg-Hansen R.

Publication Types: 
    Case Reports

PMID: 4514360 [PubMed - indexed for MEDLINE]

9366: J Clin Pathol Suppl (R Coll Pathol). 1972;6:46-50.

Varicella-zoster and related viruses.

McCarthy K.

Publication Types: 
    Review

PMID: 4376154 [PubMed - indexed for MEDLINE]

9367: J Clin Pathol Suppl (R Coll Pathol). 1972;6:152-3.

Systems of virus survival.

Fraser KB.

PMID: 4376150 [PubMed - indexed for MEDLINE]

9368: J Clin Pathol Suppl (R Coll Pathol). 1972;6:121-31.

Immune responses in persistent virus infections.

Allison AC.

Publication Types: 
    Review

PMID: 4376149 [PubMed - indexed for MEDLINE]

9369: Scand J Infect Dis. 1972;4(2):91-6.

Infantile herpes zoster.

Kouvalainen K, Salmi A, Salmi TT.

PMID: 4341818 [PubMed - indexed for MEDLINE]

9370: Scand J Infect Dis. 1972;4(2):83-9.

Varicella and herpes zoster: differences in antibody response revealed by the
platelet aggregation technique.

Palosuo T.

PMID: 4341817 [PubMed - indexed for MEDLINE]

9371: Scand J Infect Dis. 1972;4(1):23-5.

Herpes zoster in childhood.

McKendrick GD, Raychoudhury SC.

PMID: 4336586 [PubMed - indexed for MEDLINE]

9372: Br J Dermatol. 1972 Jan;86(1):40-8.

Experimental zosteriform herpes simplex virus infection in mouse skin.

Robinson TW, Dover JR.

PMID: 4334153 [PubMed - indexed for MEDLINE]

9373: J Neurol Sci. 1972;15(1):35-48.

Herpes Zoster. Demonstration of virus in trigeminal nerve and ganglion by
immunofluorescence and electron microscopy.

Esiri MM, Tomlinson AH.

PMID: 4332851 [PubMed - indexed for MEDLINE]

9374: J Clin Pathol Suppl (R Coll Pathol). 1972;6:1-7.

Host-virus relationship with special reference to Newcastle disease and serum
hepatitis.

Waterson AP.

Publication Types: 
    Review

PMID: 4218239 [PubMed - indexed for MEDLINE]

9375: Arch Dermatol Forsch. 1972;244:409-11.

[Therapy of herpes simplex and herpes zoster]

[Article in German]

Nasemann T.

PMID: 4119338 [PubMed - indexed for MEDLINE]

9376: J Infect Dis. 1972 Jan;125(1):82-4.

Prevention and control of varicella-zoster infections.

Judelsohn RG.

PMID: 4109437 [PubMed - indexed for MEDLINE]

9377: Lancet. 1971 Dec 18;2(7738):1349-50.

Dermal transmission of virus as a cause of shingles.

Thomas M, Robertson WJ.

PMID: 4108266 [PubMed - indexed for MEDLINE]

9378: Schweiz Rundsch Med Prax. 1971 Dec 7;60(49):1649-53.

[Clinical forms and abnormal localizations of herpes simplex]

[Article in French]

Reiffers J, Hunziker N, Porto e Souza L, Laugier MP.

PMID: 5140047 [PubMed - indexed for MEDLINE]

9379: Schweiz Rundsch Med Prax. 1971 Dec 7;60(49):1636-8.

[Generalized herpes zoster]

[Article in French]

Vidmar B, Porto e Souza L, Harms M.

PMID: 5140044 [PubMed - indexed for MEDLINE]

9380: Can Med Assoc J. 1971 Dec 4;105(11):1125-6.

Immunosuppressive therapy in the rheumatic diseases.

[No authors listed]

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 4948506 [PubMed - indexed for MEDLINE]

9381: Med J Aust. 1971 Dec 4;2(23):1179-80.

Multiple cranial nerve involvement with herpes zoster.

Parker WJ.

PMID: 4332487 [PubMed - indexed for MEDLINE]

9382: G Ital Dermatol Minerva Dermatol. 1971 Dec;46(12):542-3.

[Therapeutic activity of rifomycin in herpes zoster]

[Article in Italian]

Finzi AF, Solaroli C, Sagramoso Sacchetti Z.

PMID: 5172215 [PubMed - indexed for MEDLINE]

9383: Rev Rhum Mal Osteoartic. 1971 Dec;38(12):797-806.

[Complications and sequelae of immunosuppressive therapy of rheumatoid arthritis]

[Article in French]

Deshayes P, Renier JC, Bregeon C, Houdent G.

PMID: 5170383 [PubMed - indexed for MEDLINE]

9384: Therapeutique. 1971 Dec;47(10):915-7.

[Zosterian facial paralysis]

[Article in French]

Thureau E.

PMID: 5145562 [PubMed - indexed for MEDLINE]

9385: Kinderarztl Prax. 1971 Dec;39(12):561-5.

[Varicella and corticosteroids]

[Article in German]

Heyne K.

PMID: 5140552 [PubMed - indexed for MEDLINE]

9386: Arch Dis Child. 1971 Dec;46(250):886.

Herpes zoster serum in chicken-pox contacts with depressed immunological
responses.

Caunt AE, Hall EG, Mainwaring D.

PMID: 5129214 [PubMed - indexed for MEDLINE]

9387: Postgrad Med. 1971 Dec;50(6):153-7.

Herpes Zoster in the elderly.

Rogers RS 3rd, Tindall JP.

PMID: 5128036 [PubMed - indexed for MEDLINE]

9388: Biken J. 1971 Dec;14(4):425-30.

Comparative ultrastructural studies on the cores of herpes simplex and
varicella-zoster viruses.

Nii S.

PMID: 4338220 [PubMed - indexed for MEDLINE]

9389: Br Med J. 1971 Nov 20;4(5785):491-2.

Aetiology of Bell's palsy.

Korczyn AD.

PMID: 5125299 [PubMed - indexed for MEDLINE]

9390: Br Med J. 1971 Nov 20;4(5785):442-3.

Neurology of the leukaemias and lymphomas.

[No authors listed]

PMID: 5125274 [PubMed - indexed for MEDLINE]

9391: Br J Ophthalmol. 1971 Nov;55(11):761-5.

Herpes zoster ophthalmicus with trochlear nerve involvement after alcohol
injection into the Gasserian ganglion.

Boucherat RJ.

PMID: 5316102 [PubMed - indexed for MEDLINE]

9392: Am J Ophthalmol. 1971 Nov;72(5):998-1011.

Pathogenesis of occlusion of the central retinal vessels.

Hayreh SS.

PMID: 5315812 [PubMed - indexed for MEDLINE]

9393: Trans Am Acad Ophthalmol Otolaryngol. 1971 Nov-Dec;75(6):1284-301.

Facial paralysis in 403 consecutive patients: emphasis on treatment response in
patients with Bell's palsy.

Adour KK, Swanson PJ Jr.

PMID: 5153092 [PubMed - indexed for MEDLINE]

9394: Arch Dermatol. 1971 Nov;104(5):562.

Systemic lupus erythematosus, miliary tuberculosis, and bilateral herpes zoster
occurring in a Chinese woman.

Lewis RJ, Mitchell JC.

PMID: 5120186 [PubMed - indexed for MEDLINE]

9395: Oral Surg Oral Med Oral Pathol. 1971 Nov;32(5):752-9.

Viral infections of the skin and mouth: a selected review.

Muller SA.

Publication Types: 
    Review

PMID: 4329250 [PubMed - indexed for MEDLINE]

9396: Med J Aust. 1971 Oct 16;2(16):796-8.

Cytotoxic therapy in rheumatoid disease.

Thorpe P, Hassal J, York J.

Publication Types: 
    Clinical Trial

PMID: 4940712 [PubMed - indexed for MEDLINE]

9397: Z Haut Geschlechtskr. 1971 Oct 15;46(20):755-60.

[New methods in the treatment of viral skin diseases]

[Article in German]

Soltz-Szots J.

PMID: 4329920 [PubMed - indexed for MEDLINE]

9398: Munch Med Wochenschr. 1971 Oct 8;113(41):1338-45.

[Atypical poliovirus infections]

[Article in German]

Pohle HD, Museteanu C, Grutzner L.

PMID: 4331306 [PubMed - indexed for MEDLINE]

9399: Br Med J. 1971 Oct 2;4(5778):2-3.

Aetiology of Bell's palsy.

[No authors listed]

PMID: 4328920 [PubMed - indexed for MEDLINE]

9400: Nippon Ganka Kiyo. 1971 Oct;22(10):922-5.

[Non-framin used diseases of the ophthalmological field]

[Article in Japanese]

Matsuda K, Azumi K, Nakamura Y.

PMID: 5316939 [PubMed - indexed for MEDLINE]

9401: Jibiinkoka. 1971 Oct;43(10):779-87.

[Hunt's syndrome--etiology and treatment]

[Article in Japanese]

Minowada H.

PMID: 5169973 [PubMed - indexed for MEDLINE]

9402: Jibiinkoka. 1971 Oct;43(10):737-45.

[Disorders of the facial nerve and localization of the lesion]

[Article in Japanese]

Kumagami H, Watanabe I.

PMID: 5169968 [PubMed - indexed for MEDLINE]

9403: Indian J Dermatol. 1971 Oct;17(1):9-12.

Post herpetic neuralgia and facial palsy treated with prednisolone.

Sehgal VN, Rege VL, Vadiraj SN, Borker PS.

PMID: 5142130 [PubMed - indexed for MEDLINE]

9404: Z Haut Geschlechtskr. 1971 Oct;46(19):538-44.

[Cutaneous paraneoplastic syndromes]

[Article in German]

Herzberg JJ.

PMID: 5137238 [PubMed - indexed for MEDLINE]

9405: Cesk Dermatol. 1971 Oct;46(5):192-5.

[Drop infusion as a method for local drug administration]

[Article in Czech]

Holan V.

PMID: 5121701 [PubMed - indexed for MEDLINE]

9406: Int J Dermatol. 1971 Oct-Dec;10(4):227-32.

Neurocutaneous herpes simplex.

Selmanowitz VJ.

Publication Types: 
    Review

PMID: 4331379 [PubMed - indexed for MEDLINE]

9407: Lancet. 1971 Sep 25;2(7726):712.

Cytosine arabinoside and herpes zoster.

Foerster J, Hryniuk W.

PMID: 4105748 [PubMed - indexed for MEDLINE]

9408: Nat New Biol. 1971 Sep 22;233(38):115.

Inhibition of leucocyte migration by corneal antigen in chronic viral keratitis.

Henley WL, Shore B, Leopold IH.

PMID: 5315327 [PubMed - indexed for MEDLINE]

9409: N Engl J Med. 1971 Sep 9;285(11):637.

5-HIAA and HVA in spinal fluid and herpes zoster oticus.

Johansson B, Roos BE.

PMID: 5563972 [PubMed - indexed for MEDLINE]

9410: Am J Ophthalmol. 1971 Sep;72(3):555-7.

Occurrence of herpes zoster ophthalmicus in a child with absent immunoglobulin A 
and deficiency of delayed hypersensitivity.

Kielar RA, Cunningham GC, Gerson KL.

PMID: 5315092 [PubMed - indexed for MEDLINE]

9411: Med Ann Dist Columbia. 1971 Sep;40(9):573-6.

Disseminated herpes zoster: treatment with cytosine arabinoside.

Neilan BA, Schechter GP.

PMID: 5286391 [PubMed - indexed for MEDLINE]

9412: Masui. 1971 Sep;20(10):903-5.

[Nerve block therapy in the treatment of herpes zoster]

[Article in Japanese]

Tamesa T, Wakasugi B, Yuda Y, Takahashi A, Hanaki C.

PMID: 5166778 [PubMed - indexed for MEDLINE]

9413: Med Times. 1971 Sep;99(9):29 passim.

What's your diagnosis?

Owen LG.

PMID: 5110376 [PubMed - indexed for MEDLINE]

9414: Policlinico [Prat]. 1971 Sep 1;78(17):724-31.

[Skin manifestations of visceral neoplasms]

[Article in Italian]

Stocchi F.

PMID: 5098509 [PubMed - indexed for MEDLINE]

9415: Saishin Igaku. 1971 Sep;26(29):1716-20.

[Pulmonary findings in viral infections]

[Article in Japanese]

Kaji M.

Publication Types: 
    Review

PMID: 4330707 [PubMed - indexed for MEDLINE]

9416: Rev Med Liege. 1971 Sep;26(17):589-91.

[Latent viral infections]

[Article in French]

Regnister M.

PMID: 4329411 [PubMed - indexed for MEDLINE]

9417: Cesk Dermatol. 1971 Sep;46(4):161-5.

[Gamma globulin in the treatment of some dermatoses]

[Article in Czech]

Rozsivalova V, Dlabalova H.

PMID: 4107521 [PubMed - indexed for MEDLINE]

9418: Lancet. 1971 Aug 14;2(7720):374-5.

Cytosine arabinoside and herpes zoster.

Juel-Jensen BE.

Publication Types: 
    Clinical Trial

PMID: 4105070 [PubMed - indexed for MEDLINE]

9419: Hautarzt. 1971 Aug;22(8):333-5.

[Immunoglobin changes in herpes zoster]

[Article in German]

Reichel W, Bosse K.

PMID: 5566687 [PubMed - indexed for MEDLINE]

9420: Br J Prev Soc Med. 1971 Aug;25(3):147-51.

Expected and observed values for the prescription of vitamin B 12 in England and 
Wales.

Cochrane AL, Moore F.

PMID: 5564956 [PubMed - indexed for MEDLINE]

9421: Calif Med. 1971 Aug;115(2):6-10.

Triamcinolone-procaine in the treatment of zoster and postzoster neuralgia.

Epstein E.

Twenty-four patients with herpes zoster were treated with injections of 2 percent
procaine hydrochloride containing 2 mg of triamcinolone per ml. The treatments
were given subcutaneously under the cutaneous lesions and in areas of pain. The
results were excellent in 22 patients. There was one failure-postzoster neuralgia
in an 82-year-old woman.Of 12 patients with postherpetic neuralgia, eight had
improvement of 70 to 90 percent and three had complete relief.There were no
significant complications in either group.

PMID: 5563819 [PubMed - indexed for MEDLINE]

9422: Physiotherapy. 1971 Aug;57(8):374.

The use of ice-cube massage for the relief of chronic pain following herpes
ophthalmicus.

Marshall CM.

PMID: 5314989 [PubMed - indexed for MEDLINE]

9423: Oral Surg Oral Med Oral Pathol. 1971 Aug;32(2):221-34.

Herpes zoster of the oral and facial structures. Report of five cases and
discussion.

Nally FF, Ross IH.

PMID: 5284107 [PubMed - indexed for MEDLINE]

9424: N Engl J Med. 1971 Jul 29;285(5):294.

Zoster-like disease in infants and young children.

Mok CH.

PMID: 4326260 [PubMed - indexed for MEDLINE]

9425: Lancet. 1971 Jul 17;2(7716):166.

Cytosine arabinoside and herpes zoster.

Mann JR.

PMID: 4104494 [PubMed - indexed for MEDLINE]

9426: Vnitr Lek. 1971 Jul;17(7):652-9.

[Relation of herpes zoster to chronic inflammatory rheumatic diseases and to
collagenoses]

[Article in Czech]

Vachtenheim J.

PMID: 5564643 [PubMed - indexed for MEDLINE]

9427: Neurochirurgia (Stuttg). 1971 Jul;14(4):127-33.

[Results and complications of surgery for trigeminal neuralgia]

[Article in German]

Grunert V, Pendl G, Sunder-Plassmann M.

PMID: 5562108 [PubMed - indexed for MEDLINE]

9428: Tandlaegebladet. 1971 Jul;75(7):567-75.

[A case of zoster otticus and zoster mandibularis]

[Article in Danish]

Bessermann-Nielsen M.

PMID: 5286316 [PubMed - indexed for MEDLINE]

9429: J Am Osteopath Assoc. 1971 Jul;70(11):1196-8.

Herpes simplex: diagnosis and management.

Ulbrich AP.

PMID: 5207190 [PubMed - indexed for MEDLINE]

9430: Klin Med (Mosk). 1971 Jul;49(7):130-1.

[Lichen circumscriptus in myocardial infarct]

[Article in Russian]

Misevichus IR, Stanaitite NI.

Publication Types: 
    Case Reports

PMID: 5151419 [PubMed - indexed for MEDLINE]

9431: G Mal Infett Parassit. 1971 Jul;23(7):618-49.

[Herpes zoster]

[Article in Italian]

Bartolozzi G, Bernini G.

PMID: 5140781 [PubMed - indexed for MEDLINE]

9432: Cancer. 1971 Jul;28(1):170-4.

Systemic syndromes associated with neoplastic disease including cancer of the
colon.

Bartholomew LG, Schutt AJ.

PMID: 5110627 [PubMed - indexed for MEDLINE]

9433: Am J Ophthalmol. 1971 Jul;72(1):205-98.

The corneal graft: a multiple variable analysis of the penetrating keratoplasty.

Moore TE Jr, Aronson SB.

PMID: 4945363 [PubMed - indexed for MEDLINE]

9434: Acta Virol. 1971 Jul;15(4):293-300.

Antigenic relationship between varicella-herpes zoster and herpes simplex viruses
studied by the gel precipitation reaction.

Trlifajova J, Sourek J, Ryba M.

PMID: 4398080 [PubMed - indexed for MEDLINE]

9435: G Mal Infett Parassit. 1971 Jul;23(7):689-729.

[Eye diseases due to herpesvirus. (Herpesvirus hominis, varicella-zoster virus)]

[Article in Italian]

Frezzotti R, Guerra R.

PMID: 4334709 [PubMed - indexed for MEDLINE]

9436: Vestn Oftalmol. 1971 Jul-Aug;4:73-5.

[Therapeutic effect of interferonogen in herpetic keratitis]

[Article in Russian]

Tkacheva EI, Gvozdilova DA, Smorodintsev AA.

PMID: 4111285 [PubMed - indexed for MEDLINE]

9437: J Am Geriatr Soc. 1971 Jun;19(6):495-504.

Geriatric herpes zoster.

Rogers RS 3rd, Tindall JP.

PMID: 5094651 [PubMed - indexed for MEDLINE]

9438: Am J Dig Dis. 1971 Jun;16(6):535-9.

Herpes zoster and chronic active hepatitis.

Rosenfield AT, Schermer DR, Gospe JM, Hartley RA.

PMID: 5089543 [PubMed - indexed for MEDLINE]

9439: Invest Ophthalmol. 1971 Jun;10(6):408-14.

Florenal in treatment of herpesvirus and adenovirus eye diseases.

Maichuk YF.

Publication Types: 
    In Vitro

PMID: 4325306 [PubMed - indexed for MEDLINE]

9440: Dtsch Med Wochenschr. 1971 May 21;96(21):924-5.

[Zoster-neuralgia]

[Article in German]

Hirschmann J.

PMID: 5580387 [PubMed - indexed for MEDLINE]

9441: Arch Dermatol. 1971 May;103(5):513-4.

Local recurrence of generalized herpes zoster following x-irradiation.

Guss SB, Sober AJ, Rosenberg GL, Arndt KA.

PMID: 5580294 [PubMed - indexed for MEDLINE]

9442: Mo Med. 1971 May;68(5):314-6.

Oral histoplasmosis followed by herpes zoster. Case report.

Dawson RB, Boyle P, Joseph DJ.

Publication Types: 
    Case Reports

PMID: 5578301 [PubMed - indexed for MEDLINE]

9443: Arch Oftalmol B Aires. 1971 May-Jun;46(5):21-4.

[Ocular lesions in ophthalmic herpes. Physiopathological aspects]

[Article in Spanish]

Victoria V, Couto J, Cattani N.

PMID: 5316076 [PubMed - indexed for MEDLINE]

9444: Mt Sinai J Med. 1971 May-Jun;38(3):303-10.

Roentgen and pathological changes in the gastrointestinal tract in herpes zoster 
generalizata: a unique case and brief review.

Khilnani MT, Keller RJ.

Publication Types: 
    Case Reports

PMID: 5314215 [PubMed - indexed for MEDLINE]

9445: Hautarzt. 1971 May;22(5):204-6.

[Clinical aspects and nosogeny of concomitant facial paresis in ophthalmic
zoster]

[Article in German]

Bandmann HJ, Lukacs I.

PMID: 5314142 [PubMed - indexed for MEDLINE]

9446: Laryngoscope. 1971 May;81(5):620-35.

Indications for surgical decompression of the facial nerve.

Alford BR, Sessions RB, Weber SC.

PMID: 5157367 [PubMed - indexed for MEDLINE]

9447: Therapeutique. 1971 May;47(5):509-12.

[Physiopathology and treatment of flashing pains]

[Article in French]

Cambier J, Dehen H.

PMID: 4327347 [PubMed - indexed for MEDLINE]

9448: Lancet. 1971 May 1;1(7705):913.

Zoster and chickenpox.

Hesling G.

PMID: 4102057 [PubMed - indexed for MEDLINE]

9449: S Afr Med J. 1971 Apr 10;45(15):406-7.

Some ophthalmological aspects of headache.

MacGregor JM.

PMID: 5579348 [PubMed - indexed for MEDLINE]

9450: S Afr Med J. 1971 Apr 10;45(15):397-9.

Some diseases involving the eye and the skin.

Gordon W.

PMID: 4996205 [PubMed - indexed for MEDLINE]

9451: N Engl J Med. 1971 Apr 8;284(14):765-73.

Recurrent viral infection (reinfection).

Chang TW.

Publication Types: 
    Review

PMID: 4323312 [PubMed - indexed for MEDLINE]

9452: Lancet. 1971 Apr 3;1(7701):690.

Understanding zoster.

[No authors listed]

PMID: 4101624 [PubMed - indexed for MEDLINE]

9453: Bord Med. 1971 Apr;4(4):1021-30.

[Diagnostic problems in infectious complications of Hodgkin's disease]

[Article in French]

Hoerni B, Aubertin J, Simon G, Chauvergne J.

PMID: 5562239 [PubMed - indexed for MEDLINE]

9454: Klin Monatsbl Augenheilkd. 1971 Apr;158(4):517-26.

[Susceptibility of corneal herpes to treatment]

[Article in German]

Marquardt R, Roth HW.

Publication Types: 
    Comparative Study

PMID: 5314194 [PubMed - indexed for MEDLINE]

9455: Oral Surg Oral Med Oral Pathol. 1971 Apr;31(4):494-501.

Clinicopathologic observations in prodromal herpes zoster of the fifth cranial
nerve. Report of a case.

Hudson CD, Vickers RA.

Publication Types: 
    Case Reports

PMID: 5279023 [PubMed - indexed for MEDLINE]

9456: Ann Ophthalmol. 1971 Apr;3(4):355-7 passim.

Herpetic keratouveitis. Clinical experiences.

Sugar HS.

PMID: 4950519 [PubMed - indexed for MEDLINE]

9457: Wis Med J. 1971 Apr;70(4):116-20.

Therapy of viral, mycoplasmal and rickettsial infections.

Rytel MW, Coonrod JD.

Publication Types: 
    Review

PMID: 4101370 [PubMed - indexed for MEDLINE]

9458: Med Interna (Bucur). 1971 Mar;23(3):341-56.

[Lymphadenopathies with "atypical" lymphomonocytosis]

[Article in Romanian]

Ciobanu V, Zalaru MC, Suteanu S, Popescu M, Pambuccian G, Barbu A, Bistreanu I.

PMID: 5574931 [PubMed - indexed for MEDLINE]

9459: Stomatologia (Bucur). 1971 Mar-Apr;18(2):113-8.

[Herpes zoster and its oral manifestations]

[Article in Romanian]

Popa E, Marcu N, Gergel L, Urtila E.

Publication Types: 
    Case Reports

PMID: 5280542 [PubMed - indexed for MEDLINE]

9460: Acta Virol. 1971 Mar;15(2):171-3.

Varicella-zoster virus cultivation in cell cultures of non-primate origin.

Sefcovicova L.

PMID: 4396416 [PubMed - indexed for MEDLINE]

9461: J Invest Dermatol. 1971 Mar;56(3):193-9.

Experimental zoster-like herpes simplex in hairless mice.

Constantine VS, Francis RD, Mason BH.

PMID: 4326622 [PubMed - indexed for MEDLINE]

9462: Cesk Oftalmol. 1971 Mar;27(2):122-5.

[Ocular herpes zoster. A review]

[Article in Czech]

Vesely L.

Publication Types: 
    Review

PMID: 4324845 [PubMed - indexed for MEDLINE]

9463: Proc R Soc Med. 1971 Feb;64(2):119-24.

A Regional Radiotherapy Centre: its development, scope and limitations.

Rhys-Lewis RD.

PMID: 5548920 [PubMed - indexed for MEDLINE]

9464: Internist (Berl). 1971 Feb;12(2):66-7.

[Differential diagnosis of the "heart attack", with special emphasis on the
stenocardial syndrome]

[Article in German]

Budelmann G.

PMID: 4926814 [PubMed - indexed for MEDLINE]

9465: Arch Ophtalmol Rev Gen Ophtalmol. 1971 Feb;31(2):109-18.

[Ophthalmic zona: isolation of a viral strain from the aqueous humor]

[Article in French]

Denis-Lassalle J, Clay C, Gherardi-Bakalova M, Offret G.

Publication Types: 
    Case Reports

PMID: 4324326 [PubMed - indexed for MEDLINE]

9466: N Engl J Med. 1971 Jan 7;284(1):24-6.

Zoster-like disease in the newborn due to herpes-simplex virus.

Music SI, Fine EM, Togo Y.

PMID: 4321028 [PubMed - indexed for MEDLINE]

9467: Life Sci Space Res. 1971;9:1-9.

Immune states in long-term space flights.

Ginsberg HS.

Department of Microbiology, School of Medicine, University of Pennsylvania,
Philadelphia, Penn., USA.

Maintenance of health, as contrasted to illness induced by infectious agents,
reflects a tenuous balance between the host's resistance and the number and
genetic characteristics of the infectious organisms present. Nature has evolved
both nonspecific defense mechanisms and specific immune systems to protect the
body against invasion by exogenous organisms or the numerous agents which may
reside dormant within the host. Long-term space flights with their accompanying
prolonged weightlessness, unaccustomed environmental factors, emotional
disturbances, and unforeseen influences may alter the host's natural or specific 
immune states. The non-specific and specific host defenses will be discussed, and
the particular effects which their alteration might have on provocation of latent
viral infections will be considered. Viruses which classically may be induced to 
cause recurrent infections such as herpes simplex and herpes zoster will be
described, but in addition the effect that altered host defenses might have on
slow virus infections such as kuru and virus-induced malignancies will be
emphasized.

PMID: 12206176 [PubMed - indexed for MEDLINE]

9468: Sov Med. 1971 Jan;34(1):151-2.

[Treatment of herpes simplex and herpes zoster by chlorophyll preparations]

[Article in Russian]

Belen'kii GB, Krikun BL.

PMID: 5580231 [PubMed - indexed for MEDLINE]

9469: Rev Neurol (Paris). 1971 Jan;124(1):76-9.

[Radiodermatitis after treatment of neurologic diseases]

[Article in French]

Dufourmentel C, Mouly R.

PMID: 5563583 [PubMed - indexed for MEDLINE]

9470: Vestn Oftalmol. 1971;2:52-4.

[Use of leukocytic interferon in combination with herpetic polyvaccine in
herpetic keratitis]

[Article in Russian]

Abadzhian GA, Maevskaia TM.

PMID: 5314361 [PubMed - indexed for MEDLINE]

9471: Vestn Oftalmol. 1971;2:48-51.

[Comparative evaluation of the therapeutic effectiveness of interferon
preparations in herpetic keratitis]

[Article in Russian]

Abadzhian GA, Balezina TI, Korabel'nikova NI, Fadeeva LL.

Publication Types: 
    Comparative Study

PMID: 5314360 [PubMed - indexed for MEDLINE]

9472: Nippon Koku Geka Gakkai Zasshi. 1971;17(6):505-8.

[Clinical study on oral mucosal disease (VII). Case report of herpes zoster in
the area of the third division of trigeminal nerve]

[Article in Japanese]

Matsuda N, Kato J, Okubo S.

PMID: 5292856 [PubMed - indexed for MEDLINE]

9473: Arch Ital Sci Med Trop Parassitol. 1971 Jan-Jun;52(1):51-8.

[Clinical case of hyperthyroidism complicating the course of herpes zoster]

[Article in Italian]

De Carlo M, Ricciuti M.

PMID: 5172546 [PubMed - indexed for MEDLINE]

9474: Trans Pa Acad Ophthalmol Otolaryngol. 1971 Fall;24(2):116-20.

Symposium: the pediatric concern of ophthalmology and otolaryngology. Pediatrics.

Smith DS.

PMID: 5134065 [PubMed - indexed for MEDLINE]

9475: Annee Ther Clin Ophtalmol. 1971;22:177-85.

[Superficial herpetic keratitis]

[Article in French]

Francois P.

PMID: 4950318 [PubMed - indexed for MEDLINE]

9476: Verh Dtsch Ges Inn Med. 1971;77:850-6.

[Recent aspects of antiviral therapy]

[Article in German]

Wacker A.

Publication Types: 
    Review

PMID: 4949706 [PubMed - indexed for MEDLINE]

9477: Brain. 1971;94(2):307-20.

Neurological syndromes in the reticuloses.

Currie S, Henson RA.

PMID: 4936866 [PubMed - indexed for MEDLINE]

9478: Scand J Infect Dis. 1971;3(3):183-7.

Studies on the specificity of the complement fixation test in cytomegalovirus
infections. With special reference to possible cross-reactions with other
herpesvirus antigens.

Andersen HK, Godtfredsen A, Spencer ES.

PMID: 4331836 [PubMed - indexed for MEDLINE]

9479: Arch Gesamte Virusforsch. 1971;33(3):288-95.

Antigenic relationship between human cytomegalovirus, herpes simplex, and
varicella-zoster virus studied by complement-fixation.

Krech U, Jung M.

PMID: 4329637 [PubMed - indexed for MEDLINE]

9480: Acta Pathol Microbiol Scand [B] Microbiol Immunol. 1971;79(3):440.

Immunodiffusion tests for antibodies to herpes simplex (H.S.), varicella zoster
(V.-Z.) and cytomegaloviruses (CMV).

Grandien M, Christensson B, Espmark A.

PMID: 4327011 [PubMed - indexed for MEDLINE]

9481: Postgrad Med. 1971 Jan;49(1):87-92.

Oral reflections of infectious diseaes. 1.

Shklar G.

PMID: 4321922 [PubMed - indexed for MEDLINE]

9482: Arch Dermatol. 1971 Jan;103(1):45-9.

Further electron microscopic observations of herpes zoster virus.

Hasegawa T.

PMID: 4321802 [PubMed - indexed for MEDLINE]

9483: Oftalmol Zh. 1971;26(1):29-32.

[Comparative effectiveness of gamma-globulin, deoxyribonuclease and kerecid in
herpetic keratitis]

[Article in Russian]

Zagaigora EP.

Publication Types: 
    Comparative Study

PMID: 4105822 [PubMed - indexed for MEDLINE]

9484: Zh Mikrobiol Epidemiol Immunobiol. 1971;48(6):126-31.

[Human immunoglobulins and their role in infectious pathology (review)]

[Article in Russian]

Stefani DV.

Publication Types: 
    Review

PMID: 4105768 [PubMed - indexed for MEDLINE]

9485: Br Med J. 1970 Dec 26;4(5738):776-80.

Treatment of zoster with idoxuridine in dimethyl sulphoxide. Results of two
double-blind controlled trials.

Juel-Jensen BE, MacCallum FO, Mackenzie AM, Pike MC.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 4925077 [PubMed - indexed for MEDLINE]

9486: Dtsch Med Wochenschr. 1970 Dec 4;95(49):2500.

[Herpes zoster in old age]

[Article in German]

Hirschmann J.

PMID: 5486571 [PubMed - indexed for MEDLINE]

9487: J R Coll Gen Pract. 1970 Dec;20(101):323-7.

The natural history of shingles. Events associated with reactivation of
varicella-zoster virus.

Juel-Jensen BE.

PMID: 5533234 [PubMed - indexed for MEDLINE]

9488: Arch Otolaryngol. 1970 Dec;92(6):632-5.

Herpes zoster oticus.

Harner SG, Heiny BA, Newell RC.

PMID: 5486960 [PubMed - indexed for MEDLINE]

9489: Arch Dermatol. 1970 Dec;102(6):680-92.

Skin markers of malignancy.

Newbold PC.

Publication Types: 
    Review

PMID: 4251202 [PubMed - indexed for MEDLINE]

9490: Am J Ophthalmol. 1970 Dec;70(6):886-97.

The effect of structural alteration on anterior ocular inflammation.

Aronson SB, Moore TE Jr, O'Day DM.

PMID: 4099190 [PubMed - indexed for MEDLINE]

9491: N Engl J Med. 1970 Nov 26;283(22):1222-3.

Interferon and herpes zoster.

Ho M.

PMID: 4319628 [PubMed - indexed for MEDLINE]

9492: N Engl J Med. 1970 Nov 26;283(22):1182-7.

Cutaneous interferon production in patients with Hodgkin's disease and other
cancers infected with varicella or vaccinia.

Armstrong RW, Gurwith MJ, Waddell D, Merigan TC.

PMID: 4319626 [PubMed - indexed for MEDLINE]

9493: Wien Med Wochenschr. 1970 Nov 21;120(47):846-8.

[Indication for Sjoqvist's tractotomy and its results]

[Article in German]

Grunert V, Sunder-Plassmann M, Pendl G.

PMID: 5481430 [PubMed - indexed for MEDLINE]

9494: Lancet. 1970 Nov 21;2(7682):1065-6.

Zoster sine herpete causing acute trigeminal neuralgia.

Easton HG.

Publication Types: 
    Case Reports

PMID: 4098355 [PubMed - indexed for MEDLINE]

9495: Minerva Otorinolaringol. 1970 Nov-Dec;20(6):236-7.

[Herpes zoster of the ear]

[Article in French]

Papathanassopoulos AM.

PMID: 5514484 [PubMed - indexed for MEDLINE]

9496: J Med Soc N J. 1970 Nov;67(11):729-30.

Herpes zoster ophthalmicus. With ipsilateral parotitis; coincidence or
association?

Marshall FA.

PMID: 5312154 [PubMed - indexed for MEDLINE]

9497: Klin Monatsbl Augenheilkd. 1970 Nov;157(5):593-604.

[The cryoextraction of cataract and its influence on cryo-ophthalmology]

[Article in German]

Krwawicz T.

Publication Types: 
    Historical Article

PMID: 4924123 [PubMed - indexed for MEDLINE]

9498: Postgrad Med J. 1970 Nov;46(541):653-8.

Zoster, a recrudescence of VZ virus infection.

Blank H, Eaglstein WH, Goldfaden GL.

Publication Types: 
    Review

PMID: 4321947 [PubMed - indexed for MEDLINE]

9499: Lakartidningen. 1970 Oct 21;67(43):4993-5.

[Headache (8): ophthalmologic point of view]

[Article in Swedish]

Wulfing B.

PMID: 5312262 [PubMed - indexed for MEDLINE]

9500: Br Med J. 1970 Oct 10;4(5727):117.

Dentistry, herpes zoster, and varicella.

Easton HG.

PMID: 5471761 [PubMed - indexed for MEDLINE]

9501: Hinyokika Kiyo. 1970 Oct;16(10):574-85.

[Herpes zoster causing bladder atony]

[Article in Japanese]

Yachiku S, Nagata H, Kashiwai K.

PMID: 5529393 [PubMed - indexed for MEDLINE]

9502: Masui. 1970 Oct;19(11):1205-12.

[Indication of effects of treatment at the pain clinic--with special reference to
chest pain]

[Article in Japanese]

Hyodo M.

PMID: 5528943 [PubMed - indexed for MEDLINE]

9503: Arch Belg Dermatol Syphiligr. 1970 Oct-Dec;26(4):579-80.

[Auricular zona]

[Article in French]

Morimont M, Morimont P.

PMID: 5512156 [PubMed - indexed for MEDLINE]

9504: J Infect Dis. 1970 Oct;122(4):335-8.

Herpes-zoster meningoencephalitis.

Norris FH Jr, Leonards R, Calanchini PR, Calder CD.

PMID: 5504713 [PubMed - indexed for MEDLINE]

9505: J Assoc Physicians India. 1970 Oct;18(10):853-4.

Lower extremity paralysis complicating herpes zoster.

Lal S, Lebbai MS.

PMID: 5503061 [PubMed - indexed for MEDLINE]

9506: Am J Med. 1970 Oct;49(4):480-3.

Zoster, reinfection or activation of latent virus? Observations on the antibody
response.

Miller LH, Brunell PA.

PMID: 4320119 [PubMed - indexed for MEDLINE]

9507: Hautarzt. 1970 Oct;21(10):437-43.

[Dermatological news from America. I]

[Article in German]

Hollander A.

Publication Types: 
    Review

PMID: 4254917 [PubMed - indexed for MEDLINE]

9508: Br Med J. 1970 Sep 5;3(5722):587.

Paralysis in herpes zoster.

Anderson JP.

Publication Types: 
    Case Reports

PMID: 5454365 [PubMed - indexed for MEDLINE]

9509: Sist Nerv. 1970 Sep-Oct;22(5):298-302.

[Clinical evaluation of the use of G-32883 in trigeminal neuralgia]

[Article in Italian]

Gentili E.

PMID: 5514248 [PubMed - indexed for MEDLINE]

9510: J Urol. 1970 Sep;104(3):422-5.

Urinary retention associated with herpes zoster.

Ray B, Wise GJ.

PMID: 5459977 [PubMed - indexed for MEDLINE]

9511: J Tenn Med Assoc. 1970 Sep;63(9):758-64.

Immunological competence and infectious disease.

[No authors listed]

PMID: 5456563 [PubMed - indexed for MEDLINE]

9512: Mod Treat. 1970 Sep;7(5):973-98.

Cutaneous inflammations of the male genitalia.

Young AW Jr.

Publication Types: 
    Review

PMID: 4327026 [PubMed - indexed for MEDLINE]

9513: Appl Microbiol. 1970 Sep;20(3):497-504.

Experience with electron microscopy in the differential diagnosis of smallpox.

Long GW, Nobel J Jr, Murphy FA, Herrmann KL, Lourie B.

The usefulness of negative-contrast electron microscopy in the rapid differential
diagnosis of poxvirus and herpesvirus exanthems is described in this study of 301
specimens from patients with vesicular exanthematous diseases. Specimens from
patients with smallpox, various forms of vaccination complications, varicella,
zoster (shingles), and herpes simplex are included in this evaluation. Electron
microscopy, when applied to the study of lesion material, was found to be more
sensitive than the classical techniques of virus isolation in the diagnosis of
both poxvirus and herpes/varicella virus infections. However, since specific
identification of a virus within a group cannot be made morphologically by
electron microscopy, it is recommended that both electron microscopy and virus
isolation methods be employed for the routine differential diagnosis of vesicular
exanthematous diseases in the reference diagnostic laboratory.

PMID: 4322005 [PubMed - indexed for MEDLINE]

9514: Nippon Ganka Gakkai Zasshi. 1970 Sep;74(9):1293-300.

[On the significance of local immunoglobulin and antibody production of anterior 
chamber tissues]

[Article in Japanese]

Miyanaga Y, Yoshida K.

PMID: 4097355 [PubMed - indexed for MEDLINE]

9515: Br Med J. 1970 Aug 15;3(5719):407.

Dentistry, herpes zoster, and varicella.

Eggleston D, Nally F.

Publication Types: 
    Case Reports

PMID: 5451602 [PubMed - indexed for MEDLINE]

9516: Naika. 1970 Aug;26(2):340-8.

[Clinical statistics on leukemia with herpes zoster]

[Article in Japanese]

Takahashi I, Ishizaki M, Saito K, Nagao T, Kinoshita H.

PMID: 5449757 [PubMed - indexed for MEDLINE]

9517: Nippon Ganka Gakkai Zasshi. 1970 Aug;74(8):645-50.

[Immunofluorescence study of herpes zoster keratitis]

[Article in Japanese]

Oshima M.

PMID: 4917514 [PubMed - indexed for MEDLINE]

9518: Br Med J. 1970 Aug 1;3(5717):251-4.

Clinically evident, non-terminal infections with herpesviruses and the wart virus
in immunosuppressed renal allograft recipients.

Spencer ES, Andersen HK.

PMID: 4317670 [PubMed - indexed for MEDLINE]

9519: Br Med J. 1970 Jul 25;3(5716):222.

Dentistry, herpes zoster, and varicella.

West RJ.

PMID: 5448789 [PubMed - indexed for MEDLINE]

9520: Munch Med Wochenschr. 1970 Jul 17;29:1367-70.

[Dexamonosone as a rheuma therapeutic agent]

[Article in German]

Schopen RD.

PMID: 5468380 [PubMed - indexed for MEDLINE]

9521: Indian J Dermatol. 1970 Jul;15(4):105-6.

Facial paralysis complicating herpes zoster.

Lal S, Sawhney KL, Arunthathi S.

PMID: 5482743 [PubMed - indexed for MEDLINE]

9522: Bull Soc Fr Dermatol Syphiligr. 1970 Jul;77(1):130-3.

[Frequency of motor and neurotrophic complications of zona of the limbs]

[Article in French]

Bureau Y, Barriere H, Litoux P, Bureau B.

PMID: 5430028 [PubMed - indexed for MEDLINE]

9523: Arzneimittelforschung. 1970 Jul;20(7):930-1.

[Treatment of chronic pain syndromes. Analgesic effect of a neuroleptic]

[Article in German]

Lutzenkirchen H, Mertens HG.

PMID: 4248468 [PubMed - indexed for MEDLINE]

9524: Ann Ottalmol Clin Ocul. 1970 Jun;96(6):291-6.

[Ophthalmic herpes zoster with total ophthalmoplegia, retrobulbar neuritis and
Argyll-Robertson. Clinical contribution]

[Article in Italian]

Perotti S, Manfredini U.

PMID: 5314996 [PubMed - indexed for MEDLINE]

9525: Practitioner. 1970 Jun;204(224):838-42.

A survey of the use of vitamin B12 in general practice.

Ellis FR, Nasser S, Wrighton RJ.

PMID: 5271299 [PubMed - indexed for MEDLINE]

9526: Biken J. 1970 Jun;13(2):133-43.

Studies of herpes zoster virus in vitro. II. An autoradiographic study of
intranuclear inclusions.

Nii S, Maeda Y.

PMID: 4319270 [PubMed - indexed for MEDLINE]

9527: Dev Med Child Neurol. 1970 Jun;12(3):378-9.

Varicella-Zoster encephalomyelitis.

Librach IM.

PMID: 4317445 [PubMed - indexed for MEDLINE]

9528: Br Med J. 1970 May 16;2(5706):379.

Paralysis in herpes zoster.

[No authors listed]

PMID: 5420601 [PubMed - indexed for MEDLINE]

9529: Appl Microbiol. 1970 May;19(5):872-4.

Fungal disfigurement of paper, and soft rot of cedar shingles.

Eveleigh DE.

Disfiguration of paper by Cladosporium cladosporioides is described, and the
association between "soft rot" fungi and the greying of cedar shingles in marine 
locations is reported.

PMID: 5463581 [PubMed - indexed for MEDLINE]

9530: Am Rev Respir Dis. 1970 May;101(5):755-8.

Diaphragmatic paralysis caused by herpes zoster.

Dutt AK.

PMID: 5444742 [PubMed - indexed for MEDLINE]

9531: Paraplegia. 1970 May;8(1):14-8.

Intramedullary spinal cord metastasis from mammary carcinoma.

Mastaglia FL, Kakulas BA.

PMID: 5423699 [PubMed - indexed for MEDLINE]

9532: Przegl Dermatol. 1970 May-Jun;57(3):345-9.

[Diadynamic currents in the treatment of some skin diseases]

[Article in Polish]

Bowszyc J, Brozozowski J.

PMID: 5310966 [PubMed - indexed for MEDLINE]

9533: Dent J Malaysia Singapore. 1970 May;10(1):39-43.

Herpes Zoster.

Lee HT, Soon SK.

PMID: 5271013 [PubMed - indexed for MEDLINE]

9534: Nurs Mirror Midwives J. 1970 May 1;130(18):17.

Herpes zoster.

Parry WH.

PMID: 5199816 [PubMed - indexed for MEDLINE]

9535: Rinsho Byori. 1970 May;18(5):379-82.

[Serodiagnosis of herpes zoster and varicella by immunofluorescence;
determination of antibody titer]

[Article in Japanese]

Shigeta S, Goto S, Koriyama H, Ishitoya Y, Kumasaka T.

Publication Types: 
    Comparative Study

PMID: 4916050 [PubMed - indexed for MEDLINE]

9536: Arch Ophthalmol. 1970 May;83(5):637-57.

Cornea and sclera.

Laibson PR.

Publication Types: 
    Review

PMID: 4315586 [PubMed - indexed for MEDLINE]

9537: Wiad Lek. 1970 May 1;23(9):769-71.

[Generalized zoster in lymphatic leukemia]

[Article in Polish]

Lemanczyk M, Kaminska E.

Publication Types: 
    Case Reports

PMID: 4195445 [PubMed - indexed for MEDLINE]

9538: JAMA. 1970 Apr 13;212(2):322.

Herpes zoster with motor involvement.

Greenberg J.

PMID: 5467243 [PubMed - indexed for MEDLINE]

9539: Rev Med Liege. 1970 Apr 1;25(7):231-3.

[Zona and postzona pain]

[Article in French]

Lapiere CH.

PMID: 5446801 [PubMed - indexed for MEDLINE]

9540: Cesk Dermatol. 1970 Apr;45(2):70-3.

[Paraneoplastic dermatoses]

[Article in Czech]

Jilek M.

PMID: 5445711 [PubMed - indexed for MEDLINE]

9541: Ann Ocul (Paris). 1970 Apr;203(4):371-8.

[The use of DNAase in the treatment of herpetic ocular diseases]

[Article in French]

Colain AA, Salganik RI, Mikhailovskaya IE, Gorban IM.

PMID: 5310478 [PubMed - indexed for MEDLINE]

9542: Med Ann Dist Columbia. 1970 Apr;39(4):195-7.

Herpes zoster in children.

Saracli T, Scott RB.

PMID: 5270303 [PubMed - indexed for MEDLINE]

9543: Arch Ophtalmol Rev Gen Ophtalmol. 1970 Apr;30(4):337-55.

[Infectious pathology. II. Viral pathology]

[Article in French]

Verin P.

Publication Types: 
    Review

PMID: 4317303 [PubMed - indexed for MEDLINE]

9544: Practitioner. 1970 Apr;204(222):523-8.

Facial paralysis.

Kendall D.

PMID: 4315340 [PubMed - indexed for MEDLINE]

9545: JAMA. 1970 Mar 16;211(11):1831-3.

Hospital-acquired herpes zoster following exposure to chickenpox.

Berlin BS, Campbell T.

PMID: 4313291 [PubMed - indexed for MEDLINE]

9546: Z Haut Geschlechtskr. 1970 Mar 15;45(6):Suppl:29-36.

[Virus diseases of the external female genitalia. 2. Zoster (Gurtelrose, zona,
shingles)]

[Article in German]

Grimmer H.

PMID: 5513210 [PubMed - indexed for MEDLINE]

9547: Lancet. 1970 Mar 14;1(7646):572.

Varicella and cytosine arabinoside.

Juel-Jensen BE.

PMID: 4190397 [PubMed - indexed for MEDLINE]

9548: JAMA. 1970 Mar 9;211(10):1681-3.

The effects of early corticosteroid therapy on the skin eruption and pain of
herpes zoster.

Eaglstein WH, Katz R, Brown JA.

Publication Types: 
    Clinical Trial
    Randomized Controlled Trial

PMID: 4905733 [PubMed - indexed for MEDLINE]

9549: Sem Hop. 1970 Mar 8;46(12):791-813.

["Cancer-chronic lymphoid leukemia" association. 27 cases extracted from a series
of 365 cases of chronic lymphoid leukemia and review of the literature]

[Article in French]

Coeur P, Morel P, Gentilhomme O.

PMID: 4315229 [PubMed - indexed for MEDLINE]

9550: Z Haut Geschlechtskr. 1970 Mar 1;45(5):23-8 passim.

[Virus diseases of the external female genitalia. 1. Herpes (simplex) genitalis
(herpes progenitalis, herpes venereus, vulvitis or vulvovaginitis herpetica)]

[Article in German]

Grimmer H.

PMID: 5420457 [PubMed - indexed for MEDLINE]

9551: Klin Monatsbl Augenheilkd. 1970 Mar;156(3):405-9.

[Zoster ophthalmicus in hematological diseases]

[Article in German]

Eichholtz W.

PMID: 5314282 [PubMed - indexed for MEDLINE]

9552: Klin Monatsbl Augenheilkd. 1970 Mar;156(3):305-17.

[Zoster and the eye]

[Article in German]

Nover A.

PMID: 5314281 [PubMed - indexed for MEDLINE]

9553: Proc Soc Exp Biol Med. 1970 Mar;133(3):750-3.

Persistence of phosphoglucomutase (PGM) polymorphism in long-term lymphoid lines.

Conover JH, Hathaway P, Glade PR, Hirschhorn K.

PMID: 5265246 [PubMed - indexed for MEDLINE]

9554: Arch Maragliano Patol Clin. 1970 Mar-Apr;26(2):127-37.

[On a reticulosarcomatosis with positive Paul-Bunnell-Davidsohn seroreaction]

[Article in Italian]

Arcuri F, Robert L.

PMID: 4930287 [PubMed - indexed for MEDLINE]

9555: Naika. 1970 Mar;25(3):421-6.

[Zoster encephalitis]

[Article in Japanese]

Takahashi A.

Publication Types: 
    Review

PMID: 4910672 [PubMed - indexed for MEDLINE]

9556: Thromb Diath Haemorrh. 1970 Feb 28;23(1):159-69.

Second phase platelet aggregation induced by adenosine diphosphate in patients
with cerebral vascular disease and in control subjects.

Danta G.

PMID: 5420427 [PubMed - indexed for MEDLINE]

9557: Br Med J. 1970 Feb 14;1(5693):382-3.

Paralysed hemidiaphragm and shingles.

[No authors listed]

PMID: 5434652 [PubMed - indexed for MEDLINE]

9558: Vestn Khir Im I I Grek. 1970 Feb;104(2):133-4.

[Herpes zoster simulating acute abdomen]

[Article in Russian]

Pomosov DV, Zhitniuk RI.

Publication Types: 
    Case Reports

PMID: 5429924 [PubMed - indexed for MEDLINE]

9559: Arch Dermatol. 1970 Feb;101(2):238-9.

Herpes zoster with ocular destruction.

Wallk S, McNeese J.

Publication Types: 
    Case Reports

PMID: 5308661 [PubMed - indexed for MEDLINE]

9560: Shinkei Kenkyu No Shimpo. 1970;14(3):443-8.

[Case of myasthenic syndrome developing in the course of herpes zoster
encephalomeningitis]

[Article in Japanese]

Hiyamuta E, Okudaira N, Kase M.

PMID: 5531592 [PubMed - indexed for MEDLINE]

9561: Folia Allergol (Roma). 1970 Jan-Feb;17(1):61-70.

[Autoantibodies in pemphigus and related diseases]

[Article in Italian]

Panconesi E, Bigazzi PL.

PMID: 5445778 [PubMed - indexed for MEDLINE]

9562: Zh Nevropatol Psikhiatr Im S S Korsakova. 1970;70(1):76-80.

[Changes in the bioelectric activity of the brain in typical trigeminal neuralgia
and facial sympathalgia]

[Article in Russian]

Erokhina LG, Puchinskaia LM.

PMID: 5425804 [PubMed - indexed for MEDLINE]

9563: Oftalmol Zh. 1970;25(5):351-4.

[Papain treatment of corneal diseases]

[Article in Russian]

Starkov GL, Saprykin ID, Savinykh VI.

PMID: 5312240 [PubMed - indexed for MEDLINE]

9564: Oftalmol Zh. 1970;25(2):138.

[Results of treatment of herpetic keratitis with kerecid at the regional
ophthalmologic dispensary]

[Article in Russian]

Zagaigora EP.

PMID: 5311909 [PubMed - indexed for MEDLINE]

9565: Klin Oczna. 1970;40(4):579-81.

[Abducens paresis as a complication of zoster ophthalmicus]

[Article in Polish]

Horodenski J, Ledzinska K.

PMID: 5311410 [PubMed - indexed for MEDLINE]

9566: Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove. 1970;13(2):119-23.

[Ganglionitis in herpes zoster]

[Article in German]

Nozicka Z, Vortel V.

PMID: 5275065 [PubMed - indexed for MEDLINE]

9567: Pathol Microbiol (Basel). 1970;36(5):279-80.

[Demonstrations from clinical bacteriology]

[Article in German]

Reber H.

PMID: 4935367 [PubMed - indexed for MEDLINE]

9568: Trans St Johns Hosp Dermatol Soc. 1970;56(2):117-21.

Treatment of rheumatoid arthritis with cytotoxic and antimetabolic drugs.

Currey HL.

Publication Types: 
    Clinical Trial
    Review

PMID: 4933579 [PubMed - indexed for MEDLINE]

9569: Mie Med J. 1970 Jan;19(3):189-92.

Lupus erythematosus and herpes zoster.

Hamaguchi T, Kotani Y, Imanaka S, Morito S, Kawamura Y.

Publication Types: 
    Historical Article

PMID: 4923873 [PubMed - indexed for MEDLINE]

9570: Gerontol Clin (Basel). 1970;12(5):283-7.

Diaphragmatic paralysis following herpes zoster.

Shivalingappa G.

Publication Types: 
    Historical Article

PMID: 4918559 [PubMed - indexed for MEDLINE]

9571: Acta Virol. 1970 Jan;14(1):25-34.

Preparation of concentrated intracellular precipitating antigens of
varicella-zoster and herpes simplex viruses and results obtained with them in the
gel precipitation reaction.

Trlifajova J, Sourek J, Ryba M.

PMID: 4392074 [PubMed - indexed for MEDLINE]

9572: Monatsschr Ohrenheilkd Laryngorhinol. 1970;104(9):409-12.

[Irreversible nerve damages after herpes zoster oticus]

[Article in German]

Bauer E, Keintzel K.

PMID: 4331876 [PubMed - indexed for MEDLINE]

9573: Trans Ophthalmol Soc U K. 1970;90:899-930.

Herpes zoster ophthalmicus.

Scheie HG.

Publication Types: 
    Review

PMID: 4326688 [PubMed - indexed for MEDLINE]

9574: J Laryngol Otol. 1970 Jan;84(1):65-70.

The incidence of herpes zoster antibodies in patients with peripheral facial
palsy.

Peitersen E, Caunt AE.

PMID: 4323301 [PubMed - indexed for MEDLINE]

9575: Arch Klin Exp Dermatol. 1970;239(1):22-9.

[Experimental herpes simplex virus infection of the skin of hairless mice]

[Article in German]

Munk K, Jung EG.

PMID: 4320161 [PubMed - indexed for MEDLINE]

9576: Ann Anat Pathol (Paris). 1970 Jan-Mar;15(1):129-52.

[Viral diseases of the nervous system]

[Article in French]

Tommasi M, Berard-Baier M, Toga M, Vedrenne C.

PMID: 4315389 [PubMed - indexed for MEDLINE]

9577: J Oral Med. 1970 Jan-Mar;25(1):7-11.

Chronic oral ulceration.

Cohen L.

PMID: 4313952 [PubMed - indexed for MEDLINE]

9578: Acta Derm Venereol. 1970;50(1):69-73.

Treatment of herpes zoster and postzoster neuralgia by the sublesional injection 
of triamcinolone and procaine.

Epstein E.

PMID: 4191892 [PubMed - indexed for MEDLINE]

9579: J Immunol. 1970 Jan;104(1):23-7.

Demonstration of viral antibody activity in two immunoglobulin G subclasses in
patients with varicella-zoster virus infection.

Leonard LL, Schmidt NJ, Lennette EH.

PMID: 4189103 [PubMed - indexed for MEDLINE]

9580: Br Med J. 1969 Dec 13;4(5684):667-9.

Facial pain.

Foster JB.

PMID: 5359924 [PubMed - indexed for MEDLINE]

9581: Z Arztl Fortbild (Jena). 1969 Dec 1;63(23):1249-52.

[Zoster. A study on the clinical aspects and rational therapy of zoster (Z.) in
the consulting hour]

[Article in German]

Bittersohl R.

PMID: 5404741 [PubMed - indexed for MEDLINE]

9582: J Urol. 1969 Dec;102(6):689-92.

Herpes zoster causing bladder atony.

Constantian HM.

PMID: 5372022 [PubMed - indexed for MEDLINE]

9583: Rev Paul Med. 1969 Dec;75(6):361-70.

[Infection following renal transplantation]

[Article in Portuguese]

Ianhez LE, Sabbaga E, de Goes GM, Cabral AD, de Campos-Freire JG.

PMID: 4906881 [PubMed - indexed for MEDLINE]

9584: Biken J. 1969 Dec;12(4):219-30.

Studies of herpes zoster virus in vitro. I. Isolation of two variants.

Nii S, Maeda Y.

PMID: 4313516 [PubMed - indexed for MEDLINE]

9585: Arch Neurol. 1969 Dec;21(6):559-70.

Varicella-Zoster encephalomyelitis. A morphologic and virologic study.

McCormick WF, Rodnitzky RL, Schochet SS Jr, McKee AP.

Publication Types: 
    Case Reports

PMID: 4311227 [PubMed - indexed for MEDLINE]

9586: Vestn Dermatol Venerol. 1969 Dec;45(12):58-60.

[Role of ointments containing hydrocortisone and prednisolone in the therapy of
dermatoses in children]

[Article in Russian]

Lipets ME.

PMID: 4246375 [PubMed - indexed for MEDLINE]

9587: Orv Hetil. 1969 Nov 30;110(48):2813-4.

[Viral diseases of the mouth mucosa treated with Morgalin]

[Article in Hungarian]

Sallay K, Gurtler A.

PMID: 5362772 [PubMed - indexed for MEDLINE]

9588: Med Welt. 1969 Nov 29;48:2636-49.

[Treatment of neurologic diseases with synthetic corticotropin
(beta-1-24-corticotropin)]

[Article in German]

Steinbrecher W.

Publication Types: 
    Review

PMID: 4318400 [PubMed - indexed for MEDLINE]

9589: G Mal Infett Parassit. 1969 Nov;21(11):849-52.

[Distamycin A in therapy of most severe types of herpes zoster]

[Article in Italian]

Bassetti D.

PMID: 5397338 [PubMed - indexed for MEDLINE]

9590: Nippon Jibiinkoka Gakkai Kaiho. 1969 Nov;72(11):2072-80.

[Case of Hunt's syndrome with special reference to chronological observation on
hearing disorder]

[Article in Japanese]

Tsuiki T, Nakamura H.

PMID: 5390936 [PubMed - indexed for MEDLINE]

9591: Vrach Delo. 1969 Nov;11:132-4.

[Recurrent herpes zoster]

[Article in Russian]

Iliutovich GM.

PMID: 5384402 [PubMed - indexed for MEDLINE]

9592: Blood. 1969 Nov;34(5):706-11.

Cytosine arabinoside therapy for disseminated herpes zoster in a patient with IgG
pyroglobulinemia.

McKelvey EM, Kwaan HC.

PMID: 5352659 [PubMed - indexed for MEDLINE]

9593: Br Med J. 1969 Nov 1;4(5678):303.

Herpes zoster and multiple sclerosis.

Beebe GW, Kurtzke JF.

PMID: 5345951 [PubMed - indexed for MEDLINE]

9594: Vestn Oftalmol. 1969 Nov-Dec;6:82-4.

[Possibility of the virus carrier state in conjunctival epithelium in ocular
herpes]

[Article in Russian]

Voronova NS, Glukhovskaia SS.

PMID: 5309752 [PubMed - indexed for MEDLINE]

9595: Am J Ophthalmol. 1969 Nov;68(5):824-8.

Circulating lymphoid cells in chronic viral keratitis.

Henley WL, Paltrowitz IM, Heopold IH, Hirschhorn K, Glade PR.

Publication Types: 
    In Vitro

PMID: 5308007 [PubMed - indexed for MEDLINE]

9596: N Z Med J. 1969 Nov;70(450):317-20.

The enhancing effect of dimethylsulfoxide vehicle upon the anti-viral actions of 
5-iododeoxyuridine.

Turnbull BC, MacGregor I, Stringer HC.

PMID: 5264455 [PubMed - indexed for MEDLINE]

9597: J Pract Nurs. 1969 Nov;19(11):27 passim.

Herpes Zoster: a nursing challenge.

Judd E.

PMID: 5196279 [PubMed - indexed for MEDLINE]

9598: Ann Ocul (Paris). 1969 Nov;202(11):1105-22.

[Pathological anatomy of endogenous uveitis]

[Article in French]

Hervouet F.

PMID: 4324131 [PubMed - indexed for MEDLINE]

9599: Vopr Virusol. 1969 Nov-Dec;14(6):646-55.

[Virus infections and intrauterine pathology]

[Article in Russian]

Oganesian OT, Rutova VV, Chebotarev VV.

Publication Types: 
    Review

PMID: 4312949 [PubMed - indexed for MEDLINE]

9600: Vestn Dermatol Venerol. 1969 Nov;43(11):76-7.

[Herpes zoster developing during treatment with griseofulvin]

[Article in Russian]

Chistiakov AM.

Publication Types: 
    Case Reports

PMID: 4246091 [PubMed - indexed for MEDLINE]

9601: Br J Dermatol. 1969 Nov;81(11):874-6.

Management of herpes zoster.

Ashton H, Beveridge GW, Stevenson CJ.

Publication Types: 
    Review

PMID: 4188178 [PubMed - indexed for MEDLINE]

9602: J Iowa Med Soc. 1969 Nov;59(11):1035-6.

A chickenpox preventive for high-risk children and adults.

[No authors listed]

PMID: 4186782 [PubMed - indexed for MEDLINE]

9603: Br Med J. 1969 Oct 11;4(5675):62.

Passive immunization against chicken-pox.

[No authors listed]

PMID: 4186271 [PubMed - indexed for MEDLINE]

9604: J Urol Nephrol (Paris). 1969 Oct-Nov;75(10):826-30.

[Acute urinary retention in zona]

[Article in French]

Arvis G, Aboulker P.

PMID: 5363699 [PubMed - indexed for MEDLINE]

9605: Br J Dis Chest. 1969 Oct;63(4):222-6.

Cervical herpes zoster and diaphragmatic paralysis.

Anderson JP, Keal EE.

PMID: 5346817 [PubMed - indexed for MEDLINE]

9606: Int Z Klin Pharmakol Ther Toxikol. 1969 Oct;2(4):371-3.

Review of therapeutic properties of emetine in nonamoebic infections.

Synek P, Synek V.

Publication Types: 
    Clinical Trial
    Review

PMID: 4903989 [PubMed - indexed for MEDLINE]

9607: Br J Plast Surg. 1969 Oct;22(4):382-3.

Self-medication of herpes zoster with an arsenic paste. A case report.

Fakirbhai MD.

PMID: 4902101 [PubMed - indexed for MEDLINE]

9608: Can J Ophthalmol. 1969 Oct;4(4):387-9.

Optic atrophy following herpes zoster ophthalmicus in a child.

Ahmad M, Bowen SF Jr, Burke R.

PMID: 4186212 [PubMed - indexed for MEDLINE]

9609: Dtsch Med Wochenschr. 1969 Sep 12;94(37):1861-6.

[Segmental motor pareses in herpes zoster]

[Article in German]

Schliack H, Schneider H.

PMID: 5356319 [PubMed - indexed for MEDLINE]

9610: Anesth Analg. 1969 Sep-Oct;48(5):816-23.

Intrathecal cold saline solution: a new approach to pain (evaluation).

Collins JR, Juras EP, VanHouten RJ, Spruell L.

PMID: 5820362 [PubMed - indexed for MEDLINE]

9611: HNO. 1969 Sep;17(9):278-9.

[A case of herpes zoster of the vagus nerve with paresis of the recurrent nerve
and partial deglutition paralysis]

[Article in German]

Gruter L.

PMID: 5405516 [PubMed - indexed for MEDLINE]

9612: Ann Otolaryngol Chir Cervicofac. 1969 Sep;86(9):509-16.

[Electronystagmography in spontaneous facial paralysis]

[Article in French]

Bouche J, Freche C, Tronche R, Ray J, Adrianjatovo J.

PMID: 5361811 [PubMed - indexed for MEDLINE]

9613: Postgrad Med. 1969 Sep;46(3):257-8.

How I treat herpes zoster.

Wilhelmj CM Jr.

PMID: 5344254 [PubMed - indexed for MEDLINE]

9614: Fracastoro. 1969 Sep-Oct;62(5):474-84.

[Herpes zoster and neoplasms (case contribution and radiotherapy)]

[Article in Italian]

Donati E.

PMID: 4923241 [PubMed - indexed for MEDLINE]

9615: Ann Urol (Paris). 1969 Sep;3(3):139-41.

[Acute urinary retention in herpes zoster]

[Article in French]

Arvis G, Aboulker P.

Publication Types: 
    Case Reports

PMID: 4311470 [PubMed - indexed for MEDLINE]

9616: Obstet Gynecol. 1969 Sep;34(3):434-66.

Herpes vulvitis.

Dickie EG.

Publication Types: 
    Review

PMID: 4308748 [PubMed - indexed for MEDLINE]

9617: Hifuka Kiyo. 1969 Aug;64(3):209-12.

[Therapeutic effects of Cepharantine on herpes zoster]

[Article in Japanese]

Shimizu M, Morito S, Kawamura Y.

PMID: 5393937 [PubMed - indexed for MEDLINE]

9618: J Am Osteopath Assoc. 1969 Aug;68(12):1265-8.

The syndrome of postherpetic neuralgia: complication and an approach to therapy.

Hallaq IY, Harris JD.

PMID: 5195921 [PubMed - indexed for MEDLINE]

9619: J Med Microbiol. 1969 Aug;2(3):317-25.

Laboratory studies on the varicella-zoster virus.

Meurisse EV.

Publication Types: 
    In Vitro

PMID: 4325755 [PubMed - indexed for MEDLINE]

9620: N Engl J Med. 1969 Jul 31;281(5):273.

Booster effect of herpes zoster.

Shaw EB.

PMID: 4183007 [PubMed - indexed for MEDLINE]

9621: Med J Aust. 1969 Jul 5;2(1):27-8.

The use of intravenous procaine infusion in the treatment of postherpetic
neuralgia.

Collins EB.

PMID: 5799007 [PubMed - indexed for MEDLINE]

9622: Arch Neurol. 1969 Jul;21(1):25-31.

Virus-like particles in myositis accompanying herpes zoster.

Norris FH Jr, Dramov B, Calder CD, Johnson SG.

PMID: 5772548 [PubMed - indexed for MEDLINE]

9623: Rev Otoneuroophtalmol. 1969 Jul-Aug;41(5):241-50.

[Rhythmic segmental myoclonus of spinal cord origin. Apropos of 2 cases]

[Article in French]

Castaigne P, Cambier J, Laplane D, Cathala HP, Brunet P, Pierrot-Deseilligny E.

PMID: 5403127 [PubMed - indexed for MEDLINE]

9624: Ann Ocul (Paris). 1969 Jul;2(7):751-62.

[Charles de Saint-Yves (1667-1736)]

[Article in French]

Munchow W.

Publication Types: 
    Biography
    Historical Article

Personal Name as Subject: 
    de Saint-Yves C

PMID: 4926646 [PubMed - indexed for MEDLINE]

9625: Br Med J. 1969 Jun 21;2(5659):765-6.

Immunity to cancer.

Wyburn-Mason R.

PMID: 5786776 [PubMed - indexed for MEDLINE]

9626: Arch Sci Med (Torino). 1969 Jun;126(6):369-72.

[A case of herpes zoster appearing during pulmonary sarcoidosis. (Its clinical
significance)]

[Article in Italian]

Cascone A.

PMID: 5363535 [PubMed - indexed for MEDLINE]

9627: J All India Ophthalmol Soc. 1969 Jun;17(3):120.

Herpes Zoster ophthalmicus involving the nasociliary nerve alone.

Pandey R.

Publication Types: 
    Case Reports

PMID: 5308858 [PubMed - indexed for MEDLINE]

9628: Voen Med Zh. 1969 Jun;6:44-5.

[Low frequency impulse currents in therapeutic practice]

[Article in Russian]

Ievlev VA, Likholetova AG.

PMID: 4308888 [PubMed - indexed for MEDLINE]

9629: Postgrad Med J. 1969 Jun;45(524):382-5.

Herpes encephalitis. I. The clinical picture.

Campbell AM.

PMID: 4307947 [PubMed - indexed for MEDLINE]

9630: J Hyg (Lond). 1969 Jun;67(2):343-52.

Neutralization tests with varicella-zoster virus.

Caunt AE, Shaw DG.

Publication Types: 
    In Vitro

PMID: 4183291 [PubMed - indexed for MEDLINE]

9631: Am J Ophthalmol. 1969 Jun;67(6):873-96.

Corticosteroid therapy in central stromal keratitis.

Aronson SB, Moore TE Jr.

PMID: 4182154 [PubMed - indexed for MEDLINE]

9632: N Engl J Med. 1969 May 29;280(22):1237-8.

Passive immunization against chicken pox.

Janeway CA.

PMID: 4181207 [PubMed - indexed for MEDLINE]

9633: N Engl J Med. 1969 May 29;280(22):1191-4.

Prevention of varicella by zoster immune globulin.

Brunell PA, Ross A, Miller LH, Kuo B.

Publication Types: 
    Clinical Trial
    Controlled Clinical Trial

PMID: 4181206 [PubMed - indexed for MEDLINE]

9634: Minerva Med. 1969 May 2;60(35):1703-5.

[New therapy of herpes zoster. (Preliminary note)]

[Article in Italian]

Rossi GD.

PMID: 5790014 [PubMed - indexed for MEDLINE]

9635: Acta Pathol Jpn. 1969 May;19(2):115-49.

Ultrastructural zonation of the human adrenal cortex.

Kawaoi A.

PMID: 5394735 [PubMed - indexed for MEDLINE]

9636: Zentralbl Bakteriol [Orig]. 1969 May;210(1):140-3.

[Encephalitis and myelitis in herpes zoster]

[Article in German]

Jezek P, Houbal V.

PMID: 5361075 [PubMed - indexed for MEDLINE]

9637: Mil Med. 1969 May;134(5):341-7.

Practical and theoretical considerations in Nerve Excitability (NE) testing.

Hale MS, Silverstein H.

PMID: 4976907 [PubMed - indexed for MEDLINE]

9638: Scand J Infect Dis. 1969 May;1(1):47-9.

Varicelliform eruptions in herpes zoster--some clinical and serological
observations.

Oberg G, Svedmyr A.

PMID: 4329058 [PubMed - indexed for MEDLINE]

9639: Public Health. 1969 May;83(4):169-75.

Some current problems in infections of the skin with the virus of herpes simplex 
and varicella-zoster.

Juel-Jensen BE.

PMID: 4308031 [PubMed - indexed for MEDLINE]

9640: Br Med J. 1969 Apr 26;2(5651):218-20.

Herpes zoster and multiple sclerosis.

Lenman JA, Peters TJ.

PMID: 4305401 [PubMed - indexed for MEDLINE]

9641: JAMA. 1969 Apr 14;208(2):326-31.

Hodgkin's disease.

Dorfman R, Reinhard E, Wessler S, Avioli LV.

Publication Types: 
    Case Reports

PMID: 5818486 [PubMed - indexed for MEDLINE]

9642: Indian J Med Sci. 1969 Apr;23(4):210-3.

Incidence of chickenpox and herpes zoster among the armed forces persons--a
preliminary communication.

Seetaram K.

PMID: 5799719 [PubMed - indexed for MEDLINE]

9643: Clin Chim Acta. 1969 Apr;24(1):111-20.

Presence of L-amino-acid oxidase in the blood in pemphigus, dermatitis
herpetiformis Duhring and herpes zoster.

Mecher T, Masszi J.

PMID: 5780154 [PubMed - indexed for MEDLINE]

9644: Br J Urol. 1969 Apr;41(2):238-41.

Herpes zoster causing retention of urine.

Rankin JT, Sutton RA.

Publication Types: 
    Case Reports

PMID: 5769086 [PubMed - indexed for MEDLINE]

9645: Rev Med Chir Soc Med Nat Iasi. 1969 Apr-Jun;73(2):459-62.

[Considerations on 2 cases of buccal zona]

[Article in Romanian]

Haimovici A, Constantin I, Feodorov D.

PMID: 5306557 [PubMed - indexed for MEDLINE]

9646: Eye Ear Nose Throat Mon. 1969 Apr;48(4):216-8.

Coexisting herpes zoster and herpes simplex ocular involvement.

Giles CL.

PMID: 5304977 [PubMed - indexed for MEDLINE]

9647: Vestn Dermatol Venerol. 1969 Apr;43(4):14-21.

[The use of optic quantum generators (lasers) in dermatology (a review of foreign
literature)]

[Article in Russian]

Khromov BM, Frygin NV.

Publication Types: 
    Review

PMID: 4905002 [PubMed - indexed for MEDLINE]

9648: Proc R Soc Med. 1969 Apr;62(4):374-8.

Immunofluorescence and tissue culture.

Banatvala JE.

PMID: 4897830 [PubMed - indexed for MEDLINE]

9649: Czas Stomatol. 1969 Apr;22(4):305-9.

[Lyzozyme 2. Medical use]

[Article in Polish]

Gratkowska H, Kozlowska I, Szymczyk T.

Publication Types: 
    Review

PMID: 4892890 [PubMed - indexed for MEDLINE]

9650: J Gen Virol. 1969 Apr;4(3):321-8.

Immunological relationship between herpes simplex and varicella-zoster viruses
demonstrated by complement-fixation, neutralization and fluorescent antibody
tests.

Schmidt NJ, Lennette EH, Magoffin RL.

PMID: 4306713 [PubMed - indexed for MEDLINE]

9651: JAMA. 1969 Mar 31;207(13):2439-40.

Triamcinolone injections in herpes zoster lesions.

Epstein E.

PMID: 5818451 [PubMed - indexed for MEDLINE]

9652: Z Haut Geschlechtskr. 1969 Mar 15;44(6):197-210.

[Cell composition of a peculiar cutaneous so-called lymphoma (lymphocytoma)]

[Article in German]

Feyrter F, Luger A.

PMID: 4902562 [PubMed - indexed for MEDLINE]

9653: Nord Med. 1969 Mar 13;81(11):333-7.

[Therapy of superficial eye diseases with the strontium 90 beta-ray applicator]

[Article in Danish]

Rasmussen KE.

PMID: 4239935 [PubMed - indexed for MEDLINE]

9654: Przegl Dermatol. 1969 Mar-Apr;56(2):203-6.

[Ramsay-Hunt syndrome]

[Article in Polish]

Litwinski T, Cislo M.

PMID: 5790578 [PubMed - indexed for MEDLINE]

9655: Ann Otolaryngol Chir Cervicofac. 1969 Mar;86(3):190-3.

[Paraneoplastic syndromes]

[Article in French]

Labayle J, Fleury P.

PMID: 5769832 [PubMed - indexed for MEDLINE]

9656: Vestn Dermatol Venerol. 1969 Mar;43(3):92.

[A case of herpes zoster in a patient with lung cancer]

[Article in Russian]

Glukhen'kii TT, Sabkhak VI.

Publication Types: 
    Case Reports

PMID: 5376338 [PubMed - indexed for MEDLINE]

9657: Minerva Oftalmol. 1969 Mar-Apr;11(2):43-7.

[Action of snake Bothrops jararaca venom in the treatment of ophthalmic zona]

[Article in Italian]

Arezzi R.

PMID: 5311912 [PubMed - indexed for MEDLINE]

9658: Rinsho Hoshasen. 1969 Mar;14(3):248-52.

[Herpes zoster after radiation therapy of malignant tumors]

[Article in Japanese]

Otake H, Toda H, Tamagawa Y, Sasaki H.

PMID: 5194573 [PubMed - indexed for MEDLINE]

9659: Clin Obstet Gynecol. 1969 Mar;12(1):161-78.

Viral and virus-like infections of the female genital tract.

Josey WE, Nahmias AJ, Naib ZM.

Publication Types: 
    Review

PMID: 4307790 [PubMed - indexed for MEDLINE]

9660: J Fr Otorhinolaryngol Audiophonol Chir Maxillofac. 1969 Mar;18(3):197.

[Value of antiviral medical therapy of herpes zoster facial paralysis]

[Article in French]

Martin H, Bernard P.

PMID: 4245688 [PubMed - indexed for MEDLINE]

9661: Masui. 1969 Feb;18(2):133-7.

[Posttherapeutic trigeminal neuralgia after herpes zoster]

[Article in Japanese]

Hyodo M, Tanaka M, Higo G, So S, Nagayama K.

PMID: 5814264 [PubMed - indexed for MEDLINE]

9662: Z Gesamte Inn Med. 1969 Feb 1;24(3):76-81.

[Virus-induced hemorrhagic diatheses]

[Article in German]

Schott G.

PMID: 5796643 [PubMed - indexed for MEDLINE]

9663: Klin Monatsbl Augenheilkd. 1969 Feb;154(2):225-7.

[Treatment of neuralgiform pain in the orbital area using
5-carbamyl-5H-dibenzo(b,f)azepin (Tegretol)]

[Article in German]

Steiner L.

PMID: 5307784 [PubMed - indexed for MEDLINE]

9664: Cancer Chemother Rep. 1969 Feb;53(1):49-51.

Development of herpes zoster in a patient with acute leukemia after therapy with 
cytosine arabinoside (NSC-63878).

Wiernik PH, Serpick AA.

PMID: 5254023 [PubMed - indexed for MEDLINE]

9665: Arch Sci Med (Torino). 1969 Jan;126(1):18-9.

[Complications of ophthalmic herpes zoster]

[Article in Italian]

Boschetti G, Manganelli R, Farina A, Rigamonti L.

Spedali Civili di Brescia, Reparto Oculistico.

Publication Types: 
    Case Reports

PMID: 17342909 [PubMed - indexed for MEDLINE]

9666: Rev Dent Liban. 1969 Jan-Mar;19(1):80-7.

Herpes zoster simulating odontalgia: report of a case.

Barakat NJ, Latronica RJ, Loiselle RJ.

Publication Types: 
    Case Reports

PMID: 5812399 [PubMed - indexed for MEDLINE]

9667: Zh Nevropatol Psikhiatr Im S S Korsakova. 1969;69(4):525-9.

[A study of the therapeutic effect of deoxyribonuclease in shingles (herpes
zoster)]

[Article in Russian]

Boldyrev LP, Salganik RI.

PMID: 5796670 [PubMed - indexed for MEDLINE]

9668: Dtsch Med J. 1969 Jan;20(2):74-7.

[Medivitan, an addition to our therapeutic possibilities]

[Article in German]

Grebe H.

PMID: 5785577 [PubMed - indexed for MEDLINE]

9669: J Invest Dermatol. 1969 Jan;52(1):71-7.

Cutaneous nerve changes in zoster.

Muller SA, Winkelmann RK.

PMID: 5761931 [PubMed - indexed for MEDLINE]

9670: Arch Ital Dermatol Venereol Sessuol. 1969;35(5):373-85.

[On 2 unusual cases of herpes zoster. Ramsay-Hunt syndrome and generalized herpes
zoster]

[Article in Italian]

Serena A.

PMID: 5385234 [PubMed - indexed for MEDLINE]

9671: Bull Soc Fr Dermatol Syphiligr. 1969;76(6):750-1.

[Brachial zona secondarily generalized with residual algo-dystrophy]

[Article in French]

Degos R, Touraine R, Bernadou M, Revuz MJ.

Publication Types: 
    Case Reports

PMID: 5384188 [PubMed - indexed for MEDLINE]

9672: Zh Ushn Nos Gorl Bolezn. 1969 Jan-Feb;29(1):111-2.

[Herpes of the external ear and tympanic membrane of the left ear]

[Article in Russian]

Androsov MD.

Publication Types: 
    Case Reports

PMID: 5376690 [PubMed - indexed for MEDLINE]

9673: Bull Soc Fr Dermatol Syphiligr. 1969;76(4):614-7.

[Fatal generalized zona in 5-week-old infants. Possible immunological deficiency]

[Article in French]

Duverne J, Bonche M, Couette Y, Gogue Y.

PMID: 5368311 [PubMed - indexed for MEDLINE]

9674: Br J Dermatol. 1969;81:Suppl 3:72-9.

Linear lesions.

Macdonald RH, Sims RT.

PMID: 5365813 [PubMed - indexed for MEDLINE]

9675: Schweiz Arch Neurol Neurochir Psychiatr. 1969;104(2):225-45.

[Diaphragmatic paralyses with special reference to paralyses in neurologic
disorders]

[Article in German]

Gunzel I.

PMID: 5365116 [PubMed - indexed for MEDLINE]

9676: Zh Nevropatol Psikhiatr Im S S Korsakova. 1969;69(6):850-2.

[Experience with use of tegretol in trigeminal neuralgia]

[Article in Russian]

Gorbunova VG.

PMID: 5364234 [PubMed - indexed for MEDLINE]

9677: Arch Ital Dermatol Venereol Sessuol. 1969;36(2):126-34.

[Herpes zoster in the 1960-69 case records of the Clinica Dermatologica di
Bologna]

[Article in Italian]

Bonelli U.

PMID: 5314379 [PubMed - indexed for MEDLINE]

9678: Bull Soc Ophtalmol Fr. 1969 Jan;69(1):20-8.

[Herpes, cold and light]

[Article in French]

Chabat-Riviere H.

PMID: 5314107 [PubMed - indexed for MEDLINE]

9679: Acta Ophthalmol (Copenh). 1969;47(3):591-5.

Traumatic ophthalmic zoster.

Holm-Pedersen E.

PMID: 5307564 [PubMed - indexed for MEDLINE]

9680: J Assoc Physicians India. 1969 Jan;17(1):71-3.

Ramsay Hunt syndrome with trigeminal herpes (trigemellofacial zoster).

Mital HS, Govil MK, Mehrotra PP.

PMID: 5307418 [PubMed - indexed for MEDLINE]

9681: Nippon Ganka Kiyo. 1969 Jan;20(1):49-52.

[Effect of IDC to viral keratitis]

[Article in Japanese]

Kurimoto S, Kandor F, Kishida T.

PMID: 5306292 [PubMed - indexed for MEDLINE]

9682: Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove. 1969;12(2):189-91.

A case of herpes zoster on the trunk with affliction of the acoustic nerve.

Michalek V.

PMID: 5261132 [PubMed - indexed for MEDLINE]

9683: Med Glas. 1969 Jan-Apr;23(1):20-3.

[Herpes zoster. Some observation on patients in Nis]

[Article in Croatian]

Faninger A, Jankovic D.

PMID: 5200358 [PubMed - indexed for MEDLINE]

9684: Br J Dermatol. 1969;81:Suppl 3:66-71.

Regional variation in susceptibility to virus infections.

Platt H.

Publication Types: 
    Review

PMID: 4904053 [PubMed - indexed for MEDLINE]

9685: Proc Int Acad Oral Pathol. 1969:99-100.

Viruses and the salivary glands.

Gear JH.

PMID: 4327903 [PubMed - indexed for MEDLINE]

9686: Oftalmol Zh. 1969;24(6):451-3.

[Oxoline in virus diseases of the conjunctivae and cornea]

[Article in Russian]

Filatova ZA.

PMID: 4319407 [PubMed - indexed for MEDLINE]

9687: Arch Ital Dermatol Venereol Sessuol. 1969;35(6):447-61.

[The zoster-varicella association. (Apropos of a clinical case)]

[Article in Italian]

Babini G.

PMID: 4317959 [PubMed - indexed for MEDLINE]

9688: Postgrad Med J. 1969 Jan;45(519):36-9.

Virus infections in patients with malignant disease.

Heath RB.

Publication Types: 
    Review

PMID: 4307161 [PubMed - indexed for MEDLINE]

9689: Acta Derm Venereol. 1969;49(6):569-83.

Aspects of the natural history of herpes zoster. A follow-up investigation of
outpatient material.

Molin L.

PMID: 4190107 [PubMed - indexed for MEDLINE]

9690: Acta Derm Venereol. 1969;49(4):436-7.

Herpes simplex in the course of zoster.

Kandil E.

PMID: 4185114 [PubMed - indexed for MEDLINE]

9691: Bibl Psychiatr Neurol. 1969;139:370-4.

[Therapy of herpes zoster]

[Article in German]

Swahn B.

PMID: 4109459 [PubMed - indexed for MEDLINE]

9692: Ann Ottalmol Clin Ocul. 1969 Jan;95(1):49-58.

[Therapy of ophthalmic herpes zoster. (Review)]

[Article in Italian]

Verraz R.

Publication Types: 
    Review

PMID: 4098555 [PubMed - indexed for MEDLINE]

9693: Dermatol Wochenschr. 1968 Dec 14;154(50):1182-9.

[Cytological studies with the phase contrast microscope in bullous skin diseases]

[Article in German]

Fulop E.

PMID: 4886631 [PubMed - indexed for MEDLINE]

9694: Ann Ottalmol Clin Ocul. 1968 Dec;94(12):1573-81.

[Acute retrobulbar optic neuritis during herpes zoster oticus with paralysis of
the facial nerve and cochleo-vestibular disorders]

[Article in Italian]

Passeri S, Vinciguerra E, Mammarella E.

PMID: 5735938 [PubMed - indexed for MEDLINE]

9695: Med Times. 1968 Dec;96(12):1190-4.

The Ramsay Hunt syndrome.

Srisomboon P, Cipcic JA.

Publication Types: 
    Case Reports

PMID: 5705943 [PubMed - indexed for MEDLINE]

9696: Ganka. 1968 Dec;10(12):902-4.

[Ocular herpes zoster with severe intraocular inflammation]

[Article in Japanese]

Hokama H.

PMID: 5304973 [PubMed - indexed for MEDLINE]

9697: Dent Cadmos. 1968 Dec;36(12):1765-70.

[On a case of herpes zoster, probably of post-extraction origin]

[Article in Italian]

Preda CE, Brusotti C.

Publication Types: 
    Case Reports

PMID: 5252365 [PubMed - indexed for MEDLINE]

9698: J Virol. 1968 Dec;2(12):1458-64.

Labile coat: reason for noninfectious cell-free varicella-zoster virus in
culture.

Cook ML, Stevens JG.

Experiments designed to determine why cell-free varicella-zoster virus replicated
in cell culture is noninfectious were performed. Electron micrographs in which
varicella-zoster virus (a herpesvirus) was compared to herpes simplex virus in
primary human amnion cell cultures showed that the viruses were morphologically
indistinguishable inside the nucleus. However, extranuclear varicella-zoster
viruses were distinguished from herpes simplex virus by the presence of
pleomorphism, incomplete coats, and a resultant loss of central dense cores. This
result indicates that varicella-zoster virus possesses a labile coat which is
degraded outside the nucleus. It is suggested that the labile coat is a principal
reason for the lack of cell-free infectious virus in this system.

PMID: 4315604 [PubMed - indexed for MEDLINE]

9699: Cesk Dermatol. 1968 Dec;43(6):413-22.

[Recent findings on viral diseases of the herpes group]

[Article in Czech]

Sedlacek V.

Publication Types: 
    Review

PMID: 4303698 [PubMed - indexed for MEDLINE]

9700: Can J Public Health. 1968 Dec;59(12):484-6.

Zoster encephalitis: a case report.

Joncas J, Lussier G, Podoski MO, Rona S.

PMID: 4302588 [PubMed - indexed for MEDLINE]

9701: Ann Otol Rhinol Laryngol. 1968 Dec;77(6):1101-19.

Facial paralysis in cephalic herpes zoster.

Devriese PP.

PMID: 4302071 [PubMed - indexed for MEDLINE]

9702: Arch Ophthalmol. 1968 Dec;80(6):791-807.

Neuro-ophthalmology.

Knox DL.

Publication Types: 
    Review

PMID: 4301976 [PubMed - indexed for MEDLINE]

9703: Prensa Med Argent. 1968 Nov 29;55(40):1907-8.

[Carbamazepine in the therapy of herpes zoster]

[Article in Spanish]

Helman M.

PMID: 5714060 [PubMed - indexed for MEDLINE]

9704: Pol Tyg Lek. 1968 Nov 23;23(52):2021-4.

[Eye manifestations in the major virus diseases]

[Article in Polish]

Trzcinska-Dabrowska Z.

Publication Types: 
    Review

PMID: 4885992 [PubMed - indexed for MEDLINE]

9705: Przegl Dermatol. 1968 Nov-Dec;55(6):775-80.

[Generalized zoster in lymphatic leukemia and mycosis fungoides]

[Article in Polish]

Budner S.

PMID: 5709702 [PubMed - indexed for MEDLINE]

9706: Nurs Times. 1968 Nov 1;64(44):1478-9.

Shingles (herpes zoster).

Geddes AM.

PMID: 5685340 [PubMed - indexed for MEDLINE]

9707: Laryngoscope. 1968 Nov;78(11):1853-78.

Herpes zoster oticus.

Crabtree JA.

Publication Types: 
    Review

PMID: 4881774 [PubMed - indexed for MEDLINE]

9708: Dtsch Med Wochenschr. 1968 Oct 18;93(42):2021-5.

[The therapy of virus diseases using corticosteroids]

[Article in German]

Schumacher H.

Publication Types: 
    Review

PMID: 4879893 [PubMed - indexed for MEDLINE]

9709: Br Med J. 1968 Oct 12;4(5623):89-92.

Rapid diagnosis of herpesvirus hominis infections in superficial lesions by
immunofluorescent antibody technics.

Gardner PS, McQuillin J, Black MM, Richardson J.

Publication Types: 
    Comparative Study

PMID: 4301396 [PubMed - indexed for MEDLINE]

9710: J Med Lyon. 1968 Oct 5;49(150):1467-8.

[Unusual cause of acute hemicrania: cervical zona]

[Article in French]

Perret J, Chattelain R.

PMID: 5738895 [PubMed - indexed for MEDLINE]

9711: Z Haut Geschlechtskr. 1968 Oct 1;43(19):811-6.

[Serum acetylcholinesterase activity in various skin diseases]

[Article in German]

Kipping D.

PMID: 5723218 [PubMed - indexed for MEDLINE]

9712: Minerva Dermatol. 1968 Oct;43(10):551.

[Kobner phenomenon caused by herpes zoster in a case of psoriasis]

[Article in Italian]

Vivarelli I.

PMID: 5718240 [PubMed - indexed for MEDLINE]

9713: Iryo. 1968 Oct;22(10):1125-30.

[Observations on senile dermatoses]

[Article in Japanese]

Kitamura S, Kawasumi A.

PMID: 5710124 [PubMed - indexed for MEDLINE]

9714: Cesk Dermatol. 1968 Oct;43(5):318-20.

[Generalized herpes zoster with involvement of motor nerves]

[Article in Czech]

Konopik J, Zaruba F, Teskova H.

Publication Types: 
    Case Reports

PMID: 5700864 [PubMed - indexed for MEDLINE]

9715: Br J Clin Pract. 1968 Oct;22(10):444-5.

Zoster encephalitis.

Dunn M, Salter RH.

PMID: 5684644 [PubMed - indexed for MEDLINE]

9716: Minerva Dermatol. 1968 Oct;43(10):528-31.

[Data on the use of a sodium salt of escin in herpes zoster]

[Article in Italian]

Giannetti A, Pelfini C.

PMID: 5305036 [PubMed - indexed for MEDLINE]

9717: Nippon Ganka Kiyo. 1968 Oct;19(10):1018-23.

[Diagnosis of herpetic ophthalmopathies by electron microscopy. Demonstration of 
virus particles from patients with epidemic keratoconjunctivitis]

[Article in Japanese]

Asayama T, Ijiri H.

PMID: 5304458 [PubMed - indexed for MEDLINE]

9718: J Indian Med Assoc. 1968 Oct 1;51(7):353.

Herpes zoster ophthalmicus in myeloid leukaemia.

Chhabra HN, Sharma DP.

Publication Types: 
    Case Reports

PMID: 5304133 [PubMed - indexed for MEDLINE]

9719: Quintessenz. 1968 Oct;19(10):93-5.

[Diseases of the gingiva, oral mucosa and lips]

[Article in German]

Strassburg M, Knolle G.

PMID: 5250962 [PubMed - indexed for MEDLINE]

9720: Oral Surg Oral Med Oral Pathol. 1968 Oct;26(4):441-5.

Localized odontalgia occurring during herpes zoster of the maxillary division of 
the fifth cranial nerve. Report of a case.

Verbin RS, Heineman HS, Stiff RH.

Publication Types: 
    Case Reports

PMID: 5244773 [PubMed - indexed for MEDLINE]

9721: Lyon Med. 1968 Sep 29;220(39):749-50.

[Generalized zona in a tubercular patient]

[Article in French]

Colomb D, Colombani R.

PMID: 5745872 [PubMed - indexed for MEDLINE]

9722: Med Welt. 1968 Sep 14;37:1973-6.

[Herpes zoster as complication. Primary disease--therapy--prevention]

[Article in German]

Meiers HG.

PMID: 5712118 [PubMed - indexed for MEDLINE]

9723: Riv Otoneurooftalmol. 1968 Sep-Oct;43(5):497-511.

[Central neurologic manifestations during herpes zoster infection.
Anatomo-clinical study]

[Article in Italian]

Pittaluga E, Giordano R, Mocchetti E.

PMID: 5737892 [PubMed - indexed for MEDLINE]

9724: Br J Vener Dis. 1968 Sep;44(3):241-50.

Herpes genitalis.

Hutfield DC.

PMID: 5687048 [PubMed - indexed for MEDLINE]

9725: Ann Ottalmol Clin Ocul. 1968 Aug;94(8):926-8.

[Lactoflavin therapy of herpetic keratitis. Preliminary note]

[Article in Italian]

Cuppini R, Scoccianti M.

PMID: 5306658 [PubMed - indexed for MEDLINE]

9726: Ann Ottalmol Clin Ocul. 1968 Aug;94(8):1011-26.

[New treatment of ophthalmic herpes zoster with the hemocoagulating fraction of
Bothrops jacaraca venom (Hemocoagulase)]

[Article in Italian]

Valvo A.

PMID: 5306657 [PubMed - indexed for MEDLINE]

9727: Sov Med. 1968 Aug;31(8):94-8.

[On the problem of herpes zoster ophthalmicus]

[Article in Russian]

Kalamkarian AA, Kochetkov VD.

PMID: 5306585 [PubMed - indexed for MEDLINE]

9728: J Oral Surg. 1968 Aug;26(8):534-6.

Herpes zoster in childhood: report of case.

Freedman GL, Hooley JR.

Publication Types: 
    Case Reports

PMID: 5243136 [PubMed - indexed for MEDLINE]

9729: Lancet. 1968 Jul 20;2(7560):170-1.

Shingles.

Elliott FA.

PMID: 4173290 [PubMed - indexed for MEDLINE]

9730: Dtsch Gesundheitsw. 1968 Jul 4;23(27):1249-54.

[On the epidemiology and therapy of herpes corneae]

[Article in German]

Pietruschka G.

PMID: 5303003 [PubMed - indexed for MEDLINE]

9731: Cleve Clin Q. 1968 Jul;35(3):169-76.

Motor paralysis of the lower extremities in herpes zoster.

Fee CF, Evarts CM.

PMID: 5747186 [PubMed - indexed for MEDLINE]

9732: Arch Phys Ther (Leipz). 1968 Jul-Aug;20(4):227-8.

[Therapy of herpes zoster with ultrasonics]

[Article in German]

Walther H.

PMID: 5733023 [PubMed - indexed for MEDLINE]

9733: GP. 1968 Jul;38(1):119-20.

Effective treatment of herpes zoster.

Sutton RL.

PMID: 5666469 [PubMed - indexed for MEDLINE]

9734: Can J Ophthalmol. 1968 Jul;3(3):279-83.

Herpes zoster ophthalmicus with sixth nerve palsy.

Goldsmith MO.

PMID: 5302943 [PubMed - indexed for MEDLINE]

9735: An Esp Odontoestomatol. 1968 Jul-Aug;27(4):304-10.

[Clinical history for diagnosis]

[Article in Spanish]

Carbonell Garcia J.

PMID: 5246714 [PubMed - indexed for MEDLINE]

9736: Lancet. 1968 Jun 29;1(7557):1427.

Shingles.

Phillips R.

PMID: 4173011 [PubMed - indexed for MEDLINE]

9737: Lancet. 1968 Jun 22;1(7556):1370.

Shingles.

Wigglesworth R.

PMID: 4172670 [PubMed - indexed for MEDLINE]

9738: Br Med J. 1968 Jun 8;2(5605):577-80.

Pain in the face.

Miller H.

PMID: 5654625 [PubMed - indexed for MEDLINE]

9739: Lancet. 1968 Jun 8;1(7554):1242.

Shingles.

[No authors listed]

PMID: 4172788 [PubMed - indexed for MEDLINE]

9740: Minerva Dermatol. 1968 Jun;43(6):288-95.

[Treatment of zoster with high doses of oral lysozyme]

[Article in Italian]

Strani GF.

Publication Types: 
    Comparative Study

PMID: 5745066 [PubMed - indexed for MEDLINE]

9741: Ann Ottalmol Clin Ocul. 1968 Jun;94(6):668-74.

[Yeast therapy in ophthalmic herpes zoster]

[Article in Italian]

Mazza C, Panagis P.

PMID: 5312163 [PubMed - indexed for MEDLINE]

9742: Hautarzt. 1968 Jun;19(6):256-9.

[Contribution on the etiology of the Melkersson-Rosenthal syndrome]

[Article in German]

Dlabalova H, Danda J.

PMID: 4979397 [PubMed - indexed for MEDLINE]

9743: Ned Tijdschr Geneeskd. 1968 May 18;112(20):964-5.

[Herpes zoster with facial nerve paralysis]

[Article in Dutch]

Devriese PP.

PMID: 5665020 [PubMed - indexed for MEDLINE]

9744: Med Klin. 1968 May 17;63(20):794-5.

[Simultaneous occurrence of epidemic parotitis and herpes zoster]

[Article in German]

Schley G, Bock KD.

PMID: 4236687 [PubMed - indexed for MEDLINE]

9745: Z Arztl Fortbild (Jena). 1968 May 15;62(10):528-32.

[Immunological view-points on the pathogenesis of zoster]

[Article in German]

Schubert H.

PMID: 5727607 [PubMed - indexed for MEDLINE]

9746: Klin Wochenschr. 1968 May 15;46(10):534-40.

[Intranuclear inclusions in malignant melanoma and zoster. Attempt of a
morphological coordination into the system of cell inclusions]

[Article in German]

Nasemann T, Braun-Falco O.

PMID: 5699106 [PubMed - indexed for MEDLINE]

9747: N Engl J Med. 1968 May 2;278(18):1020.

Pathogenesis of herpes zoster.

Ritchie RG.

PMID: 5644577 [PubMed - indexed for MEDLINE]

9748: J Invest Dermatol. 1968 May;50(5):405-10.

Lactate dehydrogenase isozyme patterns in blister fluids.

Fleischmajer R, Krol S, Moschella SL.

PMID: 5653238 [PubMed - indexed for MEDLINE]

9749: Arch Intern Med. 1968 May;121(5):458-62.

Herpes zoster in a patient with Hodgkin's disease. Treatment with idoxuridine.

Waltuch G, Sachs F.

Publication Types: 
    Case Reports

PMID: 5645723 [PubMed - indexed for MEDLINE]

9750: Am J Ophthalmol. 1968 May;65(5):686-8.

Ophthalmic zoster in malignant disease.

Blodi FC.

PMID: 5301146 [PubMed - indexed for MEDLINE]

9751: Pediatr Clin North Am. 1968 May;15(2):337-44.

Recent advances in pediatric ophthalmology.

Frayer WC.

Publication Types: 
    Review

PMID: 4872897 [PubMed - indexed for MEDLINE]

9752: Arch Neurol. 1968 May;18(5):583-9.

Ramsay Hunt syndrome.

Brody IA, Wilkins RH.

Publication Types: 
    Historical Article

PMID: 4869674 [PubMed - indexed for MEDLINE]

9753: Przegl Dermatol. 1968 May-Jun;55(3):385-90.

[Treatment of infections caused by herpes simplex viruses and viruses of the
group zoster-varicella in the light of modern views]

[Article in Polish]

Jakubowicz K, Markowski R.

Publication Types: 
    Review

PMID: 4298645 [PubMed - indexed for MEDLINE]

9754: Dermatol Wochenschr. 1968 Apr 27;154(17):385-7.

[Treatment of herpes zoster with griseofulvin]

[Article in German]

Wolfram S.

PMID: 5730767 [PubMed - indexed for MEDLINE]

9755: Z Haut Geschlechtskr. 1968 Apr 15;43(8):311-2.

[Relationship between herpes zoster and gravidity, possibly exacerbation, also
due to drugs]

[Article in German]

Nasemann T.

PMID: 4298891 [PubMed - indexed for MEDLINE]

9756: Ned Tijdschr Geneeskd. 1968 Apr 13;112(15):685-7.

[Pain in herpes zoster]

[Article in Dutch]

Bethlem J.

PMID: 5664443 [PubMed - indexed for MEDLINE]

9757: Appl Ther. 1968 Apr;10(4):265-8.

The hair and the scalp.

Linton WT.

PMID: 5655424 [PubMed - indexed for MEDLINE]

9758: Am J Ophthalmol. 1968 Apr;65(4):533-41.

Histopathology of herpes zoster ophthalmicus.

Naumann G, Gass JD, Font RL.

PMID: 5300433 [PubMed - indexed for MEDLINE]

9759: Radiol Clin North Am. 1968 Apr;6(1):97-106.

Neurologic manifestations and complications of lymphoma.

Verity GL.

PMID: 4297421 [PubMed - indexed for MEDLINE]

9760: Am J Dis Child. 1968 Apr;115(4):432-7.

Zoster in children.

Brunell PA, Miller LH, Lovejoy F.

PMID: 4296012 [PubMed - indexed for MEDLINE]

9761: Nervenarzt. 1968 Apr;39(4):180-1.

[Zoster in C5-C6 with Sudeck's disease]

[Article in German]

Ketz E, Schliack H.

PMID: 4173975 [PubMed - indexed for MEDLINE]

9762: N Engl J Med. 1968 Mar 28;278(13):743.

Spread of Herpes-zoster virus.

Johnson RT.

PMID: 5638711 [PubMed - indexed for MEDLINE]

9763: N Engl J Med. 1968 Mar 28;278(13):743.

Spread of Herpes-zoster virus.

Massarelli JJ.

PMID: 5638710 [PubMed - indexed for MEDLINE]

9764: Dtsch Med J. 1968 Mar 20;19(6):193-8 concl.

[On the therapy of skin and veneral diseases. Review of the literature 1965-66]

[Article in German]

Walther H.

Publication Types: 
    Review

PMID: 4181102 [PubMed - indexed for MEDLINE]

9765: Br Med J. 1968 Mar 16;1(5593):685.

Zosteriform late cutaneous syphilide.

Kodandapani C.

Publication Types: 
    Case Reports

PMID: 5640651 [PubMed - indexed for MEDLINE]

9766: Z Haut Geschlechtskr. 1968 Mar 15;43(6):243-6.

[On the reciprocal modification of coexisting diseases]

[Article in German]

Streitmann B.

PMID: 4233720 [PubMed - indexed for MEDLINE]

9767: Dtsch Med Wochenschr. 1968 Mar 8;93(10):435-8.

["Malignant zoster" in normoproteinemic plasmacytoma (Bence-Jones plasmacytoma)]

[Article in German]

Meiers HG, Gehrmann G.

PMID: 5639657 [PubMed - indexed for MEDLINE]

9768: Med J Aust. 1968 Mar 2;1(9):350-1.

Biperiden in the treatment of post-herpetic neuralgia.

Lang GA.

PMID: 5655175 [PubMed - indexed for MEDLINE]

9769: Radiobiol Radioter Fis Med. 1968 Mar-Apr;23(2):107-40.

[Place of radiotherapy in the treatment of zona]

[Article in Italian]

Pezzi A.

PMID: 5747121 [PubMed - indexed for MEDLINE]

9770: Kinderarztl Prax. 1968 Mar;36(3):101-3.

[Zoster in children]

[Article in German]

Kyin UA.

PMID: 5715779 [PubMed - indexed for MEDLINE]

9771: Neurology. 1968 Mar;18(3):308.

EEG studies of recurrent herpetic infection in rabbits.

Griffith JF, Kibrick S, Dodge PR.

PMID: 5301470 [PubMed - indexed for MEDLINE]

9772: Riv Otoneurooftalmol. 1968 Mar-Apr;43(2):177-99.

[Clinico-therapeutic considerations on cephalic herpes zoster]

[Article in Italian]

Bardin PG, Battaggia P.

PMID: 4302965 [PubMed - indexed for MEDLINE]

9773: Horumon To Rinsho. 1968 Mar;16(3):177-88.

[ACTH or adrenocortical hormone therapy in myasthenia gravis, myotonia and herpes
zoster]

[Article in Japanese]

Takahashi A.

Publication Types: 
    Review

PMID: 4300299 [PubMed - indexed for MEDLINE]

9774: Med Klin. 1968 Feb 16;63(7):256-9.

[Experimental studies and clinical experience with gentamycin]

[Article in German]

Meyer-Rohn J.

PMID: 5664711 [PubMed - indexed for MEDLINE]

9775: N Engl J Med. 1968 Feb 15;278(7):397.

Effect of surgical scar on herpes zoster.

Lorant A.

PMID: 5635654 [PubMed - indexed for MEDLINE]

9776: Am J Dis Child. 1968 Feb;115(2):279-80.

Geniculate ganglion syndrome (Hunt's syndrome, Herpes zoster oticus).

Gellis SS, Feingold M, Black DC.

PMID: 5636504 [PubMed - indexed for MEDLINE]

9777: Bull Soc Ophtalmol Fr. 1968 Feb;68(2):287-90.

[Atypic cases of ophthalmic zona]

[Article in French]

Guyard M, Perdriel G, Ceruti F.

PMID: 5313984 [PubMed - indexed for MEDLINE]

9778: Ann Ottalmol Clin Ocul. 1968 Feb;94(2):187-92.

[Case of scleral staphyloma after scleritis caused by herpes zoster]

[Article in Italian]

Parducci F, Cappelli L.

Publication Types: 
    Case Reports

PMID: 5310495 [PubMed - indexed for MEDLINE]

9779: Curr Med Drugs. 1968 Feb;8(6):19-31.

Herpes zoster.

Morton O.

PMID: 5305761 [PubMed - indexed for MEDLINE]

9780: Z Haut Geschlechtskr. 1968 Feb 1;43(3):79-83.

[On a combination therapy of Zoster]

[Article in German]

Weber G, Roth WG.

PMID: 5302107 [PubMed - indexed for MEDLINE]

9781: Ned Tijdschr Geneeskd. 1968 Jan 20;112(3):132-3.

[Lung tumor (?) in herpes zoster]

[Article in Dutch]

Dagnelie PR.

PMID: 5664980 [PubMed - indexed for MEDLINE]

9782: Sem Hop. 1968 Jan 20;44(4):239-44.

[Study of the therapeutic action of a combination of vitamins B1, B6 and
hydroxocobalamin in large doses]

[Article in French]

Pluvinage R.

PMID: 4297112 [PubMed - indexed for MEDLINE]

9783: Atti Accad Fisiocrit Siena [Med Fis]. 1968;17(2):941-53.

[Clinico-therapeutic considerations on the association of herpes zoster and
chronic lymphatic leukemia]

[Article in Italian]

Lunghetti R, Bianco G, Di Paolo N, Bravi A, Scalise G.

PMID: 5760340 [PubMed - indexed for MEDLINE]

9784: Langenbecks Arch Chir. 1968;322:552-65.

[Pathogenesis of clinical pain syndromes. Main neurologic lecture]

[Article in German]

Struppler A.

PMID: 5758774 [PubMed - indexed for MEDLINE]

9785: Mars Med. 1968;105(3):209-12.

[Disseminated zona and chronic lymphoid leukemia (2 cases)]

[Article in French]

Mongin M, Moutaffian JJ.

PMID: 5739885 [PubMed - indexed for MEDLINE]

9786: Bull Soc Fr Dermatol Syphiligr. 1968;75(6):767-8.

[Recurrent zona]

[Article in French]

Boutet B, Teillard J, Many P, Lapeyre J.

Publication Types: 
    Case Reports

PMID: 5712987 [PubMed - indexed for MEDLINE]

9787: Trans Am Neurol Assoc. 1968;93:253-6.

Neuromyositis in a patient with recurring herpes zoster.

Norris FH Jr, Dramov B, Johnson SG.

PMID: 5711034 [PubMed - indexed for MEDLINE]

9788: Mars Med. 1968;105(4):381-3.

[2 cases of zosterian paralysis: thoracic zona followed by myelitis and
velolaryngeal paralysis associated with geniculous zona]

[Article in French]

Force L, Jouffe G, Martin, Perrouty P.

PMID: 5680103 [PubMed - indexed for MEDLINE]

9789: Bull Soc Fr Dermatol Syphiligr. 1968;75(2):280-2.

[Generalized herpes zoster in a tubercular patient]

[Article in French]

Colomb D, Colombani R.

Publication Types: 
    Case Reports

PMID: 5677932 [PubMed - indexed for MEDLINE]

9790: Hautarzt. 1968 Jan;19(1):16-20.

[On the pathogenesis of herpes zoster in systemic diseases, especially in mycosis
fungoides]

[Article in German]

Koehler H.

PMID: 5674041 [PubMed - indexed for MEDLINE]

9791: Monatsschr Ohrenheilkd Laryngorhinol. 1968;102(3):182-91.

[Results of intratemporal bone facial nerve surgery]

[Article in German]

Moeltzner KH.

PMID: 5671729 [PubMed - indexed for MEDLINE]

9792: J Neurosurg. 1968 Jan;28(1):61-2.

Postherpetic trigeminal neuralgia ten years after retro-gasserian rhizotomy. Case
report.

Teng P, Papatheodorou C.

PMID: 5635963 [PubMed - indexed for MEDLINE]

9793: Gerontol Clin (Basel). 1968;10(2):116-27.

Clinical uses of systemic deoxyribonuclease.

Lloyd TW.

PMID: 5635169 [PubMed - indexed for MEDLINE]

9794: Med Times. 1968 Jan;96(1):43-9.

Herpes Zoster ophthalmicus. Prevention of ocular complications and therapy.

Freiwald MJ.

PMID: 5310992 [PubMed - indexed for MEDLINE]

9795: Vopr Kurortol Fizioter Lech Fiz Kult. 1968 Jan;33(1):83-4.

[The use of diadynamic currents in pain syndromes in patients with herpes zoster]

[Article in Russian]

Shatova LI, Shaposhnikov PK.

PMID: 5310630 [PubMed - indexed for MEDLINE]

9796: Trans Pac Coast Otoophthalmol Soc Annu Meet. 1968;49:185-95.

The treatment of ocular inflammation with hydroxymesterone.

Bedrossian RH.

PMID: 5305896 [PubMed - indexed for MEDLINE]

9797: Z Alternsforsch. 1968;21(2):137-46.

[Occurrence and course of inflammatory corneal diseases in various age groups]

[Article in German]

Marre M.

PMID: 5303999 [PubMed - indexed for MEDLINE]

9798: Nippon Rinsho. 1968 Jan;26(1):132-7.

[Inflammation and anti-inflammatory agents. Non-steroid anti-inflammatory drugs
and eye diseases]

[Article in Japanese]

Tokuda H.

PMID: 5303253 [PubMed - indexed for MEDLINE]

9799: Ophthalmologica. 1968;155(4):300-7.

Acute anterior uveitis of unknown origin and its connection with herpes simplex.

Hemmes GD.

PMID: 5301409 [PubMed - indexed for MEDLINE]

9800: Proc Rudolf Virchow Med Soc City N Y. 1968-1969;27:1-9.

Angina pectoris--true or false?

Lax H.

PMID: 5292174 [PubMed - indexed for MEDLINE]

9801: Arch Gesamte Virusforsch. 1968;25(1):52-7.

Simultaneous rise in complement-fixing antibodies against herpesvirus hominis and
varicella-zostervirus in patients with chickenpox and shingles.

Schaap GJ, Huisman J.

PMID: 4306835 [PubMed - indexed for MEDLINE]

9802: Zentralbl Allg Pathol. 1968;111(5):544-50.

[Occurrence of giant cells in the lung]

[Article in German]

Meerbach W, Wockel W, Guthert H.

Publication Types: 
    Review

PMID: 4305292 [PubMed - indexed for MEDLINE]

9803: Pediatr Akus Ginekol. 1968;6:21-2.

[Hydrocortisone treatment of some dermatoses in children]

[Article in Ukrainian]

Lipets' ME.

PMID: 4247441 [PubMed - indexed for MEDLINE]

9804: Proc Aust Assoc Neurol. 1968;5(3):459-61.

Specific neural stimulation for inhibition of pain.

Sweet WH.

PMID: 4179480 [PubMed - indexed for MEDLINE]

9805: Landarzt. 1967 Dec 31;43(36):1788-92.

[What is new in the field of dermatology?]

[Article in German]

Walther H.

PMID: 4235747 [PubMed - indexed for MEDLINE]

9806: Munch Med Wochenschr. 1967 Dec 15;109(50):2656-7.

[Plasmacytoma with internittent left bundle-branch block and recurrent zoster]

[Article in German]

Kittel K.

PMID: 5632011 [PubMed - indexed for MEDLINE]

9807: Wiad Lek. 1967 Dec 15;20(24):2191-6.

[On the pathogenesis of meningocerebral complications in herpes zoster]

[Article in Polish]

Wichlinski S.

PMID: 5587206 [PubMed - indexed for MEDLINE]

9808: Minerva Dermatol. 1967 Dec;42(12):658-60.

[On the radiotherapy of herpes zoster]

[Article in Italian]

Mazzola S, Braccio FN.

PMID: 5622854 [PubMed - indexed for MEDLINE]

9809: Naika. 1967 Dec;20(6):1022-8.

[Herpes zoster and progressive multifocal leukoencephalopathy]

[Article in Japanese]

Toyokura Y.

PMID: 5598627 [PubMed - indexed for MEDLINE]

9810: Infirm Fr. 1967 Dec;90:13-5.

[Zona]

[Article in French]

Poulain E.

PMID: 5184001 [PubMed - indexed for MEDLINE]

9811: Arch De Vecchi Anat Patol. 1967 Dec;50(3):615-27.

[In vivo studies, using the skin-window technic, on the inflammatory cellular
reactivity in hodgkin's disease]

[Article in Italian]

Maglulo E, Carco FP, Giraldi M, Sprovieri G.

PMID: 4951032 [PubMed - indexed for MEDLINE]

9812: Jibiinkoka. 1967 Dec;39(12):1297-9.

[Hunt's syndrome]

[Article in Japanese]

[No authors listed]

PMID: 4300355 [PubMed - indexed for MEDLINE]

9813: Arch Dermatol. 1967 Dec;96(6):657-64.

Association of zoster and malignant disorders in children.

Muller SA.

PMID: 4294716 [PubMed - indexed for MEDLINE]

9814: Arch Ophtalmol Rev Gen Ophtalmol. 1967 Dec;27(8):823-30.

Some aspects of therapeutic keratoplasty.

Leigh AG.

PMID: 4230318 [PubMed - indexed for MEDLINE]

9815: Nippon Igaku Hoshasen Gakkai Zasshi. 1967 Nov 25;27(8):1083-7.

[Herpes zoster following radiation therapy--the results of enquete]

[Article in Japanese]

Kobayashi T, Kiyono K, Nakanishi F, Sakamoto Y, Fujimori H.

PMID: 4877843 [PubMed - indexed for MEDLINE]

9816: J Neurol Sci. 1967 Nov-Dec;5(3):441-55.

Multiple sclerosis with amyotrophy complicated by oligodendroglioma. History of
recurrent herpes zoster.

Barnard RO, Jellinek EH.

PMID: 6073212 [PubMed - indexed for MEDLINE]

9817: Arch Fr Mal App Dig. 1967 Nov;56(11):1126-7.

[Icterigenic hepatitis with localized thoracic zona]

[Article in French]

Bert JM, Garrigues JM, Barthelemy.

PMID: 5622136 [PubMed - indexed for MEDLINE]

9818: Vestn Dermatol Venerol. 1967 Nov;41(11):73-4.

[Complex treatment with ultraviolet irradiation and diadynamic currents of the
pain syndrome in herpes zoster]

[Article in Russian]

Serebriakova VM.

PMID: 5621362 [PubMed - indexed for MEDLINE]

9819: J Clin Pathol. 1967 Nov;20(6):835-40.

Further observations on inclusion-bearing cells in urinary sediment in infectious
diseases.

Boyd JF, Nedelkoska N.

A study of the cytology of the urinary sediment in 43 patients with known viral
diseases has revealed a variety of inclusion-bearing cells in 28.The morphology
of the cells suggest that the changes recorded may be due to the viral
infections, at least in some instances, bearing in mind the findings of workers
quoted in our 1964 report that cellular changes very similar to those induced by 
virus infections can be initiated by non-viral stimuli. Multinucleate giant cells
are occasionally found in chickenpox, measles, herpes simplex infection, and in
mumps.

PMID: 5614069 [PubMed - indexed for MEDLINE]

9820: Br J Ophthalmol. 1967 Nov;51(11):775-9.

Unusual corneal lesion following herpes ophthalmicus.

Sears ML, Fenton RH.

PMID: 5299400 [PubMed - indexed for MEDLINE]

9821: Arch Ital Otol Rinol Laringol Patol Cervicofacc. 1967 Nov-Dec;78(6):801-11.

[Herpes zoster oticus. Etiopathological and clinical considerations on a case
with involvement of the bulbar vestibular nuclei]

[Article in Italian]

Dufour A, Felletti V.

PMID: 4388659 [PubMed - indexed for MEDLINE]

9822: Mayo Clin Proc. 1967 Nov;42(11):744-53.

Experiences in laboratory diagnosis of herpes simplex, varicella-zoster, and
vaccinia virus infections in routine medical practice.

Herrmann EC Jr.

PMID: 4293943 [PubMed - indexed for MEDLINE]

9823: Z Haut Geschlechtskr. 1967 Oct 15;42(20):813-6.

[Electrophoretic and serologic studies of herpes zoster]

[Article in German]

Ebner H, Soltz-Szots J.

PMID: 5596632 [PubMed - indexed for MEDLINE]

9824: Dtsch Gesundheitsw. 1967 Oct 5;22(40):1893-4.

[Negative cholecyst-cholangiogram in herpes zoster in the 8th thoracic segment on
the right side]

[Article in German]

Roth A, Ong Oei L.

PMID: 5600836 [PubMed - indexed for MEDLINE]

9825: Dtsch Gesundheitsw. 1967 Oct 5;22(40):1889-92.

[On therapeutic problems of herpes zoster]

[Article in German]

Staps R, Maluschka R.

PMID: 5600835 [PubMed - indexed for MEDLINE]

9826: Anaesthesia. 1967 Oct;22(4):568-74.

4 years' Pain Clinic experience.

Swerdlow M.

PMID: 6072474 [PubMed - indexed for MEDLINE]

9827: Boll Soc Med Chir Cremona. 1967 Oct-Dec;21(4):203-9.

[On the use of Neuleptil in inveterate peripheral neuralgias (note on 5 treated
cases)]

[Article in Italian]

Zanibelli G.

PMID: 4387687 [PubMed - indexed for MEDLINE]

9828: Hippokrates. 1967 Sep 30;38(18):727-8.

[Herpes "zoster" of the urinary bladder]

[Article in German]

Vogl A.

PMID: 5610063 [PubMed - indexed for MEDLINE]

9829: Wiad Lek. 1967 Sep 15;20(18):1745-8.

[Cerebrospinal meningitis in the course of herpes zoster]

[Article in Polish]

Wojciechowski L, Chrominska H.

Publication Types: 
    Case Reports

PMID: 6063484 [PubMed - indexed for MEDLINE]

9830: Z Haut Geschlechtskr. 1967 Sep 15;42(18):749-54.

[Dermatological experience with dimethyl sulfoxide (DMSO)]

[Article in German]

Weitgasser H.

PMID: 5591425 [PubMed - indexed for MEDLINE]

9831: Geriatrics. 1967 Sep;22(9):151-9.

Herpes zoster in the elderly.

Hope-Simpson RE.

PMID: 6033209 [PubMed - indexed for MEDLINE]

9832: J Indian Med Assoc. 1967 Sep 1;49(5):237-40.

Herpes zoster. A clinical study.

Mathur MP, Mathur AK, Saxena HC, Bhatia RK.

PMID: 5587620 [PubMed - indexed for MEDLINE]

9833: Gan No Rinsho. 1967 Sep;13(9):714-8.

[Herpes zoster in radiotherapy for malignant tumors--report of 5 cases and
significance of lysozyme preparations]

[Article in Japanese]

Kobayashi T, Kiyono K, Sakamoto Y, Fujimori H, Maruyama Y.

PMID: 4874817 [PubMed - indexed for MEDLINE]

9834: Wien Med Wochenschr. 1967 Aug 19;117(32):764-5.

[On the management of trigeminal neuralgia using Tegretol]

[Article in German]

Goldschmidt F.

PMID: 5588056 [PubMed - indexed for MEDLINE]

9835: HNO. 1967 Jul;15(7):196-200.

[Surgical treatment of facial parases and its problems]

[Article in German]

Kricheldorff H.

PMID: 5608328 [PubMed - indexed for MEDLINE]

9836: Riv Neurobiol. 1967 Jul-Sep;13(3):438-46.

[EMG findings in 2 cases of motor paralysis caused by herpes zoster]

[Article in Italian]

Perfetti CC, Lorizio A.

PMID: 5596319 [PubMed - indexed for MEDLINE]

9837: Indian Pract. 1967 Jul;20(7):457-9.

Cyanocobalamin (vitamin B 12) in the management of herpes zoster.

Gupta AK, Mital HS.

PMID: 5299609 [PubMed - indexed for MEDLINE]

9838: Stomatologia (Bucur). 1967 Jul-Aug;14(4):367-72.

[Considerations on the geniculate zone (Ramsay-Hunt syndrome) and its nosologic
relations with facial pain syndromes]

[Article in Romanian]

Pollingher B.

PMID: 5244536 [PubMed - indexed for MEDLINE]

9839: Wien Med Wochenschr. 1967 Jun 24;117(25):670.

[Zoster sacralis with involvement of the bladder]

[Article in German]

Weber H, Wolfram S.

PMID: 5585448 [PubMed - indexed for MEDLINE]

9840: Lancet. 1967 Jun 3;1(7501):1230-1.

Azauridine in viral eye infections.

Myska V, Elis J, Plevova J, Raskova H.

PMID: 4165149 [PubMed - indexed for MEDLINE]

9841: Acta Otolaryngol. 1967 Jun;63(6):533-50.

Herpes zoster auris associated with facial nerve palsy and auditory nerve
symptoms: a case report with histopathological findings.

Blackley B, Friedmann I, Wright I.

PMID: 6037903 [PubMed - indexed for MEDLINE]

9842: J Invest Dermatol. 1967 Jun;48(6):567-70.

Role of some biologically active substances in the mechanism of blister
formation.

Kandhari KC, Bhide NK, Sood VK.

PMID: 6028009 [PubMed - indexed for MEDLINE]

9843: Arch Otolaryngol. 1967 Jun;85(6):632-9.

Audiologic findings in Ramsay Hunt syndrome.

Harbert F, Young IM.

Publication Types: 
    Case Reports

PMID: 6024492 [PubMed - indexed for MEDLINE]

9844: J Med Bord. 1967 Jun;144(6):881-94.

[Ideas on indications for intrathecal corticotherapy]

[Article in French]

Vallat JN, Lepetit JM, Leger J.

PMID: 5633239 [PubMed - indexed for MEDLINE]

9845: Anaesthesist. 1967 Jun;16(6):172-4.

[Block treatment of acute idiopathic herpes zoster]

[Article in German]

Colding A.

PMID: 5617517 [PubMed - indexed for MEDLINE]

9846: Arch Oftalmol B Aires. 1967 Jun;42(6):131-5.

[Treatment of ophthalmic herpes zoster with Urgociton using the Eriksen method]

[Article in Spanish]

Sampaolesi R.

PMID: 5304899 [PubMed - indexed for MEDLINE]

9847: Am J Ophthalmol. 1967 Jun;63(6):1796-8.

Complications of herpes zoster ophthalmicus.

Ramsell TG.

PMID: 5298081 [PubMed - indexed for MEDLINE]

9848: Bull Soc Ophtalmol Fr. 1967 May-Jun;67(5):511-4.

[Dacryoadenitis due to zona associated with corneal lesions]

[Article in French]

Ravault MP, Moulin J, Girod M, Marin E.

Publication Types: 
    Case Reports

PMID: 5302534 [PubMed - indexed for MEDLINE]

9849: Am J Ophthalmol. 1967 May;63(5):992-3.

Coexistent herpes zoster and herpes simplex.

Acers TE, Vaile V 3rd.

Publication Types: 
    Case Reports

PMID: 5297901 [PubMed - indexed for MEDLINE]

9850: Br J Ophthalmol. 1967 May;51(5):350-1.

Intercalary staphyloma in a case of herpes zoster ophthalmicus.

Dugmore W.

Publication Types: 
    Case Reports

PMID: 5297861 [PubMed - indexed for MEDLINE]

9851: Sem Ther. 1967 May;43(5):305-7.

[Test of an antiviral treatment in some cutaneo-mucosal diseases]

[Article in French]

David V, Kuffer R.

PMID: 4299985 [PubMed - indexed for MEDLINE]

9852: Monatsschr Kinderheilkd. 1967 May;115(5):356-64.

[Immunoglobulin therapy]

[Article in German]

Hitzig WH.

Publication Types: 
    Review

PMID: 4172852 [PubMed - indexed for MEDLINE]

9853: Landarzt. 1967 Apr 20;43(11):533-4.

[Pain following herpes zoster]

[Article in German]

Nasemann T.

PMID: 5585072 [PubMed - indexed for MEDLINE]

9854: Br J Clin Pract. 1967 Apr;21(4):207-8.

Erythema multiforme major following herpes zoster.

Freeman DM.

Publication Types: 
    Case Reports

PMID: 6041133 [PubMed - indexed for MEDLINE]

9855: Eye Ear Nose Throat Mon. 1967 Apr;46(4):444-50.

Prevention of complications of herpes zoster ophthalmicus with special reference 
to steroid therapy.

Freiwald MJ.

PMID: 5298763 [PubMed - indexed for MEDLINE]

9856: Aust Dent J. 1967 Apr;12(2):83-91.

Ulceration of the mouth in children.

Kramer IR.

PMID: 5229244 [PubMed - indexed for MEDLINE]

9857: Wien Med Wochenschr. 1967 Mar 25;117(12):286-9.

[Value of cortisone in the management of virus encephalitis]

[Article in German]

Hohenegger M.

PMID: 4296791 [PubMed - indexed for MEDLINE]

9858: Minerva Med. 1967 Mar 3;58(18 Suppl):776-8.

[Use in geriatric therapy of a new preparation with anti-rheumatic action]

[Article in Italian]

Ronchi W, Bianchi F.

PMID: 6021527 [PubMed - indexed for MEDLINE]

9859: Minerva Med. 1967 Mar 3;58(18 Suppl):753-6.

[On the use of a new injectable antirheumatic-antiarthritic drug in some diseases
of orthopedic importance]

[Article in Italian]

Salvagni A.

PMID: 5297787 [PubMed - indexed for MEDLINE]

9860: Arch Dermatol. 1967 Mar;95(3):298.

Zoster and herpes simplex. Simultaneous occurrence in the same patient.

Kahn G.

Publication Types: 
    Case Reports

PMID: 6019800 [PubMed - indexed for MEDLINE]

9861: Vestn Dermatol Venerol. 1967 Mar;41(3):31-6.

[Changes in the cerebrospinal fluid in herpes zoster]

[Article in Russian]

Boldyrev LP.

PMID: 5603698 [PubMed - indexed for MEDLINE]

9862: Arch Ital Sci Med Trop Parassitol. 1967 Mar-Apr;48(3):99-103.

[On a case of atypical herpes zoster. (Further clinical contribution to the study
of the relations between herpes zoster and varicella)]

[Article in Italian]

De Carlo M, Ricciuti M.

Publication Types: 
    Case Reports

PMID: 5603352 [PubMed - indexed for MEDLINE]

9863: Arch Otolaryngol. 1967 Mar;85(3):298-302.

Neuronitis vestibularis.

Wlodyka J.

PMID: 5297533 [PubMed - indexed for MEDLINE]

9864: Z Haut Geschlechtskr. 1967 Mar 1;43(5):211-6.

[On the therapy of itching dermatoses in general practice]

[Article in German]

Zettl J.

PMID: 4231073 [PubMed - indexed for MEDLINE]

9865: J Med Lyon. 1967 Feb 5;48(114):187-93.

[Generalized zona and lymphosis: apropos of 2 cases, 1 of them associated with
osseous Paget's disease]

[Article in French]

Duverne J, Brizard CP, Mounier R, Volle H.

PMID: 5600101 [PubMed - indexed for MEDLINE]

9866: Am J Phys Med. 1967 Feb;46(1):544-54.

Pain of neurologic interest.

Drachman DA.

PMID: 6067163 [PubMed - indexed for MEDLINE]

9867: Dan Med Bull. 1967 Feb;14(3):68-70.

Herpes zoster in Hodgkin's disease.

Bichel J, Thorling K.

PMID: 6044405 [PubMed - indexed for MEDLINE]

9868: Am J Ophthalmol. 1967 Feb;63(2):326-30.

Horner's syndrome with geniculate zoster occurring in association with trigeminal
herpes in which the ophthalmic division was spared.

Jarrett WH.

Publication Types: 
    Case Reports

PMID: 6018668 [PubMed - indexed for MEDLINE]

9869: Practitioner. 1967 Feb;198(184):280-2.

Herpes zoster following vaccination.

Heymann K.

PMID: 5298624 [PubMed - indexed for MEDLINE]

9870: JAMA. 1967 Jan 30;199(5):315-7.

Varicella-zoster infections in pregnancy.

Brunell PA.

PMID: 4162975 [PubMed - indexed for MEDLINE]

9871: Urol Int. 1967;22(3):222-6.

Herpes zoster as a cause of urinary retention.

Gernert JE, Bischoff AJ, Bors E.

PMID: 6031944 [PubMed - indexed for MEDLINE]

9872: Bull Soc Belge Ophtalmol. 1967;146:264-72.

[Zona and chorioretinal complications]

[Article in French]

Appelmans M, Lebas P.

PMID: 5622638 [PubMed - indexed for MEDLINE]

9873: Oftalmol Zh. 1967;22(5):357-60.

[Cryotherapy in herpetic and other diseases of the cornea]

[Article in Russian]

Zolotareva MM, Chvialeva KI.

PMID: 5306355 [PubMed - indexed for MEDLINE]

9874: Riv Otoneurooftalmol. 1967 Jan-Feb;42(1):25-30.

[Bilateral paralysis of the constrictory of the iris during herpes zoster of the 
opthalmic branch of the right trigeminal nerve]

[Article in Italian]

Dorello U.

PMID: 5303079 [PubMed - indexed for MEDLINE]

9875: Klin Monatsbl Augenheilkd. 1967;150(4):523-9.

[On the clinical features of zoster ophthalmicus]

[Article in German]

Thomann H.

PMID: 5302465 [PubMed - indexed for MEDLINE]

9876: Acta Ophthalmol (Copenh). 1967;45(6):787-93.

Zoster ophthalmicus. Local treatment with cortisone.

Bergaust B, Westby RK.

PMID: 5300717 [PubMed - indexed for MEDLINE]

9877: Klin Oczna. 1967;37(5):711-3.

[Value of low temperature application in cataract extraction and treatment of
corneal herpes]

[Article in Polish]

Lenkiewicz E.

PMID: 5299561 [PubMed - indexed for MEDLINE]

9878: J Coll Gen Pract. 1967 Jan;13(1):110-4.

The treatment of herpes simplex and zoster with Terramycin.

Maran JI, Lawson SS, Hill AF, Ball JS.

PMID: 4382532 [PubMed - indexed for MEDLINE]

9879: Prog Med Virol. 1967;9:35-104.

Virus infections of the newborn.

Eichenwald HF, McCraken GH Jr, Kindberg SJ.

Publication Types: 
    Review

PMID: 4294436 [PubMed - indexed for MEDLINE]

9880: Bull Soc Fr Dermatol Syphiligr. 1967;74(2):168-70.

[Viral pustulosis on Hailey-Hailey pemphigus]

[Article in French]

Mascaro JM, Badillet G, Noury JY.

PMID: 4294016 [PubMed - indexed for MEDLINE]

9881: Hautarzt. 1967 Jan;18(1):31-5.

[Effective treatment of viral skin diseases with combinations of proteolytic
enzymes]

[Article in German]

Nasemann T, Schirren CG.

PMID: 4291685 [PubMed - indexed for MEDLINE]

9882: Bull Soc Fr Dermatol Syphiligr. 1967;74(4):412-3.

[Hematodermia. Generalized zona]

[Article in French]

Duperrat B, Escande JP, Pringuet R.

PMID: 4230999 [PubMed - indexed for MEDLINE]

9883: Z Haut Geschlechtskr. 1967 Jan 1;42(1):27-32.

[Therapeutic trials of various skin diseases using chinoline and chinaldine
derivatives]

[Article in German]

Wanic A.

Publication Types: 
    Clinical Trial

PMID: 4226653 [PubMed - indexed for MEDLINE]

9884: Br Med J. 1966 Dec 24;2(5529):1571-2.

Diaphragmatic paralysis after herpes zoster.

Brostoff J.

Publication Types: 
    Case Reports

PMID: 5926264 [PubMed - indexed for MEDLINE]

9885: J Med Lyon. 1966 Dec 20;47(111):1823-4 passim.

[Zona and malignant hemopathy (apropos of a generalised zona revealing a myeloma]

[Article in French]

Thiers H, Moulin G, Guibaud P.

PMID: 5990284 [PubMed - indexed for MEDLINE]

9886: Ugeskr Laeger. 1966 Dec 15;128(50):1503-5.

[Zoster oticus. Serologic confirmation of a clinically doubtful case]

[Article in Danish]

Petersen H.

PMID: 5980449 [PubMed - indexed for MEDLINE]

9887: Med Welt. 1966 Dec 3;49:2653-62.

[The significance of segmental vasomotor reflex processes for the localization of
dermatoses, especially herpes zoster]

[Article in German]

Hauser W.

PMID: 5980292 [PubMed - indexed for MEDLINE]

9888: Nunt Radiol. 1966 Dec;32(12):1717-23.

[Observations on radiotherapy of herpes zoster]

[Article in Italian]

Mazzola S, Braccio NF.

PMID: 5999429 [PubMed - indexed for MEDLINE]

9889: Minerva Dermatol. 1966 Dec;41(12):433-6.

[Generalized herpes zoster in chronic lymphatic leukemia. Reproduction of the
leukemic picture in sites of herpetic lesions]

[Article in Italian]

Carlesimo OA, Nini G, Barduagni O.

PMID: 5997510 [PubMed - indexed for MEDLINE]

9890: Rocky Mt Med J. 1966 Dec;63(12):37-9.

Shingles and chickenpox.

Ratcliff RG.

Publication Types: 
    Case Reports

PMID: 5981133 [PubMed - indexed for MEDLINE]

9891: J Indian Med Assoc. 1966 Dec 1;47(11):562-4.

Ramsay Hunt syndrome.

Thomas E, Anantachari MD.

PMID: 5980946 [PubMed - indexed for MEDLINE]

9892: Tidsskr Nor Laegeforen. 1966 Nov 15;86(22):1551-2.

[Zoster and varicellae. Simultaneous appearance in a 3-year-old girl]

[Article in Norwegian]

Barkve T.

Publication Types: 
    Case Reports

PMID: 5979063 [PubMed - indexed for MEDLINE]

9893: Vestn Dermatol Venerol. 1966 Nov;40(11):74-5.

[A case of herpes zoster in lymphogranulomatosis]

[Article in Russian]

Rakhmankulov AG.

Publication Types: 
    Case Reports

PMID: 6002994 [PubMed - indexed for MEDLINE]

9894: G Mal Infett Parassit. 1966 Nov;18(11):786-9.

[Hemiplegic herpes zoster encephalitis]

[Article in French]

Janni A.

PMID: 5987233 [PubMed - indexed for MEDLINE]

9895: Przegl Dermatol. 1966 Nov-Dec;53(6):637-42.

[On histological differential diagnosis of pityriasis lichenoides et
varioloformis acuta Mucha-Haberman]

[Article in Polish]

Nasemann T, Markowski R, Jakubowicz K.

PMID: 5979552 [PubMed - indexed for MEDLINE]

9896: Vrach Delo. 1966 Nov;11:126.

[Diadynamic currents in the complex treatment of patients with herpes zoster]

[Article in Russian]

Brudnaia EN.

PMID: 5304658 [PubMed - indexed for MEDLINE]

9897: Rev Otoneuroophtalmol. 1966 Nov;38(6):309-11.

[Unilateral abolition of the photomotor reflex, a sequella of ophthalmic zona]

[Article in French]

Thiebaut F, Matavulj N, Collard M, Remy R.

PMID: 5298705 [PubMed - indexed for MEDLINE]

9898: Dtsch Med Wochenschr. 1966 Oct 14;91(41):1844-5.

[Therapy of herpes zoster]

[Article in German]

Braun-Falco O.

PMID: 5925288 [PubMed - indexed for MEDLINE]

9899: Br J Ophthalmol. 1966 Oct;50(10):610-1.

Ophthalmological herpes zoster complicated by hemiplegia.

Pandi DN, Romanes GJ.

PMID: 5297178 [PubMed - indexed for MEDLINE]

9900: Med J Aust. 1966 Sep 10;2(11):502-4.

Varicella-Zoster in Sydney. 3. Herpes zoster and complications.

Boughton CR.

PMID: 5296958 [PubMed - indexed for MEDLINE]

9901: Minerva Med. 1966 Sep 8;57(72):2918-21.

[Considerations on the association of herpes zoster and chronic lymphatic
leukemia]

[Article in Italian]

Abrate M, Baiotti G.

PMID: 5917934 [PubMed - indexed for MEDLINE]

9902: Lyon Med. 1966 Sep 4;216(36):392-6.

[Apropos of pain in herpes zoster. Treatment with a new drug complex with a base 
of D-propoxyphene]

[Article in French]

Rollier R, Rollier M.

PMID: 5990997 [PubMed - indexed for MEDLINE]

9903: Med Parazitol (Mosk). 1966 Sep-Oct;35(5):600-1.

[Herpes zoster as a result of the toxic effect of antimony compounds on the
organism]

[Article in Russian]

Aslamazov EG, Metel'skaia OA, Tumol'skaia NI.

PMID: 6003353 [PubMed - indexed for MEDLINE]

9904: J Lab Clin Med. 1966 Sep;68(3):463-74.

The activation of varicella-zoster virus infections by immunosuppressive therapy.

Rifkind D.

PMID: 5332136 [PubMed - indexed for MEDLINE]

9905: G Clin Med. 1966 Sep;47(9):779-89.

[Herpetic manifestations and hemoblastosis]

[Article in Italian]

Scaramelli M, Zavagli G.

PMID: 5239169 [PubMed - indexed for MEDLINE]

9906: Hautarzt. 1966 Sep;17(9):395-9.

[On histological differential diagnosis of pityriasis lichenoides et
varioliformis acuta Mucha-Habermann]

[Article in German]

Nasemann T, Markowski R, Jakubowicz K.

PMID: 4871982 [PubMed - indexed for MEDLINE]

9907: Med J Aust. 1966 Aug 27;2(9):392-7.

Varicella-zoster in Sydney. I. Varicella and its complications.

Boughton CR.

PMID: 5917155 [PubMed - indexed for MEDLINE]

9908: Z Haut Geschlechtskr. 1966 Aug 15;41(4):145-9.

[Zoster as an isomorphous irritation effect in psoriasis vulgaris (a case
contribution)]

[Article in German]

Pohler H.

Publication Types: 
    Case Reports

PMID: 5992177 [PubMed - indexed for MEDLINE]

9909: Dermatol Wochenschr. 1966 Aug 6;152(32):819-23.

[Herpes zoster varicellosus generalisatus in chronic lymphatic lymphadenitis]

[Article in German]

Lehmann H.

PMID: 5925461 [PubMed - indexed for MEDLINE]

9910: Klin Med (Mosk). 1966 Aug;44(8):105-10.

[Some current problems of the clinical aspects and therapy of herpes zoster]

[Article in Russian]

Kalamkarian AA, Kochetkov VD.

PMID: 5995806 [PubMed - indexed for MEDLINE]

9911: Z Haut Geschlechtskr. 1966 Aug 1;41(3):85-90.

[Generalized herpes zoster in Hodgkin's disease. (Case report and immunological
studies)]

[Article in German]

Ebner H, Soltz-Szots J.

PMID: 5991440 [PubMed - indexed for MEDLINE]

9912: Minerva Dermatol. 1966 Aug;41(8):259-63.

["Generalized" herpes zoster during chronic lymphoid leukemia]

[Article in Italian]

Leigheb G.

PMID: 5989243 [PubMed - indexed for MEDLINE]

9913: Acta Otolaryngol. 1966 Jun 27:Suppl 224:296+.

Spontaneous course of 220 peripheral non-traumatic facial palsies.

Peitersen E, Andersen P.

PMID: 6011525 [PubMed - indexed for MEDLINE]

9914: Acta Otolaryngol. 1966 Jun 27:Suppl 224:301+.

Electrodiagnosis in facial palsy of endotemporal origin.

Etholm B.

PMID: 5300395 [PubMed - indexed for MEDLINE]

9915: Med Klin. 1966 Jun 10;61(23):916-9.

[Clinical experience with virostatic drugs]

[Article in German]

Fischer H, Tronnier H.

PMID: 5987575 [PubMed - indexed for MEDLINE]

9916: Strahlentherapie. 1966 Jun;130(2):198-204.

[Contribution on the occurrence of herpes zoster in patients with malignant
tumors treated by ionizing radiation]

[Article in German]

Vich Z.

PMID: 5987351 [PubMed - indexed for MEDLINE]

9917: Clin Proc Child Hosp Dist Columbia. 1966 Jun;22(6):157-63.

Grand rounds: herpes zoster.

Parrott RH, Glew WB, Hatger W.

Publication Types: 
    Case Reports

PMID: 5218929 [PubMed - indexed for MEDLINE]

9918: Dermatol Wochenschr. 1966 May 28;152(22):558-63.

[Casuistics in pictures]

[Article in German]

Bologa EI.

PMID: 6010643 [PubMed - indexed for MEDLINE]

9919: Dtsch Med Wochenschr. 1966 May 27;91(21):998.

[On the clinical aspects, pathogenesis and therapy of herpes zoster, with special
reference to the incidence of zoster duplex unilateralis]

[Article in German]

Hauser W.

PMID: 5930214 [PubMed - indexed for MEDLINE]

9920: Jibiinkoka. 1966 May;38(5):497-501.

[Case of otitic herpes zoster]

[Article in Japanese]

Ichihara M, Komatsu A, Kamio T, Shigeyama M, Kubota T.

PMID: 6006880 [PubMed - indexed for MEDLINE]

9921: Strahlentherapie. 1966 May;130(1):57-72.

[Is there a causative connection between radiotherapy and herpes zoster]

[Article in German]

Gremmel H, Schulte-Brinkmann W.

PMID: 5992447 [PubMed - indexed for MEDLINE]

9922: Rocky Mt Med J. 1966 May;63(5):43-6.

The Ramsey-Hunt syndrome.

Eckberg TJ.

Publication Types: 
    Case Reports

PMID: 5930969 [PubMed - indexed for MEDLINE]

9923: Bull Soc Ophtalmol Fr. 1966 May-Jun;66(5):590-6.

[Hypertension in zona ophthalmica]

[Article in French]

Corbel M, Beal F, Asseman R.

PMID: 5300653 [PubMed - indexed for MEDLINE]

9924: Ganka. 1966 May;8(5):388-97.

[Clinical experience with IDU ointment--effect of IDU on cornea]

[Article in Japanese]

Sano M.

Publication Types: 
    Comparative Study

PMID: 5297544 [PubMed - indexed for MEDLINE]

9925: Indian Pract. 1966 May;19(5):371-3.

Herpes zoster ophthalmicus with maxillary involvement. (A case report).

Prasad VN, Kumar S.

Publication Types: 
    Case Reports

PMID: 5296072 [PubMed - indexed for MEDLINE]

9926: SSO Schweiz Monatsschr Zahnheilkd. 1966 May;76(5):512-6.

[Early manifestations of some organic diseases in the mouth]

[Article in German]

Seidner S.

PMID: 5220740 [PubMed - indexed for MEDLINE]

9927: Arch Ital Otol Rinol Laringol. 1966 May-Jun;77(3):273-94.

[Contribution to the etiopathogenesis of herpes zoster oticus with particular
reference to cochleo-vestibular disturbances]

[Article in Italian]

Bergomi A, Perani G, Girardi G.

PMID: 4381061 [PubMed - indexed for MEDLINE]

9928: Rev Clin Esp. 1966 Apr 30;101(2):136-8.

[Paralysis of the phrenic nerve caused by herpes zoster]

[Article in Spanish]

Schaposnik F.

Publication Types: 
    Case Reports

PMID: 5935830 [PubMed - indexed for MEDLINE]

9929: Lakartidningen. 1966 Apr 6;63(14):1318-9.

[Multiple sclerosis, tonsillectomy, and herpes zoster varicellosus]

[Article in Swedish]

Meurman L, Wising P.

PMID: 5917042 [PubMed - indexed for MEDLINE]

9930: Dermatol Wochenschr. 1966 Apr 2;152(14):337-43.

[Experimental and clinical contributions to dermatocardiac reflex relations]

[Article in German]

Pastinszky I, Kenedi I.

PMID: 5929174 [PubMed - indexed for MEDLINE]

9931: Neurology. 1966 Apr;16(4):351-4.

Isocitric dehydrogenase in the cerebrospinal fluid. Clinical usefulness of its
determination.

Van Rymenant M, Robert J, Otten J.

PMID: 5948643 [PubMed - indexed for MEDLINE]

9932: Bull Soc Ophtalmol Fr. 1966 Apr;66(4):394-401.

[Glaucomatous zoster algias and atropine]

[Article in French]

Sedan J.

PMID: 5296956 [PubMed - indexed for MEDLINE]

9933: Landarzt. 1966 Mar 20;42(8):346-8.

[Therapy of late zoster neuralgia]

[Article in German]

Absolon P.

PMID: 5974225 [PubMed - indexed for MEDLINE]

9934: Vestn Otorinolaringol. 1966 Mar-Apr;28(2):90-1.

[Observation of a case of herpes zoster oticus]

[Article in Russian]

Sidorchuk TV, Ponomarev VS.

Publication Types: 
    Case Reports

PMID: 6003065 [PubMed - indexed for MEDLINE]

9935: Actas Dermosifiliogr. 1966 Mar-Apr;57(3):104-6.

[Generalized zoster with lethal course]

[Article in Spanish]

Jaqueti G, Ballesteros N, Corripio F.

Publication Types: 
    Case Reports

PMID: 5959649 [PubMed - indexed for MEDLINE]

9936: Bull Soc Fr Dermatol Syphiligr. 1966 Mar-Apr;73(2):157-60.

[Apropos of zosterian pains. Their treatment with a new medicinal complex with a 
base of D-propoxyphene]

[Article in French]

Rollier R, Rollier M.

PMID: 5914157 [PubMed - indexed for MEDLINE]

9937: Rev Med Moyen Orient. 1966 Mar-Apr;23(2):217-20.

[Hodgkin's disease and zona]

[Article in French]

Haddad FS, Haddad FN, Ponthus P.

PMID: 5227241 [PubMed - indexed for MEDLINE]

9938: Med Welt. 1966 Feb 12;7:360-2.

[Clinical experience with the vitamin combination "Medivitan"]

[Article in German]

Jahnichen S.

PMID: 4166612 [PubMed - indexed for MEDLINE]

9939: Dtsch Med Wochenschr. 1966 Feb 11;91(6):263-7.

[On the clinical features, pathogenesis and therapy of herpes zoster especially
on the incidence of zoster duplex unilateralis]

[Article in German]

Helle S.

Publication Types: 
    Case Reports

PMID: 4159458 [PubMed - indexed for MEDLINE]

9940: N Engl J Med. 1966 Jan 27;274(4):181-5.

Serologic and virus-isolation studies of patients with varicella or herpes-zoster
infection.

Gold E.

Publication Types: 
    Case Reports

PMID: 4285450 [PubMed - indexed for MEDLINE]

9941: Zh Nevropatol Psikhiatr Im S S Korsakova. 1966;66(2):189-93.

[Meningitis and meningoencephalitis in herpes zoster]

[Article in Russian]

Malkova EV.

PMID: 6000256 [PubMed - indexed for MEDLINE]

9942: Z Kinderheilkd. 1966;97(4):291-8.

[Studies on the enzyme activity in skin blister serum]

[Article in German]

Sitzmann FC.

PMID: 5985318 [PubMed - indexed for MEDLINE]

9943: Gerontol Clin (Basel). 1966;8(2):70-6.

A statistical and clinical study of herpes zoster.

Hellgren L, Hersle K.

PMID: 5925840 [PubMed - indexed for MEDLINE]

9944: Vestn Oftalmol. 1966 Jan-Feb;79(1):48-53.

[Cytological changes in the epithelium of the cornea and conjunctiva in herpetic 
disease of the eye]

[Article in Russian]

Tarasova LN.

PMID: 5298932 [PubMed - indexed for MEDLINE]

9945: Vestn Oftalmol. 1966 Jan-Feb;79(1):45-8.

[The role of skin tests in the diagnosis and therapy of herpetic keratits]

[Article in Russian]

Lavrent'eva AM.

PMID: 5298931 [PubMed - indexed for MEDLINE]

9946: Geriatrics. 1966 Jan;21(1):145-54.

The etiology of uveitis in the aged.

Bergaust B.

PMID: 5295374 [PubMed - indexed for MEDLINE]

9947: Acta Med Scand Suppl. 1966;464:57-65.

Smallpox outbreak and vaccination problems in Stockholm, Sweden 1963. 3.
Diagnosis, clinical classification and symptoms, differential diagnosis and
therapy.

Strom J, Gerzen P, Herzenberg H, Jansson U, Ursing J, Werneman H.

PMID: 5229014 [PubMed - indexed for MEDLINE]

9948: Haematologica. 1966;51(12):947-60.

[Histioleukemia appearing during grave disseminated herpes zoster]

[Article in Italian]

Panelli G, Marigo S, Ferrero E.

PMID: 4967330 [PubMed - indexed for MEDLINE]

9949: Acta Neurol Psychiatr Belg. 1966 Jan;66(1):53-75.

[Clinical and anatomical study of 2 cases of zosterial encephalitis. Review and
discussion of the literature]

[Article in French]

Perier O, Vanderhaeghen JJ, Franken L, Parmentier N.

Publication Types: 
    Case Reports
    In Vitro

PMID: 4957520 [PubMed - indexed for MEDLINE]

9950: Int Ophthalmol Clin. 1966 Winter;6(4):869-901.

Steroid therapy in uveitis.

Coles RS.

Publication Types: 
    Review

PMID: 4294917 [PubMed - indexed for MEDLINE]

9951: Klin Monatsbl Augenheilkd. 1966;149(4):449-57.

[On the differential diagnosis of keratitis]

[Article in German]

Boke W, de Decker W.

PMID: 4294222 [PubMed - indexed for MEDLINE]

9952: Vestn Dermatol Venerol. 1966 Jan;40(1):16-20.

[On the causative agent of herpes zoster]

[Article in Russian]

Vasilenko PV.

PMID: 4292669 [PubMed - indexed for MEDLINE]

9953: Vopr Virusol. 1966 Jan-Feb;11(1):73-6.

[Some properties of various strains of Herpes simplex virus]

[Article in Russian]

Shubladze AK, Maevskaia TM.

PMID: 4292047 [PubMed - indexed for MEDLINE]

9954: Zh Nevropatol Psikhiatr Im S S Korsakova. 1966;66(3):366-70.

[Treatment of herpes zoster]

[Article in Russian]

Malkova EV.

PMID: 4175032 [PubMed - indexed for MEDLINE]

9955: Pol Tyg Lek. 1965 Dec 6;20(49):1854-6.

[Herpetic viral diseases and systemic lupus erythematosus]

[Article in Polish]

Vachtenheim J, Grossmann J.

PMID: 5862123 [PubMed - indexed for MEDLINE]

9956: Bull Soc Ophtalmol Fr. 1965 Dec;65(12):1116-8.

[Zosterian dacryo-adenitis]

[Article in French]

Paufique L, Bonnet M, Guyon M, Sinno W.

Publication Types: 
    Case Reports

PMID: 5295722 [PubMed - indexed for MEDLINE]

9957: Am J Ophthalmol. 1965 Dec;60(6):1111-4.

Complications of herpes zoster ophthalmicus.

Harrison EQ.

Publication Types: 
    Case Reports

PMID: 5295201 [PubMed - indexed for MEDLINE]

9958: Oral Surg Oral Med Oral Pathol. 1965 Dec;20(6):726-42.

Bacteriostasis and virology of herpetic lesions of the face and oral mucous
membranes.

Levin HL.

PMID: 5215963 [PubMed - indexed for MEDLINE]

9959: Med J Aust. 1965 Nov 20;2(21):869-72.

Treatment of post-herpetic neuralgia.

Woodforde JM, Dwyer B, McEwen BW, De Wilde FW, Bleasel K, Connelley TJ, Ho CY.

PMID: 5852886 [PubMed - indexed for MEDLINE]

9960: Concours Med. 1965 Nov 20;87(47):6859-60.

[Herpes zoster and chickenpox. The relations between these 2 diseases]

[Article in French]

Tournier P.

Publication Types: 
    In Vitro

PMID: 4284739 [PubMed - indexed for MEDLINE]

9961: Nippon Rinsho. 1965 Nov;23(11):2239-45.

[Herpes zoster observed in malignant tumor patients, with special reference to
their etiology and clinical value]

[Article in Japanese]

Sunada T, Tanaka S, Omoto T.

Publication Types: 
    Case Reports

PMID: 5895395 [PubMed - indexed for MEDLINE]

9962: Ther Ggw. 1965 Nov;104(11):1435-44.

[Treatment of varicella zoster virus infections]

[Article in German]

Nasemann T.

PMID: 5885562 [PubMed - indexed for MEDLINE]

9963: J Pediatr. 1965 Nov;67(5):763-71.

Factors contributing to severity of herpes zoster in children.

Bacon GE, Oliver WJ, Shapiro BA.

Publication Types: 
    Case Reports

PMID: 5845441 [PubMed - indexed for MEDLINE]

9964: Eye Ear Nose Throat Mon. 1965 Nov;44(11):71-5.

Herpes zoster ophthalmicus---management.

Jain BS, Srivastava KN.

PMID: 5294365 [PubMed - indexed for MEDLINE]

9965: Dent Clin North Am. 1965 Nov:577-89.

Acute lesions of the oral cavity.

Huebsch RF.

PMID: 5213629 [PubMed - indexed for MEDLINE]

9966: Rev Clin Esp. 1965 Oct 31;99(2):127-8.

[Bronchopulmonary neoplasms preceded by generalized herpes zoster]

[Article in Spanish]

Dumm FR, Acuna F.

Publication Types: 
    Case Reports

PMID: 5865077 [PubMed - indexed for MEDLINE]

9967: Minerva Med. 1965 Oct 31;56(87):3681-95.

[Action of the blood coagulating fraction of the venom of Bothrops jararaca on
herpes zoster, herpes simplex and varicella. First clinico-therapeutic
experiences]

[Article in Italian]

Sannino M, Felici A, Ferrea E.

Publication Types: 
    Clinical Trial

PMID: 5320396 [PubMed - indexed for MEDLINE]

9968: Dermatol Wochenschr. 1965 Oct 23;151(43):1235-7.

[Development of a basal cell carcinoma into a completely undifferentiated tumor. 
Metastasis formation in zoster scar?]

[Article in German]

Scheicher-Gottron E, Matheis H.

PMID: 5881899 [PubMed - indexed for MEDLINE]

9969: Lancet. 1965 Oct 9;2(7415):708-11.

Antigenic relationship of varicella-zoster and herpes simplex.

Ross CA, Subak Sharpe JH, Ferry P.

Publication Types: 
    In Vitro

PMID: 4157772 [PubMed - indexed for MEDLINE]

9970: Calif Med. 1965 Oct;103(4):277-9.

Acute herpes zoster. Successful treatment by continuous epidural analgesia.

Marmer MJ.

PMID: 5828176 [PubMed - indexed for MEDLINE]

9971: Calif Med. 1965 Oct;103(4):261-6.

Muscle paralysis in herpes zoster.

Rubin D, Fusfeld RD.

Herpes zoster may, in some instances, cause motor paralysis as well as the usual 
sensory and cutaneous manifestations. It is suggested that the presence of
electromyographic denervation potentials be used as the criterion of muscle
paresis in order to avoid mistaking atrophy of disuse for true lower motor neuron
disease. Use of the proper physical therapy procedures hastens the recovery of
function and may serve to retard denervation atrophy and fibrosis in patients
with muscle paralysis.

Publication Types: 
    Case Reports

PMID: 5828175 [PubMed - indexed for MEDLINE]

9972: Am J Ophthalmol. 1965 Oct;60(4):713-6.

Canalicular inflammation in ophthalmic cases of herpes zoster and herpes simplex.

Bouzas A.

Publication Types: 
    Case Reports

PMID: 5294609 [PubMed - indexed for MEDLINE]

9973: Proc Soc Exp Biol Med. 1965 Oct;120(1):56-9.

Zoster-like lesions from herpes simplex virus in newborn rats.

Tanaka S, Southam CM.

PMID: 4285242 [PubMed - indexed for MEDLINE]

9974: J Immunol. 1965 Oct;95(4):683-91.

Characteristics of herpes zoster and varicella viruses propagated in vitro.

Gold E.

Publication Types: 
    In Vitro

PMID: 4284677 [PubMed - indexed for MEDLINE]

9975: Rev Clin Esp. 1965 Sep 30;98(6):412-5.

[A case of multiple myeloma with generalized herpes, hyperlipemia and
xanthomatosis]

[Article in Spanish]

Schuller Perez A, Perez Sotelo R, Barreiro Tella P, Martinez Fernandez A, De
Benito A, Alvarez P.

Publication Types: 
    Case Reports

PMID: 5865271 [PubMed - indexed for MEDLINE]

9976: Riforma Med. 1965 Sep 18;79(38):1037-43.

[On two cases of acute benign idiopathic pericarditis in the course of infectious
mononucleosis and herpes zoster]

[Article in Italian]

Colonna A, Solinas P.

Publication Types: 
    Case Reports

PMID: 5852765 [PubMed - indexed for MEDLINE]

9977: Riforma Med. 1965 Sep 11;79(37):1037-42.

[On two cases of acute benign idiopathic pericarditis in the course of infectious
mononucleosis and herpes zoster]

[Article in Italian]

Colonna A, Solinas P.

Publication Types: 
    Case Reports

PMID: 5852762 [PubMed - indexed for MEDLINE]

9978: Am J Med. 1965 Sep;39:452-63.

VARICELLA-ZOSTER INFECTION IN HODGKIN'S DISEASE: CLINICAL AND EPIDEMIOLOGICAL
ASPECTS.

SOKAL JE, FIRAT D.

PMID: 14338296 [PubMed - indexed for MEDLINE]

9979: Arch Intern Med. 1965 Sep;116:329-35.

HERPES ZOSTER HOUSE EPIDEMIC IN STEROID-TREATED PATIENTS. A CLINICAL AND VIRAL
STUDY.

RADO JP, TAKO J, GEDER L, JENEY E.

PMID: 14330618 [PubMed - indexed for MEDLINE]

9980: Jibiinkoka. 1965 Sep;37(9):887-90.

[The use of Neuzym (lysozyme) in diseases of the ear, nose and throat]

[Article in Japanese]

Hine S.

PMID: 5890548 [PubMed - indexed for MEDLINE]

9981: Sov Med. 1965 Sep;28(9):127-30.

[Current status of the problem of the etiology and pathogenesis of herpes zoster]

[Article in Russian]

Malkova EV.

PMID: 5871686 [PubMed - indexed for MEDLINE]

9982: Klin Med (Mosk). 1965 Sep;43(9):42-4.

[Vegetative disturbances in herpes zoster]

[Article in Russian]

Bogolepov NK, Malkova EV.

PMID: 5870048 [PubMed - indexed for MEDLINE]

9983: Bull Los Angeles Neurol Soc. 1965 Sep;30(3):148-52.

Conservative treatment of post-herpetic neuralgia.

Todd EM, Crue BL Jr, Vergadamo M.

PMID: 5847972 [PubMed - indexed for MEDLINE]

9984: Acta Paedopsychiatr. 1965 Sep;32(9):260-9.

[Zoster Encephalitis in early childhood]

[Article in German]

Schipkowensky N.

Publication Types: 
    Case Reports

PMID: 5322935 [PubMed - indexed for MEDLINE]

9985: J Lab Clin Med. 1965 Sep;66(3):403-12.

Immunofluorescent staining in the laboratory diagnosis of varicella-zoster virus 
infections.

Schmidt NJ, Lennette EH, Woodie JD, Ho HH.

Publication Types: 
    In Vitro

PMID: 5319786 [PubMed - indexed for MEDLINE]

9986: Wiad Lek. 1965 Aug 15;18(16):1349-51.

[A case of generalized herpes zoster]

[Article in Polish]

Marks E, Szewczykowski J.

Publication Types: 
    Case Reports

PMID: 5853017 [PubMed - indexed for MEDLINE]

9987: Practitioner. 1965 Aug;195:235-7.

A TRIAL OF "VIRUGON" IN HERPES ZOSTER.

MCKNIGHT AG.

PMID: 14328869 [PubMed - indexed for MEDLINE]

9988: Vrach Delo. 1965 Aug;8:148-9.

[Catamnesis of patients who have had herpes zoster]

[Article in Russian]

Malkova EV.

PMID: 5870979 [PubMed - indexed for MEDLINE]

9989: Vopr Okhr Materin Det. 1965 Aug;10(8):90-1.

[On the connection between herpes zoster and chickenpox and its significance in
the epidemiology of these diseases]

[Article in Russian]

Zorin PM.

PMID: 5870358 [PubMed - indexed for MEDLINE]

9990: J All India Ophthalmol Soc. 1965 Aug;13(2):73-4.

Meningo-encephalitis and herpes zoster-varicella.

Kerawala SD.

Publication Types: 
    Case Reports

PMID: 4284061 [PubMed - indexed for MEDLINE]

9991: Ann N Y Acad Sci. 1965 Jul 30;130(1):192-208.

Clinical studies with systemic administration of antimetabolites of pyrimidine
nucleosides in viral infections.

Calabresi P.

Publication Types: 
    Case Reports

PMID: 4221776 [PubMed - indexed for MEDLINE]

9992: Lancet. 1965 Jul 17;1(7403):102-4.

RADIOTHERAPY IN HERPES ZOSTER.

RHYS-LEWIS RD.

PMID: 14330029 [PubMed - indexed for MEDLINE]

9993: Ugeskr Laeger. 1965 Jul 15;127(28):880-3.

[A complement fixation reaction for herpes zoster. Was this herpes zoster
oticus?]

[Article in Danish]

Petersen H.

PMID: 5869873 [PubMed - indexed for MEDLINE]

9994: Rev Asoc Med Argent. 1965 Jul;79(7):312-5.

[Herpes zoster. Virus disease of the aged]

[Article in Spanish]

Mosso HE, Pergola F, Barros CA.

PMID: 5853388 [PubMed - indexed for MEDLINE]

9995: Indian J Dermatol. 1965 Jul;10(4):160-2.

Observation on herpes zoster oticus & laryngs.

Dayanidhi Das.

Publication Types: 
    Case Reports

PMID: 5831547 [PubMed - indexed for MEDLINE]

9996: Internist (Berl). 1965 Jul;6(7):342-54.

[Herps zoster (virology and clinical aspects)--review of the literature]

[Article in German]

Nasemann T.

Publication Types: 
    Review

PMID: 5320430 [PubMed - indexed for MEDLINE]

9997: Bull Soc Ophtalmol Fr. 1965 Jul-Aug;65(7):630-2.

[Viral dacryocystitis. Apropos of 3 cases]

[Article in French]

Cantat MA.

Publication Types: 
    Case Reports

PMID: 5294687 [PubMed - indexed for MEDLINE]

9998: Jibiinkoka. 1965 Jul;37(7):657-62.

[Observation of herpes zoster oticus which showed vestibular dysfunction as its
main symptom]

[Article in Japanese]

Shirabe S.

Publication Types: 
    Case Reports

PMID: 5294288 [PubMed - indexed for MEDLINE]

9999: Sven Tandlak Tidskr. 1965 Jun 15;58:315-8.

[HERPES ZOSTER--A MEMENTO IN THE DIFFERENTIAL DIAGNOSIS. APROPOS OF AN UNUSUAL
CASE.]

[Article in Swedish]

AHLIN A.

PMID: 14331196 [PubMed - indexed for MEDLINE]

10000: Acta Chir Scand. 1965 Jun;129:573-80.

EXPERIENCES WITH INTRACTABLE PAIN TREATED BY STEREOTAXIC MESENCEPHALOTOMY.

HELFANT MH, LEKSELL L, STRANG RR.

PMID: 14337929 [PubMed - indexed for MEDLINE]

10001: Klin Monatsbl Augenheilkd. 1965 Jun;146:683-95.

[CORNEAL SENSITIVITY IN HERPETIC KERATITIS.]

[Article in German]

SEVERIN M.

PMID: 14315874 [PubMed - indexed for MEDLINE]

10002: Arch Neurol. 1965 Jun;12:610-2.

ZOSTER MENINGOENCEPHALITIS IN A STEROID-TREATED PATIENT.

TAKO J, RADO JP.

PMID: 14295960 [PubMed - OLDMEDLINE]

10003: J Laryngol Otol. 1965 Jun;79:479-93.

TASTE AND THE CHORDA TYPANI.

BULL TR.

PMID: 14292248 [PubMed - indexed for MEDLINE]

10004: Am J Surg. 1965 Jun;109:711-4.

WOUND TENSION AND WOUND SLOUGHS: A NEGATIVE CORRELATION.

MYERS MB, COMBS B, COHEN G.

PMID: 14283327 [PubMed - indexed for MEDLINE]

10005: Vestn Dermatol Venerol. 1965 Jun;39(6):76-7.

[Association of herpes zoster and smallpox in the same patient]

[Article in Russian]

Gur'ev AN, Kozlova ZM.

Publication Types: 
    Case Reports

PMID: 5859159 [PubMed - indexed for MEDLINE]

10006: Czas Stomatol. 1965 Jun;18(6):635-8.

[3 cases of herpes zoster in the oral cavity]

[Article in Polish]

Prostak-Kosowska K.

Publication Types: 
    Case Reports

PMID: 5219733 [PubMed - indexed for MEDLINE]

10007: Helv Paediatr Acta. 1965 Jun;20(2):222-6.

[Pathogenesis of herpes zoster]

[Article in German]

Frischknecht W.

PMID: 4284232 [PubMed - indexed for MEDLINE]

10008: Munch Med Wochenschr. 1965 May 21;107:1038-41.

[ZOSTER IN LEUKOSIS AND LYMPHOGRANULOMATOSIS.]

[Article in German]

HEINE KM.

PMID: 14305691 [PubMed - indexed for MEDLINE]

10009: Arch Klin Exp Dermatol. 1965 May 17;222:149-70.

[APROPOS OF LOCALIZATION OF HERPES ZOSTER.]

[Article in German]

HAUSER W.

PMID: 14311597 [PubMed - indexed for MEDLINE]

10010: Br Med J. 1965 May 15;1(5445):1308-9.

CONCURRENT HERPES ZOSTER AND VARICELLA.

SPILLANE JD.

PMID: 14278828 [PubMed - OLDMEDLINE]

10011: G Mal Infett Parassit. 1965 May;17:295-6.

[HERPES ZOSTER-VARICELLA: DESCRIPTION OF A CASE OF FAMILIAL CONTAGION.]

[Article in Italian]

GRILLONE W.

PMID: 14341363 [PubMed - indexed for MEDLINE]

10012: Cesk Stomatol. 1965 May;65:165-72.

[HERPES ZOSTER.]

[Article in Czech]

LEZOVIC J, CIGANEK L.

PMID: 14325353 [PubMed - indexed for MEDLINE]

10013: Klin Monatsbl Augenheilkd. 1965 May;146:563-77.

[HERPETIC CORNEAL DISEASES.]

[Article in German]

LIEBSCHER H, MUELLER F.

PMID: 14298503 [PubMed - indexed for MEDLINE]

10014: J Pediatr. 1965 May;66:956-8.

HERPES ZOSTER IN A NEWBORN PREMATURE INFANT.

ADKISSON MA.

PMID: 14279856 [PubMed - indexed for MEDLINE]

10015: Arch Otolaryngol. 1965 May;81:470-7.

ELECTRODIAGNOSIS IN FACIAL PALSY.

TAVERNER D.

PMID: 14275900 [PubMed - indexed for MEDLINE]

10016: Arch Otolaryngol. 1965 May;81:457-62.

QUANTITATIVE MEASUREMENTS OF THE NASOLACRIMAL REFLEX.

ZILSTORFF-PEDERSEN K.

PMID: 14275898 [PubMed - indexed for MEDLINE]

10017: Wiad Lek. 1965 May 1;18(9):765-8.

[Chlorpromazine iontophoresis in the treatment of neuralgia following herpes
zoster]

[Article in Polish]

Stein W, Drozdz J, Rymczonek C.

PMID: 5837719 [PubMed - indexed for MEDLINE]

10018: Br Med J. 1965 Apr 24;1(5442):1127-8.

CONCURRENT HERPES ZOSTER AND VARICELLA.

MULLER BK, GOMES WJ.

PMID: 14270202 [PubMed - indexed for MEDLINE]

10019: Can Med Assoc J. 1965 Apr 10;92:843.

HERPES ZOSTER.

DU JN, STAUFFER MH, LEVIN M, ROGERS AG.

PMID: 14272506 [PubMed - indexed for MEDLINE]

10020: N Y State J Med. 1965 Apr 1;65:913-7.

MOTOR INVOLVEMENT IN HERPES ZOSTER. IDENTICAL LOWER EXTREMITY PARESIS.

WESELEY MS, BARENFELD PA.

PMID: 14265338 [PubMed - indexed for MEDLINE]

10021: Minn Med. 1965 Apr;48:497-502.

HERPES ZOSTER.

GUSTILO RB, FOSS DL, LESLIE WR, TELANDER RL.

PMID: 14262301 [PubMed - indexed for MEDLINE]

10022: Pediatria (Santiago). 1965 Apr-Jun;8(2):147-50.

[Use of panthenol (Bepantol M. R.) in the treatment of herpes zoster]

[Article in Spanish]

Vucina I, Romero C, Salinas M, Pezoa L.

PMID: 5842690 [PubMed - indexed for MEDLINE]

10023: Dis Chest. 1965 Apr;47(4):451.

A renewed plea for the isolation of shingles. Report of a case.

Weingarten CM.

Publication Types: 
    Case Reports

PMID: 5836927 [PubMed - indexed for MEDLINE]

10024: Osp Ital Chir. 1965 Apr;12(4):505-8.

[The hospital of S. Antonio in Florence]

[Article in Italian]

Mannelli MA.

Publication Types: 
    Historical Article

PMID: 5318602 [PubMed - indexed for MEDLINE]

10025: Arch Klin Exp Dermatol. 1965 Mar 8;221:456-62.

[STUDIES WITH THE VARICELLA-HERPES ZOSTER VIRUS.]

[Article in German]

SOELTZ-SZOETS J.

PMID: 14272390 [PubMed - indexed for MEDLINE]

10026: Bull Soc Fr Dermatol Syphiligr. 1965 Mar-Apr;72:123-5.

[GENERALIZED ZONA IN A SUBJECT WITH LYMPHORETICULOSARCOMA.]

[Article in French]

BOLGERT M, POISSON R, TINTHOIN JF, GAMBLIN J.

PMID: 14335362 [PubMed - indexed for MEDLINE]

10027: Klin Monatsbl Augenheilkd. 1965 Mar;146:267-70.

[EXPERIENCES WITH THE VIROSTATIC IODOURACIL DESOXYRIBOSIDE (IUDR) IN HERPES
DISEASES OF THE EYE.]

[Article in German]

KOCH P.

PMID: 14286375 [PubMed - indexed for MEDLINE]

10028: Klin Monatsbl Augenheilkd. 1965 Mar;146:161-71.

[RESULTS OF KERATOPLASTY IN HERPES.]

[Article in German]

HALLERMANN W.

PMID: 14286363 [PubMed - indexed for MEDLINE]

10029: Ind Med Surg. 1965 Mar;34:269-77.

APPLICATION OF FLUORESCENT ANTIBODY TECHNIQUES TO VIRAL INFECTIONS.

RIGGS JL.

PMID: 14279056 [PubMed - OLDMEDLINE]

10030: Paraplegia. 1965 Mar;2:207-13.

THE PATHOLOGY OF VASCULAR DISORDERS OF THE SPINAL CORD.

HUGHES JT.

PMID: 14261503 [PubMed - indexed for MEDLINE]

10031: Khirurgiia (Mosk). 1965 Mar;41(3):134-5.

[Herpes zoster as a disease simulating "acute abdomen"]

[Article in Russian]

Malanina GI.

Publication Types: 
    Case Reports

PMID: 5887445 [PubMed - indexed for MEDLINE]

10032: Rass Dermatol Sifilogr. 1965 Mar-Apr;18(2):61-9.

[Cutaneous leukemic manifestations arising on the site of herpes zoster in a
subject with lymphatic leukemia]

[Article in Italian]

Marchini E, Grignani F.

Publication Types: 
    Case Reports

PMID: 5840183 [PubMed - indexed for MEDLINE]

10033: Neurol Psihiatr Neurochir. 1965 Mar-Apr;10(2):127-31.

[Zoster encephalitis. Clinical study]

[Article in Romanian]

Dimitriu R, Cinca I, Colea A, Onaca P, Hobai I.

PMID: 5827634 [PubMed - indexed for MEDLINE]

10034: J Clin Stomatol Conf. 1965 Mar;6(1):5-6.

Herpes zoster.

Rod H, Golomb IM.

PMID: 5213436 [PubMed - indexed for MEDLINE]

10035: Med Welt. 1965 Feb 27;82:460-1.

[TREATMENT OF TRIGEMINAL NEURALGIA WITH CENTROMID.]

[Article in German]

VOGT U.

PMID: 14263593 [PubMed - indexed for MEDLINE]

10036: Z Haut Geschlechtskr. 1965 Feb 15;38:123-32.

[CRITICAL REMARKS ON THE CLINICAL ASPECTS AND THERAPY OF HERPES ZOSTER.]

[Article in German]

SOELTZ-SZOETS J.

PMID: 14256639 [PubMed - OLDMEDLINE]

10037: Exp Mol Pathol. 1965 Feb;76:11-23.

A MORPHOLOGIC COMPARISON BETWEEN THE DEVELOPMENTAL STAGES OF HERPES ZOSTER AND
HUMAN CYTOMEGALOVIRUS.

BECKER P, MELNICK JL, MAYOR HD.

PMID: 14297547 [PubMed - OLDMEDLINE]

10038: Sov Med. 1965 Feb;28:70-1.

[VARICELLIFORM DISSEMINATION OF HERPES ZOSTER.]

[Article in Russian]

RUDIKOVA EM, ERDMAN IuS.

PMID: 14273963 [PubMed - indexed for MEDLINE]

10039: Ann Intern Med. 1965 Feb;62:350-8.

PNEUMONIA DUE TO HERPES ZOSTER. REPORT OF A CASE AND REVIEW OF THE LITERATURE.

PEK S, GIKAS PW.

PMID: 14259218 [PubMed - indexed for MEDLINE]

10040: J Am Geriatr Soc. 1965 Feb;13:166-75.

OBSERVATIONS ON THE TREATMENT OF POSTHERPETIC NEURALGIA WITH NANDROLONE.

ROBERTS HJ.

PMID: 14255634 [PubMed - indexed for MEDLINE]

10041: Lancet. 1965 Jan 16;1(7377):158-60.

Corticosteroids in the acute infections.

Breen GE, Talukdar PK.

Publication Types: 
    Case Reports

PMID: 4161683 [PubMed - indexed for MEDLINE]

10042: Prog Med (Paris). 1965 Jan 10;93:23-9.

[WHAT IS THE PRESENT STATUS OF ZONA OPHTHALMICA?]

[Article in French]

GANEM J.

PMID: 14282651 [PubMed - indexed for MEDLINE]

10043: Dermatol Wochenschr. 1965 Jan 9;151:33-7.

[DISSEMINATED NEUROFIBROMATOSIS AND HERPES ZOSTER IN THE SAME SEGMENTAL REGION.]

[Article in German]

KORTING GW, TUPATH-BARNISKE R.

PMID: 14265012 [PubMed - indexed for MEDLINE]

10044: Minerva Dermatol. 1965 Jan;40:15-8.

[LATEST OBSERVATIONS ON THE USE OF GRISEOFULVIN IN THE TREATMENT OF HERPES
ZOSTER.]

[Article in Italian]

RANDAZZO SD, GIARDINA A.

PMID: 14304968 [PubMed - indexed for MEDLINE]

10045: Dokl Bulg Acad Nauk. 1965;18:263-5.

[ONCOLYTIC INFECTIONS.]

[Article in French]

CHRISTOV G.

PMID: 14302595 [PubMed - OLDMEDLINE]

10046: Proc R Soc Med. 1965 Jan;58:9-20.

THE NATURE OF HERPES ZOSTER: A LONG-TERM STUDY AND A NEW HYPOTHESIS.

HOPE-SIMPSON RE.

PMID: 14267505 [PubMed - indexed for MEDLINE]

10047: Indian J Dermatol. 1965 Jan;10:61.

EMETINE HYDROCHLORIDE IN THE TREATMENT OF HERPES ZOSTER.

ANNAMALAI R.

PMID: 14266439 [PubMed - OLDMEDLINE]

10048: J Med Chir Prat. 1965 Jan;136:3-8.

[3 CASES OF GENERALIZED ZONE.]

[Article in French]

MAHOUDEAU D, BENAIM P, DUBRISAY J, GRUPPER C.

PMID: 14258499 [PubMed - indexed for MEDLINE]

10049: Geriatrics. 1965 Jan;20:78-82.

ANGINA PECTORIS PAIN AND HERPES ZOSTER: REPORT OF A CASE WITH REVIEW OF THE
LITERATURE.

HORTON GE.

PMID: 14249992 [PubMed - indexed for MEDLINE]

10050: Minn Med. 1965 Jan;48:79-87.

BACK PAIN AND HERPES ZOSTER. REPORT OF CASE.

SILVERSTEIN MN, MARTIN WJ, TITUS JL.

PMID: 14244297 [PubMed - indexed for MEDLINE]

10051: Clin Pediatr (Phila). 1965 Jan;4:13-7.

ASSOCIATION OF HERPES ZOSTER WITH LEUKEMIA AND LYMPHOMA IN CHILDREN.

KEIDAN SE, MAINWARING D.

PMID: 14243915 [PubMed - indexed for MEDLINE]

10052: Dent Pract Dent Rec. 1965 Jan;15:179-81.

HERPES ZOSTER OF THE MAXILLARY DIVISION OF THE TRIGEMINAL NERVE ASSOCIATED WITH
VARICELLA.

COHEN L.

PMID: 14241680 [PubMed - indexed for MEDLINE]

10053: Actas Dermosifiliogr. 1965 Jan-Feb;56(1):3-8.

[Generalized herpes zoster in a patient with multiple myeloma]

[Article in Spanish]

Gomez ORBANEJA J, Gomezaaorbaneja J, Ledo Pozueta A, Sanchez Lozano de Sosa.

Publication Types: 
    Case Reports

PMID: 5874606 [PubMed - indexed for MEDLINE]

10054: Verh Dtsch Ges Kreislaufforsch. 1965;31:133-7.

[Zoster cardiopathy]

[Article in German]

Siering H.

Publication Types: 
    Case Reports

PMID: 5871261 [PubMed - indexed for MEDLINE]

10055: Trans Ophthalmol Soc N Z. 1965;17:81-4.

Motor anomalies in herpes zoster ophthalmicus.

Wales HJ.

Publication Types: 
    Case Reports

PMID: 5295396 [PubMed - indexed for MEDLINE]

10056: Ophthalmologica. 1965;149(5):405-15.

[On the pathological anatomy of uveitis]

[Article in German]

Landolt E.

PMID: 5294162 [PubMed - indexed for MEDLINE]

10057: Acta Stomatol Belg. 1965;62(4):463-99.

[Buccofacial zona]

[Article in French]

Servais R.

Publication Types: 
    Case Reports

PMID: 5218003 [PubMed - indexed for MEDLINE]

10058: Trans Ophthalmol Soc U K. 1965;85:369-78.

The diagnosis and management of episcleritis and scleritis.

Watson PG, Lobascher D.

Publication Types: 
    Clinical Trial
    Comparative Study
    Randomized Controlled Trial

PMID: 4381284 [PubMed - indexed for MEDLINE]

10059: Acta Derm Venereol. 1965;45(4):262-71.

Diagnostic importance of punch biopsy and cytologic examination in herpes zoster 
and herpes simplex.

Brehmer-Andersson E.

PMID: 4162959 [PubMed - indexed for MEDLINE]

10060: Z Haut Geschlechtskr. 1964 Dec 1;37:45-8.

[HERPES ZOSTER GANGRAENOSUS WITH FATAL OUTCOME.]

[Article in German]

ZAUN H.

PMID: 14344663 [PubMed - indexed for MEDLINE]

10061: Practitioner. 1964 Dec;193:798-9.

HERPES ZOSTER GENERALIZATUS.

WETHERED RR.

PMID: 14244390 [PubMed - indexed for MEDLINE]

10062: Bull Soc Ophtalmol Fr. 1964 Dec;64(12):1109-10.

[Metaherpetic keratitis and I.D.U.]

[Article in French]

Iu R, Reboul.

PMID: 5294205 [PubMed - indexed for MEDLINE]

10063: Dtsch Med Wochenschr. 1964 Nov 20;89:2228-34.

[THE SKIN FLAP IN THE TREATMENT OF SEVERE POSTHERPETIC INTERCOSTAL NEURALGIA.]

[Article in German]

ALTHER E.

PMID: 14213194 [PubMed - indexed for MEDLINE]

10064: Dtsch Med Wochenschr. 1964 Nov 6;89:2130-6.

[CLINICAL ASPECTS AND THERAPY OF STEROID DIABETES.]

[Article in German]

SAUER H, RAUSCH-STROOMANN JG.

PMID: 14218240 [PubMed - OLDMEDLINE]

10065: Med Clin North Am. 1964 Nov;48:1529-39.

UVEITIS: ITS VARIED MANIFESTATIONS AND CAUSES.

KURZ GH.

PMID: 14274378 [PubMed - indexed for MEDLINE]

10066: Proc Soc Exp Biol Med. 1964 Nov;117:546-9.

VIRUSES AND MAMMALIAN CHROMOSOMES. 3. EFFECT OF HERPES ZOSTER VIRUS ON HUMAN
EMBRYONAL LUNG CULTURES.

BENYESH-MELNICK M, STICH HF, RAPP F, HSU TC.

PMID: 14233492 [PubMed - OLDMEDLINE]

10067: Am J Ophthalmol. 1964 Nov;58:852-4.

OPTIC ATROPHY IN HERPES ZOSTER OPHTHALIMICUS.

PEMBERTON JW.

PMID: 14220502 [PubMed - indexed for MEDLINE]

10068: Arch Otolaryngol. 1964 Nov;80:587-91.

OTITIS MEDIA AND COMPLICATIONS.

DYSART BR.

Publication Types: 
    Review

PMID: 14216022 [PubMed - indexed for MEDLINE]

10069: Br J Dermatol. 1964 Nov;76:459-62.

5 IODO-2'-DEOXYURIDINE IN THE TREATMENT OF HERPES ZOSTER.

MCCALLUM DI, JOHNSTON EN, RAJU BH.

PMID: 14213037 [PubMed - indexed for MEDLINE]

10070: Z Haut Geschlechtskr. 1964 Oct 15;37:283-4.

[EXPERIENCES WITH THE PREPARATION "MEDIVITAN" IN HERPES ZOSTER IN GENERAL
PRACTICE.]

[Article in German]

KOST W.

PMID: 14324612 [PubMed - indexed for MEDLINE]

10071: Cardiol Prat. 1964 Oct;15:570-6.

[MYOCARDIAL INFARCT ASSOCIATED WITH HERPES ZOSTER. DESCRIPTION OF A CASE.]

[Article in Italian]

CARIELLO M.

PMID: 14292069 [PubMed - indexed for MEDLINE]

10072: Rev Med Chil. 1964 Oct;92:808-9.

[USE OF PANTOTHENOL (BEPANTOL) IN THE TREATMENT OF HERPES ZOSTER.]

[Article in Spanish]

VUCINA I, ROMERO C, SALINAS M, PEZOA L.

PMID: 14273926 [PubMed - indexed for MEDLINE]

10073: Ann Ottalmol Clin Ocul. 1964 Oct;90:585-96.

[OBSERVATIONS ON THE AUTONOMIC COMPONENTS OF ZOSTER OPHTHALMICUS.]

[Article in Italian]

CREPALDI A.

PMID: 14256768 [PubMed - indexed for MEDLINE]

10074: Ann Dermatol Syphiligr (Paris). 1964 Oct-Dec;91:505-11.

[COMPARATIVE IMMUNOELECTROPHORETIC STUDY OF PROTEINS OF SERUM AND BLISTER FLUID
IN BULLOUS DERMATOSES (60 CASES).]

[Article in French]

MOULIN G, MANUEL Y.

PMID: 14237502 [PubMed - indexed for MEDLINE]

10075: J Immunol. 1964 Oct;93:643-8.

INHIBITION BY METABOLIC ANALOGUES OF PLAQUE FORMATION BY HERPES ZOSTER AND HERPES
SIMPLEX VIRUSES.

RAPP F.

PMID: 14219080 [PubMed - OLDMEDLINE]

10076: J Med Soc N J. 1964 Oct;61:441-6.

DERMATOLOGIC PROBLEMS IN THE ELDERLY.

SATULSKY EM.

PMID: 14199354 [PubMed - indexed for MEDLINE]

10077: Sven Lakartidn. 1964 Sep 30;61:2909-15.

[HERPES ZOSTER AND VARICELLAE. 2 CASES OF GENERALIZED HERPES ZOSTER AND CHRONIC
LYMPHATIC LEUKEMIA.]

[Article in Swedish]

RECHT L.

PMID: 14222121 [PubMed - indexed for MEDLINE]

10078: Orv Hetil. 1964 Sep 27;105:1839.

[OUR EXPERIENCES WITH BIGUAMOR (PRELIMINARY REPORT).]

[Article in Hungarian]

PAJOR R, HEGEDUES J, BAJNOK G.

PMID: 14192634 [PubMed - indexed for MEDLINE]

10079: Lancet. 1964 Sep 19;2(7360):610-1.

TREATMENT OF HERPES ZOSTER WITH HIGH DOSES OF PREDNISONE.

ELLIOTT FA.

PMID: 14186147 [PubMed - indexed for MEDLINE]

10080: Arch Gesamte Virusforsch. 1964 Sep 9;15:67-73.

POSSIBLE ANTIGENIC RELATIONSHIP BETWEEN VARICELLA ZOSTER VIRUS AND HERPES SIMPLEX
VIRUS.

KAPSENBERG JG.

PMID: 14314772 [PubMed - indexed for MEDLINE]

10081: Zh Ushn Nos Gorl Bolezn. 1964 Sep-Oct;24:76-7.

[2 CASES OF HERPES ZOSTER OTICUS.]

[Article in Russian]

MARKZITSER AL.

PMID: 14322304 [PubMed - indexed for MEDLINE]

10082: Klin Med (Mosk). 1964 Sep;42:135-7.

[HERPES ZOSTER OF THE TRIGEMINAL NERVE.]

[Article in Russian]

ERKHOV IS, EVLADOVA NA, STUPNIKOVA MN.

PMID: 14246640 [PubMed - indexed for MEDLINE]

10083: Public Health Rep. 1964 Sep;79:839-42.

CRUDE TISSUE CULTURE ANTIGEN FOR DETERMINATION OF VARICELLA-ZOSTER COMPLEMENT
FIXING ANTIBODY.

BRUNELL PA, CASEY HL.

PMID: 14213793 [PubMed - OLDMEDLINE]

10084: Wis Med J. 1964 Sep;63:377-9.

HERPES ZOSTER WITH INVOLVEMENT OF THE URINARY BLADDER.

EWELL GH, STRAUGHN RA.

PMID: 14208130 [PubMed - indexed for MEDLINE]

10085: Rinsho Ganka. 1964 Sep;18:1037-44.

[VARIOUS PHASES OF OPHTHALMOPLEGIA (1).]

[Article in Japanese]

MOTOHASHI T, FUJIWARA T.

PMID: 14205675 [PubMed - indexed for MEDLINE]

10086: Lancet. 1964 Aug 22;2(7356):382-5.

INTERFERON IN HUMAN SERUM DURING CLINICAL VIRAL INFECTIONS.

WHEELOCK EF, SIBLEY WA.

PMID: 14173626 [PubMed - OLDMEDLINE]

10087: Hautarzt. 1964 Aug;15:403-8.

[NON-SPECIFIC SKIN PHENOMENA IN MALIGNANT TUMORS OF INTERNAL ORGANS.]

[Article in German]

ANDREEV VC.

Publication Types: 
    Review

PMID: 14252760 [PubMed - indexed for MEDLINE]

10088: Dermatol Wochenschr. 1964 Aug 1;150:112-6.

[ZOSTER AS A PREMORBID STATE OF A CIRCUMSCRIBED SCLERODERMA.]

[Article in German]

ZIMMERMANN H.

PMID: 14251395 [PubMed - indexed for MEDLINE]

10089: Neurology. 1964 Aug;14:744-50.

HERPETIC NEURITIS: A LIGHT AND ELECTRON MICROSCOPIC STUDY.

ZACKS SI, ELLIOTT FA, LANGFITT TW.

PMID: 14206565 [PubMed - indexed for MEDLINE]

10090: Eye Ear Nose Throat Mon. 1964 Aug;43:62.

HERPES ZOSTER--PRESENT STATUS OF TREATMENT.

GORMAN W.

PMID: 14201372 [PubMed - indexed for MEDLINE]

10091: Practitioner. 1964 Aug;193:217-9.

THE NATURE OF HERPES ZOSTER.

HOPE-SIMPSON RE.

PMID: 14199641 [PubMed - indexed for MEDLINE]

10092: Arch Neurol. 1964 Aug;11:155-72.

ZOSTER ENCEPHALOMYELITIS.

ROSE FC, BRETT EM, BURSTON J.

Publication Types: 
    Review

PMID: 14158522 [PubMed - indexed for MEDLINE]

10093: Orv Hetil. 1964 Jul 5;105:1273-5.

[CASES OF HERPES ZOSTER DURING A PROLONGED STEROID THERAPY.]

[Article in Hungarian]

FUELOEP E.

PMID: 14179214 [PubMed - OLDMEDLINE]

10094: Orv Hetil. 1964 Jul 5;105:1271-3.

[GENERALIZED HERPES ZOSTER COMPLICATED BY MENINGITIS IN A PATIENT TREATED WITH
CORTICOSTEROIDS.]

[Article in Hungarian]

TAKO J, RADO J.

PMID: 14179213 [PubMed - OLDMEDLINE]

10095: Orv Hetil. 1964 Jul 5;105:1266-70.

[GROUP OCCURRANCE OF HERPES ZOSTER IN PATIENTS TREATED WITH CORTICOSTEROIDS.]

[Article in Hungarian]

RADO J, TAKO J, GEDER L, JENEY E.

PMID: 14179212 [PubMed - OLDMEDLINE]

10096: Dermatol Wochenschr. 1964 Jul 4;150:3-6.

[THERAPEUTIC POTENTIALS OF GRISSEOFULVINGRISEOFULVIN AS AN ANTINEOPLASTIC AND
ANTIVIRAL AGENT.]

[Article in German]

RANDAZZO SD, GIARDINA A.

PMID: 14252716 [PubMed - indexed for MEDLINE]

10097: Arch Klin Exp Dermatol. 1964 Jul 3;220:105-28.

[VIROLOGICAL AND SEROLOGICAL STUDIES IN HERPES ZOSTER.]

[Article in German]

SOELTZ-SZOETS J.

PMID: 14253193 [PubMed - OLDMEDLINE]

10098: Bristol Med Chir J. 1964 Jul;79:91-2.

POLYNEURITIS COMPLICATING HERPES ZOSTER.

ETUK ES, BRIDGES D.

PMID: 14344395 [PubMed - indexed for MEDLINE]

10099: Rev Med Moyen Orient. 1964 Jul-Aug;21:400-5.

[TREATMENT OF HERPES ZOSTER WITH ULTRASONICS.]

[Article in French]

MANOUSCHERIAN F, AZIZI Z, HAMADANI D.

PMID: 14240256 [PubMed - indexed for MEDLINE]

10100: Bull Soc Fr Dermatol Syphiligr. 1964 Jul-Aug;71:529-32.

[APROPOS OF 8 CASES OF GENERALIZED ZONA.]

[Article in French]

LE COULANT, TEXIER, MALEVILLE, BROUSTET A, GENIAUX.

PMID: 14210528 [PubMed - indexed for MEDLINE]

10101: J Postgrad Med. 1964 Jul;10:131-4.

HERPES ZOSTER MYELITIS. A CASE REPORT AND REVIEW OF LITERATURE.

PENDHARKAR MB, BALSE SL, SHAH MJ.

PMID: 14199380 [PubMed - indexed for MEDLINE]

10102: Proc R Soc Med. 1964 Jul;57:589-90.

ZOSTER MYELITIS PRESENTING WITH ACUTE RETENTION OF URINE.

HARRISON RJ.

PMID: 14178942 [PubMed - indexed for MEDLINE]

10103: Am J Roentgenol Radium Ther Nucl Med. 1964 Jul;92:116-23.

DISSEMINATED HERPES ZOSTER IN THE RETICULOSES.

DAYAN AD, MORGAN HG, HOPE-STONE HF, BOUCHER BJ.

PMID: 14176022 [PubMed - OLDMEDLINE]

10104: Arch Dermatol. 1964 Jul;90:95-6.

ZOSTER IN A PATIENT WITH ATOPIC DERMATITIS.

VONGEMMINGEN GR, WINKELMANN RK.

PMID: 14149733 [PubMed - indexed for MEDLINE]

10105: Gaz Med Fr. 1964 Jun 10;71:SUPPL:35-7.

[USE OF TH-2152 IN PAINFUL SYNDROMES.]

[Article in French]

TASEI LA, ROY JC.

PMID: 14160390 [PubMed - OLDMEDLINE]

10106: Klin Med (Mosk). 1964 Jun;42:134-5.

[LESIONS OF THE URINARY BLADDER IN HERPES ZOSTER.]

[Article in Russian]

GOLUBEV IS, MAZO EB.

PMID: 14243243 [PubMed - indexed for MEDLINE]

10107: Vestn Dermatol Venerol. 1964 Jun;38:26-9.

[HERPES ZOSTER IN RHEUMATOID ARTHRITIS PATIENTS.]

[Article in Russian]

VACHTENHEIM J.

PMID: 14229317 [PubMed - indexed for MEDLINE]

10108: Ann Ottalmol Clin Ocul. 1964 Jun;90:273-84.

[HERPES ZOSTER AND OCULAR HYPERTENSION.]

[Article in Italian]

CHINAGLIA V, BELCI C.

PMID: 14210351 [PubMed - indexed for MEDLINE]

10109: Int Ophthalmol Clin. 1964 Jun;4:311-24.

OCULAR LESIONS ASSOCIATED WITH OTHER VIRAL DISEASES.

ALLEN JH.

PMID: 14199221 [PubMed - indexed for MEDLINE]

10110: Munch Med Wochenschr. 1964 May 29;106:1033-8.

[THE VISCERAL MANIFESTATIONS OF HERPES ZOSTER.]

[Article in German]

SCHWARCZMANN P.

PMID: 14221312 [PubMed - indexed for MEDLINE]

10111: N Engl J Med. 1964 May 21;270:1101-11.

RECENT ADVANCES IN THE DIAGNOSIS AND TREATMENT OF VIRAL DISEASES OF THE SKIN.

ARTENSTEIN MS, DEMIS DJ.

Publication Types: 
    Review

PMID: 14121491 [PubMed - indexed for MEDLINE]

10112: N Engl J Med. 1964 May 7;270:979-82.

AN OUTBREAK OF HERPES SIMPLEX AMONG WRESTLERS (HWEPES GLADIATORUM).

SELLING B, KIBRICK S.

PMID: 14122793 [PubMed - indexed for MEDLINE]

10113: JAMA. 1964 May 4;188:SUPPL:30.

STEROID ADMINISTRATION MAY BE VALUABLE IN HERPES ZOSTER.

ELLIOTT FA.

PMID: 14125229 [PubMed - indexed for MEDLINE]

10114: Klin Med (Mosk). 1964 May;42:115-6.

[HERPES ZOSTER AS A DISEASE SIMULATING "ACUTE ABDOMEN".]

[Article in Russian]

MOZHAEV VI.

PMID: 14228625 [PubMed - indexed for MEDLINE]

10115: Vestn Otorinolaringol. 1964 May-Jun;26:87-8.

[OBSERVATION ON HERPES ZOSTER OTICUS.]

[Article in Russian]

SEREBRIAKOVA SN.

PMID: 14202062 [PubMed - indexed for MEDLINE]

10116: Proc Soc Exp Biol Med. 1964 May;116:144-9.

A COMPLEMENT-FIXING ANTIGEN FOR VARICELLA-ZOSTER DERIVED FROM INFECTED CULTURES
OF HUMAN FETAL DIPLOID CELLS.

SCHMIDT NJ, LENNETTE EH, SHON CW, SHINOMOTO TT.

PMID: 14200088 [PubMed - OLDMEDLINE]

10117: Bull Soc Fr Dermatol Syphiligr. 1964 May-Jun;71:367-71.

[SENSITIVO-MOTOR ZONA OF THE LOWER EXTREMITY, REVEALING WALDENSTROM'S
MACROGLOBULINEMIA.]

[Article in French]

DUVERNE J, BRIZARD CP, VOLLE H, DEMILLY J.

PMID: 14195313 [PubMed - indexed for MEDLINE]

10118: Clinique (Paris). 1964 May;59:293-4.

[A VIRUSTATIC AGENT WITH LOCAL ACTION.]

[Article in French]

WEKSTEIN C.

PMID: 14169468 [PubMed - indexed for MEDLINE]

10119: Am J Ophthalmol. 1964 May;57:843-6.

EPICANTHOID SECONDARY TO HERPES ZOSTER OPHTHALMICUS.

GOLDSMITH MO.

PMID: 14167202 [PubMed - indexed for MEDLINE]

10120: Practitioner. 1964 May;192:673-4.

HERPES ZOSTER OPHTHALMICUS WITH VARICELLA.

FRY A.

PMID: 14147257 [PubMed - indexed for MEDLINE]

10121: Practitioner. 1964 May;192:669-72.

HERPES ZOSTER AND CANCER.

MOYNIHAN NH.

PMID: 14147256 [PubMed - indexed for MEDLINE]

10122: Practitioner. 1964 May;192:629-38.

VIRUS INFECTIONS OF THE SKIN.

CHURCH R.

PMID: 14147249 [PubMed - indexed for MEDLINE]

10123: Arch Intern Med. 1964 May;113:679-86.

DISSEMINATED HERPES ZOSTER. A REPORT OF 17 CASES.

MERSELIS JG Jr, KAYE D, HOOK EW.

PMID: 14120593 [PubMed - indexed for MEDLINE]

10124: Lancet. 1964 Apr 25;1(7339):911-2.

THE RAPID DIAGNOSIS OF VIRUS INFECTIONS BY IMMUNOFLUORESCENT TECHNIQUES APPLIED
TO BLOOD LEUCOCYTES.

SOMMERVILLE RG, MACFARLANE PS.

PMID: 14124086 [PubMed - indexed for MEDLINE]

10125: Bull Soc Ophtalmol Fr. 1964 Apr;64:436-9.

[APROPOS OF MENINGOENCEPHALITIS WITH OCULAR PORT OF ENTRY.]

[Article in French]

BONNET, ISTRE.

PMID: 14295583 [PubMed - indexed for MEDLINE]

10126: Vestn Dermatol Venerol. 1964 Apr;38:14-7.

[DERMATO-NEUROLOGICAL OBSERVATIONS IN HERPES ZOSTER.]

[Article in Russian]

KALAMKARIAN AA, KOCHETKOV VD.

PMID: 14200997 [PubMed - indexed for MEDLINE]

10127: Hell Iatr. 1964 Apr;33:386-90.

[ON THE ETIOLOGICAL RELATIONSHIP BETWEEN CHICKENPOX AND HERPES ZOSTER.]

[Article in Swedish]

LOUTSIDES E.

PMID: 14142866 [PubMed - indexed for MEDLINE]

10128: J Med Assoc State Ala. 1964 Apr;33:306-8.

PARALYSIS OF THE DIAPHRAGM SECONDARY TO HERPES ZOSTER.

DONALD TC.

PMID: 14141884 [PubMed - indexed for MEDLINE]

10129: Minerva Med. 1964 Mar 28;55:966-7.

[HERPES ZOSTER AND CHICKENPOX.]

[Article in Italian]

DINOLA F.

PMID: 14137804 [PubMed - indexed for MEDLINE]

10130: Dia Med. 1964 Mar 26;36:212-3.

[LOCAL TREATMENT OF SOME CUTANEOUS VIRUS DISEASES WITH IDU.]

[Article in Spanish]

VIGLIOGLIA PA, SARACENO EN, BERNAL A, ALGRANATTI A, RINALDI O.

PMID: 14145583 [PubMed - indexed for MEDLINE]

10131: Vestn Dermatol Venerol. 1964 Mar;38:81.

[HERPES ZOSTER OF THE ORAL MUCOSA AND TONGUE.]

[Article in Russian]

STURUA GA.

PMID: 14183921 [PubMed - indexed for MEDLINE]

10132: Vestn Oftalmol. 1964 Mar-Apr;77:8-12.

[EXPERIMENTAL AND CLINICAL STUDIES ON THE USE OF ENZYMES IN OPHTHALMOLOGY.]

[Article in Russian]

PROTOPOPOV BV, MURZIN AA.

PMID: 14176837 [PubMed - indexed for MEDLINE]

10133: Klin Monatsbl Augenheilkd. 1964 Mar;144:219-29.

[ON THE ETIOLOGY OF OCULAR MUSCLE PARALYSIS.]

[Article in German]

THOMANN H.

PMID: 14176401 [PubMed - indexed for MEDLINE]

10134: Hautarzt. 1964 Mar;15:131.

[ON MANIFESTATIONS IN THE COURSE OF CUTANEOUS VACCINATIONS DURING A VARIELA
EPIDEMIC.]

[Article in German]

MIERZECKI H.

PMID: 14171204 [PubMed - indexed for MEDLINE]

10135: Minerva Dermatol. 1964 Mar;39:81-8.

[CURRENT STATUS AND FUTURE PROSPECTS OF THE THERAPEUTIC USE OF GRISEOFULVIN.]

[Article in Italian]

RANDAZZO SD, GIARDINA A.

Publication Types: 
    Review

PMID: 14159835 [PubMed - OLDMEDLINE]

10136: Minerva Dermatol. 1964 Mar;39:81-8.

[CURRENT STATUS AND FUTURE PROSPECTS OF THE THERAPEUTIC USE OF GRISEOFULVIN.]

[Article in Italian]

RANDAZZO SD, GIARDINA A.

Publication Types: 
    Review

PMID: 14159568 [PubMed - OLDMEDLINE]

10137: Union Med Can. 1964 Mar;93:317-9.

[LEVOMEPROMAZINE IN THE TREATMENT OF PRURIGINOUS DERMATOSES.]

[Article in French]

PANACCIO V.

PMID: 14142346 [PubMed - indexed for MEDLINE]

10138: Rev Med Suisse Romande. 1964 Mar;84:215-7.

[APROPOS OF ZONA AND VARICELLA.]

[Article in French]

BONARD EC.

PMID: 14133464 [PubMed - indexed for MEDLINE]

10139: Rev Med Suisse Romande. 1964 Mar;84:211-4.

[ZONA AND VARICELLA.]

[Article in French]

CHRISTELER A, KOENIG R.

PMID: 14133463 [PubMed - indexed for MEDLINE]

10140: Am J Ophthalmol. 1964 Mar;57:392-7.

PSEUDOMELANOMA OF THE IRIS AFTER HERPES ZOSTER OPHTHALMICUS.

KLIEN BA, FARKAS TG.

PMID: 14129246 [PubMed - indexed for MEDLINE]

10141: Acta Virol. 1964 Mar;8:135-42.

LABORATORY DIAGNOSIS OF SMALLPOX AND SIMILAR VIRAL DISEASES BY MEANS OF TISSUE
CULTURE METHODS. II. DIFFERENTIATION OF SMALLPOX VIRUS FROM VARICELLA, VACCINIA, 
COWPOX AND HERPES VIRUSES.

MARENNIKOVA SS, GURVICH EB, YUMASHEVA MA.

PMID: 14127272 [PubMed - OLDMEDLINE]

10142: Arch Ophthalmol. 1964 Mar;71:371-6.

HERPES ZOSTER OPHTHALMICUS WITH CONTRALATERAL HEMIPLEGIA.

ACERS TE.

PMID: 14100760 [PubMed - indexed for MEDLINE]

10143: Med Klin. 1964 Feb 28;59:328-30.

[ASSOCIATION BETWEEN SMALLPOX VACCINATION AND HERPES ZOSTER.]

[Article in German]

LYON E.

PMID: 14151260 [PubMed - OLDMEDLINE]

10144: Arch Klin Exp Dermatol. 1964 Feb 26;218:339-46.

[HERPES ZOSTER GENERALISATUS VARICELLOSUS IN BRONCHIAL ASTHMA.]

[Article in German]

SCHIMPF A.

PMID: 14156695 [PubMed - indexed for MEDLINE]

10145: Arch Klin Exp Dermatol. 1964 Feb 6;218:215-21.

[HERPES ZOSTER AS AN ISOMORPHOUS EFFECT OF STIMULATION IN CHRONIC LYMPHATIC
LEUKEMIA.]

[Article in German]

RAAB W.

PMID: 14163497 [PubMed - OLDMEDLINE]

10146: Sov Med. 1964 Feb;27:101-5.

[ON DIFFERENTIAL DIAGNOSIS OF HERPES ZOSTER.]

[Article in Russian]

MALKOVA EV.

PMID: 14177295 [PubMed - indexed for MEDLINE]

10147: Klin Monatsbl Augenheilkd. 1964 Feb;144:54-8.

[ZOSTER EXOPHTHALMOS AND OPHTHALMOPLEGIA.]

[Article in German]

SIEGERT P.

PMID: 14164546 [PubMed - indexed for MEDLINE]

10148: Z Laryngol Rhinol Otol. 1964 Feb;43:103-7.

[VARICELLA - HERPES ZOSTER INFECTION.]

[Article in German]

ROSSBERG G, SCHAUPP H.

PMID: 14162275 [PubMed - indexed for MEDLINE]

10149: Toulouse Med. 1964 Feb;65:267-72.

[TERRAMYCIN OINTMENT WITH HYDROCORTISONE AND TERRAMYCIN NEBULIZER WITH
HYDROCORTISONE AND GENERAL MEDICINE.]

[Article in French]

BARTHE JJ.

PMID: 14143543 [PubMed - OLDMEDLINE]

10150: Hifuka Kiyo. 1964 Feb;59:31-6.

[STATISTICAL OBSERVATIONS OF HERPES ZOSTER AND VARICELLA.]

[Article in Japanese]

NAMIKI S, TAKAHASHI H.

PMID: 14134970 [PubMed - indexed for MEDLINE]

10151: J Indian Med Assoc. 1964 Feb 1;42:119-22.

MANAGEMENT OF HERPES ZOSTER OPHTHALMICUS. A CLINICAL STUDY OF 78 CASES.

JAIN BS, NATH J, SRIVASTAVA KN.

PMID: 14126883 [PubMed - OLDMEDLINE]

10152: Am J Ophthalmol. 1964 Feb;57:205-13.

RETINOPATHY OF OBSCURE (TOXIC?) ORIGIN IN HODGKIN'S DISEASE.

KURZ GH.

PMID: 14123443 [PubMed - OLDMEDLINE]

10153: Ann Phys Med. 1964 Feb;10:169-79.

UNILATERAL LUMBO-SACRAL ROOT COMPRESSION.

YATES DA.

PMID: 14120545 [PubMed - indexed for MEDLINE]

10154: Orv Hetil. 1964 Jan 26;105:168-71.

[APPENDICITIS AND INFECTIOUS DISEASES.]

[Article in Hungarian]

PODHRAGYAY L.

PMID: 14133786 [PubMed - indexed for MEDLINE]

10155: Med Welt. 1964 Jan 11;33:110-1.

[ON THE THERAPY OF HERPES ZOSTER OPHTHALMICUS.]

[Article in German]

DAMMER M.

PMID: 14127681 [PubMed - indexed for MEDLINE]

10156: Bull Soc Ophtalmol Fr. 1964 Jan;64:109-14.

[ACTION OF NL,NL-ANHYDROBIS-(BETA-HYDROXYETHYL)-BIGUANIDE HCL ON VIRAL OCULAR
DISEASES.]

[Article in French]

PAUFIQUE L, MAGNARD P, MONTIBERT J.

PMID: 14297429 [PubMed - indexed for MEDLINE]

10157: Arcisp S Anna Ferrara. 1964;17:1113-25.

[THE RAMSAY-HUNT SYNDROME.]

[Article in Italian]

RUBERTI A, TOBALDIN G, BURIANI GF.

PMID: 14265723 [PubMed - indexed for MEDLINE]

10158: Ber Zusammenkunft Dtsch Ophthalmol Ges. 1964;65:321-2.

[NEW VIEWPOINTS ON THE THERAPY OF VIRUS DISEASES OF THE EYE.]

[Article in German]

BAUER F.

PMID: 14260545 [PubMed - indexed for MEDLINE]

10159: Urol Int. 1964;18:96-9.

[REFLEX-ANURIA.]

[Article in German]

BOSHAMER K.

PMID: 14215749 [PubMed - indexed for MEDLINE]

10160: Klin Oczna. 1964;34:207-10.

[EMETINE THERAPY OF HERPES ZOSTER OPHTHALMICUS.]

[Article in Polish]

GROSZ I.

PMID: 14210058 [PubMed - indexed for MEDLINE]

10161: Otolaryngol Pol. 1964;18:287-9.

[AVELLIS' SYNDROME RELATED TO HERPES ZOSTER.]

[Article in Polish]

JASIENSKA A, KUZNIARZ J.

PMID: 14194015 [PubMed - indexed for MEDLINE]

10162: Oftalmol Zh. 1964;19:100-3.

[ON PRIMARY HERPETIC KERATOCONJUNCTIVITIS IN CHILDHOOD.]

[Article in Russian]

KAPLINA KP.

PMID: 14176573 [PubMed - indexed for MEDLINE]

10163: HNO. 1964 Jan;12:1-9.

[THE CLINICAL PICTURE OF THE ZOSTER OTICUS WITH SPECIAL REFERENCE TO ACUTE
DISORDERS AND PERMANENT DAMAGE OF THE ORGAN OF HEARING AND EQUILIBRIUM.]

[Article in German]

JATHO K, WAHLE H, SCHLOTHANE R, PAMPUS I.

Publication Types: 
    Review

PMID: 14157995 [PubMed - indexed for MEDLINE]

10164: J New Drugs. 1964 Jan-Feb;45:38-45.

CLINICAL EVALUATION OF SQ 10,269 IN PATIENTS WITH CHRONIC PAIN.

CASS LJ, FREDERIK WS.

PMID: 14157083 [PubMed - OLDMEDLINE]

10165: Vestn Oftalmol. 1964 Jan-Feb;77:60-1.

[DIADYNAMIC CURRENTS IN THE TREATMENT OF HERPETIC KERATITIS.]

[Article in Russian]

PALAMARCHUK GS.

PMID: 14149487 [PubMed - indexed for MEDLINE]

10166: Acta Ophthalmol (Copenh). 1964;42:193-200.

OXYPHENBUTAZONE AND ITS USE IN OPHTHALMOLOGY.

SVANE-KNUDSEN P.

PMID: 14141420 [PubMed - OLDMEDLINE]

10167: Minerva Dermatol. 1964 Jan;39:4-10.

[CUTANEOUS VIRAL DISEASES: THEIR FREQUENCY AND TRIAL OF AN ANTIVIRAL AGENT.]

[Article in Italian]

ELZAWAHRY M.

PMID: 14135784 [PubMed - indexed for MEDLINE]

10168: Ophthalmologica. 1964;147:229-34.

[OBSERVATIONS OF A MICROBIOLOGIST.]

[Article in German]

WIESMANN E.

PMID: 14133723 [PubMed - indexed for MEDLINE]

10169: Schweiz Arch Neurol Neurochir Psychiatr. 1964;93:35-71.

[ON THE CLINICAL PICTURE, PROGNOSIS AND THERAPY OF CRYPTOGENETIC PERIPHERAL
FACIAL PARALYSIS WITH SPECIAL REFERENCE TO PREDNISONE THERAPY. CLINICAL STUDIES
BASED ON 278 FOLLOW-UP CASES.]

[Article in German]

MUELLER GP.

Publication Types: 
    Review

PMID: 14127224 [PubMed - indexed for MEDLINE]

10170: Jibiinkoka. 1964 Jan;36:45-7.

[CASE OF HERPES ZOSTER OTICUS ACCOMPANIED BY MULTIPLE CRANIAL NERVE PARALYSIS.]

[Article in Japanese]

MARUYAMA R, TAKENOUE T, GOTO K.

PMID: 14111131 [PubMed - indexed for MEDLINE]

10171: Gazz Int Med Chir. 1963 Dec 31;68:SUPPL:3281-94.

[ON CHANGES IN LEUKOCYTE OXIDO-PEROXIDASE ENZYME ACTIVITY IN INFECTIOUS
DISEASES.]

[Article in Italian]

FRACCHIA P, ANTOGNETTI RM, GIRALDI A.

PMID: 14177571 [PubMed - indexed for MEDLINE]

10172: Med Klin. 1963 Dec 13;58:2052-4.

[THE CONTROL OF PAIN STATES IN NEUROLOGICAL DISEASES BY NEUROBION.]

[Article in German]

STOERGER R, MENGI E, REINHARDT G.

PMID: 14133384 [PubMed - indexed for MEDLINE]

10173: Dia Med. 1963 Dec 12;35:2059-60.

[TREATMENT OF HERPES WITH DIHYDROERGOTAMINE.]

[Article in Spanish]

GORDON CJ.

PMID: 14116560 [PubMed - indexed for MEDLINE]

10174: Gaz Med Fr. 1963 Dec 10;70:3721-8.

[ZONA OF THE CRANIAL NERVES.]

[Article in French]

HAMARD H.

PMID: 14102145 [PubMed - indexed for MEDLINE]

10175: Z Arztl Fortbild (Jena). 1963 Dec 1;57:1293-6.

[ELECTROCARDIOGRAPHIC CHANGES IN HERPES ZOSTER.]

[Article in German]

PASTINSZKY I, KENEDI I.

PMID: 14112844 [PubMed - indexed for MEDLINE]

10176: Arch Fr Pediatr. 1963 Dec;20:1225-7.

[DIAGNOSTIC SIGNIFICANCE OF GIANT CELLS IN CERTAIN INFECTIOUS DISEASES IN
CHILDREN.]

[Article in French]

KURKUS M, PSTRAGOWSKA W, ZALEWSKA I.

PMID: 14099573 [PubMed - indexed for MEDLINE]

10177: Br J Clin Pract. 1963 Dec;17:715-9.

AUDITORY HERPES ZOSTER WITHOUT AURICULAR ERUPTION.

PHILLIPS BL.

PMID: 14084638 [PubMed - indexed for MEDLINE]

10178: Tex Med. 1963 Dec;59:1141-6.

BENIGN LESIONS OF THE VULVA.

GARDNER HL.

PMID: 14083601 [PubMed - OLDMEDLINE]

10179: Dermatol Wochenschr. 1963 Nov 16;148:542-4.

[ZOSTER ENCEPHALITIS.]

[Article in German]

KLUGE K.

PMID: 14154362 [PubMed - indexed for MEDLINE]

10180: Wien Med Wochenschr. 1963 Nov 9;113:841-2.

[ANTIVIRAL CHEMOPROPHYLAXIS WITH FLUMIDIN (ABOB) FOR MORBIDITY ACCOMPANYING COLDS
AMONG SOLDIERS IN THE AUSTRIAN ARMY.]

[Article in German]

KLETTENHAMMER HP.

PMID: 14098696 [PubMed - indexed for MEDLINE]

10181: Med Welt. 1963 Nov 9;45:2301-2.

[CAN ORAL VACCINATION AGAINST POLIOMYELITIS BE EFFECTIVE IN SKIN DISEASES?]

[Article in German]

SCHMITZ R.

PMID: 14095426 [PubMed - indexed for MEDLINE]

10182: Bull Soc Fr Dermatol Syphiligr. 1963 Nov-Dec;70:792-3.

[ON 3 CASES OF AN ECCHYMOTIC CUTANEOUS ERUPTION WITH ZOSTERIAN TOPOGRAPHY.
(ECCHYMOTIC FORM OF ZONA?)]

[Article in French]

DESMONTS T.

PMID: 14157886 [PubMed - indexed for MEDLINE]

10183: Rass Dermatol Sifilogr. 1963 Nov-Dec;16:247-52.

[FIRST EXPERIENCES WITH AN INHIBITOR OF VIRAL DNA SYNTHESIS IN DERMATOLOGY.]

[Article in Italian]

PANCONESI E.

PMID: 14127745 [PubMed - OLDMEDLINE]

10184: Hifuka Kiyo. 1963 Nov;58:214-6.

[THERAPY OF SKIN DISEASES WITH PR-199 (SALVISOL) OINTMENT.]

[Article in Japanese]

OKAMOTO S.

PMID: 14096285 [PubMed - indexed for MEDLINE]

10185: Naika. 1963 Nov;12:822-5.

[ANGINA-LIKE PAIN.]

[Article in Japanese]

TAKAYASU M.

PMID: 14096025 [PubMed - indexed for MEDLINE]

10186: J Indian Med Assoc. 1963 Nov 1;41:456-8.

HERPES ZOSTER WITH AN UNUSUAL SEQUELA.

SAXENA KN, SRIVASTAVA MC, TANDON MK.

PMID: 14083193 [PubMed - indexed for MEDLINE]

10187: Orv Hetil. 1963 Oct 27;104:2031-4.

[EXPERIMENTAL ISOLATION OF THE HERPES ZOSTER VIRUS.]

[Article in Hungarian]

GEDER L, KOLLER M, GOENCOEL E, JENEY E, GOENCOEL I.

PMID: 14100358 [PubMed - OLDMEDLINE]

10188: Can Med Assoc J. 1963 Oct 26;89:871-3.

THE OCULAR SEQUELAE OF THIRD CRANIAL NERVE PALSY.

JOHNSTON AC, PRATT-JOHNSON JA.

PMID: 14069610 [PubMed - indexed for MEDLINE]

10189: Bull Mem Soc Med Hop Paris. 1963 Oct 11;114:997-1003.

[3 CASES OF GENERALIZED ZONA.]

[Article in French]

MAHOUDEAU D, BENAIM P, DUBRISAY J, GRUPPER C.

PMID: 14098870 [PubMed - indexed for MEDLINE]

10190: Z Haut Geschlechtskr. 1963 Oct 1;35:183-7.

[SUCCESSES AND LIMITATIONS OF LOCAL TREATMENT OF SKIN DISEASES WITH FLUOCINOLONE 
ACETONIDE ("JELLIN") FOIL BANDAGES.]

[Article in German]

HASSELMANN CM.

PMID: 14109396 [PubMed - indexed for MEDLINE]

10191: Hautarzt. 1963 Oct;14:447-51.

[ELECTRON MICROSCOPY AND TISSUE CULTURE AS AIDS FOR THE DIAGNOSIS AND
DIFFERENTIAL DIAGNOSIS OF VIRAL DERMATOSES.]

[Article in German]

NASEMANN T, SCHIRREN CG.

PMID: 14099981 [PubMed - OLDMEDLINE]

10192: Minerva Dermatol. 1963 Oct;38:339-42.

[XENALAMINE IN SKIN DISEASES AND NON-GONOCOCCAL URETHRITIS.]

[Article in Italian]

DOGLIOTTI M.

PMID: 14098401 [PubMed - indexed for MEDLINE]

10193: Minerva Dermatol. 1963 Oct;38:334-7.

[ENERGETIC AND FAVORABLE ACTION OF MASSIVE DOSES OF GRISEOFULVIN IN A CASE OF
HERPES ZOSTER.]

[Article in Italian]

RANDAZZO SD, GIARDINA A.

PMID: 14098399 [PubMed - indexed for MEDLINE]

10194: Iryo. 1963 Oct;17:609-18.

[DIAGNOSIS AND TREATMENT OF VERTIGO.]

[Article in Japanese]

INO H.

PMID: 14092804 [PubMed - OLDMEDLINE]

10195: J Invest Dermatol. 1963 Oct;41:181-96.

FLUORESCENCE MICROSCOPY IN DERMATOLOGY.

MESCON H, GROTS IA.

Publication Types: 
    Review

PMID: 14066596 [PubMed - indexed for MEDLINE]

10196: Surv Ophthalmol. 1963 Oct;54:377-92.

UVEITIS ASSOCIATED WITH SYSTEMIC DISEASES. I. BACTERIAL INFECTIONS.

COLES RS.

Publication Types: 
    Review

PMID: 14057428 [PubMed - indexed for MEDLINE]

10197: Arch Dermatol. 1963 Oct;88:457-8.

ZOSTER BRACHIALIS IN AN INFANT.

PATNAIK R, THOMAS E.

PMID: 14051356 [PubMed - indexed for MEDLINE]

10198: Can Med Assoc J. 1963 Sep 21;89:607-12.

CURRENT CONCEPTS IN DERMATOLOGY. II. THE SKIN AND SYSTEMIC DISEASE.

JACKSON R.

PMID: 14063940 [PubMed - indexed for MEDLINE]

10199: Rhumatologie. 1963 Sep-Oct;15:227-37.

[SYMPATHETIC NEURO-OSTEO-TROPHIC SYNDROME CAUSED BY ZONA. GENERAL OBSERVATIONS ON
A NEW CASE.]

[Article in French]

LAPEYRE L, COMMANDRE F, BARALIS G, TARAMASCO H, GUILLEMIN R.

PMID: 14194087 [PubMed - indexed for MEDLINE]

10200: Bull Soc Fr Dermatol Syphiligr. 1963 Sep-Oct;70:663-7.

[RESULTS OBTAINED IN THE TREATMENT OF SEVERAL DERMATOSES WITH A BIGUANIDE
DERIVATIVE.]

[Article in French]

DELUC J, LABOUCHE.

PMID: 14120096 [PubMed - indexed for MEDLINE]

10201: Bull Soc Fr Dermatol Syphiligr. 1963 Sep-Oct;70:732-5.

[POSSIBILITIES AND LIMITATIONS OF A BIGUANIDE DERIVATIVE (JD-1022) IN
DERMATOLOGY.]

[Article in French]

HURIEZ C, DESMONS F, BOMBART M, FOSSATI R.

PMID: 14119366 [PubMed - indexed for MEDLINE]

10202: Bull Soc Fr Dermatol Syphiligr. 1963 Sep-Oct;70:677-9.

[ACTION OF VIRUSTAT IN DERMATOLOGY.]

[Article in French]

BONNET J, CALAS E, FLORENS A, CASTELAIN PY.

PMID: 14119349 [PubMed - indexed for MEDLINE]

10203: Klin Med (Mosk). 1963 Sep;41:45-9.

[POSTHERPETIC TRIGEMINAL NEURALGIA.]

[Article in Russian]

EROKHINA LG, MALKOVA EV.

PMID: 14090835 [PubMed - indexed for MEDLINE]

10204: Med Trop (Mars). 1963 Sep-Oct;23:691-4.

[ASCENDING POLYRADICULONEURITIC MANIFESTATIONS AND INTERCOSTAL ZONA.]

[Article in French]

LEVANTI J, VEDY J.

PMID: 14086958 [PubMed - indexed for MEDLINE]

10205: J Laryngol Otol. 1963 Sep;77:783-8.

CHICKENPOX AND HERPES ZOSTER OTICUS.

NAESSEN R.

PMID: 14064160 [PubMed - indexed for MEDLINE]

10206: Ther Ggw. 1963 Sep;102:1056-61.

[TRIALS WITH THE PERCUTANEOUS USE OF BUTAZOLIDINE.]

[Article in German]

STEINHOFF H.

PMID: 14057436 [PubMed - indexed for MEDLINE]

10207: Arch Dermatol. 1963 Sep;88:322-4.

ZOSTER CAUSING VARICELLA. CURRENT DANGERS OF CONTAGION WITHOUT ISOLATION.

BRODKIN RH.

PMID: 14043626 [PubMed - indexed for MEDLINE]

10208: Hippokrates. 1963 Aug 31;34:672-3.

[TRIALS OF LOCAL BUTAZOLIDINE TREATMENT IN DERMATOLOGICAL PRACTICE.]

[Article in German]

KOCH R.

PMID: 14043936 [PubMed - indexed for MEDLINE]

10209: Dia Med. 1963 Aug 5;35:1184-7.

[DIAPHRAGMATIC EVENTRATION.]

[Article in Spanish]

MANGUEL M, BRENER C.

PMID: 14060218 [PubMed - indexed for MEDLINE]

10210: J Neurol Neurosurg Psychiatry. 1963 Aug;26:345-52.

TRIGEMINAL ROOT AND GANGLION INJECTIONS USING PHENOL IN GLYCERINE FOR THE RELIEF 
OF TRIGEMINAL NEURALGIA.

JEFFERSON A.

PMID: 14043050 [PubMed - indexed for MEDLINE]

10211: Pol Tyg Lek. 1963 Jul 15;18:1057-60.

[ON HERPES ZOSTER OTICUS.]

[Article in Polish]

OMULECKI M.

PMID: 14074754 [PubMed - indexed for MEDLINE]

10212: Dtsch Z Nervenheilkd. 1963 Jul 10;185:183-90.

[ON THE CORTISONE TREATMENT OF VARIOUS INFECTIOUS DISEASES OF THE NERVOUS
SYSTEM.]

[Article in German]

WAHREN W.

PMID: 14045383 [PubMed - indexed for MEDLINE]

10213: Psychiatr Neurol Neurochir. 1963 Jul-Oct;66:446-53.

[CUTANEOUS SURGERY IN THE TREATMENT OF POST-HERPETIC NEURALGIA OF THE TRUNK.]

[Article in French]

VERBIEST H, CALLIAUW L.

PMID: 14062208 [PubMed - indexed for MEDLINE]

10214: J Chronic Dis. 1963 Jul;16:677-701.

INFECTIONS, FEVER AND HOST RESISTANCE IN NEOPLASTIC DISEASES.

SILVER RT.

Publication Types: 
    Review

PMID: 14047258 [PubMed - indexed for MEDLINE]

10215: Ther Ggw. 1963 Jul;102:837-40.

[1ST TRIALS WITH MEDIVITAN IN HERPES ZOSTER.]

[Article in German]

NICKEL G, WALTHER H.

PMID: 14045818 [PubMed - indexed for MEDLINE]

10216: Cesk Neurol. 1963 Jul;26:280-3.

[ZOSTER POLYRADICULONEURITIS WITH MANIFESTATIONS OF LANDRY'S PARALYSIS.]

[Article in Czech]

NEVSIMAL O, LEHOVSKY M.

PMID: 14042823 [PubMed - indexed for MEDLINE]

10217: Proc R Soc Med. 1963 Jul;56:615-6.

Herpes zoster presenting with retention of urine.

BURKE J.

PMID: 14017040 [PubMed - indexed for MEDLINE]

10218: J Assoc Physicians India. 1963 Jul;11:597-9.

Quadriplegia following herpes zoster. A case report.

MERCHANT HC, RAMAMOORTHY K, CHOKSI ND, SHIKARIPURKAR NK, SHAH SR.

PMID: 13934939 [PubMed - indexed for MEDLINE]

10219: Sem Hop. 1963 Jun 20;39:1553-4.

[Digestive disorders during thoraco-abdominal zona (D5-L1).]

[Article in French]

DEBRAY C, MEHAUTM.

PMID: 14026249 [PubMed - indexed for MEDLINE]

10220: Sem Hop. 1963 Jun 20;39:1540-50.

[Paralysis of the large muscles of the abdomen during thoraco-abdominal zona
(D5-l1).]

[Article in French]

DEBRAY C, MEHAUT M.

PMID: 14026248 [PubMed - indexed for MEDLINE]

10221: Br Med J. 1963 Jun 15;1(5345):1605.

Herpes zoster and steroid therapy.

FRY A.

PMID: 13959963 [PubMed - indexed for MEDLINE]

10222: Pol Tyg Lek. 1963 Jun 10;18:865-8.

[ON THERAPEUTIC PROBLEMS IN HERPES ZOSTER.]

[Article in Polish]

GUTKOWSKA K.

Publication Types: 
    Review

PMID: 14069111 [PubMed - indexed for MEDLINE]

10223: Med J Aust. 1963 Jun 8;50(1):850-3.

Herpes zoster and its motor lesions, with a report of a case of phrenic nerve
paralysis.

SPIERS AS.

PMID: 13990116 [PubMed - indexed for MEDLINE]

10224: Harefuah. 1963 Jun 2;64:371.

[The chemotherapy of herpes zoster.]

[Article in Hebrew]

COHEN A.

PMID: 14021988 [PubMed - indexed for MEDLINE]

10225: Laval Med. 1963 Jun;34:642-60.

[Dermatosis and internal cancers.]

[Article in French]

BUREAU Y, BARRIERE H.

PMID: 14016934 [PubMed - indexed for MEDLINE]

10226: Magy Radiol. 1963 Jun;15:161-3.

[Herpes zoster following roentgen irradiation.]

[Article in Hungarian]

VETRO E.

PMID: 13996975 [PubMed - indexed for MEDLINE]

10227: Pol Przegl Radiol Med Nukl. 1963 May-Jun;27:259-64.

[SYMPTOMATIC HERPES ZOSTER DURING THE COURSE OF A NEOPLASTIC DISEASE.]

[Article in Polish]

OSINSKA M, ULKOWSKI M.

PMID: 14057297 [PubMed - indexed for MEDLINE]

10228: Pol Przegl Radiol Med Nukl. 1963 May-Jun;27:259-64.

[SYMPTOMATIC HERPES ZOSTER DURING THE COURSE OF A NEOPLASTIC DISEASE.]

[Article in Polish]

OSINSKA M, ULKOWSKI M.

PMID: 14056688 [PubMed - indexed for MEDLINE]

10229: Skin (Los Angeles). 1963 May;2:151.

The prodrome and syndrome of herpes zoster.

RONCHESE F.

PMID: 13982665 [PubMed - indexed for MEDLINE]

10230: W V Med J. 1963 May;59:120-2.

Generalized herpes zoster (with case report and review of the literature).

GILE JH.

PMID: 13947852 [PubMed - indexed for MEDLINE]

10231: Med Klin. 1963 Apr 26;58:699-701.

[Local recurrences in existing immunity. On the pathomechanism of zoster, lip
herpes and other diseases.]

[Article in German]

HORING FO.

PMID: 13954897 [PubMed - indexed for MEDLINE]

10232: Minerva Med. 1963 Apr 14;54:1064-5.

[Varicella as a result of the corticoid therapy of herpes zoster.]

[Article in Italian]

MOSONYI L, GSIKY T, KUCSERA P.

PMID: 13936188 [PubMed - indexed for MEDLINE]

10233: Lancet. 1963 Apr 6;1(7284):752.

Korsakov's syndrome following herpes-zoster encephalitis.

HALL P.

PMID: 13952125 [PubMed - OLDMEDLINE]

10234: Bull Soc Fr Dermatol Syphiligr. 1963 Apr-May;70:202-4.

[ACTION OF VIRUSTAT IN ZONA, HERPES AND APHTHOSA.]

[Article in French]

LAUGIER P, BULTE C.

PMID: 14075178 [PubMed - indexed for MEDLINE]

10235: Arch Phys Med Rehabil. 1963 Apr;44:233-4.

Ramsay Hunt syndrome: report of a case.

SMITH IC.

PMID: 13989443 [PubMed - indexed for MEDLINE]

10236: Med Bull US Army Eur. 1963 Apr;20:106.

Phrenic paralysis due to herpes zoster. A case report.

BEARD HW.

PMID: 13969945 [PubMed - indexed for MEDLINE]

10237: Am J Clin Pathol. 1963 Apr;39:389-92.

Diagnostic patterns-vesicular lesions of the skin.

GOULD SE, HINERMAN DL, BATSAKIS JG, BEAMER PR.

PMID: 13949564 [PubMed - indexed for MEDLINE]

10238: Lancet. 1963 Mar 23;1(7282):669-70.

Hypertension with herpes zoster.

SCHWARCZMANN P.

PMID: 13987348 [PubMed - indexed for MEDLINE]

10239: Z Arztl Fortbild (Jena). 1963 Mar 15;57:320-4.

[Herpes zoster and collagen diseases.]

[Article in German]

VACHTENHEIM J.

PMID: 13995674 [PubMed - indexed for MEDLINE]

10240: Monatsschr Ohrenheilkd Laryngorhinol. 1963 Mar-May;97:115-21.

[FACIAL PARALYSIS AS A COMPLICATION OF EAR DISEASES.]

[Article in German]

STRICKER G.

PMID: 14081036 [PubMed - indexed for MEDLINE]

10241: Arch Dermatol. 1963 Mar;87:393-4.

Two interesting cases of zoster.

KILE RL.

PMID: 14032597 [PubMed - indexed for MEDLINE]

10242: Arch Dermatol. 1963 Mar;87:393-4.

Two interesting cases of zoster.

KILE RL.

PMID: 14032596 [PubMed - indexed for MEDLINE]

10243: Cesk Oftalmol. 1963 Mar;19:104-8.

[On the problem of corneal nerve involvement in ocular herpes zoster.]

[Article in Czech]

SIMKOVA M.

PMID: 13993037 [PubMed - indexed for MEDLINE]

10244: Br Med J. 1963 Feb 23;1(5329):493-6.

Clinical clues in virus infections.

TYRRELL DA.

PMID: 13995046 [PubMed - indexed for MEDLINE]

10245: Orv Hetil. 1963 Feb 3;104:234-5.

[Data on the clinical aspect of herpes zoster.]

[Article in Hungarian]

HEGEDUS S.

PMID: 13953306 [PubMed - indexed for MEDLINE]

10246: Rev Bras Med. 1963 Feb;20:118-9.

[BRIEF CASE-REPORTS.]

[Article in Portuguese]

MONTERA A.

PMID: 14150276 [PubMed - indexed for MEDLINE]

10247: East Afr Med J. 1963 Feb;40:39-46.

DERMATOLOGICAL PHOTOGRAPHY.

HARGREAVES A.

PMID: 14071690 [PubMed - indexed for MEDLINE]

10248: Z Gesamte Inn Med. 1963 Jan 15;18:63-5.

[Defense against infection by insulin.]

[Article in German]

MESSNER J.

PMID: 13935148 [PubMed - indexed for MEDLINE]

10249: Zh Nevropatol Psikhiatr Im S S Korsakova. 1963;63:1828-34.

[LESIONS OF THE NERVOUS SYSTEM IN HERPES ZOSTER.]

[Article in Russian]

MALKOVA EV.

PMID: 14189574 [PubMed - indexed for MEDLINE]

10250: Br J Ophthalmol. 1963 Jan;47:60-1.

HERPES ZOSTER OPHTHALMICUS IN AN 8-YEAR-OLD CHILD.

BIRKS DA.

PMID: 14186864 [PubMed - indexed for MEDLINE]

10251: J Egypt Med Assoc. 1963;46:1303-14.

VIRUS SKIN DISEASES: FREQUENCY AND TRIAL OF AN ANTIVIRAL AGENT.

ELZAWAHRY M.

PMID: 14162107 [PubMed - indexed for MEDLINE]

10252: Prog Med Virol. 1963;5:219-94.

VIRUS DISEASES ASSOCIATED WITH CUTANEOUS ERUPTIONS.

WENNER HA, LOU TY.

Publication Types: 
    Review

PMID: 14159144 [PubMed - indexed for MEDLINE]

10253: Nervenarzt. 1963 Jan;34:12-23.

[DISORDERS OF THE FEMORAL NERVE. A CONTRIBUTION TO THEIR ETIOLOGY BY MEANS OF
CATAMNESTIC EXAMINATIONS IN 22 CASES.]

[Article in German]

KAMMERER T.

PMID: 14157237 [PubMed - indexed for MEDLINE]

10254: Arch Ortop. 1963;76:205-11.

[ZONAL SACCROCOCCYGEAL DERMATITIS IN THE POSTOPERATIVE COURSE IN
HEMILAMINECTOMY.]

[Article in Italian]

MARSANO R.

PMID: 14133261 [PubMed - indexed for MEDLINE]

10255: Trans Ophthalmol Soc U K. 1963;83:647-51.

HERPES ZOSTER OPHTHALMICUS.

ORR HC.

PMID: 14123180 [PubMed - indexed for MEDLINE]

10256: Acta Derm Venereol. 1963;43:544-7.

BASOPHIL LEUKOCYTES IN LESIONS OF VARIOUS DERMATOSES.

ASPEGREN N, FREGERT S, RORSMAN H.

PMID: 14088644 [PubMed - OLDMEDLINE]

10257: Acta Microbiol Acad Sci Hung. 1963;10:155-61.

ISOLATION OF HERPES ZOSTER VIRUS STRAINS.

GEDER L, KOLLER M, GOENCZOEL E, JENEY E, GOENCZOEL I.

PMID: 14059905 [PubMed - OLDMEDLINE]

10258: Otolaryngol Pol. 1963;17:89-93.

[HERPES ZOSTER OF THE UPPER RESPIRATORY TRACT.]

[Article in Polish]

KWILMAN A, RUDNY J.

PMID: 14057975 [PubMed - indexed for MEDLINE]

10259: Pediatr Pol. 1963 Jan;38:27-32.

[DIAGNOSTIC SIGNIFICANCE OF GIANT CELLS IN SOME INFECTIOUS DISEASES IN CHILDREN.]

[Article in Polish]

KURKUS M, PSTRAGOWSKA W, ZALEWSKA I.

PMID: 14048494 [PubMed - indexed for MEDLINE]

10260: Gerontol Clin (Basel). 1963;5:77-86.

The place of neurosurgery in the care of the aged.

KERR AS.

PMID: 14042145 [PubMed - indexed for MEDLINE]

10261: Clin Orthop Relat Res. 1963;27:200-5.

Resistant herpes neuralgia. Case report.

DAVIS ED.

PMID: 14025464 [PubMed - indexed for MEDLINE]

10262: J Dent Res. 1963 Jan-Feb;2:343-7.

Exfoliative cytology in evaluating oral lesions.

COOKE BE.

PMID: 14022793 [PubMed - indexed for MEDLINE]

10263: Sem Hop Ther Paris. 1963 Jan;39:24-8.

[Study of Virustat in dermatology. Apropos of 34 cases.]

[Article in French]

VERNIER P, MENANTEAU JP.

PMID: 13996851 [PubMed - indexed for MEDLINE]

10264: Oral Surg Oral Med Oral Pathol. 1963 Jan;16:120-2.

Ramsey-Hunt syndrome (herpes zoster meningo-encephalitis).

SWOOPE CC Jr.

PMID: 13979744 [PubMed - indexed for MEDLINE]

10265: Med Esp. 1963 Jan;49:17-9.

[Facial herpes-like process with involvement of several homolateral pairs of
cranial nerves (extrinsic and intrinsic ophthalmoplegia, etc.)]

[Article in Spanish]

BARRAQUER-BORDAS L, DE ASPRER-CASADO J.

PMID: 13969501 [PubMed - indexed for MEDLINE]

10266: Arch Dermatol. 1963 Jan;87:18-27.

Cytodiagnosis of inflammatory dermatoses.

GRAHAM JH, BINGUL O, BURGOON CB Jr.

PMID: 13949775 [PubMed - indexed for MEDLINE]

10267: Acta Med Acad Sci Hung. 1963;19:23-30.

Electrocardiographic changes associated with herpes zoster.

PASTINSZKY I, KENEDI I.

PMID: 13941740 [PubMed - indexed for MEDLINE]

10268: Med Welt. 1962 Dec 8;49:2615-7.

[Disorders of bladder emptying and zoster.]

[Article in German]

BERGHAUS H.

PMID: 13970710 [PubMed - indexed for MEDLINE]

10269: Fulorrgegegyogyaszat. 1962 Dec;8:182-6.

[Postoperative sinus thrombosis following herpes zoster cephalicus.]

[Article in Hungarian]

JURCSAK L.

PMID: 14029953 [PubMed - indexed for MEDLINE]

10270: Oral Surg Oral Med Oral Pathol. 1962 Dec;15:1434-6.

Herpes zoster involving the fifth and tenth cranial nerves.

BURTSCHI TA.

PMID: 14017251 [PubMed - indexed for MEDLINE]

10271: Lille Med. 1962 Dec;7:1027-9.

[An epidemic of zona.]

[Article in French]

WAROT P, FOISSAC-GEGOUX P.

PMID: 13998967 [PubMed - indexed for MEDLINE]

10272: Fulorrgegegyogyaszat. 1962 Dec;8:182-6.

[Postoperative sinus thrombosis following herpes zoster cephalicus.]

[Article in Hungarian]

JURCSAK L.

PMID: 13958101 [PubMed - indexed for MEDLINE]

10273: Nervenarzt. 1962 Dec;33:538-40.

[Herpes zoster oticus with multiple simultaneous cranial nerve deficiencies.]

[Article in German]

GUETSCHOW E.

PMID: 13951161 [PubMed - indexed for MEDLINE]

10274: J Ultrastruct Res. 1962 Dec;7:409-17.

Fine structure of the Zoster virus in human skin.

LUTZNER MA.

PMID: 13931855 [PubMed - OLDMEDLINE]

10275: Presse Med. 1962 Nov 17;70:2343-5.

[Relapsing typhoid fever, relapsing meningoencephalitis and herpes zoster.]

[Article in French]

PERROUTY P, DAOULAS R, BERTON M.

PMID: 13942614 [PubMed - indexed for MEDLINE]

10276: Bull Soc Ophtalmol Fr. 1962 Nov;62:554-6.

[A rare sequel of ophthalmic zona: fatty dystrophy of the cornea.]

[Article in French]

COLLIER M.

PMID: 14022337 [PubMed - indexed for MEDLINE]

10277: Arch Neurol. 1962 Nov;7:423-6.

Surgical treatment of postherpetic neuralgia. Results of skin undermining and
excision in 14 patients.

TINDALL GT, ODOM GL, VIETH RG.

PMID: 13985113 [PubMed - indexed for MEDLINE]

10278: Vopr Virusol. 1962 Nov-Dec;7:706-12.

[On the isolation and cultivation of chickenpox and herpes zoster viruses in
tissue culture.]

[Article in Russian]

GURVICH EB.

PMID: 13951365 [PubMed - OLDMEDLINE]

10279: Fukushima Igaku Zasshi. 1962 Oct;12:329-33.

[Herpes zoster after irradiation.]

[Article in Japanese]

KIMURA K, ANAZAWA A, TAKAKUDA K.

PMID: 14041698 [PubMed - indexed for MEDLINE]

10280: Neurology. 1962 Oct;12:725-7.

Postherpetic neuralgia.

SEHGAL AD, GARDNER WJ.

PMID: 13910276 [PubMed - indexed for MEDLINE]

10281: Med Klin. 1962 Sep 28;57:1651-2.

[On the treatment of inflammatory neurological diseases with a vitamin-enzyme
combination.]

[Article in German]

PRITZSCHE G.

PMID: 13986258 [PubMed - indexed for MEDLINE]

10282: Med Klin. 1962 Sep 28;57:1644-7.

[On cases of zoster ophthalmicus.]

[Article in German]

GRAEBER W.

PMID: 13949722 [PubMed - indexed for MEDLINE]

10283: Pol Tyg Lek. 1962 Sep 3;17:1430-3.

[A case of generalized herpes zoster with paresis during the course of chronic
lymphatic leukemia.]

[Article in Polish]

SYC S, PEC K.

PMID: 13979756 [PubMed - indexed for MEDLINE]

10284: Ned Tijdschr Geneeskd. 1962 Sep 1;106:1749-53.

[Herpes and zoster.]

[Article in Dutch]

PRAKKEN JR.

PMID: 14488476 [PubMed - indexed for MEDLINE]

10285: Bull Soc Fr Dermatol Syphiligr. 1962 Aug-Oct;69:828-9.

[Xenalamine in the treatment of viral dermatoses of the herpes zona group.
(Preliminary note)]

[Article in French]

COLOMB D.

PMID: 14041487 [PubMed - indexed for MEDLINE]

10286: Bull Soc Fr Dermatol Syphiligr. 1962 Aug-Oct;69:828-9.

[Xenalamine in the treatment of viral dermatoses of the herpes zona group.
(Preliminary note)]

[Article in French]

COLOMB D.

PMID: 14041395 [PubMed - indexed for MEDLINE]

10287: Bull Soc Fr Dermatol Syphiligr. 1962 Aug-Oct;69:828-9.

[Xenalamine in the treatment of viral dermatoses of the herpes zona group.
(Preliminary note)]

[Article in French]

COLOMB D.

PMID: 14040724 [PubMed - indexed for MEDLINE]

10288: N C Med J. 1962 Aug;23:357-60.

Abitylguanide (ABOB) in treating herpes zoster.

WILKINSON JS.

PMID: 14007060 [PubMed - indexed for MEDLINE]

10289: J Radiol Electrol Med Nucl. 1962 Aug-Sep;43:567-8.

[105 cases of zoster treated by radiotherapy of the posterior roots.]

[Article in French]

WANGERMEZ C, ESBELIN R, WANGERMEZ J, WANGERMEZ A, BISCH X.

PMID: 13998821 [PubMed - indexed for MEDLINE]

10290: Z Haut Geschlechtskr. 1962 Aug 1;33:77-84.

[A special clinical course of Hodgkin's disease in herpes zoster.]

[Article in German]

RAAB W.

PMID: 13972808 [PubMed - indexed for MEDLINE]

10291: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1962 Aug;141:116-22.

[Atrophy of the optic nerve and ophthalmoplegia in ophthalmic zoster.]

[Article in German]

VOGELSANG K.

Publication Types: 
    Case Reports

PMID: 13926453 [PubMed - OLDMEDLINE]

10292: Am J Ophthalmol. 1962 Aug;54:298-301.

Isolated abducens paresis complicating herpes zoster ophthalmicus.

HERMANN JS.

PMID: 13906716 [PubMed - OLDMEDLINE]

10293: Sem Med. 1962 Jul 12;121:158-61.

[Action of vitamin B-1 and B-12 in massive doses in posterpes zoster neuralgia.]

[Article in Spanish]

RABINSTEIN S, BUMAGUIN DE RABINSTEIN S.

PMID: 13972883 [PubMed - indexed for MEDLINE]

10294: Arch Intern Med. 1962 Jul;110:98-101.

Herpes zoster generalisatus pneumonia. Varicella pneumonia in a patient with
herpes zoster generalisatus; report of a case in a patient with Hodgkin's
disease.

KAIN HK, FELDMAN CA, COHN LH.

Publication Types: 
    Case Reports

PMID: 14453135 [PubMed - indexed for MEDLINE]

10295: Arch Ital Otol Rinol Laringol. 1962 Jul-Aug;73:485-512.

[Herpes zoster oticus. (Clinical study and pathogenetic consideratkons on 10
cases)]

[Article in Italian]

CIS C, BORGO M.

PMID: 14021417 [PubMed - indexed for MEDLINE]

10296: Arch Pediatr. 1962 Jul;79:263-5.

Herpes zoster associated with small pox vaccination.

SCHNECK H.

PMID: 13908882 [PubMed - indexed for MEDLINE]

10297: Bull Soc Fr Dermatol Syphiligr. 1962 Jun-Jul;69:508-10.

[Paralytic herpes zoster of the upper extremity. Electromyographic study.]

[Article in French]

BUREAU Y, BARRIERE H, GUIARD D, LITOUX, VEILHAN.

PMID: 14016931 [PubMed - indexed for MEDLINE]

10298: Radiol Med. 1962 Jun;48:589-601.

[Contribution to the pathogentic problem of herpes zoster in the course of
irradiated neoplastic forms. Presentation of 21 personal cases.]

[Article in Italian]

CIAMPELLI I, CROCELLA R.

PMID: 13879471 [PubMed - indexed for MEDLINE]

10299: Dtsch Med J. 1962 May 5;13:259-66.

[Diseases caused by herpes viruses (herpes simplex, zoster, herpangina).]

[Article in German]

KOEPPE HW.

PMID: 14457723 [PubMed - indexed for MEDLINE]

10300: Clin Med (Northfield Il). 1962 May;69:1173-4.

Herpes zoster opthalmicus: systemic steroid therapy.

SCHEIE HE, McLELLAN TG Jr.

PMID: 15445866 [PubMed - indexed for MEDLINE]

10301: Ann Intern Med. 1962 May;56:779-84.

Herpes zoster (zona) encephalitis. Case report with electroencephalographic and
cerebrospinal fluid studies.

LIDSKY MD, KLASS DW, McKENZIE BF, GOLDSTEIN NP.

PMID: 14465128 [PubMed - indexed for MEDLINE]

10302: Actas Dermosifiliogr. 1962 May;53:236-7.

[Presentation of a case of generalized gangrenous zona.]

[Article in Spanish]

ALVAREZ CASCOS M.

PMID: 14012394 [PubMed - indexed for MEDLINE]

10303: Laryngoscope. 1962 May;72:653-63.

Herpes zoster involving the head and neck.

WELSH LW, WELSH JJ.

Publication Types: 
    Case Reports

PMID: 14006067 [PubMed - OLDMEDLINE]

10304: J Indian Med Assoc. 1962 Apr 1;38:345-6.

Herpes ophthalmicus with varicella.

BEHERA UC, MISRA MC.

Publication Types: 
    Case Reports

PMID: 13866581 [PubMed - indexed for MEDLINE]

10305: Practitioner. 1962 Mar;188:396-7.

Herpes zoster as an infectious disease.

WILSON JB.

Publication Types: 
    Case Reports

PMID: 14007363 [PubMed - indexed for MEDLINE]

10306: Hifuka No Rinsho. 1962 Mar;4:137-46.

[Relation between herpes zoster and blister.]

[Article in Japanese]

SUZUKI S.

PMID: 13918634 [PubMed - indexed for MEDLINE]

10307: Klin Med (Mosk). 1962 Mar;40:143-6.

[A case of combined herpes zoster and chickenpox.]

[Article in Russian]

ASHMARIN IuIa, ORLOVA MV.

PMID: 13862856 [PubMed - indexed for MEDLINE]

10308: Ugeskr Laeger. 1962 Jan 26;124:103-6.

[Keratitis herpetica. Unfortunate results after treatment with corticosteroids.]

[Article in Danish]

MADSEN PH.

PMID: 14468140 [PubMed - indexed for MEDLINE]

10309: Pol Tyg Lek. 1962 Jan 15;17:100-3.

[Herpes zoster oticus (Ramsey Hunt syndrome).]

[Article in Polish]

OSWALDO-RUSINOWA A.

Publication Types: 
    Case Reports

PMID: 14037227 [PubMed - OLDMEDLINE]

10310: Ann Ottalmol Clin Ocul. 1962 Jan;88:22-7.

[Observations on the use of prednisolone hemisuccinate in various ocular
diseases.]

[Article in Italian]

PALIAGA GP.

PMID: 14483331 [PubMed - indexed for MEDLINE]

10311: Otolaryngol Pol. 1962;16:381-6.

[Herpes zoster oticus.]

[Article in Polish]

MALICKA K.

Publication Types: 
    Case Reports

PMID: 14468907 [PubMed - indexed for MEDLINE]

10312: Dtsch Z Nervenheilkd. 1962;183:589-99.

[Meningoencephalitis after zoster with a tendency to torsion along the
longitudinal axis and body image disorders.]

[Article in German]

KNUEPPEL H.

PMID: 14457394 [PubMed - indexed for MEDLINE]

10313: Wien Z Nervenheilkd Grenzgeb. 1962;19:285-90.

[Myelitis zosteriana.]

[Article in German]

RISTIC J, GOSPAVIC J, TIL E.

PMID: 13974060 [PubMed - indexed for MEDLINE]

10314: Lek Wojsk. 1962;38:1115-20.

[Herpes zoster cephalicus.]

[Article in Polish]

KWILMAN A, RUDNY J.

PMID: 13927757 [PubMed - indexed for MEDLINE]

10315: Bull Soc Fr Dermatol Syphiligr. 1962 Jan-Mar;69:164-5.

[Especially painful hemorrhagic zona, refractory to therapy, in a young woman
undergoing corticotherapy for chronic evolutive polyarthritis.]

[Article in French]

VIGNON G, COLOMB D, BADY B.

Publication Types: 
    Case Reports

PMID: 13925889 [PubMed - indexed for MEDLINE]

10316: Neurol Neurochir Psychiatr Pol. 1962 Jan-Feb;12:131-3.

[Recurrent herpes zoster of the face after a severe cranial injury.]

[Article in Polish]

STEPIEN M.

Publication Types: 
    Case Reports

PMID: 13916939 [PubMed - OLDMEDLINE]

10317: J Mich State Med Soc. 1962 Jan;61:60-2.

Surgical treatment of postherpetic neuralgia by subdermal denervation.

FARBMAN AA.

PMID: 13891596 [PubMed - indexed for MEDLINE]

10318: Neurology. 1962 Jan;12:34-5.

Varicella-zoster and herpes simplex antibody responses in patients with Bell's
palsy.

DODGE PR, POSKANZER DC.

PMID: 13886858 [PubMed - indexed for MEDLINE]

10319: Am J Med. 1962 Jan;32:25-31.

Herpes zoster encephalitis.

APPELBAUM E, KREPS SI, SUNSHINE A.

PMID: 13861912 [PubMed - indexed for MEDLINE]

10320: Dia Med. 1961 Nov 20;33:2789.

[Herpes zoster. Its treatment with histamine.]

[Article in Spanish]

SCOLNIK AJ.

PMID: 13909886 [PubMed - indexed for MEDLINE]

10321: Boll Ocul. 1961 Nov;40:791-9.

[Bilateral herpetic keratitis and Kaposi's varicelliform eruption.]

[Article in Italian]

MAGGI C.

Publication Types: 
    Case Reports

PMID: 14468270 [PubMed - indexed for MEDLINE]

10322: Clinique (Paris). 1961 Oct 15;56:498-500.

[Radiotherapy in zona.]

[Article in French]

FRAIN C, DABAN C.

PMID: 13894446 [PubMed - indexed for MEDLINE]

10323: Cas Lek Cesk. 1961 Oct 13;100:1284-9.

[Experiences with vitamin B12 in neurological diseases, especially herpes
zoster.]

[Article in Czech]

PRAGEROVA V, WAELSCH JH.

PMID: 14488464 [PubMed - indexed for MEDLINE]

10324: Sem Hop. 1961 Oct 2;37:2653-60.

[Herpes of the newborn with auriculo-ventricular dissociation. Clinical, anatomic
and virological study.]

[Article in French]

BERNARD R, PAYAN H, TAMALET J, AUDIBERT G.

PMID: 13868056 [PubMed - OLDMEDLINE]

10325: Ann Ottalmol Clin Ocul. 1961 Oct;87:578-82.

[A case of isolated paralysis of the abducent nerve in the course of ophthalmic
herpes zoster.]

[Article in Italian]

NUCCI E.

PMID: 14480685 [PubMed - OLDMEDLINE]

10326: Dia Med. 1961 Oct;33(Special):2483-5.

[Atypical cells in vesicles and in peripheral blood in zona (herpes zoster).]

[Article in Spanish]

MINOPRIO JL, DURANDEU A, ROSALES SR, LEMOS E.

PMID: 14474356 [PubMed - indexed for MEDLINE]

10327: Acta Otolaryngol. 1961 Oct;53:536-8.

Glossopharyngeal zoster.

HEIBERG S.

Publication Types: 
    Case Reports

PMID: 13905965 [PubMed - indexed for MEDLINE]

10328: Arch Intern Med. 1961 Oct;108:594-8.

Severe herpes zoster during corticosteroid therapy. Report of a severe attack in 
a patient with rheumatoid arthritis.

ECKHARDT WF Jr, HEBARD GW.

PMID: 13889107 [PubMed - indexed for MEDLINE]

10329: Rev Prat. 1961 Sep 11;11:2275-85.

[Clinical forms and complications of zona (with the exclusion of ocular
complications).]

[Article in French]

KISSEL P, DUREUX JB.

PMID: 13756408 [PubMed - indexed for MEDLINE]

10330: Rev Prat. 1961 Sep 11;11:2287-94.

[Ophthalmic zona.]

[Article in French]

FOREST A, JEGLOT A.

PMID: 13700762 [PubMed - indexed for MEDLINE]

10331: Rev Prat. 1961 Sep 11;11:2327-33.

[Treatment of herpes and zona.]

[Article in French]

CELICE J.

PMID: 13691882 [PubMed - indexed for MEDLINE]

10332: Rev Prat. 1961 Sep 11;11:2263-73.

[The herpes virus and the varicella-zona virus.]

[Article in French]

CATHALA F.

PMID: 13691560 [PubMed - indexed for MEDLINE]

10333: Cas Lek Cesk. 1961 Sep 8;100:1141-5.

[Lesions of the central nervous system during the course of herpes zoster.]

[Article in Czech]

DUNIEWICZ M, KROO A, DOBIAS J.

PMID: 13888474 [PubMed - indexed for MEDLINE]

10334: Acta Med Scand. 1961 Sep;170:339-49.

Herpes zoster--varicellae in cases of leukemia. A clinical report including
determination of serum proteins and total hemolytic complement.

NORDEN A, SWAHN B.

PMID: 14480283 [PubMed - indexed for MEDLINE]

10335: J Mt Sinai Hosp N Y. 1961 Sep-Oct;28:473-4.

Herpes zoster and varicella occurring in siblings following contact with
chickenpox.

REICH JS, BAUMAL A.

Publication Types: 
    Case Reports

PMID: 13740417 [PubMed - indexed for MEDLINE]

10336: Dia Med. 1961 Aug 7;33:1556-9.

[Considerations on the therapeutic use of a proteolytic enzyme extracted from the
gastric mucosa of the hog.]

[Article in Spanish]

SAGRERAS RP.

PMID: 13745393 [PubMed - indexed for MEDLINE]

10337: N Z Med J. 1961 Aug;60:382-90.

The myotonic convergence reaction of the pupil and herpes zoster: with a
localisation of the lesion and a note on the corneal reflex.

ALLEN IM.

PMID: 13860544 [PubMed - indexed for MEDLINE]

10338: Arch Dermatol. 1961 Aug;84:242-4.

Herpes zoster and malignancy.

WRIGHT ET, WINER LH.

PMID: 13786777 [PubMed - OLDMEDLINE]

10339: Arch Otolaryngol. 1961 Aug;74:178-80.

The Ramsey Hunt syndrome. Report of a case with vestibular and cochlear
involvement successfully treated with prednisolone acetate (Medrol).

MADDOX HE 3rd.

Publication Types: 
    Case Reports

PMID: 13765051 [PubMed - indexed for MEDLINE]

10340: Orv Hetil. 1961 Jul 30;102:1470-2.

[Rare cases of herpes zoster oticus and their treatment.]

[Article in Hungarian]

FURSTNER J, KRALOVANSZKY Z.

PMID: 13702682 [PubMed - OLDMEDLINE]

10341: Minerva Med. 1961 Jul 4;52:2362-4.

[Meniere-like syndrome caused by auricular zona.]

[Article in Italian]

BAROCCI C.

PMID: 13687163 [PubMed - OLDMEDLINE]

10342: Dis Chest. 1961 Jul;40:74-5.

Herpes zoster pneumonitis: case report.

WILSON FW, MATLOCK TB.

PMID: 13785652 [PubMed - indexed for MEDLINE]

10343: JAMA. 1961 Jun 24;176:1041-3.

Treatment of herpetic pain and postherpetic neuralgia with intravenous procaine.

SHANBROM E.

PMID: 13750666 [PubMed - indexed for MEDLINE]

10344: Aust J Dermatol. 1961 Jun;6:54-8.

Herpes zoster: intravenous procaine in the treatment of post-herpetic neuralgia.

GUNTHER WW, SCHALIT I.

PMID: 13902979 [PubMed - indexed for MEDLINE]

10345: Nippon Hifuka Gakkai Zasshi. 1961 Jun;71:642-50.

[Electron microscopic study of viral diseases.]

[Article in Japanese]

DOHI J, OTA Y, AMANO F, MORI R, TAKAKI F, YASUDA H, SUZUKI A, WAKAMORI T.

PMID: 13723471 [PubMed - indexed for MEDLINE]

10346: Jibiinkoka. 1961 Jun;33:519-24.

[Herpes zoster of the external ear.]

[Article in Japanese]

ICHIHARA M, KOMATSU A, MATSUMOTO M.

Publication Types: 
    Case Reports

PMID: 13717362 [PubMed - OLDMEDLINE]

10347: J Hyg (Lond). 1961 Jun;59:249-58.

The soluble antigens of varicella-zoster virus produced in tissue culture.

CAUNT AE, RONDLE CJ, DOWNIE AW.

PMID: 13691671 [PubMed - indexed for MEDLINE]

10348: Dia Med. 1961 May 22;33:789-98.

[Observations on 65 cases of zona. Clinico-therapeutic deductions.]

[Article in Spanish]

D'AGOSTINO M.

PMID: 13719120 [PubMed - indexed for MEDLINE]

10349: Trans Indiana Acad Ophthalmol Otolaryngol. 1961 May;44:5-7.

Gamma globulin in the treatment of herpes zoster (a case report).

SLAUGHTER HC.

PMID: 13913826 [PubMed - indexed for MEDLINE]

10350: Bull Soc Ophtalmol Fr. 1961 May-Jun;5:345-7.

[Physical therapy in zona ophthalmica.]

[Article in French]

CORDIER J, ALGAN B, STEHLIN H.

PMID: 13881310 [PubMed - OLDMEDLINE]

10351: Med World. 1961 May;94:421-3.

B12 peptide in shingles and chickenpox.

JOLLES KE.

PMID: 13790421 [PubMed - indexed for MEDLINE]

10352: Laboratorio. 1961 May;39:95-8.

[On lesions of certain internal organs in herpes zoster.]

[Article in Russian]

MARTYNOV IV, ASHMARIN IuIa, BUROV GP.

PMID: 13767614 [PubMed - indexed for MEDLINE]

10353: J Neurol Neurosurg Psychiatry. 1961 May;24:167-72.

Herpes zoster and the Landry-Guillain-Barre syndrome.

KNOX JD, LEVY R, SIMPSON JA.

PMID: 13757221 [PubMed - indexed for MEDLINE]

10354: Hawaii Med J. 1961 May-Jun;20:449-50.

Zoster facialis. A case report.

CLARK JR.

Publication Types: 
    Case Reports

PMID: 13693841 [PubMed - OLDMEDLINE]

10355: Sem Hop. 1961 Apr 8;37:1212-4.

[Apropos of geniculate herpes zoster.]

[Article in French]

BEAL G.

PMID: 13688198 [PubMed - indexed for MEDLINE]

10356: Arch Dermatol. 1961 Apr;83:61-3.

Herpes zoster in an infant with probable postherpetic neuralgia. A case report.

LUMPKIN LR.

PMID: 13764253 [PubMed - indexed for MEDLINE]

10357: Ophthalmologica. 1961 Apr;141:271-7.

[On the clinical aspects and therapy of herpes zoster ophthalmicus.]

[Article in German]

LEUENBERGER A.

PMID: 13761274 [PubMed - OLDMEDLINE]

10358: Stud Gen (Berl). 1961 Apr;89:505-6.

[Epidemic hepatitis and herpes zoster.]

[Article in Undetermined Language]

KRCIC M.

PMID: 13754162 [PubMed - indexed for MEDLINE]

10359: Oral Surg Oral Med Oral Pathol. 1961 Apr;14:414-8.

Herpes zoster of the mandibular nerve. Report of a case.

GARDNER JA, HANFT RJ.

Publication Types: 
    Case Reports

PMID: 13703615 [PubMed - OLDMEDLINE]

10360: Rev Neurol (Paris). 1961 Apr;104:342-5.

[Apropos of zosterian paralysis. 1. Zona of the geniculate ganglion with
diaphragmatic paralysis. 2. Brachial zona with homolateral brachial paralysis,
heterolateral crural paralysis and albumino-cytological dissociation of the
cerebrospinal fluid.]

[Article in French]

CREMIEUX A, ROGER J, POINSO Y, RAMELLA B.

PMID: 13696384 [PubMed - OLDMEDLINE]

10361: JAMA. 1961 Mar 25;175:1104-6.

A false-positive Treponema pallidum complement fixation (TPCF) test.

MANDEL EH, MARKEL J, KIM YP.

PMID: 13766055 [PubMed - indexed for MEDLINE]

10362: JAMA. 1961 Mar 18;175:1008-10.

Herpes zoster resembling acute varicella associated with multiple myeloma.

YAFFEE HS, GREENBERG MS.

Publication Types: 
    Case Reports

PMID: 13787040 [PubMed - indexed for MEDLINE]

10363: J Indian Med Assoc. 1961 Mar 16;36:243-4.

Geniculate herpes with herpes of the fifth cranial nerve and posterior roots of
first two cervical nerves with facial paralysis.

KAMDAR HR.

PMID: 13751019 [PubMed - indexed for MEDLINE]

10364: Minerva Med. 1961 Mar 3;52:798-801.

[Herpes zoster associated with acute meningoencephalitis with outcome of
dementia.]

[Article in Italian]

MANZINI B.

Publication Types: 
    Case Reports

PMID: 13766358 [PubMed - indexed for MEDLINE]

10365: Arch Ital Otol Rinol Laringol. 1961 Mar-Apr;72:193-237.

[Auricular herpes zoster.]

[Article in Italian]

TRIVELLA G, MASCIALINO L.

Publication Types: 
    Case Reports

PMID: 13922534 [PubMed - OLDMEDLINE]

10366: J Belge Med Phys Rhumatol. 1961 Mar-Apr;16:49-54.

[Electromyography in 7 cases of zona with paralysis.]

[Article in French]

ROSSELLE N, VAN BETSBRUGGE A, DE DEKEN E, FOLLON H, LIGOT S.

PMID: 13743671 [PubMed - indexed for MEDLINE]

10367: Vestn Otorinolaringol. 1961 Mar-Apr;23:23-7.

[On the problem of herpes zoster oticus.]

[Article in Russian]

NIKOL'SKAIA MI.

PMID: 13729106 [PubMed - indexed for MEDLINE]

10368: Tidsskr Nor Laegeforen. 1961 Mar 1;81:248-50.

[Varicella-herpes zoster. A case of herpes zoster generalisatus.]

[Article in Norwegian]

ENGER SC.

PMID: 13696864 [PubMed - indexed for MEDLINE]

10369: Presse Med. 1961 Feb 18;69:347-8.

[Zona.]

[Article in French]

PESTEL M.

PMID: 13734723 [PubMed - indexed for MEDLINE]

10370: Bull Off Chambre Synd Med Seine. 1961 Feb 10;56:233-5.

[The anniversary of herpes zoster. A contribution to the history of
neurodermatology.]

[Article in German]

LEIBBRAND W.

PMID: 13760516 [PubMed - indexed for MEDLINE]

10371: Przegl Epidemiol. 1961;15:423-4.

[Herpes zoster and chickenpox.]

[Article in Polish]

KRAJEWSKA B.

PMID: 14459249 [PubMed - indexed for MEDLINE]

10372: An Fac Med Univ Repub Montev Urug. 1961;46:232-9.

[Ophthalmic herpes zoster.]

[Article in Spanish]

FERRER J, VIGNALE A.

Publication Types: 
    Case Reports

PMID: 13892562 [PubMed - OLDMEDLINE]

10373: G Psichiatr Neuropatol. 1961;89:145-66.

[Considerations on a case of unilateral Argyll Robertson pupil subsequent to
ophthalmic zona.]

[Article in Italian]

TARASCHI G, TOSARELLI L.

PMID: 13775290 [PubMed - indexed for MEDLINE]

10374: Wien Z Nervenheilkd Grenzgeb. 1961;18:224-35.

[Lesion of the central nervous system during an attack of herpes zoster.]

[Article in German]

KROO AH, DUNIEWICZ M, DOBIAS J.

PMID: 13754511 [PubMed - indexed for MEDLINE]

10375: Arch Ohren Nasen Kehlkopfheilkd. 1961;177:187-92.

[On the histopathology of zoster oticus.]

[Article in German]

GRUENBERG H.

PMID: 13709193 [PubMed - OLDMEDLINE]

10376: Srp Arh Celok Lek. 1960 Dec;88:1207-17.

[Herpes zoster oticus.]

[Article in Undetermined Language]

DJORDJEVIC S, SIMONOVIC M.

Publication Types: 
    Case Reports

PMID: 13723185 [PubMed - indexed for MEDLINE]

10377: Arch Maragliano Patol Clin. 1960 Dec;16:987-1000.

[Considerations on 2 cases of neuraxitis associated with herpes zoster.]

[Article in Italian]

GAMBARO GC, PAVERO A, DE GAETANI G.

Publication Types: 
    Case Reports

PMID: 13703247 [PubMed - indexed for MEDLINE]

10378: Oral Surg Oral Med Oral Pathol. 1960 Dec;13:1429-37.

Herpes zoster-a primary manifestation of chronic lymphatic leukemia; report of a 
case.

CHACONAS CP.

PMID: 13692121 [PubMed - indexed for MEDLINE]

10379: J Med (Oporto). 1960 Nov 5;43:448-9.

[Treatment of zona.]

[Article in Portuguese]

GEISER JD.

PMID: 13704224 [PubMed - indexed for MEDLINE]

10380: Practitioner. 1960 Nov;185:680.

A dressing for herpes zoster.

CORBETT AC.

PMID: 13695434 [PubMed - indexed for MEDLINE]

10381: Rum Med Rev. 1960 Oct-Dec;4:33-5.

Varicellous herpes zoster, with special reference to 3 cases.

DUNA F, VOICULESCU M.

PMID: 13724958 [PubMed - indexed for MEDLINE]

10382: Lancet. 1960 Sep 24;2(7152):671-3.

Alleviation of post-herpetic neuralgia.

TEVERNER D.

PMID: 13776135 [PubMed - indexed for MEDLINE]

10383: Dermatol Wochenschr. 1960 Sep 24;142:1049-54.

[A contribution to the zoster problem.]

[Article in German]

HOCHLEITNER H.

PMID: 13714779 [PubMed - indexed for MEDLINE]

10384: Ann Intern Med. 1960 Sep;53:523-33.

Herpes zoster in hematologic neoplasias: some unusual manifestations.

SHANBROM E, MILLER S, HAAR H.

Publication Types: 
    Case Reports

PMID: 13750664 [PubMed - indexed for MEDLINE]

10385: Minerva Dermatol. 1960 Sep;35:354-70.

[On the histopathogenesis of leukoses. (Apropos of a case of generalized herpes
zoster inlymphatic leukemia)]

[Article in Italian]

SAPUPPO A.

Publication Types: 
    Case Reports

PMID: 13746454 [PubMed - indexed for MEDLINE]

10386: Wis Med J. 1960 Sep;59:565-9.

Herpes zoster generalisatus.

CHELIUS CJ.

PMID: 13692741 [PubMed - indexed for MEDLINE]

10387: Lyon Med. 1960 Aug 7;92:255-9.

[Bucco-facial zona.]

[Article in French]

FREIDEL C, BERTOIN P, MATHIEU L, LOIRE.

Publication Types: 
    Case Reports

PMID: 13701677 [PubMed - OLDMEDLINE]

10388: Arch Dermatol. 1960 Aug;82:247-9.

Herpes zoster trigeminal neural gia. Pain relief by alcoholic block of the great 
occipital nerve.

SKILLERN SD, RODIN H.

PMID: 13831475 [PubMed - indexed for MEDLINE]

10389: Strahlentherapie. 1960 Aug;112:587-94.

[Herpes zoster after x-irradiation.]

[Article in German]

KOEHLER J.

PMID: 13831012 [PubMed - indexed for MEDLINE]

10390: Bull Soc Fr Dermatol Syphiligr. 1960 Aug-Oct;67:814-5.

[Generalized visceral zona in a leukemia patient.]

[Article in French]

THIERS H, COLOMB D, GATE A, FAYOLLE J, MIRAILLET P.

Publication Types: 
    Case Reports

PMID: 13776347 [PubMed - indexed for MEDLINE]

10391: S Afr Med J. 1960 Jul 9;34:594-5.

A new approach to the treatment of herpes zoster.

RAFF A.

PMID: 14435806 [PubMed - indexed for MEDLINE]

10392: Med J Aust. 1960 Jul 9;47(2):63-4.

Herpes zoster ophthalmicus and pregnancy.

WILSON E.

PMID: 13845047 [PubMed - indexed for MEDLINE]

10393: Minerva Fisioter Radiobiol. 1960 Jul-Aug;5:196-200.

[Antalgic effectiveness of roentgenotherapy in various diseases.]

[Article in Italian]

MAGGI GC, GRASSI E.

PMID: 13765218 [PubMed - OLDMEDLINE]

10394: Arch Pediatr Urug. 1960 Jul;31:379-82.

[A case of association of zona ophthalmica and varicella in a 9-year-old boy.]

[Article in Spanish]

FOSSATI H, TAQUIOSI A, MASSERA MJ, DE BERTERRECHE JA.

PMID: 13700954 [PubMed - indexed for MEDLINE]

10395: Sem Med. 1960 Jun 23;116:1249-50.

[Clinical experience with promazine.]

[Article in Spanish]

RIU JA.

PMID: 13741918 [PubMed - indexed for MEDLINE]

10396: Br Med J. 1960 Jun 4;1(5187):1713.

Herpes zoster occuring in a patient with chicken-pox.

TAYLOR-ROBINSON D.

Publication Types: 
    Case Reports

PMID: 13855032 [PubMed - indexed for MEDLINE]

10397: W V Med J. 1960 Jun;56:191-3.

Treatment of herpes zoster ophthalmicus (with case reports).

SHUPALA E.

PMID: 14446332 [PubMed - indexed for MEDLINE]

10398: Minerva Dermatol. 1960 Jun;35:245-8.

[Synergistic polyvitamin combination with ATP in the treatment of herpes zoster.]

[Article in Italian]

ALBERTAZZI F.

PMID: 13792395 [PubMed - indexed for MEDLINE]

10399: Ann Inst Pasteur (Paris). 1960 May;98:750-3.

[Preservation of the herpes virus.]

[Article in French]

LEPINE P, ARTZET F, CEO LIN G.

PMID: 14415877 [PubMed - indexed for MEDLINE]

10400: Pa Med J. 1960 May;63:697-8.

Use of protamide in the treatment of herpes zoster.

BAKER AG.

PMID: 13795972 [PubMed - indexed for MEDLINE]

10401: Minn Med. 1960 May;43:346.

Herpes zoster treated with prednisolone.

TUDOR RB.

PMID: 13778550 [PubMed - indexed for MEDLINE]

10402: Monatsschr Ohrenheilkd Laryngorhinol. 1960 Apr;94:79-81.

[Herpes zoster of the maxillary sinus confirmed by endoscopy.]

[Article in German]

WODAK E.

PMID: 13845542 [PubMed - OLDMEDLINE]

10403: Rev Cubana Cardiol. 1960 Apr-Jun;21:57-74.

[Electrocardiographical changes in herpes zoster.]

[Article in Spanish]

PUJOL J.

PMID: 13738434 [PubMed - indexed for MEDLINE]

10404: Ann Ottalmol Clin Ocul. 1960 Apr;86:115-20.

[Treatment of human herpetic keratitis with new synthetic antiviral agents.]

[Article in Italian]

PALIAGA GP.

Publication Types: 
    Case Reports

PMID: 13732226 [PubMed - indexed for MEDLINE]

10405: Munch Med Wochenschr. 1960 Mar 4;102:479-80.

[Concordant zoster oticus in uniovular twins.]

[Article in German]

NEUSS O.

Publication Types: 
    Case Reports

PMID: 14426723 [PubMed - OLDMEDLINE]

10406: Riv Clin Pediatr. 1960 Mar;65:201-11.

[Considerations on an epidemic of varicella caused by a case of herpes zoster in 
a tuberculous meningitis ward.]

[Article in Italian]

RAGAZZINI F.

PMID: 14435842 [PubMed - indexed for MEDLINE]

10407: Sov Med. 1960 Mar;24:140-1.

[On the effectiveness of pantothenic acid in the treatment of herpes zoster.]

[Article in Russian]

CHEBOTAREV KS.

PMID: 13809543 [PubMed - indexed for MEDLINE]

10408: Rev Neuropsiquiatr. 1960 Mar;23:113-24.

[Optic neuromyelitis zoster with pseudoileus.]

[Article in Spanish]

ROEDENBECK S.

PMID: 13742668 [PubMed - indexed for MEDLINE]

10409: Clin Otorinolaringoiatr. 1960 Mar-Apr;12:133-47.

[Pharyngo-otic zona: clinicoserological considerations.]

[Article in Italian]

CERESIA G, ROSSI M.

PMID: 13691963 [PubMed - OLDMEDLINE]

10410: Sem Hop. 1960 Feb 18;36:497-505.

[The role of the nervous system in the appearance of gynecomastia.]

[Article in French]

SEILLE G, de BRUX, ENTAT F.

PMID: 14444636 [PubMed - OLDMEDLINE]

10411: R I Med J. 1960 Feb;43:104.

Autohemotherapy in the treatment of post-herpetic pain.

SCHIFF BL.

PMID: 14442736 [PubMed - indexed for MEDLINE]

10412: Arch Ophthalmol. 1960 Feb;63:273-80.

Herpes zoster ophthalmicus complicated by contralateral hemiplegia.

LAWS HW.

Publication Types: 
    Case Reports

PMID: 14414739 [PubMed - OLDMEDLINE]

10413: Sov Med. 1960 Feb;24:140.

[Treatment of herpes zoster with levomycetin.]

[Article in Russian]

ZEL'DIN GS.

PMID: 13847196 [PubMed - indexed for MEDLINE]

10414: Minerva Dermatol. 1960 Feb;35:71-2.

[Lymphatic leukemia and generalized herpes zoster.]

[Article in Italian]

CORICCIATI L.

Publication Types: 
    Case Reports

PMID: 13811973 [PubMed - indexed for MEDLINE]

10415: Bull Soc Fr Dermatol Syphiligr. 1960 Jan-Mar;67:163-6.

[Cervicobrachial zona, followed by a sudden viral generalization.]

[Article in French]

PRUNIERAS M, de BEER.

Publication Types: 
    Case Reports

PMID: 14435152 [PubMed - indexed for MEDLINE]

10416: Rev Prat. 1960;32:38-41.

[Foreign body of the cornea and zona. (Physiopathological and medicolegal
considerations)]

[Article in French]

GIROIRE, CHARBONNEL, VERCELLETTO.

PMID: 13850291 [PubMed - indexed for MEDLINE]

10417: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1960;136:230-3.

[Zoster opthalmicus gangraenosus with loss of the eyeball.]

[Article in German]

DODEN W.

PMID: 13817142 [PubMed - indexed for MEDLINE]

10418: J Chronic Dis. 1960 Jan;11:69-76.

Postherpetic pain.

CRIKELAIR GF, MINERVINI F.

PMID: 13812864 [PubMed - indexed for MEDLINE]

10419: Bull Soc Fr Dermatol Syphiligr. 1960 Jan-Mar;67:15-7.

[Pemphigus foliaceus complicated by zona, treated by the association of
quinacrine, aureomycin in large doses and corticotherapy in small doses.]

[Article in French]

BOLGERT M, LE SOURD M, PEILLON F.

PMID: 13802295 [PubMed - indexed for MEDLINE]

10420: Trans Am Ophthalmol Soc. 1960;58:245-62.

The unfavorable effect of topical steroid therapy on herpetic keratitis.

THYGESON P, HOGAN MJ, KIMURA SJ.

Publication Types: 
    Case Reports

PMID: 13776796 [PubMed - indexed for MEDLINE]

10421: Hautarzt. 1960 Jan;11:32-4.

[The modification of herpes zoster by dihydroergotamine Sandoz.]

[Article in German]

MATANIC V.

PMID: 13768026 [PubMed - indexed for MEDLINE]

10422: Annee Ther Clin Ophtalmol. 1960;11:387-98.

[Medical treatment of ophthalmic zona.]

[Article in French]

SEDAN J, FARNARIER G.

PMID: 13749567 [PubMed - OLDMEDLINE]

10423: Sven Lakartidn. 1959 Dec 23;56:3682-4.

[Herpes zoster and acute abdomen.]

[Article in Swedish]

CULLHED I.

PMID: 13813247 [PubMed - indexed for MEDLINE]

10424: Sven Lakartidn. 1959 Dec 18;56:3563-6.

[Herpes zoster treated with N',N-anhydrobis(2-hydroxyethyl)-biguanide HC1
(ABOB).]

[Article in Swedish]

SCHERSTEN B.

PMID: 14442681 [PubMed - indexed for MEDLINE]

10425: Nord Med. 1959 Dec 10;62:1767-71.

[Herpes zoster oticus.]

[Article in Norwegian]

NORDAHL T.

PMID: 14427561 [PubMed - OLDMEDLINE]

10426: Br J Exp Pathol. 1959 Dec;40:521-32.

Chickenpox and herpes zoster. III. Tissue culture studies.

TAYLOR-ROBINSON D.

PMID: 13855031 [PubMed - indexed for MEDLINE]

10427: Br J Exp Pathol. 1959 Dec;40:517-20.

Chickenpox and herpes zoster. II. Ouchterlony precipitation studies.

TAYLOR-ROBINSON D, RONDLE CJ.

PMID: 13855030 [PubMed - indexed for MEDLINE]

10428: Pa Med J. 1959 Dec;62:1827-30.

Adrenal corticosteroids in herpes zoster.

FREEMAN JT.

PMID: 13824743 [PubMed - indexed for MEDLINE]

10429: Pol Tyg Lek. 1959 Nov 30;14:2106-9.

[On herpetic meningospinal meningitis.]

[Article in Polish]

WOLSKI J.

PMID: 13845778 [PubMed - indexed for MEDLINE]

10430: Hippokrates. 1959 Nov 15;30:789-91.

[Experiences with the treatment of herpes zoster.]

[Article in German]

NEBEL C.

PMID: 14426285 [PubMed - indexed for MEDLINE]

10431: J Indian Med Assoc. 1959 Nov 1;33:377-8.

Herpes of the geniculate ganglion.

SITARAMAN N.

Publication Types: 
    Case Reports

PMID: 14447232 [PubMed - indexed for MEDLINE]

10432: Montp Med. 1959 Nov;56:232-7.

[The shoulder-hand syndrome in cervicobrachial zona.]

[Article in French]

SERRE H, SIMON L.

PMID: 14445125 [PubMed - OLDMEDLINE]

10433: Practitioner. 1959 Nov;183:587-95.

Herpes simplex and varicella-zoster.

MACCALLUM FO.

PMID: 14419272 [PubMed - indexed for MEDLINE]

10434: Bull Soc Ophtalmol Fr. 1959 Nov;8:737-41.

[2 Rare ocular manifestations of ophthalmic zona: retinal periarteritis, "dysoric
nodules".]

[Article in French]

COLLIER M.

PMID: 13848209 [PubMed - OLDMEDLINE]

10435: Bull Soc Ophtalmol Fr. 1959 Nov;8:761-4.

[Atypical tuberculous keratitis and corneal viroses.]

[Article in French]

THOMAS C, CORDIER J, ALGAN B.

PMID: 13837917 [PubMed - OLDMEDLINE]

10436: Bull Soc Fr Dermatol Syphiligr. 1959 Nov-Dec;5:817-9.

[Varicella or generalized zona of rapid development in a patient with myeloid
leukemia.]

[Article in French]

DUPONT A, VANDAELE R.

PMID: 13818743 [PubMed - indexed for MEDLINE]

10437: Bull Soc Ophtalmol Fr. 1959 Nov;8:742-7.

[Left ophthalmic zona. Scleral complications, osteoporosis of the superior
maxilla, congenital abnormalities of the iris and fundus of the eye.]

[Article in French]

COLLIER M.

PMID: 13811239 [PubMed - OLDMEDLINE]

10438: Vie Med. 1959 Nov;40:999-1000.

[Treatment of common zona.]

[Article in French]

AMIEL C.

PMID: 13793181 [PubMed - indexed for MEDLINE]

10439: J Am Med Assoc. 1959 Oct 17;171:876-80.

Herpes zoster in children.

WINKELMANN RK, PERRY HO.

PMID: 13856493 [PubMed - indexed for MEDLINE]

10440: Munch Med Wochenschr. 1959 Oct 2;101:1736-7.

[Indications of a segmental manifestation of a latent herpes zoster.]

[Article in German]

ARNDT J, BUTTENBERG H.

PMID: 13794339 [PubMed - OLDMEDLINE]

10441: Arch Ophthalmol. 1959 Oct;62:579-87.

Treatment of herpes zoster ophthalmicus with corticotropin and corticosteroids.

SCHEIE HG, McLELLAN TG Jr.

PMID: 14442569 [PubMed - OLDMEDLINE]

10442: Ophthalmologica. 1959 Oct;138:311-4.

[A new procedure for the treatment of keratitis herpetica.]

[Article in German]

ALBERTH B.

PMID: 13792396 [PubMed - indexed for MEDLINE]

10443: Nord Med. 1959 Sep 24;62:1414-7.

[Accumulation of cases of herpes zoster generalisatus.]

[Article in Swedish]

FLODERUS S, ROLANDER A.

PMID: 13823542 [PubMed - indexed for MEDLINE]

10444: Sem Hop. 1959 Sep 18-28;35:2572-8.

[Lymphadenia, terrain of choice for certain ectodermo-neurotropic viruses (the
chickenpox-herpes zoster virus in particular).]

[Article in French]

BOUSSER J, CHRISTOL D, GROUBERMANN S.

PMID: 13803382 [PubMed - indexed for MEDLINE]

10445: N Engl J Med. 1959 Sep 3;261:517-8.

CORTISONE and herpes zoster.

[No authors listed]

PMID: 13857821 [PubMed - indexed for MEDLINE]

10446: Arch Ophthalmol. 1959 Sep;62:381-5.

The treatment of ophthalmic herpes zoster with protamide.

SCASSELLATI SFORZOLINI G.

PMID: 14442262 [PubMed - indexed for MEDLINE]

10447: Ann Otolaryngol Chir Cervicofac. 1959 Sep;76:796-8.

[Zona of the pneumogastric.]

[Article in French]

PONCET P, BARON G.

Publication Types: 
    Case Reports

PMID: 14433982 [PubMed - indexed for MEDLINE]

10448: J Am Osteopath Assoc. 1959 Sep;59:10-1.

Herpes zoster ophthalmicus.

GILLETT CF.

PMID: 13850103 [PubMed - indexed for MEDLINE]

10449: Br Med Bull. 1959 Sep;15:197-200.

Chickenpox and zoster.

DOWNIE AW.

PMID: 13817909 [PubMed - indexed for MEDLINE]

10450: Pol Tyg Lek. 1959 Aug 31;14:1619-20.

[Two cases of generalized herpes zoster in chronic lymphatic leukemia.]

[Article in Polish]

WYSOCKI K, DURKALEC J.

PMID: 13846312 [PubMed - indexed for MEDLINE]

10451: Wien Med Wochenschr. 1959 Aug 8;109:636-7.

[Zoster changes of the eye.]

[Article in German]

KREIBIG W.

PMID: 14411887 [PubMed - indexed for MEDLINE]

10452: J Med Liban. 1959 Aug;12:404-5.

[Herpes zoster ophthalmicus.]

[Article in Arabic]

SALEEBY S.

PMID: 14440936 [PubMed - indexed for MEDLINE]

10453: Br J Exp Pathol. 1959 Aug;40:398-409.

Chickenpox and herpes zoster. 1. Complement fixation studies.

TAYLOR-ROBINSON D, DOWNIE AW.

PMID: 13837220 [PubMed - indexed for MEDLINE]

10454: Br J Ophthalmol. 1959 Aug;43:471-6.

Lesions of the ciliary ganglion as a cause of Argyll Robertson and Adie pupils.

CAMERON ME.

PMID: 13807165 [PubMed - indexed for MEDLINE]

10455: Ugeskr Laeger. 1959 Jul 30;121:1199-200.

[Zoster ophthalmicus generalisatus.]

[Article in Danish]

NORN MS.

Publication Types: 
    Case Reports

PMID: 14427643 [PubMed - OLDMEDLINE]

10456: Ann N Y Acad Sci. 1959 Jul 21;81:6-16.

A comparison of in vitro and in vivo characteristics as related to the
pathogenesis of measles, varicella, and herpes zoster.

CHEATHAM WJ.

PMID: 13809542 [PubMed - indexed for MEDLINE]

10457: Scalpel (Brux). 1959 Jul 4;112(27):637-40.

Not Available

[Article in English, French]

ROSSELLE N, DE DONCKER K, JOLIE P, VAN BETSBRUGGE A, LIGOT S, TORDEURS J, MAGNUS 
L.

PMID: 13675753 [PubMed - indexed for MEDLINE]

10458: Br J Ophthalmol. 1959 Jul;43:438-9.

Vitamin B12 and herpes zoster ophthalmicus.

HEATON JM.

PMID: 14400447 [PubMed - indexed for MEDLINE]

10459: Arch Ital Otol Rinol Laringol. 1959 Jul-Aug;70:601-18.

[Considerations on the pathogenesis of cochleo-vestibular manifestations
associated with herpes zoster.]

[Article in Italian]

GIORDANO R, ZANOTTI G.

PMID: 13828059 [PubMed - OLDMEDLINE]

10460: Ann Anat Pathol (Paris). 1959 Jul-Sep;4:574-86.

[Anatomoclinical study of two cases of zosterian adenitis.]

[Article in French]

FRUHLING L, SACREZ R, LE GAL Y, PORTE P, DORNER M.

PMID: 13825439 [PubMed - indexed for MEDLINE]

10461: Minerva Med. 1959 Jun 13;50(47):1921-4.

[Medullary pseudoaplasia with leukemoid manifestation & hemorrhagic herpes zoster
in relation to prednisone treatment for ulcerative colitis.]

[Article in Italian]

BILE G, MANES L, VENTRUTO V.

PMID: 13674233 [PubMed - indexed for MEDLINE]

10462: Concours Med. 1959 May 30;81(22):2567-8.

[Various cases of indolent zonas.]

[Article in French]

SIDI E, HINCKY M.

Publication Types: 
    Case Reports

PMID: 13663529 [PubMed - indexed for MEDLINE]

10463: N Engl J Med. 1959 May 21;260(21):1062-5.

Herpes zoster involving the urinary bladder.

MEYER R, BROWN HP, HARRISON JH.

Publication Types: 
    Case Reports

PMID: 13657339 [PubMed - indexed for MEDLINE]

10464: Z Haut Geschlechtskr. 1959 May 15;26(10):292-4.

[Atypical courses in herpes zoster.]

[Article in German]

JANSON P.

Publication Types: 
    Case Reports

PMID: 13669574 [PubMed - indexed for MEDLINE]

10465: J Oral Surg Anesth Hosp Dent Serv. 1959 May;17(3):57-9.

Herpes zoster of the mandibular division of the trigeminal nerve: report of a
case.

JARABAK JP.

PMID: 13665436 [PubMed - OLDMEDLINE]

10466: J Neurol Neurosurg Psychiatry. 1959 May;22(2):120-3.

Acute demyelinating disease complicating herpes zoster.

McALPINE D, KUROIWA Y, TOYOKURA Y, ARAKI S.

PMID: 13655101 [PubMed - indexed for MEDLINE]

10467: Presse Med. 1959 Apr 25;67(21):859-60.

[Is any efficiency to be attributed to herpes zoster treatments.]

[Article in French]

LE BEAU J, CASTAIGNE P, DELZANT O, GAILLARD G, MEYER DE SCHMID JJ, MOLLARET P.

PMID: 13658016 [PubMed - indexed for MEDLINE]

10468: Sem Hop. 1959 Apr 12;35(17):1273-81.

Not Available

[Article in French]

LAYANI F, DURUPT L, PAQUET J.

PMID: 13646778 [PubMed - OLDMEDLINE]

10469: Bull Soc Ophtalmol Fr. 1959 Apr;No 4:304-9.

[Medicolegal considerations on posttraumatic zona (in reality, abuses).]

[Article in French]

SEDAN J.

PMID: 14444431 [PubMed - indexed for MEDLINE]

10470: Bull Soc Fr Dermatol Syphiligr. 1959 Apr-May;66:250-1.

[Zona with double homolateral localization.]

[Article in French]

FOUSSEREAU J, HIRSCH C.

Publication Types: 
    Case Reports

PMID: 13824206 [PubMed - indexed for MEDLINE]

10471: Bull Soc Fr Dermatol Syphiligr. 1959 Apr-May;66:259-60.

[Abdominocrural zona after metastasis of uterine cancer.]

[Article in French]

BONNET J, CALAS E, DAVIN A, COULIER L.

Publication Types: 
    Case Reports

PMID: 13802562 [PubMed - OLDMEDLINE]

10472: Z Haut Geschlechtskr. 1959 Apr 1;26(7):194-8.

[Peroral and parenteral pyramidon-pyrazolidine therapy of erythema exudative
multiforme, erythema nodosum contusiforme and zoster with irgapyrine.]

[Article in German]

MATANIC V.

PMID: 13648551 [PubMed - indexed for MEDLINE]

10473: AMA Arch Neurol Psychiatry. 1959 Apr;81(4):433-8.

Myeloradiculo-ganglionitis following zoster.

PALFFY G, BALAZS A.

PMID: 13636512 [PubMed - OLDMEDLINE]

10474: Sem Hop. 1959 Mar 4;35(11):872-5.

[Emetine in the treatment of zona; report on five years of experience.]

[Article in French]

GRIVEAUD E, ACHARD J.

PMID: 13646738 [PubMed - indexed for MEDLINE]

10475: J Belge Med Phys Rhumatol. 1959 Mar-Apr;14(2):81-84.

Not Available

[Article in French]

DE GRAEVE R.

PMID: 13654244 [PubMed - indexed for MEDLINE]

10476: Boll Ist Sieroter Milan. 1959 Mar-Apr;38(3-4):80-5.

[Isolation of herpes simplex virus from cases of herpetic keratitis by growth in 
cultures of rabbit kidney.]

[Article in Italian]

SERRA C, VERDI GP.

PMID: 13651408 [PubMed - OLDMEDLINE]

10477: Arch De Vecchi Anat Patol. 1959 Mar;29(1):265-75.

[Two cases of herpes zoster of the ear.]

[Article in Italian]

GIAGNONI A.

Publication Types: 
    Case Reports

PMID: 13650830 [PubMed - indexed for MEDLINE]

10478: Laryngoscope. 1959 Mar;69(3):260-7.

Facial paralysis: a method of treatment with massive doses of histamine.

DEBLASIO SH.

PMID: 13642934 [PubMed - OLDMEDLINE]

10479: AMA Arch Otolaryngol. 1959 Mar;69(3):266-75.

Histopathology of the facial nerve in herpes zoster oticus.

GULDBERG-MOLLER J, OLSEN S, KETTEL K.

PMID: 13626314 [PubMed - OLDMEDLINE]

10480: AMA Arch Derm. 1959 Mar;79(3):299-304.

Immunologic aspects of herpes simplex, herpes zoster, and vaccinia.

BALDRIDGE GD.

PMID: 13626226 [PubMed - indexed for MEDLINE]

10481: Med Klin (Munich). 1959 Feb 6;54(6):216-8.

[Herpes zoster and cortisone therapy.]

[Article in German]

LYON E.

PMID: 13643547 [PubMed - indexed for MEDLINE]

10482: Therapie. 1959;14:818-24.

[The treatment of zona and of its associated pains. Study of the results obtained
with levomepromazine.]

[Article in French]

SIGWALD J, BOUTTIER D, CAILLE F.

PMID: 14446614 [PubMed - indexed for MEDLINE]

10483: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1959;135:1-31.

[Zoster diseases of the eye.]

[Article in German]

KREIBIG W.

PMID: 14411888 [PubMed - indexed for MEDLINE]

10484: Arch Psychiatr Nervenkr Z Gesamte Neurol Psychiatr. 1959;199:596-600.

[Zoster and Landry's paralysis.]

[Article in German]

WANISSORN R.

PMID: 13842835 [PubMed - indexed for MEDLINE]

10485: Acta Rheumatol Scand. 1959;5:157-63.

Shoulder-hand syndrome and herpes zoster: report of a case with signs of
vasodilatation and vasoconstriction in the same hand.

GRAUDAL H.

PMID: 13829051 [PubMed - OLDMEDLINE]

10486: Actas Dermosifiliogr. 1959 Jan-Feb;50(1):31-2.

Not Available

[Article in Spanish]

LEDO DUNIPE E, LEDO POZUETA A.

Publication Types: 
    Case Reports

PMID: 13660977 [PubMed - indexed for MEDLINE]

10487: Z Laryngol Rhinol Otol. 1959 Jan;38(1):1-4.

Not Available

[Article in German]

JEZEK A.

PMID: 13648608 [PubMed - OLDMEDLINE]

10488: J Sci Med Lille. 1959 Jan;77(1):36-42.

[Paralysis of the lower extremity following herpes zoster.]

[Article in French]

DEREUX J, VANDENHAUTE, MAHIEU M, PHILIPPE F.

PMID: 13631677 [PubMed - OLDMEDLINE]

10489: J Exp Med. 1958 Dec 1;108(6):869-90.

The etiologic agents of varicella and herpes zoster; serologic studies with the
viruses as propagated in vitro.

WELLER TH, WITTON HM.

PMID: 13598817 [PubMed - indexed for MEDLINE]

10490: J Exp Med. 1958 Dec 1;108(6):843-68.

The etiologic agents of varicella and herpes zoster; isolation, propagation, and 
cultural characteristics in vitro.

WELLER TH, WITTON HM, BELL EJ.

PMID: 13598816 [PubMed - indexed for MEDLINE]

10491: Nervenarzt. 1958 Nov 20;29(11):516-7.

[Motor paralysis in herpes zoster.]

[Article in German]

POPELLA E.

PMID: 13622877 [PubMed - OLDMEDLINE]

10492: Lyon Med. 1958 Nov 16;90(46):799-800 contd.

[Temporary re-activation of positive results of a Nelson test in an elderly
syphilitic with herpes zoster.]

[Article in French]

THIERS H, COLOMB D, FAYOLLE J, MOULIN G.

PMID: 13612301 [PubMed - indexed for MEDLINE]

10493: Rev Neurol (Paris). 1958 Nov;99(5):535-57.

[Encephalomyelitis caused by herpes zoster; anatomy & clinical manifestation of 2
case reports.]

[Article in French]

BOUDIN G, BARBIZET J, BRION S, PEPIN B.

PMID: 13658792 [PubMed - OLDMEDLINE]

10494: J Laryngol Otol. 1958 Nov;72(11):926-8.

A case of herpes zoster of the VIIth, VIIIth, IXth, Xth and XIth cranial nerves.

CARTER BS.

Publication Types: 
    Case Reports

PMID: 13611412 [PubMed - OLDMEDLINE]

10495: Am J Ophthalmol. 1958 Nov;46(5 Part 1):741-2.

Herpes zoster ophthalmicus; report of a case in a three and one-half-year-old
child.

GARRETT FE.

Publication Types: 
    Case Reports

PMID: 13595053 [PubMed - indexed for MEDLINE]

10496: Clin Proc Child Hosp Dist Columbia. 1958 Nov;14(11):254-7.

Herpes zoster facialis.

OBERMAN JW, PARKS MM.

PMID: 13585647 [PubMed - OLDMEDLINE]

10497: Sven Lakartidn. 1958 Oct 3;55(40):2766-77.

Not Available

[Article in Swedish]

LUNDMARK F.

Publication Types: 
    Case Reports

PMID: 13592720 [PubMed - indexed for MEDLINE]

10498: Arch Dis Child. 1958 Oct;33(171):437-9.

Herpes zoster ophthalmicus in children.

TUCKER SM.

PMID: 13584024 [PubMed - indexed for MEDLINE]

10499: Lyon Med. 1958 Sep 21;90(38):373-8.

[Segmentary dorsal myelitis & the cauda equina syndrome caused by herpes zoster: 
2 clinical cases.]

[Article in French]

SCHOTT B, BOREL.

PMID: 13589155 [PubMed - OLDMEDLINE]

10500: Minerva Med. 1958 Sep 15;49(74):3556-8.

[Generalized herpes zoster during malignant hemopathy.]

[Article in Italian]

GRASSI A.

PMID: 13600185 [PubMed - indexed for MEDLINE]

10501: Concours Med. 1958 Sep 13;80(37):3925-6.

Not Available

[Article in French]

VERCELLETTO P.

PMID: 13585795 [PubMed - indexed for MEDLINE]

10502: AMA Arch Derm. 1958 Sep;78(3):392-3.

A clinical note on herpes zoster.

GOLDBERG LC.

Publication Types: 
    Case Reports

PMID: 13570699 [PubMed - indexed for MEDLINE]

10503: Dia Med. 1958 Aug 21;30(58):2180-1.

[Combined tetracycline & chloramphenicol in various neurological diseases: herpes
zoster, neuraxitis & influenza with encephalic symptoms.]

[Article in Spanish]

CASTELLUCCIO R.

PMID: 13586081 [PubMed - indexed for MEDLINE]

10504: Br Med J. 1958 Aug 16;2(5093):418-21.

Zoster sine herpete.

LEWIS GW.

PMID: 13560886 [PubMed - indexed for MEDLINE]

10505: Physiotherapy. 1958 Aug 10;44(8):230-1.

Ultra violet light for relief of post-herpetic pain.

OWEN JM.

PMID: 13590963 [PubMed - indexed for MEDLINE]

10506: Lancet. 1958 Aug 2;2(7040):226-31.

Some aspects of referred pain.

WHITTY CW, WILLISON RG.

PMID: 13564804 [PubMed - OLDMEDLINE]

10507: Pharm Acta Helv. 1958 Aug-Oct;33(8-10):743-6.

[Emetine treatment of zoster ophthalmicus.]

[Article in German]

FAVRE M, GOLDMANN H.

PMID: 13601123 [PubMed - indexed for MEDLINE]

10508: Virology. 1958 Aug;6(1):293-5.

Isolation of herpes zoster virus from spinal fluid of a patient.

ROBBINS FC.

PMID: 13581536 [PubMed - indexed for MEDLINE]

10509: Tex State J Med. 1958 Aug;54(8):594-6.

Gamma globulin in the treatment of herpes zoster.

LEA WA Jr, TAYLOR WB.

PMID: 13580917 [PubMed - indexed for MEDLINE]

10510: J Neurol Neurosurg Psychiatry. 1958 Aug;21(3):210-2.

Ophthalmic herpes zoster with contralateral hemiplegia.

ANASTASOPOULOS G, ROUTSONIS K, IERODIAKONOU CS.

PMID: 13576172 [PubMed - OLDMEDLINE]

10511: Wien Z Inn Med. 1958 Jul;39(7):293-9.

[Herpes zoster in the gastrointestinal tract.]

[Article in German]

DOBY T, TOTH J.

Publication Types: 
    Case Reports

PMID: 13604279 [PubMed - indexed for MEDLINE]

10512: Z Laryngol Rhinol Otol. 1958 Jul;37(7):436-43.

[Catamnestic studies in herpes zoster oticus.]

[Article in German]

BITTRICH K, WILKE J.

PMID: 13581918 [PubMed - indexed for MEDLINE]

10513: Practitioner. 1958 Jul;181(1081):87-90.

Two unusual diseases seen in general practice in one week.

HORN R.

Publication Types: 
    Case Reports

PMID: 13567284 [PubMed - indexed for MEDLINE]

10514: Pol Tyg Lek (Wars). 1958 Jun 23;13(25):959-62.

[Herpes zoster after the treatment of breast cancer with x-rays.]

[Article in Polish]

GIERMANSKI A.

Publication Types: 
    Case Reports

PMID: 13591057 [PubMed - indexed for MEDLINE]

10515: Bull Soc Fr Dermatol Syphiligr. 1958 Jun-Jul;65(3):257-8.

[Thoracic zona followed by an ascending quadriplegia of fatal development:
nosological discussion.]

[Article in French]

DUPERRAT B, PRINGUET R.

PMID: 13608214 [PubMed - OLDMEDLINE]

10516: Friuli Med. 1958 May-Jun;13(3):441-5.

[Treatment of herpes zoster with A. T. P.; clinical contribution.]

[Article in Italian]

BISARO A, CASASOLA M, MILESI C.

PMID: 13574315 [PubMed - indexed for MEDLINE]

10517: Pediatriia. 1958 Apr;41(4):59-62.

[Epidemiology of herpes zoster.]

[Article in Russian]

GOLEMBA PI.

PMID: 13578563 [PubMed - indexed for MEDLINE]

10518: Bull Soc Fr Dermatol Syphiligr. 1958 Apr-May;65(2):184-5.

[Development of a transient positive reaction to the Nelson qualitative test in a
former syphilitic with negative serology during an attack of zona.]

[Article in French]

THIERS H, COLOMB D, FAYOLLE J, MOULIN G.

PMID: 13573079 [PubMed - indexed for MEDLINE]

10519: Alger Medicale. 1958 Apr;62(4):451-2 passim.

Not Available

[Article in French]

COSSET J, AMIEL JL, LONGCOTE J.

PMID: 13559120 [PubMed - indexed for MEDLINE]

10520: Z Haut Geschlechtskr. 1958 Apr 1;24(7):192-7.

[Ganglion-blocking agents and vitamin B12 in the treatment of bullous
manifestations of herpes zoster.]

[Article in German]

MATANIC VI.

PMID: 13558288 [PubMed - OLDMEDLINE]

10521: Pediatria (Napoli). 1958 Mar-Apr;66(2):250-65.

[A case of herpes zoster in a newborn infant.]

[Article in Italian]

MORMONE V.

PMID: 13590801 [PubMed - OLDMEDLINE]

10522: Bull Soc Ophtalmol Fr. 1958 Mar;3:278-81.

[Current treatment of ophthalmic zona.]

[Article in French]

ROUGIER, ROYER.

PMID: 13561085 [PubMed - OLDMEDLINE]

10523: S Afr Med J. 1958 Feb 8;32(6):166-8.

Cutaneous nerves in herpes zoster.

VAN BILJON PJ.

PMID: 13529211 [PubMed - indexed for MEDLINE]

10524: Scott Med J. 1958 Feb;3(2):93-4.

A note on the Ramsay Hunt syndrome and the place of cortisone in its treatment.

McNICOL GP.

Publication Types: 
    Case Reports

PMID: 13529052 [PubMed - indexed for MEDLINE]

10525: Dermatol Wochenschr. 1958 Jan 25;137(4):100-3.

[Experiences with a sympatholytic in the treatment of herpes zoster.]

[Article in German]

ROSENKRANZER R.

PMID: 13523996 [PubMed - indexed for MEDLINE]

10526: Z Gesamte Inn Med. 1958 Jan 15;13(2):71-6.

[Effect of emetine in herpes zoster.]

[Article in German]

JORDA V, LENFELD J, ROTHSCHILD L.

PMID: 13544359 [PubMed - indexed for MEDLINE]

10527: Przegl Epidemiol. 1958;12(2):177-80.

[Certain observations on varicella and herpes zoster.]

[Article in Polish]

STARZECKA B, TOMASIK W, ZASOWSKA K.

PMID: 13602006 [PubMed - indexed for MEDLINE]

10528: Otorinolaringol Ital. 1958;26(6):430-73.

Not Available

[Article in Italian]

PANEBIANCO G, MANARA E.

PMID: 13600845 [PubMed - indexed for MEDLINE]

10529: G Psichiatr Neuropatol. 1958;86(2):655-62.

[Brain disease picture in herpes zoster.]

[Article in Italian]

VOLTERRA V.

PMID: 13598158 [PubMed - OLDMEDLINE]

10530: Dtsch Z Nervenheilkd. 1958;178(3):313-29.

[Clinical aspects & pathomorphology of a polyradiculomyelitic form of herpes
zoster.]

[Article in German]

STAMMLER A, STRUCK G.

PMID: 13597664 [PubMed - OLDMEDLINE]

10531: Arcisp S Anna Ferrara. 1958;11(5):889-903.

[Gangrenous zoster & generalized varicella in a man with lymphatic leukemia.]

[Article in Italian]

MOLINARI R.

PMID: 13596202 [PubMed - indexed for MEDLINE]

10532: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1958;132(2):252-3.

[Ophthalmic herpes zoster.]

[Article in German]

SCHIRMER R.

Publication Types: 
    Case Reports

PMID: 13550766 [PubMed - indexed for MEDLINE]

10533: Z Haut Geschlechtskr. 1958 Jan 1;24(1):9-14.

[Zoster with participation of bladder mucosa.]

[Article in German]

LEHMANN F, FELKL K.

Publication Types: 
    Case Reports

PMID: 13531306 [PubMed - OLDMEDLINE]

10534: Lyon Med. 1957 Dec 22;89(51):696-8.

[Severe necrotic herpes zoster, generalized in 1 case, during blood diseases
treated by corticotherapy.]

[Article in French]

DUVERNE J, MULLER B, MOUNIER R, BLANCHET.

PMID: 13515522 [PubMed - OLDMEDLINE]

10535: Ann Otolaryngol Chir Cervicofac. 1957 Dec;74(12):993-5.

Not Available

[Article in French]

DECROIX G.

PMID: 13509408 [PubMed - OLDMEDLINE]

10536: N Z Med J. 1957 Dec;56(316):668-72.

Herpes zoster of the ear.

SALAS JR.

PMID: 13504531 [PubMed - OLDMEDLINE]

10537: Am J Med. 1957 Dec;23(6):999-1002.

Herpes zoster with ileus simulating intestinal obstruction.

FIGIEL SJ, FIGIEL LS.

PMID: 13487618 [PubMed - indexed for MEDLINE]

10538: Prog Med (Napoli). 1957 Nov 30;13(22):747-51.

[Pathological involvement of the sympathetic nerves in herpes zoster.]

[Article in Italian]

RIZZI D.

PMID: 13505927 [PubMed - indexed for MEDLINE]

10539: Arztl Wochensch. 1957 Nov 8;12(44-45):998-1000.

[Herpes zoster generalisatus in chronic lymphadenosis treated with cytotoxic
drugs.]

[Article in German]

LAMBERS K.

PMID: 13497922 [PubMed - OLDMEDLINE]

10540: Bull Soc Fr Dermatol Syphiligr. 1957 Nov-Dec;64(5):768-9.

Not Available

[Article in French]

RIMBAUD P, RAVOIRE J, DUNTZE F.

Publication Types: 
    Case Reports

PMID: 13536737 [PubMed - indexed for MEDLINE]

10541: Rev Bras Med. 1957 Nov;14(11):830-1.

[Ultraviolet ray therapy of zona ophthalmica.]

[Article in Portuguese]

DE MORAES WR.

PMID: 13527868 [PubMed - OLDMEDLINE]

10542: Medizinische. 1957 Oct 19;2(42):1537-9.

Not Available

[Article in German]

WILL E.

PMID: 13482916 [PubMed - indexed for MEDLINE]

10543: Med Interna (Bucur). 1957 Oct;9(10):1581-6.

[Notes on the relation between chickenpox and zona.]

[Article in Romanian]

PASCU I.

PMID: 13516048 [PubMed - indexed for MEDLINE]

10544: AMA Arch Derm. 1957 Oct;76(4):408-12; discussion 412-4.

The treatment of herpes zoster.

EPSTEIN E, ALLINGTON HV.

PMID: 13457421 [PubMed - indexed for MEDLINE]

10545: Br Med J. 1957 Sep 28;2(5047):746-8.

Treatment of ophthalmic zoster with prednisone.

CARTER AB, ROYDS JE.

PMID: 13460373 [PubMed - indexed for MEDLINE]

10546: Minerva Med. 1957 Sep 19;48(75):2954-9.

Not Available

[Article in Italian]

MAURO G, PRATO V.

PMID: 13483311 [PubMed - indexed for MEDLINE]

10547: Br Med J. 1957 Sep 14;2(5045):616-8.

Motor complications of herpes zoster.

KENDALL D.

PMID: 13460335 [PubMed - OLDMEDLINE]

10548: Sem Med Prof Med Soc. 1957 Sep 6-10;33(32-33):1258-9.

Not Available

CARRIE J.

PMID: 13486138 [PubMed - indexed for MEDLINE]

10549: Tidsskr Nor Laegeforen. 1957 Sep 1;77(17):734-7.

[Motor paralysis in zoster; review with reference to a case.]

[Article in Norwegian]

SKOMEDAL GN.

PMID: 13496051 [PubMed - OLDMEDLINE]

10550: Int Rec Med Gen Pract Clin. 1957 Sep;170(9):545-6.

Herpes zoster ophthalmicus.

CURY D.

Publication Types: 
    Case Reports

PMID: 13491167 [PubMed - OLDMEDLINE]

10551: J Med Bord. 1957 Sep;134(9):1135-6.

Not Available

[Article in French]

AUBERTIN E.

PMID: 13481504 [PubMed - indexed for MEDLINE]

10552: J Med Bord. 1957 Sep;134(9):1133-4.

Not Available

[Article in French]

AUBERTIN E.

PMID: 13481503 [PubMed - indexed for MEDLINE]

10553: J Med Bord. 1957 Sep;134(9):1131-2.

Not Available

[Article in French]

AUBERTIN E.

PMID: 13481502 [PubMed - indexed for MEDLINE]

10554: Ann Otolaryngol Chir Cervicofac. 1957 Sep;74(9):710-1.

[A special case of deafness during zona of superior maxillary nerve.]

[Article in French]

MORIN M, PIALOUX P, BOUCHET J.

Publication Types: 
    Case Reports

PMID: 13478947 [PubMed - OLDMEDLINE]

10555: Br Med J. 1957 Aug 17;2(5041):384-6.

Pneumonia and bronchial vesiculation associated with herpes zoster, with
reference to other visceral associations of zoster.

ANDREWS RH.

Publication Types: 
    Case Reports

PMID: 13446490 [PubMed - indexed for MEDLINE]

10556: Bull Soc Fr Dermatol Syphiligr. 1957 Aug-Oct;39(4):433-5.

[Severe necrotic zonas, generalized in one case, during corticotherapy of blood
diseases.]

[Article in French]

DUVERNE J, MULLER B, MOUNIER R, BLANCHET.

Publication Types: 
    Case Reports

PMID: 13511048 [PubMed - OLDMEDLINE]

10557: Bull Soc Fr Dermatol Syphiligr. 1957 Aug-Oct;39(4):396-7.

[Kaposi-Juliusberg's pustolosis of probable herpetic origin.]

[Article in French]

HADIDA E, BERANGER J, TIMSIT E.

PMID: 13511036 [PubMed - indexed for MEDLINE]

10558: Zhonghua Nei Ke Za Zhi. 1957 Aug;5(8):678-9; English abstract 75.

[Vitamin B12 in herpes zoster; two case reports.]

[Article in Chinese]

CHU TY, LU CH.

PMID: 13472937 [PubMed - indexed for MEDLINE]

10559: Dia Med. 1957 Jul 11;29(46):1548 passim.

Not Available

[Article in Spanish]

BALTER I, BARQUET J, FERNANDEZ C.

PMID: 13461701 [PubMed - OLDMEDLINE]

10560: Sov Med. 1957 Jul;21(7):133-4.

[Two cases of herpes zoster simulating acute appendicitis.]

[Article in Russian]

BELEDA RV.

PMID: 13506837 [PubMed - indexed for MEDLINE]

10561: Ann Dermatol Syphiligr (Paris). 1957 Jul-Aug;84(4):400-5.

Not Available

[Article in French]

VIEGAS LB, VIEGAS LC.

PMID: 13458910 [PubMed - indexed for MEDLINE]

10562: R I Med J. 1957 Jul;40(7):387-92; passim.

Chickenpox and herpes zoster.

WESSELHOEFT C.

PMID: 13454474 [PubMed - indexed for MEDLINE]

10563: Praxis. 1957 Jun 27;46(26):581-2.

[Irgapyrin in the treatment of herpes zoster.]

[Article in German]

CAMPELL R.

PMID: 13453139 [PubMed - indexed for MEDLINE]

10564: Nord Med. 1957 Jun 13;57(24):858-9.

Not Available

[Article in Norwegian]

EIMIND K.

PMID: 13452148 [PubMed - OLDMEDLINE]

10565: Nord Med. 1957 Jun 13;57(24):855-8.

[Herpes zoster ophthalmicus and its therapy, especially with liver extract.]

[Article in Swedish]

OKSALA A.

PMID: 13452147 [PubMed - OLDMEDLINE]

10566: Nord Med. 1957 Jun 13;57(24):854-5.

Not Available

[Article in Norwegian]

HEGGO O, BOROVSKI G.

PMID: 13452146 [PubMed - OLDMEDLINE]

10567: J Am Med Assoc. 1957 May 18;164(3):265-9.

The natural history of herpes zoster.

BURGOON CF Jr, BURGOON JS, BALDRIDGE GD.

PMID: 13415974 [PubMed - OLDMEDLINE]

10568: Boll Ocul. 1957 May;36(5):293-307.

[A case of retrobulbar optic neuritis with cervical herpes zoster.]

[Article in Italian]

PANNARALE MR.

PMID: 13479554 [PubMed - OLDMEDLINE]

10569: Z Haut Geschlechtskr. 1957 Apr 15;22(8):230-41.

[Encephalitis in herpes zoster.]

[Article in German]

MEYER R.

PMID: 13434257 [PubMed - OLDMEDLINE]

10570: Z Haut Geschlechtskr. 1957 Apr 1;22(7):202-6.

[Herpes zoster as an isomorphous irritant in psoriasis.]

[Article in German]

BOHNSTEDT RM.

PMID: 13434254 [PubMed - indexed for MEDLINE]

10571: Praxis. 1957 Mar 28;46(13):281-4.

[A rare complication of herpes zoster: acute urinary retention.]

[Article in French]

JEANNERET JP, DELACRETAZ J.

PMID: 13431636 [PubMed - OLDMEDLINE]

10572: Br Med J. 1957 Mar 23;1(5020):678-81.

Visceral lesions in herpes zoster.

WYBURN-MASON R.

PMID: 13404270 [PubMed - indexed for MEDLINE]

10573: Sem Hop. 1957 Mar 22;33(18):1137-9.

[Phenothiazine treatment of herpes zoster & zosteroid pains (including various
refractory pains).]

[Article in French]

SIGWALD J, HEBERT H, QUETIN A.

PMID: 13432869 [PubMed - indexed for MEDLINE]

10574: Acta Belg Arte Med Pharm Mil. 1957 Mar;110(1):67-74.

[Treatment of herpes zoster by low-frequency currents.]

[Article in Dutch]

DE DONCKER K, ROSSELLE N.

PMID: 13487112 [PubMed - indexed for MEDLINE]

10575: Fulorrgegegyogyaszat. 1957 Mar;(1):10-3.

Not Available

[Article in Hungarian]

VARADY-SZABO M.

Publication Types: 
    Case Reports

PMID: 13448233 [PubMed - OLDMEDLINE]

10576: Bull Soc Ophtalmol Fr. 1957 Mar;(3):169-81; discussion, 181-2.

[A new case of traumatic zona.]

[Article in French]

DE SAINT-MARTIN R.

Publication Types: 
    Case Reports

PMID: 13437083 [PubMed - OLDMEDLINE]

10577: Actas Dermosifiliogr. 1957 Mar;48(3):176-8.

[Intercostal herpes zoster in the mother with simultaneous varicella in the three
daughters.]

[Article in Spanish]

LEDO DUNIPE E, LEDO POZUETA A.

Publication Types: 
    Case Reports

PMID: 13435025 [PubMed - indexed for MEDLINE]

10578: AMA Arch Derm. 1957 Mar;75(3):397-400.

Herpes zoster.

LEIDER M, CONTRERAS MA.

PMID: 13402213 [PubMed - indexed for MEDLINE]

10579: J Med (Oporto). 1957 Feb 9;32(733):327; passim.

[Zona and emetine hydrochlorate.]

[Article in Portuguese]

VIEGAS LB, VIEGAS LC.

PMID: 13415785 [PubMed - indexed for MEDLINE]

10580: AMA Arch Derm. 1957 Feb;75(2):193-6.

The outcome of patients with herpes zoster.

DE MORAGAS JM, KIERLAND RR.

PMID: 13393787 [PubMed - indexed for MEDLINE]

10581: Presse Med. 1957 Jan 23;65(7):140.

[A case of pseudoappendicular zona with eosinophilia.]

[Article in French]

ALAZRAKI H.

PMID: 13420030 [PubMed - OLDMEDLINE]

10582: Br Med J. 1957 Jan 12;1(5010):84-7.

Herpes zoster, chicken-pox, and cancer in general practice.

MCGREGOR RM.

PMID: 13383200 [PubMed - OLDMEDLINE]

10583: Dtsch Z Nervenheilkd. 1957;177(2):180-93.

[Cerebral complications of herpes zoster.]

[Article in German]

HULTSCH EG.

PMID: 13524070 [PubMed - indexed for MEDLINE]

10584: Encephale. 1957;46(5-6):699-707.

[Zona; its clinical neuraxial manifestations.]

[Article in French]

SUSIC Z, LEDIC P, CUK S, BABIC M.

PMID: 13501170 [PubMed - OLDMEDLINE]

10585: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1957;131(1):72-7.

[Oculomotor muscle paralysis in ophthalmic herpes zoster.]

[Article in German]

PRIGGERT W.

PMID: 13482164 [PubMed - OLDMEDLINE]

10586: Riv Patol Nerv Ment. 1957;78(1):304-18.

[Histopathological changes in the nervous system in herpes zoster; findings on a 
fatal case with cutaneous onset.]

[Article in Italian]

BARONTINI F.

PMID: 13466952 [PubMed - OLDMEDLINE]

10587: Rev Otoneuroophtalmol. 1957;29(1):28-31.

Not Available

[Article in French]

OURGAUD AG, BERARD PV.

Publication Types: 
    Case Reports

PMID: 13454326 [PubMed - OLDMEDLINE]

10588: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1957;130(2):262-4.

[Gangrenous herpes zoster of the first branch of the trigeminal nerve with optic 
nerve involvement.]

[Article in German]

SCHIRMER R.

Publication Types: 
    Case Reports

PMID: 13439942 [PubMed - OLDMEDLINE]

10589: Arch Ital Dermatol Sifilogr Venereol. 1957;28(4):299-306.

[Case of herpes zoster with brachial localization.]

[Article in Italian]

GIACOMETTI C.

Publication Types: 
    Case Reports

PMID: 13436148 [PubMed - OLDMEDLINE]

10590: Br J Clin Pract. 1957 Jan;11(1):41-7.

Herpes zoster.

JONES AT.

PMID: 13396126 [PubMed - indexed for MEDLINE]

10591: Rev Asoc Med Argent. 1956 Dec 15-30;70(833-834):411-4.

[Motor disorders in herpes zoster; a case of quadriplegia.]

[Article in Spanish]

MAGGI AL, MEEROFF M, COSEN JN, HIRSCHMAN B.

PMID: 13466226 [PubMed - OLDMEDLINE]

10592: Munch Med Wochenschr. 1956 Dec 7;98(49):1693-4.

[Zoster with leukemia, lymphogranulomatosis, lymphosarcoma, and plasmocytoma.]

[Article in German]

HOFFMANN K.

PMID: 13387609 [PubMed - indexed for MEDLINE]

10593: Br J Ophthalmol. 1956 Dec;40(12):762-4.

Herpes ophthalmicus.

MACLATCHY RS.

PMID: 13396165 [PubMed - OLDMEDLINE]

10594: Br J Urol. 1956 Dec;28(4):417-21.

A case of herpes zoster with involvement of the urinary bladder.

GIBBON N.

PMID: 13383174 [PubMed - OLDMEDLINE]

10595: Wis Med J. 1956 Dec;55(12):1319-20.

Autohemotherapy; an effective treatment for herpes zoster.

ANSFIELD FJ, RENS JL.

PMID: 13381143 [PubMed - indexed for MEDLINE]

10596: J Indian Med Assoc. 1956 Nov 16;27(10):356.

Treatment of herpes zoster with vitamin B12.

SRIVASTAVA JR.

PMID: 13385515 [PubMed - indexed for MEDLINE]

10597: Magy Radiol. 1956 Nov;8(4):227-31.

[Herpes zoster in the gastrointestinal system.]

[Article in Hungarian]

DOBY T, TOTH J.

PMID: 13417790 [PubMed - OLDMEDLINE]

10598: Can Med Assoc J. 1956 Nov 1;75(9):750-1.

Herpes zoster, leukaemia cutis and leukaemic infiltration of the lesions of
herpes zoster.

ANHALT AW, FORSEY RR.

PMID: 13364829 [PubMed - indexed for MEDLINE]

10599: Br Med J. 1956 Oct 13;2(4997):865.

Herpes zoster after fractured spine complicating E.C.T.

ROITH AI.

PMID: 13364348 [PubMed - OLDMEDLINE]

10600: Br Med J. 1956 Oct 13;2(4997):864-5.

Herpes zoster.

BARFORD LJ.

Publication Types: 
    Case Reports

PMID: 13364347 [PubMed - indexed for MEDLINE]

10601: Presse Med. 1956 Oct 6;64(71):1621-2.

[Pseudosurgical forms of intercostal zona.]

[Article in French]

DETRIE P.

PMID: 13389256 [PubMed - indexed for MEDLINE]

10602: Mil Med. 1956 Oct;119(4):253-5.

Herpes Zoster; etiology, diagnosis, and effective management of a case.

YETWIN IJ.

Publication Types: 
    Case Reports

PMID: 13369189 [PubMed - indexed for MEDLINE]

10603: J Tn State Med Assoc. 1956 Oct;49(10):350-4.

Herpes zoster ophthalmicus and its treatment.

BENEDICT WH.

Publication Types: 
    Case Reports

PMID: 13368215 [PubMed - indexed for MEDLINE]

10604: Boll Ocul. 1956 Sep-Dec;35(9-12):903-8.

[Case of herptic keratitis on a transplanted corneal flap.]

[Article in Italian]

MIGLIOR M.

Publication Types: 
    Case Reports

PMID: 13436641 [PubMed - indexed for MEDLINE]

10605: Rhumatologie. 1956 Sep-Oct;(5):211-3.

Not Available

[Article in French]

ISEMEIN L, FOURNIER AM.

PMID: 13421357 [PubMed - indexed for MEDLINE]

10606: Circulation. 1956 Sep;14(3):379.

Peripheral vascular spasm as a prodrome of herpes zoster.

BEHREND A, BLUMBERG L.

PMID: 13365049 [PubMed - indexed for MEDLINE]

10607: Alger Medicale. 1956 Sep;60(9):718-9.

Not Available

[Article in French]

AUBRY P, FOURRIER A, GUIVARC'H J, SUDAKA P, THIODET J.

PMID: 13362036 [PubMed - OLDMEDLINE]

10608: N Y State J Med. 1956 Sep 1;56(17):2684-7.

Paravertebral procaine block for the treatment of herpes zoster.

ROSENAK SS.

PMID: 13358890 [PubMed - indexed for MEDLINE]

10609: Dtsch Med Wochenschr. 1956 Aug 31;81(35):1401-3.

[Herpes zoster and liver lesions.]

[Article in German]

SIEDE W.

PMID: 13365419 [PubMed - OLDMEDLINE]

10610: Ugeskr Laeger. 1956 Aug 2;118(31):906-7.

Not Available

[Article in Danish]

BECH K.

Publication Types: 
    Case Reports

PMID: 13392046 [PubMed - indexed for MEDLINE]

10611: Nord Med. 1956 Aug 2;56(31):1093-5.

Not Available

[Article in Swedish]

GRAHNE B, VAHERI E.

PMID: 13369833 [PubMed - OLDMEDLINE]

10612: Ideggyogy Sz. 1956 Aug;9(4):102-4.

[Polyganglionitis in zoster.]

[Article in Hungarian]

PALFFY G, BALAZS B.

PMID: 13405541 [PubMed - OLDMEDLINE]

10613: Neurology. 1956 Aug;6(8):601-2.

Recent advances in neurology and neuropsychiatry.

BRAIN R, STRAUSS EB.

PMID: 13348823 [PubMed - OLDMEDLINE]

10614: Boll Ocul. 1956 Jul;35(7):479-84.

[Unusual combinations of pathological ocular manifestations: neuroretinal lesions
caused by Vaquez disease and retrobulbar optic neuritis with oculomotor paralysis
caused by herpes zoster ophthalmicus.]

[Article in Italian]

CAMBIAGGI A.

Publication Types: 
    Case Reports

PMID: 13404021 [PubMed - OLDMEDLINE]

10615: Acta Clin Belg. 1956 Jul-Aug;11(4):365-82.

[Herpes zoster with Guillain-Barre syndrome and orthostatic hypotension; review
of motor complications of herpes zoster.]

[Article in French]

FRIART J, JEANTY C.

PMID: 13372141 [PubMed - indexed for MEDLINE]

10616: Arch Sci Med (Torino). 1956 Jul;102(1):75-85.

[Association of scapulohumeral periarthritis (Duplay's disease) with herpes
zoster; preventive note.]

[Article in Italian]

SCALA A, TRINCHIERI P.

PMID: 13355575 [PubMed - OLDMEDLINE]

10617: Prensa Med Argent. 1956 Jun 22;43(25):1970-4.

[Motor disorders in herpes zoster; a case with quadriplegia.]

[Article in Spanish]

COSEN JN, HIRSCHMAN B, MAGGI AL, MEEROFF M.

PMID: 13379196 [PubMed - OLDMEDLINE]

10618: Z Haut Geschlechtskr. 1956 Jun 15;20(12):389-96.

[Generalized gangrenous herpes zoster in aleukemic lymphadenosis.]

[Article in German]

STOHR H, HOLSCHER-IMMISCH V.

PMID: 13353326 [PubMed - indexed for MEDLINE]

10619: J Am Med Assoc. 1956 Jun 9;161(6):511-5.

Chronic postherpetic neuralgia.

VAN BLARICOM LS, HORRAX G.

PMID: 13318953 [PubMed - indexed for MEDLINE]

10620: Br J Urol. 1956 Jun;28(2):198-200.

Bladder involvement in a case of herpes zoster.

DALES M, WILSON G.

PMID: 13342463 [PubMed - indexed for MEDLINE]

10621: AMA Arch Derm. 1956 Jun;73(6):553-5.

Treatment of herpes zoster and chicken pox with immune globulin.

RODARTE JG, WILLIAMS BH.

PMID: 13312652 [PubMed - indexed for MEDLINE]

10622: Actas Dermosifiliogr. 1956 May;47(8):629-35.

[Generalized zoster.]

[Article in Spanish]

CAPDEVILA JM, CARDENAL C, VILANOVA X.

PMID: 13354501 [PubMed - indexed for MEDLINE]

10623: Borgyogy Venerol Sz. 1956 May;10(3):132-4.

[Case of occupational arsenic poisoning with herpes zoster.]

[Article in Hungarian]

VINCZE E.

PMID: 13342092 [PubMed - indexed for MEDLINE]

10624: AMA Arch Otolaryngol. 1956 Apr;63(4):351-4.

Chorda tympan nerve section for postherpetic neuralgia of the tongue.

VAHERI E, GRAHNE B.

PMID: 13312789 [PubMed - indexed for MEDLINE]

10625: Neurology. 1956 Apr;6(4):262-8.

The Ramsay Hunt syndrome, geniculate herpes.

SACHS E Jr, HOUSE RK.

PMID: 13309605 [PubMed - OLDMEDLINE]

10626: HNO. 1956 Mar 29;5(9):283-5.

Not Available

[Article in German]

BOGNER H.

PMID: 13318496 [PubMed - indexed for MEDLINE]

10627: N Engl J Med. 1956 Mar 8;254(10):472-4.

Disseminated herpes zoster complicating chronic lymphatic leukemia; report of
case of electron-microscope study of vesicle fluid.

RODNAN GP, RAKE GW.

PMID: 13297137 [PubMed - indexed for MEDLINE]

10628: Bull Soc Fr Dermatol Syphiligr. 1956 Mar-Apr;(2):215-6.

[Value of early radiotherapy in herpes zoster.]

[Article in French]

BUREAU Y, JARRY, BARRIERE.

PMID: 13342817 [PubMed - indexed for MEDLINE]

10629: Arch Ital Otol Rinol Laringol. 1956 Mar-Apr;67(2):305-10.

[Auricular herpes zoster with paralysis of the facial nerve.]

[Article in Italian]

ZANOTTI G.

PMID: 13341339 [PubMed - OLDMEDLINE]

10630: Rev Bras Cir. 1956 Mar;31(3):385-9.

[Herpes zoster and lymphoma.]

[Article in Portuguese]

SANTOS SILVA M.

PMID: 13323412 [PubMed - indexed for MEDLINE]

10631: Cyprus Med J. 1956 Mar;8(3):284-5.

The use of phenylbutazone in herpes zoster.

PARTELIDES G.

PMID: 13317496 [PubMed - indexed for MEDLINE]

10632: J Allergy. 1956 Mar;27(2):169.

Successful treatment of herpes zoster ophthalmicus with antihistaminic therapy.

GLASSER J.

PMID: 13294985 [PubMed - OLDMEDLINE]

10633: Concours Med. 1956 Feb 18;78(7):740.

Not Available

[Article in French]

DURAND P.

PMID: 13305181 [PubMed - indexed for MEDLINE]

10634: Am J Ophthalmol. 1956 Feb;41(2):253-6.

Total detachment and reattachment of the retina; in herpes zoster ophthalmicus.

LINCOFF HA, WISE GN, ROMAINE HH.

PMID: 13292488 [PubMed - OLDMEDLINE]

10635: Calif Med. 1956 Feb;84(2):120-1.

Presumptive herpes zoster meningoencephalitis.

KOCH R.

PMID: 13284645 [PubMed - indexed for MEDLINE]

10636: Dia Med. 1956 Jan 30;28(5):122.

[Observations relative to the use of dihydroergotamine.]

[Article in Spanish]

SAS A.

PMID: 13305419 [PubMed - indexed for MEDLINE]

10637: G Psichiatr Neuropatol. 1956;84(4):695-706.

[Ramsay-Hunt syndrome, associated with paralysis of several cranial nerves and
pyramidal affections.]

[Article in Italian]

TURINESE A.

PMID: 13415420 [PubMed - OLDMEDLINE]

10638: Trans Opthal Soc U K. 1956;76:227-33.

A case of left herpes zoster ophthalmicus followed by virus encephalitis with
right-sided anaesthesia, paraesthesiae and hemiplegia.

MINTON J.

Publication Types: 
    Case Reports

PMID: 13409543 [PubMed - OLDMEDLINE]

10639: Trans Opthal Soc U K. 1956;76:187-92.

Herpetic infections of the outer eye.

GOLDSMITH AJ.

PMID: 13409540 [PubMed - indexed for MEDLINE]

10640: Ann Paediatr Fenn. 1956;2(2):142-9.

Herpes simplex meningoencephalomyelitis with prolonged course; isolation of the
virus, demonstration of intranuclear inclusions, and development of antibodies.

HALONEN P, HJELT L, KASSILA E, PENTTINEN K.

PMID: 13373121 [PubMed - OLDMEDLINE]

10641: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1956;128(6):727-32.

[Treatment of herpes zoster ophthalmicus.]

[Article in German]

ROSSLER H.

PMID: 13358176 [PubMed - OLDMEDLINE]

10642: Acta Psychiatr Neurol Scand Suppl. 1956;108:53-9.

Herpes zoster in Hodgkin's disease.

BICHEL J.

PMID: 13354437 [PubMed - indexed for MEDLINE]

10643: Arch Ital Dermatol Sifilogr Venereol. 1956;28(1):56-65.

[Case of localized herpes zoster with exclusive localization of the arm and
especially of the hand.]

[Article in Italian]

RANDAZZO SD.

PMID: 13341328 [PubMed - OLDMEDLINE]

10644: Arch Ital Dermatol Sifilogr Venereol. 1956;28(1):49-55.

[Case of bilateral herpes zoster in a case of chronic myeloid leukemia.]

[Article in Italian]

ZANCA A.

PMID: 13341327 [PubMed - indexed for MEDLINE]

10645: Dermatol Wochenschr. 1956;133(7):161-72.

[Radiotherapy and herpes zoster.]

[Article in German]

KRUCHEN C, SCHMITT T.

PMID: 13330412 [PubMed - indexed for MEDLINE]

10646: Minerva Otorinolaringol. 1956 Jan-Feb;6(1):42-4.

[Ambramycin in the treatment of the geniculate ganglion zone (Ramsay-Hunt
syndrome).]

[Article in Italian]

COASSOLO M.

PMID: 13321681 [PubMed - indexed for MEDLINE]

10647: Boll Ocul. 1956 Jan;35(1):56-64.

[Rare concomitant manifestations of ophthalmic herpes zoster and herpes febrilis 
of the cornea; three personal observations.]

[Article in Italian]

QUINTIERI C.

PMID: 13315637 [PubMed - OLDMEDLINE]

10648: Acta Ophthalmol (Copenh). 1956;34(1):35-44.

Not Available

[Article in French]

FRANCOIS J, NEETENS A.

PMID: 13301649 [PubMed - OLDMEDLINE]

10649: AMA Arch Derm. 1956 Jan;73(1):69.

An interesting case of herpes zoster.

KILE RL.

Publication Types: 
    Case Reports

PMID: 13275127 [PubMed - indexed for MEDLINE]

10650: Echo Med Nord. 1955 Dec;26(12):465-7.

Not Available

[Article in French]

MARCHAND M, BURSTIN S.

PMID: 13317807 [PubMed - OLDMEDLINE]

10651: Strahlentherapie. 1955 Dec;98(4):582-606.

[Herpes zoster and roentgen irradiation; contribution to the etiology of herpes
zoster.]

[Article in German]

SEELENTAG W.

PMID: 13298880 [PubMed - OLDMEDLINE]

10652: Nervenarzt. 1955 Nov 20;26(11):493-4.

[Incidence of herpes zoster in the course of a minor insulin treatment.]

[Article in German]

HEIDRICH R.

PMID: 13297072 [PubMed - OLDMEDLINE]

10653: Br Med J. 1955 Nov 5;2(4948):1106-9.

Malignant change arising in tissues affected by herpes.

WYBURN-MASON R.

PMID: 13260671 [PubMed - indexed for MEDLINE]

10654: Med Arh. 1955 Nov-Dec;9(6):49-56.

[Etiologic and epidemiologic aspects of herpes zoster and its treatment with pure
vitamin B12 and liver extracts.]

[Article in Undetermined Language]

MATANIC V.

PMID: 13347696 [PubMed - indexed for MEDLINE]

10655: Vestn Khir Im I I Grek. 1955 Nov;76(10):113-5.

[Herpes zoster simulating acute abdomen.]

[Article in Russian]

MERINA VM.

PMID: 13299563 [PubMed - indexed for MEDLINE]

10656: J Albert Einstein Med Cent (Phila). 1955 Nov;4(1):33-7.

Generalized herpes zoster; report of an unusual case associated with multiple
myeloma.

GREENSTEIN RH, CAHN MM.

PMID: 13286037 [PubMed - indexed for MEDLINE]

10657: Med World. 1955 Nov;83(5):433-5.

Vitamin B12 in the treatment of herpes zoster.

JOLLES KE.

PMID: 13279389 [PubMed - indexed for MEDLINE]

10658: Northwest Med. 1955 Nov;54(11):1249-52.

Clinical evaluation of protamide in sensory nerve root inflammations and allied
conditions.

LEHRER HW, LEHRER HG, LEHRER DR.

PMID: 13272938 [PubMed - OLDMEDLINE]

10659: N Engl J Med. 1955 Oct 20;253(16):693-5.

Treatment of herpes zoster with ACTH.

APPELMAN DH.

PMID: 13266022 [PubMed - indexed for MEDLINE]

10660: Med Interna (Bucur). 1955 Oct-Dec;7(4):122-6.

[Dimercaptopropanol therapy of herpes zoster.]

[Article in Romanian]

D-TRU G, GRIGORESCU C.

PMID: 13399601 [PubMed - indexed for MEDLINE]

10661: Ill Med J. 1955 Oct;108(4):226-7.

Uncommon sites of herpes zoster.

NORBURY FG.

PMID: 13270923 [PubMed - OLDMEDLINE]

10662: Maroc Med. 1955 Sep;34(364):1130-2.

[Pseudo-occlusive forms of zona; two case reports.]

[Article in French]

GARIPUY A.

PMID: 13308360 [PubMed - indexed for MEDLINE]

10663: J Med Soc N J. 1955 Sep;52(9):474-5.

Treatment of herpes zoster with topical application of hydrocortisone.

MARSHALL FA.

PMID: 13252393 [PubMed - indexed for MEDLINE]

10664: Cas Lek Cesk. 1955 Aug 26;94(34-35):939-42.

[Two cases of zoster encephalitis.]

[Article in Czech]

JEDLICKA P, STYBLOVA V.

PMID: 13261111 [PubMed - OLDMEDLINE]

10665: Dtsch Med Wochenschr. 1955 Aug 5;80(31-32):1139-40.

[Vitamin B12 treatment in neurology, especially in states of pain.]

[Article in German]

HAMPP H.

PMID: 13250976 [PubMed - indexed for MEDLINE]

10666: Rev Bras Med. 1955 Aug;12(8):519-20.

[Electron microscopy of the herpes zoster virus and effects of various
antibiotics.]

[Article in Portuguese]

KOZOUSEK V, KOZOUSCOVA J.

PMID: 13323420 [PubMed - OLDMEDLINE]

10667: Z Laryngol Rhinol Otol. 1955 Aug;34(8):511-20.

Not Available

[Article in German]

RAUCH S.

PMID: 13257481 [PubMed - OLDMEDLINE]

10668: Stanford Med Bull. 1955 Aug;13(3):357-60.

Treatment of postherpetic neuralgia.

REICHERT FL.

PMID: 13256181 [PubMed - indexed for MEDLINE]

10669: Prakt Lek. 1955 Jul 20;35(14):322-4.

[Contribution to the therapy of herpes zoster.]

[Article in Czech]

PATEJDL Z.

PMID: 13254603 [PubMed - indexed for MEDLINE]

10670: Revue Stomatol. 1955 Jul;56(7):516-21.

[Localized mandibular necrosis during trigeminal herpes.]

[Article in French]

DECHAUME, DESCROZAILLES C, GARLOPEAU F, ROBERT J.

PMID: 15444869 [PubMed - OLDMEDLINE]

10671: J Mt Sinai Hosp N Y. 1955 Jul-Aug;22(2):79-90.

Generalized herpes zoster initiating a minor epidemic of chickenpox.

MOSCOVITZ HL.

PMID: 14392455 [PubMed - indexed for MEDLINE]

10672: Reumatismo. 1955 Jul-Aug;7(4):263-8.

[Multiple myeloma and herpes zoster; a case of myeloma associated with
generalized herpes zoster of the varicella type.]

[Article in Italian]

DANEO V.

PMID: 13280927 [PubMed - indexed for MEDLINE]

10673: Acta Med Orient. 1955 Jul-Aug;14(7-8):181-92.

Herpes zoster.

LYON E.

PMID: 13258156 [PubMed - indexed for MEDLINE]

10674: Sem Med. 1955 Jun 30;106(26):974-5.

[Localization of herpes zoster still not described.]

[Article in Spanish]

DE LARA F, GUINEA AI.

PMID: 13246721 [PubMed - OLDMEDLINE]

10675: Sem Med. 1955 Jun 16;106(24):875-6.

Not Available

[Article in Spanish]

PARPAGLIONE CA.

PMID: 13246707 [PubMed - indexed for MEDLINE]

10676: Strahlentherapie. 1955 Jun;97(2):297-304.

[Herpes zoster after roentgen irradiation.]

[Article in German]

RUBE W.

PMID: 13256247 [PubMed - indexed for MEDLINE]

10677: J Urol. 1955 May;73(5):836-9.

Herpes zoster: a case of acute urinary retention.

LERMAN PH, MILLSTEIN G.

PMID: 14368730 [PubMed - OLDMEDLINE]

10678: Rev Laryngol Otol Rhinol (Bord). 1955 May-Jun;76(5-6):323-5.

Not Available

[Article in French]

GOUBLET.

PMID: 13246315 [PubMed - indexed for MEDLINE]

10679: J Am Med Assoc. 1955 Apr 30;157(18):1611.

Treatment of herpes zoster with gamma globulin.

WEINTRAUB II.

PMID: 14367019 [PubMed - indexed for MEDLINE]

10680: Sem Med. 1955 Apr 28;106(17):534-5.

[Experiment in the treatment of herpes zoster with phenylbutazone and
aminopyrine.]

[Article in Spanish]

MANZI RO, COLOMBO CV.

PMID: 14385986 [PubMed - indexed for MEDLINE]

10681: Nervenarzt. 1955 Apr 20;26(4):170-1.

[Periarteriitis nodosa zosterica of the brain with zoster ophthalmicus.]

[Article in German]

DIETZ H.

PMID: 14383919 [PubMed - OLDMEDLINE]

10682: Monatsschr Ohrenheilkd Laryngorhinol. 1955 Apr-Jun;89(2):88-92.

[Herpes zoster of the Xth brain nerve.]

[Article in German]

SCHWETZ F.

PMID: 14394008 [PubMed - OLDMEDLINE]

10683: Monatsschr Ohrenheilkd Laryngorhinol. 1955 Apr-Jun;89(2):81-8.

[Herpes zoster oticus and a contribution to the determination of localization of 
the disease focus in the auditory meatus with the aid of audiometry.]

[Article in German]

GLANINGER J.

PMID: 14394007 [PubMed - OLDMEDLINE]

10684: Minerva Dermatol. 1955 Apr;30(4):128-32.

[Generalized herpes zoster.]

[Article in Italian]

DOGLIOTTI M.

PMID: 14383432 [PubMed - indexed for MEDLINE]

10685: AMA Arch Derm. 1955 Apr;71(4):488-91.

Herpes zoster; treatment of postherpetic neuralgia with cortisone, corticotropin,
and placebos.

SAUER GC.

PMID: 14360764 [PubMed - indexed for MEDLINE]

10686: J Med (Oporto). 1955 Mar 19;26(634):709-10.

[Chlorhydrate of emetine in the treatment of herpes zoster.]

[Article in Portuguese]

OLIVEIRA Ada S.

PMID: 14366855 [PubMed - indexed for MEDLINE]

10687: Kinderarztl Prax. 1955 Mar;23(3):107-9.

[Herpes zoster and chickenpox.]

[Article in German]

KROGER U.

PMID: 14382294 [PubMed - indexed for MEDLINE]

10688: Bull Soc Fr Dermatol Syphiligr. 1955 Mar-Apr;2:149-50.

[Severe zona with generalized vesicular eruption during erythrodermic
reticulosis.]

[Article in French]

BUREAU Y, JARRY A, BARRIERE H.

PMID: 13240347 [PubMed - indexed for MEDLINE]

10689: Acta Med Scand. 1955 Feb 23;151(2):131-4.

Zoster ophthalmicus; report of a case in a child of 15 months.

POULSEN PA.

PMID: 14349631 [PubMed - indexed for MEDLINE]

10690: Med Monatsschr. 1955 Feb;9(2):109.

[Herpes zoster as result of an accident.]

[Article in German]

MAYR J.

PMID: 14383236 [PubMed - OLDMEDLINE]

10691: Pediatr Clin North Am. 1955 Feb:41-5.

Ramsay Hunt syndrome (geniculate zoster); a rare complication of herpes of the
central nervous system, with a note on herpes simplex.

SHEV EE.

PMID: 13236404 [PubMed - indexed for MEDLINE]

10692: J Pediatr. 1955 Feb;46(2):215-8.

Cranial nerve paralysis in herpes zoster encephalitis of childhood; clinical and 
electroencephalographic observations.

SCHMIDT RP, ROSEMAN E, STKIGMAN AJ.

PMID: 13234019 [PubMed - OLDMEDLINE]

10693: Conn State Med J. 1955 Feb;19(2):103-5.

Herpes zoster of the face and neck, with paralysis, earache, dizziness and nausea
(J. Ramsay Hunt syndrome).

SHEARD C Jr, FELDER EA.

PMID: 13231500 [PubMed - OLDMEDLINE]

10694: Am J Ophthalmol. 1955 Feb;39(2, Part 1):157-61.

Herpes zoster as a cause of congenital cataract.

DUEHR PA.

PMID: 13228523 [PubMed - indexed for MEDLINE]

10695: Presse Med. 1955 Jan 22;63(5):84.

[Action of adenosinetriphosphatase on zona.]

[Article in French]

BROUS M.

PMID: 14357258 [PubMed - indexed for MEDLINE]

10696: Mars Med. 1955;92(6):373-7.

Not Available

MURATORE R.

PMID: 14393122 [PubMed - indexed for MEDLINE]

10697: Confin Neurol. 1955;15(2):95-8.

[Audiometric comments with reference of a case of herpes zoster of the ear.]

[Article in French]

ROCHAT R, TERRIER G.

PMID: 14390941 [PubMed - OLDMEDLINE]

10698: Ann Otolaryngol Chir Cervicofac. 1955;72(4):324-7.

[Audiometric considerations in a case of zoster oticus.]

[Article in French]

ROCHAT R, TERRIER G.

PMID: 14388414 [PubMed - indexed for MEDLINE]

10699: Ann Med Exp Biol Fenn. 1955;33(1-2):116-21.

Treatment of herpes zoster neuralgia with massive doses of vitamin B12.

HELLE J, OHELA K.

PMID: 14388327 [PubMed - OLDMEDLINE]

10700: Friuli Med. 1955 Jan-Feb;10(1):91-4.

[Herpes zoster and chickenpox in an adult.]

[Article in Italian]

PETRONIO G.

PMID: 14380558 [PubMed - indexed for MEDLINE]

10701: Arch Ital Otol Rinol Laringol. 1955 Jan-Feb;66(1):71-81.

Not Available

[Article in Italian]

PIATTI A.

PMID: 14377820 [PubMed - OLDMEDLINE]

10702: J Med Bord. 1955 Jan;132(1):61-2.

[Treatment of herpes zoster with emetine hydrochloride.]

[Article in French]

MARTIN C.

PMID: 14354389 [PubMed - indexed for MEDLINE]

10703: Bull Soc Belge Ophtalmol. 1955;110:114-25; discussion, 125-6.

Not Available

[Article in French]

FRANCOIS J, NEETENS A.

Publication Types: 
    Case Reports

PMID: 13413511 [PubMed - OLDMEDLINE]

10704: Rev Otoneuroophtalmol. 1955;27(7):385-91.

[Paroxysmal lacrimation and Ramsay-Hunt syndrome.]

[Article in French]

ALFANDARY MI.

PMID: 13390341 [PubMed - indexed for MEDLINE]

10705: Rev Otoneuroophtalmol. 1955;27(6):330-3.

Not Available

[Article in French]

DE MORSIER G, FORNI S, FRANCESCHETTI A.

PMID: 13371152 [PubMed - OLDMEDLINE]

10706: Otolaryngol Pol. 1955;9(4):343-8.

Not Available

[Article in Polish]

GODLEWSKI J.

PMID: 13310021 [PubMed - OLDMEDLINE]

10707: Wien Z Nervenheilkd Grenzgeb. 1955;12(1):114-8.

[Demonstration of a case of herpes zoster encephalitis.]

[Article in German]

BECKER G.

PMID: 13300106 [PubMed - OLDMEDLINE]

10708: Suvr Med (Sofiia). 1955;6(6):68-74.

[Herpes simplex and herpes zoster viruses.]

[Article in Bulgarian]

KARPAROV A.

PMID: 13267783 [PubMed - OLDMEDLINE]

10709: Dermatol Wochenschr. 1955;132(36):937-42.

[Hypoprothrombinemia and theoretical basis for liver therapy in herpes zoster.]

[Article in German]

PASTINSZKY S, KOVACS E, RACZ S, GESZTI O.

PMID: 13261631 [PubMed - OLDMEDLINE]

10710: Arch Fr Pediatr. 1955;12(6):573-80.

[Curable herpetic encephalitis; virological and immunological study.]

[Article in French]

THIEFFRY S, MARTIN C, DROUHET V, BOUCHARD J.

PMID: 13259705 [PubMed - OLDMEDLINE]

10711: Urol Int. 1955;1(2):139-41.

Paralysis of the urinary bladder in herpes zoster.

ZACHARIAE F.

PMID: 13256830 [PubMed - OLDMEDLINE]

10712: Eye Ear Nose Throat Mon. 1955 Jan;34(1):44-8.

Herpes zoster of the cephalic extremity.

SABRI JA.

PMID: 13220627 [PubMed - OLDMEDLINE]

10713: AMA Arch Ophthalmol. 1955 Jan;53(1):38-44.

Treatment of herpes zoster ophthalmicus with cortisone or corticotropin.

SCHEIE HG, ALPER MC.

PMID: 13217545 [PubMed - indexed for MEDLINE]

10714: Lancet. 1954 Dec 25;267(6852):1299-302.

Studies on shingles: is the virus ordinary chickenpox virus?

SIMPSON RE.

PMID: 13222825 [PubMed - indexed for MEDLINE]

10715: Medizinische. 1954 Dec 18;51:1721-2.

[A case of zoster generalisatus in chronic lymphatic leukemia.]

[Article in German]

TIESSEN HJ.

PMID: 13235169 [PubMed - OLDMEDLINE]

10716: Z Haut Geschlechtskr. 1954 Dec 15;17(12):378-81.

[The treatment of herpes zoster with high doses of vitamin B12.]

[Article in German]

JOHNE HO.

PMID: 14374879 [PubMed - indexed for MEDLINE]

10717: Harefuah. 1954 Dec 15;47(12):250-1.

[Procaine for control of pruritus.]

[Article in Hebrew]

BERLIN C, MEIROVITZ K, TADJER A.

PMID: 14353366 [PubMed - indexed for MEDLINE]

10718: Rev Bras Med. 1954 Dec;11(12):843.

[My familial case of herpes zoster and varicella.]

[Article in Portuguese]

FECURY J.

PMID: 14372283 [PubMed - indexed for MEDLINE]

10719: Arch Belg Dermatol Syphiligr. 1954 Nov;10(3):288-95.

[Value of therapy of herpes zoster.]

[Article in French]

LAKAYE G.

PMID: 14362561 [PubMed - indexed for MEDLINE]

10720: Arch Belg Dermatol Syphiligr. 1954 Nov;10(3):272.

[Nodulare panvasculitis appearing during zona.]

[Article in French]

VAN DER MEIREN L.

PMID: 14362551 [PubMed - OLDMEDLINE]

10721: Stomatologiia (Mosk). 1954 Nov-Dec;6:16.

[A case of herpes zoster of mucosa of the mouth.]

[Article in Russian]

LEIN AA.

PMID: 14358995 [PubMed - indexed for MEDLINE]

10722: J Sci Med Lille. 1954 Nov;72(11):513.

Not Available

[Article in French]

COUSIN J, DAVID P.

PMID: 13234079 [PubMed - indexed for MEDLINE]

10723: Fr Med. 1954 Nov;17(11):17-22.

Not Available

[Article in French]

LOMBARD G.

PMID: 13232091 [PubMed - OLDMEDLINE]

10724: Minn Med. 1954 Nov;37(11):815-7.

Cat-scratch disease associated with encephalitis and herpes zoster.

FRICK PG.

PMID: 13213829 [PubMed - indexed for MEDLINE]

10725: J Am Geriatr Soc. 1954 Nov;2(11):726-35.

Herpes zoster; review, with preliminary report on new method for treatment of
postherpetic neuralgia.

SCHILLER F.

PMID: 13211194 [PubMed - indexed for MEDLINE]

10726: Lancet. 1954 Oct 30;267(6844):898-9.

Hemiplegia complicating ophthalmic zoster.

COPE S, JONES AT.

PMID: 13213069 [PubMed - OLDMEDLINE]

10727: Minerva Med. 1954 Oct 13;45(82):910-4.

[Zosteriform recurrent dermatitis with giant bullae caused by
ganglio-radiculitis.]

[Article in Italian]

RESSA P, APRA A.

PMID: 13235393 [PubMed - OLDMEDLINE]

10728: Bull Soc Ophtalmol Fr. 1954 Oct;6:512-3.

[The importance of vitamin C in the treatment of herpetic keratitis.]

[Article in French]

GROSJEAN G.

PMID: 14351934 [PubMed - OLDMEDLINE]

10729: Ann Phys Med. 1954 Oct;2(4):132-4.

Shoulder-hand syndrome following herpes zoster.

RICHARDSON AT.

PMID: 13229232 [PubMed - OLDMEDLINE]

10730: Br J Dermatol. 1954 Oct;66(10):357-60.

Discoid lupus erythematosus following trauma.

SCHIFF BL, KERN AB.

PMID: 13208924 [PubMed - OLDMEDLINE]

10731: Am J Nurs. 1954 Oct;54(10):1217-9.

Herpes zoster.

JEGHERS H.

PMID: 13197447 [PubMed - indexed for MEDLINE]

10732: Wien Klin Wochenschr. 1954 Sep 24;66(38):733-5.

[Zoster generalisatus in chronic lymphatic leukemia.]

[Article in German]

MATRAS A.

PMID: 14348873 [PubMed - indexed for MEDLINE]

10733: Hautarzt. 1954 Sep;5(9):391-7.

[Herpes zoster.]

[Article in German]

FEYRTER F.

PMID: 13221134 [PubMed - indexed for MEDLINE]

10734: Rev Med Nancy. 1954 Sep;79:547-53.

[Brachial monoplegia caused by zosterian myelitis.]

[Article in French]

ARNOULD G, HARTEMANN P, DEBRY G.

PMID: 13204947 [PubMed - OLDMEDLINE]

10735: Maroc Med. 1954 Aug;33(351):789.

[Two cases of herpes zoster treated by vitamin B12 in doses of 1000 gammas.]

[Article in French]

DASTE M.

PMID: 14369110 [PubMed - indexed for MEDLINE]

10736: Proc Soc Exp Biol Med. 1954 Aug-Sep;86(4):789-94.

Fluorescent antibody studies with agents of varicella and herpes zoster
propagated in vitro.

WELLER TH, COONS AH.

PMID: 13204357 [PubMed - OLDMEDLINE]

10737: Lek List. 1954 Aug 1;9(15-16):368-9.

[Ganglion blocking method in the treatment of herpes zoster; preliminary
communication.]

[Article in Czech]

MASEK O.

PMID: 13202518 [PubMed - indexed for MEDLINE]

10738: Boll Ocul. 1954 Aug;33(8):491-4.

Not Available

[Article in Italian]

MIGLIOR M.

PMID: 13199130 [PubMed - OLDMEDLINE]

10739: South Med J. 1954 Aug;47(8):728-32.

Bilateral herpes zoster; report of three cases.

HAILEY H.

PMID: 13186949 [PubMed - indexed for MEDLINE]

10740: Ill Med J. 1954 Aug;106(2):131-3.

Treatment of herpes zoster with cortisone.

DOENGES JP.

PMID: 13183633 [PubMed - indexed for MEDLINE]

10741: Hautarzt. 1954 Jul;5(7):306-10.

[Limitations of sensory disorders and skin changes in herpes zoster and their
relationship to the topography of systematized, especially striated dermatoses.]

[Article in German]

FEGELER F.

PMID: 13200964 [PubMed - OLDMEDLINE]

10742: Am J Ophthalmol. 1954 Jul;38(1:1):23-33.

Argyll Robertson pupil; following herpes zoster ophthalmicus, with remarks on the
efferent pupillary pathways.

NAQUIN HA.

PMID: 13180601 [PubMed - OLDMEDLINE]

10743: N Y State J Med. 1954 Jul 1;54(13):1927-30.

The treatment of herpes zoster, neuralgias, and neuritis with thiamine
potentiated with neostigmine (thiastigmine).

WALDMAN S, PELNER L.

PMID: 13176682 [PubMed - indexed for MEDLINE]

10744: Ugeskr Laeger. 1954 Jun 10;116(23):885-6.

[Treatment of zoster.]

[Article in Undetermined Language]

WILKEN JENSEN K.

PMID: 13179331 [PubMed - indexed for MEDLINE]

10745: Ann Ocul (Paris). 1954 May;187(5):467-70.

Not Available

[Article in English, French]

REYNON M.

PMID: 13189185 [PubMed - OLDMEDLINE]

10746: J Med Bord. 1954 May;131(5):472-5.

[Laryngeal herpes zoster and total dysphagia.]

[Article in Undetermined Language]

PORTMANN M, MALINEAU, CLAVERIE G.

PMID: 13184267 [PubMed - OLDMEDLINE]

10747: Proc R Soc Med. 1954 May;47(5):371-84.

THE RAMSAY HUNT syndrome.

[No authors listed]

PMID: 13167057 [PubMed - OLDMEDLINE]

10748: Rev Bras Med. 1954 Apr;11(4):240-3.

[Herpes zoster; topographical study of cutaneous lesions in 70 patients.]

[Article in Portuguese]

MARQUES RJ.

PMID: 13194983 [PubMed - indexed for MEDLINE]

10749: Dermatologica. 1954 Apr-Jun;108(4-6):295-9.

[Observations of the course and comments on the therapy of herpes zoster.]

[Article in German]

BURCKHARDT W, VON SZECHY H.

PMID: 13190909 [PubMed - indexed for MEDLINE]

10750: Feldsher Akush. 1954 Apr;4:19-21.

[Herpes.]

[Article in Undetermined Language]

SHEKLAKOV ND.

PMID: 13183150 [PubMed - indexed for MEDLINE]

10751: Lyon Med. 1954 Mar 14;86(11):240-2.

[Effect of emetine on the development of herpes zoster.]

[Article in Undetermined Language]

GIRARD M, POTTON F, GRIVET A.

PMID: 13164469 [PubMed - indexed for MEDLINE]

10752: J Am Med Assoc. 1954 Mar 13;154(11):911-2.

Treatment of herpes zoster with cortisone.

GELFAND ML.

PMID: 13129068 [PubMed - indexed for MEDLINE]

10753: Zentralbl Allg Pathol. 1954 Feb 22;91(6-8):279-301.

[Problem of zoster.]

[Article in Undetermined Language]

FEYRTER F.

PMID: 13170522 [PubMed - indexed for MEDLINE]

10754: Orv Hetil. 1954 Feb 7;95(6):154-6.

[Clinical aspects and pathogenesis of herpes zoster.]

[Article in Undetermined Language]

MARTON K, SZEGO L.

PMID: 13166250 [PubMed - indexed for MEDLINE]

10755: Rev Bras Med. 1954 Feb;11(2):97-9.

[Herpes zoster of prolonged evolution, complicated by cutaneous gangrene during
cortisone therapy; varicella in two children of the patient.]

[Article in Undetermined Language]

DE MACEDO AG, DA S MOREIRA MB.

PMID: 13167583 [PubMed - indexed for MEDLINE]

10756: Z Haut Geschlechtskr. 1954 Feb 1;16(3):80.

[Etiological aspects of the herpes zoster problem.]

[Article in Undetermined Language]

ELST E.

PMID: 13157552 [PubMed - OLDMEDLINE]

10757: Ann Soc Belg Med Trop (1920). 1954 Jan 28;34(1):5-8.

[Bilateral herpetiform zona caused by Loa loa.]

[Article in Undetermined Language]

BROWNE SG.

PMID: 13181226 [PubMed - OLDMEDLINE]

10758: Odontoiatr Rev Iberoam Med Boca. 1954;11(132):724.

[Herpes zoster of the tongue and palate and its neurological complications.]

[Article in Spanish]

STEPAN H.

PMID: 14384170 [PubMed - OLDMEDLINE]

10759: Z Tuberk. 1954;104(1-3):41-6.

[Herpes zoster as a results of isonicotinic acid hydrazide; contribution to the
enurotropictoxic effects of INH.]

[Article in German]

SCHWADERER A.

PMID: 14375008 [PubMed - OLDMEDLINE]

10760: Rev Otoneuroophtalmol. 1954;26(4):218-21.

[Cochleovestibular disorders with involvement of the trigeminal and mixed nerves 
of central origin after eruption of zoster.]

[Article in French]

GREINER GF, PHILIPPIDES D, BERNHARDT C, MENGUS M.

PMID: 14372687 [PubMed - OLDMEDLINE]

10761: Przegl Lek. 1954;10(11):295-6.

[Considerations on smallpox and herpes zoster.]

[Article in Polish]

MARCINKOWSKI T.

PMID: 14357484 [PubMed - indexed for MEDLINE]

10762: Ther Hung. 1954;1:25-6.

Vitamin B12 in the treatment of herpes zoster.

LOVEI E, ANTALOCZY Z.

PMID: 13247259 [PubMed - indexed for MEDLINE]

10763: Osterr Z Kinderheilkd Kinderfuersorge. 1954;10(1-2):43-56.

[Pathogenesis of zoster, chickenpox and herpetic diseases in man.]

[Article in German]

FEYRTER F.

PMID: 13236243 [PubMed - OLDMEDLINE]

10764: Rass Studi Psichiatr. 1954;43(4):673-9.

[Homolateral paralysis of the abducent and facial nerves during auricular herpes 
zoster.]

[Article in Italian]

CATALANO V, IMBERCIADORI E.

PMID: 13224881 [PubMed - OLDMEDLINE]

10765: Dtsch Arch Klin Med. 1954;201(4):377-88.

Not Available

[Article in German]

FEYRTER F.

PMID: 13220260 [PubMed - OLDMEDLINE]

10766: Arch Kinderheilkd. 1954;148(3):281-4.

[Second occurrence of varicella appearing as sequel to herpes zoster.]

[Article in German]

KIRCHER W.

PMID: 13208216 [PubMed - indexed for MEDLINE]

10767: Zdrav Vestn. 1954;23(5-6):102-6.

Not Available

[Article in Undetermined Language]

RUS S.

PMID: 13188026 [PubMed - indexed for MEDLINE]

10768: Virchows Arch. 1954;325(1):70-89.

[Essential features of zoster.]

[Article in Undetermined Language]

FEYRTER F.

PMID: 13179470 [PubMed - indexed for MEDLINE]

10769: Strahlentherapie. 1954;93(3):417-25.

[Herpes zoster after roentgen irradiation.]

[Article in Undetermined Language]

SCHMITT HG, THIERFELDER F.

PMID: 13178897 [PubMed - OLDMEDLINE]

10770: Przegl Dermatol. 1954 Jan-Feb;4(1):59-63.

Not Available

[Article in Undetermined Language]

KACZOROWSKA H.

PMID: 13177744 [PubMed - indexed for MEDLINE]

10771: J Pediatr. 1954 Jan;44(1):116-8.

Varicella and herpes zoster.

BLATTNER R.

PMID: 13131206 [PubMed - indexed for MEDLINE]

10772: Oral Surg Oral Med Oral Pathol. 1954 Jan;7(1):60-3.

Herpes zoster; report of a case.

STERNLICHT HC.

PMID: 13120130 [PubMed - indexed for MEDLINE]

10773: Med J Aust. 1953 Dec 12;2(24):890-1.

Motor effects of herpes zoster.

PETERSON BH.

PMID: 13119047 [PubMed - OLDMEDLINE]

10774: Arch Belg Dermatol Syphiligr. 1953 Dec;9(4):345-7.

[Diadynamic currents in therapy of herpes zoster.]

[Article in Undetermined Language]

FIEVEZ C.

PMID: 13139659 [PubMed - indexed for MEDLINE]

10775: Lek List. 1953 Dec 1;8(23):541-2.

[Morphology of herpes zoster virus and effect of certain antibiotics, preliminary
note.]

[Article in Undetermined Language]

KOZOUSEK V, KOZOUSKOVA J.

PMID: 13131909 [PubMed - OLDMEDLINE]

10776: Calif Med. 1953 Dec;79(6):444-8.

Mandibular herpes zoster; with report on the use of cortisone in a case with
geniculate ganglion symptoms.

SHEVICK IM.

Herpes zoster, an acute specific viral infection, occurs more commonly than is
generally supposed. It should be differentiated from other diseases involving the
ear and skin; it must be considered as a possible etiologic agent in some palsies
of the facial, glossopharyngeal or vagal nerves.The type of cephalic herpes
zoster should be carefully differentiated; cases involving the "geniculate zone" 
may be other than "Ramsay Hunt's syndrome." This syndrome is now defined as a
herpes zoster eruption of the external ear at the "geniculate zone" with
involvement of the seventh or seventh and eighth nerves.The "topognostic" method 
is the best for determining the level at which the facial nerve has been
affected.It is questioned whether there is a single outstanding therapeutic agent
for this disease. Cortisone had no apparent therapeutic effect in a case reported
herein.

PMID: 13106732 [PubMed - indexed for MEDLINE]

10777: Prakt Lek. 1953 Nov 20;33(22):510.

[Studies on the relationship between etiologic agents of herpes zoster and
varicella.]

[Article in Undetermined Language]

NEMEC J.

PMID: 13133915 [PubMed - indexed for MEDLINE]

10778: Belg Tijdschr Geneesk. 1953 Nov 15;9(22):1016-23.

[Current treatment of herpes zoster.]

[Article in Undetermined Language]

ROSSELLE N.

PMID: 13115331 [PubMed - indexed for MEDLINE]

10779: Riv Neurol. 1953 Nov-Dec;23(6):804-9.

[Neurologic complications of herpes zoster.]

[Article in Undetermined Language]

ZANOCCO G.

PMID: 13168150 [PubMed - OLDMEDLINE]

10780: Vie Med. 1953 Nov;34(11):1017-21.

[Treatment of herpes zoster.]

[Article in Undetermined Language]

GUERRE J.

PMID: 13136867 [PubMed - indexed for MEDLINE]

10781: Lyon Med. 1953 Oct 25;85(43):270-1.

[A case of generalized herpes zoster.]

[Article in Undetermined Language]

MICHEL PJ, SAINT-PAUL J, MARTIN A.

PMID: 13118904 [PubMed - indexed for MEDLINE]

10782: J Med Lyon. 1953 Oct 5;34(810):747-57.

[On the so called generalized zona: a personal case.]

[Article in Undetermined Language]

MICHEL PJ, MARTIN A.

PMID: 13109402 [PubMed - indexed for MEDLINE]

10783: Munch Med Wochenschr. 1953 Oct 2;95(40):1074-76.

[Herpes zoster in pulmonary tuberculosis.]

[Article in Undetermined Language]

LINGEMANN O.

PMID: 13111146 [PubMed - indexed for MEDLINE]

10784: Arch Pediatr Urug. 1953 Oct;24(10):695-6.

[Intercostal herpes zoster in an infant 7 months old.]

[Article in Undetermined Language]

PELUFFO E, LORENZO Y DEAL J, MOTTA H.

PMID: 13125913 [PubMed - indexed for MEDLINE]

10785: Dia Med. 1953 Oct 1;25(66):1849.

[Relation between herpes zoster and varicella.]

[Article in Undetermined Language]

TESORO J.

PMID: 13107486 [PubMed - indexed for MEDLINE]

10786: Clin Proc Child Hosp Dist Columbia. 1953 Sep;9(9):199-201.

Herpes zoster and varicella simulating poliomyelitis.

WOLF SI, PARROTT RH.

PMID: 13116474 [PubMed - indexed for MEDLINE]

10787: Arch Belg Dermatol Syphiligr. 1953 Sep;9(2):125-35.

[Appearance of a varicelliform herpes zoster in the course of chronic lymphoid
leukemia.]

[Article in Undetermined Language]

VAN STEENACKER G.

PMID: 13105374 [PubMed - indexed for MEDLINE]

10788: Tex State J Med. 1953 Sep;49(9):693-5.

Inactivated influenza virus vaccine in the therapy of herpes zoster; clinical
evaluation.

GRISWOLD CM, BOWEN SS.

PMID: 13102361 [PubMed - indexed for MEDLINE]

10789: Conn State Med J. 1953 Sep;17(9):771.

HERPES zoster in old age.

[No authors listed]

PMID: 13083006 [PubMed - OLDMEDLINE]

10790: J Sci Med Lille. 1953 Aug 15;71(8):384-5.

[Zona and varicella.]

[Article in Undetermined Language]

LESAGE V, DAVID P.

PMID: 13109842 [PubMed - indexed for MEDLINE]

10791: Minerva Dermatol. 1953 Aug;28(8):189-97.

[Pathogenesis of complications after zoster.]

[Article in Undetermined Language]

MORETTI G.

PMID: 13110809 [PubMed - OLDMEDLINE]

10792: Reumatismo. 1953 Jul-Aug;5(4):276.

[Herpes zoster and periarthritis of the shoulder.]

[Article in Undetermined Language]

FILOGAMO G, CARTESEGNA F.

PMID: 13121378 [PubMed - OLDMEDLINE]

10793: Pediatr Pol. 1953 Jul;28(7):740-2.

[Case of herpes zoster with simultaneous symptoms of varicella and meningitis.]

[Article in Undetermined Language]

GODLEWSKI J, ZEMAN F.

PMID: 13120224 [PubMed - indexed for MEDLINE]

10794: Rev Otoneuroophtalmol. 1953 Jul;25(5):273-6.

[Otoneuro-ophthalmologic complications following facial zona.]

[Article in Undetermined Language]

BRONNER A, LOBSTEIN PA.

PMID: 13112914 [PubMed - OLDMEDLINE]

10795: Boll Ocul. 1953 Jul;32(7):413-22.

[Antihistaminics and cortisone in herpetic infection.]

[Article in Undetermined Language]

BOLES-CARENINI B, CIMA V.

PMID: 13105866 [PubMed - OLDMEDLINE]

10796: Z Haut Geschlechtskr. 1953 Jul 1;15(1):7-8.

[Paresis of facial nerve according to Zoster.]

MEYER-ROHN J.

PMID: 13103257 [PubMed - OLDMEDLINE]

10797: J Lancet. 1953 Jul;73(7):288-92.

The treatment of post-herpetic neuralgia.

MILLER ZR.

PMID: 13096930 [PubMed - indexed for MEDLINE]

10798: Rev Clin Esp. 1953 Jun 30;49(6):397-9.

[Paralysis of hemidiaphragm by herpes zoster.]

[Article in Undetermined Language]

CERVIA T.

PMID: 13100878 [PubMed - OLDMEDLINE]

10799: Rev Asoc Med Argent. 1953 Jun 15-30;67(751-2):198-9.

[Paralytic mydriasis after zoster ophthalmicus; deductions about the lesion of
the ciliary ganglion.]

[Article in Undetermined Language]

SPOTA BB, BRAGE D.

PMID: 13112566 [PubMed - indexed for MEDLINE]

10800: Nord Med. 1953 Jun 12;49(24):856.

[Zoster as a symptom.]

[Article in Undetermined Language]

MOLTKE E.

PMID: 13087707 [PubMed - OLDMEDLINE]

10801: Cesk Otolaryngol. 1953 Jun;2(2):106-10.

[Problem of herpes zoster and its therapy with aureomycin.]

[Article in Undetermined Language]

STRELKA J.

PMID: 13116324 [PubMed - indexed for MEDLINE]

10802: Proc Soc Exp Biol Med. 1953 Jun;83(2):340-6.

Serial propagation in vitro of agents producing inclusion bodies derived from
varicella and herpes zoster.

WELLER TH.

PMID: 13064265 [PubMed - indexed for MEDLINE]

10803: Wien Med Wochenschr. 1953 May 30;103(22):398.

[Sudden occurrence of an epithelial blister on the lower half of the cornea in
connection with keratitis herpetica.]

[Article in Undetermined Language]

PURTSCHER A.

PMID: 13078564 [PubMed - indexed for MEDLINE]

10804: Prensa Med Argent. 1953 May 22;40(21):1281-4.

[Cephalomotor forms of herpes zoster.]

[Article in Undetermined Language]

BARDECI CA, KIERMAN HJ.

PMID: 13073950 [PubMed - indexed for MEDLINE]

10805: Prensa Med Argent. 1953 May 15;40(20):1220-2.

[Herpes zoster and dihydroergotamine.]

[Article in Undetermined Language]

CANCIO C.

PMID: 13073938 [PubMed - indexed for MEDLINE]

10806: Ugeskr Laeger. 1953 May 14;115(20):788-9.

[Zoster and chickenpox once again.]

[Article in Undetermined Language]

DAHL S.

PMID: 13077993 [PubMed - indexed for MEDLINE]

10807: Rev Otoneuroophtalmol. 1953 May-Jun;25(4):251-2.

[Auricular zona and facial paralysis.]

[Article in Undetermined Language]

SITBON J, ZERMATI M.

PMID: 13112910 [PubMed - OLDMEDLINE]

10808: Neurol Psychiatr Ceskoslov. 1953 May;16(1-2):54-60.

[Herpes zoster palatinus.]

[Article in Undetermined Language]

VOJIR R.

PMID: 13087566 [PubMed - OLDMEDLINE]

10809: Med Monatsschr. 1953 May;7(5):316-7.

[Zoster with aberrant small vesicles in spondylitis tuberculosa; problem of
segmental disposition.]

[Article in Undetermined Language]

HAUSNER W.

PMID: 13086528 [PubMed - indexed for MEDLINE]

10810: N Y State J Med. 1953 May 1;53(9):1118-9.

A case of Bell's palsy followed by herpes zoster oticus.

MCSWEENY AJ.

PMID: 13063729 [PubMed - OLDMEDLINE]

10811: AMA Arch Derm Syphilol. 1953 May;67(5):512-3.

Improving the recovery time of herpes zoster.

BERG GO.

PMID: 13050161 [PubMed - indexed for MEDLINE]

10812: Am J Pathol. 1953 May-Jun;29(3):401-11.

The relation of heretofore unreported lesions to pathogenesis of herpes zoster.

CHEATHAM WJ.

PMID: 13040486 [PubMed - OLDMEDLINE]

10813: Ugeskr Laeger. 1953 Apr 30;115(18):689-91.

[An etiological factor analogous to zoster and poliomyelitis.]

[Article in Undetermined Language]

JANSEN J.

PMID: 13077968 [PubMed - OLDMEDLINE]

10814: Lyon Med. 1953 Apr 19;188(16):319-20.

[An interesting treatment for zona.]

[Article in Undetermined Language]

GRIVEAUD, ACHARD, MORIN.

PMID: 13070795 [PubMed - indexed for MEDLINE]

10815: Riforma Med. 1953 Apr 11;67(15):411-4.

[A case of cutaneous gangrene following herpes zoster.]

[Article in Undetermined Language]

RANDAZZO SD.

PMID: 13075732 [PubMed - indexed for MEDLINE]

10816: Wien Med Wochenschr. 1953 Apr 4;103(14):258-60.

[Neurological complications in herpes zoster of tongue and palate.]

[Article in Undetermined Language]

STEPAN H.

PMID: 13078510 [PubMed - OLDMEDLINE]

10817: Pediatr Pol. 1953 Apr;28(4):407-9.

[Problem of herpes zoster and chickenpox.]

[Article in Undetermined Language]

MISIUREWICZ M.

PMID: 13088146 [PubMed - indexed for MEDLINE]

10818: J Med Bord. 1953 Apr;130(4):558-61.

[Non specific factors in zona.]

[Article in Undetermined Language]

LOISEAU P.

PMID: 13069900 [PubMed - OLDMEDLINE]

10819: Northwest Med. 1953 Apr;52(4):291-2.

Vitamin B12 in massive dosages for herpetic lesions.

LEITCH GB.

PMID: 13055119 [PubMed - indexed for MEDLINE]

10820: J Med Assoc State Ala. 1953 Apr;22(10):267-8.

Hypersensitivity to protamide; report of case.

ZDANIS AS.

PMID: 13053111 [PubMed - indexed for MEDLINE]

10821: Ugeskr Laeger. 1953 Mar 19;115(12):459-62.

[Chickenpox, zoster; concluding remarks.]

[Article in Undetermined Language]

DAHL S.

PMID: 13077899 [PubMed - indexed for MEDLINE]

10822: Z Haut Geschlechtskr. 1953 Mar 15;14(6):190-3.

[Zoster and leukemia (leukemia cutis in zostere.]

[Article in Undetermined Language]

KEYENBURG GW.

PMID: 13078922 [PubMed - indexed for MEDLINE]

10823: Sem Hop. 1953 Mar 10;29(17):845-50.

[The skeleton in herpes zoster.]

[Article in Undetermined Language]

ISEMEIN L, FOURNIER A.

PMID: 13076327 [PubMed - indexed for MEDLINE]

10824: Bull Soc Ophtalmol Fr. 1953 Mar;3:231-3.

[Zona ophthalmica and sulfarsenol.]

[Article in Undetermined Language]

HERVOUET F, CHEVANNES.

PMID: 13106624 [PubMed - indexed for MEDLINE]

10825: Bull New Engl Med Cent. 1953 Mar;15(1):23-31.

Coagulation defects due to acquired anticoagulants and fibrinolysis; their
detection and treatment.

[Article in English, Undetermined Language]

STEFANINI M, CAMPBELL EW, PLITMAN GI, SALOMON L.

PMID: 13032681 [PubMed - indexed for MEDLINE]

10826: AMA Arch Neurol Psychiatry. 1953 Mar;69(3):392-3.

Herpes zoster with muscular involvement: report of three cases.

FREIMAN IS, LADERMAN P.

PMID: 13029981 [PubMed - OLDMEDLINE]

10827: Resen Clin Cient. 1953 Feb;22(2):44-8.

[Herpes zoster.]

[Article in Undetermined Language]

BAILEY P.

PMID: 13074625 [PubMed - indexed for MEDLINE]

10828: Lattante. 1953 Feb;24(2):99-100.

[Relations between herpes zoster and chickenpox.]

[Article in Undetermined Language]

BULLA G.

PMID: 13070641 [PubMed - indexed for MEDLINE]

10829: J Nerv Ment Dis. 1953 Feb;117(2):157-8.

Herpes zoster with muscular involvement report of three cases.

FREIMAN IS, LADERMAN P.

PMID: 13061962 [PubMed - indexed for MEDLINE]

10830: Minn Med. 1953 Feb;36(2):152; passim.

Herpes zoster with motor paralysis.

BLANSHARD TP.

PMID: 13025256 [PubMed - OLDMEDLINE]

10831: Med Klin (Munich). 1953 Jan 23;48(4):106-8.

[Zoster and trauma.]

[Article in Undetermined Language]

LAUSECKER H.

PMID: 13119256 [PubMed - indexed for MEDLINE]

10832: Ugeskr Laeger. 1953 Jan 15;115(3):82-6.

[Motor symptoms in zoster.]

[Article in Undetermined Language]

MOLTKE E.

PMID: 13049674 [PubMed - OLDMEDLINE]

10833: Manedsskr Prakt Laegegern. 1953 Jan;31(1):33-9.

Not Available

[Article in Danish]

DAHL S.

PMID: 13202574 [PubMed - indexed for MEDLINE]

10834: Ann Otolaryngol Chir Cervicofac. 1953;70(11-12):798-801.

[Zonas of the face.]

[Article in Undetermined Language]

CAMBRELIN MG.

PMID: 13148908 [PubMed - OLDMEDLINE]

10835: J Radiol Electrol Arch Electr Medicale. 1953;34(5-6):396-7.

[Some aspects of the bones of the upper extremity and more especially of the
carpal bone during the evolution of zona.]

[Article in Undetermined Language]

FOURNIER AM.

PMID: 13097500 [PubMed - OLDMEDLINE]

10836: J Radiol Electrol Arch Electr Medicale. 1953;34(5-6):379-80.

[Herpes zoster and antihistaminic ionization.]

[Article in Undetermined Language]

DANO R.

PMID: 13097492 [PubMed - indexed for MEDLINE]

10837: Rev Otoneuroophtalmol. 1953 Jan;25(1):12-5.

[Pharyngo-otic zona.]

[Article in Undetermined Language]

MONTANDON A.

PMID: 13075409 [PubMed - indexed for MEDLINE]

10838: Bull Soc Fr Dermatol Syphiligr. 1953 Jan-Feb;60(1):106-7.

[Interesting therapy of zona.]

[Article in Undetermined Language]

GRIVEAUD, ACHARD, MORIN.

PMID: 13066915 [PubMed - indexed for MEDLINE]

10839: Bull Soc Fr Dermatol Syphiligr. 1953 Jan-Feb;60(1):102-3.

[Cervico-scapular zona and generalized varicella.]

[Article in Undetermined Language]

DUVERNE J, BONNAYME R, MONTAGNON.

PMID: 13066911 [PubMed - indexed for MEDLINE]

10840: J Pathol Bacteriol. 1953 Jan;65(1):221-7.

The pathology of acute herpes zoster ophthalmicus.

GOODBODY RA.

PMID: 13035615 [PubMed - indexed for MEDLINE]

10841: J Indian Med Assoc. 1953 Jan;22(4):158-62.

Treatment of herpes zoster ophthalmicus with methanesulphonate of hydrogenated
ergotamine.

AGARWAL LP, ADHAULIA HN, MEHRA KS, SHURMA CK.

PMID: 13035143 [PubMed - indexed for MEDLINE]

10842: Antiseptic. 1953 Jan;50(1):59-60.

A case of mumps following herpes zoster.

ROY SK.

PMID: 13017572 [PubMed - indexed for MEDLINE]

10843: N Y State J Med. 1952 Dec 15;52(24):3033-4.

Herpes zoster and varicella.

GLOTZER S.

PMID: 13013556 [PubMed - indexed for MEDLINE]

10844: Med J Aust. 1952 Dec 6;2(23):810-5.

Facial paralysis, a clinical review with an autopsy report of the histo-pathology
in a case of infection of the geniculate ganglion by the virus of cephalic herpes
zoster.

FINDLAY JP.

PMID: 13012431 [PubMed - OLDMEDLINE]

10845: An Bras Derm Sifilogr. 1952 Dec;27(4):195-8.

[2 Cases of facial zoster (Hunt syndrome and Meniere complex.]

[Article in Undetermined Language]

RUTOWITSCH M.

PMID: 13040733 [PubMed - OLDMEDLINE]

10846: Nord Med. 1952 Nov 28;48(48):1661.

[Ophthalmic zoster with cranial nerve complication.]

[Article in Undetermined Language]

PETERSEN J.

PMID: 13025946 [PubMed - OLDMEDLINE]

10847: Nord Med. 1952 Nov 14;48(46):1591.

[Zoster and trauma.]

[Article in Undetermined Language]

MOLTKE E.

PMID: 13025912 [PubMed - OLDMEDLINE]

10848: Nord Med. 1952 Nov 14;48(46):1589-90.

[Chloromycetin allergy with joint & cardiac symptoms and psychic reaction.]

[Article in Undetermined Language]

GULLBERG S.

PMID: 13025911 [PubMed - indexed for MEDLINE]

10849: Arch Belg Dermatol Syphiligr. 1952 Nov 3;8(3):307-10.

[Zona with multiple localizations in hemolytic jaundice.]

[Article in Undetermined Language]

LEGROS A.

PMID: 13031591 [PubMed - OLDMEDLINE]

10850: Rass Medica. 1952 Nov;29(11):264-6.

[Herpes zoster and chickenpox.]

[Article in Undetermined Language]

VERGA G.

PMID: 13047595 [PubMed - indexed for MEDLINE]

10851: Acta Physiother Rheumatol Belg. 1952 Nov-Dec;7(6):354-6.

[Treatment of herpes zoster by ultrasound.]

[Article in Undetermined Language]

FORMIGAL LUZES F.

PMID: 13040043 [PubMed - indexed for MEDLINE]

10852: Z Laryngol Rhinol Otol. 1952 Nov;31(11):545-57.

[Differential diagnosis and clinical observation in zoster oticus.]

[Article in Undetermined Language]

PELLNITZ D.

PMID: 13039391 [PubMed - indexed for MEDLINE]

10853: Hautarzt. 1952 Nov;3(11):483-8.

[Applications of electron microscopy in dermatology.]

[Article in Undetermined Language]

NASEMANN T.

PMID: 13021710 [PubMed - indexed for MEDLINE]

10854: Miss Valley Med J. 1952 Nov;74(6):186-7.

Herpes zoster; treatment with x-radiation.

WEST T, MAN M, DALTON C.

PMID: 13013142 [PubMed - indexed for MEDLINE]

10855: N C Med J. 1952 Nov;13(11):632-5.

HERPES zoster; presentation of a case.

[No authors listed]

PMID: 13003002 [PubMed - indexed for MEDLINE]

10856: Med Ann Dist Columbia. 1952 Nov;21(11):606-7.

Herpes zoster and varicella occurring simultaneously in the same case.

JONES BC Jr.

PMID: 12992053 [PubMed - indexed for MEDLINE]

10857: Sem Med. 1952 Oct 26;28(39):659.

[Serum of convalescent subjects of herpes zoster and chickenpox in therapy of
herpes zoster.]

[Article in Undetermined Language]

TZANCK A, HERZOG F, GAIFFE M.

PMID: 13028544 [PubMed - indexed for MEDLINE]

10858: Rev Med Liege. 1952 Oct 15;7(20):653-5.

[Presentation of otorhinolaryngological cases.]

[Article in Undetermined Language]

VANDAM J.

PMID: 13027882 [PubMed - OLDMEDLINE]

10859: Rev Medica Hosp Esp. 1952 Oct-Dec;22(10-12):165-70.

[Teleroentgenotherapy of neuralgia following zona.]

[Article in Undetermined Language]

MATEOS MB.

PMID: 13064523 [PubMed - indexed for MEDLINE]

10860: Borgyogy Venerol Sz. 1952 Oct;6(5):151-2.

[Aureomycin treated gangrenous herpes zoster.]

[Article in Undetermined Language]

NAGY E, FEJES D.

PMID: 13032221 [PubMed - indexed for MEDLINE]

10861: Hopital. 1952 Oct;40(615):305-6.

Not Available

[Article in Undetermined Language]

VIDAL J.

PMID: 13021861 [PubMed - indexed for MEDLINE]

10862: Minerva Med. 1952 Oct 1;43(79):545-7.

[Relations between herpes zoster, herpes simplex and varicella manifestations.]

[Article in Undetermined Language]

ZANROSSO G.

PMID: 13013018 [PubMed - OLDMEDLINE]

10863: Minn Med. 1952 Oct;35(10):961.

Herpes zoster; report of a case occurring in an infant eight months old.

MADDEN JF.

PMID: 13002213 [PubMed - indexed for MEDLINE]

10864: Am Pract Dig Treat. 1952 Oct;3(10):797-8.

Treatment of herpes zoster with chloromycetin.

WRIGHT CS, ROXBY JB Jr.

PMID: 12986161 [PubMed - indexed for MEDLINE]

10865: Praxis. 1952 Sep 11;41(37):805-6.

[Neurosurgical therapy of intolerable post-zona neuralgia.]

[Article in Undetermined Language]

WERNER A.

PMID: 13026708 [PubMed - indexed for MEDLINE]

10866: Prensa Med Argent. 1952 Sep 5;39(36):2090-2.

[Paralytic mydriasis following zona ophthalmica; considerations on a lesion of
the ciliary ganglion.]

[Article in Undetermined Language]

SPOTA BB, BRAGE D.

PMID: 12993676 [PubMed - OLDMEDLINE]

10867: Dtsch Med Wochenschr. 1952 Sep 5;77(36):1074-6.

[Therapy of herpes zoster with human globulin.]

[Article in Undetermined Language]

GROS H.

PMID: 12979748 [PubMed - indexed for MEDLINE]

10868: AMA Arch Neurol Psychiatry. 1952 Sep;68(3):314-7.

Pain of herpes zoster ophthalmicus.

DOLAN RA, BUCY PC.

PMID: 14952068 [PubMed - indexed for MEDLINE]

10869: Bibl Laeger. 1952 Sep-Oct;144:222-4.

[Modes of transmission in zoster.]

[Article in Undetermined Language]

DAHL S.

PMID: 13159866 [PubMed - indexed for MEDLINE]

10870: Bibl Laeger. 1952 Sep-Oct;144:217-21.

Not Available

[Article in Undetermined Language]

DAHL S.

PMID: 13159865 [PubMed - indexed for MEDLINE]

10871: Bibl Laeger. 1952 Sep-Oct;144:213-6.

Not Available

[Article in Undetermined Language]

DAHL S.

PMID: 13159864 [PubMed - indexed for MEDLINE]

10872: Archivos Soc Oftalmol Hisp Am. 1952 Sep;12(9):1106-21.

[Chemotherapy of herpetic infections in ophthalmology.]

[Article in Undetermined Language]

DIAZ FERRON E.

PMID: 13017993 [PubMed - indexed for MEDLINE]

10873: Rev Med Chil. 1952 Sep;80(9):568.

[Treatment of herpes zoster with terramycin.]

[Article in Undetermined Language]

LOPEZ N.

PMID: 13014616 [PubMed - indexed for MEDLINE]

10874: Calcutta Med J. 1952 Sep;49(9):367-70.

Herpes zoster with eye complications.

GHOSH CK.

PMID: 13009453 [PubMed - indexed for MEDLINE]

10875: Boll Ocul. 1952 Sep;31(9):547-58.

[Studies on the effect of cortisone in experimental herpes ophthalmicus.]

[Article in Undetermined Language]

BRUNA F, SALVI GL.

PMID: 12997595 [PubMed - OLDMEDLINE]

10876: J Maine Med Assoc. 1952 Sep;43(9):301-3.

The value of adrenocorticotropic hormone in herpes zoster ophthalmacus.

POULIN JE.

PMID: 12990927 [PubMed - indexed for MEDLINE]

10877: Br J Dermatol. 1952 Sep;64(9):324-8.

Herpes zoster following trivial injury: with notes on a case.

KINNEAR J.

PMID: 12978204 [PubMed - OLDMEDLINE]

10878: Med Klin (Munich). 1952 Aug 15;47(33):1053-4.

[Primary generalized herpes zoster causing death in chronic
lymphogranulomatosis.]

[Article in Undetermined Language]

HAUSNER W.

PMID: 13012791 [PubMed - indexed for MEDLINE]

10879: Ugeskr Laeger. 1952 Aug 14;114(33):1109-10.

[Pituitrin preparations in therapy of herpes zoster.]

[Article in Undetermined Language]

SECHER K.

PMID: 13015713 [PubMed - OLDMEDLINE]

10880: Dia Med. 1952 Aug 11;24(50):1303-4.

[Chloromycetin in therapy of zoster ophthalmicus.]

[Article in Undetermined Language]

TELLO EE.

PMID: 13020712 [PubMed - OLDMEDLINE]

10881: Postgrad Med. 1952 Aug;12(2):127-32.

Herpes zoster.

BAILEY P.

PMID: 14957687 [PubMed - indexed for MEDLINE]

10882: Minerva Dermatol. 1952 Aug;27(8):187-90.

[Chloramphenicol therapy of herpes zoster.]

[Article in Undetermined Language]

GIULIANI V.

PMID: 13012918 [PubMed - indexed for MEDLINE]

10883: N Y State J Med. 1952 Aug 1;52(15):1915-6.

Herpes zoster during cortisone therapy in three patients with rheumatoid
arthritis.

KUPPERMAN HG, DAVIS JS Jr, BARTFELD H.

PMID: 13002765 [PubMed - OLDMEDLINE]

10884: Antiseptic. 1952 Aug;49(8):587-94.

Herpes zoster and varicella.

SUBBA RAO KV.

PMID: 12986712 [PubMed - indexed for MEDLINE]

10885: Prensa Med Argent. 1952 Jul 25;39(30):1723-6.

[Treatment of herpes zoster with chloramphenicol.]

[Article in Undetermined Language]

TELLO EE.

PMID: 14957748 [PubMed - indexed for MEDLINE]

10886: Rev Bras Med. 1952 Jul;9(7):455-62.

[Generalized herpes zoster and lymphoma.]

[Article in Undetermined Language]

SILVA MS.

PMID: 13064469 [PubMed - indexed for MEDLINE]

10887: Arch Dermatol Syph. 1952 Jul;194(4):366-75.

[A clinically and pathologically unusual case of herpes zoster multiplex with
peculiar ileitis.]

[Article in Undetermined Language]

SCHIRDUAN M, DIETZE HH.

PMID: 12996985 [PubMed - indexed for MEDLINE]

10888: Orv Hetil. 1952 Jun 15;93(24):708-10.

[A case of atypic zoster oticus.]

[Article in Undetermined Language]

GAL P.

PMID: 13003324 [PubMed - indexed for MEDLINE]

10889: Calif Med. 1952 Jun;76(6):396-401.

RELATION OF A STREPTOCOCCUS TO EPIDEMIC POLIOMYELITIS-Studies in Etiology,
Diagnosis and Specific Treatment.

Rosenow EC.

The production in 1915 of herpes zoster or "posterior" poliomyelitis in animals
with a streptococcus led to further research on the etiologic importance of
streptococci in "anterior" poliomyelitis.A specific streptococcus was
demonstrated consistently in persons with poliomyelitis and in well persons
having contact with them or merely inhabiting an area in which poliomyelitis was 
epidemic. That the organism was not present in areas remote from contact with the
disease was likewise demonstrated.The streptococcus has been isolated from
filtrates of poliomyelitis virus and from the tissues and exudates which harbor
the virus. It appears in the spinal fluid in the preparalytic stage of
poliomyelitis and disappears from the spinal fluid during the severe stage of the
disease.Antibody and antigen prepared from the streptococcus were used to
determine the presence of antigen and antibody indicative of streptococcal
infection in many patients with poliomyelitis and in well persons. The intensity 
of reaction indicating specific streptococcal antigen was directly proportional
to the degree of paralysis in patients; the reaction was greater in persons whose
age, sex and previous isolation from the disease would normally indicate greater 
susceptibility. The test for antibody gave opposite results.Specific agglutinins 
for the streptococcus and neutralizing antibody for the virus were present
consistently in the serum of persons and monkeys during recovery from
poliomyelitis.Virus produced in vitro from the associated streptococcus caused
all the clinical and pathologic features of poliomyelitis in monkeys inoculated
with it, and the animals that recovered from the disease thus induced were proved
to be immune thereafter to the natural virus.Antistreptococcic serum prepared in 
horses was used to treat poliomyelitis. In a group of monkeys inoculated with the
virus of the disease, 6 per cent of those receiving the serum before inoculation 
died of the disease; of the control group, 82 per cent. In a series of
poliomyelitis patients treated with the serum the mortality rate was 8 per cent; 
in a control series, 21 per cent. In a series treated in all stages of the
disease by the author, 10 per cent died; of those who did not receive the serum, 
25 per cent.An antibody has been prepared from the streptococcus which appears to
prevent paralysis and otherwise mitigate poliomyelitis and to provide
immunization from the disease.The conclusion is reached that the virus of
poliomyelitis is a form of the specific streptococcus, which is the agent in
primary infections and in the development of the immunizing antibody.

PMID: 18731824 [PubMed]

10890: Montp Med. 1952 Jun;41-42(4):414-6.

[Trophic disorders and osteoporosis after herpes zoster of the upper extremity.]

[Article in Undetermined Language]

MARGAROT J, RIMBAUD P, IZARN P, BERTRAND A.

PMID: 13013182 [PubMed - OLDMEDLINE]

10891: Sem Med. 1952 May 2;100(18):554-6.

[Now concept on physiopathology of nerve fibers.]

[Article in Undetermined Language]

ARETA T.

PMID: 14950318 [PubMed - indexed for MEDLINE]

10892: Rev Med Chil. 1952 May;80(5):266-9.

[Treatment of herpes zoster with ACTH and cortisone.]

[Article in Undetermined Language]

WEINSTEIN M, LAMAS R.

PMID: 14949663 [PubMed - indexed for MEDLINE]

10893: Va Med Mon (1918). 1952 May;79(5):250-3.

Herpes zoster of the cranial nerves.

McGOVERN FH, FITZ-HUGH GS.

PMID: 14943005 [PubMed - indexed for MEDLINE]

10894: Practitioner. 1952 May;168(1007):513-4.

A plan for the non-specific treatment of herpes zoster.

ROGERS SC.

PMID: 14941724 [PubMed - indexed for MEDLINE]

10895: Bull Soc Fr Dermatol Syphiligr. 1952 May-Jun;59(3):215-6.

[Case of hemiplegic zona.]

[Article in Undetermined Language]

TZANCK A, MELKI GR, ARNAULT P.

PMID: 12987950 [PubMed - indexed for MEDLINE]

10896: Arch Dis Child. 1952 Apr;27(132):126-7.

Herpes zoster neonatorum.

FELDMAN GV.

PMID: 14924677 [PubMed - OLDMEDLINE]

10897: Rass Medica. 1952 Apr;29(4):74-5.

[Case of herpes zoster treated with synthomycetin ointment.]

[Article in Undetermined Language]

URBANO P.

PMID: 12994060 [PubMed - indexed for MEDLINE]

10898: Rass Medica. 1952 Apr;29(4):70-1.

[Therapeutic action of chloramphenicol in herpes zoster.]

[Article in Undetermined Language]

AVOLIO W.

PMID: 12994056 [PubMed - indexed for MEDLINE]

10899: N Y State J Med. 1952 Mar 15;52(6):706-8.

Herpes zoster; its treatment with protamide.

COMBES FC, CANIZARES O.

PMID: 14910892 [PubMed - OLDMEDLINE]

10900: Br Med J. 1952 Mar 8;1(4757):533.

Parkinson's syndrome following severe herpes ophthalmicus.

STRONG G.

PMID: 14904972 [PubMed - OLDMEDLINE]

10901: Br Med J. 1952 Mar 8;1(4757):520-3.

Herpes zoster varicellosus.

McCALLUM DI.

PMID: 14904966 [PubMed - indexed for MEDLINE]

10902: AMA Arch Otolaryngol. 1952 Mar;55(3):307-20.

Herpes zoster of the cephalic extremity.

McGOVERN FH, FITZ-HUGH GS.

PMID: 14902214 [PubMed - indexed for MEDLINE]

10903: Bull Soc Fr Dermatol Syphiligr. 1952 Mar-Apr;59(2):153-5.

[Zona adenitis; histological study.]

[Article in Undetermined Language]

MARGAROT J, RIMBAUD P, IZARN P.

PMID: 12978820 [PubMed - OLDMEDLINE]

10904: Medicina (Madr). 1952 Feb;20(2):152-7.

[Epidemic outbreak of chickenpox following a case of herpes zoster in a ward for 
tuberculous meningitis.]

[Article in Undetermined Language]

CROS CAMPILLO T.

PMID: 14928931 [PubMed - indexed for MEDLINE]

10905: Rev Otoneuroophtalmol. 1952 Feb-Mar;24(2):114-6.

[Genicular zoster syndrome; pre-eruptive facial paralysis, and late meningitis.]

[Article in Undetermined Language]

AYMES G, MOUSSION VH.

PMID: 14921426 [PubMed - OLDMEDLINE]

10906: Med Klin (Munich). 1952 Feb 1;47(5):149-51.

[Rare forms of herpes zoster.]

[Article in Undetermined Language]

LAUSECKER H.

PMID: 14918974 [PubMed - indexed for MEDLINE]

10907: Practitioner. 1952 Feb;168(1004):191-4.

The treatment of herpes zoster.

KINMONT PD.

PMID: 14911512 [PubMed - indexed for MEDLINE]

10908: J Neurol Neurosurg Psychiatry. 1952 Feb;15(1):45-9.

Herpes zoster ophthalmicus and post-herpetic neuralgia.

TATLOW WF.

PMID: 14908614 [PubMed - indexed for MEDLINE]

10909: N Engl J Med. 1952 Jan 31;246(5):200-1.

ELUSIVE virus.

[No authors listed]

PMID: 14890836 [PubMed - indexed for MEDLINE]

10910: N Engl J Med. 1952 Jan 31;246(5):167-72.

Clinical evaluation of aureomycin and chloramphenicol in herpes zoster.

KASS EH, AYCOCK RR, FINLAND M.

PMID: 14890830 [PubMed - indexed for MEDLINE]

10911: Riv Patol Nerv Ment. 1952;73(1):151-65.

[Zosterian encephalitis.]

[Article in Undetermined Language]

CAVALCA GG.

PMID: 14950048 [PubMed - indexed for MEDLINE]

10912: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1952;120(6):636-9.

[Diseases of the optic nerve in herpes zoster ophthalmicus.]

[Article in Undetermined Language]

BORNER R.

PMID: 14939607 [PubMed - OLDMEDLINE]

10913: Acta Derm Venereol. 1952;32(1):20-6.

Herpes zoster following bilateral supranuclear sympathicotomy.

SVENDSEN IB.

PMID: 14932665 [PubMed - indexed for MEDLINE]

10914: Acta Derm Venereol. 1952;32(2):184-9.

Aureomycin and chloromycetin in the treatment of herpes zoster.

SCHAFFER G, SVENDSEN IB.

PMID: 14923195 [PubMed - indexed for MEDLINE]

10915: South Med J. 1952 Jan;45(1):76.

Simultaneous herpes zoster and chickenpox; report of two cases.

AUSTIN SD, BRANDON WH, McGEE RR.

PMID: 14892981 [PubMed - indexed for MEDLINE]

10916: Arch Ital Dermatol Sifilogr Venereol. 1952-1953;25(6):453-6.

[Cocarboxylase in the treatment of neuritis in herpes zoster.]

[Article in Undetermined Language]

BOTTOLI A.

PMID: 13115086 [PubMed - indexed for MEDLINE]

10917: Stomatologiia (Mosk). 1952;6(4):21-2.

[Herpes zoster of the oral mucosa and of facial skin.]

RABINOVICH MV, SOTOVA AM.

PMID: 13076952 [PubMed - OLDMEDLINE]

10918: Cesk Otolaryngol. 1952;1(2):62-9.

Not Available

[Article in Undetermined Language]

CHYTIL S.

PMID: 13033013 [PubMed - indexed for MEDLINE]

10919: Bull Mem Soc Med Hop Paris. 1952;68(30-31):1119-21.

[Zona and malignant lymphogranulomatosis.]

[Article in Undetermined Language]

PUIG R.

PMID: 13019580 [PubMed - indexed for MEDLINE]

10920: Mars Med. 1952;89(4):242-3.

[Zona and dysenteric syndrome.]

[Article in Undetermined Language]

MONGES A, MARTIN J.

PMID: 12991973 [PubMed - indexed for MEDLINE]

10921: Cesk Oftalmol. 1952;8(4):248-51.

[Relation of focal infection to herpes corneae.]

[Article in Undetermined Language]

SIMKOVA M.

PMID: 12979029 [PubMed - OLDMEDLINE]

10922: Cesk Oftalmol. 1952;8(4):245-7.

[Review of herpetic diseases of the cornea treated since 1921 in the
ophthalmologic clinic in Pilzen.]

[Article in Undetermined Language]

MOSINGEROVA D.

PMID: 12979028 [PubMed - OLDMEDLINE]

10923: Ned Tijdschr Geneeskd. 1951 Dec 15;95(50):3732-7.

[A case of herpes zoster encephalitis.]

[Article in Undetermined Language]

BRIET W, VAN DER MOLEN HR.

PMID: 14919711 [PubMed - OLDMEDLINE]

10924: Ned Tijdschr Geneeskd. 1951 Dec 8;95(49):3687-90.

[Herpes zoster after smallpox revaccination and certain conclusions based on
this.]

[Article in Undetermined Language]

BOS CH, BOS GJ.

PMID: 14919705 [PubMed - indexed for MEDLINE]

10925: Borgyogy Venerol Sz. 1951 Dec;5(6):165-8.

[Hypoprothrombinemia in herpes zoster.]

[Article in Undetermined Language]

PASTINSZKY I, KOVACS E, GESZTI O.

PMID: 14895755 [PubMed - indexed for MEDLINE]

10926: Ugeskr Laeger. 1951 Nov 15;113(46):1537-40.

[Aureomycin and chloromycetin therapy of zoster.]

[Article in Undetermined Language]

SCHAFFER G, SVENDSEN IB.

PMID: 14922547 [PubMed - indexed for MEDLINE]

10927: Rev Otoneuroophtalmol. 1951 Nov-Dec;23(8):477-80.

[Pains from zona ophthalmica; sympathalgias; treatment by posterior pituitary
hormone.]

[Article in Undetermined Language]

BELZ, BOUCHEL.

PMID: 14930605 [PubMed - OLDMEDLINE]

10928: Rev Rhum Mal Osteoartic. 1951 Nov;18(11):618-20.

[Osseous manifestations of zona; one observations.]

[Article in Undetermined Language]

BACRI J, MUTIN S.

PMID: 14921509 [PubMed - OLDMEDLINE]

10929: Rass Medica. 1951 Nov;28(11):195-6.

[Therapy of herpes zoster with chloramphenicol pomade.]

[Article in Undetermined Language]

CADORE L.

PMID: 14920766 [PubMed - indexed for MEDLINE]

10930: U S Armed Forces Med J. 1951 Oct;2(10):1563-5.

Herpes zoster following German measles.

WRIGHT PE, PEAR EG, SEMLER WL.

PMID: 14876823 [PubMed - OLDMEDLINE]

10931: AMA Arch Derm Syphilol. 1951 Oct;64(4):407-10.

Herpes zoster appearing after trauma.

KLAUDER JV.

PMID: 14867846 [PubMed - OLDMEDLINE]

10932: Med J Aust. 1951 Sep 29;2(13):425-6.

Further revision of the dermatomes.

YOUNG JH.

PMID: 14890169 [PubMed - indexed for MEDLINE]

10933: Br Med J. 1951 Sep 22;2(4733):716-7.

Herpes zoster with involvement of anterior horn cells.

McINTYRE JH.

PMID: 14869702 [PubMed - indexed for MEDLINE]

10934: Sem Hop. 1951 Sep 2-6;27(65-66):2612-5.

[Localized zona, pathogenesis.]

[Article in Undetermined Language]

MAZET G.

PMID: 14883878 [PubMed - OLDMEDLINE]

10935: Dtsch Med Wochenschr. 1951 Aug 31;76(35):1066-9.

[Herpes zoster therapy with ganglia blocking preparation pendiomid (9295 Ciba).]

[Article in Undetermined Language]

NORPOTH L, DRUGEMOLLER P, FLOSSDORF T.

PMID: 14879578 [PubMed - indexed for MEDLINE]

10936: Orv Hetil. 1951 Aug 12;92(32):1041-2.

[Polyganglionic radiculitis in a case of herpes zoster.]

[Article in Undetermined Language]

PALFFY G.

PMID: 14863905 [PubMed - indexed for MEDLINE]

10937: J Am Med Assoc. 1951 Aug 11;146(15):1410-2.

Cytologic smears in diagnosis of herpes simplex, herpes zoster, and varicella.

BLANK H, BURGOON CF, BALDRIDGE GD, McCARTHY PL, URBACH F.

PMID: 14850308 [PubMed - indexed for MEDLINE]

10938: Prensa Med Argent. 1951 Aug 3;38(31):1942-4.

[Herpes zoster, D. H. E. 45 therapy.]

[Article in Undetermined Language]

CAPORALETTI A.

PMID: 14864358 [PubMed - indexed for MEDLINE]

10939: Rev Med Chir Mal Foie. 1951 Aug-Sep;26(8-9):14-5.

[Alternation of hepato-biliary crises with zona.]

[Article in Undetermined Language]

CORSET P.

PMID: 14900791 [PubMed - indexed for MEDLINE]

10940: Acta Otolaryngol. 1951 Aug;39(4):291-5.

Disturbances of smell in course of herpes zoster cephalicus.

LASKIEWICZ A.

PMID: 14868478 [PubMed - indexed for MEDLINE]

10941: AMA Arch Derm Syphilol. 1951 Aug;64(2):192-4.

Generalized herpes zoster encephalitis and lymphatic leukemia. a case report.

FRANK L.

PMID: 14856409 [PubMed - indexed for MEDLINE]

10942: Vie Med. 1951 Jul;32(7):29-30.

[Management of herpes zoster. Conclusion of the inquiry.]

[Article in Undetermined Language]

LE GOARANT de TROMELIN.

PMID: 14867196 [PubMed - indexed for MEDLINE]

10943: Vie Med. 1951 Jul;32(7):22-6.

[Management of herpes zoster and its complications. Radiotherapy should be early,
at the beginning of the disease.]

[Article in Undetermined Language]

GUGLIEMI M.

PMID: 14867195 [PubMed - indexed for MEDLINE]

10944: Vie Med. 1951 Jul;32(7):21-2.

[Management of herpes zoster and its complications. Various treatments must
frequently be combined from the start.]

[Article in Undetermined Language]

LAUGIER P.

PMID: 14867194 [PubMed - indexed for MEDLINE]

10945: Vie Med. 1951 Jul;32(7):16-9.

[Management of herpes zoster and its complications. Early, energetic treatment is
the best preventive of post-eruptive pain.]

[Article in Undetermined Language]

FOURNIER A.

PMID: 14867193 [PubMed - indexed for MEDLINE]

10946: Vie Med. 1951 Jul;32(7):8-15.

[The management of herpes zoster and its complications: ocular complications;
symptomatic treatment.]

[Article in Undetermined Language]

BEAUVIEUX J, JULIEN RG.

PMID: 14867192 [PubMed - indexed for MEDLINE]

10947: Am J Ophthalmol. 1951 Jul;34(7):1035-7.

Herpes zoster ophthalmicus.

AHL BN, NADBATH RP.

PMID: 14846877 [PubMed - indexed for MEDLINE]

10948: Paris Med. 1951 Jun 2-9;41(21-22):299.

[Syndrome of hepato-biliary tract and herpes zoster.]

[Article in Undetermined Language]

PARTURIER G, CORSET P.

PMID: 14853588 [PubMed - indexed for MEDLINE]

10949: South Med J. 1951 Jun;45(6):529-33.

Attenuated virus in autogenous blood serum as a therapeutic agent in herpes
zoster.

BONDURANT CP.

PMID: 14931027 [PubMed - indexed for MEDLINE]

10950: Acta Otolaryngol. 1951 Jun;39(2-3):172-5.

A case of lingual herpes zoster with homolateral facial paralysis.

JEPSEN O.

PMID: 14868461 [PubMed - OLDMEDLINE]

10951: Gazz Med Ital. 1951 Jun;110(6):204-6.

[A modern therapeutic application in herpes zoster; experimental contribution.]

[Article in Undetermined Language]

SACINO G.

PMID: 14860432 [PubMed - indexed for MEDLINE]

10952: Alger Medicale. 1951 Jun-Jul;55(6):965-7.

[Herpes zoster of the cornea and aureomycin.]

[Article in Undetermined Language]

FABREGOULE M, LARMANDE A.

PMID: 14856925 [PubMed - indexed for MEDLINE]

10953: Mil Surg. 1951 Jun;108(6):491-4.

Herpes zoster ophthalmicus successfully treated with aureomycin.

BENEDEK T.

PMID: 14852620 [PubMed - indexed for MEDLINE]

10954: Laval Med. 1951 Jun;16(6):763-9.

[Present-day treatment of zona.]

[Article in Undetermined Language]

BEAUDRY M.

PMID: 14851762 [PubMed - indexed for MEDLINE]

10955: Northwest Med. 1951 Jun;50(6):432.

Banthine in herpes zoster.

BROWN HS, REEKIE RD, SINCLAIR WJ.

PMID: 14843589 [PubMed - indexed for MEDLINE]

10956: Am J Ophthalmol. 1951 Jun;34(6):893-4.

Herpes zoster ophthalmicus. Report of a case successfully treated with
aureomycin.

PRITIKIN RI, DUCHON ML.

PMID: 14838072 [PubMed - indexed for MEDLINE]

10957: AMA Arch Derm Syphilol. 1951 Jun;63(6):772-6.

Generalized herpes zoster: report of a case following roentgen ray therapy,
associated with chronic lymphatic leukemia, leukemia cutis and Mikulicz's
syndrome.

BOSWORTH EL.

PMID: 14829061 [PubMed - indexed for MEDLINE]

10958: Br Med J. 1951 May 5;1(4713):987-91.

Investigation into the effects of aureomycin and chloramphenicol in herpes
zoster.

CARTER AB.

PMID: 14830825 [PubMed - indexed for MEDLINE]

10959: Bull Soc Fr Dermatol Syphiligr. 1951 May-Jun;58(3):334-5.

[Zona and cancer of the breast.]

[Article in Undetermined Language]

GROS CM, VEILLON A.

PMID: 14869996 [PubMed - indexed for MEDLINE]

10960: Riv Ital Stomatol. 1951 May;6(5):522-31.

[Contribution to the knowledge of the relationship between trauma and herpes
zoster (case following the alcoholization of the gasserian ganglion).]

[Article in Undetermined Language]

RUSCONI L.

PMID: 14865789 [PubMed - indexed for MEDLINE]

10961: Rev Laryngol Otol Rhinol (Bord). 1951 May-Jun;72(5-6):461-4.

[Auricular and trigeminal zoster.]

[Article in Undetermined Language]

MESNAGE J, RABECHAULT R.

PMID: 14865416 [PubMed - indexed for MEDLINE]

10962: Alger Medicale. 1951 May;55(5):918-22.

[Neuralgia following zoster cured by ACTH (325 milligr.).]

[Article in Undetermined Language]

LACROIX A, ANTOINE G, TIMSIT E.

PMID: 14856914 [PubMed - indexed for MEDLINE]

10963: Med Gen Fr. 1951 May;11(5):102-3.

[Therapy of zona by vitamin B12.]

[Article in Undetermined Language]

HEYBLON R.

PMID: 14852012 [PubMed - indexed for MEDLINE]

10964: Ann West Med Surg. 1951 May;5(5):487.

Herpes zoster appearing during cortisone therapy: case report.

FISHMAN HC.

PMID: 14838569 [PubMed - indexed for MEDLINE]

10965: Postgrad Med. 1951 May;9(5):433-5.

Treatment of herpes zoster.

EBERT MH.

PMID: 14833955 [PubMed - indexed for MEDLINE]

10966: J Lancet. 1951 May;71(5):184.

Herpes zoster with motor involvement.

TUDOR RB.

PMID: 14824718 [PubMed - indexed for MEDLINE]

10967: S Afr Med J. 1951 Apr 21;25(16):271-2.

Herpes zoster of the lower extremity.

SHEDROW A.

PMID: 14855020 [PubMed - indexed for MEDLINE]

10968: Presse Med. 1951 Apr 21;59(27):544.

[Zoster osteoporosis of the hand.]

[Article in Undetermined Language]

PIZON P.

PMID: 14844173 [PubMed - indexed for MEDLINE]

10969: Conn State Med J. 1951 Apr;15(4):334-5.

Herpes zoster.

BLUMER G.

PMID: 14887264 [PubMed - indexed for MEDLINE]

10970: Accad Medica. 1951 Apr;66(4):121-3.

[Efficacy of para-aminobenzoic acid (so-called vitamin H1) in the treatment of
herpes zoster.]

[Article in Undetermined Language]

ACCORNERO SR.

PMID: 14877432 [PubMed - indexed for MEDLINE]

10971: Medicina (Madr). 1951 Apr;19(4):297-9.

[Aureomycin in herpes zoster.]

[Article in Undetermined Language]

DIEZ APARICIO JL.

PMID: 14852363 [PubMed - indexed for MEDLINE]

10972: Am J Ophthalmol. 1951 Apr;34(4):623-5.

Herpes zoster ophthalmicus treated with chloromycetin.

BEIL WC, KEITH F, MIMS JL Jr.

PMID: 14819197 [PubMed - indexed for MEDLINE]

10973: Sven Lakartidn. 1951 Mar 30;48(13):760-6.

[Treatment of herpes zoster with aureomycin.]

[Article in Undetermined Language]

BLUMENTHAL B.

PMID: 14835369 [PubMed - indexed for MEDLINE]

10974: Orv Hetil. 1951 Mar 25;92(12):388-9.

[Aureomycin therapy.]

[Article in Undetermined Language]

VARKONYI G.

PMID: 13046844 [PubMed - indexed for MEDLINE]

10975: Sven Lakartidn. 1951 Mar 22;48(12):721-2.

[Aureomycin and herpes zoster.]

[Article in Undetermined Language]

LINDBERG G.

PMID: 14835359 [PubMed - indexed for MEDLINE]

10976: Nervenarzt. 1951 Mar 20;22(3):110.

[Transverse myelitis in herpes zoster.]

[Article in Undetermined Language]

BIRKMAYER W.

PMID: 14833498 [PubMed - indexed for MEDLINE]

10977: Sven Lakartidn. 1951 Mar 9;48(10):583-8.

[Case of herpes zoster treated with aureomycin.]

[Article in Undetermined Language]

SCHERSTEN B.

PMID: 14835342 [PubMed - indexed for MEDLINE]

10978: Cas Lek Cesk. 1951 Mar 9;90(10):299-302.

[Significance of pathology of the intervertebral disks in herpes zoster.]

[Article in Undetermined Language]

VRANESIC Z.

PMID: 14821999 [PubMed - indexed for MEDLINE]

10979: Med J Aust. 1951 Mar 3;1(9):339.

Report of two cases of herpes zoster treated with "chloromycetin".

BABBAGE NF.

PMID: 14826185 [PubMed - indexed for MEDLINE]

10980: Z Haut Geschlechtskr. 1951 Mar 1;10(5):186-8.

[Herpes zoster following calcification of a nucleus pulposus in the same region.]

[Article in Undetermined Language]

KRIEGK HJ.

PMID: 14836926 [PubMed - indexed for MEDLINE]

10981: Neurology. 1951 Mar-Apr;1(2):167-9.

Herpes zoster of the right trigeminal nerve with left hemiplegia.

HUGHES WN.

PMID: 14827069 [PubMed - indexed for MEDLINE]

10982: Conn State Med J. 1951 Mar;15(3):199-200.

Herpes zoster encephalitis; report of a case with recovery.

FOSTER JH, JACKSON AH.

PMID: 14822525 [PubMed - indexed for MEDLINE]

10983: Ann Ottalmol Clin Ocul. 1951 Mar;77(3):101-14.

[Zosteriform eruption and ocular hypertension.]

[Article in Undetermined Language]

ROSSETTI D.

PMID: 14819834 [PubMed - indexed for MEDLINE]

10984: J Am Med Assoc. 1951 Feb 24;145(8):560-1.

Herpes zoster with a varicelliform eruption and parotitis in chronic leukemia.

GELFAND ML.

PMID: 14794487 [PubMed - indexed for MEDLINE]

10985: Pediatrics. 1951 Feb;7(2):200-5.

Neurologic complications of herpes zoster.

NACHMAN AR.

PMID: 14827622 [PubMed - indexed for MEDLINE]

10986: G Clin Med. 1951 Feb;32(2):235.

[Herpes zoster and the new antibiotics.]

[Article in Undetermined Language]

TELO W.

PMID: 14823372 [PubMed - indexed for MEDLINE]

10987: AMA Arch Neurol Psychiatry. 1951 Feb;65(2):131-45.

Postherpetic trigeminal neuralgia.

SUGAR O, BUCY PC.

PMID: 14798991 [PubMed - indexed for MEDLINE]

10988: South Med J. 1951 Feb;44(2):137-40.

Herpes laryngis: herpes zoster of the vagus nerve.

McGOVERN FH.

PMID: 14798555 [PubMed - indexed for MEDLINE]

10989: Minerva Med. 1951 Jan 27;42(5):157-9.

[Herpes zoster and motor paralysis of the muscles of the abdominal wall.]

[Article in Undetermined Language]

DE DOMINICIS G.

PMID: 14826588 [PubMed - OLDMEDLINE]

10990: Izv Meditsinskite Inst Bulg Akad Naukite Sofia Otd Biol Meditsinski Nauki.
1951;4-5:275-80.

[Case of simultaneous pulmonary tuberculosis and herpes zoster ophthalmicus;
cure; preliminary communication.]

[Article in Undetermined Language]

MINCHEV S.

PMID: 14937918 [PubMed - OLDMEDLINE]

10991: Bull Soc Pathol Exot Filiales. 1951;44(7-8):425-6.

[2 Cases of intercostal herpes zoster induced by penicillin therapy.]

[Article in Undetermined Language]

CASILE M, SACCHARIN H.

PMID: 14905190 [PubMed - OLDMEDLINE]

10992: Dermatologica. 1951;103(2):109-16.

Some climatological and other particulars on herpes zoster from the northern and 
southern hemisphere; contribution to dermatology in the tropics.

SIMONS RD.

PMID: 14872645 [PubMed - indexed for MEDLINE]

10993: Klin Monatsblatter Augenheilkd Augenarztl Fortbild. 1951;118(6):620-9.

[Scleral staphyloma following ophthalmic herpes zoster.]

[Article in Undetermined Language]

ADELUNG JC.

PMID: 14862075 [PubMed - indexed for MEDLINE]

10994: Acta Derm Venereol. 1951;31(4):486-8.

Case of herpes zoster generalisatus.

LECZINSKY CG.

PMID: 14856598 [PubMed - indexed for MEDLINE]

10995: Confin Neurol. 1951;11(4):227-40.

Bactifebrin therapy of acute encephalo-radiculo-neuritis and
myelo-radiculo-neuritis.

ROSENZWEIG A.

PMID: 14849142 [PubMed - indexed for MEDLINE]

10996: Acta Ophthalmol (Copenh). 1951;29(2):227-31.

Increased intraocular pressure associated with herpes zoster ophthalmicus without
any signs of iritis.

SALOMAA S.

PMID: 14846578 [PubMed - indexed for MEDLINE]

10997: Rev Neurol (Paris). 1951 Jan;84(1):59-60.

[Recurrent zosteriform eruption following disk compression with retrolisthesis.]

[Article in Undetermined Language]

TARDIEU G, LIQUIER A, CAROIT M.

PMID: 14845360 [PubMed - OLDMEDLINE]

10998: Bull Soc Fr Dermatol Syphiligr. 1951 Jan-Feb;58(1):62-3.

[Coexistence of ophthalmic zona and chickenpox in the same patient; aureomycin
therapy.]

[Article in Undetermined Language]

VERNIER L, FOUCHE G.

PMID: 14839440 [PubMed - indexed for MEDLINE]

10999: Bull Soc Fr Dermatol Syphiligr. 1951 Jan-Feb;58(1):54-5.

[Cervical zona in a newborn evolving from birth.]

[Article in Undetermined Language]

CLEISZ L, BOLGERT M, LE SOURD M, HABIB G, DEVENY P.

PMID: 14839435 [PubMed - indexed for MEDLINE]

11000: Acta Derm Venereol. 1951;31(3):275-7.

Trauma and herpes zoster.

TOTTIE M.

PMID: 14837651 [PubMed - indexed for MEDLINE]

11001: Arch Ital Dermatol Sifilogr Venereol. 1951;24(1):27-32.

[Zoster and chickenpox.]

[Article in Undetermined Language]

TORCHI M.

PMID: 14820512 [PubMed - indexed for MEDLINE]

11002: Actas Dermosifiliogr. 1951 Jan;42(4):412-4.

[Rare localization of herpes zoster (femoral region).]

[Article in Undetermined Language]

AGUILERA MARURI C.

PMID: 14818849 [PubMed - indexed for MEDLINE]

11003: Z Haut Geschlechtskr. 1951 Jan 1;10(1):16-9.

[Atypical herpes zoster or epizoonosis (trombidiosis)?]

[Article in Undetermined Language]

WESENER G.

PMID: 14818250 [PubMed - indexed for MEDLINE]

11004: Am J Ophthalmol. 1951 Jan;34(1):45-8.

Herpes zoster ophthalmicus with bilateral hemorrhagic retinopathy.

BARTLETT RE, MUMMA CS, IRVINE AR.

PMID: 14799578 [PubMed - indexed for MEDLINE]

11005: Calif Med. 1951 Jan;74(1):41-2.

Anal herpes with generalized varicelliform eruption. Report of a case.

HAMILTON CI Jr, PERKINS EK.

PMID: 14792379 [PubMed - indexed for MEDLINE]

11006: AMA Arch Derm Syphilol. 1951 Jan;63(1):134-5.

Treatment of herpes zoster ophthalmicus with aureomycin.

ROSENBERG WA.

PMID: 14789217 [PubMed - indexed for MEDLINE]

11007: Ann Otolaryngol Chir Cervicofac. 1951;68(8-9):745-7.

[Case of herpes zoster of the facial, cochlear and vestibular nerves.]

[Article in Undetermined Language]

MADURO R.

PMID: 12986477 [PubMed - OLDMEDLINE]

11008: Br Med J. 1950 Dec 23;2(4694):1424-5.

Herpes zoster provoked by smallpox vaccination.

GREENWOOD K.

PMID: 14792047 [PubMed - indexed for MEDLINE]

11009: Sem Hop. 1950 Dec 10;26(91):4717-8.

[Vasomotor and trophic sequels of zona.]

[Article in Undetermined Language]

ISEMEIN, PERDRIX, REDON.

PMID: 14809321 [PubMed - indexed for MEDLINE]

11010: Prensa Med Argent. 1950 Dec 8;37(49):2978-81.

[Herpes zoster.]

[Article in Undetermined Language]

STEINBERG IR, MARZETTI AA.

PMID: 14797605 [PubMed - indexed for MEDLINE]

11011: Neurol Psychiatr Ceskoslov. 1950 Dec;13(6):350-4.

[The viruses of herpes zoster, choriomeningitis and rabies.]

[Article in Undetermined Language]

LEPINE P.

PMID: 14833524 [PubMed - indexed for MEDLINE]

11012: Boll Ocul. 1950 Dec;29(12):788-94.

[Lysozymic rate of aqueous humor in induced herpetic keratitis.]

[Article in Undetermined Language]

MARSICO V.

PMID: 14821077 [PubMed - indexed for MEDLINE]

11013: Boll Ocul. 1950 Dec;29(12):745-50.

[Case of simultaneous bilateral herpetic keratitis.]

[Article in Undetermined Language]

PANZARDI D.

PMID: 14821075 [PubMed - indexed for MEDLINE]

11014: Ann Ocul (Paris). 1950 Dec;183(12):1034-9.

[The treatment of zona ophthalmica.]

[Article in Undetermined Language]

MAGITOT A.

PMID: 14800052 [PubMed - indexed for MEDLINE]

11015: N Y State J Med. 1950 Dec 1;50(23):2825-6.

A further report on the use of ether in the treatment of herpetic keratitis.

KRONENBERG B.

PMID: 14796849 [PubMed - indexed for MEDLINE]

11016: Am J Ophthalmol. 1950 Dec;33(12):1921-2.

Epidemic herpes zoster ophthalmicus. Report of a case treated with aureomycin.

SHIER JM, PROVISOR B.

PMID: 14789945 [PubMed - indexed for MEDLINE]

11017: U S Armed Forces Med J. 1950 Dec;1(12):1499-1502.

Herpes zoster concurrent with varicelliform eruption. Report of 5 cases.

HENDERSON AT, YOUNG DC.

PMID: 14788438 [PubMed - indexed for MEDLINE]

11018: J Prat Rev Gen Clin Ther. 1950 Nov 30;64(48):586.

[Therapy of herpes and herpes zoster with intravenous vitamin C.]

[Article in Undetermined Language]

ZUREICK M.

PMID: 14908970 [PubMed - indexed for MEDLINE]

11019: Ugeskr Laeger. 1950 Nov 23;112(47):1640-1.

[Aureomycin therapy of herpes zoster.]

[Article in Undetermined Language]

HVID-HANSEN N.

PMID: 14855664 [PubMed - indexed for MEDLINE]

11020: Wis Med J. 1950 Nov;49(11):1025.

Additional thoughts about herpes zoster.

TATUM AL.

PMID: 14788856 [PubMed - indexed for MEDLINE]

11021: Nurs Mirror Midwives J. 1950 Oct 27;92(Emergency News Letter):3-4.

Cause, treatment, prognosis of shingles.

ROBERTS A.

PMID: 14807124 [PubMed - indexed for MEDLINE]

11022: Ugeskr Laeger. 1950 Oct 5;112(40):1391-3.

[Aureomycin in the treatment of ophthalmic herpes zoster.]

[Article in Undetermined Language]

JESSEN H, MOSEGAARD KE.

PMID: 14788371 [PubMed - indexed for MEDLINE]

11023: N Z Med J. 1950 Oct;49(273):569-71.

Herpes zoster with involvement of anterior horn cells.

McINTYRE JH.

PMID: 14806884 [PubMed - indexed for MEDLINE]

11024: Riforma Med. 1950 Sep 16;64(37):1015-8.

[Treatment of herpes zoster with liver extracts.]

[Article in Undetermined Language]

GOBBO A.

PMID: 14787166 [PubMed - indexed for MEDLINE]

11025: Nord Med. 1950 Sep 15;44(37):1475-8.

[Herpes zoster and leukemia.]

[Article in Undetermined Language]

HALLGREN BE.

PMID: 14806941 [PubMed - indexed for MEDLINE]

11026: Sem Hop. 1950 Sep 10;26(67):3572-9.

[Viral neuralgias (herpes zoster encephalitis); amputation stump pains.]

[Article in Undetermined Language]

DURUPT L.

PMID: 14781922 [PubMed - indexed for MEDLINE]

11027: Arztl Wochensch. 1950 Sep 1;5(34):657-9.

[Treatment of herpes zoster, with a note on the effect of aureomycin.]

[Article in Undetermined Language]

HOFFMEISTER W.

PMID: 14789634 [PubMed - indexed for MEDLINE]

11028: Laryngoscope. 1950 Sep;60(9):939-44.

Aureomycin in treatment of otitic and ophthalmic herpes zoster.

GANS EW.

PMID: 14779416 [PubMed - indexed for MEDLINE]

11029: U S Armed Forces Med J. 1950 Sep;1(9):1045-7.

Treatment of herpes zoster with protamide.

MARSH WC.

PMID: 14776843 [PubMed - indexed for MEDLINE]

11030: Arch Pediatr. 1950 Sep;67(9):397-9.

Herpes zoster in the newborn associated with congenital blindness; report of
case.

COUNTER CE, KORN BJ.

PMID: 14771967 [PubMed - indexed for MEDLINE]

11031: Dtsch Med Wochenschr. 1950 Aug 11;75(31-32):1033-5.

[Treatment of pain following herpes zoster.]

[Article in Undetermined Language]

SCHMITT W.

PMID: 14773285 [PubMed - indexed for MEDLINE]

11032: Med Klin. 1950 Jul 28;45(30):931-2.

[Penicillin therapy of ischialgia and herpes zoster.]

[Article in Undetermined Language]

HERRLIGKOFFER KM.

PMID: 15438600 [PubMed - indexed for MEDLINE]

11033: Arztl Wochensch. 1950 Jul 21;5(28):512-5.

[Herpes zoster following transfusion.]

[Article in Undetermined Language]

VOEGT H, ROESTER U.

PMID: 15432227 [PubMed - indexed for MEDLINE]

11034: Lyon Chir. 1950 Jul;45(5):539-40.

[Treatment of the pain following zoster.]

[Article in Undetermined Language]

LERICHE R.

PMID: 15429327 [PubMed - indexed for MEDLINE]

11035: Rev Neurol (Paris). 1950 Jul;83(1):30-1.

[Virus of herpes, herpes zoster choriomeningitis & rabies.]

[Article in Undetermined Language]

LEPINE P.

PMID: 14787026 [PubMed - indexed for MEDLINE]

11036: Rev Bras Med. 1950 Jul;7(7):457-60.

[Recapitulation of herpes zoster.]

[Article in Undetermined Language]

GARCIA DE LIMA E.

PMID: 14781477 [PubMed - indexed for MEDLINE]

11037: Bull Mem Soc Med Hop Paris. 1950 Jun 30-Jul 7;66(23-24):1218-21.

[Zona and aureomycin.]

[Article in Undetermined Language]

TZANCK A, ALBAHARY C, CALDERA R.

PMID: 14777974 [PubMed - indexed for MEDLINE]

11038: J Prat Rev Gen Clin Ther. 1950 May 4;64(18):214.

[Aureomycin: use in the treatment of zoster.]

[Article in Undetermined Language]

REYMOND JC.

PMID: 15437385 [PubMed - indexed for MEDLINE]

11039: Z Haut Geschlechtskr. 1950 May 1;8(9):333-42.

[Clinical manifestation of the Sanarelli-Shwartzman phenomenon in dermatology. I.
Herpes zoster generalisatus and the Sanarelli-Shwartzman phenomenon.]

[Article in Undetermined Language]

RICHTER R, JOHNE HO.

PMID: 15431793 [PubMed - indexed for MEDLINE]

11040: Ophthalmologica. 1950 May;119(5):285-91.

Herpes zoster generalisatus with complications of the eye.

FORSIUS H.

PMID: 15417176 [PubMed - indexed for MEDLINE]

11041: Am J Ophthalmol. 1950 May;33(5):790-1.

Herpes zoster disciform keratitis.

GAYNON IE.

PMID: 15413682 [PubMed - indexed for MEDLINE]

11042: N Y State J Med. 1950 May 1;50(9):1112.

Herpes zoster treated with chloromycetin.

ST JOHN DB.

PMID: 15412720 [PubMed - indexed for MEDLINE]

11043: J Mich State Med Soc. 1950 Apr;49(4):452-3.

Chickenpox and herpes zoster; simultaneous occurrence in same patient.

WATSON EH.

PMID: 15415719 [PubMed - indexed for MEDLINE]

11044: Am J Med. 1950 Apr;8(4):456-67.

Zoster-like eruptions caused by the virus of herpes simplex.

SLAVIN HB, FERGUSON JJ Jr.

PMID: 15410724 [PubMed - indexed for MEDLINE]

11045: Cyprus Med J. 1950 Mar;3(5):360-1.

One case of rare manifestation of herpes zoster.

SPANOPOULOS GJ.

PMID: 14773206 [PubMed - indexed for MEDLINE]

11046: Pol Tyg Lek (Wars). 1950 Feb 20;5(8):297-8.

[A contribution to the study of correlation of chickenpox and herpes zoster.]

[Article in Undetermined Language]

MARCINKOWSKI T.

PMID: 15440410 [PubMed - indexed for MEDLINE]

11047: Med Press. 1950 Feb 8;223(6):126-8.

The relationship between herpes zoster and varicella.

BARNETT CH.

PMID: 15406059 [PubMed - indexed for MEDLINE]

11048: U S Armed Forces Med J. 1950 Feb;1(2):222-4.

Herpes zoster with concurrent encephalitis; report of a case.

HENDERSON AT, YOUNG DC, KEMPTON GB.

PMID: 15410222 [PubMed - indexed for MEDLINE]

11049: Wis Med J. 1950 Feb;49(2):142.

Newer drugs in the treatment of herpes zoster.

BECKMAN H.

PMID: 15409982 [PubMed - indexed for MEDLINE]

11050: Ann Intern Med. 1950 Feb;32(2):257-60.

The use of sympathetic nerve block in the ambulatory patient with special
reference to its use in herpes zoster.

FERRIS LM, MARTIN GH.

PMID: 15403190 [PubMed - indexed for MEDLINE]

11051: Med Press. 1950 Jan 18;223(3):54-6.

Herpes zoster ophthalmicus.

PENMAN GG.

PMID: 15401523 [PubMed - indexed for MEDLINE]

11052: Bull Mem Soc Med Hop Paris. 1950;66(21-22):1116-20.

[Herpes zoster in cancerous subjects.]

[Article in Undetermined Language]

HUGUENIN R, FAUVET J, PIERART A.

PMID: 15434697 [PubMed - indexed for MEDLINE]

11053: Accad Medica. 1950 Jan;65(1):18.

[Herpes zoster of the VIII beginning with erysipelas; Ramsay Hunt syndrome.]

[Article in Undetermined Language]

LIVERIERO E.

PMID: 15425267 [PubMed - indexed for MEDLINE]

11054: Rev Otoneuroophtalmol. 1950 Jan;22(1):51-3.

[Hypertensive zoster iritis.]

[Article in Undetermined Language]

FARNARIER G, BREMOND J, SOBREPERE G.

PMID: 15424568 [PubMed - indexed for MEDLINE]

11055: R I Med J. 1950 Jan;33(1):28.

Herpes zoster oticus; report of a case.

McDONALD CA, O'CONNELL WJ.

PMID: 15409481 [PubMed - indexed for MEDLINE]

11056: Arch Otolaryngol. 1950 Jan;51(1):73-82, illust.

Herpes zoster oticus (Ramsay Hunt's syndrome) comments on an article by Johnson
and Zonderman.

TSCHIASSNY K.

PMID: 15408839 [PubMed - indexed for MEDLINE]

11057: Acta Derm Venereol. 1950;30(1):34-46.

The incidence of zoster, particularly zoster ophthalmicus.

BJORK A.

PMID: 15403959 [PubMed - indexed for MEDLINE]

11058: J Laryngol Otol. 1950 Jan;64(1):17.

A case of herpes zoster confined to the tenth cranial nerve.

BATEMAN GH, MAWSON SR.

PMID: 15403561 [PubMed - indexed for MEDLINE]

11059: J Invest Dermatol. 1950 Jan;14(1):53-6.

Herpes zoster; treatment of pain with dehydroergotamine-45.

COMBES FC, CANIZARES O, SIMUANGCO S.

PMID: 15402167 [PubMed - indexed for MEDLINE]

11060: J Radiol Electrol Arch Electr Medicale. 1950;31(11-12):772-4.

[Herpes zoster and cancer of the breast.]

[Article in Undetermined Language]

GROS CM, VEILLON A.

PMID: 14825362 [PubMed - indexed for MEDLINE]

11061: Acta Anat (Basel). 1950;10(4):363-76.

[Morphologic investigations on the pathogenesis of Zoster.]

[Article in Undetermined Language]

von HEILBORN F.

PMID: 14810404 [PubMed - indexed for MEDLINE]

11062: Arch Ital Dermatol Sifilogr Venereol. 1950;23(4):300-4.

[Bismuth camphocarbonate in the treatment of herpes zoster.]

[Article in Undetermined Language]

LOT G.

PMID: 14772021 [PubMed - indexed for MEDLINE]

11063: N Engl J Med. 1949 Dec 29;241(26):1037-47.

Aureomycin treatment of herpes zoster.

FINLAND M, FINNERTY EF Jr, et al.

PMID: 15398246 [PubMed - indexed for MEDLINE]

11064: Br Med J. 1949 Dec 10;2(4640):1323-8.

Herpes zoster after irradiation.

ELLIS F, STOLL BA.

PMID: 15396846 [PubMed - indexed for MEDLINE]

11065: J Am Med Assoc. 1949 Dec 10;141(15):1050.

Treatment of herpes zoster with aureomycin.

BINDER ML, STUBBS LE.

PMID: 15394064 [PubMed - indexed for MEDLINE]

11066: Arch Intern Med (Chic). 1949 Dec;84(6):907-16.

Motor manifestations of herpes zoster; report of a case of associated permanent
paralysis of the phrenic nerve.

HALPERN SL, COVNER AH.

PMID: 15408090 [PubMed - OLDMEDLINE]

11067: Arch Ophthal. 1949 Dec;42(6):808-12.

Herpes zoster ophthalmicus sine eruption.

ROSS JV.

PMID: 15396395 [PubMed - indexed for MEDLINE]

11068: Lancet. 1949 Nov 26;2(6587):985-7.

Acute disseminated encephalomyelitis following herpes zoster, vaccination, and
immunization.

WOLMAN L.

PMID: 15407725 [PubMed - indexed for MEDLINE]

11069: Am J Ophthalmol. 1949 Nov;32(11):1592.

Herpes zoster ophthalmicus initiated by keratitis.

THUMIM M.

PMID: 15406715 [PubMed - indexed for MEDLINE]

11070: Arch Neurol Psychiatry. 1949 Nov;62(5):638-52.

Herpes zoster of the seventh, eighth, ninth and tenth cranial nerves.

ENGSTROM H, WOHLFART G.

PMID: 15396341 [PubMed - indexed for MEDLINE]

11071: Arch Derm Syphilol. 1949 Nov;60(5, Pt. 1):641-8.

Histologic changes in sensory nerves of the skin in herpes zoster.

EBERT MH.

PMID: 15390442 [PubMed - indexed for MEDLINE]

11072: J Okla State Med Assoc. 1949 Oct;42(10):429-32.

The treatment of herpes zoster.

DOYLE WH.

PMID: 18148123 [PubMed - indexed for MEDLINE]

11073: Am J Clin Pathol. 1949 Oct;19(10):981-4.

Reticulo-epithelioid cell granulomas in bone marrow in herpes zoster; report of
case.

SCHLEICHER EM.

PMID: 18147963 [PubMed - indexed for MEDLINE]

11074: Union Med Can. 1949 Oct;78(10):1237.

[Not Available.]

[Article in Undetermined Language]

GOBEIL LJ.

PMID: 18143821 [PubMed - indexed for MEDLINE]

11075: Ann Surg. 1949 Oct;130(4):622-36.

Herpes zoster; a surgical procedure for the treatment of post-herpetic neuralgia.

BROWDER J, DeVEER JA.

PMID: 18143173 [PubMed - indexed for MEDLINE]

11076: Arch Derm Syphilol. 1949 Oct;60(4):636-8.

Autohemotherapy of herpex zoster; results in 154 cases.

POTH DO.

PMID: 18140385 [PubMed - OLDMEDLINE]

11077: Arch Derm Syphilol. 1949 Oct;60(4):558-69.

Paralysis of cranial nerves complicating herpes zoster.

COSTELLO MJ, SCOTT MJ.

PMID: 18140378 [PubMed - OLDMEDLINE]

11078: Ann Surg. 1949 Oct;130(4):622-35.

Herpes Zoster: A Surgical Procedure for the Treatment of Postherpetic Neuralgia.

Browder J, de Veer JA.

PMID: 17859456 [PubMed]

11079: Med J Aust. 1949 Sep 10;2(11):380-2.

Herpes zoster of the nervus chorda tympani with facial paralysis.

FINDLAY JP.

PMID: 18143632 [PubMed - indexed for MEDLINE]

11080: Calif Med. 1949 Sep;71(3):214.

Aureomycin in the treatment of herpes zoster.

CASE RB.

PMID: 18229036 [PubMed - indexed for MEDLINE]

11081: J Hyg (Lond). 1949 Sep;47(3):253-62.

A study of herpes zoster particularly in its relationship to chickenpox.

SEILER HE.

PMID: 15408424 [PubMed - indexed for MEDLINE]

11082: Br Med J. 1949 Aug 13;2(4623):386.

Strains of Bact. coli.

BRAY J.

PMID: 18229034 [PubMed - OLDMEDLINE]

11083: J Med Lyon. 1949 Aug 5;30(710):604.

[Not Available.]

[Article in Undetermined Language]

FERRARI AV.

PMID: 18146939 [PubMed - OLDMEDLINE]

11084: Rev Bras Med. 1949 Aug;6(8):537-9.

[Not Available.]

[Article in Undetermined Language]

LACORTE JG.

PMID: 18143744 [PubMed - indexed for MEDLINE]

11085: South Med J. 1949 Aug;42(8):696.

Herpes zoster; treatment with chloramphenicol.

DAWSON LM, SIMON HE.

PMID: 18137594 [PubMed - indexed for MEDLINE]

11086: Rev Asoc Med Argent. 1949 Jul 15-30;63(657-658):326-30.

[Not Available.]

[Article in Undetermined Language]

BARDECI CA.

PMID: 18147593 [PubMed - indexed for MEDLINE]

11087: Arch Otolaryngol. 1949 Jul;48(1):1-8.

Herpes zoster oticus; Ramsay Hunt syndrome; report of a case.

JOHNSON L, ZONDERMAN B.

PMID: 18113035 [PubMed - indexed for MEDLINE]

11088: Br Med J. 1949 Jun 11;1(4614):1037.

Treatment of herpes zoster with liver extract.

GASKELL HS.

PMID: 18131644 [PubMed - OLDMEDLINE]

11089: Proc Soc Exp Biol Med. 1949 Jun;71(2):283-6.

Electron microscope studies of the vesicle and spinal fluids from a case of
herpes zoster.

EVANS AS, MELNICK JL.

PMID: 18134038 [PubMed - indexed for MEDLINE]

11090: Am J Med Sci. 1949 Jun;217(6):674-80.

On the occurrence of herpes zoster in carcinoma of the breast.

PENDERGRASS EP, KIRSH D.

PMID: 18129793 [PubMed - indexed for MEDLINE]

11091: Urol Cutaneous Rev. 1949 Jun;53(6):321-4.

Neurogenic bladder associated with herpes zoster.

SHULLENBERGER WA, WISHARD WN Jr.

PMID: 18121286 [PubMed - OLDMEDLINE]

11092: Minerva Med. 1949 May 26;40(25):754-8.

[Not Available.]

[Article in Undetermined Language]

DE LUCA R.

PMID: 18152475 [PubMed - indexed for MEDLINE]

11093: Med Press. 1949 May 25;221(21):510-2.

Ophthalmic herpes zoster with contralateral pontine lesions.

WORSTER-DROUGHT C, SARGENT F.

PMID: 18129950 [PubMed - OLDMEDLINE]

11094: Schweiz Med Wochenschr. 1949 May 14;79(19):436-8.

[Not Available.]

[Article in Undetermined Language]

DAHL S.

PMID: 18150479 [PubMed - indexed for MEDLINE]

11095: Arch Intern Med (Chic). 1949 May;83(5):502-4.

Concurrent herpes zoster and chickenpox; report of a case.

FETTER F, SCHNABEL TG.

PMID: 18129805 [PubMed - indexed for MEDLINE]

11096: J Neurol Neurosurg Psychiatry. 1949 May;12(2):152-4.

Some unusual complications of herpes zoster.

WHITTY CW, COOKE AM.

PMID: 18127085 [PubMed - indexed for MEDLINE]

11097: Lyon Med. 1949 Apr 10;181(15):234.

[Not Available.]

[Article in Undetermined Language]

FERRARI AV.

PMID: 18126872 [PubMed - OLDMEDLINE]

11098: J Invest Dermatol. 1949 Mar;12(3):153-5.

Treatment of herpes zoster with moccasin venom.

DENNIE CC, MORGAN DB, COOMBS FP.

PMID: 18117760 [PubMed - indexed for MEDLINE]

11099: N Y State J Med. 1949 Mar 1;49(5):531.

Ramsay Hunt's syndrome.

MELANT JH.

PMID: 18111011 [PubMed - indexed for MEDLINE]

11100: W V Med J. 1949 Mar;45(3):53-6.

Herpes zoster ophthalmicus; sodium iodide therapy.

MOORE TW.

PMID: 18109872 [PubMed - indexed for MEDLINE]

11101: Nature. 1949 Feb 12;163(4137):260.

Elementary bodies of varicella and herpes zoster.

FARRANT JL, O'CONNOR JL.

PMID: 18123486 [PubMed - indexed for MEDLINE]

11102: Arch Neurol Psychiatry. 1949 Feb;61(2):194-8.

Tetraethylammonium chloride in treatment of herpes zoster and intercostal
neuralgia.

FISHER RL, ZUKERMAN M, SWEENY DN Jr.

PMID: 18152784 [PubMed - OLDMEDLINE]

11103: New Orleans Med Surg J. 1949 Feb;101(8):378-80.

Herpes zoster therapy; pain relief by simple procedure.

FASTING GF.

PMID: 18109623 [PubMed - indexed for MEDLINE]

11104: Cesk Dermatol. 1949;24(2):73.

[Not Available.]

[Article in Undetermined Language]

WOHLSTEIN E.

PMID: 18236542 [PubMed - OLDMEDLINE]

11105: Am J Ophthalmol. 1949 Jan;32(1):130-4.

Herpes zoster ophthalmicus; a case with manifold complications.

PINCUS MH.

PMID: 18122920 [PubMed - OLDMEDLINE]

11106: Dtsch Z Nervenheilkd. 1949;160(1-2):43-8.

[Not Available.]

[Article in Undetermined Language]

SCHILF E.

PMID: 18117484 [PubMed - indexed for MEDLINE]

11107: Pediatriia. 1949 Jan-Feb;4(1):27-31.

[Interrelation of herpes zoster and chicken-pox.]

[Article in Undetermined Language]

VERCNER VN.

PMID: 18111417 [PubMed - indexed for MEDLINE]

11108: Br Med J. 1948 Dec 11;2(4588):1035.

Herpes zoster treated by anthisan.

HONIGSBERGER M.

PMID: 18100447 [PubMed - indexed for MEDLINE]

11109: Univ Hosp Bull. 1948 Dec;14(12):125-8.

Herpes zoster; review of the literature and report of a case.

HALEY RR.

PMID: 18109868 [PubMed - indexed for MEDLINE]

11110: Actas Dermosifiliogr. 1948 Dec;40(3):312-6.

[Not Available.]

[Article in Undetermined Language]

SICILIA, JAQUETI DEL POZO.

PMID: 18109062 [PubMed - OLDMEDLINE]

11111: Physiotherapy. 1948 Dec;34(12):205.

Treatment of ophthalmic herpes.

CUTNER M, STUTTARD M.

PMID: 18107282 [PubMed - OLDMEDLINE]

11112: J Prat Rev Gen Clin Ther. 1948 Nov 4;62(45):555-7.

[Not Available.]

[Article in Undetermined Language]

BRU P.

PMID: 18099181 [PubMed - indexed for MEDLINE]

11113: Philipp Med World. 1948 Nov;3(11):341-6.

Thiamine therapy of herpes zoster.

ORTIZ AL.

PMID: 18106593 [PubMed - indexed for MEDLINE]

11114: Med Ann Dist Columbia. 1948 Nov;17(11):617-20.

Meningo-encephalitis complicating thoracic herpes zoster; report of a case with
recovery.

BILLINGSLEY WK Jr.

PMID: 18102010 [PubMed - OLDMEDLINE]

11115: Ned Tijdschr Geneeskd. 1948 Oct 9;92(41):3195-3200.

[Not Available.]

[Article in Undetermined Language]

LORENTZ DE HAAS AM.

PMID: 18100650 [PubMed - OLDMEDLINE]

11116: Wien Klin Wochenschr. 1948 Oct 8;60(40):652-5.

[Not Available.]

[Article in Undetermined Language]

SCHNEIDER H.

PMID: 18102366 [PubMed - indexed for MEDLINE]

11117: J R Nav Med Serv. 1948 Oct;34(4):152.

Zoster lymphadenitis.

MALLOWS HR.

PMID: 18100829 [PubMed - indexed for MEDLINE]

11118: Prog Med (Paris). 1948 Sep 24;76(18):443-5.

[Not Available.]

[Article in Undetermined Language]

CHAVANY JA, GODLEWSKI S, et al.

PMID: 18887104 [PubMed - indexed for MEDLINE]

11119: U S Nav Med Bull. 1948 Sep-Oct;48(5):742-9.

Herpes zoster following exposure to varicella; treatment of herpes zoster with
cowpox vaccine.

HORTON SH Jr.

PMID: 18883807 [PubMed - indexed for MEDLINE]

11120: J Bacteriol. 1948 Sep;56(3):293-303.

The relationship of varicella and herpes zoster; electron microscope studies.

RAKE G, BLANK H, et al.

PMID: 18880570 [PubMed - indexed for MEDLINE]

11121: Arch Derm Syphilol. 1948 Sep;58(3):265-75.

Herpes zoster ophthalmicus; results of treatment with transfusions of
convalescent blood.

BECKER FT.

PMID: 18117049 [PubMed - indexed for MEDLINE]

11122: J Bacteriol. 1948 Sep;56(3):293-303.

The Relationship of Varicella and Herpes Zoster: Electron Microscope Studies.

Rake G, Blank H, Coriell LL, Nagler FP, Scott TF.

Division of Microbiology, The Squibb Institute for Medical Research, New
Brunswick, New Jersey.

PMID: 16561573 [PubMed]

11123: Cas Lek Cesk. 1948 Aug 20;87(32):887-9.

[Not Available.]

[Article in Undetermined Language]

PECHA J.

PMID: 18881349 [PubMed - OLDMEDLINE]

11124: Med J Aust. 1948 Jul 31;2(5):126.

Severe zoster associated with leuchaemia.

ANDERSON D.

PMID: 18881612 [PubMed - OLDMEDLINE]

11125: Br Med J. 1948 Jun 19;1(4563):1206.

Gastric herpes zoster.

FITZPATRICK PE.

PMID: 18865978 [PubMed - indexed for MEDLINE]

11126: Med Gen Fr. 1948 Jun 10;8(11):153.

[Not Available.]

[Article in Undetermined Language]

HALBRON P.

PMID: 18875932 [PubMed - indexed for MEDLINE]

11127: Br Med J. 1948 May 15;1(4558):953.

Accidental syphilis.

MARSHALL J.

PMID: 18858443 [PubMed - OLDMEDLINE]

11128: Dtsch Med Wochenschr. 1948 May 14;73(17-20):195-8.

[Not Available.]

[Article in Undetermined Language]

ZUR G.

PMID: 18869945 [PubMed - indexed for MEDLINE]

11129: Br Med J. 1948 May 8;1(4557):882.

Gastric herpes zoster.

STONE RV.

PMID: 18858427 [PubMed - OLDMEDLINE]

11130: Surgery. 1948 May;23(5):773-7.

Herpes zoster and the surgical abdomen.

BOSHER LH Jr, WILLIAMS C Jr.

PMID: 18915494 [PubMed - indexed for MEDLINE]

11131: Am J Syph Gonorrhea Vener Dis. 1948 May;32(3):286-8.

Simultaneous herpes zoster and lymphogranuloma venereum.

GARDNER L.

PMID: 18912218 [PubMed - indexed for MEDLINE]

11132: Med J Aust. 1948 Apr 17;1(16):542.

Herpes zoster with lymphocytic meningitis.

SHERWOOD J.

PMID: 18934583 [PubMed - indexed for MEDLINE]

11133: Arch Derm Syphilol. 1948 Apr;57(4):782.

Leukemic infiltration in scars of herpes zoster generalisatus.

NETHERTON EW.

PMID: 18886313 [PubMed - indexed for MEDLINE]

11134: Portland Clin Bull. 1948 Apr;1(4):75-82.

Relationship of trauma and herpes zoster; report of three cases.

SELLING L.

PMID: 18862789 [PubMed - indexed for MEDLINE]

11135: Ned Tijdschr Geneeskd. 1948 Mar 27;92(13):928.

[Not Available.]

[Article in Undetermined Language]

KORTMANN W.

PMID: 18870292 [PubMed - indexed for MEDLINE]

11136: Br Med J. 1948 Mar 13;1(4549):521.

Rarer manifestations of herpes zoster.

GUTHANER E.

PMID: 18933736 [PubMed - indexed for MEDLINE]

11137: Dtsch Med Wochenschr. 1948 Mar 12;73(9-12):119.

[Not Available.]

[Article in Undetermined Language]

FRANK A.

PMID: 18914563 [PubMed - indexed for MEDLINE]

11138: Arch Derm Syphilol. 1948 Mar;57(3):319-27.

Herpes zoster associated with monocytic leukemia.

BLUEFARB SM.

PMID: 18871393 [PubMed - OLDMEDLINE]

11139: Arch Derm Syphilol. 1948 Mar;57(3 Pt. 2):568.

Causalgic state secondary to brachial herpes zoster.

AYRES S Jr.

PMID: 18098716 [PubMed - indexed for MEDLINE]

11140: Br Med J. 1948 Feb 21;1(4546):365.

Herpes zoster and varicella.

DICKSON JW, BLAIR G.

PMID: 18933247 [PubMed - indexed for MEDLINE]

11141: Bras Med. 1948 Feb 7-14;62(6-7):39.

[Not Available.]

[Article in Undetermined Language]

FERRARI A.

PMID: 18908110 [PubMed - indexed for MEDLINE]

11142: Klin Med Osterr Z Wiss Prakt Med. 1948 Jan 15;3(2):73.

[Not Available.]

[Article in Undetermined Language]

TAPPEINER.

PMID: 18933781 [PubMed - indexed for MEDLINE]

11143: Klin Med Osterr Z Wiss Prakt Med. 1948 Jan 15;3(2):73.

[Not Available.]

[Article in Undetermined Language]

TAPPEINER.

PMID: 18906751 [PubMed - indexed for MEDLINE]

11144: Br Med J. 1948 Jan 3;1(4539):8-10.

Rarer manifestations of herpes zoster; a report on three cases.

PARKINSON T.

PMID: 18920007 [PubMed - indexed for MEDLINE]

11145: J Neuropathol Exp Neurol. 1948 Jan;7(1):100.

Pathologic changes in early herpes zoster.

RIGGS HE, RUPP C.

PMID: 18917339 [PubMed - indexed for MEDLINE]

11146: Vestn Otorinolaringol. 1948 Jan-Feb;58(1):81.

[Herpes zoster oticus.]

[Article in Undetermined Language]

IAZYKOV SA.

PMID: 18887457 [PubMed - indexed for MEDLINE]

11147: Acta Psychiatr Neurol. 1948;23(1-2):69-77.

Pathogenesis of cranial nerve lesions, notably ophthalmoplegias, complicating
herpes zoster ophthalmicus.

GODTFREDSEN E.

PMID: 18881892 [PubMed - OLDMEDLINE]

11148: Acta Psychiatr Neurol. 1948;23(1-2):13-48.

Herpes zoster following operations for facial pain; a clinical investigation of
830 cases.

EPSTEIN L.

PMID: 18881889 [PubMed - indexed for MEDLINE]

11149: Dermatologica. 1948;96(5):373-6.

[Not Available.]

[Article in Undetermined Language]

FELLNER M.

PMID: 18880899 [PubMed - indexed for MEDLINE]

11150: Dermatologica. 1948;97(1-3):78-80.

[Not Available.]

[Article in Undetermined Language]

PICARD H.

PMID: 18100135 [PubMed - indexed for MEDLINE]

11151: Lancet. 1947 Dec 27;2(6487):946.

Glossopharyngeal zoster followed by varicella in two contacts.

WRIGHT FJ.

PMID: 18897739 [PubMed - OLDMEDLINE]

11152: Lancet. 1947 Dec 20;2(6486):910.

Bilateral zoster; report of a case.

THOMAS EW.

PMID: 18896092 [PubMed - indexed for MEDLINE]

11153: N Z Med J. 1947 Dec;46(256):538.

Herpes zoster and varicella in the same patient.

VALENTINE JJ.

PMID: 18920225 [PubMed - OLDMEDLINE]

11154: J Philipp Med Assoc. 1947 Dec;23(12):593-9.

Treatment of herpes zoster with cobra venom and sulfanilamide; report of 5 cases.

TAN MG, INES-TAN AR.

PMID: 18902799 [PubMed - indexed for MEDLINE]

11155: J Med Lyon. 1947 Nov 5;28(668):795-806.

[Not Available.]

[Article in Undetermined Language]

GIRARD PF, GARDE A.

PMID: 18899139 [PubMed - indexed for MEDLINE]

11156: Bol Veracruz Mexico. 1947 Nov-Dec;8(5-6):3-5.

[Not Available.]

[Article in Undetermined Language]

SAINZ TREJO.

PMID: 18909476 [PubMed - indexed for MEDLINE]

11157: Concours Med. 1947 Sep 20;69(38):1569.

[Not Available.]

[Article in Undetermined Language]

GAILLARD P.

PMID: 18898087 [PubMed - indexed for MEDLINE]

11158: Ann Dermatol Syphiligr (Paris). 1947 Jun;7(6):202.

[Not Available.]

[Article in Undetermined Language]

FLANDIN C.

PMID: 18900222 [PubMed - indexed for MEDLINE]

11159: Dtsch Zahnarztl Z. 1947;2(19-20):701.

[Not Available.]

[Article in Undetermined Language]

WENZEL H.

PMID: 18935669 [PubMed - indexed for MEDLINE]

11160: Actas Dermosifiliogr. 1947-1948;39(1):87-93.

[Not Available.]

[Article in Undetermined Language]

DE LAS OBRAS Y LOSCERTALES JM.

PMID: 18903793 [PubMed - indexed for MEDLINE]

11161: Br J Ophthalmol. 1943 Oct;27(10):465-7.

HERPES ZOSTER OPHTHALMICUS-TWO RARE MANIFESTATIONS.

Parry TG, Laszlo GC.

PMID: 18169961 [PubMed]

11162: Trans Am Ophthalmol Soc. 1942;40:390-439.

Herpes Zoster Ophthalmicus: Report of Cases and a Review of the Literature.

Edgerton AE.

PMID: 16693295 [PubMed]

11163: Trans Am Ophthalmol Soc. 1940;38:124-37.

Convalescent Blood for Treatment of Herpes Zoster Ophthalmicus: Second Report.

Gundersen T.

PMID: 16693209 [PubMed]

11164: Br Heart J. 1939 Oct;1(4):291-302.

HERPES ZOSTER AND ANGINA PECTORIS.

Spillane JD, White PD.

Massachusetts General Hospital, Boston, U.S.A.

PMID: 18609826 [PubMed]

11165: Cal West Med. 1939 Sep;51(3):172-3.

Herpes Zoster and Varicella in Patient with Carcinoma of Pleura and Lung.

Alderson HE, Pierson PH.

PMID: 18745309 [PubMed]

11166: Cal West Med. 1939 Aug;51(2):105-6.

Herpes Zoster: Treatment with Thiamin Chlorid.

Goodman MJ.

PMID: 18745253 [PubMed]

11167: Cal West Med. 1939 May;50(5):364-6.

Herpes Zoster.

[No authors listed]

PMID: 18745147 [PubMed]

11168: Cal West Med. 1935 May;42(5):370-5.

Herpes Zoster-Some of Its Clinical Aspects.

Somers MR, Pouppirt PS.

PMID: 18743250 [PubMed]

11169: Trans Am Ophthalmol Soc. 1935;33:508-20.

Convalescent Blood for Herpes Zoster.

Gundersen T.

PMID: 16693071 [PubMed]

11170: Br J Ophthalmol. 1933 Sep;17(9):513-24.

HERPES ZOSTER OPHTHALMICUS.

Doggart JH.

Moorfields Research Scholar.

PMID: 18169151 [PubMed]

11171: Trans Am Ophthalmol Soc. 1933;31:42-8.

An Unusual Corneal Opacity: A Persistent, Spreading Opacity Following Herpes
Zoster Corneae.

Holzer WF.

PMID: 16692986 [PubMed]

11172: Br J Ophthalmol. 1932 Jun;16(6):358-60.

RETINAL DETACHMENT OCCURRING PROBABLY AFTER HERPES ZOSTER OPHTHALMICUS IN A CASE 
OF SIMPLE GLAUCOMA.

Scott AA.

Dundee.

PMID: 18169039 [PubMed]

11173: Cal West Med. 1928 Aug;29(2):112.

Dermatology: The Relationship Between Herpes Zoster and Varicella.

Templeton HJ.

PMID: 18740785 [PubMed]

11174: Cal West Med. 1928 Aug;29(2):100-1.

PHENOBARBITAL SODIUM: NEW THERAPEUTIC USES IN TABETIC CRISES, HERPES ZOSTER, AND 
MORPHINISM.

Gunther L, Behneman HM.

PMID: 18740772 [PubMed]

11175: Cal West Med. 1926 Jan;24(1):46-9.

THE TREATMENT OF HERPES ZOSTER.

Jacobson HP.

PMID: 18739850 [PubMed]

11176: Trans Am Ophthalmol Soc. 1919;17:297-305.

Report of Two Unusual Complications of Herpes Zoster Ophthalmicus: (a) Acute
Retrobulbar Neuritis (Neuritis Axialis); (b) Acute Glaucoma.

Veasey CA.

PMID: 16692478 [PubMed]

11177: Br J Ophthalmol. 1918 Dec;2(12):624-5.

HERPES ZOSTER AFFECTING THE CILIARY NERVES.

Thompson GW.

London.

PMID: 18167840 [PubMed]

11178: Cal State J Med. 1918 Oct;16(10):453-4.

CEREBROSPINAL FLUID FINDINGS IN HERPES ZOSTER.

Schaller WF.

PMID: 18737729 [PubMed]

11179: Trans Am Ophthalmol Soc. 1917;15:134-40.

Glaucoma as a Result of Herpes Zoster Frontalis, with Report of Cases.

Weeks JE.

PMID: 16692407 [PubMed]

11180: Cal State J Med. 1906 Apr;4(4):119-21.

Motor Complications of Herpes Zoster.

Hewlett AW.

PMID: 18733806 [PubMed]

11181: Trans Am Ophthalmol Soc. 1870;1(7):101-3.

Three Cases of Herpes Zoster Frontalis seu Ophthalmicus.

Jeffries BJ.

PMID: 16691676 [PubMed]

11182: Trans Am Ophthalmol Soc. 1868;1(4-5):75-91.

A Case of Herpes Zoster Ophthalmicus, in a Patient nearly Eighty Years of Age,
causing Fatal Prostration.

Jeffries BJ.

PMID: 16691742 [PubMed]